Objective To explore the effect and safety of rituximab (RTX) in children with frequently relapsed nephrotic syndrome.Methods Twelve children (8 male and 4 female) with frequently relapse nephrotic syndrome were treated with RTX.They all showed resistance to various immunosuppressive agents and relapsed when steroid was reduced at 1.5-2.0 mg/kg.All immunosuppressive agents were stopped.Steroid was prescribed at doses of 2 mg/(kg · d),followed by alternate-day dosing (2 mg/kg) after proteinuria was negative for 5 days,and then tapered by 5 mg every 2 weeks until to low dose (＜ 0.5 mg/kg on alternate day) or discontinued.RTX was administered at a dose of 375 mg/m2 once every week for 3 weeks.Results The patients were followed up for 4-19 months [median (7.79 ± 3.00) months].Proteinuria turned negative on 1-14 d after first RTX treatment.Mean steroid dosages were significantly reduced than before treatment [alternate-day dosing (1.83 ± 1.02) mg/kg vs alternate-day dosing (0.34 ± 0.16) mg/kg,t =3.78,P =0.002].Gingival hyperplasia and Cushing appearance were significantly improved and steroid-induced glaucoma disappeared.The height was significantly increased compared with before treatment [(2.21 ± 1.40) cm/year vs (8.27 ±2.10) cm/year].Six cases had no relapse during follow-up.Another 6 cases relapsed in 5.5-19.0 months.All patients showed CD19 + B lymphocytes depletion after RTX treatment.However,CD19 + recovery could be seen in 5.5-12.0 months.Serum immunoglobulin did not significantly change.None of the patients was found with adverse events.Conclusions RTX can significantly reduce the dosage of steroid or even stop medication in children free of immunosuppressive agents,maintain remission for (7.79 ± 3.00) months,significantly improve the adverse reaction induced by steroid and immune-suppression.Thus,for children with frequently relapsed nephritic syndrome/steroid-dependent nephrotic syndrome who show resistance to immunosuppressive therapies,RTX treatment may be considered.

?AIM:To study the clinical value of non-steroidal anti-inflammatory drug in adjuvant treatment of intravitreal triamcinolone acetonide ( IVTA ) for macular edema caused by retinal vein occlusion ( RVO) .?METHODS: Forty - eight eyes in 48 patients were randomly divided into trial and control group ( 24 eyes each ) in this prospective study. In the trial group, additional pranoprofen drops was administered from 1d before IVTA to 30d after injection. Central foveal thickness ( CFT ) was measured with optical coherence tomography ( OCT ) . Available documents of best corrected visual acuity ( BCVA ) , CFT, intraocular pressure and complications pre- and post-injection at 3d, 1,2wk, 1 and 3mo were evaluated.?RESULTS: After IVTA, BCVA was improved in both groups at different levels; but there was no statistically significant between two groups at each time point ( P>0. 05). The CFT values were 629 ± 43μm vs 605 ± 57μm before IVTA in the trail vs control groups (P>0. 05). The values were 432±74μm vs 511±32μm (t=7. 533, P<0. 05), and 275±54μm vs 379±29μm (t=13. 212, P<0. 05) of the trial vs control groups at 1 and 3mo after IVTA, respectively. Ocular hypertension occurred in 5 eyes after injection in trail group, and was controlled with anti-glaucoma medication and one eye with filtration surgery. Progression of cataract was noted in 3 of 35 phakic eyes and cataract surgery was performed in 2 eyes at 4-12mo after injection in trail group. Progression of cataract was noted in 4 eyes and cataract surgery was performed in 2 eyes at 4- 12mo after injection in control group. No retinal detachment and endophthalmitis happened during the whole period of follow-up.?CONCLUSION: Application of non - steroidal anti -inflammatory eye drops in perioperative period can be useful to improve the outcome of IVTA for macular edema, which needs further evaluation.

Purpose To report the c1inicopatho1ogica1 characteristics,diagnosis and differentia1 diagnosis of extranoda1 fo11icu1ar den-dritic ce11 sarcoma( FDCS)of the pharyngea1 region. Methods The c1inica1 features,histopatho1ogica1 changes and immunohisto-chemica1 findings were ana1yzed in three cases of FDCS with review of the re1ated 1iterature. Results Case 1,a 70-year-o1d man pres-ented with the comp1aint of a pain1ess mass in pharyngea1 region accompanied by shortness of breath for the past 2 months. Case 2,a 40-year-o1d woman presented with the comp1aint of pharyngea1 foreign body sensation and b1oody sputum for the past 1 month. Case 3, a 38-year-o1d man presented with the comp1aint of intermittent epistaxis for the past 2 months. 3 cases showed simi1ar morpho1ogies:the neop1astic ce11s were ovoid to spind1e-shaped,with indistinct ce11 borders,dispersed granu1ar chromatin,and scattered sma11 nuc1e-o1i. Notab1y,severa1 nuc1ear inc1usions were identified,and rare binuc1ear and mu1tinuc1eated ce11s were a1so present. There were main1y 3 kinds of growth patterns in the tumors:diffuse sheets,fascic1es,and storiform arrangements admixed with sma11 1ymphocytes, which sometimes gathered into a mass. Immunohistochemica11y,tumor ce11s( 3/3 )were strong1y and diffuse1y positive for fo11icu1ar dendritic ce11 markers CD21,CD23 and CD35. Tumor ce11s(3/3)were a1so diffuse1y positive for fascin and D2-40. Some tumor ce11s (1/3)were diffuse1y positive for CXCL-13. Ki-67 pro1iferation index was estimated at 6%-20%. Conclusions Extranoda1 FDCS of the pharyngea1 region is rare and misdiagnosis is frequent1y made. A comprehensive eva1uation of c1inica1 manifestations,patho1ogic features and immunohistochemica1 findings are essentia1 for definitive diagnosis.

Aged ; Cell Dedifferentiation ; Chondrosarcoma ; pathology ; Humans ; Ribs ; pathology

OBJECTIVETo obtain more information on DNA fingerprintings and to confirm the genetic relationships of ten wide populations of Pinellia tornata.

METHODCollect wide-type or cultivated P. tornata from ten major production areas nation-wide as material. Twelve combinations of EcoR I and Mse I primers were used to asses divergence among ten populations. The data were analyzed using unweighted pair-group method, based on arithmetic averages (UPGMA) bootstrap analysis. Cluster analyses were performed by using NTSYSpc software version 2.1. The alkaloid was extracted from P. ternate with chlorolform and determined in UV absorption spectroscop.

RESULT1,673 bands were applied with 12 combinations. These results of cluster were congruent with differences in total alkloids.

CONCLUSIONThe results of the study showed a potential application of AFLP fingerprinting for identification of P. ternata.

Alkaloids ; analysis ; China ; Cluster Analysis ; DNA Fingerprinting ; DNA, Plant ; genetics ; Phylogeny ; Pinellia ; chemistry ; genetics ; Plants, Medicinal ; chemistry ; genetics ; Quality Control

Background The pathogenesiof age-related maculadegeneration (AMD) iassociated with the senility of human retinal pigmenepithelium (RPE) cells.Seeking drug to arresRPE cell senility iof significance fothe prevention and treatmenof AMD.Research showed thathe lycium barbarum polysaccharide (LBP) can delay senility,buitinfluence on RPE cell aging iunclear.Objective Thistudy wato discusthe protective effecand mechanism of LBP on RPE cell aging.MethodPorcine retinal neural epithelial layewaisolated,and photoreceptooutesegmen(POS) waextracted by density gradiencentrifugation and marked by FITC.The POwathen co-cultured with RPE cellin the medium containing 0.01,0.10 and 1.00 g/L LBP fo24 hours.The areof fluorescence,representing the amounof POphagocytosed by RPE cells,wameasured undethe fluorescenmicroscope to evaluate the influence of LBP on the phagocytifunction of RPE cells.The POS-induced RPE lipofuscin-uptake cell model waestablished by co-culturing human RPE cellwith porcine POfo3 weeks.The RPE-POco-culture cell model waincubated in medium containing 0.01,0.10 o1.00 g/L LBP,and the autofluorescence caused by lipofuscin up-taken into RPE cellwadetected with flow cytometry.cell counting kiwaused to assescell proliferation and viability (value) 24,48 and 72 hourafteculturing.ResultPorcine POpresented athin rodundethe lighmicroscope and appeared abilayedisc-like structureundethe transmission electron microscope,and itFITC-labeled yellow-green autofluorescence waobserved undethe fluorescenmicroscope.No POwaup-taken into the RPE cellin the normal control group,buthe areof POphagocytosed by RPE cellwagradually enlarged with increasing doseof LBP,showing significandifference among the group(F =21.425,P =0.006).Compared with the POcontrol group,the phagocytosed areincreased avariouconcentrationof LBP+POgroup(P＜0.01).Flow cytometry showed thathe autofluorescence value in the POcontrol group wamore highethan thaof the normal control group.Athe LBP dose increased,the autofluorescence value in the RPE celldeclined gradually and iwaneathe normal value in the 1.00 g/L LBP+ POgroup.The rate of proliferation of the lipofuscin RPE cellvaried with the increase of doseof LBP with the maximal value in the normal RPE group and minimal value in the lipofuscin RPE group,and the rate of proliferation of the lipofuscin RPE cellascended with increasing doseof LBP until neathe normal value in the 1.00 g/L LBP + lipofuscin RPE cellgroup (P＞0.05).ConclusionLBP enhance the anti-aging effecof human RPE cellby strengthening the phagocytiability to POand the ability to remove lipofuscin and by heightening the proliferation of human RPE cells.

Objective To determine the therapeutic effect of recombined rat insulin-like growth factory 1 gene and transforming growth factor beta-1(TGF-?_1)gene on anterior cruciate ligament transection(ACLT)- induced osteoarthritis-like changes in NZW rabbit knee joints.Methods Eighteen NZW rabbits were divided into 3 groups randomly after osteoanhritis was established by ACLT and another six rabbits were used as normal control group(group 1).Chondrocytes which had been transfected with IGF-1 gene,co-transfected with TGF-?_1 and IGF-1 gene(group 3,4)were injected into the rabbits knee joints.Experimental control group(group 2)only had ACLT bul was not transfected.After 4,8 weeks,rabbits were sacrificed and their joints were evaluated by morphological grades,histological examination,in situ hybridization examination,immunohistochemistry exami- nation,and transmission electron microscopy examination(TEM).Results The morphological grades showed that the normal control group had a very significant difference with the experimental control group(P

Background and purpose: Extraskeletal myxoid chondrosarcoma (EMC) is a malignancy of uncertain differentiation tumor characterized by a multinodular structure and abundant myxoid matrix. Its preferred sites were the deep soft tissues of the extremities. The aim of this study was to investigate the clinicopathologic characteristics, diagnosis and differential diagnosis of EMC. Methods: Seven cases of EMC were analyzed for clinicopathological and immunohistochemical features with review of the related literature. Results: It occurred predominantly in females (male/female=2︰5). Five cases were located in low extremities and two in upper limb girdles, more commonly near the joint. Grossly, the masses showed as grey, lobular and somewhat transparent with a relatively well-deifned margin. Microscopically, the small ovary or plump spindle-shaped cells arranged in strand and cord patterns and lobular architecture which separated by delicate fibrous networks with an abundant myxoid but hypovascular background. And the tumors were immunoreactive for vimentin, and partly for S-100 and EMA, meanwhile, negative for CK. Conclusion:EMC is a rare soft tissue sarcoma with distinctive histopathological features. It should be distinguished from some mimics especially those tumors with a myxoid stroma or chondroid differentiation, such as chordoma and chondrosarcoma.

?AlM:To study the relationship between blood lead level and abnormal eye blinking in children.
? METHODS: The patients with chief complaint of frequent eye blinking, whose diagnosis of abnormal eye blinking, were randomized to experimental group. The patients in this group carried out vision and the slit-lamp examination, detected corneal fluorescein staining and tear break-up time, and improved the level of blood lead and trace elements examination. The patients in control group with chief complaint of health physical examination in our hospital, excepted of blood lead level, the other body check results were normal and were divided into boys group and girls group according to the gender. The changes of the experimental group and control group in blood lead level were compared.
?RESULTS: Totally 371 cases ( male:295 cases; female:76 cases) with mean age was 6. 56±2. 41 years and 6. 08±2. 82 years respectively were in experimental groupe. ln control group, there were 300 cases ( male: 186 cases;female:114 cases) with mean age was 6. 99±3. 01 years and 6. 56±2. 80 years respectively. The average of blood lead level of boys in experimental group was 63. 82 ±24. 56μg/L and 53. 98±15. 42μg/L in control group. The average of blood lead level in experimental group was higher than that in control group. The difference between of the two group was statistically significant (χ2=16. 96, P<0. 01 ). The average of blood lead level of girls in experimental group was 56. 96±16. 69μg/L and 48. 18±12. 35μg/L in control group. There was no difference between of the two group (χ2=5. 77, P=0. 56). ln control group, the average of blood lead level with <3 years, 3~6 years and >6 years children were 48. 73±11. 67μg/L, 51. 39 ± 14. 87μg/L, 52. 98 ± 14. 45μg/L respectively. ln expirement group, the results were 56. 57±17. 89μg/L, 59. 92±18. 46μg/L and 67. 00±32. 55μg/L in <3, 3~6 and >6 children, respectively. There was no significant difference with <3 years (χ2=3. 54, P=0. 17). The difference with 3~6 years and >6 years children were statistically significant (χ2 = 9. 62, P = 0. 008 ) and (χ2 = 19. 22, P = 0. 000 ) respectively. The blood lead level were divided into three grades: <50μg/L, 50 ~100μg/L, >100μg/L, and relative risk (RR) were 0. 65, 1. 22, and 10. 11 respectively.
?CONCLUSlON: Blood lead level of experimental group is higher than that of control group. The relationship between blood lead level and abnormal eye blinking in children is positive correlation.

Objective To determine the impact of fluorine and aluminum,and both action combined on the number of rat osteoclasts and bone resorption cultured in vitro and to explore its mechanisms.Methods The osteoclasts and bone marrow stromal cells (BMSCs) isolated from long bone of new born rats were cultured,respectively,in TC199 medium (containing 10％ fetal bovine serum) with fluoride,aluminum and fluoride combined with aluminum.The osteoclasts were inoculated in 96-well culture plate and ivory slice,BMSCs in 6-well culture plate,and culture medium was changed after 2 hours incubation.The cells were divided into control group,fluoride group,aluminum group and fluoride combined with aluminum group; the doses of sodium fluoride were 0,1.0 × 10-4,0,1.0 × 10-4 mol/L and the doses of aluminum chloride were 0,0,1.0 × 10-5,1.0 × 10-5 mol/L,respectively.Tartrate-resistant acid phosphatase (TRAP) staining positive cells were counted under light microscope after TRAP staining on the 5th day and the pit formed in ivory slices were measured by histomorphometry after staining with toludine blue.The expression of osteoprotegerin(OPG) and receptor activator of nuclear factor kappa-B ligand (RANKL) was detected by real-time fluorescence quantitative PCR in BMSCs after 8 h treatment.Results ① Fluoride,aluminum and the interactive effects of fluoride and aluminum all had impact on the numbers of osteoclasts (F =7.15,6.56 and 7.98,respectively,all P ＜ 0.05).The numbers of osteoclasts in fluoride group,aluminum group and fluoride combined with aluminum group[(136.9 ± 22.99),(135.4 ± 23.5),(163.0 ± 24.4) per well] were higher than that in the control group[(92.5 ± 22.1) per well,all P ＜ 0.05].② Fluoride,aluminum and the interactive effects of fluoride and aluminum all had impact on the resorption pit area on ivory slices(F =10.47,12.64,14.29,respectively,all P ＜ 0.05).The resorption pit area on ivory slices in fluoride group,aluminum group and fluoride combined with aluminum group[(0.242 ± 0.031),(0.293 ± 0.026),(0.333 ± 0.016)mm2 per slice] was higher than that in the control group [(0.088 ± 0.030)mm2 per slice,all P ＜ 0.05].③Fluoride,aluminum and the interactive effects of fluoride and aluminum all had impact on the expression ratios of RANKL/OPG in BMSCs (F =8.15,15.38,23.59,respectively,all P ＜ 0.05).The expression ratios of RANKL/OPG in BMSCs in fluoride group,aluminum group and fluoride combined with aluminum group [(193.98 ± 137.93)％,(326.11 ± 176.78)％,(599.84 ± 275.82)％] were higher than that in the control group[(100.00 ± 56.02)％,all P ＜ 0.05].Conclusions Both fluoride and aluminum can cause increase in the number of osteoclasts in vitro and promote cell differentiation and bone resorption activity,which may be related to increased expression ratio of RANKL/OPG mRNA in BMSCs.The stimulating effects of fluoride on osteoclasts differentiation and bone resorption is enhanced by aluminum.