After the research of PLA2R1 and its antibodies, Thrombospondin type-1 domain-containing 7A and its antibodies to membranous nephropathy (MN) has made a new understanding.Some researches have reported that the antibodies of PLA2R1 and THSD7A were mutually exclusive in MN, because THSD7A was found in PLA2R1-negative MN patients.But the latest researcher showed that these antibodies can be both positive in MN patients.Similar to the function of PLA2R1, THSD7A can assist clinical diagnosis, treatment, and monitor of MN.In contrast to PLA2R1, THSD7A was also highly expressed on both human and murine podocytes.We can use the mice model to study the pathogenesis of THSD7A-associated MN in the future.In this review, we describe the structure and function of Thrombospondin type-1 domain-containing 7A and its autoantibodies, highlight its role in MN and suggest possible aspects of its future clinical application.

Objective To investigate the damage of hippocampal neurons induced by chronic cerebral ischemia in the rats,and to clarify its mechanism.Methods 90 healthy adult male SD rats were randomly divided into sham operation group (n=30 ) and experimental group (n=60 ). The chronic cerebral ischemia rat models were established by permanently ligating the common carotid arteries on both sides of the rats in experimental group.The rats in sham operation group were established by incising the cervical median,only the common carotid arteries on both sides were separated without ligating. The rats in sham operation group and experimental group were respectively sacrificed at the 7th,14th and 21st day after operation.At each time point 10 rats in sham operation group and 20 rats in experimental group were selected and sacrificed.Immunohistochemistry staining was used to observe the dynamic changes of the expression levels of choline acetyltransferase(ChAT)in hippocampus neurons, and TA-FE method was used to observe the dynamic changes of hippocampal microvascualr architecture. MiVnt image analytical system was used to quantitatively analyze the immunohistochemistry result,the microvessel density (MVD)and micorvessel area density (MVA)of horizontal part of hippocampus in the rats. Results Compared with sham operation group,the ChAT expression levels in hippocampus neurons of the rats in experimental group at different time points were significantly decreased(P<0.05);and with the prolongation of time,the ChAT expression levels were gradually decreased;the ChAT expression level in 14-day experimental group was significantly lower than that in 7-day experimental group (P<0.05 );the ChAT expression level in 21-day experimental group was significantly lower than those in 7-day and 14-day experimental groups(P<0.05).The MVD and MVA of hippocampus of the rats in experimental group at different time points were obviously decreased compared with sham operation group(P<0.05);the MVA was gradually decreased with the prolongation of time, and the MVA of hippocampus of the rats in 21-day and 14-day experimental groups were obviously decreased compared with 7-day experimental group(P<0.05);the MVD was gradually decreased with the prolongation of time,the MVD of hippocampus of the rats in 21-day and 14-day experimental groups was obviously decreased compared with 7-day experimental group(P<0.05);the MVD of hippocampus of the rats in 21-day experimental group was obviously decreased compared with 14-day experimental group(P<0.05).Conclusion Chronic cerebral ischemia can lead to the progressive decrease of the ChAT expression level,MVD and MVA of hippocampus of the rats to aggravate gradually the learning and memory dysfunction, which may be one of the reasons of vascular dementia.

Objective To study the kidney histological categories of isolated hematuria in children.Methods Twenty-three children with isolated hematuria were performed renal biopsy under real time ultrasound guidance utilizing menghini style negative pressure biopsy device after local anesthesia or general anesthesia.The renopuncture tissue was directly sent by the mail-boxes to the remote pathologic service.All of the biopsies were examined by light microscopy,electron microscopy and immunohistochemistry.Results Biopsies were classified as measangial proliferative glomerulonephritis(MsPGN)(8 cases),minimal change nephropathy(MCN)(5 cases),IgA nephropathy(IgAN)(4 cases),thin basement membrane nephropathy(TMN)(3 cases),Alport′s syndrome(AS)(1 case),focal segmental glomerulosclerosis(FSGS)(1 case)and IgM nephropathy(IgMN)(1 case).Conclusions In this series,MsPGN,MGA,IgAN are the most common biopsy diagnosis.TMN and Alport′s are account for some proportion.A few IgMN and FSGS may also present as isolated hematuria.

[Objective]To explore the mechanism of nucleoplasty combined with oxygen-ozone for the treatment of lumbar disc herniation，and to evaluate its therapeutic effects.[Method]From June 2005 to June 2006，62 patients with lumbar disc herniation were treated by nueleoplasty combined with oxygen-ozone，34 were male and 28 were female，ranging in age from 32 to 76 years，with an average of 53.4 years.The course of this disease ranged from 3 to 56 months，meanly 1.3 years.Thirteen patients had the herniation at L4.5 and L3，4，thirty two patients at L4、5，eight patients at L4、5 and L5S1，and nine patients at L5S1.The curative effect was assessed by using a modified MacNab method.[Result]After 25～35 months'follow-up，there were no servious complications in all 62 cases.According to modified MacNab assessment，50 cases(80.7%)achieved excellent outcomes，8 cases(12.9%)good，2 cases(3.2%)fair and 2 cases(3.2%)poor.The excellent and good rate was 93.5%.[Conclusion]The micro-invasive technique of nueleoplasty combined with oxygen-ozone is effective in the treatment of lumbar disc herniation，and it has maximized the clinical effect and minimized the local damage：it also expanded adaptive cases with lumbar disc herniation and enlarged the applicable scope of minimally invasive technique in treating lumbar disc hemiation.

Objective To describe the genetic epidemiologic features of alopecia areata (AA) patients in China and to presume the possible genetic mo del of AA.Methods A case-controlled study of 1032 AA patients was performed to analyze the effect of genetic factors on the liability to AA.Complex segreg ation and heritability analysis were performed using Falconer's method and SAGE-REGTL programs.Results The mean age of onset was 28.98 ? 13.43 years.The d ifference in the mean age of onset was not significant between males and females.A total of 82.6 percent of patients experienced their first episode of AA befo re the fourth decades of life.A positive family history of AA was obtained in 8 7 patients (8.43%).The prevalences of AA were 1.58%,0.19% and 0.03% in the firs t-,second-and third-degree relatives of the probands respectively,which were significantly higher than those in the controls(P

OBJECTIVETo explore the best freezing time and the optimum analgesia modality.

METHODSIn dogs, intercostal nerves were froze at -70 degrees C at different time including 30, 60, 90, 120, 180 s. Samples were got at the operative day, in 10 days and 60 days respectively, then carried on the pathology exam. In clinical study, 150 patients undergoing thoracotomy were randomly designated into 5 groups, all patients were recorded the heart rate, blood pressure, SO2, VAS, the dosage of dolantin, and observed the complications and side effects.

RESULTSAt operative day, the freezing nerves appeared brown print macroscopically, and presented degeneration, necrosis of the nerve fiber microscopically with more than 90 s. After 10 days, nerves with more than 90 s became thinner than normal. After 60 days, all nerves had no obvious differentiation than normal. In clinical study, both 90 s group and 90 s with PCIA group were significantly better than 60 s group or PCIA group; The VAS of 90 s with PCIA group was significantly lower than 90 s group but had more side effects such as vomiting, nausea.

CONCLUSIONSAt -70 degrees C, the freezing time should be no less than 90 s. The freezing intercostal nerves can safely and effectively relieve postoperative chest pain. The effect of analgesia of 90 s with PCIA group is the best, but has many side effects.

Adult ; Aged ; Animals ; Chest Pain ; etiology ; therapy ; Cryoanesthesia ; adverse effects ; methods ; Disease Models, Animal ; Dogs ; Female ; Humans ; Intercostal Nerves ; Male ; Middle Aged ; Nausea ; etiology ; Pain, Postoperative ; etiology ; therapy ; Random Allocation ; Thoracotomy ; adverse effects ; Time Factors ; Vomiting ; etiology

Objective To investigate the association between polymorphisms of thyroid-stimulating hormone receptor(TSHR)gene intron 1(rs179247, rs12101261)and Graves′ disease(GD)in the China Han population from Xuzhou city, Jiangsu Province. Methods Total 1 066 GD patients and 1 107 control subjects were recruited for genotyping by Taqman probe technique on Fluidigm EP1 platform. Meanwhile, serum concentrations of thyroid hormone and TSH receptor antibodies(TRAb)were determined. Results The rs179247_A, rs12101261_T were significantly associated with GD risk(OR=1.35, 95%CI 1.19-1.54, P=5.92×10-6; OR=1.32, 95%CI 1.16-1.50, P=2.22×10-5). Logistic regression identified that rs179247 was an independent susceptibility locus of GD. Serum TRAb concentration showed a significant difference(P=0.015)among rs179247_AA, AG, and GG genotypes. Conclusion rs179247 and rs12101261 in TSHR intron 1 are both associated with GD, and rs179247 may contribute risk to GD independently. The polymorphism is associated with TRAb, but not with serum concentration of thyroid hormones, age of onset, diffused thyroid goiter, ophthalmic signs, and relapse.

Objective To investigate the correlation between the paired inspiratory and expiratory quantitative CT and pulmonary function tests (PFTs) in patients with chronic obstructive pulmonary disease (COPD).Methods A total of 84 patients with COPD were enrolled.For each patient,CT scan was performed in deep inspiration and expiration.Using automatic post-processing software,a three-dimension quantitative measurement was employed to assess the CT parameters of emphysema and air trapping.The correlation between CT and PFT was evaluated by the Spearman rank correlation test and multivariate linear regression analysis.Results The percent 1 [Perc1,(-984.28 ± 17.93) HU] and percent 15 [Perc15,(-948.35 ± 22.26) HU] from the CT parameters of emphysema were positively correlated with the forced expiratory volume in 1 second predicted (FEV1％,48.69 ± 23,47),the ratio of forced expiratory volume in 1 second over forced vital capacity [FEV1/FVC,(45.89 ± 15.36)％,r =0.454.-0.67,P ＜0.01],was negatively correlated with the ratio of residual volume to total]ung capacity [RV/TLC,(61.32 ±14.48)％].The other CT parameters of emphysema index (EI) and the parameters of air trapping,the change in relative lung volume with attenuation values from-860 to-950 HU [RVC-860--950,(17.66 ±22.36)％],the expiration to inspiration ratio of mean lung density (MLDex/in,0.93 ± 0.06),the expiration to inspiration ratio of lung volume(LVex/in,0.71 ± 0.14) had negative correlations with logFEV1 ％,FEV1/FVC (r=-0.48--0.69,P＜0.01) and positive correlations with RV/TLC (r =0.41-0.66,P ＜0.01).The further univariate linear regressions showed that EI,Perc1,Pere15,RVC-860--950,MLDex/in,LVex/in were correlated with the parameters of PFTs (R square values of the regression equation,ranged from 0.27 to 0.66,P ＜ 0.01).After the pairwise combinations of the parameters of emphysema and air trapping,multivariate stepwise regressions showed better R square values from 0.66 to 0.85.Conclusions CT parameters of emphysema and air trapping can reflect pulmonary function in COPD patients.The combinations of the two types of CT parameters are more correlated with the PFTs parameters.

Objective To discuss the initial expression of serum procalcitonin (PCT) in patients with severe traumatic brain injury (TBI) and determine the potential value of PCT to predict the neurological outcome.Methods A retrospective analysis was made on patients admitted due to severe TBI (GCS≤8 points) from July 2011 to August 2012.Mortality and neurological outcome of the survivors were determined using Glasgow outcome scale (GOS) at 6 months after TBI.Results A total of 52 patients (39 males and 13 females),at median age of 38 years (range,15-65 years) were included in the study.Twenty-eight patients had good outcome (GOS of grade Ⅳ-Ⅴ),whereas 24 patients had poor outcome or died (GOS of grade Ⅰ-Ⅲ).Within 24 hours after TBI,serum PCT level was significantly higher in patients with bad outcome compared to those with good outcome (0.778 ng/ml:0.094 ng/ml,P ＜0.01).Enhanced PCT level presented a close correlation with the poor outcome (r =0.657,P ＜0.01).Area under the receiver operating characteristic curve (ROC) was 0.879 [95％ CI (0.757,1.000)].A cutoff value of 0.2 ng/ml had a sensitivity of 100％ and a specificity of 72.2％.Once the PCT level was superior to 4.7 ng/ml,none of the patients regained consciousness.Conclusion PCT is a simple and effective method for prediction of the outcome after severe TBI.