Tuberous sclerosis complex (TSC) is a genetic disorder affecting every organ system, but disease manifestations vary significantly among affected individuals.The diverse and varied presentations and progression can be life-threatening with significant impact on quality of life.The 2012 international Tuberous Sclerosis Complex Consensus Recommendations provide an evidence-based, standardized approach for optimal clinical care provided for individuals with TSC.

Objective To study the mechanism of adipose-derived mesenchymal stem cell (ADMSC) in treating rats ischemia/reperfusion (I/R) induced acute kidney injury (AKI).Methods From June 2011 to March 2012,AKI was induced in 40 male SD rats (weight 180-220 g) by clamping bilateral renal pedicles for 40 minutes.Another 8 SD rats (weight 60-80 g) were used to obtain the primary ADMSC from inguinal fat tissue.After being transferred by lentivirus,those cells were cultured for transplantation until passage two.Animals with AKI were then randomly treated by intraparenchymally injecting ADMSC/PBS solutions (ADMSC/PBS group,n =20) or PBS solutions only (PBS group,n =20) (2× 106 cells,100 μl).During injection,the solutions were injected into the upper,middle and lower part of left kidney.The HE staining from 5 rats in each group was used to detect the histological injury at 3 days and 4 weeks after injection,respectively.The apoptosis and proliferation of host renal cells were evaluated using TUNEL staining and PCNA staining.The serum levels of SCr and BUN in animals were measured at day 1,3,14 and 28 after injection.Results HE staining showed ADMSC/PBS group got a lower injury score compared with that in PBS group at 3 days and 4 weeks,respectively (2.0 vs.3.4,1.3 vs.2.6,P＜0.05).In the result of TUNEL staining,the mean number of apoptosis cells was 30 in ADMSC/PBS group and 55 in PBS group.In terms of PCNA staining,the mean number of proliferative cells was 35 in ADMSC/PBS group and 10 in PBS group.All those results suggested that ADMSC could significantly reduce apoptosis and increase proliferation of renal cell (P＜0.05,repectively).The levels of serum SCr in ADMSC/PBS group were lower than those in PBS groups at day 1,3,14 and 28,after injection,respectively (40 vs.70 μmol/L,32 vs.58 μmol/L,26 vs.38 μ mol/L,26 vs.37 μmol/L; P＜0.05).The similar results were shown in the levels of serum BUN between the 2 groups (15 vs.24 mmol/L,13 vs.20 mmol/L,10 vs.13 mmol/L,7 vs.10 mmol/L; P＜0.05).Conclusion ADMSC could repair AKI after acute I/R injury.

Objective To explore the relationship between platelet to lymphocyte ratio (PLR) and microangiopathyin type 2 diabetes mellitus. Methods In this case-control study, the clinical data on 428 adult patients with type 2 diabetic microangiopathy in our hospital from January 2009 to December 2015 were retrospectively analyzed. PLR, age, sex, fasting blood glucose, glycosylated hemoglobin, total cholesterol and triglyceride were tested to investigate their relationship with type 2 diabetic microangiopathy. Results Logistic regression analysis showed that PLR was a risk factor of type 2 diabetic microangiopathy (OR = 3.162, 95%CI:1.556 ~ 7.421, P < 0.05). Conclusions Greater PLR is closely related to type 2 diabetic microangiopathy, and we should pay attention to type 2 diabetic microangiopathy with a greater PLR in clinical practice.

Objective To compare the clinical efficacy of diciofenac sodium suppository and terazosin in treatment of prostatodynia. Methods 120 patients(age ranging from 19 to 48 years,mean age was 29. 8 years) suffering from prostatodynia, were randomly divided into 2 groups: diciofenac sudium suppositoy group of 60 patients (50mg,rectal medication, q12h for 2 weeks) and terazosin group of 60 patients (2mg, per os, q12h or qn for 2 weeks).The therapeutic effects and side-effects were compared after 2 weeks treatment. Results The total clinical effective rate in diciofenac sudium suppository group was 97% , higher than that (80%) of terazosin groups(P

Objective To detect whether adipose-derived mesenchymal stem cells (ADMCSs)can differentiate into renal tubular epithelial cells and be used for treatment of acute kidney injury (AKI).Methods ADMSCs were separated and cultured in vitro,and were transfected with lentivirus carrying reporter genes of firefly luciferase and monomeric red fluorescent protein (fluc-mrfp).Transfected ADMCSs (2 × l06) were directly injected into renal parenchyma after establishment of AKI models induced by ischemic reperfusion injury.Distribution and differentiation of ADMSCs in rats were detected by bioluminescence imaging (BLI) and immunofluorescent staining,respectively.Results ADMSCs had positive expressions of CD29 and CD90,rather than expressions of CD34,CD45 and CD31.Lentivirus-transduced ADMSCs had stable expressions of mrfp and fluc reporter genes.BLI showed persistent fluorescence signal in vivo even at day 14 after ADMSCs transplantation.Immunofluorescence staining further indicated that the transplanted ADMSCs could differentiate into tubular epithelial cells.Conclusion ADMSCs in vivo can differentiate into renal tubular epithelial cells,which provides an experimental basis for more researches on ADMSCs transplantation for treatment of AKI.

Objective To compare their antipyretic effect of diclofenac suppository (diclofenac) and injectio amidopyrini compositae (amidopyrin) in the treatment for surgical infection with high fever. Methods One hundred patients suffering from surgical infection with high fever were randomly divided into two groups: 50 cases in diclofenac group (50 mg with rectal administration) and 50 cases in amidopyrin group (2 ml, with intramuscular injection) , and their antipyretic effects were observed. Results The antipyretic effect of diclofenac (with an overall effective rate of 96% ) was better than that of amidopyrin (82% ), with a P-value less than 0.05, and their remarkably effective rates were 82% and 58% for the two groups, respectively, with a P-value less than P

ObjectiveTo investigate the preventive effects of rosiglitazone on nonalcoholic steatohepatitis (NASH) rats and to explore the potential mechanisms in modulating peroxisome proliferator-activated receptor gamma (PPARγ),nuclear factor kappa B (NF-κB),and cyclooxygenase-2 (COX-2) expression.Methods Thirty male SD rats were assigned into the normal group ( n =10),the model group ( n =10),rosiglitazone prevention group [ n =10,simultaneously 4mg/( kg · d) gavage daily at beginning].Liver appearance,liver index,and histological changes were assessed.Serum tumor necrosis factor-o (TNF-c) and prostaglandin E2 (PGE2) were determined using enzyme-linked immunosorbent assay.The expressions of PPARγ,NF-κB,and COX-2 in liver were determined using immunohistochemical methods.The mRNA and protein expressions of COX-2 were disclosed by real-time polymerase chain reaction and Western blot analysis.ResultsCompared with the normal group,the liver index significantly increased in model group (3.92 ±0.72 vs.5.71 ± 1.05,P =0.004).HE and Masson staining showed significantly increased steatosis,inflammation,and fibrosis.The serum levels of TNF-α,PGE2 in high-fat-diet-fed rats were significantly increased ( 11.72 ± 2.47 vs.29.39 ± 5.32,P =0.002 ; 236.60 ± 24.90vs.288.24 ± 17.17,P =0.004).Immunohistochemistry showed NF-κB and COX-2 in livers were significantly elevated,but PPARγ wasdecreased in nonalcoholic steatohepatitis rats.Real-time polymerase chain reaction and Western blot found mRNA and protein expressions of COX-2 were increased in the model group (0.57 ± 0.08 vs.2.83 ± 0.24,P =0.0007 ; 0.38 ± 0.03 vs.1.00 ± 0.03,P =0.004).Compared with the model group,the expressions of PPARγsignificantly increased and the expressions of NF-κB and COX-2 significantly decreased ( mRNA:2.83 ± 0.24 vs.0.46 ± 0.11,P =0.002 ; protein: 1.00 ± 0.03 vs.0.62 ± 0.02,P =0.006 ) in the rosiglitazone prevention group.ConclusionBy inhibiting NF-κB and COX-2 expressions,rosiglitazone can reduce insulin resistance and then prevent the occurrence and deve lopment of nonalcoholic steatohepatitis.

Objective To systematically evaluate the performance of the Sysmex CS2000i Automatic Blood Coagulation Analysis System .Methods According to the standards of the Clinical and Laboratory Standards Institute (CLSI) ,the precision ,accuracy ,lin‐earity ,biological reference interval and carry‐over rates of the Sysmex CS2000i Automatic Blood Coagulation Analysis System were detected ,meanwhile the detections of 5 clinical specimens were compared between this system and the Sysmex CA 1500 Automatic Blood Coagulation Analysis System .Results The intra‐assay precision coefficient of variation (CV) ,inter‐day precisions CV carry‐over rate ,accuracy and linearity of plasma prothrombin time ,activated partial thromboplastin time ,fibrinogen and D‐dimmer detec‐ted by the Sysmex CS2000i Automatic Blood Coagulation Analysis System were all consistent with the quality target requirements of our laboratory .Conclusion The Sysmex CS2000i Automatic Blood Coagulation Analysis System has better performance in vari‐ous aspects ,the detection results could be used for the clinical diagnosis and treatment of related diseases .

Objective To investigate the genotype-phenotype correlation between TSC1 and TSC2 associated tuberous sclerosis complex(TSC).Methods Nineteen infants with TSC were enrolled in the study.Their clinical manifestations and mutations of TSC gene were analyzed by chip capturing and next-generation sequencing.Results Among the total of 19 patients with TSC,13 TSC2 mutations and 4 TSC1 mutations were detected.The ratio of TSC2/TSC1 mutation-positive cases was 3.4/1.Six mutations were novel.There were epilepsy in 10 cases carrying TSC2 mutations,including 4 cases (31％) with refractory to antiepileptic treatment,and 3 cases carrying TSC1 mutations,including 1 case (25 ％)with refractory to antiepileptic treatment.The incidence and severity (grade 2)of epilepsy,brain imaging were not different in TSC2 and TSC1 patients(P =0.480 7,0.462 2).Compared with clinical manifestations,incidence of mental retardation (grade 1 or grade 2) was higher in TSC2 patients (85 ％,11/13 cases) than TSC1 patients (50 ％,2/4 cases).Also,the incidence of moderate and severe mental retardation (grade 2) was higher in TSC2 patients (54％,7/13 cases) in comparison with TSC1 patients(25％,1/4 cases).Compared with the phenotype of TSC2 and TSC1 patients,the frequencies of skin,renal and cardiac lesions were significantly higher in TSC2 patients than TSC1 patients.Conclusions TSC2 mutation may be the prominent molecular pathogenesis in Han population with TSC.TSC2 patients have much profound muhisystemitc leisions than TSC1 patients,including mental retardation,epilepsy,facial angiofibromas and renal angiomyolipomas etc,which should be confirmed further in domestic multicenter and large samples.

Objective To evaluate the efficacy and safety of bilateral transversus abdominis plane block (TAPB)combined with bilateral rectus sheath block (RSB)in abdominal surgery. Methods Ninety ASA Ⅰ or Ⅱ patients,35 males,55 females,aged 19-79 years,with body mass index 18-30 kg/m2 ,scheduled for elective laparoscopic cholecystectomy were randomly divided into three groups(n=30):ultrasound-guided bilateral TAPB combined with bilateral RSB group (group TR),ultrasound-guided bilateral TAPB group (group T),patient-controlled intravenous analgesia (PCIA)group (group P).In group TR,ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were per-formed with 10 ml of 0.22% ropivacaine mesylate injection in each side before surgery.In group T, ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery.In group P,ultrasound-guided bilateral TAPB were performed with 20 ml of NS in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery, and PCIA was applied in group P.BP,HR,SpO2 were observed when patients were sent into the op-erating room, 2 minutes before trocar puncture, and 2 minutes after trocar puncture, the consumption of propofol and remifentanil used during the surgery were recorded.The score of visual analogue scale (VAS)during rest and movement were recorded at 2,6,12,24 h after surgery.The patient analgesia satisfaction and the adverse reactions were recorded.Results Compared with group T and group P,group TR had less change of BP before and after trocar puncture(P <0.05).The VAS score was significantly lower in group TR after operation(P <0.05).There were no statistical significant differences of VAS score at 24 h after operation among the three groups.The patient anal-gesia satisfaction was significantly better in group TR than other two groups (P < 0.05 ). Conclusion Ultrasound-guided bilateral transversus abdominis plane block combined with bilateral rectus sheath block is of safety and much efficacy of postoperative analgesia in patients undergoing laparoscopic cholecystectomy.