Objective:To analyze characteristics and trends of histopathological diagnosis of adult renal biopsy in Beijing from 2008 to 2020.Methods:A total of 4 652 cases of adult renal biopsy were collected from three hospitals in Beijing between 2008 and 2020. The patients were divided into three age groups: 18-40 years, 40-65 years and≥ 65 years; and also divided into three period: 2008-2011, 2012-2015, and 2016-2020. The pathological characteristics and changes of renal biopsy were analyzed in three age groups at different periods.Results:Among 4 652 cases primary glomerular disease accounted for 81.8%, the membranous nephropathy (MN, 32.4%, 1 509/4 652), IgA nephropathy (IgAN, 29.2%, 1 356/4 652) and minor glomerular abnormalities (MGA, 11.3%, 526/4 652) were the top three pathological types. The overall proportion of MN and diabetic nephropathy (DN) increased from 20.3% and 2.3% in 2008-2011 to 37.3% and 10.1% in 2016-2020) (χ2=99.9 and 96.1, both P<0.01), respectively. For age group 18-40 years, the MN and DN increased from 11.2% and 1.6% in 2008-2011 to 24.7% and 5.5% in 2016-2020 (χ2=32.7 and 20.7, both P<0.01), respectively. For age group 40-65 years the MN and DN increased from 26.6% and 3.2% in 2008-2011 to 41.5% and 13.1% in 2016-2020 (χ2=39.1 and 57.3, both P<0.01), respectively. For age group≥65 years the MN was the most common pathological type in the three periods, fluctuating between 41.3% and 55.0% (χ2=5.2, P=0.08); and DN increased from 0(0/63) in 2008-2011 to 7.5%(22/292) in 2016-2020 (χ2=8.1, P=0.02). Conclusion:The renal biopsy data show that membranous nephropathy and diabetic nephropathy are the most common primary and secondary adult glomerular diseases in Beijing recently.

Objective:To assess proton biological dose with using two kinds of relative biological effect models and to compare them with traditional clinical proton biological dose ( Dose1.1). Methods:Based on Particle simulation tools(TOPAS), physical dose, LET d and LET t were calculated in water phantom and two anthropomorphic phantoms (brain and prostate tumors) respectively. Then DoseLET d and DoseLET t were calculated according to different relative biological effect models, an RBE was 1.1 in traditional clinical proton biological dose calculation. Three kinds of biological doses were compared in the water phantom. To quantify the differences between three method in anthropomorphic phantoms, three points ( D1, D2, D3) were selected according to the physical dose to compare the biological dose. Results:DoseLET d and DoseLET t in water phantom showed the same trend with water depth and both of them were higher than Dose1.1 at the end of proton beam range. The maximal difference between DoseLET d and DoseLET t in the anthropomorphic phantoms was 10.08 cGy, where the relative difference was less than 5%. When DoseLET d and DoseLET t were compared with Dose1.1, the maximal differences in brain tumor target were 71.97 cGy and 61.91 cGy respectively, where the relative differences were less than 25%. The maximal differences in prostate tumor target were 25.95 and 19.96 cGy respectively, where the relative differences were less than 12%. However, the differences outside the target were very small, where the maximal differences in brain and prostate tumors were 5.99 cGy and 9.92 cGy respectively, and the relative differences were less than 5%. Conclusions:Biological doses calculated by two method are of little difference in both water and anthropomorphic phantoms, however, large differences were observed when they were compared with the traditional clinical proton biological dose especially in the high dose area.

Objective:To investigate the medicinal retention of different concentrations of melatonin in the bone tissue of type 2 diabetic osteoporosis (T2DOP) rats and explore to efficacy of improvement of the bone microstructure of T2DOP rats.Methods:A total of 95 SD rats were selected, 60 of which had intraperitoneal in jection of high-fat diet combined with low-dose streptozotocin establishing a T2DOP rat model. Two months later, 45 rats' model was determined to be successful by detecting blood glucose and insulin sensitivity index. 30 successful modelling and 30 normal SD rats were randomly selected for melatonin distribution experiment, and were divided into four groups according to the injected melatonin concentration, including modeling rat high concentration group (50 mg/kg), modeling rat low concentration group (10 mg/kg), normal rat high concentration group (50 mg/kg) and normal rat low concentration (10 mg/kg), and there were15 rats in each group. Each group was divided into 5 sub-groups according to the time point of sampling (5, 15, 30, 60, 120 min), 3 animals per group. The bone tissue of each group was pretreated, and then the melatonin drug distribution in the bone tissue was detected by high performance liquid chromatography (HPLC). Another 15 rats were successfully modeled, and were divided into T2DOP group, high melatonin group (50 mg/kg) and low melatonin group (10 mg/kg), 5 rats in each group. 5 normal SD rats were taken as controls (control group), and Micro-CT was used to detect changes in bone microstructure after 8 weeks of treatment with melatonin.Results:The results of the drug distribution experiment showed that after melatonin was injected intraperitoneally, there were drugs remaining in the bone tissues of the rats in each group. The drug concentration reached the highest after 30 min of administration, and significantly decreased after 120 min. Compared with the normal rat low concentration group, there was no significant difference in the drug concentration between the two groups at 5 time points. However, the drug concentration at the four time points of 5, 15, 30, and 60 min in the modeling rat high concentration group were 7.613±2.568 ng/ml, 13.983±2.262 ng/ml, 18.816±1.291 ng/ml, 6.172±1.962 ng/ml, 1.112±0.566 ng/ml, which were significantly different compared with normal rat high group. Micro-CT results showed that after 8 weeks of melatonin treatment, the bone density of the high concentration group was (205.72±28.41 g/cm 3) significantly lower than that in the low concentration group (223.63±35.41 g/cm 3), but both groups were significantly higher than the normal rat group (158.31±31.86 g/cm 3). Conclusion:Exogenous melatonin is distributed in bone tissue, and the drug absorption rate of T2DOP rats is higher. Meanwhile, there is no difference in the distribution of melatonin in bone tissue with different concentrations, and these two concentrations of melatonincan canimprove the bone microstructure of T2DOP rats.

Objective Because of high precision and mild side effects,intensity-modulated proton therapy (IMPT) has become a hot spot in the radiotherapy field.Nevertheless,the precision of IMPT is extremely sensitive to the range uncertainties.In this paper,a novel robust optimization method was proposed to reduce the effect of range uncertainty upon IMPT.Methods Firstly,the robust optimization model was established which contained three types of range including the increased range,the normal range and the shortened range.The objective function was expressed in quadratic function.The organ dose contribution matrix of each range was calculated by proton pencil beam algorithm.The range deviation was discretized and the probability of each range was obtained based on the Gauss distribution function.Finally,the conjugate gradient method was adopted to find the optimal solution to make the actual dose coverage of the target area and the organs at risk distributed within the expected dose as possible.Results The 3 sets of simulation tests provided by the AAPM TG-119 Report were utilized to evaluate the effectiveness of this method:nasopharyngeal carcinoma,prostate and "C"-type cases.Compared with conventional IMPT optimization approach,this novel method was less sensitive to the range uncertainty.When the range deviation occurred,the dose coverage of the target area and organs at risk of the nasopharyngeal carcinoma and prostate cases almost reached the expected dose,and the high dose coverage of the target area and organs at risk protection were improved in the"C"-type cases.Conclusions To compensate for the range uncertainty,this novel method can enhance the dose coverage of the target area and reduce the dose coverage of the organs at risk.

Objective To investigate the effects of Tim-3 on the renal ischemia-reperfusion injury (IRI),and explore the role of monocyte-macrophage cell system.Methods Totally 72 C57BL/ 6 mice were randomly divided into four groups (n =18 each).(1) IR + Tim-3 rnAb group (experimental group):Each mouse was intraperitoneally injected with 200μg of anti-Tim-3 mAb and the IR model of mouse kidney was established after 1 day;(2) IR + IgG monoclonal antibody group (negative control group):each mouse was intraperitoneally injected with anti-IgG mAb (200 μg) and the IR model of mouse kidney was established after 1 day;(3) IR group:mouse kidney IR model was established only;(4) Control group:mouse kidney IR model was not established.At 6,24 and 48 h after IR respectively,venous blood of 6 mice in each group was taken from the infrarenal vein.Scr and CystinC were detected and PAS staining was used to observe the pathological change of renal tissues.Cell apoptosis was detected by TUNEL staining.Pax,bcl-2 and caspase-3 expression in renal tissue was detected by Western blotting.Immunohistochemistry was used to detect the distribution of Tim-3 and activated macrophage cells.Flow cytometry and ELISA were used to evaluate the level of Tim-3 and inflammatory cytokines secretion respectively.Results Compared with control group,the Tim-3 expression was dramatically increased in IR group and I/R + Tim-3 mAb group.The serum Scr and CystinC levels were increased in IR group,and Tim-3 blocking decreased the levels of serum Scr and CystinC (P＜0.05).PAS and TUNEL staining showed that renal injury score and apoptotic index were higher in IR group than those in control group.Tim-3mAb significantly decreased those markers,and ameliorated the renal tubulointerstitial injury induced by IRk The expression levels of Caspase-3 and Bax/bcl-2 was increased in IR group,but deceased by Tim-3mAb.IR induced F4/80 + distribution and inflammatory cytokines secretion in renal tubular interstitial tissues,while Tim-3mAb down-regulated F4/80 + activation and the levels of inflammatory cytokines.Conclusion The findings demonstrated Tim-3 may promoted renal IRI through regulating mononuclear phagocyte system function.

Objective To investigate the CT findings of primary abdominal dedifferentiated liposarcoma(DDL),and to improve the diagnostic accuracy.Methods CT images of 23 cases with primary abdominal DDL confirmed by pathologically were analyzed retrospectively,and the CT findings were compared with pathological results.Results The masses in 20 cases out of 23 cases were located in retroperitoneal region,2 in abdominal cavity and 1 in the pelvic extraperitoneal space.The mean diameter of the masses was 26.5 cm.CT showed the fatty and non-fatty regions in the masses.In 2 1 cases,the non-fatty region was manifested as a single mass and was located at the edge or on the surface of fatty region.In 2 cases,the non-fatty region was manifested as multiple well-defined masses and was located within the fatty region.In 2 1 cases,the fatty region showed misty density with strip and reticular septa.In 2 other cases,the fatty region showed slightly low density,mingled with some fat tissue density,which showed no enhancement with mild enhanced internal septa.In 20 cases,the non-fatty region showed soft tissue density,with mild to moderate heterogeneous enhancement.In 3 other cases,the density of non-fatty region varied between liquid and soft tissue with patchy enhancement on delayed phase.In addition,stippled calcification was found in 4 cases.Conclusion The primary abdominal DDL has relatively specific CT findings,which different dedifferentiated components pro-duce different CT characterizes.Finding well-differentiated fat components around non-fatty mass may help to improve the accuracy of diagnosis and reduce the misdiagnosis.

Objective: To explore the differences among three methods of nucleic acid extraction and three kinds of real-time fluorescence quantitative PCR instrument. Methods: Twenty-five respiratory virus nucleic acid and 25 enterovirus nucleic acid positive samples were with selected at random and nucleic acids were extracted by using three methods (method A, B, and C). The results among different methods were analyzed by randomized block design. 25 respiratory viral nucleic acid positive specimens and enterovirus nucleic acid positive samples were detected by using three kinds of real-time fluorescence quantitative PCR instrument (instrument A, B, and C). The results among different instruments were analyzed by randomized block design. Results: There was a significant difference among three methods of nucleic acid extraction in results(χ²=42.9162, P<0.001), in which method A and C had not significant difference(Z=0.837, P=0.3816>0.05), while method A vs. B, B vs. C were significantly different(Z=7.025, P<0.001; Z=7.9, P<0.001). There was also a significant difference among three kinds of real-time fluorescence quantitative PCR instrument in results(χ²=23.773, P<0.001), in which instrument B and C had no significant difference(Z=0.75, P=0.4533>0.05), while instrument A vs. B, A vs. C were significantly different(Z=5.70, P<0.001; Z=6.45, P<0.001). Conclusions There is difference among different methods and instruments in the test results under the same condition, which call for options in practical work according to need.

Objective To investigate the correlation between plasma-soluble urokinase plasminogen activator receptor (suPAR) levels and disease severity in psoriasis patients.Method 60 psoriasis patients and 60 healthy controls were enrolled from Jan.2013 to Dec.2015 in the hospital.The plasma suPAR of all objects were measured by ELISA.Kruskal-Wallis and Mann-Whitney U test were used to compared plasma suPAR in the difference groups.Correlation between clinical data and plasma suPAR were analyzed by Spearmans's rho method.Result The plasma suPAR of psoriasis patients (3.92± 1.74 ng/ml) were higher than controls (3.03 ± 1.08 ng/ml,Z=13.05,P=0.009).The plasma suPAR of mild patients (PASI＜ 10) were lower than moderate patients (10≤ PASI≤ 20,3.90 ± 1.67 ng/ml,Z =8.00,P =0.035) and severity patients (PASI＞20,4.55 ± 1.88 ng/ml,Z=48.5,P=0.031).Positive correlation were found between plasma suPAR and psoriasis area and severity dndex (PASI) score (r=0.264,P=0.041).The plasma suPAR of the patients with disease duration＞10years (n=35,4.43 ± 1.98 ng/ml) were higher than the patients with disease duration＜10 years (n=25,3.41 ± 0.69 ng/ ml,Z=-2.064,P=0.035).Conclusion There was a positive correlation between the plasma suPAR and psoriasis disease severity.The Plasma suPAR can be the biomarker of psoriasis disease severity.It facilitate the clinical diagnosis of psoriasis.

Objective To investigate the risk factors of cerebral microbleeds (CMBs) in patients with acute isch?emic stroke of large-artery atherosclerosis. Methods One hundred twelve patients with acute ischemic stroke of large-ar?tery atherosclerosis admitted from July 2013 to January 2014 in Nanjing First Hospital affiliated to Nanjing Medical Uni?versity were enrolled. According to the results of MRI magnetic sensitive weighted imaging, the patients were divided into CMBs group or non-CMBs group. The history, general clinical data, serum biochemical results and MRI in both groups were enrolled. All the data were analyzed by the univariate and multivariate analysis. Results The results of univariate analysis showed that there were significant differences in age (61.620±11.479 vs. 70.620±11.185), serum uric acid (UA) level (278.920±69.512 vs. 353.460±111.206), serum creatinine (Cr) level (71.360±19.797 vs. 90.450±44.989), serum ho?mocysteine (Hcy) level (12.587±2.664 vs. 21.715±10.437) between the two groups (P<0.05). There were significant differ?ences in constituent ratio of Fazekas' s grade of periventricular hyperintensities and deep white matter hyperintensities between the two groups (P<0.05). The results of multivariate analysis showed that age (OR=0.963, 95%CI:0.905~1.025, P<0.05) and serum Hcy level (OR=1.487, 95%CI:1.219~1.813, P<0.05) were the independent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis. Conclusions Age and serum Hcy level are the inde?pendent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis.

Objective To explore the efficacy and adverse effects of nimotuzumab combined with chemotherapy and radiotherapy in the treatment of locally advanced cervical cancer.Methods Sixty patients with stage Ⅲ cervical cancer by the histopathologic diagnosis were collected,and they were randomly divided into two groups using the random number table method.The control group (n =30)using intensity-modulated radiotherapy,intracavitary afterloading therapy and periodic chemotherapy,the observation group (n =30)in addition to the intensity-modulated radiotherapy,intracavitary afterloading therapy and periodic chemotherapy, the nimotuzumab (200 mg)was given to the patients before weekly radiotherapy.All patients were received 6 to 7 times of treatment.Results The curative effects of all the patients were evaluated after radiotherapy 3 months.In the observation group,there were 20 cases of CR,5 cases of PR,4 cases of SD,1 case of PD,the total effective rate (CR +PR)was 83.3%.In the control group,there were 1 8 cases of CR,3 cases of PR,6 cases of SD,3 cases of PD,the total effective rate was 70.0%.The difference was statistically significant (χ2 =8.356,P <0.05).The main adverse reactions in the observation group and control group included slight radioactive proctitis (1 6.7% vs 1 3.3%),radioactive cystitis (1 0.0% vs 1 0.0%),nausea and vomiting (50.0% vs 46.7%),reduction of white blood cells (40.0% vs 43.3%),with no significant differences (χ2 =3.357,P =0.71 9;χ2 =2.71 7,P =0.925;χ2 =5.882,P =0.623;χ2 =4.728,P =0.687).There were no skin rashes and allergic reactions.Conclusion Nimotuzumab can enhance the locally stage cervical cancer patients′sensitivity on radiotherapy,which can increase the efficacy and doesn′t increase adverse
reaction obviously.