Humans ; Kidney Failure, Chronic ; therapy ; Renal Insufficiency, Chronic ; therapy

Objective To analyze the clinical features of immunoglobulin A(IgA) nephropathy(IgAN) occurring in the context of pre-vious acute glomerulonephritis.Methods The clinicopathologic features of 108 cases(77 males,31 females,aged 3.2 to 14.0 years old) of IgAN were analyzed restrospectively with the onset of acute glomerulonephritis in this department from Jan.1994 to Dec.2005.Results Of 108 cases with IgAN,10 cases were with the onset of acute glomerulonephritis. All the 10 cases presented with edema, hematuria and proteinuria.Eight cases had macroscopic hematuria, lasting for 2 days to 2 months.Four cases had recurrent macroscopic hematuria,microscopic hematuria lasting for 16 months.Urine protein qualitative +-+++ lasted for 1-8 months.Two cases had hypertension;2 cases had increasing blood uria nitrogen and serum creatinine.The increase of anti-streptolysin O(ASO) titer was detected in 5 of 9 cases.Two cases had a high titer of DNase-B antibody, and 4 cases had hypocomplementemia.Eight cases had prodromal infection with an interval time varying from 1 to 5 days.Renal biopsies revealed mesangial proliferative glomerulonephritis in 9 cases and focal segmental glomerulosclerosis in 1 case, all with mesan-gial IgA deposition.Conclusions The interval time between the prodromal infection and nephritis symptoms is mostly short in IgAN with the onset of acute glomerulonephritis, while macroscopic and microscopic hematuria remain a fairly long time or recurrently aggravate. Renal biopsy is necessary to diagnose IgAN for this kind of children.

Objective Hepatitis-associated aplastic anemia( HAAA) is a rare and severe disease that can be fatal,if left untreated. In the childhood,it is a syndrome in which marrow failure follows the develop-ment of hepatitis. The aim of this study was to summary clinical characteristic of children with HAAA. Methods We retrospectively reviewed the hospital records of 7 children with HAAA from 2001 to 2010,and summarized and classified the clinical features of HAAA,the laboratory characteristics in 7 patients with com-bined aplastic anemia and severe hepatits,the immune status of those patients,the pathogen of those patients and the results of treatment. Results The average age of patients was 11. 1 years old(8~14 years old). The clinical features were similar in all cases. The early stage of disease,all the children had markedly elevated liver enzyme levels and peripheral blood count was normal. After symptomatic treatment,the hepatic function began to recover but appeared pancytopenia. Bone marrow biopy showed hypoplasia. The median time from onset of hepatic symptoms until diagnosis of aplasic anemia was 43. 3 days. All the children had immune dis-order. Only one boy showed parovirus B19-IgM positive and another girl was diagnosed as acute HAV hepati-tis,the pathogen results of other children were negative. All the patients were treated by immunosuppressive therapy,one patient gave up due to some reasons and others had completed remission. Conclusion HAAA is a life-threatening hematologic disorder in which an episode of hepatitis precedes AA by a period of weeks or months. Characteristically,the HAAA syndrome is more prevalent among young men. It is reported that it is in a higher frequency of patients with non-A,non-B hepatitis. Clincal features and experimental results strong-ly suggest a central role for an immune-mediated pathogenesis. The main treatment is immunosuppressive therapy,which include hormone,antithymocyte glubulin and cyclosporine.

Adult ; Chromosome Aberrations ; Chromosome Disorders ; epidemiology ; Gold ; Humans ; Lymphocytes ; Male ; Middle Aged ; Mining ; Occupational Exposure ; Young Adult

Objective To investigate the clinical characteristics of pre-malignant and malignant polyps in postmenopausal patients and to evaluate the diagnositic value of hysteroscopy in this disease. Methods From June 2005 to October 2014, 403 postmenopausal patients with polyps were treated in the Gynecologic Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital. There were 27 patients including 22 patients with pre-malignant and 5 patients with malignant polyps. All malignant lesions were endometrioid adenocarcinoma. The clinical data were retrospectively analyzed. Based on pathology, the diagnostic value of hysteroscopy was evaluated. Results (1) Clinical characteristics: there were 27 cases with pre-malignant and malignant polyps (group 1) and 376 cases with benign polyps (group 2). Compared the two groups, the average age was (60 ± 8) vs (58 ± 6) years old, the period of menopause was (9.8 ± 8.1) vs (8.3 ± 6.9) years. Thirteen cases (48.1%, 13/27) in group 1 and 159 cases (42.3%, 159/376) in group 2 had clinical symptoms including postmenopausal bleeding and vaginal discharge. Twelve cases (44.4%, 12/27) in group 1 and 140 cases (37.2%, 140/376) in group 2 were with hypertension. Five cases (18.5%, 5/27) in group 1 and 43 cases (11.4%, 43/376) in group 2 were with diabetes. The measures above were no significant differences(P>0.05)(2) Ultrasound features:the average thick of endometrium in group 1 and group 2 were respectively (1.3±0.7) and (0.8±0.4) cm, which had statistical significance (t=4.98, P=0.001). (3) Hysteroscopic diagnosis:the average diameters of polyp in group 1 and group 2 were respectively (2.4 ± 1.0) and (1.6 ± 1.0) cm, which had statistical significance (t=2.93, P=0.004). Six cases in group 1 were diagnosed by hysteroscopy including 4 cases of malignant polyp and 2 cases of pre-malignant polyp. The sensitivity, specificity, positive predictive value, negative predictive value and the accuracy were 22.2%(6/27), 100.0%(376/376), 100.0%(6/6), 94.7%(376/397) and 94.8%(382/403), respectively. Conclusions Pre-malignant and malignant endometrial polyps are more common in the subjects with the larger diameters and the thicker endometrium. All polyps should be under complete resection by hysteroscopy and through pathology examination.

Medical research has entered the era of mega-science.The multidisciplinary collaboration has attracted great attention.besides studies on genes and the environment interaction,multidisciplinary research between natural sciences has received widespread recognition.However muhidisciplinary researches on the interaction between the gene and social factors or behavioral factors on health science deserve more emphasis.This article described development of multidisciplinary research and its features;analyzed importants of conducting multidisciplinary research between natural and social disciplines,and finally provided suggestions on research organization reform in order to promote the multidisciplinary research.

Objective:To explore the personnel arrangement in the outpatient pharmacy by calculating working hour to provide ref-erence for the rational staffing in hospital. Methods:The daily work content and working hour of 18 pharmacists in the outpatient phar-macy of a large general hospital from January to March in 2013 were following-up observed and recorded using the working hour meas-urement. The data were input the EXcellsoftware to establish the database, and the workload in various positions was collected and sorted. The obtained relative parameters were used to calculate the needed worker number on the basis of manpower planning model. Results:The research confirmed the mean operation time for 9 work programs in the outpatient pharmacy, and the time for drug dispen-sing and distributing was detailed. The needed number of pharmacists was 13. 29 according to the calculation, plus the officer-in-charge and sanitation workers, the total number was 15. 29(approx. 16). Conclusion:The working hour measurement can scientifically de-termine the time for each job, and the workload should be used as the foundation for configuring personnel qualification and the number in outpatient pharmacy.

Objective To study the different biomechanics surgical effects of posterolateral fusion , the transverse fusion and the interbody fusion. Method Scan CT was followed with preprocess of images. The Mimics , HyperMesh and Geomagic Studio Reverse engineering softwares were used to establish the modles of lumbar fusion , then the finite element computation was conducted by using the Abaqus finite element software. Result The EF of each lumbar modle was established , the EF of the interbody fusionwas rised evidently. After the fusion , the stress of the adjacent lumbar were also rised, among them the stress of the upper adjacent segment in tnterbody fusion was the most in extension and rotation , with statistical significance ( P < 0 . 05 ) . In the antexion the stress of the transverse fusion was the most, and the new type of posterolateral fusion least, three of them all hadstatistical significance (P<0.05). In the lateral flexion, they had no statistical significance (P>0.05). About the under adjacent sengment, in the extension and antexion, the stress of the interbody fusion was the most, and the new type of posterolateral fusion was the least, the three of them all haved statistical significance (P<0.05, respectively). In the rotation and lateral flexion, with no statistical significance (P>0.05). Conclusion After the fusion, the EF of the lumbar and the stress of the lumbar disc are all established, the interbody fusion is most, while the others are lower.

Objective:To investigate the relationship between gene polymorphisms of disease-relevant multiple cytokines including TNF-α,IL-6,IL-10,TGF-β1,IFN-γand acute graft versus host disease(aGVHD) in allogeneic hematopoietic stem cell trans-plantation ( allo-HSCT ) . Methods:32 cases of recipients received allo-HSCT and 36 cases of normal groups in January 2014 to December 2015 were selected as objects of study. We detected genotypes on specific SNP of target genes by polymerase chain reation ( PCR) combined with gene sequencing and observed the occurrence of aGVHD in postoperative recipients. The influence of cytokine gene polymorphisms on prognosis of allo-HSCT patients was analyzed,and the potential relationship between specific SNP mutation of the disease-relevant cytokine genes and severity of aGVHD was discussed. Results:Distribution of cytokines gene polymorphism including TNF-α-308(G/A),IL-6-174(G/C),IL-10-1082(A/G),TGF-β1+915(G/C),IFN-γ(T/A) had no significant differences with incidence of severe aGVHD(P>0. 05). However,the occurrence of severe aGVHD in allo-HSCT recipients with C/T genotype was significantly higher than C/C and T/T in SNP of TGF-β1+869(P<0. 01). Conclusion:Gene polymorphism of TGF-β1+869(C/T) in allo-HSCT patients was closely related to the occurrence of severe aGVHD. The research show allo-HSCT patients with C/T genotype occurred severe aGVHD more frequently, which is an important potential risk factor to induce the incidence of severe aGVHD. Therefore,detecting gene polymorphism of TGF-β1+869 ( C/T ) in allo-HSCT recipients and developing the appropriate therapeutic regimen may be helpful to reduce the incidence of aGVHD.

Objective To analyze the relationship between cystatin C(Cys C) and homocysteine(Hcy) in patients with early diabetic nephropathy.Methods48 cases of T2DM patients from June 2013 to December 2015 in our hospital for treatment were chosen as the observation group, including 30 patients with early diabetic nephropathy patients as the observation group 1, 18 cases of T2DM patients as the observation group 2, were selected in our hospital physical examination of 28 healthy persons as control group,serum Cys C and Hcy levels were measured at the same time, urinary albumin / creatinine ratio (Ualb/cr) was measured in the observation group, test results of three groups were analyzed and compared.ResultsThe serum Cys C and Hcy in the observation group were significantly higher than the control group, and Cys C and Hcy levels in observed 1 group were significantly higher than that observed in the 2 group, the difference was statistically significant in the observation group, serum Cys C and Hcy level was positively correlated with Ualb/cr.ConclusionThe relationship between Cys C and Hcy levels and early diabetic nephropathy has very important significance in the early diagnosis of diabetic nephropathy, can effectively improve the rate of diagnosis of early diabetic nephropathy patients.