Objective To investigate the clinical significance of the urine micro albumin(MA)and urine enzyme detections in early renal injury in children with allergic purpura.Methods 120 patients with allergic purpura were chosen as the research sub-jects and divided into the early renal injury group and non-renal injury group according to whether having the renal injury.Contem-poraneous 40 healthy children were chosen as the healthy control group.The urine MA and urine enzyme levels were detected and compared among the various groups.Results MA was (17.5 ±3.8)mg/L in the study group,transferring(TRF)was (0.56 ± 0.34)mg/L,β2-MG was (0.35 ±0.07 )mg/L,NAG was (18.6 ±5.1 )U/g,which were significantly higher than those in the healthy control group,the differences were statistically significant (P <0.05 );in the early renal injury group,MA was (42.1 ± 21.3)mg/L,TRF was (1.65±0.54)mg/L,β2-MG was (0.43±0.06)mg/L and NAG was (23.1±5.12)U/L,which were signif-icantly higher than those in the non-renal injury group,the differences had statistically significance (P <0.05).Conclusion The de-tection of urine MA and urine enzyme can be used as the indexes for monitoring the early renal injury in children with allergic pur-pura,and is conducive to early discovery,in time intervention and reduce the occurrence of complications.

Objective To explore the value of dual energy CT imaging in the diagnosis of gouty tophus deposition.Methods Sixty-five cases of patients with gout treated in this hospital between December 2012 to December 2015 were selected.Another 65 cases of patients(rheumatoid arthritis,degenerative osteoarthritis and unexplained leg pain) were selected as control group.The re sults of dual energy CT imaging between two group were compared.Three experienced clinicians who didn't understand the imaging results were selected.They had a medical history and physical examination in patients with gout.The differences between clinical evaluation and imaging results were compared.Results Dual energy CT imaging showed that there were no tophi deposition in con trol group;the topi deposition in wrist joint,knee joint and ankle joint were 6.06％oo (33/34),100.00％ (22/22) and 96.49％ (55/57) in gout group.Dual energy CT imaging detected a total of 545 parts of tophus deposition.It was 4.36 times of the result of clinical evaluation(125 parts).Conclusion Dual energy CT imaging shows the advantages of simple noninvasive,high accuracy and low rate of misdiagnosis in diagnosing gout nodules.

Objective To investigate the expression of lipoprotein(a)and fibrinogen different genders of patients with coronary heart disease(CHD)and its clinical significance.Methods 1 500 patients with CHD in the hospital from January 2009 to December 2013 were selected as the observation group,including 954 males and 546 females.Contemporaneous 500 healthy people with physi-cal examination were selected as the control group,including 329 males and 171 females.The myocardial enzymes,serum lipid,blood coagulation function and various proteins were detected.Results Whether males or females,CK,CKMB,AST,LDH,α-HBDH, TC,TG,LDL-C,Fib,D-D,TT,FDP,LPa,cTnI,MYO and HCY in the observation group were significantly higher than those in the control group.HDL-C,APTT,INR and PT in the observation group were significantly lower than those in the control group.The differences were statistically significant(P <0.05 ).Conclusion Whether males or females,the different degrees of abnormal ex-pression of myocardial enzyme spectral indexes,blood lipid indexes,coagulation indexes,apolipoprotein,troponin,myoglobin and ho-mocysteine exist in the patients with CHD.Lipoprotein(a)and fibrinogen have high expression in the CHD patients,which can pro-vide the reliable scientific basis for diagnosis and treatment of the disease.

Objective To investigate the effect of Pericarpium Citri Reticulatae on changes of the intestinal absorption of ginsenoside components in Yi Gong San based on the rat model of spleen deficiency and whether its effect is related to the exocytosis of P-gp protein.Methods The group design included the P-gp protein agonist rifampicin and the inhibitor verapamil,and 36 SD rats were randomly divided into a blank control group(6 rats)and a model group(30 rats),and then subcutaneously injected with rifampicin to establish a model of splenic deficiency,and then the model group was divided into the Yigong San fullparty(Y)group,the lack of Pericarpium Citri Reticulatae(Y-C)group,the YiGong San combined with rifampin(Y+R)group,the lack of Pericarpium Citri Reticulatae combined with verapamil(Y-C+V)group and the lack of Pericarpium Citri Reticulatae combined with rifampin(Y-C+R)group,Ginsenoside Rb1,ginsenoside Re and ginsenoside Rg1 were used as the index components in an in situ unidirectional intestinal perfusion test,and HPLC-MS was used to determine the content of the index components and to calculate the kinetic parameters of intestinal absorption,the effective permeability coefficient(Peff)and the absorption rate constant(Ka).Results Compared with group Y,Peff of ginsenoside Rb1 and Re were significantly lower in Y-C at multiple perfusion sessions,and Peff and Ka of ginsenoside Rb1,ginsenoside Re,and ginsenoside Rg1 were lower in Y+R at multiple perfusion sessions,suggesting that Pericarpium Citri Reticulatae promotes the intestinal absorption of ginsenoside Rb1 and ginsenoside Re and that this effect is related to the activity of the P-gp protein,but failed to change the intestinal absorption of ginsenoside Rg1.The P-gp protein inhibitor verapamil significantly increased the Peff of ginsenoside Rb1 and Re in the Y-C+V compared with the Y-C,while the P-gp protein agonist rifampicin significantly decreased the Peff and Ka of ginsenoside Rb1,ginsenoside Re,and ginsenoside Rg1 in the Y-C+R in multiple perfusion sessions.The significant decrease in Peff and Ka at multiple perfusion times suggests that ginsenoside Rb1,ginsenoside Re,and ginsenoside Rg1 may be substrates for P-gp proteins in the absence of Pericarpium Citri Reticulatae intervention.Conclusion Pericarpium Citri Reticulatae promotes the intestinal absorption of ginsenoside Rb1 and ginsenoside Re by exerting a verapamil-like effect that inhibits the activity of P-gp proteins in Yi Gong San.

Objective:To compare the effectiveness of proximal femoral nail antirotation (PFNA) with intertrochanteric antegrade nail (InterTAN) in the treatment of intertrochanteric fractures in the elderly. Methods:A retrospective study of 62 elderly patients with intertrochanteric fractures who received two operation methods from Sep 2014 to May 2016 was done. There were 28 patients in PFNA group, and 34 patients in InterTAN group. The operation time, blood loss in operation, hospitalization time, healing time, and Harris hip joint functional score were compared and analyzed. Results:Operation time and the amount of intraoperative blood loss in PFNA group were less than that in InterTAN group. Hospitalization time,fracture healing time and Harris hip joint functional score after ten months had no significant difference between the two groups. And 59 cases in total were followed up with an average of 11.5 months (from 9 to 16 months) . In PFNA group, 27 patients were followed up, and one patient was lost to follow up, who died because of chronic renal insufficiency. The rest 26 patients all achieved bony union (including one case of hip versus) . At follow-up 9 months, hip joint function was excellent in 18 cases, good in 6, fair in 2, bad in 1, and the excellent-good rate was 88.9%. In InterTAN group,32 patients were followed up,and two cases were lost to follow up. In followed-up cases, there was one patient who was no healing of fracture. After hip arthroplasty, this patient got recovery. The hip joint function was excellent in 21 cases, good in 7, fair in 3, and bad in 1. The differences between the two groups were not statisticaly significant. Conclusion:Both PFNA and InterTAN can treat intertrochanteric fractures in the elderly with good result,but PFNA has obvious advantages over InterTAN on less hemorrhage and operation time.