Henoch-Scholein purpura(HSP)is a common systemic vasculitis of the small vessel in children,with a variety of clinical manifestations.The main diagnostic criteria include palpable skin purpura.Patients who have gastrointestinal tract as the main symptoms suffer clinically abdominal pain and gastrointestinal bleeding,they are easily misdiagnosed before skin purpura,the rate of misdiagnosis can be as high as 87.5%,and the main treatment is early application-oriented glucocorticoids.This review include etiopathogenisis,pathogenesis,pathology,clinical manifestations,auxiliary examination and treatment about gastrointestinal manifestations in HSP.

Objective To investigate the blood perfusion characteristic of acute pancreatitis (AP) using multisection dynamic CT. To detect the changes of the perfusion parameters in patients with AP and assess the value of the perfusion parameters as severity indicators in AP. Methods 120 cases (34 cases of normal pancreas and 86 cases of AP) were examined for pancreatic perfusion from August 2006 to April 2008. The multisection dynamic CT perfusion series was performed by a multisection CT scanner (Siemens somatom Sensation 64) and the perfusion parameters, including BF, BV, TTP, PS, were collected and were compared with APACHE Ⅱ score, Ranson score, CRP, CTSI, time to abdominal pain cessation, length of hospital stay and complication rate for correlation analysis. Results The mean BF, BV, TTP and PS in AP patients were (113.57 ±50.04) ml · 100 mg~(-1) · min~(-1), (146.61 ±45.11) ml/L, (148. 88 ±21. 16) 0.1 s, (119.53± 52.36) 0. 5 ml · 100 ml · min , respectively; when compared with normal control, BF, BV decreased significantly (P<0.05) , while the change of TTP, PS were not statistically significant. Both BF and BV were correlated with APACHE II score, Ranson score, CRP, CTSI (P<0. 05) , as well as the time to abdominal pain cessation, length of hospital stay and complication rate (P < 0. 05). Conclusions Pancreatic vessel perfusion was decreased in AP. Both BF and BV were correlated with APACHE Ⅱ score and Ranson score, CRP, CTSI, and could be used to predict severity of acute pancreatitis.

Objective To present a method to treat soft tissue defects with bone exposure after the distal tihial fracture.Methods Twenty-six patients who had suffered from the distal tibial fracture complications leading to exposure of the bone or fixation material sought medical help in our department.The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases.Five of the 26 cases were treated using a free microvascular muscle flap and the mesh skin graft by one stage.Twenty-one of them were re- paired with the same method by two-stage.Results Follow-ups were 10 to 24 months.The microvascular re- construction was successful in 22 patients.Two of the 26 cases had partial necroses of the skin graft,and the other two cases had delayed wound healing.All the fractures united.Conclusion Microvascular free muscle flap re- construction of the leg is regarded as a reliable method to treat legs with massive soft-tissue defects or defects with bone exposure and chronic infection or fistulation at the distal leg.

Objective To investigate the heterogeneity of immunomodulatory function of exosomes secreted from human umbilical cord-derived mesenchymal stem cells(hUC-MSC).Methods Five different hUC-MSCs lines were isolated and cultured.Exosomes were isolated from the supernatant.The expression of specific surface markers CD9,CD63,CD81 and CD44 was detected by flow cytometry.The protein concentration of hUC-MSCs exosomes(hUC-MSCs-ex)was evaluated by the BCA assay.Concanavalin A and rhIL-2 stimulated umbilical cord blood mononuclear cells (UBMCs) from healthy donor were co-cultured at different concentrations of hUC-MSCs-ex from different cell lines for 72 h.The growth rate of UBMCs was detected by MTT assay.ELISA was used to test the levels of IFN-γ and TNF-α of the supernatants.The UBMCs co-cultured with hUC-MSCs were co-cultured with K562 cells at the ratio of 5∶1.The cytotoxic activity was calculated by MTT assay.Results hUC-MSCs-ex expressed CD9,CD63,CD81and CD44.Different hUC-MSCs lines had different regulating activities on the proliferation,secretion and killing ability of UBMCs.Conclusion hUC-MSCs-ex has heterogeneity of immunomodulatory function on UBMCs.

Aim To investigate the mechanisms in protecting HUVEC against ischemia/reperfusion(I/R) injury directed by curcumin.Methods Hypoxia/reoxgenation(H/R) model was established on HUVEC.MTT colorimetric assay was used to observe the injury degree of hypoxia and reoxygenation at the different time.With preconditioning by different concentration of Cur,the survival rate of HUVEC subjected to H/R was assessed by MTT colorimetric assay.Pretreated with Cur(5 ?mol?L-1),the expression of LC3,cathepsin B,cathepsin L,Bax and Bcl-2 were observed by fluorescent staining and Western blot in HUVEC during H/R process.Results Cur(1.25~5 ?mol?L-1) played a protective role during H/R in HUVEC in a dose-dependent manner.During H/R,the expressions of LC3,cathepsin B and the ratio of Bax/Bcl-2 increased,and the nuclear translocation of cathepsin L was induced;when cur was pretreated,LC3 was furtherstrengthened,at the same time,the up-regulation of cathepsin B,the ratio of Bax/Bcl-2 and the nuclei-location of cathepsin L were inhibited partly by Cur.Conclusions Cur can raise the survival rate of HUVEC in the process of H/R.Cur increases the autophagy activity,depresses cathepsins and Bax/Bcl-2 to protect the endothelial cells.

Animals ; Dose-Response Relationship, Drug ; Perchlorates ; toxicity ; Quaternary Ammonium Compounds ; toxicity ; Rabbits

Group A β-hemolytic streptococcus (GAS),namely Streptococcus pyogenes,is one of the most im-portant human pathogen.GAS can cause skin and mucous membrane superficial infectious diseases,life -threatening invasive disease,toxin -mediated diseases and immune -related diseases.Antibiotic is an effective mean to control GAS infection.The β-lactam antibiotics remain the first -choice treatment for GAS infection and the macrolides are often recommended as a replacement therapy for β-lactam antibiotics allergic patients or a means to blocking GAS exotoxin product.But with the widespread use of macrolides autibiotics,macrolide -resistant GAS spread in the world. This paper will elaborate the situation of macrolide -resistant clones.

Objective To observe the effect of wound specialist group on preventing and managing pressure ulcer in operation. Methods The knowledge about pressure ulcer and ability of risk assessment for pressure ulcer of operating room nurses were tested and the incidenc-es of pressure ulcer were compared before and after the intervention of the wound specialist group. Results After the intervention of the wound specialist group, the passing rate of nurses in operating room increased from 58.23%to 94.11%in pressure ulcer theory (χ2=29.63, P<0.001) and from 56.96%to 95.29%in new type of dressings paste (χ2=33.80, P<0.001), and the rate of pressure ulcer risk factor assessment increased from 56.38%to 93.35%(χ2=5828.07, P<0.001), accuracy of assessment increased from 56.23%to 96.78%(χ2=4674.89, P<0.001). The incidence of intraoperative acute pressure ulcer decreased from 1.5‰to 0.22‰(χ2=17.59, P<0.001). Conclusion The intervention of wound specialist group may improve the awareness of assessing risk factors of pressure ulcer in the operation room and standardize the oper-ation to prevent pressure ulcer, and reduce the incidence of pressure ulcer in operation.

An analysis of medical liability insurance practice at the hospital in the past 6 years found that medical liability insurance failed to work as expected in medical dispute prevention and risk sharing.The analysis also found that such an insurance will take a greater role in risk sharing,exposure to conflicts,cause discovery,and responsibility,with enhanced government role in guidance and intervention.Thus medical liability insurance is highly advocated by such means as compulsory execution,coordinating mechanism of insurance funding,prevention“medical dispute profiteers”,and adaptation to new approaches in medical dispute settlement.

Animals ; Lung ; drug effects ; metabolism ; Perchlorates ; toxicity ; Quaternary Ammonium Compounds ; toxicity ; RNA, Messenger ; genetics ; Rabbits ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; genetics ; metabolism