Objective To observe the effects of alendronate sodium and alfacalcidol on the parameters of atherosclerosis in old women with type 2 diabetes mellitus(T2DM ) complicating osteoporosis .Methods 28 old women with T2DM complicating osteopo-rosis were taken as the osteoporosis group and 25 old women with T2DM and without osteoporosis were taken as the control group .Alendronate sodium(70 mg/week) and alfacalcidol(0 .5 μg/d) were given to the osteoporosis group for 12 month .The pa-rameters of the bone mass density (BMD)of femoral neck and ,T value ,arkle brachial index (ABI) ,cardio-ankle vascular index (CAVI) and carotid artery intima-media thickness(IMT) ,blood fat and glycosylated hemoglobin were observed .Results Com-pared with the control group ,BMD ,T value and ABI in the osteoporosis group were significantly decreased (P<0 .01) ,while CAVI and IMT were obviously increased(P<0 .05) .Compared with before treatment ABI ,CAVI and IMT after 12 month treatment in the osteoporosis group had no significant changes ,but BMD and T value of femoral neck and ward triangle area were significantly increased(P<0 .05) ,the atherosclerosis degree after 12 months in the control group was significantly aggravated (P<0 .05) .BMD and T value had no obvious change .Conclusion Alendronate sodium combined with alfacalcidol for treating T 2DM complicating os-teoporosis can improve the atherosclerosis parameters and has certain role in preventing and treating cardiovascular and cerebrovas-cular diseases .

Objective To investigate the clinical efficacy and safety of low-dose rituximab (RTX) for patients in primary Sj(..o)gren's syndrome (pSS) with thrombocytopenia.Methods Four pSS patients,2 with refractory thrombocytopenia and 2 with glucocorticoid-dependent thrombocytopenia,were treated with rituximab at 100 mg,intravenous,weekly for a total of two cycles,together with prednisone 1-2 mg · kg-1 ·d-1,and the counts of platelets and B-cells were evaluated.Results Efficacy of treatment was observed in all patients.The counts of platelets,at (3-39) x 109/L baseline,incleased in 1-2 weeks,and went up to ( 107-241 ) × 109/L in 3-8 weeks.Sustained remission had been achieved for 27-52 weeks.The doses of prednisone were tappered to 3.75-7.50 mg/day in 12 weeks.One patient who relapsed at the 27th week (platelet count 47 x 109/L),was retreated with 100 mg of RTX and still had good efficacy.The counts of B-cells reduced to (0.007-0.010) × 109/L,but they did not achieved the depletion.There were no severe adverse events during RTX therapy.Conclusions Our study has shown good efficacy and tolerability of lowdose RTX for pSS with thrombocytopenia.Low-dose RTX allows for reduction in corticosteroid doses and B-cells,while large-scale randomized double-blind controlled trials are needed to confirm the results.

Objective To evaluate the efficacy and safety of hydroxychloroquine sulfate (HCQ) on pregnancy outcomes in patients with systemic lupus erythematosus (SLE). Methods One hundred and sixty-six pregnant patients with SLE from Janurary 2010 to December 2015 were studied retrospectively . Fifty-two patients were excluded due to new-onset during pregnancy, active disease or termination of pregnancy as a result of continuous intaking of immunosuppressant. The remaining 114 SLE patients in stable condition before pregnancy were divided into the following two groups: prednisone combined with HCQ and prednisone alone. The effects of HCQ on disease activity and pregnancy outcome were analyzed. Differences between groups were analyzed by chi-square test. Results A total of 90 patients (78.9%) had successful pregnancy. Among 71 patients treated with prednisone combined with HCQ, 60 patients (84.5%) had no disease flare and 62 cases (87.3%) had successful pregnancy. Among 43 patients treated with prednisone alone, 28 patients (65.1%) had no disease flare and 28 cases (65.1%) had successful pregnancy. No abnormality of neither visual field nor fundus was observed among patients treated with HCQ. No congenital abnormalities were found among new born infants. Conclusion HCQ intake during pregnancy in SLE patients can reduce disease flare and improve the pregnancy outcome, indicating that HCQ is safe for SLE patients during pregnancy.

Objective To investigate the effect of three kinds of low molecular weight heparin combined with methylprednisolone on the high coagulation state and renal function in patients with refractory nephrotic syndrome.Methods 140 cases of refractory nephrotic syndrome were divided into four groups, 35 cases in each group.The control group were treated with methylprednisolone.Small, medium, and large dose group in the control group on the basis of the treatment, were given low molecular weight heparin on once every other day, once daily, twice daily treatment, 3075 AxaIU per times.The improvement of renal function and high coagulation state were compared between the four groups before and after treatment.In the course of treatment, the occurrence of adverse reactions was recorded.Results Remission rate in large, medium and small dose group remission rate was higher than the control group(χ2 =4.375,P<0.05); there was no significant difference in remission rate of three different dose groups.The 24h urine protein and ALB of the four groups after treatment were significantly increased, BUN and SCr were significantly lower(P<0.05).The 24h urine protein, ALB, BUN, SCr of improvement of large, medium and small dose group were significantly better than the control group( P<0.05).The 24 h urine protein, ALB, BUN, SCr in large dose group improved significantly better than those in small dose group(P<0.05).The APTT, PT in large, medium and small dose groups after treatment increased significantly, FIB decreased significantly(P<0.05).The improvement of FIB, APTT, PT in large, medium and small dose group were significantly better than the control group after treatment ( P <0.05 ).The FIB, APTT, PT in large dose group improved significantly better than those in medium and small dose group ( P <0.05 ) .Conclusion The low molecular weight heparin combined with methylprednisolone can significantly improve hypercoagulable state and renal function in the patients with refractory nephrotic syndrome, and the large dose of low molecular weight heparin effect is the best, and no significant adverse reactions occurred.

Objective To investigate the clinical characteristics of bronchopulmonary amyloidosis secondmy to primary Sj(0)gren's syndrome (pSS).Methods One patient in our series and 42 patients in the literatures were analyzed.The clinical manifestations,imaging features,diagnosis,treatments and prognosis of these patients were described respectively.Results Among the 43 cases,42 patients were female (98％).The median age was 57 (range 29-79) years.The diagnosis of bronchopulmonary amyloidosis was made subsequently to that of pSS with a median delay of 8.9 (range 0-30) years.Thirty-eight cases (88％) were localized amyloidosis.Most cases were related to AL amyloidosis (21/28,75％ ).The main clinical manifestations included cough (18/38,47％),short of breath (13/38,34％ ),sputum (9/38,24％) and hemoptysis (5/38,13％ ).Nine patients (9/38,24％ ) had no clinical symptoms.The most common patterns of radiological manifestations included multiple nodules (40/43,93％),multiple cysts or bullae (16/43,37％),interstitial lung disease (16/43,37％ ),irregular luminal narrowing and airway wall thickening (8/43,19％ ).The pulmonary function test was done in 17 patients,which revealed moderate to severe reduced diffusion capacity for carbon monoxide (8/17,47％ ).The diagnosis of amyloidosis was made based on pathological findings in all cases.Pathologic examination showed diffuse deposits of amorphous,eosinophilic,Congo-red positive staining material.The treatments were symptomatic.The prognosis of most patients was good.The median follow-up time was 26.5 (range 2-96) months,only 2 patients died during the follow-up.Conclusion The bronchopulmonary amyloidosis secondary to pSS is localized amyloidosis in most cases.Clinical manifestations depend on the location and extent of airway lesions.The appearance of multiple lung nodules with calcified or cysts in chest images should be considered as secondary amyloidosis.No specific therapy is available for these cases,however,this condition in majority of patients progresses slowly.

Objective To investigate the association between the results of Dermatophagoides pteronyssinus ( Der p) and Dermatophagoides farinae ( Der f) allergen SPT and serum sIgE in diagnosis of IgE-mediated mite allergy.Methods A total of 166 allergic outpatients with positive expression of serum sIgE of Der p and Der f diagnosed in Beijing Tongren Hospital,the General Hospital of Shenyang Military Region and Guangzhou Institute of Respiratory Disease were enrolled in the study.The SPT was performed by injecting liquid containing the allergen of Der p and Der f.One hundred ninety healthy subjects with negative serum sIgE of Der p and Der f were assigned as controls according to paired design ratio,1 to 1.The sensitivity and specificity of SPT used Der p and Der f allergen were evaluated in the diagnosis of mite allergy.The association between the results of SPT and serum sIgE was analyzed by linear regression method.Results In the allergic group,the positive rates of SPT for Der p and Der f were 98.80％ ( 164/166) and 95.18％ (158/166) respectively.In the control group,the positive rate of STP for Der p and Der f were 2.11％ (4/190) and 1.58％ (3/190) respectively.The SPT results of Der p and Der f showed significant statistical difference between healthy subjects and allergic patients (x2 =285.5,386.3;P＜0.01 ).The sensitivity and specificity of the SPT were 98.80％ (164/166) and 97.89％ (186/190) for Der p and 95.18％ (158/166) and 98.42％ (187/190) for Der f,respectively.There was a significant association between SPT and sIgE with linear correlation analysis( r =0.737,0.708;P ＜ 0.O1 ).Conclusions Both SPT of Der p and Der f is highly sensitive and specific.At the same time,SPT has a significant positive correlation with sIgE.It can be used as an accurate,convenient and fast test in diagnosis of mite allergic diseases.

Objective To study the association between house dust endotoxin levels and the airway responsiveness as well as allergen sensitization in adolescence in the urban and rural areas of Guangdong province.Methods Middle school students,aged 13-14,188 (male 109,female 79) from Guangzhou,129(male 70,female 59) from Conghua with positive responses,and 231 (male 125,female 106) and 307(male 145,female 162) of their respective reference students are selected from questionnaire prescreening.A detailed questionnaire,the lung function test,histamine bronchial provocation test,skin prick test and peripheral blood eosinophil count are undertaken.Seventy-six students from Guangzhou and 80 from Conghua were selected randomly for mattress dust sample collection to detect the levels of endotoxin.Results The prevalence of wheeze symptom,diagnosed asthma,nasal symptoms and allergic rhinitis of Guangzhou was significantly higher than that of Conghua (P＜0.0001),with 28.6％,27.7％,66.0％,46.4％ for Guangzhou respectively,and 5.0％,2.5％,31.0％,6.2％ for Conghua respectively.The positive rates of bronchial provocation test and skin sensitization against Dermatophagoides pteronyssinus(Der.p),D.farinae (Der.f),cat and dog allergen in the students of Guangzhou were significantly higher than that of Conghua (P＜0.0001).The positive rate of cockroach of Conghua was significantly higher than that of Guangzhou (P＜0.0001).The levels of endotoxin (amount,concentration and load) of samples from Conghua were significantly higher than that from Guangzhou (Conghua:6452 EU,10.95 EU/mg,1794 EU/m2 ;Guangzhou:1591 EU,6.45 EU/mg,508.80 EU/m2,respectively).PD20-FEV1 was correlated positively with endotoxin amount(r=0.174,P＜0.05).The diameters of the skin wheal size for Der.p and Der.f were correlated inversely with endotoxin amount and load (P＜0.001).Conclusion The prevalence of wheeze symptom,diagnosed asthma,nasal symptoms and allergic rhinitis in 13-14 year-old adolescent of Guangzhou was significantly higher than that of Conghua.Cockroach was the second major allergen of Conghua followed by house dust mite.The level of endotoxin was correlated positively with PD20-FEV1,but correlated inversely with skin sensitization to Def.p and Der.f.The study suggests that environmental endotoxin may have effect to protect children from developing allergic diseases.

ObjectiveTo study the effects and feasibility of Smart Equitest Balance Master training for severe balance disorder caused by cerebellar hemorrhage in children. MethodsA 10-year-old boy with severe ataxia caused by cerebellar hemorrhage were trained with Smart Equitest Balance Master. He was assessed with Smart Equitest Balance Master, Modified Barthel Index and Berg Balance Scale. ResultsAfter 22 weeks of balance training, he improved in equilibrium, gait, posture control, activity of daily living, dysarthria, and return to school to continue his study. ConclusionSmart Equitest Balance Master training can significantly improve balance function，motor function and activities of daily living after cerebellar hemorrhage.

BACKGROUND: In recent years, myocardial tissue engineering has developed rapidly. By using exogenous biomaterials to simulate extracellular matrix, damaged myocardial cells can be effectively repaired or reconstructed, which has great potential value in the treatment of ischemic heart diseases such as myocardial infarction. OBJECTIVE: To review the research progress of myocardial scaffolds in the treatment of myocardial infarction. METHODS: NCBI and WanFang databases were retrieved for relevant articles published from 2008 to 2018, with the key words of "myocardial scaffold materials, myocardial infarction" in English and Chinese, respectively. RESULTS AND CONCLUSION: At present, the commonly used myocardial scaffolds are mainly natural biomaterials (including collagen/Matrigel, fibrin, chitosan, hyaluronic acid, and algae hydrochloric acid) , synthetic materials (polyester synthetic materials and nanomaterials) and composite scaffolds. Due to the complexity of cardiac environment and heart function, the selection of scaffold materials should fully take account of biocompatibility, immunogenicity, conductivity, degradation rate and susceptibility to ischemia and hypoxia. Although many scaffold designs have begun to meet many requirements, there are still many kinds of stent materials for clinical application. It is believed that with the further development of researchers and application tools, people can expect to create myocardial scaffolds close to the physiological function of the original tissue, so that the heart function can be better restored.

Objective To investigate feasibility of CM-Dil labeling mesenchymal stem cells in vitro.Methods We separate,culture and identify rat bone marrow mesenchymal stem cells,after labeling MSCs with CM-Dil concentration respectively in 1,2,4μg/mL,observe label rate of MSCs after 15 min,24 h,48 h,72 h,5 passage and 8 passage,then detect cell cycle with FCM and cell proliferation capability with CCK8.Results MSC cultured with the whole bone marrow adherent method were strongly positive for CD44,CD29 and negative for CD34,CD45.The label rates of MSC 15 min after labeled with CM-Dil 1,2,4 μg/mL were respectively (31.60±1.25)％,(88.73±1.79)％,(96.89±1.31)％,and there has statistically difference (F=1 757.21,P=0.000);the growth curve of the 4 groups was similar,and the percentages of G1 phase,S phase and G2/M phase between the 4 groups have no statistically difference (P＞0.05).Conclusion CM-Dil in concentration 4 μg/mL has high label rate and low cytotoxicity,therefore could be a efficient and stable method of labeling MSCs.