Objective:To examine the risk factors and predictive value of depression following mild acute ischemic stroke in elderly individuals.The aim is to enhance early identification and intervention, ultimately leading to improved prognosis.Methods:A case-control study was conducted on 988 elderly patients with mild acute ischemic stroke.The study collected general population and social data, as well as clinical laboratory data such as blood glucose, blood lipids, and AD7C-NTP in urine.Additionally, the patients underwent assessments using the Montreal Cognitive Assessment Scale(MoCA), National Institutes of Health Stroke Scale(NHISS), Barthel index(BI), Hamilton Anxiety Scale(HAMA), and Hamilton Depression Scale(HAMD).Based on the HAMD depression scale score, the patients were divided into a nopost-stooke depression(NPSD)group and a post-stooke depression(PSD)group.The study then analyzed the related risk factors and predictive value of PSD.Results:A total of 988 patients were eligible for inclusion, with 132 being excluded and 856 being included.The NPSD and PSD groups showed significant differences in age, hypertension, smoking history, education level, and stroke history(all P<0.05).Regarding clinical data, there were statistically significant differences between the two groups in total cholesterol(TC), triacylglycerol(TG), HDL, urinary AD7C-NTP, MoCA, and HAMA scores(all P<0.05).The results of the multi-factor logistic regression analysis revealed that gender( OR=1.975, 95% CI: 1.223-3.190, P=0.005), stroke history( OR=1.352, 95% CI: 0.877-2.086, P=0.042), and HAMA score( OR=1.216, 95% CI: 0.932-1.526, P=0.043)were identified as independent risk factors for post-stroke depression in the elderly.Conversely, MoCA score( OR=0.873, 95% CI: 0.814-0.937, P<0.001)was found to be an independent protective factor.Furthermore, the ROC curve analysis demonstrated that the HAMA score(AUC=0.892, sensitivity: 0.721, specificity: 0.854, cut-off value: 9.5)exhibited significant predictive value, while the other indexes had limited predictive value. Conclusions:Gender, stroke history, and HAMA score have been identified as potential independent risk factors for post-stroke depression(PSD)in the elderly, while MoCA score may serve as an independent protective factor.Notably, HAMA score demonstrates a strong predictive ability for PSD.Early identification of these factors and timely intervention could significantly contribute to improving prognosis.

The American College of Gastroenterology Guidelines:Management of Acute Pancreatitis(referred to as the"2024 guidelines"),released in March 2024,presents 11 recommendations and 23 key concepts for the management of acute pancreatitis(AP)based on different levels of evidence quality.The 2024 guidelines provide detailed explanations regarding the diagnostic criteria,etiology,initial assessment,severity stratification,initial management,endoscopic retrograde cholangiopancreatography,antibiotic use,nutritional support,and surgical interventions for AP.Compared to the 2023 edition of the American College of Gastroenterology Guidelines,the 2024 edition offers more detailed recommendations and comprehensive evidence-based medical data,which is of great significance in optimizing the diagnosis and treatment process for AP patients and improving patient outcomes.

Objective:To study the clinical significance of alveolar-arterial oxygen gradients (P A-aO 2) for late preterm and full-term infants with acute respiratory distress syndrome (ARDS). Methods:From January 2020 to June 2022, infants (gestational age ≥34 weeks) diagnosed with ARDS were admitted to the Neonatology Department of our hospital. The infants were assigned into the invasive group and the non-invasive group according to the ventilation mode. The infants with the same gestational age and diagnosed with neonatal wet lung were assigned into the control group. P A-aO 2 levels within 1 h after birth were compared among the three groups. The correlation of P A-aO 2 with ARDS, ventilation mode and duration were studied. Receiver operating characteristic (ROC) curve was used to determine the predictive value of P A-aO 2 within 1 h after birth for ARDS and the need of invasive ventilation. Results:A total of 36 cases were enrolled in the invasive group, 19 cases in the non-invasive group and 50 cases in the control group. Within 1 h after birth, P A-aO 2 in the invasive group was significantly higher than the non-invasive group and the control group ( P<0.05), and the non-invasive group higher than the control group ( P<0.05). Correlation analysis showed that P A-aO 2 within 1 h after birth in the invasive group was positively correlated with the duration of invasive ventilation and total mechanical ventilation ( r=0.601, P<0.001; r=0.504, P=0.002); P A-aO 2 before successful withdrawal of invasive ventilation was not correlated with subsequent non-invasive ventilation duration; and no correlation existed between P A-aO 2 within 1 h after birth and the duration of non-invasive ventilation in the non-invasive group. The area under the ROC curve for P A-aO 2 within 1 h after birth to predict ARDS was 0.875, with a sensitivity of 87.3% and a specificity of 72.0% at a cutoff value of 50.0 mmHg. The area under the ROC curve for predicting the need for invasive ventilation in infants with ARDS was 0.851, with a sensitivity of 80.0% at a cutoff value of 73.3 mmHg and a specificity of 75.0%. Conclusions:Late preterm and full-term infants have a higher risk of ARDS at P A-aO 2>50.0 mmHg within 1 h after birth. Infants with ARDS are more likely to require invasive ventilation if P A-aO 2>73.3 mmHg. The higher the level of P A-aO 2, the longer the duration of invasive ventilation and total duration of mechanical ventilation.

Objective:To explore the risk factors for cognitive impairment 3 months after an ischemic stroke and their predictive value.Methods:A retrospective case-control study considered the records of 856 elderly patients who had survived an ischemic stroke. All had been evaluated using the Montreal Cognitive Assessment scale (MoCA). They were divided according to their MoCA scores into a group without cognitive impairment (the PSNCI group) and an impaired (PSCI) group. The subjects′ demographic and clinical laboratory data were compiled. All had been assessed using the National Institutes of Health stroke scale (NIHSS), the Barthel Index (BI), and the Hamilton depression scale (HAMD). Univariate and multivariate logistic regressions were evaluated and a receiver operator characteristics (ROC) curve was computed.Results:There were significant differences between the two groups in terms of gender distribution, age, hypertension and heart disease history, family history of dementia and education level. Moreover, significant differences were observed in the groups′ average total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), urinary neurofilament protein (AD7c-NTP), NIHSS scores, BIs and ADL scores. Logistic regression showed that a history of heart disease, urinary AD7C-NTP level and HAMD score were significant independent predictors of cognitive impairment 3 months after a stroke. A high BI was an independent protective factor. The area under the ROC curve for urinary AD7C-NTP was the largest (0.875) and had significant predictive value with a cut-off value of 2.43, sensitivity of 0.94 and specificity of 0.75.Conclusion:Age, sex, education, smoking, drinking, body mass index, a history of heart disease or stroke, a family history of dementia and elevated AD7C-NTP, TC or TG are risk factors for cognitive impairment after a stroke. A high BI suggests a better prognosis. Urinary AD7c-NTP is a useful predictor of PSCI 3 months after a stroke.

Adult ; Humans ; Diabetes Mellitus, Type 1 ; Nutritional Status ; Blood Glucose ; Surveys and Questionnaires ; Insulin

Acute-on-chronic liver failure (ACLF) is a syndrome characterized by multiple organ failure and high short-term mortality rate, and it has always been a research hotspot in the field of severe liver diseases. Therefore, early and accurate risk stratification and timely intervention are of great significance to improve prognosis. This article summarizes the serum biomarkers identified in recent years for evaluating the prognosis of patients with ACLF, and it is pointed out that new serum biomarkers have an important guiding significance in the prognostic evaluation of ACLF patients.

Objective:To explore the application of computer simulation teaching based on GasMan @ software in anesthesiology standardized nursing training. Methods:Thirty-six anesthesia nurses undergoing standardized training were selected as research objects. They were randomly divided into the traditional teaching group (group C) and the computer simulation teaching based on GasMan @ software group (group G), with 18 nurses in each group. All the nurses received the theory test before and after the training, and the practical operation assessment and the teaching satisfaction survey were conducted after the training. SPSS 17.0 was used for independent-samples t test and chi-square test. Results:There was no significant difference in the theoretical test scores of the anesthesia nurses before class between the two groups ( P > 0.05); the theoretical test, practical performance and satisfaction survey of group G were significantly better than those of group C, with statistical significance ( P < 0.05). Conclusion:Computer simulation teaching based on GasMan @ software is in favor of the anesthesia nurse to learn and master the relevant theory of inhalation general anesthesia, especially to improve practical skills.

Portal vein thrombosis (PVT) is one of the most common complications of liver cirrhosis. Due to coagulation disorder and the risk of bleeding in liver cirrhosis, there are many controversies over the treatment of liver cirrhosis with PVT in clinical practice. Common therapies for PVT include anticoagulant therapy, intervention, and thrombolysis. This article elaborates on the current status of the treatment of liver cirrhosis with PVT, in order to provide help for the development of standard and reasonable clinical treatment strategies.

Objective:To investigate the protective role of YAP in TNF-α induced intestinal epithelial barrier injury.Methods:Caco-2 cells was cultured 14d to establish the intestinal mucosal barrier model, and then they were transfected with YAP plasmid and control plasmid vector, and 24h later they were exposed to TNF-α, and 48h later cell viability was quantified by CCK-8 assays.Cell cycle was determined by flow cytometric analysis.Cell migration was monitored by Transwell.Results:Compared to the normal control group, after exposed to TNF-α, the growth rate of Caco-2 cells was significantly decreased, and the ratio of G0/G1 phase cells was significantly higher, while the S phase and G2/M phase proportion decreased, and markedly reduced cells proliferation.The over expression of YAP significantly ameliorated the decrease of the growth rate induced by TNF-α, and promoted the cell cycle in G0/G1 phase to S phase and G2/M phase transition.Transwell results showed that the number of cell migration in control group was(172.4±13.1), after adding TNF-α stimulation decreased significantly(80.4±9.3), while the number of cell migration induced by transfection of YAP was(124.2±9.2). The difference was statistically significant( P<0.01). Conclusion:YAP inhibits intestinal epithelial barrier injury induced by TNF-α through regulating intestinal epithelial cell survival and migration.