北京大学学报（医学版）最新文献

{"title":"[Clinical characteristics of primary Sjögren syndrome with leukopenia].","authors":"Zhenhang Zhu, Fang Cheng, Yanling Wang, Yang Liu, Xiangyan Ai, Keke Zhang, Futao Zhao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical characteristics of leukopenia in a large cohort of patients with primary Sjögren syndrome (pSS), to discuss its pathogenic mechanism, and to enhance clinicians ' understanding of the disease, and reduce missed diagnosis and misdiagnosis.</p><p><strong>Methods: </strong>A total of 401 inpatients and outpatients who were initially diagnosed with pSS at the Department of Rheumatology and Immunology, Ninth People' s Hospital, Shanghai Jiaotong University School of Medicine, from November 2019 to March 2023 were selected for this study. The clinical data and laboratory examinations of these patients were analyzed retrospectively.</p><p><strong>Results: </strong>Of the 401 patients, 107 (26.68%) were complicated with blood leukopenia. The reasons for the first diagnosis were analyzed. The patients with leukopenia had a lower xerostomia and xerophthalmia (39.25% <i>vs.</i> 54.76%, <i>P</i>=0.006), but a higher incidence of fatigue (26.17% <i>vs.</i> 12.59%, <i>P</i>=0.001) and thrombocytopenia (11.21% <i>vs.</i> 2.72%, <i>P</i>=0.001) than those without leukopenia. There were no significant differences in arthralgia, oral ulcer, caries, chest tightness, asthma and anemia between the two groups (<i>P</i>>0.05). The laboratory test indicators were analyzed. The patients with leukopenia had a higher prevalence of anti-SSA/Ro52+ (81.31% <i>vs.</i> 68.35%, <i>P</i>=0.040), anti-SSB+ (47.66% <i>vs.</i> 28.57%, <i>P</i> < 0.001), immunoglobulin G (IgG)+ (68.22% <i>vs.</i> 51.02%, <i>P</i>=0.002), erythrocyte sedimentation rate (ESR) elevation (67.29% <i>vs.</i> 41.32%, <i>P</i>=0.001), and thrombocytopenia (22.43% <i>vs.</i> 13.27%, <i>P</i>=0.026) than those without leukopenia. There were no significant differences in antinuclear antibody (ANA)+, anti-SSA/Ro60+, centromere protein B(CENP-B)+, rheumatoid factor (RF)+, and anemia between the two groups (<i>P</i>>0.05). The positive rate of abnormal salivary gland ultrasound in pSS with leukopenia group was higher than that in normal group (<i>P</i>=0.029). There was no significant difference in salivary flow rate, dry eye test and lip gland biopsy between the two groups (<i>P</i>>0.05). The incidence of pSS combined with leukopenia and autoimmune hepatitis (10.28% <i>vs.</i> 3.40%, <i>P</i>=0.006) was higher than that of the normal group, and the incidence of interstitial pneumonia (16.82% <i>vs.</i> 14.97%, <i>P</i>=0.649), renal tubule acidosis (2.80% <i>vs.</i> 3.06%, <i>P</i>=0.649) and renal tubule acidosis (2.80% <i>vs.</i> 3.06%, <i>P</i>=0.893) were no significant differences between the two groups (<i>P</i>>0.05). Analysis of the effect of antibody on leukopenia showed that the proportion of leukopenia was higher in anti-SSA/Ro52+ group (30.00% <i>vs.</i> 18.02%, <i>P</i>=0.015). The percentages of leukopenia (37.78% <i>vs.</i> 21.05%, <i>P</i> < 0.001), neutropenia (31.85% <i>vs.</i> 16.92%, <i>P</i> < 0.001) and lymphocytopenia (24.44% <i>vs.</i>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1017-1023"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190991","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":"[Reliability and accuracy of digital three-dimensional reconstruction techniques in the measurement in intrabony defect].","authors":"Ziyi Li, Zhihui Tang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the reliability and precision of digital three-dimensional (3D) reconstruction technology in quantifying periodontal intrabony defects, utilizing preoperative cone beam CT (CBCT) data to assess the validity of 3D reconstruction methods in digital intrabony defect measurement.</p><p><strong>Methods: </strong>A retrospective analysis was performed on clinical and radiographic data from 32 patients with 38 teeth who underwent periodontal surgery, including flap surgery, bone grafting, and guided tissue regeneration (GTR) at the Second Clinical Division, Peking University School and Hospital of Stomatology from September 2021 to June 2024. Preoperative CBCT scans were used to reconstruct digital models of intrabony defects with 3D Slicer software. Two resident doctors performed digital measurements of the height and width of the intrabony defects, which were taken one week apart and recorded as the digital measurement group. The measurements obtained during the surgical procedure using probing were considered the actual measurement group. SPSS 26.0 software was utilized to calculate the intraclass correlation coefficient (ICC) for the consistency of repeated measurements by the same examiner and the consistency between different examiners, as well as paired <i>t</i> tests to detect differences in measurement results between the two methods.</p><p><strong>Results: </strong>The study demonstrated good consistency for both intra-examiner (ICC=0.994) and inter-examiner (ICC=0.997) reliability. There was no statistically significant difference between the digital measurement values and the clinical measurement values in the depth (<i>t</i>=-0.563, <i>P</i>=0.576) and width (<i>t</i>=-0.816, <i>P</i>=0.425) of the intrabony defects. The digital measurement values showed the highest consistency with clinical measurement values for simple intrabony defects (ICC: 0.905-0.991), followed by compound intrabony defects (ICC: 0.785-0.788). For complex intrabony defects, the consistency in depth measurements was high (ICC=0.880), while the consistency in width measurements was moderate (ICC=0.505).</p><p><strong>Conclusion: </strong>Digital 3D reconstruction technology has good repeatability and accuracy in measuring periodontal intrabony defects and holds certain clinical reference value.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"927-931"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191033","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":"[Conversion from Bricker to orthotopic neobladder: A case report].","authors":"Han Yang, Rui Zhang, Zongliang Zhang, Kai Zhao, Xinbao Yin, Guanqun Zhu, Mokhtar Aldhabi, Ke Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bladder cancer (BCa) significantly impacts patients' quality of life, particularly following radical cystectomy (RC) and urinary diversion. A 68-year-old male patient, diagnosed with BCa, underwent RC and Bricker urinary diversion six months prior. Despite successful tumor control, the patient struggled to adapt to the stoma, leading to a decline in his quality of life and increased psychological burden. Recognizing the need for a more satisfactory solution, we explored the feasibility of converting the Bricker diversion to an orthotopic neobladder (ONB), a procedure that promised to restore voluntary urination and enhance patient autonomy. Thorough biochemical and imaging examinations revealed no signs of tumor recurrence. In response to the patient' s strong desire for a better quality of life, a comprehensive assessment was conducted, and laparoscopic conversion from Bricker to ONB was decided upon after in-depth communication with the patient and his family. In this case, we performed a laparoscopic conversion from Bricker to ONB, addressing the complexities associated with prior abdominal surgeries and potential adhesions. The surgical approach involved careful dissection and identification of anatomical structures to minimize complications. Postoperatively, the patient demonstrated remarkable recovery, achieving normal urinary function without complications such as bowel obstruction. He reported a significant improvement in his quality of life, expressing high satisfaction with the surgical outcome. This case highlights the technical feasibility and safety of laparoscopic conversion from Bricker to ONB, providing a viable alternative for patients dissatisfied with their initial urinary diversion methods or experiencing related complications. However, it is essential to note that the success of this individual case does not imply a change in treatment protocols for all patients. The selection criteria for this surgical approach and the management of the surgical process remain subjects of ongoing debate. In conclusion, while laparoscopic conversion from Bricker to ONB is technically feasible, the selection of appropriate candidates for this procedure is still contentious. This surgical option may serve as an alternative for patients who struggle with non-continent urinary diversions or experience complications. Urologists should engage in thorough discussions with patients regarding their options and exercise caution when selecting initial urinary diversion methods to minimize the need for conversion surgeries. Our findings contribute to the evolving landscape of urinary diversion techniques and underscore the importance of personalized patient care.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1095-1098"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191034","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":"[Selenium-containing polyurethane-modified titanium modulates osteogenic differentiation of mesenchymal stem cells and M2 polarization of macrophages].","authors":"Mo Zhai, Xiaoqiang Bai, Yang Fu, Huaping Xu, Yongsheng Zhou, Longwei Lv","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To address the issue of implant failure in clinical titanium implants due to inflammation, disease microenvironments, poor osseointegration through surface modification, and to explore the regulatory effects of selenium-containing biomaterial-modified titanium on the osteogenic differentiation of rat bone marrow mesenchymal stem cells (rBMMSCs) and the M2 polarization of RAW 264.7 cells.</p><p><strong>Methods: </strong>Selenium-containing polyurethane (SePU) was synthesized, and titanium sheets were modified by immersion in SePU solutions at concentrations of 1, 3, and 5 g/L. Pure titanium sheets served as the control group. rBMMSCs and RAW 264.7 cells were then cultured on the modified titanium surfaces. The surface contact angles of the SePU-modified titanium sheets were characterized. After 2 days of culture, the effect of SePU-modified titanium on the viability of rBMMSCs and RAW 264.7 cells was observed using live/dead cell staining. The osteogenic differentiation of rBMMSCs was evaluated using alkaline phosphatase (ALP) staining and quantification, alizarin red S (ARS) staining and quantification, as well as the expression levels of osteogenic-related genes. The polarization state of RAW 264.7 cells was assessed by analyzing the expression levels of macrophage polarization-related genes.</p><p><strong>Results: </strong>SePU-modified titanium sheets were successfully prepared and their surface contact angles increased with the immersion concentration. Following 2 days of culture, the majority of rBMMSCs and RAW 264.7 cells on both the pure titanium and SePU-modified titanium surfaces were viable, with only a negligible presence of dead cells. Notably, compared with the pure titanium group, the SePU-modified titanium groups exhibited more profound ALP and ARS staining, coupled with a statistically significant increase in the expression levels of osteogenic-related genes (<i>P</i> < 0.05). Among these groups, the 3 g/L group showed the deepest ALP staining and the most significant increase in osteogenic-related gene expression. Furthermore, the SePU-modified titanium groups displayed decreased expression of proinflammatory genes and increased expression of anti-inflammatory genes compared with the unmodified pure titanium group, with statistically significant differences (<i>P</i> < 0.05). The 3 g/L group exhibited the most significant effect among the modified titanium groups.</p><p><strong>Conclusion: </strong>SePU-modified titanium not only exhibits increased surface contact angles but also has no significant effect on cell viability. It effectively promotes the osteogenic differentiation of rBMMSCs and the M2 polarization of RAW 264.7 cells, indicating its potential for enhancing bone regeneration and modulating immune responses in biomedical applications.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"912-920"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191136","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":"[Analysis of prognostic factors in patients with acute coronary syndrome complicated with moderate to severe chronic kidney disease after percutaneous coronary intervention].","authors":"Jingda Cui, Fangfang Wang, Dan Li, Lijie Sun, Baoxia Chen, Jiangli Han","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the prognostic factors of patients with acute coronary syndrome (ACS) complicated with moderate to severe chronic kidney disease (CKD) after percutaneous coronary intervention (PCI) and to establish a risk predictive model.</p><p><strong>Methods: </strong>The medical records of 148 ACS patients with moderate to severe CKD who received PCI in the Department of Cardiology, Peking University Third Hospital from September 2021 to January 2023 and completed 12-month follow-up were retrospectively analyzed. According to whether the patients had a major adverse cardiovascular disease (MACE) 12 months after PCI, they were divided into MACE group and non-MACE group. Binary Logistic regression analysis was performed on the general clinical data, clinical test results, echocardiography, coronary angiography and PCI data of the two groups of patients, the prognostic factors were analyzed by backward stepwise regression, and the risk prediction model was established. The receiver operating characteristic (ROC) curve was drawn to test the predictive efficiency of the model.</p><p><strong>Results: </strong>A total of 148 patients with ACS combined with moderate to severe CKD were included in the study, including 50 patients in the MACE group and 98 patients in the non-MACE group, and the incidence of MACE 12 months after PCI was 33.8%.Binary Logistic analysis of hospitalization data of the two groups showed that white blood cell (<i>OR</i>＝1.145; 95%<i>CI</i>: 1.017-1.290; <i>P</i>＝0.026), age (<i>OR</i>＝1.032; 95%<i>CI</i>: 1.001-1.065; <i>P</i>＝0.046) and left ventricular ejection fraction (LVEF; <i>OR</i>＝0.962; 95%<i>CI:</i> 0.934-0.990; <i>P</i>＝0.009) were independent influencing factors for MACE 12 months after PCI (<i>P</i> < 0.05), CKD stage was not associated with the occurrence of MACE 12 months after PCI. The risk prediction model for MACE was Logit(<i>P</i>) = 0.032× age +0.136× leukocyte－0.039×LVEF. ROC curve analysis showed that this model had good prediction efficiency, and the area under the curve (AUC) predicted by the prediction model was 0.749, 95%<i>CI</i> was 0.666 to 0.832. The sensitivity and specificity were 72% and 68%.</p><p><strong>Conclusion: </strong>The incidence of MACE was higher in ACS patients with moderate to severe CKD 12 months after PCI, and white blood cells, age and LVEF were independent factors influencing the occurrence of MACE in these patients after PCI.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"980-986"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190949","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":"[Outcomes of adult patients with mucopolysaccharidoses type Ⅰ treated by enzyme replacement therapy].","authors":"Xinhua Wang, Xiying Yang, Yan Meng, Weihua Ren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mucopolysaccharidosis type Ⅰ was a rare inherited metabolic disorder caused by a deficiency of alpha-<i>L</i>-iduronidase, resulting in the incomplete degradation of glycosaminoglycans that accumulate in lysosomes, leading to tissue damage and organ dysfunction. The main treatment options for mucopolysaccharidosis type Ⅰ were hematopoietic stem cell transplantation and enzyme replacement therapy. Patients who did not receive early replacement therapy often struggle to survive into adulthood, and cases of enzyme replacement therapy initiated in adulthood were extremely rare. This article summarized and analyzed the clinical data and enzyme replacement therapy experiences of two adult mucopolysaccharidosis type Ⅰ patients. Through the two cases analysis and literature review, we tried to enhance understanding of the disease characteristics and the efficacy and adverse reactions associated with enzyme replacement therapy, ultimately aiming to benefit the mucopolysaccharidosis type Ⅰ patients. Both patients were adult male and more than twenty years old. And they had the different economic backgrounds. They both presented symptoms at one year old and had normal intellectual development. Clinical features included typical manifestations of mucopolysaccharidosis type Ⅰ such as short stature, coarse facial features, and joint contractures. They were diagnosed with the intermediate form of mucopolysaccharidosis type Ⅰ, with significantly reduced alpha-<i>L</i>-iduronidase activity. The alpha-<i>L</i>-iduronidase gene mutations were as follows: Patient 1 presented c.2T>C, p.M1? /c.1898C>T p.S633L, and Patient 2 had c.532G>A, p.E178K/. Patient 1 received laronidase injections for six months, while Patient 2 was treated with laronidase for thirty months, with both showing varying degrees of symptom improvement. Following their initial dose, both patients experienced fever, nausea, vomiting, diarrhea, and rash, but these symptoms were alleviated with symptomatic treatment. Laronidase therapy demonstrated clear efficacy in adult patients with mucopolysaccharidosis type Ⅰ, with most adverse reactions occurring during the first injection stage, including fever, rash, and gastrointestinal symptoms, all of which were manageable. Early diagnosis and specific treatment for this condition are crucial, and such therapies can be implemented in regular domestic hospital settings.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1071-1075"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191085","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":"[Correlation between acute kidney injury diagnosed by serum creatinine and urine output criteria and short-term prognosis in critically ill patients following non-cardiac surgery].","authors":"Fangfei Xie, Min Xie, Weijie Zhou, Nan Li, Shuangling Li","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze the correlation between acute kidney injury (AKI) diagnosed by elevated serum creatinine (Scr) versus only meeting the urine output (UO) reduction criteria and short-term adverse outcomes in critically ill patients following non-cardiac surgery, and to evaluate the association between even mild elevations in Scr and clinical outcomes furthermore.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was a secondary analysis of data from a prospective cohort study. A total of 1020 non-cardiac surgery adults admitted to the intensive care unit (ICU) of Peking University First Hospital from May 20, 2019 to March 7, 2022 were included. According to Kidney Disease: Improving Global Outcomes (KDIGO) guideline, AKI patients were classified into two groups: the AKI-Scr group (those meeting the Scr elevation criteria) and the AKI-UO group (those fulfilling only the UO reduction criteria). The primary outcome was in-hospital mortality in patients with AKI, and the secondary outcomes were major renal adverse events, post-operative renal replacement therapy (RRT), postoperative complications, postoperative mechanical ventilation time, ICU stay, postoperative hospital stay, total hospital stay, and total medical costs. Multivariate Logistic regression analysis was used to identify risk factors of hospitalized death in critically ill patients with AKI following non-cardiac surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1020 non-cardiac surgical patients admitted to the ICU were enrolled, among whom 429 were diagnosed with AKI. There were 91 cases in the AKI-Scr group and 338 cases in the AKI-UO group. The primary study endpoint: no statistically significant difference in in-hospital mortality was observed between the AKI-Scr and AKI-UO groups (5.5% &lt;i&gt;vs.&lt;/i&gt; 2.1%, &lt;i&gt;P&lt;/i&gt;&gt;0.05). The secondary study endpoints: compared with the AKI-UO group, the patients in the AKI-Scr group had a higher incidence of major renal adverse events (9.8% &lt;i&gt;vs.&lt;/i&gt; 4.4%), postoperative RRT (4.4% &lt;i&gt;vs.&lt;/i&gt; 0.3%) and postoperative complications (50.5% &lt;i&gt;vs.&lt;/i&gt; 24.0%, all &lt;i&gt;P&lt;/i&gt; &lt; 0.05), a significantly longer duration of postoperative mechanical ventilation (12.0 d &lt;i&gt;vs.&lt;/i&gt; 7.5 d), ICU stay (2 d &lt;i&gt;vs.&lt;/i&gt; 1 d), postoperative hospital stay (14 d &lt;i&gt;vs.&lt;/i&gt; 9 d) and total hospital stay (21 d &lt;i&gt;vs.&lt;/i&gt;17 d, all &lt;i&gt;P&lt;/i&gt; &lt; 0.05), and a significantly higher total medical expenditure (112000 yuan &lt;i&gt;vs.&lt;/i&gt; 89000 yuan, &lt;i&gt;P&lt;/i&gt;&lt;0.001). Multivariate Logistic regression analysis showed that postoperative RRT (&lt;i&gt;OR&lt;/i&gt;=33.164, 95%&lt;i&gt;CI&lt;/i&gt;: 1.305-842.794, &lt;i&gt;P&lt;/i&gt;=0.034) and sepsis during hospitalization (&lt;i&gt;OR&lt;/i&gt;=23.096, 95%&lt;i&gt;CI&lt;/i&gt;: 4.242-125.175, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) were independent risk factors for hospitalized death in the critically ill patients with postoperative AKI. Compared with the &lt;i&gt;Δ&lt;/i&gt;Scr≤24% patients (Scr increased by less than 24% from baseline within 7 d), even in the patients with only a minor elevation in Scr (&lt;i&gt;Δ&lt;/i&gt;Scr inc","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"965-973"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191047","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":"[Explore the potential diagnostic markers of primary Sjögren syndrome by bioinformatics combined with machine learning].","authors":"Bingle Li, Li Bai, Yongfu Wang, Lingyan Zhu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To develop a diagnostic model for primary Sjögren syndrome (pSS) utilizing transcriptomics-based machine learning techniques, and to explore potential therapeutic targets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We selected patients diagnosed with pSS and control subjects with salivary gland samples from the Gene Expression Omnibus (GEO) database for transcriptome sequencing. This was complemented by methylation sequencing data, followed by weighted gene co-expression network analysis (WGCNA) in conjunction with clinical data to identify candidate diagnostic genes. Subsequently, we refined the gene list using least absolute shrinkage and selection operator (LASSO), random forest (RF), Gaussian mixed model (GMM), and support vector machine (SVM). Ultimately, we constructed a composite diagnostic model for pSS employing SVM, neural networks (NN), Logistic regression (LR), decision trees (DT), adaptive boosting (AdaBoost), bootstrap aggregating (Bagging), random forest, and Naive Bayes classifiers, totaling eight distinct machine learning algorithms, and predicted drug targets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Through differential gene screening combined with WGCNA analysis of the GEO database, we identified 12 key genes. Further variable selection &lt;i&gt;via&lt;/i&gt; machine learning techniques yielded four significant genes: &lt;i&gt;VNN2&lt;/i&gt;, &lt;i&gt;NAPSB&lt;/i&gt;, &lt;i&gt;SAMSN1&lt;/i&gt;, and &lt;i&gt;MS4A1&lt;/i&gt;. The area under curve (AUC) values were calculated for each gene: AUC&lt;sub&gt;&lt;i&gt;VNN2&lt;/i&gt;&lt;/sub&gt; =0.865, AUC&lt;sub&gt;&lt;i&gt;NAPSB&lt;/i&gt;&lt;/sub&gt;=0.896, AUC&lt;sub&gt;&lt;i&gt;SAMSN1&lt;/i&gt;&lt;/sub&gt; =0.872, AUC&lt;sub&gt;&lt;i&gt;MS4A1&lt;/i&gt;&lt;/sub&gt; =0.914, all demonstrating diagnostic relevance. We then employed these machine learning methods to construct a composite diagnostic model, and F1 score (the harmonic mean of precision and recall rate) was used to evaluate the prediction performance of each model in the internal test set. The top-performing models included those based on SVM polynomial kernel models, SVM linear kernel models, random forest approaches, and Naive Bayes classification as determined through ranking criteria based on AUC comparisons; notably, both SVM polynomial kernel models and linear kernel models exhibited superior AUC values compared with individual genes alone. The external validation set, SVM polynomial kernel function model in GSE159574, AUC=0.865 (95%&lt;i&gt;CI&lt;/i&gt;: 0.728-1.000), sensitivity 0.812, specificity 0.846; The AUC of SVM polynomial kernel model in GSE173808, AUC=0.896 (95%&lt;i&gt;CI&lt;/i&gt;: 0.797-0.996), the sensitivity was 0.778, and the specificity was 1.000. In order to facilitate clinical diagnosis, we verified that the AUC of the SVM polynomial kernel function model in the peripheral blood GSE84844 dataset was 0.827 (95%&lt;i&gt;CI&lt;/i&gt;: 0.719-0.934), the sensitivity was 0.867, and the specificity was 0.767. Thus, our proposed model demonstrated robust diagnostic capability for pSS. Additionally, our investigation into potential drug targets indicated that these four identified ge","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1007-1016"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191057","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 of positive surgical margin and multifocal positive surgical margin after robot-assisted radical prostatectomy].","authors":"Kang Wang, Xu Chen, Silu Chen, Zihao Tao, Qi Shen, Meng Zhang, Zhongyuan Zhang, Han Hao, Wei Yu, Cheng Shen, Xuesong Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence, location distribution and risk factors of positive surgical margin (PSM) and multifocal PSM after robot-assisted radical prostatectomy (RARP).</p><p><strong>Methods: </strong>We retrospectively and continuously reviewed clinical and pathological data of 926 patients with RARP performed by a single surgeon in Department of Urology, Peking University First Hospital from January 2019 to May 2024. The median age of the patients was 66 (62-77) years, the median body mass index (BMI) was 24.69 (22.86-26.54) kg/m², and the median preoperative total prostate specific antigen (tPSA) was 10.45 (6.92-16.30) μg/L. Univariate and multivariate Logistic regression were used to analyze the risk factors of PSM and multifocal PSM.</p><p><strong>Results: </strong>The overall PSM rate was 30.7% (272/926), and the multifocal PSM rate was 13.4% (124/926). The PSM rate in pT3 patients was 45.9% (219/477), while the PSM rate in pT2 patients was 14.0% (62/444). The PSM was primarily distributed in the apex (221 cases, 77.8%), the right peripheral zone (91 cases, 32.0%), and the left peripheral zone (89 cases, 31.3%). Multivariate Logistic regression analysis indicated that preoperative variables including tPSA (<i>OR</i>=1.020, 95%<i>CI</i>: 1.007-1.032, <i>P</i>=0.002), clinical T stage 3 (<i>OR</i>=1.678, 95%<i>CI</i>: 1.110-2.538, <i>P</i>=0.014), International Society Urological Pathology (ISUP) grading of puncture pathology (<i>OR</i>=1.169, 95%<i>CI</i>: 1.034-1.321, <i>P</i>=0.012) was an independent risk factor for PSM; Postoperative variables including pathological T stage 3-4 (<i>OR</i>=3.966, 95%<i>CI</i>: 2.806-5.607, <i>P</i> < 0.001), pathological ISUP group (<i>OR</i>=1.360, 95%<i>CI</i>: 1.181-1.566, <i>P</i> < 0.001) was an independent risk factor for PSM. The independent risk factors for multifocal PSM included BMI (<i>OR</i>=1.101, 95%<i>CI</i>: 1.021-1.188, <i>P</i>=0.013), pathological T stage 3-4 (<i>OR</i>=2.776, 95%<i>CI</i>: 1.350-5.711, <i>P</i>=0.006), and pathological ISUP group (<i>OR</i>=1.307, 95%<i>CI</i>: 1.024-1.667, <i>P</i>=0.032). Multifocal PSM (<i>HR</i>=1.916, 95%<i>CI</i>: 1.110-3.306, <i>P</i>=0.020) was one of the independent factors for biochemical recurrence (BCR)-free survival.</p><p><strong>Conclusion: </strong>The apex was the most common site for PSM after RARP. Clinicopathological characteristics reflecting the degree of tumor progression and aggressiveness were associated with the risk of PSM and multifocal PSM. Patients with multifocal PSM had a higher risk of BCR.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1048-1055"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191110","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":"[Effect of leg-split-free lateral decubitus position and lithotomy position on renal pelvic pressure and clinical outcomes during flexible ureteroscopic lithotripsy].","authors":"Shicong Lai, Huanrui Wang, Runfeng Ni, Haopu Hu, Chenlong Wang, Tao Xu, Hao Hu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To compare intrarenal pelvic pressure profiles and clinical outcomes between the leg-split-free lateral decubitus position and the conventional lithotomy position during flexible ureteroscopy with a negative-pressure aspiration sheath.</p><p><strong>Methods: </strong>A prospective study was conducted at Peking University People' s Hospital among patients undergoing unilateral flexible ureteroscopy with a negative-pressure aspiration sheath from January 2024 to December 2025. Participants were allocated into two groups according to surgical positioning: Leg-split-free lateral decubitus group and conventional lithotomy group. An intelligent, pressure- and temperature-controlled flexible ureteroscopy system was employed to continuously monitor intrapelvic pressure and temperature throughout the procedure. The incidence, duration, and clinical implications of intrapelvic hypertension were compared between the two groups.</p><p><strong>Results: </strong>A total of 40 patients were enrolled, 20 in each group. No statistically significant differences were observed between the groups in baseline characteristics, including gender, age, stone diameter, stone number, stone location, or degree of hydronephrosis (all <i>P</i>>0.05). Intraoperative analysis revealed that the duration of intrapelvic hypertension was significantly shorter in the leg-split-free lateral decubitus group than in the lithotomy group [25.0 (0.0, 31.8) s <i>vs</i>. 115.0 (79.8, 176.0) s, <i>P</i> < 0.01]; similarly, the duration of elevated intrapelvic temperature was also significantly reduced [3.0 (2.0, 9.8) s <i>vs</i>. 18.5(16.0, 24.5) s, <i>P</i> < 0.01]. Postoperative follow-up showed no cases of fever in the leg-split-free lateral decubitus group, whereas two patients in the lithotomy group developed fever; however, this difference in febrile complication rate did not reach statistical significance (<i>P</i>=0.15). All the patients underwent computed tomography three months postoperatively to assess stone-free status. The results indicated that the stone-free rate in the leg-split-free lateral decubitus position group was significantly higher than that in the lithotomy position group (<i>P</i>=0.04).</p><p><strong>Conclusion: </strong>This prospective exploratory study suggests that compared with the lithotomy position, the leg-free lateral decubitus position may be more conducive to maintaining lower intrapelvic pressure and temperature during the operation and is associated with a higher stone clearance rate postoperatively. However, these findings still need to be verified by large-sample, multi-center, randomized controlled trials.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"748-753"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576543","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}