Abstract:Objective To observe the application effect of individualized treatments for ischemic stroke patients guided by the results of clopidogrel-related gene polymorphism and platelet aggregation tests.Methods A total of 120 patients with ischemic stroke who were admitted to Department of Neurology,Wuzhou Gongren Hospital from January 2022 to January 2024 were recruited and divided into research group and control group by random number table method,with 60 patients in each group.The control group was given conventional antiplatelet therapy[oral administration of clopidogrel(75mgq.d.)and aspirin(100 mg q.d.)].The research group was given conventional oral administration of aspirin(100 mg q.d.),and individualized treatment regimens were formulated according to the results of clopidogrel-related genes[including CYP2C19*2(rs4244285)、CYP2C19*3(rs4986893)、CYP2C19*17(rs12248560),ABCB1 C3435T(rs1045642)and CES1 G143E(rs71647871)]test and platelet aggregation test.The patients with CYP2C19 gene phenotypes of ultrarapid metabolizer(UM)and extensive metabolizer(EM)and ABCB1 C3435T carrying the G allele were treated with clopidogrel.The patients with CYP2C19 gene phenotypes of intermediate metabolizer(IM)and poor metabolizer(PM)and ABCB1 C3435T carrying the A allele were treated with ticagrelor.The patients with CYP2C19 gene phenotype of EM and ABCB1 C3435T of AA type,as well as those with CYP2C19 gene phenotype of IM and ABCB1 C3435T of GG type,were initially treated with clopidogrel.After 5 days of the medication,if the platelet adenosine diphosphate(ADP)receptor aggregation rate was less than 30%,clopidogrel treatment should be continued,and if the platelet ADP receptor aggregation rate was greater than or equal to30%,clopidogrel treatment should be switched to ticagrelor treatment.If the patients'CES1 G143E was CT type or TT type,ticagrelor was used for the treatment.The patients were followed up for 1 year to compare the occurrence of major adverse cardiovascular and cerebrovascular events(MACCE)between the two groups,and to analyze the impact of different genotypes on the prognosis of the patients receiving individualized treatment of clopidogrel.Results According to the results of clopidogrel-related gene polymorphism and platelet aggregation tests,a total of 28 patients in the research group had their medications adjusted.During the 1-year follow-up,no patients were lost to follow-up in either group.There were 21 cases of MACCE in the control group and 7 cases of MACCE in the research group.The research group had better results in terms of MACCE-free situation[HR(95%CI)=3.37(1.55-7.31),P=0.002].In the patients of the research group,there was no statistically significant difference in the occurrence of MACCE between the patients with CYP2C19 gene phenotypes of UM type/EM type and those with CYP2C19 gene phenotypes of IM type/PM type[HR(95%CI)=1.92(0.42-8.85),P=0.400],and there was no statistically significant difference in the occurrence of MACCE between the patients with ABCB1 C3435T gene of GG type and those with ABCB1 C3435T gene of GA type/AA type[HR(95%CI)=0.34(0.07-1.57),P=0.165].Conclusion Individualized treatments guided by the results of clopidogrel-related gene polymorphism and platelet aggregation tests can reduce the risk of MACCE in ischemic stroke patients.

Abstract:Polymyositis(PM)is a rare heterogeneous autoimmune disorder,characterized by symmetrical proximal muscle weakness as the mainly clinical manifestation,which can affect the quality of life and life expectancy of the patients.The etiology and pathogenesis of PM are complex and highly heterogeneous,involving multiple levels and pathways such as genetic susceptibility,environmental triggering factors and the immune system.In this paper,the research progress in complex immunopathogenesis and multi-target therapy of PM is reviewed.

Abstract:Immunoglobulin A(IgA)nephropathy(IgAN),also known as Berger's disease,is a glomerular disease characterized by the deposition of IgA or IgA immune complexes in the glomerular mesangial area.At present,IgAN is the most common primary glomerular disease worldwide.The characteristics of IgAN are complex due to differences in region,race,gender and age,suggesting that genetic and environmental factors play key roles in IgAN.In recent years,breakthroughs have been made in the research on the pathogenesis of IgAN in the aspects of immunology and molecular pathological mechanisms.The core link in the development of IgAN is the imbalance in the formation and clearance of the galactose-deficient immunoglobulin A1(Gd-IgA1)immune complex driven by mucosal immune dysregulation,resulting in IgA-specific deposition in the mesangial area and complement activation,which is the result of the interplay of genetic-environmental-immune factors.The hypothesis on anti-mesangial cell autoantibodies proposed in recent years has provided a new perspective for research on the etiology of IgAN.This paper systematically integrates the cutting-edge evidence on the epidemiology and pathogenesis of IgAN,providing a theoretical basis for the individualized treatment of IgAN.

Abstract:Kidney diseases pose one of the major burdens on global public health,and their incidence and mortality continue to rise.The rapid development of artificial intelligence(AI)provides revolutionary tools for exploring the mechanisms of kidney diseases and optimizing clinical treatments.This review summarizes the main types of kidney diseases and their complex pathogenic mechanisms,and points out the limitations of traditional research methods,and elaborates on the applications of AI in multi-omics data analysis,pathological image recognition in kidney diseases,big data-driven risk prediction,and mechanism analysis of rare kidney diseases.In clinical treatments,AI assists early screening,optimizations of individualized nutrition and dialysis,management of prognosis,and kidney transplant matching,significantly improving diagnostic accuracy and patient prognosis.This review also analyzes the challenges faced by AI and looks forward to the future prospects of multimodal fusion,federated learning,and large language models in precision medicine for kidney diseases.

Abstract:This paper reports a case of primary squamous cell carcinoma of the breast.

Abstract:Objective To explore the related mechanisms of oxidative damage and apoptosis of renal tubules in hyperuricemia mediated by the Rho kinase signaling pathway via the mitochondrial pathway.Methods Human renal tubular epithelial cells(HK-2 cells)were divided into 6 groups:NC group(normal control),transforming growth factor-β1(TGF-β1)group,uric acid group(intervention with high uric acid stimulation),fasudil group[receiving Rho-associated protein kinase(ROCK)inhibitor],ROCK1 siRNA group(intervention with ROCK1 gene silencing),sc-siRNA group(negative control).The expression levels of mitochondrial-related proteins in the cells of each group were detected by using Western blot and quantitative real-time polymerase chain reaction(qRT-PCR),and the expression levels were compared among different groups.Results High uric acid significantly upregulated the expression of myosin phosphatase-targeting subunit 1(MYPT1)in HK-2 cells,suggesting an increase in Rho kinase activity.High uric acid upregulated the expression level of manganese superoxide dismutase 2(MnSOD2)mRNA in HK-2 cells,while the pretreatment with fasudil significantly inhibited this change.After transfection with ROCK1 siRNA,the expression level of MnSOD2 mRNA in HK-2 cells was significantly decreased.The regulations of mitochondrial dynamin and biosynthesis genes via the Rho kinase pathway also affected the apoptosis process of the cells.Conclusion Rho kinase may accelerate the progression of hyperuricemic nephropathy by regulating mitochondrial oxidative damage and apoptosis.

Abstract:Objective To analyze the application value of VITEK®2 AST-YS08 card in drug sensitivity test of non-Candida albicans(NAC).Methods A total of 159 strains of NAC isolated from the normal germfree sites of the inpatients in Xiamen Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Xiamen University from January 2017 to December 2021 were selected,including 93 strains of C.parapsilosis complex(80 strains of C.parapsilosis,8 strains of C.orthopsilosis,4 strains of C.metapsilosis and 1 strain of Lodderomyces elongisporus),28 strains of C.tropicalis,18 strains of C.glabrata(including 1 strain of C.nivariensis),18 strains of Meyerozyma guilliermondii(including 1 strain of Kodamaea ohmeri)and 2 strains of Pichia kudriavzevii.The minimal inhibitory concentration(MIC)of NAC was tested in parallel using Sensititre YeastOne method(SYO method)and VITEK®2 AST-YS08 card,respectively,and the results were interpreted according to the CLSI-M27S44 standard issued by the Clinical and Laboratory Standards Institute(CLSI).Taking the results of SYO method as the reference,the essential agreement(EA),category agreement(CA),very major error(VME),major error(ME)and minor error(mE)of the results were analyzed between VITEK®2 AST-YS08 card and SYO method.Results Taking the results of SYO method as the reference,the EAs of the results in testing the sensitivity of NAC strains to micafungin,fluconazole,voriconazole,5-flucytosine and caspofungin between VITEK®2 AST-YS08 card and SYO method were 91.82%to 100.00%,and the CAs of the results were 86.79%to 95.12%.Among them,the EA of the results in 5-flucytosine sensitivity test was the highest(100.00%),followed by that in voriconazole sensitivity test(99.29%).The VME of the results in caspofungin sensitivity test by using VITEK®2 AST-YS08 card was associated with the MIC values of the strains of C.orthopsilosis closing to the antimicrobial breakpoints for interpretation.Conclusion VITEK®2 AST-YS08 card is easy to operate and convenient for automation.Taking the results of SYO method as the reference,the CAs of the results in testing the sensitivity of NAC strains to 5-flucytosine,micafungin,fluconazole,caspofungin and voriconazole between VITEK®2 AST-YS08 card and SYO method are higher,and VITEK®2 AST-YS08 card has better clinical application value.

Abstract:Objective To analyze the effects of intravenous infusions of human serum albumin(HSA),intravenous immunoglobulin(IVIG),and rabbit anti-human thymocyte immunoglobulin(ATG)on blood transfusion compatibility testing.Methods The clinical data of 34 patients whose blood samples were received by Department of Transfusion Medicine,the First Medical Center,Chinese People's Liberation Army General Hospital from January 2022 to December 2023 due to the infusions of albumin products or immunoglobulin(Ig)products resulting in incompatible cross-matching,positive results of unexpected antibody screening,and ABO blood group discrepancies were retrospectively analyzed.ABO/RhD typing test,unexpected antibody screening and identification,cross-matching test,direct antiglobulin test(DAT)and acid elution test were performed by using microcolumn gel method.Results Among the 10 patients infused with HSA,IgG-type anti-A was detected in the red blood cell(RBC)eluate of 5 patients with type A and 2 patients with type AB,IgG-type anti-B in the RBC eluate of 1 patient with type B,and agglutination phenomenon of B cells in reverse typing occurred in 1 patient with type B,and both IgG-type anti-A and IgG-type anti-B in the RBC eluate of 1 patient with type AB.Among the 18 patients infused with IVIG,IgG-type anti-A was detected in the RBC eluate of 8 patients with type A,IgG-type anti-A in the RBC eluate of 5 patients with type AB,and both IgG-type anti-A and IgG-type anti-B in the RBC eluate of 1 patient with type AB,and agglutination phenomenon of A1 cells in reverse typing occurred in 3 patients with type A and 1 patient with type AB.Non-specific antibodies were detected in 6 patients infused with ATG.Conclusion After infusions of HSA,IVIG or ATG,the patients are prone to develop positive DAT results,positive results of unexpected antibody screening,ABO blood group discrepancies,and incompatible cross-matching,which interfere with ABO blood typing and cross-matching.

Abstract:Objective To observe the clinical efficacy of serplulimab in non-small cell lung cancer(NSCLC)and its influence on T cell function.Methods A total of 162 patients with NSCLC who were admitted to Taizhou People's Hospital from December 2022 to April 2024 were recruited and divided into serplulimab treatment group(58 patients)and conventional chemotherapy group(104 patients)according to the patients'treatment intentions.The conventional chemotherapy group received a platinum-based concurrent chemotherapy regimen,while the serplulimab treatment group received the same chemotherapy regimen as the conventional chemotherapy group plus an additional serplulimab treatment.All the patients were treated continuously for 2 cycles(3 weeks as 1 treatment cycle).The levels of T lymphocyte subsets and tumor markers were compared between the patients in the two groups before and after treatment.The therapeutic effects were evaluated according to Response Evaluation Criteria in Solid Tumors version 1.1(RECIST 1.1).After a one-year follow-up,the progression-free survival and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)and cytokeratin fragment antigen 21-1(CYFRA21-1)in both groups were significantly lower than those before treatment(P＜0.05),but there were no statistically significant differences in the levels of these indicators between the two groups after treatment(P＞0.05).Compared with those in the conventional chemotherapy group,the levels of CD4+and CD4+/CD8+ratio in the serplulimab treatment group were higher after treatment(P＜0.05),and the differences were statistically significant(P＜0.05).The objective response rate and disease control rate of the patients in the serplulimab treatment group were significantly higher than those in the conventional chemotherapy group(58.62%vs 37.50%,χ2=6.709,P=0.010;82.76%vs 60.58%,χ2=8.493,P=0.004).The median progression-free survival in the serplulimab treatment group was 12 months and that in the conventional chemotherapy group was 9 months.The prognosis of progression-free survival in the serplulimab treatment group was significantly better than that in the conventional chemotherapy group(log-rank test:χ2=10.931,P=0.001).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Serplulimab has good clinical therapeutic effects on NSCLC.It can effectively improve T lymphocyte immune function and levels of serum tumor markers in the NSCLC patients,and has clinical promotion value.

Abstract:Objective To explore the associations of interleukin-17A(IL-17A),intercellular adhesion molecule-1(ICAM-1)and mucin 5AC(MUC5AC)levels in bronchoalveolar lavage fluid(BALF)and serum with Mycoplasma pneumoniae pneumonia(MPP)complicating airway mucus plugs(AMP)and clinical prognosis in pediatric patients.Methods A total of 249 pediatric patients with MPP who were admitted to the Fourth Hospital of Changsha from October 2020 to October 2024 were recruited in a 1∶2 matching design.The pediatric patients were divided into AMP group(83 patients)and non-AMP group(166 patients)according to the occurrence of AMP.BALF and serum specimens were collected before treatment.The levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum were detected by using enzyme-linked immunosorbent assay(ELISA)and were compared between the two groups.The pediatric patients were followed up and their prognosis was observed 28 days after admission for treatment.The factors influencing prognosis of the MPP pediatric patients complicated with AMP were analyzed by using logistic regression.The efficacy of IL-17A,ICAM-1 and MUC5AC levels in BALF and serum in diagnosing the MPP pediatric patients complicated with AMP and the efficacy in predicting the prognosis of the MPP pediatric patients complicated with AMP were analyzed by using receiver operating characteristic(ROC)curve.Results The levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum in the AMP group were higher than those in the non-AMP group,with statistically significant differences between the two groups(P＜0.05).The results of ROC curve analysis showed that the levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum could effectively diagnose the MPP pediatric patients complicated with AMP(P＜0.05),and the diagnostic efficacy of the combination of the three indicators was superior to that of a single indicator(P＜0.05),and the combined diagnostic efficacy of the three indicators in BALF was comparable to that of the three indicators in serum,and the difference was not statistically significant(Z=1.303,P=0.193).The poor prognosis rate of the MPP pediatric patients complicated with AMP was 36.14%(30/83).The results of multivariate logistic regression analysis showed that higher levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum were independent risk factors for poor prognosis in the MPP pediatric patients complicated with AMP(P＜0.05).The results of ROC curve analysis showed that the levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum could effectively predict the poor prognosis of the MPP pediatric patients complicated with AMP(P＜0.05),and the diagnostic efficacy of the combination of the three indicators was superior to that of a single indicator(P＜0.05).The combined diagnostic efficacy of the three indicators in BALF was comparable to that of the three indicators in serum,and the difference was not statistically significant(Z=1.426,P=0.141).Conclusion Elevated levels of IL-17A,ICAM-1 and MUC5AC in BALF and serum are associated with the complicating AMP and poor clinical prognosis in MPP pediatric patients.The combined detection of the three indicators is helpful for clinicians to identify the high-risk pediatric patients and perform active interventions and treatments,improving the prognosis of the pediatric patients.

Abstract:The global burden of diseases in cervical cancer,endometrial cancer and ovarian cancer continues to increase,and the onset age of patients with these diseases shows a trend of getting younger.As an emerging therapeutic strategy,hyperthermic intraperitoneal chemotherapy(HIPEC)has been proven to significantly improve the prognosis of patients with advanced,recurrent or metastatic gynecological malignant tumors by constructing a synergistic thermochemotherapy system,especially in ovarian cancer patients after interval cytoreductive surgery.Given that the regulation of tumor microenvironment is a key mechanism for HIPEC to exert therapeutic effects,in-depth research on the mechanism is expected to provide the patients with more precise personalized treatment regimens.In this paper,the research progress of HIPEC combined with multimodal therapy in regulating the microenvironment of gynecological malignant tumors is reviewed.

Abstract:In recent years,several large-scale evidence-based medical researches published in top international journals have confirmed that intensive blood pressure control can effectively decrease the mortality of patients with hypertension and reduce their cardiovascular events.However,the impact of intensive blood pressure control on renal outcomes is controversial.Researches have shown that intensive blood pressure control may increase the risk of renal adverse events in the short term,but long-term observations have found that intensive blood pressure control has the effect of delaying the progression of nephropathy in patients with chronic kidney disease(CKD).Intensive blood pressure control has a more significant protective effect on the kidneys of CKD patients complicated with proteinuria and advanced CKD stages,suggesting that CKD patients with different clinical characteristics may obtain differential renal benefits from intensive blood pressure control strategies.Antihypertensive treatment should aim not only at achieving single-time target goal but also at maintaining long-term time in target range.For a long time,the rate of achieving blood pressure targets among CKD patients in China has been low,and the problem of hypertension resulting in the progression of kidney disease has not been effectively controlled.This paper elaborates on the comprehensive benefits of antihypertensive treatment for CKD patients.Based on the latest clinical research results and international guidelines,it emphasizes that efforts should not only be made to increase the rate of achieving blood pressure targets among CKD patients,but also to strive for intensive blood pressure control and achieving long-term time in target range.

Abstract:This paper reports a case of giant pulmonary bulla treated by percutaneous lung puncture combined with endoscopic cryoprecipitate instillation.

Abstract:Objective To explore the mechanism of action of nalfurafine in treatment of chronic kidney disease-associated pruritus(CKD-aP)based on network pharmacology and molecular docking techniques.Methods The basic information and target sites of nalfurafine were obtained via Chemical Book platform,SwissTargetPrediction database and GeneCards database.Comparative Toxicogenomics Database(CTD)and GeneCards database were used to screen the target sites related to chronic kidney disease(CKD)and pruritus.The data update of the relevant databases was up to July 2025.The protein-protein interaction(PPI)network was constructed.Gene Ontology(GO)function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed on the common target sites.Results A total of 100 effect target genes of nalfurafine,4277 target genes related to CKD,4091 target genes related to pruritus,and 49 nalfurafine and CKD-aP common target genes were obtained.Nine key target genes were obtained through the screening of PPI network.A total of 933 enrichment results were obtained by using GO enrichment analysis,among which biological processes(BP)were mainly involved in phosphorylation,transmembrane receptor protein tyrosine kinase signal pathway and protein phosphorylation,and cellular components(CC)were mainly involved in receptor complex,postsynaptic portion andⅠA phosphatidylinositol 3-kinase complex,and molecular functions(MF)were mainly involved in protein kinase activity,phosphotransferase activity with ethanol as receptor and kinase activity.A total of 139 pathways were obtained by using KEGG enrichment analysis,which were mainly involved in epidermal growth factor receptor(EGFR)tyrosine kinase inhibitor resistance,PI3K-Akt signal pathway and ErbB signal pathway.Conclusion Nalfurafine can treat CKD-aP via multiple targets and pathways,which provides a theoretical basis for further research on nalfurafine.

Abstract:Artificial intelligence(AI)has brought new transformations to academic research and scholarly publishing,emerging as a new productive force driving technological progress and societal development.However,the application of AI in medical research and publishing field faces a series of ethical risks,which has attracted widespread attention in the publishing industry.This article provides an overview of the current application status,ethical dilemmas,and governance pathways of AI technology in various aspects of medical research and scholarly publishing,aiming to offer references for medical science and technology journals in addressing ethical issues arising from the application of AI in the field of medical research.

Abstract:Objective To explore correlations of serum microRNA-27b-3p(miR-27b-3p)and microRNA-142-5p(miR-142-5p)levels with disease progression of clear cell renal cell carcinoma(ccRCC)and poor prognosis after retroperitoneal laparoscopic partial nephrectomy(RLPN).Methods A total of 110 patients with ccRCC who underwent RLPN in the Second Hospital of Qinhuangdao from January 2020 to February 2022 were recruited as ccRCC group,and 55 healthy individuals who underwent physical examination during the same period were selected as control group.The levels of serum miR-27b-3p and miR-142-5p in the ccRCC group before the operation and those in the control group during physical examination were detected by using real-time fluorescence quantitative polymerase chain reaction.The correlations of serum miR-27b-3p and miR-142-5p levels with the clinicopathological indicators of ccRCC were analyzed.Cox regression was used to analyze the factors influencing poor prognosis of the ccRCC patients after RLPN.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum miR-27b-3p and miR-142-5p levels in predicting poor prognosis of the ccRCC patients after RLPN.The progression-free survival(PFS)curves of the ccRCC patients with different levels of serum miR-27b-3p and miR-142-5p after RLPN were plotted by K-M method and were compared by using log-rank test.Results Compared with the control group,the ccRCC group had lower serum level of miR-27b-3p,but higher serum level of miR-142-5p,with statistically significant differences between the two groups(P＜0.05).The levels of serum miR-27b-3p and miR-142-5p were significantly correlated with TNM staging and Fuhrman grading(P＜0.05),but were not significantly correlated with gender,age,and tumor site(P＞0.05).The poor prognosis rate of the ccRCC patients after RLPN was 23.64%(26/110).The results of multivariate Cox regression analysis showed that TNM stage T2,Fuhrman gradesⅢ-Ⅳ,and higher serum miR-142-5p level were independent risk factors for poor prognosis in the ccRCC patients after RLPN(P＜0.05),while higher serum miR-27b-3p level was an independent protective factor against poor prognosis in the ccRCC patients after RLPN(P＜0.05).The results of ROC curve analysis showed that the efficacy of the combined use of serum miR-27b-3p and miR-142-5p in predicting poor prognosis of the ccRCC patients after RLPN was better than that of a single indicator(Zcombination of the two indicators-miR-27b-3p=2.148,P=0.032;Zcombination of the two indicators-miR-142-5p=2.329,P=0.020),with a sensitivity of 0.885 and a specificity of 0.857.The progression-free survival prognosis of the high miR-27b-3p group(≥1.37,53 cases)was significantly better than that of the low miR-27b-3p group(＜1.37,57 cases)(P＜0.05).The progression-free survival prognosis of the low miR-142-5p group(＜1.08,58 cases)was significantly better than that of the high miR-142-5p group(≥1.08,52 cases)(P＜0.05).Conclusion The levels of serum miR-27b-3p and miR-142-5p in ccRCC patients are related to the disease progression and prognosis after RLPN.The combined detection of the two indicators is helpful for the early identification of high-risk patients with poor prognosis after RLPN.

Abstract:Objective To study the regulatory role of NOD-like receptor family pyrin domain containing 3(NLRP3)inflammasome in acute kidney injury(AKI)mediated by high-mobility group nucleosome-binding protein 1(HMGN1)and its downstream Toll-like receptor 4(TLR4)-nuclear factor-kappa B(NF-κB)signaling pathways.Methods Eighteen C57BL/6 mice were selected and randomly divided into control group,AKI group and cytokine release inhibitory drug 3(CRID3)group(AKI+NLRP inhibitor),with 6 mice in each group.A mouse model of AKI induced by ischemia-reperfusion(I/R)was established by using the bilateral renal pedicle clamping method.The changes in renal function were evaluated by detecting the levels of serum blood urea nitrogen(BUN),serum creatinine(Scr)and cystatin C.The pathological changes in renal tissues were observed by using hematoxylin-eosin(HE)staining,Masson staining and Sirius Red staining.The expressions of HMGN1,NLRP3 and TLR4 in the renal tissues were detected by using immunohistochemical staining and Western blot method.The levels of inflammatory factors of interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in serum were detected by using enzyme-linked immunosorbent assay(ELISA).Results Compared with those in the control group,the levels of serum BUN,Scr and cystatin C were significantly increased(P＜0.05),and the pathological injuries of the renal tissues were aggravated,with renal tubular necrosis,interstitial fibrosis and inflammatory cell infiltration,and the expressions of HMGN1,NLRP3 and TLR4 proteins in the renal tissues were significantly increased(P＜0.05),and the levels of serum IL-1,IL-6 and TNF-α were significantly increased in the AKI group(P＜0.05).Compared with those in the AKI group,the levels of serum BUN,Scr and cystatin C were significantly decreased(P＜0.05),and the pathological injuries,inflammation and fibrosis of the renal tissues were alleviated,and the expressions of HMGN1,NLRP3 and TLR4 proteins in the renal tissues were significantly decreased(P＜0.05),and the levels of serum IL-1,IL-6 and TNF-α were significantly decreased in the CRID3 group(P＜0.05).Conclusion NLRP3 participates in the pathological process of AKI by regulating the expression of HMGN1 and the downstream TLR4 signaling pathway.Inhibiting the expression of NLRP3 can improve renal function,alleviate pathological injuries and inflammatory response in renal tissues.

Abstract:Objective To analyze the efficacy and safety of rituximab(RTX)in treatment of refractory primary focal segmental glomerulosclerosis(FSGS)in adults.Methods The clinical data of 14 adult patients who were diagnosed with refractory primary FSGS and received RTX treatment in Department of Nephrology,the People's Hospital of Guangxi Zhuang Autonomous Region from January 1,2021 to July 31,2025 were retrospectively analyzed.These data were sourced from the electronic medical record system of the People's Hospital of Guangxi Zhuang Autonomous Region and the follow-up records of the patients.Results The pathological types included 12 cases of non-specific type and 2 cases of apical type.The median age of the patients receiving RTX treatment for the first time was 37.5(23.0,69.5)years.Nine patients received single-dose treatment and 5 patients received 2-dose treatment,and the regular follow-up was completed in all the patients.At the 6-month follow-up,9 patients achieved complete remission and 5 patients achieved partial remission.Three FSGS patients with steroid-resistant type achieved complete remission at the sixth month of RTX treatment.Three overweight patients and one obese patient were treated with a single dose of RTX and all of them achieved complete remission 6 months after RTX treatment.During the follow-up period,all the patients did not experience any drug-related adverse reactions.Conclusion A single dose of RTX is not only effective for adult patients with steroid-dependent type and frequently relapsing type of FSGS,but also applicable to steroid-resistant type of FSGS.The therapeutic response to a single dose of RTX in overweight and obese patients may not be significantly different from that in normal-weight and underweight patients.After RTX treatment,the patients need to be closely followed up and attention should be paid to preventing infection in them.

Abstract:Objective To analyze the plaque characteristics between small and large infarction lesions in the middle cerebral artery territory using 3.0T high-resolution vessel wall magnetic resonance imaging(HR-VW-MRI)technology.Methods The clinical data of 63 patients with acute ischemic stroke in the middle cerebral artery territory who were admitted to Beijing Geriatric Hospital from December 2021 to December 2024 were retrospectively analyzed.According to the manifestations of diffusion-weighted imaging and apparent diffusion coefficient,the patients were divided into small subcortical infarction(SSI)group(42 patients)and large subcortical infarction(LSI)group(21 patients).All the patients underwent HR-VW-MRI examination.The number of quadrants with plaque formation,distribution of plaque locations on blood vessel walls,intraplaque hemorrhage,plaque burden(PB),vascular remodeling patterns at the plaque site,and the degree of vascular stenosis at the plaque site were observed in both groups.Results Among the 42 patients in the SSI group,34 patients were detected with plaques,totalling 34 plaques.All 21 patients in the LSI group were detected with plaques,totalling 21 plaques.There was statistically significant difference in the number of quadrants with plaque formatin between the two groups(P＜0.05),with a higher proportion of the plaques involving only one quadrant in the SSI group.The proportion of intraplaque hemorrhage in the LSI group was higher than that in the SSI group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in PB between the two groups(P＞0.05).There was no statistically significant difference in the distribution of plaque locations on blood vessel walls between the two groups(P＞0.05),and the plaques in both groups were most commonly found on the ventral and superior abdominal walls,followed by those found on the dorsal abdominal walls,and the plaques on the inferior abdominal walls were the least common.There were no statistically significant differences in vascular remodeling patterns at the plaque site between the two groups(P＞0.05),and more than half of the plaques exhibited positive remodeling.There was statistically significant difference in the degree of vascular stenosis at the plaque site between the two groups(P＜0.05),with a higher proportion of mild vascular stenosis at the plaque site in the SSI group and a higher proportion of moderate to severe vascular stenosis at the plaque site in the LSI group.Conclusion There are significant differences in plaque characteristics between SSI and LSI.Compared with those in the LSI area,the plaques in the SSI area are in a more limited involvement range,and have a lesser degree of vascular stenosis at the plaque site,and a lower proportion of intraplaque hemorrhage.

Abstract:Objective To explore the effects of high expression of insulin-like growth factor 2 mRNA-binding protein 1(IGF2BP1)on paclitaxel-resistant ovarian cancer cells and its mechanisms.Methods Kaplan-Meier Plotter database and ROC Plotter database were used to analyze the correlations of IGF2BP1 expression with the ovarian cancer patients'prognosis and paclitaxel resistance,respectively.The ovarian cancer cell line SKOV3 sensitive to paclitaxel and the ovarian cancer cell line SKOV3-R resistant to paclitaxel were selected for experiment.IGF2BP1-overexpressing lentivirus and empty vector were transfected into SKOV3-R cells,which were named S-R-IGF2BP1-OE cells and S-R-EV cells,respectively.Cell proliferation activity was detected by using CCK-8 assay.The expression of IGF2BP1 mRNA was detected by using reverse transcription-quantitative real-time polymerase chain reaction(RT-qPCR).Cell cycle distribution was detected by using flow cytometry.The expression levels of cell cycle-related factors were detected by using Western blot assay.Results High expression of IGF2BP1 was significantly correlated with worse overall survival(OS)and progression-free survival(PFS)in the ovarian cancer patients(P＜0.05).The expression level of IGF2BP1 mRNA in the chemotherapy-resistant group was significantly higher than that in the chemotherapy-sensitive group(P＜0.05).The expression level of IGF2BP1 mRNA in SKOV3-R cells was significantly higher than that in SKOV3 cells(P＜0.05).Under the intervention of paclitaxel,the proliferation activity of S-R-IGF2BP1-OE cells was higher than that of S-R-EV cells(P＜0.05).The half maximal inhibitory concentration(IC50)of paclitaxel for S-R-IGF2BP1-OE cells and the IC50 of paclitaxel for S-R-EV cells were 187.02 nmol/L and 98.76 nmol/L,respectively.The proportions of G0/G1 phase and G2/M phase in S-R-IGF2BP1-OE cells were significantly lower than those in S-R-EV cells(P＜0.05).The expression level of cyclin A2 in S-R-IGF2BP1-OE cells was higher than that in S-R-EV cells,and the expression levels of p27 kinase inhibitor protein 1(p27 KIP1),p27 CDK-interacting protein 1(p21 Cip1),glycogen synthase kinase-3β(GSK-3 β),and cell cyclin-dependent kinase 7(CDK7)in S-R-IGF2BP1-OE cells were lower than those in S-R-EV cells,and the differences were statistically significant(P＜0.05).Conclusion High expression of IGF2BP1 is associated with poor prognosis in ovarian cancer patients,which may mediate paclitaxel resistance by regulating the cell cycle of ovarian cancer cells.