Background: Reduction of immunosuppression (ROI) remains the mainstay of treatment for BK virus infection (BKVI) in kidney transplantation (KT). This review explored the role of intravenous immunoglobulin (IVIG) and mammalian target of rapamycin inhibitor (mTORi) regimens as alternative therapies for KT recipients with BKVI, focusing on viral clearance and graft-related outcomes. Methods: An electronic search was conducted for articles examining IVIG or mTORi use in treating BKVI among adult and/or pediatric KT recipients. Meta-analyses of proportions were performed for relevant outcomes. Results: Twenty-seven studies (13 evaluating IVIG and 14 evaluating mTORi) were included; all but three enrolled only adult participants. In IVIG studies, the pooled viral clearance rate was 76.4% (95% confidence interval [CI], 64.2%–85.5%), with numerically higher clearance for IVIG after ROI compared to IVIG with ROI (87.0% vs. 66.1%). Overall graft survival was 84.7% (95% CI, 70.7%–92.7%), with numerically higher survival in IVIG after ROI than in IVIG with ROI (93.6% vs. 78.4%). Pooled histological clearance and graft rejection rates were 82.8% and 14.5%, respectively. In mTORi studies, the pooled viral clearance rate was 68.0% (95% CI, 58.0%–76.7%) and overall graft survival was 89.1% (95% CI, 82.7%–93.4%), with no significant difference between patients with and without prior ROI. Histological clearance and graft rejection rates were 59.8% and 8.6%, respectively. Conclusions IVIG and mTORi regimens appear to be feasible alternatives to ROI in KT recipients with BKVI, achieving viral clearance while maintaining graft survival. Future randomized controlled trials are needed to further define their role and strengthen current evidence with higher-quality data.

Background: Kidney transplant recipients (KTRs) are at risk of coronavirus disease 2019 (COVID-19) complications and mortality. This study examined factors associated with moderate, severe, or critical COVID-19 infection among KTRs during the Omicron-predominant period. Methods: This single-center retrospective study included KTRs aged ≥18 years diag-nosed with COVID-19 between January 1, 2022, and December 31, 2023. Mild infection was defined as symptomatic illness without lower respiratory tract infection (LRTI);moderate infection as LRTI without hypoxia; severe infection as oxygen saturation <94% on room air; and critical infection as respiratory failure, septic shock, or multiple organ dysfunction. We compared the characteristics of KTRs with asymptomatic or mild COVID-19 versus those with moderate to critical disease. Logistic regression analysis was performed to identify factors associated with moderate to critical illness. Results: Most KTRs (94.4%) had received three or more vaccine doses. Of 603 episodes of COVID-19 infection during the study period, 554 (91.9%) were asymptomatic or mild, while 49 (8.1%) were moderate to critical. Multivariate analysis revealed that older age (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.006–1.069) and longer symptom duration before seeking care (aOR, 1.288; 95% CI, 1.155–1.436) were associated with higher odds of moderate to critical disease. Protective factors included receiving a vaccine booster within the past year (aOR, 0.414; 95% CI, 0.212–0.809) and higher glomerular filtration rate (aOR, 0.971; 95% CI, 0.956–0.986). Conclusions KTRs should seek care early if infected with COVID-19 and keep their COVID-19 vaccine boosters updated within 1 year of the last dose.

Background: Kidney transplant recipients (KTRs) are at risk of coronavirus disease 2019 (COVID-19) complications and mortality. This study examined factors associated with moderate, severe, or critical COVID-19 infection among KTRs during the Omicron-predominant period. Methods: This single-center retrospective study included KTRs aged ≥18 years diag-nosed with COVID-19 between January 1, 2022, and December 31, 2023. Mild infection was defined as symptomatic illness without lower respiratory tract infection (LRTI);moderate infection as LRTI without hypoxia; severe infection as oxygen saturation <94% on room air; and critical infection as respiratory failure, septic shock, or multiple organ dysfunction. We compared the characteristics of KTRs with asymptomatic or mild COVID-19 versus those with moderate to critical disease. Logistic regression analysis was performed to identify factors associated with moderate to critical illness. Results: Most KTRs (94.4%) had received three or more vaccine doses. Of 603 episodes of COVID-19 infection during the study period, 554 (91.9%) were asymptomatic or mild, while 49 (8.1%) were moderate to critical. Multivariate analysis revealed that older age (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.006–1.069) and longer symptom duration before seeking care (aOR, 1.288; 95% CI, 1.155–1.436) were associated with higher odds of moderate to critical disease. Protective factors included receiving a vaccine booster within the past year (aOR, 0.414; 95% CI, 0.212–0.809) and higher glomerular filtration rate (aOR, 0.971; 95% CI, 0.956–0.986). Conclusions KTRs should seek care early if infected with COVID-19 and keep their COVID-19 vaccine boosters updated within 1 year of the last dose.

Background: Kidney transplant recipients (KTRs) are at risk of coronavirus disease 2019 (COVID-19) complications and mortality. This study examined factors associated with moderate, severe, or critical COVID-19 infection among KTRs during the Omicron-predominant period. Methods: This single-center retrospective study included KTRs aged ≥18 years diag-nosed with COVID-19 between January 1, 2022, and December 31, 2023. Mild infection was defined as symptomatic illness without lower respiratory tract infection (LRTI);moderate infection as LRTI without hypoxia; severe infection as oxygen saturation <94% on room air; and critical infection as respiratory failure, septic shock, or multiple organ dysfunction. We compared the characteristics of KTRs with asymptomatic or mild COVID-19 versus those with moderate to critical disease. Logistic regression analysis was performed to identify factors associated with moderate to critical illness. Results: Most KTRs (94.4%) had received three or more vaccine doses. Of 603 episodes of COVID-19 infection during the study period, 554 (91.9%) were asymptomatic or mild, while 49 (8.1%) were moderate to critical. Multivariate analysis revealed that older age (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.006–1.069) and longer symptom duration before seeking care (aOR, 1.288; 95% CI, 1.155–1.436) were associated with higher odds of moderate to critical disease. Protective factors included receiving a vaccine booster within the past year (aOR, 0.414; 95% CI, 0.212–0.809) and higher glomerular filtration rate (aOR, 0.971; 95% CI, 0.956–0.986). Conclusions KTRs should seek care early if infected with COVID-19 and keep their COVID-19 vaccine boosters updated within 1 year of the last dose.

Background: Kidney transplant recipients (KTRs) are at risk of coronavirus disease 2019 (COVID-19) complications and mortality. This study examined factors associated with moderate, severe, or critical COVID-19 infection among KTRs during the Omicron-predominant period. Methods: This single-center retrospective study included KTRs aged ≥18 years diag-nosed with COVID-19 between January 1, 2022, and December 31, 2023. Mild infection was defined as symptomatic illness without lower respiratory tract infection (LRTI);moderate infection as LRTI without hypoxia; severe infection as oxygen saturation <94% on room air; and critical infection as respiratory failure, septic shock, or multiple organ dysfunction. We compared the characteristics of KTRs with asymptomatic or mild COVID-19 versus those with moderate to critical disease. Logistic regression analysis was performed to identify factors associated with moderate to critical illness. Results: Most KTRs (94.4%) had received three or more vaccine doses. Of 603 episodes of COVID-19 infection during the study period, 554 (91.9%) were asymptomatic or mild, while 49 (8.1%) were moderate to critical. Multivariate analysis revealed that older age (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.006–1.069) and longer symptom duration before seeking care (aOR, 1.288; 95% CI, 1.155–1.436) were associated with higher odds of moderate to critical disease. Protective factors included receiving a vaccine booster within the past year (aOR, 0.414; 95% CI, 0.212–0.809) and higher glomerular filtration rate (aOR, 0.971; 95% CI, 0.956–0.986). Conclusions KTRs should seek care early if infected with COVID-19 and keep their COVID-19 vaccine boosters updated within 1 year of the last dose.

OBJECTIVE To evaluate the clinical efficacy and safety of Xiaoyin capsules combined with secukinumab in the treatment of moderate to severe plaque psoriasis. METHODS A retrospective study was conducted on 105 patients with moderate to severe plaque psoriasis who received treatment in the Dept. of Dermatology of Xinxiang Central Hospital from January 2021 to June 2024. According to the treatment plan， they were divided into conventional group（n＝32）， monoclonal antibody group（n＝45）， and combination group（n＝28）. The conventional group was given Calcipotriol ointment+Fluticasone propionate cream+Acitretin capsules； the monoclonal antibody group was treated with secukinumab injection in addition to the treatment of the conventional group； the combination group received oral administration of Xiaoyin capsules in addition to the treatment of the monoclonal antibody group. All patients received at least 12 weeks of treatment. The psoriasis area and severity index（PASI） score， PASI improvement rate， dermatology life quality index（DLQI） score， physician’s global assessment（PGA） score， patient’s global assessment（PtGA） score before and after treatment， and the incidence of adverse reactions during treatment were compared among the three groups. RESULTS Before treatment， there was no statistically significant difference in the above scores among the three groups（P＞0.05）. After treatment， the scores of all three groups of patients significantly decreased compared to before treatment （P＜0.05）； the total PASI score and erythema， scales， affected body surface area score， the total DLQI score and symptom perception， daily activity， social score， the PGA and PtGA scores of the combination group were significantly lower than the other two groups（P＜0.05）； PASI 50（the proportion of patients whose PASI score decreased by ≥50% from baseline， and so on）， PASI 75， and PASI 90 were significantly higher than the other two groups（P＜0.05）； the total PASI score， erythema， and affected body surface area score of patients in the monoclonal antibody group were significantly lower than the conventional group（P＜0.05）， and PASI 75 was significantly higher than the conventional group（P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions among the 3 groups（P＝0.637）. CONCLUSIONS The combination of Xiaoyin capsules and secukinumab can significantly improve the skin lesions and quality of life in patients with moderate to severe plaque psoriasis， with good tolerability in the short term and no significant increasein the risk of serious adverse reactions.

Objective To investigate the expressions of annexin A2 and glycogen synthesis kinase-3β(GSK-3β)in cutaneous squamous cell carcinoma(CSCC)tissues,and to analyze their correlation with CSCC as well as their clinical pathological diagnostic value.Methods The pathological tissues of 68 patients with CSCC and 40 patients with keratoacanthoma(KA)who underwent surgical treatment in the Department of Dermatology of the Second Hospital of Nanning from October 2020 to May 2024 were collected,and the surrounding normal skin tissues of 32 patients with benign skin diseases were used as controls.The expressions of annexin A2,GSK-3β and β-catenin were detected by immunohistochemistry and Western blotting.Spearman was used to evaluate the correlation between the expressions of annexin A2 and GSK-3β and the pathological characteristics in CSCC.The receiver operating characteristic(ROC)curve was drawn to analyze the clinical diagnostic value of annexin A2 and GSK-3β in CSCC.Results Compared with the normal skin tissues,the expressions of annexin A2 and β-catenin in CSCC increased,and GSK-3β decreased(P＜0.05);Compared with the KA tissues,the expression of annexin A2 in CSCC tissues increased(P＜0.05).The expression of annexin A2 was negatively correlated with that of GSK-3β in CSCC(r=-0.3901,P＜0.01).GSK-3β expression was related to tissue differentiation,with lower expression in poorly differentiated patients'cancer tissues(P＜0.05).The sensitivity of annexin A2 and GSK-3β for diagnosis of CSCC was 85.3%and 41.2%,respectively,with specificities of 46.9%and 84.4%respectively.The sensitivity of annexin A2 for distinguishing between CSCC and KA was 85.3%,with a specificity of 40.0%.Conclusion Annexin A2 and GSK-3β may be used as potential biomarkers for the early diagnosis or differential diagnosis of CSCC,and play important roles in the development of CSCC.Their mechanism may be related to the activation of Wnt/β-catenin signaling pathway.

OBJECTIVE: To assess the association of single nucleotide polymorphisms (SNPs) of interleukin-23 receptor (IL-23R) gene with susceptibility to psoriasis. METHODS: Two hundred and ten psoriasis patients admitted to Xinxiang Central Hospital from January 2019 to December 2024 were selected as the study group, and 210 healthy individuals undergoing physical examination during the same period were selected as the control group. 3 mL of peripheral venous blood sample was collected from each individual from the two groups, and PCR-Restriction fragment length polymorphism (PCR-RFLP) assay was used to determine the polymorphisms of the IL-23R gene at rs2201841, rs1004819, rs10889677, rs1343151 and rs1495965 loci. Genotypic and allelic distribution of each SNP locus was calculated to assess the association between SNPs of the IL-23R gene with the onset of psoriasis, and the difference in serum IL-23 levels among patients with different genotypes at each locus was compared. This study was approved by the Medical Ethics Committee of Xinxiang Central Hospital (Ethic No. 2024-749). RESULTS: The results showed that the frequency of CC genotype at rs1004819 locus of the study group was significantly higher than that of the control group (26.19% vs. 18.10%, P < 0.05), and the frequency of C allele was also significantly higher than that of the control group (54.05% vs. 42.62%, P < 0.05). There was no significant difference in allelic and genotypic frequencies between the two groups at rs2201841, rs10889677, rs1343151, and rs1495965 loci (P > 0.05). The dominant and recessive inheritance patterns at the rs1004819 locus are associated with susceptibility to psoriasis (P < 0.05), while the different inheritance patterns at rs2201841, rs10889677, rs1343151, and rs1495965 loci are not associated with psoriasis (P > 0.05). The serum IL-23 levels of patients with CC genotype at the rs1004819 locus were higher than those with the CT and TT genotypes (P < 0.05). No significant difference was detected in the serum levels of IL-23 between patients with different genotypes for the rs2201841, rs10889677, rs1343151, and rs1495965 loci (P > 0.05). CONCLUSION The polymorphism at the rs1004819 locus of the IL-23R gene is associated with susceptibility to psoriasis, and individuals carrying the CC genotype and C allele have a higher risk of developing the disease.
Humans ; Psoriasis/genetics* ; Polymorphism, Single Nucleotide ; Receptors, Interleukin/genetics* ; Genetic Predisposition to Disease ; Male ; Female ; Adult ; Middle Aged ; Genotype ; Alleles ; Gene Frequency ; Case-Control Studies ; Interleukin-23/blood*

To explore the value of the diaphragm thickness fraction (TF) and diaphragm mobility (DM) measured by ultrasound for predicting ventilator withdrawal success in patients with acute respiratory distress syndrome (ARDS) after cardiac surgery. Methods: This study included 246 patients undergoing the spontaneous breathing trial. Diaphragmatic function was evaluated by ultrasound, including the diaphragm thickness at the end of calm breathing (thickness of the diaphragm at functional residual capacity [TdiFRC]) and the maximum diaphragm thickness at the end of inspiration (thickness of the diaphragm at full vital capacity [TdiFVC]); TF=(TdiFVC–TdiFRC)/TdiFRC×100%. DM, the oxygenation index (the ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen), and the rapid shallow breathing index (RSBI) were measured. Results: Successful liberation from mechanical ventilation was observed in 209 patients. There were no significant differences in the TdiFRC (0.3±0.1 cm vs. 0.3±0.1 cm) or TdiFVC (0.3±0.1 cm vs. 0.2±0.1 cm) between the ventilator withdrawal success group and the ventilator withdrawal failure group (P>0.05). The TF was greater in the ventilator withdrawal success group than in the ventilator withdrawal failure group (40.8%±15.8% vs. 37.7%±9.2%, P<0.01). DM in the ventilator withdrawal success group was greater than that in the ventilator withdrawal failure group (1.5±0.5 cm vs. 1.2±0.4 cm, P=0.040). The RSBI was lower in the ventilator withdrawal success group than in the ventilator withdrawal failure group (74.3±25.6 breaths·min–1·L –1 vs. 89.9±34.5 breaths·min–1·L –1, P<0.01). Conclusions: Diaphragmatic ultrasound can be used to predict the success of ventilator withdrawal in patients with ARDS.

INTRODUCTION: Radiofrequency ablation (RFA) avoids the complications of general anaesthesia, reduces length of hospitalisation and reduces morbidity from surgery. As such, it is a strong alternative treatment for patients with comorbidities who are not surgical candidates. However, to our knowledge, there have only been 1 systematic review and 3 combined systematic review and meta-analyses on this topic to date. This systematic review and meta-analysis seeks to evaluate the efficacy and safety of RFA in the treatment of papillary thyroid carcinoma (PTC) with longer follow-up durations. METHOD: PubMed, Embase and Cochrane databases were searched for relevant studies published from 1990 to 2021; 13 studies with a total of 1366 patients were included. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and Sandelowski et al.'s approach1 to "negotiated consensual validation" were used to achieve consensus on the final list of articles to be included. All authors then assessed each study using a rating scheme modified from the Oxford Centre for Evidence-Based Medicine. RESULTS: Pooled volume reduction rates (VRRs) from 1 to 48 months after RFA, complete disappearance rates (CDR) and complications were assessed. Pooled mean VRRs were 96.59 (95% confidence interval [CI] 91.05-102.13, I2=0%) at 12 months2-6 and 99.31 (95% CI 93.74-104.88, I2=not applicable) at 48 months.2,5 Five studies showed an eventual CDR of 100%.2,4,7-9 No life-threatening complications were recorded. The most common complications included pain, transient voice hoarseness, fever and less commonly, first-degree burn. CONCLUSION RFA may be an effective and safe alternative to treating PTC. Larger clinical trials with longer follow-up are needed to further evaluate the effectiveness of RFA in treating PTC.
Humans ; Radiofrequency Ablation/methods* ; Thyroid Cancer, Papillary/surgery* ; Thyroid Neoplasms/surgery* ; Treatment Outcome ; Postoperative Complications/etiology*