Objective:To investigate the association of Subclinical Carotid AtheroSclerosis (SCAS) and prediabetes or Diabetes Mellitus (DM)in the healthy people.Methods:From September 2018 to June 2019, participants who underwent physical examination in the Health Management Center of Beijing Tiantan Hospitial were enrolled consecutively. The baseline characters were collected prospectively. Carotid Ultrasound was evaluated by radiologists according to the standard operating protocol. Univariable analysis and multivariable logistic analysis were used to estimate the association of prediabetes or DM with SCAS.Results:Totally 401 participants were eligible and enrolled. The mean age was (52.2±10.4) years and 43.7% (252/401) of them were females. The prevalence of DM and SCAS were 16.4% (66/401) and 48.9% (196/401) respectively. In the univariate analysis, elder age (≥60 years old) ( OR=5.93, 95% CI: 3.86-9.09, P<0.001), hypertension ( OR=2.76, 95% CI: 1.84-4.15, P<0.01), prediabetes( OR=1.67, 95% CI: 1.08-2.58, P<0.05) and DM ( OR=3.60, 95% CI: 1.97-6.58, P<0.01), cigarettes smoking ( OR=2.64, 95% CI: 1.82-3.81, P<0.001), lower HDLlevel<1.04 mmol/L ( OR=1.58, 95% CI: 1.04-2.42, P<0.001) and hyperhomocysteinemia (≥15 μmol/L)( OR=1.69, 95% CI: 1.17-4.04, P<0.01) were associated with higher prevalence of SCAS. On the contrary, female sex ( OR=0.53, 95% CI: 0.39-0.74, P<0.001) was associated with lower prevalence of SCAS. In the multivariable logistic analysis, elder age(≥60 years old) ( OR=6.04, 95% CI: 3.13-11.7, P<0.01), hypertension ( OR=2.14, 95% CI: 1.13-3.87, P<0.05), cigarettes smoking ( OR=2.19, 95% CI: 1.21-3.98, P<0.05) and DM ( OR=2.32, 95% CI: 1.16-4.67, P<0.05) were associated with SCAS independently. The association between prediabetes and SCAS was not statistically significant. Conclusions:DM is independently associated with SCAS in neurological healthy people, while prediabetes tended to increase the risk of SCAS.

Objective To compare minimally invasive percutaneous nephroscope and channel percutaneous nephroscope clinical curative effect for the treatment of kidney stones.Methods According to the digital table, 1 10 cases of patients with renal stones were selected and randomly divided into the control group 58 cases and obser-vation group of 52 cases.The control group underwent big channel percutaneous nephrolithotomy(PCNL),the observa-tion group were treated by minimally invasive percutaneous nephrolithotomy(MPCNL).Compared the two groups of patients with stone size,operation time,bleeding volume,decreased hemoglobin values before and after operation,and one-staged stone clearance rate.The changes of renal function in the two groups of patients before and after operation were analyed.Results The two groups with operation were completed successfully,no bleeding and other operation condition happened.The operation hemorrhage of the control group was (118.7 ±31.3)mL,the operation hemorrhage of observation group was (56.8 ±31.7)mL,there was a significant difference between the two groups (t=-10.192, P<0.05).In the control group,the stone size,operation time,operation decreased hemoglobinvalue and one-staged stone clearance rate were (19.2 ±4.8)mm,(115.8 ±44.7)min,(11.2 ±3.9)g/L,88.5%.In the observation group,the stone size,operation time,operation decreased hemoglobinvalue and one-staged stone clearance rate were (21.5 ±7.3)mm,(126.3 ±25.7)min,(56.8 ±31.7)g/L,78.1%.The two groups showed no significant differ-ences (P>0.05).Renal function of the two groups were not significantly changed before and after 4 weeks of opera-tion,the two groups showed no significant differences(P>0.05 ).Conclusion The curative effects of two kinds of operations are similar,but the amount of hemorrhage of minimally invasive nephrolithotomy is less.Two kinds of opera-tion methods had no significant effects on patients renal function.

Objective:To observe any differential clinical effect of supplementing ultrasound-guided injection of the subacromial bursa with extracorporeal shock wave stimulation in the treatment of non-calcific tendinitis of the supraspinatus tendon.Methods:Sixty individuals with non-calcific tendinitis of the supraspinatus tendon were randomly divided into an observation group and a control group, each of 30. Both groups received routine medication, health education and extracorporeal shock wave treatment, but the observation group additionally received ultrasound-guided injection of compound betamethasone injection plus 2% lidocaine intothe subacromial bursa. The treatment′s effect was evaluated using a visual analogue scale (VAS) and the UCLA shoulder rating scale (UCLA). Absorption of hydrops in the subacromial bursa was assessed using ultrasound imaging after 7 and 14 days of the treatment.Results:After 7 and after 14 days the average VAS scores had decreased significantly, while the average UCLA score had increased significantly. At both time points the observation group′s average results were significantly better than those of the control group. The total effective absorption rate of hydrops in the subacromial bursa in the observation group (80.0%) was significantly higher than in the control group after 14 days of treatment.Conclusion:Extracorporeal shock wave stimulation combined with injection of the subacromial bursa can effectively alleviate the pain of non-calcific tendinitis of the supraspinatus tendon, improve joint function, and promote the absorption of hydrops.

ObjectiveTo investigate the efficacy and safety of artificial liver support therapy with an Evanure-4A selective membrane plasma separator and its influence on platelet count in the treatment of patients with acute-on-chronic liver failure （ACLF） patients with different platelet counts. MethodsA total of 302 patients with ACLF who were hospitalized in Department of Hepatology， Chengdu Public Health Clinical Medical Center， from January 2021 to May 2023， were enrolled， and according to the platelet count （PLT）， they were divided into group A （25×10⁹/L — 50×10⁹/L） with 101 patients， group B （51×10⁹/L — 80×10⁹/L） with 98 patients， and group C （81×10⁹/L — 100×10⁹/L） with 103 patients. In addition to medical treatment， all patients received different modes of artificial liver support therapy based on their conditions， including plasma perfusion combined with plasma exchange， double plasma molecular adsorption combined with plasma exchange， and bilirubin system adsorption combined with plasma exchange. The paired t-test was used for comparison of continuous data before and after treatment in each group； an analysis of variance was used for comparison between multiple groups， and the SNK-q test was used for further comparison between two groups； the chi-square test was used for comparison of categorical data between multiple groups. ResultsOf all 302 patients， 268 （88.74%） achieved varying degrees of improvement in clinical symptoms after artificial liver support therapy. After treatment， all three groups had varying degrees of reductions in alanine aminotransferase （t=14.755， 21.614， and 15.965， all P<0.001）， aspartate aminotransferase （t=11.491， 19.301， and 13.919， all P<0.001）， total bilirubin （t=19.182， 17.486， and 21.75， all P<0.001）， and international normalized ratio （INR） （t=3.497， 3.327， and 4.358， all P<0.05）. After artificial liver support therapy with an Evanure-4A selective membrane plasma separator， PLT in group A decreased from （37.73±6.27）×10⁹/L before treatment to （36.59±7.96）×10⁹/L after treatment， PLT in group B decreased from （66.97±7.64）×10⁹/L before treatment to （62.59±7.37）×10⁹/L after treatment， and PLT in group C decreased from （93.82±5.38）×10⁹/L before treatment to （85.99±12.49）×10⁹/L after treatment； groups B and C had significant reductions in PLT after treatment （t=12.993 and 8.240， both P<0.001）， but there was no significant difference in group A （P>0.05）. There was no significant difference in the incidence rate of adverse reactions during artificial liver support therapy between the three groups （P>0.05）. ConclusionArtificial liver support therapy can improve liver function and INR in patients with ACLF. The use of Evaure-4A selective membrane plasma separator during artificial liver support therapy has little influence on platelets， and it is safe in the treatment of ACLF patients with a significantly lower level of platelets.