Objective To explore the correlation between the immune status of patients with multiple myeloma(MM)and the dynamic changes in peripheral blood red blood cell distribution width standard deviation(RDW-SD),serum free light-chain κ/λ ratio(sFLCR),and soluble B-cell maturation antigen(sBCMA),as well as their implications for prognosis.This study aims to provide a reference for evaluating disease progression and assessing patient outcomes.Methods 182 MM patients admitted to the hospital between July 2019 and July 2021 were enrolled as the study group.All selected patients were followed up for 3 years,with 6 cases lost to follow-up,resulting in a final cohort of 176 patients.These patients were further divided into two groups based on their progno-sis:the poor-prognosis group(53 cases)and the good-prognosis group(123 cases).Additionally,50 healthy volunteers who underwent health check-ups during the same period were randomly selected as the control group.The immune status of both the study group and the control group was compared.Univariate analysis was conducted to identify factors associated with poor prognosis in MM patients,and Cox regression analysis was performed to determine risk factors for poor prognosis.The good-prognosis group was designated as the negative group,while the poor-prognosis group was designated as the positive group.The predictive value of peripheral blood RDW-SD,serum sFLCR,and sBCMA-both individually and in combination-for poor prognosis in MM patients was evaluated by constructing receiver operating characteristic(ROC)curves.The area under the curve(AUC)was calculated,and the optimal cut-off value was determined using the Youden index.Finally,the predictive value of the combined test was analyzed by fitting an appropriate equation.Results Levels of peripheral blood Th17 cells and platelet-to-lymphocyte ratio(PLR)were significantly higher in the study group compared to the control group(P<0.05),while the level of peripheral blood regulatory T cells(Tregs)was significantly lower than that in the control group(P<0.05).Additionally,levels of peripheral blood RDW-SD and serum sBCMA were significantly higher in the poor prognosis group compared to the good prognosis group(P<0.05),whereas the serum level of sFLCR was significantly lower than that in the good prognosis group(P<0.05).Cox regression analysis revealed that elevated peripheral blood RDW-SD(HR=1.091,95%CI:1.027～1.159),reduced serum sFLCR(HR=1.095,95%CI:1.035～1.159),and increased serum sBCMA(HR=1.095,95%CI:1.016～1.165)were independent risk factors for poor prognosis in patients with MM(P<0.05).ROC curve analysis demonstrated that the combination of peripheral blood RDW-SD,serum sFLCR,and sBCMA assays achieved an AUC value of 0.880 for predicting poor prognosis in MM patients,which was significantly higher than those of the three individual assays(AUC values:0.805,0.786,0.780;P<0.05).The sensitivity and specificity of this combined assay were 94.34%and 68.29%,respectively.Conclusions MM patients exhibited abnormal immune status and poor prognosis,which was associ-ated with elevated levels of peripheral blood RDW-SD and serum sBCMA,as well as reduced serum sFLCR.More-over,the combination of peripheral blood RDW-SD,serum sFLCR,and sBCMA demonstrated superior predictive value for poor prognosis in MM patients.

Objective:To identify the risk factors and their predictive value for complications in neonates with early-onset group B streptococcus (GBS) sepsis. Methods:This case-control study retrospectively analyzed 96 neonates with early-onset GBS sepsis (age of onset<7 days) admitted to Children's Hospital of Soochow University between January 1, 2007, and December 31, 2022. Patients were categorized into complication ( n=36) and non-complication ( n=60) groups. Receiver operating characteristic (ROC) curves determined optimal cutoff values of Pediatric Sequential Organ Failure Assessment (pSOFA) and Pediatric Logistic Organ Dysfunction Score 2 (PELOD-2) for predicting complications in the neonates with early-onset GBS sepsis. Independent t-tests, Mann-Whitney U tests, Chi-square tests and Fishe exact tests were used for group comparison of general information, clinical manifestations, auxiliary examinations, and treatment during hospitalization. Multivariate logistic regression identified independent risk factors, and ROC curves evaluated their predictive performance for complications in the neonates with early-onset GBS sepsis. Results:ROC analysis identified pSOFA>4.5 scores and PELOD-2>5.5 scores as optimal thresholds for complication prediction in neonates with early-onset GBS sepsis. (1) The complication group exhibited higher rates of preterm birth [30.6% (11/36) vs. 5.0% (3/60), χ2=11.80], maternal clinical chorioamnionitis [25.0% (9/36) vs. 5.0% (3/60), χ2=6.50], prolonged rupture of membranes≥18 h [22.2% (8/36) vs. 5.0% (3/60), χ2=4.99], invasive mechanical ventilation [36.1% (13/36) vs. 13.3% (8/60), χ2=6.83], fever [22.2% (8/36) vs. 3.3% (2/60), χ2=6.70], lethargy [77.8% (28/36) vs. 51.7% (31/60), χ2=6.48], mottled skin as the initial clinical manifestation [38.9% (14/36) vs. 20.0% (12/60), χ2=4.07], leukopenia [44.4% (16/36) vs. 18.3% (11/60), χ2=7.59], hypoalbuminemia [27.8% (10/36) vs. 3.3% (2/60), χ2=10.16], pSOFA>4.5 [83.3% (30/36) vs. 35.0% (21/60), χ2=21.11], PELOD-2>5.5 [50.0% (18/36) vs. 5.0% (3/60), χ2=26.66], and dual-positive blood and cerebrospinal fluid cultures [25.0% (9/36) vs. 0.0% (0/60), Fisher exact test] compared to the non-complication group (all P<0.05). Serum creatinine [(88.4±17.7) vs. (61.9±17.7) μmol/L, t=－6.02], urea nitrogen [(3.7±0.4) vs. (3.4±0.6) mmol/L, t=－3.18], and lactate [(7.5±3.4) vs. (5.8±2.2) mmol/L, t=－2.80] were elevated, while fibrinogen [(2.2±1.1) vs. (2.7±1.0) g/L, t=2.03], pH (7.3±0.2 vs. 7.4±0.1, t=2.04), and albumin [(28.2±3.9) vs. (31.9±4.2) g/L, t=4.32] were reduced in the complication group (all P<0.05). (2) Multivariate analysis identified preterm birth ( OR=6.642, 95% CI: 1.210-36.473), along with hypoalbuminemia ( OR=8.202, 95% CI: 1.184-56.811), pSOFA>4.5 scores ( OR=5.284, 95% CI: 1.573-17.749), and PELOD-2>5.5 scores ( OR=8.464, 95% CI: 1.922-37.279) assessed on admission day 1 as independent risk factors (all P<0.05). The area under the curve for predicting complications in early-onset GBS sepsis neonates was 0.628 (95% CI: 0.523-0.724) for preterm birth, and 0.622 (95% CI: 0.517-0.719), 0.742 (95% CI: 0.642-0.826), and 0.725 (95% CI: 0.624-0.811) for hypoalbuminemia, pSOFA>4.5 scores, and PELOD-2>5.5 scores assessed on admission day 1, respectively. The combined predictive model integrating all four risk factors achieved the highest area under the curve of 0.868 (95% CI: 0.784-0.929). Conclusion:Preterm birth as well as hypoalbuminemia, pSOFA>4.5 scores, and PELOD-2>5.5 scores at admission are critical risk factors for complications in early-onset GBS sepsis, warranting heightened clinical vigilance.

Objective:To investigate the association between the triglyceride-glucose(TyG)index and the incidence and mortality of cardiovascular disease(CVD)in a large population-based cohort.Methods:Participants aged 40-79 years without a history of CVD at baseline were drawn from the CHi-nese Electronic health Records Research in Yinzhou(CHERRY)study between January 1,2010,and May 31,2020.The TyG index was calculated using baseline triglyceride and fasting blood glucose.Cox proportional hazards models were used to assess the association between the TyG index and the composite outcome of CVD(incidence and mortality),adjusting for age,gender,education,region,smoking sta-tus,body mass index,systolic blood pressure,and total cholesterol.Hazard ratios(HR)and 95％confi-dence intervals(CI)were calculated.Nonlinear associations between the TyG index and CVD were fur-ther evaluated using restricted cubic splines,and subgroup analyses by gender and age were conducted to explore potential differences.Results:A total of 226 406 individuals were included,with a mean age of(55.0±9.7)years at baseline,46.8％of whom were men,and a median TyG index of 8.68.Over a median follow-up of 7.99 years,9 815(4.34％)participants experienced CVD incidence or mortality.After adjusting for age,gender,education,region,smoking status,body mass index,systolic blood pressure and total cholesterol,the risk of CVD increased with higher TyG index levels(P＜0.001).The risk in the highest TyG quartile(TyG＞9.10)was 42％higher than in the lowest quartile(TyG ≤8.32)(HR=1.42,95％CI:1.34-1.51).Individuals under 60 years had a higher HR for CVD compared with those aged 60 years and above(HR:1.71 vs.1.27,P＜0.05).Restricted cubic spline analysis revealed a reverse L-shaped association between the TyG index and CVD risk in the overall population(P＜0.001 for nonlinear trend),with risk increasing after the TyG index exceeded 8.67.However,the threshold varied by gender,with a lower threshold in women(8.51)than in men(8.67).Conclusion:A significant nonlinear relationship was revealed between the TyG index and CVD risk,with a threshold effect.The risk of CVD increased once the TyG index surpassed a certain threshold,with a lower threshold in women than in men.These findings suggest that cardiovascular risk prediction and interven-tions based on the TyG index should be gender-stratified,and early intervention for individuals under 60 years old might have important public health implications.

Objective:To investigate the association between the triglyceride-glucose(TyG)index and the incidence and mortality of cardiovascular disease(CVD)in a large population-based cohort.Methods:Participants aged 40-79 years without a history of CVD at baseline were drawn from the CHi-nese Electronic health Records Research in Yinzhou(CHERRY)study between January 1,2010,and May 31,2020.The TyG index was calculated using baseline triglyceride and fasting blood glucose.Cox proportional hazards models were used to assess the association between the TyG index and the composite outcome of CVD(incidence and mortality),adjusting for age,gender,education,region,smoking sta-tus,body mass index,systolic blood pressure,and total cholesterol.Hazard ratios(HR)and 95％confi-dence intervals(CI)were calculated.Nonlinear associations between the TyG index and CVD were fur-ther evaluated using restricted cubic splines,and subgroup analyses by gender and age were conducted to explore potential differences.Results:A total of 226 406 individuals were included,with a mean age of(55.0±9.7)years at baseline,46.8％of whom were men,and a median TyG index of 8.68.Over a median follow-up of 7.99 years,9 815(4.34％)participants experienced CVD incidence or mortality.After adjusting for age,gender,education,region,smoking status,body mass index,systolic blood pressure and total cholesterol,the risk of CVD increased with higher TyG index levels(P＜0.001).The risk in the highest TyG quartile(TyG＞9.10)was 42％higher than in the lowest quartile(TyG ≤8.32)(HR=1.42,95％CI:1.34-1.51).Individuals under 60 years had a higher HR for CVD compared with those aged 60 years and above(HR:1.71 vs.1.27,P＜0.05).Restricted cubic spline analysis revealed a reverse L-shaped association between the TyG index and CVD risk in the overall population(P＜0.001 for nonlinear trend),with risk increasing after the TyG index exceeded 8.67.However,the threshold varied by gender,with a lower threshold in women(8.51)than in men(8.67).Conclusion:A significant nonlinear relationship was revealed between the TyG index and CVD risk,with a threshold effect.The risk of CVD increased once the TyG index surpassed a certain threshold,with a lower threshold in women than in men.These findings suggest that cardiovascular risk prediction and interven-tions based on the TyG index should be gender-stratified,and early intervention for individuals under 60 years old might have important public health implications.

Objective To explore the correlation between the immune status of patients with multiple myeloma(MM)and the dynamic changes in peripheral blood red blood cell distribution width standard deviation(RDW-SD),serum free light-chain κ/λ ratio(sFLCR),and soluble B-cell maturation antigen(sBCMA),as well as their implications for prognosis.This study aims to provide a reference for evaluating disease progression and assessing patient outcomes.Methods 182 MM patients admitted to the hospital between July 2019 and July 2021 were enrolled as the study group.All selected patients were followed up for 3 years,with 6 cases lost to follow-up,resulting in a final cohort of 176 patients.These patients were further divided into two groups based on their progno-sis:the poor-prognosis group(53 cases)and the good-prognosis group(123 cases).Additionally,50 healthy volunteers who underwent health check-ups during the same period were randomly selected as the control group.The immune status of both the study group and the control group was compared.Univariate analysis was conducted to identify factors associated with poor prognosis in MM patients,and Cox regression analysis was performed to determine risk factors for poor prognosis.The good-prognosis group was designated as the negative group,while the poor-prognosis group was designated as the positive group.The predictive value of peripheral blood RDW-SD,serum sFLCR,and sBCMA-both individually and in combination-for poor prognosis in MM patients was evaluated by constructing receiver operating characteristic(ROC)curves.The area under the curve(AUC)was calculated,and the optimal cut-off value was determined using the Youden index.Finally,the predictive value of the combined test was analyzed by fitting an appropriate equation.Results Levels of peripheral blood Th17 cells and platelet-to-lymphocyte ratio(PLR)were significantly higher in the study group compared to the control group(P<0.05),while the level of peripheral blood regulatory T cells(Tregs)was significantly lower than that in the control group(P<0.05).Additionally,levels of peripheral blood RDW-SD and serum sBCMA were significantly higher in the poor prognosis group compared to the good prognosis group(P<0.05),whereas the serum level of sFLCR was significantly lower than that in the good prognosis group(P<0.05).Cox regression analysis revealed that elevated peripheral blood RDW-SD(HR=1.091,95%CI:1.027～1.159),reduced serum sFLCR(HR=1.095,95%CI:1.035～1.159),and increased serum sBCMA(HR=1.095,95%CI:1.016～1.165)were independent risk factors for poor prognosis in patients with MM(P<0.05).ROC curve analysis demonstrated that the combination of peripheral blood RDW-SD,serum sFLCR,and sBCMA assays achieved an AUC value of 0.880 for predicting poor prognosis in MM patients,which was significantly higher than those of the three individual assays(AUC values:0.805,0.786,0.780;P<0.05).The sensitivity and specificity of this combined assay were 94.34%and 68.29%,respectively.Conclusions MM patients exhibited abnormal immune status and poor prognosis,which was associ-ated with elevated levels of peripheral blood RDW-SD and serum sBCMA,as well as reduced serum sFLCR.More-over,the combination of peripheral blood RDW-SD,serum sFLCR,and sBCMA demonstrated superior predictive value for poor prognosis in MM patients.

Objective:To identify the risk factors and their predictive value for complications in neonates with early-onset group B streptococcus (GBS) sepsis. Methods:This case-control study retrospectively analyzed 96 neonates with early-onset GBS sepsis (age of onset<7 days) admitted to Children's Hospital of Soochow University between January 1, 2007, and December 31, 2022. Patients were categorized into complication ( n=36) and non-complication ( n=60) groups. Receiver operating characteristic (ROC) curves determined optimal cutoff values of Pediatric Sequential Organ Failure Assessment (pSOFA) and Pediatric Logistic Organ Dysfunction Score 2 (PELOD-2) for predicting complications in the neonates with early-onset GBS sepsis. Independent t-tests, Mann-Whitney U tests, Chi-square tests and Fishe exact tests were used for group comparison of general information, clinical manifestations, auxiliary examinations, and treatment during hospitalization. Multivariate logistic regression identified independent risk factors, and ROC curves evaluated their predictive performance for complications in the neonates with early-onset GBS sepsis. Results:ROC analysis identified pSOFA>4.5 scores and PELOD-2>5.5 scores as optimal thresholds for complication prediction in neonates with early-onset GBS sepsis. (1) The complication group exhibited higher rates of preterm birth [30.6% (11/36) vs. 5.0% (3/60), χ2=11.80], maternal clinical chorioamnionitis [25.0% (9/36) vs. 5.0% (3/60), χ2=6.50], prolonged rupture of membranes≥18 h [22.2% (8/36) vs. 5.0% (3/60), χ2=4.99], invasive mechanical ventilation [36.1% (13/36) vs. 13.3% (8/60), χ2=6.83], fever [22.2% (8/36) vs. 3.3% (2/60), χ2=6.70], lethargy [77.8% (28/36) vs. 51.7% (31/60), χ2=6.48], mottled skin as the initial clinical manifestation [38.9% (14/36) vs. 20.0% (12/60), χ2=4.07], leukopenia [44.4% (16/36) vs. 18.3% (11/60), χ2=7.59], hypoalbuminemia [27.8% (10/36) vs. 3.3% (2/60), χ2=10.16], pSOFA>4.5 [83.3% (30/36) vs. 35.0% (21/60), χ2=21.11], PELOD-2>5.5 [50.0% (18/36) vs. 5.0% (3/60), χ2=26.66], and dual-positive blood and cerebrospinal fluid cultures [25.0% (9/36) vs. 0.0% (0/60), Fisher exact test] compared to the non-complication group (all P<0.05). Serum creatinine [(88.4±17.7) vs. (61.9±17.7) μmol/L, t=－6.02], urea nitrogen [(3.7±0.4) vs. (3.4±0.6) mmol/L, t=－3.18], and lactate [(7.5±3.4) vs. (5.8±2.2) mmol/L, t=－2.80] were elevated, while fibrinogen [(2.2±1.1) vs. (2.7±1.0) g/L, t=2.03], pH (7.3±0.2 vs. 7.4±0.1, t=2.04), and albumin [(28.2±3.9) vs. (31.9±4.2) g/L, t=4.32] were reduced in the complication group (all P<0.05). (2) Multivariate analysis identified preterm birth ( OR=6.642, 95% CI: 1.210-36.473), along with hypoalbuminemia ( OR=8.202, 95% CI: 1.184-56.811), pSOFA>4.5 scores ( OR=5.284, 95% CI: 1.573-17.749), and PELOD-2>5.5 scores ( OR=8.464, 95% CI: 1.922-37.279) assessed on admission day 1 as independent risk factors (all P<0.05). The area under the curve for predicting complications in early-onset GBS sepsis neonates was 0.628 (95% CI: 0.523-0.724) for preterm birth, and 0.622 (95% CI: 0.517-0.719), 0.742 (95% CI: 0.642-0.826), and 0.725 (95% CI: 0.624-0.811) for hypoalbuminemia, pSOFA>4.5 scores, and PELOD-2>5.5 scores assessed on admission day 1, respectively. The combined predictive model integrating all four risk factors achieved the highest area under the curve of 0.868 (95% CI: 0.784-0.929). Conclusion:Preterm birth as well as hypoalbuminemia, pSOFA>4.5 scores, and PELOD-2>5.5 scores at admission are critical risk factors for complications in early-onset GBS sepsis, warranting heightened clinical vigilance.

Objective:To evaluate the health benefits and intervention efficiency of different strategies of initiating antihypertensive therapy for the primary prevention of cardiovascular diseases in a community-based Chinese population from the Chinese electronic health records research in Yinzhou(CHERRY)study.Methods:A decision-analytic Markov model was used to simulate and compare different antihy-pertensive initiation strategies,including:Strategy 1,initiation of antihypertensive therapy for Chinese adults with systolic blood pressure(SBP)≥140 mmHg(2020 Chinese guideline on the primary preven-tion of cardiovascular diseases);Strategy 2,initiation of antihypertensive therapy for Chinese adults with SBP≥130 mmHg;Strategy 3,initiation of antihypertensive therapy for Chinese adults with SBP ≥140 mmHg,or with SBP between 130 and 140 mmHg and at high risk of cardiovascular diseases(2017 American College of Cardiology/American Heart Association guideline for the prevention,detection,evaluation,and management of high blood pressure in adults);Strategy 4,initiation of antihypertensive therapy for Chinese adults with SBP≥ 160 mmHg,or with SBP between 140 and 160 mmHg and at high risk of car-diovascular diseases(2019 United Kingdom National Institute for Health and Care Excellence guideline for the hypertension in adults:Diagnosis and management).The high 10-year cardiovascular risk was de-fined as the predicted risk over 10％based on the 2019 World Health Organization cardiovascular disease risk charts.Different strategies were simulated by the Markov model for ten years(cycles),with parame-ters mainly from the CHERRY study or published literature.After ten cycles of simulation,the numbers of quality-adjusted life years(QALY),cardiovascular events and all-cause deaths were calculated to evaluate the health benefits of each strategy,and the numbers needed to treat(NNT)for each cardiovas-cular event or all-cause death could be prevented were calculated to assess the intervention efficiency.One-way sensitivity analysis on the uncertainty of incidence rates of cardiovascular disease and probabilis-tic sensitivity analysis on the uncertainty of hazard ratios of interventions were conducted.Results:A to-tal of 213 987 Chinese adults aged 35-79 years without cardiovascular diseases were included.Com-pared with strategy 1,the number of cardiovascular events that could be prevented in strategy 2 increased by 666(95％UI:334-975),while the NNT per cardiovascular event prevented increased by 10(95％UI:7-20).In contrast to strategy 1,the number of cardiovascular events that could be prevented in strategy 3 increased by 388(95％UI:194-569),and the NNT per cardiovascular event prevented decreased by 6(95％UI:4-12),suggesting that strategy 3 had better health benefits and intervention efficiency.Compared to strategy 1,although the number of cardiovascular events that could be prevented decreased by 193(95％UI:98-281)in strategy 4,the NNT per cardiovascular event prevented decreased by 18(95％UI:13-37)with better efficiency.The results were consistent in the sensitivity analyses.Conclusion:When initiating antihypertensive therapy in an economically developed area of China,the strategy combined with cardiovascular risk assessment is more efficient than those purely based on the SBP threshold.The cardiovascular risk assessment strategy with different SBP thresholds is suggested to balance health benefits and intervention efficiency in diverse populations.

OBJECTIVE To evaluate the cost-effectiveness of the first-line treatment using the combination therapy of sugemalimab and chemotherapy (hereinafter referred to as the "combination therapy") for advanced esophageal squamous cell carcinoma (ESCC) with high programmed death-ligand 1 (PD-L1) expression from the perspective of the Chinese healthcare system. METHODS A partitioned survival model was constructed based on data from the GEMSTONE-304 study. The model cycle was set at 3 weeks,with a study duration of 10 years and a discount rate of 5％. The primary output parameters of the model included total costs,quality-adjusted life year (QALY),incremental costs,and incremental cost-effectiveness ratio (ICER). Cost-utility analysis was employed to assess the economic feasibility of the combination therapy compared to chemotherapy alone. The robustness of the base case analysis results was evaluated through univariate sensitivity analysis,probabilistic sensitivity analysis,and scenario analysis. RESULTS The ICER of the combination therapy compared to chemotherapy alone was 288430.35 yuan/QALY,significantly exceeding the willingness-to-pay (WTP) threshold of 173354.52 yuan/QALY which was set at 1.94 times the per capita gross domestic product (GDP) in 2023. The price of sugemalimab was the primary factor influencing the ICER. When the WTP threshold was set at 1.94 times the per capita GDP (173354.52 yuan/QALY),the probability of the combination therapy being cost-effective compared to chemotherapy alone was 0. The combination therapy only became cost-effective compared to chemotherapy alone when the price of the drug dropped to 6107.41 yuan per box (600 mg). CONCLUSIONS From the perspective of the Chinese healthcare system,the combination therapy for first-line treatment of advanced ESCC with high PD-L1 expression is not cost-effective;the combination therapy is cost-effective when the price of sugemalimab decreas by 50.65％.

Objective:The aims of this study were to develop a simple and easy-to-use scale, named Methamphetamine Use Disorder (MUD) Severity Scale (MUDSS), and to complete the reliability and validity tests, so as to provide a new tool for the measurement of substance use.Methods:Participants with MUD ( n=286) were recruited from 2 compulsory isolated detoxification centers in Changsha, Hunan Province from April to September 2019. The item pool of MUDSS ( n=19) was obtained according to diagnostic items of stimulant use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the opinions of experts in the field of addiction. The scale was applied to participants with MUD. Items of the scale were first screened according to the results of item analysis, and then the formal scale was formed. Exploratory factor analysis was used to construct the scale dimension, and the reliability of the total scale and each dimension were tested by Cronbach α coefficient. Pearson correlation analysis was used to verify criterion validity and DSM-5 was used as criterion. Results:The effective information of 257 subjects was collected. According to the results of item analysis, the fourth item from the preliminary MUDSS was deleted, and the remaining 18 items were included in the formal scale, including four dimensions: adverse consequences, tolerance, priority, and craving. The internal consistency coefficient of the total scale and the four dimensions ranged from 0.646 to 0.909, and the test-retest reliability ranged from 0.592 to 0.724. The correlation between MUDSS total score and DSM-5 was 0.654.Conclusions:The reliability and validity of MUDSS are good and have reached the standard of psychometrics, therefore it can be further applied in a larger sample of subjects with MUD.

Objective:The aims of this study were to develop a simple and easy-to-use scale, named Methamphetamine Use Disorder (MUD) Severity Scale (MUDSS), and to complete the reliability and validity tests, so as to provide a new tool for the measurement of substance use.Methods:Participants with MUD ( n=286) were recruited from 2 compulsory isolated detoxification centers in Changsha, Hunan Province from April to September 2019. The item pool of MUDSS ( n=19) was obtained according to diagnostic items of stimulant use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the opinions of experts in the field of addiction. The scale was applied to participants with MUD. Items of the scale were first screened according to the results of item analysis, and then the formal scale was formed. Exploratory factor analysis was used to construct the scale dimension, and the reliability of the total scale and each dimension were tested by Cronbach α coefficient. Pearson correlation analysis was used to verify criterion validity and DSM-5 was used as criterion. Results:The effective information of 257 subjects was collected. According to the results of item analysis, the fourth item from the preliminary MUDSS was deleted, and the remaining 18 items were included in the formal scale, including four dimensions: adverse consequences, tolerance, priority, and craving. The internal consistency coefficient of the total scale and the four dimensions ranged from 0.646 to 0.909, and the test-retest reliability ranged from 0.592 to 0.724. The correlation between MUDSS total score and DSM-5 was 0.654.Conclusions:The reliability and validity of MUDSS are good and have reached the standard of psychometrics, therefore it can be further applied in a larger sample of subjects with MUD.