Arsenic trioxide (ATO) serves as a component of traditional Chinese medicine and a modern anticancer agent, demonstrating remarkable efficacy in the long-term treatment of acute promyelocytic leukemia. With increasing research into its application in solid tumors, ATO's diverse mechanisms of action and potential clinical value have attracted widespread attention. ATO can inhibit tumor cell proliferation by inducing various forms of cell death, such as apoptosis, autophagy, pyroptosis, necroptosis, and ferroptosis, as well as by regulating cell differentiation. Moreover, its modulatory effects on the tumor immune microenvironment provide a new aspectto its antitumor activity. Nevertheless, the clinical application of ATO in solid tumors faces challenges such as low bioavailability, inadequate targeting, and adverse effects. The development of nanocarriers and targeted delivery systems has emerged asa key strategy for enhancing the therapeutic efficacy of ATO. This review systematically summarizes the multiple mechanisms of action of ATO in solid tumors and recent advances in nanodelivery technologies, explores the potential of ATO-based combination therapies, and discusses future directions, aiming to provide a theoretical foundation and practical guidance for the clinical application of ATO in solid tumors.

Childhood primary renal tubular diseases are chronic kidney diseases characterized by impaired renal tubular reabsorption. Primary renal tubular disease has diverse clinical manifestations and lacks of specificity. Laboratory tests are limited，making it prone to missed diagnosis and misdiagnosis. Based on the current knowledge of renal tubular diseases，authors propose early warning signals of renal tubular diseases such as family history of primary tubular diseases，unexplained polyhydramnios during pregnancy，polydipsia，polyuria，delayed growth and development or rickets，decreased muscle strength and tone，unexplained electrolyte disturbance，hyperuricemia，acid-base disturbance，positive urine sugar test，renal tubular proteinuria，urinary imaging examination suggesting kidney stones，calcium deposition，renal cysts and early onset of eye，ear，joint and neuron injury.Meanwhile，some universal management strategies for primary renal tubular disease are proposed，emphasizing the importance of multidisciplinary collaboration，genetic testing and individualized intervention to improve the long-term prognosis of childhood primary renal tubular diseases.

Objective:To evaluate the effect of preoperative mild cognitive impairment (MCI) on the potency of sevoflurane in inhibiting body movement responses during skin incision in aged female patients.Methods:This was a prospective study. Female American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 60-75 yr, with body mass index of 18.5-23.9 kg/m 2, scheduled to undergo radical mastectomy between January 2022 and March 2023 in our hospital, were selected. The patient′s cognitive function was assessed using Mini-Mental State Examination and Montreal Cognitive Assessment. The patients were divided into 2 groups based on whether they had MCI or not before operation: normal group (group N) and MCI group (group M). General anesthesia was induced by inhaling 8% sevoflurane, and the laryngeal mask airway was inserted after they lost consciousness and their jaws relaxed. According to the Dixon′s up-and-down method, the end-tidal concentration of sevoflurane in the first patient was set at 2%. If the body movement response occurred, the concentration was increased by 2% in the next patient, otherwise the concentration was decreased by 2% in the next patient. The MAC and 95% confidence interval ( CI) of sevoflurane were calculated using the probability regression method. Results:The minimum alveolar concentration of sevoflurane was 1.60% (95% CI 1.48% -1.70%) in group N and 1.38% (95% CI 1.25%-1.49%) in group M, and there was statistically significant difference ( P<0.05). Conclusions:Preoperative MCI can increase the potency of sevoflurane in inhibiting body movement responses during skin incision in aged female patients.

Objective:To study the distribution of drug resistance genes and virulence genes in multidrug-resistant Salmonella typhimurium strains.Methods:A total of 96 strains of Salmonella typhimurium were collected，and drug sensitivity tests were performed to evaluate the drug resistance and multidrug-resistance of Salmonella typhimurium.Multidrug-resistant Salmonella typhimurium strains were selected to conducted whole genome sequencing，and the distribution of drug resistance genes and virulence genes in the strain were analyzed.Results:Salmonella typhimurium strains had the highest resistance rates to ampicillin and ampicillin/sulbactam，with 89.58% and 76.04%，respectively.Followed by trimethoprim/sulfamethoxazole，ceftriaxone，and aztreonam，with 47.92%，38.54% and 33.33%，respectively，and low resistance rates to ciprofloxacin and levofloxacin，with 8.33% and 4.17%，respectively.Ninety-six strains were all sensitive to carbapenem antibiotics and piperacillin/tazobactam.Fifty-seven strains（59.38%）of Salmonella typhimurium showed multidrug-resistance.Resistance genes were detected in all 57 multidrug-resistant Salmonella typhimurium strains,with higher carrier rates of 98.25%,77.19%,and 59.65% for aac(6')-Iaa,aadA22,and blaTEM-1B,respectively.The multidrug-resistant Salmonella typhimurium strains had the highest carrier rates for invA，sipA，sseL，and sopB.Conclusion:Multidrug-resistant Salmonella typhimurium strains have a high incidence and a high carrier rate for multiple drug resistance genes and virulence genes.The monitoring and prevention of Salmonella typhimurium should be strengthened in the clinic in order to reduce the spreading epidemic of multidrug-resistant strains.

Objective:To explore the expression and clinical significance of long non-coding RNA colorectal neoplasia differentially expressed (lncRNA CRNDE), microRNA-181a-5p (miR-181a-5p) and autophagy related 5 (ATG5) in the peripheral blood of patients with gouty arthritis (GA) patients.Methods:The clinical data, laboratory parameters and peripheral blood samples were collected from 40 patients with acute gout (AG), 40 patients with intermittent gout (IG) and 50 healthy subjects (HC). The expression levels of lncRNA CRNDE, miR-181a-5p and ATG5 mRNA were detected by real-time fluorescence quantification (RT-qPCR) and the expression level of ATG5 protein was detected by Western-blot. The expression levels of lncRNA CRNDE, miR-181a-5p, ATG5 mRNA were compared among the three groups and correlated with clinical indices, and a subject operating characteristic curve (ROC) was constructed to assess the value of lncRNA CRNDE, miR-181a-5p, ATG5 mRNA in the diagnosis of gout. Measurements conforming to normal distribution were analyzed using t test or ANOVA, data with non-normal distribution was analyzed using Mann-Whitney U test or Kruskal-Wallis H test, correlation analysis between variables was analyzed using Spearman's analysis, and the diagnostic value of each indicator was analyzed using ROC curve. Results:① The differences in the expression of lncRNA CRNDE, miR-181a-5p, and ATG5 mRNA between the three groups were statistically significant ( H=32.12, 57.73, 68.32, all P<0.001). Among them, lncRNA CRNDE expression level in the AG group was significantly higher than that in the IG group and healthy control group [61.95(11.39, 108.30)×10 -3, 25.71(15.40, 38.40)×10 -3, 13.80(3.97, 23.99)×10 -3; Z=-3.24, P=0.001; Z=-5.03, P<0.001], and the expression level of IG group was higher than that of healthy control group( Z=-3.56, P<0.001); miR-181a-5p and ATG5 mRNA expression levels in AG group were significantly lower than those in IG group and healthy control group [miR-181a-5p: 39.81(31.22, 69.38)×10 -3, 60.74(44.19, 90.35)×10 -3, 121.30(101.50, 316.90)×10 -3; Z=-3.01, P=0.030; Z=-6.93, P<0.001. ATG5 mRNA: 4.52(2.31, 26.63)×10 -3, 43.63(13.72, 102.70)×10 -3, 153.90(66.62, 365.80)×10 -3; Z=-5.47, -7.36, all P<0.001)], which were expressed at lower levels in the IG group than in the healthy controls ( Z=-5.25, -4.47, all P<0.001). The difference of ATG5 protein expression level among the three groups expressed was statistically significant ( F=6.24, P=0.030), and the AG group was higher than the healthy control group, and the difference was statistically significant [(0.96±0.13) vs.(0.61±0.04), t=4.25, P=0.013], but the difference between the IG group (0.78±0.15) and the AG group and the HC group was not statistically significant ( t=1.51, P=0.206; t=1.85, P=0138). ② Spearman correlation analysis showed that lncRNA CRNDE was negatively correlated with the expression levels of miR-181a-5p and ATG5 mRNA in gout patients ( r=-0.49, P<0.001; r=-0.35, P=0.002); miR-181a-5p was positively correlated with ATG5 mRNA expression levels ( r=0.64, P<0.001); lncRNA CRNDE expression level was positively correlated with ESR and WBC ( r=0.49, P<0.001; r=0.43, P=0.001); miR-181a-5p expression level was negatively correlated with ESR and WBC ( r=-0.29, P=0.009; r=-0.35, P=0.002), and ATG5 mRNA expression levels were negatively correlated with ESR, WBC, and GR ( r=-0.26, P=0.021; r=-0.26, P=0.024; r=-0.27, P=0.021). In the AG group lncRNA CRNDE was positively correlated with ESR and WBC ( r=0.36, P=0.022; r=0.36, P=0.026) and miR-181a-5p was negatively correlated with WBC ( r=-0.34, P=0.038) ③ ROC curve showed that the areas under ROC curve of lncRNA CRNDE, miR-181a-5p and ATG5 mRNA expression levels to predict gout were 0.764, 0.875 and 0.864, respectively. The area under ROC curve of gout predicted by the three combined was 0.928. Conclusion:lncRNA CRNDE, miR-181a-5p, and ATG5 may be involved in the pathoge-nesis of primary gouty arthritis, and are potential biological parameters for studying the pathogenesis of gout.

Objective:To investigate the expression of N6-methyladenosine(m6A) modification-related genes and their possible roles in peripheral blood mononuclear cells (PBMCs) of patients with primary gouty arthritis (GA).Methods:Forty-five patients each with acute gout (AG), intermittent gout (IG), and age-and gender-matched healthy controls (HC) were collected from the outpatient clinic of the Department of Rheumatology and Immunology of the Affiliated Hospital of Chuanbei Medical College between October and December of 2023. The expression levels of m6A modification-related genes (METTL3、METTL14、WTAP、FTO、ALKBH5、IGF2BP2、IGF2BP3、YTHDF1、YTHDC2) in PBMCs among the 3 groups were detected by RT-qPCR and correlation analysis with clinical indicators was performed. Measurements conforming to normal distribution were analyzed using ANOVA or t-tests, and data were analyzed using the Kruskal-Wallis H-test and Mann-Whitney U-test for data that is not-normaly distributed. The value of m6A modification-related genes for the diagnosis of GA was evaluated using subject characterization curve ROC. Results:①There were statistically significant differences in the expression of IGF2BP2 ( Z=-3.59, P<0.001)、WTAP ( Z=-5.25, P<0.001)、METTL14 ( Z=-3.62, P<0.001)、YTHDF1 ( Z=-2.12, P=0.034)and YTHDC2 ( Z=-2.00, P=0.045) in the disease group and the normal control group. Among them, the expression of IGF2BP2 in the GA group [28.08 (17.99, 47.06)×10 -4] was significantly higher than that in the HC group [19.23 (12.90, 25.78)×10 -4], and the expressions of WTAP、METTL14、YTHDF1 and YTHDC2 in the GA group [298.61 (213.61, 377.80)×10 -4, 9.94 (6.43, 13.46)×10 -4, 52.63 (28.22, 72.77)×10 -4, 40.24 (20.74, 73.32)×10 -4] were significantly lower than those in the HC group [398.45(339.88, 454.89)×10 -4, 13.27(11.07, 15.85)×10 -4, 64.43(43.61, 87.10)×10 -4, 53.11(36.37, 79.28)×10 -4]. Further subgroup analysis revealed statistically significant differences in the expression of IGF2BP2、WTAP、METTL14、YTHDF1 and YTHDC2 among the 3 groups ( H=19.62、31.73、13.14、16.64、28.90, all P≤0.001). The expressions of WTAP and METTL14 in the AG group [311.13(234.96, 426.67)×10 -4, Z=-3.27, P=0.001; 9.64 (5.21, 15.21)×10 -4, Z=-2.71, P=0.008] and IG group [272.27 (203.29, 347.95)×10 -4, Z=-5.78, P<0.001; 10.40(6.88, 12.88)×10 -4, Z=-3.54, P=0.003] were lower than those in the HC group [398.45 (339.88, 454.89)×10 -4, 13.27(11.07, 15.85)×10 -4]. However, there was no significant difference between AG and IG group ( P>0.05). Both YTHDF1 and YTHDC2 were significantly lower in the AG group [38.10(16.19, 56.78)×10 -4, 24.31 (14.35, 42.77)×10 -4] than those in the IG group [64.13 (48.28, 74.40)×10 -4(Z=-3.54, P<0.001, 65.49 (39.89, 91.23)×10 -4(Z=-4.96, P<0.001)] and HC group [64.43 (43.61, 86.92)×10 -4(Z=-3.51, P<0.001), 53.11 (36.37, 79.28)×10 -4(Z=-4.25, P<0.001)]. But there was no statistically significant difference between IG and HC groups ( P>0.05); IGF2BP2 was significantly lower in the AG group [25.32(16.40, 40.43)×10 -4, Z=-2.46, P=0.014] and HC group [19.23 (12.90, 25.78)×10 -4, Z=-4.54, P<0.001] than in the IG group [31.10(22.60, 49.58)×10 -4], but the comparison between AG and HC showed no statistically significant difference( P>0.05). ②Spearman correlation analysis showed that in GA patients, the expression of IGF2BP2、METTL14 and YTHDF1 was positively correlated with plasma glucose、blood uric acid(sUA) and total cholesterol level respectively ( r=0.22, P=0.037; r=0.38, P=0.003; r=0.23, P=0.034), and WTAP was negatively correlated with GLU ( r=-0.25, P=0.020). ③The ROC curve for the joint prediction of the five differential genes showed that the 95% CI for area under the curve in GA was 0.90 (0.84, 0.95). Conclusion:The m6A modification-related genes are abnormally expressed in GA and are correlated with clinical indicators such as GLU and UA, which are hypothesized to be involved in the pathogenesis of GA and have a certain reference value for the evaluation of metabolism in GA patients.

Objective:To explore the impact of weekend hospitalization on total hospitalization expenses for elderly patients with hip fracture under the geriatric orthopedic co-management.Methods:A retrospective analysis was conducted to analyze the clinical data of elderly patients with hip fracture who had been hospitalized for surgical treatment at Beijing Jishuitan Hospital from May 2015 to December 2020. They were divided into 2 groups based on their admission date. Group A was admitted from Monday to Thursday while Group B from Friday to Sunday. The general demographic data, diagnostic information, comorbidities, hospitalization expenses of the patients were collected. The differences in total hospitalization expenses, hospitalization time, rate of surgery within 48 hours and rate of hospital mortality between the 2 groups were analyzed by rank sum test, chi square test, correlation analysis, and multiple linear regression.Results:A total of 6,075 patients with hip fracture were included in this study, including 1,675 males and 4,400 females with a median age of 80 (74, 85) years. There were 3,935 ones in group A and 2,140 ones in group B. The total hospitalization expenses for group A was 58,160.52 (49,215.45, 72,748.94) yuan, insignificantly lower than those for Group B [58,412.90 (49,163.58, 72,712.61) yuan] ( P>0.05). The rate of surgery within 48 hours for group A was 75.8% (2,984/3,935), significantly higher than that for group B [49.3% (1,054/2,140)]. The hospitalization time for group A was 5 (4, 7) days, significantly less than that for group B [5 (4, 7) days] ( P<0.05). There was no significant difference in the rate of hospital mortality between the 2 groups ( P>0.05). Multiple linear regression analysis showed that total hospitalization expenses were significantly higher for patients admitted on weekends, hospitalization time was positively correlated with total hospitalization expenses, and total hospitalization expenses were significantly lower for the patients undergoing surgery within 48 hours ( P<0.05). Conclusion:Admission on weekends can increase total hospitalization expenses, prolong hospitalization time, and reduce rate of surgery within 48 hours for elderly patients with hip fracture.

Objective:To This study was to investigate the expression and possible clinical significance of microRNA-146b (miR-146b) and signal transducer and transcriptional activator 1 and 3 (STAT1/3) in peripheral blood mononuclear cells (PBMCs) of patients with primary gouty arthritis (GA).Methods:The peripheral blood samples, clinical data and laboratory indexes of 120 male cases of GA [including 57 cases of acute (AG group) and 63 cases of intermittent (IG group)]and 66 healthy subjects (HC group) were collected. The expression levels of miR-146b and STAT1/3 in PBMCs were detected by real-time fluorescence quantitative PCR (RT-qPCR). The differences among the three groups were compared and the correlation between them and clinical indexes was analyzed. The receiver operating characteristic curve (ROC) was constructed to evaluate its diagnostic value in GA. After the PBMCs of 18 healthy subjects were stimulated by 100 μg/ml MSU for 3 hours to simulate acute gout inflammatory environment, the transcriptional changes of IL-1β, miR-146b and STAT1/3 were detected by RT-qPCR, and the expressions of IL-1β, STAT1/3 protein and phosphorylated protein were detected by Western blotting. T test or one-way ANOVA and LSD- t test were used in accordance with the normal measurement data, Kruskal-Wallis H and Mann-Whitney U test were used in the non-normal data, Spearman correlation analysis was used in the correlation between variables, and the diagnostic value was evaluated by the receiver working characteristic curve ROC. Results:①There were statistical differences in the expression of miR-146b, STAT1 and STAT3 among the three groups ( F=7.02、19.52、17.07, all P<0.001). The expression of miR-146b in gout group [(0.32±0.28)] was significantly higher than that in HC group (0.19±0.18)( t=2.96, P=0.003), while STAT1(0.019±0.012) and STAT3(0.014±0.010) were significantly lower than those in HC group (0.038±0.029),(0.025±0.016)( t=6.26, 5.56, both P<0.001). Further subgroup analysis showed that the expression of miR-146b in AG and IG groups was higher than that in HC group[(0.27±0.17), (0.38±0.35), (0.19±0.18), t=2.09, 3.30, both P<0.05], but that in AG group was lower than that in IG group ( t=2.02, P<0.05). The expression of STAT1 mRNA in AG and IG groups was lower than that in HC group [(0.020±0.012), (0.019±0.012), (0.038±0.029), t=4.89, 4.56, both P<0.001], but there was no statistical significance between AG and IG groups ( t=0.24, P>0.05). The expression of STAT3 mRNA in AG and IG groups was lower than that in HC group [(0.016±0.012), (0.012±0.008), (0.025±0.016), t=5.64, 3.33, both P<0.01], and the expression of STAT3 mRNA in AG group was higher than that in IG group ( t=2.12, P<0.05). ② Spearman correlation analysis showed that the expression of miR-146b in GA was negatively correlated with HCY ( r=-0.37, P=0.014), STAT1 was negatively correlated with Crea ( r=-0.29, P=0.019), positively correlated with eGFR ( r=0.25, P=0.047), and STAT3 was negatively correlated with HDL-C ( r=-0.27, P=0.033). ③ROC curve showed that the AUC (95% CI) of miR-146b, STAT1 and STAT3 were 0.679(0.582, 0.776), 0.710(0.629, 0.791) and 0.705(0.626, 0.783), and the combined AUC(95% CI) of the three was 0.836 (0.765, 0.907). ④Compared with blank control group and negative control group, the expression of miR-146b in PBMCs of 18 cases of HC was significantly decreased ( H=14.44, P=0.003), while the expression of IL-1β, STAT1 and STAT3 mRNA was significantly increased after 3 h of MSU stimulation ( H=26.44、27.26、15.90, all P<0.001). The expression of IL-1β, STAT1 and STAT3 protein and phosphorylated protein in the model group were significantly higher than those in the blank control group, and the differences were statistically significant ( t=9.97、6.63、7.48、11.25、6.28, all P<0.01). Conclusion:The abnormal expression of miR-146b and STAT1/3 in GA is related to some clinical indicators, suggesting that it may be involved in the regulation of gout immune inflammatory response and metabolism, and the specific mechanism is worth further study.

Objective:To explore the molecular mechanism of cell death of the peripheral blood mononuclear cells (PBMCs) of patients with primary gouty arthritis, and provide new idea for the treatment of gout.Methods:Peripheral blood samples and clinical data were collected from 30 patients with acute gout (AG), 30 patients with intermittent gout (IG) and 40 healthy controls(HC). Real-time fluorescence quantitative detection of cell apoptosis related molecules, including the mRNA expression level of nucleotide binding oligomerization domain like domain like receptor protein 3(NLRP3), cysteine aspartic proteinase-1/4/5 (caspase-1/4/5), Gasdermin A/B/C/E. And NLRP3, precursor caspase-1 (pro-caspase-1), clipped caspase-1 (caspase-1 + p10), Gasdermin D(GSDMD), N segment GSDMD (GSDMD-N), precursor IL-1β (pro IL-1β), mature IL-1β (clevated IL-1β)were detected by western blot. The measurement data of normal or approximate normal distribution were analyzed by independent sample t test or one-way variance analysis (ANOVA), the measurement data of non-normal distribution were analyzed by Mann-Whitney U test or Kruskal-Wallis H test, and the counting data was compared by Chi-square test. Pearson's correlation analysis was used for the continuous variables with normal distribution, and Spearman's correlation analysis was used for the continuous variables with non-normal distribution. The logistic regression analysis was used to assess risk factors. Results:① There were no significant differences in MPR and BMI between AG and IG ( χ2=0.64, P=0.426; t=0.04, P=0.972), and there was significant difference in disease course [25.0 (9.8, 63.0), 54.0 (33.0, 102.0)mouth, Z=2.01, P=0.044]. Comparison of labora-tory parameters: there were statistical significant differences in ESR between AG and IG ( t=5.24, P<0.001), eGFR, GR, LY, RBC, HCT, UA, Creatinin, ALT and AST. ② In the three groups, the expression lev-els of caspase-1, GSDMC, GSDMD, GSDME, NLRP3 mRNA were statistically significantly different. In AG and IG groups, mRNA expression levels of caspase-1 (1.55±0.62), (1.58±0.62), GSDMD (4.7±1.4), (3.5±1.53), NLRP3 [2.63(2.03, 4.10), 2.39(1.57, 3.49)] were higher than those of the HC group [(1.24±0.59), 1.16±0.71, 1.16 (0.50, 2.34)] ( P=0.037, P=0.023, P<0.001, P<0.001, P<0.001, P<0.001). In IG group, mRNA expression levels of GS-DMD (3.53±1.53) were lower than those of AG group (4.68±1.43) ( P<0.001).The mRNA expression levels of GS-DMC and GSDME [0.57(0.33, 0.78), (0.32±0.15)]were lower than those of the HC group [0.80 (0.47, 1.86), (1.06 ± 0.36) ( P=0.004, P<0.001), and the mRNA expression levels of GSDME (0.62±0.29) in the IG group were lower ( P=0.004, P<0.001), However, in the IG group, GSDMC and GSDME [0.87 (0.51, 1.53), (0.62±0.29)] were higher than those in the AG group [0.57 (0.33, 0.78), (0.32±0.15)] ( P=0.003, P<0.001). ③ The expression levels of NLRP3, pro-caspase-1, caspase-1 + p10, GSDMD, GSDMD-N, pro-IL-1β, clevated IL-1β protein were statistically different among the three groups [( F=50.04, P<0.001; F=9.65, P=0.013; F=30.71, P=0.001; F=7.38, P=0.024; F=23.66, P=0.001; F=30.11, P=0.001; F=6.01, P=0.036]. The expression of NLRP3 protein in the AG group (1.14±0.12) was significantly higher than that in the IG and HC group (0.35±0.18), (0.17±0.03) (all P=0.001), the expression levels of Pro caspase-1, caspase-1+p10 protein in the AG (1.11±0.15), (0.93±0.38) and IG (0.98±0.14), (1.14±0.17) group were higher than those in the HC (0.42±0.28), (0.29±0.16) ( P=0.006, P=0.015). The expression levels of GSDMD protein in the AG group (1.04±0.16) were higher than those in the IG and HC group(0.53±0.26), (0.39±0.22) ( P=0.029, P=0.011). The expression level of GSDMD-N protein in the AG and IG group (0.97±0.06), (0.90±0.04) was higher than that in the HC (0.27±0.23) ( P=0.001, P=0.001). The expression level of pro-IL-1β protein in the AG group (1.01±0.06) was significantly higher than that in the IG and HC group (0.32±0.14), (0.64±0.11) ( P<0.001, P=0.006), but lower than that in the HC (0.64±0.11) ( P=0.011). The expression of clevated IL-1β protein was higher in the AG group (1.08±0.20) than in the HC group (0.33±0.24) ( P=0.014). ④ Negative correlation between NLRP3, GSDMD and LY ( r=-0.32, P=0.001; r=-0.24, P=0.017) and positive correlation between GSDMD and WBC, GR ( r=0.43, P<0.001; r=0.23, P=0.019) were found and Logistic regression analysis showed that the GSDMD and NLRP3 were risk factors for AG [ OR ( 95%CI)=11.29 (3.92, 32.48), P<0.001; OR( 95%CI)=2.21(1.00, 4.85), P=0.049]. GSDMD was risk factor for IG [ OR( 95%CI)=6.84(2.52, 18.53), P<0.001]; While GSDMD was the protective factor for IG [ OR( 95%CI)=0.61(0.41, 0.30), P=0.013]. Conclusion:The expression's of NLRP3, Caspase-1 and GSDMD are increased in PBMCs of AG patients, while the expression's of GSDMC and GSDME are decreased. NLRP3/Caspase-1/GSDMD may be associated with the onset of acute gouty arthritis.

Objective:To investigate the clinical characteristics and short-term follow-up outcomes of primary nephrotic syndrome (PNS) children infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the Omicron variant outbreak in Shanghai, and to provide a reliable reference for clinicians in the diagnosis and treatment.Methods:It was a case-control study. The clinical data of children with PNS (PNS group) who were diagnosed and followed-up up to 1 year in the nephrology department of four children's medical centers in Shanghai, and the children (control group) who had no underlying diseases and were infected with SARS-CoV-2 in Shanghai Jinshan Public Health Center, including the data when they were infected with SARS-CoV-2, were retrospectively analyzed.Results:(1) From March 30th to April 13th, 2022, 6 PNS children in Shanghai were infected with SARS-CoV-2, including 5 boys and 1 girl. The median age was 4.5 (2.0, 11.0) years old. And 30 children were matched by sex, age and disease type as control group, including 20 males and 10 females. The median age was 4.5 (2.0, 9.0) years. There were no significant differences between the PNS group and the control group in clinical symptoms (including fever duration), treatment regimens, vaccine doses and virus clearance time (all P>0.05). (2) The 6 children with PNS included 3 cases of steroid-sensitive type, 3 cases of steroid-resistant type, 2 cases of minimal change disease, 2 cases of focal segmental glomerulosclerosis and 2 cases with no renal biopsy. Before SARS-CoV-2 infection, their primary disease-PNS were stable, and urine protein was negative, four of them were under maintenance treatment with oral steroids or immunosuppressive drugs. At the time of SARS-CoV-2 infection, the symptoms of all of the 6 cases were mild, no severe, critical or fatal cases, and they were all cured and discharged from hospital through medical isolation observation or symptomatic treatment of infections. (3) Five cases of them still had discomfort symptoms such as cough, anorexia, and fatigue after being discharged from the hospital, which lasted for about 1 week. Within 1 year of follow-up, none of the children have suffered from "recurrent positive PCR results" or "secondary infection" of the SARS-CoV-2. (4) Among them, 4 cases of PNS relapsed after SARS-CoV-2 infection, timely addition of steroids was effective, their urine protein quickly turned negative, and there was no recurrence after 1 year of follow-up. (5) Before infection with SARS-CoV-2, the levels of immunoglobulin IgG were lower than the normal reference value in the 4 cases with PNS recurrence. Conclusions:During the Omicron variant outbreak in Shanghai, the infection of SARS-CoV-2 in children with PNS are resulted in high transmission among household contacts. Most of them have mild symptoms and good prognosis. PNS is prone to relapse after SARS-CoV-2 infection, and steroid therapy is effective and safe for these relapse. IgG may be a potential marker for the prognosis of PNS children infected with SARS-CoV-2.