Objective: To recognize the characteristics of anemia in patients with drug-associated renal parenchymal ARF and to investigate the possible relations among Hb, serum level of EPO and the renal tubulointerstitial injury. Methods: Sixteen in-patients with drug-associated renal parenchymal ARF (including ATN and ATIN groups)for the last five years and 8 healthy volunteers (control group) were assessed in this study. The general information of these patients was analyzed retrospectively. Anemia related laboratory parameters, serum EPO, serum creatinine (Scr) and the renal tubular function from the samples on the time of renal biopsy in each group were compared. For pathological comparison of renal tubulointerstitial pathological changes, renal biopsy specimens from 5 patients with mild non-IgA mesangial proliferative glomerulonephritis were used as negative controls. The pathological changes in renal tubules and interstitial area were semi-quantitive scored by a computer imaging system. The correlations between Hb and EPO levels, as well as EPO level and renal function or pathological injury index were analyzed, respectively. Results: There was no significant difference among the ages, genders and the time intervals both from the administration to the onset of the disease and from the onset to the kidney biopsy among ATN and ATIN groups. Scr level was all higher than that in the control group (P

Objective To improve standards of diagnosis and therapy for acute focal bacterial nephritis bY comparing the characters of acute focal bacterial nephritis and acute pylonephritis.Methods Thirty-five patients of upper urinary tract infection whoever accepted ultrasonographic and computed tomographic (CT) examinations in Beijing Hospital from January 2007 to January 2013 were studied retrospectively.Eighteen patients were diagnosed as acute focal bacterial nephritis (AFBN) according to CT imaging features,the other 17 patients were diagnosed as acute pyelonephritis (non-AFBN).The clinical feature,laboratory and imaging examination were compared between the two groups.Results Leukocyte count,percentage of neutrophil,fasting blood-glucose,ESR,NAG/Cre of urine,the combination of more than one kind of antibiotics and duration of antibiotic treatment were higher or much more in AFBN group patients than non AFBN patients,the differences between two groups were statistical significance(P ＜ 0.05).Urine microorganism culture was mainly Escherichia coli no matter in AFBN group or non-AFBN group,microorganism species of AFBN patients were more complex than non-AFBN patients.The most common contrast-enhanced CT feature of AFBN included local distribution of inflammatory area,wedge-shaped or unregular-shaped hypodense lesions on bilateral or single kidney,and mass-like hypodense lesions in more severe cases.NAG/CRE of urine was higher in AFBN group patients with bilateral kidney lesions than with single kidney lesions and non AFBN patients.The remission time of AFBN and non-AFBN was (3.4 ± 2.9) d,(3.0 ± 1.8)d respectively.The relapsing rate of AFBN and non-AFBN within half a year was 2/18,2/17,respectively.Conclusions The symptoms of acute focal bacterial nephritis are not specific.Abdominal contrast-Enhanced CT,ESR,leukocyte count,urine NAG/CRE are probably a predictor of AFBN.Antibiotic treatment with appropriate usage and sufficient duration could bring satisfactory outcomes and prognosis in acute focal bacterial nephritis and pyelonephritis patients.

Objective To explore the diagnostic value of helical CT in superior mesenteric vein(SMV) thrombosis.Methods Characteristic CT appearances of SMV thrombosis verified by clinic in 13 patients were retrospectively analysed.Precontrast and postcontrast CT scan were performed in all patients.After the data were acquired,they were transferred to workstation for maximum intensity projection of muti-plane.Results Hyperaemia and edema of the mesentery could be seen in all patients.After administration of contrast material,the filling defects of SMV could be showed in 8 cases,and the distal SMV was occluded in other patients.The thrombi could be directively showed by CT,but distended bowel loops,bowel wall thicking with or without the target sign,absent or poor enhancement of the bowel wall,and the pneumatosis at interbowel were showed by CT,the later two findings were more important and specific signs of ischemic bowel.There was not directively relation between bowel necrosis and the thrombus was whether or not localized at main SMV.Conclusion Helical CT is a important modality for the diagnosis of SMV thrombosis.

JMJD5 belongs to the protein family of JMJD and is closely related to tumorigenesis. JMJD5 plays a carcinogenic role in some tumors, such as oral cancer, prostate cancer, breast cancer, colon cancer and atypical meningiomas, JMJD5 promotes the proliferation, migration and invasion of cancer cells. However, JMJD5 not only plays a carcinogenic role in some tumors, but also plays an anticancer role. For example, in bladder cancer, JMJD5 inhibits the metastasis of bladder cancer; in liver cancer, on the one hand JMJD5 promotes the replication of hepatitis B virus (HBV), and on the other hand it inhibits the growth of cancer cells; in lung cancer, on the one hand JNJD5 promotes the proliferation of cancer cells, and on the other hand it inhibits the metastasis of cancer cells by promoting the stabilization of microtubules. This article will focus on the mechanisms of JMJD5 in tumors, in order to provide a new target for tumor prevention and treatment.

ObjectiveTo approach effects of acupuncture on ganglioside in rats with acute cerebral ischemia.Methods204 Wistar rats were randomly divided into the normal group, model group, acupuncture group and medicine group, and middle cerebral artery embolism has been made by thread-ligation method in the latter three groups. Ganglioside content in the rat brain had been measured respectively after cerebral ischemia 1,2,3,5,7,12 and 24 hours.ResultsThe content of lipid-bound sialic acid (LBSA) has decreased significantly after the acute cerebral ischemia, but LBSA contents of the acupuncture group and medicine group were higher significantly than that of the model group, and these two groups have been similar in curative effect, and have difference only at embolism 2,3 and 5 hours.Conclusion Acupuncture can regulate ganglioside and play the role of cerebral protection and neuroplasticity.

Objective To investigated the role of antithrombin Ⅲ (AT-Ⅲ) levels in the early diagnosis of disseminated intravascular coagulation (DIC) in patients with sepsis and the predictive effect of AT-Ⅲ on the development of DIC.Methods A retrospective study was conducted. Patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of China Medical University from January to December in 2015 were enrolled. The patients were divided into sepsis group and non-sepsis group according to the diagnostic criteria of sepsis. In addition, sepsis patients were divided into 3 subgroups according to the international society on thrombosis and haemostasis (ISTH) scores on the first day: overt DIC (ISTH ≥ 5), non-overt DIC (ISTH 1-4) and none DIC group (ISTH = 0). Blood routine test, prothrombin time (PT), fibrinogen (Fib), D-dimer, fibrin degradation products (FDP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores, sequential organ failure assessment (SOFA) scores and ISTH scores were recorded on the first ICU day. AT-Ⅲ was recorded during 7 days. The differences were compared among these 3 groups. Correlations of AT-Ⅲ with various parameters were calculated by using Pearson correlation analysis in sepsis group and overt DIC group. Receiver operating characteristic (ROC) curves for diagnosis of DIC with AT-Ⅲ, AT-Ⅲ+PT were drawn to evaluate the diagnostic efficiency. The AT-Ⅲ levels of DIC patients were compared between early-onset DIC and late-onset DIC during their ICU stay. The change of AT-Ⅲ levels with time and prognosis in patients with early-onset DIC was compared between groups.Results Totally 445 patients were recruited, with 138 patients in sepsis group, and 307 in non-sepsis group. There were 20 patents diagnosed with overt DIC on the first ICU day, 115 patients non-overt DIC and 3 patients of none DIC. Twenty-five sepsis patients were diagnosed overt DIC during the ICU days. AT-Ⅲ level in sepsis patients on the first ICU day were lower than that in non-sepsis patients [(55.29±13.92)% vs. (76.54±12.31)%,P < 0.01]. Patients with overt DIC had a lower AT-Ⅲ level than non-overt DIC or none DIC patients [(43.85±13.00)% vs. (56.95±13.03)%, (68.00±16.52)%, bothP < 0.05]. It was shown by Pearson correlation analysis that AT-Ⅲ level of sepsis patients on the first ICU day was negatively correlated to ISTH score and PT (r value were -0.467, -0.654, bothP < 0.01). AT-Ⅲ level of overt DIC patient on the first ICU day was negatively correlated with PT (r = -0.675,P = 0.001). It was shown by ROC curve that area under ROC curve (AUC) of AT-Ⅲ combined with PT for diagnosis overt DIC in sepsis patients was higher than that of AT-Ⅲ or PT alone (0.843 vs. 0.763, 0.834), the sensitivity 90.0%, specificity 73.7%. The cut-off value for overt DIC diagnosis in sepsis patients of AT-Ⅲ level alone was 48.5%, sensitivity was 78.0%, specificity was 70.0%. On the first ICU day, AT-Ⅲ level was risen when ISTH score improved in patients with sepsis. There was similar change of AT-Ⅲ level between patients with early-onset DIC and late-onset DIC. AT-Ⅲ level increased with DIC improvement.Conclusion AT-Ⅲ level can be used for diagnosing sepsis-associated overt DIC independently or with a combination of PT. When ISTH score improved, AT-Ⅲ level was risen in patients with sepsis associated DIC.

Objective To investigate the clinical diagnostic significance of detecting T in peripheral blood lymphocyte subsets (CD4+,CD8+ and the ratio of pulmonary tuberculosis with diabetes) and explore drug therapy of the five thymus peptide combined anti-tuberculosis on the diabetes complicated with pulmonary tuberculosis.Methods Eighty cases of pulmonary tuberculosis complicated with diabetes mellitus were selected as our treatment subject,who were treated with anti-tuberculosis drug treatment and five thymus peptide regulating immunity treatment.T lymphocyte subsets (CD4 +,CD8 + and their ratio) were detected.Meanwhile acid-fast bacilli and image detection were performed.Another 80 cases were as our control group that treated with anti-tuberculosis drug.Results Following the thymus peptide five treatment for 1,2,and 6 months,T lymphocyte subsets were (CD4+:(34.34 ± 7.32) ％,(39.23 ± 6.62) ％,(41.06 ± 7.13) ％),(CD8+:(31.42 ±8.91)％,(32.52 ±8.58)％,(32.12 ±8.59)％),(CD4+/CD8+:(1.23 ±0.31),(1.34 ±0.30),(1.36 ± 0.32),higher than that of before treatment (30.26 ± 8.25) ％,(30.36 ± 9.86) ％,(1.13 ± 0.42) CD4 +.Through 2 months treatment,CD4+,CD4+/CD8+ of patient in treatment groups were different with that of control group (P ＜ 0.01 or P ＜ 0.05).80 patients after anti-TB plus application thymopentin regulating immunity for 2 months,normal sputum negative conversion rate of CD4+ was 97.2％ and improvement rate was 98.0％.However cases with high CD4+ T lymphocyte subsets showed 78.6％ negative rate of acid-fast bacilli and 88.0 ％ cured rate,and there was significant difference (x2 =4.764,7.680,respectively,P ＜ 0.05).Conclusion Thymic peptide five might have the ability of improving the cellular immune function in patients with pulmonary tuberculosis and diabetes.The prognosis is better when T lymphocyte subsets CD4+ of patient was back to normal through treatment.

Objective To analyze the epidemiological characteristics of malaria in Nanjing City,so as to provide the evi?dence for further formulating and adjusting the malaria prevention and control strategy. Methods The data of malaria situation, malaria cases and epidemiological investigations were collected from the Internet Reporting System in Nanjing City from 2010 to 2015 and analyzed statistically. Results A total of 137 confirmed malaria cases were reported in Nanjing City from 2010 to 2015,including 102 falciparum malaria cases(74.45%),33 vivax malaria cases(24.09%),one ovale malaria case(0.73%) and one quartan malaria case(0.73%). Among the 137 malaria cases,126 cases(91.97%)were imported from foreign coun?tries,2 cases(1.46%)were infected locally,and nine cases(6.57%)were imported from other provinces in China. Among the 126 overseas imported cases,117 cases were imported from African countries and 9 from Asian countries. These malaria cases were majorly young men working as migrant workers,laborers and technical persons. About 19.30%of the cases went to hospital on onset day,and 55.65%were confirmed by medical institutions as malaria in the same day. The majority of diagnosis institu?tions were municipal hospitals(74.45%). Conclusions The number of malaria cases in Nanjing City is declining year by year. The local infections are eliminating gradually. However,the situation of imported malaria from overseas is still serious. There?fore,the surveillance work and health education still should be strengthened,so as to reduce the risk of imported malaria.

Objective To explore the curative effects of endoscopic band ligation combined with drug injection in the treatment of hepatic cirrhosis complicated with upper gastrointestinal hemorrhage. Methods 76 patients with hepatic cirrhosis complicated with upper gastrointestinal hemorrhage were divided into 2 groups by random double blind method, with 38 cases in each group. The control group were treated by conservative regimen alone while the experimental group were treated by endoscopic band ligation combined with drug injection, based on the control group. The clinical curative effects, adverse reactions, hemostasis time, hospitalization time , rebleeding , haemodynamics and other indexes before and after the treatment in the 2 groups were compared. Results The total effective rate, rebleeding rate and the incidence of fever in the experimental group were 2.6% and 10.5%, respectively. Compared with those in the control group (71.1%, 21.1%, 28.9%), the differences were statistically significant (P < 0.05). The differences in volume of blood transfusion, hemostasis time , time of improvement of symptoms and hospitalization time between the experimental group and the control group were significant (P < 0.01). The blood flow of portal vein(550.2 ± 143.4)mL and splenic vein (284.3 ± 96.4)mLin the experimental group was significantly less than that in the control group [(628.1 ± 156.0)mL, (332.6 ± 100.3)mL] (P < 0.05). Condusions Endoscopic band ligation combined with drug injection in the treatment of hepatic cirrhosis complicated with upper gastrointestinal hemorrhage is effective and can significantly improve the varicose hemodynamics in patients. The rate of rebleeding is low.

Objective To observe the effect of nursing intervention on unilateral spatial neglect after brain injury.MethodsPatients with unilateral spatial neglect after brain injury were divided into nursing intervention group and general nursing group.The patients of nursing intervention group were treated with general nursing and rehabilitative nursing.Their cognitive function were assessed with line bisection,digit cancellation test and clock drawing.ResultsThere was significant difference between these two group (P<0.001).ConclusionRehabilitative nursing can significant impact the recovery of unilateral spatial neglect.