Objective To determine the function and binding properties of SR-A in HMC.Methods A human mesangial cell line(HMCL) with high expression of type A SCR(HMCL-SCR) was established after stable transfection of expressive vector with cDNA encoding SR-A.Uptake of fluorescence Dil-labeled acetylated low density lipoprotein(Dil-Ac-LDL) and oxidized LDL(Ox-LDL) by HMC were evaluated by fluorescence microscopy,con-focal microscopy and Oil Red "O" staining respectively.SCR mRNA expression was examined with reverse transcription-polymerase chain reaction(RT-PCR).Results More uptake of Ox-LDL and Ac-LDL was observed in HMCL-SCR than that in the untransfected HMCL.Unlabeled Ox-LDL and Ac-LDL at a 40-fold excess concentration competed significantly with the uptake of Dil-Ac-LDL by HMC.Otherwise this phenomenon was not observed when co-cultured with LDL.Conclusion This results suggest that SR-A mediates the uptake of modified-LDL with high affinity and high specificity in human mesangial cells.

Objective: To investigate the clinical efficacy of combination therapy of selenium yeast and levothyroxine sodium in the treatment of type 2 diabetes mellitus complicated with chronic lymphocytic thyroiditis(CLT). Methods: A total of 96 patients with type 2 diabetes mellitus complicated with CLT who admitted to Wenling Hospital of Traditional Chinese Medicine from June 2017 to December 2018 were randomly divided into control group and treatment group according to the digital table, with 48 patients in each group.On the basis of stable blood sugar control, the control group received routine treatment with levothyroxine sodium tablets.The treatment group was given selenium yeast on the basis of the control group.The blood glucose, thyroid, clinical efficacy within 3 months of treatment were recorded. Results: The total effective rate of the study group was 95.83%(46/48), which was significantly higher than 68.75%(33/48) of the control group(χ²=12.080, P<0.05). The levels of blood sugar and glycosylated hemoglobin in the study group were significantly lower than those in the control group after treatment(all P<0.05), and the levels of C-peptide in the fasting and postprandial 2h were significantly higher than those in the control group(t=4.927-8.725, all P<0.05). After treatment, the serum selenium level in the study group was significantly higher than that in the control group(P<0.05), and the serum TPOAb and TGAb levels were significantly lower than those in the control group(t=17.264-27.032, all P<0.05). There were no statistically significant differences in serum TSH, FT₃ and FT₄ levels between the two groups(t=0.704-1.926, all P>0.05). Conclusion The clinical efficacy of selenium yeast and levothyroxine in the treatment of type 2 diabetes with CLT is significantly better than traditional treatment.

Objective To investigate the feasibility and prospects of nested real-time PCR(NR-PCR)technique for Treponema palladium(Tp)detection in various samples of different stages of syphilis from patients preliminarily diagnosed as syphilis. Methods Targeting the Tp polA gene, NR-PCR was performed to detect Tp DNA in various samples from the patients with various stages of syphilis at the first clinic visit, including skin tissue fluid swabs, serum, whole blood, cerebrospinal fluid(CSF)and earlobe blood. Data were analyzed with SPSS software version 13. Results A total of 368 clinical samples were collected from 200 patients with syphilis. With a detection limit of 2 Tp/ml, NR-PCR showed that the total positive rate for Tp DNA was 71.7%(264/368). The Tp DNA positive rate was highest in earlobe blood samples (92.0%, 23/25), followed by CSF samples(90.2%, 46/51), skin tissue fluid swabs(74.3%, 26/35), serum samples(66.9%, 99/148)and whole blood samples(64.2%, 70/109). There was good agreement between NR-PCR results and serologic test results, with a consistency rate of 76.0%(152/200). Furthermore, the Tp DNA positive rate did not differ between patients with primary(12/19)and secondary syphilis(14/16)in skin tissue fluid swabs(χ2 = 2.62, P > 0.05), and was slightly but insignificantly higher in patients with secondary syphilis than those with primary syphilis in the serum samples(χ2=3.6, P=0.06). The Tp DNA positive rate of whole blood samples was also higher in patients with secondary syphilis than those with any other types of syphilis. Among patients with neurosyphilis, no significant difference was observed in the Tp DNA positive rate between earlobe blood samples and CSF samples(P=0.06). Among patients with latent syphilis, the Tp DNA positive rate was significantly higher in serum samples with an RPR titer of ≥ 1:8 than those with an RPR titer of≤1:4. Conclusion NR-PCR is feasible for detecting Tp DNA in various kinds of samples, and the Tp DNA positive rate is influenced by stages of syphilis and types of samples, as well as RPR titers.

Objective To investigate haemodynamic change during hemodialysis and analyze effects of cardiac index (CI) on hemodynamic parameters and associated influencing factors in maintenance hemodialysis (MHD) patients.Methods Seventy-five patients bearing an arteriovenous fistula (AVF) entered the study.Cardiac output (CO),cardiac index (CI),central blood volume (CBV) and peripheral vascular resistance (PR) were determined by ultrasound dilution technique at the end of 1 hour,2 hours and 3 hours of dialysis.AVF blood flow (Qa) was also measured with the same device before haemodynamic parameters investigation.Results Mean age of patients was (55.84 ±12.39) years old (range 21-81 years) and 43 patients (57.3％) were female.Systolic arterial pressure,SV,CO,CI and CBV were significantly declined and no significant change for diastolic arterial pressure and heart rates at the end of 2 hour and 3 hour hemodialysis,whereas PR was increased gradually during hemodialysis.Patients were divided into there groups with CI less than 2.5 L·min 1·(m2)-1,2.5-4.2 L·min-1·(m2)-1 and more than 4.2 L·min-1 ·(m2)-1 at the end of 1 hour dialysis.Statistically significant decreasing SV,CO and increasing PR were detected in patients with CI＜2.5 L·min-1· (m2)-1 and 2.5-4.2 L· min-1· (m2)-1,compared with CI＞4.2 L·min-1· (m2)-1 group (P＜0.01).The hemodynamic change was the most obvious in the group of CI less than 2.5 L· min-1· (m2) 1,and no significant changes happened in CI＞4.2 L·min-1 ·(m2)-1 group.Some factors were found to be associated to CI values.Qa and systolic arterial pressure had positive relationship with CI,while age and diabetes had negative relationship with CI.Conclusions Systolic arterial pressure,CO,CI and CBV decrease and PR increases during hemodialysis.Obvious change occurs when CI is less than 2.5 L·min-1· (m2)-1.CI is associated with Qa,systolic arterial pressure,age and diabetes.

Objective To analysis the clinical and pathological features, results of laboratory tests and prognosis of nephrotic syndrome (NS) in patients with non-heamatological maligancy. Methods The data were collected from 25 patients who presented with NS around the diagnosis of non-heamatological malignancy. Results Twenty-five cases were investigated (age: (56.6±17.7) years; male/female ratio: 20/5). Malignancy and NS occurred within one year in 92% patients. There was a wide distribution of malignancy with involvement of 36% in digestive system and 20% in respiratory system. Ten patients (40%) presented with NS as their initial manifestation. Heamaturia appeared in 67% patients and acute renal insufficiency was complicated in 12% cases before treatments. Some other non-specific laboratory tests were found including elevated serum gamma-globulin in 50% and anemia not related with renal failure in 28% cases. Membranous nephropathy was the most common pathological changes in 67% cases. Although NS still continued for several weeks in 8 of 9 cases after surgery and/or chemical therapy, glucocorticoids was helpful to achieve the remission in these patients. However, no remission was achieved in patients without the treatment for malignancy. Conclusion Malignancy may present with NS as its initial manifestation. It should be inspected routinely and regularly in elder patients with NS, especially in those with membranous nephropathy, as well as gamma-globulinemia and anemia.

OBJECTIVETo discusses the necessity and methods of replantation for complete amputation of finger composite lateral tissue.

METHODSFrom March 2012 to April 2015, 62 cases of complete amputated finger lateral tissue for various causes were retrospectively analyzed, including 34 males and 28 females with an average age of 29.1 years old ranging from 17 to 52 years old, involved 27 cases of thumb, index finger in 15 cases, 13 cases of middle finger, ring finger in 8 cases, 2 cases of the little finger, 2 fingers were injured in 3 cases, 14 cases involving the distal interphalangeal joint. The time from injury to treatment was 30 min to 2 hour with an average of 1 hour. The appearance of the fingers, finger tip sensation and the recovery of the functional of the patients were followed up and observed.

RESULTSOf 62 cases, 58 cases survived, the survival time was 3 to 15 months with an average of 6.5 months. According to the Chinese medical association upper part of replantation function evaluation standard to assess efficacy trial, 52 cases were excellent, 3 cases were good, 3 cases were good, the excellent and good rate was 94.8%.

CONCLUSIONSThe appearance and function is good after block from the broken replantation finger lateral organizations survive, as long as the patient general condition allows, away from the broken body is complete, there are available for blood vessels and nerves anastomosis, it should strive to reattach it.

Objective To investigate clinical characteristics,diagnosis,treatment and prognosis of mucormycosis in patients with renal failure. Methods We reported a 65-year old case of mucormycosis with chronic renal failure. The patient was successfully treated with amphotericin B. Mucormycosis complicated with renal failure were reviewed excluding mucormycosis peritonitis associated with peritoneal dialysis and desferrioxamine-related mucormycosis. Results Fifteen cases including our case were involved with mean age of 49.87?15.84 years old. Rhinocerebral,pulmonary,and disseminated forms accounted for 46.7%,33.3% and 20% respectively. Autopsy was made in 46.7% of patients. Mortality was 73.3% in all of them and 42.9% in seven patients who received antifungal therapy. All patients without treatments died. Conclusion Mucormycosis is a lethal invasive infection in patients with renal failure. The management to improve prognosis are early diagnosis,surgical debridement,drainage and aggressive antifungal chemo-therapy.

Objective To investigate the life quality in infants with food allergy before and after treatment by using of Food Allergy Quality of Life Questionnaire - Parent Form(FAQLQ - PF). Methods The severity of eczema in 46 children with food allergy was determined by eczema area and severity index(EASI). The life quality of such infants was assessed by the FAQLQ - PF after 2 - months treatment. Results (1)Among the 50 subjects,46(92% )respon-ded to the tests;the average age was(4. 78 ± 1. 48)months. Twenty - nine(63. 04% )subjects had family history of allergic disease. Egg(73. 91% )was the most common allergen,followed by cow milk(43. 48% ),fish and shrimp (8. 70% ),and carrot(4. 35% ).(2)The scores of EASI,FAQLQ - PF in children with food allergy before treatment were 13. 20 ± 12. 86 and 2. 12 ± 1. 33,respectively,the scores after treatment declined(2. 02 ± 4. 40 and 1. 33 ± 1. 08, respectively),there was a statistical significance(t = 28. 070,4. 014,all P ﹤ 0. 05).(3)Compared with pre - treat-ment,the scores of emotional impact subscale and food anxiety subscale declined,from 2. 10 ± 1. 47 and 2. 63 ± 1. 83 to 1. 30 ± 1. 09 and 1. 68 ± 1. 37,respectively,and there were statistically significant differences(t = 5. 204,8. 818,all P ﹤ 0. 05).(4)There was a positive correlation between the EASI and FAQLQ - PF scores(ρ = 0. 205,P ﹤ 0. 05). Conclusions Food allergy adversely affects the quality of life in infants. The poor life quality is associated with more severe symptoms. The life quality in infants and parents can be improved by standardized treatment.