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Background and Objectives: In the last month of 2019, the novel Coronavirus (COVID-19) emerged in Wuhan, China, and raised worldwide attention. The clinical manifestation of COVID-19 ranges from respiratory to organ failure. In this regard, cardiovascular complications have caused significant concern due to the increasing reports.   Methods: In this study, we aimed to investigate the cardiovascular complications caused by COVID-19 in patients admitted to Ghaem Hospital in Mashhad, between June 2020 and June 2021. All patients with a definite diagnosis of COVID-19 admitted to the hospital with cardiac consultation were included and followed using patient files and the Hospital Information System (HIS).   Results: Of the 3,628 patients with a confirmed COVID-19 diagnosis, 54.4% were men and 45.5% were women, with an average age of 68.34 ± 15.47 years. About 15% of these patients required cardiac consultation, and cardiovascular complications were identified in 154 patients (27.2%) who had cardiac consultations. The most common complications were coronary artery ischemia (37.7% of cases), atrial fibrillation (22.7%), and heart failure (11.7%). Mortality among those with cardiovascular complications was significantly higher than in those without, with 55.8% of ICU patients succumbing compared to 36% in the general ward.   Conclusion: Based on the results obtained from the present study, the mortality rate in patients who underwent cardiac consultation is significantly higher, also, it appears that coronary artery ischemia is the most common cardiac complication following AF (atrial fibrillation) and heart failure.
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 Background and Objectives: Gastrointestinal stromal tumors (GIST) are a rare group of tumors occur from the mesenchymal tissue of the gastrointestinal tract. Many classifications have been developed to assess the survival of GISTs. Aim of this study is to evaluate the effects of tumor characteristics and existing classification systems on survival in GISTs.    Methods: Study was conducted as a single center retrospective cohort study. We evaluated pathology results and the medical records of patients who had surgery for GIST at Tepecik Training and Research Hospital between 2010 and 2020 retrospectively.   Results: A total of sixty-eight patients were detected. Thirty-three (48.5%) of the patients were male and the mean age at initial diagnosis was 60.8±11.9 years. Thirty-seven (54.4%) of the primary tumor was localized in the stomach and the median tumor size was 6.8 cm. Mortality rate was higher in patients with irregular tumor contour (P=0.044). Mortality rate was higher in patients with colonic GIST (P=0.026). Armed Forces Institute of Pathology (AFIP) was found as the best classification system that could assess the prognosis (AUC:0.758 (0.644-0.872), P=0.001). Among various factors, only the mitotic index was found as a risk factor in the development of recurrence (HR (95%CI): 1.019 (1.006-1.032), P=0.004).     Conclusion: The best prognostic factor for disease-free survival in GISTs is the mitotic index. In addition, Ki-67 index, tumor size, presence of necrosis and hemorrhage should be considered as other factors that may be related to disease-free survival. Colorectal GISTs have the worst postoperative mortality and recurrence rates.
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Background and Objectives: Atherosclerosis (AS) is a major cause of cardiovascular disease with complex immune-mediated pathogenesis. This study aimed to identify hub immune-related genes involved in AS and investigate their causal mechanisms using comprehensive bioinformatics and experimental approaches.   Methods: Differentially expressed immune-related genes (DE-IRGs) were identified from GSE20129 dataset (48 AS, 71 controls) using bioinformatics analysis (|log2 fold change| > 1.0, adjusted p-value < 0.05). Functional enrichment, protein-protein interaction network analysis, and immune cell infiltration analysis were performed. A nomogram model for AS risk prediction was developed and validated internally. Mendelian randomization (MR) analysis explored causal relationships between hub genes and AS. STAT1 function was experimentally validated using siRNA knockdown in RAW264.7 cells treated with LPS (100 ng/mL, 24h) followed by qPCR, migration, and cytokine assays.   Results: We identified 125 DE-IRGs primarily involved in cytokine signaling and leukocyte functions. Ten hub DE-IRGs were identified, with STAT1 having the highest connectivity. The nomogram model demonstrated good predictive performance (calibration curve with minimal deviation). MR analysis revealed a potential causal relationship between STAT1 levels and AS susceptibility (OR=0.916, 95%CI=0.835-1.004, P=0.042). Experimental validation showed STAT1 knockdown significantly reduced LPS-induced inflammatory cytokine production and macrophage migration.   Conclusion: This study provides valuable insights into the molecular pathogenesis of AS through integrated bioinformatics, MR analysis, and experimental validation. The identified hub genes, particularly STAT1, represent promising candidates for targeted interventions in AS management and prevention.
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Background and Objectives: Circular RNAs (circRNAs) are gaining attention as potential biomarkers and regulators in various biological processes, including cancer. Their role in breast cancer and chemotherapy response monitoring is particularly promising. This study investigates the expression profiles of hsa_circ_0008717/circABCB10 and hsa_circ_0065173 in the peripheral blood of breast cancer patients before and after chemotherapy, aiming to identify non-invasive possible biomarkers for treatment response.   Methods: The expression levels of hsa_circ_0008717/circABCB10 and hsa_circ_0065173 were quantified in peripheral blood samples obtained from breast cancer patients using SYBR-Green Real-Time RT-qPCR before and after chemotherapy.   Results: Both hsa_circ_0008717/circABCB10 and hsa_circ_0065173 were exclusively expressed in breast cancer patient’s blood. Elevated levels were significantly associated with lymph node involvement and metastasis (P<0.0001) and advanced disease stages. While hsa_circ_0008717/circABCB10 levels did not significantly change before and after chemotherapy (P=0.24), hsa_circ_0065173 expression decreased significantly post-chemotherapy (P<0.004).   Conclusion: The expression of hsa_circ_0008717/circABCB10 and hsa_circ_0065173 in blood samples shows promise as diagnostic biomarkers and prognostic indicators for breast cancer. Notably, hsa_circ_0065173 appears to be a potential candidate for monitoring chemotherapy response. 
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Background and Objectives: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast whose pathogenesis is not yet fully understood. While the literature reports an association between IGM and arthritis and/or erythema nodosum (EN)  in a small number of patients, the diagnosis and treatment of these individuals are not well-documented. The objective of this study is to present our case series of patients with IGM and EN and/or arthritis, to discuss the incidence, characteristics, and treatment approaches of these cases in more detail.    Methods: We performed a retrospective analysis of patients who were treated for histologically confirmed IGM at our medical center between 2015 and 2022. Additionally, patients who exhibited concurrent symptoms of EN and arthritis were identified and grouped for further analysis of their treatment regimens and outcomes. Statistical comparisons were performed using chi-square and Fisher’s exact tests; a P < 0.05 was considered statistically significant.   Results: Our general surgery clinic followed up with 153 patients diagnosed with IGM, who had a mean age of 38.2 ± (8.84) and were mostly women of reproductive age.  The definitive diagnosis was confirmed through incisional biopsy and core needle biopsies. EN was present in 31 (20.2%) patients, and inflammatory arthritis was present in 28 (18.3%) patients. In the 13 patients with this triple association, recurrence rates were higher despite a response to antibiotics and steroids.    Conclusion: IGM is a challenging disease to diagnose and manage due to its complexity. It can occur concomitantly with EN and arthritis, and we suspect its frequency is higher than previously anticipated. Recognizing these distinct entities emphasizes the need for a multidisciplinary approach to diagnosing the condition.
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Objective To systematically evaluate the effect of multimodal preemptive analgesia in the rehabilitation of patients after thoracoscopic lung surgery. Methods Randomized controlled trials on the use of multimodal preemptive analgesia in the rehabilitation of patients undergoing thoracoscopic lung surgery were retrieved from the Cochrane Library, Web of Science, Embase, PubMed, CBM, Wan fang, CNKI, and VIP.The retrieval period was from the establishment of the databases to February 28, 2023. Literature screening, data extraction and quality assessment of included literature were carried out by two researchers. The meta-analysis was performed using RevMan5.3 software. Results A total of 576 patients from 8 articles were finally included. The meta-analysis results showed that the incidence of postoperative pulmonary complications in the experimental group was lower than that in the control group (P<0.00001). Three days after surgery, the pain score in the experimental group was lower than that in the control group (P=0.002). The incidence of adverse reactions in the experimental group was lower than that in the control group (P<0.00001). The number of days of hospitalization in the experimental group was significantly lower than that in the control group (P<0.00001), and the number of days of chest tube retention in the experimental group was significantly lower than that in the control group (P=0.004). The dose of opioids in the experimental group was lower than that in the control group (P=0.01), and the number of postoperative analgesia additions in the experimental group was lower than that in the control group (P<0.00001). Conclusion The existing evidence that multimodal preemptive analgesia can effectively reduce the thoracoscope lung surgery in patients with postoperative pain, reduce the incidence of postoperative pulmonary complications and analgesia incidence of adverse reactions, decrease the times of opioid usage and postoperative analgesia drug additional shorten the chest tube indwelling time and hospitalization time, and promote patient recovery.
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Background and Objectives: Although the COVID-19 pandemic has been declared over, endemic cases continue, and hospitals still play a pivotal role in managing the disease. This study aims to assess the readiness and capacities of hospitals in Ilam Province, Iran, in managing COVID-19.   Methods: This cross-sectional facility-based survey was conducted in November 2023 across all 13 hospitals in Ilam Province. The adopted version of the tool developed by the World Health Organization (WHO) was used to collect and analyze the data.   Results: Of the 3,975 total hospital staff, 99.4% had received at least one dose of the COVID-19 vaccine, and 99.1% had received at least two doses. 4.8% of staff were diagnosed with COVID-19 the previous month, with the highest infection rate among nurses (6.1%) and the lowest among radiology staff (0%). Up-to-date national guidelines, policies, and standard operating procedures for infection prevention and control (IPC) regarding COVID-19 were available in all hospitals. The average scores for hospital readiness in training and supportive supervision, IPC, and availability of medicines and equipment were 10.7 out of 11, 24.6 out of 26, and 23.9 out of 28, respectively.   Conclusion: The status of inpatient COVID-19 management capacities in hospitals of Ilam Province is generally favorable. However, the availability of necessary medicines and equipment requires more attention.
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 Background and Objectives: Early revascularization of occluded coronary arteries in patients with ST-elevation myocardial infarction (STEMI) has been shown to reduce mortality. Currently, physicians rely on electrocardiographic (ECG) features to identify the most likely location of occlusion in coronary arteries. We sought to more accurately predict these culprit arteries using deep learning.   Methods: This retrospective case-control study was conducted to diagnose culprit lesion based on ECG using artificial intelligence (AI) in patients with STEMI referred to Imam Khomeini Hospital and Tehran Heart Center, Tehran, Iran. In this study, 804 patients who underwent coronary angiography (CAG) in STEMI setting were included. Subsequently, the ECG and angiography data of these patients were reevaluated, and AI experts analyzed the ECG and CAG using the EfficientNet_B7 algorithm, a deep learning approach that employs convolutional neural networks for high accuracy and computational efficiency. Finally, the presented model was analyzed.   Results: This study evaluated a cohort of 804 patients. The proposed architecture, based on the EfficientNet_B7 algorithm, effectively integrates Transfer Learning and EfficientNet techniques to optimize data pre-processing prior to network input. A learning rate of 1×10−4 was employed to facilitate gradual weight updates, while a batch size of 32 was selected, thereby minimizing the risks of overfitting and underfitting. The training dataset was divided into 70% for training, 15% for validation, and 15% for testing, with the network's error function determined using Binary Cross Entropy loss. These findings underscore the potential of AI-driven approaches in enhancing diagnostic accuracy. Utilizing an AI model for ECG signal analysis, we achieved an impressive overall prediction accuracy of 98%. The model demonstrated a sensitivity of 96% and precision of 98% in identifying the left anterior descending (LAD) artery as the culprit vessel.   Conclusion: Deep learning has the potential to enhance the diagnosis of culprit vessel in patients with STEMI. Our model successfully detected LAD occlusion in STEMI with 98% accuracy, 96% sensitivity, and 98% F1-score.
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Background and Objectives: Crush syndrome (CS) is a significant metabolic disorder commonly observed after earthquakes, with inflammatory processes playing a key role in its pathophysiology. This study aimed to evaluate the clinical utility of inflammatory indices, including the Systemic Inflammatory Index (SI), Systemic Inflammation Response Index (SIRI), and Pan-Immune-Inflammatory Value (PIV).    Methods: Our study was conducted retrospectively at a single centre. A total of 278 patients admitted to the emergency department due to post-earthquake trauma were included in the study as the trauma group. This group was further divided into two subgroups: the non-crush trauma group (n=115) and the CS group (n=163). Additionally, 168 patients admitted to the emergency department for non-traumatic causes during the same period were included as the control group. The three groups were retrospectively compared based on SI, SIRI, and PIV values, as well as their predictive ability for key clinical outcomes, including the need for hemodialysis, hospitalization, prediction of CS and mortality. Receiver operating characteristic (ROC) analysis was used to determine the predictive values.    Results: SIRI demonstrated the highest accuracy in predicting CS (AUC = 0.829, P < 0.001). SI was the best predictor of hospitalization (AUC = 0.778, P < 0.001), while SIRI showed superior performance in predicting the need for hemodialysis (AUC = 0.799, P < 0.001).    Conclusion: SI, SIRI and PIV can help clinicians in predicting CS, the need for hemodialysis, critical care and therefore the need for hospitalization.
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Background and Objectives: Effective evaluation is a critical component of disaster preparedness exercises, yet there is a notable lack of structured frameworks to support evaluators in complex scenarios. This study aims to design a structured framework based on critical systems methodologies to conduct the activities of the disaster exercise evaluators.   Methods: An embedded mixed method study was carried out in three phases: first, identifying evaluator activities using document review and interviews with 12 experts selected through purposive sampling and using qualitative content analysis; second, developing the framework using Team Syntegrity and Social Network Analysis; and third, validating it by an operational exercise in Tehran using quantitative exercise evaluation results from a purposive selection of 30 evaluators and analysis using Ucinet & NetDraw software.   Results: Evaluator activities were initially grouped into six groups. These activities were further refined and 30 key activities integrated into a structured framework consisting of four core phases aligned with the disaster exercise timeline: 1) concept and planning, 2) exercise conduct, 3) exercise evaluation, and 4) post-exercise evaluation. The application of the framework during an emergency accommodation exercise held in Tehran revealed valuable insights for planners in 12 areas of learning based on the findings of the quantitative and qualitative analysis presented.   Conclusion: The proposed framework demonstrates the potential to enhance communication, role clarity, and learning outcomes across all phases of the exercise cycle. Future efforts should focus on adapting evaluation methods to account for exercise complexity and integrating systems thinking to enhance learning and preparedness capabilities.
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Background and Objectives: Hospitalized children are particularly vulnerable to medical errors, which can have profound long-term effects on their health and development. Adverse events resulting from these errors contribute to significant morbidity and mortality in pediatric patients. Effective interventions to minimize errors are critical in improving patient safety. This systematic review aims to evaluate the effectiveness of interventions designed to reduce adverse events in pediatric hospital departments.    Methods: Following PRISMA 2020 guidelines, we searched Embase, PubMed, Google Scholar, Scopus, Cochrane Library, and Web of Science for studies published up to September 3, 2024. The search strategy was based on key terms including pediatric adverse events, medical errors, medicinal errors and medication error. We included randomized controlled trials, quasi-experimental studies, and before-and-after studies assessing interventions to reduce adverse events in pediatric departments. The primary outcome was the reduction of medicinal and non-medicinal errors. Risk of bias was assessed using the Cochrane Risk of Bias tool.    Results: A total of 23 studies, covering 22,871 participants from multiple countries, were included. Most studies (n = 19) focused on reducing medicinal errors, while four addressed non-medicinal errors. Interventions such as pharmacist-led strategies, technology-based solutions, educational programs, labelling tools, pictogram-based interventions, checklists, and multifaceted approaches were generally effective. Nineteen studies reported a significant reduction in error rates, while four found no significant impact.    Conclusion: Although various interventions effectively reduced pediatric medical errors, some studies demonstrated limited effectiveness. Factors such as small sample sizes, risk of bias, and observational designs affect the generalizability of findings.
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   Background and Objectives: Interleukin 8 (IL-8) is a major mediator involved in the development and progression of liver cancer. In this study, we assess whether IL-8 controls the expression of MMP-9 during the progression of liver cancer.   Methods: The expression levels of IL-8, MMP-9, CXCR1, and CXCR2 in liver cancer cells with/without IL-8 knockdown or IL-8 treatment were determined by qRT-PCR and western blotting. Wound healing and Transwell assays were performed to assess the effects of IL-8-and IL-8/MMP-9-blocking antibodies on cell migration and invasion. The effects of GROα and CXCR2-neutralizing antibody on MMP-9 expression were also evaluated.   Results: IL-8 and MMP-9, which were highly expressed in Huh-7 cells, were reduced by IL-8 knockdown. IL-8 treatment enhanced the expression levels of IL-8, MMP-9, CXCR1, and CXCR2. IL-8-neutralizing antibody inhibited liver cancer cell motility. MMP-9-neutralizing antibody counteracted IL-8 promotion of malignant characteristics. The IL-8-induced MMP-9 release was partially reversed by CXCR2-neutralizing antibody, but not CXCR1-neutralizing antibody. Furthermore, GROα-mediated MMP-9 release was counteracted by CXCR2-neutralizing antibody.   Conclusion: The present study showed that IL-8 increased MMP-9, CXCR1, and CXCR2 expression and enhanced motility in Huh-7 liver cancer cells. These results suggested that IL-8 promotes liver cancer cell migration and invasion by upregulating MMP-9, primarily through the CXCR2 signaling pathway.
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Background Post-discharge management for elderly patients with chronic obstructive pulmonary disease (COPD) is often insufficient, leading to poor patient outcomes and high readmission rates. This study addresses the critical need for comprehensive, technology-driven health management models to support this vulnerable population. Objectives This research seeks to evaluate the effectiveness of a comprehensive digital health management approach, known as 'Internet Plus', for older adults living with COPD. Methods This study was a randomized controlled trial (RCT) involving 100 elderly COPD patients (age > 70). Patients were randomly assigned to an intervention group (n=50) or a control group (n=50). The intervention group received a comprehensive 'Internet Plus' health management model for three months, which included a personal health platform (via app and WeChat), remote data collection of vital signs, and interactive health coaching. The control group (n=50) received standard nursing care and episodic telephone follow-up. The COPD Assessment Test (CAT score) and a Self-Management Ability Scale were assessed for both groups at baseline and after the three-month intervention. Results After three months, the intervention group showed significantly higher self-management ability (145.34 ± 6.54) compared to the control group (141.75 ± 7.28; P=0.021). The intervention group also reported a significantly better quality of life (lower CAT score) (14.43 ± 2.79) than the control group (16.82 ± 3.31; P<0.001). Conclusions Implementing a comprehensive digital health management approach, known as 'Internet Plus', for older adults with COPD significantly enhances their self-care capabilities and overall well-being.
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Background: One of the most common diagnostic and therapeutic methods in heart patients is coronary angiography, which increases the level of anxiety. Anxiety is itself a predisposing factor in heart problems. This study aimed to determine the effect of acupressure at GV20 and BL62 points on anxiety levels in patients undergoing coronary angiography.   Methods: this randomized clinical trial study was performed on 102 candidates for coronary angiography at Farshchian Heart Hospital in Hamadan, Iran, in 2020. Eligible patients were randomly divided into three groups. The two intervention groups received hypertension one half hour before angiography for 5 minutes at GV20 and BL62 and the control group did not receive any intervention. Patients' anxiety was measured before and one hour after the intervention. Data collection tools were demographic information questionnaire and Spielberger anxiety questionnaire.   Results: The mean score of anxiety in the three groups before the intervention was significantly different (P<0.05). One hour after the intervention, by adjusting the effect of heterogeneous variables, the level of anxiety in the two experimental groups was significantly lower than the control group (P<0.05), but there was no significant difference between the two experimental groups (P>0.05).    Conclusion: Acupressure is effective in reducing anxiety in patients undergoing coronary angiography; therefore, it can be suggested as a method to reduce anxiety before angiography.
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Objectives: To map EBI-after-SAH research using a title-level WoS bibliometric analysis and to identify major contributors, outlets, thematic distribution, and funding patterns. Methods: We searched the WoS Core Collection for title records containing “early brain injury” AND “subarachnoid hemorrhage,” including original SCI/SCI-E articles published before January 1, 2024. We extracted publication year, language, journal/publisher, authors, institutions, countries, WoS categories, funding information, and citation counts, and summarized the corpus using descriptive statistics. Results: Of 416 records, 331 met eligibility. Output rose after 2014, peaking in 2016 and 2021 (n=36 each) and 2022 (n=39). All included articles were published in English per the inclusion criteria; 45.9% were open access. As of January 1, 2024, total citations were 10,815 (mean 32.7 per article). Publications appeared in 132 journals; Brain Research ranked first (n=16). Elsevier and Springer Nature led publishers. China contributed the most articles (n=273), followed by the United States (n=56) and Japan (n=19). Across 38 WoS categories, Neurosciences and Clinical Neurology predominated. Among 1,406 authors, the most prolific contributors included Chen G., Wang Z., and Zhang J.H. Funding was reported in 299 articles, most frequently from the National Natural Science Foundation of China (n=150), followed by NIH and HHS (n=31 each). Conclusions: This title-level corpus shows rapidly growing EBI–SAH output with substantial citation impact, driven mainly by China and the United States, and spanning mechanistic and clinical domains.
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Background and Objectives: Psychological resilience plays a crucial role in child development, impacting emotional and behavioral outcomes. Understanding the dynamics of family functioning and parent-child conflict is essential for addressing internalizing problems in children. This study examines the influence of maternal psychological flexibility on internalizing problems in preschool children, while also investigating how family functioning and parent-child conflict mediate this relationship.    Methods: A total of 889 mothers of preschool children participated, completing various assessments, including the Parental Psychological Flexibility Questionnaire, the Strengths and Difficulties Questionnaire (Parent version), the McMaster Family Assessment Device, and the Child-Parent Relationship Scale.    Results: The results indicated that maternal psychological flexibility by itself had no significant effect on children's internalizing problems. However, it was found that family dynamics and conflicts between parents and children served as mediators in this relationship. In essence, these two elements combined to shape how maternal flexibility influenced children's emotional difficulties. Enhancing maternal psychological flexibility can contribute to improved family functioning, reduced parent-child conflict, and ultimately aid in preventing and alleviating children's internalizing problems.    Conclusion: This study used an artificial neural network (ANN) to investigate the relationships between maternal psychological flexibility, family functioning, parent-child conflict and children's internalizing problems. The neural network predictions were verified using cross-validation techniques.
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Background and Objectives: Colorectal cancer is a major health problem worldwide, and major complications after rectal cancer surgery seriously affect patient prognosis. This study aimed to investigate the relationship between body composition parameters and major complications after rectal cancer surgery using the CoreSlicer artificial intelligence-based application.   Methods: A retrospective study was conducted on 271 patients who underwent surgery for rectal cancer between January 2014 and December 2018. The study included analyses of muscle and fat tissue areas using the CoreSlicer application with computerized tomography imaging data in the preoperative period. Patients included in the study were compared between two groups: those with and without major complications (III and above) according to the Clavien-Dindo classification. Data were evaluated using the IBM SPSS Statistics 25.0 program. Since the data were non-parametric, groups were compared using the Mann-Whitney U test. A value of P<0.05 was considered statistically significant.   Results: The mean age of the 210 patients included in the study was 63.7 ± 12.46 years, and 60% (126 patients) were male. The major complication rate was 12.9% (27 patients). No significant difference was found between the groups in terms of the right and left psoas muscle and total muscle areas (P=0.393, P=0.442, and P=0.431, respectively). Similarly, subcutaneous and visceral fat tissue areas did not differ in complication development.   Conclusion: No statistical association was found between major complications and body composition parameters. However, the study's findings indicate that muscle functions should also be evaluated instead of muscle volume. It is thought that dynamic monitoring of preoperative muscle loss may improve the prediction of complications.
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Background and Objectives: Obesity is growing one of the health problems in the world and is becoming pandemic. We aimed to evaluate the inflammatory parameters associated with cardiovascular diseases in morbid obese patients by comparing neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), and monocyte/ High-density lipoprotein (HDL) (MHR) ratios with the healthy group.   Methods: This is a retrospective observational study. A hundred patients who were diagnosed with morbid obesity by applying to Adana Training and Research Hospital Endocrinology and Metabolism Diseases polyclinic between January 2019 and December 2020 will be screened retrospectively. Seventy-two patients who were not diagnosed with obesity and any disease affecting the cardiovascular system will form the control group. Neutrophil/lymphocyte, platelet/lymphocyte, monocyte/HDL ratios of both groups will be calculated, recorded and evaluated. Statistical analysis was performed using SPSS 25.0 software.   Results: Compared to the control group, platelet (P=0.001), neutrophil (P=0.001), lymphocyte (P=0.001), glucose (P=0.001), and insulin levels (P=0.030), BMI (P=0.001), NLR (P=0.020), and MHR (P=0.005) were statistically significantly higher in the morbid obese group. The risk factors found to be significantly associated with morbid obesity in the multiple logistic regression analysis included insulin level (P=0.010, OR (95% CI): 1.037 (1.009-1.068)) and MHR (P=0.008, OR (95% CI): 18.726 (4.876-32.576)).   Conclusion: NLR and MHR are both cost-effective and straightforward to compute. Particularly, MHR could serve as a valuable indicator for anticipating cardiovascular ailments in individuals with obesity. We think that morbid obesity has an effect on inflammatory parameters associated with cardiovascular diseases. 
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   Background and Objectives: The global epidemic of childhood obesity is escalating, with China reporting the highest incidence among children. Obesity is associated with respiratory health impairments; however, its relationship with lung function in pediatric populations remains controversial. This study aims to investigate the correlation between lung function and childhood obesity.    Methods: This retrospective study enrolled 666 Chinese children with obesity aged 5 to 17 years, admitted to a tertiary pediatric hospital in China, comprising 471 boys and 195 girls. Lung function was assessed using standardized spirometry, with abnormalities defined according to American Thoracic Society (ATS)/European Respiratory Society (ERS) recommendations. Multifactorial linear regression analysis and multivariable logistic regression were employed to analyze the correlations between obesity indices and lung function.   Results: The prevalence of abnormal lung function in children with obesity was 32.88% with a peak in the 10 to 14 age group. Children with severe obesity had higher rates of lung function abnormalities compared to those with mild obesity (41.24% vs. 32.48%, P < 0.05). Obstructive ventilatory defects were more common, particularly in boys. Metabolic comorbidities were frequent, with dyslipidemia (65.75%), hyperuricemia (59.36%), and type 2 diabetes mellitus (T2DM) (45.66%) being the most prevalent. In boys, body composition indices, such as waist circumference instead of BMI, were closely associated with lung function parameters, while in girls, this association was not observed. In boys, severe obesity and hypertension were independently associated with the risk of abnormal lung function; in girls, liver injury, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) showed independent associations.    Conclusion: The high prevalence of abnormal lung function (32.88%) among Chinese children with obesity underscores its clinical significance. Importantly, gender-specific screening—focusing on abdominal obesity in boys and lipid profiles in girls—may enhance the early detection of obesity-related pulmonary impairment.