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This article reported the diagnosis and treatment of a boy with Dent disease presenting with massive proteinuria.He was 3 years old and found to have massive proteinuria during routine physical examination without hypoalbuminemia, urine protein electrophoresis indicated mainly low molecular weight proteins, with hypercalciuria, and metabolic acidosis, no diabetes, no amino acid urine, and renal ultrasound showed no renal calcium deposition, He had no mental and physical developmental delay and no abnormal family history. Gene detection revealed one missense mutation in exon 15 of the OCRL1 gene, c.1477C > T (p.Arg493Trp). After the diagnosis was confirmed, restrictions in dietary intake of calcium, sodium, and oxalate was restricted and oral potassium citrate and hydrochlorothiazide was prescribed. During two months of follow-up, we observed a decrease in urinary calcium levels and normal renal function. This article aims to improve the understanding of this disease among physicians and provide reference for the diagnosis and treatment of this disease through typical case report and review of previous literatures.

Bartter syndrome (BS, OMIM #601678) is a rare inherited salt-losing tubulopathy characterized by hypokalemia metabolic alkalosis with secondary renin-angiotensin-aldosterone system activation. As reported, BS type 1 is generally presented prenatal and neonatal period, and symptoms usually appear before and after birth or in infancy, accompanied by severe salt loss, whilst kidney function remains mostly normal. In this study, we report a case of BS type 1 with childhood onset and proteinuria and renal impairment. The child was born preterm due to hyperamniotic fluid, but there were no apparent symptoms after birth until the age of 3 when the child began to present with polydipsia, polyuria and increased nocturnal uria. At the age of 5, she had elevated serum creatinine level and proteinuria. After admission, she was diagnosed with chronic tubulointerstitial disease and stage 2 chronic kidney disease(CKD). According to the chloride clearance test, the abnormal function of medullary thick ascending limb Henle′s loop, was confirmed and BS type 1 was diagnosed by gene sequencing. After active management of complications, kidney function of the child improved. In the long-term follow-up, the urinary protein amount of the child still increased, eGFR slowly decreased, and the child was currently in the CKD2 stage. Children with prenatal BS may not present typical clinical manifestations immediately after birth until the onset of relevant clinical symptoms in childhood. BS type 1 patients may have renal impairment, which needs to be identified in time. Clinical differentiation diagnosis between BS and Gitelman syndrome can be made by chloride clearance tests. Early diagnosis and treatment are critical to improve prognosis.

As an innovative neural modulation technique, the transcranial magneto-acousto-electric (MAE) stimulation (TMAES) realizes the synergistic regulation of neuronal discharge through the ultrasonic mechanical and inductive electric effects, offering significant prospects in biomedical applications. However, the stimulation accuracy is still limited by the unidirectional distribution of MAE field intensity. A method of constructing center-converging MAE field by coupling the helical wave fronts of focused acoustic-vortex (FAV) beams with a coaxial magnetic field is proposed. By describing FAVs with Laguerre–Gaussian functions, the theory of MAE field construction is derived in explicit formulae and the spatiotemporal characteristics of MAE fields in the focal region are analyzed. It is theoretically and experimentally demonstrated that the MAE field generated by the FAV of lth order is determined by those of (l − 1)th and (l + 1)th orders. The center-converging phase-rotating MAE field can only be generated by the FAV of first order, maintaining a constant peak intensity at the vortex center. Experimental distributions of MAE fields for FAVs of different orders show good agreements with numerical simulations. With the peak pressure of 0.86 MPa and the magnetic intensity of 0.3 T, the peak intensity of 62.1 mV/m reaching the electric stimulation threshold is achieved. The center-converging MAE field constructed by FAV may develop a new synergistic neural modulation scheme for TMAES with enhanced precision and flexibility while ensuring safety and efficacy, thereby exhibiting significant scientific and practical implications. [ABSTRACT FROM AUTHOR]

A primary wideband calibration method for noise hydrophones is developed, which can be applied to obtain noise acoustic spectral density sensitivity in the free-field. In this method, a wideband three-transducer spherical wave reciprocity calibration method is proposed in the frequency domain. A lowpass spatial domain filter is utilized to eliminate the reflecting acoustic waves from boundaries and water surface, and the wideband frequency responses of the transducer pair are calculated. Wideband calibrations are performed in a laboratory anechoic water tank, and two hydrophones with different reference sensitivities are calibrated in the frequency range of 250 Hz to 20 kHz using noise signals. The decidecade band sensitivities are obtained by the primary wideband calibration, which is in agreement with the single frequency sensitivities. The expended uncertainty of the primary wideband calibration is analyzed and estimated to be 8.9% (k = 2). [ABSTRACT FROM AUTHOR]

Malignant insulinoma is an extremely rare type of functioning pancreatic neuroendocrine tumour with a high degree of malignancy and a high incidence of metastasis. However, it is still unclear how malignant insulinomas develop and metastasize. Serum amyloid P component (SAP), a member of the pentraxin protein family, is an acute‐phase protein secreted by liver cells. The role of SAP in insulinoma and the related mechanism are still unknown. To determine the effect of SAP on insulinoma, we crossed Rip1‐Tag2 mice, which spontaneously develop insulinoma, and SAP knockout (KO) mice to generate Rip1‐Tag2;SAP−/− mice. We found that SAP deletion significantly promoted the growth, invasion and metastasis of malignant insulinoma through C‐X‐C motif chemokine ligand 12 (CXCL12) secreted by cancer‐associated fibroblasts (CAFs). Further study showed that SAP deletion promoted CXCL12 secretion by CAFs through the CXCR4/p38/ERK signalling pathway. These findings reveal a novel role and mechanism of SAP in malignant insulinoma and provide direct evidence that SAP may be a therapeutic agent for this disease. [ABSTRACT FROM AUTHOR]

As human‐machine interaction (HMI) in healthcare continues to evolve, the issue of trust in HMI in healthcare has been raised and explored. It is critical for the development and safety of healthcare that humans have proper trust in medical machines. Intelligent machines that have applied machine learning (ML) technologies continue to penetrate deeper into the medical environment, which also places higher demands on intelligent healthcare. In order to make machines play a role in HMI in healthcare more effectively and make human‐machine cooperation more harmonious, the authors need to build good human‐machine trust (HMT) in healthcare. This article provides a systematic overview of the prominent research on ML and HMT in healthcare. In addition, this study explores and analyses ML and three important factors that influence HMT in healthcare, and then proposes a HMT model in healthcare. Finally, general trends are summarised and issues to consider addressing in future research on HMT in healthcare are identified. [ABSTRACT FROM AUTHOR]

Sonodynamic therapy (SDT) has emerged as a novel and highly researched advancement in the medical field. Traditional ultrasound contrast agents and novel bubble-shaped agents are used to stimulate cavitation and enhance SDT efficiency. However, the impact of artificially modified shell structures on the acoustic properties of microbubbles remains to be explored. Alternatively, in the absence of bubble-shaped agents, some clinically available organic sonosensitizers and advanced inorganic materials are also used to enhance the efficacy of SDT. Diagnostic and therapeutic ultrasound can also activate cavitation bubbles, which supply energy to sonosensitive agents, leading to the production of cytotoxic free radicals to achieve therapeutic effects. While inorganic materials often spark controversy in clinical applications, their relatively simple structure enables researchers to gain insight into the mechanism by which SDT produces various free radicals. Some organic-inorganic hybrid sonosensitive systems have also been reported, combining the benefits of inorganic and organic sonosensitive agents. Alternatively, by employing cell surface modification engineering to enable cells to perform functions such as immune escape, drug loading, gas loading, and sonosensitivity, cellular sonosensitizers have also been developed. However, further exploration is needed on the acoustic properties, ability to generate reactive oxygen species (ROS), and potential clinical application of this cellular sonosensitizer. This review offers a comprehensive analysis of vesical microbubbles and nanoscale sonocatalysts, including organic, inorganic, combined organic-inorganic sonosensitizers, and cellular sonosensitizers. This analysis will enhance our understanding of SDT and demonstrate its important potential in transforming medical applications., Competing Interests: Competing interests: The authors declare that they have no competing interests., (Copyright © 2024 Xiaoge Wu et al.)

Objectives: To investigate the incidence and risk factors for acute kidney injury (AKI) in children with primary nephrotic syndrome (PNS), as well as the role of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in the early identification of AKI in these children., Methods: A prospective collection of clinical data from children hospitalized with PNS at the Children's Hospital of the Capital Institute of Pediatrics from January 2021 to October 2022 was conducted. The children were divided into two groups based on the presence of AKI: the AKI group (47 cases) and the non-AKI group (169 cases). The risk factors for AKI in children with PNS were identified by multivariate logistic regression analysis. Urinary KIM-1 and NGAL levels were compared between the AKI and non-AKI groups, as well as among the different stages of AKI., Results: The incidence of AKI in children with PNS was 21.8%. Multivariate logistic regression analysis revealed that steroid-resistant nephrotic syndrome, gastrointestinal infections, and heavy proteinuria were independent risk factors for AKI in these children with PNS ( P <0.05). Urinary KIM-1 and NGAL levels were higher in the AKI group compared to the non-AKI group ( P <0.05), and the urinary NGAL and KIM-1 levels in the AKI stage 2 and stage 3 subgroups were higher than those in the AKI stage 1 subgroup ( P <0.017)., Conclusions: KIM-1 and NGAL can serve as biomarkers for the early diagnosis of AKI in children with PNS. Identifying high-risk populations for AKI in children with PNS and strengthening the monitoring of related risk factors is of significant importance.

Acute focal bacterial nephritis (AFBN) without pyuria is a subtype of urinary tract infection in children, often leading to diagnostic challenges. The clinical characteristics of 6 children diagnosed with AFBN, who exhibited an absence of pyuria, were retrospectively summarized and compared with the control group consisting of 49 hospitalized AFBN children with pyuria. The cases of AFBN without pyuria presented with more severe inflammatory responses and were predisposed to complications, such as sepsis and neurological abnormalities., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)