Objective To find time pint of the irreversible kidney injuru by observing renal pathological appearance and podocytes phenotype after complete ureteral obstruction.Methods The animal model of complete unilateral uretersal obstruction was consructed in 2-weekold and 2-month-old rats respectively.HE staining was employed to evaluate the degree of pathological changes,and immunofluorescence double staining to observe the transitional progression of podocyte.Results Grossly,there appeared pyelectasis at 2 h after obstruction and thinner renal cortex after 3 days of obstruction.Histologically,proximal tube display dilated and hydropic degeneration of tubular epithelial cells was observed after 12-day obstruction.The tubular epithelium showed distorted swelling after 3-day obstruction.Immunofluorescence double staining showed that podocytes decreased and the double-labeled macrophages was increased during 1 d to 2 d after unilateral ureteral obstruction operation.Conclusion Compared with control groups,the unilateral ureteral obstruction groups shows podocyte-to-macrophage transition at 1 d after the operation, while the pelvis shows obviously dilated.From the 1st day to the 7th day after unilateral ureteral obstruction,it shows increasing tendency of the podocytes transition.

Objective To study the clinical efficacy of Qihuang-Juantong decoction combined with morphine sulfate sustained-release tablets in treatment of cancer pain. Methods A total of 107 patients with cancer pain were divided into the control group (n=53) and the treatment group (n=54) randomly. The control group were treated with morphine sulfate sustained-release tablets, and the treatment group were treated with Qihuang-Juantong decoction combined with morphine sulfate sustained-release tablets. The two groups were treated for 14 days. The clinical efficacy of the two groups after treatment was compared. The kamofsky performance status (KPS) score of the two groups before and after treatment were compared. The initial dose and dose after two periods of treatment of morphine sulfate sustained-release tablets of the two groups were compared. The CD4+, CD8+ and CD4+/CD8+of the two groups before and after treatment were compared. The adverse reactions rates of the two groups during the treatment were compared. Results Total effective rate of treatment group was 92.59％ (50/54), which was significantly higher than the control group 71.70％ (38/53), and the difference was statistically significant (χ2=7.996, P<0.05). After treatment, the KPS score (70.3 ± 6.4 vs. 63.4 ± 6.0, t=5.711) in the treatment group were significantly higher than that in the control group (P<0.05), the dose after two periods of treatment of morphine sulfate sustained-release tablets (42.20 ± 5.31 mg vs. 47.08 ± 6.23 mg, t=4.364) in the treatment group were significantly lower than that in the control group (P<0.01). After treatment, the CD4+(45.58％ ± 6.17％ vs. 31.06％ ± 4.87％, t=13.496), CD4+/CD8+(1.26 ± 0.15 vs. 0.69 ± 0.10, t=23.083) in the treatment group were significantly higher than those in the control group (P<0.05), the CD8+(36.18％ ± 3.36％ vs. 44.96％ ± 5.04％, t=10.621) in the treatment group were significantly lower than those in the control group (P<0.01). The adverse reactions rate of the treatment group during the treatment was 11.11％ (6/54), which was significantly lower than the control group 35.85％ (19/53), and the difference was statistically significant (χ2=9.142, P<0.05). Conclusions The Qihuang-Juantong decoction combined with morphine sulfate sustained-release tabletshas a good efficacy and low adverse reaction rates for the cancer pain, can improve the quality of life and cellular immune function, reduce the dose of opioid, and it was worthy clinical application.

Objective In order to further accurate diagnosis of the special serum with HDV IgM antibody positive but conventional HBV five detection negative.Methods designing the specific primers,by extracting the nucleic acid of the virus in the serum,amplifying the virus genome conservative region,and then blast the sequences in Genebak.Results In this study,the HDV and HBV conserved regions were amplified in the serum,after blast,the amplified sequences were found to be consistent with the conserved regions of HBV and HDV.Conclusion In clinical,HDV infection will appears in the serum of HDV antibody IgM positive but HBV S antigen negative,it should cause more attention in clinic for HDV infected.

Objective:To analyze the prognostic factors of children with septic shock in the pediatric intensive care unit.Methods:The clinical data of children diagnosed with septic shock in the pediatric intensive care unit of Guiyang Maternal and Child Health Hospital from April 2018 to April 2022 were retrospectively collected,and the children were divided into the death group and the survival group according to seven days regression.The basic data of the two groups were statistically compared，and the relationship between lactic acid，vasoactive-inotropic score one hour after admission，time of antibiotic initiation，serum potassium，serum sodium，serum calcium，serum troponin T，fluid resuscitation volume in the first hour，glutamyl aminotransferase，creatinine，total leukocyte count，C-reaction protein，brain natriuretic peptide were compared.The risk factors affecting the death of children were analyzed by Logistic regression.The relationship between fluid resuscitation volume in the first hour and prognosis was analyzed using the receiver operator characteristic (ROC) curve.Results:（1）A total of 67 children were included，19 died and 48 survived.（2）The first-hour liquid resuscitation dose in the survival group was lower than that in the death group，and the difference was statistically significant（ P<0.05）.（3）The ROC curve showed that the optimal cut-off of the first-hour liquid resuscitation dose was 25 mL/kg，with a sensitivity of 57.9% and a specificity of 72.9%.（4）In unifactorial analysis，lactic acid in the first hour of admission，early lactic acid after resuscitation，serum calcium，serum troponin T，alanine aminotransferase，combined septic encephalopathy，Glasgow coma score，and pediatric critical illness score were all risk factors for death in children within seven days（ P<0.05）.(5) Multivariate Logistic regression analysis showed that serum calcium（ OR=1.435， P=0.001）and lactic acid value after resuscitation（ OR=0.040， P=0.021）were independent risk factors for death in septic shock. Conclusion:The higher the total fluid resuscitation in the first hour，the higher the fatality rate.Serum calcium and early lactic acid after resuscitation are independent risk factors for death in children within seven days.

Objective:To investigate the availability, prices and affordability of essential medicines in pediatric population across China, in the hope of improving rational use of medicines.Methods:A multicenter cross-sectional survey of medicine prices, availability and affordability was conducted in 17 provinces, municipalities and autonomous region across east, south-central part, west and north of China. Data on 42 medicines used in pediatric population, both original and generic, were collected in 55 public hospitals from May 26 to June 2, 2017. Availability was expressed as the percentage of hospitals with stock of the target medicine on the day of data collection,and median price ratio (MPR) was the ratio of price upon investigation to international reference. Based on national minimum daily wage, affordability represents the number of working days needed to earn the expense which covers a standard course using the target medicine. Statistical software SPSS 13.0 was applied for descriptive analysis of availability, MPR and affordability.Results:Mean Availability of original and generic medicine was 33% and 32%, with median MPR being 5.43 and 1.55. Among the 19 medicines with price information for both original and generic product, the median MPR was 7.73 and 2.04 respectively. Regarding the five medicines used to treat four common pediatric diseases (pneumonia,peptic ulcer, congenital hypothyroidism, refractory nephrotic syndrome), the affordability was 0.63 (0.16-6.17) d for generic medicine, and 1.03 (0.16-11.53) d for its original counterpart.Conclusions:The availability to both original and generic products of the 42 medicines used in pediatric population was low in China. The prices of generic medicines seem to be lower and affordability higher than those of original medicines. There is an urgent need to improve the availability and affordability of pediatric medicines.