C-type natriuretic peptide(CNP),mainly expressed in central nervous system and vascular endothelial cells maintains renal homeostasis by autocrine or paracrine pathway,which regulates water-electrolyte metabolism,vascular resistance,glomerular permeability,and cell proliferation.Thus,clarifying the characteristics of CNP metabolism in kidney would appear promising to develop some new prospects for the evaluation of kidney injury and the targeted therapy.

This paper reported a new method of Armillaria mellea isolation-Gastrodia elata tissue isolating. Compared with normal isolating method-rhizomorph isolating method, it showed that the success rate of new method (78% ) was higher than the rhizomorph isolating method (16% ) , besides this, the new method was easier, and growth characteristic of obtained strain was superior to that obtained from rhizomorph isolating method.

目的观察三联疗法治疗膝骨性关节炎的临床疗效。方法对80例膝骨性关节炎患者给予三联治疗,即透明质酸钠关节腔内注射、关节周围痛点阻滞麻醉和针刀松解关节周围软组织。结果患者的膝关节疼痛症状明显好转,运动功能明显提高,治疗有效率98.3%。结论三联疗法治疗膝骨性关节炎疗效可靠,不破坏关节结构,无严重后遗症。

AIM: To investigate the characteristics and surgical management of retinal detachment (RD) after laser-assisted in situ keratomileusis (LASIK) in myopia.METHODS: Documents of patients with RD observed in 18342 eyes (9 598 patients) who underwent LASIK were retrospectively reviewed. None of the patients had history of corneal or other diseases before LASIK and preoperative fundus examination was performed. Patients were followed for a mean of 20 months and the clinical features of the eyes which developed RD after LASIK were investigated.RESULTS: Six patients including 2 males and 4 females developed RD, and the incidence of RD after LASIK was 0.33‰. Mean pre-LASIK myopia in these 6 eyes was 9.33D.None of these eyes had prophylactic treatment history of any retinal lesions. Mean time interval between LASIK and RD development was 9.2 months. All RDs happened spontaneously and were managed with vitrectomy and other techniques.Retinal reattachment was achieved at the first retinal detachment surgery in all 6 eyes (100%) at mean follow-up of 9.3months.CONCLUSION: RD after LASIK is not common. The study suggests no cause-effect relationship between RD and LASIK procedure in myopic eyes. However, clinicians should still be aware of retinal pathology in patients undergoing LASIK.

AIM: To assess the efficacy and safety of prophylactic laser photocoagulation for retinal breaks before laser in situ keratomileusis (LASIK) in myopic eyes.METHODS: From April 2000 to April 2004, totally 1 845 eyes ( 1 233 patients ) requesting LASIK had a fundus examination with indirect ophthalmoscopy before the surgery. They were divided into two groups according to the presence (Group 1) or absence of retinal breaks (Group 2). All patients with retinal breaks, though they were asymptomatic, underwent prophylactic laser photocoagulation to seal the breaks before LASIK.RESULTS: Patient age ranged from 18 to 43 ( 25.3±5.7) yaers old. Mean preoperative spherical equivalent refraction (PSER) was -7.44± 2.13 D (range, -1.50 to -14.50 D). Retinal breaks were identified and treated in 37eyes (2.05%) of 32 patients;1 808 eyes of 1 201 patients had no retinal breaks. No statistical difference was found in age ( P ＞0.05) or gender (P ＞0.05) between the two groups. Significant difference of PSER was noted between Group 1 (-9.41± 4.15D) and Group 2 (-7.52±3.71D) (P＜0.05). During a mean 14mo follow-up, none of the patients developed retinal detachment.CONCLUSION: The efficacy and safety of prophylactic laser photocoagulation for retinal breaks was confirmed.Retinal breaks should be identified and treated by photocoagulation in eyes before LASIK for myopia.

Objective To assess the feasibility,safety and efficacy of endoscopic papillectomy (EP) for tumors at the ampulla of Vater (AV).Methods A total of 15 patients with tumor at AV that were indicated for EP were included in this prospective study.Their clinical profiles,procedural parameters and outcome were evaluated.Results All patients underwent EP procedure successfully.Four patients who were diagnosed as having chronic inflammation in the reference endoscopy were confirmed as having adenoma after EP.Out of the 11 patients who were previously diagnosed as andenoma on biopsy,2 of low differentiated adenocarcinoma,1 of well differentiated adenocarcinoma and 1 malignant transformation were pathologically confirmed after EP.Stents were implanted in 8 patients with dilated pancreatic and/or common bile duct.Except for 2 cases of melena and 2 transient elevated level of blood amylase after EP,no other major complications occurred.Three patients,including 1 case of low-differentiated adenocarcinoma,1 case of malignant transformation and 1 case of lesion residual,were referred to surgery,another patient with low-differentiated adenocarcinoma declined any additional intervention because of old age.In the remaining 11 cases ( 11/15,73.3％ ) including one well differentiated adenocarcinoma,no recurrence was observed during a follow-up period of 23.4 (5 to 47) months.Conclusion EP is a minimal invasive,safe and effective treatment for tumors at AV,which also can provide an accurate staging of the lesion.

Objective To investigate the variation of morbidity and clinical features of Henoch-Seh(o)nlein purpura (HSP) in childhood in recent years.Methods The clinical data of 901 cases with HSP admitted to our hospital from January 1,1995 to December 31,2005 were retrospectively analyzed.The constitute rate of admission,the initial clinical presentations,specific manifestations such as multi-system 23/2165(1.06%),29/2098(1.38%),24/1973(1.22%),39/2008(1.94%),54/2433(2.22%),86/2611(3.29%),94/2724(3.45%),99/3014(3;28%),138/2900(4.76%),143/3177(4.50%)and 172/3500(4.91%),resp-sixty-five of 901 HSP children (1 8.3%) had no palpable purpura at onset, 90 cases initially manifested as abdominal pain and (or) gastrointestinal bleeding,14 of them was diagnosed by gastroendoscopy which demonstrated mucous membrane vasculitis.Sixty-three cases manifested as arthritis/arthralgias,6 cases presented as renal involvement,1 case with neurological symptoms and 5 cases with other symptoms at their pancreatic involvement was present in 3 cases,cardiac involvement in 47 Cases and one case had lung hemorrhage.Conclusion The morbidity of HSP has increased in recent years.The diagnosis in patients who do not have palpable purpura at onset and patients who present with the cerebral,pulmonary,cardiac and pancreatic involvement as the initial manifestations is difficult.Special attention should be paid to this group of patients.Gastrointestinal endoscope is valuable in diagnosing HSP in patients whose initial symptoms are abdominal pain and (or) gastrointestinal bleeding.

Objective To explore the clinical characteristics and outcome of correction with Ilizarov fixator for the knee deformities.Methods From May 2003 to April 2010,21 patients (22 knees) underwent knee deformity correction with Ilizarov fixator,including 12 males and 9 females with an average age of 20.3 years (range,8-48).Causes of the deformities included poliomyelitis in 4,burn in 2,osteomyelitis in 2,trauma in 9,Blount diseases in 2,and multiple osteochondromatosis in 2.Five patients had fixed flexion contracture due to soft tissue,they were corrected through a combination of Ilizarov's frame crossover the joint with a pair of hinges by gradual posterior distraction.Eight patients (9 limbs) had one way bony deformities and 7 patients had complex deformations.The frame with 4 hinge-posts was used for correction by restoring the alignment firstly,and then gradual lengthening to correct bone shortening.Additionally,an overlay frame of the above mentioned combinations was applied for correction of bony deformity combined with soft tissue contracture for 1 patient.Results The average time in frame was 22.3 weeks (range,12-36).At the time of removing frame,satisfactory alignment was achieved in all of the affected knees,and solid bony healing was obtained in osteotomy or bone lengthening area in 16 patients (17 limbs) with bony correction.All patients were followed up for an average of 32.1 months (range,6-86).The range of motion was improved from 102.14°±49.36° preoperatively to 126.90°±24.31° at the final follow-up.Additionally,the Japanese Orthopaedic Association knee score was also increased from 50.24±23.64 before operation to 85.71±10.52 at the final follow-up.All of them were able to walk without crutches,deal with daily life independently.Only 2 patients with the range of motion of the knee less than 90° were not able to squat.Conclusion Ilizarov fixator has advantages of minimal intervention to local tissue in operation and nimble adjustment at any time,and disadvantages related to a longer time in frame.

c-Met is one member of the receptor tyrosine kinases (RTKs).It is closely related between the over-expression of c-Met and a wide variety of tumor occurrence, development, invasion, metastasis, prognosis and drug resistance.Therefore, c-Met is a potential target for oncotherapy, and researches on its inhibitors have become a hot spot in the field of tumor treatment.Aptamers targeting c-Met are gained from systematic evolution of ligands by exponential enrichment (SELEX).They can bind to c-Met with high specificity and affinity, resulting in the activation or inhibition of c-Met.We envision that anti-c-Met aptamers would be ideal new c-Met inhibitors after optimization, and could be developed into potential targeted drugs for cancers.

Objective To compare the surgical results between anterior fixation and posterior vertebral osteotomy in patients with old thoracolumbar fracture. Methods 39 cases of old thoracolumbar fracture with posttraumatic kyphosis and neurologic compromise underwent either anterior fixation (n=19) or posterior vertebral osteotomy(n=20). In the anterior group, the average patient age was 38.3 years (range:21 to 64), the mean time from injury to operation was 5.3 months (range:2 to 16), and the mean preoperative kyphotic angle was 25.2?(range:10?to 43?). In the posterior group, the average patient age was 39.9 years (range:18 to 68), the mean time from injury to operation was 5.6 years (range: 2months to 16 years), and the mean preoperative kyphotic angle was 27.6?(range:5?to 60?). Results In the anterior group, the mean operation time was 274 minutes (range:140 to 395) with a mean blood loss of 994 mL (range: 300 to 2000), the mean postoperative kyphotic angle was 14.7?(range: 0?to 35?), and the mean angle of correction was 10.5 ?(range: 5?to 16?). In the posterior group, the mean operation time was 283 minutes (range:190 to 390) with a mean blood loss of 1654 mL (range: 800 to 3800), the mean postoperative kyphotic angle was 4.4?(range:-10?to 35?), and the mean angle of correction was 23.2?(range: 7?to 40?). All the patients with incomplete neural injury had improvement of neurologic function. Conclusion The posterior vertebral osteotomy can produce better results in kyphotic correction, while it does not increase the trauma of operation.