Henoch-Schnlein purpura(HSP) is a common autoimmune small vessel vasculitis that primarily affects children.Although the pathogenesis of HSP is unknown,there are tantalizing clues on the immune abnormalities mediated by IgA,which mainly affects the vessels of the skin,gastrointestinal tract and kidneys.The reasons of deposition maybe involve in the increases of serum IgA,the abnormalities of IgA-specific autoantibodies,structures and acceptors of IgA1,complements,and so on,which mediates the abnormal expressions of adhesion molecules and cytokines.

Congenital heart disease often lost the opportunity of radical sureryfor secondary pulmonary hypertension.pulmonary hypertension is pathologicallycharacterizzed by pulmonary vascular remodeling,including the vascular smooth musclecell' s proliferation,migration and extracelluar matrix deposition,Recently,someresearchers have found that connective tissue growth factor can bind with somesurface receptors of vascular smooth muscle cells,causing some biological behaviorchanges such as proliferation,migration and extracellular matrix abnormaldeposition,and activating crresponding gene expression through this signaltransduction pathway.Pulmonary vascular remodeling may be one of the molecularpathogenesis in pulmonary hypertension.

Objective To draw up a satisfaction rating scale utilized by outpatients in general hospitals,for the quality evaluation of the out-patient service.Methods Outpatients at four municipal general hospitals in Hangzhou City were as the subjects.The validity and reliability of the rating scale were estimated.Results The response rate to items was 98.82% ,and valid rate reached 96.8% ,the internal consistency coefficient was in the range of 0.76 to 0.87.The composition of the scale conforms well to the management practice,the relativity inside the factor was stronger than the relativity among the factors,which supported the contents validity.Factor analysis results demonstrated that both the factor loads and structures were consistent with the structures of the rating scale,which supported the structure validity.Conclusion All of validity indexes of the rating scale meet the requirements of psychometrics.This scale is practicable to estimate the satisfaction of outpatients to the service they received,and provides valuable evidence to estimate the quality of hospital therapeutic services.

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.

Digital subtraction angiography has long been recognized as a gold standard for detecting cerebrovascular lesions.With the development of CT techniques,CT angiography(CTA)has been widely used in intracranial and extracranial vascular evaluation.This article reviews the development of CTA technique and its application in the diagnosis of cerebrovascular lesions.

Objective To investigate the effects of preconditioning with emulsified isoflurane(eISO)on inflammatory response to myocardial ischemia-reperfusion(I/R)injury in rats.Methods Forty SD rats of both sexes weighing 250-280 g were randomly allocated into 4 groups(n =10 each):groupⅠ sham operation(S);group Ⅱ myocardial I/R + normal saline(NS); group Ⅲ I/R + eISO and group Ⅳ I/R + 30％ intralipid(Ⅱ.)(vehicle for eISO).Myocardial ischemia was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 180 min reperfusion.NS,30％ intralipid and elSO 2 ml/kg were infused iv over 30 min at 30 min before myocardial ischemia in groups Ⅱ,Ⅲ and Ⅳ respectively.The animals were killed at the end of 180 min repeffusion.Their hearts were removed for determination of infarct size and myocardial NF-κB p65 and ICAM-1 expression(by immuno-histochemistry)and plasma concentration of TNF-t(by radioimmunoassay).Results Myocardial I/R induced myocardial infarct and significantly increased plasina TNF-a concentration and myocardial ICAM-1 and NF-κB p65 expression in gro up Ⅱ,Ⅲ and Ⅳ as compared with'sham operation group (Ⅰ).Plasma TNF-a concentration and myocardial ICAM-1 and NF-kB p65 expression were significantly lower in group Ⅲ(eISO)than in group Ⅱ and Ⅳ.Conclusion Down-regulation of myocardial NF-kB and ICAM-1 expression and inhihition of inflammatoy response are involved in the mechanism by which preconditioning with iv elso protects against myocardial I/R injury.

ObjectiveTo explore the efficacy of large trauma craniotomy with bilateral frontal coronal incision in treating contusion and laceration of bilateral frontal lobes.MethodsThe clinical data of 68 patients with contusion and laceration of bilateral frontal lobes who were treated with bilateral decompressive craniectomy were analyzed retrospectively.There were 36 cases(observation group) treated with large trauma craniotomy with bilateral frontal coronal incision and 32 cases (control group) given bilateral decompressive craniectomy by stages.The prognosis of two groups were observed and compared.The prognosis was evaluated at 6 months after surgery by Glasgow outcome scale (GOS) score.ResultsThere were 23 cases (63.89％,23/36) who got good recovery,8 cases(22.22％,8/36) with poor prognosis and 5 dead cases (13.89％,5/36) in observation group.There were 11 cases (34.38％,11/32) who got good recovery,9 cases (28.12％,9/32) with poor prognosis and 12 dead cases (37.50％,12/32) in control group.The rate of good recovery and mortality between two groups had significant differences (P ＜ 0.05).ConclusionsThe large trauma craniotomy with bilateral frontal coronal incision can significantly relieve or ease intracranial hypertension of patients with contusion and laceration of bilateral frontal lobes.And it can improve the prognosis and decrease the mortality.

Objective To investigate the protective effect of astragaloside on cardiomyocyte mitochoddria and inhibition effect on cardiomyocytes apoptosis of the rats with heart failure, and explore the treatment mechanism. Methods Sixty SD rats were randomly divided into control group, model group, astragaloside group, and trimetazidine group. The last three groups were injected subcutaneously with isoproterenol to make the heart failure model. Astragaloside group was given astragaloside 50 mg/(kg?d), and trimetazidine group was given trimetazidine 10 mg/(kg?d) orally for three consecutive weeks. At the end of the experiment, the myocardial tissue specimens of each group were made, inverted fluorescence microscope was utilized for measuring mitochondrial membrane potential (MMP), immunoblotting was utilized for detecting cardiomyocyte telomerase reverse transcriptase (TERT) expression, and flow cytometry was untilized for detecting cardiomyocyte apoptosis. Results The MMP ratio of astragaloside group was 3.226±0.371, significantly higher than the model group and trimetazidine group (P<0.01). The cardiomyocyte apoptosis rate of astragaloside group was 8.91±2.12, significantly lower than the model group and trimetazidine group (P<0.01), and the most obvious expression of TERT was found in astragaloside group. Conclusion Astragaloside can protect damaged mitochondria, promote TERT expression, inhibit cardiomyocyte apoptosis and protect cardiomyocytes.