Objective To explore the relationship between the pathological classification and clinical manifestations of lupus nephritis(LN)in children by renal biopsy and laboratory examination. Methods Renal biopsy and routine laboratory tests were performed in 35 cases of LN . The pathological classification of LN was made according to the criteria of WHO1982. Results Type Ⅳ of LN was most common(37.4%), and type Ⅴ(31.7%) and type Ⅲ(20.0%) were next. Type Ⅳ and type Ⅴ usually appeared as nephritic syndrome, while Type Ⅱ and Ⅲ mainly appeared as nephritis syndrome. The frequency of hypertension and renal dysfuction was the highest in type Ⅳ. Generally the renal interstitial injury of LN was mild, but that of type IV of LN was relatively obvious. There was a positive correlation between serum creatinine level and the degree of renal interstitial injury. Conclusion Lupus nephritis in childhood possessed some features in renal pathological change and clinical manifestations. Renal biopsy was important to diagnosis, treatment and prognosis evaluation of lupus nephritis.

Background:Because of its non-invasiveness,direct inspection,and high detection rate,capsule endoscopy(CE) has been accepted as the first-line examination for diagnosis of obscure gastrointestinal bleeding(OGIB). However,no matter the result of CE is positive or negative,it is unable to accurately predict the occurrence of rebleeding. Aims:To preliminarily investigate the related risk factors of rebleeding in OGIB patients with positive or negative CE for reducing the rebleeding rate. Methods:One hundred and sixteen OGIB patients undergone CE and with follow-up data from October 2009 to October 2013 at the First Affiliated Hospital of Soochow University were recruited,the rebleeding rate of patients with positive and negative CE,and the risk factors of rebleeding were analyzed. Results:CE diagnostic rate was 56. 9% , and the overall rebleeding rate was 37. 9% . The rebleeding rate in CE positive patients was significantly higher than that in CE negative patients(48. 5% vs. 24. 0% ,P < 0. 01). Male,age ≥50 years,hypertension,accumulated bleeding ≥500 mL within 3 months before CE were the independent risk factors of increase in rebleeding rate in CE positive patients. Age≥50 years,abnormal blood coagulation,without specific treatment were the independent risk factors of increase in rebleeding rate in CE negative patients. Conclusions:Followed-up should be performed in OGIB patients with risk factors of rebleeding for at least 24 months after CE. Repeated examination can be avoided in OGIB patients without risk factors.

Background:SEMA3B is a candidate tumor suppressor gene,which plays an essential role in tumorigenesis and progression of a wide variety of cancer. Aims:To explore preliminarily the influence of DNA methylation on regulation of SEMA3B gene expression in gastric cancer. Methods:Real-time PCR was used to determine the expression of SEMA3B mRNA in six human gastric cancer cell lines(SGC7901,AGS,MGC803,BGC823,MKN45,and HGC27),one gastric epithelial cell line(GES-1),and 41 gastric cancer tissue and paired adjacent noncancerous tissue specimens. Methylation specific PCR was used to detect the promoter methylation of SEMA3B gene,and correlation between methylation of SEMA3B gene and clinicopathological characteristics of gastric cancer was analyzed. After treated with a demethylation agent,5-Aza-dC(10μmol/L),for 72 hours,the methylation and mRNA expression of SEMA3B gene were re-examined in above-mentioned cell lines. Results:SEMA3B mRNA expression was significantly lower in six gastric cancer cell lines and gastric cancer tissues than that in GES-1 cells(P <0. 001)and paired adjacent noncancerous tissues(P <0. 01). Promoter methylation of SEMA3B gene could be detected in all six gastric cancer cell lines but not GES-1 cells. Frequency of SEMA3B gene methylation was significantly higher in gastric cancer tissues than in paired adjacent noncancerous tissues (67. 6% vs. 32. 4%,P <0. 01),and the frequency was correlated with differentiation and lymph node metastasis of gastric cancer(P<0. 05). After treated with 5-Aza-dC,hypermethylation of SEMA3B gene in 5 gastric cancer cell lines was decreased,accompanied by up-regulation of SEMA3B mRNA expression. Conclusions:Hypermethylation in promoter of SEMA3B gene might be one of the mechanisms accounting for the reduced expression of SEMA3B,and being involved in tumorigenesis and progression of gastric cancer. SEMA3B might be a potential biomarker for diagnosis and prognostic assessment for gastric cancer and a promising epigenetic therapeutic target.

ObjectiveTo evaluate the nephroprotective effects of transplanting metanephric mesenchymal cells (MMCs) into the renal subcaspsule of rats with acute tubular necrosis (ATN) induced by gentamicin. MethodsMMCs were expanded in culture and immunocytochemistry was used to characterize the cells. After gentamicin-induced ATN, fluorescence-labeled cells were transplanted and traced in kidney tissues by fluorescence microscopy. Serum creatinine (Scr) and N-acetyl-b-D-glucosaminidase (NAG) were tested. Kidney pathology was studied by hematoxylin-eosin staining. Apoptosis was examined by the TUNEL assay. Ki-67 and Bcl-2 expression was examined by immunohistochemistry. ResultsMMCs were expanded in culture and the phenotype of the cells was vimentin-positive and keratin-negative. Compared with other ATN groups, in the MMCs-treated group, Scr and NAG clearly decreased[14d Scr: (101.38±20.46) μmol/L vs (248.78±23.15), (252.98±33.52), (229.08±18.18) μmol/L;NAG: (14.83±7.74) U/L vs (33.33±14.88), (29.62±10.54), (30.22±10.94) U/L, P<0.05, respectively];the histopathoiogic lesion scores were lower (P<0.05);the Ki-67 antibody and apoptosis of renal tubular epithelial cells were improved or reduced respectively;the expression of Bcl-2 protein was up-regulated (P<0.05). ConclusionThe subcapsular transplantation of MMCs can ameliorate renal function and repair kidney injury.

Objective To explore the role of nuclear translational factor homeobox A13(HOXA13)gene in epithelial - to - mesenchymal transition(EMT)induced by human serum albumin(HSA)overload in human renal tu-bular epithelial(HKC)cells. Methods HKC cells were treated with different concentrations of HSA(ranging from 0 - 30 g/ L)for 48 h or 20 g/ L HSA for different times(ranging from 0 - 72 h)in vitro. The protein expressions of cy-tokeratin(CK),Vimentin,and HOXA13 protein in HKC cells were detected by using Western blot respectively. Mean-while,liposome - mediated DNA transfection was used to transfect the HOXA13 gene into HKC cells before HSA treat-ment,and the expressions of CK,Vimentin and HOXA13 protein in HKC cells were also detected by using Western blot. Results (1)The protein expression of CK decreased but Vimentin increased after HKC cells were exposed to HSA,which was in a concentration - and time - dependent manner.(2)Expression of HOXA13 was down - regulated by HSA in a dose - and time - dependent manner,and the expressions of HOXA13 protein in HKC in 5 g/ L,10 g/ L, 20 g/ L,30 g/ L group were 58. 24%(P = 0. 005),44. 73%(P = 0. 003),38. 40%(P = 0. 033)and 24. 83%(P =0. 011)respectively as compared with 0 g/ L group. Likewise,the protein expressions of HOXA13 in 24 h,48 h,72 h group were 52. 00%(P = 0. 023),46. 83%(P = 0. 008)and 35. 10%(P = 0. 034)respectively as compared with 0 h group.(3)There was a positive correlation between the levels of HOXA13 protein expression and CK protein expression (r = 0. 86,P = 0. 005),while the relationship between the levels of HOXA13 protein expression and Vimentin protein expression was negative(r = - 0. 94,P = 0. 002).(4)Up - regulated expression of HOXA13 in HKC cells by lipo-fectamine transfection alleviated the degree of EMT induced by HSA significantly. The expression of Vimentin decreased by 35. 34%(P = 0. 005)while the expression of CK increased 360. 00% - fold(P = 0. 005),compared with that of untransfected HKC cells. Conclusion EMT induced by HSA in HKC cells may play a role through HOXA13.

Background:The incidence of inflammatory bowel disease(IBD)is increasing recently. However,the pathogenesis has not been fully clarified. Aims:To investigate the expressions and significance of interleukin-22( IL-22),matrix metalloproteinase-9(MMP-9)and macrophage migration inhibitory factor(MIF)in peripheral blood of patients with IBD. Methods:A total of 80 patients with IBD admitted from May 2011 to Nov. 2014 at the First Affiliated Hospital of Soochow University were enrolled,in which 43 cases were Crohn’s disease(CD),37 cases were ulcerative colitis(UC). Forty healthy subjects were served as normal controls. Peripheral levels of IL-22,MMP-9 and MIF were detected by ELISA. Multivariate Logistic regression model was used to analyze IL-22,MMP-9 and MIF in active CD and UC and ROC curve was used to evaluate the diagnostic performance of these markers for screening of active CD and UC. Results:Compared with normal control group,peripheral levels of IL-22,MMP-9 and MIF increased significantly in CD and UC groups(P <0. 05),while no significant difference was found between CD and UC groups(P > 0. 05). Peripheral levels of IL-22, MMP-9 and MIF in active CD and UC were significantly higher than those in remission stage(P < 0. 05). For screening of active IBD,the area under ROC curve(AUC)of combined detection of IL-22 and MMP-9(0. 853 for CD,0. 867 for UC) was superior to that of IL-22,MMP-9 or MIF only(0. 747,0. 770 and 0. 699 for CD,0. 774,0. 815 and 0. 761 for UC). Conclusions:Peripheral levels of IL-22,MMP-9 and MIF increase markedly in IBD patients,which are correlated closely with the activity of IBD. Combined detection of IL-22 and MMP-9 might greatly increase the accuracy for screening of active IBD.

Objective: To investigate the effect of pseudodeficiency alleles on the newborn screening of glycogen storage disease type Ⅱ(GSDⅡ) by using afluorometric enzymatic assay to determine acid α-glucosidase (GAA) activity in dried blood spot (DBS). Methods: A total of 30 507 newborns′ DBSs, obtained from Newborn Screening Center of Xinhua Hospital Shanghai Jiao Tong University School of Medicine from May to December 2017, were screened for GSD Ⅱ by fluorometric enzymatic assay of GAA activity. The suspected positive DBSs after the first and second screening were directly analyzed by Sanger sequencing of GAA to confirm the diagnosis. Retrospective analysis of 3 172 controls without GSDⅡand 36 GSD Ⅱ patients were conducted to investigate the carrier status of pseudodeficiency alleles. Statistical analysis of frequency of pseudodeficiency alleles were carried out by Chi-square test or Fisher exact probability test. Results: GAA activity of 30 507 newborns showed a positively skewed distribution.Twenty-nine cases of newborns, suspected to be GSDⅡwere confirmed to be normal with genetic analysis of the original DBSs. Among the 29 suspected positive cases, 24 cases were homozygous for pseudodeficiency alleles c.[1726A/A; 2065A/A], and the other 5 cases were c.[1726G/A; 2065G/A] heterozygote. The frequency of c.1726G>Ahomozygote in 3 172 non-GSD Ⅱcontrols was 2.08% (66/3 172), and c.1726G>A homozygote occurred in allelic conjunction with c.2065G>Ahomozygote. Frequency of c.[1726A; 2065A] haplotype in 3 172 controls was 3.2%(206/6 344). Frequency of c.[1726A/A; 2065A/A] homozygote in 36 GSDⅡpatients (16.67%, 6/36) was significantly higher than that in non-GSD Ⅱcontrols(2.08%, 66/3 172) (χ²=34.517, P<0.001). Conclusions Pseudodeficiency alleles show a high frequency in Chinese, which leads to a high false positive rate in the newborns screening of GSDⅡ.The afterword genetic analysis of the original DBS after the GAA activity screening could reduce the effect of pseudodeficiency alleles on the newborns screening of GSDⅡ.

Objective To explore the value of the combination of homocysteine analysis, liquid chromatography tandem mass spectrometry(LC-MS/MS)and gas chromatography mass spectrometry(GC/MS)in the prenatal diagnosis of combined methylmalonic acidemia and homocystinuria(cblC defect)in amniotic fluid.Methods This is a retrospective study of 187 cases of pregnancies that came to our hospital for prenatal diagnosis between 2014/01-2017/03,among which 78 cases′probands were cblC defect patients and 109 cases′probands were not organic academia patients(control group).Amniotic fluid samples from pregnant women were obtained at 16 -24 weeks of gestation.Propionylcarnitine(C3)and acetylcarnitine (C2)were measured by LC-MS/MS, methylmalonic acid and methylcitric acid were analyzed by GC /MS, and homocysteine was determined by fluorescence polarization immunoassay.Some pregnancies received MMACHC gene sequencing with cultured cells from amniotic fluid.Data were analyzed using Mann-Whitney U and Kruskal-Wallis H tests.Results Among those 78 pregnant women whose probands were diagnosed to be cblC defect,24 cases were diagnosed to be cblC defect(positive group)and 54 pregnant women were diagnosed to be negative(negative group).In positive group, levels of homocysteine, C3, C3/C2, methylmalonic acid and methylcitric acid were all significantly higher than their normal reference ranges, negative group and control group(P values are 0.00).Cases that were diagnosed to be cblC defect by MMACHC gene sequencing were all turned out to be positive in the tests of the above metabolites in amniotic fluid.Cases with negative results of the metabolites were all excluded to be cblC defect by gene sequencing. Besides,2 cases of pregnancies were diagnosed to be positive by homocysteine and mass spectrometric analysis while only one mutation were detected by gene sequencing.Conclusions The combination of homocysteine, LC-MS/MS and GC/MS analysis in amniotic fluid turns out to be reliable for prenatal diagnosis of cblC defect,which may further cover the defect of prenatal diagnosis of those pregnancies whose probands′gene mutation is unknown.

Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P＜0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P＜0.01 or P＜0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P＞0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.