Objective: To establish a prediction model for high-risk cardiovascular disease (CVD) among residents aged 35 to 75 years, so as to provide the basis for improving CVD prevention and control measures. Methods: Permanent residents aged 35 to 75 years were selected from Dongcheng District, Beijing Municipality using the stratified random sampling method from 2018 to 2023. Demographic information, lifestyle, waist circumference and blood biochemical indicators were collected through questionnaire surveys, physical examinations and laboratory tests. Influencing factors for high-risk CVD among residents aged 35 to 75 years were identified using a multivariable logistic regression model, and a prediction model for high-risk CVD was established. The predictive effect was evaluated using the receiver operating characteristic (ROC) curve. Results: A total of 6 968 individuals were surveyed, including 2 821 males (40.49%) and 4 147 females (59.51%), and had a mean age of (59.92±9.33) years. There were 1 155 high-risk CVD population, with a detection rate of 16.58%. Multivariable logistic regression analysis showed that gender, age, smoking, central obesity, systolic blood pressure, fasting blood glucose, triglyceride and low-density lipoprotein cholesterol were influencing factors for high-risk CVD among residents aged 35 to 75 years (all P<0.05). The area under the ROC curve of the established prediction model was 0.849 (95%CI: 0.834-0.863), with a sensitivity of 0.693 and a specificity of 0.863, indicating good discrimination. Conclusion The model constructed by eight factors including demographic characteristics, lifestyle and blood biochemical indicators has good predictive value for high-risk CVD among residents aged 35 to 75 years.

The red doctor culture runs through the development process of China’s red health undertakings. It is a unity of revolutionary culture， health culture， and educational culture， providing rich educational resources for ideological and political education in medical colleges and universities. From the perspective of historical logic， red doctor culture is rooted in the traditional medical ethics thought of “medicine is the art of benevolence” in ancient China， as well as has evolved alongside the century-long development of the health and well-being undertakings led by the Communist Party of China. From the perspective of theoretical logic， red doctor culture is closely related to Xi Jinping Thought on Culture， the principle of the dialectical relationship between social existence and social consciousness， and the theory of cultural leadership. From the perspective of practical logic， it is necessary to clarify the practical path from three aspects， namely accurately grasping the Marxist theoretical foundation of the red doctor culture and highlighting its orientation of the ideological and political education of medical students； making effective use of existing resources of red doctor culture to improve the content of ideological and political education and consolidate the foundation of red doctor literacy； optimizing the construction of teaching teams for ideological and political theory courses in medical colleges and universities. From the perspective of value orientation， the red doctor culture is conducive to cultivating the professional ethics spirit of medical students， meeting the teaching needs of ideological and political theory courses in medical colleges and universities， and assisting the construction of the healthy China initiative.

The translation of genetic findings from genome-wide association studies into actionable therapeutics persists as a critical challenge in Alzheimer's disease (AD) research. Here, we present PI4AD, a computational medicine framework that integrates multi-omics data, systems biology, and artificial neural networks for therapeutic discovery. This framework leverages multi-omic and network evidence to deliver three core functionalities: clinical target prioritisation; self-organising prioritisation map construction, distinguishing AD-specific targets from those linked to neuropsychiatric disorders; and pathway crosstalk-informed therapeutic discovery. PI4AD successfully recovers clinically validated targets like APP and ESR1, confirming its prioritisation efficacy. Its artificial neural network component identifies disease-specific molecular signatures, while pathway crosstalk analysis reveals critical nodal genes (e.g., HRAS and MAPK1), drug repurposing candidates, and clinically relevant network modules. By validating targets, elucidating disease-specific therapeutic potentials, and exploring crosstalk mechanisms, PI4AD bridges genetic insights with pathway-level biology, establishing a systems genetics foundation for rational therapeutic development. Importantly, its emphasis on Ras-centred pathways-implicated in synaptic dysfunction and neuroinflammation-provides a strategy to disrupt AD progression, complementing conventional amyloid/tau-focused paradigms, with the future potential to redefine treatment strategies in conjunction with mRNA therapeutics and thereby advance translational medicine in neurodegeneration.

OBJECTIVE: To assess the relationship between blood pressure reactivity index (BPRI) and in-hospital mortality risk in patients with sepsis-associated acute kidney injury (SA-AKI). METHODS: A retrospective cohort study was conducted to collect data from patients admitted to the intensive care unit (ICU) and clinically diagnosed with SA-AKI between 2008 and 2019 in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database in the United States. The collected data included demographic characteristics, comorbidities, vital signs, laboratory parameters, sequential organ failure assessment (SOFA) and simplified acute physiology scoreII(SAPSII) within 48 hours of SA-AKI diagnosis, stages of AKI, treatment regimens, mean BPRI during the first and second 24 hours (BPRI_0_24, BPRI_24_48), and outcome measures including primary outcome (in-hospital mortality) and secondary outcomes (ICU length of stay and total hospital length of stay). Variables with statistical significance in univariate analysis were included in LASSO regression analysis for variable selection, and the selected variables were subsequently incorporated into multivariate Logistic regression analysis to identify independent predictors associated with in-hospital mortality in SA-AKI patients. Restricted cubic spline (RCS) analysis was employed to examine whether there was a linear relationship between BPRI within 48 hours and in-hospital mortality in SA-AKI patients. Basic prediction models were constructed based on the independent predictors identified through multivariate Logistic regression analysis, and receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive performance of each basic prediction model before and after incorporating BPRI. RESULTS: A total of 3 517 SA-AKI patients admitted to the ICU were included, of whom 826 died during hospitalization and 2 691 survived. The BPRI values within 48 hours of SA-AKI diagnosis were significantly lower in the death group compared with the survival group [BPRI_0_24: 4.53 (1.81, 8.11) vs. 17.39 (5.16, 52.43); BPRI_24_48: 4.76 (2.42, 12.44) vs. 32.23 (8.85, 85.52), all P < 0.05]. LASSO regression analysis identified 20 variables with non-zero coefficients that were included in the multivariate Logistic regression analysis. The results showed that respiratory rate, temperature, pulse oxygen saturation (SpO₂), white blood cell count (WBC), hematocrit (HCT), activated partial thromboplastin time (APTT), lactate, oxygenation index, SOFA score, fluid balance (FB), BPRI_0_24, and BPRI_24_48 were all independent predictors for in-hospital mortality in SA-AKI patients (all P < 0.05). RCS analysis revealed that both BPRI showed "L"-shaped non-linear relationships with the risk of in-hospital mortality in SA-AKI patients. When BPRI_0_24 ≤ 14.47 or BPRI_24_48 ≤ 24.21, the risk of in-hospital mortality in SA-AKI increased as BPRI values decreased. Three basic prediction models were constructed based on the identified independent predictors: Model 1 (physiological indicator model) included respiratory rate, temperature, SpO₂, and oxygenation index; Model 2 (laboratory indicator model) included WBC, HCT, APTT, and lactate; Model 3 (scoring indicator model) included SOFA score and FB. ROC curve analysis showed that the predictive performance of the basic models ranked from high to low as follows: Model 3, Model 2, and Model 1, with area under the curve (AUC) values of 0.755, 0.661, and 0.655, respectively. The incorporation of BPRI indicators resulted in significant improvement in the discriminative ability of each model (all P < 0.05), with AUC values increasing to 0.832 for Model 3+BPRI, 0.805 for Model 2+BPRI, and 0.808 for Model 1+BPRI. CONCLUSIONS BPRI is an independent predictor factor for in-hospital mortality in SA-AKI patients. Incorporating BPRI into the prediction model for in-hospital mortality risk in SA-AKI can significantly improve its predictive capability.
Humans ; Acute Kidney Injury/mortality* ; Sepsis/complications* ; Retrospective Studies ; Hospital Mortality ; Prognosis ; Blood Pressure ; Intensive Care Units ; Male ; Female ; Length of Stay ; Middle Aged ; Aged ; Adult ; Logistic Models

Objective:To explore the impact of diabetes mellitus on perioperative myocardial injury and cardiac function recovery in patients undergoing off-pump coronary artery bypass grafting (CABG).Methods:The clinical data of 40 patients with coronary heart disease who underwent off-pump CABG in Changsha Central Hospital from 2015 to 2025 were retrospectively included. They were divided into the diabetes group (20 cases) and the control group (20 cases) according to whether they had type 2 diabetes mellitus. Myocardial injury markers (creatine kinase isoenzyme, troponin I, lactate dehydrogenase) before surgery, on the 1st and 3rd days after surgery and before discharge, as well as cardiac function indicators (B-type natriuretic peptide, left ventricular ejection fraction) before surgery and before discharge were compared between the two groups. The postoperative recovery speed (mechanical ventilation time, intensive care unit stay, vasoactive drug use time, postoperative hospital stay) was also compared between the two groups.Results:Before surgery, there were no statistically significant differences in myocardial injury markers and cardiac function indicators between the two groups (all P>0.05). On the 3rd day after surgery, lactate dehydrogenase in the diabetes group was significantly higher than that in the control group ( P<0.05), while there were no statistically significant differences in creatine kinase isoenzyme and troponin I between the two groups (all P>0.05). Before discharge, the levels of creatine kinase isoenzyme and B-type natriuretic peptide in the diabetes group were significantly higher than those in the control group (all P<0.05), and the left ventricular ejection fraction was significantly lower than that in the control group ( P<0.05). Compared with the control group, the diabetes group had significantly longer mechanical ventilation time, intensive care unit stay, and postoperative hospital stay (all P<0.05), but there was no statistically significant difference in the use time of vasoactive drugs ( P>0.05). Conclusions:For patients with coronary heart disease complicated with diabetes mellitus, their preoperative cardiac status is comparable to that of patients without diabetes mellitus, but they show a characteristic dynamic injury pattern after surgery: early elevation of lactate dehydrogenase suggests susceptibility to subcellular injury, and long-term abnormalities of creatine kinase isoenzyme, B-type natriuretic peptide, and decrease in left ventricular ejection fraction indicate myocardial repair disorders. Compared with patients without diabetes mellitus, those with diabetes mellitus require a longer recovery time after off-pump CABG, and targeted perioperative management strategies are urgently needed.

Objective To systematically summarize the real experiences of the patients with totally implanted venous access ports(TIVAP)over the survival period of port-carrying,and provide references for formulation of the targeted health management programs.Methods A systematic search was conducted on databases of PubMed,Web of Science,Cochrane Library,CINAHL,Embase,PsycNET,China National Knowledge Infrastructure(CNKI),SinoMed,Wanfang Data base,and Vip for a qualitative study on the life experiences,needs,and feelings of patients with implanted infusion ports.The search period spanned from the inception of the databases to 3rd August,2024.Results A total of 14 studies were included,in 12 categories extracted from 38 research findings.Four synthesised results were further summarised,they were:impact on individual physical and mental health,impact on home life,challenges and needs in self-management and self-coping strategies of patients.Conclusion The implantation of TIVAP can produce both positive and negative experiences to the treatment as well as the life of patients.Healthcare professionals should be aware of the differences in emotion,cognition,need and personal coping strategy among the patients,hence to take effective measures to optimise the port-carrying experience of the patients,enhance the self-management enthusiasm and improve the quality of life of patients.

Primary aldosteronism(PA) is the most common endocrine cause of secondary hypertension and is characterized by hypertension, hypokalemia, suppressed renin, and inappropriately elevated aldosterone. Increasing evidence indicates disturbances in calcium homeostasis among patients with PA. The calcium-regulatory system encompasses calcium and phosphate, parathyroid hormone(PTH), and vitamin D. Patients with PA frequently exhibit hypocalcemia, hypophosphatemia, elevated PTH, and reduced vitamin D levels. Clarifying the contribution of calcium dysregulation to PA pathogenesis is clinically relevant for mitigating target-organ damage. This review summarizes: (1) the role of aberrant calcium signaling in the development of PA; (2) characteristic features of calcium homeostasis in PA; and (3) the interactions between the renin-angiotensin-aldosterone system(RAAS) and calcium-regulatory pathways. Overall, abnormalities in calcium signaling appear integral to the pathogenesis of PA, and disrupted calcium homeostasis may aggravate target-organ injury in affected patients.

Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.

Objective To investigate the effect of serum expression of immune-related guanosine triphosphatase M(IRGM)and Syndecan-1levels in patients with acute ST-segment elevation myocardial infarction(ASTEMI)on the prognosis after percutaneous coronary intervention(PCI).Methods 135 patients with ASTEMI admitted to Suzhou Jiulong Hospital of Shanghai Jiaotong University School of Medicine from January 2021 to January 2023(ASTEMI group)were selected and divided into the poor prognosis group(n=37)and the good prognosis group(n=98)after PCI treatment for 3 months,and 65 physically examined and healthy people(control group)were also selected during the same period.The enzyme-linked immunosorbent assay(ELISA)was used to detect serum IRGM,Syndecan-1 levels,Logistic regression was used to analyze the influencing factors of poor prognosis after PCI in ASTEMI patients,and receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of serum IRGM,Syndecan-1 levels on poor prognosis after PCI in ASTEMI patients.Results Compared with the control group,serum IRGM(6.17±2.50 ng/ml vs 2.59±0.94 ng/ml),Syndecan-1(420.97±123.65 ng/ml vs 278.89±43.06 ng/ml)levels were higher in the ASTEMI group,and the differences were statistically significant(t=14.628,11.932,all P<0.001).During a three-month follow-up,the incidence of poor prognosis after PCI in 135 patients with ASTEMI was 27.41%(37/135).The age,proportion of KILLIP grade≥II,Gensini score,white blood cell count,LDL-C,IRGM and Syndecan-1 levels in the poor prognosis group were higher than those in the good prognosis group,and the LVEF scores was lower than those in the good prognosis group,and the differences were statistically significant(χ2/t/Z=2.119～8.042,all P<0.05).Independent risk factors for poor prognosis after PCI in patients with ASTEMI were KILLIP classification≥II,high Gensini score,high IRGM,high Syndecan-1,and high LVEF were the independent protective factors(Wald χ2=4.225～11.413,all P<0.05).The AUC(95%CI)of serum IRGM combined with Syndecan-1 level in predicting poor prognosis in patients with ASTEMI after PCI was larger than that of IRGM,and Syndecan-1 alone predictsed poor prognosis,and the differences were statistically significant(Z=3.400,2.905,all P<0.05).Conclusion High serum IRGM,Syndecan-1 level is an independent risk factor for poor prognosis after PCI in pa-tients with ASTEMI,and the combination of serum IRGM,Syndecan-1 level has a high predictive value for it.