北京大学学报（医学版）最新文献

{"title":"[Clinicopathological features and prognostic factors associated with long-term survival (≥5 years) in patients with clear cell renal cell carcinoma and venous tumor thrombus].","authors":"Zhiming DU, Weiliang Zhang, Lei Zhao, Min Qiu, Lulin Ma, Ye Yan, Huiying He, Ruiyang Xie, Shudong Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the clinicopathological features of long-term survivors among patients with clear cell renal cell carcinoma (ccRCC) and venous tumor thrombus (VTT) who underwent surgical treatment, and to explore potential prognostic factors beyond tumor-related variables, with particular emphasis on host-related inflammatory and nutritional indicators.</p><p><strong>Methods: </strong>The patients with ccRCC and VTT who underwent radical nephrectomy combined with tumor thrombectomy at Peking University Third Hospital between 2014 and 2019 were retrospectively analyzed. The patients were stratified into a long-term survival group (overall survival ≥60 months) and a non-long-term survival group (overall survival < 60 months). The following parameters were compared between the two groups: clinical characteristics (age, sex, body mass index, Mayo classification), pathological features (T stage, M stage, histological grade, sarcomatoid change, perirenal fat invasion), perioperative parameters (surgical approach, operative time, intraoperative blood loss, complications), and laboratory parameters (platelet count, albumin, neutrophil count, <i>etc</i>.). Optimal cutoff values for continuous variables, such as age, body mass index (BMI), platelet count and serum albumin level, were determined using X-tile software based on the minimum <i>P</i>-value principle. Subsequently, Kaplan-Meier survival analysis with Log-rank test was performed within the long-term survival cohort to evaluate the association of the above-mentioned factors with long-term survival.</p><p><strong>Results: </strong>Long-term survival was achieved in 13.9% of 397 patients with ccRCC and VTT. Significant differences were observed between the long-term survival group (<i>n</i>=55) and the non-long-term survival group (<i>n</i>=342) in baseline platelet count (<i>P</i>=0.040), pathological T stage (<i>P</i>=0.001), histological grade (<i>P</i>=0.006), surgical approach (<i>P</i> < 0.001), as well as receipt of systemic therapy (<i>P</i>=0.028), treatment timing (<i>P</i>=0.003), and treatment regimen (<i>P</i> < 0.001). Regarding T stage, the long-term survival group had a significantly higher proportion of pT3a tumors (63.6% <i>vs</i>. 42.4%) and a significantly lower proportion of pT4 tumors (10.9% <i>vs</i>. 33.0%) compared with the non-long-term survival group. The long-term survival group also had a higher proportion of low-grade tumors (G1/G2: 50.9% <i>vs</i>. 31.9%). Regarding surgical approach, laparoscopic surgery predominated in the long-term survival group (35/55, 63.6%), whereas the non-long-term survival group had a more balanced distribution, including open surgery (102/342, 29.8%), laparoscopic surgery (123/342, 36.0%), and robotic surgery (117/342, 34.2%). Regarding systemic therapy, in the long-term survival group, 26 patients (47.3%) received systemic therapy, all of whom (100.0%) received adjuvant therapy. In the non-long-term survival g","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"692-699"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577050","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":"[Comparison of preoperative nutritional scoring systems for predicting survival in upper tract urothelial carcinoma].","authors":"Zejing Guo, Changhai Sun, Shicong Lai, Hanlin Gao, Yiqing DU, Tao Xu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between preoperative nutritional indicators and survival outcomes in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU), and to compare the predictive performance of different nutritional scoring systems.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on UTUC patients who underwent RNU. Nutritional scores [geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), controlling nutritional status (CONUT), triglycerides-total cholesterol-body weight index (TCBI)] were calculated. Variables with <i>P</i> < 0.10 in univariable Cox regression were entered into multivariable analysis using backward stepwise selection based on the Akaike Information Criterion (AIC) to identify independent predictors and construct a nomogram. Kaplan-Meier curves with log-rank tests and time-dependent ROC curves were applied for survival analysis. A two-sided <i>P</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 481 UTUC patients were included. Multivariable analysis identified pathological T3/T4 stage, N1/N2 stage, high World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade, estimated glomerular filtration rate (eGFR), blood transfusion, ureteral management, GNRI, and PNI as independent predictors of overall survival (OS) (<i>P</i> < 0.05). Independent predictors of cancer-specific survival (CSS) included pathological T2-T4 stage, N1/N2 stage, laparoscopic surgical approach, blood transfusion, GNRI, and PNI (<i>P</i> < 0.05). The nomogram constructed based on these independent predictors demonstrated good calibration. Patients with GNRI < 98 or PNI < 52 had significantly shorter OS and CSS (Log-rank <i>P</i> < 0.05). At the end of 60 months, the area under the curve (AUC) values of GNRI and PNI for predicting OS were 0.623 and 0.632, respectively, and for predicting CSS were 0.632 and 0.645, respectively. Time-dependent ROC analysis showed that both indicators had stable predictive performance for CSS, while their predictive ability for OS showed a mild increasing trend over the follow-up time.</p><p><strong>Conclusion: </strong>Preoperative GNRI and PNI are independently associated with OS and CSS in patients with UTUC after RNU, demonstrating stable predictive performance across different follow-up periods.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"808-817"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577055","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":"[Current status of prostate cancer screening research].","authors":"Ming Liu, Huiling Chen, Zhengtong Lyu, Huimin Hou, Jiamin Sun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Prostate cancer is the second most common malignant tumor among men worldwide. Its early diagnosis relies on screening. How to increase the detection rate of clinically significant prostate cancer, avoid overdiagnosis and over-treatment of low-risk tumors, while also considering economic benefits, has become a core issue in the field of screening. Currently, international prostate cancer screening strategies are moving from a single prostate-specific antigen (PSA) screening to individualized risk stratification, and exploring the roles of various stratification tools, such as magnetic resonance imaging (MRI), new biomarkers, and risk prediction models. However, there is no universally recognized unified approach. In recent years, although the incidence of prostate cancer in China has increased rapidly, the early diagnosis rate is still low. This is directly related to the insufficient prevalence of prostate cancer screening in China. Moreover, China also faces problems such as the lack of a reasonable screening model for elderly high-risk populations, insufficient public awareness, and the absence of a refined screening path. Future work involves building stratified screening strategies suitable for the Chinese population based on Chinese data, promoting the transition of screening from opportunistic to systematic, and is a task that needs to be carried out.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"686-691"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577105","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":"[Incidence and associated factors of anemia within six months after kidney transplantation in pediatric recipients].","authors":"Wenlin Li, Lei Yu, Wenbo Yang, Jiankang Dong, Yujie Yang, Zhao Zhao, Jianfei Wang, Weiyu Zhang, Qiang Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Anemia is a common complication following kidney transplantation in children, yet its epidemiological characteristics and associated factors are not fully understood. This study aimed to investigate the incidence and clinical features of anemia within six months after pediatric kidney transplantation and to identify its associated factors, thereby providing evidence for management.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted on pediatric patients who underwent kidney transplantation at Peking University People' s Hospital from January 2022 to August 2025. Demographic, perioperative, and serial laboratory data up to 6 months post-transplantation were collected. Anemia was diagnosed according to the World Health Organization (WHO) age-specific criteria. Univariate analysis, multivariate binary Logistic regression, and receiver operating characteristic (ROC) curve analysis were performed to identify associated factors and assess their diagnostic value.</p><p><strong>Results: </strong>The study included 46 pediatric recipients. The incidence of anemia within 6 months post-transplantation was 41.3% (19/46), with normocytic anemia being the most prevalent type (63.1%, 12/19). Multivariate binary Logistic regression analysis showed that age (<i>OR</i>=0.293, <i>P</i>=0.018), postoperative serum urea at 6 months (<i>OR</i>=3.281, <i>P</i>=0.006), and estimated glomerular filtration rate (eGFR) (<i>OR</i>=0.893, <i>P</i>=0.030) were independently associated with anemia. Exploratory stratified analysis suggested that age < 13 years, serum urea >7 mmol/L, and eGFR < 120 mL/(min·1.73 m²) might serve as reference thresholds for clinical screening. ROC curve analysis indicated that postoperative serum urea had the best diagnostic value for anemia (area under the curve=0.890, <i>P</i> < 0.001). Hemoglobin levels began to differ significantly between the anemic and non-anemic groups from the third month postoperative onward, with the gap widening over time.</p><p><strong>Conclusion: </strong>This study demonstrates a high incidence of early-onset anemia after pediatric kidney transplantation, primarily mild to moderate normocytic anemia. It is associated with younger age and suboptimal allograft function, with the divergence in hemoglobin levels becoming apparent from the third month postoperative. Close monitoring of high-risk children, particularly those aged < 13 years or with serum urea >7 mmol/L and eGFR < 120 mL/(min·1.73 m²), and early intervention may help reduce the occurrence or severity of post-transplant anemia.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"729-737"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576965","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":"[CRISPR-Cas9 activation screening identifies candidate chemokine regulators of ter-tiary lymphoid structure formation in bladder cancer].","authors":"Yongcun Wang, Hongchen Song, Yiqing DU, Tao Xu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify the cytokine genes influencing the formation of tertiary lymphoid structures (TLS) through CRISPR-Cas9 library screening, and to discover potential key regulatory molecules, providing new targets for enhancing the efficacy of bladder cancer immunotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on a mouse whole-genome library, 44 chemokine-related genes were identified, and an single-guide RNA (sgRNA) library targeting these genes was designed and constructed, with three sgRNAs assigned to each gene. Using a lentiviral packaging system, the library plasmids were used to transfect HEK293T cells to generate a lentiviral library, which was then used to infect the mouse bladder cancer cell line MB49. Purinomycin selection was performed to obtain the MB49-mCherry cell line stably over-expressing chemokines. The cells were inoculated into the peritoneal cavity of C57BL/6 mice to establish a bladder cancer xenograft model, and tumor growth was monitored. Three weeks later, tumor tissue was excised, genomic DNA was extracted for high-throughput sequencing, and sgRNA enrichment was analyzed to screen for differentially expressed cytokine genes. Concurrently, immunohistochemical staining was performed to detect TLS markers CD20 and CD3, and the number, distribution, and maturity of TLS were assessed. The selected candidate genes were validated individually &lt;i&gt;in vivo&lt;/i&gt; to further confirm their impact on TLS formation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We successfully constructed a cytokine gene library containing 132 sgRNAs, covering 44 chemokine genes. Following lentiviral infection, we obtained the MB49-mCherry cell line, which stably expressed the library, and isolated dead Cas9-positive monoclonal cell lines &lt;i&gt;via&lt;/i&gt; flow cytometry to ensure the homogeneity and reproducibility of subsequent experiments. Intratumoral tumor experiments in mice revealed that the number of TLS cells in the experimental group was significantly higher than in the control group, primarily distributed at the tumor margins. High-throughput sequencing results showed that, compared with the control group, in the experimental group, &lt;i&gt;Cxcl16&lt;/i&gt; sgDNA was significantly enriched, while &lt;i&gt;Ccl20&lt;/i&gt; and &lt;i&gt;Cx3lc1&lt;/i&gt; sgDNA levels decreased compared with baseline (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Further validation of the individual roles of each factor &lt;i&gt;via&lt;/i&gt; intraperitoneal injection revealed that the number of TLSs in tumors decreased in the group treated with the CX3CL1 chemokine, suggesting that CX3CL1 might negatively regulate TLS formation. Immunohistochemical results showed that in the CX3CL1-treated group, the aggregation of CD20-positive B cells and CD3-positive T cells in the tumor tissue was reduced, and the TLS structure was incomplete.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Through CRISPR-Cas9 library screening combined with &lt;i&gt;in vivo&lt;/i&gt; validation, this study successfully identified CX3CL1 as a potential negative regulator of TLS formatio","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"707-715"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577133","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 for perioperative acute kidney injury following partial nephrectomy in patients with stage 3 chronic kidney disease].","authors":"Ruotao Xiao, Zhifei Xie, Peng Hong, Bin Yang, Lei Liu, Shudong Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the risk factors for acute kidney injury (AKI) in patients with stage 3 chronic kidney disease (CKD) after partial nephrectomy.</p><p><strong>Methods: </strong>The clinical data of 126 stage 3 CKD patients who underwent partial nephrectomy at Peking University Third Hospital from January 2013 to December 2025 were retrospectively analyzed. Demographic characteristics, comorbidities, surgical-related indicators, and laboratory data of the patients were collected. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Univariate and multivariate regression analyses were used to identify the independent risk factors for postoperative AKI, and the predictive cutoff value of the receiver operating characteristic (ROC) curve was determined.</p><p><strong>Results: </strong>A total of 126 stage 3 CKD patients were included. The incidence of AKI after surgery was 31.0% (39/126). Univariate analysis showed that the proportion of robotic surgery was lower in the AKI group (12.8% <i>vs</i>. 33.3%, <i>P</i>=0.018), the duration of renal artery occlusion was longer (25 min <i>vs</i>. 18 min, <i>P</i> < 0.001), and the intraoperative blood loss was greater (20 mL <i>vs</i>. 50 mL, <i>P</i>=0.028). Multivariate Logistic regression analysis confirmed that the duration of renal artery occlusion (<i>OR</i>=1.105, 95%<i>CI</i>: 1.041-1.173, <i>P</i>=0.001) and intraoperative blood loss (<i>OR</i>=1.004, 95%<i>CI</i>: 1.000-1.007, <i>P</i>=0.046) were independent risk factors for postoperative AKI. ROC curve analysis showed that the area under the curve for predicting AKI by renal artery occlusion time was 0.737, and the optimal cutoff value was 18 min. The incidence of AKI was significantly higher in the patients with renal artery occlusion time ≥ 18 min than those with < 18 min (43.2% <i>vs</i>. 8.8%, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The incidence of AKI after partial nephrectomy in stage 3 CKD patients is relatively high. The duration of renal artery occlusion and intra-operative blood loss are independent risk factors for postoperative AKI. Controlling the renal artery occlusion time within 18 min and minimizing intraoperative blood loss can help reduce the risk of AKI in this high-risk population after surgery.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"723-728"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576945","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":"[Single-stage arthrodesis for septic arthritis of the ankle and hindfoot].","authors":"Zhiyu Wang, Wenjing Li, Baozhou Zhang, Ying Li, Hui DU, Yan Wang, Yong Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes of one-stage debridement, arthrodesis, and Ilizarov external fixation for the treatment of septic arthritis of the ankle and hindfoot.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 12 patients with septic arthritis of the ankle or hindfoot who underwent one-stage debridement, arthrodesis, and Ilizarov external fixation performed by the same surgeon between April 2015 and June 2023. The study included 8 males and 4 females, with a mean age of (53.6±16.2) years at surgery; all procedures were unilateral. General clinical characteristics, bacterial culture results, and the time to external fixator removal were recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS) for pain were recorded and compared between the preoperative period and the final follow-up. Patient satisfaction with the surgery and the occurrence of complications were also documented.</p><p><strong>Results: </strong>All patients were followed up for a mean of (51.3±34.0) months postoperatively. Positive bacterial cultures were found in 7 cases. Infection control was achieved in all patients, with a 100% bone fusion rate confirmed by radiographs or CT. The median time to external fixator removal was 16 (12, 24) weeks. Preoperatively, the median VAS score was 7 (5.3, 7.8) points, and the mean AOFAS ankle-hindfoot score was (42.8±10.4) points. At the final follow-up, the median VAS score was 1 (0, 2) point, and the mean AOFAS score was (77.6±10.2) points, both showing significant improvement compared with preoperative values (<i>P</i> < 0.01). Regarding complications, there was 1 case of pin tract infection, 3 cases of limb shortening, and 2 cases of skin numbness. Nine patients were very satisfied with the surgery, and 3 were satisfied.</p><p><strong>Conclusion: </strong>One-stage debridement, arthrodesis, and Ilizarov external fixation are a reliable method for treating septic arthritis of the ankle and hindfoot. It effectively controls infection, shortens treatment duration, and yields favorable functional and imaging outcomes, with high patient satisfaction and acceptable complication rates.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"842-847"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576951","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 and molecular features of acquired cystic kidney disease and associated renal cell carcinoma].","authors":"Haijing Liu, Wenyang Guo, Shunan Shi, Huiying He","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the clinicopathological and genetic features of acquired cystic kidney disease (ACKD) and secondary renal cell carcinoma (RCC) in end-stage renal disease (ESRD) patients undergoing dialysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The clinicopathological data of 9 patients with ACKD, of whom, 7 had concurrent RCC, of the Department of Pathology, Peking University Third Hospital from 2020 to 2025 were retrospectively analyzed. Immunohistochemistry (IHC) and next-generation sequencing (NGS) were used to detect RCC-related proteins and targeted-drug associated gene variations/microsatellite instability (MSI) status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 9 patients were all male, aged 29-64 years. Causes of ESRD included hypertension, IgA nephropathy, chronic glomerulonephritis, and diabetes. Dialysis duration ranged from 1 to 30 years (median 9.0 years), and 3 patients had kidney transplantation history. Imaging showed reduced kidney size and multiple cysts, including complex cysts. Solid lesions were found in the cyst wall of 5 patients with secondary RCC. The maximum diameter of tumors was 1.3-7.0 cm (median 3.0 cm). Histologically, except for typical morphological changes of ACKD and atypical renal cysts, some cases had papillary adenoma and hemorrhage. Six ACKD-associated RCC (ACKD-RCC) patients and 1 papillary RCC (pRCC) patient were diagnosed. Most ACKD-RCC tumor cells had eosinophilic cytoplasm; 5 patients predominantly showed papillary structure, and 1 patient mainly presented sieve-cystic with acinar/solid/micropapillary structures. Oxalate crystals were found in all ACKD-RCC cases, and most patients were accompanied by necrosis and calcification. P504S and CK7 were diffusely or focally positive in all the cases, while CAⅨ was negative. The World Health Organization/International Society of Urological Pathology (WHO/ISUP) nuclear grading of ACKD-RCC and pRCC were 2-3 and 3-4, respectively. Pathological staging of 5 RCC patients was pT1 and of the other 2 patients was pT3a. NGS results identified one &lt;i&gt;PIK3CA&lt;/i&gt; point mutation and &lt;i&gt;SETD2&lt;/i&gt; deletion in one ACKD-RCC patient and the pRCC patient, which were accompanied by marked necrosis and pT3a staging. The RCC patients were regularly followed up for 1-32 months postoperatively without additional treatment, and no recurrence or metastasis was observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;ACKD is a common complication in ESRD patients undergoing dialysis. In our cohort, ACKD-RCC was predominantly characterized by papillary architecture histologically with oxalate crystals in all cases. Immunohistochemically, P504S and CK7 were positive. Regardless of secondary occurrent tumor, atypical renal cysts were present in all ACKD cases in this study. NGS detected &lt;i&gt;PIK3CA&lt;/i&gt; and &lt;i&gt;SETD2&lt;/i&gt; (Tier Ⅱ) variants in 2 RCC patients, respectively, accompanied by coagulative necrosis and advanced pathological stage, which may indicate a poor prognosis. This study su","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"700-706"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576971","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":"[Comparison of clinical outcomes between radical prostatectomy and permanent prostate brachytherapy in patients with oligometastatic prostate cancer: A propensity score-matched study].","authors":"Dandan Su, Baishun Li, Ruotao Xiao, Fan Zhang, Shudong Zhang","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare radical prostatectomy (RP) versus permanent prostate brachytherapy (PPB) as primary local treatment modalities in delaying disease progression to castration-resistant prostate cancer (CRPC) among patients with oligometastatic prostate cancer (omPCa) receiving standard androgen deprivation therapy (ADT), and to provide clinical evidence for individualized treatment strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a retrospective cohort analysis of 88 patients diagnosed with omPCa (defined as ≤5 metastatic lesions) at a single tertiary center between April 2011 and August 2019. All the patients, after receiving either RP (&lt;i&gt;n&lt;/i&gt;=62) or PPB (&lt;i&gt;n&lt;/i&gt;=26), were placed on a regimen of continuous ADT. To address significant baseline disparities-notably in patient age, presenting prostate-specific antigen (PSA) levels, and nodal disease burden: A 1 ∶ 1 propensity score matching (PSM) protocol was implemented. Matching variables included age at diagnosis, baseline PSA, clinical T stage (≤T2c &lt;i&gt;vs.&lt;/i&gt; ≥ T3), and nodal status (N0 &lt;i&gt;vs.&lt;/i&gt; N1). The primary study endpoint was the time interval from ADT initiation to CRPC development, as defined by the prostate cancer working group 3 (PCWG3) criteria. Survival outcomes were compared using Kaplan-Meier curves and the Log-rank test. Independent risk factors for progression were identified through both univariate and multivariate Cox proportional hazards regression analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Prior to PSM, the RP and PPB groups exhibited significant differences in key prognostic factors: the PPB group was older (mean 73.2 &lt;i&gt;vs.&lt;/i&gt; 68.1 years, &lt;i&gt;P&lt;/i&gt;=0.002), had a higher median PSA (31.2 &lt;i&gt;vs.&lt;/i&gt; 9.8 μg/L, &lt;i&gt;P&lt;/i&gt;=0.002), and had a greater incidence of lymph node involvement (42.3% &lt;i&gt;vs.&lt;/i&gt; 12.9%, &lt;i&gt;P&lt;/i&gt;=0.006). Following PSM, a balanced cohort of 36 patients (18 in each group) was achieved. Over a median follow-up of 30.5 months (range: 3.2 to 113.4 months), 15 patients (17.0%) developed CRPC, with 8 events occurring in the PPB group and 7 in the RP group. Survival analysis demonstrated a consistent, statistically significant advantage for RP. In the pre-matched cohort, the RP group showed a significantly delayed progression to CRPC (Log-rank &lt;i&gt;P&lt;/i&gt;=0.033, &lt;i&gt;HR&lt;/i&gt;=3.38, 95%&lt;i&gt;CI&lt;/i&gt;: 1.10-10.40), with a median CRPC-free survival of 80.0 months for PPB and not reached for RP. In the matched cohort, the survival advantage of RP was more pronounced (Log-rank &lt;i&gt;P&lt;/i&gt;=0.032, &lt;i&gt;HR&lt;/i&gt;=4.60, 95%&lt;i&gt;CI&lt;/i&gt;: 1.14-18.49), with a median CRPC-free survival of 80.0 months for PPB and not reached for RP. Multivariate Cox regression, adjusting for T and N stages, confirmed treatment modality as a powerful independent predictor. Patients treated with PPB faced an 8.56-fold higher risk of progression compared with those treated with RP (&lt;i&gt;HR&lt;/i&gt;=8.56, 95%&lt;i&gt;CI&lt;/i&gt;: 1.51-48.64, &lt;i&gt;P&lt;/i&gt;=0.015). Advanced primary tumor stage (≥T3) was also identi","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"787-793"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577070","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":"[Characteristics of urinary organic acid metabolic profile and screening of key metabolic markers in patients with urolithiasis].","authors":"Zixuan Qi, Xiaolong Bian, Haopu Hu, Cong Tian, Chenlong Wang, Yumou Zhou, Tao Xu, Hui Wang, Linlin Cao, Hao Hu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To systematically compare the differences in urinary organic acid metabolic profiles between patients with urinary calculi and non-calculi individuals, to screen disease-specific characteristic metabolic biomarkers and key signaling pathways, and to elucidate the potential mechanism underlying the occurrence and progression of urinary calculi at the metabolic level, so as to provide a theoretical basis for basic research and screening of intervention targets for urinary calculi.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 99 patients with urinary calculi and 57 non-calculi subjects were enrolled. Twenty-four-hour urine samples were collected and subjected to untargeted urinary organic acid metabolomics detection by gas chromatography-mass spectrometry (GC-MS). Principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were used to analyze the differences in metabolic profiles between the groups and the effects of clinical covariates. Volcano plot and variable importance in the projection (VIP) analysis were applied to screen differential organic acids. The Kyoto Encyclopedia of Genes and Genomes (KEGG) database were used for metabolic pathway enrichment analysis. Machine learning algorithms were adopted to screen the most representative core metabolite combinations and verify the discriminatory efficacy of organic acids for disease status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The urinary organic acid metabolic profiles showed a significant separation trend between the calculi group and the non-calculi group (OPLS-DA: &lt;i&gt;R2X&lt;/i&gt; =0.139, &lt;i&gt;R2Y&lt;/i&gt; =0.48, &lt;i&gt;Q2&lt;/i&gt; =0.457). Gender was an important covariate affecting metabolic profiles, while diabetes, hypertension and stone recurrence status exerted no significant influence. A total of 44 differential organic acids were screened (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), including 6 upregulated and 38 downregulated metabolites. Ten core differential metabolites were identified via VIP analysis (&lt;i&gt;P&lt;/i&gt; &lt; 0.001, all downregulated). Differential organic acids were mainly enriched in energy metabolism pathways such as glyoxylate and dicarboxylate metabolism, as well as amino acid metabolism pathways including tryptophan metabolism. Among machine learning models, Gradient Boosting Machine and Random Forest exhibited the optimal efficacy with an average area under the curve (AUC) of 0.996. Five core metabolites including propionylglycine, 5-hydroxyindole-3-acetic acid, kynurenic acid, orotic acid and fumaric acid were identified as the optimal combination. The nomogram model constructed based on this combination yielded an AUC of 0.997; after calibration bias correction, the calibration curve was highly consistent with the ideal curve, with a mean absolute error of 0.022, which could effectively distinguish calculi patients from non-calculi individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with urinary calculi present obvious disorders in urinary or","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"738-747"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577033","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}