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.

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 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 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

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.

Aim To prepare soluble human C1 q and tumor necrosis factor related protein-6 in Escherichia coli and analyze the bioactivity. Methods Recombi-nant plasmid was transformed into E. coli expression strain, and the recombinant protein Trx-hCTRP6 was expressed induced by IPTG and then purified. Results Trx-hCTRP6 was expressed efficiently and purified using Ni-NTA affinity chromatography and Superdex G-75 column. The purified Trx-hCTRP6 was shown to be active under in vivo and in vitro assay conditions. Con-clusion Active Trx-hCTRP6 is efficiently prepared from E. coli protein expression system.

BACKGROUND:Extraction of a wel fixed cementless femoral stem or a cemented stem is difficult during revision of total hip arthroplasty. The extended trochanteric osteotomy provides excellent methods, and combining with long-stem cementless prosthesis can better reduce postoperative complications.
OBJECTIVE:To retrospectively analyze the recent clinical curative effect after extended trochanteric osteotomy combined with long-stem cementless prosthesis in hip revision.
METHODA total of 25 patients undergoing hip revision were selected from the Department of Osteoarthrosis, Pingdingshan First People’s Hospital, China from May 2008 to May 2013. Of them, 17 patients were subjected to the extended trochanteric osteotomy combined with single-incision and double-approaches. The femurs were reconstructed with long-stem cementless prosthesis. Al patients were fol owed-up for 12 to 60 months. Pre-operative and post-operative Harris hip scores, the post-operative complications, the bone cutting length, the length of stem in contact with cortical bone, the length of the end of bone cutting to the end of the prosthesis were recorded.
RESULTS AND CONCLUSION:17 patients were fol owed-up. The mean length of bone was 17 cm (15-23 cm). The mean length of stem in contact with cortical bone was 6.4 cm (4-11 cm). The mean length of the end of bone to the end of the prosthesis was 11.5 cm (8-18.5 cm). After fol ow-up, the mean Harris hip scores were improved from (39.0 ± 13.6) scores preoperatively to (75.0 ± 14.9) scores postoperatively (P<0.01). Subsidence occurred in two hips. The cutting sites of 17 cases of extended trochanteric osteotomy were fixed wel . These data suggested that the operation through single-incision and double-approach to the hip, while preserving the attachment of the external rotators and posterior capsule, wil strength rear hip stability and prevent postoperative dislocations. Recent effects were satisfactory, but the long-term outcomes should be further investigated.

Objective To detect the levels of IL-9,IL-17,and IFN-γ in CD4+T cells from patients with rheumatoid arthritis (RA).Methods The peripheral blood mononuclear cells (PBMCs) from patients with RA and healthy controls were obtained,then the CD4+ T lymphocytes were tested by immunomagnetic beads.The protein levels of IL-9,IFN-γ and IL-17 were measured by flow cytometry (FCM).The mRNA levels of IL-9,IL-17,RORγt and IFN-γwere also detected by qRT-PCR.Data were analyzed by comparison between groups using variance analysis,and Pearson's correlation analysis was used for linear correlation analysis.Results The isolation of untouched human CD4+ T cells from PBMC was effective and its purity was over 90％.The protein levels of IL-9,IL-17,IFN-γwere higher in patients with active RA as compared with patients with inactive RA (P＜0.01) which were (1.62±0.23)％ vs (1.15±0.24)％(P＜0.01),(1.47±0.20)％ vs (1.04±0.26)％(P＜0.01) and (8.1±0.6)％ vs (6.9±1.0)％(P＜0.01) respectively,so did the patients with RA when compared with healthy controls (P＜0.01).The mRNA levels of IL-9,IL-17,RORγt and IFN-γ were higher in patients with active RA as compared with inactive RA patients (P＜0.01),which were (3.0±0.6) vs (1.8±0.4) (p＜0.01) (4.2±0.9)vs (2.3±0.7) (P＜0.01),(4.1±0.7)vs (2.9±0.3) (P＜0.01)and (4.0±0.8)vs (2.3±0.6) (P＜0.01) respectively,so did the patients with RA when compared with healthy controls (P＜0.01).Intracelluar IL-9 levels were positively correlated with IL-17 (r=0.632,P=0.001),IFN-γ (r=0.515,P=0.008),DAS28 (r=0.519,P=0.009) and ESR (r=0.857,P=0.038) but had no correlation with CRP (r=0.38,P=0.61).Conclusion The levels of IL-17,IL-9,IFN-γare higher in the PBMCs of RA patients,and these cytokines may participate in the pathogenesis of RA.