Objective To investigate the incidence and clinical characteristics of urinary carcinoma in the patients with aristolochic acid nephropathy(AAN)in uremia stage who received maintenance hemodialysis or renal transplantation.Methods The data of 38 AAN patients who had received renal replacement therapy and treated in the authors' service from Mar.2000 to Dec.2006 were reviewed,and the incidence and clinical pathological features of urinary carcinoma in these 38 AAN patients were summarized,in order to look for correlation between the frequency of hemodialysis and the occurrence of carcinoma.Results 15 of the 38 AAN patients received hemodialysis,and the remaining 23 patients underwent renal transplantation.During the follow-up period,seven patients who received hemodialysis were reported to have developed urinary carcinoma,the incidence was 46.7%(7/15),which was significantly higher than the incidence in patients who had undergone renal transplantation(3/23,13.0%;P0.05).Conclusion The prevalence of urinary carcinoma was much lower in the AAN patients who had undergone successful renal transplantation than in those patients who received only maintenance hemodialysis.Renal transplantation may be of a better treatment for the AAN patients in uremia stage.There was no correlation between the frequency of hemodialysis and the incidence of carcinoma.

Objective:To compare clinical and radiographic success rates of a modified primary root ca-nal filling ( ingredients:zinc oxide-eugenol, iodoform and calcium hydroxide, MPRCF) vs. zinc oxide-eugenol cement ( ZOE) and calcium hydroxide/iodoform paste ( Vitapex) in pulpectomized primary mo-lars at the end of 6 and 12 months, and to evaluate the degradation of materials in the root canals and in apical area. Methods:In the study, 160 primary molars from 155 children ( the average age:5. 88 ± 1. 27 years) that met the inclusion criteria were allocated to one of the three materials via block randomi-zation. A two-visit pulpectomy was performed by an investigator. The clinical and radiographic diagnoses were blindly assessed by other two investigators. Results:At the end of 6 and 12 months, the ZOE and MPRCF success rates were 100% both in clinical and radiographic evaluation. The Vitapex group showed the clinical success of 100% at the end of 6 months and 94. 5% at the end of 12 months. Radiographic evaluation for the Vitapex group showed 80 . 4% success at the end of 6 months and 60 . 7% at the end of 12 months. No statistically significant differences were noted at the end of 6 months in the three groups both in clinical and radiographic evaluation. The success rates in clinical and radiographic evaluation at the end of 12 months for ZOE and MPRCF groups were not significantly different, and better than those for Vitapex group with statistically significant difference. The completely resorb rate of excess extruded extraradicularly were 14. 3%, 100% and 71. 4% for ZOE, Vitapex and MPRCF at the end of 12 months. The rates of resorption of material at the same rate of the root were 5. 8%, 7. 2% and 40. 9% for ZOE, Vi-tapex and MPRCF at the end of 12 months. Conclusion:MPRCF, a mixture of zinc oxide eugenol and io-doform with calcium hydroxide can be used as a root canal filling material in primary teeth, taking account of the success rate and resorbing at a similar rate with the roots of the primary teeth.

Objective To investigate the clinical effect and safety of kidney transplantation from donors with severe hand-foot-mouth disease (HFMD).Methods Five cases of kidney transplantation from three donors with HFMD between Jan.2014 and Dec.2016 were analyzed.The age of three donors was 2 years,2 years and one month,and 3 years and 11 months respectively,and body weight was 11 kg,10 kg and 15 kg respectively.The age of recipients ranged from 26 to 41 years and weight from 50 to 59 kg.Single kidney transplantations were performed on 4 cases,and dual separating kidney transplantation on one case.Results One case of the transplantations was failure due to the allograft artery thrombosis.The rest 4 cases gained satisfied clinical effect.None of the 5 cases showed any symptoms associated with HFMD.Conclusion The clinical effect of kidney transplantation from donors with severe HFMD is satisfactory.The organs from donors with severe HFMD could only be used by adult recipients.

OBJECTIVE: To explore the nature of pathology of sluggishness of lung-defensive qi and to offer objective experimental indexes for weifen syndrome (defensive phase syndrome). METHODS: According to the completely random design, the plasma levels of vasoactive intestinal peptide (VIP) and thromboxane B2 (TX2) of 19 patients with weifen syndrome and 13 patients with qifen syndrome (qi phase syndrome) were detected by radioimmunoassay. The plasma levels of VIP and TX2 at different stages of weifen syndrome and qifen syndrome were observed. RESULTS: The plasma levels of VIP in weifen syndrome and in the late stage of weifen syndrome increased greatly at different stages as compared to qifen syndrome and the blank group (P < 0.01), while the plasma level of TX2 of weifen syndrome was higher only at the late stage than the blank group and qifen syndrome (P < 0.01). As for the levels of VIP and TX2 in weifen syndrome with different internal organs infected, there was no significant difference (P > 0.05). CONCLUSION: VIP may be an index reflecting the pathology of weifen syndrome, and it is one of the material foundations of sluggishness of lung-defensive qi, but it has nothing to do with the infected internal organs. The level of TX2 increases only after the fever of patients with weifen syndrome subsided, so it can not be the basis for diagnosis of the early stage of weifen syndrome. It doesn't increase in qifen syndrome either, the mechanism remains to be further studied.

Objective:To investigate the relationship between the mechanism of mental dependence of propofol and adenosine A2A receptor-neurotransmitter-extracellular signal-regulated kinase (ERK) pathway in rats.Methods:Forty-eight healthy male Sprague-Dawley rats, aged about 7 weeks, weighing 200-300 g, were used in this study.The model of propofol dependence was established by intraperitoneal injection of propofol 40 mg/kg for 14 consecutive days.The rats were divided into 6 groups ( n=8 each) using a random number table method: central control group (group c-C), central agonist group (group c-CGS), central antagonist group (group c-DMPX), peripheral control group (group p-C), peripheral agonist group (group p-CGS) and peripheral antagonist group (group p-DMPX). Adenosine A2A agonist CGS-21680 2.5 ng/0.5 μl was intracranially injected immediately after establishing the model in group c-CGS, while the equal volume of normal saline was given instead in c-C group.CGS-21680 0.1 mg/kg was intraperitoneally injected in group p-CGS, while the equal volume of normal saline was given instead in group p-C.Adenosine A2A receptor antagonist DMPX 50 ng/0.5 μl was intracranially injected at 20 min before each propofol injection in group c-DMPX, and DMPX 0.25 mg/kg was intraperitoneally injected in group p-DMPX.The position preference value (CPP value) was determined before establishing the model, immediately after establishing the model, and after administration of agonist or normal saline (after intervention). The animals were sacrificed at 1 day after establishing the model, and blood samples and brain tissues were obtained for determination of the levels of dopamine (DA) and glutamate (Glu) in plasma and hippocampus and content of serotonin (5-HT) in cerebral cortex (by enzyme-linked immunosorbent assay) and expression of phosphorylated ERK1/2 (p-ERK1/2) in cerebral cortex (by Western blot). Results:Compared with the baseline before establishing the model, CPP value was increased immediately after establishing the model in c-C, c-CGS, p-C and p-CGS groups ( P<0.05), and no significant change was found in CPP value immediately after establishing the model in c-DMPX and p-DMPX groups ( P>0.05). Compared with the value immediately after establishing the model, no significant change was found in CPP value after intervention in c-C and p-C groups ( P>0.05), and CPP value was increased after intervention in c-CGS and p-CGS groups ( P<0.05). Compared with group c-C, the contents of hippocampal DA and Glu were significantly increased in group c-CGS, and the contents of hippocampal Glu were decreased, the content of 5-HT in cerebral cortex was increased, and the expression of p-ERK1/2 was down-regulated in group c-DMPX ( P<0.05). Compared with group p-C, no significant change was found in levels of DA and glutamate (Glu) in plasma and hippocampus and 5-HT and p-ERK1/2 in cerebral cortex in group p-CGS ( P>0.05), and the contents of hippocampal DA and Glu were significantly decreased, the content of 5-HT in cerebral cortex was increased, and the expression of p-ERK1/2 was down-regulated in group p-DMPX ( P<0.05). Conclusion:The mechanism underlying the development of propofol mental dependence may be related to activating adenosine A2A receptors, increasing excitatory neurotransmitters in brain, and thus up-regulating ERK activity in rats.

Objective:To discuss the strategies of distal embolic filter protection(DEFP) during excimer laser ablation (ELA) or percutaneous mechanical thrombectomy (PMT) in treatment of peripheral artery disease.Methods:Clinical data of 29 patients undergoing ELA or PMT under the DEFP from Oct 2019 to Aug 2021 were retrospectively collected to analyze the strategies of DEFP and high-risk factors of capturing clinically significant macrodebris.Results:There were 21 males and 8 females, aged (70.3±11.0) years with 32 lesions (29 limbs) including 5 in-stent restenosis (ISR), 10 thrombosis and 17 chronic total occlusion (CTO). The technical success rate of DEFP device release and recovery was 100%. The overall debris capture rate was 77.3% and the macrodebris capture rate was 36.4%. Even with DEFP the distal embolization (DE) incidence was 3.4%. When ELA for CTO with severe calcification or long-segment ISR lesions, the capture rate of macrodebris was as high as 60.0%, and the former was significantly higher than ELA for CTO without high calcification lesions ( P<0.05). Conclusion:ELA or PMT under the DEFP in treatment of peripheral artery disease appears to be of great significance in preventing DE.