Objective:To explore the correlation between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and the risk of hypertension in elderly physical examination populations.Methods:This study was a cross-sectional study. A total of 1 028 patients aged≥60 years who underwent physical examinations at the Health Management Center of Fuwai Central China Cardiovascular Hospital from September 2023 to February 2024 were included in this study. The general demographic data, past medical history, physical examination and laboratory examination indicators of the physical examiners were collected, and according to whether they had hypertension or not, they were divided into hypertension group (390 cases) and non-hypertension group (638 cases), and all UHR values were arranged from small to large, and the UHR was divided into three groups by tertiles of UHR, and the general data and blood biochemical indexes between the groups were compared. Spearman rank correlation was used to analyze the correlation between UHR level and body mass index, total cholesterol, triglyceride and other indexes in the elderly population. Logistic regression was used to explore the relationship between UHR level and hypertension in the elderly population, and the stratification analysis of the physical examination population was carried out according to diabetes, coronary heart disease and dyslipidemia, and the interaction test between groups was carried out.Results:Among the 1 028 geriatric physical examination cases, 580 (56.4%) were males and 448 (43.6%) were females, aged (66.7±5.8) years. UHR levels were higher in the hypertensive group compared to the non-hypertensive group [248.88 (191.19, 322.25) vs 213.52 (165.94, 275.29); Z=-5.445, P<0.05]. With the increase of UHR level, the detection rate of hypertension in the elderly population increased (accounted for 27.8%, 38.2% and 47.8%, respectively; χ2=29.211, P<0.05). Spearman rank correlation analysis showed that UHR was positively correlated with body mass index, triglycerides, serum uric acid, serum creatinine and fasting blood glucose ( r=0.318, 0.334, 0.774, 0.474, 0.080; all P<0.05), and negatively correlated with total cholesterol, glomerular filtration rate and low-density lipoprotein cholesterol ( r=-0.239, -0.303, -0.154; all P<0.05). When the confounding factors were not adjusted (model 1), the risk of hypertension in high UHR group was 2.382 times higher than that in low UHR group and 1.607 times higher than that in medium UHR group; after adjusting for all confounding factors such as age, gender, body mass index, systolic blood pressure, diastolic blood pressure, junior high school education or below, smoking, alcohol consumption, glomerular filtration rate, etc., the risk of hypertension in the high-level UHR group was 1.732 times higher than that in the low-level UHR group (95% CI: 1.139-2.635) ( P<0.05). The elderly physical examination population was further stratified according to whether there was diabetes, dyslipidemia and coronary heart disease, and it was found that there was no interaction between UHR and diabetes, dyslipidemia and coronary heart disease on the prevalence of hypertension (all P>0.05). Conclusions:Hypertension detection rate increases with higher UHR levels. UHR is closely related to the incidence of hypertension in the elderly population.

Objective:To investigate the predictive value of radiomics features derived from dynamic contrast-enhanced MRI (DCE-MRI) based on habitat imaging technology for pathological complete response after neoadjuvant therapy (NAT) for breast cancer.Methods:All patients were female, aged 25-67 years. Patients were stratified into training ( n=83) and validation ( n=36) sets via stratified random sampling (7∶3 ratio). Pathological complete remission (pCR) and non-pathological complete remission (non-pCR) were defined using the Miller-Payne grading system. All patients underwent DCE-MRI before NAT. ITK-Snap software was used to outline the region of interest (ROI), the imaging histological features of the entire tumor region were extracted and screened, a traditional imaging histological model for predicting post-NAT pCR (ROI overall model) was constructed; the tumor region was divided into three subregions using habitat imaging technology, and the imaging histological features within ROI subregion 1, ROI subregion 2, and ROI subregion 3 were extracted and screened, and the habitat imaging model for predicting post-NAT pCR were constructed (ROI subregion 1 model, ROI subregion 2 model, ROI subregion 3 model). Univariate logistic regression identified clinical predictors of pCR for clinical model construction. Combined models integrating clinical predictors and habitat imaging features were established. The efficacy of each model in predicting pCR after NAT in breast cancer was evaluated using receiver operating characteristic curves and area under the curve (AUC), and the efficacy of clinical application of the models was evaluated using decision curve analysis (DCA). Results:Of the 119 patients, 74 were pCR patients, with 52 in the training set and 22 in the validation set, and 45 were non-pCR patients, with 31 in the training set and 14 in the validation set. Logistic regression analysis showed that human epidermal growth factor receptor 2 status ( OR=0.254, 95% CI 0.093-0.697, P=0.008) was an independent predictor of pCR after NAT, and this was used to construct a clinical prediction model. The predictive efficacy of ROI subregion 1 model and ROI subregion 2 model in the habitat model was higher than that of the traditional imaging histology model (ROI overall model), with AUCs of 0.805, 0.748,0.728 for the training set and 0.776,0.718,0.708 for the validation set, respectively. The combined clinical prediction model for predicting pCR after NAT in breast cancer had AUCs of 0.877 and 0.818 for the training and validation sets, respectively. DCA showed a higher net benefit for the combined model than for the traditional imaging histology model and the habitat imaging histology model. Conclusion:Compared with the traditional method of extracting the entire tumor region, extracting radiomics features from DCE-MRI subregions based on habitat imaging technology can improve the predictive performance of NAT efficacy in breast cancer.

Objective:To explore the correlation between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and the risk of hypertension in elderly physical examination populations.Methods:This study was a cross-sectional study. A total of 1 028 patients aged≥60 years who underwent physical examinations at the Health Management Center of Fuwai Central China Cardiovascular Hospital from September 2023 to February 2024 were included in this study. The general demographic data, past medical history, physical examination and laboratory examination indicators of the physical examiners were collected, and according to whether they had hypertension or not, they were divided into hypertension group (390 cases) and non-hypertension group (638 cases), and all UHR values were arranged from small to large, and the UHR was divided into three groups by tertiles of UHR, and the general data and blood biochemical indexes between the groups were compared. Spearman rank correlation was used to analyze the correlation between UHR level and body mass index, total cholesterol, triglyceride and other indexes in the elderly population. Logistic regression was used to explore the relationship between UHR level and hypertension in the elderly population, and the stratification analysis of the physical examination population was carried out according to diabetes, coronary heart disease and dyslipidemia, and the interaction test between groups was carried out.Results:Among the 1 028 geriatric physical examination cases, 580 (56.4%) were males and 448 (43.6%) were females, aged (66.7±5.8) years. UHR levels were higher in the hypertensive group compared to the non-hypertensive group [248.88 (191.19, 322.25) vs 213.52 (165.94, 275.29); Z=-5.445, P<0.05]. With the increase of UHR level, the detection rate of hypertension in the elderly population increased (accounted for 27.8%, 38.2% and 47.8%, respectively; χ2=29.211, P<0.05). Spearman rank correlation analysis showed that UHR was positively correlated with body mass index, triglycerides, serum uric acid, serum creatinine and fasting blood glucose ( r=0.318, 0.334, 0.774, 0.474, 0.080; all P<0.05), and negatively correlated with total cholesterol, glomerular filtration rate and low-density lipoprotein cholesterol ( r=-0.239, -0.303, -0.154; all P<0.05). When the confounding factors were not adjusted (model 1), the risk of hypertension in high UHR group was 2.382 times higher than that in low UHR group and 1.607 times higher than that in medium UHR group; after adjusting for all confounding factors such as age, gender, body mass index, systolic blood pressure, diastolic blood pressure, junior high school education or below, smoking, alcohol consumption, glomerular filtration rate, etc., the risk of hypertension in the high-level UHR group was 1.732 times higher than that in the low-level UHR group (95% CI: 1.139-2.635) ( P<0.05). The elderly physical examination population was further stratified according to whether there was diabetes, dyslipidemia and coronary heart disease, and it was found that there was no interaction between UHR and diabetes, dyslipidemia and coronary heart disease on the prevalence of hypertension (all P>0.05). Conclusions:Hypertension detection rate increases with higher UHR levels. UHR is closely related to the incidence of hypertension in the elderly population.

Objective:To investigate the predictive value of radiomics features derived from dynamic contrast-enhanced MRI (DCE-MRI) based on habitat imaging technology for pathological complete response after neoadjuvant therapy (NAT) for breast cancer.Methods:All patients were female, aged 25-67 years. Patients were stratified into training ( n=83) and validation ( n=36) sets via stratified random sampling (7∶3 ratio). Pathological complete remission (pCR) and non-pathological complete remission (non-pCR) were defined using the Miller-Payne grading system. All patients underwent DCE-MRI before NAT. ITK-Snap software was used to outline the region of interest (ROI), the imaging histological features of the entire tumor region were extracted and screened, a traditional imaging histological model for predicting post-NAT pCR (ROI overall model) was constructed; the tumor region was divided into three subregions using habitat imaging technology, and the imaging histological features within ROI subregion 1, ROI subregion 2, and ROI subregion 3 were extracted and screened, and the habitat imaging model for predicting post-NAT pCR were constructed (ROI subregion 1 model, ROI subregion 2 model, ROI subregion 3 model). Univariate logistic regression identified clinical predictors of pCR for clinical model construction. Combined models integrating clinical predictors and habitat imaging features were established. The efficacy of each model in predicting pCR after NAT in breast cancer was evaluated using receiver operating characteristic curves and area under the curve (AUC), and the efficacy of clinical application of the models was evaluated using decision curve analysis (DCA). Results:Of the 119 patients, 74 were pCR patients, with 52 in the training set and 22 in the validation set, and 45 were non-pCR patients, with 31 in the training set and 14 in the validation set. Logistic regression analysis showed that human epidermal growth factor receptor 2 status ( OR=0.254, 95% CI 0.093-0.697, P=0.008) was an independent predictor of pCR after NAT, and this was used to construct a clinical prediction model. The predictive efficacy of ROI subregion 1 model and ROI subregion 2 model in the habitat model was higher than that of the traditional imaging histology model (ROI overall model), with AUCs of 0.805, 0.748,0.728 for the training set and 0.776,0.718,0.708 for the validation set, respectively. The combined clinical prediction model for predicting pCR after NAT in breast cancer had AUCs of 0.877 and 0.818 for the training and validation sets, respectively. DCA showed a higher net benefit for the combined model than for the traditional imaging histology model and the habitat imaging histology model. Conclusion:Compared with the traditional method of extracting the entire tumor region, extracting radiomics features from DCE-MRI subregions based on habitat imaging technology can improve the predictive performance of NAT efficacy in breast cancer.

Purpose/Significance The paper analyzes the application of remote consultation in Henan province and the factors affect-ing service efficiency,optimizes service mode,and provides suggestions for the sound development of telemedicine.Method/Process The volume of remote consultation business,patient and doctor data,and consultation process data carried out through the regional tele-medicine integrated service platform in Henan province in 2022 are collected and sorted out.IBM SPSS 23.0 software is used to analyze the distribution of patients and business development of remote consultation,and factors affecting the efficiency of consultation are ana-lyzed through multiple logistic regression.Result/Conclusion The level of the hospital applying for remote consultation and the consulta-tion department affect the duration of the consultation process.The consultation department,expert titles,and referral suggestions are the main factors affecting the response time of consultation.It is suggested to optimize the service process of remote consultation,enhance the enthusiasm of doctors to participate in consultation,reduce the response time of consultation,and improve the efficiency of consultation.

Objective:To investigate the efficacy of functional endoscopic sinus surgery（FESS） in the treatment of olfactory dysfunction in patients with chronic rhinosinusitis with nasal polyps （CRSwNP） , at the same time, it provides an evidence for the prognosis evaluation of olfaction and the clinical application of oERPs to evaluate the plasticity of olfaction cortex. Methods:From October 2021 to October 2022, 45 patients with CRSwNP who underwent FESS nine-step standardized treatment in our department were recruited as the research subjects, divided into 22 patients with eosinophilic CRSwNP（ECRS）and 23 patients with non-eosinophilic CRSwNP（nECRS）. VAS-olfactory dysfunction （VAS-OD） score, SNOT-22 olfactory score, Sniffin' Sticks test and oERPs collection and processing were performed before the operation. All items were evaluated again 3 months after the operation. Results:VAS-OD and SNOT-22 olfactory score were significantly lower in all CRSwNP patients after the operation than those before the operation[F（1, 43） =357.429, P<0.001; F（1, 43） =185.657, P<0.001], the scores of T, D, I and TDI scores in Sniffin' Sticks test were significantly higher than those before the operation[F（1, 43） =126.302, P<0.001; F（1, 43） =311.301, P<0.001; F（1, 43） =131.401, P<0.001; F（1, 43） =295.885, P<0.001]; The decrease of VAS-OD and SNOT-22 olfactory score in the ECRS group was smaller than that in the nECRS group[F（1, 43） =4.825, P=0.033; F（1, 43） =9.916, P=0.003], T, D and TDI scores were significantly lower in nECRS group than those in nECRS group[F（1, 43） =6.719, P=0.013; F（1, 43） =4.890, P=0.032; F（1, 43） =4.469, P=0.040]; There was a positive correlation between preoperative eosinophil-to-lymphocyte ratio（ELR） and SNOT-22 olfactory score and how much it changes（r=0.455, P=0.002; r=-0.414, P=0.005）, a negative correlation between T, TDI score and how much they change respectively（r=-0.431, P=0.003; r=-0.385, P=0.009; r=-0.383, P=0.010; r=-0.316, P=0.035）. The latency of P3 was significantly shorter after operation than that before operation in all CRSwNP patients[F（1, 14） =24.840, P<0.001], however, the amplitude has no significant surgical effect. Conclusion:FESS could significantly improve the olfactory function of CRSwNP patients, while changes in plasticity may occur in the olfactory cortex. In addition, the preoperative peripheral blood eosinophil granulocyte level can predict the postoperative olfactory improvement.
Humans ; Prospective Studies ; Nasal Polyps/surgery* ; Rhinitis/surgery* ; Sinusitis/surgery* ; Olfaction Disorders/etiology* ; Chronic Disease ; Endoscopy/adverse effects*

Objective:To investigate the relationship between monocyte/high-density lipoprotein ratio (MHR) and clinical parameters and the prognosis of patients with chronic kidney disease (CKD).Methods:Clinical data were collected of CKD patients who were diagnosed and followed up regularly in Henan Provincial People's Hospital from January 1, 2017 to June 30, 2020. According to the median baseline MHR of the selected patients, they were divided into two groups: low-level MHR group (MHR≤0.347 8) and high-level MHR group (MHR>0.347 8). The patients were regularly followed up for 3-42 months, the renal adverse prognostic events were defined as serum creatinine doubled, estimated glomerular filtration rate (eGFR) reduced to at least 50% of the original, new entry into end-stage renal disease (ESRD), starting renal replacement therapy, death due to renal or cardiovascular events. The Kaplan-Meier method was used to compare the differences in survival rates between the two groups, and Cox regression analysis method was used to explore the influencing factors of renal adverse prognosis in CKD patients. Stratified analysis was used to find special factors that might affect the relationship between MHR and renal adverse prognosis in CKD patients.Results:A total of 405 patients were included in this study. Their age was (49.77±14.82) years old. Body mass index was (25.18±4.22) kg/m 2. Women accounted for 30.62%(124/405). The proportion of patients with smoking, drinking, hypertension and diabetes was 39.51%(160/405), 35.06%(142/405), 73.33%(297/405) and 38.27%(155/405), respectively. Compared with the low-level MHR group ( n=202), the high-level MHR group ( n=203) had more people in late CKD, males, and hypertension (all P<0.01), and body mass index, white blood cells, monocytes, serum creatinine, serum uric acid, serum urea nitrogen, retinol binding protein, cystatin C, blood phosphorus were higher (all P<0.05), while hemoglobin, high density lipoprotein and eGFR were lower (all P<0.05). Spearman rank correlation results show that MHR level was positively correlated with white blood cells, serum creatinine, serum uric acid, serum urea nitrogen, retinol-binding protein, cystatin C, serum phosphorus (all P<0.01), and negatively correlated with hemoglobin and eGFR (both P<0.01). The median follow-up time was 8(4, 16) months. To the end of the follow-up, 113 patients (27.90%) had renal adverse prognostic events. Kaplan-Meier survival analysis results showed that the renal cumulative survival rate of the high-level MHR group was lower than that of the low-level MHR group ( χ2=8.277, P=0.004). Multivariate Cox regression analysis showed that high MHR level was an independent influencing factor for poor renal prognosis in CKD patients ( HR=1.628, 95% CI 1.050-2.523, P=0.029). Stratified analysis showed that, without hypertension, MHR had a more significant effect on the prognosis of the kidneys ( HR=3.414, 95% CI 1.091-10.686, P for interaction=0.001). Conclusions:The level of MHR is related to the severity and poor renal prognosis of CKD, and the high MHR level is an independent predictor for poor renal prognosis in CKD patients.

Objective:To investigate the CT features of primary hepatic lymphoma in order to improve the accuracy of diagnosis.Methods:The clinical data, CT and pathological findings of 11 patients with primary hepatic lymphoma confirmed by surgery and pathology in Wenzhou Medical University Affiliated Yueqing Hospital, Wenzhou People′s Hospital of Zhejiang Province and the First Affiliated Hospital of Wenzhou Medical College from September 2008 to September 2018 were retrospectively analyzed.Results:Among the 11 patients, the tumors were located in the right liver in 7 cases, in the left liver in 2 cases, and in the left and right lobe of the liver in 2 cases; there were 27 tumors with the largest diameter of 1.7 to 12.6 cm; the tumors were round in 3 cases, oval in 5 cases and irregular in 3 cases; the tumor boundary was clear in 8 cases and unclear in 3 cases. CT scan showed low density in 6 cases, slightly low density in 3 cases and equal density in 2 cases; the density was uniform in 7 cases and inhomogeneous in 4 cases; CT value was 26 to 47 (38 ± 5) HU; there were 2 cases of splenic metastasis, 1 case of rib metastasis and 1 case of abdominal and retroperitoneal lymph node enlargement. CT enhanced scan showed no obvious enhancement in 1 case; in arterial phase, mild to moderate enhancement was seen in 10 cases, including 8 cases of continuous circular enhancement at the edge of the lesions in portal venous phase and delayed phase, and 2 cases with nodular enhancement; the CT value of arterial phase was 30 to 68 (53.8 ± 11.6) HU, that of portal venous phase was 52 to 69 (64.3 ± 9.3) HU, and that of delayed phase was 43 to 64 (56.4 ± 6.0) HU. Eight cases were completely resected, and 6 cases recurred after operation. Five cases survived for 3 years and 2 cases survived for 5 years; 3 cases were not completely resected, and all of them recurred after operation. One case survived for 3 years and no patient survived for 5 years. Among them,. Pathological diagnosis was diffuse large B-cell lymphoma in 10 cases and T-cell lymphoma in 1 case.Conclusions:CT examination of primary hepatic lymphoma has important value in the localization, qualitative and auxiliary clinical diagnosis of the tumor.

Objective We performed a diffusion tensor imaging (DTI) study to explore the value of mode of anisotropy (MO) and other DTI-derived indices in assessing white matter fiber damage with mild to moderate Alzheimer disease (AD) patients. Methods This study was a prospective study. From February 2015 to February 2018, 33 patients with mild to moderate AD according to criteria were prospectively recruited as AD group at the First Affiliated Hospital of Wenzhou Medical University. Twenty healthy age-, sex-matched volunteers were recruited as normoal conctrast (NC) group. All subjects were performed by conventional brain MRI and DTI scans. The MO, anisotropic fraction (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AxD) of white matter fibers were obtained from DTI images after TBSS post-processing. The statistical analyses of DTI indices between AD group and NC group were carried out in Functional MRI Software Library software. Results As compared with NC group, we found 1 cluster with significant decrease FA and increase RD in AD group, the affected fibers involving bilateral anterior thalamic radiation, corticospinal tract, cingulate gyrus, hippocampus, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, uncinated fasciculus, superior longitudinal fasciculus (P<0.05). The MD value increase(P<0.1) was found to coincide with the decrease of FA and the increase of RD, while no significant increase or decrease in P<0.05. Three clusters of MO increases (P<0.05) accompanying with increases of AxD were found in left anterior limb of internal capsule, bilateral posterior limb of internal capsule, posterior forceps, left centrum semiovale and parietal lobe. Two clusters of MO decreases (P<0.05) accompanying with decreases of FA and increases of RD were found in fornix, forceps, external capsule, centrum semiovale and left frontal lobe. Conclusions The combination of MO with DTI routine tensor indices (FA, RD, MD, AxD) can further reveal the microstructural damage of white matter fibers in AD, especially to crossing-fibers. The abnormalities of MO combined with FA, RD and MD reveal the degeneration of both bundles of crossing-fibers,and the abnormalities of MO combined with AxD reveal that the white matter damage was mainly caused by axon damage of one bundle of cross fibers.

Attention deficit hyperactivity disorder (ADHD) is a common childhood neuropsychiatric disorder that has been linked to the dopaminergic system. This study aimed to investigate the effects of regulation of the dopamine D4 receptor (DRD4) on functional brain activity during the resting state in ADHD children using the methods of regional homogeneity (ReHo) and functional connectivity (FC). Resting-state functional magnetic resonance imaging data were analyzed in 49 children with ADHD. All participants were classified as either carriers of the DRD4 4-repeat/4-repeat (4R/4R) allele (n = 30) or the DRD4 2-repeat (2R) allele (n = 19). The results showed that participants with the DRD4 2R allele had decreased ReHo bilaterally in the posterior lobes of the cerebellum, while ReHo was increased in the left angular gyrus. Compared with participants carrying the DRD4 4R/4R allele, those with the DRD4 2R allele showed decreased FC to the left angular gyrus in the left striatum, right inferior frontal gyrus, and bilateral lobes of the cerebellum. The increased FC regions included the left superior frontal gyrus, medial frontal gyrus, and rectus gyrus. These data suggest that the DRD4 polymorphisms are associated with localized brain activity and specific functional connections, including abnormality in the frontal-striatal-cerebellar loop. Our study not only enhances the understanding of the correlation between the cerebellar lobes and ADHD, but also provides an imaging basis for explaining the neural mechanisms underlying ADHD in children.
Attention Deficit Disorder with Hyperactivity ; diagnostic imaging ; genetics ; pathology ; Brain ; diagnostic imaging ; Cerebellum ; diagnostic imaging ; Child ; Corpus Striatum ; diagnostic imaging ; Female ; Frontal Lobe ; diagnostic imaging ; Genotype ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Minisatellite Repeats ; genetics ; Neural Pathways ; diagnostic imaging ; Oxygen ; blood ; Receptors, Dopamine D4 ; genetics ; metabolism ; Rest