Objective To investigate the distribution characteristics of pathogens causing infections within 90 days after liver transplantation and the influencing factors of infection. Methods Clinical data of 176 recipients who underwent liver transplantation at the Liver Transplant Center of Beijing Friendship Hospital Affiliated to Capital Medical University from September 2021 to August 2024 were retrospectively analyzed. Patients were divided into the infection group (n=124) and the non-infection group (n=52) based on whether they developed infection within 90 days after transplantation. The distribution characteristics of pathogens in infected patients were analyzed. Univariate and multivariate logistic regression analyses were used to explore the influencing factors of infection. Results Among the 176 liver transplant recipients, 124 cases developed 243 episodes of 518 bacterial, fungal, viral or mycoplasma infections within 90 days after transplantation, with an overall infection rate of 70.5% (124/176). The composition of pathogens was mainly Gram-negative bacteria (38.6%, 200/518), followed by Gram-positive bacteria (32.2%, 167/518) and viruses (15.4%, 80/518), and fungi accounted for 13.1% (68/518). Among Gram-negative bacteria, the main pathogen was Klebsiella pneumoniae (6.8%, 35/518), and among Gram-positive bacteria, the main pathogen was Enterococcus faecalis (8.5%, 44/518). Viruses included Epstein-Barr virus (3.7%, 19/518) and cytomegalovirus (3.7%, 19/518), and fungi were mainly Candida albicans (6.8%, 35/518). The most common infection site among the 243 episodes was pulmonary infection (42.0%, 102/243), followed by abdominal infection (22.6%, 55/243) and bloodstream infection (18.1%, 44/243). The infections mainly occurred within 2 weeks after transplantation (60.9%, 148/243). Multivariate logistic regression analysis indicated that preoperative infection within 2 weeks, a high preoperative model for end-stage liver disease (MELD) score, and preoperative sarcopenia were independent risk factors for infection within 90 days after liver transplantation (all odds ratio>1, P<0.05). After multivariate correction, the levels of CD4⁺T cells and CD8⁺T cells within 90 days after surgery were independently associated with the occurrence of infection. Low levels of CD4⁺T cells and CD8⁺T cells might be related to an increased risk of infection. Conclusions The infection rate after liver transplantation is high, and the pathogens are mainly Gram-negative bacteria. The lungs are the most common infection site. Preoperative MELD score, preoperative sarcopenia and preoperative infection within 2 weeks are independent risk factors for infection within 90 days after liver transplantation. Regular monitoring of immune indicators CD4⁺T cells and CD8⁺T cells levels after transplantation is helpful to reduce the occurrence of post-transplantation infection.

Objective To investigate the predictive value of preoperative combined detection of neutrophil-to-lymphocyte ratio (NLR) and prothrombin time-international normalized ratio to albumin ratio (PTAR) for early abdominal infection after liver transplantation. Methods Clinical data of 287 recipients who underwent liver transplantation at the Liver Transplant Center of Beijing Friendship Hospital, Affiliated to Capital Medical University, from January 2020 to April 2024 were retrospectively analyzed. The patients were divided into infection group (n=60) and non-infection group (n=227) based on whether abdominal infection occurred within 30 days after surgery. The distribution characteristics of pathogens and infection time in infected patients were analyzed. Spearman correlation analysis was used to assess the correlation between NLR, PTAR, Child-Pugh score and preoperative model for end-stage liver disease (MELD) score. Univariate and multivariate logistic regression analyses were performed to identify risk factors for abdominal infection. Receiver operating characteristic (ROC) curves were plotted for NLR, PTAR, and the combined prediction model to evaluate their predictive efficacy for abdominal infection after liver transplantation. Based on the cutoff value of the combined model, recipients were divided into low-risk and high-risk groups, and Kaplan-Meier analysis was used to compare the cumulative incidence of abdominal infection within 30 days after surgery between the two groups. Results Among the 287 recipients who underwent liver transplantation, 60 developed bacterial or fungal abdominal infections postoperatively. A total of 86 strains were isolated from infected patients, with Gram-negative bacteria accounting for 58%, Gram-positive bacteria for 36%, and fungi for 5%. Preoperative NLR and PTAR were positively correlated with Child-Pugh and MELD scores (all 1 > r > 0, P < 0.05). Logistic regression analysis showed that preoperative NLR, preoperative PTAR, postoperative ICU stay duration and postoperative biliary leakage were risk factors for abdominal infection within 30 days after surgery. The area under the curve (AUC) for NLR, PTAR, Child-Pugh score and MELD score were 0.771, 0.735, 0.650 and 0.741, respectively. The AUC for the combined NLR and PTAR prediction model was 0.824 (95% confidence interval: 0.763-0.885, P < 0.001), with a cutoff value of 0.168. Kaplan-Meier analysis showed that the cumulative incidence of abdominal infection within 30 days after surgery was lower in the low-risk group than in the high-risk group, with statistically significant difference (P < 0.001). Conclusions Preoperative NLR and PTAR are independent risk factors for abdominal infection within 30 days after liver transplantation. The combined prediction model of NLR and PTAR may effectively identify high-risk recipients for early abdominal infection after liver transplantation, providing basis for early intervention.

Objective:To explore and compare the clinical application value of 8-channel head phased-array coil, an 8-channel temporomandibular joint (TMJ)-specific surface coil, and a single-channel surface coil in TMJ MRI examinations.Methods:A total of 600 temporomandibular disorders (TMD) patients (1 200 joints) who underwent TMJ MRI examination in the First People′s Hospital of Jinzhong from June 2020 to January 2025 were retrospectively screened. Based on inclusion/exclusion criteria, 120 TMD patients (240 joints) with closed-mouth oblique sagittal proton density weighted imaging (OSag PDWI), coronal T2 fat-suppression weighted imaging (OCor fs T2WI) and open-mouth oblique sagittal proton density weighted imaging (OSag PDWI) were included. Patients were divided into groups A, B, and C, with 40 cases in each group. Group A (31female, 9male, median age 24 years old), underwent 8-channel head phased-array coil imaging. Group B (29 female, 11male, median age 23.5 years old) underwent TMJ imaging with an 8-channel surface coil. Group C (29 female, 11male, median age 22.5 years old) underwent single-channel surface coil imaging. There were no significant differences in age, gender, type or disease types among groups ( P>0.05). Six healthy volunteers without TMD (4 female, 2 male, range 19 to 45 years old) underwent imaging with all three coils as self-control. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality were compared for five regions of interest (ROI) in both patients and volunteers. Results:Under the same sequence and the same parameters, SNR and CNR in group B were higher than those in group A, and SNR and CNR in group C were also higher than those in group A, the differences were statistically significant ( P<0.05). However, there were significant differences in SNR and CNR between group B and group C in the closed and open positions of ROI1, the open positions of ROI3 and the open positions of ROI5 ( P<0.05), and there were no significant differences in other positions ( P>0.05). Group B had the best image quality, followed by group C and group A had the worst image quality. There were significant differences in the visualization of OSag PDWI in the closed mouth position, OCor T2WI in the coronal position, and OSag PDWI in the open mouth position, such as condyle, anterior attachment, joint disc, double lamina area, joint cavity and lateral pterygoid muscle ( P<0.05). There were significant differences between group B and group C in showing the joint cavity in the closed mouth position and showing the structure of the bilaminar area in the open mouth position ( P<0.05). There was no significant difference in other regions of interest ( P>0.05). The subjective scores of condyle, anterior attachment, articular disc, bilaminar area, articular cavity, lateral pterygos muscle and other structures were medium to high in group A, high in group B, and high or high in group C by two radiologists independently. In the five rois, the 8-channel TMJ surface coil showed more details, especially in the articular disc, condyle and lateral pterygoid muscle regions, and had more advantages in both volunteers and patients. Conclusions:The 8-channel TMJ-specific surface coil provides significantly clearer visualization of critical anatomical details within the ROIs, demonstrating the highest clinical application value and is recommended as the preferred choice.

Objective:To investigate the dynamic changes of inflammatory biomarkers in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) support after cardiac surgery, and evaluate their predictive value for in-hospital mortality.Methods:The retrospective study included 212 patients who underwent VA-ECMO support following cardiac surgery at Beijing Anzhen Hospital, Capital Medical University, from January 2021 to May 2024. Baseline characteristics and inflammatory markers during ECMO support including procalcitonin (PCT), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and fibrinogen (FBG) were collected. Univariate analysis, ROC curves, and multivariate logistic regression were performed to assess the association of these indicators with outcomes. Results:On day 3 post-ECMO, mean PCT and CRP levels were significantly higher in the deceased group (87 cases) than in the survival group (125 cases). PCT demonstrated an area under the curve ( AUC) of 0.750 (95% CI: 0.680-0.819) for predicting mortality, while CRP had an AUC of 0.701(95% CI: 0.625-0.778). No significant differences were observed in FBG, NLR, or PLR between the two groups. Lactate levels at 24 h post-ECMO ( AUC=0.723) and SOFA scores ( OR=2.511, AUC=0.713) were also significantly associated with mortality risk in the deceased group ( P<0.05). Conclusion:Dynamic increases in PCT and CRP are independent predictors of in-hospital mortality in cardiac surgery patients supported by ECMO. Elevated lactate levels and SOFA scores, aligning with previous studies, reflect severe tissue hypoperfusion and multi-organ dysfunction in non-survivors, underscoring the necessity of dynamic monitoring of inflammatory and organ function markers for prognosis assessment.

Objective:To investigate the effect of bronchoalveolar lavage fluid(BALF)cytology examination combined with lymphocyte immunoassay on clinical outcome of critically ill patients with stroke-associated pneumonia(SAP).Methods:One hundred and fifty-six critically ill patients with SAP admitted to Department of Respiratory and Critical Care Medicine of the Second People's Hospital of Weifang from September 2021 to June 2022 were selected,and randomly divided into a study group and a control group,with 78 cases in each group.Control group was treated with conventional pulmonary infection,and study group added bronchoscopic alveolar lavage treatment based on the treatment of control group,and the anti-infection treatment regimen was adjusted according to the results of BALF lymphocyte immunoassay.Clinical improvement rates,clinical symptom scores,serum inflammatory factors[procal-citonin(PCT),C-reactive protein(CRP),TNF-α],peripheral blood lymphocyte subsets(CD3+T,CD4+T,CD8+T)levels,treatment condition,in-hospital mortality and incidence of acute respiratory distress syndrome(ARDS)between the two groups were compared.Results:Clinical improvement rates were higher in study group(44.87%,58.97%,91.03%,97.44%)than that in control group(26.92%,42.31%,78.21%,88.46%)at 3 d,5 d,7 d and 10 d of treatment(P<0.05);serum PCT,CRP and TNF-α levels were lower in study group than that in control group after 10 d of treatment(P<0.05);peripheral blood CD3+T,CD4+T,CD8+T levels were higher in study group than that in control group after 10 d of treatment(P<0.05).CPIS and CURB-65 scores were lower in study group than that in control group after 10 d of treatment(P<0.05);duration of antimicrobial drug use,duration of mechanical ventilation,and length of hospital stay were shorter in study group than that in control group(P<0.05);in-hospital mortality rate(7.69%)and inci-dence of ARDS(5.13%)were lower in study group than that in control group(19.23%,15.38%)(P<0.05).Conclusion:Optimized anti-infection treatment plan based on BALF cytology examination combined with lymphocyte immunoassay can significantly improve clinical efficacy of critically ill patients with SAP,and help to promote recovery and improve the prognosis of patients.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To investigate the mechanisms of Danggui Shaoyao San(DSS)in treating adenomyosis(AM),endometriosis(EMs),and sequelae of pelvic inflammatory disease(SPID)through network pharmacology and molecular docking,guided by the traditional Chinese medicine(TCM)principle of"same treatment for different diseases".Methods Chemical components of DSS were retrieved from the TCMSP and SwissTargetPrediction databases,and their targets were identified.Disease targets for AM,EMs,and SPID were collected from DrugBank,OMIM,GeneCards,and DisGeNET.A Venn diagram was constructed using Venny 2.1 to identify common targets between DSS and the diseases.A"drug-active component-shared target"network was established via Cytoscape 3.7.2.Protein-protein interaction(PPI)networks were analyzed using STRING and Cytoscape 3.7.2 to explore molecular mechanisms.Key targets were localized to tissues using BioGPS.Functional enrichment analysis of GO terms and KEGG pathways was performed via DAVID,followed by molecular docking validation.Results Thirty-nine active components and 529 potential targets of DSS were identified,with 60 shared targets across the three diseases.Enrichment analysis revealed that DSS treats AM,EMs and SPID by modulating cancer-related pathways,the PI3K/Akt signaling pathway,HIF-1 signaling pathway,and TNF signaling pathway.Molecular docking demonstrated stable binding conformations between DSS's primary active components and core targets.Conclusion DSS treats AM,EMs and SPID through multiple compounds[e.g.,(+)-catechin,kaempferol,β-sitosterol]acting on key targets(TNF,EGFR,PTGS2,HIF1A)across various organs,modulating inflammation,immune response,angiogenesis,and cell signaling pathways,thereby exerting its"same treatment for different diseases"effect.

Objective To explore the difference of efficacy and safety between denosumab and zoledronic acid in the treatment of patients with postmenopausal osteoporosis (PMOP), and to optimize the medication regimen for PMOP patients. Methods A total of 123 PMOP patients with high risk of fracture at the Second Affiliated Hospital of Naval Medical University from September 2021 to March 2024 were selected and randomly divided into two groups: the denosumab group (n=63) and the zoledronic acid group (n=60). Both groups underwent one-year treatment and follow-up, bone metabolism indexes, lumbar vertebrae, femoral neck, and total hip bone mineral density (BMD) were monitored, and any adverse reactions were documented. Results After treatment, the lumbar vertebrae and total hip BMD of patients in the denosumab group and the zoledronic acid group were significantly improved (P＜0.05); the femoral neck BMD of patients in the zoledronic acid group was also significantly improved (P＜0.05). The improvement of lumbar vertebrae BMD in the denosumab group was significantly better than that in the zoledronic acid group, while the improvement of femoral neck and total hip BMD in the zoledronic acid group was significantly better than that in the denosumab group (P＜0.05). Bone metabolism indicators were significantly improved in both groups (P＜0.05), and no significant liver and kidney dysfunction were observed. A total of 7 patients in the zoledronic acid group had mild adverse reactions and 5 patients in the denosumab group had mild adverse reactions. Conclusions Denosumab significantly increased lumbar vertebrae BMD and improved bone metabolism markers in PMOP patients, thus reducing risk of fracture and demonstrating good safety.

Objective:To explore the association between circadian syndrome (CircS), metabolic syndrome (MetS) and mild cognitive impairment (MCI) in elderly rural adults in China.Methods:From March to September 2018, totally 5 765 participants aged 60 years or older from 52 villages in Yanlou Town, Yanggu County, Shandong Province were selected. The data included demographic, underlying disease and neuropsychological data were collected by questionaire survey. Having ≥3 of the following components was defined as MetS: elevated waist circumference, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting glucose. Having ≥4 of the following components was defined as CircS: short sleep (<6 h/d), depression and five other components which were used to define MetS, with elevated waist circumference as a mandatory item. MCI was diagnosed according to Petersen's criteria and further classified into amnestic MCI (aMCI) and non-amnestic MCI (naMCI) based on whether the memory domains impaired.Data were analyzed using multivariable Logistic regression and general linear regression models by R statistical software.Results:In the total sample ( n=4 898), 1 280 participants were diagnosed with MCI, of which 1 075 were aMCI and 205 were naMCI.Compared to the normal group, CircS alone was significantly associated with increased risks of MCI ( B=0.695, P=0.039) and aMCI ( B=0.782, P=0.024), as well as lower verbal fluency scores ( B=-0.244, P=0.045). No significant associations were found between MetS alone or both MetS and CircS and cognitive impairment( P>0.05). At the component level, short sleep and depression were associated with increased risks of MCI ( B=0.167, P=0.025; B=0.605, P<0.001) and aMCI ( B=0.185, P=0.020; B=0.600, P<0.001). Conclusion:Individuals with CircS are at a higher risk of cognitive impairment, CircS is more strongly associated with cognitive impairment than MetS, with short sleep duration and depressive symptoms potentially playing key roles.

Objective:To explore the potential risk factors for cancer in patients with adenomatous polyps based on tumor markers and polyp lesion characteristics.Methods:A retrospective analysis was conducted to collect clinical data of 115 patients with adenomatous intestinal polyps who visited Nanjing Jiangbei Hospital from November 2022 to November 2024. They were divided into a cancerous group (17 cases) and a non cancerous group (98 cases) based on whether they were cancerous or not. Clinical data such as tissue type and polyp site and tumor marker levels such as carcinoembryonic antigen (CEA) and cancer antigen 72-4 (CA72-4) were collected at the first visit of all patients. The potential risk factors of adenomatous intestinal polyp canceration were investigated by Logistic regression analysis.Results:Univariate analysis revealed that the proportion of villous tubular adenomas, central depression of polyps, and lobulated polyps in the cancerous group were higher than those in the non cancerous group. Serum levels of CEA and CA72-4 were also higher in the cancerous group than in the non cancerous group : 13/17 vs.47.96% (47/98), 7/17 vs. 15.31% (15/98), 6/17 vs. 8.16% (8/98), (6.41 ± 1.81) μg/L vs. (4.23 ± 1.48) μg/L, (6.98 ± 1.83) kU/L vs. (5.66 ± 1.78) kU/L, respectively. The difference was statistically significant ( P<0.05). The results of Logistic regression analysis showed that the histological subtype of villous tubular adenoma, central depression of polyps, lobulated polyps, and high levels of CEA and CA72-4 were independent risk factors for cancer in patients with adenomatous intestinal polyps ( P<0.05). A nomogram risk model was constructed based on the influencing factors of canceration in patients with adenomatous intestinal polyps. The calibration curve was drawn, and the calibration curve was similar to the Y-X straight line, suggesting that the evaluation results of the nomogram risk model were highly consistent with the actual observation results. The receiver operating characteristic (ROC) curve was drawn. The results showed that the area under the curve (AUC) of the nomogram risk model for evaluating the canceration of patients with adenomatous intestinal polyps was 0.956, and the evaluation value was high. The decision curve was drawn, with the threshold of high risk as the horizontal coordinate and the net rate of return as the vertical coordinate. The results showed that when the threshold was in the range of 0 - 0.85, 0.96 - 0.99, the net benefit rate of predicting the cancer risk of patients with adenomatous intestinal polyps was greater than 0 and the maximum net benefit rate was 0.148. Conclusions:The histological classification of villous tubular adenoma, central depression of polyps, lobulated polyps, and high levels of CEA and CA72-4 are independent risk factors for cancer in patients with adenomatous intestinal polyps; The evaluation efficiency of the column chart risk model constructed based on the above factors is good.