Objective To determine the therapeutic effect of IgA nephropathy treated with tonsillectomy, and investigate the indication and contraindication. Methods Thirty-five IgA nephropathy patients, who were diagnosed by renal biopsy treated with tonsillectomy, were in operation group. Twenty-four hours urine protein, one hour urine erythrocyte and serum creatine were detected before the operation, one week, two weeks, four weeks, six months after the operation. Compared with 40 IgA nephropathy patients, who were treated with medicine (control group). Results The effective power in operation group was 71.4% and in control group was 52.5%. There was significant difference between two groups. Conclusion Tonsillectomy is more effective in IgA nephropathy with chronic tonsillitis, especially when renal corpuscle is slightly impaired, conversely, when renal function is severely damaged, it belongs to surgical contraindication.

Allergic rhinitis is familiar in clinic,in recent years the incidence has the trend of increase annually and the modern medicine has no effective cure at present.How to seek a permanent solution to the problem? Chinese medical constitution has influence on the incidence,syndrome differentiation,treatment and prognosis of allergic rhinitis.It is necessary and possible to prevent it according to Chinese medical constitution.The constitution is the internal and crucial factor of allergic reaction.The external etiologic factors work through the internal etiologic factors,making people get ill through the imbalance of yin-yang.Therefore,treating allergic rhinitis on the basis of Chinese medical constitution has a positive effect on prevention,correct diagnosis and treatment,controlling the progress and improving the prognosis.

In complicated vitreoretinal surgery,vitreous substitutes play a major role in maintaining intraocular pressure.Air,expansion gases,perfluorocarbons liquid,and silicone oil are frequently used in modern vitreoretinal surgery.Long-term vitreous substitute has been attempted with collagen,hyaluronic acid,natural hydrogel polymers and so on.However,an ideal vitreous substitute is being requested for a long time.This review focused on the currently available vitreous substitutes,as well as those in the experimental phase.These compounds were classified based on their functionality,composition,and properties.The clinical use,advantages,and shortcomings of the various substitutes were discussed.Finally,the criteria for an ideal vitreous substitute was defined.

BACKGROUND: Bilateral pedicle screw fixation combined with intervertebral decompression and fusion is a classic surgical approach in treatment of lumbar degenerative diseases, but it can cause ligament and other soft tissue damage of lumbar spine and degeneration of the adjacent segments. While translaminar facet screw fixation has its unique advantages.OBJECTIVE: To compare the clinical efficacy of unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation for lower lumbar degenerative diseases.METHODS: Forty-six patients with single-level lower lumbar degenerative disease were enrolled, and were then treated with bilateral pedicle screw fixation combined with intervertebral fusion (group A, n=24) or unilateral pedicle screw along with translaminar facet screw fixation and intervertebral fusion (group B, n=22). Afterwards, the clinical indexes and efficacy were compared between two groups.RESULTS AND CONCLUSION: (1) All operations were performed successfully. The length of incision, operation time,intraoperative blood loss, postoperative drainage volume and cost of hospitalization in the group B were significantly superior to those in the group A (P < 0.05). (2) There was no significant difference in the rate of fusion between two groups (P > 0.05). (3) The visual analogue scale and Japanese Orthopaedic Association scores in both groups at 1 week,3, 6, 12 and 24 months postoperatively were significantly improved compared with baseline (P < 0.05), but the scores had no significant differences between two groups (P > 0.05). (4) To conclude, unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation both exhibit satisfactory treatment outcomes,while the former holds little trauma, good stability, high fusion rate and less cost, which is a better choice for lower lumbar degenerative diseases.

Objective: To evaluate the clinical effect of individualized enteral nutritional (EN) support in severe stroke patients.Methods: Totally 120 severe stroke patients with nutritional risk were divided into two groups according to single or double admission number.The 60 patients in the intervention group received an individualized EN with different formula and concentrations according to the clinical status,and supplemented trace elements as occasion required.In the routine group, the patients received EN with standard formula.The energy supply was 83-125 kJ· kg-1·d-1 in both groups.Blood albumin(Alb), pre-albumin(PA), hemoglobin(Hb) and vitamin C(VC) were examined before and after the 21-day nutritional support.The lung infection and gastrointestinal (GI) complications were observed, and the hospital stay and cost were recorded as well.Results: After 21 day''s nutrition support, the serum levels of Alb, PA and VC in the intervention group were not statisticly significant than before (P＞0.05), and the serum levels of Alb, PA and VC were significantly higher than those in the routine group(P＜0.05).The incidence of complications in the in the intervention group was lower than that in the routine group (P＜0.05), and the length of hospital stay and hospitalization was shorter than that in the routine group (P＜0.05).Conclusion: Individualized enteral nutritional support can significantly improve nutritional status, reduce inflammation reactions and GI complications in severe stroke patients, which is worthy of clinical use.

Quality consciousness is the guidelines of the graduate cultivation.The perfection of organization and management as well as the strength of innovation and reform also immediately influence the training quality of graduates.Today the graduate scale expands,so we should use scientific development concept to guide the graduate cultivation and to develop postgraduate education quickly and soundly.

ObjectiveTo explore the influence of locus of control,self-efficacy and self-esteem on shame.MethodsTotal 924 students from six primary and middle schools in Chengdu were recruited by stratified sampling.They were assessed with locus of control,self-efficacy,self-esteem,and shame questionnaire.Results ( 1 ) Shame was significantly negatively related with self-efficacy (r =- 0.248 ) and self-esteem (r =- 0.318 ),and was significantly positively related with locus of control (r =0.185 ).Locus of control was negatively associated with self-efficacy(r =- 0.214) and self-esteem (r =- 0.254).Self-efficacy was positively related with self-esteem (r =0.440) ; (2) Self-esteem played partial mediating role between shame and locus of control as well as self-efficacy; ( 3 ) Self-efficacy played partial mediating role between locus of control and self-esteem as well as shame ; (4) High self-esteem group and low self-esteem group existed significant differences in whole structure equation model.Based on the whole model,the high self-esteem group reduced the path from locus of control to self-esteem ; and low self-esteem group reduced the path from locus of control to self-efficacy.ConclusionLocus of control and self-efficacy are not only directly but also indirectly associated with shame by self-esteem,and self-efficacy would be regulated by the level of self-esteem.

Objective To explore the effects and safety of citalopram combined with low-dose risperidone on refractory depression. Methods All of 54 patients with the refractory depression were ran-domly divided into two groups: augmented treatment group (taken citalopram 20 mg/d, risperidone 0.5-2.0mg/d) and mono-thempy group (taken citalopram alone 20 mg/d). The treatment lasted for 6 weeks. They were estimated with Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and treatment emergent symptom scale (TESS) at baseline and every two weeks subsequently. Results In the augment-ed treatment group, total effective rate was 60.7% and recovery and excellence rate was 50.0%, while that was 26.9% and 15.4% in mono-therapy group (P< 0.05). The adverse effect of two groups was minor. Conclu-sion Rispefidone may be a useful and safe adjunct to citalopram in treatment of refractory depression.

The vulnerable carotid atherosclerosis plaque is an important risk factor for ischemic stroke.However,there are no objective diagnostic criteria for the vulnerability of carotid atherosclerosis plaque in clinical practice now.This article reviews the progress in the diagnosis of vulnerable plaque from the aspects of ultrasound,CT,MRL cerebral angiography,and biochemical indexes.

Objective Exotoxin A ( encoded by gene toxA ) , one of the most toxic protein secreted by pseudomonas aerugi-nosa(P.a.), and PcrV (encoded by gene pcrV), key component to type Ⅲsecretion system of P.a., both matter significantly to the virulence of P.a.The article was to construct a novel DNA vaccine encoding a mutated toxA gene and the pcrV gene of P .a.and i-dentify gene expressions in eukaryotic cells . Methods The genes of toxA and pcrV were amplified by PCR , and the toxA gene was mutated to reduce the toxicity of Exotoxin A .Then gene fragments toxA m and pcrV were inserted into eukaryotic expression plasmid pIRES simultaneously to construct a recombinant DNA vaccine pIRES-toxAm-pcrV.The novel plasmid was transfected into HEK-293 cells by lipofectamine 2000 .The expressions of toxA m and pcrV were detected by Western blot . Results Gel electrophoresis demon-strated the target gene fragments encoding Exotoxin A and PcrV .Western blot exhibited proteins encoded toxA and pcrV expressed by HEK 293 cells. Conclusion The recombinant plasmid pIRES-toxAm-pcrV was successfully constructed .Western blot analysis indi-cated the expressions of toxA m and pcrV in HEK-293 cells.It may be used as a potential candidate of preventive vaccine of Pseudo-monas aeruginosa .