Renal involvement is common in systemic lupus erythematosus(SLE).Treatment of lupus nephritis includes immunosuppressive and supportive therapy.The intensity of immunosuppressive therapy depends on the clinical and renal pathological disease activity.The long-term targets of treatment are to prevent lupus nephritis relapse and protect renal function.Complete remission is the goal in the induction phase,and long-term treatment is necessary in the maintenance phase.Individualization therapy and the side effects of immunosuppressive agents should be paid more attention.

Objective: It was reported that major subclasses of anti-golmerular basement membrane (GBM) antibody were IgG1 and IgG4. The IgG1 subclass was mainly found in male patients and IgG4 subclass in female patients with anti-GBM disease. This study investigates the distribution of anti-GBM IgG subclasses and their association with clinical characteristics. Methods: Sera from 50 patients diagnosed as anti-GBM disease during 1991-2003 were collected. The anti-GBM antibodies with IgG1, IgG2, IgG3, and IgG4 subclasses were detected with purified bovine ?(IV)NC1 as solid phase ligand in ELISA. The association with clinical manifestations was further investigated. Results: The positive rates of IgG anti-GBM subclasses were IgG1 94%, IgG2 56%, IgG3 12%, IgG4 88%, respectively. IgG1 and IgG4 were the main subclasses in anti-GBM IgG subclasses (P

OBJECTIVETo evaluate the short effect and safety of the acupoint application of dog days for allergic rhinitis.

METHODSTwo hundred and forty-nine patients were randomly divided into an application group (166 cases) and a placebo group (83 cases). On the first day of the first dog days, the first day of the second of the three ten-day periods of the hot season and the first day of the last of the three ten-day periods of the hot season, acupoint application was adopted mainly at Dazhui (GV 14), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) in the application group. The plaster was made of Chinese herbs, including Baijiezi (semen brassicae), Xixin (asarum), Yanhusuo (corydalis tuber) and Gansui (euphorbia kansui). Buckwheat plaster without medical ingredient was used in the placebo group. The application was pasted for 2-6 h every time. On the first three days of all the three periods of dog days, treatment was used continuously. The whole period of dog days was made into one course. The changes of symptom and syndrome scores, visual analogue scale (VAS) for symptom before and after treatment and the adverse reaction with the condition disposed were observed in the two groups.

RESULTSAfter treatment, the symptom and syndrome scores and VAS for symptom were improved compared with those before treatment in the two groups (all P < 0.05), and the improvements of the application group were more obvious than those of the placebo group (all P < 0.05). The short effective rate of the application group was 68.1% (113/166), which was better than 48.2% (40/83) of the placebo group (P < 0.05). The adverse reaction rates were 4.2% (7/166), 2.4% (2/83) respectively, with no statistical significance between the two groups (P > 0.05).

CONCLUSIONThe dog days plaster achieves obvious effect with good safety for allergic rhinitis.

Acupuncture Points ; Adolescent ; Adult ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; Treatment Outcome ; Young Adult

ObjectiveTo investigate the etiology, exacerbating factors and outcome of geriatric patients with acute renal failure (ARF) in emergency and critical internal medicine. MethodsClinical features of elderly inpatients with ARF who were diagnosed in internal medicine of our hospital during the past 10 years were retrospectively analyzed. Patients were divided into community-acquired ARF (CA-AFR) group and hospital-acquired ARF (HA-ARF) group. Comparisons between CA-ARF group and HA-ARF group, and between elderly patients and non-elderly patients with ARF in internal medicine were performed. ResultsAmong 381 elderly ARF patients in internal medicine, there were 218 (57.2%) CA-ARF patients and 163 (42.8%) HA-ARF patients. Most of the HA-ARF patients (153 cases) were distributed in medical intensive care. Compared with CA-ARF group, patients in HA-ARF group were older, with more underlying diseases, a higher ratio of infections and/or heart failure and more severe acute renal failure. Infection and heart failure/severe myocardial isehemia were the major exacerbating factors for HA-ARF. Of the 163 patients with HA-ARF, 146 patients died and 17 patients survived. Patients in the death group had more underlying diseases, a higher ratio of severe infections and heart failure/severe myocardial ischemia, a higher ratio of cases with multiple organ dysfunction syndrome(MODS) and a higher score of APACHE Ⅱ.When compared with non-elderly patients with ARF, the elderly patients had a higher proportion ofHA-ARF, a higher ratio of MODS, a higher score of APACHEⅡ and a higher mortality of ARF.ConclusionsThe elderly critical patients are susceptible to HA-ARF with more chronic underlying diseases. Infection and heart failure/severe myocardial ischemia are the major exacerbating factors.The prognosis depends on the treatment of predisposing diseases and removal of exacerbating factors.

Circulating tumor cells (CTCs) are essential for establishing metastasis. Detecting CTCs can help clinicians detect early metastases or recurrences more effectively. Compared with traditional histological analyses and imaging, CTC detection has a much higher reproducibility and sensitivity and can provide more timely prognostic information in human breast cancer.

Objective To study the clinicopathological features of C3 glomerulonephritis and the associations between plasma complement fragments level and clinical manifestations.Methods The clinical and pathological data of the 12 patients with C3 glomerulonephritis in our division from January 1999 to June 2010 were analyzed retrospectively.Concentrations of plasma factor B,Ba,C3,C3a,C4a and C5a were detected by commercial available sandwich ELISA kits on the day of renal biopsy.Results Ten of the 12 patients were C3 glomerulonephritis without MPGN,and the rest 2 were C3 glomerulonephritis with MPGN.All the patients presented proteinuria.Two of the 10 C3 glomerulonephritis patients without MPGN presented nephrotic range proteinuria,6 with microhematuria,1 with gross hematuria,and 2 with renal insufficiency.One of the 2 C3 glomerulonephritis patients with MPGN presented nephrotic range proteinuria,accompanied by microhematuria,hypertension and renal insufficiency.The other patient showed moderate proteinuria with normal renal function.Most of C3 glomerulonephritis patients without MPGN showed mild mesangial proliferative glomerulonephritis,and 4/10 patients had various degree cresentic formation.One C3 glomerulonephritis patient with MPGN had 47.1％ cresentic formation.The concentration of plasma C3 in C3 glomerulonephritis patients was normal,while the plasma factor B was significantly decreased,and the concentrations of plasma Ba,C3a,C4a and C5a were significantly elevated.The concentration of plasma Ba was positively correlated with the proteinuria level,while the concentrations of plasma C3a,C4a and C5a were not correlated with the levels of proteinuria or plasma creatinine.Conclusions Majority of these 12 patients were C3 glomerulonephritis without MPGN,manifests as nephritic syndrome clinically and mild mesangial proliferative glomerulonephritis histopathologically.Complement activation via alternative pathway may play an important role in the pathogenesis of C3 glomerulonephritis.

Objective: To investigate the effects of DC derived from IL-12-induced erythroleukemia cells on the induction of CTL and protective antituinor immunity. Methods: The cytotoxicity of CTL was assessed by 4h 51 Cr-release assay. HE staining and eleclromicroscopy were used to observe the histological changes after immunized with erythroleukemia-derived DCs. Results: After incubation with naive T cells, the IL-12-induced FBL-3 cells could apparently induce the generation of CTL which exihibit the specific cytotoxicity against wild-type FBL-3 cells in vitro. We further assayed the cytotoxicity of CTL in vivo after immunized with erythroleukemia-derived DCs. CTL cytotoxicity of mice immunized with IL-12-in-duced FBL-3 cells was higher than that of mice immunized with IL-I2-uninduced FBL-3 cells. C57BL/6 mice immunized with IL-12-induced FBL-3 cells could resistant the subsequent rechallenge with the wild-type FBL-3 cells. The tumor growth was efficiently inhibited. Histological observation showed that more inflammatory cells infiltrated into the tumor tissue and necrosis of leukemia cells existed. By transmission electron microscopy, apoptositic phenomena were observed in the tumor of group immunized with IL-12-induced FBL-3 cells. However, these changes were not observed in the group immunized with IL-12-uninduced FBL-3 cells. Conclusion: These data indicate that erythroleukemia cells-derived DCs could induce specific CTL efficiently in vitro and in vivo, and may be used as new vaccine to activate antituinor immune responses.

Objective To study the detectable rate of antineutrophil cytoplasmic antibodies (ANCA) in Chinese patients with clinical suspected small vessel vasculitis,and the target antigens.Methods All 5 604 sera sent to the authors′ laboratory for ANCA screening were tested by indirect immunofluorescence (IIF),anti myeloperoxidase (MPO),and anti proteinase 3 (PR3) ELISA.Then the positive sera with IIF ANCA but negetive with MPO and PR3 ANCA were further tested by antigen sepecific ELISA using other five highly purified known ANCA antigens as solidphase ligands.The known antigens included human leukocyte elastase (HLE),lactoferrin (LF),cathepsin G (CG),bactericidal/permeability increasing protein (BPI) and azurocidin (AZU).Results Of the 5 604 sera,298(5 3%) were IIF ANCA positive,and 390/5 604(7%) were ANA positive.Patients′ANCA presented mainly in summer or winter.Of the IIF ANCA positive patients,213 were anti MPO positive,32 were anti PR3 positive and 5 were positive for both.Of the 48 sera positive by IIF,yet negative by MPO and PR3 ANCA,13 sera(27%) recognized other target antigens,7 sera recognized BPI,5 recognized HLE,one recognized CG and one recognized AZU,and none of the sera recognized LF.One serum recognized both BPI and HLE.There was no difference in gender(M∶F=1∶1 12) in ANCA positive patient with a mean age of 53 1 years.However,the M/F ratio was 1 17∶1 for patients over 60 years,and was 1∶4 for patients less than 20 years.Conclusion ANCA related diseases are not rare in China and the major antigens are MPO and PR3.When IIF technique is used to detect ANCA,ANA should be carefully distinguished.Some sera also recognized other known ANCA antigens,but for a few sera the target ANCA antigens are still unkown.

Objective:To investigate the TCM pathogenesis of Parkinson’s disease(PD).Methods: Correlation of kidney deficiency and blood stasis and invasion of PD is analyzed based on such points as age of onset,symptoms,location,course of disease,mechanism of molecular biology and treatment.Results: It proved that deficiency of kidney and debility of marrow is the internal condition,and blood stasis is the necessary factor.Pathogenesis of PD includes the characteristic of kidney deficiency and blood stasis,deficiency correlated to stasis.In addition,Chinese herb formula with function of strengthening kidney and activating circulation shows the anti-brain-aging and neuroprotective effect to PD.Conclusion: Kidney deficiency and blood stasis is the fundamental pathogenesis of PD.

Objecttve To explore the roles of p53,Bax and Bcl-2 in rat lens epithelial cells apoptosis induced by ultraviolet radiation.Methods Healthy SpragueDawley rats (40,6-weeks old,150 g) were selected and divided into 5 groups randomly.After SD rats were injected 100 g · L-1 chloral hydrate (0.35 mL/100 g) intraperitoneally and pupil dilation,the eyes of SD rats were radiated 15 minutes by using UV-B (300-320 nm).The exposed animals were sacrificed at 1 day,3 days,5 days and 7 days after exposure.Both lenses from all animals were extracted.The apoptosis of rats lens epithelial cells was performed by Hoechst 33258 staining.The expression of p53,Bax and Bcl-2 in rat lens epithelial cells at mRNA level was detected by real-time PCR.The distribution and expression of p53,Bax and Bcl-2 were observed by immunohlstochemistry.Results The apoptosis of lens epithelial cells was aggravated after exposure.The expression of p53 and Bax at mRNA and protein level was increased after UV exposure (P ＜ 0.01).But for Bcl-2 the expression both at mRNA and protein level was decreased after a 1 day-exposure(P ＜0.01) and was increased after UV exposure of 5 days and 7 days(P ＜ 0.01).The mRNA expression level of p53 was positively correlated with the Bax (r =0.952,P ＜ 0.01).The expression of p53 and Bax protein were increased after UV exposure,and transferred from cytoplasm to nucleus;While the expression of Bc1-2 protein was decreased at 1 day after UV exposure,and increased gradually at 3 days,5 days and 7 days.Conclusion The apoptotic process of rat lens epithelial cells induced by ultraviolet may be related with p53 regulating the expression of Bax/Bcl-2.