Red Blood Cells In Urine Research Articles

MO319BEDSIDE URINE SEDIMENT EXAMINATION IN IMMUNOGLOBULIN A NEPHROPATHY PATIENTS PERFORMED BY NEPHROLOGISTS

Abstract Background and Aims Urine sediment microscopy is mostly abandoned by nephrologists nowadays, however it is an important diagnostic tool in kidney and urinary tract diseases. The aim of this study is to emphasize the benefits of urine microscopy performed by a nephrologist. Method A prospective cohort study at Pauls Stradins Clinical University Hospital Nephrology center included patients with histologically confirmed diagnosis of IgA nephropathy from 1st January 2020 till December 2020. Appropriately collected urine samples were examined using manual microscopy within an hour after sample collection and by automated urinalysis. Samples were centrifuged at 4000 rpm for 4 minutes, the supernatant urine was carefully decanted, 1 - 1,5 ml of the left urine was mixed by gentle agitation and placed on a standard glass slide with a cover slip. Sample examination was performed using low (magnification x10) and high power (magnification x40) using brightfield microscopy with a minimum of 10 fields. Results A total of 37 patients (24 men, mean age 42.7 ± 10.9 years) were included in the study. 59.5 % of patients (n = 22) had hematuria based on automated urine sediment analysis and 62.2 % (n = 23) of patients had hematuria based on manual urine microscopy. 45.9 % of patients (n=17) had dysmorphic erythrocytes, 13.5 % of patients (n = 5) had isomorphic red blood cells (RBC) and 40.5 % of patients (n = 15) did not have RBC in urine samples by manual urine microscopy. 54.2 % (13/24) of men and 30.8 % (4/13) of women had dysmorphic RBC in urine. Conclusion Manual urine sediment examination was more sensitive than automated analysis. Majority of IgA nephropathy patients have active urine sediment with hematuria and dysmorphic RBC. Manual microscopy remains an effective and reliable method that can be easily and quickly performed by nephrologists.

Gender Differences in Neuromuscular, Haematological and Urinary Responses during Padel Matches.

Research on the acute physiological response to a padel match is limited. The present study aimed to: (a) evaluate neuromuscular, urinary, and hematological responses after simulated padel competition (SC) and (b) analyze possible gender differences. In this study, 28 high-level padel players participated (men = 13, age = 26.83 ± 6.57 years; women = 15, age = 30.07 ± 4.36 years). The following parameters were analyzed before and after SC: neuromuscular (hand grip strength, squat jump (SJ), countermovement jump (CMJ), and Abalakov jump (ABK)), hematological (red blood cells, hemoglobin, and hematocrit), and urinary (pH, specific gravity, microalbuminuria, and red blood cells). Significant gender differences were found in neuromuscular and hematological responses, with men obtaining higher values (p < 0.05). For the SC influence, changes were noted in ABK and microalbuminuria (p < 0.05). The percentages of change in hand grip strength, SJ (height and watts), CMJ (height), and ABK (height) were higher for men than women (p < 0.05). SC negatively influenced the neuromuscular parameters to a greater extent in women. Our results could be related to gender differences in game actions, the temporal structure, and anthropometric and physiological characteristics. Game dynamics and a different organic response between male and female padel playing were confirmed.

MO661COMPARISON OF CLINICAL EFFICACY OF CENTRIFUGAL-MEMBRANOUS DOUBLE FILTRATION PLASMAPHERESIS AND MEMBRANOUS DOUBLE FILTRATION PLASMAPHERESIS ON SEVERE LUPUS NEPHRITIS

Abstract Background and Aims The Study delves into the clinical efficacy and advantages of centrifugal double filtration plasmapheresis on severe lupus nephritis (LN) by comparing it with membranous double filtration plasmapheresis (DFPP). Method A retrospective analysis was performed on 56 patients who were diagnosed with severe LN and had received DFPP treatment from May 2016 and January 2020. Of them, 38 were given centrifugal DFPP and had their plasma centrifuged in a blood cell separator, and 18 were given membranous DFPP and had their plasma centrifuged in an MPS07 plasma separator. An EC20W plasma component separator was used as the secondary filter to reprocess the separated plasma of all of them. The two DFPPs were compared for differences in clinical efficacy, vascular access, dosage of anticoagulant, treatment cost and adverse events in patients with severe LN. Results Of the 56 severe LN patients (including 43 females and 13 males), the median of age of onset was 29 years old, the SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) was 18.6±6.0 points and the serum creatinine was 402(294,553) umol/L, and all patients had acute kidney injury and 51 of them (91.1%) required renal replacement therapy (RRT). A total of 142 DFPPs were performed, including 97 centrifugal DFPPs and 45 membranous DFPPs. After treatment and at Month 3 of follow-up visit, patients in both the centrifugal DFPP group and the membranous DFPP group had ANA, AdsDNA titer, quantitative urinary protein, urinary red blood cell count and serum creatinine significantly dropped and hemoglobin significantly increased over those before treatment, the differences in which between the two groups, however, were not statistically significant. The centrifugal DFPP group had a more significant drop in complements C3 and C4 after treatment. Comparison of the data before and after a single DFPP treatment showed that the membranous DFPP group had a more significantly longer prothrombin time, but there were no differences in partial prothrombin time, fibrinogen and platelet change between the two groups. At Month 3 of follow-up visit, 31 of the 51 RRT patients (60.8%) (including 34 given centrifugal DFPP and 17 given membranous DFPP) were released from dialysis, including 23 given centrifugal DFPP and 8 given membranous DFPP. In the membranous DFPP group, all patients had the vascular access built via the central venous catheter, while in the centrifugal DFPP group, 6 patients (15.8%) had the vascular access built by puncturing into the artery or vein. The dosage of the anticoagulant, the low molecular weight heparin, to the centrifugal DFPP group was significantly lower than that to the membranous DFPP group (1174±243 vs 4106±399IU, P&amp;lt;0.001), and in the centrifugal DFPP group, 29 patients (76.3%) were given 4% citric acid alone for anti-coagulation. No blood coagulation occurred. In terms of treatment consumables, the membranous DFPP group had a significantly higher cost than the centrifugal DFPP group (RMB4340.2±237.0 vs 5677.0±0.0, P&amp;lt;0.001). Two patients (4.4%) in the membranous DFPP group developed skin ectasis, epistaxis or aggravated alveolar hemorrhage after treatment, and four patients (4.1%) in the centrifugal DFPP group developed perioral numbness, numbness in distal extremities or tetany during treatment, which was alleviated after calcium supplementation. Conclusion Centrifugal DFPP differed little from membranous DFPP in clinical efficacy in severe LN patients, but had lower anti-coagulation requirements, cost less on treatment consumables, and caused no severe adverse events, so it can be used as an important means to treat severe LN.

Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy.

BackgroundThere are few studies describing the clinical course and spontaneous remission of IgA nephropathy (IgAN) in adult patients receiving conservative treatment.MethodData from 62 adult patients with biopsy-diagnosed IgAN, who received conservative treatment at least 5 years prior, were retrospectively investigated. No patients received corticosteroids, other immunosuppressants, or tonsillectomy. Remission of proteinuria and hematuria were defined as proteinuria <0.3 g/gCr and urine red blood cells (RBC) <5 / high power field (HPF) on three consecutive urinalyses obtained during an observation period of ≥6 months.ResultThirty-eight (61.3%) patients had remission of hematuria, 24 (38.7%) had remission of proteinuria, and 19 (30.6%) had remission of both. Remission rates increased in patients with proteinuria <0.5 g/g Cr at diagnosis. The median time to remission of hematuria was 2.8 years and that of proteinuria was 2.6 years. Patients who showed renal function decline (defined as 30% decline of estimated glomerular filtration rate [eGFR] from baseline) were older, had significantly lower eGFR, and higher proteinuria at diagnosis. Two patients with preserved renal function and normal proteinuria at diagnosis experienced renal function decline. Renal function did not decline within 3 years of diagnosis in patients with proteinuria <1 g/gCr at diagnosis.ConclusionsRelatively high rates of spontaneous remission were observed. Remission of both hematuria and proteinuria were frequent within 3 years after diagnosis, and renal function was well preserved during this period. These data indicate that it is rational to use conservative treatment for 3 years after the diagnosis instead of aggressive treatments.

Pre-treatment hematuria and crescents predict estimated glomerular filtration rate trajectory after methylprednisolone pulse therapy with tonsillectomy for IgA nephropathy.

Glomerular hematuria and proteinuria are typical manifestations of IgA nephropathy (IgAN). However, hematuria severity is not considered a useful marker of the potential benefits of corticosteroid administration as proteinuria severityonly is includedin the current guidelines. In this retrospective cohort study, we enrolled 133 patients diagnosed with IgAN through biopsy. We calculated the 2-year estimated glomerular filtration rate (eGFR) slope (mL/min/1.73m2/year) and eGFR trajectory after methylprednisolone pulse therapy using mixed effects models stratified by the Oxford classification and three categories of pre-treatment hematuria: mild [urinary red blood cells (URBCs) < 10/high-power field (HPF)], moderate (URBCs 10-30/HPF), and severe (URBCs ≥ 30/HPF). The severe pre-treatment hematuria group showed a significantly higher likelihood of having crescents (odds ratio (OR), 4.3; 95% confidence interval (CI), 1.7-10.9). In the longitudinal analysis of 103 patients, most of whom underwent tonsillectomy, the severe pre-treatment hematuria group had a significantly higher 2-year eGFR slope after methylprednisolone pulse therapy than the mild and moderate hematuria groups (mild, -0.52 ± 1.97; moderate, -0.32 ± 1.99; severe, 1.44 ± 3.20 mL/min/1.73m2/year). Patients with C2 scores showed a significantly higher 2-year eGFR slope after methylprednisolone pulse therapy than those with C0 and C1 scores (C0, -0.38 ± 1.74; C1, 0.81 ± 3.02; C2, 3.29 ± 3.68 mL/min/1.73m2/year). Analyses of eGFR trajectory after methylprednisolone pulse therapy revealed that the eGFR improved only in patients with severe pre-treatment hematuria or C2 score (Pinteraction with time < 0.001). The eGFR is likely to improve after methylprednisolone pulse therapy with tonsillectomy in IgAN patients with severe pre-treatment hematuria or a high percentage of crescents.

Urine red blood cell classification based on Siamese Network

Urine examination is an important examination commonly used in medical in vitro examination. The morphological classification of red blood cells in urine plays an important role in the diagnosis of hematuria and renal diseases. In order to improve the accuracy and efficiency of urine red blood cell classification, a urinary red blood cell classification algorithm based on Siamese Network of dual-mode contrastive loss function was proposed. In the dual-mode contrastive loss function, the Cosine Similarity measure and a weight factor were added as the constraint of Euclidean distance in the Contrastive Loss function, which improves the similarity judgment ability of the Contrastive Loss function for the two input eigenvectors. The experimental results show that the Cosine Similarity measure has a positive effect on the Contrastive Loss function, and can effectively improve the accuracy of the whole classification model.

Clinical and pathological analysis of 101 cases of ANCA-associated vasculitic kidney injury.

To analyze the clinical and pathological features of patients with anti-neutrophilic cytoplasmic antibody (ANCA)-associated vasculitic (AASV)-kidney injury (AASVKI). From January 2015 to December 2018, a total of 101 AASVKI patients treated in the First Hospital of Jilin University were divided into 2 groups (the pANCA-positive group and the cANCA-positive group) for comparison; 63 patients were performed renal biopsy and divided into 3 groups according to pathological results [the non-crescent nephritis group (non-C), the crescent nephritis group (C), and the sclerotic nephritis group (S)] for comparison. Compared with the Group pANCA, Group cANCA exhibited higher incidence of eye involvement (P = 0.039) and skin mucosa destruction (P = 0.045), higher serum creatinine (Scr) (P < 0.001), higher 24-h urine protein quantification (P = 0.045), but lower hemoglobin (Hb) (P < 0.001). Compared with Group non-C, Group C had higher Scr (P < 0.001) and urinary red blood cells (P = 0.010), lower estimated glomerular filtration rate (eGFR) (P = 0.003), hemoglobin (HD)-dependence (P = 0.042), and higher mortality rate within 1year (P = 0.005); compared with Group S, Group C had faster onset of erythrocyte sedimentation rate (ESR) (P = 0.031), higher urinary red blood cells (P = 0.029), and lower incidence of HD-dependence (P = 0.038). AASVKI patients with positive cANCA have poor renal function, among whom the patients with crescent type have poorer renal function than those with non-crescent type, have higher urinary red blood cells while lower HD-dependence than those with sclerotic type.

Protective Mechanism of Xiyin Liangxue Decoction on Immunoglobulin A Nephropathy Rats

Immunoglobulin A nephropathy is the most common glomerular disease in China, accounting for about 20 % to 47 % of primary glomerular diseases. Xiyin liangxue decoction is a common experience in the treatment of Immunoglobulin A nephropathy in recent years. The research of this formula in the clinical treatment of Immunoglobulin A nephropathy has achieved obvious curative effect. This article aims to study the protective mechanism of xiyin liangxue decoction on Immunoglobulin A nephropathy rats and analyzes and compares the advantages of xiyin liangxue decoction and western medicine in the treatment of Immunoglobulin A nephropathy rats with Sprague dawley nephropathy rats. The results of the study showed that after treatment of Immunoglobulin A nephropathy rats with xiyin liangxue decoction, the renal function of the rats in the treatment group was significantly improved, the expressions of alanine aminotransferase and aspartate aminotransferase increased by 19 % and 5 % and the expressions of albumin and globulin increased by 19 % and 25 %. In addition, in the treatment group, the number of urine red blood cells, urine protein and urine mannose binding lectin decreased by 29 %, 13 % and 25 %, respectively. The urine volume of rats in the high dose group was significantly reduced by 13 % and the expressions of blood urea nitrogen and blood creatinine increased 22 % and 8 % respectively. After treatment with xiyin liangxue decoction, the cure rate of experimental Immunoglobulin A rats reached 24 % and 33 % had significant improvement. It can be seen that xiyin liangxue decoction has a good clinical treatment effect on Immunoglobulin A nephropathy rats.

A Correlation Analysis between the Nutritional Status and Prognosis of COVID-19 Patients.

PurposeThe present study investigated the correlation between the nutritional status and prognosis of COVID-19 patients, and analyzed the epidemiological characteristics of COVID-19 patients with different nutritional status.Methods429 patients who were diagnosed positive for COVID-19 in Hubei Provincial Hospital of Traditional Chinese Medicine from December 2019 to March 2020 were selected and divided into different groups based on Controlling Nutritional Status (CONUT) score (0–4: the low CONUT score group; 5–12: the high CONUT score group). Multivariate logistic regression analysis was applied to investigate the effects of CONUT score on prognosis.ResultsThe total score of admission status of patients with higher CONUT score was higher than that of those with lower CONUT score (χ2 = 7.152, P = 0.007). The number of adverse outcomes of female was higher than that of male (χ2 = 10.253, P = 0.001). The number of adverse outcomes was higher for patients with smoking history (P = 0.004) or hypertension (χ2 = 11.240, P = 0.001) than those without. Also, the number of adverse outcomes was higher for older patients than younger ones (χ2 = 15.681, P < 0.001). Patients with adverse outcomes had lower urine red blood cell count than patients without adverse outcomes (χ2 = 5.029, P = 0.025). However, BMI, drinking history and diabetes did not show correlation with the prognosis of COVID-19 (P > 0.05). Among patients ≥ 61 years old, the risk of adverse outcomes in the high CONUT score group was 6.191 times that of the low CONUT score group (OR = 6.191, 95% CI: 1.431–26.785). Among the non-diabetic patients, the risk of adverse outcomes in the high CONUT group was 11.678 times that of the low CONUT group (OR = 11.678, 95% CI: 2.754–49.41). For the patients who had a total score of admission status < 6, the risk of adverse outcomes in the high CONUT score group was 8.216 times that of the low CONUT score group (OR = 8.216, 95% CI: 2.439–27.682).ConclusionCOVID-19 patients with good nutritional status showed a small chance to have adverse outcomes. Gender, age, hypertension, the number of urine red blood cell count and CONUT score affected the adverse outcomes of patients.

The Role of Specific Diet on the Treatment of Pediatric Asymptomatic Microscopic Hematuria; a Before and After Study:

Background and Aim: Asymptomatic microscopic hematuria (AMH) in children has been known as a troublesome clinical condition which demands a patient to visit a physician. This study aimed to investigate the role of a specific diet on the amelioration of AMH in children. Methods: The current analysis was carried out in children ranging from 6 months to 14 years. This before and after research study was performed to evaluate the effects of certain diet on the treatment of pediatric AMH. Renal function tests, kidney ultrasonography and urinary assessments were performed and patients with AMH were enrolled in this query. Study group was ordered to consume a specific hypoallergenic diet. The number of urinary red blood cells was compared before and after diet. Data were analyzed using SPSS. A value of P < 0.05 was considered significant. Results: Our special diet was effective in the treatment of stable microscopic hematuria in 72% of study group. Statistically, after a special diet, there was a significant decrease in the number of red blood cells in urine test (P <0.001). Conclusion: Specific hypoallergenic diet was effective in treatment of AMH in children. Reducing urinary red blood cell counts has been linked to the effectiveness of diet in the management of stable microscopic hematuria.

Risk factors affecting renal function and survival of patients with myeloperoxidase anti-neutrophil cytoplasmic antibody-associated glomerulonephritis

To determine the prognostic values of clinical and laboratory features at the time of presentation on renal function and survival of patients with myeloperoxidase anti-neutrophil cytoplasmic antibody-associated glomerulonephritis. (MPO-ANCA GN). A total of 119 patients (52 males and 67 females) with MPO-ANCA GN and hospitalized at the First Affiliated Hospital of Nanjing Medical University from January 2010 to April 2018 were enrolled. The baseline clinical characteristics, renal biopsy pathological data, and risk factors predictive of renal and patient survival were retrospectively analyzed. Among these 119 patients, the median serum creatinine at diagnosis was 354.30 (range, 216.10 - 637.30) mmol/L and the median estimated glomerular filtration rate (eGFR) was 14.78(range, 7.23-29.21) mL/min. In total, 58(48.7%) patients received initial renal replacement therapy (RRT). During a median follow-up duration of 32 (range, 3 - 113) months, 57(47.9%) patients progressed to end-stage renal disease (ESRD). Initial renal function status (i.e., initial RRT, serum creatinine, and eGFR) (p < 0.001) and hemoglobin level (p = 0.027) were significant risk factors for renal survival. During the follow-up, 69 (57.6%) of 119 patients survived. Age (p = 0.009) and urine red blood cell count (p = 0.012) were predictive of patient survival. Among patients with MPO-ANCA GN, poor renal function and lower hemoglobin level were predictive of ESRD, while older age and higher urinary red blood cell count were associated with a higher risk for all-cause mortality.

Renal abnormalities and its associated factors among school-aged children living in Schistosoma mansoni endemic communities in Northwestern Tanzania

BackgroundIn sub-Saharan Africa, renal abnormalities are a major public health concern, especially in children living in Schistosoma haematobium endemic areas. However, there is a dearth of data on renal abnormalities among children living in Schistosoma mansoni endemic areas. The objective of the study was to assess the prevalence of renal abnormalities among school children in a Schistosoma mansoni endemic community in Northwestern Tanzania.MethodsA cross-sectional study was conducted between January and March 2017 among school children aged 6–13 years, attending three primary schools located along the shoreline of Lake Victoria. A single urine sample was collected from each child and screened for S. mansoni using circulating cathodic antigen and for S. haematobium eggs using a urine filtration technique. A urine dipstick was used to screen for urine protein levels, creatinine levels, microalbuminuria, and red blood cells. Venous blood was obtained for estimation of creatinine level and for malaria diagnosis. The primary outcomes were the prevalence of renal abnormalities, defined by the presence of low estimated glomerular filtration rate (eGFR), proteinuria or microalbuminuria, and hematuria in urine.ResultsOf 507 children included in the final analysis, 49.9% (253/507) were male with a mean age of 8.51 ± 1.3 years. Overall, 64.0% (326/507) of the children were infected with S. mansoni, and 1.6% (8/507) of the children were infected with S. haematobium. A total of 71 (14%) of the children had proteinuria, 37 (7.3%) had hematuria, and 8 (1.6%) had a low estimated glomerular filtration rate (eGFR). Overall prevalence of renal abnormalities was 22.9%. Renal abnormalities (proteinuria) were associated with S. mansoni infection (OR = 4.9, 95% CI 2.1–11.2, p < 0.001) and having red blood cells in urine (OR = 5.3, 95% CI 2.5–11.2, p < 0.001).ConclusionTwenty-two percent of school children who participated in this study had renal abnormalities associated with S. mansoni infection. Given the high prevalence of S. mansoni, longitudinal epidemiological surveillance is warranted to measure the burden of renal abnormalities and assess the impact of the praziquantel treatment on these abnormalities.

原发性系统性淀粉样变性一例

A 58-year-old man suffered from itchy eruptions on the extensive surface of extremities and buttocks for 20 years.Skin lesions was the most prominent and primary manifestation.Physical examination showed glossauxesis with hard texture,no significant abnormality of cardiopulmonary and abdominal,and no swelling of general superficial lymph nodes.Accessory examination found a large number of red blood cells in urine and moderate proteinuria,an increase in creatinine and BUN as well as left side pleural thickening,which suggested the involvement of other systems.Skin biopsy showed mild hyperplasia of squamous cells and hyperkeratosis.The homogeneous eosinophilic material was found to deposit at the dermis of which congo red staining was positive.The diagnosis of primary systemic amyloidosis was made.

Genetic variants of the MIR31HG gene are related to a risk of IgA nephropathy

IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Previous studies reveal that genetic factors play a crucial role in IgAN progression. This study was conducted to investigate the association between MIR31HG variants and IgAN risk.A total of 836 subjects were recruited to detect the relationship of MIR31HG variants with IgAN susceptibility. Odds ratios (OR) and 95% confidence intervals (CI) were computed to evaluate the associations. Multifactor dimensionality reduction was performed to analyze the SNP-SNP interaction with IgAN risk.Our study showed that rs1332184 and rs55683539 significantly related to an increased risk of IgAN (OR 1.34, p = 0.041; OR 1.39, p = 0.025). Stratified analyses indicated rs72703442, rs55683539, and rs10965064 exhibited strongly enhanced risk of IgAN in age ≤ 35 years (OR 1.55, p = 0.023; OR 1.60, p = 0.012; OR 1.46, p = 0.037). Besides, we found rs1332184, rs55683539 and rs2181559 significantly increased the susceptibility of IgAN in males (OR 1.71, p = 0.003; OR 1.44, p = 0.042; OR 1.60, p = 0.010). We also observed that rs1332184 could enhance IgAN risk for Lee’s grade ≥ III (OR 1.39, p = 0.045). Rs55683539 significantly increased a risk of IgAN (OR 1.58, p = 0.027), while rs2025327 had a lower risk of IgAN in Lee’s grade < III (OR 0.46, p = 0.007). Interestingly, we found rs72703442 polymorphism was related to hemoglobin (p = 0.043), and rs10965064 was associated with Urine red blood cell (p = 0.040).Our study proposed that MIR31HG polymorphisms associate with susceptibility to IgAN in Chinese population.

Double false-negative traps in urine routine test: a case report

Abstract Background Urinalysis is one of the most commonly performed tests in clinical practice and supplies important information for a series of clinical conditions, including renal and urinary tract diseases. The clinical laboratory often completes urinalysis through the combined use of urinary dry-chemistry and formed-element analyzers. Urine red blood cell (RBC) morphology test is often used to discriminate the source of hematuria by manual microscopy. Case presentation In this case report, we describe a 39-year-old woman with chronic glomerulonephritis (CGN) who underwent both urine routine test and RBC morphology test. Her RBC count was in the normal range and the occult blood test was negative in routine test, while the RBC morphology test indicated the presence of non-homogeneous hematuria. Conclusions Therefore, we analyzed the causes of false-negative result on the urine chemical analyzer and the automatic microscope system, respectively.

Clinical observation on combined use of dry chemical method and urinary sediment in routine urine examination

Objective To study the clinical effect of dry chemical method combined with urinary sediment in routine urine examination. Methods From January 2018 to October 2018, 200 patients with suspected urinary tract infection who underwent routine urine examination in the Traditional Chinese Medicine Hospital of Yuyao were selected for prospective study, and fresh morning urine samples were collected from 200 patients.Urine samples were detected by urine dry chemistry analyzer and urine sediment analyzer respectively, and the urine routine indicators of urine dry chemistry method and urine sediment method were compared.According to the results of urine bacterial culture, the sensitivity, specificity and accuracy of urine dry chemical method, urine sediment method and urine dry chemical method for the diagnosis of urinary tract infection were calculated and compared.Then, the consistency test was used to analyze the consistency of results of urine dry chemistry method, urine sediment method, urine dry chemical method+ urine sediment method with urine bacterial culture. Results (1)There were no statistically significant differences between the results of urine dry chemical method and urine sediment method on the urine red blood cell, white blood cell, transparent tube type and other indicators (t=0.562, 0.343, 0.901, all P>0.05). (2)Among 200 suspected patients with urinary tract infection, 157 patients were confirmed to have urinary tract infection by urine bacterial culture, and the remaining 43 patients had no urinary tract infection.The sensitivity, specificity, accuracy of urine dry chemistry method and urine sediment method in the diagnosis of urinary tract infection had no statistically significant differences (χ2=0.120, 0.081, 0.022, all P>0.05). But the sensitivity, specificity, accuracy of urine dry chemistry method + urine sediment method in the diagnosis of urinary tract infection were 96.18%, 97.67%, 96.50%, respectively, which were higher than those of the urine dry chemistry method and urine sediment method (χ2=6.497, 6.081, 11.923, 8.219, 4.962, 12.858, all P<0.05). According to the consistency analysis, the diagnosis results of urinary tract infection by urine dry chemical method and urine sediment method were in good consistency with the results of urine bacterial culture, with the Kappa value of 0.854, while the consistency of urine dry chemical method, urine sediment method with the urine bacterial culture results were all moderate, with the Kappa value of 0.642 and 0.637, respectively. Conclusion The combination of urine dry chemical method and urine sediment method can improve the accuracy of urine routine examination and improve the value of urine routine examination in the diagnosis of urinary tract infection. Key words: Urinary tract infection; Urine routine; Medical examination; Urine dry chemistry; Urine sedimentation method; Diagnosis; Red blood cell; Leukocyte; Hyaline tube type

Comprehensive expression profile of long non-coding RNAs in Peripheral blood mononuclear cells from patients with neuropsychiatric systemic lupus erythematosus.

BackgroundLong noncoding RNAs (lncRNAs) are emerging as critical regulators of gene expression in the immune system, but their impact on neuropsychiatric systemic lupus erythematosus (NPSLE) remains unknown.MethodsRNA sequencing analysis was used to screen the comprehensive expression profile of lncRNAs and messenger RNAs (mRNAs) in peripheral blood mononuclear cells (PBMCs) from NPSLE patients, active SLE patients who had never experienced neuropsychiatric manifestations (Non-NPSLE) and healthy controls. Differentially expressed (DE) lncRNA levels were validated by qRT-PCR in 26 NPSLE patients, 31 Non-NPSLE patients and 30 healthy controls. Further, correlations of DE lncRNAs with clinical manifestations of NPSLE patients were analyzed. Finally, a bioinformatic analysis was performed to investigate the potential functions of DE genes.ResultsFour hundred and fifty-one lncRNAs and 272 mRNAs were DE between the NPSLE patients and Non-NPSLE patients, among which, significantly upregulated expression levels of NONHSAT208182.1, NONHSAT182114.1, NONHSAT106801.2, NONHSAT039491.2, ENST00000356215, NONHSAT087499.2 and NONHSAT207026.1 while downregulated expression levels of NONHSAT001281.2 and NONHSAT024353.2 were further validated in PBMCs from NPSLE patients by qRT-PCR. Bioinformatic analysis suggested several gene ontology (GO) terms and signal pathways may play important roles in NPSLE development. Co-expression networks analysis indicated that 170 lncRNAs and 46 mRNAs were included in the co-expression network. The expression level of NONHSAT039491.2 was associated with the activity of SLE and the presence of anti-dsDNA, anti-RNP antibody, dizziness and headache. NONHSAT087499.2 level correlated with anti-RNA antibody, ENST00000356215 level correlated with olfactory threshold and oral ulcer. NONHSAT208182.1 level correlated with the presence of fever, unstable walking and urinary red blood cells. NONHSAT106801.2 correlated with frequency of B cells and the presence of fever. NONHSAT024353.2 level was associated with serum IgG levels and the presence of anti-SSA and disorder of consciousness.ConclusionsOur data provided comprehensive evidence regarding the differential expression of lncRNAs in PBMCs from NPSLE patients, indicating that these DE lncRNAs may play roles in NPSLE development. Our finding shed light on the understanding of the molecular mechanisms of lncRNAs in the pathogenesis of NPSLE.

Crude polysaccharides from the seeds of Vaccaria segetalis prevent the urinary tract infection through the stimulation of kidney innate immunity

Ethnopharmacological relevanceThe seeds of Vaccaria segetalis (Neck.) Garcke is used for the treatment of urinary diseases in Traditional Chinese Medicine according to the Chinese Pharmacopoeia. Crude polysaccharides and the aqueous extract from the seeds of V. segetalis (SVCP) were proved to be effective on treating benign prostatic hyperplasia. Aim of the studyThe aim of this study was to test the effects of SVCP on urinary tract infection (UTI) induced by uropathogenic Escherichia coli (UPEC) strain CFT073 in the rat model and to investigate the underlying mechanisms. Materials and methodsA rat UTI model was established with the infection of UPEC strain CFT073. After oral administration of SVCP, the urinalysis and histological examination were evaluated. The levels of pro-inflammatory cytokines, procalcitonin (PCT) and polymeric Ig receptor (PIGR) were used to test the effects of SVCP on host immunity. The mRNA level of PapG in CFT073 was used to test the influence of SVCP on virulence factor. The effects of SVCP on the inhibition of bacterial adhesion were evaluated with mice UTI model. ResultsIn the rat UTI model, the levels of bacterial load, white blood cells (WBC) and red blood cells (RBC) in urine and the pathological injury in the bladder were significantly up-regulated, the expression of PIGR in kidney was down-regulated, no significant change was observed on the pro-inflammatory cytokines in urine. After oral administration of SVCP for 3 days, the levels of bacterial load, WBC and RBC in urine were significantly decreased, the pathological injury in the bladder were remarkably inhibited. The expression of IL-6, IL-8 in urine and PIGR in kidney were significantly up-regulated by SVCP (200 mg/kg). SVCP showed no effect on the concentration of PCT in serum. SVCP failed to down-regulate the mRNA level of PapG in CFT073. In the mice UTI model, pre-treatment of SVCP failed to inhibit the intracellular bacterial load in the bladder. ConclusionsThe therapeutic effects of SVCP on treating UTIs might result from the up-regulation of innate immunity in the kidney. SVCP can be used as an alternative therapeutic agent for UTIs.

A Lower Urine White Blood Cell Median Can be a Predictor of Undiscovered Urolithiasis in Patients with Acute Urinary Tract Symptoms

Purpose: Acute urinary tract infection (UTI) causes symptoms including urgency, frequency, dysuria, and pain in the lower urinary tract. However, these symptoms are not unique to infection. Urolithiasis, injury, neurological disease, and malignancy present with the same symptoms. We aimed to find predictors in urinalysis to detect underlying causes in patients with acute UTI symptoms. Materials and Methods: We recruited 192 patients who presented with acute UTI symptoms from a single institute between September 2012 and September 2018. Each patient received urinalysis, kidney–ureter–bladder X-ray, and kidney plus transabdominal bladder sonography as primary surveys. Patients with flank pain and hydronephrosis but without definitive radiopaque lesion received computed tomography (CT) scan as an advanced intervention. Cystoscopy was ordered by the physician if the patient had gross hematuria and was suspected to have intravesical lesion. We correlated the urine nitrate, the median of red blood cells (RBCs) and white blood cells (WBCs), and the ratio of red and WBCs with the finding on image studies, which included sonography, X-ray, and CT by statistical models. Results: In patients with urolithiasis detected by either X-ray or CT, logistic regression showed that higher urine RBC and lower urine WBC medians were predictors of urolithiasis. In the ROC analysis, WBC median lower than 7.75 per high power field (HPF) was a significant predicting factor for the positive finding of urolithiasis on a CT scan. Conclusion: When presenting with acute UTI symptoms, patients with a lower urine WBC median are correlated with a higher probability to have urolithiasis. In addition, WBC median lower than 7.75 per HPF in urinalysis is a predictor for urolithiasis found on CT in patients with flank pain or hydronephrosis.

Changes of B cell-activating factor and a proliferation-inducing ligand in serum of children with Hen(o)ch-Sch(o)nlein purpura nephritis

Objective To investigate the changes of B cell-activating factor (BAFF) and a proliferation- inducing ligand (APRIL) in serum of children with Henoch- Schonlein purpura nephritis (HSPN), and to explore their role in the pathogenesis of children HSPN. Methods A total of 28 children with HSPN who were before treatment were selected in Department of Pediatrics Nephrology and Rheumatology, Shengjing Hospital of China Medical University from November 2017 to August 2018.Sixteen children with Henoch-Schonlein purpura were selected as HSP group, and 20 healthy children were selected as healthy control group.Followed the HSPN guideline to cure the patients for 6-8 weeks.The clinical data were collected.Serum levels of BAFF and APRIL were measured by adopting enzyme-linked immunosorbent assay (ELISA). Results (1)Changes of serum BAFF level: the serum levels of BAFF in HSPN children were significantly lower than those in the HSP group and the healthy control group[ HSPN group (0.652±0.360) μg/L, HSP group (1.276±0.459) μg/L, healthy control group (1.285±0.299) μg/L, F=17.519, P=0.000]. Moreover, the serum levels of BAFF in before treatment were significantly lower than those in after treatment [before treatment (0.652±0.360) μg/L, after treatment (0.860±0.262) μg/L, P 0.05). (2)Changes of serum APRIL level: the serum levels of APRIL in HSPN and HSP children were both significantly higher than those in healthy control group, but there were no marked differences between the 2 groups [HSPN group (2.285±1.015) μg/L, HSP group (2.609±1.264) μg/L, healthy control group (1.677±0.118) μg/L, F=3.647, P=0.016]. There were no significant differences in the serum levels of APRIL between before treatment and after treatment [ before treatment (2.285±1.015) μg/L, after treatment (2.042±0.695) μg/L, P>0.05]. (3)Pearson correlation analysis results showed that the serum levels of BAFF were negatively correlated with 24 h urinary protein, urinary microalbumin, and urine red blood cell count (r=-0.587, -0.608, -0.515, all P<0.05). The serum levels of APRIL were positively correlated with serum IgA(r=0.588, P<0.05). Conclusions The level of serum BAFF decreased and APRIL increased in children with HSPN, which was related to the degree of renal involvement.It suggests that BAFF and APRIL may be related to the pathogenesis of HSPN in children. Key words: Henoch- Schonlein purpura nephritis; Child; B cell-activating factor; Proliferation-inducing ligand