The improvement of blood purification technologies in the recent years brings new methods of treating autoimmune diseases. Blood purification therapy mainly includes plasma exchange, immune adsorption and cell purification etc. It can rapidly remove a great amount of circulating pathological elements like autoantibodies,or remove the immune cells. It is effective for the treatment of refractory rheumatoid arthritis,severe systemic lupus erythematosus, acute autoimmune hemolytic, myasthenia gravis and other autoimmune diseases. But this is only a symptomatic treatment. Long-term steroid and immunosuppressive therapy are still needed to consolidate the curative effect.

Biological agents has opened a new chapter in the targeted therapy of rheumatism,and provides a new choice for the rheumatism children who is refractory to traditional disease-modifying antirheumatic drugs.This article described the classification,application,efficency,side effects and precautions of the cytokines antagonists and the cell targeting biological agents,to provide a reference for rational application in clinical work.

Objective To summarize the clinical and pathogenic characteristics of urinary tract infection(UTI)in infants,and to provide reference for clinical diagnosis and treatment.Methods One hundred and eighty-eight cases of hospitalized infants with UTI diagnosis standard in Department of Pediatric Renal Rheumatism Immunology,Shengjing Hospital Affiliated to China Medical University from January 2012 to January 2015 were collected,and on the basis of the imaging they were divided into complex group(complicated UTIs) and non-complex group(non-complicated UTIs),the differences between 2 groups in the general condition,clinical manifestations,serological examination,urine culture and distribution of pathogenic bacteria and drug sensitivity results were analyzed.Results Among 188 UTI infants,148 were male and 40 were female,50 cases were in complex group (26.6％),and 138 cases were in non-complex group (73.4％).In complex group,the prevalence of prenatal ultrasound abnormalities (34.0％),the incidence of recurrent infections(24.0％),the number of fever incidence(78.0％),and peripheral WBC count [(16.4 ± 4.3) × 109/L] were higher than those in non-complex group[1.5％,10.9％,58.7％,(14.6 ± 3.5) × 109/L] (all P ＜ 0.05),and the naked eye hematuria incidence was lower than that of the non-complex group (14.0％ vs 34.8％,P =0.006).In complex group,pneumonia klebsiella bacteria positive rate was higher than that of non-complex group (22.0％ vs 2.9％,P =0.000),and the positive rate of Escherichia coli was lower than that of non-complex group(26.0％ vs 46.4％,P =0.000).There was no difference in the drug sensitivity and resistance of the pathogenic bacteria in the urine culture of 2 groups.Conclusions For fever,increased peripheral WBC,repeated infection and urine culture for Klebsiella pneumoniae UTI infants,in particular,should be alert to the prese-nce of urinary tract abnormalities,timely improve the urinary system ultrasound and urinary tract contrast is very necessary.

Autoimmune hemolytic anemia is a disorder of immune function caused by various reasons, by produceing autoantibody or complement which can react with erythrocyte autoantigen, increasing the destruction of red blood cell and beyond the compensatory ability of bone marrow hematopoiesis.Children usually have acute onset and the clinical manifestations are related to the pathogenesis.As the first-line treatment of glucocorticoids, Most children respond well to glucocorticoids.Some children suffer from steroid dependence and resistance; or recurrence due to different types of antibodies, often requiring second-line treatment, such as splenectomy, immunosuppressive, etc.This article reviews the recent progress in the treatment of children with autoimmune hemolytic anemia.

Systemic lupus erythematosus (SLE) is a serious multisystem autoimmune disease with different clinical manifestations.Childhood-onset SLE (cSLE) is similar to adult-onset SLE, while its morbidity and mortality are higher than adults, and it is prone to damage important organs.Therefore, early diagnosis and treatment are very important.With the in-depth exploration of the pathogenesis and the development of cell and molecular biology, the progress of drug therapy for SLE has been promoted.Immunosuppression still remains the cornerstone of treatment, and glucocorticoids still plays a leading role.Biologics bring the gospel to SLE patients, and non-specific immunotherapy gains treatment time for refractory and severe SLE patients.Treatment options are led by the level of disease severity.It is of great significance to understand the treatment progress of cSLE and combine theory with practice together to control the disease activity and improve the prognosis.This article reviews recent advances regarding the update on the treatment of cSLE in recent years.

Objective To summarize our clinical experience of prophylaxis and treatment for complications associated with catheterization of brachial artery. Methods 87 patients underwent endovascular treatment via brachial artery. Complications associated with catheterization of brachial artery were retrospectively analyzed. Results Under ultrasonic guidance the catheterization procedure of brachial artery was successful in all 87 patients. The success rate of cannulation was 100%. In 53 patients(61% ) ultrasonic guided cannulation was successful at the first attempt, the other 35 (39% ) with 2 or more than 2 times puncture. Complications associated with catheterization of brachial artery were detected in 16 cases. The complication rate was 18. 4%. Guidewire insertion into peri vascular compartment took place in 4 cases (4. 6% ). Episodes of local hematomas were noted in 11 cases( 12. 6% ) and in three of the 11 cases nerve injuries were detected (one of which was of late-onset type). Brachial artery pseudoaneurysm was found in 1 case(1.2%). Conclusion Familiarity with the anatomical features of the brachial access, skillful application of the techniques for the catheterization, full understanding of complications and sufficient preparation of treatment strategies can prevent those complications effectively.

Objective To explore the effect of peritoneal dialysis to treat renal failure in children.Methods There were 11 admitted patients of renal failure in our department from July 2003 to April 2008.Their clinical data and follow-up results were analyzed.Results No patient was dead during treatment.The average time of peritoneal dialysis treatment in the children with acute renal failure was 15.5 days in hospital,which was 22.8 days in the chronic patients.After treatment the levels of serum nitrogen and creatine were decreased significantly from (34.03±8.44)mmol/L and (710.09±167.54)μmol/L to (15.94±4.93)mmol/L and (233.87±92.71)μmol/L (P＜0.01).The serum sodium and bicarbonate ion were increased from (130.91±9.15)mmol/L and (14.56±2.07)mmol/L to (139.46±3.98)mmol/L and (22.47±3.29)mmol/L (P＜0.05,P＜0.01).The duration of follow-up were from one month to 5 years.The level of serum nitrogen and creatine in 5 patients of acute renal failure were normal and the analysis of urine was also normal during follow-up.One patient had renal transplantation after peritoneal dialysis.Three patients still regularly underwent peritoneal dialysis.Conclusion The peritoneal dialysis combining with multi-modality treatment was the better style of renal replacement therapy in renal failure patients.

Objective To investigate the mechanism of the kidney injure in the newborn rats with endotoxemia.Methods Eighty Wistar rats aged 7 days were randomly divided into 2 groups:control group (intraperitoneal injection of saline of 0.1 ml;n = 40),lipopolysaccharide(LPS) group(intraperitoneal injection of LPS of 5 mg/kg;n =40).The rats in either group were killed at 1 h,4 h,8 h and 12 hours after intraperitoneal injection,respectively.The expressions of NF-κB and TGF-β1 in the kidney were detected by using the immunohistochemical assay.Renal ultrastructural changes was observed with a CM100 Philips electron microscope.Results The NF-κB in control group had no expression.NF-κB in LPS group mainly expressed in the renal tubular epithelial cell,increased at 1 h after test and peaked at 8 h,and slightly descended at 12 h.The expression of TGF-β1 in control group was slight,and had not show significant difference from control group at 1 h,4 h and 8 h,but significantly higher than that in control group at 12 h.In LPS group,newborn rat renal glomerular basement membrane was complete,part epithelial cell foot processes were fused and renal tubules epithelial cell mild mitochondria vacuolization was found at 4 h.Renal glomeruli epithelial cell foot processes obvious confluenced,quantities of mesangial cells mitochondria vacuole,and renal tubules epithelial cell mitochondria expanded to bubbles at 12 h.Conclusion The NF-κB involves in the pathogenesis of kidney damage induced by endotoxemia,but TGF-β1 may help to repair the damaged kidney,and may repress the production of NF-κB.

Objective To investigate the effects of local injection of Botulinum toxin A (BTX-A) on hemifacial spasm guided by periph-eral nerve stimulation. Methods 57 patients with hemifacial spasm from January, 2012 to June, 2015 received local multi-point injection of BTX-A guided by peripheral nerve stimulation. The grades of facial spasm were evaluated before, 72 hours and 6 months after treatment. They were followed up for 3-9 months. Results The spasm reduced in the patients both 72 hours and 6 months after treatment (χ2=4.946, P<0.05). The incidence was 98.25% of satisfaction and 92.99% of very well 72 hours after treatment, while it was 91.23% and 78.95% 6 months after treatment. The relief of spasm was maintained for (23.1 ± 2.3) weeks. Conclusion Injection of BTX-A guided by peripheral nerve stimulation is effective on hemifacial spasm for a long time.

Paired box2 ( PAX2 ) is a transciption factor which mainly expressed in the developing kid-ney. Researches indicate that PAX2 promote the transcription through interactions with the adaptor PAX transac-tivation domain interacting protein(PTIP). Otherwise,PAX2 protein can lead to chromatin compaction and gene silencing through interactions with Grg4. PAX2 reexpressed in acute kidney injury and involved in promoting cell proliferation. Congenital PAX2 gene mutation is closely related to congenital abnormalies of the kidney and uri-nary tract. In chronic kidney disease,PAX2 promote proliferation and cyst formation. Here,the recent researches on the function of PAX2 and its role in acute kidney injury and chronic kidney disease are reviewed.