Objective To investigate the independent risk factors affecting the prognosis of chronic active antibody-mediated rejection (caAMR) after kidney transplantation. Methods A retrospective analysis was conducted on 61 patients who underwent renal biopsy and were diagnosed with caAMR. The patients were divided into caAMR group (n=41) and caAMR+TCMR group (n=20) based on the presence or absence of concurrent acute T cell-mediated rejection (TCMR). The patients were followed up for 3 years. The value of 24-hour urinary protein and estimated glomerular filtration rate (eGFR) at the time of biopsy in predicting graft loss was assessed using receiver operating characteristic (ROC) curves. The independent risk factors affecting caAMR prognosis were analyzed using the LASSO-Cox regression model. The correlation between grouping, outcomes, and Banff scores was compared using Spearman rank correlation matrix analysis. Kaplan-Meier analysis was used to evaluate the renal allograft survival rates of each subgroup. Results The 3-year renal allograft survival rates for the caAMR group and the caAMR+TCMR group were 83% and 79%, respectively. The area under the ROC curve (AUC) for predicting 3-year renal allograft loss was 0.83 ［95% confidence interval (CI) 0.70-0.97］ for eGFR and 0.78 (95% CI 0.61-0.96) for 24-hour urinary protein at the time of biopsy. LASSO-Cox regression analysis and Kaplan-Meier analysis showed that eGFR≤25.23 mL/(min·1.73 m²) and the presence of donor-specific antibody (DSA) against human leukocyte antigen (HLA) class I might be independent risk factors affecting renal allograft prognosis, with hazard ratios of 7.67 (95% CI 2.18-27.02) and 5.13 (95% CI 1.33-19.80), respectively. A strong correlation was found between the Banff chronic lesion indicators of renal interstitial fibrosis and tubular atrophy (P<0.05). Conclusions The presence of HLA class I DSA and eGFR≤25.23 mL/(min·1.73 m²) at the time of biopsy may be independent risk factors affecting the prognosis of caAMR.

OBJECTIVE To compare the efficacy and safety of lacosamide （LCM） and carbamazepine （CAR） as monotherapy in the treatment of adult patients with newly diagnosed epilepsy. METHODS By methods of retrospective analysis， 84 adult patients with newly diagnosed epilepsy， were admitted to the Department of Neurology， Huaihe Hospital of Henan University during Sept. 2020-Jun. 2022， were divided into the control group （40 cases， receiving CAR treatment） and the observation group （44 cases， receiving LCM treatment） according to different medication regimens. Total response rate， epilepsy seizure frequency， blood lipid levels， and the occurrence of adverse events （AEs） of patients were compared between the 2 groups. RESULTS In the first month after treatment， there was no statistically significant difference in the total response rate between the observation group （63.64%） and the control group （55.00%， P＞0.05）； the frequency of epilepsy seizure in both groups was significantly reduced compared to before treatment （P＜0.05）， but there was no statistically significant difference between 2 groups （P＞0.05）. In the third month after treatment， the total response rate of the observation group （90.91%） was significantly higher than control group （67.50%， P＜0.05）； the frequencies of epilepsy seizure in both groups were significantly reduced compared to before treatment， and the observation group was significantly lower than the control group （P＜0.05）. In the third month after treatment， the levels of total cholesterol （TC）， triglyceride （TG） and low-density lipoprotein cholestrol （LDL-C） in the control group and the level of LDL-C in the observation group were significantly higher than before treatment， and the levels of TC， TG and LDL-C in the observation group were significantly lower than those in the control group （P＜0.05）. There was no statistically significant difference in the incidence of AEs between the observation group （15.91%） and the control group （17.50%， P＞0.05）. CONCLUSIONS Both LCM and CAR have certain effects in the treatment of newly diagnosed epilepsy in adults， which can reduce the frequency of epilepsy seizure in patients and have comparable safety. Meanwhile， LCM has better long-term efficacy than CAR in treating newly diagnosed epilepsy in adults， and its impact on the patient’s blood lipid is smaller than CAR.

Objective:To analyze the epidemiological characteristics of imported malaria cases from 2019 to 2023 after the elimination of malaria in Shanxi Province, and provide reference for formulating scientific and effective malaria prevention and control strategies in Shanxi Province.Methods:The data of imported malaria cases were collected China Information System for Disease Control and Prevention and National Parasitic Disease Control Information Management System in Shanxi Province, from 2019-2023. Descriptive epidemiological method and SPSS 26.0 statistical software were used for descriptive epidemiological statistical analysis.Results:A total of 51 malaria cases were reported in Shanxi Province in 2019-2023, all imported from abroad. Among them, there were 38 cases of falciparum malaria (74.51%), 6 cases of plasmodium ovale (11.77%), 5 cases of plasmodium vivax (9.80%), 1 case of plasmodium triticum malaria (1.96%), and 1 case of mixed infections (1.96%), with nodeaths; cases were predominantly males (94.12%, 48/51) and workers who went abroad for work (84.31%,43/51); the median age of onset was 37 years old; and there were imported cases every month, with no obvious peak of incidence; Taiyuan City reported the most cases, accounting for 72.55% (37/51) of the total number of cases,the source of infection of cases was mainly from Africa (96.08%), with the Democratic Republic of the Congo (16 cases), Nigeria (6 cases), Equatorial Guinea (5 cases), Mozambique (3 cases), and Republic of the Congo (3 cases) in that order; the median time between the onset of disease and first diagnosis, and the median time between first diagnosis and confirmation, were two times longer than that of first diagnosis, and the median time between first diagnosis and confirmation was two times longer than that of first diagnosis. The M( Q1, Q3) intervals from onset to first diagnosis and from first diagnosis to confirmed diagnosis were 2(0,4) days and 1(0,3) days, respectively, with statistically significant differences between different years from onset to first diagnosis ( H=17.41, P=0.048), and from first diagnosis to confirmed diagnosis ( H=20.82, P=0.010). A total of 101 146 blood tests for febrile patients were conducted in the province during the five years, with the minimum number of blood tests in 2020 (19 867 person-times) and the maximum number of blood tests in 2023 (20 778 person-times). Conclusions:After the elimination of malaria in Shanxi Province from 2019 to 2023, all malaria cases were imported from abroad, and it is still necessary to strengthen the surveillance of people traveling to and from malaria-endemic areas, implement the combination of medical treatment and prevention, and jointly prevent and control the occurrence of imported malaria.

Shoulder pain ranks the third in musculoskeletal pain,with relatively high incidence in the population.Early diagnosis of shoulder diseases is crucial.Deep learning(DL)in shoulder joint imaging was conducive to clinical diagnosis,treatment and prognosis evaluation of shoulder diseases.The research progresses of DL in shoulder joint imaging were reviewed in this article.

Objective:To establish a HPLC characteristic spectrum method of Centipeda minima based on standard decoction; To evaluate the correlation of materia medica, decoction pieces, standard decoction, intermediates and formula granule; To provide a reference for the quality standard research of Centipeda minima formula granules.Methods:The materia medica, decoction pieces, standard decoction, intermediates and formula granules of Centipeda minima were analyzed by a HPLC characteristic spectrum method, and the software "Similarity Evaluation System for Chromatographic Fingerprint of TCM" was employed to conform the common peaks. The clustering analysis (CA), principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were adopted to find out the correlation of materia medica, decoction pieces, standard decoction, intermediates and formula granules of Centipeda minima. The Iconic components which can make differences was screened at the same time.Results:The characteristic chromatogram of materia medica, decoction pieces, standard decoction, intermediates and formula granules of Centipeda minima shared high similarity with the respective control chromatogram. Fourteen common peaks were confirmed, and eleven chromatographic peaks were identified. The results of CA and PCA were consistent, and the standard decoction, intermediates and formula granules of Centipeda minima were closer. Six differential components with VIP values greater than 1 were screened by OPLS-DA.Conclusions:The method is stable, accurate and characteristic. The study can provide a reference for the quality standard research of Centipeda minima Formula Granules by analyzing the correlation of characteristic spectrum of materia medica, decoction pieces, standard decoction, intermediates and formula granules.

Atherosclerosis is the pathological basis of a variety of cardiovascular diseases,which are still the leading cause of human death worldwide.Ferroptosis is a kind of iron dependent non-apoptotic cell death mode,which is closely related to various physiological mechanisms.Recent studies have found that ferroptosis in macrophages plays an important role in the occurrence and development of atherosclerosis.Based on the imbalance of iron metabolism in macrophages,this paper reviews the correlation between ferroptosis in macrophages and atherosclerosis in terms of the interaction between ferroptosis in macrophages and lipid peroxidation,inflammation,oxidative stress,etc.,in order to provide new ideas for the study of the pathogenesis of atherosclerosis.

Objective:To investigate the effect of hematopoietic stem cell transplantationon(HSCT)survival outcomes in older patients with myeloid neoplasms.Methods:We retrospectively analyzed the treatment outcomes of 54 patients aged≥55 years with myeloid neoplasms who underwent HSCT between January 2018 and May 2023 at Zhujiang Hospital of Southern Medical University.Results:Among the 54 pa-tients,45 had acute myeloid leukemia(AML)and 9 had myelodysplastic syndrome.The median age of the patients was 57.5(55-68)years.Fifty-three patients underwent hematopoietic reconstitution,with a median time to neutrophil reconstitution of 13(8-24)days and median time to platelet reconstitution of 15(9-75)days.The cumulative incidence was 23.3%for acute graft-versus-host disease(GVHD)and 24.6%for 3-year chronic GVHD.With a median follow-up of 28.2 months,the 3-year cumulative relapse rate(CIR)was 18%and 3-year non-relapse mortality rate was 28.3%.The 3-year relapse-free survival(RFS)rate was 58.2%and 3-year overall survival(OS)rate was 56.5%.Conclu-sions:HSCT is an effective and safe therapy for achieving long-term survival in older patients with myeloid tumors.

Objective To analyze the correlation between internal iliac artery calcification and delayed graft function (DGF) and short-term prognosis of kidney transplant recipients. Methods Clinical data of 222 kidney transplant recipients were retrospectively analyzed. According to the recovery of renal function, all recipients were divided into the DGF group (n=50) and immediate graft function (IGF) group (n=172). According to whether the recipients were complicated with severe internal iliac artery calcification, DGF and IGF groups were further divided into the high-risk DGF (n=22), low-risk DGF (n=28), high-risk IGF (n=41) and low-risk IGF(n=131) subgroups, respectively. Clinical data of donors and recipients were statistically compared between two groups. The incidences of postoperative DGF and internal iliac artery calcification were recorded. The risk factors of DGF after kidney transplantation, and the correlation between internal iliac artery calcification and clinical parameters were analyzed. Short-term prognosis of recipients with DGF complicated with severe internal iliac artery calcification was evaluated. Results The incidence of DGF was 22.5% (50/222). Among all recipients, 28.4% (63/222) were complicated with severe internal iliac artery calcification. In the DGF group, 44% (22/50) of the recipients were complicated with severe internal iliac artery calcification, higher than 23.8% (41/172) in the IGF group (P < 0.05). Univariate analysis showed that high serum creatinine (Scr) level of donors, male donor, high triglyceride level and severe internal iliac artery calcification of recipients were the risk factors for DGF after kidney transplantation (all P < 0.05). Multivariate logistic regression analysis revealed that Scr≥143 μmol/L of donors and severe internal iliac artery calcification of recipients were the independent risk factors for DGF after kidney transplantation (both P < 0.05). Correlation analysis indicated that internal iliac artery calcification was weakly correlated with the age of recipients and renal artery anastomosis (both P < 0.05). In the DGF group, the Scr level at postoperative 1 month was significantly higher, whereas the estimated glomerular filtration rate (eGFR) was significantly lower than those in the IGF group (both P < 0.05). The eGFR at postoperative 12 months in the high-risk DGF subgroup was significantly lower than those in the low-risk DGF, high-risk IGF and low-risk IGF subgroups (all P < 0.05). Conclusions Internal iliac artery calcification is not only a risk factor for recovery of renal allograft function, but also negatively affects short-term prognosis of renal allograft function.

Objective To investigate clinical and epidemiological features of pneumocystis jirovecii pneumonia (PJP) in kidney transplant recipients. Methods Clinical data of 68 kidney transplant recipients admitted from July, 2021 to December, 2021 were collected. All patients were divided into the PJP group (n=11), common pulmonary infection group (n=24) and non-pneumonia group (n=33) according to the status of pulmonary infection. The incidence and treatment of PJP after kidney transplantation were analyzed. Basic characteristics and laboratory parameters of the recipients were compared among all groups. The genotyping and transmission map of PJP patients were evaluated. Results Among 64 kidney transplant recipients, 11 cases were definitely diagnosed with PJP. The most common clinical manifestations included elevated body temperature, and dry cough complicated with progressive dyspnea. Chest CT scan showed diffuse interstitial inflammation and ground glass-like lesions of bilateral lungs in all patients. After diagnosis, all patients were orally given with compound sulfamethoxazole for 3-4 weeks. Two patients received non-invasive ventilator-assisted ventilation due to severe lung infection and dyspnea, and the remaining patients were given with nasal cannula oxygenation. One patient experienced elevated serum creatinine level upon discharge, and developed renal allograft failure. The remaining 10 recipients with PJP obtained normal renal allograft function, and no recipient died. Compared with the non-pneumonia group, the rejection rate was higher, the length of hospital stay was longer, the lymphocyte count was less, the lymphocyte proportion was lower, the levels of C-reactive protein, serum creatinine and lactate dehydrogenase were higher, and the levels of serum albumin was lower and CD4⁺T cell count was less in the PJP group (all P < 0.05). Compared with common pulmonary infection group, the lymphocyte count was less, the lymphocyte proportion was lower, the CD4⁺T cell count was less and 1, 3-β-D- glucan (BDG) level was higher in the PJP group (all P < 0.05). No new genotype was detected in 10 of the 12 testing samples. It was considered that PJP mainly depended on two transmission chains and two independent transmission individuals. Conclusions Kidney transplant recipients are prone to pneumocystis jirovecii (PJ) infection due to impaired cellular immune function. The most common clinical manifestations consist of elevated body temperature and dry cough complicated with progressive dyspnea, accompanied by headache and fatigue in partial patients. Chest CT scan shows diffuse interstitial inflammation and ground glass-like lesion of bilateral lungs. PJ may be transmitted through respiratory tract. Small-scale PJP might occur in the follow-up outpatient of kidney transplant recipients. Preventive measures should be delivered in a timely manner.

Objective : To examine the association between dietary patterns during pregnancy and gestational diabetes mellitus (GDM), so as to provide the evidence for guiding the establishment of healthy and balanced dietary patterns and reducing the prevalence of GDM. Methods: Pregnant women who underwent oral glucose tolerance tests in Hangzhou Obstetrics and Gynecological Hospital from 2020 to 2021 were enrolled, and their demographic information were collected using questionnaires. Pregnant women's diets during the past three months were collected using Food Frequency Questionnaires (FFQs), and dietary patterns were extracted using principal component analysis. In addition, the association between dietary patterns and risk of GDM was examined using a multivariable logistic regression model. Results: A total of 1 689 pregnant women were included, with a median age of 28.53 (interquartile range, 2.47) years and a median gestational age of 26.00 (interquartile range, 2.00) weeks. Five dietary patterns were identified according to pregnant women's types of diets, including meat-based diets, dessert-fruit-refined grain diets, plant-based diets, eggs-milk-nut diets and whole-grain diets, with a cumulative contribution rate of 58.76%. The prevalence of GDM was 24.57% (415 cases) among the study subjects. Multivariable logistic regression analysis showed that pregnant women with scores in the highest quartile (Q4) of the meat-based diets had an increased risk of GDM (OR=1.372, 95%CI: 1.043-2.055) relative to those with scores in the lowest quartile (Q1), and pregnant women with Q4 scores of the dessert-fruit-refined grain diets had an increased risk of GDM (OR=1.743, 95%CI: 1.397-2.432) relative to those with Q1 scores, while pregnant women with Q4 scores of the plant-based diets had a reduced risk of GDM (OR=0.382, 95%CI: 0.346-0.613) relative to those with Q1 scores. Conclusion A plant-based dietary pattern may reduce the risk of GDM, while meat-based and dessert-fruit-refined grain dietary patterns may increase the risk of GDM.