Objective The article was to analyze the features of gene mutation and clinical phenotype in Alport syndrome. Methods Next-generation sequencing was applied to capture the exons of COL4A3, COL4A4, COL4A5 genes in 30 cases of children with suspected or confirmed diagnosis of Alport syndrome and Sanger method was used to identify gene mutations of related family mem-bers.Provean database was applied in protein function prediction.We collected and analyzed clinical data of AS patients on the basis of gene mutation. Results All 30 children were diagnosed with AS by gene sequencing, among whom 4 boys were autosomal reces-sive inheritance, 16 boys and 10 girls were X-linked Alport syndrome.Next-generation sequencing detected 35 different gene mutations of COL4A3, COL4A4, COL4A5, including 19 missense mutations, 2 synonymous mutations, 4 splice-site mutations, 3 truncating mu-tations, 2 insertion mutations, 4 deletion mutations and 1 compound mutations.It was observed by Sanger sequencing that 20 mutations were inherited from the mother, 8 from the father, homozygous mutation in 1 propositus from the parents respectively, 8 novel mutations and 1 with unidentified source.All the 30 children had an onset of hematuria or proteinuria, 17 cases had a positive family history, 1 case had hearing loss, and no pathogenesis or renal insufficiency was found in the children.Renal biopsy was performed on 23 children, 13 minimal change disease ( MCD) and 10 mesangial proliferative glo-merulonephritis ( MsPNG) by light microscope.Extensive lamination and split of glomerular basement membrane dense layers were found in 9 children by electron microscope. Conclusion XLAS ac-counts for most AS patients and missense mutation is the main type in pathogenic mutations.Altogether, 31 mutations without disease notification were found.Most of children showed MCD in renal biopsy, with atypical electron microscope manifestations and rare extra renal manifestations.

Hereditary glomerular disease is an important part of kidney diseases .In recent years , hereditary glomerular disea-ses had a high incidence and poor prognosis .Thus, the studies involving hereditary glomerular diseases such as Alport syndrome , he-reditary nephritis syndrome and thin basement membrane disease , etc.have significant implications .This review mainly focuses on the pathogenesis , clinical features , diagnosis and treatment of Alport syndrome and hereditary nephritis syndrome .

The paper analyzes the current status of and problems in the development of non-government medical institutions in Shanghai, the advantages non-government medical institutions possess and the difficulties they face in the process of development. It advances the development orientation of non-government medical institutions, arguing that it is imperative to create circumstances and conditions for fair competition, formulate perfect supporting policies, and lead non-government medical institutions to the integration of their own development with the reform and development of the medical and health cause of the country. It argues, on the other hand, that non-government medical institutions must stress simultaneously the accumulation and the operation of capital so as to have a niche in the fierce competitions of the medical market.

Objective To discuss clinical effects of combined use of duodenoscopy and laparoscopy in the treatment of acute billiary pancreatitis(ABP).Methods The clinical data of 94 ABP patients who underwent minimally invasive treatment from February 2001 to Feburary 2006 were retrospectively reviewed.Among 94 ABP patients,59 patients had gallbladder stones were given laparoscopic cholecystectomy(LC)alone;14 patients had common bile duct stones received endoscopic nasobiliary drainage(ENBD),combined endoscopic sphincterotomy(EST)and LC;21 patients had both gallbladder and common bile duct stones received combined EST and LC.Results Postoperatively,in the whole group,only one patient had recurrent pancreatitis,one patient had hemobilia,and both cases followed ERCP+EST;two cases had lung infection,and one case had infection of abdominal incision.All of the 5 cases with postoperative compllcations were successfully treated by conservative therapy.The effective rate for the whole group was 100%.Conclusions Combined use of duodenoscopy and laparoscopy is significantly effective for treatment of acute biliary pancreatitis and this minimally invasive treatment is the ideal therapy for acute biliary pancreatitis.

The origin and the course of the thoracic duct and its opening into the vein were studied in 150 cadavers including 15 fetuses and 138 infants. They are classfied into 5 types.1. The normol type of the thoracic duct begins in the abdominal cavity as a single trunk, It ascends along the right side of the aorta and empties into the venous system on the left side at the root of the neck. This type of the duct which is described in the general text book, occurred in 84.67 per cent.2. The two-trunk type of the thoracic duct begins in the abdominal cavity as two trunks and ascends along the each side of the aorta. The two trunks join together at different levels in the thorax forming a single trunk which empties into the venous system on the left side at the root of the neck. This type of the duct occurred in 10.66 per cent.3. The bifurcated-type of the thoracic duct starts in the abdominal cavity as a single trunk and passing cephalad on the right side of the aorta and divides into two branches at the level of the 6th～4th thoracic vertebra, The right branch opens into the venous svstem on the right side and the left branch opens into the venous system on the left side. This type of the duct occurred in 3.33 per cent. The type which ascends along the left side of the aorta was found.4. The right thoracic duct begins in the abdominal cavity as a single trunk and runs its entire course along the left side of the aorta. The termination opens into the right jugular venous angle. This type of the duct occurred in 0.67 per cent.5. The left thoracic duct begins in the abdominal cavity as a single trunk and ascends along the left side of the aorta. It empties into the left jugular venous angle. This type of the duct occurred in 0.67 per cent.

The spatial structure of hemolymph node in the rat is studied by light, transmission and scanning electron microscopy after the fixation of arterial perfusion. The structure of hemolymph node is similar to that of the normal lymph node, and main characteristic is that a number of the red cells are seen in it. The erythrocytes were carried to the afferent lymphatic vessel and reach the medullary sinus, many erythrocytes travel through the rsubcapsula and cortical sinuses, and reach the lymphatic tissue of the local cortex with selectivity, and going through the paracortical zone and the sinus wall to the medulary sinus. Most of the red blood cells are phagocytosed by macrophages in the sinuses. The subcapsular and cortical sinuses of hemolymph nodes connect with medullary sinuses, and form a reticular lymphatic passage. Reticular cells in the sinuses constitute a spatial each other. There are macrophages, lymphocytes, plasmocytes and numerous red blood cells in the nets. Macrophages are anchored on the reticular cells by their pseudopodla, traping and phagocytosing the red cells and foreign matters. Sometimes a macrophage is found closely associated with lymphocytes.

Objective To observe the effect of different cryoprotective agents and temperature factors on the viability of Blastocystis hominis so as to explore the ideal method for preservation of B.hominis.Methods B.hominis agents were obtained from a patient's fecal specimen.Having washed by normal saline and divided into tubes,the samples were cryopreserved in-20 ℃ refrigerator or in-l96 ℃ liquid nitrogen with 10% DMSO,40% glycerol and 15% ethylene glycol respectively.The thawed B.hominis agents were then used for culture.By trypan blue staining and microscopy,the viability and proliferation of those resuscitative cells were investigated.Results B.hominis survived for 3 weeks at 18 ℃-20 ℃ while less than 1 week at 4 ℃-6 ℃.When stored in-20 ℃ refrigerator or liquid nitrogen with cryoprotective agents,they survived for more than 3 months.The cryopreservation with 40% glycerol at-196 ℃ for 6 months resulted in 41.7% viability of the revivified cells.Cleavage cells were easily observed after culturing for 72 hours.Conclusion Preserving B.hominis in liquid nitrogen with 40% glycerol is an optimal cryopreservation protocol.

Objective Saxagliptin regulates the level of blood glucose by selectively inhibiting high-performance dipeptidyl peptidase 4, but its action mechanism is not yet clear .This study was to investigate the effect of the novel hypoglycemic agent Saxaglip -tin on the expression of long non-coding RNA (LncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and its target gene products transforming growth factor-β1 ( TGF-β1 ) in human umbilical vein endothelial cells ( HUVECs) stimulated by high glucose. Methods HUVECs were cultured in with D-glucose (D-GS) at the concentrations of 5.5, 10, 20, and 30 mmol/L and Saxagliptin at 0, 0.01, 0.1, 1, and 10μmol/L.The best concentrations of D-GS and Saxagliptin were determined as 30 mmol/L and 1 μmol/L, respectively.The HUVECs were divided into four groups:control (5.5 mmol/L D-GS), Saxagliptin (5.5 mmol/L D-GS+1 μmol/L Saxagliptin ) , high glucose ( 30 mmol/L D-GS ) , and high glucose +Saxagliptin (30 mmol/L D-GS +1μmol/L Saxaglip-tin), all cultured for 24 hours.Then the expressions of MALAT1 and TGF-β1 mRNA in the cells were detected by qRT-PCR, that of the TGF-β1 protein determined by Western blot , and the level of TGF-β1 in the supernatant measured by ELISA . Results The expressions of LncRNA-MALAT1 and TGF-β1 were significantly increased in the high glucose group as compared with the control ( 8.65 ±0.70 vs1.00 ±0.00 and 1.36 ±0.07 vs 1.00 ±0.00, P<0.01) but markedly inhibited in the high glucose +Saxagliptin group in compari-son with the high glucose group (2.17 ±0.24 vs 8.65 ±0.70 and 1.15 ±0.02 vs 1.36 ±0.07, P<0.05). Conclusion High glu-cose can induce the overexpression of LncRNA-MALAT1 and its target gene products TGF-β1 in HUVECs and cause damage to the cells, while Saxagliptin can significantly suppress this effect .

Although private hospitals are generally encountering development difficulties, some private non-profit medical institutions thrived in the medical market. These hospitals have rich experiences in terms of manage-ment system, operation mechanism, and competition methods. In this paper, we summarize the experiences of those well-functioning private non-profit hospitals and analyze the essential conditions for developing private non-profit med-ical institutions. These conditions include meeting local health market needs, ensuring that the hospital management system and operation mechanism result in high-quality health services, ensuring hospital development meets local health plans ( in order to obtain policy support) , ensuring the goal of the hospital is public welfare and that the hospital has strong financial support, obtaining certain social and political capital, and ensuring high-quality managers and staff.

Objective To investigate the dose-response of micronuclei (MN) frequency in the lymphocytes irradiated with or without combination of α-particles and γ-rays. Methods Human lymphoblast cells HMy2.CIR were irradiated with 0 - 1 Gy of α-particles,0 - 5 Gy of γ-rays,and 0.025 -0.5 Gy of α-particles followed by different doses of γ-rays,respectively.The micronuclei (MN) in the irradiated cells were measured with the cytokinesis block technique,and the dose-responses of MN were established under different irradiation conditions.Results For γ-ray irradiation,the dose-response of MN was well-fit by the linear-quadratic model with an equation Y =c + αD + βD2.For α-particle irradiation,the MN induction increased linearly with the dose less than 0.250 Gy. But when the dose of α-particles increased continually,the dose-response curve bended and could be well fit with the BaD model Y =c + αD + σ[ 1 - exp( - δD) ] exp( - βD) where radiation-induced bystander effect (RIBE) was indicated.For the combined exposure,the dose-response of MN was similar to that of γ-irradiation when the dose of α-particles was lower than 0.1 Gy,but it was similar to that of α-irradiation when the dose of α-particles was higher.When the dose of α-particles was 0.2 and 0.5 Gy,MN induced by the mixed radiation were significantly higher than the sum of corresponding irradiation alone ( t =5.22 - 11.86,P ＜ 0.05 ).Conclusions The radiation damage of α-particles differs from that of γ-rays,where RIBE may be involved.The combination irradiation of α-particles and γ-rays has a synergistic effect on radiation damage of lymphoblast cells.