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- Abstract：Ischemia reperfusion injury （IRI） is often accompanied by serious clinical manifestations， including myocardial hibernation， acute heart failure， brain dysfunction， kidney dysfunction， gastrointestinal dysfunction， liver transplant rejection， systemic inflammatory response syndrome， multiple organ dysfunction syndrome， and so on， which pose important treatment challenges for doctors in clinical practice. Single cell sequencing technology is high-throughput sequencing of the genome， transcriptome， or epigenome at the single-cell level， in order to reveal cellular heterogeneity， and to understand the developmental trajectory， type， state， and various interactions of cells. Since its first discovery， single-cell sequencing technology has been widely applied in various fields， especially in early diagnosis and personalized treatment of tumors. This article mainly reviews the application and progress of single-cell sequencing in various organ dysfunctions caused by IRI， so as to further understand the mechanisms and signaling pathways of IRI， and to provide new ideas for targeted therapy of organ IRI.Keywords：ischemia reperfusion injury;single cell sequencing;apoptosis;transplantation;heterogeneity;signal pathway684|2863|1<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：In the process of accelerating the construction of a strong country in health and sports in China， the mode of promoting health has shifted from passive health to active health. Guided by the concept of “active health”， there is a new understanding of the relationship between sports， health， and medical care. The integration of sports and medicine is a concrete manifestation and implementation of the concept of “active health”， and an important measure to implement the Healthy China strategy， which is regarded as an important strategy to promote public health reform. This article reviews the historical path of the integration of sports and medicine from its concept to practical implementation， and finds that China proposed the integration of sports and medicine relatively late， but it has become an intense focus of academic research； The sports and medical departments have launched guidelines for chronic disease exercise and standards related to exercise prescriptions， and local governments in China have explored diversified models of integrating sports and medicine； Under the institutional requirements of top-level design， the exploration of the “integration of sports and medicine” model is flourishing. There are currently problems in promoting the integration of sports and medicine， such as the lack of a “sports and medicine integration” system and a shortage of “sports and medicine integration” talents. Drawing on the international experience of integrating sports and medical services in other countries，We propose a development strategy of “concept first， government leading， and sports and medical cooperation”； We recommend institutional optimization such as improving medical insurance related systems， establishing certification， employment， and management systems for integrated sports and medical talents， and improving the training system for integrated sports and medical talents in universities； We also advocate propose a “dual wheel” promotion path of upgrading hospital rehabilitation centers and expanding community health centers， in order to provide reference for policy formulation and promote the integration of sports and medicine to play a greater role in China’s public health.Keywords：healthy china;proactive health;passive health;integration of sports and medicine;research progress2728|8073|1<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
Invited Review
- Abstract：Gynecological malignancies pose a serious threat to women's health， and the early diagnosis and precise treatment are crucial for improving patients' prognosis. With the rapid advancement of Artificial Intelligence （AI） technology， it has become a revolutionary tool in the medical field. Through functions such as image recognition， data mining， and pattern recognition， it has opened up new avenues for the diagnosis and management of gynecological malignancies. This review comprehensively summarizes the latest research progress of AI in cervical cancer， ovarian cancer and endometrial cancer， with a special focus on its practical applications in tumor management involving early screening，diagnosis， treatment effect evaluation and prediction of prognosis，so as to provide guidance for the future research direction of AI in gynecological malignancies.Keywords：artificial intelligence;cervical cancer;ovarian cancer;endometrial cancer;early diagnosis;prognosis prediction1132|2741|1<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：Human exhaled breath is rich in volatile organic compounds （VOCs） with thousands of varieties. In addition to VOCs inhaled from external air， the vast majority of VOCs come from human metabolism and metabolism of the internal microorganisms. Therefore， exhaled VOCs carry abundant information about the human body， which works as "fingerprint" of an individual's exhalation pointing to the underlying metabolic status， making VOCs an ideal tool for health monitoring and disease diagnosis. In recent years， a large number of studies on disease and exhaled VOCs have shown valuable results. Many diseases in the human body are closely related to oxidative stress reaction which also produces plentiful VOCs discharged through the lungs， offering a new window for monitoring diseases. In the future， the use of exhaled VOCs analysis to detect and diagnose infectious diseases， metabolic diseases and tumors may become a new trend. This paper presents a review on VOCs in terms of concept， collection， detection， clinical application， and the relationship between exhaled VOCs and diseases.Keywords：exhaled volatile organic compounds;tumor;asthma;chronic obstructive pulmonary disease;infection880|3343|2<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：Stroke is a common acute cerebrovascular disease. Post-stroke cognitive impairment （PSCI） is one of the most common complications of stroke， which seriously affects the quality of life and physical health of patients. As a cutting-edge medical therapy， stem cells transplantation has great potential in the treatment of PSCI by reducing inflammation， promoting axon regeneration and immune regulation， and has become the focus of current research. However， the relationship between stem cells transplantation and PSCI has not been systematically summarized. Therefore， this paper will briefly summarize the biological functions of different types of stem cells， systematically comb out and summarize the mechanisms of stem cells transplantation in PSCI regulation and its applications in PSCI treatment， providing a deeper understanding and strategy for clinical PSCI management.Keywords：stem cells transplantation;stroke;cognitive dysfunction;mesenchymal stem cells;neural stem cells346|1047|1<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：Diabetic kidney disease （DKD） has become the first cause of chronic kidney disease （CKD） hospitalisation in China， and is also the main cause of end-stage renal disease （ESRD） and new haemodialysis. DKD has an insidious onset， low awareness， continuous progression， and poor prognosis. Moreover， there is still a lack of effective medication and management. Accurate assessment and identification of high-risk patients with poor clinical prognosis of DKD， as well as early intervention， is of great significance to the improvement of survival rate， quality of life， and prognosis for patients with DKD. Current methods of DKD prognosis assessment mainly include pathological typing， clinical indicators， mathematical models， and biomarkers. Various methods provide means for early prediction and intervention of DKD prognosis， but each has its own advantages and disadvantages. This article provides a review of recent research progress， conducts an in-depth analysis of the application of various DKD prognostic assessment methods in clinical practice， and further explores the potential for combining different methods. It aims to provide a theoretical basis for optimizing diagnostic and treatment processes and for the exploration and development of future DKD prognostic assessment methods.Keywords：diabetic kidney disease;prognosis;assessment;methodology;review413|2362|1<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：Approximately one-third of stroke patients experience post-stroke cognitive impairment （PSCI）， which significantly impacts their quality of life and survival time. The clinical evaluations of PSCI mainly rely on subjective neurophysiological scales due to its complex pathogenesis and lack of reliable， objective diagnostic tools. However， electroencephalogram （EEG） and magnetic resonance imaging （MRI） could provide objective indicators for diagnosis of PSCI. Based on EEG， MRI and EEG-MRI fusion， this article reviews recent advances in the central mechanisms of PSCI， focusing on changes in brainwave spectrum， brain structure， brain network etc.， in order to explore the clinical values of EEG and MRI in predicting and diagnosing PSCI， enhance the understanding of its pathogenesis and provide a basis for accurate clinical diagnosis.Keywords：post-stroke cognitive impairment;electroencephalogram;magnetic resonance imaging;central mechanisms;review801|3921|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
Review
NAD+ Ameliorates Endothelial Dysfunction in Hypertension via Activation of SIRT3/IDH2 Signal Pathway
Abstract：ObjectiveTo investigate the effect of nicotinamide adenine dinucleotide on vascular endothelial injury in hypertension and its molecular mechanism.MethodsC57BL/6J mice were randomly divided into saline group （Saline） and hypertension group （Ang Ⅱ， which were infused with Ang Ⅱ via subcutaneously implanted osmotic pumps）， and supplemented daily with nicotinamide mononucleotide （300 mg/kg）， a precursor of NAD+. Blood pressure， endothelial relaxation function and pulse wave velocity were measured after 4 weeks. Wound healing assay and adhesion assay were used to evaluate the function of endothelial cells in vitro. mtROS levels were detected by immunofluorescence staining. RT-PCR was used to detect the mRNA expression of mtDNA， SIRT3 and isocitrate dehydrogenase 2 （IDH2）. 8-hydroxy-2'-deoxyguanosine levels were detected by enzyme-linked immunosorbent assay. The protein expression levels of p-eNOS， eNOS， SIRT3 and IDH2 were detected by Western blot.ResultsNMN supplementation reduced blood pressure （P<0.001） and improved endothelial function and arterial stiffness （P<0.001） in hypertensive mice. In vitro， NMN improved endothelial function in AngII-stimulated endothelial cells （P<0.05） and attenuated mitochondrial oxidative stress levels （P<0.001）. Mechanistically， NMN elevated SIRT3 activity （P<0.001）， which subsequently enhanced IDH activity （P<0.001） and reduced oxidative stress levels in endothelial cells. Conversely， knockdown of IDH2 would reverse the effect of SIRT3 in improving endothelial function （P<0.001）.ConclusionNAD+ lowers blood pressure and enhances vascular function in hypertension by reducing the level of oxidative stress in endothelial cells through activation of the SIRT3/IDH2 signal pathway.Keywords：hypertension;vascular endothelial injury;nicotinamide adenine dinucleotide;SIRT3;oxidative stress553|548|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20- Abstract：ObjectiveTo clearly identify the difference between rescue injuries and agonal injuries and to avoid duplicate identifications and misidentifications.MethodsBased on the forensic pathological data of 5 923 cases of death cause identification from 2013 to 2022 in Sun Yat-sen University Forensic Identification Center and Guangzhou Tianhe District Branch of Guangzhou Public Security Bureau， this study retrospectively studied the characteristics of rescue injuries and agonal injuries seen in cause of death identification and their influence on cause of death identification.ResultsAmong all the 5 923 cases， 640 cases were found to have rescue injuries or agonal injuries， and 624 cases received treatment， of which 609 cases were found to have rescue injuries （97.60%）， 44 cases were found to have agonal injuries， and 13 cases were found to have both types of injuries. Among the 640 cases， 441 were male and 199 were female. The age of death was discontinuously distributed from 0 to 95 years old. The leading cause of death was disease， followed by mechanical injury and asphyxia. The main manifestations of rescue injuries were rib and sternum fractures， soft tissue injuries in the prechest area or face， and pericardial rupture. The most common injuries in agonal stage were falling after unconsciousness， inhalation of foreign body in respiratory tract or multiple violent injuries. Among the 640 cases， 19 cases were repeatedly identified， including 15 cases of rescue injuries， 6 cases of agonal injuries， and 2 cases of both types of injuries. Compared with the cases where neither type of injuries was detected， the repeated identification rate of treatment injuries and agonal injuries was significantly increased （χ²=4.04， P=0.044； χ²=43.49， P<0.001）. Among the 640 cases， 11 cases （1.72%） were misidentified as the initial injuries in the first identification， and 13 cases had combined rescue injuries or agonal injuries that were involved in death.ConclusionsBy elucidating the epidemiological characteristics of the two types of injuries， this study proved that the two types of injuries were associated with higher rates of repeated identification and misidentification， which provided a reference for reducing repeated identification and misidentification and improving the accuracy of cause of death identification.Keywords：identification of cause of death;rescue injuries;agonal injuries;duplicate identification;forensic pathology566|1038|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveLeveraging the advanced capabilities of nanopore long-read sequencing technology， our study undertook a comprehensive analysis of the distinct transcriptomic alterations occurring in normal liver parenchymal cells and liver cancer cells subjected to hypoxic conditions. The primary goal was to elucidate the underlying mechanisms governing tumor cell survival and metastasis in low-oxygen environments， thereby paving the way for innovative targeted cancer therapies.MethodsThe normal liver parenchymal cell line THLE-3 and the hepatocellular carcinoma cell line Hep3B were chosen as the focal points of this investigation. Following a 48-hour incubation period in both normoxic and hypoxic conditions， total RNA was extracted from these cells. Subsequently， we employed nanopore sequencing technology to conduct a high-throughput， high-fidelity analysis of the transcriptomes of these two cell lines across different oxygen levels.ResultsThis study established a hypoxic transcriptome dataset using third-generation nanopore sequencing technology， achieving an unprecedented level of sequencing accuracy. By conducting a Gene Ontology （GO） enrichment analysis， we systematically identified and explored the key biological pathways associated with the hypoxic response （P＜0.05）. Furthermore， we integrated molecular dynamics simulation techniques to gain deeper insights into the dynamic structural changes of Solute Carrier Family 1 Member 5 （SLC1A5） during the translation of hypoxic-specific subtypes， providing direct evidence to elucidate its functional regulation.ConclusionThe application of nanopore long-read sequencing technology has proven to be a powerful tool， not only successfully capturing the distinctive expression patterns and specific subtypes of mRNA under hypoxic conditions， but also offering robust technical support for delving into the intricate transcriptomic landscape of hypoxic microenvironments. By further integrating protein structure simulations and molecular dynamics， we have proposed novel avenues for exploring protein structures in hypoxic microenvironments. The findings of this study have significantly enriched the field of hypoxic-specific transcriptomics， providing a more reliable data foundation for investigating hypoxic-specific protein structures. Moreover， these discoveries have unveiled potential hypoxic-specific targets that could be harnessed for the development of future targeted cancer treatment strategies.Keywords：nanopore sequencing;hypoxia;transcript;alternative splicing;hepatocellular carcinoma310|721|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveTo investigate the prevalence of high-risk HPV infection among women in Kashgar area， analyze related risk factors， conduct follow-up and health education interventions for positive cases in the past three years， and assess intervention outcomes to improve HPV screening awareness and reduce cervical cancer incidence.MethodsThis study randomly selected 571 women from Kashgar who underwent HPV screening as part of a health check-up in the First People’s Hospital of Kashgar between January 2021 and June 2023. High-risk HPV-DNA was detected using the PCR-RDB method. Based on the test results， participants were divided into HPV-negative and HPV-positive groups， and the infection rates and associated risk factors were analyzed. Additionally， follow-up was conducted for women who tested positive for high-risk HPV during the screening to assess the effectiveness of health management interventions.ResultsFrom 2021 to 2023， the high-risk HPV positive rate among women in Kashgar showed a year-on-year decline， recorded at 19.15%， 16.43%， and 11.30%， respectively （P<0.001）， with a total of 3，921 cases （16.13%） testing positive for high-risk HPV during this period. Uyghur women had a significantly higher infection rate compared with those of Han nationality and other ethnic minorities （P<0.05）. Risk factors included age， age at first sexual activity， number of sexual partners， contraceptive methods， and a history of vaginal inflammation （P<0.05）. Health management interventions significantly improved participants’ awareness scores regarding cervical cancer prevention and the proportion of women voluntarily receiving HPV vaccination （P<0.05）.ConclusionsHigh-risk HPV infection among Uyghur women in Kashgar area is relatively high， with single infection of HPV-16 and HPV-52 and mixed infections of HPV-16 +HPV-52 and HPV-16 +HPV-58 being predominant. Risk factors include age at first sexual activity， number of sexual partners， contraceptive methods， and history of vaginal inflammation. Through triple-education interventions， the incidence of cervical cancer in Kashgar has been effectively reduced， and standards for primary-level diagnosis， treatment， and health supervision have been improved.Keywords：Kashgar region;high-risk HPV;status of infection;risk factors;intervention;evaluation510|390|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveTo explore the correlation between general anesthesia and mild cognitive impairment in older adults so as to provide new ideas for early prevention and timely intervention of mild cognitive impairment（MCI）.MethodsBased on the baseline survey of the Hubei memory and aging cohort study（2018-2023）， the participants completed a thorough neuropsychological assessment and physical examination， and self-reported a history of general anesthesia and surgery. The association of general anesthesia and MCI in the elderly was analyzed using the logistic regression model. In addition， the stratification and interaction analysis of anesthesia history， anesthesia number and physical intellectual exercise were conducted separately.ResultsA total of 5 069 older adults aged 65 and above were included in this study， including 3 692 city dwellers and 1 377 rural people， among whom were 2 584 women （51%）. Out of the 1 472 participants with history of general anesthesia， 249 people （17.4%） had MCI. After controlling for confounding factors， there was a 39.6% increased risk of MCI in older adults who underwent general anesthesia ［OR=1.396，95%CI（1.169，1.668），P<0.001］， suggesting that general anesthesia may be an independent influence on MCI. For the older adults who had one general anesthesia ［OR=1.235，95%CI（1.001，1.523），P=0.049］， two general anesthesia ［OR=1.779，95%CI （1.292，2.450），P<0.001］， and three OR more general anesthesia ［OR=2.395，95%CI （1.589，3.610），P<0.001］， their risks of MCI were increased by 23.5%， 77.9%， and 139.5%， respectively. Compared with the older adults without a history of general anesthesia who did not exercise， the risk of developing MCI was significantly negatively correlated with the exercise group， cognitive exercise group， and combined exercise and cognitive exercise groups （all P<0.001）. The risk of developing MCI in the exercise group was 60.2% of that in the no exercise group ［OR = 0.602， 95% CI（0.456， 0.795）］， the risk in the cognitive exercise group was 42.4% of that in the no exercise group ［OR = 0.424， 95% CI（0.294， 0.613）］， and the risk in the combined exercise and cognitive exercise group was 27.0% of that in the no exercise group ［OR = 0.270， 95% CI （0.208， 0.353）］. In the older adults with a history of general anesthesia， compared with the no exercise group， the risk of developing MCI was significantly negatively correlated with the cognitive exercise group and the combined exercise and cognitive exercise group （all P < 0.05）. The risk of developing MCI in the cognitive exercise group was 47.7% of that in the no exercise group ［OR=0.477， 95% CI （0.256，0.892）］， the risk in the combined exercise and cognitive exercise group was 34.5% of that in the no exercise group ［OR=0.345， 95% CI （0.220， 0.540）］， while the risk in the exercise-only group did not show a significant difference.ConclusionThe risk of MCI increased significantly in older adults with a history of general anesthesia， and this risk increased with the times of anesthesia. Physical and mental exercise reduces the risk of MCI. it is recommended that older adults with a history of anesthesia incorporate physical and mental exercise into their daily lives to prevent mild cognitive impairment.Keywords：community older adults;history of general anesthesia;mild cognitive impairment;influencing factors;physical and cognitive activity200|1081|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveThis study aims to identify potential risk factors， establish a nomogram prediction model and propose intervention strategies for iron deficiency anemia （IDA） in late pregnancy.MethodsQuestionnaire surveys and routine blood tests were performed on pregnant women who received regular antenatal check-ups at Yangzhou Maternal and Child Health Hospital from July 2022 to December 2023. Of the 500 cases enrolled， 482 completed the trial and were divided into IDA and non-IDA groups based on the presence of IDA in the third trimester. Univariate analysis and multivariate logistic regression were employed to identify risk factors for IDA， while R software was used to construct a nomogram prediction model.ResultsThe incidence of IDA in late pregnancy was 19.92% （96/482）. Univariate analysis revealed significant associations between IDA in late pregnancy and factors such as economic independence， preconception body mass index （BMI）， number of pregnancies， and regular iron supplementation during pregnancy （P<0.05）. Multivariate logistic regression showed that economic independence （P=0.031， OR=0.583） and regular iron supplementation during pregnancy （P<0.001， OR=5.337） were protective factors against IDA. Conversely， a low preconception BMI （P=0.021， OR=2.375） and three or more pregnancies （P=0.015， OR=2.253） emerged as significant risk factors. The receiver operating characteristic （ROC） curve analysis demonstrated that the area under the curve （AUC） for the nomogram predicting IDA was 0.84， with an optimal cutoff value of -1.481， a sensitivity of 81.2% and a specificity of 75.1%.ConclusionsThe incidence of IDA in late pregnancy is quite high. A low preconception BMI and three or more pregnancies are risk factors， while economic independence and regular iron supplementation are protective factors. These insights have enabled the construction of a prediction model， which， in turn， could provide guidance for prediction and treatment of IDA in late pregnancy.Keywords：late pregnancy;iron deficiency anemia;risk factors;protective factors;nomogram;prediction model449|1700|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
Preclinic Research
- Abstract：ObjectiveTo investigate the non-suicidal self-injury （NSSI） behaviors in adolescents with depressive disorder， analyze related influencing factors， and provide theoretical basis and reference for the prevention and treatment of NSSI.MethodsAccording to DSM-5 criteria， 95 depressive adolescents were divided into two groups： one with NSSI （NSSI group） and one without NSSI （nNSSI group）. All patients were assessed with Adolescent Non-suicidal Self-injury Assessment Questionnaire （ANSAQ）， Self-Rating Depression Scale （SDS）， Self-Rating Anxiety Scale （SAS）， Simplified Coping Style Questionnaire （SCSQ）， Experiences in Close Relationships-Relationship Structures Scale （ECR-RS）， and Childhood Trauma Questionnaire-Short Form （CTQ-SF）. The inter-group differences were compared. The influencing factors of NSSI were analyzed by using binary logistic regression.ResultsOf the 95 depressive adolescents， 59 cases of NSSI were identified， with a detection rate of 62.11%. NSSI group had higher scores than nNSSI group on SDS， SAS， negative coping style， paternal attachment anxiety， maternal attachment anxiety and avoidance， CTQ-SF total score， emotional neglect， physical neglect， emotional abuse， and sexual abuse （all P<0.05）. Binary logistic regression analysis showed that anxiety， negative coping style， maternal attachment avoidance and emotional abuse increased the risk of NSSI among adolescents with depressive disorders （all P< 0.05）.ConclusionsAdolescents with depression have a high incidence of NSSI behaviors， which is related to anxiety， negative coping style， maternal attachment avoidance and emotional abuse. In addition to improving patients' depression and anxiety in clinical setting， attention should also be paid to patients' coping styles， parent-child relationship and childhood trauma to reduce the occurrence of NSSI behaviors.Keywords：adolescent depression;non-suicidal self-injury;coping style;parent-child relationship;Childhood trauma832|3132|5<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectivePatients with hepatic glycogen storage disease（GSD）have recurrent episodes of hypoglycemia. This study aimed to investigate and analyze blood glucose and biochemical indicators in pediatric patients with hepatic GSD， thus provide data support for hypoglycemia prevention and its clinical management.MethodsA cross-sectional field study was conducted among patients with hepatic GSD treated in the Department of Pediatrics of Guangdong Provincial People's Hospital on July 14， 2024. We collected the peripheral blood samples of the patients and their healthy family controls on site， then analyzed and compared their blood glucose and biochemical indicators.ResultsOf the 44 patients with hepatic GSD， there were 34 males and 10 females， including GSD Ib（n =14）， GSD Ia（n=15）， GSD Ⅲ（n=2）， GSD Ⅵ（n=7）and GSD Ⅸ（n=6）. The average age was 7.60（5.08-11.98）years. All patients were on uncooked cornstarch（UCCS）therapy. Of the patients， 77.3%（34/44）had hepatomegaly， 61.4%（27/44）had recurrent hypoglycemia， 61.4%（27/44）had blood glucose ≤ 3.9 mmol/L， 18.2%（8/44）had blood glucose ≤ 2.8 mmol/L， and none of the 8 cases was GSD Ib. The lowest blood glucose level was 1.19 mmol/L and no episodes of hypoglycemia occurred. Of the family control subjects， 65.9%（29/44）had blood glucose ≤ 3.9 mmol/L. There was no significant difference in hypoglycemia prevalence between hepatic GSD group and control group（P=0.658）. The hepatic GSD patients had hyperlactacemia， hyperuricemia and hypercholesterolemia prevalence rates of 65.9%， 45.5% and 9.1%， respectively， as compared with 18.2%， 43.2% and 15.9%， respectively， for the family control subjects. No significant difference was found in the prevalence rates of hyperuricemia and hypercholesterolemia between the two groups（P=0.830 and P=0.334， respectively）.ConclusionsAsymptomatic hypoglycemia is common in patients with hepatic GSD， especially in non-GSD-Ib patients. It is necessary to optimize the diet management of UCCS， conduct dynamic blood glucose monitoring and follow a light diet， so as to decrease hyperuricemia and hypercholesterolemia， avoid and reduce the serious adverse reactions and complications caused by severe hypoglycemia.Keywords：hepatic glycogen storage disease;hypoglycemia;blood biochemical indicator;cross-sectional study;children;family control226|604|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveTo establish a risk recognition model for coronary artery stenosis by using a machine learning method and to identify the key causative factors.MethodsPatients aged ≥18 years，diagnosed with coronary heart disease through coronary angiography from January 2013 to May 2020 in two prominent hospitals in Shanxi Province， were continuously enrolled. Logistic regression，back propagation neural network （BPNN）， and random forest（RF）algorithms were used to construct models for detecting the causative factors of coronary artery stenosis. Sensitivity （TPR）， specificity （TNR）， accuracy （ACC）， positive predictive value （PV+）， negative predictive value （PV-）， area under subject operating characteristic curve （AUC）， and calibration curve were used to compare the discrimination and calibration performance of the models. The best model was then employed to predict the main risk variables associated with coronary stenosis.ResultsThe RF model exhibited superior comprehensive performance compared to logistic regression and BPNN models. The TPR values for logistic regression，BPNN，and RF models were 75.76%， 74.30%， and 93.70%， while ACC values were 74.05%， 72.30%， and 79.49%， respectively. The AUC values were：logistic regression 0.739 9； BPNN 0.723 1； RF 0.752 2. Manifestations such as chest pains，abnormal ST segments on ECG，ventricular premature beats with hypertension， atrial fibrillation， regional wall motion abnormalities（RWMA） by color echocardiography， aortic regurgitation（AR）， pulmonary insufficiency （PI）， family history of cardiovascular diseases，and body mass index（BMI）were identified as top ten important variables affecting coronary stenosis according to the RF model.ConclusionsRandom forest model shows the best comprehensive performance in identification and accurate assessment of coronary artery stenosis. The prediction of risk factors affecting coronary artery stenosis can provide a scientific basis for clinical intervention and help to formulate further diagnosis and treatment strategies so as to delay the disease progression.Keywords：Gensini score;back propagation neural network;random forests;coronary artery stenosis;machine learning346|978|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveTo clarify the associations between plasma fibrinogen （Fbg） and volumetric bone mineral density （vBMD） as well as osteoporosis measured by quantitative computed tomography （QCT）， and to explore the role of plasma Fbg in early screening and diagnosis of osteoporosis.MethodsPatients with hypertension who were hospitalized in the Department of Endocrinology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2018 to June 2022 and underwent QCT examinations were included for cross-sectional analysis. The study analyzed the correlation between plasma Fbg and osteoporosis in patients. The diagnostic efficacy of plasma Fbg for osteoporosis was evaluated by the area under the receiver operating characteristic （ROC） curve （AUC）.ResultsTotally 441 subjects were included in the analysis， with an average age of 46.0±14.5 years and a prevalence of osteoporosis of 6.4% （28/441）. As the level of plasma fibrinogen increased， the incidence of osteoporosis significantly increased （P<0.000 1）while the average bone mineral density of L1 and L2 were significantly decreased （P<0.05）. Compared with the first quartile of plasma Fbg（1.99g/L -2.37g/L）， the risk of osteoporosis in the fourth quartile of plasma Fbg （3.67g/L-4.46g/L） increased by 8.85 times after adjusting for related confounding factors.ConclusionThis study found a negative correlation between plasma fibrinogen levels and bone density in patients with hypertension. Plasma fibrinogen levels may serve as a potential screening indicator for osteoporosis， aiding in early diagnosis and therapeutic monitoring. This discovery offers a new perspective for the study of bone metabolic diseases and warrants further investigation.Keywords：osteoporosis;hypertension;fibrinogen;quantitative computed tomography;volumetric bone mineral density298|989|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveTo discuss the clinical manifestations and image features of Neuromyelitis Optica Spectrum Disorder （NMOSD）with respiratory insufficiency. We present a retrospective review about the use of double filtration plasmapheresis in the treatment of the acute attack of NMOSD in these patients.MethodsAll of our patients with central respiratory insufficiency who suffered attacks of NMOSD were retrospectively considered for inclusion. Extended Disability Status Scale（EDSS）scores were compared within six months after double membrane filtration plasma exchange.ResultsThe clinical data of the six patients included were analyzed. Magnetic Resonance Imaging confirmed that the demyelinating plaques in our patients could involve the medulla oblongata and upper spinal cord. They were managed by plasma exchange given as an initial therapy. The clinical symptoms improved significantly and the patients were successfully withdrawn from the ventilator，with EDSS scores significantly reduced （P<0.001）.ConclusionDemyelination of medulla oblongata and upper spinal cord in NMOSD may lead to acute life-threatening respiratory compromise， and early initiation of double filtration plasmapheresis can be a safe and effective treatment.Keywords：neuromyelitis optica spectrum disorder;respiratory insufficiency;double filtration plasmapheresis;medulla oblongata;upper spinal cord291|471|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveTo investigate the prevalence rate of chronic non-communicable diseases （NCDs） and the association with quality of life in middle-aged and elderly patients with HIV/AIDS.MethodsThis cross-sectional study surveyed 432 patients with HIV/AIDS （aged≥45 years） in the Infectious Disease Center in Guangzhou Eighth People’s Hospital of Guangzhou Medical University， and 366 participants were included in the analysis after quality control. A questionnaire and the EuroQol 5-Dimensional 3-level version （EQ-5D-3L） were used to investigate NCDs and quality of life and Tobit regression model was used to estimate the association between chronic diseases and quality of life.ResultsAmong the 366 participants， 29（7.9%） had cardiovascular disease， 45（12.3%） had hypertension， 122（33.3%） had hyperglycemia， 151（41.3%）had hyperlipidemia，7（1.9%） had cancer， 17 （4.6%） had chronic kidney disease， 38 （10.4%） had chronic liver disease， 21（5.7%） had musculoskeletal disorders， and 253（69.1%） suffered from at least one type of chronic diseases. The median （lower and upper quartiles） of EQ-5D utility index was 1.000（0.964~1.000）. Multivariate Tobit regression results of the total population showed that cancer ［ba=-0.08，95%CI （-0.15，-0.01），P=0.036］， chronic kidney disease ［ba=-0.07， 95%CI （-0.12，-0.02），P=0.006］， musculoskeletal disease ［ba=-0.09， 95%CI （-0.13， -0.05），P<0.001］， and ≥3 types of chronic diseases［ba=-0.05， 95%CI（-0.08，-0.01），P=0.013］ were negatively correlated with EQ-5D utility index. The stratified analysis results of different CD4+T cell levels showed that hypertension ［ba=-0.07， 95%CI （-0.12， -0.02）， P=0.007］， chronic kidney disease ［ba=-0.10，95%CI （-0.18，-0.03）， P=0.006］， musculoskeletal disease ［ba=-0.15， 95%CI （-0.22，-0.07）， P<0.001］ and ≥3 types of chronic diseases ［ba=-0.09， 95%CI （-0.09， -0.01）， P<0.001］ were negatively correlated with EQ-5D utility index in the group with CD4≤500 （cells/μL）， whereas cancer［ba=-0.11， 95%CI （-0.20，-0.01）， P=0.031］ was negatively correlated with EQ-5D utility index in the group with CD4＞500（cells/μL）.ConclusionsThe prevalence rate of chronic non-communicable diseases in middle-aged and elderly patients with HIV/AIDS is relatively high. The classification of NCDs such as cancer or chronic kidney disease or other chronic diseases and the numbers of NCDs categories are negatively correlated with quality of life. However，this association varies among patients with HIV/AIDS of different CD4+T cell levels. It is suggested that we should try to prevent and identify NCDs at an early stage， strengthen linkages and integration of health services for AIDS and chronic NCDs， and jointly manage and control AIDS with chronic diseases to improve the quality of life among people living with HIV/AIDS.Keywords：HIV;AIDS;middle-aged and elderly;chronic non-communicable diseases;prevalence;quality of life485|1079|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
- Abstract：ObjectiveTo study the clinical features of viral encephalitis with isolated dizziness，and to analyze the diagnostic efficacy of vestibular function examination and cerebrospinal fluid cytology in these patients.MethodsTotally 37 cases of viral encephalitis with isolated dizziness and 10 healthy volunteers were included. Clinical data ［dizziness handicap inventory （DHI） score，head imaging，electroencephalogram，vestibular function test，cerebrospinal fluid routine，biochemistry，cell morphology，etiology second-generation sequencing，misdiagnosis］ were collected. The area under the ROC curve（AUC）of diagnostic value of each type of test was analyzed. The changes of each examination before and after treatment were compared.ResultsWe found 89.19%（33/37）of the patients were misdiagnosed. Vestibular function smooth follow-up test indicated vestibular central lesion （AUC value：0.82）in 64.86%（24/37）of the patients. The number of CSF transformed lymphocytes increased in 86.49%（32/37）of the patients（AUC value：0.93），the CSF large lymphocytes increased in 97.30% （36/37）of the patients （AUC value：0.99），and the mononucleosis was activated in 94.59%（35/37）of the patients（AUC value：0.97）. Furthermore，18.92%（7/37）of the patients had increased EEG slow wave（AUC value：0.60），while 13.51%（5/37） of the patients showed cortical swelling on head MR （AUC：0.60）. After antiviral treatment，dizziness grade decreased（Z=-4.899，P<0.001），smooth tracking abnormalities decreased（Z=-4.583，P<0.001），the proportion of CSF transformed lymphocytes decreased（t=4.281，P<0.001），and the proportion of large lymphocytes decreased（t=6.905，P<0.001）.ConclusionThe misdiagnosis rate of viral encephalitis with isolated dizziness is high. Incorporating into diagnosis the increased large lymphocytes， transformed lymphocytes，activated monocytes in CSF cytology with smooth follow-up test may improve diagnostic efficiency .Keywords：cerebrospinal fluid cytology;vestibular function;viral encephalitis;giddy;diagnostic efficiency225|872|0<HTML><L-PDF> <Meta-XML>Updated：2025-01-20
Clinical Research
