Objective:Analyze the risk factors of gastrointestinal perforation caused by foreign body and summarize the experience of surgical treatment of foreign bodies.Method:From Jan 2008 to Dec 2023, 89 patients with foreign bodies in the digestive tract were admitted to the Department of Gastrointestinal Surgery, Peking University First Hospital. Relevant data were collected and binary logistic regression was used to analyze the independent risk factors for intestinal perforation, resection and anastomosis of intestine or enterostomy/colostomy.Results:The mean age of 89 patients was (60.1±16.2) years old, 65 patients (73%) had unintentionally ingested foreign bodies. The most common foreign bodies were jujube pits (40 cases). Thirty-nine patients diagnosed with gastrointestinal perforation. Binary Logistic regression analysis showed that the total number of leukocytes ( OR=4.085, 95% CI: 1.214-13.745, P=0.023), sharp foreign body ( OR=26.124, 95% CI: 5.194-131.392, P<0.001), and the location of foreign body ( OR=3.980, 95% CI: 1.178-13.465, P=0.026) were the independent risk factors for gastrointestinal perforation. Thirty-three patients underwent gastrointestinal repair surgery, and 36 patients underwent resection and anastomosis of intestine or enterostomy/colostomy. Binary Logistic regression analysis showed that the foreign body located in the colorectum ( OR=71.928, 95% CI: 4.646-1 113.479, P=0.002) and the length of the foreign body ≤2.5 cm ( OR=5.791, 95% CI: 1.606-20.882, P=0.007) were the independent risk factors for resection and anastomosis of intestine or enterostomy/colostomy. Conclusions:Leukocyte count ≥10×10 9/L, sharp foreign body, and location of foreign body are independent risk factors for gastrointestinal perforation. Foreign body located in the colorectum and foreign body length ≤2.5 cm are risk factors for resection and anastomosis of intestine or enterostomy/colostomy.

Objective:Analyze the risk factors of gastrointestinal perforation caused by foreign body and summarize the experience of surgical treatment of foreign bodies.Method:From Jan 2008 to Dec 2023, 89 patients with foreign bodies in the digestive tract were admitted to the Department of Gastrointestinal Surgery, Peking University First Hospital. Relevant data were collected and binary logistic regression was used to analyze the independent risk factors for intestinal perforation, resection and anastomosis of intestine or enterostomy/colostomy.Results:The mean age of 89 patients was (60.1±16.2) years old, 65 patients (73%) had unintentionally ingested foreign bodies. The most common foreign bodies were jujube pits (40 cases). Thirty-nine patients diagnosed with gastrointestinal perforation. Binary Logistic regression analysis showed that the total number of leukocytes ( OR=4.085, 95% CI: 1.214-13.745, P=0.023), sharp foreign body ( OR=26.124, 95% CI: 5.194-131.392, P<0.001), and the location of foreign body ( OR=3.980, 95% CI: 1.178-13.465, P=0.026) were the independent risk factors for gastrointestinal perforation. Thirty-three patients underwent gastrointestinal repair surgery, and 36 patients underwent resection and anastomosis of intestine or enterostomy/colostomy. Binary Logistic regression analysis showed that the foreign body located in the colorectum ( OR=71.928, 95% CI: 4.646-1 113.479, P=0.002) and the length of the foreign body ≤2.5 cm ( OR=5.791, 95% CI: 1.606-20.882, P=0.007) were the independent risk factors for resection and anastomosis of intestine or enterostomy/colostomy. Conclusions:Leukocyte count ≥10×10 9/L, sharp foreign body, and location of foreign body are independent risk factors for gastrointestinal perforation. Foreign body located in the colorectum and foreign body length ≤2.5 cm are risk factors for resection and anastomosis of intestine or enterostomy/colostomy.

Objective:The study retrospectively analyzed the etiology, clinical manifestations, emergency treatment and etiological treatment of a large sample of cases with hypercalcemic crisis.Methods:The clincial data of patients with hypercalcaemia cirisis who were administered in First Medical Center of Chinese PLA General Hospital from January 2009 to July 2022 were analyzed, inculding the general data, clinical manifestations, etiology, photographic examination, emergency treatment, etiological treatment, serological examination before and after treatment, pathological immunohistochemical findings and prognosis.Results:A total of 143 hypercalcaemia crisis patients(84 males and 59 females) with a mean age of 53.51±16.60 were enrolled. The most common disease was hyperparathyroidism(62/143), followed by solid malignancy(57/143) and multiple myeloma(12/143). Patients presented with digestive system symptoms at 76.91%, followed by neurological symptoms at 63.60%, urinary system symptoms at 58.76%, musculoskeletal symptoms at 55.23%, and cardiovascular system symptoms at 32.91%. After emergency calcium-lowering treatment, the remission rate of hypercalcemic crisis in 143 patients was 100%(143/143), and after etiological treatment, the remission rate of hypercalcemia was 85.31%(122/143).Conclusion:Early identification, emergency treatment and etiology treatment of hypercalcaemia crisis are essential. Effective treament with comprehensive calcium reduction can quickly relieve clinical symptoms and create opportunities for treatment for the cause. Targeted etiological interventions can lead to the correction or long-term remission of hypercalcemia.

Objective:To study the relationship between hemoglobin glycation index (HGI) and blood lipid indices such as low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and plasma atherogenic index (AIP).Methods:This cross-sectional study included 16 049 participants from the Beijing Apple Garden community between December 2011 and August 2012. The subjects were divided into three groups based on the HGI quartile: low ( n=5 388), medium ( n=5 249), and high ( n=5 412). The differences in blood lipid indicators between different HGI groups were compared and multivariate logistic regression model was established to analyze the association between HGI and dyslipidemia. And multivariate logistic regression model was established to analyze the relationship between HGI and blood lipid indicators in different glucose metabolism populations. Results:There were 16 049 participants in all (mean age: 56 years), including 10 452 women (65.1%). They were classified into normal glucose tolerance (9 093 cases), prediabetes (4 524 cases), and diabetes (2 432 cases) based on glucose tolerance status. In the general population, with the increase of HGI, LDL-C, non-HDL-C, and AIP gradually increased (all P values for trends were <0.05), and the proportion of abnormalities increased significantly ( χ2=101.40, 42.91, 39.80; all P<0.001). A multivariate logistic regression model was established, which suggested a significant correlation between HGI and LDL-C, non-HDL-C, and AIP (all P<0.05), after adjusting for factors such as age, sex, fasting blood glucose, hypertension, body mass index, smoking, and alcohol consumption. In the overall population, normal glucose tolerance group, and diabetes group, HGI had the highest correlation with non-HDL-C ( OR values of 1.325, 1.678, and 1.274, respectively); in the prediabetes group, HGI had a higher correlation with LDL-C ( OR value: 1.510); and in different glucose metabolism groups, AIP and HGI were both correlated ( OR: 1.208-1.250), but not superior to non-HDL-C and LDL-C. Conclusion:HGI was closely related to LDL-C, non HDL-C, and AIP in the entire population and people with different glucose metabolism, suggesting that HGI may be a predictor of atherosclerotic cardiovascular disease.

Objective:To analyze the correlation between fatty liver index (FLI) and myocardial remodeling.Methods:For cross-sectional study, cluster sampling was used to conduct a follow-up study of “Risk evaluation of cancers in Chinese diabetic individuals: A longitudinal (REACTION) study” among communities of Gucheng and Pingguoyuan of Beijing from April 2015 to September 2015. According to the inclusion and exclusion criteria, 8 848 participants were selected. Biochemical indicators such as body mass index, waist circumference, triglycerides, and γ-glutamyl transpeptidase were detected to calculate the FLI. The correlation between FLI and myocardial remodeling was analyzed. Interventricular septal thickness (IVS), left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD), and the presence of diastolic dysfunction were measured by color doppler ultrasound. The participants were divided into Q1 group (FLI<30, 4 529 cases), Q2 group (30≤FLI<60, 2 762 cases), and Q3 group (FLI≥60, 1 557 cases) based on FLI levels. Single factor analysis of variance was used for inter-group comparison, logistic regression analysis was used to analyze the correlation between FLI and myocardial remodeling.Results:A total of 8 848 subjects were selected for the study (3 110 male and 5 738 female, mean age: 59.96 years). The IVS of Q1, Q2, and Q3 groups were (9.35±1.08), (9.73±1.22), and (10.07±1.31) mm, respectively. The LAD were (30.94±3.90), (33.37±4.12), and (34.98±4.47) mm, respectively. The LVEDD were (42.51±5.05), (44.43±5.10), and (46.06±5.52) mm, respectively. All increased with the increase of FLI (all P<0.001). FLI was an independent risk factor for IVS thickening, LAD increase, LVEDD increase, and diastolic function decrease. The respective risks for IVS thickening, LAD increase, LVEDD increase, and diastolic function decrease in a population with intermediate and higher FLI levels was 1.62 times (95% CI 1.39-1.89) and 2.53 times (95% CI 2.13-3.00); 2.71 times (95% CI 2.39-3.06) and 5.00 times (95% CI 4.12-6.08); 2.36 times (95% CI 1.85-3.00) and 4.33 times (95% CI 3.33-5.62); and 1.90 times (95% CI 1.63-2.19) and 1.95 times (95% CI 1.60-2.37) than those with lower FLI levels. Conclusion:There is a certain relevance between FLI and myocardial remodeling.

Objective:To analyze the correlation between fatty liver index (FLI) and the outcomes of individuals with high normal blood pressure.Methods:In this retrospective cohort study, data from the follow-up population of the Beijing branch of the Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal (REACTION) study conducted from December 2011 to August 2012 were selected. Obtain indicators such as height, weight, waist circumference, fasting blood glucose, 2-h postprandial blood glucose, triglycerides, high-density lipoprotein cholesterol, and glutamyl transpeptidase were measured, and the FLI was calculated. The population with high normal blood pressure was divided into the FLI<30 group (1 822 cases); 30≤FLI<60 group (1 026 cases); and FLI≥60 group (473 cases) based on FLI levels. The blood pressure outcome data from the follow-up survey of this population from April 2015 to September 2015 were collected. Single factor analysis of variance was used for intergroup comparison, and logistic regression was used to analyze the correlation between FLI and the outcome of high normal blood pressure in the population.Results:The FLI was an independent influencing factor for their conversion to normal blood pressure (all P<0.01). Among all observed populations, the likelihood of conversion to normal blood pressure in the 30≤FLI<60 group and FLI≥60 group was 0.63 (95% CI 0.51-0.78) and 0.61 (95% CI 0.45-0.82) of the FLI<30 group, respectively. In the population of 40≤age<60 years, this likelihood was 0.60 (95% CI 0.47-0.76) and 0.57 (95% CI 0.41-0.79), respectively. FLI is not an independent influencing factor for the conversion to normal blood pressure in individuals aged over 60 years ( P=0.161). FLI is an independent risk factor for hypertension (all P<0.05). Among all observed populations and population of 40≤age<60 years and age>60 years, the risk of hypertension in the 30≤FLI<60 group and FLI≥60 group was 1.49 times (95% CI 1.23-1.80) and 1.54 times (95% CI 1.19-1.98); 1.41 times (95% CI 1.13-1.75) and 1.38 times (95% CI 1.04-1.83); and 1.75 times (95% CI 1.22-2.53) and 2.10 times (95% CI 1.24-3.58) of the FLI<30 group, respectively. Conclusions:There is a correlation between FLI levels and future outcomes of individuals with normal high blood pressure. Although people with higher FLI are more likely to develop hypertension, those with higher FLI are also less likely to develop normal blood pressure in the 40≤age<60-year group.

Objective:To explore the repair effect of nucleus pulposus spherical cell clusters in the process of intervertebral disc degeneration and its potential therapeutic application.Methods:The degradation and rheological properties of SupraGel hydrogel were characterized, and the biocompatibility of spherical nucleus pulposus cell clusters in SupraGel hydrogel was tested by live-dead cytological staining. A caudal disc puncture degeneration model was established in 20 SD rats, and the rats were divided into groups and intervention measures: puncture of degenerated segment without intervention (positive control group), puncture of degenerated segment injection of SupraGel hydrogel (hydrogel group), puncture of degenerated segment injection of spherical cell clusters (cell cluster group), puncture of degenerated segment injection of SupraGel hydrogel loaded with spherical cell clusters (hydrogel + cell cluster group) and healthy segment (negative control group). X-rays and MRI examinations were performed at the 4th and 8th weeks after intervention, and the disc degeneration was evaluated according to the disc height index and Pfirrmann grading. HE staining, safranin O-fast green staining and COL-2 immunohistochemical staining were used to evaluate the changes in the disc structure and extracellular matrix.Results:The degradation residual rate of SupraGel hydrogel was 73.7% after 10 h, which showed excellent shear thinning and self-recovery properties. Nucleus pulposus cells could spontaneously aggregate in SupraGel hydrogel to form stable spherical cell clusters, which remained active on the 7th day. In the in vivo experiment, the intervertebral height index of the hydrogel + cell cluster group was 88.12%±4.55% and 74.13%±4.09% at 4 and 8 weeks after intervention, which were higher than those of the positive control group and hydrogel group, and lower than those of the negative control group, with statistically significant differences ( P<0.05); the Pfirrmann grades were 2.40±0.55 and 2.60±0.89, which were lower than those of the positive control group and hydrogel group at 4 weeks, and lower than those of the positive control group, hydrogel group and cell cluster group at 8 weeks, and higher than those of the negative control group, with statistically significant differences ( P<0.05); the morphological scores were 6.60±0.55 and 9.40±1.14, which were lower than those of the positive control group, hydrogel group and cell cluster group at 4 weeks, at the 8th week, the levels of collagen type II were lower than those of the positive control group, hydrogel group and cell cluster group, but higher than those of the negative control group, and the difference was statistically significant ( P<0.05). The optical density of type II collagen was 0.12±0.01 and 0.10±0.01, respectively, which were higher than those of the positive control group, hydrogel group and cell cluster group at the 4th week, and higher than those of the positive control group and hydrogel group at the 8th week, and the difference was statistically significant ( P<0.05). Conclusion:Nucleus pulposus spherical cell clusters can be successfully constructed and have been shown to have the effect of delaying degeneration in the rat intervertebral disc degeneration model.

Objective:To explore the repair effect of nucleus pulposus spherical cell clusters in the process of intervertebral disc degeneration and its potential therapeutic application.Methods:The degradation and rheological properties of SupraGel hydrogel were characterized, and the biocompatibility of spherical nucleus pulposus cell clusters in SupraGel hydrogel was tested by live-dead cytological staining. A caudal disc puncture degeneration model was established in 20 SD rats, and the rats were divided into groups and intervention measures: puncture of degenerated segment without intervention (positive control group), puncture of degenerated segment injection of SupraGel hydrogel (hydrogel group), puncture of degenerated segment injection of spherical cell clusters (cell cluster group), puncture of degenerated segment injection of SupraGel hydrogel loaded with spherical cell clusters (hydrogel + cell cluster group) and healthy segment (negative control group). X-rays and MRI examinations were performed at the 4th and 8th weeks after intervention, and the disc degeneration was evaluated according to the disc height index and Pfirrmann grading. HE staining, safranin O-fast green staining and COL-2 immunohistochemical staining were used to evaluate the changes in the disc structure and extracellular matrix.Results:The degradation residual rate of SupraGel hydrogel was 73.7% after 10 h, which showed excellent shear thinning and self-recovery properties. Nucleus pulposus cells could spontaneously aggregate in SupraGel hydrogel to form stable spherical cell clusters, which remained active on the 7th day. In the in vivo experiment, the intervertebral height index of the hydrogel + cell cluster group was 88.12%±4.55% and 74.13%±4.09% at 4 and 8 weeks after intervention, which were higher than those of the positive control group and hydrogel group, and lower than those of the negative control group, with statistically significant differences ( P<0.05); the Pfirrmann grades were 2.40±0.55 and 2.60±0.89, which were lower than those of the positive control group and hydrogel group at 4 weeks, and lower than those of the positive control group, hydrogel group and cell cluster group at 8 weeks, and higher than those of the negative control group, with statistically significant differences ( P<0.05); the morphological scores were 6.60±0.55 and 9.40±1.14, which were lower than those of the positive control group, hydrogel group and cell cluster group at 4 weeks, at the 8th week, the levels of collagen type II were lower than those of the positive control group, hydrogel group and cell cluster group, but higher than those of the negative control group, and the difference was statistically significant ( P<0.05). The optical density of type II collagen was 0.12±0.01 and 0.10±0.01, respectively, which were higher than those of the positive control group, hydrogel group and cell cluster group at the 4th week, and higher than those of the positive control group and hydrogel group at the 8th week, and the difference was statistically significant ( P<0.05). Conclusion:Nucleus pulposus spherical cell clusters can be successfully constructed and have been shown to have the effect of delaying degeneration in the rat intervertebral disc degeneration model.

Objective To investigate the risk factors of coronary microvascular disease(CMVD)in elderly female patients.Methods Clinical data of 109 consecutive female elderly patients who re-ceived coronary angiography and coronary flow reserve(CFR)in our hospital from September 2020 to June 2022 were retrospectively collected in this study.According to CFR value,they were divided into CMVD group(CFR＜2.0,n=55)and non-CMVD group(CFR ≥2.0,n=54).The basic clinical data were compared between the two groups,and influencing factors associated with CMVD were analyzed.Results Significantly higher BMI and elevated UA,hs-CRP,TG,LDL and Lp-PLA2 levels,while lower HDL level was observed in the CMVD group than the non-CMVD group(P＜0.05,P＜0.01).Lp-PLA2 and hs-CRP were negatively correlated with CFR(r=-0.816;r=-0.399,P＜0.01).Spearman correlation analysis indicated that CRV value was nega-tively correlated with Lp-PLA2 and hs-CRP levels(r=-0.816,-0.399,P＜0.01).Logistic re-gression analysis showed that hs-CRP and Lp-PLA2 were independent risk factors for CMVD in elderly female patients(P＜0.05).ROC curve analysis revealed that the AUC value of Lp-PLA2 for diagnosing CMVD in elderly female patients was 0.745(95％CI:0.655-0.836),with a sensi-tivity of 69.1％and a specificity of 67.0％.And,the AUC value of hs-CRP was 0.752(95％CI:0.661-0.844).Conclusion Lp-PLA2 and hs-CRP levels are quite higher in elderly female CMVD patients,and can predict the occurrence of CMVD in elderly female patients.

A 38-year-old female presented with irregular menstruation and hirsutism that started at age of 16 and diagnosed with polycystic ovary syndrome at age of 29 with elevated testosterone. When treated with ethinestradiol cyproterone tablets, her menstruation returned to normal and androgen levels was not changed. At age of 38 she was referred to the hospital with infertility, a diagnosis of nonclassical 21-hydroxylase deficiency was confirmed using 17-hydroxyprogesterone, dehydroepiandrosterone-sulfate, a cosyntropin-stimulation test and genetic test. This case suggested that nonclassical congenital adrenal hyperplasia should be considered when a patient is presented with oligomenorrhea, hirsutism with hyperandrogenemia and infertility.