Objective:To explore the association between cardiometabolic multimorbidity(CMM), the number of cardiometabolic diseases(CMD)and mild cognitive impairment(MCI)among the older adults in urban communities.Methods:Based on the baseline data of the Hubei Memory and Aging Cohort Study(HMACS)from 2018 to 2023, CMM was defined as the coexistence of two or more CMDs(Type 2 diabetes, stroke and ischemic heart disease). Multivariate logistic regression was employed to examine the association between CMM, the number of CMDs and the prevalence of MCI, as well as subgroup heterogeneity.Results:This study included 6 113 urban participants aged ≥65 years(55.6% were female; mean age 71.9±5.7 years). The prevalence of MCI was 19.3%, with an increasing trend observed as the number of CMD increased(17.7%, 20.5%, 24.6%, 28.3%). After adjusting for all variables, a significant association was observed between CMM group and the prevalence of MCI( OR: 1.24, 95% CI: 1.01-1.52)compared with the non-CMM group.As the number of CMD increased, the prevalence of MCI increased( Ptrend=0.011), but the association was only significant in the group with two CMDs.Subgroup analyses revealed that in males( OR: 1.48, 95% CI: 1.10-2.00), those with more than 9 years of education( OR: 1.52, 95% CI: 1.15-2.02), and those with hypertension( OR: 1.33, 95% CI: 1.05-1.67), CMM was significantly associated with MCI, and the association with MCI increased significantly with the increase in the number of CMDs(all Pfor trend <0.05). Conclusions:Among urban community-dwelling older adults aged ≥65 years in China, CMM and the cumulative number of CMDs are significantly associated with an increase of MCI, particularly in males, those with higher education levels, and those with hypertension.In the future, the need for enhanced MCI screening for CMM patients should be strengthened, and targeted prevention and control of cognitive impairment should be implemented for high-risk populations.

Objective:To observe the characteristics of gastrointestinal tract symptoms in patients with Parkinson′s disease (PD) and analyze the characteristics of these symptoms in patients with different PD subtypes.Methods:A total of 297 PD patients who were admitted to the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2022 to March 2024 were enrolled. The gastrointestinal symptoms of PD patients were evaluated using Drooling Severity and Frequency Scale (DSFS), Sialorrhea Clinical Scale for Parkinson′s disease (SCS-PD), Drooling Rating Scale (DRS), Eating Assessment Tool 10 (EAT-10), Gastroparesis Cardinal Symptom Index (GCSI), and Rome Ⅳ diagnostic criteria. The patients were grouped based on the presence or absence of gastrointestinal symptoms. Additionally, they were stratified according to disease duration (≤2 years, 2-5 years, 5-10 years, and>10 years) and motor symptom subtype [tremor-dominant (TD) vs. postural instability and gait difficulty (PIGD)]. One-way ANOVA and logistic regression analysis were applied to examine between-group differences while Spearman correlation analysis was employed to assess correlations between clinical symptoms.Results:The average age of the patients with PD was 67.0 (60.0, 72.0) years, and 161 (54.2%) were male. The incidence of PD combined with gastrointestinal symptoms was, in descending order: constipation (191, 64.3%), salivation (155, 52.2%), gastroparesis (93, 31.3%), and dysphagia (68, 22.9%). Compared with PD patients without gastrointestinal symptoms, those with symptoms had higher scores in the RBD-HK [12.0 (5.0, 21.5) vs. 5.0 (0.0, 9.0), Z=-3.74, P=0.017], ESS [6.0 (2.0, 12.0) vs. 3.0 (0.0, 6.0), Z=-3.20, P=0.023], and MDS-UPDRS Part Ⅰ [9.0 (5.0, 14.0) vs. 5.0 (2.3, 9.0), Z=-3.61, P=0.014]. The severity of sialorrhea and deglutition disorders, along with the incidence of constipation, all increased with longer disease duration. Patients with the PIGD subtype had higher GCSI scores than those with the TD subtype [0.0 (0.0, 1.9) vs. 0.0 (0.0, 0.0), Z=-3.57, P=0.007]. Across the cohort, sialorrhea, deglutition disorders, gastroparesis, and constipation were positively associated with the H-Y stage, MDS-UPDRS Ⅰ, HAMD, NMSQ, and SCOPA-AUT; EAT-10 scores were negatively correlated with MoCA ( r=-0.171, P<0.05); and GCSI scores were negatively correlated with MMSE and MoCA ( r=-0.154, r=-0.169, both P<0.05). Conclusions:Overall, 84.5% of the patients with PD had one or more gastrointestinal symptoms, and the incidence and severity of gastrointestinal symptoms increased with disease duration. The severity of gastroparesis was higher in the PIGD group than in the TD group. The scores of all gastrointestinal symptoms were positively correlated with the H-Y stage and MDS-UPDRS Ⅰ, while the GCSI scores were negatively correlated with the cognitive scores.

Objective:To investigate the clinical value of filling ultrasound combined with microflow imaging（MFI）in diagnosing small intestinal polyps for Peutz-Jeghers syndrome（P-JS）patients.Methods:From February 2022 to October 2024，86 P-JS patients were consecutively enrolled in the Air Force Special Medical Center. All patients underwent a filling ultrasound with oral 2.5% mannitol solution and MFI examination，with final polyp confirmation by enteroscopy. Polyps were categorized based on image quality（good or poor）and diameter（classified into different ranges）. The relationships between ultrasound characteristics，blood perfusion，and small intestine polyps were analyzed. ROC curve analysis was performed to evaluate the diagnostic efficacy of filling ultrasound alone and in combination with MFI for small intestine polyps.Results:Oral mannitol filling of the small intestine was successfully demonstrated. Multiple small intestinal polyps were detected in 82 patients，and no polyps in 4 patients. Filling ultrasound significantly improved the detection rate of small intestinal polyps in P-JS patients，especially for polyps ≤ 35 mm（ P<0.05）. However，there was no significant difference between the detection rate of polyps >35 mm and that of conventional ultrasound（ P>0.05）. In the case of poor image quality，filling ultrasound combined with MFI further improved the detection rate of ≤35 mm polyps（ P<0.05）. The results of the multivariate analysis showed that the maximum polyp diameter（ P=0.030）and blood flow pattern（ P=0.016）showed by MFI were influencing factors for the diagnosis P-JS small intestinal polyps. The diagnostic efficacies of filling ultrasound and filling ultrasound combined with MFI were good. The diagnostic AUC value，accuracy，sensitivity，and specificity of filling ultrasound were 0.887，0.863，0.850，and 0.765，respectively，while the diagnostic AUC value，accuracy，sensitivity，and specificity of filling ultrasound with MFI were 0.913，0.927，0.969 and 0.923，respectively. Conclusions:Filling ultrasound with oral 2.5% mannitol solution combined with MFI significantly optimizes the detection efficiency of small intestinal polyps in P-JS patients，providing strong support for clinical diagnosis.

Objective:To explore the association between cardiometabolic multimorbidity(CMM), the number of cardiometabolic diseases(CMD)and mild cognitive impairment(MCI)among the older adults in urban communities.Methods:Based on the baseline data of the Hubei Memory and Aging Cohort Study(HMACS)from 2018 to 2023, CMM was defined as the coexistence of two or more CMDs(Type 2 diabetes, stroke and ischemic heart disease). Multivariate logistic regression was employed to examine the association between CMM, the number of CMDs and the prevalence of MCI, as well as subgroup heterogeneity.Results:This study included 6 113 urban participants aged ≥65 years(55.6% were female; mean age 71.9±5.7 years). The prevalence of MCI was 19.3%, with an increasing trend observed as the number of CMD increased(17.7%, 20.5%, 24.6%, 28.3%). After adjusting for all variables, a significant association was observed between CMM group and the prevalence of MCI( OR: 1.24, 95% CI: 1.01-1.52)compared with the non-CMM group.As the number of CMD increased, the prevalence of MCI increased( Ptrend=0.011), but the association was only significant in the group with two CMDs.Subgroup analyses revealed that in males( OR: 1.48, 95% CI: 1.10-2.00), those with more than 9 years of education( OR: 1.52, 95% CI: 1.15-2.02), and those with hypertension( OR: 1.33, 95% CI: 1.05-1.67), CMM was significantly associated with MCI, and the association with MCI increased significantly with the increase in the number of CMDs(all Pfor trend <0.05). Conclusions:Among urban community-dwelling older adults aged ≥65 years in China, CMM and the cumulative number of CMDs are significantly associated with an increase of MCI, particularly in males, those with higher education levels, and those with hypertension.In the future, the need for enhanced MCI screening for CMM patients should be strengthened, and targeted prevention and control of cognitive impairment should be implemented for high-risk populations.

Objective:To observe the characteristics of gastrointestinal tract symptoms in patients with Parkinson′s disease (PD) and analyze the characteristics of these symptoms in patients with different PD subtypes.Methods:A total of 297 PD patients who were admitted to the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2022 to March 2024 were enrolled. The gastrointestinal symptoms of PD patients were evaluated using Drooling Severity and Frequency Scale (DSFS), Sialorrhea Clinical Scale for Parkinson′s disease (SCS-PD), Drooling Rating Scale (DRS), Eating Assessment Tool 10 (EAT-10), Gastroparesis Cardinal Symptom Index (GCSI), and Rome Ⅳ diagnostic criteria. The patients were grouped based on the presence or absence of gastrointestinal symptoms. Additionally, they were stratified according to disease duration (≤2 years, 2-5 years, 5-10 years, and>10 years) and motor symptom subtype [tremor-dominant (TD) vs. postural instability and gait difficulty (PIGD)]. One-way ANOVA and logistic regression analysis were applied to examine between-group differences while Spearman correlation analysis was employed to assess correlations between clinical symptoms.Results:The average age of the patients with PD was 67.0 (60.0, 72.0) years, and 161 (54.2%) were male. The incidence of PD combined with gastrointestinal symptoms was, in descending order: constipation (191, 64.3%), salivation (155, 52.2%), gastroparesis (93, 31.3%), and dysphagia (68, 22.9%). Compared with PD patients without gastrointestinal symptoms, those with symptoms had higher scores in the RBD-HK [12.0 (5.0, 21.5) vs. 5.0 (0.0, 9.0), Z=-3.74, P=0.017], ESS [6.0 (2.0, 12.0) vs. 3.0 (0.0, 6.0), Z=-3.20, P=0.023], and MDS-UPDRS Part Ⅰ [9.0 (5.0, 14.0) vs. 5.0 (2.3, 9.0), Z=-3.61, P=0.014]. The severity of sialorrhea and deglutition disorders, along with the incidence of constipation, all increased with longer disease duration. Patients with the PIGD subtype had higher GCSI scores than those with the TD subtype [0.0 (0.0, 1.9) vs. 0.0 (0.0, 0.0), Z=-3.57, P=0.007]. Across the cohort, sialorrhea, deglutition disorders, gastroparesis, and constipation were positively associated with the H-Y stage, MDS-UPDRS Ⅰ, HAMD, NMSQ, and SCOPA-AUT; EAT-10 scores were negatively correlated with MoCA ( r=-0.171, P<0.05); and GCSI scores were negatively correlated with MMSE and MoCA ( r=-0.154, r=-0.169, both P<0.05). Conclusions:Overall, 84.5% of the patients with PD had one or more gastrointestinal symptoms, and the incidence and severity of gastrointestinal symptoms increased with disease duration. The severity of gastroparesis was higher in the PIGD group than in the TD group. The scores of all gastrointestinal symptoms were positively correlated with the H-Y stage and MDS-UPDRS Ⅰ, while the GCSI scores were negatively correlated with the cognitive scores.

Objective:To investigate the clinical value of filling ultrasound combined with microflow imaging（MFI）in diagnosing small intestinal polyps for Peutz-Jeghers syndrome（P-JS）patients.Methods:From February 2022 to October 2024，86 P-JS patients were consecutively enrolled in the Air Force Special Medical Center. All patients underwent a filling ultrasound with oral 2.5% mannitol solution and MFI examination，with final polyp confirmation by enteroscopy. Polyps were categorized based on image quality（good or poor）and diameter（classified into different ranges）. The relationships between ultrasound characteristics，blood perfusion，and small intestine polyps were analyzed. ROC curve analysis was performed to evaluate the diagnostic efficacy of filling ultrasound alone and in combination with MFI for small intestine polyps.Results:Oral mannitol filling of the small intestine was successfully demonstrated. Multiple small intestinal polyps were detected in 82 patients，and no polyps in 4 patients. Filling ultrasound significantly improved the detection rate of small intestinal polyps in P-JS patients，especially for polyps ≤ 35 mm（ P<0.05）. However，there was no significant difference between the detection rate of polyps >35 mm and that of conventional ultrasound（ P>0.05）. In the case of poor image quality，filling ultrasound combined with MFI further improved the detection rate of ≤35 mm polyps（ P<0.05）. The results of the multivariate analysis showed that the maximum polyp diameter（ P=0.030）and blood flow pattern（ P=0.016）showed by MFI were influencing factors for the diagnosis P-JS small intestinal polyps. The diagnostic efficacies of filling ultrasound and filling ultrasound combined with MFI were good. The diagnostic AUC value，accuracy，sensitivity，and specificity of filling ultrasound were 0.887，0.863，0.850，and 0.765，respectively，while the diagnostic AUC value，accuracy，sensitivity，and specificity of filling ultrasound with MFI were 0.913，0.927，0.969 and 0.923，respectively. Conclusions:Filling ultrasound with oral 2.5% mannitol solution combined with MFI significantly optimizes the detection efficiency of small intestinal polyps in P-JS patients，providing strong support for clinical diagnosis.

OBJECTIVE To explore the construction of the physical identification model of twenty-five people of yin and yang by combining the hand diagnosis image analysis of machine learning,in order to enrich the input of physical identification features.METHODS Based on the theory of twenty-five people of yin and yang,the hand images of 542 patients with cardiovascular disease were collected by self-developed hand diagnosis acquisition equipment.The key points of the hand were extracted by the Mediapipe palm key point algorithm,and the palm area was segmented by geometry to obtain the length and color gamut characteristics of different parts.The physician with clinical license was used to determined the patient's yin and yang twenty-five constitution according to the e-lectronic medical record,and the patient's constitution was identified by comparing Random Forest,Logistic Regression,Xgboost algo-rithm and Light GBM.RESULTS This study successfully constructed a TCM constitution identification model based on hand charac-teristics,which can identify ten basic constitution types including gold wood,gold fire,gold water,gold soil,wood fire,wood water,wood soil,water fire,water soil and fire soil.After sample equalization,the Random Forest model performed best in physical identifi-cation,with an accuracy rate of 0.69,which was significantly better than other models.CONCLUSION The constitution identifica-tion model of TCM hand diagnosis based on hand characteristics can realize the constitution identification of the five elements of TCM.However,due to the use of only hand diagnosis data of TCM,the accuracy needs to be improved.Compared with the traditional body mass scale,it is more objective,convenient,highly stable and consistent.In the future,multimodal integration with face diagno-sis and whole body inspection can be carried out to promote the accuracy,intelligence and multi-dimensional evaluation ability of TCM constitution identification technology.

OBJECTIVE To explore the construction of the physical identification model of twenty-five people of yin and yang by combining the hand diagnosis image analysis of machine learning,in order to enrich the input of physical identification features.METHODS Based on the theory of twenty-five people of yin and yang,the hand images of 542 patients with cardiovascular disease were collected by self-developed hand diagnosis acquisition equipment.The key points of the hand were extracted by the Mediapipe palm key point algorithm,and the palm area was segmented by geometry to obtain the length and color gamut characteristics of different parts.The physician with clinical license was used to determined the patient's yin and yang twenty-five constitution according to the e-lectronic medical record,and the patient's constitution was identified by comparing Random Forest,Logistic Regression,Xgboost algo-rithm and Light GBM.RESULTS This study successfully constructed a TCM constitution identification model based on hand charac-teristics,which can identify ten basic constitution types including gold wood,gold fire,gold water,gold soil,wood fire,wood water,wood soil,water fire,water soil and fire soil.After sample equalization,the Random Forest model performed best in physical identifi-cation,with an accuracy rate of 0.69,which was significantly better than other models.CONCLUSION The constitution identifica-tion model of TCM hand diagnosis based on hand characteristics can realize the constitution identification of the five elements of TCM.However,due to the use of only hand diagnosis data of TCM,the accuracy needs to be improved.Compared with the traditional body mass scale,it is more objective,convenient,highly stable and consistent.In the future,multimodal integration with face diagno-sis and whole body inspection can be carried out to promote the accuracy,intelligence and multi-dimensional evaluation ability of TCM constitution identification technology.

Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel and minimally invasive technology. Since the US Food and Drug Administration approved unilateral ventral intermediate nucleus-MRgFUS for medication-refractory essential tremor in 2016, studies on new indications, such as Parkinson's disease (PD), psychiatric diseases, and brain tumors, have been on the rise, and MRgFUS has become a promising method to treat such neurological diseases. Currently, as the second most common degenerative disease, PD is a research hotspot in the field of MRgFUS. The actions of MRgFUS on the brain range from thermoablation, blood-brain barrier (BBB) opening, to neuromodulation. Intensity is a key determinant of ultrasound actions. Generally, high intensity can be used to precisely thermoablate brain targets, whereas low intensity can be used as molecular therapies to modulate neuronal activity and open the BBB in conjunction with injected microbubbles. Here, we aimed to summarize advances in the application of MRgFUS for the treatment of PD, with a focus on thermal ablation, BBB opening, and neuromodulation, in the hope of informing clinicians of current applications.
Humans ; Parkinson Disease/therapy* ; Brain ; Blood-Brain Barrier ; Essential Tremor/surgery* ; Brain Neoplasms ; Magnetic Resonance Imaging/methods* ; Magnetic Resonance Spectroscopy