Objective To evaluate the correlation between MRI burden of cerebral small vessel disease and cognitive impairment in elderly hypertensive people.Methods Data of elderly hypertensive people with CSVD at Xingtai People's Hospital Affiliated to Hebei Medical University from January 2018 to September 2024 were analyzed.According to the total MRI burden score,patients were divided into mild to moderate(0-2)and severe(3-4)burden groups.The baseline data and cognitive impairment were compared between groups.The correlation between risk factors of MRI burden and cognitive impairment was analyzed.Results The severe burden group had higher systolic blood pressure[178(155,180)mmHg vs.159.50(147.75,170)mmHg,higher fasting blood glucose[5.70(5.37,5.92)mmHg vs.5.38(4.83,5.70)mmHg,P<0.05]and higher the proportion of cognitive impairment[8(28.1%)vs.3(6.8%),P<0.05]than the mild to moderate group.Multivariate logistic regression analysis revealed that systolic blood pressure(OR=1.033,95%CI:1.001-1.067,P<0.05)was the independent risk factor for total MRI burden.Spearman correlation analysis revealed that MRI total burden was negatively correlated with MMSE score(r=-0.315,P=0.011)and MoCA score(r=-0.662,P<0.001).Compared with the mild to moderate burden group,the severe group performed worse in the areas of orientation,attention and computation,language ability on the MMSE,and worse in visual space and executive ability,attention,language,delayed recall,and orientation on the MoCA(P<0.05).Conclusion Systolic blood pressure is the independent risk factor of MRI total burden in elderly hypertensive people.The higher the total MRI burden,the more severe the cognitive impairment,the worse performance in orientation,visual space and executive ability,attention and computation,language,and delayed recall.

Objective:To explore the clinical application of mobile-intelligent medical management system for gout patients.Methods:This study was a randomized controlled trial. One hundred and two patients with gout who visited rheumatology department of the First Hospital of Jilin University from January 2022 to October 2023 were randomly divided into study group ( n=53) and the control group ( n=49). Patients in the study group were managed by the mobil-gout(M-G) health management system which consists of a distant management plateform and an App. The body weight and blood uric acid levels were regularly self-tested by patients, and the information was sent to the system, the doctor gave feed-back advice on medication adjustment and dietary management every 2 weeks. While patients in the control group were managed following the conventional outpatient consultation mode. The serum uric acid levels, liver and kidney function tests and physical examinations were conducted on the day of enrollment and 3 and 6 months after treatment. The number of affected joints and the frequency of attacks were evaluated, and pain was assessed using the visual analog scale (VAS). The efficacy of treatment were compared between two groups. Results:After 3 and 6 months of treatment, the serum uric acid levels in study group were significantly lower than those in control group (408.0 (345.0, 450.0)μmol/L vs. 458.0 (409.0, 482.0)μmol/L, 371.0 (338.5, 409.0) μmol/L vs. 412.0 (368.5, 445.0)μmol/L; Z=3.37, 4.61, P<0.01); and VAS scores were also significantly lower than those in control group (6.66±1.46 vs. 4.68±1.80, 7.45±1.06 vs. 5.88±1.52; t=14.12, 13.72, P<0.01). After 6 months of treatment, the frequency of gout attacks in the study group was significantly lower than that in the control group ( χ2=9.30, P<0.05). As the follow-up period was extended, the average number of joints affected by gout attacks and the frequency of gout attacks in the study group showed a reducing trend compared to the control group, but the differences were not statistically significant ( P>0.05). Conclusions:The M-G medical management system can more effectively control uric acid levels and alleviate symptome for gout patients.

Objective To evaluate the correlation between MRI burden of cerebral small vessel disease and cognitive impairment in elderly hypertensive people.Methods Data of elderly hypertensive people with CSVD at Xingtai People's Hospital Affiliated to Hebei Medical University from January 2018 to September 2024 were analyzed.According to the total MRI burden score,patients were divided into mild to moderate(0-2)and severe(3-4)burden groups.The baseline data and cognitive impairment were compared between groups.The correlation between risk factors of MRI burden and cognitive impairment was analyzed.Results The severe burden group had higher systolic blood pressure[178(155,180)mmHg vs.159.50(147.75,170)mmHg,higher fasting blood glucose[5.70(5.37,5.92)mmHg vs.5.38(4.83,5.70)mmHg,P<0.05]and higher the proportion of cognitive impairment[8(28.1%)vs.3(6.8%),P<0.05]than the mild to moderate group.Multivariate logistic regression analysis revealed that systolic blood pressure(OR=1.033,95%CI:1.001-1.067,P<0.05)was the independent risk factor for total MRI burden.Spearman correlation analysis revealed that MRI total burden was negatively correlated with MMSE score(r=-0.315,P=0.011)and MoCA score(r=-0.662,P<0.001).Compared with the mild to moderate burden group,the severe group performed worse in the areas of orientation,attention and computation,language ability on the MMSE,and worse in visual space and executive ability,attention,language,delayed recall,and orientation on the MoCA(P<0.05).Conclusion Systolic blood pressure is the independent risk factor of MRI total burden in elderly hypertensive people.The higher the total MRI burden,the more severe the cognitive impairment,the worse performance in orientation,visual space and executive ability,attention and computation,language,and delayed recall.

Objective:To explore the clinical application of mobile-intelligent medical management system for gout patients.Methods:This study was a randomized controlled trial. One hundred and two patients with gout who visited rheumatology department of the First Hospital of Jilin University from January 2022 to October 2023 were randomly divided into study group ( n=53) and the control group ( n=49). Patients in the study group were managed by the mobil-gout(M-G) health management system which consists of a distant management plateform and an App. The body weight and blood uric acid levels were regularly self-tested by patients, and the information was sent to the system, the doctor gave feed-back advice on medication adjustment and dietary management every 2 weeks. While patients in the control group were managed following the conventional outpatient consultation mode. The serum uric acid levels, liver and kidney function tests and physical examinations were conducted on the day of enrollment and 3 and 6 months after treatment. The number of affected joints and the frequency of attacks were evaluated, and pain was assessed using the visual analog scale (VAS). The efficacy of treatment were compared between two groups. Results:After 3 and 6 months of treatment, the serum uric acid levels in study group were significantly lower than those in control group (408.0 (345.0, 450.0)μmol/L vs. 458.0 (409.0, 482.0)μmol/L, 371.0 (338.5, 409.0) μmol/L vs. 412.0 (368.5, 445.0)μmol/L; Z=3.37, 4.61, P<0.01); and VAS scores were also significantly lower than those in control group (6.66±1.46 vs. 4.68±1.80, 7.45±1.06 vs. 5.88±1.52; t=14.12, 13.72, P<0.01). After 6 months of treatment, the frequency of gout attacks in the study group was significantly lower than that in the control group ( χ2=9.30, P<0.05). As the follow-up period was extended, the average number of joints affected by gout attacks and the frequency of gout attacks in the study group showed a reducing trend compared to the control group, but the differences were not statistically significant ( P>0.05). Conclusions:The M-G medical management system can more effectively control uric acid levels and alleviate symptome for gout patients.

Objective To obtain portal vein diameter in children of different ages using upper abdomen enhanced CT.Methods Data of upper abdomen enhanced CT in 390 children without obvious abnormality of portal vein were retrospectively analyzed.The children were divided into＜12 months group(group A,n=70),13-60 months group(group B,n=87),61-120 months group(group C,n=102)and＞120 months group(group D,n=131)according to age.Portal vein diameter was measured based on reconstructed images of portal vein stage and compared among groups.Pearson correlation analysis was performed to observe the correlations of portal vein diameter with age,height and body mass,respectively.Results Portal vein diameter in groups A to D was(4.79±0.86),(7.14±1.17),(9.37±1.41)and(10.79±1.63)mm,respectively,which enlarged successively with the increase of age(all P＜0.001).Portal vein diameter in children of different ages were moderately to highly positively correlated with age,height and body mass(r=0.763-0.852,all P＜0.05),but not significant correlated with gender(r=0.070,P＞0.05).Conclusion The reference range of portal vein diameter in children with different ages in China were preliminarily evaluated.

Objective To obtain portal vein diameter in children of different ages using upper abdomen enhanced CT.Methods Data of upper abdomen enhanced CT in 390 children without obvious abnormality of portal vein were retrospectively analyzed.The children were divided into＜12 months group(group A,n=70),13-60 months group(group B,n=87),61-120 months group(group C,n=102)and＞120 months group(group D,n=131)according to age.Portal vein diameter was measured based on reconstructed images of portal vein stage and compared among groups.Pearson correlation analysis was performed to observe the correlations of portal vein diameter with age,height and body mass,respectively.Results Portal vein diameter in groups A to D was(4.79±0.86),(7.14±1.17),(9.37±1.41)and(10.79±1.63)mm,respectively,which enlarged successively with the increase of age(all P＜0.001).Portal vein diameter in children of different ages were moderately to highly positively correlated with age,height and body mass(r=0.763-0.852,all P＜0.05),but not significant correlated with gender(r=0.070,P＞0.05).Conclusion The reference range of portal vein diameter in children with different ages in China were preliminarily evaluated.

Psoriatic arthritis is a chronic systemic autoimmune disease, characterized by psoriasis skin lesions and inflammation of the spine and joint. It has complicated clinical manifestations and individual variations. Nearly half of the patients will have joints erosion in two years, which is crippling. The severity of the skin and joint disease frequently do not correlate with each other. Currently, the understanding of the disease is insufficient in China with the lack of standardized diagnosis and treatment. Therefore, researchers from the Chinese Rheumatology Association formulated this specification based on the diagnosis and management experience together with guidelines at home and abroad. The specification summarizes the present situation of domestic diagnosis and treatment, aiming to standardize the diagnosis process and treatment protocols of psoriatic arthritis. Furthermore, it can reduce misdiagnosis and missed diagnosis, as well as improve the prognosis.

Objective    To analyze the near-term clinical efficacy of two different surgical procedures (Sun's procedure and Debranching combined endovascular stent-graft procedure) to cure Stanford type A aortic dissection, and summarize the clinical experience to help better master the indications of the two surgical procedures. Methods     We retrospectively analyzed the clinical data of 46 patients with Stanford A aortic dissection in our hospital between September 2014 and September 2017. There were 39 males and 7 females at age of 20–74 (48.67±11.80) years. According to different surgical methods, the patients were divided into a Sun's procedure group (26 patients) and a debranching combined endovascular stent-graft procedure group (20 patients). The clinical effect of the two groups was compared. Results     The debranching combined endovascular stent-graft procedure group was significantly superior to the Sun's group in cardiopulmonary bypass (CPB) time, aortic cross clamp(ACC) time, intraoperative urine output, postoperative mechanical ventilation time, postoperative 24 h volumes of drain, CICU time, renal function recovery of postoperative 72 h and total hospital stay(P<0.05). The incidence of transient neurological damage after operation in the debranching combined endovascular stent-graft procedure group was significantly lower than that of the Sun's procedure group(P<0.05). The follow-up time ranged from 3 to 36 months. And the follow-up rate was 90.5%. One patient in the Sun's procedure group died of serious pulmonary infection postoperative 30 days. One patient in the debranching combined endovascular stent-graft group was found to have internal leakage in the early postoperative examination and   disappeared after 6 months. Sun's procedure group did not find endoleak. All patients during the follow-up time did not appear brain, coagulation disorders, stroke, paraplegia, upper limb ischemia and other complications. Conclusion     For Stanford type A aortic dissection, debranching combined surgery may have the risk of postoperative endoleak, but the overall effect is superior to Sun's operation. Therefore, debranching combined surgery should be preferred for the treatment of this type of dissection.

Objective To compare right anterolateral minithoracotomy and traditional median sternotomy in the treatment of left atrial myxoma. Methods Forty-one patients with left atrial myxoma treated in our hospital from January 2009 to January 2018 were divided into two groups according to the operation method: a right anterolateral minithoracotomy group including 15 patients, with 7 males and 8 females, aged 45.1±15.4 years; a median sternotomy group including 26 patients, with 10 males and 16 females, aged 49.4±11.9 years. The clinical data of the two groups were compared. Results There was no significant difference in preoperative clinical data between the two groups. All patients completed the operation without perioperative death. There was no significant difference in the operation time, cardiopulmonary bypass time, aortic clamp time or the incidence of postoperative complications between the two groups. However, compared with the median sternotomy group, the right anterolateral minithoracotomy group had shorter duration of mechanical ventilation, ICU stay and postoperative hospital stay, and less volume of drainage and blood transfusion 24 hours after surgery (all P<0.05). After 3–106 months follow-up, no recurrence was observed in both groups. Conclusion Compared with traditional median sternotomy for left atrial myxoma resection, right anterolateral minithoracotomy is safe, effective and less traumatic. It can be used as a routine treatment for left atrial myxoma.

Objective    To analyze the effect of loop-in-loop technique and annuloplasty ring for the treatment of mitral valve prolapse (MVP) under total thoracoscopy. Methods    Between May 2012 and May 2017, 21 patients with MVP underwent mitral valve repair in our hospital. There were 12 males and 9 females with a mean age of 50.90±9.66 years and the mean weight of 64.81±11.56 kg. Loop-in-loop artificial chordae tendonae reconstruction and mitral annuloplasty were performed through the right atrial-atrial septal incision under total thoracoscopy. The water test and transesophageal echocardiography were performed during the operation to evaluate the effect of mitral annuloplasty. Data of echocardiography and chest radiography were collected postoperatively one week, before discharge and after discharge. Results    All the operations were successful without re-valvupoplasty or valve replacement, conversion to median thoracotomy, malignant arrhythmia, perioperative death or wound infection. Among them, 10 patients underwent tricuspid valvuloplasty, 1 patient underwent tricuspid valvuloplasty plus radiofrequency ablation simultaneously. The mean cardiopulmonary bypass time was 255.57±37.24 minutes, aortic occlusion time was 162.24±19.61 minutes, the number of loop was 2–5 (3.29±0.78), the size of ring was 28–34 (31.11±1.88) mm, ventilator assistance time was 19.43±14.68 hours, ICU time was 58.45±24.60 hours and postoperative hospital stay was 12.28±3.61 days. Transthoracic echocardiography was re-examined postoperatively. Mild-mitral regurgitation was found in 3 patients. Warfarin anticoagulant therapy was given orally for 6 months postoperatively. The patients were followed up regularly for 2–51 months at 1, 3, 6 and 12 months postoperatively. Left ventricular end-diastolic diameter (LVEDD) was 45.06±2.96 mm, left ventricular end-diastolic volume 108.11±17.09 mL, left atrial diameter (LAD) 35.56±6.93 mm and cardiothoracic ratio 0.53±0.13 at discharge which were significantly smaller than those at admission (P<0.05). Pulmonary artery pressure was 19.22±6.38 mm Hg which was significantly lower than that at admission (P<0.05), but left ventricular ejection fraction (62.33%±4.00%) had no significant change (P>0.05). The LAD and LVEDD were significantly smaller than those before operation, and the cardiac function improved to some extent during the follow-up. No new mitral valve prolapse, increased regurgitation, infective endocarditis, thromboembolism or anticoagulation-related complications were found during the follow-up. Conclusion    Loop-in-loop artificial chordae tendon implantation combined with mitral annuloplasty is a safe and effective method for MVP under total thoracoscopy with minimal trauma, satisfactory cosmetic effect, and good early- and medium-term results. It is worth of popularizing. However, the operation time needs to be further shortened, and its long-term clinical effect needs further follow-up and other researches to confirm.