Objective To determine the therapeutic effect of IgA nephropathy treated with tonsillectomy, and investigate the indication and contraindication. Methods Thirty-five IgA nephropathy patients, who were diagnosed by renal biopsy treated with tonsillectomy, were in operation group. Twenty-four hours urine protein, one hour urine erythrocyte and serum creatine were detected before the operation, one week, two weeks, four weeks, six months after the operation. Compared with 40 IgA nephropathy patients, who were treated with medicine (control group). Results The effective power in operation group was 71.4% and in control group was 52.5%. There was significant difference between two groups. Conclusion Tonsillectomy is more effective in IgA nephropathy with chronic tonsillitis, especially when renal corpuscle is slightly impaired, conversely, when renal function is severely damaged, it belongs to surgical contraindication.

Allergic rhinitis is familiar in clinic,in recent years the incidence has the trend of increase annually and the modern medicine has no effective cure at present.How to seek a permanent solution to the problem? Chinese medical constitution has influence on the incidence,syndrome differentiation,treatment and prognosis of allergic rhinitis.It is necessary and possible to prevent it according to Chinese medical constitution.The constitution is the internal and crucial factor of allergic reaction.The external etiologic factors work through the internal etiologic factors,making people get ill through the imbalance of yin-yang.Therefore,treating allergic rhinitis on the basis of Chinese medical constitution has a positive effect on prevention,correct diagnosis and treatment,controlling the progress and improving the prognosis.

In complicated vitreoretinal surgery,vitreous substitutes play a major role in maintaining intraocular pressure.Air,expansion gases,perfluorocarbons liquid,and silicone oil are frequently used in modern vitreoretinal surgery.Long-term vitreous substitute has been attempted with collagen,hyaluronic acid,natural hydrogel polymers and so on.However,an ideal vitreous substitute is being requested for a long time.This review focused on the currently available vitreous substitutes,as well as those in the experimental phase.These compounds were classified based on their functionality,composition,and properties.The clinical use,advantages,and shortcomings of the various substitutes were discussed.Finally,the criteria for an ideal vitreous substitute was defined.

The vulnerable carotid atherosclerosis plaque is an important risk factor for ischemic stroke.However,there are no objective diagnostic criteria for the vulnerability of carotid atherosclerosis plaque in clinical practice now.This article reviews the progress in the diagnosis of vulnerable plaque from the aspects of ultrasound,CT,MRL cerebral angiography,and biochemical indexes.

O bjective Different degrees of oxidative stress may exist in patients with diabetes mellitus (DM).The aim of this study was to explore the roles of oxidative stress and the level of vascular endothelial growth factor ( VEGF) in the development and progression of DM in the rat model of type 1 DM (T1DM). Methods We established the T1DM model in 23 male SD rats and in-cluded another 17 in the control group .We determined the total anti-oxidation capacity ( T-AOC) and the levels of super-oxide dis-mutase (SOD), glutathione (GSH), and malondialdehyde (MDA) by chromatometry, and measured that of VEGF by ELISA. Results At 7 weeks after modeling, the level of fasting blood glucose(FBG) was significantly increased in the T1DM rats as com-pared with the controls ([23.01 ±3.62] vs [5.08 ±0.46] mmol/L, P<0.05); the levels of GSH and SOD were markedly lower (18.8 [0.36] vs [3.82 ±1.05] g/L and [192.06 ±34.57] vs [242.37 ±32.79] U/mL, both P<0.05) while those of serum MDA and VEGF remarkably higher in the T1DM than in the control rats ([4.94 ±0.63] vs [4.42 ±0.37] nmolm/L and [23.97 ±1.84] vs [22.32 ±1.71] pg/mL, both P<0.05);no statistically significant differences were found in T -AOC between the two groups (P>0.05).FBG was correlated positively with MDA (r=0.51) and VEGF (r=0.47) but negatively with GSH (r=-0.71) and SOD (r=-0.40), while serum VEGF positively with MDA (r=0.32) and negatively with GSH ( r=-0.34 ) in the experimental rats . Conclusion Peroxidation is increased and the anti-oxidation mecha-nism weakened during the development and progression of T 1DM, which is closely related to hyperglycemia .High VEGF is associated with hyperglycemia and enhanced peroxidation .

The 39th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT 2013) was held in London,UK from 7 to 10 April,2013.The meeting received more than 1000 submitted papers,covering leukemia,lymphoma,aplastic anemia,cellular and gene therapies and biology of graft-versus-host disease(GVHD).This review focuses on haploidentical hematopoietic stem cell transplantation (HSCT),improvements of conditioning regimen and early diagnosis and the management of GVHD.

Objective To analyze acute coronary syndrome patients with clinical characteristics and the sta-tus survey of the interventional treatment in the datong area.Methods 162 cases of hospitalized patients with unsta-ble angina pectoris(UA)and non ST segment elevation myocardial infarction(NSTEMI)were selected through clini-cal records,with UA78 cases and NSTEMI 84 cases.Results Clinical features:(1 )Two groups of high incidence were men,and incidence cases were 2 times than that in women.Peaks in males were 50 -60 years old,and lasted 20 years in UA group;Peaks delayed 10 years of women thanthat of men in UA group,delayed 20 years in NSTEMI group.Over the 70 -year -old,there were no gender,number differences in the two groups.Hypertension,hyperlipi-demia,diabetes,number of cases were quite in two groups.(2)The history of coronary heart disease (CHD)were respectively:in UA group,patients with 1 year or less were 48 (61.5%),30 cases (38.5%)>1 year.NSTEMI group had 67 cases (79.8%)in 1 year or less,>1 year with 7 cases (20.2%),(t =2.915,-2.743,all P <0.01).In the subgroups which the morbidity was 1 day or less,UA group had 5 cases (6.4%),NSTEMI group had 25 cases (29.8%)(t =4.066,P <0.01).(3)History of OMI respectively:UA group 18 cases (23.1%),the NSTE-MI group 8 cases (9.5%)(t =-2.533,P <0.05),the difference between the two groups had statistical signifi-cance.Coronary lesions:(1 )stents:During 78 cases of patients with UA,direct percutaneous coronary intervention (PCI)treatment were 71 cases (91.0%).During 84 NSTEMI patients,direct PCI were 63 cases (75.0%).(2)Sin-gle lesion:UA group of stents treatment were 18 cases (11.1%),the NSTEMI group were10 cases (6.2%),and had a statistically significant difference between the two groups (χ2 =26.309 P <0.01).The third.The incidence of heart for death in hospitalized patients:In the 162 cases of patients,hospital death was 3 patients (1.9%),and had occurred in NSTEMI group (3.6%),there was statistically significant difference between the two groups (χ2 =2.838 P1 -sided <0.05).Conclusion In front of coronary heart disease incidence peak,the high -risk groups:hyperten-sion,hyperlipidemia,diabetes,to carry on the curative effect of standard treatment for a long time,it is the key to avoid the risk of coronary heart disease (CHD).NSTEMI cardiac mortality,need hospital treatment.Not only secondary pre-vention of coronary artery disease focus groups of HP,hyperlipidemia,DMand also cannot ignore OMI crowd.because myocardial ischemia often,even NSTEMI.Correct myocardial ischemia is the key of the coronary heart disease treat-ment,if the drug is invalid,stents treatment should be taken into account.

BACKGROUND: Bilateral pedicle screw fixation combined with intervertebral decompression and fusion is a classic surgical approach in treatment of lumbar degenerative diseases, but it can cause ligament and other soft tissue damage of lumbar spine and degeneration of the adjacent segments. While translaminar facet screw fixation has its unique advantages.OBJECTIVE: To compare the clinical efficacy of unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation for lower lumbar degenerative diseases.METHODS: Forty-six patients with single-level lower lumbar degenerative disease were enrolled, and were then treated with bilateral pedicle screw fixation combined with intervertebral fusion (group A, n=24) or unilateral pedicle screw along with translaminar facet screw fixation and intervertebral fusion (group B, n=22). Afterwards, the clinical indexes and efficacy were compared between two groups.RESULTS AND CONCLUSION: (1) All operations were performed successfully. The length of incision, operation time,intraoperative blood loss, postoperative drainage volume and cost of hospitalization in the group B were significantly superior to those in the group A (P < 0.05). (2) There was no significant difference in the rate of fusion between two groups (P > 0.05). (3) The visual analogue scale and Japanese Orthopaedic Association scores in both groups at 1 week,3, 6, 12 and 24 months postoperatively were significantly improved compared with baseline (P < 0.05), but the scores had no significant differences between two groups (P > 0.05). (4) To conclude, unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation both exhibit satisfactory treatment outcomes,while the former holds little trauma, good stability, high fusion rate and less cost, which is a better choice for lower lumbar degenerative diseases.

Objective: To evaluate the clinical effect of individualized enteral nutritional (EN) support in severe stroke patients.Methods: Totally 120 severe stroke patients with nutritional risk were divided into two groups according to single or double admission number.The 60 patients in the intervention group received an individualized EN with different formula and concentrations according to the clinical status,and supplemented trace elements as occasion required.In the routine group, the patients received EN with standard formula.The energy supply was 83-125 kJ· kg-1·d-1 in both groups.Blood albumin(Alb), pre-albumin(PA), hemoglobin(Hb) and vitamin C(VC) were examined before and after the 21-day nutritional support.The lung infection and gastrointestinal (GI) complications were observed, and the hospital stay and cost were recorded as well.Results: After 21 day''s nutrition support, the serum levels of Alb, PA and VC in the intervention group were not statisticly significant than before (P＞0.05), and the serum levels of Alb, PA and VC were significantly higher than those in the routine group(P＜0.05).The incidence of complications in the in the intervention group was lower than that in the routine group (P＜0.05), and the length of hospital stay and hospitalization was shorter than that in the routine group (P＜0.05).Conclusion: Individualized enteral nutritional support can significantly improve nutritional status, reduce inflammation reactions and GI complications in severe stroke patients, which is worthy of clinical use.

Objective To explore the effects and safety of citalopram combined with low-dose risperidone on refractory depression. Methods All of 54 patients with the refractory depression were ran-domly divided into two groups: augmented treatment group (taken citalopram 20 mg/d, risperidone 0.5-2.0mg/d) and mono-thempy group (taken citalopram alone 20 mg/d). The treatment lasted for 6 weeks. They were estimated with Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and treatment emergent symptom scale (TESS) at baseline and every two weeks subsequently. Results In the augment-ed treatment group, total effective rate was 60.7% and recovery and excellence rate was 50.0%, while that was 26.9% and 15.4% in mono-therapy group (P< 0.05). The adverse effect of two groups was minor. Conclu-sion Rispefidone may be a useful and safe adjunct to citalopram in treatment of refractory depression.