The immunopathogenesis of IgA vasculitis and IgA nephropathy both demonstrate IgA deposition,and abnormal glycosylation of IgAl molecule is their major pathogenesis.Therefore,it is clinically controversial that they are actually one disease.The present text will delineate their similarities and differences from aspects of epidemiology,clinic,pathology,mechanism and prognosis.

In the use of antiepileptic drugs in patients with epilepsy,1/3 of the patients with epilepsy can not get effective control,showing resistance to antiepileptic drugs.Now the mechanism of drug resistance is considered to be caused by multiple factors work together.The concept and connotation between drug-resistant epilepsy and refractory epilepsy are different.Since 2010,the international union of antiepileptic proposeddrug-resistant epilepsy expert consensus,different medical centers use the new defition to study different populations and confirm that the new definition is effective and reliable.However,there are some controversier about the drug dosage,drug kinds,judge for determining evaluation index and the treatment judgement in that definition.

In recent years,it is a tendency to substitute acute kidney injury (AKI) foracute renal failure (ARF)in the aspect of international nephrology and emergency medicine.Compared with the past,the causes for AKI in children at present has been transferred from primary kidney disease to multi-factors,moreover,the morbidity and mortality of AKI is staying at a high level.From the perspective of epidemiology this paper briefly analyses the common cause,mortality and morbidity of AKI in children.

Objective To observe and study the variation ofinterleukin (IL),trace elements and adhesion molecule in allergic rhinitis patients.Methods Forty-seven allergic rhinitis patients who were diagnosed from March 2011 to March 2013 were selected as observation group.Among the total,intermittence was 27 patients,continuity was 20 patients,mild was 15 patients,moderate was 19 patients,severe was 13 patients.Forty-seven healthy person at the same time were selected as control group.The level of IL,trace elements and adhesion molecule in two groups were compared,and all the indexes of observation group with different types and severity were compared too.Results The level of IL-4,IL-5,IL-6,IL-10,soluble intercellular adhesion molecule (sICAM)-1,soluble vascular cell adhesion molecule (sVCAM)-1,soluble P-selectin (sP-selectin),soluble E-selectin (sE-selectin) in observation group were significantly higher than those in control group [(28.97 ± 3.27) ng/L vs.(4.35 ± 0.65) ng/L,(17.46 ± 2.15) ng/L vs.(2.71 ± 0.34)ng/L,(10.39 ± 1.28) ng/L vs.(5.96 ± 0.94) ng/L,(31.36 ± 3.44) ng/L vs.(5.53 ± 0.76) ng/L,(483.72 ± 39.25) μ g/L vs.(319.65 ± 29.86) μ g/L,(516.85 ± 50.27) μ g/L vs.(327.46 ± 31.53)μg/L,(12.58 ± 1.36) μg/Lvs.(3.43±0.76) μg/L,(31.34 ±2.84) μg/L vs.(10.22± 1.52)lμg/L] (P＜0.05).The level of serum Zn in observation group was significantly lower than that in control group[(7.14 ±1.35) μ mol/L vs.(16.83 ± 1.71) μ mol/L] (P ＜ 0.05).The level of serum Cu and Mn in observation group were significantly higher than those in control group [(23.24 ± 2.79) μ mol/L vs.(13.15 ± 2.08) μ mol/L,(4.13 ± 0.27) μ mol/L vs.(2.24 ± 0.19) μ mol/L] (P ＜ 0.05).In observation group,the change of above indexes in continuity and severe patients had significant difference compared with intermittence and mild,moderate patients (P ＜ 0.05).Conclusions The change of IL,trace elements and adhesion molecule in allergic rhinitis patients are obviously,and among different types and degrees,the change are obviously too.So,these indexes can be the important basis of clinical diagnosis and treatment.

Objective To investigate the expression of Rac 1 in the guinea pig cochlea of gentamicin-induced ototoxic damage and prevention with antioxidant sodium salicylate , and to explore the roles of Rac 1 in the ototoxic mechanism of aminoglycoside antibi-otics.Methods Thirty healthy male guinea pigs were involved in this study .All the guinea pigs were randomly divided into 3 groups and received intraperitoneal injections according to their arranged group .Group I (control) was treated with normal saline for 7 days. Group II [Gentamicin (GM)] was treated with gentamicin alone for 7 days.Group III [GM+sodium salicylate(SA)] was treated with gentamicin in combination with sodium salicylate for 7 days.Paraffin-embedded cochlear section with immunohistochemical stai-ning was used for evaluation of Rac 1 expression in the cochlea .The protein was extracted from the cochlea tissues , and Rac1 protein levels in the cochlea were detected by Western blot assay .Results Immunohistochemistry showed a slightly positive reaction for Rac 1 staining found in the cochlea of the control group was mainly shown in the cytoplasm and cytomembrane of ganglion and organ of Corti ;a highly positive expression was shown in GM group;and the extent of Rac 1 expression of GM+SA group was between the control and GM groups.Image analysis showed that the differences in Rac1 expression between each two groups were statistically significant ( P <0.05).Western blot assay showed that expression of Rac 1 protein was highest in GM group and decreased in GM +SA group, while the intensity of Rac1 protein expression in GM +SA group was between the control and GM group .Statistics analysis showed that the expression between each two groups had significant difference ( P <0.05 ) .Conclusions A slightly positive reaction for Rac 1 stai-ning was found in the cochlea of guinea pigs , and mainly observed in the cytoplasm and cytomembrane of spiral ganglion and organ of Corti.With the administration of gentamicin , Rac1 protein expression was upregulated in the cochlea .Simultaneous administration of antioxidant sodium salicylate could significantly decrease the expression of Rac 1 protein.These results indicated that Rac1 might play an important role in the processes of gentamicin-induced oxidative damage of cochlea .

Objective To investigate the effect of dexmedetomidine (Dex) on postoperative sufentanil consumption in patient-controlled intravenous analgesia (PCIA).Methods Eighty patients (ASA Ⅰ or Ⅱ) undergoing abdominal hysterectomy and general anesthesia were divided into 2 groups with 40 cases each by random digits table.Patients in experiment group were received Dex 0.6 μg/kg (in 10 minutes).Patients in control group were recieved normal saline respectively by pumped infusion one hour before the operation finishing.All patients received a standadized sufentanil PCIA one hour before the operation finishing,sufentanil 2 μg/kg in 100 ml saline with tropisetron 5 mg,the loading dose was 4 ml,the backgroud dose was 1 ml/h,the controlled dose was 1 ml/h,the lock time was 10 minutes.The scores of VAS and RSS were recorded 1,2,6,12 and 24 hours after PCIA,and the incidence rate of the nausea,vomiting and shivering were recorded too for 24 hours.Results There was no statistical significance between the two groups in the scores of VAS and RSS after PCIA.The sufentanil consumption 1,2,6,12 and 24 hours after PCIA in experiment group [(4.5 ± 0.6),(7.4 ± 1.2),(14.2 ± 2.2),(25.4 ± 3.1),(40.1 ± 5.3) μg] was less than that in control group [(8.9 ± 0.9),(13.8 ± 2.9),(27.2 ± 4.1),(40.2 ± 5.2),(62.3 ± 7.1) μg] (P ＜0.05).The incidence of postoperative nausea,vomiting and shivering in experiment group [7.5％(3/40),2.5％(1/40),2.5％(1/40)] was less than that in control group [15.0％(6/40),7.5％(3/40),10.0％(4/40)](P ＜ 0.05).Conclusion The patients receive Dex 0.6 μg/kg one hour before the operation finishing,need less consumption of sufentanil and occur less postoperative nausea,vomiting and shivering.

Objective To examine the early effects of prostaglandin E 2 (PGE 2 ) on cancellous bone in 20-month aged male rats. Methods PGE 2 was given to the aged rats for 10 and 30 days at dose of 3 mg?kg -1 d -1 respectively, while designing intact aged male rats as controls. After twice in vivo fluorochrome labeling, undecalcified longitudinal sections were subjected to analysis of bone histomorphometry. Results After 10 days treatment, osteoblast surface 〔(12.3?7.6)%〕 and osteoid surface 〔(20.4?7.2)%〕 were markedly increased than that of controls 〔(1.6?0.7)% and (4.3?1.7)%, P

New studies have shown that metabolism of bone is controlled by the central nervous system.Gonadotropins secreted by the anterior pituitary stimulate the formation and function of osteoclasts which are closely related to the bone turnover and changes of bone mass. This study overviews the relationship between gonadotropins and bone metabolism.

The osteocyte has been found to be an orchestrator of bone remodeling.The damage of bone leads to osteocyte apoptosis.Sclerostin secreted by osteocyte causes feedback inhibition of bone formation,so inhibition of sclerostin expression has become a new target of treatment for osteoporosis.It seems resonable to direct clinical practise and treatment of metabolic bone diseases through understanding the function of osteocyte in the process of bone remodeling.