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 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 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.

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 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 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 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 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. 

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 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 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 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 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 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 establish the fingerprints of the standard decoction of radix Paeoniae Alba, and to identify the active ingredients of radix Paeoniae Alba, in order to provide theoretical basis for the quality control and clinical application of radix Paeoniae Alba. Methods  Ten batches of radix Paeoniae Alba were collected and the standard decoction of radix Paeoniae Alba was prepared; the fingerprints of the standard decoction of radix Paeoniae Alba were established by ultra performance liquid chromatography (UPLC）, and the fingerprints were analyzed by the 2012 version of the Fingerprint Similarity Evaluation System for Traditional Chinese Medicine; and the common peaks were identified by comparing with the control product, and by checking the mass spectral data with the literature. Results  The fingerprints of 10 batches of standard decoction of radix Paeoniae Alba were identified with 22 common peaks, and the peaks were well separated, with the similarity of each sample>0.9. Five common peaks were recognized, which were catechin, albiflora, paeoniflorin,  pyrethrin II, and benzoylpaeoniflorin, respectively. Conclusion  The established fingerprint method has good precision, reproducibility and stability, and can provide a basis for the quality evaluation of radix Paeoniae Alba.

Objective  To evaluate the correlation between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods  All patients were diagnosed with aSAH and received microsurgery clipping at the Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University from December 1, 2019 to June 1, 2022. The patients received head computed tomography (CT) and subdural ICP monitoring devices were kept to monitor the ICP. The ONSD were measured with CT and ICP was recorded. The agreement among the three observers was evaluated with intraclass correlation coefficient (ICC), and the regression of ONSD and ICP was evaluated with Spearman's correlation coefficient. Results  A total of 184 patients were included, with 282 data of ONSD and ICP recorded. The median ICP was 12 (9, 18) mmHg (1 mmHg=0.133 kPa)， and the median ONSD was 5.59 (5.26, 5.99) mm. The ICC of left and right ONSD measured by three observers was 0.895 (0.872-0.915, P<0.001) and 0.869 (0.841-0.894, P<0.001), respectively. There was a significant positive correlation between ONSD and ICP (r=0.273，95% CI: 0.158-0.381, P<0.001). The area under the receiver operating characteristics curve of ONSD to predict ICP>22 mmHg was 0.753 (95% CI: 0.670-0.836, P<0.001), The cutoff point was 5.61 mm, with 85.2% sensitivity and 55.3% specificity. Conclusion  Measurement of ONSD by CT is repeatable, and it significantly correlates by ICP. 

Objective  To evaluate the influence of vagus nerve stimulation on renal function in septic rats and explore its mechanism. Methods  Forty male SD rats were divided into four groups：sham group, sepsis group, vagus nerve stimulation（VNS）group, and alpha7 nicotinic acetylcholine receptors（α7nAChR）antagonist group（n=10）. Rats in sham injury group only underwent laparotomy to expose the cecum, and then the cecum was returned to the abdominal cavity. Sepsis rat model was constructed by cecal ligation and perforation（CLP）. Rats in VNS group were given electrical stimulation on left cervical vagus nerve for 20 min after CLP. Rats in α7nAChR antagonist group were intraperitoneally injected with 2 mg/kg methyllycaconitine（MLA） at 30 min before CLP. At 24 h after CLP, serum of rats was collected to detect levels of blood urea nitrogen（BUN）, serum creatinine（Scr）, tumor necrosis factor-α（TNF-α）and interleukin-6（IL-6）by biochemical and enzyme-linked immunosorbent assay（ELISA）. The 24 h urine volume of each rat was collected, and the 24 h urine volume per kilogram body weight of each rat was calculated. Urinary neutrophil gelatinase-associated lipocalin（NGAL）and kidney injury molecule-1（KIM-1）were analyzed by ELISA. hematoxylin-eosin (HE) staining and TdT-mediated dUTP nick-end labeling (TUNEL) staining were performed to evaluate renal histopathological changes and tubule cell apoptosis. Results  ① The levels of BUN, Scr, TNF-α and IL-6 of rats in sepsis group were significantly higher than those in sham group and VNS group（P<0.01）. ② The 24 h urine volume per kilogram body weight of rats in sepsis group was significantly lower than that in sham group and VNS group （P<0.01）. ③ The levels of urinary NGAL and KIM-1 in sepsis group were significantly higher than those in sham group and VNS group（P<0.01）. ④ As compared with those of rats in sham group and VNS group, the renal histological damage score and the renal tubule apoptotic cell coun of rats in sepsis group were significantly increased（P<0.01）. ⑤ Scr, BUN, TNF-α, IL-6, urinary NGAL, urinary KIM-1, 24 h urine volume per kilogram, renal histological damage score, and renal tubule cell apoptosis count in sepsis group showed no significant difference from α7nAChR antagonist group（P>0.05）. Conclusion  Electrical stimulation of vagus nerve can significantly alleviate sepsis-induced acute kidney injury in rats，through the activation of α7nAChR dependent cholinergic anti-inflammatory pathway.

Objective  To explore the risk factors of postoperative complications after uniportal-video-assisted thoracic surgery(VATS) lobectomy or segmentectomy in elderly patients with lung cancer. Methods  Lung cancer patients aged 60 years or older who underwent radical lobectomy or segmentectomy by uniportal-VATS from January 2020 to December 2021 were retrospectively studied. Preoperative and postoperative clinical data,including age,gender,smoking index,preoperative comorbidities,respiratory function,Charlson Comorbidity Index,surgical procedure,operation time et al.were collected.Univariate and multivariate Logistic regression were used to analyze risk factors.  Results  A total of 387 patients,comprising 171 (44.2%) male and 216 (55.8%) female were enrolled. The median age was 67 (range 60-87)years. Postoperative complications were observed in 66 (17.1%) patients; postoperative mortalities occurred in 1(0.3%) patient. Univariate and multivariate analyses showed that male (P=0.020),forced expiratory volume in the first second(FEV1)<1.5L(P=0.017),diffusion capacity of the lungs for carbon monoxide as a percentage of the predicted value(DLCO%pred)<80%(P=0.016),preoperative pulmonary comorbidities(P<0.001),preoperative stroke(P<0.001) and operation time≥3 h(P=0.018) were associated with postoperative complications. And preoperative pulmonary comorbidities(P<0.001) and operation time≥3 h(P=0.002)were associated with postoperative pulmonary complications. Conclusion  Elderly patients with lung cancer may have postoperative complications due to preoperative pulmonary comorbidities,poor lung function and longer operation time and so on. Therefore,the physiological status of elderly lung cancer patients should be fully evaluated preoperatively. By strengthening perioperative management,we may reduce the effect of postoperative complications on the treatment effect of uniportal-VATS surgery in elderly lung cancer patients.

Objective  To investigate the cognitive functions and processing disparities between individuals dominated by the Fire Element and those dominated by the Water Element, based on the theory of the Five Elements in traditional Chinese medicine (TCM). The objective is to lay a foundation for further enriching the theoretical framework of TCM's Five Elements theory and advancing the development of a localized personality theory model in China. Methods  Participants were recruited and screened  by using the previously devised “Quantitative Standard for Facial Phenotypic Classification of TCM Five Elements People” to identify typical individuals dominated by the Fire and Water Elements. Cognitive performance was assessed by using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) cognitive function assessment tool, along with the Top-down and Bottom-up cognitive psychological test paradigms. Independent sample t-tests were employed to analyze cognitive function differences between the two participant groups. Results  Of the recruited participants, 24 were classified as Fire Element individuals and 20 as Water Element individuals. In comparison to the Water Element group, the Fire Element group exhibited significantly higher scores in the attention function dimension. In RBANS cognitive tasks, the Fire Element group achieved higher scores in digit span and coding tasks. In the Bottom-up cognitive psychological test paradigm, the Fire Element group displayed shorter reaction times and higher accuracy in long-term cognitive processing. In contrast, Water Element individuals demonstrated a statistically significant negative difference in accuracy in short-term processing (P < 0.05). Conclusion  In the Five elements of traditional Chinese medicine, the Five Elements group is more likely to be highly focused and attracted by the cue, but the attention maintenance time is shorter. At the same time, the Water Elements group has a longer attention reaction time, is less likely to be affected by the cue, and the attention stability is stronger.

目的 探讨T-LAK细胞源蛋白激酶/PDZ连接激酶（T-LAK cell-originated protein kinase/PDZ-binding-kinase,TOPK/PBK）在卵巢癌中的表达情况以及TOPK/PBK抑制剂HI-TOPK-032对卵巢癌细胞增殖的影响。方法 利用基于基因表达水平值的交互式分析（gene expression profiling interactive analysis, GEPIA）数据库分析TOPK/PBK在卵巢癌与正常卵巢组织中的表达差异。噻唑蓝法（methyl thiazolyl tetrazolium, MTT）细胞活力和增殖检测实验及平板克隆实验分析HI-TOPK-032对OVCAR3及SKOV3细胞增殖能力的影响，构建卵巢癌裸鼠皮下瘤模型验证HI-TOPK-032对卵巢癌瘤体生长能力的影响。结果 与正常卵巢组织相比，卵巢癌中TOPK/PBK的表达显著升高（P<0.05）。同时，小分子抑制剂HI-TOPK-032可抑制TOPK/PBK表达，致OVCAR3及SKOV3细胞的增殖能力明显下降（P<0.0001）,裸鼠皮下成瘤实验也表明HI-TOPK-032处理组瘤体质量[（0.670±0.450）g vs（1.514±0.358）g]和体积[（0.418±0.171）cm³ vs（0.973±0.262）cm³]均显著小于对照组。结论 TOPK/PBK在卵巢癌中高表达，TOPK/PBK抑制剂HI-TOPK-032可抑制卵巢癌细胞增殖。这一发现提示TOPK/PBK可能成为卵巢癌的一个新的治疗靶点。

目的 探讨围绝经期及绝经后期女性人体体成分与腰椎骨密度(bone mineral density, BMD)之间的关系，进一步分析该人群骨量减少的影响因素。方法 招募2021年10月至2024年3月于首都医科大学附属北京妇产医院内分泌科就诊的围绝经期及绝经后期女性300例为研究对象。采用定量电子计算机断层扫描技术(quantitative computed tomography, QCT)测量腰椎骨密度，根据测量结果分为骨量正常组和骨量减少组，采用肌肉功能分析仪测定所有受试者的体质量、脂肪、下肢肌肉、膝关节活动等人体成分情况，采用更年期症状全面评估量表采集所有研究对象的年龄、绝经状态及活动类型。采用单因素方差分析比较骨量正常组和骨量减少组的人体体成分之间的差异性，采用多因素Logistic回归分析探讨骨量减少的危险因素。结果 300例研究对象中，围绝经期女性148例(49%),平均年龄(51.40±5.03)岁；绝经后期女性152例(51%),平均年龄(53.59±6.04)岁。绝经后期女性的骨密度低于围绝经期女性，差异有统计学意义(P<0.05)。骨量减少组118例(39%),骨量正常组182例(61%)。骨量减少组女性年龄、脂肪百分比、绝经后期占比和无锻炼占比均高于骨量正常组，差异有统计学意义(P<0.05);而下肢肌肉分布系数、下肢肌力和有锻炼占比均低于骨量正常组，差异有统计学意义(P<0.05)。Spearman相关性分析结果表明围绝经期和绝经后期女性BMD与年龄、脂肪百分比、绝经后期占比均呈显著负相关(r=-0.492、-0.125、-0.287,P<0.05),而与下肢肌肉分布系数、下肢肌力、有锻炼占比均呈显著正相关(r=0.143、0.180、0.193,P<0.05)。二元Logistic回归分析结果显示，年龄大、脂肪百分比大、下肢肌肉分布少、锻炼少是骨量减少的危险因素(P<0.05)。结论 与围绝经期女性相比，绝经后期女性的腰椎骨密度明显降低，围绝经期及绝经后期女性腰椎骨密度与人体体成分及活动类型密切相关，其中年龄大、脂肪百分比大、下肢肌肉分布少、锻炼少是骨量减少的危险因素(P<0.05)。建议临床医生关注此时期女性的腰椎骨密度及人体体成分的变化，以便通过及时合理的干预措施来提高她们的生活质量，预防骨质疏松的发生。

目的 分析多囊卵巢综合征(polycystic ovary syndrome, PCOS)女性患者体成分对肝、肾功能和血脂的影响。方法 本研究为横断面、病例对照研究，招募2020年10月至2023年12月于首都医科大学附属北京妇产医院内分泌科就诊的678例20～40岁的育龄期女性作为研究对象。根据2004年国际鹿特丹标准，将研究对象分为PCOS组(n=578)和对照组(n=100)。测量身高、体质量、腰围、臀围，并计算身体质量指数(body mass index, BMI)、测量体脂百分比(body fat percentage, BFP)、检测丙氨酸氨基转移酶(alanine transaminase, ALT)、门冬氨酸氨基转移酶(aspartate aminotransferase, AST)、肌酐(creatinine, Cre)、尿酸(uric acid, UA)、尿素氮(blood urea nitrogen, BUN)、总胆固醇(total cholesterol, TC)、三酰甘油(triglycerides, TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol, LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol, HDL-C)、脂蛋白(a)[lipoprotein(a),LP(a)]。并分析PCOS体成分对肝功能的影响。结果 PCOS组体质量、腰围、BMI均高于对照组，差异有统计学意义(P均<0.05),PCOS组ALT、AST、UA也高于对照组，差异有统计学意义(P均<0.05);PCOS组BUN、Cre、HDL-C与对照组相比，差异无统计学意义。PCOS组BFP高于对照组，差异有统计学意义(P<0.05),64.07%PCOS患者伴有超重或者肥胖。PCOS组转氨酶异常率高达12.8%,超重肥胖的PCOS患者转氨酶异常率高达17.86%,显著高于瘦型PCOS组和对照组(P均<0.05)。关于血脂方面，PCOS患者TC、TG、LDL-C、LP(a)均显著高于对照组。结论 PCOS患者尤其是那些超重或肥胖者，面临更高的肝功能受损风险和血脂异常问题。因此，针对PCOS患者的管理应特别关注其体成分对肝、肾功能和血脂的影响，通过控制体质量、改善胰岛素抵抗、调节饮食和增加运动，有助于提高PCOS患者的整体健康状况和远期生命质量。

目的 研究新型可视化工具集成的骨科机器人系统，对比可视化机器人系统与传统徒手腰椎椎弓根螺钉内固定术的置钉准确率和临床效果。方法 回顾性分析43例可视化机器人系统辅助单节段腰椎管扩大减压植骨融合内固定术患者，匹配85例传统徒手置钉法患者为对照组。通过术后腰椎电子计算机断层扫描(computed tomography, CT)影像评估椎弓根螺钉的准确性，对比两组患者的置钉优良率、钉道调整次数、螺钉调整次数、视觉模拟评分(Visual Analogue Scale, VAS)改善指数，日本骨科协会(Japanese Orthopaedic Association Scores, JOA评分)改善指数、手术时间，出血量、术后住院时间、术后并发症。结果 机器人组置钉准确率显著高于对照组(P<0.05),钉道调整次数和螺钉调整次数均显著低于对照组(P<0.05),手术时间显著长于对照组(P<0.05),其余围术期参数与对照组差异无统计学意义(P>0.05)。结论 新型可视化机器人系统辅助的置钉准确性显著优于徒手置钉，并可以减少重复调整钉道和重复置钉的次数。尽管其手术时间长于传统手术，但其临床疗效不劣于传统手术，且具有一次性置钉成功率高的优势。

目的 本研究旨在观察旋毛虫副肌球蛋白（Trichinella spiralis paramyosin,TsPmy）对于慢性结肠炎的影响。方法 首先制备TsPmy蛋白，并通过初始T细胞诱导的方法在Rag1 KO小鼠中构建慢性结肠炎模型。随后将Rag1 KO小鼠采用随机数字表法分为3组：接受CD4⁺Foxp3^-CD45RB^hi T细胞与TsPmy共处理的小鼠组、接受CD4⁺Foxp3^-CD45RB^hi T细胞与磷酸盐缓冲液（phosphate buffered saline, PBS）共处理的对照组，以及未经处理的Rag1 KO小鼠组。对小鼠进行腹腔内TsPmy预处理，并对其临床症状以及结肠缩短情况进行评估。通过苏木精-伊红染色（hematoxylin-eosin staining, HE）法观察结肠组织以评估炎症情况。此外，通过流式细胞术分析结肠固有层免疫细胞中的辅助性T细胞1（T helper 1 cell, Th1）和辅助性T细胞17（T helper 17 cell, Th17）细胞比例，以及肠道中特异性CD103⁺耐受性树突状细胞（dendritic cell, DC）的比例。结果 TsPmy能显著减轻小鼠的体质量下降、疾病活动指数、结肠组织的病理损害以及结肠固有层中炎性Th1和Th17细胞的比例，同时能增加耐受性CD103⁺DC的丰度。结论 TsPmy可能通过增加CD103⁺DC的数量并减少Th1和Th17细胞的比例来缓解慢性结肠炎，显示其具有作为潜在治疗慢性结肠炎的候选分子的可能性。

目的 探究原发性恶性高血压肾硬化(malignant hypertensive nephrosclerosis, MHTN)患者的临床病理及预后特征，明确影响MHTN患者预后的关键因素。方法 收集2012年12月至2023年6月空军军医大学西京医院经肾活体组织检查确诊的高血压肾病患者的病理及临床资料，根据病理结果区分MHTN和良性肾动脉硬化(benign arteriolosclerosis nephrosclerosis, BAN)。采用单因素和多因素Cox回归分析确定影响MHTN患者肾脏预后的危险因素，通过Kaplan-Meier生存曲线计算肾脏累积生存率。研究终点定义为终末期肾病或死亡的复合终点。结果 共计231例原发性高血压肾病患者纳入研究，其中MHTN患者75例，中位随访时间为20.8(13.2,47.1)个月，共36例(52.0%)达到肾脏复合终点。与BAN患者相比，MHTN患者平均年龄更小、临床表现更重、预后更差。单因素Cox分析显示，估算肾小球滤过率(estimated glomerular filtration rate, eGFR)、尿微量白蛋白肌酐比、N-乙酰-β-D氨基葡萄糖苷酶、血浆白蛋白、血清钙、胱抑素C(cystatin C,Cys-C)、血红蛋白(hemoglobin, Hb)、纤维蛋白原(fibrinogen, FIB)和肾脏总体慢性病理评分(Total Renal Chronic Pathological Score, TRCS)与MHTN患者肾脏复合终点的发生风险增加相关。校正病理评分后的多因素Cox分析显示，Cys-C(HR=1.490,95%CI:1.144～1.942,P=0.003)、Hb(HR=0.981,95%CI:0.963～0.999,P=0.042)、FIB(HR=1.650,95%CI:1.125～2.419,P=0.010)、TRCS(HR=1.317,95%CI:1.057～1.640,P=0.014)是影响MHTN患者肾脏预后的独立危险因素。结论 在MHTN患者中，Cys-C、FIB升高、Hb降低和更严重的肾脏病理改变预示着不良肾脏结局。进一步提升临床诊疗过程中MHTN患者的肾活体组织检查率更有助于评估患者预后。

目的 探讨维持性血液透析(maintenance hemodialysis, MHD)患者肾性贫血和血β2微球蛋白(β2-microglobulin, β2-MG)水平的相关性，为临床诊断和治疗肾性贫血提供新的观点和依据。方法 选取2021年12月至2023年12月在武汉大学人民医院确诊为终末期肾病、病情稳定的MHD患者为研究对象，根据其血红蛋白水平分为贫血组和对照组，收集患者相关临床资料和实验室检查资料。使用SPSS 22.0软件包行数据的统计学分析处理。结果 与对照组相比，贫血组血清β2-MG显著升高，患者血红蛋白与白细胞、总蛋白、白蛋白呈正相关(P<0.05),与超敏C反应蛋白(high sensitivity C-reactive protein, hs-CRP)及β2-MG呈负相关(P<0.05);多因素Logistic回归显示低血白蛋白、高β2-MG水平是MHD患者发生贫血的独立危险因素。结论MHD患者血清β2-MG水平升高与血红蛋白降低相关，低血白蛋白、高血清β2-MG是患者肾性贫血的危险因素。因此在治疗MHD患者肾性贫血时，需要尤其注意患者营养状态和β2-MG等大分子炎性毒素的清除，必要时先纠正营养不良和使用β2-MG吸附柱可能对纠正肾性贫血更为有利，从而进一步减少MHD患者心血管并发症的发生，改善预后。

神经轴突导向分子家族(slit guidance ligand, Slit)是一类高度保守的分泌型糖蛋白，与其单次跨膜受体(roundabout guidance receptor, Robo)相互作用。目前，已经在人类发现3个Slit基因(Slit1-3)和4个Robo基因(Robo1-4)。Slit3具有广泛的生物学功能，如细胞迁移、骨形成、血管生成和肿瘤发生。Slit3在不同临床疾病中的致病作用及机制尚未完全阐明，值得深入研究探索。通过研究Slit3在不同疾病中的作用和发病机制，将为探索其生物学作用及发病机制，研发靶向治疗方案提供理论依据和新思路。本文综述Slit3在各类疾病中的研究进展，并阐述其在相关疾病中的作用及可能机制。

目的 探讨一次性输尿管软镜同时行钬激光碎石取石术和肾囊肿内切开引流术治疗肾盂旁囊肿合并同侧继发性肾结石的临床治疗效果。方法 2019年9月至2023年2月，在首都医科大学附属北京同仁医院使用一次性输尿管软镜对58例肾盂旁肾囊肿合并同侧肾结石患者行钬激光碎石取石术和肾囊肿内切开引流术治疗。分别于术后1、2、6、12个月于门诊随访超声和计算机断层扫描检查以检测残结石及肾囊肿复发情况。结果 患者平均年龄分别为(39.3±15.6)岁。肾盂旁囊肿平均大小为(5.8±1.9)cm,包括54例BosniakⅠ类和4例BosniakⅡ型肾囊肿患者，肾结石的平均大小为(13.3±5.5) mm,平均手术时间为(33.4±12.1)min,平均住院时间为(2.3±0.7) d,并发症包括3例患者短暂发热(>38℃)和1例患者明显出血，无严重并发症。手术后1个月和2个月的无结石率分别为94.1%(53例)和98.3%(57例),术后1年随访期间，囊肿复发率为6.9%(4例),结石复发率为5.2%(3例)。结论 一次性输尿管软镜下行钬激光碎石取石术和肾囊肿内切开引流术同时治疗肾结石和肾盂旁囊肿是安全有效的，清石率令人满意，囊肿复发率低。

目的 分析RhD阴性患儿行神经外科手术围术期血液管理的特点以提高临床预后和安全性。方法 回顾性收集2015至2022年接受颅内占位切除的RhD阴性患儿的病历记录，分析人口学资料、实验室检测结果、备血及输血相关围术期血液管理。结果 23例RhD阴性患儿被纳入分析，患儿平均年龄(7±3.5)岁，术前22例(95.7%)申请备异体血，17例(73.9%)备血成功，5例(21.7%)术前备血未成功，从申请备血到手术的平均时间为(5.8±3)d,备异体红细胞260(260,455)mL,1例(4.3%)患儿术前储存自体全血400 mL;术中出血4.8(2.2,13.3)mL/kg,总计10例进行了输血，其中7例(30.4%)仅输入异体红细胞，1例(4.3%)输入异体红细胞及自体回收红细胞，1(4.3%)例输入自体回收红细胞，1例(4.3%)输入储存全血150 mL,输血率为43.5%,配血输注比(cross-match/transfused, C/T值)=2.7,输血指数(transfusion index, Ti)=1。术中12例(52.2%)患儿行动脉血气分析，2例(8.7%)患儿监测血栓弹力图，术后血红蛋白(117±19.4) g/L,6例(26.1%)患儿术后出现轻度贫血，2例(8.7%)中度贫血。结论 RhD阴性患儿行神经外科手术备血困难，需根据病变类型及部位针对性制定围术期血液管理方案，并采用多模式治疗策略以减少出血及对异体RhD阴性血的依赖，保障患儿手术安全。

邹丽颖,女,主任医师,副教授,硕士研究生导师。本科毕业于河北医学院(现河北医科大学)临床医学系;研究生就读于首都医科大学,获得硕士和博士学位。2005年至今在首都医科大学附属北京妇产医院从事产科临床工作。2010年至2011年,赴美国辛辛那提大学儿童医院学习胎儿医学及高危妊娠管理。2015年开始担任首都医科大学附属北京妇产医院围产医学部产一科副主任,2019年挂职青海省海东市卫生健康委副主任、海东市人民医院副院长。现任首都医科大学附属北京妇产医院围产医学部副主任,兼任中国优生优育协会生殖与孕育专业委员会副主任委员、世界中医药学会联合会优生优育专业委员会常务理事兼副秘书长、中国医药教育协会母婴健康管理专业委员会常务委员、北京医学会早产与早产儿医学分会常务委员等学术任职。

目的 比较瑞马唑仑与丙泊酚两种麻醉药对脑血管内手术的老年患者术后谵妄的发生是否存在差别。方法 选取2023年6月至2024年4月，在首都医科大学附属北京朝阳医院择期行脑血管内手术的老年患者，采用随机数字表法将患者分为瑞马唑仑麻醉组(R组)和丙泊酚麻醉组(P组),共纳入106例患者，每组53例。主要研究指标为拔管后30 min至术后7d谵妄(postoperative delirium, POD)发生率。次要研究指标为麻醉时低血压、心动过缓发生率、血管活性药物使用率、拮抗药氟马西尼使用剂量、麻醉苏醒时间、延迟拔管发生率及术后48 h患者恢复质量[采用术后康复质量15条(Quality of Recovery-15,QoR-15)问卷评估]。结果 共有103例患者(R组51例，P组52例)完成研究。R组和P组术后7d内POD发生率分别为5.88%和3.85%,两组比较差异均无统计学意义(P>0.05)。R组术中低血压和心动过缓发生率(19.60%, 9.80%)较P组(53.85%, 25.00%)显著降低，两组比较差异有统计学意义(P=0.001 3,P=0.042)。R组术中去甲肾上腺素和麻黄素使用率明显低于P组，两组比较差异有统计学意义(P=0.020,P=0.033,)。两组患者麻醉苏醒时间、拔管时间和氟马西尼使用剂量的差异均无统计学意义(P>0.05)。两组术后48 h QoR-15评分比较差异无统计学意义(P>0.05)。结论 对接受脑血管内手术的老年患者，与丙泊酚相比，瑞马唑仑不增加术后谵妄发生率，不增加麻醉苏醒和拔管时间，血流动力学更稳定，也不影响患者恢复质量。

北京时间2024年10月9日，瑞典皇家科学院宣布将2024年诺贝尔化学奖一半授予美国化学家大卫·贝克(David Baker),以表彰其在计算蛋白质设计方面的贡献；另一半则共同授予英国伦敦人工智能公司谷歌DeepMind公司的戴密斯·哈萨比斯(Demis Hassabis)和约翰·M·詹珀(John M. Jumper),以表彰其在蛋白质结构预测方面的贡献。

杨新春,主任医师、教授、博士生导师。原首都医科大学附属北京朝阳医院心脏中心主任、心内科主任、河北燕达医院医疗院长,首都医科大学心血管疾病研究所所长、首都医科大学心血管病学系副主任、北京市高血压病研究重点实验室主任。先后于日本Nihon大学留学,美国哈佛大学医学院、美国克利夫兰心脏中心、美国霍普金斯大学霍普金斯医院、英国牛津大学牛津医学中心等学习交流。获1999年赛克勒(Sackker)中国医师年度奖,2005年起为享受国务院特殊津贴专家,2012年被评为“全国卫生系统先进工作者”。在国内外学术期刊以第一作者/通信作者发表论文200余篇,SCI论文100余篇,累计影响因子280。主编《急性冠脉综合征》《现代心血管药物与临床》等10余部专著。长期从事心血管病临床医疗教学及科研工作。尤其在介入心脏病学、心律失常、冠心病及高血压病诊疗方面颇有造诣;对房扑、特发性室速、房颤的射频消融治疗做了积极地探索工作;在心脏中心和“绿色通道”的建立、管理和完善方面做出较突出的贡献。完成射频消融治疗心律失常、起搏器植入及PCI手术数千例。担任美国和欧洲心脏病学院委员、美国和欧洲心律学学会委员、国家心血管病专家委员会委员、中华医学会心血管病学分会常委、中华医学会心血管病学分会心脏康复学组组长及心脏急重症学组组长等,以及《中华心血管病杂志》《中华心律失常杂志》等期刊编委。

目的 探讨非糖尿病的慢性肾脏病（chronic kidney disease, CKD）不同肾功能分期患者中糖代谢异常的患病率及相关影响因素。方法 选择2020年4月至2022年4月于中国康复研究中心北京博爱医院肾内科住院的140例CKD患者，其中CKD早期（CKD1-3a期）34例，中期（CKD3b-4期）35例，晚期（CKD5期）71例。记录入组患者的人口统计学资料以及临床生化指标，并进行口服葡萄糖耐量试验（oral glucose tolerance test, OGTT）,测定0、1、2h的血糖、胰岛素及C肽水平，共有71例患者完成了OGTT试验。结果 （1）在CKD早期、中期、晚期的患者中，糖耐量减低的患病率分别为42.1%、41.2%、37.1%;糖尿病的患病率分别为42.1%、17.6%、34.3%;空腹血糖异常的患病率分别为29.4%、14.3%、14.1%;（2）在校正了性别、血白蛋白、血红蛋白、血压、血脂等因素后，多因素Logistic回归分析显示，CKD患者糖代谢异常的影响因素为年龄、体质量指数（body mass index, BMI）、尿酸，OR值分别为1.057、1.132、1.007,P值分别为0.028、0.035、0.012,即年龄每增加10岁，糖代谢异常发生的风险增加约57%,BMI每增加1 kg/m²,糖代谢异常发生的风险增加约13.2%,尿酸每增加100μmol/L,糖代谢异常发生的风险增加约70%。结论 （1）CKD患者糖耐量减低的患病率高达39.4%,糖尿病患者比例达32.4%,均明显高于普通人群（15.5%和9.7%）。（2）CKD患者早期即出现糖代谢异常。（3）CKD患者糖代谢异常的影响因素为年龄、BMI和尿酸。