Value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and its correlation with the clinicopathological features / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.</p><p><b>METHODS</b>Sixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.</p><p><b>RESULTS</b>Patients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.</p><p><b>CONCLUSION</b>In the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.</p>

Cutaneous and subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei after renal transplantation: a case report / 南方医科大学学报

We report a case of cutaneous and subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei after renal transplantation in Guangdong. A 66-year-old man who had a renal transplantation 6 years ago was admitted in October 2011 for the presence of 16 nodules (0.5-1.5 cm) found on his right middle finger, wrist and forearm for 5 months. Microscopic examination of the purulent exudate showed segmented and branched brown mycelium, and tissue biopsy and PAS staining showed fungal hyphae. The isolate was processed for morphological identification and molecular sequence analysis. A black colony was found after culture of the isolate on SDA at 26 degrees Celsius;, and small culture identified the isolate as Exophiala jeanselmei. ITS sequence analysis of the isolate showed a 100% homology with Exophiala jeanselmei. E-test strip was used in drug sensitivity test, and the isolate was sensitive to amphotericin B, voriconazole, itraconazole and fluconazole, but resistant to 5-flucytosine and caspofungin. Good response was obtained with surgical intervention, local injection and systemic antifungal treatment.

Correlation of the expressions of MMPs-9, TIMP-1 and TIMP-2 with cesarean section scar / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the roles of MMPs-9, TIMP-1 and TIMP-2 in cesarean section scar healing.</p><p><b>METHODS</b>The expressions of the MMPs-9, TIMP-1 and TIMP-2 were detected by EnVision immunohistochemistry in 22 pregnant women with serious complications of the uterine scar, including 8 with early caesarean scar pregnancy (CSP) and 14 with full-term pregnancy undergoing hysterectomy for placenta previa or implanted placenta. Thirty-eight full-term pregnant women without serious complications of the uterine scar and 32 normal full-term pregnant women served as the control I and control II groups, respectively.</p><p><b>RESULTS</b>The expressions of MMPs-9 and TIMP-1 differed significantly between the 3 groups (P<0.05), whereas TIMP-2 did not (P>0.05). Spearman rank correlation analysis showed that the expression of MMPs-9 in the uterine scar tissues was positively correlated with poor uterine scar healing with the correlation coefficients of 0.309 and 0.643. An increased severity of poor healing scar was associated with a significantly increased expression of MMPs-9 (P<0.05).</p><p><b>CONCLUSION</b>The imbalanced expressions of MMPs-9 and TIMP-1 in injury repair can be related to poor uterine scar healing and CSP.</p>

Detect small early colorectal lesions by i-scan endoscopy / 中华消化内镜杂志

Objective To evaluate the efficacy of i-scan endoscopy in detecting small colorectal precancerous lesions.Methods A total of 127 patients were randomized into 2 groups to underwent conventional colonoscopy and i-scan endoscopy respectively.The findings were compared with pathologic examinations.Results A total of 84 lesions were detected by conventional endoscopy in 64 patients,while 147 lesions were found in 63 patients with high resolution detection only,which was increased to 259 with i-scan,including 102 flat lesions.With respect to histology,adenomatous lesions could be predicted with a high sensitivity (80％) and a high specificity ( 100％ ) by i-scan endoscopy.Conclusion More small colorectal lesions can be detected by i-scan endoscopy,which can distinguish neoplasm from non-neoplasm colorectal lesions.

Digital chrome endoscopy and confocai laser endomicroscopy in diagnosis of Barrett esophagus / 中华消化内镜杂志

ObjectiveTo evaluate digital chrome endoscopy (I-Scan) and confocal laser endomicroscopy (CLE) for diagnosis of Barrett esophagus (BE).MethodsFrom July 2010 to July 2011,a total of 878 outpatients who had upper gastrointestinal symptoms underwent routine endoscopy and I-Scan examination,screened patients with suspected Barrett's epithelial were further referred to CLE and endoscopy.The detection rate and image features of BE between routine endoscopy and I-Scan,and the diagnosis of BE between pathology and CLE,were compared respectively.ResultsSuspected BE was diagnosed in 46 patients (5.2％) by routine endoscopy,and in52 (5.9％) by I-Scan,and there was no significant difference in detection rate between 2 methods (x2 =0.533,P ＞ 0.05 ).The detection rate of paliform blood vessels between SCJ and GEJ was higher using I-Scan (35/52,67.3％ ) than routine endoscope (21/46,45.7％,P ＜0.05).A total of 19 suspected BE underwent CLE and biopsy,and BE was diagnosed by CLE with a sensitivity of 93％ and a specificity of 100％.ConclusionI-Scan is capable of identifying paliform blood vessels between SCJ and GEJ,and can improve the detection rate of suspected BE.CLE is able to provide in-vivo histological diagnosis of BE with a high sensitivity and specificity.