Objective To investigate the clinic-pathological significance of von Willebrand factor (vWF) and P-selectin expression in patients with lupus nephritis (LN).Methods Biopsy specimens from 71patients with LN whose disease course ranged from 2 months to 10 years were examined and scored according to a standardized method.SLE activity was evaluated by the SLE disease activity index (SLEDAI) and the British Isles Lupus Assessment Group index.Immunohistochemistry was used to detect the expressions of vWF and P-selectin in the renal tissue of LN patients and 10 normal controls.Of all the patients,7 had World Health Organization type Ⅱ,10 had type Ⅲ and 36 had WHO type Ⅳ,18 had type Ⅴ lupus nephritis.At the same time,the 24-h urine protein (UP) excretion level,the serum creatinine,the serum C3,C4,album level,antinuclear antibody (ANA),anti-double stranded DNA and disease activity scores of all patients were detected.The relationship of their expressions with the clinicopathological parameters of lupus nephritis was analyzed.ANOVA,Nemenyi test and Pearson's analysis were used for statistical analysis.Results Compared with the control group,the in situ expressions of vWF and P-selectin in the lupus nephritis patients were significantly higher.Among these patients,renal expressions of vWF were higher in type Ⅳ (0.30±0.10) than those with type Ⅱ and Ⅲ (0.12±0.05,0.22±0.14)(x2=9.273,x2=8.712,P＜0.05),while the expressions of P-selectin were higher in type Ⅳ and Ⅴ (0.29±0.05,0.36.±0.10)than those in type Ⅱ and Ⅲ (0.27±0.09,0.29±0.05 )(P＜0.05).Correlation analysis indicated that vWF was correlated significantly with AI and 24-h UP (r=0.403,0.332,P＜0.05 ),while P-selectin was correlated significantly with the scores of activity index (AI),24-h UP excretion rate and SLEDAI (r=0.283,0.453,0.297,P＜0.05 ).The expression of vWF was also closely related to P-selectin expressions (r=0.371,P=0.001).Conclusion These results indicate that vWF and P-selectin play a critical role in the pathogenesis of LN.The detection of these two factors will provide a valuable clinical reference for renal damage.These information provide valuable clues for making better treatment regimen plan and achieving more favorable prognosis.

Objective To compare the efficacy of sequential therapy combined with probiotics,pure sequen-tial therapy and standard triple therapy for Helicobacter pylori eradication.Methods Selected the clinical data of 240 patients admitted.The 240 patients were randomly divided into 3 groups.Group A received standard triple thera-py,group B received sequential therapy and Group C received sequential therapy in combination with probiotics. Then,we compared the eradication rate,the score of gastrointestinal tract symptoms before and after treatment,and the side effects among 3 groups.Results The eradication rate was 72.5% in groupA,87.5% in group B,and 96.3% in group C.The eradication rate of group C was significantly better than group A and group B (χ2 =18.531,P <0.001).There was no difference in the score of gastrointestinal tract symptoms before treatment(F =0.206,P >0.05),but they all significantly decreased after treatment among 3 groups(P <0.05),with group C a better result(F =25.581,P <0.05).The side effects of 3 groups were 16.3%,13.8%,3.8%,respectively.There were a significantly differencec between group C and the other 2 groups(χ2 =7.011,P =0.030).Conclusion Sequential therapy in combination with probiotics can achieve a higher eradication rate,improve the score of gastrointestinal tract symptoms, and decrease side effects.

Objective:To explore the curative effect of acupuncture combined with huanglian wendan decoction on the mild cognitive impairment after stroke.Methods:100 patients with mild cognitive impairment after stroke were enrolled in our hospital from June 2013 to August 2016 and randomly divided into two groups.The control group (n=50) accepted nimodipine,and the study group (n=50)accepted huanglian wendan decoction combined with acupuncture treatment based on the control group.The MMSE and MSSS scores were evaluated and compared,and the improvement of cognitive dysfunction and nervous dysfunction,quality of life were compared and analyzed.Results:After treatment,the MMSE,ADL scores of patients were remarkably decreased compared with those before treatment (P＜0.05),and the decreasing degree of study group was significantly higher than those of the control group (P＜0.05).The MSSS,MBI scores of both groups were significantly increased compared with those before treatment (P＜0.05),and the increasing degree of study group was significantly higher than those of the control group (P＜0.05).The effective rates of improvement in cognitive dysfunction and nervous dysfunction,quality of life of study group were significantly higher than those of the control group (P＜0.05).Conclusions:Huanglian wendan decoction combined with acupuncture treatment was effective for the mild cognitive impairment after stroke and could improve the quality of life.

Purpose To explore the relationship of Tei index and the concentration of plasma brain natriuretic peptide (BNP) in patients with dilated cardiomyopathy. Materials and Methods Fifty healthy individuals (control group) and fifty dilated cardiomyopathy patients (study group) were recruited in this study. BNP level was measured by enzyme-linked immunosorbent assay (ELISA). Color Doppler echocardiography were performed to measure the cardiac indices including left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic diameter (LVESd), interventricular septal thickness at diastole (IVSd), left ventricular ejection fraction (LVEF). Tei index was then calculated. The indices between the two groups were compared and correlation of Tei index and BNP with cardiac indices was analyzed. Results LVEDd, LVESd, Tei index, and BNP were significantly higher in study group than those in control group (t=14.4, 23.4, 21.9 and 22.3, P<0.01). IVSd and LVEF were significant lower in the study group (t=12.4 and 12.5, P<0.01). BNP was negatively correlated with LVEF (r= -0.266, P<0.05), and positively correlated with Tei index and LVEDd (r=0.401 and 0.326, P<0.05). Tei index was negatively correlated with LVEF and E/A (r= -0.480 and - 0.241, P<0.05), and positively correlated with LVEDd (r=0.375, P<0.05). Multiple stepwise regression analysis showed that the variates of BNP stepwise regression equation were Tei index, LVEF and LVEDd (t=5.984, -2.477 and 2.326, P<0.05); after correcting LVEF, the stepwise regression analysis showed closer relationship between Tei index and BNP (t=2.728, P<0.05). Conclusion There is correlation between Tei index and BNP. Tei index may be a good index for accurately estimating global ventricular function.

Objective To study the normal anatomy and pathologic CT findings of HDL and compare the HDL dimension of two conditions.Methods 160 consecutive CT scans of the normal upper abdomen were reviewed and 19 cases of cadavers were used.Results There was no statistics differences between the cadavers and normal subjects on HDL.Conclusion The real dimension of HDL can be replaced by the measurement on CT image,CT is a accurate means of measuring HDL in vival of human being.

In order to solve the problem of selection and in vivo delivery problem in siRNA treatment, hepatitis B virus (HBV) HBx gene which could be targeted by siRNA was studied. The siRNA expression plasmid which specific inhibits HBx expression was obtained by in vitro selection via a dual-luciferase plasmid including HBx-Fluc fusion protein expression domain. The selected siRNA expression plasmid was then encapsulated in PEG-modified cationic liposome, which was devoted into pharmacodynamic studies at both cellular and animal level. The results illustrated that the cationic liposome which encapsulated siRNA expression plasmid could effectively inhibit HBx gene expression both in vitro and in vivo.

Objective To analyze the change of phosphotidyl serine(PS) in apheresis platelets(plts) during storage process,and to evaluate the quality of the plts during the storage period.Methods The apoptosis ligand Fas(CD95) was used to induce plts as apoptosis model,and by which the method to detect plts PS by flow cytometry(FCM) was established.Subsequently the resting PS expressive rate and the induced PS expressive rate of 30 apheresis plts,which induced by CD95,were determined using the FCM method established in storage process.Results At the 1st,5th,7th,8th day of storage process,the PS expression of plts kept on increasing.The PS expressive rate of plts were 2.03%?0.91%,3.26%?1.86%,8.98%?4.60%,26.68%?21.28%,and 38.85%?26.43%,respectively,and there were significant differences among groups respectively(P0.05).Conclusion The PS expression of apheresis plts increase significantly with the prolongation of storage time;Fresh plts has the ability of anti-apoptosis;Apheresis plts could keep normal function until storage 7 d.

Objective:To evaluate the clinical effect of Toric design orthokeratology in myopic teenagers with mild-to-moderate astigmatism.Methods:A non-randomized controlled clinical study was conducted.Eighty juvenile myopia patients (160 eyes) diagnosed with mild to moderate astigmatism with myopia after mydriatic computer optometry and received the treatment of orthokeratology at Zhejiang Rongjun Hospital from January 2016 to June 2017 were enrolled.The patients were divided into regular spherical design orthokeratology group and Toric design orthokeratology group, with 80 eyes (40 cases) in each group.The patients wore orthokeratology for 8 to 10 hours every night and were re-examined at 1 day, 1 week and 1, 3, 6, 12 and 18 months after wearing, respectively.The visual acuity, refraction, corneal health status and central deviation of the treatment area in the corneal topography map were measured and recorded during the 18-month treatment.The complications during treatment were recorded.After 12-month wearing, the uncorrected visual acuity and the center deviation of the treatment area were compared between the two groups.After 18-month wearing, patients in the two groups stopped wearing the orthokeratology lens for 1 month, and then the refraction examination, IOLMaster and corneal topography were performed to compare the spherical equivalent, axial length and degree of astigmatism.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhejiang Rongjun Hospital (No.2020-10). Written informed consent was obtained from guardians prior to any medical examination.Results:After 12-month wearing, the center deviation of the shaping treatment area was (0.86±0.23)mm in the Toric design orthokeratology group, which was significantly lower than (1.16±0.44)mm in the regular spherical design orthokeratology group ( t=5.404, P<0.001). After 12-month wearing, the uncorrected visual acuity was (0.03±0.08) LogMAR in the Toric design orthokeratology group, which was significantly higher than (0.09±0.10) LogMAR in the regular spherical design orthokeratology group ( t=2.963, P=0.004). The spherical equivalent and the axial length of Toric design orthokeratology group were significantly smaller than those of the regular spherical design orthokeratology group ( t=2.542, 2.107; both at P<0.05), and there was no statistically significant difference in the degree of astigmatism between the two groups ( t=0.821, P=0.413). During the 18-month follow-up, the adverse reaction, punctate corneal epithelial opacity, occurred in 18 eyes.The incidence of adverse effect was 6.26%(5/80) in the Toric design orthokeratology group, which was significantly lower than the 16.25% (13/80) in the regular spherical design orthokeratology group ( χ2=3.897, P=0.048). Conclusions:The Toric design orthokeratology shows better efficacy in myopia control as well as reducing the adverse reaction rate in juvenile myopia, and it can better solve the deviation in corneal shaping in the use of regular spherical design orthokeratology.

Objective To evaluate the application way and value of autologous succus entericus reinfusion in neonatal enterostomy.Methods Clinical data from 109 neonatal patients receiving enterostomy in Children's Hospital of Nanjing Medical University from January 2010 to December 2017 were retrospectively analyzed.The neonatal patients were divided into two groups according to whether succus entericus reinfusion conducted as succus entericus reinfusion group (63 neonatal patients) and control group (46 neonatal patients).The 90-day weight gain of the neonatal patients,age of the second stage enterostomy closure,cessation of intravenous infusion time after operation and the rate of re-admission before the second stage enterostomy closure were collected.Results The distance between enterostomy mouth and the Treitz ligament was 80-120 cm in all the children patients,and there was no significant difference between the two groups (P=0.42).The succus entericus reinfusion group was superior to the control group in the weight gain of 90 days after birth (single lumen group vs.single lumen control group:[1.97±0.55] vs.[1.50±0.57] kg,P=0.017;double lumens group vs.double lumenscontrol group:[1.82±0.49] vs.[1.48±0.65] kg,P=0.013),age of the second stage enterostomy closure (single lumen group vs.single lumen control group:[115.76± 15.85] vs.[117.40 ± 11.06] d,P =0.025;double lumens group vs.double lumens control group:[115.48± 14.33] vs.[126.03±8.85] d,P=0.001),cessation of intravenous infusion time after operation (single lumen group vs.single lumen control group:[14.24±3.30] vs.[16.40±2.74] d,P=0.046;double lumens group vs.double lumens control group:[15.07±3.65] vs.[18.71±3.63] d,P＜0.01),and the rate of re-admission before the second stage enterostomy closure (single lumen group vs.single lumen control group:9.5％ [2/21] vs.20％ [3/15],P=0.337;double lumens group vs.double lumens control group:7.1％ [3/42] vs.25.8％ [8/31],P =0.028).Conclusion Autologous succus entericus reinfusion can improve the absorption of nutrients after the operation of small intestinal stoma,improve the function of the distal enteral tube,and create conditions for the early recovery of intestinal continuity.

Objective:To explore the clinical value of shear wave elastography in the diagnosis and pathological classification of nephrotic syndrome.Methods:A retrospective analysis was conducted on the clinical data of 43 patients with primary nephrotic syndrome (primary nephrotic syndrome group) diagnosed through renal biopsy at the Yongchuan Hospital Affiliated to Chongqing Medical University from June 2022 to March 2023. They were further divided into three subgroups: mesangial proliferative glomerulonephritis group, membranous nephropathy group, and minimal change nephropathy group. Another 30 healthy individuals were selected as the control group. We applied shear wave elastography to measure the shear wave velocity of the right renal lower pole parenchyma and statistically analyzed the differences in shear wave velocity between each group.Results:There was a statistically significant difference in shear wave velocity between the primary nephrotic syndrome group [(1.76±0.41)m/s] and the control group [(1.55±0.34)m/s] ( P<0.05); The shear wave velocity in the membranous nephropathy group [(1.97±0.36)m/s] was the highest, and there was a statistically significant difference ( P<0.05) compared to the small lesion nephropathy group [(1.54±0.42)m/s]; There was no statistically significant difference in shear wave velocity between the membranous nephropathy group and the mesangial proliferative glomerulonephritis group [(1.74±0.38)m/s], as well as between the mesangial proliferative glomerulonephritis group and the small lesion nephropathy group (all P>0.05). Conclusions:Shear wave elastography is a non-invasive examination that provides valuable clinical clues for the diagnosis and pathological classification of nephrotic syndrome by detecting the shear wave velocity of the kidney.