Objective To explore the clinical features of systemic lupus erythematosus (SLE) induced by sunlight.Methods The clinical data of 52 patients with SLE induced by sunlight and 40 SLE patients without photosensitivity were analyzed. Results Compared with SLE patients without photosensitivity, malar rash and anti-ds-DNA antibody in patients with SLE induced by sunlight were more common,which pleuritis, pericarditis, renal disorder and hemolytic anemia were less frequency. There were not significant differences in oral ulcers, arthritis, neurologic disorder, leukopenia, positive anti-Sm antibody and antinuclear antibody between the two groups patients. Conclusion We should pay more attention to the clinical features of SLE induced by sunlight.

Objective To investigate the clinical features of patients with systemic lupus erythematosus (SLE) complicating with hepatitis B virus (HBV) infection.Methods The medical records of 40 inpatients with SLE complicating with HBV infection and 60 SLE inpatients without HBV infection were analyzed retrospectively.Chi-square test and t test were used for statistical analysis.Results Forty patients with SLE complicating with HBV infection were included,including 4 men and 36 women,with the mean age of (32±13) yr.Twenty-three patients suffered from chronic HBV hepatitis,5 patients were serological HBsAg carriers,12 patients with HBV occult infection.Twenty-one patients had mild liver dysfunction,presented mainly as increased ALT,2 patients presented with severe liver function abnormality.The main types of lupus rlephritis were Class Ⅳ and Class Ⅴ,2 patients complicating with HBV-associated glomerulonephritis.Compared with the control group,patients with SLE complicating with HBV infection had a significantly higher prevalence of fever,liver involvement,renal lesion,thrombocytopenia and cytomegalovirus infection respectively.One patient with severe liver abnormality had poor prognosis.Conclusion More attention should be paid to the clinical features of SLE complicating with HBV infection.Patients with SLE complicating with HBV infection have a significantly higher prevalence of fever,liver involvement,renal lesion,thrombocytopenia and cytomegalovirus infection respectively.Patients with SLE complicating with HBV infection may suffer from HBV-associated glomerulonephritis.Severe liver abnormality predicts poor prognosis.Anti-HBV drugs should be prescribed for SLE patients with serological positive HBsAg while immunosuppressive agents are used.

Objective:To summarize the clinical and pathological characteristics, treatment methods, and prognosis of papillary renal neoplasm with reverse polarity (PRNRP).Methods:The clinical and pathological data of six pathologically confirmed PRNRP patients admitted to Renji Hospital affiliated with Shanghai Jiaotong University School of Medicine from August 2022 to August 2023 were retrospectively analyzed. Among them, three were male and three were female, with an average age of (55.3±10.5) years old. All six cases were incidentally discovered during health examinations. Preoperative contrast-enhanced CT scans showed tumors with cortical phase manifestations of uneven enhancement, avascularity, and indistinct borders, with CT values of (85.6±18.7) HU. In the corticomedullary phase, the CT values showed mild elevation, with an average of (94.3±4.7) HU. In the delayed phase, the tumor boundaries were clear, and the enhancement degree was significantly lower than that of the surrounding renal cortex and medulla, with a tumor CT value of (86.3±11.9) HU. The pseudocapsule of the tumor was not clearly displayed on contrast-enhanced CT scans. All cases underwent partial nephrectomy, including two cases of robot-assisted laparoscopic partial nephrectomy and four cases of laparoscopic partial nephrectomy.Results:Postoperative pathological measurements revealed a maximum tumor diameter ranging from 6 to 15 mm, with an average diameter of (11.0±3.5) mm. All six cases were classified as pT 1aN 0M 0 stage. Microscopically, the tumors exhibited branching papillary structures with eosinophilic cytoplasm, and the tumor cells displayed low-grade nuclei located at the top of the cytoplasm and away from the basal membrane. Immunohistochemical analysis showed diffuse strong positivity for GATA3 and CK7, while CA-Ⅸ expression was negative. The median follow-up time after surgery was 10(9, 13) months, and no tumor recurrence or metastasis was observed. Conclusions:PRNRP is a rare, low-grade malignant papillary renal tumor. Contrast-enhanced CT scan has characteristic features of avascularity. Pathological morphological features are low-grade nuclei located at the top of the cytoplasm and far away from the basal membrane, forming a "reverse polarity". The immunophenotype shows positive expression of GATA3 and CK7. Partial nephrectomy is the recommended treatment approach, and the postoperative prognosis is favorable.