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The benchmark dose (BMD) method has been proposed as an alternative to the no-observed-adverse-effect level (NOAEL) approach for assessing noncancer risks associated with hazardous compounds. The benchmark dose method is a more powerful statistical tool than the traditional NOAEL approach and represents a step in the right direction for a more accurate risk assessment. The benchmark dose method involves fitting a mathematical model to all the dose-response data within a study, and thus more biological information is incorporated in the resulting estimates of guidance values. The BMD and the lower confidence limit on BMD (BMDL) of blood lead to cause renal dysfunction were determined in the population exposure to lead. The blood lead level was used as an exposure biomarker, while total protein (TP), beta(2)-microglobulin (beta(2)-MG), and N-Acetyl-beta-D-glucosaminidase (NAG) in the urine were considered as effect biomarkers. The dichotomized data were used as effect endpoints. The BMD and BMDL of blood lead were determined at the 10% benchmark response for the effect biomarkers by using BMDS Version 1.3.1. The results showed that BMD and BMDL of blood lead for NAG, TP, and beta(2)-MG ranged from 323.6 to 754.3 mug/L and 274.2 to 541.5 mug/L, respectively. The BMDL for blood lead was ranked from high to low as TP, beta(2)-MG, and NAG. Urinary NAG activity could be served as a sensitive indicator to detect early renal dysfunction.

Background. To explore the curative effect of Shuangshen Decoction combined with immunological preparations in the treatment of pediatric nephrotic syndrome and its influence on concurrent infection and recurrence rate. Methods. Ninety children with nephrotic syndrome were divided into the routine group and the combined group. The routine group received conventional treatment and immune agents, and the combined group was treated with Shuangshen Decoction on the basis of the routine group. The clinical indexes of the two groups were analyzed and followed up. The infection rate and recurrence rate were calculated. Results. The TCM syndrome scores in the combined group were significantly lower than those in the routine group. The total effective rate of the combined group was significantly higher than that of the routine group. The recurrence rate and infection rate of the combined group were significantly lower than those of the routine group. The incidence of adverse reactions in the combined group was significantly lower than that in the routine group. Conclusion. Shuangshen Decoction combined with immune preparations is effective in treating pediatric nephrotic syndrome and can reduce the incidence of adverse reactions, infection rate, and recurrence rate.