Objective:To explore the association between chest high resolution CT (HRCT) scoring and prognostic factors of interstitial lung disease (ILD) in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM).Methods:The patients with DM admitted to Kailuan General Hospital between January 2017 and December 2019 were included into the study including 13 patients with positiveanti-MDA5 antibody (7 survivors, 6 deaths) and 18 patients with anti-synthase (ARS)-antibody positive. All patients underwent chest HRCT prior to treatment. The consolidation, ground-glass opacity (GGO) and fibrosis were scored to assess HRCT findings. The clinical manifestations were compared between the two groups. Cox regression analysis adjusted for age and sex was used to determine the prognostic factors for anti-MDA5 antibody-related ILD.Results:Compared with ARS patients, glutamyl transferase (GGT) and ferritin levels were significantly higher in MDA5-ILD patients [70.0(37.0, 122.5) vs 21.0(16.5, 33.5), Z=-3.37, P=0.001; 977.0(502.5, 1 366.0) vs 307.1(72.3, 546.9) , Z=-3.44, P=0.001]. The cumulative survival rate was significantly lower in patients with positive anti-MDA5 antibody than in those with positive anti-ARS antibody (100% vs 70%, P=0.001). The DM complicated with acute/subacute interstitial pneumonia (A/SIP) were found to significantly relate to death. There were no significant differences in chest HRCT scoringbetween the survivors and the deceased patients [ HR=1.08, 95% CI(0.95, 1.23), P=0.229; HR=0.97, 95% CI(0.72, 1.30), P=0.814]. Conclusion:Anti-MDA5 antibody is an important index for early diagnosis of DM complicated with acute/subacute interstitial pneumonia (A/SIP). The chest HRCT scoreis is not associated with the prognosis of anti-MDA5 antibody-related ILD patients.

Objective To investigate the relationship between serum uric acid ( UA) level and brachial?ankle pulse wave velocity ( baPWV) in patients with systemic lupus erythematosus ( SLE) and lupus nephritis (LN)??Methods A total of 110 hospitalized,out?patient and healthy examinees from January 2017 to September 2017 were selected from Kailuan General Hospital??They were divided into three groups:(1)Fifty?five healthy controls were examined at the same time,and those who had no history of hypertension, myocardial infarction and stroke were excluded by physical examination??(2)Thirty?four SLE patients without LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology ( ACR) in 1997,excluding those with lupus nephritis??( 3) 21 SLE patients with LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology (ACR) in 1997??Pearson correlation coefficient and multivariate linear regression model were used to analyze the related factors affecting baPWV??Results The level of baPWV and the proportion of baPWV (≥1400 cm／s) in SLE without LN group and SLE with LN group were higher than those in healthy control group (all P＜0??05)??In SLE without LN group, baPWV was positively correlated with age, systolic blood pressure (SBP) and total cholesterol ( CHOL) ( r＝ 0??623,0??528,0??402, P＜0??01 or P＜0??05), and negatively correlated with blood uric acid(UA) ( r＝－0??371,P＜0??05),but the correlation was not significant??The correlation between UA and baPWV disappeared after after correction of age,SBP,diastolic blood pressure (DBP) by partial correlation analysis??In SLE with LN group,baPWV was positively correlated with SBP, DBP and serum creatinine ( Cr) ( r＝0??815, 0??725, 0??464, P＜0??01 or P＜0??05)??Multivariate stepwise regression analysis showed that SBP was independently correlated with baPWV in SLE group ( t＝2??54,P＝0??026); UA in SLE group without LN was independently negatively correlated with baPWV(t＝－2??96,P＝0??042); UA(t＝4??24,P＝0??013) and SBP(t＝7??70,P＝0??002) were independently positively correlated with baPWV in SLE group with LN??Logistic regression analysis showed that SLE was a risk factor for baPWV (≥1 400 cm／s),and the OR (95% CI) was 4??31 ( 1??56－11??88),P＝0??005,and there was statistical significance after adjusting for age,SBP,DBP,body mass index ( BMI)??However,UA was not a risk factor for baPWV (≥1 400 cm／s) (P values were 0??163 and 0??519,respectively)??Conclusion The degree of arteriosclerosis in SLE patients is higher than that in normal subjects,and the level of UA in SLE patients may be related to baPWV??

Objective:To investigate the risk factors and their early warning effectiveness for the occurrence of early neurological deterioration (END) in patients with moderate traumatic brain injury (modTBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 265 patients with modTBI admitted to the Second Affiliated Hospital of Fuyang Normal University from January 2018 to April 2023. There were 165 males and 100 females, with age range of 20-91 years [(59.5±14.4)years]. The patients were divided into END group ( n=46) (17.4%) and non-END group ( n=219) (82.6%) according to whether the Glasgow Coma Score (GCS) decreased by 2 points or more within 72 hours after injury. Data of the two groups were recorded, including gender, age, basic diseases (hypertension and diabetes), cause of injury (traffic injuries, falls, etc), vomiting before admission, admission GCS, first CT scan time, epilepsy, brain contusion, subarachnoid hemorrhage, types of intracranial hematoma (epidural, subdural, and intracerebral hematoma), types of fracture (skull base fracture and skull fracture), laboratory indicators [platelet count (PLT), blood potassium level, serum total calcium concentration, thrombin time (TT), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), level of fibrinogen (FIB), and level of D-dimer. Correlations between above-mentioned indicators and occurrence of END among modTBI patients were assessed and the independent risk factors were revealed by univariate and multivariate binary Logistic regression analysis. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to evaluate the early-warning effectiveness of each risk factor for END. Results:Univariate analysis showed that admission GCS, first CT scan time, epidural hematoma, subdural hematoma, intracerebral hematoma, serum potassium level, FIB and D-dimer were statistically correlated with occurrence of END among modTBI patients ( P<0.05 or 0.01). Multivariate binary Logistic regression analysis showed that admission GCS≤10 points ( OR=0.53, 95% CI 0.34, 0.84, P<0.01), first CT scan time≤2.0 hours ( OR=0.58, 95% CI 0.37, 0.92, P<0.05), epidural hematoma ( OR=0.26, 95% CI 0.10, 0.69, P<0.05), intracerebral hematoma ( OR=0.14, 95% CI 0.04, 0.44, P<0.01), level of FIB≤2.3 g/L ( OR=0.34, 95% CI 0.18, 0.64, P<0.01), level of D-dimer>10.4 mg/L ( OR=1.04, 95% CI 1.02, 1.07, P<0.01) were independent risk factors for END among modTBI patients. ROC curve analysis showed that the first CT scan time had relatively higher early warning value (AUC=0.79, 95% CI 0.74, 0.84), level of D-dimer (AUC=0.75, 95% CI 0.70, 0.80) and level of FIB (AUC=0.70, 95% CI 0.65, 0.76) had moderate early warning value, which was higher than that of admission GCS (AUC=0.62, 95% CI 0.56, 0.68), intracerebral hematoma (AUC=0.62, 95% CI 0.56, 0.68) and epidural hematoma (AUC=0.60, 95% CI 0.54, 0.66). The combination of the risk factors revealed superior early warning efficiency for END (AUC=0.90, 95% CI 0.85, 0.93). Conclusions:Admission GCS≤10 points, first CT scan time≤2.0 hours, epidural hematoma, intracerebral hematoma, level of FIB≤2.3 g/L and level of D-dimer>10.4 mg/L are independent risk factors for END among modTBI patients. The early warning value of the first CT scan is the highest, followed by D-dimer and FIB, and the early warning effectiveness of admission GCS, intracerebral hematoma and epidural hematoma is ordinary.The combination of the above risk factors has better early warning efficiency for occurrence of END among modTBI patients.

Objective To investigate the correlation between cumulative serum uric acid (cumUA) and brachial-ankle pulse wave velocity (baPWV).Methods Among the workers who participated in the four health check-up of Kailuan Group from 2010 to 2017,subjects who completed one PWV test were selected.The subjects who met the selection criteria were 20 688,subjects who lacked the first three uric acid tests and sex data were excluded.The subjects who had ischemic stroke (excluding lacunar infarction),transient ischemic attack and myocardial infarction were excluded.Decreased subjects were excluded and the extreme value were also excluded,20 295 subjects eventually meet the inclusion criteria and were included for statistical analysis.Stepwise linear regression,multivariate logistic regression and natural spline function were used to analyze the relationship between cumUA and baPWV and the influence of cumUA on baPWV.Results Among 20 295 subjects,the incidence of baPWV ≥ 14 m/s (criteria for judging atherosclerosis) increased with the increase of cumUA.There was significant difference in the incidence of baPWV ≥ 14 m/s (53.07％,54.35％,56.42％,58.41％,61.91％) among different cumUA partition groups (β=0.11,P＜0.01).In stepwise linear regression analysis,after adjusting for other confounding factors,it was found that cumUA was positively correlated with baPWV.In multivariate logistic regression analysis,after adjusting for other confounding factors,the results showed that baPWV ≥aPWVm were all risk factors for the third,fourth and fifth subgroups of cumUA compared with the first subgroup,and the OR05％CI) was 1.35(1.13,1.62) (P=0.01),1.60(1.29,1.97) (P＜0.01) and 2.14(1.64,2.80) (P＜0.01),respectively.Natural spline analysis exhibited a similar J curve relationship between cumUA and increased baPWV.Conclusion CumUA is a risk factor for increased baPWV.