Search

A 60-year-old woman with bilateral lower extremity oedema for several days was admitted to the hospital on 21 November 2023. Previously, after receiving rectal cancer resection in February 2023, she had been receiving drug chemotherapy, during which she had normal urinalysis and renal function. However, 10 days before admission, after the drug regimen was adjusted to tislelizumab + fruquintinib, she developed bilateral lower extremity oedema with foamy urine; this was later extended to facial oedema. After a histologic examination of renal biopsy, it was judged as drug-induced glomerular microangiopathy (GMA) with focal segmental glomerulosclerosis-like lesions accompanied by immune complex-mediated glomerulonephritis. The condition was controlled by stopping the anti-tumour drug, lowering glucose with linagliptin, and providing renal protection with Nephritis Rehabilitation Tablets, and the patient recovered well at the follow-up visit after 6 months. This case may be GMA induced by tislelizumab or fruquintinib and was examined in this study.

The aim of this study was to observe the remission of primary membranous nephropathy (PMN) and evaluate the efficacy of tacrolimus (TAC) monotherapy for PMN in comparison with TAC combined with a low-dose glucocorticoid (GC) protocol (TAC + GC).

Timely and accurate fault diagnosis for a lithium-ion battery pack is critical to ensure its safety. However, the early fault of a battery pack is difficult to detect because of its unobvious fault effect and nonlinear time-varying characteristics. In this paper, a fault diagnosis method based on relative entropy and state of charge (SOC) estimation is proposed to detect fault in lithium-ion batteries. First, the relative entropies of the voltage, temperature and SOC of battery cells are calculated by using a sliding window, and the cumulative sum (CUSUM) test is adopted to achieve fault diagnosis and isolation. Second, the SOC estimation of the short-circuit cell is obtained, and the short-circuit resistance is estimated for a quantitative analysis of the short-circuit fault. Furthermore, the effectiveness of our method is validated by multiple fault tests in a thermally coupled electrochemical battery model. The results show that the proposed method can accurately detect different types of faults and evaluate the short-circuit fault degree by resistance estimation. The voltage/temperature sensor fault is detected at 71 s/58 s after faults have occurred, and a short-circuit fault is diagnosed at 111 s after the fault. In addition, the standard error deviation of short-circuit resistance estimation is less than 0.12 Ω/0.33 Ω for a 5 Ω/10 Ω short-circuit resistor.

To analyze the value of real-time shear wave elastography (SWE) multi-point measurement in the evaluation of muscle elasticity in patients with end-stage renal disease (ESRD) complicated with sarcopenia.

To analyze the potential causes of peritoneal dialysis-associated refractory peritonitis and summarize related nursing measures. The clinical treatment and nursing process of two cases of peritoneal dialysis-associated refractory peritonitis were retrospectively analyzed. The operating procedure of peritoneal dialysis was not strictly followed in these two patients with slim body type and hypoproteinemia, and treatment was delayed due to insufficient awareness about peritoneal dialysis -associated peritonitis. Anti-infective treatment was administrated for intra-abdominal and peripheral infection, and treatment was switched to hemodialysis as no obvious improvement of bacteriological examination results. The treatment environment, operation procedure, intestinal factor and awareness of disease were main factors influencing the peritoneal dialysis -associated refractory peritonitis, and efforts should be made to enhance the self-management skills of peritoneal dialysis patients. (探讨腹膜透析相关性难治性腹膜炎潜在原因及拔管后相应的护理措施。回顾性分析科室2例难治性腹膜炎患者的临床诊疗及护理经过, 总结疾病临床特征及护理经验。2例患者均体型偏瘦, 且存在低蛋白血症, 日常未严格按操作规程进行, 同时未引起对腹膜透析相关性腹膜炎的重视度, 导致延时就诊。入院后给予腹腔及外周抗感染治疗后10～20 d, 腹腔细菌学检查无明显改善, 给予拔管, 改行血液透析。环境、操作、肠道原因、营养状态、对腹膜炎的认识及重视度是导致难治性腹膜炎发生的原因, 应加强对腹膜透析患者的自我管理。)

Objective To investigated when and how to retraining in peritoneal dialysis(PD) patients and its role in decreasing the incidence of peritonitis according to analysis of the characteristics of peritonitis in the PD center. Methods In a retrospective study, 2 years of data from 2019 before continuous quality improvement(CQI) and 2020 after CQI in our PD center were analyzed. According to analyzing the characteristics of peritonitis before CQI, when and how to retrain PD patients were put forward. The incidence and the characteristics of peritonitis were calculated and analyzed before and after CQI. Results There were 27 episodes of peritonitis in 22 out of total 99 PD patients in 2019. Totally 17 cases with peritonitis occurred for the first time and 11 of them (64. 71%) occurred in their first 6 months after PD initiate. Culture-positive was in 12 episodes (among them, 7 episodes of Coagulase-negative Staphylococcus or Staphylococcus Aureus). The whole year peritonitis rate was 1 episode every 35. 2 months in 2019 before CQI. The first retraining was taken in the third month after PD initiate and redirecting their behavior was made. There were 11 episodes of peritonitis in 10 patients out of 101 patients after CQI in 2020. There were 9 episodes of peritonitis occurred for the first time and 2 of them (22. 22%) occurred in their first 6 months after PD initiate. The rate of culture-positive peritonitis was increased to 63. 64%. In the 7 culture-positive episodes, 3 were Staphylococcus Aureus and 4 were Escherichia coli. The whole year peritonitis rate decreased to 1 episode every 108. 5 months in 2020 after CQI. Conclusion First retraining in the third month after PD initiate and redirecting their behavior to reduce the risk of peritonitis was an effective program in PD center. (目的 分析医院腹膜透析中心腹膜透析相关性腹膜炎发生原因、特点, 探讨再培训的时机、内容及实施效果。方法 选择河北医科大学第三医院腹膜透析中心因终末期肾脏病而行腹膜透析治疗并能规律随访的患者。分析2019年本中心腹膜炎发生率及特点, 根据持续质量改进的原则, 提出再培训的时机、内容、护理流程, 并观察实施效果, 与2020年腹膜透析患者腹膜炎发生率及特点进行比较。结果 2019年99例腹膜透析患者中22例患者发生27例次腹膜炎。全年腹膜炎发生率为1/35. 2个病人月。其中有17例患者首次发生, 11(64. 71%)例发生于腹膜透析置管后的6个月内。12例次培养阳性, 其中凝固酶阴性葡萄球菌及金黄色葡萄球菌感染7例次。将第一次再培训时机设为开始腹膜透析后的第3个月, 主要内容为规范操作。实施再培训后, 2020年本中心101例腹膜透析患者共10例患者发生11例次腹膜炎, 全年腹膜炎发生率为1/108. 5个病人月, 9例首次发生腹膜炎的患者中2(22. 22%)例发生于置管术后6个月内。7(63. 64%)例次培养阳性, 其中金黄色葡萄球菌感染3例次, 大肠杆菌4例次。结论 开展再培训计划, 可使医院腹膜透析中心的腹膜透析相关性腹膜炎的发生率明显减少。)

In military contexts, synthetic aperture radar (SAR) automatic target recognition (ATR) models frequently encounter the challenge of imbalanced data, resulting in a noticeable degradation in the recognition performance. Therefore, the authors propose a cost‐sensitive awareness generative adversarial network (CAGAN) model, aiming to improve the robustness of ATR models under imbalanced data. Firstly, the authors introduce a convolutional neural network (DCNN) to extract features. Then, the synthetic minority over‐sampling technique (SMOTE) is applied to achieve feature‐level balancing for the minority category. Finally, a CAGAN model is designed to perform the final classification task. In this process, the GAN‐based adversarial training mechanism enriches the diversity of training samples, making the ATR model more comprehensive in understanding different categories. In addition, the cost matrix increases the penalty for misclassification results and further improves the classification accuracy. Simultaneously, the cost‐sensitive awareness can accurately adjust the cost matrix through training data, thus reducing dependence on expert knowledge and improving the generalisation performance of the ATR model. This model is an end‐to‐end ATR scheme, which has been experimentally validated on the MSTAR and OpenSARship datasets. Compared to other methods, the proposed method exhibits strong robustness in dealing with various imbalanced scenarios and significant generalisation capability across different datasets. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to analyze the early mental health (MH) and quality of life (QoL) of discharged patients with coronavirus disease 2019 (COVID-19), which can provide a scientific basis for the further development of intervention programs.Methods: In total, 108 subjects participated in this study, including an experimental group (90 patients diagnosed with COVID-19 from March to April 2020 and hospitalized in Wuhan China Resources & WISCO General Hospital, Wuhan, China, 83.3%) and a control group (18 healthy participants, 16.7%). Their MH and QoL were measured through the 12-item Short Form Health Survey version 2 (SF-12v2), the Self-rating anxiety scale (SAS), the Self-rating depression scale (SDS), and the International Physical Activity Questionnaire (IPAQ). The results of questionnaires were compared between these two groups.Results: (1) Comparison of anxiety status: among 90 discharged patients with COVID-19, 30 patients (33.3%) had a state of anxiety. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of anxiety and more severe anxiety symptoms (P < 0.05). (2) Comparison of depression status: among 90 discharged patients with COVID-19, 29 patients (32.2%) had a state of depression. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of depression and more severe depression symptoms (P < 0.05). (3) Comparison of QoL: 78 patients (86.7%) presented a decrease in physical health-related quality of life (HRQoL) and 73 patients (81.1%) presented a decrease in psychology-related QoL. The SF-12v2 physical component summary (PCS) and the SF-12v2 mental component summary (MCS) of patients were significantly lower than those of healthy people, especially in physical function (PF), vitality (VT), social function (SF), and mental health (MH) (all P < 0.05). (4) Gender differences in mental health and the QoL among patients with COVID-19: women had more severe anxiety/depression symptoms than men (P < 0.05). The scores of women in all dimensions of SF-12V2 were lower than those of men, and there were statistically significant differences between the two groups in PCS, PF, general health (GH), VT, and role-emotional (RE) (P < 0.05).Conclusion: During the early phase after being discharged, patients with COVID-19 might experience negative emotions, such as anxiety or depression, and also problems with reduced QoL, especially among female patients. Therefore, an intervention plan should focus on strengthening psychological condition and improving physical function, and gender-specific rehabilitation programmes should be adapted to improve psychological status and QoL.

This study aimed to further validate the prognostic role of fibrinogen in upper tract urothelial carcinoma (UTUC) in a large Chinese cohort. A total of 703 patients who underwent radical nephroureterectomy were retrospectively identified. Fibrinogen levels of ≥4.025 g l−1 were defined as elevated. Logistic regression analysis was performed to determine the association between fibrinogen and adverse pathological features. Kaplan–Meier analysis and Cox regression models were used to assess the associations of fibrinogen with cancer-specific survival (CSS), disease recurrence-free survival (RFS), and overall survival (OS). Harrell c-index and decision curve analysis were used to assess the clinical utility of multivariate models. The median follow-up duration was 42 (range: 1–168) months. Logistic regression analysis revealed that elevated fibrinogen was associated with higher tumor stage and grade, lymph node involvement, lymphovascular invasion, sessile carcinoma, concomitant variant histology, and positive surgical margins (all P < 0.05). Multivariate Cox regression analysis demonstrated that elevated fibrinogen was independently associated with decreased CSS (hazard ratio [HR]: 2.33; P < 0.001), RFS (HR: 2.09; P < 0.001), and OS (HR: 2.09; P < 0.001). The predictive accuracies of the multivariate models were improved by 3.2%, 2.0%, and 2.8% for CSS, RFS, and OS, respectively, when fibrinogen was added. Decision curve analysis showed an added benefit for CSS prediction when fibrinogen was added to the model. Preoperative fibrinogen may be a strong independent predictor of worse oncologic outcomes in UTUC; therefore, it may be valuable to apply this marker to the current risk stratification in UTUC.

Two undescribed furanones (1-2) were isolated from Coptis deltoidea rhizome. HRESIMS, NMR and ECD calculations were used to ascertain their structures. Based on the inflammation cell model of RAW264.7 macrophage which induced by lipopolysaccharides (LPS), RNA-Seq was used to reveal the biological activity of 1. According to the findings, 1 dramatically changed the genes expression profile of the inflammatory cell model produced by LPS in RAW264.7 cells which indicated that it had potential anti-inflammatory activitiy. [ABSTRACT FROM AUTHOR]

The authors wish to make the following corrections to this paper [...]

Objective: Fibroblast‐like synoviocytes (FLSs) contribute to inflammation and joint damage in rheumatoid arthritis (RA). However, the regulatory mechanisms of FLSs in relapse and remission of RA remain unknown. Identifying FLS heterogeneity and their underlying pathogenic roles may lead to discovering novel disease‐modifying antirheumatic drugs. Methods: Combining single‐cell RNA sequencing (scRNA‐seq) and spatial transcriptomics, we sequenced six matched synovial tissue samples from three patients with relapse RA and three patients in remission. We analyzed the differences in the transcriptomes of the FLS subsets between the relapse and remitted phases. We validated several key signaling pathways using quantitative real‐time PCR (qPCR) and multiplex immunohistochemistry (mIHC). We further targeted the critical signals in vitro and in vivo using the collagen‐induced arthritis (CIA) model in rats. Results: Lining and sublining FLS subsets were identified using scRNA‐seq. Differential analyses indicated that the fibroblast growth factor (FGF) pathway was highly activated in the lining FLSs from patients with relapse RA for which mIHC confirmed the increased expression of FGF10. Although the type I interferon pathway was also activated in the lining FLSs, in vitro stimulation experiment suggested that it was independent of the FGF10 pathway. FGF10 knockdown by small interfering RNA in FLSs significantly reduced the expression of receptor activator of NF‐κB ligand. Moreover, recombinant FGF10 protein enhanced bone erosion in the primary human‐derived pannus cell culture, whereas the FGF receptor (FGFR) 1 inhibitor attenuated this process. Finally, administering an FGFR1 inhibitor displayed a therapeutic effect in a CIA rat model. Conclusion: The FGF pathway is a critical signaling pathway in relapse RA. Targeted tissue‐specific inhibition of FGF10/FGFR1 may provide new opportunities to treat patients with relapse RA. [ABSTRACT FROM AUTHOR]

Oxygen evolution reaction (OER) is a bottleneck to photoelectrochemical (PEC) water splitting; however, there remains an impressive challenge for intrinsic charge transport for the development of integrated photoanodes. Herein, covalent triazine frameworks as conjugated molecules are grafted on the surfaces of ferroelectric BaTiO3−x (CTF/BTO) nanorod array, and then oxyhydroxide oxygen evolution cocatalyst (OEC) is constructed as an integrated photoanode. The OEC/CTF/BTO array not only achieves a high photocurrent density of 0.83 mA cm−2 at 1.23 V versus reversible hydrogen electrode (vs RHE) and low onset potential of ≈0.23 VRHE, but also optimizes outstanding stability. To disclose the origin, the enhanced PEC activity can be contributed to the integration of CTF and OEC, enhancing light‐harvesting capability, boosting charge carrier mediation, and promoting water oxidation kinetics through electrochemical analysis and density functional theory calculations. This study not only provides an alternative to accelerate charge transfer, but also paves the rational design and fabrication of integrated photoanodes for boosting PEC water splitting performance. [ABSTRACT FROM AUTHOR]

The mechanisms underlying osteoarthritis (OA) have recently been hypothesized to involve a dysfunctional immune system. In this study, we collected synovium, synovial fluid (SF), and peripheral blood from 21 patients. Mononuclear cells were characterized using FCM. H&E staining and mIHC histological assessment of synovium were performed. Cytokine levels in the SF were measured using ELISA. We observed similar frequencies of immune cells in the synovium and SF, which were enriched in DCs. Notably, CD1c+CD163+ DC3s were expanded in the synovium and SF. Furthermore, we found that DC3s were primarily located within the ectopic lymphoid-like structure (ELLS) in close proximity to CD8+ T cells. Finally, the level of TNF-α and IL12p70 in the SF correlated with the severity of OA. These data suggest that OA is an immune system-related disease and that DC3s may play an active role in OA progression by promoting ELLS formation and inflammatory responses. [ABSTRACT FROM AUTHOR]