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Clinical Focus    2024, 39 (10): 935-939.   DOI: 10.3969/j.issn.1004-583X.2024.10.012 Abstract （131）   HTML （6）    PDF（pc） （803KB）（227）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (4): 372-376.   DOI: 10.3969/j.issn.1004-583X.2025.04.014 Abstract （81）   HTML （3）    PDF（pc） （988KB）（205）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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The risk prediction models for pneumonia in patients with intracerebral hemorrhage: A systematic review Liu Jinteng, Liu Xingyu, Huang Lumei, Pan Hailong Clinical Focus    2025, 40 (1): 5-13.   DOI: 10.3969/j.issn.1004-583X.2025.01.001 Abstract （133）   HTML （4）    PDF（pc） （976KB）（194）       Knowledge map    Save Objective To systematically analyze and evaluate the risk prediction model for pneumonia in patients with intracerebral hemorrhage (ICH). Methods Articles reporting risk prediction model for pneumonia in ICH patients published prior to February 2023 were searched in the online databases of Pubmed, Web of Science, Embase, The Cochrane Library, Scopus, Ovid Medline, CNKI (China National Knowledge Infrastructure), WanFang Data, VIP and CBM (Chinese Biomedical Literature Database). Two researchers were independently responsible for screening literature and extracting data. The quality of the literature included in this study was rigorously evaluated, and both the risk of bias and adaptability were assessed in accordance with the Transparent Reporting of a Multivariable Prediction Model for Individal Prognosis or Diagnosis(TRIPOD), and the Prediction Model Risk of Bias Assessment Tool(PROBAST). Results A total of 12 relevant studies were included, involving 7 registered studies, 1 ovarian case-control study, 3 single-center case-control studies, and 1 retrospective cohort study. Logistic regression and machine learning were used for modeling. Eight studies were validated internally, 2 studies were only validated externally, and 2 studies were validated both. The area under the receiver operating characteristic curve of the model was 0.740-0.920. The range of predictors in the 12 studies ranged from 4 to 11, and the common predictors were the age, the National Institutes of Health Stroke Scale score, the Glasgow Coma Scale score, dysphagia, smoking, chronic obstructive pulmonary disease, and nasogastric tube feeding. Model calibration was performed in 9 studies and not in 3 studies. The model was mainly presented in the form of risk score, risk calculation formula and nomogram. The included studies exhibited moderate quality and a high risk of bias. Conclusion The current model for predicting the risk of pneumonia in ICH patients demonstrates good predictive ability, and the predictive factors are relatively easy to obtain. However, there are also significant defects and high bias. In future research, it is recommended that researchers adhere to the TRIPOD guideline and PROBAST statement when conducting prediction model studies. It is important to summarize the advantages and disadvantages of existing models and to conduct external verification, thus developing a risk prediction model for pneumonia in ICH patients with excellent predictive performance and ease of use. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Interpretation of the Chinese Expert Consensus on Gastrointestinal Endoscopic Treatment of Obesity Su Miao, Wang Sashuang, Zhao Dongqiang Clinical Focus    2025, 40 (4): 366-371.   DOI: 10.3969/j.issn.1004-583X.2025.04.013 Abstract （60）   HTML （1）    PDF（pc） （468KB）（187）       Knowledge map    Save Obesity is a chronic disease that increases the risk of cardiovascular and metabolic disorders. Current treatment methods for obesity mainly include lifestyle interventions, pharmacotherapy, and surgical procedures. Traditional lifestyle interventions result in a poor long-term compliance, and pharmacotherapy is often associated with side effects or weight regain. Although surgical procedures can lead to significant weight loss, they are limited by the invasiveness, high complication risks, and irreversibility. In recent years, endoscopic bariatric therapy has emerged as a safer and more effective treatment option due to its reversibility, minimal invasiveness, and cost-effectiveness. To standardize this approach in China, the National Clinical Medical Research Center for Digestive Diseases, in collaboration with experts in this field, developed the Chinese Expert Consensus on Gastrointestinal Endoscopic Treatment of Obesity. This article reviewed the key points of the consensus, aiming to enhance the understanding of endoscopic bariatric therapy among both healthcare providers and patients. The goal is to advance and refine endoscopic bariatric therapy while promoting academic exchange and expanding awareness of minimally invasive treatment options in China. Reference | Related Articles | Metrics | Comments（0）

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Interpretation for the third edition of WHO Operational Handbook on Tuberculosis, Module 6: Tuberculosis and Comorbidities Zeng Jian, Wang Xiaomin, Fang Mutong, Lu Shuihua Clinical Focus    2025, 40 (3): 270-274.   DOI: 10.3969/j.issn.1004-583X.2025.03.014 Abstract （74）   HTML （1）    PDF（pc） （871KB）（176）       Knowledge map    Save 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. Reference | Related Articles | Metrics | Comments（0）

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Interpretation of the Guidelines for the Assessment and Clinical Practice of Behavioral and Psychological Symptoms of Dementia 2025 Gao Yan, Qu Shuo, Li Yang, Qiu Huiqing, He Sha, Ma Xiaowei Clinical Focus    2025, 40 (5): 389-393.   DOI: 10.3969/j.issn.1004-583X.2025.05.001 Abstract （76）   HTML （4）    PDF（pc） （826KB）（172）       Knowledge map    Save Currently, more than 55 million people suffer from dementia worldwide. Alzheimer's disease (AD) is the most common diagnostic cause of dementia, accounting for 50%-70% of all dementia cases. In March 2025, the Canadian Coalition for Seniors' Mental Health (CCSHM) released the Guidelines for the Assessment and Clinical Practice of Behavioral and Psychological Symptoms of Dementia 2025, targeting on the assessment and management of BPSD in AD patients. The present article focused on the five major symptoms of BPSD, including agitation, depression, anxiety, mental symptoms and potential risk sexual behavior manifestations, as well as the the reduction of antipsychotics and psychotropic drugs. Through interpreting key suggestions in the guideline, three aspects of diagnostic criteria, evaluation methods and treatment measures were discussed to provide references for clinical treatment of BPSD and optimizing the whole-process management of BPSD symptoms in AD patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (9): 842-846.   DOI: 10.3969/j.issn.1004-583X.2024.09.015 Abstract （249）   HTML （11）    PDF（pc） （905KB）（165）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical efficacy of individualized vestibular rehabilitation in the treatment of vestibular neuritis Zhang Xiuling, Zhang Li, Chen Jinxiang Clinical Focus    2025, 40 (3): 227-230.   DOI: 10.3969/j.issn.1004-583X.2025.03.006 Abstract （87）   HTML （2）    PDF（pc） （856KB）（154）       Knowledge map    Save 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. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (6): 564-569.   DOI: 10.3969/j.issn.1004-583X.2025.06.015 Abstract （24）   HTML （1）    PDF（pc） （938KB）（149）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Longitudinal cohort study of oral health status and cognitive function in the elderly: A meta-analysis Wang Lin, Wang Ting, Pu Xiaolan, Ju Mei Clinical Focus    2024, 39 (8): 677-683.   DOI: 10.3969/j.issn.1004-583X.2024.08.001 Abstract （221）   HTML （7）    PDF（pc） （1364KB）（145）       Knowledge map    Save Objective To explore the correlation between oral health status and the risk of cognitive dysfunction by meta-analysis. Methods Cohort studies on the correlation between oral health status and cognitive function from inception to August 2023 were searched in PubMed, Web of Science, EMBASE, Scopus, Chinese National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Wanfang, VIP and Duxiu databases. Two reviewers independently screened literatures, extracted data and evaluated the quality of included studies. Meta-analysis was performed using RevMan 5.3 and Stata 17.0 software. Results A total of 34 cohorts were included. The results of meta-analysis showed that the risk of cognitive impairment in the elderly with poor oral health status was significantly higher than that in the elderly with good oral health status (RR=1.31, 95%CI 1.18-1.46, P<0.01). The results of subgroup analysis showed that there were significant differences in periodontitis disease, posterior occlusal support, dentition status, and tooth loss (P<0.05), but there was no significant difference in the oral frailty (RR=1.32, 95%CI 0.96-1.81, P=0.09). There was no significant difference in the risk of oral health status and cognitive impairment in the subgroup with a follow-up time>10 years (RR=1.01, 95%CI 0.83-1.23, P=0.90), but a significant difference was detected in the subgroup with a follow-up time ≤10 years (RR=1.48, 95%CI 1.32-1.67, P<0.001). There was no significant difference in the risk of oral health status and cognitive impairment in the moderate quality subgroup (RR=1.05, 95%CI 0.91-1.20, P=0.51), but a significant difference was detected in the high quality subgroup (RR=1.35, 95%CI 1.21-1.51, P<0.01). Conclusion Oral health status is associated with the risk of cognitive dysfunction. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (1): 90-96.   DOI: 10.3969/j.issn.1004-583X.2025.01.015 Abstract （101）   HTML （5）    PDF（pc） （1062KB）（141）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (1): 76-81.   DOI: 10.3969/j.issn.1004-583X.2025.01.012 Abstract （111）   HTML （3）    PDF（pc） （863KB）（130）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Risk prediction model for readmission of chronic obstructive pulmonary disease: A systematic review Zhu Jieyun, Gao Min, Huang Chunli, Pan Dongzan, Wang Qiaoyan, Lu Zhao Clinical Focus    2024, 39 (9): 773-779.   DOI: 10.3969/j.issn.1004-583X.2024.09.001 Abstract （227）   HTML （10）    PDF（pc） （597KB）（130）       Knowledge map    Save Objective To systematically evaluate the risk for readmission in patients with chronic obstructive pulmonary disease (COPD) and provide references for the construction and optimization of prediction model.Methods The literatures on the risk prediction model for COPD readmission were independently screened in China National Knowledge Infrastructure (CNKI), VIP, WanFang Data, Cochrane Library, PubMed, Embase databases from database inception to November 22, 2023 by two researchers. After extracting data, the bias risk and applicability of the models were evaluated using the PROBAST tool. Results Twelve cohort studies representing 21 models were finally included. Eleven studies reported the area under a receiver operator characteristic (ROC) curve (AUC) and one study for the C-index. The AUC ranged from 0.603 to 0.917, with AUC>0.7 for 16 models. Six studies conducted model calibration and eight studies for internal or external validation. The overall applicability of the 12 studies was good, but with a high risk of bias, mainly in the analysis domain. The included studies had significant differences in the predictive factors, with the most common predictive factors of lung function indicators, Charlson comorbidity index, times of hospitalization due to a history of acute exacerbation during the previous year, eosinophil levels, and inhaled drug therapy. Conclusion The performance of the included models varied greatly, with good applicability but high risk of bias. Due to the incomplete screening method, and there were significant differences in predictive factors of the included studies. Future prediction models should focus on lung function, Charlson comorbidity index, times of hospitalization due to a history of acute exacerbation during the previous year, eosinophil levels, and inhaled drug therapy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (12): 1125-1130.   DOI: 10.3969/j.issn.1004-583X.2024.12.012 Abstract （97）   HTML （5）    PDF（pc） （907KB）（123）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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A case report of adult MOGAD and literature review Zhong Yuan, Meng Fenglei Clinical Focus    2025, 40 (1): 70-75.   DOI: 10.3969/j.issn.1004-583X.2025.01.011 Abstract （100）   HTML （4）    PDF（pc） （1403KB）（116）       Knowledge map    Save Objective To discuss the clinical manifestations, magnetic resonance imaging (MRI) features, MOG-IgG testing, diagnostic criteria, treatment and prognosis of myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD). Methods We reported a case of adult MOGAD, and reviewed relevant literatures. Results A 38-year-old female presented with headache and blurred vision in both eyes for three days. She had a history of prodromal fever. The head MRI showed lesions and enhancement in the thalamus, basal ganglia, cerebral peduncle, and brainstem. Serum and cerebrospinal fluid antibody testing showed a weak positive MOG IgG at a 1:10 ratio in both serum and cerebrospinal fluid. She was diagnosed with MOGAD, mainly manifested as optic neuritis and brainstem encephalitis. The combination therapy of corticosteroid and rituximab was given, and the patient's symptoms were completely disappeared at the 4-month follow-up. Conclusion MOGAD is a rare, antibody-mediated infl ammatory demyelinating disorder of the central nervous system (CNS) with cardinal features of optic neuritis, myelitis, brainstem encephalitis, cerebral cortical encephalitis (often with seizures) and acute disseminated encephalomyelitis. New diagnostic criteria for MOGAD have recently been proposed by an international panel of experts in 2023. MOG-IgG detection is the key to diagnosing MOGAD. There is no clear guideline for MOGAD treatment. About 50% of patients will experience a recurrence. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Comparative study on the clinical efficacy of different antiviral drugs in the treatment of COVID-19 Wu Wanfeng, Wang Yunyun, Yang Daokun Clinical Focus    2025, 40 (2): 147-152.   DOI: 10.3969/j.issn.1004-583X.2025.02.009 Abstract （146）   HTML （1）    PDF（pc） （860KB）（116）       Knowledge map    Save Objective To explore the clinical efficacy of different antiviral drugs in the treatment of Coronavirus Disease 2019 (COVID-19). Methods A total of 456 COVID-19 patients admitted to Jincheng People's Hospital from February 2023 to June 2023 were selected for the study. According to the random number method, they were randomly divided into group A (treated with azvudine, n=152), group B (treated with nirmatrelvir/ritonavir, n=152) and group C (treated with simnotrelvir/ritonavir, n=152). The clinical efficacy, symptom and sign recovery time, mortality, lung imaging, complete blood count (white blood cell count [WBC], absolute neutrophil count [ANC], and lymphocyte count [LYC]), CT values (mRNA levels) of the ORF1ab and N genes, and adverse events were observed. Results There were no significant differences in the clinical efficacy, symptom and sign recovery time, CT values of the ORF1ab and N genes, mortality, time required for lung imaging improvement, and negative conversion time of nucleic acid testing among groups A, B and C (P>0.05). After treatment, WBC and ANC significantly decreased, and LYC significantly increased in all the three groups, although intergroup comparisons did not show significant differences (P>0.05). The total incidence of adverse events was 15.12%(23/152) in group A, 16.44%(25/152) in group B, and 13.80% (21/152) in group C. There was no significant difference in the total incidence of adverse events among groups A, B and C (P>0.05). Conclusion Azvudine, nirmatrelvir/ritonavir, and simnotrelvir/ritonavir have significant antiviral effects against COVID-19, although leading to some adverse events and medication restrictions. Therefore, when using the above drugs in clinical practice, the specific conditions and medication risks of patients should be fully considered, and a strict compliance and medication guidance are essential, aiming to ensure patient's safety and efficacy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Association of urinary transferrin with new-onset cardiovascular disease in type 2 diabetes mellitus Ma Jiannan, Tao Jie, Sang Dasen, Wu Shouling, Zhang Qi Clinical Focus    2024, 39 (8): 700-705.   DOI: 10.3969/j.issn.1004-583X.2024.08.004 Abstract （140）   HTML （8）    PDF（pc） （1135KB）（116）       Knowledge map    Save Objective To explore the correlation between urinary transferrin to urinary creatinine ratio (uTRF/Cr) and new onset cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Methods A total of 8 163 T2DM patients who participated in the 6th health examination in Kailuan and underwent urinary transferrin and urinary creatinine detection were recruited. Subjects were divided into the first group (n=2 721), the second group (n=2 721), and the third group (n=2 721) based on baseline uTRF/Cr. The effects of uTRF/Cr on the risk of CVD were analyzed by multivariate Cox regression model. Results The baseline age of the study population was (60.46±9.96) years, with 78.30% of males, and 0.24(0.16-0.47) mg/mmol of baseline uTRF/Cr. The median follow-up time was 3.85(3.43-4.22) years, with 411(6.79%) of CVD events occurred. The cumulative incidence of total CVD events in the first, second and third groups was 3.81%, 4.65%, and 7.29%, respectively. After adjusting for relevant influencing factors, the risk of total CVD events in the second and third groups of uTRF/Cr was 1.12(95%CI 0.86-1.46) times and 1.52(95%CI 1.18-1.97) times that in the first group, respectively. Conclusion Increased uTRF/Cr is an independent risk factor for CVD in T2DM populations, and the risk of CVD increases with increased uTRF/Cr, even before the onset of macroalbuminuria. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Efficacy and safety of anticoagulant therapy in patients with cirrhosis: A meta-analysis Su Rui, Wang Cunkai, Wang Dingxin, Cai Conghui, Zhang Jian, Hou Hongtao, Bai Yun Clinical Focus    2025, 40 (4): 293-303.   DOI: 10.3969/j.issn.1004-583X.2025.04.001 Abstract （97）   HTML （11）    PDF（pc） （1999KB）（115）       Knowledge map    Save Objective To investigate the efficacy and safety of anticoagulant therapy and prophylactic anticoagulant therapy in cirrhosis patients with or without portal vein thrombosis (PVT). Methods Literature searchs were conducted using PubMed, Cochrane, Embase, Web of Science, CNKI, Wanfang, and VIP databases, and relevant references were also reviewed. The included literatures were assessed for quality and data extraction. A meta-analysis was conducted using Revman5.3 and Stata14.0. Results Twenty-three eligible articles were included in 3423 retrieved articles. In patients with cirrhosis and PVT, the PVT recanalization rate in the anticoagulant therapy group was significantly higher than that of the non-anticoagulant group (OR=3.39, 95%CI: 2.59-4.44, P<0.001), without an increase in adverse events. The PVT recanalization rate of direct oral anticoagulants (DOAC) was significantly higher than that of traditional anticoagulants (OR=39.49, 95%CI: 9.65-161.68, P<0.001), and the rate of major bleeding was significantly lower than that of traditional anticoagulants (OR=0.35, 95%CI: 0.13-0.97, P=0.04). In patients with cirrhosis without PVT, the rate of PVT formation in the prophylactic anticoagulation group was significantly lower than that of non-anticoagulant group (OR=0.15, 95%CI: 0.05-0.43, P<0.001), with no difference of bleeding between groups (OR=1.96, 95%CI: 0.72-5.30, P=0.19), but the all-cause mortality rate in the prophylactic anticoagulation group was significantly lower (OR=0.51, 95%CI: 0.43-0.60, P<0.001). Conclusion Anticoagulant therapy can treat or prevent PVT in patients with cirrhosis and is a relatively safe treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Cortical “ribbon sign” on DWI in adults: A case report and literature review Zhang Yingqiu, Zhang Jin, Ge Shihao, Chen Junmin Clinical Focus    2024, 39 (9): 821-824.   DOI: 10.3969/j.issn.1004-583X.2024.09.010 Abstract （152）   HTML （3）    PDF（pc） （1059KB）（114）       Knowledge map    Save Objective To investigate the clinical characteristics of cortical “ribbon sign” on diffusion-weighted imaging (DWI). Methods The clinical data, relevant examination data, and imaging data of a case of cortical “ribbon sign” were analyzed, and relevant literatures were reviewed. Results The patient was admitted to the hospital due to involuntary grasping of objects with a walking instability for 10 days, and aggravated for 2 days. Brain imaging examination showed cortical “ribbon sign”, manifesting as a high signal intensity along the cerebral sulcus on T1-weighted imaging, DWI and fluid-attenuated inversion recovery sequence. The increase in signal intensity was pronounced on DWI sequence, reflecting the cytotoxic edema of the cerebral cortex. Symptomatic treatment was performed. The patient's symptoms gradually worsened and died about half a year later. Conclusion Cortical ribbon sign is a typical imaging change of laminar necrosis of the cerebral cortex, usually observed in vascular, infectious, metabolic, and toxic nerve system diseases. A deep mining of the pathogenesis and causes of cortical ribbon sign favors the clinical diagnosis and differentiation diagnosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (9): 861-864.   DOI: 10.3969/j.issn.1004-583X.2024.09.019 Abstract （196）   HTML （9）    PDF（pc） （897KB）（113）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (3): 275-280.   DOI: 10.3969/j.issn.1004-583X.2025.03.015 Abstract （80）   HTML （3）    PDF（pc） （884KB）（108）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Trilaciclib combined with chemotherapy in the treatment of extensive-stage small cell lung cancer: A case report and literature review Wang Yinfeng, Li Manxiang Clinical Focus    2025, 40 (4): 355-359.   DOI: 10.3969/j.issn.1004-583X.2025.04.011 Abstract （63）   HTML （2）    PDF（pc） （1512KB）（105）       Knowledge map    Save Objective To study the effect of trilaciclib combined with chemotherapy on extensive small cell lung cancer (ES-SCLC). Methods A case of ES-SCLC patient treated with trilaciclib combined with chemotherapy in the First Affiliated Hospital of Xi'an Jiaotong University was retrospectively reviewed, and the related literatures were reviewed. Results The 56-year-old female patient was diagnosed with ES-SCLC of the left lung, large airway stenosis, and type I respiratory failure. She developed severe myelosuppression after receiving rescue chemotherapy, and gradually recovered after 11 days of drug administration and blood transfusion. After 5 cycles of chemotherapy combined with trilaciclib, severe myelosuppression was not reported, and chemotherapies were successfully completed. Conclusion The administration of trilaciclib within 4 h before chemotherapy in ES-SCLC patients can effectively reduce the degree of bone marrow suppression, shorten the duration of bone marrow suppression, and increase the tolerance to chemotherapy drugs without adverse impacts on the efficacy, suggesting clinical promotion. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (6): 570-576.   DOI: 10.3969/j.issn.1004-583X.2025.06.016 Abstract （26）   HTML （2）    PDF（pc） （970KB）（104）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (4): 381-384.   DOI: 10.3969/j.issn.1004-583X.2025.04.016 Abstract （48）   HTML （3）    PDF（pc） （363KB）（103）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Systematic review and meta-analysis of contrast-enhanced ultrasound in diagnosing hepatic echinococcosis Pu Wutao, Xiao Yixin, Tuo Li, Kailibinuer·Muti , Fan Xueting, Chong Le Clinical Focus    2025, 40 (3): 197-204.   DOI: 10.3969/j.issn.1004-583X.2025.03.001 Abstract （116）   HTML （10）    PDF（pc） （2209KB）（103）       Knowledge map    Save 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. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Risk factors for constipation in patients with chronic kidney disease in Gansu province: a single-center study Pu Qian, Cheng Gang, Dao Jiecao, Qi Zizhao, Dou Lele, Zhao Junfang, Zhang Wenjun, Guo Caixia, Wang Yingying Clinical Focus    2025, 40 (1): 44-53.   DOI: 10.3969/j.issn.1004-583X.2025.01.007 Abstract （110）   HTML （3）    PDF（pc） （1033KB）（102）       Knowledge map    Save Objective To investigate the prevalence of constipation among patients with chronic kidney disease (CKD) in Gansu province, and to analyze potential risk factors. Methods CKD patients in the Department of Nephrology and Dialysis Center & Clinical Medical School of the Second Hospital, Lanzhou University were surveyed by a constipation questionnaire developed according to the Rome III criteria during the two periods of July 2022 to August 2022, and January 2023 to February 2023 via the WJX platform. At the same time, demographics, hemodialysis-related data, laboratory parameters, and use of drugs such as iron and phosphorus binders were collected. Results Totally 279 adult CKD patients older than 18 years were enrolled, including 191 hemodialysis patients and 88 non-dialysis patients. The prevalence of constipation in CKD stage 1-2, 3-4, and 5 patients was 36.2%, 45.8%, and 29.8%, respectively. Univariate Logistic regression analysis showed that primary diabetic nephropathy (OR=4.694, 95% CI 1.436-15.350, P=0.011) was a significant risk factor for constipation in non-dialysis patients. High serum triglyceride (TG) (OR=1.493, 95% CI 1.082-2.060, P=0.015) was a risk factor for constipation in CKD patients receiving hemodialysis. The risk factors for constipation in CKD patients included the use of phosphorus binding agents (OR=1.669, 95% CI 1.001-2.784, P=0.049) and use of iron agents (OR=1.745, 95% CI 1.047-2.909, P=0.033), high serum glucose (Glu)(OR=1.070, 95% CI 1.008-1.135, P=0.026) and TG (OR=1.254, 95% CI 1.017-1.546, P=0.034). Multivariate Logistic regression showed that female (OR=3.258, 95% CI 1.022-10.386, P=0.046) and diabetic nephropathy (OR=13.863, 95% CI 1.815-105.901, P=0.011) were independent risk factors for constipation in non-dialysis patients. In addition, diabetic nephropathy (OR=2.137, 95% CI 1.015-4.499, P=0.046) was a risk factor for constipation in CKD patients. Conclusion Diabetic nephropathy is an independent risk factor for constipation in CKD patients. The female gender represents an independent risk factor for constipation in non-dialysis patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Evidence summary of the application of the diary method in adult ICU patients Wang Yu, Peng Lili, Shi Yao, Du Yunhong, Duan Yuliang, Wang Li Clinical Focus    2024, 39 (9): 780-786.   DOI: 10.3969/j.issn.1004-583X.2024.09.002 Abstract （159）   HTML （4）    PDF（pc） （1158KB）（101）       Knowledge map    Save Objective To systematically screen, evaluate, summarize and extract the optimal evidence for the application of the diary method in adult patients in the intensive care unit (ICU), so as to provide evidence-based basis for the implementation of the diary method in ICU. Methods All the evidence on the application of the diary to adult ICU patients were searched in relevant professional websites and databases at home and abroad, including the guidelines, evidence summary, expert consensus, systematic reviews, clinical decisions, etc. The retrieval time was from the establishment of the database to January 25, 2024. Two researchers independently conducted literature screening, quality evaluation, data extraction, classification and evidence summary according to the topic. Results A total of 13 articles were included, with 1 expert consensus, 2 guidelines and 10 systematic reviews. The optimal evidence for the application of diary method in ICU adult patients was formed, including 8 dimensions (application cognition, application effect, target population, writers, diary content, writing notes, application guidance and diary management) and 32 pieces of evidence. Conclusion Medical staff should carefully select appropriate evidence according to the corresponding clinical situation, and a multidisciplinary team cooperation should be carried out to yield the optimal individualized evidence practice of the diary method in ICU. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Vitamin D deficiency and orthostatic hypotension in the elderly: A systematic review and meta-analysis Zhao Jiahua, Ma Qinghua, Yu Jianghua Clinical Focus    2024, 39 (10): 869-876.   DOI: 10.3969/j.issn.1004-583X.2024.10.001 Abstract （177）   HTML （6）    PDF（pc） （1279KB）（95）       Knowledge map    Save Objective To study the relationship between vitamin D deficiency, defined as 25-hydroxyvitamin D3 (25 (OH) D3) deficiency and the risk of orthostatic hypotension (OH) in the elderly population. Methods From the establishment of the database to June 2023, a systematic literature search was conducted on Pubmed, Embase, Web of Science, Scopus, and Cochrane databases. Two researchers independently screened the included literatures, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was performed using Stata software (version 17.0) and RevMan5.4 software. Results A meta-analysis was conducted using the random-effect model involving 9,155 participants from 9 cross-sectional studies. Serum 25-hydroxyvitamin D levels were measured by radioimmunoassay (RIA) and liquid chromatography mass spectrometry (LC-MS). The overall analysis results showed that vitamin D deficiency was directly correlated with OH in the elderly population. Compared with individuals with normal vitamin D levels, low serum vitamin D levels significantly increased the risk of OH in the elderly (OR=1.22, 95%CI=1.12-1.33,P<0.05). Conclusion There is a clear correlation between vitamin D deficiency and the risk of OH in the elderly. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical predictive value of urine organic acid metabolites in intrahepatic cholestasis of pregnancy You Yilan, Chen Lingyan, Miao Keyan, Ni Luohang, Zhang Yan, Xiao Jianping Clinical Focus    2025, 40 (6): 519-526.   DOI: 10.3969/j.issn.1004-583X.2025.06.007 Abstract （31）   HTML （0）    PDF（pc） （1739KB）（88）       Knowledge map    Save Objective To identify the role of organic acid metabolites in the prediction of intrahepatic cholestasis of pregnancy (ICP) by performing targeted metabolomic analysis of urine samples from pregnant women. Methods A total of 10 pregnant women with ICP from Wuxi Maternity and Child Health Care Hospital were selected as the observation group and 10 healthy pregnant women as the control group. Their general information was collected. Targeted metabolomics studies were carried out on the urine of both groups. Differences in metabolites between the two groups were examined using the Student's t-test, and preliminary screening was performed based on the fold change. The receiver operating characteristic curve was drawn to analyze the diagnostic performance of the initially screened organic acid metabolites and screen out metabolites with high diagnostic performance. Pearson correlation was performed to analyze the correlation of the urine levels of seven organic acid metabolites with liver function indexes and the newborn weight in ICP patients.Results A total of 18 metabolites, such as oleic acid, and linoleic acid in the urine of the observation group significantly differed from those in the control group (P<0.05). The area under the curve (AUC) of 12 metabolites in distinguishing ICP among pregnant women was larger than 0.8, showing good sensitivity and specificity. The AUC of 7 metabolites (nonanoic acid, sebacic acid, oleic acid, linoleic acid, palmitic acid, 3-hydroxypropionic acid, and L-phenylalanine) was larger than 0.9, showing more significant differences between the observation group and the control group and more desirable predictive abilities. The seven metabolites were correlated with some indexes of liver function (total bile acids, aspartate aminotransferase, alanine aminotransferase)(P<0.05). Nonanoic acid and 3-hydroxypropionic acid were correlated with the newborn weight (P<0.05). Conclusion The expression levels of nonanoic acid and sebacic acid in the urine are upregulated in pregnant women with ICP, while those of oleic acid, linoleic acid, palmitic acid, 3-hydroxypropionic acid, and L-phenylalanine are downregulated. These seven metabolites have important clinical predictive value for ICP patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Association of TyG index and its derivatives with the risk of diabetic kidney disease in patients with type 2 diabetes mellitus Li Jiawen, Liu Yanlan, Li Yaoshuang, Qiu Huina, Li Fang, Wu Fan, Lin Chenying, Lin Jingna Clinical Focus    2024, 39 (10): 901-908.   DOI: 10.3969/j.issn.1004-583X.2024.10.006 Abstract （201）   HTML （3）    PDF（pc） （1253KB）（85）       Knowledge map    Save Objective To study the correlation of triglyceride-glucose (TyG) and its derivative index with the risk of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM), and to explore its clinical application value. Methods This was a cross-sectional study including 895 T2DM patients hospitalized in the Endocrinology Department of Tianjin People's Hospital from 2018 to 2022. Patients were divided into DKD group (n=326) and non-DKD group (n=569) according to whether they had DKD or not. The clinical data of the two groups were compared. The correlation of TyG, triglyceride glucose-waist circumference (TyG-WC), triglyceride glucose-body mass index (TyG-BMI), and homeostatic model assessment for insulin resistance (HOMA-IR) with DKD was identified. The interaction of TyG and its derivatives with stratification factors was explored. Results There were significant differences in TyG, TyG-WC, TyG-BMI and HOMA-IR between the two groups (P<0.05). TyG and TyG-WC were independent influencing factors of the risk of DKD before and after adjusting for influencing factors (P<0.05). The prevalence of DKD in T2DM patients increased gradually with the increased TyG, TyG-WC and HOMA-IR (trend test P<0.05). In the T3 subgroup of TyG and TyG-WC, the prevalence of DKD was significantly higher than that of T1 subgroup (P<0.05). At varied levels of TyG, it was an independent risk factor for the risk of DKD before and after adjusting for the influencing factors (P<0.05). Conclusion As an independent risk factor for the risk of DKD, continuous and categorical variables of TyG and its derivatives as well as HOMA-IR stably predict DKD in T2DM patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of lean metabolic-associated fatty liver disease among young and middle-aged people and its risk factors Tong Mingxia, Chen Ke, Xiang Xiaocong, Zhou Lifeng Clinical Focus    2025, 40 (2): 128-132.   DOI: 10.3969/j.issn.1004-583X.2025.02.005 Abstract （113）   HTML （2）    PDF（pc） （859KB）（81）       Knowledge map    Save Objective To explore the metabolic-associated fatty liver disease (MAFLD) in young and middle-aged people and its risk factors. Methods From January 2022 to December 2023, clinical data of 16 173 young and middle-aged people receiving physical examinations in the Health Management Center of Nanchong Central Hospital were collected. Lean MAFLD and risk factors in them were analyzed. Results All lean MAFLD patients were male, and most of them aged 45-59 years with a body mass index (BMI) ranging from 20-23 kg/m2. There were significant differences in age, gender, BMI, blood pressure, fasting plasma glucose (FPG), blood lipids and blood uric acid (UA) between the two groups (P<0.05). The detection rate of abnormal glucose metabolism in the lean MAFLD group was 12.5%, which was significantly higher than that in the lean non-MAFLD group (P<0.001). The detection rates of abnormal lipid metabolism, hypertriglyceridemia, low high density lipoprotein and mixed hyperlipidemia were 62.8%, 33.7%, 17.6% and 18.4%, respectively, which were significantly higher than those in the lean non-MAFLD group (P<0.001). Hypercholesterolemia was detected in 7.4% of lean MAFLD, which was significantly lower than that in lean non-MAFLD group (P<0.001). The detection rate of UA metabolic abnormalities was 26.9%, which was significantly higher than that of lean non-MAFLD group (P<0.001). Multivariate logistic regression analysis showed that gender, age, BMI, hypertension, abnormal glucose metabolism, triglyceride (TG), mixed hyperlipidemia, high-density lipoprotein cholesterol (HDL-C) and hyperuricemia were the independent risk factors of lean MAFLD. Conclusion Interventions on the related risk factors should be conducted as early as possible. Strengthening the early health education for the physical examination population, and taking measures against the risk factors of MAFLD are expected to reduce the incidence of MAFLD. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Risk prediction models for weaning failure from mechanical ventilation: A systematic review Hu Feifei, Wang Fang, Wang Yongni, Huang Shini, Ming Yao Clinical Focus    2025, 40 (2): 107-116.   DOI: 10.3969/j.issn.1004-583X.2025.02.002 Abstract （140）   HTML （2）    PDF（pc） （1306KB）（80）       Knowledge map    Save Objective To systematically evaluate the risk prediction models for mechanical ventilation weaning failure. Methods Computerised searches of PubMed, Embase, Web of Science, Cochrane Library, CBM, CNKI, Wanfang and VIP databases were conducted to collect risk prediction models for weaning failure from mechanical ventilation from the establishment of the database to February 2025. The risk of bias and applicability of risk prediction models were evaluated using the prediction model risk of bias assessment tool (PROBAST) after the literatures were independently screened and data extracted by two researchers. Results Twenty-one literatures representing 44 risk prediction models for weaning failure from mechanical ventilation were included. The number of predictors ranged from 3-21, with the most common predictors being the duration of mechanical ventilation, age, and the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ). The area under the receiver operating characteristic curve (AUC) of the included models ranged 0.689-0.926. The models had a good overall predictive performance, but the overall risk of bias was high. Conclusion Currently, the risk prediction models for weaning failure from mechanical ventilation has well overall predictive performance, but the clinical applicability of the model requires further validation because most studies have not been externally validated and there are variations in the definitions of outcome metrics. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of risk factors for bronchopulmonary dysplasia in extremely premature/very low birth weight infants Zhao Yipin, Cui Qingyang Clinical Focus    2025, 40 (1): 60-64.   DOI: 10.3969/j.issn.1004-583X.2025.01.009 Abstract （111）   HTML （3）    PDF（pc） （880KB）（80）       Knowledge map    Save Objective To explore the risk factors of bronchopulmonary dysplasia (BPD) in extremely preterm/low birth weight infants and to construct a logistic regression prediction model. Methods Medical records 140 ultra-premature infants/ultra-low birth weight infants hospitalized in Zhoukou Maternal and Child Health Hospital and the neonatal intensive care unit of Zhoukou Hospital of TCM from January 1, 2017 to December 31, 2023 were recruited. A total of 102 cases were finally included according to the inclusion and exclusion criteria. They were divided into BPD group and non-BPD group based on whether BPD occurred. The general data of the two groups were compared, and the pathological causes of ultra-premature infants/ultra-low birth weight infants were analyzed using logistic regression. Results A total of 102 ultra-premature/ultra-low birth weight infants were included in this study, and 59 of them developed BPD, with an incidence of 57.8%. Fetal conditions were as follows. Infants in the BPD group had significantly lower birth weight and gestational age, but higher proportions of 1-min Apgar≤7 points, neonatal pneumonia and neonatal sepsis, and longer mechanical ventilation time than those of the non-BPD group (P<0.05). Maternal conditions were as follows. The proportions of premature amniotic rupture>18 hours, and chorioamnionitis in the BPD group were significantly higher than those of the non-BPD group (P<0.05). Multivariate logistic regression analysis showed that gestational age and birth weight were independent protective factors for BPD in ultra-premature infants/ultra-low birth weight infants, and mechanical ventilation time and chorioamnionitis were independent risk factors for BPD in ultra-premature infants/ultra-low birth weight infants (P<0.05). Based on the results of multiple factors, a logistic regression risk prediction model was constructed. Logit (P) ranged from 0 to 1. The test results showed that the area under the curve (AUC) of the model in predicting extremely preterm/low birth weight infants with concurrent BPD was 0.891 (95%CI: 0.846-0.939), with the chi-square value (χ2) in the Hosmer-Lemeshow test of 6.543(P=0.072). Conclusion Birth weight, gestational age, duration of mechanical ventilation, and chorioamnionitis are all risk factors for the development of BPD in extremely preterm infants/very low birth weight infants. A logistic regression model based on these factors has high predictive value and can be used as an effective clinical model in predicting the occurrence of BPD. It also has certain guiding significance for subsequent clinical decisions. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of clinical, pathological and genetic characteristics of LMX1B-induced nail-patella syndrome: A case report and literature review Xu Zichuan, Li Yue, Yang Huabin, Deng Huiying, Gao Xia Clinical Focus    2025, 40 (4): 360-365.   DOI: 10.3969/j.issn.1004-583X.2025.04.012 Abstract （41）   HTML （2）    PDF（pc） （2157KB）（76）       Knowledge map    Save Objective Nail-patella syndrome (NPS) is a rare hereditary disease that effects multiple systems and holds great difficulty in the clinical diagnosis. This paper described the clinical features, renal pathology and genotype in a girl with NPS, in order to raise the doctors` vigilance in making the clinical diagnosis of NPS. Methods Pathological data of a 9-year-old girl with proteinuria and admitted in Guangzhou Women and Children’s Medical Center Affiliated to Guangzhou Medical University were retrospectively analyzed. Clinical manifestations, renal biopsy findings and the second-generation whole-exon sequencing data were examined. Results Physical examinations identified development abnormalities, including hypoplasia of thumb nail, abnormal clavicle morphology especially on the right side, and inability to abduct of the left elbow joint. Laboratory abnormalities mainly included decreased serum albumin level (30.4 g/L), increased cholesterol level (6.14 mmol/L), the mass proteinuria (55.6 mg/[kg·24h]), accompanied by glomerular hematuria. Renal pathology showed no obvious damages under light microscope, while much disordered collagen-like structure in the basement membrane was observed under the electron microscope. The second-generation whole-exon sequencing found a missense mutation in the exon 5 of the LMX1B gene (c.755t > CP), where leucine (Leu) at position 252 was altered to proline (Pro). At 3 months of discharge follow-up, the urinary protein fluctuated around+positivity, and the serum albumin and cholesterol returned to normal. Conclusion A detailed physical examination holds great importance for the diagnosis of NPS in children with multi-system abnormality. The gene sequencing and pathological characteristics are necessary to make the diagnosis of NPS and to reduce the misdiagnosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (10): 940-944.   DOI: 10.3969/j.issn.1004-583X.2024.10.013 Abstract （130）   HTML （3）    PDF（pc） （945KB）（76）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Effects of cardiac contractility modulation on the autophagy of cardiomyocytes in rabbits with chronic heart failure and the underlying mechanisms Hao Qingqing, Lv Shilin, Zhang Jing, Zhang Litao, Zhang Feifei Clinical Focus    2024, 39 (11): 1026-1034.   DOI: 10.3969/j.issn.1004-583X.2024.11.011 Abstract （102）   HTML （4）    PDF（pc） （1303KB）（76）       Knowledge map    Save Objective To explore the effect of cardiac contractility modulation (CCM) on the autophagy of cardiomyocytes in rabbits with chronic heart failure (CHF) and the underlying mechanisms. Methods Thirty healthy New Zealand White rabbits weighing 2.5-3.5 kg were randomly assigned to the sham operation group, HF group, and CCM group, with 10 rabbits in each group. A CHF model was established by the ascending aortic constriction method, followed by CCM for 4 weeks. At 12 and 16 weeks, echocardiography was employed to assess the cardiac function. Expression level of the microtuble-associated protein 1 light chain 3 (LC3) was detected by immunofluorescence staining. Protein levels of P62, Beclin1, light chain 3B II/I (LC3B II/I), protein kinase B (AKT)1, AKT2, AKT3, phosphatidylinositol 3-kinase (PI3K) α110, PI3K α85 and mammalian target of rapamycin (mTOR) in myocardial tissue were detected by Western blot.Results At 12 weeks, rabbits in the HF and CCM groups had significantly larger left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD), and lower left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) than those of sham operation group (P<0.05). At 16 weeks, significant improvements in LVEF, LVFS, LVESD and LVEDD were observed in the CCM group than HF group (P<0.05). Compared with those of the HF group, rabbits in the CCM group had significantly upregulated p62, PI3K α110 and PI3K α85, less LC3-positive immunofluorescence staining, downregulated Beclin1, LC3B, AKT1-3 and mTOR in myocardium and lower LC3B(II/I) ratio (all P<0.05). Conclusion CCM can improve the abnormal expression of LC3B (II/I), Beclin1 and p62 protein in myocardium of CHF rabbits, reduce the activity of autophagy in rabbit myocardium, and improve myocardial contractile and diastolic function by regulating the PI3K/AKT signaling pathway. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (9): 847-850.   DOI: 10.3969/j.issn.1004-583X.2024.09.016 Abstract （196）   HTML （7）    PDF（pc） （885KB）（76）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Construction of a nomogram to predict postoperative hydrocephalus in patients with aneurysmal subarachnoid hemorrhage based on the Dryad database and its validation Wang Zhuangzhuang, Ren Huan, Liu Yanting, Tian Chunlei Clinical Focus    2025, 40 (4): 313-319.   DOI: 10.3969/j.issn.1004-583X.2025.04.003 Abstract （70）   HTML （2）    PDF（pc） （1240KB）（72）       Knowledge map    Save Objective To explore the influencing factors for postoperative hydrocephalus in patients with aneurysmal subarachnoid hemorrhage (aSAH), and to construct a nomogram and validate its performance. Methods A total of 236 aSAH patients with clinical data recorded in the Dryad database from January 2010 to December 2015 were collected. They were randomly divided into the training set (n=166) and validation set (n=70) at a ratio of 7∶3. Univariate and multivariate logistic regression analyses were used to determine the independent influencing factors for postoperative hydrocephalus in aSAH patients, and a nomogram was therefore constructed. The receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were used to evaluate the test efficiency of the nomogram. Results The results of multivariate logistic regression analysis showed that age≥60 years (HR=1.170, P=0.032), craniotomy clipping (HR=2.018, P=0.041), ventricular hemorrhage (HR=1.439, P=0.032), rebleeding (HR=1.095, P=0.001), delayed cerebral ischemia (HR=1.318, P=0.038), and prolonged mechanical ventilation time (HR=3.112, P=0.012) were independent risk factors for postoperative hydrocephalus in aSAH patients (all P<0.05). Based on this, a nomogram was constructed to predict the risk of postoperative hydrocephalus in aSAH patients. The area under the curve (AUC) was 0.757 in the training set, and 0.667 in the validation set. The calibration curve fitted well with the ideal curve, and the DCA curve showed good clinical net benefits within the threshold probability range of 0.20-0.80. Conclusion Age≥60 years, craniotomy clipping, ventricular hemorrhage, rebleeding, delayed cerebral ischemia, and prolonged mechanical ventilation time are independent risk factors for postoperative hydrocephalus in aSAH patients. The nomogram can be used to predict the incidence of postoperative hydrocephalus in aSAH patients, providing a reference for clinicians to select appropriate individualized treatment plans. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (9): 855-860.   DOI: 10.3969/j.issn.1004-583X.2024.09.018 Abstract （200）   HTML （5）    PDF（pc） （952KB）（71）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Risk factors for hydrocephalus in children with cerebral hemorrhage and its prediction model Xu Huifeng, Jin Yanyong, Gou Ruolan, Hu Mingzhe Clinical Focus    2025, 40 (4): 325-328.   DOI: 10.3969/j.issn.1004-583X.2025.04.005 Abstract （72）   HTML （1）    PDF（pc） （890KB）（70）       Knowledge map    Save Objective To explore the risk factors of hydrocephalus in children with cerebral hemorrhage and to create a prediction model. Methods A retrospective analysis was conducted on the clinical data of 120 children with cerebral hemorrhage admitted from April 2016 to December 2023. The incidence of concurrent hydrocephalus was statistically analyzed. Univariate and multivariate logistic regression analyses were used to clarify the risk factors for its occurrence. Results Among 120 children with cerebral hemorrhage, 22/120 (18.33%) developed hydrocephalus. The proportion of patients<8 years old, cerebrospinal fluid protein>3 g/L, intraventricular hemorrhage, and hospitalization complications in the hydrocephalus group was significantly higher than that of the non-hydrocephalus group (P<0.05). Multivariate logistic regression analysis showed that <8 years old (OR=4.593), cerebrospinal fluid protein>3 g/L (OR=6.525), and intraventricular hemorrhage (OR=14.500) were independent risk factors affecting the occurrence of hydrocephalus (P<0.05). The area under the curve (AUC) of the prediction model in identifying hydrocephalus in children with cerebral hemorrhage was 0.841, with a 95% confidence interval (CI) of 0.760-0.937, a sensitivity of 0.928, and a specificity of 0.783. In the validation set, the AUC was 0.822, with a 95%CI of 0.706-0.937. Conduct Hosmer Lemeshow test showed an acceptable goodness of fit (χ2=1.635, P=0.201), indicating a good credibility. Conclusion Children with cerebral hemorrhage may develop hydrocephalus, and age, cerebrospinal fluid protein level, bleeding site are all risk factors for hydrocephalus. Establishing a prediction model can effectively evaluate the incidence of hydrocephalus. Table and Figures | Reference | Related Articles | Metrics | Comments（0）