Objective To explore the influencing factors of cognitive impairment in non-dialysis patients with chronic kidney disease(CKD).Methods A total of 60 hospitalized non-dialysis patients with CKD in the Department of Nephrology of Northern Jiangsu People's Hospital Affiliated to Yangzhou University from September 2022 to September 2023 were enrolled as research objects.According to the estimated glomerular filtration rate(eGFR),they were divided into stage 1 to 2 of CKD group[eGFR ≥60 mL/(min·1.73 m2)]with 23 cases,the stage 3 of CKD group[eGFR 30～＜60 mL/(min·1.73 m2)]with 20 cases,and stage 4 to 5 of CKD group[eGFR＜30 mL/(min·1.73 m2)]with 17 cases.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate the cognitive function of the patients.Basic data and common clinical laboratory in-dicators on hospital admission were collected to analyze the differences in cognitive function levels under different renal function statuses and to explore the influencing factors of cognitive impairment.Results The incidence rates of cognitive impairment in the stage 1 to 2 of CKD group,stage 3 of CKD group,and stage 4 to 5 of CKD group were 47.8％,85.0％,and 94.1％respectively,the median MoCA scored 26,24 and 20 respectively,with statistically significant between-group differ-ences(P＜0.05).Cognitive function was significantly negatively correlated with age(r=-0.634,P＜0.001),blood urea nitrogen(BUN)(r=-0.574,P＜0.001),serum creatinine(Cr)(r=-0.417,P＜0.001),cystatin C(Cys-C)(r=-0.327,P=0.011),serum β2-microglobulin(β2-MG)(r=-0.259,P=0.046),and N-terminal pro-brain natriuretic peptide(NT-proBNP)(r=-0.474,P＜0.001),and was significantly positively correlated with hemoglobin(HB)(r=0.401,P=0.001)and eGFR(r=0.485,P＜0.001).Multivariate Logistic regression analysis showed that age(P=0.006)and NT-proBNP(P=0.041)were influencing factors of cognitive im-pairment in non-dialysis patients with CKD.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC),sensitivity,and specificity of age for prediction were 0.860,0.864 and 0.812 respectively,the AUC,sensitivity,and specificity of NT-proBNP for pre-diction were 0.808,0.795 and 0.875 respectively,and the combined prediction of age and NT-proBNP had an AUC,sensitivity,and specificity of 0.893,0.955,and 0.750,respectively.Conclusion As renal function deteriorates,the incidence rate and severity of cognitive impairment in non-dialysis patients with CKD tend to increase.Advanced age,renal function deterioration,high NT-proBNP level,and anemia are associated with the occurrence of cognitive impairment in non-di-alysis patients with CKD,among which age and NT-proBNP are influencing factors for cognitive im-pairment.

Primary liver cancer is one of the prevalent malignant neoplasm in China, characterized by a high incidence rate and a dismal prognosis. Upon diagnosis, the majority of patients have progressed to an advanced or intermediate stage, rendering radical surgery impracticable. With the advent and ongoing advancement of translational therapy, the prognosis of patients with middle- to late-stage unresectable hepatocellular carcinoma has been substantially enhanced through the successful conversion of this disease from unresectable to surgically resectable. At present, the primary clinical treatment options for transformative conditions consist of local therapy, systemic therapy, or a combination of the two. This article examines and anticipates the diverse facets of the conversion treatment options for initial unresectable hepatocellular carcinoma, surgical indications and timing following treatment, and postoperative adjuvant therapy.

Objective:To investigate the effects of hepatitis B virus X (HBx) on hepatocellular carcinoma (HCC) proliferation, invasion, and sorafenib resistance.Methods:HepG2 cell line infected with HBx ORF lentivirus was set as the HBx high expression group and infected with empty vector was set as the negative control group. The interference group was infected with the HBx siRNA virus based on the HBx high expression group to reduce HBx expression. Interference control group as interference group but with infected empty vector virus. Western blotting was used to measure the protein level of HBx. Cell proliferation, invasion ability, and sorafenib semi-inhibitory concentration (IC50) of HCC cells under different HBx expression levels were respectively detected by cell proliferation assay kit, Transwell invasion assay, and cell titer-glo kit.Results:Western blotting showed that the stable cell lines were successfully established. Cell proliferation of the HBx high expression group was better than that of the blank control and negative control groups, and the cell proliferation of the interference group was lower than that of the interference control and HBx high expression groups, and the differences were all statistically significant ( P<0.05). The number of cells crossing Matrigel gel was (46.2±4.1), (50.7±5.1) and (48.2±5.2) in the blank control group, negative control group, and interference group, respectively. The number of cells crossing Matrigel gel in the HBx high expression group (124.2±8.3) and the interference control group (117.2±7.5) were higher than the above three groups, respectively, and the differences were all statistically significant ( P<0.05). The IC50 of cells in the HBx high expression group and the interference control group were (5.36±0.31) μmol/L and (5.48±0.20) μmol/L, respectively, which were higher than those in the blank control group, the negative control group, and the interference group (4.75±0.22) μmol/L, (4.60±0.14) μmol/L and (3.98±0.03) μmol/L. The differences were all statistically significant ( P<0.05). Conclusion:HBx promoted the tumor proliferation and invasion of HepG2 HCC cells, enhanced the ability to sorafenib resistance, and inhibited apoptosis.

Objective To investigate the clinical significance of complement activation in patients with HBV related glomerulonephritis (HBV-GN).Methods Biopsy-proven HBV-GN patients admitted in our hospital were retrospectively recruited.Decreased serum C3 level was defined as C3 ＜ 85 mg/dL.According to the serum C3 level,the patients were divided into the decreased serum C3 group and normal serum C3 group,and the pathological and clinical differences were compared between the two groups.According to the intensity of C3 deposition in the kidney,patients were divided into negative and positive group,and the pathological and clinical differences were compared.Results In this study,29 HBV-GN patients were recruited.There were 18 (62.07％) patients in the normal serum C3 group and 11 (37.93％) patients in the decreased serum C3 group.Compared with the patients with normal serum C3 level,patients with decreased serum C3 level had higher serum creatinine level,lower eGFR level,severer mesangial proliferation and renal interstitial fibrosis (P ＜ 0.05).There were 9 (31.03 ％) patients with negative C3 deposition in the kidney,and 20 (68.97％) patients with positive C3 deposition.Higher cholesterol,higher IgG levels,lower serum albumin,serum C 3 levels,lower eGFR level,severer glomerular sclerosis,inflammatory cell infiltration in renal interstitial,renal tubular atrophy,and renal interstitial fibrosis were associated with a higher grade of C3 deposition in the kidney (P ＜ 0.05).Conclusion There are different levels of complement activation in patients with HBV-GN.Local and systemic complement activation is associated with decreased renal function.Complement activation may be involved in the development of HBV-GN.

Objective To investigate the clinical significance of complement activation in patients with HBV related glomerulonephritis (HBV-GN).Methods Biopsy-proven HBV-GN patients admitted in our hospital were retrospectively recruited.Decreased serum C3 level was defined as C3 ＜ 85 mg/dL.According to the serum C3 level,the patients were divided into the decreased serum C3 group and normal serum C3 group,and the pathological and clinical differences were compared between the two groups.According to the intensity of C3 deposition in the kidney,patients were divided into negative and positive group,and the pathological and clinical differences were compared.Results In this study,29 HBV-GN patients were recruited.There were 18 (62.07％) patients in the normal serum C3 group and 11 (37.93％) patients in the decreased serum C3 group.Compared with the patients with normal serum C3 level,patients with decreased serum C3 level had higher serum creatinine level,lower eGFR level,severer mesangial proliferation and renal interstitial fibrosis (P ＜ 0.05).There were 9 (31.03 ％) patients with negative C3 deposition in the kidney,and 20 (68.97％) patients with positive C3 deposition.Higher cholesterol,higher IgG levels,lower serum albumin,serum C 3 levels,lower eGFR level,severer glomerular sclerosis,inflammatory cell infiltration in renal interstitial,renal tubular atrophy,and renal interstitial fibrosis were associated with a higher grade of C3 deposition in the kidney (P ＜ 0.05).Conclusion There are different levels of complement activation in patients with HBV-GN.Local and systemic complement activation is associated with decreased renal function.Complement activation may be involved in the development of HBV-GN.

Objective To analyze the CT manifestation and clinical characteristics of appendiceal mucinous tumor for improving the diagnostic and therapeutic level. Methods The CT and clinical data of 7 patients with appendiceal mucinous tumor verified by histopathology were retrospectively analyzed. Results Among the 7 cases, mucinous cystadenomas was in 6 cases, and mucinous cystadenocarcinoma was in 1 case. One case had no obvious discomfort;3 cases visited because of pain on right hypogastrium and fever;3 cases had the medical history ofchronic appendicitis, among whom 2 cases had the mass on right hypogastrium which had existed for 1 day or 2 years. The unenhanced CT showed that all of 7 cases had the cystic tumors on right hypogastrium near the cecum, and the maximum traverse diameter was 25-208 (67 ± 27) mm. The cyst walls of mucinous cystadenoma in 6 cases were flimsy, symmetrical, 2.3-3.5 mm thickness and smooth. Three cases had cyst walls calcification; the cyst wall of mucinous cystadenocarcinoma was thick and asymmetrical, and the thickness of cyst wall was 3.5-5.7 mm. Small nodes could be found inside the walls. 7 cases had much mucilage, with CT value 14.0-33.5 HU. Four cases had slight septa. The enhanced CT showed that the cyst walls of mucinous cystadenoma in 6 cases were mild to moderate continuous enhancement during venous phase; the cyst wall and nodes mucinous cystadenocarcinoma was obvious and continuous enhancement. Four cases showed clear boundary, while 3 cases accompanied with acute inflammation showed dim edge. The enlargement of lymphatic nodes could be seen near mesentery in 1 case. All the 7 cases were treated by surgical treatment. One patient who survived after 26 months showed the metastasis of peritoneal pseudomyxoma after 20 months. The 6 patients with mucinous cystadenoma were followed up for 18 - 36 months, they did not had metastasis or recurrence by CT review. Conclusions Appendiceal mucinous tumor is often short of characteristic in clinical symptom and physical sign, but has favourable prognosis. CT is a vital tool for its diagnosis and identification.

Humans ; Indium ; urine ; Mass Spectrometry ; methods ; Spectrum Analysis ; methods