Objective To assess the possible differences of the clinical features and renal pathology between children and adults with Henoch Schoelein purpura (HSP),and the contribution of clinical and renal biopsy parameters to predict the disease outcome.Methods A retrospective study was performed in 156 patients with HSP.Patients younger than 16 years at disease onset were considered children,and those aged 16 years or over were considered adults.Results The male was more prevalent in both adults and children HSP groups (M∶F=1 5∶1).The previous drug treatment,and special food intake were more frequent among the adults ( P =0 03 and 0 009,respectively).Renal involvement,increased ESR and serum IgA levels were more frequent in adults,but vomiting and joint pain were more in children.The frequencies of previous upper respiratory tract infection (URTI),fever,abdominal pain,melena and nephrotic syndrome were similar in both groups.Multivariate analysis showed that age at the disease onset,URTI and abdominal pain were predictive for renal involvement (RR=7 8,4 1 and 4 6,respectively).There were no differences of the renal pathologic types between two groups.However,lesions other than glomeruli including tubular and interstitial involvement were more frequent in adults.The outcome was better in children after a mean follow up of 6 2 years.Renal disease was the main clinical manifestation in non complete remission (NCR) patients.The proteinuria and the other area lesions out of glomeruli predict the decreased remission rate (RR=5 3 and 6 7,respectively).Conclusion These results indicate that HSP is more serious and nephritis is more frequent in adults.Proteinuria and lesions other than glomeruli are the higher risk factors of NCR.

Objective To evaluate the current situation of autoantibodies detection in China in order to improve the quality of detection. Method Inviting letters to partitcipate this evaluation were sent to all laboratories that detect auto-antibodies. Those responding laboratories were enrolled to this study. The testing items included antinuclear antibody, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondrial antobody and anti-smooth muscle antibody. The distribution of samples and the analysis of results were both double-blinded. Result The correct rate of ANA, anti-dsDNA antibody, anti-ENA antibody, anti-mitochondria antibody and anti-smooth muscle antibody was 85.4%,81.8%,36.9%, 66.7%, and 50% respectively. Conclusion Comparing with the first quality control results, the overall results is this evaluation have been improved, but there is still a longway to go.

ObjectiveTo evaluate the therapeutic effect of vitreo-retinal surgery on oclular siderosis. MethodsThe clinical data of 22 patinets (22 eyes) with ocular siderosis due to the magnetic foreign body at intraocular postsegment were retrospectively analyzed. The patients aged from 6 to 54 years (average 40 years), including 21 males and 1 femal. The duration of the magnetic foreign body remained in the eye lasted for 1 month to 20 years. The preoperative best corrected visual acuity (BCVA) was <0.01 in 15 eyes, 0. 01-0. 15 in 5 eyes and 0.1-0.2 in 2 eyes. There was Intra-vitreous foreign body in 18 eyes and ocular wall embedded foreign body in 4 eyes; intraocular foreign body (IOFB) combined with cataract in 18 eyes; combined with retinal detachment in 3 eyes; scleral buckling combined with silicon oil filled in 12 eyes and C3F8 filled in 7 eyes.Cataract extraction was performed in 12 eyes, and 2 eyes underwent filtrating surgery. ResultsThe IOFB was successfully removed by one-off surgery in 22 eyes. BCVA increased in 20 eyes (90.9%) and kept unchanged in 2 eyes (9. 1%), including<0.1 in 7 eyes, 0. 1-0.4 in 8 eyes, and 0.5-1.0 in 7 eyes. Operative complications involved retinal holes with retinal detachment in 2 eyes and vitreous haemorrhage secondary to enlarge sclera incision in 2 eyes.Postoperative complications included secondary cataract in 4 eyes, retinal detachment due to silicon oil removal 3 months after submacular removal of foreign body in 1 eye, and retinal detachment 7 days after C3F8 filling in 1 eye; the latter two eyes had reattached retina after another silicon oil filling. At the end of the follow-up period, retina reattached in 22 eyes. ConclusionAdvanced modern vireo-retinal operation is ffective on oclular siderosis, which can avoid the release of Fe+ and improve the patients' visual function.

OBJECTIVE: To explore a new hospital pharmacy management mode. METHODS: The tradition pharmacy management model undergone reformation by integrating the original outpatient pharmacy, out - patient traditional Chinese pharmacy (excluding cut crude drug section) and inpatient pharmacy into one general pharmacy. RESULTS: The operation of general pharmacy not only reduced the personnel, the storing space and the stock of drugs, but also simplified the management flow - sheet. CONCLUSION: Under permitted condition, hospitals might take into account general pharmacy management mode.

Objective To observe the therapeutic effect of tumor necrosis factor inhibitor (Etanercept) on intractable ankylosing spondylitis (AS) related hip joint lesion. Methods Thirty-five patients with AS with unilateral or bilateral hip joints pain and limitation of joint motion were included into this study. The patients' conditions were not controlled under standard treatment by non-steroidal anti-inflamma-tory drug and antirheumatic medications. The clinical trial was designed as a prospectiveopen study, 35 pati-ents received Etanercept 50 mg once a week for 12 weeks, combined with methotrexate (MTX) 10 mg once a week. Parameters including Harris hip score, Bath ankylosing spondylitis radiologic index-hip (BASRI-hip), Bath ankyiosing spondylitis disc.use activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), Erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were evaluated and side effects were observed before and after the treatment. Results Fifty-five hip joints were involved in 35 patients, in which unilateral hip involvement in 15 patients and bilateral in 20 patients. Harris score of the hips iner-eased significantly from 51±4 before treatment to 86±5 (P=0.000) after treatment ; Before and after treatment, BASDAI changed from 6.4±1.2 to 4.4±0.8 (P=0.000), BASFI was changed from 6.3±1.1 to 3.4±0.8 (P=0.000), before and after treatment ESR was changed from (68±28) mm/l h to (25±6) mm/l h (P=0.001), CRP changed from (59.1±22.3) mg/l, to (6.9±1.1) mg/L (P=0.000) before and after treatment respectively, but BASRI-hip was not changed obviously before and after treatment. No tuberculosis and serious side effects was observed during the treatment and follow-up period. Conclusion Etanercept, when combined with methotrexate, could be used to treatintractahle AS-related hip joint lesions. This regimen could improve the hip joint function and control the disease activity without serious side effects.

Objective To assess the effect of IL 1Ra gene transfer on amelioration of symptoms and cartilage injury of osteoarthritis (OA) in rabbit. Methods Thirty New Zealand rabbits were divided into 3 groups. Synovial membrane was harvested from the left knee, and synovial fibroblasts were isolated and cultured. Fibroblasts from each rabbit were traanfected using the retrovirus with either IL 1Ra gene (group 3) or marker gene (group 2) in vitro . OA was induced in the right knee of all rabbits by anterior cruciate ligament transection (ACLT). The autologous cells tranfected with IL 1Ra gene or marker gene were respectively injected into the right knee of group 3 and 2. At the end of 2nd and 4th week, IL 1Ra level in synonival fluid (SF) of the right knee were determined by ELISA. The results were evaluated by grading local pain stimulating response, change of gait, joint swelling, and range of joint motion. The degree of injury to the cartilage was graded by the staining of India ink and pathological examination. Results The IL 1Ra level in the right knee SF of group 3 were 20 16?1 8 ng/ml and 4 82?0 52 ng/ml at the end of 2 and 4 weeks after gene delivery, respectively, while that in the group 2 and group 1 was very low. In IL 1Ra gene transfection group, the symptoms of the joint injury and the degree of cartilage lesion were less severe compared with control group. Conclusion This study showed that IL Ra transfer could raise IL 1Ra level in knee joints, thereby alleviate the symptoms and cartilage injury in experimental osteoarthritis

3 on biopsy contributed significantly to the prognostic value of RSR,and the presence of tubular atrophy was associated with decreased both SR and RSR.Conclusion These results indicate that early diagnosis is significantly associated with increased SR and RSR.Cr and 24UP are independent indicators of prognosis in clinical respect.Chronic renal histological features and renal artery lesion serve an additional important role in the assessment of prognosis in patients with LN.

Objective To explore the value of serum SC5b-9, anti-C1q antibody, C3 and C4 levels in the assessment of lupus activity. Methods The enzyme linked immunosorbent assay (ELISA) was used to measure SC5b-9 and anti-C1q antibody, rate nepheiometry was used to detect the serum level of C3 and C4 in sera of 62 SLE patients, 35 patients with other rheumatic diseases (including rheumatoid arthritis, ankylosing spondylitis, primary Sjogren' s syndrome, mixed connective tissue disease, dermatomyositis, polymyositis, systemic sclerosis and vasculitis) and 35 healthy controls. And the correlation between above-mentioned parameters and lupus clinical manifestations, disease activity and histological type of lupus nephritis were analyzed. Results In SLE patients, the levels of SC5b-9 and anti-C1q antibody were significantly higher than those in patients with other rheumatic diseases and healthy controls (P<0.05). The titers of SC5b-9 and anti-C1q antibody negatively correlated with C3 and C4 (P<0.05), and positively correlated with SLEDAI (P<0.05). The sensitivity and specificity of the combination of these three measurements for SLE was 95.37% and 98.46 respectively. SC5b-9 and anti-C1q antibody were associated with the presence of proliferative glomerulonephritis (P <0.05). Conclusion Taking the evaluation of all these three measurements simultaneously is valuable for the diagnosis of lupus flare. SC5b-9 and anti-C1q antibody may play major roles in the immunopathogenesis of lupus nephritis.

Objective To investigate the characteristics and related risk factors associated with tuberculosis(TB) in patients with systemic lupus erythematosus (SLE) who received glucocorticoid and immunosuppressive therapy. Methods Among the 452 SLE patients underwent the treatment of glucocorticoid and immunosuppressive agent, the clinical data was reviewed and summarized retrospectively.Results 42 of 452(9.29% ) patients were diagnosed as TB infection. 11 patients (23.81% )had exudative pulmonary tuberculosis and 31 patients(73.81% ) had extra-plumonary TB. Statistics of the 31 patientsshowed that 8 patients( 19.05% ) had hematogenous disseminated pulmonary tuberculosis;6 (14.29%) had tuberculo-meningitis ;2 (4.76%) had thoracic cavity TB; 2 ( 4.76% ) had abdominal cavity TB; 1 ( 2.38% )had crewels ; 1 ( 2.38% ) had bone tuberculosis and 1 (2.38%) had nephronophthisis. The focus of infection was not found in 10 patients. Of all 42 patients with TB infection, 38 cases suffered form lupus nephritis, 40 with hypoalbuminosis, 10 with TB history, 14 had leucocytopenia or hyperglycaemia, respectively. The effect of antiTB therapy started up at least 7 days, or in 4 weeks as longest. 2 patients died of hematogenous disseminated pulmonary tuberculosis. Conclusion Under the treatment of glucocorticoid and immunosuppressive agent ,TB incidence in patients with SLE is obviously higher than that of common people.Extra-pulmonary rib and serious infection are more frequently. It is shown that those who had lupus nephritis or TB history are more susceptible to TB.

Objective To investigate the major risk factors of aseptic necrosis of bone in patients with systemic lupus erythemattrsus (SLE),and thus provide evidence for decision-making on prevention.Methods Meta-analysis Was used to systemically evaluate the 14 case-control studies about the risk factors of aseptic necrosis of bone in patients with SLE.Review Manager 4.2 Was utilized to carry out homogeneity checking and calculate the pooled odds ratio (OR) with 95% confidence interval.Results The OR values of risk factor of AVN in patients with SLE and 95% CI were as follows:Raynaud's phenomenon 2.43(1.12～5.29):dental ulcer 2.33(1.11～4.88);renal involvement 1.76(1.27～2.44);vasculitis 4.65(1.62～13.33):hyperlipidemia 3.28(1.76～6.12);anti-phospholipid antibody(APL)2.06(0.84～5.06):hypocomplementemia 0.63(0.35～1.14).Conclusion Glucocorticosteroid is an important risk factor in inducing aseptic necrosis of bone in patients with SLE,but it is not the only factor.Raynaud's phenomenon,dental ulcer,renal involve-ment,vasculitis and hyperlipidemia are major risk factors of aseptic necrosis of bone in patients with SLE.