Objective To investigate the impact of coronary myocardial bridge(MB)on parameters of proximal pericoronary adipose tissue(PCAT).Methods Totally 287 patients with clinically suspected coronary heart disease but no coronary plaque on CT angiography(CCTA)were retrospectively collected.According to the presence or not of MB in left anterior descending(LAD),the patients were divided into MB group(n=150)and non-MB group(n=137).The length and depth of LAD-MB in MB group were measured,and patients in MB group were divided into deep MB subgroup and superficial MB subgroup according to LAD-MB depth.LAD PCAT parameters,i.e.fat attenuation index(FAI)and fat volume(FV),were compared between groups and subgroups within MB subgroup.Univariate and multivariate linear regression were used to explore the correlations of clinical factors(age,sex,body mass index),MB length,MB depth and PCAT parameters in MB group.Results FAI in MB group was higher,while FV was lower than those in non-MB group(both P＜0.001).Among 150 cases of LAD-MB,superficial type were found in 99 cases(superficial subgroup),while deep type were found in 51 cases(deep subgroup).FAI in superficial subgroup was lower,while FV was higher than those in deep subgroup(both P＜0.001).The median length and median depth of LAD-MB in 150 cases was 20.10 mm and 0.80 mm,respectively.Univariate linear regression analysis showed that for all 287 patients,gender was negatively correlated with FAI,whereas LAD-MB length and LAD-MB depth were positively correlated with FAI but negatively correlated with FV in MB group(all P＜0.05).Multifactor linear regression analysis showed that in MB group,both LAD-MB length and depth were positively correlated with FAI(B=0.105,1.797,both P＜0.05)and negatively correlated with FV(B=-15.585,-162.343,both P＜0.05),while clinical factors were not significantly correlated with FAI and FV(all P＞0.05).Conclusion MB could increase FAI and decrease FV of proximal PCAT.

Objective To investigate the impact of coronary myocardial bridge(MB)on parameters of proximal pericoronary adipose tissue(PCAT).Methods Totally 287 patients with clinically suspected coronary heart disease but no coronary plaque on CT angiography(CCTA)were retrospectively collected.According to the presence or not of MB in left anterior descending(LAD),the patients were divided into MB group(n=150)and non-MB group(n=137).The length and depth of LAD-MB in MB group were measured,and patients in MB group were divided into deep MB subgroup and superficial MB subgroup according to LAD-MB depth.LAD PCAT parameters,i.e.fat attenuation index(FAI)and fat volume(FV),were compared between groups and subgroups within MB subgroup.Univariate and multivariate linear regression were used to explore the correlations of clinical factors(age,sex,body mass index),MB length,MB depth and PCAT parameters in MB group.Results FAI in MB group was higher,while FV was lower than those in non-MB group(both P＜0.001).Among 150 cases of LAD-MB,superficial type were found in 99 cases(superficial subgroup),while deep type were found in 51 cases(deep subgroup).FAI in superficial subgroup was lower,while FV was higher than those in deep subgroup(both P＜0.001).The median length and median depth of LAD-MB in 150 cases was 20.10 mm and 0.80 mm,respectively.Univariate linear regression analysis showed that for all 287 patients,gender was negatively correlated with FAI,whereas LAD-MB length and LAD-MB depth were positively correlated with FAI but negatively correlated with FV in MB group(all P＜0.05).Multifactor linear regression analysis showed that in MB group,both LAD-MB length and depth were positively correlated with FAI(B=0.105,1.797,both P＜0.05)and negatively correlated with FV(B=-15.585,-162.343,both P＜0.05),while clinical factors were not significantly correlated with FAI and FV(all P＞0.05).Conclusion MB could increase FAI and decrease FV of proximal PCAT.

Objective To analyze the effects of Porphyromonas gingivalis(Pg)infection and expression of vitamin D pathway-related proteins on the survival and prognosis of patients with esophageal squamous cell carcinoma(ES-CC).Methods Pg infection and the expression of 24 hydroxylase(CYP24A1),1α hydroxylase(CYP27B1)and vitamin D receptor(VDR)in 173 ESCC tissues were detected by immunohistochemistry.The correlation between each index and the survival time of patients was analyzed.Results The positive rates of Pg,CYP24A1,CYP27B1 and VDR in ESCC were 43.35％,37.57％,20.23％and 21.97％,respectively.The 5-year survival time of ES-CC patients in the Pg+CYP24A1+CYP27B-VDR-high-risk group was shortened(P＜0.05).Conclusion Pg infection and vitamin D pathway-associated proteins can be used as reliable indicators to predict the survival and prognosis of ESCC patients.

OBJECTIVES: Tubulointerstitial diseases is one of the common causes of renal dysfunction. Some rare pathological types are easy to be misdiagnosed and missedly diagnosed because of their low prevalence and relatively insufficient understanding, which affects the treatment and prognosis of patients. This study aims to explore clinical manifestations and pathological characteristics of several rare tubulointerstitial diseases, and therefore to improve their diagnosis and treatment. METHODS: A total of 9 363 patients diagnosed by renal biopsy in the Department of Nephrology, Second Xiangya Hospital, Central South University from November 2011 to September 2021 were selected. Six cases of light chain cast nephropathy (LCCN), 2 cases of light chain proximal tubulopathy (LCPT), 1 case of LCCN with LCPT, 4 cases of genetic tubulointerstitial disease, and 6 cases of non-genetic related tubulointerstitial lesion were screened out, and their clinical manifestations and renal biopsy pathological results were collected, compared, and analyzed. RESULTS: Patients with LCCN presented with mild to moderate anemia, microscopic hematuria, and mild to moderate proteinuria. Compared with patients with LCPT, proteinuria and anemia were more prominent in patients with LCCN. Five patients with LCCN and 2 patients with LCPT had elevated serum free kappa light chain. Five patients with LCCN presented clinically with acute kidney injury (AKI). Two patients with LCPT and 1 patient with LCCN and LCPT showed CKD combined with AKI, and 1 LCPT patient presented with typical Fanconi syndrome (FS). Five patients with LCCN, 2 patients with LCPT, and 1 patient with LCCN and LCPT were diagnosed with multiple myeloma. Five patients with LCCN had kappa light chain restriction in tubules on immunofluorescence and a "fractured" protein casts with pale periodic acid-Schiff (PAS) staining on light microscopy. Immunohistochemical staining of 2 LCPT patients showed strongly positive kappa light chain staining in the proximal tubular epithelial cells. And monoclonal light chain crystals in crystalline LCPT and abnormal lysosomes and different morphological inclusion bodies in noncrystalline LCPT were observed under the electron microscope. Six patients with LCCN were mainly treated by chemotherapy. Renal function was deteriorated in 1 patient, was stable in 4 patients, and was improved in 1 patient. Two patients with LCPT improved their renal function after chemotherapy. Four patients with genetic tubulointerstitial disease were clinically presented as CKD, mostly mild proteinuria, with or without microscopic hematuria, and also presented with hyperuricemia, urine glucose under normal blood glucose, anemia, polycystic kidneys. Only 1 case had a clear family history, and the diagnosis was mainly based on renal pathological characteristics and genetic testing. Compared with patients with non-genetic related tubulointerstitial lesion, patients with genetic tubulointerstitial disease had an earlier age of onset, higher blood uric acid, lower Hb and estiated glomemlar fitration (eGFR), and less edema and hypertension. Renal pathology of genetic tubulointerstitial disease presented tubular atrophy and interstitial fibrosis, abnormal tubular dilation, glomerular capsuledilation, and glomerular capillary loop shrinkage. Glomerular dysplasia and varying degrees of glomerular sclerosis were observed. Genetic tubulointerstitial disease patients were mainly treated with enteral dialysis, hypouricemic and hypoglycemic treatment. Two genetic tubulointerstitial disease patients had significantly deteriorated renal function, and 2 patients had stable renal function. CONCLUSIONS Patients with AKI or FS, who present serum immunofixation electrophoresis and/or serum free kappa light chain abnormalities, should be alert to LCCN or LCPT. Renal biopsy is a critical detection for diagnosis of LCCN and LCPT. Chemotherapy and stem cell transplantation could delay progression of renal function in patients with LCCN and LCPT. If the non-atrophic area of the renal interstitium presents glomerular capsule dilatation, glomerular capillary loop shrinkage, and abnormal tubular dilatation under the light microscopy, genetic tubulointerstitial disease might be considered, which should be traced to family history and can be diagnosed by genetic testing.
Humans ; Hematuria ; Immunoglobulin Light Chains/analysis* ; Multiple Myeloma ; Proteinuria ; Nephritis, Interstitial ; Acute Kidney Injury ; Anemia ; Renal Insufficiency, Chronic

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

In this paper, 2 cases of collagen Type Ⅲ glomerulopathy were analyzed. The clinical manifestations mainly included nephrotic syndrome, proteinuria, hypertension and renal dysfunction. One patient showed that the complement factor H-related protein 5 (CFHR5) gene was likely a disease-causing mutation. The pathological examination of renal tissues showed hyperplasia of mesangial matrix, sub-endothelial insertion, and double-track formation. Immunohistochemistry of Type III collagen was positive. Electron microscopy revealed that massive collagen fibers (40-70 nm in diameter) deposited in the mesangial matrix and basement membrane. As for the follow-up results, the normal renal function had kept steady and the proteinuria was moderate in 1 case treated with angiotensin Ⅱ receptor blocker. Due to other system disease, another case developed into acute kidney injury and then received hemodialysis. The clinical manifestations of collagen Type Ⅲ glomerulopathy was atypical, the light microscope pathological features were various, and the disease was mainly diagnosed by electron microscopy and immunohistochemistry.
Collagen Type III ; genetics ; Glomerular Mesangium ; Humans ; Kidney Diseases ; Kidney Glomerulus ; Proteinuria

Objective:To examine the expression ofphospholipase A2 receptor (PLA2R) in renal tissues and the level of anti-PLA2R antibody in serum in patients with idiopathic membranous nephropathy (IMN) and secondary membranous nephropathy (SMN),and to evaluate their diagnostic value in IMN.Methods:A total of 73 patients,who were diagnosed between May,2014 and February,2015 in the Department of Nephrology of the Second Xiangya Hospital,Central South University,were divided into three groups:an IMN group (n=48),an SMN group (n=17) and a minimal change disease group (n=8) according to the renal biopsy.PLA2R expression in renal tissues and the level of antiPLA2R antibody in serum were detected by indirect immunofluorescence technique.Results:The positive rate and fluorescence intensity for PLA2R in the renal tissues in the IMN group were higher than those in the SMN group (91.7％ in the IMN group vs 29.4％ in the SMN group,P＜0.05),while the positive rate and serum level for anti-PLA2R antibody in the IMN group were higher than those in the SMN group (85.4％ in the IMN group vs 29.4％ in the SMN group,P＜0.05);the expression of PLA2R in renal tissues and the serum level for anti-PLA2R antibody were not detected in the minimal change disease group,The serum level of anti-PLA2R antibody was positively correlated with 24 h urine protein (r=0.432,P＜0.01) and negatively correlated with serum albumin (r=-0.307,P＜0.05).Conclusion:The expression of PLA2R in renal tissues and the serum level of anti-PLA2R antibody might be potential markers for diagnosis oflMN.

Objective To investigate the feasibility of bone marrow mesenchymal stem cells (BMSCs) combined with type Ⅱ collagen-hyaluronic acid-oxidized chondroitin sulfate (Col Ⅱ-HA-OCS) biomimetic hydrogel to repair articular cartilage defect in porcine and the role of the transplanted cells played in the process of cartilage repair.Methods A articular cartilage defect model which remaining cartilage calcified zone was created in the knee of Bama minipigs,the autologous BMSCs was used as seeds for transplantation and was labeled by the 5,6-carboxyfluorescein diacetate succinimidyl ester (CFDA SE).Animals were randomly divided into three groups:Group A (blank group) was left untreated,group B (cell-free biomimetic hydrogel group) was filled with biomimetic hydrogel and group C (BMSCs combined with biomimetic hydrogel group) was filled with the CFDA SE labeled autologous BMSCs combined with biomimetic hydrogel.One month after the operation,BrdU labeled liquid was injected intravenously into the animals 24 h and 48 h before specimens were taken from the executed animals.Partial cartilage repaired tissue in Group C was taken,cryosectioned and stained with DAPI and BrdU immunofluorescence.Confocal laser scanning microscope was used to observe and count the cells.Specimens of the three groups were analyzed through gross observation and histological staining,and scored according to the international cartilage repair society (ICRS) gross morphological score and ICRS histological score.Results Laser scanning confocal microscopy showed (97.3 ± 2.6) ％ of the cells were derived from the implanted BMSCs in repaired tissue and that the ratio of these cells with proliferative capacity was (76.6 ± 2.5) ％.Gross observation suggested most of the cartilage defect areas in Group C were filled with ivory tissue,but those in Group A and B were still obvious depression.Histological staining showed the cartilage defect areas in Group C were filled with cartilage like tissue,which was well integrated with the surrounding normal cartilage,presented a few cartilage lacunas could be seen,and had contents of Col Ⅱ and glycosaminoglycan similar with the adjacent normal cartilage.There was almost no filler in the defect area in Group A.There was little fibrous tissue in the defect area in Group B.ICRS gross score was (8.3 ± 1.0) points in Group C,higher than that in Group A [(0.5 ± 0.6) points] and Group B [(2.3 ± 0.5) points] (P ＜ 0.05).ICRS histological score was (10.3 ± 2.4) points in Group C,higher than that in Group A [(0.5 ± 0.6) points] and Group B [(4.5 ± 1.0) points] (P ＜ 0.05).Conclusions BMSCs combined with Col Ⅱ-HA-OCS biomimetic hydrogel for repairing porcine articular cartilage defects can achieve satisfactory results.Implanted BMSCs are the main component of the cell composition in the repaired tissue and gradually differentiated into chondrocytes.

Objective To compare the stress distributions on the anterior horn,body part and posterior horn of menisci between the normal and the injured knees with anterior cruciate ligament (ACL) deficiency using the three-dimensional finite element analysis.Methods A three-dimensional finite element model of tibiofemoral joint was created to simulate the motion states of the normal and ACL-deficiency knees at extension,as well as 15° and 30° flexions.Meanwhile,700N axial load and 134N posterior load were applied to the femur.Then,the stress on the anterior horn,body part and posterior horn of medial and lateral menisci were compared between the normal and ACL-deficient knees.Results With ACL deficiency,when stretching the knees straightly,the stress on the anterior horn of medial meniscus increased to 100.7％ of the normal knees,bigger than that of the affected lateral meniscus (30.7％).At 15° and 30° flexions,the stress on the posterior horn of the medial meniscus in ACL-deficiency knees increased by 36.4％ and 59.7％ respectively when compared to normal knees,while the stress on that of the lateral meniscus did not increase significantly.Apart from the stress on the body part of the lateral meniscus increasing by 39.5％ at extension in ACL-deficiency knees,no obvious changes were observed in the stress on the body part of the medial and lateral menisci.Conclusion ACL deficiency has different effect on the stress of different parts of the meniscus.It mainly increases the stress on the anterior horn of the medial meniscus at extension and that of the posterior horn of the medial meniscus at flexion.

To examine levels of M-type phospholipase A2 receptor (PLA2R) and its antibody in the patients with hepatitis B virus-associated membranous nephropathy (HBV-MN), and to explore the correlation of PLA2R with laboratory parameters and pathological characteristics.
 Methods: A total of 49 adult patients with biopsy-proved HBV-MN were enrolled in this study. Levels of anti-PLA2R antibody in serum and PLA2R in renal tissue were detected. Patients were assigned into two groups: a positive PLA2R group and a negative PLA2R group. Differences in laboratory parameters and pathological characteristics were compared between the two groups.
 Results: Of 49 patients with HBV-MN, 17 had positive PLA2R expression in renal tissues. In the positive PLA2R group, 10 patients were positive for serum anti-PLA2R antibody. Patients with positive PLA2R expression in renal tissues showed higher levels of 24 hour urinary protein [(4.6±3.9) g/d], serum HbsAg (70.5%) and renal HbsAg expression (71%), while lower level of serum albumin [(24.1±7.5) g/L] than those of the negative group.
 Conclusion: PLA2R is expressed in the renal tissues and serum anti-PLA2R antibody can be detected in some HBV-MN patients. Positive PLA2R expression in renal tissue might be related to HbsAg deposition in serum and renal tissues. Patients with positive PLA2R expression in renal tissue have more severe glomerular sclerosis.
Adult ; Antibodies ; Autoantibodies ; genetics ; physiology ; Biopsy ; Glomerulonephritis, Membranous ; complications ; etiology ; genetics ; Hepatitis B ; complications ; Hepatitis B Surface Antigens ; adverse effects ; Hepatitis B virus ; Humans ; Kidney ; blood supply ; chemistry ; physiopathology ; Kidney Diseases ; etiology ; genetics ; physiopathology ; Male ; Prognosis ; Proteinuria ; epidemiology ; genetics ; Receptors, Phospholipase A2 ; blood ; physiology ; Serum Albumin ; genetics