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Background: Transbronchial cryobiopsy (TBCB) provides larger tissue samples and improved sampling depth, but its role in diagnosing acute cellular rejection (ACR) in lung transplant patients is unclear due to limitations in existing studies. To address this, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of TBCB., Methods: A thorough literature review was conducted to evaluate TBCB in post-lung transplant surveillance, assessing the quality of studies and conducting a meta-analysis comparing diagnostic yields of TBCB and transbronchial forceps biopsy (TBFB), as well as evaluating procedural complications., Results: Our meta-analysis, incorporating 11 studies with a total of 915 patients, showed that TBCB had a diagnostic rate of 38.27% (225/588) for ACR post-lung transplantation, notably higher than the 35.65% (251/704) for TBFB. The inverse-variance weighted odds ratio was calculated at 2.32 (95% confidence interval: 1.24-4.32; p=0.008). Funnel plot analysis indicated no major publication bias. Meta-analysis of 6 studies demonstrated that TBCB, compared to TBFB, significantly increased the diagnostic rate for chronic rejection post-transplantation (25.00% vs 10.93%, p=0.005). Our meta-analysis comparing the safety of TBCB and TBFB in post-lung transplant surveillance found no significant differences in moderate to severe bleeding (5.99% vs 6.31%, p=0.98), or pneumothorax incidence (3.90% vs 3.29%, p=0.75)., Conclusions: Our study indicates that TBCB may enhance the diagnosis of acute and chronic rejection post-lung transplantation with a safety profile comparable to TBFB. Further research and the development of standardized procedures are warranted to ensure the safe and effective application of TBCB in broader clinical practice., (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: The precise cause of antibody-mediated immune responses on chronic obstructive pulmonary disease (COPD), asthma, and lung function remains unclear. We characterized the relationship between antibody-mediated immune responses to COPD, asthma, and lung function, ultimately achieve the prevention or treatment., Methods: We obtained summary data from published genome-wide association studies, including antibody-mediated immune responses, COPD, asthma, forced expiratory volume in the first second (FEV1), forced expiratory volume (FVC), and FEV1/FVC. Bidirectional two-sample mendelian randomization (MR) analysis was used to assess causal relationships of antibody-mediated immune responses, COPD, asthma, FEV1, FVC, and FEV1/FVC., Results: A total of 20 antibody-mediated immune responses were identified have a significant causal effect on COPD, asthma, FEV1, and FVC, with six exhibiting reverse causality. Importantly, the results of the five MR analyses were almost identical with respect to the causal effect of anti-polyomavirus 2 IgG seropositivity and varicella zoster virus glycoprotein E and I antibody levels on the risk of COPD, asthma, FEV1, and FVC., Conclusions: This study contributes to existing knowledge by investigating the causal relationship between antibody-mediated immune responses and respiratory conditions, including COPD, asthma, and lung function, using a two-sample MR design. The key findings can aid in identifying individuals at risk of these conditions and facilitate early prevention and diagnosis., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Background: The superiority between TAF and ETV remains unclear. Which is the best choice for patients with CHB? Thus, this meta-analysis aimed to evaluate the efficacy and safety of TAF and ETV for patients with CHB., Methods: MEDLINE/PubMed, Cochrane Library, EMBASE, Web of Science and CNKI were searched for eligible studies from inception to January 2024 and a meta-analysis was done., Results: 24 trials with a total of 6753 subjects were screened. TAF significantly improved 12- and 24-week complete virological response (CVR), 12-week biochemical response (BR) and 24-week HBeAg loss, but could not improve 48- and 96-week CVR, 24-, 48- and 96-week BR, 96-week HBeAg loss, adverse events, 48-week HBsAg decline and loss, 12-, 24- and 48-week HBeAg seroconversion, 96-week HCC incidence compared to ETV. Subgroup analysis was conducted according to race, research type and switching. Different results were obtained from different subgroups., Conclusions: TAF was superior to ETV at 12- and 24-week CVR, 12-week BR and 24-week HBeAg loss. Race and switching might affect the efficacy of TAF and ETV., (Copyright © 2024 Elsevier España, S.L.U. All rights reserved.)

Background: The order of clinical symptoms of POEMS syndrome is different, and the first diagnosis department is different accordingly, which is easy to cause misdiagnosis by clinicians., Methods: A retrospective study was conducted between 2019 and 2023 in West China Hospital. Demographic, clinical and laboratory test indicators data were collected., Results: Out of a total of 48 patients, 32 patients were from outpatient clinics and 16 were inpatients. The median age was 51 years old, and 30 were male. The most prevalent initial symptom is polyneuropathy (77.1%). 22 out of the 48 patients had an elevated VEGF. The most prevalent serum M protein was lgA λ(54.2%), and one patient had no M protein which could be regarded as the atypical POEMS syndrome., Conclusions: At present, the diagnosis of POEMS syndrome is based on the combination of clinical manifestations and laboratory tests. Emphasizing pluralism is of great significance for the diagnosis of this disease., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Background: Bladder cancer (BLCA) is a malignant urothelial carcinoma with a high mortality rate. Ferroptosis is a new type of programmed cell death and functions in suppressing tumor growth and progression. However, few studies focus on ferroptosis and BLCA., Materials and Methods: We explored the potential oncogenic roles of ferroptosis-related genes in BLCA based on multiple public datasets. We then used univariate and multivariate cox regression to build a new survival model based on ferroptosis-related genes to predict the survival of BLCA., Results: We found that 23 ferroptosis-related genes had a strong correlation with each other in BLCA. Eight ferroptosis-related genes, CDKN1A, HSPA5, NFE2L2, MT1G, FANCD2, CISD1, TFRC, NCOA4, had a significantly different expression and heat-map. HSPA5 and CISD1 have a statistically significant difference in OS and DFS. Besides, CISD1 had an ideal nomogram to predict the 1-3-5-year OS (C-index: 0.701, P < .001). Furthermore, HSPA5 and CISD1 had a lower DNA methylation rate than normal tissue and HSPA5 had a positive connection with TMB (P = .02). In addition, HSPA5 participated in the DNA replication and P53 signaling pathway, and CISD1 mediated the oxidative phosphorylation and positive regulation of the intrinsic apoptotic signaling pathway., Conclusion: Ferroptosis-related genes had a strong correlation with BLCA, notably, HSPA5 and CISD1 may play a role in inducing ferroptosis to suppress bladder tumorigenesis and CISD1 can be a novel prognostic biomarker as well as an effective target for diagnosis and treatment in BLCA., (Copyright © 2022 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Idiopathic nephrotic syndrome is the most common glomerular disease in children, but there are still some difficulties in treating childhood steroid-dependent or steroid-resistant nephrotic syndrome (SDNS/SRNS). Rituximab (RTX) might be an effective and safe choice., Methods: Studies were searched from PubMed, Web of Science, Cochrane library and some Chinese databases up to April 2020. Only randomized controlled trials (RCT) were included., Results: Of 1383 screened articles, 6 RCTs with 334 participants were included. RTX was better than the control group at improving relapse-free rate in the short term [RR (risk ratio) (95% CI (confidence interval)), 1.84(1.41, 2.39)]. As for long-term, RTX did not show significant improvement [RR (95% CI), 4.43(.57, 34.67)]; but in subgroup analysis, RTX was still better than conventional drugs and tacrolimus [RR (95% CI), 9.91(1.95, 50.52) and 1.42(1.15, 1.75), respectively]. And there was a difference between the two groups of prednisolone dose after treatment [MD (mean difference) (95% CI), -.22(-.36, -.09) mg/kg/d)]. However, RTX did not significantly improve serum albumin and creatinine [MD (95% CI), 3.46(-1.40, 8.32)g/L and -3.66(-11.79, 4.48)μmol/L, respectively]. No significant differences between the RTX and the control group were found in total adverse events (AEs) or serious AEs., Conclusion: Childhood SDNS/SRNS patients appear to benefit from RTX in relapse-free rate and dose of prednisolone use. Also, RTX did not significantly increase the incidence of AEs. But RTX did not show improvements in biological indicators, more studies are required to explain the effect of RTX., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

Background and Aims: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the digestive tract with malignant potential. The current risk classification standard is unable to accurately evaluate the invasiveness and clinical outcomes of GISTs. Ki-67 labelling index (LI) may be an effective indicator in assessing tumour invasiveness and prognosis, however, its exact value in GISTs is still uncertain. The aims of our study were to evaluate the correlation of the Ki-67 LI and clinicopathological features of GISTs and to assess the potential value of the Ki-67 LI in GISTs classification and prognosis., Methods: The clinical, pathological and prognostic data were collected and analysed to identify the independent influential factors of GISTs risk stratification and the predictors of GISTs prognosis., Results: The Ki-67 LI was significantly associated with the clinicopathological features of tumour progression (P<0.05). It was an independent influential factor of GISTs risk classification (odds ratio: 1.322; 95% confidence interval: 1.031-1.696) (P=0.028), and the area under the curve (AUC) value of the Ki-67 LI on the discrimination ability of GISTs risk stratification was 0.906 (P<0.001). The optimal cutoff value of the Ki-67 LI was 6% (sensitivity of 87.5% and specificity of 76.2%), and patients with Ki-67 LI≥6% exhibited significantly poorer progression-free survival (PFS) than those with Ki-67 LI<6% (P<0.001). The AUC value of the Ki-67 LI for predicting PFS in postoperative patients was 0.813 (P=0.03)., Conclusions: The Ki-67 LI has appreciated value to predict the risk grade and prognosis of GISTs. Patients with Ki-67 LI≥6% are prone to recurrence and metastasis after operation and may need a close follow-up., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

Introduction: Viral hepatitis infection is associated with negative impacts on renal function that may lead to nephropathy. We investigated associations between chronic hepatitis B virus (HBV) infection and chronic kidney disease (CKD) and/or end-stage renal disease (ESRD) in a large, representative sample from a nationwide U.S., Methods: This population-based, retrospective observational study extracted data from the U.S. Nationwide Inpatient Sample (NIS) database, including adults ≥18 years old admitted to U.S. hospitals between 2005 and 2014 with records of chronic HBV infection in medical history. The final analytic sample included 70,674 HBV-infected patients and 282,696 matched non-HBV controls. Study endpoints were prevalent CKD and ESRD. Associations between CKD/ESRD and HBV and patients' clinical characteristics were determined by logistic regression analysis., Results: HBV infection was associated with slightly increased risk of prevalent CKD (OR: 1.06, 95% CI: 1.004-1.119) and an approximate 2-times risk of prevalent ESRD (OR: 1.98, 95% CI: 1.880-2.086). HBV infection in both genders was associated with slightly increased risk of CKD (males, OR: 1.09, 95% CI: 1.02-1.16; females, OR: 1.07, 95% CI: 0.98,1.17), and significantly associated with increased risk for CKD among non-diabetic patients (OR: 1.23, 95% CI: 1.15-1.32), white patients (OR: 1.14, 95% CI: 1.06-1.23) and Asian/Pacific Islanders (OR: 1.13, 95% CI: 0.98-1.30)., Conclusions: Chronic HBV infection is associated with slightly increased risk for CKD and greater risk for ESRD in males and females, Whites and Asian/Pacific Islanders and non-diabetic patients., (Copyright © 2020 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Objective: After 131 I treatment in patients with differentiated thyroid carcinoma (DTC), we sometimes find a star-shaped intense uptake of 131 I on therapeutic whole body scans (Rx-WBS), called star artifacts. Therefore, we analyzed the relevant clinical factors and prognostic value of star artifacts in DTC patients., Methods: 809 DTC patients who received 131 I treatment were retrospectively evaluated and divided into 2 groups of patients with and without star artifacts. We evaluated the therapeutic response which was divided into excellent response (ER), biochemical incomplete response (BIR), indeterminate response (IR), and structural incomplete response (SIR). Clinical factors for the presence of star artifacts were analyzed. We also compared the rate of ER, BIR, IR, SIR and recurrence rate between group 1 and group 2., Results: The major clinical factors included stimulated thyroglobulin (sTg)>1.8ng/ml, 24h radioiodine uptake (RAIU)>2.2%, and positive 99m TcO4 - thyroid imaging for the presence of star artifacts. In patients with sTg levels>10ng/ml, patients in group 1 had a higher rate of ablation success and ER than patients in group 2 (80.2% vs 65.6%, P=0.038, 31.6% vs 13.1%, P=0.008, respectively) and had a similar rate of BIR, IR, SIR. Recurrence rate was similar between group 1 and group 2 (5.2% vs 3.1%, P=0.13)., Conclusion: More remnant thyroid tissue is one of the factors associated with the presence of star artifacts on Rx-WBS. Patients with star artifacts exhibit a better therapeutic response (ER) when sTg levels are >10ng/ml. However, star artifacts have no effect on the recurrence rate., (Copyright © 2020 Sociedad Española de Medicina Nuclear e Imagen Molecular. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Idiopathic pulmonary fibrosis (IPF) is an irreversible and progressive fatal interstitial lung disease with a poor prognosis. The aim of this study is to investigate the predictive value of combined blood biomarkers, pulmonary function and quantitative monitoring by computer-aided diagnosis (CAD) system in IPF patients., Methods: Pulmonary baseline function and pathological features of 126 patients with IPF were analyzed using spirometry and chest X-ray. Patients were divided into survival group and non-survival group after 5 years follow-up. The relationships the levels of peripheral blood biomarkers, quantitative imaging characteristics and pulmonary function were analyzed between the two groups., Results: The baseline level of serum Krebs von den Lungen-6 (KL-6) and C-X-C motif chemokine 13 (CXCL13) were moderately or highly correlated with annual changes in forced vital capacity (FVC), carbon monoxide diffusing capacity (DLCO), total lung capacity (TLC), total interstitial lung disease (ILD) lesions, and the volume changes of reticular. The baseline level of serum KL-6 was higher than the cut-off value of 800.0U/ml and baseline level of serum CXCL13 was higher than the cut-off value of 62.0pg/ml. IPF patients with baseline levels of serum KL-6 and CXCL13 lower than the cut-off value had longer median survival time., Conclusions: Serum KL-6 and CXCL13 may be predictive biomarkers for the outcomes of patients with IPF patients and their baseline levels were related to the progression of pulmonary function and quantitative monitoring by CAD system., (Copyright © 2020. Publicado por Elsevier España, S.L.U.)

Background: The role of probiotics supplementation in gestational diabetes mellitus (GDM) remains controversial. We conducted this meta-analysis to investigate the effects of probiotics on fasting blood glucose (FBG), high-sensitivity C-reactive protein (hs-CRP), total glutathione (GSH), malonaldehyde (MDA) and nitric oxide (NO) levels in pregnant women with GDM., Methods: We systematically searched the Cochrane Library, Embase and PubMed electronic databases up to November 2018. A meta-analysis was then conducted using weighted mean difference (WMD) and 95% confidence interval (CI) as effect measures., Results: A total of 7 studies were enrolled in the final meta-analysis. Data showed that probiotics reduced FBG (WMD: -3.19mg/dl, 95% CI: -5.55 to -0.82, P=0.008) in pregnant women with GDM. Sub-group analysis suggested that the effect of probiotics on lowering FBG was more significant in patients with a baseline FBG ≥92mg/dl (WMD: -3.62mg/dl, 95% CI: -6.64 to -0.60, P=0.019), a duration of probiotic treatment ≤6 weeks (WMD: -3.24mg/dl, 95% CI: -4.96 to -1.53, P=0.000) and a dose<6×10 9 colony-forming unit (CFU) (WMD: -3.37mg/dl, 95% CI: -6.64 to -0.10, P=0.043). In addition, probiotics were effective in reducing hs-CRP and MDA in pregnant women with GDM, but had no significant effect on either GSH or NO., Conclusion: This meta-analysis suggests that probiotics supplementation might have a small effect on the reduction of FBG in pregnant women with GDM, and might have certain effects on some biomarkers of inflammation and oxidative stress. However, given the heterogeneity between studies, the results should be interpreted with caution but are worthy of further investigation., (Copyright © 2019 Elsevier España, S.L.U. All rights reserved.)

Background: There is growing evidence that vitamin D is related to the development of a variety of diseases. The current study was performed to investigate the status of serum vitamin D distribution among adult Chinese people and reveal the influence of gender, age, seasonality and residential regions on serum vitamin D levels., Method: This cross-sectional study included 14,302 participants aged from 18 years old to 65 years old from six major cities in China. The basic demographic information and the levels of serum vitamin D (25(OH)D) and vitamin D 3 (25(OH)D 3 ) were collected from Jan 2, 2014 to Dec 25, 2017., Result: The prevalence of 25(OH)D 3 concentration <30ng/mL reached up to 83%, in which the rate of vitamin D insufficiency (20-29ng/mL) was 32.7%, and vitamin D deficiency (10-19ng/mL) accounted for 41.9%, and vitamin D severe shortage (<10ng/mL) accounted for 8.4%. Women were more likely to have vitamin D 3 deficiency and lower serum vitamin D 3 concentration than men (both p<0.001). The mean concentration of serum 25(OH)D and 25(OH)D 3 in summer and autumn were higher than that in spring and winter (p<0.001), and the mean concentration of serum 25(OH)D in people from Southern China was higher than that in people from other regions (p<0.001). Although the mean concentrations of serum 25(OH)D and 25(OH)D 3 were both increased by age, the percentage of patients with serum 25(OH)D 3 insufficiency was also increased., Conclusion: Serum vitamin D deficiency is very common in adults in China. The level of serum vitamin D may be associated with age, sex, seasonality and residential regions., (Copyright © 2019 Elsevier España, S.L.U. All rights reserved.)

Background: Cervical lymph node metastasis (LNM) has been proven to be a predictor for locoregional recurrence in differentiated thyroid carcinoma (DTC). Clinicopathological features could be effective predictive factors for central and lateral LNM of DTC, and provide references to surgeons for cervical neck dissection., Methods: Retrospective analysis of clinicopathological data was performed on 420 patients who underwent initial surgery from 2010 to 2015., Results: The incidence of central and lateral LNM was calculated. Of 420 patients, 247 (58.8%) exhibited central LNM, and 185 (44.1%) exhibited lateral LNM. There were 29 (6.9%) cases confirmed to have skip metastasis. Univariate and multivariate analysis revealed that tumour location, tumour size, multifocality, capsular invasion, affected lobes, and age were independent predictors of central LNM. Tumour location, capsular invasion, affected lobes, and tumour size were independent predictors of lateral LNM., Conclusions: Our findings suggest that tumour location, affected lobes, capsular invasion, age, tumour size and multifocality may be taken as predictive factors for cervical LNM of DTC. Meticulous perioperative evaluation of cervical LNM and prophylactic cervical lymph node dissection that aims to remove the occult lymph nodes may be an option for DTC with risk factors., (Copyright © 2017. Publicado por Elsevier España, S.L.U.)

Background/aim: To describe the epidemiological profile of nasal carriage of Staphylococcus aureus (S. aureus) strains, its antibiotic resistance and mecA and Panton Valentine leukocidin (PVL) genes presence, in school children residing in high altitude areas of Southwestern China., Methods: The cross sectional study screened nasal swabs taken from students for S.aureus. PCR was performed to identify mecA and PVL genes., Results: Of the total 314 children 5.10% (16/314) was detected S.aureus. The resistance of isolated strains to penicillin, erythromycin, clindamycin, rifampicin and cefoxitin was 100%, 81.3%, 81.3%, 0.0%, and 6.3% respectively. No strains demonstrated resistance to vancomycin; expression of mecA gene was detected in 3 isolates and 10 isolates were PVL-positive., Conclusion: S. aureus was detected in 5.10% (16/314) of the study population; 0.96% (3/314) had methicillin resistant S.aureus (MRSA); expression of the mecA and PVL genes were detected in 3 and 10 isolates respectively.