Objective To analyze the correlation between cardiac function and degree of coronary artery lesion in elderly patients with coronary heart disease. Methods A total of 110 elderly patients with coronary heart disease and 30 elderly people without coronary heart disease (non-coronary heart disease group) in the Third People's Hospital of Chengdu were selected for the study. Based on Gensini score, the patients with coronary heart disease were classified into mild, moderate and severe lesion groups. The echocardiographic indicators and myocardial injury indicators [cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase isoenzyme (CK-MB)] were compared among the groups. The correlation between cardiac function indicators and degree of coronary artery lesion and the evaluation value of various indicators on severe coronary artery lesion were analyzed. Results The left ventricular ejection fraction (LVEF) was represented as severe lesion groupmoderate lesion group>mild lesion group> non-coronary heart disease group (P<0.05). LVEF showed a negative correlation with degree of coronary artery lesion (P<0.05), while LVEDD, LVESD, cTnI, CK and CK-MB all exhibited positive correlations with degree of coronary artery lesion (P<0.05). The combined detection of the above indicators demonstrated superior evaluation efficiency on severe coronary artery lesion compared to any single indicator (P<0.05). Conclusion There is a significant correlation between cardiac function and degree of coronary artery lesion in elderly patients with coronary heart disease. Comprehensive evaluation of these indicators is conducive to clinical disease risk stratification and individualized treatment.

Background and Aims:Totally implantable venous access port(TIVAP)are widely used for chemotherapy,blood transfusion,and nutritional support in patients with malignancies.Among them,upper arm port(UAP)are increasingly recommended in clinical practice due to their advantages in avoiding thoracic complications and providing more concealed incisions.Currently,two main implantation techniques are used for UAP:the tunnel needle-transverse incision technique and the puncture point-transverse incision technique.This study aims to compare the clinical outcomes of these two techniques in patients with hematological malignancies,focusing on safety and cosmetic appearance,to provide evidence for clinical decision-making.Methods:A retrospective analysis was conducted on 412 patients with hematological malignancies who underwent UAP implantation at Xiangya Hospital of Central South University between December 2021 and December 2024.Based on the implantation method,patients were divided into the tunnel needle-transverse incision group(n=200)and the puncture point-transverse incision group(n=212).Intraoperative variables(operative time,intraoperative pain score,catheter kinking at the pocket,intraoperative blood loss)and postoperative indicators(incidence of complications and incision aesthetic satisfaction)were compared between the two groups.Results:There were no significant differences in baseline characteristics between the two groups(all P>0.05),indicating comparability.The puncture point-transverse incision group showed superior performance in operative time[(32.99±4.91)min vs.(41.42±5.35)min],catheter kinking rate(1.4％vs.8.5％),and incision aesthetic satisfaction(7.99±0.58 vs.6.26±0.86)compared with the tunnel needle-transverse incision group(all P<0.05).Although the puncture point group had slightly more intraoperative bleeding[(4.52±1.02)mL vs.(4.16±0.83)mL],the difference,while statistically significant,was of limited clinical relevance.No significant differences were observed between the two groups in intraoperative pain scores or incidence of postoperative complications(both P>0.05).Conclusion:The puncture point-transverse incision technique offers significant advantages in terms of operative efficiency,reduced catheter kinking,and improved incision aesthetics,without compromising safety.It represents a promising alternative to the traditional tunnel needle-transverse incision method and has strong potential for broader clinical adoption.The puncture point-transverse incision technique offers advantages such as shorter operative time,lower catheter kinking rate,and higher incision aesthetic satisfaction.It is a promising alternative to the traditional tunnel needle-transverse incision technique and has good potential for clinical application and promotion.

Regarding the challenge of early identification of critically ill patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),a radiomics-clinical fusion model is proposed based on non-contrast CT images of accessory respiratory muscles to predict life-threatening conditions.A retrospective study is conducted involving 233 AECOPD patients(153 non-life-threatening and 80 life-threatening cases).Patients are divided into a training set(n=186)and a test set(n=47)at a 4:1 ratio.A total of 1 874 radiomic features are extracted from the erector spinae and pectoralis muscle regions delineated by radiologists on non-contrast CT images,and the features selection is performed using maximum relevance minimum redundancy and least absolute shrinkage and selection operator(LASSO)algorithms.Meanwhile,clinical data are analyzed with t-test and LASSO for variable screening.The selected features are input into C-support vector classification,Logistic regression,random forest,adaptive boosting(AdaBoost),and extreme gradient boosting(XGBoost)to construct radiomics model,clinical model,and fusion model.Predictive performance and clinical practicality are evaluated in the test set using receiver operating characteristic curve,area under the curve(AUC),and decision curve analysis.The radiomics-clinical fusion model built with XGBoost outperformed standalone radiomics and clinical models,achieving an AUC of 0.902(95％CI 0.846,0.994),with accuracy,sensitivity,specificity,and precision of 0.837,0.933,0.786,and 0.7,respectively.Results demonstrate that the fusion model based on the non-contrast CT radiomics of accessory respiratory muscles and clinical data exhibits promising diagnostic performance,highlighting its potential clinical significance for stratified management and preemptive critical care intervention in AECOPD patients.

Background: Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship. Methods: This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders. Results: The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively. Conclusions The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.

Background: Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship. Methods: This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders. Results: The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively. Conclusions The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.

Background: Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship. Methods: This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders. Results: The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively. Conclusions The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.

Background: Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship. Methods: This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders. Results: The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively. Conclusions The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.

Background: Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship. Methods: This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders. Results: The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively. Conclusions The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.

Background and Aims:Totally implantable venous access port(TIVAP)are widely used for chemotherapy,blood transfusion,and nutritional support in patients with malignancies.Among them,upper arm port(UAP)are increasingly recommended in clinical practice due to their advantages in avoiding thoracic complications and providing more concealed incisions.Currently,two main implantation techniques are used for UAP:the tunnel needle-transverse incision technique and the puncture point-transverse incision technique.This study aims to compare the clinical outcomes of these two techniques in patients with hematological malignancies,focusing on safety and cosmetic appearance,to provide evidence for clinical decision-making.Methods:A retrospective analysis was conducted on 412 patients with hematological malignancies who underwent UAP implantation at Xiangya Hospital of Central South University between December 2021 and December 2024.Based on the implantation method,patients were divided into the tunnel needle-transverse incision group(n=200)and the puncture point-transverse incision group(n=212).Intraoperative variables(operative time,intraoperative pain score,catheter kinking at the pocket,intraoperative blood loss)and postoperative indicators(incidence of complications and incision aesthetic satisfaction)were compared between the two groups.Results:There were no significant differences in baseline characteristics between the two groups(all P>0.05),indicating comparability.The puncture point-transverse incision group showed superior performance in operative time[(32.99±4.91)min vs.(41.42±5.35)min],catheter kinking rate(1.4％vs.8.5％),and incision aesthetic satisfaction(7.99±0.58 vs.6.26±0.86)compared with the tunnel needle-transverse incision group(all P<0.05).Although the puncture point group had slightly more intraoperative bleeding[(4.52±1.02)mL vs.(4.16±0.83)mL],the difference,while statistically significant,was of limited clinical relevance.No significant differences were observed between the two groups in intraoperative pain scores or incidence of postoperative complications(both P>0.05).Conclusion:The puncture point-transverse incision technique offers significant advantages in terms of operative efficiency,reduced catheter kinking,and improved incision aesthetics,without compromising safety.It represents a promising alternative to the traditional tunnel needle-transverse incision method and has strong potential for broader clinical adoption.The puncture point-transverse incision technique offers advantages such as shorter operative time,lower catheter kinking rate,and higher incision aesthetic satisfaction.It is a promising alternative to the traditional tunnel needle-transverse incision technique and has good potential for clinical application and promotion.

Chronic myeloid leukemia (CML) is a malignant hematologic disorder caused by abnormal proliferation of hematopoietic stem cells. In recent years, while the application of tyrosine kinase inhibitors (TKIs) has significantly improved the prognosis of CML patients through in-depth exploration of pathogenesis of CML and advancements in targeted therapies, some patients still face challenges including drug resistance, disease relapse, and failure to achieve treatment-free remission. Imunotherapy, as a complementary or alternative strategy, holds significant potential for overcoming these limitations, and has gradually emerged as a critical research focus in CML treatment. This review aims to summarize the current research status and latest advances in immunotherapy for CML.