Early screening of non-alcoholic fatty liver disease (NAFLD) is critical for early diagnosis and management. The disease was renamed and its diagnostic criteria revised as metabolic-associated FLD (MAFLD) in 2020 and further updated to metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023. This study evaluated the predictive performance and clinical feasibility of non-invasive diagnostic indicators across the NAFLD, MAFLD and MASLD diagnostic criteria.
Cross-sectional study.
Health Management Centre in China.
A total of 5810 participants aged ≥18 years were enrolled. Individuals with missing laboratory data, imaging results or self-reported information were excluded.
Disease-specific indicators included Fatty Liver Index (FLI), Hepatic Steatosis Index and Zhejiang University index (ZJU). Non-disease-specific indicators included lipid accumulation product (LAP), Visceral Adiposity Index and the Triglyceride and Glucose Index. Subgroup analysis was performed by gender and Body Mass Index (BMI).
The area under the receiver operating characteristic curve (AUROC) for all six non-invasive indicators exceeded 0.7. FLI showed the optimal predictive performance across the three criteria (NAFLD-AUROC: 0.802, MAFLD-AUROC: 0.847 and MASLD-AUROC: 0.811), with comparable performance observed for ZJU (0.797, 0.838 and 0.809, respectively). Pairwise z-tests demonstrated a significant difference between FLI and ZJU for MAFLD (p0.05). Subgroup analyses revealed that ZJU performed better in males (NAFLD-AUROC: 0.790, MAFLD-AUROC: 0.839 and MASLD-AUROC: 0.803), while FLI was superior in females (NAFLD-AUROC: 0.832, MAFLD-AUROC: 0.838 and MASLD-AUROC: 0.838) and in participants who were overweight (NAFLD-AUROC: 0.709, MAFLD-AUROC: 0.765 and MASLD-AUROC: 0.709). LAP exhibited the highest predictive efficacy in the normal BMI subgroup (NAFLD-AUROC: 0.758, MAFLD-AUROC: 0.804 and MASLD-AUROC: 0.796).
FLI exhibited the highest predictive efficacy across all diagnostic criteria, and ZJU showed comparable performance. Considering diagnostic accuracy and clinical practicality, ZJU is recommended as a favourable, non-invasive tool for population-based screening in the Chinese population.
This study aims to investigate the predictors of very poor outcomes in patients with acute ischaemic stroke due to large vessel occlusion after successful endovascular thrombectomy.
A multicentre, retrospective study.
Data were derived from tertiary care facilities in five cities of China.
This study included 1242 patients with anterior circulation large-vessel occlusion who underwent endovascular thrombectomy, and they were stratified by 90-day modified Rankin Scale (mRS) scores into a very poor outcome group (mRS 5–6) and a non-very poor outcome group (mRS 0–4).
The primary outcome was very poor outcomes. Data from 1242 patients were analysed for demographic, laboratory, imaging and perioperative data.
Among the 1242 recruited patients, 318 (25.60%) exhibited very poor outcomes. In multivariate analysis, predictors of very poor outcomes were higher age (OR 1.059, 95% CI 1.043 to 1.075, p
The very poor outcomes were associated with advanced age, CHD history, stroke history, high NIHSS score, high neutrophil count, low ASPECTS and presence of MCE and sICH, while receiving intravenous thrombolysis was a protective factor. These poor outcome predictors might play a crucial role in informing clinical decision-making.
ClinicalTrials.gov (NCT06290076); pre-results.
This study aims to determine the incidence and impact of ocular injuries among the different combat sports disciplines of boxing, mixed martial arts (MMA), kickboxing and Muay Thai in Texas, USA.
A case–control study was conducted to analyse retrospective postmatch physical reports from combat sports matches that took place in the state of Texas from January 2019 to January 2022. Ocular injuries and other match characteristics such as sport type and match outcome were identified by postmatch physical reports. Postmatch physical reports were collected from the Texas Department of Licensing and Regulation database. Statistical analysis was used to stratify injuries and compare the impact of injuries on match outcome.
Combat sports fighters in Texas, USA.
3070 participants were included in the study. Participants were fighters who participated in combat sports matches in Texas, USA, between January 2019 and January 2022.
The original plan was to measure the incidence of ocular injuries across different combat sports including boxing, MMA, kickboxing and Muay Thai. However, due to a limited sample size of kickboxing and Muay Thai matches, the ocular injury incidence was only measured for boxing and MMA. The association between ocular injury and match outcome was assessed using 2 statistical analysis.
The respective incidence rates of ocular injuries in boxing and MMA were 9.7 and 12.2 injuries per 100 matches. The association between ocular injury and match outcome (win, lose or draw) was statistically significant in boxing but not statistically significant in MMA matches.
Our findings revealed that ocular injuries are significantly associated to losing a boxing match (p=0.011), but not associated to match outcome in MMA (p=0.232). Additionally, MMA matches report a larger variety of ocular injuries compared with boxing matches.
Prognosis estimation is the basis for establishing the personal interventions in sepsis patients. Serum biomarkers are potential tools for predicting the outcomes of sepsis patients admitted to the intensive care unit (ICU). Here, we plan to perform a prospective study to investigate the prognostic value of serum biomarkers. We named this study Hospital Outcome of Host Heterogeneity, Organ dysfunction and Trajectory in sepsis (HOHHOT).
This prospective cohort study is being performed in several hospitals in the Inner Mongolia Autonomous Region between 2025 and 2027. The inclusion criteria were adult sepsis patients admitted to the ICU. A serum specimen will be collected at the onset of sepsis and stored at –80°C for future use. The endpoint of the HOHHOT study includes, but is not limited to, hospital outcome (eg, mortality, occurrence of organ dysfunction, treatment response and the progression of sepsis). We will analyse the predictive value of serum biomarkers for outcomes using a receiver operating characteristic curve and decision curve analysis. The association between baseline characteristics and serum biomarkers will be estimated using a logistic regression model, net reclassification index and integrated discriminatory index. We will also construct some predictive models using machine learning algorithms.
The HOHHOT study has been approved by the Ethics Committee of the Affiliated Hospital of Inner Mongolia Medical University (NO: KY2025005). The findings derived from the HOHHOT study will be submitted to international academic journals.
Chinese Clinical Trial Registry (ChiCTR2500100770); pre-results.
Premature acute coronary syndrome (PACS) presents with a poor prognosis and significant risks. This study aimed to investigate the association between small-dense low-density lipoprotein cholesterol (sdLDL-C) levels and the severity of coronary lesions, as well as its potential role in risk stratification for PACS patients with multivessel disease (MVD).
Retrospective cross-sectional study.
First Affiliated Hospital of Xinjiang Medical University in China, between May 2022 and November 2023.
900 PACS patients with MVD confirmed by coronary angiography (CAG) and 600 age-matched and sex-matched controls with normal CAG results.
Patients with PACS and MVD were stratified by the Global Registry of Acute Coronary Events (GRACE) score, and sdLDL-C levels were compared among the different GRACE score groups. The association between sdLDL-C and the GRACE score was evaluated using Pearson’s correlation analysis. Multivariate logistic regression analysis was employed to identify factors associated with PACS and MVD. The discriminatory ability of sdLDL-C for PACS with MVD was assessed using receiver operating characteristic (ROC) curve analysis. Restriction cubic spline (RCS) analysis was used to examine the potential nonlinear association between sdLDL-C levels and the high-risk groups of PACS with MVD.
Patients with PACS and MVD exhibited significantly higher sdLDL-C levels compared with control group (p
Elevated sdLDL-C levels demonstrated a significant association with the risk of PACS and MVD. These findings indicate sdLDL-C may serve as a potential biomarker for risk stratification in this high-risk population. However, causal inferences require validation in prospective studies.
ChiCTR2300074166
Proximal gastrectomy (PG) has emerged as the preferred surgical approach for adenocarcinoma of the upper 1/3 stomach and selected cases of oesophagogastric junction adenocarcinoma. We developed a novel oesophagogastric anastomosis technique with an antireflux mechanism (Hao’s Esophagogastrostomy by Fissure Technique). It may have a superior effect on patient weight maintenance compared with the double-tract reconstruction. We intend to conduct a prospective, multicentre, randomised controlled clinical trial to validate this hypothesis.
The primary objective evaluates body weight loss at 12 months postoperatively. Secondary objectives assess surgical safety through comprehensive analysis of complication rates and nutritional parameters, including serial haematological evaluations during follow-up. The study will enrol 52 participants across multiple centres with planned 3-year longitudinal monitoring to evaluate both immediate postoperative outcomes and intermediate-term clinical impacts.
This study was approved by the hospital institutional review board of Huashan Hospital, Fudan University (2024-1173) and is being conducted in accordance with the Declaration of Helsinki and the Good Clinical Practice guidelines. On completion of the study, the results will be published in a peer-reviewed journal.