Objective: To investigate the regional differences in the incidence of urothelial carcinoma among kidney transplant recipients between northern and southern China，so as to provide reference for early diagnosis of this disease. Methods: A comprehensive search was conducted across multiple databases，including CNKI，Wanfang，CBM，and PubMed，using the keywords “kidney transplantation” and “tumor” to collect clinical data from qualified kidney transplant centers.The latest and most complete literature data published by 17 transplant centers in northern China and 14 in southern China were included.Statistical analyses were performed to compare the incidence of post-transplant urothelial carcinoma and non-urothelial malignancies. Results: A total of 37 475 kidney transplant recipients were included，among whom 837 (2.23%) developed post-transplant malignancies，including urothelial carcinoma (366/837，43.73%)，non-urothelial carcinoma (444/837，53.05%)，and malignancies with unspecified pathology (27/837，3.23%).The incidence of malignancies was significantly higher in northern China than in southern China [(2.82±1.39)% vs. (1.67±0.83)%，P=0.011]，with a particularly pronounced difference in the incidence of urothelial carcinoma [(1.68±1.12)% vs. (0.32±0.32)%，P<0.001].No significant difference was observed in the incidence of non-urothelial carcinoma between the two regions [(1.11±0.56)% vs. (1.35±0.65)%，P=0.279].Additionally，female transplant recipients exhibited a higher incidence of malignancies than males in both regions (southern China：2.38% vs. 1.80%; northern China：8.93% vs. 2.52%). Conclusion: The incidence of urothelial carcinoma following kidney transplantation is significantly higher in northern China than in southern China，underscoring the importance of implementing regular tumor screening for kidney transplant recipients，particularly for female patients in northern China，to facilitate early diagnosis and timely intervention.

Objective To investigate the behavioral changes and monoamine neurotransmitter levels in a rat model of chronic unpredictable mild stress(CUMS)-induced depression and explore the potential effects of Vitamin B12(VitB12)on CUMS model rats and the underlying mechanisms.Methods A total of 72 Sprague-Dawley(SD)rats were randomly assigned to 3 groups,a control group,a CUMS group(subjected to three weeks of CUMS),and a CUMS+VitB12 group(CUMS rats receiving microinjections of VitB12 in the neck).The body mass of the rats was measured,and behavioral assessments were conducted using the sucrose preference test,open field test,and forced swimming test.High-performance liquid chromatography(HPLC)was used to analyze the levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA),in each group of rats.Hematoxylin-eosin(HE)staining was performed to observe pathological changes in hippocampal neurons.Western blot was performed to detect the expression of signal pathway-related proteins,including brain-derived neurotrophic factor(BDNF),tropomyosin receptor kinase B(TrkB),and cyclic adenosine monophosphate(cAMP)response element-binding protein(CREB)in the hippocampal tissue.Results Starting from week 5,rats in the CUMS group exhibited lower average body mass compared to the control group,while the CUMS+VitB12 group showed a significant increase in body mass compared to the CUMS group(P＜0.05).At weeks 3 and 6,sucrose preference of rats in the CUMS group was significantly lower than that in the control group(P＜0.001).At week 3,sucrose consumption in the CUMS+VitB12 group was significantly higher than that in the CUMS group(P＜0.01),with a more pronounced increase observed in week 6(P＜0.001).Starting from week 4,the CUMS group showed reduced scores in grid crossing,grooming,and rearing activities in the open field test compared to the control group,indicating reduced locomotor activity and exploratory behavior(P＜0.001).The CUMS+VitB12 group showed improved behavioral performance compared to the CUMS group(P＜0.01,P＜0.001).In the forced swimming test at weeks 3 and 6,the immobility time of rats in the CUMS group was significantly longer than that in the control group(P＜0.01).At week 6,the immobility time of rats in the CUMS+VitB12 group was significantly shorter compared to that of the CUMS group(P＜0.01).HPLC results showed that the levels of 5-HT,NE,and DA in the cerebral cortex of rats in the CUMS group were significantly lower than those in the control group(P＜0.01,P＜0.001),while these neurotransmitter levels were significantly higher in the CUMS+VitB12 group compared to those in the CUMS group(P＜0.05,P＜0.01).HE staining results showed that the number of hippocampal cells in the CUMS group was significantly reduced,with shrunken nuclei,while the CUMS+VitB12 group showed an increased number of neurons with intact morphology compared to the CUMS group(P＜0.05).Western blot analysis showed that the expression levels of BDNF,TrkB,and CREB proteins in the hippocampus were significantly lower in rats in the CUMS group than those in the control group(P＜0.05),while the expression levels of BDNF,TrkB,and phosphorylated CREB(p-CREB)were significantly higher in the CUMS+VitB12 group compared to the CUMS group(P＜0.05).Conclusion In CUMS rats,the levels of monoamine neurotransmitters(5-HT,NE,and DA)in the cerebral cortex of the brain are decreased,accompanied by a decrease in neuronal cells,which results in anxiety-and depression-like behaviors.VitB12 can upregulate the levels of these neurotransmitters,ameliorate the cytopathological conditions,and regulate the BDNF/TrkB/p-CREB signaling pathway,thereby alleviating depressive symptoms.

Objective To investigate the predictive value of serum 25-hydroxyvitamin D[25(OH)D]level in early renal transplantation for acute rejection(AR).Methods A total of 324 renal transplant recipients from January 2019 to August 2022 in the Second People's Hospital of Shanxi Province were selected.The clinical data of the recipients were collected.The levels of serum 25(OH)D,parathyroid hormone(PTH),and calcium,phosphorus in early(within 1 month)transplantation were detected by chemiluminescence immunoassay and colorimetry,respectively.The detection season was recorded,and the occurrence of AR within 1 year after renal transplantation was observed.The 25(OH)D level ≥ 20ng/ml was defined as normal,≥ 12 ng/ml～＜20 ng/ml as insufficient and＜12ng/ml as deficient,they were divided into of 25(OH)D normal group(n=106),insufficient group(n=112)and deficient group(n=106).According to the occurrence of AR,they were divided into AR group(n=51)and non-AR group(n=273).The basic situation of serum 25(OH)D level was analyzed.The differences in serum PTH,calcium,phosphorus levels and seasons as well as AR incidence among the three groups of 25(OH)D were compared.Multivariate logistic regression was used to analyze the influencing factors of AR,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 25(OH)D level for AR.Results The incidence of serum 25(OH)D deficiency or insufficiency was 67.28％(218/324).In the 25(OH)D normal group,insufficient group and deficiency group,the serum PTH levels were 75.44(46.42,113.23)pg/ml,78.29(58.27,152.10)pg/ml and 86.84(54.64,127.3)pg/ml,and the incidences of AR were 2.47％(8/324),6.17％(20/324)and 7.10％(23/324),respectively.All of them were the highest in the deficiency group and the lowest in the normal group,and the differences were significant(H=6.784,x2=8.580,all P＜0.05).Additionally,25(OH)D deficiency(OR=3.340,95％CI:1.409～7.916),25(OH)D insufficiency(OR=2.442,95％CI:1.006～5.925)and human leucocyte antigen(HLA)mismatch(4～6)(OR=2.117,95％CI:1.027～4.363)were independent risk factors for AR(all P＜0.05).The area under the curve(AUC)of serum 25(OH)D level in predicting AR was 0.702(95％CI:0.625～0.779),the optimal cut-off value was 13.59 ng/ml,the specificity and the sensitivity were 66.7％and 65.6％,respectively.Conclusion In this study,25(OH)D deficiency(＜12ng/ml)or insufficiency(≥ 12～＜20ng/ml)was an independent risk factor for AR,and serum 25(OH)D level may have a certain predictive value for AR.

Objective To evalutate changes in laboratory indicators and clinical efficacy of roxadustat(Rox)in treating anemia patients after advanced kidney transplantation.Methods A retrospective analysis of 101 patients with anemia after kidney transplantation admitted to the Center of Kidney Diseases and Hemodialysis of Shaanxi Provincial People's Hospital from March 2020 to March 2023 was performed.Among them 48 cases were treated with roxadustat(Rox group)and 53 cases were treated with recombinant human erythropoietin(rhEPO)(rhEPO group).Both groups were treated with polyferose,methycobal and folic acid.The change of red blood cell(RBC),hemoglobin(Hb),erythropoietin(EPO),serum ferrin(SF),transferrin saturation(TSAT),and hepcidin(HePc),tacrolimus trough concentration(Tac CO),cyclosporine A trough concentration(CsA CO),mycophenolic acid area under curve(MPA-AUC),lymphocyte(Lym),T lymphocyte subgroup Th/Ts ratio(Th/Ts),serum creatinine(Scr)and blood urea nitrogen(BUN)were observed in the 1st,3rd and 6th month after treatment respectively.The incidence of side effect induce by medicine during 6 months between the two groups were analysed.Results Before the beginning treatment,there was no significant difference in RBC,Hb,EPO,SF,TSAT,HePc,Tac CO,CsA CO,MPA-AUC,Lym,Th/Ts,Scr and BUN between the two groups and the differences were not statistisally significant(t=-0.319～2.024,all P＞0.05).After the 1st,3rd and 6th month of treatment,the RBC,Hb,EPO,SF,TSAT of the two groups of patients were increased compared to before treatment,while HePc was decreased compared to before treatment,and there were significant differences within the groups(F=234.890,219.907;256.171,201.231;138.023,89.247;92.89,215.780;189.198,179.092;112.132,76.127,all P＜0.05).The RBC,Hb and SF levels in the Rox group were higher than those in the rhEPO group(F=9.672,8.165,139.360),while EPO and HePc levels were lower than those in the rhEPO group(F=124.437,78.147),and the differences were significant(all P＜0.05).There was no significant difference in TSAT between the two groups(F=7.118,P=0.119).Tac CO,CsA CO,MPA-AUC,Lym,Th/Ts showed no significant changes between groups compared to before treatment,the Scr and BUN showed a slight increase compared to before treatment,but there were no statistically significant differences in intra group and between two groups comparisons(F=0.665,1.167,1.097,1.343,5.219,0.696,1.106,all P＞0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(x2=0.083,P=0.773).Conclusion Roxadustat has better clinical efficacy in the treatment of patients with anemia after kidney transplantation,which can effectively improve anemia and regulate iron metabolism in the body.There is no significant impact on the immune status of the transplant recipients,and the transplanted kidney function is stable and safe.

The incidence of intracranial aneurysms is higher in population, and the death and disability rates after rupture are extremely high. Early detection of intracranial aneurysms, prediction of rupture risk, operation program, and evaluation of treatment outcomes are all the clinical concerns. With the continuously deepening integration of artificial intelligence technology and medicine, its application in the diagnosis and treatment of intracranial aneurysms is becoming increasingly widespread. This article reviews the current application status of artificial intelligence technology in the diagnosis and treatment of intracranial aneurysms.

OBJECTIVE: Our study aimed to conduct genomic characterization of Salmonella strains carrying the bla _NDM-1 gene in the intestinal tract of healthy individuals. The objectives were to underscore the importance of genomic surveillance for drug resistance in both commensal and pathogenic bacteria among healthy populations, and to establish protocols for regulating drug resistance plasmids based on the completion of a comprehensive map of drug resistance plasmid genomes. METHODS: We performed antimicrobial susceptibility testing and employed second- and third-generation sequencing techniques to analyze Salmonella strains harboring the bla _NDM-1 gene, to surveil drug-resistant bacteria in the intestines of healthy subjects. Sequence comparison was conducted using both core- and pan-genome approaches. Concurrently, conjugation experiments were carried out to assess the efficiency of plasmid transfer. RESULTS: We isolated a carbapenem-resistant Salmonella enterica serovar Typhimurium strain from a healthy food worker in China. This strain harbored an IncHI2/IncHI2A plasmid carrying bla _NDM-1 along with multiple antibiotic resistance genes (ARGs). Our findings highlight the potential for asymptomatic carriers to facilitate the transmission of ARGs. Pan-genomic analysis revealed that bla _NDM-1-positive plasmids could traverse bacterial species barriers, facilitating cross-host transmission. CONCLUSION This study marks the first detection of bla _NDM-1 in Salmonella strains isolated from healthy individuals. We underscore the risk associated with the transmission of conjugative hybrid plasmids carrying bla _NDM-1, which have the potential to be harbored and transmitted among healthy individuals. Enhanced surveillance of drug-resistant pathogens and plasmids in the intestinal microbiota of healthy individuals could provide insights into the risk of ARG transmission and pathways for population-wide dissemination via ARG transfer factors.
beta-Lactamases/genetics* ; Plasmids/genetics* ; Humans ; Anti-Bacterial Agents/pharmacology* ; China ; Microbial Sensitivity Tests ; Salmonella typhimurium/isolation & purification* ; Salmonella/isolation & purification* ; Salmonella Infections/microbiology*

So far, the endovascular treatment of intracranial aneurysms has gone through three stages: coil embolization, stent-assisted coil embolization, and placement of flow diverter, which significantly increases the occlusion rate of intracranial aneurysms. Its safety and effectiveness have also been confirmed by many large-scale studies. However, for wide-neck bifurcation aneurysms, there are still issues of difficult treatment and poor treatment outcome. The emergence of intratumoral turbulence devices has provided a new treatment option for wide-neck bifurcation aneurysms and has achieved good short- and mid-term treatment effects. This article reviews the application of the Woven EndoBridge intratumoral turbulence device in intracranial wide-neck bifurcation aneurysms.

Objective:To assess the efficacy of Tamsulosin monotherapy for overactive bladder(OAB)symptoms in benign prostatic hyperplasia(BPH)patients with the prostate volume(PV)<40 ml, and to analyze related factors affecting the efficacy.Methods:300 BPH patients with OAB were enrolled, with an average age of(66.9±7.7)years and the PV<40 ml.Smoking, drinking and other living habits were investigated.Data on the Overactive Bladder Symptom Score(OABSS), International Prostate Symptom Score(IPSS)and Quality of Life Scale(QOLS)were collected before and after 4 weeks of treatment with Tamsulosin 0.2 mg QN.The maximum urine flow rate(Qmax)and bladder residual urine volume(PVR)were measured before and after treatment.OBASS was used as the main assessment parameter to analyze the correlation of efficacy with age, lifestyle, pre-treatment symptom scores, PV, Qmax and PVR.Results:257 patients completed the study, and 169 patients were treated effectively, with an overall effectiveness rate of 65.8%.The effectiveness rates of the mild, moderate and severe OAB groups were 83.6%, 62.4% and 38.5%, respectively, with statistical significance( χ2=13.037, P=0.001).3 patients showed adverse drug reactions, including 2 patients with mild dizziness and 1 patient with nausea.The baseline OABSS score, the proportion of smoking patients and the proportion of drinking patients in the effectively treated OAB group were significantly lower than those in the ineffectively treated group.Multivariate analysis showed that baseline OABSS score( OR=0.735, P<0.001)and smoking( OR=2.111, P=0.029)were correlated with tamsulosin's efficacy in treating BPH patients with OAB with PV<40 ml. Conclusions:The effectiveness rate of Tamsulosin for the treatment of BPH patients with mild OAB with PV<40 ml is high.The baseline OABSS score and smoking are factors affecting the efficacy of Tamsulosin on OAB symptoms in these patients.

Objective:To investigate the clinical features, diagnosis, treatment and prognosis of primary urethral carcinoma.Methods:The clinical and follow-up data of 12 patients with primary urethral carcinoma admitted to Beijing Hospital from July 2016 to December 2020 were retrospectively analyzed.Results:There were four males and eight females, with an average age of 66.3(53~75)years.Nine patients underwent magnetic resonance examination before operation, and eight patients presented with abnormal urethral signals.The clinical stage of female patients was generally later than those of male patients, and all patients received surgical treatment.Four male patients did not receive post-operative adjuvant treatment, and all of them attained disease-free survival.Among the eight female patients, four patients received postoperative adjuvant radiotherapy or chemotherapy, five patients had recurrence or metastasis during follow-up, and two patients died.Conclusions:The clinical stage of female urethral cancer is later than that of male.MRI examination is beneficial to the determination of local invasion of urethral cancer.For female proximal urethral cancer and male posterior urethral cancer, radical resection has a good therapeutic effect.

Objective:To examine whether multiple-course prophylactic intravesical instillation chemotherapy is superior to single-course chemotherapy in preventing bladder tumor recurrence after radical nephroureterectomy(RNU)for primary upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the PubMed, Wanfang Data and China National Knowledge Infrastructure and all publications before March 2021 about clinical trials comparing the effects of single-course and multiple-course prophylactic intravesical instillation chemotherapy after RNU for UTUC were retrieved.Analysis was performed using Stata/SE 12.0.Results:Seven trials included a total of 998 patients, with 473 participants receiving multiple-course and 525 receiving single-course intravesical instillation chemotherapy.Bladder cancer recurrence occurred in 69 out of 473 patients(14.6%)with multiple-course chemotherapy and in 123 out of 525 patients(23.4%)with single-course chemotherapy.The absolute risk reduction was 8.8% and the relative risk reduction was 37.6%.Compared with a single-course instillation, the pooled OR of bladder cancer recurrence was 0.55(95% CI: 0.40-0.76, P<0.001)for multiple-course instillations.No serious adverse events were reported. Conclusions:Compared with single-course instillation chemotherapy, multiple-course prophylactic intravesical instillation chemotherapy significantly decreases the risk of bladder cancer recurrence in primary UTUC patients treated with RNU, indicating multiple intravesical instillation chemotherapy is superior to single instillation chemotherapy.