Objective This study examined changes in serum growth hormone(GH)and insulin-like growth factor 1(IGF-1)levels,as well as insulin resistance,in patients with type 2 diabetes mellitus(T2DM)across different stages of diabetic kidney disease(DKD).It explored the relationship between these factors and the occurrence and progression of DKD,with the aim of identifying new targets for the prevention and treatment of DKD.Methods In this cross-sectional study,T2DM patients aged 18-80 years were selected from the Department of Endocrinology,The Second Affiliated Hospital of Xi'an Jiaotong University,from November 30,2019 to March 30,2021.Their serum GH and IGF-1 levels were tested.Results The serum GH level increased gradually in the groups,and the difference was statistically significant(P＜0.05).The level of serum IGF-1 decreased first and then increased among the groups,but with no significant difference(P＞0.05).HOMA-IR showed no significant correlation among the groups(P＞0.05),but HOMA-β gradually decreased among the groups,with statistically significant difference(P＜0.05).Multivariate Logistic regression analysis showed that the increase of serum GH level was closely related to the progression of T2DM to early DKD,and that the increase of serum IGF-1 level might be related to the deterioration of renal function in patients with T2DM at DKD stage.HOMA-IR and HOMA-β were not found to have correlation with the occurrence or development of DKD in T2DM patients.Conclusion In patients with T2DM,elevated serum GH level is closely associated with the occurrence and progression of early DKD.The increase of serum GH level may promote the occurrence of early DKD in T2DM,and the increase of serum IGF-1 level may be related to the deterioration of renal function in clinical DKD stage.In this study,we did not find correlation of HOMA-IR and HOMA-β with the occurrence or development of DKD in T2DM patients.

Objective:To analyze the early risk factors of necrotizing pneumonia (NP) in children with Mycoplasma pneumoniae pneumonia (MPP) and construct a clinical prediction model.Methods:In this case-control study, the clinical data of MPP patients who were hospitalized at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology, from January 2021 to May 2024 were retrospectively analyzed.According to whether NP occurred, the children were divided into the NP group and the non-NP (NNP) group.A total of 62 and 124 children were included in the NP and NNP groups after nearest neighbor matching at a ratio of 1∶2 (with a caliper value of 0.02), respectively.LASSO regression was used to select the optimal factors, and the multivariate Logistic regression analysis was used to establish a clinical prediction model.Internal and external validation of the prediction model was then conducted.The receiver-operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive ability and calibration of the prediction model.The clinical decision curve analysis (DCA) was used to evaluate its clinical predictive value.Results:The LASSO regression analysis showed that white blood cells (WBC), neutrophil percentage, C-reactive protein (CRP), procalcitonin, D-dimer, ferritin, fever duration, and lung consolidation were factors influencing the occurrence of NP in children with MPP ( P<0.05).The ROC analysis showed that the area under the curve (AUC) of the prediction model was 0.838 (95% CI: 0.765-0.911, P<0.001) in the training set, 0.834 (95% CI: 0.755-0.913, P<0.001) in the validation set, and 0.924 (95% CI: 0.902-0.981, P<0.001) in the external validation set.Bootstrap was used for repeated sampling for 1 000 times for internal validation, and the calibration curve showed that the model had good early consistency.The clinical DCA showed that the model had good clinical application value. Conclusions:WBC, CRP, D-dimer, ferritin, fever duration and lung consolidation have good value for the early prediction of MPNP in children.

Objective This study examined changes in serum growth hormone(GH)and insulin-like growth factor 1(IGF-1)levels,as well as insulin resistance,in patients with type 2 diabetes mellitus(T2DM)across different stages of diabetic kidney disease(DKD).It explored the relationship between these factors and the occurrence and progression of DKD,with the aim of identifying new targets for the prevention and treatment of DKD.Methods In this cross-sectional study,T2DM patients aged 18-80 years were selected from the Department of Endocrinology,The Second Affiliated Hospital of Xi'an Jiaotong University,from November 30,2019 to March 30,2021.Their serum GH and IGF-1 levels were tested.Results The serum GH level increased gradually in the groups,and the difference was statistically significant(P＜0.05).The level of serum IGF-1 decreased first and then increased among the groups,but with no significant difference(P＞0.05).HOMA-IR showed no significant correlation among the groups(P＞0.05),but HOMA-β gradually decreased among the groups,with statistically significant difference(P＜0.05).Multivariate Logistic regression analysis showed that the increase of serum GH level was closely related to the progression of T2DM to early DKD,and that the increase of serum IGF-1 level might be related to the deterioration of renal function in patients with T2DM at DKD stage.HOMA-IR and HOMA-β were not found to have correlation with the occurrence or development of DKD in T2DM patients.Conclusion In patients with T2DM,elevated serum GH level is closely associated with the occurrence and progression of early DKD.The increase of serum GH level may promote the occurrence of early DKD in T2DM,and the increase of serum IGF-1 level may be related to the deterioration of renal function in clinical DKD stage.In this study,we did not find correlation of HOMA-IR and HOMA-β with the occurrence or development of DKD in T2DM patients.

Objective:To analyze the early risk factors of necrotizing pneumonia (NP) in children with Mycoplasma pneumoniae pneumonia (MPP) and construct a clinical prediction model.Methods:In this case-control study, the clinical data of MPP patients who were hospitalized at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology, from January 2021 to May 2024 were retrospectively analyzed.According to whether NP occurred, the children were divided into the NP group and the non-NP (NNP) group.A total of 62 and 124 children were included in the NP and NNP groups after nearest neighbor matching at a ratio of 1∶2 (with a caliper value of 0.02), respectively.LASSO regression was used to select the optimal factors, and the multivariate Logistic regression analysis was used to establish a clinical prediction model.Internal and external validation of the prediction model was then conducted.The receiver-operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive ability and calibration of the prediction model.The clinical decision curve analysis (DCA) was used to evaluate its clinical predictive value.Results:The LASSO regression analysis showed that white blood cells (WBC), neutrophil percentage, C-reactive protein (CRP), procalcitonin, D-dimer, ferritin, fever duration, and lung consolidation were factors influencing the occurrence of NP in children with MPP ( P<0.05).The ROC analysis showed that the area under the curve (AUC) of the prediction model was 0.838 (95% CI: 0.765-0.911, P<0.001) in the training set, 0.834 (95% CI: 0.755-0.913, P<0.001) in the validation set, and 0.924 (95% CI: 0.902-0.981, P<0.001) in the external validation set.Bootstrap was used for repeated sampling for 1 000 times for internal validation, and the calibration curve showed that the model had good early consistency.The clinical DCA showed that the model had good clinical application value. Conclusions:WBC, CRP, D-dimer, ferritin, fever duration and lung consolidation have good value for the early prediction of MPNP in children.

Objective To summarize the aortographic features of child patients with Kawasaki disease(KD)complicated by coronary artery lesion(CAL)who were treated at the Wuhan Children's Hospital of China.Methods The clinical data of 30 child patients with early recovery stage KD complicated by CAL,who received aortic angiography examination at Wuhan Children's Hospital of China between June 2016 and June 2023,were retrospectively analyzed.Preoperative echocardiography was adopted to evaluate the severity of CAL,and aortic angiography under laryngeal mask general anesthesia was performed.Results Successful aortic angiography examination was accomplished in all the 30 child patients with KD complicated by CAL.After angiography,the CAL risk classification results showed that grade I was seen in 5,grade Ⅱ in 7,grade Ⅲ in 12,grade Ⅲ in 4,and grade V in 2 child patients.Of all child patients,old coronary thrombosis was found in one(grade Ⅲb),and coronary artery stenosis with collateral circulation formation in one(grade Ⅴ).The CAL was located at the proximal segment(n=15),middle segment(n=3)and distal segment(n=2)of the right coronary artery,at the left main coronary artery(n=12),and at the proximal segment of left coronary artery anterior descending branch(n=9).Electrocardiography showed sinus rhythm(n=17),sinus arrhythmia(n=4),right bundle branch block(n=4),atrial premature beat(n=1),ventricular premature beat(n=2),T-wave change(n=1),and Q-wave change(n=1,coronary lesion grade V,echocardiography suggested left heart enlargement).No cardiac enlargement,cardiac functional insufficiency,or valvular regurgitation signs were observed in the remaining child patients.Conclusion It is clinically safe and feasible to perform aortic angiography examination in child patients with early recovery stage KD complicated by CAL.In this series of child patients with KD,CAL mainly occurs at the proximal segment of coronary artery,especially at the proximal segment of right coronary artery as well as at the left main artery and left anterior descending branch.

Background and objective Lung cancer is the malignant tumor with the highest incidence rate and the heaviest disease burden in China.In recent years,lung cancer has shown a high incidence trend,seriously affecting the health of the population.In this paper,we analyze the characteristics of lung cancer incidence in 2019 and the trend of incidence rate from 2010-2019 in the tumor registration area of Gansu province,in order to provide a reference basis for the development of lung cancer prevention and control strategies in Gansu province.Methods By analyzing the cases of lung cancer incidence in the tumor registration area of Gansu province in 2019,we calculated the incidence rate,medium incidence rate,world in-cidence rate and other related indexes;we used Joinpoint to calculate the annual percentage change(APC)for trend analysis.Results In 2019,a total of 3757 new cases of lung cancer were reported in Gansu province,accounting for 14.96%of all new malignant tumors.The incidence rate,medium incidence rate and world incidence rate and world rate of lung cancer were 40.52/105,25.78/105,25.86/105;and the cumulative rate of 0-74 years old,and the truncation rate of 35-64 years old were 3.23%,40.03/105,respectively.The incidence of lung cancer rises with age,and is high in the age group of 40 years and above,and the incidence peaks in the male and female populations in the group of 75 years and above,and the group of 80 years and above,respectively.The crude incidence rate of lung cancer in the tumor registration area of Gansu province from 2010-2019 showed an overall increasing trend,and the rate of increase was relatively fast,with an APC 5.39%(P<0.05);Separately,accord-ing to gender,urban and rural areas,the incidence of lung cancer in all populations showed an increasing trend,and the APC of male,female,urban and rural populations were 4.98%,6.39%,6.26%,and 4.64%,respectively(all P<0.05).According to the trend analysis of lung cancer incidence rate by age group,only lung cancer incidence in the age group of 65 years and above increased at an annual average rate of 4.15%(P<0.05).Conclusion The incidence rate of lung cancer in the tumor registration area of Gansu province from 2010 to 2019 shows a rising trend year by year,and there are differences in the incidence of lung cancer in people of different genders,regions and age groups,so comprehensive prevention and control work should be carried out for the key populations of lung cancer incidence.

Objective:To assess the efficacy of Rituximab (RTX) in treating children with refractory nephro-tic syndrome.Methods:A retrospective study was carried out.Twenty-two children diagnosed with refractory nephrotic syndrome in the Department of Nephrology of Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from November 2018 to November 2020 were included in the study.All patients were treated with RTX.Patients with CD 19+ B lymphocytes≥1% total lymphocytes in peripheral blood were supplemented with one dose of RTX (375 mg/m 2), and each patient received 3-4 doses of RTX on average.The patients were treated with Mycophenolate mofetil after early discontinuation of calcineurin inhibitors (CNI). The Kaplan-Meier method was used to analyze the proteinuria relapse-free rate and the incidence of frequently recurrent nephrotic syndrome or steroid-dependent nephrotic syndrome in children after RTX treatment.The relapse times before and after using RTX were analyzed by the Wilcoxon signed rank test.Besides, the body mass indexes (BMI) and height of children before and after RTX treatment were compared by the rank sum test. Results:Of 22 patients studied, 20 patients accomplished the therapeutic protocol.One-year and two-year proteinuria relapse-free survival rates were 85% and 40%, respectively.The recurrence rate was reduced under the discontinuation of CNI.Compared with those before RTX treatment, the BMI and height of all children were significantly improved at 1 year and 2 years after RTX treatment (all P<0.05). However, no significant improvement was observed between 1 or 2 years after RTX treatment (all P>0.05). Conclusions:The use of RTX can effectively reduce the recurrence rate of refractory nephrotic syndrome even when hormones and other immunosuppressants are discontinued.At the same time, RTX can significantly improve the BMI and height of children.RTX is safe and effective for treatment of refractory nephrotic syndrome.

Lower limb ankle exoskeletons have been used to improve walking efficiency and assist the elderly and patients with motor dysfunction in daily activities or rehabilitation training, while the assistance patterns may influence the wearer's lower limb muscle activities and coordination patterns. In this paper, we aim to evaluate the effects of different ankle exoskeleton assistance patterns on wearer's lower limb muscle activities and coordination patterns. A tethered ankle exoskeleton with nine assistance patterns that combined with differenet actuation timing values and torque magnitude levels was used to assist human walking. Lower limb muscle surface electromyography signals were collected from 7 participants walking on a treadmill at a speed of 1.25 m/s. Results showed that the soleus muscle activities were significantly reduced during assisted walking. In one assistance pattern with peak time in 49% of stride and peak torque at 0.7 N·m/kg, the soleus muscle activity was decreased by (38.5 ± 10.8)%. Compared with actuation timing, the assistance torque magnitude had a more significant influence on soleus muscle activity. In all assistance patterns, the eight lower limb muscle activities could be decomposed to five basic muscle synergies. The muscle synergies changed little under assistance with appropriate actuation timing and torque magnitude. Besides, co-contraction indexs of soleus and tibialis anterior, rectus femoris and semitendinosus under exoskeleton assistance were higher than normal walking. Our results are expected to help to understand how healthy wearers adjust their neuromuscular control mechanisms to adapt to different exoskeleton assistance patterns, and provide reference to select appropriate assistance to improve walking efficiency.
Aged ; Ankle/physiology* ; Ankle Joint/physiology* ; Biomechanical Phenomena/physiology* ; Electromyography ; Exoskeleton Device ; Gait/physiology* ; Humans ; Muscle Contraction ; Muscle, Skeletal/physiology* ; Walking/physiology*

The interleukin (IL) -23/IL-17 axis is the main pathway in the pathogenesis of plaque-type psoriasis vulgaris, and IL-17A plays a key role in the relevant immune pathways. IL-17A mediates overlapping inflammatory pathways in atherosclerosis and psoriasis, promotes inflammation, coagulation and thrombosis, and plays an important role in the occurrence and development of cardiovascular comorbidities in patients with psoriasis. Inhibiting the inflammatory effect of IL-17A can reduce the incidence and mortality of cardiovascular comorbidities in patients with severe psoriasis. This review summarizes recent research progress in IL-17A-mediated systemic inflammation and cardiovascular comorbidities in patients with psoriasis, and provides a reference for prevention and reduction of cardiovascular comorbidities in patients with psoriasis in clinical practice.