Objective:To explore the clinical correlation of HLA-DRB1 shared epitope with IgA mesangial proliferative glomer-ulonephritis( IgA MsPGN).Methods:The renal function were examined routinely,and HLA-DRB1 shared epitope were determined by PCR in a total of 164 patients with IgA MsPGN and 164 healthy subjects.The renal function and HLA-DRB1 shared epitope were compared in patients with IgA MsPGN and healthy subjects,and clinical correlation of HLA-DRB1 shared epitope and renal function were analyzed.Results:(1)24 h proteinuria,serum creatinine and serum urea nitrogen were significantly different in patients with IgA MsPGN and healthy subjects(P<0.01);(2)The high-frequency gene of HLA-DRB1 in patients with IgA MsPGN were DRB1*04, DRB1*07,DRB1*09,DRB1*11,DRB1*14 and DRB1*15;(3) The distribution frequency of DRB1*09 and DRB1*11 in patients with IgA MsPGN increased significantly(P<0.01 or P<0.05);(4)24 h proteinuria,serum creatinine and serum urea nitrogen in patients with IgA MsPGN with DRB1*09 and DRB1*11 were significantly different compared with those in patients with IgA MsPGN with other HLA-DRB1 shared epitope(P<0.01).Conclusion:HLA-DRB1 shared epitope is related to IgA MsPGN,DRB1*09 and DRB1*11 can increase the risk of IgA MsPGN,and related to the severity of glomerulonephritis.

Objective To research the impact of formaldehyde air pollution on fractal characteristics of Osmanthus Fragrans leaves and the application of fractal theory in formaldehyde air pollution monitoring.Methods As the experimental materials, dwarfed potted Osmanthus Fragrans were exposed to formaldehyde at different doses of 0.001,0.005,0.025,0.125,0.625 mg/m3 by air.After new leaves matured, the vein samples were first produced;then their fractal dimension was analyzed with fractal theory and the computer system.Thirdly, the quantitative analysis of the variability degree was made and dose-response relationship among the newborn leaves of every dose group was researched.Results The corresponding correlation coefficients of leaf fractal dimension were more than 0.997 0(P

Objective To analyze and evaluate the related data of bottom clearance in Fuling section of Three Gorges Reservoir. Methods Bottom clearance in Fuling section of Three Gorges Reservoir was carried out in Fuling district during the period from May to December in 2002. All the data related to clearance were collected before and after the bottom clearance. Based on the collected data, the effect of clearance was assessed. Results 5 882 general pollution sources, 68 contagion pollution sources were cleaned in Fuling district, the clearance rates of both were 100%. The rat densities in agriculture areas and the dismantling cities were 3.97% and 2.97% respectively before rat extinguishment, then became 0.65% and 0.33% after rat extinguishment. Conclusion Through the bottom clearance of Three Gorges Reservoir, contagion and general pollution sources in the emigrant areas have been cleaned up, so water pollution in Three Gorges Reservoir and the rats mediated diseases have been prevented and controlled.

Unsteadiness and falls in the elderly are a common complaint in primary care and their incidence is expected to increase as the population ages. These patients are physiologically less able to withstand traumatic forces than their younger counterparts and are thus more prone to morbidity and mortality. Aside from intrinsic and extrinsic risk factors, there may be more sinister pathologies underlying these events. We report a case of an elderly gentleman who presented with unsteadiness, clumsiness and recurrent falls. The patient’s son brought to our attention subtle suspicious findings which eventually led to further evaluation. The patient was found to have had bilateral acute on chronic subdural haemorrhages with associated mass effect, underwent emergent decompression surgery and showed marked functional recovery. We review the incidence and outcomes of recurrent falls in the elderly, as well as the incidence, risk factors and varied presentations of subdural haemorrhage in the primary care setting. The case also reminds clinicians of the tendency to overlook and undermanage such patients with seemingly “minor” falls, and the value of family members’ inputs during consultation. It highlights the need for a high index of suspicion and the necessity of lower referral thresholds for further evaluation if indicated.

Anorexia Nervosa is one of the eating disorders, as classified in the Diagnostic and Statistical Manual, the fifth edition. It is characterised by a pathological fear of weight gain associated with an overwhelming drive for thinness. Patients do present to primary care with vague, non-specific complaints. A heightened degree of suspicion is required for the diagnosis, as patients tend to hide symptoms and are often in denial. We present a case in an 11-year-old girl brought by her mother to the polyclinic with a history of restrictive eating and excessive exercise for three weeks. This case provided a learning opportunity on the assessment and management of an eating disorder, as well as the adverse effects of undernutrition.

ObjectiveTo explore the personality traits of Han Chinese women with recurrent depression.MethodsAssessed by the Big Five Inventory (BFI),a comparison research was conducted between 118 Han Chinese women with recurrent depression and 65 sex,race and culture background matched health controls.Results Han Chinese women with recurrent depression scored lower in extraversion,conscientiousness and openness ( 17.93± 5.43,30.24 ± 5.94,30.03 ± 7.33 ) than matched controls ( 20.72 ± 3.79,31.94 ± 3.84,32.75 ± 5.32 ),while scored higher in neuroticism (21.38 ± 3.91) than the later one ( 27.57 ± 6.19 ).A binary logistic regression model,with group (case vs.control) as dependent variable and extroversion,conscientiousness,openness and neuroticism as independent variables,was built to assess each personality dimension's independent impact on recurrent depression.It came out to be that only extraversion ( OR =0.881,95％ CI =0.083-0.966,P=0.007) and neuroticism ( OR =1.225,95％ CI =1.134-1.323,P ＜ 0.01 ) were statistically significantly associated with recurrent depression ( P＜ 0.05 ).ConclusionIn the big five personality model,extraversion and neuroticism might act as independent personality traits to impact Han Chinese women with recurrent depression in a positive and negative way respectively.

Objective To investigate the death causes and risk factors of uremia patients in order to improve the prognosis of uremia patients.Methods Clinical data of 247 uremia inpatients and outpatients from 2001 to 2011 in our hospital were retrospectively analyzed.Dead patients were served as death group (n=124) and survival patients as control group (n=123).Death causes and primary disease were studied.Frequency of hemodialysis,prealbumin,albumin,natremia and pulmonary infection were compared between two groups.Results Age and gender were not associated with the death of uremia patients.The most common cause of death was cardiovascular disease followed by respiratory failure,uremic encephalopathy,cerebral hemorrhage,gastrointestinal hemorrhage,etc.Hemodialysis frequency,prealbumin,albumin and natremia of dead patients were obviously lower than those of control group.More patients in death group suffered from pulmonary infection.Logistic multivariate analysis revealed that death risk increased by 40.7％ when reducing 1 time per week of hemodialysis; death risk increased by 53.4％ when reducing 50 mg/L of prealbumin; death risk increased by 14.6％ when reducing 5 mmol/L of blood sodium; death risk of patients with pulmonary infection increased by 15.06 times of patients without pulmonary infection;death risk of diabetes mellitus increased by 4.26 times of patients without diabetes mellitus.Conclusions Cardiovascular disease,respiratory failure,uremic encephalopathy,cerebral hemorrhage,and gastrointestinal hemorrhage are common causes of death in uremia patients.Hemodialysis frequency,prealbumin,hyponatremia,pulmonary infection and diabetes can be regarded as risk factors for death of uremia patients.

Objective to evaluate the validation of atypical depression among Chinese outpatients with depressive episodes and explore the role of atypical depressive symptoms in distinguishing bipolar depression from unipolar depression.Methods Structural clinical interviews with self-compiled questionnaires were performed on 276 outpatients with current depressive episode,then comparison of clinical characteristics including age of onset,gender proportion,seasonality,comorbidity of anxiety disorder,bipolar property,psychotic features,number of depressive episodes,and maximum duration of depressive episode were conducted between atypical (defined by DSM-Ⅳ-TR) and nonatypical depression.then the rate of atypical depressive symptoms were compared between unipolar depression and bipolar depression.Results The proportion of atypical depression among all the participants was 23.9％.Compared to nonatypical depression,psychotic features were more likely seen in atypical depression (20.0％ vs 9.1％,P＜0.05),but no difference was found in other clinical features between atypical and nonatypical depression.Except mood reactivity,atypical symptoms including oversleeping(45.5％ vs 26.0％),overeating (22.7％ vs 15.4％),weight gain(24.1％ vs 14.6％),leaden paralysis (56.6％ vs 47.2％),interpersonal rejection sensitivity(66.7％ vs 34.2％) were more likely to occur in bipolar depression than in unipolar depression,the difference was statistically significant for oversleeping and interpersonal rejection sensitivity (P ＜ 0.05).Patients with mood reactivity differed little from those without mood reactivity in other clinical features.No association was found between mood reactivity,leaden paralysis and other criteria symptoms of atypical depression.Conclusion-Atypical depression might be a useful concept,but its diagnostic criteria needs further validation among Chinese population.

AIM: We sought to evaluate the expression of apoptosis related genes, p53 and bcl-2, in cultured vascular smooth muscle cells (VSMCs) in which apoptosis was induced by the ligands of PPAR?-ox-LDL,ciglitazone and 15-deoxy-△ 12,14-PGJ 2,and then influenced by PGF 2?,an antagonist of PPAR?. To clarify whether PPAR? is involved in the regulations of p53 and bcl-2.METHODS: Rat aorta smooth muscle cells were isolated and cultured in DMEM containing 10%FBS. ox-LDL,ciglitazone and 15 d-PGJ 2 were added into the medium for 24 h, respectively. Using PGF 2? to inhibit PPAR? activation via activation of MAP kinase. We employed the flow cytometry analysis to quantitatively analyze the apoptosis of VSMCs. Also, we measured and analyzed the discrepancies of the expression of p53 and bcl-2 between every groups. RESULTS: During the process of apoptosis induced by PPAR?,the expression of P53 protein increased (P

Objective To explore the effect of comprehensive nursing intervention on the rehabilitation of patients with schizophrenia,and to provide reference for clinical nursing.Methods Sixty-seven long-term hospitalized patients with schizophrenia received 6 months comprehensive nursing intervention.The instruments of the nurse observation scale for inpatient evaluation(NOSIE),insight and treatment attitude questionnaire (ITAQ),scale of social function in psychosis inpatients (SSPI) were administered both at the start and the end of intervention.Result After 6 months of treatment,the scores on mental disorder,recovery of social ability and treatment compliance and recovery or selfconcicousness increased as compared with pre-intervention (all P＜0.001).Conclusion The comprehensive nursing intervention can improve the mental symptoms and social function,alleviate their depression and promote mental rehabilitation of the patients with schizophrenia.