<b><i>Introductions:</i></b> Kidney injury molecule-1 (KIM-1) and periostin (POSTN) are proximal and distal tubule injury biomarkers. We tested whether baseline urine KIM-1/Cr (uKIM-1/Cr) and/or uPOSTN/Cr correlated with disease severity or improved a remission prediction model. <b><i>Methods:</i></b> Baseline uKIM-1/Cr and uPOSTN/Cr were measured on spot urine samples from immunosuppression-free patients enrolled in Nephrotic Syndrome Study Network until December 15, 2014. Urine protein/Cr (UPCR) and albumin/Cr (UACR) were measured at baseline, 4 months, and until last follow-up. Glomerular and tubulointerstitial (TI) expression arrays were analyzed from a baseline research renal biopsy core collected during a clinically indicated biopsy. Renal diagnoses were centrally confirmed, sections scanned, and measured morphometrically. Correlations between baseline uKIM-1/Cr and uPOSTN/Cr and UPCR, UACR, histopathologic features, glomerular and TI KIM-1 and POSTN expression levels, and renal outcomes were assessed. <b><i>Results:</i></b> Baseline uKIM-1/cr correlated with UPCR and UACR and were associated with complete remission (CR) after adjustment for proteinuria, histopathologic diagnosis, and treatment. Baseline uKIM-1/Cr also correlated with degree of foot process effacement and acute tubular injury. Glomerular and TI KIM-1 expression levels correlated with UPCR and UACR. Higher TI KIM-1 expression levels correlated with interstitial fibrosis, tubular atrophy, and global glomerulosclerosis, while glomerular KIM-1 expression correlated with time to remission. Findings for POSTN were of lesser statistical strength. <b><i>Discussion/Conclusion:</i></b> Lower baseline uKIM-1/Cr values were associated with more rapid time to CR after adjusting for proteinuria, histopathologic diagnosis, and treatment. Increased TI KIM-1 expression levels in proteinuric states were associated with chronic morphological injury; lower glomerular expression levels were associated with a greater potential for proteinuria reversibility.

BackgroundNone studies have been reported focused on Early gastric cancer(EGC) at the gastric angle although EGCs have been commonly found in this region in Chinese patients. We attempted to discover the characteristics of EGC patients treated Endoscopic submucosal dissection(ESD) at the gastric angle that have not yet to be reported.METHODS We reviewed the medical records of patients with EGC treated with ESD from January 2010 to December 2018, and investigated and analyzed clinicopathologic features and ESD outcomes of EGC patients.RESULTSIn all 444 EGC patients receiving ESD treatment, the second most common anatomic site was the gastric angle (23.0%), following the gastric antrum (55.6%). Compared to the other gastric parts, the EGC at the gastric angle had a relatively higher percentage of the flat or depressed lesions (67.7%)( P=0.05) . The rate of severe submucosal fibrosis was significantly higher in the gastric angle lesions(15.69%) than those in the gastric body (4.5%) ,cardia (3.9% ),antrum (1.21%) (P < 0.001) .Among EGCs at the gastric angle there were lower rates of en bloc resection , complete resection and curative resection , as well as higher perforation rate and longer procedure time in the severe submucosal fibrosis group (P<0.05) .CONCLUSIONSThe gastric angle is the second most common location of EGCs resected with ESD.There is a higher rate of severe submucosal fibrosis in EGCs at the gastric angle ,which suggests more attention should be paid to patients with EGCs at the gastric angle referred for ESD.