Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide, accounting for 20%-40% of primary glomerulonephritis cases. Approximately 40% of patients progress to end-stage renal disease within 20 years. Traditional treatments primarily involve renin-angiotensin system inhibitors and glucocorticoids, but some patients show limited response and face infection risks. In recent years, the dual-target biologic agent Telitacicept, which targets B cell-activating factor/B lymphocyte stimulator(BAFF/BLyS) and a proliferation-inducing ligand (APRIL), has demonstrated significant potentialin the treatment of IgAN. By simultaneously neutralizing BAFF/BLyS and APRIL, Telitacicept suppresses abnormal B-cell activation and the production of pathogenic IgA1, significantly reducing urinary protein levels and preserving renal function. This article systematically reviews its mechanism of action, clinical efficacy, and safety, aiming to provide insights for the clinical management of IgAN.

Objective We evaluated serum levels of 25hydroxyvitamin D（25（OH）D）and Creactive protein（CRP）in patients presenting acutely with Vestibular neuritis（VN）and healthy controls and investigated the possible correlation of serum 25（OH）D and CRP levels with VN.Methods A total of 46 consecutive patients diagnosed with VN within 7 days of symptom onset and 66 ageand sexmatched healthy controls in NO731 Hospital，between March 2019 and August 2020 were recruited. Demographic and clinical data，such as age，sex，height，weight，living habits，ongoing health problems，and medication history，for all subjects were recorded，and levels of 25（OH）D and CRP were measured and compared. 〖WT5”HZ〗Results〖WT5”BZ〗Serum levels of 25（OH）D were significantly lower in patients with VN than in controls（18.30± 6.19 vs. 22.43±5.23 ng/ml，P<0.001）.whereas serum levels of CRP were higher in patients with VN than in controls （15.86±8.37 vs. ng/ml，P<0.001）Regression analyses demonstrated that vitamin D and CRP were associated with VN，with an odds ratio of 1.187 （95%CI 1.046～1.093，P=0.001）and 1.223 （95%CI=1.10～1.36，P=0.000）.Conclusion VN is associated with evidence of an acute inflammatory response，we found that serum 25（OH）D and CRP may be associated with VN occurrence.

A case of recurrent stroke with clopidogrel secondary prevention, CYP2C19 gene testing result of " clopidogrel slow metabolism" , platelet aggregation test result of " platelet aggregation significantly inhibited" as an example, the dialectical relationship among the above gene testing, platelet aggregation test, stroke recurrence were analyzed, and the choice of antiplatelet drugs was discussed.Clopidogrel gene testing has certain guiding significance for the secondary prevention of stroke patients.Platelet aggregation test results can not comprehensively evaluate the physiology and function of platelets in vivo.In order to find a more safe, effective and reasonable antiplatelet therapy, antiplatelet therapy should be further explored and optimized.

Leucine rich glioma inactivated 1 (LGI1) is a protein which is identified as the target involving in autoimmune encephalitis. Seizures and cognitive declines are two main symptoms of LGI1-antibody encephalitis. However, autonomic dysfunction symptoms are not prominent as seizures and cognitive defection and are easily overlooked by physicians. We reported a case with LGI1-antibody encephalitis whose onset symptoms were autonomic dysfunction including sweating, orthostatic hypotension. The features of this case was described in detail and the related literatures were reviewed in order to enhance the knowledge of the disease.