To investigate the degrees of EB virus reactivation in patients with inflammatory bowel disease (IBD) treated with different biologics and the levels of important cytokines associated with relapse under the influence of this virus, and to assess its diagnostic efficacy as a risk factor for identifying disease relapse. A case-control retrospective study based on patients′ hospitalization history data was conducted to select a total of 105 patients who were hospitalized in the Department of Gastroenterology, Huashan Hospital, Fudan University, with a confirmed diagnosis of IBD from 2021 to 2023. Based on the quantitative copy level of whole blood EBV DNA to determine the status of EB virus infection in patients, integrated cytokine 8 (IL-2, IL-4, IL-6, IL-10, IL-12p70, IL-17, TNF-α, IFN-γ), C-reactive protein, and fecal calreticulin, to find the risk variable associated with treatment relapse. Logistic regression was used to analyze the relative risk between this variable and treatment relapse, and ROC curves were used to predict the diagnostic efficacy of cytokine multifactorial thresholds for treatment relapse. Results showed that the median age of the study was 37(26, 54)years, with a minimum of 18 years and a maximum of 70 years, with a median age of 34(24, 51) years for Crohn′s Disease (CD) patients and 46(35, 60) years for Ulcerative colitis (UC) patients, with a statistically difference between the ages of the two groups ( t=2.675, P=0.009). The median age at 50 years of patients treated with Vedolizumab (VDZ) in the UC group was higher than in the treatment groups other than VDZ. The highest rate of EB virusreactivation was found in the group treated with immunosuppressants Azathioprine (AZA) combined with anti-tumor necrosis factor-α (anti-TNF-α) and VDZ (62.5% in both groups), and the lowest in the group treated with Ustekinumab (UST) (0%). IL-2 levels were elevated in the AZA+anti-TNF-α and anti-TNF-α groups after EB virus entryreactivation. Three treatment groups, AZA+anti-TNF-α, anti-TNF-α, and VDZ, had elevated levels of IL-6 expression after EB virus entry reactivation.In the anti-TNF-α treatment-related group IL-2was associated with treatment relapse in IBD ( OR=1.127, 95% CI: 1.044-1.256, P=0.007). ROC analysis showed that the AUC for IL-2 combined with EB virus in a replicative state was 0.8282 ( P=0.006), with a negative predictive value and a positive value of 90% and 75%, respectively. As well as IL-6 was associated with treatment relapse of IBD in the anti-TNF-αtreatment-related group as well as in the VDZ-treated group ( OR=1.049, 95% CI: 1.017-1.095, P=0.008). ROC analysis showed that the diagnostic sensitivity and specificity for post-treatment relapse at a critical value of 6.10 pg/ml for IL-6 was 83.33% and 82.93%, respectively. The AUC for IL-6 combined with EB virus in a replicative state was 0.900 ( P<0.000 1), with negative and positive predictive value of 84.09% and 73.33%, respectively. In summary, the imbalance of proinflammatory and anti-inflammatory cytokines varies between drugs, with EBV in a replication-activated state, combined with elevated levels of IL-2 as well as IL-6 expression being a risk factor for relapse in patients treated with anti-TNF-α-related drugs and VDZ.

Objective:To explore the mediating effect of empowerment between self-perceived burden and medication adherence in kidney transplant recipients, so as to provide reference for improving medication adherence in kidney transplant recipients.Methods:This study was a cross-sectional survey. From August to December 2022, convenience sampling was used to select 240 kidney transplant recipients who were followed up at the Kidney Transplantation Center of Shanghai General Hospital as the research subject. A survey was conducted on subjects using the General Information Questionnaire, Self-Perceived Burden Scale (SPBS), Client Empowerment Scale (CES), and Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) to analyze the correlation between patient self-perceived burden, empowerment, and medication compliance, as well as the mediating effect of empowerment between the two.Results:A total of 240 questionnaires were distributed, and 226 valid questionnaires were collected, with a valid response rate of 94.2% (226/240). Among 226 kidney transplant recipients, the total scores of SPBS, CES, and BAASIS were (27.34±8.03), (159.86±13.45), and (5.05±1.75), respectively. The SPBS score of the recipient was negatively correlated with the CES score ( r=-0.366, P<0.05), and positively correlated with the BAASIS score ( r=0.448, P<0.05). The CES score was negatively correlated with the BAASIS score ( r=-0.456, P<0.05). The above differences were statistically significant. Empowerment partially mediated the association between self-perceived burden and medication adherence in kidney transplant recipients, with a mediating effect ratio of 38.7%. Conclusions:Renal transplant recipients have poor medication adherence, and empowerment is a mediating variable between self-perceived burden and medication adherence. Medical and nursing staff should attach importance to and enhance the empowerment of kidney transplant recipients, in order to alleviate the negative impact of self-perceived burden, increase medication compliance of recipients, and improve their health outcomes.

To investigate the degrees of EB virus reactivation in patients with inflammatory bowel disease (IBD) treated with different biologics and the levels of important cytokines associated with relapse under the influence of this virus, and to assess its diagnostic efficacy as a risk factor for identifying disease relapse. A case-control retrospective study based on patients′ hospitalization history data was conducted to select a total of 105 patients who were hospitalized in the Department of Gastroenterology, Huashan Hospital, Fudan University, with a confirmed diagnosis of IBD from 2021 to 2023. Based on the quantitative copy level of whole blood EBV DNA to determine the status of EB virus infection in patients, integrated cytokine 8 (IL-2, IL-4, IL-6, IL-10, IL-12p70, IL-17, TNF-α, IFN-γ), C-reactive protein, and fecal calreticulin, to find the risk variable associated with treatment relapse. Logistic regression was used to analyze the relative risk between this variable and treatment relapse, and ROC curves were used to predict the diagnostic efficacy of cytokine multifactorial thresholds for treatment relapse. Results showed that the median age of the study was 37(26, 54)years, with a minimum of 18 years and a maximum of 70 years, with a median age of 34(24, 51) years for Crohn′s Disease (CD) patients and 46(35, 60) years for Ulcerative colitis (UC) patients, with a statistically difference between the ages of the two groups ( t=2.675, P=0.009). The median age at 50 years of patients treated with Vedolizumab (VDZ) in the UC group was higher than in the treatment groups other than VDZ. The highest rate of EB virusreactivation was found in the group treated with immunosuppressants Azathioprine (AZA) combined with anti-tumor necrosis factor-α (anti-TNF-α) and VDZ (62.5% in both groups), and the lowest in the group treated with Ustekinumab (UST) (0%). IL-2 levels were elevated in the AZA+anti-TNF-α and anti-TNF-α groups after EB virus entryreactivation. Three treatment groups, AZA+anti-TNF-α, anti-TNF-α, and VDZ, had elevated levels of IL-6 expression after EB virus entry reactivation.In the anti-TNF-α treatment-related group IL-2was associated with treatment relapse in IBD ( OR=1.127, 95% CI: 1.044-1.256, P=0.007). ROC analysis showed that the AUC for IL-2 combined with EB virus in a replicative state was 0.8282 ( P=0.006), with a negative predictive value and a positive value of 90% and 75%, respectively. As well as IL-6 was associated with treatment relapse of IBD in the anti-TNF-αtreatment-related group as well as in the VDZ-treated group ( OR=1.049, 95% CI: 1.017-1.095, P=0.008). ROC analysis showed that the diagnostic sensitivity and specificity for post-treatment relapse at a critical value of 6.10 pg/ml for IL-6 was 83.33% and 82.93%, respectively. The AUC for IL-6 combined with EB virus in a replicative state was 0.900 ( P<0.000 1), with negative and positive predictive value of 84.09% and 73.33%, respectively. In summary, the imbalance of proinflammatory and anti-inflammatory cytokines varies between drugs, with EBV in a replication-activated state, combined with elevated levels of IL-2 as well as IL-6 expression being a risk factor for relapse in patients treated with anti-TNF-α-related drugs and VDZ.

With the development of modern sequencing techniques and bioinformatics, genomes that were once thought to be noncoding have been found to encode abundant functional micropeptides (miPs), a kind of small polypeptides. Although miPs are difficult to analyze and identify, a number of studies have begun to focus on them. More and more miPs have been revealed as essential for energy metabolism homeostasis, immune regulation, and tumor growth and development. Many reports have shown that miPs are especially essential for regulating glucose and lipid metabolism and regulating mitochondrial function. MiPs are also involved in the progression of related diseases. This paper reviews the sources and identification of miPs, as well as the functional significance of miPs for metabolism-related diseases, with the aim of revealing their potential clinical applications.
Humans ; Open Reading Frames ; Peptides ; Glucose ; Genome ; Metabolic Diseases

Renal transplant recipients have a high rate of unplanned readmission, which will seriously affect the quality of life of recipients and their families, increase medical costs and the medical burden. Unplanned readmission of renal transplant recipients is the result of multiple factors, which is difficult to be well intervened by a single measure. This article reviews the status quo, related reasons, influencing factors and interventions of unplanned readmission of renal transplant recipients for reference in clinical practice.

Objective:To understand the current status of kidney transplant patient empowerment and explore the factors affecting kidney transplant patient empowerment.Methods:This study was a cross-sectional survey. From September to November 2022, convenience sampling was used to select 201 patients who were followed up by the Renal Transplantation Department of Shanghai General Hospital as the study subject. A survey was conducted using the Patient General Information Questionnaire, Client Empowerment Scale (CES), General Self-Efficacy Scale (GSES), Nurse-Patient Trust Scale, and Chinese Version of Chronic Illness Resource Survey (CV-CIRS). Multiple linear regression analysis was used to explore the influencing factors of empowerment levels in kidney transplant patients.Results:A total of 201 questionnaires were distributed and 197 valid questionnaires were collected, with an effective recovery rate of 98.01% (197/201). The total empowerment score of 197 kidney transplant patients was (161.85±13.08). Multiple linear regression analysis showed that willingness to participate in health decision-making, general self-efficacy, and chronic disease resource support were the influencing factors for kidney transplant patient empowerment ( P<0.05) . Conclusions:The empowerment of kidney transplant patients is at a moderate to upper level. The willingness of patients to participate in health decision-making, general self-efficacy, and chronic disease resource support are influencing factors for kidney transplant patient empowerment.

Objective:To preliminarily understand the living habits, medication taking and treatment status including the therapeutic regimen, compliance and short-term efficacy of patients with chronic atrophic gastritis and erosion in Beijing area.Methods:From April to September in 2019 at Peking Union Medical College Hospital, Peking University Third Hospital and Peking University Shougang Hospital, the outpatients with chronic atrophic gastritis and erosion diagnosed with endoscopy within two weeks before visiting were prospectively included in this non-interventional observation study. Chi square test was used for statistical analysis.Results:A total of 277 patients with chronic atrophic gastritis and erosion had complete follow-up data, of which male patients accounted for 49.8% (138/277). The common initial symptoms of patients with chronic atrophic gastritis and erosion included acid reflux, abdominal distension, epigastric pain and postprandial distension, which accounted for 60.3% (167/277), 59.6% (165/277) , 58.8% (163/277) and 52.3% (145/277), respectively. For treatment, 36.8% (102/277) of the patients only received lifestyle instruction without medication. Among the patients with medication treatment, the short-term efficacy of gastric mucosal protectants+ proton pump inhibitor+ gastro-kinetic agent for abnominal distension, postprandial distention, acid reflux and nausea was highest as compared with other therapeutic regimen, and the differences were statistically significant ( χ2=25.18, 19.49, 13.75, 8.84, all P<0.05). Conclusions:Chronic gastritis with erosion may be caused by a combination of multiple factors, and the symptoms of which lack specific. If necessary, gastroscopy may help the diagnosis. Individualized treatment strategies based on the symptoms of patients is needed for treatment.

Objective: To describe the clinical manifestations of central nerve system inflammatory demyelinating disease associated with anti-myelin oligodendrocyte glycoprotein antibody (MOG-IDD) in children, and to explore the clinical characteristics of the children. Methods: The clinical and laboratory characteristics of the patients diagnosed in Beijing Children′s Hospital, Capital Medical University, from October 2016 to August 2018 were described, and the clinical data of the patients with unipolar and recurrent diseases were compared. Results: A total of 50 patients were included, among whom the ratio of male to female was 24:26, and the average age of onset was (6.7±3.1) years old (0.4-12.6 years old). There was no significant difference in the age of onset between boys and girls(t=0.712, P=0.480). The main symptoms included fever (31/50 cases), encephalopathy (26/50 cases) and optic neuritis (22/50 cases), etc.In the last follow-up, 26 patients (52.0%) had a monophasic course and 24 patients (48.0%) had a recurrent course.There were age differences in encephalopathy and ataxia in the first episode of [(5.7±2.8) years old vs.(8.1±3.0) years old, (5.0±2.5) years old vs. (7.7±3.0) years old](t=2.746, P=0.009; t=2.837, P=0.007). The average number of recurrence was (2.1±1.4) times (1-7 times), in which 17 cases (70.8%) of recurrence presented within 12 months and 20 cases (83.3%) of recurrence presented within 24 months after onset.Convulsion incidences of recurrent cases were 10 cases and 13 cases respectively in the first episode and recurrent courses, which were significantly higher than those of monophasic cases (4 cases, 4 cases)(χ²=7.912, P=0.005; χ²=8.365, P=0.004). All patients were sensitive to first-line immunotherapy.Seven patients with recu-rrence were treated with mycophenolatemofetil, and 17 patients with repeated first-line therapy.In the last follow-up, all patients were in remission and 2 patients had mild neurological dysfunction. Conclusions MOG-IDD can occur in childhood.Encephalopathy and optic neuritis are the most common symptoms.Encephalopathy and ataxia are more common in young children.Convulsions may indicate the course of recurrence.

Objective To summarize the characteristics of IgG4 related disease (IgG4-RD),and to avoid unnecessary surgical procedures due to misdiagnosis.Methods Retrospective analysis of the clinical data of one case of IgG4 related disease involving the renal pelvis in our hospital,and the clinical features of IgG4 related disease involving the renal pelvis were reviewed and discussed.A 56-year-old man presented with microscopic hematuria,CT showed right renal pelvis and ureteral wall thickening,local soft tissue density,post contrast CT showed low-density renal pelvic mass and the wall of the ureter-pelvic was irregularly thicken,indicating renal pelvic cancer and lymph node metastasis.PET-CT (18F-FDG) findings indicated that the renal pelvic mass was a malignant tumor,because the glucose metabolism was very high.The preoperative diagnosis was retroperitoneal lesion,suspecting renal pelvic carcinoma or lymphoma.The patient underwent 3D laparoscopic nephroureterectomy with out preoperative biopsy.During operation,we found extensive enlargement of the right renal portal and retroperitoneal lymph nodes,including that the renal portal and the renal pelvis mass had a serious adhesion to the vena cava and renal arterial vein.Results Postoperative pathology results revealed lymphatic tissue hyperplasia and germinal center formation.Immunohistochemical staining showed that most plasma cells positive expression of IgG4 (IgG4 ＞ 40％,IgG4 ＞ 100/HPF),reactive hyperplasia of lymph node,considering the IgG4 related diseases.Serum IgG4 level was 15.2 g/L (0.03-2.01 g/L)after operation.Combined with serological examination,IgG4 related disease was confirmed.There was no evidence of IgG4-related disease at any other site during the follow up period,thereby obviating the need for any additional therapy.Conclusions IgG4 related disease is a novel clinical disease entity characterized by elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells,which leads to the enlargement of the organ or nodular/proliferative lesions.The disease can be revealed as a soft tissue tumor of the renal pelvis and be misdiagnosed as malignant tumor.Surgical intervention could be avoided according to the correct diagnosis.

Objective To observe the stellate ganglion block (SGB) on obstructive sleep apnea syndrome (OSAS) combined the curative effect of sleep respiration and blood pressure control in patients with hypertension.Methods Incorporating meets the criteria for the OSAS patients with high blood pressure in hospital order randomly assigned into normal group and experimental group and routine group was given antihypertension drugs,adjustment in lifestyle,continuous positive airway pressure (CPAP) treatment,the experimental group on the basis of conventional treatment at the same time give SGB to intervene.Using t test on admission and intervention were compared after a period of treatment in patients with sleep apnea and blood pressure control,using 2 test comparison blood pressure control rates of two groups patients.Results Compared with normal group,the experimental group after intervention in a course of apnea hypoventilation index (AHI),SaO2 and 24 h mean arterial pressure were obviously improved,the difference was statistically significant (P＜0.05).Conclusion SGB as a new treatment method,not only can improve clinical symptoms in patients with OSAS,but also make the patients get better control of blood pressure.