Objective To investigate the feasibility of non-ECG-gated scan using wide-body detector in left atrial computed tomo-graphy angiography(CTA)and to assess its value in evaluating left atrial appendage closure(LAAC)outcomes.Methods Patients who underwent LAAC and completed left atrial CTA were prospectively selected.Participants were randomly divided into groups A and B.In group A,the heart rate was measured using a finger clip oximeter before the examination,and the heart rate was set as the simula-ted heart rate.The simulated signal was generated by the CT equipment to complete the examination.In group B,the conventional ECG-gated scan was adopted.The residual leakage of left atrial appendage occluder,image quality,patient comfort and radiation dose of the two groups were compared,and statistical analysis was performed for these indicators.Results Both groups completed the evaluation of the endothelialization degree of the left atrial appendage occluder,and there was no significant difference in the objective image quality evaluation or subjective image score between the two groups(P＞0.05).The total scores of the physiological dimension,psy-chological dimension,social cultural dimension and environmental dimension of patients in group A were higher than those in group B(P＜0.001),and the volume CT dose index(CTDIvol)and dose length product(DLP)decreased by 25％and 25.36％respectively,with statistically significant differences(P＜0.001).Conclusion During the left atrial CTA examination,the wide-body detector with non-ECG-gated scan mode can provide good image quality for clinical use and observe the embolization of the left atrial appendage after LAAC surgery.At the same time,it can effectively reduce the radiation dose for patients and improve patient comfort dur-ing the examination,showing high clinical feasibility and appli-cation value.

Background::An evidence gap still exists regarding the efficacy and safety of tegoprazan in patients with erosive esophagitis (EE) in China. This study aimed to verify the efficacy and safety of tegoprazan vs. esomeprazole in patients with EE in China. Methods::This study was a multicenter, randomized, double-blind, parallel, active-controlled, non-inferiority phase III trial of patients with EE randomized 1:1 to tegoprazan 50 mg/day vs. esomeprazole 40 mg/day. This study was conducted in 32 sites between October 24, 2018 and October 18, 2019. The primary endpoint was the cumulative endoscopic healing rate at week 8. The secondary endpoint included endoscopic healing rate at week 4, changes in the reflux disease questionnaire (RDQ) and gastroesophageal reflux disease health-related quality of life (GERD-HRQL) scores, and symptom improvement. Results::A total of 261 patients were randomized: 132 to the tegoprazan group and 129 to the esomeprazole group. The cumulative endoscopic healing rate at 8 weeks in the tegoprazan group was non-inferior to that of the esomeprazole group (91.1% vs. 92.8%, difference: -1.7%, 95% confidence interval [CI]: -8.5%, 5.0%, P = 0.008). There were no statistically significant differences in the changes in RDQ (total, severity, and frequency) and GERD-HRQL scores between the two groups (all P >0.05). The percentages of days without symptoms, including daytime and nighttime symptoms based on patients' diaries, were similar between the two groups (all P >0.05). In the tegoprazan and esomeprazole groups, 71.5% (93/130) and 61.7% (79/128) of the participants reported adverse events (AEs), 2.3% and 0 experienced serious AEs, while 70.0% and 60.2% had treatment-emergent AEs, respectively. Conclusion::Tegoprazan 50 mg/day demonstrated non-inferior efficacy in healing EE, symptom improvement, and quality of life, and it has similar tolerability compared with esomeprazole 40 mg/day.

OBJECTIVES: Near vision loss (NVL) is one of the leading causes of visual impairment worldwide, exerting a profound impact on individual quality of life and socio-economic development. This study aims to analyze the burden of NVL in China by sex and age groups from 1990 to 2021 and to project trends over the next 15 years. METHODS: Using data from the Global Burden of Disease (GBD) 2021 database, we conducted descriptive analyses of NVL prevalence in China, calculated age-standardized prevalence rates (ASPR) and age-standardized disability-adjusted life years rates (ASDR) to compare burden differences between sexes and age groups, and applied an autoregressive integrated moving average (ARIMA) model to predict NVL trends for the next 15 years. The model selection was based on best-fit criteria to ensure reliable projections. RESULTS: From 1990 to 2021, China's ASPR of NVL rose from 10 096.24/100 000 to 15 624.54/100 000, and ASDR increased from 101.75/100 000 to 158.75/100 000. In 2021, ASPR (16 551.70/100 000) and ASDR (167.69/100 000) were higher among females than males (14 686.21/100 000 and 149.76/100 000, respectively). China ranked highest globally in both NVL cases and disability-adjusted life years (DALYs), with female burden significantly exceeding male burden. Projections indicated this trend and sex gap will persist until 2036. Compared with 1990, the prevalence cases and DALYs increased by 239.20% and 238.82%, respectively in 2021, with the highest burden among females and the 55-59 age group. The ARIMA model predicted continued increases in prevalence and DALYs by 2036, with females maintaining a higher burden than males. CONCLUSIONS This study reveals a marked increase in the NVL burden in China and predicts continued growth in the coming years. Public health policies should prioritize NVL prevention and control, with special attention to women and middle-aged populations to mitigate long-term societal and health impacts.
Humans ; China/epidemiology* ; Male ; Female ; Prevalence ; Middle Aged ; Disability-Adjusted Life Years ; Adult ; Global Burden of Disease ; Adolescent ; Quality-Adjusted Life Years ; Aged ; Sex Factors ; Child ; Young Adult ; Child, Preschool ; Cost of Illness ; Infant ; Aged, 80 and over ; Vision Disorders/epidemiology*

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 evaluate the efficacy,safety and patient compliance of a quadruple therapy containing minocycline compared with the traditional quadruple therapy in the treatment of Helicobacter(H.)pylori.Methods This study included 200 H.pylori positive patients,with 100 assigned to the minocycline-containing bismuth quadruple therapy group(LBMC group)and the other 100 to the amoxicillin-containing bismuth quadruple therapy group(LBAC group).After matching the two groups of patients using the propensity score matching(PSM)method,there were 86 cases in each group.Telephone follow-up was conducted on the 14th day after the start of treatment to record patient medication compliance and adverse drug reactions.A 13C urea breath test was performed for re-examination at least one month after completing the treatment plan and discontinuing medication.The intention-to-treat(ITT)and per-protocol(PP)analyses were used to compare the H.pylori eradication rates between the two groups,and Chi-square test and t-test were used for intergroup comparison.Results In the ITT analysis,the eradication rates of the LBMC group and the LBAC group were 89.5%(77/86,95%CI:82.9%～96.1%)and 82.6%(71/86,95%CI:74.4%～90.7%),respectively.In the PP analysis,the eradication rates were 92.6%(75/81,95%CI:86.8%～98.4%)and 88.8%(71/80,95%CI:81.7%～95.8%),respectively.The adverse reaction rate of the LBMC group was 27.9%(24/86),and that of the LBAC group 31.4%(27/86),showing no statistically significant difference(P>0.05).In terms of compliance,the LBMC group was 94.2%(81/86),and the LBAC group 93.0%(80/86),revealing no statistically significant difference(P>0.05).Conclusion As a first-line treatment for eradicating H.pylori,regimens containing minocycline demonstrate equivalent eradication rates to those containing amoxicillin,with similar safety and compliance.They can be used as an alternative treatment for patients allergic to penicillin.

Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer.Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study,including 49 cases of lung adenocarcinoma(LUAD),30 cases of lung squamous cell carci-noma(LUSC),and 15 cases of small cell lung cancer(SCLC).All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE.Two radiologists independently measured the spectral and perfusion parameters of the three groups of images,including spectral curve slope(K),iodine concentration in the lesion area(ICL),effective atomic number(Zeff),surface permeability(PS),and perfusion index(PI),and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features.All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1.The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Statistical analysis showed that the spectral curve slope,ICL,NIC,and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients(P<0.05),while there were no significant differences in these parameters between LUSC and SCLC patients(P>0.05).Among the perfusion CT parameters,surface permeability(PS)showed significant differences among the three groups(P<0.05),while blood volume(BV),blood flow(BF),perfusion index(PI),time to peak(TTP),and mean transit time(MTT)did not show statistical differences.The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance:the area under the curve(AUC)of the LUAD and LUSC discrimination model was 0.806/0.77(training group/test group)in the arterial phase and 0.867/0.9(training group/test group)in the venous phase;the AUC of the LUAD and SCLC discrimination model was 0.885/0.883(training group/test group)in the arterial phase and 0.851/0.776(training group/test group)in the venous phase.Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes.The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer,providing precise imaging evidence for the formulation of individualized treatment plans.

Objective To investigate the feasibility of non-ECG-gated scan using wide-body detector in left atrial computed tomo-graphy angiography(CTA)and to assess its value in evaluating left atrial appendage closure(LAAC)outcomes.Methods Patients who underwent LAAC and completed left atrial CTA were prospectively selected.Participants were randomly divided into groups A and B.In group A,the heart rate was measured using a finger clip oximeter before the examination,and the heart rate was set as the simula-ted heart rate.The simulated signal was generated by the CT equipment to complete the examination.In group B,the conventional ECG-gated scan was adopted.The residual leakage of left atrial appendage occluder,image quality,patient comfort and radiation dose of the two groups were compared,and statistical analysis was performed for these indicators.Results Both groups completed the evaluation of the endothelialization degree of the left atrial appendage occluder,and there was no significant difference in the objective image quality evaluation or subjective image score between the two groups(P＞0.05).The total scores of the physiological dimension,psy-chological dimension,social cultural dimension and environmental dimension of patients in group A were higher than those in group B(P＜0.001),and the volume CT dose index(CTDIvol)and dose length product(DLP)decreased by 25％and 25.36％respectively,with statistically significant differences(P＜0.001).Conclusion During the left atrial CTA examination,the wide-body detector with non-ECG-gated scan mode can provide good image quality for clinical use and observe the embolization of the left atrial appendage after LAAC surgery.At the same time,it can effectively reduce the radiation dose for patients and improve patient comfort dur-ing the examination,showing high clinical feasibility and appli-cation value.

Objective To evaluate the efficacy,safety and patient compliance of a quadruple therapy containing minocycline compared with the traditional quadruple therapy in the treatment of Helicobacter(H.)pylori.Methods This study included 200 H.pylori positive patients,with 100 assigned to the minocycline-containing bismuth quadruple therapy group(LBMC group)and the other 100 to the amoxicillin-containing bismuth quadruple therapy group(LBAC group).After matching the two groups of patients using the propensity score matching(PSM)method,there were 86 cases in each group.Telephone follow-up was conducted on the 14th day after the start of treatment to record patient medication compliance and adverse drug reactions.A 13C urea breath test was performed for re-examination at least one month after completing the treatment plan and discontinuing medication.The intention-to-treat(ITT)and per-protocol(PP)analyses were used to compare the H.pylori eradication rates between the two groups,and Chi-square test and t-test were used for intergroup comparison.Results In the ITT analysis,the eradication rates of the LBMC group and the LBAC group were 89.5%(77/86,95%CI:82.9%～96.1%)and 82.6%(71/86,95%CI:74.4%～90.7%),respectively.In the PP analysis,the eradication rates were 92.6%(75/81,95%CI:86.8%～98.4%)and 88.8%(71/80,95%CI:81.7%～95.8%),respectively.The adverse reaction rate of the LBMC group was 27.9%(24/86),and that of the LBAC group 31.4%(27/86),showing no statistically significant difference(P>0.05).In terms of compliance,the LBMC group was 94.2%(81/86),and the LBAC group 93.0%(80/86),revealing no statistically significant difference(P>0.05).Conclusion As a first-line treatment for eradicating H.pylori,regimens containing minocycline demonstrate equivalent eradication rates to those containing amoxicillin,with similar safety and compliance.They can be used as an alternative treatment for patients allergic to penicillin.

Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer.Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study,including 49 cases of lung adenocarcinoma(LUAD),30 cases of lung squamous cell carci-noma(LUSC),and 15 cases of small cell lung cancer(SCLC).All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE.Two radiologists independently measured the spectral and perfusion parameters of the three groups of images,including spectral curve slope(K),iodine concentration in the lesion area(ICL),effective atomic number(Zeff),surface permeability(PS),and perfusion index(PI),and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features.All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1.The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Statistical analysis showed that the spectral curve slope,ICL,NIC,and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients(P<0.05),while there were no significant differences in these parameters between LUSC and SCLC patients(P>0.05).Among the perfusion CT parameters,surface permeability(PS)showed significant differences among the three groups(P<0.05),while blood volume(BV),blood flow(BF),perfusion index(PI),time to peak(TTP),and mean transit time(MTT)did not show statistical differences.The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance:the area under the curve(AUC)of the LUAD and LUSC discrimination model was 0.806/0.77(training group/test group)in the arterial phase and 0.867/0.9(training group/test group)in the venous phase;the AUC of the LUAD and SCLC discrimination model was 0.885/0.883(training group/test group)in the arterial phase and 0.851/0.776(training group/test group)in the venous phase.Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes.The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer,providing precise imaging evidence for the formulation of individualized treatment plans.

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.