Objective To explore the relationship of immunoglobulin A(IgA) nephropathy (IgAN) and Henoch - Schonlein purpura nephritis(HSPN) in children by making comparison in the aspects of clinical symptoms, laboratory tests and renal pathology. Methods Process the data of 69 cases of HSPN and 33 cases of IgAN respectively in clinical symptoms' frequency, indices of urinalysis and blood cell count, protein quantity in urine of 24 hours, serum level of immunoglobulins, C3 and C4, as well as renal pathologic results. Results In IgAN group, the incidence of male was higher than that of female, respiratory tract infections usually occur as prodrome. Macroscopic hematuria was the most prominent clinical feature, while rash, joint pain, abdominal symptoms seldom happened. Level of hemoglobin in IgAN group was decreased significantly. There were no significant differences in edema, hypertension, proteinuria degree, level of plasm albumin, level of serum IgA, IgG, IgM, IgE, C3 and C4, as well as the features of renal pathologic changes between IgAN and HSPN.Conclusions IgAN and HSPN have similar features in clinical symptoms,level of immunoglobulins and complements and renal pathology. But it is still under discussion whether they are different stages of the same disease.

Objective To explore the method and therapeutic principle of transcatheter closure of coronary artery fistula, aortopulmonary collaterals and aortopulmonary window. Methods Interventional occlusion of 4 cases of coronary artery fistulas and 1 case of aortopulmonary collaterals with Cook coils, 1 case of coronary artery fistulas and 1 case of aortopulmonary window with AGA Amplatzer duct occluder. The mean age of 7 children were 8.5 years. Results Transcatheter closure of 7 cases of vascular malformations were successful. During the follow-up period of 1 month to 5 years, no residual shunt and other complications appeared. Conclusion The curative effect of transcatheter closure of vascular malformations was good. But for the occlusions′ success and prevention from complications occurrence, the indications of closure should be obeyed, the time of X-ray exposure should be less than 60 minutes.

AVNRT, (3)There was no evidence of new arrhythmia occurring for the late electrophysiologic sequelae of RFCA lesions. Conclusion The technique of RFCA is safe, it causes significant minor myocardial injury and takes 3 months to develop from initially resembling coagulation necrosis to fibrosis. There is no evidence of new arrhythmia occurring for late electrophysiologic sequelae of RFC lesions.

Objective To evaluate the therapeutic effect of transcatheter closure of perimenbranous ventricular septal defect (PMVSD) with membranous VSD occluder device and compare the effect of transcatheter closure of VSD with surgery. Methods The therapeutic effect of transcatheter occlusion in 48 children with VSD is compared with that of other 73 cases who had received surgical treatment. Age, height, weight, pulmmary artery pressure, size of the defect, time for hospitalization, success rate as well as complications after operations are compared between the 2 groups. All the data are proccessed either by means of t test or ? 2 test statistically. Results There are no statistical differences between the two groups in age, height, weight, pulmonary systolic pressure and the rate of success. But the size of VSD is smaller and the time for operation and hospitalization is shorter in the group of transcatheter occlusion. There are no significant differences between the two groups in the rate of complications including the second surgery, residual shunt, bleeding, nerve injury, hemolysis, Ⅲ atrioventricular block, pneumothorax, hydrothorax, hydropericardium, aortic valve insufficiency and infection. But left anterior bundle branch block and complete left bundle branch block occur more often in the group of the catheter interventions during or after the occlusion. Conclusion Transcatheter occlusion shows a promising therapeutic effect on VSD. To prevent complications, therapeutic rules and technical criterias should be obeyed and close monitoring after the closure should be carried out.

It has become a vital question to find out the approaches of stomatological course system to meet the demands of modern times.By analyzing the characteristics of stomatological courses systems at home and abroad, the author found out the differences,which was helpful the to optimize the courses system of stomatology education.

The paper summed up the experiences of course system reform and set forth how to optimize the course system of stomatology education to cultivate the practical abilities of stomatology undergraduates intensively.

ObjectiveTo investigate the role of iNOS in the middle and late stage of pulmonary hypertension (PH) and the effect of L-Arginine(L-Arg) on these stage.MethodsThirty healthy male SD rats were randomly divided into five groups.All rats except those in control group were injected intraperitoneally (ip) with a single dose (50 mg/kg) of MCT to induce PH.Then the L3 and L5 groups were injected ip with 500 mg/kg L-Arg daily for 3 weeks and 5weeks respectively,the M3 and M5groups received a daily ip injection of the same amount of saline as L-Arg for 3 weeks and 5 weeks respectively; the same amount of saline was injected ip daily in control group for 5 weeks.Right ventricular systolic pressure(RVSP) was measured before lungs were excised for immunohistochemistry at the end of experiments. ResultsThe expressions of iNOS and elastin in M3 and M5 were higher compared to the control group,but L-Arg partly reduced the expressions of iNOS and elastin both at 3weeks and 5 weeks post-MCT.The reduction of eNOS expression in L3 and L5 groups were lower compared to M3 and M5 groups,but the eNOS expression in L3 and L5 groups were still lower than control group.ConclusionDuring the middle and late stage of PH,the expression of eNOS was decreased.The expression of iNOS was induced,which would produce numerous NO.However,these NO had no benefit on the development of PH.L-Arg could restore the balance of eNOS and iNOS,and could inhibit the development of PH,which may provide a new clues to explore the pathogenesis and treatment of PH.

Objective To evaluate the feasibility and clinical effect of stage Ⅰ posterior vertebral corpectomy filled with titanium mesh cages plus long-segmental instrumentation for treatment of Denis type D and E severe unstable thoracolumbar burst fracture.Methods A retrospectively review was made on 14 patients with Denis type D and E severe unstable thoracolumbar burst fracture,having had posterior vertebral corpectomy,titanium mesh bone grafting and long-segmental pedicle screw fixation.Parameters recorded were operation time,amount of bleeding,bone fusion and reduction,postoperative complications,low back pain,neurological performance,restoration and loss of anterior vertebral height,correction and loss of kyphosis,and intraspinal space occupying lesion.Results Mean operation time was 207.1 min (range,148-306 min) and blood loss was 585 ml (range,300-1,500 ml).Intraoperative fracture reduction was satisfactory.Follow-up ranged from 18 to 54 months (mean,28 months),which showed no complications of infection,screw-rod breakage,loosening or shifting of the internal fixation device,titanium mesh subsidence and pseudarthrosis,and no signs of adjacent segment degeneration.Six months after operation,CT scan showed bony fusion of the bone-implant interface.At the final follow-up,the Denis pain scale improved significantly including 12 patients with completely relieve of pain (P1) and 2 ache slightly but no need of taking painkiller (P2).Neurological functions were improved by 1-3 degree in all patients.Percentage of anterior vertebral height was (41.2 ± 8.9)％ before operation,significantly reduced to (8.3 ± 4.8) ％ one week after operation and to (8.9 ± 5.1) ％ at the final follow-up (P ＜0.01).Mean loss of anterior vertebral height was 0.6％.Sagittal kyphotic angle was (36.9 ± 4.9) °before operation,significantly reduced to (8.1 ± 3.4) ° one week after operation and (8.5 ± 3.8) °at the final follow-up (P ＜0.01).Mean loss of kyphotic angle was 0.9°.Ratio of intraspinal space occupancy was (74.9 ± 11.3) ％ before operation but recovered to (4.1 ± 1.6) ％ one week after operation and (1.8 ± 1.4) ％ at the final follow-up,with significant differences in pair comparison (P ＜ 0.01).Conclusion The use of posterior vertebral corpectomy and fusion with titanium mesh cage fusion in conjunction with long-segment instrumentation are effective for spinal canal decompression,fracture reduction,three-column reconstruction as well as rigid fusion at one stage,lumbar pain relief,neurological function recovery,prevention of correction loss and vertebral height restoration.

BACKGROUND:Studies have shown that paeoniflorin functions as replenishing blood and treatment of autoimmune diseases, and bone marrow mesenchymal stem cels also play an important role in the body’s blood and immune function. However, paeoniflorin effects on bone marrow mesenchymal stem cel proliferation and cytokine secretion and expression are rarely reported. OBJECTIVE:To investigate the effect of paeoniflorin on proliferation of bone marrow mesenchymal stem cels and the expression of interleukin-6. METHODS:Human bone marrow mesenchymal stem cels were separated and culturedin vitro by density gradient centrifugation combined with attachment method. The biological characteristics of bone marrow mesenchymal stem cels were identified by flow cytometry and osteogenic/adipogenic induction. The proliferation of bone marrow mesenchymal stem cels under different concentrations of paeoniflorin was detected by MTT method. The mRNA expression and secretion of interleukin-6 in the supernatant of bone marrow mesenchymal stem cels were detected by RT-PCR and ELISA, respectively. RESULTS AND CONCLUSION: Bone marrow mesenchymal stem cels were isolated successfuly and had osteogenic and adipogenic differentiation potential. Compared with the controlgroup, 2 μmol/L and 10 μmol/L paeoniflorin significantly promoted the proliferation of bone marrow mesenchymal stem cels. 10 μmol/L paeoniflorin could significantly decrease the proportion of bone marrow mesenchymal stem cels in G0/G1 phase and increase this proportion in S phase. Compared with the control group, the experimental group could significantly increase the secretion and mRNA expression of interleukin-6 (P < 0.01). It is concluded that paeoniflorin at certain concentrations can obviously promote the proliferation of bone marrow mesenchymal stem cels, and increase the expression and secretion of interleukin-6.

AIM: To evaluate the different surgical methods on the function of tear film after pterygium surgery.

METHODS: A retrospective case series study, a total of 106 pterygium patients(106 eyes)were randomly divided into two groups, 50 patients(50 eyes)received pterygium excision combined with amniotic membrane transplantation served as membrane group, 56 patients(56 eyes)received pterygium excision combined with autologous limbal stem cell transplantation served as stem cell group. Respectively before surgery and 1mo, 3mo after surgery, the BUT, SⅠt, OSDI were checked. The data were compared and analyzed.

RESULTS: There were significant differences in different times of two groups.(1)Compared between groups, before operation and 1mo after surgery. There were no significant differences among BUT, SⅠt and OSDI(P>0.05). But 3mo after surgery, BUT and SⅠt of the stem cell group was higher than the membrane group(P<0.05). OSDI of the stem cell group was better than the membrane group(P<0.05).(2)Compared within group, BUT, SⅠt and OSDI were no significant differences between before operation and 1mo after surgery(P>0.05), but there were significant differences between 3mo after surgery and 1mo after surgery, before operation(P<0.05).

CONCLUSION: The function of tear film was restored by pterygium excision combined with amniotic membrane transplantation or combined with autologous limbal stem cell transplantation, and the later was better than the former in effect.