Objective To investigate the predictive value of early fluid balance combined with daily average fluid intake on the prognosis of patients who received hematoma evacuation for spontaneous intracerebral hemorrhage(sICH).Methods This study retrospectively and consecutively enrolled patients who underwent hematoma evacuation for sICH admitted to the Neurosurgical Intensive Care Unit of North China University of Science and Technology Affiliated Hospital between January 2023 and January 2025.Patients'baseline and clinical data were collected,including gender,age,admission vital signs(body temperature,respiratory rate,heart rate,systolic and diastolic blood pressure),medical history(hypertension,diabetes mellitus,coronary heart disease),admission Glasgow coma scale(GCS)score,admission laboratory parameters(including white blood cell count,red blood cell count,platelet count,urine bacterial levels,urine ketones,urine pH,homocysteine),hemorrhage location,hemorrhage volume,time from ictus to surgery,and hematoma evacuation rate(hematoma evacuation rate[％]=[preoperative hematoma volume-postoperative hematoma volume]/preoperative hematoma volume × 100％).Fluid intake,output,balance,daily average intake,and cumulative fluid balance during the early postoperative period(the first to seventh 24-hour periods)were assessed and recorded.Fluid intake comprised the sum of intravenously administered fluids(crystalloids,hypertonic fluids,colloids,blood products,and parenteral nutrition),enteral nutrition(nasogastric feeding solutions and water),and renal replacement therapy fluids.Fluid output comprised the sum of urine volume,vomitus,drainage fluid,and dialysis fluid losses.Fluid balance was defined as the difference between fluid intake and output.Daily average intake was calculated as the average of the fluid intake over the first seven postoperative 24-hour periods.Cumulative fluid balance was the sum of the fluid balances over the first seven postoperative 24-hour periods.Patient outcomes were assessed at 30 days postoperatively.Discharged patients underwent outpatient review or telephone follow-up,while inpatients were evaluated by neurosurgeons.Prognosis was evaluated using the 30-day modified Rankin scale(mRS)score:mRS scores 0-3 were classified as favorable prognosis,and mRS scores 4-6 as poor prognosis.Patients were subsequently divided into favorable prognosis and poor prognosis groups based on mRS scores.Factors with P＜0.05 in univariate comparisons and without collinearity(multicollinearity was defined by:tolerance＜0.1 and variance inflation factor＞10)were included in multivariate Logistic regression analysis to identify independent risk factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of relevant factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Results A total of 320 patients who underwent hematoma evacuation for sICH were enrolled,including 192 males and 128 females,with an age range of 20-91 years(median age 62[53,68]years).Among them,144 patients were assigned to the favorable prognosis group and 176 to the poor prognosis group.The poor prognosis group exhibited significantly higher hemorrhage volume,homocysteine level,fluid intake at the 3rd,5th,6th,and 7th 24-hour periods,fluid balance at the 3rd,5th,6th,and 7th 24-hour periods,daily average intake,and cumulative fluid balance compared to the favorable prognosis group(all P＜0.05).The favorable prognosis group had a significantly higher hematoma evacuation rate,GCS score,proportion of supratentorial hemorrhage and negative urine ketones than the poor prognosis group(all P＜0.05).No significant differences were found in other clinical data(all P＞0.05).Fluid balance over the first seven postoperative 24-hour periods displayed a rise-decline-rise pattern in the poor prognosis group and a rise-decline pattern in the favorable prognosis group.Both groups peaked at the 3rd 24-hour period.Multivariate Logistic regression analysis identified fluid balance at the 3rd 24-hour period(OR,2.013,95％CI 1.386-2.922,P＜0.01)and daily average intake(OR,3.583,95％CI 1.793-7.161,P＜0.01)as independent influencing factors for poor 30-day prognosis after hematoma evacuation in sICH patients.ROC curve analysis revealed that the area under the curve(AUC)for fluid balance at the 3rd 24-hour period and daily average intake in predicting poor 30-day prognosis were 0.699(95％CI 0.642-0.757)and 0.765(95％CI 0.712-0.819),respectively.The combined model of fluid balance at the 3rd 24-hour period and daily average intake achieved an AUC of 0.804(95％CI 0.756-0.853),demonstrating significantly superior predictive performance compared to either variable alone(both P＜0.05).Conclusions The combination of fluid balance at the 3rd 24-hour period and daily average intake demonstrates modest predictive value for poor 30-day prognosis after hematoma evacuation in sICH patients.These findings require validation through multicenter,large-scale,prospective studies.

Objective To compare and analyze the predictive value of a variety of novel blood inflammation composite indicators in spontaneous intracerebral hemorrhage(sICH)patients'prognosis.Methods This retrospective study consecutively enrolled 329 sICH patients admitted to the Neurosurgical Intensive Care Unit of North China University of Science and Technology Affiliated Hospital between September 2022 and December 2024.Patients were categorized into favorable(with modified Rankin scale[mRS]score ≤2)or unfavorable(mRS score ≥ 3)prognosis groups based on 90-day post-onset assessments.Baseline and imaging data,included age,gender,smoking history,alcohol consumption history,admission systolic/diastolic blood pressure,medical history(diabetes,coronary heart disease,stroke),24-hour laboratory parameters after admission(albumin,hemoglobin,blood glucose,potassium,platelets,lymphocytes,monocytes,neutrophils,homocysteine,red cell distribution width[RDW]),site of hemorrhage(basil ganglia,lobes,cerebellum,brain stem),hemorrhage volume,the National Institutes of Health stroke scale(NIHSS)score.Systemic complications during hospitalization(pulmonary/urinary tract/bloodstream infections)were recorded.Head CT and CT angiography(CTA)were performed at 24 h after admission to measure hematoma volume.Calculate and analyze the comprised inflammatory indices including systemic immune-inflammation index(SII;platelets × neutrophils/lymphocytes),platelet-to-lymphocyte ratio(PLR),RDW to albumin ratio(RAR;RDW/albumin),hemoglobin to RDW ratio(HRR,hemoglobin/RDW),systemic inflammation response index(SIRI;neutrophils × monocytes/lymphocytes),lymphocyte-neutrophil-albumin ratio(LANR;lymphocytes × albumin/neutrophils),neutrophil-to-albumin ratio(NPAR;neutrophil％/albumin),glucose-to-lymphocyte ratio(GLR;glucose/lymphocytes),and glucose-to-potassium ratio(GPR,glucose/potassium).Variables with P＜0.05 in univariate analysis were included in a collinearity analysis(a tolerance＜0.1 or variance inflation factor[VIF]＞10 indicating collinearity).Significant non-collinear variables with P＜0.05 in univariate analysis were included in multivariate Logistic regression to identify factors influencing prognosis in sICH patients.Receiver operating characteristic(ROC)curves was utilized to compare the predictive power of each indictors through net reclassification improvement(NRI)and integrated discrimination improvement(IDI).With NRI/IDI＞0 indicated superiority of new models over the old ones(higher values denote greater improvement).Delong's test was performed to evaluate the area under the curve(AUC)differences.Results Among the 329 sICH patients enrolled(185 males,144 females;mean age[68±6]years,ranged 36-91),138 were categorized into the favorable prognosis group(mRS score≤ 2)and 191 into the unfavorable prognosis group(mRS score ≥ 3),all patients had received a standardized treatment.Significant differences were observed in alcohol consumption history,diabetes,prior stroke,albumin,hemoglobin,blood glucose,platelets,lymphocytes,monocytes,neutrophils,homocysteine,RDW,hematoma volume,lung infection,and NIHSS score between two groups(all P＜0.05).While no significant differences were observed in the rest baseline/imaging data between the two groups(all P＞0.05).The favorable prognosis group exhibited significantly lower GLR(4.67[3.76,5.92]vs.6.67[4.66,10.32]),SIRI(1.92[1.12,3.24]v.s.4.43[2.25,8.33]),PLR(125.11[105.11,156.20]vs.164.46[122.42,232.63]),RAR(0.28[0.27,0.29]vs.0.32[0.30,0.35]),and NPAR(0.18[0.13,0.21]vs.0.22[0.16,0.33];all P＜0.01);and significantly higher SII(1 632.90[882.18,2 429.78]vs.967.93[702.83,1 290.51]),LANR(9.63[7.75,13.10]vs.5.49[3.25,9.77]),and HRR(11.73[10.97,12.62]vs.10.89[10.00,11.82];all P＜0.01).No significant differences were found in GPR(2.15[1.80,2.65]vs.2.28[1.83,3.31])between the favorable and unfavorable prognosis groups(P=0.094).After excluding factors with multicollinearity(including,lymphocytes,platelets,neutrophils,monocytes,albumin,RDW and hemoglobin),the other factors were included in a multivariate analysis,which identified SIRI(OR,1.312,95％CI1.043-1.650,P=0.020),RAR(OR,1.578,95％CI 1.376-1.810,P＜0.01),and HRR(OR,0.641,95％CI 0.480-0.854,P=0.002)as independent predictors of poor 90-day prognosis for sICH patients.ROC analysis showed that the AUC of RAR,SIRI,and HRR were 0.862,0.739 and 0.683 respectively,with RAR demonstrating superior sensitivity(82.20％vs.SIRI 68.06％vs.HRR 51.83％)and specificity(78.26％vs.SIRI 69.57％vs.HRR 76.81％).IDI confirmed RAR's significantly greater predictive ability versus SIRI(IDI=0.210,P＜0.01)and HRR(IDI=0.263,P＜0.01),and SIRI have superior predictive ability over HRR(IDI=0.053,P=0.040).Delong test showed that RAR had significantly greater predictive power than both SIRI and HRR(both P＜0.01),while the predictive power of SIRI and HRR did not differ significantly(P=0.138).Conclusions The three blood inflammatory indicators(RAR,SIRI,HRR)are effective predictors of poor prognosis in sICH patients at 90 d from onset,and among the three composite inflammatory parameters,RAR is significantly more effective than SIRI and HRR indicators.

Objective To predict the value of admission dehydration state combined with fluid accumulation index for post-operative prognosis in elderly patients with intracerebral hemorrhage(ICH).Methods A retrospective study was conducted on 320 elderly ICH patients receiving surgical treatment in Department of Neurosurgery and then admitted to its Intensive Care Unit of the Affiliated Hospital of North China University of Science and Technology from May 2023 to March 2024.According to the survival status at 30 d after onset,they were divided into a survival group(202 cases)and a death group(118 cases).Clinical data such as basic information,admission vital signs,laboratory indicators,and fluid supplementation were compared between the two groups.ROC curve was plotted.Results The death group exhibited significantly advanced age,more bleeding sites,higher 7-day fluid accumulation index,and larger proportions of ventricular rupture,midline displacement and admission dehydration status,but lower uric acid level than the the survival group(P＜0.05,P＜0.01).Binary logistic regression analysis showed that admission dehydration status and 7-day fluid accumulation index were risk factors for 30-day mortality in elderly ICH patients after surgery(P＜0.01).ROC curve analysis showed that the AUC value of admission dehydration status combined with 7-day fluid accumulation index in predicting 30-day death of elderly ICH patients after surgery was 0.774(95％CI:0.722-0.825),and that of the combination was better than that of each indicator alone(P＜0.05).Conclusion Hospital dehydration status combined with 7-day fluid accumulation index has the best effectiveness in predicting 30-day mortality in elderly ICH patients after surgical treatment.

Objective To analyze changes in sleep,mood state,and brain function in healthy populations living in near-sea-level environments before and after exposure to high-altitude environment,and to explore the correlations between regional brain functional changes and variations in sleep and mood states.Methods A total of 45 healthy volunteers were enrolled.The participants came from regions of near-sea-level altitudes and were exposed to the high-altitude environment for a short period of time.The Pittsburgh Sleep Quality Index(PSQI),Zung Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9(PHQ-9),Zung Self-Rating Anxiety Scale(SAS),and Generalized Anxiety Disorder-7(GAD-7)were administered to assess sleep quality as well as depressive and anxiety symptoms at 4 time points—prior to high-altitude exposure,immediately after exposure,one month after returning to low-altitude regions,and three months after returning to low-altitude regions.Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected before and after high-altitude exposure,and regional brain functional parameters,including the amplitude of low-frequency fluctuations(ALFF)and functional connectivity strength,were analyzed.Statistical analyses were performed,including a linear mixed-effects model to evaluate longitudinal changes in scale scores,paired-sample t-tests to compare brain function differences before and after exposure,and Pearson correlation analyses to examine the relationship between brain functional changes and alterations in sleep and mood states.Results Compared with the pre-exposure findings,the participants exhibited significantly increased PSQI scores(8.89±4.41 vs.5.08±2.69,P<0.05)and PHQ-9 scores(3.60±4.19 vs.1.54±2.30,P<0.05)immediately after high-altitude exposure.One month after returning to the low-altitude environment,both sleep and depression scores decreased relative to the findings immediately after exposure(PSQI:3.88±2.13 vs.8.89±4.41,P<0.05;PHQ-9:1.50±2.25 vs.3.60±4.19,P<0.05)and showed no statistically significant difference compared with the pre-exposure findings(P>0.05).Three months after returning to near-sea-level environment,sleep,depression,and anxiety scores were all reduced compared with the findings immediately after exposure(PSQI:3.76±2.31 vs.8.89±4.41,P<0.05;PHQ-9:1.24±2.13 vs.3.60±4.19,P<0.05;SAS:23.84±5.93 vs.27.93±7.05,P<0.05),also showing no significant difference compared with the pre-exposure levels(P>0.05).Brain function analysis revealed that,relative to the pre-exposure levels,ALFF in the bilateral superior temporal gyrus,insula,and dorsolateral prefrontal cortex(DLPFC)increased after high-altitude exposure(P<0.05),and that functional connectivity strength in the DLPFC was also elevated(P<0.05).Furthermore,changes in DLPFC functional connectivity strength were positively correlated with changes in sleep and mood scores(P<0.05).Conclusion High-altitude exposure has a significant impact on the sleep,mood states,and brain function of populations from near-sea-level regions,and DLPFC,in particular,is closely associated with changes in sleep and mood states.The findings of this study provide a theoretical basis for health management and intervention strategies in high-altitude environments.

Objective To investigate the predictive value of early fluid balance combined with daily average fluid intake on the prognosis of patients who received hematoma evacuation for spontaneous intracerebral hemorrhage(sICH).Methods This study retrospectively and consecutively enrolled patients who underwent hematoma evacuation for sICH admitted to the Neurosurgical Intensive Care Unit of North China University of Science and Technology Affiliated Hospital between January 2023 and January 2025.Patients'baseline and clinical data were collected,including gender,age,admission vital signs(body temperature,respiratory rate,heart rate,systolic and diastolic blood pressure),medical history(hypertension,diabetes mellitus,coronary heart disease),admission Glasgow coma scale(GCS)score,admission laboratory parameters(including white blood cell count,red blood cell count,platelet count,urine bacterial levels,urine ketones,urine pH,homocysteine),hemorrhage location,hemorrhage volume,time from ictus to surgery,and hematoma evacuation rate(hematoma evacuation rate[％]=[preoperative hematoma volume-postoperative hematoma volume]/preoperative hematoma volume × 100％).Fluid intake,output,balance,daily average intake,and cumulative fluid balance during the early postoperative period(the first to seventh 24-hour periods)were assessed and recorded.Fluid intake comprised the sum of intravenously administered fluids(crystalloids,hypertonic fluids,colloids,blood products,and parenteral nutrition),enteral nutrition(nasogastric feeding solutions and water),and renal replacement therapy fluids.Fluid output comprised the sum of urine volume,vomitus,drainage fluid,and dialysis fluid losses.Fluid balance was defined as the difference between fluid intake and output.Daily average intake was calculated as the average of the fluid intake over the first seven postoperative 24-hour periods.Cumulative fluid balance was the sum of the fluid balances over the first seven postoperative 24-hour periods.Patient outcomes were assessed at 30 days postoperatively.Discharged patients underwent outpatient review or telephone follow-up,while inpatients were evaluated by neurosurgeons.Prognosis was evaluated using the 30-day modified Rankin scale(mRS)score:mRS scores 0-3 were classified as favorable prognosis,and mRS scores 4-6 as poor prognosis.Patients were subsequently divided into favorable prognosis and poor prognosis groups based on mRS scores.Factors with P＜0.05 in univariate comparisons and without collinearity(multicollinearity was defined by:tolerance＜0.1 and variance inflation factor＞10)were included in multivariate Logistic regression analysis to identify independent risk factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of relevant factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Results A total of 320 patients who underwent hematoma evacuation for sICH were enrolled,including 192 males and 128 females,with an age range of 20-91 years(median age 62[53,68]years).Among them,144 patients were assigned to the favorable prognosis group and 176 to the poor prognosis group.The poor prognosis group exhibited significantly higher hemorrhage volume,homocysteine level,fluid intake at the 3rd,5th,6th,and 7th 24-hour periods,fluid balance at the 3rd,5th,6th,and 7th 24-hour periods,daily average intake,and cumulative fluid balance compared to the favorable prognosis group(all P＜0.05).The favorable prognosis group had a significantly higher hematoma evacuation rate,GCS score,proportion of supratentorial hemorrhage and negative urine ketones than the poor prognosis group(all P＜0.05).No significant differences were found in other clinical data(all P＞0.05).Fluid balance over the first seven postoperative 24-hour periods displayed a rise-decline-rise pattern in the poor prognosis group and a rise-decline pattern in the favorable prognosis group.Both groups peaked at the 3rd 24-hour period.Multivariate Logistic regression analysis identified fluid balance at the 3rd 24-hour period(OR,2.013,95％CI 1.386-2.922,P＜0.01)and daily average intake(OR,3.583,95％CI 1.793-7.161,P＜0.01)as independent influencing factors for poor 30-day prognosis after hematoma evacuation in sICH patients.ROC curve analysis revealed that the area under the curve(AUC)for fluid balance at the 3rd 24-hour period and daily average intake in predicting poor 30-day prognosis were 0.699(95％CI 0.642-0.757)and 0.765(95％CI 0.712-0.819),respectively.The combined model of fluid balance at the 3rd 24-hour period and daily average intake achieved an AUC of 0.804(95％CI 0.756-0.853),demonstrating significantly superior predictive performance compared to either variable alone(both P＜0.05).Conclusions The combination of fluid balance at the 3rd 24-hour period and daily average intake demonstrates modest predictive value for poor 30-day prognosis after hematoma evacuation in sICH patients.These findings require validation through multicenter,large-scale,prospective studies.

Objective To compare and analyze the predictive value of a variety of novel blood inflammation composite indicators in spontaneous intracerebral hemorrhage(sICH)patients'prognosis.Methods This retrospective study consecutively enrolled 329 sICH patients admitted to the Neurosurgical Intensive Care Unit of North China University of Science and Technology Affiliated Hospital between September 2022 and December 2024.Patients were categorized into favorable(with modified Rankin scale[mRS]score ≤2)or unfavorable(mRS score ≥ 3)prognosis groups based on 90-day post-onset assessments.Baseline and imaging data,included age,gender,smoking history,alcohol consumption history,admission systolic/diastolic blood pressure,medical history(diabetes,coronary heart disease,stroke),24-hour laboratory parameters after admission(albumin,hemoglobin,blood glucose,potassium,platelets,lymphocytes,monocytes,neutrophils,homocysteine,red cell distribution width[RDW]),site of hemorrhage(basil ganglia,lobes,cerebellum,brain stem),hemorrhage volume,the National Institutes of Health stroke scale(NIHSS)score.Systemic complications during hospitalization(pulmonary/urinary tract/bloodstream infections)were recorded.Head CT and CT angiography(CTA)were performed at 24 h after admission to measure hematoma volume.Calculate and analyze the comprised inflammatory indices including systemic immune-inflammation index(SII;platelets × neutrophils/lymphocytes),platelet-to-lymphocyte ratio(PLR),RDW to albumin ratio(RAR;RDW/albumin),hemoglobin to RDW ratio(HRR,hemoglobin/RDW),systemic inflammation response index(SIRI;neutrophils × monocytes/lymphocytes),lymphocyte-neutrophil-albumin ratio(LANR;lymphocytes × albumin/neutrophils),neutrophil-to-albumin ratio(NPAR;neutrophil％/albumin),glucose-to-lymphocyte ratio(GLR;glucose/lymphocytes),and glucose-to-potassium ratio(GPR,glucose/potassium).Variables with P＜0.05 in univariate analysis were included in a collinearity analysis(a tolerance＜0.1 or variance inflation factor[VIF]＞10 indicating collinearity).Significant non-collinear variables with P＜0.05 in univariate analysis were included in multivariate Logistic regression to identify factors influencing prognosis in sICH patients.Receiver operating characteristic(ROC)curves was utilized to compare the predictive power of each indictors through net reclassification improvement(NRI)and integrated discrimination improvement(IDI).With NRI/IDI＞0 indicated superiority of new models over the old ones(higher values denote greater improvement).Delong's test was performed to evaluate the area under the curve(AUC)differences.Results Among the 329 sICH patients enrolled(185 males,144 females;mean age[68±6]years,ranged 36-91),138 were categorized into the favorable prognosis group(mRS score≤ 2)and 191 into the unfavorable prognosis group(mRS score ≥ 3),all patients had received a standardized treatment.Significant differences were observed in alcohol consumption history,diabetes,prior stroke,albumin,hemoglobin,blood glucose,platelets,lymphocytes,monocytes,neutrophils,homocysteine,RDW,hematoma volume,lung infection,and NIHSS score between two groups(all P＜0.05).While no significant differences were observed in the rest baseline/imaging data between the two groups(all P＞0.05).The favorable prognosis group exhibited significantly lower GLR(4.67[3.76,5.92]vs.6.67[4.66,10.32]),SIRI(1.92[1.12,3.24]v.s.4.43[2.25,8.33]),PLR(125.11[105.11,156.20]vs.164.46[122.42,232.63]),RAR(0.28[0.27,0.29]vs.0.32[0.30,0.35]),and NPAR(0.18[0.13,0.21]vs.0.22[0.16,0.33];all P＜0.01);and significantly higher SII(1 632.90[882.18,2 429.78]vs.967.93[702.83,1 290.51]),LANR(9.63[7.75,13.10]vs.5.49[3.25,9.77]),and HRR(11.73[10.97,12.62]vs.10.89[10.00,11.82];all P＜0.01).No significant differences were found in GPR(2.15[1.80,2.65]vs.2.28[1.83,3.31])between the favorable and unfavorable prognosis groups(P=0.094).After excluding factors with multicollinearity(including,lymphocytes,platelets,neutrophils,monocytes,albumin,RDW and hemoglobin),the other factors were included in a multivariate analysis,which identified SIRI(OR,1.312,95％CI1.043-1.650,P=0.020),RAR(OR,1.578,95％CI 1.376-1.810,P＜0.01),and HRR(OR,0.641,95％CI 0.480-0.854,P=0.002)as independent predictors of poor 90-day prognosis for sICH patients.ROC analysis showed that the AUC of RAR,SIRI,and HRR were 0.862,0.739 and 0.683 respectively,with RAR demonstrating superior sensitivity(82.20％vs.SIRI 68.06％vs.HRR 51.83％)and specificity(78.26％vs.SIRI 69.57％vs.HRR 76.81％).IDI confirmed RAR's significantly greater predictive ability versus SIRI(IDI=0.210,P＜0.01)and HRR(IDI=0.263,P＜0.01),and SIRI have superior predictive ability over HRR(IDI=0.053,P=0.040).Delong test showed that RAR had significantly greater predictive power than both SIRI and HRR(both P＜0.01),while the predictive power of SIRI and HRR did not differ significantly(P=0.138).Conclusions The three blood inflammatory indicators(RAR,SIRI,HRR)are effective predictors of poor prognosis in sICH patients at 90 d from onset,and among the three composite inflammatory parameters,RAR is significantly more effective than SIRI and HRR indicators.

Objective To construct an animal model of dilated cardiomyopathy(DCM)with heart failure toxin syndrome that conforms to the characteristics of traditional Chinese medicine(TCM)syndrome and identify potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.Methods Fifteen male SD rats were divided into a blank control,doxorubicin,or DCM with heart failure toxin syndrome group using a random number table method,with five rats per group.The doxorubicin group received intraperitoneal injection of doxorubicin at a dose of 1.25 mg/kg,administered on the first and fourth days of each week,along with a standard diet.The DCM with heart failure toxin syndrome group,in addition to the doxorubicin treatment,was given 42％white liquor(10 mL/kg)via gavage every other day,along with a 45％high-fat feed and 10％fructose water.The blank control group received intraperitoneal injection of an equivalent volume of phosphate-buffered saline at the same time points as the doxorubicin group,along with a standard diet.The model was established for 10 weeks.At the fourth and tenth weeks of modeling,echocardiography was performed to measure left ventricular ejection fraction(LVEF),fractional shortening(FS),systolic left ventricular posterior wall thickness(LVPWs),diastolic left ventricular posterior wall thickness,systolic left ventricular internal diameter(LVIDs),and diastolic left ventricular internal diameter(LVIDd);macroscopic changes in fur color of the rats were assessed using the red-green-blue colorimetric method.After modeling,the open field test was conducted to evaluate the exercise tolerance of the rats,and the grip strength test was performed to assess changes in forelimb grip strength.Hematoxylin-eosin,Masson,and wheat germ agglutinin staining were used to evaluate pathological changes in cardiac tissue.Bulk RNA sequencing analysis was performed to identify differentially expressed genes(DEGs)in the hearts of rats between the blank control and the DCM with heart failure toxin syndrome groups.Using DCM,the Blue value of rat fur color,and forelimb grip strength as phenotypic traits,weighted gene co-expression network analysis(WGCNA)was performed to screen for characteristic module gene sets(MEs)associated with DCM with heart failure toxin syndrome.Overlapping analysis was performed on DEGs,immune-related gene sets,and MEs,and the intersecting genes were identified as potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.The sensitivity and specificity of these targets were evaluated using receiver operating characteristic(ROC)curve analysis.Results Compared with the blank control group,at the tenth week of modeling,the LVEF,FS,and LVPWs of rats in the doxorubicin group and the DCM with heart failure toxin syndrome group decreased,whereas LVIDs and LVIDd increased,and the movement distance of the open field test and forelimb grip strength were reduced(P＜0.05).At the 10th week of modeling,the Blue value of fur color in the DCM with heart failure toxin syndrome group was significantly lower than that of the blank control and doxorubicin groups(P＜0.05).Compared with the blank control group,rats in the doxorubicin and DCM with heart failure toxin syndrome groups exhibited significant cardiac dilation and increased immune cell infiltration in cardiac tissue,accompanied by collagen deposition and cardiomyocyte hypertrophy.Bulk RNA sequencing identified 2,003 DEGs,including 1,082 downregulated genes and 921 upregulated genes.WGCNA results revealed that the MEturquoise module had the strongest positive correlation with DCM and the strongest negative correlation with the Blue value and forelimb grip strength.The overlapping analysis identified four intersecting genes:bone morphogenetic protein 6(Bmp6),serine-threonine-protein kinase 1(Pak1),proto-oncogene JunD(JunD),and S100 calcium-binding protein A3(S100A3).ROC curve analysis demonstrated that these four genes exhibited high sensitivity and specificity for DCM with heart failure toxin syndrome.Conclusion The rat model constructed by intraperitoneal injection of doxorubicin combined with a high-fat feed,fructose water,and white liquor gavage closely aligns with the characteristics of the DCM with heart failure toxin syndrome.Bmp6,JunD,Pak1,and S100A3 are potential biomarkers or therapeutic targets for DCM heart failure toxin syndrome.

Objective To construct an animal model of dilated cardiomyopathy(DCM)with heart failure toxin syndrome that conforms to the characteristics of traditional Chinese medicine(TCM)syndrome and identify potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.Methods Fifteen male SD rats were divided into a blank control,doxorubicin,or DCM with heart failure toxin syndrome group using a random number table method,with five rats per group.The doxorubicin group received intraperitoneal injection of doxorubicin at a dose of 1.25 mg/kg,administered on the first and fourth days of each week,along with a standard diet.The DCM with heart failure toxin syndrome group,in addition to the doxorubicin treatment,was given 42％white liquor(10 mL/kg)via gavage every other day,along with a 45％high-fat feed and 10％fructose water.The blank control group received intraperitoneal injection of an equivalent volume of phosphate-buffered saline at the same time points as the doxorubicin group,along with a standard diet.The model was established for 10 weeks.At the fourth and tenth weeks of modeling,echocardiography was performed to measure left ventricular ejection fraction(LVEF),fractional shortening(FS),systolic left ventricular posterior wall thickness(LVPWs),diastolic left ventricular posterior wall thickness,systolic left ventricular internal diameter(LVIDs),and diastolic left ventricular internal diameter(LVIDd);macroscopic changes in fur color of the rats were assessed using the red-green-blue colorimetric method.After modeling,the open field test was conducted to evaluate the exercise tolerance of the rats,and the grip strength test was performed to assess changes in forelimb grip strength.Hematoxylin-eosin,Masson,and wheat germ agglutinin staining were used to evaluate pathological changes in cardiac tissue.Bulk RNA sequencing analysis was performed to identify differentially expressed genes(DEGs)in the hearts of rats between the blank control and the DCM with heart failure toxin syndrome groups.Using DCM,the Blue value of rat fur color,and forelimb grip strength as phenotypic traits,weighted gene co-expression network analysis(WGCNA)was performed to screen for characteristic module gene sets(MEs)associated with DCM with heart failure toxin syndrome.Overlapping analysis was performed on DEGs,immune-related gene sets,and MEs,and the intersecting genes were identified as potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.The sensitivity and specificity of these targets were evaluated using receiver operating characteristic(ROC)curve analysis.Results Compared with the blank control group,at the tenth week of modeling,the LVEF,FS,and LVPWs of rats in the doxorubicin group and the DCM with heart failure toxin syndrome group decreased,whereas LVIDs and LVIDd increased,and the movement distance of the open field test and forelimb grip strength were reduced(P＜0.05).At the 10th week of modeling,the Blue value of fur color in the DCM with heart failure toxin syndrome group was significantly lower than that of the blank control and doxorubicin groups(P＜0.05).Compared with the blank control group,rats in the doxorubicin and DCM with heart failure toxin syndrome groups exhibited significant cardiac dilation and increased immune cell infiltration in cardiac tissue,accompanied by collagen deposition and cardiomyocyte hypertrophy.Bulk RNA sequencing identified 2,003 DEGs,including 1,082 downregulated genes and 921 upregulated genes.WGCNA results revealed that the MEturquoise module had the strongest positive correlation with DCM and the strongest negative correlation with the Blue value and forelimb grip strength.The overlapping analysis identified four intersecting genes:bone morphogenetic protein 6(Bmp6),serine-threonine-protein kinase 1(Pak1),proto-oncogene JunD(JunD),and S100 calcium-binding protein A3(S100A3).ROC curve analysis demonstrated that these four genes exhibited high sensitivity and specificity for DCM with heart failure toxin syndrome.Conclusion The rat model constructed by intraperitoneal injection of doxorubicin combined with a high-fat feed,fructose water,and white liquor gavage closely aligns with the characteristics of the DCM with heart failure toxin syndrome.Bmp6,JunD,Pak1,and S100A3 are potential biomarkers or therapeutic targets for DCM heart failure toxin syndrome.

Objective To predict the value of admission dehydration state combined with fluid accumulation index for post-operative prognosis in elderly patients with intracerebral hemorrhage(ICH).Methods A retrospective study was conducted on 320 elderly ICH patients receiving surgical treatment in Department of Neurosurgery and then admitted to its Intensive Care Unit of the Affiliated Hospital of North China University of Science and Technology from May 2023 to March 2024.According to the survival status at 30 d after onset,they were divided into a survival group(202 cases)and a death group(118 cases).Clinical data such as basic information,admission vital signs,laboratory indicators,and fluid supplementation were compared between the two groups.ROC curve was plotted.Results The death group exhibited significantly advanced age,more bleeding sites,higher 7-day fluid accumulation index,and larger proportions of ventricular rupture,midline displacement and admission dehydration status,but lower uric acid level than the the survival group(P＜0.05,P＜0.01).Binary logistic regression analysis showed that admission dehydration status and 7-day fluid accumulation index were risk factors for 30-day mortality in elderly ICH patients after surgery(P＜0.01).ROC curve analysis showed that the AUC value of admission dehydration status combined with 7-day fluid accumulation index in predicting 30-day death of elderly ICH patients after surgery was 0.774(95％CI:0.722-0.825),and that of the combination was better than that of each indicator alone(P＜0.05).Conclusion Hospital dehydration status combined with 7-day fluid accumulation index has the best effectiveness in predicting 30-day mortality in elderly ICH patients after surgical treatment.

BackgroundChronic insomnia is characterized by a prolonged and recurrent course. The efficacy of repeated transcranial magnetic stimulation （rTMS） as a physical therapy method to improve sleep quality remains inadequately supported by evidence， particularly regarding its relationship with personality traits. ObjectiveTo explore the efficacy and influencing factors of rTMS in the treatment of chronic insomnia， and to provide insights into its therapeutic potential. MethodA total of 46 patients who met the diagnostic criteria for chronic insomnia according to the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， and were treated at the Third Hospital of Mianyang from September 2022 to September 2023 were selected. Prior to treatment， participants underwent assessments using the Eysenck Personality Questionnaire （EPQ）， Hamilton Depression Scale-17 item （HAMD-17） and Hamilton Anxiety Scale （HAMA）. The Pittsburgh Sleep Quality Index （PSQI） was used to assess sleep quality before treatment， at the end of the second week of treatment and one week post-treatment. ResultsAt the end of the second week of treatment， patients exhibited significantly improved total PSQI score and subscale scores related to subjective sleep quality， sleep latency， sleep duration， sleep efficiency， sleep disturbance and daytime dysfunction （t=4.755~13.361， P<0.01）， with 24 cases （54.35%） showing effective treatment outcomes. Multiple linear regression analysis showed that introverted and extroverted personality traits contributed significantly to the regression equation （B=0.317， P<0.01）， explaining 29.90% of the total variation （R²=0.299）. ConclusionrTMS treatment may effectively improve the sleep quality of patients with chronic insomnia， with its therapeutic effect appearing to associated with introverted and extroverted personality traits. ［Funded by National Natural Science Project of China （number， 82372080）］