Systemic lupus erythematosus(SLE) is an autoimmune connective-tissue disorder with a wide range of clinical features.Although the clinical symptoms and immunological findings of pediatric SLE are similar to those of adult SLE patients,the pediatric SLE has some special aspects.In the recent years,although there was no abrupt development in the diagnosis and treatment of SLE,there were some new findings,maybe not mature.On the basis of recent findings outsides,this study drew attention to the advances in the novel clinical manifestation,update treatment of pediatric SLE.

AIM: To study the application of macular ganglion cell complex (mGCC) and peripapillary retinal nerve fiber layer thickness (pRNFL) measured by optical coherence tomography (OCT) in the early diagnosis of glaucoma.METHODS: Case-control study.Eighty-six subjects, including 30 eyes in normal subjects, 27 eyes in suspected primary open angle glaucoma, 29 eyes in primary open angle glaucoma were enrolled in this study.The thickness of mGCC and pRNFL were measured by OCT.The area under the receiver operating characteristic(AROC) curve at fixed specificities were calculated for each parameter.RESULTS: There were significant differences in mean pRNFL thickness, superior pRNFL thickness and inferior pRNFL thickness between normal group, suspected glaucoma group and early glaucoma group (P=0.001, 0.004, 0.011).The mean mGCC thickness, the thickness of the top mGCC, the thickness of the lower mGCC were statistically significant (P=0.008, 0.002, 0.003);the difference of general loss of volume (GLV) and focal loss of volume (FLV) between the three groups was statistically significant (P=0.002).Compared with the normal group, all the pRNFL and the mGCC parameters were higher in the suspected glaucoma group, and the FLV had the highest AROC (0.801), all the remaining AROC was >0.700 except above Prnlf (0.688).Compared with the normal group and the early glaucoma group, all the pRNFL and the mGCC had higher AROC, average mGCC was hightest(0.804), all parameters AROC were >0.700 except mean pRNFL (0.683).In suspected glaucoma group, 58% patients had abnormal mGCC thickness and 23% had abnormal pRNFL thickness;in early glaucoma group, 98%patients had abnormal mGCC thickness and 90% had abnormal pRNFL thickness;in normal group, 93%patients had abnormal mGCC thickness and 93%had abnormal pRNFL thickness, the correlation between the three groups was statistically significant (x2=12.11, P<0.05).CONCLUSION: OCT measurement of mGCC thickness and pRNFL thickness in early glaucoma have good diagnostic ability;mGCC thickness measurement can be used as an effective method for early diagnosis of glaucoma.

AIM: To compare the effect of treating cataract by sodium hyaluronate injection and lens - loop nucleus extraction of small incision cataract excision and explore more suitable method to promote the use of surgery in primary hospital.
METHODS: All 146 cataract patients ( 166 eyes ) were allocated to two groups in random: the control group 78 patients ( 84 eyes ) received conventional lens loop for extracapsular cataract extraction;the experiment group 68 patients (82 eyes) underwent nucleus extraction in small incision with sodium hyaluronate injection for extracapsular cataract extraction. Postoperative visual acuity and intraoperative and postoperative complications were compared between two groups.
RESULTS: Incidence of posterior capsule rupture difference was statistically significant (P<0. 05) in small incision nucleus extraction with sodium hyaluronate injection compared with conventional lens loop for extracapsular cataract extraction. And there was no significant difference ( P> 0. 05 ) in postoperative visual acuity, astigmatism degree and postoperative complications compared with those of pre-operation.
CONCLUSION: Compared with the lens loop nucleus extraction, sodium hyaluronate injection for extracapsular cataract extraction can effectively protect the posterior lens capsule and can be promoted in small incision cataract surgery.

Anterior plate fixation of the cervical spine provides good primary stability to allow early mobilization without significant external support. Despite the obvious advantages of anterior cervical fixation, neurological injury resulting from the direct trauma of a drill bit or screw are possibile with this technique. In addition, screw loosening leading to dyphagia has been reported. The cervical spine locking plate (CSLP) system maintains the mechanical advantages of internal fixation and eliminate the neurological risks of perforating the posterior cortex. The purpose of this study is to review our experience with this device, to critically assess its ability to stabilize the cervical spine, and to assess for complications associated with this device. The authors reviewed 28 consecutive patients in whom the CSLP system was applied between April 1994 to April 1995. Average age was 44 years ranged from nineteen to seventy-two. Patients with trauma were eight and degenerative diseases were twenty. Eighteen screws were inserted in C3 bodies, twenty-four in C4, forty-one in C5, thirty-six in C6, twenty-four in C7, two in Tl and nine on grafted bone. With a mean follow-up of 15 months, 27 of 28 patients went on to fusion. Mean time to fusion was three months (range 2-5). Fusion status of one patient was considered as uncertain. Three patients had screws placed in the disc rather than in bone. One patient suffered deep wound infection, which developed to tracheoesophagial fistula. No patient showed neurological injury as a result of this device.
Early Ambulation ; Fistula ; Follow-Up Studies ; Humans ; Spine* ; Transplants ; Wound Infection

In the investigation of patients with internal disc disruption, a discography has been the best method to decide whether intervertebral disc is normal or abnormal. Magnetic resonance imaging (MRI) of the spine is a new technique which offers an alternative method of obtaining this information. Some authors have reported MRI was more accurate than discography, but other reports have indicated discography was more useful test in symptomatic lumbar disc disease. The authors performed retrospective study to evaluate the diagnostic value of the image findings of MRI and discography in the internal disc disruption. Image findings of MRI and discography were analyzed comparing to pattern of provocative pain during discography. The concordant pain at discography was considered as a gold standard for evaluation of the diagnostic value of these modalities. The image findings of MRI and discography for 60 discs of 21 patients were graded and compared with the pain response at discography. The validity and predictive value (PV) of these modalities were calculated and the correlation between these image findings was evaluated. The sensitivities of discography and MRI were 83.3% and 90.9% respectively. The specificities of these findings were 47.1% and 46.7%. The positive PV of discography and MRI were 52.6% and 55.6%, and the negative PV were 80% and 87.5% respectively. There was no statistical significance in these discrepancies. The determinations of symptomatic disc level based on image findings are unreliable. The MRI can be considered as a screening test for internal disc disruption since it is non-invasive and sensitive diagnostic tool. The fusion level should be decided by the pain pattern at discography.
Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Mass Screening ; Retrospective Studies ; Spine

Objective To investigate the hemodynamics and structural effect of rat endothelial progenitor cells (EPC) transplant on pulmonary artery hypertension (PAH) induced by monocrotaline(MCT) in rats.Methods EPCs were identified and marked.Twenty-one days after injection of EPCs,the pulmonary hemodynamic parame- ters,average pulmonary artery pressure (mPAP),right heart index were determined.The vascular endothelial cells and pulmonary vascular structural changes were verified by fluoresccuse microscope.Results Compared with the model,EPCs treatment(n=10) decreased mPAP significantly (mPAP,EPCs:25.9?0.7 mmHg vs model group:29.3?2.2 mmHg,P

STUDY DESIGN: Thirty-eight patients with thoracolumbar and lumbar burst fractures were evaluated according to the treatment methods of the retropulsed fragments. OBJECTIVE: To confirm the pure effect of ligamentotaxis according to the approaching methods to tile involved area. SUMMARY OF BACK GROUND DATA: Retropulsed fragments were effectively treated by indirect posterior reduction. Regardless of size of the retropulsed fragments, remodelling process of the retropulsed fragments was progressed during follow-up period. METHODS: 38 patients with burst fractures of thoracolumbar and lumbar spine were divided into two groups according to tile reduction method of the retropulsed fragments ; the one group consisted of 18 cases which were treated by posterior instrumentation and indirect reduction(Group I: ligamentotaxis) and the other groups consisted of 20 cases which were treated by posterior instrumentation and posterior direct reduction(Group II). Change of neural canal compromise rate, neurologic status, remodelling process of the retropulsed fragments were measured using pre-, post-operative and follow-up radiographs and CT. RESULTS: Comparing the two groups, neural canal compromise rates were decreased at postoperative period but, there were no significant differences in both groups. There were no correlation of neurologic status and neural canal compromise rate. We could confirm the remodelling process of the retropulsed fragments, but there were no significant changes according to the size of the retropulsed fragments between two groups. CONCLUSIONS: Indirect reduction by posterior instrumentation( ligamentotaxis ) could effectively treat the retropulsed fragments in burst fractures of thoracolumbar and lumbar spine without directs posterior reduction.
Follow-Up Studies ; Humans ; Neural Tube ; Postoperative Period ; Spine

STUDY DESIGN: Changes of morphology and phenotype of cultured cells in media added lactate were observed. OBJECTIVES: To evaluate the effect of lactate on morphology and phenotype of cultured intervertebral disc cell. SUMMARY OF LITERATURE REVIEW: It was reported that lactate and pH were important factor in the degeneration of intervertebral disc. However the effect of lactate on morphology and phenotype of cultured intervertebral disc cell have not been studied. MATERIALS AND METHODS: Cells were dissociated enzymatically from rabbit nucleus pulposus. After attaining monolayer growth, the cells were incubated in media added 2mM or 5mM lactate. Total cell counts and morphological changes of the cells were periodically observed. Changes in cell phenotype were investigated by use of anti-collagen antibody stain. RESULTS: The cell groups added no lactate and 2mM lactate showed no difference in cell counts, morphology and phenotype. The cell group added 5mM lactate showed a reduction in final cell Counts and highel'ratio of fibroblastic cell in total population. Anti-collagen I Ab stained the Intra-and extra-cellular area of fibroblastic cells and intracellular area of chondrocytic cells. CONCLUSIONS: The current study suggests that high concentration of lactate inhibit intervertebral disc cell proliferation and accelerate morphological and phenotypical change to fibroblastic cell.
Cell Count ; Cell Proliferation ; Cells, Cultured ; Fibroblasts ; Hydrogen-Ion Concentration ; Intervertebral Disc* ; Lactic Acid* ; Phenotype*

Objective To investigate the expression of peroxisome proliferator-activated receptor-γ(PPAR-γ) and angiotensin receptor (AT2R) in chronic pancreatitis tissue. Methods Between April 2006 and February 2009, 24 patients were pathologically diagnosed as chronic pancreatitis were enrolled and 12 samples of normal pancreatic tissues were treated as controls. Immunohistochemical staining was used to detect PPAR-γ and AT1R, AT2R expression in pancreatic tissues. Results PPAR-γ and AT1R were mostly negatively expressed in normal pancreatic tissues, the positive scores were 0.33±0.49 and 0.42 ± 0. 51, respectively, while AT2R were weakly positively or negatively expressed in acinus and islet cell, and it was weakly positively expressed in ductal epithelial cells, the positive score was 2. 33 ± 1. 37. In chronic pancreatitis tissue, PPAR-γ, AT1R and AT2R were positively expressed in acinus, ductal epithelial cells, and islet cell, the positive scores were 3.28 ± 2.46, 4.36 ± 2.80 and 4.61 ± 2.89, which were significantly higher than those in the normal group (P<0.01, P <0.01, P<0.05). Conclusions PPAR-γ, AT1R and AT2R were positively expressed in chronic pancreatitis tissue, and they may be the treatment target of chronic pancreatitis.

Objective To investigate the expression of Hedgehog signaling pathway members,Shh,Gli1,Sufu and TAK1 as well as phosphorylation-TAK1 (p-TAK1) protein in human pancreatic carcinoma tissues and to explore its relationship between the expression of proteins and the clinicopathologic parameters.Methods The expressions of Shh,Glil,Sufu,TAK1,p-TAK1 proteins in 38 samples of pancreatic cancer tissues and pairing adjacent normal pancreatic tissues were detected by immunohistochemical method.The relationship among the proteins and the relationship between the expression of the proteins and the clinicopathologic parameters were examined.Results The positive expression rates of Shh,Glil,Sufu,TAK1,p-TAK1 protein in human pancreatic carcinoma were 86.8％ (33/38),52.6％ (22/38),68.4％(26/38),55.3％ (21/38),52.6％ (20/38),but they were not expressed in adjacent normal pancreatic tissues.Gli1 expression was positively related to distant metastasis and clinical staging (r =0.524,0.361,P ＜0.05),Sufu expression was positively related to patient's gender (r =-0.378,P ＜0.05),TAK1 expression was positively related to clinical staging (r =0.468,P ＜ 0.05),p-TAK1 expression was positively related to clinical staging and distant metastasis (r =0.418,0.361,P ＜ 0.05).Gli1 expression was positively related to TAK1 and p-TAK1 expression in pancreatic cancer tissues (P ＜ 0.05).Conclusions Hedgehog signaling pathway and p-TAK1 may play a role in the pathogenesis of pancreatic cancer,and the two pathways may interact with each other.