To investigate the predictive value of total load of cerebral small vascular disease (CSVD) and triacyl-glucose body mass index (TyG-BMI) in early neurologic deterioration (END) of rt-PA intravenous thrombolysis in elderly patients with acute anterior circulation cerebral infarction over 60 years old.

Elderly patients aged over 60 years old with acute anterior circulation cerebral infarction who were hospitalized in the First People's Hospital of Suqian from July 2021 to July 2024 after rt-PA intravenous thrombolysis were retrospectively included. According to whether the NIHSS score has increased by≥4 points within 24 hours of intravenous thrombolysis, the patients were divided into END group and non END group. Clinical data and hematological indicators were collected. TyG-BMI was calculated. T test or Chi-square test was used to compared between the two groups. Total burden of CSVD was obtained based on MR Images. Multivariate Logistic regression analysis was used to determine the risk factors of END. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of risk factors to END.

A total of 242 old patients with acute anterior circulation cerebral infarction were included, including 67 patients in the END group and 175 patients in the non-END group. The results of the univariate analysis indicated that there were statistically significant differences in age, BMI, baseline NIHSS score, atrial fibrillation (AF), FPG, TG, LDL-C, TyG-BMI and total burden of CSVD in the END group (P < 0.05). Multivariate logistic regression analysis showed that Age, baseline NIHSS score, AF, total burden of CSVD and TyG-BMI were risk factors for END (P < 0.05). ROC curve analysis showed that the area under the curve for predicting END using total burden of CSVD and TyG-BMI were 0.763 (95%CI: 0.702-0.854, P < 0.01) and 0.755 (95%CI: 0.698-0.835, P < 0.01). The optimal cut-off values were 2.5 points and 218.74, respectively.

Both the total load of CSVD and the TyG-BMI have certain predictive value for END in elderly patients over 60 years old with acute anterior circulation cerebral infarction after rt-PA intravenous thrombolysis, and their combination offers higher predictive value.

To compare the efficacy and safety of bowel preparation using lactulose alone versus compound polyethylene glycol electrolyte powder in high-risk populations.

High-risk individuals who were scheduled to undergo colonoscopy in the Gastroenterology Department of the Second Hospital of Tianjin Medical University from July 2023 to June 2025 were selected and divided into a lactulose group (160 cases) and a compound polyethylene glycol group (160 cases) using a random number table method. The observation indicators included the adequacy rate of bowel preparation, Boston score, colonoscope lens clarity score, time of advancing and withdrawing the scope, detection rate of polyps and adenomas, interval time to the first defecation, blood electrolyte levels, blood glucose levels, blood pressure, blood creatinine levels, plasma osmolarity levels, and adverse reactions in both groups of patients. Additionally, a questionnaire was used to investigate the proportion of patients who were willing to use the bowel cleansing regimen again. T test was used to compared the measurement data, Chi-square test was used to compared the count data.

147 patients in the lactulose group and 145 patients in the compound polyethylene glycol group completed the study. The adequacy rate of bowel preparation, Boston score, and colonoscopy lens clarity score in the lactulose group were 72.8% (107/147), (6.67±1.24) points, and (1.28±0.33) points, respectively, while those in the polyethylene glycol compound group were 57.2% (83/145), (6.31±1.20) points, and (1.41±0.37) points, respectively. The differences were statistically significant (χ²=2.772, t=2.523, 2.521; P < 0.05 or P < 0.01). The detection rates of polyps and adenomas in the lactulose group were 51.7% (76/147) and 40.1% (59/147), respectively, while those in the compound polyethylene glycol group were 39.3% (57/145) and 28.3% (41/145), respectively. The differences were statistically significant (χ²=2.119, 2.126; P < 0.05). The mean time to the first defecation in the lactulose group was (1.16±0.44) hours, while that in the compound polyethylene glycol group was (1.44±0.97) hours, with a statistically significant difference (t=3.167, P < 0.01). The total incidence of adverse reactions after bowel cleansing and the proportion of patients willing to use the medication again in the lactulose group were 21.1% (31/147) and 95.2% (140/147), respectively, while those in the compound polyethylene glycol group were 46.9% (68/145) and 82.8% (120/145), respectively. The differences were statistically significant (χ²=4.564, 11.958; P < 0.01).

For high-risk populations, using lactulose alone for bowel preparation exhibits better cleansing efficacy and a higher adenoma detection rate compared to compound polyethylene glycol, along with a lower incidence of adverse reactions and minimal impact on blood circulation.

To explore the value of interpretable machine learning (ML) models based on magnetic resonance imaging (MRI) parameters in predicting sentinel lymph node metastasis (SLNM) in elderly patients with breast cancer.

This single-center retrospective study enrolled 93 elderly (≥60 years) breast cancer patients diagnosed between January 2019 and September 2025. Clinical data and preoperative dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) images were collected. LASSO regression was used for feature selection. Based on the selected five features, four predictive models were constructed: multivariate logistic regression, extreme gradient boosting (XGBoost), support vector machine (SVM), and random forest (RF). The models' discrimination ability was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity. Calibration and clinical net benefit were assessed via calibration curves and decision curve analysis. SHapley Additive exPlanations (SHAP) was employed for interpretability analysis of the best-performing model. T test was used to compared the measurement data, Chi-square test was used to compared the count data.

Forty-five cases were positive for sentinel lymph node biopsy (metastasis group), and 48 cases were negative (non-metastasis group). Compared with the non-metastatic group, the metastatic group exhibited higher proportion of Ki-67 high expression, larger tumor maximum diameter, higher long-to-short diameter ratio, higher proportions of annular enhancement and adjacent vascular proliferation, and higher early enhancement rate, along with a lower relative apparent diffusion coefficient (rADC), all with statistically significant differences (χ²=5.604, 3.930, 3.891; t=2.083, 4.313, 5.055, 2.408; P < 0.05 or P < 0.01). Five features were selected by LASSO for model construction: early enhancement rate, rADC, annular enhancement, long-to-short diameter ratio, and Ki-67 index. The XGBoost model demonstrated the best predictive performance (AUC=0.915, 95%CI: 0.870-0.950; accuracy=85.7%, sensitivity=83.3%, specificity=86.7%), with its calibration curve closest to the ideal diagonal and the highest clinical net benefit in the probability threshold range of 0.2-1.0. SHAP analysis revealed that early enhancement rate contributed the most to the model predictions, followed by rADC, annular enhancement, Ki-67 index, and long-to-short diameter ratio.

The XGBoost model integrating preoperative multiparametric MRI and clinical variables can effectively predict sentinel lymph node metastasis status in elderly breast cancer patients. SHAP interpretability analysis elucidates the contribution of key imaging and pathological features, enhancing model transparency and clinical credibility.

To observe the efficacy of Tanreqing injection combined with bronchoalveolar lavage via bronchoscopy in the treatment of severe pneumonia in elderly patients.

A total of 108 elderly patients with severe pneumonia admitted to the Second Hospital of Tianjin Medical University from June 2022 to June 2025 were selected and randomly divided into a control group and an observation group using a random number table method, with 54 cases in each group. The control group was treated with bronchoalveolar lavage via bronchoscopy, while the observation group was treated with Tanreqing injection combined with bronchoalveolar lavage via bronchoscopy. The efficacy, pulmonary function, arterial blood gas, inflammatory response, and adverse reactions were compared between the two groups. T test was used to compared the measurement data, Chi-square test was used to compared the count data.

The total effective rate in the observation group was significantly higher than that in the control group (χ²=6.000, P < 0.05). After treatment, the levels of forced expiratory volume in one second, peak expiratory flow, forced vital capacity, arterial oxygen saturation, and partial pressure of arterial oxygen in the observation group were higher than those in the control group (t=3.491, 3.032, 3.414, 7.914, 7.107; P < 0.01), while the levels of residual volume/total lung capacity, partial pressure of arterial carbon dioxide, procalcitonin, C-reactive protein, and white blood cell were lower than those in the control group (t=5.051, 10.913, 4.933, 7.730, 5.421; P < 0.01). The recovery time of clinical signs, sputum culture conversion time, and inflammatory lesion absorption time in the observation group were significantly shorter than those in the control group (t=5.257, 7.391, 6.762; P < 0.05).

Tanreqing injection combined with bronchoalveolar lavage via bronchoscopy in the treatment of severe pneumonia in elderly patients can alleviate pulmonary inflammation, improve clinical symptoms, arterial blood gas, and pulmonary function.

To explore the application of serum creatinine (Scr), blood urea nitrogen (BUN), and interleukin-21 (IL-21) in the efficacy evaluation of elderly patients with stage 2-3 chronic kidney disease.

A total of 168 elderly patients with chronic kidney disease admitted to Huangshi Traditional Chinese Medicine Hospital from January 2020 to February 2022 were selected. After 3 months of systematic and standardized treatment, the clinical efficacy was evaluated. At the same time, fasting venous blood samples were collected from patients in the morning to measure serum levels. The expression levels of Scr, BUN, IL-21 and their clinical significance were compared and analyzed in patients with different therapeutic effects. Analysis of variance was used to compared the measurement data, Chi-square test was used to compared the count data, and multiple linear regression was usd to analyzed the correlation.

Out of 168 elderly CKD patients treated, 47 were cured, 84 showed significant improvement, 31 were effective, and 16 were ineffective. There were statistically significant differences in CKD staging, disease type, duration, and Scr, BUN, and IL-21 levels among elderly CKD patients with different clinical efficacy (χ²=33.253, 25.465; F=2.924, 17.738, 12.947, 7.374; P < 0.05 or P < 0.01). Multiple linear regression analysis showed that high disease staging and high levels of Scr, BUN, and IL-21 were risk factors for clinical efficacy in elderly CKD patients (t=-5.270, -4.010, -4.615, -3.278; P < 0.01).

There are significant differences in the expression levels of Scr, BUN, and IL-21 among elderly CKD patients with different clinical efficacy, which can serve as auxiliary indicators for clinical efficacy evaluation.

Systemic hemodynamic atherosclerotic thrombosis syndrome (SHATS) is a syndrome of systemic atherosclerotic vascular diseases. It is caused by the pulsatile hemodynamic stress (i.e., blood pressure variability, BPV) generated by central arterial pressure and blood flow, combined with multiple thrombotic and metabolic risk factors, and driven by their interaction and synergy. It often leads to damage in multiple target organs such as the heart, brain, and kidneys. Assessment and intervention for BPV and arterial diseases can not only delay the progression to hypertension in young patients but also reduce the risk of cardiovascular disease and organ damage in elderly patients. This article systematically reviews the pathophysiological mechanisms of SHATS, including the vicious cycle between BPV and arterial stiffness, as well as its impact on target organ damage and cardiovascular event risk. It also summarizes and provides an outlook on the diagnosis, scoring criteria, and treatment of SHATS, aiming to deepen the clinical understanding of SHATS and offer new perspectives for the early identification and intervention of cardiovascular risk.