BACKGROUND: Pathogenesy of immunoglobulin A nephropathy (IgAN) is not clear up to now. Present research has verified that the key pathogenetic pathway is abnormalities of IgA1 molecular O-glycosylation induced by decrease of β1, 3-galactosyltranferase activity in IgA1 hinge region of IgAN patients. Prophase study by the authors supposed that the key of IgAN O-glycosylation abnormality might be due to the decrease of β1, 3-galactosyltranferase specific molecular protein chaperone Cosmc in B lymphocyte of peripheral blood in IgAN patients.OBJECTIVE: To measure DNA sequence of β1, 3-galactosyltranferase specific molecular chaperone in coding region of Cosmc gene in IgAN patients, and compared with the sequence of Gene Bank.DESIGN: Case-controlled observation.SETTING: Department of Nephrology, West China Hospital, Sichuan University.PARTICIPANTS: Totally 27 IgAN patients and 10 non-IgAN patients were recruited in Department of Nephrology of West China Hospital of Sichuan University from November 2005 to August 2006, and five normal controls were included in this study. All the subjects knew the fact and agreed to participate in the experiment.METHODS: The experiment was performed at the State Key Laboratory of Biotherapy of Sichuan University. 2 mL peripheral venous blood of all the samples were taken into heparin sodium anticoagulated tubes, from which total genomic DNA were extracted by phenol/chloroform precipitation method. Concentration of DNA was determined by ultraviolet spectrophotometer. The polymerase chain reaction (PCR) was used to amplify the coding region of β1, 3-galactosyltranferase specific molecular chaperone Cosmc gene in all the subjects and direct sequencing was done in PCR products of each subjects. The results of all the sequencing were compared with Gene Bank one by one.MAIN OUTCOME MEASURES: Amplification findings and sequencing of coding region of β1, 3-galactosyltranferase specific molecular chaperone Cosmc gene by PCR.RESULTS: ①Coding region of Cosmc gene located at 257-1 213, and amplified Cosmc gene was 1 247 bp. ②The sequence of Cosmc gene coding region was similar in IgAN patients, non-IgAN patients and normal controls, and no difference of gene sequence was noticed in all the result sequences as compared with the Gene Bank registered sequence.CONCLUSION: No abnormal sequence is found in coding region of Cosmc gene in IgAN patients, suggesting that this coding region probably is not associated with the abnormalities of IgA1 O-glycosylation in IgAN.

Objective To evaluate the clinical application of anterior approach microendoscopic discectomy for cervical spondylosis. Methods Clinical data of 21 cases of cervical spondylosis from October 2001 to June 2002 treated by anterior approach decompression with bone allograft or autograft for cervical fusion by means of microendoscopic discectomy system were reviewed. Results The mean intraoperative blood loss was 150 ml. The drainage was removed 48 hours and the stitches taken out 5 days after the operations. The mean hospital stay was 10 days. All the patients got out of bed for motion wearing a cervical collar 2 days after the operations. Follow-up ranged 6～12 months with a mean of 9 months.The outcome was determined using Odom grading. Of the 21 cases, 16 were classified as excellent results, 4 as good, 1 as poor, the rate of excellent or good results being 95%.Complications were found in 3 cases:rupture of threaded fusion cage in 1 case;hoarseness in 1 case;and multiple infarction of brain stem in 1 case. Conclusions Anterior approach microendoscopic discectomy in the treatment of cervical spondylosis has the advantages of minimal invasion and rapid recovery. It offers a clear surgical vision for vertebral posterior margin and effective protection for blood vessels and nerves, conforming to the standards of minimally invasive surgery.

AIM: To study the effect of bFGF on cell proliferation, secretion of type I collagen and expression of integrin ? 1 in human kidney fibroblasts (KFB). METHODS: The KFB was cultured and stimulated by bFGF in vitro. The proliferation and collagen I secreting of KFB, the expression of integrin ? 1 were measured by MTT, ELISA and flow cytometer, respectively. RESULTS: bFGF (25-50 ?g/L) could obviously stimulate the cell proliferation ( P

Objective:To explore changes of peripheral blood levels of C reactive protein (CRP)and matrix metallo-proteinase-9 (MMP-9)in patients with coronary heart diseases (CHD)and percutaneous coronary intervention (PCI),and analyze their relationship with patients'prognosis.Methods:A total of 278 CHD patients undergoing PCI in our hospital from Jul 2009 to Apr 2011 were regarded as PCI group;another 234 CHD patients not receiving PCI were enrolled as CHD control group.According to results of coronary angiography,PCI group was further di-vided into single-vessel (n=143),double-vessel (n=92)and triple-vessel disease group (n=43).Changes of CRP and MMP-9 levels were compared between two groups in different time,and the relationship among these two in-flammatory factors and coronary disease,its prognosis was analyzed.Results:Compared with on admission,there were significant rise in levels of CRP [(2.43±0.62)mg/L vs.(2.87±0.73)mg/L,(2.98±0.87)mg/L]and MMP-9 [(12.63±2.68)ng/ml vs.(14.62±3.49)ng/ml,(19.62±4.63)ng/ml]in PCI group on 24h and 48h after PCI,P <0.05~<0.01;there were no significant difference in CRP and MMP-9 levels between on admission and 14d after PCI,P >0.05;The more severe coronary lesion was,the higher CRP and MMP-9 levels were,CRP and MMP-9 levels of triple-vessel group [(2.51 ±0.64)mg/L,(14.67±2.97)ng/ml]were significantly higher than those of single-vessel group [(1.83±0.51)mg/L,(9.68±1.42)ng/ml]and double-vessel group [(2.17±0.59) mg/L,(11.62±2.19)ng/ml],P <0.05~<0.01;incidence rates of cardiovascular events in patients with CRP≥3 mg/L and MMP-9≥15 ng/ml (33.3%,29.1%)were significantly higher than those of patients with CRP <3 mg/L and MMP-9<15 ng/ml (16.1%,18.2%)respectively,P <0.05 both.Conclusion:Serum levels of CRP and MMP-9 significantly rise in CHD patients on 48h after PCI,and their increasing level is related with extent of coronary ar-tery lesion and prognosis.

Objective To investigate the changes of surfactant associated protein A (ST-A) concentration inBALF and its relatiomhips with pulmonary injury after blast injury and blast injury combined with hypoxia. MethodTotally 131 Wistar rats (purchased from animal center of research Institute of Surgery, Daping Hospital, ThirdMilitary Medical University) were randomly divided into four groups: blast injury group ( BI group), blast injurycombined with hypoxia group Ⅰ (BAg Ⅰ group), blast injury combined with hypoxia group Ⅱ (BA Ⅱ group) andnormal control group. After blast injury was made by KST - Ⅰ bio-shock tube, rats of BA Ⅰ and BA Ⅱ groups wereput into hypoxia cabins immediately, where gas mixtures of 12.5% and 10.0% oxygeon were given, respectively.Rats were sacrificed at 1, 3 and 6 hours after injury for gross anatomic examination, light and electron microscopeobservation and lung water determination. The level of SP-A in BALF was detected by Western blot. The data wereprocessed by t test or Chi-square test. Results The respiration increased with shortness of breath and dysphoria inrats of BA Ⅰ and BA Ⅱ groups, and obvious cyanosis on the lips and nose in rats of BA Ⅱ group after blast injury.The lung water in rats of all injury groups was significantly higher than that in normal control group (P<0.05).Gross anatomy changes were mainly pulmonary bleeding and edema. Under light microscope, incrassation of alveo-lar wall, bleeding in alveolar and mesenchyme edema were found. Whereas under electron microscope, breakageof alveolar wall and decrease of lamellar bodies in type Ⅱ cell were observed. All these changes were most obviousin BA Ⅱ group followed by BA Ⅰ and BI groups in severity decling order, with mortality rate of 37.5%, 11.1%and 2.1% respectively at 6 hours (P<0.01). The SP-A level in BALF decreased significantly (P<0.01) andhad a good negative relationship with the lung water after injury (r=0.796, P<0.001 ). Conclusions Blastinjury combined with hypoxia significantly deteriorates the lung injury. More severe and longer hypoxia may resultin more severe lung injury and higher mortality rate. A decrease in SP-A value in BALF shows a good negative re-lationship with the pulmonary edema. The SP-A can be a good indicator for lung injury severity after blast injuryand blast injury combined with hypoxia.

The actual efficacy of acupuncture on cerebral infarction was explored in clinical practice. The retro spective cohort study was adopted to investigate 344 cases via inpatient's medical cases. According to whether acupuncture was received or not, an acupuncture group (207 cases) and a non-acupuncture group (137 cases) were divided. The matching method, regression method and weighting method of propensity score (PS) were adopted, and the efficacy on muscle strength was taken as effect index so that the specific impacts of acupuncture were ex plored on the muscle strength in the patients of cerebral infarction. Before matching, COX regression model and Logistic regression model were used. And PS hierarchical regression, PS inverse probability weighting method (IPTW) and PS standardized mortality weighting method (SMRW) were applied to the analysis on the relationship between the muscle strengthen changes and the total effective rate in the two groups. It was found that the efficacy in the acupuncture group was better than that in the non-acupuncture group, indicating the significant difference (P<0.05). Meanwhile, the rehabilitation therapy also brought the obvious impacts on the efficacy evaluation (OR=2.737, P=0.0055). After PS matching, the Logistic regression model was used to analyze whether acupuncture or rehabilitation therapy impacted the total effective rate of muscle strength. The results showed that the efficacy was impacted apparently with the rehabilitation therapy involved (OR=2.930, P=0.0247). Without the rehabilitation effect considered, the efficacy in the acupuncture group was better potentially than that in the non-acupuncture group, but without significant difference (OR=2. 235, P=0,058 7). All of these indicate that on the basis of routine treatment, without the effect of rehabilitation therapy considered, acupuncture improves in tenden cy of the muscle strength of the patients with cerebral infarction. However, it is expected to increase the study medical cases for further verification.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cerebral Infarction ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Muscle Strength ; Propensity Score ; Retrospective Studies ; Treatment Outcome

Objective To clarify whether the Cosmc gene down-regnhtion in lgA nephropathy (IgAN) patients is resulted from genetic disorders or external suppressions. Methods Forty IgAN patients, 16 non-IgAN glomerulonephritis patients and 21 healthy controls were enrolled in the study. Genomie DNA was extracted and then Cosmc gene was amplified and sequenced. Peripheral B lymphoeytes were isolated and cultured with RPMI-1640 alone or plus lipopolysaecharide (LPS). The Cosmc mRNA expression levels at baseline, after RPMI-1640 culture or RPMI-1640+LPS treatment were measured respectively by real-time RT-PCR. Results (1) Only 2 missense mutations and 2 silent mutations were detected in coding frame region of Cosine gene in 2 IgAN patients. (2) The baseline Cosmc gene expression level was significantly lower in IgAN patients (31% of that in healthy controls) than that in healthy controls. (3) Relative quantification PCR indicated that Cosmc mRNA expression level was significantly increased (219% of baseline) after RPMI-1640 culture, and treatment of LPS could strongly inhibit this effect. (4) The Cosmc gene expression of healthy control was not affected by RPMI-1640 or LPS. Conclusion It is not genetic disorders but external suppression to cause the down-regulation of Cosmc gene mRNA expression in IgAN.

Objective To evaluate the impact of cerebrospinal fluid drain(CSFD) on the incidence of acute spinal cord injury(SCI) following extensive TAAA repair.Methods From February 2009 to July 2016,153 patients underwent extensive TAAA repairs with a consistent strategy of normal thermia,non-circulatory bypass,sequential aortic cross clamping,aortic-lilac bypass,and intercostal artery reconstruction.The repairs were performed with preoperative CSFD (n =78) or without CSFD (n =75).In the former group,CSFD was inserted after the patient has been anaesthetized and continued for 72 hours after surgery.The target CSF pressure was 10 mmHg or less.Results The mean age of patients was (38 ± 10) years and 108 (70.6％) were male.There were 87 (53.8％) patients with previous aortic surgeries and 33 (22％) with Marfan syndrome.The two groups had similar risk factors for paraplegia.Aortic clamp time,operation time and number of reattached intercostal arteries were similar in both groups.In-hospital mortality rates were 1.3％ (one patient) and 6.7％ (five patients) for CSFD and the group without CSFD,respectively (P =0.086).Ten patients (13.3 ％) in the group without CSFD had paraplegia develop.In contrast,only two patients in the CSFD group(2.6％) had postoperative paraplegia(P =0.013).Stepwise logistic regression analysis identified CSFD had spinal cord protection,P =0.026;OR =0.171;95％ CI:0.036-0.809).No patients occurred CSF catheter related complications.Conclusion This randomized clinical trial showed that preoperative CSFD placement could be an effective strategy in preventing SCI following extensive aortic aneurysm repair.Care should be taken to prevent complications related to overdrainage.

Objective To study the effect of hyperbaric oxygen(HBO) treatment on plasma endotoxin,sCD14 and plasma endotoxin inactivation capacity(EIC) in acute necrotizing pancreatitis(ANP) in rats and its possible mechanism.Methods SD rats were randomly divided into control group,sham operation group,ANP group and ANP+HBO group.Rat ANP models were made by retrograde injection of 3.5% sodium(taurocholate)(2.5mL/kg) into the pancreatic duct.Thirty minues after models had been made,ANP+HBO group was treated by hyperbaric oxygen for 2h.At 3h,6h,and 10h after establishment of rat models,the plasma endotoxin,sCD14,EIC,TXB_2 and 6-K-PGF_(1a) leves were determined in each group.Results At 3h and 6 h after rat models were established,the levels of endotoxin,sCD14,and TXB_2 in ANP+HBO group were significantly lower than those in ANP group(P

Objective The aim of this study was to evaluate whether the reoperation is the risk factor for mortality after Sun's procedure(Total aortic arch replacement + frozen elephant trunk) for Stanford type A aortic dissection involving aortic arch.Methods Between February 2009 to February 2012,data from 383 patients who underwent Sun's procedure for Stanford type A aortic dissection involving aortic arch were collected retrospectively.35 patients had history of cardiac surgery.Of these patients,16 patients had underwent Bentall procedure,7 patients ascending aortic replacement,4 patients Wheat surgery,4 patients aortic valve replacement,2 patents Bentall combined with mitral valve replacement or plasty,1 patient bivalve replacement,1 patient atrial septal defect repair,1 patient coronary artery surgery.All the risk factors related to mortality were analyzed by univariate statistical analysis.Significant univariate variables were entered into multiple logistic analysis.Results Total 31 patients died in the hospital and the mortality was 8.07％.Of the 35 patients with history of cardiac surgery,3 patients died and the mortality was 8.33％.Univariate analysis showed that symptom onset before surgery less than 1 week,preoperative limb ischemia,combining with coronary artery surgery and cardiopulmonary bypass time longer than 300 minutes in the operative were risk factors for mortality.After these factors were entered into multiple logistic regression analysis,the result showed that symptom onset before surgery less than 1 week (P =0.038,OR =2.43),cardiopulmonary bypass time longer than 300 minutes(PP ＜0.001,OR =12.05) were final independent risk factors for mortality.Reoperation was not the independent risk factor for mortality.The intensive care unit and mechanical ventilation length of reoperation group was (2.09 ± 1.89) days and(30.09 ±33.42) hours respectively,while that of primary group was(2.71 ±3.01) days (P =0.25) and(33.86 ±40.98) hours(P =0.61) respectively.The incidence of postoperative bleeding of reoperation group was 3.03％,while that of primary group was 1.88％ (P =0.50).Conclusion Reoperation was not the independent risk factor for mortality after Sun's procedure for Stanford type A aortic dissection involving aortic arch and the morbidity was also not higher than primary surgery.For these patients,sun' s procedure should be advocated.