Autoimmune polyendocrinopathy syndrome type Ⅰ( APS-Ⅰ) is a rare autosomal recessive disorder caused by mutations in autoimmune regulator gene( AIRE) . A number of mutations have been described in the AIRE gene of patients with APS-Ⅰ, including nonsense mutation, missense mutation, silent mutation, splice site mutation, insertions and deletions mutation, et al. The mutation characteristics of the APS-Ⅰ pathogenic gene have been reviewed in the article.

Objecfive To detect serum antibodies to Pmp in patients with urogenital Chlamydia trachomatis infection and to assess the relationship between Pmp and urogenital C.traehomatis infection.Methods Twenty healthy adults and 77 patients with urogenital C. trachomatis infection were recruited into this study.A 3-month foilow-up was carried out in 43 patients,who were classified into persistent infection group(n=19)and negative-conversion group(n=24).Western-blot was performed to detect serum antibodies to Pmp in all subjects.Results The positivity rate of anti-Pmp antibodies was 90.20% (71/77) in patients,significantly higher than that in the normal controls[20% (4/20),P<0.05].All the 9 types of anti-Pmp antibodies were detected in patients with a varying positivity rates,which were 61.04% (47/77),88.31% (68/77),63.63% (49/77),28.57% (22,77),63.63% (49/77),75.32% (58/77),62.34% (48/77),77.92% (60/77)and 70.13% (54/77) for antibodies against PmpA,PmpB,PmpC,PmpD,PmpE,PmpF,PmpG,PmpH and PmpI respectivelyThe prevalence was highest for anti-Pmp B antibodies and lowest for anti-Pmp D antibodies.There was no significant difference in the positivity rate of anti-Pmp antibodies between persistent infection group and negativeconversion group.Conclusions Anti-Pmp antibodies could be generated in patients infected with C. trachomatis.The immunogenicity of different Pmps is different,and the immunoprotective activity of Pmps is rather weak.Individual differences exist in serum anti-Pmp antibodies among patients.Nine types of Pmps are expressed in patients with urogenital C. trachomatis infection.

Objective To discuss the clinical value and nursing of the three-endoscope in the treatment of eholedoeholithiasis. Methods 45 eases of choledocholithiasis patients who were treated with LCDE (three-endoscope) were named as the research group.56 patients who received traditional open ab-dominal surgery were set as the control group. The average hospitalization time and satisfaction degree with nursing were compared, t test and χ2 test were adopted. Results The average hospitalization time was shorter and satisfaction degree with nursing was higher in the research group than those in the control group. Conclusions The treatment of choledochohthiasis with three-endoscope is safe and feasible, es-pecially when combined with antibiotics lavage and stone dissolution through naso-biliary duct.The opera-tion can widen the surgical indication,reduce the risk of surgery with little damage,clear stones completely, reduce postoperative complicatioas,make patients recover faster, shorten the hospital stay and achieve the same or better treatment results when compared to the traditional open abdominal surgery.

Objective To report 1 case with renal immunoglobulin light and heavy chain deposited disease (IgG-κ light chain and γ1 heavy chain).Methods The clinical manifestations,serum immunofixation electrophoresis,light and heavy chain abnormalities of blood and urine,bone marrow biopsy and renal biopsy data laboratory data were recorded and analyzed.Results A 63-year-old woman presented with massive proteinuria,microscopic hematuria,hypertension,anemia and serum IgG-κ light chain.Bone marrow aspirate revealed 4％ plasma cells.Renal biopsy revealed nodular glomerulopathy with congo red staining-negative.Immunofluorescence showed that κ light chain and IgG1 (γ1 heavy chain) were deposited along the glomerular basement membranes (GBM) and tubular basement membranes (TBM).Electron-microscopy revealed electrondense deposits that delineate the outer aspect of TBM and endothelial aspect of GBM.Conclusion The diagnosis of renal immunoglobulin light and heavy chain deposited disease (IgG-κ light chain and γ1 heavy chain) should be addressed combine with clinical and is pathology,especially with immune pathological examination.

Objective Membranous nephropathy ( MN) is rarely complicated by crescents.This study was to observe the clinicopathologic characteristics of MN with crescents. Methods This retrospective study included 53 cases of biopsy-proven idiopathic MN with crescents in the absence of immunologic and clinical etiologic factors and another 100 MN patients without histological crescents as controls.The clinicopathologic features, treatment response, and out-comes were analyzed and compared between the two groups of pa-tients. Results Significantly higher percentages of hypertension and decreased eGFR were observed in the MN +crescents group than in the control (47.2%vs 19.0%, P<0.05;28.3%vs 40.%, P<0.05).Circulating autoantibodies against the M-type phospholipase A2 receptor (PLA2R) were found in 66.7%(30/45) of the patients.The glomeruli exhibited a median of 4.6%(1.8%-35.3%) involvement of crescents.Compared with the controls, the MN +crescents group showed remarkably higher rates of segmental glomer-ulosclerosis lesions (16.0%vs 49.1%, P<0.05), capillary loops necrosis (0.0%vs 11.3%, P<0.05), interstitial fibrosis/tubu-lar atrophy (IFTA) (54.0%vs 86.8%, P<0.05) and afferent arterial lesions (65.0%vs 92.5%, P<0.05).No significant differ-ences were found in the outcomes of the two groups of patients. Conclusion MN with crescents is rare, and secondary MN and cres-centic glomerulonephritis should be considered.Crescentic MN usually presents with hypertension and renal dysfunction clinically and high rates of severe segmental and global glomerulosclerosis, capillary loops necrosis, and IFTA histologically.The condition has a fa-vorable short-term prognosis.

Objective To investgute the effect of lO-Hydrocamptothecin (HCPT) on collagen induced arthritis (CIA) rats, and to explore the potential value of it in the treatment of Rheumatoid arthritis(RA). Methods After the model of CIA was established ,the rats were randomly divided into five groups: control group, CIA model group, MTX treatment group, high dose HCPT treatment group and low dose HCPT treatment group. The synovium was examined with regular HE stain and the apoptosis of synoviocytes was detected with TUNEL All these pathological changes were evaluated. In addition, the change of articular volume was measured,and the serum TNF-α and IL-1β level was also measured at different time point. The results were analyzed by the statistical software SPSS 11.5. Results Comparing to CIA model group, both MTX and HCPT group could improve patients' general condition, alleviate joint swelling, inhibit proliferation of synoviocytes, induce apoptosis of synoviocyte and decrease the plasma level of TNF-α, IL-1β (P<0.05), however, there was no significant difference could be found between the MTX and HCPT group (P>0.05). Conclusion HCPT has the potential value in the treatment of RA.

Objective To investigate the effects of exercising on a cycle ergometer on lower limb motor function and the walking ability of hemiplegic stroke patients.MethodsSixty hemiplegic stroke patients were randomly divided into a treatment group and a control group with 30 in each. Both groups were treated with routine rehabilitation, but the treatment group also undertook cycle ergometer training. The training lasted for 10-20 min/d, 6 d/week for 6 weeks. All patients were assessed with the Fugl-Meyer lower limb assessment ( FMA), functional ambulation category (FAC) classification and the modified Barthel index (MBI) pretreatment and 6 weeks post treatment.ResultsBefore intervention there was no significant difference between the two groups in any of the assessments. Six weeks post treatment, the average FMA, FCA classification and MBI results in the treatment group were significantly better than those pretreatment and better than those in the control group.ConclusionsCycling exercise combined with routine rehabilitation training can distinctly improve the motor function of the lower limbs and the walking ability of hemiplegic stroke patients.

Objective To clone, express and purify Chlamydia trachomatis polymorphic membrane protein (Pmp G), and to identify its immunogenicity. Methods The Pmp G gene of C. trachomatis serotype E was amplified by PCR, cloned into prokaryotic expression vector PET30a (+). The positive recombinant was transformed into the bacterium E coli (BL-21), identified by enzyme digestion, PCR amplification and gene sequencing. Then, it was induced to express followed by the identification of expression product with SDS-PAGE and Western blotting. The purified protein was used to immunize BALB/C mice to test its immunogenicity. Results PCR produced a 1092 bp-sized DNA fragment, which had a sequence consistent with that of PmpG gene of C. trachomatis E type in the GenBank database. The molecular weight of expression product was 55 kD, which was proved to be the expected size, and Western Blotting confirmed it to be the specific protein. Moreover, special antibodies to PmpG were induced to be generated by mice immunized with the purified protein. Conclusions The constructed prokaryotic expression vector for PmpG is expressed successfully in E. coli, and the expression product shows immunogenicity.

The expressions of NF-κB and PPARγ were increased in adipose tissue of insulin resistant rats.The angiotensin receptor blocker decreased NF-κB protein expression by 21%,increased PPARγ protein expression by 28%and diminished adipocyte size,suggesting that these findings may be involved in the improvement of obesity-induced inflammation and insulin resisitance.

Objective To construct a model for persistent genital tract infection with Chlamydia trachomatis in mice with low serum iron. Methods Iron deficiency was induced in female BALB/c mice by lowiron diet. Mice with or without iron-deficency were inoculated intravaginally with direct instillation of 50 μl of bacterial suspension containing 3.4344 × 107 IFU/ml of C. trachomatis serovar E elementary body 1 week after intramuscular injection of progesterone. Moxifloxacin and ferrous sulfate, alone or in combination were given to inoculated mice with iron deficiency daily for 1 week. Subsequently, vaginal discharge was obtained from mice and observed under an immunofluorescence microscope, and tissue specimens were resected from the uterus,uterine tube and ovary of mice and subjected to pathological examination at various time points. Results Compared with normal-iron mice, iron-deficient mice were infected with C. trachomatis for a longer duration (more than 18 weeks). After 18-week infection with C. trachomatis, there was an obvious chronic inflammation and lymphocytic infiltration in tissues specimens from the uterus,uterine tube and ovary of mice. Immunofluorescent examination of vaginal discharge for C. trachomatis turned negative in 60% of iron-deficient mice treated with both moxifloxacin and ferrous sulfate, but not in any of those receiving moxifloxacin or ferrous sulfate alone. Conclusion As animal models show, low serum iron may contribute to the persistent genital tract infection with C. trachomatis.