Thin basement membrane nephropathy(TBMN) is one of the most common disorders of the kidney,affecting at least 1% of the population.It seems to be a disease of the adult glomerular basement membrane(GBM) type Ⅳ collagen trimer ?3∶?4∶?5.Genetic evidence indicates that autosomal TBMN is caused by heterozygous mutations in either COL4A3 or COL4A4, whereas homozygous or combined heterozygous mutations in the same genes lead to autosomal recessive Alport syndrome.The author summarized the epidemiology,clinical features,renal biopsy,genetics,pathogenesis,diagnosis and therapy of TBMN.

At present,the most commonly used methods for liver function evaluation in clinical practice is static detection represented by blood biochemical examinations,with a focus on the degree of liver injury and liver dysfunction;however,such methods have significant timitations on the reflection of liver reserve function.Indocyanine green (ICG) clearance test is commonly used for the testing of liver reserve function in clinical practice and it is a minimally invasive,simple,and quick procedure available for bedside real-time monitoring and can be repeated during a short period of time.The application value of ICG clearance test in the field of liver surgery has been widely recognized.In recent years,more and more studies have been focusing on the application of ICG clearance test in the fields of internal medicine,liver interventional therapy,critically ill patients,and drug safety assessment.This article reviews the current clinical application,related advances,and future perspectives of ICG clearance test.

Objective To analysis the causes and characteristic of cracked teeth with pulpitis and explore clinical diagnosis and treatment methods.Methods A total of 78 tooth that was identified as a cracked tooth with pulpitis was recorded and analyzed in terms of the age,the position in the mouth,and the location of crack-line.After reducing the cusp height,root canal therapy and crown restoration,the patients were followed up for one year and the treatment effectiveness was reviewed.Results The most prevalent age was 39-49 years.The most of cracked teeth were found in the maxillary molars.There were 65 cases (83.33%)that were treated successfully,the function of 1 1 cases (14.10%)were improved,and the rate of failure were 2.56% (2 cases).Conclu-sion Reasonable clinical diagnosis and treatment can contribute to the retention of the cracked teeth.Coronal restoration after root canal therapy might be a very effective way to treat cracked teeth with pulpitis.

Objective To study the reasons of the conversion to laparotomy during laparoscopic cholecystectomy. Methods Correlative literatures were retrieved from 1994 to 1999, and were tabulated and critically appraised in terms of sample size, outcomes, and the causes of the conversion to laparotomy. Results In the 5260 cases of LCs, 169(3.21%) converted to laparotomy. The data examined revealed a bile duct injury in 22 cases (13%), bleeding in 25(14.8%), severe adhesion in 81(48%), acute choecystitis in 16(9.5%), bile leakage in 3 (1.8%), gastric cancer in 1(0.6%), carcinoma of gallbladder in 10(6%), distension of common bile duct and choledocholith in 4 (2.4%), fistula of gallbladder in 2 (1.2%), injury of stomach or bowel in 4(2.4%), unsatisfactory pneumoperitoneum in 1 (0.6%). Conclusions The major causes of the conversion to laparotomy during laparoscopic choecystectomy are severe adhesion, injury of bile duct and bleeding.

Objective To investigate the general conditions of the injury of blood vessels during laparoscopic cholecystectomy in China. Methods The cases of the injury of blood vessels complicated with laparoscopic cholecystectomy and its locations and reasons were reviewed according to articles published in the last years in CMCC. Results There were 86 cases (0.26%) of blood vessel injury in 33584 paitnets received laparoscopic cholecystectomy. The positions of bleeding included cystic artery (47), cholecyst bed (24), puncture port (6), hepatic vein(2), hepatic artery(1), and others places(6). 5 patients died of the bleeding Conclusions The injury of blood vessels complicated with laparoscopic cholecystectomy was considered as one fatal technical complication. It is one of the major causes of laparotomy and reoperation.

Amino Acid Metabolism, Inborn Errors ; Humans ; Infant, Newborn ; Isovaleryl-CoA Dehydrogenase ; deficiency ; Male ; Metabolism, Inborn Errors ; physiopathology

ObjectiveTo observe the effects of Yishen-Huoxue-Huatan capsule on carotid artery intima-media thickness (IMT),carotid atherosclerosis plaque area and the level of serum lipids,plasma endothelin (ET) and nitric oxide (NO) in patients with carotid atherosclerosis.Methods126 patients with carotid atherosclerotic were randomly assigned to treatment group and control group.Patients in treatment group was treated by yishen huoxue huatan capsule,and patients in control group was treated by zocor.Each patient was treated for 24 weeks.ResultsAfter the treatment,carotid IMT [respectively (0.81±0.11)mm,(1.10± 0.27)mm],atherosclerotic plaque area [respectively (11.21 ± 9.3)mm2,(16.53± 6.9)mm2] in both the treatment group and the control group were significantly lower compared with the same group before treatment (P＜0.05),and the treatment group was better than the control group (P＜0.05); serum cholesterol (TC),respectively [ (4.51 ± 0.37) mmol/L,(5.15 ± 0.20) mmol/L],triglyceride (TG) [respectively ( 1.77± 0.09) mmol/L,(1.79 ± 0.36) mmol/L],high-density lipoprotein cholesterol (HDL-C) [respectively (1.28 ± 0.26) mmol/L,(1.27 ±0.36) mmol/L],low-density lipoprotein cholesterol (LDL-C) [ (2.50± 0.30) mmol/L,(3.10± 0.39) mmol/L] in the treatment group and the control group were improved significantly (P＜0.05) compared with the same group before treatment,and the TC and LDL-C levels in the treatment group were significantly lower than the control group (P＜0.05); plasma ET [respectively (67.26± 14.13) ng/L,(79.38± 11.54)ng/L] NO [respectively (71.65± 111.64)μmol / L,(60.64±14.02)μmol/L] in the treatment group and the control group were higher than those in the same group before treatment (P＜0.05),and the plasma ET levels in the treatment group was significantly lower than the control group (P＜0.05),while the plasma NO level was significantly higher(P＜ 0.05).ConclusionYishen-Huoxue-Huatan capsule is effective in the treatment of carotid atheroselerosis.

The current study suggested that gastrointestinal motility has a close relationship with ascending-descending theory of spleen and stomach of TCM.Gastrointestinal symptoms caused by Qi disorder of spleen are identical with the clinical manifestations of gastrointestinal motility disorders.Although spleen and stomach act as the pivot of Qi transporting in the body,the dysfunction of liver,lung,kidney,and heart may also cause disorders of Qi in ascending and descending,manifested as pathological gastrointestinal motility.Therefore,when gastrointestinal motility appears abnormality,we should pay attention to other organs besides analyzing dysfunction of spleen and stomach

Child ; Cough ; chemically induced ; Disinfectants ; adverse effects ; Humans ; Irritants ; adverse effects ; Male

Objective: To evaluate the clinical efficacy of SKy bone expander system in percutaneous kyphoplasty for treatment of osteoporotic verterbral compression fracture. Methods: Twenty-two patients (aged 62-90 years, 32 vertebrae) underwent percutaneous kyphoplasty using SKy bone expander system. The bone cement was injected into the collapsed vertebrae. The vasual analogue scale (VAS) and complications were recorded during follow up. Results: The operations were successful in all patients via unilateral or bilateral approach. The operation time ranged from 30 to 120 min. The mean volume of cement injected into each vertebra body was (4.8±1.1) ml, ranged from 3.1 to 6.8 ml. Extravertebral leakage of bone cement was observed in two vertebrae with no symptoms. All patients had their pain relieved; the VAS was 7.6±0.8 before operation,3.5± 0.5 one day after operation, 2.8±0.6 one week after operation, and 2.4±0.6 one month after operation, with significant difference found between preoperation and postoperation (P<0.05). The symptoms of the patients were improved during a follow up of 12-26 months without recurrence. Conclusion: Application of SKy bone expander system in percutomeous kyphoplasty can relieve pain and restore the vertebrae height; it may be an effective treatment for aged patients with osteoporotic verterbral compression fracture.