目的：分析冠状动脉CT血管成像（CTA）联合动态心电图（DCG）与冠心病患者冠脉狭窄程度及预后情况的关联。方法：研究对象选择我院2024年1月~2025年3月收治的210例冠心病患者及同期接受检查的210例非冠心病患者，分别列为病例组和对照组，比较两组CTA参数、DCG参数间差异。依据入院测得（Gensini）评分不同，将入组患者分别列为轻度组（60例，Gensini评分≤30分）、中度组（75例，Gensini评分＞30分、≤60分）和重度组（75例，Gensini评分＞60分），比较三组CTA参数、DCG参数间差异，分析CTA参数、DCG参数与Gensini评分的相关性。统计入组患者不良预后发生情况，比较不同预后患者CTA参数、DCG参数间差异，归纳冠心病患者预后影响因素，检验CTA参数、DCG参数对患者不良预后的预测效能。结果：病例组的最小管腔直径（MLD）、最小管腔面积（MLA）、血流储备分数（FFR）、正常窦性间期的标准差（SDNN）、每5min平均RR间期的标准差（SDANN）、相邻RR间期差值的均方根（RMSSD）均低于对照组，斑块总体积（TPV）、低频/高频比值（LF/HF）均高于对照组（t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389；P＜0.05）。重度组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于中度组，轻度组，TPV、LF-HF均高于中度组，轻度组（F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983；P＜0.05）。MLD、MLA、FFR、SDNN、SDANN、RMSSD均与Gensini评分负相关，TPV、LF-HF均与Gensini评分正相关（r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355；P＜0.05）。经统计，210例冠心病患者的不良预后发生率为38.10%（80/210）。预后不良组的MLD、MLA、FFR、SDNN、SDANN、RMSSD均低于预后良好组，TPV、LF-HF均高于预后良好组（t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465；P＜0.05）。MLA、FFR、SDNN升高为冠心病不良预后的保护因素，LF/HF升高为冠心病不良预后的危险因素。FFR、SDNN联合检测预测不良预后的 AUC 值优于两项指标单独检测（Delong检验，P＜0.05）。结论：CTA、DCG能客观评估冠心病患者冠脉狭窄程度，联合检测FFR、SDNN可作为预测冠心病不良预后的重要辅助手段。

Objective:To analyze the correlation between CTA combined with DCG and the degree of coronary stenosis and prognosis in patients with coronary heart disease.Methods:The research subjects selected were 210 patients with coronary heart disease admitted to our hospital from January 2024 to March 2025, as well as 210 non coronary heart disease patients who underwent examinations during the same period. They were divided into a case group and a control group. The differences in CTA parameters and DCG parameters between the two groups were compared. According to the different Gensini scores obtained upon admission, the enrolled patients were divided into mild group (60 cases, Gensini score ≤ 30 points), moderate group (75 cases, Gensini score>30 points, ≤ 60 points), and severe group (75 cases, Gensini score>60 points). The differences in CTA parameters and DCG parameters among the three groups were compared, and the correlation between CTA parameters, DCG parameters, and Gensini score was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in CTA and DCG parameters among patients with different prognoses, summarize the factors affecting the prognosis of coronary heart disease patients, and test the predictive power of CTA and DCG parameters for poor prognosis in patients.Results:The MLD, MLA, FFR, SDNN, SDANN, and RMSSD in the case group were all lower than the control group, while the TPV and LF/HF were higher than the control group (t=24.128，25.811，15.613，37.636，26.858，9.195，59.862，29.389; P<0.05). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the severe group were lower than the moderate group, mild group, while the TPV and LF-HF of the mild group were higher than the moderate group, mild group (F=190.291，51.562，186.482，42.084，44.413，22.541，56.503，109.983; P<0.05). MLD, MLA, FFR, SDNN, SDANN, and RMSSD are all negatively correlated with Gensini score, while TPV and LF-HF are positively correlated with Gensini score (r=-0.352，-0.377，-0.445，-0.472，-0.332，-0.356，0.401，0.355; P<0.05). According to statistics, the incidence of poor prognosis in 210 patients with coronary heart disease was 38.10% (80/210). The MLD, MLA, FFR, SDNN, SDANN, and RMSSD of the poor prognosis group were lower than the good prognosis group, while TPV and LF-HF were higher than the good prognosis group (t=6.827，12.219，19.313，6.097，7.097，5.027，7.088，12.465; P<0.05). High MLA, FFR, and SDNN are protective factors for poor prognosis of coronary heart disease, while higher values than LF/HF are risk factors for poor prognosis of coronary heart disease. The combined detection of FFR and SDNN has a better AUC value for predicting poor prognosis of coronary heart disease than the detection of FFR and SDNN alone (Delong test, P<0.05）.Conclusion:CTA and DCG can objectively evaluate the degree of coronary stenosis in patients with coronary heart disease, and combined detection of FFR and SDNN can be an important auxiliary tool for predicting poor prognosis of coronary heart disease.

目的：探究阻塞性冠心病患者中舌象纹理特征与冠周脂肪影像组学的相关性。 方法：收集辽宁中医药大学附属医院131例就诊的疑似冠心病患者，其中阻塞性冠心病63例、非阻塞性冠心病68例，提取临床常规指标、舌象纹理特征及右冠状动脉影像组学参数。独立样本t检验、曼-惠特尼U检验、卡方检验、错误发现率校正用于比较组间差异。使用斯皮尔曼相关性分析舌象纹理特征与冠周脂肪影像组学的相关性。采用弹性网络进行特征筛选,按照7：3的比例随机抽样划分为训练集和测试集，使用BP神经网络模型构建冠周脂肪及冠周脂肪与舌象纹理特征联合模型，使用ROC曲线、准确性、精度、召回率、特异度、F1分数、Kappa系数评估模型。 结果：在疑似冠心病患者中，舌象纹理与冠周脂肪影像组学共检出22组弱负相关、1组中等正相关及23组弱正相关；阻塞性冠心病患者中检出4组中等负相关、4组弱负相关、2组中等正相关及6组弱正相关；非阻塞性冠心病患者中检出1组中等负相关、6组弱负相关、1组中等正相关及10组弱正相关。基于BP神经网络构建诊断模型，联合舌象纹理特征后较单一冠周脂肪影像组学模型测试集AUC有所提升。 结论：舌象纹理特征与冠周脂肪影像组学参数在阻塞性冠心病中存在一定的相关性；舌象纹理信息对冠周脂肪诊断阻塞性冠心病具有增量价值。

Abstract:Objective: To investigate the correlation between tongue image texture features and pericoronary adipose tissue (PCAT) radiomics in patients with obstructive coronary heart disease. Methods: A total of 131 patients with suspected coronary heart disease admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were enrolled, including 63 cases of obstructive coronary heart disease and 68 cases of non-obstructive coronary heart disease. Clinical routine indicators, tongue image texture features, and right coronary artery radiomics parameters were extracted. Independent sample t-test, Mann-Whitney U test, Chi-square test, and false discovery rate correction were used to compare intergroup differences. Spearman correlation analysis was employed to examine the correlation between tongue image texture features and PCAT radiomics. Elastic net was applied for feature selection. The dataset was randomly split into training and test sets at a 7:3 ratio. BP neural network models were constructed using PCAT features alone and in combination with tongue image texture features. Model performance was evaluated using receiver operating characteristic (ROC) curves, accuracy, precision, recall, specificity, F1 score, and Kappa coefficient. Results: In patients with suspected coronary heart disease, 22 weak negative correlations, 1 moderate positive correlation, and 23 weak positive correlations were identified between tongue image texture features and PCAT radiomics. In patients with obstructive coronary heart disease, 4 moderate negative correlations, 4 weak negative correlations, 2 moderate positive correlations, and 6 weak positive correlations were detected. In patients with non-obstructive coronary heart disease, 1 moderate negative correlation, 6 weak negative correlations, 1 moderate positive correlation, and 10 weak positive correlations were observed. The BP neural network diagnostic model combining tongue image texture features with PCAT radiomics demonstrated improved performance on the test set compared with the PCAT radiomics model alone. Conclusion: Tongue image texture features exhibit certain correlations with PCAT radiomics parameters in obstructive coronary heart disease, and tongue texture information provides incremental value for the diagnosis of obstructive coronary heart disease when combined with PCAT radiomics.

目的：分析血脑屏障标志物闭合蛋白（Occludin，OCLN）、密封蛋白-5（Claudin-5，CLDN5）与帕金森病（PD）患者神经功能损伤程度及不良预后的关联。方法：研究对象选择2024年6月~2025年6月就诊于我院的180例PD患者，及同期接受检查的180例健康志愿者，将其分别列为病例组、对照组，比较两组OCLN、CLDN5间差异。依据病情严重程度不同，将PD患者分别列为早期组（50例）、中期组（65例）和晚期组（65例），比较三组患者OCLN、CLDN5，神经损伤标志物间差异，分析晚期组患者OCLN、CLDN5与神经损伤标志物的相关性。统计入组患者不良预后发生情况，比较不同预后患者OCLN、CLDN5及神经损伤标志物间差异，分析PD患者预后影响因素，验证OCLN、CLDN5对PD患者不良预后的预测效能。结果：病例组的外周血OCLN、CLDN5均高于对照组（t=50.450，51.670；P＜0.05）。晚期组外周血OCLN、CLDN5、神经元特异性烯醇化酶（NSE）、泛素羧基末端水解酶L1（UCH-L1）、神经丝轻链蛋白（NfL）、胶质纤维酸性蛋白（GFAP）均高于中期组、早期组（F=280.611，378.453，82.254，122.413，185.272，257.733；P＜0.05）。晚期组的OCLN、CLDN5均与NSE、UCH-L1、NfL、GFAP正相关（r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503；P＜0.05）。180例PD患者的不良预后发生率为28.89%（52/180）。预后不良组的外周血OCLN、CLDN5、NSE、UCH-L1、NfL、GFAP均高于预后良好组（t=17.096，14.405，7.632，6.903，11.695，10.702；P＜0.05）。Logistic多因素回归分析结果显示，外周血OCLN、CLDN5、NfL、GFAP高表达为PD患者发生不良预后的危险因素。经ROC检验，外周血OCLN、CLDN5联合检测对于PD不良预后的预测AUC高于外周血OCLN、CLDN5单独检测（DeLong检验，P＜0.05）。结论：外周血OCLN、CLDN5可随PD患者神经损伤程度加剧而不断升高，联合检测外周血OCLN、CLDN5或可作为预测患者不良预后的重要辅助手段。

Objective:To analysis of the association between blood-brain barrier markers Occludin (OCLN), Claudin-5 (CLDN5) and the degree of neurological damage and poor prognosis in PD patients.Methods:The research subjects selected 180 PD patients who visited our hospital from June 2024 to June 2025, as well as 180 healthy volunteers who underwent examinations during the same period. They were divided into a case group and a control group, and the differences between the two groups in terms of OPLN and CLDN5 were compared. According to the severity of the disease, PD patients were divided into early group (50 cases), middle group (65 cases), and late group (65 cases). The differences in OCLN, CLDN5, and nerve injury markers among the three groups of patients were compared, and the correlation between OCLN, CLDN5, and nerve injury markers in the late group of patients was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in OCLN, CLDN5, and nerve injury markers among patients with different prognoses, analyze the factors affecting the prognosis of PD patients, and verify the predictive power of OCLN and CLDN5 for poor prognosis in PD patients.Results:The peripheral blood levels of OCLN and CLDN5 in the case group were higher than the control group (t=50.450，51.670; P<0.05). The levels of OCLN, CLDN5 NSE,UCH-L1,NfL, and GFAP in peripheral blood of the late stage group were higher than those of the mid stage and early stage groups (F=280.611，378.453，82.254，122.413，185.272，257.733; P<0.05). The OCLN and CLDN5 in the late stage group were positively correlated with NSE, UCH-L1, NfL, and GFAP (r=0.411，0.457，0.505，0.494，0.465，0.425，0.491，0.503; P<0.05). The incidence of poor prognosis in 180 PD patients was 28.89% (52/180). The peripheral blood levels of OCLN, CLDN5, NSE, UCH-L1, NfL, and GFAP in the poor prognosis group were higher than those in the good prognosis group (t=17.096，14.405，7.632，6.903，11.695，10.702; P<0.05). The results of logistic multiple regression analysis showed that high expression of peripheral blood OCLN, CLDN5, NfL, and GFAP were risk factors for poor prognosis in PD patients. According to ROC test, the combined detection of peripheral blood OCLN and CLDN5 has a higher AUC for predicting poor prognosis of PD than the detection of peripheral blood OCLN and CLDN5 alone (DeLong test, P<0.05).Conclusion:Peripheral blood OCLN and CLDN5 can exacerbate and continuously increase the degree of nerve damage in PD patients. Combined detection of peripheral blood OCLN and CLDN5 may serve as an important auxiliary tool for predicting poor prognosis in patients.

       目的   探讨慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞（EOS）、血清白细胞介素-5（IL-5）水平与第一秒用力呼气容积（FEV1）、第一秒用力呼气容积与用力肺活量的比值（FEV1/FVC）、用力肺活量（FVC）的相关性。方法   纳入2023年3月—2024年3月于佛山市顺德区第五人民医院住院的73例慢性阻塞性肺疾病急性加重期患者，以2%作为外周血EOS比例（EOS%）截断值分为两组，研究组（EOS%≥2%）34例，对照组（EOS%＜2%）39例，收集两组患者_{的一般临床资料、实验室检查结果、肺功能检查结果（FEV1}、FVC、FEV₁/FVC），比较组间差异，分析指标间的相关性。结果   对照组与实验组患者EOS%分别为0.5（0.1，0.9）%、5.15（2.60，10.05）%，两组患者EOS%差异有统计学意义（P＜0.05）。对照组与实验组患者IL-5水平分别为0.98（0.56，1.78）ng/L、3.6（1.73，6.77）ng/L，两组IL-5水平差异有统计学意义（P＜0.05）。对照组FEV₁（L）、FVC（L）、FEV₁/FVC水平分别为1.32（1.18，1.58）、2.07（1.92，2.62）、0.62（0.57，0.67）；实验组分别为1.24（1.00，1.52）、2.22（1.94，2.56）、0.58（0.47，0.67），两组FEV₁、FVC、FEV₁/FVC水平差异均无统计学意义（P＞0.05）。Spearman等级相关检验结果显示，EOS%与IL-5水平呈正相关（rs=0.870，P＜0.001）；按组别进行分层后结果显示，对照组、试验组EOS%与IL-5水平均呈正相关（r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）。EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（r_s=0.039，P＞0.05）。对照组EOS%、IL-5水平与FEV₁、FEV₁/FVC、FVC不相关（P＞0.05）；实验组EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（P＞0.05）。结论 慢性阻塞性肺疾病急性加重期血EOS%与血清IL-5水平呈正相关，外周血EOS%≥2%时血EOS%、血清IL-5与FEV₁、FEV₁/FVC呈负相关，与FVC无关。

       Objective  To explore the correlation among blood eosinophil levels，serum interleukin-5（IL-5）levels，and forced expiratory volume in one second（FEV₁），the ratio of forced expiratory volume in one second to forced vital capacity（FEV₁/FVC），and forced vital capacity（FVC）during the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods  From March 2023 to March 2024，73 patients hospitalized for AECOPD at Shunde District Fifth People’s Hospital of Foshan City were included，and divided into two groups based on a cutoff value of 2% for peripheral blood eosinophil（EOS%）．The experimental group（EOS%≥2%）included 34 patients，while the control group（EOS%＜2%）included 39 patients．General clinical data，laboratory test results，and pulmonary function test results（FEV₁，FVC，FEV₁/FVC）were collected from both groups．Results  The median quartiles of EOS% for the control group and experimental group were 0.5（0.10.9）% and 5.15（2.60，10.05）%，respectively．There was a statistically significant difference between the EOS% of two groups（P＜0.05）．The median quartiles of IL-5 levels for the control group and experimental group were 0.98（0.56，1.78）ng/L and 3.6（1.73，6.77）ng/L，respectively．There was also a statistically significant difference in IL-5 levels between the two groups（P＜0.05）．For the control group，the median quartiles of FEV₁，FVC，and FEV₁/FVC were 1.32（1.18，1.58），2.07（1.92，2.62）and 0.62（0.57，0.67），respectively．For the experimental group，they were 1.24（1.00，1.52），2.22（1.94，2.56）and 0.58（0.47，0.67）respectively．There was no statistically significant difference between the two groups in FEV₁，FVC and FEV₁/FVC levels（P＜0.05）．Spearman rank correlation analysis showed a positive correlation between EOS% and IL-5 level （r_s=0.870，P＜0.001）．Stratified by group，both the control and experimental groups showed a positive correlation between EOS% and IL-5 level （r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）．There was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．In the control group，there was no correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC，or FVC（P＞0.05）．In the experimental group，there was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV₁/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．Conclusions  During AECOPD，blood EOS% is positivelycorrelated with serum IL-5 levels．When peripheral blood eosinophils are ≥2%，blood EOS%，serum IL-5，and FEV₁，FEV₁/FVC are negatively correlated，while there is no correlation with FVC．

       目的   探讨脓毒性休克患者肿瘤坏死因子相关受体6 （TRAF6）、胆碱酯酶（ChE）及急性生理学和慢性健康状况评价Ⅱ（APACHE Ⅱ）对预后不良的预测价值。方法   回顾分析2023年2月—2024年3月于某院ICU病区收治的226例脓毒性休克患者的临床资料，基于患者预后情况分为预后良好组（n=151）以及预后不良组（n=75）。回顾226例脓毒性休克患者入院时及治疗后的TRAF6、ChE表达变化，并记录患者APACHEⅡ评分和序贯器官功能衰竭评估（SOFA）评分动态变化；比较并分析两组患者详尽的临床资料，探讨TRAF6、ChE联合APACHE Ⅱ评分之间的关联性以及上述指标对脓毒性休克患者预后情况的临床评估价值。采用Logistic回归来分析对脓毒性休克患者生存状况产生影响的潜在因素。结果   多因素Logistic回归分析，年龄、APACHE Ⅱ评分、SOFA评分、机械通气时间、TRAF6与ChE表达水平均是影响患者预后的独立危险因素（P＜0.05）；受试者操作特征曲线分析显示，年龄、APACHE Ⅱ评分、机械通气时间、SOFA评分、TRAF6、ChE表达水平联合预测脓毒性休克患者预后不良的曲线下面积为0.925，高于单独检测的0.689、0.783、0.794、0.781、0.708、0.827。结论   临床需要及时识别高龄、长时间机械通气时间、高APACHE Ⅱ与SOFA评分、高TRAF6和ChE表达水平的高风险患者，TRAF6、ChE表达水平、SOFA评分、APACHE Ⅱ评分可作为评估脓毒性休克患者预后情况的临床指标，联合应用能进一步提升临床价值。

      Objective  To explore the predictive value of tumor necrosis factor receptor associated factor 6（TRAF6），cholinesterase（ChE）and Acute Physiology and Chronic Health Evaluation II scove（APACHE II）for adverse prognosis in patients with septic shock．Methods  The clinical data of 226 patients with septic shock admitted to the Intensive Care Unit（ICU） of a hospital from February 2023 to March 2024 were retrospectively analyzed，and the patients were divided into a good prognosis group（n=151）and an adverse prognosis group（n=75）based on their prognosis．The expression of TRAF6 and ChE in 226 patients with septic shock was reviewed at admission and after treatment，while the dynamic changes of APACHE  II score and Sequential Organ Failure Assessment（SOFA）score were recorded．Detailed clinical data of the two groups were compared and analyzed to explore the correlation between TRAF6，ChE，APACHE II scores and the clinical evaluation value of the above indexes in the prognosis of patients with septic shock．Logistic regression was used to analyze the potential factors affecting the survival of septic shock patients．Results  Multiple Logistic regression analysis revealed that age，APACHE II score，SOFA score，mechanical ventilation time，TRAF6 and ChE expression levels were independent risk factors for prognosis（P＜0.05）．Receiver Operating Characteristic（ROC）curve analysis showed that the area under curve（AUC）was 0.925，which was higher than single index prediction（0.689，0.783，0.794，0.781，0.708 and 0.827）．Conclusions  High-risk patients with advanced age，prolonged mechanical ventilation，high APACHE II and SOFA scores，and high TRAF6 and ChE expression levels need to be identified in time．TRAF6，ChE expression levels，SOFA scores，and APACHE  II scores can be used as clinical indicators to evaluate the prognosis of septic shock patients．The combined application of those four indicators can further improve the clinical value．

     目的   探讨2型糖尿病（T2DM）患者葡萄糖目标范围内时间（TIR）与高尿酸血症（HUA）的相关性。方法   纳入2021年10月—2024年10月厦门大学附属第一医院收治的110例T2DM合并HUA的患者，将其分为T2DM并HUA组，另选取同期110例单纯T2DM患者，分为单纯T2DM组，比较两组一般资料及实验室相关指标，采用Logistics回归模型分析T2DM患者HUA发生的影响因素。随后将110例T2DM合并HUA的患者依照其病情严重程度分为轻度组（58例）、中度组（37例）及重度组（15例），比较三组临床相关指标及TIR水平，分析临床相关指标及TIR水平与T2DM患者HUA严重程度的相关性。结果  T2DM并HUA组与单纯T2DM组患者体质指数（BMI）、糖化血红蛋白、总胆固醇、甘油三酯、血肌酐（Scr）、TIR对比差异有统计学意义（P＜0.05）；将具有统计学差异的指标纳入Logistics回归模型，以是否合并HUA作为因变量（合并HUA=1，未合并HUA=0），结果显示，BMI、糖化血红蛋白、总胆固醇、甘油三酯、Scr、TIR为T2DM患者HUA发生的重要影响因素（P＜0.05）；HUA不同严重程度患者临床相关指标及TIR水平对比发现，轻度组、中度组与重度组糖化血红蛋白、总胆固醇、甘油三酯、Scr水平对比差异无统计学意义（P＞0.05），轻度组、中度组与重度组BMI、TIR对比差异显著（P＜0.05），重度组BMI高于轻度组对比差异有统计学意义（P＜0.05），重度组TIR低于轻度组和中度组对比差异有统计学意义（P＜0.05）；Spearman相关分析显示：BMI与HUA严重程度呈正相关，TIR与HUA严重程度呈负相关（P＜0.05）。结论  TIR降低为T2DM患者HUA发生的重要影响因素之一，且TIR水平与HUA严重程度密切相关。

        Objective  To explore the correlation between time in range（TIR）of glucose and hyperuricemia（HUA）in patients with type 2 diabetes mellitus（T2DM）．Methods  From October 2021 to October 2024，110 patients with T2DM complicated with HUA admitted to our hospital were divided into T2DM with HUA group，and 110 patients with T2DM only in the same period were divided into T2DM group．The general data and laboratory related indicators of the two groups were compared，and the influencing factors of the occurrence of HUA in T2DM patients were analyzed by logistic regression model．Subsequently，110 patients with T2DM complicated with HUA were divided into mild group（58 cases），moderate group（37 cases），and severe group（15 cases）according to their severity．The clinical related indicators and TIR levels of the three groups were compared，and the correlation between clinical related indicators and TIR levels and the severity of HUA in T2DM patients was analyzed．Results  Body mass index（BMI），glycosylated hemoglobin，total cholesterol，triglyceride，and blood creatinine（Scr）between T2DM with HUA group and T2DM group were significantly different（P＜0.05）．The indicators with statistical differences were included in the logistics regression model to determine whether to merge HUA as the dependent variable（with HUA=1，without HUA=0）．The results showed that，BMI，glycosylated hemoglobin，total cholesterol，triglycerides，Scr，and TIR were important influencing factors for the occurrence of HUA in T2DM patients（P＜0.05）．Comparison of clinical indicators and TIR levels in patients with different degrees of HUA revealed no significant differences in glycosylated hemoglobin，total cholesterol，triglycerides，and Scr levels among the mild，moderate，and severe groups（P＞0.05），while there were significant differences in BMI and TIR levels among the mild，moderate，and severe groups（P＜0.05）．The difference between the severe group and the mild group was statistically significant（P＜0.05），and the difference between the severe group and the moderate group was statistically significant（P＜0.05）．The Spearman correlation analysis  results showed that BMI was positively correlated with the severity of HUA，while TIR was negatively correlated with the severity of HUA（P＜0.05）．Conclusions  The decrease of TIR is one of the important influencing factors of HUA in T2DM patients，and the level of TIR is closely related to the severity of HUA．

目的 探讨不同类型尿结石患者肠道菌群结构与尿酸代谢的相关性研究。方法 随机选取2022年5月—2023年5月广州市第一人民医院泌尿外科住院的尿结石患者60例为研究组, 选取同期体检中心健康体检人群30名为对照组,按照结石成分将研究组患者分为尿酸组和非尿酸组, 每组各30例, 所有入选患者均接受结石样本、尿样本、大便样本、血样本的采集, 所有样本经光谱、质谱、基因测序、尿常规及血生化检测 , 比较入选对象的肠道菌群及血尿生化指标变化。结果 尿酸组和非尿酸组患者的血磷（SNK-q=7.970、3.542）、血BUN（SNK-q=5.647、4.756）、血SUA（SNK-q=8.178、3.623）、血SCr（SNK-q=7.300、5.553）、血LPS（SNK-q=13.101、9.705）及24h尿酸（SNK-q=4.462、6.426）水平均高于对照组, 具有统计学意义（P<0.05）, 尿酸组和非尿酸组患者的血钙水平低于对照组（SNK-q=3.918/3.047, P<0.05）。非尿酸组患者的血磷、血SUA、血LPS均低于尿酸组, 均有统计学意义（SNK-q=4.428、4.555、3.397, P<0.05）。尿酸组和非尿酸组患者肠道中双歧杆菌数量低于对照组, 差异具有统计学意义（SNK-q=3.754、3.143, P<0.05）。非尿酸组患者肠道中乳酸杆菌数量高于对照组和尿酸组（SNK-q=4.105、3.463, P<0.05）, 尿酸组及非尿酸组患者的血尿酸及24 h尿尿酸水平与肠道双歧杆菌数量呈负相关（P<0.05）。结论 肠道双歧杆菌数量对结石患者血尿酸代谢及尿结石形成具有相关性。

Objective To explore the relationship of intestinal flora and uric acid metabolism in different urinary stones patients．Methods From May 2022 to May 2023, 60 patients with urinary stones patients in Guangzhou First People’s Hospital were selected as the study group, and 30 health check-up people in the same period of the medical examination center were selected as the control group．Study group was divided into the uric acid group and the non-uric acid group, 30 cases each group, all patients received stone samples, urine samples, stool samples,blood samples collection, mass spectrometry, gene sequencing, urine routine, blood biochemical detection were performed．Intestinal flora and blood urinary biochemical indicators of the patients were compared．Results The levels of blood phosphorus（SNK-q=7.970, 3.542）, blood BUN（SNK-q=5.647, 4.756）, blood SUA （SNK-q=8.178, 3.623）, blood SCr（SNK-q=7.300, 5.553）, blood LPS（SNK-q=13.101, 9.705）, and 24-hour urine uric acid （SNK-q=4.462, 6.426）in the uric acid group and the non-uric acid group were all higher than those in the control group,and were statistically significant（P<0.05）．The blood calcium levels of the patients in the uric acid group and the non-uric acid group were lower than those in the control group（SNK-q=3.918/3.047, P<0.05）．The blood phosphorus, blood SUA and blood LPS levels of the non-uric acid group were all lower than those of the uric acid group, and the differences were statistically significant （SNK-q=4.428, 4.555, 3.397, P<0.05）．The number of bifidobacteria in the intestines of patients in the uric acid group and the non-uric acid group was lower than that of the control group,and the differences were statistically significant（SNK-q=3.754, 3.143, P<0.05）．The number of lactobacilli in the intestines of patients in the non-uric acid group was higher than that of the control group and the uric acid group（SNK-q=4.105, 3.463, P<0.05）．The levels of blood uric acid and 24-hour urine uric acid in the uric acid group and the non-uric acid group were negatively correlated with the number of Bifidobacterium in the intestines（P<0.05）．Conclusions The number of intestinal bisidobacteria has a significant correlation with the metabolism of blood uric acid and urinary stones in patients with stones．

目的 探究老年脑梗死患者抑郁与共病之间的相关性。方法 选择2021年9月—2023年7月于开封市第五人民医院接受治疗的80例老年脑梗死康复期患者,均使用老年抑郁量表（GDS）对其进行评测,按照评测结果将患者区分为无抑郁组（n=39,GDS≤10分）和抑郁组（n=41,GDS>10分）,并按照受试者是否存在共病区分为不同亚组（如并消化系统疾患、并发循环系统疾患等）,对比不同亚组患者占比差异,并采用Pearson相关性分析的方式,分析入组80例老年脑梗死患者GDS评分与其Charlson共病指数（CCI）评分的相关性。结果 80例患者中抑郁占比为51.25%,对比显示共病循环系统、内分泌系统以及运动系统疾病的老年脑梗死患者抑郁发生率明显更高（P<0.05）;Pearson相关性分析显示老年脑梗死患者GDS评分与其CCI评分呈正相关（r=0.180,P<0.001）。结论 老年脑梗死患者抑郁发生率较高,对并发循环系统疾病、内分泌系统疾病、运动系统疾病的老年脑梗死患者应予以更多关注,预防抑郁的发生。

Objective To explore the correlation between depression and comorbidity in elderly patients with cerebral infarction．Methods A total of 80 elderly patients treated from September 2021 to July 2023 were selected．The patients were evaluated using the Geriatric Depression Scale（GDS）,patients were divided into the non-depression group（n=39,GDS≤10 points）and the depression group（n=41,GDS>10 points）,and they were divided into different subgroups（such as concurrent digestive disorders,concurrent circulatory disorders,etc.）．Comparing the differences in patient proportions in different subgroups,and the correlation between the GDS score and its Charlson comorbidity index（CCI）score in 80 elderly patients with cerebral infarction was analyzed with Pearson correlation analysis．Results The proportion of depression in 80 patients was 51.25%,showing a significantly higher incidence of depression in elderly patients with a comorbid circulatory system,endocrine system and motor system disease（P<0.05）;Pearson correlation analysis showed that GDS score in elderly patients with a cerebral infarction was positively correlated with their CCI score（r=0.180,P<0.001）．Conclusions The incidence of depression in elderly patients with cerebral infarction is relatively high,and more attention should be paid to elderly patients with concurrent circulatory system diseases,endocrine system diseases and motor system diseases to prevent the occurrence of depression．

目的 分析高原地区3~6年级学生屈光状态及屈光参数之间的关系。方法 2023年9月,采用随机抽样方法选取林芝市波密县某两所小学3~6年级535名学生进行校园筛查。计算并记录裸眼远视力（UCVA）,非睫状肌麻痹电脑验光下散光及其轴位、等效球镜（SE）、眼轴（AL）、角膜曲率半径（CR）和眼轴/角膜曲率半径轴率比（AL/CR）。采用SPSS 22.00统计软件分析数据。结果 3~6年级学生AL和AL/CR大体趋势为随年级升高而增长,SE随年级升高而降低。3~6年级学生总体筛查性近视患病率为29.91%,且3~6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%,其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA<5.0作为筛查性近视的诊断,AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534,曲线下面积（AUC）为0.802,优于AL评估（AUC=0.764）。结论 高原地区3~6年级学生的筛查性近视患病率随年级升高而快速增长,且散光患病率较高,视力不良者较多。AL／CR值对筛查性近视监测具有一定的临床意义。

Objective To analyze the relationship between refractive status and refractive parameters of students in grades three-six in plateau area．Methods In September,2023,a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County,Nyingchi City,for school screening．Distance uncorrected visual acuity（UCVA）,astigmatism and its axis position,equivalent spherical（SE）,axial length（AL）,corneal radius（CR）,and axial length/corneal radius ratio（AL/CR）were calculated and recorded．The data was analyzed using the statistical software SPSS 22.00. Results The general trend of AL and AL/CR for grade three-six students was increased with grade increasing,while SE decreased with grade increasing．The overall prevalence of screening myopia was 29.91%,and the prevalence of screening myopia in grades three to six was 20.35%,25.53%,30.53% and 51.38%,respectively．The overall prevalence rate of astigmatism was 51.59%,including 90.22%,7.61% and 2.17% for astigmatism with the rule,astigmatism against the rule and oblique astigmatism,respectively．About 40.37% of the students had poor vision．Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA<5.0．The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887,respectively,with a Youden index of 0.534 and an area under the curve（AUC）of 0.802．This was superior to the AL evaluation,which had an AUC of 0.764．Conclusions The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area．And there were high prevalence of astigmatism and more poor vision．AL/CR value has a certain clinical significance in the monitoring of screening myopia．

目的 探讨眼底豹纹斑密度（FTD）及视盘旁萎缩弧（PPA）与眼轴长（AL）的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组：A组（AL<23 mm）;B组（23 mm≤AL<24 mm）;C组（24 mm≤AL）。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1％。三组组间AL、AL/CR和SE比较均有统计学差异（P<0.05）。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异（P<0.05）,C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异（P<0.05）,Spearman相关性分析表明,AL与PPA（r=0.443）和FTD（r=0.322）呈正相关（P<0.001）。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关（P=0.028）,B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关（P<0.05）,C组仅PPA与AL呈正相关（P=0.005）。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。

Objective To investigate the correlation between fundus tessellated density（FTD）and peripapillary atrophy（PPA）with axial length（AL）,providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children．Methods This study randomly selected third-grade students from two primary schools in Liwan District,Guangzhou City,as research subjects．Axial length（AL）,corneal radius（CR）,and fundus color photographs were collected simultaneously during the school vision screening process．AI software was utilized to perform quantitative analysis on the fundus color photographs,with quantification indicators including the area size of PPA and FTD in different regions and ranges．Subjects were divided into three groups based on axial length：Group A（AL<23 mm）;Group B（23 mm≤AL<24 mm）;Group C（AL≥24 mm）．Results A total of 398 right eyes were included in the statistical analysis,with an age range of 8 to 11,a median age of 9,and 55.1% were male．There were significant statistical differences in AL,AL/CR,and spherical equivalent（SE）among the three groups（P<0.05）．Compared with Group B,Group A showed significant statistical differences in FTD in the overall posterior pole,the 3 mm diameter area centered on the fovea,and the superior area of the 3 mm foveal center（P<0.05）．Compared with Group B,Group C showed significant differences in PPA area and FTD in the overall posterior pole,the 4.5 mm diameter area centered on the optic disc,and the 3 mm and 6 mm diameter areas centered on the fovea（P<0.05）．Spearman correlation analysis indicated that AL was significantly positively correlated with PPA（r=0.443）and FTD（r=0.322）（P<0.001）．Subgroup correlation analysis showed that in Group A,only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL（P=0.028）．In Group B,PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL（P<0.05）．In Group C,only PPA was significantly positively correlated with AL（P=0.005）．Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children．PPA and FTD show significant positive correlations with AL,with varying degrees of correlation in different regions and ranges of FTD with AL．The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis．FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation,while PPA primarily manifests as a biomarker in the later stages of elongation．