Objective To observe the effect of leflunomide and cyclophosphamide combined with prednisone in the treatment of idiopathic membranous nephropathy .Methods 30 patients with idiopathic membranous nephropa-thy were randomly divided into two groups ,15 cases in each group .A group was treated by leflunomide combined with prednisone , B group was treated by cyclophosphamide combined with prednisone , 6 months a course .The clinical effect,24h urine protein quantity,serum albumin levels,blood fat,renal functions and adverse reactions were com-pared.Results 3,6 months after treatment ,the remission rates in A group were 60.00%,73.33%,those in B group were 53.33%,66.67%(χ2 =0.965,0.896,all P>0.05).After treatment,24h urine protein quantity,serum albu-min levels in the two groups [A group:(1.33 ±1.25)g/24h,(38.24 ±4.84)g/L;B group:(1.42 ±1.37)g/24h, (37.12 ±5.43)g/L] were significantly lower than those before treatment [A group:(7.34 ±2.75)g/24h,(20.31 ± 7.33)g/L;B group:(7.22 ±2.84)g/24h,(20.46 ±7.73)g/L] (A group:t=6.232,5.734,all P<0.05;B group:t=5.934,5.267,all P<0.05).After treatment,total cholesterol,triglyceride in the two groups [A group:(6.74 ± 1.45)mmol/L,(2.43 ±0.75)mmol/L;B group:(6.63 ±1.45)mmol/L,(2.14 ±0.63)mmol/L] were significantly lower than those before treatment [A group:(11.94 ±2.98) mmol/L,(3.56 ±1.35) mmol/L;B group:(11.53 ± 2.84)mmol/L,(3.24 ±1.46)mmol/L] (A group:t=6.246,5.234,all P<0.05;B group:t=5.256,5.672,all P<0.05).There were no significant differences in urea nitrogen ,serum creatinine between before and after treatment in the two groups(all P>0.05).There were no significant differences in above indicators between A group and B group after treatment (all P>0.05).The incidence rate of adverse reactions in A group (13.33%) was significantly lower than that in B group(40.00%)(χ2 =4.246,P<0.05).Conclusion The clinical efficacy of leflunomide is similar to cyclophosphamide in treating idiopathic membranous nephropathy with fewer adverse reactions .

According to the structure-activity relationships (SARs) of modafinil, a therapeutic drug of hypnolepsy, we designed and synthesized two series of compounds 2-[(diphenylmethane)sulfinyl] acetamides and 2-[(diphenylmethyl)thio] acetamides, and measured their biological activities. The target compounds (6a-6o) were synthesized beginning with diphenyl carbinol by substitution, oxidation, acylation and so on. Their structures were confirmed by ESI-MS, 1H NMR and elemental analysis. The central stimulatory effects of the target compounds were determined by the independent activity assay on mice. Compounds 6c, 6f and 6n have considerable activities, while the central stimulative effect of 6h is slightly better than the positive control modafinil.

Objective To observe and compare the antiemetic effectiveness and adverse effects of magnetotherapy plus the 5 -hydroxytryptamine (5-HT3 ) receptor inhibitor granisetron hydrochloride with that of granisetron hydrochloride alone with chemotherapy patients. Methods Sixty-four patients were randomized to receive either granisetron hydrochloride alone ( control group: granisetron hydrochloride 3 mg intravenous infusion before chemotherapy, from the 1st day of chemotherapy until the day after the chemotherapy course was completed) or magnetotherapy plus granisetron hydrochloride ( treatment group: the same granisetron hydrochloride regimen plus rotatory magnetotherapy of 1 h/time every day after chemotherapy). The baseline characteristics of the two groups were similar. The patients' emesia was evaluated according to the WHO's criteria. The density of 5-HT, in serum was detected by enzyme-linked immunosorbent assay ( ELISA). Results In terms of acute vomiting, there was no significant difference between the two groups, but in terms of tardive vomiting, the effectiveness in the treatment group was significantly better than in the control group. The densities of S-HT, in serum in the treatment and the control group were (225.32±57.29 ) ng/ml vs (213.00±53.29 ) ng/ml before chemotherapy and (273.88±5.42) ng/ml vs ( 313.17±76.36 ) ng/ml after chemotherapy, a significant difference. The rates of adverse events were 36.36% and 48.39% respectively in the treatment group and control group, a difference which was not significant. Conclusions Magnetotherapy plus granisetron hydrochloride is more effective than granisetron hydrochloride alone, and the two therapies have a synergistic effect. Adverse events didn't rise in the treatment group.

As society develops,it has become one of the important goals of higher medical personnel training to cultivate medical students' information literacy.After explaining the definition of information literacy,this paper discussed the importance of information analysis and evaluation in information literacy education.

Endoscopy ; Foreign Bodies ; surgery ; Humans ; Maxillary Sinus ; surgery ; Orbit ; surgery

Objective To investigate the significance of neutrophil gelatinase associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in the patients of primary nephmpathy syndrome (PNS) complicated with acute kidney injury (AKI) by detecting urinary level of NGAL and KIM-1.Methods Senventy-two patients of PNS were selected as our subjects including 34 case with minimal change disease (MCD),23 cases with membranous nephropathy(MN),15 cases with mesangial proliferative glomerulonephritis (MsPGN).Fifteen cases of healthy physical examination were selected as control group.Meanwhile subjects were also divided into PNS with ATN group (15 cases) and PNS without ATN group (57 cases) according to their pathology check.ELISA was applied to detect the urinary level of NGAL and KIM-1,whose correlation with pathological type and clinical index were analyzed.Results The urinary level of NGAL and KIM-1 in patients with PNS were (42.37 ± 28.24) μg/L,(2.76 ± 1.11) μg/L respectively,higher than that of control group (P ＜0.01).The urinary level of NGAL in the MCD group,MN group,MsPGN group were higher than that of control group (46.81 ± 15.75) μg/L,(22.09 ± 7.69) μg/L,(15.31 ± 3.74) μg/L,(8.03 ± 0.35) μg/L respectively,P ＜ 0.05).The urinary level of NGAL in MCD group was significantly highest than that in the other groups (P ＜ 0.05).The urinary level of KIM-1 in the MCD group,MN group,MsPGN group were higher than that of control group(2.41 ±0.58) μg/L,(2.54 ±0.67) μg/L,(2.87 ±0.50) μg/L,(0.73 ±0.35) μg/L respectively,P ＜0.05).But there was no significant difference among MCD,MN,MsPGN groups(P ＞ 0.05).The urinary level of NGAL and KIM-1 in patients PNS were (42.37 ± 28.34) μg/L and (2.76 ± 1.11) μg/L,significantly higher than that of control group (t =4.668,12.665,P ＜ 0.05).The urinary level of NGAL and KIM-1 in patients PNS with ATN were significantly higher than patient without ATN (NGAL:(74.98 ±9.52) μg/L vs.(31.31 ±2.34) μg/L;KIM-1:(3.60 ±0.92) μg/L vs.(2.54 ±0.81) μg/L,P ＜0.05).The correlation analysis showed that the urinary level of NGAL and KIM-1 was positively correlated with serum β2-MG,serum creatinine,serum blood urea nitrogen and 24-hour urine protein.(r =0.432,0.299,0.234,0.254,0.434,0.650,0.276,0.301 respectively,P ＜ 0.05).Conclusion The urinary level of NGAL and KIM-1 could be considered as the early,non-invasive biologic factors to reflect in patients of PNS with ATN.

AIM:To study the effect and the molecular mechanism of CDX 2 over-expression on the prolifera-tion, growth and cell cycle of human gastric cancer cell line SGC-7901.METHODS:The SGC-7901 cells in LV-CDX2-GFP group were transfected with the recombinant lentivirus vector LV-CDX2-GFP, the cells in LV-GFP group were trans-fected with the negative control lentiviral vector for the negative control , and the cells in blank control group were without any treatment.The cell proliferation was detected by CCK-8 assay.The cell cycle distribution was analyzed by flow cytome-try.The expression of CDX2, Bax, Bcl-2, cyclin D1 and survivin was determined by semi-quantitative RT-PCR and Wes-tern blotting .RESULTS:Compared with LV-GFP group and blank control group , the proliferation activity of the SGC-7901 cells was significantly lower (P<0.05), the G0/G1 phase proportion increased (P<0.05), the mRNA and protein levels of Bcl-2, cyclin D1 and survivin were reduced (P<0.05), and the mRNA and protein levels of Bax were up-regula-ted (P<0.05) in LV-CDX2-GFP group.No statistically significant difference of the above indexes was observed (P>0.05) between LV-GFP group and blank control group .CONCLUSION:Over-expression of CDX2 mediated by lentivirus inhibits the proliferation and growth of human gastric cancer SGC-7901 cells and arrestes the cell cycle at G 0/G1 phase, which may be related to down-regulation of Bcl-2, cyclin D1 and survivin and up-regulation of Bax .

Objective To study the efficacy and safety of high intensity focused ultrasound (HIFU) treatment for advanced pancreatic cancer.Methods In this study,25 patients with advanced pancreatic cancer received high-intensity focused ultrasound (HIFU) treatment.Liver and kidney function,CA19-9 levels,tumor size changes,pain relief,survival rate before and after treatment were evaluated.Results The blood routine test,liver and kidney function,blood amylase did not alter significantly after HIFU treatment in all patients.The CA19-9 level of 12 patients decreased.The appetite of 15 patients improved,5 patients with body weight gain after HIFU treatment.Pain was relieved after HIFU treatment in 18 cases,pain relief rate was 72％ (18/25).In 15 cases tumor ablation volume ＞ 90％ after HIFU treatment,5 patients with tumor ablation volume ＞ 50％,tumor ablation effective rate was 80％ (20/25).There were no major complications such as acute pancreatitis,gastrointestinal injury after HIFU treatment.After HIFU treatment,the median survival period was 8 months,1 year survival rate was 30％.Conclusions High-intensity focused ultrasound is a safe and effective method of palliative treatment for advanced inoperable pancreatic cancer.

To search for fluoroquinolones(FQs)with antitumor activity;the C-3 carboxylic acid group of peflox-acin (1)was replaced by fused heterocyclic core;and twelve novel thiazolo[3;2-b][1;2;4]triazole heterocycles(6a-6l)were designed and synthesized.The structures of target compounds were characterized by elemental anal-ysis and spectral data.The results of the in vitro antiproliferative effect on SMMC-7721;L1210 and HL60 cell lines showed that the title compounds exhibited more significant antitumor activity than both of the pefloxacin and the corresponding opening-ring intermediates(5 a-5 l).Among them;the target compounds which possess a ben-zene ring bearing a hydroxyl group (6e)or a fluorine atom (6j)exhibited more potent antiproliferative effect on SMMC-7721 cells than other compounds.Therefore;the antitumor fluoroquinolones can be designed by replacing the C-3 carboxylic acid group of fluoroquinolones with the thiazolo[3;2-b][1;2;4]triazole moiety.

To discover novel antitumor rhodanine unsaturated ketones, a series of fluoroquinolone (rhodanine α, β-unsaturated ketone) amine derivatives (5a-5r) were designed and synthesized with fluoroquinolone amide scaffold as a carrier. The structures of eighteen title compounds were characterized by elemental analysis, 1H NMR and MS. The in vitro anti-proliferative activity against Hep-3B, Capan-1 and HL60 cells was evaluated by MTT assay. The results showed that the title compounds not only had more significant anti-proliferative activity against three tested cancer cell lines than that of the parent ciprofloxacin 1, but also exhibited the highest activity against Capan-1 cells. The SAR revealed that some compounds carrying aromatic heterocyclic rings or phenyl attached to an electron-withdrawing carboxyl or sulfonamide substituent were comparable to or better than comparison doxorubicin against Capan-1 cells. As such, it suggests that fluoroquinolone (rhodanine α, β-unsaturated ketone) amines are promising leads for the development of novel antitumor fluoroquinolones or rhodanine analogues.