Objective To summarize the treatment of perianal abscess with diabetes.Methods 90 patients with perianal abscess with diabetes were randomly divided into the triple therapy group,the microwave group,Chinese group 3 groups.Three groups received conventional surgery,control of blood sugar,anti-infection treatment.Microwave therapy group WaS given microwave therapy and Chinese medicine group was given Chinese medicine,triple therapy group increase chinese medicine treatment and microwave based conventional surgery.The effect,the average lost time of exudate,wound healing time was analyzed.Results The triple group was significantly improved efficiency,83.3%,total effective rate of 100%.Conclusion The triple therapy combined with conventional surgery,Chinese medicine and microwave treatment could promote postoperative wound healing and exudate disappeared time and improve the efficiency of treatment to relieve patient concerns of treating perianal abscess with diabetes.

Objective To explore the clinical characteristics of Henoch-Sch(o)nlein purpura complicated with acute necrotizing acute pancreatitis,in order to provide information for the diagnosis and differentiation of Henoch-Scht(o)nlein purpura complicated with acute abdominal disease.Methods There was a case present with purpura,abdominal pain,massive ascites and poor spirit in Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University.The clinical manifestations and physical examination results were summarized and discussed,some pediatric specialists from nephrology department,surgery department,digestive system department were invited to discuss the case.The treatment was adjusted according to result of discussion,the final diagnosis was tracked.Results The case was firstly diagnosed with Henoch-Sch(o)nlein purpura,acute diffuse peritonitis with cause in dispute.After the discussion,the intestinal necrosis,perforation could not be excluded,acute pancreatitis required further identification.Exploratory laparotomy was received because of the changing condition after discussion.The intraoperative diagnosis was acute necrotizing pancreatitis.The patient recovered well with medical treatment.Conclusion When children with Henoch-Sch(o)nlein purpura had an acute abdominal disease,acute necrotizing pancreatitis should be considered in addition to intestinal necrosis,perforation.

Objective To investigate the changes in serum cortisol and adrenocorticotrophic hormone(ACTH) levels in children with steroid-sensitive nephritic syndrome (SSNS) and the clinical significance of intervention.Methods According to whether a child with SSNS would relapse,48 children with SSNS were divided into non-recurrence group(n =19) and recurrence group(n =29),at the same time 14 age-matched healthy children were enrolled as the healthy control group.Serum cortisol and ACTH were measured in patients with SSNS by using electrochemiluminesence methods.In recurrence group,methylpredisolone or methylprednisolone combined with ACTH injection therapy was used on 15 patients with their serum cortisol and ACTH below normal.Results Before standard glucocorticoid treatment,the serum levels of cortisol and ACTH had no difference among 3 groups (all P ＞ 0.05).By the end of remission phase,the serum levels of cortisol and ACTH in recurrence group were statistically lower than those of the non-recurrence group[(113.03 ± 80.02) μg/L vs (251.54 ± 185.05) μg/L,t =-2.925,P ＜ 0.05 ; (12.81 ± 10.14) ng/L vs (23.53 ± 12.05) ng/L,t =-0.885,P ＜ 0.05].Eight to 12 weeks after being adjusted,the serum level of cortisol and the average monthly time of recurrent were both significantly improved in 15 abnormal children in recurrence group [(168.90 ± 133.43) μg/L vs (73.62 ± 58.04) μg/L,t =3.016,P ＜ 0.05 ; (0.09 ± 0.08) times vs (0.35 ± 0.11) times,t =-7.560,P ＜0.05],but as to the serum level of ACTH,there was no significant difference in abnormal children in recurrence group [(14.05 ± 10.99) ng/L vs (8.72 ± 4.11) ng/L,t =1.991,P ＞ 0.05].Conclusions The concentrations of serum cortisol and ACTH can reveal the risk of recurrence for children with SSNS to some extent,and effective intervention can reduce the recurrence rate and shorten the course of disease.

Objective To explore the effect and safety of mycophenolate mofetil (MMF) and glucocorticoid on Henoch-Schonlein purpura nephritis in children and compared with cyclophosphamide (CTX).Methods The data of 48 patients diagnosed as Henoch-Schonlein purpura by renal biopsy were retrospectively analyzed.Median follow-up time was 22(7,48) months.The subjects were divided into 2 groups.34 cases were in the MMF group:MMF (15-20 mg · kg-1 · d-1 or 800-1200 mg/m2)+prednisone,and 14 cases in the CTX group:CTX (8-12 mg · kg-1 · d-1) + prednisone.Clinical and laboratory data were collected at baseline and 1,3,6 months after treatment.During follow-up,cumulative retreatment rate and adverse reactions after treatment were recorded.Results In two groups after treatment for 1,3,6 months,24 hours urinary protein quantitative was significantly lower than the baseline value,serum albumin (sAlb) was significantly higher than the baseline value,and serum creatinine (Scr) indicated no statistically significant difference during the follow-up period.After the treatment of 1 month,the efficient rate of MMF group was higher than the CTX group (MMF 73.5 ％ vs 42.9％,P=0.046),the effective treatment of 3,6 months at the end of the follow-up,no statistically significant difference were observed in the accumulative remission rate.The total rate of retreatment was 10.4％ (5/48),where MMF group was lower that of the than CTX group (3.0％ vs 28.6％,P＜0.001).The retreatment often occurred after discontinuation of prednisone and CTX,MMF reduction process.Eleven children received IMPDH2 gene polymorphisms test in MMF group,9 AA children had shorter time for drugs to be effective than that of the AG and GG children.The incidence of adverse reactions of MMF group was obviously lower than CTX group at the end of the follow-up (8.8％ vs 35.7％,P=0.025),where two groups developed fungal infection.Conclusions The short-term effect of both groups are the same,but the recurrent rate and incidence of adverse reactions of MMF group are lower than those of the CTX group.The preliminary study shows that IMPDH2 gene polymorphisms is associated with MMF curative effect and adverse reactions.

Objective To search for novel potent 3-ester derivatives of arenobufagin and test their antitumor activities in vitro. Methods Target compounds were synthesized by esterification of arenobufagin with acids. CellTiter method was used to assay the in vitro antitumor activities. Results 3-Ester derivatives exhibited excellent antitumor activities against all the cancer cells. Conclusion Among the 3-ester derivatives, compound 2a had the best activities with the IC₅₀ of 4.0−91.7 nmol/L and appeared to be a valuable candidate for further study.

Objective:To summarize the clinical features and gene phenotype of children with spondyloenchondrodysplasia with immune dysregulation (SPENCDI) caused by ACP5 gene mutation. Methods:The medical data and genetic phenotype of a child diagnosed with SPENCDI in the Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University in February 23, 2017 were analyzed retrospectively.Besides, " spondyloenchondrodysplasia" were taken as the search terms to perform the retrieval in CNKI, Wanfang Data, and PubMed, in an attempt to conduct the literature review.χ 2 test was used to compare the factors among children with different mutations. Results:The 4.5-year-old girl was admitted to hospital for complaint of " fever and chilblain-like rash" when she was 2 years old.She was diagnosed with systemic lupus erythematosus (SLE) concomitant with lupus nephritis.Methylprednisolone combined with cyclophosphamide, mycophenolate mofetil was used for the treatment.However, she experienced multiple infections, thrombocytopenia, limp, and growth retardation during the treatment.Genetic detection identified ACP5 gene compound hybrid mutation: c.779C>A and c. 770T>C.She was diagnosed with SPENCDI, and was subjected to follow-up.A total of 78 SPENCDI patients were retrieved from the databases, with various clinical manifestations of SPENCDI, commonly with skeletal involvement and immune phenotypes; 73.08% of the cases were positive for antinuclear antibodies, 57.69% of cases were positive for anti-double stranded-DNA antibodies and 34.62% of cases had neurological symptoms.In 58 cases, ACP5 gene mutations were detected, including 44 homozygous mutations and 14 compound heterozygous mutations.Patients with ACP5 gene homozygous mutation had a higher probability of consanguineous marriage in parents [56.82% (25/44 cases) vs.14.29% (2/14 cases)]; patients with ACP5 gene heterozygous mutation were more likely to develop SLE [64.29% (9/14 cases) vs.34.09% (15/44 cases)]( χ2=7.722, 3.992; all P<0.05). Conclusions:The majority of the ACP5 gene mutations are homozygous mutations in patients with SPENCDI, and heterozygous mutations are rare.The clinical manifestations of SPENCDI are various and complex, it is prone to develop autoimmune diseases, and there was no clear correlation between clinical features and gene phenotype in SPENCDI patients.