Overlapping obesity-related glomerulopathy and immunoglobulin A nephropathy: clinical and pathologic characteristics and prognosis

Clinical and Experimental Nephrology - In this study, we investigated the clinical and pathologic characteristics and prognosis of overlapping obesity-related glomerulopathy (ORG) and...     

Surgical Treatment and Proposed Modified Classification for Harrington Class III Periacetabular Metastases

ObjectivesThis study aims to: (i) evaluate the outcome of patients with Harrington class III lesions who were treated according to Harrington classification; (ii) propose a modified surgical classification for Harrington class III lesions; and (iii) assess the efficiency of the proposed modified classification.MethodsThis study composes two phases. During phase 1 (2006 to 2011), the clinical data of 16 patients with Harrington class III lesions who were treated by intralesional excision followed by reconstruction of antegrade/retrograde Steinmann pins/screws with cemented total hip arthroplasty (Harrington/modified Harrington procedure) were retrospectively reviewed and further analyzed synthetically to design a modified surgical classification system. In phase 2 (2013 to 2019), 62 patients with Harrington class III lesions were classified and surgically treated according to our modified classification. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) 93 scoring system. The outcome of local control was described using 2‐year recurrence‐free survival (RFS). Owing to the limited sample size, we considered P < 0.1 as significant.ResultsIn phase 1, the mean surgical time was 273.1 (180 to 390) min and the mean intraoperative hemorrhage was 2425.0 (400.0 to 8000.0) mL, respectively. The mean follow‐up time was 18.5 (2 to 54) months. Recurrence was found in 4 patients and the 2‐year RFS rate was 62.4% (95% confidence interval [CI] 31.6% to 93.2%). The mean postoperative MSTS93 score was 56.5% (20% to 90%). Based on the periacetabular bone destruction, we categorized the lesions into two subgroups: with the bone destruction distal to or around the inferior border of the sacroiliac joint (IIIa) and the bone destruction extended proximal to inferior border of the sacroiliac joint (IIIb). Six patients with IIIb lesions had significant prolonged surgical time (313.3 vs 249.0 min, P = 0.022), massive intraoperative hemorrhage (3533.3 vs 1760.0 mL, P = 0.093), poor functional outcome (46.7% vs 62.3%, P = 0.093), and unfavorable local control (31.3% vs 80.0%, P = 0.037) compared to the 10 patients with IIIa lesions. We then modified the surgical strategy for two subgroup of class III lesions: Harrington/modified Harrington procedure for IIIa lesions and en bloc resection followed by modular hemipelvic endoprosthesis replacement for IIIb lesions. Using the proposed modified surgical classification, 62 patients in the phase 2 study demonstrated improved surgical time (245.3 min, P = 0.086), intraoperative hemorrhage (1466.0 mL, P = 0.092), postoperative MSTS 93 scores (65.3%, P = 0.067), and 2‐year RFS rate (91.3%, P = 0.002) during a mean follow‐up time of 19.9 (1 to 60) months compared to those in the phase 1 study.ConclusionThe Harrington surgical classification is insufficient for class III lesions. We proposed modification of the classification for Harrington class III lesions by adding two subgroups and corresponding surgical strategies according to the involvement of bone destruction. Our proposed modified classification showed significant improvement in functional outcome and local control, along with acceptable surgical complexity in surgical management for Harrington class III lesions.     

The introduction of treatment and the cultural adaptability of western psychotherapies for eating disorders in China

In the past 40 years, the prevalence of eating disorders (ED) in China has shown an increasing trend, leading to an urgent need to develop efficient treatment modes and methods. Since the beginning of the new century, the diagnosis, treatment, and research of ED in China have been under development. This article gives an introduction and commentary on the treatment modes, treatment methods and their applications in ED in China. There are two main treatment forms for ED until now, that is, inpatient treatment and outpatient treatment. Inpatient treatment is recommended as the first choice. Since 2008, clinical psychotherapies such as cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and family-based treatment (FBT), which are effective for pathological symptoms of ED, have been introduced into China and developed clinically. Group CBT and group DBT for patients with ED and group FBT for caregivers might be the most efficient psychotherapy in China nowadays. A multi-family FBT support group could be developed as the basic treatment of ED patients. Although these new types of psychotherapy have observed effectiveness in clinical application, the Randomized Controlled Trials (RCT) are rare and need to be developed.     

二氧化硅法纯化琼脂糖凝胶中的DNA

利用二氧化硅特异地吸附核素的特性，建立了从琼脂糖凝胶中回收ＤＮＡ的方法。结果表明本方法对１３００￣３５００ｂｐ的ＤＮＡ回收效果较好，回收效率达６０％￣７０％，１００￣１５００ｂｐ，３５００￣５０００ｂｐ的ＤＮＡ亦能被有效地回收。通过对回收ＤＮＡ的酶切，连接等实验，证实了所回收的ＤＮＡ片段能够满足进一步的实验要求。该方法简单，快捷，经济，适用，值得推广。     

国人男性椎管的测量与观察

本文对广西出土的113例男性干燥椎骨的椎孔,进行了矢径、横径的测量和形态观察。椎孔的矢、横径在壮族(30例),汉族(57例)间无显著差异(P>0.05)。在C_(3～6)椎骨水平,推管的矢径和形态与脊髓的外形不一致,矢径于该处形成生理性狭窄,以C_4处为最小(12.92mm)。除C_1外,椎管的形态可分为4型:Ⅰ型圆型;Ⅱ型三角型;Ⅲ型过渡型;Ⅳ型不整型。 C_(1,2)椎管的形状为圆型,向下至C_6,通过半圆形逐步过渡到三角形(C_6占81.31％);再向下至T_6,三角形通过蛤形和多边形又逐渐过渡为圆形(T_6占84.76％);再向下至L_5,又通过蛤形逐渐过渡为三角型(L_5占99％)。从L_3至L_5,三角形椎孔有逐步通过钟形向三叶形过渡的趋势。三叶形腰椎管占5.02％。本文结果支持Eisenstein的观点,认为三叶形结构是一种普通的、非病理性的现象,与年龄增长、骨赘或椎孔狭窄无关,这或许是一种正常的发育性变异。     

淋巴因子激活的NK细胞杀伤肿瘤细胞的免疫电镜观察

用胶体金标记的扫描与透射免疫电镜术观察ＣＤ１６＾＋淋巴因子激活的杀伤细胞杀伤肺腺癌细胞系ＬＴＥＰａ２或人红白血病细胞Ｋ５６２的过程。发现ＣＤ１６＾＋ＬＡＫ细胞能伸出分支的指状突起较深地插入肿瘤细胞浆内，造成靶细胞表面大小深浅不等的隐窝，及陷窝内局部细胞膜损伤，在ＣＤ１６＾＋ＬＡＫ细胞这种指状突起基底部附近的浆内，有大量胞浆颗粒与囊泡聚集。靶细胞被攻击后常发生凋落型死亡。同时可见坏死型死亡。说明ＣＤ     

Primary study of iontophoresis of zinc ion in treatment of retinitis pigmentosa

We report here the preliminary effects of zinc iontophoresis in treatment of 26 Rp patients who had decreased zinc serum level or abnormal ratio of serum copper to zinc. Through more than 20 to 30 times of therapy, the vision of 15.38% eyes increased more than "3 lines", 4% eyes increased more than 5 degrees in the visual field, 13.46% eyes improved in dark adaptation threshold (greater than 1.0), the visual functions of the rest eyes were slightly improved or unimproved. The fundus didn't change before & after treatment. There were no changes of ERG in 8 eyes of 4 cases. In addition, the advantages and disadvantages between Zn iontophoresis and Zn compound taken orally, the improvement of vision by direct electric current therapy, the relationship between the metabolism of Zn element and Vit A and influence of Zn over the mechanism of dark adaptation were also briefly discussed.     

石蜡切片中BCL-6抗原失活机制及修复

目的　探讨石蜡切片中BCL 6抗原失活机制及修复的最佳方法 .方法　淋巴组织反应性增生 11例石蜡切片分别用二乙胺四乙酸 (EDTA)、柠檬酸、碳酸钠及去离子水 4种与钙离子结合力不同的修复液 ,结合高压、微波和煮沸 3种不同方法修复后 ,比较检出的BCL 6阳性率及强度 .结果　BCL 6阳性率由高至低依次为 :EDTA 0 .73>柠檬酸 0 .45 (P<0 .0 1) >碳酸钠 0 .12 (P <0 .0 1) ,去离子水组无 1例阳性 .高压修复阳性率 0 .5 5 >微波修复 0 .2 8和煮沸修复 0 .12 (P <0 .0 5 ) .不同修复液与高压结合修复检出BCL 6阳性率及强度 :EDTA与柠檬酸阳性率分别为 1,0 .82 (P >0 .0 5 ) ,高于碳酸钠组 (0 .36 )和去离子水组 (0 ) (P <0 .0 1) .EDTA组强阳性占 0 .82 ,显著高于其他各组 (P <0 .0 1) .结论　EDTA结合高压是修复BCL 6抗原的理想方法 ,钙离子的参与可能是甲醛固定后BCL 6抗原失活的原因之一