Incidence and risk factors of acute kidney injury in preterm infants: a multicenter retrospective study / 中国小儿急救医学

Objective:To estimate the incidence and risk factors of acute kidney injury (AKI) in preterm infants, and provide basis for better evaluation and treatment of renal function in preterm infants.Methods:All the hospitalized premature infants who were admitted to three research centers (Department of Neonatology at Beijing Children′s Hospital; Department of Neonatology at Beijing Obstetrics and Gynecology Hospital; Department of Neonatology at Shunyi Maternal and Children′s Hospital of Beijing Children′s Hospital)from January 1, 2017 to June 30, 2019 and had more than two serum creatinine values or urine output were included.The incidence of AKI in preterm infants was calculated and the difference among different gestational weeks was compared.Preterm infants were divided into AKI and non-AKI groups according to AKI diagnostic criteria, and the clinical characteristics between two groups were compared, and the risk factors of AKI in preterm infants were analyzed.Results:A total of 763 premature infants were included in the analysis.Twenty two cases were diagnosed with AKI.The incidence of AKI in premature infants was 2.9%.The incidence of AKI was 33.3% (3/9), 3.7% (5/134), and 2.3% (14/620) in the 24-27 + 6 weeks, 28-31 + 6 weeks, and 32-36 + 6 weeks gestational age, respectively, and the difference was statistically significant ( χ2=31.010, P<0.001). Preterm infants in AKI group had a higher proportion of males(77.3% vs. 53.3%), lower gestational weeks[29(27, 33) weeks vs.31(29, 33)weeks], higher proportions of infants with diabetic mothers(40.9% vs.19.4%), lower Apgar scores at 1 and 5 minutes[8(7, 10) vs.9(8, 10), 9(9, 10) vs.10(9, 10), respectively], higher proportions of invasive and noninvasive respiratory support(45.5% vs.11.3%, 63.6% vs.19.2%, respectively), longer duration of invasive respiratory support[260(136, 742)h vs.72(18, 160)h], longer hospital stays[66(19, 88)d vs.42(26, 58)d], and higher rates of sepsis (27.3% vs. 6.5%), respiratory distress syndrome(40.9% vs. 11.6%), and patent ductus arteriosus that requiring ibuprofen or surgical closure(13.6% vs. 3.0%), diuretic(27.3% vs. 3.9%), and vasoactive drug use (22.7% vs. 3.6%) than those in non-AKI group, and the differences were statistically significant(all P<0.05). Multivariate regression analysis showed that sepsis was an independent risk factor for AKI in preterm infants ( P=0.039, OR=3.498, 95% CI 1.065-11.490) after adjustment of gestational age and birth weight. Conclusion:The incidence of AKI is relatively high in preterm infants with gestational age<28 weeks.Compared with preterm infants without AKI, preterm infants with AKI have smaller gestational weeks and longer hospital stay.Sepsis is an independent risk factor for AKI in preterm infants.

Expression of microRNA-21 in multiple myeloma patients and its clinical significances / 白血病·淋巴瘤

Objective:To investigate the expression of miRNA-21 in serum of patients with multiple myeloma (MM) and its significance.Methods:The data of 55 MM patients and 20 healthy controls in the Second Hospital of Hebei Medical University from July 2019 to June 2020 were retrospectively analyzed. Among the MM patients, 20 cases were diagnosed without treatment, 15 cases were in complete remission (CR), and 20 cases were clinically relapsed. Blood samples were collected from all subjects, and the relative expression levels of miRNA-21 were detected by real-time quantitative polymerase chain reaction (qRT-PCR), and the correlation of miRNA-21 expression with β 2-macroglobulin (β 2-MG), creatinine, hemoglobin, albumin, t(4;14) mutation, 13q14 mutation and prognosis were analyzed. The MM cell line LP-1 was selected, and normal bone marrow CD138-positive plasma cells were sorted by immunomagnetic beads as control cells. The relative expression levels of miRNA-21 in the two groups of cells were detected by qRT-PCR. Results:The serum relative expression level of miRNA-21 in MM group was higher than that in healthy control group (1.50±0.10 vs. 1.03±0.06, t = 7.04, P = 0.002). The serum expressions of miRNA-21 in newly diagnosed untreated MM patients and relapsed/refractory MM patients were high (1.50±0.10 and 3.13±0.32), and compared with the healthy control group, the differences were statistically significant ( t values were 7.04 and 10.22, both P < 0.05). The relative expression level of miRNA-21 in MM patients with complete remission (CR) was 1.27±0.25, which had no significant difference compared with the healthy control group ( t = 1.76, P = 0.152). The serum expression level of miRNA-21 in MM patients with high β 2-MG, high creatinine, low hemoglobin, low albumin, t(4;14) mutation, 13q14 mutation, non-remission and recurrence was significantly increased (all P < 0.05). The relative expression level of miRNA-21 in LP-1 cell line was higher than that in control cells (1.56±0.05 vs. 1.00±0.06), and the difference was statistically significant ( t = 11.73, P < 0.01). Conclusions:The miRNA-21 may be a molecular marker to assist in the diagnosis and efficacy evaluation of MM.

Analysis of metabolites of rocuronium bromide in human bile and the study of transmembrane transport mechanism / 药学学报

Rocuronium bromide is an acetylcholine N2 receptor antagonist, which can be used as an auxiliary drug for general anesthesia. It has been reported that rocuronium has two possible metabolic pathways: N-dealkylation and O-deacetylation, which are mainly taken up by liver and excreted by bile in the form of primary drugs. In this paper, the metabolites of rocuronium in human bile were detected by UHPLC-QE-orbitrap-MS, thirteen metabolites were detected, including eleven phase I metabolites and two phase II metabolites, eleven of which had not been previously reported. At the same time, HEK293 cells overexpressing transporter were used to explore the transmembrane transport mechanism of rocuronium, the results showed that rocuronium was the substrate of MATE1, OCT1, OATP1B1 and OATP1B3. The above research results enrich the metabolic pathway of rocuronium in vivo, and put forward the possible transport mechanism of liver uptake and bile excretion, which can better guide the accurate and safe clinical drug application. The collection of human bile samples in this study was approved by the ethics committee of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (Approval Number: 2019-775-130-01).

Chemical constituents of Scrophulariae Radix and their antitumor activities in vitro / 中国中药杂志

The present study investigated the chemical constituents of Scrophulariae Radix and their antitumor activities in vitro. The compounds in the ethyl acetate extract were separated and purified by conventional column chromatographies(such as silica gel, Sephadex LH-20, and ODS column) and semi-preparative high-performance liquid chromatography(HPLC), and their structures were identified by various spectral techniques such as nuclear magnetic resonance(NMR) and mass spectrometry(MS). Twenty-three compounds were isolated and identified as benzyl-β-D-(3',6'-di-O-acetyl) glucoside(1), 5-O-p-methoxybenzoyl kojic acid(2), 5-O-methoxybenzoyl kojic acid(3), 7-O-methylbenzoyl kojic acid(4), 5-O-benzoyl kojic acid(5), methyl ferulate ethyl ether(6), trans-ferulic acid(7), trans-isoferulic acid(8), trans-caffeic acid(9), trans-caffeic acid methyl ester(10), caffeic acid ethyl ester(11), trans-cinnamic acid(12), trans-p-methoxycinnamic acid(13), trans-p-hydroxycinnamic acid(14), trans-p-hydroxycinnamic acid methyl ester(15), 2-(3,4-dihydroxyphenethyl) alcohol(16),(p-hydroxyphenyl) propanoic acid(17), coniferaldehyde(18), sinapaldehyde(19), benzyl β-primeveroside(20), 5-(hydroxymethyl) furfural(21), furan-2-carboxylic acid(22), and decanedioic acid(23). Among them, compound 1 is a new benzyl glucoside, compounds 2-4 are new pyranone compounds, compound 5 is a new natural product of pyranone. The NMR data of compounds 5 and 6 are reported for the first time. Compounds 6 and 20 were isolated from the Scrophularia plant for the first time. Compounds 8, 11, 14, 16, 18, 19, 22, and 23 were isolated from this plant for the first time. The in vitro cytotoxic activities of these compounds against three tumor cell lines(HepG2, A549, and 4 T1) were evaluated. The results showed that compounds 10 and 15 showed cytotoxic activities against HepG2 cells with IC_(50) values of(19.46±0.48) μmol·L~(-1) and(46.10±1.21) μmol·L~(-1).

Progress of three-dimensional multimodal ultrasound in the evaluation of neoadjuvant chemotherapy for breast cancer / 中国医师杂志

In recent years, the incidence rate of breast cancer has increased year by year, and gradually tends to be younger. Neoadjuvant chemotherapy (NACT) has become the standard treatment for locally advanced breast cancer (LABC). Therefore, it is of great clinical significance to evaluate the efficacy of neoadjuvant chemotherapy in early and effective manner. Multimodal ultrasound plays an important role in evaluating the response of neoadjuvant chemotherapy. This article will review the recent research progress of three-dimensional multimodal ultrasound in the evaluation of neoadjuvant chemotherapy for breast cancer .

Changes of serum 25 hydroxyvitamin D 3 expression in diabetic patients and its correlation with macrovascular complications / 中国医师进修杂志

Objective:To analyze the changes of serum 25-hydroxyvitamin D 3[25-(OH)D 3] expression in diabetic patients and its correlation with macrovascular complications. Methods:Two hundreddiabetic patients admitted to Cangzhou Central Hospital from February 2018 to November 2019 were divided into macrovascular complications group (87 cases) and without macrovascular complicationsgroup (113 cases). According to the degree of 25-(OH)D 3 deficiency, 32 cases were divided into 25-(OH)D 3 normal group, 94 cases were mild deficiency group and 74 cases were moderate and severe deficiency group. At the same time, 168 outpatients were selected as control group. The levels of serum 25-(OH)D 3 were compared between diabetic group and control group, macrovascular complications group and without macrovascular complications group, and the correlation between the level of serum 25-(OH)D 3 and carotid intima-media thickness (IMT) was analyzed. Results:The level of serum 25-(OH)D 3 in diabetic group was lower than that in control group: (24.79 ± 3.02) μg/L vs. (39.18 ± 4.38) μg/L, the difference was statistically significant ( P<0.05). The level ofserum 25-(OH)D 3 in diabetic patients with macrovascular complications group was lower than that in without macrovascular complications group: (21.08 ± 2.64) μg/L vs. (27.65 ± 3.31) μg/L; while the IMT was higher than that without macrovascular complications group: (1.29 ± 0.13) mm vs. (0.93 ± 0.10) mm, the differences were statistically significant ( P<0.05). The incidence of macrovascular complications in 25-(OH)D 3 moderate and severe deficiency group was higher than that in 25-(OH)D 3 mild deficiency group and 25-(OH)D 3 normal group: 60.81%(45/74) vs. 40.43%(38/94), 12.50%(4/32), the difference was statistically significant ( χ2 = 21.896, P<0.05). The level of serum 25-(OH)D 3 in patients with diabetic macrovascular complications was negatively correlated with IMT ( r = -0.513, P<0.05). Conclusions:The level of serum 25-(OH)D 3 in diabetic patients is decreased, and the change of its concentration is related to the occurrence of macrovascular complications.

Construction of "2R network pharmacology" research method for effective components of traditional Chinese medicine based on "prediction of dominant components-screening of potential targets" / 中国中药杂志

Chinese traditional medicine compound is the main form of Chinese medicine clinical application. The elucidation of the effective components of traditional Chinese medicine is one of the key scientific issues to promote the modernization of traditional Chinese medicine. At present, there are many research ideas on the effective components of traditional Chinese medicine compounds. By analyzing the current status and existing problems of existing research ideas, the author proposes a "double reduction network pharmacology"(2 R network pharmacology) research method based on "prediction of dominant components-potential target selection". Chemical components with good properties were selected by ADMET property prediction technology, and compared with the blood components and target organ components to determine the dominant components with potential therapeutic effect, that is "reducing constituents"; the potential core regulatory pathway of traditional Chinese medicine compound was enriched by RNA-Seq technology combined with network database, and then the target of traditional Chinese medicine compound was mined based on the signal pathway, that is "reducing targets". To improve the efficiency and accuracy of effective component screening, the network relationship of "component target" was established by the related technology of network pharmacology. The purpose of this study is to provide practical research ideas and methods for clarifying the effective components of traditional Chinese medicine, revealing the law of compatibility of traditional Chinese medicine and clarifying the target of drug action.

Recognition and treatment of adrenal crisis complicated with nephrotic syndrome in children / 中国小儿急救医学

Up to 60% of children with nephrotic syndrome may occur secondary adrenal insufficiency, and even adrenal crisis.Adrenal crisis is one of the serious complications of nephrotic syndrome in children.The mortality rate is high and it seriously threatens the life.Adrenal crisis is often lack of specific manifestations, and usually begin with gastrointestinal symptoms, accompanied by circulatory dehydration, neuropsychiatric symptoms, hyponatremia, hyperkalemia and hypoglycemia.Glucocorticoid replacement therapy is important.Active prevention can reduce the incidence of crisis and improve prognosis.

Prediction of Disintegration Time of Traditional Chinese Medicine Tablets Based on Generalized Regression Neural Network / 中国实验方剂学杂志

Objective:This paper constructs a generalized regression neural network （GRNN） model to predict the disintegration time of traditional Chinese medicine （TCM） tablets. Method:Taking Astragali Radix as a model drug， the mixed Astragali Radix powders with different powder properties were prepared by mixing Astragali Radix extract powders with microcrystalline cellulose and lactose， which were made to Astragali Radix tablets by direct compression method. The powder properties of mixed Astragali Radix powders and the disintegration time of Astragali Radix tablets were determined， respectively. The correlation between the original data was eliminated by principal component analysis （PCA）. The principal component factors were used as the input layer of the GRNN model， and the disintegration time was used as the output layer for network training. Finally， the verification group data was used to predict the disintegration time， and the network prediction accuracy was calculated by comparing with the actual value. Result:Three principal component factors were obtained through PCA by analyzing the original nine variables that were correlated with each other （Hausner ratio， true density， tap density， compression degree， angle of repose， bulk density， porosity， water content and total dissolved solids）， which reduced the complexity of the network. The prediction value of the disintegration time based on this prediction method was in good agreement with the actual value， the error of disintegration time was 0.01-1.34 min and the average relative error was 3.16%. Conclusion:Based on the GRNN mathematical model， the physical properties of Astragali Radix extract powders can be used to accurately predict the disintegration time of Astragali Radix tablets， which provides a reference for studying the disintegration time of TCM tablets.

Optimization of Lumbar Oblique-Pulling Manipulation Based on Multi-Rigid Body Mechanical Model / 医用生物力学

Objective Comprehensively considering the effectiveness and safety of massage, a method for evaluating the pros and cons of oscillation excitation and pulse excitation for lumbar oblique-pulling manipulation was proposed, and lumbar oblique-pulling manipulation under oscillation excitation was optimized. Methods A multi-rigid body biomechanical model of thoracolumbar spine was established. The manipulation force was used as the input force of the model. Using MATLAB/Simulink, variation of the displacement and acceleration of each lumbar segment with time was simulated. For the optimization of lumbar massage manipulation, the core elements of massage force, namely, frequency (f) and operand (n) were changed, and then the maximum relative displacement and maximum acceleration of each lumbar segment were compared. A new index z was proposed to comprehensively evaluate effectiveness and safety of the manipulation. Results The maximum relative displacement of each lumbar segment was almost equal when lumbar oblique-pulling manipulation under two kinds of excitation was applied. For lumbar oblique-pulling manipulation, the maximum acceleration of each lumbar segment under oscillation excitation was significantly smaller than that under pulse excitation. When the frequency of massage was 1-2.5 Hz, the overall effect of massage was better, and the overall effect had no relation with the operands, and the force of massage lasted for one operand; when the frequency of message was 3.33 Hz and the operands were more than 5, the massage had the best effect, meanwhile the strength of each lumbar segment was relatively large; when the frequency of massage exceeded 5 Hz, and the overall performance of massage was not good. Conclusions Lumbar oblique-pulling manipulation under oscillation excitation is safer than that under pulse excitation. The research findings provide doctors with a reasonable range of operating parameters for lumbar oblique-pulling manipulation under pulse excitation.

Association between different paths of diabetic progression and dyslipidemia among adults aged 18 years and above in Nanjing / 中华健康管理学杂志

Objective:To explore the association between different paths of diabetic progression and dyslipidemia in a Nanjing adult population.Methods:From January 2017 to June 2018, 61, 098 local residents aged ≥18 years were selected from the Chronic Disease and Risk Factor Surveillance database in Nanjing using a five-stage stratified cluster random sampling method. Data were collected through interview surveys, physical measurements, and laboratory examinations. The relationship between different rates of diabetic progression and dyslipidemia was analyzed using complex weighting and multilevel models.Results:In all, 60, 283 participants were finally enrolled in the study. The weighted proportions of normal glucose regulation, pre-diabetes, and diabetes were 71.2%, 17.9%, and 10.9%, respectively. The overall weighted prevalence, awareness, treatment, and control of dyslipidemia were 29.8%, 41.6%, 28.9%, and 22.9%, respectively. The weighted proportion of patients with dyslipidemia combined with diabetes was 52.9%. The weighted prevalence of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 24.0%, 38.8%, and 52.9%, respectively (all P<0.001). Compared to the normal glucose regulation group, subjects with pre-diabetes ( OR = 2.04, 95% CI: 1.95-2.13) or diabetes ( OR= 3.87, 95% CI: 3.66-4.10) had possibly gradually increased risks of dyslipidemia (all P<0.001). In addition, there was an increasing trend toward awareness, treatment, and control of dyslipidemia with increasing levels of glucose (all P<0.001). The weighted awareness of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 36.3%, 42.8%, and 56.2%, respectively; the corresponding rates of treatment and control were 23.7%, 29.2%, and 43.7%, and 20.4%, 22.6%, and 30.1%, respectively. Conclusion:Diabetes and dyslipidemia have become the main chronic diseases in the Nanjing population.

Identification of Gastrodiae Rhizoma chromatographic peaks identification by liner calibration with two reference substances assisted / 药学学报

This study aimed to establish a method for positioning six chromatographic peaks occurred in HPLC profile of Gastrodiae Rhizoma. The "liner calibration with two reference substances" (LCTRS) method was used to calculate the retention time so as to assist in positioning of chromatographic peaks in terms of the prediction accuracy of retention time and the coincidence rate of chromatographic column. A total of 24 C18 chromatographic columns from different brands and types available were used to determine the retention times of six components in Gastrodiae Rhizoma, then the average retention time of each component was obtained as standard retention time (SRT). Parishin E (peak 3) and Parishin A (peak 6) were simultaneously taken as reference substance to forecast the retention time of the other four components by using the LCTRS method. Four different C18 columns were employed to verify the method. Meanwhile, for the purpose of comparison, the relative retention time (RRT) method was applied to forecast the retention time, by using Parishin E as the single reference substance. The comparison between LCTRS and RRT methods indicated that the former was more accurate in predicting the retention time and more applicable in utilization of chromatographic columns. This study demonstrated that the LCTRS method shows the superior performance in positioning of chromatographic peak, and therefore has a good prospect of application.

Full understanding the importance of scleral buckling surgery and improving the success rate of retinal detachment surgery / 中华眼底病杂志

Scleral buckling surgery is a main surgical method for rhegmatogenous retinal detachment, and it is the basic skill of retinal surgeons. As a kind of classic treatment, retinal surgeons must recognize and understand the essence and connotation of scleral buckling surgery, master and apply skillfully, improve the success rate of rhegmatogenous retinal detachment, and use the minimum amount of surgical combination to achieve anatomical retinal reattachment and restore visual function as much as possible.

Effects of isoprenylcysteine carboxylmethyltransferase silencing on the migration and invasion of tongue squamous cell carcinoma / 华西口腔医学杂志

OBJECTIVES@#The effect of isoprenylcysteine carboxymethyltransferase (ICMT) silencing on the migration and invasion of tongue squamous cell carcinoma was investigated by constructing the small interfering RNA (siRNA) of ICMT.@*METHODS@#Through liposomal transfection, siRNA was transfected into human tongue squamous cell carcinoma CAL-27 and SCC-4 cells (ICMT-siRNA group) with a negative control group (transfected with NC-siRNA) and a blank control group (transfected with a transfection reagent but not with siRNA). Quantitative real-time polymerase chain reaction was performed to analyze the mRNA expression of ICMT and RhoA in each group of cells after transfection and to measure the silencing efficiency. Western blot was applied to examine the expression levels of ICMT, total RhoA, membrane RhoA, ROCK1, matrix metalloproteinase (MMP)-2, and MMP-9 proteins in each group. The migration and invasion abilities were evaluated via wound healing and Transwell motility assays.@*RESULTS@#After CAL-27 and SCC-4 cells were transfected with ICMT-siRNA, the expression levels of ICMT genes and proteins decreased significantly in the experimental group compared with those in the negative and blank control groups (@*CONCLUSIONS@#The migration and invasion abilities of CAL-27 and SCC-4 cells were reduced significantly after the transfection of ICMT-siRNA, and the involved mechanism might be related to the RhoA-ROCK signaling pathway.

Effects of isoprenylcysteine carboxyl methyltransferase silencing on the proliferation and apoptosis of tongue squamous cell carcinoma / 华西口腔医学杂志

OBJECTIVES@#This study aimed to explore the effects of silencing isoprenylcysteine carboxyl methyltransfe-rase (Icmt) through small interfering RNA (siRNA) interference on the proliferation and apoptosis of tongue squamous cell carcinoma (TSCC).@*METHODS@#Three siRNA were designed and constructed for the Icmt gene sequence and were then transfected into TSCC cells CAL-27 and SCC-4 to silence Icmt expression. The tested cells were divided as follows: RNA interference groups Icmt-siRNA-1, Icmt-siRNA-2, and Icmt-siRNA-3, negative control group, and blank control group. The transfection efficiency of siRNA was detected by the fluorescent group Cy3-labeled siRNA, and the expression of Icmt mRNA was screened by quantitive real-time polymerase chain reaction (qRT-PCR) selected the experimental group for subsequent experiments. The expression of Icmt, RhoA, Cyclin D1, p21, extracellular regulated protein kinases (ERK), and phospho-extracellular regulated protein kinases (p-ERK) were analyzed by Western blot. The proliferation abilities of TSCC cells were determined by cell counting kit-8 assay. The change in apoptosis was detected by AnnexinV-APC/propidium staining (PI) assay. Cell-cycle analysis was conducted by flow cytometry.@*RESULTS@#The expression of Icmt mRNA and protein in TSCC cells significantly decreased after Icmt-siRNA transfection (@*CONCLUSIONS@#Silencing Icmt can effectively downregulate its expression in TSCC cells, reduce the RhoA membrane targeting localization and cell proliferation, and induce apoptosis. Thus, Icmt may be a potential gene therapy target for TSCC.

Study on the action mechanism of Wuling Powder on treating osteoporosis based on network pharmacology / 中国天然药物

Osteoporosis is a health problem to cause global concern. A lot of methods have been used to prevent and treat osteoporosis, but there is still a lack of effective treatment for osteoporosis owing to limited understanding of its mechanism. Therefore, the aim of this present study is to explore the underlying mechanism of Wuling Powder, a traditional Chinese medicine on treating osteoporosis. In this study, we firstly screened and identified the common targets between Wuling Powder and osteoporosis through the related databases, and then explored the relationships among these targets, Wuling Powder and osteoporosis by using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and network analyses. Subsequently, the molecular docking was performed by using systemsDock to evaluate the potential binding relationships between the active components of Wuling Powder and their related targets. The results showed that in total of 14 common targets including CREBBP, ADAM17, GOT1, GAPDH, USP8, ERBB2, EEF1A1, MTOR, RAC1, ETS1, DDX58, GCK, EGF and S100A8 were screened. EGF, ERBB2, MTOR and HIF-1 were the potential therapeutic targets for osteoporosis, and they were also the related targets for predicting active components in Wuling Powder. Taken together, we concluded that Wuling Powder might be used to treat osteoporosis through above these targets.

Value of Oxford classification and ISKDC classification in the prognosis of children with Henoch-Schönlein purpura nephritis / 中华肾脏病杂志

Objective@#To analyze the Oxford classification (MESTC) and the International Study of Kidney Disease in Children (ISKDC) classification for evaluating the clinical manifestations, histological lesion and short-term prognosis of children with Henoch-Schönlein purpura nephritis (HSPN).@*Methods@#According to the Oxford classification and ISKDC classification, the histological lesions of children with HSPN diagnosed by renal biopsy from Beijing Children's Hospital affiliated to Capital Medical University from January 2018 to December 2018 were re-evaluated. The renal biopsy specimens of the selected subjects were scored according to the Oxford classification and the ISKDC classification. According to whether the first symptom was combined with renal performance, MESTC score and ISKDC classification, children were grouped. The differences in clinicopathological manifestations between the groups were compared. Correlation between MESTC and ISKDC grades was analyzed by nonparametric test rank correlation. Kaplan-Meier survival curve and Log-rank test were used to compare the difference of proteinuria remission rate between the two groups. Univariate and multivariate Cox regression equations were used to analyze the influencing factors of the proteinuria remission rate.@*Results@#A total of 78 children with HSPN were enrolled. There were 37 male patients (47.4%) with age of (10.4±2.9) years. When the patients were divided according to MESTC scores and ISKDC classification, the results showed that the proportion of children with nephrotic-range proteinuria in the group of endocapillary hypercellularity (E1, P=0.008), segmental glomerulosclerosis (S1, P=0.015) and ISKDCⅢ(P=0.041) was higher than that of E0, S0 and ISKDCⅡ groups. The proportion of children with E1 (P=0.015), crescents (C1&C2, P=0.025) or ISKDCⅢ(P=0.017) that had been treated with high-dose methylprednisolone was higher. The result of Kaplan-Meier survival curve showed more difficult for proteinuria remission in children with C2 are than C0&C1 group (P=0.026), while no difference were found when children were grouped by M, E, S, T and ISKDC. Multivariate Cox regression analysis showed that the C2 (HR=0.143, 95%CI 0.020-1.046, P=0.055) might be a risk factor for proteinuria remission, while the P value was close to 0.05.@*Conclusions@#Children with HSPN scored as ISKDCⅢ, E1 and S1 are more likely to show nephrotic-range proteinuria. C2 may indicate that patients are more difficult to achieve proteinuria remission.

Assisting technical development in closed reduction for distal femoral fractures / 中华骨科杂志

Distal femoral fracture is one of the difficult fractures to treat due to the complex types and varies complications after operation. The concept about closed reduction to deal with fracture has been accepted widely with the innovation of surgical technology and internal fixation. Some tissue, including joint capsule, ligaments, muscles and tendons, surround femoral condyle, which indicates they may tract the fractured bone to deformity. In addition, the difficulty of reduction during operation may be increased with combined other injuries. At present, the idea of using different methods to reduce the re-injury before the closed reduction of distal femoral fracture has been recognized and popularized. A kind of appropriate reduction and internal fixation can not only reduce the difficulty of operation but also shorten the operation duration and reduce the incidence of postoperative complications. In addition to the common reduction method of manual reduction, plate can not only be taken as internal fixation, but also achieve reduction reviewing literatures about the methods of reduction in recent years. However, it is not suitable for some complex fractures. The traction table is not widely used at present due to varies complications. Distractors like AO distractor or other kinds of femoral distractors can achieve reduction by providing reverse force. However, it should be noticed that some risk factors such as vascular and nerve injury can occur during the surgery. The present study summarized different ways that were adopted during the closed reduction and internal fixation of distal femoral fractures. The appropriate method chose by surgeons to improve the efficiency and reduce risks should be used based on the need of surgery.

The value of ABVS in evaluating the response of neoadjuvant chemotherapy for different molecular subtypes of breast cancer / 中国医师杂志

Objective:To explore the value of Automated Breast Volume Scanner (ABVS) in evaluating the response of neoadjuvant chemotherapy(NACT) for different molecular subtypes of breast cancer.Methods:Based on immunohistochemical technique, breast cancer was divided into three molecular subtypes according to the negative or positive results of estrogen receptor (ER), progesterone receptor (PR) and proto oncogene human epidermal growth factor receptor 2 (HER2), namely luminal group [ER(+ ) or PR(+ ), and HER2(-/+ )], triple-negative group [ER(-), PR(-) and HER2(-)], HER2 group [ER(-), PR(-)and HER2(+ )]. ABVS was used to analyze the changes of tumor size related parameters in 78 breast cancer patients with three subtypes during NACT.Results:After NACT, the size , area and volume of primary lesion diminished obviously ( P<0.05). 19 cases achieved complete response and 40 cases achieved partial response according to response evaluation criteria in solid tumors (RECIST). After the end of the second cycle of NACT, the primary tumor shrank significantly in HER2 group, and luminal and tri-negative groups were significantly reduced after the end of the third cycle. Conclusions:ABVS has a good value in evaluating the efficacy for different molecular substypes of NACT in breast cancer.

Early intervention with Di-Dang Decoction prevents macrovascular fibrosis in diabetic rats by regulating the TGF-β1/Smad signalling pathway / 中国天然药物

Macroangiopathy is a complication of Type II Diabetes Mellitus (T2DM), which is mainly caused by fibrosis of blood vessels. Using T2DM rat models, we investigated whether the traditional Chinese medicine, Di-Dang Decoction (DDD), exhibited anti-fibrotic actions on great vessels. T2DM rats were randomly divided into non-intervention group, early-, middle-, late-stage DDD intervention groups and control groups, including pioglitazone group and aminoguanidine group. After administration of DDD to T2DM rats at different times, we detected the amount of extracellular matrix (ECM) deposition in the thoracic aorta. The results showed that early-stage intervention with DDD could effectively protect great vessels from ECM deposition. Considering that TGF-β1 is the master regulator of fibrosis, we further validated at the molecular level that, compared to middle- and late-stage intervention with DDD, early-stage intervention with DDD could significantly decrease the expression levels of factors related to the activated TGF-β1/Smad signalling pathway, as well as the expression levels of downstream effectors including CTGF, MMP and TIMP family proteins, which were directly involved in ECM remodelling. Therefore, early-stage intervention with DDD can reduce macrovascular fibrosis and prevent diabetic macroangiopathy.