Objective To observe recycle homorheology index of two autologous blood recover machines in orthopedic operation , including maximum deformation index (DImax) ,aggregation index(AImax) ,osmotic fragility ,hematocrit(Hct) ,hemoglobin(Hb) , blood electrolytes and pH value ,the changes of in vivo Hct ,Hb ,blood electrolyte and pH value after the autotransfusion to provide references for rational clinical use of cell salvage .Methods Seventy‐six patients were randomly divided into group A (CATS) and group B (Cell Saver) ,38 cases in each group .Autologous test of DImax ,AImax ,osmotic fragility ,Hct ,Hb ,blood electrolytes ,pH value and Hct ,Hb ,osmotic fragility ,pH value of patients before and after autotransfusion ,24 h after operation ,used to determine the in vivo salvaged were measured .Results DImax of group A were lower than that of group B with no difference(P<0 .05);AImax of both groups had no different(P>0 .05) ,but was lower than the reference value .RBC osmotic fragility curve shifted to the right in group A ,each index was significantly lower than its reference value(P<0 .05) .The in vivo Hct ,Hb ,K+ of group A were significantly higher than that of group B ,Na+ level of group A was lower than of group B ,each index had significantly difference with its reference value(P<0 .05) .pH value of both groups was slightly alkaline .The in vivo Hct ,Hb ,K+ ,Na+ level and pH value of both groups had no difference at the point of before and immediately after autotransfusion and 24 h postoperatively ,there were no statistically difference(P>0 .05) .The in vivo Hct of both groups after autotransfusion were significantly higher than before(P<0 .05) .Conclusion The hemorheology index and quality of salvaged blood acquired from these two cell salvage systems in orthopae‐dic operation have no obvious differences .The function of these two kinds of cell salvage systems is safer and reliable .

Objective To evaluate the blood-saving efficacy of acute hypervolemic hemodilution (AHH)-hemostatics-intraoperative blood salvage (IOBS) in patients undergoing orthopedic surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, scheduled for elective orthopedic surgery under general anesthesia with an expected blood loss of 800 ml or more, were randomly divided into 4 groups ( n = 30 each) : AHH + IOBS + hemostatics group; IOBS + hemostatics group; AHH + IOBS group; AHH + bemostatics group. AHH was induced with 6% hydroxyethyl starch 130/0.4 15 ml/kg infused iv at a rate of 40 ml/min immediately after tracheal intubation until the time of immediately before skin incision, IOBS was performed immediately before skin incision. Intravenous hemocoagulase 2 kU and im hemocoagulase 1 kU were injected 10 min before skin incision. The total volume of fluid intake and output, HR, MAP and CVP were recorded during the operation. Vein blood samples were taken for determination of Hb, Hct, platelet counts (Plt), prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen concentration (Fib) .Results CVP was significantly lower in IOBS+ hemostatics group than in AHH + IOBS + hemestaties group ( P < 0.05), while no significant difference in CVP was found between AHH + IOBS and AHH + IOBS + hemostatics group and between AHH + hemostatics and AHH +IOBS + hemostaties group (P > 0.05). The volume of blood loss was significantly higher in AHH + IOBS group, and the allogenic blood transfusion volume was significantly higher, while the percentage of the patients without allogeneie blood transfusion and without FFP transfusion lower in AHH + hemostatics group than in AHH + IOBS + hemostatics group ( P < 0.05 or 0.01 ), but there were no significant differences in the above parameters between IOBS + hemostatics group and AHH + IOBS + hemostatics group ( P > 0.05). Hb, Hct, Plt and Fib were significantly higher in IOBS + hemostatics group than in AHH + IOBS + hemostafics group( P < 0.05), but there were no significant differences in the above parameters between AHH + IOBS and AHH +IOBS + hemostatics group and between AHH + hemostatics and AHH + IOBS + hemestatlcs group (P > 0.05 ). Conclusion The blood-saving efficacy of AHH-bemostatics-IOBS is good in patients undergoing orthopedic surgery and it is a safe technique.

Objective To research Henoch-Schonlein purpura purpura (HSP) and renal pathology in children.Methods 31 hospitalized HSP children that with normal urine routine and accepted renal biopsy in our hospital.Results There were different levels of kidney pathological damage in this group of 31 cases,the results of light microscope were from grade Ⅱ to grade Ⅵ The proportion was grade Ⅱ(35.48％,11 of 31),grade Ⅲ (54.83％,17 of 31),and grade Ⅳ,Ⅴ and Ⅵ (each 1 case of 31,3.23％ ).lmmunofluorescence pathology results were showed as following:merely IgA depositional (48.38％,15 of 31 ),IgA + IgG depositional ( 19.36％,6 of 31 ),IgA + IgM depositional ( 19.36％,6of 31 ),IgA + igG + IgM depositional ( 12.90％,4 of 31 ).Microalbuminuria had been founded in 14 cases,and the microalbuminuria level of 10 cases were higher than normal value( 10 of 14,71.43％ ).Conclusions HSP children had renal pathologic dysfunction,even the urine routine were normal,and the detection of urine microalbumin was a significant marker in the early stage.

Objective To investigate the changes in the concentration of myocardin in children with lupus nephritis (LN) under different degree of vessel damage.Methods Forty-nine children diagnosed with LN by routine tissue immunolfuorescence, light microscope, and electron microscope were included, and 30 healthy children were included as control group. The pathological classiifcations were performed according to the ISN/RPS 2003 LN pathological classiifcation criterion. According to the Katafuchi evaluation method, the semi quantitative assessment of glomerular and kidney tubule damage was carried out, and the degree of vascular damage was evaluated at the same time. Double antibody sandwich method was used to detect the concentration of serum myocardin.Results The glomerular and kidney tubules damage in children with LN were signiifcantly aggravated with higher pathological classification (P<0.05). Glomerular damage was positively correlated with renal interstitial damage (r=0.96, P<0.01). The degree of vascular damage was related to the degree of glomerular injury and renal interstitial injury, while it was no related with the results of clinical tests. There were different concentrations of myocardin among mild-, moderate-, severe-vessel damage and control groups (F=378.61,P<0.001), and the concentration of myocardin in moderate- and severe-vessel damage groups were obviously lower than those in control group and mild-vessel damage group (P<0.01) while there was no difference between control group and mild-vessel damage group (P>0.05). According to pathological type, there were signiifcant differences in the concentration of myocardial between control group and different pathological types (F=626.793,P<0.01). FromⅡ,Ⅲ,Ⅲ+Ⅴ,Ⅳ toⅣ+Ⅴ, the concentrations of myocardial were decreased systematically, and there were statistic differences between groups (P all<0.05).Conclusion The concentration of myocardin in children with LN can relfect the renal vascular damage to a certain extent. Elevation of myocardin concentration may be helpful for the repair of vascular damage.

Objective To investigate the effects of hemocoagulase in preventing and treating perioperative hemorrhage in patients undergoing total hip replacement and study its effects on perioperative blood coagulation function so as to provide objective basis for better clinical usage of hemocoagulase. Methods Eighty ASA Ⅰ Ⅱ patients undergoing total hip replacement under general anesthesia were randomly and equally divided into two groups, ie, Group Ⅰ (control group) that received normal saline for 4 ml iv and normal saline for 2 ml im 10 minutes preoperatively; GroupⅡ(hemocoagulase group) that received hemocoagulase for 2 kU iv and Hemocoagulase for 1 kU im 10 minutes preoperatively. The perioperative and postoperative bleeding volume was measured respectively; meanwhile, the indices of blood coagulation function were measured during operation, immediately, one and five days after operation. Results (1) The perioperative and postoperative bleeding volume in GroupⅡ was significantly less than that in Group Ⅰ ( P

ObjectiveStudy the relationship among CaSR expression, tubulointerstitial damage,metabolic disturbance of calcium and phosphorus and microvascular density around the tubulointerstitium in children with steroid-resistant nephrotic syndrome.Methods36 cases of children with primary nephrotic syndrome were divided into hormone-sensitive group and steroid-resistant group.Semi-quantitative scores for tubulointerstitial pathological evaluation of the extent of damage, automatic biochemical analyzer for the determination of serum calcium (Ca), phosphorus (P) concentration of renal tubular epithelial CaSR expression and microvessel microvascular density around the tubulointerstitium were determined by immunohistochemical assay.ResultsMore severe the tubulointerstitial damage, lower level of serum Ca and higher level of serum P were observed [(2.26 ± 0.15) mmol/L]in children of the steroid-resistant group and the steroid-sensitive group [(1.90 + 0.12) mmol/L, P ＜ 0.05].CaSR expression (4.63 + 0.78) of renal tubular epithelial cells in the steroid- sensitive group was significantly lower than that in the steroid-resistant group (6.56 + 1.22, P ＜ 0.05), but microvascular density was significantly higher in the steroid- sensitive group(2.98 +0.35 vs 2.02 +0.24, P ＜0.05).When the tubulointerstitial damage was mild, CaSR expression (4.15 +0.58) in renal tubular epithelial cells in the steroid- sensitive group (4.26 ±0.61) was lower than the steroid-resistant group(3.12 ± 0.33; 3.01 ± 0.21), and microvascular density was higher,but the difference was not significant(P ＞0.05).In the moderate tubulointerstitial damage, CaSR expression in renal tubular epithelial cells in the steroid- sensitive group (5.35 ± 0.64) was significantly lower than the resistant group (7.37 +0.81, P ＜0.01), and microvascular density was significantly higher than the resistant group (2.81 ±0.16, 2.02 ±0.14, P ＜0.05).Compared by mild and moderate tubulointerstitial damage in children with the steroid-resistant, CaSR expression (11.46 ± 1.38) in children with severe tubulointerstitial damage was significantly increased, and microvascular density (1.15 ± 0.11) was significantly decreased (all P ＜ 0.01).ConclusionsCaSR expression was increased and microvascular density around the tubulointerstitium was decreased in children with steroid-resistant nephrotic syndrome.Dut to steroid resistance, the cytotoxic of steroid damaged the renal tubular epithelial cells, the metabolic disturbance of calcium and phosphorus and the damage of blood vessel endothelium finally resulted in severe tubulointerstitial damage.

We enrolled 60 patients with American Association of Anesthesiologists grade Ⅰ - Ⅱ undergoing unilateral total knee arthroplasty. All patients received combined epidural and spinal anesthesia,and a nerve stimulator was used to guide placement of a femoral nerve catheter. Patients were divided into three groups according to the catheter location on X-ray : psoas muscle group ( n = 18 ), iliacus muscle group (n = 19) and local group (n =23). Visual analog scale (VAS) pain scores were recorded at rest and with movement at 4, 24 and 48 h postoperatively and sensory blockade of the femoral, obturator and lateral femoral cutaneous nerves was recorded at 24 h.There were no significant differences in femoral nerve blockade among the three groups. Obturator nerve blockade was significantly better in the psoas muscle group than in the iliacus muscle and local groups, and was also better in the local group than in the iliacus muscle group. There was no significant difference in lateral femoral cutaneous nerve blockade between the psoas muscle and iliacus muscle groups, but there was better blockade in both these groups than in the local group. At 4 h postoperatively, VAS pain scores at rest were significantly lower in the psoas muscle group than in the iliacus muscle and local groups, but there were no significant differences in VAS pain scores with movement among the three groups. At 24 and 48 h postoperatively, VAS scores at rest and with movement were significantly lower in the psoas muscle group than in the iliacus muscle and local groups.

Objective To explore the relationship between vascular endothelial growth factor (VEGF) concentration in urine and renal vascular damage in children with Henoch Schonlein purpura nephritis (HSPN).Methods The kidney pathological lesion of 78 biopsy-proven HSPN children was assessed with renal vascular damage, glomerular pathological damage, and tubulointerstitial pathological damage semi-quantitative points. The children were divided into 3 groups (light, medium, and heavy group) according to the renal vascular, glomerular, tubulointerstitial, glomerular and tubulointerstitial total pathological points. Blood and urine vascular endothelial growth factor concentration was detected by enzyme linked immunosorbent assay;the localized renal VEGF expression and microvessel density were detected by immunohistochemistry assay in the kidneys. Results The semi-quantitative points of glomerular, tubulointerstitial, renal vascular, and glomerular and tubulointerstitial total points in different groups had significant difference (all P＜0.01);the minor renal vascular damage, the higher light microvessel density, blood and kidney concentration of VEGF, and the VEGF excretion in the urine were also lower in different groups, and there were significant differences (all P＜0.01). Glomerular points were positively related with tubular points, vascular points, kidney total score (r=0.596,0.612, and 0.728;P＜0.05, 0.05, and 0.01 respectively). Microvessel density was highly positively related with blood VEGF and renal VEGF, and negatively rela-ted with urine VEGF (r=0.601, 0.696, and -0.639,all P＜0.01). Conclusion The urinary excretion of VEGF leads to the decrease of local kidney VEGF concentration resulting in the renal vascular injury, which may be the important reason for renal vascular damage and pathology chronic progress in HSPN children.

Objective To explore the effects of BCG and Poly I:C co-vaccination on the development of spleen T cell subsets of neonatal BALB/c mice. Methods Neonatal BALB/c mice were inoculated with BCG and/or Poly I:C intraperitoneally within 2-3 d after birth. Four weeks later, spleen cells of mice were isolated and the percentage of CD3+ CD8+ IFN-γ+,CD3+ CD8-IFN-γ+,CD3+ CD8+ IL-4+,CD3+ CD8- IL-4+,CD4+ Foxp3+ T cells,which represent Tc1,TH1,Tc2,TH2,Treg cells,respectively,were tested by flow cytometry at single cell level,and the ratios of TH 1/TH 2 and Tc1/Tc2 were calculated. Results The percentages of TH1 and Tc1 cells of BCG-vaccinated mice,Poly I:C-vaccinated mice and BCG plus Poly I:C-vaccinated mice were significantly higher than that of control mice(P＜0.05 or P＜0.01),and there was no difference among the three vaccinated group. The ratios of TH1/TH2 and total IFN-γ/IL-4 of the three vaccinated groups were higher than that of control group,but not the ratio of Tc1/Tc2. The TH1/TH2 ratio of BCG plus Poly I:C-vaccinated group was higher than that of BCG-vaccinated group(P＜0.05).The percentages of Trge cells showed no difference among the four groups(P＞0.05). Conclusion BCG and Poly I:C co-vaccination can significantly increase the number of Tc1 and TH 1 cells and TH 1/TH2 ratio in spleen cells. BCG and Poly I:C vaccination may have a synergistic effect on TH 1/TH2 ratio of spleen cells in neonataI mice. The percentage of CD4+ Foxp3+ T cells among four groups showed no significant difference.

The incidence of acute kidney injury(AKI) in neonate is not low,it occurs in many cases such as ischemic-hypoxic injury,infection,administration of nephrotoxicity drugs and urinary tract obstruction,of which perinatal asphyxia ranked first in China.Due to the severe food security crisis,the occurrence of urinary tract obstruction is rising in recent years.The child health care should pay attention to prevent and screen this kind of disease for the high risk group.The diagnosis of AKI is difficult for newborn because serum creatinine and urine are hard to make a definite boundary.So study of early markers of AKI seems to be of great importance,of which neutrophil gelatinase associated lipocalin and cystatin C are research focuses,treatments should aim at solving primary disease such as ischemic,and so on.Renal replacement therapy is recommended when it comes to severe cases,but mortality still remains high,corresponding to severe primary disease and complications.