Objective To explore the correlation between the systemic immune-inflammation index(SII)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN).Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected.The clinical and pathological data of the patients were collected,and SII was calculated.According to the median SII level of 554.78 in peripheral blood,the IgAN patients were divided into the low SII group(SII≤554.78,175 cases)and the high SII group(SII>554.78,175 cases).Based on the presence or absence of endocapillary hyperplastic(E)lesion,350 patients were also divided into the E0 group(279 cases,79.7%)and the E1 group(71 cases,20.3%).Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients.A predictive model was established,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve.Results There were higher systolic blood pressure(SBP),platelet count(PLT),neutrophil count(NEU),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),total cholesterol(TC),serum creatinine(Scr),serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group,while the lymphocyte count(LYM)was lower(P＜0.05).In terms of pathological manifestations,the proportion of E1 was higher in the high SII group than that of the low SII group(P＜0.05).There were lower PLT,NEU,NLR,PLR,Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group,while higher Hb,LYM and ALB levels in the E0 group than those of the E1 group(P＜0.05).Multivariate Logistic regression analysis showed that elevated SII,Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients(P＜0.05).The area under the curve(AUC)of the predictive model for E1 lesion in IgAN patients was 0.781(95%CI:0.722-0.840).Conclusion SII can reflect the clinical and pathological severity in IgAN patients,providing new insights for clinical evaluation of the disease progression in IgAN patients.

Objective To investigate the association between remnant cholesterol(RC)and clinicopatho-logical parameters in patients with IgA nephropathy(IgAN),and to assess the clinical significance of RC in the progression and management of IgAN.Methods A total of 366 patients with a biopsy-proven diagnosis of IgAN were consecutively enrolled in this retrospective study.Clinical and pathological data were systematically collected,and RC was calculated.Participants were stratified into two groups according to the median RC value.Baseline characteristics were compared between these groups.The association between RC and the presence of tubular atrophy/interstitial fibrosis(T1/2 lesions)in IgAN patients was evaluated using binary logistic regression,restricted cubic spline(RCS)analysis,receiver operating characteristic(ROC)curve analysis,and subgroup analyses.Results In this study,the high-RC group exhibited significantly higher levels of body weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),total cholesterol(TC),non-high-density lipoprotein cholesterol(non-HDL-C),uric acid(UA),complement 3(C3),and 24-hour urinary protein,as well as lower levels of albumin(ALB),estimated glomerular filtration rate(eGFR),and high-density lipoprotein cholesterol(HDL-C),compared to the low-RC group.Patients with T1/2 lesions showed elevated levels of SBP,DBP,TC,non-HDL-C,UA,24-hour urinary protein,and RC,along with reduced levels of hemoglobin(Hb),ALB,and eGFR,relative to those with T0 lesions.Multivariate logistic regression analysis indicated that increased RC and decreased eGFR were independent risk factors for the presence of T1/2 lesions in patients with IgAN(P<0.05).RCS analysis revealed a linear association between RC and the likelihood of T1/2 lesions(non-linearity P=0.343).The area under the receiver operating characteristic curve(AUC)for a predictive model incorporating RC,Hb,UA,and eGFR was 0.833,indicating good discriminative ability.Subgroup analyses consistently demonstrated a significant associa-tion between RC and the risk of T1/2 lesions,with no statistically significant interactions observed across subgroups(all P>0.05).Conclusion RC can reflect the severity of both clinical and pathological manifestations in patients with IgAN,making RC monitoring a potentially valuable tool for assessing disease progression in clinical practice.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

Objective To investigate the association between remnant cholesterol(RC)and clinicopatho-logical parameters in patients with IgA nephropathy(IgAN),and to assess the clinical significance of RC in the progression and management of IgAN.Methods A total of 366 patients with a biopsy-proven diagnosis of IgAN were consecutively enrolled in this retrospective study.Clinical and pathological data were systematically collected,and RC was calculated.Participants were stratified into two groups according to the median RC value.Baseline characteristics were compared between these groups.The association between RC and the presence of tubular atrophy/interstitial fibrosis(T1/2 lesions)in IgAN patients was evaluated using binary logistic regression,restricted cubic spline(RCS)analysis,receiver operating characteristic(ROC)curve analysis,and subgroup analyses.Results In this study,the high-RC group exhibited significantly higher levels of body weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglycerides(TG),total cholesterol(TC),non-high-density lipoprotein cholesterol(non-HDL-C),uric acid(UA),complement 3(C3),and 24-hour urinary protein,as well as lower levels of albumin(ALB),estimated glomerular filtration rate(eGFR),and high-density lipoprotein cholesterol(HDL-C),compared to the low-RC group.Patients with T1/2 lesions showed elevated levels of SBP,DBP,TC,non-HDL-C,UA,24-hour urinary protein,and RC,along with reduced levels of hemoglobin(Hb),ALB,and eGFR,relative to those with T0 lesions.Multivariate logistic regression analysis indicated that increased RC and decreased eGFR were independent risk factors for the presence of T1/2 lesions in patients with IgAN(P<0.05).RCS analysis revealed a linear association between RC and the likelihood of T1/2 lesions(non-linearity P=0.343).The area under the receiver operating characteristic curve(AUC)for a predictive model incorporating RC,Hb,UA,and eGFR was 0.833,indicating good discriminative ability.Subgroup analyses consistently demonstrated a significant associa-tion between RC and the risk of T1/2 lesions,with no statistically significant interactions observed across subgroups(all P>0.05).Conclusion RC can reflect the severity of both clinical and pathological manifestations in patients with IgAN,making RC monitoring a potentially valuable tool for assessing disease progression in clinical practice.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

Objective To explore the correlation between the systemic immune-inflammation index(SII)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN).Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected.The clinical and pathological data of the patients were collected,and SII was calculated.According to the median SII level of 554.78 in peripheral blood,the IgAN patients were divided into the low SII group(SII≤554.78,175 cases)and the high SII group(SII>554.78,175 cases).Based on the presence or absence of endocapillary hyperplastic(E)lesion,350 patients were also divided into the E0 group(279 cases,79.7%)and the E1 group(71 cases,20.3%).Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients.A predictive model was established,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve.Results There were higher systolic blood pressure(SBP),platelet count(PLT),neutrophil count(NEU),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),total cholesterol(TC),serum creatinine(Scr),serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group,while the lymphocyte count(LYM)was lower(P＜0.05).In terms of pathological manifestations,the proportion of E1 was higher in the high SII group than that of the low SII group(P＜0.05).There were lower PLT,NEU,NLR,PLR,Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group,while higher Hb,LYM and ALB levels in the E0 group than those of the E1 group(P＜0.05).Multivariate Logistic regression analysis showed that elevated SII,Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients(P＜0.05).The area under the curve(AUC)of the predictive model for E1 lesion in IgAN patients was 0.781(95%CI:0.722-0.840).Conclusion SII can reflect the clinical and pathological severity in IgAN patients,providing new insights for clinical evaluation of the disease progression in IgAN patients.

BACKGROUND:WIF-1 is a tumor suppressor gene. Promoter hypermethylation causes WIF-1 down-regulationin most tumors. DNA methylation inhibitor can lead to gene demethylation and restore its expression. OBJECTIVE:To observe the differences of tumor pathology and, WIF-1 mRNAand proteinchanges using WIF-1 or 5-aza-2'-deoxycytidine demethylation in animalmodels of osteosarcoma.
METHODS:Murine osteosarcoma models were established and divided into three groups. In the control group, no treatment was given. In the 5-aza-2'-deoxycytidine group, an appropriate amount of 5-aza-2'-deoxycytidine was injected ineach mouse daily. In the WIF-1 group, an appropriate amount of Wnt/β-catenin signal transduction pathway inhibitor WIF-1 was injected in each mouse daily. Seven days after medication, the weight of nude mouse was weighed every 7 days. Short tumor diameter (a) and the long diameter (b) were measured. Therelative tumor volume was calculated. The relative growth rate of tumor was calculated at 7, 14, 21, 28 and 56 days. Four nude mice from ach group were sacrificed by puling the neck at 7, 14, 21, 28 and 56 days after medication. Tumor tissues were stripped and the weight of them was weighed. Pathological analysis of the tumor was conducted. The expression of WIF-1protein and WIF-1 mRNA was detected in osteosarcoma at 56 days after medication in the three groups.
RESULTS AND CONCLUSION:(1) Compared withthe medication and control groups, the weight of nude mice was increased at 7, 14, 21, 28 and 56 days in the treatment group. No significant difference was found between the medication and control groups. (2) The tumor size was significantly smaler in themedication group than in the control group. WIF-1 mRNA and WIF-1 protein expression was increased in the medication group compared with the control group to different degrees. (3) Results suggested that WIF-1 gene promoter methylation is one of the mechanisms of the development of osteosarcoma. Use of WIF-1 or 5-aza-2'-deoxycytidine demethylation can inhibit tumor growth in animal models of osteosarcoma.

OBJECTIVE:To compare the efficacy and safety of ferrous succinate or Shengxuening in the adjuvant treatment of renal anemia in patients with diabetic nephropathy peritoneal dialysis (CAPD). METHODS:64 diatetic nephropathy CAPD pa-tients with renal anemia were randomly divided into observation group (32 cases) and control group (32 cases). All patients re-ceived subcutaneous injection of insulin for blood glucose control (adjusted the insulin dosage based on fasting blood glucose lev-els),hypertension patients actively controlled blood pressure,corrected acid-base and electrolyte balance disorders,orally received fo-lic acid and vitamin B12,ambulant CAPD,then rhEPO was subcutaneously injected with initial dose of 100-150 U/(kg·week) for 2-3 times and other conventional treatment. Based on it,observation group received 1 g of Shengxuening tablet,3 times a day;control group received 0.2 g Ferrous succinate tablet,3 times a day. The treatment course for both groups was 16 weeks. The rhEPO dose was monthly adjusted to make Hb 100-120 g/L. Clinical efficacy,serum iron,serum ferritin,total iron binding capacity,transfer-rin saturation before and after treatment,Hb,Hct,hs-CRP,rhEPO dose before treatment and after 4,8,12 and 16 weeks of treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There was no significant difference in the total effective rate between 2 groups (P>0.05). After treatment,serumiron,total iron binding capacity,transferrin saturation,Hb and Hct in 2 groups were significantly higher than before,and it gradually increased by treatment time,serum ferritin,hs-CRP was sig-nificantly lower than before,and it gradually decreased by treatment time,the differences were statistically significant(P<0.05);but there was no significant difference between 2 groups(P>0.05). The rhRPO dose in observation group 8,16 and 16 weeks af-ter treatment and in control group 8 weeks after treatment were significantly lower than 4 weeks after treatment,and 12 and 16 weeks after treatment in observation group were lower than control group,the differences were statistically significant (P<0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on conventional treatment,both ferrous succinate and Shengxuening show good ef-ficacy in the adjuvant treatment of renal anemia with diabetic nephropathy CAPD,both can improve anemia and iron metabolism, while Shengxuening is superior to ferrous succinate in terms of improving microinflammatory state and reducing rhEPO dose,with better safety.

Objective To investigate the effect of vascular inner diameter and artery flow velocity on the flow of internal arteriovenous fistula. Methods Sixty-two patients received the operation of internal fistula were enrolled. According to the inner diameter (Group A: d ≤ 1.5 mm, Group B: 1.5 mm < d ≤ 2.0 mm, Group C: 2.0 mm < d ≤ 3.0 mm, Group D: d > 3.0 mm), the patients were divided into four groups in terms of artery flow velocity (Group a: v ≤ 20 cm/s, Group b:20 cm/s < v≤50 cm/s, Group c:50 cm/s < v ≤ 100 cm/s, Group d:v > 100 cm/s), the differences of fistula and dialysis flow for two months were analyzed among various groups. Results Compared with Group B/b, patients in Group A/a had higher risk of operation failure, with lowered inner fistula flow and dialysis flow. In terms of inner venous diameter , there were significant differences between Group B and C. Conclusions It is not recommended to carry out the inner vascular fistula operation. Followed with the thickening and increasing of inner artery diameter and artery flow , the inner fistula flow and the dialysis flow increase. The inner venous diameter has no significant impact on the inner fistula flow.

[Objective]To investigate the expression of Survivin and its relationship with expression of PTEN and cyclinD1.[Method]Immonohistochemical method(SP method)was used to detect the expression of Survivin,PTEN and cyclinDl in 40 osteosarcoma tissues and 20 ostanchondroma tissues.[Result]The expression rate of Survivin was significantly higher in osteosarcoma(62.5%)than that in osteochondroma(10.0%)(P