Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide, accounting for 20%-40% of primary glomerulonephritis cases. Approximately 40% of patients progress to end-stage renal disease within 20 years. Traditional treatments primarily involve renin-angiotensin system inhibitors and glucocorticoids, but some patients show limited response and face infection risks. In recent years, the dual-target biologic agent Telitacicept, which targets B cell-activating factor/B lymphocyte stimulator(BAFF/BLyS) and a proliferation-inducing ligand (APRIL), has demonstrated significant potentialin the treatment of IgAN. By simultaneously neutralizing BAFF/BLyS and APRIL, Telitacicept suppresses abnormal B-cell activation and the production of pathogenic IgA1, significantly reducing urinary protein levels and preserving renal function. This article systematically reviews its mechanism of action, clinical efficacy, and safety, aiming to provide insights for the clinical management of IgAN.

Objective:To explore the status and problems of safety recommendations in clinical practice guidelines and expert consensuses (guidelines/consensuses) on Chinese patent medicine (CPM) in China.Methods:Wanfang Med Online, CNKI, VIP, China Biology Medicine Database, Chinese Medical Journal Full Text Database, and the websites of Medlive, and China Association of Chinese Medicine were searched, and the guidelines/consensuses related to CPM were collected. The basic information, types, subject areas, evidence rating methods, safety reporting items, safety recommendation levels, and evidence sources of these guidelines/consensuses were extracted and analyzed by descriptive statistics.Results:A total of 138 guidelines/consensuses were included in the analysis, including 19 guidelines and 119 consensuses. The first guideline/consensus on CPM was published in 2004. Five, 3, 9, 15, 29, 32, 29, and 11 guidelines/consensuses were published respectively from 2016 to 2023. From 2020 to 2023, 101 guidelines/consensuses were published, which was 2.73 times the total number of those published in the past 16 years.(101/37). Among the 138 guidelines/consensuses, 59 (42.75%) were "disease-based" and 79 (57.25%) were "drug-based". The top 5 institutions in terms of the number of publications were National Administration of Traditional Chinese Medicine, China Association of Chinese Medicine, Institute of Basic Research in Clinical Medicine of China Academy of Chinese Medical Sciences, Chinese Association of Integrative Medicine, and Chinese Medical Association, of which National Administration of Traditional Chinese Medicine issued 19 guidelines. However, the issuing units of 26 guidelines/consensuses were medical colleges/medical institutions and the issuing units of 8 guildlines/consensuses were not clearly stated. Among the 138 guidelines/consensuses, 18 (13.04%) did not describe the safety of drugs and 120 (86.96%) described. Among the 120 guidelines/consensuses, none of the safety recommendations were graded according to The Grading of Recommendations Assessment, Development and Evaluation, and only 32.50% (39/120) of the evidence sources contained randomized controlled trials. A proportion of 50.72% (70/138) in 138 guidelines/consensuses did not report the funding situation, and 37.68% (52/138) did not disclose the conflict of interest.Conclusions:In recent years, the number of guidelines/consensuses on CPM has increased significantly in China, but the issuing agencies of some of them had poor authority. Most of the guidelines/consensuses are "drug-based", the descriptions of safety are insufficient, the evidence level is low, and there may be some bias.

Objective:To explore the status and problems of safety recommendations in clinical practice guidelines and expert consensuses (guidelines/consensuses) on Chinese patent medicine (CPM) in China.Methods:Wanfang Med Online, CNKI, VIP, China Biology Medicine Database, Chinese Medical Journal Full Text Database, and the websites of Medlive, and China Association of Chinese Medicine were searched, and the guidelines/consensuses related to CPM were collected. The basic information, types, subject areas, evidence rating methods, safety reporting items, safety recommendation levels, and evidence sources of these guidelines/consensuses were extracted and analyzed by descriptive statistics.Results:A total of 138 guidelines/consensuses were included in the analysis, including 19 guidelines and 119 consensuses. The first guideline/consensus on CPM was published in 2004. Five, 3, 9, 15, 29, 32, 29, and 11 guidelines/consensuses were published respectively from 2016 to 2023. From 2020 to 2023, 101 guidelines/consensuses were published, which was 2.73 times the total number of those published in the past 16 years.(101/37). Among the 138 guidelines/consensuses, 59 (42.75%) were "disease-based" and 79 (57.25%) were "drug-based". The top 5 institutions in terms of the number of publications were National Administration of Traditional Chinese Medicine, China Association of Chinese Medicine, Institute of Basic Research in Clinical Medicine of China Academy of Chinese Medical Sciences, Chinese Association of Integrative Medicine, and Chinese Medical Association, of which National Administration of Traditional Chinese Medicine issued 19 guidelines. However, the issuing units of 26 guidelines/consensuses were medical colleges/medical institutions and the issuing units of 8 guildlines/consensuses were not clearly stated. Among the 138 guidelines/consensuses, 18 (13.04%) did not describe the safety of drugs and 120 (86.96%) described. Among the 120 guidelines/consensuses, none of the safety recommendations were graded according to The Grading of Recommendations Assessment, Development and Evaluation, and only 32.50% (39/120) of the evidence sources contained randomized controlled trials. A proportion of 50.72% (70/138) in 138 guidelines/consensuses did not report the funding situation, and 37.68% (52/138) did not disclose the conflict of interest.Conclusions:In recent years, the number of guidelines/consensuses on CPM has increased significantly in China, but the issuing agencies of some of them had poor authority. Most of the guidelines/consensuses are "drug-based", the descriptions of safety are insufficient, the evidence level is low, and there may be some bias.

Objective We evaluated serum levels of 25hydroxyvitamin D（25（OH）D）and Creactive protein（CRP）in patients presenting acutely with Vestibular neuritis（VN）and healthy controls and investigated the possible correlation of serum 25（OH）D and CRP levels with VN.Methods A total of 46 consecutive patients diagnosed with VN within 7 days of symptom onset and 66 ageand sexmatched healthy controls in NO731 Hospital，between March 2019 and August 2020 were recruited. Demographic and clinical data，such as age，sex，height，weight，living habits，ongoing health problems，and medication history，for all subjects were recorded，and levels of 25（OH）D and CRP were measured and compared. 〖WT5”HZ〗Results〖WT5”BZ〗Serum levels of 25（OH）D were significantly lower in patients with VN than in controls（18.30± 6.19 vs. 22.43±5.23 ng/ml，P<0.001）.whereas serum levels of CRP were higher in patients with VN than in controls （15.86±8.37 vs. ng/ml，P<0.001）Regression analyses demonstrated that vitamin D and CRP were associated with VN，with an odds ratio of 1.187 （95%CI 1.046～1.093，P=0.001）and 1.223 （95%CI=1.10～1.36，P=0.000）.Conclusion VN is associated with evidence of an acute inflammatory response，we found that serum 25（OH）D and CRP may be associated with VN occurrence.

A case of recurrent stroke with clopidogrel secondary prevention, CYP2C19 gene testing result of " clopidogrel slow metabolism" , platelet aggregation test result of " platelet aggregation significantly inhibited" as an example, the dialectical relationship among the above gene testing, platelet aggregation test, stroke recurrence were analyzed, and the choice of antiplatelet drugs was discussed.Clopidogrel gene testing has certain guiding significance for the secondary prevention of stroke patients.Platelet aggregation test results can not comprehensively evaluate the physiology and function of platelets in vivo.In order to find a more safe, effective and reasonable antiplatelet therapy, antiplatelet therapy should be further explored and optimized.

Leucine rich glioma inactivated 1 (LGI1) is a protein which is identified as the target involving in autoimmune encephalitis. Seizures and cognitive declines are two main symptoms of LGI1-antibody encephalitis. However, autonomic dysfunction symptoms are not prominent as seizures and cognitive defection and are easily overlooked by physicians. We reported a case with LGI1-antibody encephalitis whose onset symptoms were autonomic dysfunction including sweating, orthostatic hypotension. The features of this case was described in detail and the related literatures were reviewed in order to enhance the knowledge of the disease.