Objective:To investigate the clinicopathological characteristics of renal light and heavy chain amyloidosis (AHL).Methods:Ten patients with renal AHL diagnosed by renal biopsy in Peking University First Hospital and Institute of Nephrology of Peking University from January 2015 to June 2020 were enrolled. Clinicopathological data of these patients was collected and reviewed.Results:AHL typically affected older patients, with a male/female ratio of 7:3. The clinical manifestations were mainly edema and heavy proteinuria. At the same time, 7/10 of patients presented with nephrotic syndrome, 7/10 presented with microscopic hematuria, and 3/10 presented with renal insufficiency. Laboratory examinations showed monoclonal immunoglobulin in blood and urine in all patients, and IgGλ was the most common one (5/10). Decreased serum complement could be seen in some patients. The ratio of serum free κ light chain and free λ light chain was abnormal in all patients who underwent serum free light chain test. None of the 10 patients met the diagnostic criteria of multiple myeloma. Except for one of the 10 patients who was diagnosed as Waldenstrom's macroglobulinemia, the rest were diagnosed as monoclonal gammopathy of renal significance (MGRS). Bone marrow of 2/6 of patients were positive for amyloid. Cardiac involvement was confirmed in only one patient. Renal biopsy demonstrated amorphous eosinophilic material, which was Congo red positive, was deposited in glomerular mesangial area (10/10), capillary vessels (8/10), renal interstitium (9/10), peritubular capillary walls (9/10) and arterioles (8/10). This material showed apple green birefringence under polarized light. Immunofluorescence showed that single heavy chain and single light chain were positive at the same time, which was consistent with the results of mass spectrometry analysis. Ultrastructural evaluation revealed randomly oriented, non-branching fibrils with a diameter of 8-12 nm.Conclusions:Main clinical manifestations of AHL amyloidosis are edema and massive proteinuria, along with a high incidence of hematuria, a low portion of heart involvement and high frequency of whole molecule of monoclonal immunoglobulin (IgGλ dominant) by serum immunofixation electrophoresis. Renal pathology shows the commonly involved kidney compartments of amyloid deposits are glomerular capillary walls and peritubular capillary walls in patients with AHL amyloidosis.

OBJECTIVETo observe the relationship between the amount of HBV DNA in serum/liver tissue and HGV infection in patients with chronic hepatitis B (CH-B) for exploring the effect of HGV infection on hepatitis B virus (HBV) replication of CH-B.

METHODSHGV RNA in serum, HGV nonstructural region 5 (NS5) antigen (HGV Ag) in liver tissue and the amount of HBV DNA in serum, liver tissue were detected for 56 patients with CH-B by reverse transcription-polymerase chain reaction (RT-PCR) assay, peroxidase antiperoxidase (PAP) immunohistochemical method and fluorescence quantitative PCR assay, respectively. Then the relationship between HGV Ag expression in liver tissue and HGV RNA expression in serum was analysed and the amount of HBV DNA in serum and liver tissues from the serum HGV RNA or liver tissue HGV Ag positive patients were compared with those of the serum HGV-RNA or liver tissue HGV Ag negative patients, respectively.

RESULTSTen (17.9%) and eight (14.3%) patients were positive for serum and liver tissues,respectively.HGV RNA expression in serum was closely related to HGV Ag expression in liver tissues, but there was HGV RNA in serum from some of the liver tissues HGV Ag negative patients ?cases of HGV RNA and HGV Ag positive or negative,HGV RNA positive but HGV Ag negative, HGV RNA negative but HGV Ag positive, respectively: 5,43,5,3,(P<0.01). There was no significant difference in the amount of HBV DNA in serum and liver tissues between HGV RNA or HGV Ag positive and negative patients (P>0.05).

CONCLUSIONSHGV infection may not affect HBV replication. Liver is the site of HGV replication, but HGV probably also replicates in extrahepatic tissues. HGV hepatic pathogenicity is probably mild and further studies are still needed.

Adult ; DNA, Viral ; analysis ; blood ; Female ; Flaviviridae Infections ; complications ; virology ; GB virus C ; genetics ; immunology ; pathogenicity ; Hepatitis Antigens ; analysis ; Hepatitis B virus ; genetics ; physiology ; Hepatitis B, Chronic ; complications ; virology ; Hepatitis, Viral, Human ; virology ; Humans ; Liver ; virology ; Male ; RNA, Viral ; blood ; Virus Replication

Objective To investigate the biomechanical properties of our self-designed 4 cannulated screws in 4 configurations for fixation of extremely unstable femoral neck fractures.Methods Twelve adult cadaveric femoral specimens were randomly divided into 4 equal groups (n =3) and made into models of extremely unstable femoral neck fracture combined with comminution (Pauwels type Ⅲ).Group A was subjected to fixation in configuration of “double axial compressions plus double stabilizations”,group B to configuration of “positive triangle parallel compression plus small angle screwing”,group C to configuration of “inverted triangle parallel compression plus small angle screwing”,and group D to configuration of “diamond pattern screwing”.Static compression tests,cyclic loading tests and limit load tests were carried out for the 4 groups on a biomechanical testing machine.Results For groups A,B C and D,the axial compression stiffness was respectively 995.29 ±34.16 N/mm,509.89 ± 138.90 N/mm,559.28 ± 111.25 N/mm and 610.18 ±232.35 N/mm,and the limit load was respectively 3,225.33 ±461.31 N,2,008.67 ±237.27 N,2,705.67 ±496.39 N and 2,395.33 ±403.71 N,showing significant differences between the 4 groups (P ＜ 0.05).For groups A,B C and D,the displacement was respectively 0.46 ± 0.10 mm,1.47 ± 0.72 mm,1.14 ±0.24 mm and 1.22 ±0.22 mm,and the limit stiffness was respectively 1,139.28 ±342.09 N/mm,843.56 ±408.91 N/mm,585.98 ± 81.60 N/mm and 729.96 ±251.37 N/mm,showing no significant differences between the 4 groups (P ＞ 0.05).Conclusions In the fixation of extremely unstable femoral neck fracture with our self-designed 4 cannulated screws,the configuration of “double axial compressions plus double stabilizations” may lead to the greatest biomechanical advantage while the configuration of “positive triangle parallel compression plus small angle screwing” may result in the poorest biomechanical properties.

【Objective】 To study the expression level of ABO blood group antigen on the surface of platelets of blood donors. 【Methods】 A total of 506 donors with normal ABO blood group were selected to analyze the ABO antigen on platelets by flow cytometry. Among them, 30 donors were selected to monitor the changes of ABO antigen on platelets during the storage period, and the remaining 476 to analyze the expression difference of ABO antigen among blood donors. 【Results】 The ABO antigen on platelets of each sample fluctuated slightly but was relatively stable over 1~7 days in vitro. According to MFI values, the donors were divided into low-, moderate- and high- expression groups, with the average frequency of 59.6%, 35.5% and 4.9%, respectively. The A and B antigens of blood group AB platelets exhibited a competitive co-expression pattern. 【Conclusion】 Most individuals have low-expression phenotype of ABO antigen on platelets and can be potential platelet donors for ABO-incompatibility transfusion, which is helpful to improve platelets transfusion strategy.

Extra-articular distal tibial fractures as a result of high-energy damage are often comminuted or displaced, frequently accompanied by severe soft tissue injuries.Poor blood supply and various complications make the treatment more difficult,affecting life quality of the patients.The main goals of the treatment are to abtain a healed,well-aligned fracture,functional range of motion of the ankle joint and minimizing complications.It is generally recommended that surgical treatment be performed in the proper context of local conditions to facilitate early functional exercise.Plate fixation and intramedullary nail fixation are the common options for closed fractures.This article focuses on the two treatment methods and some important auxiliary technologies in both domestic and foreign, hoping to provide some references for clinical treatment.