BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

OBJECTIVE By conducting evidence evaluation research on literatures,this study aims to reveal the o-verall characteristics and research hotspots in the field of combat trauma-related infections,ultimately providing data support for the prevention and control of such infections.METHODS Relevant research in this field was sys-tematically collected from open-source databases to construct a dataset.The overall characteristics,research hotspots,prevention and control strategies,and future challenges of trauma-related infections were summarized and analyzed.RESULTS From 2004 to 2024,184 papers were published.The United States contributed the most publications,with Uniformed Services University of the Health Sciences being the most productive research insti-tution and Professor Clinton K.Murray as the author with the highest number of publications.The top five key-words with the highest frequency were combat related injury,infection,Acinetobacter baumannii,epidemiology and management.Among the publicly published literature data on war trauma-related infections,blast injuries ac-counted for the largest proportion,mainly multi-site injuries,with limb injuries being the most common.Bacteri-al infections were more common than fungal infections,with gram-negative bacteria being predominant and A.baumannii being the most common.Besides early wound management and the use of antibacterial drugs,in-creased attention should be paid to infection prevention and control in austere environments and the development of novel countermeasures.These advancements are critical to address projected changes in combat trauma,inclu-ding increasingly complex injuries and substantially elevated risks of infection and antimicrobial resistance.CONCLUSION This study systematically presents research hotspots,developmental trends,and prospects in com-bat trauma-related infections through evidence evaluation study,providing novel perspectives for researchers and facilitating further development in this field.

Objective:To explore the impact of previous cytomegalovirus (CMV), herpes simplex virus (HSV), and rubella virus (RV) infection on pregnancy outcomes in infertile women undergoing the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) treatment. Methods:A retrospective cohort study was conducted to analyze the clinical data of women who underwent IVF/ICSI-ET for the first time at the Reproductive Medicine Center, the First Affiliated Hospital of Zhengzhou University from December 2017 to December 2022. The patients were divided into CMV-IgG (+) group ( n=154), RV-IgG (+) group ( n=86), HSV-IgG (+) group ( n=93) and IgG all-negative group ( n=172). The pregnancy outcomes of the patients in the virus-only infection group and the IgG all-negative group were compared. Patients who were previously co-infected with CMV and HSV were classified as the CMV+HSV-IgG (+) group ( n=344), and the pregnancy outcomes of patients with previous CMV and HSV co-infection and those with infection alone were further compared. Results:The two pronuclei (2PN) fertilization rate [63.90% (1 195/1 870)], the clinical pregnancy rate [51.30% (79/154)], and the live birth rate [45.45% (70/154)] of the CMV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.001; 61.05% (105/172), P=0.005]. The 2PN fertilization rate [61.62% (729/1 183)], the clinical pregnancy rate [50.54% (47/93)], and the live birth rate [43.01% (40/93)] of the HSV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.004; 61.05% (105/172), P=0.005]. There were no statistical differences in the 2PN fertilization rate, the clinical pregnancy rate, and the live birth rate between the RV-IgG (+) group and the IgG completely negative group (all P>0.05). Compared with the IgG completely negative group, there were no significant differences in the risk of complications such as gestational diabetes, hypertensive disorders of pregnancy and neonatal outcomes in the CMV-IgG (+) group, RV-IgG (+) group, and HSV-IgG (+) group (all P>0.05). Multivariate logistic regression analysis showed that CMV-IgG (+) ( OR=0.453, 95% CI: 0.280-0.734, P=0.001; OR=0.515, 95% CI: 0.321-0.825, P=0.006), HSV-IgG (+) ( OR=0.425, 95% CI: 0.245-0.738, P=0.002; OR=0.447, 95% CI: 0.259-0.771, P=0.004) and CMV+HSV-IgG (+) ( OR=0.491, 95% CI: 0.329-0.733, P=0.001; OR=0.528, 95% CI: 0.357-0.780, P=0.001) were all independent influencing factors of patients' clinical pregnancy and live birth. There were no statistical differences in the clinical outcomes between the previous CMV and HSV co-infection group and the single infection group ( P>0.05). Conclusion:Previous CMV or HSV infection alone reduced the fertilization rate, the clinical pregnancy rate and the live birth rate of patients undergoing IVF/ICSI-ET treatment, but had no significant impact on pregnancy complications and neonatal outcomes. Pregnancy outcomes of patients with previous CMV and HSV co-infection were similar to those with infection alone.

Objective : To investigate the antidepressant effects and the underlying mechanisms of tetrahydrocurcumin(THC) and its nanoparticle formulation(THCN). Methods : Forty-six male ICR mice were randomly divided into Con group, LPS group, THC group, THCN group and SER group. A mouse depression model was established by intraperitoneal administration of LPS. The anxiety and depression-like behaviors of mice were evaluated by open field test(OFT) and forced swimming test(FST). Myelin staining was applied to assess the extent of demyelination in the prefrontal cortex of the mice. The prefrontal cortex and hippocampus were further examined for the expression levels of glial fibrillary acidic protein(GFAP) and Toll-like receptor 4(TLR4) through quantitative immunofluorescence assays. Results : Compared with the Con group, the LPS group showed increased anxiety-like and depressive-like behaviors in both the long-term and short-term experiments(P<0.05); the degree of demyelination increased in the LPS group of the long-term experiment(P<0.01); the expression of GFAP was reduced in the LPS group of the short-term experiment(P<0.01), while the expression of TLR4 increased(P<0.05); the expression of TLR4 decreased in the THC group(P<0.01); the expression of GFAP in the prefrontal cortex of the THCN group was reduced(P<0.01), while the expression of TLR4 increased(P<0.05). Compared with the LPS group, the THC group showed reduced depressive-like behaviors in the long-term experiment(P<0.05), while the anxiety-like and depressive-like behaviors of the THCN group and the SER group were reduced(P<0.05), and the anxiety-like and depressive-like behaviors of the THC group and the THCN group were reduced in the short-term experiment(P<0.05); the degree of demyelination was reduced in the THC group, THCN group and SER group in the long-term experiment(P<0.05); the expression of GFAP increased in the THC group of the short-term experiment(P<0.05), while the expression of TLR4 was reduced(P<0.05), and the expression of GFAP increased in the THCN group(P<0.05). Compared with the THC group, the THCN group and the SER group showed reduced anxiety-like behaviors in the long-term experiment(P<0.05); the expression of GFAP in the prefrontal cortex of the THCN group was reduced in the short-term experiment(P<0.05), while the expression of TLR4 in the hippocampal DG area increased in the short-term experiment(P<0.01). Conclusion Tetrahydrocurcumin and its nanoparticle formulation both exert significant ameliorative effects on depression-like behaviors and demyelination in mice induced by lipopolysaccharide. The antidepressant mechanism of THC appears to be mediated through the down-regulation of TLR4 and the up-regulation of GFAP. The mechanism underlying the antidepressant action of THCN seems predominantly focused on the enhancement of GFAP expression.

Objective:The research group had previously developed an artificial intelligence algorithm to predict sepsis within 24 hours at the triage stage in emergency departments. This research studied the doctors’ response to algorithm-generated risk alerts and designs appropriate physician-algorithm collaboration strategies to further enhance sepsis risk identification capabilities.Methods:The research collected 40 cases of sepsis in the emergency departments from the open medical database MIMIC-IV (Medical Information Mart for Intensive Care) for a collaboration test. The cases were selected according to their typicality and classified according to the model’s confidence in its prediction. A total of 165 emergency doctors from 58 hospitals in China, stratified by professional rank, participated in the study. Four collaboration modes were designed with different information volumes and reading costs using the information offered by the algorithm. During the test, before and after the model presented its results and interpretive information according to the collaboration mode, the doctors were asked to rate the sepsis risk for each sample and record their confidence.Results:Analysis of the 4 704 valid evaluations done by 147 doctors showed that different collaboration modes caused no significant difference on doctors’ detection of sepsis risk. For cases with high model confidence, physicians’ diagnostic accuracy improved by 2.6%±0.6% ( P=0.02) post-algorithm input, with increased confidence in correct judgments. Conversely, for low-confidence model predictions, diagnostic accuracy decreased by 2.6%±1.4% ( P=0.06), accompanied by reduced clinician confidence in accurate assessments. Conclusions:The collaboration effect is mostly determined by the model’s confidence in its prediction. Different collaboration modes cause no significant difference, and doctors of different titles are influenced consistently with the same model confidence. Suggestions for collaboration design are as follow. When the model has low confidence in its own assessment of a patient’s sepsis risk, it should not directly demonstrate its assessment. When the model has high confidence, its assessment can be offered to the doctors as a reference. When predicting sepsis at the triage stage in the emergency departments, no extra interpretive information is needed.

Cronkhite-Canada syndrome(CCS)is a rare non-hereditary disease characterized by multiple gastrointestinal polyps and ectodermal abnormalities.Its etiology remains unclear,and there is a lack of a gold standard for diagnosis.Patients with CCS have a higher risk of developing gastrointestinal tumors compared to the general population.Early diagnosis is challenging,and the disease is prone to recurrence,necessitating long-term follow-up.The Digestive Disease Branch of China Alliance for Rare Diseases/Beijing Association of Rare Disease Diagnosis,Treatment and Security,in collaboration with the Rare Disease Collaborative Group of the Chinese Society of Gastroenterology,Chinese Medical Association,developed this consensus to provide cor-responding recommendations on the pathogenesis,clinical manifestations,diagnosis,and treatment of CCS.

Objective:To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad, so as to provide a reference for removing low-value care measures in the future.Methods:Arksey and O'?Malley scoping review method was used to systematically search the China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP, PubMed, Cochrane Library, CINAHL, Embase, and Web of Science. The search period was from database establishment to January 1, 2024. Literature was screened based on inclusion and exclusion criteria, and catheter care site, disinfection/cleaner type, frequency, institutional norms, and determinants were independently extracted by two researchers, where determinants were framed based on the theoretical domains framework.Results:A total of 21 papers were included. Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals. Thirteen strategies were proposed to remove urethra low-value care measures. Factors that influenced the removal of low-value care behaviors included knowledge, reinforcement, environment and resources, social influences, personal roles and identities, outcome beliefs and memories, and attention and decision-making processes.Conclusions:Future researchers should further refine the evidence on urethra care and develop contextualized care for complex, multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.

Objective:To explore the impact of previous cytomegalovirus (CMV), herpes simplex virus (HSV), and rubella virus (RV) infection on pregnancy outcomes in infertile women undergoing the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) treatment. Methods:A retrospective cohort study was conducted to analyze the clinical data of women who underwent IVF/ICSI-ET for the first time at the Reproductive Medicine Center, the First Affiliated Hospital of Zhengzhou University from December 2017 to December 2022. The patients were divided into CMV-IgG (+) group ( n=154), RV-IgG (+) group ( n=86), HSV-IgG (+) group ( n=93) and IgG all-negative group ( n=172). The pregnancy outcomes of the patients in the virus-only infection group and the IgG all-negative group were compared. Patients who were previously co-infected with CMV and HSV were classified as the CMV+HSV-IgG (+) group ( n=344), and the pregnancy outcomes of patients with previous CMV and HSV co-infection and those with infection alone were further compared. Results:The two pronuclei (2PN) fertilization rate [63.90% (1 195/1 870)], the clinical pregnancy rate [51.30% (79/154)], and the live birth rate [45.45% (70/154)] of the CMV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.001; 61.05% (105/172), P=0.005]. The 2PN fertilization rate [61.62% (729/1 183)], the clinical pregnancy rate [50.54% (47/93)], and the live birth rate [43.01% (40/93)] of the HSV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.004; 61.05% (105/172), P=0.005]. There were no statistical differences in the 2PN fertilization rate, the clinical pregnancy rate, and the live birth rate between the RV-IgG (+) group and the IgG completely negative group (all P>0.05). Compared with the IgG completely negative group, there were no significant differences in the risk of complications such as gestational diabetes, hypertensive disorders of pregnancy and neonatal outcomes in the CMV-IgG (+) group, RV-IgG (+) group, and HSV-IgG (+) group (all P>0.05). Multivariate logistic regression analysis showed that CMV-IgG (+) ( OR=0.453, 95% CI: 0.280-0.734, P=0.001; OR=0.515, 95% CI: 0.321-0.825, P=0.006), HSV-IgG (+) ( OR=0.425, 95% CI: 0.245-0.738, P=0.002; OR=0.447, 95% CI: 0.259-0.771, P=0.004) and CMV+HSV-IgG (+) ( OR=0.491, 95% CI: 0.329-0.733, P=0.001; OR=0.528, 95% CI: 0.357-0.780, P=0.001) were all independent influencing factors of patients' clinical pregnancy and live birth. There were no statistical differences in the clinical outcomes between the previous CMV and HSV co-infection group and the single infection group ( P>0.05). Conclusion:Previous CMV or HSV infection alone reduced the fertilization rate, the clinical pregnancy rate and the live birth rate of patients undergoing IVF/ICSI-ET treatment, but had no significant impact on pregnancy complications and neonatal outcomes. Pregnancy outcomes of patients with previous CMV and HSV co-infection were similar to those with infection alone.

Objective To explore the association between cardiorespiratory fitness and total atherosclerotic burden of brain-and heart-arteries in patients with ischemic stroke.Methods This study retrospectively enrolled consecutive patients with ischemic stroke of the large-artery atherosclerosis or small-artery occlusion subtypes accompanied by cervicocephalic atherosclerosis,who were admitted to the Department of Neurology,Xuanwu Hospital,Capital Medical University,between May 2023 and December 2024.General and clinical data,including age(＜60years,≥60years),sex,admission blood pressure,body mass index,history of hypertension,diabetes mellitus,hyperlipidemia,ischemic stroke,symptomatic coronary artery disease,smoking,alcohol consumption,and medication use(including antiplatelet drugs,anticoagulants,lipid-lowering drugs,antidiabetic drugs,antihypertensive drugs,and β-blockers),characteristics of ischemic stroke(including the duration of onset,ischemic side[left,right,bilateral],and ischemic location[anterior circulation,posterior circulation,bilateral circulation])were collected from all patients enrolled.On the morning after admission,fasting venous blood samples were collected to measure the levels of triglycerides,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,fasting blood glucose,glycated hemoglobin,homocysteine,fibrinogen,D-dimer,C-reactive protein,high-sensitivity C-reactive protein,N-terminal pro-B-type natriuretic peptide,creatine kinase-MB,cardiac troponin T,and myoglobin.Transthoracic echocardiography was performed within 7 days after admission to evaluate cardiac function.Left ventricular ejection fraction and cardiac output were recorded,and cardiac index were calculated.Upon admission,neurological impairment,disability,motor function,and balance ability were assessed using the National Institutes of Health stroke scale(NIHSS),modified Rankin scale(mRS),Fugl-Meyer assessment(FMA),and Berg balance scale,respectively.The Saltin-Grimby physical activity level scale was used to evaluate the intensity of habitual physical activity prior to stroke onset.Cardiopulmonary exercise testing was performed within 7 days after admission to assess cardiopulmonary fitness.During the test,peak oxygen uptake(VO2peak),percentage of predicted VO2peak(VO2peak%pred),and metabolic equivalent of task(MET)were recorded.Based on the minimum oxygen uptake required for independent living(15 ml/[kg·min]),VO2peak was classified into low VO2peak(＜15 ml/[kg·min])and high VO2peak(≥15 ml/[kg·min]).With VO2peak%pred＜0.60 as the cutoff,VO2peak%pred was divided into low VO2peak%pred(＜0.60)and high VO2peak%pred(≥0.60).MET were categorized into low MET(＜mean MET)and high MET(≥mean MET)according to the mean value of MET in this study population.Imaging data of cardio-cerebral arteries were obtained by simultaneous CT arteriography within 7 days after admission.Total atherosclerotic burden of brain-and heart-supplying arteries(TAB-BHAs)was used to quantitatively evaluate the overall degree of cardio-cerebral atherosclerosis.And patients were stratified into high TAB-BHAs(≥4 points)and low TAB-BHAs(＜4 points)groups.The differences in general and clinical characteristics,as well as cardiopulmonary fitness indices,were assessed among different groups of TAB-BHAs.Spearman' s correlation was used in the preliminary analysis of the relationship between cardiorespiratory fitness indicators and TAB-BHAs.Multivariate Logistic regression was conducted with VO2peak,low VO2peak%pred,and low METs as independent variables,and high TAB-BHAs as the dependent variable to assess the association between cardiopulmonary fitness and TAB-BHAs.Covariates were selected through regressions stratified by age≥60 years,male,the least absolute shrinkage and selection operator(LASSO),and the variables exhibit statistically significant differences between the low and high TAB-BHAs groups,respectively.Results A total of 104 patients with ischemic stroke were enrolled.Among all patients enrolled,60patients(with ages ranging from 30 to 72years and a mean age of[54±11]years)met the inclusion and exclusion criteria,and were ultimately included.Amid the 60 patients,52 were male and 8 were female.There were 20 patients(33.3%)with low VO2peak,28 patients(46.7%)with low VO2peak%pred,and 31 patients(51.7%)with low MET(MET＜5.0).45 patients were classified into the low TAB-BHAs group and 15 into the high TAB-BHAs group.(1)Compared with the low TAB-BHAs group,patients in the high TAB-BHAs group were significantly older and had a higher proportion of patients aged≥60 years,they also showed significantly higher fibrinogen levels and a history of antihypertensive drug use(all P＜0.05).No significant differences were observed in other general or clinical characteristics between the two groups(all P＞0.05).Regarding cardiopulmonary fitness parameters,patients in the high TAB-BHAs group had lower VO2peak and MET levels,and higher proportions of patients with low VO2peak,low VO2peak%pred,and low MET compared with those in the low TAB-BHAs group(all P＜0.05).(2)Based on the Spearman's correlation analysis,VO2peak(r=-0.298,P=0.021),VO2peak%pred(r=-0.305,P=0.018),MET(r=-0.303,P=0.018)all exhibited negative correlations between and TAB-BHAs.(3)LASSO regression was used to identify the most pertinent variables for high TAB-BHAs,including low VO2peak,low VO2peak%pred,and fibrinogen.Multivariate Logistic regression analysis was then performed with low VO2peak,low VO2peak%pred,and low MET as independent variables and high TAB-BHAs as the dependent variable.The results showed that after adjusting for age≥60 years,male,and fibrinogen,both low VO2peak(adjusted OR,4.420,95%CI 1.052-18.573,P=0.042)and low VO2peak%pred(adjusted OR,7.423,95%CI 1.411-39.046,P=0.018)were independently associated with high TAB-BHAs in ischemic stroke patients.After further adjusting for variables that differed among high and low TAB-BHAs groups(including age≥60 years,male,fibrinogen,and history of using antihypertensive drugs),multivariate Logistic regression showed that low VO2peak%pred remained independently associated with high TAB-BHAs in ischemic stroke patients(adjusted OR,6.347,95%CI 1.170-34.418,P=0.032).Conclusion Poor cardiopulmonary fitness might be associated with high degree of overall cardio-cerebral atherosclerosis,suggesting cardiorespiratory fitness as a potential correlated indicator that could provide clues for improving early screening of patients with heavy cardio-cerebral atherosclerotic burden and for exploring the underlying mechanisms.