Objective To discuss MRI manifestations of overlap syndrome of autoimmune liver diseases and the diagnostic value of the MRI .Methods Seven patients of overlap syndrome of autoimmune liver diseases were recruited .The MRI examination (inclu‐ding T1WI ,T2WI ,DWI and MRCP )were underwent on these patients .MR features of overlap syndrome were reviewed by two ra‐diologists by consensus .Two radiologists independently reviewed the studies in a blinded fashion .Results AIH/PBC 4 cases ,AIH/PSC 1 case ,PBC/PSC 1 case ,AIH/PBC/PSC 1 case was collected .MRI of AIH/PBC has the MRI feature of AIH and PBC .MRI of AIH/PSC has the MRI feature of AIH and PSC .MRI of PBC/PSC has the MRI feature of PBC and PSC .MRI feature of AIH/PBC/PSC has the MRI feature of AIH ,PBC and PSC .Conclusion If the patients who sufferd autoimmune liver diseases displayed the MIR images of other autoimmune liver diseases ,the patients were considered that had developed into overlap syndrome of autoim‐mune liver diseases .

Objective To assess the value of functional magnetic resonance urography (fMRU)for the unilateral renal function in children with hydronephrosis.Methods Fourteen children with congenital hydronephrosis (unilateral hydronephrosis in 1 2 cases,bilateral hydronephrosis in 2 cases)examined by fMRU in Beijing Children′s Hospital,Capital Medical University,were enrolled.In 7 patients of them,diuretic renal scintigraphy (DRS)was per-formed within 1 0 days before fMRU examination.The following parameters in fMRU,as renal parenchymal volume,volu-metric differential renal function (vDRF),Patlak,Patlak differential renal function (pDRF),index of glomerular filtra-tion rate (GFR)and differential renal function based on index of GFR (gDRF),were calculated and analyzed.Statisti-cal analysis was performed by using SPSS 1 3.0.Results In 7 cases whose fMRU and DRS were examined,the indexes of GFR obtained from fMRU and GFR from DRS were well correlated (r =0.892,P <0.001 )in 1 4 kidneys.The gDRF determined by 2 methods on the left kidneys[the average was(46.80 ±1 9.20)% and(45.1 8 ±20.29)%,respective-ly]had no significant difference (t =0.051 6,P =0.624),which was also highly correlated (r =0.91 2,P =0.004). In 1 2 cases with unilateral hydronephrosis,vDRF,pDRF,index of GFR and gDRF in hydronephrotic side[(43.54 ± 9.61 )%,(42.80 ±1 0.83)%,(38.56 ±29.23)mL/min,(38.37 ±1 3.61 )%]were all less than those in the con-tralateral side[(56.46 ±9.61 )%,(57.1 9 ±1 0.83)%,(57.02 ±26.22)mL/min,(61 .63 ±1 3.61 )%](t =2.326, 2.300,2.422,2.960;P =0.040,0.042,0.034,0.01 3).However,there was no statistical difference in both renal pa-renchymal volume and Patlak between the hydronephrotic and the contralateral side kidneys(t =1 .765,1 .450;P =0.1 05,0.1 75).Conclusions fMRU is a very valuable examination method in evaluating single kidney function in children with congenital hydronephrosis,and able to demonstrate that gDRF,indexes of GFR,vDRF and pDRF decrease in the hydronephrotic kidney.

Objective To observe the effects of transitional care on BiPAP ventilation in patients with COPD combined with respiratory failure and to explore an effective implementation form of developing home treatment with BiPAP.Methods Patients with COPD combined with typeⅡ respiratory failure who would receive home treatment with BiPAP after leaving Shanghai Pudong Gongli Hospital were recruited by convenience sampling method from July 2014 to December 2015. They were divided into intervention group (n=48) and control group (n=45) with random number table. Patients of both groups all received long-term treatment with BiPAP after leaving hospital. On this foundation,patients in the control group accepted telephone follow-up for one time while patients in the intervention group received transitional care including telephone follow-up,home visits,group lectures,intervention by WeChat group for several times. The pulmonary ventilation function,inflammatory factors,6-minute walk test (6MWT) and BiPAP related complications were recorded between two groups before,three months and six months after discharging from hospital. Results There was a statistically significant difference in pulmonary function index changing over time (P<0.05). Grouping and interaction had no significant effect on pulmonary function indexes (P>0.05). There were statistically significant differences in arterial blood gas indexes and levels of inflammatory factors of patients among different times,grouping and interaction between the two groups(P<0.05). Besides,there were statistically significant differences in 6MWT among different times,grouping and interaction between the two groups (P<0.05). The incidence of facial pressure ulcer and readmission rate in intervention group were lower than those in control group with significant differences (P<0.05).Conclusions Under the comprehensively transitional care intervention,home treatment with BiPAP for patients with COPD combined with typeⅡ respiratory failure would help to improve the dispersion of oxygen and inflammatory reaction,increase activity tolerance and prevent the progressive decline of pulmonary ventilation function.

Objective:To investigate the impact of different type of dyslipidemia on clinical and pathological characteristics in children with IgA nephropathy (IgAN).Methods:A retrospective study was performed at the Children Kidney Disease Center, the First Affiliated Hospital of Sun Yat-sen University between January 2006 to September 2019. Children diagnosed with primary IgAN was divided into dyslipidemia group and normal blood lipid group according to whether the blood lipid is normal, and was divided into the following four groups: hypercholesterolemia group, hypertriglyceridemia group, mixed hyperlipidemia group and low high-density lipoprotein cholesterol (HDL-C) group according to clinical classification. The clinical and pathological features in different groups were analyzed, and the risk factors of dyslipidemia were analyzed by using multivariate logistic regression analysis.Results:A total of 252 children with IgAN were enrolled in this study, including 169 males and 83 females, with a male/female ratio of 2.04∶1 and an age of (9.3±3.1) years. Among them, 34.5% IgAN children were complicated with hypertension, and 170 cases (67.5%) were in dyslipidemia group, 82 cases (32.5%) in normal blood lipid group. According to clinical classification, the children in dyslipidemia group were divided into hypercholesterolemia group (58 cases, 23.0%), hypertriglyceridemia group (16 cases, 6.3%), mixed hyperlipidemia group (77 cases, 30.6%) and low HDL-C group (19 cases, 7.5%). The systolic blood pressure, diastolic blood pressure, proportion of hypertension, blood urea nitrogen, uric acid and urinary protein in dyslipidemia group were higher than those in normal blood lipid group (all P<0.05), and the levels of serum albumin, blood IgA and estimated glomerular filtration rate (eGFR) were less (all P<0.05). The proportion of IgAN children in chronic kidney disease (CKD) stage 1 and CKD stage 2-5 with dyslipidemia was 65.0% and 84.4% respectively, and the proportion of IgAN children with CKD stage 2-5 in dyslipidemia group was higher than that in normal group ( P<0.05). The dyslipidemia group had a higher proportion of Lee Ⅲ-V grade than normal blood lipid group ( P<0.01). The results of Oxford pathological classification showed that the proportions of M1 and E1 in dyslipidemia group were higher than those in normal lipid group (all P<0.05), and there was no significant difference in segmental glomerulosclerosis, tubular atrophy or interstitial fibrosis and crescent between the two groups (all P>0.05). The comparison results between groups with different types of dyslipidemia showed that systolic blood pressure, diastolic blood pressure, serum uric acid and urinary protein in the mixed hyperlipidemia group were higher than those in other groups (all P<0.05), and the serum albumin level was less ( P<0.01). The results of Oxford pathological classification showed that the proportion of E1 in hypercholesterolemia group and mixed hyperlipidemia group was higher ( P<0.05). Multivariate logistic regression analysis showed that hypertension ( OR=2.734, 95% CI 1.327-5.632, P=0.006) and low serum albumin ( OR=0.838, 95% CI 0.791-0.889, P<0.001) were the risk factors of dyslipidemia in children with IgAN. Conclusions:In our center, 67.5% IgAN children are accompanied by dyslipidemia. The clinical manifestations and pathological changes of these dyslipidemia children are more severe than those with normal blood lipid, and the IgAN children with mixed hyperlipidemia are more notable. Hypertension and low serum albumin are the risk factors of dyslipidemia in children with IgAN.

Objectives:To analyze the clinical characteristics, treatment effectiveness and long-term prognosis of childhood-onset lupus nephritis (LN), and to explore the risk factors for progression to end-stage renal disease (ESRD).Methods:In this retrospective study, the clinical data including general conditions, clinical manifestations, laboratory examinations, treatment, following up (till December 31st, 2020) and prognosis of 343 children with LN who were treated and followed up in the First Affiliated Hospital of Sun Yat-sen University from January 1, 2003 to December 31, 2019 were analyzed. Complete remission rates were compared between different pathological types according to renal biopsies and flare rates were compared between complete remission group and partial remission group according to the treatment effectiveness after 6 months of induction treatment. To investigate the risk factors of ESRD, the prognosis of flare and non-flare cases, and of cases with normal and elevated serum creatinine levels at baseline, was compared. Chi-squared tests were used for comparison between groups, and cumulative survival rate and renal survival rates were calculated by Kaplan-Meier survival analysis. Risk factors for ESRD were analyzed by COX regression model.Results:Among the 343 children, 68 were males (19.8%) and 275 were females (80.2%) with a median age of 13.0 (11.0, 16.0) years. Regarding the renal symptoms, 305 (88.9%) children had proteinuria and 245 (71.4%) had hematuria; while for extra-renal manifestations, 273 (79.6%) had anemia, 183 (53.4%) had rashes and 165 (48.1%) had fever. A total of 212 (61.8%) children had severely active SLE at initial presentation. After 6 months of induction treatment, the complete remission rate was 63.8% (219/343) and the partial remission rate was 27.1% (93/343). The complete remission rate was significantly higher in type Ⅰ and type Ⅱ LN compared to type Ⅳ LN (10/12 vs. 82/135 (60.7%), χ2 =3.936, P=0.047). One hundred and ten children who achieved remission, including complete remission and partial remission, experienced renal flare with a flare rate of 35.3% and a mean time to flare was (43.2±28.4) months. There was no significant difference in flare rates between complete and partial remission group (36.1% (79/219) vs. 33.3% (31/93), χ2=3.394, P=0.065). The follow-up time of all the children was 60.4 (32.3, 100.9) months. During the follow-up period, 15 children died and the cumulative survival rates at 3, 5 and 10 years were 97.2%, 96.4% and 93.3%, respectively; 14 children progressed to ESRD and the cumulative renal survival rates at 3, 5, and 10 years were 99.2%, 97.1%, and 93.4%, respectively. COX multivariate analysis demonstrated that elevated serum creatinine at baseline, nephritic flare and nephrotic flare were independent risk factors for progression of ESRD ( hazard ratio (HR)=3.575, 21.550 and 8.590, 95% CI 1.127-11.341, 2.394-194.027 and 1.042-70.823, P=0.031, 0.006, and 0.046, respectively). Conclusions:Children with LN are characterized by high SLE disease activity and multi-system involvement at onset. After 6 months of induction treatment, most of LN children could achieve clinical remission but some would experience renal flare. Nephritic flare, nephrotic flare and elevated serum creatinine at onset are independent risk factors for the progression of ESRD in children with LN.

Objective:To investigate the expression, prognostic value and potential mechanism for the role of SNHG4 in gastric cancer.Methods:The expression of SNHG4 in gastric cancer was analyzed by UALCAN database. The relationship between SNHG4 and prognosis of gastric cancer was analyzed by Kaplan-Meier Plotter. SNHG4-miRNA-mRNA regulatory network was constructed by StarBase, Targetscan, microT-CDS and Cytoscape. The target genes were analysis GO and KEGG pathway enrichment by DAVID database.Results:The expression of SNHG4 in gastric cancer was significantly higher than that in normal tissues ( P=8.882E-16) . The overall survival time of patients with high SNHG4 expression was lower than that of patients with low expression ( P=8.900E-05) . Through the construction of RNA regulatory network, we found that hsa-let-7a-5p ( P=1.02E-03) , hsa-miR-152-3p ( P=4.51E-06) , hsa-miR-204-5p ( P=6.68E-04) and hsa-miR-363-3p ( P=8.06E-03) could be used as the binding sites of SNHG4 in gastric cancer, and these four miRNAs further regulated 250 downstream target genes. Through GO and KEGG enrichment analysis of the target genes, we found that these target genes played roles in the biological process of protein phosphorylation regulation, transcription negative regulation, RNA polymerase II promoter transcription, and participated in the occurrence and development of gastric cancer by blocking or activating Wnt and other signal pathways. Conclusions:SNHG4 can be used as a potential tumor marker for gastric cancer to judge the prognosis of gastric cancer. By constructing a SNHG4-miRNA-mRNA regulatory network, the pathogenesis of gastric cancer can be studied at the molecular level. This provides a clear direction for experimental and clinical research.

Objective To establish a clinical-CT model,and to observe its value for evaluating lymphovascular invasion(LVI)and/or perineural invasion(PNI)in esophageal squamous cell carcinoma(ESCC).Methods Data of 156 ESCC patients were retrospectively analyzed.The patients were divided into positive group(n=58,LVI[+]and/or PNI[+])and negative group(n=98,LVI[-]and PNI[-])according to postoperative pathological results.Clinical and CT data were compared between groups.Logistic regression analysis was performed to establish a model,and its efficacy of evaluating ESCC LVI and/or PNI was analyzed.Results Significant differences of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),tumor thickness,tumor volume and CT venous phase value(CTV),the difference between CTV and CT plain phase value(CTP)(△CTV-P)and venous phase enhancement rate(V％)were found between groups(all P＜0.05),and the area under the curve(AUC)of the above parameters for evaluating ESCC LVI and/or PNI was 0.702,0.690,0.731,0.744,0.621,0.631 and 0.599,respectively.CEA,CA199,tumor thickness,tumor volume and CTV were all independent predictive factors for ESCC LVI and/or PNI.A combined model was established based on the above features,and its accuracy,sensitivity and specificity for evaluating ESCC LVI and/or PNI was 82.05％,65.52％and 91.84％,respectively,with AUC of 0.838,higher than that of each single parameter(all P＜0.05).Conclusion The established clinical-CT model could effectively evaluate ESCC LVI and/or PNI.

Primary splenic angiosarcoma is a rare highly malignant hematologic neoplasms. Based on the combination of PET/CT diagnosis of primary splenic angiosarcoma: 1 case was analyzed. The diagnosis and treatment of primary splenic angiosarcoma and the diagnostic significance of PET/CT in this disease were studied.

OBJECTIVE To establish the HPLC fingerprint and content determination of five components in Ranunculus sceleratus L.. METHODS The separation was developed on an Agilent ZORBAX SB C18 chromatographic (4.6 mm×250 mm, 5 μm)column by gradient elution with methanol(A)-0.1 % phosphoric acid aqueous solution(B) as mobile phase to establish HPLC fingerprint of Ranunculus sceleratus L.. Combined with similarity evaluation, cluster analysis, principal component analysis, and orthogonal partial least squares-discriminant analysis, the quality of 13 batches of Ranunculus sceleratus L. was evaluated. RESULTS Thirteen batches of Ranunculus sceleratus L. samples were calibrated with 20 common peaks, of which 5 common peaks were identified, and the similarity ranged from 0.874 to 0.984. The results of cluster analysis and principal component analysis were basically the same, indicating that there might be differences in the content of chemical components of Ranunculus sceleratus L. in different regions. Protocatechuic aldehyde, caffeic acid, ferulic acid, hyperoside and isoquercitrin were determined in thirteen batches of Ranunculus sceleratus L., and their contents were 0.016−0.035, 0.010−0.070, 0.010−0.029, 0.016−0.051, 0.028−0.086 mg·g–1, respectively. CONCLUSION The established HPLC fingerprint and content determination method is simple, stable, and reliable, which can be used for qualitative analysis and provide reference to quality evaluation and resource utilization of Ranunculus sceleratus L..