Objective · To analyze pathology and clinical indexes of the patients diagnosed as IgA nephropathy by renal biopsy so as to determine the correlation between the clinical indexes and the extent of renal pathological damage. Methods · The pathological files of 73 patients with IgA nephropathy confirmed by renal biopsy in East Hospital affiliated to Tongji University from 2012 to 2016 were retrospectively analyzed. Clinical indexes, such as blood pressure, serum uric acid, serum creatinine, blood urea nitrogen, 24 h urine protein quantitation, evaluated glomerular filtration rate (eGFR), triacylglycerol,total cholesterol and complement C3, were compared among the patients with different grades, types and extents of IgA nephropathy. The correlations were also conducted. Results · The 73 patients with IgA nephropathy had an average onset age of (37.07±12.58) years old, whose male to female ratio was 1.21:1. The results showed that there was statistic difference in the indexes of serum uric acid, serum creatinine, blood urea nitrogen and eGFR among the different Hass grades and Oxford pathological classification (P<0.05). Besides, serum complement C3 level and partial immunofluorescence sediment intensity of kidney were correlated with pathological types. The lower serum complement C3 level was, the stronger immunofluorescence sediment intensity was, the severer pathological grading was, and the worse renal function was. Conclusion · The clinical parameters of IgA nephropathy patients can be used to predict the extent of renal pathological damage. Serum uric acid, serum creatinine, blood urea nitrogen, eGFR and serum complement C3 level can be used as the indexes to judge the degree of pathologic damage and the progression of the disease at early stage.

0bjective To explore the diagnosis and treatment of delayed traumatic epistaxis and put forward a concept of arteriola pseudoaneurysmal epistaxis originated from maxillofacial medium-sized artery.nethotis The clinical data of 53 patients who had the typical symptoms of delayed traumatic epistaxis and received digital subtraction angiography examination and treated in recent 10 years were retrospectively analyzed.Results Among the 53 patients,8 patients suffered from interal carotid artery pseudoaneurysm.For these 8 patients,1 died of massive epistaxis before embolization,7 received transcatheter arterial embolization(6 cured and 1 died).Twenty Patients suffered from traumatic carotid cavernous fistula.all were cured with endovascular occlusion by detachable baUoom Twenty-five patients suffered from maxillofacial artery hemorrhage.For these 25 patients,21 were treated by transcatheter artefial embolization with gelatin sponge and coils,4 by anterior ethmoidal artery ligation.The followed-up ranged from 6-72 months(median 5 years).All patients were successfully treated without serious complications and recurrent hemorrhage,except one patient who had recurred hemorrhage three weeks after transcatheter arterial embolization.This Patient was again successfully treated by artery ligation.Conclusions Interal carotid artery pseudoaneurysm,carotid cavernous fistula and maxillofacial medium-sized artery and arteriola pseudoaneurysm are the main causes of delayed traumatogenic epistaxis.Early diagnosis by digital subtraction angiography examination and transcatheter arterial embolization or artery ligation are the useful methods to treat delayed traumatic epistaxis and pseudoaneurysm.

Objective To establish an animal model of traumatic optic neuropathy (TON) that resemble to clinical state and study the mechanical principle and change of pathophysiology of its nerve injury for clinical diagnosis and treatment. Methods New Zealand white rabbits were used as the research objects. The method introduced by Wang Yi was repeated and improved. Mild and severe animal models of TON were established by reformed Wang Yi operation separately. After the spring gun struck, all animals were observed on pupils and direct light reflex and received the examinations of pattern reversal visual evoked potentials (PR-VEP). The pathophysiology of normal and injury optic nerve was observed. Results After recovery from anesthesia, the mydriasis and disappearance or dullness of direct light reflex happened in all injured eyes. No brain contusion, infection, orbital fracture and death were found. One optic nerve was broken with complete tanica vaginalis. The latency and amplitude of injured eyes deteriorated gradually. In group B, the waves became flat rapidly. After injury, the optic nerve underwent 3 stages: edema, hyperplasia and atrophy. The pathomorphological changes of injured eyes in group B were more serious than that in group A in any time. Conclusions The reformed operation can establish constant nerve injury with high success rate. In mildly injured eyes, the injury deteriorated gradually. However, part visual function remained. In severely injured eyes, the pathomorphological changes were irreversible sooner after struck, and the visual function lost completely. There is a good correlation between PR-VEP and pathomorphology. PR-VEP can guide the clinical diagnosis and treatment.

Objective To investigate whether elevated baseline levels of high sensitivity C-Reactive Protein (hsCRP) and neutrophil (NE) are associated with an increased risk of breast cancer in Kailuan female cohort. Methods Females from Kailuan cohort (2006-2007) were included in this study. Information on check-up, hsCRP and NE were collected at baseline for all subjects. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (95%CI) of association between baseline hsCRP and NE values and breast cancer risk. Results By December 31, 2015, a total of 18 866 participants were enrolled in this study. During the follow-up, 183 new cases of breast cancer were observed. All participants were divided into three groups according to the level of hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L). The cumulative incidence of breast cancer were 829/105, 1 211/105 and 1 495/105 in these 3 groups, respectively ( 2=12.08， P=0.002). Compared with participants with lower hsCRP levels (<1 mg/L), individuals with the highest hsCRP (>3 mg/L) levels had significantly increased risk of breast cancer (HR=1.71,95%CI: 1.18-2.47, P=0.005), howerver, we didn’t find the statistically significant association between NE level (<3.70×109/Lvs. ≥3.70×109/L) and the risk of brease cancer (P>0.05). Conclusions Elevated levels of hsCRP at baseline might increase the risk of breast cancer in females.

Background::The calcineurin inhibitor (CNI)-based immune maintenance regimen that is commonly used after renal transplantation has greatly improved early graft survival after transplantation; however, the long-term prognosis of grafts has not been significantly improved. The nephrotoxicity of CNI drugs is one of the main risk factors for the poor long-term prognosis of grafts. Sirolimus (SRL) has been employed as an immunosuppressant in clinical practice for over 20 years and has been found to have no nephrotoxic effects on grafts. Presently, the regimen and timing of SRL application after renal transplantation vary, and clinical data are scarce. Multicenter prospective randomized controlled studies are particularly rare. This study aims to investigate the effects of early conversion to a low-dose CNI combined with SRL on the long-term prognosis of renal transplantation.Methods::Patients who receive four weeks of a standard regimen with CNI + mycophenolic acid (MPA) + glucocorticoid after renal transplantation in multiple transplant centers across China will be included in this study. At week 5, after the operation, patients in the experimental group will receive an additional administration of SRL, a reduction in the CNI drug doses, withdrawal of MPA medication, and maintenance of glucocorticoids. In addition, patients in the control group will receive the maintained standard of care. The patients’ vital signs, routine blood tests, routine urine tests, blood biochemistry, serum creatinine, BK virus (BKV)/cytomegalovirus (CMV), and trough concentrations of CNI drugs and SRL at the baseline and weeks 12, 24, 36, 48, 72, and 104 after conversion will be recorded. Patient survival, graft survival, and estimated glomerular filtration rate will be calculated, and concomitant medications and adverse events will also be recorded.Conclusion::The study data will be utilized to evaluate the efficacy and safety of early conversion to low-dose CNIs combined with SRL in renal transplant patients.Trial registration::Chinese Clinical Trial Registry, ChiCTR1800017277.

ObjectiveTo establish the determination for index components in benchmark samples of Erdongtang， and clarify the content and transfer rate rages of index components in 15 batches of benchmark samples， and to explore the quantity transfer of index components of decoction pieces to benchmark samples. MethodFifteen batches of benchmark samples were prepared， the contents of mangiferin， baicalin and glycyrrhizic acid were determined by high performance liquid chromatography （HPLC）-diode array detector （DAD）， the mobile phase was acetonitrile （A）-0.1% formic acid aqueous solution （B） for gradient elution （0-10 min， 10%-17%A； 10-25 min， 17%-19%A； 25-28 min， 19%-25%A； 28-45 min， 25%-33%A； 45-46 min， 33%-45%A； 46-60 min， 45%-55%A）， detection wavelength was set at 254 nm. Contents of timosaponin BⅡ and the sum of protoneodioscin and protodioscin were determined by HPLC-evaporative light scattering detector （ELSD）， the mobile phase was acetonitrile （A）-water （B） for gradient elution （0-20 min， 24%A； 20-25 min， 24%-27%A； 25-33 min， 27%-28%A； 33-36 min， 28%-90%A； 36-41 min， 90%-24%A）. ResultThe methodological verification of the established method was good， which could be used for determination of five index components in benchmark samples. The content ranges of mangiferin， baicalin， glycyrrhizic acid， timosaponin BⅡ， and the sum of protoneodioscin and protodioscin in 15 batches of benchmark samples of Erdongtang were 0.14%-0.23%， 2.40%-3.37%， 0.07%-0.44%， 0.43%-0.95%， and 0.15%-0.47%， the transfer rate ranges of them were 33.90%-52.15%， 84.46%-105.61%， 22.59%-93.86%， 38.07%-61.43%， and 53.28%-96.11%， respectively. ConclusionThe consistencies of transfer rate of mangiferin， baicalin， timosaponin BⅡ and the sum of protoneodioscin and protodioscin （except glycyrrhizic acid） between decoction pieces and benchmark samples of Erdongtang are good， indicates that the transfer rates of 4 index components are stable during the preparation process of benchmark samples， which can provide data support for research and development of the compound preparation of this formula.

OBJECTIVEIn mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.

METHODSAn enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.

RESULTSFrom June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.

CONCLUSIONAn outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.

Animals ; Bacteremia ; epidemiology ; microbiology ; China ; epidemiology ; Disease Outbreaks ; Humans ; Meningitis, Bacterial ; epidemiology ; microbiology ; Shock, Septic ; epidemiology ; microbiology ; Streptococcal Infections ; epidemiology ; microbiology ; veterinary ; Streptococcus suis ; isolation & purification ; Swine ; Swine Diseases ; microbiology

Objective:To establish the quality evaluation methods of Asparagi Radix decoction pieces and its standard decoction. Method:Ten batches of Asparagi Radix standard decoction were prepared. High performance liquid chromatography-evaporative light scattering detection method (HPLC-ELSD) was established for the determination of protodioscin and protoneodioscin in Asparagi Radix decoction pieces and its standard decoction, and the fingerprint detection of Asparagi Radix decoction pieces with acetonitrile-water as mobile phase for gradient elution. UHPLC-LTQ-Orbitrap-MS/MS was used to identify ten main common peaks in the fingerprint with acetonitrile-0.1% formic acid solution as mobile phase for gradient elution, electrospray ionization (ESI) and positive and negative ion mode scanning were employed, the detection range was m/z 100-1 400. Result:The total content of protodioscin and protoneodioscin in Asparagi Radix decoction pieces was 0.41%-0.72%, and their total content in Asparagi Radix standard decoction was 0.33%-0.59%, the transfer rate of these two components was 73.6%-98.3%. The dry extract yield of the standard decoction was 59.0%-73.0%, and its pH was 4.9-5.6. There were 10 common peaks in the fingerprint, and all of them were saponins, including protoneodioscin, protodioscin, aspacochioside A and its isomer, methyl protodioscin, asparagoside F, (25R)-26-O-β-D-glucopyranosyl-furostan-5, 20-diene-3β, 26-diol-3-O-[α-L-rhamnopyranosyl (1→2)]-[β-D-glucopyranosyl (1→4)-α-L-rhamnopyranosyl (1→4)]-β-D-glucopyranoside, 26-O-β-D-glucopyranosyl-furostan-20 (22)-ene-3β, 26-diol-3-O-[α-L-rhamnopyranosyl (1→2)]-[α-L-rhamnopyranosyl (1→4)]-β-D-glucopyranoside, pseudodiosgenin, aspacochioside C. Conclusion:In this paper, the quality evaluation methods of Asparagi Radix decoction pieces and its standard decoction are established, and these methods are stable and feasible, which can provide reference for the quality control of pharmaceutical preparations containing Asparagi Radix.