Anti-CD20 monoclonal antibodies for the treatment of refractory nephrotic syndrome （RNS） in children. The first- generation rituximab is the most widely used in clinical practice； it shows definite efficacy in children with RNS， is recommended by guidelines， particularly for achieving a high remission rate in minimal change nephrosis， and can significantly reduce the cumulative use of glucocorticoids and immunosuppressants. The second-generation ofatumumab has potential as an alternative treatment for patients who are intolerant or resistant to rituximab， while the third-generation obinutuzumab has shown efficacy in complex cases such as rituximab resistance or post-transplant recurrence. However， there is still controversy regarding the optimization of rituximab treatment dosage and whether ofatumumab and obinutuzumab offer greater advantages than rituximab for the treatment of RNS in children. The most common adverse reaction induced by anti-CD20 monoclonal antibodies is infusion reactions， and long-term adverse events mainly include increased risks of sustained immunosuppression and infections. Rituximab has significant economic advantages for the treatment of RNS， but additional pharmacoeconomic research based on China’s healthcare environment is needed to evaluate the cost-effectiveness of ofatumumab and obinutuzumab in this population. Given that the current use of ofatumumab and obinutuzumab in this field is considered off-label use， clinical application should only proceed after a rigorous evaluation of the patient’s benefits and risks.

A complete plant body consists of elements on different scales, including microscopic molecules, mesoscopic multicellular structures, and macroscopic tissues and organs, which are interconnected to form complex biological networks. The growth and development of plants involve the regulation of elements on different scales and their biological networks, which requires the coordinated operation of multiple molecules, cells, tissues, and organs. It is difficult to reveal the essence of multi-level life activities by a single method or technology. In recent years, the development of various novel imaging technologies has provided new approaches for revealing the complex life activities in plants. Using multi-modal imaging technologies to study the cross-scale network connections of plants from the microscopic, mesoscopic, and macroscopic levels is crucial for understanding the complex internal connections behind biological functions. This paper first summarizes multi-modal cross-scale imaging technologies, three-dimensional reconstruction, and image processing methods, outlines the basic framework of cross-scale network connection properties, and then summarizes the applications of multi-modal imaging technologies in elucidating plant multi-scale networks. Finally, this review systematically integrates the combined analysis of cross-scale 3D spatial structural data and single-cell omics, laying a theoretical foundation for the innovation of novel plant imaging technologies. Furthermore, it provides a new research paradigm for in-depth exploration of the interaction mechanisms among cross-scale elements and the principles of biological network connectivity in plant life activities.
Plants/metabolism* ; Imaging, Three-Dimensional/methods* ; Image Processing, Computer-Assisted/methods* ; Multimodal Imaging/methods* ; Plant Physiological Phenomena

Objective: To explore the correlation between different nutritional status and depressive symptoms among adolescents, so as to provide a theoretical basis for targeted improvement of nutritional status and depressive symptoms in adolescents. Methods: A total of 8 102 adolescents aged 12-17 years in Shanghai, Urumqi, Changsha and Kunming were selected by random cluster sampling. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale(CES-D). Height and weight were measured. Kruskal Wallis H test, Chi square test and ordinal Logistic regression were used to analyze the relationship between nutritional status and depressive symptoms in adolescents. Results: The overall detection rate of depressive symptoms in adolescents was 25.6%, with girls (30.1%) higher than that of boys (21.1%) ( χ 2=87.60, P <0.01). There were statistically significant differences in the scores of depressive symptoms among girls with different nutritional status ( Z =8.34, P <0.05). The detectable rate of depressive symptoms increased with BMI among girls( χ 2 trend =6.04, P <0.05). After controlling for confounding factors, ordinal Logistic regression showed that the obese girls had higher risks in depressive symptoms detection compared with normal weight girls ( OR=1.45, 95%CI=1.10-1.91, P <0.05). Conclusion The nutritional status of girls is better than boys, but the prevalence of depressive symptoms is higher than boys. The risk of depressive symptoms in girls increases with BMI.

Objective: To explore the correlation between non suicidal self injury(NSSI) behaviors and depressive symptoms in adolescents and to provide a theoretical basis for improvement of adolescent physical and mental health. Methods: A total of 8 102 adolescents aged 12-17 years were selected by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming, using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Adolescent Non Suicidal Self Injurious Behavior Assessment Questionnaire. Depressive symptoms and the occurrence of NSSI behaviors were assessed. The relationship between NSSI behaviors and depressive symptoms was analyzed using Chi square test, one way analysis and Logistic regression analysis. Results: The overall detection rate of NSSI in adolescents, 24.6%, with a significantly lower detection rate in boys (23.1%) than in girls (26.2%) ( χ 2=10.97, P <0.05), and 24.7%, 24.6% in the middle school and high school segments, respectively, but the difference was not statistically significant ( χ 2=0.01, P >0.05). The overall detection rate of adolescent depressive symptoms was 49.7 % in the group with NSSI and 17.7% in the group without NSSI, with statistically significant differences ( χ 2=808.80, P < 0.01 ). The detection rates of adolescent depressive symptoms in the group with NSSI (male:44.0%, female:54.7%, middle school:49.6%, high school:49.8%) and the group without NSSI (male:14.2%, female:21.4%, middle school:14.3%, high school: 21.0 %) were statistically significant by sex and age groups ( χ 2=385.58, 412.44, 520.60, 313.78, P ＜0.01). Logistic regression models, after adjusting for gender and age, the risk for depressive symptoms was 2.65 times (95% CI =2.27-3.09) and 7.28 times (95% CI = 6.34- 8.37) more frequently in adolescents with episodic self injurious behavior and frequent self injurious behavior, respectively, compared to those without self injurious behavior. The association between NSSI status and depressive symptoms did not show sex differences ( P >0.05). Conclusion Adolescent NSSI behavior is positively associated with depressive symptoms, the attention should be paid to adolescent physical and mental health to reduce the occurrence of NSSI.

Objective: To analyze the correlation between physical activity and depressive symptoms in adolescents, so as to provide a reference for the early prevention of depression among adolescents. Methods: Using a random cluster sampling method, 8 102 adolescents from Shanghai, Urumqi, Changsha and Kunming were investigated via the Physical Activity Assessment Questionnaire of Chinese Children and Adolescents aged 7 to 18 and the Center for Epidemiologic Studies Depression Scale (CES-D) for physical activity and depressive symptoms. Multivariate Logistic regression analysis was used to analyze the correlation between physical activity and depressive symptoms in adolescents. Results: The proportion of adolescents who met moderate to vigorous physical activity (MVPA) standard was 37.0%, and the detection rate of depressive symptoms was 25.6%. The detection rate of depressive symptomsin compliant with MVPA standard group was significantly lower than that in non compliant group among different age and gender( χ 2=7.62-34.54, P <0.05). Adolescents with severe depressive symptoms had high light intensity physical activity(LPA) duration and low vigorous intensity physical activity(VPA) duration, while adolescents with mild depressive symptoms or asymptomatic adolescents had higher MVPA duration. There were differences in LPA and VPA among adolescents with different levels of depressive symptoms in the overall sample, and the differences were still significant among girls, middle school and statistically significant differences in LPA, moderate intensity physical activity(MPA), MVPA were also found among the high school subgroup. However, differences only in LPA were observed among boys with different levels of depression( H=46.48, 10.31, 25.02, 29.54, 30.25, 19.80, 22.20, 9.54, 8.62, 18.06, P <0.05). Multivariate Logistic regression model showed that gender and duration of MVPA were significantly related to risk of depressive symptoms( OR=1.56, 1.42, P <0.05). Conclusion Physical activity among adolescents is significantly related to depressive symptoms. MVPA may be an effective measure to reduce the degree of depressive symptoms.To improve the physical health and prevent depression among adolescents, it is important to choose appropriate physical activity types and effectively increase the duration of MVPA.

Objective:To analyze the distribution characteristics of plasma renin concentration (PRC) in patients with aldosterone-producing adenoma (APA) and its impact on diagnosis.Methods:In this retrospective case series, clinical data from 200 patients with APA (80 men and 120 women; mean age 45.6 years) in the First Affiliated Hospital of Chongqing Medical University from November 2013 to January 2022 were evaluated. PRC was determined by automated chemiluminescence immunoassay. The distribution characteristics of PRC were analyzed, and 8.2 mU/L was used as the low renin cutoff to evaluate whether renin was suppressed.Results:The median PRC was 1.6 mU/L (range, 0.4-41.5 mU/L). There were 116 patients with APA with PRC of ≤2 mU/L, 41 patients with 28.2 mU/L) in 8.0% (16/200) of the patients with APA. And PRC was not suppressed in 2.5% (5/200) of the patients with APA, resulting in a primary aldosteronism negative screening outcome.Conclusions:Although most patients with APA have low PRC, there are a small number (8%) of patients whose PRC has not been fully suppressed, which can lead to missed diagnoses during primary aldosteronism screening. While primary aldosteronism is highly suspected, further investigations are required to determine the diagnosis, even if PRC is not fully suppressed at screening.

ObjectiveTo evaluate the clinical efficacy of Niuhuang Chengqitang in the treatment of acute gastrointestinal injury （AGI） in patients with severe traumatic brain injury （sTBI） and observe the effect on serum motilin （MTL）， diamine oxidase （DAO）， and neuron-specific enolase （NSE）. MethodBy the prospective randomized controlled trial （RCT） method， 86 sTBI inpatients with AGI were randomly divided into an observation group（43 cases）and a control group （43 cases）. All patients were given conventional western medicine treatment， including actively targeting the primary diseases and combined diseases， supply of enteral nutrition as soon as possible， and gastrointestinal agents， while those in the observation group received additional Niuhuang Chengqitang by nasal administration. The treatment course of both groups was 7 days. The clinical efficacy of the two groups was compared before treatment and 7 days after treatment. Gastrointestinal failure （GIF） score and intra-abdominal pressure （IAP） of the two groups were recorded， and serum MTL， DAO and NSE levels were detected before treatment， 3 days and 7 days after treatment. The Glasgow Coma Scale （GCS） score， duration of mechanical ventilation， length of ICU stay， and 28-day mortality were recorded. ResultDuring the treatment and observation， 4 cases fell off and 82 cases were finally enrolled， including 41 in the observation group and 41 in the control group. After treatment， the total effective rate in the observation group was 80.49%（33/41）， higher than 56.10%（23/41） in the control group （χ²=9.137，P<0.05）. GIF and IAP scores in the observation group were significantly improved after 3 and 7 days of treatment （P<0.01）， and the observation group was superior to the control group after 7 days of treatment （P<0.05）. The serum levels of MTL， DAO， and NSE in the two groups were improved after 3 and 7 days of treatment （P<0.05， P<0.01）. The levels of MTL and NSE in the observation group were better than those in the control group after 3 days of treatment （P<0.05， P<0.01）， and the levels of MTL， DAO， and NSE in the observation group were superior to those in the control group after 7 days of treatment （P<0.05， P<0.01）. The 28-day GCS score in the observation group was higher than that in the control group （P<0.01）， and the duration of mechanical ventilation and ICU stay in the observation group were significantly shorter than those in the control group （P<0.05）. There was no significant difference in 28-day mortality between the two groups. No adverse reactions related to Niuhuang Chengqitang occurred in the observation group. ConclusionNiuhuang Chengqitang can effectively improve the gastrointestinal function， regulate MTL， DAO， and NSE levels， shorten the ICU stay， and promote the recovery of sTBI patients with AGI.

The clinical data of a case of compound oxidative phosphorylation deficiency type 10 (COXPD10) caused by a new site mutation of MTO1 gene in the Department of Pediatrics, Affiliated Hospital of Southwest Medical University on December 29, 2020 were retrospectively analyzed.The patient was a 2 months and 19 days old boy of Han nationality.The main clinical manifestations were shortness of breath, hyperlactic acidemia, hyperammonemia and brain damage.Cardiac hypertrophy was not obvious.Heterozygous mutations at c. 344delA and c. 1055C>T sites in the MTO1 gene have not been reported in domestic and foreign literature.COXPD10 caused by MTO1 gene mutations may result in diversified clinical manifestations due to inconsistent mutation sites.For hyperlactic acidemia with unknown predisposing factors, early genetic examination should be conducted to confirm the possibility of COXPD10.

BACKGROUND: Studies have shown that injury and scar of the Achilles tendon in rats with terminal disease are difficult to heal, and the early treatment of Achilles tendon micro-injury caused by exhaustive exercise can avoid the accumulation of injury and prevent the occurrence of terminal disease. Therefore, it is necessary to explore the mechanism of Achilles tendon micro-injury caused by acute exhaustive exercise. OBJECTIVE: Through the comparison of the changes of ultra-structure, transforming growth factor-β1 (TGF-β1), Collagen-I, Collagen-III, matrix metalloproteinases-1 (MMP-1) and tissue inhibitors of metalloproteinase-1 (TIMP-1) mRNA and protein expression in the Achilles tendon before and after exhaustive exercise, to discuss the mechanism of Achilles tendon micro-injury caused by acute exhaustive exercise in rats. METHODS: Wistar rats were randomly divided into a control group and an exhaustive exercise group. No intervention was performed in the control group. In the exhaustive exercise group, rats were subjected to treadmill running. After exhaustive exercise, the two groups of rats were immediately killed under anesthesia. Through the observation using hematoxylin-eosin staining and transmission electronic microscopy, Achilles tendons were measured by reverse transcription-polymerase chain reaction and double antibody sandwich ABC-ELISA to show the genetic expression and protein expression of TGF-β1, Collagen-I, III, MMP-1 and TIMP-1. RESULTS AND CONCLUSION: Compared with the control group, the acute exhaustive exercise group showed the disordered arrangement of collagen fibers in Achilles tendon and the partially damaged structure of tendon cells. The mRNA and protein expressions of TGF-β1, MMP-1 and TIMP-1 were significantly higher in the exhaustive exercise group than the control group (P < 0.05), whereas the mRNA and protein expressions of Collagen-I and Collagen-III were significantly decreased (P < 0.05). These findings indicate that the over-expression of TGF-β1 results from the gradual accumulation of Achilles tendon micro-injuries caused by acute exhaustive exercise. Collagen synthesis decreases while the degradation accelerates; the tendon function is impaired as the micro-injuries continue. There is a similar variation tendency of MMP-1 and TIPM-1, which reminds an irreversible damage do not occur. Micro-injuries of the Achilles tendon caused by acute exhaustive exercise should be treated and repaired in time, avoiding excessive damage and scar repair.