RESUMEN
OBJECTIVES: To explore the clinical value of the renal phosphorus threshold (ratio of tubular maximum reabsorption of phosphate to glomerular filtration rate, TmP/GFR) in the diagnosis and treatment of children with X-linked hypophosphatemic rickets (XLH). METHODS: A retrospective study was conducted, including 83 children diagnosed with XLH at Children's Hospital of Nanjing Medical University from January 2010 to January 2023. Initial diagnosis and follow-up data were collected to investigate the correlation of TmP/GFR with the severity of rickets, calcium and phosphorus metabolism indicators, and the dosage of phosphate treatment. Children were divided into two groups based on the occurrence of renal calcification: the renal calcification group (n=47) and the non-renal calcification group (n=36). Clinical data between the two groups were compared. Multivariate logistic regression analysis was used to identify factors influencing renal calcification in XLH children. The predictive value of TmP/GFR for renal calcification in XLH children was evaluated using receiver operating characteristic (ROC) curves. RESULTS: In the 83 XLH children, the initial TmP/GFR was (0.78±0.21) mmol/L, with significant individual variation (range: 0.28-1.24 mmol/L). TmP/GFR showed no significant correlation with the severity of rickets (P>0.05). Parathyroid hormone was negatively correlated with TmP/GFR (rs=-0.020, P=0.008), while blood phosphorus (rs=0.384, P<0.001), blood calcium (rs=0.251, P<0.001), and 25-hydroxyvitamin D (rs=0.179, P<0.001) were positively correlated with TmP/GFR. No significant correlation was found between TmP/GFR and alkaline phosphatase (rs=-0.002, P=0.960) or phosphate treatment dosage (rs=0.012, P=0.800). Blood calcium and TmP/GFR levels were significantly lower in the renal calcification group than in the non-renal calcification group (P<0.05), while parathyroid hormone and urine calcium levels were significantly higher in the renal calcification group (P<0.05). Multivariate logistic regression analysis indicated that TmP/GFR and urine calcium levels were closely associated with renal calcification in XLH children (P<0.05). ROC curve analysis revealed that the areas under the curve for TmP/GFR, urine calcium, and their combined detection predicting renal calcification in XLH children were 0.696, 0.679, and 0.761, respectively. CONCLUSIONS: TmP/GFR may serve as an important diagnostic indicator for pediatric XLH; however, it does not reflect the severity or activity of rickets and cannot be used to judge the efficacy of traditional treatment. Urine calcium and TmP/GFR are valuable predictors for renal calcification in XLH children.
Asunto(s)
Raquitismo Hipofosfatémico Familiar , Tasa de Filtración Glomerular , Fósforo , Humanos , Fósforo/sangre , Masculino , Femenino , Raquitismo Hipofosfatémico Familiar/diagnóstico , Preescolar , Niño , Estudios Retrospectivos , Lactante , Riñón/fisiopatología , Adolescente , Calcio/sangre , Calcio/orinaRESUMEN
Ultrathin 2D perovskite nanoplatelets (NPLs) have many excellent optical properties including narrow absorption and emission spectra, and large exciton binding energies. Doping Mn2+ into perovskite NPLs also introduces strong orange luminescence due to the d-d de-excitation recombination. However, it is very challenging to synthesize Mn2+ doped ultrathin perovskite NPLs. Here, we report the successful development of a room temperature method for Mn ion doped perovskite NPLs. The impact of the Mn2+ concentration on their optical properties has been systematically investigated. The highest PLQY is up to 71% when the Mn2+ doping level is 38.6%. Furthermore, we have observed a self-purification effect of these n = 2 NPLs, where the Mn ions were ejected from the n = 2 NPLs and injected into the n = 3 NPLs. An efficient energy transfer from the n = 2 host to the n = 3 NPLs has also been found. Additionally, we have used this fast ejecting and injecting property to fabricate an anti-counterfeiting film. The film shows weak blue and strong orange color under room temperature and high temperature, respectively. Most importantly, the process can be repeated several cycles without damage, which shows great potential for anti-counterfeiting applications.