This article reports a case of an elderly male patient presenting with nephrotic syndrome. Renal biopsy pathology indicated membranous nephropathy, with both renal tissue staining for M-type phospholipase A2 receptor (PLA2R) and serum anti-PLA2R antibodies being negative. Nephrotic syndrome achieved remission following treatment with prednisone combined with tacrolimus; however, the patient relapsed during tacrolimus maintenance therapy. Subsequent laboratory evaluation revealed positive anti-nuclear antibodies and anti-double-stranded DNA antibodies, accompanied by decreased complement levels. Exostosin 1 and Exostosin 2 staining performed on the initial renal biopsy specimen yielded positive results, leading to a diagnosis of lupus nephritis. Due to the patient's history of rituximab-related allergic reactions, pulmonary infection, and acute kidney injury, the subsequent treatment regimen consisted of obinutuzumab sequentially combined with belimumab, in addition to prednisone 10 mg/d. During the two-year follow-up period, the patient's anti-double-stranded DNA antibodies converted to negative, complement levels normalized, proteinuria achieved complete remission, and no adverse events such as severe infection occurred. This article reviews the diagnosis, treatment, and relevant literature for this case, aiming to provide clinical insights for the early diagnosis and selection of therapeutic strategies for similar patients.

Objective To explore the epidemiological characteristics of gouty arthritis in Northwest China from 2023 to 2025, and to formulate preventive intervention measures. Methods By retrospectively analyzing the case data of medical institutions in Northwest China from January 2023 to June 2025 (a total of 8 139 cases), the incidence trend and population distribution characteristics of gouty arthritis in this area were analyzed. Multivariate logistic regression analysis was performed to identify risk factors. Results From 2023 to 2025, the prevalence rate of gouty arthritis in adult residents in Northwest China was 3.74% (304/8 139). Among the sites affected by gouty arthritis, the metatarsophalangeal joint accounted for the highest proportion (P<0.05). From the perspective of age distribution, the prevalence rate was the highest in 40-59 years old group (5.90%), followed by 66-80 years old group (4.21%) and >80 years old group (2.75%). The incidence rate in 40-65 years old group was higher than that in the other age groups (P<0.05). High blood uric acid and creatinine, alcohol drinking, obesity, high purine diet, concurrent chronic kidney disease and metabolic syndrome were risk factors affecting gouty arthritis in Northwest China (P<0.05). Conclusion High blood uric acid level, high creatinine level, alcohol drinking, obesity, high purine diet, concurrent chronic kidney disease and metabolic syndrome are risk factors influencing gouty arthritis in Northwest China. Based on the above factors, this study proposes comprehensive prevention strategies from the individual, community and public health levels to provide a scientific basis for reducing the incidence rate of gouty arthritis.

Objective To explore the effects of Peiyuan Yishen Antai Decoction on cell senescence and decidualization of aged mice with recurrent spontaneous abortion(RSA)based on P53/P21 signaling pathway;To discuss its mechanism in the treatment of RSA.Methods 8-9 month old CBA/J female mice were randomly divided into aging model group(normal saline 0.3 mL/d),Chinese materia medica group(18.72 g/kg)and dydrogesterone group(2.6 mg/kg).6-8 week old CBA/J female mice were assigned to a reproductive age blank group(normal saline 0.3 mL/d),with five mice in each group.After administering the corresponding solutions by gavage for 2 weeks,the reproductive age blank group mice were housed in cages with BALB/c male mice,while the remaining groups were housed in cages with DBA/2 male mice.After confirming the presence of vaginal plug,gavage was continued until the 9th day of pregnancy for sampling.Mice embryo loss rate was observed,HE staining was used to observe the morphology of uterine decidua,immunohistochemistry was used to detect the localization and expression of aging related protein Pi6INK4a in decidua tissue,RT-PCR and Western blot were used to detect the mRNA and protein expressions of P53,P21,insulin-like growth factor binding protein 1(IGFBP-1)and prolactin(PRL)in decidual tissue.Results Compared with the reproductive age blank group,the embryo loss rate of the aging model group significantly increased(P＜0.05),the irregular endometrial cells were vacuolated,the number of glands and blood vessels was reduced,the expression of P16INK4a in decidual tissue significantly increased(P＜0.05),and the expressions of P53,P21 mRNA and protein significantly increased(P＜0.05),the mRNA and protein expressions of IGFBP-1 and PRL significantly decreased(P＜0.05).Compared with the aging model group,the Chinese materia medica group and the dydrogesterone group showed an decreasing trend in embryo loss rate in mice,the arrangement of cells in the decidua tissue was relatively neat,and the number of blood vessels and glands increased,the expression of P16INK4a in decidua tissue was significantly decreased(P＜0.05),the mRNA and protein expressions of P53 and P21 were significantly decreased(P＜0.05),while the mRNA and protein expressions of IGFBP-1 and PRL significantly increased(P＜0.05).Conclusion Peiyuan Yishen Antai Decoction can improve the aging status of endometrial stromal cells in aged RSA model mice by regulating the P53/P21 signaling pathway,promote decidualization process,and thus exert a protective effect on pregnancy.

Objective To investigate the changes in oral microbiota of db/db mice and provide an experimental basis for exploring the relationship between type 2 diabetes mellitus and oral microecology.Methods Eight 10-week-old male db/db mice were designated as the diabetes experimental group(db/db group),while eight 10-week-old male db/m mice were assigned as the normal control group(db/m group).After a 5-day adaptive feeding period,tail venous blood samples were collected on the 6th and 37th days,and fasting blood glucose(FBG)levels and oral glucose tolerance test(OGTT)were performed for both groups to verify the reliability of the diabetes model.On the 15th day of feeding with the same diet,oral microbiota samples were collected from the buccal mucosa,dorsal and ventral tongue surfaces,oral floor mucosa,hard palate mucosa,and the gingival areas of both the upper and lower jaws of the two groups.Genomic DNA from the oral microbiota was extracted,and the V3-V4 regions of the 16S ribosomal RNA(16S rRNA)gene were amplified using a GeneAmp 9700 thermocycler.The composition of the oral microbiota was evaluated through double-labelled amplification and sequencing on the Illumina MiSeq platform,followed by bioinformatics analysis using QI I ME software(version 1.6.0).Results The FBG levels and OGTT results on the 6th and 37th days after the start of the experiment indicated that db/db mice exhibited more pronounced symptoms of type 2 diabetes compared to db/m mice.Alpha diversity(αdiversity)analysis showed no significant difference in the diversity of oral microbiota between the two groups(P＞0.05);however,there was a significant difference in richness(P＜0.05).Principal coordinate analysis(PCoA)revealed differences in the oral microbiota composition between the db/db group and db/m group(P＜0.05).Species composition analysis and LEfSe analysis demonstrated that the relative abundance of oral microbiota in db/db group mice,predominantly composed of p_Proteobacteria,increased significantly at the phylum level(P＜0.05).At the genus level,the relative abundances of g_Proteus and g_Enterococcus showed a significant increase(P＜0.001).Conclusion The composition and diversity of oral microbiota in db/db mice with type 2 diabetes mellitus significantly differed from those without the disease.

Objective To investigate the changes in oral microbiota of db/db mice and provide an experimental basis for exploring the relationship between type 2 diabetes mellitus and oral microecology.Methods Eight 10-week-old male db/db mice were designated as the diabetes experimental group(db/db group),while eight 10-week-old male db/m mice were assigned as the normal control group(db/m group).After a 5-day adaptive feeding period,tail venous blood samples were collected on the 6th and 37th days,and fasting blood glucose(FBG)levels and oral glucose tolerance test(OGTT)were performed for both groups to verify the reliability of the diabetes model.On the 15th day of feeding with the same diet,oral microbiota samples were collected from the buccal mucosa,dorsal and ventral tongue surfaces,oral floor mucosa,hard palate mucosa,and the gingival areas of both the upper and lower jaws of the two groups.Genomic DNA from the oral microbiota was extracted,and the V3-V4 regions of the 16S ribosomal RNA(16S rRNA)gene were amplified using a GeneAmp 9700 thermocycler.The composition of the oral microbiota was evaluated through double-labelled amplification and sequencing on the Illumina MiSeq platform,followed by bioinformatics analysis using QI I ME software(version 1.6.0).Results The FBG levels and OGTT results on the 6th and 37th days after the start of the experiment indicated that db/db mice exhibited more pronounced symptoms of type 2 diabetes compared to db/m mice.Alpha diversity(αdiversity)analysis showed no significant difference in the diversity of oral microbiota between the two groups(P＞0.05);however,there was a significant difference in richness(P＜0.05).Principal coordinate analysis(PCoA)revealed differences in the oral microbiota composition between the db/db group and db/m group(P＜0.05).Species composition analysis and LEfSe analysis demonstrated that the relative abundance of oral microbiota in db/db group mice,predominantly composed of p_Proteobacteria,increased significantly at the phylum level(P＜0.05).At the genus level,the relative abundances of g_Proteus and g_Enterococcus showed a significant increase(P＜0.001).Conclusion The composition and diversity of oral microbiota in db/db mice with type 2 diabetes mellitus significantly differed from those without the disease.

Objective To build an automatic segmentation model of temporomandibular joint(TMJ)based on magnetic resonance im-aging(MRI)using deep learning method.Methods The MRI data of TMJ of 104 subjects were collected,with the articular disc,con-dyle and glenoid fossa marked.The adaptive U-Net framework(nnU-Net)was used to construct a segmentation model,which was sub-jected to both quantitative and qualitative assessments.Results The segmentation model demonstrated excellent accuracy in segmenta-tion.In the segmentation of different joint structures,the model achieved Dice of 0.77 for the articular disc,0.85 for the condyle,and 0.66 for the glenoid fossa.The model showed similar segmentation performance when processing MRI images in both open-mouth and closed-mouth states.Conclusion This study developed an automatic segmentation model for TMJ MRI based on deep learning,which can assist clinicians in diagnosing anterior displacement of the TMJ disc.

Objective:To investigate whether spectacle lens wear affects the exophthalmometry values (EVs) on myopia and explore the risk factors for EVs in myopia.Methods:A cross-sectional study was conducted.A total of 935 university freshmen (935 eyes) who received eye examinations were enrolled from September to December 2019.Anterior segments were examined by slit lamp microscopy.EVs were measured with a Hertel exophthalmometer.Non-cycloplegia auto-refraction, lensometer test, visual acuity test and subjective refraction were performed on all subjects.Ocular biometric parameters including axial length (AL) and average corneal radius (CR) were obtained by Lenstar 900.A 1∶1 propensity score matching (PSM) was performed between the spectacle group and the non-spectacle group to compare the differences in EVs and visual acuity.Linear regression was used to analyze the effect of different factors on the EVs in all myopic students.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2021KY-16).Written informed consent was obtained from each subject.Results:The mean EVs of students was (14.03±1.87)mm.There were significant differences in the distribution of myopia severity between the spectacle group and non-spectacle group before matching ( χ2=345.800, P<0.001), and after PSM, the baseline characteristics of the two groups were well balanced with good comparability.After PSM, there was no significant difference in EVs between the spectacle group and non-spectacle group ([13.93±1.87]mm vs.[13.66±1.85]mm; t=1.140, P=0.25), and the spectacle group had better visual acuity of 1.0(0.8, 1.0) than 0.4(0.2, 0.8) in non-spectacle group, with a statistically significant difference ( Z=-8.450, P<0.001).Multivariate linear regression showed that EVs increased by 0.06 mm for every 1 D increase in spherical equivalent towards myopia ( β=-0.06, 95% CI: -0.11--0.01, P=0.03), and EVs increased by 0.17 mm for every 1 mm increase in AL ( β=0.17, 95% CI: 0.06-0.28, P<0.01).Average CR did not influence EVs significantly ( β=0.07, 95% CI: -0.10-0.24, P=0.43). Conclusions:Wearing spectacles may not affect the EVs and not wearing spectacle may affect visual acuity in myopic patients.The higher the degree of myopia, the longer the AL, the higher the EVs may be.

Objective To observe the value of non-contrast CT radiomics for predicting recurrence of acute pancreatitis(AP).Methods Totally 356 patients with first-episode AP were retrospectively enrolled.The patients were categorized into recurrence group(n=78)and non-recurrence group(n=278)based on whether recurrence after 3 months of complete/near disappearance of symptoms,also divided into training set(n=213)and test set(n=143)at the ratio of 6∶4.For 116 cases who underwent contrast-enhanced CT,taken portal venous phase images as references,ROI of pancreatic parenchyma was manually delineated on non-contrast CT,while SegResNet segmentation model was used for automatic segmentation on non-contrast CT images for the rest 240 cases.The optimal radiomics features were extracted and selected to construct a radiomics model based on YeoJohnson transformer and Bagging decision tree.The receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the obtained model for predicting AP recurrence.Results Totally 2 264 radiomics features were extracted from ROI of pancreatic parenchyma,and finally 4 optimal features were screened.The AUC of radiomics model for predicting recurrence was 0.887 and 0.889 in training set and test set,respectively.Conclusion Non-contrast CT radiomics could be used to effectively predict recurrence of AP.

OBJECTIVE To observe the expressions of microribonucleic acid(miR)-155,miR-141,interleukin(IL)-22 and IL-17 in peripheral blood of the chronic renal failure(CRF)and hemodialysis(HD)patients compli-cated with hospital-associated infections and analyze the clinical treatment outcomes.METHODS A total of 561 CRF patients who underwent HD in Wuhan First Hospital from Jun.2022 to Jun.2023 were enrolled in the study and were divided into the infection group with 182 cases and the non-infection group with 379 cases according to the status of hospital-associated infections.The patients of the infection group were divided into the survival group with 138 cases and the death group with 44 cases according to the clinical therapeutic outcomes of a 6-month fol-low-up.The distribution of pathogens isolated from the CRF HD patients with hospital-associated infections was analyzed,the clinical data were compared between the infection group and the non-infection group;the levels of serum miR-155,miR-141,IL-22 and IL-17 were observed and compared among the groups.The values of the se-rologic markers in prediction of the clinical therapeutic outcomes of the CRF HD patients with hospital-associat-ed infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of pa-tients with no less than 1 year of hemodialysis,femoral venous catheter indwelling and long-term catheter indwell-ing were higher in the infection group than those in the non-infection group(P＜0.05).Totally 202 strains of pathogens were isolated from the infection group,125(61.88％)of which were gram-negative bacteria.There were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the infection group and the no infection group(P＜0.05),the biomarker with the greatest difference value was miR-141(t=37.145,P＜0.001).As compared with the patients with different therapeutic outcomes in the infection group,there were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the survival group and the death group(P＜0.05),and the index with the greatest difference value was IL-17(t=35.848,P＜0.001).The values of the four markers in prediction of the therapeutic outcomes of the CRF HD patients compli-cated with hospital-associated infections were analyzed by ROC curves,and the area under the curve(AUC)of the joint detection 0.922 was the highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the CRF HD patients complicated with hospital-associated infections.The levels of se-rum miR-155,miR-141,IL-22 and IL-17 are elevated with the incidence of infections and deterioration of progno-sis.The joint detection of the markers has high predictive value.

OBJECTIVE To observe the expressions of microribonucleic acid(miR)-155,miR-141,interleukin(IL)-22 and IL-17 in peripheral blood of the chronic renal failure(CRF)and hemodialysis(HD)patients compli-cated with hospital-associated infections and analyze the clinical treatment outcomes.METHODS A total of 561 CRF patients who underwent HD in Wuhan First Hospital from Jun.2022 to Jun.2023 were enrolled in the study and were divided into the infection group with 182 cases and the non-infection group with 379 cases according to the status of hospital-associated infections.The patients of the infection group were divided into the survival group with 138 cases and the death group with 44 cases according to the clinical therapeutic outcomes of a 6-month fol-low-up.The distribution of pathogens isolated from the CRF HD patients with hospital-associated infections was analyzed,the clinical data were compared between the infection group and the non-infection group;the levels of serum miR-155,miR-141,IL-22 and IL-17 were observed and compared among the groups.The values of the se-rologic markers in prediction of the clinical therapeutic outcomes of the CRF HD patients with hospital-associat-ed infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of pa-tients with no less than 1 year of hemodialysis,femoral venous catheter indwelling and long-term catheter indwell-ing were higher in the infection group than those in the non-infection group(P＜0.05).Totally 202 strains of pathogens were isolated from the infection group,125(61.88％)of which were gram-negative bacteria.There were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the infection group and the no infection group(P＜0.05),the biomarker with the greatest difference value was miR-141(t=37.145,P＜0.001).As compared with the patients with different therapeutic outcomes in the infection group,there were significant differences in the levels of serum miR-155,miR-141,IL-22 and IL-17 between the survival group and the death group(P＜0.05),and the index with the greatest difference value was IL-17(t=35.848,P＜0.001).The values of the four markers in prediction of the therapeutic outcomes of the CRF HD patients compli-cated with hospital-associated infections were analyzed by ROC curves,and the area under the curve(AUC)of the joint detection 0.922 was the highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the CRF HD patients complicated with hospital-associated infections.The levels of se-rum miR-155,miR-141,IL-22 and IL-17 are elevated with the incidence of infections and deterioration of progno-sis.The joint detection of the markers has high predictive value.