Objective To explore the correlation between remnant cholesterol level and CI-AKI in elderly patients with ACS and concomitant T2DM following PCI.Methods A retrospective case-control study was conducted on 759 elderly T2DM patients with ACS undergoing PCI in the Affi-liated Hospital of Xuzhou Medical University between January 2020 and December 2023.The pa-tients were randomly allocated into a training group(n=608)and a validation group(n=151)in a ratio of 8∶2.Based on CI-AKI diagnostic criteria,the training group was further stratified into a CI-AKI subgroup(n=95)and a non-CI-AKI subgroup(n=513).Multivariate logistic regression analysis was used to identify the independent risk factors for CI-AKI.Results The remnant cho-lesterol level was significantly higher in the CI-AKI subgroup than the non-CI-AKI subgroup[0.78(0.51,1.07)mmol/L vs 0.57(0.40,0.81)mmol/L,P＜0.01].Red blood cell count,remnant cholesterol,age,uric acid,log-transformed systemic immune-inflammatory(SII)index,and cysta-tin C were identified as independent predictors for CI-AKI in T2DM patients with ACS after PCI(P＜0.01).ROC curve analysis demonstrated that the model combining remnant cholesterol with other independent predictors exhibited superior discriminative performance in both the training group(AUC=0.818,95％CI:0.773-0.863)and validation group(AUC=0.787,95％CI:0.686-0.889)when compared to the models excluding remnant cholesterol(P＜0.01).Conclusion Rem-nant cholesterol is an independent predictor of CI-AKI in elderly patients with ACS and T2DM af-ter PCI.A risk prediction model based on remnant cholesterol and other independent risk factors demonstrates enhanced predictive performance for postoperative CI-AKI in the patients.

Objective To investigate the predictive value of the atherogenic index of plasma(AIP)and systemic inflammatory re-sponse index(SIRI)for contrast-induced acute kidney injury(CI-AKI)in patients with hypertension complicated by acute ST-seg-ment elevation myocardial infarction(STEMI)undergoing emergency percutaneous coronary intervention(PCI).Methods A total of 964hypertensive patients with acute STEMI who underwent PCI treatment at the Affiliated Hospital of Xuzhou Medical University from Jan-uary 2021 to April 2025 were retrospectively enrolled.Using a randomized grouping method,the sample was divided into the training group(n=771)and the validation group(n=193)in a ratio of 8∶2.According to the diagnostic criteria for CI-AKI,the training group was further divided into the CI-AKI group(n=151)and the non-CI-AKI group(n=620),with baseline characteristics compared between the two groups.Multivariate Logistic regression models were constructed to identify independent predictors of postoperative CI-AKI,followed by receiver operating characteristic(ROC)curve analysis to evaluate the predictive efficacy of AIP,SIRI,and their combined detection for CI-AKI occurrence after PCI treatment.Results Left ventricular ejection fraction(LVEF),urea metabolism level,high-density lipoprotein cholesterol(HDL-C),diuretics,SIRI,and AIP showed significant correlations with the occurrence of CI-AKI in hypertensive patients with acute STEMI after PCI(P＜0.05).Multivariate Logistic regression analysis revealed that SIRI(OR=1.148,95％CI:1.060-1.244)and AIP(OR=5.946,95％CI:3.250-10.879)were independent risk factors for CI-AKI.The results of ROC curve analysis demonstrated that the combined detection of SIRI and AIP yielded an area under the curve of 0.805(95％CI:0.774-0.835),with the sensitivity of 70.8％and the specificity of 75.0％,which was significantly better than that of indi-vidual indicators(P＜0.001).The results of restricted cubic spline(RCS)indicated that when SIRI ≥ 2.773 or AIP ≥2.089,the risk of CI-AKI increased with rising levels of SIRI and AIP.Conclusion AIP and SIRI are independent risk factors for CI-AKI in hyperten-sive patients with acute STEMI after PCI,and their combined detection can improve the predictive efficacy of CI-AKI in hypertensive pa-tients with acute STEMI following PCI.

Objective To investigate the predictive value of the atherogenic index of plasma(AIP)and systemic inflammatory re-sponse index(SIRI)for contrast-induced acute kidney injury(CI-AKI)in patients with hypertension complicated by acute ST-seg-ment elevation myocardial infarction(STEMI)undergoing emergency percutaneous coronary intervention(PCI).Methods A total of 964hypertensive patients with acute STEMI who underwent PCI treatment at the Affiliated Hospital of Xuzhou Medical University from Jan-uary 2021 to April 2025 were retrospectively enrolled.Using a randomized grouping method,the sample was divided into the training group(n=771)and the validation group(n=193)in a ratio of 8∶2.According to the diagnostic criteria for CI-AKI,the training group was further divided into the CI-AKI group(n=151)and the non-CI-AKI group(n=620),with baseline characteristics compared between the two groups.Multivariate Logistic regression models were constructed to identify independent predictors of postoperative CI-AKI,followed by receiver operating characteristic(ROC)curve analysis to evaluate the predictive efficacy of AIP,SIRI,and their combined detection for CI-AKI occurrence after PCI treatment.Results Left ventricular ejection fraction(LVEF),urea metabolism level,high-density lipoprotein cholesterol(HDL-C),diuretics,SIRI,and AIP showed significant correlations with the occurrence of CI-AKI in hypertensive patients with acute STEMI after PCI(P＜0.05).Multivariate Logistic regression analysis revealed that SIRI(OR=1.148,95％CI:1.060-1.244)and AIP(OR=5.946,95％CI:3.250-10.879)were independent risk factors for CI-AKI.The results of ROC curve analysis demonstrated that the combined detection of SIRI and AIP yielded an area under the curve of 0.805(95％CI:0.774-0.835),with the sensitivity of 70.8％and the specificity of 75.0％,which was significantly better than that of indi-vidual indicators(P＜0.001).The results of restricted cubic spline(RCS)indicated that when SIRI ≥ 2.773 or AIP ≥2.089,the risk of CI-AKI increased with rising levels of SIRI and AIP.Conclusion AIP and SIRI are independent risk factors for CI-AKI in hyperten-sive patients with acute STEMI after PCI,and their combined detection can improve the predictive efficacy of CI-AKI in hypertensive pa-tients with acute STEMI following PCI.

Objective To explore the correlation between remnant cholesterol level and CI-AKI in elderly patients with ACS and concomitant T2DM following PCI.Methods A retrospective case-control study was conducted on 759 elderly T2DM patients with ACS undergoing PCI in the Affi-liated Hospital of Xuzhou Medical University between January 2020 and December 2023.The pa-tients were randomly allocated into a training group(n=608)and a validation group(n=151)in a ratio of 8∶2.Based on CI-AKI diagnostic criteria,the training group was further stratified into a CI-AKI subgroup(n=95)and a non-CI-AKI subgroup(n=513).Multivariate logistic regression analysis was used to identify the independent risk factors for CI-AKI.Results The remnant cho-lesterol level was significantly higher in the CI-AKI subgroup than the non-CI-AKI subgroup[0.78(0.51,1.07)mmol/L vs 0.57(0.40,0.81)mmol/L,P＜0.01].Red blood cell count,remnant cholesterol,age,uric acid,log-transformed systemic immune-inflammatory(SII)index,and cysta-tin C were identified as independent predictors for CI-AKI in T2DM patients with ACS after PCI(P＜0.01).ROC curve analysis demonstrated that the model combining remnant cholesterol with other independent predictors exhibited superior discriminative performance in both the training group(AUC=0.818,95％CI:0.773-0.863)and validation group(AUC=0.787,95％CI:0.686-0.889)when compared to the models excluding remnant cholesterol(P＜0.01).Conclusion Rem-nant cholesterol is an independent predictor of CI-AKI in elderly patients with ACS and T2DM af-ter PCI.A risk prediction model based on remnant cholesterol and other independent risk factors demonstrates enhanced predictive performance for postoperative CI-AKI in the patients.

Objective:Revise the Chinese version of body dysmorphic disorder scale (CBDDS) and test its reliability and validity in Chinese college students.Methods:In October 2022, college students were surveyed with the body dysmorphic disorder scale (BDDS), the body image disorders scale (BIDS), the appearance anxiety scale-brief (AAS-B), the Chinese body shame scale (CBSS) and short-depression scale (SDS). Totally 59 college students (sample 1) were subjected to evaluate the popularity degree of the scale, 493 college students (sample 2) were subjected to complete item and exploratory factor analysis, 457 colleges students (sample 3) were subjected to complete the confirmatory factor analysis, totally 89 colleges students (sample 4) were subjected to complete the re-test reliability analysis.SPSS 25.0 software was used for item analysis, exploratory factor analysis, reliability analysis, Pearson correlation analysis.AMOS 24.0 software was used for confirmatory factor analysis, convergent validity analysis.Results:(1) The CBDDS was consisted of 3 dimensions including pathological beliefs, appearance anxiety and overgrooming, and the three-factor model fitted well ( χ2/ df=3.14, GFI=0.93, CFI=0.91, TLI=0.91, RMSEA=0.07). (2) The score of CBDDS was positively correlated with the score of BIDS, AAS-B, CBSS and SDS ( r=0.41-0.81, all P<0.01). In addition, the composite reliability coefficients were 0.75-0.95 and AVE coefficients were 0.51-0.56.(3) The CBDDS had good internal reliability with Cronbach's α coefficients from 0.75 to 0.94, split-half reliability coefficients from 0.65 to 0.90 and re-test reliability coefficients from 0.71 to 0.91 (all P<0.01). Conclusion:The CBDDS has acceptable reliability and validity and can be an effective scale for Chinese college students.

Objective:To evaluate the application value of bismuth shielding combined with organ tube current modulation (X-care) in brain CT scanning by measuring the radiation dose of sensitive organs.Methods:The head and neck phantom was scanned with Siemens dual source CT at the same volume CT dose index (CTDI vol) by X-care, bismuth shielding and x-care combined with bismuth shielding, and by dual energy CT angiography (DE-CTA) with and without bismuth shielding. The CT values of cerebral vessels, adjacent brain tissues and cerebrospinal fluid and image noise were measured, and the contrast noise ratio of cerebral vessels and brain parenchyma was calculated. Organ dose equivalent ( HT) was calculated by placing thermoluminescent personal dosimeter (TLD), and CTDI vol and dose length product (DLP) were recorded after each scan. Results:Under the same CTDI vol, the mean values of HT, lens with X-care, Bi shielding and X-care combined with Bi shielding were(37.89 ± 2.00), (42.20 ± 2.96) and (28.21 ± 1.31) mSv, respectively, significantly lower than those of conventional sequence scanning( F=186.52, P<0.05). The values of HT, thyroid with Bi shielding and X-care combined with Bi shielding were (0.77 ± 0.07) and (0.89 ± 0.08) mSv, lower than those of routine brain scan and X-care( F=103.26, P<0.05). The values of HT, lens and HT, thyroidof DE-CTA with bismuth shielding were (11.56 ± 1.04) and (0.32 ± 0.03) mSv, respectively, significantly lower than those without bismuth shielding( t=5.07, P<0.05). There was no significant difference in noise and CNR in routine brain scan between with and without X-care, bismuth shielding and X-care combined with bismuth shielding. There was no significant difference in noise and CNR in dual energy CTA scanning between with and without Bi shielding. Conclusions:Using bismuth shielding and organ tube current modulation, we can significantly reduce organ dose of lens and thyroid during brain CT scanning without sacrificing the image quality.

OBJECTIVE：To study the effects of Calpeptin inhibitor Calpeptin on the transformation and stemness markers expression induced by estradiol（E2），and to investigate its mechanism. METHODS ：Taking human mammary epithelial cells MCF-10A as research object ，transformed cells were induced by E 2 treatment. Cells were divided into control group （0.1％DMSO）， E2-transformed group （50 nmol/L），E2-transformed+Calpeptin group （50 nmol/L E 2+1 μmol/L Calpeptin），then continuously treated with corresponding drug-containing culture medium for 15 generations. Then ，MTT assay was used to determine the proliferation rate of cells （24，48 h）；plate colony test was used to detect the Clone formation rate of cells ；the number of sphere-forming cells was measured by suspension spheroidization test ；mRNA expressions of stemness marker （CD44，Nanog，OCT4）and extracellular sigal-regulated kinase （ERK）were detected by RT-qPCR ，and protein expressions of CD 44，Nanog，OCT4 ，ERK and p-ERK were detected by Western blotting assay. Another E 2-transformed cells were divided into control group （0.1％DMSO）and U0126 （ERK inhibitor ）group（10 μmol/L）. Clone formation rate ，the number of sphere-forming ，protein expressions of CD 44，Nanog， OCT4，ERK and p-ERK were determined with above methods ，and to validate the relationship of ERK inhibition with transformed cell behavior and the expression of stemness markers. RESULTS ：Compared with control group ，proliferation rate and clone formation rate of E 2 transformed group were increased significantly （P＜0.01），and the number of sphere-forming was increased significantly（P＜0.01）；mRNA expression levels of CD 44，Nanog，OCT4，ERK and protein expression levels of CD 44，Nanog， OCT4 and p-ERK in cells were increased significantly （P＜0.01）. Compared with E 2-transformed group ，proliferation rate （24，48 h）and clone formation rate of E 2-transformed + Calpeptin group were decreased significantly （P＜0.01），and the number of sphere-forming was decreased significantly （P＜0.05）；mRNA expression levels of CD 44，Nanog，OCT4 ，ERK and protein expression levels of CD 44，Nanog，OCT4，p-ERK in cells were decreased significantly （P＜0.05 or P＜0.01）. After treated with ERK inhibitor U 0126，clone formation rate of E 2-transformed cells ，the number of sphere-forming ，protein expression levels of CD44，Nanog，OCT4 and p-ERK were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：Calpeptin can inhibit the transformation and the expression of stemness markers of human mammary epithelial cells MCF- 10A，and the mechanism of it may be associated with inhibiting the activation of Calpain-ERK signaling pathway.

Objective To investigate the influence of acquisition time of C-arm cone-beam CT on image quality and radiation dose of cerebral angiography.Methods C-arm cone-beam CT of cerebral angiography was performed on the male anthropomorphic head phantom,with DynaCT imaging mode and the acquisition time of 5 s,8 s and 20 s were used.Scanning was performed with each acquisition time for three times,and VR,MIP and MPR images were reconstructed.The attenuation values and their standard deviations of intracranial segment of the internal carotid artery (ICA),middle cerebral artery(MCA),anterior cerebral artery(ACA) and uniformed brain tissues were measured to calculate the image noise,signal to noise ratio (SNR) and contrast to noise ratio (CNR).We used the image noise,SNR and CNR as the objective standard to evaluate the image quality,and One-way ANOVA analysis of variance was used to assess the difference among them.A scale with scores 1 to 5 was used to rate the quality of the reconstructed image of ICA,MCA,ACA as a subjective evaluation,the difference among the evaluation scores were analyzed using Kruskal-wallis.We recorded the dose area product (DAP) of each acquisition time and the effective dose(ED) was calculated to assess the radiation dose,the difference among them were analyzed using One-way ANOVA analysis of variance.Results In C-arm cone beam CT 20 s imaging,the SNR of intracranial segment of the ICA,M CA,ACA were 22.29± 1.41,29.36 ±0.11 and 23.13 ±2.10 respectively,in 5 s imaging13.83 ±0.61,14.65 ±0.16 and 12.79±0.19 respectively,in 8 s imaging 14.92±0.96,18.97 ± 1.24 and 16.65 ±0.46 respectively,all the results showed a significant difference (F valued 58.19,327.29,52.74 respectively,all P valued＜0.01),the CNR of 20 s imaging were higher than that of 5 s and 8 s imaging,the Noise of ICA,MCA,ACA and the uniformed brain tissues of 20 s imaging were lower than that of 5 s and 8 s imaging,all the results showed significant difference (all P valued＜0.01).The subjective evaluation scores of VR imaging of 5 s,8 s and 20 s were 3.61 ±0.49,4.06±0.53,4.72±0.45 respectively,the scores of MIP imaging were 3.42±0.50,3.83±0.65 and 4.50±0.51 respectively,the scores of MPR imaging were 2.83±0.45,3.14±0.35 and 3.67±0.49 respectively,all the results showed significant difference (x2 valued 51.29,42.25 and 43.56 respectively,all P valued ＜0.01).The DAP values in C-arm cone beam CT 5 s,8 s and 20 s imaging were (9.11 ±0.18),(13.81±0.75)and(58.62±0.62)Gy· cm2,ED values were (0.91 ±0.02),(1.38±0.75)and(5.84± 0.11) mSv,all the results showed significant difference (F valued 3 720.30 and 3 654.85 respectively,all P valued＜0.01).Conclusion The image quality and radiation dose of C-arm cone-beam computed tomography are closely correlated with acquisition time.

Objective To compare the differences of pulmonary nodule detection rates between iterative reconstruction (sinogram affirmed iterative reconstruction,SAFIRE)algorithm and filtered back projection (FBP) algorithm in chest CT, and to evaluate the detection accuracy.Methods Three groups of tube voltage values of 80,100,and 120 kV were defaulted on the new dual-source CT,with automatic mAs care dose 4D technology, the chest phantom with simulated pulmonary nodules was scanned, then the images were reconstructed with FBP and SAFIRE (grade 1-5 ),respectively. The detection rates of simulated pulmonary nodules in the chest CT images reconstructed of SAFIRE (grade 1-5 )and FBP were compared, and their diameters and CT values were measured.Results With the same tube voltage, no significant difference was found in the detection rate of simulated pulmonary nodules between SAFIRE (grade 1-5 )and FBP (P>0.05 ), the diameter deviation of simulated nodules of SAFIRE (grade 3 )was less than FBP, and the difference in the average CT value of the simulated nodules between SAFIRE (grade 3)and FBP was not statistically significant (P>0.05);the simulated nodule detection rate of 100 kV was equivalent to the detection rate of 120 kV,the simulated nodule (-800 HU and 3 mm )detection rate of 80 kV was less than that of 120 kV;as the tube voltage reduced,or simulated nodule diameter decreased,or the density of simulated nodule reduced,the nodule’s diameter deviation was increased. Conclusion Compared with FBP,the capabilities of SAFIRE in pulmonary nodule detection in different densities and different sizes are same,and SAFIRE algorithm is helpful for accurate displaying of pulmonary nodules,and it can be used for low-dose CT lung cancer screening program.