Objective To explore the role of phospholipase A2 receptor 1 (PLA2R1) in the diagnosis,differential diagnosis and evaluation of idiopathic membranous nephropathy (IMN) in adult patients.Methods A total of 242 renal disease patients diagnosed by renal biopsy from March 2015 to January 2016 were enrolled,consisting of 90 IMN,20 secondary membranous nephropathy (SMN),82 IgA nephropathy (IgAN),30 minimal changed disease (MCD),16 focal segmental glomerulosclerosis (FSGS) and 4 membranoproliferative glomerulonephritis (MPGN).Their clinical data including age,sex,serum creatinine (Scr),serum albumin and 24 h urinary protein were collected.Serum PLA2R1 was measured by enzyme linked immunosorbent assay.PLA2R and IgG subclasses in glomeruli were detected by indirect immunofluorescence assay.The positive rate of serum PLA2R1 among those groups and its correlation with clinical-pathological parameters were analyzed.Results Compared with IMN patients,SMN,MCD and FSGS patients were younger (all P ＜ 0.01); IgAN patients were younger and had higher serum albumin and lower 24 h proteinuria (all P ＜ 0.001); MPGN patients had higher Scr (all P ＜ 0.01).The positive rate of serum PLA2R1 was 75.6％ in IMN patients,while it was 0.0％ in non-IMN patients.The distribution between serum PLA2R1 and pathological diagnosis had difference (P ＜ 0.001),their positive coincidence rate was 100％,negative coincidence rate was 87.4％,total coincidence rate was 90.9％ and their consistency was well (Kappa=0.795,P ＜ 0.001).Among IgG subtype comparisons between IMN patients and SMN patients in the glomeruli,only moderate or more positive IgG4 had statistical differences (82.2％ vs 5.0％,P ＜ 0.001); the positive rate of glomerular PLA2R1 was 41.1％ in IMN patients,higher than 10.0％ in SMN patients (P=0.009); positive PLA2R1 with moderate or more positive IgG4 in glomeruli in IMN patients was more than that in SMN patients (40.0％ vs 0.0％,P ＜ 0.001),which could improve the diagnostic specificity of IMN.In IMN patients serum PLA2R1 and glomerular PLA2R1 had statistical differences (P＜0.001).Spearman rank correlation analysis showed that serum PLA2R1 of IMN patients positively correlated with 24 h proteinuria (r=0.315,P=0.002),negatively correlated with serum albumin (r=-0.228,P=0.030) and didn't correlate with Scr (r=0.199,P=0.059).Conclusions Serum PLA2R can be used as the specific indicator for diagnosis,differential diagnosis of IMN and to reflect the severity of IMN in patients.

Objective To explore the application value of diffusion tensor imaging and diffusion tensor tractography in the benign lesion of spinal cord.Methods 30 cases with the benign lesions of spinal cord and 10 healthy volunteers underwent MRI and DTI scanning by 1.5T MR.Results Compared with normal control group,ADC values [(1.29±0.24)×10 -3 mm2/s]of extramedullary group-Ⅰwere increased slightly,and FA values (0.46±0.06)were decreased slightly(P <0.05).In extramedullary group-Ⅱ,ADC values [(2.03±0.19)×10-3 mm2/s]were significantly increased and FA values (0.37±0.03)decreased in the lesion level (P <0.05).The ADC values [(1.71±0.24)×10 -3 mm2/s]of intramedullary group was significantly elevated,and the FA values (0.30±0.06)was obviously reduced (P <0.05 ).The fiber tracts showed the abnormality of the white matter,including compression,sparseness, grow downwards,interruption and other changes.Conclusion The changes of the FA and ADC values,diffusion tensor imaging of the bundle can quantitatively evaluate the severity of spinal cord damage and stereo display fiber bundle damage.

Objective To investigate the relationship between polymorphisms of gene promoter region INS 5′UTR single nu-cleotide and type 2 diabetes and serum IAA-Ab levels.Methods By Sequenom MassArray SNP genotyping detection technology, INS 3 pyomter regime single nucleotide polymorphisms (rs689,rs714641 77 and rs3842738)of 497 patients in Chongqing with type 2 diabetes cases(treatment group)and 500 cases(control group)were genotyped and analyzed.IAA-Ab levels in diabetes patients was detected.Theχ2 test statistic was used to analyze the treatment group and control groups.The genotype frequency distribution of IAA-Ab-positive and negative groups SNP was analyzed by non-conditional logistic regression,adjusted for sex,age impact,cal-culated the odds ratio (OR)and 95 % confidence interval(CI ).The polymorphic loci with type 2 diabetes susceptibility and serum GAD-Ab levels was evaluated.Results The genotype frequency distribution of rs689AA,TT and AT was 58.75%,28.77% and 12.47%,respectively.The control group are 50.40%,35.60% and 14.00% respectively.The difference was statistically significant (χ2 =3.923,P <0.05).Compared with the genotype of AA,TT genotype can decrease risky of diabetes,with OR values 0.35(95%CI :0.18-1.06).There was significant difference of AA,TT,AT genotypes between IAA-Ab negative and IAA-Ab positive pa-tients (P < 0.05 ).Conclusion INS polymorphisms might be related to the risky of type 2 diabetes and serum IAA-Ab level in chinses population.

Objective To explore the value of cMRI and MRS in diagnosis and differential diagnosis of single brain metastases and localized high grade gliomas.Methods The cMRI (T1WI,T2WI and contrast-enhanced MRI)and MRS data of 23 cases with single brain metastases and in 28 cases with high grade gliomas confirmed by pathology were collected and analyzed retrospectively.Results cMRI:①There were no significant differences of T1WI,T2WI and constrast-enhanced MRI between single brain metastases and high-grade gliomas.②Enhanced images of single brain metastases and localized high-grade gliomas showed that there was a significant difference in the peritumoral edema area:the nodular or ring enhancement were found in single brain metastases,the outer outline of ring enhancement was smooth,and there was no enhancement at the peripheral edema area;Irregular patchy or ring enhancement were found in localized high-grade glioma tumor,both of the outer and inner edges of the ring enhancement rough,a little patchy enhancement at the peripheral edema area were found in 1 6 patients,and there was no enhancement of the edema area in the other 1 2 patients.MRS:①There were no significant differences of the tumor parenchyma in the peaks of NAA,Cr,Cho and central Lac between single brain metastases and localized high grade gliomas.②A significant difference of the peripheral edema area were observed between them.The peaks of NAA,Cr,Cho at the edema area in all single brain metastases patients were normal.But in all high-grade glioma patients,the NAA and Cr peaks were decreased,while the Cho peaks were increased.Conclusion The morphological manifestations of single brain metastases are similar to localized high grade gliomas.An obvious difference of cMRI and MRS lines exists in the peritumoral edema area between them,which could be used for differential diagnosis.

Objective:To analyze the related factors that affect the occurrence of femoral head necrosis in patients with femoral neck fracture after surgery, and to build a nomogram predictive model.Methods:Using a retrospective study method, 180 patients with femoral neck fracture who were admitted to Hainan Provincial Hospital of Traditional Chinese Medicine from June 2019 to October 2021 were selected as the study objects. According to whether the patients had femoral head necrosis, they were divided into the occurrence group (75 cases) and the non occurrence group (105 cases). The receiver operating characteristic (ROC) curve was used to analyze the predictive value; Logistic regression was used to analyze the risk factors of postoperative femoral head necrosis; internal data were used to verify the clinical efficacy of nomogram model.Results:There was no significant difference in age, sex, body mass index and other general data between the two groups ( P>0.05); compared with the non occurrence group, Garden fracture in the occurrence group was mostly classified as type Ⅲ or Ⅳ, and more patients with preoperative traction, fracture displacement and unsatisfactory reduction quality, and the time from trauma to surgery was longer ( P>0.05). The area under curve of the time from trauma to surgery was 0.766 (95% CI 0.697 to 0.826), and the optimal cutoff value was 42 h; Garden fracture classification (type Ⅲ or Ⅳ), preoperative traction (yes), fracture displacement (yes), reduction quality (unsatisfactory) and time from trauma to surgery (>42 h) were the risk factors affecting the postoperative femoral head necrosis in patients with femoral neck fracture ( P<0.05). The risk of femoral head necrosis predicted by nomogram model was 0.802 (95% CI 0.692 to 0.873). The risk threshold of femoral head necrosis predicted by the model was >0.09, and nomogram model provides clinical net income. Conclusions:Garden fracture classification (type Ⅲ or Ⅳ), preoperative traction (yes), fracture displacement (yes), reduction quality (unsatisfactory) and time from trauma to surgery (>42 h) are the risk factors affecting the postoperative femoral head necrosis in patients with femoral neck fracture, and the nomogram model based on variables has a better predictive ability.

Objective To evaluate the mid-to-long term therapeutic effect of endoscopic pneumatic dilation for achalasia of cardia (AC).Methods Endoscopic pneumatic dilation was used in 45 AC patients, with follow-up of 2-12 years. Eckardt score and Stooler grading were used before and after the operation for evaluation of curative effect of dilation. Results The operation success rate was 97. 8%( 44/45) and the effective remission rate was 93. 2%( 41/44 ). No massive hemorrhage, perforation or other serious complications occurred.The longest follow-up time was up to 144 months.Ten cases were followed up for over 60 months. Patients′symptoms relieved significantly (P＜0. 01). Eckardt scores in 24 months and 60 months after operation significantly decreased compared with those before the operation ( P＜0. 01). But Eckardt score in 60 months was higher than that in 24 months ( P＜0. 01). The length of the disease history was positively related to post-operative scores, and negatively related to efficacy ( P＜0. 01). Conclusion Endoscopic balloon dilation is a satisfactory therapy to AC with good efficacy and safety.

BACKGROUND:Unaccustomed exercise triggers skeletal muscle damage,but produces a specific training effect that reduces muscle re-injury to reduce pain-muscle memory. OBJECTIVE:Based on the etiology of delayed onset muscle soreness,to review the existence and possible mechanism of skeletal muscle memory in delayed onset muscle soreness and to present new insights into the prevention and treatment of delayed onset muscle soreness. METHODS:The first author searched in PubMed,Embase,Web of Science,CNKI and WanFang databases for relevant literature published from January 1990 to December 2022.The keywords were"DOMS,skeletal muscle memory,exercise skeletal muscle adaptation,repeat turn effect,exercise and autophagy,autophagy and inflammation"in English and Chinese,respectively.A total of 102 articles were finally included for review. RESULTS AND CONCLUSION:The etiology of delayed onset muscle soreness is currently believed to be an acute inflammatory response due to metabolic disorders,mechanical injury and oxidative stress,while exercise-induced skeletal muscle memory can reduce delayed onset muscle soreness and exercise re-injury.When the duration,frequency and intensity of centrifugal training are gradually increased,symptoms of the injury can be minimized or even avoided.Therefore,based on the mechanism of exercise-induced skeletal muscle memory,it is the future research direction to find more effective ways to prevent and alleviate exercise-induced muscle injury.This review aims to(1)clarify the existence of exercise-induced skeletal muscle memory;(2)explore the possible mechanisms of exercise-induced skeletal muscle memory and propose the relationship between this memory and skeletal muscle autophagy;and(3)provide new strategies for the prevention and treatment of delayed onset muscle soreness by improving the level of skeletal muscle autophagy.

OBJECTIVE：To study spectrum-effect relationship of 11 different solvent extracts from Trollius chinensis against hypoxia/reoxygenation injury of cardiomyocyte . METHODS ：HPLC-MS/MS method was used to establish the fingerprints of 11 different solvent extracts from T. chinensis ，the compounds corresponding to the common peaks were identified by comparing with the substance control and literature information. MTT assay was used to detect the effects of 11 different solvent extracts from T. chinensis on the survival rate of rat myocardial H 9c2 cells injured by hypoxia/reoxygenation. The MDA content ，ROS level in cells and LDH content in the supernatant were detected by ELISA. GRA and PLS method were used to analyze the spectrum-effect relationship between the compounds corresponding to common peak and anti-hypoxia/reoxygenation injury of cardiomyocyte （drug effect）. RESULTS ：There were 22 common peaks in 11 different solvent extracts from T. chinensis ，and 22 compounds were identified. Compared with hypoxia/reoxygenation injury group ，survival rate of hypoxia/reoxygenation injury+S 1-S6，S9 and S 10 groups were increased significantly ，while MDA content ，ROS level and LDH content were decreased significantly （P＜0.05）； ROS level and LDH content of hypoxia/reoxygenation injury+S 8 group w ere decreased significantly （P＜0.05）. The r of GRA analysis of 22 compounds with drug effects were all higher than 0.8. Except for peaks 1，2，7，13，14 and 21，r of PLS analysis of rest peaks with drug effects were higher than 0 发。电话：0431-86058683。E-mial：nml2000@163.com （being positive correlation ）. Top 9 common peaks in the list of contribution rate were peak 6＞11＞4＞5＞8＞9＞12＞10＞15. CONCLUSIONS ：Orientin（peak 6），vitexin（peak 11）， orientin-2″-O-β-L-galacto- pyranosl （peak 4），orientin-2″-O-β-D-Pyrine xylosides （peak 5），quercetin-3-O-glucopyranoside（peak 8），vitexin-2″-O-β-L-galactoside（peak 9），hyperoside（peak 12），vitexin-2″-O-β-D-pyrine xylosides （peak 10），2″-O-（2″′- methylbutyry-loxy）-orientin（peak 15）may be the main components of anti-hypoxia/reoxygenation injury of cardiomyocytes.