Objective To investigate the relationship between mental status and some physical indicators,so as to identify the influencing factors of anxiety and depression in health check-up populations.Methods A total of 3885 health check-up adults enrolled in this investigation.Self-rating anxiety scale (SAS),self-rating depression scale (SDS),and Symptom Checklist 90 (SCL90) were used to evaluate mental health of the participants.Physical indicators,including body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),serum free three iodine armour gland original acid (FT5),serum free thyroxine (FT4),and thyroid-stimulating hormone (TSH),were retrospectively reviewed.Pearson correlation analysis was used to assess the relationship between mental health and physical signs,and the Logistic regression analysis was performed to confirm the influencing factors of anxiety and depression.Results Increased prevalence of anxiety and depression was found in females or those with lower education level.For the health check-up populations,anxiety and depression were negatively correlated to BMI,SBP,DBP,LDL-C,FT3 and FT4.In Logistic regression analysis,LDL-C,FT3 and FT4 were related to SDS score,while SBP,FT3,and FT4 were related to SAS score.Conclusion Our data suggest that emotion could be affected by gender and education level; SBP,LDL-C,FT3,and FT4 may be protective factors of anxiety and depression.

Objective To analyze the effect of Chinese diabetes risk score in health checkup of elderly population and to explore the risk factors of abnormal glucose metabolism in the elderly patients.Methods Chinese diabetes risk score(C-DRs)screening,glucose tolerance test(OGTT),blood biochemical parameters and history collection were performed in 1 181 elderly people participating the health checkup.The area under the ROC curve(AUC)was used to evaluate the accuracy of the screening method.The effect of different cumulative C-DRs on screening target population was reflected by the Gordon index.Multivariate logistic regression analysis was used to analyze relevant risk factors for the glucose metabolic abnormalities.Results The AUC of screening for diabetes was 0.749(95%CI:0.715-0.782),and the best cut-point value was 32.5 points.The sensitivity was 86.50%,the specificity was 60.84%,and the Gordon index was 0.47(P=0.000).The AUC of screening for the pre-diabetes was 0.760(95%CI:0.733-0.787),and the best cut-point was 33.5 points.The sensitivity was 70.89%,the specificity was 68.72%,and the Gordon index was 0.40(P=0.000).The AUC of screening for MS was 0.797(95% CI:0.772-0.823),and the best cut-point value was 32.5 points.The sensitivity was 83.62%,the specificity was 64.90%,and the Gordon index was 0.49(P=0.000).The AUC of screening for insulin resistance was 0.609(95%CI:0.645-0.734),and the best cut-point value was 30.5 points.The sensitivity was 81.25%,the specificity was 44.81%,and the Gordon index was 0.26(P=0.000).Multiple logistic regression analysis showed that age over 80 years,abdominal obesity(waist circumference,male ≥ 90 cm,female ≥ 85 cm),hypertension,hypertriglyceridemia,family history of diabetes were risk factors for abnormality of glucose metabolism in the elderly.The odd ratio values of the above were 1.557,1.543,1.495,1.569,1.625,1.715(all P<0.05).Conclusions Chinese diabetes risk score may be used to screen for diabetes,metabolic syndrome and insulin resistance in the elderly population.Old age,abdominal obesity,hypertension,hypertriglyceridemia and family history of diabetes are independent risk factors for abnormal glucose metabolism in the elderly population.

Objective:To explore and analyze the effect of massive transfusion protocol (MTP) in early massive transfusion and prevention of coagulation disease for patients with multiple injuries.Methods:A retrospective analysis was made in 117 patients with multiple injuries admitted to Yiwu Central Hospital from March 2015 to May 2019.According to different blood transfusion schemes, they were divided into control group(53 cases) and observation group(64 cases). The patients in the control group received routine blood transfusion scheme, and the patients in the observation group received MTP blood transfusion scheme.The changes of blood routine and coagulation function, the amount of blood loss within 24h, the amount of allogeneic blood component input, the length of hospital stay and mortality were compared between the two groups.Results:The levels of Hb, HCT and PLT in the two groups after 24h of blood transfusion were significantly higher than admission[(112.73±12.73)g/L vs.(96.74±10.28)g/L, (115.28±19.27)g/L vs.(95.37±11.47)g/L, (39.72±5.21)% vs.(31.47±4.22)%, (39.10±4.97)% vs.(30.56±4.13)%, (220.93±54.28)×10 9/L vs.(142.83±36.47)×10 9/L, (216.87±64.03)×10 9/L vs.(148.96±40.22)×10 9/L, t=7.818, 6.464, 9.844, 9.621, 9.554, 6.538, all P<0.05], but there were no statistically significant differences between the two groups( t=0.681, 1.172, 0.864, 0.746, 0.740, 1.363, all P>0.05). After 24h of blood transfusion, the time of Pt and APTT in the observation group were significantly lower than admission[(13.21±2.93)s vs.(16.28±4.26)s, (46.28±3.97)s vs.(54.37±6.42)s, t=4.705, 8.574, all P<0.05], but there were no statistically significant changes in the control group[(15.84±3.62)s vs.(16.93±5.17)s, (54.02±6.39)s vs.(55.29±7.02)s, t=0.212, 0.332, all P>0.05]. The time of Pt and APTT in the observation group after 24h of blood transfusion were significantly lower than those in the control group ( t=4.344, 8.006, all P<0.05). There were no statistically significant differences in FIB levels between the two groups[(4.30±0.48)g/L vs.(4.36±0.56)g/L, (4.41±0.58)g/L vs.(4.51±0.63)g/L, t=0.651, 0.934, all P>0.05]. There were no statistically significant differences in 24h bleeding volume and fresh frozen plasma(RBC) input between the two groups[(2 684.92±703.47)mL vs.(2 725.86±810.32)mL, (17.28±3.74)U vs.(17.02±2.95)U, t=0.293, 0.411, all P>0.05]. The input amount of red blood cell suspension(PF) and the ratio of PF: RBC in the observation group were significantly higher than those in the control group[(9.28±3.27)U vs.(6.29±3.18)U, (0.55±0.12) vs.(0.39±0.10), t=4.985, 7.733, all P<0.05]. The observation group had significantly lower SOFA scores and ICU stays compared with the control group[(5.93±1.64)points vs.(7.28±2.10)points, (7.21±1.85)d vs.(9.10±2.37)d, t=3.814, 4.732, all P<0.05], and the mortality rate in the observation group was significantly lower than that in the control group[6.25%(4/64) vs.20.75%(11/53), χ 2=5.457, P<0.05]. Conclusion:The standardized rescue strategy of a large number of blood transfusion treatment schemes and the early proportion of components of blood products (erythrocyte suspension, fresh frozen plasma, platelets) can significantly improve the coagulation function of patients with multiple injuries, reduce the incidence of coagulopathy and help reduce the fatality rate of major bleeding, which is worthy of clinical promotion.

Objective:Metabolic syndrome (MS) patients and determine factors related to platelet hyperactivation.Methods:A total of 999 participants (822 males and 177 females) were enrolled. Participants were divided into two groups according to the metabolic index: MS group (501) and normal control (NC) group (498). Platelet function was tested with PFA100 (Siemens USA, Deerfield, Illinois) which measures the time it takes for blood to occlude an aperture (closure time, CT) following stimulation with collagen and adenosine diphosphate. Statistical analyses were performed using the SPSS statistical software package, version 22.0 (IBM Corporation, Armonk, NY, USA).Results:MS group had significantly shorter CT values compared with NC group (106.6±27.8s) vs (113.7±27.9s). Higher BMI, WC, BP, TC, TG, LDL-C, UA, and PRL were correlated with shorter CT values (all P<0.05). Conclusion:Our results indicated platelet hyperactivation exists in MS which was related to obesity and elevated blood pressure, blood lipids, uric acid, and PLR.

Objective:To evaluate the diagnostic value of thromboelastogram (TEG) parameters for cognitive impairment in patients with recurrent ischemic stroke (RIS), and construct a nomograph model.Methods:The clinical data of 75 patients with RIS and treated in the Yiwu Central Hospital from June 2020 to June 2022 were retrospectively summarized. Multivariate Logistic regression model was used to screen the risk factors of cognitive impairment in RIS patients. R software was used to establish a nomogram model, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of TEG index and nomogram on cognitive impairment in RIS patients.Results:The results of multivariate Logistic regression analysis showed that National Institutes of Health Stroke Scale (NIHSS) score on admission, stroke interval, change in clotting time 48 h after admission and 48 h before discharge (ΔR) and change in maximum clot intensity (ΔMA) were the risk factors for cognitive impairment 3 months after RIS ( P<0.05). Age, ΔR and ΔMA were the risk factors for cognitive impairment 12 months after the onset of RIS ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) predicted by the nomogram for cognitive impairment 3 and 12 months after the onset of RIS was higher than that of the patients with ΔR and ΔMA ( P<0.01). Conclusions:Detection of TEG parameters, especially ΔR and ΔMA, establishment of nomogram model have good practical value for guiding clinical rapid identification of high-risk patients with cognitive impairment.

Objective To investigate the feasibility and application value of the benign and malignant classificational methods of renal occupying CT images based on convolutional neural networks (CNN). Methods An image omics method that can automatically learn the image features and classify CT images was used. Firstly, the CNN model obtained by large-scale natural image training was used to migrate the characteristics of the renal occupancy lesions CT images, and then the fine-tuning of the full connection layer was used to realize the benign and malignant classification of the images. Results The evaluation indexes of the VGG19 model were lower than ResNet50 and Inception V3, and the training result showed obvious overfitting. The accuracy, sensitivity and negative prediction values of the Inception V3 model was 93.8％, 99.5％ and 99.1％, respectively, which were higher than that of the ResNet50 model. Conclusions The benign and malignant classification of renal occupancy lesions CT images using CNN is a reasonable and feasible method, and the fine-tuned Inception V3 model has a better classification performance.

Objective To investigate the relationship between serum uric acid and the risk of nonalcoholic fatty liver disease.Methods A cohort study was performed among individuals who had physical examination at Beijing Hospital medical examination center during 2009.A total of 732 subjects without nonalcoholic fatty liver disease,30-60 years old,were selected.Subjects were divided into 4 groups (Q1,Q2,Q3,Q4) according to serum uric acid level.Theincidence of NAFLD in each group in 2013 were observed.Serum alanine aminotransferase,aspartate aminotransferase,triglycerides,total cholesterol,high density lipoprotein-cholesterol,low density lipoprotein-cholesterol,fasting plasma glucose,and imaging examinations were determined.Cumulative incidence ofNAFLD was compared between each group and effect of baseline serum uric acid on new-onset NAFLI was assessed by logistic regression analysis.Results The cumulative incidence of NAFLD increased irconjunction with the increase of baseline serum uric acid in 4 groups (Q1 8.70％,Q2 13.04％,Q3 19.23％,Q4 32.97％,x2=37.865,P＜0.05).Logistic regression showed that the incidence of nonalcoholic fattyliver disease was increased along with elevated levels of serum uric acid.Subjects in the Q2,Q3,Q4 groups showed an increased risk of NAFLD,relative risks were 1.575 (0.807-3.074);2.580 (1.329-54.701);5.164 (2.838-9.397),compared to those in Q1 group.Moreover,after adjustment for baseline factors (e.g.Age,sex),risk of NAFLD remained higher,with odds ratio at 1.234,and the difference was statistically significant.Conclusions Serum uric acid was found to be correlated with the prevalence of nonalcoholic fatty liver disease.Serum uric acid appeared to be an independent risk factor for NAFLD.

Total 732 subjects aged 30-60 years undergoing health check-up at Beijing Hospital Medical Examination Center in 2009,who had no history of non-alcoholic fatty liver disease (NAFLD) were recruited in the study.According to the quartile of hemoglobin (HGB) level,the subjects were divided into 4 groups:Q1:HGB ≤ 131 g/L (n =192),Q2:HGB ＞ 131 g/L and ≤ 140 g/L (n =178),Q3:HGB ＞ 140 g/L and ≤152 g/L (n =184),Q4:HGB ＞ 152 g/L (n =178).All participants were followed up for 4 years,the prevalence rates of NAFLD in groups Q1,Q2,Q3 and Q4 were 8.3％ (16/192),17.4％ (31/178),23.4％ (43/184) and 25.3％ (45/178),respectively (P ＜0.05).Logistic regression showed that the rates of NAFLD in groups Q2,Q3 and Q4 were 2.32 (1.22-4.41),3.36 (1.81-6.21) and 3.72(2.02-6.87) times higher as group Q1 (P ＜ 0.05).Multiple logistic regression analysis showed that the hemoglobin level,TG and BMI were the independent risk factors of NAFLD.

BACKGROUND:Electrical stimulation is a physical method that can be used to induce various cellular activities such as cell proliferation,differentiation,and apoptosis.The induction of osteogenic differentiation of stem cells will be beneficial in the field of bone regeneration. OBJECTIVE:To observe whether micro-current field can promote the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells. METHODS:The fresh human umbilical cord tissue was cut to obtain umbilical cord mesenchymal stem cells,which were inoculated into a 6-well plate after cell culture and passage to the third generation.After 24 hours,the cells were cultured under a stimulation of 0,50,and 100 mV/mm micro-electric field,at a frequency of 1 hour per day for 3 continuous days.The growth and morphological changes of human umbilical cord mesenchymal stem cells were observed by a microscope.The cell proliferation was detected by CCK-8 assay and EdU staining.Alizarin red staining was used to detect the osteogenic differentiation ability of cells.Western blot assay was used to determine the expression of ERK signal pathway proteins. RESULTS AND CONCLUSION:(1)The optical density value and the number of proliferating cells in 50 and 100 mV/mm groups were significantly higher than those of the unstimulated group(P<0.05).(2)Human umbilical cord mesenchymal stem cells could be induced to differentiate into osteocytes before and after micro-electric field stimulation,but the differentiation rate of 50 and 100 mV/mm groups was faster than that of unstimulated groups.(3)The protein expression of p-ERK1/2 in the 50 and 100 mV/mm groups was higher than that in the unstimulated group,and significant difference was detected between the 100 mV/mm group and the unstimulated group(P<0.05).(4)Micro-electric field can promote the proliferation of human umbilical cord mesenchymal stem cells,and the mechanism may be achieved by promoting the phosphorylation of ERK.

Objective:To explore the potential of integrating virtual surgery with three-dimensional (3D) printed guides in the surgical management of mandibular benign tumors and subsequent reconstruction of bone defects.Methods:A retrospective analysis was conducted on the clinical data of patients who underwent computer-assisted resection and vascularized fibular flap reconstruction for benign mandibular tumors at the Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, from June 2013 to December 2020. According to the utilization of guide plates for mandibular and fibular osteotomy during surgical procedures or not, the patients were categorized into two cohorts: a guide plate cohort and a non-guide plate cohort. In the guide plate group, custom-designed gudie plates based on virtual surgical plans were fabricated using 3D printing technology and employed intraoperatively; In the non-guide plate group, surgery was exclusively performed based on virtual surgical plan and prebent titanium plate without any supplementary plating. The measured outcomes included fibular flap osteotomy, operation duration, and clinical flap survival. Computed tomography images obtained one week post-surgery were utilized to assess the intersegmental commissure degree between fibular segments as well as between fibular segments and mandible, commissure degree between fibular segments and prebent titanium plate, and condyle position. The satisfaction of patients with their facial appearance was evaluated 6 months after the surgery using a visual analogue scale. Statistical analysis was conducted using SPSS 21.0 software. Independent sample t-tests was utilized to compare the duration of operation and and postoperative evaluation of facial appearance, the Chi-square tests was utilized for condyle position, commissure degrees among interactions involving fibular segments, prebent titanium plates, bone segments( P<0.05 denoted statistical significance). Results:A total of 30 patients were enrolled, comprising 17 males and 13 females, with a median age of 24 years (16-64 years). The preparation process of fibular flaps proceeded smoothly. The required length of fibula was measured as (14.1 ± 1.9) cm (5.7-18.1 cm), while the number of fibular segments ranged from 2 to 4, averaging at approximately 2.9 ± 0.6. The mandibular defects were repaired using a single-layer fibula in 12 cases, a vascularized folded fibula in 7 cases and a combination of vascularized and non-vascularized fibula in 11 cases. The operation time for the guide plate group was recorded as ( 335.9 ± 64.0) min (240-433 min), while it was observed to be (470.7 ± 140.5 ) min (280-680 min) for the non-guide plate group.The postoperative follow-up duration ranged from 9 to 23 months, with an average period of 11 months. All fibular flaps demonstrated clinical survival. The number of patients with good commissure degree between fibular and mandibular segments, between prebent titanium plate and fibular and mandibular segments and the position of condyle were 15, 15 and 13 cases in guide plate group, 10, 13 and 11 cases in non-guide plate group respectively. The statistical analysis revealed a significant difference ( P<0.05) in the degree of commissure between the fibular and the mandibular segments (15/15 vs. 10/15) in the two groups. Both groups exhibited high levels of satisfaction regarding their postoperative facial appearance at the 6 months follow-up, observed to be 9.6±0.5 and 9.3±0.5 respectively, and the statisticla analysis revealed non-significant difference ( P>0.05). Conclusion:The integration of virtual surgery with 3D printed guide plates can effectively reduce operative time and improve precision in the repair and reconstruction of free-fibular flaps following resection of benign tumors of the mandible.