Acute Kidney Injury (AKI) is a common and severe complication after cardiac surgery. The pathogenesis of cardiac surgery-associated AKI (CSA-AKI) is complex, and it is associated with increased patient mortality and poor renal prognosis. To identify high-risk patients as early as possible, numerous clinical studies have explored perioperative risk factors and developed a variety of biomarkers with good diagnostic capabilities. Currently, multiple prediction models for AKI after cardiac surgery have been developed internationally; however, there is no effective treatment for CSA-AKI. Therefore, implementing reasonable and comprehensive preventive strategies is crucial. In addition, the clinical application of some interventions is controversial, which means more research and exploration are needed to make more informed decisions regarding the prevention and treatment of CSA-AKI.

Obesity is a major global public health challenge and a leading cause of multiple metabolic disorders,including hypertension and diabetes.In China,more than half of the adult population is overweight or obese.While anti-obesity pharmacotherapies(such as GLP-1 receptor agonists)and bariatric surgery have both advanced rapidly,strategies for integrating these two modalities remain unclear.In particular,controversies persist regarding surgical eligibility after drug discontinuation,and standardized clinical guidelines are lacking.In July 2025,the International Federation for the Surgery of Obesity and Metabolic Disorders released the world's first statement focusing on"metabolic bariatric surgery after pharmacotherapy-induced weight loss",which emphasizes the chronic disease model of obesity management and clarifies the synergistic relationship between pharmacotherapy and surgery.This article interprets the statement from the perspectives of treatment strategies,surgical eligibility,and drug-surgery coordination,aiming to provide evidence-based reference for clinicians and to promote standardized,integrated obesity management.

Acute kidney injury (AKI) usually requires renal replacement therapy (RRT). Common RRT modes include peritoneal dialysis, continuous renal replacement therapy, intermittent hemodialysis and continuous low-efficiency hemodialysis. In clinical practice, there is still controversy over how to select the appropriate RRT mode for AKI patients and when initiating RRT is more beneficial for AKI patients. This article summarizes previous studies on the impact of RRT mode and initiation timing on the prognosis of AKI patients, with the aim of providing assistance for clinical decision-making.

Obesity is a major global public health challenge and a leading cause of multiple metabolic disorders,including hypertension and diabetes.In China,more than half of the adult population is overweight or obese.While anti-obesity pharmacotherapies(such as GLP-1 receptor agonists)and bariatric surgery have both advanced rapidly,strategies for integrating these two modalities remain unclear.In particular,controversies persist regarding surgical eligibility after drug discontinuation,and standardized clinical guidelines are lacking.In July 2025,the International Federation for the Surgery of Obesity and Metabolic Disorders released the world's first statement focusing on"metabolic bariatric surgery after pharmacotherapy-induced weight loss",which emphasizes the chronic disease model of obesity management and clarifies the synergistic relationship between pharmacotherapy and surgery.This article interprets the statement from the perspectives of treatment strategies,surgical eligibility,and drug-surgery coordination,aiming to provide evidence-based reference for clinicians and to promote standardized,integrated obesity management.

Acute kidney injury (AKI) usually requires renal replacement therapy (RRT). Common RRT modes include peritoneal dialysis, continuous renal replacement therapy, intermittent hemodialysis and continuous low-efficiency hemodialysis. In clinical practice, there is still controversy over how to select the appropriate RRT mode for AKI patients and when initiating RRT is more beneficial for AKI patients. This article summarizes previous studies on the impact of RRT mode and initiation timing on the prognosis of AKI patients, with the aim of providing assistance for clinical decision-making.

Acute Kidney Injury (AKI) is a common and severe complication after cardiac surgery. The pathogenesis of cardiac surgery-associated AKI (CSA-AKI) is complex, and it is associated with increased patient mortality and poor renal prognosis. To identify high-risk patients as early as possible, numerous clinical studies have explored perioperative risk factors and developed a variety of biomarkers with good diagnostic capabilities. Currently, multiple prediction models for AKI after cardiac surgery have been developed internationally; however, there is no effective treatment for CSA-AKI. Therefore, implementing reasonable and comprehensive preventive strategies is crucial. In addition, the clinical application of some interventions is controversial, which means more research and exploration are needed to make more informed decisions regarding the prevention and treatment of CSA-AKI.

BackgroundThere exist differences in the subjective and objective cognitive functions of patients with depressive disorder， ane there are limited research on influencing factors of such phenomenon currently. ObjectiveTo explore the differences in subjective and objective cognitive function in patients with depressive disorder as well as influencing factors， and to provide references for further understanding of cognitive impairment in patients with depressive disorder. MethodsA total of 77 patients with depressive disorder who received outpatient or inpatient treatment in the Fourth People's Hospital of Chengdu from January 13， 2022 to December 11， 2023 were selected for the study. These patients also met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition（DSM-5）. Various tools were employed to assess patients in this study： Montgomery-Asberg Depression Rating Scale （MADRS） for the depressive symptoms， Perceived Deficits Questionnaire for Depression （PDQ-D） and Chinese Version of Brief Neurocognitive Test Battery （C-BCT） for the subjective and objective cognitive function， Sheehan Disability Scale （SDS） for the social function， and Clinical Global Impression-Severity of Illness（CGI-SI） for the severity of patient's condition. Pearson correlation analysis was used to examine the correlation of subjective and objective cognitive function and their differences with age， years of education， MADRS total score， SDS total score， and CGI-SI score. Multiple linear regression was used to explore the influencing factors of the differences between subjective and objective cognitive function. ResultsThere was a statistically significant difference in the total PDQ-D scores and the difference of subjective and objective cognitive function （D value） between depressive patients with and without medication （t=-4.228， -2.392， P<0.05 or 0.01）. There was no statistically significant correlation in subjective and objective cognitive function in patients with depressive disorder （r=-0.148， P>0.05）. Negative correlations can be observed between the PDQ-D total score and age or years of education （r=-0.333， -0.369， P<0.01）. The PDQ-D total score was positively correlated with MADRS total score， SDS total score and CGI-SI score （r=0.487， 0.637， 0.434， P<0.01）. D value was negatively correlated with age and years of education （r=-0.411， -0.362， P<0.01）， while positively correlated with MADRS total score， SDS total score and CGI-SI score （r=0.259， 0.468， 0.299， P<0.05 or 0.01）. Age （β=-0.328， P<0.01） and SDS total score （β=0.409， P<0.01） were two predictive factors for D value. ConclusionThe difference between subjective and objective cognitive function among patients with depressive disorder is related to several factors including age， years of education， severity of symptoms and impairment of social function. ［Funded by Surface Project of National Natural Science Foundation of China （number， 62173069）； Technological Innovation 2030-Major Project of "Brain Science and Brain-Like Research" （number， 2022ZD0211700）； Key R&D Support Program and Major Application Demonstration Project of Chengdu Science and Technology Bureau （number， 2022-YF09-00023-SN）］

Objective To establish the Logistic regression model by reporting and data system version 2 (PI-RADS v2)and prostate specific antigen (PSA),and to evaluate the diagnostic efficiency in transition zone prostate cancer (PCa).Methods MRI and PSA data of 33 patients with PCa and 54 patients with non-PCa confirmed by pathology were analyzed retrospectively.The PI-RADS v2 was used to evaluate the risk of 2 groups (from low to high as 1 to 5 points).Total PSA (t-PSA),free to total PSA ratio (f-PSA/t-PSA),PSA density (PSAD) and PI-RADS v2 scores were compared between 2 groups.The Logistic regression models were established with parameters which were significantly different between 2 groups.The Logistic regression was divide into three protocols:PI-RADS v2-+ t-PSA (A),PI-RADS v2 + f-PSA/t-PSA (B),PI-RADS v2+PSAD (C).The ROC curves were constructed by the new parameters Logit (P) and PI-RADS v2 scores for assessing the diagnostic efficiency.Results The t-PSA,f-PSA/t-PSA,PSAD and PI-RADS v2 scores had significant differences between the 2 groups (all P＜0.01).Predictive multivariate model of A,B,C was established as Logit (P)=-8.682+1.507 PI-RADS v2+0.234 t-PSA (x2=65.993,P＜0.01),Logit(P)=-5.425+1.906 PI-RADS v2 13.921 f-PSA/t-PSA (x2 =65.993,P＜0.01),Logit(P)=-7.534+1.045 PI-RADS v2+13.318 PSAD (x2 =74.036,P＜0.01),their area underthe curve (0.945,0.919,0.960) were all higher than that of PI-RADS v2 score (0.861,all P ＜0.01).The protocol C had the best diagnostic efficiency,and the sensitivity and specificity were 87.88 ％ and 92.59 ％.The sensitivity and specificity of PI-RADS v2 score were 87.88％ and 77.78％.Conclusion The diagnostic efficiency of the Logistic regression model which includes the PI-RADS v2 score and PSA are superior to the PI-RADS v2 score alone for transition zone PCa,which can provide a reliable basis for patients whether need biopsy or not.

Objective To compare the display effect of contrast enhanced MR angiography (CE-MRA) and CTA in evaluating blood supply of early stage cervical cancer.Methods CE-MRA and CTA before the operation of 30 patients with pathologically confirmed early stage cervical cancer were analyzed retrospectively.The origins and continuity of bilateral uterine arteries and the conspicuity of bilateral decending branch of uterine arteries between CE-MRA and CTA were evaluated.Results Fifty uterine arteries could classify as origins clearly visible and vessels clearly visible without discontinuity,5 uterine arteries as origins clearly visible but vessels unclearly visible on both CEMRA and CTA.Both CE-MRA and CTA were conformed well in evaluating the origin and continuity of uterine arteries (Kappa=0.80,P＜0.05).The conspicuity of decending branches for CE-MRA was 55.00％ (33/60),which was lower than that of CTA (73.33％ [44/60]),which had statistically significant difference between CE-MRA and CTA (x2 26.22,P＜0.01).Conclusion For early stage cervical cancer,CE-MRA and CTA can both provide a good performance in evaluating the origin and continuity of uterine arteries,CTA reveals advantage over CE MRA in detecting conspicuity of decending branch of uterine arteries.

Objective To explore the feasibility of intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH).Methods A total of 407 patients with clinically-suspected HCC or FNH underwent conventional and dynamic enhanced MRI and IVIM-DWI,60 patients (40 cases of HCC,20 cases of FNH) were enrolled.Parameters of ADC,slow apparent diffusion coefficient (D),fast apparent diffusion coefficient (D*) and fraction of fast apparent diffusion coefficient (f) were obtained by monoexponential model and biexponential model respectively.Results The values of ADC,D,D* and f in FNH group were (1.60±-0.25) × 10-3mm2/s,(1.12±0.17)×10-3mm2/s,(44.89±18.23)× 10-3 mm2/s and (34.80 ± 9.68)％,and those in HCC group were (1.32 ± 0.21) × 10-3 mm2/s,(0.82±-0.21) × 10-3mm2/s,(49.82±20.11) × 10 3mm2/s and (28.72±13.84) ％,respectively.Significant inter-group differences were observed in ADC and D (both P＜0.001),however,there were no significant differences in D* and f (both P＞0.05).The areas under the ROC curve of D were 0.90,and taking D=0.96 × 10-3 mm2/s as cut-off value,the sensitivity and specificity of D in diagnosis of HCC were 84.44％ and 90.02％.Conclusion IVIM-DWI is useful to distinguish FNH from HCC,and the D value in biexponential model has the best diagnostic efficacy for differentiations.