Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

Hepatitis B virus（HBV）infection remains a major global public health challenge. Over the past three decades，significant progress has been made in HBV prevention and control，including the widespread implementation of hepatitis B vaccination and mother-to-child transmission（MTCT）blockade strategies，advancements in antiviral therapies，and improvements in public health awareness. The extensive administration of hepatitis B vaccines has markedly reduced the incidence of new infections. The development of antiviral treatments，such as nucleos（t）ide analogues，has effectively suppressed viral replication，thereby decreased the incidence of liver cirrhosis and hepatocellular carcinoma. Furthermore，enhanced public health awareness and the implementation of screening programs have enabled earlier diagnosis and treatment for more patients. Nevertheless，the complete elimination of hepatitis B continues to face challenges. Firstly，inadequate vaccine coverage，particularly in low- and middle-income countries，sustains the risk of HBV transmission. Secondly，suboptimal diagnosis and treatment rates persist among individuals with chronic HBV infection. Additionally，the long-term management of chronic HBV carriers remains complex，necessitating continuous monitoring and personalized therapeutic strategies. This article summarizes the major achievements in the prevention and control of hepatitis B over the past 30 years，analyzes current challenges，and explores future directions. Novel vaccines，including therapeutic vaccines and mRNA-based vaccines，are demonstrating therapeutic potential in clinical trials and may offer new hope for chronic hepatitis B patients. Emerging antiviral agents，such as capsid assembly modulators and RNA interference-based therapeutics，which target distinct stages of the HBV life cycle，hold promise for achieving functional cure of hepatitis B. In conclusion，despite ongoing challenges，the complete elimination of hepatitis B remains an attainable goal through sustained innovation and global collaboration.

Objective:To analyze the liver histological characteristics and clinically related factors in inactive hepatitis B surface antigen (HBsAg) carriers (IHC), and also explore whether antiviral treatment is necessary for IHC, as defined in the 2022 version of the hepatitis B prevention and treatment guidelines.Methods:A multicenter, retrospective cohort study was conducted. Two hundred and thirty-one IHC cases who underwent liver biopsy histopathological examination in nine medical institutions, including Beijing Youan Hospital affiliated with Capital Medical University, from January 2018 to December 2023 were included. General informative data, clinical serological markers, and transient elastography (TE) examination results were collected. Patients were divided into a positive (148 cases) and a negative group (83 cases) according to the results of hepatitis B virus (HBV) DNA detection. The differences in liver pathological inflammatory activity (G) and liver fibrosis stage (S) were analyzed between the two groups to explore the correlation between liver tissue conditions and clinically related factors. Comparsions of normally distributed continwous data, skeukd continuous data, and categorical data between groups are performed using t tests, Mann-Whitney U tests and χ2 tests, respectively. Results:The age of 231 IHC cases was 43 (38, 51) years old, with 95.2% (220/231) aged ≥30 years, and males accounted for 64.9% (150/231). HBsAg and HBV DNA levels were 131.9 (20.8, 400.9) IU/mL and 94.0 (0, 448.5) IU/mL, respectively, of which 35.9% (83/231) were HBV DNA negative (<20 IU/mL). The remarkable proportions of G≥2, S≥2, and liver injury (G≥2 and/or S≥2) in liver tissue were 16.5% (38/231), 29% (67/231), and 35.9% (83/231), respectively. The S≥2 proportion was significantly higher in the HBV DNA-negative group than the positive group (42.2% vs. 21.6%, P<0.001), and it mainly occurred in the population cohort over 30 years old (44.9% vs. 31.0%, P=0.04). The liver stiffness measurement (LSM), aspartate transaminase to platelet ratio index (APRI), and platelet (PLT) were significantly higher in the S≥2 group than the S<2 group ( P<0.05). Conclusion:Clinicians can comprehensively evaluate the degree of liver fibrosis in IHC based on clinical factors such as age, PLT, APRI, and LSM, even if the liver histological results are lacking. The China 2022 version guidelines define that nearly half of IHC has histological indications for antiviral therapy, and liver biopsy and prompt treatment can be recommended.

Objective: o develop an onset risk prediction nomogram for patients with homocysteine-type (H-type) hypertension (HTH) based on pulse diagram parameters to assist early clinical prediction and diagnosis of HTH. Methods: Patients diagnosed with essential hypertension and admitted to Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai Hospital of Traditional Chinese Medicine, and Shanghai Hospital of Integrated Traditional Chinese and Western Medicine from July 6th 2020 to June 16th 2021, and from August 11th 2023 to January 22nd 2024, were enrolled in this retrospective research. The baselines and clinical biochemical indicators of patients were collected. The SMART-I TCM pulse instrument was applied to gather pulse diagram parameters. Multivariate logistic regression was adopted to analyze the risk factors for HTH. RStudio was employed to construct the nomogram model, receiver operating characteristic (ROC) curve, and calibration curve (bootstrap self-sampling 200 times), and clinical decision curve were drawn to evaluate the model’s discrimination and clinical effectiveness. Results: A total of 168 hospitalized patients with essential hypertension were selected and divided into non-HTH group (n = 29) and HTH group (n = 139). Compared with non-HTH group, HTH group had a lower body mass index (BMI), and higher proportions of male patients and drinkers (P < 0.05). The ventricular wall thickening (VWT) could not be determined. The proportions of left common carotid intima-media wall thickness (LCCIMWT) and serum creatinine (SCR) were higher in HTH group (P < 0.05). The pulse diagram parameter As was significantly higher, and H4/H1 and T1/T were lower in HTH group (P < 0.05). Gender, alcohol consumption, serum creatinine, and the pulse diagram parameter H4/H1 were identified as independent risk factors for HTH (P < 0.05). The nomogram’s area under the ROC curve (AUC) was 0.795 [95% confidence interval (CI): (0.706 6, 0.882 8)], with a specificity of 0.724 and sensitivity of 0.799. After 200 times repeated bootstrap self-samplings, the calibration curve showed that the simulated curve fits well with the actual curve (x2 = 9.5002, P = 0.301 9). The clinical decision curve indicated that the nomogram’s applicability was optimal when the threshold for predicting HTH was between 0.38 and 1.00. Conclusion The nomogram model could be valuable for predicting the onset risk of HTH and pulse diagram parameters can facilitate early screening and prevention of HTH.

Objective To analysed the related studies on varicocele in children and adolescents,and investigate the development status,research focus and frontiers in this field.Methods The literatures on varicocele in children and adolescents published between 2000 and 2023 was retrieved from Web of Science and visualized with R language software.Results A total of 684 articles were included,and the annual number of publications showed a steady growth trend.The United States ranked the first in the world and formed a core group of authors.Key words clustering showed that"semen parameters/infertility/oxidative stress","repair/ligation of spermatic vein","measurement and evaluation of testicular volume","testis and ultrasound examination","laparoscopic examination and treatment","sclerotherapy and embolization of spermatic vein"were the focus of current research.The mechanism of sperm quality decline was a research frontier.Conclusion The correlation between varicocele and male fertility in children and adolescents is a clinical problem worthy of further study.

Objective:To analyze the clinical characteristics of 18 patients with Brucella melitensis infection (abbreviated as brucellosis) in Xinjiang Uygur Autonomous Region (abbreviated as Xinjiang). Methods:A retrospective analysis was conducted on the medical records of 18 patients diagnosed with Brucella melitensis infection by blood culture at the First Affiliated Hospital of Shihezi University from March 2023 to March 2024, including general information, epidemiological characteristics, clinical manifestations, laboratory test results, etc. Results:Among the 18 patients with sheep brucellosis, 14 patients were aged 45-59 years old and 13 patients were male, with 13 cases having a clear history of contact with cattle and sheep. The main clinical manifestations were fever (18 cases), bone and joint pain (5 cases), and fatigue (5 cases). Laboratory test results confirmed all 18 cases as Brucella melitensis infection (AMOS-PCR), with one case originating from cattle. Laboratory tests showed that 12 patients had elevated lactate dehydrogenase (LDH) levels. Correlation analysis revealed, there was a positive association between aspartate aminotransferase (AST) and LDH ( r = 0.84, P < 0.001); a positive correlation between the number of affected systems and the percentage of neutrophils (N%, r = 0.73, P = 0.001); a positive correlation between the duration of medication and the number of affected systems ( r = 0.82, P < 0.001) and N% ( r = 0.75, P = 0.001); and a negative correlation between treatment duration and lymphocyte percentage (LYM%, r =-0.76, P = 0.001). Conclusions:The main source of Brucella melitensis infection in Xinjiang is sheep, and contact with cattle can also cause Brucella melitensis infection. Brucella melitensis patients are more common in middle-aged males. The clinical manifestations are diverse and atypical; N% and LYM% are correlated with the number of affected systems.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

Objective:To analyze the clinical characteristics of 18 patients with Brucella melitensis infection (abbreviated as brucellosis) in Xinjiang Uygur Autonomous Region (abbreviated as Xinjiang). Methods:A retrospective analysis was conducted on the medical records of 18 patients diagnosed with Brucella melitensis infection by blood culture at the First Affiliated Hospital of Shihezi University from March 2023 to March 2024, including general information, epidemiological characteristics, clinical manifestations, laboratory test results, etc. Results:Among the 18 patients with sheep brucellosis, 14 patients were aged 45-59 years old and 13 patients were male, with 13 cases having a clear history of contact with cattle and sheep. The main clinical manifestations were fever (18 cases), bone and joint pain (5 cases), and fatigue (5 cases). Laboratory test results confirmed all 18 cases as Brucella melitensis infection (AMOS-PCR), with one case originating from cattle. Laboratory tests showed that 12 patients had elevated lactate dehydrogenase (LDH) levels. Correlation analysis revealed, there was a positive association between aspartate aminotransferase (AST) and LDH ( r = 0.84, P < 0.001); a positive correlation between the number of affected systems and the percentage of neutrophils (N%, r = 0.73, P = 0.001); a positive correlation between the duration of medication and the number of affected systems ( r = 0.82, P < 0.001) and N% ( r = 0.75, P = 0.001); and a negative correlation between treatment duration and lymphocyte percentage (LYM%, r =-0.76, P = 0.001). Conclusions:The main source of Brucella melitensis infection in Xinjiang is sheep, and contact with cattle can also cause Brucella melitensis infection. Brucella melitensis patients are more common in middle-aged males. The clinical manifestations are diverse and atypical; N% and LYM% are correlated with the number of affected systems.

Hepatitis B virus（HBV）infection remains a major global public health challenge. Over the past three decades，significant progress has been made in HBV prevention and control，including the widespread implementation of hepatitis B vaccination and mother-to-child transmission（MTCT）blockade strategies，advancements in antiviral therapies，and improvements in public health awareness. The extensive administration of hepatitis B vaccines has markedly reduced the incidence of new infections. The development of antiviral treatments，such as nucleos（t）ide analogues，has effectively suppressed viral replication，thereby decreased the incidence of liver cirrhosis and hepatocellular carcinoma. Furthermore，enhanced public health awareness and the implementation of screening programs have enabled earlier diagnosis and treatment for more patients. Nevertheless，the complete elimination of hepatitis B continues to face challenges. Firstly，inadequate vaccine coverage，particularly in low- and middle-income countries，sustains the risk of HBV transmission. Secondly，suboptimal diagnosis and treatment rates persist among individuals with chronic HBV infection. Additionally，the long-term management of chronic HBV carriers remains complex，necessitating continuous monitoring and personalized therapeutic strategies. This article summarizes the major achievements in the prevention and control of hepatitis B over the past 30 years，analyzes current challenges，and explores future directions. Novel vaccines，including therapeutic vaccines and mRNA-based vaccines，are demonstrating therapeutic potential in clinical trials and may offer new hope for chronic hepatitis B patients. Emerging antiviral agents，such as capsid assembly modulators and RNA interference-based therapeutics，which target distinct stages of the HBV life cycle，hold promise for achieving functional cure of hepatitis B. In conclusion，despite ongoing challenges，the complete elimination of hepatitis B remains an attainable goal through sustained innovation and global collaboration.

Objective:To analyze the liver histological characteristics and clinically related factors in inactive hepatitis B surface antigen (HBsAg) carriers (IHC), and also explore whether antiviral treatment is necessary for IHC, as defined in the 2022 version of the hepatitis B prevention and treatment guidelines.Methods:A multicenter, retrospective cohort study was conducted. Two hundred and thirty-one IHC cases who underwent liver biopsy histopathological examination in nine medical institutions, including Beijing Youan Hospital affiliated with Capital Medical University, from January 2018 to December 2023 were included. General informative data, clinical serological markers, and transient elastography (TE) examination results were collected. Patients were divided into a positive (148 cases) and a negative group (83 cases) according to the results of hepatitis B virus (HBV) DNA detection. The differences in liver pathological inflammatory activity (G) and liver fibrosis stage (S) were analyzed between the two groups to explore the correlation between liver tissue conditions and clinically related factors. Comparsions of normally distributed continwous data, skeukd continuous data, and categorical data between groups are performed using t tests, Mann-Whitney U tests and χ2 tests, respectively. Results:The age of 231 IHC cases was 43 (38, 51) years old, with 95.2% (220/231) aged ≥30 years, and males accounted for 64.9% (150/231). HBsAg and HBV DNA levels were 131.9 (20.8, 400.9) IU/mL and 94.0 (0, 448.5) IU/mL, respectively, of which 35.9% (83/231) were HBV DNA negative (<20 IU/mL). The remarkable proportions of G≥2, S≥2, and liver injury (G≥2 and/or S≥2) in liver tissue were 16.5% (38/231), 29% (67/231), and 35.9% (83/231), respectively. The S≥2 proportion was significantly higher in the HBV DNA-negative group than the positive group (42.2% vs. 21.6%, P<0.001), and it mainly occurred in the population cohort over 30 years old (44.9% vs. 31.0%, P=0.04). The liver stiffness measurement (LSM), aspartate transaminase to platelet ratio index (APRI), and platelet (PLT) were significantly higher in the S≥2 group than the S<2 group ( P<0.05). Conclusion:Clinicians can comprehensively evaluate the degree of liver fibrosis in IHC based on clinical factors such as age, PLT, APRI, and LSM, even if the liver histological results are lacking. The China 2022 version guidelines define that nearly half of IHC has histological indications for antiviral therapy, and liver biopsy and prompt treatment can be recommended.