Drug-associated IgA nephropathy(DA-IgAN)is an important subtype of secondary IgA nephropathy(sIgAN),with insidious clinical manifestations and highly overlapping pathological features with primary IgA nephropathy(IgAN),leading to a high risk of misdiagnosis.The disease's pathogenesis is complex and involves a variety of drugs.Non-steroidal anti-inflammatory drugs and antibiotics were the most common in the past.Recent studies have revealed that a variety of drugs[such as tumor necrosis factor-α(TNF-α)inhibitors,interleukin-12/interleukin-23(IL-12/IL-23)inhibitors,immune checkpoint inhibitors(ICIs),cytotoxic T-lymphocyte associated antigen 4(CTLA-4)inhibitors,oral anticoagulants,thiourea derivatives,and anti-vascular endothelial growth factors]may trigger or aggravate IgAN through different mechanisms.This article summarizes the pathogenic drugs,mechanisms,diagnosis,and treatment progress of drug-induced IgAN,providing some evidence for improved clinical diagnosis and management.

Drug-associated IgA nephropathy(DA-IgAN)is an important subtype of secondary IgA nephropathy(sIgAN),with insidious clinical manifestations and highly overlapping pathological features with primary IgA nephropathy(IgAN),leading to a high risk of misdiagnosis.The disease's pathogenesis is complex and involves a variety of drugs.Non-steroidal anti-inflammatory drugs and antibiotics were the most common in the past.Recent studies have revealed that a variety of drugs[such as tumor necrosis factor-α(TNF-α)inhibitors,interleukin-12/interleukin-23(IL-12/IL-23)inhibitors,immune checkpoint inhibitors(ICIs),cytotoxic T-lymphocyte associated antigen 4(CTLA-4)inhibitors,oral anticoagulants,thiourea derivatives,and anti-vascular endothelial growth factors]may trigger or aggravate IgAN through different mechanisms.This article summarizes the pathogenic drugs,mechanisms,diagnosis,and treatment progress of drug-induced IgAN,providing some evidence for improved clinical diagnosis and management.

Objective:To investigate the changes in the white matter fiber structure of fetal brain with mild to moderate isolated ventriculomegaly (IVM) using diffusion tensor imaging (DTI) model and fixed based analysis (FBA) method of diffusion MRI (dMRI).Methods:This was a case-control study. Twenty fetuses diagnosed with mild to moderate IVM who were admitted to the Provincial Hospital Affiliated to Shandong First Medical University from August 2022 to August 2023 were included prospectively as the IVM group, with gestational age ranging from 24 to 36 (29.9±3.6) weeks. The control group included 22 normal control fetuses obtained from the dMRI atlas data of Chinese fetal brain, with gestational age ranging from 24 to 36 (30.2±3.7) weeks. The dMRI data were collected for all fetuses and the DTI model was used to obtain fractional anisotropy (FA), mean diffusivity, axial diffusivity, and radial diffusivity of 7 main fiber bundles, including the genu and splenium of the corpus callosum, middle cerebellar peduncle, bilateral cortico-spinal tract, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and anterior thalamic radiation. The FBA method was used to obtain fiber density (FD), fiber cross-sectional area (FC), and fiber density and cross-section (FDC) of the whole brain. The comparison of DTI parameters of each fiber bundle between the two groups was conducted using independent sample t test or Mann-Whitney U test. The comparison of FBA parameters between the two groups was performed using covariance analysis, and the MRtrix3 software package was used to display the brain regions with significant differences. Results:The FA values of the inferior longitudinal fasciculus in the IVM group and the control group were 0.142±0.012 and 0.133±0.015, respectively, and the difference was statistically significant ( t=2.21, P=0.033), while the DTI parameters of the other fiber bundles showed no statistically significant differences ( P>0.05). The whole brain FBA results showed that compared with the control group,FD decreased while FC increased in the corpus callosum, fornix, and sagittal stratum in IVM fetuses, while FDC decreased in the cortico-spinal tract. Conclusion:There are microstructural changes of the brain white matter fiber in intrauterine fetuses with mild to moderate IVM, which are mainly located in the white matter fiber bundles surrounding the body, atrium, and temporal horn of the lateral ventricle.

A case control study including 45 acute pancreatitis and 44 healthy volunteers was performed to investigate the association between intestinal microbial community and acute pancreatitis. High-throughput 16S rRNA gene amplicon sequencing was used to profile the microbiological composition of the samples. In total, 27 microbial phyla were detected and the samples of pancreatitis patients contained fewer phyla. Samples from acute pancreatitis patients contained more Bacteroidetes and Proteobacteria and fewer Firmicutes and Actinobacteria than those from healthy volunteers. PCoA analyses distinguished the fecal microbial communities of acute pancreatitis patients from those of healthy volunteers. The intestinal microbes of acute pancreatitis patients are different from those of healthy volunteers. Modulation of the intestinal microbiome may serve as an alternative strategy for treating acute pancreatitis.

Objective To evaluate the images of MRCP acquired by adjusting 0.3 Tesla MR unit heavy T 2-weighted scanning parameters and altering scanning angle and diagnostic correctivity to biliary obstructive disease.Methods Routine MR T 1WI,T 2WI scanning were performed axial in 50 cases of patients with biliary obstruction.All of them were divided into two groups,20 cases of them were scanned coronal with FSE T 2-weighted fixed parameters,30 cases of them were scanned with altering scanning angle,increasing scanning slices,decreasing distance of two near slices,reducing signal collection times(NSA),shortening scanning time.Results The acquired images through adjusting FSE T 2-weighted scanning parameters were visualized clearly.The boundary of cholangiopancreatie ducts were showed clearly.The display rate of biliary and pancreatie ducts was elevaled from 20% to 83.3%.The accuracy of it for evaluating the causes of obstruction was increased from 88.9% to 93.3%.The accuracy of it in the detection of the location of bile duct obstruction was 100%.Conclusion Through adjusting scanning purameters low field MRCP is very helpful in improved images quality and reflecting veliable signs of biliary and pancreatie duct obstruction disease combined with MRI T 1-weighted T 2-weighted message.This method can increased the diagnostic accuracy of the causes of obseruction and supply the reliable ground for clinical treatment.