Objective To evaluate the efficiency and safety of corticosteroid therapy for IgA nephropathy.Methods Pubmed,Medline/embase,and Te Cochrane Library databases were searched for randomized controlled trials (RCTs) of hormone therapy for IgA nephropathy from database establishment to September 2017.According to the Cochrane system evaluation method,two reviewers independently screened the literature,extracted data,evaluated the quality of the included studies and cross-checked them according to inclusion and exclusion criteria.The Cochrane bias risk method was used to evaluate the quality of the included studies.The fixed effect model was used to assess the risk of serum creatinine change and progression to end-stage renal disease (ESRD).The random-effect models were used to assess 24-hour urinary protein quantification and the incidence of adverse events leading to drug withdrawal or hospitalization.The data were pooled using RevMan 5.3 software.The quadratic variables were odds ratio (OR) and the continuous variables were mean difference (MD).The odds ratio was used as the effect variable for the two variables,and the mean variance was used as the effect variable for the continuous variable data.Results A total of 9 RCTs were enrolled.Meta-analysis showed that compared with the control group,the steroid treatment group could slow down the increase of serum creatinine by more than 50％ in IgA nephropathy patients (OR =0.15,95％ CI:0.04-0.53,P =0.003) and delay the progression to ESRD (OR =0.38,95％ CI:0.16-0.87,P =0.02),but there was no significant difference in the level of serum creatinine (MD =-0.03,95％ CI:-0.29-0.24,P =0.85),the 24 hour urinary protein quantification (MD =-0.55,95％ CI:-1.42-0.31,P =0.21),and the incidence of adverse reactions (OR =1.68,95％ CI:0.69-4.11,P =0.26).Conclusions The meta analysis showed that there was no significant difference in the safety of steroid treated IgA nephropathy compared with the control group,and may be beneficial to the long-term prognosis of patients with IgA nephropathy.

In order to identify rat ovarian germ cells, we expressed and purified rat RVLG protein in Escherichia coli cells and prepared a mouse anti-rat RVLG polyclonal antibody. The rat RVLG cDNA was obtained from rat testicle tissue by RT-PCR and was cloned into the vector pMD19-T. Sequence analysis proves that the cloned RVLG cDNA fragment was 60 bp longer than that released in the GenBank (NM_001077647), resulting from an alternative splicing of the RVLG pre-mRNA. The RVLG cDNA was double digested with the restriction endonucleases BamH I and EcoR I, and then was extracted from gel and inserted into the prokaryotic expression vector pGEX-4T-1. The recombinant expression plasmid pGEX-RVLG was verified for successful construction and then was transformed into Escherichia coli BL21(DE3) for induction to express the GST-RVLG fusion protein by IPTG. The GST-RVLG fusion protein was expressed in Escherichia coli BL21 (DE3) at a high level which accounts for more than 10% of the total bacterial cellular protein. The purified RVLG protein was used as an antigen to immunize KM mouse for the production of polyclonal antibody in ascetic fluid followed by celiacly injecting the mouse with S180 cells. The mouse anti-rat RVLG antibody was analyzed by ELISA, Western blotting and immunohistochemistry for its specificity and titer. The antibody could recognize RVLG protein specifically and its titer was about 1:20 000. These results confirm that the mouse anti-rat RVLG polyclonal antibody with high affinity and specificity has been prepared successfully, and lay a foundation for our ongoing research on the specific expression of RVLG in rat ovary.
Animals ; Antibodies, Monoclonal ; biosynthesis ; Base Sequence ; Cloning, Molecular ; DEAD-box RNA Helicases ; biosynthesis ; genetics ; immunology ; DNA, Complementary ; biosynthesis ; genetics ; Escherichia coli ; genetics ; metabolism ; Female ; Mice ; Molecular Sequence Data ; Ovary ; cytology ; metabolism ; RNA, Messenger ; biosynthesis ; genetics ; Rats ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; immunology

Objective:To evaluate the efficacy and safety of allopurinol in the treatment of chronic kidney disease.Methods:The databases of Embase, PubMed and the Cochrane library were searched for randomized controlled trials of allopurinol in patients with chronic kidney disease. According to the Cochrane system evaluation method, two evaluators independently screened the literature and extracted the data, and analyzed the results with Revman 5.3 software.Results:Finally, 10 articles were included, including 940 patients (472 in the experimental group and 468 in the control group). Meta analysis showed that allopurinol treatment could reduce blood uric acid ( MD=-2.40, 95% CI: -2.74--2.05, P<0.01), 24-hour urinary protein ( MD=-0.61, 95% CI: -1.17--0.06, P=0.03) and increase estimation of glomerular filtration rate(eGFR) ( MD=2.51, 95% CI: 1.86-3.17, P<0.01). There was no significant difference in adverse events between the experimental group and the control group ( OR=1.40, 95% CI: 0.61-3.19, P=0.42), but allopurinol treatment could reduce the risk of cardiovascular events ( OR=0.58, 95% CI: 0.38-0.89, P=0.01). Conclusions:Allopurinol treatment of chronic kidney disease can reduce urinary protein, improve eGFR, and reduce the risk of cardiovascular events.

OBJECTIVE: To compare the clinical application and health economic values of non-invasive prenatal testing (NIPT) and second trimester serum screening (STSS). METHODS: A retrospective analysis was carried out on 54 026 singleton pregnant women undergoing NIPT and STSS from March 1, 2018 to December 31, 2019 in Changsha Maternal and Child Health Care Hospital. For pregnant women with high-risk results of NIPT, prenatal diagnosis and follow-up of pregnancy outcomes were conducted. The data was grouped to 4 screening models, and their cost-benefit was analyzed. RESULTS: The sensitivity, specificity and positive predictive value of NIPT were all higher than STSS. Screening models 1 to 4 have prevented the birth of 71, 29, 52 and 54 patients with Down syndrome, respectively. The safety index of screening models 1 to 4 were 0.0036, 0.3944, 02215 and 0.1281, respectively. When the price of NIPT was decreased to 600 RMB, the cost-benefit of the screening models 1 to 4 was 0.46, 0.65, 0.44 and 0.40 million RMB, respectively. CONCLUSION NIPT has a better detection performance than STSS. When the price of NIPT is 600 RMB, screening model 1 has the best screening effect and the highest accuracy, safety index and health economical value.
Child ; China ; Cost-Benefit Analysis ; Down Syndrome/diagnosis* ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis/methods* ; Retrospective Studies

The onset, severity, and ultimate outcome of malaria infection are influenced by parasite-expressed virulence factors as well as by individual host responses to these determinants. In both humans and mice, liver injury follows parasite entry, persisting to the erythrocytic stage in the case of infection with the fatal strain of Plasmodium falciparum. Hepatic nuclear factor (HNF)-1alpha is a master regulator of not only the liver damage and adaptive responses but also diverse metabolic functions. In this study, we analyzed the expression of host HNF-1alpha in relation to malaria infection and evaluated its interaction with the 5'-untranslated region of subtilisin-like protease 2 (subtilase, Sub2). Recombinant human HNF-1alpha expressed by a lentiviral vector (LV HNF-1alpha) was introduced into mice. Interestingly, differences in the activity of the 5'-untranslated region of the Pf-Sub2 promoter were detected in 293T cells, and LV HNF-1alpha was observed to influence promoter activity, suggesting that host HNF-1alpha interacts with the Sub2 gene.
5' Untranslated Regions/*genetics ; Animals ; Cell Line ; DNA, Protozoan/genetics ; Gene Expression Regulation/*genetics ; Genetic Vectors ; Hepatocyte Nuclear Factor 1-alpha/administration & dosage/genetics/*metabolism ; Host-Parasite Interactions ; Humans ; Injections, Intravenous ; Lentivirus/genetics ; Malaria, Falciparum/metabolism/*parasitology/pathology ; Mice ; Plasmodium falciparum/drug effects/*genetics ; Promoter Regions, Genetic/genetics ; RNA, Messenger/genetics ; RNA, Protozoan/genetics ; Recombinant Proteins ; Signal Transduction ; Subtilisins/*genetics/metabolism

The onset, severity, and ultimate outcome of malaria infection are influenced by parasite-expressed virulence factors and individual host responses to these determinants. In both humans and mice, liver injury is involved after parasite entry, which persists until the erythrocyte stage after infection with the fatal strain Plasmodium falciparum (Pf). Hepatocyte growth factor (HGF) has strong anti-apoptotic effects in various kinds of cells, and also has diverse metabolic functions. In this work, Pf-subtilisin-like protease 2 (Pf-Sub2) 5'untranslated region (UTR) was analyzed and its transcriptional activity was estimated by luciferase expression. Fourteen TATA boxes were observed but only one Oct-1 and c-Myb were done. In addition, host HGF interaction with Pf-Sub2 was evaluated by co-transfection of HGF- and Pf-Sub2-cloned vector. Interestingly, -1,422/+12 UTR exhibited the strongest luciferase activity but -329 to +12 UTR did not exhibit luciferase activity. Moreover, as compared with the control of unexpressed HGF, the HGF protein suppressed luciferase expression driven by the 5'untranslated region of the Pf-Sub2 promoter. Taken together, it is suggested that HGF controls and interacts with the promoter region of the Pf-Sub2 gene.
*5' Untranslated Regions ; Artificial Gene Fusion ; Cell Line ; Genes, Reporter ; Hepatocyte Growth Factor/*metabolism ; Hepatocytes/parasitology ; *Host-Parasite Interactions ; Humans ; Luciferases/genetics/metabolism ; Plasmodium falciparum/*pathogenicity ; Protein Binding ; Subtilisins ; *Transcription, Genetic

OBJECTIVE: To estimate the social and economic burden of Downs syndrome for patients and their families residing in Changsha, China. METHODS: An 160-item self-administered questionnaire was designed and distributed to the primary caregivers of the patients in March 2020. A total of 81 eligible participants had completed the questionnaire, among which 20 were excluded for incomplete data. A patient perspective was taken to estimate the economic burden of the disease. The social impact of the disease on the patient's family was evaluated through questions adapted from the Stanford Psychological Wellbeing (PWB) Scale. RESULTS: The estimated life-course cost of a Downs syndrome patient in Changsha is 4 985 659 RMB, with the patient and caregiver's loss of income taking the greater proportion. In addition, as the majority of the patients' primary caregivers, female caregivers experienced not only considerable financial hardship caused by the care provision, but also a significant amount of psychological pressure and social discrimination. CONCLUSION Increased level of social welfare for the patients and social support for their female caregivers are essential for reducing economic burden and improving their quality of life in the area. In addition, prenatal screening and diagnosis for Downs syndrome are important for reducing both the social and economic burden of the disease by preventing its occurrence.
Caregivers ; China ; Down Syndrome ; Female ; Financial Stress ; Humans ; Quality of Life ; Social Discrimination ; Surveys and Questionnaires

Objective:To investigate the differences of clinical data and pathological changes in patients with primary IgA nephropathy (IgAN) with different blood types.Methods:The clinical and pathological data of patients with primary IgAN diagnosed by renal biopsy in the People's Hospital of Ningxia Hui Autonomous Region from May 2016 to May 2021 were collected. They were divided into groups A, O, B and AB according to blood group. The clinical manifestations and pathological changes of the four groups during renal biopsy were analyzed.Results:A total of 258 patients with primary IgAN were included, including 87 cases of type A, 74 cases of type O, 72 cases of type B and 25 cases of type AB. The male to female ratio was 1.34∶1, and the median age was 36 (29, 47) years old. There was no significant difference in age, sex, blood pressure, hemoglobin and renal function among the four groups (all P>0.05). Neutrophil gelatinase-associated lipocalin (NGAL) in patients with type A and B was higher than other groups (all P<0.05). There were no significant differences in mesangial cell hyperplasia (M), capillary cell hyperplasia (E), glomerular segmental sclerosis (S), renal tubule atrophy/interstitial fibrosis (T), crescent body (C) lesions and proportion of sclerosed glomeruli among the four groups (all P>0.05). Subgroup analysis by gender showed that the hemoglobin, uric acid and creatinine of male patients were higher than those of female patients (all P<0.05), but the estimated glomerular filtration rate (eGFR) and urinary protein had no statistical significance (all P>0.05). Women with blood type A and O were heavier than men under microscope. The pathological manifestations of M, E, S and C lesions in women with type A blood were heavier than those in men, and S and T lesions in men with type B blood were heavier than those in women. There was no significant difference in the general baseline data, inflammation and kidney indexes between the four groups of men and women (all P>0.05). Pathologically, the M lesions of men with B blood group were more severe than those of other blood groups, while the S and T lesions of women with B blood group were less severe than those of other blood groups. Conclusions:The clinical and pathological manifestations of IgAN women with type A are heavier, the pathological manifestations of IgAN women with type B are lighter, but the pathological lesions of IgAN men with type B are heavier.