Objective To explore the clinical value of high-sensitivity C-reactive protein(hsCRP) in chronic kidney disease(CKD) and the relationship between hsCRP and the different stages of CKD in children.Methods This study population consisted of patients who was diagnosised as CKD in Beijing Children′s Hospital from Mar.2007 to Feb.2008.The total number of subjects was 62 patients with 35 male and 27 female,the mean age was(8.7?4.0)years old,the course was from 3 months to 10 years.The healthy control group contains 30 healthy children with 16 male and 14 female,the mean age was(7.8?3.2) years old.The serum levels of hsCRP,creatine and ?2-microglobulin(?2-MG) were determined.The glomerular filtration rate(GFR) was caculated.The relationship between serum levels of hsCRP and ?2-MG,blood pressure as well as the renal function in these patients with CKD,stratified according to GFR were evaluated.The relationship between hsCRP and the blood pressure was evaluated.The statistical analysis for the data was done with SPSS 12.0 software.Use the t-test,order and examination and correlation analysis,P

Objective To investigate the possible mechanism of curcumin inhibition to murine melanoma growth.Methods Melanoma cell line B16F10 was injected subcutaneously into the outer side of mouse right thigh to establish a melanoma-bearing mouse model.Seven days after the establishing the model, these mice were treated with intraperitoneal injection of curcumin at 50 and 100 mg/kg respectively or RPMI 1640 culture medium as control.Fourteen days later,the mice were killed,tumor weight was calculated;the tumor nuclear factor?B activity and survivin mRNA expression were measured by Western blot and RT-PCR,respectively.Results The tumor weight was significantly lower in the curcumin-treated mice than that in the controls (P

ObjectiveTo determine the source of IL-6 in detached retina and the change of IL-6 level in detached and reattached retina.MethodsRetinas of SD rat were examined after subretinal injection of 1.4% Healon GV at different period of time, and the level of IL-6 in detached and reattached retina were detected by radio-immune histochemistry method. Wax-embeded sections were labeled with IL-6 antibody to determine the location of IL-6.ResultsDetached retina with normal vitreous and inner limiting membrane could only induce the subretinal fibrosis. This kind of fibrosis reached to its peak at 10th day and then remolded with time. Retinal pigment epithelial (RPE) cell, Muller cell, endothelial cell, glial cell were labled with IL-6, and the level of IL-6 in neuro-retina reached to its peak at 3rd-4th day and then downed to normal within a few days. The level of IL-6 in reattached retina was lower than in detached retina. The expression of IL-6 in RPE of detached area was stronger than in attached area.ConclusionIL-6 takes active part in wound healing process induced by the separation of RPE and neuro-retina. Reattachment can lower the expression of IL-6 in retina.

ObjectiveTo investigate the expression of integrin β1 during retinal detachment and reattachment of rabbits.Methods24 rabbits were used to make retinal detachment and reattachment model by using hyaluronidase and micropipette. The expression of integrin β1 were observed with hybridization in situ.ResultsThe expression of integrin β1 in reattached retina was lower than that in detached retina.ConclusionRetinal reattachment may inhibit the development of proliferative vireoretinopathy.

ObjectiveTo analysis the clinical features of thoracic spine and spinal cord injury (SCI) and summarize the inclusive standard of cellular transplant clinical trial for SCI.MethodsThe data of 72 cases with thoracic spine and spinal cord injury from 1990 to 2005 were analyzed retrospectively.ResultsMean follow-up period was 20 months (6～48 months). There was no recovery in 12 spinal cord injury without radiographic abnormality (SCIWORA) patients, but improvement of urine function in 4 cases. 5 cases of 52 fracture-dislocation complete injury were improved to grade B (sense recovery), rate of recovery was 9.6%; recovery rate was 62.5% in incomplete injury. Sense recovery of all cases was better than motor recovery. Partial cases appeared spasm paralysis relief.ConclusionIncidence rate of complete injury is high and recovery is bad in thoracic spine and spinal cord injury. The inclusive standard of cellular transplant clinical trial for SCI is old complete thoracic spinal cord injury without residual compression.

Objective To study the effects of hormone,anesthetie and contrast medium on the activities of collagenase lysis.Methods Nuclear tissues were divided into equal amount for different groups and same units of collagenase were used for the lysis.The only difference in the control group from experimental groups was that there were no dexamethasone,lidocaine or omnipaque but existing in experimental groups.Twenty four hours later,the concentrations of the hydroxyproline were determined in different groups and the data were analyzed by statistical software with computer.Results 1.The concentrations of hydroxyproline in the dexamcthasone group,lidocaine group and omnipaque group were significantly lower than that of control group,especially that of lidocaine group,P value was＜0.05 or 0.01.2. The concentrations of hydroxyproline in the dexamethasone+lidocaine group,dexamethasone+omnipaque group,lidocaine+omnipaque group and dexamethasone+lidocaine+omnipaque group were significantly lower than that of control group;and simultaneously lower in dexamethasone group,lidocaine group,omnipaque group respectively;P value was also＜0.05 or 0.01.Conclusion Dexamethasone,lidocaine and omnipaque can individually inhibit the activity of collagenase at different degrees,so they shouldn't be used together with collagenase in treating the lumber disc herniation.

Objective To explore the clinical features of invasive fungal infection in 27 children treated at nephrology department between 1999 and 2014.Methods Twenty-seven cases of invasive fungal infection at nephrology department were analyzed retrospectively.Results Candida urinary infection was found in 9 cases,pneumocystis carinii pneumonia were found in 8 cases,invasive pulmonary aspergillosis and urinary aspergillosis found in 4 cases and 1 case respectively,cryptococcus neoformans meningitis and pulmonary candidiasis found respectively in 2 cases,and pulmonary filamentous fungal disease was found in 1 case.These 27 cases showed different features of illness:10 primary nephrotic syndrome,7 secondary nephrotic syndrome,6 malformation of urinary development and 4 preterm birth ＜ 32 weeks gestational age with low birth weight.All of the cases had the history of taking antibiotics.Seventeen cases of them had used corticosteroid and cytotoxic drugs in a long-term.Sixteen cases had experienced invasive procedures.All children had fever in varying degrees,14 cases showed gasp,7 cases had progressive hypoxia and respiratory failure,and 5 cases developed into multiple organs failure.Chest computed tomographic (CT) imaging data showed diffuse ground-glass opacity with mosaic sign of pneumocystis carinii pneumonia(8 cases).The features of pulmonary aspergillosis included multiple nodules and cavity in bilateral lungs (4 cases).The radiologic findings showed patching lesions with indistinct edge and uncertained density of bilateral middle-lower lung fields with pulmonary candidiasis (2 cases).Full dose of antifungal drug was given to 23 cases of them,16 cases recovered completely,3 got better,4 cases died.Four cases gave up full dose antifungal therapy.Conclusions Long-term use of corticosteroid and cytotoxic drugs,use of broad-spectrum antibiotics,invasive therapies,such as indwelling centralvenous catheters,endotracheal intubation with mechanical ventilation,and preterm birth with low birth weight were risk factors in predicting invasive fungal infection.Chest CT findings were different among these cases.Even though not specific,the relatively differences were helpful to the differential diagnosis of these diseases.

Objective To explore the clinical feature of spontaneous bacterial peritonitis (SBP) in children with nephrotic syndrome (NS).Methods Eleven cases of SBP in children with NS from Department of Nephrology,Beijing Children's Hospital Affiliated to Capital University of Medical Science between January 2010 and June 2014 were analyzed retrospectively.The clinical features,laboratory data and efficacy of therapy were reviewed.Results In this study,12 episodes of primary peritonitis were detected in 11 patients.One patient had 2 attacks.There were 11 cases including 9 boys and 2 girls.The age of the patients ranged from 2 years and 11months to 14 years and 11 months.Nine cases of them received steroid therapy and/or cytotoxic drugs.Peritonitis was characterized by abdominal pain,mild abdominal pain occurred in 7 cases with slow onset.Ten cases had fever of varying degrees,8 cases had abdominal distention,5 cases had diarrhea and 4 cases had nausea and vomiting.Shock signs were present suddenly in 2 cases before therapy of antibiotics.Apparent edema and severe ascites were present in all cases.Five of them were presented with increasingly rapid severe ascites and showed no response to diuretic drugs.Blood investigation showed leukocytosis and high C-reactive protein.Serum albumin levels and IgG and CD4 ratio were very low in all cases.Ascites were like cloudy pus with raised neutrophil cells.Streptococcus pneumonia was positive in both blood culture and ascites culture in 2 cases.Cephalosporin was used empirically to all cases for 7 to 10 days in 9 cases and 4 weeks in 2 cases with positive blood culture.Paracentesis to release ascites fluid was performed in 5 cases with constant ascites.Eleven cases recovered from peritonitis completely.The proteinuria was negative in 2 cases after they recovered from peritonitis.Conclusions SBP was atypical in children with NS and sometimes patients might have to abdominal pain and rebound tenderness,which may be ignored and may induce deterioration suddenly and clinicians should be aware of it clearly.SBP could lead to relapse of NS and the cure of SBP by treatment could help the children recover from NS.

Objective To investigate the treatment of atypical hemolytic uremic syndrome (aHUS) in their acute phase and relate the prognostic factors.Methods Twenty-eight patients with aHUS treated in Department of Nephrology,Beijing Children's Hospital Affiliated to Capital Medical University from January 2011 to March 2015 were collected,the outcomes of the treatment were summarized.Results All the patients were given plasma exchange (PE)treatment,21 patients with hemodialysis (HD) treatment;13 patients with H factor (FH) antibody were further treated with corticosteroid therapy,and 1 patient was treated with the combination of mycophenolate mofetil.Evaluation of patients' indices were conducted at month 3.Out of the 28 patients,there were 13 patients with complete remission;of the 14 patients showed improvement,6 patients were complicated with hypertension and 4 patients with renal dysfunction.One patient,with ongoing hemodialysis,did not show restoration of renal function.There was no death in children.Statistical analysis showed that the acute phase serum creatinine levels were (430.0 ± 124.7) μmol/L and (265.6 ± 90.8)μmol/L for the group with remaining kidney injury and the group with complete remission,respectively,the difference was statistically significant(P ＜0.01).The levels of FH for the 2 groups were (206.5 ± 134.9) mg/L and(415.4-±214.1) mg/L,and the difference was statistically significant (P ＜ 0.01) as well.Statistical analysis showed that differences were no statistically significant between the 2 groups of patients on their age,platelets,complement C3,complement C4,hemoglobin and lactate dehydrogenase (all P ＞ 0.05).For the group with positive antibody,its average serum creatinine was (346.4 ± 112.5) μmol/L.For the group with negative antibody,its average serum creatinine was (297.0 ± 89.3) μmol/L.The FH for group with positive antibody and group with negative antibody were (307.4 ±187.3) mg/L and (379.8 ± 203.5) mg/L,respectively.The differences were not statistically significant (all P ＞0.05).Conclusions PE is an effective treatment for aHUS at acute phase,and corticosteroid and immunosuppressive therapy are effective for patients with positive anti-FH antibody.For patients with severe kidney injury at acute phase,the possibility of long-term kidney damage is high.Low concentration of serum FH indicates a poor prognosis.

Objective To analyze the clinical features of pediatric sepsis with initial symptoms of autoimmune hemolytic anemia(AIHA) and acute renal failure.Methods Ten cases of pediatric sepsis with initial symptoms of AIHA and acute renal failure were selected from January 2000 to January 2014 in Department of Nephrology,Beijing Children's Hospital Affiliated to Capital University of Medical Science.The clinical data were retrospectively analyzed and long-time follow-up was taken.Results There were 8 boys and 2 girls of the 10 cases.The ages ranged from 8 months to 12.8 years.There were 8 children less than 6 years old having a prevalence of 80％.There were sudden dark urine and progressive anemia in all the cases,jaundice in 9 cases,abdominal pain and vomiting in 6 cases.Urine volume decreased in 7 cases and anuria in 3 cases.Four cases showed disorder of consciousness and 2 developed shock.Respiratory failure and disseminated intravascular coagulation happened in 1 case respectively.In terms of pathogens,2 cases were infected by mycoplasma and 1 case was infected by hemolytic streptococcus.The rest of the pathogen was unknown.The Coomb's test was 3 +-4 + positive.Serum urea nitrogen and creatinine gradually increased.High level total serum bilirubin and unconjugated bilirubin were shown in 8 cases and low level complement in 7 cases.Bone marrow films showed hyperplasia in all the cases.Renal biopsy was taken in 3 cases and no microthrombus was found.Corticosteroid was used in all 10 cases for 6 months.Blood purification was taken in 8 cases.Respiratory support was used in 4 cases.Nine recovered and 1 case gave up treatment.Further follow-up was taken for 2.2-8.1 years.Eight cases had normal urine and blood routine test and renal function.Relapse happened in 1 girl 1 year later.One case lost follow-up.Conclusions Once sudden hemoglobinuria,anemia and progressively decreased urine output occur in sepsis cases,the clinicians should consider AIHA and acute renal failure.Based on active infection control,the early use of steroids and blood purification treatment can improve the prognosis.