1.Development of A Prognostic Prediction Model for Primary Membranous Nephropathy in the Elderly Based on Machine Learning
Yuzhu XU ; Shuqin LIU ; Dingding WANG ; Wei CHEN ; Xin WANG
Medical Journal of Peking Union Medical College Hospital 2026;17(2):370-381
Elderly patients with primary membranous nephropathy (PMN) exhibit significant prognostic heterogeneity and poor tolerance to immunotherapy. However, there is a lack of early prognostic prediction tools specifically for this population. This study aimed to develop a prognostic prediction model applicable to elderly PMN patients. This study retrospectively included elderly patients with PMN confirmed by renal biopsy. The primary endpoint was a adverse composite outcome including end-stage renal disease (ESRD), a ≥50% decline in estimated glomerular filtration rate (eGFR), or all-cause death. Patients were randomly divided into a training cohort and a validation cohort at a ratio of 7∶3. Key prognostic features were identified using least absolute shrinkage and selection operator (LASSO) regression combined with random survival forest, and a predictive model was constructed based on penalized Cox regression. Model performance was evaluated using the concordance index (C-index), time-dependent area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curve analysis. The SurvSHAP (t) method was employed for interpretability analysis of the model. A total of 309 elderly patients with PMN were included in this study, with a median age of 65.00 years (IQR, 62.00-68.00) and a male predominance 61.2%(189/309).During a median follow-up of 47.00 months (IQR, 25.00-89.00), 38.2%(118/309) reached the endpoint event. The final model included nine key features, including eGFR, total protein (TP), glomerular capsular adhesion, urine glucose, segmental glomerulosclerosis proportion, fibrinogen, urea, age, and activated partial thromboplastin time (APTT). In the validation cohort, the model demonstrated good discrimination, with a C-index of 0.731(95% CI: 0.652-0.797). The time-dependent AUROCs for predicting adverse outcomes at 3, 5, and 10 years were 0.758(95% CI: 0.614-0.901), 0.781(95% CI: 0.646-0.916), and 0.866(95% CI: 0.740-0.993), respectively. Calibration curves demonstrated a high degree of concordance between predicted probabilities and actual event rates. Decision curve analysis confirmed the net clinical benefit of the model.SurvSHAP (t) analysis showed that eGFR, TP, glomerular capsular adhesion, urine glucose, and the proportion of segmental glomerular sclerosis were the top five variables contributing to the model. This prognostic model effectively predicts the risk of adverse outcomes in elderly patients with PMN in the internal validation cohort, offering a potential scientific basis for individualized risk stratification and treatment decision-making in this population.
2.Eculizumab for Refractory Immune Complex-Mediated Glomerulonephritis Following Acute Hepatitis B Infection: A Case Report
Jinyuan LIU ; Dan WANG ; Shuqin LIU ; Wenfang CHEN ; Wei CHEN ; Xin WANG
Medical Journal of Peking Union Medical College Hospital 2026;17(2):389-395
Infection-related glomerulonephritis (IRGN) is an immune-mediated glomerular injury triggered by infectious agents. This article reports a case of immune complex-mediated glomerulonephritis following acute hepatitis B virus infection, which continued to progress despite standard antiviral and immunosuppressive therapy. Given the significant elevation of soluble complement membrane attack complex (sC5b-9), an indicator of terminal complement pathway activation, the patient was treated with eculizumab. Following treatment, the patient's urine protein-to-creatinine ratio significantly decreased, hypoalbuminemia and hematuria markedly improved, and sC5b-9 levels declined. This case suggests that abnormal complement system activation may be a key mechanism driving disease persistence in some patients with IRGN. For those unresponsive to conventional therapy, complement function screening and targeted terminal complement pathway inhibition may represent an effective salvage strategy.
3.Trajectories and influencing factors of intrinsic capacity in elderly hemodialysis patients based on latent class growth model
Huimin WEN ; Shuqin XIAO ; Xue LIU ; Huan FAN
Chinese Journal of Modern Nursing 2025;31(14):1876-1883
Objective:To explore latent categories of trajectories in intrinsic capacity in elderly hemodialysis patients and to analyze their influencing factors.Methods:Elderly hemodialysis patients in the Blood Purification Center of Beijing Tongren Hospital affiliated with Capital Medical University from September 2022 to January 2023, were selected for the study using a convenience sampling method. A baseline survey was conducted using the General Information Questionnaire, Hemodialysis Self-Management Instrument, Social Environmental Factor Scale, and Intrinsic Capacity Scale. The Intrinsic Capacity Scale was used to investigate the intrinsic capacity of patients at 6 and 12 months after baseline. The latent class growth model was used to identify latent categories of intrinsic capacity trajectories of elderly hemodialysis patients. Ordered multiclass Logistic regression was used to analyze the influencing factors of latent categories.Results:A total of 317 elderly hemodialysis patients were investigated at baseline, and finally, 309 completed follow-ups. Among the 309 elderly hemodialysis patients, the trajectory of intrinsic capacity was categorized into a low-level slow-decline group (26.2%, 81/309) , a medium-level smooth-decline group (39.8%, 123/309) , and a high-level slow-decline group (34.0%, 105/309) . Ordered multiclass Logistic regression analysis showed that gender, age, mode of residence, per capita monthly income, type of dialyzer, C-reactive protein, score of hemodialysis self-management scale, housing conditions score, transportation condition score, and environmental condition score were the influencing factors of the latent categories of the trajectory in intrinsic capacity of elderly hemodialysis patients, and the difference was statistically significant ( P<0.05) . Conclusions:There is population heterogeneity in the intrinsic capacity trajectory of elderly hemodialysis patients. Healthcare professionals can provide targeted interventions based on the factors influencing the trajectory.
4.Application and progress of magnetic surgical technique in organ anastomosis reconstruction
Long LIU ; Shuqin XU ; Rongqian WU ; Yi LYU
Chinese Journal of Surgery 2025;63(10):974-978
Magnetic surgery,as an emerging discipline,utilizes the principle of “non-contact” magnetic force to drive the innovative development of surgical technology. Magnetic compression anastomosis (MCA),a significant branch of magnetic surgical technology,demonstrates notable advantages in reducing surgical trauma,shortening operation time,and lowering the risk of complications,particularly in the reconstruction of digestive tract and vascular anastomoses. Compared to traditional suturing and mechanical anastomoses,MCA avoids defects such as the “pinhole effect” and “foreign body reaction”,leveraging the advantages of magnetic force′s non-contact nature,gradient variation, uniformity,and directionality to significantly reduce the risks of anastomotic bleeding,stenosis,and fistula. However,the widespread adoption of MCA still faces challenges,including the biological safety of magnetic materials,optimization of magnet design,intelligent application,and large-scale clinical validation. To address these,it is necessary to further standardize clinical operation procedures,enhance safety assessments,promote interdisciplinary integration,and accelerate technological iteration and translation of research findings,with the aim of facilitating broader clinical application of MCA for the benefit of patients.
5.Analysis of the efficacy of etoposide (Vp16) -intensified allogeneic hematopoietic stem cell transplantation in treating relapsed/refractory acute myeloid leukemia
Fan YANG ; Wenjing WANG ; Xinhong FEI ; Weijie ZHANG ; Jiangying GU ; Shuqin ZHANG ; Tingting LI ; Wenya LIU ; Jingbo WANG
Chinese Journal of Organ Transplantation 2025;46(5):375-381
Objective:To evaluate the efficacy of an etoposide (Vp16) -intensified conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of relapsed/refractory acute myeloid leukemia (AML).Method:A retrospective analysis was conducted on the clinical data of 27 recipients with relapsed/refractory AML who underwent allo-HSCT using a Vp16-intensified conditioning regimen at Aerospace Center Hospital from January 2019 to January 2022. Transplantation-related complications and treatment outcomes were observed. Kaplan-Meier survival analysis was used to assess the overall survival (OS) and disease-free survival (DFS) rates.Result:Among the 27 recipients, there were 14 males and 13 females, with a median age of 41 years (range: 12~55 years). Except for one recipient who experienced primary graft failure, the remaining 26 recipients achieved hematopoietic reconstitution. The median neutrophil and platelet engraftment times were 13 days (range: 9~20 days) and 13.5 days (range: 11~33 days), respectively. Regimen-related toxicity (RRT) was mainly gastrointestinal toxicity and oral mucositis, and no deaths were attributed to RRT. A total of 12 recipients (44.44%) developed acute graft-versus-host disease (aGVHD), of whom 3 cases (11.11%) had grade III~IV aGVHD. Chronic GVHD (cGVHD) occurred in 13 recipients (48.15%), including 8 cases (29.63%) of extensive cGVHD. The median follow-up time after transplantation was 17 months (range: 1~48 months). Fifteen recipients (55.56%) survived without disease, while 12 recipients (44.44%) died— 9 due to relapse and 3 due to transplant-related complications. The 1-year overall survival and DFS rates were 74.07% and 59.26%, respectively; the 2-year overall survival and DFS rates were 59.26% and 55.56%, respectively. The 2-year relapse rate and transplant-related mortality (TRM) were 33.33% and 11.11%, respectively.Conclusion:The Vp16-intensified conditioning regimen in allo-HSCT appears to be a viable treatment option for patients with relapsed/refractory AML, offering favorable efficacy and manageable safety.
6.Advances in physiological and molecular mechanisms of therapeutic re-lief of type 2 diabetes mellitus by weight loss
Danqi QIU ; Jie CHEN ; Hao LIU ; Li LI ; Shuqin CHEN
Chinese Journal of Pathophysiology 2025;41(7):1407-1413
Type 2 diabetes mellitus(T2DM)has emerged as a significant public health challenge and a con-siderable threat to human well-being due to its chronic nature.Consequently,it cannot be overlooked.In response to this pressing issue,scientific weight loss treatments have demonstrated their effectiveness as a coping strategy.Particularly,for patients in the early stages of the disease with preserved pancreatic islet function and obesity,weight loss treatment has been shown to significantly enhance their glucose tolerance and ameliorate metabolic disorders.Ongoing research has led to a growing body of evidence regarding the mechanisms and clinical data supporting the use of weight loss therapy in miti-gating type 2 diabetes.This paper aims to evaluate the impact of weight loss therapy on the major metabolic organs of the body,such as the liver,pancreas,skeletal muscle,and adipose tissue,and to delve into the physiological and molecular mechanisms involved in the remission of T2DM.
7.Research Progress in the Clinical Efficacy and Mechanism of TCM for the Treatment of Functional Dyspepsia with Liver Depression and Spleen Deficiency Syndrome
Chengfei AN ; Yingying CHEN ; Jing NING ; Huanan LI ; Wei ZHANG ; An BAO ; Shuqin LIU ; Tao TAN
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(1):181-185
Functional dyspepsia(FD)is a common functional gastrointestinal disease in clinical practice,which has the characteristics of high incidence,difficult to cure,and recurrence.FD belongs to the categories of"ruffian"and"stomach pain"in TCM,and the disease is located in the stomach,which is closely related to the liver and spleen,and the syndrome of liver depression and spleen deficiency is the most common.This article summarized the literature related to the TCM treatment for FD with liver depression and spleen deficiency syndrome,and concluded the clinical application,efficacy characteristics and mechanism,so as to provide reference for clinical treatment and basic research.The analysis found that the clinical efficacy of TCM in the treatment of FD is significant,which can not only improve the digestive symptoms of patients,but also improve their anxiety and depression state and daily life quality,and has the characteristics of overall regulation,syndrome differentiation and treatment,and improvement of physical fitness.Its mechanism may involve multiple pathways and levels such as abnormal gastric motility,abnormal brain-intestinal interaction and immune inflammatory response.
8.Batokines in the cross-talk between brown adipose tissue and other organs: An update
Hao LIU ; Jie CHEN ; Danqi QIU ; Kailai XU ; Li LI ; Shuqin CHEN
Chinese Journal of Endocrinology and Metabolism 2025;41(2):156-163
Brown adipose tissue(BAT), a metabolically active organ, not only plays a pivotal role in thermogenesis, but also exerts endocrine effects that regulate both its own metabolic processes and the function of various other organ systems. These effects are primarily mediated by brown adipose tissue-derived factors, or batokines. Recent advances in the understanding of batokine types, target organs, and underlying mechanisms have highlighted their significant role in the crosstalk between BAT and other organs. This review focuses on the various batokines secreted by BAT and their involvement in regulating interactions with key target organs such as the liver, cardiovascular system, skeletal muscle, and nervous system. By examining the specific functions and molecular mechanisms of these factors, this review aims to offer novel insights and suggest potential research directions for the prevention and treatment of related metabolic diseases.
9.Progress in the innovative application of magnetic surgery technology in digestive tract diseases
Chinese Journal of Digestive Surgery 2025;24(4):452-458
Magnetic surgery technology leverages the principle of "non-contact" magnetic force, demonstrating revolutionary potential in the field of digestive surgery. It has been widely applied in areas such as gastrointestinal anastomosis, esophageal atresia recanalization, and biliary stricture treatment. Magnetic surgery techniques can be categorized into the following six major types based on their application methods and principles: magnetic compression technology, magnetic navigation technology, magnetic anchoring technology, magnetic levitation technology, magnetic tracing technology, and magnetic drive technology. These innovative surgical techniques significantly simplify surgical operations, solve complex and difficult problems, and improve clinical treatment outcomes. Meanwhile, the deepening application of magnetic surgery technology requires further standardization of clinical operation and quality control standards, reinforcement of safety research, and acceleration of multidisciplinary integration and development. The authors review the develop-ment history of magnetic surgical technology and offer a perspective on its future, highlighting the core concept of surgical innovation. The authors also summarize the clinical applications of magnetic surgery in the treatment of digestive diseases, as well as its key theoretical and technological advance-ments. Looking forward, the authors anticipate that interdisciplinary collaboration and intelligent development, with the aim of further promoting the continuous innovation of surgical technology and enhancing clinical treatment value.
10.Development trajectory and influencing factors of intrinsic capacity in community-dwelling older adults
Xue LIU ; Shuqin XIAO ; Huimin WEN ; Huan FAN ; Weiyao LI
Chinese Journal of Modern Nursing 2025;31(22):2954-2961
Objective:To investigate the current status and trajectory of intrinsic capacity in community-dwelling older adults and to analyze its influencing factors.Methods:A longitudinal study was conducted from September 2022 to March 2024. A total of 360 older adults were selected by convenience sampling from the Desheng community, Xicheng District of Beijing City and Liucun Community of Xingtai City, Hebei Province. The Intrinsic Capacity Assessment Scale and the Influencing Factors Questionnaire were administered at three-time points: baseline (T1), 6 months (T2), and 12 months (T3). Binary Logistic regression analysis revealed that age, grip strength, the number of geriatric syndromes, and types of social activities were significant influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Results:A total of 360 participants were assessed at T1, with 58 and 30 lost to follow-up at T2 and T3, development respectively. Ultimately, 272 older adults completed the follow-up. The growth mixture modeling identified two trajectory types: a high-score stable group (92.3%, 251/272) and a low-score declining group (7.7%, 21/272). Binary Logistic regression analysis showed that age, grip strength, number of geriatric syndromes, and types of social activities were influencing factors of intrinsic capacity trajectories in community-dwelling older adults ( P<0.05) . Conclusions:Intrinsic capacity development trajectories in community-dwelling older adults are heterogeneous. Healthcare professionals should focus on older adults with advanced age, lower grip strength, more geriatric syndromes, and fewer types of social activities to assess and manage their intrinsic capacity and formulate targeted interventions at an early stage.

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