Objective To analyse the clinicopathological changes of Alport syndrome (AS) and to detect the deposition of type Ⅳ collagen within basement membrane of Alport patients. Methods Fourteen patients with AS (12 families) hospitalized from 1990. 1 to 1996. 6 were investigated. Eleven were male and 3 female (mean age 29. 4 years). Results Microscopic hematuria was found in 13, with recurrent gross hematuria in 7. All had proteinuria. Three patients presented nephrotic syndrome. Progressive renal failure occured in 10 of 11 male(11 - 39 years) and 1 female (40 years). Six patients were treated with hemodialysis, two of them with transplantation. Sensorineural deafness was observed in 9 patients particularly high frequency sound. Anterior lenticonus were presented in 2. It showed heterogeneitic, 50% transmitted as X-linked dominant(XD) trait. In 7 renal biopsies, the findings by light microscopy mostly revealed focal and segmental sclerosis glomerulonephritis (4/7). The results of immunofluorescenc e (IF) were ne gatt ye in 4. Ultrastructural studies showed variable thickening, thinning of glomerular basement membrane (GBM) in 7 specimens with lamellation and basket-weaving of GBM in 1. Using the iIF technique, the ?3, 4, 5 (Ⅳ) chains were absent within both GBM and EBM of 4 male XD-AS patients. Conclusions AS is not a rare hereditary disease characterized by hematuria, proteinuria and progressive renal failure with sensorineural deafness and ocular lesions. Type Ⅳ collagen within Alpori patients' basement membrane is abnormal and iIF study of type Ⅳ collagen chains distribution is useful to confirm the diagnosis of AS.

16?Gy) of STRS seems to reduce the incidence of rebleeding after radiosurgery. However,there is no histopathologic evidence of vascular obliteration in the resected CCA specimens after radiosurgery. The benefits and risks must be carefully balanced before the use of radiosurgery for cerebral cavernous hemangioma.

Objective To reproduce a rat model of collagen-induced arthritis with anemia,and to probe the effects of thalidomide on hemoglobin of these rats.Methods 128 male Wistar rats were randomly divided into 5 groups:Ⅰ(normal control group,n=24),Ⅱ(model group,n=26),Ⅲ(model group with high dosage of thalidomide,n=26,200mg?kg-1?d-1),Ⅳ(model group with low dosage of thalidomide,n=26,100 mg?kg-1?d-1)andⅤ(model group with methotrexate(MTX),n=26,2.7mg?kg-1?w-1).Every group was divided into 6 sub-groups(14,21,28,35,42 and 60d)according to different time points.The rat models with collagen-induced arthritis and anemia were reproduced by multiple subcutaneous injections at intervals of emulsion of collagen Ⅱ and Freund's complete adjuvant.Different kinds of treatment were given to the rats of different groups beginning on the 12th day after the first injection.The levels of hemoglobin in rats of group Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ were determined,and serological characteristics,morphologic changes,and serum iron content,total iron binding capacity,and pathological changes in bone marrow in rats of group Ⅰ and Ⅱ were observed.Results On the 28th day after the first injection,anemia appeared in rats of group Ⅱ,in which the hemoglobin level was lower significantly compared with that of group Ⅰ(P

Objective To isolate and identify differential expression genes associated with multidrug resistance of leukemia . Methods Differential expression genes between leukemia cell line K 562 and resistant cell lines K562/DOX were isolated by using suppression subtractive hybridization (SSH) technique .Total RNA were extracted .cDNA were synthesized and digested by restric-tion enzyme Rsa Ⅰ ,then connected with adopter1 and adopter2R ,and linked with pMD19-T vector .Constructed vectors were trans-ferred into E .coli .Subtracted cDNA library was constructed ,and the positive clones were screened according to base sequences and homologous sequences .The differential expression genes were indentified by comparison analysis of Gene Bank database .Results A total of 220 differential expression genes were sequenced ,including hemoglobin ,ribosomes and mitochondria related genes ,and heat shock factor binding protein 1 (HSPB1) gene and other genes .Conclusion SSH method and molecular cloning technique could be used to construct subtracted cDNA library of differential expression genes between drug resistant and not -resistant leukemia cells , which might be useful for further screening and cloning of differential expression genes of multidrug resistant tumor cells .

Objective To explore common risk factors of the first acute ischemic cerebral stroke patients′neurological deficits and build a short-term prognosis model. Methods 89 hospitalized patients with acute is-chemic cerebral stroke were chosen for study from September 2014 to December 2015 in the Fifth Affiliated Hos-pital of Zhengzhou University. Our study′s evaluation methods were using the unified questionnaires , the NIHSS score and the mRS scale. Results Traditional risk factors were no significant difference among the three groups (P > 0.05); 6 kinds of hematology indexes such as WBC count had significant difference in NIHSS score (P <0.05) and prognosis(P < 0.05); 6 kinds of hematology indexes such as D-D and the NIHSS score had a signifi-cant effect on prognosis (OR = 1.800, 0.976, 1.112, 1.327, 5.564, 6.456, 1.227); the area under ROC curve was 0.976, which proved the model had a good predictive value. Conclusion Traditional risk factors had no significant difference among the different neurological deficits groups; 6 kinds of hematology indexes such as D-D and NIHSS score on admission had a significant influence on prognosis; the model predicted the short-term prognosis of acute ischemic cerebral stroke more accurately.

Objective To discuss the effective nursing measures in interventional therapy for deep vein thrombosis (DVT) of lower extremities in order to improve the successful rate of the procedure and to decrease the occurrence of complications. Methods Comprehensive nursing measures, including general nursing care, specific nursing care and emergency nursing care, were employed in 63 DVT patients receiving interventional therapy. Clinical response and complications were observed. Results After the treatment, the disorder was cured in 31 cases, while excellent result was seen in 26 cases and obvious improvement in 6 cases. During the procedure, bleeding at puncture site occurred in 16 cases, pulmonary embolism in 2 cases and cerebral hemorrhage in one case. No death occurred. Conclusion Comprehensive nursing measures can effectively prevent or reduce the occurrence of complications, decrease the mortality rate. Therefore, Comprehensive nursing measures are the most helpful nursing care for DVT patients receiving interventional therapy.

Objective To explore the effect of triperygium wilfordii polyglucoside(TWP) on the podocytes of rats with diabetes nephropathy(DN). Methods One hundred SD rats were randomly divided into normal control group (Group A),DN group (Group B),TWP group(Group C).TWP group was divided into 3 subgroups(Ca,Cb,Cc)according to the different doses 4,8,16mg·kg-1·d-1,respectively.Rats in DN group and TWp group were given streptozocin(STZ)by intraperitoneal injection to establish animal model of diabetes.After 12 weeks,24 h urinary protein excretion rate(UAER),BUN,Scr,white blood cell(WBC),blood glucose(Glu),and kidney weight (KW)/body weight(BW)were determined.The renal pathological changes were evaluated by HE staining.The structural change of podocytes was observed by transmission electron microscope.The expressions of nephrin and podocin were evaluated by immunofluorescence staining. Results (1)Compared to group A,Scr,BUN,Glu,KW/BW,and UAER were significantly higher(P＜0.05)in group B and group C.Whereas the elevated liver enzymes and the decreased WBC were presented in group Cc (3/20). Compared to group A, the protein expressions of nephrin and podocin in nephridial tissue were lower, and the significant differences of pathomorphology in glomerulus,tubules and podocytes were observed in group B and group C. (2) Compared to group B, KW/BW and UAER were lower in group C (P＜0.01); the protein expressions of nephrin and podocin were higher in nephridial tissue; the pathomorphological improvements were exhibited in glomerulus,tubules and podocytes in group C, paralleled with the increase of TWP dose (P＜0.05 or P＜0.01).Conclusions TWP may exert the protective effect on podocytes in diabetic nephropathy rats,dependent on the dose of TWP. The mechanism may be associated with the up-regulatied expressions of nephrin and podocin.

Objective To investigate the underlying mutation in a late-onset Chinese patient with classic Bartter syndrome. Methods The mutation analysis of CLCNKB gene was performed by the PCR direct sequencing. The patient's parents and siblings were studied as well. Fifty normal volunteers were analyzed as control group. Results The heterozygous deletion mutation cDNA 753delG and heterozygous missense mutation G433E were detected in the patient. Her father was found to carry heterozygous G433E and her mother to carry cDNA 753delG mutation respectively. Her brother carried heterozygous G433E and her sister was normal. Conclusions Two mutations of the CLCNKB gene in this Chinese patient with late-onset classic Bartter syndrome are identified. The cDNA 753delG mutation has not been reported previously.

Objective To screen the mutations in 30 exons of COL4A5 gene from X-linked Alport syndrome. Methods 20 Chinese X-linked Alport syndrome patients from 16 families were examined. Genomic DNA was extracted from peripheral leukocyte and exon-specific primers were designed for 30 exons(1-25、31、 32、41、 50、51) . Polymerase chain reaction amplification was performed and followed bydegenerating gel gradient electrophoresis (DGGE) analysis. All abnormal migration bands were sequenced and one hundred normal persons selected as control. Results Four abnormal bands were detected, which were all point mutations and predicted to be functionally pathogenic, in four unrelated patients. One patienthad a nonsense mutation in exon 1 (Glu 22 Term); one had a missense mutation in exon 3l(Gly852Val).Two patients carried splicing mutations in intron 1 and 25 respectively(283+1G→T、2150 + 1G→T) .Conclusions X-linked Alport syndrome is caused by various kinds of COL4A5 gene mutations without any hotspot. Paralleled with the significance of exon mutations, intron mutations also play a critical role in the pathogenesis. Furthermore, these four pathogenic mutations have never been reported in the genebank and showed good correlation with clinical manifestations.

Objective To explore methods to develop a hospital quality of care index system of county level hospitals based on the homepage of inpatient medical records and examine the validity of this system. Methods By means of literature review, homepage data and panel discussion, along with theories and statistical methods, indexes were identified. The dimensions and indices of the index system were pinpointed. Confirmatory factor analysis and normalization methods were combined to calculate the weights and scores of such indices. Scores were adjusted by Charlson comorbidity index ( CCI) with multi-regression method. The hospitals were ranked by adjusted scores in each dimension. The validity was evaluated by comparing the application results to universally acknowledged standards, such as hospital level and economic level of the geographic areas. Results An index system with 6 dimensions and 25 indices was developed, and the application results proved valid to some extent. The adjustment of CCI also proved effective. The 6 dimensions were correlated yet their directions were not consistent. Conclusions The methods and data used to develop the system have demonstrated strong operability and availability. The application results can reflect medical care quality in different aspects making it applicable among homogeneous hospitals. It is meaningful to assess dimensions respectively.