Objective To explore the correlation between changes in spleen volume and stiffness before and after transjugular intrahepatic portosystemic shunt (TIPS) and the occurrence of hepatic encephalopathy. Methods A retrospective study was conducted on 104 patients who underwent TIPS in the Department of Interventional Therapy, Zhongshan Hospital, Fudan University, from January 1, 2023 to July 30, 2024. Spleen volume and stiffness were measured before and after surgery. Patients were divided into the overt hepatic encephalopathy (OHE) group and the non-OHE group. Univariate and multivariate logistic regression analyses were used to identify factors correlated with OHE after TIPS. The predictive values of the related factors of OHE were evaluated using receiver operating characteristic (ROC) curves. Results OHE occurred in 34 patients (32.69%). Compared with the non-OHE group, the OHE group had a smaller percentage reduction in spleen volume after TIPS (P＜0.001), but there was no statistically significant difference in the percentage reduction in spleen stiffness between the two groups. Multivariate logistic regression analysis revealed that the percentage reduction in spleen volume was correlated with postoperative OHE (OR＝0.90, P＜0.001). ROC analysis showed that the area under the curve (AUC) for spleen volume reduction percentage in predicting postoperative OHE was 0.773, superior to spontaneous portosystemic shunt (SPSS; Z＝2.088, P＝0.037). Conclusions Reduction in spleen volume after TIPS may be a protective factor against hepatic encephalopathy, while changes in spleen stiffness were not found to be correlated with its occurrence.

Objective:To investigate the short-term efficacy and safety of rituximab (RTX) in children with calcineurin inhibitor (CNI) resistant steroid resistant nephrotic syndrome (SRNS).Methods:A retrospective case analysis was conducted. Thirteen children with CNI resistant SRNS who were regularly treated with RTX (375 mg/m 2 per dose (maximum dose 500 mg), 1 dose per week, a total of 4 doses) in Department of Nephrology, Children′s Hospital of Fudan University from January 2016 to December 2023 were enrolled. The general data, disease related information, urinary protein/creatinine, serum albumin, blood creatinine before RTX treatment, immunosuppressants, adverse events, and monthly urinary protein/creatinine, serum albumin, and blood creatinine indexes within 6 months after RTX treatment were collected. The changes of urinary protein/creatinine, serum albumin and estimated glomerular filtration rate (eGFR) before and after RTX at 3 and 6 months were analyzed by using paired sample t test and Wilcoxon signed-rank test. Results:Among the 13 patients, 8 were male and 5 were female. The age of disease onset was 4.0 (2.9, 6.8) years and the age of RTX treatment was 9.8 (5.9, 13.6) years. There were 8 cases of focal segmental glomerulosclerosis, 3 cases of minimal change disease and 2 cases of mesangial proliferative glomerulonephritis. No clinically significant gene variation was detected in 12 cases and the other one did not receive gene test. Before RTX treatment, 11 cases were in chronic kidney disease stage G1, and 1 case each was in stage G2 and stage G3. Ten children completed 4 doses of RTX treatment, 1 patient completed 3 doses, and 2 patients completed 2 doses. Urinary protein/creatinine in 13 children at 3 and 6 months after RTX treatment was significantly lower than baseline (0.60 (0.13, 2.04), 0.49 (0.28, 1.10) vs. 1.44 (0.76, 4.11) mg/mg, Z=-2.34, -2.34, both P<0.05), and serum albumin was significantly higher than baseline ((35±8), (34±7) vs. (30±6) g/L, t=2.30, 2.60, both P<0.05). The eGFR at 6 months after RTX treatment was not significantly different from the baseline ((110±32) vs. (113±35) ml/(min·1.73 m 2), t=-0.76, P>0.05)). No serious adverse reactions occurred in this study. Conclusion:RTX could reduce urinary protein and increase serum albumin in short-term treatment in children with CNI resistant SRNS without significant side effects.

Objective:To investigate the short-term efficacy and safety of rituximab (RTX) in children with calcineurin inhibitor (CNI) resistant steroid resistant nephrotic syndrome (SRNS).Methods:A retrospective case analysis was conducted. Thirteen children with CNI resistant SRNS who were regularly treated with RTX (375 mg/m 2 per dose (maximum dose 500 mg), 1 dose per week, a total of 4 doses) in Department of Nephrology, Children′s Hospital of Fudan University from January 2016 to December 2023 were enrolled. The general data, disease related information, urinary protein/creatinine, serum albumin, blood creatinine before RTX treatment, immunosuppressants, adverse events, and monthly urinary protein/creatinine, serum albumin, and blood creatinine indexes within 6 months after RTX treatment were collected. The changes of urinary protein/creatinine, serum albumin and estimated glomerular filtration rate (eGFR) before and after RTX at 3 and 6 months were analyzed by using paired sample t test and Wilcoxon signed-rank test. Results:Among the 13 patients, 8 were male and 5 were female. The age of disease onset was 4.0 (2.9, 6.8) years and the age of RTX treatment was 9.8 (5.9, 13.6) years. There were 8 cases of focal segmental glomerulosclerosis, 3 cases of minimal change disease and 2 cases of mesangial proliferative glomerulonephritis. No clinically significant gene variation was detected in 12 cases and the other one did not receive gene test. Before RTX treatment, 11 cases were in chronic kidney disease stage G1, and 1 case each was in stage G2 and stage G3. Ten children completed 4 doses of RTX treatment, 1 patient completed 3 doses, and 2 patients completed 2 doses. Urinary protein/creatinine in 13 children at 3 and 6 months after RTX treatment was significantly lower than baseline (0.60 (0.13, 2.04), 0.49 (0.28, 1.10) vs. 1.44 (0.76, 4.11) mg/mg, Z=-2.34, -2.34, both P<0.05), and serum albumin was significantly higher than baseline ((35±8), (34±7) vs. (30±6) g/L, t=2.30, 2.60, both P<0.05). The eGFR at 6 months after RTX treatment was not significantly different from the baseline ((110±32) vs. (113±35) ml/(min·1.73 m 2), t=-0.76, P>0.05)). No serious adverse reactions occurred in this study. Conclusion:RTX could reduce urinary protein and increase serum albumin in short-term treatment in children with CNI resistant SRNS without significant side effects.

Objective A neuroblastoma(NB)liver transplantation model was established and compared with the adrenal orthotopic transplantation model to explore its characteristics.Methods 5× 105 SK-N-SH cells were implanted along the long axis of the left lobe of mouse livers with a micro-injection needle.The growth,metastasis,expression of related genes,and histopathological changes of tumors were detected after the modeling.Results The tumor formation rate in mice inoculated with tumor cells reached 100％after 21 days,and tumor growth,metastasis,related gene expression changes,and pathological characteristics were apparent.Conclusions In this study,a neuroblastoma liver transplantation model was successfully constructed via a relatively simple surgical method to provide a more suitable choice for future scientific NB experiments.

Objective:To investigate the clinical characteristics and short-term follow-up outcomes of primary nephrotic syndrome (PNS) children infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the Omicron variant outbreak in Shanghai, and to provide a reliable reference for clinicians in the diagnosis and treatment.Methods:It was a case-control study. The clinical data of children with PNS (PNS group) who were diagnosed and followed-up up to 1 year in the nephrology department of four children's medical centers in Shanghai, and the children (control group) who had no underlying diseases and were infected with SARS-CoV-2 in Shanghai Jinshan Public Health Center, including the data when they were infected with SARS-CoV-2, were retrospectively analyzed.Results:(1) From March 30th to April 13th, 2022, 6 PNS children in Shanghai were infected with SARS-CoV-2, including 5 boys and 1 girl. The median age was 4.5 (2.0, 11.0) years old. And 30 children were matched by sex, age and disease type as control group, including 20 males and 10 females. The median age was 4.5 (2.0, 9.0) years. There were no significant differences between the PNS group and the control group in clinical symptoms (including fever duration), treatment regimens, vaccine doses and virus clearance time (all P>0.05). (2) The 6 children with PNS included 3 cases of steroid-sensitive type, 3 cases of steroid-resistant type, 2 cases of minimal change disease, 2 cases of focal segmental glomerulosclerosis and 2 cases with no renal biopsy. Before SARS-CoV-2 infection, their primary disease-PNS were stable, and urine protein was negative, four of them were under maintenance treatment with oral steroids or immunosuppressive drugs. At the time of SARS-CoV-2 infection, the symptoms of all of the 6 cases were mild, no severe, critical or fatal cases, and they were all cured and discharged from hospital through medical isolation observation or symptomatic treatment of infections. (3) Five cases of them still had discomfort symptoms such as cough, anorexia, and fatigue after being discharged from the hospital, which lasted for about 1 week. Within 1 year of follow-up, none of the children have suffered from "recurrent positive PCR results" or "secondary infection" of the SARS-CoV-2. (4) Among them, 4 cases of PNS relapsed after SARS-CoV-2 infection, timely addition of steroids was effective, their urine protein quickly turned negative, and there was no recurrence after 1 year of follow-up. (5) Before infection with SARS-CoV-2, the levels of immunoglobulin IgG were lower than the normal reference value in the 4 cases with PNS recurrence. Conclusions:During the Omicron variant outbreak in Shanghai, the infection of SARS-CoV-2 in children with PNS are resulted in high transmission among household contacts. Most of them have mild symptoms and good prognosis. PNS is prone to relapse after SARS-CoV-2 infection, and steroid therapy is effective and safe for these relapse. IgG may be a potential marker for the prognosis of PNS children infected with SARS-CoV-2.

Objective:To explore stereoscopic vision and its correlation with cognitive function in first-episode drug-na?ve patients diagnosed with schizophrenia (FNPS).Methods:A study was conducted from January 2019 to September 2020. A total of 146 FNPS, 124 patients with chronic schizophrenia (PCS) and 101 healthy controls (HCs) were recruited. Stereoscopic vision was evaluated by Titumus stereotests. Their clinical symptoms were assessed by positive and negative syndrome scale. Cognitive function was assessed by the repeatable battery for the assessment of neuropsychological status (RBANS). The differences in stereoscopic vision and cognitive function among the three groups were analyzed by analysis of covariance. The Spearman correlation and multiple regression analysis were used to identify the correlation between stereoscopic vision and clinical symptoms or cognitive function.Results:(1) There were significant differences in stereoscopic vision and cognitive function among the three groups ( P<0.05). After pairwise comparison, it was found that the stereoscopic vision and cognitive functions of FNPS group and PCS group were significantly different from HCs group. However, there were no significant differences in stereoscopic vision and cognitive function between FNPS and PCS groups. (2) Spearman correlation analysis showed that stereoscopic vision was not correlated with the severity of clinical symptoms in FNPS, but it was correlated with visuospatial score ( r=-0.193, P=0.019), language score ( r=-0.261, P=0.001), attention score ( r=-0.168, P=0.042), and RBANS total scores ( r=-0.236, P=0.004). Moreover, there was no correlation of stereoscopic vision with the severity of clinical symptoms or cognitive function in HCs and PCS. Further multiple linear regression showed the significant effect of stereoscopic vision on visuospatial score ( β=-0.213, P=0.011), language score ( β=-0.252, P=0.003), attention score ( β=-0.189, P=0.019), RBANS total score ( β=-0.235, P=0.003) in FNPS. Conclusions:FNPS and PCS show significant impairments in stereoscopic vision and cognitive function. Stereoscopic vision is closely correlated with cognitive function rather than the severity of clinical symptoms in FNPS.

Objective:To explore stereoscopic vision and its correlation with cognitive function in first-episode drug-na?ve patients diagnosed with schizophrenia (FNPS).Methods:A study was conducted from January 2019 to September 2020. A total of 146 FNPS, 124 patients with chronic schizophrenia (PCS) and 101 healthy controls (HCs) were recruited. Stereoscopic vision was evaluated by Titumus stereotests. Their clinical symptoms were assessed by positive and negative syndrome scale. Cognitive function was assessed by the repeatable battery for the assessment of neuropsychological status (RBANS). The differences in stereoscopic vision and cognitive function among the three groups were analyzed by analysis of covariance. The Spearman correlation and multiple regression analysis were used to identify the correlation between stereoscopic vision and clinical symptoms or cognitive function.Results:(1) There were significant differences in stereoscopic vision and cognitive function among the three groups ( P<0.05). After pairwise comparison, it was found that the stereoscopic vision and cognitive functions of FNPS group and PCS group were significantly different from HCs group. However, there were no significant differences in stereoscopic vision and cognitive function between FNPS and PCS groups. (2) Spearman correlation analysis showed that stereoscopic vision was not correlated with the severity of clinical symptoms in FNPS, but it was correlated with visuospatial score ( r=-0.193, P=0.019), language score ( r=-0.261, P=0.001), attention score ( r=-0.168, P=0.042), and RBANS total scores ( r=-0.236, P=0.004). Moreover, there was no correlation of stereoscopic vision with the severity of clinical symptoms or cognitive function in HCs and PCS. Further multiple linear regression showed the significant effect of stereoscopic vision on visuospatial score ( β=-0.213, P=0.011), language score ( β=-0.252, P=0.003), attention score ( β=-0.189, P=0.019), RBANS total score ( β=-0.235, P=0.003) in FNPS. Conclusions:FNPS and PCS show significant impairments in stereoscopic vision and cognitive function. Stereoscopic vision is closely correlated with cognitive function rather than the severity of clinical symptoms in FNPS.

Aim To investigate the effect of curcumin against high-fat-diet induced C57BL/6J mice bone changes and the correlation between the expression of cathepsin K and curcumin.Methods Curcumin treated C57BL/6J mice had been on high fat diet for 12 weeks.The HE, Alizarin red S staining and Safranin O/fast green staining of femur were employed to evaluate bone microstructure, bone metabolism and bone development.The expressions of cathepsin K were assessed by Western blot and immunohistochemical staining.Results Histopathological results showed that curcumin could improve the destruction of trabecular bone structure, cartilage development and bone calcification.Biomechanical results proved that curcumin could improve the bone strength of the type 2 diabetic mice induced by high fat.The results of immunohistochemistry and Western blot assay indicated that curcumin could significantly inhibit the expression of cathepsin K in bone tissues of mice.Conclusion Curcumin can increase bone strength, improve bone microstructure, and enhance the degree of bone calcification, which may be achieved by inhibiting the expression of cathepsin K.

Objective: To evaluate the clinical efficacy of posterior short segment pedicle screw fixation combined with transpedicular intracorporeal grafing in the treatment of thoracolumbar fractures .Methods :The clinical data of 30 patients with thoracolumbar fractures ,who were admitted and treated with posterior short segment pedicle screw fixation combined with transpedicular intracorporeal grafting during June 2011 and June 2013 ,were retrospectively analyzed .The operation time ,intra‐operational bleeding amount , preoperative and postoperative visual analogue scale (VAS ) score ,the ratio of anterior and posterior vertebral height ,Cobb angle ,neurological function(Frankel grade) and complications were recorded .Results:All the cases had been followed up for 14 .6 months averagely(range from 6 to 23 months) .There was significant difference between the VAS score at the last follow‐up and the preoperative one (P<0 .05) .The ratio of anterior and posterior vertebral height as well as the Cobb angle improved significantly at the 3rd day after operation and the last follow‐up as compared with preoperative ones(P<0 .05) .The ratio of anterior and posterior vertebral height as well as Cobb angle at the 3rd day after operation was not significantly different from that at the last follow‐up(P>0 .05) .The postoperative Frankel grade in patients with neurological function damage improved significantly .There was no breakage or loosening happened with the internal fixation .Conclusions :The posterior short segment pedicle screw fixation combined with transpedicular intracorporeal grafting can reconstruct vertebral body height ,rebuild anatomic form of vertebra ,obtain better kyphosis correction ,maintain the correction effect and avoid the long term lumbago and back pain .This surgical method is safe and effective .

Osteoporosis is a progressive metabolic disease. In traditional Chinese medicine (TCM), deficiency of the liver, spleen and kidney and blood stasis can induce osteoporosis. The main etiology was kidney deficiency which harmed the liver and spleen and causeqi-blood deficiency and blood stasis. The insufficiency of natural endowment and postnatal malnutrition caused poor nutrition of tendons and vessels, which induced debility of bone. This article discussed the etiology and pathogenesis of TCM understanding on osteoporosis in details. Opportunities and challenges of TCM in osteoporosis treatment were explored. The homology of Chinese medicine and food as well as the long-term of osteoporosis showed that TCM had incomparable superiority in osteoporosis treatment. While, the scientific research methods and reasonable evaluation of TCM safety were important to display its advantages in osteoporosis treatment.