Japan 3·11 Fukushima nuclear accident releases a huge amount of radioiodine-131 and attracts public concern with it. This article discusses the feature of radioiodine-131 and the use of potassium iodide in nuclear accident.The potassium iodide has a good role in protecting thyroid.It should pay attention on taking time and dosage based on instruction issued by public health authority.

Clinical records of a patient with olfactory neuroblastoma presented with hyponatremia as initial symptoms were analyzed and the literatures were reviewed. At initial onset, the patient presented with hyponatremia. After pathological examination, the diagnosis was olfactory neuroblastoma. The blood sodium has been normal after operation and radiotherapy. The incidence rate of olfactory neuroblastoma is low, and it is easily misdiagnosed. Its diagnosis relies on pathological examination. We should pay more attention to the unspecific symptoms of patients with hyponatremia, which can help to improve early diagnosis and the prognosis.
Esthesioneuroblastoma, Olfactory ; complications ; pathology ; Humans ; Hyponatremia ; etiology ; Nasal Cavity ; pathology ; Nose Neoplasms ; complications ; pathology ; Prognosis

Objective To investigate the risk factors and prognosis of acute kidney injury (AKI) in elderly patients with sepsis in intensive care unit (ICU).Methods Clinical data of 108 elderly patients diagnosed as sepsis admitted in ICU in our hospital,from May 2010 to May 2014 were analyzed retrospectively.Patients were divided into two groups:the AKI group and the non-AKI group.Clinical characteristics,laboratory and physiologic data were compared between groups.Multivariate Logistic regression analysis was used to analyze the independent risk factors for AKI in these patients,and clinical outcome was retrospectively analyzed.Results Among the 108 elderly patients,60 patients developed AKI and the incidence was 55.6％.Baseline glomerular filtration rate (GFR) and mean arterial pressure (MAP) were lower in the AKI group than in non-AKI group (t=4.536 and 3.28).Prothrombin time (PT) (t=3.053),multiple organ dysfunction score (MODS) (t =2.201),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (t=3.423),the incidence of septic shock (x2 =5.400) and patients undergoing surgical operation within two weeks (x2 =5.625) were higher or longer in AKI group than in non-AKI group (all P＜0.05).Multivariate Logistic regression analysis showed that MAP (OR =0.833),baseline GFR (OR=0.776),MODS (OR=2.039) were independent risk factors for AKI occurrence.Hospital mortality,length of stay in ICU and hospitalization time were higher or longer in AKI group than in non-AKI group (P=0.001,0.026 and 0.042).Conclusions MAP,baseline GFR and MODS are the independent risk factors for AKI occurrence in elderly adults with sepsis in ICU.Hospital mortality,length of stay in ICU and hospitalization time are increased in sepsis patients combined with AKI.

Objective To determine the role of nuclear factor-?B(NF-?B) in ischemic acute renal failure (ARF) rats. Methods Gel mobility shift assay was used to detect the DNA binding activity of NF-KB in ischemic ARF rats and reverse transcription-polymerase chain reaction (RT-PCR) assay was used to study the expression of renal inducible nitric oxide synthase (iNOS) . The relationship between DNA binding activity of NF-?B and expression of iNOS was also analyzed. Results The DNA binding activity of NF-?B in renal cortex increased from 1.00 ?0.17 of controls to 3. 67 ? 1. 94 of 6 hours after ischemia-reperfusion ( P

OBJECTIVETo explore the differences of electroacupuncture (EA) on onset time and symptom improvement for treatment of different types of functional constipation.

METHODSThirty-eight cases of constipation were selected, including 9 cases of constipation-predominant irritable bowel syndrome (IBS-C), 10 cases of slow transit constipation (STC), 10 cases of pelvic floor dyssynergia (PFD) and 9 cases of inadequate defecatory propulsion (IDP). The electroacupuncture was applied at Tianshu (ST 25), Fujie (SP 14), Shenshu (BL 23), Dachangshu (BL 25) and so on in abdominal and lumbosacral area, 5 times per week, 10 times as a treatment course. The onset time, score of clinical symptoms of constipation and improvement of every symptom in each group were compared.

RESULTS(1) The onset time was (1.78 +/- 0.83) days in IBS-C type, (3.11 +/- 1.90) days in IDP type, (4.10 +/- 1.85) days in STC type and (4.30 +/- 2.00) days in PFD type, indicating statistical differences between IBS-C type and STC type, IBS-C type and PFD type (both P < 0.05). (2) Compared before the treatment, the total scores of symptoms on the onset day in each group were all improved (P < 0.05, P < 0.01), and score of IBS-C type was superior to the rest 3 types (P < 0.05, P < 0.01). (3) EA improved desire to defecate or frequency of defecation in each type (P < 0.05, P < 0.01), in which both were improved in STC type and PFD type, and the improvement of defecation frequency was more significant in STC type (P < 0.01). EA relieved unsmooth defecation or pendant-expansion feeling in each type (all P < 0.05), in which both were improved in IBS-C type (both P < 0.05). EA relieved abdominal distension and pain in IBS-C type, STC type and PFD type (all P < 0.05), while its effects were not obvious on defecation difficulty, defecation time and defecation texture (all P > 0.05).

CONCLUSIONThe electroacupuncture for treatment of 4 types of constipation is characterized by rapid onset; the improved symptoms are not identical in the electroacupuncture treatment plan for each type of defecation; the main improvement of symptoms are lied on desire to defecate and frequency of defecation, unsmooth defecation or pendant-expansion feeling and abdominal distension and pain. Meanwhile the improvements of defecation texture, defecation difficulty and defecation time were not signi-ficant.

Adult ; Aged ; Constipation ; etiology ; physiopathology ; therapy ; Defecation ; Electroacupuncture ; Female ; Humans ; Irritable Bowel Syndrome ; complications ; Male ; Middle Aged ; Pelvic Floor Disorders ; complications ; Treatment Outcome ; Young Adult

Objective To assess the clinical usefulness and value of the 5 models for the prediction of acute kidney injury (AKI),severe AKI which renal replacement treatment was needed (RRT-AKI) and death after cardiac surgery procedures in Chinese patients.Methods One thousand and sixty-seven patients who underwent cardiac surgery procedures in the department of cardiac surgery in the Zhongshan Hospital,Fudan University between May 2010 and January 2011 were involved in this research.The predicting value for AKI (AKICS),RRT-AKI (Cleveland,SRI and Mehta score) and death (EURO score) after cardiac surgery procedures was evaluated by Hosmer-Lemeshow goodness-of-fit test for the calibration and area under receiver operation characteristic curve (AUROC)for the discrimination.Results The incidence of AKI was 20.34％(217/1067),and 63.13％ of their renal function recovered completely.The incidence of RRT-AKI was 3.56％(38/1067) and the mortality of AKI and RRT-AKI was 9.68％ (21/217) and 44.73％ (17/38) respectively.The total mortality was 3.28％ (35/1067).The discrimination and calibration for the prediction ofAKI of AKICS were low.For the prediction ofRRT-AKI,the discrimination and calibration of Cleveland score were high enough,but the predicated value was lower than the real value (1.70％ vs 3.86％).The discrimination of Mehta score and the calibration of SRI were low.The discrimination and calibration for the prediction of death of EURO score was low.Conclusion According to the 2012 KDIGO AKI definition,none of the 5 models above is good at predicting AKI after cardiac surgery procedures.Cleveland score has been validated to have a proper impact on predicting RRT-AKI after cardiac surgery procedures,but the predicting value is still in doubt.EURO score has been validated to have an inaccurate predicting value for death after cardiac surgery procedures.

Objective To compare the efficacy of different therapies for idiopathic membranous nephropathy (IMN) patients, and to discuss their rationality. Methods The clinicopathological data and therapies of 76 patients with IMN in our hospital was retrospectively analyzed and reviewed, and the efficacy was followed up.According to the different therapies, 76 patients were divided into 4 groups, including symptomatic treatment group, glucocorticoid-alone group, immunosuppressant-alone group, and glucocorticoid in combination with immunosuppressant group (combination group). Comparison and analysis of the efficacy of the different therapies were made. Results (1) The incidence of nephrotic syndrome and 24-hour proteinuria of patients in symptomatic treatment group were significantly lower than those in glucocorticoid-alone group and combination group. (2) The remission rates of 4 groups were 56.3%,73.7%,66.7% and 78.9%, respectively. In general, no statistical differences were observed in the remission rates of patients among the symptomatic treatment group, glucocorticoid-alone group and combination group. The 2-year and 5-year renal survival rates were 89.2% and 79.3%, respectively. (3) Patients in glucocorticoid-alone group and combination group were divided into low-risk, moderate-risk and high-risk patients. No difference in remission rate was observed between the two therapies for low-risk and moderate-risk patients.But for high-risk patients,the remission rate in combination group was significantly higher than that in glucocorticoid-alone group.(4) Patients in glucocorticoid-alone group and combination group were divided into remission subgroup and non-remission subgroup. It showed that only estimated glomerular filtration rate (eGFR) between these two subgroups had statistical difference, and eGFR in non-remission subgroup was lower than that in the remission subgroup. Conclusions For high-risk patients,treatment with glucocorticoid combined with immunosuppressant may improve the remission rate of proteinuria significantly.Glomerular filtration rate before treatments is an important prognostic factor.

Objective To investigate the incidence and risk factors of acute kidney injury(AKI)after different types of cardiac valve replacement surgery. Methods A single cohort of 1113 patients who received cardiac valve replacement surgery from April 2009 to March 2010 in Zhongshan Hospital,Fudan University were prospectively analyzed.Multivariate Logistic regression analysis was used to evaluate possible risk factors associated with post-operative AKI.Akl was defined as a relative 50% increase or an absolute increment of 26.4 μmol/L in Scr within 48 hours and/or urine volume <0.5ml·kg-1·h-1 up to 6h.Results Of the 1113 patients, the incidence of AKI was 33.24%.In-hospital mortality of AKI patients was 6.49%,which was 5.373 times higher than that of non-AKI patients(P<0.01).The incidence of AKI in patients who simultaneously received cardiac valve replacement and coronary artery bypass grafting was 75.00%,which was significantly higher as compared to other types of valve replacement surgery(P<0.01).Unconditional multivariate Logistic regression analysis revealed that male,old age,long extracorpeal circulation (CPB)time(≥120 min)and combined with coronary artery bypass grafting surgery were the independent predictors of AKI episodes,and the corresponding OR values were 1.455,2.110,1.768 and 2.994 respectively. Conclusions AKI is a common and serious complication after cardiac valve replacement surgery.Patients who received combined cardiac surgery as valve replacement and coronary artery bypass grafting have higher incidence of AKI.Old age,male,long CPB time(≥120 min)and combined with coronary artery bypass grafting surgery are the independent risk factors of post-operative AKI for patients undergoing cardiac valve replacement surgery.

Objective To observe the influence of recombinant human thyrotropin(rhTSH)on serum concentration of endogenous thyrotropin(TSH), free triiodothyronine(FT3), free thyroxine(FT4), thyroglobulin antibody(TGAb), and thyroglobulin(Tg). To evaluate the efficacy of rhTSH-aided radioiodine treatment in patients with differentiated thyroid carcinoma(DTC). Methods The study recruitment took place between November 2007 and March 2009. 62 patients(including 45 females)with biopsy confirmed DTC had undergone total or nearly total thyroidectomy, and received 131I treatment. 31 patients(including 22 females), median age of 45 years(23-72), received radioiodine treatment 4 weeks after L-thyroxine(T4)withdrawal. The other 31 patients(including 23 females), median age of 44 years(14-70), underwent rhTSH-aided radioiodine treatment. Before and after rhTSH injection, serum TSH, FT3, FT4, TGAb, and thyroglobulin were tested. Post-radiotherapy whole body scan was performed 5 to 7 days after radioiodine treatment and qualitatively and blindly evaluated by two nuclear medicine physicians. Follow-up took place 6 to 12 months after radioiodine treatment. The efficacy of rhTSH-aided radioiodine treatment was evaluated by whole body scan with diagnostic dose radioiodine. SPSS 13.0 statistical software was applied. Results (1)Before and after rhTSH-aided radioiodine treatment, the serum TSH was(1.08±4.01)vs(140.26±27.20)mIU/L(P＜0.05), thyroglobulin(23.75±132.92)vs(169.58±178.49)μg/L(P＜0.05), FT3(4.52±1.16)vs(4.42±1.11)pmol/L(P＞0.05), and FT4(15.09±5.83)vs(13.66±5.85)pmol/L(P＞0.05),respectively.(2)rhTSH-aided radioiodine ablation treatment had the same effect as L-T4withdrawal aided. The complete response ratio was 77.4% vs 71.0%(P＞0.05)by radioiodine whole body scan of diagnostic dose. Conclusion rhTSH-aided radioiodine treatment of DTC was effective and safe, and did at least at equivalent degree as did L-T4withdrawal. Furthermore, Serum thyroglobulin level could be effectively stimulated by rhTSH with tumor relapse or metastasis.

ObjectiveTo clarify the clinicopathological features of renal amyloidosis in order to achieve early diagnosis and treatment.MethodsClinicopathological data of 26 biopsyproven renal amyloidosis cases in Department of Nephrology,Zhongshan Hospital,Fudan University between2006and2010wereanalyzedretrospectively.Immunohistochemistryand immunofluorescence of amyloid A protein,immunoglobulin light chains such as K、λ were performed on renal specimens for further classification.ResultsAge of 26 patients ranged from 40 to 77 years old,average(58.54±10.07) years.Twenty-two out of 26 patients(84.62％) were treated in local hospital before admitted to our department,and 21 patients(95.45％) were misdiagnosed as chronic primary glomerulonephritis.The prominent clinical manifestations of renal amyloidosis were nephrotic syndrome(17 cases,65.38％),decreased blood pressure(16 cases,61.53％),organ enlargement (8 cases,30.77％) and bodyweight loss (6 cases,23.08％).Fourteen out of 25 patients (56.00％) were found to have monoclonal light chains in serum by immunofixation electrophoresis.Three patients with mild pathological changes who had no confirmable Congo red stain were conffimed by electron microscopy. Twenty-three(88.46％) patients werediagnosed as AL amyloidosis,one(3.85％) as AA amyloidosis,one was strongly suspected of hereditary amyloidosis,and one was undetermined.ConclusionsRenal amyloidosis is frequently misdiagnosed.Middleaged and old nephrotic patients with decreased blood presure,organ enlargement and bodyweight loss may be the most helpful clues of the disease.Most patients have monoclonal light chains in serum or urine.Renal biopsy,especially electronic microscopy plays a crucial role in the early diagnosis of renal amyloidosis.Immunohistochemistry is important for patients with renal amyloidosis in pathological classification and treatment.