Objective To study clinical feature,pathology,treatment and outcome of acute renal failure(ARF) in idiopathic nephrotic syndrome(IDNS).Methods History-taking of 38 cases were carried out all detailly 24-hour urine protein,biochemistry markers,hemorheology,renal histopathology were detected.Results The study fandings that 82 percent of patients were less than 40 years old,76 3 percent were male,74 percent(28 patients) were non-oliguria and 52 6 percent were minimal change glomerulonephritis through the renipuncture,most of the cases had edema of interstitium, by give prednisone of standard dosage,symptomatic treatment or dialysis the satisfying efficacy was got.Conclusions The main features of IDNS complicated with ARF are usual,it is non-oliguria type in clinic minimal glomerulonephritis in pathology,and deficient blood volume leads to occurrence of ARF,but the renal function could be recovered by give prednisone of routine dosage,symptomatic treatment and hemodialysis therapy.

Objective To explore the role of clinical pharmacist in individualized treatment of hypertension.Methods A patient withH hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed.Results Patient's MTHFR (C677T) gene type was TT homozygous.Clinical pharmacist suggested doctor modify treatment,and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1,and blood pressure dropped from 173/ 111 mmHg(1 mmHg =0.133 kPa) to 130/80 mmHg.Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.

A total of 62 critically ill patients were randomly allocated to the intensive insulin therapy group and the conventional insulin therapy group. The effect of therapy on the prognosis, the activity of NF-κB in peripheral blood monouclear cells and plasma intercellular adhesion molecule-1 level were investigated. The results showed that the intensive insulin therapy may improve the prognosis and insulin had a reliable anti-inflammatory effect in the critically ill patients.

BACKGROUND: Acute respiratory insufficiency is common complication of surgical treatment of adolescent scoliosis patients. The preventive effects of breathing exercise before surgery is still uncertain.OBJECTIVE: To explore the feasibility and efficacy of breathing exercises for scoliosis patients before operation.DESIGN: Nonrandomized cross sectional study.SETTING, PARTICIPANTS and METHODS: Totally 35 hospitalized kids with scoliosis and pulmonary dysfunction aged from 9 to 15 years old were selected from Shanghai Changhai Hospital. A set of breathing exercise including which included pursed lip breathing, abdominal breathing, diaphragmatic breathing and blowing balloon was performed to these patients one week before surgery. The changes of pulmonary function were recorded and compared before and after exercises.MAIN OUTCOME MEASURES: The change of vital capacity, lung capacity, forced ventilation capacity(FVC), maximal ventilation volume(MVV) before and after breath exercises.RESULTS: All sorts of indes are improved comparing with those before exercises. The vital capacity, lung capacity, FVC and MVV were greatly improved from(1.77 ±0. 36), (2.67 ±0. 84), (2.07 ±0.46), (52.5 ± 14.0) L before exercises to(2.65 ±0. 29), (3.56 ±0.79), (2.41 ±0.41), (70. 1 ± 17.0) L respectively( t = 3.63 - 11.28, P < 0.01).CONCLUSION: Preoperative breathing exercises can improve the pulmonary functions of kids with scoliosis and improve their tolerance to surgery and prevent the postoperative respiratory insufficiency.

Objective To detect the msr gene which confers resistance to erythromycin, and ana-lyze its distributing difference between the two biovars of Ureaplasma urealyticum. Methods Broth dilution method was used to determine the minimum inhibitory concentrations (MIC) to erythromycin among 72 U. urealyticum clinical isolates. The msrA, msrB, msrC and msrD genes detection and biotyping of U. urea-lyticum were conducted using PCR. Results The MICs of 72 U. urealyticum isolates to erythromycin ranged from ≤0. 125 μg/ml to ≥128 μg/ml. MIC_(50) was 32 μg/ml and MIC_(50) was ≥128 μg/ml. Biotyping showed that biovar Parvo had 51 strains (51/72, 70.83%) and biovar T960 had 21 (21/72, 29.17%) strains.The msrA, msrB, msrC and msrD genes were obtained in 1, 12, 0 and 24 strains, respectively, with five strains carrying the msrB and msrD genes, and one strain carrying the msrA, msrB and msrD genes. There was no resistance difference to erythromycin between the two biovars when the MIC≥8 μg/ml was considered resistance to eryt hromycin. But the msrB gene was predominantly detected in biovar T960. Conclusion U. urealyticum clinical isolates harbeur the msrA, msrB and msrD genes, and the predominantly detected msrB gene is of biovar T960.

Objective To explore the role of sialic acid-binding immunoglobulin-like lectin-one (Siglec-1) in the process of atherosclerotic inflammation induced by oxidized low-density hpepmtein (ox-LDL). Methods Ox-LDL was synthesized by oxidization of native LDL and different concentration of ox-LDL was added to the culture medium of RAW264.7. Forty-eight hours later, cells and supernatants were collected separately. The expression of Siglec-1 protein and mRNA were measured by flow cytometry(FCM) and real-time quantitative RT-PCR, respectively. The levels of monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1α(MIP-1α) and IL-8 in supernatants were determined by ELISA. Re-sults By the stimulation of ox-LDL, Siglec-1 protein and mRNA on RAW264.7 cells were significantly in-creased, meanwhile, the cytokines levels in culture supematants were significantly higher than that in the control group. And both Siglec-1 expression and cytokine secretion were ox-LDL dose-dependent. Conclu-sion Ox-LDL can increase Siglec-1 protein and mRNA expression and some inflammatory cytokines secre-tion on RAW264.7 cells in a dose-dependent manner. Manifested by enhanced Siglec-1 expression, the acti-vated macmphages may take a part in the development and progression of atherosclerosis.

Objective To study the relationship between erythromyein sensitivity and ermB gene in 143 Ureaplasma urealyticum (Uu) clinical isolates. Methods We detected the minimum inhabit concen-trations (MICs) of Uu to erythromycin by broth dilution method and MIC≥8 μg/ml was used as standard concentration of resistance to erythromycin. Polymerase chain reaction was used to detect the ermB gene and biotype Uu with primers based on multi-band antigen gene. Results The MICs, MIC50 MIC90 of Uu to erythromycin were ≤0. 125 μg/ml to ≥128 μg/ml, 16 μg/ml, and ≥128 μg/ml, respectively, with a high resistance rate of 64.38%. ermB gene, which was mainly detected in Uu with MIC≥8 μg/ml, was positively detected in 40 out of 143 Uu strains (27.97%). No significant differences of the resistance to erythromycin and positive rate of ermB gene were found between the two biovars in the study . Conclusion ermB gene may probably be one of the important genes conferring resistance to erythromycin in Uu. Further studies are needed to discover the difference of resistance and mechanism of erythromycin between the two bi-ovars.

Objective To explore the relation of early time secretion function of Beta cell in newly diag-nosed type 2 diabetic patient and the changes of body weight following intensification therapy of insulin. Methods 237 newly diagnosed type 2 diabetic patients were divided into 1 kg lower group, the 1-5 kg group, the 5 kg above group. The maximum body weight and waist circumference were recorded. The present body weight and waist circum-ference were measured according to OGTT study, meanwhile,30 minuets blood sugars, the insulin and the C-peptide (C-P) level and the blood pressure(BP) and the insulin resistance index (HOMA-IR), the early insulin secretion index (△I30/△G30) was calculated. All cases were treated for 14 days. Results Early time secretion function of Beta cell in the group keeping above lose weight 5 kg was the worst, after treatment insulin secretion level were in-creased 1.12 times and 1.86 times in 1 kg lower group than in the 1-5 kg group and above 5 kg group. Conclusions Early time secretion function of Beta cell in newly diagnosed type 2 diabetic patient is correlated with the maxi-mum body weight decrease.

Objective To study the resistance mechanism of Ureaplasma urealyticum (Uu) to erythromycin.Methods The susceptibility of 73 clinical isolates of Uu to erythromycin was evaluated by using broth dilution techniques. PCR and DNA sequencing were carried out to screen hot spot mutations at the variable region of 23S ribosomal RNA in erythromycin-resistant strains of Uu. Moreover, erythromycin resistance methylase genes (ermA, ermB, ermC) and efflux pump genes (mefA/E, msrA/B, mreA) were screened by using PCR with specific primers. Results There were 35 (47.95%) resistant Uu strains out of the 73 isolates, and the minimal inhibitory concentration varied from 8 to 32 mg/L among these resistant strains. The ermB gene was detected in 19 (54.29%) resistant strains, and msrA/B gene in 9 (25.71%) resistant strains. Two resistant strains harbored both ermB gene and msrA/B gene. No mutation at 23S ribosomal RNA or amplification of resistance-associated genes was noted in sensitive or reference strains of Uu. Conclusion The ermB and msrA/B genes may be responsible for the erythromycin resistance of Uu.

A 23-year-old man in remission from acute myeloblastic leukemia after allogeneic peripheral blood stem cell transplantation developed peripheral neuropathy presenting as sciatic and peroneal nerve deficits. Electrophysiological tests localized the lesions to the left sciatic and common peroneal nerve. Magnetic resonance imaging revealed nerve thickening and enhancement, while a positron emission tomography-computed tomography scan demonstrated increased fluorodeoxyglucose uptake tracking along the nerve, suggesting peripheral nerve infiltration. This report demonstrates an unusual presentation of acute leukemia relapse presenting as focal neuropathy