After the research of PLA2R1 and its antibodies, Thrombospondin type-1 domain-containing 7A and its antibodies to membranous nephropathy (MN) has made a new understanding.Some researches have reported that the antibodies of PLA2R1 and THSD7A were mutually exclusive in MN, because THSD7A was found in PLA2R1-negative MN patients.But the latest researcher showed that these antibodies can be both positive in MN patients.Similar to the function of PLA2R1, THSD7A can assist clinical diagnosis, treatment, and monitor of MN.In contrast to PLA2R1, THSD7A was also highly expressed on both human and murine podocytes.We can use the mice model to study the pathogenesis of THSD7A-associated MN in the future.In this review, we describe the structure and function of Thrombospondin type-1 domain-containing 7A and its autoantibodies, highlight its role in MN and suggest possible aspects of its future clinical application.

Objective To study the protective effect of fluvastatin on cardiac remodeling and cardiac function, and to investigate its effect on Von Willebrand factor (VWF). Methods The rat model of cardiac heart failure (CHF) was in-duced by isoproterenol injection (170 mg/kg) via subcutaneous. Eighteen model rats were randomly divided into fluvastatin (20 mg ·kg-1·d-1) group, placebo group and control group. Rats were treated with normal saline in placebo group and control group. After 6-week treatment, the structure and function of hearts were measured by echocardiography in three groups. The ventricular weight index, the serum levels of VWF and B-type natriuretic peptide (BNP) were measured by ELISA assay. The levels of VWF mRNA in cardiac muscle were measured by RT-PCR. Results Compared with control group, the val-ues of left ventricular end-diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were significantly increased in placebo group and fluvastatin group, while values of left ventricular ejection fraction (LVEF) and left ventricular ejection fraction shortening (LVFS) were significantly decreased (P＜0.05). The values of left ventricular wet weight/body weight (LVRW) and right ventricular wet weight/body weight (RVRW) were increased in placebo group and fluvastatin group. The expression of VWF mRNA in cardiac tissues was enhanced significantly (P＜0.01). Compared with placebo group, the values of LVEDD, LVRW and RVRW were significantly decreased in fluvastatin group. The expression of VWF mRNA in cardiac tissues was significantly decreased (P＜0.01), and the values of LVEF and LVFS were significant increased in fluvas-tatin group (P＜0.05). The level of VWF was positively corrected with BNP(r=0.996). Conclusion Fluvastatin could im-prove the cardiac function and cardiac remodeling, which may be by reducing the level of VWF and improving endothelial function.

Objective To investigate the effect of atorvastatin on vascular endothelial cell function and vasoactive substances in essential hypertensive patients without hyperlipemia. Methods Sixty-five essential hypertensive(EH) patients without hyperlipemia were enrolled and randomly divided into atorvastatin group and conventional treatment group(oral taken atorvastatin or placebo once every night in addition of routine antihypertensive drugs).Twenty five healthy subjects were also recruited as control.All cases were followed up for eight weeks.Serum cholesterol,nitric oxide(NO),emdothelin-1(ET-1),vonWillebrand-factor(vWF) levels were determined in each case.Flow-medizted dilation(FMD) was determined by high-resolution ultrasonography before and after eight weeks atorvastatin medication.Results (1)Before treatment,the FMD and NO levels of EH group were significantly lower than those of control group(P＜0.01),while the ET-1 and vWF levels of EH group were significantly higher than those of control group(P＜0.01);(2)In EH patients,the FMD and NO levels significantly increased after treatment and increased even more dramatically in atorvastatin group,when compared to conventional treatment group(Ps＜0.01);(3)In EH patients,the ET-1 and vWF levels significantly decreased after treatment and decreased even more dramatically in atorvastatin group,when compared to conventional treatment group(Ps＜0.01).Conclusion In patients of EH without hyperlipemia,atorvastatin can decrease plasma levels of ET-1,vWF,while increase plasma NO concentration and improve vascular endothelial function.

Objective To investigate the value of urine liver?type fatty acid?binding proteins(L?FABP) for early diagnosis and progress predicting of acute kidney injury(AKI)after lung transplantation. Methods Urine L?FABP and Scr blood samples in perioperative periods of 119 lung transplant recipients (hospitalized between 2013?2014)were involved in the research. Patients were divided into AKI group and non?AKI group according to KDIGO. Changes in urine L?FABP and Scr of two groups at various time points were recorded. Results Of 119 patients,57 developed AKI after surgery. Urine L?FABP from 0 h to 48 h in the two groups increased significantly, and the difference at 6 h to 48 h between the two groups is significant. In terms of diagnostic value,ROC area of urine L?FABP at 6h is 0.818. When 2254.52 ng/mg Cr was taken as diagnostic dividing line ,sensitivity and specificity was 0.782 and 0.814. In predicting AKI progression ,AUC below AUC of urine L?FABP 0.852. When 4313.17 ng/mgCr was taken as diagnostic dividing line ,sensitivity and specificity was 0.867 and 0.700. Conclusion Urinary L?FABP appears to be a sensitive and specific marker of AKI in lung transplant recipients ,could be a biological marker in the early diagnosis and progression tendency of AKI.

Diagnostic Errors ; Female ; Humans ; Infant, Newborn ; Inhalation ; Male ; Organophosphate Poisoning ; Poisoning ; diagnosis

Objective To investigate and analyze the demands of ethical review knowledge training among clinical investigators and determinants,thus to discuss countermeasures to optimize the training pattern of ethical review knowledge training among clinical investigators and to provide scientific evidence and proposals for training management.Methods A total of 366 clinical investigators from third-class and first-grade general hospitals in Beijing were surveyed by questionnaires according to stratified random sampling method based on the professional titles,and the results were analyzed by SPSS 20.0.Results There existed training demands of ethical review knowledgeamong clinical investigators.For investigators with primary and intermediate titles,knowledge training about informed consent process,subject safety and rights protection,and principles of privacy security were highly needed.The training patterns researched were mainly short-term training and lectures organized by administrative department of the hospital.Most investigators expressed that the primary influence factor of training was lack of time and effort.Conclusions Based on the results of the survey,the demands of ethical review knowledge training are analyzed and countermeasures to optimize and enrich current training patterns are discussed,to improve the efficiency of training and the recognition and knowledge of ethical review among clinical investigators.

Animals ; Animals, Newborn ; Brain Edema ; prevention & control ; Hypoxia-Ischemia, Brain ; prevention & control ; Progesterone ; therapeutic use ; Rats ; Rats, Wistar

Objective To explore the associated factors and clinical significance of acute renal injures in cerebral stroke.Methods The renal function,BUN,CR,UA patients with acute stroke in 7 days were estimated their neurologic impairment by the scardinanvian stroke scare(SSS) were assessed at the same time,then were compared with control group.Results The incidence of acute renal injure of intracerebral hemorrhage(ICH) group and cerebral infarction(CI) group were both higher than that of control group(P

Objective To provide the anatomical basis for detecting distal outflow tract in late atherosclerosis obliteration in lower extremities.Methods Ten lower extremities that were amputated above knees because of late atherosclerosis obliteration were used in this experiment.The blood vessels in the residual bodies were perfused to run blood vessel cast mould to observe the anatomical and pathological change of the popliteal artery,the anterior and posterior tibial arteries and their collateral vessels.The number and distribution of those collateral vessels were also observed.Results The popliteal artery,anterior and posterior tibial arteries were all occluded due to atherosclerosis.However,there were three types of those collateral arteries:① Atheromatous plaque in bole stretched into collateral arteries and led to occlusion.② Obliteration was only observed at the initial segment,with no obstruction at the distal end but extenuated.③ The collateral arteries originated from the bole artery symmetrically,keeping communicative with each other through punctiform interspaces.The last two types were mainly distributed at the inferior segment of popliteal artery,the superior segment of anterior and posterior tibial arteries,forming vascular anastomosing network in the whole cnemis muscle group.Conclusion Un-obstructed collateral arteries in certain places can be still found,though atherosclerosis obliteration is formed in popliteal artery,anterior and posterior tibial arteries in lower extremities.Therefore,it may be possible to construct collateral outflow tracts if endo-membrane stripping operation is performed.

Objective: To evaluate the feasibility,the safety and the effect of early postoperative enteral nutrition in patients with esophageal cancer.Methods: On the first postoperative day,40 patients were randomly divided into two groups.One group was given isocaloric total parenteral nutrition through central vein(TPN group) and the other group was fed with enteral nutrition through nasoenteric tubes or jejunostomy tubes which were inserted during the operation(EEN group).All variables were measured before operation and on postoperative day 1 and 8.Blood was drawn at different time points to assess albumin,prealbumin and transferrin.Immune response was determined by immunoglobins,total lymphocytes,T-lymphocyte subsets and NK cells. Inflammatory response were determined by C-reactive protein,IL-6 and TNF-?.Morbidity,mortality and length of hospital stay were also evaluated. Results: Tolerance of enteral nutrition was excellent.Neither mortality nor serious morbidity occurred in all patients during the period of study.After the study,the levels of serum prealbumin,total lymphocytes,CD3,CD4 and CD4/CD8 ratio in the EEN group were significantly higher than the levels in the TPN group.The concentrations of IL-6 and the length of hospital stay in the EEN group were significantly lower than in the TPN group.Conclusion: Early postoperative enteral nutrition in patients with esophageal cancer is safe,and also has the benefit effects of enhancing the body status of nutrition and immune function,and reducing the inflammatory response and the length of hospital stay.