Cohort study on different BMI and blood pressure levels in children and adolescents / 中国学校卫生

Objective@#To analyze the relationship between the baseline BMI level and body mass index (BMI) changes of primary and middle school students and the blood pressure level and the risk of elevated blood pressure after 8 years of follow up(also known as the end stage), so as to provide a basis for the prevention and control of blood pressure in children and adolescents.@*Methods@#The physical examination data of 9 748 primary and secondary school students were selected from a cohort study design in Longkou City, Shandong Province for 8 years from 2014 to 2022, and analyzed the association of baseline BMI level and BMI changes with end stage blood pressure level and the risk of elevated blood pressure. Chi square test was used to compare differences between groups, and the generalized linear model and Logistic regression model were used to analyze the effect of baseline BMI level and BMI changes on blood pressure level and elevated blood pressure after 8 year follow up.@*Results@#Among non overweight and obesity group at baseline, the prevalence of high blood pressure was 9.1%. Among the overweight and obesity group, the prevalence of high blood pressure was 12.0%. Under different BMI status at baseline, the incidence of high blood pressure in boys was higher than that in girls. Compared with the BMI Z value≤-1 group, with the increase of BMI Z value, the systolic blood pressure level and the risk of high blood pressure gradually increased; with the BMI change continuously low as the control, sustained high and increased groups showed an increased risk of end stage high blood pressure ( OR=4.00, 2.21, P <0.01), and boys had a greater risk of elevated blood pressure.@*Conclusion@#Children and adolescents with higher baseline BMI level and increased BMI changes are at a higher risk of elevated blood pressure. Therefore, secondary school students should monitor the occurrence and development of blood pressure level in real time, and take comprehensive and effective measures to control the occurrence of elevated blood pressure level in childhood.

Exosomes are involved in calcification of vascular smooth muscle cells induced by high phosphorus / 中华肾脏病杂志

Objective:To explore the regulatory role of exosomes in calcification of rat vascular smooth muscle cells (VSMC) induced by high phosphorus.Methods:VSMC (A7r5 cells) were cultured in vitro and randomly divided into three groups: normal phosphorus group (0.9 mmol/L), high phosphorus group (2.6 mmol/L) and high phosphorus exosomes induction group (i.e. the exosomes extracted from high phosphorus group were added to VSMC in normal culture). Until the 7th day of culture, the culture medium of normal phosphorus group and high phosphorus group obtained during the change of cell culture medium was collected, and the precipitate was obtained by ultracentrifugation and suspended by phosphate buffered saline. The protein content of the precipitate was determined by BCA protein quantitative method. The precipitates were identified. The structure and size of exosomes were observed by transmission electron microscope. The exosomes marker proteins tumor susceptibility gene 101 protein (TSG101) and CD9 were detected by Western blotting. The miRNA in exosomes was extracted, and the expression of related miRNA (miR-30b, miR-204, miR-211) were observed by real-time quantitative PCR. After 7 days of cultivation, the exosomes uptake process of VSMC in high phosphorus exosomes induction group was observed. The calcium deposition was detected by Alizarin stain, and the calcium content was detected by O-cresol complex copper. The content of alkaline phosphatase was detected by colorimetry. The protein expression of Runx2 was quantified by Western blotting. Results:(1) The precipitate obtained by ultracentrifugation of the cell culture fluid was identified as exosomes by electron microscopy morphology. Western blotting confirmed that the expression of the exosomal marker proteins TSG101 and CD9 were positive. (2) The exosomes were rich in miRNAs. The expression of miR-30b, miR-204, miR-211, which negatively regulated the transcription of Runx2, was significantly down-regulated in the high-phosphorus group compared with the normal group ( P<0.05). (3) After culturing rat VSMC with high phosphorus for 7 days, calcium salt deposition was obvious. Compared with the normal phosphorus group, calcium content and alkaline phosphatase activity were significantly increased (both P<0.05), and Runx2 expression was also significantly increased ( P<0.05). (4) Added the obtained high-phosphorus exosomes to the normal cultured VSMC, the exosomes could be taken up by VSMC and successfully induced VSMC calcification. The levels of cell calcification indicators and Runx2 expression were significantly increased. Conclusions:High phosphorus induces calcification of VSMC and promotes the increase of Runx2 expression. The mechanism may be realized by releasing exosomes from VSMC to transmit cell signals.

Effect of Qianggan capsules on insulin resistance index and liver fibrosis score in patients with nonalcoholic fatty liver disease / 临床肝胆病杂志

ObjectiveTo investigate the effect of Qianggan capsules on liver fibrosis score and insulin resistance index in patients with nonalcoholic fatty liver disease (NAFLD). MethodsA total of 85 NAFLD patients who were treated in the Eighth People′s Hospital of Shanghai from August 2014 to July 2015 were enrolled and randomly divided into treatment group (45 patients) and control group (40 patients). The patients in the treatment group were given Qianggan capsules, and those in the control group were given polyene phosphatidylcholine capsules. The course of treatment was 24 weeks for both groups. The changes in serum aminotransferases ［aspartate aminotransferase (AST) and alanine aminotransferase (ALT)］, homeostasis model assessment of insulin resistance (HOMA-IR), and NAFLD fibrosis score (NAFLDFS) after treatment were observed in both groups. The t-test was used for comparison of continuous data between groups, before-after comparison within each group was made by paired t-test; and the chi-square test was used for comparison of categorical data between groups. ResultsBoth groups showed significant improvements in ALT and AST levels after treatment (all P＜001). After treatment the treatment group showed significant reductions in HOMA-IR and NAFLDFS (358±085 vs 248±078，t=640，P＜001; -178±124 vs -235±098,t=240,P＜001) and the treatment group had significantly lower HOMA-IR and NAFLDFS than the control group(1248±078 vs 309±089,t=336,P＜001;-235±098 vs -148±108,t=380,P＜001). No serious adverse events were observed during the course of treatment. ConclusionQianggan capsules not only reduce the levels of serum aminotransferases, but also improve insulin resistance and reduce fibrosis degree in NAFLD patients.

Endocapillary proliferative glomerulonephritis with hepatitis B virus antigen deposition in children:a clinicopathologic analysis of 9 cases / 临床与实验病理学杂志

Purpose To analyze clinicopathologic and prognostic features in 9 cases of children endocapillary proliferative glomerulone-phritis with hepatitis B virus antigen deposition ( HBV-ECPGN) . Methods Retrospective analysis of demographic information, clini-cal manifestations, laboratory parameters, pathological and prognostic features was carried out for 9 cases of HBV-ECPGN and 13 cases of acute poststreptococcal infection endocapillary proliferative glomerulonephritis ( APS-ECPGN) for comparison. Renal biopsy tissue were fixed in formalin and embedded in paraffin, stained with HE, PAS and PAM-Masson. Immunohistochemical study with EliVision method was performed. Three cases were submitted for electron microscopy. Results There were 7 males and 2 females ( M ∶ F=7 ∶ 2) of HBV-ECPGN. The median age was 10. 3 years. Serum C4 deposition ratio HBV-ECPGN was significantly greater than APS-ECPGN group (P<0. 05). There was an average of 11. 2 weeks of HBV-ECPGN kidney disease duration, which was significantly lon-ger than an average of 3. 8 weeks of APS-ECPGN group (P<0. 05). There was no disease relapse in all cases during 53. 55 months follow-up. C4d deposit was significantly stronger in all HBV-ECPGN cases compared with control group (APS-ECPGN cases). There were no significant differences in deposit of IgG, IgM, IgA, C3d and C1q between the two groups. HBsAg deposit in juxtaglomerular sites was identified in all cases. Conclusions Serum C4 decrease is more common in HBV-ECPGN than APS-ECPGN. Which may be associated with HBV infection, there is longer disease duration of HBV-ECPGN. C4d deposit is significantly stronger than control group, suggesting pathogenesis of HBV-ECPGN and APS-ECPGN is different. HBsAg deposit may be closely related to the pathogene-sis of HBV-ECPGN. HBsAg deposit in juxtaglomerular sites may be characteristic of HBV-ECPGN.

Inflammatory fibroid polyps in digestive tract:a clinical and pathological analysis of 14 cases / 临床与实验病理学杂志

Purpose To investigate the clinical and pathological features of inflammatory fibroid polyps ( IFPs) and to discuss its diag-nosis, differential diagnosis and treatment. Methods Clinicopathological data of 14 cases of IFPs were collected and analyzed retro-spectively. Results Most of the 14 cases were found to have submucosal polyps of the digestive tract protruding growing into the cavi-ty. Perivascular onion skinning which formed by spindle fibrocytes around vascular proliferation and eosinophilic inflammatory infiltrates were present as the characteristic feature of lesions. ABC results demonstrated that the lesions showed fibroblastic, myofibroblastic and dendritic cell signs. Conclusions IFPs are rare, benign tumors that can arise throughout the digestive tract, with unique histological changes in pathology. Surgical excision or endoscopic removal is the main treatment.