OBJECTIVE To compare the short-term efficacy and safety of small-caliber polyvinyl alcohol （PVA） microsphere-based transcatheter arterial chemoembolization （TACE） versus conventional iodized oil emulsion-based TACE in the treatment of unresectable hepatocellular carcinoma （HCC）.METHODS Clinical data of 146 patients with unresectable HCC who underwent TACE at Gansu Provincial Second People’s Hospital （Affiliated Hospital of Northwest Minzu University） from June 1， 2024， to June 30， 2025， were retrospectively collected. According to the treatment strategy， the patients were divided into the control group （conventional iodized oil emulsion-based TACE， n ＝79） and the observation group （small-caliber PVA microsphere-based TACE， n ＝67）. One-to-one propensity score matching （PSM） was performed， and the matched cohort （62 patients in each group） was used for the primary analysis. The objective response rate （ORR） and disease control rate （DCR） at 1 and 3 months post-treatment， serum levels of tumor markers （alpha-fetoprotein， alpha-fetoprotein lectin-binding fraction L3， and protein induced by vitamin K absence or antagonist-Ⅱ） before treatment and at 1 and 3 months post-treatment， the occurrence of adverse events， progression-free survival （PFS）， and overall survival （OS） were compared between the two groups. Sensitivity and interaction analyses were also performed.RESULTS After PSM， the ORRs in the observation group at 1 and 3 months post-treatment were both 59.7%， and the DCRs were 91.9% and 93.5%， respectively， significantly higher than those in the control group （ORRs： 41.9% and 38.7%； DCRs： 77.4% and 75.8%； P ＜0.05）. At 1 and 3 months post-treatment， the serum levels of tumor markers decreased significantly from baseline in both groups， with significantly lower levels in the observation group than in the control group （ P ＜0.05）. No statistically significant differences were observed in the overall incidence of adverse events or the incidence of grade≥3 adverse events between the two groups （ P ＞0.05）. The median PFS was 10.6 months in the control group and 14.3 months in the observation group， with no statistically significant difference [hazard ratio （HR） of 0.69， 95% confidence interval （CI） of 0.44-1.09， P ＝0.111]. During follow-up， 8 and 9 patients died in the control and observation groups， respectively， and the median OS was not reached in either group. The 12-month OS rates were 88.8% and 87.3%， respectively， with no statistically significant difference （HR of 0.88， 95%CI of 0.35-2.24， P ＝0.790）. After adjustment for potential confounding factors in the original cohort， the ORR at 3 months post-treatment remained significantly higher in the observation group than in the control group （adjusted odds ratio of 2.67， 95%CI of 1.28-5.56， P ＝0.009）. Additionally， the interaction between treatment modality and Barcelona Clinic Liver Cancer staging had no statistically significant impact on the ORR at 3 months post-treatment （ P ＝0.391）.CONCLUSIONS For patients with unresectable HCC， compared with conventional iodized oil emulsion-based TACE， small-caliber PVA microsphere-based TACE demonstrates superior efficacy in terms of early radiological response and improvement in tumor markers， and the two regimens are comparable in terms of safety.

OBJECTIVE To observe the clinical efficacy of Yijinjing in the treatment of elderly sarcopenia and its effect on chro-nic inflammatory response in patients,and to explore the Yijinjing exercise prescription suitable for elderly patients with sarcopenia.METHODS A total of 120 elderly patients with sarcopenia admitted to the Department of Rehabilitation Medicine,Suzhou Hospital of Traditional Chinese Medicine from September 2022 to September 2024 were selected and randomly divided into a control group and a Yijinjing group,with 60 cases in each group.The control group received health education and dietary guidance,and the Yijinjing group received Yijinjing exercises on the basis of the intervention of the control group.The changes in skeletal muscle mass,upper and lower limb muscle strength,muscle thickness,muscle cross-sectional area,physical fitness and chronic inflammation level were observed in the two groups before and after the intervention.RESULTS After intervention,the skeletal muscle mass,grip strength,30 s sit-stand test times,rectus femoris thickness and cross-sectional area,vastus intermedius thickness,and physical fit-ness assessment of the patients in the Yijinjing group were significantly increased compared with those before treatment(P<0.05),and the indicators after intervention were higher than those in the control group(P<0.05);the serum TNF-α and IL-18 levels in the Yi-jinjing group were significantly decreased compared with those before treatment(P<0.05),and the indicators after intervention were lower than those in the control group(P<0.05);there was no statistically significant change in the biceps brachii thickness and serum IL-6 level in the Yijinjing group compared with those before treatment(P>0.05);there was no significant correlation between the bi-ceps brachii thickness and grip strength after Yijinjing intervention,r=0.139 8,P>0.05;there was a significant negative correlation between the TNF-α level and grip strength after Yijinjing intervention,r=-0.313 8,P<0.05.CONCLUSION Yijinjing exercises can improve muscle mass and strength in elderly patients with sarcopenia,and improve the physical fitness of patients,which may be related to improving the chronic inflammatory state of the body.

OBJECTIVE To observe the clinical efficacy of Yijinjing in the treatment of elderly sarcopenia and its effect on chro-nic inflammatory response in patients,and to explore the Yijinjing exercise prescription suitable for elderly patients with sarcopenia.METHODS A total of 120 elderly patients with sarcopenia admitted to the Department of Rehabilitation Medicine,Suzhou Hospital of Traditional Chinese Medicine from September 2022 to September 2024 were selected and randomly divided into a control group and a Yijinjing group,with 60 cases in each group.The control group received health education and dietary guidance,and the Yijinjing group received Yijinjing exercises on the basis of the intervention of the control group.The changes in skeletal muscle mass,upper and lower limb muscle strength,muscle thickness,muscle cross-sectional area,physical fitness and chronic inflammation level were observed in the two groups before and after the intervention.RESULTS After intervention,the skeletal muscle mass,grip strength,30 s sit-stand test times,rectus femoris thickness and cross-sectional area,vastus intermedius thickness,and physical fit-ness assessment of the patients in the Yijinjing group were significantly increased compared with those before treatment(P<0.05),and the indicators after intervention were higher than those in the control group(P<0.05);the serum TNF-α and IL-18 levels in the Yi-jinjing group were significantly decreased compared with those before treatment(P<0.05),and the indicators after intervention were lower than those in the control group(P<0.05);there was no statistically significant change in the biceps brachii thickness and serum IL-6 level in the Yijinjing group compared with those before treatment(P>0.05);there was no significant correlation between the bi-ceps brachii thickness and grip strength after Yijinjing intervention,r=0.139 8,P>0.05;there was a significant negative correlation between the TNF-α level and grip strength after Yijinjing intervention,r=-0.313 8,P<0.05.CONCLUSION Yijinjing exercises can improve muscle mass and strength in elderly patients with sarcopenia,and improve the physical fitness of patients,which may be related to improving the chronic inflammatory state of the body.

Objective:To investigate the risk factors of vascular complications (VC) after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis.Methods:A total of 80 patients with aortic stenosis admitted to the Affiliated Hospital of Jining Medical University from January 2018 to June 2023 were retrospectively included as the study objects. All patients underwent TAVI surgery and were divided into VC group (13 cases, 16.3%) and N-VC group (67 cases, 83.7%) according to whether VC occurred after TAVI surgery. The preoperative basic characteristics, surgery-related indexes and preoperative laboratory indexes were compared between the two groups. Multivariate logistic regression analysis was used to screen out independent predictors of postoperative VC in patients with aortic stenosis after TAVI. Based on independent predictors, a nomogram model was constructed, and the calibration curve of the nomogram model was drawn for internal verification. Receiver operating characteristic (ROC) curves were drawn to predict VC after TAVI in patients with aortic stenosis, and the predictive efficacy of the combined prediction model was further analyzed.Results:The proportion of female patients, the proportion of diabetic patients, the mean cross-valve pressure difference, the proportion of vascular wall calcification, the proportion of transapical surgical routes, brain natriuretic peptide (BNP) and creatinine in VC group were significantly higher than those in the N-VC group, and the left ventricular ejection fraction was significantly lower than that in the N-VC group, with statistical significance (all P<0.05). Multivariate logistic regression analysis showed that gender, combined diabetes, surgical path and BNP were independent risk factors of postoperative VC in patients with TAVI (all P<0.05). Based on four independent risk factors, a nomogram model was constructed to predict the occurrence of VC after TAVI in patients with aortic stenosis. The calibration curve showed that the predicted value of VC after TAVI in patients with aortic stenosis was in good agreement with the actual observed value ( P>0.05). ROC curve analysis results showed that the area under the curve (AUC) of gender, combined diabetes, surgical path and BNP in predicting the occurrence of VC after TAVI in aortic stenosis patients were 0.745, 0.769, 0.834 and 0.857, respectively, and the AUC of the combined prediction was 0.938. Conclusions:Gender, age, surgical path and BNP are independent predictors of VC after TAVI in patients with aortic stenosis. The nomogram model based on independent predictors has high predictive value.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA

Objective To investigate the factors influencing the severity of cerebral white matter hyperintensity in hypertensive patients with acute cerebral infarction,and focus on the independ-ent roles of treatment adherence,advanced age,and multidimensional risk factors.Methods A single-center cross-sectional study was conducted on 262 hypertensive patients with acute cerebral infarction admitted to our department from January 2020 to June 2023.According to their score of Morisky Medication Adherence Scale(MMAS-8),they were divided into an adherence group(116 cases)and a non-adherence group(146 cases).Their demographic data,medical history,and blood pressure data were collected through electronic medical records.Fazekas score was assessed blind-ly to quantify the severity of white matter hyperintensity.MMAS-8 and Montreal Cognitive Assessment Scale(MoCA)were used to assess the behavioral indicators,and modified Rankin Scale(mRS)was employed to evaluate the neurological function.Univariate and multivariate logistic regression analyses were performed to screen the risk factors.Results There were statis-tical differences in marital status,mRS score and Fazekas score between the adherence group and the non-adherence group(P＜0.05,P＜0.01).The non-adherence group had significantly higher diastolic blood pressure than the adherence group[(87.29±7.51)mm Hg(1 mm Hg=0.133 kPa)vs(83.98±8.11)mm Hg,P=0.001].Univariate logistic regression analysis showed age of≥80 years,duration of hypertension≥5 years,systolic blood pressure,and MoCA score＜10 were no-tably correlated with severity of white matter hyperintensity(P＜0.01).Multivariate logistic re-gression analysis indicted that age of≥80 years(OR=3.305,95％CI:1.560-7.001,P=0.002),systolic blood pressure(OR=1.026,95％CI:1.008-1.044,P=0.003),MoCA score＜10(OR=5.210,95％CI:2.060-13.176,P=0.000),and treatment non-adherence(OR=2.380,95％CI:1.346-4.209,P=0.003)were independent risk factors for white matter hyperintensity severity,and duration of hypertension showed no significance in the multivariate model(P＞0.05).Conclusion Poor treatment adherence and advanced age are core factors for white matter hyper-intensity progression in hypertensive patients with acute cerebral infarction.

Objective:To investigate the application value of cervical vascular ultrasound(CVUS)combined with transcranial Doppler ultrasound(TCD)in the diagnosis of carotid artery stenosis and collateral circulation in patients with ischemic cerebrovascular disease(ICVD).Methods:In this study,86 patients with ICVD admitted to the Cardio-Cerebrovascular Disease Specialist Hospital of Qinghai Province from January 2021 to January 2023 were selected.All patients underwent CVUS,TCD and digital subtraction cranial angiography(DSA)examination,and the diagnosis results of DSA were taken as the gold standard.To observe and compare the diagnostic efficacy of CVUS and TCD alone and combined CVUS and TCD for carotid artery stenosis and collateral circulation in ICVD patients.Results:Among the 86 patients with ICVD,a total of 597 vascular stenoses were detected by DSA examination,424 vascular stenoses were detected by CVUS,388 vascular stenoses were detected by TCD,and 586 vascular stenoses were detected by CVUS combined with TCD.The diagnostic coincidence rates of CVUS and TCD alone detection were 71.02%(424/597)and 64.99%(388/597),respectively,and the diagnostic coincidence rate of the combined detection of the two methods was 98.16%(586/597).The comparison showed that there was no statistically significant difference in the diagnostic coincidence rate of the degree of vascular stenosis between CVUS combined with TCD detection and DSA(P>0.05).Among the 86 patients with ICVD,collateral circulation formation was detected in 69 cases by DSA,in 55 cases by CVUS,in 51 cases by TCD,and in a total of 67 cases by CVUS combined with TCD.There was no significant difference in the detection rate between the combined detection of CVUS and TCD and that of DSA(P>0.05).Through analysis,it was concluded that the diagnostic sensitivity and accuracy of CVUS combined with TCD detection were both higher than those of CVUS and TCD single detection,and the difference was statistically significant(x2=10.180 and 12.204,P<0.05)14.969 and 18.124,P<0.05).The accuracy rate of the combined detection of CVUS and TCD was 96.51%,the sensitivity was 97.10%,and the specificity was 94.12%,which was highly consistent compared with DSA(Kappa value=0.896).Conclusion:CVUS combined with TCD detection has high clinical application value in the diagnosis of carotid artery stenosis and collateral circulation in ICVD patients.The combined detection of the two methods can further improve the diagnostic sensitivity,and the diagnostic accuracy is close to the gold standard,which can provide a reliable reference for clinical rational treatment and improvement of prognosis.

BACKGROUND:Understanding the characteristics and influencing factors of the gut microbiota in athletes can help determine the optimal gut microbial composition for relevant sport events.Further investigation in this area could provide important insights for improving athletic performance and recovery as well as developing personalized nutrition prescriptions.OBJECTIVE:To summarize the characteristics of gut microbiota in athletes,and to elucidate the important factors influencing the gut microbiota characteristics of athletes from the perspectives of exercise training and dietary intake.METHODS:A literature search was conducted using the PubMed,ScienceDirect,CNKI,WanFang and VIP databases for publications from 2004 to 2024.The search terms included"microbiota,microbiome,athlete,exercise,training,diet,nutrition,dietary fiber,protein,ketogenic,fat"in English and Chinese.After excluding studies of poor quality and irrelevant content,a total of 65 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)The gut microbiota of elite athletes differs from that of the general population,characterized by increased α-diversity,elevated Firmicutes/Bacteroidetes ratio,increased abundance of beneficial bacteria,and enrichment of functional pathways contributing to athletic performance.(2)The type of sport and training load are closely related to the species structure and functional expression of the gut microbiota in athletes.(3)The bidirectional communication between the host and gut microbiota mediated by metabolites is an important mechanism by which exercise influences the gut microbiota.(4)Phase training typically induces adaptive changes in the gut microbiota,and alterations in the structure or function of the microbiota have lasting effects.(5)The type,quantity,and combination of macronutrients intake can significantly influence the structure and function of the gut microbiota,and interact synergistically or antagonistically with exercise training.(6)In the future,it is important to continue the exploration of the gut microbiota in athletes,clarify causal relationships,and establish new targets for exercise training interventions.

Objective To explore the application of low-concentration contrast agent and low tube voltage(dual-low)scanning technology combined with iterative reconstruction technique in computed tomography perfusion(CTP)scanning for patients with acute cerebral infarction(ACI).Methods A retrospective analysis was conducted on 120 patients diagnosed with ACI at Gansu Second People's Hospital from December 2018 to December 2022.All patients underwent CTP examination,and according to CTP contrast agent and tube voltage,they were divided into dual-low group(n=64,low-concentration contrast agent with an iodine content of 270 mgI/mL,low tube voltage of 80 kV)and control group(n=56,conventional concentration contrast agent with an iodine content of 350 mgI/mL,standard tube voltage of 120 kV).Images quality was compared between two groups,with the intraclass correlation coefficient used to evaluate the consistency of image quality.The radiation dose,intake of ioversol injection,CT value at M1 segment of the middle cerebral artery,signal-to-noise ratio,and contrast-to-noise ratio were also compared between two groups.Results The difference in CTP image quality between dual-low group and control group was trivial(P>0.05).The dual-low group exhibited lower dose-length product,effective radiation dose,and intake of ioversol injection than control group(P<0.05).No significant differences were observed in CT value at M1 segment of the middle cerebral artery,signal-to-noise ratio or contrast-to-noise ratio between two groups(P>0.05).Conclusion The application of dual-low scanning technology combined with iterative reconstruction algorithm can reduce intake of contrast agent and radiation dose while ensuring CTP images quality in ACI patients.