Stroke is a critical health issue in China, and carotid artery stenosis and plaque play key roles in its prevalence. Despite the acknowledged significance of this condition, detailed information regarding the prevalence of carotid artery stenosis and plaque across the Chinese population has been scarce. This study analyzed data from the China Stroke High-risk Population Screening and Intervention Program for 2020-2021, focusing on 194 878 Chinese adults aged 40 years and above. It assessed the prevalence of carotid artery stenosis and plaque and identified their associated risk factors. Results revealed a standardized prevalence of 0.40% for carotid artery stenosis and 36.27% for carotid plaque. Notably, the highest rates of stenosis were observed in north and south China at 0.61%, while southwestern China exhibited the highest plaque prevalence at 43.17%. Key risk factors included older age, male gender, hypertension, diabetes, stroke, smoking, and atrial fibrillation. This study highlights significant geographical and demographic disparities in the prevalence of these conditions, underlining the urgent need for targeted interventions and policy reforms. These measures are essential for reducing the incidence of stroke and improving patient outcomes, addressing this significant health challenge in China.
Humans ; China/epidemiology* ; Male ; Female ; Prevalence ; Middle Aged ; Carotid Stenosis/epidemiology* ; Risk Factors ; Aged ; Adult ; Plaque, Atherosclerotic/epidemiology* ; Stroke/epidemiology* ; Aged, 80 and over

Dental caries, a chronic disease characterized by tooth decay, occupies the second position in terms of disease burden and is primarily caused by cariogenic bacteria, especially Streptococcus mutans, because of its acidogenic, aciduric, and biofilm-forming capabilities. Developing novel targeted anti-virulence agents is always a focal point in caries control to overcome the limitations of conventional anti-virulence agents. The current study represents an up-to-date review of in silico approaches of drug design against dental caries, which have emerged more and more powerful complementary to biochemical attempts. Firstly, we categorize the in silico approaches into computer-aided drug design (CADD) and AI-assisted drug design (AIDD) and highlight the specific methods and models they contain respectively. Subsequently, we detail the design of anti-virulence drugs targeting single or multiple cariogenic virulence targets of S. mutans, such as glucosyltransferases (Gtfs), antigen I/II (AgI/II), sortase A (SrtA), the VicRK signal transduction system and superoxide dismutases (SODs). Finally, we outline the current opportunities and challenges encountered in this field to aid future endeavors and applications of CADD and AIDD in anti-virulence drug design.

Among numerous medical imaging modalities, diffusion weighted imaging (DWI) is extremely sensitive to acute ischemic stroke lesions, especially small infarcts. However, magnetic resonance imaging is time-consuming and expensive, and it is also prone to interference from metal implants. Therefore, the aim of this study is to design a medical image synthesis method based on generative adversarial network, Stroke-p2pHD, for synthesizing DWI images from computed tomography (CT). Stroke-p2pHD consisted of a generator that effectively fused local image features and global context information (Global_to_Local) and a multi-scale discriminator (M ²Dis). Specifically, in the Global_to_Local generator, a fully convolutional Transformer (FCT) and a local attention module (LAM) were integrated to achieve the synthesis of detailed information such as textures and lesions in DWI images. In the M ²Dis discriminator, a multi-scale convolutional network was adopted to perform the discrimination function of the input images. Meanwhile, an optimization balance with the Global_to_Local generator was ensured and the consistency of features in each layer of the M ²Dis discriminator was constrained. In this study, the public Acute Ischemic Stroke Dataset (AISD) and the acute cerebral infarction dataset from Yantaishan Hospital were used to verify the performance of the Stroke-p2pHD model in synthesizing DWI based on CT. Compared with other methods, the Stroke-p2pHD model showed excellent quantitative results (mean-square error = 0.008, peak signal-to-noise ratio = 23.766, structural similarity = 0.743). At the same time, relevant experimental analyses such as computational efficiency verify that the Stroke-p2pHD model has great potential for clinical applications.
Humans ; Tomography, X-Ray Computed/methods* ; Diffusion Magnetic Resonance Imaging/methods* ; Cerebral Infarction/diagnostic imaging* ; Stroke/diagnostic imaging* ; Neural Networks, Computer ; Image Processing, Computer-Assisted/methods* ; Algorithms

Dental caries,a chronic disease characterized by tooth decay,occupies the second position in terms of disease burden and is primarily caused by cariogenic bacteria,especially Streptococcus mutans,because of its acidogenic,aciduric,and biofilm-forming capabilities.Developing novel targeted anti-virulence agents is always a focal point in caries control to overcome the limitations of conventional anti-virulence agents.The current study represents an up-to-date review of in silico approaches of drug design against dental caries,which have emerged more and more powerful complementary to biochemical attempts.Firstly,we categorize the in silico approaches into computer-aided drug design(CADD)and AI-assisted drug design(AIDD)and highlight the specific methods and models they contain respectively.Subsequently,we detail the design of anti-virulence drugs targeting single or multiple cariogenic virulence targets of S.mutans,such as glucosyltransferases(Gtfs),antigen Ⅰ/Ⅱ(AgⅠ/Ⅱ),sortase A(SrtA),the VicRK signal transduction system and superoxide dismutases(SODs).Finally,we outline the current opportunities and challenges encountered in this field to aid future endeavors and applications of CADD and AIDD in anti-virulence drug design.

Objectives:To investigate the factors influencing intraoperative blood loss in spinal metastatic tu-mor surgery and provide scientific evidence for personalized surgical planning and blood loss control measures in clinical practice.Methods:We retrospectively analyzed the clinical data of 223 patients with spinal metastatic tumors treated at the Spinal Surgery Department of Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2019 to September 2024.The surgical methods included vertebroplasty,tumor resection or partial resection,vertebral body reconstruction and internal fixation,and palliative surgery.Data collected included patient demographics(age,sex,BMI,etc.),tumor characteristics(primary tumor type,vertebral metastasis location and involvement area,number of extraspinal metastases,etc.),surgical factors(surgical ap-proach,robotic assistance,operative time,etc.),and intraoperative blood loss.Univariate regression analysis was conducted on each of the above indicators,and multivariate regression analysis was performed on the in-dicators with statistical significance to identify the influence of each factor on intraoperative blood loss.Re-sults:The intraoperative blood loss was 300mL(10,1000mL).Among the 223 patients,the proportion of metastasis in the thoracic and lumbar vertebrae was relatively high,and the blood loss was relatively signifi-cant in hypervascular tumors.The amount of blood loss in the tumor resection or partial resection and verte-bral body reconstruction and internal fixation groups was greater than that in the other two groups.Univariate analysis revealed that BMI(P＜0.001),primary tumor type(P＜0.001),vertebral metastasis location(P＜0.001),verte-bral involvement area(P＜0.001),number of extraspinal metastases(P=0.03),surgical approach(P＜0.001),robotic assistance(P＜0.001),and operative time(P＜0.001)were associated with intraoperative blood loss.Multivariate analysis identified BMI(P＜0.001),primary tumor type(P=0.02),vertebral metastasis location(P=0.02)and involve-ment area(P=0.004),surgical approach(P=0.04),and operative time(P＜0.001)as the independent predictors of intraoperative blood loss.Conclusions:Intraoperative blood loss in spinal metastatic tumor surgery is influ-enced by multiple factors,including BMI,primary tumor type,vertebral metastasis location and involvement area,surgical approach,and operative time.Sufficient preoperative evaluation shall be carried out,appropriate surgical approach shall be selected,and surgical techniques shall be improved to shorten operative time.

Objective To compare the short-term outcomes and postoperative complications of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)in the treatment of early colorectal cancer.Methods A total of 110 patients with early colorectal cancer who were admitted to Suining Central Hospital from June 2020 to June 2022 were prospectively enrolled and randomly assigned to two groups by random number table.Of them,58 patients underwent ESD and 52 patients underwent EMR.Operation related indexes,inflammatory factors(interleukin-6[IL-6],tumor necrosis factor-α[TNF-α],and C-reactive protein[CRP])before operation and 3 days after operation,and postoperative quality of life index(QL-Index)were compared between the two groups.The complications of the two groups were observed.Results The operation time,hospital stay,postoperative exhaust time,defecation time,and intraoperative blood loss in ESD group were lower than those in EMR group,and the rates of complete resection and en bloc resection in ESD group were higher than those in EMR group(P<0.05).The levels of IL-6,TNF-α and CRP were increased 3 d after operation in both groups,but the levels of IL-6,TNF-α and CRP in ESD group were lower than those in EMR group(P<0.05).The total score of QL-Index and the scores of activity,daily activities,health,and overall situation in ESD group were significantly higher than those in EMR group(P<0.05).The incidence of complications in ESD group was higher than that in EMR group,without significant difference(P>0.05).Conclusion The pocket ESD can effectively promote postoperative rehabilitation,increase resection rate,reduce postoperative inflammation,and improve the quality of life of patients with early colorectal cancer,and there is no obvious complication.

Stroke associated with infective endocarditis is rare and has a high mortality rate.Lack of clinical understanding can easily lead to misdiagnosis,and delayed treatment can lead to poor prognosis.This article reports a case of infective endocarditis complicated with severe mixed stroke,in order to improve clinicians'attention to the diagnosis and treatment of such diseases.

Objectives:To investigate the factors influencing intraoperative blood loss in spinal metastatic tu-mor surgery and provide scientific evidence for personalized surgical planning and blood loss control measures in clinical practice.Methods:We retrospectively analyzed the clinical data of 223 patients with spinal metastatic tumors treated at the Spinal Surgery Department of Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2019 to September 2024.The surgical methods included vertebroplasty,tumor resection or partial resection,vertebral body reconstruction and internal fixation,and palliative surgery.Data collected included patient demographics(age,sex,BMI,etc.),tumor characteristics(primary tumor type,vertebral metastasis location and involvement area,number of extraspinal metastases,etc.),surgical factors(surgical ap-proach,robotic assistance,operative time,etc.),and intraoperative blood loss.Univariate regression analysis was conducted on each of the above indicators,and multivariate regression analysis was performed on the in-dicators with statistical significance to identify the influence of each factor on intraoperative blood loss.Re-sults:The intraoperative blood loss was 300mL(10,1000mL).Among the 223 patients,the proportion of metastasis in the thoracic and lumbar vertebrae was relatively high,and the blood loss was relatively signifi-cant in hypervascular tumors.The amount of blood loss in the tumor resection or partial resection and verte-bral body reconstruction and internal fixation groups was greater than that in the other two groups.Univariate analysis revealed that BMI(P＜0.001),primary tumor type(P＜0.001),vertebral metastasis location(P＜0.001),verte-bral involvement area(P＜0.001),number of extraspinal metastases(P=0.03),surgical approach(P＜0.001),robotic assistance(P＜0.001),and operative time(P＜0.001)were associated with intraoperative blood loss.Multivariate analysis identified BMI(P＜0.001),primary tumor type(P=0.02),vertebral metastasis location(P=0.02)and involve-ment area(P=0.004),surgical approach(P=0.04),and operative time(P＜0.001)as the independent predictors of intraoperative blood loss.Conclusions:Intraoperative blood loss in spinal metastatic tumor surgery is influ-enced by multiple factors,including BMI,primary tumor type,vertebral metastasis location and involvement area,surgical approach,and operative time.Sufficient preoperative evaluation shall be carried out,appropriate surgical approach shall be selected,and surgical techniques shall be improved to shorten operative time.

Stroke associated with infective endocarditis is rare and has a high mortality rate.Lack of clinical understanding can easily lead to misdiagnosis,and delayed treatment can lead to poor prognosis.This article reports a case of infective endocarditis complicated with severe mixed stroke,in order to improve clinicians'attention to the diagnosis and treatment of such diseases.

Objective:To assess the efficacy and safety of the treat-and-extend (TAE) regimen and pro re nata (PRN) regimen of intravitreal conbercept in polypoidal choroidal vasculopathy (PCV) patients.Methods:A non-randomized controlled study was performed.Ninety-one patients (91 eyes) diagnosed with treatment-na?ve PCV from October 2016 to January 2019 at Department of Ophthalmology, Peking University People's Hospital were enrolled.All the patients received the intravitreal injection of 0.5 mg conbercept.After the initial treatment, the patients were divided into 3+ PRN group and 3+ TAE group according to their willingness.The follow-up time was one year.All the eyes underwent visual acuity test with ETDRS chart, optical coherence tomography (OCT) examination, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). Best corrected visual acuity (BCVA), central retinal thickness (CRT), maximum retinal thickness (MRT), pigment epithelium detachment (PED) height, the number and area of polypoidal lesions, the area of retinal hemorrhage and the area of branching vascular network (BVN) were recorded.Treatment interval and injection frequencies during the one-year follow-up were compared between the two groups.This study adhered to the Declaration of Helsinki.The study protocol was approved by Peking University People's Hospital (No.2020PHB250-01). Written informed consent was obtained from each patient.Results:One-year after treatment, the BCVA improvement in the 3+ PRN group and 3+ TAE group was 5.0(-2.0, 15.0) and 6.0(-1.0, 14.0) letters, respectively, showing no significant difference ( Z=-0.352, P=0.725). No significant differences were found in CRT, MRT and PED height between the two groups ( Z=-0.145, -0.529, -0.985, all at P>0.05). There was no significant difference in polypoidal lesions number, polypoidal lesions area, the number of eyes with different degrees of polyp regression, BVN area and retinal hemorrhage area between the two groups ( Z=-0.502, -0.300, -0.047, -0.265, -1.243, all at P>0.05). After the one-year follow-up, the mean injection frequency of 3+ PRN group was (7.6±0.9) times, which was lower than (8.4±2.0) times of 3+ TAE group, showing a significant difference ( t=2.432, P=0.019). The mean follow-up frequency was (11.3±1.5) times of 3+ PRN group, which was significantly higher than (10.1±1.7) times of 3+ TAE group ( t=3.403, P=0.001). For the 3+ TAE group, 17.1%(6/35) of patients achieved an extension interval of 12 weeks after the first 3 doses, and 48.5%(17/35) of patients achieved an extension interval of 8 weeks or more, with a mean maximum extension interval of (9.5±2.0) weeks.During the follow-up, 10 patients in 3+ PRN group and 8 patients in 3+ TAE group received photodynamic therapy as a rescue treatment. Conclusions:The 3+ PRN and 3+ TAE regimens of intravitreal injection of conbercept combined with photodynamic therapy as a rescue treatment have similar efficacy in visual and anatomical outcomes for PCV patients.3+ TAE regimen has a higher treatment frequency and fewer follow-up visits.