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.

AIM: To further investigate the immunologic mechanism of myasthenia gravis(MG). METHODS: Acetylcholine receptor antibodies(AchRab) and presynaptic membrane antibodies (PsMab) was determined by ELISA in 285 cases of MG patients. Tumor necrosis factor- alpha(TNF-?) and RBC-C3b receptor rosette rate(RBC-C3bRR)and RBC-IC rosette rate (RBC-ICR)was determined in 202 patients with MG. Furthermore, the peripheral blood lymphocyte subsets was examined in 104 cases MG patients. RESULTS: The positive rates of the AchRab and PsMab in MG were very significantly higher than that of control.The positive rate of PsMab in patients with negative AchRab was very significantly higher than that of patients with the positive AchRab.In 202 MG patients, the TNF-? was significantly higher, but the RBC-C3bRR was significantly lower than those of control, while the RBC-ICR has no significant change. CONCLUSION: MG is an autoimmune disease with damaged postsynaptic membrane by the AchRab, and some patients with both the AchRab and PsMab could manifest disfunction in the postsynaptic and presynaptic membrane. While the patients who just has the PsMab maybe damaged only in the presynaptic membrane. Other body fluid immune or/and cell immune mechanism may be involved in MG patients without AchRab and PsMab. [

Objective To examine the effectiveness and safty of intraperitoneal injection of rapamycin on epileptogenesis in a rat model of pentylenetetrazole-induced kindling epilepsy. Method The Sprague Dawley rats at 6-8 weeks old were randomly divided into group PTZ+RAPA and group PTZ+NS. The body weight, mortality and seizures were recorded at 1, 4 and 6 weeks after treatment. Mossy fiber sprouting in the hippocampal CA3 area and DG area was examined by Tim staining. Results 1.The rats mortality was 22.9% in PTZ+RAPA and 10.4% in PTZ+NS. Weight alteration was statistically significant between PTZ+RAPA and PTZ+NS at the corresponding time points (P< 0.001); 3. The kindling rate was 66.7% in PTZ+RAPA and 58.3% in PTZ+NS at 6 weeks and the difference was statistical significant between these two groups (P>0.05). There was no statistical significance in the seizure scores be-tween PTZ+RAPA and PTZ+NS (P> 0.05). 4.The scores of mossy fiber sprouting in hippocampal CA3 and DG areas was higher in PTZ+NS than in PTZ+RAPA (P<0.05). Conclusion Rapamycin cannot reduce or curb epileptic seizures in young rats. It can obviously reduce the weight of the young SD rats which may be associated with its side effects.

Objective To analyze the internal fixator remove time in different age patients after non-fusion cross injured vertebral screw of thoracolumbar vertebral fracture. Methods Sixty-eight patients who had underwent non-fusion cross injured vertebral screw were divided into 2 group according to the age:young group (20-44 years, 36 cases) and middle aged group (45-59 years, 32 cases). The numeric rating score (NRS), Oswestry disablility index (ODI), discoideum index (DI) and kyphotic Cobb angle 6, 9, 12 and 15 months after surgery were compared between 2 groups. Results The kyphotic Cobb angle, ODI and NRS 9, 12 and 15 months after surgery in 2 groups were significantly lower than those 6 months after surgery, which was in young group: (37.34 ± 6.86)° , (36.81 ± 6.78)° and (36.90 ± 6.97)° vs. (56.31 ± 3.56)° , (2.45 ± 0.55)%, (2.24 ± 0.53)% and (2.09 ± 0.41)% vs. (3.02 ± 0.89)%, (18.46 ± 2.73), (18.44 ± 3.05) and (18.28 ± 2.98) scores vs. (19.79 ± 2.85) scores, and in middle aged group: (37.11 ± 6.80)° , (35.58 ± 5.48)° and (35.40 ± 5.44)° vs. (56.03 ± 3.68)° , (2.21 ± 0.41)%, (2.08 ± 0.43)%and (1.97 ± 0.39)%vs. (3.04 ± 0.93)%, (19.17 ± 2.99), (18.57 ± 2.98) and (18. 43 ± 2.92) scores vs. (20.95 ± 2.49) scores. There were statistical differences (P<0.05). The DI 12 and 15 months after surgery in young group were significantly lower than that 6 and 9 months after surgery:(50.59 ± 4.60)%and (47.57 ± 4.30)%vs. (56.60 ± 3.98)%and (56.32 ± 3.87)%, and there were statistical differences (P<0.05). The DI 15 months after surgery in middle aged group was significantly lower than that 6, 9 and 12 months after surgery:(47.95 ± 4.87)%vs. (56.34 ± 3.97)%, (56.13 ± 3.88)%and (55.63 ± 3.94)%, and there were statistical differences (P<0.05). Conclusions The internal fixator remove time in the young patients after non-fusion of cross injured vertebral screw of thoracolumbar vertebral fracture is 9 months after surgery, and in the middle aged patients is 12 months after surgery. Intervertebral disc degeneration is one of the risk factors for delayed removal.

The guidelines for the early management of patients with ischemic stroke from the American Heart Association/American Stroke Association in 2013 recommend antiplatelet therapy with aspirin alone,but did not recommend other antiplatelet agents and the combination of a variety of antiplatelet drugs.However,since 2013,a great deal of published literature has shown that dual antiplatelet agents are superior to single antiplatelet agent in the prevention and treatment of ischemic stroke and transient ischemic attack.In addition,they evaluated the safety of the treatment of dual antiplatelet therapy.

Objective To examine the expression of IgA1 and B1a positive cells in palatine tonsils of IgA nephropathy (IgAN) patients, and to analyze the association between B1a cells and clinicopathological changes. Methods Eight patients diagnosed as IgAN by renal biopsy and 8 chronic tonsillitis patients without nephritis as control were enrolled in the study.Immunofluorescence and laser scanning confocal microscope (LSCM) were applied to observe the localization and quantitative calculation of Bla and IgA1 positive cells. Statistic analysis of the association of B1a cells with proteinuria and pathological Lee's grading was performed. Results Bla cells were mainly localized in germinal center of tonsil, and IgA1 positive cells were mainly localized in subepithelium of tonsil. Compared to control group, the percent of B1a cells and IgA1 positive cells was significantly higher in IgAN (P＜0.01). There was a positive correlation between Bla cells and IgA1 cells (P＜0.05). In IgAN, the percent of B1a cells in patients with hematuria and proteinuria was obviously higher than that of patients with hematuria only (P＜0.05). The number of Bla cells in IgAN patients with≥Lee's grade Ⅲ was significantly higher than that of those ＜ grade Ⅲ (P＜0.05). Conclusions IgA1 may be secreted by Bla cells in the tonsil of IgAN patients. The number of B1a cells is correlated with exacerbation of proteinuria and pathological severity, which may play an important role in pathogenesis of IgAN.

Objective To examine the correlation of urinary podocyte number and giomerular podocalyxin expression with clinicopathology in IgA nephropathy(IgAN)patients. Methods Morning urinary specimens(100 ml)3 days before renal biopsy from 50 patients with IgAN diagnosed by renal biopsy and from 20 healthy volunteers as control were collected. After centrifugation, 300 μI sediment was used for smear. Immunohistochemical staining with monoclonal anti-podocalyxin antibody was performed to detect urinary podocytes and the number of podocyte was counted under optical microscope. Computer image analysis system was used to examine glomerular PCX expression. Renal pathology and classification were investigated based on Lee's grading and Katafuchi semi-quantitative integration method. Relevance analysis was carried out on urinary podocyte number, glomerular PCX expression with pathological score and clinical data. Results The amount of urinary podocytes in IgAN was obviously higher than that in healthy controls(P<0.01). Significant differences were found in multiple comparison of the median of urinary podocytes among Lee's grade groups. I - II group was lower as compared to Ⅲ , Ⅳ, Ⅴ groups(all P<0.05). Ⅲ group was lower as compared to V group(P<0.05). The positive rate of urinary podocyte was the highest in Ⅳ and V groups(100%), while the lowest in Ⅰ - Ⅱ group(55%). Glomerular PCX expression in IgAN decreased with the aggravation of renal pathology. Significant differences were found in multiple comparison of the glomerular PCX expression with the pathological score. Lee's Ⅰ - Ⅱ group was higher as compared to Ⅲ, Ⅳ, Ⅴ groups(all P<0.05). Ⅳ and Ⅳ groups were higher as compared to V group(P<0.05). In IgAN, urinary podocyte excretion was negatively correlated with glomerular PCX expression(r=-0.702, P<0.01), positively correlated with 24-hour urinary protein(r=0.465, P<0.01)and positively correlated with glomerular and tubular scores(r=0.233, 0.307, P<0.05). Glomerular PCX expression was negatively correlated with 24-hour urinary protein(r=-0.367,P<0.05)and negatively correlated with glomerular and tubular scores(r =-0.560, -0.377, P <0.05). Conclusions Injury and desquamation of glomerular podocytes may involve in the development of IgAN. The number of urinary podocyte can reflect the loss of podocytes in renal tissue, which may be used as a marker of disease progression of IgAN.

Objective To investigate the role of the neuropsychological tests and functional imaging in differentiation between multiple system atrophy parkinsonism-predominant (MSA-P) and multiple system atrophy predominant cerebellar ataxia (MSA-C) or idiopathic Parkinson' s disease (PD).Methods We collected three groups of patients including MSA-P (n =8),MSA-C (n =13),idiopathic PD (n =13),and control group (n =13) between December 2012 and November 2013 in General Hospital of People's Liberation Army.We then compared the scores of neuropsychological assessment and parameters obtained from diffusion tensor imaging (DTI) examination among the four groups.Results (1) MSA-P group had longer time-consuming of trail-making test((103.7 ± 25.9) s) and lower graphic symbol test scores (20.9 ±6.1) than that of the MSA-P group ((80.9 ± 29.1) s ; 28.1 ± 7.4) and PD group ((72.0 ± 19.6) s ;29.0 ± 9.4 ; all P ＜ 0.05).(2) Mean diffusivity (MD) in both putamen (8.01 ± 0.76,7.91 ± 0.74) and the left substantia nigra (8.31 ± 0.43),thalamus (8.30 ± 0.69),external capsule (8.12 ± 0.32) of MSA-P group was significantly different from that of MSA-C group (7.27 ± 0.42,7.34 ± 0.3 1,7.58 ±0.81,7.81 ±0.34,7.70 ±0.44) and PD group (7.35 ±0.43,7.45 ±0.43,7.66 ±0.45,7.72 ±0.40,7.56 ± 0.37) ; Significantly higher MD in both middle cerebellar peduncle (8.54 ± 0.74,8.28 ± 0.71),medulla oblongata (8.32 ± 0.61) was demonstrated in MSA-C group than that of MSA-P group (8.54 ±0.74,8.28 ±0.71,8.32 ±0.61),PD group (7.25 ±0.70,7.30 ±0.66,7.65 ±0.50) and control group (6.94±0.39,7.08 ±0.32,7.44 ±0.41; all P＜0.01).(3) Fractional anisotropy (FA) in the left external capsule (0.45 ± 0.35) and right thalamus (0.28 ± 0.27),occipital lobe (0.47 ± 0.87) in MSA-P group was significantly different from that in MSA-C group (0.48 ± 0.36,0.23 ± 0.24,0.49 ± 0.49 ; P ＜0.05) ; FA in the left occipital lobe (0.46 ± 0.10) in PD group was significantly different from that in MSAP group (0.56 ± 0.82 ; P ＜ 0.01).Conclusion Trail-making test,graphic symbol test and DTI can be used to differentiate MSA-P type from MSA-C type or PD.

Objective To explore the relationship between glycated albumin ( GA ) in 2 consecutive months and hemoglobin A1c ( HbA1c) in diabetes patients.Methods Totally 100 consecutive patients with main diagnosis of diabetes mellitus were enrolled retrospectively from April 2015 to January 2016 in outpatient clinic of endocrinology of Peking Union Medical College Hospital, who had undertaken GA tests every 4 weeks for 2 successive months and had HbA1c test in the second month.GA was measured with liquid enzymatic method. HbA1c was measured by ion-exchange high performance liquid chromatography.The relationship between HbA1c and GA for the 2 successive months was determined.Results A total of 85 patients were enrolled.The regres-sion equation between HbA1c (y) and average GA (j) for successive 2 months was y=3.187+0.218j (adjusted R2 =0.520, P=0.000), which showed a similar effect as the regression equation for HbA1c and the levels of GA tested for the 2 successive months (adjusted R2 =0.514, P=0.000), and both had more significant regressive effect than the regression equation for HbA1c and single measurement of GA (adjusted R2 =0.392, P=0.000). Conclusions The regressive effect between HbA1c and GA (or the average of GA) in successive 2 months is bet-ter than that with single measurement of GA, hence could better predict HbA1c in clinical practice.

To explore novel non-opioid analgesic agents, 16 compounds were synthesized and their structures were confirmed by 1H NMR and HR-MS. YX0611-1 was treated as the leading compound. The results of mice writhing model and hot plate model showed that compounds 2, 7, 8, 9, 11 and 15 had obvious analgesic activities in vivo. The test of affinity to mu, delta, kappa receptor displayed that active compounds didn't act on opioid receptor. The results of preliminary toxicity and pharmacokinetic tests showed that compound 7 had better safety and pharmacokinetic properties than that of YX0611-1, and it deserved further development.