Objective To quantify the association between obesity and erectile dysfunction (ED) risk through a meta-analysis. Methods Following PRISMA guidelines, systematic searches of Chinese and English databases (up to March 2025) were conducted to include observational studies (cohort, cross-sectional, case-control). Adjusted effect sizes (OR and 95% CI) were extracted. Study quality was assessed using the Agency for Healthcare Research and Quality(AHRQ) scale, and a random-effects model was applied to pool effect sizes. Subgroup analyses (geographic region, obesity definitions) and sensitivity analyses were performed to validate robustness. Results Ten studies (n=230 744), including nine cross-sectional studies, were included. The meta-analysis revealed that obesity significantly increased ED risk (random-effects OR=1.80, 95% CI: 1.29-2.51), with high heterogeneity (I2=99.9%). Subgroup analyses indicated stronger associations in USA populations (OR=2.10, 95% CI: 1.23-3.60) than in Chinese populations (OR=1.16, 95% CI: 1.05-1.28). The highest effect size was observed when using BMI≥25 kg/m3 as the obesity threshold (OR=3.05, 95% CI: 2.06-4.51). Sensitivity analyses confirmed robust results (OR: 1.60-1.94 after excluding any single study). Conclusions Obesity is a critical risk factor for ED, with effect strength influenced by geographic region and obesity definitions. Interventions targeting BMI≥30 kg/m2 in Western populations and metabolic risks at BMI≥25 kg/m3 in Asian populations are recommended.

Objective To explore the mechanisms of"treating different diseases with the same method"for chronic obstructive pulmonary disease(COPD)and diabetes mellitus(DM)with Shen-ling Baizhu San based on network pharmacology and molecular docking.Methods Comprehensive databases were searched to collect the active ingredients and targets of Shenling Baizhu San,which were then performed standardized process.Relevant targets for COPD and DM were collected from data platforms such as GeneCards and Online Mendelian Inheritance in Man(OMIM).The intersection tar-gets of the drug and diseases were identified using Venn software,imported into the STRING database to construct a protein-protein interaction(PPI)network,and performed visualized analysis using Cyto-scape software.Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed using R software.Molecular doc-king and visualization analysis were conducted using the CB-Dock2 platform.Results After screening,215 potential targets of Shenling Baizhu San were obtained.Venn diagram analysis showed that there were 70 potential intersection targets for the treatment of COPD and DM with Shenling Baizhu San.Key active ingredients included quercetin,stigmasterol,kaempferol,sitosterol,and luteolin,while core targets included tumor necrosis factor(TNF),interleukin-6(IL-6),interleukin-β(IL-1 β),prostaglandin-endoperoxide synthase 2(PTGS2),and tumor protein p53(TP53).GO functional en-richment analysis yielded 2,599 biological process terms,49 cellular component terms,and 230 molecular function terms.The main pathways obtained from KEGG pathway enrichment analysis in-cluded lipid and atherosclerosis,interleukin-17(IL-17)signaling pathway,TNF signaling pathway,and human cytomegalovirus infection.Molecular docking results showed that stigmasterol had the best docking activity with PTGS2.Conclusion Shenling Baizhu San may achieve the"treatment of different diseases with the same method"for COPD and DM through multiple components,multiple targets,and multiple pathways,and there is a certain correlation in the treatment mechanisms of two diseases,providing a theoretical basis and direction for subsequent research.

Objective:To analyze and summarize the medical security situation of the snowmobile,sled,and steel frame snowmobile tracks at the National Sliding Centre,and to provide experience for future event hosting and medical security work for mass ice and snow sports.Methods:Retrospective analysis of injuries and treatment of athletes participating in the International Training Week and World Cup for Ski,Sled,and Steel Frame Ski from October to November 2021(hereinafter referred to as"Inter-national Training Week"),as well as the Ski,Sled,and Steel Frame Ski events at the Beijing Winter Olympics in February 2022(hereinafter referred to as the"Beijing Winter Olympics").We referred to and drew on the"Medical Security Standards for Winter Snow Sports"to develop specific classification standards for analyzing injured areas,types of injuries,and accident locations.Results:A total of 743 athletes participated in the International Training Week and the Beijing Winter Olympics.During the com-petition,there were 58 incidents of overturning,prying,and collision,of which 28(28 athletes)were in-jured,accounting for 48.3％of the total accidents and 3.8％of the total number of athletes.Among them,there were 9 males(32.1％)and 19 females(67.9％),with an average age of(26.3±4.7)years.Among the 28 injured athletes,20 cases(71.4％)received on-site treatment for Class Ⅰ injuries,while 8 cases(28.6％)had more severe injuries,including Class Ⅱ injuries(7 cases)and Class Ⅲ injuries(1 case),which were referred to designated hospitals for further treatment.Among the 28 injured athletes,3 cases(10.7％)experienced multiple injuries,including 2 cases of 2 injuries and 1 case of 3 injuries.The most common injuries were in the ankle and toes(10/32,31.3％).Out of 28 injured athletes,one(3.6％)experienced two types of injuries simultaneously,with joint and/or ligament injuries being the most common(11/29,37.9％).The most accident prone point on the track was the ninth curve(18/58,31.0％).Conclusion:Through the analysis and summary of medical security work,it can provide better experience and reference for the future development of snowmobile,sled,and steel frame snowmobile sports in China,making the National Snowy and Ski Center truly a sustainable Olympic heritage.

Objective:To analyze the clinical characteristics of invasive klebsiella pneumoniae liver abscess syndrome (IKPLAS), and compare it with common pyogenic liver abscess (CPLA). Methods:The social demography and clinical data of inpatients with pyogenic liver abscess from January 2011 to December 2021 in the Peking University People's Hospital were collected. Based on the presence or absence of invasive infections and the results of bacterial etiology, IKPLAS was diagnosed and compared with CPLA. The general information, symptoms, past medical history, auxiliary examinations and prognosis indicators of the two groups of patients were compared.Results:Total of 172 patients with pyogenic liver abscess were collected, including 25 cases of IKPLAS. Compared with CPLA group, the proportion of fever in IKPLAS group was lower, the proportion of diabetes history was higher, the proportion of monocytes was lower, and procalcitonin and urea nitrogen were higher(all P<0.05), the proportion of multiple abscesses is higher, and the positive rate of blood culture and the cultivation of klebsiella pneumoniae are both higher (all P<0.05).A total of 9 cases (5.2%) of patients developed septic shock, of which 2 cases (1.2%) died. The IKPLAS group had a higher proportion of ICU admissions ( P<0.05),but but the difference of mortality between the two groups was not statistically significant ( P>0.05). The most common sites of invasion infection in the IKPLAS group are the lungs(22/25), brain(9/25), and eyes(9/25). Conclusions:There are differences in clinical characteristics between IKPLAS and CPLA, the most common sites of invasion infection are the lungs, brain, and eyes, but there is no difference in mortality in this study. For PLA with pathogenic Klebsiella pneumoniae, it is necessary to carefully evaluate the presence of invasive lesions and provide targeted local treatment to better improve prognosis.

Objective:To establish an early prediction model based on triglyceride glucose index (TyG) and procalcitonin (PCT) for patients of acute pancreatitis (AP) complicated with acute kidney injury (AKI), and evaluate the diagnostic value of prediction model.Methods:This study was a single center prospective study. AP patients were recruited from the Emergency Department at Peking University People’s Hospital from January to December 2022. The observation endpoint was 14 days after the diagnosis of acute pancreatitis, patients were divided into AKI and control (no AKI) groups according to the observation endpoint. The general characteristics, clinical laboratory examinations, complications, and clinical scores were compared. The risk for AKI development was determined using logistic analyses to establish a risk prediction model. The receiver operating characteristic curve was drawn and the area under the curve (AUC) was calculated. The diagnostic sensitivity and specificity of the model were calculated, and the diagnostic value of the model was compared with that of Ranson score, APACHEⅡ score and BISAP score.Results:A total of 258 patients were selected for this study, including 79 in the AKI group and 179 in the control group. There was no significant difference in serum creatinine and blood urea nitrogen levels between the two groups. Compared with the control group, the AKI group had a higher proportion of males, older age, and had a higher proportion of hypertension. The ratio of neutrophil/lymphocyte ratio, PCT, and TyG were significantly increased. The Ranson score, APACHE Ⅱ score, and BISAP score were higher, and more patients had ARDS and serous fluid accumulation in the later period. Multivariate logistic regression showed that age ( OR=1.071, 95% CI: 1.020-1.125, P=0.006), increased TyG index ( OR=2.632, 95% CI: 1.423-4.866, P=0.002), and elevated PCT ( OR=1.275, 95% CI: 1.067-1.524, P=0.008) were risk factors for AKI in AP patients. According to the risk factors, forecast the AP patients complicated with AKI risk assessment model is established: Logistic (AKI/AP) = -16.697+0.069×age+ 0.968×TyG+0.243×PCT. The sensitivity and specificity of the model for predicting AKI in AP were 79.75% and 96.65%, respectively, and the AUC was 0.856 (95% CI: 0.790-0.922). The predictive ability was better than that of Ranson score, BISAP score and APACHE Ⅱ score (AUC: 0.856 vs. 0.691 vs. 0.745 vs. 0.705, P=0.041). Conclusion:The prediction model based on age, TyG and PCT was valuable for the prediction of AP concurrent AKI in early stage.

Objective:To analyze the relationship between the systemic immune inflammation index (SII) and risk stratification of acute pulmonary embolism.Methods:The clinical data of patients with moderate to critical pulmonary embolism admitted to the emergency department of Peking University People's Hospital from January 2018 to May 2022 were respectively collected. The patients divided into a medium to high-risk group and a medium to low-risk group according to risk stratification. The SII index, simplified pulmonary embolism severity index (sPESI), general information, disease history, laboratory test results, and other indicators between two groups of patients were compared. Logistic regression was used to analyze the relationship between SII and risk stratification in patients with acute pulmonary embolism.Results:A total of 97 patients with moderate to critical pulmonary embolism were included, including 43 were in the medium high risk group and 54 were in the medium low risk group. The data of SII index, white blood cell count, C-reactive protein, and sPESI of patients in the medium to high-risk group were significantly higher than those in the medium to low-risk group (all P<0.05), and lower lymphocyte count than those in the medium to low-risk group ( P<0.05). Logistic regression analysis showed that SII ( OR=1.001, 95% CI: 1.000-1.002, P=0.027) and sPESI ( OR=2.000, 95% CI: 1.155-3.464, P=0.013) were the main factors affecting risk stratification in patients with acute pulmonary embolism. The AUC of SII, sPESI score, and their combined evaluation of acute pulmonary embolism risk stratification were 0.710, 0.625, and 0.739, respectively. The combined evaluation value of the two indicators was higher than that of a single indicator ( P=0.007). Conclusion:SII has good application value in risk stratification of acute pulmonary embolism, and the combined sPESI score has higher value.

Objective To investigate the effect of altered oxidative stress system on liver function after partial splenic embolization(PSE).Methods Twenty-nine patients with liver cirrhosis and hypersplenism who received PSE were selected.Peripheral venous blood was drawn from the patients before and at 1 week,1 month,and 3 months after PSE,and the indexes of oxidative stress system factors including malondialdehyde(MDA),superoxide dismutase(SOD),advanced oxidiation protein products(AOPPs),and gluta-thione peroxidase(GSH-Px)were detected,as well as liver function indexes.Results There were positive correlation between SOD activity and total bilirubin(TBil)and model for end-stage liver disease(MELD)scores at 1 week postoperatively(TBil:r=0.725,P＜0.05;MELD:r=0.764,P＜0.05).There was positive correlation between GSH-Px activity and alanine aminotransferase(ALT)at 1 month postoperatively(r=0.777,P＜0.05),however,the AOPPs was negatively correlated with ALT and aspartate aminotransferase(AST)at 3 months postoperatively(ALT:r--0.900,P＜0.05;AST:r=-0.957,P＜0.05).Conclusion PSE can improve the body oxidative stress system and enhance the body's antioxidant response,and then improve the liver function.

Objective:To summary the clinical phenotype and genotype characteristics of 2 cases of autosomal dominant mental retardation (MRD) caused by TRIO gene variation. Methods:Retrospective study of the clinical data of 2 cases of autosomal dominant MRD caused by TRIO gene mutations diagnosed at the Department of Neurology, Children′s Hospital Affiliated to Zhengzhou University in April 2019 and January 2023 was conducted. The clinical features were summarized and gene analysis and follow-up were carried out. Results:The 2 patients were 6 years and 5 months old and 5 months old males, respectively. Clinical manifestations included seizures, cognitive and motor disorders, low intelligent development; case 1 had microcephaly, attention deficit disorder, ataxia, and aggressive behavior, and case 2 had macrocephaly. Brain magnetic resonance imaging revealed cerebellar atrophy in case 1, and non-specific dilation of the subarachnoid space and hypoplasia of the corpus callosum in case 2. Analysis of chromosome karyotype and chromosome copy number variation in 2 children showed no abnormalities. Whole exome sequencing revealed novel missense mutations in the TRIO gene in both patients [NM_007118:c.4289C>A(p.Thr1430Lys), c.4111C>A(p.His1371Asn), respectively]. The application of rehabilitation function training and a variety of anti-seizure medications can not fully and effectively control the seizure. Conclusion:TRIO gene c.4289C>A(p.Thr1430Lys), c.4111C>A(p.His1371Asn) de novo missense variants were the genetic etiology of the 2 probands,causing rare autosomal dominant MRD type 44 and 63.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.