Diet therapy is considered as the basic treatment of chronic kidney disease (CKD),and its primary goals are improving metabolic disorder,relieving symptoms and prevent complications,hence to retard renal function lost of CKD patients.However,there have been controversies about the results of clinical studies on nutritional treatment for CKD.This article reviews the effectiveness,safety and compliance of low-protein diet (LPD) for CKD patients,and related clinical management strategies.The article also recommends the feasible diet scheme to provide a reference of clinical LPD therapy for patients with CKD.

Acid-lable subunit (ALS)plays an important role in stablizing the insulin-like growth factor ( IGF),which has an great impact on the process of human growth and develepment.Mutations of the human IGF ALS gene result in ALS deficiency.Some degree of insulin insensitivity,as well as high level of insulin,low serum concentrations of IGF- Ⅰ and IGF binding protein ( IGFBP)-3,short stature,growth retardation,was generally found in patients with human ALS deficiency.Meanwhile,bone mineral desity reduction only occures in some cases.However,the exact mechanisms of insulin insensitivity and bone mineral density reduction have still remained unclear.

Objective To evaluate the method and result of thyroid artery embolization as a new therapy for hyperthyroidism. Methods Twenty two patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 52 thyroid arteries were embolized with microspheres. The indications to this therapy were following: hyperthyroid patients having indications to surgical and 131 I therapy, clinically being difficult to complete the preparation for subtotal thyroidectomy and having high risk for surgical process because of their huge thyroid gland. Results Serum level of thyroid hormones dropped significantly [median T3 from 8 8 nmol/L(4 3～ 43 0 nmol/L) to 4 0 nmol/L(1 1～9 2 nmol/L), median T4 from 206 4 nmol/L(77 4～748 2 nmol/L) to 144 5 nmol/L(25 8～279 9 nmol/L), P

0.05).From ≤40 years to 71～80 years, the proportion of proximal colon cancers remained stable, distal colon cancers increased from 14.7% to 26.9%, and rectal cancers decreasd from 58.6% to 47.8% (P

Objective To study the apoptotic effect of brazilein on human lung cancer A549 cells and endoplasmic reticulum stress .Methods The cytotoxic activity was tested by MTT assay in A549 cells .The flow cytometry was used to detect apoptosis . Western blotting was performed to detect GRP78 and cyto c protein expression .Results The IC50 values of brazilein against A549 cells was (5 .36 ± 0 .62)μmol/L .After treatment with 0 ,5 ,10 and 20 μmol/L brazilein for 48 h ,the percent of apoptosis was (1 .15 ± 0 .32)% ,(19 .61 ± 4 .52)% ,(30 .18 ± 6 .35)% and (39 .48 ± 7 .44)% respectively .There was significant difference among the different treatment (P< 0 .05) .Compared with control group ,the protein expression of GRP78 and cytosolic cyto c was in‐creased after 5 ,10 and 20 μmol/L brazilein treated for 48 h .Conclusion Brazilein induced apoptosis in human lung cancer A549 cells though endoplasmic reticulum stress pathway .

BACKGROUND:Bone marrow is the main source of mesenchymal stem cells(MSCs)at present,but its application has been limited,because of some reasons such as inconvenience of isolation,and the quantity of cells decreases with human increased age.Umbilical cord as a new source of MSCs has been widespread concerned recently.OBJECTIVE:To explore the approach of isolating and culturing MSCs from Wharton's jelly of human umbilical cord,and the methods of identifying the surface antigens and the differentiation potential.METHODS:MSCs were isolated and amplified via tissue-cultivation,and cultured by FasGrow medium.Morphology of MSCs from Wharton's jelly of human umbilical cord was observed under the optical microscope.Its immunophenotypes were detected using immunohistochemistry.The differentiation of MSCs into the osteoblasts was determined utilizing Gomori calcium-cobalt alkaline phosphatase staining,von Kossa calcium node staining,and tetracyclinefluorescence labeling.The differentiation of MSCs into the adipocytes was detected using oil red O staining.RESULTS AND CONCLUSION:MSCs were easily obtained from Wharton's jelly of human umbilical cord via the proposed approach.The primary cells grew up to 70%-80% confluence after 12-16 days of culture,and meanwhile the undifferentiated state was maintained and proliferation was stabilized after passage.The cell cycle of double increase was about 2 days,and proliferation in vitro reached twenty generation above.Surface antigen analysis showed that CD44,CD105,CD133,MHC-I were positively expressed,while CD34,CD45 were negatively expressed.Experiments of differentiation in vitro indicated that the obtained cells were capable of differentiating into fat,osteoblast and nerve-like cells.

Objective To investigate the effect of metformin used during early pregnancy on pregnancy outcome of pregnant women with polycystic ovary syndrome (PCOS).Methods Two hundred and fifteen pregnant women with PCOS history were selected into our investigation from March 2007 to February 2010,among which,58 patients were taken as metformin group as they had taken metformin during early pregnancy,or with impaired glucose tolerance complicated by marked hyperinsulinemia and history of recurrent miscarriage.All patients in the study group received metformin (1.0～1.5 g/d) during early pregnancy.The rest 157 gravidas with PCOS history did not receive metformin as control group.The outcomes of pregnancy in the two groups were compared with x2 or t test.Results The early spontaneous miscarriage rate of metformin group was significantly lower than that of control group (5.2 ％ vs 28.7 ％,x2 =13.476,P＜0.01).There was no statistical difference in the rate of late abortion (6.90％ vs 6.4 ％ ),hypertension during pregnancy (3.9％ vs 4.9％),preeclampsia (3.9％ vs 3.9％),preterm birth (13.7％ vs 20.6％) and oligohydramnios (5.9％ vs 3.0％) between control group and metformin group (P ＞ 0.05 respectively).And there was no significant difference in neonatal birth weights [(2925±530) g vs (2910± 659) g],the rate of asphyxia (3.7％ vs 6.8％),malformation (0.0％ vs 0.9％),hypoglycaemia ( 5.6％ vs 6.8％),fetal macrosomia ( 1.9％ vs 3.4％),fetal growth restriction (5.6％ vs 6.0％) and rate of neonatal intensive care unit admission (18.0％ vs 27.4％) between the two groups (P＞0.05,respectively).The infants were followed up for 3 years and all are physically and mentally normal.Conclusions Metformin administration during early pregnancy might reduce the early spontaneous miscarriage rate of PCOS patients,and the adverse effects of metformin have not been identified on fetals and infants.

Objective: To learn the disease entities and medical costs of the patients admitted in the Pediatric Department of a general hospital.Methods: We collected from the Hospital Information System(HIS) the related data of the patients admitted in the Department of Pediatrics from October 2001 to October 2007 and analyzed the patients' main types of diseases and medical expenditure.Results: Among the total number of 8 062 patients,diseases of the genitourinary,respiratory and digestive systems and of blood and hematogenic organs accounted for 47.82%,36.78%,4.22% and 3.16%,ranking as the first 4 disease entities.The per patient medical costs in the first 4 places were those of the diseases of the musculoskeletal system and connective tissues($6 368),tumors($5 845),diseases of the genitourinary system($5 818) and congenial anomalies($5 469).Conclusion: The largest number of patients were those with genitourinary system diseases,and the highest medical costs per patient were those of the diseases of the musculoskeletal system and connective tissues in the Department of Pediatrics.

The lumber ligaments play an important role in spinal bsomechanics. The results of three-dimensional finite element analysis showed that one of functions of lumbar ligaments is transmission of the tensile load between the lumbar vertebrae. The anterior longitudinal ligament is loaded in extension of lumbar spine and the resistance to the tensile load in flexion is provided by other ligaments. These ligaments are subject to much more tension with degsneration of the intervertebral disc so that a series of pathological changes occur. Relevant significance in clinical aspect is also discussed.

Objective To study a new stuff-block therapy method to promote closure of external gastrointestinal fistula. Methods Twenty-eight patients with different type of external gastrointestinal fistulae in different sites were treated with fibrin glue stuff-blocking technique. The fibrin glue dispensary system designed by the authors has a double-lumen catheter in different size.When the catheter inserted via the fistula to about 1cm from the intestinal fistula,the glue was relased through the catheter to seal the whole fistula. Results The insertion of dispensary catheter into the fistulae was successful in all the cases. No side-effect was observed in all the patients. In 17 patients the fistulae healed about one week after one time treatment, 11 patients′ fistulae healed in about two weeks after 2-3 time treatment. Twenty-five patents were followed up for 3-6 months . The fistula sustained healing and normal deal was restored.Conclusions Stuff-blocking of the fistula with fibrin glue by means of the dispensary system designed by the authors has satisfy results. It provided a new method for the treatment of external gastrointestinal fistula .