Objective To analysis the clinical and pathological features, results of laboratory tests and prognosis of nephrotic syndrome (NS) in patients with non-heamatological maligancy. Methods The data were collected from 25 patients who presented with NS around the diagnosis of non-heamatological malignancy. Results Twenty-five cases were investigated (age: (56.6±17.7) years; male/female ratio: 20/5). Malignancy and NS occurred within one year in 92% patients. There was a wide distribution of malignancy with involvement of 36% in digestive system and 20% in respiratory system. Ten patients (40%) presented with NS as their initial manifestation. Heamaturia appeared in 67% patients and acute renal insufficiency was complicated in 12% cases before treatments. Some other non-specific laboratory tests were found including elevated serum gamma-globulin in 50% and anemia not related with renal failure in 28% cases. Membranous nephropathy was the most common pathological changes in 67% cases. Although NS still continued for several weeks in 8 of 9 cases after surgery and/or chemical therapy, glucocorticoids was helpful to achieve the remission in these patients. However, no remission was achieved in patients without the treatment for malignancy. Conclusion Malignancy may present with NS as its initial manifestation. It should be inspected routinely and regularly in elder patients with NS, especially in those with membranous nephropathy, as well as gamma-globulinemia and anemia.

objective To analyze the clinicopathological features and prognosis of antiglomerular basement membrane(GBM)disease,and evaluate the efficacy and safety of double filtration plasmapheresis(DFPP). Methods A total of 35 hospitalized patients diagnosed as anti-GBM disease in our department were enrolled in the study.All the patients were divided into 3 groups according to the manifestations at admission.Group Ⅰ∶24 patients with severe pulmonary hemorrhage or rapidly progressive glomerulonephritis(RPGN)received pulse methylprednisolone with or without DFPP,and then followed by prednisone and CTX.Group Ⅱ∶5 patients without severe pulmonary hemorrhage and RPGN received prednisone and CTX.Group Ⅲ∶5 ESRD patients and 1 normal renal function patient did not receive immunosuppression therapy.Anti-GBM antibody titer of pre-and post-DFPP in 4 patients was measured consecutively,and removal rate was calculated.Results The mean age of all the patients was(41.1±16.6)years.Sixteen patients(45.7%)presented Goodpasture's syndrome.Eighteen patients(51.4%)had anti-GBM glomerulonephritis alone,whereas one suffered solely from pulmonary hemorrhage.20%patients had positive P-ANCA serology.54.2%crescentic glomerulonephritis and 7 with other glomerulonephritis were revealed by kidney biopsy in 24 patients.Patients in Group Ⅰ showed more severe manifestation at admission:higher Scr level,higher titer of anit-GBM antibody,greater percentage of crescents.Within the follow-up period,7 patients died and kidneys of 50%patients survived.No patient died in Group Ⅱ and Ⅲ.The elder age,anemia,higher Scr(＞300 μmol/L),oliguria or anuria,emergency hemodialysis at admission,and more glomerular sclerosis were predictors of poor prognosis.The anti-GBM antibody was negative after 4 to 6 sessions of DFPP.and the mean removal rate was 55%.During total 94 DFPP sessions,there was no unacceptable morbidity. Conclusions Different therapy strategy is necessary for anti-GBM disease with different clinical manifestations.DFPP is an effective and safe clearance way of anti-GBM antibody.

Objective To investigate the clinical features of pneumocystis pneumonia (PCP) in patients with chronic kidney disease. Methods Clinial data of 21 cases of the primary and secondary kidney diseases complicated with PCP,excluding renal transplantation,were analyzed retrospectively. Results Twenty-one cases consisted of 6 cases of primary renal diseases and 15 eases of secondary renal diseases.Twenty patients (95.2%) were receiving immunesuppressive therapy at the PCP onset.Main manifestations were fever,progressive dyspnea,cough with no or seldom sputum.Twenty patients presented obvious hypoxemia and 12 of them were type I respiratory failure.X-ray and CT imaging of 20 patients revealed diffuse pulmonary interstitial shadows or ground glass opacities in both lungs.All the patients were treaed with trimethoprim-sulfamethoxazole.Eleven patients died accounting for 52.3%.Compared with the survivors,elder age (60.91±15.08 vs 44.50±14.83,P＜0.05),lower blood oxygen pressure at onset [(48.11±19.05)mm Hg vs (65.91±13.13)mm Hg,P＜0.01],higher percentage of respirator application and other secondary lung infection were found in dead patients.No PCP relapsed after average 16-month follow-up in the survival patients. Conclusions PCP is a severe complication with high mortality during immunosuppressive therapy in patients with chronic renal disease.Early diagnosis and proper treatment are important to improve prognosis.

Objective:To establish a method for the determination of 4-methyl-2-pentanol in the air of workplace by gas chromatography.Methods:In January 2022, 4-methyl-2-pentanol in the air of workplace was collected by activated carbontube, eluted with dichloromethane-methanol (95∶5, V/ V), separated by capillary column and determined by gas chromatogram. Results:The limit of detection for 4-methyl-2-pentanol was 0.04 μg/ml. The linear range of 4-methyl-2-pentanol was 0.16-1616.60 μg/ml, with the regression equation of y=1.94 x-5.48, and the coefficient correlation was 0.99958, and the minimum detection concentration was 0.03 mg/m 3 (collected sample volume was 1.50 L). The within-run precisions were 1.08%-1.75% and the between-run precisions were 1.41%-2.52%. The desorption rates were 95.15%-99.91%. The samples could be stored at least 3 days at room temperature and 7 days at 4 ℃ without significant loss. Conclusion:The method has the advantages of good precision, high sensitivity and simple operation. It is suitable for the determination of 4-methyl-2-pentanol in the air of workplace.

Objective:To establish a method for the determination of 4-methyl-2-pentanol in the air of workplace by gas chromatography.Methods:In January 2022, 4-methyl-2-pentanol in the air of workplace was collected by activated carbontube, eluted with dichloromethane-methanol (95∶5, V/ V), separated by capillary column and determined by gas chromatogram. Results:The limit of detection for 4-methyl-2-pentanol was 0.04 μg/ml. The linear range of 4-methyl-2-pentanol was 0.16-1616.60 μg/ml, with the regression equation of y=1.94 x-5.48, and the coefficient correlation was 0.99958, and the minimum detection concentration was 0.03 mg/m 3 (collected sample volume was 1.50 L). The within-run precisions were 1.08%-1.75% and the between-run precisions were 1.41%-2.52%. The desorption rates were 95.15%-99.91%. The samples could be stored at least 3 days at room temperature and 7 days at 4 ℃ without significant loss. Conclusion:The method has the advantages of good precision, high sensitivity and simple operation. It is suitable for the determination of 4-methyl-2-pentanol in the air of workplace.

Objective: To explore the effects and mechanisms of NADPH oxidase 4(NOX4) and nucleotide-binding oligomeric structural domain protein-like receptor protein 3(NLRP3) inflammasome on aging-associated renal injury in mice. Methods: The 6, 16, 20, and 24-month-old mice were used in this study. The levels of serum creatinine(SCr) and blood urea nitrogen(BUN) were detected by the kit. Frozen sections of kidney tissue were used to detect the levels of β-Galactosidase(β-Gal) and reactive oxygen species(ROS). The pathological changes of the kidney were observed by H&E, PAS, and Masson staining. The expressions of collagen Ⅳ and NLRP3 were detected by immunohistochemistry. Western blot was used to detect the expression of related proteins in the NOX4-NLRP3 signaling pathway in kidney tissues. Results: The results showed that, compared with 6-month-old mice, the levels of BUN and SCr in serum, β-Gal activity, and ROS level in the renal cortex increased, the glomerular and tubular injury was mild, and there was no obvious renal fibrosis change in 16-month-old mice. However, in 20 and 24-month-old mice, these indexes increased, the damage of glomeruli and renal tubules increased, and renal fibrosis appeared. In addition, expression of NOX4 and NLRP3 inflammasome-associated proteins mediating ROS production was upregulated in the kidneys of 20-and 24-month-old mice. Conclusion The NOX4-NLRP3 signaling pathway may activate and promote renal aging and renal fibrosis during aging.