Objective To establish the measurement of IgA1 O-glycan-specific antiglycan autoantibodies in patients with IgA nephropathy (IgAN),and evaluate their role in the development and progression of IgAN.Methods In the IgAN regular follow-up cohort of Peking University Institute of Nephrology from January 2006 to December 2015,170 patients drawn by stratified randomization were enrolled in this study.Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of plasma galactose-deficient IgA1 (Gd-IgA1) and antiglycan autoantibody (IgG and IgA1).The correlation between antiglycan autoantibodies and clinicopathological parameters was analyzed by linear correlation and multiple linear regression analysis.The receiver operating characteristic curve (ROC) was used to evaluate the value of plasma anti glycide antibodies in the diagnosis of IgAN.Results IgG and IgA1 antiglycan antoantibodies that specifically recognized Fab-hinge region (Fab-HR) antigens could be detected in both IgAN and healthy control group.Agglutinin inhibition test showed that the specific antigen epitope was N-acetylgalactosamine (GalNAc) residue exposed to galactose deficiency in IgA1 hinged region.There was no significant difference in the absolute levels of plasma IgG antiglycan autoantibodies between IgAN and healthy controls (P=0.963).After adjustment of the plasma level of IgG,the normalized antiglycan autoantibody (ln[IgG antiglycan antibody/IgG]) in patients with IgANwas significantly higher than that in healthy controls (0.58±0.31 vs 0.37±0.11,P ＜ 0.01).The normalized level of IgG antiglycan autoantibody in IgAN patients was positively correlated with 24 h urine protein level during renal biopsy (Spearman r=0.183,P ＜ 0.05),and was also significantly correlated with 24 h urinary protein level after adjusting for baseline clinical and pathological factors (β=0.713,95％CI 0.323-1.102,P ＜ 0.01).The area under ROC curve (AUC) of normalized IgG antiglycan autoantibody in the diagnosis of IgAN was 0.764 (95％ CI 0.682-0.845,P ＜ 0.05).Using the cut-off value of 0.396,the sensitivity and specificity of normalized IgG antiglycan autoantibody for IgAN were 0.729 and 0.700 respectively.There was no significant difference in the absolute or normalized levels of IgA1 antiglycan autoantibodies between IgAN patients and healthy controls.Conclusions Gd-IgA1-specific antiglycan autoantibodies can be detected both in IgAN patients and healthy controls.They are elevated in some patients with IgAN and possibly involved in the development of IgAN.

Objective To explore the clinical and sonographic characteristics of pancreatic acinar cell carcinoma (PACC).Methods The clinical data and abdominal sonographic findings of 13 cases of PACC identified with pathology were reviewed,including contrast-enhanced ultrasound (CEUS) images.There were 9 males and 4 females with the average of 53.9 years old.Symptoms included upper abdominal pain,nausea,chest distress and weight loss.Results The serum level of tumor maker was elevated in only 5 cases.Eight masses (61.5％) were located in the pancreatic body-tail,4 (30.8％) in the head,the whole pancreas was involved in 1 case.The mean maximal diameter was 8.0 cm.Four lesions (30.8％) presented as solid-cystic mass.Well-defined border was showed in 6 cases (60.0％).Exophytic type was observed in 5 cases (38.5％).Pancreatic ductal dilation was seen in 3 cases (23.1％),in which 2 cases showed obstruction of common biliary duct.Liver metastasis was assessed in 4 patients (30.8％),and lymph node metastasis in 3 cases (23.1％).Vessels were invaded in 4 cases (30.8％).In 2 cases by CEUS,one showed arterial iso-enhancement,the other with strong enhancement.Conclusion Certain characteristic clinical and ultrasonographic features could be revealed in PACC,as a sizable,exophytic,solid-cystic and relatively hypervascular mass with well-definded border.

Objective To study the effect of evidence-based nursing intervention in preventing postoperative concurrent infection in patients with acute cholecystitis.Methods A total of 120 patients with acute cholecystitis who underwent surgical treatment in our hospital were divided into control group and study group according to random number table method,with 60 cases per grop.Patients in the control group were given routine care,and the study group was given evidence-based nursing intervention based on routine nursing.The exhaust,hospitalization time,postoperative 24,72 h pain score and postoperative complications were compared between the two groups.Results After operation,the exhaust time and hospitalization time of the study group were lower,the pain scores at 24,72 h were lower than that in the control group,and the differences were statistically significant (P ＜ 0.05).The total postoperative infection rate in the study group was lower than that in the control group (5.0％ vs.18.3％,P ＜0.05).Conclusion Evidence-based care intervention can reduce the risk of postoperative concurrent infection in patients with acute cholecystitis,reduce postoperative pain,and promote patients'rehabilitation.

Objective To study the effect of evidence-based nursing intervention in preventing postoperative concurrent infection in patients with acute cholecystitis.Methods A total of 120 patients with acute cholecystitis who underwent surgical treatment in our hospital were divided into control group and study group according to random number table method,with 60 cases per grop.Patients in the control group were given routine care,and the study group was given evidence-based nursing intervention based on routine nursing.The exhaust,hospitalization time,postoperative 24,72 h pain score and postoperative complications were compared between the two groups.Results After operation,the exhaust time and hospitalization time of the study group were lower,the pain scores at 24,72 h were lower than that in the control group,and the differences were statistically significant (P ＜ 0.05).The total postoperative infection rate in the study group was lower than that in the control group (5.0％ vs.18.3％,P ＜0.05).Conclusion Evidence-based care intervention can reduce the risk of postoperative concurrent infection in patients with acute cholecystitis,reduce postoperative pain,and promote patients'rehabilitation.