OBJECTIVE: To explore the clinical features of patients with necrotizing soft tissue infection (NSTI) and the related factors for sepsis, so as to provide a basis for early intervention and improvement of patients' prognosis. METHODS: A retrospective case series study was conducted to analyze the clinical data of NSTI patients admitted to the department of burns and wound repair surgery of Guangdong Provincial People's Hospital from October 2021 to December 2024. Demographic information, underlying diseases, infection characteristics, laboratory test results and etiological findings at admission, treatment status, occurrence of complications (including sepsis) and prognosis were collected. Univariate and multivariate Logistic regression analyses were used to identify the associated factors for sepsis in NSTI patients. Receiver operator characteristic curves (ROC curves) were plotted to evaluate the predictive value of individual and combined factors for sepsis. RESULTS: A total of 159 NSTI patients were enrolled, mainly middle-aged and elderly males. Most patients had comorbidities, including diabetes mellitus (110 cases, 69.2%) and hypertension (67 cases, 42.1%). The main infection site was the lower extremities (104 cases, 65.4%). Common symptoms included redness (96 cases, 60.4%), swelling (129 cases, 81.1%), local heat (60 cases, 37.7%), pain (100 cases, 62.9%), and skin ulceration or necrosis (9 cases, 5.7%). Imaging findings included soft tissue swelling (66 cases, 57.9%), gas accumulation (41 cases, 36.0%), and abnormal signal/density shadows (50 cases, 43.9%). Staphylococcus aureus was the main pathogenic bacterium [12.0% (31/259)], and drug-resistant Escherichia coli had the highest detection rate among drug-resistant bacteria [35.1% (13/37)]. Regarding debridement and repair, most patients (80 cases, 50.3%) underwent debridement ≥ 72 hours after admission, while only 10.1% (16 cases) received debridement within 6 hours. Most patients underwent multiple debridements, with 2 times of debridements being the most common (68 cases, 42.8%), and the maximum times of debridements reached 6. The largest number of patients received secondary suture (44 cases, 27.7%). In terms of complications, sepsis was the most common (66 cases, 41.51%), followed by acute kidney injury, respiratory failure requiring mechanical ventilation, and multiple organ dysfunction syndrome (MODS), while disseminated intravascular coagulation (DIC) was the least common. During the follow-up period, 9 patients (5.66%) were readmitted within 90 days, and 11 patients died, with a mortality rate of 6.92%. Univariate analysis showed that diabetes, coronary heart disease, gout, body temperature, heart rate, C-reactive protein, platelet count, total bilirubin, albumin, creatinine, out-of-hospital treatment, and out-of-hospital use of antimicrobial agents were significantly associated with sepsis in NSTI patients (all P < 0.05). Multivariate Logistic regression analysis showed that coronary heart disease [odds ratio (OR) = 30.085, 95% confidence interval (95%CI) was 2.105-956.935], C-reactive protein (OR = 1.026, 95%CI was 1.009-1.054), and total bilirubin (OR = 1.436, 95%CI was 1.188-1.948) were independent associated factors for sepsis in NSTI patients (all P < 0.05). ROC curve analysis revealed that the combination of the three predictors yielded the highest AUC for predicting sepsis in NSTI patients compared to any individual predictor [area under the curve (AUC) = 0.799 (95%CI was 0.721-0.878)]. CONCLUSIONS The clinical features of NSTI patients show certain regularity. Coronary heart disease, C-reactive protein, and total bilirubin are independent associated factors for sepsis in NSTI patients.
Humans ; Retrospective Studies ; Male ; Sepsis ; Soft Tissue Infections/microbiology* ; Female ; Middle Aged ; Aged ; Adult ; Prognosis ; Risk Factors ; Necrosis ; Logistic Models ; Fasciitis, Necrotizing

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To explore the predictive potential of dual-energy CT (DECT) quantitative parameters in identifying breast cancer molecular subtypes and the expression of the epidermal growth factor receptor (EGFR) .Methods:A cohort of 97 breast cancer patients, treated between Jun. 2022 and Jun. 2024 were selected. The study compared DECT parameters-such as iodine concentration (IC) , normalized iodine concentration (NIC) , spectral curve slope (λ HU) , and effective atomic number (Z eff) in both arterial and venous phases across different molecular subtypes. A multiclass logistic regression model was employed to assess the parameters' value in predicting molecular subtypes, while a binary logistic regression model was used to evaluate their predictive value for EGFR expression. Results:Multiple Logistic regression analysis showed that after adjusting for confounder age and family history, IC ( OR=1.72, 2.78, 3.05) , NIC ( OR=2.52, 1.94, 2.93) , λ HU ( OR=2.08, 2.54, 3.17) and Z eff ( OR=2.03, 2.30, 2.37) at arterial stage were independently correlated with the molecular subtypes of breast cancer ( P<0.05) . Binary logistic regression analysis, adjusted for tumor size and lymph node metastasis, identified arterial phase IC ( OR=3.45) , NIC ( OR=2.73) , λ HU ( OR=2.59) , and Z eff ( OR=1.76) as independent risk factors for EGFR-positive breast cancer ( P<0.05) . Conclusion:DECT quantitative parameters, particularly arterial phase IC, NIC, λ HU, and Zeff, offer valuable insights into the molecular subtyping of breast cancer and EGFR expression, thereby assisting in the development of personalized treatment strategies.

Objective:To explore the predictive potential of dual-energy CT (DECT) quantitative parameters in identifying breast cancer molecular subtypes and the expression of the epidermal growth factor receptor (EGFR) .Methods:A cohort of 97 breast cancer patients, treated between Jun. 2022 and Jun. 2024 were selected. The study compared DECT parameters-such as iodine concentration (IC) , normalized iodine concentration (NIC) , spectral curve slope (λ HU) , and effective atomic number (Z eff) in both arterial and venous phases across different molecular subtypes. A multiclass logistic regression model was employed to assess the parameters' value in predicting molecular subtypes, while a binary logistic regression model was used to evaluate their predictive value for EGFR expression. Results:Multiple Logistic regression analysis showed that after adjusting for confounder age and family history, IC ( OR=1.72, 2.78, 3.05) , NIC ( OR=2.52, 1.94, 2.93) , λ HU ( OR=2.08, 2.54, 3.17) and Z eff ( OR=2.03, 2.30, 2.37) at arterial stage were independently correlated with the molecular subtypes of breast cancer ( P<0.05) . Binary logistic regression analysis, adjusted for tumor size and lymph node metastasis, identified arterial phase IC ( OR=3.45) , NIC ( OR=2.73) , λ HU ( OR=2.59) , and Z eff ( OR=1.76) as independent risk factors for EGFR-positive breast cancer ( P<0.05) . Conclusion:DECT quantitative parameters, particularly arterial phase IC, NIC, λ HU, and Zeff, offer valuable insights into the molecular subtyping of breast cancer and EGFR expression, thereby assisting in the development of personalized treatment strategies.

Objective:To explore relationships and differences of perceived social support and depression-anx-iety symptoms between rural-to-urban migrated residents and rural residents.Methods:A total of 5 958 rural-to-ur-ban migrated residents and 4 720 rural residents were recruited.The Patient Health Questionnaire-9,Generalized Anxiety Disorder-7,and Perceived Social Support Scale were used to assess symptoms of depression,anxiety,and social support,respectively.Network estimation,centrality and predictability measurement,accuracy and stability verification,and network comparison were conducted based on R 4.2.0 to compare the network structure differ-ences between the two groups of residents.Results:In rural-to-urban migrated residents,"lack of energy"in depres-sive symptoms and"inability to control worry"in anxiety symptoms were the nodes with the highest expected influ-ence(EI).In rural residents,"low self-evaluation"in depressive symptoms and"difficulty relaxing"in anxiety symptoms were the nodes with the highest EI.The highest node of perceived social support EI for both groups was"support from relatives/leaders."The bridge nodes were the same for rural-to-urban migrated residents and rural residents,with"be down in spirits"being the nodes with the highest bridge expected influence.The results of net-work comparison test showed that the overall network structure of rural-to-urban migrated residents and rural resi-dents was statistically different(P＜0.05).Conclusion:There are correlation and difference among depressive symptoms,anxiety symptoms,and perceived social support in rural-to-urban migrated and rural residents.

Objective:To explore the risk factors of suicidal ideation in community residents in Shandong province,China,and to establish a prediction model and a nomogram for the risk of suicidal ideation.Methods:To-tally 11 087 community residents in Jining City,Zoucheng City,and Weifang City,Shandong Province,were recrui-ted as the study subjects.The general information questionnaire,Composite International Diagnostic Interview-3.0,General Anxiety Disorder-7,were used to collect demographic information,mental health status,family information,and lifestyle using a computer-assisted interview system to conduct face-to-face interview.LASSO regression and binary logistic regression analyses were used to develop a nomogram model of the risk of suicidal ideation.Results:Young people,female,smoking,non-new town residents,no physical exercise,difficulty approaching people,anxiety symptoms and depression were effective predictors of suicidal ideation.The area under the curve(AUC)of the training set(AUC)was 0.89(95％CI:0.85-0.93)and AUC of the validation set(AUC)was 0.83(95％CI:0.75-0.92).Conclusion:The nomogram prediction model constructed in this study on suicidal ideation in com-munity residents has a high degree of differentiation and accuracy.It could be used to screen people at high risk of suicide and provide intervention to suicidal ideation in community residents.

Objective:To explore relationships and differences of perceived social support and depression-anx-iety symptoms between rural-to-urban migrated residents and rural residents.Methods:A total of 5 958 rural-to-ur-ban migrated residents and 4 720 rural residents were recruited.The Patient Health Questionnaire-9,Generalized Anxiety Disorder-7,and Perceived Social Support Scale were used to assess symptoms of depression,anxiety,and social support,respectively.Network estimation,centrality and predictability measurement,accuracy and stability verification,and network comparison were conducted based on R 4.2.0 to compare the network structure differ-ences between the two groups of residents.Results:In rural-to-urban migrated residents,"lack of energy"in depres-sive symptoms and"inability to control worry"in anxiety symptoms were the nodes with the highest expected influ-ence(EI).In rural residents,"low self-evaluation"in depressive symptoms and"difficulty relaxing"in anxiety symptoms were the nodes with the highest EI.The highest node of perceived social support EI for both groups was"support from relatives/leaders."The bridge nodes were the same for rural-to-urban migrated residents and rural residents,with"be down in spirits"being the nodes with the highest bridge expected influence.The results of net-work comparison test showed that the overall network structure of rural-to-urban migrated residents and rural resi-dents was statistically different(P＜0.05).Conclusion:There are correlation and difference among depressive symptoms,anxiety symptoms,and perceived social support in rural-to-urban migrated and rural residents.

Objective:To explore the risk factors of suicidal ideation in community residents in Shandong province,China,and to establish a prediction model and a nomogram for the risk of suicidal ideation.Methods:To-tally 11 087 community residents in Jining City,Zoucheng City,and Weifang City,Shandong Province,were recrui-ted as the study subjects.The general information questionnaire,Composite International Diagnostic Interview-3.0,General Anxiety Disorder-7,were used to collect demographic information,mental health status,family information,and lifestyle using a computer-assisted interview system to conduct face-to-face interview.LASSO regression and binary logistic regression analyses were used to develop a nomogram model of the risk of suicidal ideation.Results:Young people,female,smoking,non-new town residents,no physical exercise,difficulty approaching people,anxiety symptoms and depression were effective predictors of suicidal ideation.The area under the curve(AUC)of the training set(AUC)was 0.89(95％CI:0.85-0.93)and AUC of the validation set(AUC)was 0.83(95％CI:0.75-0.92).Conclusion:The nomogram prediction model constructed in this study on suicidal ideation in com-munity residents has a high degree of differentiation and accuracy.It could be used to screen people at high risk of suicide and provide intervention to suicidal ideation in community residents.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 &mu;m/year in women and 5.8 &mu;m/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.