Objective:To compare the efficacy of low-dose febuxostat and low-dose benzbromarone in lowering serum uric acid and their impact on liver function in male patients with renal underexcretion gout.Methods:This prospective cohort study enrolled 303 patients with renal underexcretion gout and normal baseline liver function. Participants were assigned to either the low-dose febuxostat group(20 mg qd) or the low-dose benzbromarone group(25 mg qd). A linear mixed-effects model was used to compare the uric acid target achievement rate(<360 μmol/L) and changes in liver enzyme levels between the two groups.Results:At week 4, the proportion of patients achieving the serum uric acid target(<360 μmol/L) was significantly higher in the benzbromarone group than that in the febuxostat group(64.2% vs 42.3%, P<0.001), with a trend toward greater efficacy at weeks 8 and 12. The incidence of alanine aminotransferase(ALT) or aspartate aminotransferase(AST) elevation above the upper limit was significantly higher in the febuxostat group compared to the benzbromarone group(35.2% vs 13.85%, P<0.001). After adjusting for baseline liver enzyme levels in the mixed-effects model, mean ALT and AST levels remained significantly higher in the febuxostat group than those in the benzbromarone group at weeks 4, 8, and 12( P<0.05). In the febuxostat group, ALT and AST levels significantly increased over time during weeks 0-4 and 4-8 ( P<0.001), peaking at week 8 followed by a decreasing trend. By week 12, the levels were not significantly different from baseline ( P>0.05). Whereas there was no significant difference at each follow-up time point in the benzbromarone group( P>0.05). Conclusions:In male patients with renal underexcretion gout, low-dose benzbromarone demonstrated superior urate-lowering efficacy and better hepatic safety compared to low-dose febuxostat.

Cross-border teaching provides new opportunities for college students to gain diverse insights amid the globalization and internationalized education, In July 2024, guided by the Chinese Association for Science and Technology, the Chinese Nutrition Society and the Hong Kong Nutrition Association collaborated to host a three-week clinical nutrition internship at Peking Union Medical College Hospital for five college students from Hong Kong SAR, China. This program included participating in outpatient rounds, attending in inpatient nutrition management, and attending lectures, aiming to enhance students' professional skills and clinical experience. Cultural exchange and value-based education also enriched students' social responsibility and cultural understanding. The Hong Kong students also brought diverse cultural backgrounds and inputs, enabling multidimensional communication during the training. Post-internship feedback survey showed that the students found the inernship valuable for their career development and hoped for more learning opportunities. This cross-border high-quality internship program fostered skill enhancement, cultural exchange between young students in Beijing and Hong Kong and contributed to advancement of clinical nutrition.

Anhedonia is one of the core features of major depressive disorder (MDD) and is associated with poor functional outcomes in MDD patients. Psychosocial functional recovery is an important goal for achieving MDD remission. Although longitudinal studies have found association between anhedonia and impaired psychosocial function, there is still a lack of neurobiological biomarkers that can indicate this relationship. In this review, brain structural and functional changes associated with anhedonia and impaired psychosocial function in MDD patients are reviewed from the perspective of magnetic resonance imaging. It finds that anhedonia and psychosocial dysfunction in MDD may share common neuroimaging changes, manifested in abnormal brain regions such as the nucleus accumbens, caudate nucleus, putamen nucleus, orbitofrontal cortex, insula, amygdala, anterior cingulate cortex, dorsolateral prefrontal cortex, superior parietal lobe, inferior frontal gyrus and temporal lobe. These findings help to better understand the pathophysiology of the disease and offer potential insights for developing new treatment strategies.

Objective:To investigate the occurrence of work-related musculoskeletal disorders (WMSDs) in bus drivers in Zhuhai City, analyze the ergonomic factors, and explore the prevention and control measures of WMSDs.Methods:From March to May 2023, 1675 active bus drivers from 5 branches of a bus group in Zhuhai were selected by stratified sampling method. The incidence of WMSDs among bus drivers in the past 12 months was investigated by using the modified Chinese Version of Musculoskeletal Disorders Questionnaire. The influencing factors of WMSDs were analyzed by χ2 test and generalized linear model. Results:The total incidence of WMSDs in bus drivers in the past 12 months was 47.2% (790/1675) , and the incidence of WMSDs in neck and shoulder and lower back was 36.9% (618/1675) and 31.7% (531/1675) , respectively. The χ2 test showed that there were statistically significant differences in the incidence of WMSDs among bus drivers with different individual factors such as body mass index (BMI) , physical exercise and looking down at mobile phones ( P<0.05) . There were significant differences in the incidence of WMSDs in the neck and shoulder of bus drivers with different years of service and number of stops on their routes ( P<0.05) . There were statistically significant differences in the incidence of WMSDs in the lower back of bus drivers with different one-way driving time, shift patterns, and rest breaks during work ( P<0.05) . Abnormal BMI, professional working years >12 years, uncomfortable working posture, frequent turning, slightly forward neck posture, large forward neck posture and long shoulder posture were the risk factors for WMSDs of bus drivers ( P<0.05) , and comfortable seat was the protective factor ( P<0.05) . One-way driving time >70 min, shift work schedules, uncomfortable working posture, slightly forward back posture, and frequent turning were the risk factors leading to lower back WMSDs ( P<0.05) , and physical exercise, comfortable driving cabin space, and seat comfort were the protective factors ( P<0.05) . Conclusion:The total incidence of WMSDs in bus drivers is higher, and ergonomic factors are related to the occurrence of WMSDs. In the implementation of bus driving space comfort, human-computer interaction interface friendliness and seat comfort, employers should be reasonable allocation of fitness facilities, regular training, reasonable shift organization and other measures to prevent and control the occurrence of bus drivers WMSDs.

Photoacoustic imaging (PAI), an emerging hybrid imaging modality, integrates the high spatial resolution of optical imaging with the deep-tissue imaging capability of ultrasound. Emerging evidence from recent studies in dental medicine has demonstrated the unique potential of PAI in screening, diagnosis, and therapeutic monitoring of oral pathologies, including periodontal diseases, oral cancers, and pulpal disorders. However, its clinical translation remains contingent upon addressing multiple technical barriers, particularly signal attenuation induced by optical scattering in biological tissues and limitations in real-time imaging efficiency. Therefore, investigating the advancements and challenges of PAI technology in the diagnosis of oral diseases will contribute to advancing further research and clinical applications, thereby providing practical support for improving the accuracy of early diagnosis and the efficacy of treatment for oral diseases.

The intestinal flora is a vast and complex microbial system，and its dysregulation may be associated with the occurrence and progression of various diseases.Nephrotic syndrome is a kidney disease characterized by massive proteinuria，hypoalbuminemia，edema，and hyperlipidemia.Some studies have found alterations in the intestinal flora of patients with nephrotic syndrome.Short-chain fatty acids produced by intestinal flora metabolism，particularly butyrate，may influence the occurrence and progression of nephrotic syndrome by regulating immune responses and inflammatory processes through their effects on the differentiation and function of regulatory T cells.These findings provide insights for exploring the pathophysiology of nephrotic syndrome and developing novel therapeutic strategies.

Childhood primary renal tubular diseases are chronic kidney diseases characterized by impaired renal tubular reabsorption. Primary renal tubular disease has diverse clinical manifestations and lacks of specificity. Laboratory tests are limited，making it prone to missed diagnosis and misdiagnosis. Based on the current knowledge of renal tubular diseases，authors propose early warning signals of renal tubular diseases such as family history of primary tubular diseases，unexplained polyhydramnios during pregnancy，polydipsia，polyuria，delayed growth and development or rickets，decreased muscle strength and tone，unexplained electrolyte disturbance，hyperuricemia，acid-base disturbance，positive urine sugar test，renal tubular proteinuria，urinary imaging examination suggesting kidney stones，calcium deposition，renal cysts and early onset of eye，ear，joint and neuron injury.Meanwhile，some universal management strategies for primary renal tubular disease are proposed，emphasizing the importance of multidisciplinary collaboration，genetic testing and individualized intervention to improve the long-term prognosis of childhood primary renal tubular diseases.

Hydroxychloroquine is a classical antimalarial agent that has been widely used in the treatment of autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis due to its notable anti-inflammatory and immunomodulatory effects. In recent years，increasing attention has been paid to the therapeutic potential of hydroxychloroquine in immune-related kidney diseases，including lupus nephritis，IgA nephropathy，and renal ischemia-reperfusion injury. Although clinical studies have shown encouraging results，the underlying mechanisms of hydroxychloroquine remain incompletely understood. Emerging evidence suggests that hydroxychloroquine may exert renal protective effects through multiple immunoregulatory pathways. These include inhibition of lysosomal acidification and autophagy，modulation of innate immune signaling via Toll-like receptors，suppression of NLRP3 inflammasome activation，and reduction of NADPH oxidase activity and oxidative stress. Moreover，hydroxychloroquine can downregulate the production of pro-inflammatory cytokines such as IL-6，tumor necrosis factor-alpha（TNF-α），and interferon-α（IFN-α），contributing to a reduction in renal inflammation. Additional mechanisms involve the modulation of the Th17/Treg cell balance and the inhibition of neutrophil extracellular trap formation，which further supports its role in modulating immune responses，attenuating renal inflammation，and preserving kidney function. This article provides a concise review of the mechanisms of hydroxychloroquine in immune-related renal diseases.

Crystalline nephropathy is a kidney disorder characterized by crystal deposition in the renal tubules and interstitium，leading to renal dysfunction. Clinical manifestations include polydipsia，polyuria，renal function abnormalities，with or without crystalluria. The pathogenesis involves direct and indirect cytotoxicity caused by crystal deposition，inflammatory kidney injury，tubular obstruction，oxidative stress and inflammatory responses，which further promote renal fibrosis. It represents a significant cause of both acute and chronic renal failure. In adults，it is primarily induced by medications and secondary factors，while it is relatively rare and mainly caused by genetic and metabolic disorders in children. Diagnosis relies on clinical presentation，urinalysis，and medical imaging，while confirmatory diagnosis requires renal biopsy. Currently，due to the limitid awareness of pediatric crystalline nephropathy，it is essential to enhance pediatrician' understanding of this disease for early and precise diagnosis and treatment，thereby improving prognosis and reducing the risk of end-stage renal disease.

In recent years, research on the quality and safety detection of bear bile powder has mainly involved three aspects. First, the identification of active components and substitutes. Quantitative analysis of bile acids and other components is performed using HPLC, HPLC-tandem mass spectrometry, and other techniques, combined with near-infrared spectroscopy, X-ray diffraction, and polymerase chain reaction to identify adulteration. Isotope fingerprint analysis and glycosylation modification detection are used to distinguish natural products from biosynthetic substitutes, revealing significant differences in δ13C values and the proportion of specific glycosylation modifications between natural bear bile powder and synthetic products. Second, the detection of veterinary drug residues, mainly based on ultra-high performance liquid chromatography-tandem mass spectrometry, which can screen over 100 types of residues, but targeted purification strategies are needed to address interference from the bile acid matrix. Thirdly, heavy metal detection, mainly using inductively coupled plasma mass spectrometry and atomic absorption spectrometry, has revealed that contamination is associated with the breeding environment, with significant regional differences. Related detection technologies are gradually evolving from single-target analysis to multi-modal and intelligent approaches. Existing research faces issues, such as matrix effect interference, lack of international standards, and ethical controversies. It is suggested that future efforts should focus on the interdisciplinary application of detection technologies, develop rapid detection methods such as non-invasive monitoring and microfluidic chips, promote the standardization and equivalence evaluation of synthetic alternatives, and establish a full-chain quality control system integrating spatially resolved mass spectrometry imaging, artificial intelligence, and big data.