Objective To investigate the epidemiological characteristics of hemoglobin variability (Hb-Var) in dialysis patients,and to explore the factors related to Hb-Var and the relationship between Hb-Var and patients outcomes.Methods The study enrolled 178 hemodialysis and peritoneal dialysis patients in the Department of Nephrology,Peking University People's Hospital between October 2009 and March 2010.First six months were observation period,and then followed up for 12 months.The Hb-Var was described by residual standard deviation (Res-SD) and fluctuation across threshold of the Hb level.Non-fatal cardiovascular events and mortality were the primary endpoints.Results The Res-SD was (4.74±2.66) g/L in dialysis patients.Most patients fell into groups of high amplitude (HA) and low amplitude low (LAL),with frequency of 29.8％ and 33.1％ respectively.The related factors of Hb-Var were fluctuation of erythropoietin (EPO) dosage and hemodialysis.Kaplan-Meier survival curve and multivariable adjusted Cox regression indicated that Res-SD had no impact on the primary endpoints.Accumulative time to reach target hemoglobin level was an independent factor related to outcome.Conclusion Hb-Var occurs commonly in dialysis patients.The fluctuation of EPO dosage and dialysis style increase Hb-Var.Accumulative time to reach target hemoglobin level is an independent factor related to patients outcomes.

This article summarizes the current literature about serum test parameters of thyroid function during aging and thyroid dysfunction in the elderly.The aim is to highlight the importance of the individualized strategy and employing additional caution before assigning diagnoses of hypothyroidism or hyperthyroidism to elderly patients and initiation of treatment modalities.In the last few years,the emergence of age-specific reference ranges for thyroid-stimulating hormone (TSH) has added to the complexity of diagnosis of thyroid dysfunction in this age group,especially in thesubclinical category.Application of age-specific TSH reference ranges may avoid misclassification of elderly subjects without thyroid disease.Overt hypothyroidism and hyperthyroidism require immediate treatment.Treatment of subclinical hyperthyroidism may be considered in the part of elderly patients,while follow-up care and monitoring must be provided for the other part of older subjeets.Careful waiting may be an appropriate approach for older patients with subclinical hypothyroidism with TSH＜ 10 mU/L.The senile elderly,especially extreme longevity people with TSH＜10 mU/L are generally not treated with thyroid hormone replacement therapy.

With the development of cardiothoracic surgery, anesthesia, myocardial protection and in vitro technique, the management of congenital heart disease has gradually become younger and lower, and the nursing management of the postoperative system plays an important role. The purpose of this study was to analyze the causes of malnutrition in children with congenital heart disease<6 kg, the significance of postoperative enteral nutrition support, nutritional assessment, oral feeding and tube feeding. Postoperative enteral nutrition support in children with congenital heart disease provides the most appropriate and accurate care, reduce the incidence of complications, optimize their quality of life and postoperative outcome.

OBJECTIVE:To determine the rheological properties of xanthan gum and to investigate its suspending effect.METHODS:Under different conditions such as light,refrigeration and additives,the NDJ-1 rotative viscometry was used to measure the change of viscosity by various rates of shearing.We used sucralfate as model drug,xanthan gum as suspension agent,and prepared 100g.L-1 of sucralfate suspesion.RESULTS:Plastic construction and thixotropy appeared in the solutions.Its optimum concentration for suspension was 3g.L-1 and this suspension appeared significant thixotropy.CONCLUSION:Some factors such as light,refrigeration and additives have no effects on thixotropy.The solution of xanthan gum can be applied as suspension agent.

Background Glaucoma is characterized by loss of retinal ganglion cells (RGCs) followed by visual field defects.Spectral domain OCT(SD-OCT) enabled more precise and quantitative assessments of macular ganglion cell complex (GCC) thickness.Objective This study was to evaluate the diagnostic ability of GCC thickness in identifying primary open angle glaucoma (POAG).Methods A prospective study was performed.Seventy POAG patients and 30 healthy volunteers were enrolled in Beijing Tongren Hospital from November 2015 to April 2016.Macular GCC thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were measured with RTVue SD-OCT,and Humphrey perimetry was performed on the eyes.The patients were assigned to the early stage POAG group,advanced POAG group and later stage POAG group based on the mean defect (MD) of visual field.The average,superior,inferior GCC and RNFL,focal loss volume (FLV),and global loss volume (GLV) were measured and compared among the groups.The correlations between GCC thickness or RNFL thickness with MD were evaluated in the POAG eyes.The discrimination capabilities of GCC thickness or RNFL thickness were assessed and compared by using areas under the receiver operating characteristic (ROC) curves (AUC).Results Compared with the normal control group,the average,superior,inferior GCC thickness and RNFL values were evidently reduced,the FLV and GLV were significantly increased in the early stage POAG group,advanced POAG group and later stage POAG group (all at P＜0.001).Compared with the early stage POAG group,the average GCC and RNFL thickness values were significantly reduced,and GLV was increased in the advanced POAG group and later stage POAG group (all at P＜0.05).In the later stage POAG group,superior RNFL was thinner than that in the early stage POAG group (P =0.003).The superior GCC value were lower in the later stage POAG group than that in the early stage POAG group and advanced POAG group (all at P＜0.001).Compared with the early stage POAG group,the inferior GCC and RNFL thicknesses were decreased and the FLV was increased in the advanced POAG group and the later stage POAG group (all at P≤0.01).Linear positive correlations were found between average GCC,superior GCC,inferior GCC,average RNFL,superior RNFL or inferior RNFL and MD (r =0.624,0.583,0.601,0.571,0.447,0.537,all at P＜0.001),and the positive correlations were also seen between average GCC and average RNFL,between superior GCC and superior RNFL or between inferior GCC and inferior RNFL (r =0.648,0.630,0.602,all at P＜0.001).The AUCs were 0.965,0.979,0.924,0.985,0.980,0.990,0.979 and 0.992 in the average GCC,superior GCC,inferior GCC,FLV,GLV,average RNFL,superior RNFL and inferior RNFL,with the largest AUCs in the FLV and inferior RNFL thickness.No significant difference was found in the AUC between FLV and inferior RNFL thickness (P＞0.05).Conclusions Inferior GCC is more susceptible to glaucomatous damage.FLV and GLV from GCC pattern parameters are sensitive indicators for diagnosis of POAG.GCC thickness could be a valid structural parameter for detecting glaucoma and can be used as a marker in glaucoma assessment.

Child ; Humans ; Lymphoma, Follicular ; diagnosis

Aim To investigate the effect of piperazinyl estrone(PE) on estrogen receptor expression and the transcriptional regulation of target genes.Methods Ovariectomized mice were given with PE in different doses (0.5 mg·kg~(-1),1 mg·kg~(-1),2 mg·kg~(-1))and estrone(0.71 mg·kg~(-1)) for 42 days,the protein expressions of Ers(Erαand Erβ)were shown by immunohistochemical method; To study transcriptional regulation of PE, PACT2-hERα and ERE2-TATA-LUC were co-transfected into MCF-7 cells by using Tfx 50 cationic liposome.Results Compared with ovx group, the groups with PE could up-regulate Ers of uteri in a dose-dependent manner,but its effect on Erα subtype was obvious.The classical ER signaling pathways could be activated by PE in co-transfected MCF-7 cells,but activation of PE was feebler than estrone with the same dose.Conclusion PE can up-regulate estrogen receptors in uteri. PE can transactivate ERE reportor gene through Erα and Erβ in MCF-7 cells, but its effect is feeble.

The accurate location of acupoints is the prerequisite for the efficacy of acupuncture-moxibustion. Bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement are commonly used in clinic for acupoints location. Based on the systematic review of the ancient literatures, this article discussed the meaning, evolution and relations of bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement. It’s concluded that the bone-length measurement should be a benchmark in ancient anthropometry and an important basis for acupoints location. Bone proportional measurement, used in different genders, ages and body sizes, was based on the relatively stable proportional relations of various body parts, though some of the standards were adjusted in accordance with the correlation between meridians and acupoints. Location of points by proportional unit of the body simplified the application of bone-length measurement and bone proportional measurement, based on the ratio between short and long bones or the ratio of same body parts in anthropometry. However, proportional unit of the body measurement should be applied for the specific body parts. Bone-length measurement, bone-proportional measurement, and proportional unit of the body measurement are correspondingly the benchmark measurement, relative measurement, and simplified measurement.

Objective:To establish an HPLC method to determine the content of carfilzomib for injection. Methods:The chroma-tographic column was a Waters symmetry C18(250 mm ×4.6 mm, 5 μm)column, the sample solvent was methanol, the mobile phase was 0. 05% trifluoroacetic acid-acetonitrile(57 ∶43) at a flow rate of 1. 0 ml · min-1 , the detection wavelength was 210 nm, the col-umn temperature was 25℃ and the injection volume was 10 ml. Results:The linear range of carfilzomib was 120-600 μg·ml-1 ( r=0. 999 7). The average recovery was 100. 4%( RSD=0. 24%,n=9). Conclusion:The method is rapid and effective, which can be used for the content determination of carfilzomib for injection.

ObjectiveTo evaluate the therapeutic efficacy of low-dosage methyltestosterone or andriol in men with senile osteoporosis. MethodsA total of 134 male patients with senile osteoporosis and the decreased serum level of free testosterone were divided into three groups. 45 patients were treated with low-dosage methyhestosterone(100 mg, once a day, sublingual) and 46 patients were treated with low-dosage andriol (40 mg, once a day, orally), while 43 patients were treated with placebo. The duration of treatment in each group was 1 year. The bone density, blood and urine biochemical indexes related to bone metaholites,the quality of life indexes, ultrasonography for prostate,serum prostate specific antigen,blood routine, urine routine, hepatic and renal function were detected before and after the treatment. ResultsBoth low-dosage methyltestosterone and low-dosage andriol could prevent the decrease of bone mineral density and improve patients' general health, role-emotional function and vitality (all P＜0.05). The difference values of femoral neck bone mineral density before and after treatment with low-dosage andriol and low-dosage methyltestosterone were (0.14+0.18)g/cm2 and (0.12±0.09)g/cm2 , respectively(P＜0.05). Low-dosage andriol hadstronger effects in increasing the level of estradiol (32.5±14.2 )ng/L than low-dosage methyltestosterone(19.3±9.2)ng/L(P＜0.05) and showed more notable effects in improving the physical functioning and role-physical function than low-dosage methyhestosterone. The use of the two androgenic hormones at low dosage showed safety. ConclusionsBoth low-dosage methyltestosterone and low-dosage andriol can be used to treat senile osteoporosis in men and to improve life quality. Both of them are effective and safe therapeutic choices.