Idiopathic Refractory Nephrotic Syndrome (IRNS) has been an intractable problem in clinical treatment .Anti CD20 monoclonal antibody is a new type of immunosuppressive agent , which can induce the lysis and apoptosis of B cells .Significant-ly, it improves the prognosis of IRNS patients .In recent years, a number of case studies and clinical trials have been conducted on the effectiveness of anti CD20 monoclonal antibody in the treatment of children with IRNS .In this paper, the mechanism, clinical applica-tion, adverse effects and problems in the study of anti CD 20 monoclonal antibody in IRNS will be reviewed .

Animals ; Animals, Newborn ; Cells, Cultured ; Fibroblasts ; cytology ; metabolism ; Matrix Metalloproteinase 1 ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Myocardium ; cytology ; metabolism ; Oligopeptides ; physiology ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; pharmacology

According to the ultrasonic manifestations of the gall bladder before laparoscopic cholecystectomy(LC),including size,morphology,wall thickness,presence or absence of gallstone,congenital anomaly of biliary duct,surrounding adhesion and state of common bile duct,tbe patients Werc dividcd into 4 groups:A.Most suitable for LC,B.Sitable for LC,C.Relatively suitable for LC. D.Not suitable for LC.This provided clinicians the basis for patient selection.Comparing with the sur.gical findings,the coincidence rate of B-mode ultrasonography was 97.8%.Preoperative B-mode ul-trasonography of gall bladder has significant clinical value to relieve the patients from pain,decrease the operative risk and conversion rate of LC.

Animals ; Centrifugation, Density Gradient ; methods ; Chickens ; Cytochrome P-450 Enzyme System ; analysis ; Microsomes, Liver ; chemistry ; ultrastructure ; Sucrose

Beverages ; Exercise ; Female ; Glycyrrhizic Acid ; pharmacology ; Humans ; Physical Endurance ; Students

Adolescent ; Adult ; Child ; Factor VIII ; genetics ; metabolism ; Hemophilia A ; blood ; diagnosis ; Humans ; Male ; Young Adult

Objective To explore the clinicopathological features ,diagnosis and differential diagnosis of pleuropulmonary blasto-ma(PPB) .Methods A case of PPB was reported by light microscopic observation ,immunohistochemistry and molecular pathology study with review of related literature .Results A 45-year-old female was admitted to the hospital because of cough and dyspnea . Chest radiogram revealed a solid mass in the left lung .Grossly ,the tumor was described as a firm lesion with lumina or multicystic components and well-circumscribed margins .Microscopically ,the tumor was composed of sheets of malignant primitive small cells and fascicles of embryonal rhabdomyosarcoma-like cells with foci hyalinized stroma .Beneath the benign epithelium ,the primitive mesenchymal cells showed as mixed blastematous and sarcomatous characteristics that plump spindle shaped cells presented poor differention with abundant eosinophilic cytoplasms and brisk mitotic activities .Immunohistochemically ,vimentin and MyoD-1 were positive in malignant small cells but some epithelial markers are negative .Meanwhile ,K-RAS extron 3 mutation was detected by high resolution melting analysis(HRMA) .Conclusion Pleuropulmonary blastoma(PPB) is a rare malignant tumor with unique clinicopathological features .It should be distinguished from some mimics such as pulmonary blastoma and embryonal rhabdomyo-sarcoma .

Objective To study the value of MSCT angiography(MSCTA)in diagnosing lower extremities arterial disease (LEAD) of diabetic foot ulcers and analyze the possible influential factors on the onset of diabetic foot ulcers.Methods 80 diabetic patients for MSCTA examination were divided into two groups by whether combined with foot ulcers.The tibial artery calcification score (TACS) and peripheral arterial occlusion index (PAOI) were calculated and the possible risk factors of diabetic foot ulcer were analyzed.Results There were 30 cases suffered with foot ulcer and 18 cases occurred lower extremity arterial occlusion (LEAO), the average PAOI was 4.40(3.60, 5.75).Non-foot ulcer cases were 50, and there were 8 cases suffered with LEAO, the average PAOI was 2.05(1.43, 3.10).Compared to patients without foot ulcer, patients with foot ulcer were older, had a lower BMI, and were more likely to have a history of tobacco use.They usually had higher TACS and severer peripheral arterial occlusive disease (PAOD).Stepwise regression model showed that foot ulcers had significant correlation with TACS and PAOI.Partial correlation analysis showed TACS was independent from PAOI in impacting diabetic foot ulcer.Conclusion MSCTA has important clinical value in diagnosing and valuing diabetic foot ulcer LEAD.Age, smoking history,BMI,TACS and PAOI affect the incidence of diabetic foot ulcers, and TACS and PAOI are the independent risk factors for diabetic foot ulcers.

To observe the morphology of corneal endothelial cells after femtosecond laser in situ keratomileusis ( Femto-LASlK) .METHODS:From May to September in 2013, 88 eyes of 45 patients with myopia who accepted Femto-LASlK were enrolled in this study. The morphology of central corneal endothelial cells was measured by a non-contact corneal endothelial cell analyzer before, 1mo and 1a after surgery. The number, density, average size, size standard deviation, size coefficient of variation and hexagonality of the corneal endothelial cells were observed. All the measurements were analyzed by statistical analysis.RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery;One month after surgery, the endothelial cell density (ECD) was 2815. 34±297. 07/mm2, which had a 2. 64% decrease compared with preparative ECD (t=4. 60, P= 0. 00), there was no statistical significance between ECD measurements of 1mo and 1a after surgery ( P>0. 05 ); One month after surgery, the size standard deviation ( SSD ) was 118. 47 ± 31. 58μm2 , which increased significantly compared with the preoperative SSD(t=-3. 87, P=0. 03), there was no statistical significance between SSD measurements of 1mo and 1a after surgery ( P>0. 05 );After surgery, the number, hexagonality, average size and size coefficient of variation of the corneal endothelial cells didn't change statistically(P>0. 05).CONCLUSlON: ln the early period after Femto-LASlK, the ECD decreased slightly, however this kind of surgery did not have significant harm to the function of corneal endothelial cells, and the surgery didn't cause the progressive loss of corneal endothelial cells.

? AIM: To investigate the influence of phacoemulsification on corneal endothelial cells and its injury risk factors in diabetic cataract patients.?METHODS: From January 2013 to October 2015, 186 diabetic cataract patients ( 224 eyes ) as diabetes group and 190 patients with simple cataract ( 227 eyes ) as control group in our hospital were enrolled. All patients received phacoemulsification combined with intraocular lens implantation. Observation of corneal endothelial cell density, coefficient of variation and percentage of hexagonal cells preoperatively, 1d, 1wk, 1 and 3mo postoperatively were carried out, and multiple Logistic regression analysis for risk factors of corneal endothelial cell injury was taken.?RESULTS: There were no significant difference in the density of corneal endothelial cells, the coefficient of variation and the percentage of hexagonal cells between the two groups before surgery (P>0. 05). Each time point after operation corneal endothelial cell density and the percentage of hexagonal endothelial cells of diabetes group were significantly lower than the preoperative and those of control group ( P < 0. 05 ). Each time after operation endothelial cell coefficient of variation of diabetes group were significantly higher than the preoperative(P<0. 05). The endothelial cell coefficient of variation in diabetes group of the 1wk, 1 and 3mo after operation were significantly higher than those of the control group ( P<0. 05 ) . Corneal endothelial cell density and percentage of hexagonal cells of the control group at 1wk, 1 and 3mo after operation were significantly lower than the preoperative ( P<0. 05 ). The endothelial cell coefficient of variation of control group at 1wk, 1 and 3mo after operation were significantly higher than the preoperative(P<0. 05). Single factor analysis showed that age, shallow anterior chamber, long ultrasonic time, short eye axis, high energy ultrasonic, high cumulative released energy, a lot of perfusate and nuclear hardness ≥ grade Ⅲ associated with corneal endothelial cell injury ( P< 0. 05 ) . Multivariate Logistic regression analysis showed that age, long ultrasonic time, high ultrasonic energy, high cumulative released energy and nuclear hardness ≥ grade Ⅲ were the risk factors of corneal endothelial cell injury, the OR value and 95%CI were 1. 742 (1. 056-2. 682), 1. 958 (1. 227-3. 135), 2. 064(1. 274-3. 256), 2. 585(1. 493-3. 682), 2. 193 (1. 348-3. 316).?CONCLUSION: The injury of corneal endothelial cells after phacoemulsification in diabetic cataract patients is more serious than in patients with simple cataract. Age, long ultrasonic time, high ultrasonic energy, high cumulative released energy and nuclear hardness ≥grade Ⅲ are the risk factors of corneal endothelial cell injury.