Objective To retrospectively analyze the clinical epidemiology features of adult idiopathic membranous nephropathy (IMN) in Zhongshan Hospital,and to investigate their therapeutic effect and its possible influence factors.Methods A total of 183 patients admitted to the Zhongshan Hospital of Fudan University and diagnosed as IMN by renal biopsy from January 2013 to December 2015 were involved.Their baseline information including demographics and pathologic was collected.Patients were followed up for at least 12 months.Serum albumin ＜ 30 g/L and 24 h urine protein ＞ 3.5g were defined as nephrotic syndrome (NS).IMN patients were divided into NS and non-NS groups and compared.Furthermore,the baseline data of remission and no remission patients were compared,and the correlations of their baseline data with conservative and immunosuppressive therapy were assessed by logistic regression analysis.Results (1) IMN accounted for 11.1％ of renal biopsy cases in our hospital,with an average age of 57 years and 59.6％ male patients.(2) Compared with patients without NS,IMN patients with NS were older,had a shorter time from the onset to receive renal biopsy,lower estimated glomerular filtration rate,and higher total cholesterol,low density lipoprotein cholesterol,triglyceride and serum creatinine (all P ＜ 0.05).(3) The effective rate of conservative treatment in IMN patients without NS was 65.7％,and the ineffective group had higher triglyceride compared with the effective group (P=0.019).(4) The effective rate of immunosuppressive therapy in IMN patients with NS was 81.2％,and low serum albumin was an independent risk factor for the poor efficacy of immunosuppressive therapy (OR=1.202,95％ CI 1.003-1.440,P=0.046).(5) The effective rate of conservative treatment in IMN patients with NS was 55.5％,and low serum albumin was an independent risk factor for the poor efficacy of conservative treatment (OR=1.629,95％CI 1.047-2.536,P=0.023).Conclusions The detection rate of IMN is increasing year by year,but the remission rate of conservative treatment is still not low in mild and moderate patients.For the patients without NS,high triglyceride may predict a poor effect of conservative treatment.Hypoproteinemia is a predictor of poor effect,no matter what a NS patient takes immunosuppressive therapy or conservative treatment.

Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease ( CAD ) in the first-degree relatives or non-first-degree relatives of men with type 2 diabetes. Methods Three hundred and eighty-one men with negative coronary angiography for the first time were divided into diabetes and non-diabetes groups and followed-up for 5 years. The primary outcome was acute coronary syndrome suspected during subsequent 5 years, and the coronary angiography was conducted simultaneously. The severity of CAD was assessed by the coronary stenosis index ( CSI) and the number of coronary lesion vessels. Results In normal blood glucose group, serum uric acid was higher in the first-degree relatives of diabetics compared with non-first-degree relatives(P<0. 01), along with higher morbidity of CAD, CSI, and coronary lesion vessels (all P<0.01). Correlation analysis showed that CSI(r=0. 250, P=0. 041) and coronary lesion vessels(r=0. 252, P=0. 040) in non-diabetics group were associated with baseline levels of serum uric acid. Conclusion The elevation of serum uric acid was closely related to subsequent CAD, especially in first-degree relatives of male with type 2 diabetes, which could be used as an early indicator for CAD prediction.

Methods: Patients with dry eye who were treated in the Ophthalmology Ward and Outpatient Department of the First Hospital of Hunan University of Chinese Medicine from October 1, 2020, to October 30, 2021 were enrolled as the research participants in the study. They were assigned to two groups based on traditional Chinese medicine (TCM) syndrome types: heat stagnation in liver meridian pattern group and Qi-Yin deficiency pattern group. Healthy volunteers who underwent health check-ups in the Health Management Department were included as healthy group following the random number table method. The tears of the patients and the healthy volunteer participants were tested by high-performance liquid chromatography-mass spectrometry (LC-MS). The differential metabolites were screened out by multivariate statistical analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment was performed on the differential metabolites. Finally, the association analysis of differential proteins and metabolites was conducted to verify and supplement the metabolites. Results: A total of 32 dry eye patients were enrolled, including 16 cases with heat stagnation in liver meridian pattern and 16 cases with Qi-Yin deficiency pattern. Fourteen healthy volunteers were included as healthy group. There were no significant differences in baseline characteristics among the three groups (P > 0.05). A total of 412 biomarkers were determined in Qi-Yin deficiency pattern group, mainly including lipids, lipid-like molecules, organic acids and their derivatives, organic heterocyclic compounds, and nucleosides and their analogues. For heat stagnation in liver meridian pattern group, 112 metabolites were determined, mainly including organic acids and their derivatives, lipids, and lipid-like molecules. The KEGG enrichment results of pathways and the relative content analysis of differential markers demonstrate that purine metabolism and caffeine metabolism pathways are common metabolic characteristics of all dry eyes. Among them, deoxyinosine monophosphate (dIMP) and 2-(formamido)-N1-(5-phospha-D-ribosyl) acetamidine can serve as their biomarkers. The main characteristics of Qi-Yin deficiency syndrome pattern were the significant enhancement of metabolic pathways such as lysine degradation, ovarian steroidogenesis, cholesterol metabolism, pyrimidine metabolism, and bile secretion (P < 0.05). Dry eye associated with the heat stagnation in liver meridian pattern is mainly characterized by inhibition of the valine, leucine, and isoleucine biosynthesis pathways (P < 0.05). Conclusion Metabolomics can be used as an effective basis for TCM syndrome classification. Different patterns of dry eye syndrome exhibit typical characteristics in the types and concentrations of metabolites, which correspond to the syndrome classification in TCM. This study initially confirms the rationality of TCM syndrome classification and provides significant reference for the mechanism of dry eye and drug development.

OBJECTIVETo verify the therapeutic effect of acupuncture with Ling gui Ba fa (method for picking eight points linked with extraordinary meridians according to time) for treatment of chronic superficial gastritis (CSG) of liver-stomach disharmony type.

METHODSSixty cases were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated with Ling gui Ba fa and acupuncture at Neiguan (PC 6) and Taichong (LR 3); the control group was treated with routine acupuncture at Zusanli (ST 36), Zhongwan (CV 12), Taichong (LR 3), Neiguan (PC 6), Ganshu (BL 18) and Weishu (BL 21), 3 times a week, 10 times constituted one course. After two courses of treatment, the clinical and gastroscopy effects were evaluated.

RESULTSThe clinical curative rate of 66.7% (20/30) in observation group was superior to that of 26.7% (8/30) in control group (P < 0.01); the gastroscopy curative rate of 66.7% (20/30) in observation group was superior to that of 23.3% (7/30) in control group (P < 0.01).

CONCLUSIONThe clinical effect and gastroscopy examination of the acupuncture with Ling gui Ba fa are superior to those of routine point selection for treatment of CSG of liver-stomach disharmony type.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Chronic Disease ; therapy ; Female ; Gastritis ; physiopathology ; therapy ; Humans ; Liver ; physiopathology ; Male ; Middle Aged ; Stomach ; pathology ; physiopathology ; Young Adult

Objective To assess the effective length of jejunal graft when the 3~(rd) intestinal artery is u- tilized as vascular pedicle and afford a reliable theoretic base for clinical esophageal reconstruction.Methods In 32 formalin preserved and 21 fresh cadaver specimens,the diameter of 1st to 5th intestinal arteries and diameter of arterial arches are measured with linear calibre.Measure the length of jejunum that can be harves- ted as graft when the arches are extended.In the 21 fresh specimens,the 1st,2nd,4th and 5th intestinal ar- teries are ligated,acetic ester stained with red dye were injected into the lumen of 3rd intestinal artery via catheter.Extent of distribution of the arteries to the jejunum was observed.And then red ABS solution was in- jected into the 3rd intestinal artery to make into cast specimen.The blood supply distribution of jejunum through 3rd intestinal artery-arterial arch and communicating system were observed again.Results The di- ameter of the 3rd intestinal artery was the largest among the 1st to 5th intestinal arteries.The length of jejunum vascularized by 3rd intestinal artery can be as long as (142.2?62.3) (69.0～206.60cm) in acetic ester in- filtrated specimens.While in ABS east specimen,the average available extent of donor jejunum was(30.8?7.3) (23.0～37.3cm).Conclusion As observed by this applied anatomy study,the jejunum graft vascu- larized by 3rd intestinal artery alone has sufficient length to meet the need of esophageal reeonstrution.

Background Following the accelerated speed of population aging in China,the incidence of cataract is rising gradually.Researches indicated that senescenee marker protein-30 ( SMP-30 ) is closely associated with the occurring and developing of cataract. Objective This study was to investigate the expression of SMP-30 in human lens epithelial cells(LECs) of age-related cataract and study the relationship between SMP-30 and apoptosis.Methods Capsulotomy was performed on 80 eyes of 59 patients with simple cortex age-related cataract and 70 eyes of 53 age-matched patients with nucleus age-related cataract.The anterior capsular specimens were obtained by circularly capsulorhexis during the operation.Expressions of the SMP-30 protein and mRNA in the LECs of two types of cataract were detected using immunochemistry and real-time PCR respectively.Apoptosis of the LECs was assayed by TUNEL.The differences of expression of SMP-30 and apoptosis were compared between the two types of cataract.Results Immunochemistry showed that SMP-30 was expressed in cytoplasm of LECs.The expression intensity of SMP-30 was higher in the center zone compared with periphery zone.The apoptosis rate of LECs was significantly higher in the center of the anterior capsule than the periphery in both two types of cataract ( nucleus cataract:19.34％±0.11％ vs 8.32 ％ ± 0.57 ％,P =0.025 ; cortex cataract:42.07 ％ ± 0.86 ％ vs 13.55 ％ ± 0.64 ％,P =0.010 ).The expression amount of SMP-30 mRNA was lower at the periphery than the center of lens in both two types of cataract (nucleus cataract:45.21±2.79 vs 76.42±11.21,P=0.042 ;cortex cataract:108.32±4.32 vs 206.34±15.67,P=0.037 ),and that of nucleus cataract was significantly lower than cortex cataract (60.02±9.08 vs 157.33 ± 13.01,P =0.034),and the apoptosis rate of LECs was declined in the nucleus cataract group compared with the cortex cataract group ( 14.05％ ±0.22％ vs 27.70％ ±0.81％,P =0.007 ). Conclusions LECs apoptosis exists in age-related cataract.SMP-30 probably plays an important role in the formation of cataract.

The International Pediatric Multiple Sclerosis Study Group (IPMSSG) put forward the 2007 version of the diagnostic criteria for multiple sclerosis and other immune-mediated demyelinating diseases of the central nervous system in children in 2007 ("2007 version" for short). In 2012, IPMSSG proposed the new diagnostic criteria with reference to the latest research achievements of 150 members ("2012 version" for short). The 2012 version of the consensus statements covers the diagnostic criteria for acute disseminated encephalomyelitis, clinically isolated syndrome, neuromyelitis optica, and multiple sclerosis in children. As the two IPMSSG members in China, the authors give an interpretation of the 2012 version of the consensus statements with reference to related literature and clinical and scientific experience. The authors focus on how the 2012 version comprehensively and thoroughly elaborates on the clinical features, diagnostic criteria, influencing factors, and new ideas of acute demyelinating diseases of the central nervous system in children. These become more operable in clinical diagnosis and treatment of multiple sclerosis and other immune-mediated demyelinating diseases of the central nervous system in children.
Child ; Consensus ; Demyelinating Diseases ; diagnosis ; Encephalomyelitis, Acute Disseminated ; diagnosis ; Humans ; Multiple Sclerosis ; diagnosis ; Neuromyelitis Optica ; diagnosis

OBJECTIVETo investigate the changes of serum soluble CD 163 (sCD 163) level, to assess the severity of critical illness and to evaluate the immune status of sepsis or severe sepsis in children.

METHODA prospective study was conducted. The sCD 163 was determined in 50 cases with sepsis or severe sepsis in pediatric intensive care unit (PICU) and 23 cases of age- and gender-matched healthy children were enrolled as control during the period from April 2010 to March 2011. Double-antibody sandwich ELISA was used for sCD 163 measurement. The relationship with sCD 163 level and disease severity score (pediatric critical illness score, PCIS; and pediatric risk of mortality III, PRISM III), lymphocyte subsets, C-reactive protein (CRP), tumor necrosis factor α (TNFα) were analyzed.

RESULTThe sCD 163 in sepsis/severe sepsis groups (171.04 ± 177.85) mg/L was significantly higher than that in control group (44.19 ± 86.48) mg/L (P < 0.01).sCD 163 in sepsis group [(105.32 ± 145.87) mg/L] was significantly lower than that of severe sepsis group [(233.32 ± 171.78) mg/L] (P < 0.05). sCD 163 level was significantly higher in lower PCIS score patients. (P < 0.01). The sCD 163 levels was higher in PRISM III ≥ 10 than the PRISM III < 10 group. The sCD 163 levels were higher in death group than the survival group. The sCD 163 was negatively correlated with CD4 +, CD4 +/CD8 + (R = -0.820, P < 0.05; R = -0.839, P < 0.01).

CONCLUSIONDetection of sCD 163 was helpful in predicting the severity of sepsis and severe sepsis, and sCD 163 may reflect the immune status of critically ill children with sepsis.

Adolescent ; Antigens, CD ; blood ; Antigens, Differentiation, Myelomonocytic ; blood ; Biomarkers ; blood ; C-Reactive Protein ; analysis ; Case-Control Studies ; Child ; Child, Preschool ; Critical Illness ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Lymphocyte Subsets ; immunology ; Male ; Prognosis ; Prospective Studies ; Receptors, Cell Surface ; blood ; Sepsis ; blood ; immunology ; mortality ; Severity of Illness Index ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo explore the influence of moxibustion at Shenque (CV 8) point on aging and its mechanism.

METHODSForty-eight health rabbits were randomly divided into 8 groups, ie., group I (normal control group), group II (model group), group III (prevention with moxibustion at Shenque (CV 8) group), group lY (prevention with moxibustion both at Shenque (CV 8) and Zusanli (ST 36) group), group V (prevention with moxibustion both at Shenque (CV 8) and Mingmen (GV 4) group), group VI (treatment with moxibustion at Shenque (CV 8) group), group XII (treatment with moxibustion both at Shenque (CV 8) and Zusanli (ST 36) group), and group VIII (treatment with moxibustion both at Shenque (CV 8) and Mingmen (GV 4) group). The rabbit models of kidney-yang deficiency were created by pouring Hydroxyurea. The serum superoxide dismutase (SOD) activity was detected and the effect of the moxibustion from both prevention and treatment aspects were compared. And then the effect of different compatibility of acupoints was observed.

RESULTSAfter modeling, obvious symptoms of kidney-yang deficiency and decrease of SOD activity (all P < 0.01) were found in groups II, VI, VII and VIII. After the moxibustion treatment, the syndromes of kidney-yang deficiency were significantly improved (all P < 0.01) and SOD activities were increased obviously in groups VI, VII and VIII (all P < 0.01); a few syndromes of kidney-yang deficiency were found in groups III, IV and V after modeling, but with no significant changes of SOD activity (all P > 0.05). There was no significant difference in three moxibustion treatment groups (all P > 0.05).

CONCLUSIONThree acupoints compatibilities of moxibustion treatment can all regulate serum SOD activity in rabbits with kidney-yang deficiency effectively and have the significant effect both at prevention and treatment aspects and there is close relationship between their mechanisms on aging and regulating serum SOD activity.

Acupuncture Points ; Animals ; Disease Models, Animal ; Female ; Humans ; Kidney ; physiopathology ; Male ; Moxibustion ; Rabbits ; Random Allocation ; Superoxide Dismutase ; blood ; Yang Deficiency ; enzymology ; physiopathology ; therapy

OBJECTIVETo evaluate the value of laparoscopy combined with double-balloon enteroscopy (DBE) for the diagnosis and treatment of intestinal diseases.

METHODSClinical data of 69 cases with suspected small bowel diseases undergoing laparoscopic and DBE for the diagnosis and treatment were retrospectively analyzed.

RESULTSThe lesions were found in 48 cases by laparoscopy. DBE was required in the remaining 21 patients to identify the underlying condition. All the operations were successfully completed using the laparoscopic approach, including totally laparoscopic bowel resection (n=11), and laparoscopic-assisted bowel resection (n=58). There were no anastomotic leakage, postoperative bleeding, intestinal obstruction, or wound infection. All the patients were discharged within 7 to 9 days after surgery. Postoperative pathological examination showed vascular abnormally (n=10), gastrointestinal stromal tumor (n=20), intestinal adenocarcinoma (n=5), intestinal neurofibroma (n=2), diverticulum (n=5), intestinal mucosal ulceration (n=8), intestinal tuberculosis (n=3), postoperative pouch bleeding (n=1), intestinal polyp (n=6), Crohn's disease (n=5), Meckel diverticulum (n=2), metastatic kidney cancer (n=1), and metastatic lung cancer (n=1). Length of follow up ranged from 3 months to 4 years, during which no re-bleeding occurred, 2 patients with gastrointestinal stromal tumor died of local recurrence and liver metastasis, 1 patient with adenocarcinoma died of local recurrence involving pancreatic head, duodenum, and mesenteric vessels, 2 patients with metastatic disease died of peritoneal recurrence and liver metastasis.

CONCLUSIONLaparoscopic combined with DBE has a high detection rate for small intestinal disease with accurate localization, less trauma, and quicker recovery.

Double-Balloon Enteroscopy ; Humans ; Intestinal Diseases ; diagnosis ; Laparoscopy ; Neoplasm Recurrence, Local ; Retrospective Studies