Objective:To analyze the risk factors for muscle cramps in maintenance hemodialysis patients and construct a nomogram prediction model.Methods:It was a retrospective cohort study. Patients undergoing regular hemodialysis at the Blood Purification Center of the Fourth Hospital of Hebei Medical University (West and East Campuses) from June 2023 to December 2023 were enrolled in this study. Patients were divided into a muscle cramps group and a non-muscle cramps group based on whether cramps occurred during or after dialysis. Patients from the West Campus were allocated to the training set, while those from the East Campus were assigned to the validation set, with an approximately 5∶1 ratio. Multivariate logistic regression analysis was used to identify risk factors for muscle cramps in the training set. A nomogram prediction model was constructed using R software. Model performance was evaluated using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis in both the training and validation sets.Results:A total of 498 maintenance hemodialysis patients were enrolled, including 409 in the training set (22.98% incidence of muscle cramps) and 89 in the validation set. Multivariate logistic regression analysis revealed that heart failure history ( OR=8.566, 95% CI 2.448-29.979, P=0.001), pre-dialysis corrected narrowed inferior vena cava width ( OR=0.531, 95% CI 0.433-0.650, P<0.001), increased ultrafiltration rate ( OR=1.002, 95% CI 1.001-1.003, P=0.002), decreased hemoglobin level ( OR=0.971, 95% CI 0.948-0.994, P=0.014), and decreased serum albumin ( OR=0.886, 95% CI 0.799-0.982, P=0.021) were independent associated factors for muscle cramps in the training set. The nomogram model based on these factors demonstrated an area under the ROC curve ( AUC) of 0.813 (95% CI 0.760-0.866, P<0.001) in the training set, with a Brier score of 0.129, indicating stable predictive performance. In the validation set, the area under of the ROC curve was 0.821 (95% CI 0.731-0.911, P<0.001) with a Brier score of 0.142. The decision curve showed that the model provided high clinical net benefit when the risk threshold probability for muscle cramps ranged from 0.22 to 0.77. Conclusion:Combined heart failure, narrowed inferior vena cava width, increased ultrafiltration rate, and decreased hemoglobin and serum albumin levels were the independent correlated factors for muscle spasm in maintenance hemodialysis patients. The nomogram model constructed based on these risk factors holds significant clinical value for predicting muscle cramps in maintenance hemodialysis patients.

Objective:To analyze the risk factors for muscle cramps in maintenance hemodialysis patients and construct a nomogram prediction model.Methods:It was a retrospective cohort study. Patients undergoing regular hemodialysis at the Blood Purification Center of the Fourth Hospital of Hebei Medical University (West and East Campuses) from June 2023 to December 2023 were enrolled in this study. Patients were divided into a muscle cramps group and a non-muscle cramps group based on whether cramps occurred during or after dialysis. Patients from the West Campus were allocated to the training set, while those from the East Campus were assigned to the validation set, with an approximately 5∶1 ratio. Multivariate logistic regression analysis was used to identify risk factors for muscle cramps in the training set. A nomogram prediction model was constructed using R software. Model performance was evaluated using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis in both the training and validation sets.Results:A total of 498 maintenance hemodialysis patients were enrolled, including 409 in the training set (22.98% incidence of muscle cramps) and 89 in the validation set. Multivariate logistic regression analysis revealed that heart failure history ( OR=8.566, 95% CI 2.448-29.979, P=0.001), pre-dialysis corrected narrowed inferior vena cava width ( OR=0.531, 95% CI 0.433-0.650, P<0.001), increased ultrafiltration rate ( OR=1.002, 95% CI 1.001-1.003, P=0.002), decreased hemoglobin level ( OR=0.971, 95% CI 0.948-0.994, P=0.014), and decreased serum albumin ( OR=0.886, 95% CI 0.799-0.982, P=0.021) were independent associated factors for muscle cramps in the training set. The nomogram model based on these factors demonstrated an area under the ROC curve ( AUC) of 0.813 (95% CI 0.760-0.866, P<0.001) in the training set, with a Brier score of 0.129, indicating stable predictive performance. In the validation set, the area under of the ROC curve was 0.821 (95% CI 0.731-0.911, P<0.001) with a Brier score of 0.142. The decision curve showed that the model provided high clinical net benefit when the risk threshold probability for muscle cramps ranged from 0.22 to 0.77. Conclusion:Combined heart failure, narrowed inferior vena cava width, increased ultrafiltration rate, and decreased hemoglobin and serum albumin levels were the independent correlated factors for muscle spasm in maintenance hemodialysis patients. The nomogram model constructed based on these risk factors holds significant clinical value for predicting muscle cramps in maintenance hemodialysis patients.

Objective:To analyze the effect of hyperbaric oxygen (HBO) combined with large bone flap decompression in the treatment of craniocerebral injury and its influence on the prognosis of cognitive function.Methods:A total of 108 patients with craniocerebral injury admitted to the Neurosurgery Department of Anyang People′s Hospital from the June of 2015 to the December of 2017 were selected and divided into control group and observation group, with 54 cases in each group. The control group was given the modified large bone flap decompression and other conventional symptomatic and supportive treatments. The observation group was treated with HBO on the basis of the treatments of the control group. The clinical efficacy of the two groups was compared after 3 courses of treatment. The peak systolic velocity ( Vs), mean velocity ( Vm) of blood flow, and pulsatility index (PI) of the middle cerebral artery were measured by transcranial doppler, the intracranial pressure and arterial partial pressure of oxygen (PaO 2) were observed, and the levels of serum Tau protein and glial fibrillary acidic protein (GFAP) were detected. The Neurobehavioral Cognitive Status Examination (NCSE) was used to assess the effect on the prognosis of cognitive function. Results:After 3 courses of treatment, the total effective rate of the observation group (83.33%) was significantly higher than that of the control group (62.96%) ( χ2=8.585, P<0.05). In both groups, Vs, Vm, and PaO 2 significantly increased, and the PI and intracranial pressure significantly decreased. Regarding the improvements of these indicators, those of the observation group were better than those of the control group, with statistically significant difference ( P<0.05). The levels of serum Tau protein and GFAP in both groups decreased, and the levels in the observation group were significantly lower than those in the control group ( P<0.05). Cognitive function scores in both groups increased, and the score of the observation group was significantly higher than that of the control group ( P<0.05). Conclusion:HBO combined with large bone flap decompression treatment can perceptibly improve the cerebral blood flow, reduce the levels of serum Tau protein and GFAP, promote the nerve functional recovery, and improve the cognitive ability, which is worthy of popularization and application in clinic.

Objective:To analyze the effect of hyperbaric oxygen (HBO) combined with large bone flap decompression in the treatment of craniocerebral injury and its influence on the prognosis of cognitive function.Methods:A total of 108 patients with craniocerebral injury admitted to the Neurosurgery Department of Anyang People′s Hospital from the June of 2015 to the December of 2017 were selected and divided into control group and observation group, with 54 cases in each group. The control group was given the modified large bone flap decompression and other conventional symptomatic and supportive treatments. The observation group was treated with HBO on the basis of the treatments of the control group. The clinical efficacy of the two groups was compared after 3 courses of treatment. The peak systolic velocity ( Vs), mean velocity ( Vm) of blood flow, and pulsatility index (PI) of the middle cerebral artery were measured by transcranial doppler, the intracranial pressure and arterial partial pressure of oxygen (PaO 2) were observed, and the levels of serum Tau protein and glial fibrillary acidic protein (GFAP) were detected. The Neurobehavioral Cognitive Status Examination (NCSE) was used to assess the effect on the prognosis of cognitive function. Results:After 3 courses of treatment, the total effective rate of the observation group (83.33%) was significantly higher than that of the control group (62.96%) ( χ2=8.585, P<0.05). In both groups, Vs, Vm, and PaO 2 significantly increased, and the PI and intracranial pressure significantly decreased. Regarding the improvements of these indicators, those of the observation group were better than those of the control group, with statistically significant difference ( P<0.05). The levels of serum Tau protein and GFAP in both groups decreased, and the levels in the observation group were significantly lower than those in the control group ( P<0.05). Cognitive function scores in both groups increased, and the score of the observation group was significantly higher than that of the control group ( P<0.05). Conclusion:HBO combined with large bone flap decompression treatment can perceptibly improve the cerebral blood flow, reduce the levels of serum Tau protein and GFAP, promote the nerve functional recovery, and improve the cognitive ability, which is worthy of popularization and application in clinic.

Objective To compare the efficacy of partial splenic embolization (PSE)with 150－350 μm and 350－560 μm polyvinyl alcohol (PVA).Methods A total of 24 patients were analyzed retrospectively in this study.Among them,9 patients underwent PSE with PVA of 1 50－350 μm (group A)and 1 5 patients with PVA of 350－560 μm (group B).Hematological parameters including white blood cell and platelet counts before and 1 week after surgery were compared between the two groups,as well as postoperative complications. Results The white blood cell and platelet counts were both significantly increased after 1 week of surgery compared with that before surgery (both P＜0.05).Furthermore,group A had obvious advantage over group B in increasing platelets (P＝0.05).The incidences of postoperative complications were 100% (9/9)in group A and 87% (13/15)in group B,respectively,but the incidence and severity of complications between two groups were comparable.Conclusion PSE with PVA of 1 50－3 50 μm has advantage in postoperative platelet improvement over PVA of 350－560 μm.

Objective To observe the effects and regulatory mechanism of rotavirus infection on the expression and bioactivity of Na+/H+exchanger 3 (NHE3) on Caco-2 cells. Methods A cell model of Caco-2 cells expressing NHE3 was constructed. Four groups were set up,which were control(CTL) group, rotavirus(RV) infection group, Cdc42 inhibitor (Pirl-1) group and Pirl-1+RV group. Bioactivity and ex-pression of NHE3 on the surface of Caco-2 cells were determined by BCECF-AM and biotinylation method, respectively. Expression of Cdc42 protein was measured by Western blot. Co-immunoprecipitation was per-formed to detect the interaction between NHE3 and Cdc42. Results Compared with the CTL group,RV in-fection significantly inhibited the bioactivity and expression of NHE3 on Caco-2 cells. These inhibitory effects were antagonized by Pirl-1. Moreover,RV infection enhanced the expression of Cdc42 protein and promoted the interaction between NHE3 and Cdc42, which were also antagonized by Pirl-1. Conclusion RV infec-tion might regulate the expression and bioactivity of NHE3 through Cdc42-dependent endocytosis pathway.

Objective To design a kind of nasal feeding nutritional tube that can carry 125I particles,to use this tube for the treatment of upper digestive tract malignant occlusive disease in order to achieve double effect of nasal feeding nutrition and brachytherapy.Methods 125I particles were put into a 3F catheter,then both ends of the catheter were sealed off to make 125I particle chain.By using binding technology,the 125I particle chain was fixed on the nasal feeding tube.Under DSA guidance,the nasal feeding tube carrying 125I particle chain was inserted into the esophagus,with the 125I particle chain segment crossing over the section of esophageal stenosis or occlusion to conduct brachytherapy.This technique was employed in 6 patients with advanced esophageal carcinoma.The technical success rate,operation time and complications were recorded.Two months after the treatment,the Karnofsky score,visual analogue scale (VAS) pain score,Neuhaus dysphagia grading,esophagus patency on esophageal radiography,and local tumor control rate were determined.Results The preparation of nasal feeding nutritional tube carrying 125I particle chain was simple.The technical success rate was 100％,the mean operation time was 15.5 min,no serious complications such as bleeding or infection occurred.Two months after the treatment,the Karnofsky score,VAS pain score and Neuhaus dysphagia grading were significantly improved when compared with the preoperative data (P＜0.O1).On esophageal radiography,the contrast agent passed through the narrow area smoothly.Partial remission (PR) of local tumor was obtained in all patients,and the local tumor control rate was 100％.The patients were followed up for 2-6 months,one patient developed recurrent obstruction.Conclusion It is simple and easy to prepare a nasal feeding nutritional tube carrying 125I particle chain,the use of this kind of tube can achieve both parenteral nutrition and brachytherapy at the same time.Therefore,this technique opens a new way for the treatment of esophageal malignant tumor.

Objective To evaluate the safety and efficacy of 125I seed strands cavity brachytherapy for ureteral carcinoma.Methods To tally 10 patients with ureteral carcinoma underwent Carm CT and DSA guided percutaneous nephrostomy with 125I seed strands cavity brachytherapy.The technical success rate,complications,tumor local control rate,ureteral patency andsurvival time,and compared the Karnofsky scores,Girignon grade,pain score before and after treatment were evaluated.The dose related parameters were compared between pre-and post-treatment.Results 125I seed strands implantation was successfully completed in all patients with technical success rate of 100％.The mean procedure time was (12.3 ±3.8) min.No severe complications such as ureteral perforation,infection,severe bleeding occurred.Local tumor response was CR in 4 cases and PR in 6 cases,showing local control efficiency (CR + PR) 100％ after 2-3 months.Ureteral patency rate was 50％ (5/10).Postprocedure Karnofsky scores,Girignon grades,and pain scores were significantly improved (Z =-2.72,-2.88,-2.83,P＜0.01).The average follow-up time was (14.6 ±6.5) months (5-25 months),tumor progression was observed in 3 cases,stable disease in 7 cases.Nine cases were alive and one died due to multiple organ failure.The differences of D90％,mPD,V100％,V150％,V200％,CI,EI,HI between the preand post-treatment were not statistically significant (P ＞ 0.05).Conclusions 125I seed strands cavity brachytherapy for ureteral carcinoma is an effective and safe procedure without serious complications,and an effective alternative treatment for patients who are unable to undergoor refuse surgery.