Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

As an essential trace element in living organisms, copper is actively involved in normal physiological processes in various systems and is maintained at low level to achieve copper homeostasis. Copper homeostasis, once being disrupted, would induce cell death, and this new form of cell death is known as copper death. In recent years, copper death has been increasingly recognized as an important factor mediating the onset and progression of central nervous system (CNS) diseases. Therefore, we review the pathogenic mechanism of copper death in CNS diseases, as well as its therapeutic strategies so as to deepen the understanding of researchers.

Objective:To explore the value of machine learning models based on multiple structural MRI features for diagnosis of Parkinson disease (PD).Methods:The clinical and imaging data of 60 PD patients (PD group) diagnosed in the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2017 to August 2019 and 56 normal elderly people (NC group) recruited from the community were retrospectively analyzed. All subjects underwent brain MR imaging. Multiple structural MRI features were extracted from cerebellum, deep nuclei and of brain cortex based on different partition templates. The Mann-Whitney U test, as well as least absolute shrinkage and selection operator regression were used to select the most discriminating features. Finally, logistic regression (LR) and linear discriminant analysis (LDA) classifier combined with the 5-fold cross-validation scheme were used to construct the models based on structural features of cerebellum, deep nuclei and cortex, and a combined model based on all features. The receiver operating characteristic curves were drawn, and the diagnostic performance and clinical net benefit of each model were evaluated by the area under curve (AUC) and the decision curve analysis (DCA). Results:In total, four cerebellum (asymmetry index of Lobule Ⅵ volume, asymmetry index of Lobule ⅦB cortical thickness, asymmetry index of total gray matter volume and absolute value of right Lobule Ⅵ gray matter volume), 3 deep nuclei (absolute value of right nucleus accumbens volume, absolute and relative value of total nucleus accumbens volume) and 3 cortex features (local gyration index of left PFm, local fractal dimension of right superior frontal gyrus and sulcal depth of left superior occipital gyrus) were selected as the most discriminating features, and the related models were constructed. In validation set, the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LR classifier were 0.692, 0.641, 0.747 and 0.816; the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LDA classifier were 0.726, 0.610, 0.752 and 0.818. The diagnostic efficiency of the combined models based on LR and LDA classifiers were significantly better than those of other models ( P<0.05). The DCA curve demonstrated that the combined models based on LR and LDA classifiers showed the highest clinical net benefit. Conclusion:The combined models with all structural features of cerebellum, deep nuclei and cortex included based on LR and LDA classifiers showed favorable performance and clinical net benefit for diagnosis of PD, which have the potential application value in clinical diagnosis.

Objective:To construct a plasmid for expression Mycobacterium tuberculosis ( Mtb) Rv3133c and to evaluate the immunogenicity of Rv3133c through population and mice experiments. Methods:The recombinant expression plasmid pPROEX-Rv3133c was constructed. The transformed E. coli BL21 (DE3) carrying expression plasmid was induced by IPTG to express the recombinant Rv3133c (rRv3133c). Western blot was used to identify the expressed protein. Whole-blood IFN-γ release assay (WBIA) was preformed to assess the immunogenicity of rRv3133c in Mtb-infected population. Antigen-specific antibodies in serum, Th1 type cytokines in splenocytes, functional T cell subset responses in splenocytes and the expression of cytokines at mRNA level in lung tissues were detected after immunizing mice subcutaneously with rRv3133c and adjuvant DC. Results:The rRv3133c was constructed and expressed successfully. Stimulation with rRv3133c promoted the production of IFN-γ in Mtb-infected population, especially in patients with latent tuberculosis infections. After immunizing mice with rRv3133c+ DC, the levels of IFN-γ, TNF-α and IL-2, the number of IFN-γ + TNF-α + CD4 + T cells in spleen and the expression of antigen-specific IFN-γ, TNF-α and iNOS at mRNA level in lung tissues were higher than those in BCG-immunized mice, but lower than those in BCG+ rRv3133c+ DC group. The serum IgG2a/IgG1 ratios in the rRv3133c+ DC group and the BCG+ rRv3133c+ DC group were greater than 1, and significantly higher than that of the BCG group. Conclusions:The rRv3133c had good immunogenicity and could induce strong Th1 immune response, suggesting that it was a potential candidate antigen for subunit vaccine against tuberculosis.

Objective To investigate the association between serum level of secretory type Ⅱ phospholipase A2 (sPLA2 Ⅱ a) and carotid intima-media thickness (CIMT) in elderly patients with metabolic syndrome (MS).Methods A total of 124 consecutive MS patients aged over 65 years were enrolled and another 90 elderly non-MS subjects were served as controls.The serum concentration of sPLA2 Ⅱ a was measured by enzyme-linked immunosorbent assay.Blood pressure,blood lipids and blood glucose levels etc.were also measured.The carotid intima-media thickness was examined by color Doppler ultrasonography.Results Serum level of sPLA2 Ⅱ a was significantly higher in elderly MS patients than in control group [(4.41±1.55)μg/L vs.(2.39±0.97)μg/L,P＜ 0.05].Compared with the control group,elderly MS patients showed CIMT was significantly increased [(1.17±0.24) mm vs.(0.89±0.24)mm,P＜0.05].Serum level of sPLA2 Ⅱ a were higher in elderly obesity patients than in normal BMI subjects [(4.76±0.99)μg/L vs.(2.84±0.54)μg/L,P＜0.05].Multiple regression analysis indicated that sPLA2 Ⅱ a level was an independent risk factor for CIMT in elderly MS patients after adjusting for the effects of BMI,IL-6 and high sensitive C-reactive protein (hs CRP) on CIMT(r=0.38,P＜0.01).Conclusions Serum level of sPLA2 Ⅱ a is increased in elderly MS patients and is independently correlated with CIMT,which has a predictive value for atherosclerosis,sPLA2 Ⅱ a may be involved in the process of vascular endothelial injury.

Objective To analyze CT manifestation of Schistosoma haematobium cystitis.Methods Retrospective analysis 32 patients,who were tested for Schistosoma haematobium cystitis using the urine filtration method.CT scan was performed for each patient with contrast enhancement.Results The vast majority of urinary tract schistomiasis lesions were in the urinary bladder.Calcification of the bladder wall was observed in all patients and mild enhancement in non calcified zone was found after intravenous contrast.Except for 5 patients of bladder cancer,the rest were no abnormality in size of bladder when bladder was filling or emptying.Ureteral wall annular calcification could also be identified in 25 patients.Twenty two patients were companied with ureteric hydronephrosis.Seminal vesicle calcification was seen in 4 patients among 11 male patients,while both uterine and ovarian in female and prostate in men had non calcification.Serious illness can be combined with bladder cancer.In 5 patients of patients with bladder cancer,bladder showed irregular soft tissue mass which was enhanced moderately after post-contrast scan,with vesical calcification in mass medially.Conclusion Bladder calcification is the most prominent CT feature of Schistosoma haematobium cystitis,which is useful in diagnosis the disease.

Objective To identify the potential value of event-related potentials ( ERPs ) and electroencephalogram(EEG) in early diagnosis of dementia.Methods From June 2008 to July 2011,113 patients with dementia were recruited fom First Affiliated Hospital of Anhui College of Traditional Chinese Medicine.Meanwhile,100 healthy individuals conducting physical examination at this hospital were collected as the control group.P300 and EEG were measured in patients and healthy controls.Results ( 1 ) Compared with healthy controls,patients with early diagnosis of dementia had significantly longer latency(402.5 ± 37.4)ms vs.( 320.4 ± 23.5 ) ms ;t =19.40 ; P =0.02 ) and lower amplitude of P300 ( 3.76 ± 1.76 ) μV vs.( 5.32 ± 1.38 )μV;t=7.24;P=0.01 ).(2)Significant higher proportionof abnormal EEG cases was found in individuals with dementia (68/113,60.2％ ) than that of participants in the healthy control group(34/100,34.0％ ) ( x2 =13.54,P ＜0.01 ).Specifically,patients with early diagnosis of dementia had significantly higher prevalence of moderate (26.5 ％ [ 18/68 ] vs.5.9 ％ [ 2/34 ] ; x2 =4.85,P =0.02 ) and severe ( 8.8 ％ [ 6/68 ] vs.2.9 ％ [ 1/34 ] ; x2 =1.22,P =0.02 ) abnormal EEG than healthy controls,while there were no significant difference of the proportions of mild or borderline abnormal EEG between the two groups ( P ＞ 0.05 ).Conclusion P300 is an extraordinary objective indicator for early diagnosis of dementia.EEG can provide evidence of impaired brain function for individuals with dementia.