Objective To observe the effect of intermedin on renal interstitial fibrosis of unilateral ureteral obstruction rats. Methods Forty male Wistar rats were randomly divided into two groups:the sham-operation group (n=10) underwent the left ureteral dissection,the other 30 rats were made as unilateral ureteral obstruction models and divided into the model group (UUO),the losartan group,the IMD group (each group n=10).At the day 14,21 after operation,randomly 5 rats from each group were blooded by abdominal arotic and obstructive kidneys were taken out.The renal histopathological changes were observed by HE and Masson staining.The BUN,Scr,and hydroxyproline (Pro) of the obstructive kideys were measured by colorimetry. The expression of TGF-β1 and intermedin was observed by immunohistochemisty staining. Results Compared with the sham-operated group,the levels of BUN,Scr,Pro,TGF-β1 and IMD in the model group increased (P＜0.05).Compared with the UUO group,the levels of Scr,BUN,Pro,TGF-β1 and IMD in the losartan group were lower (P＜0.05).However,IMD in the IMD group was significantly up-regulated (P＜ 0.05),the others were down-regulated (P＜0.05). Conclusion IMD can improve the renal interstitial fibrosis,and the mechanism maybe antagonizes the TGF-β1.

Objective To explore the diagnosis, treatment and prognosis of testicular benign tumors in children.Methods The clinical data of 26 boys ( aged between 17 days to 12 years and average age was 2.5 years) with testicular benign tumors treated in our center between January 2008 and December 2015 were retrospectively analyzed.The tumors were on the left side in 17 cases, on the right side in 9 cases. Twenty patients presented with painless scrotal mass.3 with cryptorchidism, 2 cases with hydrocele, and 1 case with varicocele.These boys underwent ultrasound or CT examination, results the enlarged tests with space-occupying lesions in 20 cases,3 cases were presented as scrotal empty,3 cases were showed as cystic masses.Twenty-four boys had taken tumor marker detection,which including 3 cases of AFP rised, 2 cases of Neuron-specific enolase slightly higher, 1 case of Ferritin increased.26 patients were performed surgical treatment, 23 cases have taken testicular tumor resection, and 3 cases underwent orchiectomy because of abnormal morphology, according to the intraoperative findings and quick frozen pathological examination results.Results Postoperative pathological diagnosis showed of maturity teratoma in 14 cases, not maturity teratoma in 3 cases, gonadoblastoma in 3 cases, interstitial cell tumor in 2 cases, epidermoid cyst in 2 cases, fibrocellular tumor and testicular inflammatory granuloma in 1 case respectively.The 23 cases were followed up for 3-70 months.All respondents children were alive, and no complications were found such as residual tumor atrophy or tumor recurrence and metastasis.Conclusions Early diagnosis and treatment is the key to obtaining a good effect of testicular tumors. Detailed specialist examination, preoperative ultrasound, CT and determination of tumor markers are important ways to diagnose testicular cancer; rapid intraoperative frozen check may manifest nature of the tumors.For pediatric testicular benign tumor, testis-sparing surgery should be considered.

Objective:To investigate the effect of miR-106a on osteoarthritis.Methods:Twenty-four S-D female rats were randomly divided into three groupsaccording to the random number table: the sham operation group, the osteoarthritis (OA) group and the miR-106a mimic group. Eightweeks after operation, all rats were killed and articular cartilage was separated from the medial tibial plateau of each rat. Histopathology was used to observe the morphological changes and denatured quantity of chondrocytes, the level of inflamm-atory cytokines [interleukin (IL)-1, IL-6, tumor necrosis factor (TNF)-β 1], the expression of apoptosis receptor p65, DR6 protein and the expression of mir-106a RNA. The mean between groups was compared by one-way analysis of variance (ANOVA), and the least significant difference (LSD)- t test was used for the comparison between the two groups. Results:Histopathological staining results showed that the articular surface and synovium of rats in the sham operation group were intact, the chondrocytes were arranged horizontally, and the articular cartilage edge was smooth.In the OA group, the articular cartilage edge was seriously damaged and the arrangement of chondrocytes was disordered.In the miR-106a simulation group, the cartilage structure tended to be normal, occasionally uneven, and the articular cartilage surface was not smooth. Compared with sham operation group, the expression of miR-106a in OA group was significantly decreased ( F=918.02, P<0.01); the expression of inflammatory mediators (IL-1, IL-6, TNF-β) in OA group was also signifi-cantly increased ( F=41 914.86, P<0.01; F=64 85.16, P<0.01; F=8 873.31, P<0.01). The expression levels of DR6 and p65 in OA group were higher ( F=2 319.338, P<0.01; F=1 253.882, P<0.01). Compared with OA group, the levels of inflammatory mediators (IL-1, IL-6, TNF-β) in miR-106a mimetic group were significantly decreased (1.270±0.020, 6.040±0.170, 5.690±0.080), and the expressions of DR6 and p65 were decreased (1.53±0.09, 0.41±0.04). Conclusion:miR-106a can reduce the inflammatory changes and the degeneration of chondrocytes in osteoarthritis rats.

Objective Idiopathic pulmonary fibrosis, the fibrosis score (i.e., the combined extent of reticulation and honeycombing) is associated with worse survival. The aim of this study was to identify high-resolution computed tomography (HRCT) patterns and patient characteristics that could predict poor prognosis in rheumatoid arthritis-related ILD (RA-ILD). Methods We retrospectively analyzed 130 patients with newly diagnosed RA-ILD from 2011 to 2017 at Shanxi People's Hospital. The Pearson correlation analysis was used for the correlation between the fibrosis score and the worse survival of RA-ILD, and Using Cox regression analysis was used to identify the associations with mortality. A value of P less than 0.05 was considered statistically significant. Results During a median follow-up of 65 months, 32/130 (24.6％) patients died. Univariate analysis identified 6 significant poor prognostic factors: lower baseline ％ predicted forced vital capacity [HR=0.97, 95％CI(0.94, 0.99);P=0.008], total interstitial disease score [HR=1.06, 95％CI(1.03, 1.08);P<0.01], reticulation score [HR=1.07, 95％CI (1.04, 1.09); P<0.01], traction bronchiectasis score [HR=2.04, 95％CI (1.21, 3.40);P=0.008], fibrosis score [HR=1.07, 95％CI (1.01, 1.13);P<0.01], and definite UIP pattern [HR=4.18, 95％CI (1.40, 12.51); P=0.010]. Fibrosis score remained to be an independent significant poor prognostic factor of survival on bivariate analysis [HR=8.136, 95％CI (2.87, 28.35); P=0.001]. Patients with a fibrosis score>20％ had high mortality. Conclusion This study has shown that fibrosis score is strongly associated with worse survival in RA-ILD, and patients with fibrosis score>20％ have a 8.136-fold increased risk of mortality.

Objective To investigate the causes of misdiagnosis related to rheumatism diseasecases.Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases reports which were published in Chinese Journal and a retrospective analysis was conducted.All data were analyzed by chi-square test and Fisher's exact test.Results We screened 705 citations and identified 215 articles on the rheumatic diseases,finally,187 reports and 195 cases in total with definite diagnosis were included,accounting for 25.5％ of the total number of misdiagnosed cases.Primary vasculitis (72 cases),rheumatoid arthritis (25 cases),spondyloarthropathy (17 cases),polymyositis (14 cases),systemic lupus erythematosus (13 cases) and Sj(o)gren's syndrome (SS) (12 cases) were amongst the top misdiagnosed rheumatic diseases.There was no difference between 1998-2006 and 2007-2015 in the overall misdiagnosis cases.Single disease comparison,polymyositis,spondyloarthropathy and IgG4 related disease were increased (P=0.002;P=0.034;P=0.060;respectively),while polymyositis was delayed (P=0.002).Rheumatism misdiagnosed cases reported mainly came from tertiary hospitals and the department of rheumatology.Conclusion Misdiagnosed rheumatism are common in clinic.Strengthen the physicians' continuous education,the validity of clinical thinking mode and rational use of diagnostic criteria are important to make correct diagnosis.

Objective: To compare the clinical features, ultrasonic imaging manifestations and therapeutic evaluations between elderly onset rheumatoid arthritis (EORA) and EORA with osteoarthritis (OA). Methods: Eighty-eight patients with rheumatoid arthritis were divided into two groups: group EORA (n=36) and group EORA+OA (n=52). The onset age of all patients was 60 years or older. General conditions, joint involvement distribution, ultrasonic manifestations and disease activity scores (DAS28-3) of patients in the two groups were analyzed. The χ² test/Fisher's exact probability test and the Student's t test/Mann-Whitney U test were used to analyze data. Results: There was no significant difference in the proportion of male and female patients and erythrocyte sedimentation rate (ESR) between the two groups (P>0.05). The onset age of patients in group EORA+OA [(68±4) years old] was higher than that in group EORA [(65±4) years old], and the difference was statistically significant (t=-3.465, P=0.001). Duration of the disease and body mass index in group EORA+OA were significantly higher respectively than those in group EORA. Joint involvement in the two groups was mainly found in shoulder, wrist, Metacarpophalangeal joint (MCP)2, MCP3, proximal inter-phalangeal joint (PIP)2, PIP3, PIP4, and knee joint (34.7%-86.5%). The percentage of MCP2[36.5%(38/104), 70.8%(51/72); χ²=20.02, P<0.01], MCP3[33.7%(35/104), 59.7%(43/72); χ²=11.72, P=0.001], MCP4[4.8%(5/104), 22.2%(16/72); χ²=12.28, P<0.01], PIP2[69.2%(72/104), 83.3%(60/72); χ²=4.51, P=0.034] and PIP3[53.8%(56/104), 70.8%(51/72); χ²=5.15, P=0.023] in the EORA+OA group was lower while the percentage of MCP1, DIP 2, DIP3, DIP4 and knee joints were higher than that in the EORA group (P<0.05). In group EORA+OA, the synovial thickness of the wrist joints [(4.2±0.5) mm] and knee joints [(7.7±0.8) mm] were significantly thicker than those in group EORA [(3.2±0.9) mm; (6.3±0.8) mm, t=-5.82, P<0.01; t=-7.22, P<0.01]; The proportion (70.0%) of level 2 and 3 of patients' wrist joint synovium pannus blood flow and knee joint synovium pannus in group EORA+OA were increased than group EORA (51.9%; 52.3%), the difference between the two groups was statistically significant (χ²=4.64, P=0.031; χ²=4.43, P=0.035). There was no significant difference in DAS28-3 scores between the two groups before patients received treatment. After 2 weeks and 12 weeks of glucocorticoid treatment, DAS28-3 scores in group EORA [3.62(2.88, 4.03); 2.35(2.26, 2.62) points] were significantly lower than group EORA+OA [5.01(4.68, 5.26); 3.38(2.28, 3.83) points] (Z=-7.766, P<0.01; Z=-3.461, P<0.01). Conclusion Compared with patients of EORA alone, patients of EORA with OA have more obvious joint symptoms, MCP1, DIP and knee joint are susceptible to the co-involvement among them, longer duration of disease, and were prone to synovial hyperplasia and pannus flow formation. The therapeutic effects of glucocorticoid on joint inflammation in patients of EORA alone are superior to those patients of EORA with OA.

There is a high incidence of venous thrombosis in patients undergoing gynecological surgery, which causes symptoms as limbs swelling, edema and pain. Postoperative recovery of patients is delayed and financial burden is increased More seriously, the obstruction of pulmonary artery by deep venous thrombosis is fatal and always leads to the death of patients. The article provides a theoretical basis for the prevention of venous thrombosis by reviewing the risk factors and risk assessment for venous thrombosis in patients undergoing gynecological surgery and related research progress.

Objective To analyze the relationship between clinical features and age of operation on children with hypospadias,and to explore and determine the factors for hypospadias associated with age at surgery.Methods Retrospective study was conducted in children with hypospadias undergoing operation at the First Affiliated Hospital of Zhengzhou University between January 2011 to December 2016.The demographics,the degree of hypospadias,complications,age at first urethroplasty and the other factors in patients were recorded,t-test was used to determine the factors associated with surgical timing and the difference was significant when P ＜ 0.05.Results A total of 1 051 cases were included in the study.Among these patients with hypospadias 268 cases (25.5％) were of mild cases,525 cases (50.0％) of moderate,and 258 cases(24.5％) of severe.Nine hundred and forty-six cases(90.0％) did not have complications,while 105 cases(10.0％) had complications.The median age at first urethroplasty was 5.3 years old and 66.22％ of them were operated after 3 years,and 4.09％ of them were after 18 years old.Insurance types,household income,race did not influence with surgical timing statistically (P ＞ 0.05).Multivariate analysis showed that the several factors were significantly associated with time of surgery:the severity of hypospadias (t =28.10,P =0.000),with or without complications (t =64.17,P =0.000),urban-rural gap (t =7.49,P =0.000),parental education level (t =36.90,P =0.000) and the age of receiving advice from pediatric surgeon (t =5.00,P =0.000).Conclusions The age of surgery in children with hypospadias were significantly affected by the severity of hypospadias,the presence of complications,differences between urban and rural areas,the degree of parental education,and the time of medical advice in the pediatric department of urology.,and the education of hypospadias knowledge for children's parents and related medical personnel at the grass-roots level will advance the age of surgery in children with hypospadias.

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Adult ; Asian Continental Ancestry Group* ; China ; Comorbidity ; Developed Countries ; Developing Countries ; Diagnosis* ; Epidemiologic Studies ; Epidemiology ; Global Health ; Humans ; Hypersensitivity* ; Prevalence ; Rhinitis, Allergic*