Objective To assess the nutritional status in elderly patients with chronic renal insufficiency (CRI) and reveal the key factors affecting the nutritional status. Methods A total of 310 elderly patients with CRI who received hospitalization treatment and outpatient follow-up in the hospital from January 2021 to June 2024 were selected as the investigation subjects. The nutritional status of patients was evaluated by mini-nutritional assessment (MNA) questionnaire, and the nutritional status and dietary structure of patients were comprehensively evaluated by anthropometric indicators [height, weight, body mass index (BMI), upper arm circumference, calf circumference], biochemical indicators [serum albumin (ALB), prealbumin (PA), hemoglobin (Hb), transferrin (TF)] and 24-hour dietary review method. According to the investigation results of nutritional status, the patients were divided into good nutrition group (MNA score≥24 points), nutritional risk group (MNA score of 17-23.5 points) and malnutrition group (MNA score<17 points). Univariate analysis was adopted to screen the potential influencing factors of elderly CRI. Multivariate logistic regression model was applied to analyze the influencing factors of malnutrition in elderly CRI patients. Results Among the 325 questionnaires were distributed, but only 310 valid questionnaires were recovered, with an effective recovery rate of 95.38%. Investigation results revealed that among the 310 patients, 29.35% (91 cases) had good nutritional status, and 42.26% (131 cases) had nutritional risk, and 28.39% (88 cases) had malnutrition. Univariate analysis indicated that there were statistical differences in BMI, CRI staging, serum ALB, PA, Hb, TF, protein intake and total calorie intake among the good nutrition group, the nutritional risk group and the malnutrition group (P<0.05). Multivariate logistic regression analysis suggested that low BMI (OR=0.903, 95%CI: 0.867-0.941), high CRI stage (OR=1.091, 95%CI: 1.053-1.130), low serum ALB (OR=0.907, 95%CI: 0.867-0.948), PA (OR=0.918, 95%CI: 0.888-0.949), Hb (OR=0.944, 95%CI: 0.909-0.997), TF (OR=0.912, 95%CI: 0.874-0.952), insufficient protein intake (OR=0.924, 95%CI: 0.882-0.969) and insufficient total calorie intake (OR=0.938, 95%CI: 0.909-0.968) were influencing factors for malnutrition in elderly patients with CRI (all P<0.05). Drawing ROC curve of malnutrition in elderly patients with CRI according to the prediction probability of logistic regression model found that the AUC, sensitivity, specificity, 95%CI and Youden index were 0.976, 93.18%, 92.34%, 0.953-0.990 (P<0.05) and 0.855. Conclusion The incidence rate of malnutrition is high in elderly patients with CRI, and is mainly affected by factors such as low BMI, high CRI stage, low serum ALB, PA, Hb and TF levels and insufficient protein and total calorie intakes. In addition, logistic regression model has high predictive value and can provide a reference for early clinical identification of high-risk population with malnutrition among elderly patients with CRI.

Objective To investigate the changes of serum levels of soluble scavenger receptor 163 (sCD163),angiopoietin-like protein 3 (ANGPTL3) before and after intravenous thrombolysis in patients with acute cerebral infarction (ACI) and their correlation with prognosis. Methods A total of 60 ACI patients accepted by Cangzhou Central Hospital from June 2021 to June 2022 were collected as the ACI group,and another 60 healthy individuals were regarded as the control group. According to the National Institutes of Health Stroke Scale (NIHSS) score after admission,60 patients were divided into mild group (n=10),moderate group (n=38) and severe group (n=12).According to the scores on the modified Rankin scale 90 days after thrombolysis,patients were separated into a good prognosis group (n=42) and a poor prognosis group (n=18). The serum levels of sCD163 and ANGPTL3 were detected using enzyme linked immunosorbent assay (ELISA),and receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sCD163 and ANGPTL3 levels for the prognosis of ACI patients after intravenous thrombolysis therapy. Results Compared with the control group,the levels of serum sCD163 (687.55±86.43 ng/ml vs 411.07±58.24 ng/ml) and ANGPTL3 (60.28±10.55 mg/L vs 25.34±5.93 mg/L) in ACI group were significantly increased,and the differences were significant (t=20.549,22.363,all P<0.05). The levels of serum sCD163 (551.65±69.66 ng/ml,668.92±81.12 ng/ml,859.79±117.24 ng/ml) and ANGPTL3 (44.52±8.12 mg/L,58.67±10.37 mg/L,75.34±13.12 mg/L) in mild,moderate and severe groups were gradually increased,and the differences were significant (F=36.011,23.007,all P<0.05). Compared with the good prognosis group,the proportion of time from onset to thrombolysis≥ 3 h,the proportion of NIHSS score>10 at admission,and the serum sCD163 and ANGPTL3 levels before and after thrombolysis were significantly increased in the poor prognosis group,and the differences were statistically significant (t/x2=5.644,4.775,8.982,10.866,10.293,9.702,all P<0.05). ROC results showed that the area under the curves(95％ confidence intervals)[AUC(95％CI)]of serum sCD163 and ANGPTL3 level alone in predicting the prognosis of ACI patients were 0.830 (0.711～0.915) and 0.783 (0.658～0.879),and their sensitivity and specificity were 72.22％ and 85.71％,77.78％ and 85.71％,respectively. The AUC(95％CI)of combined prediction of serum sCD163 and ANGPTL3 in predicting the prognosis of ACI patients[0.950(0.861～0.990)]was obviously greater than the AUC predicted by sCD163 and ANGPTL3 alone (Z=2.378,2.109,P=0.017,0.035). Conclusion sCD163 and ANGPTL3 levels are elevated in the serum of ACI patients,and are related to their severity and prognosis.

Objective:To analyze the changing trends and international differences in the incidence and disability-adjusted life years (DALY) of hypertensive disorders in pregnancy (HDP) in China from 1990 to 2021 based on the Global Burden of Disease (GBD) database.Methods:The data were derived from the GBD database, covering the incidence and DALY data of HDP in countries or regions around the world. Descriptive statistics were used to compare the differences in disease burden between China and different regions of Europe, America and other developed countries, and to analyze the disease burden characteristics of women of childbearing age in different age groups (every 5 years). The Joinpoint regression model was used to identify trend change points. The age-period-cohort model was used to analyze the independent effects of age, period and birth cohort.Results:(1) From 1990 to 2021, the incidence of HDP in China showed an overall downward trend, from 387.18/100 000 in 1990 to 216.35/100 000 in 2021. Compared with the global incidence rate (1990: 1 167.28/100 000; 2021: 923.48/100 000), the incidence rate of HDP in China was relatively low, but it was still higher than that in some developed countries. (2) The analysis of the Joinpoint regression model showed that the incidence rate of HDP in different age groups first decreased, then increased, and finally leveled off. The connection point with the lowest point was in 2005. DALY showed a continuous downward trend in all age groups. Among them, the decline in maternal DALY of pregnant women in all age groups from 15 to 39 years old was more obvious. (3) The age-period-cohort effect model showed that the incidence rate and DALY of HDP in women of childbearing age aged 20 to 24 years reached their peak.Conclusions:The burden of HDP in China continues to decrease, and the disease prevention and control has achieved remarkable results, but the incidence rate is still higher than that in some developed countries. It is suggested that personalized interventions should be developed for different risk groups to further reduce the burden of disease.

Objective To evaluate the performance of an improved DeepSurv model for survival analysis in lung cancer patients,and investigate key factors affecting the prognosis of lung cancer.Methods The lung cancer data from the SEER database(2018-2021)was used in the study,and the DeepSurv model was optimized by incorporating a self-attention mechanism,a residual network,a LIME module and an entropy regularization term to enhance prediction accuracy and interpretability.Model performance was assessed using C-index and Brier score,and the improved model was utilized to evaluate the effects of various features on the prognosis of lung cancer.Results The improved DeepSurv model achieved a C-index of 0.852 and a Brier score of 0.139.Feature importance analysis identified age as the primary determinant of the survival of lung cancer patients.Conclusion The improved DeepSurv model outperforms both the Cox proportional hazards model and the original DeepSurv model in terms of accuracy,robustness and interpretability,offering a novel methodology for personalized medicine and survival analysis.

Objective:To evaluate the left atrial structure and function in patients with non-obstructive hypertrophic cardiomyopathy（NOHCM）and atrial fibrillation（AF）using four-dimensional automatic left atrial quantification（4D Auto LAQ）technology，and to explore the correlation between left atrial remodeling and AF.Methods:Ninety patients with NOHCM treated in the First Affiliated Hospital of Zhengzhou University from May 2023 to September 2024 were prospectively selected and divided into AF group（ n=27）and non-AF group（ n=63）according to whether they had AF. Clinical data of all enrolled patients were collected，and two-dimensional，color Doppler，and tissue Doppler ultrasound parameters were measured. 4D Auto LAQ technology was used to obtain left atrial volume and strain parameters. Inter-group comparison，univariate and multivariate Logistic regression analysis，and repeatability test were used to analyze the data. Results:Compared with non-AF group，left atrial maximum volume index（LAVImax），left atrial minimum volume index（LAVImin）and left atrial pre-systolic volume index（LAVIpreA）were increased in the AF group，but left atrial total ejection fraction（LAEF），left atrial passive ejection fraction（LApEF），left atrial active ejection fraction（LAaEF）and the absolute values of left atrial reservoir longitudinal and circumferential strains（LASr，LASr-c），left atrial conduit longitudinal and circumferential strains（LAScd，LAScd-c）and left atrial contraction longitudinal and circumferential strains（LASct，LASct-c）were decreased（all P<0.05）. Multivariate Logistic regression analysis showed that LAVImin was independently associated with AF（ OR=0.837， P<0.001）. Conclusions:4D Auto LAQ can quantitatively evaluate the left atrial structure and function in patients with NOHCM and AF，and LAVImin is independently associated with the presence of AF.

Objective:To explore the value of three-dimensional automatic right ventricular quantitive analysis（3D Auto RVQ）technology in predicting the improvement of left ventricular ejection fraction（LVEF）in patients with heart failure with reduced ejection fraction（HFrEF）.Methods:A retrospective analysis was conducted on 89 HFrEF patients admitted to the Cardiology Department of Central China Fuwai Hospital of Zhengzhou University from April 2022 to June 2024. All patients received medication treatment and were further divided into heart failure with improved ejection fraction（HFimpEF）group and non HFimpEF group based on changes detected by echocardiography in LVEF after treatment. The clinical data，biological indicators，and medication treatment status of patients were collected，routine echocardiographic parameters and right ventricular strain parameters were measured，3D right ventricular ejection fraction（3D-RVEF），3D right ventricular stroke volume index（3D-RVSVI），3D right ventricular end-diastolic volume index（3D-RVEDVI），3D right ventricular end-systolic volume index（3D-RVESVI），3D tricuspid annular plane systolic excursion（3D-TAPSE），and 3D right ventricular fractional area change（3D-RVFAC）were measured using 3D Auto RVQ technology. The differences of the above parameters between the two groups were compared. The ROC curve was used to analyze the predictive efficiency of right ventricular parameters for HFimpEF，and the area under ROC curve（AUC）was calculated and compared. Logistic regression models were used to analyze the predictive value of right ventricular parameters for HFimpEF.Results:Compared with the non HFimpEF group，the HFimpEF group had a younger age，shorter heart failure course，a smaller proportion of males，New York Heart Association（NYHA）functional class ≥Ⅲ，and patients with concomitant coronary heart disease. The baseline LVEF，absolute value of two dimensional right ventricular global longitudinal strain（2D-RVGLS），3D-RVEF，3D-TAPSE，and 3D-RVSVI were higher in the HFimpEF group（all P<0.05）. ROC curve analysis showed that the AUC of 3D-RVEF for predicting HFimpEF was 0.858，and the predictive efficiency was higher than other right ventricular parameters. According to the Yoden index，the optimal cutoff value for predicting HFimpEF based on 3D-RVEF was 36.2%，with a corresponding sensitivity of 84.0% and specificity of 75.0%. After adjusting for clinical and other echocardiographic parameters，the logistic regression model showed that 3D-RVEF was an independent predictor of HFimpEF（ OR=1.435，95% CI=1.145-1.800， P<0.05）. Conclusions:The 3D-RVEF evaluated by 3D Auto RVQ technology has high predictive value for HFimpEF，which can provide a reference for clinical treatment，thereby improving the prognosis of HFrEF patients.

Objective:To analyze the changing trends and international differences in the incidence and disability-adjusted life years (DALY) of hypertensive disorders in pregnancy (HDP) in China from 1990 to 2021 based on the Global Burden of Disease (GBD) database.Methods:The data were derived from the GBD database, covering the incidence and DALY data of HDP in countries or regions around the world. Descriptive statistics were used to compare the differences in disease burden between China and different regions of Europe, America and other developed countries, and to analyze the disease burden characteristics of women of childbearing age in different age groups (every 5 years). The Joinpoint regression model was used to identify trend change points. The age-period-cohort model was used to analyze the independent effects of age, period and birth cohort.Results:(1) From 1990 to 2021, the incidence of HDP in China showed an overall downward trend, from 387.18/100 000 in 1990 to 216.35/100 000 in 2021. Compared with the global incidence rate (1990: 1 167.28/100 000; 2021: 923.48/100 000), the incidence rate of HDP in China was relatively low, but it was still higher than that in some developed countries. (2) The analysis of the Joinpoint regression model showed that the incidence rate of HDP in different age groups first decreased, then increased, and finally leveled off. The connection point with the lowest point was in 2005. DALY showed a continuous downward trend in all age groups. Among them, the decline in maternal DALY of pregnant women in all age groups from 15 to 39 years old was more obvious. (3) The age-period-cohort effect model showed that the incidence rate and DALY of HDP in women of childbearing age aged 20 to 24 years reached their peak.Conclusions:The burden of HDP in China continues to decrease, and the disease prevention and control has achieved remarkable results, but the incidence rate is still higher than that in some developed countries. It is suggested that personalized interventions should be developed for different risk groups to further reduce the burden of disease.

Objective To investigate the changes of serum levels of soluble scavenger receptor 163 (sCD163),angiopoietin-like protein 3 (ANGPTL3) before and after intravenous thrombolysis in patients with acute cerebral infarction (ACI) and their correlation with prognosis. Methods A total of 60 ACI patients accepted by Cangzhou Central Hospital from June 2021 to June 2022 were collected as the ACI group,and another 60 healthy individuals were regarded as the control group. According to the National Institutes of Health Stroke Scale (NIHSS) score after admission,60 patients were divided into mild group (n=10),moderate group (n=38) and severe group (n=12).According to the scores on the modified Rankin scale 90 days after thrombolysis,patients were separated into a good prognosis group (n=42) and a poor prognosis group (n=18). The serum levels of sCD163 and ANGPTL3 were detected using enzyme linked immunosorbent assay (ELISA),and receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum sCD163 and ANGPTL3 levels for the prognosis of ACI patients after intravenous thrombolysis therapy. Results Compared with the control group,the levels of serum sCD163 (687.55±86.43 ng/ml vs 411.07±58.24 ng/ml) and ANGPTL3 (60.28±10.55 mg/L vs 25.34±5.93 mg/L) in ACI group were significantly increased,and the differences were significant (t=20.549,22.363,all P<0.05). The levels of serum sCD163 (551.65±69.66 ng/ml,668.92±81.12 ng/ml,859.79±117.24 ng/ml) and ANGPTL3 (44.52±8.12 mg/L,58.67±10.37 mg/L,75.34±13.12 mg/L) in mild,moderate and severe groups were gradually increased,and the differences were significant (F=36.011,23.007,all P<0.05). Compared with the good prognosis group,the proportion of time from onset to thrombolysis≥ 3 h,the proportion of NIHSS score>10 at admission,and the serum sCD163 and ANGPTL3 levels before and after thrombolysis were significantly increased in the poor prognosis group,and the differences were statistically significant (t/x2=5.644,4.775,8.982,10.866,10.293,9.702,all P<0.05). ROC results showed that the area under the curves(95％ confidence intervals)[AUC(95％CI)]of serum sCD163 and ANGPTL3 level alone in predicting the prognosis of ACI patients were 0.830 (0.711～0.915) and 0.783 (0.658～0.879),and their sensitivity and specificity were 72.22％ and 85.71％,77.78％ and 85.71％,respectively. The AUC(95％CI)of combined prediction of serum sCD163 and ANGPTL3 in predicting the prognosis of ACI patients[0.950(0.861～0.990)]was obviously greater than the AUC predicted by sCD163 and ANGPTL3 alone (Z=2.378,2.109,P=0.017,0.035). Conclusion sCD163 and ANGPTL3 levels are elevated in the serum of ACI patients,and are related to their severity and prognosis.

Objective:To explore the application value of CT-guided percutaneous coaxial needle biopsy (CT-PTCB) in the diagnosis of malignant tumors.Methods:A retrospective case series study was conducted. The clinical data of 802 suspected malignant tumor patients who underwent CT-PTCB upon admission to Beijing Chaoyang District Huanxing Cancer Hospital from January 2019 to December 2023 were analyzed. All patients underwent imaging follow-up combined with CT-PTCB or surgical pathology to determine the final diagnosis. The CT-PTCB puncture effect, diagnosis effect and incidence of complications were recorded.Results:Among the 802 patients, 488 (60.8%) were male and 314 (39.2%) were female, with the age of (51±11) years. The puncture sites included 610 cases (76.1%) in the chest, 169 cases (21.1%) in the abdomen, 17 cases (2.1%) in the bones, and 6 cases (0.7%) in the pelvic cavity. The success rate of CT-PTCB puncture upon admission was 99.5% (798/802), the diagnostic accuracy was 96.5% (774/802), and the false negative rate was 3.5% (28/802). The incidence of pneumothorax and bleeding in patients undergoing pulmonary CT-PTCB was 13.0% (75/575) and 17.9% (103/575), respectively; the incidence of puncture bleeding in patients undergoing liver CT-PTCB was 0.8% (1/125), and the incidence of pain was 1.6% (2/125); the incidence of pneumothorax in patients undergoing mediastinal CT-PTCB was 8.7% (2/23); no obvious complications were observed in other puncture sites. All complications were cured through active treatment.Conclusions:The application of CT-PTCB for the diagnosis of malignant tumors has high success rate and diagnosis rate, and is safe and minimally invasive.