The incidence of malnutrition among patients with chronic kidney disease (CKD) constantly increases despite the development of health care and dialysis techniques.New nutritional targets for CKD patients upon maintenance treatment have been developed.Before dialysis,evidences have shown that a long-term nutritional care plan,with a control of protein intake,can effectively correct metabolic disorders including proteinuria and acidosis.During the maintenance dialysis,the optimal protein and energy intakes have been recently challenged.The new classification of nutritional disorders in CKD patients may help the easily identification of protein-energy wasting.

Objective If IL-2 and IFN-? are united,perhaps we may see a more significant antitumor effect.A fusion gene of IL-2 and IFN-? was designed and constructed by DNA engineering.Methods CEA promotor、IL-2cDNA and IFN-?cDNA were obtained by PCR and RT-PCR.SDS-PAGE was used to examine the results;pcDNA-IL-2、pcDNA-IFN-?、pCEA-IL-2/ IFN-?、pEGFP-IL-2/ IFN-? were transfected to CEA high expression cell line(Lovo)by use of liposome.The fusion protein expression was examined by fluorescence microscope and Western blotting.Results IL-2/ IFN-? fusion gene can be expressed in tumor cells.Its expression is more obvious in CEA high expressed cells(Lovo),and can be located in cell plasma.Conclusion The fusion gene can be expressed in plasma of CEA high expressed cell lines.It may have a new anti-tumor effects.

The initiation and development of diabetic chronic complications is associated not only with the level of blood glucose,but also with the glucose fluctuation.The damage in large artery and microvessel may be caused by glucose fluctuation.There are two causes which induce glucose fluctuation in clinical:one is postprandial hyperglyceamia with not well controlled,the other is hypoglycemia causes by unsuitable therapy.A lot of effective new types of substances were applicated in clinical,such as ?-glucosidase inhibitor,glinide-insulin secretagogus,fast-acting and long-acting insulin analogues.With these new powerful tools,there is possibility to treat diabetes more correctly and safely,and control the blood glucose in a stable and good level.

Objective To evaluate the effectiveness of prevention and control measures in drinking waterborn endemic fluorosis areas after water improvement in Xuchang City,Henan Province.Methods In the drinking water-born endemic fluorosis areas of Xuchang City,Henan Province,15 villages were selected based on the following parameters:the unimproved water group,the water improvement time ＜ 3 years group,the water improvement time 3-5 years group and the water improvement time ＞ 5 years group,using a multi-stage random sampling method.In those villages,the concentration of urinary fluoride was tested by the ion selective electrode method on 30 children selected by every village,and Deans method was applied for diagnosis of dental fluorosis on all students age 8-12 years old of the 15 villages.Results The dental fluorosis prevalence rates of the unimproved water group,the water improvement time ＜ 3 years group,the water improvement time 3-5 years group and the water improvement time ＞ 5 years group were 53.57％ (120/224),63.64％ (98/154),37.30％ (47/126) and 22.99％ (40/174),respectively,and the urinary fluoride geometry means were 2.10,1.30,1.07 and 1.02 mg/L,respectively.The prevalence of dental fluorosis was significantly different between the improvement time 3-5 years and the unimproved water groups (x2 =8.56,P ＜ 0.008),and between the improvement time ＞ 5 years and the unimproved water groups too (x2 =38.10,P ＜ 0.008).The geometric mean of urinary fluoride was significantly different between the improvement time ＜ 3 years and the unimproved water groups (q =5.66,P ＜ 0.01),between the improvement time 3-5 years and the unimproved water groups (q =8.14,P ＜ 0.01),and between the improvement time ＞ 5 years and the unimproved water groups (q =8.28,P ＜ 0.01).The level of urine fluoride in children was positively correlated with the fluoride content in the village (r =0.659,P ＜ 0.01),and was positively correlated with dental fluorosis index too (r =0.758,P ＜ 0.01).Conclusions The content of urinary fluoride has decreased significantly in less than three years after water improvement in drinking water-born endemic fluorosis areas.The incidence of dental fluorosis in children is related to the improvement of water supply.The longer the time of the water improvement,the more obvious the detection rate decreased more obvious.

Medical words distinguish medical paper from any other papers,and the right choice of medical words plays an important role in conveying medical content.However,with respect to the whole text,a larger number of words are still nonmedical ones,to which great importance should also be attached.In the writing of a medical paper,three principles of exactness,conciseness,and readability in selecting nonmedical words should be followed to make the paper more internationally accepted.

Objective To explore the role of sanyrene in decreasing skin itching and observe its therapeutic effect on skin pruritus in patients with diabetes. Methods According to the principle of voluntary patients, 221 cases were divided into three groups: conventional therapy plus calamine smear including 80 cases, conventional therapy plus sanyrene including 80 cases and the conventional treatment only control group including 61 cases. Results Generalized estimating equations were established. Referring to the control group, model one was established. The coefficients in sanyrene treatment and calamine control group were 2.20 and 1.29 respectively (P<0.01). The therapeutic efficacy was significantly increased with 9.03 (OR=e2.20) times in sanyrene group and 3.63 (OR=e1.29) times in calamine group compared to the blank control,indicating effect of sanyrene and calamine were better than the control group;Referring to calamine group, Model two was established,shows better efficacy of sanyrene in calamine. The coefficients in sanyrene treatment and blank control group were 0.91 and-1.29 respectively (P<0.01). The therapeutic efficacy was significantly increased 2.48 (OR = e0.91) times in sanyrene group and 0.28 (OR = e-1.29) times in blank group compared to calamine control. Conclusions Sanyrene is effective in improving in diabetic skin pruritus situation. And compared with calamine, the treatment efficacy of sanyrene is better, which suggesting that sanyrene can be used in the clinical treatment of diabetic skin pruritus.

Objective To discuss the application and effect of evaluation system in the experiment teaching of pathogenic biology and immunology.Methods The study was based on result of the peacetime assessment,operating test and theory test of 1303 clinical medicine students of Grade 2013.Reversion 3.2.3 was used to calculate the normal distribution,difficulty index,discrimination index and correlation coefficient,and then the characteristics of the assessment methods and the relationship among the components were analyzed.Result The operation test and theoretical test showed a good normal distribution,but the peacetime result showed a certain negative skewness.It was an easy evaluation model because the difficulty index of the examination system was more than 0.70.In peacetime grade,the proportion of high scores accounted up to 62.09％,and the degree of differentiation was low,only about 0.10.In the evaluation system,there were significant positive correlations (r＞0,P＜0.01) in the peacetime,operation and the theoretical results.Conclusion The performance,operation and theoretical results according to the 3:3:4 ratio is reasonable,but some of the problems need to be improved.

BACKGROUND:A variety of stem cells as seed cells for cartilage tissue engineering have been extensively studied.
OBJECTIVE:To analyze the biological characteristics of different kinds of stem cells and their application in cartilage tissue engineering.
METHODS:By retrieving recent studies on sources of stem cells and influential factors in cartilage tissue engineering, the authors focused on optimization of harvesting stem cells from different sources in bone tissue engineering, problems, and factors that affect cellgrowth, differentiation, reproduction and metabolism, which provide a theoretical basis for tissue-engineered cartilage repair.
RESULTS AND CONCLUSION:A large number of experimental studies have confirmed that exogenous stem cells can be used as seed cells for cartilage tissue engineering. Influential factors relative to cartilage tissue engineering construction using seed cells include growth factors, cellscaffold, cellseeding density, oxygen concentration, stress and micro-gravity. However, tissue-engineered cartilage is stil in the stage of laboratory research, and stem cells for cartilage tissue engineering involves many issues, such as stem celltransformation, in vitro culture of stem cells, how to prolong the survival of cells, reduce cellantigenicity and enhance the host’s immune tolerance, which are yet to be resolved.

Narcolepsy is a disabling sleep disorder characterized mainly by irresistible excessive daytime sleepiness.It seriously influences patient's academic,family,and social function.The etiology of narcolepsy is still elusive,but the hereditary and environmental factors have been suggested to contribute the most.It is a multi-gene regulation disease,the researches of Human Leucocyte Antigen(HLA) gene type HLA-DQB1 * 0602 and HLA-DRB1 * 1501 are most popular in recent years.Especially the HLA-DQB1 * 0602 is regard as the major HLA susceptibility allele for narcolepsy almost in all ethnic groups.And the hypocretin excreting neurons and the hypocretin's deficits would directly lead to somnolence.Some environmental factors which are newly found these years are still playing important roles,such as the contact with certain antigens,infection of beta hemolytic streptococcus,passive smoking and so on.

Objective To explore the best choice mode of repregnancy after cesarean section.Methods 312 cases with repregnancy after cesarean section were divided into the repeat cesarean section (RCS) group (210 cases),vaginal birth after cesarean(VBAC) group (102 cases),and the first time cesarean(PCS)group(210 cases).The maternity delivery mode and outcome were observed and the relevant conditions (postpartum hemorrhage,the average length of hospital stay and hospital costs,etc.) were compared among the three groups.Results The trial production was in 144 cases,and vaginal delivery in 102 cases,the success rate was 70.83％.168 cases with direct vaginal delivery,the success rate was 53.85％.The postpartum hemorrhage of RCS group[(310.5 ± 30.2)ml] was significantly higher than that of VBAC group [(143.5 ± 25.2) ml] (U =7.55,P ＜ 0.01) and PCS group [(244.2 ± 28.3) ml] (U =20.4,P ＜ 0.05).The hospital stay time of RCS group [(7.5 ± 0.2) d] was significantly more than that of VBAC group[(3.0 ±0.3)d] (U =25.50,P ＜0.01)and PCS group[(6.6 ±0.6)d] (U=16.7,P ＜0.05).The hospitalization costs of RCS group [(4 451.5 ± 62.4) yuan] was significantly higher than that of VBAC group [(1 223.6±12.3)yuan](U=71.5,P＜0.01) and PCS group[(3 756.4± 54.6)d](U=25.2,P＜0.01).Conclusion Repregnancy after cesarean section is not absolute indications for cesarean section,vaginal birth is safe and feasible as long as the medical intensive care effectively,and it can reduce the rate of cesarean section.