ABSTRACT
Objective · To explore the correlation between immunofluorescence (IMF) deposition and corticosteroid effect in childhood focal segmental glomerulosclerosis (FSGS) manifesting with nephrotic syndrome (NS). Methods · Renal IMF deposition and clinical data of the children clinically diagnosed with NS and pathologically diagnosed with FSGS in the Department of Pediatric Nephrology in Xinhua Hospital, Shanghai Jiao Tong University from January 1990 to December 2015 were reviewed and analyzed retrospectively. Results · The renal pathological types classified by IMF of 47 patients diagnosed with FSGS manifesting with NS showed that 2 cases (4.26%) were IgA type, 12 cases (14.89%) were IgM type, 4 cases (8.51%) were complement (C) type, 1 case (2.13%) was IgG+A+M type, 5 cases (10.64%) were IgG+A+M+C type, 1 case (2.13%) was IgA+C type, 12 cases (25.53%) were IgM+C type, and there was no immune complexes present in 15 cases (31.91%). The IMF deposition showed 9 cases with IgA+, 25 cases with IgM+, 8 cases with IgG+, 23 cases with C3+, 3 cases with C4+, 6 cases with C1q+, 5 cases with FN+, 12 cases with all negative. After 4 weeks of treatment with oral prednisone at full dose, complete remission was presented in 34 cases (72.34%), partial remission was presented in 7 cases (14.89%), and no remission was presented in 6 cases (12.77%). There was no statistically difference in the corticosteroid effect among the different types of IMF (H=1.792, P=0.408). The corticosteroid effect had statistical differences between C1q+ and C1q- patients (χ2=7.22, P=0.027), while it had no significant differences in other conditions. Conclusion · In childhood FSGS manifesting with NS, C1q+ patients have relatively poor reaction to the corticosteroid therapy compared to C1q- ones.
ABSTRACT
Objective · To explore the correlation between immunofluorescence (IMF) deposition and corticosteroid effect in childhood focal segmental glomerulosclerosis (FSGS) manifesting with nephrotic syndrome (NS). Methods · Renal IMF deposition and clinical data of the children clinically diagnosed with NS and pathologically diagnosed with FSGS in the Department of Pediatric Nephrology in Xinhua Hospital, Shanghai Jiao Tong University from January 1990 to December 2015 were reviewed and analyzed retrospectively. Results · The renal pathological types classified by IMF of 47 patients diagnosed with FSGS manifesting with NS showed that 2 cases (4.26%) were IgA type, 12 cases (14.89%) were IgM type, 4 cases (8.51%) were complement (C) type, 1 case (2.13%) was IgG+A+M type, 5 cases (10.64%) were IgG+A+M+C type, 1 case (2.13%) was IgA+C type, 12 cases (25.53%) were IgM+C type, and there was no immune complexes present in 15 cases (31.91%). The IMF deposition showed 9 cases with IgA+, 25 cases with IgM+, 8 cases with IgG+, 23 cases with C3+, 3 cases with C4+, 6 cases with C1q+, 5 cases with FN+, 12 cases with all negative. After 4 weeks of treatment with oral prednisone at full dose, complete remission was presented in 34 cases (72.34%), partial remission was presented in 7 cases (14.89%), and no remission was presented in 6 cases (12.77%). There was no statistically difference in the corticosteroid effect among the different types of IMF (H=1.792, P=0.408). The corticosteroid effect had statistical differences between C1q+ and C1q- patients (χ2=7.22, P=0.027), while it had no significant differences in other conditions. Conclusion · In childhood FSGS manifesting with NS, C1q+ patients have relatively poor reaction to the corticosteroid therapy compared to C1q- ones.
ABSTRACT
<p><b>OBJECTIVE</b>To prepare a porcine acellular dermal matrix (PADM), and to optimize the interpore distance between PADM and co-grafted split-thickness autologous skin.</p><p><b>METHODS</b>Porcine skin was treated with trypsin/Triton X-100 to prepare an acellular dermal matrix. Micropores were produced on the PADM with a laser punch. The distance between micropores varied as 0.8 mm, 1.0 mm, 1.2 mm and 1.5 mm. Full-thickness defect wounds were created on the back of 144 SD rats. The rats were randomly divided into 6 groups as follows, with 24 rats in each group. Micropore groups I -IV: the wounds were grafted with PADM with micropores in four different intervals respectively, and covered with split-thickness autologous skin graft. Mesh group: the wounds were grafted with meshed PADM and split-thickness autograft.</p><p><b>CONTROL GROUP</b>with simple split-thickness autografting. The gross observation of wound healing and histological observation were performed at 2, 4, 6 weeks after surgery. The wound healing rate and contraction rate were calculated.</p><p><b>RESULTS</b>Two and four weeks after surgery, the wound healing rate in micropore groups I and II was lower than that in control group (P < 0.05), but no obvious difference was between micropore groups I , II and mesh group (P > 0.05) until 6 weeks after grafting( P <0.05). The wound contraction rate in micropore groups I and II ([(16.0 +/- 2.6)%, (15.1 +/- 2.4)%] was remarkably lower than that in control group 4 and 6 weeks after grafting (P < 0.05), and it was significantly lower than that in mesh group [(19.3 +/- 2.4)%] 6 weeks after surgery (P <0.05). Histological examination showed good epithelization, regularly arranged collagenous fibers, and integral structure of basement membrane.</p><p><b>CONCLUSION</b>Laser micropore PADM (0.8 mm or 1.0 mm in distance) grafting in combination with split-thickness autografting can improve the quality of wound healing. PADM with laser micropores in 1.0 mm distance is the best choice among them.</p>