Objective:The purpose of this study was to examine the clinical features and initial treatment outcomes of elderly individuals with idiopathic membranous nephropathy.Methods:This study retrospectively analyzed the clinical characteristics and therapeutic effect of hospitalized patients aged 60 years or older with renal-biopsy-proven idiopathic membranous nephropathy for at least one year.Results:This study enrolled a total of 91 elderly patients with IMN, consisting of 51 males(56.0%)and 40 females(44.0%). The median age of the patients was 67 years.The urinary protein creatinine ratio(uPCR)and urinary albumin creatinine ratio(uACR)of the patients were 4 454.3 mg/g and 2 258.5 mg/g, respectively.The median 24-hour urinary protein and urinary albumin levels were 5 098.2 mg/24 h and 2 800.6 mg/24 h, respectively.The average estimated glomerular filtration rate(eGFR)was(60.5±20.4)ml·min -1·1.73 m -2.Out of the total of 61 patients, 67.0% achieved remission, including complete and partial remission, within a year of renal biopsy.The levels of uPCR and uACR were significantly higher in the non-remission group compared to the remission group(5 462.5 vs.2 271.1 mg/g, P<0.001; 2 774.4 vs.1 320.0 mg/g, P=0.001). Additionally, the levels of 24h urinary protein and urinary albumin were significantly higher in the non-remission group compared to the remission group(6 526.4 vs.3 210.4 mg/g, P=0.002; 3 067.7 vs.2 102.4 mg/g, P=0.007). The remission group had a higher proportion of patients receiving immunosuppressive therapy(85.2% vs.33.3%, P<0.001). The remission rates were higher in patients treated with glucocorticoid combined with cyclophosphamide, glucocorticoid combined with calcineurin inhibitors, or glucocorticoid combined with mycophenolate mofetil compared to those receiving conservative treatment(88.2% vs.31.0%, P=0.001; 80.0% vs.31.0%, P<0.001; 100.0% vs.31.0%, P=0.007). There was no significant difference in remission rate between the three immunosuppressive therapy groups( P>0.05). However, upon further analysis, it was found that the levels of uPCR, uACR, and serum cystatin C(CysC)were higher in the immunosuppressive therapy groups compared to conservative treatment.Additionally, serum total protein and albumin were lower in the immunosuppressive therapy groups, and these differences were statistically significant( P<0.05). Conclusions:The majority of elderly patients diagnosed with IMN have multiple comorbidities.For those at high risk with elevated urinary protein levels, early initiation of immunosuppressive therapy may lead to a higher initial urinary protein remission rate.Therefore, it is advisable to develop individualized treatment plans for elderly patients with IMN based on their clinical characteristics, as well as the risks and benefits associated with immunosuppressive therapy.

The present study aimed to investigate the inhibitory effect and mechanism of Isodon terricolous-medicated serum on lipopolysaccharide(LPS)-induced hepatic stellate cell(HSC) activation. LPS-induced HSCs were divided into a blank control group, an LPS model group, a colchicine-medicated serum group, an LPS + blank serum group, an I. terricolous-medicated serum group, a Toll-like receptor 4(TLR4) blocker group, and a TLR4 blocker + I. terricolous-medicated serum group. HSC proliferation was detected by methyl thiazolyl tetrazolium(MTT) assay. Enzyme-linked immunosorbent assay(ELISA) was used to measure type Ⅰ collagen(COL Ⅰ), COL Ⅲ, transforming growth factor-β1(TGF-β1), intercellular adhesion molecule-1(ICAM-1), α-smooth muscle actin(α-SMA), vascular cell adhesion molecule-1(VCAM-1), cysteinyl aspartate-specific proteinase-1(caspase-1), and monocyte chemotactic protein-1(MCP-1). Real-time PCR(RT-PCR) was used to detect mRNA expression of TLR4, IκBα, and NOD-like receptor thermal protein domain associated protein 3(NLRP3), nuclear factor-κB(NF-κB) p65, gasdermin D(GSDMD), and apoptosis-associated speck-like protein containing a CARD(ASC) in HSCs. Western blot(WB) was used to detect the protein levels of TLR4, p-IκBα, NF-κB p65, NLRP3, ASC, and GSDMD in HSCs. The results showed that I. terricolous-medicated serum could inhibit the proliferation activity of HSCs and inhibit the secretion of COL Ⅰ, COL Ⅲ, α-SMA, TGF-β1, caspase-1, MCP-1, VCAM-1, and ICAM-1 in HSCs. Compared with the LPS model group, the I. terricolous-medicated serum group, the colchicine-medicated serum group, and the TLR4 blocker group showed down-regulated expression of p-IκBα, NLRP3, NF-κB p65, GSDMD, and ASC, and up-regulated expression of IκBα. Compared with the TLR4 blocker group, the TLR4 blocker + I. terricolous-medicated serum group showed decreased expression of TLR4, p-IκBα, NLRP3, NF-κB p65, GSDMD, and ASC, and increased expression of IκBα. In conclusion, I. terricolous-medicated serum down-regulates HSC activation by inhibiting the TLR4/NF-κB/NLRP3 signaling pathway.
NF-kappa B/metabolism* ; Hepatic Stellate Cells ; Transforming Growth Factor beta1/metabolism* ; NF-KappaB Inhibitor alpha/metabolism* ; Intercellular Adhesion Molecule-1/metabolism* ; Isodon ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Toll-Like Receptor 4/metabolism* ; Vascular Cell Adhesion Molecule-1/metabolism* ; Lipopolysaccharides/pharmacology* ; Signal Transduction ; Colchicine/pharmacology* ; Caspases

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

In Korea and China, ilaprazole is a widely used proton pump inhibitor in the treatment of gastric ulcers. In this study, a specific and sensitive LC-MS/MS method has been developed and validated for the quantification of ilaprazole enantiomers in the rat plasma, using R-lansoprazole as the internal standard. The enantioseparation was achieved on a CHIRALPAK AS-RH column (4.6 mm × 150 mm, i.d. 5μm), with a mobile phase composed of 10 mM ammonium acetate aqueous solution and acetonitrile (60:40, V/V), at a flow-rate of 0.5 mL/min. The method was validated over the concentration range of 0.5-300 ng/mL for both, R- and S -ilaprazole. The lower limit of quantification was 0.5 ng/mL for both enantiomers. The relative standard deviation (RSD) of intra- and inter-day precision of R-ilaprazole and S-ilaprazole was less than 10.9％, and the relative error accuracy (RE) ranged from -0.5％-2.0％. Finally, the method was successfully evaluated in rats in a stereoselective pharmacokinetic study of the ilaprazole racemate.

Endophytic fungi strains (n = 81) were isolated from the leaves, barks, and fruits of Camellia oleifera from Hunan province (China) to delineate their species composition and potential as biological control agents of C. oleifera anthracnose. The fungi were identified by morphological and phylogenetic analyses. Fungal colonization rates of the leaves, barks, and fruits were 58.02, 27.16, and 14.81%, respectively. The isolates were identified as 14 genera, belonging to two subdivisions, Deuteromycotina and Ascomycotina; 87.65% of all isolates belonged to Deuteromycotina. The dominant species, occurring with a high relative frequency, were Pestalotiopsis sp. (14.81%), Penicillium sp. (14.81%), and Fusarium sp. (12.35%). The Simpson’s and Shannon’s diversity indices revealed the highest species diversity in the leaves, followed by the barks and fruits. The similarity index for the leaves versus barks comparison was the highest, indicating that the number of endophytic fungal species shared by the leaves and barks was higher than barks and fruits or leaves and fruits. Based on the results of dual culture experiments, only five strains exhibited antifungal activity against C. oleifera anthracnose pathogen, with isolate ty-64 (Oidium sp.) generating the broadest inhibition zones. Our results indicate that the endophytes associated with C. oleifera could be employed as natural agents controlling C. oleifera anthracnose.
Biological Control Agents ; Camellia* ; Colon ; Endophytes ; Fruit ; Fungi* ; Fusarium ; Penicillium

Objective To explore the safety and efficacy of Kushen Gel and amphotericin B vaginal effervescent tablets in the treatment of postpartum vulvovaginal candidiasis.Methods A total of 186 postpartum vulvovaginal candidiasis patients in postpartum lactation in our hospital were randomly divided into monotherapy group(n =90) and combination group(n =96),receiving amphotericin B vaginal effervescent tablets alone,and Kushen Gel combined with amphotericin B effervescent tablets treatment,respectively.And vaginal pH value before and after treatment,vaginal flora density,sexual pain after treatment and adverse reactions of two groups were compared.Results There was no significant difference in vaginal pH,vaginal flora density of the two groups before treatment (P ＜ 0.05).After treatment,the leucorrhea was decreased,improvement time of pruritus vulvae,mucosal hyperemia symptoms in the combination group were significantly shorter when compared to the monotherapy group (P ＜ 0.05);Vaginal pH value of the two groups was significantly improved,and showed a significant difference at 3 months of follow-up (P ＜ 0.05);After treatment and 3 months of follow-up,proportions of vaginal flora density for grade 1 of the combined group were significantly higher than that of the monotherapy group (P ＜ 0.05).After treatment,grade I sexual pain of the combination group was higher than that of the monotherapy group (63.54％ vs.42.22％,P ＜ 0.05).But there was no significant differences in adverse reactions in two groups (P ＞ 0.05).Conclusion Amphotericin B effervescent tablets for the treatment of patients with postpartum vulvovaginal candidiasis presents certain effect on improvement of symptoms and vaginal micro ecological environment,but has more adverse reactions,so Kushen Gel in combination can enhance the effect and safety.

Objective To analyze the change of thyroid function,thyroglobulin antibody and thyroglobulin after cervical lymph node dissection of thyroid carcinoma.Methods A total of 240 patients with thyroid disease were selected and treated with cervical lymph node dissection of thyroid carcinoma.The surgical effect was analyzed,and the thyroid function,thyroglobulin antibody and thyroglobulin after operation were analyzed.Results The efficacy of the observation group was significantly better than the control group (P ＜ 0.05).Three days after treatment,the levels of T3,T4,FT3,FT4 and TSH significantly decreased (P ＜ 0.05),and the decreasing degree in the control group was significantly greater than the observation group (P ＜ 0.05).Six months after operation,the levels of TgAb and Tg decreased significantly in both groups,and the level of TgAb and Tg in the observation group decreased more significantly than the control group (P ＜ 0.05).Conclusion Compared with the traditional surgical treatment for thyroid cancer,cervical lymph node dissection is more worthy of clinical application.

Objective To explore the safety and efficacy of Kushen Gel and amphotericin B vaginal effervescent tablets in the treatment of postpartum vulvovaginal candidiasis.Methods A total of 186 postpartum vulvovaginal candidiasis patients in postpartum lactation in our hospital were randomly divided into monotherapy group(n =90) and combination group(n =96),receiving amphotericin B vaginal effervescent tablets alone,and Kushen Gel combined with amphotericin B effervescent tablets treatment,respectively.And vaginal pH value before and after treatment,vaginal flora density,sexual pain after treatment and adverse reactions of two groups were compared.Results There was no significant difference in vaginal pH,vaginal flora density of the two groups before treatment (P ＜ 0.05).After treatment,the leucorrhea was decreased,improvement time of pruritus vulvae,mucosal hyperemia symptoms in the combination group were significantly shorter when compared to the monotherapy group (P ＜ 0.05);Vaginal pH value of the two groups was significantly improved,and showed a significant difference at 3 months of follow-up (P ＜ 0.05);After treatment and 3 months of follow-up,proportions of vaginal flora density for grade 1 of the combined group were significantly higher than that of the monotherapy group (P ＜ 0.05).After treatment,grade I sexual pain of the combination group was higher than that of the monotherapy group (63.54％ vs.42.22％,P ＜ 0.05).But there was no significant differences in adverse reactions in two groups (P ＞ 0.05).Conclusion Amphotericin B effervescent tablets for the treatment of patients with postpartum vulvovaginal candidiasis presents certain effect on improvement of symptoms and vaginal micro ecological environment,but has more adverse reactions,so Kushen Gel in combination can enhance the effect and safety.

Objective To analyze the change of thyroid function,thyroglobulin antibody and thyroglobulin after cervical lymph node dissection of thyroid carcinoma.Methods A total of 240 patients with thyroid disease were selected and treated with cervical lymph node dissection of thyroid carcinoma.The surgical effect was analyzed,and the thyroid function,thyroglobulin antibody and thyroglobulin after operation were analyzed.Results The efficacy of the observation group was significantly better than the control group (P ＜ 0.05).Three days after treatment,the levels of T3,T4,FT3,FT4 and TSH significantly decreased (P ＜ 0.05),and the decreasing degree in the control group was significantly greater than the observation group (P ＜ 0.05).Six months after operation,the levels of TgAb and Tg decreased significantly in both groups,and the level of TgAb and Tg in the observation group decreased more significantly than the control group (P ＜ 0.05).Conclusion Compared with the traditional surgical treatment for thyroid cancer,cervical lymph node dissection is more worthy of clinical application.

Objective To compare the difference in recurrence rates between the endovenous laser therapy(EVLT) combined with percutaneous continuous circumsature (PCCS) and simplex EVLT following the treatment of great saphanous vein incompetence through the introduction of propensity score matching (PSM).Methods T the baseline data of 170 patients diagnosed with great saphanous vein incompetence who were treated in Punan Hospital in Pudong New District of Shanghai from 2009 to 2014 were retrospectively analyzed,of which underwent EVLT were 87 cases as EVLT group and EVLT combined with PCCS were 83 cases as EVLT +PCCS group.The groups covariate were balanced based on the PSM function of SPSS software using 1 ∶ 1 nearest neighbor matching method.The recurrence rates of the two groups were estimated by Kaplan-Meier method and the differences between the two groups were evaluated by Log-rank test.Results Sixty-seven pairs of patients were successfully matched.No significant difference between the two matched groups in the basic clinical features.Before PSM,the 1,2,and 3 year cummulative recurrence rates were 3.5％,5.4％ and 7.3％ in the EVLT group,and 0.9％,4.7％ and 4.7％ in the EVLT+PCCS group,respectively,there were no statistically significant differences between the two groups by Log-rank test (P =0.491).After PSM,the 1,2,and 3 year cummulative recurrence rates were 5.2％,5.2％ and 7.1％ in the EVLT group,and 0％,1.0％ and 1.0％ in the EVLT+PCCS group,there were statistically significant differences between the two groups (P =0.031).Conclusion The PSM methods can effectively balanced the covariates of groups in non-randomised study.EVLT combined with PCCS can effectively reduce the recurrence rate after the treatment of great saphanous vein incompetence.