Long-term exposure to particulate matter has been increasingly implicated in the progression of chronic kidney disease (CKD). However, its impact on IgA nephropathy (IgAN), a leading cause of end-stage renal disease (ESRD), remains unclear. A total of 1768 IgAN patients, confirmed by renal biopsy were included in this cohort study. Long-term exposure to PM_2.5 and PM₁₀ was assessed using high-resolution satellite-based data from the China High Air Pollutants (CHAP) dataset. Cox proportional hazards models were used to estimate the associations between PM_2.5 or PM₁₀ and ESRD risk, adjusting for demographic, clinical, and biochemical covariates. Over a median follow-up of 3.63 years, 209 participants progressed to ESRD. Higher exposure to both PM_2.5 and PM₁₀ was significantly associated with an increased risk, with hazard ratios of 1.62 and 1.36 per 10 µg/m³ increase, respectively. A nonlinear dose-response relationship was observed, with risk increasing markedly beyond threshold levels. Trajectory modeling of prebaseline exposure identified a subgroup with persistently high and fluctuating particulate matter exposure that showed the highest risk. This study provides strong evidence that prolonged exposure to ambient particulate matter contributes to renal disease progression in individuals with IgAN.
Humans ; Glomerulonephritis, IGA/pathology* ; Particulate Matter/adverse effects* ; Male ; Female ; Kidney Failure, Chronic/epidemiology* ; Adult ; China/epidemiology* ; Disease Progression ; Environmental Exposure/adverse effects* ; Middle Aged ; Proportional Hazards Models ; Risk Factors ; Air Pollutants/adverse effects* ; Cohort Studies

Objective:To investigate the image characteristics of woven coronary artery (WCA)on intravascular ultrasound(IVUS) and optical coherence tomography(OCT).Methods:Thirty-seven patients suspected of WCA on coronary angiography were enrolled from Teaching Hospital of Chengdu University of Traditional Chinese Medcine, Zhengzhou Cardiovascular Disease Hospital and Zhongshan Hospital of Fudan University from January 2013 to July 2020. The intraluminal imaging features of WCA were analyzed using IVUS and OCT.Results:Of the 37 patients admitted at the cardiology service, 9 patients had WCA. All the patients underwent coronary angiography, IVUS and OCT, of which 6 lesions were located on the right coronary artery, 2 lesions were located on the left anterior descending artery and 1 patient had WCA on the circumflex artery. The mean length of WCA lesions was 2.2 cm(ranged from 1.2 cm to 4.5 cm). The angiographic appearance of WCA was numerous small tortious channels origined form the main lumen. The channels appeared to be " doughnut" like pattern and they merged to normal artery again after the anomalous segment. Flow limitation was rare unless there was coronary atherosclerosis. OCT and IVUS showed multiple spiral channels in the anomalous segment, which were independent of each other and each channels had a relatively complete three-layers vascular structure.Conclusions:With typical image characteristics, IVUS and OCT are able to screen out WCA and guide the treatment decision making.

This cross-sectional, non-interventional, observational study evaluated depression in patients in China who presented to a general neurologist with chronic, medically unexplained, painful physical symptoms. Of the 402 patients enrolled, 197 patients (49.0%) met the criteria for a current major depressive episode (MDE+ group), as assessed using module A of the Mini International Neuropsychiatric Interview, and 205 patients (51.0%) did not (MDE- group). The mean pain severity visual analogue scale (VAS) score was signifi cantly higher in the MDE+ group than the MDE- group (65.3 vs 55.6 mm; p<0.001). The mean depression severity score, as assessed using the 9-item Patient Health Questionnaire (PHQ-9), was 8.4 units (95% CI: 7.3 to 9.5) higher in the MDE+ group than the MDE- group (mean PHQ-9 total score: 14.8 vs 6.4). Anxiety and perceived health state were signifi cantly worse, on average, in the MDE+ group (mean Hospital Anxiety and Depression Scale anxiety subscale score 10.7 vs 5.9 units; mean EuroQoL-5 Dimensions VAS score 56.4 vs 67.7 mm; each p<0.001). Only 14.2% of patients had received treatment for depression during the past 3 months. These results suggest depression was common and may have been under-treated in this group of Chinese patients with chronic, medically unexplained painful physical symptoms.