Objective To investigate the clinical manifestations, pathological features and prognosis of antiglomerular basement membrane(anti-GBM) disease with membranous nephropathy(MN), and to provide a reference for the diagnosis and treatment of this rare disease. Methods A retrospective analysis was conducted on 58 patients diagnosed with anti-GBM disease via renal biopsy at our center between January 2016 and December 2024. Enrolled subjects included 34 patients with anti-GBM glomerulonephritis, 16 with anti-GBM disease and concurrent anti-neutrophil cytoplasmic antibody-associated vasculitis(anti-GBM+ANCA) and 8 with anti-GBM disease and MN(anti-GBM+MN). Laboratory tests and pathological information were analyzed among the three groups, and prognosis was assessed through continuous follow-up. Renal survival rates were calculated using the Kaplan-Meier method. Results The average age of enrolled subjects was over 45 years, and no significant gender differences were observed. Hemoptysis occurred in 14.7%(5/34) of the anti-GBM group and18.7%(3/16) of the anti-GBM+ANCA group, while no hemoptysis was exhibited in the anti-GBM+MN group. Compared with patients with classical anti-GBM and anti-GBM + ANCA disease, those with anti-GBM disease with MN presented a lower incidence of acute kidney injury(AKI), no hemoptysis, and higher hemoglobin levels(P = 0.011). The proportion of glomerular crescents in the anti-GBM + MN group was significantly lower than in the other two groups(P < 0.001). 75%(6/8) of cases were positive for circulating anti-PLA2R and 87.5%(7/8) of cases showed positive PLA2R staining in renal tissue. Survival curve analysis revealed that renal outcomes in the anti-GBM+MN group were better than those in the anti-GBM and anti-GBM+ANCA groups(P = 0.049). Conclusion Patients with both anti-GBM disease and MN showed atypical antiGBM disease. They had a lower proportion of glomerular crescents and a better renal function prognosis than patients with classical anti-GBM. Early identification and treatment of anti-GBM disease associated with MN are needed to improve renal recovery.

Objective To investigate the expression and clinical significance of serum interleukin-6(IL-6), monocyte chemoattractant protein-1(MCP-1), and serum amyloid A(SAA) in urinary tract infections(UTIs) after kidney stone surgery.Methods Between October 2023 and October 2024, 187 patients who underwent Kidney Stone Surgery in Fuxing Hospital,Capital Medical University were recruited and divided into the UTI group(n = 45) and the non-UTI group(n = 142) based on whether UTI occurred postoperatively. Serum levels of IL-6, MCP-1, and SAA were detected using ELISA. A microbial analyzer was used for pathogen detection and identification. Multiple logistic regression was applied to explore the influencing factors of UTI occurrence. ROC curve analysis was used to evaluate the diagnostic value of serum IL-6, MCP-1, and SAA for UTI after kidney stone surgery. Results Compared with the non-UTI group, the UTI group had significantly higher serum levels of IL-6, MCP-1, and SAA(t = 6.691, 6.060, 5.549, P <0.05). A total of 65 strains of pathogenic bacteria were isolated from the urine of 45 postoperative UTI patients, including 22 strains of Gram-positive bacteria, 38 strains of Gram-negative bacteria, and 5 strains of fungi. Preoperative placement of ureteral stent, prolonged indwelling time of urinary catheter, and elevated levels of IL-6, MCP-1, and SAA were identified as influencing factors for UTI occurrence[OR(95%CI) = 2.453(1.527-3.942), 3.023(1.580-5.784), 4.112(3.168-5.337), 3.786(2.058-6.965), 4.978(2.859-8.669)]. The AUC values of serum IL-6, MCP-1, and SAA levels alone and in combination for diagnosing postoperative UTI in patients with kidney stones were0.753, 0.766, 0.832, and 0.931, respectively. The combination of the three markers was superior to their individual diagnostic values(Z = 4.255, 4.303, 3.568,P <0.001). Conclusion Serum IL-6, MCP-1, and SAA are highly expressed in patients with UTI after kidney stone surgery, and their combined detection can improve the diagnostic efficacy for UTI occurrence.

Objective To investigate the levels of bone turnover markers in patients with osteoporotic fractures and their correlation with postoperative skeletal muscle status.Methods A total of 98 patients with osteoporotic femoral neck fractures who were treated at the Orthopedic Center of Xinjiang Uygur Autonomous Region People' s Hospital from January2023 to January 2025 were selected as the research subjects. According to the skeletal muscle status of the patients one month after the operation, they were divided into a sarcopenia group(54 cases) and a non-sarcopenia group(44 cases). Pearson correlation analysis was used to investigate the correlation between bone turnover marker levels and postoperative skeletal muscle status. Multiple logistic regression analysis was applied to investigate the influencing factors of postoperative skeletal muscle status in patients with osteoporotic fractures. Receiver operating characteristic(ROC) curve analysis was applied to evaluate the predictive value of bone turnover marker levels for the postoperative skeletal muscle status of patients with osteoporotic femoral neck fractures.Results The grip strength of both hands, 6-meter walking speed, and postoperative skeletal muscle index(SMI) level in the sarcopenia group were lower than those in the non-sarcopenia group(t/P = 6.138/<0.001, 8.584/<0.001,7.610/<0.001). The levels of parathyroid hormone(PTH), type Ⅰ procollagen amino-terminal peptide(PⅠNP), and type I collagen carboxyl-terminal peptide β special sequence(β-CTX) in the sarcopenia group were higher than those in the non-sarcopenia group(t/P = 4.425/<0.001, 3.924/<0.001, 4.982/<0.001). Osteocalcin(OC), blood phosphorus, blood calcium, and 25-hydroxyvitamin D were lower than those in the non-sarcopenia group(t/P = 7.788/<0.001, 6.899/<0.001, 6.400/<0.001, 3.568/<0.001). Pearson correlation analysis showed that the levels of OC, blood phosphorus, blood calcium, and 25-hydroxyvitamin D in patients with osteoporotic femoral neck fractures were positively correlated with postoperative SMI(r/P = 0.574/< 0.001,0.523/<0.001, 0.659/<0.001, 0.653/<0.001). The levels of PTH, PⅠNP and β-CTX were negatively correlated with postoperative SMI(r/P =-0.786/<0.001,-0.670/<0.001,-0.637/<0.001). High PⅠNP and high β-CTX were independent risk factors affecting the postoperative skeletal muscle status of patients with osteoporotic femoral neck fractures[OR(95%CI) = 1.152(1.001-1.325), 17.282(2.333-128.011)]. High OC and high 25-hydroxyvitamin D were independent protective factors [OR(95%CI) = 0.196(0.062-0.622), 0.314(0.099-0.997)]. The AUCs of OC, 25-hydroxyvitamin D, PⅠNP, and β-CTX levels alone and in combination for predicting the postoperative skeletal muscle status of patients with osteoporotic femoral neck fractures were 0.844, 0.689, 0.716, 0.822, and 0.956, respectively. The combined prediction of the four was superior to the individual predictive values of OC, 25-hydroxyvitamin D, PⅠNP, and β-CTX(Z/P = 2.362/0.018, 4.637/<0.001, 2.721/0.006,4.381/<0.001).Conclusion The levels of OC, 25-hydroxyvitamin D, PⅠNP, and β-CTX are closely related to the postoperative skeletal muscle status of patients with osteoporotic femoral neck fractures. The combined prediction of the four has a relatively high value in predicting postoperative skeletal muscle reduction in patients.

Objective To construct a risk prediction model for recurrence in breast cancer patients after breast-conserving surgery and radiotherapy based on the cadherin expression profile and tumor pathological features, and to evaluate the efficacy of this model. Methods A total of 298 breast cancer patients who underwent breast-conserving surgery at the Affiliated Cancer Hospital of Xinjiang Medical University from February 2020 to February 2023 were selected as the research subjects. Based on whether recurrence occurred within 2 years after breast-conserving surgery combined with radiotherapy, the patients were divided into a recurrence group(19 cases) and a non-recurrence group(279 cases). Immunohistochemistry(IHC)was used to detect the expressions of E-cadherin, N-cadherin, P-cadherin, and VE-cadherin. Multivariate logistic regression analysis was performed to identify influencing factors related to recurrence in breast cancer patients after breast-conserving surgery and radiotherapy, and a nomogram prediction model was constructed. Receiver operating characteristic(ROC) curve analysis was used to evaluate the value of the model in predicting recurrence after breast-conserving surgery and radiotherapy in breast cancer patients. Results Compared with the non-recurrence group, the recurrence group had a larger maximum tumor diameter, higher proportions of poorly differentiated tumors, TNM stage Ⅱ tumors, and HER-2 positivity, as well as a higher Ki-67 index, while the proportions of ER positivity and PR positivity were lower(t/χ 2/P = 2.385/0.018, 6.569/0.037,4.566/0.033, 4.689/0.030, 3.837/0.049, 4.502/0.034, 2.453/0.015). Additionally, the recurrence group had a longer operation time, a higher proportion of systemic radiotherapy-related adverse reactions, and a lower proportion of patients who received boost irradiation to the tumor bed compared with the non-recurrence group(t/χ 2/P = 2.092/0.037, 4.264/0.039, 4.264/0.039).The proportions of low E-cadherin expression, high N-cadherin expression, and high VE-cadherin expression in the recurrence group were higher than those in the non-recurrence group(χ 2/P = 7.968/0.005, 6.866/0.009, 6.170/0.013). Multivariate logistic regression analysis showed that larger maximum tumor diameter, poorly differentiated tumor, higher Ki-67 index, high N-cadherin expression, and high VE-cadherin expression were independent risk factors for recurrence in breast cancer patients after breast-conserving surgery and radiotherapy[OR(95%CI) = 16.846(2.653-106.984), 4.276(1.459-12.536), 1.342(1.082-1.664), 4.034(1.038-15.675), 4.217(1.070-16.624)], while receiving boost irradiation to the tumor bed and high E-cadherin expression were independent protective factors [OR(95%CI) = 0.154(0.036-0.666), 0.130(0.027-0.624)]. ROC curve analysis showed that the area under the curve(AUC) of the model for predicting recurrence after breast-conserving surgery and radiotherapy in breast cancer patients was 0.905(95%CI = 0.850-0.961), with a sensitivity of 0.886 and a specificity of 0.900.Conclusion Maximum tumor diameter, tumor differentiation degree(poor differentiation), Ki-67 index, receipt of boost irradiation to the tumor bed, and expressions of E-cadherin, N-cadherin, and VE-cadherin in breast cancer patients are all associated with recurrence after breast-conserving surgery and radiotherapy. The model constructed based on the aforementioned tumor pathological features and cadherin expression profile can effectively predict the recurrence risk of breast cancer patients after breast-conserving surgery and radiotherapy.

Objective To investigate the expression of tumor suppressor p53(TP53) and serine/threonine kinase 11(STK11) in cervical cancer tissues and adjacent tissues, with a focus on analyzing the correlation between TP53 and STK11 expression in cancer tissues and clinicopathological characteristics and prognosis. Methods A retrospective analysis was conducted on 113 cervical cancer patients who underwent surgical treatment at Heilongjiang Provincial Hospital from January2018 to December 2022. The expression of TP53 and STK11 in cancer tissues and adjacent tissues was statistically analyzed,and postoperative follow-up data were reviewed. Patients were grouped according to their prognosis(recurrence and metastasis within 2 years after surgery), and the expression of TP53 and STK11 in cancer tissues was compared under different pathological characteristics and prognosis conditions. Cox regression analysis, nomogram, and decision curve analysis were used to analyze the possible relationship between TP53 and STK11 expression and prognosis. Results The expression levels of TP53m RNA and STK11 m RNA in cervical cancer tissues were lower than those in adjacent tissues(t/P = 6.642/<0.001, 24.874/<0.001). The International Federation of Gynecology and Obstetrics(FIGO) stage ⅡA and the proportion of lymph node metastasis in the recurrence group were higher than those in the non-recurrence group(χ 2/P = 14.962/0.001, 9.611/0.002). The expression levels of TP53 m RNA and STK11 m RNA in the recurrence group were lower than those in the non-recurrence group(t/P = 3.511/0.001, 3.553/0.001). Multivariate Cox regression analysis revealed that FIGO stage ⅡA and lymph node metastasis were significant risk factors for cervical cancer recurrence[HR(95%CI) = 3.556(1.126-11.235), 2.804(1.071-7.342)], while TP53 and STK11 demonstrated protective effects [HR(95%CI) = 0.427(0.190-0.959), 0.472(0.268-0.831)]. The nomogram based on Cox regression analysis showed that a 0.05 decrease in TP53 m RNA expression level increased the postoperative recurrence risk of cervical cancer by 13.75 points, while a 0.05 decrease in STK11 m RNA expression level raised the risk by12.50 points. The nomogram model predicted a C-index of 0.856(95%CI : 0.794-0.917) for evaluating the risk of postoperative cervical cancer recurrence, indicating good model discrimination. Conclusion The low expression of TP53 and STK11 in cervical cancer tissues is associated with the risk of postoperative recurrence in patients and may serve as a novel biomarker for evaluating the prognosis of cervical cancer patients.