Genetic kidney diseases refer to a broad category of renal disorders associated with genetic etiologies. They are the leading cause of end-stage kidney disease in children and adolescents，accounting for over 25% of pediatric patients requiring renal replacement therapy. In recent years，advancements in genetic testing technology have significantly improved the diagnostic rates of genetic kidney diseases，while comprehensive clinical evaluation and early screening of high-risk populations are of great diagnostic value. Currently，most genetic kidney diseases lack targeted therapies. Drug treatment prima-rily aims to provide symptomatic support，control proteinuria，and delay kidney function decline. The rapid development of gene therapy technology has brought hope for targeted etiological treatment of genetic kidney diseases. From 2014 to 2020，clinical phenotypes and whole-exome sequencing data from 2 256 pediatric patients with kidney diseases were analyzed to characterize the genetic spectrum of kidney diseases in Chinese children. The clinical diagnoses included steroid-resistant nephrotic syndrome （23.5%），glomerulonephritis （32.2%），CAKUT （21.2%），cystic kidney disease （3.9%），nephrocalcinosis or renal calculus （3.6%），tubulopathies （9.7%），and CKD of unknown etiology （5.8%）. The precision and treatment strategies，established based on the Chinese Children Genetic Kidney Disease Database （CCGKDD），enhance the diagnosis and treatment capabilities for pediatric genetic kidney diseases by focusing on genetic spectrum characterization，exploration of new genes and mechanisms，multi-center clinical research，and full life-cycle management.

Primary membranous nephropathy (PMN) has seen a significant global rise in incidence, with data from China showing an annual growth of 13%, making it the leading cause of nephrotic syndrome in people over 40 years old. The diagnosis of PMN traditionally depends on renal biopsy, but recent studies have provided new directions for non-invasive diagnosis. The discovery of anti-phospholipase A2 receptor (PLA2R) antibodies in 2009 marked a milestone in PMN research, and the identification of other target antigens (such as THSD7A and NELL-1) further advanced the understanding of the pathogenesis. Serum PLA2R antibody detection has high specificity but limited sensitivity, potentially lea-ding to missed diagnosis of non-PLA2R-related cases. The combined disease risk score integrating susceptibility loci identified through genome-wide association studies (GWAS) (such as PLA2R1 and HLA-DQA1) with serum antibodies has significantly improved the accuracy of non-invasive diagnosis (area under the receiver operating characteristic curve reaching 0.96). Additionally, gut microbiome analysis demonstrates diagnostic potential, though its clinical application requires further optimization. In terms of advances in prognostic assessment, PMN exhibits remarkable heterogeneity in its natural course, with approximately one-third of patients achieving spontaneous remission and another one-third progressing to renal function decline. Age, proteinuria level, eGFR, PLA2R antibody titer, and the extent of tubulointerstitial lesions are key prognostic predictors. A model combining clinical risk score (CRS) with clinical parameters (such as age, proteinuria, and eGFR) can effectively identify high-risk patients and guide precision treatment. Traditional regimens (such as hormone combined with alkylating agents or calcineurin inhibitors) are effective but have significant toxic side effects. In recent years, anti-CD20 monoclonal antibodies, represented by rituximab (RTX), have become first-line treatments, substantially improving efficacy, though they remain ineffective for some patients. Novel biologics and complement pathway inhibitors provide new options for treatment-resistant patients. Combination strategies (such as RTX combined with tacrolimus) are under investigation, but the balance between efficacy and safety needs to be carefully considered. Future efforts should focus on further optimizing risk stratification and individualized treatment strategies to improve the long-term prognosis of PMN patients.

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary renal cystic disorders and a major cause of end-stage renal disease requiring renal replacement therapy. In February 2025, Kidney Disease: Improving Global Outcomes (KDIGO) released the first clinical practice guideline specifically for ADPKD entitled "KDIGO Clinical Practice Guideline for the Evaluation, Management, and Treatment of Autosomal Dominant Polycystic Kidney Disease". The guideline comprises 10 chapters covering nomenclature, diagnosis, prognosis, and prevalence of ADPKD; renal manifestations; management and progression of chronic kidney disease, renal failure, and renal replacement therapy; treatments to delay renal disease progression; polycystic liver disease; intracranial aneurysms and other extrarenal manifestations; lifestyle and psychosocial considerations; pregnancy and reproductive problems; pediatric problems; and approaches to ADPKD patient management. It highlights early diagnosis, risk stratification, integrated management, and application of the new drug tolvaptan. Additionally, the guideline introduces a new nomenclature system based on pathogenic genes for the first time, along with more stringent blood pressure management plans. By integrating guideline highlights, evidence-based medicine, and China's clinical practice, this study interprets two key clinical issues in the updated guideline: "early diagnosis and risk stratification of ADPKD" and "treatment and daily management of kidney-related symptoms." A thorough analysis of the guideline's implications and limitations is conducted, aiming to promote standardized diagnosis and therapy for ADPKD.

The integration of radionuclide diagnosis and treatment combines the dual functions of radionuclide imaging and treatment, and has been widely applied in the diagnosis and treatment of various tumors. Significant progress has been made in this field over the past few years, advancing tumor visualization for diagnostic assessment and precision treatment. However, issues such as inconsistent dose distribution between radionuclide imaging and therapy, short retention time of radionuclides, optimization of imaging radiation dose, and prediction of therapeutic dose remain prominent. This study introduces the current status and potential solutions to the above issues, including identifying different targets and probes, and screening patients sensitive to treatment, so as to improve the efficacy of radionuclide imaging and therapy. By modifying radionuclide imaging agents and using polymers or albumin conjugation, the retention time of radionuclides can be prolonged. Artificial intelligence is employed to reconstruct full-dose images or non-CT-attenuation-corrected images, thereby reducing imaging radiation dose. Machine learning models are utilized to optimize personalized therapeutic dose prediction. Overcoming these challenges can strongly promote the development of integrated radionuclide diagnosis and treatment.

Objective To assess the burden of chronic kidney disease (CKD) caused by type 2 diabetes (T2D) (CKD-T2D) among populations of different ages, genders, regions, and socio-demographic index (SDI) levels globally and in China from 1990 to 2021. Methods Based on data from the 2021 Global Burden of Disease Study (GBD), incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of CKD-T2D in 204 countries and regions were analyzed, with absolute numbers and their 95% uncertainty intervals (UIs) calculated. Results From 1990 to 2021, the global burden of CKD-T2D increased significantly. In 2021, there were 2 012 024 (95%UI: 1 857 800-2 154 288) new cases, marking a 167.2% (95%UI: 153.5%-182.6%) increase from 1990. The age-standardized incidence rate (ASIR) reached 23.07 per 100 000 (95%UI: 21.40-24.72), an increase of 21.0% (15.0%-27.5%) since 1990. Regional analysis showed that North Africa and the Middle East had the highest ASIR (42.802 per 100 000). Compared to 1990, China's CKD-T2D incidence rose significantly to 354,157 cases (95%UI: 321 265-382 784), with crude incidence increasing by 177.6% (95%UI: 154.8%- 205.5%) and ASIR rising slightly by 7.8% [95%UI: (-0.1%) to 17.8%]. For other indicators, crude rates increased whereas age-standardized rates declined. In 2021, CKD-T2D incidence was highest among people aged 65-74 worldwide [364 163 new cases in ages 65-69 (95%UI: 272 571-475 468) and 366 045 in ages 70-74 (95%UI: 286 728-459 891)], with males bearing a higher burden than females [65-69: males 187 097 (95%UI: 140 064-243 571), females 177 066 (95%UI: 132 338-231 769); 70-74: males 187 216 (95%UI: 146 377-234 997), females 178 830 (95%UI: 140 938-224 801)]. SDI stratification indicated that from 1990 to 2021, high-SDI regions had the highest ASIR with a continuous upward trend, while low-SDI regions had the highest mortality rates with limited improvement. Hyperglycemia, obesity, high-calorie diets, and hypertension were the main risk factors for CKD-T2D. Conclusion CKD-T2D remains a major public health issue, with a particularly high disease burden among elderly males and in low- and middle-income countries. While crude rates have risen in China, age-standardized mortality rate (ASMR) and DALYs have declined.

Objective To evaluate the clinical efficacy of rituximab (RTX) in patients with phospholipase A2 receptor (PLA2R)-negative primary membranous nephropathy (PMN) presenting as nephrotic syndrome, and to identify predictors for treatment efficacy. Methods This retrospective cohort study included 19 biopsy-proven PLA2R-negative PMN patients with nephrotic syndrome who received RTX at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between March 2020 and March 2024. Additionally, 38 PLA2R-positive PMN patients with nephrotic syndrome who received RTX were matched as controls. All patients were followed for at least 6 months (median = 12 months) to evaluate the clinical efficacy of RTX in both groups and to analyze potential predictors of treatment efficacy in PLA2R-negative MN patients. Results In PLA2R-negative PMN patients treated with RTX for 12 months, the 24-hour proteinuria significantly decreased from (9.8±4.3) g/d to (2.6±2.6) g/d and serum albumin increased from (20.3±4.3) g/L to (36.4±7.1) g/L (P<0.05). The overall change in estimated glomerular filtration rate showed no statistical significance [(90.7±30.0) mL·min^-1·1.73 m^-2 vs. (84.4±22.19) mL·min^-1·1.73 m^-2] (P>0.05). Overall remission rates in the PLA2R-negative group at 3 months (57.89%), 6 months (57.89%), 12 months (85.71%) were comparable to those in the PLA2R-positive group (P>0.05). However, the complete remission rate was significantly higher in the PLA2R-negative group at 3 months (21.5% vs. 0%, P=0.009 8) and 6 months (36.84% vs. 10.53%, P=0.030 5), indicating statistical significance. The univariate logistic regression analysis showed that factors influencing clinical remission at 12 months of RTX treatment in PLA2R-negative PMN patients were 3-month 24-hour proteinuria (OR=0.993, P=0.047 1) and 3-month serum albumin (OR=1.309, P=0.048 8). Conclusion RTX treatment is effective in treating PLA2R-negative PMN. Compared with the PLA2R-positive group, the overall remission rate at 12 months was comparable, with a slightly higher complete remission rate at 3 months. The 3-month 24-hour proteinuria and 3-month serum albumin levels may serve as potential predictors for clinical remission at 12 months in PLA2R-negative PMN patients.

Objective This study aims to observe the expression of programmed cell death 1 ligand 1 (PD-L1), P53, and androgen receptor (AR) in tumor tissues of patients with urothelial carcinoma (UC) and analyze their correlation with patient prognosis. Methods A retrospective analysis was conducted on 115 UC patients with complete clinical data who were admitted consecutively to the General Hospital of Eastern Theater Command and Nanjing Drum Tower Hospital from May 2017 to February 2020. Immunohistochemistry was used to detect the expression of PD-L1, P53, and AR proteins in pathological tissues. The chi-square test (χ² test) was employed to analyze the correlation between these biomarkers and clinicopathological characteristics. Kaplan-Meier survival analysis was used to evaluate the relationship between biomarker expression and prognosis. Results The median follow-up time for the study cohort was 32.5 months (range: 1-54 months). Disease progression occurred in 22 cases, and 17 patients (17.2%) died. The expression rates of PD-L1, P53, and AR in UC tissues were 46.1%, 45.2%, and 7.8%, respectively. Positive PD-L1 expression was associated with clinical progression (54.9% in the positive group vs. 31.8% in the negative group, P=0.016). AR-positive cases were more likely to exhibit multifocal tumor growth (21.7% vs. 4.3%, P=0.019). P53 expression showed no significant correlation with the clinical characteristics of UC. The positive expression of PD-L1, P53, and AR was not associated with overall survival in UC patients. Conclusion Positive PD-L1 expression is associated with disease progression in UC. The expression of PD-L1, P53, and AR is not correlated with short-term survival prognosis in UC patients. Among them, AR expression rate is low and shows no association with short-term prognosis, suggesting that AR-targeted therapy for UC patients has certain limitations.

Objective To explore the application value of contrast-enhanced ultrasound (CEUS) combined with magnetic resonance imaging (MRI) in T staging of middle and low rectal cancer, providing an accurate basis for multidisciplinary treatment (MDT). Method AA retrospective analysis was conducted on the case data of 80 consecutive patients with middle and low rectal cancer admitted to the hospital from April 2023 to February 2025. All patients underwent transrectal ultrasound (TRUS), CEUS, and 3.0T MRI examinations within one week before biopsy or surgery. Using postoperative pathological results as the gold standard, the diagnostic performance of single and combined examinations in diagno-sing T staging of low rectal cancer was calculated separately. Result The combined examination for T₁ rectal cancer showed a sensitivity of 87.5%, specificity of 99%, positive predictive value of 99.9%, and negative predictive value of 96.7%. For T₂ rectal cancer, the sensitivity, specificity, positive predictive value, and negative predictive value were 91.3%, 96.3%, 91.3%, and 96.3%, respectively. For T₃ rectal cancer, these values were 93.5%, 97.8%, 96.7%, and 95.7%, respectively. For T₄ rectal cancer, these values were 90%, 98.5%, 90%, and 98.5%, respectively. The diagnostic accuracy of the combined examination for T₁-T₄ rectal cancer was 97.5%, 97.5%, 96.25%, and 98.7%, respectively. The diagnostic accuracy of CEUS examination alone for T₁-T₄ stages was 87.5%, 86.96%, 80.65%, and 80%, respectively. The diagnostic accuracy of MRI examination alone for T₁-T₄ stages was 81.25%, 78.26%, 90.32%, and 90%, respectively. The accuracy of the combined examination was significantly higher than that of CEUS or MRI examination alone (P<0.05). The consistency between the combined examination and pathological staging was good (Kappa value=0.877, P<0.05). After CEUS combined with MRI examination, the area under the curve (AUC) of the receiver operating characteristic curve of the diagnostic model rose to 0.85, significantly exceeding that of single examination methods(CEUS AUC=0.75, MRI AUC=0.758). Additionally, it was found that T₁-T₂ rectal cancer showed varying degrees of uniform enhancement on CEUS, and the specificity of CEUS combined with MRI in diagnosing T₁-T₂ rectal cancer reached over 96.3%. The low enhancement observed on CEUS in the portal phase achieved a high specificity of 95.5% for diagnosing T₃ and higher-stage tumors. Conclusion CEUS combined with MRI has significant advantages in the diagnosis of T staging of rectal cancer, especially for T₁ and T₂ stages, which have notable superiority over single examination. The accuracy of the combined examination can reach 97.5% and 97.5%, and the specificity can reach 99% and 96.3%, respectively, making it useful for ruling out non-neoplastic lesions.

Objective This study aims to investigate the effect of the N6-methyladenosine (m6A) methyltransferase KIAA1429 on programmed death-ligand 1 (PD-L1) expression and CD8⁺ T cell infiltration in colorectal cancer (CRC). Methods The effects of KIAA1429 expression on PD-L1 expression and CD8⁺T cell infiltration in CRC were analyzed using online databases. Tissue samples from tumor and adjacent normal regions were collected from patients with pathologically confirmed CRC treated at the Affiliated Taizhou People's Hospital of Nanjing Medical University, admitted and diagnosed between 2020 and 2022. Immunohistochemical (IHC) staining was performed to evaluate and compare the expression levels of KIAA1429 and PD-L1, as well as the degree of CD8⁺ T cell infiltration. In CRC cell lines, quantitative polymerase chain reaction (qPCR) and western blotting were used to measure PD-L1 mRNA and protein expression levels after KIAA1429 knockdown, respectively. After KIAA1429 knockdown in CRC syngeneic mouse models, tumor size and body weight were recorded every 3 days, and flow cytometry was used to assess changes in CD8⁺ T cell infiltration degree within the tumor tissue. Results Bioinformatics analysis indicated that KIAA1429 was highly expressed in CRC (P<0.05), associa-ted with poor prognosis (P=0.028), and negatively correlated with CD8⁺T cell infiltration degree (P=3.981×10^-2). IHC results demonstrated that KIAA1429 expression levels in CRC were significantly higher than in adjacent normal tissues (P=2.196×10^-7), positively correlated with PD-L1 expression levels (P=1.017×10^-7), and negatively correlated with CD8⁺T cell infiltration degree (P=0.021). KIAA1429 knockdown in CRC cells downregulated both PD-L1 mRNA and protein expression levels (P<0.01). In the CRC syngeneic mouse models, KIAA1429 knockdown inhibited tumor growth (P<0.01) and enhanced CD8⁺T cell infiltration degree (P<0.05). Conclusions The m6A methyltransferase KIAA1429 may suppress tumor immunity in CRC by upregulating PD-L1 expression and reducing CD8⁺T cell infiltration. Targeting KIAA1429 may help improve the prognosis of CRC patients and enhance the efficacy of CRC immunotherapy.

Objective To establish a deep learning model based on 3D ultrasound videos (DL-3DUV) and investigate its application value in assisting radiologists with different levels of experience to differentiate benign and malignant breast masses. Methods The ResNet50 model was employed to develop DL-3DUV for the classification of benign and malignant breast masses. A retrospective study was conducted using automated breast volume scanner (ABVS) dynamic videos from 400 patients with breast masses (a total of 525 lesions), which were randomly divided into training and testing sets at an 8∶2 ratio. The diagnostic performance of DL-3DUV was compared with that of senior and junior radiologists, both independently and in combination. Results When diagnosing independently, DL-3DUV demonstrated comparable sensitivi-ty (83.33% vs. 81.77%), accuracy (82.50% vs. 84.60%), and area under the curve (AUC) (0.83 vs. 0.85) compared to senior radiologists (all P>0.05), though its specificity was significantly lower (81.58% vs. 87.73%, P<0.05). Compared with junior radiologists, DL-3DUV showed significantly higher sensitivity (83.33% vs. 78.60%), specificity (81.58% vs. 57.00%), accuracy (82.50% vs. 68.37%), and AUC (0.83 vs. 0.68) (P<0.05). The combination of senior radiologists and DL-3DUV achieved higher sensitivity (89.70% vs. 81.77%) and AUC (0.91 vs. 0.85) than senior radiologists alone (all P<0.05), with no significant differences in specificity (91.23% vs. 87.73%) or accuracy (89.17% vs. 84.60%) (all P>0.05). Similarly, the combination of junior radiologists and DL-3DUV significantly improved diagnostic performance compared to junior radiologists alone, with statistically significant differences in sensitivity (88.10% vs. 78.60%), specificity (82.47% vs. 57.00%), accuracy (85.47% vs. 68.37%), and AUC (0.85 vs. 0.68) (all P<0.05). Conclusions DL-3DUV exhibits significant value in differentiating benign and malignant breast masses and is expected to become a useful tool to assist ultrasonographers, particularly for junior radiologists.

Objective This study aims to explore the clinicopathologic features of patients with acquired immune deficiency syndrome (AIDS) with cytomegalovirus (CMV) infection, and to analyze the differential diagnosis with other common viral infections and non-infectious diseases. Methods A total of 38 patients confirmed CMV-positive by immunohistochemical staining, HIV-positive, with complete clinical data and meeting the inclusion criteria were collected from the Department of Pathology, Shanghai Public Health Clinical Center from 2013 to 2023. A comprehensive analysis was conducted based on histological morphology, special staining, in situ hybridization, and clinical data. Result The main symptoms of the patients were fever, nausea and vomiting, gastric discomfort, abdominal pain and diarrhea, while a few cases presented with hematemesis, hematochezia, cough, and hemoptysis. Tissue samples from 32 cases were obtained via gastrointestinal endoscopic biopsies, including 10 cases with biopsies from more than 2 sites. 2 cases were from lymph nodes, and 1 case each from skin, submandibular gland, lung, and perianal biopsies. Pathological results showed gastrointestinal mucosal erosion with acute and chronic inflammation, with ulceration forming in 3 cases. Lymph node biopsies showed reactive lymphoid follicle hyperplasia. Acute and chronic inflammatory cell infiltration with focal coagulative necrosis was observed in skin, perianal tissue, submandibular gland, and lung specimens. In this study, 35 patients showed enlargement of epithelial cells, endothelial cells, macrophages, and fibroblasts, with eosinophilic viral inclusions in the nuclei surrounded by a clear halo, resembling an "owl's eye". In the other 3 patients, no definite inclusion bodies were observed in their biopsy specimens (gastrointestinal mucosal tissue). Immunohistochemical testing showed that all 38 cases were positive for CMV and negative for herpes simplex virus (HSV) and latent membrane protein (LMP). Special staining revealed that acid-fast staining was positive for Mycobacterium in 3 cases, while periodic acid Schiff stain and methenamine silver staining detected one case each of Talaromyces marneffei in the transverse colon, Candida albicans in the stomach, and Aspergillus in the lungs. The results of in situ hybridization for Epstein-Barr encoded RNA (RNAEBER) were negative in all 38 cases. Conclusion The distinctive pathological feature of AIDS patients with CMV infection is the enlargement of infected cells, with eosinophilic viral inclusions in the nuclei resembling an "owl's eye". Combined with immunohistochemistry, precise locali-zation of CMV expression within the cells can be achieved. Additionally, special staining and in situ hybridization provide robust evidence for the differential diagnosis of lesions caused by EBV, HSV, respiratory viruses, and Hodgkin's lymphoma.

Objective To investigate the correlation between severe coronary stenosis detected by coronary CT angio-graphy (CCTA) before cryoablation and atrial fibrillation (AF) recurrence. Methods From January 2021 to November 2022, 613 consecutive patients with symptomatic paroxysmal or persistent AF undergoing first-time cryoablation and successful preprocedural CCTA screening were enrolled. Severe coronary stenosis on CCTA was defined as >70% stenosis in at least one major coronary vessel. Patients were divided into two groups: severe stenosis group (n=53) and non-severe stenosis group (n=560). All patients were regularly followed up after ablation to observe safety endpoints such as AF recurrence and surgical complications. Kaplan-Meier analysis was used to assess AF-free survival rate, and multivariate Cox regression was performed to identify predictors of AF recurrence. Results 22.5% of patients were diagnosed with coronary heart disea-se (CHD), of whom 8.6% (53/560) had severe stenosis on pre-ablation CCTA. Compared to the non-severe stenosis group, the severe coronary stenosis group had higher age [(69.6±10.3) years vs. (62.3±11.9) years], higher prevalence of persistent AF (59.3% vs. 31.6%), higher CHA2DS2 -VASc score (2.3±1.6 vs. 1.5±1.4), lower left ventricular ejection fraction (LVEF) [(48.8%±10.3%) vs. (57.2%±8.9%)], higher left atrial volume index (LAVI) [(50.3±11.7) mL/m² vs. (37.0±12.3) mL/m²], and higher E/A ratio (1.6±0.4 vs. 1.1±0.5) (all P<0.05). Among the 53 patients with severe stenosis detected by CCTA, 50 (94.3%) were newly diagnosed with CHD. After a median follow-up of 28 months, the AF recurrence rate was 20.1% (123/613). The severe stenosis group showed an AF recurrence rate of 35.8% (19/53), significantly higher than the 18.6% (104/560) in the non-severe stenosis group (P<0.05). There was no statistically significant difference in the safety endpoint between the two groups (P>0.05). Kaplan-Meier analysis showed lower AF-free survival rate in the severe stenosis group (71.6% vs. 84.8%, P=0.039). Multivariate Cox regression identified age (OR=1.20, 95%CI: 1.09-1.39, P=0.033), persistent AF (OR=2.750, 95%CI: 1.64-5.37, P=0.001), and LAVI (OR=1.14, 95%CI: 1.10-1.38, P=0.008) as independent predictors of AF recurrence. Conclusions Patients with severe coronary stenosis before ablation screening have lower AF-free survival rate, but severe coronary stenosis itself is not an independent predictor of AF recurrence after cryoablation.

Objective To analyze the distribution of serum allergens in children with allergic diseases in Shanghai and provide diagnostic and therapeutic evidence for the prevention and management of allergic diseases. Methods A total of 560 children diagnosed with allergic diseases (including bronchial asthma, allergic rhinitis, and atopic dermatitis) who attended the pediatric outpatient clinic at Ruijin Hospital from 2021 to 2023 were enrolled. Total serum IgE levels were measured using scattering turbidimetry, and specific serum IgE antibodies against various allergens were detected by immunoblotting. A retrospective analysis was performed. Results 1. Among the 560 children, the positive rate of total IgE was high, and multiple allergens were commonly found. 2. The allergens were mainly Dermatophagoides farinae (59.11%), Dermatophagoides pteronyssinus (58.75%), cow’s milk (28.04%), egg (22.14%) and Aspergillus niger with rosary branches (21.43%). No significant gender differences were observed in allergen distribution (P>0.05). 3. For inhalant allergens, the positive rates of Dermatophagoides farinae, Dermatophagoides pteronyssinus, and cat dander increased with age, with the highest rates observed in children aged 7-15 years (72.55%, 71.76%, and 26.67%, respectively), and the differences were statistically significant (P<0.05). For food allergens, the positive rate for cow’s milk was highest during early childhood (34.55%) and decreased with age (P<0.05). 4. Regarding inhalant allergens, the positive rate for Aspergillus niger with rosary branches showed seasonal variation (P<0.05), peaking in autumn (28.89%). Among children sensitized to cockroaches, the positive rate for shrimp/crab was as high as 38.5%, and a significant correlation was observed between cockroach sensitization and crustacean food allergens (P<0.05). Conclusions In children with allergic diseases in Shanghai, the most common inhalant allergen is Dermatophagoides farinae, followed by Dermatophagoides pteronyssinus and cat dander, with age-related differences observed. The most common food allergen is cow’s milk, followed by egg white, peanut/soy, lamb/beef, cashew, pistachio, almond, and walnut. There is a significant correlation between cockroach and shrimp/crab sensitization, suggesting that children sensitized to crustaceans should be closely monitored for potential cockroach sensitization.

According to the International Diabetes Federation (IDF) 2025 report, the global number of diabetic patients is projected to exceed 700 million, with approximately 40% of type 2 diabetes mellitus (T2DM) patients developing diabetic nephropathy (DN). As the global incidence rate of diabetes continues to rise, the clinical diagnosis and treatment of DN have become increasingly critical. Although DN exhibits certain characteristic clinical manifestations, its early-stage symptoms often closely resemble those of non-diabetic renal diseases (NDRD), posing significant challenges to accurate diagnosis. Renal biopsy, as the gold standard for diagnosing DN, is limited in its widespread application due to its invasive nature. The innovative development and multimodal integration of ultrasound technology have increasingly highlighted its value in the differential diagnosis and disease assessment of DN. Conventional ultrasound techniques, including grayscale and Doppler ultrasound, evaluate renal morphology and hemodynamic changes. DN patients typically show increased kidney volume, enhanced renal cortical echogenicity, and elevated renal artery resistive index (RRI), which are closely associated with glomerular basement membrane thickening and reduced vascular compliance due to arteriosclerosis of the affe-rent arterioles. Ultrasound elastography provides a new dimension for assessing renal fibrosis by quantitatively measuring tissue stiffness. In DN patients, shear wave velocity (SWV) exhibits a characteristic pattern of "initial increase followed by decrease", which may correlate with histopathological staging. Contrast-enhanced ultrasound (CEUS) dynamically evaluates renal cortical microcirculation using microbubble tracking technology. CEUS images of DN patients demonstrate significantly reduced area under the curve (AUC) and peak intensity (PI), indicating decreased blood perfusion in the renal cortical microvascular bed. In recent years, the integration of artificial intelligence (AI) with ultrasound technology has advanced rapidly in the diagnosis and treatment of renal diseases. However, its deep integration with ultrasound for differential diagnosis and disease monitoring of DN has not yet been realized. In the future, combining AI algorithms with ultrasound technology is expected to enable automatic learning and identification of renal structures and pathological features from large volumes of ultrasound images, automatic quantification of key parameters such as RRI and SWV, and dynamic analysis of changes in renal microcirculation, thereby significantly improving the accuracy and efficiency of DN diagnosis.

Secretory carcinoma of breast (SCB) is a rare salivary gland-type malignant tumor of the breast. This study reports two female patients with SCB admitted between 2019 and 2023, both presenting with breast masses. Breast ultrasonography indicated a BI-RADS category Ⅲ heterogeneous hyperechoic nodule in one case and a BI-RADS category Ⅳa hypoechoic nodule in the other. Histopathological examination showed that the maximum tumor diameters were 13 mm and 14 mm, respectively, with grayish-white cut surfaces, moderate consistency, and well-defined margins. Tumor cells exhibited mild to moderate atypia, with round or oval nuclei and a single small nucleolus. The cytoplasm was eosinophilic or vacuolated, and cells were arranged in microcystic, solid, or papillary patterns, with some showing cystic, hypersecretory lesion morphology. Eosinophilic secretions were observed within the lumens, and stromal fibrous tissue hyperplasia with hyaline degeneration was noted. Immunohistochemistry showed tumor cell expression of S100, pan-TRK, CD117, CK5/6, and GATA3, with low expression of ER and AR, and no expression of GCDFP-15, PR, or HER2. The Ki-67 proliferation index was approximately 5%. Alcian blue staining and periodic acid-Schiff staining showed positively stained secretions both within the cytoplasm and extracellularly. Molecular testing showed ETV6-NTRK3 gene fusion in both patients. A literature review of Chinese and English publications from 2020 to 2024 revealed 438 reported SCB cases, among which 80 had relatively complete clinicopathological and immunophenotypic data. This study summarized the clinicopathological characteristics, immunophenotypes, and molecular alterations of the 80 cases together with the two cases from our hospital, totaling 82 cases. The results showed expression rates of S100, pan-TRK, and GATA3 at 97%, 95%, and 100%, respectively. Approximately 50% of the cases showed low to moderate ER expression, about 20% showed low PR expression, and HER2 was generally negative. Molecular testing indicated that 98% of the cases had the characteristic ETV6-NTRK3 gene fusion, and two cases also had TERT promoter or PDGFR mutations.