Objective:To investigate the effects of hyperuricemia on the prognosis of IgA nephropathy (IgAN) using propensity score matching (PSM) method.Methods:IgAN patients proven by biopsy were included. PSM was used to match patients. Kaplan-Meier method was used for survival analysis, and Cox regression analysis was used to analyze the effects of hyperuricemia on IgAN prognosis. Primary outcome events were defined as death, or end-stage renal disease (dialysis, transplantation), or a decrease in estimated glomerular filtration rate (eGFR) greater than 40%. Renal outcome was defined as end-stage renal disease (dialysis, transplantation), or a decrease in eGFR greater than 40%.Results:A total of 1 454 IgAN patients were included in this study, including 850 females and 604 males. Uric acid level was (368.26±92.87) μmol/L in the males, and (277.23±92.71) μmol/L in the females. The median follow-up time was 85.00(56.10, 106.33) months. During the follow-up period, a total of 134 patients reached the primary outcome events, including 5 deaths, 24 dialysis patients, 5 kidney transplant patients, and 100 patients with eGFR decreased by more than 40%. After 1∶1 matching, 131 males and 159 females in the hyperuricemia group were successfully matched with 131 males and 159 females in the normal uric acid group, and there was no significant statistical difference in each parameter in baseline between the hyperuricemia group and normal uric acid group after matching. Kaplan-Meier survival analysis showed that either before or after matching, the incidence of primary outcome events in male or female patients with hyperuricemia was higher than those with normal uric acid, but there was no statistically significant difference in incidence of primary outcome events between female hyperuricemia group and female normal uric acid group after matching (Log-rank test, χ2=3.586, P=0.058). Cox proportional hazard regression model showed that, in the pre-match fully adjusted model, the hazard ratio ( HR) of entering primary outcome events was 2.29-fold (95% CI 1.27-4.11, P=0.006) for men with hyperuricemia and 1.85-fold (95% CI 1.01-3.37, P=0.045) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering primary outcome events was 2.41-fold (95% CI 1.18-4.93, P=0.016) for men with hyperuricemia and 1.83-fold (95% CI 0.91-3.67, P=0.091) for women with hyperuricemia compared with those with normal uric acid. In the pre-match fully adjusted model, the HR of entering renal outcome events was 2.68-fold (95% CI 1.47-4.88, P=0.001) for men with hyperuricemia and 1.81-fold (95% CI 0.99-3.33, P=0.056) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering renal outcome events was 2.89-fold (95% CI 1.36-6.15, P=0.006) for men with hyperuricemia and 1.81-fold (95% CI 0.88-3.72, P=0.106) for women with hyperuricemia compared with those with normal uric acid. Conclusion:Hyperuricemia may be associated with IgAN progression, and it has a more significant effect on male IgAN patients.

Objective To explore the effects of moist exposed burn ointment ( MEBO) and in situ skin regeneration technology in the treatment of pressure ulcers in elderly patients in community. Methods A total of 31 elderly patients with pressure ulcers in community were treated with MEBO and in situ skin regeneration technology. The amount of wound exudate, histological types and area change were observed dynamically to evaluate the condition of wound healing. Results There were 14 elderly patients with StageⅠ-Ⅱ pressure ulcers healed within two weeks after treatment, and other 17 patients were healed without skin-grafting within 120 days. Conclusions The application of MEBO and in situ skin regeneration technology can effectively promote healing of pressure ulcers in elderly patients in community and is worthy of clinical promotion and application.

OBJECTIVETo investigate the effects of exogenous hydrogen sulfide (H2S) on β-site APP cleaving enzyme 1 (BACE-1) and β-amyloid peptide (Aβ) metabolism in primary culture of neurons under high-glucose condition.

METHODSThe cortical neurons in primary culture under normal and high glucose (60 mmol/L) conditions for 24 h were exposed to 25, 50 and 100 µmol/L NaHS. Aβ1-42 concentration in the cell culture was measured by ELISA, and BACE-1 mRNA and protein levels were detected by fluorescent quantitative real-time PCR and Western blotting, respectively.

RESULTSCompared with the neurons cultured in normal glucose, the neurons exposed to high glucose showed significantly increased Aβ1-42 concentration and BACE-1 mRNA and protein expressions (P<0.05). Exposure to 25, 50 and 100 µmol/L NaHS significantly decreased Aβ1-42 concentration and BACE-1 mRNA and protein expressions in the high-glucose cell culture (P<0.05).

CONCLUSIONNeurons exposed to high glucose exhibit increased Aβ1-42 levels and BACE-1 mRNA and protein expressions, which can be concentration-dependently decreased by NaHS.

Amyloid Precursor Protein Secretases ; metabolism ; Amyloid beta-Peptides ; metabolism ; Animals ; Aspartic Acid Endopeptidases ; metabolism ; Cells, Cultured ; Culture Media ; chemistry ; Glucose ; chemistry ; Hydrogen Sulfide ; pharmacology ; Neurons ; drug effects ; metabolism ; Peptide Fragments ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To investigate the effects of exogenous hydrogen sulfide (H2S) onβ-site APP cleaving enzyme 1 (BACE-1) and β-amyloid peptide (Aβ) metabolism in primary culture of neurons under high-glucose condition. Methods The cortical neurons in primary culture under normal and high glucose (60 mmol/L) conditions for 24 h were exposed to 25, 50 and 100μmol/L NaHS. Aβ1-42 concentration in the cell culture was measured by ELISA, and BACE-1 mRNA and protein levels were detectedby fluorescent quantitative real-time PCR and Western blotting, respectively. Results Compared with the neurons cultured in normal glucose, the neurons exposed to high glucose showed significantly increased Aβ1-42 concentration and BACE-1 mRNA and protein expressions (P<0.05). Exposure to 25, 50 and 100 μmol/L NaHS significantly decreased Aβ1-42 concentration and BACE-1 mRNA and protein expressions in the high-glucose cell culture (P<0.05). Conclusion Neurons exposed to high glucose exhibit increased Aβ1-42 levels and BACE-1 mRNA and protein expressions, which can be concentration-dependently decreased by NaHS.

Objective To investigate the effects of exogenous hydrogen sulfide (H2S) onβ-site APP cleaving enzyme 1 (BACE-1) and β-amyloid peptide (Aβ) metabolism in primary culture of neurons under high-glucose condition. Methods The cortical neurons in primary culture under normal and high glucose (60 mmol/L) conditions for 24 h were exposed to 25, 50 and 100μmol/L NaHS. Aβ1-42 concentration in the cell culture was measured by ELISA, and BACE-1 mRNA and protein levels were detectedby fluorescent quantitative real-time PCR and Western blotting, respectively. Results Compared with the neurons cultured in normal glucose, the neurons exposed to high glucose showed significantly increased Aβ1-42 concentration and BACE-1 mRNA and protein expressions (P<0.05). Exposure to 25, 50 and 100 μmol/L NaHS significantly decreased Aβ1-42 concentration and BACE-1 mRNA and protein expressions in the high-glucose cell culture (P<0.05). Conclusion Neurons exposed to high glucose exhibit increased Aβ1-42 levels and BACE-1 mRNA and protein expressions, which can be concentration-dependently decreased by NaHS.

Objective To explore the clinico-pathological features and outcomes of primary focal segmental glomerular sclerosis with IgM deposition.Methods One hundred and two patients with primary focal segmental glomemlar sclerosis (pFSGS) in Hangzhou hospital of traditional Chinese medicine between 1996 and 2012 were retrospectively studied.The patients were divided into IgM deposition group (n =66) with IgM deposition in glomeruli and none-IgM deposition group (n =36) without IgM deposition.Baseline and clinical characteristics of all FSGS patients were assessed and outcomes were reviewed.The survival rates of the patients were analyzed using the Kaplan-Meier method.Results (1) There were not difference in age,sex ratio,incidence of microscopic hematuria,hypertension,renal insufficiency,eGFR,Ccr and Scr between two groups.However,proteinuria,incidence of nephrotic syndrome,urine microalbumin,urine NAG,serum cholesterol,serum high-density lipoprotein,and serum IgM in IgM deposition group were significantly higher than those in none-IgM deposition group (P ＜ 0.05),serum albumin and serum IgA in IgM deposition group were significantly lower than those in none-IgM deposition group (P ＜ 0.05).(2) The IgM deposition group had a significantly higher incidence of glomerular deposition of IgA,IgG,C3,C1q and fibrinogen than none-IgM deposition group (P ＜ 0.05).The score of mesangial matrix proliferation in the IgM deposition group was lower than that in none-IgM deposition group (P ＜ 0.05).(3) fifty-four patients (35 patients in IgM deposition group and 19 patients in none-IgM deposition group) were followed-up for a median of 64.6 (22.8,103.8) months.Progression to renal failure was observed in 5 patients of IgM deposition group and none in none-IgM deposition group.Compared with the none-IgM deposition,the survival rates in the IgM deposition group were statistically lower (P ＜ 0.05).Conclusions PFSGS patients with IgM deposition were severer in proteinuria,higher incidence of IgA,IgG,C3,C1q and fibrinogen deposition in glomeruli and worse outcome than those without IgM deposition.

BACKGROUND: About one fourth of diabetic patients suffer from diabetic retinopathy(DR) and has greatly impacted their quality of life due to the decreased vision. Social support plays important role on rehabilitation of patients.OBJECTIVE: To analyze the relationship between social support and quality of life(QOL) in patients with diabetic retinopathy in order to direct clinical practice and improve the patients' QOL.DESIGN: Cross-sectional study based on patients with diabetic retinopathy.SETTING: Department of Ophthalmology, General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: Totally 81 patients admitted into Department of Ophthalmology, General Hospital of Nanjing Military Area Command of Chinese PLA with diabetic retinopathy during January 2002 to May 2003 were selected. Inclusion criteria: suffer from diabetic retinopathy and willing to attend this study. Exclusion criteria: people with other complications (hypertension, kidney disease) . The patients were divided into two groups according to vision: 28 cases in the group with binocular vision between 0.06 -0. 1; 53 cases in the group with vision less than 0. 05.METHODS: Investigation was conducted to the two groups from three dimensions including objective support, subjective support and usage in order to assess the social support to patients with diabetic retinopathy of different vision. And modified quality of life index (MQLI) was used to assess the QOL in patients with diabetic retinopathy that covered 5 dimensions: somatic health, mental health, social function, self-image and material base.MAIN OUTCOME MEASURES: The total score of social support and QOL of patients with diabetic retinopathy, score of somatic health, mental health,social functions and material base as well as the correlations among them.RESULTS: The total score of social support, score of objective support factor, subjective support factor and usage factor in roup with vision between 0.06 and 0. 1 were much higher than those in group with vision less than 0.05 ( P < 0.01 ). For patients with diabetic retinopathy, the social support had strong correlation with total score of QOL and factor score of other dimensions except of self-image( P < 0.05 or P < 0.01).CONCLUSION: Social support is an important factor that impacts QOL to patients with diabetic retinopathy. It will improve their QOL by reinforcing the social support.