Objective To search for a way of treating chi1dren's idtopathic nephrotic syndrome (INS) hypoadrenocorticismand its significance. Meethods Thirty-nine patients (31 males and 8 females) with INS were randomly divided into twogroups: 21 patients in tera-peutic group (treated by prednisone, astragali and acanthopanax root) and 18patients in control group (Simply treated by prednisone). 1ml blood was respectively drawn from all thepatients at 8 o'clock (one time before treatment and one time after treatment), the serum cortisol wasdetermined by radioimmunoassay (RIA). Results In control group, the levels of serum cortisol still remained lower than the normal value aftertreatment and the levels after large dosages prednisone treatment were markedly lower than that beforetrea-tment. The values of serum cortisol returned to be normal after treatment in therapeutic group. Conclusion Astragali and acanthopanax root can restore the hypoadrenocorticism in children with INS.

Objective To explore the correlation of β2-adrenergic receptor (β2-AR) polymorphisms (Arg16Gly) with early onset Myasthenia Gravis (MG). Methods Forty-eight with age less than 40 years at disease onset were divided into three groups:normal thymus (13 cases), thymic hyperplasia (22 cases) and thymoma (7 cases) groups according to the thymus histology. These patients were further divided into different subgroups including female (31 cases) and male groups (17 cases) based on the gender, OMG (29 cases) and GMG (19 cases) groups according to the symptom of disease onset and groups associated with (10 cases) or without (33cases) other autoimmune diseases Or with unknown causes (5 cases). The genotypes ofβ2-AR in 48 early onset MG were determined by gene sequencing. Results Arg/Arg was more common in early MG patient with normal thymus ( 53.8%)and thymic hyperplasia(54.6%)whereas Arg/Gly was more common in thymus group(71.4%). The difference in distribution of the genotypes between the three groups was not statis?tically significant (χ2=5.657,P=0.226). Arg/Arg was more common in early female MG patient (58.1%) and Arg/Gly was more common in male MG patients (58.8%). The difference in distribution of the genotypes between the two groups was
statistically significant (χ2=6.064,P=0.048). Arg/Arg was more common in early OMG patient (48.3%). Arg/Arg(42.1%) and Arg/Gly(47.4%) were equal common in GMG patients. The difference in distribution of the genotypes between the two groups was statistically significant ( χ2=1.623,P=0.444). Arg/Arg was more common in early MG patient associated with other autoimmune diseases (80.0%). Arg/Gly was more common in MG patients without other autoimmune diseases (39.4%). The difference in distribution of the genotypes between the three groups was statistically significant (χ2=6.394, P=0.041). Conclusionβ2-AR gene polymorphism in position 16 is associated with gender and other autoimmune diseas?es in patients with early onset of MG.

Objective To explore the correlation of β2-adrenergic receptor (β2-AR)polymorphisms (Arg16Gly) with the prognosis of myasthenia gravis (MG) complicated with other autoimmune diseases.Methods Among the 75 MG patients in analysis,17 cases were complicated with other autoimmune diseases (AIDMG),58 cases without other autoimmune diseases (NAIDMG).MG patients,AIDMG patients,NAIDMG patients were separately divided into recurrence groups and nonrecurrence groups according to the progression at 2 years after onset.The genotypes of β2-AR in 75 MG patients were determined by gene sequecing.Results The frequencies of three genotypes (Arg/Arg,Arg/Gly and Gly/Gly) in position 16 were 30.8％,50.0％,19.2％ in recurrence MG group and 42.9％,38.8％,18.3％ in non-recurrence MG group respectively.The difference in distribution of the genotypes between recurrence MG group and non-recurrence MG group was not statistically significant (x2 =1.150,P=0.563).The frequencies of Arg and Gly allele were 55.8％ and 44.2％ in recurrence MG group,and 62.2％ and 37.8％ in non-recurrence MG group.The difference in distribution of the alleles between the two groups was not statistically significant.The frequencies of 3 genotypes in position 16 were 27.3％,63.6％ and 9.1％ in recurrence AIDMG group and 100.0％,0,0 in non-recurrence AIDMG group,respectively.The frequencies of Arg and Gly allele were 59.1％,40.9％ in recurrence AIDMG group,and 100.0％,0 in non-recurrence AIDMG group.The difference in distribution of the genotypes between recurrence AIDMG group and non-recurrence AIDMG group was statistically significant (P =0.009).There also was significant difference in distribution of alleles between recurrence and non-recurrence AIDMG groups (x2 =6.676,P =0.010).The frequencies of 3 genotypes in position 16 were 33.3％,40.0％ and 26.7％in recurrence NAIDMG group and 34.9％,44.2％,20.9％ in non-recurrence NAIDMG group,respectively.The frequencies of Arg and Gly allele were 53.3％,46.7％ in recurrence NAIDMG group,and 57.0％,43.0％ in non-recurrence NAIDMG group.There was no significant difference in distribution of genotypes or alleles between recurrence and non-recurrence NAIDMG groups.Conclusion β2-AR gene polymorphism in position 16 may predict the prognosis of AIDMG,and there is no correlation between the polymorphism in position 16 of β2-AR and the prognosis of MG and NAIDMG.

Objective To investigate the association of glucocorticoid receptor (GR) polymorphisms (BclI)with the prognosis of myasthenia gravis (MG).Methods We totally enrolled 74 patients diagnosed as MG from the Department of Neurology,Beijing Shijitan Hospital between 2002 and 2014.Of them,54 patients started with ocular MG and 20 patients started with general MG.MG patients were divided into recurrence group and non-recurrence group according to the progression at two years after onset.Patients with simple ocular symptom at disease onset were further divided into generalized MG (GMG) group and single ocular MG (OMG) group according to disease progression or not.The GMG group was divided into two groups (≤6 months,7-24 months) according to the progression time of generalization.The GMG group was further divided into three groups (limbs,throat,both limbs and throat) according to the first symptom of generalization.The genotypes of GR were determined by polymerase chain reaction and nucleotide sequence determination.Results The frequencies of three genotypes (GG,CG,CC) in BclI were 57.7％,34.6％,7.7％ in recurrence MG and 64.6％,31.3％,4.1％ in non-recurrence MG respectively.The difference in distribution of the genotypes between the two groups was not statistically significant (x2 =0.570,P =0.750).The frequencies of G and C allele were 75.0％ and 25.0％ in recurrence MG,and 80.2％ and 19.8％ in non-recurrence MG.The difference in distribution of the alleles between the two groups was not statistically significant (x2 =0.540,P =0.462).The frequencies of three genotypes GG,GC and CC were 55.9％,35.3％,8.8％ in GMG and 2/6,4/6,0/6 in OMG respectively.The frequencies of G and C allele were 73.5％ and 26.5 ％ in GMG,and 8/12,4/12 in OMG.The difference in distribution of the genotypes and alleles between the two groups was not statistically significant (x2 =2.278,P =0.320;x2 =0.241,P =0.624).The frequencies of three genotypes GG,GC,CC were respectively 61.9％,28.6％,9.5％ and 3/6,3/6,0/6 in ≤6 months,7-24 months of GMG group.The frequencies of G and C allele were 76.2％,23.8％ and 9/12,3/12 in the two groups.The difference in distribution of the genotypes and alleles between two of the three groups was not statistically significant (x2 =1.326,P =0.515;x2 =0.007,P =0.932).The frequencies of three genotypes GG,GC and CC were respectively 2/8,4/8,2/8;11/13,2/13,0/13 and 3/6,3/6,0/6 in limbs,throat,both limbs and throat of GMG group.The frequencies of G and C alleles were 8/16,8/16;92.3％,7.7％ and 9/12,3/12 in the three groups.The difference in distribution of the genotypes and alleles between two of the three groups was statistically significant (x2 =8.813,P =0.028;x2 =9.706,P =0.008).The genotype frequencies in every group were all in Hardy-Weinberg equilibrium.Conclusions BclI polymorphism may predict the first generalized symptom of OMG.BclI polymorphisms of GR might have no relationship with the recurrence of MG,generalization and generalized time of OMG during the first two years after MG onset.

Objective To study the liver damage induced by platelet activating factor (PAF) and the protective effects of the PAF antagonist WEB2170. Methods Experiments in vivo: after the administration of PAF to induce liver damage in rats, serum levels of aspartate transaminase (AST), alanine transaminase (ALT), lactic dehydrogenase (LDH) and tissue malonyldialdehyde (MDA) were determined by biochemical method, the succinate dehydrogenase (SDH) activity in mitochondrion was assessed by histochemical method, and the morphologic changes in hepatic structure were observed. In the treatment group, WEB2170 was used for intervention. Experiments in vitro: the fluidity of cellular velum of liver cells was detected with DPH probe, and the effect of TNF and MDA produced by Kupffer cells cultured by PAF stimulation was observed. Results PAF increased the expression of serum AST, ALT, LDH and tissue MDA (P

Objective To discuss the application of Germany Cooperation for Transparency and Quality in Health Care (KTQ) quality certification system in the field of nursing management. Methods The Plan-Do-Check-Act (PDCA) from KTQ was used in the management of ward nursing quality. The post-interventional quality of basic nursing, critical nursing, health education, ward management, nursing safety and disinfection and isolation were compared and contrasted with the pre-interventional one. Result The quality of basic nursing, critical nursing, health education, ward management, nursing safety and disinfection and isolation were significantly improved after intervention with PDCA from KTQ (P<0.01). Conclusion The KTQ quality certification system can be applied to improve the nursing quality in the process of nursing management.

Objective:To discuss the effect of improved supine position on the prevention of pressure injuries of emergency patients under observation and their comfort levels.Methods:A total of 114 patients in our Emergency Observation Ward were randomly divided into the intervention group and control group, 57 patients in each. Patients in the control group were treated with routine supine position and pressure injury prevention nursing; while patients in the intervention group were treated with improved supine position nursing intervention. Then, the incidence of pressure injury, its risk score and its comfort evaluation were compared between patients under observation in the two groups.Results:The incidence of pressure injury of the intervention group was obviously lower than that in the control group ( Z value was -2.426, P<0.05). The scores of sensation, humidity, activity, friction and shear force of patients in the intervention group were 3.36 ± 0.59, 2.92 ± 0.47, 3.21 ± 0.52 and 2.61 ± 0.29 respectively, which were significantly higher than those in the control group, specifically 2.87 ± 0.51, 2.24 ± 0.38, 2.76 ± 0.44 and 2.04 ± 0.32. The difference was statistically significant ( t value was 4.74-9.96, P<0.01). In addition, the scores of the physiological and psychological comfort level of patients in the prevention group were 15.41±2.49 and 27.26 ± 3.42 respectively, which were significantly higher than 11.01±1.97 and 22.14± 3.23 in the control group. The difference was statistically significant ( t value was 10.46, 8.21, P<0.05). Conclusions:The improved supine position nursing method can effectively lower the occurrence of pressure injury in emergency patients under observation and enhance patients’ comfort degree. Therefore, it is applicable to emergency patients under observation.

Objective To observe the intervene effects of montmorillonite powder and mannitol on rat with acute paraquat poi-soning by intragastric administration .Methods 40 male SD rats were divided into four groups randomly ,control group(C) ,pa-raquat group(P) ,PT1 groups were treated with montmorillonite powder and mannitol gavage after paraquat exposure one hour ,PT2 group was treated after paraquat exposure four hours .P ,PT1 ,and PT2 groups were exposed to paraquat 50 mg/kg .one and four hour later ,PT1 and PT2 group rats were given 7 g/kg montmorillonite-mannitol solution respectively ,C group and P group with sa-line instead .then to observe general state in rats .Give rats run training before and after intragastric administration ,comparison the fall times from the treadmill among groups before and 5 ,10 ,15 days after administration ,rats were killed in 15 th days exposed pa-raquat ,collect their lung tissue ,hydroxyproline content were measured in lung tissue of rat by alkaline hydrolysis ,observe the path-ological changes by HE staining in rat lungs .Results the general condition were poor in P ,PT1 and PT2 group rats .And those mean food intakes were significantly lower than the control group (P<0 .01) .there are no significant of the weight gain and the fall times from the treadmill before and 5 th ,10 th after administration among four groups(P>0 .05) ,but P group′s fall times increased significantly than the others group′s at 15 th day after exposed(P< 0 .05) .the all group rat lung tissue hydroxyproline overall difference significant(P<0 .01) ,from the two-two compared results ,three paraquat exposed groups higher than control group ,and P group also higher than PT1 and PT2 group(P<0 .05) .From the lung tissue slices ,P ,PT1 and PT2 group showed significant pul-monary fibrosis than C group ,and the P group′s was the most severe .Conclusion Pulmonary interstitial fibrosis may be alleviated by early use of montmorillonite powder and mannitol on paraquat poisoning rats .

This study was aimed to observe the clinical effect of nerve root cervical spondylosis treatment by muscle meridian manipulation with small-angle sagittal localized rotational pulling of the neck . A total of 60 cases of nerve root cervical spondylosis were randomly divided into two groups , which are the treatment group (by muscle meridian manipulation with small-angle sagittal localized rotational pulling of the neck) and the control group ( by tendon-soothing manipulation ) . The results showed that there were significant differences ( P< 0 . 01 ) in the comparison of cure rate after treatment . The total efficiency of the treatment group was 93 . 33%, and the control group was 70 . 00%. The treatment group showed better clinical effect with significant difference ( P < 0 . 05 ) . It was concluded that the application of muscle meridian manipulation with small-angle sagittal localized rotational pulling of the neck is maneuverable and time-saving in the treatment of cervical spondylosis . It has a remarkable therapeutic effect and is suitable for clinical application .

Objective To use bioinformatics methods to analyze large amounts of data generated by gene chips and to screen common key genes in hepatocellular carcinoma in human and rat.Methods For search of the medical literature,3 sets of gene chip with data which met our predetermined criteria were downloaded from the GEO database.The data were standardized by using the bioconductor and R version of the 2.10.1 version.The original data of the affymetrix platform were normalized with background correction,standardized and transformed into log2 by using the algorithm of the affy packages RMA.The TTEST function of the excel was then used to calculate the significance of each gene.The DAVID was used for gene ID conversion and a table was established for samples and the corresponding gene expression data.A meta analysis was performed to calculate the common genes of human and rat.An enrichment regulation pathway was gained with the KEGG in the DAVID library. Results There were 26 common expression genes in the development process of hepatocellular carcinoma in human and rat.Five of these genes were up-regulation genes,while twenty-one were down-regulation genes.An enrichment pathway,which is a focal adhesion pathway,was found and this pathway has been reported to be associated with development of hepatocellular carcinoma.Conclusion With bioinformatics,we were able to screen common key genes and a pathway which were closely related to development of hepatocellular carcinoma in human and rat.