ObjectiveTo analyze the influencing factors for recurrence in successfully treated pulmonary tuberculosis patients with isoniazid-resistant and rifampicin-sensitive in Shaoxing City, Zhejiang Province. MethodsData on general demographic information, treatment information and drug susceptibility test results for pulmonary tuberculosis patients admitted to the designated tuberculosis medical institutions and registered in the tuberculosis information management system was collected in Shaoxing City from January 2011 to August 2024. A total of 428 patients with isoniazid resistance (including isoniazid single resistance and multiple resistance) but who were successfully treated were included in the study. Information for the recurrence after successful treatment of the patients was analyzed. The Cox proportional hazards models were used to analyze the influencing factors of recurrence in patients. ResultsAmong the 428 successfully treated patients included in the study, 31 cases (accounting for 7.24%) had recurrence by the end of the observation period, with a recurrence rate density of 1.31 per 100 person-years and a median recurrence time of 0.99 (0.08, 8.27) years. Among the relapsed population, 51.61% of the patients relapsed within one year after successful treatment. 77.42% of the patients relapsed within two years after successful treatment. Multivariate Cox regression analysis showed that when isoniazid resistance was discovered, the diagnosis classification of relapse (HR=4.115, 95%CI: 1.734‒9.767) and positive 0-month sequence smear (HR=4.457, 95%CI: 1.053‒18.866) were risk factors for recurrence after successful treatment in patients. ConclusionRegular follow-up should be strengthened for at least two years after the successful treatment of isoniazid-resistant pulmonary tuberculosis patients. Special attention should be paid to the treatment effect and regular re-examination and monitoring after the end of the treatment course of isoniazid-resistant pulmonary tuberculosis patients who have been re-treated and were sputum smear positive at baseline, so as to prevent recurrence and disease progression in high-risk populations.

As the need for antibody production rises, there is an urgent need to lower the costs and enhance the efficiency of the separation process. Currently, the chromatographic media used for antibody separation and purification often focus on individual properties of antibodies, such as affinity, hydrophobicity, and charge, leading to issues like low purification efficiency or inadequate adsorption capacity. To address this, an electrostatically coupled polypeptide affinity medium (FD7-3, 5-diaminobenzoic acid n-sepharose, FD7-DA-Sepharose) was developed for rapid purification of antibodies from cell culture supernatant. This medium utilized 3, 5-diaminobenzoic acid as a spacer to attach the heptapeptide-affinity ligand (FYEILHD, FD7) to agarose microspheres. Antibodies could be adsorbed through charge interactions with the carboxyl functional group of the FD7-DA-Sepharose spacer, while FD7 enhanced electrostatic coupling and affinity adsorption through synergistic effects, significantly increasing the adsorption capacity while maintaining the affinity and specificity. The influences of pH and ionic strength on adsorption capacity were investigated with human immunoglobulin as a model protein. The static adsorption capacity (Q_m) of FD7-DA-Sepharose in the solution of pH 6.0 reached 67.73 mg/mL, representing a 52.68% increase compared with that (44.36 mg/mL) of the commercial Protein A affinity medium. Furthermore, the elution conditions for FD7-DA- Sepharose were mild (20 mmol/L PB, 0.5 mol/L NaCl, pH 6.0), in contrast to the harsh acidic elution (pH 2.7-3.6) typically associated with Protein A, which can damage antibody integrity. The FD7-DA-Sepharose medium was then employed to purify antibodies from cell culture supernatant, achieving the yield of 94.8% and the purity of 98.4%. The secondary structure of the purified antibody was determined by circular dichroism spectroscopy. The results demonstrated that FD7-DA-Sepharose enabled efficient purification of antibodies from cell culture supernatant, which provided a cost-effective solution (approximately one-third the price of commercial Protein A affinity medium) with gentle elution conditions that preserve the natural conformation of antibodies. This approach paves a novel, economical, and efficient way for the separation and purification of antibodies from cell culture supernatant.
Chromatography, Affinity/methods* ; Static Electricity ; Humans ; Sepharose/analogs & derivatives* ; Peptides/chemistry* ; Adsorption ; Antibodies/isolation & purification*

Objective To compare the safety and efficacy of flexible terminal suction ureteral access sheath(FTS-UAS)and negative pressure ureteral access sheath(NPUAS)in flexible ureteroscopic lithotripsy with holmium laser in treatment of renal calculi less than 2 cm in diameter.Methods A total of 68 patients(largest diameter of stone＜2 cm)with renal calculi treated in Yangjiang Hospital Affiliated to Guangdong Medical University during Nov.2022 and Aug.2023 were divided into FTS-UAS group(n=34)and NPUAS group(n=34)according to different surgical methods.The perioperative parameters and stone-free rate(SFR)were compared between the two groups.Results The average SFR on the first day after operation was significantly higher in the FTS-UAS group than in the NPUAS group[85.3％(29/34)vs.61.8％(21/34),P=0.028].The operation time was significantly lower in the FTS-UAS group than in the NPUAS group[(65.85±13.16)min vs.(75.59±20.21)min,P=0.022].For lower calyceal renal calculi,the SFR was significantly higher in the FTS-UAS group than in the NPUAS group[82.4％(14/17)vs.43.8％(7/16),P=0.032].One month after operation,the SFR was higher in the FTS-UAS group than in the NPUAS group[94.1％(32/34)vs.85.3％(29/34),P=0.452].There were no significant differences in hemoglobin reduction,serum creatinine level,postoperative complications,hospital stay and hospitalization costs between the two groups(P＞0.05).Conclusion FTS-UAS in flexible ureteroscopic lithotripsy can shorten the operation time and improve stone-clearance rate,which is safe,effective,and worthy of clinical promotion.

Objective To analyze the influencing factors of clinical pregnancy and live birth rates in patients undergoing frozen-thawed embryo transfer(FET)for the first time.Methods The clinical data of 1 458 patients who underwent FET cycle-assisted pregnancy for the first time were retrospectively analyzed and divided into four groups according to clinical pregnancy and live bith outcomes.The clini-cal data were compared to analyze the factors affecting clinical pregnancy and live birth rates in FET cycles that were included in multiple logistic regression analysis.Results Of the 1458 cycles,the clinical pregnancy and live birth rates were 44.0% and 34.0%,respectively.The mean age of the clinical pregnancy and live birth groups was lower than that in non-clinical pregnancy and stillbirth groups(P<0.05).The clinical pregnancy and live birth rates of patients aged<35 years were higher than those aged≥35 years(P<0.05).The clinical preg-nancy and live birth rates of patients with≥8 mm endometrial thickness were higher than those with<8 mm endometrial thickness(P<0.05).The clinical pregnancy rate of natural cycles of endometrial preparation regimen was higher than that of HRT cycles(P<0.05).The clinical pregnancy and live birth rates of double-embryo transfers were higher than that of single-embryo transfers(P<0.05).The clinical pregnancy and live birth rates of blastocyst transfers were higher than those of cleavage stage(P<0.05).Conclusion Age,endometrial thickness,number of transplanted embryos,and embryo morphology were the independent factors influencing clinical pregnancy and live birth outcomes during FET cycle transplantation.

Objective Coronary heart disease(CHD)is one of the major lethal diseases in the world at present.The detection of biomarkers is an important non-invasive method to evaluate the progression of CHD,which is of great significance for the diagnosis and secondary prevention of CHD.This study aims to screen diagnostic biomarkers in the pathogenesis of myocardial infarction,analyze cuprotosis-related genes in the development of this disease,and further predict the traditional Chinese medicine of regulating cuprotosis-related genes.Methods The GEO database was searched to obtain chip data of myocardial infarction,differentially expressed genes(DEGs)were analyzed.Then,DEGs enrichment analysis was performed,and key genes were screened based on least absolute shrinkage and selection operator(LASSO)and random forest(RF)methods.Diagnostic model was constructed and verified.After immune cell infiltration analysis was performed on differential genes,the results were further combined with weighted gene co-expression network analysis to obtain differentially expressed immune-related genes,which were intersected with cuproptosis genes to obtain cuproptosis immune-related Hub genes.The correlation between cuproptosis-related genes and diagnostic genes were analyzed.Gene set enrichment analysis(GSEA)was performed on cuproptosis-related genes to further predict the traditional Chinese medicines of regulating the genes related to cuproptosis.Results A total of 115 DEGs,which were mainly enriched in the biological processes and pathways related to lymphocyte-mediated immunity,mitochondrial respiratory chain complex Ⅳ,C-type lectin receptor signaling pathway,and chemokine signaling pathway,were obtained by differential analysis.Five diagnostic genes,SNORA20,SNORA19,H4C3,SNORD81,and COX7B,were screened out by machine learning methods.Immune infiltration analysis found dendritic cells,macrophages M2,monocytes,neutrophils,natural killer cells,CD4+T cells,CD8+T cells,and γδ T cells.It was indicated the above eight immune cells play a certain role in the pathogenesis of myocardial infarction in coronary heart disease.Weighted correlation network analysis(WGCNA)and immune infiltration analysis were used to obtain 358 key module genes,which were intersected with cuproptosis genes to obtain three cuproptosis and immune signature genes.The correlation analysis results of five diagnostic genes and Hub genes showed that there was a correlation between the expressions of SLC31A1 and SNORA20,LIAS and SNORA19,SNORD81,MTF1 and H4C3,SNORA20,SNORA19,SNORD81.GSEA analysis results indicated that LIAS and MTF1 had a significant effect on the NF-κB signaling pathway,NOD-like receptor signaling pathway and Toll-like receptor signaling pathway.The potential regulatory Chinese medicines are mainly blood-activating and stasis-eliminating,qi-promoting and analgesic drugs.Conclusion SNORA20,SNORA19,H4C3,SNORD81,COX7B have a certain diagnostic value for myocardial infarction in coronary heart disease.The prediction of genes related to cuproptosis and immune infiltration in the pathogenesis of myocardial infarction provides a certain reference for the study of the mechanism of traditional Chinese medicine intervention in myocardial infarction.

Adrenocortical carcinoma (ACC) is a rare and highly aggressive endocrine malignancy. This paper provides a review of the pathways involved in the development of ACC and the progress of targeted drug therapy. The pathways reviewed include Wnt/β-catenin, P53, epithelial-mesenchymal transition(EMT), insulin growth factor(IGF) and fibroblast growth factor(FGF) signalling pathways.

Objective:To explore the safety and feasibility of adrenal tumor resection under day surgery mode for the treatment of unilateral primary aldosteronism (UPA).Methods:The clinical data of 83 patients who underwent adrenalectomy for the treatment of UPA from January 2020 to January 2023 were retrospectively analyzed. There were 42 males (50.6%)and 41 females (49.4%), age (49.0±12.3)years old. Body mass index (25.4±3.6)kg/m 2. There were 17 patients with diabetes, 58 patients with preoperative hypertension, and the duration of hypertension was 8.2(1, 15)years. Systolic blood pressure was 151.8(137.0, 160.0)mmHg (1 mmHg=0.133 kPa), and diastolic blood pressure was 97.4(87.0, 107.0)mmHg. 20 cases had severe preoperative hypokalemia, with preoperative blood potassium levels of (2.9±0.6)mmol/L. The ratio of preoperative plasma aldosterone to renin activity was 54.1(13.0, 77.2). Tumors were located on the left side in 47 cases (56.6%)and on the right side in 36 cases (43.4%). The maximum diameter of the tumor is 1.5(1.0, 1.7)cm. Patients diagnosed with unilateral primary aldosteronism were included, and patients diagnosed with adrenal pheochromocytoma, adrenal malignancy, or severe cardiovascular disease that cannot tolerate surgery were excluded. The patient was admitted to the hospital on the same day, underwent surgery on the same day, and was evaluated after extubation within one day after surgery. The patient had no fever or lower back pain after surgery, was able to freely get out of bed, and had no obvious abnormalities in blood routine, electrolyte and other test indicators. The patient was discharged from the hospital and received continuous care outside the hospital. The patient was guided to undergo regular outpatient follow-up. Evaluate the efficacy using the Primary Aldosterone Hyperaldosteronism Surgical Outcome (PASO)criteria. Results:The patients had a mean length of hospital stay of 43.0(40.3, 44.6)hours, an operation time of 89.6(70.0, 103.0)minutes, and an operation cost of 23 820.2 (21 150.8, 24 948. 3)yuan. The postoperative free position time was 29.5(20.8, 39.7)hours, the postoperative time for fluid placement of the diet was 25.2(20.1, 27.8) hours, and 42.2(37.9, 41.9)hours of postoperative drain removal. The overall postoperative clinical remission rate was 85.5%. There were four postoperative complications, accounting for 4.8% of cases. These included two cases of interosseous vein thrombosis, one case of delayed healing, and one case of peritoneal rupture. No case of readmission was reported within 30 days.Conclusions:UPA adrenal tumour resection in ambulatory mode is safe and effective when strict inclusion and exclusion criteria are followed, adequate preoperative preparation is carried out, and expert physician assessment is provided.

Objective:To investigate the correlation between hearing loss and microvascular complications in diabetes.Methods:This cross-sectional study conducted the data from 572 patients with diabetes hospitalized in the Endocrinology Department of the General Hospital of Southern Theater Command from September 2022 to July 2023. All participants underwent electrical audiometry and acoustic immittance in the ENY department. Based on the audiometric results, participants were categorized into normal hearing group and hearing loss group. Additionally, 572 non-diabetic patients from the outpatient department were enrolled as the non-diabetic group. The general information and laboratory results were collected and compared using t test, rank sum test or χ2 test. Binary logistic regression analysis was used to evaluate the association of diabetic hearing loss with diabetic kidney disease(DKD), diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN). Results:Among 572 patients with diabetes, 429 suffered from hearing loss and 143 were normal. χ2 test showed significant differences in combined DKD and DPN between two groups, but not in DR. Multivariate binary logistic regression analysis identified DKD and DPN as risk factors for hearing loss, but no correlation was found with DR. Conclusion:Diabetic patients with DKD or DPN should be monitored for potential hearing loss. Early screening and treatment are crucial to prevent severe hearing impairment.

Objective To study the relationship between serum urine regulator protein and cystatin C levels and pathological characteristics and prognosis in patients with hypertensive nephropathy.Methods A total of 100 patients admitted in the hospital from August 2021 to October 2022 were selected as the study group,and 40 healthy persons who underwent the physical examination in the hospital were selected as the control group,complete data of all patients were collected and analyzed,the levels of serum urinary regulatory protein and cystatin C in each group were tested,and the relationship between serum urinary regulatory protein and cysta-tin C levels,pathological characteristics,and prognosis was analyzed.Results The urine regulatory protein and glomerular filtration rate in the study group were lower than those in the control group,but cystatin C,u-rea nitrogen,and blood creatinine were all higher than those in the control group,and the differences were sta-tistically significant(P＜0.05).Urinary regulatory protein was negatively correlated with urea nitrogen and blood creatinine,but positively correlated with glomerular filtration rate(P＜0.05).Cystatin C was positively correlated with urea nitrogen and blood creatinine,but negatively correlated with glomerular filtration rate(P＜0.05).Urinary regulatory protein level was related to crescent formation,renal tubular atrophy/intersti-tial fibrosis(P＜0.05),while level the expression of cystatin C was related to glomerular segmental sclerosis,glomerular glomerular sclerosis,and glomerular ischemic shrinkage(P＜0.05).The survival rate of the high urinary regulatory protein level group(≥126.49 ng/mL)was higher than that of the low urinary regulatory protein level group(＜126.49 ng/mL),while the survival rate of the high cystatin C level group(≥2.43 mg/L)was lower than that of the low cystatin C level group(＜2.43 mg/L)(P＜0.05).Urinary regulatory protein,cystatin C,renal tubular atrophy/interstitial fibrosis were factors that affected the occurrence of end-stage renal disease in hypertensive nephropathy(P＜0.05).Conclusion Hypertensive kidney disease patients u-sually have higher levels of cystatin C and lower levels of urinary regulatory protein,among which cystatin C is closely related to pathological features of glomerular segmental sclerosis,glomerular glomerular sclerosis,and glomerular is-chemic shrinkage,and urinary regulatory protein is closely related to crescent formation,renal tubular atrophy/intersti-tial fibrosis.In addition,urinary regulatory protein and cystatin C have a significant impact on the development of hy-pertensive nephropathy into end-stage renal disease,and could become important indicators for evaluating patient prognosis.

The clinical manifestations of colorectal polyps are consistent with the characteristics of dampness, stickiness and heaviness. The TCM constitutions in the prone population are mostly related to dampness. The pathological changes of intestinal flora imbalance, intestinal micro inflammation, neuroendocrine immune network and abnormal aquaporin in colorectal polyps are consistent with the research results of modern mechanism of dampness pathogen. This article believed that the TCM pathogenesis of colorectal polyps caused by damp pathogen is the accumulation of spleen deficiency and dampness caused by improper diet, poor emotion and other factors, and the interweaving of various diseases and pathogens to form tangible foreign bodies. According to the pathogenic characteristics of damp pathogen and the pathogenic factors of colorectal polyps, the influence of damp pathogen on the pathogenesis of colorectal polyps was discussed, in order to provide an effective TCM theoretical basis for the diagnosis and treatment of colorectal polyps in clinic.