1.Diagnostic value of serum Mac-2 binding protein for the severity of schistosomiasis-induced liver fibrosis
Jun WU ; Meiqun LUO ; Shuying XIE ; Ronghua ZHU ; Hui XU ; Long TANG ; Fei HU ; Sheng DING
Chinese Journal of Schistosomiasis Control 2026;38(1):38-43
Objective To evaluate the value of serum Mac-2 binding protein (M2BP) for assessment of the severity of schisto somiasis-induced liver fibrosis, so as to provide insights into non-invasive diagnosis and disease surveillance of liver fibrosis caused by schistosomiasis. Methods A total of 234 individuals with a history of Schistosoma japonicum infection were sampled from Xinhua Village, Lushan City, Jiangxi Province from 2019 to 2020, and 234 serum samples were collected from all participants. All participants received B-ultrasound examinations of the liver. Serum samples were categorized into four groups (grades 0, Ⅰ, Ⅱ and Ⅲ schistosomiasis-induced liver fibrosis groups) according to B-ultrasound examination results, and then, each group was randomly divided into a receiver operating characteristic (ROC) curve group and an efficacy assessment group at a ratio of 7∶3. Serum M2BP concentration was measured in four groups using the enzyme-linked immunosorbent assay (ELISA), and differences in serum M2BP concentrations were compared with analysis of variance and Spearman correlation analysis. Serum M2BP concentration was subjected to ROC curve analysis among individuals with different grades of schistosomiasis-induced liver fibrosis in the ROC curve group to determine the optimal diagnostic threshold of M2BP concentration at different fibrosis grades, and the area under the ROC curve (AUC) was calculated to evaluate the diagnostic performance. The diagnostic accuracy was verified by comparing the accordance rate and Kappa consistency test in the efficacy assessment group. Results Among 234 serum samples, there were 79 samples with grade 0 schistosomiasis-induced liver fibrosis, 87 samples with Grade Ⅰ, 46 samples with Grade Ⅱ and 22 samples with Grade Ⅲ according to the B-ultrasound examinations. The mean serum M2BP concentrations were (0.40 ± 0.31) [95% confidence interval (CI): (0.33, 0.47)], (0.64 ± 0.48) [95% CI: (0.53, 0.74)], (1.76 ± 0.58) [95% CI: (1.59, 1.93)] μg/mL and (2.56 ± 0.93) [95% CI: (2.14, 2.97)] μg/mL in the four groups, respectively (F = 150.796, P < 0.001), and the severity of schistosomiasis-induced liver fibrosis significantly positively correlated with serum M2BP concentration (rs = 0.715, P < 0. 001). The sample sizes of grades 0, Ⅰ, Ⅱ and Ⅲ schistosomiasis-induced liver fibrosis sera were randomly allocated as follows: 55 versus 24, 61 versus 26, 32 versus 14, and 15 versus 7 in the ROC curve and efficacy assessment groups, respectively, and the serum M2BP concentrations were (0.39 ± 0.29) μg/mL and (0.42 ± 0.36) μg/mL (F = 0.196, P > 0.05), (0.59 ± 0.47) μg/mL and (0.75 ± 0.51) μg/mL (F = 1.967, P > 0.05), (1.73 ± 0.59) μg/mL and (1.85 ± 0.57) μg/mL (F = 0.417, P > 0.05), and (2.46 ± 0.64) μg/mL and (2.76 ± 1.41) μg/mL (F = 0.491, P > 0.05), respectively. ROC curve analysis showed that the optimal diagnostic thresholds of serum M2BP concentration were 0.347 86 μg/mL (AUC = 0.635, P < 0.05), 1.188 83 μg/mL (AUC = 0.938, P < 0.000 1) and 2.021 21 μg/mL (AUC = 0.821, P < 0.000 1) for grade Ⅰ, Ⅱ and Ⅲ schistosomiasis-induced liver fibrosis. In addition, the accordance rates between the optimal diagnostic threshold of serum M2BP and B-ultrasound examinations for predicting grade Ⅰ, Ⅱ and Ⅲ schistosomiasis-induceed liver fibrosis were 69.23%, 85.71% and 71.43% (χ2 = 1.340, P > 0.05), and the overall Kappa consistency test showed moderate consistency [Kappa = 0.608, 95% CI: (0.428, 0.788); Z = 6.609, P < 0.000 1]. Conclusions Serum M2BP may serve as a potential biomarker for assessing moderate to advanced schistosomiasis-induced liver fibrosis; however, its diagnostic value for early-stage schistosomiasis-induced liver fibrosis remains limited.
2.Comparative analysis of the characteristics of imported malaria cases in Nanning City in 2024 and the same period of the previous year
Shu-lin WEI ; Zhi-qiang QU ; Yuan-yuan LUO ; Yan-cui HUANG ; Shu-qin DIAO ; Xue LI ; Sheng-long YANG ; Xiao-yu HUANG ; Mi-fang LUO
Acta Parasitologica et Medica Entomologica Sinica 2026;33(2):81-84
Objective To investigate the epidemiological characteristics of malaria and provide a basis for developing improved prevention and control measures. Methods Data were obtained from the Chinese Disease Prevention and Control Information System. Malaria surveillance data for Nanning City from January 1,2023, to December 31,2024, were exported from the Infectious Disease Reporting Information Management Subsystem. The characteristics of the two groups of malaria cases were compared. Results A total of 103 imported malaria cases were reported in Nanning City in 2024, representing a 38.32% decrease compared with the same period of the previous year. No statistically significant difference were observed between cases reported in 2023 and 2024 in terms of average age, gender ratio, proportion of parasite species, and monthly reporting distribution;however, statistically significant differences were found in the proportion of reporting areas and current residence areas(χ2= 13.572 and 10.355, respectively; P = 0.001 and 0.035, respectively). The proportion of cases reported in Shanglin County and the proportion of cases residing in Shanglin County were both lower than those during the same period of the previous year. Conclusions The high aggregation of imported malaria cases in Nanning City has decreased. Medical institutions in areas other than Shanglin County should strengthen their vigilance against malaria.
3.Effects and Regulation of Glycosylation Modifications on G Protein-coupled Receptor Function
Fang-Ming WU ; Sheng-Long LING ; Pan SHI ; Yu SUN ; Chang-Lin TIAN
Progress in Biochemistry and Biophysics 2026;53(9):2352-2364
Glycosylation constitutes a critical, highly intricate, and diverse co- and post-translational modification characterized by the covalent attachment of sugar moieties to proteins, lipids, or small RNAs. Complex glycans are ubiquitously present across nearly all living organisms. Despite their prevalence, our comprehension of glycan diversity remains limited, likely due to the inherent challenges associated with elucidating their structural complexity. Among post-translational modifications, protein glycosylation is notably prevalent, involving the enzymatic transfer of oligosaccharides to specific amino acid residues by glycosyltransferases. This modification plays a pivotal role in modulating protein function, including participation in various biological and biochemical recognition processes. G protein-coupled receptors (GPCRs), encoded by approximately one thousand genes, share a conserved architecture comprising seven transmembrane helices interconnected by three intracellular and three extracellular loops. Representing the largest family of human membrane proteins, GPCRs regulate a vast array of physiological and pathological processes, thereby constituting the most extensive class of therapeutic targets. In mammalian systems, the majority of GPCRs undergo glycosylation predominantly at their extracellular N-terminus or extracellular loops, primarily through N-linked and O-linked glycosylation. These covalent carbohydrate modifications exert profound effects on multiple facets of GPCR biology, including endoplasmic reticulum folding and quality control, membrane trafficking and surface expression, receptor internalization and recycling or degradation, ligand binding and signal transduction, biased signaling, and receptor dimerization. Notably, glycosylation can exert both positive and negative regulatory influences on these processes. Dysregulation of GPCR glycosylation has been implicated in a range of pathological conditions, such as cancer, diabetes, and neurological disorders, underscoring its physiological and pathological significance. Aberrant glycosylation patterns may lead to dysfunctional receptor signaling, thereby contributing to disease progression. Consequently, elucidating the precise roles of glycosylation in GPCR function not only enhances fundamental understanding of receptor biology but also facilitates the development of novel therapeutic strategies targeting glycosylation pathways or specific GPCR glycoforms. Although the functional consequences of glycosylation have been investigated for several decades, delineating their exact structural underpinnings has remained challenging due to the intrinsic flexibility and heterogeneity of carbohydrate structures. Recent advances in structural biology, particularly single-particle cryo-electron microscopy (cryo-EM) and X-ray crystallography, have catalyzed a paradigm shift in our understanding of GPCR glycosylation. The integration of these sophisticated structural techniques with biochemical approaches has redefined glycosylation as a complex structural element integral to receptor function. These developments provide a molecular framework for comprehending how glycans influence receptor pharmacology and open new avenues for the rational design of glyco-engineered biologics and allosteric modulators targeting specific extracellular motifs. This mini-review concentrates on glycosylation within the GPCR superfamily, summarizing the impact of glycosylation modifications on receptor function and regulatory mechanisms, recent progress in the structural biology of GPCR glycosylation, and prospective directions for future research in this field.
4.Relationship between frailty and acute kidney injury after hip fracture surgery in the elderly
Shu-Jun YE ; Kai-Hong ZHANG ; Xiao-Man SUN ; Huan-Kai ZHANG ; Zhi-Liang HUANG ; Duo YANG ; Long-Sheng ZHANG
Medical Journal of Chinese People's Liberation Army 2025;50(7):831-838
Objective To analyze the relationship between frailty and acute kidney injury(AKI)after hip fracture surgery in the elderly.Methods A total of 405 elderly patients who underwent hip fracture surgery in Jieyang People's Hospital from August 2021 to January 2023 were retrospectively analysed.According to the modified frailty index(mFI),they were divided into frail group(mFI≥0.27,n=112)and non-frail group(mFI<0.27,n=293).Postoperative AKI was defined according to the Kidney Disease:Improving Global Outcomes(KDIGO)criteria.After 1:1 propensity score matching(PSM),100 cases in each group were successfully matched.Univariable and multivariable logistic regression models,propensity score adjustment,PSM,inverse probability of treatment weighting(IPTW),standardized mortality ratio weighting(SMRW),pairwise algorithm(PA)weighting,and overlap weighting(OW)methods were used to analyze the relationship between frailty and postoperative AKI.Stratified analyses were performed according to age(≥80 or<80 years),gender,whether angiotensin-converting enzyme inhibitors(ACEI)/angiotensin Ⅱreceptor antagonists(ARB)were used,and whether intraoperative hypotension occurred.Results After PSM,there were no significant differences between the two groups in age,sex,surgical type,ACEI/ARB,blood urea nitrogen,serum creatinine,intraoperative blood loss,and intraoperative hypotension[standardized mean difference(SMD)<0.1].In both the original cohort and the matched cohort,the incidence of AKI was higher in frail group than in non-frail group(25.9%vs.8.9%,P<0.001;28.0%vs.11.0%,P=0.002).Analysis of the risk of postoperative AKI in elderly hip fracture patients in frail group found that compared with the non-frail group,in the univariate logistic regression model the odds ratio(OR)and a 95%confidence interval(CI)for the frail group was 3.59(2.00-6.43),P<0.001,and in the multivariable logistic regression model,the OR(95%CI)for frail group was 3.04(1.55-5.95),P=0.001.After adjustment for propensity score,the OR(95%CI)for frail group was 2.85(1.52-5.34),P=0.001,and the OR(95%CI)for frail group after PSM was 3.15(1.47-6.75),P=0.003.After IPTW,SMRW,PA weighting,and OW,the OR(95%CI)for frail group were 2.48(1.37-4.50),2.43(1.41-4.19),2.63(1.25-5.54),and 2.69(1.07-6.78),respectively,with P<0.05.The interaction tests were not statistically significant for age,sex,use of ACEI/ARB,and intraoperative hypotension(P>0.05).Conclusion In elderly patients with hip fractures,preoperative frailty may be a risk factor for postoperative AKI.
5.Molecular mechanism and therapeutic strategies of necrotic apoptosis in Alzheimer's disease
Zhi-Cheng LU ; Li-Na TANG ; Sheng-Long MO ; Cheng-Min YANG ; Chong-Dong JIAN ; Jing-Wei SHANG
Acta Anatomica Sinica 2025;56(2):239-247
This review delves into the pivotal role of necrotic apoptosis in Alzheimer's disease(AD),with a focus on treatment strategies,drug development,prospects,and challenges,highlighting its significance in the progression of the disease.Firstly,necrotic apoptosis plays a crucial role in the pathogenesis of AD,particularly in association with the abnormal metabolism of β-amyloid(Aβ)and Tau proteins.The primary focus of drug design is to regulate the metabolism pathways of these two proteins to slow down or inhibit the progression of necrotic apoptosis.Secondly,the progress in drug development further emphasizes the importance of necrotic apoptosis in treating AD.Current research mainly focuses on drugs that affect the metabolism of Aβ and Tau proteins,such as lecanemab.Still,inconsistent result underscore the necessity for a more comprehensive understanding of the molecular mechanisms of necrotic apoptosis.Finally,the prospects and challenges of necrotic apoptosis research in AD are thoroughly discussed.A deeper understanding of necrotic apoptosis contributes to a better comprehension of the pathological mechanisms of AD but also may reveal new therapeutic targets.However,challenges such as multifactorial influences and the selection of treatment timing necessitate further in-depth research in the future.In conclusion,this review advocates for future research to deepen the understanding of the molecular mechanisms of necrotic apoptosis,enhance research on treatment strategies,gain a deeper understanding of its cross-regulation with other cell death pathways,and promote collaboration between basic research and clinical practice to advance the comprehensive understanding and treatment of Alzheimer's disease and necrotic apoptosis.
6.Extraction process optimization,component analysis and biological activity evaluation for total polyphenols from Conioselinum vaginatu
Jun-long WANG ; Hui-jie YAN ; Yong-gang LIN ; Zi-wei LI ; Wen-pan SHI ; Sheng-qi JIANG ; Bin WU ; Qin-ze GU
Chinese Traditional Patent Medicine 2025;47(5):1449-1455
AIM To optimize the extraction process for total polyphenols from Conioselinum vaginatu(Spreng.)Thell.,make component analysis,and evaluate their anti-oxidant,hypoglycemic activities.METHODS The effects of ultrasound,enzymatic hydrolysis,acid hydrolysis,alcohol extraction and hydrolysis processes on the extraction quantity of total polyphenols were investigated,respectively.With extraction temperature,extraction time,ethanol concetration and liquid-solid ratio as influencing factors,extraction quantity of total polyphenols as an evaluation index,the extraction process was optimized by response surface method.HPLC was adopted in the identification of polyphenolic composition and determination of their contents.Subsequently,total polyphenols' scavenging capacities on DPPH,ABTS,OH free radicals,total reducing power and inhibitory capacity on α-glucosidase were determined.RESULTS The highest extraction quantity of total polyphenols was observable when extraction process was employed.The optimal conditions were determined to be 62 ℃ for extraction temperature,54 min for extraction time,69%for ethanol concentration,and 50∶1 for liquid-solid ratio,the extraction quantity of total polyphenols was(9.51±0.2)mg GAE/g.Seven constituents existed in C.vaginatu,among which ferulic acid demonstrated the highest content,followed by that of myricetin,while D-tryptophan content was the lowest.At the concentration of 7.61 mg/L,total polyphenols displayed the scavenging rates on DPPH,ABTS,OH free radicals of 80.70%,85.97%,28.60%,total reducing power of 0.22,and inhibition rate on α-glucosidase of 77.23%,respectively.CONCLUSION This stable and reliable method can be used for the extraction of total polyphenols from C.vaginatum with strong anti-oxidant,hypoglycemic activities.
7.High-altitude hypoxia inhibits PPAR pathway induced ferroptosis in spleen of mice
Jiayang WANG ; Ying HU ; Yuzhen XU ; Qifu LONG ; Chaoqun TANG ; Sheng YONG
Chinese Journal of Immunology 2025;41(2):263-270
Objective:To explore molecular mechanism of high-altitude hypoxia regulates PPAR signaling pathway induced ferroptosis in spleen.Methods:Hypoxia animal model was constructed,target genes were screened and predicted by combination of transcriptomics and protein omics.Key genes in PPAR and ferroptosis pathways under hypoxia exposure were explored by GO and KEGG enrichment analysis and verified by RT-qPCR and Western blot.Results:Combination of transcriptomics and protein omics showed that 95 predicted target genes(protein)showed significantly differential expression under hypoxic exposure.GO annotation analysis and KEGG enrichment analysis showed that differential genes were mainly significantly enriched in PPAR and ferroptosis signaling pathways.A negative correlation was found between PPAR and ferroptosis signaling pathways,and GSEA showed that differential gene sets of PPAR and ferroptosis signaling pathways exhibited opposite expression trend in high-altitude hypoxia group.Validation of key genes PPARA,RXRB,APOA1 and SCD-1 in PPAR signaling pathway revealed that both mRNA and protein expres-sions were down-regulated under hypoxic exposure.Subsequently,differential expression was observed in mRNA and protein expres-sions of GPX4 in endogenous pathway and SLC7A11,TRP53 and TFRC in exogenous pathway in ferroptosis signaling pathway.Corre-lations between four key genes for ferroptosis and differential inflammation-associated genes(DE-IRGs)were positively or negatively.IL-1β,IL-6,IL-12,IL-18,IFN-γ and TNF-α expressions in spleen tissue were up-regulated under hypoxic exposure.Conclusion:High-altitude hypoxia exposure further induces ferroptosis through PPAR signaling pathway-mediated lipid metabolism disorders,and accompanied by occurrence of inflammatory response,which causes damage of spleen tissue.
8.Total knee arthroplasty assisted by 3D printing for traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture
Senlei LI ; Wei HAN ; Long CHEN ; Ning SHENG ; Jianyang LI ; Yankun LI ; Li SUN
Chinese Journal of Orthopaedic Trauma 2025;27(6):507-511
Objective:To evaluate the clinical outcomes of total knee arthroplasty (TKA) assisted by 3D printing in the treatment of traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture.Methods:A retrospective study was conducted to analyze the clinical data of the 18 patients who had been treated for traumatic osteoarthritis secondary to severe knee deformity after old tibial plateau fracture at Department of Orthopaedics, The People's Hospital of Guizhou Province from March 2015 to June 2017. The cohort included 7 males and 11 females, with a mean age of (64.0±7.7) years. The left knee was affected in 12 cases and the right in 6 ones. The injury was caused by a traffic accident in 12 cases, by a fall from heights in 4 cases, and by a heavy object in 2 cases. The time from fracture to TKA was (5.9±2.8) years. All patients underwent TKA assisted by 3D printing after admission. Knee range of motion (ROM), Hospital for Special Surgery (HSS) knee score, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared between preoperation and postoperative 6 months. Complications during the follow-up period were also recorded.Results:All the 18 patients completed a 6-month follow-up. At 6 months after operation, the knee ROM increased significantly from preoperative 85.1°±2.9° to 125.3°±1.3°, the HSS knee score increased significantly from preoperative (39.6±1.4) points to (75.8±1.8) points, and the WOMAC score decreased significantly from preoperative (49.3±1.0) points to (8.3±0.7) points in the 18 patients ( P<0.05). One patient experienced poor wound healing 1 week after operation, and 3 patients developed low-lying patella postoperatively. No such complications as prosthesis loosening, infection, or joint stiffness were reported during the follow-up period. Conclusion:For patients with traumatic osteoarthritis secondary to severe deformity following old tibial plateau fracture, TKA assisted by 3D printing can significantly improve their knee ROM and restore their limb function, but lead to no serious complications.
9.Predictive value of caliceal pelvic height-to-infundibular length ratio for stone-free rate in lower calyx stone treatment with flexible ureteroscopic lithotripsy
Shiwei HUANG ; Sheng ZHONG ; Guangming YIN ; Long WANG ; Zhiqiang JIANG ; Kai HUANG ; Jing TAN
Chinese Journal of Urology 2025;46(8):600-606
Objective:This study aims to explore the predictive value of the ratio of caliceal pelvic height to infundibular length(CPH/IL)for the stone-free rate(SFR)in the treatment of lower calyx stones using flexible ureteroscopic lithotripsy(FURL)combined with a distally bendable negative pressure suction sheath.Methods:A retrospective analysis was conducted on the clinical data and anatomical parameters of 312 patients with lower calyx stones or combined lower calyx stones admitted to the Third Xiangya Hospital of Central South University from September 2022 to December 2023,all of whom were treated with FURL combined with a distally bendable negative pressure suction sheath. Stone clearance was defined as no residual stones or residual stones with a diameter of ≤3 mm without any symptoms. Patients were divided into the clearance group(265 cases,84.90%)and the non-clearance group(47 cases,15.10%). There were no significant differences in gender(male/female:173/92 cases vs. 29/18 cases),age[(44.69 ± 13.14)years vs.(42.60 ± 10.93)years],degree of hydronephrosis(no hydronephrosis/mild hydronephrosis/moderate to severe hydronephrosis:122/85/58 cases vs. 21/12/14 cases),side of lower calyx stones(left/right:157/108 cases vs. 31/16 cases),maximum diameter of stones(MDS)[(19.23 ± 6.41)mm vs.(17.77 ± 6.18)mm],and CT value of stones[(993.46 ± 249.12)Hu vs.(1013.43 ± 300.90)Hu]between the two groups( P > 0.05),indicating comparability between groups. There was no significant difference in the distance from the midpoint of the lower lip of the renal pelvis to the ureter at the lowest plane of the lower calyx(K-A line)between the clearance and non-clearance groups[(26.16 ± 5.18)mm vs.(25.70 ± 8.66)mm, P > 0.05]. However,significant differences were observed in the infundibulopelvic angle(IPA)[(53.97 ± 15.72)° vs.(37.43 ± 15.39)°],infundibular length(IL)[(27.26 ± 5.11)mm vs.(33.04 ± 7.38)mm],infundibular width(IW)[(8.27 ± 2.82)mm vs.(7.09 ± 3.20)mm],caliceal pelvic height(CPH)[(19.96 ± 4.63)mm vs.(30.32 ± 7.56)mm],ureter-lower calyx distance(ULD)[(23.00 ± 5.59)mm vs.(18.78 ± 6.31)mm],CPH/IL ratio[(0.73 ± 0.11)vs.(0.92 ± 0.09)],and curvature of the lower calyx of the renal pelvis[(0.06 ± 0.01)mm -1 vs.(0.08 ± 0.03)mm -1]between the two groups( P <0.05). Univariate and logistic multivariate regression analyses were used to identify the independent risk factors affecting the postoperative SFR of FURL-treated lower calyx stones and to assess the value of CPH/IL for SFR in the treatment of lower calyx stones using FURL combined with a distally bendable negative pressure suction sheath. A logistic multivariate regression model and a corresponding nomogram were constructed,and the predictive ability of the model for SFR was evaluated using the receiver operating characteristic(ROC)curve. The calibration curve and the Hosmer -Lemeshow test were used to assess the consistency and accuracy of the model. The clinical utility of the model was evaluated using decision curve analysis(DCA). Results:Univariate analysis revealed that seven anatomical parameters differed significantly between the clearance and non-clearance groups(all P < 0.05):infundibulopelvic angle(IPA, OR = 0.27,95% CI 0.17-0.42, P < 0.01),infundibular length(IL, OR = 2.52,95% CI 1.83-3.47, P < 0.01),infundibular width(IW, OR = 0.64,95% CI 0.45-0.90, P = 0.011),caliceal pelvic height(CPH, OR = 5.78,95% CI 3.67-9.10, P < 0.01),ureter-lower calyx distance(ULD, OR = 0.43,95% CI 0.30-0.63, P < 0.01),CPH/IL ratio( OR = 13.62,95% CI 6.86-27.03, P < 0.01),and curvature of the lower calyx of the renal pelvis( O = 3.15,95% CI 2.08-4.78, P < 0.01). Multivariate logistic regression further identified CPH/IL( OR = 9.87,95% CI 4.92-19.79, P < 0.01),IPA( OR = 0.41,95% CI 0.23-0.71, P = 0.001),and ULD( OR = 0.50,95% CI 0.29-0.87, P = 0.014)as independent risk factors influencing the stone-free rate after flexible ureteroscopic lithotripsy combined with a distally bendable negative-pressure suction sheath. The area under the ROC curve(AUC)of the univariate regression model showed that for IPA,the AUC was 0.788(95% CI 0.711-0.864);for IL,it was 0.731(95% CI 0.643-0.819);for ULD,it was 0.677(95% CI 0.586-0.767);for CPH,it was 0.867(95% CI 0.804-0.929);for IW,it was 0.628(95% CI 0.535-0.721);for CPH/IL,it was 0.906(95% CI 0.850-0.961)with an optimal cutoff value of 0.882,corresponding to a sensitivity of 83.02% and a specificity of 92.08%;and for curvature of the lower calyx of the renal pelvis,it was 0.744(95% CI 0.662-0.827). The AUC of the multivariate regression model was 0.929(95% CI 0.884-0.974)with an optimal cutoff value of 0.364,corresponding to a sensitivity of 82.98% and a specificity of 95.09%. Calibration curves demonstrated close agreement between the predicted and actual stone-free rates after FURL(C-index = 0.921). The Hosmer-Lemeshow goodness-of-fit test indicated no significant discrepancy between predicted and observed probabilities( P = 0.135,>0.05). Decision-curve analysis further revealed that basing clinical decisions on the model ,s predicted probability yields a higher net clinical benefit than either withholding FURL for all patients or treating all patients regardless of risk,and it also outperforms strategies guided by any single independent predictor alone. Conclusions:IPA,IL,IW,CPH,ULD,CPH/IL ratio,and curvature of the lower calyx of the renal pelvis can all predict the postoperative SFR of FURL combined with a distally bendable negative pressure suction sheath for the treatment of lower calyx stones to varying degrees. Among them,CPH/IL has the highest predictive value. When CPH/IL >0.88,it may be difficult to use FURL to treat lower calyx stones.
10.Analysis of Risk Factors for Uremic Encephalopathy in Maintenance Hemodialysis Patients
Hai-yan KANG ; Zhi-yan TAN ; Liu-yu TAN ; Wei-guang LU ; Qiong HUANG ; Sheng-bao LONG
Progress in Modern Biomedicine 2025;25(16):2630-2635
Objective:To explore the independent risk factors for uremic encephalopathy(UE)in maintenance hemodialysis(MHD)patients and provide evidence for early clinical warning and intervention.Methods:A case-control study was conducted,enrolling 67 MHD patients diagnosed with UE(UE group)at Laibin People's Hospital from January 2010 to December 2024,and 67 non-UE patients during the same period(control group).Demographic characteristics,dialysis parameters,laboratory indicators,and infection events were collected.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for UE.Results:The UE group had significantly higher rates of infection(58.2%vs.29.9%),serum creatinine(789 vs.702 μmol/L),and iPTH levels(568 vs.385 pg/mL)compared to the control group(P<0.05).Multivariate analysis revealed that concurrent infection(OR=3.022,95%CI:1.312-6.958),elevated serum creatinine(OR=1.004,95%CI:1.000-1.008),and elevated iPTH(OR=1.002,95%CI:1.001-1.003)were independent risk factors for UE(P<0.05).The combined prediction model achieved an AUC of 0.878(95%CI:0.822-0.934),with 82.1%sensitivity and 80.6%specificity.Conclusion:Infection,elevated serum creatinine,and elevated iPTH significantly increase the risk of UE in MHD patients.Clinical management should emphasize infection prevention,toxin clearance optimization,and parathyroid function regulation to reduce UE incidence.


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