Biological agents has opened a new chapter in the targeted therapy of rheumatism,and provides a new choice for the rheumatism children who is refractory to traditional disease-modifying antirheumatic drugs.This article described the classification,application,efficency,side effects and precautions of the cytokines antagonists and the cell targeting biological agents,to provide a reference for rational application in clinical work.

Paired box2 ( PAX2 ) is a transciption factor which mainly expressed in the developing kid-ney. Researches indicate that PAX2 promote the transcription through interactions with the adaptor PAX transac-tivation domain interacting protein(PTIP). Otherwise,PAX2 protein can lead to chromatin compaction and gene silencing through interactions with Grg4. PAX2 reexpressed in acute kidney injury and involved in promoting cell proliferation. Congenital PAX2 gene mutation is closely related to congenital abnormalies of the kidney and uri-nary tract. In chronic kidney disease,PAX2 promote proliferation and cyst formation. Here,the recent researches on the function of PAX2 and its role in acute kidney injury and chronic kidney disease are reviewed.

Anti- inflmmatory effects of ferulofen(FL)and its mechanisms were studied. In the rat carrageenin pleurisy, FL produced a dose-related reduction of exudate volume, protein contents and leucocyte numbers in the exudate. FL also reduced activity of ?-glucuronidase in the exudate only in higher dose 3 h after carrageenin. These results suggest that FL has a marked anti-inflammatory action and its mechanisms may be similar to indomethacin. Ia vitro, FL caused a dose-dependent inhibition of hydrogen peroxide release from rat peritioneal macrophages ( M0 ) stimulated by opsonized zymosan. It suggested that its anti-inflammatory mechanisms may also relate to inhibitting cell activation. ?-receptor agonist ( Isoproterenol, ISO), in a ineffective dose, synergized with FL in inhibitting M H2O2 release and the synergic mechanism remains to be established.

Objective:To summarize the characteristics of methylmalonic acidemia(MMA) with thrombotic microangiopathy as the prominent manifestation.Methods:Clinical data was collected from MMA patients with thrombotic microangiopathy as the prominent manifestation, who were treated at Shengjing Hospital of China Medical University from September 2014 to December 2019.The clinical manifestations, laboratory results, imaging results, histopathological examination, treatment and prognosis were analyzed.Results:Six children aged 1 month to 7 years old were included in our study, including 5 males and 1 female.Six cases were all MMA complicated hyperhomocysteinemia.All patients had a history of prodromal infection before admission.All cases had edema.Five patients were hypertenson and 4 patients accompanied neurologic presentation.One patient had a family history.All patients were treated with Vitamin B 12, levocarnitine, folic acid and betaine.Three patients′ psychiatric symptoms and renal function were improved and hemolysis were controlled.Two of them were similar with the same age children in intelligence and motor development, with normal renal function, good blood pressure control and normal urine protein.The third one was significantly improved in intelligence development, but still slightly worse than that of the children with the same age.He had no convulsions occurred in recent one year with antiepileptic drugs in oral.His blood pressure was maintained between 135/90-160/110 mmHg(1 mmHg=0.133 kPa), 24-hour urine volume was about 2 000 mL, creatinine was maintained at about 150 μmol/L, ionic level was normal, and urinary protein was 2 + .One case discharged from hospital.Two patients died of multiple organ failure. Conclusion:An early screening of metabolic diseases should be achieved for thrombotic microangiopathy of unknown etiology.Early screening of homocysteine is important for early detection and treatment.

Objective:To study the healing effect of Chitin dressing on second-degree scalds in mice and rabbits respectively.Methods:The model of the second-degree scald was established in mice and rabbits respectively by vapour and hot water;the healing time was observed and the tissue specimens were obtained from the scalds for pathologic analysis.Results:Compared with the contrast group,the healing time in chitin dressing treated group was shorter(P

Objective To identify uropathogens responsible for urinary tract infection in children less than 5 years of age and determine the antibiograms.Methods The data of 523 children(2 months to 5 years old) admitted at the Shengjing Hospital of China Medical University from January 2008 to December 2013 were studied retrospectively.Results Out of 523 children suffering from urinary tract infection,54 (10.3％) were complicated urinary tract infection,including 24 vesicoureteral reflux,8 ureter-pelvic junction stenosis,5 hydronephrosis,4 double kidneys,2 renal dysplasia,2 bladder diverticula,2 bladder ear,2 neurogenic bladder,1 urethral vaginal fistula,1 congenital megaureter,1 horseshoe kidney,and 1 Ureteral cyst and stone.A total of 487 cases underwent urine culture,207 (42.5 ％) had positive bacterial growth,the gramnegative bacteria accounted for 94.69％,gram-positive bacteria 5.31％.E coli was the most common uropathogens in gram-negative bacteria (79.23 ％),the second was Klebsiella (5.31％),the third was Proteus mirabilis(2.90％).Gram-positive bacteria was almost Enterococcus (4.35％).Twenty one strains were extended-spectrum beta-lactamase enzyme positive(ESBLs +),and they were sensitive to imipenem,amikacin and piperacillin/tazobactam.Conclusion The clinical features were atypical in children with urinary tract infection,we should investigate the underlying causes such as urinary anomalies or stones.E coli was still the most common uropathogens in children with urinary tract infection,the empirical therapy should according to the patient's conditions while awaiting the culture and sensitivity results.

Objective To examine the clinical features and long - term outcome of pediatric IgA nephropathy and to explore the clinical effect of Mycophenolate Mofetil(MMF)and Cyclophosphomide(CTX)in children with IgA nephropathy with nephrotic syndrome(NS). Methods A single - centre,retrospective,observational study of 115 chil-dren with IgA nephropathy from 2004 to 2013 in Pediatric Nephrology of Shengjing Hospital of China Medical University was conducted. Demographic and clinical data were reviewed retrospectively for age,sex,medical history,presenting symptoms,medications,follow - up duration and the responsiveness to treatment. Results In all children,NS occurred in 20(17. 4% ). There were 35 patients(30. 4% )with non - NS and 60 patients(52. 2% )with isolated hematuria. No special treatment in patients with IgA nephropathy with isolated hematuria. Among patients with proteinuria less than 20 mg/(kg·d),12 patients were treated with angiotensin - converting - enzyme - inhibitor(ACEI),8 patients were trea-ted with ACEI and corticosteroid. At all time points,mean proteinuria was significantly decreased in ACEI and cortico-steroid group compared with ACEI group(P ﹤ 0. 001). Patients with 20 - 49 mg/(kg·d)proteinuria were treated with ACEI and corticosteroid. At all time points,mean proteinuria was significantly decreased compared with the prior time point. Patients with NS were treated with MMF and corticosteroid or CTX and corticosteroid. Eleven patients were trea-ted with MMF,9 patients were treated with CTX. A significantly difference was seen after 3 months in proteinuria greater decrease from pretreatment in CTX group than those in MMF group(P ﹤ 0. 001). No significant difference in proteinuria was observed at other time point. No significant change in white blood cell count was observed in MMF group and CTX group. No serious complication developed in any patient during treatment. During the median follow - up of 35. 2 months (range 4. 0 - 124. 6 months),no patient progressed to end stage renal disease. Conclusions IgA nephropathy patients with isolated hematuria should be long - term followed up. Children with non - nephrotic - range proteinuria should be treated with ACEI or corticosteroid. Patients with NS should be treated with corticosteroid and MMF or CTX. The long -term prognosis within 3 - 5 years should be good if proteinuria within normal range in pediatric IgA nephropathy pa-tients.

Objective To compare the treatment response of plasma exchange and immunoadsorption for children suffering from severe systemic lupus erythematosus (SLE),and then find the more advantageous treatment method.Methods Between March 2007 and March 2013,27 children with severe SLE were collected from the Department of Pediatric Nephrology and Rheumatology of Shengjing Hospital of China Medical University.Part of them about 11 children accepted plasma exchange treatment (plasma exchang group) and the others accepted immunoadsorption(immunoadsorption group).The clinical features,ANA,IgG,serum ions,the cost of treatment and the hospitalization time were reviewed,and the comparative analysis were performed in two groups.Results There were comparabilities between plasma exchange group and immunoadsorption group in age,gender,couse of disease and systemic lupus erythematosus disease activity index(SLEDAI) score before treatment.(1)In plasma exchang group,11 children were conducted 26 times treatment.The SLEDAI score significantly decreased after plasma exchange (19.00 ± 3.77 vs 5.34 ± 4.35,P ＜0.05),and the ANA and IgG significantly decreased as well[2 439.58 ± 1 430.56 vs 303.54 ± 169.32; (8.35 ± 5.67) g/L vs (4.04 ± 2.23) g/L,P ＜ 0.05].(2) There were 16 children in immunoadsorption group,they accepted immunoadsorption treatment about 44 times.The SLEDAI score after immunoadsorption significantly decreased (18.25 ± 4.62 vs 4.25 ± 2.23,P ＜ 0.05),and the ANA and IgG significantly decreased as well [2 560.39 ± 1 563.78 vs 289.62 ± 137.62 ; (9.98 ± 6.03) g/L vs (3.23 ± 1.37) g/L,P ＜0.05].(3) There were no statistical differences in the value of SLEDAI score,ANA and IgG after the treatment between two groups.(4) The concentrations of serum potassium,sodium and chlorine and calcium in the children treated by plasma exchange or immunoadsorption were consistent with the original.(5) The hospitalization expense in plasma exchange group was distinctly higher than that of immunoadsorption group (P ＜ 0.05).(6) There was no significant difference in the length of hospitalization between two groups [(33.6 ± 8.60) d vs (31.9 ± 14.6) d,P ＞ 0.05].Conclusion The treatment both plasma exchange and immunoadsorption were effective methods for the children with severe SLE.However,the cost of plasma exchange was much higher and had a great influence on the concentration of antihypertensive drugs.

Objective To investigated the effect of procyanidin (PC) on the expression of cysteine proteinase -3 (Caspase -3) in type 2 diabetes mellitus SD rats with focal cerebral ischemia. Methods Following the random principle, 40 healthy Sprague - Dawley (SD) rats were numbered sequentially and randomly divided to normal rats with focal cerebral ischemia group,type 2 diabetes mellitus SD rats with focal cerebral ischemia group,PC low/ middle/ high -dose groups,with 8 rats in each group. The type 2 diabetes mellitus - MCAO model was set up. The doses of PC for low,middle and high - dose groups were 50 mg/ kg,100 mg/ kg,200 mg/ kg. Immunohistochemistry method was used to measure the activity of Caspase - 3. Results Compared with that in the normal rats with focal cerebral ischemia group[(11. 42 ±2. 52)],the expression of Caspase -3 increased in the type 2 diabetes with ischemia group[(15. 00 ± 2. 38)](t = 2. 17,P < 0. 01). Compared with that in the type 2 diabetes with ischemia group,the expression of Caspase - 3 decreased in the PC groups[(9. 38 ± 2. 00),(7. 71 ± 1. 55),(6. 96 ± 1. 57)](t = 2. 86,3. 13,3. 36,all P < 0. 01),whereby the middle and high - dose groups showed more significant decrease (t = 1. 92,2. 03,all P <0. 01) and with no statistically significant difference between the two groups(t = 1. 13,P > 0. 05). Conclusion PC can decrease the expression of Caspase - 3 protein in type 2 diabetes mellitus SD rats with focal cerebral ischemia, finally may inhibit the apoptosis.

Objective To investigate the mechanism of antioxygen reaction of epigallocatechin-3-gallate (EGCG) in renal tubular epithelial cells of rats with oxidative stress induced by H2O2. Methods Cultured cells were divided into control group, H2O2 group and EGCG group. Cell survival was observed with MTT. The expressions of Nrf2 mRNA and -γ-GCS mRNA in cultured cells were examined by real time quantitative PCR. Immunohistochemistry and western blotting were used to detecte the expressions of Nrf2 and γ-GCS protein. Results The survival rate of tubular cells was 97. 61 ± 6.33 in control group. There was a significant decrease in H2 O2 group (56. 38 ± 5.57) (P < 0.01), while increased when the EGCG concentration were 5,10,20 mg/L(77.42 ±5.31,83.27 ±5.94,90.24 ±5.72) (P <0.05,P <0.01). EGCG up-regulated the expressions of Nrf2 and γ-GCS mRNA and protein in renal tubular epithelial cells with dose depen-dentment. Conclusion The expressions of Nrf2 and-γ-GCS increase in renal tubular epithelial cells with oxidative stress. Resulting from suppression of oxidative stress,EGCG exerts protective effect on NRK,and this antioxidative effect may be partly induced by activating the Nrf2 signal pathway.