Renal involvement is common in systemic lupus erythematosus(SLE).Treatment of lupus nephritis includes immunosuppressive and supportive therapy.The intensity of immunosuppressive therapy depends on the clinical and renal pathological disease activity.The long-term targets of treatment are to prevent lupus nephritis relapse and protect renal function.Complete remission is the goal in the induction phase,and long-term treatment is necessary in the maintenance phase.Individualization therapy and the side effects of immunosuppressive agents should be paid more attention.

MYO1E gene is located on chromosome 15 and encodes myosin 1e,which acts as an actin-based molecular motor of cytoskeleton. Myosin 1e is critical to maintain the podocyte function and the conse-quent integrity of the glomerular filtration barrier. Mutations in MYO1E gene has been indentified to be the cause of childhood-onset,familial steroid-resistant focal segmental glomerulosclerosis. Surprisingly,three patients with MYO1E mutations had partial remission by cyclosporine therapy. Detection of the MYO1E gene in the patients suffering from steroid-resistant nephrotic syndrome will be beneficial to make therapeutic decisions and predict prognoses.

Objective To explore the expression of discoidin domain receptor 1 (DDR1) in rats with pulmonary fibrosis induced by paraquat (PQ) poisoning, and its relationship with the expression of transforming growth factor-β1 (TGF-β1). Methods 120 Sprague-Dawley (SD) rats were divided into control group and 20, 40, and 80 mg/kg PQ poisoning groups (each n = 30). Pulmonary fibrosis induced by PQ poisoning model was reproduced by one time administration of 20, 40, 80 mg/kg of 20% PQ, and the rats in control group were given 4 mL normal saline. Fifteen rats in control and different doses of PQ groups were sacrificed at 7 days and 21 days after intragastric administration, and lung tissues were collected. Pulmonary fibrosis was observed after hematoxylin-eosin (HE) staining. The immune-histochemical method was used to determine the expressions of DDR1 and TGF-β1. The relationship between the expression of TGF-β1 and DDR1 was analyzed by Pearson correlation analysis. Results The rats in control group were active, and no pathological changes in lung tissue were found. The rats in PQ groups became shortness of breath, bristles, and slow reaction etc. 0.5 hours after intragastric administration. After 7 days, the lung tissue was dark red, hard texture, appearance of yellow soil fiber nodules and obsolete hemorrhage, destruction of alveolar structure. The extent of lung injury increased gradually with the time of poisoning and the increase of PQ dose. It was shown by immune-histochemical staining that the control group had only a small amount of DDR1 and TGF-β1 positive expressions; in PQ groups, there were a large number of DDR1 and TGF-β1 positive expression particles in the alveolar wall, pulmonary interstitial and alveolar cavity. It was displayed by quantitative analysis that compared with the control group, DDR1 and TGF-β1 expressions were significantly increased in 20, 40, 80 mg/kg PQ groups with time- and dose-dependent [DDR1 (integral A value): 0.221±0.014, 0.249±0.021, 0.364±0.016 vs. 0.121±0.036 at 7 days; 0.247±0.025, 0.321±0.015, 0.432±0.027 vs. 0.139±0.021 at 21 days; TGF-β1 (integral A value): 0.230±0.016, 0.265±0.015, 0.339±0.016 vs. 0.129±0.032 at 7 days; 0.248±0.011, 0.295±0.016, 0.399±0.026 vs. 0.119±0.026 at 21 days; all P < 0.05]. It was shown by Pearson correlation analysis that DDR1 expression was positively correlated with TGF-β1 expression with the increase of PQ dose and poisoning time (DDR1 with TGF-β1: r = 0.996, P < 0.000; DDR1 with PQ dose: r = 0.985, P < 0.000; DDR1 with poisoning time: r = 0.989, P < 0.000; TGF-β1 with PQ dose: r = 0.992, P < 0.000; TGF-β1 with poisoning time: r = 0.972, P < 0.000). Conclusions The expression of DDR1 in the lung tissue in PQ poisoning rats showed a time- and dose-dependent change, and it was positively correlated with TGF-β1 expression. DDR1 may be involved in the process of pulmonary fibrosis induced by PQ poisoning.

Objective To investigate the effects of transcranial magnetic stimulation(TMS)on the recovery of neurological function and the expression of neurofilament protein(NFP)-200 in rats with cerebral infarction.Methods The string-fastening method was used to establish focal ischemia-reperfusion models in 60 Sprague-Dawley rats and the rats were divided into the TMS group and the sham TMS group(composed of 30 rats each).Then each group were divided into the treated 1 d,3 d,7 d,14 d and 21 d subgroups(composed of 6 rats each).TMS group rats were administered with 2 sessions of TMS(200 pulses total)daily,keeping on corresponding days in different groups.The recovery of neurological function and the optical density of NFP-200 by immunohistochemistry in the infarct peripheral zone in two groups were detected after therapy.Results At the 14 d and 21 d after treatment,neurological deficit scores of TMS group(2.67?0.82,1.50?0.55) were significantly lower than those of the sham TMS group(3.67?0.52,3.17?0.75)(P

Aged ; Aged, 80 and over ; Candidiasis ; complications ; microbiology ; Coal Mining ; Esophagitis ; complications ; microbiology ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; microbiology

Objective To investigate the biological properties of human amniotic mesenchymal stem cells (hAMSCs) which were preconditioned with phosphodiesterase-5 inhibitor (Vardenfil). Methods hAMSCs were in vitro isolated and cultured, hAMSCs were pre-treated with vardenfil in final concentration of 10 μmol/L. The morphology of Vard-hAMSCs was observed, and the immunological characteristics, proliferative capacity, and ability of anti-oxidative damage of hAMSCs and Vard-hAMSCs were analyzed by flow cytometry. Double labeling immunofluorescent staining was used to count the differences of differential potential between neural cells of hAMSCs and Vard-hAMSCs. Results (1)Flow cytometry revealed that both hAMSCs and Vard-hAMSCs positively expressed CD90、CD105 and CD73, and negatively expressed CD34、CD45、CD11b and HLA-DR. The SPF and PI in Vard-hAMSCs group were (0.57 ± 0.40)% and (2.20 ± 1.60)% respectively, there was no statistical significance compared with hAMSCs group; (2)After 4 hours treated by H2O2, the apoptosis rate in Vard-hAMSCs group were (7.67 ± 0.82)%,which were markedly lower than that in the hAMSCs group and specific blocker group; (3)Under the same induction condition, positive rates of MAP-2 and GFAP in Vard-hAMSCs group were (49.8 ± 6.42)%and (55.2 ± 6.10)% respectively detected by double labeling immunofluorescent staining, which were significantly higher than the control group. Conclusion The strategy that hAMSCs are treated with vandenfil can enrich the ability of anti-oxidative damage and the differential potential for neural cells in a certain time, and the morphology, immunological characteristics, proliferative capacity of Vard-hAMSCs have no significant change. It suggests that pre-treatment with vandenfil may provide a optimized experimental strategey for hAMSCs which were used to treat nervous system disease.

AlM: To evaluate the effect of rigid gas permeable contact lens ( RGP ) in correcting high myopia and astigmatism.METHODS: Forty-one patients ( 65 eyes ) with myopia (-9. 03 ± 6. 19DS, maximum -23. 00DS) and astigmatism (-1. 41 ± 1. 32DC, maximum -5. 50DC) were fitted with RGP after strict routine ophthalmological examination, objective refraction and subjective refraction. All these patients were followed after 1wk, 1, 3mo and half one year.RESULTS:Sixty-five eyes were fitted with RGP (-9. 92± 5. 96DS). RGP base curve ( BC) was majorly located within the range 7. 20 ~8. 25mm. 46. 2% eyes with RGP achieved 1. 0 ( BCVA ) and 80. 1% achieved above 0. 6 ( BCVA) . However, with spectacles, the percent was 28%(1. 0) and 60% (>0. 6), respectively. BCVA of RGP was 0. 81 ± 0. 22, but BCVA with spectacles was 0. 66 ± 0. 28, there was statistical significance (P<0. 01). There were 40 eyes (62%) fitted with RGP whose vision were enhanced more than 1 line, 24 eyes ( 37%) whose vision were not changed and 1 eye (2%) whose vision were dropped 1 line.CONCLUSlON:RGP effectively improves visual acuity of high myopia and astigmatism compared with spectacles.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Tracheostomy ; adverse effects ; Young Adult

Objective To investigate the methods and results of lengthened proximal femoral nail antirotation (PFNA) in the treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Methods Of the 21 patients with femoral shaft combined with ipsilateral femoral neck fractures treated by lengthened PFNA from 2006 to 2009,16 patients with complete follow-up were retrospectively studied.There were 15 males and 1 female,at mean age of 35 years (range,21-51 years).Injury causes were all high-energy trauma including traffic injuries in 11 patients and fall injuries in five.According to Garden classification,there were seven patients with type Ⅰ femoral neck fractures,six with type Ⅱ and three with type Ⅲ.Femoral shift fractures contained six superior part fractures and nine medial part fractures and one inferior part fracture.According to Winquist classification,there were two patients with type Ⅰ femoral shaft fractures,four with type Ⅱ,six with type Ⅲ and four with type Ⅳ.Two patients had open fractures belonging to type Ⅰ Gustilo-Anderson.Harris hip score was used to evaluate functional outcomes at the last follow-up postoperatively. Result The mean follow-up time was 2.4years (range,1-4 years ).The mean period for healing of femoral neck and shaft fractures was 4.2months ( range,3-6 months) and 5.1 months ( range,3-8 months) respectively.Four patients showed delayed diagnoses of femoral neck fractures ; two patients had delayed union of femoral shaft fractures ; one suffered from avascular necrosis of the femoral head ; one patient presented 3 cm of extension of the affected limb and was accompanied by active pain of the knee joint for over four months.According to Harris score,function of hip joints was excellent in seven patients,good in six and fair in three,with excellence rate of 82％. Conclusions It is relatively few that the femoral shaft fracture is combined with ipsilateral femoral neck fracture.The rate of missed diagnosis of femoral neck fractures is high and the patients with high energy trauma hould be highly paid attention to.Lengthened PFNA conforms to characteristics of biomechanical fixation and presents short operation time and solid fixation. Lengthened PFNA achieves affirmatory effects for treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures.

In recent years, the medical graduates who take part in postgraduate examination have been increasing each year. The preparation for postgraduate examination affects the clinical practice, but not yet has a quantitative report. This article studied the students in general surgery, which were divided into postgraduate examination group and clinical practice group. By comparing the theoretical knowledge results and the clinical practice skills between the two groups we found that there was no difference between the two groups in the theoretical and operating skill when they were just in the department, and the operating results in the clinical practice group were better than the postgraduate examination group when they were out of the department.