Crohn’s disease( CD)is a gastrointestinal progressive granulomatous disease with unknown etiology. It is characterized as active stage alternating with remission stage,long-term course with many complications,sometimes needing surgery and having the tendency of relapse in patient ’s whole life. Therefore,it is important to define an effective therapeutic endpoint to ameliorate the natural course of CD. This article reviewed the progress in defining treatment endpoint of CD.

Inflammatory bowel disease( IBD)includes ulcerative colitis( UC)and Crohn’s disease( CD),its incidence is increasing yearly in our country. With the progress of molecular biology,genetics,the understanding of IBD is deepen,however,the exact pathogenesis of IBD is still not fully clear,and it may be related to gene,environment, immunity,microorganism. Studies have shown that smoking,vitamin D,sex hormones,emotions,diet may be related with the occurrence of IBD. This article reviewed the role of environmental factors in IBD.

Objective To investigate the diagnostic significance of combined detection of neuron specific enolase (NSE ) , cytokeratin 19 fragment(CYFRA21-1) ,carcinoembryonic antigen(CEA) ,carbohydrate antigen 125(CA125) ,carbohydrate antigen 19-9(CA19-9) and serum ferritin(SF) in non-small-cell lung cancer(NSCLC) .Methods NSE ,CYFRA21-1 ,CEA ,CA125 ,CA19-9 and SF were detected by chemiluminescent immunoassay in 52 patients with NSCLC(NSCLC group) ,35 patients with benign lung diseases(benign lung diseases group) and 44 healthy controls(control group) .Results These serum tumor markers in NSCLC group were significantly higher than those in benign lung diseases group and control group(P<0 .01) .Serum level of CEA was ob-viously higher ,while CYFRA21-1 was lower in patients with adenocarcinoma than those in patients with squamous carcinoma(P<0 .05) .The sensitivity(96 .2% ) ,specificity(87 .3% ) and accuracy(90 .8% ) of combined detection of these tumor markers preceded any single ones .Conclusion The combined detection of NSE ,CYFRA21-1 ,CEA ,CA125 ,CA19-9 and SF can improve the diagnos-tic sensitivity and accuracy of NSCLC ,which could provide higher clinical value in the diagnosis of NSCLC .

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Objective To investigate the clinical effects of arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation for treatment of moderate and severe patellofemoral osteoarthritis.Methods A retrospective case-control study was done on 80 patients with moderate to severe patellofemoral osteoarthritis who were treated in our hospital between March 2013 and March 2015.According to treatment methods,the patients were divided into two groups:Group A including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic debridement,and Group B including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation.The Kujula scores and Lysholm scores of the patellofemoral joint were compared between the two groups before and after operation.The lateral patellofemoral angle was measured according to patellar axial X-ray performed 3 months after operation to evaluate patellofemoral joint function.Results All patients were followed up for 13-36 months (average 19.8 months).The patellofemoral joint scores of the two groups was increased at different degrees after operation.In moderate patellofemoral osteoarthritis patients,at 3 months after operation and the last follow-up of Group B,Kujula scores [(85.1 ± 6.8)points,(86.8 ± 4.6)points] and Lysholm scores [(88.1 ± 1.8) points,(88.4 ± 2.3) points] were higher than that of Group A [(78.1 ± 5.7) points,(78.3±5.3)points,(82.4 ±2.9)points,and (82.5 ±2.5)points] (P＜0.05).In each group,the Kujula scores and Lysholm scores at 3 months after operation and the last follow-up were improved to be higher than preoperation (P ＜ 0.05),with insignificant statistical difference between the two groups (P ＞ 0.05).According to the Lysholm scores,the excellent rate after operation in Group B (86％) was higher than that of Group A (55％) (P ＜ 0.05).For patients with severe patellofemoral osteoarthritis,Kujula scores [(72.3 ± 5.3) points,(72.7 ± 3.6) points] and Lysholm scores [(75.1 ± 1.9) points,(75.3 ± 2.3) points] at 3 months postoperatively and at the last follow-up in Group B were higher than that of Group A [(70.8 ± 5.2) points,(71.1 ± 4.2) points,(73.4 ± 2.8) points,and (73.6 ± 2.5) points],but the difference was not statistically significant (P ＞ 0.05).Within each group,although the Kujula scores and Lysholm scores at 3 months postoperatively and at the last follow-up were improved compared with before operation,but the difference was not statistically significant (P ＞ 0.05).According to the Lysholm scores,although the excellent rate after operation of Group B (33％) was higher than that of Group A (28％),with insignificant statistical difference (P ＞ 0.05).No matter Outerbridge Ⅲ or Ⅳ patellofemoral osteoarthritis a patient was,the lateral patellofemoral angle of Group A after operation had no significant improvement (P ＞ 0.05),while Group B showed significant improvement after operation (P ＜0.01).Group B had better improvements than that of Group A (P ＜0.01).Conclusions Compared with simple arthroscopic debridement,patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation can better relieve the symptoms of moderate patellofemoral osteoarthritis and improve knee function.But for patients with severe patellofemoral osteoarthritis,this method is not effective.

The expression of heat shock proteins(HSPs) can protect against acute lung injury(ALI).However,HSPs are restrained from clinical application due to the toxicity of most of the former inductors.Glutamine,which also has the ability to induce the expression of HSPs,can protect against ALI and sepsis,and may serve as a candidate for clinical application.

Objective To investigate the in vivo effects of glutamine(Gln) on inflammatory cytokine release in murine peritoneal macrophages during sepsis. Methods Sixty Kunming mice were randomly divided into sham-operation group(Sham group,n=20),operation control group(Con group,n=20) and Gln-treatment group(Gln group,n=20).Sepsis was induced by cecal ligation and puncture in Gln group and Con group,and Gln(0.75 g/kg) or saline was immediately administered via single tail vein injection.Serum was collected and macrophages were harvested from peritoneal lavage at 6 h in these three groups.Intracellular and serum cytokines of tumor necrosis factor-?(TNF-?),interleukin(IL)-6 and IL-10 were detected by ELISA.The expression of TNF-? mRNA in macrophages was analyzed by RT-PCR,and the expression of heat shock protein(HSP) 72 in macrophages was evaluated by Western blotting. Results Gln group demonstrated significantly lower intracellular TNF-? and IL-6 levels than Con group(P0.05).The serum TNF-? level was significantly lower in Gln group than in Con group(P

Objective To observe the pathologic changes of ganglion cell and nerve plexus in internal anus sphincter of rats with congenital anorectal malformations (ARM).Methods Healthy and pregnant Wistar-Imammichi rats were induced to ARM by ethylene thiourea (ETU). There were 67 rats with ARM at all. The pelvis was continuously cut from the exactly midsagittal plane. The HE staining was performed, and the numbers of the ganglion cell and nerve plexus in the internal anus sphincter were observed under the microscope.Results The average numbers of the ganglion cell and nerve pluxes in the ARM embryos were (1.206±0.012) and (0.308±0.051). Those of the normal control embryos were (3.710±0.043) and (1.227±0.072) respectively. There was a significant difference between two groups ( P<0.05～0.01). While, those of the embryos without ARM which dealt with ETU were (3.012±0.032) and (1.187±0.004) respectively, didn't differ from the normal control embryos.Conclusion The decrease of the ganglion cell and the nerve plexus in internal anus sphincter is an important pathologic change of ARM.

BACKGROUND:Establishing the animal model of membranous nephropathy is of importance to figure out the pathogenesis of membranous nephropathy.
OBJECTIVE:To investigate the expression of nephrin and podocin in the model of membrane nephropathy in rats, and to investigate their relationships with the pathogenesis of membranous nephropathy.
METHODS:A total of 40 Sprague-Dawley rats were equivalently randomized into model and control groups. Rats in the model group were in premunity by given subcutaneous and multi-point injection of 1 mg cationic bovine serum albumin firstly dissolved in 0.5 mL normal saline and then ful y emulsified with the equal incomplete Freund’s adjuvant for 1 week, and 16 mg/kg cationic bovine serum albumin was injected via vein tails, once every other day for 4 weeks. The same volume of normal saline was injected into the controls. The mRNA expressions of nephrin and podocin in renal tissues were detected using real-time PCR, and biochemical indicators and morphological observation were measured at 2 and 4 weeks after modeling.
RESULTS AND CONCLUSION:(1) In the model group, the total amount of urine and serum albumin levels were significantly decreased accompanying with overt proteinuria, and the serum creatinine, urea nitrogen, cholesterol and triglyceride levels were significantly increased al in a time-independent manner compared with the control group (P<0.01), and the difference was significant (P<0.05). (2) The pathological examination showed that rats in the model group had different degrees of renal tubular dilatation, glomerular basement membrane thickening, mesangial cel s and stromal hyperplasia, which was typical of membranous nephritis. (3) Moreover, the mRNA expressions of podocin and nephrin in the model group were lower than those in the control group. (4) In conclusion, the decreased expressions of podocin and nephfin may disturb the integrity of the slit membrane of podocytes giving rise to the damage of glomerular filtration barrier, and proteinuria appears in final.

Objective To observe the expression of uPA, tPA and PAI-1 in whole blood of rat membranous ne-phropathy ( MN) models induced by cationic bovine serum albumin ( C-BSA) , and to explore the effect of fibrinolytic sys-tem on podocyte apoptosis and pathological changes. To explore the possible preventive and therapeutic effects and the pos-sible mechanisms of early prevention of fibrinolysis. Methods We developed a MN model with the modified Border meth-od. At the end of the 1st, 2nd, 3th, and 4th week of immunization, respectively, the levels of whole blood uPA, tPA and PAI-1 were determined by ELISA. The rat kidney tissues were examined by light microscopy and electron microscopy to i-dentify the pathological changes. The expression levels of nephrin and WTl were detected with immumofluorescence staining and their correlation was analyzed. Results Compared the treatment group with control group, the levels of whole blood uPA, tPA and PAI-1 of the model group were decreased, while PAI-1 was elevated, showing a significant difference ( P<0. 05). The degree of renal interstitial fibrosis was more serious. Correlation analysis showed that the whole blood tPA and uPA levels were positively correlated with the changes of nephrin protein expression in the kidney tissue, while the whole blood PAI-1 level was negatively correlated with the nephrin protein expression in the kidney tissue. Conclusions In the process of MN development, the fibrinolytic system may have important significance for podocyte apoptosis. Determination of early phase of MN podocyte injury may be another therapy target for prevention of the disease development, and then pro-vide new ideas for clinical research and drug development for MN.