Objective To examine the relationship between renal vascular lesions and clinical prognosis in lupus nephritis patients. Methods Renal biopsy specimens and clinical data of 451 patients with lupus nephritis in our hospital from January 1998 to February 2006 were enrolled in this study. According to renal vascular lesions, those patients were classified into six groups: no renal vascular lesion (NVL), immune complex deposits (ICD), lupus vasculopathy (LV),thrombotic microangiopathy (TMA), vasculitis (VAS) and arteriosclerosis (AS). The relationship of renal vascular lesions and the clinical features was retrospectively analyzed. Results (1) In 451 lupus nephritis patients, 247 eases (54.8%) had renal vascular lesion. The incidence of the ICD, LV, TMA, AS and VAS were 8.4%, 9.8%, 6.7%, 29.3% and 0.7%, respectively. (2) The incidence of vascular lesions in IV type lupus nephritis was 69.7%, which was higher than others.(3) Except ICD group, the incidences of renal insufficiency and hypertension were significantlyhigher in vascular lesion groups than those in NVL group (P<0.05). TMA group showed the most severe clinical manifestation, including anemia and depression of platelet. (4) The prognosis of TMAgroup was the worst. The prognosis among other groups was not significantly different.Conclusions Vascular lesions are common in lupus nephritis. TMA patients present not only the most severe clinical manifestation with the poorest prognosis. Other vascular lesions also indicate an elevation of blood pressure and Scr level, but without significant difference in prognosis.

Objective To test reliability and validity on the scale of hurting factors participation for mental disorders (SHFP-MD).Methods 402 cases were retrospectively evaluated by SHFP-MD from 13 forensic psychiatric appraisal agencies in China,and all cases were involved causal relationships in mental injury from July 2010 to June 2012.42 cases were evaluated a month later again.13 raters evaluated respectively for five cases.52 cases involved causal relationship of mental impairment were evaluated prospectively in January 2013 to June 2014.The validity of the scale was tested by experts assessed as a criterion level of relationship.Results ①The retest correlation coefficient on all items of SHFP-MD were between 0.746-0.989,and the time reliability of test-retest on the full scale score was 0.970 interval of one month.Raters reliability between 0.57 to 1.00; overall average reliability was 0.84 (P＜0.01).②The total coincidence rate was 90.4％-91.0％ between the demarcation scores of SHFP-MD and the grade identification of forensic psychiatrists respectively and prospectively(P＞0.05).Conclusion SHFP-MD has good reliability and validity,and met the basic requirements of scale assessment.

Objective To observe the clinical effect of magnesium isoglycyrrhizinate on moderate and severe nonalcoholic steatohepatitis(NASH) and analyse its mechanism. Methods 42 cases with moderate and severe nonalcoholic steatohepatitis were selected in our study. All patients were divided into observation group and control group randomly. Control group were received simvastatin while the observation group were received simvastatin combined with magnesium isoglycyrrhizinate treatment. The course was 6 weeks.The changes of NASH classiifcation, clinical symptom, liver function, lipid levels and liver ifbrosis items in two groups before and after treatment were observed and recorded. Results All patients were received 6 week treatment, none of them dropped out. The clinical symptoms were improved in both two groups. There were 5 severe NASH improved to moderate NASH, 8 moderate NASH improved to mild NASH in observation group while only 3 severe NASH improved to moderate NASH in control group. The difference of NASH classiifcation between two groups was signiifcant(P<0.05). Compared to pre-treatment, the AST, ALT, TBIL,γ-GT were decreased in both two groups. But the liver function items in observation were lower than control group(P<0.05). The lipid level were decreased in both two group and there were no signiifcant differences between two groups after treatment. The level of PC III, HA, C-IV were decreased in observation group while had no changes in control group. Conclusion The magnesium isoglycyrrhizinate could decrease the AST, ALT and lipid level, improve the classiifcation of liver ifbrosis, and had low rate of side effect during treatment.