ObjectiveTo observe the effect of irbesartan and triptolide combination on the level of urine protein in patients with diabetic nephropathy at high altitude area.MethodsFifty patients with diabetic nephropathy (24-hour urine protein excretion over 1.0 g and serum creatinine level below 265.2 μmol/L) at high altitude area were randomly divided into two groups,the control group were treated with irbesartan 150 mg/d for three months,and the treatment group received irbesartan 150 mg/d combined with triptolide 40 mg/d for three months.24-hour urine protein concentration,arterial pressure,liver function and renal function were measured before and after the treatment.Results After three months' treatment,the levels of 24-hour urine protein and arterial pressure were significantly lower in both control and treatment group (P ＜ 0.01 ).Twenty-four hour urine protein in treatment group were reduced from ( 8.34 ± 1.29) g before treatment to (6.42 ± 0.95 ) g after treatment ( t =5.994,P ＜ 0.001 ).Twenty four-hour urine protein in control group were reduced from (8.57 ± 0.53 )g before treatment to (7.10 ± 0.79 )g after treatment( t =7.730,P ＜ 0.001 ).Systolic pressure in treatment group were reduced from ( 152.04 ± 18.80)mm Hg before treatment to ( 131.24 ± 10.56)mm Hg after treatment(t =4.817,P ＜ 0.001 ) ; Diastolic pressure in treatment group was reduced from (93.60 ± 11.36 )mm Hg before treatment to ( 82.68 ± 7.30) mm Hg after treatment ( t =4.053,P ＜ 0.001 ).Systolic pressure in control group were reduced from ( 151.20 ± 10.17 ) mm Hg before treatment to ( 130.00 ± 10.10 ) mm Hg after treatment(t =7.396,P ＜ 0.001 );Diastolic pressure in treatment group were reduced from (92.76 ± 7.03 )mm Hg before treatment to (84.20 ± 7.56)mmHg after treatment (t =4.147,P ＜ 0.01 ).No statistic differences were observed in liver function and renal function before and after the treatment ( P ＞ 0.01 ).Conclusion Irbesartan and triptolide combination can reduce 24-hour urine protein to a certain extent and donot adversely affect liver function and renal function in patients with diabetic nephropathy at high altitude area

Objective To investigate the prenatal diagnosis and prenatal genetic conselling of pseudomosaic trisomy 20. Methods One case of pseudomosaic trisomy 20 was analyzed and relative literatures were reviewed. Results A 31-year-old gravid 1, para 0 woman underwent amniocentesis at 18 weeks of gestation due to high risk of trisomy 21 during maternal serum screening in September, 2012. Interphase fluorescence in situ hybridization (FISH) of amniocytes with probes GLP13/GLP21/CSP18/CSPX/CSPY showed a normal result, while cytogenetic analysis of cultured amniocytes revealed a karyotype of 47,XY,+20[7]/46,XY[9]. The level of trisomy in the cultured amniocytes was 7/16. Cordocentesis revealed a karyotype of 46,XY in cultured cord blood cells. Interphase FISH analysis was performed using the probes D20Z1 (20p11.1-q11.1) and D20S1157/20QTEL14 (20 per/qter). Each probe showed two signals in all uncultured amniocytes. The prenatal ultrasound findings were unremarkable. The mosaicism was considered to be pseudomosaicism. After genetic counseling, the parents selected to continue the pregnancy. A healthy male baby was delivered at 39 weeks of gestation. Postnatal cytogenetic analysis revealed a karyotype of 46,XY in peripheral blood lymphocytes. Interphase FISH analysis of the uncultured buccal cast-off cells using the probes D20Z1 and D20S1157/20QTEL14 showed normal results in 100%cells. There was no phenotypic abnormality at the age of seven months. Conclusions When mosaic trisomy 20 is identified in amniocytes, further evaluation and genetic counseling are required. Interphase FISH of the uncultured amniocytes with a chromosome-specific probe is a useful tool for confirmation of the prenatal diagnosis of mosaicism. Genetic analysis of multiple tissues is required postnatally.

In order to investigate the effect of curcumin on proliferation and apoptosis of human pterygium fibroblasts (HPF) in culture and search for a new method to prevent the recurrence after pterygium surgery, HPF was incubated with 0-160 micromol/L curcumin for 24-96 h. The MTT method was used to assay the biologic activities of curcumin at different time points and different doses. The expression of proliferating cell nuclear antigen (PCNA) in each group was detected by immunohistochemistry. The cell cycle distribution was detected by flow cytometry (FCM). Administration of 20-80 micromol/L curcumin for 24-72 h could significantly inhibit HPF proliferation in a dose-and time-dependent manner (P<0.05). After treatment with curcumin at different concentrations of 20, 40, 80 and 160 micromol/L for 24 h, FCM revealed there was a significant sub-G1 peak at each concentration. The number of HPF in G0/G1 phase was increased, while in S phase, it was decreased (P<0.05). At the concentration of 20-80 micromol/L, curcumin, in a dose-dependent manner (P<0.05), could inhibit the expression of PCNA in HPF. It was suggested that curcumin could significantly inhibit the proliferation of HPF, make HPF arrest in G0/G1 phase and induce the apoptosis of HPF in a dose-and time-dependent manner.

Objective To confirm the vancomycin loaded gelatin/β-TCP composite porous scaffolds could be used as sustained-release system,and investigate its efficiency of eliminating infections and repairing bone defects for the treatment of infected bone defects in rabbit.Methods The biodegradable gelatin sponge containing different contents (0,10％,30％,50％) of β-tricalcium phosphate ceramic (β-TCP) was prepared for the controlled-release of vancomycin and labeled with G-0 TCP,G-10 TCP,G-30 TCP and G-50 TCP respectively.Examinations of scanning electron microscopy,porosity analyses and mechanical test were performed.The K-B method was used to investigate the controlled release of vancomycin.Chronic Methicillin-resistant Staphylococcus aureus osteomyelitis models of rabbit were established.After thorough debridement,the infected bone defects were treated in four different groups:blank control group,G-0 TCP group,G-10 TCP group,and G-30 TCP group.At 4 and 8 weeks after implantation,X-ray and histological examinations were carried out to investigate the efficiency of eliminating infections and repairing bone defects.Results The prepared gelatin/β-TCP scaffold exhibited a homogeneously interconnected-3-D porous structure.And the β-TCP granules were localized evenly on the walls of the composite scaffold.There were no significant differences in the pore size of different scaffolds.However,the β-TCP granules can improve the interconnection.The porosity exhibited an obvious increase in G-10 TCP and G-30 TCP composite scaffolds compared with G-0 TCP scaffold.In contrast,too high content of β-TCP granules decreased the porosity.And the porosity exhibited an obvious reduction in the G-50 TCP composite scaffold.The compressive modulus of the vancomycin loaded scaffolds increased with the increase of the β-TCP amount.The scaffold G-0 TCP exhibited the longest duration of vancomycin release and the duration reached 8 weeks.With the increased content of β-TCP granules,the release duration shortened obviously.Compared with the G-50 TCP composite scaffold,the G-10 TCP and G-30 TCP composite scaffolds revealed a better controlled release of the drugs,and the total amount of the drugs was released within 7 weeks.However,the total amount of vancomycin released from the G-50 TCP composite scaffold lasted for 3 weeks.In the treatment of chronic MRSA osteomyelitis of rabbits,the G-30 TCP composite scaffold showed a better performance in the eliminating infections and bone defects repair.At 8 weeks after implantation,signs of osteomyelitis,including osteolysis,development of periosteal reactions,and sequestral bone formation were observed in the animals of blank control group.Signs of infection were absent in other treatment group.In the group treated with G-30 TCP composite scaffold,the bonedefects were repaired completely at 8 weeks after implantation.However,in the groups treated with G-0 TCP and G-10 TCP composite scaffold,the bone defects were not repaired.Conclusion The composite scaffolds could achieve local therapeutic drug levels over an extended duration.And the gelatin with 30％ β-TCP granules composite scaffold had optimal porosity,interconnection,mechanical properties and controlled release performances.It exhibited good performances in infection control and bone defect repair in the chronic MRSA osteomyelitis model.

Objective To explore the impacts of Danhong injection on physiological and biochemical indicators in malnourished mice at physiological low doses, evaluate its safety, and test the practical value of safety re-evaluation of Traditional Chinese Medicinal ( TCM) injections. Methods A total of 32 ICR mice during growth period were selected to set up corn deficient nutrition mice model. Mice were assigned into the normal control group (given 0. 9% saline), Danhong injection at low, medium and high dosages (0. 2, 0. 4 and 0. 6 mL) groups (n=8 in each group);Mice were administered with respective medications intraperitoneally for 7 consecutive days. Blood samples were taken and mice were executed on the 8th day. All 9 kinds of organ or tissue were obtained completely, to measure related physiological and serum biochemical parameters. The safety of Danhong injection was evaluated by using Benefit and Damage Index - General Score ( BDI-GS ) system. Results The Danhong injection showed only slight damages on major organs or tissues, the BDI values were all above 0. 85, and the GS values were all above 9. 0;BDI values for Danhong injection at different dosages were all above 1. 0 for spleen and pancreas, showing better replenishing and healthy effects, and the differences were of statistical significance compared with the normal control group (P<0. 05 or P<0. 01). Meanwhile, it exerted obviously hypoglycemic effect. Conclusion Danhong injection is of rather low risk under physiological dosages, and therefore is safe to use. The mal-nutrition model combined with the BDI-GS system may be developed as a novel approach for safety re-evaluation of TCM injection in clinic.

Objective To analyze the relationship between karyotypes and clinic features of patients with primary amenorrhea. Method Karyotype analysis of patients with primary amenorrhea was performed by using G-banding technique. Results Karyotype analysis of 468 patients with primary amenorrhea revealed that 255 patients (54. 49% ) had normal female karyotypes and 213 patients (45.51%) had abnormal karyotypes, including 143 patients with abnormal X chromosome, 4 patients with mosaic X -Y chromosome, 57 patients with 46, XY karyotype, 8 patients with abnormal autosome and one patient with Xautosome translocation. 75.52% primary amenorrhea patients with short stature had abnormal X chromosome, and all primary amenorrhea patients with deletion or break-up of Xp11. 1 - 11.4 and Xp21 - 22 were short statures. Conclusion One of the main reasons of primary amenorrhea was chromosome abnormity,especial heterosome abnormity. Karyotype analysis should be used to detect primary amenorrhea patients in regular. There might be relationship between height improvement and the abnormity of Xp11. 1 - 11.4 and Xp21 - 22.

Objective To establish the multiple quantitative fluorescent polymerase chain reaction (QF-PCR)assay and evaluate its clinical application in prenatal diagnosis.Methods Totally 170 samples Were collected between May 2008 and July 2009 in prenatal center of Peking Union Medical College Hospital:123 of them were amniotic fluid,9 were chofionic villous samples,20 were fetal blood and 18 were villi from aborted fetuses.All samples were from women of Han nationality,with mean age of (34.1±4.6) years old,and with mean gestational age of(19.6±1.0)weeks.Cytogenetic cultures and karyotyping were made to every sample.Genomic DNA wag extracted from the samples.The sequences of twenty short tandem repeat (STR) markers were designed according to the GenBank and references,including 6 STR markers in chromosome 21.4 in chromosome 18.4 in chromosome 13,4 in chromosome X,1 in chromosome Y and 1 universal marker in both X and Y chromosome.Each sample was amplified by two sets of multiple QF-PCR,which included 4 STR markers in each of 21,18,13 and sex chromosomes. If the result was uninformative,the third set of anotherd 4 STR markers was added. Results ( 1 ) Karyotyping. Cytogenetic analysis were made for all the 170 samples, 151 (89%) of which were normal, and 19 (11% ) were abnormal (2)QF-PCR assay. 167(98% ) samples were detected by QF-PCR. The results were obtained within 2 -3 days after sampling. 134 samples were proved normal by QF-PCR, which was consistent with karyotyping. Among the 19 abnormal karyotype samples, 18 were detected as abnormal( eight were 21-trisomy, three were 18-trisomy)by QF-PCR. Among the 167 samples, 150(90% ) were detected using the first and second set of STR mixtures, and 3(2% ) were detected when the third set of STR was added. The remain 14(8% ) were uninformative. (3) The diagnostic efficiency of QF-PCR. The sensitivity of QF-PCR in prenatal diagnosis of common aneuploidities was 95%, the specificity, the false positive rate, the false negative rate, the positive predictive value and negative predictive value were 100% ,0,5%, 100% and 99% , respectively. (4)Autusome and sex chromosome detection by QF-PCR. Among all the STR markers,D21S1270 and D21S1411 had the highest heterozygosifies in chromosome 21, and DXS8377 had the highest in sex chromosome. The amplifications were stable. Conclusion Multiple QF-PCR assay is a valid alternative in rapid prenatal diagnosis of common chromosome aneuploidies. With high accuracy, it can be used for numerous sample test in large-scale laboratories.

Objective To explore the surgical method of double flag-shaped flap to correct the shortened middle part of upper lip deformity of post burn.Methods From January 2009 to December 2013,9 cases of shortened middle part of upper lip post burn deformity were corrected by double flag-shaped flap,including 4 males and 5 females who aged from 18 to 37 years.They received the surgery from 1 to 3 years after burn.The main clinical manifestations included the upper lip eversion,too short middle part of upper lip,the destruction of the normal anatomy philtrum,philtrum column deformity and poor continuity vermilion border.Results The height of the middle of upper lip of 9 patients enrolled in the experimental treatment was lengthened by 4 to 6 mm after operation,which fundamentally corrected the shortened middle part of upper lip deformity of post burn.The patients were followed up for a period of 3 months to 2 years and received satisfactory results.The operative incisions of 9 cases were primary healing,with no flap blood supply disorders,wound infection,dehiscence and other complications.Conclusions Double flag-shaped flap of the upper lip at the nostrils bottom is a simple and good effective method to correct the shortened middle part of upper lip deformity of post burn.

Pathology is a subject that studies the etiology,pathogenesis,pathological changes,progression and outcome of diseases.Pathology links the basic research and clinical practice and is an important part of translational medicine.In order to cultivate qualified pathological graduates with solid pathological theories and the abilities of proposing and addressing scientific hypotheses from pathological morphology changes,we employ modularized special training to divide the pathology training courses into morphology learning module,article searching and reading module,project design module,experiment operation module and scientific presentation module.The training contents among these modules are relatively independent but closely connected,and compose a strategy that aims to improve the scientific innovation ability of pathological graduates.