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.

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.

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.

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.

OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

OBJECTIVETo explore the effect of Tongfu Jinghua Decoction (TJD) on hemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsis shock.

METHODSTotally 60 patients were randomly assigned to the treatment group and the control group, 30 in each group. Patients in the treatment group took TJD or were administered with TJD by nasal feeding in combined with conventional Western medical treatment, while patients in the control group only received conventional Western medical treatment. Changes of each index in hemodynamics and tissue oxygen metabolism were observed before treatment, and at 6, 12, 24, and 48 h after treatment.

RESULTSCompared with before treatment in the same group, hemodynamic changes were significantly improved at each time point in the two groups. All indices of tissue oxygen metabolism at each time point of the two groups were significantly improved, except changes of O2 extraction ratio (ER) after treatment in the control group (P < 0.05, P < 0.01). Compared with the control group in the same period, heart rate (HR), systemic vascular resist- ance (SVR), and cardiac output (CO) were significantly improved with statistical difference (P < 0.05, P < 0.01). Mean arterial pressure (MAP), central venous pressure (CVP), and cardiac index (CI) were significantly improved at 6, 12, and 24 h after treatment with statistical difference (P < 0.05, P < 0.01). Each index of tissue oxygen metabolism in the treatment group were all improved at each time point with statistical difference (P < 0.05, P < 0.01).

CONCLUSIONTJD combined with conventional Western medical treatment could quickly improve hemodynamics and tissue oxygen metabolism disorder in patients with septic shock, and its curative effect was superior to that of conventional Western medical treatment alone.

Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Heart Rate ; Hemodynamics ; drug effects ; Humans ; Oxygen ; metabolism ; Sepsis ; Shock, Septic ; drug therapy ; metabolism

Advance on chemical constituents and pharmacological activities of Stellera plants have been conducted. The chemical constituents include terpenes, coumarins, flavonoids, lignans, volatile oils, and other compounds. Pharmacological studies showed that diterpenoids and biflavones showed strong activities, such as antitumor, anti-HIV, and immune regulations. This review hopes to provide a scientific basis for further research and explorations of the medicinal values of the genus.
Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Sequence Data ; Molecular Structure ; Thymelaeaceae ; chemistry ; classification

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 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.