Renal interstitial fibrosis is basically the common terminal pathway of various progressive renal diseases. Decrease of interstitial capillary density plays an important role in renal interstitial fibrosis. Endothelial progenitor cells can be induced to differentiate into mature vascular endothelial cells. They contribute to angiogenesis and angiopoiesis, and therefore may be a potential therapeutic approach for chronic kidney disease..

Evans syndrome is a rare autoimmune disease.Clinical presentation are the different degrees of bleeding and hemolysis,similar to immune thrombocytopenia and autoimmune hemolytic anemia.The treatments are divided into first-line therapy,second-line therapy and third-line therapy,including corticosteroids,intravenous immunoglobulin; immunosuppressive agents,splenectomy; haemopoietic stem cell transplantation,romiplostim and so on.The treatment of refractory Evans syndrome is difficult.Immunosuppressive agents and haemopoietic stem cell transplantation are effective.This review focuses on recent developments in the treatment of Evans syndrome.

Objective To observe the effect of gastroscopy injection of norepinephrine combined with routine triple therapy on peptic ulcer with gastrointestinal bleeding. Methods 84 cases of gastroscopy upper gastrointestinal bleeding caused by peptic ulcer patients were randomly divided into two groups, the control group 42 cases;the observation group 42 cases, the observation group was guven endoscopic injection of norepinephrine combined conventional triple therapy,the control group was given conventional triple therapy with hemostatic therapy. Efficiency and adverse reactions were observed in patients. Results In the observation group,36 csses was significantly effective,5 cases was effective,1 case was not effective,the total effective rate was 97.6%. In the control group,21 cases was significantly effective, 16 cases was effective ,5 cases was not effective,the total effective rate was 88. 1% ,the difference of the total effective rate between the two groups was significant( x2 =5. 137, P ＜ 0. 05 ). There was no serious adverse reactions in the two groups. Conclusion Endoscopic injection of norepinephrine and routine triple therapy in treatment of gastrointestinal hemorrhage of peptic ulcer was significantly better than conventional medical treatment alone.

Objective:To discuss the method of Video Assisted Thoracoscopy(VATS) in diagnosis and treatment of small peripheral lung neoplasm.Methods:A wedge-shaped excision with VATS had been performed on 20 patients with small peripheral lung neoplasm.The sample had been sent to pathology during surgery.Lobectomy was done with the malignant tumor.Results:14 cases(70%) were malignant in stage IA ,6 cases were benign.The mean follow-up time postoperatively was 24 months(12～36months),there was no relapse case.Conclusion:For those patients,the diameter of neoplasm is smaller than 15mm,and antibiotic treatment is ineffective for 2～3 weeks,VATS can be available for diagnosis and treatment.

Since the current diagnostic techniques difficult to accurately distinguish the source of uric candidas between colonization and infection,making the clinical status and the value of diagnosis and treatment of candiduria were not given sufficient attention.This paper analyzes research and case reports of cadiduria both home and abroad,and the results showed that there is a close relationship between candiduria and candidemia,and candiduria has more easier initiated the invasive candidiasis than other sites colonization of candidas.So it is worth to give more clinical attention,especially for critical patients,and should be active in antifungal therapy after identified the cause of candiduria.

Objective To investigate the pathogeny,pathological characteristics and treatments of anorectal malformation induced postoperative dysporia in children.Methods Between January 1985 and December 1998,120 children with anorectal malformation were treated.Of thesepatients,follow-up has ranged 106 children(78 males,28 females),from 4 to 14 years (median,10 years).The ratio of follow-up was 80%.Results 38 patients were high-type anomalies (36%),and with postoperative dysporia (36%),32 patients were intermediate-type anomalies (30%),15 cases with postoperative dysporia (14%),36 patients were low-type anomalies (34%),6 cases with postoperative dysporia (6%).Conclusions Among the high anorectal malformation patients,no one reached normal fecal continence.This may be due to bony spinal deformities and variable degrees of neurologic deficit.Intermediate and low anorectal malformation induced postoperative dysporia may be associated with surgical techniques.The application of laparoscopic assisted techniques for high and intermediate anorectal malformation has led to dramatic improvement in postoperative dysporia.

Objective:To analyze the reasons of complicated arrhythmia after resection of lung. Methods:The relation of arrhythmia with age, operation mode,preoperative lung function and postoperative blood gas of 562 cases of lung resection were analyzed. Results:There were 104 of 562 cases (18.5%) complicated with arrhythmia postoperatively. 38.77% of them were older than 70 years. 27.72% had operation of pneumonectomy.The parameters of FEV 1,MVV,FVC lower than 50% were 67.24%,46.53% and 67.93% respectively.Postoperative blood gas analysis of the 23 cases showed that Po 2 was lower than 60 mmHg,Pco 2 was higher than 45 mmHg,So 2 was lower than 96%.21 of them developed postoperative arrhythmia.After tracheotomy and immediately correcting anoxia,all the 21 patients recovered from arrhythmia within 3 days.4 patients died in this group(3.84%).Conclusion:Pneumonectomy,in patients older than 70,results in the parameters of FEV 1,MVV and FVC lower than 50%.Significant anoxia is the cause of arrhythmia.

Objective To explore the influence of psycho-behavioral intervention on psychological status and quality of life in patients with gastroesophageal reflux disease (GERD). Methods 62 patients with GERD were divided into intervention group (n=30) and control group (n=32). Both groups received routine treatment, and the intervention group received psychological care applying cognitive, emotional,behavioral, social support intervention in addition. They were assessed with Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Generic Quality of Life Inventory (GQOLI) before and 6 weeks after intervention. Results The scores of SAS, SDS, and GQOLI (all the dimensions and total) improved in the intervention group compared with the control group after intervention (P<0.05). Conclusion Psycho-behavioral intervention can reduce the anxiety and depression, and improve the quality of life for patients with GERD.

BACKGROUND:About 50% patients with coronary heart disease have no symptoms of cardiac disease before the first onset of myocardial infarction. Therefore, it is of great importance to make early and accurate detection of coronary heart disease and myocardial ischemia.OBJECTIVE: To measure the time of heart repolarization with magnetocardiography and probe into the role of non-invasive magnetocardiographic examination in evaluating cardiac function in patients with coronary heart disease.DESIGN: Case-control observation.SETTING: Department of Cardiology of Philippustift Hospital, Essen,GermanyPARTICIPANTS: Totally 52 patients hospitalized for suspected coronary heart disease in the Department of Cardiology of Philippustift Hospital(Essen, Germany) between March 1998 and December 2002 were recruited,and another 10 patients diagnosed as old myocardial infarction were set as myocardial infarction group. Informed consents were obtained from the patients. Totally 32 healthy volunteers aged above 40 years old were recruited as the control group.METHODS: All the patients received the following examinations: physical and laboratory examinations, rest and stress electrocardiography(ECG), echocardiography, coronary artery angiography and magnetocardiography(MCG) examination. The control group received only rest ECG and MCG examination. The values of QT dispersion with ECG and MCG were compared between the patients and healthy controls. The diagnostic criteria for coronary heart disease: stenosis of one coronary artery ≥ 75% according to coronary artery angiography; index of repolarization time of the heart was measured with MCG QT dispersion and MCG dispersion coincidence (the mean of probe signal and QT dispersion of peripheral probe in each MCG).MAIN OUTCOME MEASURES: ECG QT dispersion, MCG QT dispersion as well as coincidence index of QT dispersion of the observed subjects in each group.RESULTS: The 52 patients with suspected coronary heart disease,10 with myocardial infarction, and 32 healthy controls all entered the result analysis. The patients with suspected coronary disease were divided into 2 groups: group with coronary heart disease (n=27) and group without coronary heart disease (n=25). [1] Comparison of ECG QT dispersion: there was no significant difference among the groups(P ＞ 0.05). [2] Comparison of MCG QT dispersion: MCG QT dispersion in myocardial infarction group was significantly higher than that in control group [81.3±21.5, 52.4±13.6 (F=13.113, P ＜ 0.05)]. [3]Comparison of coincidence index of QT dispersion: Coincidence index of QT dispersion in myocardial infarction group and coronary heart disease group was both significantly higher than that in control group [15.6±4.2, 14.9±4.1, 10.2±2.7 (F=2.403, 3.332, P ＜ 0.01)].CONCLUSION: Compared with ECG, MCG can better reflect changes in the repolarization process of patients with coronary heart disease,and coincidence index of dispersion is superior to QT dispersion. This is because MCG is more sensitive to tangential currents presented at the precardial region when myocardial ischemia and infarction occur.