Objective To investigate the value of combination of echocardiographic(ECG)parameters and geriatric nutritional risk index(GNRI)in predicting the prognosis of elderly chronic heart failure(CHF).Methods A retrospective study was conducted on 102 elderly CHF patients admitted to our hospital from February 2023 to July 2024.According to their clinical outcomes after 6 months of follow-up,they were divided into a good prognosis group(67 cases)and a poor prognosis group(35 cases).The clinical data,such as left ventricular ejection fraction(LVEF),left ventricular end-diastolic inner diameter(LVEDD)and left ventricular end-systolic inner diameter(LVESD),and GNRI were compared between two groups.Logistic regression analysis was adopted to identify the influencing factors of prognosis of elderly CHF patients,and ROC curve was plotted to analyze the predictive efficiency of ECG parameters and GNRI for the prognosis.Results The poor prognosis group exhibited significantly advanced age,higher LVEDD and LVESD,longer course of CHF,and lower LVEF and GNRI in comparison with the good prognosis group(P＜0.01).Multivariate logistic regression analysis indicated that LVEF,LVEDD,LVESD and GNRI were identified as influencing factors for elderly CHF prognosis(P＜0.05,P＜0.01).In evaluating the poor prognosis,LVEF,LVEDD,LVESD,GNRI and their combination presented an AUC value of 0.854,0.773,0.785,0.850 and 0.902,respectively.The evaluation efficiency of combined detection was superior to that of single detection in assessing the poor prognosis in elderly CHF patients(P＜0.01).Conclusion ECG parameters and GNRI are related to the prognosis in elderly CHF patients,and combined detection has good evaluation efficiency for the poor prognosis.

Objective:To investigate the effect of dapagliflozin on non-dipper blood pressure in patients with diabetic kidney disease(DKD).Methods:A total of 104 patients with DKD treated in the Department of Nephrology of Henan Provincial Hospital of Tradi-tional Chinese Medicine from January 2023 to January 2024 were selected as the study subjects.The patients were divided into a dapa-gliflozin group and a control group by the random number table method,with 52 patients in each group.The control group was given conventional Western medicine treatment,and the dapagliflozin group was additionally given dapagliflozin(10 mg/dose,once a day)on the basis of the treatment in the control group.Both groups re-ceived continuous treatment for 12 weeks.The following indicators and the incidence of adverse reactions after treatment were com-pared between the two groups,including blood glucose indicators[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 h PBG),and glycated hemoglobin(HbA1c)],renal function markers[serum cystatin C(CysC),blood urea nitrogen(BUN),se-rum creatinine(Scr),estimated glomerular filtration rate(eGFR),and urinary albumin/creatinine ratio(UACR)],24-h ambulatory blood pressure,proportion of non-dipper blood pressure and reversal rate of dipper blood pressure,blood electrolytes[potassium(K),sodium,chlorine,calcium,magnesium,and phosphorus],serum uric acid(SUA),and urine electrolytes[urine potassium,urine sodium(UNa),urine chlorine,urine calcium,urine magnesium(UMg),and urine phosphorus].Results:The FPG,2 h PBG,HbA1c,CysC,BUN,Scr,UACR,mean 24 h systolic blood pressure(24 h SBP),mean daytime systolic blood pressure,and mean nighttime diastolic blood pressure were decreased and the eGFR was elevated in both groups after treatment.The mean nighttime systolic blood pressure(nSBP),K,and SUA were decreased and the UNa and UMg were increased in the dapagliflozin group after treatment(P<0.05).Com-pared with the control group,the dapagliflozin group experienced decreases in CysC,BUN,Scr,UACR,24 h SBP,nSBP,K,and SUA and increases in eGFR,UNa,and UMg after treatment(P<0.05).The proportion of non-dipper blood pressure after treatment in the dapagliflozin group was lower than that in the control group and before treatment,and the reversal rate of dipper blood pressure was higher than that in the control group(P<0.05).During treatment,the incidence rates of adverse reactions was 3.85%in the dapa-gliflozin group and 5.77%in the control group(P=1.000).Conclusion:Dapagliflozin improves the renal function,decreases the noctur-nal blood pressure,and increases the reversal rate of dipper blood pressure in patients with DKD.Dapagliflozin promotes UNa excre-tion and decreases the SUA level,which may be the potential mechanism of reversing non-dipper blood pressure.

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

OBJECTIVE: To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit (ICU). METHODS: We analyzed 545 patients with hepatic coma in the ICU from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Associations between serum chloride levels and 28-day and 1-year mortality rates were assessed using restricted cubic splines (RCSs), Kaplan-Meier (KM) curves, and Cox regression. Subgroup analyses, external validation, and mechanistic studies were also performed. RESULTS: A total of 545 patients were included in the study. RCS analysis revealed a U-shaped association between serum chloride levels and mortality in patients with hepatic coma. The KM curves indicated lower survival rates among patients with low chloride levels (< 103 mmol/L). Low chloride levels were independently linked to increased 28-day and 1-year all-cause mortality rates. In the multivariate models, the hazard ratio ( HR) for 28-day mortality in the low-chloride group was 1.424 (95% confidence interval [ CI]: 1.041-1.949), while the adjusted hazard ratio for 1-year mortality was 1.313 (95% CI: 1.026-1.679). Subgroup analyses and external validation supported these findings. Cytological experiments suggested that low chloride levels may activate the phosphorylation of the NF-κB signaling pathway, promote the expression of pro-inflammatory cytokines, and reduce neuronal cell viability. CONCLUSION Low serum chloride levels are independently associated with increased mortality in patients with hepatic coma.
Humans ; Male ; Female ; Middle Aged ; Intensive Care Units ; Prognosis ; Chlorides/blood* ; Aged ; Coma/blood* ; Adult

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

Traditional Chinese medicine （TCM） compound prescriptions serve as crucial practical embodiments of TCM theoretical frameworks， characterized by their complex multi-component composition and multi-target interactions. The research on the material basis of their pharmacological effects has gradually become the key to promoting the modernization of TCM. In recent years， new ideas and theories regarding the research on pharmacodynamic substance basis of TCM compound prescriptions have been continuously proposed. This review systematically summarizes and reviews analytical techniques such as targeted fishing technology， spectrum-effect relationship analysis， serum pharmacochemistry， network pharmacology， high-throughput screening， and cell membrane chromatography. It is found that these techniques exhibit unique advantages in areas including target-specific analysis， component-pharmacological effect correlation analysis， identification of the material basis in vitro and in vivo， prediction of multi-target mechanisms， efficient screening of active ingredients， and analysis of interactions between cell membrane receptors. These techniques compensate for the shortcomings of traditional research methods， enhance the systematicness and precision of research on pharmacodynamic substance based TCM compound prescriptions， and can provide theoretical support for the promotion and clinical application of TCM compound prescriptions.