Objective To investigate the association between gut microbiota metabolite,trimethy-lamine-N-oxide(TMAO),and total imaging burden in diabetic patients with cerebral small vessel disease(CSVD).Methods A prospective study was conducted on 112 elderly diabetic patients with CSVD admitted in our hospital from June 2022 to May 2024.According to the total imaging burden score,they were divided into a high burden group(burden score≥2,57 cases)and a low burden group(burden score＜2,55 cases).High-performance liquid chromatography with online electrospray ionization tandem mass spectrometry was applied to detect the plasma level of TMAO.Then based on the tertile of plasma TMAO level,the patients were also assigned into low(＜2.44 μmol/L,38 cases),median(2.44 μmol/L≤TMAO＜5.18 μmol/L,37 cases)and high TMAO(≥5.18 μmol/L,37 cases)groups.ROC curve analysis was used to assess the predictive value of plasma TMAO level for high imaging burden in diabetic patients with CSVD.Binary logistic regression analysis was employed to analyze the correlation between plasma TMAO level and high imaging burden.Results The high burden group exhibited significantly higher plasma TMAO level than the low burden group(P=0.002).The AUC value of plasma TMAO level in predicting high imaging burden was 0.669(95％CI:0.569-0.769,P=0.002).The percentage of high imaging burden was 34.2％,54.1％and 64.9％,respectively among the low,median and high TMAO groups,with significant differences among them(Chi-square=7.270,P=0.026).Binary logistic regression analysis indicated the correlation between TMAO and high imaging burden(OR=1.178,95％CI:1.019-1.364,P=0.027).Conclusion In elderly diabetic patients with CSVD,plasma TMAO level is closely associated with high imaging burden,with higher TMAO level,higher risk for high imaging burden.

Objective:To explore the predictive value of systemic immune inflammation index combined with stress response index for postoperative urinary tract infection in patients with complicated kidney stones.Methods:From June 2021 to June 2023,97 patients who underwent treatment for urinary tract infection after complex kidney stone operation in Cangzhou Hospital of Integrated Traditional and Western Medicine were selected as infected group,and 87 patients who did not develop urinary tract infection after complex kidney stone operation were selected as uninfected group.Systemic immunoinflammatory index(SII),neutrophils,lympho-cyte,platelet,malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT)levels were detected.Multivariate Logistic regression analysis was performed to analyze risk factors of postoperative urinary tract infection,and ROC curve was drawn to analyze the predictive value of SII,MDA,SOD and CAT alone and combined detection for postoperative urinary tract infection in patients with complex kidney stones.Results:Compared with uninfected group,levels of SII,neutrophils and MDA were increased in infected group,while levels of SOD and CAT were decreased(P<0.05).Levels of lymphocytes and platelets were decreased,the difference was not statistically significant(P>0.05).Multivariate Logistic regression analysis showed that presence of urinary tract history,opera-tion time≥100 min,urinary catheter retention time≥7 d,presence of preoperative urinary tract infection,stone load≥1 000 mm2,combined renal dysfunction,and preoperative blood glucose≥6.15 mmol/L were main risk factors for postoperative urinary tract infection in patients with complex kidney stones.ROC curve showed that combined detection was significantly more effective than single detec-tion of SII,MDA,SOD and CAT in the diagnosis of postoperative urinary tract infection in patients with precomplex kidney stones.Conclusion:Patients with urinary tract infection after complicated kidney stones have increased SII and MDA,decreased SOD and CAT levels,and the abnormal increased or decreased expression level are the predictors of risk of urinary tract infection after compli-cated kidney stones,which may be related with the diagnosis,development and prognosis of the disease.

Objective:To explore the predictive value of systemic immune inflammation index combined with stress response index for postoperative urinary tract infection in patients with complicated kidney stones.Methods:From June 2021 to June 2023,97 patients who underwent treatment for urinary tract infection after complex kidney stone operation in Cangzhou Hospital of Integrated Traditional and Western Medicine were selected as infected group,and 87 patients who did not develop urinary tract infection after complex kidney stone operation were selected as uninfected group.Systemic immunoinflammatory index(SII),neutrophils,lympho-cyte,platelet,malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT)levels were detected.Multivariate Logistic regression analysis was performed to analyze risk factors of postoperative urinary tract infection,and ROC curve was drawn to analyze the predictive value of SII,MDA,SOD and CAT alone and combined detection for postoperative urinary tract infection in patients with complex kidney stones.Results:Compared with uninfected group,levels of SII,neutrophils and MDA were increased in infected group,while levels of SOD and CAT were decreased(P<0.05).Levels of lymphocytes and platelets were decreased,the difference was not statistically significant(P>0.05).Multivariate Logistic regression analysis showed that presence of urinary tract history,opera-tion time≥100 min,urinary catheter retention time≥7 d,presence of preoperative urinary tract infection,stone load≥1 000 mm2,combined renal dysfunction,and preoperative blood glucose≥6.15 mmol/L were main risk factors for postoperative urinary tract infection in patients with complex kidney stones.ROC curve showed that combined detection was significantly more effective than single detec-tion of SII,MDA,SOD and CAT in the diagnosis of postoperative urinary tract infection in patients with precomplex kidney stones.Conclusion:Patients with urinary tract infection after complicated kidney stones have increased SII and MDA,decreased SOD and CAT levels,and the abnormal increased or decreased expression level are the predictors of risk of urinary tract infection after compli-cated kidney stones,which may be related with the diagnosis,development and prognosis of the disease.

Objective To investigate the association between gut microbiota metabolite,trimethy-lamine-N-oxide(TMAO),and total imaging burden in diabetic patients with cerebral small vessel disease(CSVD).Methods A prospective study was conducted on 112 elderly diabetic patients with CSVD admitted in our hospital from June 2022 to May 2024.According to the total imaging burden score,they were divided into a high burden group(burden score≥2,57 cases)and a low burden group(burden score＜2,55 cases).High-performance liquid chromatography with online electrospray ionization tandem mass spectrometry was applied to detect the plasma level of TMAO.Then based on the tertile of plasma TMAO level,the patients were also assigned into low(＜2.44 μmol/L,38 cases),median(2.44 μmol/L≤TMAO＜5.18 μmol/L,37 cases)and high TMAO(≥5.18 μmol/L,37 cases)groups.ROC curve analysis was used to assess the predictive value of plasma TMAO level for high imaging burden in diabetic patients with CSVD.Binary logistic regression analysis was employed to analyze the correlation between plasma TMAO level and high imaging burden.Results The high burden group exhibited significantly higher plasma TMAO level than the low burden group(P=0.002).The AUC value of plasma TMAO level in predicting high imaging burden was 0.669(95％CI:0.569-0.769,P=0.002).The percentage of high imaging burden was 34.2％,54.1％and 64.9％,respectively among the low,median and high TMAO groups,with significant differences among them(Chi-square=7.270,P=0.026).Binary logistic regression analysis indicated the correlation between TMAO and high imaging burden(OR=1.178,95％CI:1.019-1.364,P=0.027).Conclusion In elderly diabetic patients with CSVD,plasma TMAO level is closely associated with high imaging burden,with higher TMAO level,higher risk for high imaging burden.

【Objective】 To analyze the predictive value of serum β-defensin-3 (HBD-3) and decoy receptor 3 (DCR3) for urinary tract infection after percutaneous nephrolithotomy (PCNL) in patients with complex kidney calculi. 【Methods】 A prospective study was conducted on 112 patients treated with PCNL at our hospital during Jan.2020 and Dec.2022.The patients were divided into the non-infection group (52 cases) and infection group (60 cases).The general data, HBD-3 and DCR3 levels of the two groups were compared.Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of C reactive protein (CRP), procalcitonin (PCT), HBD-3 and DCR3 levels for postoperative urinary tract infection. 【Results】 Compared with the non-infection group, the infection group had higher levels of HBD-3 [(0.77±0.08) ng/mL vs. (1.36±0.25) ng/mL, P=0.001] and DCR3 [(4.68±0.53) ng/mL vs.(13.21±0.28) ng/mL, P=0.001].Multivariate logistic regression showed that a history of urinary tract surgery, preoperative urinary tract infection, operation time, catheterization time, stone load, type of antibiotics, concomitant renal dysfunction, intraoperative channel type, CRP, PCT, HBD-3 and DCR3 were risk factors of postoperative urinary tract infection (P<0.05).The ROC curve showed that the accuracy of CRP, PCT, and CRP plus PCT were 70.54%, 72.32%, and 78.57%, respectively; the accuracy of HBD-3, DCR3, and HBD-3 plus DCR3 were 69.64%, 75.89%, and 86.61%, respectively. 【Conclusion】 Postoperative urinary tract infection in patients with complex kidney calculi is associated with multiple factors, especially high expression levels of HBD-3 and DCR3.Combined detection has high predictive value.

Purpose/Significance To summarize the common dimensions of data quality evaluation,and to expound the types and characteristics of medical big data quality evaluation and management methods,so as to provide references for medical big data quality e-valuation and management.Method/Process The paper reviews domestic and foreign medical big data quality related literature,and em-phatically analyzes medical big data quality evaluation dimensions,methods and management.Result/Conclusion Data quality standards are conducive to standardized management of medical big data.A scientific and reasonable medical big data quality evaluation system and a whole-process data quality management system in line with national conditions in China should be established and improved as soon as possible to promote the development and application of medical big data in our country.

Objective To construct and verify Nomogram model for individualized prediction of the risk of infectious complications in patients with complex kidney stones after percutaneous nephrolithotripsy(PCNL).Methods A total of 585 patients with complex kid-ney stones admitted to Cangzhou Hospital of Integrated Traditional and Western Medicine from March 2021 to June 2023 were collected as the study subjects,and divided into modeling group(n=410)and validation group(n=175)at 7∶3.The modeling group was further di-vided into non-complication group(n=342)and complication group(n=68)according to whether there were infectious complications after PCNL surgery.The clinical data were collected and multivariate Logistic regression analysis was applied to determine the factors that affected the occurrence of infectious complications after PCNL surgery in patients with complex kidney stones,and Nomogram model was constructed to predict the occurrence of infectious complications after PCNL surgery in patients with complex kidney stones.Results There were no statistically significant differences in gender,age,body mass index,surgical time,interleukin-6(IL-6)level,C-re-active protein(CRP)level,location and number of stone between the modeling group and the validation group(P＞0.05);compared with the non-complication group,the operation time and stone diameter,the levels of IL-6,CRP in the complication group was higher(t were 5.084,6.727,5.936,7.869,P＜0.05),and the proportions of diabetes and preoperative urinary tract infection were higher(x2 were 12.520,35.117,P＜0.05).The results of multivariate Logistic regression analysis showed that operation time(OR=1.077),stone diameter(OR=1.303),IL-6(OR=1.334),CRP(OR=1.381),diabetes(OR=3.288),preoperative urinary tract infection(OR=5.458)were all independent risk factors for infection complications after PCNL surgery in patients with complex kidney stones(P＜0.05).The area under the curve for the modeling group and validation group were 0.919(95％CI:0.889-0.949)and 0.939(95％CI:0.882-0.996),respectively.The results of the Hosmer-Limeshow goodness of fit test showed that the modeling group x2=5.484,P=0.705;validation group x2=10.101,P=0.258.Conclusion Operation time,stone diameter,IL-6,CRP,diabetes and preoperative urinary tract infection are independent risk factors for infectious complications after PCNL in patients with complex kidney stones.The Nomogram model based on these factors has high degree of discrimination and consistency.

Objective To systematically review the epidemiological studies on primary biliary cholangitis (PBC), and to investigate the prevalence rate of PBC in the Chinese general population and its influencing factors. Methods PubMed, Embase, The Cochrane Library, CNKI, and Wanfang Data were searched for articles on the epidemiology of PBC in China published up to 31th March 2022. Two researchers independently performed screening and data extraction, and then related analyses were performed. Results A total of 9 articles were included. The positive rate of AMA was 1 049.05/100 000 (ranging fr om 159.65/100 000 to 2287.40/100 000), and the prevalence rate of PBC was 123.68/100 000 (ranging from 42.70/100 000 to 276.59/100 000). The positive rate of AMA was 636.51/100 000 (ranging from 52.55/100 000 to 1 164.33/100 000) in men and 1 265.47/100 000 (ranging from 225.23/100 000 to 1 704.93/100 000) in women, with a male/female ratio of 1∶1.99 for the prevalence rate of AMA. The prevalence rate of PBC was 40.81/100 000 (ranging from 23.54/100 000 to 75.10/100 000) in men and 148.71/100 000 (ranging from 77.36/100 000 to 214.91/100 000) in women, with a male/female ratio of 1∶3.64 for the prevalence rate of PBC. Conclusion Different studies show great differences in the positive rate of AMA and the prevalence rate of PBC in the Chinese general population, which is mainly affected by sex, age, and region. The positive rate of AMA and the prevalence rate of PBC increase with age, and the patients aged ≥50 years have a significantly higher positive rate of AMA than those aged < 50 years. The positive rate of AMA is significantly higher than the prevalence rate of PBC. There are significantly more women than men in the AMA-positive population and the PBC patients, and the influence of sex on AMA is lower than that on PBC.

Purpose/Significance To clarify the construction mode and key factors of data sharing in Chinese medical alliances,and to provide references for promoting data sharing in medical alliances.Method/Process Taking children's medical alliance of Yangtze River Delta as an example,Delphi method and qualitative interview method are used to explore the key contents and effect evaluation of specialty alliance construction,and the key factors of specialty alliance data sharing are defined based on the technology-organization-environment framework;SWOT analysis model is used to propose development strategies.Result/Conclusion Member hospitals are less satisfied with the construction effect of information interconnection.Key factors for realizing data sharing in specialty alliances include:support from government administrative departments,uniform and systematic compatibility of information standards,information security emergency response,patient privacy protection and informed consent,willingness of department directors to share,and internal communi-cation and compensation mechanism of alliances.

Objective:To investigate the influence of trimethylamine N-oxide(TMAO)on the development of early neurological deterioration(END)in diabetic patients with acute ischemic stroke.Methods:In this cross-sectional study, 108 type 2 diabetes patients with acute ischemic stroke treated at the Department of Neurology in the Affiliated Wuxi People’s Hospital of Nanjing Medical University between October 2019 and November 2020 were consecutively recruited.END was defined as an increase in the National Institutes of Health Stroke Scale(NIHSS)≥ 2 points and exclusion of intracranial hemorrhage or bleeding transformation in cranial imaging evaluation within 5 days of initial deterioration of neurological dysfunction.The patients were divided into 2 groups, an END(n=36)group and a non-END group(n=72). Fasting plasma TMAO was measured using isotope dilution liquid chromatography coupled to tandem mass spectrometry.Results:Of the 108 patients, 36(33.3%)were diagnosed with END, and their plasma TMAO levels were significantly higher compared with patients without END( Z=-3.500, P<0.001). For prediction of END, the area under the ROC curve for plasma TMAO levels was 0.707(95% CI: 0.603-0.811, P<0.001). The frequencies of END in subjects grouped via tertiles of TMAO were 22.2%, 19.4% and 58.3%, respectively, with significant differences between the 3 groups( χ2=14.979, P=0.001). Univariate analysis showed that elevated TMAO( OR=1.160, 95% CI: 1.050-1.282, P=0.004)was associated with END.A multivariate logistic regression model further confirmed the association between TMAO and END( OR=1.145, 95% CI: 1.033-1.269, P=0.010). Conclusions:Increased plasma TMAO levels are associated with END in diabetic patients with acute ischemic stroke.