ABSTRACT
Objective To observe the clinical,pathological features and prognosis of IgA nephropathy in children with crescent formation.Methods A total of 38 cases of children with IgA nephropathy diagnosed by renal biopsy at Qilu Hospital of Shandong University were retrospectively analyzed.According to whether there were crescent formation,they were divided into crescents formation group (crescent formation≥10％,n=18) and control group consisting of children with complete clinical data and matching age,gender and course of disease (no crescent formation,n=20).The clinical,pathological features and prognosis of the two groups were compared.Results Fourteen cases (77.78％) of crescents formation group were associated with nausea hematuria,and 12 cases (66.67％) had hypertension,8 patients in control group (40％) had gross hematuria,and 6 cases (30％)had high blood pressure.The differences were statistically significant (P ＜ 0.05).In crescents formation group,Alb and eGFR were significantly lower than those of control group.24 h urine protein and Scr were significantly higher than those of control group and there were significant statistically differences between two groups (P ＜ 0.05).Nephropathological changes in crescent formation group were mainly in grade Ⅱ and grade Ⅲ and were usually combined with tubular interstitial damages.In addition to IgA immunoglobulin deposition,they often accompanied by IgG and IgM immunoglobulin deposition.In control group,nephropathological changes were mainly in grade Ⅰ and grade Ⅱ and tubular interstitial damages were rare.IgA was the main form of deposition in control group.After 12 weeks steroid treatment and (or) immunosuppressive therapy,urinary protein turned negative in 7 cases in crescent formation group,24 h urinary protein level declined by half than before in 7 cases and no obvious change in 4 cases.In control group,urinary protein turned negative in 12 cases,6 cases showed a more than 50％ decline in urinary protein level and 2 cases had no obvious change.During the 1-3 years of follow-up,renal function of 14 cases and 19 cases was normal in the crescent formation group and control group respectively,serum creatinine of 3 cases and 1 case increased mildly in the crescent formation group and control group respectively,1 case needed dialysis treatment in the crescent formation group and the one in the control group who had slightly increasement of Scr did not reach the standard of dialysis treatment.Conclusions The clinical and pathological manifestations of children with IgA nephropathy with crescent formation are more severe and more likely to manifest renal insufficiency,suggesting that crescent formation is one of the indicators of poor prognosis.
ABSTRACT
OBJECTIVE@#To investigate the expression of microtuble-associated protein 1 light chain 3 (LC3) in laryngeal squamous cell carcinoma (LSCC).@*METHOD@#The expression of LC3 in 50 cases of LSCC, 45 cases of para-carcinoma, 10 cases of laryngeal papilloma and 16 cases of polyp of vocal cord were detected by immunohistochemistry (MaxVision method). Expression level of LC3 mRNA was assayed by RT-PCR in 41 of LSCC, 41 of para-carcinoma tissue and 11 of polyp of vocal cord.@*RESULT@#The positive rates of LC3 protein expression were 60.0%, 93.3%, 90.0%, 93.8% in LSCC tissue, para-carcinoma, laryngeal papilloma and poly of vocal card tissues, respectively. The positive rates of LC3 were significantly lower in LSCC than in para-carcinoma and poly of vocal cord (chi2 = 18.135, P 0.05).@*CONCLUSION@#Expression of LC3 are down-regulated in LSCC. The change of autophagic capacity may play an important role in occurrence and development of LSCC.