1.Laparoscopic pyeloplasty (report of 11 cases)
Xin GAO ; Jianguang QIU ; Yubing CAI
Chinese Journal of Urology 2001;0(10):-
Objective To evaluate the technique of laparoscopic pyeloplasty. Methods 11 cases with ureteropelvic junction (UPJ) obstruction underwent laparoscopic pyeloplasty via post abdominal cavity approach. Results All the operations have been successful,the operating time being 2 to 4 h and the blood loss 40 to 90 ml. Ultrasound B investigation 3 to 24 months after the procedure showed no hydronephrosis in all and IVU analysis in 6 cases one year after the operation disclosed good outcome with less morbidity. Conclusions Laparoscopic pyeloplasty is an effective way to treat UPJ obstruction with minimal trauma to the patient.
2.Analysis on urinary system lesions of IgG4-related disease
Ke ZHENG ; Xuemei LI ; Jianfang CAI ; Yubing WEN
Chinese Journal of Nephrology 2012;(12):937-942
Objective To explore the clinical features of renal and urinary lesions in IgG4-related disease (IgG4-RD).Methods Clinical manifestation,laboratory profiles,iconography images,pathologic findings,treatment and prognosis of 6 IgG4-RD patients with renal and urinary system involvement from Peking Union Medical College Hospital during Aug 2010 to Dec 2011 were analyzed retrospectively.Results Six patients had renal and/or urinary lesions among IgG4-RD cases diagnosed in our hospital,including 4 males and 2 women,with median age of 59 years (36 to 72 years) and median disease course of 10.5 months.All the patients presented multiple organ involvement simultaneously.Urinary system lesion varied,including renal dysfunction,abdominal pain and edema.Hyperglobulinemia,elevated serum IgG (median 23.3 g/L) and IgG4 (median 4227.0 mg/L),tubular proteinuria were found in all the 6 patients,and elevated Scr (median 237 μmol/L) in 5 cases.Kidney CT image often showed renal swelling,hydronephrosis,multiple low density focus with attenuation and kidney atrophy.Renal pathology revealed interstitial inflammatory cells infiltration comprising predominantly plasma cells and lymphocytes,with a high prevalence of IgG4-positive cells often admixed with fibrosis,which fit the features of tubulointerstitial nephritis.Patients with IgG4-RD nephropathy presented good response to glucocorticoids.After therapy,the symptoms were improved and serum IgG,IgG4 and Scr decreased.Conclusions Renal and urinary lesions of IgG4-RD are heterogeneous in clinical manifestation,and are often complicated with various organ lesions.The feature of renal histopathology is tubulointerstitial nephritis infiltrated by plasma cells and lymphocytes with positive IgG4.Glucocorticoids treatment is effective for this disease.
3.Detection of apolipoprotein B-100 gene mutation in patients of primary hypercholesterolemia families.
Ruimin YU ; Yubing ZHOU ; Jiansheng FENG ; Qilu CAI ; Chunlan LIN
Chinese Journal of Practical Internal Medicine 2001;0(10):-
Objective To detect genetic mutation of apolipoprotein B-100(apoB-100)in patients with primary hypercholesterolemia.Methods One special segment of apoB-100 gene from nucleotide 10549 to 10895 was amplified by polymerase chain reaction(PCR).The PCR products were denatured and hybridized with specific aligonucleotide labeled with digoxigenin,and were analyzed by single strand conformation polymorphism(SSCP)to detect the apoB-100 gene mutation 3531CGC→CGT or other mutations.Results Overall 41 members of 11 primary hypercholesterolemia families were detected,but the above genetic mutation was not detected.Conclusion This genetic mutation is unlikely to exist or of significantly low incidence in Chinese population,and might not be the main cause of primary hypercholesterolemia in the 11 primary hypercholesterolemia families.
4.Analysis of SAA proteins in renal tissue from patientswith secondary amyloidosis by laser microdissection and mass spectrometry
Ying SUN ; Jian SUN ; Jianfang CAI ; Yubing WEN ; Zhengguang GUO ; Wei SUN ; Mingxi LI ; Xuemei LI
Basic & Clinical Medicine 2017;37(8):1088-1093
Objective To analyze serum amyloid protein A (SAA) subtype and amino acid mutation sequence of the renal biopsy specimens from patients with renal amyloidosis secondary to ankylosing spondylitis (AS) by laser microdissection combined with mass spectometry.Methods Kidney biopsy formalin-preserved paraffin-embedded (FFPE) specimen slices were stained by Congo red,the positive areas of Congo red staining were selected by microdissection,after trypsin hydrolysis and filtration,peptide samples were subjected to liquid chromatography tandem mass spectrometry.Analysis softwares were used to evaluate the results,and the patient's amino acid sequence of SAA protein was compared to mutant amino acid sequence reported by literature or deduced from mutant SAA gene to determine whether there was a variation.Results SAA1 and SAA2 proteins with high abundance were identified by mass spectrometry,serum amyloid P and apolipoprotein E were also detected.No variation of SAA1 and SAA2 protein was detected.Conclusions The SAA1 and SAA2 proteins in AA amyloidosis secondary to ASwere identified for the first time,which enriched the pathogenesis of amyloidosis secondary to AS and provided a new method for the accurate classification of AA amyloidosis.
5.Clinical and pathological analysis of patients presenting renal lesion and monoclonal gammopathy
Chao LI ; Yubing WEN ; Hang LI ; Wei SU ; Jian LI ; Jianfang CAI ; Mingxi LI ; Limeng CHEN ; Xuemei LI ; Xuewang LI
Chinese Journal of Nephrology 2017;33(6):422-428
Objectives To analyze the spectrum of renal diseases associated with monoclonal gammopathy and unrelated renal diseases.Methods Hospitalized patients in Peking Union Medical College Hospital who underwent renal biopsy between January,2013 and December,2015.They had monoclonal gammopathy on serum protein electrophoresis (SPE),serum immunofixation electrophoresis (IFE),urine IFE and/or serum free light chain (FLC).64 patients met the inclusion criteria and were classified as monoclonal gammopathy of renal significance (MGRS) (n=36),monoclonal gammopathy of undetermined significance (MGUS) (n=17) and hematologic malignancy (n=11).Results Renal lesions in MGRS subgroup included light chain amyloidosis (n=28,77.8%),light chain deposition disease (n=7,19.4%),and fibrillary glomerulopathy (n=l,2.8%).eGFR in light chain amyloidosis subgroup differed significantly,compared with light chain deposition disease [eGFR 93 ml· min-1 · (1.73m2)-1 vs 28 ml· min-1 · (1.73 m2) 1,P < 0.01],as well as HTN incidence (35.7% vs 100.0%,P < 0.01).Renal diseases in MGUS subgroup included membranous nephropathy (n=10,58.8%),focal segmental glomerulosclerosis (n=3,17.6%),diabetic glomerulopathy (n=l,5.9%),Henoch-Schonlein purpura nephritis (n=l,5.9%),anti-glomerular basement membrane disease concurrent with membranous nephropathy (n=l,5.9%) and glomerulomegaly (n=l,5.9%).Various renal lesions related/unrelated to hematologic malignancy were seen in third subgroup,including light chain cast nephropathy (n=3,27.3%),tubulo-interstitial lesions (n=2,18.2%),light chain amyloidosis (n=1,9.1%),light chain deposition disease(n=1,9.1%),IgA nephropathy (n=1,9.1%),mesangial proliferative glomerulonephritis (n=l,9.1%),endocapillary proliferative glomerulonephritis (n=1,9.1%) and acute tubular necrosis (n=1,9.1%).Positive rates of SPE,serun IFE and urine IFE in MGRS subgroup were 40.6%,52.8% and 69.4%,respectively.Positive rates of SPE,serum IFE and urine IFE in MGUS subgroup were 68.8%,100.0% and 37.5%,respectively.Positive rates of SPE,serum IFE and urine IFE in hematologic malignancy subgroup were 54.5%,72.7% and 81.8% respectively.MGRS and MGUS subgroups differed significantly in positive rate of serum IFE (P < 0.001).Abnormal rates of serum FLC ratio in above three subgroups were 83.3%,17.6% and 90.9%,respectively,with that in MGUS group being significantly lower than the rates in other two groups (P < 0.001,respectively).Conclusions The significance of monoclonal gammopathy in patients with renal disease should be evaluated by other clinical data,as well as renal pathology.
6.Validation of the new histopathological classification of ANCA associated glomerulonephritis and its correlation with renal outcome
Haiting WU ; Hang LI ; Wei YE ; Yubing WEN ; Jianfang CAI ; Mingxi LI ; Limeng CHEN ; Xuemei LI ; Xuewang LI
Chinese Journal of Nephrology 2017;33(5):349-355
Objective To assess the predictive value of Berden classification in ANCA associated glomerulonephritis.Methods Patients with confirmed ANCA associated glomerulonephritis were included,by retrieving the medical database in Peking Union Medical College Hospital from January 2000 to May 2015.Their detailed information during hospitalization and follow-up was recorded.The patients were divided into four categories based on Berden classification.The differences in clinical characters,renal function and response for treatment were compared.Results Among the 88 patients with ANCA-associated glomerulonephritis,19 (21.6%),21 (23.9%),32 (36.4%)and 16 (18.2%) patients were classified as focal,mixed,crescentic and sclerotic category.22 patients developed ESRD,and 19 patients died during follow up (1 patient developed ESRD before died).The mean estimated glomerular filtration rate (eGFR) at baseline was 68.04,25.45,30.04,15.16 ml·min-1·(1.73 m2)-1 (P < 0.05) in focal,crescentic,mixed and sclerotic category,respectively.During follow-up period,focal category always had the best renal function,while sclerotic category had the worst renal function.Crescentic category and mixed category were similar and in the middle.Remission rate at 6m was 62.5%,73.7%,57.5%,30.8%(P > 0.05).And crescentic category had the greatest improvement in eGFR at 6m.Conclusions Focal category had relatively preserved renal function and favorable renal outcome,while the sclerotic category had the worst renal outcome.Crescentic and mixed category had an intermediate outcome.We support the use of the Berden classification in predicting the renal prognosis of patients with ANCA associated glomerulonephritis.
7.Analysis of clinical manifestations and outcomes of idiopathic membranous nephropathy compared with diabetic nephropathy in patients with type 2 diabetes
Huaiya XIE ; Yubing WEN ; Bingyan LIU ; Wei YE ; Wenling YE ; Jianfang CAI ; Hang LI ; Xuemei LI ; Xuewang LI
Chinese Journal of Nephrology 2017;33(3):169-174
Objective To evaluate the predictive factors and renal outcomes of idiopathic membranous nephropathy (IMN) in patients with type 2 diabetes (T2DM).Methods In this retrospective study,clinical data of 101 IMN patients with T2DM and 96 patients with diabetic nephropathy (DN) were consecutively collected.Logistic regression was used to assess potential clinical factors indicating IMN and COX regression was employed to analyze risks of IMN in developing to endstage renal disease (ESRD),as compared with that of DN,in patients with T2DM.Results In a multivariate model,age ≥55 years old,presence of nephrotic syndrome,estimated glomerular filtration rate (eGFR) > 60 ml · min-1 · (1.73 m2)-1,duration of diabetes≤5 years and absence of diabetic retinopathy,were associated with IMN,as compared with DN,in patients with T2DM.In T2DM patients presented with nephrotic syndrome,age≥55 years old,eGFR > 60 ml· min1· (1.73 m2)-1,duration of diabetes≤5 years and absence of diabetic retinopathy,were also associated with IMN,as compared with DN.Receiver operating characteristic curve (ROC) showed eGFR 65.5 ml · min-1 · (1.73 m2) 1 was an optimal cutoff in differentiating DN and IMN.DN was associated with 16.8 times as high risk of incident ESRD as compared with IMN in T2DM patients.Conclusions In patients with T2DM,age≥55 years,presence of nephrotic syndrome,early stage of CKD,duration of diabetes≤5 years and absence of retinopathy,may indicate IMN rather than DN.T2DM patients with IMN have much better renal prognosis as compared with DN.
8.Analysis on relevant factors for hepatitis B virus-associated glomerulonephritis
Jianfang CAI ; Xiaoli DOU ; Yubing WEN ; Wei YE ; Bingyan LIU ; Wenling YE ; Hong XU ; Jianling TAO ; Hongwei FAN ; Xiaoqing LIU ; Hang LI ; Xuemei LI
Chinese Journal of Nephrology 2011;27(2):96-99
Objective To retrospectively evaluate the relevant factors for hepatitis B virus-associated glomerulonephritis (HBV-GN).Methods A total of 86 patients with pathologyproven HBV-GN and 135 HBV carriers with non-HBV-GN were included in this retrospective casecontrol study.Logistic regression analysis was used to detect the relevant factors for HBV-GN.Results On univariate analysis,the factors associated with HBV-GN were as follows: male (OR 2.79,95%CI 1.48-5.25,P=0.001),HBeAg positivity (OR 2.60,95%CI 1.49-4.53,P=0.001),HBV replication (OR 3.63,95%CI 1.80-7.33,P<0.01),liver cirrhosis (OR 4.58,95%CI 1.41-14.91,P=0.011),and elevated alanine aminotransferase (ALT) (OR 2.53,95%CI 1.42-4.51,P=0.002).On multivariate analysis,the associations remained significant for male (OR 2.21,95%CI 1.12-4.33,P=0.022),HBV replication (OR 2.77,95%CI 1.28-5.97,P=0.01),liver cirrhosis (0R 4.55,95%CI 1.29-16.10,P=0.019) and elevated ALT (OR 1.96,95%CI 1.04-3.69,P=0.037).Compared with HBV-associated IgA nephritis (HBV-IgAN) in multivariate model,HBV-associated membranous nephropathy (HBV-MN) or membranoproliferative glomerulonephritis (HBV-MPGN) was significantly associated with male (OR 6.51,95%CI 1.76-24.11,P=0.005) and HBV replication (OR 7.22,95%CI 1.68-30.97,P=0.008).Conclusions Male,HBV replication,liver cirrhosis and elevated ALT may be predictive factors for HBV-GN.Compared with HBV-IgAN,HBV-MN or HBV-MPGN is significantly associated with male and HBV replication.
9.Effects of gross motor skills on physical activity in preschoolers aged 3-6 years
MA Xiaoran, CAI Yujun, DONG Baolin, CHEN Sitong, ZHUANG Ping, XU Jun, WANG Yubing
Chinese Journal of School Health 2020;41(8):1217-1219
Objective:
To investigate the effect of gross motor skills on physical activity of children aged 3-6 years, and to provide basis for children’s health behavior intervention.
Methods:
A total of 332 young children in Shanghai Xiangyin kindergarten were selected as survey objects. The development of gross movements of young children was measured by TGMD-2. Caregivers reported children’s physical activity using the International Physical Activity Questionnaire (IPAQ-SF).
Results:
The development level of gross movements of children aged 3-6 in Shanghai was relatively low(54.76±13.86). The physical activity of children was mainly light-intensity physical activity, and the daily moderate-to-vigorous intensity physical activity time was (58.62±52.73) minutes every day. Locomotor skills had the greatest effect on children’s VPA (β=0.19) and TPA(β=0.12), with a contribution rate of 3.3% and 1.1%, respectively; Object control skills has the greatest effect on children’s MVPA (β=0.17) and MPA (β=0.12) had the largest effect(P<0.05), with contribution rates of 2.5% and 1.2%, respectively. The relationship between gross motor skills and physical activity had nothing to do with gender and age.
Conclusion
Children’s gross motor skills in the 3-6 year-old population should be improved and may be an effective way to promote physical activity.
10.Efficiency of glucocorticoid treatment in IgA nephropathy with massive proteinuria
Zhenjie CHEN ; Hang LI ; Jianfang CAI ; Yubing WEN ; Chao LI ; Peimei ZOU ; Xin ZHANG ; Mingxi LI ; Limeng CHEN ; Xuemei LI ; Xuewang LI
Chinese Journal of Nephrology 2017;33(8):561-566
Objective To investigate the clinicopathological characteristics of IgAN patients with massive proteinuria,as well as their treatment response to glucocorticoids and long-term prognosis.Methods Clinical and pathological parameters were collected in patients diagnosed with IgA nephropathy in our hospital from Jan 2003 to Oct 2015.Patients were followed up for at least six months under the treatment with full dosage of glucocorticoids.Responses of patients with and without nephrotic syndrome were compared.Results A total of 156 patients were enrolled for the analysis (86 patients in the nephropathic proteinuria group,and 70 patients in the nephrotic syndrome group).Patients presented with nephrotic syndrome showed higher proportion of IgM deposition in renal slides.There exited no difference in treatment response to glucocorticoids between the two groups.Patients with full or partial remission showed a better prognosis by Kaplan-Meier analysis than no remission group (P < 0.001).The ratio of segmental sclerosis was negatively correlated with treatment response to glucocorticoids by multiple linear regression (3 value=-0.330,P < 0.001).Multivariate Cox regression model showed that glomerular density (HR=0.45,P=0.02) and eGFR (HR=0.95,P=0.001)were independent influential factors for renal survival.Conclusions Patients presented with nephrotic syndrome show higher proportion of IgM deposition in renal slides.Patients in remission after treatment with 6-month glucocorticoids present a better prognosis than no remission patients,and glomerular density as well as eGFR are independent influential factors for renal survival.