Focal segmental glomerulosclerosis (FSGS) is the main pathologic type that causes end-stage kidney diseases and the recurrence after kidney transplantation.So far, the pathogenesis of FSGS is still not entirely clear.However, more and more mutations have been reported on the FSGS, especially on the genetic FSGS.It is clear that podocyte plays an important role in the development of FSGS.At the same time, the role of soluble urokinase-type plasminogen activator receptor in the recurrence after kidney transplantation has become the research focus.This article will make a brief review on the progress of the pathogenesis of FSGS.

During the last fifty-year medical treatments have made great advances in the treatment of heart failure(HF).The current applicatin of treatment improves the life quality of patients with HF,and reduces their clinical envents and mortality.But the patients with refractory heart failure(RHF) have poor prognosis.This article reviews and analyzes the advances in the therapies for patients with RHF.

Objective: To establish a method for the determination of norcantharidin in norcantharidin in situ gel .Methods:An optimal HPLC method was set up and an Agilent ZORBAX SB-C18 column (150 mm ×4.6 mm, 5μm) was adopted.The mobile phase was acetonitrile-phosphate buffer solution(1∶9, adjusting pH to 3.1 with phosphorjc acid).The flow rate was 0.8 ml· min-1 and the column temperature was 25℃.The detection wavelength was set at 210 nm and the injection volume was 20μl.Results:Norcanthari-din had a good linear relationship within the range of 0.02-1.00 mg· ml-1 (r=0.999 9).The average recovery was 97.5%and RSD was 0.98%(n=9).Conclusion:The method is accurate, simple and reproducible, which can be used for the determination of nor-cantharidin in norcantharidin in situ gel .

[Objective]To sum up pro. Lian Jianwei’s clinical experience in treating acne. [Method] By proved recipe analysis, it shows pro. Lian Jianwei ’s treatment based on differentiation of signs from different angles and the clinical thought of flexibly applying ancient formulae on acne. [Result] Pro. Lian Jianwei is good at revising ancient formulae for treating acne with good effect, according to patients ’pulse signs and mechanism;if the food is stagnated in the gastric-intestine, which wil transform into heat and up along the channel, Baohe Pil shal be used to remove stagnation and heat; if the liver is de-pressed with heat, deficient blood and weak spleen, Xiaoyan Powder shal be used for regulation and stretching the wood; use Wenqing Drink to nourish blood and remove toxin for deficient blood and hot liver, toxic heat implicated in spleen and stomach; apply Zisheng Pil to regulate and tonify middle part of the body for deficient spleen and stomach with turbidness and dyspepsia, etc. [Conclusion] Pro. Lian Jianwei has rich clinical experience, his clinical thought of “treatment based on differentiation of signs, with flexible methods and formulae, coping with shifting diseases by sticking to a fundamental principle”, worthy our deep experiencing and study.

Purpose] This paper aims to summarize the clinical practice of using Buzhong Yiqi Decoction to treat the obstructed nine orifices. [Approach] After explaining Li Dongyuan’s theory that those obstructed nine orifices reflecting headaches and tinnitus are caused by intestines and stomach diseases,which is in his Suwen On Deficiency and Excess and analyzing several simple cases of using buzhong yiqi decoction to treat the obstructed nine orifices,this paper tries to trace the theoretical origin of Prof. Lian’s practice and present the practical experience of flexible usage of Buzhong Yiqi Decoction. [Result] The outcome of several patients under treatment shows that the short-and-mid-term treatment is very effective. [Conclusion] Prof. Lian’s philosophy of traditional Chinese medicine reflects his attitude that “those patients suffering from insufficiency of primordial Qi and clear Yang failing to distribute”or“clear Yang coming out of stomach”ask for strengthening the spleen and stomach so their stomach recovers to the healthy state. As a result,their Yang Qi has been greatly improved,the spleen and stomach in the middle energizer have returned to their original place,reaching the autonomous regulation of the nine orifices,which has shed some light on the usefulness of Buzhong Yiqi on treatment diseases other than those of spleen and stomach.

Objective To summarize 5 otospongiosis cases with profound sensory hearing loss who received cochlear implante(CI) in routine way.To analyze their characteristics in audiology and temporal CT,and the effects after CI.Methods 5 cases of profound sensorineural hearing loss with otospongiosis received pure tone test,otoacoustic emission,auditory brainstem evoked potential and temporal CT before operation.One of the patients received binaural CIs.Mapping was done one month after operation.Follow-up tests were provided 6 months after operation to assess the effects.Results 5 cases showed clinical characteristics of gradual binaural hearing reduction,PTA greater than 90 dB HL,mixed or sensorineural deafness,normal tympanic membranes,reduced peaks in acoustic impedance,and typical CT findings.5 patients(6 ears) were implanted in routine manner.It was difficult to open the cochlea scala tympani.The scala tympani was filled with loose bony tissues.It was about 7～9 mm between the round window and the normal scala tympani.All patients showed the standard wave from in nerves reaction remote monitoring.The patients were followed up from 8 months to 3.1years.The average PTA was 20～37dB HL.The speech discrimination score was 95%～99% for open Chinese audiometry.Conclusion CI was an effective way to help patients with profound sensory hearing loss and otospongiosis.

Background Neovascular glaucoma (NVG) is a serious eye disease with a variety of causes.It results from the secretion of growth factors by hypoxic retinal tissue,such as vascular endothelial growth factor (VEGF),but anti-VEGF treatment alone dose not completely inhibit neovascularization.Our previous study found that platelet-derived growth factor-c (PDGF-C) is also an important factor in pathological angiogenesis.However,the role of PDGF-C in the development of NVG remains unknown.Objective This study was to quantitatively detect the levels of VEGF and PDGF-C in the aqueous humor of patients with NVG and provide a basis for the anti-angiogenesis therapy.Methods A prospective cohort study was carried out.Sixty-two eyes of 62 patients with advanced NVG and 11 control subjects with age related cataract were included in Xijing Hospital of the Fourth Military Medical University from January 2014 to August 2015.Ten of 62 NVG eyes received retinal photocoagulation and/or cryotherapy,and 16 eyes resulted from central retinal vein occlusion,20 eyes from diabetic retinopathy,5 eyes from postopeartion of retinal detachment,4 eyes from Eales disease and 7 eyes from unknown cause.Iris neovascularization of grade Ⅱ was found in 13 eyes,grade Ⅲ in 29 eyes and grade Ⅳ in 10 eyes.Aqueous humor specimen was collected for 0.1-0.2 ml during the surgery,and the contents of VEGF and PDGF-C in the aqueous humor were detected by ELISA assay.Written informed consent was obtained from each subject prior to any medical procedure.Results The VEGF and PDGF-C concentrations in the aqueous humor were (1 138.17±69.31) ng/L and (29.80±1.64) ng/L in the NVG group,respectively,which were significantly higher than (679.54±49.81) ng/L and (18.60±1.85)ng/L in the control subjects (t=20.95,20.49,both at P＜0.01).The VEGF and PDGF-C concentrations in aqueous humor were (1 095.99±52.71) ng/L and (28.55±0.94) ng/L in the retinal photocoagulation group,showing significantly decreases in comparison with (1 146.28±69.57) ng/L and (30.04± 1.64) ng/L in the untreatment group (t =-2.160,P =0.034;t =-2.760,P =0.008).The VEGF content in aqueous humor was positively correlated with PDGF-C content in the patients with NVG (r=0.346,P=0.006).However,the aqueous levels of VEGF and PDGF-C were not significantly different among various primary disease groups and different iris neovascularitation gradings (all at P＞0.05).Conclusions Both VEGF and PDGF-C contents in the aqueous humour are considerably elevated in NVG patients.Retinal photocoagulation and/or cryotherapy can inhibit the release of VEGF and PDGF-C in the aqueous humor.PDGF-C may be a target for the treatment of NVG.

[Objective] To investigate the effect of sevoflurane and isoflurane anesthesia on the renal function of patients with severe fracture after surgery.[Methods] Sixty-two patients with severe fracture who needed surgery were enrolled and all received general anesthesia.All the patients were divided by random digits table method into two groups with 31 cases each:sevoflurane group(anesthesia maintenance with 1.5％-3.0％ sevoflurane)and isoflurane group(anesthesia maintenance with 1.5％-3.0％ isoflurane).The patients in two groups received 0.1-0.2 μg/(kg·min)remifentanll continuous intravenous infusion and atracuurium intermittent intravenous injection for anesthesia maintenance.Serum creatinine(SCr)and blood urea nitrogen(BUN)in two groups after surgery were compared,as well as the number of hemodialysis.[Results]SCr and BUN at 1,3,7 d after surgery in two groups were significantly lower than those before surgery[seveflurane group:(517 ± 187),(163 ± 110),(103 ± 99)μ mol/L vs.(853 ± 220)μmol/L,(17.1 ± 7.8),(9.5 ± 4.1),(9.7 ± 3.8)mmol/L vs.(21.8 ± 9.3)mmol/L;isoflurane group:(539 ± 188),(136 ± 108),(101 ± 95)μ mol/L vs.(881 ± 220)μmol/L,(17.5 ± 7.4),(9.5 ± 3.5),(9.8 ± 3.3)mmol/Lvs.(20.0 ± 8.9)mmol/L](P ＜ 0.05).SCr and BUN between two groups at every time point after surgery had no statistical significance(P ＞ 0.05).There was 1 case(3.2％)in sevoflurane group needed hemodialysis within 7 d after surgery,as well as in isoflurane group,and there was no statistical significance between two groups(P＞0.05).[Conclusions] For patients with severe fracture who need general anesthesia and surgery,sevoflurane and isoflurane both have no significant adverse reaction to renal function.Therefore,it is acceptable for the patients to use sevoflurane for anesthesia and it is worthy of clinical popularization and application.

Objective To investigate the inhibitory effects of histidine grafted poly (β-amino es-ter) ( HGPAEs) vector-based RNA interference ( RNAi) on the expression of gene encoding myeloid differ-entiation factor 88 (MyD88) in rat liver tissues.Methods The sequence of small hairpin RNA (shRNA) was designed based on the genetic information of MyD 88.HGPAEs vector was constructed and coupled with shRNA plasmid targeting MyD88 to construct pMyD88-HGPAEs vector.Rats were divided into five groups including control group , HGPAEs treatment group , pHK-HGPAEs treatment group , shRNA treatment group and pMyD88-HGPAEs treatment group .The rats in each group were transfected with the corresponding inter-ventions through portal vein injection .Real-time PCR and Western blot assay were performed to detect the expression of MyD88 in liver tissues 3 days after transfection .Results The pMyD88-HGPAEs vector was successfully constructed .The expression of gene encoding MyD 88 was inhibited in rats from shRNA treat-ment group and pMyD88-HGPAEs treatment group (P<0.05).Significantly decreased expression of gene encoding MyD88 at mRNA and protein levels were observed in rats from pMyD 88-HGPAEs treatment group as compared with those from other groups (P<0.01).Conclusion HGPAEs vector might be used as a po-tential gene carrier .The expression of gene encoding MyD 88 in rat liver tissues could be significantly inhibi-ted through portal vein injection of pMyD 88-HGPAEs vector .This study provided evidences for further re-search on pMyD88-HGPAEs vector in a high responder model of rat orthotopic liver transplantation .

Objective To investigate the chemical preventive effect of matrine on ethyl nitrate nitroguanidine nitrate induced gastric cancer in rats. Methods 100 male Wistar rats were selected and randomly divided into four groups,each had 25 rats ,treated with different drugs respectively.Rats in the negative control group (group A)freely drunk water;each rat in gastric carcer model group (group B)drunk ethyl nitrate nitroguanidine nitrate (ENNG)1.5 mg/d by themselves;gastric cancer model rats of experimental group (group C)drunk matrine 150 mg/(kg · d)ethyl nitrate nitroguanidine nitrate (ENNG)150mg/(kg·d)by themselves;negative control group (group D)rats drunk matrine for injection 150 mg/(kg·d)by themselves.Rats were killed after 24 weeks,rats were observed on gastric mucosa change by naked eye and microscope ,and detected proliferating cell nucleus antigen (PCNA)of stomach tissue ,levels of serum transforming growth factorβ1 (TGF-β1 )and B cell lymphoma/leukemia-2 (Bcl-2).Results Canceration rate [64.00% (16/25)]of the rat gastric mucosa in Group B was significantly higher than that in group C [12.00% (3/25)],and the difference was statistically significant (P<0.05 );PCNA,TGF-β1 and the Bcl-2 level of rats in group C was lower than those in group B,and the difference was statistically significant (P<0.05 );after raising 24 weeks,change rate of gastric mucosa atrophy and hyperplasia in group B were significantly higher than those of group C,and the difference was statistically significant (P<0.05 );after raising 24 weeks,there was no cancerous changes on gastric mucosa in group A and D ,and the change of gastric mucosa atrophy and hyperplasia had no obvious difference,there was no statistically significant difference.Conclusion Matrine could inhibit rat gastric cancer induced by ENNG by lowering PCNA,TGF-β1 and the Bcl-2 levels,which provides evidence for the potential chemical preventive effect on human gastric cancer.