Objective To analyze the clinical and pathologieal characteristics of IgA nephmlogy secondary to primary sj(o)gren's syndrome(pSS).Method The clinical and pathological data of 8 patients with pSS and IgA in Changzheng Hospital from 2004 to 2009 were analyzed.Results The average age of seven female and one male was (44±8) years old.Five patients presented with edema and proteinuria.Eight patients presented with microhematuria.The average 24-hour proteinuria was (3±4) g.Two patients had hypertension.Serum creatinine levels of two patients were higher than normal level,the others'were normal.Light microscopy examination showed three patients were mild mesangial proliferation with Lee's classification grade Ⅰ;five patients had global sclerosis with Lee's classification grade Ⅱ,Ⅲ and Ⅳ.Positive IgA was mainly found under immunofluorescence microscopy.Electronic microscopy showed no electron-dense deposits.Conclusion IgA nephrology secondary to pSS is different from primary IgA nephrology under immunofluorescence microscopy.

Objective To observe the efficacy of ealcitonin and bisphosphonates on renal osteopathy of maintenance hemodialysis (MHD)patients. Methods Forty-three MHD patients were raindomly divided into two groups: A group and B group. All the patients were routinely received oral calcium carbonate 1.0 g tid and calcitriol 0.25 μg qd. Calcitonin (20U) hypodermic injection was given three times a week additionally during hemodialysis in A group. Patients in B group received bisphosphonates 70 mg once a week based on the therapy of A group. Serum levels of intact parathyroid hormone (iPTH), calcium, phosphorus, alkaline phosphatase (AKP), bone mass density (BMD) of lumbar spine and femoral neck, and the degree of bone ache (visual analogue scale, VAS) were assessed before the therapy and 3, 6 and 12 months after treatment. The adverse reactions were recorded during treatment. Results The levels of AKP and iPTH in both two groups decreased significantly after treatment. The above values of pre-treatment and 12 months after treatment were as follows: AKP(U/L)of A group 244.05±41.99 and 148.35±27.71,of B group 245.60±40.86 and 143.40±28.03;PTH(ng/L) of A group 697.5±119.7 and 267.4±45.9,of B group 708.2±120.3 and 277.6±41.9 (all P<0.05). While the levels of calcium and phosphorus did not change obviously during treatment (P>0.05). BMD was not improved at 3, 6 mouths and became better at 12 mouths after treatment. As compared to pre-treatment, BMD of lumbar spine(g/cm2) in A group was 1.062±0.223 vs 1.202±0.251 ,in B group 1.033±0.152 vs 1.189±0.225; BMD of femoral neck (g/cm2)in A group was 0.993±0.108 vs 1.067±0.095,in B group 0.947±0.083 vs 1.018 ±0.217 (all P<0.05). The scores of VAS also decreased significantly at 3, 6, 12 months after treatment(P<0.05). No severe adverse reaction was found during the treatment. Conclusions Utilization of calcitonin and combination with bisphosphonates during bemodialysis can effectively preserve the BMD and prevent bone loss in MHD patients and is well tolerated. No significant difference of therapeutic effect is observed between using ealcitonin or combination with bisphosphonates.

Objective To explore the role of defoamer enema combined with bellym assage on the colonic preparation in elderly patients with constipation. Methods One hundred patients were divided into two groups by random number table method, the experimental group and the control group with 50 cases each. Patients in the control group were told to drink polyethyleneglycolelectrolytesolution 3000 ml. Patients in the experimental group were told to drink polyethyleneglycolelectrolytesolution 2000 ml. After medicinepre paration, the patients of experimental group were given defoamer enema. After that, they were undertaken counterclockwise massage for10 mins, then massageing clockwise until defecation. Results 14 patients with oral catharsis drugs failed to give up check, 46 cases of intervention group and 40 cases of control group finally complete intestinal preparation and colonoscopy. Intervention group patients after bowel preparation before the incidence of abdominal distension, abdominal pain were 6.52% (3/46), 8.70%(4/46), lower than the control group 65.00% (26/40), 25.00% (10/40), the difference was statistically significant (χ2= 32.74, 4.17, P< 0.05). Percent of pass was 65.22%(30/46) for intestinal preparation intervention group, significantly higher than the control group 35.00% (14/40), the difference was statistically significant (χ2= 7.82, P< 0.05). Intervention group intestinal cleanliness ratings of Ottawa total score was 4.00 (4.00), which was lower than the control group 7.00 (4.50), the difference was statistically significant (Z= 3.80, P< 0.05). Endoscopic check process, the intervention group arrived at the terminal ileum and mirror back time were 7.00 (3.00) and 9.00 (1.00) min, were less than 9.00(6.50) and 10.50 (3.00) min in the control group, the difference was statistically significant (Z= 2.09, 4.53, P< 0.05). Intervention group of colons polyps detection rate was 67.39% (31/46), higher than that of control group 30.00% (12/40), the difference was statistically significant (χ2 = 11.97, P< 0.05). Conclusions The bowel preparation with defoamer enema will enhance the intestinal tract cleaness and the detection rate of polyps in elderly patients with constipation.

Objective:To evaluate one-year efficacy and safety of sirolimus-eluting stent with biodegradable polymer coating (EXCEL stent) in treating patients with coronary artery disease. Methods:One hundred consecutive hospitalized patients with coronary artery diseases exclusively treated with EXCEL stents were prospectively enrolled.After undergoing porcutaneous coronary intervention (PCI) all patients received dual anti-platelet therapy with clopidogrel and aspirin for 6 months and followed by aspirin alone.The primary end point was major adverse cardiac events(MACE) at 12 months.The secondary end points included binary in-stent restenosis rate(ISR)measured by quantitative coronary angiography (QCA) analysis at mean 8 months post the index PCI procedure,and MACE at 30 days and 6 months. Results:All patients were successfully treated with EXCEL stents during PCI procedure.Among all 153 target lesions,127 lesions were type B2/C complex lesions (83.0%).The mean length and diameter of the target lesions were 29.42?15.90 mm and 3.17?0.53 mm,respectively.A total of 211 EXCEL stents were implanted with average stent number of 2.02?1.53 per patient.The mean stent length and diameter were 35.34?17.35 mm and 3.23?0.46 mm,respectively.Four patients (4.0%) reached the primary end point at 12 months,which were 4 target lesion re-PCI due to ISR.No death,MI,or in-stent thrombosis occurred during the 6-month aspirin treatment alone after comleting 6-month dual anti-platelet therapy.QCA analysis of 112 le- sions of 75 patients showed 3.6% (4/112) of in-stent restenosis and 5.4% (6/112) of in-segment restenosis. Conclusions:The initial registry study showed that comparison with the published data from previous pivotal studies of others drug-eluting stents,the EXCEL stent revealed similarly incidence of 12-month ISR and/or MACE for the real world patients with coronary artery disease.The anti-platelet regimen of 6-month clopidogrel treatment after EXCEL implantation was safe.This con- clusion requires further investigation by large scale,multi-center,and longer-term follow-up clinical trials.

Objective To investigate the application value of modified early warning score (MEWS) for assessment of patients in pre hospital first aid.Methods For patients with MEWS method in 3 478 cases of pre hospital first aid,scored in 0-4,5-9 and ≥ 10 points.Analysis of the relationship between the distribution and severity in patients with different grades,and tracing the fate and the condition of patients after admission.Results In MEWS patients with low 0-4 points was divided into pre hospital first aid,accounted for 69.18％ (2 406/3 478),severe cases accounted for 2.58％ (62/2 406); MEWS 5-9 accounted for 21.54％ (749/3 478),severe patients increased to 37.92％ (284/749); MEWS ≥ 10 points accounted for only 9.29％ (323/3 478),severe patients increased to 87.00％ (281/323).MEWS scores higher ratio in patients with severe more,MEWS 5-9 points,severe patients with MEWS ≥ 10 points 0-4 critical patients proportion (P ＜ 0.01).MEWS 5-9 points,≥ 10 points patients admitted to a specialist ward and intensive care units treatment compared with MEWS 0-4 points patients increased significandy (P ＜ 0.01),the mortality rate was also significandy increased (P ＜ 0.01).Conclusion The MEWS method in pre hospital first aid to early warning of potential in critically ill patients,the higher score,the more serious condition,the higher mortality rate.

0.05).The difference between the two groups was not significant(P=0.834).Conclusion:The incidence of drug fever induced by the use of puerarin sterile injection powder was not more than that of the controlled group.

Objective To assess the clinical value of measuring the concentration of serum osteoprotegerin (OPG) in detecting the bone metastases in patients with prostate cancer. Methods The concentration of serum OPG in 40 patients was determined by ELISA. The data of ECT bone scan and Gleason score was collected simultaneously. The correlations between serum OPG and bone metastases, Gleason score were tested. Results The concentration of serum OPG in patients with bone metastases by ECT scan was( 16 237. 19 ±5144. 26) ng/L,which was significantly higher than the concentration in patients without bone metastases , which was (12 123.32 ±4136. 50)ng/L. There was no significant correlation between serum OPG and Gleason score. Conclusions The serum OPG has an important clinical value in prediction of prostate cancer with bone metastases. There is no significant correlation between serum OPG and the Gleason score.

Objective:To establish experimental teaching model for slippery pulse by mini-pig.Methods:The model of slippery pulse was established by driping low molecule dextran in vein.The normal and slippery pulse were extracted from axil artery of mini-pig by two experienced traditional Chinese physician through double blind method.Meanwile,the correlative parameters of pulse graph of axil artery such as MSAB,MSBC,HFF,HE/HB and TW were extracted through optimizational extraction method by using NX-8 multifunctional sphygmograph.Results:The pulse rate of slippery pulse of mini-pig was slightly fast than that of normal pulse.The rhythm of slippery pulse was regularity,the nger sensation was powerful,and the pulse syate was smooth.Compared with the normal pluse,the pulse graph of slippery pluse displayed a steep ascend ramus,high and narrow B wave,tiny D wave,lower E valley and obvious F wave.HB,MSAB and MSBC increased(P

PurposeIt has been reported that women have higher incidence of Modic changes than men and it may be related to the change of female hormone levels during menopause which leads to osteoporosis and other factors. This paper investigated the relationship between vertebral bone mineral density (BMD) of menopausal female suffering from chronic low pain and lumbar vertebral Modic changes on MRI, to explore the effect of vertebral bone mineral density upon Modic changes.Materials and Methods A total of 205 menopausal women with chronic low back pain were enrolled and underwent vertebral bone mineral density measurement and lumbar MRI examination. The bone mass of vertebral body and bone imaging data were observed. All patients were divided into three groups according to their level of bone mass: group of normal bone mass: 128 cases; osteopenia group: 58 cases; osteoporosis group: 19 cases. The incidence rate of Modic changes was compared among the three groups and the relationship between bone mineral density and vertebral Modic changes was further analyzed.Results Among 205 patients, 128 were with normal bone mass, 44 had Modic changes (type I: 19 cases; type II: 22 cases; type III: 3 cases) and the incidence rate was 34.4%; osteopenia occurred in 58 patients, among whom 34 had Modic changes (type I: 15 cases; type II: 17 cases; type III: 2 cases), which showed that the rate was 58.6%; 19 patients presented osteoporosis, 15 of whom appeared Modic changes (type I: 6 cases, type II: 7 cases;type III: 2 cases), with the rate of 78.9%. There was statistically signiifcant difference in incidence rate of Modic changes among the three groups (χ2=18.995,P<0.05). Pearson column connection numberC=0.29<0.40. The osteopenia group and osteoporosis group both had higher incidence rates than the group of normal bone mass (χ2=9.636 and 13.680,P<0.01), and the incidence rate showed no difference between the osteopenia group and osteoporosis group (χ2=2.555,P>0.05).Conclusion Lumbar vertebral bone mineral density is correlated to the incidence of vertebral Modic changes in menopausal women with chronic low back pain. With the loss of vertebral bone mass, the incidence of vertebral Modic changes gradually rise. However, the correlation is rather weak; Modic change is a dynamic process, which is also influenced by other factors except vertebral bone mineral density.

Objective To evaluate the effects of alendronate sodium on bone mineral density (BMD) in maintenance haemodialysis (MHD) patients with osteoporosis. Methods Twenty-eight MHD patients with osteoporosis diagnosed by dual energy X-ray absorptiometry were randomly divided into control group (n=15) and treatment group (n=13). Patients in treatment group were treated with oral 70 mg alendronate sodium once a week for 18 months. BMD of hip and lumbar spine was measured by dual energy X-ray absorptiometry at baseline and the end of the 6th, 12th and 18th month. Parathyroid hormone, calcium, phosphorous, alkaline phosphatase levels, blood routine, hepatic and renal function were assayed at baseline and the end of the 18th month, Kt/V was calculated, new bone fracture was recorded. Results The BMD, T-scores and Z-scores in the lumbar spine and specific regions of the hip were stable in the treatment group and obviously decreased in the control group (P<0.01). New bone fracture was found in 1 patient of the treatment group and 5 patients of the control group. The side-effect of alendronate sodium was epigastric discomfort in 1 cases. Conclusions Oral alendronate sodium appears to be well tolerated in MHD patients and keep the BMD stable in the lumbar spine and specific regions of the hip.