Objective To explore the prognostic implications of coagulation-fibrinolysis biomarkers in intracerebral hemorrhage(ICH)and to construct a multivariable logistic regression model for individualized risk prediction.Methods A total of 101 ICH patients who were admitted to Nanfang Hospital of Southern Medical University from January 2020 to December 2023 were retrospectively enrolled.These patients were stratified into a poor outcome group(ΔGCS≤0)and a good outcome group(ΔGCS>0)according to the difference in Glasgow Coma Scale(GCS)scores between discharge and admission.Coagulation and fibrinolysis markers collected upon admission were analyzed.The Least Absolute Shrinkage and Selection Operator(LASSO)regression was employed to screen variables.A logistic regression model was constructed using 70%of the cases(the training set),while the remaining 30%were utilized for validation.The performance of the model was evaluated through receiver operating characteristic(ROC)curves,calibration plots,Hosmer-Lemeshow goodness-of-fit test,and decision curve analysis(DCA).Results Univariate analysis indicated that thrombin-antithrombin complex(TAT),D-dimer,and age exhibited significant differences between the two outcome groups(P<0.05).These three variables were selected via LASSO regression and incorporated into the logistic model.The final model equation was expressed as:logit(P)=-6.234+1.132×TAT+0.867×D-dimer+0.699×Age.In the training set,the area under the ROC curve(AUC)was 0.795.The calibration curve demonstrated excellent agreement between the predicted and observed outcomes,with a Hosmer-Lemeshow test P-value of 0.8568.DCA revealed that the model achieved net clinical benefit across a broad range of risk thresholds(0.1～0.8).Conclusions TAT,D-dimer,and age are independent predictors of poor prognosis in patients with ICH.The logistic regression model based on these variables demon-strates favorable discriminatory ability and clinical utility.The nomogram derived from this model enables individu-alized risk assessment and may aid clinicians in early prognostic evaluation and treatment planning.

The prevalence of chronic constipation among the elderly is significant, exerting adverse effects on both their physical and mental health.Presently, pharmacological therapy remains the predominant treatment modality for elderly patients with chronic constipation; however, prolonged use can lead to drug dependence, tolerance, and adverse effects.This article systematically reviews non-pharmacological interventions for chronic constipation in elderly patients, both domestically and internationally, aiming to provide a comprehensive reference for clinical practice.

Objective To study the effectiveness of combining antidepressant drug with high-frequency repeated transcranial magnetic stimulation(rTMS)in treating adolescent depression and explore its impact on electroencephalogram.Methods 60 cases of adolescent depression,who admitted to Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University from September to December 2024 were selected and randomly divided into control group and observation group,with 30 cases in each group.Patients of control group were treated with selective serotonin reuptake inhibitor(SSRI),while patients of observation group received the same SSRI treatment in addition to high-frequency rTMS.The treatment lasted for 2 weeks.Both groups were assessed by using 24-item Hamilton depression rating scale(HAMD-24)and depression self-rating scale for children(DSRSC)before the start of treatment and at the end of two weeks of treatment.Adverse reactions were recorded throughout the treatment,and electroencephalogram monitoring was taken before and after treatment.Results Observation group showed a significantly higher treatment response rate compared to control group(P<0.05).After two weeks of treatment,HAMD-24 and DSRSC scores in observation group were notably lower than those in control group(P<0.01).Both groups exhibited improvements in brain wave power(δ,θ,α,β)after treatment(P<0.05),with observation group demonstrating superior β wave power compared to control group(P<0.01).Additionally,a negative correlation was found between α and β wave power in the left frontal region and DSRSC scores in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Compared with SSRI treatment,rTMS combined with SSRI treatment can more effectively improve depressive symptoms,increase α and β brainwave power,and the combination therapy does not increase the incidence of adverse reactions,demonstrating good safety.

Objective To investigate the diagnostic potential of combining 3.0T magnetic resonance imag-ing(MRI)T2 mapping sequences with serum nesfatin-1 levels for detecting early osteoarthritis(OA)in elderly knees.Methods 97 elderly patients with knee osteoarthritis(OA group)and 52 elderly individuals undergoing physical examinations(control group)were recruited from a hospital between May 2023 and May 2024.Based on X-ray findings,the OA group was further divided into an early-stage subgroup and a non-early-stage subgroup.All participants underwent 3.0T MRI T2 mapping sequence scans to measure the T2 values in the knee cartilage region,and serum nesfatin-1 levels were assessed.Differences in these indicators were compared between groups.Additionally,a receiver operating characteristic(ROC)curve was constructed to evaluate the diagnostic value of these parameters for early-stage knee OA in elderly individuals.Results Among 97 elderly patients with knee OA,35 cases were classified into the early-stage group,and 62 cases were categorized into the non-early-stage group.The T2 values in five cartilage regions of the knee and serum nesfatin-1 levels were significantly higher in the OA group compared to the control group(P<0.05).Moreover,these values were significantly lower in the early-stage group than in the non-early-stage group(P<0.05).The areas under the curve(AUC)for diagnosing early-stage OA using T2 values in knee cartilage regions and serum nesfatin-1 levels ranged from 0.774 to 0.871.Notably,the AUC for combined diagnosis reached 0.939(P<0.05).Conclusion 3.0T MRI using the T2 mapping sequence in combination with serum nesfatin-1 level detection demonstrates high diagnostic value for early OA in elderly patients with knee involvement.

Objective To explore the prognostic implications of coagulation-fibrinolysis biomarkers in intracerebral hemorrhage(ICH)and to construct a multivariable logistic regression model for individualized risk prediction.Methods A total of 101 ICH patients who were admitted to Nanfang Hospital of Southern Medical University from January 2020 to December 2023 were retrospectively enrolled.These patients were stratified into a poor outcome group(ΔGCS≤0)and a good outcome group(ΔGCS>0)according to the difference in Glasgow Coma Scale(GCS)scores between discharge and admission.Coagulation and fibrinolysis markers collected upon admission were analyzed.The Least Absolute Shrinkage and Selection Operator(LASSO)regression was employed to screen variables.A logistic regression model was constructed using 70%of the cases(the training set),while the remaining 30%were utilized for validation.The performance of the model was evaluated through receiver operating characteristic(ROC)curves,calibration plots,Hosmer-Lemeshow goodness-of-fit test,and decision curve analysis(DCA).Results Univariate analysis indicated that thrombin-antithrombin complex(TAT),D-dimer,and age exhibited significant differences between the two outcome groups(P<0.05).These three variables were selected via LASSO regression and incorporated into the logistic model.The final model equation was expressed as:logit(P)=-6.234+1.132×TAT+0.867×D-dimer+0.699×Age.In the training set,the area under the ROC curve(AUC)was 0.795.The calibration curve demonstrated excellent agreement between the predicted and observed outcomes,with a Hosmer-Lemeshow test P-value of 0.8568.DCA revealed that the model achieved net clinical benefit across a broad range of risk thresholds(0.1～0.8).Conclusions TAT,D-dimer,and age are independent predictors of poor prognosis in patients with ICH.The logistic regression model based on these variables demon-strates favorable discriminatory ability and clinical utility.The nomogram derived from this model enables individu-alized risk assessment and may aid clinicians in early prognostic evaluation and treatment planning.

Objective To study the effectiveness of combining antidepressant drug with high-frequency repeated transcranial magnetic stimulation(rTMS)in treating adolescent depression and explore its impact on electroencephalogram.Methods 60 cases of adolescent depression,who admitted to Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University from September to December 2024 were selected and randomly divided into control group and observation group,with 30 cases in each group.Patients of control group were treated with selective serotonin reuptake inhibitor(SSRI),while patients of observation group received the same SSRI treatment in addition to high-frequency rTMS.The treatment lasted for 2 weeks.Both groups were assessed by using 24-item Hamilton depression rating scale(HAMD-24)and depression self-rating scale for children(DSRSC)before the start of treatment and at the end of two weeks of treatment.Adverse reactions were recorded throughout the treatment,and electroencephalogram monitoring was taken before and after treatment.Results Observation group showed a significantly higher treatment response rate compared to control group(P<0.05).After two weeks of treatment,HAMD-24 and DSRSC scores in observation group were notably lower than those in control group(P<0.01).Both groups exhibited improvements in brain wave power(δ,θ,α,β)after treatment(P<0.05),with observation group demonstrating superior β wave power compared to control group(P<0.01).Additionally,a negative correlation was found between α and β wave power in the left frontal region and DSRSC scores in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Compared with SSRI treatment,rTMS combined with SSRI treatment can more effectively improve depressive symptoms,increase α and β brainwave power,and the combination therapy does not increase the incidence of adverse reactions,demonstrating good safety.

Objective To investigate the diagnostic potential of combining 3.0T magnetic resonance imag-ing(MRI)T2 mapping sequences with serum nesfatin-1 levels for detecting early osteoarthritis(OA)in elderly knees.Methods 97 elderly patients with knee osteoarthritis(OA group)and 52 elderly individuals undergoing physical examinations(control group)were recruited from a hospital between May 2023 and May 2024.Based on X-ray findings,the OA group was further divided into an early-stage subgroup and a non-early-stage subgroup.All participants underwent 3.0T MRI T2 mapping sequence scans to measure the T2 values in the knee cartilage region,and serum nesfatin-1 levels were assessed.Differences in these indicators were compared between groups.Additionally,a receiver operating characteristic(ROC)curve was constructed to evaluate the diagnostic value of these parameters for early-stage knee OA in elderly individuals.Results Among 97 elderly patients with knee OA,35 cases were classified into the early-stage group,and 62 cases were categorized into the non-early-stage group.The T2 values in five cartilage regions of the knee and serum nesfatin-1 levels were significantly higher in the OA group compared to the control group(P<0.05).Moreover,these values were significantly lower in the early-stage group than in the non-early-stage group(P<0.05).The areas under the curve(AUC)for diagnosing early-stage OA using T2 values in knee cartilage regions and serum nesfatin-1 levels ranged from 0.774 to 0.871.Notably,the AUC for combined diagnosis reached 0.939(P<0.05).Conclusion 3.0T MRI using the T2 mapping sequence in combination with serum nesfatin-1 level detection demonstrates high diagnostic value for early OA in elderly patients with knee involvement.

The prevalence of chronic constipation among the elderly is significant, exerting adverse effects on both their physical and mental health.Presently, pharmacological therapy remains the predominant treatment modality for elderly patients with chronic constipation; however, prolonged use can lead to drug dependence, tolerance, and adverse effects.This article systematically reviews non-pharmacological interventions for chronic constipation in elderly patients, both domestically and internationally, aiming to provide a comprehensive reference for clinical practice.

Objective:To evaluate myocardial microcirculation perfusion with myocardial contrast echocardiography (MCE) in patients with acute myocardial infarction after percutaneous coronary intervention (PCI), and to explore the prognostic value of different types of myocardial microcirculation perfusion.Methods:This is a prospective cohort study. Patients with acute myocardial infarction who underwent successful PCI in Nanfang Hospital of Southern Medical University and Kanghua Hospital of Dongguan City from October 2019 to June 2021 were selected. All the enrolled patients completed MCE examination within 72 hours after PCI. According to the examination results, the patients were divided into normal microcirculation perfusion group, delayed microcirculation perfusion group, and blocked microcirculation perfusion group. Adverse cardiovascular events including all-cause death, cardiovascular death, and angina re-hospitalization were followed up, and left ventricular ejection fraction (LVEF) review results were collected at six months to one year after surgery. Kaplan-Meier survival curve was used to investigate the difference in the incidence of adverse cardiovascular events in different myocardial perfusion groups, and Cox regression analysis was used to evaluate the effect of myocardial perfusion on adverse cardiovascular events.Results:A total of 113 patients with acute myocardial infarction were included, aged (56.3±11.5) years, with 88(78%) males. There were 31 cases in the normal microcirculation perfusion group, 43 cases in the delayed microcirculation perfusion group and 39 cases in the blocked microcirculation perfusion group. LVEF was reviewed in 49 patients, and LVEF in the delayed microcirculation perfusion group was significantly improved compared with baseline at follow-up ((63.3±1.2) % vs. (58.6±1.8) %, P=0.043), and there was no statistically significant difference between the other two groups (all P>0.05). The median follow-up time was 473 days, during follow-up period 30 adverse cardiovascular events occurred. Kaplan-Meier survival curve analysis showed that there was a statistically significant difference in the incidence of adverse cardiovascular events among the three groups ( Plog-rank=0.029). Cox regression analysis showed that abnormal microcirculation perfusion (defined as delayed and blocked microcirculation perfusion) was an independent predictor of adverse cardiovascular events in patients with acute myocardial infarction after PCI ( HR=1.90, 95% CI1.16-3.12, P=0.011). Conclusions:Microcirculatory perfusion decrease or lost is common in patients with acute myocardial infarction after PCI. Timely restoration of blood flow reconstruction can save heart function when microcirculatory perfusion decreases. Microcirculatory perfusion is a predictor of adverse cardiovascular events in patients with acute myocardial infarction, and patients with poor myocardial perfusion are more likely to experience adverse cardiovascular events.

Objective:To explore the characteristics of SLCO1B1/ SLCO1B3 gene variants among children with Rotor syndrome (RS). Methods:Four children who were admitted to the Department of Hepatology of Hunan Children′s Hospital between January 2019 and January 2022 were selected as the study subjects. Trio-whole exome sequencing was carried out for the four families, and gel electrophoresis was used to verify an insertional variant of long-interspersed element-1 (LINE-1).Results:Genetic testing has identified three variants of the SLCO1B1 gene, including c. 1738C>T (p.R580*), c. 757C>T (p.R253*) and c. 1622A>C (p.Q541P), and two variants of the SLCO1B3 gene, including c. 481+ 22insLINE-1 and c. 1747+ 1G>A among the children. Three of them were found to harbor homozygous variants of the SLCO1B1/ SLCO1B3 genes, and one has harbored compound heterozygous variants. Sanger sequencing confirmed the existence of all variants, and gel electrophoresis has confirmed the existence of the LINE-1 insertional variant of about 6 kb within intron 6 of the SLCO1B3 gene in all children. Conclusion:The pathogenesis of the RS among the four children may be attributed to the variants of the SLCO1B1/ SLCO1B3 genes. The LINE-1 insertion variant of the SLCO1B3 gene may be common among Chinese RS patients.