Renal involvement is common in systemic lupus erythematosus(SLE).Treatment of lupus nephritis includes immunosuppressive and supportive therapy.The intensity of immunosuppressive therapy depends on the clinical and renal pathological disease activity.The long-term targets of treatment are to prevent lupus nephritis relapse and protect renal function.Complete remission is the goal in the induction phase,and long-term treatment is necessary in the maintenance phase.Individualization therapy and the side effects of immunosuppressive agents should be paid more attention.

Objective: It was reported that major subclasses of anti-golmerular basement membrane (GBM) antibody were IgG1 and IgG4. The IgG1 subclass was mainly found in male patients and IgG4 subclass in female patients with anti-GBM disease. This study investigates the distribution of anti-GBM IgG subclasses and their association with clinical characteristics. Methods: Sera from 50 patients diagnosed as anti-GBM disease during 1991-2003 were collected. The anti-GBM antibodies with IgG1, IgG2, IgG3, and IgG4 subclasses were detected with purified bovine ?(IV)NC1 as solid phase ligand in ELISA. The association with clinical manifestations was further investigated. Results: The positive rates of IgG anti-GBM subclasses were IgG1 94%, IgG2 56%, IgG3 12%, IgG4 88%, respectively. IgG1 and IgG4 were the main subclasses in anti-GBM IgG subclasses (P

Objective To study the clinicopathological features of C3 glomerulonephritis and the associations between plasma complement fragments level and clinical manifestations.Methods The clinical and pathological data of the 12 patients with C3 glomerulonephritis in our division from January 1999 to June 2010 were analyzed retrospectively.Concentrations of plasma factor B,Ba,C3,C3a,C4a and C5a were detected by commercial available sandwich ELISA kits on the day of renal biopsy.Results Ten of the 12 patients were C3 glomerulonephritis without MPGN,and the rest 2 were C3 glomerulonephritis with MPGN.All the patients presented proteinuria.Two of the 10 C3 glomerulonephritis patients without MPGN presented nephrotic range proteinuria,6 with microhematuria,1 with gross hematuria,and 2 with renal insufficiency.One of the 2 C3 glomerulonephritis patients with MPGN presented nephrotic range proteinuria,accompanied by microhematuria,hypertension and renal insufficiency.The other patient showed moderate proteinuria with normal renal function.Most of C3 glomerulonephritis patients without MPGN showed mild mesangial proliferative glomerulonephritis,and 4/10 patients had various degree cresentic formation.One C3 glomerulonephritis patient with MPGN had 47.1％ cresentic formation.The concentration of plasma C3 in C3 glomerulonephritis patients was normal,while the plasma factor B was significantly decreased,and the concentrations of plasma Ba,C3a,C4a and C5a were significantly elevated.The concentration of plasma Ba was positively correlated with the proteinuria level,while the concentrations of plasma C3a,C4a and C5a were not correlated with the levels of proteinuria or plasma creatinine.Conclusions Majority of these 12 patients were C3 glomerulonephritis without MPGN,manifests as nephritic syndrome clinically and mild mesangial proliferative glomerulonephritis histopathologically.Complement activation via alternative pathway may play an important role in the pathogenesis of C3 glomerulonephritis.

ObjectiveTo investigate the etiology, exacerbating factors and outcome of geriatric patients with acute renal failure (ARF) in emergency and critical internal medicine. MethodsClinical features of elderly inpatients with ARF who were diagnosed in internal medicine of our hospital during the past 10 years were retrospectively analyzed. Patients were divided into community-acquired ARF (CA-AFR) group and hospital-acquired ARF (HA-ARF) group. Comparisons between CA-ARF group and HA-ARF group, and between elderly patients and non-elderly patients with ARF in internal medicine were performed. ResultsAmong 381 elderly ARF patients in internal medicine, there were 218 (57.2%) CA-ARF patients and 163 (42.8%) HA-ARF patients. Most of the HA-ARF patients (153 cases) were distributed in medical intensive care. Compared with CA-ARF group, patients in HA-ARF group were older, with more underlying diseases, a higher ratio of infections and/or heart failure and more severe acute renal failure. Infection and heart failure/severe myocardial isehemia were the major exacerbating factors for HA-ARF. Of the 163 patients with HA-ARF, 146 patients died and 17 patients survived. Patients in the death group had more underlying diseases, a higher ratio of severe infections and heart failure/severe myocardial ischemia, a higher ratio of cases with multiple organ dysfunction syndrome(MODS) and a higher score of APACHE Ⅱ.When compared with non-elderly patients with ARF, the elderly patients had a higher proportion ofHA-ARF, a higher ratio of MODS, a higher score of APACHEⅡ and a higher mortality of ARF.ConclusionsThe elderly critical patients are susceptible to HA-ARF with more chronic underlying diseases. Infection and heart failure/severe myocardial ischemia are the major exacerbating factors.The prognosis depends on the treatment of predisposing diseases and removal of exacerbating factors.

OBJECTIVETo evaluate the short effect and safety of the acupoint application of dog days for allergic rhinitis.

METHODSTwo hundred and forty-nine patients were randomly divided into an application group (166 cases) and a placebo group (83 cases). On the first day of the first dog days, the first day of the second of the three ten-day periods of the hot season and the first day of the last of the three ten-day periods of the hot season, acupoint application was adopted mainly at Dazhui (GV 14), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) in the application group. The plaster was made of Chinese herbs, including Baijiezi (semen brassicae), Xixin (asarum), Yanhusuo (corydalis tuber) and Gansui (euphorbia kansui). Buckwheat plaster without medical ingredient was used in the placebo group. The application was pasted for 2-6 h every time. On the first three days of all the three periods of dog days, treatment was used continuously. The whole period of dog days was made into one course. The changes of symptom and syndrome scores, visual analogue scale (VAS) for symptom before and after treatment and the adverse reaction with the condition disposed were observed in the two groups.

RESULTSAfter treatment, the symptom and syndrome scores and VAS for symptom were improved compared with those before treatment in the two groups (all P < 0.05), and the improvements of the application group were more obvious than those of the placebo group (all P < 0.05). The short effective rate of the application group was 68.1% (113/166), which was better than 48.2% (40/83) of the placebo group (P < 0.05). The adverse reaction rates were 4.2% (7/166), 2.4% (2/83) respectively, with no statistical significance between the two groups (P > 0.05).

CONCLUSIONThe dog days plaster achieves obvious effect with good safety for allergic rhinitis.

Acupuncture Points ; Adolescent ; Adult ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; Treatment Outcome ; Young Adult

Circulating tumor cells (CTCs) are essential for establishing metastasis. Detecting CTCs can help clinicians detect early metastases or recurrences more effectively. Compared with traditional histological analyses and imaging, CTC detection has a much higher reproducibility and sensitivity and can provide more timely prognostic information in human breast cancer.

Objective: To investigate the effects of DC derived from IL-12-induced erythroleukemia cells on the induction of CTL and protective antituinor immunity. Methods: The cytotoxicity of CTL was assessed by 4h 51 Cr-release assay. HE staining and eleclromicroscopy were used to observe the histological changes after immunized with erythroleukemia-derived DCs. Results: After incubation with naive T cells, the IL-12-induced FBL-3 cells could apparently induce the generation of CTL which exihibit the specific cytotoxicity against wild-type FBL-3 cells in vitro. We further assayed the cytotoxicity of CTL in vivo after immunized with erythroleukemia-derived DCs. CTL cytotoxicity of mice immunized with IL-12-in-duced FBL-3 cells was higher than that of mice immunized with IL-I2-uninduced FBL-3 cells. C57BL/6 mice immunized with IL-12-induced FBL-3 cells could resistant the subsequent rechallenge with the wild-type FBL-3 cells. The tumor growth was efficiently inhibited. Histological observation showed that more inflammatory cells infiltrated into the tumor tissue and necrosis of leukemia cells existed. By transmission electron microscopy, apoptositic phenomena were observed in the tumor of group immunized with IL-12-induced FBL-3 cells. However, these changes were not observed in the group immunized with IL-12-uninduced FBL-3 cells. Conclusion: These data indicate that erythroleukemia cells-derived DCs could induce specific CTL efficiently in vitro and in vivo, and may be used as new vaccine to activate antituinor immune responses.

Objecttve To explore the roles of p53,Bax and Bcl-2 in rat lens epithelial cells apoptosis induced by ultraviolet radiation.Methods Healthy SpragueDawley rats (40,6-weeks old,150 g) were selected and divided into 5 groups randomly.After SD rats were injected 100 g · L-1 chloral hydrate (0.35 mL/100 g) intraperitoneally and pupil dilation,the eyes of SD rats were radiated 15 minutes by using UV-B (300-320 nm).The exposed animals were sacrificed at 1 day,3 days,5 days and 7 days after exposure.Both lenses from all animals were extracted.The apoptosis of rats lens epithelial cells was performed by Hoechst 33258 staining.The expression of p53,Bax and Bcl-2 in rat lens epithelial cells at mRNA level was detected by real-time PCR.The distribution and expression of p53,Bax and Bcl-2 were observed by immunohlstochemistry.Results The apoptosis of lens epithelial cells was aggravated after exposure.The expression of p53 and Bax at mRNA and protein level was increased after UV exposure (P ＜ 0.01).But for Bcl-2 the expression both at mRNA and protein level was decreased after a 1 day-exposure(P ＜0.01) and was increased after UV exposure of 5 days and 7 days(P ＜ 0.01).The mRNA expression level of p53 was positively correlated with the Bax (r =0.952,P ＜ 0.01).The expression of p53 and Bax protein were increased after UV exposure,and transferred from cytoplasm to nucleus;While the expression of Bc1-2 protein was decreased at 1 day after UV exposure,and increased gradually at 3 days,5 days and 7 days.Conclusion The apoptotic process of rat lens epithelial cells induced by ultraviolet may be related with p53 regulating the expression of Bax/Bcl-2.

Objective To investigate the relationship between antiendothelial cell antibodies(AECA)and anticardiolipin antibodies(ACA)in patients with lupus nephritis. Methods 58 sera from patients with lupus nephritis were studied. ELISA technique were used to detect both AECA and ACA, and immunoblotting was performed to determine specific endothelial targets. Results The prevalence of IgG-AECA and IgG-ACA positive were 36.2% and 39.7% respectively in the patients with lupus nephritis. 17 out of 23 patients with ACA had higher titers of AECA, while only 4 out of 35 patients without ACA were AECA positive(P

Objectives To study the clinical and pathological features of patients with ANCA-negative pauci-immune crescentic glomerulonephritis.Methods ANCA was detected and the clinical and pathological features were analyzed in 33 patients with pauci-immune crescentic glomerulonephritis.Results Of the 33 patients with pauci-immune crescentic glomerulonephritis, 15(45%) were ANCA negative, which accounted for 15% of the patients with crescentic glomerulonephritis. Of the 15 patients with negative ANCA,9 had multi-system involvement and 6 were clinically limited to kidney only. Renal biopsies showed small vessel vasculitis in 2 patients. After intensive immunosuppressive therapy, one out of thirteen patients was cured,six achieved clinical remission,while the other 6 became dialysis dependent.Conclusions The clinical and pathological features of the patients with ANCA-negative pauci-immune crescentic glomerulonephritis are similar to those with ANCA-positive,while the ages of these patients are younger and the prognosis poorer.