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Objective:To study the changes in long non-coding RNA C2dat1 expression in kidney tissues of rats at different stages of diabetic kidney disease (DKD) and its relationship with renal interstitial fibrosis.Methods:Forty-eight male SD rats were randomly divided into two groups with 24 rats in each group: control group and DKD group. The rats in the control group were fed with ordinary diet, while those in the DKD group were fed with high-fat diet and drank water freely. After eight weeks of feeding, the rats were fasted for 12 h with free access to water. Then, the DKD group was given a one-time intrabitoneal injection of streptozotocin and the control group was given an equal dose of sodium citrate buffer. After 72 h, the random peripheral blood glucose concentration (≥ 16.7 mmol/L for three consecutive days) and urine sugar (positive) were tested to assess the establishment of the diabetes model. Urine, blood and kidney samples were collected at 3, 6, 9 and 12 weeks. The urinary protein excretion rate within 24 h, urinary creatinine and serum total cholesterol were measured by automatic biochemical apparatus. Pathological changes in kidney tissues were observed by HE staining. The expression of calcium/calmodulin-dependent protein kinase Ⅱ delta (CaMK2D), p65, p50, α-SMA and E-cardherin was detected by immunohistochemistry. Quantitative real-time PCR (qPCR) was used to detect the expression of lncRNA C2dat1 and CaMK2D. The relationship of lncRNA C2dat1 with α-SMA, E-cardherin and CaMK2D was analyzed by correlation analysis. In in vitro experiment, renal tubular epithelial cells HK-2 were induced by high glucose. The expression of lncRNA C2dat1 and CaMK2D in HK-2 cells was detected by qPCR after 24, 48 and 72 h of intervention. Results:The rats in the DKD group showed typical symptoms such as polydipsia, polyphagia, significant weight loss and increased blood glucose as compared with the rats in the control group. Results of the biochemical tests revealed that compared with the control group, the DKD group had increased 24 h excretion rate of urinary protein, decreased urinary creatinine and up-regulated total cholesterol. HE staining showed that the rats in the control group had intact glomeruli, normal basement membrane and no mesangial hyperplasia or inflammatory cell infiltration. However, enlarged glomeruli and evenly thickened basement membrane were observed in the DKD group. Immunohistochemistry indicated that the expression of CaMK2D, p50 and α-SMA was higher in the DKD group than in the control group, while the expression of E-cardherin was lower in the DKD group. qPCR results showed that the expression of lncRNA C2dat1 and CaMK2D at mRNA level was higher in the DKD group than in the control group. In in vitro experiment, the expression of lncRNA C2dat1 and CaMK2D at mRNA level was also higher in HK-2 cells induced by high glucose than in the control group. Correlation analysis indicated that lncRNA C2dat1 was positively correlated with α-SMA and CaMK2D, but negatively correlated with E-cardherin. Conclusions:During the progression of DKD, the high expression of lncRNA C2dat1 might promote diabetic renal interstitial fibrosis by regulating the expression of CaMK2D to activate the NF-κB signaling pathway.
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Objective:This study was aimed to explore the associations between the risk of dental fluorosis and the serum biomarkers of bone metabolism in children.Methods:A total of 502 children aged 7 - 12 years were selected by cluster sampling from 4 primary schools in Tongxu County, Kaifeng City, Henan Province from April to May 2017. Morning urine and fasting peripheral blood samples were collected from each participant. Urinary fluoride concentration was determined by fluoride ion selective electrode method. Serum calcium, phosphorus, alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), osteocalcin (OC), calcitonin (CT) and parathyroid hormone (PTH) levels were measured using an automatic biochemical analyzer. Dean method was used to evaluate the prevalence of dental fluorosis in children, and the participants were divided into dental fluorosis group ( n = 173) and control group ( n = 329) after being diagnosed by trained physicians for their dental fluorosis. The associations between the risk of dental fluorosis and the serum biomarkers of bone metabolism in children were analyzed by logistic regression. Results:The levels of serum phosphorus (mmol/L: 1.54 ± 0.19 vs 1.58 ± 0.21) and OC (ng/ml: 11.59 ± 5.22 vs 12.78 ± 5.88) in children in dental fluorosis group were significantly lower than those in children in control group ( P < 0.05). Logistic regression analysis showed that serum OC level affected the risk of dental fluorosis [odds ratio ( OR) = 0.96, 95% confidence interval ( CI): 0.92 - 0.99, P < 0.05]. The relative contribution of the biomarkers of bone metabolism to the risk of dental fluorosis in descending order were serum OC (36.34%), phosphorus (25.89%), BALP (13.16%), PTH (9.73%), calcium (9.44%), CT (3.72%) and ALP (1.72%). Conclusions:The prevalence of dental fluorosis in children is related to the changes of serum biomarkers of bone metabolism. Serum OC plays an important role in the occurrence of dental fluorosis.
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Objective:To explore the association between platelet/lymphocyte ratio (PLR) and frequent peritoneal dialysis (PD) - associated peritonitis (PDAP) in PD patients.Methods:The data of PD patients with PDAP from Guizhou Provincial People's Hospital between January 2015 and June 2019 were analyzed retrospectively. The patients were divided into mono group (only once PDAP occurred in one year) and frequent group (2 or more PDAP occurred in one year) according to the frequency of PDAP. The demographic data including gender, age, height and weight, the clinical data including blood pressure, duration of PD, causes of peritonitis, the laboratory data at the first time of PDAP and the prognosis of PDAP were compared between two groups. Logistic regression analysis method was applied to analyze the relationship between PLR and frequent PDAP. The predictive power of PLR was evaluated by receiver operating characteristic curve (ROC).Results:A total of 78 PD patients with PDAP were enrolled, including 53 males and 25 females, with average age of 45.2 years. The total person-year was 765.1 person-years and the incidence of peritonitis was 0.10 case/person-year during the median follow-up of 16 months. All patients were divided into two groups: 53 patients in mono group and 25 patients in frequent group. Compared with mono group, the patients in frequent group had lower body mass index, longer dialysis duration, higher systolic blood pressure level, higher PLR level, lower uric acid level, and higher rate of drug-resistant bacteria in peritoneal effusion (all P<0.05). The extubation rate of the frequent group was 44.0%(11/25), which was significantly higher than that [15.1%(8/53)] of mono group ( P<0.05). Multivariate logistic regression analysis showed that higher PLR level was an independent related factor for frequent PDAP( OR=1.006, 95% CI 1.002-1.010, P=0.003), and the area under the ROC curve of PLR was 0.783(95% CI 0.663-0.904, P<0.001). Conclusions:High PLR level is an independent related factor of frequent PDAP for PD patients, and PLR can be a potential predictor of frequent PDAP.
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Objective To observe the effects of berberine on lipopolysaccharide (LPS) induced depressive-like behavior and changes of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels in hippocampus and prefrontal cortex of mice.Methods Fifty male Kunming adult mice were randomly divided into control group,LPS group,low dosage berberine group,middle dosage berberine group and high dosage berberine group (n=10 per group).The mice in the later three groups were respectively administrated 25,50 and 100mg/kg berberine by gavage for 7 days.Then,the later four groups mice were injected LPS intraperitoneally(0.83 mg/kg).Twenty-four hours after LPS injection,the depressive like behavior were observed and level of IL-1β and TNF-α in hippocampus and prefrontal cortex were measured.Results Compared with control group (sucrose intake:(75.7 ± 9.0) ％,immobility time:(101.2 ± 29.2) s),the sucrose intake of LPS group((41.0±14.8) ％) reduced(t=5.52,P＜0.01) and the immobility time ((158.7±31.1) s) in forced swimming test increased(t=4.34,P＜0.01).The 50 mg/kg and 100 mg/kg berberine intragastric administration significantly improved sucrose preference ((67.1 ± 15.4) ％ and (72.0± 13.1) ％) compared with that in LPS group (t=4.15,P＜0.01;t=4.93,P＜0.01));and decreased immobility time in forced swimming test ((119.4±26.3) s and (109.7±21.9)s) compared with that in LPS group((t=2.44,P＜ 0.05;t=3.69,P＜0.01)).The level of IL-1β and TNF-α in hippocampus and prefrontal cortex significantly increased in LPS group compared with those in control group,while significantly decreased in low,middle and high dosages berberine injected mice compared with those in LPS group.Conclusion Berberine can improve LPS induced depressive-like behavior in mice,and these effects may correlate with decreased level of IL-1β and TNF-α in hippocampus and prefrontal cortex.
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Objective To evaluate the reliability and validity of the Chinese version of European Five-dimensional Five-level Health Scale (EQ-5D-5L) for patients with Kaschin-Beck disease.Methods From May 2017 to September 2018,a total of 245 patients with Kaschin-Beck disease in Yongshou and Linyou counties,Shaanxi Province were interviewed face-to-face with the EQ-5D-5L.The health-related value score was used to calculate the overall health-related quality of life of patients with Kaschin-Beck disease.The higher the score,the better the overall health of the population,and vice versa (-0.391-1.000).The visual analogue system (VAS)score was used to calculate the individual health status,higher scores indicated that the health status of self-evaluation were better,and vice versa (0 to 100 points).Sixty-three patients were retested two weeks later.Evaluation was performed using internal consistency,test-retest reliability,structural validity and criterion validity.Results A total of 245 patients with Kaschin-Beck disease were investigated,including 127 males (51.8％) and 118 females (48.2％),aged (60.37 ± 7.10) years old.The medians and quartile ranges of EQ index and VAS of patients were 0.311 (0.504) and 42.5 (30.0) points,respectively.And the Cronbach coefficient of the five-dimensional score of the health description system was 0.828.The intra-class correlation coefficient (ICC) of each dimension of the health description system was 0.571-0.719.EQ index and VAS score showed that the two had a relatively stable correlation (rs =0.522,P ＜ 0.05),and the ICCs of EQ index and VAS score were 0.754 and 0.570,respectively;the EQ-5D-5L validity calculated by "Therapeutic Efficacy on Kaschin-Beck Disease" (WS/T 79-2011) was between 0.375-0.647 (P ＜ 0.05).Conclusions The overall health status of the Kaschin-Beck disease patient population and the health status of the individual self-evaluation measured by EQ-5D-5L are poor.The reliability test and validity test prove that the EQ-5D-5L is applied to the health status of patients with Kaschin-Beck disease.The EQ-5D-5L has good reliability and validity.
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Objective To analyze the occurrence characteristic of Kashin-Beck disease (KBD) in nuclear families,and to provide a scientific basis for KBD prevention.Methods KBD patients in 15 villages of Linyou County,Shaanxi Province were investigated using clinical and questionnaire survey.According to the prevalence of KBD,the nuclear families were divided into 4 different types:parents did not suffer from KBD (A,n =3 657),mother suffered from KBD and father did not (B,n =674),father suffered from KBD and mother did not (C,n =907),and both patients suffered from KBD (D,n =748).The relationship between prevalence of nuclear families and prevalence of population was analyzed using correlation analysis,and the changes of prevalence in different age groups of family members were analyzed.Results ①The prevalence of nuclear families (38.91％,2 329/5 986) and the prevalence of popttlation (14.42％,3 700/25 656) were significantly correlated (r =0.77,P ＜ 0.05);②The proportions of parental generation men and women with KBD were 9.91％ (118/1 191) vs 11.30％ (105/929) in 0-10 years old group,62.80％ (748/1 191) vs 58.45％ (543/929) in 11-20 years old group,15.70％ (187/1 191) vs 18.51％ (172/929) in 21-30 years old group,7.30％ (87/1 191) vs 7.64％ (71/929) in 31-40 years old group,2.77％ (33/1 191) vs 2.37％ (22/929) in 41-50 years old group,1.34％ (16/1 191) vs 1.51％ (14/929) in 51-60 years old group,and 0.17％ (2/1 191) vs 0.22％ (2/929) in 61-70 years old group,respectively.③Among the three nuclear families (B,C,D),the age of offspring with KBD was less than 13 years old when the age of their parents with KBD was less than 13 years old(83.33％,20/24);The age of the offspring with KBD was mainly distributed between the ages of 13 and 25 years old when the age of their parents with KBD was 13-25 years old (69.86％,51/73);When the age of parents with KBD was order than 25 years old,the age of their offspring with KBD was mainly less than 25 years old (84.85％,56/66);④Among the four nuclear families,the prevalence rates of male and female in the first filial generation were 1.41％ (52/3 683) vs 0.47％ (12/2 538) in A family (x2 =0.47,P ＞ 0.05),5.73％ (31/541) vs 0.53％ (2/378) in B family (x2 =4.32,P ＜ 0.05),6.48％ (44/679) vs 0.95％ (5/528) in C family (x2 =4.10,P ＜ 0.05),and 9.46％ (66/698) vs 3.31％ (15/453) in D family (x2 =2.96,P＞ 0.05),respectively.Conclusions ①The prevalence of the nuclear family with KBD is related to the population prevalence;②the prevalence of male and female with KBD is related to age,and KBD mainly occurs between the age of 11 and 20;③the age of offspring with KBD is partly influenced by the age of their parents;④the prevalence rate of male in the first filial generation is higher than that of female in the first filial generation.
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Objective To explore the effects of Living with Hope Program(LWHP) on family caregivers of patients with advanced lung cancer.Methods Totally 60 family caregivers of patients with advanced lung cancer were randomly divided into the experimental group and the control group.The experimental group received LWHP intervention and routine care knowledge education,the control group only received routine care knowledge education.Hope,self-efficacy,anxiety and depression,and quality of life were evaluated at the first week,the second week,the first month,and the third month.Differences between two groups were compared using variance analysis of repeated measurements.Results The self-evaluation of the intervention was 76.6％,and the main effects of hope level,selfefficacy,anxiety and depression,and mental health were statistically significant (P＜0.05);the time effect on hope level and self-efficacy were statistically significant (P＜0.05);there were interaction effects between intervention and time on hope level,self-efficacy,anxiety and depression,and mental health (P＜0.05).Conclusion LWHP can effectively improve hope level,self-efficacy and mental health status,and alleviate anxiety and depression of family caregivers of patients with advanced lung cancer.
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Hemorrhagic transformation is a common complication after ischemic stroke, especially after thrombolytic therapy. Its disability and mortality are very high. Therefore, it limits the clinical application of thrombolytic therapy. This article reviews the types of hemorrhagic transformation, possible mechanisms and predictors after thrombolysis for ischemic stroke in order to provide reference for clinical treatment and research of ischemic stroke.
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Objective To analyze the effects of dengue virus 2 ( DENV-2 ) infection on the ex-pression of IL-29 in primary human umbilical vein endothelial cells ( HUVECs) cultured on hydrogel sub-strates .Methods Primary HUVECs were isolated and cultured on hydrogel substrates .DENV-2 stains were used to infect the primary HUVECs at a multiplicity of infection( MOI) of 10.Flow cytometry analysis was performed to detect the apoptosis and infection rate of HUVECs after 48 hours of culturing .The gene chip profiling was performed to analyze mRNA expression .The expression of IL-29 at mRNA and protein levels were measured by real-time fluorescent quantitative PCR analysis and double antibody sandwich ELISA as -say, respectively.Results Compared with 96.36%of baby hamster kidney (BHK) cells that were infected with DENV-2 stains, only 4.71%primary HUVECs cultured on hydrogel substrates were infected .The pri-mary HUVECs cultured on hydrogel substrates with or without DENV-2 infection showed no significant differ-ences with the rates of cell apoptosis and infection (P>0.05).A significant difference was observed with the expression of IL-29 at mRNA level between primary HUVECs cultured on hydrogel substrates and the cells cultured in plastic bottles (P<0.05).The results of the real-time quantitative PCR analysis and ELISA as-say showed that IL-29 was highly expressed in DENV-2 infected primary HUVECs cultured on hydrogel sub-strates as compared with those in control groups (P<0.05).Conclusion The expression of IL-29 was de-tected in DENV-2 infected primary HUVECs cultured on hydrogel substrates , which was significantly differ-ent from that in DENV-2 infected primary HUVECs cultured in plastic bottles .The successful establishment of hydrogel substrates as the model of vascular basement membranes might provide a new way for the investi -gation of the pathogenesis of DENV infection .
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Objective To investigate the effects of substrate stiffness on the proliferation of human umbilical vein endothelial cells ( HUVEC) during dengue virus infection.Methods Polyacrylamide gels were prepared for cell culture [(0±4) kPa].The proliferation of HUVEC cultured on substrates with differ-ent stiffness was determined by using 3-(4,5-diethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfo-phenyl)-2H-etrazolium,inner salt ( MTS) assay.The cycle and apoptosis of HUVEC were determined by flow cytometry analysis.Dengue virus serotype 2 (DENV-2) strains were propagated and identified by con-ventional assays.The HUVEC were infected with DENV-2 strains at a MOI of 10 and cultured on traditional plastic and hydrogel substrates, respectively.The levels of nitric oxide (NO) and endothelin-1 (ET-1) were detected by nitric acid reductase assay and double antibody sandwich ELISA.Results Young′s modulus E value of the hydrogels was (3030 ±0.44) Pa.The proliferation of HUVEC and the expression of NO and ET-1 were enhanced along the increased substrate stiffness.However, no significant differences with the cell cycle and apoptosis were observed between cells cultured on different substrates.Conclusion The stiffness of substrates affected not only the proliferation of HUVEC, but also the release of cytokines during DENV-2 infection.The development of dengue fever was associated with the decreased secretion of vascular active substances as a result of blood vessel injury.The establishment of hydrogel substrates as the model of vascu-lar basement membranes might provide a new way for the in vitro investigation of the pathogenesis of DENV infection.
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Objective To investigate the improvement of quality of life of patient with Kashin-Beck disease (KBD) after knee joint cavity injection of hyaluronic acid.Methods Fifty KBD patients were selected in Yongshou County Shaanxi Province,and accepted knee joint cavity injection of hyaluronic acid (25 mg) for four times,one time a week.SF-36 health questionnaire was used to evaluate the quality of life of KBD patients,and the quality adjusted life years (QALYs) were calculated after 2 months.Results The total score of the quality of life of KBD patients was improved from 38.81 ± 17.39 to 49.35 ± 17.95 after knee joint cavity injection of hyaluronic acid.The scores of physiological function (PF),body pain (BP),general health (GH),energy (VT),social function (SF) and mental health (MH) in the eight dimensions of SF-36 scale were 54.42 ± 21.25,47.42 ± 20.80,48.00 ± 26.12,61.05 ± 19.14,68.09 ± 28.73 and 68.74 ± 14.85,respectively,after the treatment,which were higher than those before the treatment (41.51 ± 22.11,27.63 ± 11.78,38.76 ± 25.14,51.97 ± 18.14,57.89 ± 30.95 and 56.95 ± 20.47,t =-3.942,-6.344,-2.494,-2.785,-2.819 and-4.245,all P ＜ 0.05).The QALYs of KBD patients increased 0.051 ± 0.044 with 2 months followed up.Conclusion The quality of life (PF,BP,GH,VT,SF and MH) of KBD patients could be significantly improved after knee joint cavity injection of hyaluronic acid.
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Objective To evaluate the applicability of western Ontario and McMaster university osteoarthritis index (WOMAC) on Kaschin-Beck disease (KBD).Methods Clinical degree Ⅰ adult patients with KBD came from Yongshou and Linyou Counties in Shaanxi Province were investigated according to the historical diagnostic data and The Diagnosis Standard of Kashin-Beck Disease (GB 16003-1995),exclusion of other chronic diseases.Reliability of WOMAC was measured by retest reliability,1/2 coefficient and Cronbach'α reliability coefficient analysis; validity of the WOMAC was tested by the principal components,factor analysis and correlation analysis methods.Results Totally 200 adults patients with KBD were investigated,and 177 effective questionnaires were taken back (88.5 ％).Retest reliability was 0.754-0.853,1/2 coefficient was 0.886-0.971,and Cronbach'α reliability coefficient was 0.878-0.956.In three dimensions of WOMAC scale extracted a common factor,the cumulative variance contribution rate was 81.238％ through principal component factor.The pearson correlation coefficient between all items score of WOMAC and scale score and total score of WOMAC was more than 0.600.The differences of WOMAC score were not statistically significant in different ages,different grading of adult KBD patients (all P ＞ 0.05).Conclusion WOMAC scale used in KBD has good validity and reliability,but has low degree of differentiation.
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Objective To evaluate the long-term therapeutic effect of hyaluronic acid on adults with Kashia-Beck disease and the applicability of the joint dysfunction index.Methods A cluster-randomized,starch tablets-controlled trial was carried out depending on the joint dysfunction index of assessment for therapeutic efficacy on Kashin-Beck disease and self-assessment by patients of the Treatment Effect of Kaschin Beck Disease in Criterion.A total of 99 adults with Kashia-Beck disease were randomly divided into two groups:treatment group including 50 patients were intra-articular injected hyaluronic acid in knee weekly for 4 weeks,and the control group including 49 patients were treated with oral starch tablets for 3 months,2 tablets each time,3 times a day.We carried out 48 months follow-up and assessed the applicability of Kashia-Beck disease with treatment of hyaluronic acid.Results The improvement rates of joint dysfunction index were 80.0％ (40/50),83.0％ (39/47),86.4％ (38/44),85.7％(36/42),80.0％(36/45),and 47.1％(16/34) for 1 week and 1,2,3,6,48 months in treatment group,respectively,which were significantly higher than those of corresponding control group 25.0％ (12/48),28.3％ (13/46),33.3％ (16/48),25.0％ (10/40),30.0％ (12/40),and 21.4％ (6/28),and the differences were statistically significant between corresponding groups (x2=29.744,28.236,17.762,30.665,21.537,4.406; all P ＜ 0.05).Before treatment,the treatment group and control group in the joint dysfunction index scores were 7.59 ± 1.82 and 6.89 ± 1.97(t =1.837,P ＞ 0.05),respectively.After treatment,1 month follow up of the treatment group and control group in the joint dysfunction index scores were 3.44 ± 1.71 and 5.55 ± 2.34(t =4.972,P ＜ 0.01),respectively; 6 months follow up were 3.46 ± 2.78 and 6.10 ± 1.83(t =5.102,P ＜ 0.01),respectively; 48 months follow up were 5.13 ± 2.88 and 6.81 ± 3.07(t =2.219,P ＜ 0.05),respectively.The satisfaction of 85.1％ (40/47) in treatment group was significantly higher than that of 60.9％(28/46) in control group (Z =-4.012,P ＜ 0.01).Kappa value between joint dysfunction index and the overall evaluation of the treatment group after treatment was 0.526,which belong to moderate intensity of consistent degree (P ＜ 0.01).Conclusion The therapeutic effect of intra-articular injection of hyaluronic acid on adults with Kashia-Beck disease is significant and lasting,and the joint dysfunction index has better applicability to evaluate the long-term therapeutic effect.
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Objective:To study the effects of smokeless tobacco extract(ST)on the proliferation and the heat shock protein 70 (HSP70)expression of human periodontal ligament cells(hPDLCs).Methods:hPDLCs were cultured in vitro and identified by im-munohistochemistry(IHC).The cells were stimulated with ST at 0.01 6 -50 g/L respectively for 24 h,the proliferation was examine by MTT assay,HSP70 expression was detected by immunehistochemical staining and Western Blot.Results:ST inhibited the prolifer-ation and increased HSP70 expression in cytoplasm and nucleus at 0.4 -50 g/L dose dependantly.Conclusion:ST may inhibit the proliferation and increase HSP70 expression of hPDLCs in a dose depandant manner.
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BACKGROUND:In recent years, monitoring the pressure in the human body, especial y esophageal variceal pressure, becomes a hot spot. A lot of progress has been achieved regarding fiber optical sensors for measurement of the pressure in the human body. OBJECTIVE:To briefly review the fiber optical sensor applications in the human body. METHODS:A computer-based online retrieval was performed to search papers in CNKI periodical ful-text database and PubMed database (from January 1983 to March 2013) using the key words of“fiber optical sensor, pressure, measurement”in Chinese and English, respectively. After excluding objective-independent and repetitive papers, 40 papers were included for further analysis. RESULTS AND CONCLUSION:Compared with traditional sensors, fiber optical sensors, which have advantages in high sensitivity, large dynamic range, fast response, tolerance to electronic interference, explosion proofing, fireproofing and corrosion protection, have been used to measure esophageal variceal pressure, intracranial pressure, pharyngeal pressure, pediatric airway pressure, cardiovascular&blood pressure, intervertebral disc pressure, intrauterin pressure in childbirth, pressure in the colon, plantar pressure and shear force as wel as other pressures in the human body. Fiber optical sensors have been used more widely in pressure monitoring. With the development of production technology and device performance, fiber optical sensors wil further promote the rapid development of medical science in the near future.
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10.3969/j.issn.2095-4344.2013.24.018
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Objective To assess the value of acoustic radiation force impulse (ARFI) imaging in the pathological damage of Henoch-Schonlein purpura nephritis on children by comparison with renal biopsy.Methods 50 cases of healthy control group as group A; 58 children with HSPN were divided into three groups according to pathological grading:Ⅰ ～ Ⅱ class (group B),Ⅲ class (group C) and Ⅳ ～ Ⅵ class (group D).ARFI was then used to measure the shear wave velocities(SWV) of renal cortex of each group,compared the differences SWV of each group.Results SWV values of children's renal cortex with HSPN were significantly higher (t =5.883,P =0.017) than those in the group A.Pairwise comparisons found that there were statistically significant differences between group D and the other three groups (P ＜0.05).According the ROC curve,the cut-off value of SWV was 2.59 m/s when the maximum area under the curve equal to 0.719,the sensitivity and specificity were 63％ and 67％.Conclusions ARFI technology can quantify the elastic properties of the kidney,which is expected as an important indicator to evaluate the pathological extent of damage of the HSPN.
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Objective To investigate the intra- and interobserver repeatability of coronary artery disease (CAD) diagnosis based on invasive coronary angiography (ICA) and CT coronary angiography (CTCA).Methods Two readers with comparable experience ( over 10 years) independently evaluated ICA results of 42 consecutive patients with a blind method. After 30 days,one of them reviewed the same patients again.Another two comparable-experience (over 10 years) readers evaluated the results of CTCA (prospectively ECG-triggering) from the same 42 patients in the same way.The inter-reader and intra-reader repeatability of ICA and CTCA were analyzed by performing Kappa test and calculating the percentage of the segments with agreement on stenotic degree.Using ICA as reference,the accuracy of CTCA in diagnosing CAD was studied by comparing the area under ROC. Results The Kappa between readers for ICA and CTCA were 0.91 and 0.81.Intra-reader Kappa were 0.92 and 0.83 respectively (x2 =509.4 and 432.5,all P ＜0.01 ).The percentage of the segments with agreement between readers on the degree of stenosis were 80.8％ (494/611) in ICA and 75.2％ (469/624) in CTCA ( x2 =2.75,P =0.10),and within the same reader,86.9％ (531/611)in ICA and 81.9％ (511/624) in CTCA(x2 =3.76,P =0.053).With≥ 50％narrowing as a CAD diagnosis criterion,the agreement rates for two readers were 96.6％ (590/611 ) in ICA and 94.4％ (589/624) in CTCA( x2 =3.36,P =0.07),and for the same reader,97.4％ (595/611) in ICA,95.4％ (595/624) in CTCA ( x2 =3.62,P =0.06).Using ICA as reference,two readers of CTCA results achieved a sensitivity and specificity of 84.9％ (530/624)and 98.1％ (612/624).The area under ROC was 0.94 (95％ CI 0.91-0.97).Conclusions Both ICA and CTCA demonstrate good repeatability in diagnosing CAD.The repeatability of ICA is superior to that of CTCA.A certain discrepancy exists in two readings from the same reader or two readers.
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Objective To evaluate the clinical value of ultrasonography in the diagnosis of hermaphroditism.Methods Ultrasonographic appearances of 45 cases with hermaphroditism were reviewed retrospectively,and the results were compared with clinical data.Results All cases were confirmed pathologically.5 cases showed true hermaphroditism (11.1％),14 cases showed male pseudohermaphroditism (31.1 ％),24 cases showed female pseudohermaphroditism (53.3 ％),2 cases showed gonadal dysgenesis(4.4％).Compared with pathological results in the ultrasound examination,4 cases showed true hermaphroditism,the coincidence rate was 80％.11 cases showed male pseudohermaphroditism,the coincidence rate was 78.6％.20 cases showed female pseudohermaphroditism,the coincidence rate was 83.3％.1 cases showed gonadal dysgenesis,the coincidence rate was 50.0％.Conclusions Ultrasonography can not only evaluate internal reproductive organs in the patients,but also estimate the site,size,morphology and structure,which provides important imaging evidence for the clinical diagnosis and treatment.
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Objective To analyze the clinical characteristics and prognosis of acute pyelonephritis (APN) in children.Methods A retrospective analysis was performed in 230 pediatric patients with APN admitted from January 2009 to December 2010.The clinical characteristics,etiology,drug-resistant and prognosis were reviewed,and logistic regression analysis was performed to identify the risk factors of renal scarring after APN.Results Among 230 patients with APN,93 were boys and 137 were girls with a malefemale ratio of 1∶ 1.47.Ninety-nine patients were younger than 1 year with a male-female ratio of 1.30∶1 ;75 patients were 1 to 5 year with a male-female ratioof 1 ∶ 2.75 ; 56 patients were older than 5 year with a male-female ratio of 1∶2.29.A total of 106 strains were detected,in which 91 strains were Gram-negative bacteria,13 strains were Gram-positive bacteria and 2 strains were fungus.The most frequent bacteria were Escherichia coli (65 strains,61.32％),Klebsiella pneumonia (13 strains,12.6％) and Enterococcus faecium (9 strains,8.49％).Forty-four strains of Escherichia coli produced ESBLs,and all of them were resistant to ampicillin,part of them resistant to cephalosporin,compound sulfamethoxazole and aztreonam,but all were sensitive to amikacin,amoxicillin/clavulanic acid,nitrofurantoin,and imipenem.Renal emission computed tomography (ECT) was performed again in 52 children who were followed up for 6-12 months,in which 31 cases (59.62％) developed renal scar,and 21 cases (40.38％) were recovered.Abnormalities in urinary system or vesicoureteric reflux were identified as the risk factors for renal scarring after APN (OR =6.89,P ＜ 0.05).Conclusions The incidence of APN in children drops with age,which is frequently in the males younger than 1 year,and in the females older than 1 year.Escherichia coli is the most frequent pathogen of APN in children,and most strains are multidrug resistant.Children with abnormalities in urinary system or vesicoureteric reflux are prone to develop renal scarring.