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.

Patients with nonvalvular atrial fibrillation are the high-risk population of ischemic stroke.Anticoagulation therapy is mainly used to prevent the occurrence of stroke in clinical practice.However,there are some difficulties in the conventional administration of oral anticoagulant warfarin because of some restrictions.There are a number of novel oral anticoagulants with promising data for the prevention of stroke in nonvalvular atrial fibrillation,such as direct thrombin inhibitor and coagulant factor X a inhibitor.

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.

ObjectiveTo explore the influence of locus of control,self-efficacy and self-esteem on shame.MethodsTotal 924 students from six primary and middle schools in Chengdu were recruited by stratified sampling.They were assessed with locus of control,self-efficacy,self-esteem,and shame questionnaire.Results ( 1 ) Shame was significantly negatively related with self-efficacy (r =- 0.248 ) and self-esteem (r =- 0.318 ),and was significantly positively related with locus of control (r =0.185 ).Locus of control was negatively associated with self-efficacy(r =- 0.214) and self-esteem (r =- 0.254).Self-efficacy was positively related with self-esteem (r =0.440) ; (2) Self-esteem played partial mediating role between shame and locus of control as well as self-efficacy; ( 3 ) Self-efficacy played partial mediating role between locus of control and self-esteem as well as shame ; (4) High self-esteem group and low self-esteem group existed significant differences in whole structure equation model.Based on the whole model,the high self-esteem group reduced the path from locus of control to self-esteem ; and low self-esteem group reduced the path from locus of control to self-efficacy.ConclusionLocus of control and self-efficacy are not only directly but also indirectly associated with shame by self-esteem,and self-efficacy would be regulated by the level of self-esteem.

Objective Exotoxin A ( encoded by gene toxA ) , one of the most toxic protein secreted by pseudomonas aerugi-nosa(P.a.), and PcrV (encoded by gene pcrV), key component to type Ⅲsecretion system of P.a., both matter significantly to the virulence of P.a.The article was to construct a novel DNA vaccine encoding a mutated toxA gene and the pcrV gene of P .a.and i-dentify gene expressions in eukaryotic cells . Methods The genes of toxA and pcrV were amplified by PCR , and the toxA gene was mutated to reduce the toxicity of Exotoxin A .Then gene fragments toxA m and pcrV were inserted into eukaryotic expression plasmid pIRES simultaneously to construct a recombinant DNA vaccine pIRES-toxAm-pcrV.The novel plasmid was transfected into HEK-293 cells by lipofectamine 2000 .The expressions of toxA m and pcrV were detected by Western blot . Results Gel electrophoresis demon-strated the target gene fragments encoding Exotoxin A and PcrV .Western blot exhibited proteins encoded toxA and pcrV expressed by HEK 293 cells. Conclusion The recombinant plasmid pIRES-toxAm-pcrV was successfully constructed .Western blot analysis indi-cated the expressions of toxA m and pcrV in HEK-293 cells.It may be used as a potential candidate of preventive vaccine of Pseudo-monas aeruginosa .

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.

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.

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.