C3 glomerulopathy is a group of diseases with immunofluorescence staining C3 along the glomerular capillary loops deposition,may be accompanied by other immunoglobulin deposition,but C3 sedi-mentary classic way was more than other immunoglobulin and complement activation ingredients ( such as C1q,C4). C3 glomerulopathy is a group of primary glomerular disease and relatively rare. This article mainly reviewed the pathological characteristic of C3 glomerulopathy,clinical manifestation,diagnosis and treatment, in order to improve clinical understanding of C3 glomerulopathy.

Hypocalcemia often exists in critical illness children. Most of the sick children do not have an underlying disease of calcium homeostasis, and the mechanism of the hypocalcemia is complicated. Abnormal values of blood calcium may be a sign of critical illness and normalize spontaneously with resolution of the primary disease process. Hypocalcemia may be a autoprotection , and it may be harmful if we try to correct it. This article focuses on the theory and clinical treatment of hypocalcemia in critical illness children.

Exudative erythoma multiforme is a related to the immune function of children with skin and mucosa,damage to its diversity of characteristics of acute non suppurative inflammation,one of the aller-gic diseases.The disease and its pathogenesis is complex,the body can cause multi system and multi organ damage,the cause has not yet entirely clear.In recent years,due to our understanding of the exudative erytho-ma multiforme gradually thorough,both domestic and abroad on the level of diagnosis and treatment of the disease have greatly improved,the prognosis of patients with exudative erythoma multiforme has improved significantly.The progress of the pathology,clinical manifestation,diagnosis and treatment of exudative ery-thoma multiforme were summarized.

Infectious mononucleosis(IM) was one of the clinical common diseases, caused by epstein-barr virus infection in more than 90%patients. Changes of the surface antigen of the B cells with EB virus infection caused strong immune response of T lymphocytes, besides, helper T lymphocyte, dendritic cells, NK cells also played an important role in the pathogenesis of IM. The incidence of IM was not only closely related with social environment in childhood, but also closely with the number of siblings, birth order, and sunshine factor. In addition to the typical clinical manifestations, IM also can cause a variety of complications, such as spleen rupture and necrotizing mediastinitis , and could be life-threatening. Auxiliary examination means such as state of peripheral blood lymphocyte apoptosis, plasma proteomics, cerebrospinal fluid analysis, load test of EB virus can help to diagnose. Application of antiviral drugs was wider, but hormone was still controversial. Vaccine research progress had been slow, but there were vaccines for human test, which will provide effective measures for the prevention of IM.

Objective To investigate the factors affecting rural women suffering from postpartum depression in order to provide scientific basis for rational intervention.Methods 368 rural pierperas whose deliveries were in the First Affiliated Hospital of Shanxi Medical University were surveyed by trained professional nurses with the Edinburgh Postnatal Depression Scale from May 1,2013 to April 30,2014.The data were processed by chi square test and unconditional logistic regression analysis to find the independent risk factors associated with postpartum depression.Results There were 347 valid questionnaires.The incidence of depression after delivery was 25.1％ (87/347).Logistic regression analysis showed that the low income family [OR=1.982 (1.238-2.562)],the inconformity of actual and expected baby gender [OR=0.465 (0.183-0.759)] and the mother-in-law as caregiver of pierpera [OR=2.459 (1.950-2.913)] were independent risk factors for postpartum depression of rural women,three of them are significant statistically,P＜0.05.Conclusions Understanding the risk factors for postpartum depression and being targeted to guide individually can reduce the incidence of postpartum depression.

Sinus histiocytosis with massive lymphadenopathy( SHML) is also called Rosai-Dorfman disease.It is a kind of benign lymphoid tissue proliferative diseases with unknown etiology.SHML appeared mostly in children and adolescent.It has diverse clinical manifestations accompanied with multiple organ inju-ry,and no clear laboratory indicators could support the disease,being a rare disease in pediatrics,easyot miss diagnosis.Thsi article reviewde the latest progress on diagnostis and treatment of SHML,to improve teh un-derstanding of the disease.

Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitor is recently added to the list of effective lipid-lowering drugs in addition to statins, which can reduce low density lipoprotein cholesterol, treat increased low density lipoprotein cholesterol (LDL-C) and atherosclerotic cardiovascular disease (ASCVD) patients. In the past 30 years, the prevalence of dyslipidemia increased significantly. LDL-C characterized dyslipidemia is an important risk factor of ASCVD and a part of metabolic syndrome, which exists before or after or at the same time of the appearance of obesity, diabetes, and glucose intolerance, coronary heart disease and other diseases. Decreasing LDL-C level can significantly reduce the incidence and mortality risk of ASCVD. In this paper, the research on the regulation of dyslipidemia by PCSK9 inhibitors is discussed.

Objectives To explore the changes of serum interleukin-33 (IL-33), IgA anti-endothelial cell antibodies (AECA) and IgA anticardiolipin antibodies (ACA) in acute stage of Henoch-Sch?nlein purpura (HSP) in children and its clinical signiif-cance. Methods Thirty-seven children with acute HSP admitted to hospital were selected from Nov.2012 to Jan.2013. Twenty healthy children were selected as healthy controls. The serum levels of IL-33 were measured by double anti-body sandwich en-zyme-linked immunosorbent assay (ELISA) and the serum levels of AECA-IgA and ACA-IgA were detected by double antigen sandwich ELISA. Results Serum levels of IL-33, AECA-IgA and ACA-IgA in patients with acute HSP were signiifcantly higher than those in healthy controls (P<0.001). According to different clinical types, the serum levels of IL-33, AECA-IgA and ACA-IgA were signiifcantly higher in mixed-type HSP (with joint involvement and gastrointestinal symptoms and/or kidney damage) than those in HSP patients with only joint, abdomen or renal involvement (P<0.05). Serum levels of IL-33 in acute stage of HSP had a positive correlation with AECA-IgA (r=0.752, P<0.001) and ACA-IgA (r=0.788, P<0.001). Conclusions The immune pathological injury in vessels caused by the interaction of IL-33, AECA-IgA and ACA-IgA may be the important pathogenesis of HSP, which may provide a clue for the early diagnosis and treatment for HSP.

Objective To seek a scalp venipuneture method with high success rate and less pain for patients. Methods Taking the rapid parallel straight method as the control group, and the rapid vertical straight method as the experimental group, 400 patients were randomly divided into the control group and the experimental group with 200 patients in each group. The success rate of two groups were counted, pain scores were got by VAS visual imitation assessment and the results undergoing statistical analysis. Results The success rate was 91.5% in the control group, and 99.5% in the experimental group. Distinguished sig-nificance existed in VAS visual imitation score. Conclusions The rapid vertical straight method is supe-rior to rapid parallel straight method in scalp venipuncture.

Objective To investigate the relationship between the expression of Toll-like receptor 4 (TLR4) on mononuclear cells in peripheral blood and changes of serum vitamin D level in children with bronchiolitis.Methods The children who were diagnosed as bronchiolitis and received treatment in the Second Affiliated Hospital of Harbin Medical University from October 2013 to January 2014 were chosen as the pre-treatment group,and then divided them into moderate group and severe group according to the clinical symptoms,20 cases for each group.Then the cases in pre-treatment group who recovered after treatment were recruited as the after-treatment group,and the children who were healthy and medical examination in the Second Affiliated Hospital of Harbin Medical University in the same period were recruited as the healthy control group.The expressions of TLR4 on CD14 labeled mononuclear cells in the periphera were measured by flow cytometry.The level of 25 (OH) D in serum was detected by enzyme linked immunosorbent assay (ELISA).Results (1) The expression level in children with bronchiolitis of TLR4:the mode-rate group [(18.98 ±2.29)％] and severe group [(30.13 ±2.13)％] increased significantly (P ＜0.05) compared with control group [(1.17 ± 0.57) ％].And the expression level of moderate group [(2.02 ± 0.48) ％] and severe group [(11.43 ± 1.52) ％] decreased significantly after treatment (P ＜0.05).(2) Serum vitamin D level in children with bronchiolitis of the moderate group[(17.16 ± 3.34) μg/L] and severe group [(6.56 ± 2.28) μg/L] were lower than healthy control group [(53.69 ± 20.18) μg/L] before treatment (P ＜ 0.05),especially the severe group [(6.56 ±2.28) μg/L].The level of moderate group [(9.59 ± 2.31) μg/L] and severe group [(4.70 ± 0.67) μg/L] became lower after treatment (P ＜ 0.05).(3) Both severe group (r =-0.491,P ＜ 0.05) before treatment and moderate group (r =-0.436,P ＜ 0.05) after treatment showed negative correlation between TLR4 on mononuclear cells in peripheral blood and serum 25 (OH)D level in children with bronchiolitis.And no correlation was found among healthy control group,moderate group before treatment and severe group after treatment (P ＞ 0.05).Conclusions The conditions of children with bronchiolitis was positively correlated with the expression level of TLR4,and negatively correlated with the vitamin D level.The serum 25 (OH) D decreased steadily during the treatment.The expression of TLR4 in monocytes has a certain correlation with the level of vitamin D in children with bronchiolitis.