Objective To study the clinical and pathological features of primary nephrotic syndrome in elderly patients.Methods Clinical data of patients with primary nephrotic syndrome aged ≥ 60 years underwent renal biopsy were retrospectively analyzed and patients with primary nephrotic syndrome aged ＜60 years were selected as control group.Results Male patients with primary nephrotic syndrome were common in the elderly group and control group,and there was no significant difference in gender composition between the two groups (62.0％ vs.61.5 ％,P＞0.05).The degree of edema and hypertension,levels of blood urea nitrogen,serum albumin,blood IgG and ratio of IgG /IgM were higher while levels of urinary protein and blood cholesterol were lower in elderly group than in control group (all P ＜ 0.05).No significant differences in the incidence of hematuria,serum levels of creatinine,IgA,and complement were found between the two groups (all P＞0.05).The risk of primary nephrotic syndrome was higher in elderly group than in control group (P＜0.01).The level change of blood IgG was positively associated with plasma albumin,while negatively associated with urinary protein and blood cholesterol in both groups (r=0.327,-0.147,-2.860,respectively,all P＜0.05).Membranous nephropathy was the most common type in elderly patients,accounting for 49.77％,while only accounting for 23.6％ in control group,which had a significant difference between the 2 groups (x2 =62.390,P ＜ 0.01).Mesangial proliferative glomerulonephritis was common in both groups,but no significant difference(x2 =62.390,P＞0.05).Conclusions Male patients are more common than female patients in primary nephrotic syndrome.The clinical manifestations including urinary protein and serum albumin are milder but the risk is much greater in elderly patients than in the non-elderly patients.The change of blood IgG level is associated with urine albumin,plasma albumin and plasma cholesterol.Membranous nephropathy is the most common type followed by mesangial proliferative glomerulonephritis in elderly patients with nephrotic syndrome.

Objective To understand the differences between sexes in the clinical and pathological features of patients with mesangial proliferative glomerulonephritis(MPGS).MethodsOne hundred and five patients with MPGS admitted to our hospital were retrospectively studied in clinical and pathological aspects.Results( 1 ) The proportion of male patients were 75 of 105 ( 71.43 ％ ) and that of females were 30 of 105 ( 28.57％ ) ; ( 2 ) The average age of the male patients was ( 40.25 ± 15.50 ) and that of the females was (36.23 ± 15.26) in year.There was no significant difference between the two groups( t =1.206,P =0.231 ) ;(3) There was no significant difference in duration of disease,hematuria,edema,hypertension prevalence and mean blood pressure( P ＞ 0.05 ).The proportion of patients with hematuria was 56.19％ (59/105).The males accounted for 69.33％ ( 52/75 ) and the females were 63.33％ ( 19/30 ) in the main clinical manifestations of nephrotic syndrome.There was no significant difference( x2 =0.352,P ＞ 0.05 ) between the proportion of males and females; (4)Males and females groups had no significant difference( P ＞ 0.05 )on levels of urinary protein,serum albumin,immunoglobulin,complement,urea nitrogen and serum creatinine.Complement decreased in 53 cases,accounting for 53％ of all the participants.The proportion of male patients with renal insufficiency was 24.00％ (18/75),and the proportion of females with renal insufficiency was 13.33％ (4/30).There was no significant difference ( x2 =1.472,P ＞ 0.05 )on the percentage of males and females with renal insufficiency.The mean value of urea nitrogen was higher than the normal levels ; (5) The proportion of male cases with different deposition of immune complexes was 93.06％ (67/72),and the proportion in females were 92.86％ (26/28) in the exception of 5 cases ( male 3 and female 2 ) with no glomeruli in immunofluorescence examination.No significant difference was found between the two groups( x2 =0.001,P ＞ 0.05 ) ; ( 6 ) There was no significant gender differences( x2 =1.696,P ＞ 0.05 ) found in risk assessment.ConclusionThe prevalence of MPGS is higher in male patients than in females,the main clinical manifestations of which were nephrotic syndrome.Patients were found to have a higher rate of hematuria,decreased complement C3,and renal dysfunction than the normal levels.There was no significant difference in gender on the clinical and pathological aspects of MPGS.

Objective To explore the combined effects of fluoride and arsenite on the expression of Runx-related transcription 2 (Runx2) mRNA in bone of Sprague Dawley (SD) rats.Methods Fifty four SD rats were selected[body mass(109.71 ± 10.52)g,half male and half female].3 × 3 Factorial experimental design was used to evaluate the combined effects of fluoride and arsenite on the expression of Runx2 mRNA by random number talbe.Rats were exposed to NaF,NaAsO2 and NaF plus NaAsO2 for 6 months by oral perfusion at gradient doses,respectively:the control group(0 mg/kg NaF + 0.0 mg/kg NaAsO2),the low fluoride group(5 mg/kg NaF),the high fluoride group(20 mg/kg NaF),the low arsenite group(2.5 mg/kg NaAsO2),the high arsenite group(10.0 mg/kg NaAsO2),the low fluoride low arsenite group(5 mg/kg NaF + 2.5 mg/kg NaAsO2),the high fluoride low arsenite group(20 mg/kg NaF + 25 mg/kg NaAsO2),the low fluoride high arsenite group(5 mg/kg NaF + 10.0 mg/kg NaAsO2) and the high fluoride high arsenite group(20 mg/kg NaF + 10.0 mg/kg NaAsO2).The expression of Runx2 mRNA was determined by quantitative real-time RT-PCR.Results The expressions of Runx2 mRNA in the control,low fluoride,high fluoride,low arsenite,high arsenite,low fluoride low arsenite,low fluoride high arsenite,high fluoride low arsenite and high fluoride high arsenite groups were 1.024 ± 0.015,1.377 + 0.014,1.587 ± 0.012,1.182 ± 0.015,1.343 ± 0.010,1.444 ± 0.019,1.504 ± 0.013,1.608 ± 0.013 and 1.714 + 0.009,respectively.The expressions of Runx2 mRNA in experimental groups were higher than those in control group (all P ＜ 0.05),fluoride and arsenite were positively correlated with the expression of Runx2 mRNA(all P ＜ 0.01),and there was a dose-response relationship between Runx2 mRNA and fluoride-arsenite levels.Factorial analysis showed that fluorine or arsenic alone could affect the expression level of Runx2(F =46.967,8.317,all P ＜ 0.05),and there was a interaction between fluorine and arsenic to the expression of Runx2 mRNA (F =105.271,P ＜ 0.01).Conclusion Fluoride or arsenic could promote the expression of Runx2 mRNA in bone of rats; there is an interaction between fluorine and arsenic to the expression of Runx2 mRNA.

Objective To observe the effects of red blood cell lysis buffer on the isolation and culture of human bone marrow mesenchymal stem cells (hMSCs) in vitro.Methods Twenty-two bone marrow samples were randomly divided into 2 groups,including 11 samples of crushed red blood cell prepared with Tris-NH4Cl red blood cell lysis agent and 11 samples prepared without red blood cell lysis agent.The intervals from primary generation to 1,2 and 3 passages and the time of expansion to l07 cells were compared between the two groups.Results The times for P1,P2 and P3 passage was ( 9.3 ± 4.9 ) days vs.( 7.2 ± 1.0 ) days,( 14.4 ±4.7) days vs.( 14.5 ± 3.5 ) days,and ( 18.5 ± 5.0 ) days vs,( 20.1 ± 4.4 ) days,respectively,in crushed red blood cell group and non-crushed red blood cell group.The differences were not significant ( t =1.39,t =0.06,t =0.80,P ＞ O.05 ).The time for expansion to 107 cells in two groups was not significantly different ( t =0.80,P ＞0.05).Conclusion Tris-NH4Cl agent in red blood cell lysis has no significant effects on hMSCs isolation,culture and cell proliferation,which indicates erythrocyte lysing may be not an independent step for hMSCs isolation and expansion in vitro.

Objective To investigate whether human breast milk may bind to hepatitis B surface antigen (HBsAg) and its characteristics.Methods Breast milk samples from five women with negative HBsAg and hepatitis B surface antibody (anti-HBs) at one to two months post delivery were fractioned into cream and skimmed milk by centrifugation.The human breast milk and each fraction as well as cow and goat milk samples,served as controls,were separately incubated with highly purified yeast recombinant HBsAg,followed by determination of their binding capability to HBsAg by enzyme linked immunosorbent assay (ELISA) and the inhibition rate for binding of HBsAg to anti-HBs by quantitative chemiluminescence microparticle immunoassay.After boiled for 1 min or pasteurized in 65 ℃ for 30 min,the thermal stability of the active components of milk was detected.One-way ANOVA and SNK tests were performed for statistical analysis.Results The operative concentration of HBsAg was 0.1 μg/ml.Breast milk from all five women showed significantly better binding capability to HBsAg than cow or goat milk (1.306±0.300 vs 2.157±0.150 and 2.232±0.093,F=34.303,P＜0.01).The quantitative experiments showed that the inhibition rate of human breast milk was higher than that of the control group [(74.26± 17.26)％ vs (0.00±5.50)％,F=57.806,P＜0.01].The binding ability to HBsAg of skimmed milk was comparable with that of whole milk,indicating milk protein(s) played critical roles in binding to HBsAg (0.877 ± 0.486 vs 0.513 ± 0.069 and 0.376 ± 0.146,F=44.475,P＜0.01).After boiled for 1 min or Pasteurization,the binding ability to HBsAg of whole breast milk remained,but that of skimmed milk went down (F=16.598,P＜0.01).Both whole breast milk and skimmed milk could inhibit the binding of HBsAg to anti-HBs (F=278.341 and 269.408,both P＜0.01).Conclusions The inhibition of binding to HBsAg by human breast milk indicates that human milk may interact with HBsAg.The active components mainly exist in milk proteins and are thermal stable.

OBJECTIVE:To improve the ability of vaccine post-marketing surveillance,and clearly define the development di-rection of it in China. METHODS:Though introducing the background,strategic objective and operation objective of Global Vac-cine Safety Blueprint,the situation of vaccine post-marketing surveillance in China was analyzed. RESULTS&CONCLUSIONS:Vaccine post-marketing surveillance have developed fast in China recent years and get generally confirmation. However,compared with the goals in the blueprint,there are some activities should be strengthened,such as active surveillance,signal analysis and da-ta standardization,etc. We should take use of the opportunity offered by WHO and other international organizations to shrink the gap between our country and the advanced countries. Drawing support from WHO and other international institutions,vaccine post-marketing surveillance can step on the new level in China.

Objective To study the effect of specific immunotherapy (SIT) with purified humulus pollen allergens for asthma patients. Methods The humulus pollen allergens were purified partially by gelatin filtration. A double-blinded study was carried out. Eight-six patients with seasonal humulus pollen allergic asthma were divided randomly into two groups: observation group (group A) and control group (group B), which were administered SIT with purified or crude humulus pollen allergens, respectively, before the allergic season for half a year. The clinical effect and side effects were observed. The laboratory observation norms included T lymphocyte subpopulation, the wheals’diameter of IT, the average index of HBDT and the specific IgE before and after SIT . Results The general effect of SIT with purified allergens in group A was 90.7% (39/43), and that with crude allergens in group B was 79.1% (34/43) (P

Objective To purify and identif y Platanus acerifoli wild pollen. Methods We carried out intracutaneous test with Platanus pollen extract in 30 patients with allergic as thma who visited our hospital from March to May 2003. Seven subjects who had bee n diagnosed as having Platanus pollen-induced asthma were enrolled. Platanus po llen proteins were separated by gel filtration with Sephadex-G-100. To charact erize allergenic components, Platanus pollen extract was analyzed by means of so dium dodecylsulfate-polyacrylamide gel electrophoresis followed by immunoblotti ng. Results To purity the pollen we separated Platanus poll en extract in a first purification step by using gel filtration with Sephadex G -100. Two elution peaks were observed. Twelve percent SDS-PAGE analysis showed more than 10 protein bands whose molecular mass (Mr) ranged from 16 ku to 71 ku. Six bands abundant with protein at 71, 50, 35, 39, 22 and 16 ku were observed. On SDS-PAGE, the proteins of the first peak whose Mr we re 71, 50, 35, 39, and 22 ku and that of the second peak was 16 ku. SDS-PAGE and IgG-immunoblotting analysis with seven sera showed 4 IgG-binding component s whose Mr was 50, 39, 22 and 16 ku. The protein bands whose Mr was 50 ku and 22 ku had the highest binding capacity. Conclusion The strongest activity exists in the first peak which can be the major sensiti zing components and there is mild allergic activity in the second peak which is the minor sensitizing components.

Objective To study the epidemiology,pathologies and clinical manifestations of renal diseases in elderly patients of different genders in China northwest region.Methods Retrospective analysis was used to evaluate the clinical and pathological informations of patients above 60 years old who underwent renal biopsy and had the integrated data in the past 20 years.Results (1)Among the 559 patients,there were 347 men accounting for 62.1％,and there were 212 women accounting for 37.9％ ； the average age was (66.7±5.3)years,the median course of disease was 5.0months when receiving renal biopsy,and 50％ cases was (1.3 ～ 12.0)months.(2) Primary glomerulopathy accounted for 69.59％(389/559),secondary glomerulopathy,tubulointerstitial disease and the others accounted for 25.4％ (142/559),3.8％ (21/559) and 1.3％ (7/559),respectively.(3)According to clinical manifestation,nephrotic syndrome was the most common disease(accounting for 60.7％),and then chronic glomerulonephritis accounted for 31.6％.In pathology,membranous nephropathy was the most frequently category accounting for 34.5％,then mesangial proliferative glomerulonephritis accounted for 32.4％.(4) Among secondary glomerulopathy,the frequent diseases were primary polyangitis,diabetic nephropathy,amyloidosis of kidney and lupus nephritis,accounting for 24.7％,19.7 ％,13.4 ％ and 10.6 ％,respectively,and the number of women was more than men in lupus nephritis(P＜0.05).(5) The common diseases of primary glomerulopathy that would result in renal insufficiency were nephrotic syndrome and chronic glomerulonephritis,accounting for 76.5 ％ (26/34)and 76.2 ％ (48/63),respectively,and the common pathological type was both mesangial proliferative glomerulonephritis.The common diseases of secondary glomerulopathy that would result in renal insufficiency were primary small vessel vasculitis and diabetic nephropathy,accounting for 46.3％(19/41)and 34.4％(11/32),respectively.Conclusions (1)the number of men was more than women in this group,and was opposite in lupus nephritis.(2) The most common disease was primary glomerulopathy,as for clinical manifestation,nephrotic syndrome and chronic glomerulonephritis were most common； the most common pathological type were membranous nephropathy and mesangial proliferative glomerulonephritis.(3) The common disease resulting in secondary kidney damage were primary small-vessel vasculitis and diabetic nephropathy.(4)The pathological type of disease resulting in renal insufficiency was mesangial proliferative glomerulonephritis,the common diseases resulting in acute renal insufficiency were nephrotic syndrome,primary small vessel vasculitis,and those resulting in chronic renal insufficiency were chronic glomerulonephritis and diabetic nephropathy.

Objective To understand the clinical and pathological characteristics of idiopathic membranous nephropathy,and to investigate their relationships in the elderly patients.Methods The clinical and pathological data of idiopathic membranous nephropathy diagnosed by renal biopsy in the recently 10 years in our hospital were retrospectively analyzed and compared.Results Sex composition variable was not significant between elderly and non-elderly groups,with male accounting for 57.4％ and 59.2％ respectively (P＞0.05).The ratio of idiopathic membranous nephropathy in primary glomerular disease was higher in the elderly than in non-elderly group (42.8％ vs.17.4％,x2 =119.058,P＜0.01).The course of the disease,the occurrence of edema,hypertension,levels of blood urea nitrogen,serum creatinine,blood IgG,IgA and IgG/IgM ratio were higher,while glomerular filtration rate and blood IgM level were lower in elderly group than in non-elderly group (all P＜0.05).The risk for membranous nephropathy was higher in elderly than in non-elderly group (Z=-5.853,P＜0.01).Nephrotic syndrome was common in the clinical diagnosis in the two groups,but it was more common in elderly group than in non-elderly group (x2 =6.825,P=0.033).Membranous nephropathy stage Ⅱ was common in the two groups,and there were no significant differences in the pathological stages,clinical manifestations and their relationships between the two groups (all P＞0.05).Conclusions The risk for idiopathic membranous nephropathy is higher in elderly group than in non-elderly group.Edema,hypertension and renal dysfunction occur more commonly in elderly patients with idiopathic membranous nephropathy.