Tubular aggregates(TA)are ultrastructural abnormalities in muscle biopsies,which can be detected in muscle biopsy specimens from patients with a variety of hereditary and acquired disorders.A 34-year-old male patient diagnosed with systemic lupus erythematosus(SLE)presented with intermittent muscle weakness localized to the proximal extremities of both lower limbs during prolonged oral administration of methylprednisolone,hydroxychloroquine and tacrolimus.Laboratory findings indicated normal creatine kinase levels,and anti-U1-RNP/Sm antibodies were elevated up to 49.45 RU/mL.Electromyography revealed myogenic lesions in the left iliopsoas muscle and muscle pathology demonstrated TA within the muscle fibers.Genetic testing excluded the possibility of hereditary disorders with tubular aggregas.Combined with literature review,the etiology and clinical characteristics of TA were discussed to increase the understanding of the diagnosis of diseases with TA.This case report demonstrates that SLE patients can have fluctuating muscle weakness and TA in muscle pathology.The symptoms of SLE can be partially relieved by adjusting SLE medications.

Objective To investigate the clinical features and maternal and infant outcomes of super-aged pregnant women.Methods The clinical data of pregnant women who gave birth in Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University from January 2017 to June 2022 were retrospectively analyzed.According to the age of pregnant women,they were divided into super-aged group(≥40 years old,1822 cases)and age-appropriate group(<35 years old,1827 cases).The general conditions,pregnancy complication and comorbidity,delivery outcomes and neonatal outcomes of two groups were compared.Results The number of pregnancies and number of delivery in super-aged group were significantly higher than those in age-appropriate group,and the gestational week of delivery was earlier than that in age-appropriate group(P<0.01).There was no statistical significance in the proportion of assisted reproduction between two groups(P>0.05).The incidences of gestational hypertension,gestational diabetes mellitus,scarring uterus,placenta previa and preterm delivery in super-aged group were significantly higher than those in age-appropriate group(P<0.05),while the incidences of premature rupture of membranes,placental abruption and fetal distress were lower than those in age-appropriate group(P<0.05).The rate of cesarean section and the proportion of uterine binding in super-aged group were significantly higher than those in age-appropriate group(P<0.05),and the rates of vaginal delivery and lateral perineal resection were significantly lower than those in age-appropriate group(P<0.05).There was no significant difference in the average body weight of newborns between the two groups(P>0.05),but the rates of low birth weight infants,macrosomia and neonatal asphyxia in super-aged group were significantly higher than those in age-appropriate group(P<0.05).Conclusion The incidences of pregnancy complications and comorbidity,cesarean section and neonatal complications increased in super-aged pregnant women.We should attach great importance to the prenatal health care and perinatal management of super-aged pregnant women.

Sepsis is caused by various pathogens and toxic factors, which can lead to multiple organ dysfunction. The underlying mechanism of sepsis appears to be complex, involving epigenetic reprogramming, metabolic failure, immune dysfunction, neuroendocrine system disorders, coagulation abnormalities, tissue or organ failure, and many other scientific issues. With our deep understanding of the host reaction and development of sepsis, it is of great significance to explore predicative markers and therapeutic targets according to the atypical characteristics of sepsis, thereby contributing to the reduction of morbidity and mortality of sepsis.

OBJECTIVEThe purpose of this study is to comprehensively explore the risk factors of primary open angle glaucoma (POAG) in China.

METHODSTwo groups of data based on distinct resources were analyzed to explore the risk factors of POAG. One group of data was based on hospital records between 1995 and 2000 which composed of 107 patients with POAG and 149 controls without POAG. The other group of data was based on 40 patients with POAG and 120 matched controls without POAG. The former was designed by non-matched case control study, the latter was done by 1:3 matched case control study. The relationships between POAG and the factors such as age, sex, family history, diabetes, hypertension, intraocular pressure (IOP), cardiovascular diseases, smoking, drinking and mutation of TIGR gene were studied by logistic regression analysis.

RESULTSThe simple factor analysis showed that the risk of POAG was related to age, family history, hypertension, IOP, cardiovascular diseases, smoking, drinking and the mutation of TIGR gene (T353I). However, logistic regression analysis confirmed that POAG mainly related to IOP, family history, hypertension, smoking, alcohol intake and the mutation of TIGR gene.

CONCLUSIONThe most important risk factor of POAG was IOP. Family history, hypertension, smoking and the mutation of TIGR gene were also important risk factors of POAG. However, alcohol intake was a protective factor for POAG.

Adolescent ; Adult ; Age Factors ; Aged ; Alcohol Drinking ; adverse effects ; Case-Control Studies ; China ; epidemiology ; Cytoskeletal Proteins ; Eye Proteins ; genetics ; Female ; Glaucoma, Open-Angle ; epidemiology ; genetics ; Glycoproteins ; genetics ; Humans ; Male ; Middle Aged ; Risk Factors ; Smoking ; adverse effects