ObjectiveTo analyze the etiological characteristics and risk factors of autosomal dominant polycystic kidney disease （ADPKD） complicated with urinary tract infection （UTI）. MethodsA retrospective analysis was performed on 244 patients with ADPKD admitted to the Department of Nephrology. The patients were stratified into a study group （n=138） and a control group （n=106） according to the presence or absence of concurrent UTI. All patients in the study group underwent etiological testing and drug susceptibility testing. Clinical data of both groups were collected to identify the risk factors for ADPKD complicated with UTI. ResultsA total of 105 pathogens were detected in 138 cases in the study group， including 79 Gram-negative bacteria， 20 Gram-positive bacteria and 6 fungi. Escherichia coli showed a relatively high resistance rate to ampicillin， piperacillin and ciprofloxacin. Enterococcus faecalis had a relatively high resistance rate to tetracycline. There were statistically significant differences between the study group and the control group in terms of gender， history of urinary tract infection， C-reactive protein （CRP）， increased urine red blood cells， increased urine white blood cells， increased percentage of neutrophils， blood sodium， blood calcium， total cholesterol， serum iron and transferrin saturation （P<0.05）. Multivariate binary Logistic regression analysis revealed that female gender （OR=2.236， P=0.004）， history of urinary tract infection （OR=2.383， P=0.002）， increased urine white blood cells （OR=2.726， P=0.001）， increased percentage of neutrophils （OR=1.040， P=0.010）， elevated C-reactive protein （OR=1.011， P=0.007） and elevated blood calcium （OR=4.389， P=0.024） were risk factors of urinary tract infection in ADPKD patients （P<0.05）. ConclusionThe main pathogens of UTI in patients with ADPKD are Gram-negative bacteria. Female， previous history of urinary tract infection， urinary leukocytosis， increased percentage of neutrophils， increased CRP and increased serum calcium are risk factors of UTI.

Objective To investigate whether there is a synergistic pathogenic effect between triglyceride glucose index(TyG)and C-reactive protein(CRP)on new-onset nonalcoholic fatty liver disease(NAFLD)by observing the influence of combinations of TyG and CRP at different levels,and to provide a basis for identifying the high-risk population of NAFLD.Methods A total of 31 935 employees in Kailuan Group who participated in physical examination in 2006-2007 were enrolled as the observation cohort,and they had no history of drinking,fatty liver disease,cardiovascular disease,or malignant tumor and did not take antidiabetic or lipid-lowering drugs.According to the median of TyG and CRP at baseline,the subjects were divided into TyG<8.42 and CRP<0.60 mg/L group,TyG<8.42 and CRP≥0.60 mg/L group,TyG≥8.42 and CRP<0.60 mg/L group,and TyG≥8.42 and CRP≥0.60 mg/L group.A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and an analysis of variance was used for comparison of continuous data with skewed distribution between groups after logarithmic transformation;the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to calculate the cumulative incidence rate of NAFLD in different combinations of CRP and TyG levels,and the multivariate Cox regression model was used to investigate the influence of different combinations of TyG and CRP on the incidence rate of NAFLD.Results After a mean follow-up time of 7.59 years,a total of 16 592 employees developed NAFLD.The cumulative incidence rate of NAFLD in the TyG<8.42 and CRP<0.60 mg/L group,TyG<8.42 and CRP≥0.60 mg/L group,TyG≥8.42 and CRP<0.60 mg/L group,and TyG≥8.42 and CRP≥0.60 mg/L group were 59.5%,67.1%,73.8%,and 80.8%,respectively(P<0.001).After adjustment for confounding factors,compared with the TyG<8.42 and CRP<0.60 mg/L group,the TyG≥8.42 and CRP≥0.60 mg/L group had the highest risk of developing NAFLD(hazard ratio[HR]=1.54,95%confidence interval[CI]:1.47-1.61),followed by the TyG≥8.42 and CRP<0.60 mg/L group(HR=1.43,95%CI:1.36-1.49)and the TyG<8.42 and CRP≥0.60 mg/L group(HR=1.17,95%CI:1.12-1.22).Conclusion With elevated TyG and CRP levels,the cumulative incidence of NAFLD increased,and rising levels of these markers significantly augmented the risk of NAFLD development.

Objective:To explore the influence of artificial intelligence(AI)-assisted compressive sensing(ACS)technique with different acceleration factors on the image quality and scan time of three dimensional time-of-flight magnetic resonance angiography(3D-TOF-MRA)for brain.Methods:Thirty participants who underwent brain magnetic resonance imaging(MRI)at Tongzhou Branch of Beijing Friendship Hospital were recruited.All subjects underwent imaging scans about four different parameters:a non-accelerated technique(control group),ACS technique integrated with acceleration factor of 4.03(ACS4 group),ACS technique integrated with acceleration factor of 5.02(ACS5 group),and ACS technique integrated with acceleration factor of 6.06(ACS6 group).The image clarity,ranking of imaging capabilities of distal branch blood vessels and the ratio of pseudo-stenosis were qualitatively analyzed.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),edge sharpness,and scan time were quantitatively analyzed.Results:There was not difference in vessel clarity among three ACS groups at the proximal and middle intracranial segments.For distal segments of blood vessel,the ACS4 group[3.0(3.0,3.0)]and ACS5 group[3.0(3.0,3.0)]were better than ACS6[2.5(2.0,3.0)](q=29.800,27.500,P<0.05).The imaging capabilities of distal-branch vessel of ACS4 group and ACS5 group were better than ACS6 group.There was no stenosis in the proximal and middle segments of the images of the three ACS group,and there were no stenosis in the images of distal vessels of ACS4 group and ACS5 group.A total of 5 cases were pseudo-stenosis in the distal vessels of ACS6 group.Compared with the control group,the incidence of pseudo-stenosis in the distal vessels of ACS6 group was 16.7%.The SNR and CNR values of quantitative analysis for proximal vessels in ACS6 group were higher than them in ACS4 group(q=27.800,26.200,P<0.05),and there was not significant difference in them among ACS4 group,ACS6 group and ACS5 group(P>0.05).The differences of SNR and CNR values in the middle and distal segments of blood vessels among different groups were not significant(P>0.05).There was not significant difference in the edge sharpness of blood vessels among ACS4 group,ACS5 group,and ACS6 group(P>0.05),while all of them were higher than those of control group,and the differences were significant(q=48.150,53.367,44.883,P<0.001).Compared with control group,the scan-time of ACS4 group was reduced by 55.19%,and that of ACS5 group was reduced by 64.07%,and that of ACS6 group was reduced by 70%.Conclusion:ACS technique can accelerate the imaging speed of brain 3D-TOF-MRA and ensure image quality.It is clinically recommended to set the ACS acceleration factor as 5.02 to undergo brain 3D-TOF-MRA scans.

Objective:To compare the effects of propofol and dexmedetomidine for sedation on the outcome in mechanically ventilated patients with severe pulmonary infection.Methods:Patients with severe pulmonary infection (Clinical Pulmonary Infection Score >7) requiring mechanical ventilation from the Medical Information Mart for Intensive Care Ⅳ database between 2008 and 2020 were selected and divided into propofol group and dexmedetomidine group based on the sedative agent used. The primary outcome was all-cause in-hospital mortality, and secondary outcomes included 90-day all-cause mortality and duration of mechanical ventilation. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline confounders, and logistic regression and linear regression were applied to analyze the effects of the two sedative drugs on the outcomes of mechanically ventilated patients with pulmonary infection. Kaplan-Meier survival curves were used to analyze survival outcomes.Results:A total of 6 204 critically ill patients with pulmonary infection requiring mechanical ventilation were included, with 3 439 cases in propofol group and 2 765 cases in dexmedetomidine group. The baseline characteristics between the two groups were well balanced (standardized mean difference < 0.1) after IPTW adjustment. In the IPTW-adjusted cohort, the in-hospital all-cause mortality and 90-day all-cause mortality were significantly lower in dexmedetomidine group than in propofol group (439.2[18.7%] vs 563.6[24.1%], 618.0[26.3%] vs 733.6[31.3%], P<0.001), the results of Further Kaplan-Meier survival curve analysis showed that the 90-day all-cause mortality was significantly lower in dexmedetomidine group than in propofol group ( P<0.01). Conclusions:Compared with propofol, dexmedetomidine can decrease the mortality rate and improve the prognosis in mechanically ventilated patients with severe pulmonary infection when used for sedation.

Objective To investigate the association of Chinese visceral adiposity index(CVAI)and high-sensitivity C-reactive protein(hs-CRP)with the risk of digestive malignancies in the Kailuan study population,and to provide a basis for the prevention and control of digestive malignancies in the population.Methods A prospective cohort study was conducted,and a total of 94 377 Kailuan workers who participated in the 2006 health examination,had no history of cancer,and had complete data on CVAI,CRP,and related covariates were selected as the observation cohort.According to the levels of CVAI and CRP,the subjects were divided into low CVAI+CRP≤3 mg/L group[CVAI(-)CRP(-)group],low CVAI+CRP>3 mg/L group[CVAI(-)CRP(+)group],high CVAI+CRP≤3 mg/L group[CVAI(+)CRP(-)group],and high CVAI+CRP>3 mg/L group[CVAI(+)CRP(+)group].An analysis of variance was used for comparison of normally distributed continuous data between groups,and the non-parametric Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between groups;the chi-square test was used for comparison of categorical data between groups.The Cox proportional-hazards regression model was used to assess the impact of CVAI and CRP alone or in combination on the risk of digestive malignancies.Results There were significant differences between the four groups in age,male/female ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,systolic blood pressure,diastolic blood pressure,fasting blood glucose,high-sensitivity C-reactive protein,waist circumference,body mass index,marital status,alcohol consumption,smoking,reported income,and physical exercise(all P<0.05).During a mean follow-up time of 14.08±2.76 years,2 043 new-onset cases of digestive malignancies were identified by the end of follow-up on December 31,2021.The Cox proportional-hazards regression model showed that after adjustment for CRP and other factors,compared with the low CVAI group,the high CVAI group had a hazard ratio(HR)of 1.34(95%confidence interval[CI]:1.23-1.47)for the risk of digestive malignancies.After adjustment for CVAI and other factors,compared with the CRP≤3 mg/L group,the CRP>3 mg/L group had an HR of 1.14(95%CI:1.02-1.28)for the risk of digestive malignancies.Compared with the CVAI(-)CRP(-)group(n=40 978),the CVAI(-)CRP(+)group(n=6 210),the CVAI(+)CRP(-)group(n=36 502),and the CVAI(+)CRP(+)group(n=10 687)had an HR of 1.05(95%CI:1.01-1.09,P<0.05),1.32(95%CI:1.20-1.45,P<0.05),and 1.48(95%CI:1.28-1.70,P<0.05),respectively,for the risk of digestive malignancies.As for digestive malignancies at specific locations,the CVAI(+)CRP(+)group had an increased risk of liver cancer,gastric cancer,pancreatic cancer,colorectal cancer,and small intestinal cancer with an HR of 1.35(95%CI:1.05-1.81,P<0.05),1.48(95%CI:1.09-2.00,P<0.05),1.60(95%CI:1.07-2.41,P<0.05),1.76(1.40-2.21,P<0.05),and 3.85(95%CI:1.43-10.33,P<0.05),respectively.Conclusion A high level of CVAI,a high level of CRP,and high levels of CVAI and CRP in combination can all increase the risk of digestive malignancies,among which the high levels of CVAI and CRP in combination may lead to a higher risk.

Akinetic mutism (AM) is a neurological disorder characterized by a profound lack of motivation, leading to severe motor and speech impairment or complete loss of function. Due to its clinical resemblance to disorders of consciousness and locked-in syndrome, AM is often misdiagnosed or overlooked, necessitating increased awareness among clinicians. This review summarizes the recent advances in neuroanatomical basis of AM, roles of neuroimaging in AM diagnosis and prognosis, and current therapeutic strategies of AM so as to enhance the awareness of clinicians in AM.

Objective To investigate the association of Chinese visceral adiposity index(CVAI)and high-sensitivity C-reactive protein(hs-CRP)with the risk of digestive malignancies in the Kailuan study population,and to provide a basis for the prevention and control of digestive malignancies in the population.Methods A prospective cohort study was conducted,and a total of 94 377 Kailuan workers who participated in the 2006 health examination,had no history of cancer,and had complete data on CVAI,CRP,and related covariates were selected as the observation cohort.According to the levels of CVAI and CRP,the subjects were divided into low CVAI+CRP≤3 mg/L group[CVAI(-)CRP(-)group],low CVAI+CRP>3 mg/L group[CVAI(-)CRP(+)group],high CVAI+CRP≤3 mg/L group[CVAI(+)CRP(-)group],and high CVAI+CRP>3 mg/L group[CVAI(+)CRP(+)group].An analysis of variance was used for comparison of normally distributed continuous data between groups,and the non-parametric Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between groups;the chi-square test was used for comparison of categorical data between groups.The Cox proportional-hazards regression model was used to assess the impact of CVAI and CRP alone or in combination on the risk of digestive malignancies.Results There were significant differences between the four groups in age,male/female ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,systolic blood pressure,diastolic blood pressure,fasting blood glucose,high-sensitivity C-reactive protein,waist circumference,body mass index,marital status,alcohol consumption,smoking,reported income,and physical exercise(all P<0.05).During a mean follow-up time of 14.08±2.76 years,2 043 new-onset cases of digestive malignancies were identified by the end of follow-up on December 31,2021.The Cox proportional-hazards regression model showed that after adjustment for CRP and other factors,compared with the low CVAI group,the high CVAI group had a hazard ratio(HR)of 1.34(95%confidence interval[CI]:1.23-1.47)for the risk of digestive malignancies.After adjustment for CVAI and other factors,compared with the CRP≤3 mg/L group,the CRP>3 mg/L group had an HR of 1.14(95%CI:1.02-1.28)for the risk of digestive malignancies.Compared with the CVAI(-)CRP(-)group(n=40 978),the CVAI(-)CRP(+)group(n=6 210),the CVAI(+)CRP(-)group(n=36 502),and the CVAI(+)CRP(+)group(n=10 687)had an HR of 1.05(95%CI:1.01-1.09,P<0.05),1.32(95%CI:1.20-1.45,P<0.05),and 1.48(95%CI:1.28-1.70,P<0.05),respectively,for the risk of digestive malignancies.As for digestive malignancies at specific locations,the CVAI(+)CRP(+)group had an increased risk of liver cancer,gastric cancer,pancreatic cancer,colorectal cancer,and small intestinal cancer with an HR of 1.35(95%CI:1.05-1.81,P<0.05),1.48(95%CI:1.09-2.00,P<0.05),1.60(95%CI:1.07-2.41,P<0.05),1.76(1.40-2.21,P<0.05),and 3.85(95%CI:1.43-10.33,P<0.05),respectively.Conclusion A high level of CVAI,a high level of CRP,and high levels of CVAI and CRP in combination can all increase the risk of digestive malignancies,among which the high levels of CVAI and CRP in combination may lead to a higher risk.

Objective To investigate whether there is a synergistic pathogenic effect between triglyceride glucose index(TyG)and C-reactive protein(CRP)on new-onset nonalcoholic fatty liver disease(NAFLD)by observing the influence of combinations of TyG and CRP at different levels,and to provide a basis for identifying the high-risk population of NAFLD.Methods A total of 31 935 employees in Kailuan Group who participated in physical examination in 2006-2007 were enrolled as the observation cohort,and they had no history of drinking,fatty liver disease,cardiovascular disease,or malignant tumor and did not take antidiabetic or lipid-lowering drugs.According to the median of TyG and CRP at baseline,the subjects were divided into TyG<8.42 and CRP<0.60 mg/L group,TyG<8.42 and CRP≥0.60 mg/L group,TyG≥8.42 and CRP<0.60 mg/L group,and TyG≥8.42 and CRP≥0.60 mg/L group.A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and an analysis of variance was used for comparison of continuous data with skewed distribution between groups after logarithmic transformation;the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to calculate the cumulative incidence rate of NAFLD in different combinations of CRP and TyG levels,and the multivariate Cox regression model was used to investigate the influence of different combinations of TyG and CRP on the incidence rate of NAFLD.Results After a mean follow-up time of 7.59 years,a total of 16 592 employees developed NAFLD.The cumulative incidence rate of NAFLD in the TyG<8.42 and CRP<0.60 mg/L group,TyG<8.42 and CRP≥0.60 mg/L group,TyG≥8.42 and CRP<0.60 mg/L group,and TyG≥8.42 and CRP≥0.60 mg/L group were 59.5%,67.1%,73.8%,and 80.8%,respectively(P<0.001).After adjustment for confounding factors,compared with the TyG<8.42 and CRP<0.60 mg/L group,the TyG≥8.42 and CRP≥0.60 mg/L group had the highest risk of developing NAFLD(hazard ratio[HR]=1.54,95%confidence interval[CI]:1.47-1.61),followed by the TyG≥8.42 and CRP<0.60 mg/L group(HR=1.43,95%CI:1.36-1.49)and the TyG<8.42 and CRP≥0.60 mg/L group(HR=1.17,95%CI:1.12-1.22).Conclusion With elevated TyG and CRP levels,the cumulative incidence of NAFLD increased,and rising levels of these markers significantly augmented the risk of NAFLD development.

The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors.How-ever,post-surgery problems such as chewing,swallowing and speech difficulty may arise due to the defects in speech organs and inade-quate compensatory function of tissue flap repair.Speech disorders,in particular,isolate patients by making it difficult for them to com-municate with others,not only impact their quality of life but also potentially lead to psychological problems and social interaction disor-ders.Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemo-therapy have been widely recognized,there is currently no standardized and universally applicable assessment method and standardized re-habilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad.Based on previous clinical practice,combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery,the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature,relevant experts organized discussions and modifications,reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management,providing a reference for clinical practice,in order to improve patients'speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.

Objective To study the characteristics of animal models of pulmonary fibrosis so as to provide a reference for the standardization of such models,and to guide research on the pathogenesis,diagnosis,and treatment of pulmonary fibrosis.Methods Studies using experimental pulmonary fibrosis in animals published in the past 10 years were retrieved from the CNKI,Wanfang,VIP,SinoMed,and PubMed databases.Factors including animal species,sex,modeling method,and detection index were summarized,and the data were analyzed using Excel.Results A total of 292 eligible studies were included.The animals mainly included SD rats,Wistar rats,and C57BL/6 mice,and most were male.The most common modeling drugs were bleomycin,paraquat,and silica suspension,mainly administered by intratracheal injection,with a typical modeling cycle of 28 d.The detection indexes mainly comprised lung tissue pathology and measurements of protein expression,cytokine levels,and biochemical indexes.Conclusions SD rats and C57BL/6 mice were the most commonly used animals for experimental pulmonary fibrosis,and intratracheal injection of bleomycin(5 mg/kg)was the most frequently used modeling method.This approach allows for the straightforward and effective replication of pathological features resembling human pulmonary fibrosis,and may serve as a reference for future experimental studies using animal models of pulmonary fibrosis.