Objective To explore the number of peripheral blood regulatory T cells (Treg) in patients with chronic kidney disease (CKD) and its correlation with vascular calcification. Methods This was a single-center, cross-sectional, and observational study. Non-dialysis patients with CKD treated at Zhongshan Hospital, Fudan University from March 2021 to March 2022 were enrolled. Abdominal aortic calcification (AAC) was assessed using lateral abdominal X-ray. Number of Treg and cytokine levels were measured by flow cytometry. Logistic regression analysis was performed to evaluate the related factors for AAC in CKD patients. Results A total of 83 patients were included, aged 17–86 years, with 57 males (68.7%). The distribution of CKD stages was as follows: stage G1 in 7 patients (8.4%), stage G2 in 17 patients (20.5%), stage G3 in 21 patients (25.3%), stage G4 in 19 patients (22.9%), and stage G5 in 19 patients (22.9%). No AAC was observed in patients with stages G1 and G2, while the prevalence of AAC in patients with stages G3, G4, and G5 was 23.8%, 21.1%, and 26.3%, respectively. Compared with stage G1 patients, those with stages G3–5 showed decreased number of peripheral blood Treg and elevated levels of interleukin (IL)-6 and IL-17F (P＜0.05). The area under the receiver operating characteristic curve for number of peripheral blood Treg in predicting AAC in CKD patients was 0.766 (95%CI 0.652–0.879, P＝0.002). Logistic regression analysis showed that decreased number of Treg was related factor for AAC in CKD patients (OR＝0.957, 95%CI 0.922–0.992, P＝0.018). Conclusion As CKD progresses, number of peripheral blood Treg significantly decreases, which is correlated with AAC in CKD patients.

Objective:To analyze the results of the free breast cancer screening project for rural women in Qinba area, and to investigate intervention measures for the improvement of screening rate.Methods:The data of 5 974 rural women aged 35 to 64 years old with breast cancer in Qinba area during two cancer screening in 3201 Hospital Affiliated to Xi'an Jiaotong University College of Medicine and Nanjiang County Women and Children Hospital between August 2021 and March 2022 were retrospectively analyzed. The characteristics of the screened population, the results of breast ultrasonography, mammography and pathological examination were statistically analyzed.The differences in the positive rates of breast ultrasonography and breast ultrasonography supplemented with mammography in the clinical screening of breast cancer among different age groups were compared.Results:The highest participation rate was found in those aged 45 to 49 years old, accounting for 29.56% (1 766/5 974); the lowest participation rate was those aged 60 to 64 years old, accounting for 3.65% (218/5 974). According to breast ultrasonography screening, 976 (16.34%) cases were suspected positive, 282 (4.72%) cases were positive; 84 (1.41%) were screened for mammography, 18 (21.43%) cases were suspected positive and 6 (7.14%) cases were positive; and the detection rate of breast cancer was 66.96/ 100 000 (4/5 974). There were statistically significant differences in the positive rate of clinical breast cancer screening by breast ultrasonography and breast ultrasonography supplemented with mammography among different age groups (all P < 0.05). Conclusions:Breast cancer screening in Qinba area has achieved some good results. The screening mode of physical examination combined with breast ultrasound supplemented with mammography is suitable for this area, but the compliance of the population is poor. The scientific awareness of breast cancer in rural women should be improved.

Objective:To explore the potential serum biomarkers of patients with lupus nephritis(LN)by using two-dimensional electrophoresis combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF/TOF MS),so as to lay the foundation for illuminating pathogenesis.Methods:A total of 40 LN patients were divided into two groups,the active LN group and the inactive LN group,with 20 in each.In addition,20 IgA nephritis patients and 20 healthy volunteers were enrolled as IgAN group and healthy control group.Two-dimensional gel electrophoresis was used to separate and analyze the serum proteins,and MALDI-TOF/TOF MS was applied to the identification of the differentially expressed pro-teins.Results:A total of fifty differentially expressed proteins were identified.Compared with that in healthy control group,23 differentially expressed proteins were discovered in active LN group and inactive LN group,among which,8 proteins were up-regulated and 1 5 proteins were down-regulated.And 1 8 differentially expressed proteins,compared with IgA nephritis group, were found in active LN group and inactive LN group,including 13 up-regulated proteins and 5 down-regulated proteins.Fur-thermore,the number of up-regulated and down-regulated proteins in active LN group,compared with those in inactive LN group,were 4 and 5,respectively.Among the 50 identified differentially expressed proteins,the expression of serum amyloid protein A(SAA )in active LN group was higher than that in the other groups while the expression of complement component C4A in active LN group was lower than that in the other groups.And the expression of chain B (solution structure of double super helix model)in the inactive LN group was higher than that in the other groups.Compared with that in healthy control group,the expression of vitamin D-binding protein isoform 1 precursor,chain A(crystal structure of uncomplexed vitamin D-binding protein)and chain B (a covalent dimer of transthyretin that affects the amyloid pathway)was up-regulated in both ac-tive LN group and inactive LN group,while the expression of the vitronectin precursor,ficolin-2 isoform a precursor and chain A (crystal structure of the catalytic domain of human complement C1 s protease)was down-regulated.Compared with that in IgA nephritis group,the expression of lipoprotein CIII and vitronectin precursor was up-regulated in both active LN group and inactive LN group.Conclusions:Combination of two-dimensional gel electrophoresis and MALDI-TOF/TOF MS is effective for screening and identification of differentially expressed proteins in serum from LN patients.These differentially expressed pro-teins could be used as biomarkers for noninvasive diagnosis and evaluation of LN.Further study on these proteins would be conducive to understanding the pathogenesis of LN.

Objective To identify the prevalence and etiology of kidney disease and the related risk factors in type 2 diabetic patients in rural Shanghai.Methods A cross-sectional study in type 2 diabetic patients was conducted in a community of Shanghai.Questionnaire,clinical examination and laboratory tests were completed to collect the information about sociodemographic and healthcare characteristics.Results A total of 1421 eligible patients with complete information were screened from 1487 type 2 diabetic patients between November 2008 and March 2009.Of them,40.75％ were men,59.25％ were women,aged 37-86 (61.33 ± 9.65 ) years old,with diabetic duration of 0.25-43.92 (7.85 ± 6.34) years.Among them,43.42％ had diabetic retinopathy,21.18％ had neuropathy; 69.95％ met the screening definition for hypertension,76.07％ for hyperlipidemia,15.55％ for hyperuricemia and 23.65％ for cardiovascular disease.The control rates of fasting blood glucose,glycosylated hemoglobin,blood pressure and serum cholesterol were 57.71％,33.99％,14.22％ and 2.46％,respectively.The prevalence of kidney disease,diabetic nephropathy and non-diabetic renal disease was 41.31％,18.51％ and 13.44％,respectively; and 9.36％ were diagnosed as renal insufficiency of unknown reasons.Age,diabetic duration,hyperuricemia,diabetic retinopathy and poor control of blood pressure were independently associated with kidney disease;age and poor control of blood pressure were independently associated with diabetic nephropathy; age and hyperuricemia were independent risk factors of renal insufficiency in patients with diabetic nephropathy.Conclusions Although the diabetic duration of these subjects is relatively short,the prevalence of complications including diabetic nephropathy is high.The high prevalence of non-diabetic renal disease shows the importance of further screening and diagnoses for prevention.Strict control of blood glucose,blood pressure,serum cholesterol and serum uric acid are key points of cutting down the prevalence of diabetic nephropathy and chronic kidney disease.

Objective To explore the clinical characteristics and prevention management of death events caused by infections in end-stage renal disease (ESRD)patients undergoing hemodialysis. Methods Clinical data of ESRD patients undergoing hemodialysis in Nephrology Department of Zhongshan Hospital from 1998 to 2008 were retrospectively studied.Death causes,primary diseases,complications,infections,and survival time were analyzed. Results A total of 252 patients died including 162 males(64.29%)and 90 females(35.71%).Average death age was (63.48±14.77)years.In death events,emergency dialysis accounted for 59.52%,and primary glomerular disease was the major primary diseases(27.23%),then diabetic nephropathy(16.90%)and hypertensive nephrosclerosis (14.55%).34.8%death was caused by infections or promoted by infections,secondly by cerebrovascular events(23.6%).The elderly accounted for the majority of infection-associated deaths.48.15%and 38.71%patients with deaths caused or promoted by infections respectively had shorter dialysis duration(<3 months),whose percentage was much higher than those with non-infection-associated deaths (30.34%).Primary infection was still pulmonary infection(77.59%),then blood infection(10.34%)and catheter-associated infection(5.17%).58.62%infection-associated deaths had positive microbiologic test results,and gram negative bacillus accounted for 38.24%.50% of patients with positive test was complicated with fungal infection. Conclusions Infection is a main cause and a critical promotion to death in ESRD hemodialysis patients,besides it is the main cause of death in the elderly (>75 years)and hemodialysis duration within 3 months,which may result in shorter survival.Pulmonary infection and gram negative bacillus combined with fungal infection should be considered in the treatment.Prophylaxis of nosocomial infection and pulmonary infection in hemodialysis patients should be more emphasized.

Objective To evaluate the existence of occult peritoneal metastasis,Douglas′ pouch biopsy was undertaken intraoperatively in patients with gastric cancer. Methods From April 1998 to August 1999, Douglas′ pouch biopsy was performed in 16 cases of gastric cancer during laparotomy in which obvious distant peritoneal metastasis was not found by inspection or palpation.[WT5”HZ] Results Occult peritoneal metastasis in Douglas′s pouch was established in 5 out of the 16 cases,while the invasion depth of primary tumor were all under S stage category and the numbers of regional lymph node metastasis were 7 and up.Conclusion[WT5”BZ] At stages when gastric cancer invaded the visceral serosa, peritoneal biopsy in Douglas′ pouch must be performed as routine procedure in order to detect occult distant peritoneal metastasis.

or ≤50 in each patient. 5-year survival curves were estimated with the Kaplan-Meier method and compared by the log-rank test. ResultsWT5”BZ Analysis revealed that among node-negative patients, the 5-yerar's survival rate was 23% higher in patients with more than 50 nodes removed than those with less than 50. For node-positive patients, the difference of 5-year′s survival rate between the related two subgroups reached 36%.WT5”HZConclusion The number of lymph node resected has great impact on the long term survival of patients with colorectal cancer.

0.05) when all cases were put together. But the observed morbidity in group B (20%) was less than that in group A (40%) with the difference being statistically significant (?~2=4.41,P=0.036). ConclusionsThe POSSUM methodology allows satisfactory prediction of mortality and morbidity rates in patients undergoing colorectal tumor surgery.

Objective To evaluate the effect of the tention free repair on patient with abdominal insicion hernia. Methods 15 cases of abdominal insicion hernia were reviewed, all of them were repaired with polypropylene mesh. The mesh was overlaid on the defect, continuously monofilament nonabsorbable suture was used to fix the mesh on the edge of the defect and the mesh must be overlapped 2 cm on fascia abdominal layer and fixed by suture. Prophylactic antibiotics was used routinely in single dose. Result No relapse was found in follow up(rang 15～38 month). Conclusion The tension free hernia repair with polypropylene mesh in patient with abdominal incision hernia is a safe and simple operation with minimal postoperative pain.

Objective To study the relation between the surgical extent and number of lymph node dissection and the effect of metastatic lymph node number on the prognosis of proximal gastric cancer. Method Thirty-one patients with proximal gastric cancer underwent D_2 or D_3 operation, and lymph node were harvested from specimen. The number of lymph node dissection in proximal gastrectomy was compared with that in total gastrectomy. Results A total of 1971 lymph nodes were obtained from the 31 specimens, the mean was 63 per case. There were 57 lymph nodes per case for patients with proximal gastrectomy and 71 per case with total gastrectomy,64 per case with left half pancreaticosplenectomy and 63 per case with splenectomy. According to the new 5th N stage system, the 5 year survival of N_1,N_2,N_3 were 36%, 11%, and 0 respectively. Conclusion Along with the wide invasion of the carcinoma wide resection with extended lymph node dissection is mandatory, reserved left half of the pancreas has no influence on the number of harvested lymphnode, the new quantitative N staging is superior to the old in predicting the prognosis.