Objective:To investigate the association between abdominal fat-related indicators derived from quantitative computed tomography (QCT) and coronary artery calcification (CAC) in middle-aged and elderly individuals, as well as the diagnostic value of these indicators.Methods:This cross-sectional study enrolled middle-aged and elderly participants who underwent health check-ups at Kaifeng Central Hospital between January and December 2024. Participants were divided into a CAC group and a non-CAC group based on the presence or absence of CAC. The CAC group was then stratified into mild, moderate, and severe subgroups according to CAC severity. General clinical data were collected for all participants. All subjects underwent one-stop QCT scanning of the chest and abdomen. An automated abdominal fat analysis system was used to identify fat distribution regions. If accurate identification was not possible, a semi-automated segmentation algorithm combined with manual correction was applied instead. Two physicians performed the measurements independently, and inter-observer consistency was assessed. The average values were calculated to obtain visceral fat area (VFA) and subcutaneous fat area (SFA). The ratio of visceral fat area to subcutaneous fat area (VFA/SFA) was also computed. Multivariate logistic regression analysis was performed to identify the factors associated with CAC in middle-aged and elderly individuals. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of these indicators for CAC. DeLong′s test was used to compare the differences in the area under the curve ( AUC). Results:A total of 252 middle-aged and elderly individuals were included, with a median age of 61 (interquartile rang: 59, 69) years. Of these individuals, 188(74.6%) were males. Among them, 172 were classified into the CAC group and 80 into the non-CAC group. Multivariate logistic regression analysis revealed that VFA, VFA/SFA ratio, age, low-density lipoprotein cholesterol(LDL-C), and hypertension were independently associated with CAC in middle-aged and elderly individuals (all P<0.05). The mild, moderate, and severe CAC subgroups comprised 78, 51, and 43 participants, respectively. Analysis of variance (ANOVA) demonstrated that VFA and VFA/SFA increased with CAC severity, and there were statistically significant differences between the subgroups (all P<0.05). ROC curve analysis showed that the AUCs of VFA and VFA/SFA for diagnosing CAC were 0.841 and 0.810, respectively, with no significant difference between them ( P>0.05). The optimal cutoff values were 177.45 cm2 for VFA (sensitivity: 83.1%, specificity: 72.5%) and 1.592 for VFA/SFA (sensitivity: 65.7%, specificity: 83.7%). For the diagnosis of moderate-to-severe CAC, the AUCs of VFA and VFA/SFA were 0.765 and 0.761, respectively ( P>0.05 for comparison), with cutoff values of 231.75 cm2 (sensitivity: 61.7%, specificity: 83.3%) and 1.962 (sensitivity: 64.9%, specificity: 80.8%). Conclusion:Abdominal VFA and VFA/SFA derived from QCT are independently associated with the presence of CAC in middle-aged and elderly individuals, demonstrating good diagnostic performance for both overall CAC and moderate-to-severe CAC.

Objective:To investigate the association between abdominal fat-related indicators derived from quantitative computed tomography (QCT) and coronary artery calcification (CAC) in middle-aged and elderly individuals, as well as the diagnostic value of these indicators.Methods:This cross-sectional study enrolled middle-aged and elderly participants who underwent health check-ups at Kaifeng Central Hospital between January and December 2024. Participants were divided into a CAC group and a non-CAC group based on the presence or absence of CAC. The CAC group was then stratified into mild, moderate, and severe subgroups according to CAC severity. General clinical data were collected for all participants. All subjects underwent one-stop QCT scanning of the chest and abdomen. An automated abdominal fat analysis system was used to identify fat distribution regions. If accurate identification was not possible, a semi-automated segmentation algorithm combined with manual correction was applied instead. Two physicians performed the measurements independently, and inter-observer consistency was assessed. The average values were calculated to obtain visceral fat area (VFA) and subcutaneous fat area (SFA). The ratio of visceral fat area to subcutaneous fat area (VFA/SFA) was also computed. Multivariate logistic regression analysis was performed to identify the factors associated with CAC in middle-aged and elderly individuals. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of these indicators for CAC. DeLong′s test was used to compare the differences in the area under the curve ( AUC). Results:A total of 252 middle-aged and elderly individuals were included, with a median age of 61 (interquartile rang: 59, 69) years. Of these individuals, 188(74.6%) were males. Among them, 172 were classified into the CAC group and 80 into the non-CAC group. Multivariate logistic regression analysis revealed that VFA, VFA/SFA ratio, age, low-density lipoprotein cholesterol(LDL-C), and hypertension were independently associated with CAC in middle-aged and elderly individuals (all P<0.05). The mild, moderate, and severe CAC subgroups comprised 78, 51, and 43 participants, respectively. Analysis of variance (ANOVA) demonstrated that VFA and VFA/SFA increased with CAC severity, and there were statistically significant differences between the subgroups (all P<0.05). ROC curve analysis showed that the AUCs of VFA and VFA/SFA for diagnosing CAC were 0.841 and 0.810, respectively, with no significant difference between them ( P>0.05). The optimal cutoff values were 177.45 cm2 for VFA (sensitivity: 83.1%, specificity: 72.5%) and 1.592 for VFA/SFA (sensitivity: 65.7%, specificity: 83.7%). For the diagnosis of moderate-to-severe CAC, the AUCs of VFA and VFA/SFA were 0.765 and 0.761, respectively ( P>0.05 for comparison), with cutoff values of 231.75 cm2 (sensitivity: 61.7%, specificity: 83.3%) and 1.962 (sensitivity: 64.9%, specificity: 80.8%). Conclusion:Abdominal VFA and VFA/SFA derived from QCT are independently associated with the presence of CAC in middle-aged and elderly individuals, demonstrating good diagnostic performance for both overall CAC and moderate-to-severe CAC.

G protein-coupled receptors (GPCRs) are a large family of membrane protein receptors, and Takeda G protein-coupled receptor 5 (TGR5) is a member of this family. As a membrane receptor, TGR5 is widely distributed in different parts of the human body and plays a vital role in regulating metabolism, including the processes of energy consumption, weight loss and blood glucose homeostasis. Recent studies have shown that TGR5 plays an important role in glucose and lipid metabolism disorders such as fatty liver, obesity and diabetes. With the global obesity situation becoming more and more serious, a comprehensive explanation of the mechanism of TGR5 and filling the gaps in knowledge concerning clinical ligand drugs are urgently needed. In this review, we mainly explain the anti-obesity mechanism of TGR5 to promote the further study of this target, and show the electron microscope structure of TGR5 and review recent studies on TGR5 ligands to illustrate the specific binding between TGR5 receptor binding sites and ligands, which can effectively provide new ideas for ligand research and promote drug research.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic

OBJECTIVE: To analyze the clinical features of severe or critical ill adult patients with coronavirus disease (COVID-19). METHODS: The clinical data of 75 patients with severe or critical COVID-19 in Honghu People's Hospital from January to March in 2020 were collected. RESULTS: Of the 75 patients with COVID-19 pneumonia, 41 were male (54.67%) and 34 were female (45.33%) with a mean age of 67.53 ±12.37 years; 43 patients had severe and 32 had critical COVID-19, and 49.3% of the patients had underlying diseases. The main clinical manifestations included fever (78.67%) and coughing (70.67%). Compared with the severe patients, the critically ill patients had higher proportions of patients over 60 years old with elevated white blood cell count, increased prothrombin time, and higher levels of hsCRP, PCT, D-dimer, ALT, LDH, cTnI and NT-proBNP. Univariate logistic regression analysis showed that an age over 60 years, leukocytosis, hs-CRP elevation, prolonged prothrombin time, and increased levels of D-dimer, NT-proBNP and cTnI were associated with severe COVID-19. Multivariate logistic regression showed that an age over 60 years (OR=8.165, 95% : 1.483-45.576, =0.017), prolonged prothrombin time (OR=7.516, 95% : 2.568-21.998, =0.006) and elevated NT-proBNP (OR=6.194, 95% : 1.305-29.404, =0.022) were independent risk factors for critical type of COVID-19. CONCLUSIONS An age over 60 years, a prolonged prothrombin time and elevated NT-proBNP level are important clinical features of critically ill patients with COVID-19, and can be deemed as early warning signals for critical conditions of the disease.
Aged ; Betacoronavirus ; Coronavirus Infections ; Critical Illness ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; Retrospective Studies

Neural prosthesis control system is based on brain-computer interface and functional electrical stimulation technology, by an-alyzing the electroencephalograph control commands directly into the muscle system or an external device, which compensated efferent pathway from the brain-spinal cord, and recovered motor function of patients with cervical spinal cord injury. This paper described the basic structure, working principle and key technology of neural prosthetic system, summarized the application, problems and prospects of neural prosthetic technology in the rehabilitation of cervical spinal cord injury.

Objective To investigate the relationship between plasma homocysteine on admission and the outcome at discharge of acute ischemic stroke.Methods A non-concurrent cohort study was performed and a total of 1 3 1 9 patients with acute is-chemic stroke were continuously included in this study.According to tertile range of plasma homocysteine,patients were di-vided into three group.Logistic regression analysis was used to assess the independent association between plasma homocys-teine on admission and poor outcome at discharge of acute ischemic stroke.Results The difference of plasma homocysteine on admission between the poor outcome and those with good outcome had statistical significance (P<0.000 1).Without the adj ustment of multiple factors,when comparing to the first group,the second and third tertile seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 2.111 (1.297~3.437,P<0.05),2.113 (1.361~3.279,P<0.05).After adjustment for multivariate,the second and third tertile also seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 1.876 (1.160~3.036,P<0.05),2.396 (1.414~4.062,P<0.05).Conclusion The current study indicated that higher plasma homocysteine level was an independent risk factor for poor outcome at discharge in ischemic stroke patients.It would increase the risk of the outcome at discharge in patients with acute ischemic stroke,and suggests that there is a dose-response relationship between plasma homocysteine level on admis-sion and the poor outcome at discharge.

Objective To investigate the effectiveness and safety of minimal invasive surgery combined with ventriculoscope for the treatment of basal ganglia hemorrhage.Methods From June 2014 to June 2015 there were 57 patients with basal ganglia hemorrhage were selected into this study.These patients were signed into the minimal invasive surgery combined with ventriculoscope group and the craniotomy group according to the methods of surgery they received.And the clinical outcomes of the two groups were compared.Results Compared with the craniotomy group,patients in the minimal invasive surgery combined with ventriculoscope group got a significantly lower Glasgow coma scale at 7 days,14 days and 28 days after the operation (P =0.02,0.04,0.04);the hospital stays were significantly reduced in the minimal invasive surgery combined with ventriculoscope group [(21.45 ±5.67)d vs.(25.67 ±7.45)d,P =0.02];and the operation time were significantly reduced as well [(134.45 ±21.11)min vs.(178.65 ±45.32)min,P =0.000)].There was no significant difference in intra-cranial pressure,rate of hematoma clearance,rate of organ functional failure,rate of re-bleeding and mortality 28 days after operation (P >0.05).Conclusion The minimal invasive surgery combined with ventriculoscope is effective and safe for the treatment of basal ganglia hemorrhage,which is worthy of popularization.

Objective To observe the effect of acupuncture plus rehabilitation in treating deglutition disorders due to cerebral stroke and its effect on each link of the neural pathway of deglutition function. Method By adopting the prospective randomized controlled method, ninety-nine patients with deglutition disorders after cerebral stroke were recruited and divided into an acupuncture-rehabilitation group, a pharyngeal acupuncture group, and a control group, respectively 33 cases, 34 cases, and 32 cases in each group. The acupuncture-rehabilitation group was intervened by acupuncture respectively at scalp, pharyngeal, and the root of tongue plus basic treatment, the pharyngeal acupuncture group was by acupuncture at the deglutition point (Extra) plus basic treatment, while the control group was by the basic treatment alone, once a day, 4 weeks in total. The Functional Oral Intake Scale (FOIS) and Clinical Nursing Swallowing Assessment Tool (CNSAT) were evaluated and statistically analyzed before and after intervention. Result The component scores of CNSAT were significantly improved after intervention in the acupuncture-rehabilitation group (P<0.01); the component scores of CNSAT were significantly changed after intervention in the pharyngeal acupuncture group (P<0.05);the CNSAT component scores in the acupuncture-rehabilitation group were significantly different from that in the pharyngeal acupuncture group and control group after intervention (P<0.01); the CNSAT component scores in the pharyngeal acupuncture group were significantly different from that in the control group after intervention (P<0.05). The FOIS scores were enhanced in the three groups after treatment; the FOIS score was significantly changed in the acupuncture-rehabilitation group after intervention (P<0.01);the FOIS score was markedly changed in the pharyngeal acupuncture group after intervention (P<0.05);the FOIS scores in the acupuncture-rehabilitation group and pharyngeal acupuncture group were both significantly higher than that in the control group (P<0.01,P<0.05). Conclusion The scalp-pharyngeal-root of tongue sequential-acupuncture plus rehabilitation can effectively mitigate the deglutition problems after cerebral stroke, improve the food-intake ability of the patients, and reduce the risk of mistake inhalation.

Objective To examine the association between uric acid (UA)levels of patients with acute ischemic stroke at ad-mission and discharged outcome.Methods The acute ischemic stroke patients of Xinganmeng People’s Hospital in Inner Mongolia,from June 1,2009 to May 31,2012 were continuity included in the present study,the included analysis sample size were 3 440 cases.Poor discharged outcome was defined as the occurrence of disability or death.With reference to the Modi-fied Rankin's Scale (MRs)Stroke Scale,Scores were recorded in the questionnaires,score of 3 or more (MRs≥3)was de-fined as disability.The patients were all grouped by P20,P60,P90 of UA,binary logistic regression were used in studying of risk factors,calculated the odds ratios (Odds ratio,OR)and 95% confidence interval (95% Confident interval,95%CI).All tests were two-sided test and a significance level of 0.05.Results A total of 359 people occurred poor outcomes in the stud-y,accounting for 10.44%.Univariate logistic regression analysis of poor outcome occurred showed that relative to the lowest group(P20,UA≤222.6 mmol/L),the second and third group (UA:222.7 ~ 310.9 mmol/L and 311.0~419.7 mmol/L) OR (95% CI)were:0.70(0.53~0.91)(P <0.05)and 0.66(0.49~0.88)(P <0.05).After adjusted age,body tempera-ture,high blood pressure,hyperglycemia,history of stroke,high triglycerides,high LDL-C and smoking,relative to the low-est level group,the second and third group occurred poor outcoming OR (95% CI)were:0.70(0.53~0.93)(P <0.05)and 0.66(0.48~0.90)(P <0.05).Conclusion Higher levels of uric acid levels in patients with acute ischemic stroke may inde-pendently related with occurred poor discharged outcome.