Objective To investigate the clinical features of Henoch-Schonlein purpura nephritis(HSPN) and the clinical significance of plasma endothelin-1(ET-1) in HSPN.Methods The epidemiology and clinical characteristics were retrospectively analyzed in 84 patients admitted to our hospital from January 2000 to March 2005.The changes of ET-1 were measured in 84 patients and 16 controls by using radioimmunologic assay.Results The age of onset in HSPN was 5-10 years and the corresponding patients occupied 90.6%.The majority of HSPN cases(80.32%) occurred from September to March of the second year.Infection was still the main occasion factor(40.57%),and the mistaken diagnosis at rate of 33.33% as acute gastricism and appendicitis when gastrointestinal sign appeared earlier than the typical purpura.The nephritic syndrome was the most constant clinical manifestation(47.63%).The pathological type of grade Ⅱ was 37.84%,grade Ⅲ 56.40%.The level of plasma ET-1 in patients was more higher than that of normal controls.The level of plasma ET-1 had a positive correlation with plasma urea nitrogen and creatinine(r=0.584,0.523,P

Objective To study the origin of HIV-1 strains from 2 mother-to-child cases. Method DNA fragments of HIV-1 gag gene were amplified by nested PCR from the 4 target persons, and the amplified region were sequenced. Results The sequence of the specified fragment from all persons were analyzed and the strains were belonged to subtype A/E, while the sequence between mother's and child's is highly homologous. Conclusion 2 children were infected by mother-to-child transmission.

Objective To compare the efficacy of arthroscopic synovectomy between early and middle stage rheumatoid arthritis. Methods A total of 34 cases of rheumatoid arthritis (42 knee joints) either in early stage (22 cases, 24 joints) or in meddle stage (12 cases, 18 joints) underwent arthroscopic synovectomy. The bipolar radiofrequency was used for the synovial debridement and hemostasis in 32 knee joints. Postoperatively, routine anti-rheumatoid drugs were administrated. Follow-up observations in the two groups included the evaluation of knee function, the erythrocyte sedimentation rate (ESR), the C-reaction protein (CRP), and the rheumatoid factor (RF). Results The rate of excellent or good results was 91.7% in early stage (22/24) and 66.7% in middle stage (12/18), without statistical significance between the two groups ( ? 2=2.705, P =0.100). Conclusions Arthroscopic synovectomy is effective for the treatment of rheumatoid arthritis in both early and middle stage. Bipolar radiofrequency is helpful for the complete elimination of the synovium, the prevention of joint hematoma, and the rehabilitation of joint function.

Objective To study the early effect of arthroscopic bipolar radiofrequency technique in the treatment of patellofemoral malalignment. Methods 42 patients(47 knees) who were confirmed to be patellofemoral malalignment by radiographic methods, underwent arthroscopic bipolar radiofrequency chondroplasty and lateral retinacular release. The cartilage abnormality were classified according to the Outerbridge grade. 34 cases(37 knees) were followed up and mean period was 18.3 months. Patients were assessed before and after surgery using the Kujala patellofemoral score. Patellofemoral alignment were evaluated through MRI in 23 of 37 knees. The change of Cac (congruence angle of cartilage), Tac(tilt angle of cartilage), LPDc (lateral patellofemoral distance of cartilage) and LPFac(lateral patellofemoral angle of cartilage) were measured. Results The patellofemoral joint score was improved significantly in OuterbridgeⅠ,Ⅱand Ⅲ grade patients(6 knees ofⅠgrade: 60.83?3.54 preoperatively and 82.50?9.22 postoperatively, P0.05). The score of all these 37 knees was improved from 55.86?9.39 preoperatively to 69.41?14.89 postoperatively(P

Objective To analyze the effect of guizhi gancao decoction on dardiac function and serum VCAM-1 and sE-selectin levels in patients with coronary heart diseaser. Methods Fifty-eight patients with coronary heart disease were enrolled in this study from September 2014 to June 2015. According to the different treatment methods, 40 patients were treated with conventional western medicine. The observation group of 40 cases were treated with conventional western medicine and Guizhi licorice soup. The effects of cardiac function, 6-minute walking test, cardiac parameters and serum sE-Selectin and ICAM-1 levels were observed. Results Observation group of patients with cardiac ultrasound parameters LVEF (43.27 ± 5.21)%, LVEDd (59.34 ± 5.43) mm, FS (26.32 ± 1.63)%, E / A (1.23 ± 0.22) and 6 min walking distance were better than those of the control group (t=2.3628,P =0.0206;t=2.4643,P=0.0159;t=2.7831,P =0.0068;t=2.5023,P =0.0144;t=3.7571,P =0.0006). The markedly effective rate was 47.50%, which was higher than that of the control group (25.00%), and there was significant difference (χ2 = 4.3813, P= 0.0363). In the observation group, 4 patients were ineffective and the inefficiency rate was 10.00%, which was significantly lower than that of the control group (χ2 = 4.0205,P= 0.0450). The levels of TC (5.21 ± 0.82) mmol / L, TG (1.22 ± 0.32) mmol / L and LDL-C (2.44 ± 0.52) mmol / L were significantly lower in the observation group than those in the control group (t= 3.2729, P = 0.0016; t= 3.5119, P = 0.0007; t= 3.5136, P= 0.0007). While the HDL-C (1.21 ± 0.17) mmol / L index was higher than that of the control group (t = 5.4575, P = 0.0000). There was no significant difference in serum index between the two groups before treatment . After treatment, the serum sE-Selectin (75.58 ± 9.97) ng / mL and VCAM-1 (662.43 ± 65.78) ng / mL were lower than those in the control group (t = 3.4082, P = 0.0010;t = 3.3088, P = 0.0014). Conclusion Treatment of CHF patients with CRT / CRT-D pacemaker implantation in the heart after surgery can effectively improve its clinical condition, and the effect is outstanding, side effects, and CRT-D better effect.

Objective To study the level of vitamin A of children aged 7～14 in the Dongxiang and Bonan ethnic ghettos.Methods Fifty-seven children aged seven to fourteen were sampled from rural areas in the Dongxiang and Bonan ethnic ghettos from Dongxiang Autonomous County and Jishishan region,Gansu Province.The vitamin A level in serum was detected using the fluorescence method.Results The average level of vitamin A in serum was(1.41?0.42)?mol/L for children aged seven to fourteen in the Dongxiang region,and of all the fifty-seven children,there was 4 SVAD(accounted for 7.0%)and 10 suspicious SVAD(accounted for 17.6%).The average level of vitamin A in serum was(1.67?0.53)?mol/L for children aged seven to fourteen in the Bonan region,and of all the fifty-seven children,there was 1 SVAD(accounted for 1.7%)and 7 suspicious SVAD(accounted for 12.3%).There was statistically significant difference in different national and aged groups,but no difference in SVAD and suspicious SVAD.Conclusions SVAD and suspicious SVAD exist in the Dongxiang and Bonan region,and the intervention of vitamin A supplementation should focus on children suffering from SVAD and suspicious SVAD.

ObjectiveTo evaluate the diagnostic value of immunohistochemistry(IHC) for the identification and localization of Treponema pallidum(TP) in secondary syphilitic lesions.MethodsSkin tissue specimens were obtained from the lesions of 25 patients with secondary syphilis and 15 patients with dermatoses unrelated to TP infection,followed by fixation and embeding.IHC using a polyclonal antibody against TP and Warthin-Starry (W-S) silver stain were carried out respectively to detect TP in these specimens.Results TP was detected in 80.00％ (20/25) of the specimens by IHC,44.00％ by W-S silver stain (Fisher's Exact Test,P =0.046).Of the 20 IHC-based TP-positive specimens,all harbored TP in the epidermis,11 also in the dermis.The density of TP was associated with the types of skin lesions,and sequentially decreased from condyloma latum to papules,maculopapules and maculae(x2 =15.694,P =0.011 ).Spirochetes were not seen in any of the control lesional specimens.ConclusionsIHC is superior to traditional W-S silver stain for detecting spirochetes in secondary syphilitic lesions,and is of great value to the diagnosis of secondary syphilis.The accurate localization of TP by IHC may facilitate the study on the formation of syphilitic lesions.

Objective To clone survivin gene, prepare its monoclonal antibody(McAb) and check its expression in liver carcinoma cells.Methods Survivin gene cDNA was amplified by RT-PCR from human breast carcinoma cell line MCF-7 and constructed into prokaryocytic expression vector.Fusion-protein of human Survivin was expressed and used for immunizing BALB/C mice.The spleen cells from immunized mice were fused with SP2/0 cells and selectively cultured with HAT medium.ELISA and Western blot were used to screen and identify the McAbs.Immunocytochemical staining was applied for survivin expression in liver carcinoma cells.Results The full survivin gene was cloned. The hybridoma cell that secret specific monoclonal antibody against human surviving was identified.The immunoglobulin subclasses of the McAbs were IgG1.Western blot showed that the McAbs against survivin can specifically react with MS-Survivin fusion protein. The positive reaction was found in hepatocarcinoma cell line HepG2 and hepatocarcinoma tissue by immunocytochemical staining.Conclusion The McAbs against the human Survivin were successfully prepared by a MS2-Survivin fusion protein expressed by E.coli. and the McAb had positive reaction with HepG2 and hepatocarcinoma tissue. It may be a useful tool to study the functions of survivin and check clinical cancer samples.

Objective To evaluate the clinical value of serum MUC1(sMUC1)in the patients with multiple myeloma.Methods The enzyme linked immunosorbent assay(ELISA)was used to compare the sMUC1 levels in the 12 cases of newly diagnosed multiple myeloma.15 cases of post-chemotherapy and 46 healthy donors.Results The mean concentration of sMUC1 in the newly diagnosed patients with multiple myeloma was 33.44 U/ml(10.86～88.80 U/ml).In the patients of post-chemotherapy the mean concentration was 11.6U/ml(3.92～22.22 U/ml),and in the healthy donors the concentration was 12.81 U/ml(3.84～30.45 U/ml).The level of sMUC1 in the new diagnosed patients was significandy higher than that in the patients of post-chemotherapy(P=0.001)and healthy donors(P=0.000).There was no significant difference between post-chemotherapy and healthy donors(P=0.461).Conclusion sMUC1 may be one of the tumor markers for the diagnosis of multiple myeloma.sMUC1 could also be used as one of the indicators of prognosis and the evaluation of the chemotherapy efficacy.sMUC1 might be a potential target for the immunotherapy to the patients with multiple myeloma.

BACKGROUND:Valgus knee deformity is rare in the clinic. The therapeutic effects of artificial knee arthroplasty are worse than varus knee deformity. There is no unified opinion for replacement approach, soft tissue release method and procedure and prosthetic choice at present.
OBJECTIVE:To summarize case data and to observe clinical effects of total knee arthroplasty for valgus knee deformity.
METHODS:Clinical data of 37 cases of valgus knee deformity (42 knees) undergoing total knee arthroplasty, who were treated by the same group of physicians in the First Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were retrospectively analyzed. There were 11 males (13 knees) and 26 females (29 knees), at the age from 56 to 78 years, with an average age of 63.7 years. The differences in range of motion, femorotibial angle and Hospital for Special Surgery knee score were compared before and after replacement. Clinical effects of total knee arthroplasty for valgus knee deformity were evaluated.
RESULTS AND CONCLUSION:The postoperative fol ow-up lasted from 6 to 36 months. Knee joint range of motion increased from preoperative 68.5° to an average of postoperative 108.5°. Femorotibial angle reduced from preoperative 16.82° to postoperative 5.62° on average. The average Hospital for Special Surgery knee score increased from preoperative 39 points to postoperative 88 points (P<0.05). These results suggested that the curative effect of total knee arthroplasty for valgus knee deformity is proved. Total knee arthroplasty is an effective way to improve deformity.