Objective:To analyze the current situation and potential profile of self-disgust in peritoneal dialysis patients and explore the influencing factors of different categories of hemodialysis patients.Methods:Using convenient sampling method, 466 patients with peritoneal dialysis from 3 tertiary hospitals of Cangzhou People′s Hospital, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou Central Hospital were selected as the survey object from April to June 2023. A cross-sectional survey was conducted using the general data questionnaire, Questionnaire for the Assessment of Self-Disgust, Social Avoidance and Distress Scale and Perceived Social Support Scale. The potential profile of self-disgust in peritoneal dialysis patients was analyzed, and the influencing factors of different potential categories were analyzed by multiple Logistic regression.Results:Finally, 458 patients were included, with 283 males and 175 females, aged (48.68 ± 13.85) years old. The Questionnaire for the Assessment of Self-Disgust was scored (38.24 ± 5.25) points, the Social Avoidance and Distress Scale was scored (22.32 ± 3.78) points, the Perceived Social Support Scale was scored (53.59 ± 8.64) points in peritoneal dialysis patients. The level of self-disgust in peritoneal dialysis patients could be divided into 3 sections: self-pity (28.38%, 130/458), self-reflection (52.18%, 239/458) and self-acceptance (19.44%, 89/458). The results of multiple Logistic regression analysis showed that age, number of comorbidities, dialysis age, Social Avoidance and Distress Scale and Perceived Social Support Scale scores were the influencing factors of self-disgust in peritoneal dialysis patients ( OR values were 0.804-2.019, all P<0.05). Conclusions:The self-disgust in peritoneal dialysis patients was at a high level and somewhat heterogeneous. Clinical workers should focus on self-pity and self-reflective peritoneal dialysis patients, and provide targeted interventions to reduce the level of patient self-disgust according to the influencing factors of different potential categories of patients.

Objective: Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity. Materials and Methods: This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC). Results: The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85. Conclusion Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.

Objective: Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity. Materials and Methods: This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC). Results: The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85. Conclusion Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.

Objective: Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity. Materials and Methods: This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC). Results: The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85. Conclusion Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.

Objective: Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity. Materials and Methods: This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC). Results: The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85. Conclusion Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.

Objective: Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity. Materials and Methods: This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC). Results: The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85. Conclusion Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Objective To explore the mechanism of abnormal metastable dynamics in Alzheimer disease(AD)using brain network dynamic model based on MRI.Methods Data of MR T1WI diffusion tensor imaging(DTI)and resting-state functional MRI(rs-fMRI)of 25 AD patients(AD group)38 mild cognitive impairment(MCI)patients(MCI group)and 37 healthy controls(HC group)in AD Neuroimaging Initiative(ADNI)database were collected.Based on abnormal brain structural connectivity and cortical atrophy characteristics of AD group the structural virtual injury brain network model was constructed and the mechanism of abnormal metastable dynamics in AD was explored.Results The abnormal functional connectivity of white matter in AD group was concentrated in visual network(VIS)default mode network(DMN)frontoparietal network(FPN)and limbic network(LIM).The overall metastable state of AD group in sensorimotor network(SMN)dorsal attention network(DAN)&ventral attention network(VAN)(i.e.attention network[AN])and DMN specific perturbation models were all significantly lower than that in HC group and MCI group respectively(all P＜0.001).In AD group local circuits abnormality could be seen in posterior right superior temporal gyrus precentral gyrus caudal anterior cingulate gyrus and isthmus of the cingulate gyrus leading to decrease in global metastability.The structural connection damage of DMN and AN as well as cortical atrophy of FPN had significant impact on metastable dynamics in AD patients.Conclusion Multimodal MRI brain network dynamic model revealed the core factors of mechanism of metastable dynamic decline in AD included DMN AN and FPN abnormalities.

Objective:To analyze the current situation and potential profile of self-disgust in peritoneal dialysis patients and explore the influencing factors of different categories of hemodialysis patients.Methods:Using convenient sampling method, 466 patients with peritoneal dialysis from 3 tertiary hospitals of Cangzhou People′s Hospital, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou Central Hospital were selected as the survey object from April to June 2023. A cross-sectional survey was conducted using the general data questionnaire, Questionnaire for the Assessment of Self-Disgust, Social Avoidance and Distress Scale and Perceived Social Support Scale. The potential profile of self-disgust in peritoneal dialysis patients was analyzed, and the influencing factors of different potential categories were analyzed by multiple Logistic regression.Results:Finally, 458 patients were included, with 283 males and 175 females, aged (48.68 ± 13.85) years old. The Questionnaire for the Assessment of Self-Disgust was scored (38.24 ± 5.25) points, the Social Avoidance and Distress Scale was scored (22.32 ± 3.78) points, the Perceived Social Support Scale was scored (53.59 ± 8.64) points in peritoneal dialysis patients. The level of self-disgust in peritoneal dialysis patients could be divided into 3 sections: self-pity (28.38%, 130/458), self-reflection (52.18%, 239/458) and self-acceptance (19.44%, 89/458). The results of multiple Logistic regression analysis showed that age, number of comorbidities, dialysis age, Social Avoidance and Distress Scale and Perceived Social Support Scale scores were the influencing factors of self-disgust in peritoneal dialysis patients ( OR values were 0.804-2.019, all P<0.05). Conclusions:The self-disgust in peritoneal dialysis patients was at a high level and somewhat heterogeneous. Clinical workers should focus on self-pity and self-reflective peritoneal dialysis patients, and provide targeted interventions to reduce the level of patient self-disgust according to the influencing factors of different potential categories of patients.

Objective To explore the mechanism of abnormal metastable dynamics in Alzheimer disease(AD)using brain network dynamic model based on MRI.Methods Data of MR T1WI diffusion tensor imaging(DTI)and resting-state functional MRI(rs-fMRI)of 25 AD patients(AD group)38 mild cognitive impairment(MCI)patients(MCI group)and 37 healthy controls(HC group)in AD Neuroimaging Initiative(ADNI)database were collected.Based on abnormal brain structural connectivity and cortical atrophy characteristics of AD group the structural virtual injury brain network model was constructed and the mechanism of abnormal metastable dynamics in AD was explored.Results The abnormal functional connectivity of white matter in AD group was concentrated in visual network(VIS)default mode network(DMN)frontoparietal network(FPN)and limbic network(LIM).The overall metastable state of AD group in sensorimotor network(SMN)dorsal attention network(DAN)&ventral attention network(VAN)(i.e.attention network[AN])and DMN specific perturbation models were all significantly lower than that in HC group and MCI group respectively(all P＜0.001).In AD group local circuits abnormality could be seen in posterior right superior temporal gyrus precentral gyrus caudal anterior cingulate gyrus and isthmus of the cingulate gyrus leading to decrease in global metastability.The structural connection damage of DMN and AN as well as cortical atrophy of FPN had significant impact on metastable dynamics in AD patients.Conclusion Multimodal MRI brain network dynamic model revealed the core factors of mechanism of metastable dynamic decline in AD included DMN AN and FPN abnormalities.