During recent years,International Nephrology and Emergency Medicine Association preferred a cute kidney injury( AKI)rather than a cute renal failure for the diagnosis and intervention in the early phase of AKI,with the ultimate goal of reducing the mortality rate.It is not sensitive to diagnose AKI in the early phase only according to the change of urine output and serum ereatinine.It is reported that some new biomarkers are sensitive and specific and may play important roles for the early diagnosis of AKI.

Mycophenolate mofetil is a new type immunosupperssor. It has the function of the selective immune suppression and reducing T,B lymphocyte proliferation. Now it is widely used in organ transplantation, immune disease and primary glomerular disease. In this paper,the research results of mycophenolate mofetil for children with kidney disease are summarized.

Objective:To summarize the characteristics of methylmalonic acidemia(MMA) with thrombotic microangiopathy as the prominent manifestation.Methods:Clinical data was collected from MMA patients with thrombotic microangiopathy as the prominent manifestation, who were treated at Shengjing Hospital of China Medical University from September 2014 to December 2019.The clinical manifestations, laboratory results, imaging results, histopathological examination, treatment and prognosis were analyzed.Results:Six children aged 1 month to 7 years old were included in our study, including 5 males and 1 female.Six cases were all MMA complicated hyperhomocysteinemia.All patients had a history of prodromal infection before admission.All cases had edema.Five patients were hypertenson and 4 patients accompanied neurologic presentation.One patient had a family history.All patients were treated with Vitamin B 12, levocarnitine, folic acid and betaine.Three patients′ psychiatric symptoms and renal function were improved and hemolysis were controlled.Two of them were similar with the same age children in intelligence and motor development, with normal renal function, good blood pressure control and normal urine protein.The third one was significantly improved in intelligence development, but still slightly worse than that of the children with the same age.He had no convulsions occurred in recent one year with antiepileptic drugs in oral.His blood pressure was maintained between 135/90-160/110 mmHg(1 mmHg=0.133 kPa), 24-hour urine volume was about 2 000 mL, creatinine was maintained at about 150 μmol/L, ionic level was normal, and urinary protein was 2 + .One case discharged from hospital.Two patients died of multiple organ failure. Conclusion:An early screening of metabolic diseases should be achieved for thrombotic microangiopathy of unknown etiology.Early screening of homocysteine is important for early detection and treatment.

Objective Medical statistics is an important tool in scientific research and practice.The article was to evaluate the current knowledge, learning needs and related influencing factors of medical statistics among medical doctoral students to provide references for the optimization in the teaching mode of medical statistics. Methods A questionnaire was used to investigate Grade 2014 doctoral students who took medical statistics course before and after the teaching in a medical university. Results The knowl-edge of doctoral students were at different levels and they had different learning requirements.More than 81.4% of the respondents have difficulty in the choice of scientific and reasonable design and the scientific design.Over 50%students had insufficient knowledge of advanced statistics and poor software application ability.They had the demands for more practical cases explanation in theory course, more software teaching hours and some short term specialized courses. Conclusion The university and teachers should carry out teaching reform according to the particularity of doctoral students and teach in small sections according to their knowledge levels of sta-tistics and learning requirements.It is suggested that the teaching should be combined with the students'own research projects in order to improve the teaching effect and improve the students'ability in sta-tistical design and solving the practical problem in scientific research statistics.

Objective: To investigate the effect of oxidized low-density lipoprotein (ox-LDL) on expression of lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), transforming growth factor beta 1 (TGF-β 1), and secretion of extracelluar matrix (ECM) in cultured rat glomerular mesangial cells (GMCs), and to investigate the influence of LOX-1 inhibitor polyinosinic acid (PIA) on the effect of ox-LDL. Methods: Rat glomerular masengial cells were cultured in vitro. RT-PCR was employed to determine the LOX-1 mRNA expression in GMCs incubated with different concentrations of ox-LDL (0, 25, 50, 100 μg/ ml). The expression of LOX-1 and TGF-β1, mRNA was also determined by RT-PCR in the blank control group, ox-LDL (50 μg/ml) group and PIA(50 μg/ml ox-LDL+250 μg/ml PIA) group. The contents of TGF-β1 fibronectin (FN), and collagen IV (Col IV) in the supernatants of the above 3 groups were determined by ELISA. Results: RT-PCR showed that LOX-1 mRNA expression in 25, 50 and 100 μg/ml ox - LDL groups was significantly higher than that of blank control group(P<0.05), with the highest expression found in the 50 μg/ml ox-LDL group; the expression of LOX-I and TGF-β 1 mRNA was significantly higher in 50 μg/ml ox-LDL group than that in the other 2 groups (P< 0.01). ELISA results demonstrated that the supernatant contents of TGF-β1, FN and Col IV were significantly higher in 50 μg/ml ox-LDL group than those in the other 2 groups (P< 0.05). Conclusion: Ox-LDL can upregulate the expression of LOX-1 and TGF-β1, mRNA and the secretion of extracelluar matrix in GMCs. Polyinosinic acid can antagonize the above effect of ox-LDL, suggesting that LOX-1 may participate in ox-LDL-induced GMCs damage and is involved in the development and progression of glomerulosclerosis.

Objective To explore the effect of peritoneal dialysis to treat renal failure in children.Methods There were 11 admitted patients of renal failure in our department from July 2003 to April 2008.Their clinical data and follow-up results were analyzed.Results No patient was dead during treatment.The average time of peritoneal dialysis treatment in the children with acute renal failure was 15.5 days in hospital,which was 22.8 days in the chronic patients.After treatment the levels of serum nitrogen and creatine were decreased significantly from (34.03±8.44)mmol/L and (710.09±167.54)μmol/L to (15.94±4.93)mmol/L and (233.87±92.71)μmol/L (P＜0.01).The serum sodium and bicarbonate ion were increased from (130.91±9.15)mmol/L and (14.56±2.07)mmol/L to (139.46±3.98)mmol/L and (22.47±3.29)mmol/L (P＜0.05,P＜0.01).The duration of follow-up were from one month to 5 years.The level of serum nitrogen and creatine in 5 patients of acute renal failure were normal and the analysis of urine was also normal during follow-up.One patient had renal transplantation after peritoneal dialysis.Three patients still regularly underwent peritoneal dialysis.Conclusion The peritoneal dialysis combining with multi-modality treatment was the better style of renal replacement therapy in renal failure patients.

Objective To investigate the changes and effects of intercelluar adhesion molecule-1 (ICAM-1) and inhibitor protein of nuclear factor-?B(I?B?) in pulmonary hemorrhage induced by endotoxin lipopolysaccharide (LPS) in neonatal rats. Methods Sixty-eight seven to ten-day-old Wistar rats were separated into 2 groups randomly. In the experimental groups, LPS was injected intraperitoneally at the dosage of 5 mg/kg and the normal saline (NS) control group was injected with equal amount of NS intraperitoneally. The rats were sacrificed at 30 min, 1, 2, 4, 8, 16 and 24 h post injection. The histology of lung tissues were examined by microscope and electron microscope. The expression of ICAM-1, I?B?protein and mRNA expression were observed using Western blot and in situ hybridization. Results One hour after LPS administration, pulmonary hemorrhage and inflammatory responses were observed in the rat lungs. The ICAM-1 protein expression greatly increased at 2 h post injection and it was significantly higher than control group(178.13?8.18 vs 161.57?12.52, P

Objective To investigate the metabolic rules of surfactant protein A and D(SP- A,SP- D )in bronchoalveolar lavage fluid(BALF)in human fetal lungs during gestational ages. Methods BALF with 30 mL saline was performed on clinically collected human fetus with induction of labor by water- bag Their BALF was respectively retrieved [total retrieval rate(85. 6% ? 13 1)% ]for analysis of protein content. The BALF SP - A and SP - D from fetus of various gestational ages or newboms were detected by RPHA and ELISA. Results The total protein in BALF gradually increased since 10th week to newborn peak during lung development. And SP - A and SP D were respectively updated from(0.34 ?0.07 ) ,(0.05?0.01) ng/L to newborn climax[ (6 42 ? 0 36),(1.22 ? 0 13)ng/L] .Conclusions The protein in BALF gradually increases with fetal growth and lung development. SP-A and SP- D may reach prenatal climax and become the main indicator of newborn lung maturity.

Objective To know the hygienic condition of different kinds of drinking water plants in Shanxi Province.Methods In 2007,422 water plants and 2 083 secondary water supply units were selected and the information and data that provided by all Sanitation Institute for Health Inspection and Supervision in Shanxi Province were analyzed.Results The hygienic conditions of city's municipal administration water supply systems were the best.Total qualified rate of water quality was 97.67%.The hygienic conditions of rural school's homemade water supply systems were the worst,the qualified rates of all items in the program were the lowest.Most of them had no any analyst and laboratory for water quality test.Only 10.2% of them had water disinfection facilities.Total qualified rate of water quality was 75.32%.In most of water plants,the lack of water quality test facilities and disinfection facilities was one important problem in drinking water safety.In addition,the lack of clean and disinfection in secondary water supply systems was another problem.Conclusion The hygienic conditions of drinking water plans are unsatisfactory and should be improved in Shanxi Province.