This paper emphasizes the importance of the mechanism of renal tissue damage in conducting treatment of lupus nephritis in addition to the renal histology.There are at least 4 kinds of mechanisms related to the renal tissue damage of LN including circulating immune complex deposition,in situ immune complex formation,vasculitic change and thrombotic mircoangiopathy.Treatment according to the mechanisms of tissue damage will give rise to a much better result as compared with the classic treatment based on morphology alone.Multi-target immune theapy has been recommended for treatment of those severe and complicated LN.

Objective:To explore the application value of clopidogrel in patients with non ST segment elevation myo‐cardial infarction (NSTEMI) during emergency percutaneous coronary intervention (PCI) .Methods :A total of 168 NSTEMI patients treated in our hospital from Jan 2012 to Feb 2013 were randomly divided into clopidogrel group (n=84) and ticlopidine group (n=84) ,both groups received PCI .Therapeutic effect were observed and compared be‐tween two groups .Results:Compared with ticlopidine group , there were significant rise in percentage of TIMI blood flow grade 3 (88.1% vs .91.7% ) ,white blood cell counting [ (4.0 ± 2.9) 109/L vs .(7.2 ± 2.3) 109/L] and platelet counting [ (101 ± 35) 109/L vs .(141 ± 39) 109/L] ,and significant reduction in percentage of mild bleeding (40.5% vs .19.0% ) in clopidogrel group after operation 28d , P< 0.05 or < 0.01 ;compared with ticlopidine group , there were significant reductions in incidence rates of cardiovascular events (60.7% vs . 27.4% ) and adverse reactions (14.3% vs .10.8% ) in clopidogrel group after six‐month follow‐up ( P<0.05 both) .Conclusion:Clopi‐dogrel possesses satisfying therapeutic effect and high safety in patients with non ST segment elevation myocardial in ‐ farction during emergency percutaneous coronary intervention ,which is worth extension .

Total hip and knee replacements, which have developed for abou t forty years, have been widely used as effective surgical treatments for severe hip and knee diseases. This article discusses the recent advance in techniques of hip and knee replacement Chiefly in the aspects of hip or knee prosthesis des ign, improvement of materials and surgical techniques. In total hip replacement, second-generation cementing technique, new types of metal-on-metal prosthesi s and minimally invasive technique have been applied to enhance the stability, r educe the wear rate and facilitate the functional recovery. In knee replacement, mobile bearing and high flexion are great advancements made in design. The comp uter-aided operational technique has greatly improved the replacement.

Objective This study was to investigate the effects of branched-chain amino acid (BCAA) supplementation on the metabolism of glucose and gluconeogenesis. Methods 20 rowers were randomly assigned to supplemental group and control group. During 4 weeks of training, all athletes followed the same training program. After 4 weeks, tests were done on a rowing ergometer, which included an incremental test for 4 mmol/L lactate anaerobic threshold and 2km, 5km maximum intensity exercise. Blood samples were taken prior to, immediately post and 30min post exercise. Results The results showed that serum glucose, alanine values had no significant difference between BCAA group and control group in anaerobic threshold test. In 2km and 5km rowing ergometer exercise, serum glucose values in BCAA group were significant decreased immediately post exercise, but the values in control group were significant decreased both immediately post exercise and 30min post exercise. Serum alanine values in BCAA group were significant increased both immediately post exercise and 30min post exercise, but the values in control group were significant decreased immediately post exercise. Lactate concentrations increased in BCAA supplementation group and were significantly lower (P

Renal replacement therapy is an effective treatment for end-stage diabetic nephropathy.This review summarized recent literatures on hemodialysis,peritoneal dialysis and renal transplantation for end-stage diabetic nephropathy.The purpose is to guide doctors for treating end-stage diabetic nephropathy more reasonably.

Objective To investigate the effect of hypoxia on vascular endothelial growth factor (VEGF) expression and secretion in human renal fibroblasts. Methods Human renal fibroblasts were primary cultured from donor kidney, and cells in passage 3 were used in this experiment. Hypoxia was induced by incubation in a gas-tight box gassed with 10% CO2/10% H2/80% N2 for 24 hours. VEGF mRNA levels were measured by semi-quantitative RT-PCR method. VEGF proteins expressed on cell surface were measured by flow cytometry. VEGF proteins secreted into supernatants were measured by ELISA method. Results Hypoxia caused a 2. 5-fold increase of VEGF mRNA level in human renal fibroblasts. Hypoxia also induced significant increases of VEGF proteins on cell surfaces (mean fluorescence intensities: 1. 053?0. 055 vs 0.763?0.057, n=4,P

Objective:To introduce the experience of using the fresh autologous pericard ium in cardiac operation. 　　Methods:Fresh autologous pericardium unprepared by 0.5% glutardaldehyde was used in cardiac operations in 321 patients.It was used not only in repair of at rial septal defect and ventricular septal defect,but also in operations of many complicated congenital heart diseases,such as tetralogy of Fallot,double outlet of right ventricle,atrioventricular canal,single atrium anomalous pulmonary veno us connection,Ebstein's anomaly,tricuspid atresia,pulmonary atresia,single vent ricle,complete transposition of the great ateries.Autologous pericardium was als o used for enlargement aortic root in rheumatic heart disease and repairing of a trial septium after resection of the left atrial myxoma. 　　Results:Twenty patients (6.1%) died within 30 days after operation.The resi dual shunt was found in one patient with tetralogy of Fallot and three patients with ventricular septal defect.Two hundred and fourty-three patients (75.7%) w ere followed-up.No patient had hemolysis,embolism,infectious endocarditis,patch calciflcation or other complications concerned with the use of the autologous p ericardium after operation. 　　Conclusion:The fresh autologous pericardium is a good material for repairing cardiac defects.

Objective To identify the needs of home nursing of adult inpatients, and analyze the re-lated factors of the needs in order to give direction and information for the home care nursing. Methods A self-designed questionnaire was used to investigate the needs of home nursing of 172 adult inpatients. Results Of the 172 patients, 56(32.6%) patients considered the home care was necessary, and 66(38.4%) patients in an indifferent attitude,50(29.0%) patients thought it unnecessary. The need was positively related with the comprehension of home care. The need for home care of patients from different departments, age groups and subjective judgement of self-health had significant difference. Conclusions Home care are necessary for some kind of adult inpatients. We should perfect adult home care system and improve nursing level of community.

Objective To evaluate health-related quality of life in postpartum women and investigate the associated factors.Methods A questionnaire was designed to investigate the general situation of 419 postpartum women in Beijing,and use MOSSF-36 questionnaire (SF-36)developed by American Medical Outcome Research Group to evaluate and analyze their quality of life.Participants were stratified according to education level,age,occupation or family income and the SF-36 profiles in whole sample or in subgroups were compared.Results There are significant differences among different education level groups in PF and RE categories(both P＜0.05);among different age groups in RP,BP,VT,SF,RE categories (all P＜0.05);and among different occupation groups in PF,VT and SF(all P＜0.05).There is no difference among different income groups in all categories (P＞0.05).Conclusions Different age, occupation,education level,mother's and infant's age and depression play important roles in the quality of life in community postpartum women.