Objective To evaluate cardiac biomarkers as biological risk factors for cardiovascular and all-cause motality in HD patients.In addition,a multimarker approach including inflammatory index was performed to improve the cardiovascular and all-canse risk assessment of these patients.Methods The author measured Troponin-T (TnT),N-terminal pro brain natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (HsCRP),collected the clinical data at baseline (January 2012) in 229 HD patients in three hemodialysis centers in Haidian District of Beijing,recorded time and cause of death in the next 1000 days.Kaplan-Meier was used to calculate survival rate and impact factors of prognosis.Cox proportional hazard model was used to estimate significance of =TnT,NT-proBNP and HsCRP and adjusted hazard ratios (HRs) of death.Results During the followup,37 patients died,mainly from cardiac cause (54.05％,20/37).Univariate analysis found old age,diabetes,cardiovascular disease,low serum albumin,CRP≥3 mg/L,TnT≥0.1 mg/L,NT-proBNP≥ 4381 ng/L were associated with prognosis.Elevated cTnT,NT-proBNP or HsCRP were all associated with increased cardiovascular and all-cause motality.Moreover,the combination of all parameters (NTproBNP≥4381 ng/L and TnT≥0.1 mg/L and HsCRP≥3 mg/L) were dramatically associated with increased cardiovascular cause mortality (HR=25.25,P ＜ 0.01) and all-cause mortality (HR=27.33,P ＜ 0.01).The association were significant even after full adjustment for cardiovascular (HR=14.33,P ＜ 0.01) and all-cause mortality (HR=1 1.54,P ＜ 0.01) respectively.Conclusions A combined index of cardiovascular risk factors could provide supplementary risk stratification in HD patients for cardiovascular mortality and all-cause mortality,strongly supporting the annual routine determination of these biomarkers.

Objective. To evaluate the results of operative treatment of spinal fracture-dislocation without neurologic deficits. Methods. Eighteen patients with spinal fracture-dislocation were neurologically intact at the time of injury, and all were treated operatively. The fracture sites were:8 cases in cervical spine, 3 cases in thoracic spine, and 7 cases in lumbar spine. Eight patients with cervical injuries had variant degrees of forward slide and kyphotic deformity. Of the 10 thoracic and lumbar fracttwes, one had lateral dislocation, 4 cases with kyphotic deformities, 5 cases with spinal canal compromise averaged 50% (ranging from 40% to 70%). Results. The average period of follow-up was 4.4 years with a range of 11 months to 13 years. All the patientsretumed to full-time work. No patient developed neurologic deterioration. Kyphotic deformity was corrected in the 4cases, and no progressive kyphosis was noted. There was no operation-related complication. The averaged post-opera-tive hospitalization time was 13 days. Conelusions. Despite the rare incidence of spinal fracture-dislocation without neumlogic deficits, we suggested that kind of fracture be considered unstable fracture because of its potential risk of delayed neurologic deterioration and kyphotic deformity, and be treated operatively to restore the sagittal ali~ment and the stability of the spine.

Objective To assay tumor necrosis factor α(TNF-α) changes during the treatment of ulcerative colitis with the Chinese herbal prescription and study the mechanism of herbal prescription in ulcerative colitis treatment. Meth-ods 60 ulcerative colitis patients were treated with self-made enema treatment, evaluated clinical efficacy of herbal en-ema for ulcerative colitis and detected TNF-α changes in serum. Results After a course of herbal enema treatment, the total effective rate was 95.00% and the level of TNF-α decreased to (20.7±6.6) pg/mL on average. Conclusion Serum tumor necrosis factor level is significantly reduced after the herbal enema treatment. The treatment can enhance immune system function of ulcerative colitis patients and get better clinical efficacy.

Objective:To evaluate the visibility of intracranial deep medullary vein (DMV) by sensitivity weighted imaging (SWI), and explore its correlation with recent small subcortical infarct (RSSI).Methods:From March 2021 to May 2022, 277 patients with cerebral small vascular disease (CSVD) confirmed by cranial MRI in Department of Neurology, Third Hospital of Hebei Medical University, were consecutively enrolled. These patients were divided into RSSI group ( n=128) and non-RSSI group ( n=149) according to RSSI presence or not within one week of onset. According to the DMV scores, these patients were divided into mild-moderate DMV group (0-12 scores, n=199) and severe DMV group (13-18 scores, n=78). The clinical and imaging data of these groups were analyzed retrospectively and compared. Multivariate Logistic regression analysis was used to determine the correlation between DMV and RSSI, as well as the independent influencing factors for DMV grading. Results:The cerebral microbleed (CMB), periventricular white matter hyperintensity (WMH) scores, deep WMH scores, total WMH scores, total CSVD burden scores, and DMV scores in patients of the RSSI group were significantly higher than those in the non-RSSI group ( P<0.05); and patients in the RSSI group had significantly younger age and significantly lower high density lipoprotein cholesterol (HDL-C) level than those in the non-RSSI group ( P<0.05). Multivariate Logistic regression analysis showed that DMV score ( OR=1.142, 95%CI: 1.026-1.271, P=0.016) was an independent influencing factor for RSSI after adjusting for HDL-C and deep WMH scores. The severe DMV group had significantly older age, statistically higher percentages of patients having history of hypertension, CMB, lacuna and moderate to severe EPVS in basal ganglia, and significantly higher periventricular WMH scores, deep WMH scores, total WMH scores, and total CSVD burden scores as compared with the mild-moderate DMV group ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.101, 95%CI: 1.060-1.143, P<0.001) and total CSVD burden scores ( OR=3.589, 95%CI: 2.506-5.141, P<0.001) were independent influencing factors for DMV scores. Conclusion:DMV is involved in the mechanism of RSSI, and DMV visibility can be used as an indicator to diagnose RSSI and evaluate RSSI progression.