ObjectiveThe purpose of this study was to assess the efficacy,safety and optimal dose of tacrolimus monotherapy in patients with refractory lupus nephritis(LN) who were resistant to cyclophosphamide(CYC).MethodsA total of 14 LN patients (2 men and 12 women) with persistent proteinuria who were resistant to CYC treatment more than 8 g for half a year were enrolled.Tacrolimus was initiated at 2 mg/d (patient weight＜60 kg) or 3 mg/d(patient weight≥60 kg) which was administered in two divided doses.Prospective data on daily proteinuria,serum album level and serologic lupus activity were collected and followed for 6 months.ANOVA and Pearson correlation analysis were used for statistical analysis.Results Mean age at baseline was(30±9) years.Mean urinary protein decreased significantly from(6.2±5.1) g at baseline to (1.1±0.9) g at 6 months (F=16.21,P＜0.01).Mean serum album level increased significantly from (27.9±9.7) g/L at baseline to(37.8±2.2) g/L at 6 months(F=16.71,P＜0.01 ).Complete or partial response was observed in 86％ of patients receiving tacrolimus therapy.The effective dosage in this study was 0.03-0.06mg·kg-1·d-1 of the patients who had complete response or partial response to tacrolimus.The tacrolimus level in partially and completely responding patients was less than 3 ng/ml.There was no significant difference among blood tacrolimus levels of complete,partial,and no response patients [(1.6-±0.4),(2.0±0.6) and (22±1.1) ng/nl],respectively).No definite correlation was found between efficacy and tacrolimus level.Tacrolimus was well tolerated at current dose,besides one with new onset hypertension and one with alopecia.ConclusionOur results suggest that tacrolimus at low dosage and serum level is potentially effective and safe for the treatment　of patients with LN and persistent proteinuria resistant to CYC.The optimal dosage of tacrolimus for LN may　be 0.03-0.06 mg·kg-1·d-1.

OBJECTIVE: To determine the allelic frequency distribution and genetic parameters of nine non-CODIS DNA index systems of the short tandem repeat (STR) loci (D2S1772, D6S1043, D7S3048, D8S1132, D11S2368, D12S391, D13S325, D18S1364, and GATA198B05). METHODS: A total of 353 blood samples were collected, extracted, amplified, and analyzed from unrelated healthy individuals of Han nationality in Hunan Province, China. RESULTS: One hundred and fourteen alleles were observed in the population with corresponding allelic frequencies ranged from 0.001 0 to 0.323 0. For all the nine non-CODIS STR loci, the observed genotypic data showed no significant deviations from the Hardy-Weinberg equilibrium. The Ho, He, PIC, DP, and PE of the studied non-CODIS STR loci ranged from 0.1080 to 0.1950, 0.8050 to 0.8920, 0.7700 to 0.8600, 0.9250 to 0.9660 and 0.6070 to 0.7800, respectively. CONCLUSION Nine non-CODIS STR loci have high degrees of polymorphisms, which may be useful in individual forensic identification and parentage testing in forensic practice.
Alleles ; Asian People/genetics* ; China ; Ethnicity/genetics* ; Gene Frequency ; Genetics, Population ; Genotype ; Humans ; Male ; Microsatellite Repeats/genetics* ; Polymorphism, Genetic

Background Prevention and treatment of posterior capsular opacification (PCO) is a hot issue.To establish a PCO animal model is the basis of relevant studies.The most common methods of creating a PCO model are phacoemulsification surgery with or without intraocular lens (IOL) implantation.But the suitability of different methods is unclear.Objective This experiment was to compare the outcome between the two methods of establishing a PCO model in rabbit eyes.Methods Twenty New Zealand white rabbits were collected and randomized into 2 groups.Phacoemulsification of cataract with IOL or without IOL implantation was performed on the right eyes of rabbits in these two groups.The operative eyes were examined under the slit lamp from day 1 through 3 months after surgery.The inflammatory response was evaluated and compared between the two groups,and the extent of PCO was graded based on Odrich's criteria.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The inflammatory response,including conjunctival congestion,corneal edema and aqueous flare were less severe in the model eyes with IOL implantation than the eyes without IOL implantation 1-3 days after operation.Inflammatory response gradually disappeared and showed the same degree in the PCO grade from 2 weeks through 3 months in both groups.The numbers of eyes with 1-3 grade of PCO were 8 and 9,and those with 0 grade of PCO were 2 and 1 in the with IOL implantation group and without IOL implantation group,respectively,showing a significant difference (P=0.39).PCO appeared at 1 month,extended at 2 months and formed dense fibrosis following operation.Conclusions The model outcome of phacoemulsification combined with IOL implantation is better than without IOL implantation one.It is the ideal animal model for the study of after cataract.

AIM:To observe the application efficiency of 5g/L indocyanine green ( ICG ) staining technique for continuous circular capsulorhexis ( CCC ) during phacoemulsification in white cataract.
METHODS:Ninety-eight patients (98 eyes) with white cataract were randomly divided into staining group ( 50 cases, 50 eyes) and control group (48 cases, 48 eyes). The control group didn't do anterior capsule staining. The staining group was injected to fill the anterior chamber, 5g/L ICG 0.1mL was applied on the central surface of the anterior capsule, using a 27G blunt needle through the side-port after 30s, and the redundant ICG was replaced by BSS, and continuous curvilinear capsulorhexis was accomplished using capsulorhexis forceps.
RESULTS: In staining group: after ICG staining, the capsule, which presented uniform light green and visualization of the anterior capsule was significantly improved. There are 48 eyes capsulorhexis success. The rate of success was 96%. Meanwhile, in control group, there was 29 eyes capsulorhexis success. The rate of success was 60%. The difference was statistically significant (P<0. 05). During follow-up, no dye particle and the complications of iritis or high intraocular pressure were found in the eyes of staining group. Anterior chamber inflammation, corneal opacity compared with control group, the difference was not statistically significant.
CONCLUSION:Indocyanine green staining increases the visibility of anterior capsule in over mature cataract, and it should be an effective and helpful method which can increase the success rate of capsulorehxis. At the same time, it can reduce the incidence of intraoperative complications. This will help beginners quickly grasp continuous curvilinear capsulorhexis, and shorten the learning curve.

Objective To find the changes of haemagglutination inhibition ( HI ) antibody level against A/California/07/2009 (H1N1) within one month after pandemic A/H1N1 influenza vaccine (A/H1N1InfV) vaccination, and to provide data for drawing up immunization protocols against novel influenza . Methods The HI antibodies against A/California/07/2009 (H1N1) in sera from the inoculated subjects were tested by HI test .The geometric mean titer ( GMT) , geometric mean increase ( GMI) , seroconversion (SC) rate, seroprotection (SP) rate of HI antibodies were compared among the sera collected on day 3, 7, 14, 30 post vaccination .Results 961 participants were injected with A/H1N1InfV.In subjects aged 3 to 11 years, the antibody level peaked on day 14 post vaccination, but neither on day 14 nor on day 30, the lower bound of the two -sided 95%CI for the SP rate could fulfill the criteria of the FDA for influenza vac-cine.In subjects aged 12 to 60 years, the antibody level peaked on day 14 post vaccination and the SC rate , SP rate and GMI fulfilled the criteria of the European Medicines Agency ( EMEA) and the FDA for influenza vaccine. In subjects aged more than 60 years, the antibody level peaked on day 30 post vaccination , and the SC rate, SP rate and GMI on day 30 fulfilled the criteria of the EMEA and the FDA .Conclusion One dose A/H1N1InfV vaccination was able to induce enough protection on day 14 for subjects aged 12 to 60 years, on day 30 for subjects aged more than 60 years;however , for subjects aged 3 to 11 years who were antibody-negative at baseline , the lower bound of the two-sided 95%CI for the SP rate on day 14 and day 30 couldn′t fulfill the criteria of the FDA for influenza vaccine .

Objective:To explore the relationship among the self-concept clarity,social support,self-esteem and subjective well-being in secondary vocational school students.Methods:Totally 308 students were selected from one secondary vocational school in Guangzhou (196 males and 112 females).They were measured with the Self-concept Clarity Scale (SCCS),Perceived Social Support Scale (PSSS),Self-esteem Scale (SES) and Well-being Index Scale (WBIS).Results:The scores of the SCCS,PSSS,SES and WBIS were positively correlated with each other (r =0.15-0.53,Ps ＜ 0.01).Results of path analysis showed that self-concept clarity had a positive effect on social support,self-esteem and subjective well-being (β =0.21,0.47,0.20).Social support and self-es teem both had a positive effect on subjective well-being (β =0.30,0.37),social support had a positive effect on self-esteem (β =0.38).Conclusion:There may be close relationship among self-concept clarity,social support,selfesteem and subjective well-being.The role of self-concept clarity in improving subjective well-being should be paid more attention in educational practices.

Purpose To discuss the correlation between ultrasonic structural malformation and chromosomal microarray analysis (CMA) to provide a reliable basis for establishment of a prenatal diagnosis process of fetal malformation.Materials and Methods 104 pregnant women with structural malformation,who received prenatal ultrasonic screening in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University,were subjected to CMA detection.According to the results,they were divided into pathogenic group,Vous group and normal group,and the ultrasonic results and CMA results were compared and analyzed.Results Fifteen cases (14.42％) in the pathogenic group,including 9 cases of fetal aneuploidy,and 6 cases of microdeletion or mirco repetitive fetuses;28 cases (26.92％) in the Vous group and 61 cases (58.65％) in the normal group.There were 12 cases of two or more systems of deformity in the pathogenic group,in which the most common was complex congenital heart disease (9 cases),followed by nasal bone loss (4 cases);in the normal group and Vous group,most were single-system malformation,and the difference among three groups was statistically significant (x2=17.34,P＜0.01).There were 4 cases of pathogenic chromosomal abnormalities in the 17 cases of high risk pregnant women.Conclusion In prenatal counseling,if the fetus is found to have the malformation of two or more systems;the malformation variety contains complex congenital heart disease,nasal bone loss or malformation of other parts;high risk pregnant women combined with fetal structural malformation should be proposed to receive CMA detection to eliminate pathogenic chromosomal abnormalities.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Humans ; COVID-19 Vaccines/therapeutic use* ; COVID-19/prevention & control* ; SARS-CoV-2 ; China ; Antibodies, Viral

BACKGROUNDAlthough that glomerulonephritis is the major cause of end-stage renal disease in developing countries such as China, the increasing prevalence of diabetes has contributed to the changing spectrum of predialysis chronic kidney disease. Recent studies have revealed an increased proportion of patients with diabetic kidney disease (DKD) in hemodialysis populations in large cities in China. However, studies regarding the clinical phenotype of DKD in China are extremely limited. The incidence, development, and prognosis of diabetic kidney disease (INDEED) study aims to investigate the incidence, progression, and prognosis of DKD, as well as the associated genetic, behavioral, and environmental factors and biomarkers in patients with DKD in China.

METHODSINDEED study is a prospective cohort study based on all participants with diabetes in the Kailuan study, which is a general population-based cohort study in northern China. Altogether, over 10,000 participants with diabetes will be followed biennially. Questionnaires documenting general characteristics, behavioral and environmental factors, and medical history will be administrated. Anthropometric measurements and a series of laboratory tests will be performed in one central laboratory. The DNA, plasma, and urine samples of every participant will be stored in a biobank for future research.

CONCLUSIONSINDEED study will provide essential information regarding the clinical phenotype and prognosis of patients with DKD in China and will be valuable to identify factors and biomarkers associated with patients with DKD in China.

Biomarkers ; China ; epidemiology ; Diabetic Nephropathies ; epidemiology ; pathology ; Female ; Humans ; Incidence ; Male ; Prognosis ; Prospective Studies ; Surveys and Questionnaires