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Non-muscle myosin heavy chain 9-related disease (MYH9-RD) is an autosomal dominant disease caused by the mutations of the MYH9 gene encoding the non-muscle mysoin heavy chain ⅡA and leads to abnormal accumulation of myosin in cells. These further causes functional disorders of the blood, eye, ear, kidney, and liver systems. MYH9-RD displays heterogeneous kidney involvement and outcomes, but doctors still lack understandings of the mechanism and treatment strategies, owing to difficulty of conducting renal biopsies. Here, we report a case of MYH9-RD with tail fragments heterozygous mutation, which renal pathology is presented as glomerular minor lesion. Moreover, we reviewed related relevant to strengthen clinical diagnosis and understanding of MYH9-RD.

Objective To establish and validate a risk prediction model for postoperative delirium (POD) in patients with head and neck cancer (HNC) resection with free flap repair and to provide a reference for clinical practice. Methods This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. This study retrospectively collected and evaluated the risk factors and vital signs of patients undergoing head and neck cancer free flap reconstruction in the Department of Oromaxillofacial Head and Neck Oncology, Xuzhou Central Hospital from January 1, 2016, to January 1, 2022. A total of 241 cases were included, of which 171 cases were used to establish the prediction model, and 70 cases were collected for internal verification. Univariate and multivariate logistic analyses and the R Studio software package were used for modeling and statistical analysis. Results The research model finally included five risk factors: age, blood transfusion, postoperative sleep disorder and postoperative VAS pain value. The area under the working characteristic curve (AUC) of the subjects in the training set of the model was 0.869 (95% CI: 0.789-0.948), the Youden index was 0.692, the predictive value was 0.215, the sensitivity was 85.3%, the specificity was 83.9%, and the goodness of fit of the Hosmer Lemeshow test was 10.336 (P = 0.242). The model fit well. The validation set was verified according to the model. The C index was 0.827 (95% CI: 0.681-0.973), and the model prediction effect was very good. Conclusion This model may be applied to predict postoperative delirium for patients with head and neck cancer resection and free flap repair, which has a high predictive value for the risk of HNC-POD at admission. The use of this model may help to better implement preventive treatment and nursing measures.

BackgroundCOVID-19 has spread widely worldwide, causing millions of deaths. We aim to explore the association of immunological features with COVID-19 severity.MethodsWe conducted a meta-analysis to estimate mean difference (MD) of immune cells and cytokines levels with COVID-19 severity in PubMed, Web of Science, Scopus, the Cochrane Library and the grey literature.ResultsA total of 21 studies with 2033 COVID-19 patients were included. Compared with mild cases, severe cases showed significantly lower levels of immune cells including CD3+ T cell (× 106, MD, - 413.87; 95%CI, - 611.39 to - 216.34), CD4+ T cell (× 106, MD, - 203.56; 95%CI, - 277.94 to - 129.18), CD8+ T cell (× 106, MD, - 128.88; 95%CI, - 163.97 to - 93.79), B cell (× 106/L; MD, - 23.87; 95%CI, - 43.97 to - 3.78) and NK cell (× 106/L; MD, - 57.12; 95%CI, - 81.18 to - 33.06), and significantly higher levels of cytokines including TNF-α (pg/ml; MD, 0.34; 95%CI, 0.09 to 0.59), IL-5 (pg/ml; MD, 14.2; 95%CI, 3.99 to 24.4), IL-6 (pg/ml; MD, 13.07; 95%CI, 9.80 to 16.35), and IL-10 (pg/ml; MD, 2.04; 95%CI, 1.32 to 2.75), and significantly higher levels of chemokines as MCP-1 (SMD, 3.41; 95%CI, 2.42 to 4.40), IP-10 (SMD, 2.82; 95%CI, 1.20 to 4.45) and eotaxin (SMD, 1.55; 95%CI, 0.05 to 3.05). However, no significant difference was found in other indicators such as Treg cell (× 106, MD, - 0.13; 95%CI, - 1.40 to 1.14), CD4+/CD8+ ratio (MD, 0.26; 95%CI, - 0.02 to 0.55), IFN-γ (pg/ml; MD, 0.26; 95%CI, - 0.05 to 0.56), IL-2 (pg/ml; MD, 0.05; 95%CI, - 0.49 to 0.60), IL-4 (pg/ml; MD, - 0.03; 95%CI, - 0.68 to 0.62), GM-CSF (SMD, 0.44; 95%CI, - 0.46 to 1.35), and RANTES (SMD, 0.94; 95%CI, - 2.88 to 4.75).ConclusionOur meta-analysis revealed significantly lower levels of immune cells (CD3+ T, CD4+ T, CD8+ T, B and NK cells), higher levels of cytokines (TNF-α, IL-5, IL-6 and IL-10) and higher levels of chemokines (MCP-1, IP-10 and eotaxin) in severe cases in comparison to mild cases of COVID-19. Measurement of immunological features could help assess disease severity for effective triage of COVID-19 patients.

Objective: To investigate the relationship between hyperuricemia and hypertension in patients with chronic kidney disease (CKD). Methods: The demographic characteristics, blood pressure and biochemical indicators in 530 outpatients of CKD were analyzed in this study from Jan 2020 to Mar 2020 in the Nephrology Department of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Multivariate logistic regression analysis was used to evaluate the correlation between serum uric acid and hypertension in CKD patients. Results: The prevalence of hyperuricemia in CKD patients was 42.6%, and the prevalence of hypertension was 60.4%. In patients with CKD from stages 1 to 5, the prevalence of hypertension was 37.3%, 57.4%, 74.0%, 78.8%， 83.6% respectively, and the prevalence of hyperuricemia was 19.5%， 35.7%， 65.4%， 61.5%， 55.2% respectively. The prevalence of both hyperuricemia and hypertension among CKD 1-5 were significantly different. By comparison with the serum uric acid level in the first quartile (Q1，the multivariate-adjusted odds for hypertension in the Q2, Q3 and Q4 were 1.588, 1.368 and 2.542 times respectively. Among them, the risk of hypertension in the highest quartile group was 2.542 times as the risk in Q1. Conclusions: Among CKD patients, there is a significant correlation between hyperuricemia and hypertension. The risk of hypertension increases with the rise of serum uric acid level. More attention should be paid to CKD patients with asymptomatic hyperuricemia.