Objective:To investigate the role of C3a,C5a and their receptors in the pathogenesis of IgA nephropathy (IgAN). Methods:A total of twenty-eight 6-8 weeks old female BALB/c mice were investigated.And they were negative control group , WT group,C3aR-/-group,C5aR-/-group(the latter three groups were named as experimental groups ),seven mice in each group.All the mice were infected through respiratory tract with infectious SV (experimental groups) or PBS(negative control group),combined with tail vein challenge to make IgAN animal model.Testing 24 h total urinary protein , serum urea nitrogen ( BUN ) and creatinine ( Cr ) , using direct immunofluorescence to test the renal deposition of IgA and C 3,observing renal pathologic lesion under PAS staining with light microscopy.RT-qPCR was used to test the relative mRNA expression of TNF-α,TGF-β,IL-1β,IL-6,MCP-1.Results: After 15 weeks,the level of UTP in experimental group was significantly higher than negative control group ,and the same results as WT group than C3aR-/-group and C5aR-/-group.There was no significant difference among groups for BUN and Cr.Combined with negative control group , experimental groups had significant renal pathological lesions , and the changes of WT group was more severe than C3aR-/-group and C5aR-/-group.The results of relative mRNA expression of TNF-α,TGF-β,IL-1β,IL-6,MCP-1 was the same as the level of 24 h UTP,at the same time,the relative mRNA expression of IL-1β,IL-6,MCP-1 in C3aR-/-group was significantly less than C5aR-/-group.Conclusion:The deficiency of C3a/C5a receptors can protect kidney from injury in IgAN ,and C3a receptor has more significant role in protect kidney from injury in IgAN.

Objective To compare the performance of Mandarin screening version of hearing handicap inven-tory in elderly (HHIE-S)and the single question of hearing loss in the hearing screening in the old adults.Methods A total of 570 participants,aged from 50~85 years,of native Mandarin speakers were tested with standard pure tone audiometry (PTA),HHIE-S and single questionAre you now having difficulty in hearing?.HHIE-S>8 was taken as an indicator of hearing handicap.Sensitivity,specificity,negative predictive values and positive predic-tive values of both HHIE-S and single question inquiry when 0.5~4 kHz PTA average > 25 dB,>40 dB and >60 dB were compared.Results The prevalence was 83.9% (478)measured by PTA.The prevalence was 55.3%and 52.5% for HHIE-S and positive answer for single question,respectively.The sensitivity of HHIE-S when the participants grouped with 0.5~4 kHz PTA average > 25 dB,>40 dB and > 60 dB was 61%,85% and 96%, respectively,whereas the sensitivity of single question of the above 3 conditions was 58%,81% and 100%,respec-tively.The specificity of HHIE-S decreased with greater hearing loss.It was 72%,88% and 47% respectively for HHIE-S and 75%,61% and 50% for the single question.There was no significant difference either for sensitivity and specificity between the HHIE-S and the single question.Conclusion Both the Mandarin version of HHIE-S and single question are effective in the hearing screening of old adults.Depending on the purpose and availability of resources,one or both of them can be adopted.

To improve the effect of teaching practice of blood cell morphology,typical cases of peripheral blood erythrocyte,granulocyte and platelet were chosen,case show and problem-based teaching way were applied to encourage students to find information of autonomous learning.Then teacher organized the class discussion,and the information was analyzed and summarized.In the implementation of the case teaching,we should pay attention to improving students' learning initiative.At the same time,teachers need to have knowledge,comprehensive ability and ability in organization and leadership,to promote students' active participation in discussion in the teaching,pay attention to the information feedback,and improve the teaching details

Objective:To summarize the clinical characteristics of Burkitt lymphoma(BL)and Burkitt-like lymphoma(BLL)and the effect of treatment on 13 cases,and to explore the treatment-related complications and optimal treatment.Methods:Clinical data of 13 BL and BLL patients treated between August 1996 and October 2008 in our hospital were retrospectively analyzed.All of these patients received chemotherapy as the first-line treatment.The efficacy and adverse reactions were evaluated.Results:Of the 13 patients,there were 12 males and 1 female,with a median age of 15 years(ranging from 11 to 62).There were 3 stage Ⅰ cases,2 stage Ⅱ cases,2 stage Ⅲ cases,and 6 stage Ⅳ cases.The advanced stage(stage Ⅲ and Ⅳ)patients accounted for 61.5%(8 cases).CNS was involved in 4 cases and bone marrow was involved in 2 cases at diagnosis.The commonly involved sites included superficial lymph nodes(61.5%),abdominal organs(53.8%),and celiac and retro-pentoneal lymph nodes(38.5%).B symptoms were observed in 7 patients(53.8%).Serum lactate dehydrogenase level was elevated in 8 of 10 cases,while serum udc acid level was elevated in 1 of 10 cases.Eleven patients were diagnosed as BL and 2 patients were diagnosed as BLL.Of the 13 patients,11(84.6%) achieved complete remission(CR)or CR/unconfirmed(CRu),and 1 patient(7.7%) got partial remission(PR).Dudng the follow-up of 8 months(ranging from 5 to 35),6 patients were still alive.The 1-year overall survival,progression-free survival and disease-free survival were 56.98%,32.31% and 39.77%,respectively.Nine patients(69.2%)developed grade Ⅲ or Ⅳ myelosuppression.Conclusion:Intensive short-course chemotherapy is the optimal first-line treatment for BL and BLL.

Objective:To investigate the safety and efficacy of a modified baseline BEACOPP regimen(bleomycin+etoposide+adriamycin+cyclophosphamide+vincristine+ procarbazine hydrochloride+ prednisone) in the treatment of advanced Hodgkin 's lymphoma (HL). Methods:From March 2006 to September 2008, 22 previously untreated patients with stages Ⅱ(bulky), Ⅲ and Ⅳ HL were treated with a modified baseline BEACOPP regimen. Each patient was scheduled to receive 6 to 8 cycles of BEACOPP with consolidation radiotherapy to bulky (≥5 cm) or residual disease.Results:There were 11 males and 11 females with a median age of 28 years (15 to 61 years old). Twelve patients (54.5%) had nodular sclerosis HL, and 10(45.5%) had mixed cellularity HL. There were 4 patients in stageⅡ, 7 in stage Ⅲ and 11 in stage Ⅳ. Sixteen patients (72.7%) achieved a complete remission (CR) and 5 patients (22.7%) had partial remission (PR). The total effective rate (CR+PR) was 95.5%. Among all kinds of clinical factors International Prognostic Score (IPS) had significant effect on CR rate (P=0.011). The 1-, 2- and 3-year total survival rates were the same (95.5%); the 1-, 2- and 3-year progression-free survival (PFS) rates were 72.7%, 53.1% and 53.1%, respectively;the 1-, 2- and 3-year disease-free survival rates were 85.9%, 76.4% and 76.4%,respectively. Univariate analysis showed that the gender, IPS and whether achieving CR had significant effects on PFS (P<0.05). The main toxic effects were bone marrow depression and liver injury. Three patients (13.6%) had grade Ⅲ drug-induced lung injury. No treatment-related death was observed.Conclusion:The modified baseline BEACOPP regimen was effective and safe for treatment of newly diagnosed patients with advanced HL.

OBJECTIVE The aim was to explore the clinical experiences and access the auditory performance and speech intelligibility of cochlear implantation in patients with inner ear malformations. METHODS Among 700 patients who received multi-channel cochlear implantation from 1997 to 2007 in Beijing Tongren Hospital, 108 patients were diagnosed with malformed inner ear. A retrospective study was performed about the surgical characteristics and the mapping characteristics after implantation. The long term follow-up of the rehabilitative efficacy will also be presented. RESULTS ①All patients restituted auditory after operation. ②After the regular rehabilitation, the long term follow-up of the auditory performance and speech intelligibility were very positive. Everyone has shown improved listening and communication skills evaluated by Categories of Auditory Performance and Speech Intelligibility Rating. ③Most of the children are studying or working and are actively involved in their local communities. CONCLUSION The cochlear implantation can be performed safely in patients with malformed inner ear. The results suggest that cochlear implantation could also provides long-term benefits to those malformed inner ear cases.

OBJECTIVETo study the correlation between clinically detected serum galectin-3 levels and prognosis of liver failure.

METHODSFifty-five patients diagnosed with liver failure were administered a combined modality therapy and followed up until death or for 6 months. Fifty-five patients with liver failure were administered a combined modality therapy and followed up until death or for 6 months. In addition, 30 patients with chronic hepatitis B (CHB) and 30 healthy volunteers were matched for use as controls. Serum galectin-3 levels were detected at baseline and last follow-up visit and compared between groups by statistical analysis.

RESULTSAt baseline, the CHB group had a significantly higher level of serum galectin-3 than the healthy control group (F=2.701, P less than 0.01). However, the galectin-3 level 5 of the liver failure group was significantly higher than that of both the CHB group (F=8.121, P less than 0.01) and the healthy control group (F=11.231, P less than 0.01). When patients within the liver failure group were divided by survival and death occurring during the 6-month follow-up period, the patients who died (n=28) were found to have a significantly higher level of serum galectin-3 than the surviving patients (n=27) (P less than 0.01). The area under the curve of ROC curve is 0.766, and cut off value is 0.246 5 ng/ml.

CONCLUSIONThe level of serum galectin-3 is positively correlated with risk of death in patients with liver failure. Up-regulation of galectin-3 may act as a protective factor in patients with severe liver injury.

Adult ; Aged ; Case-Control Studies ; Female ; Galectin 3 ; blood ; Hepatitis B, Chronic ; blood ; Humans ; Liver Failure ; blood ; diagnosis ; Male ; Middle Aged ; Prognosis

Sjögren's syndrome (SS) is a systemic autoimmune disease that mainly affects the exocrine glands. A set of indexes have been established to evaluate the disease activity in SS, including symptoms, systemic characteristics, and long-term disease damage as well as the patients' quality of life. This article briefly introduced the background, content, and scoring rules of SS indexes. Current clinical applications and prospects were also reviewed.
Humans ; Quality of Life ; Sjogren's Syndrome

Objective:To study the clinical features, therapeutic effects, survival time, and prognosis of patents with mantle cell lymphoma (MCL). Methods:Clinical data of 98 MCL patients admitted from January 2005 to December 2013 were retrospectively an-alyzed. Results:The median age was 61 years old, and the male-to-female ratio was 2.9∶1. Among these cases, 85 (86.8%) were in Ann Arbor stageⅢ-Ⅳ, 46 (46.9%) had bone marrow involvement, 25 (25.5%) had digestive tract involvement, and 53 chose R-CHOP as first-line treatment. The expected 3-year overall survival (OS) of these patients was only 61.4%. A total of 14 cases were treated with R-CHOP followed by ASCT. The expected 5-year OS was 92.3%, and the OS of the ASCT group was significantly higher than that of the R-CHOP group (75.5 months vs. 43.6 months, P=0.039). Elevated ESR,>60 years old, increased LDH level, B symptoms, and Ki-67≥25% were poor prognostic factors. Conclusion: Most patients with MCL were elder adults with bone marrow involvement. R-CHOP followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL.

Objective:To explore the effect of medical care, elderly care and nursing management mode on self-care ability and blood pressure management in elderly patients with hypertension.Methods:From July 2018 to June 2019, 164 elderly patients with hypertension admitted into the outpatient department of the ZhejiangHospital were selected as the study objects by convenience sampling method, and randomly divided into the control group and the experimental group, 82 cases in each group. Routine hypertension management mode was given in the control group and medical care, elderly care and nursing management mode was given in the experimental group for 6 months. The Exercise of Self-Care Agency Scale (ESCA) scores and blood pressure control of the two groups were compared before and after intervention.Results:The ESCA total score and self-concept, self-care responsibility, self-care skills, and health knowledge scores of the experimental group were higher than those before intervention [(123.3±17.2) vs. (88.3±10.4) points, (26.8±3.7) vs. (20.6±3.0) points, (22.3±4.2) vs. (16.6±2.1) points, (29.3±4.1) vs. (17.6±2.4) points, (44.9±5.4) vs. (33.5±4.5) points], and higher than those of the control group [(90.0±10.2) points, (21.2±3.2) points, (16.1±2.1) points, (18.2±2.5) points, (34.5±4.2) points] (all P<0.05). The systolic blood pressure and diastolic blood pressure of the two groups after the intervention were lower than those before the intervention [control group: (142.5±7.8) vs. (161.6±8.5) mmHg (1 mmHg=0.133 kPa), (91.3±6.2) vs. (98.6±10.2) mmHg, experimental group: (132.2±8.5) vs. (160.6±8.1) mmHg, (84.2±7.4) vs. (98.1±10.3) mmHg], and the experimental group was lower than the control group (all P<0.05). The blood pressure control rate of patients in the experimental group was 88.8%, which was higher than the control group of 48.6% ( P<0.05). The satisfaction rate of quality of life in the experimental group was higher than that in the control group (28.8% vs. 18.1%), and the dissatisfaction rate was lower than in the control group (18.8% vs. 34.7%) ( P<0.05). Conclusion:The medical care, elderly care and nursing management mode can effectively improve the self-care ability and blood pressure management ability of elderly patients with hypertension.