Background: Whether there is a causal relationship between childhood obesity and increased risk of chronic kidney disease (CKD) remains controversial. This study sought to explore how body size in childhood and adulthood independently affects CKD risk in later life using a Mendelian randomization (MR) approach. Methods: Univariate and multivariate MR was used to estimate total and independent effects of body size exposures. Genetic associations with early-life and adult body size were obtained from a genome-wide association study of 453,169 participants in the U.K. Biobank, and genetic associations with CKD were obtained from the CKDGen and FinnGen consortia. Results: A larger genetically predicted early-life body size was associated with an increased risk of CKD (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.14 to 1.41; P= 1.70E-05) and increased blood urea nitrogen (BUN) levels (β=0.010; 95% CI, 0.005 to 0.021; P=0.001). However, the association between the impact of early-life body size on CKD (OR, 1.12; 95% CI, 0.95 to 1.31; P=0.173) and BUN level (β=0.001; 95% CI, –0.010 to 0.012;P= 0.853) did not remain statistically significant after adjustment for adult body size. Larger genetically predicted adult body size was associated with an increased risk of CKD (OR, 1.37; 95% CI, 1.21 to 1.54; P= 4.60E-07), decreased estimated glomerular filtration rate (β=–0.011; 95% CI, –0.017 to –0.006; P=5.79E-05), and increased BUN level (β= 0.010; 95% CI, 0.002 to 0.019; P= 0.018). Conclusion Our research indicates that the significant correlation between early-life body size and CKD risk is likely due to maintaining a large body size into adulthood.

Objective To observe the value of self-made self-coagulating denture power helmet for PET/CT scanning of adult rats.Methods Eleven adult healthy male SD rats with body weight of 290-300 g were selected.Taken 1 rat's head as a reference,a self-made helmet with a thickness of 2 mm was obtained using self-coagulating denture powder to fix the rat's head.Then the other 10 rats were randomly divided into group A and group B(each n=5).The heads of rats were fixed with helmets,and 18F-FDG PET(scanning time 20 min)and CT images were acquired.Pain models were constructed using rats in group B through injection of 5％formaldehyde solution 0.10 ml at the right foot at the 11th minute during PET collection.The imaging quality of 18F-FDG PET/CT in group A was observed,and CT gray values of the olfactory bulb covered by helmet and soft tissue area posterior occipital region without helmet coverage in group A were compared.The quality of PET images before and after pain induction in group B were analyzed to evaluate the fixation effect of helmet.Based on PET images,the changes of 18F-FDG standard uptake value ratio(SUVR)in primary somatosensory cortex hindlimb region(S1HL)in group B after pain induction were observed.Results PET and CT images in group A were clear,with no obvious foreign body artifacts.CT gray values of olfactory bulb and soft tissue in posterior occipital region in group A was 257.0±50.7 and 194.4±55.4,respectively,being not significantly different(P=0.054).PET images before and after pain induction in group B showed no obvious artifacts,and the continuity between covered area of helmet and non-covered area was good.After pain induction,S1HL on the contralateral side of pain induction in group B significantly activated.The ratio of SUVRafter pain induction/SUVRbefore pain induction in S1HL on the contralateral side of pain induction was 1.19±0.07,and SUVRafter pain induction was higher than SUVRbefore pain induction(P=0.001).Conclusion Self-made self-coagulation denture powder helmet could effectively fix head of adult rat during PET/CT scanning.

Background: Whether there is a causal relationship between childhood obesity and increased risk of chronic kidney disease (CKD) remains controversial. This study sought to explore how body size in childhood and adulthood independently affects CKD risk in later life using a Mendelian randomization (MR) approach. Methods: Univariate and multivariate MR was used to estimate total and independent effects of body size exposures. Genetic associations with early-life and adult body size were obtained from a genome-wide association study of 453,169 participants in the U.K. Biobank, and genetic associations with CKD were obtained from the CKDGen and FinnGen consortia. Results: A larger genetically predicted early-life body size was associated with an increased risk of CKD (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.14 to 1.41; P= 1.70E-05) and increased blood urea nitrogen (BUN) levels (β=0.010; 95% CI, 0.005 to 0.021; P=0.001). However, the association between the impact of early-life body size on CKD (OR, 1.12; 95% CI, 0.95 to 1.31; P=0.173) and BUN level (β=0.001; 95% CI, –0.010 to 0.012;P= 0.853) did not remain statistically significant after adjustment for adult body size. Larger genetically predicted adult body size was associated with an increased risk of CKD (OR, 1.37; 95% CI, 1.21 to 1.54; P= 4.60E-07), decreased estimated glomerular filtration rate (β=–0.011; 95% CI, –0.017 to –0.006; P=5.79E-05), and increased BUN level (β= 0.010; 95% CI, 0.002 to 0.019; P= 0.018). Conclusion Our research indicates that the significant correlation between early-life body size and CKD risk is likely due to maintaining a large body size into adulthood.

T-cell large granular lymphocyte leukemia (T-LGLL) is a rare chronic lymphoproliferative disorder. This paper presents a T-LGLL patient who had been on maintenance hemodialysis for over 20 years. Three years prior, the patient developed erythropoietin hyporesponsiveness, with hemoglobin levels declining from 100 g/L to 49 g/L over eight months, accompanied by mild leukopenia and thrombocytopenia. Initial bone marrow biopsy and peripheral blood tests yielded inconclusive results. A 99mTc-labeled red blood cell spleen scintigraphy revealed evidence of hypersplenism, which prompted a splenectomy. Following surgery, leukopenia and thrombocytopenia resolved, but anemia persisted. Subsequently, lymphocyte counts increased, and reticulocyte progressively declined. Further investigations, including bone marrow biopsy, blood smear analysis, immunophenotyping, and T-cell receptor gene analysis, ultimately confirmed the diagnosis of T-LGLL with pure red cell aplasia. Treatment with cyclosporine resulted in a significant improvement in hemoglobin, reaching 117 g/L in 6 months. This case contributes to enhancing clinicians' awareness and understanding of this disease.

Objective:To conduct a comprehensive analysis of the clinical, pathological characteristics and prognosis of patients with secondary oxalate nephropathy manifested by acute kidney injury.Methods:A retrospective analysis study was conducted on secondary oxalate nephropathy presenting with acute kidney injury and diagnosed by renal biopsy in the Department of Nephrology of the Second Affiliated Hospital of Anhui Medical University from August 2020 to July 2023. The general demographic characteristics, complications and laboratory tests were collected. All patients were followed from the time of diagnosis of oxalate nephropathy until death, loss to follow-up or the end of the study (October 2024). The primary endpoint event was the recovery of renal function.Results:During the study period, a total of 329 patients underwent renal biopsies. Among them, 12 patients (3.65%) with secondary oxalate nephropathy were included in this study, including 7 males (7/12) and 5 females (5/12), with age of 56.5 (50.0, 69.0) years. In terms of comorbidities, 5 patients (5/12) had diabetes mellitus, 8 patients (8/12) had hypertension, and 3 patients (3/12) had gastrointestinal diseases. Among the causes, 3 patients (3/12) were identified as having a high-oxalate diet, 1 patient (1/12) underwent gastric cancer surgery, and 3 patients (3/12) took medications that could induce hyperoxalemia. Additionally, no definitive cause was identified in 5 patients (5/12). All 12 patients exhibited acute tubulointerstitial injury on renal pathology, with 8 patients also demonstrating chronic tubulointerstitial lesions. Management strategies included the removal of causative factors, adequate hydration to promote oxalate excretion, and sodium bicarbonate to alkalize urine and vitamin B6 to reduce oxalate production, along with renal replacement therapy if necessary. During the follow-up of 28 (16, 39) months, 6 patients (6/10) achieved complete recovery of renal function, 4 patients (4/10) showed partial recovery, and 2 patients were lost to follow-up.Conclusions:The prevalence of secondary oxalate nephropathy at our center is 3.65%. Renal pathology in all patients demonstrates acute tubulointerstitial injury, with most patients exhibiting chronic tubulointerstitial lesions. Overall, the clinical prognosis remains favorable.

Objective: To utilize machine learning(ML) algorithms to develop accurate and effective prediction models for TAC dose/weight-adjusted trough concentration(C0/D). Methods: Data were collected on 264 TAC blood concentration monitoring data from 72 patients undergoing kidney transplantation. The effects of population statistical data, clinical features, combined medication, and ultrasound feature parameters on TAC C0/D were analyzed. Features with a significance level less than 0.05 in the univariate analysis of TAC C0/D were selected for inclusion in the random forest(RF) algorithm to identify significant features. These features were interpreted using partial dependency plots. Five ML algorithms, including RF, support vector regression(SVR), extreme gradient boosting(XGBoost), decision trees(DT) and artificial neural networks(ANN), were employed to establish the TAC C0/D prediction model. Hyper-parameter tuning was performed on the RF model that performed the best. Results : Ten characteristic variables with importance scores>5 were retained and included in the ML model: transglutaminase, red blood cell count, blood urea nitrogen, weight, serum creatinine, renal segmental arterial resistance index, renal aortic resistance index, hematocrit, renal pelvic Young′s modulus value, and time after transplantation. The partial dependence plots showed that all 10 important variables screened were positively correlated with TAC C0/D. The tuned RF model outperformed the other models with aR2of 0.81, aRMSEof 43.93, and aMAEof 29.97. Conclusion The ML models demonstrate good performance in predicting TAC C0/D and provide innovative interpretations using partial dependence plot. The optimized RF model shows optimal performance and offers a novel tool for individualized medication adjustment for TAC in renal transplant patients.

Objective: To identify the risk factors for pulmonary arterial hypertension(PAH) in maintenance peritoneal dialysis(MPD) patients and to develop and validate a nomogram-based risk-prediction model. Methods: A total of 168 hospitalized MPD patients from the Department of Nephrology were enrolled.Body-fluid composition was measured by bioelectrical impedance analysis,and pulmonary-artery systolic pressure(PASP) was assessed by echocardiography.Patients were randomly allocated into a training set and a validation set at 1:1 ratio.Variables with P< 0. 05 in multivariable Logistic regression in the training set were incorporated to construct a nomogram .The validation set was used to test the model ’s predictive performance . ROC curves , calibration curves , and decision-curve analysis were applied to evaluate accuracy , consistency , and clinical usefulness of the model . Results: Dialysis vintage ( OR : 1 . 038 , 95% CI: 1 . 008 - 1 . 069 , P = 0. 012) , hemoglobin level ( OR : 0. 961 , 95% CI: 0. 929 - 0. 994 , P = 0. 021) , and extracellular water/intracellular water ratio (E/I) (OR : 1 . 069 , 95% CI: 1 . 024- 1 . 115 , P = 0. 002) were independent risk factors for PAH . ROC analysis yielded area under curve as 0. 867 (95% CI: 0. 782 - 0. 953) and 0. 808 (95% CI: 0. 714 - 0. 902) in the training and validation sets , respectively .Calibration plots showed that the predicted curves for both the training and validation sets closely overlapped with the ideal reference line , indicating that the nomogram risk-prediction model had good predictive performance . Decision-curve analysis demonstrated that , within threshold ranges of 0. 13 - 0. 76 ( training set ) and 0. 20 - 0. 76 (val- idation set ) , clinical net benefit was substantial when interventions were guided by the nomogram . Conclusion Dialysis vintage , hemoglobin level , and fluid-overload index (E/I) are independent risk factors for PAH in MPD patients . The nomogram based on these parameters reliably predicts PAH risk and may aid clinical decision-making.

T-cell large granular lymphocyte leukemia (T-LGLL) is a rare chronic lymphoproliferative disorder. This paper presents a T-LGLL patient who had been on maintenance hemodialysis for over 20 years. Three years prior, the patient developed erythropoietin hyporesponsiveness, with hemoglobin levels declining from 100 g/L to 49 g/L over eight months, accompanied by mild leukopenia and thrombocytopenia. Initial bone marrow biopsy and peripheral blood tests yielded inconclusive results. A 99mTc-labeled red blood cell spleen scintigraphy revealed evidence of hypersplenism, which prompted a splenectomy. Following surgery, leukopenia and thrombocytopenia resolved, but anemia persisted. Subsequently, lymphocyte counts increased, and reticulocyte progressively declined. Further investigations, including bone marrow biopsy, blood smear analysis, immunophenotyping, and T-cell receptor gene analysis, ultimately confirmed the diagnosis of T-LGLL with pure red cell aplasia. Treatment with cyclosporine resulted in a significant improvement in hemoglobin, reaching 117 g/L in 6 months. This case contributes to enhancing clinicians' awareness and understanding of this disease.

Objective:To conduct a comprehensive analysis of the clinical, pathological characteristics and prognosis of patients with secondary oxalate nephropathy manifested by acute kidney injury.Methods:A retrospective analysis study was conducted on secondary oxalate nephropathy presenting with acute kidney injury and diagnosed by renal biopsy in the Department of Nephrology of the Second Affiliated Hospital of Anhui Medical University from August 2020 to July 2023. The general demographic characteristics, complications and laboratory tests were collected. All patients were followed from the time of diagnosis of oxalate nephropathy until death, loss to follow-up or the end of the study (October 2024). The primary endpoint event was the recovery of renal function.Results:During the study period, a total of 329 patients underwent renal biopsies. Among them, 12 patients (3.65%) with secondary oxalate nephropathy were included in this study, including 7 males (7/12) and 5 females (5/12), with age of 56.5 (50.0, 69.0) years. In terms of comorbidities, 5 patients (5/12) had diabetes mellitus, 8 patients (8/12) had hypertension, and 3 patients (3/12) had gastrointestinal diseases. Among the causes, 3 patients (3/12) were identified as having a high-oxalate diet, 1 patient (1/12) underwent gastric cancer surgery, and 3 patients (3/12) took medications that could induce hyperoxalemia. Additionally, no definitive cause was identified in 5 patients (5/12). All 12 patients exhibited acute tubulointerstitial injury on renal pathology, with 8 patients also demonstrating chronic tubulointerstitial lesions. Management strategies included the removal of causative factors, adequate hydration to promote oxalate excretion, and sodium bicarbonate to alkalize urine and vitamin B6 to reduce oxalate production, along with renal replacement therapy if necessary. During the follow-up of 28 (16, 39) months, 6 patients (6/10) achieved complete recovery of renal function, 4 patients (4/10) showed partial recovery, and 2 patients were lost to follow-up.Conclusions:The prevalence of secondary oxalate nephropathy at our center is 3.65%. Renal pathology in all patients demonstrates acute tubulointerstitial injury, with most patients exhibiting chronic tubulointerstitial lesions. Overall, the clinical prognosis remains favorable.

Background Prenatal chronic psychological stress may increase the risk of allergic diseases in children, and eczema is the most common allergic disease in children, the pathogenesis of which is not yet fully understood. Objective To preliminarily clarify the changes in offspring intestinal flora after chronic stress exposure during pregnancy in rats that increases offspring immune imbalance and eczema susceptibility. Methods Thirty SPF-grade adult female SD rats were selected and randomly divided into a model group and a control group (n=15). Sixteen male rats were randomly divided into a model mating group and a control mating group (n=8). A 28-day chronic unpredictable mild stress (CUMS) model during pregnancy was established. On the 7th day of stress, male and female rats were caged in a ratio of 3:1. Blood samples were collected from female rats in each group via angular vein on the 1st day before stress, and on the 7th, 14th, 21st, and 28th days after stress. The content of plasma corticosterone during pregnancy was determined by enzyme-linked immunosorbent assay (ELISA). For the offspring rats, an eczema model was constructed using 2,4-dinitrochlorobenzene (DNCB). The number of scratching times of the offspring rats within 5 min was recorded. The offspring rats were divided into 4 groups: DNCB-CUMS group (MM), DNCB-control group (MC), solvent control-CUMS group (CM), and blank control group (CC), with 8 rats in each group. The eczema was induced once every 3 days, and the induction period was 12 d. The expression level of immunoglobulin E (IgE) in the serum of offspring rats after the eczema induction experiment were determined by ELISA. The concentrations of tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-2 (IL-2), interleukin-4 (IL-4), and interleukin-13 (IL-13) in the serum were quantified by multi-parameter flow cytometry. The composition and abundance of intestinal microbiota in the feces of offspring rats were detected by 16S rRNA high-throughput sequencing technology. Results The plasma corticosterone concentrations in the model group were higher than those in the control group on the 7th and 21st days of stress (P<0.05). On the 14th and 21st days of stress, the 1% sucrose preference percentages of female rats in the model group were lower than that in the control group. On the 7th, 14th, and 21st days of stress, the horizontal movement scores of female rats in the model group and the vertical movement scores on the 7th and 14th days were lower than those in the control group (P<0.05). After 6, 9, and 12 d of model building, the scratching frequencies in the MC group and MM group were significantly higher than those in the CC group and CM group (P<0.05). Moreover, there were differences in the contents of cytokines including IFN-γ, IL-2, TNF-α, IL-4, IL-13, and IgE among the offspring rat groups (P<0.05). The CM group and MM group led to an increase in the contents of TNF-α, IL-4, IL-13, and IgE cytokines (P<0.05), while the MM group caused a decrease in the contents of IFN-γ and IL-2 (P<0.05). After the eczema induction experiment, the α-diversity analysis showed that the Simpson index and Shannon index in the CM were higher than those in the CC (P<0.05), indicating that CUMS during the pregnancy of female rats could increase the species abundance of their offspring. The abundances of Prevotella and Lactobacillus in the CM group decreased (P<0.05). Conclusion Intestinal dysbiosis in offspring due to chronic prenatal psychological stress, which may be one of the mechanisms linking maternal stress to immune imbalance and increased susceptibility to eczema in offspring.