北京大学学报（医学版）最新文献

{"title":"[Sjögren disease complicated by primary breast lymphoma: A case report].","authors":"Y Ning, X Zhang, X Li, Y Li, J He, Y Jin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case report describes the diagnostic and therapeutic management of a 67-year-old female with a 40-year history of Sjögren disease (SjD) who was hospitalized for evaluation of recurrent fever lasting over one month. The patient' s initial diagnosis of SjD was established four decades earlier based on clinical manifestations, serological findings, and evidence of glandular damage. Her clinical presentation included recurrent parotid gland enlargement accompanied by sicca symptoms, notably persistent xerostomia and xerophthalmia, followed by progressive dental caries. Serological studies demonstrated positivity for antinuclear antibodies, anti-SSA/Ro, and anti-α-fodrin antibodies. Objective assessments confirmed significant ocular involvement (Schirmer' s test ≤5 mm/5 min) and pulmonary interstitial changes on chest CT, consistent with the 2016 American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) classification criteria for SjD. The patient' s condition remained stable under low-dose corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs) until the recent onset of prolonged fever, necessitating evaluation for fever of unknown origin. Differential diagnoses considered disease flare, infection, and malignancy. The European Sjögren' s Syndrome Disease Activity Index (ESSDAI) score was 5 points, indicating moderate systemic disease activity. Initial laboratory investigations revealed no evidence of infection, and empirical anti-infective therapy proved ineffective. Notably, despite the absence of lymphadenopathy, laboratory findings including borderline positive IgM λ M-protein, elevated lactate dehydrogenase, hyperferritinemia, and increased β2-microglobulin levels raised suspicion for lymphoproliferative disorders, given the established association between SjD and lymphoma. Bone marrow aspiration showed no significant abnormalities, but PET/CT imaging detected hypermetabolic lesions in the left breast and right distal femur, suggesting potential malignancy. Subsequent histopathological examination of the breast lesion confirmed non-Hodgkin' s lymphoma (NHL), specifically diffuse large B-cell lymphoma (DLBCL) of the germinal center B-cell (GCB) subtype. Treatment with R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) induced complete metabolic remission after three cycles. However, she subsequently developed treatment-related complications, including myelosuppression and pulmonary infection. This case underscores the importance of maintaining a high index of suspicion for atypical site involvement in SjD patients, particularly when lymphoma risk factors are present. Comprehensive differential diagnosis should include lymphoma and other malignancies, and the diagnostic value of PET/CT and histopathological examination in disease evaluation is emphasized. SjD complicated by breast lymphoma is exceptionally rare, and its pathogenesis may involve lymphocytic inf","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"808-811"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of outpatient services utilization of heart failure patients on hospitalization rate and its threshold effect: Taking patients with Urban Employee Basic Medical Insurance in Zhejiang Province as an example].","authors":"H Zhang, R Jing, J Wang, H Fang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To examine the impact of outpatient service utilization on hospitalization rates in patients with heart failure, with a focus on identifying the threshold effect, and to provide evidence to support the design of outpatient medical insurance reimbursement policies for heart failure patients.</p><p><strong>Methods: </strong>Using a stratified random sampling method, individual reimbursement data of heart failure patients covered by Urban Employee Basic Medical Insurance in Zhejiang Province from year 2013 to 2017 were extracted. A panel fixed-effects logit regression model and a threshold effect model were applied to analyze the impact of annual outpatient service utilization in the previous year on the hospitalization rate in the current year and to identify the threshold effect. The annual outpatient service utilization indicators included the annual outpatient visits, annual outpatient expenses, annual outpatient drug expenses, and annual outpatient self-expenses within the policy. Hospitalization rate indicators comprised the annual hospitalization rate, rehospitalization rate within 30 days, and rehospitalization rate within 90 days.</p><p><strong>Results: </strong>(1) The study found that an increase in prior-year annual outpatient service utilization led to a decrease in the current-year annual hospitalization rate. However, the effects on the rehospitalization rate within 30 days and rehospitalization rate within 90 days were not statistically significant; (2) The thre-shold effect of prior-year annual outpatient service utilization on the current-year annual hospitalization rate was also identified. When the prior-year annual outpatient visits were less than or equal to the threshold (12 visits), the current-year annual hospitalization rate decreased as the prior-year annual outpatient visits increased and statistically significant, and the regression coefficient was not significant when the prior-year annual outpatient visits were higher than the threshold (12 visits). Correspondingly, the thresholds for annual outpatient expenses and annual outpatient self-expenses within policy in the previous year were 3 342.8 yuan and 736.9 yuan, respectively.</p><p><strong>Conclusion: </strong>There is a threshold effect of prior-year annual outpatient service utilization on the current year' s annual hospitalization rate in heart failure patients. These results have important implications for designing outpatient health insurance policies for heart failure patients to improve the patients' utilization of outpatient services and decrease the hospitalization rates. Specifically, policymakers should consider the identified thresholds when designing reimbursement policies for heart failure patients, which may help to optimize the use of medical resources and reduce the burden of medical expenses.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"753-758"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinicopathological features and survival analysis of <i>TFE3</i>-rearranged renal cell carcinoma with venous tumor thrombus].","authors":"Z Zhang, M Lu, Y Sun, J Dong, X Hou, C Xiao, G Wang, X Tian, L Ma, H Zhang, S Zhang","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To review the clinicopathological features of &lt;i&gt;TFE3&lt;/i&gt;-rearranged renal cell carcinoma (&lt;i&gt;TFE3&lt;/i&gt;-RCC) with venous tumor thrombus (VT) (&lt;i&gt;TFE3&lt;/i&gt;-VT), to explore treatment strategies and to prognostic characteristics, and to provide diagnostic and therapeutic references for &lt;i&gt;TFE3&lt;/i&gt;-VT patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients who underwent surgery at Department of Urology, Peking University Third Hospital from January 2013 to January 2024 were enrolled, including three cohorts: Pathologically confirmed &lt;i&gt;TFE3&lt;/i&gt;-VT patients, &lt;i&gt;TFE3&lt;/i&gt;-RCC patients without VT (&lt;i&gt;TFE3&lt;/i&gt;-non-VT), and non-&lt;i&gt;TFE3&lt;/i&gt;-rearranged renal cell carcinoma patients with VT (non-&lt;i&gt;TFE3&lt;/i&gt;-VT). Clinical history, imaging data, pathological data, and follow-up records were collected. Primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS), respectively. (1) Baseline characteristics were compared between the &lt;i&gt;TFE3&lt;/i&gt;-VT and &lt;i&gt;TFE3&lt;/i&gt;-non-VT patients. Normally distributed continuous variables were expressed as mean±SD and compared using Student's &lt;i&gt;t&lt;/i&gt;-test; non-normally distributed variables were expressed as &lt;i&gt;M&lt;/i&gt; (&lt;i&gt;P&lt;/i&gt;&lt;sub&gt;25&lt;/sub&gt;, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;75&lt;/sub&gt;) and analyzed with Mann-Whitney &lt;i&gt;U&lt;/i&gt; test; categorical variables were described as frequency and percentage [&lt;i&gt;n&lt;/i&gt; (%)] and compared by &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test or Fisher's exact test. (2) Clinical history, radiological presentations, surgical data, and histopathological features of the &lt;i&gt;TFE3&lt;/i&gt;-VT patients were comprehensively characterized. (3) Survival analysis was performed for the &lt;i&gt;TFE3&lt;/i&gt;-VT patients. Follow-up data of the &lt;i&gt;TFE3&lt;/i&gt;-VT patients were described in detail, and their survival outcomes were compared with the &lt;i&gt;TFE3&lt;/i&gt;-non-VT and non-&lt;i&gt;TFE3&lt;/i&gt;-VT patients. When compared with the &lt;i&gt;TFE3&lt;/i&gt;-non-VT counterparts, Kaplan-Meier method was used to generate PFS and OS curves among: (1) the &lt;i&gt;TFE3&lt;/i&gt;-RCC patients across clinical stages Ⅰ-Ⅳ; (2) &lt;i&gt;TFE3&lt;/i&gt;-VT &lt;i&gt;versus&lt;/i&gt; &lt;i&gt;TFE3&lt;/i&gt;-non-VT cohorts; (3) stage Ⅲ subgroups of the &lt;i&gt;TFE3&lt;/i&gt;-VT and &lt;i&gt;TFE3&lt;/i&gt;-non-VT patients. Intergroup survival differences were statistically evaluated using Log-rank tests. For comparisons with the non-&lt;i&gt;TFE3&lt;/i&gt;-VT patients, a 1 : 1 propensity score matching (PSM) was implemented to balance baseline characteristics between the two cohorts. Post-matching Kaplan-Meier curves were generated to compare PFS and OS between the matched groups, with Log-rank tests employed to determine statistical significance of survival disparities. All statistical analyses were conducted with R software (v 4.2.3), and two-tailed &lt;i&gt;P&lt;/i&gt; &lt; 0.05 was considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 45 &lt;i&gt;TFE3&lt;/i&gt;-RCC patients: 13 &lt;i&gt;TFE3&lt;/i&gt;-VT and 32 &lt;i&gt;TFE3&lt;/i&gt;-non-VT cases. Additionally, 523 non-&lt;i&gt;TFE3&lt;/i&gt;-VT patients were enrolled. Among the 13 &lt;i&gt;TFE3&lt;/i&gt;-VT patients, 9 were fe","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"650-661"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Kidney transplantation in low-age, low-weight children: A report of two cases].","authors":"Z Zhao, W Zhang, W Yang, Y Zhang, X Zhang, H Zhao, G Zhou, Q Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Kidney transplantation is widely recognized as the optimal treatment for children with end-stage renal disease (ESRD), offering significant improvements in growth, development, and long-term quality of life compared with prolonged dialysis. However, kidney transplantation in low-age (< 5 years old) and low-weight (< 15 kg) children presents significant clinical challenges due to their delicate vascular structures, limited surgical space, and complex perioperative management. This report presents two cases of kidney transplantation in low-age, low-weight children performed at Peking University People' s Hospital. Case 1: a 2-year-3-month-old boy (8.8 kg), presenting a preoperative serum creatinine of 248 μmol/L post-dialysis and the estimated glomerular filtration rates (eGFR) of 35.17 mL/(min·1.73 m²). Case 2: a 3-year-8-month-old girl (11.25 kg), presenting a preoperative creatinine of 281 μmol/L post-dialysis and the eGFR of 22.63 mL/(min·1.73 m²). Both recipients underwent transplantation <i>via</i> the extraperitoneal approach, with end-to-side anastomosis of the donor renal artery and vein to the recipient' s common iliac artery and vein, respectively. The ureters were anastomosed to the bladder using the tunnel technique, and double-J stents were placed intraoperatively. The surgeries were uneventful, and both patients exhibited rapid recovery of renal function. Postoperatively, serum creatinine levels decreased to 26 μmol/L (Case 1) and 39 μmol/L (Case 2) by the third day, with the eGFR reaching 245.23 mL/(min·1.73 m²) and 164.12 mL/(min·1.73 m²), respectively. No complications, such as vascular thrombosis, ureteral stenosis, or abdominal compartment syndrome were observed during follow-up. A comprehensive literature review was conducted to contextualize these cases within global advancements in pediatric renal transplantation. Current evidence highlights the growing adoption of kidney transplantation for low-age, low-weight children, though debates persist regarding optimal surgical strategies (specifically, the intraperitoneal versus extraperitoneal approaches). This case report underscores the feasibility of the extraperitoneal approach in overcoming anatomical limitations of low-weight pediatric recipients, with distinct advantages including reduced gastrointestinal complications and enhanced accessibility for post-operative ultrasound monitoring. Furthermore, mean arterial pressure (MAP) and central venous pressure (CVP) were systematically monitored intraoperatively to ensure optimal renal blood perfusion and graft viability. Our single-center experience provides valuable insights into surgical strategy selection and perioperative management for this high-risk population. Nevertheless, larger multicenter studies are warranted to validate long-term outcomes and refine standardized protocols.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"803-807"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Protective effect of knock-down the expression of <i>Blimp1</i> gene on early liver injury in CCl₄-induced mouse model of liver fibrosis].","authors":"Q Qin, R Li, Y Zhou, Y Zhang, M Han, L Zhu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the protective effect of knock-down the expression of B lymphocyte induced maturation protein 1 (&lt;i&gt;Blimp1&lt;/i&gt;) gene on early liver injury in carbon tetrachloride (CCl&lt;sub&gt;4&lt;/sub&gt;)-induced mouse model of liver fibrosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;C57BL/6 mice were intraderitoneal injected with 5% CCl&lt;sub&gt;4&lt;/sub&gt; olive oil solution to create mouse model of hepatic fibrosis. The expression of &lt;i&gt;Blimp1&lt;/i&gt; gene in the mice was reduced by intraderitoneal injection of short hairpin RNA (shRNA) adeno-associated virus (AAV). The mice were randomly divided into 3 groups: blank test group (&lt;i&gt;n&lt;/i&gt;=10), CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-NC group (&lt;i&gt;n&lt;/i&gt;=10) and CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-Blimp1 group (&lt;i&gt;n&lt;/i&gt;=10). After 27 days of preparation of the CCl&lt;sub&gt;4&lt;/sub&gt; mouse model, animal materials were carried out. Western blot and real-time PCR were used to detect the levels of Blimp1, α-smooth muscle actin (α-SMA), collagen type Ⅰ alpha 1 (COL1A1), collagen type Ⅲ alpha 1 (COL3A1), and their mRNA expression levels of liver tissue in each group. The serum of each group was separated to measure aspartate transaminase (AST) and alanine transaminase (ALT) by automatic biochemical analyzer. The pathological changes of liver tissue and the degree of liver fibrosis in the mice were detected by pathological staining including hematoxylin-eosin staining, Masson, and Sirius red.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The expression levels of Blimp1 protein in the liver of CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-NC group (2.036±0.244, &lt;i&gt;t&lt;/i&gt;=3.690, &lt;i&gt;P&lt;/i&gt;=0.002) were significantly increased than that of the blank test group. In the CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-Blimp1 group, the expression of Blimp1 protein decreased to the basal level (0.783±0.249, &lt;i&gt;t&lt;/i&gt;=6.223, &lt;i&gt;P&lt;/i&gt;=0.003). Compared with the serum levels of ALT [(1 957.8±633.6) U/L] and AST [(1 808.8±260.1) U/L] in the CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-NC group, the serum levels of ALT [(894.0±360.1) U/L, &lt;i&gt;t&lt;/i&gt;=3.998, &lt;i&gt;P&lt;/i&gt;=0.003] and AST [(820.0±100.6) U/L, &lt;i&gt;t&lt;/i&gt;=6.141, &lt;i&gt;P&lt;/i&gt;=0.004] in the CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-Blimp1 group were significantly decreased. The pathological results of the CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-Blimp1 group showed that compared with the CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-NC group, the infiltration of inflammatory cells in the liver tissue was reduced and the degree of fibrosis was alleviated. The level of α-SMA (0.676±0.064, &lt;i&gt;t&lt;/i&gt;=7.930, &lt;i&gt;P&lt;/i&gt;=0.001), COL1A1 (1.426±0.143, &lt;i&gt;t&lt;/i&gt;=6.364, &lt;i&gt;P&lt;/i&gt;=0.003) and COL3A1 (1.124±0.198, &lt;i&gt;t&lt;/i&gt;=3.440, &lt;i&gt;P&lt;/i&gt;=0.026) of liver in the CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-Blimp1 group were significantly decreased than that of CCl&lt;sub&gt;4&lt;/sub&gt;+AAV-shRNA-NC group, and the mRNA expression levels were altered as well as their protein levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Blimp1 plays an important role in CCl&lt;sub&gt;4&lt;/sub&gt;-induced liver fibrosis in mice, and knock-down the expression of &lt;i&gt;Blimp1&lt;/i&gt; gene is beneficial to protect early liver","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"727-734"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk factors associated with non-radiographic bone erosion in patients with gout].","authors":"W Liu, W Guo, Z Guo, C Li, Y Li, S Liu, L Zhang, H Song","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the factors associated with non-radiographic bone erosion in gout patients, to improve the understanding of bone erosion in gout, and to promote the early detection of bone erosion.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the medical records of gout patients treated at Beijing Jishuitan Hospital from January 2018 to January 2022. Bone erosion was detectable by ultrasound but not detected by X-ray as non-radiographic bone erosion; no bone erosion was detected by both ultrasound and joint X-ray as undetected bone erosion. A case-control study was used, and the two groups were matched 1 ∶ 2 according to age and sex. The differences between the two groups were compared in terms of general information, joint involvement characteristics, laboratory indicators and complications. In the univariate analysis, <i>P</i> < 0.1 was included in the multivariate analysis, and the conditional Logistic regression was used for the multivariate analysis. <i>P</i> < 0.05 was considered to have statistically significant differences.</p><p><strong>Results: </strong>Among the 41 patients with non-radiographic bone erosion, the top three joints with bone erosion before its occurrence were metatarsophalangeal joint (12 cases), ankle (10 cases), and knee (7 cases). There were 82 patients undetected with bone erosion. There were no significant differences in general information between the two groups (<i>P</i>>0.05), including age, gender, body mass index, and alcohol consumption history. The characteristics of affected joints in the non-radio-graphic bone erosion group were compared with those in the no bone erosion detected, and the former had more affected joints (<i>P</i>=0.02), and a higher proportion of patients with at least 3 attacks of gout per year (<i>P</i> < 0.001). There were no significant differences in serum uric acid, fasting blood glucose, cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, creatinine, homocysteine, white blood cell count, and urine pH between the two groups (<i>P</i>>0.05). The results of multivariate analysis showed that at least 3 flares of gout per year was an independent risk factor for radiologically negative bone erosion in patients with gout, with an <i>OR</i> (95%<i>CI</i>) of 5.139 (1.529-17.271).</p><p><strong>Conclusion: </strong>At least 3 flares of gout per year predicts the occurrence of radiologically negative bone erosion, and these patients should be given more attention to achieving treatment targets.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"735-739"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Robot-assisted laparoscopic inferior vena cava segmental resection for renal tumor with tumor thrombus invading the vascular wall].","authors":"S Liu, Z Liu, Y Guan, G Wang, X Tian, H Zhang, L Liu, L Ma, S Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and oncological outcomes of robot-assisted laparoscopic inferior vena cava (IVC) segmental resection in renal tumor with IVC tumor thrombus (IVCTT).</p><p><strong>Methods: </strong>Clinical data from renal tumor patients undergoing robot-assisted laparoscopic IVC segmental resection at Peking University Third Hospital from Jan. 2021 to Feb. 2025 were retrospectively analyzed. Data collection included baseline demographics, tumor characteristics, perioperative parameters, and follow-up outcomes. Surgical records and pathological reports were retrieved from the electronic medical record system. Continuous variables were presented as median (<i>P</i>₂₅, <i>P</i>₇₅), and categorical variables as frequency (percentage).</p><p><strong>Results: </strong>Forty-four patients were enrolled. The cohort comprised 31 males and 13 females, with a median age of 62 (55, 68) years. Right-sided tumors were observed in 39 cases and left-sided in 5 cases. Median tumor diameter was 8.1 (6.1, 10.1) cm. Mayo classifications included grade Ⅱ (<i>n</i>=37), Ⅲ (<i>n</i>=6), and Ⅳ (<i>n</i>=1). Neoadjuvant therapy was administered to 23 patients. Seventeen patients were complicated by IVC bland thrombus. Median operative time was 224.0 (167.3, 303.8) min, with intraoperative blood loss of 500.0 (300.0, 850.0) mL. Transfusion was administered to 19 patients, with a median blood transfusion of 800.0 (400.0, 1 200.0) mL. Postoperative complications occurred in 25 cases (56.8%), classified as Clavien-Dindo grade Ⅰ (<i>n</i>=8) and grade Ⅱ (<i>n</i>=17). Procedure-specific complications included deep vein thrombosis (<i>n</i>=6), transfusion-requiring anemia (<i>n</i>=5), lower extremity edema (<i>n</i>=2), and pulmonary embolism (<i>n</i>=2), with no procedure- related mortality. Median postoperative serum creatinine was 116.0 (86.5, 157.5) μmol/L. Pathological examination identified clear cell renal cell carcinoma as the predominant subtype, observed in 34 cases (77.3%). Pathological staging revealed T3b (<i>n</i>=12), T3c (<i>n</i>=29), and T4 (<i>n</i>=3) disease, with nodal involvement (N1) in 8 cases and distant metastasis (M1) in 17. At a median follow-up of 10 months (range: 1-49 months), cancer-specific mortality occurred in 3 patients, while 1 succumbed to other causes. Disease progression included pulmonary metastasis (<i>n</i>=5), hepatic metastasis (<i>n</i>=4), and local recurrence (<i>n</i>=4). Adjuvant therapy regimens comprised targeted-immunotherapy combinations (<i>n</i>=9) and targeted monotherapy (<i>n</i>=18).</p><p><strong>Conclusion: </strong>Robot-assisted laparoscopic IVC segmental resection achieves precise thrombus removal with confirmed short-term efficacy in renal tumor with IVCTT, though vigilance against vascular complications remains critical.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"796-802"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk assessment of perioperative adverse events and management of antiplatelet therapy in patients with bladder cancer and coronary atherosclerotic heart disease undergoing transurethral resection of bladder cancer].","authors":"Q Miao, B Hong, X Zhang, Z Sun, W Wang, Y Wang, Y Bo, J Zhao, N Zhang","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the risk factors of adverse events during the perioperative period of transurethral resection of bladder tumor (TURBT) in bladder cancer patients with coronary atherosclerotic heart disease (CAD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively analyzed the clinical data of bladder cancer patients who underwent TURBT in Beijing Anzhen Hospital from June 2022 to September 2024. All patients with bladder cancer and CAD underwent coronary computed tomography angiography (CCTA) for diagnosis and assessment of CAD before surgery. Based on the CCTA results, the patients with bladder cancer and CAD were divided into two groups: those with mild to moderate coronary stenosis and those with severe coronary stenosis. The severe coronary stenosis group was further divided into two subgroups based on whether they received low-molecular-weight heparin (LMWH) bridging therapy or continued their antiplatelet treatment before surgery. Perioperative anticoagulation and antiplatelet strategies were adjusted according to the opinions of the specialists. The incidence of adverse events within 30 days postoperatively was followed up and analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 80 bladder cancer patients with CAD who underwent TURBT were included in the study. Among the 80 patients with CAD, 55 (68.8%) had mild to moderate coronary stenosis, and 25 (31.2%) had severe coronary stenosis. Compared with those had mild to moderate coronary stenosis, the patients who had severe coronary stenosis had a higher incidence of postoperative bleeding and pulmonary embolism, although the differences were not statistically significant (&lt;i&gt;P&lt;/i&gt;&gt;0.05). However, the incidence of postoperative myocardial infarction was significantly higher in the patients who had severe coronary stenosis (&lt;i&gt;P&lt;/i&gt;=0.034). Among the patients with severe coronary stenosis, 8 (32.0%) received LMWH bridging therapy before TURBT, and 17 (68.0%) continued their previous antiplatelet treatment. Compared with those who continued antiplatelet treatment, the patients who received LMWH bridging therapy had a higher incidence of postoperative bleeding and pulmonary embo-lism, although the differences were not statistically significant (&lt;i&gt;P&lt;/i&gt;&gt;0.05). However, the incidence of postoperative myocardial infarction was significantly higher in the LMWH bridging group (&lt;i&gt;P&lt;/i&gt;=0.032).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with mild-to-moderate coronary stenosis demonstrate relatively low perioperative risk during TURBT procedures and may safely undergo TURBT following antiplatelet therapy discontinuation. Conversely, those with severe coronary stenosis exhibit significantly higher perioperative risk and require intensive monitoring. In bladder cancer patients with concomitant severe coronary stenosis, perioperative LMWH bridging therapy is associated with increased myocardial infarction risk, whereas continued antiplatelet therapy does not elevate postopera","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"698-703"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application of combined detection of inflammatory indexes and cytokines in chronic periodontitis].","authors":"Z Bao, Y Wang","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze the inflammatory indexes and cytokines levels in serum and saliva of patients with chronic periodontitis (CP), and to explore the value of single index or multiple indexes combined detection in the clinical diagnosis and treatment of CP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The serum and saliva specimens of 42 CP patients and 38 periodontal healthy people admitted to the Department of Periodontology in Peking University Hospital of Stomatology were detected by inflammatory indexes and cytokines. According to clinical periodontal parameters, CP patients were performed by clinical staging, and the correlation between inflammatory indexes and cytokines levels and the severity of CP was analyzed. To evaluate the levels of inflammatory indexes and cytokines in serum and saliva samples in the periodontal health group and CP group. Three inflammatory indexes were involved in this study: C-reactive protein (CRP), serum amyloid A (SAA), procalcitonin (PCT); and 12 cytokines: Interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12P70, IL-17, interferon (IFN)-α, IFN-γ, and tumor necrosis factor α (TNF-α). The Spearman correlation statistical method was used to analyze the correlation between the levels of inflammatory indexes and cytokines and the severity of chronic periodontitis. Mann-Whitney &lt;i&gt;U&lt;/i&gt; test was used to identify the indicators with differences between the groups, the optimal indicators were identified through binary Logistic regression analysis with stepwise selection, and the area under the curve (AUC) of receiver operating characteristic (ROC) was used to evaluate the diagnostic efficiency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;By testing the levels of inflammatory markers and cytokines in patients with chronic periodontitis with dif-ferent clinical stages, it was found that CRP, SAA, IL-8 in serum and IL-1β, IL-6, IL-8, IL-12P70, IL-17, TNF-α in saliva were significantly positively correlated with the severity of chronic periodontitis. Compared with the periodontal healthy group, the serum levels of CRP, SAA, IL-2, IL-5, IL-8, IL-12P70, IL-17 and IFN-α in the CP group were significantly increased (All &lt;i&gt;P&lt;/i&gt; &lt; 0.05). The AUC of SAA, IL-2, IL-8, IL-12P70, IL-17, IFN-α, combination 1 (IL-2+IL-8) and combination 2 (CRP+SAA+IL-12P70) were &gt;0.7, and the AUC of combination 2 (0.998) was the highest, with high sensitivity (97.6%) and specificity (97.4%). The levels of IL-1β, IL-6, IL-8 and IL-12P70 in the saliva of the CP group were significantly higher than those in the periodontal healthy group, while the levels of IL-4 in the saliva were significantly lower than those in the periodontal healthy group (All &lt;i&gt;P&lt;/i&gt; &lt; 0.05). The AUC of IL-6, IL-8 and combination 3 (IL-4+IL-6+IL-8) were &gt;0.7, and the AUC of combination 3 (0.852) was the highest. In the comparative analysis of diagnostic efficacy between single index and multi-index combined, combination 2, combination 1, and serum IL-8 demonstrated the h","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"772-778"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Low-level laser therapy for the treatment of male infertility and erectile dysfunction].","authors":"Y Niu, Z Xin, G Lin, P Ding, J Pan, Y Feng, Y Guo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Low-level laser therapy (LLLT), a noninvasive photobiomodulation technique, employs red or near-infrared (NIR) light (600-1 000 nm) with power outputs ranging from 5 to 500 mW. It exerts therapeutic effects through molecular mechanisms, specifically the activation of cytochrome C oxidase (CCO) and the modulation of intracellular signaling pathways. By enhancing mitochondrial adenosine triphosphate (ATP) synthesis, LLLT mitigates oxidative stress, regulates the reactive oxygen species (ROS)/glutathione peroxidase (GSH-Px)/superoxide dismutase (SOD) axis, and activates key pathways, including phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) and mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK). These mechanisms confer antioxidant, anti-inflammatory, and pro-regenerative properties to LLLT, making it a viable intervention for dermatological conditions, oncological therapies, and musculoskeletal disorders. Recent preclinical studies underscore LLLT' s potential in male reproductive health. Specifically, it ameliorates cavernosal fibrosis and endothelial dysfunction in erectile dysfunction (ED) models by upregulating the PI3K/Akt and MAPK/ERK pathways. In the context of sperm biology, LLLT enhances motility and acrosomal integrity in both fresh and cryopreserved spermatozoa. This is achieved through mitochondrial metabolic reprogramming, such as CCO-mediated electron transport chain activation, redox homeostasis restoration, and epigenetic modulation involving DNA methylation and histone acetylation. Additionally, LLLT alleviates scrotal heat-induced oligospermia by promoting seminiferous epithelial differentiation, elevating serum testosterone levels, and suppressing lipid peroxidation. These findings highlight the translational potential of LLLT in regenerative medicine, particularly for male sexual and reproductive disorders. Future research efforts should focus on interdisciplinary collaborations spanning life sciences, engineering, and physics. The goal is to optimize laser parameters, including wavelength, irradiance, and treatment duration, and establish standardized protocols. Rigorous preclinical and clinical investigations are paramount to validate the safety, efficacy, and long-term outcomes of LLLT, ultimately paving the way for its integration into precision medicine frameworks for urological and reproductive therapies.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 4","pages":"627-632"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}