Objective To investigate the association between serum magnesium levels,serum phosphorus concentrations,vascular calcification,and cardiovascular disease mortality in maintenance hemodialysis patients.Methods This study enrolled 200 hemodialysis patients admitted to Nanjing Drum Tower Hospital from May 2020 to May 2022 as subjects,with an additional 200 healthy individuals from the same period selected as a control group.The biochemical indicators between the two groups were compared;their correlations were analyzed.Binary logistic regression was used to investigate the independent factors of serum magnesium and phosphorus levels in relation to vascular calcification and cardiovascular events in maintenance hemodialysis patients.ROC curve analysis was employed to assess the predictive value of serum magnesium and phosphorus for vascular calcification and cardiovascular events.Results The research group's patients exhibited significantly elevated levels of blood phosphorus,calcium-phosphorus product,iPTH,AACS,and 25-(OH)-VitD compared to the control group.In contrast,their blood magnesium and BMP-7 levels were notably lower than those of the control group,with statistical significance(P<0.05).Pearson correlation showed positive correlations between serum magnesium and serum calcium,phosphorus,calcium-phosphorus product,25-(OH)-VitD3,and BMP-7(r=0.385,0.183,0.141,0.131,0.458,P<0.05);between serum calcium and serum phosphorus,calcium-phosphorus product,iPTH,AACS,25-(OH)-VitD3,and BMP-7(r=0.318),correlation(r=0.318,0.311,0.098,0.170,0.277,0.485,P<0.05);between serum phosphorus and calcium-phosphorus product,iPTH,AACS,25-(OH)-VitD3(r=0.362,0.506,0.367,0.461,P<0.05);between calcium-phosphorus product and iPTH,AACS,25-(OH)-VitD3(r=0.542,0.373,0.434,P<0.05);between iPTH and AACS,25-(OH)-VitD3 showing positive correlations(r=0.553,0.616,P<0.05)and a negative correlation with BMP-7(r=-0.373,P<0.05);between AACS and 25-(OH)-VitD3 showing a positive correlation(r=0.402,P<0.05),and a negative correlation with BMP-7(r=-0.155,P<0.05),with statistically significant differences(P<0.05).Statistically significant differences were noted between the two groups in age,diabetes,serum magnesium,serum calcium,serum phosphorus,calcium-phosphorus product,25-(OH)-VitD3,and hs-CRP(P<0.05).Logistic regression analysis showed that age,serum magnesium,serum calcium,serum phosphorus,calcium phosphate product,25-(OH)-vitamin I were all risk factors for cardiovascular disease(CVD)mortality in maintenance hemodialysis(MHD)patients(P<0.05).ROC curve analysis showed that serum magnesium,serum calcium,and serum phosphorus had predictive areas under the curve(AUC)of 0.895,0.802,and 0.851 for CVD mortality in MHD patients,with sensitivities and specificities of 87.5%/98.7%,66.7%/90.8%,and 72.9%/100%,respectively.The combined prediction for CVD mortality in MHD patients showed an AUC of 0.921,with a sensitivity of 81.3%and specificity of 93.4%.Conclusion MHD patients exhibit low blood magnesium levels,elevated serum phosphorus concentrations,and increased calcium-phosphorus product,with complex correlations among these biomarkers.Age,magnesium,calcium,and phosphorus levels were all associated with CVD mortality.ROC curve analysis demonstrates that magnesium,calcium,and phosphorus,both individually and in combination,have high predictive value for CVD mortality risk.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Children with developmental coordination disorder (DCD) commonly experience difficulties with handwriting.However, there is currently no standardized tool for assessing dysgraphia in this population.Therefore, this paper provides a review of the commonly used handwriting assessment tools both domestically and internationally, as well as their application in individuals with DCD.The aim is to offer a reference to clinical professionals involved in the diagnosis and treatment of DCD in selecting appropriate tools for assessing handwriting difficulties in children.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Children with developmental coordination disorder (DCD) commonly experience difficulties with handwriting.However, there is currently no standardized tool for assessing dysgraphia in this population.Therefore, this paper provides a review of the commonly used handwriting assessment tools both domestically and internationally, as well as their application in individuals with DCD.The aim is to offer a reference to clinical professionals involved in the diagnosis and treatment of DCD in selecting appropriate tools for assessing handwriting difficulties in children.

The sensitivity of cardiac troponin testing for diagnosing acute myocardial infarction(AMI)varies over time from chest pain onset.This study aimed to determine the diagnostic performance of point-of-care testing cardiac troponin T(POCT-cTnT)at different time intervals post-symptom onset to refine rapid rule-out approaches for AMI.Methods This retrospective study included 6,024 patients presenting with chest pain from January 2018 to December 2022.POCT-cTnT and central lab cTnI levels were measured on admission.Receiver operating charac-teristics analysis stratified by time windows assessed the accuracy of POCT-cTnT for diagnosing AMI.Results The overall AUC of POCT-cTnT for diagnosing AMI was 0.826(95%CI:0.816～0.836),with a sensitivity of 72.81%and a specificity of 86.26%.According to the time intervals of chest pain onset(＜3 hours,3～6 hours,6～12 hours,12～24 hours,24～72 hours,and≥72 hours),the AUC values for groups after 6～12 hours were 0.918,0.928,0.920 and 0.908,respectively,with no statistically significant difference(P＞0.05),but all were higher than the groups within 6 hours(P＜0.001).According to the time of chest pain onset,the AUC for the≥8h group was 0.921,with a negative predictive value(NPV)of 98.1%and a negative likelihood ratio(-LR)of 0.11.Its AUC was higher than those of the≥3 h,≥2 h,≥1 h,and overall groups(P＜0.05),but there was no statistically significant differ-ence compared with the groups after≥4 h(P＞0.05).Conclusions Chest pain onset time has a certain impact on the performance of a single POCT-cTnT test for diagnosing AMI.The duration from chest pain onset to hospital admission combined with POCT-cTnT test may improve the reliability in diagnosing AMI.Specifically,a single POCT-cTnT test at four hours after chest pain onset,especially eight hours after chest pain onset,can diagnose or exclude AMI.

Objective To evaluate the application value of percutaneous angle positioning system based on augmented reality in improving the accuracy of liver puncture.Methods A canine liver with an embedded marking ring was used as the target for puncture.A skilled physician with over 5 years of experience in liver puncture and a novice physician with limited experience in liver puncture separately performed liver puncture using either the augmented reality-based percutaneous angle localization system(navigation)or CT-guided technique alone(non-navigation).The corresponding puncturing data of non-navigation skilled group(Group A),non-navigation non-skilled group(Group B),navigation skilled group(Group C),and navigation non-skilled group(Group D)were obtained.The differences in the evaluation indicators,including the number of CT scans,number of needle adjustment,time spent for operation,and distance of error,between Group A and Group B,between Group C and Group D,between Group A and Group C,and between Group B and Group D,were analyzed.Results Statistically significant differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error existed between Group A and Group B,between Group A and Group C,and between Group B and Group D(all P＜0.0 5),while the differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error between Group C and Group D were not statistically significant(all P＞0.05)Conclusion In performing liver puncture,the use of percutaneous angle localization system can reduce the number of CT scans,number of needle adjustment,time spent for operation and distance of error,and improve the puncture accuracy as well,which provides a basis for the clinical utilization of this system and the employment of this system-guided puncture technology in primary hospitals.(J Intervent Radiol,2024,33:507-511)

Objective To observe the value of augmented reality(AR)navigation system for assisting CT-guided puncture of pulmonary nodules in dog models.Methods Five healthy dogs were selected,and 4 target lung rings were implanted in each dog to build pulmonary nodule models.Deferring to crossover design,CT-guided punctures were performed with or without AR navigation 2 and 4 weeks after successful modeling,respectively,while punctures with AR navigation were regarded as AR group and the others as conventional group,respectively.The time duration of puncturing,the times of CT scanning,of needle adjustment,and the deviation distance between needle pinpoint to the center of pulmonary nodule shown on three-dimensional reconstruction were compared between groups.Results The duration time of puncture in AR group and conventional group was(13.62±5.11)min and(20.16±4.76)min,respectively.In AR group,the times of CT scanning,of needle adjustment,and the deviation distance was 2.40±0.50,2.75±0.44 and(2.94±1.92)mm,respectively,while in conventional group was 3.10±0.64,3.70±0.57 and(4.90±3.38)mm,respectively.The introduction of AR navigation was helpful to shortening the duration of puncture,reducing times of CT scanning and needle adjustment,also decreasing positioning error of needle pinpoint(all P＜0.05).In contrast,the variance of puncture sequences and dogs had no obvious effect on the results(both P＞0.05).Conclusion AR navigation system could improve accuracy and efficiency in CT-guided puncture of pulmonary nodules in dog models.

Objective:To analyze the clinical and epidemiological characteristics of adult carotid body tumors (CBTs) in Northwest China to provide references for early diagnosis and treatment of CBTs.Methods:A multicenter, retrospective, non-intervention epidemiological investigation was conducted on adult CBTs patients who were hospitalized from January 1, 2011 to June 30, 2023 in 7 Class A tertiary hospitals in Northwest China (Departments of Neurosurgery, First Affiliated Hospital of Air Force Medical University, Second Affiliated Hospital of Lanzhou University, People's Hospital of Gansu Province, 940 th Hospital of PLA Joint Logistic Support Force, People's Hospital of Qinghai Province, General Hospital of Ningxia Medical University, People's Hospital of Ningxia Hui Autonomous Region). Medical records were collected in these patients, and they were divided into 2 groups according to their average altitude residence: high altitude group (≥1 500 m) and low altitude group (<1 500 m); meanwhile, these patients were divided into Shamblin type I, type II and type III groups according to Shamblin classification criteria; differences in general data and clinical features among patients from different altitude groups or Shamblin subgroups were compared. Independent influencing factors for Shamblin type III CBTs were analyzed by multivariate ordered Logistic regression. Results:(1) A total of 359 patients were enrolled in the study, including 276 females and 83 males, aged (48.80±12.07) years; 211 patients were into the high altitude group and 148 into the low altitude group; 165 patients were into Shamblin type I group, 146 into Shamblin type II group, and 48 into Shamblin type III group. (2) Compared with those in the low altitude group, patients in the high altitude group had higher proportion of females, older age, lower proportion of Han nationality, higher proportion of Shamblin type I, smaller tumor volume, lower platelet count, higher red blood cell count, hematocrit, hemoglobin level, platelet distribution width and mean platelet volume, and higher large platelet percentage, with significant differences ( P<0.05). (3) Compared with those in the Shamblin type I group, patients in the Shamblin type III group had younger age, lower resident altitude, larger tumor volume, longer time interval from onset to diagnosis, higher proportion of unintentional tumor discovery, larger volume of intraoperative blood loss, lower hemoglobin level, hematocrit, mean erythrocyte volume, and mean hemoglobin concentration, decreased erythrocyte distribution width variable coefficient, and increased platelet count, with significant differences ( P<0.05). Compared with those in the Shamblin type II group, patients in Shamblin type III group had younger age, larger tumor volume, longer time interval from onset to diagnosis, larger volume of intraoperative blood loss, lower hemoglobin, hematocrit and mean erythrocyte volume, higher erythrocyte distribution width variable coefficient and platelet count, with significant differences ( P<0.05). (4) Age ( OR=0.960, 95% CI: 0.942-0.977, P<0.001), residence altitude ( OR=0.992, 95% CI: 0.990-0.999, P=0.020) and time interval from onset to diagnosis ( OR=1.009, 95% CI: 1.005-1.014, P<0.001) were independent influencing factors for Shamblin type III CBTs. Conclusions:More females than males are noted in patients with adult CBTs in Northwest China, and more CBTs patients live at high altitude, with Shamblin type I enjoying the highest proportion. More female and old patients lived at high altitude is noted than those lived at low altitude; patients with Shamblin type III have the youngest age, lowest altitude, and longest time interval from onset to diagnosis. CBTs patients with young age, low residence altitude, and long time interval from onset to diagnosis are more likely to develop Shamblin type III.

Objective:To design and validate a high-quality rapid screening questionnaire based on the common medical history and clinical experience of benign paroxysmal positional vertigo (BPPV).Methods:A questionnaire was designed based on expert′s opinions, and the first-time patients who complained of dizziness and vertigo in the vertigo clinic of the First Hospital of Shanxi Medical University from September 2020 to June 2021 were prospectively screened. Taking the displacement test as the gold standard, the reliability and validity of the questionnaire were tested to evaluate its authenticity, reliability and benefit value. This study was divided into three steps. The first step was to conduct a pre-experiment and to adjust the questionnaire items; the second step was to determine the questionnaire items and the best cut-off value; the third step was to screen patients with the best cut-off value and to evaluate the quality of the questionnaire.Results:Seven items were finalized. The Cronbach′s coefficient of the questionnaire was 0.675, the content validity was 0.85, the KMO value of the construct validity was 0.648, and there were 4 factors with characteristic root>1, and the cumulative contribution rate was 76.309%. The area under the receiver operating characteristic curve (ROC) was 0.938, and its optimal cut-off value was 4.5 points. At this point, the sensitivity was 88.89% and the specificity was 85.44%.Conclusion:The BPPV rapid screening questionnaire has high sensitivity and specificity, which can be used for clinical screening of BPPV patients.