Objective To analyze the correlation between cardiac function and degree of coronary artery lesion in elderly patients with coronary heart disease. Methods A total of 110 elderly patients with coronary heart disease and 30 elderly people without coronary heart disease (non-coronary heart disease group) in the Third People's Hospital of Chengdu were selected for the study. Based on Gensini score, the patients with coronary heart disease were classified into mild, moderate and severe lesion groups. The echocardiographic indicators and myocardial injury indicators [cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase isoenzyme (CK-MB)] were compared among the groups. The correlation between cardiac function indicators and degree of coronary artery lesion and the evaluation value of various indicators on severe coronary artery lesion were analyzed. Results The left ventricular ejection fraction (LVEF) was represented as severe lesion groupmoderate lesion group>mild lesion group> non-coronary heart disease group (P<0.05). LVEF showed a negative correlation with degree of coronary artery lesion (P<0.05), while LVEDD, LVESD, cTnI, CK and CK-MB all exhibited positive correlations with degree of coronary artery lesion (P<0.05). The combined detection of the above indicators demonstrated superior evaluation efficiency on severe coronary artery lesion compared to any single indicator (P<0.05). Conclusion There is a significant correlation between cardiac function and degree of coronary artery lesion in elderly patients with coronary heart disease. Comprehensive evaluation of these indicators is conducive to clinical disease risk stratification and individualized treatment.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective:To investigate the relationship between the Palatopharyngeal Arch Staging System（PASS） and the severity of Obstructive Sleep Apnea（OSA）, as well as the patterns of airway collapse, while further assessing its clinical applicability. Methods:A total of 98 patients diagnosed with OSA at the Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University Affiliated Shenzhen Hospital, were recruited for this study. Data collected included basic demographic information, oropharyngeal laryngoscopy videos, results from awake laryngoscopy Muller tests, and indicators from sleep respiratory monitoring. The distribution of each PASS stage among patients with varying severities of OSA was compared. Additionally, both objective and subjective sleep indicators along with occurrences of airway collapse in OSA patients across different PASS stages were analyzed. Results:In total, 98 patients participated in this study. Statistically significant differences were observed in neck circumference, weight, Body Mass Index（BMI）, tongue position, and PASS stage when comparing mild-to-moderate OSA patients to those with severe OSA（P<0.05）. Furthermore, there were statistically significant variations in Apnea-Hypopnea Index（AHI）, minimum blood oxygen saturation levels, average blood oxygen saturation levels, oxygen desaturation index values, and total oxygen desaturation indices among OSA patients categorized by different PASS stages. Multiple comparisons revealed statistically significant differences in AHI as well as minimum and average blood oxygen saturation levels between patients at PASS 1 versus those at PASS 3（P<0.05）. Additionally, notable differences regarding oropharyngeal collapse rates among OSA patients across various PASS stages were identified; specifically between those at PASS stage 1 and those at PASS stage 3. Conclusion:The proportion of PASS stages for OSA varies across different severity levels. The severity of OSA and the degree of airway collapse in patients with varying PASS stages also exhibit significant differences. Patients classified as PASS 3 demonstrate a more severe form of OSA compared to those at PASS 1, with stage 3 being more susceptible to oropharyngeal collapse than its stage 1 counterpart. This assessment system is anticipated to address the current limitations in evaluating the lateral pharyngeal wall within the oropharynx.
Humans ; Sleep Apnea, Obstructive/pathology* ; Male ; Severity of Illness Index ; Female ; Middle Aged ; Polysomnography ; Adult ; Pharynx/physiopathology* ; Aged

Objective: To explore the relationship between muscle fat deposition , muscle iron deposition , and glu- cose metabolism in elderly obese patients . Methods: Elderly obese patients who visited the outpatient clinic were selected . Oral glucose tolerance tests were performed . Muscle fat and iron deposition in the abdominal wall and pa- raspinal muscles at the L3 vertebra level were quantified using the Dixon technique based on nuclear magnetic reso- nance . Results: A total of 140 elderly obese patients were included , among which 46 were newly diagnosed with type 2 diabetes mellitus (T2DM) , 44 had impaired glucose tolerance (IGR) , and 50 had normal glucose tolerance (NGT) . Compared to NGT and IGR groups , patients with T2DM had significantly increased muscle fat deposition , iron deposition , and visceral fat , while subcutaneous fat was significantly reduced (P < 0. 05) . After adjusting for confounding factors using multivariate logistic regression , muscle fat deposition was identified as an independent risk factor for glucose metabolism disorders : patients with muscle fat≥42. 2% had a 2. 9 times risk of glucose me- tabolism abnormalities compared to those with muscle fat < 42. 2% . Conclusion With the occurrence of glucose metabolism disorders , muscle fat and iron deposition gradually increase in elderly obese patients . Muscle fat depo- sition is an independent risk factor for predicting glucose metabolism abnormalities in elderly obese patients .

Objective To investigate the predictive value of dynamic monitoring of transcutaneous oxygen partial pressure [p_tc(O₂)], transcutaneous carbon dioxide partial pressure [p_tc(CO₂)], serum amyloid A (SAA), and interleukin-6 (IL-6) levels in predicting bronchopulmonary dysplasia (BPD) in neonates with neonatal respiratory distress syndrome (NRDS). Methods A total of 240 NRDS patients were selected as the research subjects and divided into BPD group (108 cases) and non-BPD group (132 cases) based on whether BPD occurred. The levels of p_tc(O₂), p_tc(CO₂), SAA, and IL-6 were compared between the two groups on the 1st, 7th, and 14th day after birth. Spearman correlation analysis was used to explore the correlation between each indicator and the degree of illness. The relative risk (RR) and 95% confidence interval (CI) were used to evaluate the impact of each indicator on BPD in NRDS patients. Receiver operating characteristic (ROC) curves and decision curve analysis were used to evaluate the predictive efficacy and clinical net benefit of each indicator for BPD. Results On the 1st day after birth, there were no statistically significant differences in p_tc(O₂), p_tc(CO₂), serum SAA, and IL-6 levels between the two groups (P>0.05). On the 7th and 14th day after birth, the p_tc(O₂) in the BPD group was lower than that in the non-BPD group, while the p_tc(CO₂) and serum SAA, IL-6 levels were higher than those in the non-BPD group (P < 0.05). Correlation analysis results showed that the degree of BPD in children was negatively correlated with p_tc(O₂) on the 7th day after birth (r=-0.724, P < 0.05), and positively correlated with p_tc(CO₂), SAA, and IL-6 on the 7th day after birth (r=0.635, 0.830, 0.715, P < 0.05). The degree of pulmonary dysfunction in children was negatively correlated with p_tc(O₂) on the 7th day after birth (r=-0.719, P < 0.05), and positively correlated with p_tc(CO₂), SAA, and IL-6 on the 7th day after birth (r=0.673, 0.756, 0.696, P < 0.05). On the 7th day after birth, the p_tc(O₂) of BPD patients was negatively correlated with SAA and IL-6 (r=-0.605, -0.623, P < 0.05), while p_tc(CO₂) was positively correlated with SAA and IL-6 (r=0.618, 0.650, P < 0.05). ROC curve showed that the combined prediction of p_tc(O₂), p_tc(CO₂), SAA, and IL-6 on the 7th day after birth for NRDS complicated with BPD was better than the individual prediction of the four indicators, with an area under the curve of 0.938 (95%CI, 0.899 to 0.965). The risk of BPD in high-expression of p_tc(CO₂), SAA, and IL-6 was 2.256, 1.668, and 1.667 times higher than that in low-expression, respectively. The risk of BPD in high-expression of p_tc(O₂) was 0.568 times higher than that in low-expression. The decision curve analysis showed that when the threshold value was within the range of 0.2 to 0.9, the combined model of p_tc(O₂), p_tc(CO₂), SAA, and IL-6 was superior to the individual prediction in predicting the net benefit rate of BPD in NRDS patients on the 7th day after birth. Conclusion The severity of NRDS complicated with BPD is closely related to p_tc(O₂), p_tc(CO₂), SAA, and IL-6, and the combined detection of the four indicators can help improve the predictive efficacy and net benefit rate of NRDS complicated with BPD.

Methods: Data were collected from the American College of Surgeons National Surgical Quality Improvement Program dataset from 2011 to 2018. The cohort was divided into patients with LOS up to 1 day (LOS ≤1 day), defined as same day or next-morning discharge, and patients with LOS >1 day (LOS >1 day). Univariable and multivariable regression analyses were performed to evaluate predictors of LOS >1 day. Propensity-score matching was performed to compare pre- and postdischarge complication rates. Results: A total of 12,664 eligible patients with TLIF were identified, of which 14.8% had LOS ≤1 day and 85.2% had LOS >1 day. LOS >1 day was positively associated with female sex, Hispanic ethnicity, diagnosis of spondylolisthesis, American Society of Anesthesiologists classification 3, and operation length of >150 minutes. Patients with LOS >1 day were more likely to undergo intraoperative/postoperative blood transfusion (0.3% vs. 4.5%, p<0.001) and reoperation (0.1% vs. 0.6%, p=0.004). No significant differences in the rates of postdischarge complications were found between the matched groups. Conclusions Patients with worsened preoperative status, preoperative diagnosis of spondylolisthesis, and prolonged operative time are more likely to require prolonged hospitalization and blood transfusions and undergo unplanned reoperation. To reduce the risk of prolonged hospitalization and associated complications, patients indicated for TLIF should be carefully selected.

Objective To investigate the distribution of the thalassemia genotypes and the characteristics of blood cell parameters in Changshou District,Chongqing.Methods Totally 4126 samples sent to our hospital were studied from June 2018 to March 2023.All samples were detected for thalassemia genotype and blood cells.The parameters of blood cells:redblood cell(RBC),hemoglobin(Hb),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC),red blood cell distribution width CV(RDW-CV),red blood cell distribution width SD(RDW-SD)were detected.Gap polymerase chain reaction(Gap-PCR)combined with reverse dot blot hybridization were used to detect alpha and beta thalassemia genotype.The rate and distribution characteristics of thalassemia gene in Changshou district were analyzed.Results Among 4126 samples,408 cases of α and β thalassemia were detected,accounting for 9.89%.Among these,there were 255 α-thalassemia cases.-α3.7/αα was the most common genotype.Two cases of--αSEA/-α3.7 and one cases of--SEA/HKαα were also detected.There were 153 cases of β-thalassemia and CD17 accounted for the highest proportion.The date of MCV,MCH,MCHC in-α3.7/αα,--SEA/αα,-α4.2/αα and ααCS/αα groups was significantly difference compared with control group(P<0.05).Parameters of MCV and MCH in CD17,CD41-42 and Ivs-2-654 groups were lower than those in control group(P<0.05),while RBC,RDW-CV and RDW-SD were higher than those in control group,the difference was statistically significant.Conclusion The most common genotype in thalassemia were-α3.7/αα,--SEA/αα,-α4.2/αα,CD17,CD41-42 and Ivs-2-654 in Changshou District,Chongqing.The parameters of MCV,MCHC,MCH,Hb,RBC,RDW-CV and RDW-SD have important clinical significance for the screening of thalassemia.

Objective To explore the application effect of recombinant human granulocyte colony stimulating factor(rhG-CSF)in the treatment of chemotherapy-induced oral mucositis in children.Methods Totally 60 children with chemotherapy-induced oral mucositis who underwent chemotherapy in the tumor surgery of our hospital from January 2020 to June 2022 were randomly divided into two groups,30 cases each.The control group was given physiological saline oral care,and the experimental group was given rhG-CSF oral care.Compare the intervention effect,oral mucositis grading,quality of life[short form of health survey(SF-36)]and nursing satisfaction of parents of the two groups.Results The total effective rate of the experimental group was higher than that of the control group(P<0.05).After 5 days of intervention,the score of oral mucositis in the experimental group was better than that in the control group(P<0.05).After 5 days of intervention,the SF-36 score of children in the two groups was higher than that before intervention,and that in the experimental group was higher than that in the control group(P<0.05).The parents'satisfaction in the experimental group was higher than that in the control group(P<0.05).Conclusion rhG-CSF oral care can effectively improve the intervention effect of chemotherapy-induced oral mucositis in children,reduce the grade of oral mucositis,improve the quality of life of children,and improve the nursing satisfaction of parents of children.

Abstract OBJECTIVE To analyze the different therapeutic effects of different formulations of recombinant human growth hormone on idiopathic short stature and the related factors before treatment. METHODS Retrospective analysis was performed on children aged 4-8 years who were diagnosed as idiopathic short stature at the Child Health Department of Sichuan Maternal and Child Health Care Hospital from January 2020 to December 2021 and treated with different formulation of recombinant human growth hormone. The changes of height growth value and growth factor levels of children in different groups during different treatment periods were compared. At the same time, Logistic regression analysis was carried out on the related factors affecting the effect of height growth before treatment. RESULTS There was no significant difference in height, IGF-1 and IGF-BP3 growth between the two groups at each stage of treatment, except for the statistical difference in IGF-BP3 increment at the third month of treatment(P<0.05); The age of treatment had an effect on the height growth outcome of children, and there was statistical significance(OR=0.258, 95%CI 0.109-0.609, P=0.002). The remaining factors had no obvious influence. CONCLUSION There is no difference in the therapeutic effect of different formulation of recombinant human growth hormone on idiopathic short stature. The age of beginning use is the main factor that affects the effect of using growth hormone.

A 38-year-old female presented with irregular menstruation and hirsutism that started at age of 16 and diagnosed with polycystic ovary syndrome at age of 29 with elevated testosterone. When treated with ethinestradiol cyproterone tablets, her menstruation returned to normal and androgen levels was not changed. At age of 38 she was referred to the hospital with infertility, a diagnosis of nonclassical 21-hydroxylase deficiency was confirmed using 17-hydroxyprogesterone, dehydroepiandrosterone-sulfate, a cosyntropin-stimulation test and genetic test. This case suggested that nonclassical congenital adrenal hyperplasia should be considered when a patient is presented with oligomenorrhea, hirsutism with hyperandrogenemia and infertility.