Lung-diaphragmatic protective ventilation aims to limit damage to the lung and diaphragm during mechanical ventilation in critically ill patients. The dynamic monitoring of respiratory drive and inspiratory effort is the focus of the clinical strategies for implementating lung-diaphragm protective ventilation strategies. This paper reviews the existing indicators for dynamic monitoring of respiratory drive and inspiratory effort at the three levels of respiratory muscle, pressure change, and pulmonary ventilation according to the physiological pathway of respiratory drive and discusses their significance, acquisition methods, and thresholds.

Objective  To establish an experimental protocol for inducing human macrophages into scar-associated macrophages (SAMs) in vitro. To investigate the mechanism underlying SAMs regulating hepatic stellate cell (HSC) activation. Methods  Published single-cell RNA sequencing (scRNA-Seq) data, which were obtained from human or murine fibrotic liver tissues, were used to study the expression of fibrosis-related genes in SAMs. Phorbol-12-myristate-13-acetate (PMA) and plasminogen (PLG) were used to induce the transformation of human monocyte THP-1 into SAMs. SAM supernatant was collected to culture with LX-2. The expressions of SAM markers, fibrosis-related genes and HSC activation markers were detected by real-time quantitative polymerase chain reaction（RT-qPCR）. Results  scRNA-seq revealed that SAMs were detected in both mouse fibrotic livers or human injured liver. SAMs highly expressed fibrosis-related genes such as SPP1, CTSD. PMA and PLG increased the expressions of SAM markers CD9, TRME2, LGALS3, CD63 in THP-1. Fibrosis-related genes SPP1, CTSD were highly expressed by SAMs. The supernatant of SAMs activated LX-2. Conclusion  SAMs are accumulated in mouse or human liver injury/fibrosis caused by different causes, and represent similar characteristics and functions. PMA and PLG induce the transformation of human monocyte THP-1 into SAMs. SAMs promote the activation of HSCs via SPP1 and CTSD, thus promoting the occurrence and development of liver fibrosis.

Objective  To explore the association between systolic blood pressure variability and in-hospital mortality in patients with sepsis. Methods  This study was a prospective, multicenter, and cohort study. Data were derived from the China Critical Care Sepsis Trial, which was conducted from January 2013 to August 2014. Patients aged ≥18 years with length of stay of intensive care unit （ICU）more than 24 h were included. The patients who were diagnosed  as sepsis for more than 48 h and lack of blood pressure for 2 h or longer were excluded. Systolic blood pressure, diastolic blood pressure, fluid intake and output were collected. The systolic blood pressure coefficient of variation (SBP_cv) was calculated and divided into four groups (Q₁, Q₂, Q₃, Q₄) according to the interquartile of SBP_cv. The multivariable Logistic regression was applied to explore the association between systolic blood pressure variability and in-hospital mortality. Results  A total of  1 356 patients with sepsis were included, with 929 (68.5%) males and 427 (31.5%) females, median age 67.0 years (52.0, 78.0).Among them,  483 (35.6%) patients died during hospitalization. After adjusting for potential confounding factors, for every 10% of SBP_cv increasing, the risk of in-hospital mortality increased 43% (OR=1.43, 95%CI:1.11-1.98). Compared with Q1 group, patients in Q4 group had a 69% increased risk of in-hospital mortality (OR=1.69, 95%CI:1.31-2.25) and a 23% increased risk of 28 d mortality (OR=1.23, 95%CI:1.07-1.84). Conclusion  Higher systolic blood pressure variability was correlated with higher risks of in-hospital mortality and 28 d mortality.

Objective  To investigate the diagnostic and differential diagnostic value of ¹¹C-Pittsburgh compound B (¹¹C-PIB) positron emission tomography (PET) imaging for Alzheimer's disease (AD), mild cognitive impairment (MCI) and non- Alzheimer's disease induced cognitive impairment (NAD) by qualitatively and semi quantitatively evaluating the degree of β-amyloid (Aβ）deposition in the brain.  Methods  AD patients (AD, n=36), mild cognitive impairment (MCI, n=20), non-AD induced cognitive impairment (NAD, n=19), and normal controls (NC, n=10) admitted to the Department of Neurology, Xuanwu Hospital, Capital Medical University in 2022 were retrospectively analyzed. All 85 subjects underwent ¹¹C-PIB PET imaging. First, Aβ Negative or positive deposition was qualitatively estimated, and then taking the brainstem as the reference brain area, the maximum standardized uptake value ratio(SUVRmax）of the frontal, parietal, temporal, and occipital lobes of the cerebral cortex Aβ was semi-quantitative measured, and the differences of SUVRmax among AD, MCI, NAD. and NC groups were analyzed. Results  Qualitative judgment showed that there were significant differences between AD group ,NC group, and other groups , but no significant difference between MCI group and NAD group. Semi quantitative analysis showed that for all brain regions (frontal lobe, parietal lobe, temporal lobe, occipital lobe), the SUVRmax value of AD group was significantly higher than that of the other three groups, with a statistically significant difference. In all brain regions, the SUVRmax value of NC group was the lowest, but there was no significant difference in SUVRmax among MCI group,NAD and NC group. Conclusion  Both qualitative and semi quantitative analysis of ¹¹C-PIB PET imaging were of high value in the diagnosis of AD, and semi quantitative analysis showed certain significance in differentiating AD and MCI.

Objective  To train C57/6J wild-type mice and Sapap3 gene knockout mice to perform reversal learning induced by olfaction, tactility audition, respectively, and to explore the feasibility of reversal learning paradigm induced by olfaction, tactility audition and the cognitive flexibility of Sapap3 gene knockout mice. Methods  C57/6J wild-type mice and Sapap3 gene knockout mice (8-10 weeks old) were randomly divided into three groups and trained with the head fixed. The correct rate, error rate and learning rate of the licking events at each stage were analyzed to observe the learning ability of the mice under the three reversal learning paradigms. Results  The time required to reach the learning criterion was significantly different between Sapap3 knockout mice and C57/6J wild type mice in the reversal stage of olfactory and auditory reversal learning paradigm. Conclusion  The behavioral paradigm of reversal learning can be used to detect cognitive flexibility, which lays a behavioral foundation for the subsequent research on the diseases and brain regions related to cognitive flexibility.

Objective  To compare the differences of clinical manifestation between odontogenic sinusitis (ODS) patients with and without sinusitis symptoms. Methods  The clinical data of totally 92 ODS patients’ clinical data were retrospectively collected, who underwent endoscopic sinus surgery in the Department of Otolaryngology, Head and Neck Surgery in Beijing TongRen Hospital, Capital Medical Uniersity, from June 2020 to June 2022. Among them, 77 cases had sinusitis symptoms（SS group）, and 15 cases had no sinusitis symptoms（non-SS group）. The survey items included medical history, symptoms, etiology, endoscopic examination and sinus computed tomography(CT)were compared.Results  Compared with the SS group, the non-SS group has a shorter course of disease ［(4.9 ± 3.4) months vs (10.4 ± 11.0) months, P=0.048)］, and a higher proportion of first consultation in Department of Stomatology (100% vs 24.7%, P=0.035). There was no statistically significant difference in the positive rates of reported toothache and tooth loosening symptoms between the two groups of patients (29.9% vs 53.3%, P=0.133; 18.2% vs 35.3%, P=0.085). The proportion of periodontal endodontic combined lesions (PECL), apical periodontitis (AP), periodontitis (PE), and iatrogenic factor, accounted for the etiology of the two groups of patients, were 53.2% vs 20% (P=0.024); 28.6% vs 33.3% (P=0.76); 11.7% vs 26.7% (P=0.215); and 6.5% vs 20% (P=0.119), respectively. CT of the sinuses showed that the SS group had a higher proportion of involvement in the ostiomeatal complex (OMC), ethmoid sinus, and frontal sinus than non-SS group did, with 83.1% vs 26.7% (P=0.000); 80.5% vs 20% (P=0.000);  and 41.6% vs 0% (P=0.002), based on the evaluation of CT opacification. Conclusions  The multidisciplinary cooperation between Otolaryngology and Stomatology could early identify ODS patients without sinusitis symptoms, diagnose and treat timely dental related diseases, such as PECL, reduce the probability of endoscopic sinus surgery, and improve life quality of  patients. 

Objective  To explore the association between cumulative exposure indicators of serum uric acid to serum creatinine ratio (SUA/Scr) and incident carotid plaque. Methods  This study included 9 228 individuals who met the inclusion and exclusion criteria from the Beijing Health Management Cohort. The cumulative exposure, cumulative exposure burden and high exposure time of SUA/Scr were calculated based on the values of SUA/Scr in three physical examinations in 2010 to 2011 (visit 1), 2012 to 2013 (visit 2), and 2014 to 2015 (visit 3). Carotid plaque was diagnosed by carotid ultrasound, and the follow-up was until December 31, 2021. Logistic regression model was used to analyze the association between SUA/Scr cumulative exposure indicators and carotid plaque occurrence, and sensitivity analysis was performed by excluding the participants with the usage of antihypertensive drugs, or glucose-lowering drugs, or lipid-lowering drugs. Results  The mean age of the study population was (48.89±10.22) years, and 5 846(63.35%) participants were males. The participants were divided into four groups according to the quartiles of SUA/Scr cumulative exposure, namely Q1-Q4 groups. After adjusting for covariates in models, compared with Q1 group, the ORs (95%CIs) of incident carotid plaque in Q2, Q3 and Q4 groups were 1.221 (95%CI：1.066-1.400), 1.255(95%CI： 1.095-1.439) and 1.478 (95%CI：1.287-1.697). Cumulative exposure burden greater than 0 (OR=1.223，95%CI：1.109-1.349) and high exposure time of 6 years (OR=1.332，95%CI：1.171-1.515) were both associated with increased risk of carotid plaque occurrence. Sensitivity analysis excluded participants with the usage of any antihypertensive drugs, glucose-lowering drugs, or lipid-lowering drugs. The results were similar to those in main analysis. Conclusion Cumulative exposure, cumulative exposure burden and high exposure time of SUA/Scr were associated with increased risk of incident carotid plaque. In the primary prevention of carotid plaque, we should focus not only on SUA/Scr value at a single point time, but also on long-term monitoring of SUA/Scr values.

Objective  To investigate the impact of Candida albicans colonization on the mortality, duration of antibiotic therapy, immune and inflammation status in patients with ventilator-associated pneumonia (VAP) caused by multidrug-resistant Pseudomonas aeruginosa. Methods  This prospective multicenter cohort study included patients with VAP caused by multidrug-resistant Pseudomonas aeruginosa (MDR-Pa) admitted to six tertiary teaching hospitals from June 2018 to June 2023. The patients were divided into colonization group and non-colonization group based on the presence of Candida albicans detected in the broncho-alveolar lavage fluid (BALF). The 30-d all-cause mortality, duration of antibiotic therapy, immune and inflammation status were compared between the two groups after VAP diagnosis on the day1, day3, day5, and day7. Results  During the five-year research period, a total of 232 VAP patients caused by MDR-Pa were included from six participating units in the intensive care unit (ICU), with 105 cases in the colonization group and 127 cases in the non-colonization group. The Pseudomonas aeruginosa detected in BALF samples from the non-colonization group showed higher sensitivity to aminoglycosides, cephalosporins, and carbapenems compared to the colonization group (P<0.05). However, both groups showed lower sensitivity to 16 antibiotics compared to China antimicrobial surveillance network (CHINET) 2022 (P<0.05).  Interleukin-17A and (1,3)-β-D glucan levels in the non-colonization group were consistently lower than those in the colonization group at various time points, and other inflammatory markers were more likely to return to normal values (P<0.05). Additionally, the absolute values of T and Th lymphocytes in the non-colonization group recovered to normal levels faster on the day 7 (P<0.05). There was no statistically significant difference in the 30-d all-cause mortality between the two groups (25.7% vs 22.8%, P=0.61), but the non-colonization group had a significantly shorter duration of antibiotic therapy compared to the colonization group ［(11.3±3.1)d vs （14.2±4.7)d, P<0.01］, with a trend towards shorter ICU hospitalization time. Conclusion  The colonization of Candida albicans in the airway does not affect the 30-d all-cause mortality of patients with VAP caused by MDR-Pa. However, it does prolong the inflammatory response and the duration of antibiotic use, as well as delay the recovery of immune function.

Myocardial fibrosis is a common pathological basis of many cardiovascular diseases and is closely related to poor prognosis of the cardiac disease. At present,there are limitations in clinical evaluation techniques for myocardial fibrosis,such as being invasive,lacking specificity,and unable to diagnose early. In recent years,nuclide imaging targeting activated fibroblasts has received attention for its potential in detecting myocardial fibrosis and in evaluating disease progression and treatment response. Based on the existing studies,the present paper focuses on its application status,advantages and limitations,and discusses its prospects in cardiovascular diseases,aiming to provide reference and inspiration  to promote the application of targeted activated fibroblast radionuclide imaging in cardiovascular diseases.

Objective  To summarize the clinical features of seizure-induced non-traumatic vertebral fractures and improve their recognition. Methods  Retrospective analysis was performed on the clinical data of patients who developed non-traumatic spinal fractures caused by seizure in Beijing Tiantan Hospital, Capital Medical University, from January 2020 to January 2023.  Results  In our retrospective analysis,we identified 4 patients who were diagnosed with non-traumatic vertebral fractures caused by seizure. Our patients were all males,with the average age of 36.3 years. In 3 of the cases,the multilevel vertebral compression fractures were located in the upper and midthoracic spine. There was only one instance of multilevel lumbar vertebral fractures. Local pain,with an atypical nature and scope,was the most common clinical symptom observed in these patients. In 75% of cases,the fracture diagnosis was missed at initial presentation. A bone density test was only performed on one patient at the time of the vertebral fracture occurred. Every patient experienced a complete recovery after conservative or surgical therapy. Conclusion  Seizure-induced non-traumatic vertebral fractures occur predominantly in young and middle-aged males,and the common pattern is thoracolumbar compression fractures. The clinical symptoms and signs of this particular type of fractures are atypical,which is prone to misdiagnosis or missed diagnosis. A detailed history and examination,including spinal imaging,are important for the diagnosis of these patients. Controlling seizure is considered to be the main preventive method. Chronic epilepsy patients should be advised to get a bone density test and they should take calcium and vitamin D supplements,when necessary,for preventing the incidence of new vertebral fracture.

Objective  To construct a bispecific antibody targeting epidermal growth factor receptor（EGFR） and OX40 and evaluate the function for tumor-specific T cell activation. Methods  The gene of anti-OX40/anti-EGFR bispecific antibody was cloned into eukaryotic expression vector, and then the constructed vector were transfected to 293F cells for the bispecific antibody purification. The binding activity of anti-OX40/anti-EGFR bispecific antibody with the cells expressing target proteins  were detected by flow cytometry. To identify the activation of T cells mediated by anti-OX40/anti-EGFR bispecific antibody, the activation of NF-κB signal activation was evaluated by Jurkat-OX40-NF-κB-GFP reporter cells and the activation of primary T cells was detected by interleukin-2（IL-2） and interferon-γ（IFN-γ） secretion of peripheral blood mononuclear cell(PBMC). Results  Anti-OX40/anti-EGFR bispecific antibody was successfully constructed and purified, and its binding ability to HEK293 cells expressing OX40 and EGFR was verified. Jurkat-OX40-NF-κB-GFP reporter cells were activated by the bispecific antibody with the crosslinking of A549 cells. Further, the anti-OX40/anti-EGFR bispecific antibody promoted the secretion of IL-2 and IFN-γ of PBMC. Conclusion  Anti-OX40/anti-EGFR bispecific antibody was successfully constructed which could specifically recognize OX40 and EGFR and activate tumor specific T cells.

Objective  To explore the correlation of simple measurement of inspiratory muscle pressure index from the ventilator (PMIvent) and reference measurement of inspiratory muscle pressure index on experimental condition (PMIref), the relationship between PMIvent and inspiratory effort, and further to determine the clinical feasibility and validity of PMI for assessing inspiratory effort during pressure support ventilation (PSV).  Methods  Adult acute respiratory failure patients undergoing mechanical ventilation were screened daily and enrolled 24 h after switching to PSV mode. Baseline ventilators were set according to the principle of keeping tidal volume/ predicted body weight(VT/PBW) at 6-8 mL/kg and respiratory rate (RR) at 20-30 breaths/min and the decision of the responsible ICU physician. A downward support pressure ( PS )titration was conducted from 20 cmH₂O to 2 cmH₂O. Three end-inspiratory holdings (EIO) and three end-expiratory holdings (EEO) were performed. PMIvent was calculated as the difference between plateau pressure (Pplat) within 2 s after EIO and the airway peak pressure (Ppeak) at EIO. PMIref was calculated as the difference between Pplat at one cardiac cycle after EIO and Ppeak at EIO. Flow, airway pressure (Paw), and esophageal pressure (Pes) signals were displayed continuously and saved. PMIref, PMIvent and esophageal pressure time product per breath (PTPes) were measured. PTPes per minute was calculated as the product of PTPes and RR. The “normal” range of PTPes per minute was defined as 50 to 200 cmH2O·s·min-1. The accuracy of PMIvent compared to PMIref was assessed with a Bland-Altman plot. The correlation between PMI and inspiratory effort was evaluated as the coefficient of determination (R²). The ability of PMI to detect high/low effort was assessed using the area under the receiver operating characteristics curve (ROC AUC). The optimal cut-off values were selected based on the Youden index. Results  The accuracy and precision of PMIvent compared to PMIref showed a low bias (0.18) with smaller 95% limits of agreements (-0.44,0.80). PMIref was significantly related to the PTPes per minute (between-patients R²=0.61, within-patients R²=0.80, respectively). PMIvent was also related to the PTPes per minute (between-patients R²=0.62, within-patients R²=0.81). For a cut-off PTPes<50 cmH₂O·s·min^-1, PMIvent showed an ROC AUC of 0.93 ［0.89,0.96］, and the best threshold was -0.77 cmH₂O. Conclusion  PMIvent can effectively replace PMIref. Like PMIref, PMIvent was significantly related to inspiratory effort and had the potential value to predict low inspiratory effort. 

Objective  To analyze the association between suicidality and biological parameters in patients with bipolar depression episodes and to provide a basis for evaluation and monitoring. Methods  A retrospective cross-sectional study was conducted on hospitalized patients with bipolar depression episodes at Beijing Anding Hospital,Capital Medical University,from January 2014 to December 2017. The patient data including demographic,clinical,and biological parameters were collected from the electronic medical records system and analyzed using R (version 4.2.2) statistical software.  Results  A total of 2 027 patients with bipolar depression episodes were included,with 417 (20.6%) exhibiting suicidal ideation or behavior. Compared to the non-suicidal group,the suicidal group had a higher proportion of females and comorbid medical conditions. Additionally,serum IgA and testosterone (TES) levels were higher in the suicidal group (all P < 0.05). Multivariate Logistic regression analysis revealed significant positive associations between IgA,comorbid medical conditions,and suicidal ideation and behavior. Conclusion  Elevated serum IgA levels and the presence of comorbid medical conditions are risk factors associated with suicidal ideation and behavior in patients with bipolar depression episodes. This finding contributes to more accurate risk identification and effective intervention strategies.

Objective  To explore the correlation between suicide attempt (SA) in adolescents with non-suicidal self-injury (NSSI)and  the function change of the hypothalamic-pituitary-thyroid (HPT) axis and the hypothalamic-pituitary-adrenal (HPA) axis function change. Methods  A cross-sectional survey was conducted among adolescents aged 13-19 years with a history of NSSI who were hospitalized in Beijing Anding Hospital,Capital Medical University from December 2020 to May 2022. The clinical features,thyroid function ［free triiodothyronine (FT3),free thyroxine (FT4),total T3 (TT3),total T4 (TT4),thyroid stimulating hormone (TSH)］, adrenocorticotropin (ACTH) and cortisol (CORT) levels were collected. The patients were divided into non-SA group and SA group according to the  absence or presence of SA in the last one year. According to the time period of SA occurrence (1 month),patients in the SA group were divided into recent SA and past SA. The multivariate logistic regression model was used to analyze the influencing factors of SA behavior.  Results  A total of 79 adolescent patients of mood disorder with NSSI were enrolled.Among them, 49 (62.03%) patients had SA and 29(59.18%) patients had attempted suicide within the past month. The univariate analysis showed that there were statistical differences in age of disease onset,gender,and education level between the SA and non-SA groups (P<0.05). There were statistical differences in age,TSH, and ACTH level between the recent SA group and past SA group (P<0.05). The logistic regression analysis showed that female (P=0.027,OR=2.941,95%CI: 1.131-7.649) was risk factor for SA behavior. Low ACTH level（P=0.043，OR=1.019，95%CI：1.001-1.037）was related factor for recent SA. Conclusion  Female adolescents of mood disorders with NSSI were more likely to attempt suicidality and ACTH was related with recent SA.

Objective  To explore the deposition of fibrin and the expression of genes related to fibrin formation and degradation in nasal mucosa of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and patients with CRSwNP comorbid asthma (CRSwNP+AS). Methods  Immunofluorescence staining was used to evaluate the deposition of fibrin in the nasal mucosa. Real-time fluorescence quantitative polymerse chain reaction (RT-qPCR) was used to detect the expression of genes related to fibrin formation and degradation ［factor ⅩⅢ A chain 1 (F13A1)， plasminogen (PLG)， plasminogen activator tissue type (PLAT)， plasminogen activator urokinase (PLAU) and plasminogen activator inhibitor 1 (PAI-1)］ in nasal mucosa of CRSwNP, CRSwNP+AS and control subjects. The patients received glucocorticoid treatment. Results  Compared with the control group, immunofluorescence staining showed obvious deposition of crosslinked fibrin in the nasal mucosa of patients with CRSwNP, and CRSwNP+AS group had more significant fibrin deposition. Gene expression analysis showed that the expression of F13A1, a gene that promotes fibrin formation, and PAI-1, a gene that inhibits fibrin degradation, were both significantly increased in the CRSwNP and CRSwNP+AS groups. In addition, the expression of F13A1 was significantly higher in CRSwNP+AS group than that in CRSwNP group. The expression of PLAT, which promotes fibrin degradation, was significantly lower in the CRSwNP+AS group than that in the CRSwNP and control groups. PLAU is upregulated in both types of CRSwNP. Glucocorticoid treatment significantly downregulates F13A1 and upregulates the expression of PLAT in patients with CRSwNP+AS. Conclusion  Patients with CRSwNP have excessive fibrin deposition in the nasal mucosa, which may be caused by the dysregulation of genes related to fibrin formation and degradation. Dysregulated F13A1 and PLAT were more significant in CRSwNP+AS. 

Objective  To preliminarily study the value of fluorine-18 deoxyglucose (¹⁸F-FDG) positron emission tomography (PET) imaging in the metabolic characteristics of various brain regions of new daily persistent headache (NDPH) patients. Methods  ¹⁸F-FDG PET images of patients with NDPH who underwent ¹⁸F-FDG PET examination at the  Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University from May 2021 to July 2023 were collected retrospectively. Cortex ID (GE Healthcare) was used to analyze the PET images and to obtain the Z-score distribution of 26 brain regions of  the NDPH patient group. The z-score distribution was applied to evaluate the metabolic characteristics of brain regions of NDPH patients.Results  NDPH patients showed reduced metabolism in multiple brain regions such as left/right prefrontal medial region（P=0.004、P=0.009）, right posterior cingulate （P=0.003）, right precuneus （P=0.003）, left sensorimotor（P=0.036）, right anterior cingulate（P=0.040）, left anterior cingulate（P=0.037）, left posterior cingulate （P=0.037）, right parietal superior （P=0.002）, left parietal superior（P=0.019）, left prefrontal lateral （P＜0.001）, left/right parietal inferior（P＜0.001）, left/right temporal mesial （P＜0.001 ）, right temporal lateral （P＜0.001）and pons（P＜0.001）. Conclusion  ¹⁸F-FDG PET can display metabolic characteristics in different brain regions of NDPH patients, which may provide metabolic information for the pathological mechanism of NDPH and its complications.

Objective  To predict the 7-year risk of hypertension among people who underwent physical examination in functional units in Beijing, and to provide foundation data for prevention of hypertension. Methods  A total of 29 209 people in health management cohort in Beijing in 2020 were selected as research subjects. Based on the information of hypertension incidence, demography, behavior habits and blood index from 2014 to 2020, we use monofactor analysis to choose the risk factors, and establish the risk assessment model for hypertension by Logistic regression, then draw the receiver operating characteristic (ROC) curve to verify the predictive ability of the model. Results  The number of new cases of  hypertension in 7 years were 2 346, the incidence of hypertension was 8.03%; the variables were used to establish a Logistic regression model, and the final model included six variables including parental history of hypertension, body mass index, gender, marriage, exercise intensity and milk drinking frequency. The area under the ROC curve was 0.736. Conclusion  The 7-year risk of hypertension is higher in functional unit population in Beijing, and parental history of hypertension, body mass index (BMI), gender, marriage, exercise intensity and milk drinking frequency are the risk factors for hypertension. Based on this, the risk assessment and prediction model is constructed. 

Objective  To deepen the understanding of acute cerebral infarction with the onset of isolated vertigo. Methods  We retrospectively analyzed the patients with the onset of isolated vertigo that were previously treated in Department of Neurology,  China Civil Aviation General Hospital. They were divided into acute cerebral infarction group(25 cases in the case group) and non-acute cerebral infarction group(25 cases in the control group). The demographic characteristics, risk factors of cerebrovascular disease and imaging characteristics were analyzed. Results  In the case group, the proportions of males and the patients who were over 55 years old were significantly higher than those of control group  (72% vs  44% and 80% vs  52%, respectively, P<0.05 ). The proportions of patients with hypertension and diabetes in the case group were higher than those in the control group(72% vs  56%, 52% vs  40%, respectively), and the proportion of patients with hyperlipidemia was lower than those in the control group (84% vs 96%). There was no significant difference between the two groups(P＞0.05). The proportions of clinical manifestations with nausea, vomiting, hearing loss and nystagmus in the case group were higher than those in the control group (68% vs  56%, 52% vs  40%, 16% vs  4%, and 24% vs  16%, respectively), while the proportion of tinnitus was lower than that in the control group (8% vs 16%). There was no significant difference between the two groups (P >0.05). In the case group, there were 18 cases（72%） of cerebellar infarction, 5 cases（20%） of brainstem infarction, 1 case（4%） of occipital lobe infarction and 1 case（4%） of hippocampus infarction. Conclusion  Among patients with acute cerebral infarction who started with isolated vertigo，Men had a significantly higher risk of acute cerebral infarction than women, and patients over 55 years old had a significantly higher risk than the adult patients under 55 years old. 2.Head magnetic resonance imaging showed most of the infarction sites were in the blood supply area of the vertebrobasilar artery system: located mainly in the cerebellum and brainstem.

Objective  To analyze the cognitive functional differences in patients with depressive episodes regarding suicidal ideation and suicidal behavior,  and further to explore the impact of cognitive functioning on suicidal behavior. Methods  A total of 133 patients with depressive episodes who sought treatment at Beijing Anding Hospital,Capital Medical University,were selected and divided into three groups based on the presence of suicidal behavior and ideation within the past two weeks: depression control (DC) group, suicidal ideation (SI) group, and suicide attempt (SA) group. The Hamilton Depression Scale-17 item (HAMD-17),the Scale for Suicide Ideation (SSI),and the MATRICS Consensus Cognitive Battery (MCCB) were used to assess the patients' clinical symptoms and cognitive functioning. Logistic regression analysis was applied to analyze various factors.  Results  The total HAMD-17 scores of the three groups (F=59.661,P<0.001) showed statistically significant differences,with post hoc comparisons revealing significantly higher scores in the SA and SI groups compared to the DC group. MCCB results indicated that the DC group had significantly higher scores in verbal learning and memory compared to the SI group (P<0.01),and both the DC and SA groups had significantly higher scores in reasoning and problem-solving compared to the SI group (P<0.05). Logistic regression results revealed that reasoning and problem-solving (P=0.022,OR=1.067,95% CI: 1.009-1.127) and cognitive impairment factors (P<0.001,OR=1.739, 95% CI: 1.128-2.2443) were independent risk factors for suicidal behavior in patients with depressive episodes，and recurrent (P=0.003,OR=0.100,95% CI: 0.022-0.458) and social cognition (P=0.033,OR=0.953,95% CI: 0.912-0.996) were protective factors for suicidal behavior in patients with depressive episodes. Conclusion  Cognitive impairment is a crucial factor influencing the occurrence of suicidal behavior in patients with depressive episodes. 

Objective  To explore the influencing factors of adolescent mood disorder (MD) patients with attempted suicide (SA). Methods  A cross-sectional survey was conducted to recruit 105 adolescent patients with MD admitted to the children and adolescents ward of Beijing Anding Hospital, Capital Medical University from August 3,2022 to September 25,2023. They were divided into an SA group (n=41) and a non-SA group (n=64) based on the presence of SA. The general demographic data of the study subjects was collected and the scale was evaluated with the Patient Health Questionnaire 9-item Scale (PHQ-9),Generalized Anxiety Disorder 7-item Scale (GAD-7),Childhood Trauma Questionnaire (CTQ),and Barratt Impulsiveness Scale (BIS-11).  The difference of the above factors of SA was analyzed with  χ²/t text, and the relevant factors of SA were analyzed with multivariate logistic regression.  Results  The incidence of SA is 39% (41/105),with 42.5% (37/87) for females and 22.2% (4/18) for males. The results of univariate analysis showed that compared with the general demographic characteristics of patients in the SA group and non-SA group, women and mothers with lower education levels were more likely to experience SA (P<0.05). The proportion of emotional and physical neglect in the PHQ-9,GAD-7 total score,and CTQ of patients in the SA group was higher than that in the non-SA group, with a statistically significance (P<0.05). The logistic regression analysis showed that anxiety (OR=1.246,95% CI: 1.048-1.480,P=0.013) and maternal education (OR=1.522，95%CI：1.040-2.229，P=0.031) were risk factors for SA in adolescent MD patients. Conclusion  A higher incidence of SA was observed in adolescent patients with MD, accompanied by anxiety symptoms and low level of maternal education as independent risk factors for SA.

Objective  To determine the optimal signal-to-cutoff (S/CO) value of the positive predictive value of hepatitis C virus  (HCV) antibody ≥ 95%,and to determine the medical decision level of the laboratory and to establish the methodology for exploring the 95% positive confidence intervals for different systems of HCV antibody detection reagents. Methods  From July 2021 to February 2022,a total of 282 plasma samples from outpatients and inpatients in Beijing Ditan Hospital,Capital Medical University were subjected to both the initial screening of chemiluminesent immunoassay (CLIA) and HCV RNA testing.Among the samples,252 showed reactivity in the antibody initial screening (S/CO ≥ 1),while 30 samples tested negative; supplemental confirmation test of recombinant immunoblot assay (RIBA) was performed and the results of HCV RNA were consulted. The antibody S/CO value of HCV infection was obtained by receiver operating characteristic  (ROC) curve when the positive predictive value in our laboratory was ≥ 95%.  Results  The 30 samples tested negative in the initial screening also showed negative results for HCV RNA testing and RIBA. Excluding 16 cases with unclear history of HCV infection,among 236 samples with HCV antibody S/CO ≥ 1,188 samples were true positive and 48 samples were negative. ROC analysis showed that the optimal S/CO value was 7.83,the sensitivity was 93.09%,the specificity was 95.83% and the area under the curve (AUC) was 0.98. (P < 0.000 1). Conclusion  It is helpful for clinical diagnosis and treatment to provide the antibody S/CO value of HCV infection when the positive predictive value was ≥ 95% in our laboratory.

Objective  To investigate the correlation between visceral fat area (VFA) and abdominal aortic calcification in patients with maintenance hemodialysis (MHD). Methods  Via cross-sectional survey,MHD patients in Beijing Luhe Hospital,Capital Medical University from April 2019 to May 2020 with complete data were selected and subjected to body composition analysis,excluding malnourished patients. The patients were divided into 4 groups according to the degree of calcium by Abdominal Aortic Calcification Score (AACs),and the clinical characteristics and VFA level were compared. Multivariate Logistic regression was used to analyze the risk factors of abdominal aortic calcification (AAC),and the predictive value of VFA level to abdominal aortic calcification was analyzed by receiver operating characteristic (ROC) curve.  Results  A total of 152 patients with MHD were included in this study and divided into non-AAC group (n=32),mild AAC group (n=45),moderate AAC group (n=54) and severe AAC group (n=21). There were statistically significant differences in serum phosphorus,intact parathyroid hormone (iPTH),high density lipoprotein-cholesterol (HDL-C),VFA and whether diabetes mellitus was combined among 4 groups (P < 0.05). Univariate correlation showed that AACs score of non-malnourished MHD patients was significantly positively correlated with diabetes,serum phosphorus,iPTH,and VFA level (r=0.188,0.238,0.223,0.392,P < 0.05),was negatively correlated with HDL-C level (r=-0.228,P < 0.05). Multivariate Logistic regression analysis showed that VFA and serum phosphorus were independent risk factors for AAC in MHD patients. ROC curve showed that the area under curve (AUC) of VFA in non-malnourished MHD patients for predicting AAC was 0.725 (P < 0.05),which had high predictive value. Conclusion  For non-malnourished MHD patients,elevated VFA is associated with the severity of AAC and is an independent risk factor for AAC,which may be a biological indicator for predicting the occurrence of AAC.

Objective  To examine the influence of cognitive function on suicidal ideation among patients with late life depression (LLD). Methods  Between January 2021 and December 2022,we enrolled 103 LLD patients from Beijing Anding Hospital, Capital Medical University. These patients were divided into two groups based on the presence of suicidal ideation (encompassing suicidal thoughts and attempted suicidality) in the past two weeks: those without suicidal ideation (n=37) and those with suicidal ideation (n=66). We collected general demographic data and assessed cognitive functions using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The study employed Logistic regression to determine significant factors.  Results  There were statistically significant differences in RBANS total score,immediate memory, and vocabulary learning between suicidal ideation and without suicidal ideation groups ［RBANS total score (137.26±28.78) vs (150.00±25.53),immediate memory (22.39±7.47) vs (26.41±6.74),vocabulary learning (16.02±4.59) vs (18.43±4.18),all P<0.05］; The logistic regression analysis indicated that the score of vocabulary learning(OR=0.012,P=0.012) and the first onset age(OR=1.036,P=0.024) served as a risk factors against suicidal ideation among LLD patients. Conclusion  The lower the vocabulary learning score and the older the age of the first onset suggested that the LLD patient may be at higher risk of suicide, which may be used as an early indicator to identify suicide risk.

Objective To explore the influencing factors of preoperative ^99mTc-MIBI single-photon emission computed tomography/computed tomography（SPECT/CT） in patients with suspected primary hyperparathyroidism (PHPT). Methods  A total of 257 patients with suspected PHPT who underwent preoperative MIBI SPECT/CT from January 2019 to August 2023 were retrospectively reviewed. The laboratory examination,pathological features,and imaging features between the positive and negative MIBI SPECT/CT groups were compared to each other. Multivariate Logistic regression analysis was used to identify the influencing factors of MIBI SPECT/CT results.  Results  The serum total calcium,parathyroid hormone（PTH）,and alkaline phosphatase（ALP） levels were significantly increased in the positive group than the negative group (P < 0.05); The pathological type,maximum diameter,volume,and location of the lesion showed statistically significant differences between the two groups (P < 0.05). Logistic regression analysis showed that preoperative serum PTH levels,pathological type,location,and maximum diameter of lesions were significantly correlated with positive MIBI SPECT/CT (P < 0.05). Conclusion  The preoperative MIBI SPECT/CT in patients with suspected PHPT were affected by multiple factors. The preoperative serum PTH level,pathological type,location and the maximum diameter of the lesion were independent factors for MIBI SPECT/CT. 

目的 探讨应激性高血糖比值(stress hyperglycemia ratio, SHR)对急性心肌梗死(acute myocardial infarction, AMI)患者院内主要不良心血管事件(major adverse cardiovascular events, MACEs)的预测价值。方法 回顾性分析2022年1月至2022年12月在首都医科大学附属北京同仁医院心血管中心住院，资料完整的AMI患者共442例。根据入院测得的第一个静脉随机血糖(admission blood glucose, ABG)和糖化血红蛋白(glycosylated hemoglobin, HbA1c)值计算得出SHR。根据是否发生院内MACEs分为MACEs组(n=79)和非MACEs组(n=363)。采用多因素Logistic回归分析探讨AMI患者院内MACEs发生的危险因素。应用受试者工作特征(receiver operating characteristic, ROC)曲线评估SHR对院内MACEs发生的预测价值。结果 院内MACEs组的SHR显著高于非MACEs组(1.30±0.44 vs 1.15±0.17,P<0.001)。多因素Logistic回归分析中，SHR是AMI患者院内MACEs发生的危险因素(OR=2.69, 95%CI:1.26～5.73,P=0.011)。ROC曲线分析结果显示，SHR对AMI患者院内MACEs有预测价值(AUC=0.63, 95%CI:0.57～0.70,P<0.001),最佳截断值为1.29,预测价值高于HbA1c(P=0.011)。结论 SHR是AMI患者院内MACEs发生的危险因素，对院内MACEs有预测价值，最佳截断值为1.29,优于HbA1c。

糖尿病视网膜病变(diabetic retinopathy, DR)是糖尿病常见的微血管并发症之一，也是目前导致成人失明的主要原因。近年来DR的治疗手段不断丰富，其中药物治疗相关的临床和基础研究更是获得了很大的进展。本文总结了DR相关治疗药物的现况和进展，包括羟苯磺酸钙(calcium dobesilate, CAD)、胰激肽原酶(pancreatic kininogenase, PK)、非诺贝特(fenofibrate)、抗血管内皮生长因子(anti-vascular endothelial growth factor, anti-VEGF)药物、胰高血糖素样肽-1受体激动剂(glucagon-like peptide-1 receptor agonist, GLP-1RA)、钠-葡萄糖共同转运蛋白2抑制剂(sodium-dependent glucose transporter 2 inhibitors, SGLT-2i)、非奈利酮(finerenone)、抗氧化剂、天然产物及褪黑素(melatonin)等。

龚树生教授,医学博士,教授,博士研究生导师,一级主任医师。世界卫生组织中国防聋合作中心常委、首席专家。享受国务院政府特殊津贴专家,中央保健会诊专家。国家残疾预防专家咨询委员会委员,中国听力医学发展基金会理事长。首都医科大学耳聋疾病临床诊治与研究中心主任。中华预防医学会残疾预防与控制专业委员会副主任委员;中华医学会耳鼻咽喉头颈外科分会常委、耳科学组组长;北京医学会耳鼻咽喉头颈外科分会副主任委员;中国康复辅助器具协会助听器人工耳蜗专业委员会学术专家组副组长。主持或参与承担“973”课题、国家重点研发计划、国家自然科学基金重点项目及面上项目、卫生部(现国家卫生健康委员会)行业基金等多项课题,发表学术论文200余篇,其中SCI论文90余篇。现任《中华耳科学杂志》副主编、《临床耳鼻咽喉头颈外科杂志》副主编。

吉训明教授是中国工程院院士，研究领域为神经病学。在动脉和静脉性卒中的发病机制、脑血流重建和神经保护等方面取得较为系统的原创性成果，并推进其临床转化与应用。(1)提出“低氧组织适应”学说，发现并证实低氧适应脑保护作用，阐明其抗缺血缺氧损伤机制；(2)建立“肢体远隔缺血适应”新方法，证实其防治缺血性脑卒中的作用，揭示多靶点协同调控的“干预外周、保护中枢”机制，奠定临床转化基础；(3)研究开发双上肢远隔缺血适应专用设备，获医疗器械注册证和生产许可证，实现临床转化；(4)创建双上肢远隔缺血适应防治缺血性脑卒中临床应用新策略，制定国际指南。这些科研突破对认识动静脉性卒中的损伤机制、系统救治及其神经保护策略均有重要意义，多项研究成果被写入国际学术专著、国际指南和国际经典教科书。

目的 探讨中性粒细胞与淋巴细胞比率(neutrophil to lymphocyte ratio, NLR)、血小板(platelet, PLT)计数联合D-二聚体(D-dimer, D-D)对重症肺炎合并脓毒症患儿预后的预测价值。方法 回顾性分析首都医科大学附属北京儿童医院急诊重症监护病房(emergency intensive care unit, EICU)2018年1月～2023年1月收治的310例重症肺炎合并脓毒症患儿的临床资料，对所有患儿治疗出院后进行门诊复查或电话随访并根据相关标准对患儿预后进行评估，根据预后情况分为预后良好组(n=198)和预后不良组(n=112)。利用医院电子病历系统，收集全部患儿年龄、性别等基本临床资料，记录入院时患儿早期预警评分[慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、序贯器官衰竭评分(sequential organ failure assessment, SOFA)],并收集诊断患儿入院24 h内的实验室指标。采用Logistic回归分析肺炎合并脓毒症患儿发生预后不良的相关影响因素，采用受试者工作特征(receiver operating characteristic, ROC)曲线分析NLR、PLT计数、D-D预测重症肺炎合并脓毒症患儿预后的灵敏度、特异度、准确度。结果 两组患儿年龄、性别差异无统计学意义(P>0.05)。预后不良组APACHEⅡ、SOFA评分显著高于预后良好组(P<0.05)。预后良好组NLR、D-D水平均低于预后不良组，PLT计数水平高于预后不良组(P<0.05)。将单因素分析的结果中P≤0.05的变量纳入多因素Logistic回归确定影响预后的独立危险因素。调整年龄、性别、APACHEⅡ评分等混杂因素，连续变量原值收入，结果表明，NLR、D-D水平是预后的保护因素(OR<1,P<0.05),PLT计数水平是预后的危险因素(OR>1,P<0.05)。ROC曲线分析结果显示，三项指标联合预测的曲线下面积(area under the curve, AUC)为0.949,灵敏度为94.95%,特异度为82.14%,准确度为90.32%,三者联合预测效能价值高。结论 重症肺炎合并脓毒症患儿的外周血NLR、PLT计数、D-D水平显著升高，三项联合检测在预测患儿28 d后的预后中具有重要的价值。

目的 观察帕金森病(Parkinson's disease, PD)与非PD患者罗库溴铵的神经肌肉阻滞效应。方法 纳入年龄18～65岁，美国麻醉医师协会(American Society of Anesthesiologists, ASA)Ⅰ～Ⅲ,接受丘脑底核-脑深部电刺激手术的PD患者(PD组)31例和行面神经减压的非PD患者(non-PD组)24例为研究对象。麻醉诱导单次给予罗库溴铵(0.6 mg/kg),采用四个成串刺激(train-of-four, TOF)监测肌松，记录罗库溴铵体内作用时间(the duration of 90%recovery of TOF, DURTOF 90%)、起效时间、临床作用时间、恢复指数和术毕2 h内严重呼吸系统并发症发生情况。结果 与non-PD组比较，PD组DURTOF 90%和临床作用时间均显著延长，差异有统计学意义(P<0.05);2组患者的起效时间差异无统计学意义(P>0.05)。PD患者的罗库溴铵DURTOF 90%与病程相关，病程越长，DURTOF 90%越长。2组患者术后均无严重呼吸系统并发症发生。结论 PD患者应用罗库溴铵的DURTOF 90%和临床作用时间明显延长，且DURTOF 90%与病程呈正相关。

目的 探究育龄期女性孕前保健服务模式的选择偏好，为优化生育保障体系、提高育龄期女性孕前保健服务利用率提供研究依据。方法 基于离散选择实验设计，采用文献综述和半结构化访谈，确立育龄期女性关注的5个孕前保健服务模式影响因素，即提供孕前检查医院等级、检查内容、提供形式、整合形式和检查地点距离。采用代表性抽样法，运用混合Logistics模型分析北京市育龄期女性孕前保健服务模式偏好及其异质性。结果 本研究共纳入有效样本329例。其中84.8%的受访者年龄在35岁以下，74.8%为城市居民。偏好分析结果显示，育龄期女性更倾向于接受检查地点距离近(β=-0.636,P<0.01)、检查内容为19项基本检查+饮食运动心理指导(β=0.611,P<0.01)、可以提供上门指导(β=0.410,P<0.01)、能与婚前检查相结合(β=0.225,P<0.01)的孕前保健服务模式。异质性分析结果显示，农村女性相比于城市女性更加倾向于选择可以提供上门指导和检查距离近的孕前保健服务；有过妊娠经历的女性更偏向选择检查内容包含基因检查的孕前保健服务。结论 北京市育龄期女性在选择孕前保健服务模式时最关注检查地点距离和检查内容。不同人口特征的育龄期女性对于孕前保健服务也存在不同的选择偏好。孕前检查应适应人群特征，缩短检查地点距离并推广饮食、运动和心理教育指导。

目的 探讨多囊卵巢综合征(polycystic ovarian syndrome, PCOS)患者不同临床表型性功能及其与临床和性激素特征的相关性。方法 使用女性性功能指数(Female Sexual Function Index, FSFI)调查问卷对首都医科大学附属北京妇产医院内分泌科2020年10月至2021年12月就诊的PCOS患者和对照女性进行研究。根据鹿特丹标准将PCOS分为四个临床表型组，A组：排卵功能障碍(oligo-ovulation or anovulation, OA)+雄激素过多(hyperandrogenism, HA)+多囊卵巢(polycystic ovaries, PCO);B组：OA+HA; C组：HA+PCO; D组：OA+PCO。收集可能影响性功能的临床资料并测定性激素水平，包括人体测量指标、血清促卵泡激素、促黄体生成素、催乳素和总睾酮。结果 910例PCOS患者和402例参数完整的对照女性纳入研究。A组FSFI总分最低(23.69±3.20)(P<0.05), B组、C组和D组呈顺序增加的趋势。对照组FSFI总分最高(24.96±3.79)(P<0.05)。与对照组相比，A组性功能障碍(female sexual dysfunction, FSD)风险百分比最高，为87.5%(P<0.05),其次分别为B组、C组、D组。A组FSD风险高于C组和D组(P<0.05), B组FSD风险高于D组(P<0.05)。多元线性回归分析显示总睾酮、年龄、腰围、体脂分布与女性性功能呈负相关。结论 与对照组相比，PCOS患者FSD风险较高，且与PCOS临床表型相关。同时符合PCOS三个诊断特征的经典表型FSD风险最高。总睾酮、年龄、腰围、体脂分布与PCOS患者的FSD风险相关。

目的 探讨新辅助免疫治疗后病理淋巴结转移情况及原发灶缓解程度对非小细胞肺癌(non-small cell lung cancer, NSCLC)患者预后的影响。方法 回顾性分析40例接受新辅助免疫治疗后行手术切除的NSCLC患者的临床病理资料。评估病理淋巴结分期(N1/N2)和原发灶缓解程度[完全缓解(pathological completeresponse, pCR)/主要缓解(major pathological response, MPR)/非客观缓解(non-objective response, non-OR)]与无进展生存期(progression-free survival, PFS)的关系，并构建预后风险分层模型。结果 病理淋巴结分期和原发灶缓解程度单独考虑时，与PFS无显著相关性，且两者无显著交互作用。对于N1患者，pCR/MPR的PFS优于non-OR (P=0.038);对于N2患者，原发灶缓解程度与PFS无显著相关性。将患者分为低危组(N1+pCR/MPR)和高危组(N1+non-OR/N2),两组PFS差异显著(P=0.003)。结论 新辅助免疫治疗后，病理淋巴结转移程度和原发灶缓解程度是NSCLC预后的关键影响因素。基于两者的预后风险分层模型有助于指导个体化治疗决策，但仍需前瞻性研究验证。

目的 探索绝经过渡期和绝经后期女性雄激素水平对性功能的影响。方法 募集2023年1月至2023年12月首次来首都医科大学附属北京妇产医院就诊的绝经过渡期和绝经后期女性，纳入符合纳入标准和排除标准的女性450例，收集人口统计学资料和既往病史、应用女性性功能指数(female sexual function index, FSFI)量表、改良Kupperman评分量表评价女性性功能和围绝经期症状；测量人体测量学指标；检测实验室指标包括总睾酮、游离睾酮、生物活性睾酮、4-雄烯二酮和雌激素。采用相关和回归分析探索雄激素水平对女性性功能的影响。结果 与绝经过渡期相比，绝经后期女性FSFI量表的各维度得分和总分明显下降(P<0.05)。多元线性回归分析显示生物活性睾酮水平与性唤起得分(β=0.190,P<0.05)和FSFI总分(β=0.178,P<0.05)呈正相关，游离睾酮水平与性欲(β=0.166,P<0.05)、性满意度(β=0.176,P<0.05)、FSFI总分(β=0.126,P<0.05)呈正相关。改良Kupperman评分与FSFI总分及各维度得分呈负相关(P<0.05)。结论 女性性功能障碍与游离睾酮和生物活性睾酮水平下降有关，与总睾酮水平无关。

目的 应用Meta分析综合评价的人工智能(artificial intelligence, AI)技术辅助诊断急性白血病的潜在价值。方法 研究人员对Ovid-Medline、Embase、IEEE Xplore和Cochrane Library等四个数据库进行系统检索，截至2023年6月1日，以“人工智能、急性白血病、骨髓穿刺、血涂片、辅助诊断分析”为主题词进行检索，对纳入的文献采用Stata 17.0,RevMan 5.4和Meta-Disc 1.4软件进行了Meta分析。结果 共纳入了15项研究涵盖了20 214张图像，合并灵敏度、特异度、阳性似然比(positive likelihood ratio, PLR)、阴性似然比(negative likelihood ratio, NLR)、诊断比值比(diagnostic odds ratio, DOR)分别为0.96 (95%CI:0.92～0.97), 0.97 (95%CI:0.94～0.98), 29.9 (95%CI:17.2～51.9), 0.05 (95%CI:0.03～0.08), 652 (95%CI:290～1 464),绘制综合受试者工作特征曲线(summaryreceiver operating characteristic, SROC),计算曲线下面积(area under the curve, AUC)为0.99。Deeks漏斗图表明不存在发表偏倚，P=0.083。结论 AI技术在急性白血病筛查及早期诊断时的灵敏度、特异度及AUC值均较高，具有临床推广应用的潜在价值，由于本文纳入研究的数量和质量的局限性，使得研究间存在显著的异质性，未来需要对这种异质性的潜在来源进行进一步的分析，为急性白血病AI辅助诊断规范化提供更加准确依据。本研究已在PROSPERO注册(编号：CRD42023480455)。