ObjectiveTo investigate the safety and efficacy of transparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy （EHL）. MethodsA retrospective analysis was performed for the clinical data of 60 patients with large common bile duct stones who were admitted to Department of Gastroenterology， Jilin People’s Hospital， from May 1， 2023 to January 31， 2026， and according to the treatment method， the patients were divided into transparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group and peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group， with 30 patients in each group. The two groups were compared in terms of the rate of successful single-session stone fragmentation and removal， procedural time， duration of electrohydraulic lithotripsy， clinical success rate， and complications. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group， the transparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy group had a significantly higher technical success rate （83.33% vs 60.00%， χ²=4.022， P=0.045） and significantly shorter procedural time ［46.00 （42.25 — 49.00） min vs 54.50 （42.00 — 65.00） min， Z=2.012， P=0.044］ and duration of electrohydraulic lithotripsy ［8.00 （6.25 — 11.75） min vs 13.50 （9.25 — 17.75） min， Z=2.749， P=0.006］. Both groups achieved a clinical success rate of 100%， with no significant difference in the incidence rate of complications （P>0.05）. ConclusionTransparent cap-assisted peroral cholangiopancreatoscopy-guided electrohydraulic lithotripsy has a high rate of successful single-session stone fragmentation and removal and a short procedural time， with good safety and efficacy， and therefore， it holds promise for clinical application.

Objective:To investigate the relationship between lipid levels and cognitive impairment in the elderly Chinese population using prospective cohort data.Methods:Based on the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) cohort, this study included 24 380 individuals aged ≥60 years who participated in the cognitive function follow-up survey from 2018 to 2019. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined according to different educational levels: MMSE ≤17 for illiterate individuals, MMSE ≤20 for those with primary education and MMSE ≤24 for those with secondary education or above. Multivariable linear regression and logistic regression models were employed to examine the associations between six baseline lipid indicators and cognitive scores, as well as cognitive impairment. Additionally, restricted cubic splines were used to explore the exposure-dose relationship between lipid levels and cognitive function.Results:The study population had a median follow-up time of 11.6 years, with a baseline age of (59.7±6.8) years. Among the participants, 9 510 (39.0%) were males, and the mean MMSE score was 24.7±6.8. A total of 3 887 individuals (15.9%) were identified as cognitively impaired. The results of multivariable linear regression and logistic regression indicated that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were not only significantly positively associated with cognitive scores but also significantly associated with a lower risk of cognitive impairment. Each 1 mmol/L increase in these lipid levels corresponded to β values (95% CI) of 0.267 (0.173-0.361), 0.385(0.271-0.499) and 0.331(0.231-0.431), respectively. Each 1 mmol/L increase in these lipid levels corresponded to odds ratio ( OR) (95% CI) values of 0.915 (0.876-0.956), 0.875 (0.830-0.923) and 0.886 (0.848-0.927), respectively. The dose-response curve demonstrated that the negative association was primarily observed within the guideline-recommended optimal lipid level range. Specifically, when LDL-C was less than 3.4 mmol/L and non-HDL-C was less than 4.1 mmol/L, the corresponding OR (95% CI) values were 0.859 (0.796-0.926) and 0.876 (0.818-0.939). Conclusion:Lipid levels exhibit a certain linear negative association with cognitive impairment in elderly Chinese adults, with LDL-C and non-HDL-C demonstrating a stronger effect, particularly within the guideline-recommended optimal range.

Medical device related infections caused by bacteria are common complications in clinical practice,and preventing bacterial colonization on the surface of medical materials is one of the important challenges in the medical field.Therefore,there is an urgent need to construct medical coatings that combine antibacterial properties and biocompatibility.In this study,a γ-polyglutamic acid(γ-PGA)complex with long-chain alkyl quaternary ammonium salts formed by electrostatic and hydrophobic interactions was prepared,which was insoluble in water but soluble in organic solvents(e.g.,ethanol),and was capable of constructing antimicrobial coatings on the surfaces of medical materials in a simple and efficient manner.The bactericidal effect of the coating was verified using viable bacteria counting experiments,and the results showed that the bactericidal rate of the coated thermoplastic polyurethane(TPU)membrane against Staphylococcus aureus was greater than 99.9%compared with that of the uncoated TPU membrane.In addition,a cytotoxicity assay was performed using the L929 fibroblast and cell proliferation detection kit(CCK-8),which showed that the survival rate of L929 fibroblasts on coated TPU was greater than 90%.Meanwhile,the hemolysis rate of coated erythrocytes was tested using fresh rabbit red blood cells(RBCs),and the hemolysis rate on the coated TPU surface was 1.5%.The above results indicated that the coating had good biocompatibility.The preparation method of medical antibacterial coating reported in this study provided a new idea for preventing bacterial infections related to implantable/interventional medical devices.

Objective:To investigate the self-perceived cognitive decline status in the community population,and to explore the association between different dietary habits and self-perceived cognitive decline.Methods:A cross-sectional study was carried out in 11 879 community residents in the three regions of Weifang,Jining,and Zoucheng in Shandong Province.The Ascertain Dementia-8 and dietary habits information questionnaire were used to assess self-perceived cognitive decline and dietary habits,and their association were analyzed using single factor and multivariate logistic regression.Results:The detection rate of self-perceived cognitive decline was 21.4％.Lo-gistic regression showed that smoking in the past was positively associated with self-perceived cognitive decline(OR=1.40,95％CI:1.14-1.73).However,intake of fruits(often,OR=0.70,95％CI:0.52-0.94;everyday,OR=0.60,95％CI:0.44-0.81),nuts(daily,OR=0.62,95％CI:0.44-0.88),mushrooms(often,OR=0.74,95％CI:0.57-0.92)and high tryptophan foods(sometimes,OR=0.79,95％CI:0.68-0.91;everyday,OR=0.54,95％CI:0.34-0.87)were negatively associated with self-perceived cognitive decline.Conclusion:Smoking history might be a risk factor for self-perceived cognitive decline,and high frequency intake of fruits,nuts,mush-rooms,and high tryptophan foods might protective factors for it.

Objective To explore whether butorphanol tartrate as an adjuvant of ropivacaine for brachial plexus block can reduce the incidence of rebound pain after brachial plexus block.Methods Based on sample size calculation,174 patients undergoing upper limb bone surgery were included in this study and randomized into three groups using statistical software:butorphanol tartrate compound local anesthetic(group B1),brachial plexus block with 0.25%ropivacaine 20 mL(including adjuvant butorphanol 1mg);intravenous butorphanol group(group B2),brachial plexus block with 0.25%ropivacaine 20 mL,in addition,1mg of butorphanol was administered i.v;control(group C),only 0.25%ropivacaine 20ml for brachial plexus block.The patients were visited the day before operation,and the basic information of the patients was obtained.At the same time,the Douleur Neuropathique 4 questions(DN4)was used to evaluate whether there were neuropathic components(DN4≥4)in the site to be operated on,and the Numerical rating scale(NRS)was introduced to the patients,and the preoperative NRS value was obtained.30 minutes before the operation,the same anesthesiologist with rich experience in nerve block completed the ultrasound-guided brachial plexus block(interscalene approach),and tested whether the block effect was perfect.After entering the operating room,the patients were given general anesthesia,and the duration of operation,vital signs during operation,dosage of analgesics and whether or not using tourniquet were recorded.After the operation,the patients were sent to the postanesthesia care unit,and then sent to the ward when the patients reached the standard of leaving the room.Distribute pain diaries to patients and their families and instruct them to fill in relevant matters.The patients were followed up at 0 h,6 h,12 h,18 h,24 h and 36 h after operation to obtain the NRS value at each time point after operation,the time when the block disappeared and the highest NRS value within 12 hours,the first use of rescue analgesics,the use of postoperative analgesics,postoperative adverse events and the quality of patient recovery.Results The incidence of rebound pain was 31.6%in B1,48.2%in B2,and 54.4%in C.The pairwise comparison showed statistical difference between B1 and C(P<0.05).Rebound pain score in the three groups was B1 group0.05).There were no statistical differences in the duration of motor block,sensory block duration,duration of analgesia,time to first request for rescue analgesia,and QoR-15 recovery quality score(P>0.05).There was no statistical difference in the incidence of postoperative adverse effects among the three groups(P>0.05).Conclusion This study found that brachial plexus block with 1mg butorphanol tartrate as an adjuvant for ropivacaine reduced the incidence of rebound pain and rebound pain scores after upper limb orthopedic surgery and reduced postoperative opioid consumption.

OBJECTIVE: This study aimed to reexplore minimum iodine excretion and to build a dietary iodine recommendation for Chinese adults using the obligatory iodine loss hypothesis. METHODS: Data from 171 Chinese adults (19-21 years old) were collected and analyzed based on three balance studies in Shenzhen, Yinchuan, and Changzhi. The single exponential equation was accordingly used to simulate the trajectory of 24 h urinary iodine excretion as the low iodine experimental diets offered (iodine intake: 11-26 μg/day) and to further deduce the dietary reference intakes (DRIs) for iodine, including estimated average requirement (EAR) and recommended nutrient intake (RNI). RESULTS: The minimum iodine excretion was estimated as 57, 58, and 51 μg/day in three balance studies, respectively. Moreover, it was further suggested as 57, 58, and 51 μg/day for iodine EAR, and 80, 81, and 71 μg/day for iodine RNI or expressed as 1.42, 1.41, and 1.20 μg/(day·kg) of body weight. CONCLUSION The iodine DRIs for Chinese adults were established based on the obligatory iodine loss hypothesis, which provides scientific support for the amendment of nutrient requirements.
Humans ; Iodine/administration & dosage* ; Male ; Female ; China ; Young Adult ; Diet ; Adult ; Nutritional Requirements ; East Asian People

Objective:To investigate the relationship between lipid levels and cognitive impairment in the elderly Chinese population using prospective cohort data.Methods:Based on the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) cohort, this study included 24 380 individuals aged ≥60 years who participated in the cognitive function follow-up survey from 2018 to 2019. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined according to different educational levels: MMSE ≤17 for illiterate individuals, MMSE ≤20 for those with primary education and MMSE ≤24 for those with secondary education or above. Multivariable linear regression and logistic regression models were employed to examine the associations between six baseline lipid indicators and cognitive scores, as well as cognitive impairment. Additionally, restricted cubic splines were used to explore the exposure-dose relationship between lipid levels and cognitive function.Results:The study population had a median follow-up time of 11.6 years, with a baseline age of (59.7±6.8) years. Among the participants, 9 510 (39.0%) were males, and the mean MMSE score was 24.7±6.8. A total of 3 887 individuals (15.9%) were identified as cognitively impaired. The results of multivariable linear regression and logistic regression indicated that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were not only significantly positively associated with cognitive scores but also significantly associated with a lower risk of cognitive impairment. Each 1 mmol/L increase in these lipid levels corresponded to β values (95% CI) of 0.267 (0.173-0.361), 0.385(0.271-0.499) and 0.331(0.231-0.431), respectively. Each 1 mmol/L increase in these lipid levels corresponded to odds ratio ( OR) (95% CI) values of 0.915 (0.876-0.956), 0.875 (0.830-0.923) and 0.886 (0.848-0.927), respectively. The dose-response curve demonstrated that the negative association was primarily observed within the guideline-recommended optimal lipid level range. Specifically, when LDL-C was less than 3.4 mmol/L and non-HDL-C was less than 4.1 mmol/L, the corresponding OR (95% CI) values were 0.859 (0.796-0.926) and 0.876 (0.818-0.939). Conclusion:Lipid levels exhibit a certain linear negative association with cognitive impairment in elderly Chinese adults, with LDL-C and non-HDL-C demonstrating a stronger effect, particularly within the guideline-recommended optimal range.

(rsFC)and their relationship with negative symptoms in schizophrenia patients with predominant negative symptoms(PNS).Methods Fifty-four schizophrenia patients with PNS and sixty-one healthy controls underwent resting-state functional magnetic resonance imaging(fMRI)scans.Data were collected on general demographic information,the Positive and Negative Syndrome Scale(PANSS),the Scale for the Assessment of Negative Symptoms(SANS),and the Temporal Experience of Pleasure Scale(TEPS).Twelve striatal subregions were selected as regions of interest(ROIs)to analyze the rsFC between each ROI and whole-brain voxels.The rsFC values of areas with significant differences were extracted for Pearson correlation analysis with negative symptoms.Results Compared with healthy controls,schizophrenia patients with PNS exhibited decreased rsFC between the right dorsal caudal putamen(DCP)and right insula,left middle frontal gyrus(MFG),right median cingulate and paracingulate gyri(MCC);between the left DCP and right putamen,left insula,left MFG;between the right dorsal rostral putamen(DRP)and bilateral MFG,left insula,right MCC;between the left DRP and right insula,left rolandic operculum;between the right ventral rostral putamen(VRP)and bilateral putamen,left MFG,right MCC;between the left VRP and right insula,left putamen,bilateral MFG,right MCC,left inferior parietal gyrus,excluding supramarginal and angular gyri.Decreased rsFC was also observed between the left ventral caudate/nucleus accumbens(inferior)and right insula,left anterior cingulate cortex,supracallosal,bilateral precuneus(a threshold of P<0.001 in voxel-level with P<0.05 in cluster-lever,corrected for family-wise error,PFWE<0.05/12=0.004).No regions showed increased rsFC in schizophrenia patients with PNS relative to healthy controls.And no significant correlations were found between striatal rsFC and negative symptoms(PBonferroni>0.05).Conclusion Schizophrenia patients with PNS exhibited widespread cortical-striatal functional connectivity abnormalities,particularly reduced rsFC between the putamen and the MFG,MCC and insula.

Objective To analyze the clinical characteristics of renal cell carcinoma patients with extracapsular segmental vein tumor thrombus during partial nephrectomy and to explore the clinical significance,thereby contributing to an advanced comprehension of the pathogenesis of cancer thrombus in renal cell carcinoma.Methods A retrospective analysis was conducted on the clinical data of 209 renal cell carcinoma patients(162 with T1a stage,47 with T1b stage)who underwent partial nephrectomy in our hospital during Sep.2023 and Jul.2025.Among them,8 patients with extracapsular segmental vein tumor thrombus were identified,and the clinical and pathological characteristics were analyzed.Results Among the 8 cases of extracapsular segmental vein tumor thrombus,1 was in T1a stage and 7 were in T1b stage.Preoperativc CT revealed roundish,solid renal masses with heterogeneous density on non-contrast scans,significant enhancement on contrast-enhanced scans,and markedly weaker enhancement in the renal parenchymal phase compared to normal renal tissue.The average tumor diameter was(4.9±0.2)cm,with clear boundaries and no evidence of vascular invasion.Postoperative pathology confirmed clear cell carcinoma in all cases,with International Society of Urological Pathology(ISUP)grades ranging from Ⅰ to Ⅳ,and all surgical margins were negative.After surgery,5 patients received adjuvant immunotherapy.In a median follow-up of 10.3(3.8-22.8)months,no tumor recurrence or metastasis was observed.Conclusion Renal cell carcinoma has a high propensity of vascular invasion,and even clinically staged T1 tumors may develop extracapsular segmental vein tumor thrombus.This finding is significant for clinical prognosis.