Objective To investigate the correlation between urinary β2-microglobulin(β2-MG)and the clinicopathological characteristics of IgA nephropathy(IgAN).Methods A retrospective analysis was conducted on 77 patients diagnosed with IgAN by renal biopsy from October 2019 to October 2024.The research group was defined as those with a urinary β2-MG value higher than or equal to the median,and the control group was defined as those with a value lower than the median.The clinicopathological indicators of the two groups were compared.The Spearman method was used to analyze the correlation of the estimated glomerular filtration rate(eGFR)and pathological indicators of IgAN patients with urinary β2-MG.Multivariate logistic regression was used to analyze the clinicopathological factors related to urinary β2-MG.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the ability of urinary β2-MG to predict related pathological damage.Result Compared with the control group,the research group had older age,elevated levels of serum creatinine and blood urea,increased 24-hour urine protein quantification,elevated levels of urine α 1-microglobulin and urinary β2-MG,elevated urine microalbumin,elevated levels of total cholesterol and D-dimer,and decreased levels of eGFR,serum albumin,hemoglobin,and complement C3(P＜0.05).Compared with the control group,the research group had more severe pathological damage in terms of renal tubular atrophy and renal interstitial fibrosis(T),as well as cellular and fibrocellular crescents(C)(P＜0.05).There was a negative correlation between the urinary β2-MG level and eGFR in patients with IgAN(P＜0.01),and a significant positive correlation with T and C(P＜0.05).After controlling for confounding factors,eGFR(OR=0.983),serum albumin(OR=0.889),triglycerides(OR=0.099),total cholesterol(OR=2.677),and pathological damage T(OR=11.358)and C(OR=12.018)were independent influencing factors associated with high urinary β2-MG levels(P＜0.05).The AUC of urinary β2-MG level for predicting the pathological indicator T in patients with IgAN was 0.784(95％CI:0.660,0.907),with the corresponding sensitivity of 0.717,and the specificity of 0.882.Conclusion The level of urinary β2-MG is closely related to multiple clinicopathological characteristics of patients with IgAN.It can be used as a potential biomarker for evaluating renal structural damage in patients,especially tubulointerstitial and renal vascular lesions,and has a certain predictive ability for tubulointerstitial injury.

Objective To investigate the correlation between urinary β2-microglobulin(β2-MG)and the clinicopathological characteristics of IgA nephropathy(IgAN).Methods A retrospective analysis was conducted on 77 patients diagnosed with IgAN by renal biopsy from October 2019 to October 2024.The research group was defined as those with a urinary β2-MG value higher than or equal to the median,and the control group was defined as those with a value lower than the median.The clinicopathological indicators of the two groups were compared.The Spearman method was used to analyze the correlation of the estimated glomerular filtration rate(eGFR)and pathological indicators of IgAN patients with urinary β2-MG.Multivariate logistic regression was used to analyze the clinicopathological factors related to urinary β2-MG.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the ability of urinary β2-MG to predict related pathological damage.Result Compared with the control group,the research group had older age,elevated levels of serum creatinine and blood urea,increased 24-hour urine protein quantification,elevated levels of urine α 1-microglobulin and urinary β2-MG,elevated urine microalbumin,elevated levels of total cholesterol and D-dimer,and decreased levels of eGFR,serum albumin,hemoglobin,and complement C3(P＜0.05).Compared with the control group,the research group had more severe pathological damage in terms of renal tubular atrophy and renal interstitial fibrosis(T),as well as cellular and fibrocellular crescents(C)(P＜0.05).There was a negative correlation between the urinary β2-MG level and eGFR in patients with IgAN(P＜0.01),and a significant positive correlation with T and C(P＜0.05).After controlling for confounding factors,eGFR(OR=0.983),serum albumin(OR=0.889),triglycerides(OR=0.099),total cholesterol(OR=2.677),and pathological damage T(OR=11.358)and C(OR=12.018)were independent influencing factors associated with high urinary β2-MG levels(P＜0.05).The AUC of urinary β2-MG level for predicting the pathological indicator T in patients with IgAN was 0.784(95％CI:0.660,0.907),with the corresponding sensitivity of 0.717,and the specificity of 0.882.Conclusion The level of urinary β2-MG is closely related to multiple clinicopathological characteristics of patients with IgAN.It can be used as a potential biomarker for evaluating renal structural damage in patients,especially tubulointerstitial and renal vascular lesions,and has a certain predictive ability for tubulointerstitial injury.

Objective:To explore the value of high resolution computed tomography（HRCT） combined with Magnetic Resonance Imaging（MRI） in the diagnosis of inner ear malformation. Methods:HRCT and MRI data of 82 patients with inner ear malformations were analyzed retrospectively. HRCT MPR and CPR reconstruction of the inner ear structure, facial nerve canal and oblique sagittal MRI reconstruction of the internal auditory canal were performed. The inner ear malformations were classified, the conditions of facial nerve canal and cochlear nerve were evaluated. The association between inner ear malformation and cochlear nerve dysplasia were analyzed by Chi-square test with continuity correction. Results:Among the 82 patients with inner ear malformations,there were 49 cases of bilateral symmetry, 11 cases of bilateral asymmetry and 22 cases of unilateral inner ear malformations. Respectively, the most prevalent types were IP-Ⅱ（42.96%）, dilatation of atrium aqueduct（18.31%） and malformations of atrium and semicircular canal 19.72%. Out of 50 cases of cochlear malformations,only 3 were isolated cochlear malformations, and the rest were accompanied by other malformations of varying degrees. In the 67 ears examined by MRI, 26（38.81%） had cochlear nerve deficiency（CND）, and the incidence of CND varied with different types of inner ear malformations. Out of 142 ears, 28（19.72%） had abnormalities of the facial nerve canal. Conclusion:HRCT combined with MRI can accurately distinguish the types of inner ear malformation and effectively evaluate the facial nerve canal and cochlear nerve, and further provides the important finger and Guide value for the clinician to formulate the reasonable treatment and the operation plan.
Humans ; Ear, Inner/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Retrospective Studies ; Female ; Male ; Tomography, X-Ray Computed/methods* ; Child ; Adolescent ; Adult ; Child, Preschool ; Cochlear Nerve/diagnostic imaging* ; Facial Nerve/abnormalities* ; Cochlea/abnormalities* ; Infant ; Young Adult

Objective To investigate the effects of preoperative symptom duration(DOS)and histolog-ical changes in the nucleus pulposus on the outcome of minimally invasive transforaminal lumbar interbody fu-sion(MIS-TLIF)in patients with lumbar degenerative diseases.Methods A total of 162 patients in this hos-pital with lumbar degenerative diseases who underwent MIS-TLIF surgery from March 2022 to June 2023 were prospectively enrolled.According to DOS,they were divided into the short-term DOS group(group S,DOS＜12 months)and the long-term DOS group(group L,DOS ≥ 12 months).Nucleus pulposus tissue was collected for hematoxylin-eosin(HE)staining to observe tissue morphology,immunohistochemical staining was used to detect protein expression of interleukin(IL)-6,IL-1,and tumor necrosis factor-α(TNF-α),and re-al-time fluorescence quantitative PCR(qPCR)was used to analyze the expression levels of IL-6 mRNA,IL-1 mRNA,and TNF-α mRNA.The Oswestry Disability Index(ODI)score and Visual Analog Scale(VAS)score for lower back pain,leg pain,and numbness before surgery and at 1,3,6,12 months after surgery were com-pared to evaluate clinical efficacy.Results There was no significant difference in baseline data between Group S and Group L(P＞0.05).HE staining showed that the degeneration,cracking,and inflammatory infiltration of the nucleus pulposus in group L were more pronounced than those in group S;The results of immunohisto-chemistry and qPCR showed that the protein expressions of IL-6,IL-1,and TNF-α in group L were more obvi-ously and their mRNA expression levels were significantly higher than those in group S(P＜0.05).Both groups showed a significant decrease in postoperative ODI,VAS score for lower back pain,VAS score for leg pain,and VAS score for numbness compared to preoperative levels(P＜0.05).However,three months after surgery,the ODI,VAS score for lower back pain and numbness in group S were lower than those in group L(P＜0.01);Six months after surgery,the VAS score for back pain,leg pain,and numbness in group S were lower than those in group L(P＜0.01);12 months after surgery,the VAS score for numbness in group S was still lower than that in group L(P＜0.01).Subgroup analysis of patients with cauda equina syndrome showed that at 3 months after surgery,the VAS score for lower back pain in group S were lower than that in group L(P＜0.01);six months after surgery,the VAS score for leg pain in group S was lower than that in group L(P＜0.01);12 months after surgery,the VAS score for back pain,leg pain,and numbness in group S were lower than those in group L(P＜0.01).Conclusion Long-term DOS is significantly associated with high ex-pression of inflammatory factors in the nucleus pulposus and delayed long-term functional recovery.Early sur-gical intervention can optimize the clinical outcomes of patients with lumbar degenerative diseases.

Objective:To investigate variation of peripheral blood monocyte subtypes in patients with rheumatoid arthritis(RA),to study variation of surface antigen expression intensity and plasma related cytokine content of monocytes of each subtype,and to discuss their clinical application value.Methods:Percentage of monocyte subtypes and mean fluorescence intensity(MFI)of monocyte surface markers(HLA-DR,CD64,CD11b)in peripheral blood of 38 patients with RA were detected by multi-parameter flow cytometry,and differences were statistically analyzed compared with 40 healthy controls(HV group).Plasma levels of five cyto-kines(IL-2,IL-6,IL-10,TNF-α and IFN-γ)were detected by flow fluorescence microsphere technology.Linear correlation analysis was performed to determine correlation between percentage of monocyte subtypes and MFI of their surface markers and expression of related cytokines in RA patients.Disease activity 28(DAS28)score was performed in RA patients to study its association with percent-age of monocyte subtypes and plasma cytokines.Results:Compared with control group,percentage of classical monocytes in RA pa-tients decreased significantly(P<0.05),while percentage of intermediate monocytes and non-classical monocytes increased signifi-cantly(P<0.01).HLA-DR expression(MFI)on monocyte subsets in RA group was significantly higher than HV group(P<0.05 or P<0.01).CD64 expression(MFI)on intermediate monocytes and non-classical monocytes in RA group was significantly higher than HV group(P<0.01 or P<0.001).CD11b expression(MFI)on intermediate monocytes in RA group was significantly higher than HV group(P<0.001).In RA group,percentage of intermediate monocytes was positively correlated with contents of IL-6,TNF-α and IFN-γ(P<0.01).HLA-DR expression(MFI)on intermediate monocytes was positively correlated with TNF-α content(P<0.05);CD64 expres-sion(MFI)on non-classical monocytes was positively correlated with contents of IL-2 and IL-10(P<0.05).In RA group,percentage of intermediate monocytes was positively correlated with DAS28(P<0.001);plasma IL-6 and TNF-α levels were positively correlated with DAS28(P<0.01).Conclusion:Characteristic expression of intermediate monocytes and their surface antigens are closely related to occurrence of RA,and related inflammation is triggered by secretion of related cytokines.Monocyte subtype detection can be a new experimental diagnostic index for RA.Dynamic monitoring of peripheral blood monocyte subtypes and plasma IL-6 and TNF-α in RA patients during treatment is helpful to guide clinical treatment of RA.

Objective:To investigate variation of peripheral blood monocyte subtypes in patients with rheumatoid arthritis(RA),to study variation of surface antigen expression intensity and plasma related cytokine content of monocytes of each subtype,and to discuss their clinical application value.Methods:Percentage of monocyte subtypes and mean fluorescence intensity(MFI)of monocyte surface markers(HLA-DR,CD64,CD11b)in peripheral blood of 38 patients with RA were detected by multi-parameter flow cytometry,and differences were statistically analyzed compared with 40 healthy controls(HV group).Plasma levels of five cyto-kines(IL-2,IL-6,IL-10,TNF-α and IFN-γ)were detected by flow fluorescence microsphere technology.Linear correlation analysis was performed to determine correlation between percentage of monocyte subtypes and MFI of their surface markers and expression of related cytokines in RA patients.Disease activity 28(DAS28)score was performed in RA patients to study its association with percent-age of monocyte subtypes and plasma cytokines.Results:Compared with control group,percentage of classical monocytes in RA pa-tients decreased significantly(P<0.05),while percentage of intermediate monocytes and non-classical monocytes increased signifi-cantly(P<0.01).HLA-DR expression(MFI)on monocyte subsets in RA group was significantly higher than HV group(P<0.05 or P<0.01).CD64 expression(MFI)on intermediate monocytes and non-classical monocytes in RA group was significantly higher than HV group(P<0.01 or P<0.001).CD11b expression(MFI)on intermediate monocytes in RA group was significantly higher than HV group(P<0.001).In RA group,percentage of intermediate monocytes was positively correlated with contents of IL-6,TNF-α and IFN-γ(P<0.01).HLA-DR expression(MFI)on intermediate monocytes was positively correlated with TNF-α content(P<0.05);CD64 expres-sion(MFI)on non-classical monocytes was positively correlated with contents of IL-2 and IL-10(P<0.05).In RA group,percentage of intermediate monocytes was positively correlated with DAS28(P<0.001);plasma IL-6 and TNF-α levels were positively correlated with DAS28(P<0.01).Conclusion:Characteristic expression of intermediate monocytes and their surface antigens are closely related to occurrence of RA,and related inflammation is triggered by secretion of related cytokines.Monocyte subtype detection can be a new experimental diagnostic index for RA.Dynamic monitoring of peripheral blood monocyte subtypes and plasma IL-6 and TNF-α in RA patients during treatment is helpful to guide clinical treatment of RA.

Objective To investigate the main dietary patterns of children in urban areas of Maanshan City, and to explore the association between dietary patterns and subthreshold autism trait (SAT), attention-deficit/hyperactivity disorder (ADHD) symptoms and comorbid behaviors in 3-year-old children. Methods Based on the birth cohort of Maanshan Maternal and Infant Health from June 2015 to June 2016，regular physical examinations were conducted from 4 to 2 to 1, and follow-up was conducted until the age of 3. A semi-quantitative food frequency questionnaire was employed to assess dietary intakes. SAT and ADHD symptoms were assessed by Clancy autism behavior scale (CABS) and the 10-item Chinese version of the Conners Abbreviated Symptom Questionnaire (C-ASQ). Social-demographic information was also collected. Results The detection rates of SAT, ADHD symptoms, and comorbidity were 11.03%, 5.28%, and 2.71%, respectively. The older the father, the higher the mother's education level, and the higher the per capita monthly income of the family, the lower the SAT detection rate (P<0.05). The higher the father's educational level, the lower the detection rate of ADHD symptoms (P<0.05). The older the mother and the higher the education level, the lower the detection rate of comorbid behavior in their children (P <0.05). After adjusting for demographic influencing factors, the low intake level was used as a reference. The vegetarian type with moderate intake level was negatively correlated with SAT, while the processed food type with high intake level was positively correlated with SAT. The vegetarian type with high intake level was negatively correlated with ADHD symptoms, while the snack type with high intake level was positively correlated with ADHD symptoms. The vegetarian type with high intake level was negatively correlated with comorbidity. Conclusion Unhealthy dietary patterns are related to children's SAT and ADHD symptoms. Correcting children's unhealthy eating patterns may help reduce children's behavior problems.

ObjectiveTo observe the clinical course and explore the risk factors for SARS-CoV-2 RNA negative conversion duration （NCD） in asymptomatic and mild-symptomatic patients infected with the SARS-CoV-2 Omicron variant. MethodsClinical data were collected from 244 confirmed cases of corona virus disease （COVID-19） with Omicron variant infection admitted to a temporal makeshift hospital in Shanghai from April 9， 2022 to May 20， 2022. Demographic and clinical data were analyzed， with a primary focus on the time of COVID-19 nucleic acid conversion. Univariate and multivariate Cox regression analysis were used to determine identify risk factors associated with NCD. ResultsThe median duration of negative RNA conversion was 9 days （ranged 7‒12 days）. The percentage of patients with positive nucleic acid results on the 5th， 7th， 10th， and 14th days after confirmed infection was 68.4%， 47.1%， 20.1%， and 5.7%， respectively. Kaplan-Meier curves indicated a median nucleic acid conversion time of 12 days （ranged 10‒14 days） for patients with hypertension， 9 days （ranged 7‒11 days） in patients without hypertension， and 11 days （ranged 9‒13 days） for patients aged ≥60 years， and 9 days （ranged 7‒11 days） for patients aged <60 years. Multivariate Cox regression analysis showed that only hypertension was an independent risk factor of NCD （RR=1.60； 95% CI： 1.03‒2.49， P=0.036）. ConclusionIn asymptomatic or mildly symptomatic patients infected with the Omicron variant， 20.1% patients continue to exhibit positive viral nucleic acid on the 10^th days of infection. The independent risk factor associated with the conversion of SARS-CoV-2 nucleic acid to negative is hypertension.

Objective:To investigate the application value of transverse perineal arc incision approach in complete resection of presacral cyst in the lithotomy position.Methods:The retrospec-tive cohort study was conducted. The clinicopathological data of 114 patients who underwent com-plete resection of presacral cyst in Henan Cancer Hospital from August 2012 to October 2021 were collected. There were 14 males and 100 females, aged (35±9)years. All patients were diagnosed as presacral cysts by preoperative magnetic resonance imaging. Of the 114 patients, 76 patients undergoing intraoperative perineal arc incision approach in the lithotomy position were divided into the innovative group, and 38 patients undergoing intraoperative Kraske approach were divided into the traditional group. Observation indicators: (1) surgical situations and specimen; (2) postoperative situations; (3) Follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and com-parison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Surgical situations and specimen. The operation time, volume of intraoperative blood loss, cases with intraoperative combined transabdominal approach or sacrectomy were (137±20)minutes, (261±101)mL, 0 in the innovation group, versus (136±34)minutes, (261±116)mL, 15 in the tradi-tional group, showing no significant difference in the operation time and volume of intraoperative blood loss between the two groups ( t=0.18, 0, P>0.05) and showing a significant difference in cases with intraoperative combined transabdominal approach or sacrectomy between the two groups ( P<0.05). Results of postoperative specimen anatomy in patients of the two groups showed complete removal of the cyst. (2) Postoperative situations. The time to postoperative removing presacral drainage tube, duration of postoperative hospital stay, cases with postoperative second stage healing of incision were (11.4±2.1)days, (13.5±3.5)days, 23 in the innovation group, versus (11.5±1.9)days, (13.7±3.8)days, 4 in the traditional group, showing no significant difference in the time to post-operative removing presacral drainage tube and duration of postoperative hospital stay between the two groups ( t=-0.20, -0.24, P>0.05) and showing a significant difference in cases with postoperative second stage healing of incision between the two groups ( χ2=5.46, P<0.05). Cases with postoperative severe complications were 4 and 2 in the innovation group and the traditional group, respectively, showing no significant difference between the two groups ( P>0.05). (3) Follow-up. All 114 patients were followed up for 48(range, 6?108)months. Cases with recurrence of cysts were 2 and 0 in the innovation group and the traditional group, respectively, showing no significant difference between the two groups ( P>0.05). During the follow-up period, the anal defecation control function of all patients was classified as grade A?B of Williams score. Conclusions:The transverse perineal arc incision approach in complete resection of presacral cyst in the lithotomy position is safe and feasible. Compared with Kraske approach, the transverse perineal arc incision approach in the lithotomy position is more suitable for patients with high presacral cyst.

Objective:To investigate the status quo of hemoglobin a1c (HbA1c) in community-dwelling patients with type 2 diabetes mellitus and its relationship with health literacy, and analyze the factors that affect HbA1c level.Methods:A total of 134 patients with T2DM who received treatment in Hbxi Hospital Affiliated to Jining Medical University (Shanxian Central Hospital) from February 2019 to February 2020 were included in this study. All patients were divided into standard group (HBA1c < 7%, n = 61) and substandard group (HbA1c ≥ 7%, n = 73) according to HbA1c level. Fasting elbow venous blood was collected to measure relevant biochemical indexes. General data were collected from patients in the two groups. The Chinese Citizen Health Literacy Questionnaire was used to evaluate the health literacy level in patients from the two groups. Results:Serum levels of creatinine, blood uric acid and blood urea nitrogen in the substandard group were significantly higher than those in the standard group (all P < 0.05). Health literacy score in the substandard group was significantly lower than that in the standard group ( P < 0.05). The percentage of patients who smoked or had relevant complications among all included patients in the substandard group was 17.81% and 16.44%, respectively, which were significantly higher than 3.28% and 4.92%,respectively, in the standard group ( χ2 = 7.05, 4.43, both P < 0.05). The percentage of patients who had regular glucose level among all included patients in the substandard group was significantly lower than that in the standard group (63.93% vs. 80.82%, χ2 = 4.82, P < 0.05). Pearson analysis results showed that HbA1c level was significantly negatively correlated with health literacy score, with the correlation coefficient r of -0.80. Logistic regression model results showed that serum levels of creatinine and blood uric acid were independent risk factors for substandard level of HbA1c, with an OR value of 3.81 (95% CI: 1.60-9.09) and 1.03 (95% CI:1.01-1.06), respectively. Health literacy score was a protective factor for substandard level of HbA1c, with an OR value of 0.23 (95% CI: 0.10-0.54). Conclusion:Less than 50% of community-dwelling patients have standard HbA1c levels. Health literacy score is remarkably negatively correlated with HbA1c level. Health literacy score is a protective factor for HbA1c level, while serum creatinine and blood uric acid are independent risk factors for substandard HbA1c.