北京大学学报（医学版）最新文献

{"title":"[Gout of the manubriosternal joints: A case report].","authors":"Di Gan, Qiang Fu, Xiaohui Tang, Chuwei Li, Zhaoping Shu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gout is a metabolic disorder caused by abnormalities in purine metabolism and/or impaired uric acid excretion. It is characterized by the deposition of monosodium urate crystals in joints or connective tissues, leading to recurrent episodes of acute arthritis. Gout can be categorized into two major types based on its etiology: primary and secondary. The majority of gout cases are associated with impaired uric acid excretion. The natural course of gout can be divided into three stages: (1) asymptomatic phase; (2) acute arthritis phase and intercritical phase; (3) chronic gouty arthritis and tophaceous phase. Acute gouty arthritis typically presents with sudden, severe joint pain, accompanied by redness, swelling, warmth, and tenderness of the affected joint and surrounding soft tissues. When large joints are involved, joint effusion may occur. Acute gouty arthritis often develops at night or in the early morning, is self-limiting, and usually resolves within two weeks. The most common site of acute gout flare-ups is the first metatarsophalangeal joint, followed by the midfoot, ankle, knee, wrist, fingers, and elbow joints. Acute gout attacks rarely affect the axial joints. Pain in these affected areas is often accompanied by limited function, significantly impacting a patient' s daily activities and quality of life. Uncommon sites of gout involvement, as well as gout with normal serum uric acid levels, can easily lead to misdiagnosis. Therefore, a comprehensive diagnosis requires a detailed medical history, physical examination, laboratory tests, and imaging studies. This case report describes a 19-year-old male who was admitted with recurrent anterior chest pain. The diagnosis at another hospital suggested ankylosing spondylitis. Physical examination revealed significant tenderness, redness, and swelling of the bilateral sternoclavicular joints, with local warmth and mildly restricted movement. MRI of the sacroiliac joints showed no significant abnormalities, and serum uric acid levels were normal. Chest dual-energy CT scans revealed multiple tophi in the sternum, bilateral clavicles, scapulae, multiple ribs, and along the edges of the sternum. Based on the patient' s medical history, physical findings, and imaging studies, a diagnosis of gout was confirmed. Treatment included urate-lowering therapy, pain management, and dietary adjustments. During a two-year follow-up period, the patient did not experience recurrent anterior chest pain, and multiple serum uric acid tests consistently showed levels below 300 μmol/L. Repeat chest dual-energy CT scans indicated significant reduction of tophi in the sternoclavicular joints and other affected areas.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"670-673"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238722","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 biological age for cardiovascular risk prediction in a community-based Chinese cohort].","authors":"Mengxi Lu, Binghan Wang, Jiali Kang, Qiuping Liu, Yifan Zhou, Yexiang Sun, Peng Shen, Hongbo Lin, Xun Tang, Pei Gao","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To independently evaluate the discrimination of the light version of biological age (Light BioAge) model for predicting all-cause mortality, to explore the association of the difference on Light BioAge and chronological age (AgeDiff) with the composite outcomes of cardiovascular disease (CVD), and to assess the performance of CVD risk prediction using the Light BioAge instead of chronological age in a large Chinese population-based cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants aged 40-79 years without a history of CVD at baseline were drawn from the CHinese Electronic health Records Research in Yinzhou (CHERRY) study. Harrell' s concordance index (C-index) was employed to assess the discrimination of Light BioAge in predicting all-cause mortality across the overall population and sex-specific subgroups. Cox proportional hazards models were used to assess the association between AgeDiff and the composite outcome of CVD onset and death, adjusting for chronological age, sex, education, region, smoking status, body mass index, systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol. Hazard ratios (&lt;i&gt;HR&lt;/i&gt;) and 95% confidence intervals (&lt;i&gt;CI&lt;/i&gt;) were calculated. Restricted cubic spline (RCS) regression was used to further analyze the potential nonlinear association between AgeDiff and CVD outcomes. Light BioAge was introduced to replace chronological age in the World Health Organization (WHO) non-laboratory CVD risk model to evaluate the discrimination and calibration in predicting 10-year CVD risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 226 406 adults were included, with a mean age of 55.0 years at baseline, 53.2% of whom were women. During a median follow-up of 7.39 years (cumulative 1 562 141 person-years), 11 703 deaths (7.49 per 1 000 person-years) and 9 815 CVD events (6.30 per 1 000 person-years) occurred. The median Light BioAge and AgeDiff were 49.31 and -5.19 years, respectively, suggesting an underestimation of chronological age. Although the Light BioAge model demonstrated good discrimination for predicting all-cause mortality in the overall population (C-index: 0.742, 95% &lt;i&gt;CI&lt;/i&gt;: 0.738-0.746), discrimination was lower in men (0.722, 95%&lt;i&gt;CI&lt;/i&gt;: 0.714-0.730) than in women (0.755, 95%&lt;i&gt;CI&lt;/i&gt;: 0.749-0.761). After adjusting for confounders, the risk of CVD events showed an elevated trend with increasing AgeDiff (&lt;i&gt;P&lt;/i&gt;&lt;sub&gt;trend&lt;/sub&gt; &lt; 0.001). Compared with the lowest quartile of AgeDiff, the risk of CVD events in the highest quartile increased by 21% in men (&lt;i&gt;HR&lt;/i&gt;=1.21, 95%&lt;i&gt;CI&lt;/i&gt;: 1.12-1.30) and 27% in women (&lt;i&gt;HR&lt;/i&gt;=1.27, 95%&lt;i&gt;CI&lt;/i&gt;: 1.17-1.38). RCS regression further indicated that in the overall population, the risk of CVD events increased with AgeDiff. Besides, no significant thre-shold effect was observed in sex-specific subgroups (&lt;i&gt;P&lt;/i&gt; for non-linearity &gt;0.05). Replacing chronological age with the Light BioAge in the WHO model did not im","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"543-550"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238401","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":"[Differences in the formation mechanism of performance-based compensation in public hospitals with different administrative affiliations].","authors":"Yuxin Zhang, Yuhan Li, Telong Ba, Zhisheng Cai, Xingyu Liu, Wen Feng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>One of the explicit goals of public hospital salary reform is to gradually and steadily narrow the salary gap among public hospitals. This study, taking public hospitals at different administrative levels as its starting point, seeks to investigate the differences in the formation mechanisms of performance-based pay.</p><p><strong>Methods: </strong>From June to November 2024, a purposeful sampling strategy was adopted. A total of 43 in-depth interviews were conducted across 14 public hospitals located in a certain municipality directly under the central government. These hospitals covered three administrative tiers: the national level, the provincial and ministerial level, and the prefectural and municipal level. All interview data were analyzed using grounded theory methodology.</p><p><strong>Results: </strong>Through three-level coding, a total of seven core categories were extracted: external constraints, strategic positioning, market capabilities, business structure, incentive systems, management capabilities, and personnel characteristics. These seven factors jointly influenced performance-based salary distribution in public hospitals, but their specific manifestations and interactions showed marked differences across hospitals at different administrative levels. Specifically, public hospitals at higher administrative levels might be fully exempt from wage total amount constraints, or, even when operating within the total framework, still retained a considerably large distributable space. Relying on their high-level strategic positioning, these hospitals developed strong market capabilities and a business structure dominated by high-pricing medical services. They adopted a metric-based, incremental incentive model that allocated rewards directly to individual physicians, with the incentive scope covering the entire chain of medical care, education, and research. In contrast, public hospitals at lower administrative levels faced triple constraints: insufficient bargaining power in the healthcare market, limited and unstable patient sources, and a single compensation pathway heavily reliant on service volume. Their business structure was mainly composed of low-pricing projects with limited profitability. Consequently, they were forced to adopt a position-based performance model, where the incentive scope narrowed to basic medical quality, leaving these hospitals struggling with fragile incentives and persistent talent loss.</p><p><strong>Conclusion: </strong>Public hospitals at different administrative levels present structural differences in their mechanisms for determining performance-based salaries. During the top-down transmission of reform policies, the hierarchical institutional environment, together with stratified market capabilities and management capacities, acts as a multi-layer filter. This filtering process leads to heterogeneous policy performances across different hospital tiers.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"464-471"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238669","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":"[Joint trajectories and evolution patterns of direct and indirect maternal mortality across 204 countries from 2000 to 2021].","authors":"Yi Zhou, Zhao Cheng, Xinglin Feng","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify joint trajectory patterns of direct and indirect maternal mortality ratios (MMR) at the country level from 2000 to 2021, and to compare phase-specific changes during the millennium development goals (MDG, 2000 to 2015) and the sustainable development goals (SDG, 2015 to 2021) periods, as well as differences in health system and policy environments across trajectory groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data on maternal mortality among women aged 15-49 years in 204 countries and territories from 2000 to 2021 were obtained from the Global Burden of Disease (GBD) Study. Direct cause MMR and indirect cause MMR at five time points (2000, 2005, 2010, 2015, and 2021) were jointly analyzed using longitudinal K-means clustering (&lt;i&gt;k&lt;/i&gt;=2-6). The optimal number of clusters was determined by the Calinski-Harabasz (CH) index. Based on the clustering results, a piecewise linear mixed effects model with random intercepts was fitted with a knot in 2015 to estimate the baseline intercept in 2000 and period-specific slopes for the MDG and SDG phases. For 2021, health system and policy-related indicators, including antenatal care coverage (≥4 visits, ANC4), proportion of women with a demand for contraception that are using a modern method, cesarean section rate, female human immunodeficiency virus (HIV) prevalence, in facility delivery rate, skilled birth attendance, and an abortion legality index were compared across clusters using the Kruskal-Wallis &lt;i&gt;H&lt;/i&gt; test. All tests were two-sided, and &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 CH index peaked at &lt;i&gt;k&lt;/i&gt;=3 (CH=342.63), classifying the 204 countries and territories into three joint trajectory clusters: high burden (&lt;i&gt;n&lt;/i&gt;= 66), medium burden (&lt;i&gt;n&lt;/i&gt;=88), and low burden (&lt;i&gt;n&lt;/i&gt;=50). In 2021, direct MMR was 334.6 (95%&lt;i&gt;CI&lt;/i&gt;: 282.5- 386.7), 65.6 (95%&lt;i&gt;CI&lt;/i&gt;: 50.4-80.7), and 5.4 (95%&lt;i&gt;CI&lt;/i&gt;: 3.7-7.0) per 100 000 live births in the high, medium, and low burden clusters, respectively; indirect MMR was 33.6 (95%&lt;i&gt;CI&lt;/i&gt;: 27.9-39.2), 18.2 (95%&lt;i&gt;CI&lt;/i&gt;: 13.5-22.9), and 0.9 (95%&lt;i&gt;CI&lt;/i&gt;: 0.6-1.3) per 100 000 live births, respectively. The piecewise mixed effects model showed significant declines in direct MMR during the MDG period in all clusters (slopes: -0.020, -0.016, and -0.036; &lt;i&gt;P&lt;/i&gt; &lt; 0.001), whereas declines slowed and became non-significant during the SDG period (-0.011, 0.011, and -0.006; &lt;i&gt;P&lt;/i&gt; &gt; 0.05). For indirect MMR, modest increases were observed during the MDG period in the high and medium burden clusters (0.029 and 0.015; &lt;i&gt;P&lt;/i&gt; &lt; 0.05), with no significant change in the low burden cluster (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). During the SDG period, indirect MMR increased markedly in the medium burden cluster (slope: 0.121; 95%&lt;i&gt;CI&lt;/i&gt;: 0.092-0.151; &lt;i&gt;P&lt;/i&gt; &lt; 0.001), while remaining broadly stable in the high and low burden clusters (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). Health system and policy indicators differed","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"496-502"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238738","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":"[Association between umbilical cord blood proteome and early infant neurodevelopmental risk].","authors":"Jingxian Mo, Haijun Wang, Jue Liu, Qin Li, Tao Su, Yuelong Ji","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To systematically investigate the associations between umbilical cord blood protein expression profiles and early infant neurodevelopment using a prospective birth cohort, to identify potential early biomarkers through high-throughput proteomics, and to explore underlying biological mechanisms, thereby providing scientific evidence for early identification of neurodevelopmental risks and understanding the molecular basis of neurodevelopmental deviations in general populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on the Peking University Birth Cohort in Tongzhou, this study enrolled 96 children who completed ages and stages questionnaires, third edition (ASQ-3) assessments at 1 and 3 years of age. Participants were classified into an abnormal group (&lt;i&gt;n&lt;/i&gt;=42) and a control group (&lt;i&gt;n&lt;/i&gt;=54) according to ASQ-3 screening results. Non-targeted quantitative proteomics was performed on cryopreserved umbilical cord blood plasma samples collected at birth. Differential expression analysis, principal component analysis (PCA), orthogonal partial least squares discriminant analysis (OPLS-DA), and weighted gene co-expression network analysis (WGCNA) were conducted to identify differentially expressed proteins, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analyses. The fold change (FC) was calculated. Independent samples &lt;i&gt;t&lt;/i&gt;-test was used for statistical comparison, with Benjamini-Hochberg method applied to calculate false discovery rate (FDR) for multiple testing correction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Proteomic analysis identified 8 214 common proteins, among which 385 proteins were differentially expressed (&lt;i&gt;P&lt;/i&gt; &lt; 0.05, |log&lt;sub&gt;2&lt;/sub&gt;FC| &gt;0.585), including 189 proteins upregulated and 196 proteins downregulated in the abnormal group. PCA and OPLS-DA revealed systematic differences in protein expression patterns between the two groups. WGCN A identified 10 co-expression modules, with the yellow module showing significant negative correlation with ASQ-3 abnormal grouping (&lt;i&gt;r&lt;/i&gt;=-0.233, &lt;i&gt;P&lt;/i&gt;=0.024) and the pink module positively correlating with communication domain scores (&lt;i&gt;r&lt;/i&gt;=0.342, &lt;i&gt;P&lt;/i&gt;=0.003). Enrichment analyses demonstrated that differential proteins and key modules were primarily enriched in two functional categories: (1) genetic information processing pathways, including ribosome, spliceosome, and mRNA processing; and (2) cytoskeleton organization and Wnt signaling pathways. These pathways held significant biological relevance in the pathogenesis of neurodevelopmental disorders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Perturbations in proteins associated with genetic information processing and cytoskeleton/Wnt signaling pathways in umbilical cord blood may represent important molecular characteristics of early neurodevelopmental screening abnormalities in infants. This study provides potential peripheral blood biomarker combinatio","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"479-489"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238365","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":"[Epidemiological characteristics of intussusception in children aged 0-3 years in Jiangsu Province from 2018 to 2023].","authors":"Yulin Wang, Xin Gao, Zhike Liu, Siyan Zhan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To describe the incidence density of intussusception and its distribution characteristics across different ages, genders, and time periods among resident children aged 0-3 years in Jiangsu Province from 2018 to 2023, providing a scientific basis for health administrative departments in the region to formulate prevention and control strategies and measures for intussusception in children aged 0-3 years.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Jiangsu Regional Health Information Platform (RHIP). Resident children aged 0-3 years born between January 1, 2018, and December 31, 2023, were included. Suspected cases were identified by retrieving the International Statistical Classification of Diseases and Related Health Problems, 10 revision (ICD-10) code \"K56.1\" and semantically related keywords for \"intussusception\" from the original text using a regular expression matching algorithm. An incident case was defined as the first occurrence of the disease during the study period. Follow-up person-years were calculated using the exact person-time method. The Poisson distribution was applied to estimate the overall and subgroup incidence densities and their 95% confidence intervals (<i>CI</i>). Poisson regression models were constructed to calculate incidence rate ratio (<i>IRR</i>) and examine the effects of age (in months) and seasonal differences on incidence density.</p><p><strong>Results: </strong>A birth cohort comprising 2 252 691 children aged 0-3 years was established, accumulating a total follow-up of 5 316 389.55 person-years. During the study period, 2 650 incident cases of intussusception were identified, including 1 600 boys (60.4%) and 1 050 girls (39.6%). The overall incidence density was 49.8 (95%<i>CI</i>: 47.9-51.7) per 100 000 person-years. The incidence density was 57.8 (95%<i>CI</i>: 54.9-60.6) per 100 000 person-years for boys and 41.2 (95%<i>CI</i>: 38.7-43.7) per 100 000 person-years for girls, with a statistically significant difference between the sexes. Seasonal variations were observed, with peaks occurring in summer and winter. The incidence density exhibited a unimodal pattern, peaking at 8 months (98.5 per 100 000 person-years). The median age of onset was 19.2 months [interquartile range (IQR): 11.4-26.6 months].</p><p><strong>Conclusion: </strong>This large retrospective cohort study based on the Jiangsu RHIP clarified the epidemiological characteristics of intussusception among local children aged 0-3 years from 2018 to 2023. Boys and children aged 8 months to 3 years were identified as high-risk populations for intussusception, with peak incidence occurring in summer and winter. These findings provide evidence-based support for health authorities to formulate targeted strategies for early surveillance, prevention, and healthcare resource allocation.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"490-495"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238705","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":"[Expression and clinical significance of lymphocyte subsets in infectious pneumonia and immune-related interstitial lung disease].","authors":"Doudou Zhao, Xuan Qi, Bo Huang, Weibo Gao, Yuanyuan Pei, Yuebo Jin, Miao Shao, Jing He","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To delineate differences in lymphocyte subset expression between patients with infectious pneumonia and immune-related interstitial lung disease (IRILD), to assess the immune status across distinct pneumonia types, and to provide novel laboratory markers through immunological profiling to effectively differentiate pneumonias.</p><p><strong>Methods: </strong>A total of 78 patients sequentially enrolled from Peking University People' s Hospital between January 2023 and March 2024 were stratified into three groups: 27 with infectious pneumonia, 27 with isolated immune-related interstitial lung disease (IRILD), and 24 with IRILD complicated by infection. Fifty age-matched healthy individuals undergoing routine physical examinations during the same period served as controls. Peripheral lymphocyte subsets were quantified in all subjects by multiparametric flow cytometry.</p><p><strong>Results: </strong>There was no statistically significant difference in age between the pneumonia patients and the healthy control group in this study (<i>P</i>>0.05). Analysis of laboratory parameters revealed that compared with the IRILD group, the infectious pneumonia group demonstrated significantly elevated levels of neutrophils, C-reactive protein, procalcitonin (PCT), erythrocyte sedimentation rate (ESR), D-dimer, and fibrinogen (<i>P</i> < 0.05), while the IRILD with superimposed infection group exhibited significantly increased levels of PCT, ESR, and immunoglobulin G (<i>P</i> < 0.05). At the lymphocyte subset level, compared with the control group, the infectious pneumonia group exhibited significantly decreased counts of T cells, B cells, natural killer (NK) cells, CD4⁺T cells, and the CD4⁺/CD8⁺ ratio (<i>P</i> < 0.05). Similarly, compared with the control group, the IRILD group showed significantly reduced counts of T cells, B cells, CD4⁺T cells, and the CD4⁺/CD8⁺ ratio (<i>P</i> < 0.05). Furthermore, compared with the control group, the IRILD-with-infection group demonstrated significantly lower counts of T cells, B cells, NK cells, CD4⁺T cells, and CD8⁺T cells (<i>P</i> < 0.05). Compared with the IRILD group, the infectious pneumonia group had a significantly lower NK cell count (<i>P</i> < 0.05). Additionally, compared with the IRILD group, the IRILD-with-infection group displayed significantly reduced counts of NK cells and CD8⁺T cells (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The study revealed significant variations in lymphocyte subset profiles among the distinct pneumonia groups, providing novel insights with potential diagnostic value for differentiating between pneumonia types.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"624-630"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238710","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":"[Dynamic stretching promotes osteogenic differentiation of human bone marrow mesenchymal stem cells in three-dimensional culture].","authors":"Xiaoqiang Bai, Zhiruo Yuan, Yongsheng Zhou, Longwei Lv","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the promotion of dynamic distraction on osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMMSCs) in three-dimensional culture.</p><p><strong>Methods: </strong>Dynamic stretching in a three-dimensional culture for hBMMSCs was achieved with proportions set at 5%, 10%, and 20%, a frequency of 0.5 Hz, and a dynamic stretching duration of 2 hours per day. Static culture was used as the control group. Deformation of hBMMSCs induced by dynamic stretching was observed through cytoplasmic fluorescence staining. After 7 days of dynamic stretching culture, the impact of dynamic stretching on the viability of hBMMSCs was observed through cell live/dead staining. The effect of dynamic stretching on the osteogenic differentiation of hBMMSCs was observed through alkaline phosphatase (ALP) staining and the expression of osteogenic related genes and proteins after 7 days of dynamic stretching culture.</p><p><strong>Results: </strong>Dynamic stretching in a three-dimensional culture for hBMMSCs was successfully constructed, which could achieve different durations, frequencies, and ratios of dynamic stretching. Dynamic stretching led to deformation of hBMMSCs, and the greater the stretching ratio, the more pronounced the cell deformation, transitioning from a circular to a flat oval shape. After 7 days of dynamic stretching culture, hBMMSCs in the static control group and dynamic stretching groups were mostly green stained live cells, with only a few red stained dead cells. The difference in the proportion of live cells between the groups was not statistically significant (<i>P</i>>0.05). The ALP staining in the dynamic stretching group was deeper than that in the static control group, and the number of ALP staining positive cells observed under the microscope was higher. The expression of osteogenic related genes and proteins increased after 7 days of dynamic stretching culture, and the difference was statistically significant (<i>P</i> < 0.05). Among them, the dynamic stretching group with 10% had the deepest ALP staining, the highest number of positive cells, and the most significant increase in the expression of osteogenic related genes and proteins compared with the static control group.</p><p><strong>Conclusion: </strong>Dynamic stretching caused deformation of hBMMSCs without a significant impact on cell viability, and it could effectively promote the osteogenic differentiation of hBMMSCs.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"641-649"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238686","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":"[Associations of subjective perceptions and income change with transitions in usual source of care among Chinese residents: A study based on China Family Panel Studies].","authors":"Chunchun Xu, Weiyan Jian","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Using the China Family Panel Studies (CFPS, 2012-2022), this study aimed to characterize changes in the distribution of usual sources of care and in subjective perceptions among Chinese adults, and to examine the associations of subjective perceptions and income change with next-wave transitions in usual source of care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective longitudinal observational study based on adult CFPS data from 2012, 2014, 2016, 2018, 2020, and 2022. We first described temporal trends in three types of usual source of care (primary care, hospitals, and clinics), as well as trends in residents' subjective perceptions of healthcare providers, and in relative income change. We then constructed person-period samples from adjacent survey waves and analyzed two transition processes separately: outflow from primary care among baseline primary care users and inflow to primary care among baseline non-primary care users. Key predictors were prior-wave satisfaction, perceived medical competence, and relative income change; the income-change variable was defined based on changes in relative income group within the same wave and same province sample. Descriptive analyses applied cross-sectional weights; the main regressions were unweighted binary Logistic models with individual-level cluster-robust standard errors, reporting odds ratios (&lt;i&gt;OR&lt;/i&gt;), 95% confidence intervals (95% &lt;i&gt;CI&lt;/i&gt;), and &lt;i&gt;P&lt;/i&gt; va-lues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The pooled sample comprised 135 986 observations from 34 010 individuals. From 2012 to 2022, the proportion using primary care as the usual source of care declined from 43.49% to 30.34%, whereas the hospital share rose from 34.06% to 46.81%. The decline in primary care was steeper during 2012-2018 (43.49% to 33.72%) and persisted at a slower pace thereafter (33.72% to 30.34%). Across adjacent survey waves, primary care outflow increased from 35.47% to 45.22%, while primary care inflow decreased from 30.09% to 19.60%, indicating simultaneous increases in exits and decreases in entries. Subjective perceptions improved for all three provider types over time; however, the relative gap between primary care and hospitals widened on perceived medical competence, and primary care shifted from a slight advantage over clinics to a clear disadvantage in composite subjective perceptions. The proportion of residents with unchanged relative income group rose from 50.64% to 60.33%. In multivariable models, each one-unit increase in satisfaction with primary care was associated with 7.5% lower odds of leaving primary care (&lt;i&gt;OR&lt;/i&gt;=0.925, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). In contrast, each one-unit increase in perceived medical competence of non-primary care providers was associated with 5.3% lower odds of moving into primary care (&lt;i&gt;OR&lt;/i&gt;=0.947, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Compared with stable relative income group, upward relative income-group mobility, particularly low-to-high movement, was assoc","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"455-463"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238402","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":"[Association between ambient personal temperature exposure and oxygen saturation during sleep in patients with chronic obstructive pulmonary disease].","authors":"Meng Zuo, Wenlou Zhang, Baiqi Chen, Chen Zhao, Yahong Chen, Jianhui He, Xinbiao Guo, Furong Deng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between personal temperature exposure and oxygen saturation (SpO₂) during sleep in chronic obstructive pulmonary disease (COPD) patients, to analyze potential susceptibility factors and to provide a scientific basis for the adoption of effective measures to safeguard the health of susceptible populations.</p><p><strong>Methods: </strong>In this prospective panel study, 96 stable COPD patients were recruited. From March 2021 to September 2023 in Beijing, all participants completed 202 nights (from 20:00 to 08:00) of dynamic real-time SpO₂ monitoring during sleep, simultaneously monitoring personal exposure level to temperature, alongside environmental humidity and other key air pollutant data. Based on previous clinical studies, SpO₂ < 90% was defined as desaturation to assess the risk of hypoxic events occurring during sleep. Linear mixed-effects models and generalized linear mixed-effects models were used to analyze the association between personal temperature exposure and SpO₂ during sleep, as well as the risk of oxygen desaturation. Interaction models were constructed to evaluate susceptibility factors.</p><p><strong>Results: </strong>During the study, the average personal temperature exposure was (27.5± 2.6) ℃, with a temperature range from 16.5 ℃ to 40.0 ℃. Short-term exposure to personal temperature was associated with a decline in SpO₂ and an increased risk of oxygen desaturation during sleep in the COPD patients. The effect of temperature exposure was strongest at lag 0-30 min, with a 0.24% (95%<i>CI</i>: -0.28%, -0.20%) decrease in SpO₂, and with an odds ratio (<i>OR</i>) of oxygen desaturation was 1.26 (95% <i>CI</i>: 1.12, 1.42) for each interquartile range (IQR, 6.0 ℃) increase in temperature. Besides, the patients exposed to medium and high humidity levels were more likely to be affected by temperature exposure compared with the patients exposed to low humidity levels. Personal temperature exposure had a stronger effect on SpO₂ during sleep in the patients with global initiative for chronic obstructive lung disease (GOLD) Ⅲ-Ⅳ compared with the patients with GOLD Ⅰ-Ⅱ (<i>P</i>_interaction < 0.05).</p><p><strong>Conclusion: </strong>From 16.5 ℃ to 40.0 ℃, personal temperature exposure is associated with SpO₂ decline during sleep in COPD patients. There was a significant synergistic amplification between temperature and humidity, patients were more susceptible to damage under high temperature and high humidity conditions. Moreover, patients with poorer lung function are more significantly affected by temperature.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 3","pages":"592-599"},"PeriodicalIF":0.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238420","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}