Objective To systematically evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in diagnosing hepatic echinococcosis. Methods By searching keywords combined with free words, articles reporting CEUS in diagnosing hepatic echinococcosis published before June 2023 were searched in the databases, including Pubmed, EMBASE, Cochrane Library, CBM, CNKI, Wanfang and CQVIP. According to the inclusion and exclusion criteria, eligible articles were screened. Data of general information, true positive, false positive, false negative, and true negative were extracted from the included articles. Using the QUADAS-2 tools to assess the included studies. Meta-disc1.4 and RevMan5.4 software were used for meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were calculated. The diagnostic odds ratio(OR) and area under the SROC curve (AUC) were calculated. Stata14.0 software was used to draw the Galbraith plot to perform heterogeneity analysis on the research data. Results According the inclusion and exclusion criteria, 7 articles were included with 348 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic OR and AUC of CEUS in diagnosing hepatic echinococcosis was 0.96 (95%CI 0.92-0.98), 0.88(95%CI 0.79-0.93), 5.73 (95%CI 1.24-26.58), 0.07 (95%CI 0.03-0.18), 95.32(95%CI 22.02-412.60), and 0.9767, respectively. According to the pooled sensitivity, specificity and AUC, CEUS had a high diagnostic efficacy in diagnosing hepatic echinococcosis. The Galbraith plot showed that all articles were distributed on both sides of the solid red effect line and within the green confidence interval range, indicating no overall heterogeneity in this study. Conclusion CEUS has a high efficacy in the diagnosis of hepatic echinococcosis and can serve as a new method for clinical diagnosis of hepatic echinococcosis.

Objective To investigate the risk factors of masked hypertension (MH) in young and middle-aged population and to develop a predictive model for MH diagnosis. Methods From January 2021 to December 2023, young and middle-aged adults who visited the cardiovascular outpatient clinic or underwent health check-up during the same period were recruited for questionnaire survey, physical examination, biochemical tests, waiting room blood pressure measurement and ambulatory blood pressure monitoring. The univariate and multifactorial logistic regression were performed to evaluate the risk factors of MH. Then a diagnostic prediction model was developed and a nomogram was created. The predictive performance of the model was evaluated using the receiver operator characteristic (ROC) curve. The bootstrap method (n=1000 times) was used for internally verification, and C-statistics, calibration curve and decision curve were created to evaluate the model. Results A total of 805 outpatients and health check-ups were included, with a prevalence rate of 18.9%(152/805). Compared to the normotensives, MH patients were elder, more male, and had significantly higher levels of body mass index (BMI), total cholesterol, triglycerides (TG), fasting blood glucose(FBG), and serum creatinine(SCR).Logistic regression revealed that age (OR=1.09, 95%CI: 1.07-1.11), BMI (OR=1.25, 95%CI: 1.15-1.35), log2(TG) (OR=1.29, 95%CI: 1.09-1.52), FBG(OR=1.28, 95%CI: 1.01-1.62) could be the independent risk factors for MH. Based on the above results, an MH prediction model and diagnostic nomogram were constructed for young and middle-aged adults, and the area under the ROC curve was 0.821. As for the internal verification by 1000 times bootstrap, the differentiation and calibration of the model were excellent. The decision curve showd that the model could yield a net benefit when the probability of MH was between 1% and 65%. Conclusion Age, BMI, FBG and TG are independent risk factors for MH in young and middle-aged adults. The prediction model based on the above risk factors has good differentiation, calibration and clinical benefit, which can contribute to the early and precisive identification of MH in outpatients.

Objective To investigate the correlation between serum uric acid (SUA) levels and coronary artery calcification (CAC) severity in patients with stable angina pectoris (SAP), thus providing a basis for the diagnosis and assessment of CAC. Methods A total of 125 patients diagnosed with SAP in Beijing Renhe Hospital from September 2021 to August 2024 were recruited, and all patients were given CTA scan in the hospital. After calculating the Agatston coronary artery calcification score (CACS), the patients were divided into non-calcification group (CACS=0, n=11), less calcification group (1≤CACS≤10, n=34), mild calcification group (11≤CACS≤100, n=26), moderate calcification group (101≤CACS≤399, n=36), severe calcification group (CACS≥400, n=18). The clinical data of each group were compared. Logistic regression analysis was employed to screen the influencing factors of CAC. Correlation analysis was used to explore the correlation between SUA level and other indicators. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the value of SUA level in predicting CAC severity. Results There were no significant differences in gender, age, drinking history, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and lipoprotein (α) (Lp[α]) levels among the five groups (P>0.05). There were statistically significant differences in the proportions of hypertension, diabetes and smoking, and levels of total cholesterol (TC) and SUA (P<0.05). The results of ordinal logistic regression analysis showed that hypertension history, diabetes history, smoking history, drinking history, TG, TC, LDL-C, LP (α) and SUA were all risk factors for CAC (P<0.05). Correlation analysis showed that SUA level was positively correlated with TC, LDL-C, LP (α) and CAC severity (P<0.05). The area under ROC curve (AUC) of SUA level in predicting CAC severity was 0.884(95%CI: 0.816-0.951), with the cutoff value of 367.5 μmol/L, the sensitivity of 81.6%, and the specificity of 90.9%. Conclusion SUA levels in SAP patients are positively correlated with CAC severity, making SUA an independent risk factor with certain diagnostic value for CAC.

Objective To analyze the predictive value of a combination of peripheral blood homocysteine (Hcy), D-dimer (D-D), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in the recurrence of acute cerebral infarction(ACI) after a thrombolytic therapy. Methods A total of 367 patients with ACI admitted to Zhoukou Central Hospital from March 2020 to March 2022 were selected, and all patients underwent intravenous thrombolysis treatment. Following a 1-year follow-up after discharge, the patients were divided into the recurrent group and non-recurrent group based on the presence or absence of recurrent cerebral infarction. Peripheral Hcy, D-D, NLR, and PLR, and other clinical data on the other day of admission were compared between the two groups. The influencing factors for the recurrence of ACI after a thrombolytic therapy were analyzed using logistic regression analysis. The predictive value of single indicator and a combination of peripheral Hcy, D-D, NLR and PLR in the recurrence of ACI after a thrombolytic therapy was analyzed using the receiver operating characteristic (ROC) curve. Results The proportion of hypertension patients, low density lipoprotein-cholesterol (LDL-C) level, Hcy, D-D, NLR and PLR in the recurrent group were significantly higher than those of the non-recurrent group (P<0.05). Hypertension, LDL-C, Hcy, D-D, NLR and PLR were influencing factors for the recurrence of ACI after a thrombolytic therapy (P<0.05). The sensitivity and area under curve (AUC) of the combination of peripheral Hcy, D-D, NLR and PLR in predicting the recurrence of ACI after a thrombolytic therapy were significantly greater than the single indicator (P<0.05). The specificity was comparable between a single detection and combination (P>0.05). Conclusion Peripheral LDL-C, Hcy, D-D, NLR and PLR are influencing factors for the recurrence of ACI after a thrombolytic therapy, and they have certain predictive value for the recurrence of ACI. Their combination has a higher efficiency in predicting the recurrence of ACI after a thrombolytic therapy.

Objective To investigate the role of family members involved in the rehabilitation training and psychological support therapy in improving daily living abilities and alleviating anxiety and depression of patients with acute ischemic stroke. Methods A total of 120 stroke patients in the recovery phase were selected and randomly divided into the control group (61 patients) and treatment group (59 patients). Patients in the control group only received 2 weeks of inpatient rehabilitation treatment, while those in the treatment group were intervened by 2 weeks of inpatient rehabilitation treatment plus rehabilitation training and psychological support therapy from their family members at home. The primary outcome was the proportion of patients with a modified Rankin sclae (mRS) score of 0-2 at 90 days, and the secondary outcomes included the proportion of patients with an mRS score of 0-3 at 90 days, the increase value in the Fugl-Meyer Scale (FMS) score at 90 days, the improvement in the Barthel index at 90 days, and the decrease value in the Self-Rating Depression Scale (SDS) score at 90 days. Results The proportion of patients with an mRS score of 0-2 at 90 days was 55.9% in the treatment group and 36.1% in the control group, showing a significant difference (P<0.05). There was a significant difference in the proportion of patients with an mRS score of 0-3 at 90 days between groups (P<0.05). The improvements in the FMS score and Barthel index at 90 days were significantly higher in the treatment group than those of the control group (P<0.05). The SDS score at 90 days decreased by 4 (0, 5) points in the treatment group, and 2 (0, 6) points in the control group, showing a significant difference between groups (P<0.05). Conclusion Training family members to provide rehabilitation training for patients with acute ischemic stroke, while also assisting family members in providing psychological counseling to patients, can improve patients' daily living abilities at 3 months and alleviate their depressive state.

Objective To investigate the clinical efficacy of individualized vestibular rehabilitation program in the treatment of vestibular neuritis. Methods Seventy-six patients with vestibular neuritis who visited the outpatient department from June 2020 to June 2023 were randomly divided into the control group and experimental group. Routine medication was given to patients of both groups. Based on physical examination, vestibular function examination, and subjective scale scores, the impairment of the vestibulo-ocular reflex (VOR) pathway and vestibular spinal reflex (VSR) pathway were assessed in patients of the experimental group, and thus managed by individualized vestibular rehabilitation plans. After three months of treatment, the various examination indicators and clinical treatment effects of the two groups were compared. Results The clinical indicators of both groups significantly improved compared to before treatment. Compared with those of the control group, patients in the experimental group had significantly better improvements in indicators such as Romberg test (ROM), directional preference (DP), video head impulse test (vHIT) gain, dizziness handicap inventory (DHI), and Berg balance scale (BBS) score (P<0.05). The clinical treatment effective was significantly higher in the experimental group than that of the control group (97.37% vs 81.57%, P<0.05). An individualized rehabilitation treatment provided a superior effective outcome to patients with VSR pathway damage. Conclusion Accurately developing individualized vestibular rehabilitation plans based on clinical examination results of patients with vestibular neuritis has significant effects and advantages in improving subjective scores, symptoms and signs, objective indicators of vestibular function. It is worth further promotion.

Objective To investigate the characteristics of medical device-related pressure injury (MDRPI) in patients underwent cardiopulmonary bypass, and to analyse its influencing factors. Methods A convenience sampling of 426 patients underwent cardiopulmonary bypass in the Cardiac Surgery Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from June 2023 to April 2024 was conducted. The patients were divided into MDRPI group (n=99) and non-MDRPI group (n=327) based on the presence or absence of MDRPI. Univariate analysis and Lasso regression were used to screen the influencing factors and included in logistic regression analysis. Results MDRPI occurred in 99 (22.2%) cases among the 426 subjects. Logistic regression analysis showed that high intraoperative heparin sodium dosage, emergency surgery, postoperative fever, and long cardiopulmonary bypass time were independent risk factors (all OR>1, P<0.05), and higher nurse level and higher platelet level were protective factors (OR<1, P<0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of model was 0.874 (95%CI: 0.837-0.910), with a sensitivity of 0.828 and a specificity of 0.768. The model discrimination was good, and the Hosmer-Lemeshow (H-L) test (χ²=3.094, P=0.928) had a good fit of the model. Conclusion After cardiopulmonary bypass, patients are prone to MDRPI due to high intraoperative heparin sodium dosage, low platelet level, emergency surgery, postoperative fever, long cardiopulmonary bypass time and low nurse energy level. Clinicians should comprehensively evaluate and give predictive preventive measures to reduce the risk of MDRPI.

Objective To investigate the clinical predictive value of serum Krebs von den Lungen-6 (KL-6), von Willebrand factor (vWF), and interleukin-8 (IL-8) in the early identification of pediatric acute respiratory distress syndrome (pARDS). Methods A total of 92 children who received mechanical ventilation in the Department of Pediatric Intensive Care Unit of the Third Affiliated Hospital of Zhengzhou University from November 2023 to November 2024 were included. According to the development of pARDS within 7 days after the confirmation of etiological damages, included children were divided into the pARDS group (n=35) and non-pARDS group (n=57). Serum biomarker levels were measured using enzyme-linked immunosorbent assay (ELISA) at the initiation of mechanical ventilation (T₁) in both groups, the time of pARDS diagnosis (T₂), and on the third day post-diagnosis (T₃) in the pARDS group. Relevant clinical data were collected and analyzed. Results At T₁, the levels of KL-6, vWF, and IL-8 were significantly higher in the pARDS group compared to the non-pARDS group (P<0.05). The levels of KL-6, vWF and IL-8 in the pARDS group were significantly different at different time points (P<0.05). The level of KL-6 at T₂ was significantly higher than that at T₁, and reached the peak at T₃ (P<0.01). The levels of IL-8 and vWF reached the peak at T₂ and then decreased at T₃ (P<0.05). Receiver operating characteristic (ROC) curve analysis demonstrated that the area under the curve (AUC) of KL-6, IL-8, and vWF in diagnosing pARDS was 0.749, 0.662, and 0.631, respectively, with the sensitivity of 74.3%, 62.9%, and 62.9%, and specificity of 82.5%, 61.4%, and 68.4%. When combined, the AUC reached 0.776(P<0.05), with the corresponding sensitivity of 85.7%, and specificity of 63.2%. Conclusion Elevated serum levels of KL-6, IL-8, and vWF are effective biomarkers for the early identification of pARDS. A combined detection of these biomarkers can improve diagnostic accuracy.

Objective To compare the clinical efficacy and safety of drug-eluting beads bronchial artery chemoembolization (DEB-BACE) versus conventional BACE alone in the treatment of advanced non-small cell lung cancer (NSCLC). Methods A retrospective analysis was conducted in 52 patients with primary NSCLC who were treated with DEB-BACE or conventional BACE alone in Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2020 to March 2024. All patients had local progression or intolerability after the first-line treatment, such as systemic chemotherapy, radiotherapy, targeting, and immunization. According to the different interventional treatment regimens, they were divided into the DEB-BACE group (n=25) and conventional BACE group (cBACE group, n=27). The short-term clinical efficacy, progression-free survival (PFS), overall survival (OS), and postoperative adverse events were compared between the two groups. Results There was no significant differences in preoperative baseline data between the two groups (P>0.05). Complete remission was 0 at 1 month, 3 months, 6 months and 12 months postoperatively. There were significant differences in the 6-month objective response rate ( 44.0% vs 14.8%, χ²=5.387, P=0.020) and 6-month disease control rate (84.0% vs 55.6%, χ²=4.930, P=0.026) between the two groups (P<0.05). The incidence of postoperative adverse events in the DEB-BACE group was significantly lower than that of the cBACE group (P<0.05). There were no serious adverse complications, such as spinal cord loss and ectopic embolism in both groups. As of September 2024, all patients were followed up for 6-34 months, with an average follow-up time of (13.2±6.6) months. Compared with the cBACE group, the median PFS and median OS of the DEB-BACE group were significantly better (P<0.05). Conclusion The use of CalliSpheres drug-eluting beads loaded with gemcitabine for BACE demonstrated a superior clinical efficacy compared to cBACE alone in the treatment of advanced NSCLC. It has a lower rate of postoperative adverse events, suggesting a new, safe, and effective treatment option for advanced NSCLC.

Objective To investigate the correlation of T2-weighted imaging (T₂WI) signal intensity and gadobenate dimeglumine (Gd-BOPTA) hepatobiliary phase (HBP) parameters with liver function grade, and to analyze their value in the diagnosis of liver function alone and combination. Methods A total of 57 cirrhosis patients who underwent enhanced magnetic resonance imaging (MRI) on T₂WI and Gd-BOPTA from June 2019 to September 2024 were retrospectively collected. At the hilar level, the region of interest (ROI) with the same size was placed on the left, right anterior and right posterior lobes of the liver on T₂WI, plain scan and 90-min MRI images of the hepatobiliary phase. The signal intensity of T₂WI (SI_T2), T₁WI (SIplain scan) and hepatobiliary phase (SI_HBP) were measured, and relative enhancement (RE) was calculated. The parameters in cirrhosis patients possessing different Child-Pugh grades were compared. The correlation between the parameters and Child-Pugh grades was discussed. The diagnostic efficacy of Child-Pugh grade B+C was analyzed, and the difference between the diagnostic efficacy was compared. Results There were significant differences in SI_T2, SI_HBP and RE among cirrhosis patients with different Child-Pugh grades (P<0.05). SI_T2 was positively correlated with Child-Pugh classification (r=0.408, P=0.002). SI_HBP and RE were negatively correlated with Child-Pugh grade (r=-0.365,-0.376, P=0.005, 0.004). However, there was no correlation between SI plain scan and the Child-Pugh grade (P=0.753). The area under the curve (AUC) of SI_T2, SI_HBP, RE and their combination in diagnosing Child-Pugh B+C cirrhosis was 0.715, 0.707, 0.757 and 0.846, respectively. The AUC of SI_T2+SI_HBP +RE was significantly larger than that of SI_HBP (P<0.05). Conclusion SI_T2, Gd-BOPTA HBP parameters SI_HBP and RE are related to liver function grading in cirrhosis patients. Each possess a certain value in diagnosing liver function grading, and their combination reaches a higher efficiency.

Objective To examine a rare case of extra-ovarian peritoneal serous papillary carcinoma (EPSPC) with an atypical growth pattern and to evaluate its clinical and pathological features and diagnostic approach. Methods A middle-aged female patient with EPSPC was retrospectively analyzed, and relevant literature was reviewed. Results The patient presented with abdominal pain and altered bowel habits for two months. Colonoscopy and magnetic resonance imaging (MRI) revealed a large rectal mass and a rectal cystic lesion, respectively. Exploratory laparotomy showed tumor involvement of the rectal left anterior wall mucosa, and the cystic wall suggested malignancy. Histopathology excluded ovarian and uterine origins. Laparoscopic radical resection of rectal cancer was performed, and EPSPC was diagnosed. Conclusion EPSPC has a high clinical misdiagnosis rate, especially intraluminal EPSPC, which mimics primary intestinal adenocarcinoma. Diagnosis relies on clinical and pathological features. Compared to ovarian serous carcinoma, EPSPC has a poorer prognosis, with surgery and chemotherapy as the main treatment options.

Objective To explore the pathogenesis, clinical manifestations, and imaging characteristics of spinal dural arteriovenous fistula (SDAVF) in young and improve the understanding of the disease. Methods The relevant literature was reviewed to assess the diagnosis and treatment process of a young patient with SDAVF. Results In the young male patient, the disease started with weakness and abnormal sensation in both lower extremities,which gradually worsened. Striped long T2 signals can be seen by spinal cord Magnetic resonance imaging (MRI) and the spinal angiography showed the presence of SDAVF at the right T12, left T10, and left L1 segmentations of spinal cord. Conclusion SDAVF is a clinically rare disease. Spinal angiography is the gold standard for diagnosis and surgical treatment should be performed as soon as possible after diagnosis.

Objective To investigate the clinical characteristics and treatment of orf infection. Methods Two spouse suffering from orf infection admitted to the Department of Dermatology of Chongqing Traditional Chinese Medicine Hospital was retrospectively analyzed, and the relevant literature was reviewed. Results A 68-year-old male patient presented for erythematous pustules on the right thumb for 2 weeks. After anti-inflammatory treatment, there was no significant improvement in the primary rash. The patient was followed up by telephone for external use of Baiduobang after discharge. Three weeks after discharge, the swelling of the right thumb rash subsided, and the scab was basically healed in 6 weeks. A 61-year-old female patient was admitted to the outpatient department for finger nodules, with painless itching for half a month, and viral inclusion bodies were found by pathological biopsy. Contact history of livestock, combined with clinical manifestations and pathological changes finally yielded the diagnosis of orf infection. The infection mode was inferred as sheep-to-human and human-to-human. After the rash improved on its own, no new hair developed. Conclusion For spouses both suffering from orf infection, the mode of transmission includes sheep transmission and human transmission. Clinicians should make a comprehensive judgment based on the past medical history, clinical manifestations, contact history, and auxiliary examinations. A clear diagnosis is carefully determined to avoid misdiagnosis and mistreatment, and unnecessary economic burden to the patient.

Tuberculosis (TB) is a major global public health challenge, and its interaction with a variety of comorbidities like mental disorder, HIV infection and diabetes significantly affects the prognosis of patients. In January 2025, the World Health Organization (WHO) released the third edition of the WHO Operational Handbook on Tuberculosis, Module 6: Tuberculosis and Comorbidities, which systematically integrated the management strategy of TB and comorbidities. Based on the three core comorbidities of mental and substance-use disorders, human immunodeficiency virus (HIV) infection and diabetes, this paper interprets the key recommendations for the operation manual including screening tools, comprehensive treatment approach, and preventive measures. it aims to provide evidence-based guidance for clinical practice and optimize the whole process management of TB patients.