OBJECTIVE: To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit (ICU). METHODS: We analyzed 545 patients with hepatic coma in the ICU from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Associations between serum chloride levels and 28-day and 1-year mortality rates were assessed using restricted cubic splines (RCSs), Kaplan-Meier (KM) curves, and Cox regression. Subgroup analyses, external validation, and mechanistic studies were also performed. RESULTS: A total of 545 patients were included in the study. RCS analysis revealed a U-shaped association between serum chloride levels and mortality in patients with hepatic coma. The KM curves indicated lower survival rates among patients with low chloride levels (< 103 mmol/L). Low chloride levels were independently linked to increased 28-day and 1-year all-cause mortality rates. In the multivariate models, the hazard ratio ( HR) for 28-day mortality in the low-chloride group was 1.424 (95% confidence interval [ CI]: 1.041-1.949), while the adjusted hazard ratio for 1-year mortality was 1.313 (95% CI: 1.026-1.679). Subgroup analyses and external validation supported these findings. Cytological experiments suggested that low chloride levels may activate the phosphorylation of the NF-κB signaling pathway, promote the expression of pro-inflammatory cytokines, and reduce neuronal cell viability. CONCLUSION Low serum chloride levels are independently associated with increased mortality in patients with hepatic coma.
Humans ; Male ; Female ; Middle Aged ; Intensive Care Units ; Prognosis ; Chlorides/blood* ; Aged ; Coma/blood* ; Adult

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate whether elevated serum uric acid (UA) in early pregnancy was an independent risk factor for pre-eclampsia (PE) and its potential predictive value.Methods:This retrospective nested case-control study analyzed clinical data from pregnant women who delivered at Beijing Friendship Hospital, Capital Medical University, between January 2022 and March 2025. With the occurrence of PE as the outcome variable, the observation objects were divided into UA-elevated group and UA-normal group according to whether the UA level in the first trimester was higher than the 75th percentile ( P75) of the total population. After balancing confounders via propensity score matching (PSM), logistic regression, subgroup analysis and sensitivity analysis were performed to evaluate the association between UA and PE risk. Results:(1) In the initial cohort, the serum UA levels of PE women (327 cases) and non-PE women (8 919 cases) in the first trimester were (264.4±64.4) and (237.1±57.9) μmol/L, respectively, and the difference was statistically significant ( t=-4.74, P<0.001). The P75 of serum UA was 264.8 μmol/L, and based on this cut-off value, 7 169 cases (77.5%, 7 169/9 246) were in the UA-normal group and 2 077 cases (22.5%, 2 077/9 246) in the UA-elevated group. After PSM matching, the two groups were balanced in age, body mass index and other covariates. The incidence of PE in the UA-normal group and the UA-elevated group was 2.76% (198/7 169) and 6.21% (129/2 077); the incidence of severe PE was 1.21% (87/7 169) and 3.42% (71/2 077), respectively; the incidence of early-onset PE was 0.49% (35/7 169) and 1.44% (30/2 077), respectively; and the differences between the two groups were statistically significant (all P<0.001). (2) Logistic regression analysis showed that indirect bilirubin, low-density lipoprotein cholesterol, plateletcrit and UA (categorical and continuous variable forms) were independent risk factors for PE (all P<0.05), among which UA had the most significant risk effect with dose-effect trend. (3) For every 10 μmol/L increase in UA level, the risk of early-onset PE increased by 3% ( OR=1.03, 95% CI: 1.00-1.06; P=0.023), and the risk of severe PE increased by 5% ( OR=1.05, 95% CI: 1.01-1.09; P=0.012). (4) Multivariate logistic analysis showed that taking P70, P75 and P80 as cut-off values, the risk of PE increased by 40% ( OR=1.40, 95% CI: 1.02-2.13; P=0.047), 86% ( OR=1.86, 95% CI: 1.08-3.22; P=0.026), 87% ( OR=1.87, 95% CI: 1.21-2.91; P=0.005), respectively. Conclusion:Elevated UA level in the first trimester of pregnancy is an independent risk factor for PE, which can be used as one of the early screening indicators to assist in identifying high-risk groups of PE.

The presence of a positive deep surgical margin in tongue squamous cell carcinoma (TSCC) significantly elevates the risk of local recurrence. Therefore, a prompt and precise intraoperative assessment of margin status is imperative to ensure thorough tumor resection. In this study, we integrate Raman imaging technology with an artificial intelligence (AI) generative model, proposing an innovative approach for intraoperative margin status diagnosis. This method utilizes Raman imaging to swiftly and non-invasively capture tissue Raman images, which are then transformed into hematoxylin-eosin (H&E)-stained histopathological images using an AI generative model for histopathological diagnosis. The generated H&E-stained images clearly illustrate the tissue's pathological conditions. Independently reviewed by three pathologists, the overall diagnostic accuracy for distinguishing between tumor tissue and normal muscle tissue reaches 86.7%. Notably, it outperforms current clinical practices, especially in TSCC with positive lymph node metastasis or moderately differentiated grades. This advancement highlights the potential of AI-enhanced Raman imaging to significantly improve intraoperative assessments and surgical margin evaluations, promising a versatile diagnostic tool beyond TSCC.
Humans ; Spectrum Analysis, Raman/methods* ; Tongue Neoplasms/diagnostic imaging* ; Carcinoma, Squamous Cell/diagnostic imaging* ; Artificial Intelligence ; Margins of Excision

The continuous accumulation of plastic waste such as polyethylene in the environment has caused serious environmental pollution issues.Considering the high similarity in the molecular structure of petroleum and polyolefin,it is feasible to apply rare earth-zeolite catalysts in polyolefin plastic upcycling,which is commonly used in fluid catalytic cracking(FCC)in the field of petroleum refining.In this study,Ce-modified HY(Ce-HY)zeolites were synthesized and characterized by a series of analytical methods,such as high-angle annular dark-field scanning transmission electron microscopy(HAADF-STEM),Fourier infrared spectroscopy(FT-IR),X-ray photoelectron spectroscopy(XPS),etc.When introducing 5% Ce species into HY zeolites,the 5Ce-HY showed excellent catalytic performance in the catalytic cracking of low-density polyethylene(LDPE),which achieved 98.4% LDPE conversion with 91.5% selectivity of gaseous alkanes at 300℃,and 75.4% of them were isoparaffins.In addition,the effect of the location of rare earth species in Y zeolites on the catalytic performance was explored by fine X-ray diffraction(XRD)in the range of 11°-13°and in situ-Raman analyses.The Ce species located in the supercage of Y zeolites were more important,which enhanced the adsorption capacity and accessibility of substrate molecules,thus facilitating the entire catalytic cracking process.This method could be used to detect the location of rare earth elements in Y zeolites to understand the mechanism of rare earth catalysis.

Objective To explore the effects of the disinfection port position and diameter and disinfectant concentration on the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device with the computational fluid dynamics(CFD)method.Methods ANSYS DesignModeler was used to construct five models for the high efficiency particulate air filter device with the disinfection port at the side end in four ones and upper end in the remained one model,with the diameter being 70,100,150,260 and 260 mm respectively;secondly,a standard k-ε turbulence model was applied to simulating the velocity field and concentration field inside the high efficiency particulate air filter device,so as to analyze the influence of the vortex position inside the device and the structure of the device on the disinfection effect and to determine the optimal structure of the device;finally,H2O2 with the concentration of 0.45,0.35 or 0.30 mol/L was selected as the disinectant to investigate the effect of the disinfectant concentration on the disinfection under the optimal device structure.Results Simulation showed that there were vortexes existed the cavity between the filter compression structure and the filter of the high efficiency particulate air filter device.The disinfection effect in case of the disinfection port at the side end was higher than that in case of the disinfection port at the upper end;the diameter of the disinfection port had influences on the disinfection effect,and high-concentration disinfectant was found in the device when the diameter was 100 mm.The optimal structure with the disinfection port at the side end and the diameter of 100 mm was determined for the high efficiency particulate air filter device.An increase in H2O2 concentration was beneficial to improve disinfection without corroding and damaging the device when the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device was carried out.Conclusion The characteristics of the internal flow field of the flow field-based biosafety high efficiency particulate air filter device and the influencing factors of the in-situ disinfection effect are revealed,and theoretical references are provided for the optimal design of the device.[Chinese Medical Equipment Journal,2025,46(9):22-27]

Objective:To investigate whether elevated serum uric acid (UA) in early pregnancy was an independent risk factor for pre-eclampsia (PE) and its potential predictive value.Methods:This retrospective nested case-control study analyzed clinical data from pregnant women who delivered at Beijing Friendship Hospital, Capital Medical University, between January 2022 and March 2025. With the occurrence of PE as the outcome variable, the observation objects were divided into UA-elevated group and UA-normal group according to whether the UA level in the first trimester was higher than the 75th percentile ( P75) of the total population. After balancing confounders via propensity score matching (PSM), logistic regression, subgroup analysis and sensitivity analysis were performed to evaluate the association between UA and PE risk. Results:(1) In the initial cohort, the serum UA levels of PE women (327 cases) and non-PE women (8 919 cases) in the first trimester were (264.4±64.4) and (237.1±57.9) μmol/L, respectively, and the difference was statistically significant ( t=-4.74, P<0.001). The P75 of serum UA was 264.8 μmol/L, and based on this cut-off value, 7 169 cases (77.5%, 7 169/9 246) were in the UA-normal group and 2 077 cases (22.5%, 2 077/9 246) in the UA-elevated group. After PSM matching, the two groups were balanced in age, body mass index and other covariates. The incidence of PE in the UA-normal group and the UA-elevated group was 2.76% (198/7 169) and 6.21% (129/2 077); the incidence of severe PE was 1.21% (87/7 169) and 3.42% (71/2 077), respectively; the incidence of early-onset PE was 0.49% (35/7 169) and 1.44% (30/2 077), respectively; and the differences between the two groups were statistically significant (all P<0.001). (2) Logistic regression analysis showed that indirect bilirubin, low-density lipoprotein cholesterol, plateletcrit and UA (categorical and continuous variable forms) were independent risk factors for PE (all P<0.05), among which UA had the most significant risk effect with dose-effect trend. (3) For every 10 μmol/L increase in UA level, the risk of early-onset PE increased by 3% ( OR=1.03, 95% CI: 1.00-1.06; P=0.023), and the risk of severe PE increased by 5% ( OR=1.05, 95% CI: 1.01-1.09; P=0.012). (4) Multivariate logistic analysis showed that taking P70, P75 and P80 as cut-off values, the risk of PE increased by 40% ( OR=1.40, 95% CI: 1.02-2.13; P=0.047), 86% ( OR=1.86, 95% CI: 1.08-3.22; P=0.026), 87% ( OR=1.87, 95% CI: 1.21-2.91; P=0.005), respectively. Conclusion:Elevated UA level in the first trimester of pregnancy is an independent risk factor for PE, which can be used as one of the early screening indicators to assist in identifying high-risk groups of PE.

Objective To explore the effects of the disinfection port position and diameter and disinfectant concentration on the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device with the computational fluid dynamics(CFD)method.Methods ANSYS DesignModeler was used to construct five models for the high efficiency particulate air filter device with the disinfection port at the side end in four ones and upper end in the remained one model,with the diameter being 70,100,150,260 and 260 mm respectively;secondly,a standard k-ε turbulence model was applied to simulating the velocity field and concentration field inside the high efficiency particulate air filter device,so as to analyze the influence of the vortex position inside the device and the structure of the device on the disinfection effect and to determine the optimal structure of the device;finally,H2O2 with the concentration of 0.45,0.35 or 0.30 mol/L was selected as the disinectant to investigate the effect of the disinfectant concentration on the disinfection under the optimal device structure.Results Simulation showed that there were vortexes existed the cavity between the filter compression structure and the filter of the high efficiency particulate air filter device.The disinfection effect in case of the disinfection port at the side end was higher than that in case of the disinfection port at the upper end;the diameter of the disinfection port had influences on the disinfection effect,and high-concentration disinfectant was found in the device when the diameter was 100 mm.The optimal structure with the disinfection port at the side end and the diameter of 100 mm was determined for the high efficiency particulate air filter device.An increase in H2O2 concentration was beneficial to improve disinfection without corroding and damaging the device when the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device was carried out.Conclusion The characteristics of the internal flow field of the flow field-based biosafety high efficiency particulate air filter device and the influencing factors of the in-situ disinfection effect are revealed,and theoretical references are provided for the optimal design of the device.[Chinese Medical Equipment Journal,2025,46(9):22-27]

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.