Objective:To investigate the clinicopathological features and the prognosis of IgA nephropathy (IgAN) in children with massive proteinuria.Methods:It was a retrospective cohort study. Clinical data of IgAN children with massive proteinuria admitted to the Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics from January 2008 to December 2021 were retrospectively analyzed. Patients were divided into effective group and ineffective group according to whether urine protein turned negative after 6 months of initial treatment. The follow-up endpoint event was defined as a reduction in proteinuria of less than 50% or end-stage renal disease (ESRD) achievement. MedCalc software was used to perform Kaplan-Meier survival analysis, and Log-rank test was used to compare the difference of renal survival between the two groups.Results:A total of 127 patients were diagnosed as primary IgAN by renal biopsy, of whom 57 patients with IgAN showed massive proteinuria. These 57 IgAN patients with macroproteinuria accounted for 44.9% of the total IgAN patients and were enrolled in the study. Among the 57 cases, 33 cases (57.9%) were Lee's grade Ⅲ, 11 cases (19.3%) were below Lee's grade Ⅲ, and 13 cases (22.8%) were above Lee's grade Ⅲ. The follow-up time was 4.0 (3.0,5.8) years. In the initial treatment, among 57 patients, 46 (80.7%) were effective (effective group) and 11 (19.3%) were ineffective (ineffective group). Compared with the effective group, the ineffective group had a higher proportion of concurrent AKI at the onset of disease and longer recovery time of renal function, with significant difference (7/11 vs. 13/46, χ2=4.878, P=0.027). Compared with the effective group, the proportion of Lee grade Ⅲ or above was higher in the ineffective group, and the difference was statistically significant (5/11 vs. 8/46, χ2=3.971, P=0.046). There were significant differences in endocapillary hypercellularity (E1), segmental glomerulosclerosis or adhesion (S1) and cellular/fibrocellular crescents (C2) of Oxford classification between IgAN children with Lee grade Ⅲ or below and those over Lee grade Ⅲ (11/13 vs. 20/44, χ2=6.204, P=0.013; 12/13 vs. 17/44, χ2=11.566, P=0.001; 9/13 vs. 7/44, χ2=14.131, P=0.001). Among 57 patients, endpoint events occurred in 2 patients who both were urinary protein unmitigated, and none of the children progressed to ESRD. There was no significant difference in cumulative renal survival between the two groups by Kaplan-Meier survival analysis and Log-rank test ( χ2=0.537, P=0.460) after addition of calcineurin inhibitors (CNIs) to the initial treatment ineffective group. Conclusions:Macroproteinuria is the prominent manifestation of IgAN in children. The pathological type is mainly Lee grade Ⅲ. Children with macroproteinuria have a good prognosis in the short and medium term after active treatment. For IgAN with macroproteinuria that does not respond well to initial treatment, AKI is more common at onset, and renal function recovery time is longer. The application of CNIs may have a certain effect on improving the renal outcome of IgAN with massive proteinuria.

Objective To study the expression of long non-coding RNA(LncRNA TTN-AS1)TTN-AS1 and squalene epoxidase(SQLE)in rectal cancer,and their correlation with clinicopathological characteristics and prognosis.Methods A total of 90 rectal cancer patients diagnosed and treated in Longquan Hospital of Chengdu University of Traditional Chinese Medicine from January 2018 to January 2020 were selected as the research subjects.Fluorescence quantitative PCR was used to detect the expression of LncRNA TTN-AS1 in tissues.Immunohistochemistry was used to detect the expression of SQLE in tissues.The relationship between LncRNA TTN-AS1,SQLE and clinicopathological characteristics of rectal cancer were compared.K-M curve analysis was used to analyze the impact of LncRNA TTN-AS1 and SQLE on the prognosis of rectal cancer.COX regression analysis was used to analyze factors affecting the prognosis of rectal cancer.Results The relative expression level of Lnc RNA TTN-AS1(3.12±0.45)and the positivity rate of SQLE(71.11％)protein in rectal cancer tissues were higher than those in adjacent tissues(0.91±0.12,8.89％),and the differences were significant(t/x2=45.156,72.593,all P＜0.001).The expression of Lnc RNA TTN-AS1 was positively correlated with SQLE in rectal cancer tissue(r=0.589,P＜0.001).The relative expressions of Lnc RNA TTN-AS1(4.26±0.52,4.10±0.49),SQLE(88.57％,91.43％)in tumor TNM stage Ⅲ and lymph node metastasis were higher than those in tumor TNM stage Ⅰ～Ⅱ(2.39±0.40,60.00％)and tissues without lymph node metastasis(2.50±0.42,58.18％),and the differences were significant(t/x2=8.409～19.211,all P＜0.05).The 3-year survival rates of the LncTTN-AS1 high expression group and low expression group were 50.00％(22/44)and 86.96％(40/46),respectively,and the difference between the curves was significant(Log-rank x=14.205,P=0.001).The 3-year survival rates of the SQLE positive and negative groups were 64.06％(41/64)and 88.46％(23/26),respectively,and the difference between the curves was significant(Log-rank x2=6.291,P=0.012).Lnc RNA TTN-AS1 high expression(HR=2.552,P=0.001),SQLE positive(HR=1.754,P=0.004),tumor TNM stage Ⅲ(HR=1.625,P=0.030),and lymph node metastasis were(HR=2.797,P=0.011)independent risk factors for the prognosis of rectal cancer.Conclusion The increased expression of LncRNA TTN-AS1 and SQLE in rectal cancer tissue are associated with TNM staging and lymph node metastasis,and both are tumor marker for evaluating the prognosis of rectal cancer.

Objective:To explore the preventive effect of disposable incision protector on incision infection in patients with hepatolithiasis after open hepatectomy.Methods:A retrospective collection of patients with hepatolithiasis who underwent open hepatectomy with a disposable incision protector from January 2015 to December 2018 in the First Affiliated Hospital of Sun Yat-sen University was used as the intervention group. At the same time, patients with hepatolithiasis who did not use the incision protector to undergo partial hepatectomy from January 2012 and December 2014 were collected as the control group. Propensity matching analysis was used to reduce case selection bias and incidences of postoperative incision infection between the two groups were compared before and after matching.Results:In the primary cohort, there were 245 patients in the intervention group and 201 patients in the control group. Patients in the intervention group were younger than those of the control group ( P<0.05) . The proportion of patients with a history of biliary tract surgery in the intervention group was lower than that of the control group, and the operation time was shorter than that of the control group (all P<0.05) . The incidence of incision infection in the intervention group before matching was 5.7% (14/245) , lower than 15.9% in the control group (32/201) , and the difference was statistically significant (χ 2=4.436, P=0.035) . After propensity matching, 165 pairs of patients were generated, there were 165 patients in each group. There was no statistically significant difference in clinical baseline variables between the two groups ( P>0.05) . In the matching cohort, the incidence of incision infection in the intervention group was 7.9% (13/165) , which was lower than 15.2% (25/165) in the control group, and the difference was statistically significant (χ 2=4.283, P=0.039) . Conclusions:The disposable incision protector can effectively prevent postoperative incision infection in patients undergoing open hepatectomy for hepatolithiasis.

Objective:To explore the clinical effects of early bed-out intervention based on enhanced recovery after surgery (ERAS) in elderly patients with hip fracture.Methods:Totally 80 patients with hip fracture admitted in Zhejiang Taizhou Hospital from January 2017 to December 2018 were selected and divided into observation group ( n=40) and control group ( n=40) according to the random number table. Patients in the control group received conventional nursing care, while patients in the observation group received early ERAS-based bed-out interventions. The incidence of adverse events, including pulmonary infection, abdominal pain and constipation, was compared between the two groups within 2 weeks. Postoperative hip joint function, daily living activities and quality of life were evaluated in the two groups. Results:The incidence of pulmonary infection, urinary tract infection, bloating, constipation and deep vein thrombosis (DVT) in lower limbs in the observation group was lower than that in the control group, and the difference of total complication rate was statistically significant ( P<0.05) . The hip joint function, daily life activity and quality of life scores in the observation group were higher than those in the control group, and the differences were statistically significant ( P< 0.05) . Conclusions:Early ERAS-based bet-out interventions taken for elderly patients with hip fracture can reduce the incidence of postoperative adverse events, and improve their hip joint function, daily activities and quality of life.

Objective To investigate the promoting effect of individualized intervention on social function rehabilitation in patients with schizophrenia. Methods Total of 200 hospitalized patients with schizophrenia in a tertiary psychiatrichospital were selected as the research object and were randomly assigned to the study group ( n=100) and the control group ( n=100) . Patients in control group were treated with routine treatment and nursing, whilepatients in study group were given individualized intervention combined with routine treatment and nursing. Brief psychiatric rating scale ( BPRS) was used to assess the severity of the psychotic symptoms.Insight and treatment attitude questionnaire ( ITAQ) was used to assess the treatment compliance of patients. Activity of daily living scale (ADL) and personal and social performance scale(PSP) were used to assess their social function. Then, we compared the results of two groups that before and after the intervention. Results Before the intervention, there was no significant difference in BPRS, ITAQ and ADL scores between two groups ( P>0.05) . The PSP scores of the study group were lower than those of the control group ( P<0.05) . After the intervention, the ITAQ and PSP scores of two groups were significantly higher than those before the intervention, and the BPRS and ADL scores were significantly lower than those before the intervention ( P<0.05) . After the intervention, there was no significant difference in BPRS and ITAQ scores between two groups ( P>0. 05) . The ADL scores of the study group were significantly lower than those of the control group, and the PSP scores were significantly higher than those of the control group (P<0.05).Conclusions Personalized intervention enhances the patient′s self-care ability, daily activities ability and social competence, and promotes the recovery of social function.

Objective To explore the clinical features of a family with myotonic dystrophy type 1 (DM1) in order to improve the knowledge of this disease.Methods Clinical data of members from the family were collected.Electrocardiogram (ECG),electromyogram (EMG) and blood biochemistry were performed in some members of the family.Characteristics of pathology and gene of the propositi were detected.Results Anticipation was found in the family which was verified as DM1.In the all 19 patients,17 had myasthenia gravis,14 had muscle atrophy,16 had myotonia,5 had complicated with cataract,and 7 had complicated with hypophrenia.The 5 patients accepted ECG all had abnormal results,3 of them had myotonic discharge and metabolic abnormalities.Pathological analysis showed the main fibers atrophy was type Ⅰ,and the protein dystrophin expression was completely in the propositi.Conclusions The clinical manifestations of patients are various.DM1 affects eye (the lens),heart (mainly the conduction system),reproductive system besides skeletal muscle.Necessary auxiliary examinations and regular follow-up should be performed to evaluate and deal with multisystemic involvement in DM1 patients.EMG and pathological results are helpful in the diagnosis.Gene analysis can verify the disease and identify subclinical patients.

Cystic liver metastasis, which lacks specific clinical manifestations and standardized treatment, rarely occurs after radical gastrectomy. This study presented two gastric cancer cases with cystic liver metastasis treated in Wuxi People's Hospital from September 2008 to November 2012. The two female patients were 66 and 65 years old, respectively. Poorly differentiated ulcerated adenocarcinoma classified as stage III B [Tumor, Node, and Metastasis Classification (T4aN2M0)] and clinical manifestations of abdominal distension and ascites were detected in both patients. Cyst fluids were subjected to cytological analysis. Results confirmed the presence of liver metastasis of gastric cancer. The two patients benefited from local intracavitary chemotherapy or systemic intravenous chemotherapy.

Objective To study the role of emergency nursing professional team in the pre-hospital care.Methods Two hundred patients from October 2011 to March 2012 were set as the control group and another 200 patients from April 2012 to September 2012 were selected as the experiment group.The control group was managed by routine emergency mode and the experiment group by the emergency nursing professional team.The two groups were compared in terms of satisfaction degree,the time for the team to start and the rate of adverse nursing events.Results After establishing the emergency nursing professional team,the satisfaction degree was significantly increased,the time for the team to start was significantly shortened and the rate of adverse nursing events was significantly decreased(all P<0.05).Conclusion The management mode of emergency nursing professional team in pre-hospital medical care can effectively improve the quality of nursing care.

Efficacy of chemotherapy for advanced gastric cancer is unsatisfactory. Molecular targeted therapies have emerged as a novel approach to the treatment of advanced gastric cancer in recent years.These therapeutic strategies include targeting EGFR signal transduction pathway,anti-angiogenesis therapy,multi-target molecular targeted drugs. Targeted drugs such as trastuzumab,cetuximab,bevacizumab,apatinib,sorafenib sunitinib,lapatinib and everolimus which are targeting HER2,EGFR,VEGF and mTOR pathway,are applied in the comprehensive treatment of advanced gastric cancer,and their therapeutic effects are encouraging.

Ticks transmit various diseases to livestock and human beings. The researches on ticks are of great importance in medical and veterinary sciences. To express a glutathione peroxidase gene (HlGPx) from Hemaphysalis longicornis in Escherichia coli (E. coli) so as to provide basis for further studies, the gene was amplified from cDNAs of H. longicornis adult ticks by PCR prompted by information from EST library. The TGA codon encoding selenocysteine in the gene was mutated into the universal genetic code for cysteine,TGC, by site-directed mutagenesis. E. coli was transformed with the recombinant expression vector pGEX-4T-1/HlGPx'(the mutated HlGPx) and induced to express recombinant HlGPx', which was then analyzed by sodium dodecylsulphate-polyacrylamide gel electrophoresis and Western blotting. The result showed that the complete coding sequence of HlGPx was obtained successfully, the deduced polypeptide was 223 aa, with a calculated molecular mass of 25.0 kDa; the recombinant fusion protein was approximately 51 kDa, correspondent to the calculated. The antibody against glutathione S-transferase (GST) recognized the recombinant protein fused with GST in a Western blotting assay, which confirmed the result above-mentioned. In conclusion, the mutated HlGPx was expressed in E. coli successfully and it could be used for further preparation of immune serum and functional analysis.