Objective:To compare the consistency of microarray chemiluminescent protein chip and immunoblotting in the autoantibody spectrum of patients and the diagnostic efficacy of systemic lupus erythematosus(SLE), and to explore the correlation between the detection results of protein microarray and clinical indicators and lymphocyte subsets.Methods:Serum autoantibodies in 649 samples collected between December 2023 and December 2024 in Nanjing Drum Tower Hospital were analyzed using the microarray chemiluminescent protein chip method, with 401 samples simultaneously tested by immunoblotting. Kappa coefficient assessed inter-method consistency. Diagnostic performance was compared via ROC curves. Spearman correlation analysis evaluated relationships between autoantibody levels and SLEDAI-2000 scores, clinical parameters, and lymphocyte subsets.Results:The two methods demonstrated good consistency across 14 antinuclear antibodies, with optimal agreement for anti-SSA/Ro ( Kappa=0.845, P<0.001), anti-SSB ( Kappa=0.825, P<0.001), and anti-CENP B ( Kappa=0.851, P<0.001). The protein chip method significantly improved SLE diagnostic efficacy, particularly for anti-dsDNA (AUC difference=0.291, P<0.001) and anti-Sm antibodies (AUC difference=0.295, P<0.001). Combined detection of anti-SSA/Ro and anti-nRNP/Sm antibodies achieved superior diagnostic performance (AUC=0.927). Anti-dsDNA, anti-histone, and anti-nucleosome antibodies positively correlated with SLEDAI-2000 ( r=0.408, 0410, 0.384, all P<0.001), complement ( P<0.001), and 24-hour urinary protein ( r=0.374, 0.387, 0.301, all P<0.001). Immunological analysis showed that the proportion of NK cells was generally negatively correlated with antinuclear antibodies such as anti-dsDNA ( r=-0.352, P<0.001) and anti-Sm ( r=-0.328, P<0.001) antibodies. Meanwhile, the proportion of CD8 + T cells was positively correlated with anti-nRNP/Sm ( r=0.229, P=0.002) and anti-Sm antibodies ( r=0.211, P=0.005). The proportion of CD4 + T cells was negatively correlated with anti-SSA/Ro ( r=-0.239, P<0.001), while the proportion of B cells was positively correlated with anti-dSDNA antibody ( r=0.300, P<0.001). Conclusion:The protein chip method showed strong consistency with immunoblotting for detecting 14 autoantibodies but demonstrated superior SLE diagnostic efficacy. The combined use of multiple detection methods can enhance the reliability of clinical diagnosis.

Purpose To investigate interhemispheric homotopic functional connectivity in patients with neuropsychological systemic lupus erythematosus(NPSLE)during resting state and its relationship with clinical indicators and neuropsychological scales.Materials and Methods This prospective study enrolled 35 patients with NPSLE and 31 healthy controls(control group)from Taizhou People's Hospital Affiliated to Nanjing Medical University(June 2020 to March 2023).All participants underwent resting state functional MRI and completed neuropsychological assessments including mini-mental state examination,Montreal cognitive assessment,hospital anxiety and depression scale,fatigue scale for motor and cognitive functions,along with laboratory tests(C3,C4,IgA,IgM,IgG).Image preprocessing and voxel-mirrored homotopic connectivity(VMHC)calculations were performed using DPABI V7.0 on Matlab R2013b.Between-group differences in VMHC values were compared,and correlations between VMHC values in significant regions and neuropsychological/clinical data were analyzed.Results The NPSLE group demonstrated significantly lower mini-mental state examination and Montreal cognitive assessment scores compared with those in control group(t=-6.297,-7.001,both P=0.001).Patients with NPSLE exhibited significantly decreased VMHC values in bilateral parahippocampal gyri,precentral gyri,middle frontal gyri,and medial/paracingulate gyri compared with those in control group(family-wise error corrected,voxel-level P<0.001,cluster-level P<0.05).In the NPSLE group,VMHC values in precentral gyri showed positive correlation with IgA levels(r=0.351,P=0.039),while VMHC values in medial/paracingulate gyri positively correlated with IgA(r=0.345,P=0.043)and negatively with C4(r=-0.368,P=0.030).Conclusion Patients with NPSLE demonstrate abnormal interhemispheric homotopic functional connectivity,and the correlation between imaging metrics and clinical data in differential brain regions may facilitate early diagnosis of NPSLE while providing novel insights into the neuropathological mechanisms of cerebral injury.

Purpose To investigate interhemispheric homotopic functional connectivity in patients with neuropsychological systemic lupus erythematosus(NPSLE)during resting state and its relationship with clinical indicators and neuropsychological scales.Materials and Methods This prospective study enrolled 35 patients with NPSLE and 31 healthy controls(control group)from Taizhou People's Hospital Affiliated to Nanjing Medical University(June 2020 to March 2023).All participants underwent resting state functional MRI and completed neuropsychological assessments including mini-mental state examination,Montreal cognitive assessment,hospital anxiety and depression scale,fatigue scale for motor and cognitive functions,along with laboratory tests(C3,C4,IgA,IgM,IgG).Image preprocessing and voxel-mirrored homotopic connectivity(VMHC)calculations were performed using DPABI V7.0 on Matlab R2013b.Between-group differences in VMHC values were compared,and correlations between VMHC values in significant regions and neuropsychological/clinical data were analyzed.Results The NPSLE group demonstrated significantly lower mini-mental state examination and Montreal cognitive assessment scores compared with those in control group(t=-6.297,-7.001,both P=0.001).Patients with NPSLE exhibited significantly decreased VMHC values in bilateral parahippocampal gyri,precentral gyri,middle frontal gyri,and medial/paracingulate gyri compared with those in control group(family-wise error corrected,voxel-level P<0.001,cluster-level P<0.05).In the NPSLE group,VMHC values in precentral gyri showed positive correlation with IgA levels(r=0.351,P=0.039),while VMHC values in medial/paracingulate gyri positively correlated with IgA(r=0.345,P=0.043)and negatively with C4(r=-0.368,P=0.030).Conclusion Patients with NPSLE demonstrate abnormal interhemispheric homotopic functional connectivity,and the correlation between imaging metrics and clinical data in differential brain regions may facilitate early diagnosis of NPSLE while providing novel insights into the neuropathological mechanisms of cerebral injury.

Objective:To compare the consistency of microarray chemiluminescent protein chip and immunoblotting in the autoantibody spectrum of patients and the diagnostic efficacy of systemic lupus erythematosus(SLE), and to explore the correlation between the detection results of protein microarray and clinical indicators and lymphocyte subsets.Methods:Serum autoantibodies in 649 samples collected between December 2023 and December 2024 in Nanjing Drum Tower Hospital were analyzed using the microarray chemiluminescent protein chip method, with 401 samples simultaneously tested by immunoblotting. Kappa coefficient assessed inter-method consistency. Diagnostic performance was compared via ROC curves. Spearman correlation analysis evaluated relationships between autoantibody levels and SLEDAI-2000 scores, clinical parameters, and lymphocyte subsets.Results:The two methods demonstrated good consistency across 14 antinuclear antibodies, with optimal agreement for anti-SSA/Ro ( Kappa=0.845, P<0.001), anti-SSB ( Kappa=0.825, P<0.001), and anti-CENP B ( Kappa=0.851, P<0.001). The protein chip method significantly improved SLE diagnostic efficacy, particularly for anti-dsDNA (AUC difference=0.291, P<0.001) and anti-Sm antibodies (AUC difference=0.295, P<0.001). Combined detection of anti-SSA/Ro and anti-nRNP/Sm antibodies achieved superior diagnostic performance (AUC=0.927). Anti-dsDNA, anti-histone, and anti-nucleosome antibodies positively correlated with SLEDAI-2000 ( r=0.408, 0410, 0.384, all P<0.001), complement ( P<0.001), and 24-hour urinary protein ( r=0.374, 0.387, 0.301, all P<0.001). Immunological analysis showed that the proportion of NK cells was generally negatively correlated with antinuclear antibodies such as anti-dsDNA ( r=-0.352, P<0.001) and anti-Sm ( r=-0.328, P<0.001) antibodies. Meanwhile, the proportion of CD8 + T cells was positively correlated with anti-nRNP/Sm ( r=0.229, P=0.002) and anti-Sm antibodies ( r=0.211, P=0.005). The proportion of CD4 + T cells was negatively correlated with anti-SSA/Ro ( r=-0.239, P<0.001), while the proportion of B cells was positively correlated with anti-dSDNA antibody ( r=0.300, P<0.001). Conclusion:The protein chip method showed strong consistency with immunoblotting for detecting 14 autoantibodies but demonstrated superior SLE diagnostic efficacy. The combined use of multiple detection methods can enhance the reliability of clinical diagnosis.

Tuberculosis, a global infectious disease caused by Mycobacterium tuberculosis infection, ranks among the top ten causes of human death. The BCG vaccine is currently the only tuberculosis vaccine in clinical use, but its effectiveness in protecting adults from tuberculosis remains uncertain. In recent years, protein subunit vaccines have garnered significant attention due to their well-defined composition, high safety profile, and ability to enhance the BCG vaccine′s effects. However, the protein antigens in subunit tuberculosis vaccines typically elicit weak immune responses, necessitating the use of adjuvants to boost their immunogenicity. This review focuses on exploring various types of adjuvants utilized in novel tuberculosis vaccine formulations, ranging from those undergoing clinical trials to those still in preclinical development. The review provides an objective assessment of the advantages, disadvantages, and suitability of different adjuvants, while also highlighting current challenges in adjuvant research and proposing future research directions.

Objective To investigate the effect of Yinchenhao decoction on renal oxidative stress injury in rats with obstructive jaundice and its association with the regulation of the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear translocation. Methods A total of 32 male Sprague-Dawley rats were randomly divided into sham-operation group (S group), model group (O group), low-dose Yinchenhao decoction group (LY group), and high-dose Yinchenhao decoction group (HY group), with 8 rats in each group. For the rats in the S group, the upper common bile duct was isolated without ligation, and for those in the other groups, double ligation of the middle and upper 1/3 of the common bile duct was performed to establish a model of obstructive jaundice. After 7 days, the rats in the LY group and the HY group were given Yinchenhao decoction by gavage at a dose of 6.3 and 18.9 mL/kg, respectively, while those in the S and O groups were given an equal volume of distilled water by gavage every day for 7 consecutive days, and the rats were treated on day 14. ELISA was used to measure the serum levels of total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), blood urea nitrogen (BUN), and creatinine (Cr); spectrophotometry was used to measure the activity of the oxidative stress factors superoxide dismutase (SOD) and malondialdehyde (MDA) in renal tissue; quantitative real- time PCR and Western blotting were used to measure the mRNA and protein expression levels of Nrf2, Kelch-like ECH-associated protein 1 (Keap1), and NAD(P)H quinone dehydrogenase 1 (NQO1) in renal tissue; immunohistochemistry was used to measure observe the nuclear translocation of Nrf2 protein in renal tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further pairwise comparison within groups. Results Compared with the S group, the O group had significant increases in the levels of TBil, DBil, ALT、GGT, BUN, and Cr, a significant reduction in the activity of SOD, and a significant increase in the level of MDA (all P < 0.05). Compared with the O group, the LY group and the HY group had significant reductions in liver and renal function parameters, a significant increase in the activity of SOD, and a significant reduction in the level of MDA (all P < 0.05). Compared with the S group, the O group had significant reductions in the mRNA and protein expression levels of Nrf2 and NQO1 in renal tissue (all P < 0.05), and compared with the O group, the LY group and the HY group had significant increases in the mRNA and protein expression levels of Nrf2 and NQO1 (all P < 0.05), while there was no significant difference in the protein expression level of Keap1 between groups ( P > 0.05). Compared with the S group, the O group had a significant reduction in the positive rate of Nrf2 in cell nucleus in renal tissue ( P < 0.05), and compared with the O group, the LY group and the HY group had a significant increase in the positive rate of Nrf2 in cell nucleus ( P < 0.05). Conclusion Yinchenhao decoction can effectively alleviate renal injury caused by obstructive jaundice, possibly by upregulating the protein expression of Nrf2 in renal tissue and regulating the nuclear translocation of Nrf2 protein, so as to mediate the protein expression of downstream NQO1, regulate oxidative stress response caused by obstructive jaundice, and thereby alleviate renal injury in rats.

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. At present, the situation of tuberculosis control in China and even the world is severe. Bacillus Calmette-Guerin (BCG) vaccine is the only approved vaccine for tuberculosis, but its protective effect is limited. Hence, it is imperative to develop more effective tuberculosis vaccines. Currently, many new tuberculosis vaccine candidates are in clinical or preclinical trials. In this paper, to provide reference for the development of tuberculosis vaccines in China, the status of the research on vaccine candidates were reviewed and the progress in new tuberculosis vaccine strategies were summarized.

Objective:To explore the prevalence and risk factors of thyroid nodules in physical examination population.Method:A total of 5934 Han people who underwent physical examination in the physical examination center of the Affiliated Hospital of Hubei University of Arts and Sciences from August 2016 to August 2019 were selected as the research objects. Retrospective research methods were used to divide them into thyroid nodule group and thyroid non nodule group according to the results of thyroid ultrasound examination, and statistical analysis was carried out in combination with relevant data. T-test was used for the comparison between measurement data groups that conform to the normal distribution and χ 2 test was used for the comparison between counting data groups. Binary Logistic regression was used to analyze the relationship between different factors and thyroid nodules, and the odds ratio ( OR) and 95% confidence interval (95% CI) were calculated. Results:(1) The prevalence of thyroid nodules in all population is 28.1% (1 668/5 934), the prevalence of thyroid nodule is 23.1% (977/4 230) in men and 40.6% (691/1 704) in women separately, and the distribution is obviously higher in women than that in male (χ 2=183.13, P=0.008). The prevalence increased with aging in both sexes ( P=0.001). (2) The correlation between the clinical data of physical examination population and thyroid nodules was analyzed according to gender. Among male patients, the rates of BMI≥23.0 kg/m 2 (82.2% (803/977)), diabetes (14.7% (144/977)), hypertension (44.4% (434/977)) and smoking history (63.1% (616/977)) in thyriod nodule group were higher than those in the non thyroid nodule group (78.9% (2 565/3 253), 8% (260/3 253), 29.3% (952/3 253), 56.9% (1 851/3 253)) (χ 2 were 5.17, 39.59, 78.35 and 11.80, respectively; P values were 0.023, 0.009, 0.005 and 0.007, respectively). Among female patients, the rates of BMI ≥23.0 kg/m 2 (55% (380/691)), obesity (31.1% (215/691)), diabetes (6.2% (43/691)), hypertension (28.9% (200/691)), high total cholesterol (43.6% (301/691)), low high-density lipoprotein cholesterol (7.1% (49/691)), high triglycerides (28.4% (196/691)), and high low-density lipoprotein cholesterol (29.1% (201/691)) in thyroid nodule group were higher than those in the non thyroid nodule group (43.6% (442/1 013), 22.5% (228/1 013), 1.9% (19/1 013), 19.2% (195/1 013), 34.7% (352/1 013), 17.9% (181/1 013), 21.5% (218/1 013), 4.5% (46/1 013)), and the differences were statistically significant (χ 2 were 21.23, 15.82, 22.14, 21.68, 13.51, 26.27, 12.69 and 5.08, respectively; P values were 0.007, 0.006, 0.009, 0.007, 0.008, 0.005, 0.005 and 0.024, respectively). (3) Multiple logistic regression analysis reveal that age ( OR=1.530, 95% CI:1.463-1.621, P=0.009), sex ( OR=3.580, 95% CI:2.931-4.381, P=0.005), smoking ( OR=1.360, 95% CI:1.161-1.592, P=0.007) and high blood pressure ( OR=1.290, 95% CI:1.121-1.482, P=0.006) were the risk factors of thyroid nodule. Conclusion:The prevalence of thyroid nodules is 28.1% in XiangYang and surrounding areas, and the elders, women, smoking and high blood pressure were the risk factors of thyroid nodule.

Objective:To explore the application value of artificial intelligence-assisted diagnosis model based on convolutional neural network (CNN) in the differential diagnosis of benign and malignant breast masses.Methods:A total of 10 490 images of 2 098 patients with breast lumps (including 1 132 cases of benign tumor, 779 cases of malignant tumor, 32 cases of inflammation, 155 cases of adenosis) were collected from January 2016 to January 2018 in Beijing Tiantan Hospital Affiliated to the Capital University of Medical Sciences. They were divided into training set and test set and the auxiliary artificial intelligence diagnosis model was used for training and testing. Two sets of data training models were compared by two-dimensional imaging (2D) and two-dimensional and color Doppler flow imaging (2D-CDFI). The ROC curves of benign breast tumors, malignant tumors, inflammation and adenopathy were analyzed, and the area under the ROC curve (AUC) were calculated.Results:The accuracies of 2D-CDFI ultrasonic model for training group and testing group were significantly improved. ①For benign tumors, the result from training set with 2D image was: sensitivity 92%, specificity 95%, AUC 0.93; the result from training set with 2D-CDFI images was: sensitivity 93%, specificity 95%, AUC 0.93; the result for test set with 2D images was: sensitivity 91%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity: 94%, AUC 0.94. ② For malignancies, the result for training set with 2D images was: sensitivity 93%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94. ③For inflammation, the result for training set with 2D images was: sensitivity 81%, specificity 99%, AUC 0.91; the result for training set with 2D-CDFI images was: sensitivity 86%, specificity 99%, AUC 0.89; the result for test set with 2D images was: sensitivity 100%, specificity 98%, AUC 0.98; the result for test set with 2D-CDFI images was: sensitivity 100%, specificity 99%, AUC 0.96. ④For adenopathy, the result for training set with 2D images was: sensitivity 88%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 98%, AUC 0.94; the result for test set with 2D images was: sensitivity 94%, specificity 98%, AUC 0.93; the result for test set with 2D-CDFI images was: sensitivity 88%, specificity 99%, AUC 0.90. Its diastolic accuracy was not affected even if the maximum diameter of the tumor was less than 1 cm.Conclusions:Through the deep learning of artificial intelligence based on CNN for breast masses, it can be more finely classified and the diagnosis rate can be improved. It has potential guiding value for the treatment of breast cancer patients.

Objective: To investigate the prevalence of metabolic syndrome in adults in Shanghai Chongming area and to analyze the relationship between metabolic syndrome and chronic kidney disease. Methods: A total of 7 679 residents aged 30 years and over in Chongming District of Shanghai were randomly sampled and investigated by questionnaires, physical examinations, and laboratory examinations. The metabolic syndrome was diagnosed by the diagnostic criteria of metabolic syndrome according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes in 2017. According to the criteria of the International Society of Nephrology Working Group on Improving the Overall Prognosis of Kidney Diseases, estimated glomerular filration rate (eGFR)<60 ml·min^-1·(1.73 m²)^-1 was diagnosed as chronic kidney disease. Results: The prevalence of metabolic syndrome was 38.61% in the total population. The prevalence of metabolic syndrome was 47.06% in males and 34.71% in females. Urinary albumin-creatinine ratio (ACR), eGFR, age, smoking, waist circumference, blood glucose, blood pressure, high density lipoprotein-cholesterol and triglyceride in metabolic syndrome group were significantly higher than those in non- metabolic syndrome group. With the increase of metabolic components, eGFR decreased, and ACR increased. According to logistic regression analysis, age, male, hyperglycemia, hypertension, hypertriglyceride were risk factors for eGFR. Male, hypertension, hyperglycemia, hypertriglyceride, central obesity, smoking history, lower education level were risk factors for ACR. Conclusion The number of metabolic components is related to renal damage. Male, hypertension, hyperglycemia, hypertriglyceride are risk factors for early renal damage.