Objective To test the predicative roles of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1( KIM-1 ) for acute kidney injury (AKI) in critically ill patients. Methods Children from pediatric intensive care unit, were randomly divided into four groups:critically ill patients with AKI (group 1 ), critically ill patients with non-AKI (group 2) , chronic kidney disease group (group 3), healthy control group (group 4). 1.5 ml venous blood and urine specimens were collected and kept under-70°C. Serum creatinine , urine NGAL and urine KIM-1 were analyzed. Results Compared with group 2, group 3 and group 4, the urine NGAL and urine KIM-1 increases obviously in group 1 (P<0.05). There is no signiifcance of urine NGAL and urine KIM-1 between group2, group3 and group 4 (P>0.05). The concentration of urine NGAL increased more than 10 times of base-line level 2 days before the diagnosis of AKI under the Acute Kidney Injury Network standard with area under curve (AUC) 0.955 (P<0.05) , and the concentration of urine KIM-1 increased more than 5 times of base-line level 1 day before AKI with AUC 0.878 (P<0.05). The AUC was 0.984 (P<0.01) when they were combined. There is negative correlation between the increased times of urinary KIM-1, urinary NGAL and vally value of creatin clearance rate. Conclusions The concentrations of urine NGAL and urine KIM-1 are useful early biomarkers for predicting AKI, especially when they were combined.

Objective To assess efficacy, infection rate and recurrence rate of tacrolimus prescribed in infants with steroid-resistant nephrotic syndrome (SRNS). Method From August 2011 to August 2014, 22 cases of SRNS infants (treatment group) received oral tacrolinms treatment, 0.1 to 0.15 mg/ kg per day and once every 12 hours were enrolled in this retrospective longitudinal study and were compared with 23 cases infant SRNS (control group) treated with high-dose methylprednisolone pulse therapy. Followed up for 1 year we analysed the data of proteinuria, lymphocyte count, proteinuria relapse and complication (infection, hyperglycemia) of the two groups’ patients at every point time. Results The pathology of the patients maintains of MCD, MsPGN, FSGS and IgM nephropathy so on. Follow-up to 6 months, the total remission rate 95.45% of treatment group was significantly higher than that in control group (60.87%). Follow-up to 6 months , 24 h urinary protein of the treatment group were respectively 67.88 mg/(kg·d) which were remarkably lower than base line [657.5 mg/(kg·d)], meanwhile which were obviously lower than the 6th month point of control group [305.55 mg/(kg·d)]. Lymphocyte counts had been done during the initial and the destination in the treatment group. Follow-up to 12 months, the CD4+ 795.16/uL, CD8+ 496.85/uL, CD19+ 358.23/uL had decreased observably than when at origin what was 2697.45/uL, 2265.63/uL, 1579.34/uL. Followed-up 1 year, the person-time of infection of treatment group existed superior to the control groups; The recurrence rate was 71.43% in treatment group, which compared with control groups (60.87%) without no significant difference. The treatment group with BG and CCr maintained stably. Conclusion Tacrolimus show its own advantages of reliable effect and less side-effect on the infant with steroid-resistant nephrotic symdrome associated with genes , but it could not lessen the relapse of the disease, and it′s long-term prognosis is still not very clear.

Objective In this study ,to explore the relationship between the renal blood flow PI ,and the AKI was caused by CPB .Methods 14 cases with heart disease were accepted .The renal aorta and renal segmental artery PI of all cases were monitored by the CDFI at the preoperative and postoperative 1 h ,2 h ,4 h ,8 h ,16 h ,24 h .The renal blood urea nitrogen (Urea) ,uric acid (UA) ,creatinine (Crea) ,were detected at the same time .All datas for statistical analysis .Results The renal aorta PI was higher at the postoperative 1 h ,2 h ,4 h ,8 h ,16 h than that at the preoperative .The renal segmental artery PI was higher at the postoperative 1 h ,2 h ,4 h ,16 h than that at the preoperative .The renal blood flow PI was positively correlated with Urea ,UA and Crea .Conclu-sion The renal aorta ,renal segmental artery PI was positively correlated with Urea ,UA and Crea after CPB .The PI may be seen as an evaluation index to assess AKI after CPB .

AIM: To investigate the effect of cobalt chloride (CoCl2) on the apoptosis of neural stem cells (NSCs) and the expression of microRNA-26a (miR-26a) in vitro, and to explore the mechanisms of NSC apoptosis in-duced by CoCl 2 .METHODS:NSCs were exposed to CoCl 2 at different doses (200~600μmol/L) for 24 h.The cell via-bility and apoptosis were measured by CCK-8 assay and TUNEL method.The expression of miR-26a-3p, miR-26a-5p, GSK-3β, caspase-3, Bcl-2 and Bax was examined by real-time PCR.The protein levels of Bcl-2 and Bax were detected by Western blotting .RESULTS: The cell viability was inhibited and the apoptosis of NSCs was increased significantly by CoCl2 in a dose-dependent manner (P<0.05).CoCl2 at concentration of 400μmol/L for 24 h was used to induce apopto-sis and the expression of miR-26a was down-regulated compared with control (P<0.05).Exposure to CoCl2 at concentra-tion of 400μmol/L up-regulated the expression of GSK-3β, caspase-3 and Bax , down-regulated the expression of Bcl-2 and Bcl-2/Bax (P<0.05).CONCLUSION:CoCl2 at concentration of 400μmol/L induces the apoptosis of NSCs obviously . CoCl2 may induce the NSC apoptosis by mitochondrial apoptotic pathway .Declining miR-26a may be related to NSC apopto-sis.

This paper presents the detail methods which innovation activities are in harmony for fundamental medical physics ex- periment teaching without increasing course period and new equipment.

Objective To investigate the application significance of 3.0T MR three dimensional double-echo steady state(3D-DESS) and three dimensional-true fast imaging with steady-state procession(3D-True FISP) sequences in diagnosis of wrist cartilage of rheumatoid arthritis (RA).Methods 26 patients who were clinically diagnosed with RA underwent wrist MR scans with 3D-DESS and 3D-True FISP sequences, while both sequences' scanning were achieved on 20 of them.340 articular-surface morphological conditions' were observed,which were divided into level 0, level 1 and level 2 damages according to morphological performance,and recorded on 3D-DESS and 3D-True FISP sequence respectively.The diagnostic differences in the number of lesions were compared for two sequences.Results The numbers were 79 and 50 for level 1 damage and 23 and 33 for level 2 damage on 3D-DESS and 3D-True FISP sequence respectively (P<0.05).The artifacts were showed in 14 patients on 3D-True FISP,and only two patients on 3D-DESS.Conclusion 3D-DESS sequence does better than 3D-True FISP in displaying RA wrist cartilage,which is able to provide certain help for treatment and prognosis evaluation of RA.

Objective To initially investigate the time - dependent relation between breviscapine with peroxisome proliferator‐ac‐tivated receptor‐alpha(PPAR‐α) ,apolipoprotein A5 (apoA5) and triglyceride(TG) in HepG2 cells in different time points by ob‐serving the effect of breviscapine on the expression and contents of PPAR‐α ,apoA5 and TG in order to lay a certain foundation for further exploring the concrete mechanism for its regulating TG metabolism .Methods On the basis of earlier stage experiment ,100 mmol/L breviscapine was selected to treat the HepG2 cells at different time points (0 ,6 ,12 ,24 ,36 ,48 h) .The levels of PPAR‐αand apoA5 gene and protein ,and the TG content in HepG2 cells were detected .Results Breviscapine could increase the levels of PPAR‐α and apoA5 gene and protein and decrease the TG content in HepG2 cells (P< 0 .05) ,moreover which showed the time -dependence .Conclusion Breviscapine may decrease the TG level in HepG2 cells ,its mechanism may be realized by increasing the expression of PPAR‐α ,thus increacing the expression of apoA5 in HepG2 cell .

Objective To study the relationship between behavioral problems and family environment in preschool-age children. Methods Children between 4-6 years of age in the kindergartens of Zhongshan city were randomly selected. Child Behavior Checklist (CBCL) was used to assess the behavioral problems in children, and self-designed general situation question-naire and Family Environment Scale-Chinese Version (FES-CV) were applied to evaluate the family environment. Results A total of 3445 children were enrolled and 29.87%children showed behavioral problems. There were signiifcant differences in the scores of feeling expression, family conlfict, intelligence, recreation, organization and control between children with and without behavior problems (P<0.001). The scores of feeling expression, intelligence, recreation, organization and control were signiif-cantly higher and the score of family conlfict was lower in healthy children in comparison with children with behavior problems. Through multivariate logistic regression, it was suggested that female (OR=2.04), non-urban population (township OR=1.45, rural OR=1.51), non-local Zhongshan resident (OR=1.39), father’s low educational level (technical secondary school OR=1.77, junior high school OR=2.17, primary school and below OR=3.24), discipline styles (indulgent OR=1.47, mixed OR=1.37), family conlfict (OR=1.13) were independent risk factors for behavioral problems (P<0.05). Mother’s age over 30 (OR=0.74) or over 40 (OR=0.46), feeling expression (OR=0.94) and intelligence (OR=0.87) were independent protective factors for behavioral prob-lems (P<0.05). Conclusions Behavioral problems in preschool-age children are closely related to family environment, which needs to be paid more attention.

Objective To establish virtual three-dimensional models of interventional devices and individualized surgical area structure in transjugular intrahepatic portosystemic shunt(TIPS)treatment,and to explore the value of virtual models for preoperative simulation in TIPS treatment.Methods Thin slice scan data of 8 patients with supine upper abdomen were obtained,three dimensional structures of bone,liver,portal vein,inferior vena cava and hepatic vein in CT scan area were reconstructed in Mimics software.According to the size of interventional instruments,a virtual RUPS-100 puncture kit and an VIATORR stent were established in 3D MAX software. Computer simulations were performed to evaluate the route from the hepatic vein puncture portal vein using the RUPS-100 puncture kit and VIATORR stent release position.Results ①The establishment of individual three-dimensional model of patients was helpful for doctors to understand the spatial relation of hepatic vein and portal vein.②Through simulation,the puncture parameters of multi angle and multi position are obtained,which was helpful for the doctor to adjust the puncture direction according to the puncture point.③The position of the bare segment of the VIATORR stent in the portal vein was obtained by simulation,which was helpful for evaluating the length of the stent.④The preoperative simulation results included the simulation parameters for each patient puncture into left portal vein,right portal vein and portal vein bifurcation.In the actual operation,we punctured into the portal vein bifurcation in 4 cases,into the right branch in 2 cases and into the left in 2 cases.⑤Preoperative simulations were performed using 8 mm×6 cm×2 cm size VIATORR stent.Howere,the actual operation of the first case was lack of experience,and the stent position was lower,then we released a bare stent at the proximal end of the VIATORR stent.The rest of the cases were the same as the simulation results.Conclusion According to the three-dimensional model of the individual structure of the patient,the preoperative simulations have high fidelity.The simulation results of the parameters of the puncture and the release position of the stent could guide the actual operation more accurately.It is of practical value to improve the success rate of operation and to train residents.

OBJECTIVETo observe the clinical effectiveness of inductions and tracheal intubating conditions with 3% sevoflurane and different doses of remifentanil without muscle relaxant in children.

METHODSTotally 120 peadiatric patients (aged 4-10 years, American Society of Anesthesiologists grade I for inhalational induction) were randomly allocated into group I (remifentanil 1 microg/kg), group II (remifentanil 2 microg/kg), group III (remifentanil 3 microg/kg), and control group (vecuronium bromide 0.1 mg/kg). After inhalational induction with 3% sevoflurane and 60% nitrous oxide in 40% oxygen for 2 minutes, remifentanil 1 microg/kg, 2 microg/ kg, and 3 microg/kg were intravenously injected over 1 minute into patients in group I , group II, and group III, respectively. After remifentanil administration and manual ventilation for 1 minute, the trachea was intubated. In the control group, 2 minutes after intravenous administration of vecuronium bromide 0.1 mg/kg, tracheal intubation was attempted. Agitation, intubating satisfactoriness, and the circulation changes after tracheal intubation and anesthesia induction were observed.

RESULTSIn these four groups, agitation occurred in 37.5% of patients during sevoflurane induction. Satisfactory intubation rate was 70.0% in group I, 86.7% in group II, 90.0% in group III, and 93.3% in the control group. Compared with the control group, the impact of tracheal intubation on the circulatory system was smaller in group I , II , and III.

CONCLUSIONSInduction with 3% sevoflurane combined with remifentanil can be smoothly performed, followed by the successful tracheal intubation. The intubating conditions are more satisfactory with 3% sevoflurane combined with remifentanil 2 microg/kg or 3 microg/kg.

Anesthesia, Inhalation ; Anesthetics, Inhalation ; administration & dosage ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Humans ; Intubation, Intratracheal ; adverse effects ; Male ; Methyl Ethers ; administration & dosage ; Piperidines ; administration & dosage