Objective:To investigate the diagnostic value of heparin-binding protein (HBP), pro-adrenomedullin (pro-ADM), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing the severity of pulmonary infection in patients with chronic heart failure (CHF).Methods:A cross-sectional study was conducted on 100 patients with CHF and pulmonary infection who were admitted to Shaanxi Rehabilitation Hospital between April 2021 and April 2023. According to clinical pulmonary infection score, the patients were classified into mild ( n = 43), moderate ( n = 31), and severe ( n = 26) groups. Additionally, 50 CHF patients without pulmonary infection, who were admitted during the same period, were included in the control group. General demographic data, as well as levels of HBP, pro-ADM, and NT-proBNP were compared among the groups. Logistic regression analysis was performed to identify the factors associated with the occurrence of pulmonary infection in CHF patients, while Pearson correlation analysis was used to assess the correlations among these indicators. Results:The levels of HBP, pro-ADM, and NT-proBNP in the severe group were (36.59 ± 4.15) μg/L, (3.69 ± 0.85) nmoL/L, and (9.63 ± 1.61) μg/L, respectively. In the moderate group, the levels were (33.09 ± 3.67) μg/L, (3.24 ± 0.58) nmoL/L, and (8.15 ± 1.42) μg/L, respectively. In the mild group, the levels were (29.12 ± 3.38) μg/L, (2.65 ± 0.37) nmoL/L, and (6.67 ± 0.68) μg/L, respectively. Significant differences were found in the levels of HBP, pro-ADM, and NT-proBNP among the three groups ( F = 34.41, 26.27, 48.53, all P < 0.05). The levels of HBP, pro-ADM, and NT-proBNP in patients with CHF and pulmonary infection were (32.29 ± 3.25) μg/L, (3.09 ± 0.41) nmoL/L, and (7.89 ± 0.92) μg/L, respectively, which were significantly higher than those in healthy controls [(26.54 ± 2.47) μg/L, (2.32 ± 0.32) nmoL/L, (5.65 ± 0.82) μg/L, t = 12.05, 12.61, 18.17, all P < 0.05]. Logistic regression analysis showed that a history of smoking, New York Heart Association (NYHA) functional classification, the presence of diabetes, as well as levels of HBP, pro-ADM, and NT-proBNP, were all factors influencing the occurrence of pulmonary infection in patients with CHF (all P < 0.05). Pearson analysis revealed that the levels of HBP, pro-ADM, and NT-proBNP in patients with CHF were significantly positively correlated with clinical pulmonary infection score ( r = 0.581, 0.540, 0.653, all P < 0.05). Conclusions:Serum levels of HBP, pro-ADM, and NT-proBNP have good predictive value for the severity of pulmonary infection in patients with CHF.

Objective:To investigate the role of the Brock, Mayo, and PKUPH combined model in risk stratification of solitary pulmonary nodules (SPNs) in health check-up population.Methods:An ambispective cohort study was conducted on 668 eligible SPNs cases from the health management center in Chongqing General Hospital from June 2018 to June 2019. The exposure condition was prospectively followed or historically retrospected, and the clinical outcomes were prospectively followed. SPNs were classified into benign and malignant groups. Descriptive statistics and univariate analysis were performed to assess the differences in risk characteristics between two groups. Receiver operating characteristic (ROC) curve, clinical decision curve, and Hosmer-Lemeshow goodness-of-fit test were used to evaluate and compare the predictive performance, clinical utility, and calibration of the combined model versus individual Brock, Mayo, and PKUPH models.Results:Among the 668 SPNs cases, 82 (12.28%) were diagnosed as malignant. Age, sex, smoking history, extrapulmonary tumor history, diameter, upper lobe, clear border and spicule sign in the malignant group were significantly different from those in the benign group (all P<0.05). The combined model demonstrated superior predictive performance, clinical utility, and calibration compared to the best-performing individual Brock model [Area under the curve (AUC): 0.88 (95% CI: 0.84-0.92) vs 0.86 (95% CI: 0.82-0.91)]. Besides, multi-grade risk stratification enabled by the combined model was better than binary classification, with the malignant rate of the four risk levels were 0.60%, 4.62%, 14.58% and 56.07%, respectively. Conclusion:The combined model addresses the limitations of individual models in SPNs risk stratification for health examination populations, improving predictive performance, clinical utility, and calibration, while proposing a superior multi-grade risk stratification system.

Objective:To investigate the relationship between lipid levels and cognitive impairment in the elderly Chinese population using prospective cohort data.Methods:Based on the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) cohort, this study included 24 380 individuals aged ≥60 years who participated in the cognitive function follow-up survey from 2018 to 2019. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined according to different educational levels: MMSE ≤17 for illiterate individuals, MMSE ≤20 for those with primary education and MMSE ≤24 for those with secondary education or above. Multivariable linear regression and logistic regression models were employed to examine the associations between six baseline lipid indicators and cognitive scores, as well as cognitive impairment. Additionally, restricted cubic splines were used to explore the exposure-dose relationship between lipid levels and cognitive function.Results:The study population had a median follow-up time of 11.6 years, with a baseline age of (59.7±6.8) years. Among the participants, 9 510 (39.0%) were males, and the mean MMSE score was 24.7±6.8. A total of 3 887 individuals (15.9%) were identified as cognitively impaired. The results of multivariable linear regression and logistic regression indicated that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were not only significantly positively associated with cognitive scores but also significantly associated with a lower risk of cognitive impairment. Each 1 mmol/L increase in these lipid levels corresponded to β values (95% CI) of 0.267 (0.173-0.361), 0.385(0.271-0.499) and 0.331(0.231-0.431), respectively. Each 1 mmol/L increase in these lipid levels corresponded to odds ratio ( OR) (95% CI) values of 0.915 (0.876-0.956), 0.875 (0.830-0.923) and 0.886 (0.848-0.927), respectively. The dose-response curve demonstrated that the negative association was primarily observed within the guideline-recommended optimal lipid level range. Specifically, when LDL-C was less than 3.4 mmol/L and non-HDL-C was less than 4.1 mmol/L, the corresponding OR (95% CI) values were 0.859 (0.796-0.926) and 0.876 (0.818-0.939). Conclusion:Lipid levels exhibit a certain linear negative association with cognitive impairment in elderly Chinese adults, with LDL-C and non-HDL-C demonstrating a stronger effect, particularly within the guideline-recommended optimal range.

Objective To observe the value of CT angiography(CTA)for classifying type of peripheral arteriovenous fistula(AVF)in children.Methods Totally 22 children with peripheral AVF were retrospectively enrolled,the type of AVF was classified with preoperative CTA,and therapeutic planning was developed.Taken digital subtraction angiography(DSA)findings during interventional therapy as gold standards,the efficacy of CTA for classifying type of AVF was analyzed.Results Among 22 cases,DSA detected 3 cases of type Ⅰ,13 cases of type Ⅱa and 6 cases of typeⅡb peripheral AVF,while 3 cases of type Ⅰ,14 cases of type Ⅱa and 5 cases of type Ⅱb peripheral AVF were classified based on CTA.CTA misdiagnosed 1 case of type Ⅱa as type Ⅱb,and 2 cases of type Ⅱb as type Ⅱa peripheral AVF,its accuracy of CTA for classifying type Ⅰ,Ⅱa and Ⅱb peripheral AVF was 100%(3/3),92.31%(12/13)and 66.67%(4/6),respectively.Among 22 cases,13 cases underwent interventional closure,2 cases underwent interventional therapy combined with surgery,while 3 cases did not receive relevant treatment due to drainage vein occlusion.One month after treatments,the symptoms of 19 cases who underwent treatment improved significantly,and no signs of AVF was found with re-examination of ultrasound nor CTA.Conclusion CTA was helpful to classifying type of peripheral AV in children,which could provide references for interventional therapy.

Objective:To construct a triple pre-rehabilitation intervention program for patients undergoing radical prostatectomy, to provide a basis for promoting pre-rehabilitation in patients undergoing radical prostatectomy.Methods:Literature analysis was used to search domestic and foreign databases such as China National Knowledge Infrastructure, Wanfang, PubMed, etc, on triple pre-rehabilitation and rapid rehabilitation of patients undergoing radical prostatectomy, with a search time frame from January 1, 2013 to December 31, 2023. The Delphi expert letter consultation was conducted later, and the final draft of the triple pre-rehabilitation intervention program for patients with radical prostatectomy was finally formed.Results:A total of 20 experts completed 2 rounds of inquiries, all were female, with an age of (40.85 ± 5.40) years old. The response rates for the 2 rounds of expert inquiries were both 100%(20/20). The authority coefficients of the experts were 0.87 and 0.90, respectively. Kendall coordination coefficients were 0.11 and 0.21, respectively. The coefficient of variation for each item in the second round of inquiries ranged from 0 to 0.15. The triple pre-rehabilitation intervention program for patients with radical resection of prostate cancer was constructed, including 4 primary indexes, 8 secondary indexes and 25 tertiary indexes.Conclusions:It is scientific, targeted and feasible to construct a triple pre-rehabilitation intervention program for patients undergoing radical prostatectomy based on Delphi method, which can provide clinical basis for pre-rehabilitation of elderly patients undergoing prostate cancer surgery.

Objective To observe the value of CT angiography(CTA)for classifying type of peripheral arteriovenous fistula(AVF)in children.Methods Totally 22 children with peripheral AVF were retrospectively enrolled,the type of AVF was classified with preoperative CTA,and therapeutic planning was developed.Taken digital subtraction angiography(DSA)findings during interventional therapy as gold standards,the efficacy of CTA for classifying type of AVF was analyzed.Results Among 22 cases,DSA detected 3 cases of type Ⅰ,13 cases of type Ⅱa and 6 cases of typeⅡb peripheral AVF,while 3 cases of type Ⅰ,14 cases of type Ⅱa and 5 cases of type Ⅱb peripheral AVF were classified based on CTA.CTA misdiagnosed 1 case of type Ⅱa as type Ⅱb,and 2 cases of type Ⅱb as type Ⅱa peripheral AVF,its accuracy of CTA for classifying type Ⅰ,Ⅱa and Ⅱb peripheral AVF was 100%(3/3),92.31%(12/13)and 66.67%(4/6),respectively.Among 22 cases,13 cases underwent interventional closure,2 cases underwent interventional therapy combined with surgery,while 3 cases did not receive relevant treatment due to drainage vein occlusion.One month after treatments,the symptoms of 19 cases who underwent treatment improved significantly,and no signs of AVF was found with re-examination of ultrasound nor CTA.Conclusion CTA was helpful to classifying type of peripheral AV in children,which could provide references for interventional therapy.

Objective:To investigate the relationship between lipid levels and cognitive impairment in the elderly Chinese population using prospective cohort data.Methods:Based on the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) cohort, this study included 24 380 individuals aged ≥60 years who participated in the cognitive function follow-up survey from 2018 to 2019. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined according to different educational levels: MMSE ≤17 for illiterate individuals, MMSE ≤20 for those with primary education and MMSE ≤24 for those with secondary education or above. Multivariable linear regression and logistic regression models were employed to examine the associations between six baseline lipid indicators and cognitive scores, as well as cognitive impairment. Additionally, restricted cubic splines were used to explore the exposure-dose relationship between lipid levels and cognitive function.Results:The study population had a median follow-up time of 11.6 years, with a baseline age of (59.7±6.8) years. Among the participants, 9 510 (39.0%) were males, and the mean MMSE score was 24.7±6.8. A total of 3 887 individuals (15.9%) were identified as cognitively impaired. The results of multivariable linear regression and logistic regression indicated that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were not only significantly positively associated with cognitive scores but also significantly associated with a lower risk of cognitive impairment. Each 1 mmol/L increase in these lipid levels corresponded to β values (95% CI) of 0.267 (0.173-0.361), 0.385(0.271-0.499) and 0.331(0.231-0.431), respectively. Each 1 mmol/L increase in these lipid levels corresponded to odds ratio ( OR) (95% CI) values of 0.915 (0.876-0.956), 0.875 (0.830-0.923) and 0.886 (0.848-0.927), respectively. The dose-response curve demonstrated that the negative association was primarily observed within the guideline-recommended optimal lipid level range. Specifically, when LDL-C was less than 3.4 mmol/L and non-HDL-C was less than 4.1 mmol/L, the corresponding OR (95% CI) values were 0.859 (0.796-0.926) and 0.876 (0.818-0.939). Conclusion:Lipid levels exhibit a certain linear negative association with cognitive impairment in elderly Chinese adults, with LDL-C and non-HDL-C demonstrating a stronger effect, particularly within the guideline-recommended optimal range.

Objective:To investigate the diagnostic value of heparin-binding protein (HBP), pro-adrenomedullin (pro-ADM), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing the severity of pulmonary infection in patients with chronic heart failure (CHF).Methods:A cross-sectional study was conducted on 100 patients with CHF and pulmonary infection who were admitted to Shaanxi Rehabilitation Hospital between April 2021 and April 2023. According to clinical pulmonary infection score, the patients were classified into mild ( n = 43), moderate ( n = 31), and severe ( n = 26) groups. Additionally, 50 CHF patients without pulmonary infection, who were admitted during the same period, were included in the control group. General demographic data, as well as levels of HBP, pro-ADM, and NT-proBNP were compared among the groups. Logistic regression analysis was performed to identify the factors associated with the occurrence of pulmonary infection in CHF patients, while Pearson correlation analysis was used to assess the correlations among these indicators. Results:The levels of HBP, pro-ADM, and NT-proBNP in the severe group were (36.59 ± 4.15) μg/L, (3.69 ± 0.85) nmoL/L, and (9.63 ± 1.61) μg/L, respectively. In the moderate group, the levels were (33.09 ± 3.67) μg/L, (3.24 ± 0.58) nmoL/L, and (8.15 ± 1.42) μg/L, respectively. In the mild group, the levels were (29.12 ± 3.38) μg/L, (2.65 ± 0.37) nmoL/L, and (6.67 ± 0.68) μg/L, respectively. Significant differences were found in the levels of HBP, pro-ADM, and NT-proBNP among the three groups ( F = 34.41, 26.27, 48.53, all P < 0.05). The levels of HBP, pro-ADM, and NT-proBNP in patients with CHF and pulmonary infection were (32.29 ± 3.25) μg/L, (3.09 ± 0.41) nmoL/L, and (7.89 ± 0.92) μg/L, respectively, which were significantly higher than those in healthy controls [(26.54 ± 2.47) μg/L, (2.32 ± 0.32) nmoL/L, (5.65 ± 0.82) μg/L, t = 12.05, 12.61, 18.17, all P < 0.05]. Logistic regression analysis showed that a history of smoking, New York Heart Association (NYHA) functional classification, the presence of diabetes, as well as levels of HBP, pro-ADM, and NT-proBNP, were all factors influencing the occurrence of pulmonary infection in patients with CHF (all P < 0.05). Pearson analysis revealed that the levels of HBP, pro-ADM, and NT-proBNP in patients with CHF were significantly positively correlated with clinical pulmonary infection score ( r = 0.581, 0.540, 0.653, all P < 0.05). Conclusions:Serum levels of HBP, pro-ADM, and NT-proBNP have good predictive value for the severity of pulmonary infection in patients with CHF.

Objective:To construct a triple pre-rehabilitation intervention program for patients undergoing radical prostatectomy, to provide a basis for promoting pre-rehabilitation in patients undergoing radical prostatectomy.Methods:Literature analysis was used to search domestic and foreign databases such as China National Knowledge Infrastructure, Wanfang, PubMed, etc, on triple pre-rehabilitation and rapid rehabilitation of patients undergoing radical prostatectomy, with a search time frame from January 1, 2013 to December 31, 2023. The Delphi expert letter consultation was conducted later, and the final draft of the triple pre-rehabilitation intervention program for patients with radical prostatectomy was finally formed.Results:A total of 20 experts completed 2 rounds of inquiries, all were female, with an age of (40.85 ± 5.40) years old. The response rates for the 2 rounds of expert inquiries were both 100%(20/20). The authority coefficients of the experts were 0.87 and 0.90, respectively. Kendall coordination coefficients were 0.11 and 0.21, respectively. The coefficient of variation for each item in the second round of inquiries ranged from 0 to 0.15. The triple pre-rehabilitation intervention program for patients with radical resection of prostate cancer was constructed, including 4 primary indexes, 8 secondary indexes and 25 tertiary indexes.Conclusions:It is scientific, targeted and feasible to construct a triple pre-rehabilitation intervention program for patients undergoing radical prostatectomy based on Delphi method, which can provide clinical basis for pre-rehabilitation of elderly patients undergoing prostate cancer surgery.