Objective To evaluate the combination score of albumin-bilirubin index(ALBI)and alkaline phosphatase(ALP)in predicting the prognosis of patients with cirrhosis complicated by portal hypertension after receiving transjugular intrahepatic portosystemic shunt(TIPS).Methods A total of 61 patients with cirrhosis complicated by portal hypertension,who received TIPS treatment at the Lishui Municipal Central Hospital of China from January 2016 to June 2024,were retrospectively collected.According to the Youden index of ALBI and ALP,the optimal cut-off values were calculated,and the patients were divided into low ALBI-low ALP group(0-point group),high ALBI-high ALP group(2-point group),and high ALBI-low ALP or low ALBI-high ALP group(one-point group).The efficacy of ALBI-ALP score in predicting the prognosis of patients was evaluated,and the survival rate and median survival time were compared between each other among the three groups.The independent risk factors affecting the survival time of patients were analyzed.Results The maximum Youden indexes of ALBI and ALP were 0.31 and 0.34 respectively,and the optimal cut-off values were-1.56 and 108.50 respectively.There were statistically significant differences in MELD score,Child-Pugh classification,and alanine aminotransferase level between each other among the three groups(all P＜0.05).The area under the ROC curve(AUC)of ALBI-ALP score was 0.77(95％ CI:0.66-0.89,P=0.000 2),which was better than 0.52 of the MELD score(95％ CI:0.37-0.67,P=0.77)as well as better than 0.57 of the Child-Pugh classification(95％ CI:0.43-0.72,P=0.34).The total mortality of patients was 49.18％.The mortality in the 0-point group was 11.11％(2/18),which was significantly lower than 59.46％(22/37)in the one-point group as well as than 100％(6/6)in the 2-point group,and the differences were statistically significant(x2=18.20,P＜0.001).In the 0-point group,as a large number of patients were still alive at the end of the study,the median survival time was unable to be calculated.The median survival time in the one-point group was 38.00 months(95％ CI:23.01-52.99 months),which in the 2-point group was only 1.00 month(95％ CI=0.00-2.60 months),the difference was statistically significant(x2=33.08,P＜0.000 1).In the 0-point group,one-point group and 2-point group,the one-year survival rates were 100％,66％ and 17％respectively,the 2-year survival rates were 100％,64％ and 17％ respectively,and the 3-year survival rates were 90％,53％ and 0％ respectively.Cox multivariate regression analysis showed that the combination score of ALBI and ALP(HR=7.11,95％ CI:2.95-17.15)was an independent risk factor for the survival time of patients with cirrhosis complicated by portal hypertension after receiving TIPS.Conclusion The combination score of ALBI and ALP can effectively predict the prognosis of patients with cirrhosis complicated by portal hypertension after receiving TIPS,and this score is an independent risk factor affecting the survival time of patients.

Background: The incidence density of metabolic dysfunction-associated fatty liver disease (MAFLD) and the effect of a healthy lifestyle on the risk of MAFLD remain unknown. We evaluated the prevalence and incidence density of MAFLD and investigated the association between healthy lifestyle and the risk of MAFLD. Methods: A cross-sectional analysis was conducted on 37,422 participants to explore the prevalence of MAFLD. A cohort analysis of 18,964 individuals was conducted to identify the incidence of MAFLD, as well as the association between healthy lifestyle and MAFLD. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) with adjustments for confounding factors. Results: The prevalence of MAFLD, non-alcoholic fatty liver disease, and their comorbidities were 30.38%, 28.09%, and 26.13%, respectively. After approximately 70 thousand person-years of follow-up, the incidence densities of the three conditions were 61.03, 55.49, and 51.64 per 1,000 person-years, respectively. Adherence to an overall healthy lifestyle was associated with a 19% decreased risk of MAFLD (HR, 0.81; 95% CI, 0.72 to 0.92), and the effects were modified by baseline age, sex, and body mass index (BMI). Subgroup analyses revealed that younger participants, men, and those with a lower BMI experienced more significant beneficial effects from healthy lifestyle. Conclusion Our results highlight the beneficial effect of adherence to a healthy lifestyle on the prevention of MAFLD. Health management for improving dietary intake, physical activity, and smoking and drinking habits are critical to improving MAFLD.

Objective:To investigate the prevalence of depression symptoms in residents, and to analyze the demographic characteristics, training status and psychological influencing factors in order to provide the evidence for the mental health management and intervention of residents in China at current stage.Methods:A total of 1 050 participants from eight different training centers in Shenyang, Dalian, Jinzhou and Fushun of Liaoning Province were investigated by Pittsburgh sleep quality index, International physical activity questionnaire, Survey of perceived organizational support, Psychological capital questionnaire and Minnesota satisfaction questionnaire, which covered questions including social demographic information, training information, sleep status, physical activity, organization support, psychological capital, job satisfaction and depressive symptoms of residents. SPSS 22.0 were used to carry out statistical analysis such as logistic regression.Results:A total of 962 valid questionnaires were collected and the results showed that 44.59% (429/962) of residents had depressive symptoms. High training grade ( ORPGY-3=1.775, P=0.006) and poor quality of sleep ( OR=1.662, P<0.001) were risk factors of depressive symptoms, whereas psychological capital ( OR=0.962, P<0.001) and job satisfaction ( OR=0.972, P=0.001) were protective factors of depressive symptoms. Conclusion:The prevalence of depressive symptoms is high in residents. Training grade, sleep quality, psychological capital and job satisfaction are closely associated with the high prevalence of depressive symptoms, which should be paid more attention to.

In 2016, a national one million general population cohort project was set up in China for the first time in "Precision Medicine Research" Key Project, National Key Research and Development Program of China, which consists of general population cohorts in seven areas in China. As one of the seven major areas in China, northeastern China has unique climate and specific dietary patterns, and population aging is serious in this area. And the burden of chronic and non-communicable diseases ranks tops in China. Therefore, it is of great significance to establish a large general population cohort in northeastern China to explore the area specific exposure factors related to pathogenesis and prognosis of chronic and non-communicable diseases, develop new prevention strategies to reduce the burden of the diseases and improve the population health in northeastern China. In July 2018, the general population cohort study in northeastern China was launched, the study includes questionnaire survey, health examination and blood, urine and stool sample collection and detection in recruited participants. By now, the cohort has covered all age groups, and the baseline data of 115 414 persons have been collected. This paper summarizes the design and practice of the general population cohort study in northeastern China to provide reference for related research in China.

Objective The flow field of electromagnetically driven pulsating perfusion blood pump was simulated by computational fluid dynamics (CFD) method, and the flow state of blood in blood pump was improved by modifying the structure of pump head, so as to improve its anti-hemolytic performance. Methods The influences of changes in pump head structure on flow field in the pump were analyzed by using Fluent 17.0. Four simulation experiments were carried out to analyze streamline distributions of the internal liquid, the turbulent flow energy distribution on axis of the model, pressure loss of blood flowing through the pump head and shear stress on surface of the model. Results In the four experiments, when the angle between the inlet and outlet of the pump head was symmetrical and the angle between the pump head and the symmetrical axis (α) was 30°, there was no obvious disturbance in the flow line and the turbulence degree was low. In Experiment 1, the pressure loss was 376.8 Pa, with the minimum value. The maximum shear stress in Experiment 2 and 3 was 258.6 Pa and 302.8 Pa, respectively, which met the biomechanical requirements of blood pump such as pressure loss and hemolysis. The model with α=30° was selected as pump head structure of the pulsating blood pump driven by electromagnetic force, and was fabricated by 3D printing technology. Conclusions By optimization of the pump head, the hemolysis performance of the blood pump was improved. The research results can be applied to the design and experiment of a new electromagnetic drive pulse perfusion blood pump.

Objective To explore the effects of cognitive behavioral intervention on fear of disease progression and negative emotionin patients with glioma.Methods A total of 60 eligible patients with glioma who were treated in neurosurgery department of the First Affiliated Hospital of Zhengzhou University from January to October 2016 were randomly divided into experimental group (n=30) and control group (n=30) according to random number table. The control group received routine care, and the experimental group patients received cognitive behavioral intervention for 12 weeks on the basis of routine care. Cognitive assessment and cognitive reconstruction were performed to achieve cognitive intervention by interviews, lectures and other forms. Behavioral intervention was achieved by musical relaxation training and personalized exercise programs for the patients. The patients were evaluated with the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) on the admission day, 1 week after surgery and 3 months after surgery to compare the fear of disease progression and negative emotion of the two groups. Results Repeated measurement analysis of variance showed that with the extension of time, the anxiety and depression scores of the two groups were decreased, and the score of the observation group was lower than that of the control group. The differences were statistically significant (P<0.05). The score of FoP-Q-SF in both groups showed a trend of rising first and then decreasing, and the peak point was as 1 week after operation. There was no statistical significant difference in the score of FoP-Q-SF between the two groups before intervention (P> 0.05). The score of the observation group was significantly lower than that of the control group at 3 months after intervention, with statistical difference (P<0.05).Conclusions There were different degrees of fear of progression and negative emotions in patients with glioma at different stages of disease. Cognitive behavioral intervention can effectively alleviate the fear of disease progression, anxiety and depression in patients with glioma, and it is worthy of clinical promotion.

Objective To analyze the discrepancy and similarities of clinical characteristics in elderly patients with ulcerative colitis (UC) and ischemic colitis (IC).Methods A total of 43 elderly patients (age≥60 yrs) with UC and 36 elderly patients with IC were enrolled from 2004 to 2015 at Peking Union Medical College Hospital.The clinical characteristics were retrospectively analyzed and compared between the two groups.Results Compared with IC group,the disease course was longer with lower incidence of cardiovascular comorbidities in UC patients (P ＜ 0.05).In UC group,more patients presented with diarrhea,mucopurulent bloody stool [39 (90.7％) vs 16 (44.4％) and 34 (79.1％) vs 2 (5.6％)respectively,both P ＜ 0.01].Yet bloody stool as the only symptom was seen in more IC patients than UC patients [61.1％ (22/36) vs 7.0％ (3/43),P ＜ 0.01].The ratio of extra-intestinal manifestations was higher [18.6％ (8/43) vs 0 (0/36)] in UC patients,while complications were lower [11.6％ (5/43) vs 30.6％ (11/36),P ＜ 0.05].As to the laboratory parameters,median platelet count [(294.38 ± 104.83) × 109/L vs (235.47±94.82) × 109/L,P ＜0.05] was higher in UC group.In addition,more patients with UC had positive perinuclear antineutrophil cytoplasmic antibody (p-ANCA) [50.0％ (15/30) vs 10.0％ (2/20),P ＜ 0.05].The most commonly involved regions of IC were descending colon and sigmoid colon,in which the lesions were clearly demarcated with the normal mucosa.Lesions in patients with UC mainly originated from rectum and might spread to the whole colon.Vascular occlusion and micro thrombosis were characteristic pathological findings of IC.The crypt abscesses were frequently seen in the UC group.Conclusion Even though UC and IC have some similar manifestations in the elderly patients,clinical and pathological discrepancy is still helpful to differentiate each other.