Objective:To establish and explore a novel model and its clinical application value based on abnormal des-gamma-carboxy prothrombin (DCP) for the early-stage diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods:A total of 420 cases with chronic HBV infection with nodular liver lesions examined by imaging at the Third Hospital of Hebei Medical University from January 2021 to June 2024 were retrospectively selected. They were divided into the HBV-HCC group (182 cases) and the control group (238 cases) according to the current HCC diagnostic criteria. The basic information of patients, liver-related biochemical indicators, serum DCP, alpha-fetoprotein (AFP) levels, and the efficacy of combined detection in diagnosing early-stage HCC were collected and analyzed. A DSGAA model based on DCP (D) combined with gender (S), γ-glutamyl transferase (GGT, G), AFP (A) and age (A) as independent variables was constructed. The diagnostic performance of the novel model was compared with that of the traditional model through nomogram visualization output and calibration curve.Results:The age, sex, hemoglobin, albumin, alanine aminotransferase, alkaline phosphatase, and GGT levels were significantly higher in patients with HCC than those of the control group ( P<0.05). The positivity detection rate in patients with HBV-HCC was significantly higher in DCP than that of AFP (85.71% vs. 59.89%, P<0.05). The abnormal detection rate of DCP in patients with AFP-negative was 76.7%. The sensitivity for diagnosing HCC was significantly higher in DCP than AFP (73.63% vs. 64.29%, P<0.05), with specificity of 83.6% in all. The specificity for diagnosing early-stage HCC was 89.09%, surpassing that of AFP at 68.06% ( P<0.05). The area under the receiver operating characteristic curve (AUC) for the constructed DSGAA diagnostic model was 0.8841, with an optimal cutoff value of 0.377, a sensitivity of 80.22%, and a specificity of 86.13%. The AUC for diagnosing early-stage HCC was 0.8122, with a sensitivity of 66.18%, and a specificity of 86.13%, and the diagnostic efficacy was higher than other models ( P<0.05). Conclusion:DCP has superior diagnostic efficacy for HBV-related HCC, and the DSGAA model is expected to be used as a new method for screening and diagnosing early-stage HBV-related HCC.

Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(P-WMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.

Objective:To explore the key factors affecting health-related quality of life in children with brain tumors following initial diagnosis and to analyze its impact on survival and prognosis.Methods:Seventy-eight pediatric brain tumor patients who participated in a prospective cohort study between June 1st，2016 and June 30th，2021 were included for health-related quality of life assessment and long-term follow-up（median follow-up duration：52 months）.Results:The male-to-female ratio among the 78 children was 1.1：1，with a median age of 7.0（4.0，10.0）years. The scores of the Pediatric Quality of Life Inventory? 4.0 Generic Core Scales（PedsQL? 4.0）were（67.40±18.26）for parent proxy reports and（67.87±20.40）for child self-reports. Cronbach's α coefficients ranged from 0.790 to 0.927，with the intraclass correlation coefficient（ICC）was 0.673. According to the PedsQL? 4.0，impaired quality of life was observed in 50.0% of children by parent proxy report and 52.8% by child self-report，primarily affecting physical and role functioning. In addition，70% of caregivers reported impaired quality of life，with worry being the most prominent issue. Key factors affecting children's quality of life included radiotherapy，tumor stage，annual family income，and parents' marital status，while caregivers' quality of life was influenced by radiotherapy and the child's IgA levels（all P<0.05）. Children with decreased total scores，impaired physical functioning，or impaired emotional functioning on the PedsQL? 4.0 parent proxy report exhibited an increased risk of mortality（all P<0.05）. In multivariate Cox regression analysis，independent prognostic factors included a decrease in the total score on the PedsQL? 4.0 parent proxy report（ HR=6.702，95% CI：1.442-31.151， P<0.05），presence of hydrocephalus（ HR=33.602，95% CI：4.354-259.333， P<0.05），tumor recurrence（ HR=16.846，95% CI：3.158-89.852， P<0.05），and absence of hydrocephalus shunt surgery（ HR=13.428，95% CI：1.761-102.394， P<0.05）. Conclusion:The quality of life of newly diagnosed children with brain tumors is lower than that of healthy children，and quality of life is an important prognostic factor. Quality of life assessment should be an integral component of a comprehensive management program for children with brain tumors.

Retinal vein occlusion(RVO)is the second most common blinding retinal vascular disease, and its secondary macular edema(ME)is an important cause of visual function impairment in patients. Intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs serves as the first-line treatment, yet it is confronted with such issues as the need for repeated injections and non-response in some patients. Imaging and laboratory biomarkers play a crucial role in the early accurate diagnosis, prediction of disease progression, and evaluation of visual prognosis of RVO-ME. This study systematically reviews the research progress of imaging and laboratory biomarkers related to the prognosis of RVO-ME after anti-VEGF treatment in recent years, covering imaging biomarkers like central retinal thickness and ellipsoid zone integrity, as well as laboratory biomarkers such as serum APLN and aqueous humor IL-6. It summarizes the associations between different biomarkers and the prognosis of anti-VEGF therapy, aiming to provide a basis for the early accurate assessment and optimization of individualized treatment for RVO-ME patients, which holds significant clinical reference value.

Objective Analyzing the impact of malignant tumors on the life expectancy of urban residents of different ages and genders.Methods Applying the Fulfillment Index proposed by Prithwis Das Gupta,analyze the 2020 national urban resident mortalitysurveillance data by age and gender using Excel software.Results In 2020,the lifeexpectancy at birth for the urban population was 81.21 years(78.80 years for males and 83.80 years for females).The loss of life expectancy due to malignant tumors was 2.90 years(3.33 years for males and 2.32 years for females).The majority of deaths from malignant tumors were concentrated in the 40~60 age group,and the impact on potential life expectancy increased with age.The 60－ age group experienced the highest loss of potential life expectancy due to malignant tumors.There were differences in the Fulfillment Index between males and females.The highest Fulfillment Index for males was in the 60－ age group(40.68),while for females,it was in the 40－ age group(47.85).In age groups below 60,the Fulfillment Index for females was consistently higher than that for males,indicating a trend of malignant tumors occurring at a younger age in females.Conclusion The loss of life expectancy due to malignant tumors varies across different age groups and genders,highlighting the need for different prevention and treatment priorities.Health authorities should guide and enhance public awareness of malignant tumor prevention to help extend life expectancy.

Objective:To establish and explore a novel model and its clinical application value based on abnormal des-gamma-carboxy prothrombin (DCP) for the early-stage diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods:A total of 420 cases with chronic HBV infection with nodular liver lesions examined by imaging at the Third Hospital of Hebei Medical University from January 2021 to June 2024 were retrospectively selected. They were divided into the HBV-HCC group (182 cases) and the control group (238 cases) according to the current HCC diagnostic criteria. The basic information of patients, liver-related biochemical indicators, serum DCP, alpha-fetoprotein (AFP) levels, and the efficacy of combined detection in diagnosing early-stage HCC were collected and analyzed. A DSGAA model based on DCP (D) combined with gender (S), γ-glutamyl transferase (GGT, G), AFP (A) and age (A) as independent variables was constructed. The diagnostic performance of the novel model was compared with that of the traditional model through nomogram visualization output and calibration curve.Results:The age, sex, hemoglobin, albumin, alanine aminotransferase, alkaline phosphatase, and GGT levels were significantly higher in patients with HCC than those of the control group ( P<0.05). The positivity detection rate in patients with HBV-HCC was significantly higher in DCP than that of AFP (85.71% vs. 59.89%, P<0.05). The abnormal detection rate of DCP in patients with AFP-negative was 76.7%. The sensitivity for diagnosing HCC was significantly higher in DCP than AFP (73.63% vs. 64.29%, P<0.05), with specificity of 83.6% in all. The specificity for diagnosing early-stage HCC was 89.09%, surpassing that of AFP at 68.06% ( P<0.05). The area under the receiver operating characteristic curve (AUC) for the constructed DSGAA diagnostic model was 0.8841, with an optimal cutoff value of 0.377, a sensitivity of 80.22%, and a specificity of 86.13%. The AUC for diagnosing early-stage HCC was 0.8122, with a sensitivity of 66.18%, and a specificity of 86.13%, and the diagnostic efficacy was higher than other models ( P<0.05). Conclusion:DCP has superior diagnostic efficacy for HBV-related HCC, and the DSGAA model is expected to be used as a new method for screening and diagnosing early-stage HBV-related HCC.

Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(P-WMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.

Objective Analyzing the impact of malignant tumors on the life expectancy of urban residents of different ages and genders.Methods Applying the Fulfillment Index proposed by Prithwis Das Gupta,analyze the 2020 national urban resident mortalitysurveillance data by age and gender using Excel software.Results In 2020,the lifeexpectancy at birth for the urban population was 81.21 years(78.80 years for males and 83.80 years for females).The loss of life expectancy due to malignant tumors was 2.90 years(3.33 years for males and 2.32 years for females).The majority of deaths from malignant tumors were concentrated in the 40~60 age group,and the impact on potential life expectancy increased with age.The 60－ age group experienced the highest loss of potential life expectancy due to malignant tumors.There were differences in the Fulfillment Index between males and females.The highest Fulfillment Index for males was in the 60－ age group(40.68),while for females,it was in the 40－ age group(47.85).In age groups below 60,the Fulfillment Index for females was consistently higher than that for males,indicating a trend of malignant tumors occurring at a younger age in females.Conclusion The loss of life expectancy due to malignant tumors varies across different age groups and genders,highlighting the need for different prevention and treatment priorities.Health authorities should guide and enhance public awareness of malignant tumor prevention to help extend life expectancy.

Objective:To improve the ability of aviation physicians and physical examiners in differential diagnosis of primary angiitis of the central nervous system (PACNS) and the level of aeromedical assessment by exploring the diagnosis and treatment of PACNS.Methods:The clinical diagnosis and treatment of a pilot with PACNS were reported and the related literatures were reviewed.Results:The clinical manifestation of the fighter trainer pilot was numbness of the left finger, and then gradually appeared numbness and weakness of the left face and left upper limb more than 1 month. The initial diagnosis was viral encephalitis and acute disseminated encephalomyelitis and the hormonal shock treatment was ineffective. The final diagnosis was PACNS. The patient′s condition was improved by cyclophosphamide shock treatment. Aeromedical assessment concluded that the pilot was temporarily grounded.Conclusions:Pilot with PACNS is rarely reported and easy to be misdiagnosed due to the clinical and imaging findings are lack of specificity. The aeromedical assessment of PACNS pilots should be individualized according to the severity of illness, type of aircraft and flight duties.

Objective:To explore the expression of long non-coding RNA(lncRNA)ZIM2-AS1 in hepatocellular carcinoma(HCC)and its clinical significance as well as diagnostic value using the data obtained from the Cancer Genome Atlas(TCGA).Meth-ods:The transcriptome sequencing(RNA-seq)data and clinical information of 374 HCC tissues and 50 paired paracancerous tissues were gathered from the TCGA database,then the expression trends of ZIM2-AS1 in HCC and its correlation with clinicopathological features,prognosis,immune cell infiltration,as well as diagnostic value was inspected by bioinformatics analysis using relevant R packages.The expression of ZIM2-AS1 in human normal liver cell line and HCC cell lines was examined by qRT-PCR.Results:The ex-pression of ZIM2-AS1 was highly expressed in HCC tissues(P<0.001),and its expression level was significantly correlated with age,gender,N stage,histologic grade and AFP level(P all<0.05).The overall survival(OS)and disease specific survival(DSS)of patients with high ZIM2-AS1 expression were significantly shorter than those of patients with low expression(P<0.05),and ZIM2-AS1 was an in-dependent risk factor affecting OS.Immune cell infiltration analysis showed that ZIM2-AS1 was closely related to the infiltration of Th2 cells,CD56brightNK cells,follicular helper T cells(Tfh),neutrophils and plasmacytoid dendritic cells(pDC)(|Spearman's r|>0.1,P<0.05)in HCC.ROC curve analysis revealed that the expression level of ZIM2-AS1 possesse potential diagnostic value in HCC,N0 stage,histologic grade G1 and G2,OS and DSS(AUC all>0.50).qRT-PCR results showed that the expression level of ZIM2-AS1 in HCC cell lines was significantly higher than that in human normal liver cells(P all<0.05).Conclusion:The elevated expression of lncRNA ZIM2-AS1 is an independent risk factor for poor prognosis of HCC patient and has potential application value as a biomarker for HCC diagnosis,prognosis as well as tumor immune microenvironment assessment.