Objective To observe the clinical efficacy and safety of prednisone and mycophenolate mofetil in treatment of IgA mesangial proliferative glomerulonephritis.Methods Ninety-six cases of IgA mesangial proliferative glomerulonephritis were divided into control group and treatment group with 48 cases each.The patients in two groups were given conventional treatment and prednisone [prednisone usage of 0.5mg/ (kg ·d),4 weeks after the gradual reduction of weekly 5-10 mg/d].On this basis,the patients in treatment group were given mycophenolate mofetil [1.5 g/d (before 6 months) ; 1.0 g/d (6-12 months) ; 0.5g/d (12 months)].The clinical efficacy,physiological indicator and adverse reactions in two groups were observed.Results The total effective rate was 87.5％(42/48) in treatment group and 60.4％ (29/48) in control group,and there was significant difference (P ＜0.05).There was no significant difference in the physiological indicator before treatment between two groups (P ＞ 0.05).The urine volume,urine protein,albumin,blood creatinine and total cholesterol after treatment in treatment group was improved compared with that in control group [(1812 ± 355) ml/24 h vs.(1365 ± 287) ml/24 h,(2.2 ± 0.6) g/24 h vs.(3.3 ±0.6) g/24 h,(30.2 ±3.1) g/L vs.(21.9 ±4.6) g/L,(116.5 ±9.9) μmol/L vs.(143.5 ± 10.6) μmol/L,(4.7 ± 0.8) mmol/L vs.(5.8 ± 0.7) mmol/L],and there was significant difference (P ＜ 0.05).There were no serious adverse reactions in the beth groups.Conclusion Prednisone and mycophenolate mofetil can improve renal function in patients with IgA mesangial proliferative glomerulonephritis and achieve better clinical efficacy with less adverse reactions.It should be widely applied.

Objective To find out about the current situation of mental health institutions in Guangdong. Methods An investigation via self-made questionnaires was made on the current situation of 62 mental health institutions in the province and a comparison was made of 22 mental hospitals between now and four years ago. Results Throughout the province, there were 9901 psychiatric beds, 1236 psychiatric doctors and 1909 psychiatric nurses, averaging respectively 1.16 beds, 0.15 doctors and 0.22 nurses per 10 thousand people. The bed utilization ratio was mostly 82.00% and only 12.00% of the mental health institutions adopted open management. A comparison of the 22 mental hospitals between now and 4 years ago showed that the numbers of hospital beds, doctors, doctors with associate senior professional tides and above, ECG machines, computers, hospital total income per year, and monthly charges for hospitalization had increased while the area of workplaces, the bed utilization ratio, the average number of daily outpatient visits, the average number of daily outpatient psychological consultations, and equipment other than ECG machines and computers remained unchanged and government funding had decreased. Couclusion The major problems with the mental health institutions in the province are shortage and lack of balance in the allocation of mental health resources, backwardness in the modes of management, difficulty in internal development, and reduction of government input.

Objective To discuss the imaging manifestations of chordoma.Methods The imaging manifestations of chordoma in 42 cases proved by surgery and pathology were retrospectively analysed.Results The lesions located at the region of skull base in 23 cases(54.8%),at the sacrococcygeal region in 18 cases(42.9%) and one case(2.3%) outside the axial skeleton as an extra-axial chordoma or parachordoma.Bone destruction in the areas near skull base and sacrococcygeal region could be found on radiography.On CT,chordoma typically appeared as a expansile soft-tissue mass that arises from the clivus and sacrococcygeal region with associated extensive lytic bone destruction.MR imaging was considerably superior to CT in the delineation of lesion extent.Conclusion Chordoma has typically distribution and characteristic imaging manifestations,especially MRI.

Objective To investigate the therapeutic effects of endovascular management for oculomotor nerve palsy caused by unruptured aneurysm of posterior communicating artery.Methods Endovascular treatment was carried out in 11 patients with oculomotor nerve palsy due to unruptured aneurysm of posterior communicating artery.The choice of the therapeutic opportune moment and the treatment way were retrospectively evaluated.The relationship between the therapeutic results and the treatment time and way was analyzed.Results Of the 11 patients,complete recovery of oculomotor nerve palsy was obtained in 10(90.91%) and partial recovery in one(9.09%).Conclusion Oculomotor nerve palsy cause by unruptured aneurysm of posterior communicating artery can be effectively treated by endovascular management,and the recovery of oculomotor nerve function depends on the time to take treatment and the degree of nerve palsy.

OBJECTIVE To avoid the hospital(infection) in the dental surgery operating room.METHODS The(international) ISO quality standard was applied to establish the quality control the hospital infection.RESULTS The quality control for the hospital infection was guaranteed in the dental surgery operating room,and the items (observed) were in the allowance of the legislations for the hospital infection.Zero case of hospital infection(happened.) CONCLUSIONS It is useful for the hospital infection administration in the dental surgery operating room to apply the international ISO quality standard.

Objective To explore the clinical efficacy and safety of leflunomide combined with prednisone in the treatment of immunoglobulin A nephropathy.Methods 80 patients with IgA nephropathy were chosen and randomly divided into two groups,40 cases in each group.The control group was orally given prednisone(initial dose 1 mg · kg-1 · d-1),after 2 months of treatment 5mg/2 weeks reduction,and 10mg/d as maintenance therapy,while the observation group was treated with 20mg/d leflunomide treatment based on the treatment of control group.All the two groups had 3 months as a course of treatment.Before treatment and after treatment,the 24h urinary protein,serum albumin,serum creatinine,glomerular filtration rate,cholesterol,triglycerides,cystatin C levels and urinary vascular cell adhesion molecule-1 after treatment (urinary VCAM-1) and interleukin-18 (IL-8) in the two groups were recorded and compared,as well as the clinical efficacy and adverse reactions.Results The total effective rate in the observation group was 92.5％,which was significantly higher than 75.0％ in the control group (x2 =4.501,P ＜ 0.05).After treatment,the serum creatinine,serum albumin,cholesterol,triglycerides,cystatin C,24h urine protein,glomerular filtration rate and urinary VCAM-1,IL-8 in the two groups were all significantly improved (t ≥ 1.945,all P ＜ 0.05).After treatment,the cholesterol and triglycerides in the two groups had no significant differences (t =0.322,1.307,all P ＞ 0.05).After treatment,in the observation group,the serum creatinine,cystatin C,24h urinary protein excretion,VCAM-1 and IL-8 in urine were significantly lower than those in the control group,while serum albumin and glomerular filtration rate were significantly higher (t ≥2.632,all P ＜ 0.05).In the observation group,the total effective rate of Ⅳ,Ⅴ grade by Lee classification were significantly higher (x2 =4.269,4.600,all P ＜ 0.05).And in the two groups,the total effective rate of Ⅰ,Ⅱ grade by Lee classification had no statistically significant differences(x2 =0.000,0.000,all P ＞0.05).In the observation group,the incidence rate of adverse reaction was 10.0％,that in the control group was 8.6％,there was no statistically significant difference between the two groups (x2 =0.157,P ＞ 0.05).Conclusion Leflunomide combined with prednisone in the treatment of IgA nephropathy has better clinical efficacy and higher safety,its mechanism may be associated with decreased urinary VCAM-1 and serum IL-18 levels.

OBJECTIVE:To develop a method for simultaneous determination of chlorogenic acid,baicalin,aloe emodin,rhe-in,emodin,chrysophanol and physcione in Kangjun xiaoyan tablets. METHODS:RP-HPLC method was adopted. The determina-tion was performed on Agilent Extend C18 with mobile phase consisted of acetonitrile-0.5% phosohoric acid solution(gradient elu-tion)at the flow rate of 1.0 mL/min. The detection wavelengths were set at 327 nm(chlorogenic acid),280 nm(baicalin)and 450 nm(aloe emodin,rhein,emodin,chrysophanol,physcione). The column temperature was 30℃,and sample size was 10μL. RE-SULTS:The linear ranges of chlorogenic acid,baicalin,aloe emodin,rhein,emodin,chrysophanol and physcione were 0.2094-4.1880μg(r=0.9999),0.3720-7.4400 μg(r=0.9999),0.0063-0.1262 μg(r=0.9999),0.0116-0.2322 μg(r=0.9999),0.0053-0.1060 μg(r=0.9998),0.0128-0.2564 μg(r=0.9999),0.0165-0.3303 μg(r=0.9998),respectively. The limits of quantita-tion were 2.01,1.93,0.76,1.25,1.24,0.53 and 1.53 ng;the limits of detection were 0.98,0.65,0.25,0.42,0.41,0.18 and 0.52 ng,respectively. The recoveries were 98.41%-100.40%(RSD=0.76%,n=9),96.17%-100.10%(RSD=1.58%,n=9), 96.11%-100.10%(RSD=1.33%,n=9),96.29%-100.80%(RSD=1.85%,n=9),96.88%-100.10%(RSD=1.22%,n=9), 97.81%-101.90%(RSD=1.64%,n=9),96.46%-101.30%(RSD=1.85%,n=9),respectively. CONCLUSIONS:The method is accurate,reliable and reproducible. It can be used for simultaneous determination of 7 components in Kangjun xiaoyan tablets.

BACKGROUND:In high-intensity exhaustive exercise process, the body must bear the exercise intensity decreasing splanchnic blood flow“ischemia”, at the same time, along with the movement of energy and material consumption, metabolite accumulation and oxidative stress in the body cause pathological damage, leading to a decline in exercise capacity. Thus, what is the impact on kidney filtration barrier? How to adapt to the change of renal tissue? Houttuynia cordata has the functions of heat clearing and detoxifying, dieresis for treating strangurtia, hemostatic, expel ing phlegm to arrest coughing and analgesia, if it has a protective effect on the renal injury caused by acute exhaustive exercise and its mechanism has not been reported in the literature. OBJECTIVE:To explore the effect of acute exhaustive exercise on kidney filtration barrier in rats and the intervention effect of Houttuynia cordata.METHODS:After resting and watching for 3 days, Sprague-Dawley rats received adaptive running for 15 minutes at a speed of 10 m/min on a 0° treadmil . A total of 24 rats, which can finish the running, were selected. They were divided into normal control group, exhaustive exercise group and dosed exhaustive exercise group according to the weight of layer (n=8). Rats in the exhaustive exercise group and dosed exhaustive exercise group on the 10° treadmil received once exhaustive exercise. Dosed exhaustive exercise group received intraperitoneal injection of sodium houttuyfonate 10 mL/kg at 30 minutes before exercises. The normal control group did not do any exercise. RESULTS AND CONCLUSION:Compared with the normal control group, serum urea nitrogen, serum creatinine, urine protein content, malondialdehyde concentration, renal cellapoptosis and apoptosis index were significantly increased, but nitric oxide content and nitric oxide synthase activity in the renal tissue were significantly deceased in the exhaustive exercise group (P<0.05 or 0.01). Glomerular filtration epithelial cells, the kidney filtration barrier of basement membrane and podocyte damage were obvious, showing abundant cellapoptosis, occasional y necrosis. Compared with the exhaustive exercise group, urine protein content, serum creatinine, malondialdehyde concentration, renal cellapoptosis and apoptosis index were significantly reduced, but nitric oxide content and nitric oxide synthase activity were significantly increased in the dosed exhaustive exercise group (P<0.05). No obvious pathological changes were detected, but apoptosis was visible. These findings confirmed that houttuynine made a reduction in renal cellinjury induced by exhaustive exercise and possibly significantly reduced apoptosis, increased nitric oxide synthase content, decreased malonaldehyde, and apparently increased superoxide dismutase activity, and final y protected injured renal tissue induced by exhaustive exercise.

Objective To study the iodine deficiency disorders (IDD) situation in Wenzhou City during 1995-2014.Method According to National IDD Surveillance Project,IDD surveillance had been consecutively carried out during the past 20 years,which consisted of goiter rate in 8-10 years old children,iodized salt and urinary iodine levels.Results The goiter rate of 8-10 years old children was decreased from the highest of 31.09％ (2 190/7 043) in 1995 to the lowest of 2.28％ (77/3 378) in 2014;the highest level of median urinary iodine was 214.78 μg/L,and the lowest level was 74.48 μg/L,and which was increased from 74.48 μg/L in 1995 to 187.00 μg/L in 1996,and then had been maintained at the appropriate level recommended by World Health Organiation (WHO),except that in 1998,2003,2004 and 2006.The qualified rate of iodized salt was increased from 54.95％ (1 471/2 677) in 1996 to 95.52％ (2 548/2 754) in 1999,but decreased to 62.75％ (768/1 224) in 2003,however it was fluctuated from 78.61％ (2 503/3 184) to 92.48％ (2 989/3 232) from 2004 to 2013,and it was 90.43％ in 2014 (2 983/3 300).Conclusions The comprehensive measures for controlling IDD,with universal salt iodization,has been gradually achieved remarkable effect in Wenzhou City,but the non-iodization salt existing in the market is still a problem,and people have misunderstandings about iodization salt.Iodine supplementation had better be conducted according to local conditions and based on scientific policy.

Objective To search specific biomarkers of pathogenic bacteria in patients with sepsis so as to guide early using rationally antibiotic treatment.Methods Prospective survey of 147 patients with sepsis in ICU was carried out from Jan 2012 to Mar 2015.When patients blood culture was positive, clinical data including age, gender, vital signs, blood and, urine routine examination, DIC, blood biochemistry, c-reactive protein (CRP), procalcitonin (PCT), microbial detection, etc were recorded.Cultured blood samples were from central venous catheter and peripheral vessel.ELISA method was employed to detect soluble toll-like receptor 2 ( sTLR2 ) and interleukin-8 ( IL-8 ) , and the Acute Physiology and Chronic Health Evaluation Ⅱ( APACHEⅡ score ) was calculated.The chi-square test and analysis of variance were performed where necessary.Receiver operating characteristic ( ROC ) curves were used to calculate cut-points ( CP ) and area under the curve ( AUC) .Results According to the results of blood culture, patients were divided into three groups:GP group [ gram-positive bacteria ( G+) group];GN group [ gram-negative bacteria ( G-) group];FG group ( fungi group) .There were no significantly statistical differences in age, APACHEⅡ score, vital signs and markers of inflammation among three groups (P>0.05).Gram negative pathogenic bacterium was the most common microbe.Compared with GN group, the level of sTLR2 in the GP group was obviously higher ( P=0.000); but there was no significant difference in sTLR2 level between GP group and FG group (P=0.187). The amount of (1, 3) -beta glucan in the FG group was significantly higher than that in the GP group ( P=0.000).The sTLR2 level in FG group was obviously higher than that in the GN group (P=0.000).There were no significantly statistical differences in PCT, CRP and IL-8 among the three groups (P>0.05).For the diagnosis of gram negative bacteria infection, sTLR2 area under the curve was 0.768, and the sensitivity and specificity were 88.90%and 59.60%, respectively and the best cut-off point was 8.083 pg/mL.Namely, the diagnosis of gram negative bacteria infection was less likely, when level of sTLR2 was higher than 8.083 pg/mL.The markers of PCT, CRP, (1, 3) -beta glucan and IL-8 were less valuable for the diagnosis of Gram negative bacteria infection because the area under the curve was less than 0.5.Conclusions The combination of inflammatory indicators such as sTLR2 and (1, 3) -beta glucan etc, can imply the kind of pathogenic microorganisms partly.