To further study the renal damage of SS with biopsy and recent determination. Methods 31 patients of SS with renal impairment from 1988 to 1995 were analyzed by routine, immunoassay,tubular function and biopsy examination. Results 25/31 cases presented dRTA, 3/25 with diabetes insipitus and 2/25 with hypokalemic paralysis. Glomerulopathy was occured in 8 of 31 (NS 5, GN 3) and mild renal failure( RF) in 4. Hypergamma-globulinemia was observed in 23 of 31 (74%). About 65% and 45% patients revealed anti ss-A and anti ss-B positive respectively. In 13 renal biopsies, 9 specimens showed CIN with large number of lymphoplasma cells infiltration and tubular atrophy and other 2 specimens revealed LN (type Ⅲ and Ⅳ ) and 2 MPGN. By IF, no positive findings were seen in 7 cases and deposition of IgA, IgM or 63 in some other patients. IgG deposits in the interstitial lymphoplasma cells in 1 patient. 19 patients were treated with prednisone and 3 combined with CTX. 14 cases remitted during the follow-up. In 4 patients with RF, Scr level returned to normal after treatment. Conclusion The renal impairment of SS may be the presenting or predominant feature. Their major clinical manifestations are dRTA and GN. The treatment with prednisone may decrease the infiltration of lymphoplasma cells in the interstitium, improve the renal function and correct RTA.

Objective To evaluate the therapeutic effect and side-effect between pulse cyclophosphamide (CTX) therapy and mycophenolate mofetil(MMF) in lupus nephritis. Methods A group (CTX group): 30 patients were given intravenous cyclophosphamide (0.5 -0.75 g/m~2) pulse plus oral prednisone. All patients were treated for (18. 65 ?6. 10) (6 -24) months. B group (MMF group): 30 patients were given MMF at a dosage of 1. 0 -1. 5 g/d and oral prednisone. All patients were treated for (21. 89?7. 48) (6-48) months. Patients in two groups were comparable in age, sex distribution, severity of renal damage. Most patients in B group were refractory to cyclophosphamide therapy, and their histories were much longer than those of A group. Results CTX and MMF both reduced proteinuria and hematuria, and improved renal function and immune indexes CTX and MMF were effective on inhibiton of autoantibodies production. The mean therapeutic period of B group was significantly longer than that of A group, but the ontcome of two groups was similar. Liver toxicity and amenorrhea were not observed, while infections(13. 3% ), herpes zoster(6. 7% ), leukopenia(3. 3% ) were found during MMF treatment. And in CTX group, liver toxicity(23. 3% ), amenorrhea(28% ), infections(23. 3% ), herpes zoster( 10% ), leukopenia (10% ) occurred. Conclusion For the treatment of lupus nephritis, the combination of mycophenolate mofetil and prednisone is as effective as the regimen of cyclophosphamide and prednisone but less toxicity.

Objective To evaluate the determination of glomerular filtration rate (GFR) by non-ionic contrast medium iohexol plasma clearance. Methods GFR of 93 patients, 45 male and 48 female, age ranged from 12 to 80, with different renal functions was determined. The patient underwent an overnight fast and 5 ml of iohexol was injected into peripheral vein in the morning. 2 ml plasma sample was collected 4 hours after injection, and plasma concentration of iohexol was measured by high performance liquid chromatography(HPLC) . The iohexol plasma clearance was calculated by two one-compartment model; Jacobsson's and Bubeck's model. 99mTc clearance was used as the reference method. Results Iohexol-GFR obtained by Jacobsson's model vs 99mTc-GFR yielded a correlation of r = 0. 85, standard error of the estimate (SE) = 16. 06 ml/min. There was also a high correlation between iohexol-GFR obtained by Bubeck's model and 99mTc-GFR, r = 0. 82, SE = 17. 75 ml/min. In the patients in early stage of renal failure, iohexol-GFR was the most sensitive indication as compared to Scr and Ccr. Conclusion Iohexol plasma clearance calculated by Jacobsson's and Bubeck's models is a simple and accurate method of determining GFR.

Background The penetration of bacterial agents into the vitreous cavity is difficult because of the existence of blood-retina barrier.So conventional drug therapy is not enough effective on endophthalmitis.Drug delivery systems can decrease drug dose and reduce the drug toxicity.To construct nano controlled-release system of anti-bacterial agents is very important for the treatment of intraocular infectious diseases.Objective This study was to investigate the toxicology and intraocular pharmacoklnetics of intravitreal PNIPAAm-PEO loaded norvancomycin nanoparticles (NV-PNIPAAm-PEO) in normal rabbit eyes.Methods NV-PNIPAAm-PEO was constructed with the drug-loading rate about 22％,and then the drug gelatin solution (20 g/L) was prepared using normal saline solution.Forty-one New Zealand albino rabbits were randomized divided into experimental group and control group.20 g/L drug gelatin solution 0.1 ml was monocularly injected into the vitreous cavity in the experimental group,and the equal volume of sterilized normal saline solution was used in the control group.In 1 day,2,3,7,14,21 and 28 days after injection,ocular anterior and posterior segments were examined by slit lamp microscope and Bsonography,and electroretinogram (ERG) was recorded and the histopathological examination was performed to evaluate the biotoxicity of the drug.Norvancomycin contents in the cornea homogenate,aqueous humor,vitreous,retinochoroid homogenate were detected by high performance liquid chromatography (HPLC) system.Results The anterior and posterior segments were normal by the slit lamp microscope and B-sonography 1-28 days after injection of NV-PNIPAAm-PEO.In 7,14,21 and 28 days after injection,there were no statistically significant difference in the a-wave latency and amplitude of max-ERG between the two groups,as well as the b-wave amplitude(P＞0.05).The histopathological examination showed that the retinal structure was normal in both groups.HPLC assay showed that the norvancomycin level was gradually declined in different eye tissues from 1 day through 28 days after injection.Norvancomycin was undetectable in the cornea during the observing duration.The maximal norvancomycin content in the blood plasma was (0.34 ± 0.11) mg/L in the second day,and norvancomycin content ranged (0.08 ± 0.04)-(2.16±0.07) mg/L in the aqueous humor,(0.11 ±0.22)-(2.54 ±0.38) μg/g in the chorioretina,respectively.The drug concentration was (5.65 ± 1.14)-(406.69 ± 21.05) mg/L in the vitreous,which was higher than the minimal inhibitory concentration (MIC) to the most gram-positive bacteria.Conclusions The intravitreal injection of 22％ NV-PNIPAAm-PEO maintains the therapeutic drug concentration till 21 days in vitreous without the toxic effect on eye tissues,suggesting a great treating potential for intraocular infecting diseases.

BACKGROUND:To ensure the catheter position is very important for interventional catheters. In emergency, rapid and accurate catheter insertion is required. Ultrasound can real-time track the movement of catheters in vivo. It is safe to patient, which has exhibited a bright future in catheter placement. OBJECTIVE: To compare the current methods for improving ultrasonic localization methods and to prospect the future development and improvement of real-time ultrasonic localization of catheters in vivo. METHODS: Literature search was carried out based on PubMed (1990-01/2015-04) and Espacenet with the key words of catheter, ultrasonic guidance, ultrasound localization, enhanced localization for the initial retrieval of relevant articles. RESULTS AND CONCLUSION:To improve the image quality and increase the accuracy of catheter placement by ultrasound, recent efforts have been focused on two paths. One is to improve the resolution of ultrasonic images by enhancing ultrasound equipment or ultrasonic guidance system. The other is to modify catheter itself to obtain high acoustic impedance differential and improve its echogenicity. The latter approach can be potentialy applied in al kinds of catheters and is more economical and practical. Therefore, in future researches, innovation and design of catheter materials for catheter fabricating wil play an important role in promoting the real-time ultrasonic localization of catheters.

Objective To study the diagnosis,surgical treatment and prognosis of patients with primary duodenal carcinoma.Methods The clinical data of 56 patients with primary duodenal carcinoma treated between 2008 to 2015 were retrospectively analyzed.Results The number of patients with tumors located in the first,second,third and fourth parts of duodenum were 3,44,6,and 3 patients respectively.Tumors which were within the papillary region accounted for 71.4％ (40 patients).Twenty-two patients (22/56,39.3％) had well differentiated adenocarcinoma,16 patients (16/56,28.6％) had moderately differentiated adenocarcinoma and 6 patients (7/56,10.7％) had undifferentiated carcinoma.The clinical manifestations were not specific,which included abdominal pain,abdominal distention,jaundice,bowel obstruction or bleeding.The correct rates of diagnosis made by endoscopy,duodenography,ultrasound and CT were 84.0％,81.3％,30.4％ and 48.2％ respectively.Forty patients underwent pancreaticoduodenectomy,5 segmental duodenectomy,9 bypass operation,and 3 subtotal gastrectomy and duodenal bulb tumor resection.The 1-,3-,and 5-year survival rates of all the patients were 82.6％,56.7％ and 30.1％ respectively.The-1,3-,and 5-year survival rates of the patients who underwent pancreaticoduodenectomy and segmental duodenectomy were 100％,68.8％,42.2％ and 100％,61.8％,0 respectively.All the patients who underwent palliative resection died 6 to 24 months after surgery.Univariate analysis revealed the operation types.,depth of tumor invasion,lymphatic invasion,and tumor differentiation correlated with prognosis.Multivariate analysis showed only the operative types,depth of tumor invasion and lymphatic invasion to be independent prognostic factors.Conclusions Tumors located in the papillary region accounted for the majority of primary malignant tumors of the duodenum and they were mainly adenocarcinomas.Duodenography and endoscopy were the major methods used in the diagnosis of primary duodenal carcinoma.Pancreaticoduodeneetomy was the best therapy for primary duodenal carcinoma.

Schistosomiasis Control and Elimination(GB 15976-2015)and Diagnostic Criteria for Schistosomiasis(WS 261-2006)are the only two national health criteria related to schistosomiasis control program implemented in P. R. China. The roles of criteria to guide and accelerate the transition from schistosomiasis control to elimination are concluded ,based on this system?atic review how the criteria led the implementation of the medium?and long?term national plan and provided the guidance when drafting the thirteen?five years national plan for schistosomiasis,and the suggestion to draft more criteria related to schistosomia?sis elimination program and strengthening the implementation of current criteria,so as to precisely guide the schistosomiasis elimination program in P. R. China.

Objective To explore the clinical efficacy of hepatic segmentectomy under segmental staining and intraoperative chemoembolization for primary liver cancer(PLC).Methods Twenty cases of liver cancer underwent hepatic segmentectomy under segmental staining and intraoperative chemoembolization(observed group),the results were compared with 22 cases of PLC after treated by routine hepatectomy(control group).AFP,CT and MRI were regularly used after hepatectomy to evaluate the outcome.Results In observed group,the operative blood loss was(295?105)mL,blood transfusion was(280?85)mL,liver function levels were in the normal range accounted for 15%(3/20) one week postoperatively,the incidence of postoperative complications was 40%(8/20),the postoperative 3-year survival rate was 60%,and the postoperative local recurrence rate was 35%;while in the control group,these parameters were(490?140)mL,(370?105)mL,40.9%(9/22),45.5%(10/22),40.91% and 68.18% respectively.In observed group,the operative blood loss,blood transfusion,cases with liver function levels in the normal range,the incidence of postoperative complications,postoperative 3-year survival rate,and postoperative local recurrence rate were significantly lower than those in the control group(P0.05).Conclusions The hepatic segmentectomy under segmental staining and intraoperative chemoembolization for PLC may reduce postoperative complications,lower postoperative relapse rate and improve survival rate.

Objective To evaluate the interventional therapy in Budd-Chiari syndrome (BCS). Methods 12 cases with BCS were treated with balloon dilatation angioplasty and placement of stent. The pathologic types were composed of complete occlusion of inferior vena eava(IVC) (9 cases) and IVC stenosis (3 cases). Results Sue-eess was achieved in 12 cases. IVC eavepressure was(4.56±1.51 )kPa before interventional therapy,and (2.51± 0.77 ) kPa after stent implantation. The symptoms disappeared or markedly improved postoperatively. Complications of hepatic venous occlusion occurred in 1 ease after IVC stent 8 months later,and the symptoms relieved after meso-RA shunt. Conclusion The interventional therapy for BCS is very effective and safe to appropriate patient.

Objective To investigate the relationship of urinary vascular endothelial growth factor (VEGF) and occurrence and invasiveness of bladder cancer. Method The expression of urinary VEGF in 48 patients with bladder cancer (bladder cancer group) and 45 normal cases (control group) were examined by ELISA immunohistochemical staining. Results VEGF levels in urine in bladder cancer group [(174.77±83.41) μg/L] were higher statistically than those in control group [(63.53 ±22.62) μg/L] (P < 0.01), and related to the staging and grading of tumors. VEGF levels were significant higher in invasive lesions [(223.00 ± 83.13) μg/L] than those in superficial ones [(130.40 ± 54.86) μg/L] (P < 0.01). VEGF levels of G3 [(259.23 ± 75.82) μg/L] were significant higher compared with G1 [(138.00± 85.60) μ g/L] and G2 [(146.22 ±47.53) μ g/L] (P < 0.01). Conclusion The concentration of urinary VEGF relates to the clinical staging and pathological grading, and it is a labeling index of the biological behavior of bladder cancer.