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 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. 

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 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 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 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 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 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 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 differentially expressed proteins in cardiomyocytes after chromatin assembly factor 1 subunit B (CHAF1B) gene knockdown and predict the regulatory network, so as to provide reference for finding the potential therapeutic targets which can promote myocardial cell repair. Methods  Cell transfection and Western blotting methods were used to screen effective small interfering RNA (siRNA). Effective siRNA was used to knock down CHAF1B in human cardiac AC16 cells and then cell viability was detected by cell counting kit-8 method. The total protein was extracted, quantified, reduced, alkylated and then cleaved into peptides by trypsin. The peptides were identified by liquid chromatography with tandem mass spectrometry method. Differentially expressed proteins were identified by searching UniProt protein resource. Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, and protein-protein interaction networks (PPI) analysis were conducted. Results  The survival of cardiomyocytes was significantly inhibited after CHAF1B gene knockdown by effective siRNA; the identification results of label-free protein quantitative mass spectrometry showed that there were 69 differentially expressed proteins, of which 50 proteins were significantly up-regulated (fold change≥2，P＜0.05) and 19 were significantly down regulated (fold change≤0.5，P＜0.05). GO analysis showed that these proteins mainly participated in biological processes such as macromolecular composite subunit matrix, cell component biogenesis and assembly, mainly distributed in the cytoplasm, vesicles and other regions, and played molecular functions such as protein binding. KEGG pathway enrichment and PPI analysis showed that the differentially expressed proteins participated in 10 signaling pathways such as proteasome, aminoacyl tRNA biosynthesis, endocytosis, pyrimidine metabolism, and amino acid biosynthesis, etc. The significantly up-regulated proteins such as proteasome subunit alpha type-2 and beta type-7 as well as 26S proteasome regulatory subunit 6B and 10B participated in the proteasome pathway; seryl-tRNA synthetase, glycine-tRNA synthetase, glutamine-tRNA synthetase and lysine-tRNA synthetase mediated aminoacyl tRNA biosynthesis. The significantly down regulated proteins, including actin-related protein 2/3 complex subunit 3 and heat shock 70 000 protein 1-like, participated in endocytosis; ribonucleoside-diphosphate reductase large subunit mediated pyrimidine metabolism. The real time quantitative polymerase chain reaction results confirmed that after transfection with CHAF1B siRNA, the mRNA levels of the gene ARPC3, which synthesized the skeletal related protein 2/3 complex subunit 3, and the key gene QARS1 for aminoacyl tRNA biosynthesis, were significantly reduced in cardiomyocytes. Conclusion  CHAF1B is a key protein for the survival of cardiomyocytes and participates in the regulation of various biological processes in cardiomyocytes. Referring to its regulatory network can help identify intervention steps that promote myocardial cell repair.

Objective  To investigate the effect and mechanism of total glucosides of paeony (TGP) in the treatment of acute lung injury in mice. Methods  Twenty-four female C57 mice were randomly divided into 4 groups： control group, lipopolysaccharide (LPS) model group, TGP group (LPS+TGP), and dexamethasone (DEX) group (LPS+DEX), with 6 mice in each group. Acute lung injury model was established by nasal inhalation of LPS (4 ng/kg) for 5 consecutive days. The LPS+TGP and LPS+DEX groups were given 50 mg·kg^-1·d^-1 TGP and 5 mg·kg^-1·d^-1 DEX by gavage, respectively. The changes in body weight of the mice in each group were observed and recorded. Lung tissue was taken for hematoxylin-eosin (HE) staining to observe lung pathological damage. Flow cytometry was used to detect the changes in the proportions of dendritic cells (DC), neutrophils, and macrophages in peripheral blood, spleen, and lung tissues, as well as the proportions of M1 and M2 macrophages in lung tissues. Enzyme linked immunosorbent assay (ELISA) was used to analyze the levels of interleukin-1β (IL-1β) and interleukin-6 (IL-6) in bronchoalveolar lavage fluid. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the mRNA expression levels of IL-1β, IL-6 and tumor necrosis factor-α (TNF-α) in lung tissue. Western blotting was used to detect the nuclear transcription factor-κB p65 (NF-κB p65) and phospho-NF-κB p65 (pNF-κB p65) protein content. Results  TGP and DEX significantly improved the weight loss caused by LPS. HE staining showed that the lung tissue of mice in the LPS group had inflammatory cell infiltration, alveolar septal destruction, and alveolar interstitial thickening, which were mitigated in the LPS+TGP and LPS+DEX groups. The results of flow cytometry of peripheral blood showed that, compared with the LPS group, the proportion of neutrophils in the LPS+TGP and LPS+DEX groups was significantly decreased, while the proportions of DC and macrophages did not change significantly. The results of flow cytometry of spleen tissues showed that, compared with the LPS group, the proportions of neutrophils, DC, and macrophages in the LPS+TGP and LPS+DEX groups were significantly decreased. The results of flow cytometry of lung tissues showed that, compared with the LPS group, the proportion of macrophages in the LPS+TGP and LPS+DEX groups did not change significantly, the proportion of M1 cells decreased significantly, the proportion of M2 macrophages increased, and the proportion of neutrophil is down. ELISA results showed that, compared with the LPS group, the levels of IL-6 and IL-1β in bronchoalveolar lavage fluid were significantly decreased； RT-qPCR results showed that, compared with the LPS group, the expression levels of IL-1β, IL-6 and TNF-α mRNA in lung tissues of the LPS+TGP and LPS+DEX groups were significantly reduced. Western blotting results showed that, the protein expression of NF-κB p65 did not change significantly in the LPS+TGP and LPS+DEX groups compared with the LPS group, and the protein content of pNF-κB p65 was significantly decreased. Conclusion  TGP can improve LPS-induced acute lung injury, which may be related to the reduction of the proportion of peripheral blood neutrophils, lung neutrophils and spleen inflammatory cells, the inhibition of M1 polarization of lung macrophages, the inhibition of NF-κB activation, and the reduction of inflammatory signaling pathway and inflammatory factor release. 

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 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 evaluate the effect of prophylactic administration of low-dose dexmedetomidine (DEX) on inflammatory response in elderly patients after hip fracture surgery. Methods  Elderly patients with hip fractures who admitted to the intensive care unit (ICU) after surgery were randomly divided to two groups, labeled “DEX group” or “control group” DEX. DEX group were received a continuous infusion of 0.1 μ g·kg^-1·h^-1 DEX. Control group received 0.025 mL·kg^-1·h^-1 of 0.9% saline intravenously. The serum levels of procalcitonin and interleukin-6 in patients at 0 hours (immediate), 6 hours, 12 hours, and 18 hours after administration were detected. The hemodynamic parameters (heart index, stroke volume index, mean arterial pressure, heart rate) and the occurrence of delirium were recorded. Results  There was no statistically significant difference in the levels of procalcitonin and interleukin-6 between the two groups at each time points (P>0.05).The incidence of delirium in the DEX group was significantly lower than that in the control group (P=0.034). The number of cases of additional use of opioid in the DEX group (P=0.039) and hypertension (P=0.012) were significantly lower than those in the control group. Conclusion  Low dose DEX did not significantly reduce postoperative inflammatory indicators in elderly patients with hip fractures, but it helped to reduce the occurrence of delirium and use of opioid analyesics in patients. Low dose DEX has minimal impact on hemodynamics and may have a circulatory protective effect on patients with postoperative hypertension.

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 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 investigate the relationship between common amino acids in the blood and early mild leukoaraiosis (LA) in middle-aged and older people and its diagnostic value in screening for mild LA. Methods  Patients who were hospitalized in the Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University with complaints of dizziness or headache from August 2020 to November 2021 were included in this study,and 21 non-LA patients and 31 patients with mild LA were enrolled based on the results of head magnetic resonance imaging(MRI). Tandem mass spectrometry was used to collect the levels of 23 blood amino acid metabolites from the patients,and the differences in blood amino acid levels between the two groups were compared. Logistic regression analysis models and receiver operating characteristic (ROC) curves were used to investigate the independent risk factors for mild LA and the screening and diagnostic value of blood amino acid levels for mild LA.  Results  The differences in age,history of coronary artery disease,tyrosine and valine were statistically significant in the non-LA group compared with the mild LA group (P < 0.05). Multifactorial Logistic regression indicated that age (OR=1.232,95% CI: 1.068-1.420) and valine levels (OR=1.059,95% CI: 1.009-1.111) were independent risk factors affecting mild LA,and increasing age and elevated valine levels increased the risk of developing mild LA. The results of the ROC curve analysis indicated that the optimal cut-off values for age and valine screening for mild LA were 58.5 years and 96.305 μmol/L,respectively,with an area under the ROC curve of 0.710 (95%CI: 0.565-0.856,P<0.05) and 0.674 (95%CI: 0.509-0.840,P<0.05),respectively. Conclusion  Changes in blood levels of common amino acids correlate with early mild LA,and increasing age and elevated valine levels are independent risk factors for mild LA,both of which are of clinical value in screening for mild LA.

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 compare the clinical efficacy between unilateral biportal endoscopy (UBE) and percutaneous endoscopic lumbar discectomy (PELD) in the treatment of patients with lumbar disc herniation (LDH). Methods  A total of 87 cases of LDH treated with spinal endoscopy from March 2020 to March 2022 were analyzed retrospectively, including 39 cases by UBE and 48 cases by PELD. The relevant data of the two groups of patients were recorded separately, including age, gender, body mass index (BMI), hospital stay, surgical time, intraoperative X-ray times, bleeding volume, preoperative and postoperative hemoglobin (Hb) reduction, follow-up time, postoperative complications. The Visual Analogue Scale (VAS) for low back pain and leg pain respectively, and Oswestry Disability Index (ODI) were evaluated before surgery, 1 month, 3 months and 12 months after operation. The modified MacNab criteria were used for evaluation of the clinical outcomes at 12 months after operation. The changes of dural sac area between two groups of patients before surgery and 12 months after surgery were compared. Results  All patients successfully completed the surgery. There was no statistically significant difference in age, gender, BMI, hospital stay, surgical time, follow-up time, and postoperative complications between the two groups of patients (P>0.05). UBE group had more intraoperative bleeding compared to PELD group (P<0.05), but there was no statistically significant difference in Hb reduction (P>0.05). The times of intraoperative X-ray in the UBE group was lower than that in the PELD group (P<0.05). The VAS score of low back and leg pain and ODI in the two groups of patients at 1 month, 3 months, and 12 months after surgery were significantly reduced compared to that before surgery (P<0.05). There was no statistical difference in VAS score of low back and leg pain and ODI at each time point between the two groups of patients (P>0.05). There was no statistically significant difference in the excellent and good rate of modified MacNab criteria between the two groups after surgery (P>0.05). The dural sac area of both groups significantly increased at 12 months after surgery compared to that  before (P<0.05), and the area of UBE group was more bigger than that of PELD group (P<0.05). Conclusion  UBE and PELD can effectively relieve pain and improve the quality of life of patients with LDH. UBE has slightly more bleeding volume than PELD, but has fewer intraoperative X-ray times and a bigger increase in dural sac area.

To summarize the clinical features and genetic characteristics of children with very early onset inflammatory bowel disease (VEO-IBD) caused by mutations in the interleukin 10 receptor A gene (IL10RA). Methods  Retrospective analysis was conducted on the children with chronic diarrhea hospitalized in the  Department of Gastroenterology Beijing Children's Hospital,Capital Medical University,from March 2007 to May 2019,who were diagnosed as very early onset inflammatory bowel disease (IBD). Among them,15 cases were diagnosed because of IL-10RA gene mutation,and 15 cases with VEO-IBD caused by non IL-10RA mutations in the control group. Clinical characteristics and gene reports were statistically analyzed. Results  Children with VEO-IBD caused by IL-10RA gene mutations,11 cases of Crohn's disease (CD) and 4 cases of ulcerative colitis (UC). The clinical symptoms  were mainly chronic diarrhea (15/15 cases,100.0%) and hematochezia (15/15 cases,100.0%),Extraintestinal manifestations were oral mucosal ulcers (6/15 cases,40.0%),skin erythema (5/15 cases,33.3%),and perianal manifestations were recto-perineal fistula in 5 cases (5/15,33.3%),4 cases of anal fistula (4/15,26.7%), 3 cases of anal fissure (3/15,20.0%),1 case of coexistence of recto-perineal fistula and skin tag (1/15,6.7%), and systemic manifestations of IL-10RA mutation group, malnutrition 13 cases （13/15 cases, 86.7%） perianal diseae 13 cases (13/15 cases, 86.7%). The control group had malnutrition 6 cases (6/15 cases, 40.0%) and perianal disease 5 cases (5/15  cases,33.3%).Compared with the IL-10RA mutation group，  the difference was statistically significant (P<0.05). Among 15 children with IL-10RA mutations,a total of 9 mutation sites were detected,with c.301c>T (p.R101W) and c.537G>A (P.T179T) being the most common mutation sites. The IL-10RA mutation led to an increase in inflammatory factors,leading to intestinal inflammatory response. Both prothrombin time and partial thromboplastin time were significantly prolonged.Conclusion  Children with very early-onset inflammatory bowel disease caused by IL-10RA gene mutations have an earlier age of onset. In addition to gastrointestinal symptoms,extraintestinal manifestations and perianal lesions are more common. The most common lesions under colonoscopy are multiple ulcers in the colon,followed by inflammatory polyps. The most prevalent mutation sites were c.301c>T (p.R101W) and c. 537G>A (P.T179T). The IL-10RA mutation led to an increase in inflammatory factors,leading to intestinal inflammatory response. 

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 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 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.

Objective  To study the effect of nitric oxide （NO） on the in vitro antibacterial activity of Porphyromonas gingivalis (P.g). Methods  The antibacterial performance of different concentrations of NO (10,30,50 mmol/L) on P.g was assessed by colony forming units,total NO detection kit,reactive oxygen species detection kit,and calcium ion fluorescent probe Fluo-4 AM. Moreover,the effects of NO treatment on intracellular levels of reactive oxygen species （ROS） and calcium ions in P.g cells were also examined.  Results  NO exhibited significant in vitro antibacterial activity against in P.g cells,and its antibacterial activity was positively correlated with the concentration of NO drugs and treatment duration (P<0.05). NO treatment significantly increased intracellular levels of ROS and calcium ions in P.g cells (P<0.05). Conclusion  NO can effectively inhibit the activity and growth ability of P.g,and cause intracellular ROS and calcium ion metabolism disorders. Our study demonstrates the potential therapeutic effect and clinical application of NO donor drugs in peri-implantitis.

Objective  To investigate the genes and signaling pathways associated with drug resistance in melanoma and establish their relationship with melanoma drug resistance. Methods  A375 and M14 melanoma cells were used as the experimental model to develop a drug-resistant melanoma cell line by gradually increasing the concentration of dacarbazine (DTIC). Transcriptomics was employed to analyze significant changes in genes and pathways within the drug-resistant melanoma cell line. Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting(WB) were conducted to validate the altered genes.  Results  (1) Successful construction of melanoma drug-resistant cell lines: drug-resistant cell lines,namely A375 and M14,were successfully established by gradually increasing the dosage of DTIC. The determination of their the half maximal inhibitory concentration (IC50) values to DTIC indicated a significant change in cell sensitivity. Flow cytometry analysis revealed that drug-resistant melanoma cells exhibited a notable ability to resist apoptosis induced by DTIC. (2) Identification of genes and signaling pathways associated with melanoma drug resistance: transcriptomic analysis by the established DTIC-resistant melanoma cell lines demonstrated that increased expression of SENP1 was correlated with abnormal activation of the Hippo signaling pathway. (3) Implication of aberrant expression of ubiquitin-specific protease SENP1 in DTIC resistance: WB analysis of wild-type and drug-resistant melanoma cell lines revealed upregulation of both SENP1 and YAP expressions in drug-resistant cells. (4) The involvement of SENP1 in DTIC resistance was confirmed by gene knockout and the effect of SENP1 on ubiquitination of YAP was preliminarily confirmed by protein interaction experiments. Conclusion  A positive correlation existed between SENP1 and DTIC resistance in melanoma,which may contribute to alterations in the Hippo signaling pathway and enhance melanoma tolerance to DTIC. 

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 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 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 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 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.

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 application value of standardized nursing in multi-tracers imaging of nuclear medicine department. Methods  One hundred and ten patients who underwent positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI) with various tracer imaging techniques at the Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University from June 2020 to November 2020 were selected as the study subjects. According to the random number table method,the subjects were divided into an observation group and a control group. The control group received routine care,while the observation group received standardized care on the basis of routine care. The Self Rating Anxiety Scale (SAS) score and satisfaction survey score of two groups were compared.  Results  All 110 subjects successfully completed the examination process of tracer injection,image acquisition,and post acquisition observation,without any adverse events. After confirmation by clinical doctors,the obtained images met the diagnostic requirements. There was no statistically significant difference in gender and age between the two groups (P>0.05). The SAS score of the observation group was lower than that of the control group (t=16.310,P<0.01), but the nursing satisfaction score was higher than that of the control group (t=4.348,P<0.01). Conclusion  The standardized nursing in nuclear medicine multi-tracers imaging can reduce patients' anxiety,improve nursing satisfaction,ensure smooth completion of examinations within a limited time window,and obtain high-quality images.

Objective To explore the fluoro-18-deoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) features of bone marrow necrosis and improve the understanding of the disease. Methods  The PET/CT and clinical data of 9 patients with bone marrow necrosis diagnosed by magnetic resonance imaging (MRI) were retrospectively analyzed. Compared to MRI,the distribution of lesions was summarized. The ¹⁸F-FDG metabolic and CT features of the selected largest lesion were analyzed.  Results  There were 6 males and 3 females with a median age of 28.0 years. All patients were diagnosed with lymphoma. MRI scans of the hip,spine and knee were performed in 6,2,and 1 case respectively. The iliac lesions in 6 cases showed internal high signal intensity on T1-weighted images (T1WI),low signal intensity on T2-fat suppressed images (T2FSI),and peripheral linear hypointensity on T1WI. The iliac lesions in 5 cases demonstrated internal decreased ¹⁸F-FDG metabolism,peripheral linear increased ¹⁸F-FDG uptake and density on PET/CT. The iliac lesion in one case did not show abnormal ¹⁸F-FDG metabolism and density on PET/CT,the lesion was narrow and long on MRI. The vertebral lesions in two cases showed isointensity to hypointensity on T1WI and hyperintensity on T2FSI. On PET/CT,one vertebral lesion was isometabolic with slightly higher density,the other vertebral lesion showed reduced ¹⁸F-FDG metabolism with normal density. One femoral lesion showed high signal intensity on T1WI and low signal intensity on T2FSI,with increased ¹⁸F-FDG metabolism and density on PET/CT. PET/CT revealed more lesions beyond the scan range of MRI in 8 cases. In 8 cases,abnormal signs were demonstrated on much earlier PET/CT scans performed at a median time about 13.5 (8.25,32.75) months before the MRI scan,but no one complained of any related discomfort at that time. The iliac lesions in 5 cases had decreased ¹⁸F-FDG uptake,of which 3 lesions showed peripheral linear high-density,and 2 lesions showed no abnormal density. The iliac lesion in one case did not show abnorma^{l 18}F-FDG metabolism and density. One vertebral lesion showed reduced metabolism and isodensity. In the case with knee MRI,the earlier PET/CT showed multiple linear increased ¹⁸F-FDG uptake in the bilateral femoral heads and the humerus heads,without abnormal density. During follow up PET/CT scans,the femoral head lesions in 3 cases showed cortical fracture and collapse,the vertebral lesions 2 cases demonstrated multiple Schmorl's nodules or compression fracture. Conclusion  Decreased ¹⁸F-FDG uptake,with probably subsequent peripheral linear increased metabolism and density,is a common PET/CT feature of bone marrow necrosis. PET/CT is helpful to detect bone marrow necrosis and find multiple skeletal lesions.

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.