Henoch-Schonlein purpura (HSP) is the most common vasculitis disease in childhood.It is a multisys-tern disease that most commonly affects skin,joints,gastrointestine and kidneys.The causes and pathogenetic mechanisms underlying HSP have not been understood yet.Recently great progress have been made on HSP and attention has been paid to the relationship between P-selectin and HSP.This article summarizes recent work in the advancement of P-selectin and HSP.

Objective To summarize treatment experiences of microsurgical clipping for anterior communicating artery aneurysm via pterional approach.Methods Clinical data of 82 cases undergoing microsurgical clipping for anterior communicating artery aneurysm via pterional approach in the first affiliated hospital of Kunming Medical University from October 2008 to December 2014 were collected and retrospectively analyzed.The patients were divided into different groups by Hunt-Hess illness grading scale,with 11 cases for level 0,7 cases for level Ⅰ,30 cases for level Ⅱ,25 cases for level Ⅲ,8 cases for level Ⅳ,and 1 cases for level Ⅴ.Twenty-one patients underwent operation at early stage of SAH (＜3d),15 at late stage of SAH (4d～2W),and 35 at prolonged stage of SAH (＞2W).The prognosis of patients was evaluated according to GOS classification criteria at discharge.Results A total of 85 ACoAA were found in 82 patients and all of them were clipped and,at the same time,3 aneurysms were resected and 11 thrombuses were punctured,cut and removed.In the operation,15 (17.6％) aneurysms ruptured again and temporary blocking happened for 73 times,with the shortest blocking time of 2 rmin,the longest of 40 rmin,and the average of 9.26min.According to GOS score,good recovery rate was 79.3％ (65/82),moderate disability rate was 12.2％ (10/82),severe disability rate was 3.7％ (3/82),vegetative state rate was 0％,and death rate was 4.9％ (4/82).Good recovery rates for the operations at early,late and prolonged stage of SAH were 85.7％,73.3％ and 82.3％ respectively and for level 0 to level Ⅴ were 90.9％,85.6％,86.7％ and 84.0％,25.0％ and 0.0％ respectively.Results of DSA or CTA re-examination upon 55 patients followed-up at discharge or three months after discharge showed that tumor pedicle were clipped and aneurysm disappeared.Fifty cases were followed up from four months to seven years after the operation,with one case of aneurysm recurrence.Another thirty-two cases were lost to follow-up.ConclusiornS Microsurgical techniques and microdissection are keys to successful operation.Pterional approach can guarantee successful clipping of aneurysms with different directions,locations and sizes.It is also an easy,effective and reliable approach with less postoperative complications.Operation for anterior communicating artery aneurysm should be performed as early as possible.

Objective To observe the migration and distribution of OECs in injured spinal cord and discuss their relation with the recovery of spinal cord function. Methods The rats were contused by a force of 10 g · 25 mm with NYU-impactor at T10 level. The OECs acutely isolated from green fluorescence protein (GFP) rats were purified, identified and then transplanted into the injured site and the rostral and caudal parts of the spinal cord one week after injury, with total volume of the transplanted OECs for 90 000/μl. Within 13 weeks after transplantation, the migration and distribution of OECs were qualitatively observed on the cryo-sections under fluorescence light microscope. The area and the length of OECs distribution were semi-quantitatively determined. The locomotor function of the spinal cord was appraised by BBB score. Results OECs were located collectively in the transplanted site at early stage after transplantation and then spread gradually mainly along the long axis of the cord. OECs could be found in the cavity of the contused spinal cord. The area and the length of OECs distribution were increased from 1.33 mm2 and 4.23 mm respectively at one week to 3.30 mm2 and 7.68 mm respectively at 13 weeks after transplantation. In the meantime, the locomotor function was gradually improved. Conclusion OECs can migrate within the contused spinal cord, as may contribute to the recovery of locomotor function.

Objective To investigate the clinical and pathological features of urothelial carcinoma with clear cell variant.Methods The pathological and clinical data of 7 cases pathological diagnosed urothelial carcinoma with clear cell variant between March 2005 and May 2014 were retrospectively reviewed.There were 6 males and 1 female,aged 46-75 years (mean,61 years).Clinical manifestations included gross hematuria in 5 cases,hematuria and backache in another 2 cases.The mean tumor size was 3.5 cm (ranged 2.0-6.0 cm).One case was multiple tumor and 6 cases were single tumor.Five cases were positive in urine cytology.All the 7 cases accepted surgical treatment,including radical nephroureterectomy in 2 cases,transurethral resection of bladder tumor plus pharmorubicin regular intravesicalinstillationin 1 case,and radical cystectomy in 4 patients.Results Pathological findings revealed that all the tumors were high-grade urothelial carcinoma with clear cell variant in different proportion.Among them,clear cell tumor was predominant in 1 case and focal in other 6 cases.Meanwhile,tumorsaccompanied by glandular differentiation were found in 2 cases,squamous differentiation was found in 1 case,and micropapillary variant was found in 1 case.Vascular tumor embolus was found in 4 cases.Pathological stage was pT2a (n =1),pT2b (n =3),and pT3a (n =3).Immunohistochemicalstaining revealed cytokeratin 7 (+),cytokeratin 20 (+),epithelial membrane antigen (+)and prostate specific antigen (-).Six cases were followed up.The bladder preservation case was followed up for 8 months without recurrence.In 3 radical cystectomy cases,1 died of cancer 25 months after surgery and another 2 case were followed up for 10 and 12 months after surgery without recurrence and metastasis.In 2 nephroureterectomy cases,1 died of tumor metastasis 18 months after surgery and the other case was followed up for 6 months without recurrence or metastasis.Conclusions Urothelialcarcinoma with clear cell variant is a malignancy often with advanced stage and poor prognosis.Radical surgery is recommended for the treatment.

Objective To evaluate the role of transient receptor potential ankyrin 1 (TRPA1) in the dorsal root ganglion neurons in the development of diabetic neuropathic pain (DNP) in rats.Methods Twenty-four Sprague-Dawley rats with DNP were randomly divided into 3 groups (n-=8 each) using a random number table:DNP group,TRPA1-specific siRNA group (siRNA group) and TRPA1-negative siRNA group (NC group).Another 8 Sprague-Dawley rats with normal blood glucose served as control group (C group).In siRNA group,TRPA1-specific siRNA 45 μl was injected intrathecally.In NC group,TRPA1-negative siRNA 45 μl was injected intrathecally.In DNP and C groups,normal saline 45 μl was injected intrathecally.On 2nd day after intrathecal administration,the lumbar segment (L4-6) of the dorsal root ganglions was removed for determination of the expression of TRPA1 mRNA.On 7,14,21 and 28 days after intrathecal administration (T1-4),MWT was measured.Results Compared with DNP group,TRPA1 mRNA expression was down-regulated in siRNA and C groups.Compared with DNP group,and MWT was significantly decreased at T1.2 in siRNA group,MWT was decreased at T1-3 in NC group,MWT was increased at T1-4 in group C.Compared with siRNA group,MWT was significantly increased at T1-4 in group C.MWT was significantly higher at T1~ in group C than in NC group.Conclusion TRPA1 in the dorsal root ganglion neurons is involved in the development of DNP in rats.

Objective To investigate the changes of intestinal floras in elderly patients with first-episode untreated schizophrenia and to analyze the role of intestinal floras in schizophrenia .Methods Thirty elderly patients(≥60 years old) with first-episode un-treated schizophrenia treated in our hospital from July to October 2016 were selected as the observation group ,while 30 healthy peo-ple undergoing physical examination in the same period were selected as the control group .The bifidobacterium ,lactobacillus and bacteroides of stool samples in the two groups were tested by 16SrRNA real-time fluorescence quantitative PCR (qPCR) .Results The bifidobacterium content of stool samples in the observation group was significantly lower than that in the control group ,while the bacteroides content was significantly higher than that in the control group ,moreover the ratios of bacteroides/lactobacillus and bacteroides/bifidobacterium in the observation group were significantly increased ,the difference was statistically significant (P<0 .05);the lactobacillus content had no obvious difference between the two groups .Conclusion The phenomena of intestinal flora disorder and intestinal flora disproportion exist in elderly patients with first-episode untreated schizophrenia .Intestinal flora may be involved in the pathogenesis of schizophrenia .

To evaluate effects and mechanism of Captopril on BP of 2 -kidney, 1 -clip reno-vascular hypertensive rats ( 2K1C - RHR ), Platelets cytosolic free calcium, concentration ([Ca2+]i) and platelets aggregation (PAg) are measured. The results are as follows: [Ca2+ ]; and PAg increase significantly (P

Objective To compare using the transabdominal route versus the transoral route in establishing naso-biliary drainage in laparoscopic surgery.Methods The combined use of laparoscopy with choledochoscopy and duodenoscopy to establish naso-biliary drainage was carried out in 204 patients with gallbladder and common bile duct calculi.In 162 patients,the naso-biliary drainage was established transabdominally and in 42 patients it was established transorally.The success and the complication rates in the two groups were compared.Results Of 162 patients using the transabdominal route,4 patients failed.There were 6 patients (3.7％) who had no output from the nasobiliary drain.There were 3 patients (1.8％) who had only intestinal juice outflow from the nasobiliary drain.Primary closure failed in 3 patients (1.8％),all resulting in bile leak.Pancreatitis occurred in 2 patients (1.2％) after the operation.There was 1 patient (0.6％) whose nasobiliary drain was wrongly ligated.Of 42 patients with nasobiliary drainage using the transoral route,6 patients failed.There was 1 patient (2.4％) who had no output from the nasobiliary drain.There was 1 patient (2.4％) who had intestinal juice output from the nasobiliary drain.Primary closure failed in 1 patient (2.4％) with resultant bile leakage.Pancreatitis occurred in 4 patients (9.5％) after the operation.The success rate of establishing a nasobiliary drainage in the transabdominal group was significantly higher than that in the transoral group,but the complications were less.Conclusions Nasobiliary drainage established through the transabdominal route in laparoscopy surgery for patients with gallbladder and common bile duct calculi was technically easier and had a high success rate.It had less complications.

Objective To investigate the effects of lipopolysaccharide(LPS) on the tryptophan-kynurenine(TRP) metabolic pathway in rat brains and provide new evidence for the relationship between inflammation and depression.Methods Rats in LPS group were given a single dose of 3.5 mg/kg LPS.while the rats in control group were given the same dosage of saline.The dialysis in ventro-hippocampus were collected by microdialysis within 8 hours and then the TRP,KYN and KA were detected by LC-MS/MS.And the expression of indoleamine 2,3-dioxygenase was detected by Western-blot.Results The level of TRP((550.15± 107.96) pmol/L) and KYN ((337.95±62.73) pmol/L) showed a time-dependent increase after administration LPS 4 h compared with the control group(TRP (368.38±59.31) pmol/L,KYN (172.80±43.96) pmol/L),while KA level in the circulation exhibited a trend to decrease,especially at 7 h ((3.47±0.62) pmol/L,P＜0.05).The ratio of KYN/TRP significantly increased at about 5 h (0.69±0.11,P＜ 0.05),and an ratio of KA/KYN (0.02±0.00) was dramatically decreased after administering LPS 4 h compared with the control group (0.05±0.01)(P＜0.05).Most of the analytes showed more dramatic changes around 4 h to 8 h.LPS group(1.48±0.37) increased the protein expression of indoleamine 2,3-dioxygenase compared with the control group(1.00±0.24) (P＜0.01).Conclusions LPS may cause tryptophan metabolic abnormalities and accelerate the way of kynurenine metabolism,leading to decreased the kynurenic acid status.

Objective To investigate the clinical significance of CD28 expression on peripheral blood T lymphocytes in children with juvenile idiopathic arthritis (JIA).Methods Flow cytometry and tri-color direct immunofluorescence were used to examine CD3 + T lymphocyte subsets and CD28 expression in whole blood (using the no-wash method) from 36 children with JIA.Results During the active phase of disease,the frequency of CD28 + expression on both CD4 + and CD8 + T cells in the peripheral blood of children with JIA was significantly lower than in normal controls (P ＜ 0.01).The frequency of CD4 + CD28-T cells in the peripheral blood of children with JIA was significantly higher than in normal controls (P ＜ 0.01).CD4 + T cell counts in the peripheral blood of children with JIA,which were mostly of the CD4 + CD28-T cell subtype,were significantly higher than in normal controls (P ＜ 0.01),whereas the CD8 + T cell count was significantly reduced (P ＜0.01).During the resting phase,CD4 +/CD8 + T cell counts and CD28 expression in the peripheral blood of children with JIA were significantly different from normal controls (P ＞ 0.05).Conclusions The frequency of CD4 + CD28-T cells can be used as an indicator of the active phase of JIA.CD4 + T cell and CD4+ CD28-T cell apoptosis was inhibited in JIA patients.These immune-active T lymphocytes with continued survival can promote the occurrence and development of JIA.