Objective:To explore the diagnostic value of the macrophage activation syndrome/systemic juvenile idiopathic arthritis（MS）score in macrophage activation syndrome（MAS）associated with systemic juvenile idiopathic arthritis（sJIA），and to provide a reference for clinical work.Methods:This study was a retrospective case-control analysis，conducted on the patients initially diagnosed as sJIA-associated with MAS and admitted into the Department of Rheumatology and Immunology of Children's Hospital Affiliated to Xi 'an Jiaotong University from July 1st，2016 to June 30th，2023. All of the patients met the diagnostic criteria for patients with MAS associated with sJIA according to the 2016 European Alliance of Associations for Rheumatology（EULAR）/American College of Rheumatology（ACR）/Pediatric Rheumatology International Trials Organization（PRINTO）standards. The basic information at baseline，clinical manifestations，and auxiliary examination results were collected. The MS score was applied to re-evaluate the children diagnosed as sJIA-associated with MAS. When the MS score ≥-2.1，the possibility of sJIA with MAS was high. Thirty cases of sJIA without MAS were randomly selected as the control group.Results:There were 28 cases in the MAS group，including 13 males（46.43%）and 15 females（53.57%），with an average age of（7.51±4.01）years. Compared with the control group，the MAS group were significantly more likely to have high fever（ χ2=8.539， P=0.003），hepatomegaly（ χ2=11.621， P<0.001），splenomegaly（ χ2=11.710， P<0.001）and neurological involvement（ χ2=27.619， P<0.001），with the differences being statistically significant. Meanwhile，there were statistically significant differences between the two groups in terms of white blood cell count（ Z=-4.001， P<0.001），neutrophil count（ Z=-3.659， P<0.001），platelet count（ Z=-4.687， P<0.001），albumin level（ Z=-4.018， P<0.001），alanine aminotransferase（ Z=-3.846， P<0.001），aspartate aminotransferase（ Z=-5.932， P<0.001），lactate dehydrogenase（ Z=-6.150， P<0.001），triglycerides（ Z=-5.874， P<0.001），fibrinogen（ Z=-5.808， P<0.001），ferritin（ Z=-5.280， P<0.001），erythrocyte sedimentation rate（ Z=-3.971， P<0.001），ferritin/erythrocyte sedimentation rate（ Z=-5.433， P<0.001），reduction of two-line cells in blood（ χ2=11.408， P<0.001）and the presence of hemophagocytosis in bone marrow smears（ χ2=28.260， P<0.001）. Moreover，there was a statistically significant difference in MS scores between the two groups（ Z=-6.148， P<0.001），with higher MS scores in the MAS group. Nevertheless，this study showed the median MS scores of both groups ≥-2.1. Conclusion:The MS score was significant to a certain degree as reference for the diagnosis of MAS，and this study showed that the MS score in the MAS group was significantly higher than the control group. However，the median MS scores in both groups were no less than -2.1. This might be related to the influence of factors during the assessment，which made it necessary to optimize the cutoff values of the MS score. Therefore，prospective studies should be carried out on the role of MS score in early identification of MAS.

Objective To investigate the clinical diagnostic value of serum sTREM2 level in patients with cerebral small vessel disease(CSVD)and its correlation with depression and its severity.Methods A total of 208 CSVD inpatients admitted in Department of Neurology of the First Affiliated Hospital of Shihezi University from December 2023 to November 2024 were en-rolled,and according to their score of HAMD,they were divided into a depression group(CSVD+D group,112 cases)and a non-depression group(CSVD—D group,96 cases).According to the 17-item HAMD,the depression group(CSVD+D group)was further divided into mild(8-17,n=80),moderate(18-24,n=27)and severe depression(≥25,n=5)subgroups.Another 208 healthy individuals who taking health checkups in the same period were selected and served as the control group.The general clinical data were compared among the groups and subgroups,and mul-tivariate logistic regression analysis was applied to identify the risk factors for the occurrence of depression and the relationship between sTREM2 and depression severity in the CSVD patients.ROC curve was plotted to evaluate the predicative performance of serum sTREM2 level for the occurrence of depression in the CSVD patients.Results The serum sTREM2 level was remark-ably higher in the CSVD patients than the control group(5.95±3.82 μg/L vs 1.40±1.21 μg/L,P＜0.01).ROC curve analysis indicated that the AUC value of serum sTREM2 level in predicting CSVD was 0.917,with a sensitivity of 87.52％and a specificity of 85.64％,and an optimal cut-ff value of 2.272 μg/L.The CSVD+D group also had significantly higher serum sTREM2 level than the CSVD—D group(6.40±3.93 μg/L vs 5.01±2.87 μg/L,P＜0.01).Multivariate logistic regression analysis showed that serum sTREM2 level was an independent influencing factor for occurrence of depression in the CSVD patients(OR=1.115,95％CI:1.019-1.220,P=0.018).Statistical difference was also observed in the patients without and with mild,moderate and severe depression(P＜0.05).Multivariate ordinal logistic regression analysis revealed that serum sTREM2 level was an independent influencing factor for mild,moderate and severe depression(OR=1.113,95％CI:1.013-1.223,P=0.026;OR=1.135,95％CI:1.004-1.284,P=0.043).The AUC value of serum sTREM2 level in predicting depressive symptoms in CSVD patients was 0.603.Conclusion Serum sTREM2 is closely associated with CSVD patients.Its level may provide certain reference value for clinical diagnosis of CSVD,and has potentially predictive value for the occurrence of depression in the CSVD patients.

Objective To explore the relationship between overactive bladder(OAB)and neuropsychological characteristics in patients with cerebral small-vessel disease(CSVD).Methods A total of 208 patients with CSVD admitted to the First Affiliated Hospital of Shihezi University from December 2023 to November 2024 were selected as research subjects.They were divided into OAB group(44 cases)and non-OAB group(164 cases)according to overactive bladder symptom score.The general information and imaging data of two groups of patients were compared.The cognitive function,anxiety and depression of patients were evaluated by using Montreal cognitive assessment(MoCA),digit span test(DST),auditory verbal learning test(AVLT),verbal fluency test(VFT),clock drawing test(CDT),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD).Logistic regression analysis was used to analyze the influencing factors of OAB in patients with CSVD.Pearson correlation analysis was used to analyze the correlation between imaging indicators and anxiety symptoms of patients in OAB group.Results The HAMA and HAMD scores of patients in OAB group were higher than those in non-OAB group(P＜0.05),but there were no statistically significant differences in MoCA,DST,AVLT,VFT,and CDT scores between two groups(P＞0.05).There was a statistically significant difference in the incidence of anxiety among patients with different degrees of OAB(P＜0.05).Multivariate Logistic regression analysis after adjusting for confounding factors showed that anxiety was an independent influencing factor for OAB in patients with CSVD(P＜0.05).The periventricular white matter hyperintensity of patients in OAB group was negatively correlated with the HAMA score(P＜0.05),while basal ganglia lacunar infarction,centrum semiovale lacunar infarction,basal ganglia enlarged perivascular space and centrum semiovale enlarged perivascular space were all positively correlated with the HAMA score(P＜0.05).Conclusion The anxiety and depression symptoms of patients with CSVD accompanied by OAB were more severe than those of non-OAB patients.Anxiety may be an independent influencing factor for the occurrence of OAB in patients with CSVD.

Objective To explore the expression of nuclear transport factor 2(NUTF2)in patients with head and neck squamous cell carcinoma(HNSCC)and analyze its relationship with prognosis.Methods 269 HNSCC patients from Handan Central Hospital between March 2016 and February 2017 were selected.Immunohistochemical staining was used to detect NUTF2 expression levels,comparing tumor tissues with adjacent tissues and NUTF2 expression across different tumor stages.The correlation between NUTF2 expression levels and tumor staging,as well as factors influencing HNSCC patient survival outcomes,were analyzed.Survival situations of HNSCC patients with different NUTF2 expression levels were compared.In vitro experiments were conducted to observe the effects of NUTF2 expression level changes on HNSCC cell proliferation and apoptosis.Results NUTF2 expression levels in HNSCC tumor tissues were higher than in adjacent tissues(P<0.05);NUTF2 expression levels were positively correlated with tumor staging(P<0.05).NUTF2 expression level(HR=3.478,95%CI 1.752～6.906)was a factor influencing HNSCC patient survival outcomes(P<0.05);HNSCC patients with high NUTF2 expression had lower survival rates compared to those with low NUTF2 expression(HR=0.486,95%CI 0.298～0.793,χ2=8.345,P=0.004).Knockdown of NUTF2 expression inhibited HNSCC cell proliferation and promoted cell apoptosis.Conclusion NUTF2 expression levels are abnormally elevated in HNSCC tumor tissues,directly affecting patient survival outcomes,with high NUTF2 expression indicating a poorer prognosis.

Objective To investigate the clinical diagnostic value of serum sTREM2 level in patients with cerebral small vessel disease(CSVD)and its correlation with depression and its severity.Methods A total of 208 CSVD inpatients admitted in Department of Neurology of the First Affiliated Hospital of Shihezi University from December 2023 to November 2024 were en-rolled,and according to their score of HAMD,they were divided into a depression group(CSVD+D group,112 cases)and a non-depression group(CSVD—D group,96 cases).According to the 17-item HAMD,the depression group(CSVD+D group)was further divided into mild(8-17,n=80),moderate(18-24,n=27)and severe depression(≥25,n=5)subgroups.Another 208 healthy individuals who taking health checkups in the same period were selected and served as the control group.The general clinical data were compared among the groups and subgroups,and mul-tivariate logistic regression analysis was applied to identify the risk factors for the occurrence of depression and the relationship between sTREM2 and depression severity in the CSVD patients.ROC curve was plotted to evaluate the predicative performance of serum sTREM2 level for the occurrence of depression in the CSVD patients.Results The serum sTREM2 level was remark-ably higher in the CSVD patients than the control group(5.95±3.82 μg/L vs 1.40±1.21 μg/L,P＜0.01).ROC curve analysis indicated that the AUC value of serum sTREM2 level in predicting CSVD was 0.917,with a sensitivity of 87.52％and a specificity of 85.64％,and an optimal cut-ff value of 2.272 μg/L.The CSVD+D group also had significantly higher serum sTREM2 level than the CSVD—D group(6.40±3.93 μg/L vs 5.01±2.87 μg/L,P＜0.01).Multivariate logistic regression analysis showed that serum sTREM2 level was an independent influencing factor for occurrence of depression in the CSVD patients(OR=1.115,95％CI:1.019-1.220,P=0.018).Statistical difference was also observed in the patients without and with mild,moderate and severe depression(P＜0.05).Multivariate ordinal logistic regression analysis revealed that serum sTREM2 level was an independent influencing factor for mild,moderate and severe depression(OR=1.113,95％CI:1.013-1.223,P=0.026;OR=1.135,95％CI:1.004-1.284,P=0.043).The AUC value of serum sTREM2 level in predicting depressive symptoms in CSVD patients was 0.603.Conclusion Serum sTREM2 is closely associated with CSVD patients.Its level may provide certain reference value for clinical diagnosis of CSVD,and has potentially predictive value for the occurrence of depression in the CSVD patients.

Objective To explore the relationship between overactive bladder(OAB)and neuropsychological characteristics in patients with cerebral small-vessel disease(CSVD).Methods A total of 208 patients with CSVD admitted to the First Affiliated Hospital of Shihezi University from December 2023 to November 2024 were selected as research subjects.They were divided into OAB group(44 cases)and non-OAB group(164 cases)according to overactive bladder symptom score.The general information and imaging data of two groups of patients were compared.The cognitive function,anxiety and depression of patients were evaluated by using Montreal cognitive assessment(MoCA),digit span test(DST),auditory verbal learning test(AVLT),verbal fluency test(VFT),clock drawing test(CDT),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD).Logistic regression analysis was used to analyze the influencing factors of OAB in patients with CSVD.Pearson correlation analysis was used to analyze the correlation between imaging indicators and anxiety symptoms of patients in OAB group.Results The HAMA and HAMD scores of patients in OAB group were higher than those in non-OAB group(P＜0.05),but there were no statistically significant differences in MoCA,DST,AVLT,VFT,and CDT scores between two groups(P＞0.05).There was a statistically significant difference in the incidence of anxiety among patients with different degrees of OAB(P＜0.05).Multivariate Logistic regression analysis after adjusting for confounding factors showed that anxiety was an independent influencing factor for OAB in patients with CSVD(P＜0.05).The periventricular white matter hyperintensity of patients in OAB group was negatively correlated with the HAMA score(P＜0.05),while basal ganglia lacunar infarction,centrum semiovale lacunar infarction,basal ganglia enlarged perivascular space and centrum semiovale enlarged perivascular space were all positively correlated with the HAMA score(P＜0.05).Conclusion The anxiety and depression symptoms of patients with CSVD accompanied by OAB were more severe than those of non-OAB patients.Anxiety may be an independent influencing factor for the occurrence of OAB in patients with CSVD.

Objective:To evaluate the incidence of arrhythmias and electrocardiographic (ECG) characteristics in cancer patients treated with immune checkpoint inhibitors (ICIs).Methods:This was a cohort study conducted in the Fourth Hospital of Hebei Medical University. Cancer patients initiating ICIs treatments from November 2020 to September 2022 were included in this study. Baseline 12-leads ECG before ICIs initiation and post-treatment ECG were analyzed. An abnormal ECG was defined as the presence of any of the following changes: sinus arrhythmias, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, ventricular tachycardia, premature contractions, conduction disorder, and ST-T changes.Results:A total of 87 patients were enrolled, aged 63 (57, 68) years, with 66 (75.9%) males. And 44.8% (39/87) of patients presented with at least one confirmed cardiovascular disease or cardiovascular risk factor at baseline. The incidence of abnormal ECG increased from 31.0% (27/87) at baseline to 65.5% (57/87) after receiving (5.0±2.7) cycles of ICIs treatment ( P<0.001). The incidence of sinus arrhythmias was significantly increased after ICIs treatment (23.0% (20/87) vs. 9.2% (8/87), P=0.023), of which only the incidence of sinus tachycardia was significantly increased (11.5% (10/87) vs. 2.3% (2/87), P=0.039). There was also a significantly increased incidence of ST-T changes after ICIs treatment (31.0% (27/87) vs. 17.2% (15/87), P=0.012), which mainly attributed to the T wave changes (29.9% (26/87) vs. 13.8% (12/87), P=0.001). The incidence of premature contractions was also significantly increased after ICIs treatment (9.2% (8/87) vs. 0, P=0.008). Additionally, compared with baseline, the P wave axis was significantly increased after ICIs treatment ((56.94±21.01)° vs. (52.00±22.69)°, P=0.043). After ICIs treatment, the heart rate was significantly increased ((79.07±15.37) beats/min vs. (75.64±13.37) beats/min, P=0.029). Sokolow-Lyon index ((2.21±0.81)mV vs. (2.33±0.75)mV, P=0.138), QTc interval ((431.44±36.04)ms vs. (428.00±30.05)ms, P=0.415) all showed signs of change after treatment, but did not reach the traditional significant level. Conclusions:The incidence of abnormal ECG is significantly increased after ICIs treatment, especially for sinus tachycardia, premature contractions and T wave changes; the P wave axis and heart rate is also significantly increased after treatment. It is important to perform regular ECG monitoring in patients receiving ICIs treatment.

Objective To explore the relationship between serum high mobility group protein B1(HMGB1)level and anxiety symptoms in patients with cerebral small vessel disease(CSVD).Methods A total of 165 CSVD patients admitted in our department from December 2022 to July 2023 were enrolled as the research subjects.All of them were evaluated by neurologists with Hamilton Anxiety Rating Scale(HAMA),and then those with HAMA score ≥7 were assigned into an anxiety group(70 cases),and the other into a non-anxiety group(95 cases).Non paramet-ric rank sum test was used to compare the serum level of HMGB1 between the two groups of pa-tients.Logistic regression analysis was employed to analyze the risk factors affecting anxiety symptoms in CSVD patients.ROC curve was plotted to evaluate the predictive value of HMGB1 for anxiety symptoms in the patients.Results The serum HMGB1 level was significantly higher in the anxiety group than the non-anxiety group[287.01(188.19,355.54)ng/L vs 260.87(146.48,328.16)ng/L,P＜0.05].Multivariate logistic regression analysis showed that after adjusting for confounding factors,serum HMGB1 level was still a risk factor for anxiety symptoms in CSVD patients(OR=1.004,95％CI:1.000-1.007,P=0.046).Spearman correlation analysis indicated that HMGB1 level was positively correlated with total score of HAMA,insomnia score,and psy-chogenic score(P＜0.05,P＜0.01).The AUC value of HMGB1 in predicting anxiety symptoms in CSVD patients was 0.609(P=0.020).Conclusion Serum HMGB1 level is associated with the oc-currence of anxiety symptoms in CSVD patients,and it has predictive value for the anxiety symp-toms in CSVD patients.

Objective:To report the sampling study design and radiography protocol of a large-sample investigation on skeletal maturation of 3 to 18-year-old children in China.Methods:Multi-stage stratified random sampling was employed in this study. Two provinces, municipalities, or autonomous regions were randomly selected from each of the seven regions of China, including Northeast China, Northwest China, North China, Central China, East China, Southwest China, and South China. Then one rural and one urban investigation site were randomly selected from each province, municipality, or autonomous region. In total 28 sites were included. Among those sites, four residential districts were randomly selected from each urban site, and four townships from each rural site. For each residential district or township, 1-4 kindergartens, primary schools, and middle schools were chosen. Random cluster sampling was used to extract 3-<6-year-old children in kindergartens, and 6-18-year-old children in primary schools and middle schools. The investigation on skeletal maturation was sampled proportionate to the sampling of the whole study. The estimated simple size was 780 for each site, and 21 840 for all 28 sites in total. There were six groups of 3-<6-year-old children classified at 0.5-year intervals, and 12 groups of 6-18-year-old children classified at 1-year intervals. Posteroanterior position radiography of the left hand and wrist was achieved for all subjects.Results:The study was performed from August 26, 2019 to October 16, 2021. In total, 20 444 children received posteroanterior position radiography of the left hand and wrist, including 10 196 males and 10 248 females, 9 711 urban and 10 733 rural, respectively. The 3-<6-year-old group included 1 611 (male 819, female 792) subjects, and the 6 to 18-year-old group included 18 833 (male 9 377, female 9 456) subjects.Conclusion:This nationwide investigation on skeletal maturation of 3 to 18-year-old children in seven regions of China was successfully preformed. The results of this study can provide an important reference for establishing the current evaluation criteria of bone age in Chinese children and adolescents.

Objective:To evaluate the applicability of bone age (BA) assessment methods and to investigate the difference between BA and chronological age (CA) based on the data of children in rural areas of Beijing.Methods:A total of 412 healthy children (226 boys, 186 girls) with the age 8.6 (6.8, 10.3) years old were included in this study. The data of the prospective study were from a subgroup of the project "National Nutrition and Health Systematic Survey for 0-18 Years Old Children in China", which included children with age of 3-12 years old in Beijing rural areas. The non-dominant hand-wrist radiographs of all participants were obtained in April 2021. The Dr.Wise BA detection and analysis system was used to assess the BA according to the Tanner Whitehouse 3 (TW3) radius-ulna-short bone score (TW3-RUS), TW3 carpal bone score (TW3-Carpal), China-05 TW3-Chinese RUS (TW3-C RUS), China-05 TW3-Chinese carpal (TW3-C Carpal), and Greulich-Pyle (G-P) standards. The cases were stratified by the sex and different CA in the statistical analysis. The estimated BA obtained using different methods were compared with the CA using Wilcoxon signed ranks test.Results:The sex-stratified results showed that no significant difference was found between the estimated BA using G-P standards and CA in boys ( Z=-0.694, P=0.488), while all the other estimated BA results were statistically significantly higher than CA ( P<0.05). Stratified by both sex and CA, the estimated BA using G-P standards in 4-6 years old boy groups, as well as the estimated BA using TW3-Carpal and TW3-C Carpal standards in 11-12 years old girl groups were lower than CA, while in the other groups, the estimated BA were higher than CA. Conclusions:There were varying degrees of deviations in the BA estimations using TW3, China 05, and G-P methods for children in rural areas of Beijing. It is imperative to establish a new standard for the BA evaluation of the contemporary Chinese children.