Objective To investigate the effect of high-flux hemodialysis on mineral and bone metabo-lism( MBD) in diabetic kidney disease patients with maintenance hemodialysis .Methods 60 cases with diabetic kidney disease undergoing maintenance hemodialysis were studied and they were randomly divided into two groups according to the number table method .Patients in each group were treated using either high-flux dialyzer or low-flux dialyzer for 6 months.Blood calcium(Ca), blood phosphorus(P), calcium*phosphorus(Ca*P), alkaline phosphatase(AKP), parathyroid hormone(PTH), and 25 hydroxy vitamin D3(25-OH-D3),etc were deter-mined at the start and end of the study .Results In high flux dialysis group , serum P, serum Ca*P, and PTH levels was(1.52 ±0.50)mmol/L,(3.05 ±1.19)pg/L and(368.61 ±235.32)pg/L respectively, which was sig-nificantly decreased than before treatment ((1.78 ±0.55)mmol/L,(3.94 ±1.31),(427.45 ±288.93)pg/L) (P<0.05), while serum Ca, and 25-OH-D3 levels were(2.3 ±0.16)mmol/L and(21.64 ±8.51)nmol/L respectively, which were increased significantly than before treatment ((2.12 ±0.18)mmol/L,(16.77 ±7.69) nmol/L)(P<0.05), yet in low flux dialysis group serum Ca, P, AKP, PTH, and 25-OH-D3 didn't change sig-nificantly before and after treatment ( P>0.05) .Conclusion High-flux dialyser provides a better effect on MBD for patients with diabetic kidney disease undergoing maintenance hemodialysis .

Objective To investigate the damage to the retinal cells and apoptosis of retinal cells of rats after ischemia-reperfusion insult. Methods The retinal ischemia-reperfusion model was developed by increasing intraocular pressure to 109 725 mm Hg in rat eyes. Morphological changes of the rat eyes were observed by means of routine histopathology with HE staining. Apoptosis of the retina was assayed by both DNA fragmentation gel-electrophoresis and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labelling (TUNEL). Results Compared with the normal control, no histopathological changes were revealed in the rat retinas 30 min after the ischemia and then reperfued for 24 h or 48 h. Retinal ganglion cell layer (RGL) and inner plaxiform layer (IPL) of the retina were observed, however, to become significantly thinner 60 min after the ischemia and then reperfued for 24 h or 48 h. Together with the pathological changes DNA ladder pattern was detected in the same group of the rats. Further, immunochemical stain of the eye demonstrated that TUNEL positive cells were localized in RGL and IPL of the retina. Conclusion Ischemia-reperfusion insult of the eye may remarkably damage the retina of the rat eye. The damage to the retinal cells is mainly localized within RGL and IPL and apoptosis is the important mechanism of the retinal disorder.

Objective To analyze the clinical features of urothelial carcinoma in renal allograft re- cipients and to investigate its diagnosis and treatment.Methods A retrospective study was undertaken on 1293 renal allograft recipients in our center between 1998 and 2003.Of them ,21 cases(72.4% )had urothe- lial carcinoma(4 males and 17 females).All the cases had not had tumor before transplantation.In 17 cases the protopathy was chronic interstitial nephritis(CIN).The mean interval between tumorigenesis and trans- plantation was 26 months(range,6-62 months).Of the 21 cases,6 had bladder transitional cell carcinoma (TCC);6 had unilateral pelvic or ureter TCC;8 had unilateral pelvic or ureter and bladder TCC;1 had bilat- eral pelvic and ureter TCC.In 10 cases,the ipsilateral upper urinary tract of the graft was involved;and in 4 cases,the contralateral upper urinary tract was involved.Painless gross hematuria and iterative urinary tract infection were the cardinal symptoms.Surgical treatment was performed in 19 cases.Postoperatively,all the cases received immunosuppressants at one third reduction dose in combination with intravesical instillation chemotherapy.Results Two cases receiving palliative treatment died 5 and 8 months after diagnosis.The other 19 cases were followed for 2-5 years.Of them,13 cases had tumor recurrence.The recurrence sites were bladder and the contralateral upper urinary tract.All the cases had no acute rejection at reduced dose of immunosuppressants,and all had normal renal function except for 2 cases,who underwent removal of the graft and had dialysis again.Conclusions Renal allograft recipients whose protopathy is CIN and female recipients have the risk of urothelial carcinoma after renal transplantation.Urothelial carcinoma occurs more often in ipsilateral upper urinary tract of the graft than in contralateral upper urinary tract.Considering the high possibility of bilateral upper urinary tract involvement by TCC,prophylactic bilateral nephroureterectomy with bladder cuff excision should be considered in renal allograft recipients who have involvement of contra- lateral upper urinary tract of the graft.

Angiolymphoid Hyperplasia with Eosinophilia ; pathology ; Child, Preschool ; Humans ; Male

Cryptococcosis ; complications ; Eosinophilia ; etiology ; Humans ; Lung Diseases, Fungal ; complications

Objective To evaluate the effect of csomeprazole with different dosage and usage regimes on intragastric pH of healthy volunteers. Methods It was a randomized, open-label, three-way crossover study. Fifteen healthy volunteers received esomeprazole with 3 different dosages (20 mg or 40 mg once daily or 20 mg twice daily) with 5 days each. Twenty-four continuous ambulatory intragastric pH was recorded at day 5 of each regime. Results The mean time of intragastric pH above 4 was higher in regime of 20 mg twice daily [(21.16 ±2.45) hours ] than that in regimes of 20 mg once daily [(18. 70±4.19) hours] and 40 mg once daily [(19.27±2.68 ) hours] (P<0.05). The percentages of the sleeping and active period that pH remained above 3,4,5 were significantly higher in regime of 20 mg twice daily(day time:95.0%±7.5% ,92.0%±10.6% ,86.7% ± 14.5% ;night time:93.2%± 13.1% ,87.8%±20.3% ,78.6%±28. 9 % )compared with regimes of 40 mg once daily(day time:87.9%±9.5% ,83.5%±11.7%,75.6%±15.50%, night time:75. 7%±20. 8%,66. 9%±23. 8%,53. 3%±30. 3%) and 20 mg once daily(day time: 85.1 % ± 16.3 %, 81.1 %± 18. 1%, 71.5 % ± 20.3 % ; night time: 72.9 % ± 30.5 %,67.2 % ± 31.9 %, 55.7 % ± 31.8 % ) (P< 0.05 ). Esomeprazole maintained intragastric pH above these pH thresholds for a similar propotion of sleeping and active periods with 40 mg once daily and 20 mg once daily.Conclusions Esomeprazole has strong inhibitory effect on intragastric acid. The regime of 20 mg twice daily is superior to 40 mg once daily and 20 mg once daily in both day and night time acid inhibition.There is no difference between esomeprazole 40 mg once daily and 20 mg once daily.

Objective To evaluate the effect of the expression of P-glycoprotein (P-gp) in tumor tissue on analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain. Methods One hundred and fifty advanced cancer patients with pain aged 51-64 yr weighing 54-65 kg were included in this study. The expression of P-gp was negative in the tumor tissue in 50 patients (group M1 and B1, n = 25 each) and positive in 100 patients (group M2 ,M3 ,and B2 ,B3, n =25 each). The PCA regimen for the 6 groups were listed in the table .Pain was assessed with VAS scores (0 = no pain, 10 = worst pain) and venous blood samples were taken for determination of blood morphine/buprenorphine concentrations at 4, 12, 24 and 48 h of PCIA. Results The six groups were comparable with respect to age, body weight, M/F sex ratio, types of cancer, baseline pain level and education. The analgesic efficacy of morphine and buprenorphine was better ( VAS scores were significantly lower)in P-gp expression negative patients (group M1 and B1 ) than in P-gp expression positive patients (group M2 and B2 ). Higher doses of morphine and buprenorphine provided better analgesic efficacy in P-gp expression positive patients in group M3 and B3 than in group M2 and B2. Plasma morphine and buprenorphine concentrations were comparable between group M1 , B1 and M2, B2 and were significantly higher in group M3 and B3 at each time point. Conclusion Positive P-gp expression in the tumor tissue can decrease the analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain.

Objective To summarize the clinical experience of diagnosis and arthroscopic treatment of intratment of intra ular osteoid osteoma.Methods Seven patients(average 22.4 years old with range from 11～32 years)with intra-articular Osteoid osteoma who underwent arthroscopy treatment from March 2006 to June 2009 were studied respectively.Thin-section CT scanning was used to confirm diagnosis and determine surgery location.Results The time span between the appearance of clinical symptoms and confirmed diagnosis was 26.0 months on average(range from 18 to 36 months).At a mean 19-month follow-up,all patients showed significant improvements including VAS decrease,no recurrence,pain relief and normal range of motion.Conclusion The atypical clinical features and radiographic findings of osetoid osteoma might lead to the delayed diagnosis.Using arthroscopy to remove intro-articular osteoid ostema was a safe and effective way.

Objective: To study whether domestic chloramphenicol eye drops with different ethylparabenin content meet the re-quirements in Chinese Pharmacopoeia. Methods:Antimicrobial effect test was used to examine the antimicrobial effect of the different eye drops. Results:The antimicrobial effect of the eye drops was in compliance with the requirements in the pharmacopoeia. Conclu-sion:The ethylparabenin concentration in the eye drops is higher than necessary. Boric acid and borax not only can adjust pH, but also show antimicrobial effect.

Objective:To investigate the content rationality of antimicrobial agent thimerosal in chloramphenicol eye drops. Meth-ods:Chloramphenicol eye drops with thimerosal at different concentrations were prepared, and the antimicrobial activity was studied. Results:When the test solution contained 0. 02 mg·ml-1 thimerosal, the antimicrobial activity could achieve the requirement in the pharmacopoeia. Conclusion:Thimerosal at different concentrations in the commercial chloramphenicol eye drops all can reach the anti-microbial effect. However, the thimerosal concentration in some eye drops is unreasonably high, which should be reduced.