Objective:To explore the value of 18F-FDG PET brain glucose metabolism imaging in the subtype differential diagnosis and prognosis evaluation of autoimmune encephalitis (AE). Methods:A retrospective analysis was conducted on PET/CT brain glucose metabolism imaging data from 58 patients with AE (from August 2020 to June 2023, Xuanwu Hospital, Capital Medical University; 31 males, 27 females; age (47.4±16.9) years). Patients were divided into 4 groups: anti-leucine-rich glioma-inactivated protein 1(LGI1) antibody-related encephalitis group, anti- N-methyl- D-aspartate receptor (NMDAR) encephalitis group, anti-γ-amino butyric acid type B receptor (GABA BR) antibody-related encephalitis group, and other types of AE group. In addition, 20 cases were included in control group (6 males and 14 females, age (58.8±7.5) years). Visual assessment was performed to evaluate changes in brain glucose metabolism among patients with different subtypes of AE, and abnormal glucose metabolism brain regions were compared by independent-sample t test between different groups. Spearman rank correlation analysis was conducted between SUV ratio (SUVR) of abnormal brain regions and modified Rankin Scale (mRS) scores at six months later. Results:Among 58 patients, 21 were diagnosed with anti-LGI1 antibody-related encephalitis, 18 were diagnosed with anti-NMDAR encephalitis, 7 were diagnosed with anti-GABA BR antibody-related encephalitis, and 12 were diagnosed with other subtypes of AE. Compared with anti-NMDAR encephalitis group: patients with anti-LGI1 antibody-related encephalitis showed increased glucose metabolism in the right occipital lobe and bilateral hippocampi, and decreased glucose metabolism in the right frontal lobe, right precentral gyrus, and bilateral superior marginal gyrus ( t values: from -5.13 to 4.89, all P<0.001); patients with anti-GABA BR antibody-related encephalitis exhibited increased glucose metabolism in the bilateral hippocampi and right fusiform gyrus, and decreased glucose metabolism in the left middle frontal gyrus ( t values: from -3.82 to 3.91, all P<0.001). Anti-NMDAR encephalitis was characterized by decreased metabolism in the bilateral parietal lobes, occipital lobes, local frontal-temporal lobes, and bilateral thalami, as well as increased metabolism in the limbic lobe and local frontal-temporal-parietal lobes ( t values: from -8.30 to 7.30, all P<0.001), and the SUVR of the right occipital lobe was negatively correlated with mRS score at six months later ( rs=-0.64, P=0.014). Other subtypes of AE showed decreased glucose metabolism in different cerebral lobes. Conclusion:18F-FDG PET/CT can evaluate brain glucose metabolism in different subtypes of AE diseases and prognosis.

Objective The Nuangong Waifu formula （NGWFF） is a traditional Chinese medicine prescription that has been used in gynecology of traditional Chinese medicine in our hospital for many years. It has a certain effect on preventing postoperative intrauterine re-adhesion. To further retrospectively analyze the clinical efficacy of NGWFF. Methods A total of 200 patients who were diagnosed with intrauterine adhesions and underwent intrauterine adhesion separation from January 2018 to December 2020 were retrospectively included. They were divided into control group and observation group according to different drug use for postoperative prevention of re-adhesion, with 100 cases in each group. All patients were given oral estrogen and progesterone （ethinyl estradiol tablets 0.037 5 mg, q12 h, or estradiol valerate tablets 3 mg, q12 h, a total of 21 days, 7 days after estrogen therapy plus dydrogesterone 20 mg, qd or progesterone capsules 200 mg, qd） to promote endometrial growth. In the control group, 100 patients only used estrogen and progesterone after operation. In the observation group, 100 patients were treated with NGWFF at Guanyuan acupoint （four fingers under the navel）, once a day. Both groups were evaluated for the degree of intrauterine adhesions under hysteroscopy and the effective rate after 3-5 menstrual cycles of drug treatment. Results Compared with using estrogen and progesterone alone, combination use of NGWFF significantly decreased in the scores of intrauterine adhesions under hysteroscopy （2.41±1.19 vs 3.31±1.18, P=0.00）, and the effective rate was also significantly higher than that in the control group （ 86 % vs 47 %, P<0.000）. Conclusion The combination use of NGWFF was more effective than using estrogen and progesterone alone in preventing re-adhesion after intrauterine adhesions， which provided a scientific basis for the clinical application of NGWFF.

Objective To explore the predictive value of combined detection of serum interleukin-35(IL-35),proprotein convertase subtilisin/kexin type 9(PCSK9),and microRNA-155(miR-155)for sepsis-induced multiple organ dysfunction syndrome(MODS).Methods A total of 170 patients with sepsis admitted in the hospital from June 2020 to June 2023 were selected.Patients were divided into MODS group and non-MODS group according to whether they developed secondary MODS within 28 days.Clinical data and serum levels ofIL-35,PCSK9,and miR-155 were compared between the two groups.Pearson method and partial correlation coefficient were used to analyze the correlation between serum IL-35,PCSK9,and miR-155 and the severity of sepsis and the risk of MODS,and receiver operating characteristics(ROC)curve was used to evaluate the pre-dictive value of serum IL-35,PCSK9,and miR-155 alone and in combination for MODS.In addition,83 patients with sepsis in the hospital from July 2023 to July 2024 were selected as external validation data sets for exter-nal validation.Results Age,percentage of patients with diabetes mellitus,quick sequential organ function as-sessment scale(qSOFA)score,acute physiology and chronic health status evaluation scale Ⅱ(APACHE Ⅱ)score,and serum IL-35,PCSK9,and miR-155 levels in the MODS group were higher than those in the non-MODS group(P＜0.05).Pearson method showed that serum IL-35,PCSK9,and miR-155 were positively cor-related with qSOFA score and APACHE Ⅱ score(P＜0.05).Partial correlation coefficient analysis showed that after excluding other factors,serum IL-35,PCSK9,and miR-155 were still significantly associated with the risk of MODS(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of the combi-nation of serum IL-35,PCSK9,and miR-155 for predicting MODS was 0.907,which was greater than the AUC of each indicator alone.External validation ROC analysis showed that the AUC of combined detection of the three was 0.914.Conclusion The expression of serum IL-35,PCSK9,and miR-155 is significantly associated with the risk of sepsis-induced MODS.Combined detection has certain predictive value for the secondary de-velopment of MODS,and could be used as auxiliary indicators for clinical prediction for MODS,thereby guid-ing clinical prevention and treatment.

Objective:To explore the value of 18F-FDG PET brain glucose metabolism imaging in the subtype differential diagnosis and prognosis evaluation of autoimmune encephalitis (AE). Methods:A retrospective analysis was conducted on PET/CT brain glucose metabolism imaging data from 58 patients with AE (from August 2020 to June 2023, Xuanwu Hospital, Capital Medical University; 31 males, 27 females; age (47.4±16.9) years). Patients were divided into 4 groups: anti-leucine-rich glioma-inactivated protein 1(LGI1) antibody-related encephalitis group, anti- N-methyl- D-aspartate receptor (NMDAR) encephalitis group, anti-γ-amino butyric acid type B receptor (GABA BR) antibody-related encephalitis group, and other types of AE group. In addition, 20 cases were included in control group (6 males and 14 females, age (58.8±7.5) years). Visual assessment was performed to evaluate changes in brain glucose metabolism among patients with different subtypes of AE, and abnormal glucose metabolism brain regions were compared by independent-sample t test between different groups. Spearman rank correlation analysis was conducted between SUV ratio (SUVR) of abnormal brain regions and modified Rankin Scale (mRS) scores at six months later. Results:Among 58 patients, 21 were diagnosed with anti-LGI1 antibody-related encephalitis, 18 were diagnosed with anti-NMDAR encephalitis, 7 were diagnosed with anti-GABA BR antibody-related encephalitis, and 12 were diagnosed with other subtypes of AE. Compared with anti-NMDAR encephalitis group: patients with anti-LGI1 antibody-related encephalitis showed increased glucose metabolism in the right occipital lobe and bilateral hippocampi, and decreased glucose metabolism in the right frontal lobe, right precentral gyrus, and bilateral superior marginal gyrus ( t values: from -5.13 to 4.89, all P<0.001); patients with anti-GABA BR antibody-related encephalitis exhibited increased glucose metabolism in the bilateral hippocampi and right fusiform gyrus, and decreased glucose metabolism in the left middle frontal gyrus ( t values: from -3.82 to 3.91, all P<0.001). Anti-NMDAR encephalitis was characterized by decreased metabolism in the bilateral parietal lobes, occipital lobes, local frontal-temporal lobes, and bilateral thalami, as well as increased metabolism in the limbic lobe and local frontal-temporal-parietal lobes ( t values: from -8.30 to 7.30, all P<0.001), and the SUVR of the right occipital lobe was negatively correlated with mRS score at six months later ( rs=-0.64, P=0.014). Other subtypes of AE showed decreased glucose metabolism in different cerebral lobes. Conclusion:18F-FDG PET/CT can evaluate brain glucose metabolism in different subtypes of AE diseases and prognosis.

Objective To explore the latent class and influencing factors between different behavioral lifestyles in community patients with diabetes, to classify the population and reveal the behavioral lifestyle characteristics of different types of diabetes, and to provide a scientific basis for active health management of diabetes, the identification of high-risk groups and maximization of the effect of intervention measures. Methods From June to August 2022, a behavioral and lifestyle follow-up survey was conducted on 1 179 diabetes patients with electronic health records from 18 community health service centers in Pingshan District, Shenzhen. The latent class analysis (LCA) method was used to cluster the life and behavior style of the study subjects, and the disordered multi-classification logistic regression was used to analyze the influencing factors of each class. Results The LCA results showed that there were three latent classes of community diabetes patients: ^“overweight and obese group^” (28.4%), ^“balanced diet group^” (30.8%), and ^“vegetarian but persistent exercise group^” (40.8%). Logistic regression analysis results showed that age, total cholesterol , LDL , fasting blood glucose, comorbidities, and hypertension history affected the latent classes of behavioral lifestyle in diabetic patients in the community (P<0.05). Conclusion The behavioral lifestyle of community diabetes patients has obvious classification characteristics and obvious differentiation in terms of eating behavior. Doctors and health managers can issue corresponding lifestyle medicine prescriptions and formulate corresponding active health management measures to prevent the occurrence of risk factors related to diabetes patients in advance and formulate personalized intervention measures.

Objective:To analyze the status and influencing factors of empathy fatigue in hospice nurses based on ABC-X model (A: stressor event; B:resources available to a family; C: family sperceptions of the stressor; X: likelihood of crisis), so as to provide a reliable basis for developing comprehensive intervention strategies.Methods:A total of 325 nurses engaged in hospice care in China from April 2022 to June 2022 were selected by convenient sampling method. The influencing factors of empathy fatigue of hospice care nurses were analyzed by ABC-X model (working environment, resilience and coping style). The hospice care nurses were investigated by self-made general questionnaire, Chinese version of Empathy Fatigue Scale, Simplified Coping Style Questionnaire, Coping Style Resilience Scale and Nursing Work Environment Scale. The statistical analysis was performed by SPSS.26.0 statistical software.Results:There were 316 females and 9 males with age of (33.0 ± 7.9) years old. The total score of empathy fatigue in 325 hospice nurses was (91.16 ± 9.60) points, the scores of empathy satisfaction, ocupational burnout and secondary traumatic stress were (31.35 ± 6.01), (28.43 ± 5.86), (31.38 ± 5.76) points respectively. The scores of positive coping style, negative coping style, psychological resilience and nursing working environment were (37.46 ± 5.69), (21.28 ± 6.90), (89.84 ± 16.46), (117.13 ± 19.95) points respectively. The negative predictive factor for empathy satisfaction among nurses with the professional title of palliative care ( t=-4.22, P<0.05), and the positive predictive factors for simple coping strategies, psychological resilience, and nursing work environment ( t=4.52, 3.05, 9.03, all P<0.05), could explain 56.7% of the total variation. Psychological resilience, simplified coping strategies, nursing work environment were negative predictive factors for occupational burnout among hospice nurses ( t=-6.93, -3.54, -2.51, all P<0.05), while work nature was a positive predictive factor ( t=2.36, P<0.05), which could explain 49.4% of the total variation. Simplified coping strategies, psychological resilience, and nursing work environment were all negative predictors of secondary traumatic stress in hospice nurses ( t=-5.40, -3.25, -5.95, all P<0.05), which could explain 48.8% of the total variation. Conclusions:Based on the ABC-X model, it is found that the empathic fatigue of hospice nurses is mainly affected by the nursing work environment, mental resilience and coping styles. It is necessary for nursing managers to actively take measures to improve the working environment and coping styles of nurses, enhance their mental resilience and reduce their empathic fatigue.

OBJECTIVES: Many studies have shown that the quality of life for patients with atrial fibrillation (AF) is significantly impaired, but the impact on family function is still unclear. This study aims to evaluate the family function and quality of life in patients with AF using scales, to analyze the correlation between family function and quality of life, and to predict the influencing factors of quality of life. METHODS: A total of 223 patients with AF who were admitted to the Department of Cardiology and General Medicine of the Lanzhou University Second Hospital from January 1, 2021 to May 1, 2022, were selected as research subjects, the general information of patients with AF were collected via a questionnaire, the family function and quality of life were assessed by the Family Assessment Device (FAD) and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) scale. The patients were divided into a non-family functional disorder group and a family functional disorder group on the basis of their FAD scores. The above data were analyzed using SPSS 26.0 statistical software. RESULTS: Among the 223 patients, 64 (28.70%) were in the non-family functional disorder group, and 159 (71.30%) were in the family functional disorder group. The total score of FAD and scores of all dimensions in the family functional disorder group were higher than those in the non-family functional disorder group (all P<0.01). AFEQT total score and symptoms, treatment concerns and daily activities in the non-family functional disorder group were significantly higher than those in the family functional disorder group (all P<0.01). The Pearson linear analysis showed that there was a linear negative correlation between the total score and each dimension of FAD with the total score and each dimension of AFEQT (all P<0.01). The variables with statistical significance in the univariate analysis were included in the multiple linear regression analysis, and the result showed that female, and the problem solving, role, affective involvement, and general functioning dimensions of family function had an impact on the quality of life (all P<0.01). CONCLUSIONS Most patients with AF have different degrees of family dysfunction. The quality of life in patients with family functional disorder group is generally low. Female, and the problem solving, role, affective involvement, and general functioning of family function have a significant impact on the quality of life in patients with AF. In clinical treatment of AF, attention should be paid to the family function of patients, and family members can be involved in clinical intervention to improve family function and improve the quality of life.
Humans ; Female ; Atrial Fibrillation ; Quality of Life ; Patients ; Surveys and Questionnaires

Objective:To analyze the value of serum related cytokines in predicting intestinal mucosal injury in patients with severe acute pancreatitis (SAP) and its correlation with intestinal mucosal injury.Methods:A total of 92 patients with SAP admitted to the First Hospital of Qinhuangdao from January 2020 to December 2021 were included in the study. According to the presence or absence of intestinal mucosal barrier dysfunction, the patients were divided into intestinal mucosal barrier dysfunction group (33 cases) and non-intestinal mucosal barrier dysfunction group (59 cases). Another 100 healthy subjects were selected as the control group. Clinical data of the subjects were collected. Serum levels of procalcitonin (PCT), D-lactic acid (D-L), endotoxin, diamine oxidase (DAO), citrulline and intestinal fatty acid binding protein (I-FABP) of the three groups were compared, and the correlation between the above indexes was analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to analyze the value of each indicator in predicting intestinal mucosal barrier dysfunction in SAP patients.Results:The levels of serum PCT, D-L, endotoxin, DAO and I-FABP in intestinal mucosal barrier dysfunction group, non-intestinal mucosal barrier dysfunction group and control group showed a downward trend, while the level of serum citrulline showed an upward trend, with statistically significant difference (all P<0.05). Pearson correlation analysis showed that serum citrulline was negatively correlated with serum PCT, D-L, and endotoxin levels ( r=-0.740, -0.629, -0.310, all P<0.05); There was a positive correlation between serum DAO and serum PCT, D-L and endotoxin levels ( r=0.482, 0.779, 0.338, all P<0.05); There was a positive correlation between serum I-FABP and serum PCT, D-L and endotoxin levels ( r=0.613, 0.421, 0.341, all P<0.05). The ROC curve results showed that the area under the curve (AUC) of serum PCT, D-L, endotoxin, DAO, citrulline, and I-FABP predicting intestinal mucosal injury in SAP patients were 0.816, 0.789, 0.732, 0.801, 0.812, and 0.857, respectively. The AUC of the combination of the above indicators predicting intestinal mucosal barrier dysfunction in SAP patients was 0.909, significantly higher than that predicted by each index alone (all P<0.05). Conclusions:The occurrence of intestinal mucosal barrier dysfunction in SAP patients may be related to the increase of serum PCT, D-L, endotoxin, DAO, I-FABP levels and the decrease of citrulline levels. It may be considered to predict the risk of intestinal mucosal injury by detecting the levels of various indicators in patients′ serum.

Objective:To establish the reference values and neurological intervention cutoffs for cerebral ventricular size in neonates born at 33 +0-41 +6 weeks of gestation and to investigate the influential factors and reliability of the related indices. Methods:This study prospectively recruited 1 370 1-to 7-day neonates born or hospitalized at the Hunan Provincial Maternal and Child Health Care Hospital from February to August 2021. All the neonates, who were born between 33 +0 and 41 +6 weeks of gestation, were subjected to ultrasound scanning to obtain the indices, including ventricular index (VI), anterior horn width (AHW), thalamo-occipital distance (TOD), and ventricular height (VH). The reference value and neurological intervention cutoff for each index were set. Quantile regression was used to estimate the correlation between each index and continuous covariates [gestational age at birth (GA) and birth weight (BW)]. Mann-Whitney U test was used to analyze the differences in the medians of indices in different categorical covariates groups (males/females, left/right lateral ventricles, vaginal delivery/cesarean section, and singleton/multiple births). Intraclass correlation coefficient (ICC) calculated by a two-way mixed effect model and absolute agreement was used to access intra-rater reliability; ICC via a two-way random effect model and absolute agreement was utilized to rate inter-rater reliability (pool reliability: ICC below 0.50; moderate reliability: ICC between 0.50 and 0.75; good reliability: ICC between 0.75 and 0.90; excellent reliability: ICC exceeding 0.90). Results:The upper limits of reference values for AHW, TOD, VI, and VH in 555 (40.5%) preterm neonates were 2.7-3.5 mm, 20.9-22.5 mm, 12.6-13.7 mm, and 3.8-4.9 mm, and in 815 (59.5%) term newborns were 3.4-4.3 mm, 18.6-21.3 mm, 14.2-14.7 mm, and 3.4-3.8 mm, respectively. The cutoff of neurosurgical intervention for each index was the upper limit of reference value plus 4 mm. AHW median was positively correlated with GA [partial regression coefficient (PRC): 0.12, P<0.05], while TOD and VH medians were negatively correlated with GA (PRC:－0.31 and－0.06, both P<0.05). VI, AHW, and TOD medians were positively associated with BW (PRC: 0.46, 0.23, and 0.97, all P<0.05). The medians of VH, AHW, and TOD in the left cerebral ventricular exceeded those in the right cerebral ventricular, respectively (VH: 2.0 vs 1.8 mm, U=836 071.50; AHW: 1.8 vs 1.7 mm, U=874 141.50; TOD: 13.6 vs 12.5 mm, U=738 409.00, all P<0.05). The medians of AHW and VI in male neonates were greater than those in female newborns, respectively (AHW: 1.8 vs 1.7 mm, U=834 124.00; VI: 11.1 vs 10.8 mm, U=884 156.50, both P<0.05). The neonates delivered vaginally had greater AHW median, but smaller TOD median than those delivered by cesarean section (AHW: 2.0 vs 1.6 mm, U=685 546.00, P<0.001; TOD: 13.1 vs 12.9 mm, U=850 797.00, P=0.010). The AHW median in singleton newborns exceeded that in multiple births (1.9 vs 1.4 mm, U=356 999.00, P<0.001). The lower limits of 95% confidence intervals for intra-rater and inter-rater ICCs exceeded 0.75 and 0.50, respectively. Conclusion:Reference values and surgical intervention thresholds for VI, AHW, TOD, VH of newborns with a gestational age of 33 +0-41 +6 weeks were preliminarily established, and the reliability of these indicators were verified.

Objective:To investigate the clinical features,therapeutic methods,therapeutic efficacy,and prognostic characteristics of older patients with acute myeloid leukemia(AML).Methods:We collected data from 134 older patients with AML treated at Peking University International Hospital between January 2015 and February 2023.White blood cell count,bone marrow primitive cell count,cytogen-etic and molecular characteristics,and European LeukemiaNet(ELN)risk stratification at initial diagnosis were retrospectively ana-lyzed.Patients were assigned into two groups according to treatment plan―high-intensity chemotherapy and low-dose treatment―to determine whether intensive chemotherapy would yield survival benefits during treatment and the factors affecting survival.Results:Among 36 patients treated with high-intensity chemotherapy,22(61.1%)achieved complete response(CR);among 90 treated with low-intensity therapy,46(51.1%)achieved CR;and among 19 treated with azacitidine(AZA)+ venecra(VEN),14(73.7%)achieved CR.Medi-an overall survival(OS)was 15 months for high-intensity chemotherapy and 14.5 months for low-intensity treatment(P=0.226).According to ELN risk stratification,patients in the low,medium,and high risk groups exhibited OS of 18,14,and 9 months,respectively(P=0.009).OS for high-intensity chemotherapy and low-dose therapy was 22 and 15 months in the low-risk group(P=0.745),9 and 15 months in the medium-risk group(P=0.783),and 9 and 8 months in the high-risk group(P=0.739),respectively.Patients in the intensive chemotherapy group(n=36)had an OS of 15 and 17 months(P=0.689)compared with AZA+VEN treatment(n=19).The prognosis of six patients with TP53 mutation was significantly worse than those without the mutation,and the median OS was 2 months and 14 months,respectively(P=0.004).One-and 3-year survival rates for the low-,medium-and high-risk groups were 79%,53%,and 44%,and 41%,20%,and 3%,respectively.Multivariate analysis revealed that high peripheral blood white blood cell count(P=0.034),ELN risk stratification(P=0.002),and complications(P=0.017)were correlated with OS,while treatment intensity,age,sex,and bone marrow primitive cell count were not significantly correlated with OS.Conclusions:High-intensity chemotherapy did not yield a significant survival benefit in older patients with AML;however,this result needs to be confirmed in patients at low risk.Patients with TP53 mutations had a poor prognosis.Multivariate analyses revealed that baseline mo-lecular characteristics,leukocyte count,and comorbidities were more important than treatment intensity in predicting survival among older patients with AML.