Objective:To investigate the characteristics of RET gene rearrangement revealed by fluorescence in situ hybridization (FISH) in lung cancer.Methods:A total of 616 formalin-fixed paraffin-embedded surgical samples from lung adenocarcinomas with wild-type EGFR gene and no ALK protein expression by immunohistochemistry obtained at Peking Union Medical College Hospital, Beijing, China between December 2019 and April 2022 were included. Thirty-three tumors with RET gene rearrangement determined by imbalanced-based reverse-transcription droplet digital PCR (RT-ddPCR) were analyzed using break-apart FISH. The results were confirmed, and RET gene fusion variants were identified through next generation sequencing (NGS).Results:RET gene rearrangements were found in all 33 RET RT-ddPCR positive cases via NGS, including 27 cases of KIF5B::RET, 3 CCDC6::RET, 2 ERC1::RET and 1 CCDC186::RET rearrangements. Moreover, 32 RET positive and 1 RET negative cases were defined using FISH. Among the RET FISH-positive cases, 25 (78.1%, 25/32) showed break-apart FISH signal pattern in 52%-100% of tumor cells with the rearrangement and 7 cases (21.9%, 7/32) presented isolated 3′ signal type in 38%-88% positive tumor cells. There was no RET-positive case with single 5′ pattern in the cohort. The most common partner gene was KIF5B (81.8%, 27/33). Most of the patients with RET gene rearrangement were female (72.7%, 24/33).Conclusion:RET FISH-positive lung cancer is commonly characterized by a high proportion of rearrangement cancer cells and break-apart FISH signal type.

Objective:To investigate the abnormalities of mesenchymal-epithelial transition factor (MET) gene in early-stage lung adenocarcinomas and to provide genetic bases for related clinical studies.Methods:A total of 630 cases of formalin-fixed and paraffin-embedded lung adenocarcinoma specimens with ALK and EGFR double-negativities were collected at Peking Union Medical College Hospital, Beijing, China between July 2020 and April 2022. Forty-three stage Ⅰ-ⅢA tumors with MET exon 14 skipping mutation identified by reverse transcription droplet digital PCR (RT-ddPCR) were identified and then evaluated for MET amplification using fluorescence in situ hybridization (FISH). MET amplification was determined using the ratio of MET to chromosome 7 enumeration probe (CEP7) or the mean of MET gene copy number (GCN).Results:Among the 43 samples with MET exon 14 skipping mutation, MET amplification was detected in 9 cases (9/43, 20.93%), including 1 case of MET/CEP7 ≥2 and GCN ≥5 (1/9), 8 cases of GCN≥5 (8/9), as well as 10 cases with high level of CEP7 (7.00-9.72) which included 5 cases with MET amplification. There were no significant differences in clinicopathological features between the two subgroups of tumors which harbored MET exon 14 skipping mutation with MET amplification versus those without ( P>0.05). Conclusions:Co-occurrence of MET exon 14 skipping mutation and MET amplification or high level of CEP7 is frequently observed in early-stage lung adenocarcinomas. The most common pattern of MET gene amplification is GCN ≥5.

Objective: To investigate the influencing factors for cognitive function among aluminum workers, so as to provide the basis for intervention and prevention of cognitive function among aluminum-exposed populations. Methods: From July to August 2019, male aluminum workers in the electrolytic aluminum workshop of an aluminum factory in Shanxi Province were selected using the cluster sampling method. Demographic information, prevalence of chronic diseases, lifestyle behaviors, night shifts, and sleep quality were collected through questionnaire surveys. Blood aluminum levels were measured using inductively coupled plasma-mass spectrometry. Cognitive function was investigated using the Montreal Cognitive Assessment. Factors affecting cognitive function among aluminum workers were analyzed by a quantile regression model. Results: A total of 142 aluminum workers were surveyed, including 57 workers aged 20 to <40 years (40.14%) and 85 workers aged 40 to 60 years (59.86%). The median blood aluminum level was 38.23 (interquartile range, 21.82) μg/L. The median cognitive function score was 24.00 (interquartile range, 3.00) points. Quantile regression analysis revealed that older age (βQ5=-0.186, 95%CI: -0.269 to -0.102), lower educational level (βQ5=1.933, 95%CI: 1.029 to 2.838; βQ10=1.743, 95%CI: 0.480 to 3.006; βQ50=1.038, 95%CI: 0.141 to 1.935; βQ75=1.006, 95%CI: 0.437 to 1.575; βQ90=1.111, 95%CI: 0.291 to 1.930), smoking (βQ5=-2.056, 95%CI: -3.264 to -0.849), alcohol consumption (βQ5=-1.821, 95%CI: -3.247 to -0.396) and higher blood aluminum level (βQ5=-0.075, 95%CI: -0.110 to -0.040; βQ10=-0.078, 95%CI: -0.127 to -0.029; βQ50=-0.075, 95%CI: -0.110 to -0.040; βQ75=-0.057, 95%CI: -0.079 to -0.035; βQ90=-0.067, 95%CI: -0.099 to -0.035) were associated with cognitive function decline among aluminum workers. Conclusions Educational level and blood aluminum level are the main factors affecting the cognitive function among aluminum workers. Among those with lower cognitive function scores, age, smoking and alcohol consumption are also associated with cognitive function.

Background Some studies have suggested that exposure to multiple metals is closely linked to the development of metabolic syndrome (MS) in the populations, but the effect of aluminum exposure on MS remains unclear. Objective To analyze the prevalence and influencing factors of MS among employees with aluminum exposure in Shanxi Province. Methods Cluster sampling was employed to survey male frontline workers in an aluminum factory in Shanxi Province. Data on general demographic information, lifestyle, occupational history, medical history, and family history of chronic diseases were collected through questionnaires. The concentration of fasting blood glucose was determined using the glucose oxidase technique, and blood lipid levels were determined using the peroxidase method. Serum aluminum levels were detected using inductively coupled plasma-mass spectrometry (ICP-MS), and blood biochemical indicators were measured using the peroxidase method. Based on the China's 2020 diagnostic criteria for MS, the participants were and divided into an MS group anda non-MS group. Variables with statistical significance in univariate analysis were included to construct a logistic regression model. Results A cohort of 312 workers participated in this research, with 84 individuals diagnosed with MS, yielding a prevalence rate of 26.92%. The logistic regression model revealed that body mass index (BMI)≥24.0 kg·m⁻² (OR=1.967, 95%CI: 1.057, 3.659), alcohol consumption (OR=1.883, 95%CI: 1.063, 3.336), experiencing major life event (OR=3.886, 95%CI: 1.509, 10.008), family history of hypertension (OR=2.112, 95%CI: 1.162, 3.837), serum aluminum concentration (OR=1.024, 95%CI: 1.012, 1.035), alanine aminotransferase (ALT) level (OR=1.032, 95%CI: 1.011, 1.054), and white blood cell (WBC) count (OR=1.210, 95%CI: 1.001, 1.465) were significant influencing factors for MS. Conclusion BMI≥24.0 kg·m⁻², alcohol consumption, experiencing major life event, family history of hypertension, elevated serum aluminum concentration, increased ALT level, and elevated WBC count are risk factors for MS among occupationally aluminum-exposed workers.

Objective:To investigate the staging criteria of renal tuberculosis，and to analyze the diagnostic and therapeutic characteristics as well as prognostic outcomes at different stages.Methods:A retrospective analysis was conducted on the clinical data of 134 patients with renal tuberculosis who were admitted to the Second Hospital of Lanzhou University between January 2019 and December 2023.The study cohort included 62 males and 72 females，with a mean age of（46.63 ± 13.52）years and a mean body mass index（BMI）of（22.85 ± 3.73）kg/m 2. A total of 107 patients resided in rural areas. Sixty patients had a history of pulmonary tuberculosis. Tuberculous lesions were located in the left kidney in 72 cases and in the right kidney in 62 cases. The main presenting complaints included irritative lower urinary tract symptoms in 85 patients and systemic symptoms in 92 patients. Ureteral involvement was observed in 97 patients，bladder involvement in 32 patients，and genital involvement in 9 patients. Based on computed tomography（CT）findings，the number，extent，and degree of renal destruction caused by tuberculous lesions were comprehensively evaluated in axial，coronal，and sagittal planes. The primary staging criteria included lesion diameter（2 cm）and the proportion of renal volume involved by the lesion（one-third，one-half，and two-thirds）. Renal tuberculosis was classified into three stages and six subtypes：Stage Ⅰa，a solitary lesion with a diameter ≤ 2 cm；Stage Ⅰb，a solitary lesion >2 cm or multiple lesions confined within one-third of the renal volume；Stage Ⅱa，lesions involving more than one-third but confined within one-half of the renal volume；Stage Ⅱb，lesions involving more than one-half but confined within two-thirds of the renal volume；Stage Ⅲa，lesions involving more than two-thirds of the renal volume with a glomerular filtration rate（GFR）of the affected kidney <10 ml/min；and Stage Ⅲb，complete renal calcification，presenting as an “autonephrectomy”. Among the 134 patients included in this study，7 were classified as Stage Ⅰa，17 as Stage Ⅰb，20 as Stage Ⅱa，19 as Stage Ⅱb，62 as Stage Ⅲa，and 9 as Stage Ⅲb. The severity of hydronephrosis was graded as follows：mild，renal pelvic separation <2 cm；moderate，2-3 cm；and severe，>3 cm. Prior to treatment，the mean renal pelvic separation was（1.76 ± 0.92）cm in Stage Ⅰa，（1.69 ± 0.81）cm in Stage Ⅰb，and（1.10 ± 0.82）cm in Stage Ⅱa，corresponding to mild to moderate hydronephrosis. All 7 patients in Stage Ⅰa underwent ureteroscopic examination and double-J stent placement，combined with a 6-month short-course anti-tuberculosis regimen consisting of isoniazid，rifampicin，pyrazinamide，and ethambutol for 2 months（intensive phase），followed by isoniazid and rifampicin for 4 months（continuation phase）. Among the 17 patients in Stage Ⅰb，13 presented with hydronephrosis and underwent ureteroscopic examination and double-J stent placement in combination with 6 months of anti-tuberculosis therapy，while 4 patients with isolated renal tuberculosis received anti-tuberculosis therapy alone for 6 months.Of the 20 patients in Stage Ⅱa，4 with hydronephrosis underwent ureteroscopic examination and double-J stent placement plus 6 months of anti-tuberculosis therapy，whereas 16 underwent nephroureterectomy. All 19 patients in Stage Ⅱb underwent nephroureterectomy. Among the 62 patients in Stage Ⅲa，60 underwent nephroureterectomy，while 2 refused surgery and were treated with the 6-month short-course anti-tuberculosis regimen. Of the 9 patients in Stage Ⅲb，8 underwent nephroureterectomy；in 1 patient，surgery was not performed due to severe adhesions in the operative field，and the patient received the 6-month short-course anti-tuberculosis regimen instead. Follow-up assessments included clinical symptoms，erythrocyte sedimentation rate（ESR），serum creatinine，degree of renal pelvic separation，and imaging findings from urinary tract CT. Efficacy was evaluated according to the following criteria：Cure was defined as clinical stability with all of the following conditions：① improvement of systemic symptoms，including absence of flank pain，fever，and lower urinary tract irritative symptoms，with normalization of erythrocyte sedimentation rate（ESR）；② negative urine culture for Mycobacterium tuberculosis；and ③ complete calcification of renal lesions and/or no evidence of tuberculous lesions at other sites. Stable disease was defined as no change in the size or extent of renal tuberculosis lesions. Progressive disease was defined as enlargement or increase in the number of tuberculous lesions or involvement of additional sites. Results:Among the 7 patients in Stage Ⅰa，follow-up imaging after treatment showed a mean renal pelvic separation of（0.44 ± 0.56）cm，which was significantly reduced compared with baseline（ t = 3.909， P = 0.008）. Five patients achieved cure，1 remained stable，and 1 showed disease progression and subsequently underwent nephroureterectomy，resulting in postoperative cure. In Stage Ⅰb，among 13 patients with hydronephrosis，post-treatment imaging showed a mean renal pelvic separation of（0.8 ± 0.75）cm，a statistically significant improvement from baseline（ t = 5.633， P < 0.01）. Six patients were cured，4 remained stable，and 3 experienced disease progression and underwent nephroureterectomy. Of the 4 patients with isolated renal tuberculosis，2 were controlled，and 2 progressed and underwent nephroureterectomy. In Stage Ⅱa，among 4 patients with tuberculous hydronephrosis，post-treatment renal pelvic separation was（1.20±0.98）cm，with no significant difference from baseline（ t = -1.675， P = 0.193）；these patients underwent nephroureterectomy 1-2 years later. The remaining 16 patients without hydronephrosis underwent nephroureterectomy and were cured. All 19 patients in Stage Ⅱb underwent nephroureterectomy；17 were cured，and 2 developed ipsilateral perirenal fluid collections 3 months postoperatively，which resolved spontaneously with the standard 6-month anti-tuberculosis regimen. Among 62 patients in Stage Ⅲa，60 underwent nephroureterectomy. Of these，54 were cured；1 developed a urinary tract infection within 2 weeks postoperatively；3 showed contralateral renal disease progression at 3 months；and 1 developed ipsilateral perirenal fluid at 3 months，which resolved spontaneously with standard anti-tuberculosis therapy. One patient developed solitary kidney failure 7 months postoperatively and underwent ureteral stent placement，with disease remaining stable thereafter. Two patients refused surgery and received only anti-tuberculosis therapy；during follow-up，1 patient experienced disease progression and died of disseminated tuberculosis after 1 year，while the other developed contralateral renal involvement at 3 months and received standard 6-month therapy，with disease remaining stable. Among 9 patients in Stage Ⅲb，8 underwent nephroureterectomy and were cured. One patient，with severe adhesions precluding surgery，received anti-tuberculosis therapy alone，and disease remained stable over a 2-year follow-up. Conclusions:The CT-based staging system for renal tuberculosis proposed in this study（three stages and six subtypes）effectively reflects the severity of renal lesions and clearly delineates the clinical characteristics and prognostic outcomes at each stage. Stage Ⅰ patients treated with anti-tuberculosis drugs combined with double-J stent placement demonstrated favorable outcomes and high renal preservation rates. In contrast，Stages Ⅱ and Ⅲ patients showed poor responses to anti-tuberculosis therapy combined with drainage，with a higher risk of disease progression and relatively worse prognosis，highlighting the recommendation for early nephroureterectomy of the affected kidney.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To investigate the characteristics of RET gene rearrangement revealed by fluorescence in situ hybridization (FISH) in lung cancer.Methods:A total of 616 formalin-fixed paraffin-embedded surgical samples from lung adenocarcinomas with wild-type EGFR gene and no ALK protein expression by immunohistochemistry obtained at Peking Union Medical College Hospital, Beijing, China between December 2019 and April 2022 were included. Thirty-three tumors with RET gene rearrangement determined by imbalanced-based reverse-transcription droplet digital PCR (RT-ddPCR) were analyzed using break-apart FISH. The results were confirmed, and RET gene fusion variants were identified through next generation sequencing (NGS).Results:RET gene rearrangements were found in all 33 RET RT-ddPCR positive cases via NGS, including 27 cases of KIF5B::RET, 3 CCDC6::RET, 2 ERC1::RET and 1 CCDC186::RET rearrangements. Moreover, 32 RET positive and 1 RET negative cases were defined using FISH. Among the RET FISH-positive cases, 25 (78.1%, 25/32) showed break-apart FISH signal pattern in 52%-100% of tumor cells with the rearrangement and 7 cases (21.9%, 7/32) presented isolated 3′ signal type in 38%-88% positive tumor cells. There was no RET-positive case with single 5′ pattern in the cohort. The most common partner gene was KIF5B (81.8%, 27/33). Most of the patients with RET gene rearrangement were female (72.7%, 24/33).Conclusion:RET FISH-positive lung cancer is commonly characterized by a high proportion of rearrangement cancer cells and break-apart FISH signal type.

Objective:To investigate the abnormalities of mesenchymal-epithelial transition factor (MET) gene in early-stage lung adenocarcinomas and to provide genetic bases for related clinical studies.Methods:A total of 630 cases of formalin-fixed and paraffin-embedded lung adenocarcinoma specimens with ALK and EGFR double-negativities were collected at Peking Union Medical College Hospital, Beijing, China between July 2020 and April 2022. Forty-three stage Ⅰ-ⅢA tumors with MET exon 14 skipping mutation identified by reverse transcription droplet digital PCR (RT-ddPCR) were identified and then evaluated for MET amplification using fluorescence in situ hybridization (FISH). MET amplification was determined using the ratio of MET to chromosome 7 enumeration probe (CEP7) or the mean of MET gene copy number (GCN).Results:Among the 43 samples with MET exon 14 skipping mutation, MET amplification was detected in 9 cases (9/43, 20.93%), including 1 case of MET/CEP7 ≥2 and GCN ≥5 (1/9), 8 cases of GCN≥5 (8/9), as well as 10 cases with high level of CEP7 (7.00-9.72) which included 5 cases with MET amplification. There were no significant differences in clinicopathological features between the two subgroups of tumors which harbored MET exon 14 skipping mutation with MET amplification versus those without ( P>0.05). Conclusions:Co-occurrence of MET exon 14 skipping mutation and MET amplification or high level of CEP7 is frequently observed in early-stage lung adenocarcinomas. The most common pattern of MET gene amplification is GCN ≥5.

Objective:To investigate the staging criteria of renal tuberculosis，and to analyze the diagnostic and therapeutic characteristics as well as prognostic outcomes at different stages.Methods:A retrospective analysis was conducted on the clinical data of 134 patients with renal tuberculosis who were admitted to the Second Hospital of Lanzhou University between January 2019 and December 2023.The study cohort included 62 males and 72 females，with a mean age of（46.63 ± 13.52）years and a mean body mass index（BMI）of（22.85 ± 3.73）kg/m 2. A total of 107 patients resided in rural areas. Sixty patients had a history of pulmonary tuberculosis. Tuberculous lesions were located in the left kidney in 72 cases and in the right kidney in 62 cases. The main presenting complaints included irritative lower urinary tract symptoms in 85 patients and systemic symptoms in 92 patients. Ureteral involvement was observed in 97 patients，bladder involvement in 32 patients，and genital involvement in 9 patients. Based on computed tomography（CT）findings，the number，extent，and degree of renal destruction caused by tuberculous lesions were comprehensively evaluated in axial，coronal，and sagittal planes. The primary staging criteria included lesion diameter（2 cm）and the proportion of renal volume involved by the lesion（one-third，one-half，and two-thirds）. Renal tuberculosis was classified into three stages and six subtypes：Stage Ⅰa，a solitary lesion with a diameter ≤ 2 cm；Stage Ⅰb，a solitary lesion >2 cm or multiple lesions confined within one-third of the renal volume；Stage Ⅱa，lesions involving more than one-third but confined within one-half of the renal volume；Stage Ⅱb，lesions involving more than one-half but confined within two-thirds of the renal volume；Stage Ⅲa，lesions involving more than two-thirds of the renal volume with a glomerular filtration rate（GFR）of the affected kidney <10 ml/min；and Stage Ⅲb，complete renal calcification，presenting as an “autonephrectomy”. Among the 134 patients included in this study，7 were classified as Stage Ⅰa，17 as Stage Ⅰb，20 as Stage Ⅱa，19 as Stage Ⅱb，62 as Stage Ⅲa，and 9 as Stage Ⅲb. The severity of hydronephrosis was graded as follows：mild，renal pelvic separation <2 cm；moderate，2-3 cm；and severe，>3 cm. Prior to treatment，the mean renal pelvic separation was（1.76 ± 0.92）cm in Stage Ⅰa，（1.69 ± 0.81）cm in Stage Ⅰb，and（1.10 ± 0.82）cm in Stage Ⅱa，corresponding to mild to moderate hydronephrosis. All 7 patients in Stage Ⅰa underwent ureteroscopic examination and double-J stent placement，combined with a 6-month short-course anti-tuberculosis regimen consisting of isoniazid，rifampicin，pyrazinamide，and ethambutol for 2 months（intensive phase），followed by isoniazid and rifampicin for 4 months（continuation phase）. Among the 17 patients in Stage Ⅰb，13 presented with hydronephrosis and underwent ureteroscopic examination and double-J stent placement in combination with 6 months of anti-tuberculosis therapy，while 4 patients with isolated renal tuberculosis received anti-tuberculosis therapy alone for 6 months.Of the 20 patients in Stage Ⅱa，4 with hydronephrosis underwent ureteroscopic examination and double-J stent placement plus 6 months of anti-tuberculosis therapy，whereas 16 underwent nephroureterectomy. All 19 patients in Stage Ⅱb underwent nephroureterectomy. Among the 62 patients in Stage Ⅲa，60 underwent nephroureterectomy，while 2 refused surgery and were treated with the 6-month short-course anti-tuberculosis regimen. Of the 9 patients in Stage Ⅲb，8 underwent nephroureterectomy；in 1 patient，surgery was not performed due to severe adhesions in the operative field，and the patient received the 6-month short-course anti-tuberculosis regimen instead. Follow-up assessments included clinical symptoms，erythrocyte sedimentation rate（ESR），serum creatinine，degree of renal pelvic separation，and imaging findings from urinary tract CT. Efficacy was evaluated according to the following criteria：Cure was defined as clinical stability with all of the following conditions：① improvement of systemic symptoms，including absence of flank pain，fever，and lower urinary tract irritative symptoms，with normalization of erythrocyte sedimentation rate（ESR）；② negative urine culture for Mycobacterium tuberculosis；and ③ complete calcification of renal lesions and/or no evidence of tuberculous lesions at other sites. Stable disease was defined as no change in the size or extent of renal tuberculosis lesions. Progressive disease was defined as enlargement or increase in the number of tuberculous lesions or involvement of additional sites. Results:Among the 7 patients in Stage Ⅰa，follow-up imaging after treatment showed a mean renal pelvic separation of（0.44 ± 0.56）cm，which was significantly reduced compared with baseline（ t = 3.909， P = 0.008）. Five patients achieved cure，1 remained stable，and 1 showed disease progression and subsequently underwent nephroureterectomy，resulting in postoperative cure. In Stage Ⅰb，among 13 patients with hydronephrosis，post-treatment imaging showed a mean renal pelvic separation of（0.8 ± 0.75）cm，a statistically significant improvement from baseline（ t = 5.633， P < 0.01）. Six patients were cured，4 remained stable，and 3 experienced disease progression and underwent nephroureterectomy. Of the 4 patients with isolated renal tuberculosis，2 were controlled，and 2 progressed and underwent nephroureterectomy. In Stage Ⅱa，among 4 patients with tuberculous hydronephrosis，post-treatment renal pelvic separation was（1.20±0.98）cm，with no significant difference from baseline（ t = -1.675， P = 0.193）；these patients underwent nephroureterectomy 1-2 years later. The remaining 16 patients without hydronephrosis underwent nephroureterectomy and were cured. All 19 patients in Stage Ⅱb underwent nephroureterectomy；17 were cured，and 2 developed ipsilateral perirenal fluid collections 3 months postoperatively，which resolved spontaneously with the standard 6-month anti-tuberculosis regimen. Among 62 patients in Stage Ⅲa，60 underwent nephroureterectomy. Of these，54 were cured；1 developed a urinary tract infection within 2 weeks postoperatively；3 showed contralateral renal disease progression at 3 months；and 1 developed ipsilateral perirenal fluid at 3 months，which resolved spontaneously with standard anti-tuberculosis therapy. One patient developed solitary kidney failure 7 months postoperatively and underwent ureteral stent placement，with disease remaining stable thereafter. Two patients refused surgery and received only anti-tuberculosis therapy；during follow-up，1 patient experienced disease progression and died of disseminated tuberculosis after 1 year，while the other developed contralateral renal involvement at 3 months and received standard 6-month therapy，with disease remaining stable. Among 9 patients in Stage Ⅲb，8 underwent nephroureterectomy and were cured. One patient，with severe adhesions precluding surgery，received anti-tuberculosis therapy alone，and disease remained stable over a 2-year follow-up. Conclusions:The CT-based staging system for renal tuberculosis proposed in this study（three stages and six subtypes）effectively reflects the severity of renal lesions and clearly delineates the clinical characteristics and prognostic outcomes at each stage. Stage Ⅰ patients treated with anti-tuberculosis drugs combined with double-J stent placement demonstrated favorable outcomes and high renal preservation rates. In contrast，Stages Ⅱ and Ⅲ patients showed poor responses to anti-tuberculosis therapy combined with drainage，with a higher risk of disease progression and relatively worse prognosis，highlighting the recommendation for early nephroureterectomy of the affected kidney.