Objective:To investigate the value of sequential ultrasound in assessing skeletal muscle and diaphragm thickness in elderly septic patients.Methods:A retrospective study was conducted.Fifty-one elderly patients with sepsis who underwent ultrasound examinations at Beijing Chaoyang Hospital from August 2021 to August 2023 were selected, including 30 males and 21 females.Ultrasound technology was used to measure the thickness of limb skeletal muscles(biceps brachii, flexor carpi radialis, quadriceps femoris, and tibialis anterior)and diaphragm, and sequential monitoring was performed at different time points(admission, the 3rd day after admission, and the 7th day after admission)to analyze the variation rules of their thickness.The correlations between the changes in muscle thickness and the severity of the disease[such as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and the Sepsis Organ Failure Assessment(SOFA)scores], mechanical ventilation time, and length of hospital stay were analyzed.Results:Compared with those at admission, the thickness of limb skeletal muscles and diaphragm in elderly septic patients with mechanical ventilation significantly decreased with the prolongation of hospital stay( P<0.05).The degree of thickness reduction in the flexor carpi radialis and rectus femoris was positively correlated with the APACHE II score.The degree of thickness reduction in the biceps brachii was positively correlated with the SOFA score.The degree of thickness reduction in the flexor carpi radialis, rectus femoris, and diaphragm was positively correlated with both mechanical ventilation time and hospital stay( P<0.05).Correlation heatmap analysis showed that the thickness of the flexor carpi radialis was significantly correlated with hospital stay days and APACHE II score(correlation coefficients were 100.20 and 67.47, respectively), indicating that the longer the hospital stay and the more severe the condition, the more serious the atrophy of the flexor carpi radialis. Conclusions:Measuring the thickness of skeletal muscles and the diaphragm in elderly sepsis patients using ultrasound serves as an efficient and non-invasive method for assessing the disease state, predicting prognosis, and guiding clinical treatment decisions.This approach provides vital imaging-based evidence for refining diagnostic and therapeutic strategies for elderly sepsis patients, thereby promising to enhance clinical outcomes and the quality of rehabilitation for these individuals.

Background Air pollution remains a critical public health issue, with persistent exposure to air pollutants continuing to pose significant health risks. Currently, research investigating the association between air pollution and myocardial infarction mortality in Shenzhen remains inadequate. Objective To quantitatively assess the association between air pollutants and myocardial infarction mortality in residents. Methods Based on the mortality surveillance system of Shenzhen Center for Disease Control and Prevention, we conducted a time-stratified case-crossover study of 10089 permanent residents who died from myocardial infarction in Shenzhen between 2013 and 2022. Using residential address information, we obtained individual-level exposure data for air pollutants from the China High Air Pollutants dataset and meteorological factors from the China Meteorological Administration Land Data Assimilation System. A time-stratified case-crossover study design was employed to construct a conditional logistic regression model to assess the association between short-term exposure to air pollutants and myocardial infarction mortality. The exposure-response relationship was visualized, and a comprehensive health risk assessment was performed. Results This study included a total of 10 089 cases of myocardial infarction deaths in Shenzhen. The median [interquartile range (IQR)] concentrations of fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃) in Shenzhen from 2013 to 2022 were 24.59 (20.19) μg·m⁻³, 42.85 (28.42) μg·m⁻³, 8.53 (3.39) μg·m⁻³, 29.47 (13.56) μg·m⁻³, 0.77 (0.27) mg·m⁻³, and 86.53 (51.39) μg·m⁻³, respectively. The moving average concentrations of PM_2.5 and PM₁₀ over the current day and the previous 2 days (lag02) showed the highest risk of myocardial infarction mortality, with an odds ratio (OR) and 95% confidence interval (95%CI) of 1.004 (1.001, 1.007) and 1.004 (1.002, 1.006), respectively. At lag05, SO₂ demonstrated the strongest association with the risk of myocardial infarction mortality, with an OR (95%CI) of 1.042 (1.019, 1.065). The exposure-response relationships of PM_2.5, PM₁₀, and SO₂ with myocardial infarction mortality were approximately linear, whereas NO₂ exhibited a nonlinear relationship. At lag05, the highest risk of myocardial infarction mortality associated with NO₂ exposure was observed when the NO₂ concentration was ≤21.92 μg·m⁻³, with an OR (95% CI) of 1.024 (1.003, 1.046). The health risk assessment indicated that, using the WHO Air Quality Guidelines as the reference, the local PM_2.5 and NO₂ exposure led to an excess mortality of 398 and 298 cases, respectively. The sensitivity analysis revealed that after adjusting for O₃ and restricting the study period to 2013—2019, the effect estimates for PM_2.5, PM₁₀, NO₂, and SO₂ on myocardial infarction mortality slightly increased. Conclusion Short-term exposure to air pollutants, including PM_2.5, PM₁₀, NO₂, and SO₂, could increase the risk of myocardial infarction mortality. This study provides important scientific evidence for environmental health risk assessment and environmental management in Shenzhen.

Objective:To investigate the value of sequential ultrasound in assessing skeletal muscle and diaphragm thickness in elderly septic patients.Methods:A retrospective study was conducted.Fifty-one elderly patients with sepsis who underwent ultrasound examinations at Beijing Chaoyang Hospital from August 2021 to August 2023 were selected, including 30 males and 21 females.Ultrasound technology was used to measure the thickness of limb skeletal muscles(biceps brachii, flexor carpi radialis, quadriceps femoris, and tibialis anterior)and diaphragm, and sequential monitoring was performed at different time points(admission, the 3rd day after admission, and the 7th day after admission)to analyze the variation rules of their thickness.The correlations between the changes in muscle thickness and the severity of the disease[such as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and the Sepsis Organ Failure Assessment(SOFA)scores], mechanical ventilation time, and length of hospital stay were analyzed.Results:Compared with those at admission, the thickness of limb skeletal muscles and diaphragm in elderly septic patients with mechanical ventilation significantly decreased with the prolongation of hospital stay( P<0.05).The degree of thickness reduction in the flexor carpi radialis and rectus femoris was positively correlated with the APACHE II score.The degree of thickness reduction in the biceps brachii was positively correlated with the SOFA score.The degree of thickness reduction in the flexor carpi radialis, rectus femoris, and diaphragm was positively correlated with both mechanical ventilation time and hospital stay( P<0.05).Correlation heatmap analysis showed that the thickness of the flexor carpi radialis was significantly correlated with hospital stay days and APACHE II score(correlation coefficients were 100.20 and 67.47, respectively), indicating that the longer the hospital stay and the more severe the condition, the more serious the atrophy of the flexor carpi radialis. Conclusions:Measuring the thickness of skeletal muscles and the diaphragm in elderly sepsis patients using ultrasound serves as an efficient and non-invasive method for assessing the disease state, predicting prognosis, and guiding clinical treatment decisions.This approach provides vital imaging-based evidence for refining diagnostic and therapeutic strategies for elderly sepsis patients, thereby promising to enhance clinical outcomes and the quality of rehabilitation for these individuals.

The paper introduces professor LU Yonghui's clinical experience in treatment of female stress urinary incontinence. Regarding the pathogenesis of this disease, qi and blood deficiency, and malnutrition of moyuan (sites where the pathogens are hidden, and the membranes outside zangfu organs) are ben (the primary, root cause), while, the dysfunction of qi movement of the triple energizer and dysfunction of bladder in controlling urination are biao (the secondary, symptoms). In treatment, under the guidance of computed tomography, Zhongji (CV 3), the front-mu point of the bladder, is punctured deeply to regulate the functions of zang organ. Qihai (CV 6) and Guanyuan (CV 4) are punctured to tonify the organs and control urine, and back-shu points of the bladder meridian are stimulated to adjust qi movement of the triple energizer. All of the acupoints co-act on nourishing moyuan, activating qi movement of the triple energizer and the bladder to control urination.
Humans ; Female ; Acupuncture Points ; Urinary Bladder/physiopathology* ; Acupuncture Therapy ; Urinary Incontinence, Stress/physiopathology* ; Meridians ; Middle Aged ; Adult

Objective:To investigate the clinical value of compression rate(CR)of median nerve combined with Young's modulus value(E)in quantitatively evaluating median nerve injury of patients with dialysis-related amyloidosis(DRA).Methods:A retrospective analysis was conducted on 53 maintenance hemodialysis(HD)patients who admitted to department of blood purification of Beijing Chao-Yang Hospital of Capital Medical University from November 2019 to October 2020,and they were divided into case group,and 60 volunteers who underwent physical examination at the outpatient of the department of ultrasound medicine were selected as healthy control group.Basic clinical data of the patients were collected.Based on the results of physical examination,the patients with dialysis were divided into a sign group(n=18)and a non-sign group(n=35).High-frequency ultrasound was used to measure the anteroposterior diameter of the median nerve at the entrance of the carpal tunnel and the protrusion of the distal radius in all subjects.The CR values of anteroposterior diameters were calculated.Shear Wave Velocity elastography(SWE)technique was employed to measure E values of the median nerves of compressed position.The differences in CR and E values between case group and healthy control group,as well as between sign group and non-sign group were respectively compared and analyzed.Furthermore,the diagnostic efficacies of CR alone,E value alone and their combination for median nerve injury were evaluated.Results:The CR and E values of median nerve of cases group were respectively(0.16±0.01)and(104.49±49.42)kPa,and they were respectively(0.07±0.05)and(42.47±15.64)kPa in health control group.The CR and E values of median nerve in case group were significantly higher than those in health control group(t=4.92,6.39,P<0.001),respectively.The CR and E values of the median nerve in the sign group of cases group were respectively(0.31±0.09)and(150.58±47.71)kPa,and those in the non-sign group of case group were respectively(0.10±0.09)and(87.95±38.73)kPa.The CR and E values of median nerve of the sign group were significantly higher than those in the non-sign group(t=7.78,4.89,P<0.001),respectively.The duration of the disease was positive correlation with E value and CR value of median nerve in HD patients who underwent dialysis(r=0.598,0.459,P<0.001),respectively.The area under curve (AUC) value of receiver operating characteristic (ROC) curve showed that the best CR cut-off value was 21％ and the E value was 76.22kpa in diagnosing median nerve injury,.and the AUC values of CR and E value were respectively 0.844 and 0.817,and the AUC value,sensitivity and specificity of the combine of them reached respectively 0.908,100％ and 89％. Conclusion:Both CR and E values of the median nerve can be used to evaluate the median nerve injury in patients with DRA,and the combination of them has a higher diagnostic efficiency. Conventional ultrasound and SWE elastography can be the preferred imaging methods for the evaluation of median nerve injury.

Objective To explore the automated identification and diameter measurement methods for inferior vena cava (IVC) based on clinical ultrasound images of IVC. Methods An automated identification and localization method based on topology and automatic tracking algorithm was proposed. Tracking algorithm was used for identifying and continuously locating to improve the efficiency and accuracy of measurement. Tests were conducted on 18 sets of ultrasound data collected from 18 patients in intensive care unit (ICU),with clinicians' measurements as the gold standard. Results The recognition accuracy of the automated method was 94.44％ (17/18),and the measurement error of IVC diameter was within the range of±1.96s (s was the standard deviation). The automated method could replace the manual method. Conclusion The proposed IVC automated identification and localization algorithm based on topology and automatic tracking algorithm has high recognition success rate and IVC diameter measurement accuracy. It can assist clinicians in identifying and locating IVC,so as to improve the accuracy of IVC measurement.

Purpose To investigate the diagnosis and the clinicopathological characteristics of gastric adenocarcinoma with enteroblastic differentiation(GAED)in biopsy,and to provide data for the pathological evaluation of endoscopic resection of early gastric cancer.Methods 26 GAED biopsy specimens were collected,and the clinicopathological features were ana-lyzed by re-reading slides,immunohistochemistry and with paired radical surgery specimen.Results Serum AFP was de-tected in 16 patients before operation,and 11 patients(68.75％)were elevated.The initial diagnosis rate and follow-up rate of GAED in biopsy were 42.31％and 92.31％.Among the biopsy specimens,5 cases of GAED were accompanied by conventional gastric adenocarcinoma,and the positive rates of SALL4 and Glypican-3 were high(both 78.57％).The accom-panying cancers in the radical resection specimens include con-ventional gastric adenocarcinoma,hepatoid adenocarcinoma,and low adhesion adenocarcinoma,with the positive rate of SALL4(81.25％),Glypican-3(75％),and AFP(62.5％).GAED was more prone to deep invasion of the gastric wall and lymph node metastasis than conventional gastric adenocarcinoma.A-mong the 6 cases of early GAED,3 cases(50％)were lymph node-positive.Conclusion GAED is easy to be missed in biop-sy,and more attention should be paid to its tissue morphology and immunophenotype.GAED needs to be excluded in the histo-logical type of endoscopic curative resection of early gastric canc-er.

Purpose To investigate the diagnosis and the clinicopathological characteristics of gastric adenocarcinoma with enteroblastic differentiation(GAED)in biopsy,and to provide data for the pathological evaluation of endoscopic resection of early gastric cancer.Methods 26 GAED biopsy specimens were collected,and the clinicopathological features were ana-lyzed by re-reading slides,immunohistochemistry and with paired radical surgery specimen.Results Serum AFP was de-tected in 16 patients before operation,and 11 patients(68.75％)were elevated.The initial diagnosis rate and follow-up rate of GAED in biopsy were 42.31％and 92.31％.Among the biopsy specimens,5 cases of GAED were accompanied by conventional gastric adenocarcinoma,and the positive rates of SALL4 and Glypican-3 were high(both 78.57％).The accom-panying cancers in the radical resection specimens include con-ventional gastric adenocarcinoma,hepatoid adenocarcinoma,and low adhesion adenocarcinoma,with the positive rate of SALL4(81.25％),Glypican-3(75％),and AFP(62.5％).GAED was more prone to deep invasion of the gastric wall and lymph node metastasis than conventional gastric adenocarcinoma.A-mong the 6 cases of early GAED,3 cases(50％)were lymph node-positive.Conclusion GAED is easy to be missed in biop-sy,and more attention should be paid to its tissue morphology and immunophenotype.GAED needs to be excluded in the histo-logical type of endoscopic curative resection of early gastric canc-er.

Objective:To explore the curative effect of synchronous bionic electrical stimulation in hyperbaric oxygen chamber on patients with sudden deafness（SD）and the changes in hemorheological indicators.Methods:A total of 128 SD outpatients and inpatients treated at the Hyperbaric Oxygen Department of the Sixth Medical Center of the Chinese PLA General Hospital from June 2020 to June 2021 were randomly divided into study group（70 cases treated with synchronous brain bionic electrical stimulator in hyperbaric oxygen chamber）and control group（58 cases given conventional hyperbaric oxygen therapy），respectively. The curative effects of the two groups were evaluated，and the hemorheological indicators，such as the whole blood（high-shear and low-shear）viscosity，plasma viscosity，and red blood cell aggregation，were analyzed by the automatic biochemical analyzer before and after treatment.Results:After two courses of treatments，the overall effective rate of the study group（88.57%）was significantly higher than that of the control group（79.31%），and the difference was statistically significant（ P<0.05）. After treatment，the whole blood（high-shear and low-shear）viscosities，plasma viscosity，and erythrocyte aggregation indicators of the two groups were significantly decreased compared with those before treatment（ P<0.05），and the above indicators in the study group were significantly lower than those in the control group（ P<0.05）. Conclusions:Synchronous brain bionic electrical stimulation in the hyperbaric oxygen chamber can improve the hemorheological indicators of the SD patients，reduce their blood hypercoagulability，and improve their hearing level and treatment effect. Hence，it is worth of clinical promotion.

Objective:To explore the curative effect of synchronous bionic electrical stimulation in hyperbaric oxygen chamber on patients with sudden deafness（SD）and the changes in hemorheological indicators.Methods:A total of 128 SD outpatients and inpatients treated at the Hyperbaric Oxygen Department of the Sixth Medical Center of the Chinese PLA General Hospital from June 2020 to June 2021 were randomly divided into study group（70 cases treated with synchronous brain bionic electrical stimulator in hyperbaric oxygen chamber）and control group（58 cases given conventional hyperbaric oxygen therapy），respectively. The curative effects of the two groups were evaluated，and the hemorheological indicators，such as the whole blood（high-shear and low-shear）viscosity，plasma viscosity，and red blood cell aggregation，were analyzed by the automatic biochemical analyzer before and after treatment.Results:After two courses of treatments，the overall effective rate of the study group（88.57%）was significantly higher than that of the control group（79.31%），and the difference was statistically significant（ P<0.05）. After treatment，the whole blood（high-shear and low-shear）viscosities，plasma viscosity，and erythrocyte aggregation indicators of the two groups were significantly decreased compared with those before treatment（ P<0.05），and the above indicators in the study group were significantly lower than those in the control group（ P<0.05）. Conclusions:Synchronous brain bionic electrical stimulation in the hyperbaric oxygen chamber can improve the hemorheological indicators of the SD patients，reduce their blood hypercoagulability，and improve their hearing level and treatment effect. Hence，it is worth of clinical promotion.