Objective To investigate secretory IgA change in uremic patients ane its relationship with inflammation. Methods Sixty uremic noneialysis patients( uremic non eialysis group)ane 60 hemoeialysis patients( hemoeialysis group ),the other 40 healthy volunteers( control group ) were selectee as our subjects. Enzyme linkee immunosorbent assay( ELISA)methoe were appliee to eetect the fecal secretory IgA content. Immune nephelometry were usee to measure the level of high sensitivity C reactive protein(hs-CRP). Results The level of fecal secretory IgA expression in hemoeialysis group((2. 39 ± 0. 81)μmol/ L)ane the non eialysis group((2. 43 ± 0. 84)μmol/ L)were significantly lower than that of the control group((2. 89 ± 0. 87)μmol/ L),ane the eifference was significant(F = 5. 042,P < 0. 01),while there was no significant eifference between the eialysis group ane the non eialysis group(P > 0. 05). The negative correlation was seen between secretory IgA content ane hs-CRP in patients(r = - 0. 629,P < 0. 01). Conclusion The secretory IgA eecreasee in patients with or without uremic eialysis ane it is correlatee with inflammatory state.

Objective To explore the clinical characteristics of hereditary spastic paraplegia with thin corpus callosum(HSP TCC).Methods Clinical data of 4 patients with HSP TCC were analysed retrospectively.Results 4 patients were at the onset during youngsters,they revealed mental impairment,walk of spasticity,spasticity of the lower extremities,slowly progressive weakness and hyperreflexia, extensor plantar responses and morbid indication for positive. Sensory impairment was not observed. 2 cases showed ataxia and sphincter disturbance;1 case showed upper limb spasticity and muscular atrophy. Cranial MRI revealed an extremely thin corpus callosum on sagittal image.Conclusion Main clinical characterizations of HSP TCC were slowly progressive spastic paraparesis, mental impairment during youngsters, cranial MRI showed extremely thin corpus callosum.

Objective To investigate the clinical and genetic characteristics of hereditary spastic paraplegia(HSP).Methods The clinical material of 113 patients in 39 families with HSP was analyzed retrospectively.Results The ratio of male to female was 1:1.17.The age at HSP onset was from 2 to 58 years old, the mean age was 21.4 years old, and 81.7% of the patients had HSP before 30. 89.4% of the patients had positive family history and they showed mostly autosomal dominant inheritance. The rate of consanguinity was 28.2%. 24 cases had pure while 89 cases had complicated spastic paraplegia. In the HSP group, we could found the weakness of legs in 65.5% patients, spasticity and hyperreflexia of lower limbs in 96.5%, extensor plantar responses in 68.1%, ataxia in 46.9%, muscular atrophy in 32.7% and dementia in 18.6%.Conclusion In the HSP group, the year of onset was mostly before 30. The female HSP cases were more than the male's, and the complicated cases were more often than the pure. Autosomal dominant was the mostly frequent inheritance, and there were more chances of HSP in the consanguineous families.

Objective To investigate the mutation characteristics of paraplegin gene in Chinese patients with hereditary spastic paraplegia (HSP) and establish the base of the gene diagnosis of HSP.Methods Mutation analysis of paraplegin gene was carried out by use of polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) combined with DNA direct sequencing in 22 unrelated affected HSP individuals in China, in which 8 probands were from autosomal recessive families and 14 cases were sporadic.Results All of the exons could be detected by PCR. 2 probands were found to have abnormal SSCP bands in exon 15 and 2 substitutes (G2063A, G2066A in exon 15) were found by DNA direct sequencing. But there were no changes in other patients of families.!The same abnormal SSCP bands and G→A substitutes were revealed in control individuals. So these changes were two polymorphisms, in which G2066A was not reported previously.Conclusion Mutations of paraplegin gene may be rare in Chinese patients with HSP. G2063A and G2066A are two polymorphisms, in which G2066A has not been reported previously.

Objective To investigate the mutation characteristics of atlastin gene in Chinese patients with hereditary spastic paraplegia(HSP) and establish the base of gene diagnosis of HSP.Methods Mutation analysis of atlastin gene was made by use of polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) combined with DNA direct sequencing in 30 unrelated affected HSP individuals in China in which 20 cases were from autosomal dominant families and ten cases were sporadic HSP patients.Results No abnormal SSCP bands were found in the 30 individuals and the results of DNA direct sequencing were also normal.Conclusion Mutation of atlastin gene may be rare in Chinese HSP patients.

Objective To analyze the clinical features of an autosomal dominant Charcot-Marie-Tooth disease(CMT) type 2F family in china.Methods Retrospective analysis were made to show the clinical manifestations and electrophysiological data of 3 patients who come from an autosomal dominant CMT2F family. Results The clinical manifestations of 3 patients were characterized by later onset (from 37 to 60 years)and mild sensory impairments. Right hearing of one patient was lost progressively after the onset. Nerve conduction studies showed there were slow sensory and motor conduction velocities or no nerve action potentials in lower limbs but normal or mildly slow in upper limbs. Somatosensory evoked potentials on tibial nerve indicated both central and peripheral somesthesia gateway were involved. Motor evoked potentials detection found the conduction velocities in the peripheral motor gateway were slowed in lower limbs. Brainstem auditory evoked potentials showed right peripheral acoustic pathway was severely impaired but left was normal. Bilateral visual evoked potentials were normal. Conclusion Patients with CMT2F had distinct characteristics in clinical manifestations and electrophysiological data which would help clinical typing and diagnosis of CMT.

Objective To summarize the experience of tension-free repair for inguinal hernia in the preperitoneal space using modified surgical mesh. Methods From Dec 2008 to May 2010, 134 cases with 138 reducible primary inguinal hernia were randomly divided into two groups. Sixty-seven patients (70 hernias) in the study group underwent tension-free repair in the preperitoneal space by modified surgical mesh, while the control group (67 cases, 68 hernias) underwent Rutkow's herniorrhaphy by surgical mesh.Results Postoperatively 127 cases (95%) were followed up from 2 to 18 months with an average of 9. 2months[64 cases of the test group were followed up with an average of(9 ±4) months, 63 cases of the control group followed up with an average of (9 ± 5 ) months]. There was no recurrence. No significant differences were found between the two groups in the operation time (P = 0. 697), blood loss (P = 0. 318 ),hospital stay (P = 0. 116) and total postoperative complications (P = 0. 080). The visual analogue scale of the study group was lower than the scale of the control group ( P = 0. 048 ). Conclusions Modified surgical mesh is more comfortable in the treatment of inguinal hernia with tension-free repair in the preperitoneal space with a comparative result to Rutkow's herniorrhaphy by surgical mesh.

Objective To evaluate the rules and features of the pseudoenhancement phenomenon of renal cysts during the multi-phases of contrast enhanced MSCT scan.Methods Ninety one patients with 112 simple renal cysts with B-ultrasound,CT examination,improved clinically enrolled in this retrospective study.The attenuation of the renal cysts were measured blindly in the images of CT plain scan and scans of arterial,venal and secrete phases,and the attenuation change of the cysts between pre-and post-enhanced scans were calculated; the accuracies of pseudoenhancement judging were calculated with 10 HU,15 HU and 18 HU as a threshold;the size were recorded; degree of intra renal parenchyma of the cyst were also confirmed,and so renal cysts were divided into three groups:type Ⅰ,Ⅱ and Ⅲ; The differences of attenuation among 3 enhancement phases,different size,different type were analyzed statistically with the Kruskal-wallis rank sum test,the correlation between the diameter and the pseudoenhancement in each enhancement phases were analyzed statistically with Spearman test.Results The attenuation median of the 112 cysts in plain scan,arterial,venal and secrete phase was 6.0 HU,11.0 HU,12.0 HU and 12.0 HU respectively,there was significant difference(x2=53.32,P＜0.01).The attenuation of the cysts in enhanced phases was higher than unenhanced.The range of attenuation change of the cysts between pre-and postenhanced scans was-10 to 31 HU,the number of cysts in groups of pseudoenhancement of 1 to 5 HU and 6 to 10 HU in each enhanced phase was dominant.The pseudoenhancement median of arterial,venal and secrete phase was 4.0 HU,5.0 HU and 6.0 HU respectively,There was significant difference among three groups(x2=10.062,P＜0.01).Taking 10 HU,15 HU and 18 HU as threshold for judging pseudoenhancement,the accuracy was 83.0％(239/288),95.1％(274/288) and 96.9％(279/288) respectively; Pseudoenhancement of small cysts(≤10 mm) was higher than other groups in each enhancement phase,and there was significant difference(P＜0.05).Type Ⅰ,Ⅱ and Ⅲ renal cysts were 62,23 and 27 respectively,the pseudoenhancement median of type Ⅰ renal cyst was 5.0 HU,6.0 HU and 8.0 HU respectively in arterial,venous,and excretion phase,which were higher than Type Ⅱ and Ⅲ (P＜0.05).It showed low negative correlation between pseudoenhancemen and diameter in arterial,venous and secrete phase(r =-0.326,-0.332 and-0.447,P＜ 0.01).Conclusion The pseudoenhancement correlated with the renal cyst size,the type and the enhance phases,which should be considered when making diagnosis.

Mesenchymal stem cells(MSCs)have a unique role in immune regulation and focus to T-cells.In the mixed lymphocyte reactions,MSCs inhibit T-cells proliferation by cycle arrest,but they do not increase T-cell apoptosis and the suppress T-cell activation.In addition,MSCs can reduce CD8~+T cells and Thl cells,and simultaneously increase Th2 cells in the reaction system to suppress the inflammatory response,which may play a therapeutic effect on the T-cells mediated autoimmune diseases.

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