Objective To investigate the significance of glomerular deposition of C4d in accessing the severity and prognosis of IgA nephropathy. Methods A total of 131 patients were recruited for the study. Immunofluorescence was used to detect the deposition of C4d in renal tissue of pa?tients with IgA nephropathy,and the relationship between C4d deposition and clinical and pathological parameters and renal remission was ana?lyzed. Results Totally 30 patients had glomerular deposition of C4d. Compared with the patients without C4d deposition,the patients with C4d deposition had significantly higher levels of serum creatinine,urinary protein excretion and C4d and higher prevalence of hypertension,but had sig?nificantly decreased levels of glomerular filtration rates. With the histopathological phenotypes segregated by Lee 's classification,the ratios of C4d deposition presented an increase(P=0.005). The patients with C4d deposition had more severe mesangial proliferation,endocapillary hypercellu?larity,segmental glomerulosclerosis and tubular?interstitial injury. The rates of renal remission were significantly lower in IgA nephropathy patients with C4d deposition than those without C4d deposition(P<0.001). Conclusion IgA nephropathy patients with C4d deposition have more se?vere clinical and pathological manifestations and lower rate of renal remission. Glomerular C4d deposition is expected to be an important pathologi?cal prognostic factor for predicting the prognosis of IgA nephropathy.

Objective:To detect the expression of BTLA on Treg cells of HIV-infected patients and investigate the role of BTLA in HIV infection.Methods: Forty-four HIV-1-infected patients (twenty-four early HIV infection,fourteen chronic HIV-infected patients with CD4+ T counts> 200 cells/μl,AIDS patients with CD4+T counts<200 cells/μl) and nine healthy people served as normal controls were selected to detect the expression of BTLA on Treg cells by flow cytometry.The correlations between BTLA expression on Treg cells and disease progression or immune activation were studied.Results: There was a higher percentage of BTLA on Treg cells in chronic HIV patients and AIDS patients than that in early HIV infected patients(P<0.05,P<0.01),and the expression of BTLA on Treg cells in AIDS patients was higher than that in normal controls(P<0.05).The expression of BTLA on Treg cells was negatively correlated with CD4+T lymphocyte counts and positively correlated with viral load (P<0.001,P<0.01).The percentage of BTLA on Treg cells was positively correlated with CD4+CD38+T lymphocytes and CD4+HLA-DR+T lymphocytes(P<0.001,P<0.001).Conclusion: Increased BTLA expression on HIV-infected Treg cells is associated with disease progression,suggesting that it may accelerate disease progression by enhancing Treg cells inhibitory function and may provide intervention information for HIV infection in the future.

To evaluate the safety and efficacy of mechanical thrombectomy with stent-retriver for anterior circulation small vessel occlusion in patients with acute ischemic stroke (AIS).Methods:From a prospectively collected thrombectomy database of consecutive patients with AIS between January 2017 and November 2018, 311 angiographic images were analyzed to assess small vessel occlusions (A 2 and M 2 segments). Patients were categorized into alteplase with thrombectomy group and thrombectomy alone group. The primary outcome was a favorable outcome (modified Rankin Scale scores 0-2) at 90 days. Secondary outcomes were successful recanalization (modified thrombolysis in cerebral infarction 2b or 3), symptomatic intracranial hemorrhage, and 90-day mortality. Results:Small vessel occlusions were identified in 19 patients, including 14 M 2occlusions, two A 2occlusions, and three M 2+A 2 occlusions. Six patients were in the alteplase with thrombectomy group and 13 patients in the thrombectomy alone group. Favorable outcome was achieved in eight of 19 patients at 90 days. Successful recanalization was achieved in 18 patients (18/19), symptomatic intracranial hemorrhage was observed in one patient (1/19), and death was recorded in five patients (5/19). No statistically significant difference was detected between the two groups with regard to successful recanalization (6/6 in the alteplase with thrombectomy group vs 12/13 in the thrombectomy alone group), symptomatic intracranial hemorrhage (0/6 vs 1/13), favorable outcome (2/6 vs 6/13) and death (1/6 vs 4/13; all P>0.05). Conclusion:As to anterior circulation small vessel occlusions, the combination-therapy within 4.5 hours or mechanical thrombectomy alone in extended time window with perfusion evaluation may be both safe and effective.

Hypertriglyceridemia-associated acute pancreatitis is an inflammatory disorder of exocrine pancreas caused by metabolism disturbances of triglyceride-rich lipoproteins.Currently,hypertriglyceridemia-associated acute pancreatitis is characterized by an escalating incidence rate,a tendency for more severe cases,and a lack of therapeutic drugs.Traditional Chinese medicine has distinct advantages in treating this disease,but its theoretical framework has not yet been established.Hypertriglyceridemia-associated acute pancreatitis manifests itself as a febrile disease,aberrant accumulation of fat and turbidity may stem from dietary imbalances and visceral dysfunction in ordinary individuals.The prolonged accumulation of fat and turbidity can transform into turbid pathogen,subsequently engendering heat,constituting a pivotal pathogenic factor.Throughout the progression of the disease,the fiery pathogen consumes the fat and turbidity,resulting in the generation of toxic heat,which is a crucial mechanism in the exacerbation of the disease severity.Thus,this article posits therapeutic principles aimed at averting the transformation of fat and turbidity into turbid pathogen and counteracting toxic heat in this disease.This article reviews two key theories from traditional Chinese medicine classics relevant to hypertriglyceridemia-associated acute pancreatitis:the theory of fat-turbidity associated with hypertriglyceridemia and the febrile disease related to acute pancreatitis.Combining these traditional theories with modern research on the mechanisms that intensify hypertriglyceridemia-associated acute pancreatitis and the corresponding targets of traditional Chinese medicine,it suggests that the pathogenesis of"fat-turbidity-toxic heat"serves as the theoretical basis of traditional Chinese medicine for the aggravated severity of hypertriglyceridemia-associated acute pancreatitis.The article aims to offer new insights for the treatment of hypertriglyceridemia-associated acute pancreatitis.