Objective To compare differences in pathological grade,clinical classification and prognosis in patients with Henoch?Sch?nlen purpu?ra nephritis(HSPN)in each age group. Methods Totally 225 cases of patients diagnosed as HSPN and treated in the hospital were selected to ret?rospectively analyze their clinical manifestations,pathological classification and prognosis and compare the difference in pathological grade,clinical classification and prognosis by age. Results Of the concomitant symptoms of HSPN,the incidence rate of abdominal pain was the highest in pa?tients of school age. There was statistical significance in the incidence rate of gastrointestinal bleeding between each age group. Of the clinical mani?festations,proteinuria was positive correlated with the pathological type,and the difference was statistically significant(r=0.471,P<0.000 1). But there was no correlation between the count of urine red blood cells in the urine and the pathological type. There was difference in the pathological grade between each age group(H=19.194,P<0.000 1). The difference mainly showed in the pathological grade between adults,children of pre?school age and adolescents(Z=-2.702,P=0.001;Z=-3.675,P<0.000 1). There was difference in clinical classification between each age group (χ2=36.114,P<0.000 1). The difference mainly showed in clinical manifestations between adults,children of school age and adolescents(χ2=19.628,P<0.000 1;χ2=18.944,P<0.000 1). For both children and adults who had developed into chronic renal failure,the renal pathology of these patients was not significantly different. Conclusion Compared with adults,children have milder pathological types and clinical manifestations and well prognosis of HSPN,and the most important factor which affects the prognosis is pathological type and urine protein can reflect the serious?ness of pathological type.

OBJECTIVE:To analyze the recent implementation and problem of GAP(Good Agricultural Practice) of Chinese traditional medicinal materials(CTMM). METHODS:The sound development of GAP in recent 10 years were given an affirmation with regard to the improvement of regulations,the progress of GAP authentication,economic achievement,scientific research and training of talents,etc.Meanwhile,the limitations in variety breeding,wildlife tending,wildlife collecting,subsequent monitoring and base organization pattern were analyzed thoroughly,and the solution was put forward. RESULTS & CONCLUSION:There has been a stable development of GAP in China; however,it remains to be improved in regulations,governmental supervising,and developmental model.

Objective:To deteat N‐terminal pro B type natriuretic peptide (NT‐pro BNP) and cystatin C (Cys C) con‐tent in Kazak patients with hypertensive heart disease (HHD) complicated heart failure (HF) and analyze the corre‐lation between them .Methods :A total of 100 Kazak HHD patients were divided into hypertension complicated HF group (Complicated HF group , n=50) and pure HHD group (n=50) .Venous blood sample was taken within 24h after hospitalization for measuring serum levels of NT‐proBNP and Cys C ,then they were compared and analyzed between two groups .Results:Compared with pure HHD group ,there were significant rise in serum levels of NT‐proBNP [ (246.53 ± 165.65) ng/L vs .(4568.32 ± 2722.36) ng/L] and Cys C [ (0.82 ± 0.31) mg/L vs .(1.93 ± 2.46) mg/L] in complicated HF group , P< 0.01 both .Spearman correlation analysis indicated that serum NT‐proBNP level was positively correlated with Cys C level in complicated HF group , r=0.961 , P<0.01. Conclusion:In Kazak patients with hypertensive heart disease complicated HF ,serum NT‐proBNP and Cys C levels significantly rise and they significantly positively correlate ,so it suggest there may be slight damaged renal function also .

Adult ; Angina Pectoris ; etiology ; Aortic Valve Insufficiency ; complications ; Bradycardia ; etiology ; Female ; Heart Valve Prosthesis ; Humans ; Prosthesis Failure

Objective To study the effects of Duliang capsule on the expression of calcitonin gene‐related peptide(CGRP) and cholecystokinin(CCK) in the midbrain of a rat migraine model ,and explored treatment effects and mechanisms of Duliang cap‐sule on rats with migraine .Methods A total of 24 rats were randomly divided into four groups :normal control groups(A) ,migraine model groups(B) ,Duliang capsule control groups(C) and Duliang capsule treatment groups(D) .C and D were intragastrically per‐fused with Duliang capsule(0 .5 g · kg -1 · d-1 ) .After 7 days ,nitroglycerin was subcutaneously injected into the buttocks of the B and D to induce migraine .Two hours after nitroglycerin injection ,the midbrain were isolated CGRP and CCK expression in midbrain were determined using SYBR Green I real‐time quantitative PCR .Results CGRP mRNA expression was significantly lower in mid‐brains of rats in the Duliang capsule treatment groups compared with migraine model groups(P<0 .05) .CCK mRNA expression was significantly lower in midbrains of rats in the Duliang capsule control groups compared with normal control groups(P<0 .05) . Conclusion Duliang capsule can exhibit the expression of CGRP and CCK in the midbrain of the migraine rats .weaken the CGRP and CCK‐induced inhibition of the analgesic effects of opioid peptides .

Objective This study assesses the influence of rizatriptan on calcitonin gene-related peptide (CGRP),proenkephalin (PENK) and cholecystokinin (CCK) mRNA expressions in the trigeminal ganglia of a rat migraine model and investigates the possible mechanisms by which triptans treat migraine.Methods A total of 24 rats were randomly divided into four groups:normal control group (A),migraine model group(B),rizatriptan control group (C) and rizatriptan treatment group(D).Groups C and D were intragastrically perfused with rizatriptan,1 mg/kg per day.After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the groups B and D to induce migraine.Two hours after nitroglycerin injection,the trigeminal ganglia was isolated.CGRP,PENK and CCK mRNA expressions in the trigeminal ganglia were determined using SYBR Green Ⅰ real-time quantitative PCR.Results The copy number of CGRP mRNA (× 107) in 200 ng total RNA of each group was 0.05 ±0.01,1.30 ±0.52,0.23 ±0.12,0.43 ±0.33 ; The copy number of PENK mRNA (× 103) in 200 ng total RNA of each group was 3.30 ± 1.65,0.34 ±0.14,3.91 ± 2.44,0.71 ± 0.13.The copy number of CGRP mRNA in the trigeminal ganglia of group B was significantly higher than that of group A (q =7.854,P ＜ 0.05) ; CGRP mRNA expressions were significantly lower in the trigeminal ganglia of rats in group D compared with group B (q =5.458,P ＜0.05).Compared with group A,PENK mRNA expressions in the trigeminal ganglia of rats were significantly lower in group B (q =4.478,P ＜ 0.05).PENK mRNA expressions were significantly higher in trigeminal ganglia of rats in group C compared with group D (q =4.838,P ＜ 0.05).CCK mRNA expression in trigeminal ganglia of rats was similar among groups.Conelusions Rizatriptan can decrease the expressions of CGRP in the trigeminal ganglia of the migraine rats and exhibits neurogenic inflammation triggered by CGRP.PENK expressions decrease in the trigeminal ganglia of the migraine rats,weaken the analgesic effects of enkephalin.

Objective To investigate the diagnostic value of serum tumors M2 pyruvate kinase (TuM2-PK),carcino-embryonic antigen (CEA),CA199,CA724,CA125 and CA242 in colon cancer.Methods Serum levels of TuM2-PK,CEA,CA199,CA724,CA125 and CA242 in 231 patients with colon cancer,105 patients with colon benign lesion diseases and 166 normal controls were measured by the ELISA and electrochemiluminescence assays.The operation working characteristic curve (ROC) and the logistic regression-ROC were used to evaluate the diagnostic value of tumor markers for colon cancer individually and in combination.The models of logistic regression analysis and partial least-squares discriminant analysis (PLS-DA) were established to diagnose patients with colon cancer based on the optimal panel of serum tumor markers.Resalts Concentrations of serum TuM2-PK,CEA,CA199,CA125 and CA724 in the colon cancer group are higher than those in the colon benign diseases group and the normal controls (P＜0.05).The area under the operation working characteristic curve (AUC) of CA199 is the highest 0.79 [95％ confidence interval (95％CI),0.75-0.83] at the cutoff value of 69.5 U/L with 64.1％ of sensitivity and 89.7％ of specificity.The AUC of combined serum tumor markers based on logistic regression analysis is higher than those in individuals,of which serum (CEA+ CA199+TuM2-PK) is the optimal [AUC=0.89,95％ confidence interval(95％CI),0.86-0.92].The diagnostic accuracy of logistic analysis and PLS-DA model for colon cancer is 82.7％ and 77.5％,and for colon cancer is 93.7％ and 95.6％,respectively.Conclusion The combination of serum tumor markers CEA,CA199 and TuM2-PK is more suitable as a diagnostic model for the screening of colon cancer.

OBJECTIVE:To study the pharmacokinetics of lidocaine and bupivacaine in children undergoing epidural anesthesia so as to evaluate the safety and efficacy of this anesthetic method.METHODS:A total of 30 children who were expected to undergo surgery for undescended testis,hernia or high ligature for hydrocele were assigned to receive 2% lidocaine(5 mg?kg-1) plus 0.75% bupivacaine(1.875 mg?kg-1)(single epidural dose) by epidural anesthesia.Plasma concentrations of lidocaine and bupivacaine were determined by HPLC.Pharmacokinetics parameters were calculated and fitted by using DAS ver 2.0 pharmacokinetic program.RESULTS:The plasma concentration-time curves of lidocaine and bupivacaine were in line with a two-compartment model.The main pharmacokinetic parameters of lidocaine vs.bupivacaine were as follows:tmax 27.0 vs.33.0 min;t1/2? 43.97 min vs.73.52 min;Cmax 2.411 mg?L-1 vs.1.475 mg?L-1;AUC0～∞ 144.714 mg?min?L-1 vs.168.541 mg?min?L-1.CONCLUSION:The dosages of the local anesthetics injected into the epidural cavity of children are proven to be safe and effective.

Inflammation is involved in the pathogenesis of many vascular disorders. Hemodynamics cause the activation of inflammatory factors in the vascular wal , resulting in dysfunction of vascular endothelial cels and vascular smooth muscle cels, activating vascular wal inflammatory cascade. Inflammatory cels, especialy macrophage infiltration and secretion of enzymes gradualy weaken the vessel wal to form aneurysm, and even cause aneurysm rupture. Therefore, inflammation plays a key role in the formation and rupture of intracranial aneurysms.

BACKGROUND: Traditional anterolateral thigh flaps transplantation has been widely used in clinics; however, a new generation of perforator free flap transplantation is still in an initial phase at home.OBJECTIVE: To investigate the method, effectiveness and clinical application of anterolateral thigh perforator free flaps transplantation for reconstruction of soft tissue defects of the head and extremeties after tumor resection.DESIGN: Case analysis.SETTING: First Affiliated Hospital of Nanhua University.PARTICIPANTS: A total of 16 patients needing skin flap transplantation were selected from Department of Burns and Plastic Surgery, the First Affiliated Hospital of Nanhua University and Department of Plastic Surgery, General Hospital of Toronto, Toronto University from April 2004 to April of 2006. Soft tissues of all patients could not be directly sutured so as to cause the exposure of tendon, vessel, nerve and sclerotin. There were 13 males and 3 females aged from 26 to 72 years. The anterolateral thigh perforator free flap for reconstruction of the soft tissue defects and/or bone exposure occurred on the head (nine cases, mean age of 50 years) or extremities (seven cases, mean age of 39 years) following tumor resection. All patients provided the informed consent.METHODS: After general anaesthesia with tracheal intubation, a two-team approach was used for resection of the tumor, and harvest of the free flap simultaneously or successively. The tumor was removed by head and neck surgeon or orthopedic surgery. And the plastic surgeons assumed the responsibility for reconstruction of the defects following the tumor resection. The dissection of recipient blood vessels (e.g., superior thyroid artery, facial artery, a branch of internal jugular vein, or external jugular vein, artery and vein of dorsal of foot, anterior tibial artery or vein) was performed. In addition, the ends of sural nerve at recipient sites that need be repaired with the anterolateral thigh cutaneous nerve were utilized in two cases with soft tissue defect on the lateral malleolus. The dimensions of the anterolateral thigh perforator flaps were determined on the basis of the defect size. The perforator flap design: A line was drawn between anterosuperior iliac spine and lateral-superior patella for the longitudinal axis of the flap. The required perforator was sought at the middle point of the longitudinal axis in the anterolateral thigh. In general, there would be one to two major perforating branches were confirmed with an ultrasound Doppler monitoring device in the flap. In this article, the biggest anterolateral thigh perforator flap measured 28 cm×15 cm with two major perforating branches. Incision of the skin and subcutaneous tissue was carried out along the periphery of the flap, and dividing and separating subcutaneous tissue layer from deep fascia layer was performed under surgical loupe magnification little by little carefully and slowly to ensure preserving one to two major perforating branches. Retrograde dissection of the deep fascia and/or muscles and/or intermuscular tissue tracing the major perforating branches until the pedicle blood vessels length and diameter were enough for anastomosis with the blood vessels in the recipient sites. If an innervated flap is required, the lateral cutaneous nerve of the thigh can be harvested with the flap. In this article, two cases used flap innervation. The incision could be primary sutured usually and a suction drain should be put at donor sites. The anastomosis of the blood vessels or nerves with 9-0 or 10-0 nylon sutures was performed under the microscope. Interrupted sutures of the edges between the flap and defect region were made; and a suction drain should be put under the flaps. The sutures on the head would be removed at 9-11 days (but 12-15 days, on the extremities) days after operation. The drainage tube would be pulled out generally at 3 days after operation. Recovery condition was observed after operation. Healing phase was classified into phase Ⅰ(healing on time after operation) and phase Ⅱ (non-healing on time after operation). Meanwhile, whether skin flap was necrosis and wound was broken were observed at the same time.MAIN OUTCOME MEASURES: Survival state of patients after skin flap transplantation; shape and function of donor site and recipient site of skin flap.RESULTS: All 16 patients who needed skin flap transplantation were involved in the final analysis. Of the sixteen cases in this group, fifteen perforator flaps survived completely; one flap underwent partial failure. Primary wound healing was achieved (stage I) in all the donor sites, in14 recipient sites and delayed in two (stage Ⅱ). In one case a small portion (about 2.5 cm) necrosed at the distal end of the flap. After removing the necrotic tissue, the wound healed. In another case with a 3 cm long wound dehiscence in the face, the wound healed through dressing change and resuture. After wound healing, there was no significant scaring, and no effect on the lower limb weight bearing and walking. But, there was a sensory loss on a small piece of skin below the donor site, due to destruction of the anterolateral thigh cutaneous nerve on that area.CONCLUSION: Because of less dornor site morbidity, superior result at the reconstructed sites, use of anterolateral thigh perforator flap free grafting is a very acceptable technique for reconstruction of soft tissue defects on head and extremeties after tumor resection.