Renal Fanconi syndrome (FS) is a rare renal manifestation of primary Sjögren's syndrome (pSS). This study aims to analyze the clinical and prognostic characteristics of patients with pSS-associated renal FS (pSS-FS) and provide insights for clinical management.

Objective:To investigate the effect of highly active antiretroviral therapy(HAART) on thyroid function in adult patients with acquired immunodeficiency syndrome(AIDS).Methods:A cross-sectional retrospective study was conducted on 1 276 AIDS patients hospitalized in the Department of Infection, Guangzhou Eighth People′s Hospital from June 2017 to May 2020. General data, the first laboratory examination on admission, thyroid function, and related antibodies were collected and analyzed. A total of 176 patients were included in the study and divided into HAART group( n=83) and no-HAART group( n=93) according to whether they received HAART treatment. Results:Among 176 AIDS patients, the rate of thyroid dysfunction was 53.98%. It was significantly lower in the HAART group, compared with no-HAART group(40.96% vs 65.59%), with a statistically significant difference ( P=0.001). The course of AIDS, body mass index, CD4 + T lymphocyte count, free triiodothyronine, and serum creatinine in HAART group were significantly higher than those in no-HAART group, and aspartate aminotransferase was significantly lower than those in no-HAART group, with statistical significance(all P<0.05). There was no significant difference in age, sex, smoking history, free thyroxine, thyroid stimulating hormone, thyroid peroxidase antibody, thyroglobulin antibodies, and alanine aminotransferase between HAART group and no-HAART group(all P>0.05). The prevalence of low T 3 syndrome in HAART group was significantly lower than that in no-HAART group(14.46% vs 39.78%), and the difference was statistically significant( P<0.001). There was no significant difference in the prevalence of hyperthyroidism, hypothyroidism, and isolated low T 4 between HAART group and No-HAART group(all P>0.05). Multivariate logistics regression analysis showed that HAART was an independent protective factor for thyroid dysfunction and isolated low T 4 in AIDS patients. Conclusions:Thyroid dysfunction is a common endocrine disorder in AIDS patients that requires attention from infectious disease specialists. HAART therapy serves as a protective factor against thyroid dysfunction. Thyroid dysfunction mainly manifests as low T3 syndrome and requires continuous monitoring of thyroid function changes.

Objective To observe the effect of adenosine A1 receptor (A1AR) on the megalin defect in type 1 diabetic mice with early kidney disease.Methods 7-8 week-old,baseline body weight and fasting blood glucose matched wild type (WT) C57BL/6J mice were selected,and randomly divided into two groups:control group (n=6) and WT DM group (n=6).In the same way,male A1AR knock-out C57BL/6J mice were selected as A1AR-/-DM group (n=6).DM model was established by intraperitoneal injection of streptozocin.The blood glucose (BG),body weight (BW),kidney weight (KW),24 h proteinuria (24hUP) and albumin creatine ratio (ACR) were measured at 4 weeks.The renal pathological lesion was observed and the expression of megalin in proximal tubules was examined by immunohistochemistry.The expression of caspase-1,IL-18 and A1AR were detected by Western blotting.Results At 4th week,compared with WT control mice,the BG,BW,KW and 24hUP of WT DM mice were increased significantly (n=6,P ＜ 0.01),with the pathological glomerular enlargement,mesangial cell proliferation,extracellular matrix accumulation and renal tubule hypertrophy being observed.Immunohistochemistry revealed decreased expression of megalin,an important multiligand protein receptor on the brush border of proximal tubular epithelial cells in WT DM mice,which was correlated with 24hUP (r=-0.645,P ＜ 0.01).Compared with the control mice,the expressions of caspase-1,IL-18 and A1AR were significantly increased in WT DM mice (P ＜ 0.05).For A1AR-/-DM mice,more serious pathological lesion and megalin defect,together with increasing of casapase-1 and heavier proteinuria were observed than those in WT DM mice.Conclusion A1AR may play a protective role in megalin expression of diabetic mice with early kidney disease,in which the mechanism may be associated with caspase-1 related pyroptosis pathway.The details need further exploration.

Objective To analyze the clinic-pathological data and peritubular capillary (PTC) injuries of malignant nephrosclerosis (MN) patients and their correlations with the long term renal survival.Methods This was a retrospective cohort study of 52 MN patients in Peking Union Medical College Hospital from January 2003 to March 2012.Their clinical data and renal biopsy samples were carefully studied.CD34 staining was performed to evaluate the PTC area,using Benign nephrosclerosis (BN,n=17) patients and glomerular minimal lesions (GML,n=19) patients as controls.Multivariate Cox proportional hazard model was used to identify the potential independent risk factors for long term renal survival.Results Fifty-two MN patients were enrolled.The sex ratio of male to female was 12:1 and the average age was (34.0±8.2) years.The maximum blood pressure (SBP/DBP) was (230.4 ± 25.0)/(156.4 ± 20.6) mmHg,companied with significant loss of eGFR and proteinuria.Glomerular sclerosis index,tubular atrophy and interstitial fibrosis correlated with eGFR and proteinuria (P ＜ 0.05).After aggressive treatment,BP control rate improved significantly (76.9％ vs 3.7％,P ＜0.01),Scr [(376.4±263.8) μmol/L vs (486.8±375.7) μmol/L,Wilcoxon test,P＜ 0.01] and proteinuria [(1.10±0.70) g/24 h vs (2.04± 1.26) g/24 h,P ＜ 0.01,n=21] also improved.PTC area in MN patients was significantly lower than those in BN patients and GML patients,and it correlated well with Scr (r=-0.553,P=0.001) and eGFR (r=0.476,P=0.004).The median follow-up time was 74 months,the cumulative renal survival rate at 1 year,5 year and 10 year was 90％,64％ and 23％,respectively.Kaplan-Meier analysis showed that the patients with higher PTC area had longer renal survival time [(114.8± 12.4) months vs (63.0±8.3) months, x2=5.312,P ＜ 0.05].Univariate Cox proportional hazard model found that unsatisfied BP control,eGFR ＜ 30 ml · min-1 · (1.73 m2)-1 upon discharge,lower PTC area,severer tubular-interstitial damage and anemia were associated with poor renal outcome.Multivariate Cox model showed that unsatisfied BP control (RR=3.89,95％ CI 1.75-8.65,P=0.001),eGFR ＜ 30 ml · min-1 · (1.73 m2)-1 upon discharge (RR=4.27,95％ CI 1.40-13.09,P=0.011) were independent risk factors for long-term renal survival.Conclusions The correlation between PTC area and renal functions in MN patients are much better than that of classic vascular changes.Unsatisfied BP control and eGFR ＜ 30 ml · min-1 · (1.73 m2)-1 upon discharge are independent risk factors for long-term renal survival.

Objective This article introduced the concrete methods and benefits of promoting and holding competition of acupuncture and moxibustion in TCM universities or colleges. A regular skill competition will not only stimulate students' passion for TCM study and expand teaching methods, but also serve as a effective way to enhance practical skills of students.

ObjectiveTo analyze the effect of lowering the upper limit of normal fasting glucose on the distribution of impaired gheose regulation(IGR)in the population in Wuhan urban area.MethodsThe health profiles of 1896 people after physical examinations were analyzed by X2 test.ResultsThe low limit for impaired fasting glucose(IFG)was decreased from 6.1 to 5.6 mmol/L,IFG increased 271 patients.the prevalence of IFG increased from 13.1%to 27.4%(X2=62.68,P<0.05),and the value of normal glucose test decreased from 60.3%to 47.5%(X2=120.03,P<0.05).Overweisht or obesity,hypetention,fatty liver,hyperlipidemia,ECG abnormality were significantly different(P<0.05)in groups of fasting glucose 5.6-6.0 mmol/L to<5.6 mmol/L and to 6.1-6.9 mmol/L ConclusionThe new cut point of IFG has significantly influenced the distribution of IGR in the population of Wuhan urban areas.In the newly IFG.increased subjects,metabolic abnormalities of glucose and lipid occur,and an intervention of life-style is needed for them.

Objective To investigate the expression of osteopontin(OPN) mRNA in breast tissues containing microcalcifications and the significance of OPN in tumor pathogenesis and metastasis of breast cancer.Methods The expression of OPNmRNA in 128 samples of tissues of breast lesions and adjacent breast tissues and 9 samples of metastatic lymph nodes were examined.Results The expression of OPNmRNA was highest in(calcified) foci of breast cancer tissues and in metastatic lynph nodes,lower in calcified foci of benign breast tissues and lowest in breast tissues adjacent to breast cancer and in benign tissues without calcification.The differences between the defferent tissues were significant(all P