Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

OBJECTIVES: To explore the value of serum cystatin C (CysC) levels in evaluating renal prognosis in IgA nephropathy (IgAN) patients. METHODS: We retrospectively collected the clinical data of IgAN patients diagnosed by renal biopsy at Guangdong Provincial People's Hospital from January, 2014 to December, 2018. Based on baseline serum CysC levels, the patients were divided into high serum CysC (>1.03 mg/L) group and normal serum CysC (≤1.03 mg/L) group. The composite endpoint for poor renal prognosis was defined as ≥50% decline in estimated glomerular filtration rate (eGFR) and/or progression to end-stage renal disease (ESRD). Lasso regression, multivariate Cox regression and Kaplan-Meier survival analysis were used to identify the risk factors and compare renal survival rates between the two groups. Smooth curves fitting and threshold effect analysis were used to explore the relationship between serum CysC levels and the outcomes. A nomogram model was constructed and its predictive performance was evaluated using concordance index, calibration curve, receiver operating characteristic (ROC) curve and the area under curve (AUC). RESULTS: A total of 356 IgAN patients were enrolled, who were followed up for 4.65±0.93 years. The composite endpoint occurred in 74 patients. High serum CysC was identified as an independent risk factor for poor renal prognosis in IgAN (HR=2.142, 95% CI 1.222 to 3.755), and the patients with high serum CysC levels had a lower renal survival rate (Log-rank χ²=47.970, P<0.001). In patients with serum CysC below 2.12 mg/L, a higher CysC level was associated with an increased risk of poor renal prognosis (β=3.487, 95% CI: 2.561-4.413, P<0.001), while above this level, the increase of the risk was not significant (β=0.676, 95% CI: -0.642-1.995, P=0.315). The nomogram model based on serum CysC and 3 other independent risk factors demonstrated good internal validity with a concordance index of 0.873 (95% CI: 0.839-0.907) and an AUC of 0.909 (95% CI: 0.873-0.945). CONCLUSIONS Serum CysC levels are associated with renal prognosis in IgAN patients, and high serum CysC an independent risk factor for poor renal prognosis.
Humans ; Glomerulonephritis, IGA/diagnosis* ; Cystatin C/blood* ; Prognosis ; Risk Factors ; Retrospective Studies ; Glomerular Filtration Rate ; Kidney Failure, Chronic ; Male ; Female ; Adult ; Nomograms ; Middle Aged

Objective To assess the effectiveness of the evaluation of military physical function(EMPF)system in predicting the occurrence of military training injuries among new recruits to provide scientific guidance and methodological choice for military training.Methods A total of 527 new recruits from 5 grassroots units from July 2016 to February 2018 were selected for the study.The recruits underwent EMPF testing,and their military training injuries were monitored over a 2-year follow-up period.Those who sustained injuries during training were divided into injury group(n=163),while the remaining recruits were placed in healthy group(n=364).The predictive ability of the total EMPF score for training injuries was assessed using the receiver operating characteristic curve(ROC),and the correlation between the total EMPF score,individual test scores,and military training injuries were analyzed using binary logistic regression.Results The total EMPF score of new recruits in injury group(19.52±1.97)was significantly lower than that of healthy group(24.31±1.54)(P<0.001),which also demonstrated a high diagnostic value in predicting the risk of military training injuries,with an area under the curve(AUC)of ROC of 0.971(P<0.001).A cut-off value of 22 scores was found to have the highest accuracy in predicting future training injuries,with an odds ratio(OR)of 25.63,sensitivity of 0.939,specificity of 0.879,positive likelihood ratio of 7.76,and a post-test probability of 0.67.Binary logistic regression analysis revealed that 6 EMPF tests,including holding the ball over and leaning back,bending forward and touching the ground with the ball,lunge squat and twist,swallow balance with holding the ball afterward,vertical jump,and respiratory pattern assessment,were negatively associated with the risk of military training injuries(P<0.0001).Conclusion The EMPF system can effectively predict the risk of military training injuries,with military personnel whose total EMPF score is less than 22 being at higher risk of sustaining such injuries.

Objective To discuss the application of ankle pump exercise with colorful ring counting command in improving the blood hypercoagulable state in patients after hepatic arterial infusion chemotherapy(HAIC).Methods A total of 105 patients,who received HAIC at the Interventional Department of a certain Grade A general hospital in Fujian Province of China from January to December of 2023,were collected.The 53 patients who received treatment from January to June of 2023 were used as the control group,and the other 52 patients who received treatment from July to December of 2023 were used as the study group.The postoperative routine nursing and ankle pump exercise was employed for the patients of the control group,while ankle pump exercise with colorful ring counting command on the basis of postoperative routine nursing was carried out for the patients of the study group.The resting status of popliteal vein,the maximum and average systolic blood flow velocity at the end of exercise,the changes in coagulation index,the incidence of deep vein thrombosis,and the compliance of ankle pump were compared between the two groups.Results There were no statistically significant differences in the resting popliteal vein blood flow velocity and incidence of deep vein thrombosis between the two groups(P＞0.05).The maximum and average popliteal vein blood flow velocity at the end of exercise in the study group were higher than those in the control group.The levels of PT,APTT,FBG,TT and D-dimer(D-D)at 72 hours after HAIC were lower than those in the control group(all P＜0.05),and the compliance of ankle pump exercise in the study group was better than that in the control group(P＜0.05).Conclusion Ankle pump exercise with colorful ring counting command can accelerate lower limb blood flow velocity,improve the blood hypercoagulable state,and improve compliance with ankle pump exercise in patients after receiving HAIC.

Objective To investigate the protective effect of electrical stimulation-induced auditory brainstem response(EABR)monitoring on the cochlear nerve pathway during acoustic neuroma surgery.Methods The data of 36 patients who underwent acoustic neuroma surgery were studied,all surgeries were performed using the middle fossa approach.Among them,18 cases were monitored intraoperatively using EABR monitoring 4 times as the mo-nitoring group,while the other 18 cases underwent surgery without monitoring as the control group.The monito-ring group,preoperatively,there were 7 ears classified as grade A,6 ears as grade B,and 5 ears as grade C.The preoperative pure tone average thresholds(0.5,1.0,2.0,4.0 kHz)were 37.60±16.95 dB HL,and the maximum tumor diameter was 13.76±4.37 mm.The control group,preoperatively,there were 4 ears classified as grade A,7 ears as grade B,and 7 ears as grade C.The preoperative pure tone average was 46.80±22.64 dB HL,and the max-imum tumor diameter was 13.74±4.26 mm.Results In the monitoring group,except for the first monitoring,the V-wave evoked rate was 72.22％(13/18),and for the remaining three times,it was 100.00％(18/18).The mini-mum current stimulation intensity that could evoke the V-wave was 0.5 mA,and the V-wave latency was 3.97±0.17 ms.Follow-up was conducted for both groups of patients within 1 to 3 months postoperatively.In the monito-ring group,there were 7 ears classified as grade A,4 ears as grade B,4 ears as grade C,and 3 ears as grade D.Among them,3 patients experienced hearing loss after surgery,and the postoperative pure tone average was 52.20±38.35 dB HL.In the control group,there was 1 ear classified as grade A,1 ear as grade B,6 ears as grade C,and 10 ears as grade D.Among them,10 patients experienced hearing loss after surgery,and the postoperative pure tone average was 90.90±37.28 dB HL.Conclusion EABR monitoring during the resection of acoustic neuroma not only has positive significance for improving the hearing protection rate of acoustic neuroma surgery,but also assists the surgeons in identifying the cochlear nerve during surgery.The integrity of the auditory nerve pathway is protec-ted to the greatest extent for possible cochlear implanting.

This article reviews the challenges faced by research teams in China, and drawing on advanced management modes both in China and abroad, proposes a "dual optimization of management modes, stable and efficient platform support, and flexible and precise talent development" mode for research team construction and student cultivation. Specifically, this mode includes promoting flexible team management through enhanced two-way feedback between mentors and students, improving shared experimental platforms to increase resource utilization efficiency, and designing tailored training programs that align with individual student needs. The aim is to enhance team cohesion, improve the communication, collaboration, and innovation in basic medical research teams, and ultimately raise the quality of talent development in universities.

Objective Metabolomics combined with machine learning algorithms was used to systematically study the preoperative serum metabolites of patients with early postoperative cognitive dysfunction(POCD)after heart valve replacement,so as to screen biomarkers that may predict early POCD after heart valve replacement and explore the corresponding metabolic regulatory mechanisms.Methods A total of 60 patients underwent heart valve replacement under extracorporeal circulation were selected and divided into early-POCD group(group P)and non-POCD group(group N)according to whether POCD occurred or not.Metabolomic analysis was performed on preoperative serum samples of patients in group P and group N to screen the differential metabolites and metabolic pathways.The biomarkers related to early POCD were identified by random forest algorithm.Results A total of 532 differential metabolites were detected by metabonomics analysis,and 5 biomarkers were screened by random forest algorithm,namely quinoline,3'-sialyllactose,sphingomyelin(d18∶1/20∶0),lysophosphatidylcholine[P-18∶1(9Z)]and 25-hydroxycholesterol.Among them,the main metabolic pathways were phenylalanine metabolism,primary bile acid biosynthesis,ascorbic acid and aldonate metabolism,pentose and glucuronate interconversion,tryptophan metabolism,drug metabolism-cytochrome P450,porphyrin and chlorophyll metabolism.Conclusion Many metabolic pathways in patients with early POCD after heart valve replacement under extracorporeal circulation have changed before operation,which may lead to the occurrence of early POCD.Quinoline,3'-sialyllactose,sphingomyelin(d18∶1/20∶0),lysophosphatidylcholine[P-18∶1(9Z)]and 25-hydroxycholesterol may be biomarkers for predicting early POCD.

Objective To investigate the protective effect of electrical stimulation-induced auditory brainstem response(EABR)monitoring on the cochlear nerve pathway during acoustic neuroma surgery.Methods The data of 36 patients who underwent acoustic neuroma surgery were studied,all surgeries were performed using the middle fossa approach.Among them,18 cases were monitored intraoperatively using EABR monitoring 4 times as the mo-nitoring group,while the other 18 cases underwent surgery without monitoring as the control group.The monito-ring group,preoperatively,there were 7 ears classified as grade A,6 ears as grade B,and 5 ears as grade C.The preoperative pure tone average thresholds(0.5,1.0,2.0,4.0 kHz)were 37.60±16.95 dB HL,and the maximum tumor diameter was 13.76±4.37 mm.The control group,preoperatively,there were 4 ears classified as grade A,7 ears as grade B,and 7 ears as grade C.The preoperative pure tone average was 46.80±22.64 dB HL,and the max-imum tumor diameter was 13.74±4.26 mm.Results In the monitoring group,except for the first monitoring,the V-wave evoked rate was 72.22％(13/18),and for the remaining three times,it was 100.00％(18/18).The mini-mum current stimulation intensity that could evoke the V-wave was 0.5 mA,and the V-wave latency was 3.97±0.17 ms.Follow-up was conducted for both groups of patients within 1 to 3 months postoperatively.In the monito-ring group,there were 7 ears classified as grade A,4 ears as grade B,4 ears as grade C,and 3 ears as grade D.Among them,3 patients experienced hearing loss after surgery,and the postoperative pure tone average was 52.20±38.35 dB HL.In the control group,there was 1 ear classified as grade A,1 ear as grade B,6 ears as grade C,and 10 ears as grade D.Among them,10 patients experienced hearing loss after surgery,and the postoperative pure tone average was 90.90±37.28 dB HL.Conclusion EABR monitoring during the resection of acoustic neuroma not only has positive significance for improving the hearing protection rate of acoustic neuroma surgery,but also assists the surgeons in identifying the cochlear nerve during surgery.The integrity of the auditory nerve pathway is protec-ted to the greatest extent for possible cochlear implanting.