Objective To investigate the differential expression of monocyte ehemoattraetant protein-1 (MCP-1) in renal biopsy tissues of patients with IgA nephropathy, and to analyse the association between these 2 markers and their effect on various pathologic types of IgA nephropathy. Methods According to pathologic type, 88 renal biopsy tissues of patients with IgA nephropathy were divided into 4 groups: a minimal change group, a mesangial proliferative glomerulonephritis group, a focal sclerosing glomerulonephritis group, and a diffused sclerosing glomerulonephritis group. Immunohistochemical staining was used to detect the in situ expression of MCP-1 and CD68 on renal biopsy tissues. The expression levels were semi-quantified by image analysis and clinical data were collected from the patients. Results The differences in glomerular MCP-1 expressions were not statistically significant among all groups, while the tubulointerstitial MCP-1 expressions were statistically different among the 4 groups, with the average scores of 1.43 ± 0. 60, 5.98 ±0.92, 10. 60 ± 0.76 and 11.65 ±0.39 for minimal change group, mesangial proliferative glomerulonephritis group, focal sclerotic glomerulonephritis, and diffused sclerotic glomerulonephritis group, respectively. The tubular and interstitial CD68 scores were 0. 75 ± 0. 71, 5. 87 ± 0. 96, 10. 42 ± 0. 61, and 11.40 ±0.49 for the 4 groups, with significant differences in both MCP-1 and CD68 among the 4 groups. Correlation analysis indicated a positive correlation between tubulointerstitial MCP-1 and CD68 (r = 0. 688, P ＜ 0. 01) . MCP-1 in tubulointerstitial was significantly correlated with 24 h urinary protein excretion (r=0.531, P＜0.01). Conclusion MCP-1 plays a critical role in mac-rophage infiltration in the kidney. MCP-1 is associated with the severity of tubulointerstitial damage and clinical prognosis.

Objective To evaluate the clinical effect of fluoride agents in prevention of caries in preschool 4 to 5 years old children.Methods 700 kindergartens 4 -5 years old children were selected to conduct prevention study with the agree of guardian.The children were randomly divided into observation group and control group. 350 preschool children in the control group received regular oral health measures and fluoride foam treatment every six months.350 preschool children in the observation group received fluoride products every six months on the basis of the control group.After two years study,the deciduous caries and caries rate of the two groups were analyzed.Results After prevention of dental caries 24 months,the prevalence of dental caries and caries of deciduous teeth surface in the observation group significantly reduced,and were significantly lower than the control group ( observation group:caries prevalence 11.3%,caries mean 0.85;control group:caries prevalence 36.1%,caries mean 1.77),the deciduous caries rate and the number of surface caries between the two groups had statistically significant differences (χ2 =4.339 1,3.016 8,all P<0.05).Conclusion Child deciduous dental caries in China is still at a relatively high inci-dence of disease,regular use of fluoride foam and fluoride products namely fluor protector can significantly prevent dental caries,oral health measures than on a regular basis is more effective,and significantly reduce deciduous caries among children,protection of children's oral health,and it is worth further clinical application.

Objective To discuss the application of cephalocervical CT angiography (CTA) and ABCD2 score in evaluating arterial characteristics and interventional curative effect for patients with transient ischemic attack (TIA). Methods During the period from Jan. 2010 to Jan. 2012, a total of 64 patients with clinically-diagnosed TIA were admitted to authors’ hospital. ABCD2 score evaluation and cephalocervical CTA examination were performed in all patients. The correlation of stenotic degree and distribution of the cephalocervical arteries with the ABCD2 score was analyzed. According to the stenotic degree of the cephalocervical arteries, the patients were divided into low-risk group and mid-to-high-risk group. Twenty-two patients in mid-to-high-risk group received stenting angioplasty treatment. Follow-up was made at 3, 6 and 12 months after the treatment. Results Of 64 TIA patients, cephalocervical artery stenosis was found in 52(81.25%) A total of 149 arterial segments were involved, including intracranial segment (n=81, 54.36%) and extracranial segment (n = 68, 45.64%). Patients in low-risk group mainly suffered slight or moderate arterial stenosis, while patients in mid-to-high-risk group had moderate or serious arterial stenosis (χ2 =10.126, P=0.018). The preoperative ABCD2 score was (6.41 ± 0.50). The ABCD2 scores determined at 3, 6 and 12 months after the treatment decreased to(2.88 ± 0.69), (2.82 ± 0.63) and(3.00 ± 0.71), respectively. The differences were statistically significant (F = 86.657, P < 0.05). Conclusion Cephalocervical CT angiography and ABCD2 score can reliably evaluate the arterial stenosis and interventional curative results in TIA patients.

To study the expression of both Fos and HSP70 proteins in the early stage of acute myocardial ischemia/reperfusion(I/R) in rats with immunohistochemistry in order to search the objective morphologic evidence for the forensic pathological diagnosis.I/R rat model was established by ligation of the anterior branch of the left coronary artery.All animals were divided into 7 groups.Tissues were cut and stained immunohistochemistry with the corresponding anti Fos and anti HSP70 sera as the first antibodies.There was no expression of both Fos and HSP70 proteins in control group.The expression of HSP70 protein began to increase in myocytes 1h after I/R in the ischemic areas and increased gradually wtih the prolongation of ischemia,while it began to express 2h after I/R in the non ischemic areas.Fos protein began to express 0 5h after I/R in the ischemic areas,1h in the non ischemic areas.The expressions of both HSP70 and Fos proteins in the non ischemic areas were weaker than those in the ischemic areas.Meanwhile,the expression of HSP70 and Fos proteins appears firstly in the inner layer of myocardium and extended gradually toward the outer layer.The expression of Fos protein mainly located in the inner layer of myocardium 0 5h after I/R and then extened to the whole layer of myocardium 1h after I/R.The expression of Fos protein in outer layer was stronger than that in inner layer at 4h after I/R.The expression of HSP70 protein located mainly in the inner layer of the myocardium at 1h and 2h after I/R,and then extended to the whole layer of the myocardium at 4h and 6h after I/R.The results indicated that the I/R induced the expression of both HSP70 and Fos proteins in the early stages of myocardial ischemia.The location and the intersity of the immunoreactivity of these two proteins changed at the different stages after I/R.These changes observed in the present study might be useful for the forensic pathological diagnosis of the early myocardial ischemia.

Objective To summarize the experience of HIV/AIDS preventive interventions among out-of-school teenagers and provide scientific evidence for the development of large-scale interventions in the future. Method Using both non-random snowball and cluster sampling approach,a total of 5,000 participants were selected from 7 provinces (9 provincial sites ) and a cross-sectional survey was conducted by employing a semi-open-ended self-administrative interview schedule to evaluate their behavioral change before and after the interventions. Results The rate of HIV related knowledge and condom use increased significantly among the participants. For instance,the rate of condom use when having sex at the last time increased by 34.86%,i.e. from 27.67% at the baseline to 59.88% after the intervention (?2=34,86,P

Objective To explore the clinical efficacy of transcutaneous autologous bone marrow transplantation in the treatment of delayed union after internal fixation of limb fracture. Methods 41 patients with delayed union after internal fixation of limb fracture with informed consent in our hospital were divided into two groups by number table,20 patients in control group were treated with conventional therapy,21 patients in observation group were treated with transcutaneous autologous bone marrow transplantation,the effects and the occurrence of complications of two groups were compared and observed. Results In observation group,excellent healing in 13 cases(61.9%),good in 7 cases(33.3%),failure in 1 case(4.8%),and in the control group,6 patients(30.0%),11 cases(55.0%),3 cases (15.0%),the difference between the two groups was statistically significant(u=4.1934,P＜0.05);the complication rate of the observation group was 9.5%,compared with 15.0% of the control group,there was no significant difference(x2=0.034,P＞0.05). Conclusion Transcutaneous autologous bone marrow transplantation in the treatment of delayed union after internal fixation of limb fracture had better efficacy and less complication.

BACKGROUND:Caspase plays a crucial role in the cellapoptosis, but the influence of different facial nerve injury on caspase 1, caspase 8, cyto-c protein expression and their correlation stil remain unclear.
OBJECTIVE:To construct facial nerve crush or distal transection injury models, observe the morphological changes of facial motoneurons, investigate death gene caspase 3, caspase 8, cyto-c expression, and analyze their correlation.
METHODS:Facial nerve crush or distal transection injury model was established in the right facial nerve of rats, while the left facial nerve served as normal controls. We observed the morphology and the death of facial motoneurons with toluidine blue staining and transmission electron microscope. Expressions of caspase 3, caspase 8 and cyto-c proteins were studied by immunohistochemistry analysis fol owing facial nerve injury.
RESULTS AND CONCLUSION:Both facial nerve distal transection and crush injury resulted in the death of facial motoneurons, and the death pattern was mainly apoptosis. Caspase 3, caspase 8 and cyto-c protein expressions were observed in the subnucleus of normal rat facial nucleus. cells of the distal transection group were stained more intensely than that of crush group. Expressions of these proteins began to increase at 3 days after the injuries. Caspase 3 and caspase 8 protein expression peaked at 14 days, whereas cyto-c protein expression peaked at 7 days after the injuries. Expressions of caspase 3, caspase 8 and cyto-c proteins were correlated with facial nerve injury type and injury time. Expressions of caspase 8 and cyto-c protein were correlated with expression of caspase 3 protein. The findings indicate that, caspase 8 and cyto-c contribute to activate caspase 3, and caspase cascade reaction plays an important role in the apoptosis of facial motoneurons.

To investigate the effect of semi-joint prosthesis replacement in treating osteosarcoma around the knee joint,15 children with osteosarcoma around the knee joint underwent semi-joint prostheses replacement and removal of the section with tumor from October 1998 to July 2006.Imageology showed that tumor of 9 children was located at the distal femur,and 6 cases at the proximal tibia.The pathologic changes involved the upper segment of the tibia 9-11 cm in length.All the children had been diagnosed with osteosarcoma by pathological examination,which was graded as stage Ⅱ a according to Enneking staging system.All the patients underwent neoadjuvant chemotherapy preoperatively for 1-2 courses.The size of prosthesis was determined based on preoperative X-ray,CT and MRI.The length of the prosthesis should be 1.0-2.0 cm longer than that of the excised bone.Patellar and collateral ligaments were reconstructed in the artificial semi-knee joint prosthesis.All the 15 patients had a successful semi-joint prosthesis replacement.During the follow-up of 2 to 6 years,body height of the children increases by 4-6 cm,and the affected limbs shortened 1-3 cm.All children could live and study normally.There were 7 excellent,5 good,2 fine and 1 poor according to Enneking evaluation system.The semi-joint prosthesis replacement in the limb salvage surgery for child osteosarcoma around the knee joint can reconstruct knee joint function,remain normal osteoepiphysis,minimize affected limb crispation after operation,and create the condition for total knee replacement in adults.

Modern medical record management is becoming more and more integrated with medical information management and computerization.With the changes in the content and mode of medical record management,the modernization of its means and the extension of its services,the managerial personnel must have such qualities as active service idea,multiple knowledge,a high sense of information,strengthened awareness of law,and abilities of communication and coordination,so as to meet the requirement of modern medical record management.