Dynamic response of honeycomb-FGS shells subjected to the dynamic loading using non-polynomial higher-order IGA

The main goal of this study is to use higher-order isogeometric analysis(IGA)to study the dynamic response of sandwich shells with an auxetic honeycomb core and two different functionally graded materials(FGM)skin layers(namely honeycomb-FGS shells)subjected to dynamic loading.Touratier's non-polynomial higher-order shear deformation theory(HSDT)is used due to its simplicity and performance.The governing equation is derived from Hamilton's principle.After verifying the present approach,the effect of input parameters on the dynamic response of honeycomb-FGS shells is carried out in detail.

Modeling Geometrically Nonlinear FG Plates: A Fast and Accurate Alternative to IGA Method Based on Deep Learning

Isogeometric analysis (IGA) is known to showadvanced features compared to traditional finite element approaches.Using IGA one may accurately obtain the geometrically nonlinear bending behavior of plates with functionalgrading (FG). However, the procedure is usually complex and often is time-consuming. We thus put forward adeep learning method to model the geometrically nonlinear bending behavior of FG plates, bypassing the complexIGA simulation process. A long bidirectional short-term memory (BLSTM) recurrent neural network is trainedusing the load and gradient index as inputs and the displacement responses as outputs. The nonlinear relationshipbetween the outputs and the inputs is constructed usingmachine learning so that the displacements can be directlyestimated by the deep learning network. To provide enough training data, we use S-FSDT Von-Karman IGA andobtain the displacement responses for different loads and gradient indexes. Results show that the recognition erroris low, and demonstrate the feasibility of deep learning technique as a fast and accurate alternative to IGA formodeling the geometrically nonlinear bending behavior of FG plates.

Efficiency and safety of Tripterygium Wilfordii Hook F for IgA nephropathy: an update systematic review and meta-analysis

Background:Immunoglobulin A Nephropathy(IgAN)currently stands as the most prevalent primary chronic glomerular disease worldwide.The latest guidelines recommend the application of renin-angiotensin system inhibitors(RASi)in conjunction with corticosteroids for the treatment of IgAN patients exhibiting persistent proteinuria of≥1 g/d.However,numerous randomized controlled trials(RCTs)have revealed a heightened risk of adverse events associated with corticosteroid treatment.Multi-glycoside of Tripterygium wilfordii Hook.f.(GTW),a traditional Chinese medicine(TCM),has been employed in the treatment of Chronic Kidney Disease(CKD)for an extensive period.Recent years have witnessed an increasing number of RCTs providing evidence supporting the effectiveness of GTW therapy in IgAN.Despite this,there remains a paucity of systematic reviews on the application of GTW therapy for IgAN.Consequently,this study undertakes a systematic review to assess the clinical efficacy and safety of GTW therapy,aiming to elucidate the role of GTW therapy in the treatment of IgAN.Methods:To collect relative information of randomized controlled trials(RCTs)of GTW in the treatment of IgAN,we searched for theses and dissertations publicized before April 10,2023,in PubMed,Embase,the Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data knowledge service platform(Wanfang Data),Chinese Scientific Journal Database(VIP),and Clinical Trial.The language limitation is English and Chinese.Independently,two reviewers performed literature screening,data extraction,and quality evaluation,and the meta-analysis was carried out with RevMan 5.4 and StataSE 15.0 software.Results:21 RCTs involving 1,405 Chinese patients were included.Compared to ACEI/ARB alone or in combination,GTW with RASi or alone reduced 24 h-Upro,ALB,Scr,GFR,BUN,CD4+,VEGF,ET-1,and improved clinical efficacy.However,no associations were found for TC,Ccr,and adverse events due to limited literature.Conclusion:This study highlights that Multi-glycoside of Tripterygium wilfordii Hook.f.(GTW)exhibits potential in safeguarding renal function and preserving the integrity of the basement membrane in patients with Immunoglobulin A Nephropathy(IgAN).Consequently,GTW emerges as a promising therapeutic option for individuals with IgAN.Nevertheless,it is crucial to acknowledge the limitations stemming from insufficient methodology and a small sample size,which currently obscure the relationships between certain clinical variables,such as total cholesterol(TC)and creatinine clearance(Ccr).Therefore,the substantiation of our findings necessitates more rigorous and expansive trials to enhance the robustness and generalizability of the results.

Efficacy of activating blood and resolving stasis therapy for IgA nephropathy:a systematic review and meta-analysis

Background:To systematically evaluate the efficacy and safety of activating blood and resolving stasis in patients with IgA nephropathy.Methods:From inception to May 2022,databases including PubMed,Embase,the Cochrane Library,Web of Science,WanFang database,Chinese Biomedical Database,VIP,and China National Knowledge Infrastructure were searched for randomized controlled trials about enhancing blood circulation and removing stasis for IgA nephropathy.For the articles that satisfied the requirements,quality assessment and meta-analysis were done.Results:Seventeen randomized controlled trials with a total of 1653 patients were included.Meta-analysis showed that activating blood and resolving stasis could increase therapeutic effectiveness(risk ratio(RR)=-0.47,95%confidence interval(CI)(-0.37,-0.2),P=0.0006)and decrease levels of serum creatinine(RR=-0.47,95%CI(-0.37,-0.2),P=0.0006),urea nitrogen(RR=0.85,95%CI(1.44,0.26),P=0.005),24-hour urinary protein quantification(RR=1.6,95%CI(2.44,0.95).P=0.00001),and urine red blood cell count(RR=1.7,95%CI(2.57,0.82),P=0.0001).There was no significant difference between the two groups in terms of security(RR=0.6,95%CI(0.36,1.01),P=0.05).Conclusion:Western medicine combined activating blood and resolving stasis is more efficient than Western medicine therapy alone in treating IgA nephropathy,but it still needs to be supported by additional large-scale,multi-center randomized controlled clinical trials due to the poor quality of the included trials.

猪初乳中PEDV IgA抗体捕获ELISA检测方法的建立及其初步应用

为建立评价猪流行性腹泻病毒(PEDV)疫苗免疫效力的方法,本研究利用纯化的PEDV免疫BALB/c小鼠,按照常规方法制备PEDV全病毒单克隆抗体(MAb)作为捕获抗体,PEDV细胞培养上清为夹心抗原,HRP标记的羊抗猪IgA为二抗,采用棋盘滴定法对各反应条件优化后建立了用于猪初乳中PEDV IgA检测的捕获ELISA方法,并确定其临界值为0.25。采用该捕获ELISA对PEDV、PCV2b、PRRSV、PRV、JEV、PPV、FMDV与CSFV IgA抗体阳性猪初乳进行检测,结果显示,除PEDV IgA抗体阳性猪初乳检测结果为阳性外,其他病毒抗体阳性猪初乳检测结果均为阴性,表明该方法特异性强。采用该方法和BIONOTE PEDV IgA试剂盒对从1∶10开始2倍倍比稀释的16个稀释度的阳性猪初乳样品检测,结果显示该方法对阳性样品检测的最大稀释度为1∶40960,是BIONOTE PEDV IgA试剂盒敏感性的16倍(1∶2560),表明本研究建立方法的敏感性高。分别采用同一批次和不同批次制备的MAb包被的ELISA板分别检测5份PEDV IgA抗体阳性和1份PEDV IgA抗体阴性猪初乳,评估该方法的重复性。结果显示,批内和批间重复性试验的变异系数分别为0.34%~4.49%和1.90%~8.71%,均小于10%,重复性好。利用该捕获ELSIA和IDEXX PEDV IgA抗体试剂盒分别对50份猪初乳检测,结果显示两种方法对样品检测的OD450nm值趋势高度一致,表明该方法检测结果与IDEXX试剂盒相关性强。利用该捕获ELISA和BIONOTE PEDV IgA试剂盒对100份临床采集的猪初乳样品检测,结果显示二者总体符合率为97.0%。利用该方法对90份免疫背景不同的猪初乳检测,结果显示,未感染PEDV且未免疫PED疫苗的母猪初乳检测结果均为阴性结果,感染了PEDV或接种过PED疫苗的母猪初乳均为阳性结果,检测结果与样品的免疫背景相符。本研究建立的捕获ELISA方法特异性强、敏感性高、重复性好,与同类进口产品检测结果符合率高,对临床样品的检测结果与其免疫背景相符。本研究为PEDV感染猪初乳的检测及PED疫苗免疫效力的评价提供了一种新的技术手段。

化学发光法检测EB VCA和EB EA IgA的方法学性能评价

目的对新产业MAGLUMI X8检测系统应用化学发光法检测EB VCA和EB EA IgA的分析性能进行方法学评价。方法选取2020年4—6月到中山大学附属肿瘤医院就诊的患者和体检人群各20例为研究对象,并收集其全血标本。分为鼻咽癌(nasopharyngeal cancer,NPC)组(经病理诊断确诊的鼻咽癌患者20例)和健康对照(healthy control,HC组)(健康体检人群20例),参考美国临床实验室标准化协会(Clinical Laboratory Standardization Institute,CLSI)系列文件及国内卫生部行业标准,制定方法学评价方案,通过MAGLUMI X8检测系统测定EB VCA和EB EA IgA的精密度、敏感性与特异性、方法学比对、线性范围和参考区间。结果EB VCA IgA低、高值质控品分析总精密度CV分别为3.978%和2.337%,EB EA IgA低、高值质控品分析总精密度CV分别为6.078%和4.131%;EBV VCA IgA和EBV EA IgA血清学检测结果针对鼻咽癌样本检测阳性率(敏感性)分别为100%和86.36%,累计阳性率(敏感性)达100%,针对体检样本检测的特异性是95.24%;针对所有试验样本,VCA IgA临床准确性为97.56%;EA IgA准确性为90.70%。两者联合检测可以达到100%;EB VCA IgA与EBV EA IgA线性相关系数均≥0.95,线性范围验证通过。结论新产业MAGLUMI X8检测系统测定EB VCA和EB EA IgA的方法学性能良好,能够满足临床检测的需要。

Bacteroides-derived isovaleric acid enhances mucosal immunity by facilitating intestinal IgA response in broilers

Background:The interaction between nutrition and immunity plays a vital role in nutrient digestion,absorption,and metabolism during poultry production.Recent studies showed that the gut microbiota contributes to the development of intestinal mucosal immunity.However,the mechanisms by which gut microbes regulate this process remain unclear.Methods:We compared the intestinal mucosal immunity and gut microbiota of Arbor Acre broilers AA(lower mucosal immunity)and Chinese native Wuliang Mountain Black-bone chickens(WLMB)(higher mucosal immunity)using 16S rDNA sequencing,transcriptomic analysis,and immunoglobulin A(IgA)antibody repertoire sequencing.We then combined 16S rDNA sequencing with transcriptomics to identify the key microbes and found that they were positively correlated with IgA production.Next,we transplanted candidate microbes into 1-day-old broiler to explore their role in intestinal mucosal immunity.Finally,we verified the function of candidate microbial metabolites in regulating the immune function of macrophages and the intestinal-epithelial cells(IECs)using in vitro experiments.Results:WLMB performs stronger mucosal immunity than AA,including higher IgA levels,more diverse IgA antibody repertoire,and higher bacterial affinity.Bacteroides was identified as the key microbes related to the intestinal IgA response.Bacteroides transplantation could increase IgA concentration in the duodenal contents by enhancing the expression of IgA,polymeric immunoglobin receptor(PIgR),B cell-activating factor of the TNF family(BAFF),and activation-induced cytidine deaminase(AID)in the duodenum.Additionally,Bacteroides-derived isovaleric acid promoted M2 macrophage polarization of macrophage via mTOR/PPAR-γ/STAT3 signaling pathways and regulated the immunologic function of IECs to produce cytokines,including interleukin(IL)-10,IL-4,BAFF,and transforming growth factor-beta(TGF-β),thus promoting IgA production in B cells by facilitating AID expression.Conclusion:Our study revealed that Bacteroides modulate the intestinal IgA response and maintain gut health in broilers.Bacteroides may be a promising alternative as an immunomodulatory microbial agent for developing nextgeneration probiotics for broiler production.

Analysis of the Effect of Hormone Therapy Combined with Hydroxychloroquine in the Treatment of IgA Nephropathy

Objective:To explore and analyze the effect of hormone therapy combined with hydroxychloroquine in the treatment of IgA nephropathy.Methods:30 patients with IgA nephropathy who were admitted to the Urology Department of Jiuquan hospital from August 2021 to May 2023 were selected as the research subjects,and they divided into an observation group and control group by drawing lots,with 15 cases in each group.The observation group underwent hydroxychloroquine treatment in addition of hormone therapy,and the control group underwent conventional treatment and hormone therapy.The rate of effectiveness of treatment,serum index,and renal function of both groups were compared.Results:The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in serum creatinine and serum albumin(P>0.05)between the groups before treatment;after treatment,the serum creatinine and serum albumin in the steroid group were significantly better than those in the reference group(P<0.05).Besides,there was no significant difference in urine protein quantification and glomerular filtration rate between the groups before treatment(P>0.05);after treatment,the hormone group’s urine protein quantification and glomerular filtration rate were significantly better than those in the reference group(P<0.05).The rate of effectiveness of the hormone group was significantly higher than that of the reference group(P<0.05).Conclusion:Hormone therapy combined with hydroxychloroquine in the treatment of IgA nephropathy is more effective than hormone therapy alone,thus this treatment plan is worthy of promotion and application.

The Neglected Significance of Glomerular Density as a 5-year Progression Indicator for IgA Nephropathy

调查 glomerular 密度( GD )是否能是为 IgA nephropathy 与的病人的一个独立预示的因素的目的与时间一般水准 proteinuria 每 1.73 m 2,或为病人估计了 30～60 ml/min 的 glomerular 过滤率( eGFR )<有证实活体检视的 IgA nephropathy 的 173 个病人全部的 0.5 g/d.Methods A 诊断了从2000年1月被包括到2010年12月。所有这些病人被跟随在上面为超过 5 年。端点是一 > 在从在 5 年的后续以后的基线的 eGFR 的 30% 衰落。GD 的最佳的截止价值被巨鸟曲线计算。Kaplan-Meier 方法和考克斯回归分析被用于幸存 analysis.Results A 在 eGFR 的 30% 衰落发生在 14.5% 所有病人。GD 的最佳的诊断截止价值是 1.99/mm 2(AUC = 0.90，敏感 =84.0% ，特性 =81.8%) 由巨鸟曲线决定了。低 GD 组(GD < 1.99 每 1.73 m 2 与 30 ～ 60 ml/min 的 eGFR 为病人在肾的端点每公里 2) 经历了重要增加(在更低的 GD 的六个病人组织，当时在另外的组的一个病人) 。为有时间一般水准 proteinuria 的病人 < 0.5 g/d，更低的 GD 组从基线显示出更高的 eGFR 衰落(4.5？？

过敏性紫癜儿童血清中25-羟基维生素D IgA水平分布特征

目的探讨过敏性紫癜(HSP)儿童血清25-羟基维生素D[25(OH)VD)]、免疫球蛋白A(IgA)水平变化及其与疾病严重程度的相关性.方法回顾性分析2014年1月至2018年6月本院儿科确诊的HSP患儿84例为疾病组,并按疾病的临床特点将其分为三组(皮肤型又称单纯型、紫癜型肾炎、混合型).70例同龄幼儿园健康幼儿为对照组.分别对各组采用电化学发光法和免疫比浊法测定其25(OH)VD、IgA水平.结果三组不同患病程度的HSP患儿25(OH)VD水平较正常对照组低,而血清IgA水平均升高,差异有统计学意义(P<0.05);三个不同患病组比较,其25(OH)VD逐渐降低,差异有统计学意义(P<0.05),而血清IgA水平升高,差异有统计学意义(P<0.05);相关性分析显示紫癜型肾炎组与混合组25(OH)VD和IgA呈现负相关(r=-0.891,P<0.05;r=-0.982,P<0.05).结论HSP患儿25(OH)VD降低而IgA水平升高,其伴随发病进程,联合监测两者水平,为临床诊治提供帮助.

中医药治疗 IgA 肾病20例临床报道

用自拟六草汤加减治疗血尿为主之ＩｇＡ肾病，以及用滋肾益气、健脾补肾、养肝滋肾配以行气祛瘀治疗大量蛋白尿为主的ＩｇＡ肾病。总有效率９５％。

腮腺肿瘤患者唾液及腮腺液中 IgA 和 IgG 含量的初步研究

对正常人31名,腮腺肿瘤患者44名(良性25名,恶性19名)的混合唾液和腮腺液中 IgA,IgG 含量进行了测定,结果表明:腮腺恶性肿瘤患者第一、二段腮腺液中 IgG 浓度比正常组、良性腮腺肿瘤组明显升高。腮腺良、恶性肿瘤腮腺液中 IgA 浓度无显著差别。影响混合唾液中 IgA 和 IgG 的含量因素多,对诊断和鉴别肿瘤性质意义不大。

Effects of rhein on intestinal epithelial tight junction in IgA nephropathy

AIM: To investigate the effects of rhein on intestinal epithelial tight junction proteins in rats with IgA nephropathy (IgAN). METHODS: Twenty-eight female Sprague-Dawley rats were randomly divided into four groups (7 per group): Control, IgAN, Rhein-treated, and Rheinprevented. Bovine serum albumin, lipopolysaccharide and CCl4 were used to establish the rat model of IgA nephropathy. The Rhein-treated group was given rhein from week 7 until the rats were sacrificed. The Rheinprevented group was given rhein from week 1. Animals were sacrificed at the end of week 10. We observed the changes in the intestinal epithelial tight junctions using transmission electron microscopy, and expression of intestinal epithelial tight junction proteins zona occludens protein (ZO)-1 and occludin by immunofluorescence using laser confocal microscopy. Changes in mRNA and protein expression of ZO-1 and occludin were measured by reverse transcriptase polymerase chain reaction and Western blotting. The ratio of urinary lactulose/mannitol was measured by high performance liquid chromatography (HPLC) for assessing the intestinal permeability. RESULTS: In the control group, the tight junctions lied between epithelial cells on the top of the outer side of the cell membrane, and appeared in dense dotted crystal structures, the neighboring cells were binded tightly with no significant gap, and the tight junction protein ZO-1 and occludin were evenly distributed in the intestinal epithelial cells at the top of the junction. Compared with the control group, in the IgAN group, the structure of the tight junction became obscured and the dotted crystal structures had disappeared; the fluorescence of ZO-1 and occludin was uneven and weaker (5.37 ± 1.27 vs 10.03 ± 1.96, P < 0.01; 4.23 ± 0.85 vs 12.35 ± 4.17, P < 0.01); the mRNA expression of ZO-1 and occludin decreased (0.42 ± 0.19 vs 0.92 ± 0.24, P < 0.01; 0.40 ± 0.15 vs 0.97 ± 0.25, P < 0.01); protein expression of ZO-1 and occludin was decreased (0.85 ± 0.12 vs 1.98 ± 0.43, P < 0.01; 0.72 ± 0.15 vs 1.38 ± 0.31, P < 0.01); and the ratio of urinary lactulose/mannitol increased (3.55 ± 0.68 vs 2.72 ± 0.21, P < 0.01). In the Rheinprevented and Rhein-treated groups, compared with the IgAN group, the intestinal epithelial tight junctions were repaired; fluorescence of ZO-1 and occludin was stronger (11.16 ± 3.52 and 8.81 ± 2.30 vs 5.37 ± 1.27, P < 0.01; 10.97 ± 3.40 and 9.46 ± 2.40 vs 4.23 ± 0.85, P < 0.01); mRNA of ZO-1 and occludin increased (0.81 ± 0.17 and 0.64 ± 0.16 vs 0.42 ± 0.19, P < 0.01; 0.82± 0.22 and 0.76 ± 0.31 vs 0.40 ± 0.15, P < 0.01); protein expression of ZO-1 and occludin was increased (2.07 ± 0.41 and 1.57 ± 0.23 vs 0.85 ± 0.12, P < 0.01; 1.34 ± 0.21 and 1.15 ± 0.17 vs 0.72 ± 0.15, P < 0.01); and the ratio of urinary lactulose/mannitol decreased (2.83 ± 0.43 and 2.87 ± 0.18 vs 3.55 ± 0.68, P < 0.01). CONCLUSION: Rhein can enhance the expression of ZO-1 and occludin, repair damaged tight junctions, and protect the intestinal barrier.

Existence and significance of hepatitis B virus DNA in kidneys of IgA nephropathy

AIM: To investigate the existence and significance of hepatitis B virus (HBV) DNA in the pathogenesis of IgA nephropathy(IgAN).METHODS: Fifty cases of IgAN with HBV antigenaemia and/or hepatitis B virus antigens (HBAg, or HBsAg, HBcAg)detected by immunohistochemistry in renal tissues were enrolled in our study. The distribution and localization of HBV DNA were observed using in situ hybridization.Southern blot analysis was performed to reveal the state of renal HBV DNA.RESULTS: Among the 50 patients with IgAN, HBs antigenemia was detected in 17 patients (34%). HBAg in renal tissues was detected in 48 patients (96%), the positive rate of HBAg, HBsAg, and HBcAg was 82% (41/50), 58% (29/50),and 42% (21/50) in glomeruli, respectively; and was 94%(47/50), 56% (28/50) and 78% (39/50) in tubular epithelia,respectively. Positive HBV DNA was detected in 72% (36/50)and 82% (41/50) cases in tubular epithelia and glomeruli respectively by in Situ hybridization, and the positive signals were localized in the nuclei of tubular epithelial cells and glomerular mesangial cells as well as infiltrated interstitial lymphocytes. Moreover, 68% (34/50) cases were proved to be HBV DNA positive by Southern blot analysis, and all were the integrated form.CONCLUSION: HBV infection might play an important role in occurrence and progress of IgAN. In addition to humoral immune damages mediated by HBAg-HBAb immune complex,renal tissues of some IgAN are directly infected with HBV and express HBAg in situ, and the cellular mechanism mediated by HBV originating from renal cells in situ may also be involved in the pathogenesis of IgAN.

补肾活血化瘀法治疗 IgA 肾病24例临床观察

对２４例经病理确诊的ＩｇＡ肾病患者，辨证分为外感风邪夹瘀、肝肾阴虚夹瘀、脾肾两虚夹瘀３型，运用补肾活血化瘀中药治疗。结果：完全缓解１０例，基本缓解８例，好转４例，无效２例，总有效率为９１．６％。临床症状、体征明显改善，实验室各项指标治疗前后对照Ｐ＜０．０５，血液流变学测定：全血比粘度、血浆比粘度、纤维蛋白原治疗前后对照Ｐ＜０．０５。

Significance of serum IgA in patients with acute hepatitis E virus infection

瞄准：学习浆液反肝炎 E 的意义在有肝炎 E 的病人的病毒(HEV ) IgA。方法：一个新方法被建立到试金 anti-HEV IgA，它能在感染的中间的阶段被检测。我们在重量的单位把 anti-HEV IgA 试金与 anti-HEV IgM 和 anti-HEV IgG 试金作比较一 from 有积极 HEV-RNA 的 60 个病人。结果：有积极 HEV-RNA 的 60 个病人与否定 HEV-RNA 让 anti-HEV IgA 和 anti-HEV IgM 和 410 个病人被用作控制。与肝炎 E 从 60 个病人获得的周期的浆液样品为 HEV RNA， anti-HEV IgM， anti-HEV IgA 和 anti-HEV IgG 被测试。他们的 HEV-RNA 在浆液是可检测的直到 20 +/- 11 d。我们使用了 anti-HEV IgM 和 anti-HEV IgA 试金检测 HEV 感染，阳性结果在 90 +/- 被发现 15 d 和 120 +/- 23 d 分别地， anti-HEV IgA 的积极的率比 anti-HEV IgM 和 HEV-RNA 的高(P 【 0.05 ) 。结论：在浆液的 anti-HEV IgA 的持续时间比 anti-HEV IgM 的长，并且 anti-HEV IgA 试金是一个好方法检测 HEV 感染。

Association of Helicobacter pylori IgA antibodies with the risk of peptic ulcer disease and gastric cancer

AIM: To compare the prevalence of Helicobacter pylori (Hpylori) IgG and IgA antibodies between adult subjects,with defined gastric diseases, nondefined gastric disorders and those representing the population.METHODS: Data on H pylori IgG and IgA antibodies,determined by enzyme immunoassay, were analyzed in 3 252 subjects with DGD including 482 patients with gastric ulcer, 882 patients with duodenal ulcer, 1 525patients with chronic gastritis only and 363 subjects with subsequent gastric cancer, 19 145 patients with NoDg and4 854 POPUL subjects. The age-adjusted prevalences were calculated for 1- and 20-year age cohorts.RESULTS: The prevalences of IgG antibodies were equally high (89-96%) in all 20-year age cohorts of the DGD groups, whereas the prevalences of IgG antibodies were lower and increased by age in the POPUL and NoDg groups. The prevalences of IgA antibodies were also higher in the DGD groups; among them CA (84-89%) and GU groups (78-91%) showed significantly higher prevalences than DU (68-77%) and CG patients (59-74%) (OR 2.49, 95%CI 1.86-3.34 between the GU and DU groups). In the CA, GU, and DU groups, the IgA prevalences showed only minor variation according to age, while they increased by age in the CG, POPUL, and NoDg groups (P≤0.0001). The IgA response, but not the IgG response, was associated with an increased risk of CA (OR 2.41, 95%CI 1.79-3.53) and GU (OR 2.57,95%CI 1.95-3.39) in comparison with CG patients.CONCLUSION: An IgA antibody response during H pylori infection is significantly more common in CA and GU patients as compared with CG patients.

Childhood Henoch-Schnlein Purpura Nephritis and IgA Nephropathy: One Disease Entity?——A Clinico-pathologically Comparative Study

Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.

VCA+EA多肽片段联合包被ELISA对血液EBV IgA检测效果的研究

目的探讨中山大学附属肿瘤医院研制的病毒壳抗原(VCA)+早期抗原(EA)多肽片段联合包被聚苯乙烯微孔板酶联免疫吸附测定(ELISA)方法对血液中Epstein-Barr病毒(EBV)免疫球蛋白A(IgA)的检测效果,并将其与进口筛选试剂盒进行比较,最终对VCA+EA多肽片段联合包被ELISA试剂盒性能进行评价。方法收集鼻咽癌患者血清86例,健康人群血清100例,用ELISA检测血清中IgA的OD值,观察该方法的最低检测限、线性范围、精密度、回收率,同时采用进口的Epstein-Barr病毒持续表达核抗原(EBNA1)+VCA-p18抗原包被ELISA方法进行检测,观察其临床性能。结果 VCA+EA多肽片段联合包被ELISA方法最低检测限为(0.003 4±0.002 6),血清稀释100倍数(及以上),其水平与吸光度呈线性关系,阴性标本、弱阳性标本、阳性标本IgA水平的日内变异系数为3.97%、9.76%、9.23%,日间变异变异系数分别为7.56%、10.20%、7.67%。VCA+EA多肽片段联合包被试剂盒与EBNA1+VCA-p18抗原包被试剂盒比较,相关系数为0.926 6;检测鼻咽癌敏感性为88.90%,特异性为77.80%,阳性预测值为80.00%,阴性预测值为87.50%。结论 VCA+EA多肽片段联合检测鼻咽癌有较高敏感性,重复性较好,阴性结果预测较可靠,可作为临床筛查鼻咽癌的新方法。

Systemic Sarcoidosis Associated to IgA Nephropathy

The sarcoidosis was rarely associated to IgA nephropathy. We report a 38-year-old man presented decreased visual acuity and xerostomia. He had two axillary lymphadenopathies and pitting edema of legs in physical examination. The ophthalmological examination revealed a right posterior uveitis. Biological investigations showed a mild renal insufficiency and elevated serum level of angiotensin-converting enzyme, β2 microglobulin and IgA. He had a proteinuria and a microscopic hematuria. The kidney echography was without abnormalities. Histological study of the renal biopsy found results in favor to IgA nephropathy. Biopsies performed in accessory salivary gland and lymph nodes revealed non-necrotising epitheloid and gigantocellular granulomatous inflammation suggesting a sarcoidosis. The diagnosis of a sarcoidosis associated to IgA nephropathy was posed. The treatment was based on oral prednisolone with gradual tapering doses. He regained normal vision. The renal function had not worsened. No relapse of sarcoidosis was noted during our follow up.