Objective:To investigate the prevalence of cardiometabolic multimorbidity (CMM) in Chinese middle-aged and elderly population, and the associated factors of cognitive function in CMM patients.Methods:It was a cross-sectional study. Data of demographic characteristics, lifestyle, chronic disease, and cognitive function in middle-aged and elderly subjects were obtained from the Harmonized CHARLS D version 2015 database, subjects with emotional and psychiatric disorders and memory-related disorders, and those with missing chronic disease data were excluded. The factors associated with cognitive function in CMM patients were analyzed with generalized linear regression model.Results:A total of 15 007 respondents aged (61.07±9.70) years were included in the analysis, 7 338 (48.9%) of whom were males. There were 3 303 cases of CMM with a prevalence rate of 22.01%, and the proportion of females was 54.9% (1 814/3 033), and the proportion of males was 45.1% (1 489/3 033). Generalized linear regression analysis showed that age, educational level, place of residence, depressive symptoms were correlated with cognitive function scores of CMM patients (all P<0.05). Conclusion:The prevalence rate of CMM in middle-aged and elderly people in China is higher, and age, education level, place of residence, depressive symptoms are associated with cognitive function in CMM patients.

Objective To explore the application effect of real-time vascular threshold detection and low-dose contrast agent peak tracking method via 64-slice spiral computed tomography angiography(CTA).Methods A total of 96 patients who underwent 64-slice spiral CT head CTA examination were selected,and all patients were divided into real-time vascular threshold detection group(n=48)and low-dose contrast agent peak tracking group(n=48)according to different scanning methods.The real-time vascular threshold detection group performed the real-time vascular threshold detection method,and the low-dose contrast agent peak tracking group used the low-dose contrast agent peak tracking method,the fulfillment diagnostic rate and radiation dose index between the two groups were compared.Results The fulfillment diagnostic rate of the low-dose contrast agent peak tracking group was significantly higher than that of the real-time vascular threshold detection group(P＜0.05).The volume CT dose index(CTDIvol),dose length product(DLP),and total radiation dose of the low-dose contrast agent peak tracking group were significantly higher than those of the real-time vascular threshold detection group(P＜0.05).Conclusion The low-dose contrast agent peak tracking method can be used in the clinic after substantially improving the image quality and diagnostic rate,and the real-time vascular threshold detection can save the contrast agent consumption,reduce the patient's radiation dose,save time,and benefit the patient's prognosis.

Objective To explore the application effect of real-time vascular threshold detection and low-dose contrast agent peak tracking method via 64-slice spiral computed tomography angiography(CTA).Methods A total of 96 patients who underwent 64-slice spiral CT head CTA examination were selected,and all patients were divided into real-time vascular threshold detection group(n=48)and low-dose contrast agent peak tracking group(n=48)according to different scanning methods.The real-time vascular threshold detection group performed the real-time vascular threshold detection method,and the low-dose contrast agent peak tracking group used the low-dose contrast agent peak tracking method,the fulfillment diagnostic rate and radiation dose index between the two groups were compared.Results The fulfillment diagnostic rate of the low-dose contrast agent peak tracking group was significantly higher than that of the real-time vascular threshold detection group(P＜0.05).The volume CT dose index(CTDIvol),dose length product(DLP),and total radiation dose of the low-dose contrast agent peak tracking group were significantly higher than those of the real-time vascular threshold detection group(P＜0.05).Conclusion The low-dose contrast agent peak tracking method can be used in the clinic after substantially improving the image quality and diagnostic rate,and the real-time vascular threshold detection can save the contrast agent consumption,reduce the patient's radiation dose,save time,and benefit the patient's prognosis.

The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has been gradually rising in recent years.According to published findings,high triglyceride levels are strongly associated with the severity of acute pancreatitis,and may lead to a higher incidence of complications and worse prognosis.However,the risk factors associated with HTG-AP have not been systematically explored.Early identification and effective management of high triglyceride levels and other potential causes thereof are crucial for reducing the recurrence of acute pancreatitis in clinical practice.Herein,we reviewed the predictive factors of HTG-AP from the perspectives of etiology,pathogenesis,and the relevant biomarkers,such as C-reactive protein,Ca2+,PT,and D-dimer.We aim to provide important early warning signals for clinicians,thereby helping develop personalized treatment protocols and building a more accurate risk prediction model.

Objective:To evaluate the safety of neoadjuvant therapy with pembrolizumab combined with 5-fluorouracil (5-FU) and cisplatin in patients with advanced temporal bone squamous cell carcinoma (TBSCC), and its impact on tumor response rate and disease-free survival (DFS).Methods:This prospective, single-arm, open-label clinical study enrolled patients with advanced (Stage Ⅲ/Ⅳ) TBSCC from Sun Yat-sen Memorial Hospital. Patients received 2-3 cycles of neoadjuvant therapy with pembrolizumab, 5-FU, and cisplatin, followed by definitive surgery. Postoperatively, patients received 6 cycles of pembrolizumab combined with radiotherapy. The primary endpoint was the 2-year disease-free survival (DFS) rate. Secondary endpoints included objective response rate (ORR) and safety indicators. Survival analysis was performed using the Kaplan-Meier method. Adverse events (AE) were assessed using the National Cancer Institute′s Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Statistical analyses were conducted using SPSS software, version 22.0.Results:From August 2021 to April 2024, 16 patients with advanced TBSCC were enrolled (13 males and 3 females), with a median age of 54 years and a median follow-up time of 2.32 years. Following neoadjuvant therapy, the objective response rate (ORR) was 64.3% (9/14), and the disease control rate (DCR) was 92.9% (13/14). The 2-year DFS rate was 86.6%. Common treatment-related adverse events (TRAE) included leukopenia (56.3%, 9/16), nausea and vomiting (50.0%, 8/16), diarrhea, oral mucositis, and elevated liver function tests (25.0%, 4/16). One patient (6.25%) experienced a grade 3 adverse event.Conclusion:Neoadjuvant pembrolizumab-chemotherapy significantly enhances objective response rate and disease-free survival in advanced TBSCC.

Objective:To investigate the factors influencing the prognosis of critically ill patients and the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index.Methods:A retrospective analysis was conducted on the clinical data of 122 critically ill patients admitted to Guoyao Dongfeng General Hospital affiliated with Hubei University of Medicine from June 2022 to December 2023. Patients were divided into a death group and a survival group based on their 28-day prognosis. Clinical data were compared between the two groups to analyze the factors influencing prognosis and assess the predictive value of various indicators. Normally distributed measurement data were expressed as Mean±SD, and intergroup comparisons were performed by independent samples t-test; non-normally distributed measurement data were expressed as M( Q1,Q3), and intergroup comparisons were performed by the Mann-Whitney U test. Counting data were expressed as case (%), and intergroup comparisons were performed by the χ2 test. Multivariate logistic regression was used to analyze factors influencing patient prognosis, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator. Results:The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, blood lactate, CRP, and B-type natriuretic peptide levels in the death group were higher than those in the survival group [22 (17, 30) points vs. 17 (14, 22) points, (4.8±1.4) mmol/L vs. (3.3±1.0) mmol/L, 134 (83, 2 381) mg/L vs. 13 (10, 27) mg/L, 259 (111, 592) ng/L vs. 108 (40, 247) ng/L; Z=3.04, P=0.002; t=5.79, P<0.001; Z=8.57, P<0.001; Z=3.28, P=0.001, respectively]. Albumin, neutrophil count, lymphocyte count (LYC), and the CALLY index were lower in the death group than in the survival group [(31±5) g/L vs. (37±6) g/L, (58±9)×10 9/L vs. (63±10)×10 9/L, 0.6 (0.4, 0.8)×10 9/L vs. 1.3 (0.8, 1.7)×10 9/L, 0.03 (0.02, 0.11) vs. 0.26 (0.13, 0.49); t=6.05, P<0.001; t=3.04, P=0.003; Z=5.82, P<0.001; Z=6.52, P<0.001, respectively]. Multivariate logistic regression analysis indicated that the APACHE Ⅱ score and CRP were risk factors for poor prognosis in critically ill patients ( OR=1.349, 95% CI: 1.004-1.821, P=0.048; OR=1.006, 95% CI: 1.003-1.010, P=0.001, respectively), while LYC and the CALLY index were protective factors ( OR=0.297, 95% CI: 0.111-0.795, P=0.016; OR=0.989, 95% CI: 0.955-0.999, P=0.001, respectively). The area under the ROC curve for the CALLY index predicting 28-day mortality in critically ill patients was 0.872 (95% CI: 0.800-0.926), which was higher than that of the APACHE Ⅱ score, LYC, and CRP [0.673 (95% CI: 0.582-0.756), 0.664 (95% CI: 0.573-0.748), 0.576 (95% CI: 0.482-0.665), respectively]. The cut-off values were 0.06, 20 points, 0.8×10 9/L, and 50 mg/L, respectively. When the CALLY index was 0.06, the specificity was 97.65%, the sensitivity was 72.97%, and the Youden index was 0.706. Conclusions:The APACHE Ⅱ score, CRP, LYC, and CALLY index are all factors influencing the prognosis of critically ill patients. The CALLY index has certain predictive value, but its false negative rate is relatively high. Further combination with other indicators is needed to improve its predictive value.

Objective:To evaluate the safety of neoadjuvant therapy with pembrolizumab combined with 5-fluorouracil (5-FU) and cisplatin in patients with advanced temporal bone squamous cell carcinoma (TBSCC), and its impact on tumor response rate and disease-free survival (DFS).Methods:This prospective, single-arm, open-label clinical study enrolled patients with advanced (Stage Ⅲ/Ⅳ) TBSCC from Sun Yat-sen Memorial Hospital. Patients received 2-3 cycles of neoadjuvant therapy with pembrolizumab, 5-FU, and cisplatin, followed by definitive surgery. Postoperatively, patients received 6 cycles of pembrolizumab combined with radiotherapy. The primary endpoint was the 2-year disease-free survival (DFS) rate. Secondary endpoints included objective response rate (ORR) and safety indicators. Survival analysis was performed using the Kaplan-Meier method. Adverse events (AE) were assessed using the National Cancer Institute′s Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Statistical analyses were conducted using SPSS software, version 22.0.Results:From August 2021 to April 2024, 16 patients with advanced TBSCC were enrolled (13 males and 3 females), with a median age of 54 years and a median follow-up time of 2.32 years. Following neoadjuvant therapy, the objective response rate (ORR) was 64.3% (9/14), and the disease control rate (DCR) was 92.9% (13/14). The 2-year DFS rate was 86.6%. Common treatment-related adverse events (TRAE) included leukopenia (56.3%, 9/16), nausea and vomiting (50.0%, 8/16), diarrhea, oral mucositis, and elevated liver function tests (25.0%, 4/16). One patient (6.25%) experienced a grade 3 adverse event.Conclusion:Neoadjuvant pembrolizumab-chemotherapy significantly enhances objective response rate and disease-free survival in advanced TBSCC.

Objective:To investigate the factors influencing the prognosis of critically ill patients and the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index.Methods:A retrospective analysis was conducted on the clinical data of 122 critically ill patients admitted to Guoyao Dongfeng General Hospital affiliated with Hubei University of Medicine from June 2022 to December 2023. Patients were divided into a death group and a survival group based on their 28-day prognosis. Clinical data were compared between the two groups to analyze the factors influencing prognosis and assess the predictive value of various indicators. Normally distributed measurement data were expressed as Mean±SD, and intergroup comparisons were performed by independent samples t-test; non-normally distributed measurement data were expressed as M( Q1,Q3), and intergroup comparisons were performed by the Mann-Whitney U test. Counting data were expressed as case (%), and intergroup comparisons were performed by the χ2 test. Multivariate logistic regression was used to analyze factors influencing patient prognosis, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator. Results:The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, blood lactate, CRP, and B-type natriuretic peptide levels in the death group were higher than those in the survival group [22 (17, 30) points vs. 17 (14, 22) points, (4.8±1.4) mmol/L vs. (3.3±1.0) mmol/L, 134 (83, 2 381) mg/L vs. 13 (10, 27) mg/L, 259 (111, 592) ng/L vs. 108 (40, 247) ng/L; Z=3.04, P=0.002; t=5.79, P<0.001; Z=8.57, P<0.001; Z=3.28, P=0.001, respectively]. Albumin, neutrophil count, lymphocyte count (LYC), and the CALLY index were lower in the death group than in the survival group [(31±5) g/L vs. (37±6) g/L, (58±9)×10 9/L vs. (63±10)×10 9/L, 0.6 (0.4, 0.8)×10 9/L vs. 1.3 (0.8, 1.7)×10 9/L, 0.03 (0.02, 0.11) vs. 0.26 (0.13, 0.49); t=6.05, P<0.001; t=3.04, P=0.003; Z=5.82, P<0.001; Z=6.52, P<0.001, respectively]. Multivariate logistic regression analysis indicated that the APACHE Ⅱ score and CRP were risk factors for poor prognosis in critically ill patients ( OR=1.349, 95% CI: 1.004-1.821, P=0.048; OR=1.006, 95% CI: 1.003-1.010, P=0.001, respectively), while LYC and the CALLY index were protective factors ( OR=0.297, 95% CI: 0.111-0.795, P=0.016; OR=0.989, 95% CI: 0.955-0.999, P=0.001, respectively). The area under the ROC curve for the CALLY index predicting 28-day mortality in critically ill patients was 0.872 (95% CI: 0.800-0.926), which was higher than that of the APACHE Ⅱ score, LYC, and CRP [0.673 (95% CI: 0.582-0.756), 0.664 (95% CI: 0.573-0.748), 0.576 (95% CI: 0.482-0.665), respectively]. The cut-off values were 0.06, 20 points, 0.8×10 9/L, and 50 mg/L, respectively. When the CALLY index was 0.06, the specificity was 97.65%, the sensitivity was 72.97%, and the Youden index was 0.706. Conclusions:The APACHE Ⅱ score, CRP, LYC, and CALLY index are all factors influencing the prognosis of critically ill patients. The CALLY index has certain predictive value, but its false negative rate is relatively high. Further combination with other indicators is needed to improve its predictive value.

Objective:To investigate the prevalence of cardiometabolic multimorbidity (CMM) in Chinese middle-aged and elderly population, and the associated factors of cognitive function in CMM patients.Methods:It was a cross-sectional study. Data of demographic characteristics, lifestyle, chronic disease, and cognitive function in middle-aged and elderly subjects were obtained from the Harmonized CHARLS D version 2015 database, subjects with emotional and psychiatric disorders and memory-related disorders, and those with missing chronic disease data were excluded. The factors associated with cognitive function in CMM patients were analyzed with generalized linear regression model.Results:A total of 15 007 respondents aged (61.07±9.70) years were included in the analysis, 7 338 (48.9%) of whom were males. There were 3 303 cases of CMM with a prevalence rate of 22.01%, and the proportion of females was 54.9% (1 814/3 033), and the proportion of males was 45.1% (1 489/3 033). Generalized linear regression analysis showed that age, educational level, place of residence, depressive symptoms were correlated with cognitive function scores of CMM patients (all P<0.05). Conclusion:The prevalence rate of CMM in middle-aged and elderly people in China is higher, and age, education level, place of residence, depressive symptoms are associated with cognitive function in CMM patients.

Objective:To explore the mediating role of disease progression′s fear and positive affect in the relationship between disease perception and demoralization in patients with chronic heart failure. It provided a theoretical basis for targeted interventions for healthcare workers.Methods:From October 2022 to March 2023, 320 patients with chronic heart failure in the First Affiliated Hospital of Zhengzhou University were selected as the research objects by convenience sampling. The General Information Questionnaire, Demoralization Scale Redacted Mandarin Version, Brief Illness Perception Questionnaire, Fear of Progression Questionnaire-Short Form, Positive and Negative Affect Schedule (Positive Affect Schedule) were used to conduct the questionnaire survey exploring the mediating effects of fear of disease progression and positive emotions between disease perception and disorientation by construction structural equation model.Results:There were 268 valid questionnaires. Of the 268 patients, 168 were male and 100 were female, 3.36% (9/268) were ≤40 years old, 55.22% (148/268) were 41-65 years old, and 41.42% (111/268) were >65 years old. Correlation analysis showed that disease perception was positively correlated with disease progression ′s fear, and every dimension of demoralization ( r values were 0.300-0.586, all P<0.01), and negatively correlated with positive affect ( r=-0.374, P<0.01); disease progression′s fear was negatively correlated with positive affect ( r=-0.318, P<0.01), and positively correlated with every dimension of demoralization ( r values were 0.339-0.464, all P<0.01); positive affect was negatively correlated with every dimension of demoralization ( r values were -0.430--0.334, all P<0.01). Structural equation model analysis showed that the direct effect of disease perception on demoralization was significant ( β=0.407, P<0.01), and both mediating effects of disease progression ′s fear and positive affect between disease perception and demoralization in patients with chronic heart failure were significant ( β=0.074, 0.079, both P<0.01). The chain mediating effect of disease progression ′s fear and positive effect was also significant ( β=0.019, P<0.01). Conclusions:Disease perception could directly predict the demoralization of patients with chronic heart failure and indirectly predict the demoralization of patients with chronic heart failure through the mediating effect of disease progression ′s fear, positive affect, and the chain mediating effect of disease progression ′s fear and positive affect.