Long-term renal outcomes of mesangial proliferative lupus nephritis in Chinese patients

Clinical Rheumatology - This study aimed to explore the long-term outcomes of mesangial proliferative lupus nephritis (LN class II) and the factors associated with its relapse and histological...     

新双源CT双能量成像对泌尿系结石成分定性诊断的价值

目的探讨新双源CT双能量成像分析泌尿系统结石成分的临床价值。方法对45例尿路结石患者行双源CT双能量扫描,分析其结石成分,比较体外红外光谱法分析结石成分的结果,分析双源CT分析各种成分泌尿系结石的特异性与敏感性。结果双源CT能准确区分尿酸结石和非尿酸结石,灵敏度和特异度均为100．00％;磷酸盐结石的诊断灵敏度为93．10％,特异度为92．00％;胱氨酸结石的诊断灵敏度为66．67％,特异度为97．90％;草酸钙结石灵敏度为85．71％,特异度为100．00％。结论新双源CT双能量成像能在治疗前对泌尿系结石的成分进行分析,对结石的治疗及预防具有重要意义。     

弥散峰度成像预测皮质脊髓束周围高级别胶质瘤患者肌力下降

目的 观察弥散峰度成像（DKI）预测皮质脊髓束（CST）周围高级别胶质瘤（HGG）患者肌力下降的价值。方法 纳入21例HGG累及CST走行区及其周围患者,比较患侧及健侧CST DKI定量参数的差异;根据手术前肢体肌力改变情况将患者分为正常组（n=14）及肌力下降组（n=7）,比较组间Karnofsky功能状态（KPS）评分及CST DKI定量参数的差异。绘制受试者工作特征（ROC）曲线,计算曲线下面积（AUC）,评价CST相对定量参数预测患者肌力下降的效能。结果 与健侧比较,患侧纤维束数量、体积、各向异性分数（FA）、平均峰度（MK）、轴向峰度（AK）和径向峰度（RK）均显著降低（P均<0.05）,而平均弥散系数（MD）及径向弥散系数（RD）均显著增高（P均<0.05）。肌力下降组KPS评分、相对FA（rFA）、相对MK（rMK）、相对AK（rAK）及相对RK（rRK）均明显低于正常组（P均<0.05）,而相对MD（rMD）、相对轴向弥散系数（rAD）及相对RD（rRD）均明显高于正常组（P均<0.05）。各相对CST定量参数预测HGG患者肌力下降的效能均较高（AUC均高于0.850）。结论 肌力下降HGG患者肿瘤周围CST的DKI定量参数改变显著;术前DKI可用于预测患者肌力下降,并间接判断CST损伤。     

Terbium doped LiLuF4 nanocrystal scintillator-based flexible composite film for high resolution X-ray imaging

Radiographic screens are widely used in high energy physics, national defense, aviation, radiodynamic therapy and medical imaging due to their scintillation materials that can transform high-energy particles or rays into ultraviolet (UV) visible light or other signals. In recent years, lanthanide doped fluoride nanocrystals (NCs) have attracted much attention due to their excellent optical properties and stability. In this work, multiple lanthanide-doped LiLuF₄ nanocrystal scintillation materials were synthesized by thermal decomposition. Among them, Tb-doped LiLuF₄ nanocrystals have high X-ray sensitivity and low detection limit (36.31 nGy s⁻¹), which is much lower than the requirement of medical imaging dose rate. After the irradiation of 42.29 mGy s⁻¹ X-ray for 1 hour, the intensity of radioluminescence basically remained unchanged. Based on the good properties of our nanocrystals, we further prepared the flexible film of nanocomposites with epoxy resin. This kind of uniform, large area, high loaded flexible film exhibits excellent performance in X-ray imaging with a spatial resolution greater than 20 line pairs per millimeter (LP/mm).

The flexible scintillation film has high X-ray imaging spatial resolution, in which LiLuF₄:15% Tb scintillation nanocrystals have excellent radioluminescence properties and low detection limits.     

Natural foci of tsutsugamushi disease in the Nan Peng Lie Islands in China

目的：近年我国南潮列遍恙虫病率明显增高,而国内并无该地区恙虫病疫源地的记载,为当地人民的健康,本研究对该地区作为恙虫病疫源地进行全面调查与研究。方法：疫源地流行病学调查,病原分离,当地预防措施的制定。结果：该地区为南亚热带岛屿疫源地,主要宿主为褐家鼠,其季节消长与发病一致。主要媒介为地里纤恙螨,褐家鼠带螨率、地里纤恙螨的季节消长与发病均一致。从宿主与媒介分离35株恙虫病立克次体,鉴定7株大部分为Karp株。血清流行病学调查表明该岛居民恙虫病抗体阳性率极高。预防措施应用以后发病率降低。结论：这是第一次成功地证明我国南澎列岛是恙虫病疫源地。     

硒酵母中硒的化学形态分析与评价

 利用Ｔｒｉｓ－缓冲液－甘油提取法对硒酵母的化学形态进行了分析，并与透析法进行比较。结果表明，经过特殊工艺生产的硒酵母虽然总硒含量达到４０００μｇ／ｇ以上，但其中５０％以上的硒为硒蛋氨酸形态的蛋白质或其它大分子态硒，无机态硒仅占３％左右，而游离态硒只占０．０１％。说明硒酵母有广阔的开发前景，同时也为硒制剂提供了适宜的质量监测方法。     

胎儿肝脏21种化学元素含量的动态变化规律及其营养生理学意义

为探索胎儿肝脏化学元素的含量及其动态变化规律和营养生理学意义 ,通过分析 4～ 10月龄胎儿肝脏 2 1个化学元素的含量并与成人比较 ,将 2 1种元素的月平均值与胎儿月龄进行相关分析、分类。结果表明 ,胎儿生长发育过程中肝脏化学元素的含量呈不均匀的非稳定状态且随月龄而变化 ,其变化趋势可区分为与月龄增长呈显著正相关、显著负相关和相关不显著 3类。呈显著正相关元素的含量在胚胎 -胎儿 -新生儿、婴幼儿期由低向高变化 ,表明母体这些元素除供胎儿整体发育所需外 ,仍可使胎儿肝脏中的这类元素含量有所增加 ;呈显著负相关的元素由高向低变化 ,使单位组织质量中元素的含量很快减少 ,增加了组织对这类元素缺乏的敏感性 ;而相关不显著的元素可能不存在营养生理问题     

Clinical–Morphological Features and Outcomes of Lupus Podocytopathy

Background and objectives

Lupus podocytopathy, which is characterized by diffuse foot process effacement without peripheral capillary wall immune deposits and glomerular proliferation, has been described in SLE patients with nephrotic syndrome in case reports and small series. This study aimed to better characterize the incidence, clinical–morphologic features, and outcomes of such patients from a large Chinese cohort.

Design, setting, participants, & measurements

Lupus podocytopathy was identified from 3750 biopsies of SLE patients obtained from 2000 to 2013 that showed mild glomerular histology in patients with a clinical sign of nephrotic syndrome. The biopsy results were divided into three groups: glomerular minimal change, mesangial proliferation, and FSGS.

Results

Fifty (1.33%) cases were identified as lupus podocytopathy and included minimal change in 13 cases, mesangial proliferation in 28 cases, and FSGS in nine cases. Extensive foot process effacement appeared in all the biopsies and mesangial electron-dense deposits were present in 47 biopsies. All patients demonstrated nephrotic syndrome, and the median proteinuria was 5.72 g/24 h (interquartile range [IQR], 3.82, 6.92). Seventeen (34%) cases presented with AKI. Forty-seven (94%) patients achieved remission after immunosuppressive therapy for a median time of 4 weeks (IQR, 2, 8). Compared with the patients with minimal change and mesangial proliferation, patients with FSGS showed significantly higher incidence of AKI and severe tubule–interstitial injury and a much lower complete remission rate. During follow-up of a median of 62 (IQR, 36, 84) months, renal relapses occurred in 28 (59.6%) patients. No patient died or developed ESRD.

Conclusions

The findings from this cohort study suggest that lupus podocytopathy may represent a special entity of lupus nephritis with distinct clinical–morphologic features. The differences in AKI incidence, tubular injury severity, and response to treatment between the patients with minimal change/mesangial proliferation and those with FSGS patterns indicate two different subtypes of lupus podocytopathy.     

硒易感性疾病病区自然演变对硒营养依存性的研究

对我国典型大央节病病区病情和硒营养的关系进行了三年现场监测和调查,结果表明：病情依硒营养水平而变化。随着农村改革开放的深入发展,经济状况有了显改善, 区居民膳食结构发生了明显的改变,外源性高硒食物输入增加,膳食中高硒食物比例不断提高,使食物链的物质循环自由自足的封闭状态向半开放－开放的模式转化,人体硒营养水平相应提高,从而逐渐降低了对原生低硒环境的依赖性,病区因此自然演变为轻或非病区。     

老年性脑卒中急性期并发症

观察258例老年脑卒中病人急性期并发症及其对预后的影响。观察期为发病后一个月内。其中男133例,女125例,脑缺血155例,脑出血103例,分为存活组和死亡组。结果：死亡组神经缺损评分显著大于存活组,并发症发生率中,除酮症和抑郁症外,其余并发症死亡组显著高于存活组,并发症发生频度,死亡组亦显著高于存活组。认为并发症是反映病情轻重和判断预后的一项有效指标。