[Objective] To explore the clinical features of IgG4-related urinary diseases so as to provide reference for the diagnosis and treatment of such diseases. [Methods] The clinical data of 4 cases of IgG4-related urinary system diseases diagnosed and treated in Xijing Hospital of Air Force Medical University during Aug.2019 and Dec.2023 were retrospectively collected.Here, we report on the diagnosis and treatment of these patients, analysing their symptoms, serology, imaging and pathology as well as their treatment and outcomes. [Results] The patients included 2 male and 2 female.The lesions were involved with the retroperitoneum and urinary system.Three patients had symptoms of lumbar pain.The imaging manifestations were complex, including retroperitoneal mass involving urinary system organs in 2 cases, tabdense shadow of the right kidney in 1 case, and simple cystic mass of kidney in 1 case.Serum IgG4 value was not detected before surgery.All patients underwent radical surgical treatment.Postoperative pathology showed fibrous tissue hyperplasia with a large number of plasma cells, lymphocytes, a few neutrophil infiltrates, and lymphoid follicles and obliterated vasculitis in some specimens.The number of IgG4⁺ plasma cells was more than 10 in all tissues under high power microscope.After surgery, 3 patients had symptoms improved, and serum IgG4 value was within the normal range; 1 patient (patem 3) had elevated IgG4 value during follow-up, received subsequent hormone therapy, and the serum IgG 4 level remained stable. [Conclusion] The symptoms of IgG4-related diseases involving the urinary system are non-specific, and the imaging findings are various, easily confused with other diseases.Early detection of serum IgG4 and biopsy pathology can help clinicians make correct diagnosis in the early stage.

Objective:To develop and validate a Self-care Ability Scale for Arteriovenous Fistula (AVF) in Maintenance Hemodialysis (MHD) patients.Methods:Guided by Orem's self-care theory, the initial item pool of the scale was developed through a literature review, semi-structured interviews, and group discussions. The initial scale was finalized after two rounds of expert consultation using the Delphi method. A convenience sampling method was used to recruit 418 MHD patients using AVF in January 2024 for item analysis, exploratory factor analysis and reliability testing. Another 293 MHD patients using AVF were recruited in March 2024 for confirmatory factor analysis.Results:The self-care ability scale for AVF in MHD patients included four dimensions: knowledge and skills of AVF self-care, willingness and attitude toward AVF self-care, recognition and prevention of AVF complications, and patient self-adjustment and adaptation, comprising 38 items. The content validity index at the scale level was 0.98. Exploratory factor analysis extracted four common factors with a cumulative variance contribution rate of 84.706%. Confirmatory factor analysis indicated good model fit, strong convergent validity, and ideal discriminant validity. The total Cronbach's α coefficient of the scale was 0.987; the split-half reliability coefficient was 0.902, and the test-retest reliability coefficient was 0.979.Conclusions:The Self-care Ability Scale for AVF in MHD patients demonstrates excellent reliability and validity, making it a suitable tool for assessing patients' ability to self-care for their AVF.

PURPOSE: To investigate the regulatory role of nerve injury-induced protein 1 (NINJ1) in the anti-inflammatory function of human umbilical cord mesenchymal stem cells (hUC-MSCs) co-stimulated by interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α). METHODS: hUC-MSCs were expanded in vitro using standard protocols, with stem cell characteristics confirmed by flow cytometry and multilineage differentiation assays. The immunomodulatory properties and cellular activity of cytokine-co-pretreated hUC-MSCs were systematically evaluated via quantitative reverse transcription RT-qPCR, lymphocyte proliferation suppression assays, and Cell Counting Kit-8 viability tests. Transcriptome sequencing, Western blotting and small interfering RNA interference were integrated to analyze the regulatory mechanisms of NINJ1 expression. Functional roles of NINJ1 in pretreated hUC-MSCs were elucidated through gene silencing combined with lactate dehydrogenase release assays, Annexin V/Propidium Iodide apoptosis analysis, macrophage co-culture models, and cytokine Enzyme-Linked Immunosorbent Assay. Therapeutic efficacy was validated in a cecal ligation and puncture-induced septic mouse model: 80 mice were randomly allocated into 4 experimental groups (n=20/group): sham group (laparotomy without cecal ligation); phosphate-buffered saline-treated group (cecal ligation and puncture (CLP) + 0.1 mL phosphate-buffered saline); hUC-MSCs (small interfering RNA (siRNA)-interferon-gamma and tumor necrosis factor-alpha co-stimulation (IT))-treated group (CLP + hUC-MSCs transfected with scrambled siRNA); and hUC-MSCs (siNINJ1-IT)-treated group (CLP + hUC-MSCs with NINJ1-targeting siRNA). RESULTS: hUC-MSCs demonstrated compliance with International Society for Cellular Therapy criteria, confirming their stem cell identity. IFN-γ/TNF-α co-pretreatment enhanced the immunosuppressive capacity of hUC-MSCs, accompanied by the reduction of cellular viability, while concurrently upregulating pro-inflammatory cytokines such as interleukin-6 and interleukin-1β. This co-stimulation significantly elevated NINJ1 expression in hUC-MSCs, whereas genetic silencing of NINJ1 effectively suppressed pro-inflammatory cytokine production and attenuated damage-associated molecular patterns release through inhibition of programmed plasma membrane rupture. Furthermore, the NINJ1 interference potentiated the ability of cytokine-pretreated hUC-MSCs to suppress LPS-induced pro-inflammatory responses in RAW264.7 macrophages. In cecal ligation and puncture-induced sepsis model, NINJ1-silenced hUC-MSCs exhibited enhanced therapeutic efficacy, manifested by reduced systemic inflammation and multi-organ damage. CONCLUSION Our findings shed new light on the immunomodulatory functions of cytokine-primed MSCs, offering groundbreaking insights for developing MSC-based therapies against inflammatory diseases via interfering the expression of NINJ1.
Mesenchymal Stem Cells/drug effects* ; Animals ; Interferon-gamma/pharmacology* ; Tumor Necrosis Factor-alpha/pharmacology* ; Humans ; Mice ; Umbilical Cord/cytology* ; Cells, Cultured ; Apoptosis ; Male

Objective:To evaluate the predictive value of the Controlling Nutritional Status (CONUT) score for severe acute pancreatitis (SAP).Methods:A total of 426 patients with acute pancreatitis (AP) admitted to the First Affiliated Hospital of Zhengzhou University between January and December 2024 were retrospectively reviewed. After applying exclusion criteria, 189 patients were included and classified into non-severe AP (NSAP) and SAP groups according to diagnostic criteria. Demographic characteristics (age, sex, underlying diseases), vital signs, CONUT score, Bedside Index for Severity in Acute Pancreatitis (BISAP) score, and laboratory parameters (including complete blood count, blood glucose, liver and kidney function, coagulation profile, amylase, and lipase) on admission were compared between the two groups. Binary logistic regression was used to identify independent risk factors associated with AP severity. Receiver operating characteristic (ROC) curves were generated to assess the predictive performance of each indicator by determining the area under the curve (AUC), sensitivity, specificity, and optimal cutoff values.Results:Compared with the NSAP group, the SAP group had significantly longer hospital stays, higher respiratory rates, and elevated levels of PCT, CRP, absolute neutrophil count, AST, GGT, PT, D-dimer, INR, fibrinogen, FDP, as well as higher CONUT, SIRS, and BISAP scores (all P < 0.05). In contrast, the NSAP group showed significantly higher red blood cell count, hemoglobin, absolute lymphocyte count, serum calcium, albumin, total cholesterol, prothrombin time activity, and PNI score (all P < 0.05). Binary logistic regression analysis identified CONUT score ( OR = 1.623, 95% CI: 1.048–2.512) and BISAP score ( OR = 19.608, 95% CI: 6.585–58.387) as independent risk factors for disease severity. The AUC values for predicting SAP using CONUT score, BISAP score, and their combination were 0.694, 0.815, and 0.864, respectively. Conclusions:The CONUT score is an early independent risk factor for SAP. Combining CONUT with BISAP scores provides better predictive performance for assessing the severity of acute pancreatitis.

Objective:To develop and validate a Self-care Ability Scale for Arteriovenous Fistula (AVF) in Maintenance Hemodialysis (MHD) patients.Methods:Guided by Orem's self-care theory, the initial item pool of the scale was developed through a literature review, semi-structured interviews, and group discussions. The initial scale was finalized after two rounds of expert consultation using the Delphi method. A convenience sampling method was used to recruit 418 MHD patients using AVF in January 2024 for item analysis, exploratory factor analysis and reliability testing. Another 293 MHD patients using AVF were recruited in March 2024 for confirmatory factor analysis.Results:The self-care ability scale for AVF in MHD patients included four dimensions: knowledge and skills of AVF self-care, willingness and attitude toward AVF self-care, recognition and prevention of AVF complications, and patient self-adjustment and adaptation, comprising 38 items. The content validity index at the scale level was 0.98. Exploratory factor analysis extracted four common factors with a cumulative variance contribution rate of 84.706%. Confirmatory factor analysis indicated good model fit, strong convergent validity, and ideal discriminant validity. The total Cronbach's α coefficient of the scale was 0.987; the split-half reliability coefficient was 0.902, and the test-retest reliability coefficient was 0.979.Conclusions:The Self-care Ability Scale for AVF in MHD patients demonstrates excellent reliability and validity, making it a suitable tool for assessing patients' ability to self-care for their AVF.

Objective To analyze the risk factors for prolonged sedation recovery time in epileptic children.Methods A cross-sectional trial was conducted on the epileptic children who underwent electroencephalography(EEG)with oral administration of chloral hydrate and nasal dexmedetomidine for sedation in our hospital from November 2019 to December 2022.Their general information and sedation and medication data were collected.Prolonged sedation recovery time was defined as beyond the 75th percentile of awaking time,and then the children were divided into recovery time ≤1 h group and＞1 h group.Univariate and multivariable logistic regression analyses were used to identify the risk factors for recovery time in these children.Results A total of 1 346 children were enrolled,including 805 males and 541 females,with a median age of 6.03(4.42,8.56)years.There were 986 children assigned into recovery time ≤1 h group and 360 ones into recovery time＞1 h group.Univariate analysis showed that significant differences were observed in the proportions of age＜1 year(0.8％vs 2.2％,P=0.046),sedation more than 3 times(35.8％vs 42.2％,P=0.031),and treated with multiple antiepileptic drugs(AEDs)(25.5％vs 36.9％,P＜0.001)between the 2 groups.Multivariable logistic regression analysis indicated that age＜1 year(OR=2.943,95％CI:1.063～8.142,P=0.034),sedation times ≥3(OR=1.287,95％CI:1.003～1.649,P=0.047)and multiple use of AEDs(OR=1.718,95％CI:1.325～2.223,P＜O.001)were risk factors for prolonged recovery time.Conclusion Age＜1 year,sedation times ≥3 and multiple use of AEDs are risk factors for prolonged sedation recovery time in epileptic children undergoing EEG after oral chloral hydrate and nasal dexmedetomidine.

Mucinous adenocarcinoma of the renal pelvis is rare in clinical practice. This article reported a case of primary renal pelvis mucinous adenocarcinoma mixed with signet ring cell carcinoma. The patient was admitted to hospital due to right low back pain, and was diagnosed with right kidney stones accompanied by hydrops and infection, right kidney abscess, and nonfunctional right kidney after complete examination. Right renal puncture drainage was performed twice, followed by laparoscopic robot assisted right neprectomy. The postoperative pathological diagnosis was right renal pelvis primary mucinous adenocarcinoma (mixed with signet-ring cell carcinoma). Eleven months after the operation, regular "sodium folinate + oxaliplatin + 5-fluorouracil" chemotherapy was performed for 12 courses, and imaging showed no signs of recurrence or metastasis.

Objective:To systematically evaluate the risk factors of sarcopenia in patients with chronic heart failure, and to provide a basis for delaying the occurrence of sarcopenia and preventing the adverse outcome of sarcopenia.Methods:Cross-sectional studies, cohort studies and case-control studies of sarcopenia in PubMed, Cochrane Library, Web of Science, EMBase, China National Knowledge Infrastructure, China biomedical database (Sinomed), VIP database, Wanfang medical database were searched from database establishment to November 30, 2023. Meta-analysis was performed using RevMan 5.4 and Stata18.0 software.Results:In total, 16 articles were included, including 11 risk factors. The results showed that the incidence of chronic heart failure was 31.00%. The age of sarcopenia in chronic heart failure ( OR = 1.09, 95% CI 1.06-1.11), other chronic diseases ( OR = 6.57, 95% CI 3.29-13.10), cardiac function grade ( OR = 3.24, 95% CI 1.48-7.08), left ventricular ejection fraction ( OR = 0.96, 95% CI 0.94-0.97). Conclusions:Advancedage, comorbididy with other chronic diseases, and high cardiac function class are the risk factors for the development of sarcopenia in patients with chronic heart failure, and high left ventricular ejection fraction is a protective factor. Medical staff should screen early, identify high-risk groups early, strengthen health education, and give targeted interventions to slow down the development of sarcopenia to improve the quality of life of patients.

Objective:To systematically evaluate the risk factors of sarcopenia in patients with chronic heart failure, and to provide a basis for delaying the occurrence of sarcopenia and preventing the adverse outcome of sarcopenia.Methods:Cross-sectional studies, cohort studies and case-control studies of sarcopenia in PubMed, Cochrane Library, Web of Science, EMBase, China National Knowledge Infrastructure, China biomedical database (Sinomed), VIP database, Wanfang medical database were searched from database establishment to November 30, 2023. Meta-analysis was performed using RevMan 5.4 and Stata18.0 software.Results:In total, 16 articles were included, including 11 risk factors. The results showed that the incidence of chronic heart failure was 31.00%. The age of sarcopenia in chronic heart failure ( OR = 1.09, 95% CI 1.06-1.11), other chronic diseases ( OR = 6.57, 95% CI 3.29-13.10), cardiac function grade ( OR = 3.24, 95% CI 1.48-7.08), left ventricular ejection fraction ( OR = 0.96, 95% CI 0.94-0.97). Conclusions:Advancedage, comorbididy with other chronic diseases, and high cardiac function class are the risk factors for the development of sarcopenia in patients with chronic heart failure, and high left ventricular ejection fraction is a protective factor. Medical staff should screen early, identify high-risk groups early, strengthen health education, and give targeted interventions to slow down the development of sarcopenia to improve the quality of life of patients.