Objective: To summarize the clinical, electrophysiological, and sural nerve pathological features of patients who developed peripheral neuropathy during tuberculosis treatment, and to explore the pathological patterns of nerve injury and their value in differential diagnosis. Methods: The clinical data, neuroelectrophysiological findings, sural nerve pathological features, and follow-up outcomes of 10 patients who developed peripheral neuropathy during tuberculosis treatment and underwent sural nerve biopsy at the Eighth Medical Center of Chinese PLA General Hospital between February 2022 and May 2024 were retrospectively analyzed. Results: Among the 10 patients, 4 were male and 6 were female, with an age at onset ranging from 23 to 69 years. Peripheral neuropathy usually developed several weeks to several months after the initiation of anti-tuberculosis treatment. The main clinical manifestations were distal numbness, pain, and weakness of the limbs, and 7 patients had grade 3-4 peripheral neuropathy according to the National Cancer Institute Common Terminology Criteria for Adverse Events. Neuroelectrophysiological studies showed sensorimotor mixed peripheral nerve involvement in all patients, predominantly characterized by axonal injury, with conduction slowing and late-response abnormalities in some cases. Sural nerve biopsy revealed varying degrees of myelinated fiber loss and axonal degeneration in all cases, with regeneration, myelin abnormalities, microvascular changes, or mild inflammatory cell infiltration in some cases. No typical tuberculous granuloma, caseous necrosis, or positive acid-fast staining was observed. Mycobacterium tuberculosis nucleic acid testing was positive in 1 case. Most patients showed limited neurological recovery during follow-up. Conclusions: Peripheral neuropathy occurring during tuberculosis treatment is pathologically characterized predominantly by axonal injury, with variable myelin changes, microvascular abnormalities, and mild inflammatory cell infiltration. Most cases showed no pathological evidence of typical direct tuberculous invasion of the peripheral nerve, suggesting that this condition may represent a heterogeneous injury process involving multiple factors in the context of tuberculosis infection. Sural nerve biopsy is useful for identifying pathological injury patterns and provides evidence for differential diagnosis in complex etiological settings.
患者女性，51岁，诊断系统性红斑狼疮12年，长期服用糖皮质激素治疗。以急性进行性发展的高热、腰背痛起病；影像学检查显示全身播散性骨病灶，高度提示恶性肿瘤；但多次病灶活检均未确诊肿瘤。通过病原体高通量测序，最终在骨髓中检测出结核分枝杆菌复合群DNA。经过足疗程的四联抗结核治疗，患者的发热及腰背痛逐渐缓解。急性全身播散性骨关节结核病例极为罕见，常规胸片和分子筛查手段难以早期诊断。通过本例诊疗过程提示临床医生，影像学检查在判断病变性质方面的局限性，并强调结核感染病灶在影像学检查中误诊恶性肿瘤的可能，以及在获取体液或组织标本时同时开展分子病原体检测的重要性。
重症超声无创、床旁、实时、可视化的优势，使其成为重症监护病房（ICU）精准诊疗的核心支撑技术。重症相关新认知的提出，促进重症超声在危重患者诊疗中逐渐凝练为五大核心应用场景：（1）重症超声可视化查房；（2）新入ICU患者重症超声可视化评估；（3）精细化及重症问题导向的重症超声可视化评估；（4）基于重症超声的可视化远程查房；（5）重症超声可视化引导操作。本文结合重症新认知，对重症超声在五大核心场景中的实施方案及临床应用研究进展进行系统综述，为重症超声在重症患者诊疗高效精准应用提供参考。
肾上腺血管瘤为罕见肾上腺良性病变，多无内分泌活性。本文报道1例55岁男性患者，因腹部不适就诊，影像学见异位右肾上腺区肿物，伴高血压、低血钾及醛固酮异常，术前拟诊异位醛固酮瘤。手术切除后病理证实为肾上腺血管瘤，术后醛固酮、血钾快速恢复正常。本病例提示肾上腺血管瘤极为罕见，临床可表现为原发性醛固酮增多症，但诊断需以术后病理为确诊依据。
Autoimmune bullous diseases (AIBDs) are a group of organ-specific autoimmune disorders caused by autoantibodies directed against skin adhesion structures. Their diagnosis and treatment heavily rely on accurate autoantibody testing. To address current challenges in China, such as the diversity of AIBDs testing methods and lack of standardization, the National Clinical Research Center for Rheumatic and Autoimmune Diseases (Peking Union Medical College Hospital) initiated the development of this guideline. In collaboration with the Key Laboratory of Rheumatology and Immunology of the Ministry of Education, National Professional Healthcare Quality Control Center for Immunology (Including Allergy), Rheumatology and Immunology Physician Committee of Chinese Medical Doctor Association, and Rheumatology Society of Chinese Medical Association, a multidisciplinary expert working group was established. Based on the latest international evidence and clinical practice in China, the group formulated this guideline by strictly adhering to evidence-based guideline development methods and procedures. This guideline focuses on eight key issues related to laboratory testing for AIBDs in China. It covers the application of autoantibodies in the diagnosis, subtyping, disease assessment, treatment guidance, identification of applicable populations, determination of testing timing, result interpretation, and quality management of AIBDs. The aim is to enhance the laboratory's capabilities in autoantibody testing and result interpretation, and offer important references for advancing precision diagnosis and treatment of the disease.
患者男性，30岁，因发现蛋白尿9年余，乏力消瘦半个月入院。曾于外院肾穿刺活检，病理诊断为不典型膜性肾病，继发性肾病可能性大。此次入院后完善血清狼疮抗体谱等免疫学检测、抗磷脂酶A2受体（PLA2R）抗体检测及重复肾穿刺活检等检查，均无法进一步确定膜性肾病病因及抗原抗体类型，遂行激光微切割质谱分析，最终明确诊断为特发性膜性肾病（PLA2R相关）。予糖皮质激素联合环磷酰胺治疗方案，患者病情缓解。
Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide. The "four-hit hypothesis" is widely recognized as a key framework for understanding the pathogenesis of IgAN. B cell activating factor (BLyS/BAFF) and a proliferation-inducing ligand (APRIL) play crucial roles in promoting B cell activation and the production of galactose-deficient IgA1 and its corresponding autoantibodies. Telitacicept is a novel dual-target biologic agent that simultaneously inhibits both BLyS/BAFF and APRIL, potentially interrupting the critical immune mechanisms underlying IgAN and thereby slowing disease progression. Telitacicept has now been approved for the treatment of IgAN. Preliminary findings from clinical trials and real-world studies have shown that telitacicept can significantly reduce proteinuria, stabilize kidney function, and is generally well-tolerated with a favorable safety profile. However, the use of telitacicept in IgAN remains in the exploratory stage. Clinicians should carefully evaluate the latest evidence and balance benefits and risks to ensure rational use of telitacicept for this indication. This suggestion document aims to provide clinicians with scientific recommendations regarding the appropriate use of telitacicept in the treatment of IgAN, summarizing its mechanism of action, pharmacokinetic properties, clinical efficacy, and safety profile, with the goal of optimizing treatment strategies and improving patient outcomes.
改善全球肾脏病预后组织（KDIGO）2026年发布的急性肾损伤（AKI）/急性肾脏病（AKD）临床实践指南是在2012版基础上的全方位更新，旨在为有AKI/AKD风险或已患病的人群提供诊疗指导。该指南整合了过去十余年在AKI及AKD诊断、预测、预防、治疗、肾脏替代治疗及长期管理等领域的最新进展，包括从既往仅依赖血肌酐和尿量定义并分期AKI，扩展至同时依据功能与结构损伤进行判断，实现更早、更精确的诊断；从确诊后治疗提前到开发风险预测模型，强调早期识别与预防，以及更为细化的多模式管理。本文旨在对新版指南的核心更新进行梳理与解读，使其更有效地指导AKI/AKD的临床实践。
A retrospective analysis was conducted on the baseline characteristics, clinical symptoms and signs, laboratory and imaging findings, and treatment prognosis of 10 PAVF patients from Northern Jiangsu People's Hospital from February 2013 to November 2024. The age of onset was between 16 and 79 years, with 3 cases in men and 7 cases in women. Among the 10 patients, 9 had pulmonary arteriovenous fistula and 1 bronchial artery-pulmonary vein fistula. Clinically, there were 4 cases of dyspnea and chest tightness, 3 cases of cough and sputum production, 1 case of chest pain, 2 cases of hemoptysis, 1 case of dizziness, 2 cases of nosebleeds, 1 case of multiple red nevi on the skin, 3 cases of asymptomatic findings upon physical examination, and 3 cases of acute cerebral infarction as the onset. Patients are mainly diagnosed with PAVF based on chest contrast-enhanced CT and/or pulmonary artery CT angiography (CTA). In terms of treatment, 6 cases underwent interventional embolization; 2 patients underwent surgical treatment: one underwent thoracotomy to remove the diseased lob, and one underwent video-assisted thoracoscopic lobectomy; 2 patients received conservative treatment. 10 patients improved and were discharged after treatment, with follow-up lasting 2.1-4.5 years. Among them, one complex PAVF patient was admitted one year after surgery for a second interventional treatment. During follow-up, 10 patients had stable conditions with no related complications, and no recurrence or signs of vascular embolization or recanalization were observed. Clinical manifestations of PAVF patients are diverse, diagnosis requires chest contrast-enhanced CT and pulmonary artery CTA, treatment methods include interventional embolization therapy and surgical treatment, follow-up is required after surgery to evaluate treatment effectiveness.
局灶性节段性肾小球硬化症（FSGS）是一类可由多种不同损伤机制引起、涵盖多种病变类型的肾脏疾病。本文报道1例免疫抑制治疗有效的局灶性节段性肾小球硬化症伴GLA基因突变病例，阐明了完善FSGS基因型-表型关联分析的重要性，为FSGS提供精准干预、治疗及改善预后。
本文报道1例因重度肥胖接受袖状胃切除术的女性，术后8个月体重下降60.0 kg，继而出现血胆固醇、低密度脂蛋白胆固醇水平较术前显著升高。在排除其他病因后，对患者进行饮食干预治疗2个月，其体重从35.0 kg逐渐增至38.1 kg，血脂水平逐渐降至正常范围，在后续随访中，患者体重增至40.0 kg，血脂水平未反弹。
Objective: To explore the clinical characteristics, efficacy and safety of different therapeutic regimens in patients with anti-MDA5 antibody positive dermatomyositis (anti-MDA5⁺DM) stratified by disease risk, and to analyze the influencing factors for prognosis. Methods: This was a retrospective cross-sectional study. Clinical data of 82 patients with anti-MDA5⁺DM admitted to the First Affiliated Hospital of Guangxi Medical University from January 2018 to June 2024 were retrospectively analyzed. All patients were stratified into low-risk group and intermediate-high-risk group based on the FLAIR model, a predictive model for mortality risk in amyopathic dermatomyositis combined with interstitial lung disease. Meanwhile, patients were divided into four groups according to treatment regimens: Regimen A: glucocorticoids combined with calcineurin inhibitors and cyclophosphamide; Regimen B: glucocorticoids combined with Janus kinase inhibitors with or without calcineurin inhibitors; Regimen C: glucocorticoids combined with calcineurin inhibitors; Regimen D: glucocorticoids combined with cyclophosphamide. The clinical manifestations, laboratory parameters, infection events and survival outcomes were compared among groups with different risk stratification and different treatment regimens. Multivariate logistic regression analysis was performed to identify clinical indicators independently associated with all-cause mortality. Results: Among the 82 patients with anti-MDA5⁺DM, 19 (23.2%) were males and 63 (76.8%) were females, with a median age of 50 years (range, 37-63 years). The incidence of cough was higher in the intermediate-high risk group [44 cases (74.6%)] than that in the low-risk group [10 cases (43.5%)] (χ²=7.12, P=0.008). The intermediate-high risk group also exhibited higher frequencies of expectoration [35 cases (59.3%) vs. 7 cases (30.4%), χ²=5.53, P=0.019], dyspnea [37 cases (62.7%) vs. 8 cases (34.8%), χ²=5.21, P=0.022] and fever [36 cases (61.0%) vs. 6 cases (26.1%), χ²=8.08, P=0.004]. Median serum ferritin level was 1 545.3 (936.8, 2 376.9) μg/L in the intermediate-high risk group versus 442.8 (138.9, 759.0) μg/L in the low-risk group (Z=-4.89, P<0.001). The intermediate-high risk group had significantly elevated median levels of lactate dehydrogenase [371.0 (302.0, 473.0) vs. 242.0 (208.0, 318.0) U/L, Z=-4.95, P<0.001], creatine kinase [87.0 (60.0, 254.0) vs. 45.0 (34.0, 113.0) U/L, Z=-2.83, P=0.005], carcinoembryonic antigen [6.8 (3.2, 12.5) vs. 3.8 (2.4, 6.0) μg/L, Z=-2.32, P=0.021], aspartate aminotransferase [74.0 (47.0, 133.0) vs. 45.0 (31.0, 55.0) U/L, Z=-3.44, P=0.001], C-reactive protein [7.6 (2.6, 16.3) vs. 2.4 (0.7, 5.0) mg/L, Z=-3.24, P=0.001] and erythrocyte sedimentation rate [42.0 (23.8, 63.5) vs. 23.0 (13.0, 34.0) mm/1 h, Z=-3.36, P=0.001].The prevalence of periorbital edematous erythema was significantly lower in the intermediate-high risk group [29 cases (49.2%)] compared with the low-risk group [17 cases (73.9%)] (χ²=4.12, P=0.042). The median immunoglobulin M level was markedly decreased in the intermediate-high risk group [1.2 (0.9, 1.6) g/L] relative to the low-risk group [1.7 (1.2, 2.8) g/L] (Z=-2.66, P=0.008).Complete follow-up data were obtained from 78 patients. The all-cause mortality rate (13.0% vs. 38.2%) and infection rate (6.7% vs. 57.1%) of the low-risk group were obviously lower than those of the intermediate-high-risk group. Within each risk stratum, there was no statistically significant difference in the incidence of severe infections among the four treatment regimens. Regimen A was associated with the highest survival rate among patients in the intermediate-high-risk group. Taking Regimen A as the reference, Regimens B, C and D were correlated with higher mortality risk, with corresponding OR values as follows: Regimen B OR=0.07 (95%CI 0.01-0.43, P=0.002), Regimen D OR=0.07 (95%CI 0.01-0.62, P=0.008), Regimen C OR=0.06 (95%CI 0.01-0.41, P=0.001).Multivariate logistic regression analysis revealed that rapidly progressive interstitial lung disease (RP-ILD) and dysphagia were independently correlated with mortality outcomes: RP-ILD (OR=24.95, 95%CI 1.47-422.55, P=0.026), dysphagia (OR=11.62, 95%CI 1.23-110.15, P=0.033). Positive anti-Ro52 antibody (OR=6.40, 95%CI 0.90-45.47, P=0.063) and elevated C-reactive protein (OR=1.04, 95%CI 0.99-1.10, P=0.091) showed a trend toward higher mortality risk. Conclusions: In patients with intermediate-high-risk anti-MDA5⁺DM, inflammatory biomarkers and clinical symptoms were positively associated with adverse mortality outcomes. RP-ILD and dysphagia were independently correlated with all-cause mortality. Among intermediate-high-risk patients, the regimen combining glucocorticoids, calcineurin inhibitors and cyclophosphamide was associated with higher survival probability, without an increased incidence of severe infections.
IgA肾病作为我国最常见的原发性肾小球肾炎，传统治疗策略的整体预后仍不理想，给患者和社会带来了沉重的疾病负担。“四重打击”学说是目前IgA肾病较为公认的发病机制，基于免疫因素的靶向治疗为患者提供了新的选择。本文系统总结了靶向肠道黏膜免疫、B细胞及补体系统的相关药物在IgA肾病中的研究进展，并对IgA肾病实现长期有效控制的未来方向进行了展望。
A 54-year-old female patient was admitted to the hospital presenting with a 9-month history of intermittent dry mouth, nausea, and vomiting, which had worsened over the past month. The patient had self-administered excessive doses of vitamin D3 for over a year, experiencing recurrent dry mouth, nausea, constipation, and significant weight loss during this period. Laboratory evaluation revealed a hypercalcemic crisis, suppressed parathyroid hormone (PTH) levels, a serum 25-hydroxyvitamin D [25(OH)D] concentration exceeding 600 nmol/L, and renal insufficiency. Alternative etiologies, including malignancies, granulomatous disorders, and endocrine diseases, were excluded, establishing a definitive diagnosis of vitamin D intoxication. Following admission, the patient was treated with hydration, calcitonin, and zoledronic acid. Serum calcium levels gradually normalized, gastrointestinal symptoms significantly improved, and renal function improved accordingly. The diagnosis and treatment of this case suggest that self-administration of excessive vitamin D supplementation is a common predisposing factor for vitamin D intoxication, which is clinically characterized by PTH-independent hypercalcemia as the core manifestation. Management requires the immediate discontinuation of vitamin D preparations, adequate hydration, the rational application of hypocalcemic drugs, and long-term follow-up to monitor serum calcium and 25(OH)D levels.
Objective: To investigate the predictive value of bedside ultrasound-assessed gastric motility parameters for feeding intolerance (FI) during enteral nutrition in critically ill patients. Methods: A prospective cohort study was conducted. Critically ill patients who received continuous nasogastric enteral nutrition in the intensive care unit (ICU) of Peking Union Medical College Hospital from March 2025 to November 2025 were consecutively enrolled. On the day of enteral nutrition initiation (D0) and the first day after initiation (D1), bedside ultrasound was performed to obtain a single-section image of the gastric antrum and measure the antral contraction frequency (ACF), antral contraction amplitude (ACA), and motility index (MI). Superior mesenteric artery blood flow parameters were also measured. All patients were followed up for 7 days after enteral nutrition initiation, or until the first occurrence of FI. Univariate analyses and multivariate logistic regression analyses, along with decision tree analysis, were used to evaluate the predictive performance of these gastric motility parameters for FI. Results: A total of 261 patients were enrolled, comprising 167 males (64.0%) and 94 females (36.0%), with a median age of 60.0 (interquartile range: 50.0, 69.0) years. The overall incidence of FI was 29.9% (78/261). Univariate analysis showed that ACA, ACF, and MI at both D0 and D1 were significantly lower in the FI group than in the non-FI group [D1 ACA: 0.31 (0.21, 0.40) vs. 0.42 (0.30, 0.51), D1 ACF: 2.00 (2.00, 3.00) vs. 4.00 (3.00, 5.00), D1 MI: 0.68 (0.41, 1.21) vs. 1.56 (1.06, 2.33); all P<0.001]. Among the superior mesenteric artery blood flow parameters, only the D0 pulsatility index showed a statistically significant difference between the two groups [2.00 (1.70, 2.52) vs. 1.83 (1.53, 2.21), P=0.009]. Multivariate logistic regression analysis showed that D0 ACF (OR=0.57, 95%CI 0.42-0.77, P<0.001) and D1 ACF (OR=0.54, 95%CI 0.40-0.73, P<0.001) were negatively associated with FI risk. Decision tree analysis further revealed that a D1 ACF <2.5 contractions per 2 min was the most critical threshold for identifying patients at high risk for FI, with this subgroup showing an FI incidence of 69.70%. Conclusions: Bedside ultrasound-assessed gastric motility parameters, particularly ACF, demonstrate strong predictive value for FI in critically ill patients. Dynamic monitoring of antral contraction function enables early identification of patients at high risk for FI and provides an objective basis for optimizing enteral nutrition management in the intensive care setting.
Objective: To investigate the correlation between advanced lung cancer inflammation index (ALI) and renal pathological activity index (AI) in lupus nephritis (LN) patients, and to evaluate its predictive value for moderate-to-severe renal pathological activity. Methods: This cross-sectional study retrospectively included 279 LN patients who underwent renal biopsy at the First Affiliated Hospital of Xi'an Jiaotong University from January 1, 2017, to December 31, 2024. The median age of the patients was 34.0 (27.0, 45.0) years, and 234 (83.9%) were female. Based on the AI, patients were divided into a low-activity group (n=177) and a moderate-to-severe activity group (n=102). Logistic regression analysis was performed to identify the influencing factors for moderate-to-severe AI. Correlation analysis was used to explore the relationship between ALI and clinical indicators. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of ALI for moderate-to-severe AI. Results: The ALI level in the moderate-to-severe activity group was significantly lower than that in the low-activity group (15.4 vs. 18.8, P<0.001). Multivariate logistic regression analysis showed that the 2000 Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) score (OR=5.54, P<0.001) and serum creatinine (OR=1.01, P=0.007) were risk factors for moderate-to-severe AI; whereas hemoglobin (OR=0.98, P=0.001) and ALI (OR=0.97, P=0.048) were protective factors. Correlation analysis revealed that ALI was negatively correlated with AI (r=-0.31, P<0.001), and positively correlated with body mass index, hemoglobin, albumin, complement C4, and IgG. ALI was negatively correlated with SLEDAI-2K, white blood cell count, neutrophil-to-lymphocyte ratio (NLR), serum creatinine, blood urea nitrogen, and C-reactive protein. ROC curve analysis demonstrated that the area under the curve (AUC) of ALI for predicting moderate-to-severe AI was 0.658 (95%CI 0.592-0.724, P<0.001). The optimal cutoff value was 13.14, with a sensitivity of 72.8% and a specificity of 55.9%. The proportion of patients with moderate-to-severe LN in the ALI <13.14 group was significantly higher than that in the ALI ≥13.14 group (50.9% vs. 27.7%, P<0.001). Conclusions: ALI is closely correlated with renal pathological AI in LN and serves as a protective factor against moderate-to-severe AI. ALI holds certain predictive value and may serve as a non-invasive auxiliary tool for evaluating renal pathological activity in LN.
随着成像光电容积描记技术的迅速发展，其在颈动脉狭窄评估中的应用价值日益凸显。本文从该技术在临床研究中的进展，技术原理、应用现状入手，分析当前研究面临的关键问题，并展望其与智能技术融合的发展趋势，旨在为该技术在颈动脉狭窄早期筛查中的临床转化与应用提供系统性参考。
本文报道1例合并ETV6/EZH2双基因突变的VEXAS（Vacuoles，E1 enzyme，X-linked，Autoinflammatory，Somatic）综合征患者，阿扎胞苷治疗后临床症状缓解，双基因突变转阴。患者中年男性，因间断眼红9个月，耳廓肿痛3个月，加重伴发热3周入院，表现为巩膜炎、软骨炎、大细胞性贫血及血小板减少、高炎症状态、骨髓涂片见空泡现象、骨髓基因检测显示UBA1突变。并且存在ETV6和EZH2双基因突变。经阿扎胞苷（皮下注射，100 mg/d共7 d，共4疗程）联合糖皮质激素治疗后，患者临床症状缓解，UBA1突变率降至8.45%，ETV6和EZH2双基因突变转阴，随访半年未见症状复发。该病例为国内罕见合并ETV6/EZH2双基因突变的VEXAS综合征，经阿扎胞苷治疗临床有效，丰富了该病的基因突变谱及临床表型谱系。
本文以1型糖尿病疾病修正治疗的研究进展为主要内容，对相关治疗方向进行了整理；传统胰岛素治疗可以把血糖控制在一定范围内，但对于持续存在的自身免疫进程，仍然难以真正阻断，而疾病修正治疗更强调通过免疫干预和β细胞保护来延缓发病并尽量保留β细胞功能。围绕这一治疗思路，本文主要梳理了替利珠单抗等T细胞靶向疗法，Janus激酶抑制剂和抗肿瘤坏死因子α药物等信号通路调节疗法，β细胞替代与再生策略，以及抗原特异性治疗和调节性T细胞疗法。
Objective: To investigate the clinical characteristics of hospitalized patients with thunderstorm asthma. Methods: Clinical data from 125 patients with thunderstorm asthma admitted to four tertiary hospitals in Lanzhou City after a thunderstorm on September 19, 2024, were retrospectively collected. Statistical methods, including the chi-square test and independent samples t-test among others were used to evaluate demographic information, clinical manifestations, medical history, pulmonary function, laboratory findings, and prognosis. Results: Among the 125 patients, 78 were male and 47 were female, with a median age of 35 years. The cohort was categorized into three age groups:<14 years (n=43), 14-60 years (n=52), and>60 years (n=30), and further divided into non-severe (n=67) and severe (n=58) groups. The primary clinical manifestations included chest tightness (77.6%, 97/125) and cough (64.8%, 81/125). Regarding medical history, 63 patients reported an Artemisia/pollen allergy, 51 had allergic rhinitis, and 22 had bronchial asthma. Severe obstructive ventilation dysfunction was observed in 19 cases (25.0%, 19/76). Serum total IgE was elevated in 73 cases (91.3%, 73/80), with the highest allergen-positive rate reported for Artemisia (81.1%, 60/74). Pairwise comparisons indicated that the proportion of severe cases was significantly higher in males than in females [53.8% (42/78) vs. 34.0% (16/47), χ2=4.63, P=0.031]. By age, the proportion of severe cases in the >60 group was significantly higher than that in the 14-60 [70.0% (21/30) vs. 44.2% (23/52), χ2=7.84, P=0.005] and <14 [32.6% (14/43), χ2=12.36, P<0.001] age groups. Furthermore, the proportion of severe cases was significantly higher in patients without than in those with a history of asthma [50.5% (52/103) vs. 27.3% (6/22), χ2=3.93, P=0.047]. The length of hospital stay in the severe group was significantly longer than that in the non-severe group [(8.3±2.6) d vs. (5.4±2.1) d, t=6.90, P<0.001]. Within the severe cohort, 10.3% (6/58) required non-invasive ventilation, and all patients achieved a favorable prognosis. Conclusions: The majority of hospitalized patients with thunderstorm asthma were male, with the highest prevalence observed in the 14-60 age group. Most patients had a history of Artemisia/pollen allergy and allergic rhinitis. Male sex, advanced age (>60 years), and the absence of asthma history were identified as high-risk factors for developing severe conditions. Health education for these high-risk populations should be prioritized.
