Objective To identify the clinical characteristics and pathological changes of patients suffered from glomerulonephritis complicating with acute interstitial nephritis (AIN) . Methods Twenty one patients of glomerulonephritis complicating with AIN diagnosed by renal biopsy were retrospectively analyzed . Thirty-five pure AIN patients were selected as controls .Results Glomerulonephritis complicating AIN accounted for 37 .5% of all the AIN cases . Βlactam antibiotics and Chinese herbs were the major causes of AIN . 76 .2% of cases received further examinations due to the elevation of serum creatinine (Scr) during their follow-up of kidney injuries or during routine exams for all kinds of discomforts . Pathological features of AIN were also detected besides glomerular leisions . The impairments of renal interstitia were severe than those of the glomeruli . Eosinophil in the renal interstitia was an important indicator for the diagnosis of AIN .The renal function returned to normal or baseline in 64 .7% of the patients of glomerulonephritis complicating with AIN whose follow-up data were available . The median period for renal function restoration was 150 days (compared with 60 days in pure AIN) . But there were no significant differences between these two groups as for the rate of irreversible renal insufficiency during a follow-up period of 2 years . Conclusions Symptoms of AIN in patients of glomerulonephritis complicating with AIN tend to be masked by their glomerular diseases . Renal biopsy is of most importance for the diagnosis . Early diagnosis and treatment leads to satisfactory prognosis .

Objective To explore the association between sleep quality and the increasing risk of type 2 diabetes mellitus (T2DM).Methods A total of 771 patients aged 25-70 years living in Xuzhou City of Jiangsu Province for at least 5 years were enrolled for the survey of risk factor related noninfectious chronic disease in 2013.In this investigation,those who suffered from other types of diabetes,neuropathy,other endocrine disease,cardiovascular,renal and hepatic dysfunction,dyspnea or cancer were excluded.To reduce the influence of confounding factors,another 771 participants were enrolled as controls.Each case was arranged to have a control who was matched in age (difference not more than 3 years),gender,residence and family history.All the participants were interviewed with self-designed questionnaire,and sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI) questionnaire.Student's t test,Chi-square and multivariate logistic regression were used for data analysis.Results The PSQI score in the T2DM patients vs.the controls were 5.15±2.40 vs.2.71 ± 1.93 (t=21.96,P＜0.01).The scores of sleep-related factors,including subjective poor sleep quality,bedtime resistance,short sleep duration,sleep efficiency,sleep disturbance,use of sleep medication and daytime dysfunction,of the T2DM patients were higher than those of the controls.The proportion of sleep related behaviors of the T2DM patients was higher,except for early awakening,cold feeling and nightmare.Poor sleep quality was associated with the increasing risk of T2DM (odds ratio 2.06,95％ CI 1.69-2.52).In multivariate logistic regression,when adjusted for confounding factors,the risk of T2DM was still increased (odds ratio 1.72,95％ CI 1.62-1.83).Sleep-related factors (e.g.subjective poor sleep quality,bedtime resistance,short sleep duration,sleep efficiency and sleep disturbance) were correlated with the risk of T2DM (odds ratio was 3.34,1.63,1.10,1.87 and 3.89,respectively).Conclusion Low quality of sleep may be strongly associated with an increased risk of T2DM.

Chronic intermitted hypoxia including sleep breathing disorder leads to brain injury. This study explores the potential therapeutic effects of grape seed proanthocyanidin as a neuroprotective agent. A rat model of chronic intermittent hypoxia was employed, and the animals were given low or high doses of grape seed proanthocyanidin. The ultrastructure changes in the brain, the biochemical components, and the animal behavior were examined. The results showed that with hypoxia exposure, neuronal mitochondria exhibited injuries at ultrastructural level, with increased malondialdehyde (MDA) content and reduced superoxide dismutase (SOD) activity. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining revealed increased cell apoptosis in hippocampus. In Morris water maze the animals showed decreased learning abilities, when compared to normal control. The administration of grape seed proanthocyanidin treatment reversed all these observed changes, and improved the learning behavior. We concluded that grape seed proanthocyanidin could alleviate the brain injury caused by hypoxia from sleep breathing disorder.

Objective:To explore the effect of cognitive-behavioral therapy on psychological stress and quality of life in patients with pulmonary tuberculosis.Methods:According to two-level cluster random design 461 patients with tuberculosis from 20 communities in Pizhou county of Jiangsu province were selected in the study from September 2018 to November 2018. The intervention group received cognitive-behavioral therapy for two months, while control group received routine follow-up. Anxiety, depression and quality of life were assessed by GAD-7, PHQ-9 and SF-36 scales, respectively. At the same time, the comparison between the two groups was conducted by independent sample t test, and the difference between the two groups before and after treatment was analyzed by paired sample ttest. Results:A total of 454 participants were finally included in this analysis; there were 230 cases in the intervention group and 224 cases in the control group. In the intervention group the scores of anxiety and depression after intervention were significantly lower than the baseline scores [(7.57±5.27) vs. (5.93±2.56), t=-4.245, P<0.01; (8.13±6.01) vs. (6.02±2.67); t=-4.866, P<0.01], and the quality of life score was significantly higher than the baseline score [(58.46±12.71) vs. (74.31±13.22); t=13.108, P<0.01]; while in the control group there were no significant differences in the scores of anxiety, depression and quality of life after intervention, compared with those at baseline [(7.62±5.41) vs.(7.65±5.38); (8.00±5.84) vs. (8.07±5.91); (59.11±13.25) vs. (60.51±13.76); t=0.059, t=0.126, t=1.104, all P>0.05]. However, only for patients with mild and moderate anxiety and depression symptoms in the intervention group, the anxiety and depression scores were decreased after intervention [(7.29±1.21) vs. (5.54±1.71), (11.99±1.31) vs. (9.17±1.55); (7.01±1.47) vs. (4.42±1.22), (11.88±1.12) vs. (8.39±2.33); t=8.056, t=10.020, t=13.558, t=8.852,all P<0.01]. Conclusion:Cognitive-behavioral therapy can relieve the psychological pressure and improve the quality of life in pulmonary tuberculosis patients with mild or moderate anxiety/depression symptoms.

ObjectiveTo introduction of perforator flaps,muscle flaps pedicled by descending branch of lateral circumflex femoral artery,method and their clinical application that multiple soft tissue defects of hand are repaire by muliplefoliated tissue flap only branch lateral circumflex femoral artery.MethodsFifteen patients with multiple soft tissue defects of hand were repaired muliplefoliated tissue flap only pedicled bydescending branch lateral circumflex femoral artery.At first,the anterolateral thigh perforator flap was designed and harvested according to the soft tissue defects of hand, then the descending branch lateral circumflex femoral artery was dissected at the same time the segmented perforator flap,fascia lata flap,rectus femoris muscle flap, vastus lateralis muscle flap, vastus intermedius muscle flap and distal spatium intermusculare flap were harvested in need according to distance among soft tissue defects.The muliplefoliated tissue flap was harvested only pedicled by descending branch lateral circumflex femoral artery, at last muscle flaps and fascia lata flaps were covered by skin graft, so the multiple soft tissue defects of hand were repaired in one time.ResultsNo vascular crisis happened. All skin grafts survived well, the contour of all repaired soft tissue defects was good and protective feeling was recovered by skin grafts of all flaps. All cases were got follow-up and the range was from 6 to 20 months(the average was 8.7 months).Wound of donor site healed well, muscle strength of quadriceps and motion of knee were normal. Three cases were excellent,nine cases were well and 3 cases were good, according to upper extremity function evaluation criteria of Chinese Medical Society for the Surgery of the Hand, the rate of good was 80 percent.ConclusionMultiple soft tissue defects of hand can be repaired by muliplefoliated flap only pedicled by descending branch of lateral circumflex femoral artery. Its advantages included reduction of operation time and treatment, good recovery of hand contour and function. It is a good method to repair multiple soft tissue defects of hand.

Wuzhuyu Tang is a classical formula for treating migraine, but its' pharmacological ingredients is unclear yet. Present study employed the everted intestinal sac model to collect the absorption samples of 10 kinds of Wuzhuyu decoction, and then analyzed the contents of 9 ingredients in Wuzhuyu Tang and absorption samples quantitatively or semi-quantitatively by HPLC-DAD method. Reserpine was used to establish the mice model of migraine, and then the contents and activities of 5-hydroxytryptamine, noradrenaline, dopamine, nitric oxide and nitricoxide synthase in brain tissues and serums were determined respectively after oral administration of Wuzhuyu Tang. Using the partial least squares regression method to correlate the total absorption quantity of 9 ingredients and pharmacodynamics. The result shows that limocitrin-3-O-beta-D-glucoside, ginsenoside Rg1 and Rb1, rutaevine, limonin, evodiamine and rutaecarpine are the main ingredients influenced the effects in absorption samples in everted intestinal sacs, especially ginsenoside Rg1, rutaevine, evodiamine and rutaecarpine among them have obvious improving effects to most pharmacodynamics index, might be the pharmacological ingredients influenced the therapeutical effects of Wuzhuyu Tang treating migraine.
Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Intestinal Absorption ; drug effects ; Intestines ; drug effects ; Male ; Mice ; Mice, Inbred ICR ; Migraine Disorders ; drug therapy ; Rats ; Rats, Wistar

Objective To explore the molecular basis of familial hypercholesteraemia(FH)by analyzing the phenotype and genotype relationship through identify the low density liporotein receptor(LDL-r)gene mutation in a FH kindred.Methods A male patient of 15 years old was selected to examine the electrocardiogram,lipid.Color Doppler was used to examine heart and great vessels.The promoter region and the 18 exons of the LDL-r gene were screened by touch-down polymerase chain reaction(PCR)and DNA sequencing.Results The caro-tid intima-media thickness(IMT)was increased to 0.23 cm,while coronary flow velocity reserve(CFVR)was decreased to 1.57,and mode-rate mitral regurgitation was found in the proband.The genetic alteration G→A change at 1 448 of exon 10 causing premature stop codon(W462X).The same heterozygous nonsense mutation was also found in his father.The mutation had been reported in other Chinese patients.In vitro experiments showed that W462X mutation leads to low LDL binding and internalization ability.Conclusions The homozygous mutation(W462X)in exon 10 of the LDL-r gene were identified in the clinically heterozygous FH proband.The W462X mutation is the underl-ying cause of hypercholesterolaemia and clinical AS manifestations.W462X is recurrent mutation among Chinese FH patients.It might be a hot spot mutation in LDL-r in Chinese FH.J Appl Clin Pediatr,2009,24(1):18-20

PURPOSE: To describe the therapeutic effect and possibility of the ultra-early surgery for poor-grade aneurysmal subarachnoid hemorrhage (Hunt-Hess grades IV - V). MATERIALS AND METHODS: Nine cases with intracranial aneurysms, demonstrated by computed tomographic angiography (CTA), were treated by ultra-early surgery under general anesthesia within 24 hours from subarachnoid hemorrhage (SAH), 5 cases were treated within 6 hours and 4 cases in 6 - 24 hours. Preoperative Hunt-Hess grade: 6 cases were IV and 3 cases were V. The clinical outcome was evaluated by Glasgow Outcome Scores (GOS). RESULTS: In operation, difficult dissection occurred in 5 cases (55.6%), and rupture of aneurysm occurred and temporary obstructions were performed in 4 cases (44.4%). After clipping of aneurysm, 2 cases underwent V-P shunt because of hydrocephalus, pulmonary infection occurred in 3 cases, hypothalamus reaction accompanied with upper gastrointestinal hemorrhage in 2 cases. The clinical outcome were favorable (GOS 4 - 5) in 4 cases (44.4%), dissatisfied (GOS 2 - 3) in 3 cases (33.3%), and dead (GOS 1) in 2 cases (22.2%) when patients departed from our hospital. CONCLUSION: The ultra-early surgery can avoid early rebleeding of intracranial aneurysm, therefore, should be considered in the treatment of Hunt-Hess grade IV-V intracranial aneurysms. The appliance of CTA can make it possible to use of ultra-early surgery and improve the therapeutic effect.
Adult ; Aged ; Cerebral Angiography ; Female ; Humans ; Intracranial Aneurysm/pathology/*surgery ; Male ; Middle Aged ; Subarachnoid Hemorrhage/pathology/*surgery

With the advent of Twenty-First century, more and more genome-wide association studies (GWAS) showed that idiosyncratic adverse drug reactions (ADRs) were closely related with human leukocyte antigen (HLA) alleles, such as the associations of abacavir-HLA-B*5701, allopurinol-HLA-B*5801, and carbamazepine-HLA-B*1502, etc. To explore the mechanisms of these idiosyncratic drug reactions, hapten hypothesis, danger signal hypothesis, pharmacological interaction (P-I) concept and autoimmune mechanism are proposed. In this paper, recent GWAS studies on the HLA-mediated adverse drug reactions and underlying mechanism are reviewed in detail.
Alleles ; Allopurinol ; adverse effects ; Anti-HIV Agents ; adverse effects ; Anticonvulsants ; adverse effects ; Carbamazepine ; adverse effects ; Dideoxynucleosides ; adverse effects ; Drug Hypersensitivity Syndrome ; etiology ; immunology ; Drug-Related Side Effects and Adverse Reactions ; genetics ; immunology ; Enzyme Inhibitors ; adverse effects ; Genome-Wide Association Study ; HLA Antigens ; genetics ; HLA-B Antigens ; immunology ; HLA-B15 Antigen ; immunology ; Humans ; Stevens-Johnson Syndrome ; etiology ; immunology

Objective:To observe the effects of Chinese herbal compound'Jisuikang'on the phagocytosis of microglia and the regeneration of injured neurons in co-culture system.Methods: Prepared drug serum of 'Jisuikang′ and isolated and identified the primary neuron and microglia.The neuron cells were induced apoptosis by glutamic acid and the microglia cells were predisposed by drug serum of'Jisuikang'.Then,the co-culture system of injured neurons and microglia cells was established.24 h and 96 h after co-culture,engulfment of neuron debris by microglia cells and regeneration of injured neurons were observed by immunofluorescence double labeling method.Results: 24 h after co-culture,middle and high dose of'Jisuikang' showed greater phagocytic percentage and phagocytic index than that of control.In comparison of LPS,high dose of'Jisuikang' showed no significant difference.96 h after co-culture,first grade of neuritis of middle and high dose of'Jisuikang' were more than that of control,and there were no significant difference in comparison of LPS.Neuritis' mean length per cell of middle and high dose of'Jisuikang' were larger than that of con-trol.Neuritis' mean length per cell of high dose of'Jisuikang' showed significant difference in comparison of LPS.Conclusion:Traditional Chinese medicine compound'Jisuikang'may enhance engulfment of neuron debris by microglia to improve local microenvi-ronment,which promote the repair and regeneration of injured neurons.