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.

ObjectiveTo observe the clinical efficacy of acupuncture combined with bloodletting and cupping in the treatment of chronic spontaneous urticaria（CSU） and to explore its potential mechanisms of action. MethodsSeventy CSU patients were randomly divided into loratadine group and acupuncture + bloodletting group， with 35 patients in each group. The loratadine group received oral loratadine tablets， 10 mg once daily in the evening. The acupuncture + bloodletting group received acupuncture at Zhongwan （CV 12）， Guanyuan （CV 4）， Tianshu （ST 25）， Zusanli （ST 36）， Sanyinjiao （SP 6）， Xuehai （SP 10）， Quchi （LI 11）， Hegu （LI 4）， Taichong （LR 3）， Baihui （GV 20）， and Shenting （GV 24）， once daily，along with bloodletting and cupping at Dazhui （GV 14） and Geshu （BL 17）， every other day. Both groups were treated for 4 weeks. The 7-day urticaria activity score（UAS7） was assessed before and after the treatment， and levels of serum immunoglobulin E （IgE）， interleukin-4 （IL-4）， interleukin-5 （IL-5）， eosinophil cationic protein （ECP）， plasma tissue factor （TF）， activated factor Ⅶ （FⅦa）， prothrombin fragment 1+2 （F1+2）， D-dimer （D-D） and complement component 5a （C5a） were detected. ResultsA total of 65 patients were included in the final analysis， 32 in the loratadine group and 33 in the acupuncture + bloodletting group. Before treatment， there was no significant difference in UAS7 score， serum IgE， IL-4， IL-5， ECP levels， or plasma TF， FⅦa， F1+2， D-D， C5a levels between groups （P＞ 0.05）. After treatment， both groups showed significant reductions in UAS7 score， serum IgE， IL-4， IL-5， and plasma TF， FⅦa， F1+2， D-D， and C5a levels compared to those before treatment （P＜0.01）. However， after treatment， there was no significant difference in UAS7 score and serum ECP， IgE， IL-4， IL-5 levels between groups （P＞0.05）. The acupuncture + bloodletting group showed lower plasma TF， FⅦa， F1+2， D-D and C5a levels compared to the loratadine group （P＜0.05 or P＜0.01）. ConclusionAcupuncture combined with bloodletting and cupping can effectively improve the skin symptoms of CSU patients and reduce the levels of inflammatory factors. The potential mechanism of action may involve the regulation of the coagulation-complement-mast cell activation axis， thereby inhibiting mast cell degranulation.

Objective:To analyze the differences in routine blood tests and infection markers among elderly AIDS patients with other opportunistic infections, to explore their immune status and inflammatory responses, and to provide new molecular markers for clinical diagnosis.Methods:The study included general indicators, routine blood tests, and infection markers of older HIV patients with other opportunistic infections admitted to Beijing You'an Hospital, Capital Medical University, from January 1, 2014, to December 31, 2024.Statistical analysis was performed using SPSS 27.0 software, with a significance level set at P<0.05. Results:A total of 94 elderly AIDS patients with various opportunistic infections were included in this study.Among them, the majority were co-infected with tuberculosis, accounting for 60 cases(63.83%), followed by 23 cases(24.47%)of AIDS patients co-infected with syphilis.Additionally, there were 7 cases of AIDS co-infected with amoebiasis(7.45%)and 4 cases of AIDS co-infected with monkeypox(4.26%).Almost all cases of combined infections were male, with males comprising 91.3% of AIDS patients co-infected with syphilis and 100% in the other co-infected groups.There were 9 blood routine and infectious markers that exhibited significant differences between patients with HIV co-infected with tuberculosis and those with other opportunistic infections.These markers included lymphocytes(LYM), hemoglobin(HGB), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio( P<0.05).Specifically, the levels of LYM, HGB, T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio in elderly AIDS patients with tuberculosis were significantly lower than those in patients with other co-infections(all P<0.05).Conversely, the levels of inflammatory factors such as PCT, ESR, and CRP were notably higher in the former group(all P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that when LYM was utilized as an individual indicator for the differential diagnosis between AIDS patients with tuberculosis and those with other opportunistic infections, the area under the curve(AUC)amounted to 0.832.However, the CRP/LYM ratio demonstrated the optimal diagnostic performance in differential diagnosis, with an AUC reaching 0.866. Conclusions:The immune function of elderly AIDS patients is further compromised following co-infection with tuberculosis, which is accompanied by a severe inflammatory response.The CRP/LYM ratio shows promise as a hematological molecular marker for differentiating between AIDS patients with tuberculosis and those with other opportunistic infections.

Hepatitis B virus(HBV)infection is worldwide and poses a serious threat to human health.Existing conventional therapeutic drugs(e.g.,interferon-alpha,nucleoside analogs)can inhibit intrahepatic replication of HBV,but it is difficult to remove HBV covalently closed circular DNA(cccDNA)from the nucleus of hepatocytes,resulting in the virus not being easily cleared and the formation of a chronic infection that is difficult to cure.However,the emergence of targeted drugs is expected to destroy cccDNA making a cure for HBV infection possible.To achieve this,in vitro cell models of HBV infection and replication are needed to screen for targeted drugs.In recent years,in vitro cell models for HBV research have made fundamental progress,providing a platform for a better understanding of virus-host interactions,in vitro studies of the HBV life cycle,and the screening and evaluation of novel antiviral drugs.In this review,the research progress of HBV infection and replication cell models,and the characteristics and limitations of different cell models are reviewed,aiming to provide a basis for exploring the mechanism of complex chronic HBV infection,screening targeted drugs and selecting suitable HBV cell models in vitro.

The study was a prospective observational study. A total of 24 patients who underwent maintenance hemodialysis (MHD) at Haidian Hospital in Beijing from May 2024 to June 2024 were included as the study subjects. The safety and efficacy of a new single-needle dialysis in MHD patients were evaluated. The reasons for using single-needle dialysis included waiting for the maturity of internal fistula(7 cases, 29.17%), autogenous arteriovenous fistula thrombosis occurred (6 cases, 25.00%), puncture difficulty occurred (7 cases, 29.17%), and pain sensitivity or elderly (4 cases, 16.67%). The results showed that the average blood flow was (155.65±5.90) ml/min, total blood volume was (35.92±2.65) L during single-needle dialysis. One patient had slight puncture leakage, and the puncture success rate was 95.83%. Relevant indicators of dialysis adequacy showed that the average urea clearance (Kt/V) was 0.90±0.42, urea reduction ratio was 58.31%±7.93%, and online real-time Kt/V monitoring average value was 0.98±0.55. The results suggest that the application of the new improved single-needle dialysis mode in MHD patients is safe and effective.

The incidence rate of metabolic associated fatty liver disease(MAFLD)is gradually increasing,and it has become a common chronic liver disease globally.MAFLD is closely associated with metabolic dysfunction,with dietary and exercise interventions as the primary treatment method,among which dietary control is of particular importance.This article summarizes related articles on the prevention and treatment of MAFLD through different fasting patterns in recent years,and the analysis showed that by restricting food intake and controlling calorie consumption,fasting therapy can help to reduce body weight and improve metabolic disorders.Further studies and clinical practice are needed to explore and validate the value of different fasting patterns in the prevention and treatment of MAFLD.

Objective To investigate the incidence of ipsilateral upper urinary tract stones after partial nephrectomy and its risk factors.Methods We retrospectively analyzed baseline patient characteristics(age,gender,and body mass index),smoking,alcohol consumption,comorbidities(hypertension,diabetes,hypertriglyceridemia,hyperuricemia,and cardiovascular diseases),preoperative tumor conditions(tumor diameter,multiple foci,location,hemorrhage,necrosis,cystic changes,and endophytic growth),preoperative glomerular filtration rate and intraoperative factors(renal collecting system damage,ischemia time,operation time,surgical approach,and estimated intraoperative blood loss)to identify the risk factors for ipsilateral upper urinary tract stones following partial nephrectomy in our center.Results The overall incidence of upper urinary tract stones following partial nephrectomy was 7.80%(112/1435).The incidence of ipsilateral upper urinary tract stones was significantly higher than those of contralateral stones(4.95%vs 1.46%,P<0.001)and bilateral stones(4.95%vs 1.39%,P<0.001).Intraoperative damage to the renal collecting system was identified as a significant risk factor for ipsilateral upper urinary tract stones(OR=4.550,95%CI:2.237-9.252,P<0.001).Diabetes was a probable risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy(OR=2.419,95%CI:0.973-6.012,P=0.057).Conclusions The incidence of ipsilateral upper urinary tract stones after partial nephrectomy is higher than that of contralateral and bilateral stones.Intraoperative renal collecting system damage is a risk factor for secondary ipsilateral upper urinary tract stones after partial nephrectomy.

Objective:This study aims to investigate the differences in hemostatic efficacy and patient comfort between an innovative domestically produced biodegradable nasal packing sponge and a traditional absorbent sponge following endoscopic nasal surgery. Methods:A prospective, randomized controlled trial design was utilized, including 30 patients who were divided into two groups according to random allocation, each receiving one of the two types of nasal packing. The study assessed the hemostatic efficacy, comfort, and safety of the materials by comparing the rates of no bleeding within 24 hours after packing, re-bleeding rates after 48 hours, pain ratings in the head and nasal areas, scores on a visual analog scale for nasal ocular symptoms, and safety indicators between the two groups. Results:The rates of no bleeding within 24 hours post-packing were 73.33% for both the experimental and control groups, with a no-bleeding rate of 100% after 48 hours in both groups. The pain rating in the head and nasal areas at various times post-packing was Grade Ⅰ（100%） in both groups, with no statistically significant difference（P=1.000）. The experimental groups sneezing score on the day of packing was（0.73±1.03）, lower than the control groups（2.27±1.67）, （P=0.007）; after 48 hours, the experimental groups sneezing score was（0.67±0.98）, also lower than the control groups（1.67±1.18）, （P=0.019）. There was no significant difference between the two groups in the Lund-Kennedy scoring during endoscopic examinations at the screening period, 7 days, 1 month, and 3 months post-packing（P>0.05）. Laboratory tests for other examination indicators were normal in both groups. Conclusion:The innovative domestically produced biodegradable nasal packing sponge not only provides hemostatic efficacy comparable to imported materials but also significantly improves patient comfort after surgery. It represents an economical and effective choice for nasal packing materials.
Humans ; Prospective Studies ; Surgical Sponges ; Endoscopy/methods* ; Male ; Female ; Epistaxis/prevention & control* ; Middle Aged ; Nasal Surgical Procedures/methods* ; Adult

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers