《中国临床新医学》杂志编辑部 -->Early Online Releases

Expression characteristics and potential biological role analysis of dhrs9 in ovarian serous carcinoma.

sunfusheng,tongxu,wangnannan, — 2026/8/14 17:19:08

Objective:To investigate the expression characteristics and potential biological functions of DHRS9 (dehydrogenase/reductase member 9) in serous ovarian carcinoma (SOC), and to analyze its association with patient prognosis, cell proliferation, invasion, migration, and drug sensitivity, thereby providing a theoretical basis for the diagnosis and individualized treatment of SOC. Methods: Bioinformatics analysis was performed to evaluate the expression of DHRS9 in SOC and its association with clinicopathological characteristics and prognosis. Gene Ontology (GO) Enrichment Analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were conducted to explore the biological processes and signaling pathways associated with DHRS9. Drug sensitivity was predicted using the Genomics of Drug Sensitivity in Cancer (GDSC) database. In vitro, DHRS9 knockdown was performed in ovarian cancer cell lines (OVCAR-3 and SK-OV-3), and its effects on cell proliferation, invasion, and migration were evaluated. Results: DHRS9 was highly expressed in SOC and was significantly associated with poor prognosis (P < 0.05). GO and KEGG analyses indicated that DHRS9 may be involved in the regulation of cell proliferation, migration, and immune-related pathways. The DHRS9 high-expression group exhibited lower IC50 values for paclitaxel, cisplatin, and gemcitabine than the low-expression group. Furthermore, DHRS9 knockdown significantly inhibited the proliferation, migration, and invasion of OVCAR-3 and SK-OV-3 cells. Conclusion: DHRS9 is highly expressed in SOC and is closely associated with patient prognosis. It may promote the development and progression of SOC by regulating cell proliferation, migration, and invasion. DHRS9 has the potential to serve as a predictive biomarker for the efficacy of antitumor chemotherapy and may represent a promising therapeutic target for SOC.

黄一琴,龙行涛,邹冬玲 — 2026/8/14 8:26:50
Genetic factors play a pivotal role in the occurrence and progression of gynecological tumors. Hereditary gynecological cancer syndromes (HGCS) are cancer susceptibility disorders caused by germline pathogenic mutations, accounting for 5%–10% of all malignant tumors. They are characterized by early onset, frequent occurrence of primary tumors, familial aggregation, and autosomal dominant inheritance. These syndromes not only increase the risk of gynecological malignancies such as ovarian cancer and endometrial cancer but also adversely affect patients' fertility and offspring health. Genetic counseling is a cornerstone of HGCS management, enabling identification of high-risk individuals through family pedigree analysis, risk stratification assessments, and interpretation of genetic testing results, thereby facilitating the development of personalized intervention strategies incorporating screening and prevention measures. This approach has been proven to reduce the incidence and specific mortality rates of related cancers. The Gynecologic Oncology Branch of the Chinese Medical Association has organized experts to compile the Guidelines for Genetic Counseling in Gynecologic Tumors (2025 Edition), which summarizes the pathogenic gene profiles, risk assessment models, and detection strategies for common hereditary gynecological cancer syndromes, aiming to standardize clinical practice in genetic counseling for gynecologic tumors in China. This article provides a clinical interpretation of these guidelines to enhance the accessibility and standardization of genetic counseling services for gynecologic tumors in China.

Title: Application of Stepwise Postural Intervention in the Risk Early Warning of Muscle Cramps during Hemodialysis

余雁 — 2026/8/12 10:26:51

Abstract Objective:Exploring the preventive effect of stepwise posture intervention on muscle spasms in maintenance hemodialysis patients. Methods: A single-center, parallel controlled, randomized controlled study design was employed, enrolling 120 maintenance hemodialysis patients who were randomly divided into an observation group and a control group, with 60 cases each. Both groups received routine dialysis care, while the observation group additionally underwent stepwise posture intervention initiated and escalated based on risk stratification. The primary outcome was the incidence of dialysis-associated muscle spasms (calculated as spasms per total dialysis sessions); secondary outcomes included the frequency of spasms, pain VAS scores, comfort (assessed via the simplified GCQ scale), and the proportion of spasms requiring medication to terminate. Results: The observation group exhibited lower rates of spasm incidence, frequency, VAS scores, and medication-termination proportions compared to the control group, along with higher comfort scores (all P<0.05). Conclusion: Stepwise posture intervention can reduce dialysis-related muscle spasms, alleviate pain, and enhance dialysis comfort, demonstrating clinical applicability.

Clinical Characteristics and Risk Factors of Invasive Fungal Infection in Severe Liver Disease Patients after Artificial Liver

刘梦君,, — 2026/8/12 10:26:36

Objective To explore the sites, distribution and risk factors of invasive fungal infection (IFI) in severe liver diseases patients after artificial liver treatment.Methods A retrospective analysis was conducted on 476 patients with severe liver diseases who received artificial liver treatment at the 3rd People's Hospital of Kunming from October 2019 to August 2025. They were divided into the observation group and the control group according to whether they were complicated with IFI. The sites and distribution of fungal infection in the patients were statistically analyzed. The analyses univariate and multivariate logistic regression were used to analyze age, gender, the number of artificial liver treatments, length of hospital stay, Child-Pugh score of liver function, WBC, HGB, PLT, TBIL, ALB, PTA, INR, and AMM, whether there are complications (such as gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, etc.), whether glucocorticoids are used, and whether broad-spectrum antibiotics have been used for≥2 weeks.Results Among the 476 patients admitted, 57 cases of IFI occurred, and the incidence of IFI was 11.97%. A total of 70 strains of fungi were detected in 57 IFI patients. The main infection sites were multi-site infections (accounting for 63.2%), and the main pathogenic fungi were Candida albicans (32.8%), Aspergillus fumigatus (27.1%), Candida tropicalis (12.9%), and Candida glabra (10.0%). After univariate analysis, there were statistically significant differences in age, the number of artificial liver treatments, WBC, ALB, concurrent complications, the use of glucocorticoids, and the use of broad-spectrum antibiotics for ≥2 weeks between the IFI group and the non-IFI group (P<0.05). After multivariate analysis, age, the number of artificial liver treatments, WBC, ALB, and the use of broad-spectrum antibiotics for ≥2 weeks were identified as risk factors for IFI in severe liver diseases patients after artificial liver treatment(P<0.05).Conclusion The sites of IFI in severe liver diseases patients after artificial liver treatment are mainly multi-site infections. The main pathogenic fungi are Candida and Aspergillus. The risk factors include age, the number of artificial liver treatments, WBC, ALB, and the use of broad-spectrum antibiotics for ≥2 weeks.

Study of neuroprotective effect of ZJU-37 in a Multiple Sclerosis Demyelination Model

Yang Shuying, — 2026/8/12 10:26:13

Objective: To investigate the neuroprotective effect of ZJU-37, a novel Receptor-interacting protein kinase 1 (RIPK1) inhibitor, in an experimental mouse model of multiple sclerosis (MS). Methods: The dataset GSE172497 was obtained from the GEO database, and differential expression analysis along with pathway enrichment analysis between the ZJU-37 treatment group and the control group in oligodendrocyte precursor cells (OPCs) were performed using R. For the animal study, an MS mouse model was established by Cuprizone induction. Mice were randomly divided into three groups: the Control group (standard diet), the Cuprizone model group (0.2% Cuprizone diet + daily solvent injection), and the ZJU-37 intervention group (Cuprizone diet + daily intraperitoneal injection of ZJU-37 at 10 mg/kg). After 6 weeks of intervention, brain tissues were collected. Immunofluorescence，Myelin staining and transmission electron microscopy (TEM) were used to evaluate the OPC proliferation，degree of demyelination and ultrastructural changes, respectively. Immunohistochemistry and Western blot were performed to detect the expression level of p-RIPK1 protein. Results:?Bioinformatics analysis suggested that ZJU-37 could regulate signaling pathways related to the cell cycle and DNA repair in OPCs. Animal experiments showed that compared with the Cuprizone model group, ZJU-37 intervention significantly promotes OPC proliferation (P < 0.001) and reduced the area of demyelination in the corpus callosum, improved myelin ultrastructure (P < 0.001), increased the proportion of myelinated axons and maintained myelin thickness (P < 0.0001), while markedly decreasing the number of p-RIPK1-positive cells (P < 0.0001) and the protein expression level of p-RIPK1. Conclusion:?ZJU-37 can down-regulate the expression of p-RIPK1 in the brain tissue of MS mice, alleviate myelin damage, and enhance neuroprotection. This effect may be related to its promotion of oligodendrocyte precursor cell (OPC) proliferation.

Analysis of Clinicopathologic Features and Prognostic Factors in 9 Cases of Cervical Clear Cell Adenocarcinoma WAN Tao, WEI Ying, ZHANG Ya-qing, et al. Department of Gynecologic Oncology II, Gansu Provincial Maternity and Child-care Hospital/Gansu Provincial Central Hospital, Lanzhou 730070, China.

Wan tao — 2026/8/12 9:48:48

Objective To analyze the clinical and pathological characteristics of patients with clear cell adenocarcinoma (CCAC) in order to provide guidance for the clinical diagnosis and treatment of this rare tumor. Methods A retrospective analysis was conducted on the clinical manifestations, histological features, immunohistochemical phenotypes, treatment, and prognosis of 9 patients with CCAC diagnosed and treated at the Gansu Provincial Maternal and Child Health Hospital from 2020 to 2023. The Kaplan-Meier method was used to calculate survival rates. Results The median age of the 9 patients was 64 years. Among them, 6 presented with postmenopausal vaginal bleeding, 2 with contact bleeding, and 1 with vaginal bleeding following subtotal hysterectomy. Eight patients tested negative for HPV (8/9); according to the International Federation of Gynecology and Obstetrics (FIGO) staging system, 4 were stage IB2, 1 was stage IIA1, 2 were stage IIA2, 1 was stage IIIC1p, and 1 was stage IIIC2r. Immunophenotype: p16-positive (8/9), PAX8-positive (5/5), Napsin A-positive (5/8), and HNF1-β-positive (5/5). The median follow-up duration was 25 months, with an overall survival rate of 55.6% and a tumor-specific survival rate of 66.7%. Conclusion This study indicates that CCAC is more common in middle-aged and older adults, and that there is no significant association between CCAC and HPV infection. Its clinical features lack specificity, and there are currently no effective screening methods for CCAC; further research is urgently needed to improve the prevention, treatment, and prognosis of CCAC.

Predictive Value of MEWS and REMS for 24-Hour Mortality After Medical Contact Across Systemic Diseases

Huang pingmao — 2026/8/10 17:40:33

Objective This study aims to analyze the predictive value of the Modified Early Warning Score (MEWS) and the Rapid Emergency Medicine Score (REMS) score for 24-hour mortality after medical contact with different systemic diseases. Methods Between January 2016 and August 2024, 281 non-traumatic patients who died within 24 hours of medical contact in the emergency resuscitation room of the People's Hospital of Guangxi Zhuang Autonomous Region were enrolled as the death group. For the six most frequent diseases in this group, cases were matched 1:3 with 542 patients who attended the same resuscitation room and were admitted to internal medicine wards during the same period, forming the survival group. Clinical data were collected. Receiver operating characteristics (ROC) curve analysis was performed to evaluate and compare the performances of MEWS and REMS scores. Results Total patients who died within 24 hours of medical contact were 281, predominantly aged 60–89 years (65.48%) . The top three systems involved in causes of death were the cardiovascular system (36.17%) , respiratory system (15.60%), and nervous system (14.59%) respectively. Within these three systems, the six most common specific diseases ranked by frequency were acute myocardial infarction (71 cases) , severe pneumonia (36 cases) , acute cerebral infarction (24 cases) , acute cerebral hemorrhage (17 cases), acute aortic dissection (16 cases), and acute heart failure (13 cases) . The MEWS and REMS scores in the death group were significantly higher than those in the survival group, and the difference was statistically significant (P<0.05) . Both two scores effectively predicted 24-hour mortality after medical contact in emergency internal medicine patients (P < 0.05). The areas under the ROC curve (AUC) were 0.885 for MEWS and 0.886 for REMS. The MEWS score had a sensitivity of 85.1% and a specificity of 72.1%, whereas the REMS score had a sensitivity of 82.1% and a specificity of 80.6%. The optimal cut-off values were 4 for MEWS and 11 for REMS. For patients with the top six diseases, both two scores significantly predicted death within 24 hours of medical contact (P < 0.05). The AUC, sensitivities and specificities for the two scores across the six diseases were as follows: for patients with acute myocardial infarction, MEWS: 0.977, 90.10%, 96.60%; REMS: 0.962, 94.40%, 91.60%. For patients with severe pneumonia: MEWS: 0.629, 66.70%, 39.00%; REMS: 0.786, 77.80%, 59.60%. For patients with acute cerebral infarction: MEWS: 0.973, 91.70%, 97.80%; REMS: 0.980, 91.70%, 87.60%. For patients with acute cerebral hemorrhage: MEWS: 0.962, 94.10%, 80.60%; REMS: 0.932, 94.10%, 75.00%. For patients with acute aortic dissection: MEWS: 0.809, 62.50%, 85.10%; REMS: 0.910, 81.30%, 79.20%. For patients with acute heart failure: MEWS: 0.920, 84.60%, 74.10%; REMS: 0.868, 76.90%, 66.70%. The optimal cut-off values ranged from 3 to 6 for MEWS and from 9 to 12 for REMS. Conclusions MEWS and REMS scores both predict death within 24 hours of medical contact in patients with various diseases , but their predictive value differs. MEWS outperformed REMS for 24?hour mortality after medical contact in acute cerebral infarction, acute heart failure, and acute cerebral haemorrhage, whereas REMS was more sensitive for acute aortic dissection. The two scores performed comparably for acute myocardial infarction ,but both showed poor predictive value for severe pneumonia.

Expert Consensus on the Implementation Strategies of Parenteral Nutrition in Critically Ill Patients in China (2025)

米元元, — 2026/8/10 17:37:28

Parenteral nutrition (PN) is an essential component of nutritional support for critically ill patients who cannot meet their energy and nutrient requirements through enteral nutrition. To bridge the gap between continuously evolving scientific evidence and clinical practice, this expert consensus aims to standardize and optimize PN implementation in intensive care units (ICUs). The consensus development group, guided by evidence-based medicine principles and the Delphi methodology, referred to the ESPEN guideline development process and the STAR criteria (scientific rigor, transparency, applicability, and ranking). Evidence was systematically retrieved, appraised, and synthesized across five key domains: indications and contraindications for PN, clinical assessment, compounding standards, nutrient supplementation, and storage management. Following two rounds of Delphi expert consultation, the Expert Consensus on the Implementation Strategies of Parenteral Nutrition in Critically Ill Patients in China (2026) was developed to provide practical guidance for clinical application.

Clinical study on reconstruction of severe alveolar bone defects with allogeneic bone combined with platelet-rich fibrin

wujing,, — 2026/8/7 17:14:57

Objective: To investigate the clinical efficacy of allogeneic bone combined with platelet-rich fibrin (PRF) in reconstructing severe alveolar bone defects. Methods: Sixty patients with severe alveolar bone defects in one or two adjacent tooth positions, who underwent allogeneic bone grafting and delayed implant treatment at the First Affiliated Hospital of Guangxi University of Chinese Medicine from October 2021 to September 2024, were selected. Using a random number table, they were divided into a control group and an experimental group, each with 30 cases. The control group received allogeneic bone grafting combined with an acellular dermal matrix (ADM) oral biofilm to cover the graft for bone reconstruction. The experimental group received a mixture of allogeneic bone and PRF for grafting, combined with ADM oral biofilm coverage. Efficacy was evaluated through morphological and imaging assessments of alveolar bone, implant stability quotient (ISQ) measurements, peri-implant soft tissue measurements after functional loading, and observation of adverse reactions. Results: At 6 months post-bone reconstruction, both groups showed significant improvements in alveolar bone height, width, and bone density compared to preoperative levels (all P< 0.05), with the experimental group demonstrating significantly greater improvements in these parameters than the control group (all P< 0.05). At 3 months post-implantation, the ISQ values in the experimental group increased significantly compared to immediate post-implantation values (P< 0.05), while no significant difference was observed in the control group between immediate and 3-month ISQ values (all P> 0.05). At 3 months post-implantation, the experimental group had significantly higher ISQ values than the control group (P< 0.05). At 3 months after functional loading, the experimental group had significantly lower probing depth (PD), gingival recession (GR), and gingival index (GI), and significantly greater keratinized tissue width (KTW) than the control group (all P< 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (χ2 = 0.741, P= 0.389). Conclusion: The combination of allogeneic bone and PRF for reconstructing severe alveolar bone defects can more significantly improve alveolar bone morphology and density, enhance implant stability and peri-implant soft tissue health, with safety comparable to allogeneic bone grafting alone, indicating higher clinical application value.

Analysis of clinical characteristics, diagnosis and treatment of patients with pulmonary infection in Tropheryma whipplei

maliyun — 2026/8/7 17:12:44

【Abtract】Objective To explore the clinical characteristics and diagnosis and treatment methods of patients with pulmonary infection in Tropheryma whipplei. Methods A retrospective analysis was conducted on the clinical data, laboratory test results, and diagnosis and treatment processes of patients who were inpatients in the Department of Respiratory and Critical Care Medicine of Beijing Aerospace General Hospital from December 2023 to September 2025 and whose bronchoalveolar lavage fluid was positive for Tropheryma whipplei using targeted next-generation sequencing technology.Results The bronchoalveolar lavage fluid of 242 patients with pneumonia was tested. The samples of 13 patients were positive for Tropheryma whipplei, 10 cases were mixed bacteria, and the only bacteria detected were Tropheryma whipplei in 3 cases. The top two mixed bacteria were Pseudomonas aeruginosa and Haemophilus influenzae..All patients had cough and expectoration, of which 8 had fever, 3 had joint pain, and 1 had chest pain, chest tightness, vomiting, diarrhea, weight loss, cognitive impairment and dermatitis.The basic diseases were hypertension, coronary heart disease and diabetes mellitus, and the rheumatoid related indicators of one case increased significantly.Ten patients (76.9%) had normal peripheral blood white blood cell and neutrophil counts. 11 patients (84.6%) had normal PCT, and 4 patients (30.8%) had decreased lymphocytes. The imaging manifestations of the patients were mainly pulmonary consolidation (7 cases) and interstitial lung lesions (4 cases), but also pleural effusion (2 cases), ground glass shadow (1 case) and pulmonary nodules (1 case).Conclusion The clinical symptoms of patients with pulmonary infection in Tropheryma whipplei are atypical, most of the inflammatory indicators are normal,Imaging findings are nonspecific.Metagenomic second-generation sequencing technology is more accurate and efficient than traditional detection methods, but it is more expensive. Targeted second-generation sequencing is less expensive than the former and is expected to become an effective detection method and provide the basis for early diagnosis and treatment.The treatment for pulmonary infection in patients with Tropheryma whipplei primarily involves combined therapy, and a short-course treatment regimen may be an option for clinical management.

Natural History and Prognostic Factors of Locally Advanced Rectal Cancer Without Chronic Underlying Diseases After Neoadjuvant Chemoradiotherapy

Du Jin Bo,,,Niu Hui Yong,,,, — 2026/8/7 16:40:18

Objective To evaluate the key prognostic factors affecting overall survival (OS) and disease-free survival (DFS) in locally advanced rectal cancer (LARC) patients without chronic underlying diseases following neoadjuvant chemoradiotherapy (nCRT) combined with total mesorectal excision (TME).Methods A retrospective analysis was conducted on 316 LARC patients without chronic underlying diseases treated at Cancer Hospital, Chinese Academy of Medical Sciences from January 2013 to May 2023. Univariate and multivariate Cox proportional hazards regression models were used to analyze prognostic factors associated with OS and DFS. Survival analysis was performed using the Kaplan-Meier method, and between-group differences were compared using the Log-rank test.Results Multivariate Cox regression analysis identified the following independent risk factors for both OS and DFS: extramural venous invasion (EMVI) positivity (OS: HR=1.658, 95%CI: 1.080-2.545, P=0.021; DFS: HR=1.746, 95%CI: 1.135-2.686, P=0.011), poor tumor differentiation (OS: HR=1.711, 95%CI: 1.050-2.790, P=0.031; DFS: HR=1.701, 95%CI: 1.040-2.782, P=0.034), lymphovascular invasion positivity (OS: HR=2.679, 95%CI: 1.516-4.736, P<0.001; DFS: HR=2.754, 95%CI: 1.558-4.867, P<0.001), and ypN positivity (ypN+) (OS: HR=1.693, 95%CI: 1.052-2.725, P=0.030; DFS: HR=1.730, 95%CI: 1.074-2.786, P=0.024).Conclusion EMVI positivity, poor tumor differentiation, lymphovascular invasion positivity, and ypN+ are independent risk factors for LARC patients without chronic underlying diseases following nCRT, which may guide individualized treatment decision-making.

Efficacy and Safety of Domestic Recombinant Human TNK Tissue-type Plasminogen Activator for Injection for Intravenous Thrombolysis in Patients Aged ≥80 Years with Acute Ischemic Stroke: An Observational Study

biyuansheng,huangxiulin,,lulin,tangyunli,weifeng,weishirong — 2026/8/7 16:38:03

Objective To investigate the efficacy and safety of domestic Recombinant Human TNK Tissue-type Plasminogen Activator for Injection (rhTNK-tPA) for intravenous thrombolysis in advanced-age (aged ≥ 80 years) patients with acute ischemic stroke (AIS).Methods We retrospectively analyzed the clinical data of 132 patients with AIS who were treated with domestic rhTNK-tPA intravenous thrombolysis within 4.5 h of symptom onset at four stroke centers in Hechi, Guangxi, between November 2023 and September 2025, namely Hechi Hospital of the First Affiliated Hospital of Guangxi Medical University, Donglan County People’s Hospital, Dahua Yao Autonomous County People’s Hospital, and Fengshan County People’s Hospital. According to age, the patients were categorized into an advanced-age group (aged ≥80 years, n=44) and a non-advanced-age group (aged <80 years, n=88). The baseline data and clinical outcomes indicators of the two groups were collected and compared. Multivariable logistic regression analysis was used to evaluate the effect of advanced age on each clinical outcome. Results Compared with the non-advanced-age group, the advanced-age group had higher proportions of female patients, previous stroke history, and cardioembolic stroke, as well as higher pre-thrombolysis National Institutes of Health Stroke Scale (NIHSS) scores; moreover, the rate of excellent outcome at 90 d after onset was lower, whereas the rates of poor outcome and all-cause mortality were higher, with statistically significant differences (P<0.05). There was no statistically significant difference in the incidence of symptomatic intracranial hemorrhage (sICH) between the two groups (P>0.05). Multivariable logistic regression analysis showed that advanced age was not significantly associated with excellent outcome, poor outcome, all-cause death at 90 d after onset, or the occurrence of sICH (all P>0.05). Conclusion Compared with non-advanced-age patients, advanced-age patients with AIS may also benefit from thrombolytic therapy with domestic rhTNK-tPA (0.25 mg/kg), without increasing the incidence of sICH or 90-day all-cause mortality after onset.

Expression analysis of PIK3IP1 in peripheral blood of patients with type 2 diabetic retinopathy and in retinal microvascular endothelial cells induced by high glucose

binhuiying,,,,,,,,, — 2026/8/6 17:06:01

Objective To analyze the expression levels of PIK3IP1 in peripheral blood of patients with type 2 diabetic retinopathy and in high glucose-treated human retinal microvascular endothelial cells, and to provide preliminary insights into the potential role of PIK3IP1 in the pathogenesis of DR. Methods (1) A total of 92 patients with type 2 diabetes mellitus (T2DM) admitted to the Ophthalmology and Endocrinology Department of the First People's Hospital of Nanning from September 2023 to December 2024 were selected. According to the results of fundus examination, the patients were divided into the normal fundus group (T2DM group, 45 cases) and the diabetic retinopathy group (DR Group, 47 cases). Forty-eight healthy people who underwent physical examination in our hospital during the same period were selected as the control group. Fasting peripheral venous blood was collected from all subjects in the morning of the next day after enrollment for subsequent experiments. Real-time quantitative PCR (RT-qPCR) and Western blotting (WB) were used to detect the mRNA and protein levels of PIK3IP1 in peripheral blood, respectively. Spearman rank correlation or Pearson correlation was used to analyze the correlation between PIK3IP1 levels and clinical variables. Multivariate linear regression analysis was used to analyze the influencing factors of PIK3IP1 level. CCK-8 method was used to screen and construct high glucose injury model of human retinal microvascular endothelial cells (HRMECs) in vitro. The mRNA and protein levels of PIK3IP1 in the control group (5.5 mmol/L, NG group) and the high glucose group (HG group) were detected by RT-qPCR and WB. The protein levels of p-AKT and AKT related to the activation of PI3K/AKT signaling pathway were detected, and the protein level of p-AKT/AKT was calculated. Results The expression levels of PIK3IP1 mRNA and protein in the DR Group were significantly higher than those in the control group and the T2DM group (P < 0.05). PIK3IP1 level was positively correlated with BMI, WBC and FPG (P < 0.05). Multiple linear regression analysis showed that FPG was the influencing factor of PIK3IP1 level (P < 0.05). Compared with NG group, the mRNA and protein levels of PIK3IP1 in HG group were increased (P < 0.05), and the protein levels of p-Akt and p-Akt /AKT were decreased (P < 0.05). Conclusion The expression of PIK3IP1 is up-regulated in peripheral blood of DR Patients and in high glucose-damaged cells of HRMECs in vitro. FPG is an influencing factor for PIK3IP1 level.

Discussion on the Formation and Mechanisms of Neutrophil Extracellular Traps in Whole Blood and Leukoreduced Red Blood Cell Suspensions during Storage

廖湘成,,, — 2026/8/6 17:05:27

[Abstract]Objective Investigating the formation and mechanisms of neutrophil extracellular traps (NETs) in whole blood and leukoreduced red blood cell suspensions during storage. Methods Blood samples were collected from the Blood Transfusion Department of Guangxi Zhuang Autonomous Region People's Hospital between January 2023 and May 2024, including whole blood (80 cases; autologous stored blood from our hospital, not leukoreduced) and leukoreduced red blood cell suspensions (80 cases; donated by donors from the Nanning Central Blood Station). The study population was stratified into four groups based on red blood cell storage duration: Group A (1–9 days), Group B (10–19 days), Group C (20–28 days), and Group D (>28 days), with each group comprising 20 subjects. Serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), interleukin-6 (IL-6), heme, and myeloperoxidase (MPO) were quantified using enzyme-linked immunosorbent assay (ELISA). Circulating cell-free DNA (cfDNA) levels in serum were determined via PicoGreen-based fluorescent spectrophotometry. Results TNF-α and IL-6 concentrations, as well as levels of heme, cf-DNA, and MPO, were significantly lower in the leukoreduced red blood cell group compared with the whole blood group (P<0.05). In contrast, in the whole blood group, TNF-α and IL-8 concentrations exhibited a progressive increase over the course of storage. cf-DNA and heme rose then fell, peaking at days 20–28. In leukoreduced red blood cell suspensions, TNF-α and heme increased steadily with storage, while cf-DNA decreased. IL-6 and MPO levels remained stable during extended storage. cf-DNA correlated positively with heme (r=0.602), TNF-α (r=0.515), and IL-6 (r=0.506), but negatively with IL-8 (r=?0.291). MPO correlated strongly with heme (r=0.409), TNF-α (r=0.856), and IL-6 (r=0.813), and showed no link to IL-8.Conclusion The levels of NETs are influenced by both the duration of storage and the method of red blood cell preparation.Specifically,the concentrations of NETs in whole blood are markedly higher than those observed in leukoreduced red blood cell suspensions.

Research Progress of Caspase-3 in Central Nervous System Diseases

machunping, — 2026/8/4 17:12:12

【】:Caspase-3 is the most critical downstream effector protein in the apoptotic cascade and plays a central role in the process of cell apoptosis. It triggers DNA fragmentation by activating endonucleases, ultimately leading to programmed cell death. This article elaborates on the physiological functions of Caspase-3, including its role as a key executioner in neuronal apoptosis, its ability to cleave Tau protein, and its function as a core executor in the mitochondrial apoptotic pathway. Additionally, it reviews the latest research progress on Caspase-3 in neurological diseases such as cerebral ischemia-reperfusion injury, central nervous system infections, multiple sclerosis, Alzheimer"s disease, and acute spinal cord injury, aiming to explore novel therapeutic strategies for neurological disorders.

Role and interventions of the carotid body in diseases associated with increased sympathetic activity

Wu Ruoyu — 2026/8/4 17:10:44

Increased sympathetic activity is an important shared pathophysiological feature of several disorders, including heart failure, resistant hypertension, and obstructive sleep apnea. Available evidence indicates that, in a subset of patients, carotid body (CB) sensitization may occur, with enhanced peripheral chemoreflex sensitivity as a common functional manifestation, and may be further accompanied by elevated sympathetic activity. The related mechanisms involve oxidative stress and inflammatory responses, imbalance of the local renin-angiotensin system (RAS), perfusion abnormalities, and disordered metabolic signaling. In recent years, pharmacological, interventional, and surgical approaches targeting the CB have shown translational potential, among which pharmacological targeting of the purinergic receptor P2X3 pathway as well as CB resection or ablation has attracted particular attention. However, evidence for these pharmacological interventions remains largely limited to preclinical studies and early exploratory investigations, and is insufficient to support routine clinical use. At present, the available evidence is concentrated mainly in obstructive sleep apnea and heart failure with reduced ejection fraction, whereas direct human physiological evidence in resistant hypertension remains relatively limited. Clinical evaluation of the CB still mainly relies on functional testing, imaging features, and neurohumoral-inflammatory clues, but adequate evidence is still lacking regarding identification of suitable patients, standardization of assessment, long-term safety, and benefits on hard clinical endpoints. This review summarizes the role of CB dysfunction in these disorders, together with key points of clinical assessment and recent advances in intervention, and discusses the major problems facing future clinical translation.

Research Advances in Novel Supportive Treatment Strategies for IgA Nephropathy

Tang Xunzi,Yu Jianglong — 2026/8/4 17:08:09

Immunoglobulin A(IgA) nephropathy (IgAN), the most prevalent primary glomerular disease? worldwide, poses a particularly heavy disease burden in the Asia-Pacific region. The disease exhibits significant heterogeneity in prognosis—approximately 30–40% of patients progress to end-stage renal disease (ESRD)? within 20–30 years, making it a major contributor to the uremia? epidemic in China. The elusive pathogenesis of IgAN presents substantial therapeutic challenges, and the limitations of conventional treatments leave many patients" needs unmet. This review focuses on analyzing the efficacy and safety of various supportive therapies? in delaying the progression of IgAN and interprets the key updates in the clinical significance of the Kidney Disease: Improving Global Outcomes (KDIGO) 2025 Clinical Practice Guidelines for the Management of IgAN. It aims to synthesize the evidence framework for supportive care in IgAN, emphasizing the importance of personalized combination therapy? for affected individuals to inform clinical decision-making.

Endometrial Microglandular Adenocarcinoma：report of a case

张波 — 2026/8/4 17:04:56

Endometrial microglandular adenocarcinoma (EMGA), also known as microglandular hyperplasia-like endometrioid carcinoma or endometrioid carcinoma with microglandular features, is a type of endometrioid carcinoma with the characteristics of cervical microglandular hyperplasia (MGH). It is a rare type of endometrioid carcinoma. Since there have been no reports on true endometrial microglandular hyperplasia so far, great caution should be exercised in diagnosis. The number of reported cases of EMGA in domestic and foreign literature is limited. Therefore, by studying the clinicopathological features of a case of EMGA in a 56-year-old female and reviewing relevant literature, this paper aims to help pathologists lacking diagnostic experience avoid missed diagnosis and misdiagnosis.

Case Report: transfusion-dependent β-Thalassemia caused by a de novo mutation in the HBB gene.

wuxin — 2026/8/4 17:00:50

This article reports a case of transfusion-dependent β-thalassemia caused by a de novo mutation in the HBB gene.

Clinical characteristics of invasive Klebsiella pneumoniae liver abscess syndrome

tanxu — 2026/8/3 17:56:04

Objective: To explore the influencing factors of invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS) in patients with Klebsiella pneumoniae liver abscess and to construct a nomogram prediction model. Methods: The clinical data of 835 patients with Klebsiella pneumoniae liver abscess treated in the First Affiliated Hospital of Guangxi Medical University were retrospectively collected. The patients were divided into a training set (584 cases) and a test set (251 cases) at a ratio of 7:3. A multivariate logistic regression prediction model was established. The model was verified in the training set and test set, and its predictive performance was evaluated through the receiver operating characteristic curve, calibration curve, and decision curve analysis. Results: A total of 835 patients with liver abscess were retrospectively collected, including 584 cases in the training set and 251 cases in the test set. The baseline characteristics of the patients in the training set and test set are shown in Table 1, and the baseline characteristics between the groups were balanced. The total incidence of IKPLAS was 35.69% (training set: n = 202; test set: n = 96). There was no statistically significant difference in the incidence of IKPLAS between the training set and test set (P > 0.05). Univariate analysis was performed in the training set to screen potential risk variables related to IKPLAS, including age, lymphocytes, PLT, white blood cells, neutrophils, ALB, hemoglobin, diabetes, cardiovascular disease, chest pain, and abdominal pain. Lasso regression was then used to screen out potential risk variables, including white blood cells, PLT, neutrophils, lymphocytes, hemoglobin, ALB, cardiovascular disease, diabetes, abdominal pain, and chest pain. Multivariate logistic regression analysis combining clinically established risk variables showed that hemoglobin (OR = 0.99, 95% CI 0.98–0.99, P = 0.041), ALB (OR = 0.93, 95% CI 0.89–0.96, P < 0.01), neutrophils (OR = 1.03, 95% CI 1.01–1.07, P = 0.033), and diabetes (OR = 2.18, 95% CI 1.47–3.24, P < 0.001) were independent risk factors for the occurrence of invasive syndrome in patients with Klebsiella pneumoniae liver abscess. The area under the curve (AUC) of the prediction model in the training set was 0.75 (95% CI 0.71–0.79); in the test set, the AUC was 0.75 (95% CI 0.68–0.81). The calibration curve showed that the model's prediction was well-fitted to the actual situation, and the decision curve analysis indicated that the model had good clinical net benefit. Conclusion: Lymphocytes, ALB, diabetes, abdominal pain, and chest pain are related factors for the occurrence of invasive syndrome in patients with Klebsiella pneumoniae liver abscess. The nomogram model constructed based on these variables can effectively predict the risk of invasive syndrome in such patients.

Research on the Variation Curve of Sense of Meaning in Life for Diabetic Nephropathy Patients Undergoing Hemodialysis

MiaoJie — 2026/8/3 17:49:17

[Abstract]Objective To analyze the risk factors affecting the sense of meaning in life for diabetic nephropathy patients undergoing hemodialysis, to plot the variation curve of their sense of meaning in life, and to explore the patterns of change in their sense of meaning in life.Methods The study selected 94 patients with diabetic kidney disease undergoing hemodialysis, who were admitted to the hospital from April 2021 to October 2024, as the research subjects. During the 0 to 12 weeks of treatment, their sense of meaning in life was measured every two weeks. SPSS 26.0 software was used to analyze the risk factors affecting the sense of meaning in life for these patients, and MATLAB 2021 software was used to plot the variation curve of their sense of meaning in life.Results There were no statistically significant differences in the sense of meaning in life scores among diabetic nephropathy patients undergoing hemodialysis with different ages, genders, places of residence, duration of diabetes, and payment methods (P>0.05). However, patients who lived alone, had a monthly household income of less than 3,000 yuan, lacked physical activity, experienced anxiety, or had an education level of junior high school or below showed significantly lower scores in the sense of meaning in life (P<0.05). The results of multiple linear regression analysis showed that living alone, monthly household income, lack of physical activity, anxiety, and education level were all factors associated with the sense of meaning in life among hemodialysis patients with diabetic kidney disease (P<0.05). The level of sense of meaning in life in these patients showed a trend of first increasing and then decreasing over different time periods. The scores for the sense of meaning in life at treatment weeks 0, 2, 4, 6, 8, 10, and 12 were 35.41± 3.61, 38.73±2.85, 44.12±3.18, 51.24±4.32, 42.83±3.78, 39.48±2.46, and 37.82±3.26, respectively. The variation curve of the sense of meaning in life in hemodialysis patients with diabetic kidney disease could be divided into three phases: weeks 0–6 (positive zone), weeks 6–8 (stagnation and hesitation zone), and weeks 8–12 (negative zone). The positive zone was characterized by an increasing level of sense of meaning in life, the stagnation and hesitation zone by a plateau in the level of sense of meaning in life, and the negative zone by a continuous decline in the level of sense of meaning in life.Conclusion Living alone, monthly household income, lack of physical activity, anxiety, and education level are all factors associated with the sense of meaning in life among hemodialysis patients with diabetic kidney disease. The sense of meaning in life in these patients shows a trend of first increasing and then decreasing over time. Providing appropriate interventions during the period when the sense of meaning in life declines may help enhance its level.

Clinical, imaging and pathological features of Rosai-Dorfman disease: analysis of 13 cases and misdiagnosis strategy

吴月琴, — 2026/8/3 17:43:55

Objective: Based on 13 confirmed cases, the multimodal characteristics and misdiagnosis patterns of Rosai-Dorfman disease (RDD) were systematically analyzed, aiming to build a clinical diagnosis path with the goal of reducing misdiagnosis and provide reference for early identification and accurate diagnosis. Methods: A retrospective analysis was conducted on the clinical, imaging, and pathological data of 13 patients with pathologically confirmed RDD between January 2016 and September 2025. All patients underwent at least one imaging examination, including ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI). Pathological analysis involved hematoxylin and eosin (HE) staining to observe histological morphology and immunohistochemical detection of markers such as S100, CD68, and CD1a. Results: Among the 13 patients, 6 were male and 7 were female, with a median age of 51 years. The anatomical distribution of lesions was as follows: soft tissue (5 cases), head (4 cases), lymph nodes (3 cases), and lung (1 case). Clinical manifestations varied significantly based on the anatomical location of involvement. Ultrasonography predominantly demonstrated heterogeneous echogenicity with detectable blood flow signals. Contrast-enhanced CT and MRI examinations primarily revealed heterogeneous enhancement patterns, with only one case in each modality demonstrating homogeneous enhancement. Imaging findings lacked specificity, and were often diagnosed as lymphoma (1 case), cavernous hemangioma (1 case), neurogenic tumor (1 case), lipoma (1 case), and meningioma (4 cases). In addition, imaging reports of 5 cases only described space-occupying lesions without giving a precise diagnosis. Histopathological examination demonstrated characteristic features: prominent histiocytic proliferation accompanied by substantial lymphocyte and plasma cell infiltration. The architectural pattern showed alternating dark and light zones composed of sheets of histiocytes and lymphoplasmacytic cells. High-power microscopy revealed emperipolesis, characterized by intact lymphocytes within histiocyte cytoplasm. Among these cases, emperipolesis was observed on HE staining in 7 cases, resulting in a missed diagnosis rate of 46.15%. Immunohistochemical analysis demonstrated consistent positivity for S100 (100%) and CD68 (100%), while CD1a was uniformly negative in all cases. Thirteen patients were followed up for a duration ranging from 1 to 110 months, with a median follow-up time of 33 months. All patients survived, among whom 3 experienced recurrence. Literature review of publications from 2019 to 2023, encompassing 13 studies and 62 cases, indicated that RDD predominantly involves extranodal sites (91.94%), presents with diverse clinical manifestations, lacks specific imaging characteristics, requires pathological confirmation for definitive diagnosis, is primarily managed surgically, and demonstrates favorable prognosis, although a minority of cases may recur. Conclusion: RDD exhibits non-specific clinical manifestations and lacks characteristic imaging features, making it highly susceptible to misdiagnosis. Pathological examination remains crucial for definitive diagnosis, with histiocytic "emperipolesis" and co-expression of S100/CD68 serving as the core diagnostic criteria. We recommend establishing a pathology-centered imaging-pathology multimodal diagnostic pathway to improve diagnostic accuracy.

Whole-Life-Cycle Management of Ovarian Cancer: Progress and Insights from Conceptual Innovation to Clinical Practice

狄文,张楠 — 2026/8/3 17:31:34

Driven by rapid advancements in precision medicine and targeted therapies, the treatment paradigm for ovarian cancer (OC) is undergoing a profound transformation from "empirical surgery" to "comprehensive chronic disease management." Drawing upon the latest clinical evidence and guidelines, this article systematically rdelineates the pathway for whole-life-cycle management of OC, and explores standardized diagnosis, treatment, and prevention strategies tailored to the Chinese healthcare context. Centered on patient care, this holistic approach encompasses a continuum of care spanning genetic risk assessment, primary standard-of-care treatment, precision-targeted therapy, relapse management, rehabilitation, and palliative care. Multidisciplinary team (MDT) collaboration and a tiered healthcare delivery system serve as the core pillars to achieve this goal. By establishing a stratified screening framework, standardizing MDT workflows, and optimizing rehabilitation support networks, we aim to effectively transform OC into a manageable chronic disease, thereby maximizing survival benefits for patients.

Survey and Analysis of Emergency Medical Services and Training Needs at the Grassroots Level in Guangxi

qin hua zhao — 2026/7/31 18:04:05

【Abstract】 Objective To investigate the current situation of emergency medical services and training needs in primary medical institutions in Guangxi, so as to provide a reference for cultivating first-aid capabilities among rural-oriented targeted clinical medical students in Guangxi. Methods From June 2024 to December 2025, a questionnaire survey was conducted among 121 primary medical institutions in 14 cities of Guangxi using stratified random sampling. The survey included the basic information of primary medical institutions and doctors, emergency medical equipment, emergency medicines, common acute illnesses and frequently used first-aid skills in primary care, as well as training needs for primary first-aid knowledge and skills. Results The educational background and professional title levels of primary physicians were generally low. Only half of the 121 primary medical institutions had set up emergency departments. The allocation of emergency equipment was unbalanced: the coverage rate of basic equipment was relatively high, while that of precise diagnosis and treatment equipment was less than 30%. Basic emergency medicines were well covered, whereas anticoagulants, thrombolytics and antidotes were poorly available. Common acute illnesses in primary care included cardiovascular and cerebrovascular emergencies, respiratory emergencies, trauma and poisoning, etc., and the commonly used first-aid skills were mainly basic ones. Primary physicians had a strong demand for training in the diagnosis and treatment of cardiovascular and cerebrovascular diseases, acute poisoning, and first-aid skills such as cardiopulmonary resuscitation (CPR), Heimlich maneuver, and debridement and suture. They preferred low-frequency, short-term and local training. Conclusions Standardizing the configuration of emergency equipment and pharmaceuticals in primary medical institutions,carry out targeted training for primary care physicians based on their educational background, professional titles and skill learning needs and cultivating rural-oriented medical students in light of the characteristics of primary emergency medical services will help improve the quality of emergency medical services at the primary level.

Clinical observation of remote ischemic preconditioning combined with edaravone on patients with cerebral small vessel disease

黄园园 — 2026/7/31 17:01:46

Objective To investigate the healing effect of remote ischemic preconditioning (RIPC) combined with edaravone on patients with cerebral small vessel disease (CSVD). Methods: Eighty CSVD patients were randomly separated into two groups: the edaravone group was treated with edaravone, and the combination group was treated with RIPC combined with edaravone. The healing effect of the two groups was compared. Results The total effective rate of the combined group was 92.50%, which was higher than the 72.50% of the edaravone group (P<0.05). After treatment, the combined group had higher scores on the Montreal Cognitive Assessment Scale and Mini Mental State Examination than the Edaravone group (P<0.05). After treatment, the cerebral blood flow velocity (CBF) and cerebral blood flow (CVB) in the combination group were higher than those in the edaravone group (P<0.05), and the mean transit time (MTT) was lower than that in the edaravone group (P<0.05). After treatment, the levels of serum vascular endothelial growth factor (VEGF) and nitric oxide (NO) in the combination group were higher than those in the edaravone group (P<0.05), while the levels of serum tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) were lower than those in the edaravone group (P<0.05). Conclusion: For CSVD patients, the combination of RIPC and edaravone treatment can achieve obvious healing effects, effectively improve cognitive function, and gradually increase the expression level of vascular endothelial growth factor, thereby reducing inflammatory reactions.

A Prospective Study on the Diagnostic Value of Monocyte Distribution Width Combined with Procalcitonin for Early Diagnosis of Sepsis in ICU Patients

yao wei qing, — 2026/7/31 17:00:11

Objective To investigate the value of monocyte distribution width (MDW) combined with procalcitonin (PCT) in the early diagnosis of sepsis in intensive care unit (ICU) patients. Methods A prospective cohort study was conducted involving 64 patients with suspected infection admitted to the Department of Critical Care Medicine at the 940th Hospital of the Joint Logistics Support Force between October 2024 and April 2025. Participants were categorised into a sepsis group (n=32) and a non-sepsis group (n=32) according to the Sepsis 3.0 criteria. Clinical data and laboratory indicators were compared between groups. Multivariate logistic regression analysed independent sepsis risk factors, while receiver operating characteristic (ROC) curves assessed predictive efficacy for sepsis. Results MDW and PCT levels were significantly higher in the sepsis group (P<0.01). Multivariate logistic regression analysis identified MDW (OR=2.153, 95% CI: 1.220–3.799) and PCT (OR=2.341, 95% CI: 0.920–7.581) as independent risk factors for sepsis. ROC curve analysis demonstrated that the area under the curve (AUC) for predicting sepsis using MDW, PCT, and their combination was 0.879, 0.768, and 0.951 respectively. The combined diagnostic sensitivity and specificity reached 81.30% and 96.8%, respectively. Conclusions Both MDW and PCT are independent risk factors for sepsis. Their combined use significantly enhances the efficacy of early sepsis diagnosis in ICU patients. As a novel biomarker, MDW holds significant clinical application value.

Establishing a clinical-intravascular ultrasound combined nomogram model for early identification of poor stent malapposition after PCI in coronary artery calcified lesions

高悦 — 2026/7/31 16:58:17

Objective ?To establish a clinical-intravascular ultrasound (IVUS) combined nomogram model for early identification of high-risk patients with poor stent expansion after percutaneous coronary intervention (PCI) for coronary artery calcification (CAC) lesions. Methods ?A total of 206 patients with CAC lesions undergoing PCI (training set) were selected in our hospital from January 2022 to June 2024. According to the stent expansion after PCI, the patients in the training set were divided into poor group and good group. Another 40 patients from July 2024 to February 2025 were selected as the validation set. The clinical data, biochemical test indexes and intravascular ultrasound examination results of the two groups were compared. Multivariate logistic regression was used to analyze the predictive variables of poor stent expansion after PCI. Based on the selected predictive variables, a nomogram for predicting poor stent expansion after PCI was drawn. The receiver operating characteristic curve (ROC) was used to analyze and predict the discrimination of the nomogram for poor stent expansion after PCI, and the calibration curve was used to further analyze its calibration. Kappa value was used to test the consistency between the nomogram prediction results and clinical practice. Results There were significant differences in GRP and GSDMD between the poor group and the good group (P<0.05). The calcification radian of the poor group was higher than that of the good group, and the proportion of patients with MLA and calcification fracture was lower than that of the good group (P<0.05). Multivariate Logistic regression analysis showed that GRP, GSDMD, MLA, calcification radian and calcification fracture were all predictors of poor stent expansion after PCI (P<0.05). The AUC of the nomogram based on the above five predictors was 0.818 (95%CI: 0.754-0.882 ), showing a good discrimination, and the predicted results of the nomogram were in good agreement with the ideal curve. In the validation set, Kappa value consistency analysis showed that the coincidence rate between the predicted results of the nomogram and the clinical practice was 92.50 %, and the Kappa value was 0.806 (P<0.05). Conclusions ?The clinical-IVUS combined nomogram model based on GRP, GSDMD and MLA, calcification radian and calcification fracture has good predictive value, which is helpful for early identification of poor stent expansion after PCI for CAC lesions and optimization of treatment strategies.

Gastrointestinal Symptoms and Internalizing Problems in Children with Comorbid ADHD and Tic Disorders: The Mediating Role of Emotional Dysregulation

简芳芳,李燕,乔红玉,孙海婷,孙新,王小兰,王彦佳,席静,赵晨锡 — 2026/7/31 16:56:16

Objective To clarify the association between gastrointestinal symptoms and internalizing behavioral problems in children with comorbid attention-deficit/hyperactivity disorder (ADHD) and tic disorders (TD), and to investigate the potential mediating role of emotional dysregulation in this relationship. Methods A total of 90 children aged 7 to 12 years were consecutively recruited from the pediatric outpatient clinic of Xijing Hospital between October 2024 and December 2025. All participants were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria and allocated to three groups with equal sample size: ADHD only, TD only, and comorbid ADHD-TD, with 30 cases in each group. Data were collected using a general information questionnaire, the Swanson, Nolan, and Pelham-IV Rating Scale (SNAP-IV), the Yale Global Tic Severity Scale (YGTSS),Questionnaire on Pediatric Gastrointestinal Symptoms-Rome Ⅳ (QPGS-Ⅳ), Conners' Parent Symptom Questionnaire (PSQ), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Depression Self-Rating Scale for Children (DSRSC). Results Children in the comorbid group exhibited significantly higher scores on gastrointestinal symptoms, anxiety, and depression compared with those in the two single-disorder groups. Full-sample analysis demonstrated significant direct effects of gastrointestinal symptoms on both anxiety and depression. Emotional dysregulation partially mediated these associations, with the mediating effect accounting for 28.1% of the total effect on anxiety and 24.7% of the total effect on depression. Subgroup analyses further indicated that these mediating pathways achieved statistical significance exclusively in the comorbid ADHD-TD group. Conclusion A significant association exists between gastrointestinal symptoms and internalizing behavioral problems in children with comorbid ADHD and TD. Emotional dysregulation represents an important psychological pathway linking these two domains, providing a promising new target for the development of comprehensive clinical interventions for this patient population.

Advances in nucleic acid amplification-CRlSPR One-Pot biosensors for molecular diagnosis

CAI Xiangjing,HE Mianyun,LAI Shiying,LIU Runbiao,MA Baoying,,ZHANG Pengfei — 2026/7/31 10:32:17

Molecular diagnostics have increasingly become the gold standard for pathogen detection. Detection systems that integrate nucleic acid amplification with Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) technology are regarded as a new generation of point-of-care molecular diagnostics due to their high specificity, programmability, sensitivity, and operational portability. CRISPR-based one-pot assays, which integrate nucleic acid amplification and CRISPR-mediated detection into a single reaction system, significantly simplify operational procedures and substantially reduce the risk of aerosol contamination, thereby exhibiting the key attributes of ideal point-of-care testing (POCT) platforms and attracting considerable research interest. In recent years, one-pot nucleic acid amplification–CRISPR systems incorporating diverse biosensors for terminal signal readout have been developed, continuously advancing overall assay performance and usability toward practical and field-deployable applications. These systems demonstrate substantial potential in rapid pathogen detection, food safety monitoring, and environmental surveillance. This review summarizes various biosensors integrated with nucleic acid amplification–CRISPR one-pot systems and their application scenarios, aiming to provide new insights and strategic perspectives for the development of point-of-care molecular diagnostics and future pathogen prevention and control.

To Develop a nomogram for predicting dietary structure and risk of cognitive impairment in older adults

zhangjian — 2026/7/24 18:25:26

Objective To develop a clinical predictive model for cognitive impairment combined with dietary structure in older adults. Methods This study utilized data from the 2018 China Longitudinal Health and Longevity Survey(CLHLS), which included community residents aged 60 and older. Researchers conducted a comprehensive health assessment covering multiple indicators affecting overall health. Cognitive function was evaluated in detail using the Mini-Mental State Examination (MMSE), and a multivariate logistic regression model was employed to analyze independent risk factors for cognitive impairment in older adults. Based on these findings, a nomogram was developed to predict cognitive impairment in older adults. Results A multivariate logistic regression model identified 12 independent predictors of cognitive impairment in older adults. Based on these findings, a nomogram incorporating these 12 predictors was developed, encompassing age, sex, staple food, vegetable consumption, fish consumption, egg consumption, dairy consumption, nut consumption, seaweed consumption, vitamin supplementation, alcohol consumption, and body mass index (BMI). The nomogram demonstrated good discriminative ability, with an area under the curve (AUC) of 0.787 for the training set.Conclusion This nomogram has been validated to have clinical value in predicting cognitive impairment in older adults. All clinical predictors included can be easily obtained through assessments of daily living.

Analysis of Eruption and Dental Caries Status of the First Permanent Molars in Third-grade Primary School Students in Wuling District, Changde City

gumengjiao,leirong,liuping,,tuziduan — 2026/7/21 8:59:56

[Abstract] Objective: To investigate the eruption status and caries prevalence of the first permanent molars among third-grade primary school students in Wuling District, Changde City, and to provide a scientific basis for regional child caries prevention and treatment programs. Methods: A cluster random sampling method was used to conduct a retrospective cross-sectional study on the eruption status and caries of the first permanent molars among third?grade students from five primary schools in Wuling District, Changde City from 2023 to 2025. The data were derived from the Hunan Dental Prevention Data Platform. Excel was used for data organization, and SPSS statistical software was used for data analysis. A total of 2,158 students were surveyed.Results: The overall eruption rate of the first permanent molars among the 2158 examined students was extremely high (>99%). The overall caries prevalence rate was 53.75%, the mean decayed, missing, and filled teeth (DMFT) score was 1.42 ± 1.619, and the filling rate among carious teeth was 6.21%. The difference in caries prevalence between genders was statistically significant (Chi-square test, P<0.001), with a higher rate in girls (58.25%) than in boys (49.55%). The difference in caries prevalence across the three years was statistically significant (P<0.0001), with rates of 52.5% in 2023, 48.96% in 2024, and 59.81% in 2025. The caries risk for mandibular first permanent molars was significantly higher than that for maxillary molars (P<0.0001). Conclusion: The caries status of the first permanent molars among third-grade primary school students in Wuling District, Changde City is severe, with a low level of caries filling. The caries risk is significantly higher in the mandible than in the maxilla, and girls have a higher caries prevalence than boys, making them a key target population for caries prevention. Targeted measures should be implemented to strengthen oral health education and individual protection.

Clinical Efficacy and Mechanism of Shortwave Combined with Low-intensity Blood Flow Restricted Resistance Training in the Treatment of Knee Osteoarthritis: A Randomized Controlled Trial

刘元元, — 2026/7/20 10:34:51

Objective ?To explore the improvement effect of shortwave combined with low-intensity blood flow restricted resistance training on pain, joint function and balance ability in patients with Kellgren-Lawrence grade II-III knee osteoarthritis (KOA), and to clarify its clinical application value. Methods ?Ninety -two KOA patients who visited the outpatient department of Beijing Nuclear Industry Hospital from June 2023 to October 2024 were selected and randomly divided into an experimental group (n=46) and a control group (n=46). The experimental group received shortwave combined with 30% 1RM blood flow restricted resistance training, while the control group received conventional rehabilitation training. The intervention period was 8 weeks. Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), active range of motion (ROM) of the knee joint, and Berg Balance Scale scores were compared before intervention, at 4 weeks, and at 8 weeks. Results? After 8 weeks of intervention, the VAS score of the experimental group decreased from the baseline (5.8 ± 1.2) to (2.1 ± 0.8), the WOMAC index decreased by 63.3%, and the Berg Balance Scale score increased to (53.6 ± 4.1). The improvement in all indicators was significantly better than that of the control group (P < 0.01). The experimental group showed significant pain relief at 4 weeks (VAS score 3.5 ± 1.0), earlier than the control group；After 8 weeks of intervention, the reduction in IL-6 and TNF-α levels in the experimental group was significantly better than that in the control group. Conclusion? The combination of shortwave and blood flow restricted resistance training through the "anti-inflammatory-muscle strength reconstruction" dual-target mechanism can rapidly relieve pain in KOA patients, significantly improve joint function and balance ability, and is safe and well-tolerated, providing an optimized non-surgical treatment option for Kellgren-Lawrence grade II-III KOA.

Research on hallucination phenomena and countermeasures of large language models in medical scenarios

SHEN Feng, — 2026/7/20 10:13:25

Large language models (LLMs) are increasingly applied in the medical field; however, their endogenous hallucination problem severely restricts safe clinical deployment. This paper systematically reviews the definition, classification, underlying mechanisms, and mitigation strategies of medical hallucinations in LLMs. First, a classification system encompassing "factuality" and "faithfulness" is constructed, and a bias transmission mechanism spanning data, architecture, algorithms, and interaction is analyzed. Second, clinical scenarios such as medical question-answering, clinical summarization, and multimodal tasks are examined to analyze specific manifestations of hallucinations, including factual contradictions and evidence fabrication. On this basis, mainstream detection and mitigation strategies—including data governance, retrieval-augmented generation, factual alignment, and uncertainty quantification—are summarized. Finally, a human-AI collaborative governance mechanism is proposed, aiming to provide a reference pathway for advancing the safe and trustworthy deployment of LLMs in clinical practices.

Research on the practical value of artificial intelligence differential evolution algorithm -patient based real time quality control intelligent monitoring platform in quality management of clinical chemistry and immunology assays

LUO CHANGLIANG,,, — 2026/7/20 10:08:23

Objective This study aimed to evaluate the practical value of artificial intelligence（AI）differential evolution algorithm-patient based real time quality control （PBRTQC）intelligent monitoring platform in quality management of ten clinical chemistry and immunology assays. Methods Routine test results for the ten assays were automatically harvested from the laboratory information system at the people's hospital of guangxi zhuang autonomous region via the PBRTQC platform across the period from January to December 2023. The differential evolution algorithm was adopted to optimize the computational parameters-including batch size, step length, truncation bound, and control limits-of the EWMA procedure. The resultant model was validated using data collected between January to May 2024, and its performance was subsequently evaluated under real?world operating conditions from June to October 2024. With predefined quality rules in force, we systematically assessed the platform's capability in detecting analytical deviations and supporting quality-related decisions. Results The PBRTQC platform successfully converged on the optimal parameter settings for all ten assays. During operational runs, the system consistently identified and promptly flagged systematic performance disturbances arising from insufficient reagent volumes, prolonged reagent exposure after bottle opening, or carryover contamination from the stirring rod, demonstrating reliable error detection with timely alerting functionality. Conclusion By enabling continuous real-time risk surveillance, the PBRTQC platform proves capable of accurately pinpointing systematic errors in the ten clinical chemistry and immunochemistry assays, highlighting its potential as a valuable adjunct to routine laboratory quality management.

Brain-on-a-chip interfaces: frontiers in AI-assisted brain organoid chips

wang yifan — 2026/7/20 10:07:06

Brain-on-a-chip interfaces (BoCIs) extend conventional brain-computer interface research from in vivo neural signal communication to controllable encoding and decoding of in vitro neural networks. By coupling two-dimensional neural networks or three-dimensional brain organoids with microelectrode arrays, optogenetic stimulation, neural decoding and closed-loop feedback, BoCIs provide a platform for recording, stimulating and modulating living neural tissues. This review summarizes the conceptual boundaries, biological substrates, bioelectronic interfaces, information interaction modes, algorithmic support and application scenarios of AI-assisted brain organoid chips, and discusses their relationship with artificial intelligence virtual organoids (AIVOs) and biomedical digital twins. Rather than replacing physical experiments, computational models are expected to support hypothesis generation, interpretable prediction and experimental prioritization in biocomputing, disease modeling and neural intervention research.

A clinical study of arm reduced robotic laparoscopic surgery with low rectal cancer in male patients

2026/7/8 11:59:26

Objective To investigate the clinical utility and effectiveness of arm reduced robotic-assisted laparoscopic low rectal resection in man as a cost-effective surgical option for total robotic surgery. Method The study retrospectively collected 120 male patients who underwent robotic assisted laparoscopic low rectal resection in the department of Gastrointestinal Surgery of South River Hill Hospital from October 2021 to September 2022. The patients were divided into two groups of 60 each: (1) the arm-reduced robotic-assisted laparoscopic surgery group (n = 60 patients), and (2) the common robotic-assisted laparoscopic surgery group (n = 60 patients). The operation time, intraoperative blood loss, the number of dissected lymph nodes, postoperative complications, hospital stay and hospital costs were recorded and compared between the two groups. Collected data were analyzed by Statistical Package for Social Sciences version 22.0. Result There was no significant statistical difference between the two groups in intraoperative bleeding, the number of postoperative lymph nodes detected, postoperative complications, and postoperative hospital stay. The operation time, intraoperative bleeding and exhaust time in arm-reduced surgery group were 143.88±23.65min, 139.17±43.03ml, 2.77±1.11days, respectively. In the arm-reduced surgery group, the above indexes were 134.08±21.67min, 114.00±36.79ml, 2.27±1.26days, respectively. The operation time and exhaust time were significantly shorter in the arm-reduced surgery group than common surgery group (134.08±21.67min versus 139.17±43.03ml P=0.002, 2.27±1.26 days versus 2.77±1.11 days P=0.023). The intraoperative bleeding in the arm-reduced surgery was less than common surgery group (114.00±36.79ml versus 139.17±43.03ml P=0.001). Two-armed surgery resulted in an 6.8% reduction in procedure-specific costs. Conclusion Arm reduced robotic-assisted laparoscopic low rectal resection appears to be a cost-effective solution for robotic surgery. Compared with common robot-assisted laparoscopic low rectal cancer, it can reduce the intraoperative time and blood loss without increasing the risk of surgery-related morbidity. This approach has the potential to be a widely preferred surgical approach in low rectal cancer treatment strategies.

Manuscript-Advances in mammary organoid culture in animals

Peng siqi,Shi xin,Zeng dejun,Zhang chenglv, — 2026/7/8 9:45:31

The mammary gland is a highly dynamic organ in mammals, with its development primarily occurring from birth to puberty and pregnancy, undergoing processes of degeneration and regeneration. The mammary gland has become an important tool for studying organ development and disease occurrence. Over the past decade, significant progress has been made in three-dimensional cell culture technology. Due to the high similarity in structural and functional characteristics between organoids and in vivo tissues, three-dimensional cell culture is considered an efficient method for studying mammary gland development and breast cancer. This article systematically summarizes the molecular regulatory network and morphogenetic process of mammary gland development, focusing on three key determinants for constructing mammary gland organoids: the three-dimensional culture microenvironment, the dynamic regulatory system of mammary stem cells, and the conditions for activating signaling pathways. Emerging evidence indicates that breast organoid technology has demonstrated significant application potential in multiple fields, including the characterization of breast stem cell properties, the study of tumorogenesis mechanisms, and the development of personalized treatment strategies, providing an innovative model platform for precision medicine research on breast diseases.

Comparative Analysis of Current Perception Threshold and Related Factors in Patients with Type 2 Diabetes Mellitus

zhangyuting, — 2026/7/7 16:48:41

【】 Objective ?The objective of this study is to make a comparison between the current perception threshold (CPT) of the feet in patients with type 2 diabetes mellitus (T2DM) and to analyze the related influencing factors of those with abnormal CPT. The ultimate goal is to identify high-risk groups with abnormal sensory nerve function and to provide evidence-based basis for early clinical warning and care intervention. Methods? A retrospective analysis was [1]conducted on 169 diabetic patients, divided into the CPT normal group (79 cases) and the CPT abnormal group (90 cases). The clinical data of the two groups were compared, and the influencing factors of CPT abnormalities were analyzed using Spearman correlation analysis and multivariate Logistic regression analysis. Results ?A statistically significant discrepancy was observed between the two groups with respect to age, duration of diabetes, urine protein/creatinine ratio, and glomerular filtration rate (P<0.05). Spearman correlation analysis revealed a significant positive correlation between abnormal CPT and age (r = 0.171, P < 0.01), duration of diabetes (r = 0.152, P < 0.01), and UACR (r = 0.238, P < 0.01). Conversely, a negative correlation was observed between eGFR and abnormal CPT (r = -0.178, P < 0.01). Multivariate logistic regression analysis included age, duration of diabetes, log-transformed UACR (log-UACR), and eGFR. A higher log-UACR (odds ratio [OR] = 2.15, 95% confidence interval [CI] = 1.38–3.35, P < 0.001) and a higher eGFR (OR = 0.97, 95% CI = 0.95–0.99, P = 0.012) were identified as independent associated factors for abnormal CPT. Conclusion? A comparative analysis was conducted between type 2 diabetic patients exhibiting abnormal CPT in the foot group and those in the normal group. The findings revealed a strong correlation between age, duration of diabetes, UACR, and eGFR, and the presence of abnormal CPT. The study established that the duration of the disease, the rise in UACR, and the rise in eGFR were independent factors contributing to the development of abnormal CPT. This finding indicates that clinicians should closely monitor the predictive capacity of the duration of the disease and the rise in UACR for the abnormal CPT, as well as the protective effect of the rise in eGFR on CPT. The timely monitoring of these associated indicators can provide valuable clinical references for the early prevention and treatment of diabetic peripheral neuropathy.

Risk factors for poor functional outcomes in intracerebral hemorrhage patients with pulmonary embolism

huang xiu lin,,wang miao,wei hong,xu li shan — 2026/7/7 16:41:10

Objective To identify independent risk factors for poor functional outcomes in intracerebral hemorrhage (ICH) patients with pulmonary embolism (PE), aiming to facilitate early risk stratification and improve prognostication. Methods We conducted a retrospective analysis of 152 patients with ICH complicated by PE admitted to the First Affiliated Hospital of Guangxi Medical University between January 2013 and December 2024. Patients were stratified into two groups based on their good or poor functional outcome, as determined by the modified Rankin Scale (mRS) score at discharge. Variables with P < 0.05 in univariate analysis were entered into multivariable logistic regression to identify independent risk factors. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff value of combined predictors for poor functional outcomes following PE in ICH patients. Results Among the 152 patients enrolled, 32.9% experienced poor functional outcomes at discharge, with an in-hospital mortality rate of 9.2%. Intraventricular hemorrhage (IVH) (P = 0.021; OR 1.08, 95%CI 1.01–1.15), elevated ΔD-dimer1 (the change in D-dimer from admission to PE diagnosis) (P = 0.013; OR 2.13, 95% CI 1.22–5.12), and increased systemic inflammatory response index (SIRI) (P = 0.042; OR 1.22, 95%CI 1.01–1.49) emerged as independent predictors of adverse outcomes in ICH patients with PE. Conclusion IVH, elevated ΔD-dimer1, and increased SIRI are independent risk factors for poor functional outcomes in ICH patients with PE.

Research on Risk Prediction of Mycoplasma Pneumonia in Children with Severe Pneumonia Based on Lasso-Nomogram Model

wangyingru — 2026/7/7 15:06:30

【】 Objective:To build and validate a prediction model for severe mycoplasma pneumonia (SMPP) in children based on a Lasso-Nomogram model. Methods:Retrospectively selected medical records of 723 children with Mycoplasma pneumonia (MPP) admitted to the First Affiliated Hospital of Xinjiang Medical University from May 2023 to May 2024. The cases were divided into a modeling set (506 cases) and a validation set (217 cases) based on a random number table method (7:3), and further categorized into mild and severe groups according to disease severity. Lasso regression was performed on the modeling set data to screen for different variables, and a forward stepwise method was used for multivariate logistic regression analysis to construct a Nomogram forecasting model. The receiver operating characteristic curve (ROC) and its area under the curve (AUC) were plotted, and calibration curve analysis was conducted to evaluate the internal and external validation efficacy of the Nomogram model, while the clinical decision curve (DCA) assessed the clinical value of the model. Results: Lasso regression and multivariate logistic regression analysis indicate that age (OR=1.134, P=0.001), weakened respiratory sound (OR=6.147, P=0.006), pulmonary complications (OR=5.466, P=0.000), elevated blood lactic acid (BLA, OR=2.164, P=0.041), and increased lactate dehydrogenase (LDH, OR=10.766, P=0.000) are independent risk factors for SMPP. The Nomogram model constructed based on this predicts the area under the ROC curve (AUC) for SMPP in the modeling set to be 0.810 (95% CI: 0.772–0.847, P <0.01), and the AUC for the validation set to be 0.773 (95% CI: 0.708–0.838, P <0.001). The calibration curves for both the modeling set and the validation set show good fit and consistency. Clinical decision curve analysis (DCA) indicates that the Lasso-Nomogram model has high clinical benefit in predicting SMPP.Conclusion: The occurrence of SMPP in children is closely related to factors such as age, weakened respiratory sounds, pulmonary complications, BLA, and elevated LDH. The Lasso-Nomogram prediction model constructed based on the above factors has high accuracy, which helps in the early identification of SMPP risk in children and the implementation of corresponding preventive and therapeutic measures.

Preoperative Assessment of Prostate Cancer Gleason Grade Grouping Based on mpMRI Radiomics and Clinical Features

宋腾腾 — 2026/7/7 8:48:09

Objective To explore the clinical application value of multiparametric magnetic resonance imaging (mpMRI) radiomics features and clinical characteristics in the preoperative assessment of low- and high-grade prostate cancer (PCa) based on Gleason grading. Methods A total of 180 patients diagnosed with PCa by pathology and hospitalized in our institution from January 2024 to December 2024 were selected as the study subjects. According to the Gleason grading results, PCa patients were divided into two groups: those with Gleason grades 1–2 were classified as the low-grade PCa group, while those with Gleason grades 3–5 were classified as the high-grade PCa group. Clinical data were collected, and the ROC curve was used to evaluate the clinical application value of mpMRI radiomics features and clinical characteristics in the preoperative assessment of low- and high-grade PCa. Univariate and multivariate logistic regression analyses were performed to identify risk factors for preoperative assessment of high-grade PCa, and a nomogram model was constructed. Results The mpMRI radiomics score was significantly higher in the high-grade PCa group compared to the low-grade PCa group (P < 0.05). An mpMRI radiomics score>0.53, tumor diameter, PSA, PSAD, and N stage were identified as independent risk factors for preoperative assessment of high-grade PCa (P <0.05). A nomogram model was constructed based on these risk factors to predict preoperative high-grade PCa, with a C-index of 0.994 (95% CI: 0.971–0.999). The calibration curve was close to the ideal state, demonstrating the high accuracy of the model. The area under the ROC curve (AUC) reached 0.996 (95%CI: 0.972–0.999), indicating excellent performance of the model in distinguishing PCa patients. Additionally, the model provided positive net benefits across a prediction probability range of 2% to 100%. Conclusion The nomogram model constructed based on mpMRI radiomics and clinical features for preoperative assessment of high-grade PCa demonstrates good predictive performance.

The influence of abdominal electrical stimulation combined with diaphragm pacing therapy device on airway clearance ability and extubation rate in patients with tracheotomy after brain trauma

刘婷 — 2026/7/6 18:04:48

Objective: To study and explore the effect of abdominal electrical stimulation combined with diaphragmatic pacing therapy on the airway and extubation rate clearance ability with tracheotomy of patients after brain trauma. Method: Select 80 cases of cerebral trauma patients with tracheotomy as object is divided into observation group and control group, 40 cases in each group. The control group was treated and intervened with a diaphragm pacing therapy device. while the observation group received additional abdominal electrical stimulation therapy on the basis of the control group. Evaluate the cough and sputum clearance ability indicators, diaphragmatic ultrasound indicators, pulmonary ventilation function, extubation time, extubation success rate, hospitalization time, and prognosis rehabilitation quality score of two groups of patients. Result: Before treatment, there was no statistically significant difference in the cough and sputum output indicators between the two groups of patients (P>0.05). After treatment, the observation group non spontaneous cough peak flow velocity (ICPF), semi quantitative cough intensity score (SCSS), and sputum output were higher than group control (P<0.05). After treatment, the ultrasound indicators of the diaphragm, including diaphragm movement, diaphragm thickness, and diaphragm thickening score, were observed to be higher than those in the control group (P<0.05). After treatment, the observation group had higher lung ventilation function indicators, including forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEF), forced vital capacity (FVC), and maximum ventilation volume (MVV), compared to the control group (P<0.05).? After treatment, the observation group success rate of extubation was higher than group control, and the extubation time and hospital stay were shorter than those in the control group (P<0.05). After treatment, the quality of life comprehensive assessment questionnaire (GQOLI-74), Mini Mental State Examination (MMSE), and Glasgow Outcome Scale (GOS) scores in the observation group were higher than those in the control group (P<0.05). Conclusion: Abdominal electrical stimulation combined with diaphragmatic pacing therapy has a significant effect on airway clearance in patients with tracheotomy after brain trauma. It can improve the patients" cough and expectoration ability, enhance the diaphragmatic motor function, improve the pulmonary ventilation function, increase the success rate of extubation, and improve the prognosis score of the patients.

Clinical Application of Ventricular-peritoneal Long-term External Drainage in Intracranial Infection Complicated with Acute Hydrocephalus

chen jiru,Du hao, — 2026/7/6 18:03:39

Objective:To observe the clinical effect of ventricular-peritoneal long-term external drainage in the treatment of intracranial infection complicated with acute hydrocephalus. Methods: A retrospective analysis of 80 patients with intracranial infection complicated with acute hydrocephalus admitted to the neurosurgery department of the Second People's Hospital of Hunan Province (Brain Hospital of Hunan Province) from January 2022 to June 2025 was conducted. The control group (n=48) was treated with external ventricular drainage via catheterization of the frontal horn of the lateral ventricle, while the test group (n=32) underwent ventricular-peritoneal long-term external drainage. We compared the two groups regarding the incidence of drainage-related complications, drainage time, number of surgical procedures, and 3-month prognosis. Results:The incidence rates of secondary intracranial infection, cerebrospinal fluid incision leakage, and catheter migration in the test group were significantly lower than those in the control group (9.4% VS 33.3%, 3.1% VS 25.0%, and 0% VS 27.1%, respectively, P<0.05), but there was no statistically significant difference in the catheter occlusion rate and puncture bleeding rate between the two groups (P>0.05). The single surgical drainage time in the test group was significantly longer than that in the control group (49.38±4.55d VS 14.17±1.88d, P<0.05), and the total number of surgeries was significantly less than that in the control group (1.09±0.30 VS 2.83±0.69, P<0.05). Three months after surgery, the improvement rate of hydrocephalus in the test group was higher than that in the control group (78.1% VS 64.6%), and the mRS score was lower than that in the control group (3.84±0.82 VS 4.16±0.75), but there were no statistical significance (P>0.05). Discussion: Ventricular-peritoneal long-term external drainage technology not only significantly lengthens drainage time and reduces the number of surgeries, but also significantly reduces the incidence of secondary intracranial infections, cerebrospinal fluid incision leakage and catheter migration. It is a less invasive, economical and effective treatment method worthy of clinical promotion.

New perspective on Alzheimer's disease lipid theory: MRI research progress related to brain structure and function

LeiMiao,LuTao — 2026/7/6 17:33:23

Alzheimer"s disease (AD) is the most common type of dementia, and its pathological mechanism has not been fully elucidated. Dyslipidemia is an important influencing factor for various chronic diseases and a controllable risk factor for AD. Studies both domestically and internationally have shown that dyslipidemia may cause changes in the gray and white matter of the brain and brain network connectivity in AD patients through multiple aspects such as β-amyloid and tau protein deposition, neuroinflammatory response, blood-brain barrier damage, and genetic susceptibility, ultimately leading to cognitive impairment. However, the specific mechanism of action remains unclear. This review analyzes the potential mechanisms of association between dyslipidemia and AD; discusses and summarizes the MRI characteristics of brain changes caused by dyslipidemia in Alzheimer"s disease, revealing its correlation from aspects such as reduced gray matter volume in specific brain regions, white matter microstructural damage, and decreased brain network connectivity, providing directions for the prevention and treatment of AD in the future.

Advances in the Application of Single-cell RNA Sequencing in Cervical Cancer

chengyinglong,,wangtianhui,zhengrui — 2026/7/6 17:32:11

Cervical cancer (CC) is the fifth most common malignant tumor among women in China, posing a significant threat to female health. While early and precise diagnosis and treatment are crucial for improving prognosis, the high heterogeneity of the tumor microenvironment (TME) hampers the development of effective therapeutic strategies. Single-cell RNA sequencing (scRNA-seq) provides a powerful tool for deciphering the cellular heterogeneity of CC. By reviewing recent advancements in scRNA-seq research on CC, this article aims to explore the potential of this technology in resolving TME heterogeneity, elucidating metastatic mechanisms, and guiding the development of therapeutic strategies.

Prenatal diagnosis of a case of 48,XXYY syndrome and literature reviewe

zhangxian — 2026/7/6 17:30:08

This paper reports a case of 48,XXYY syndrome detected through non-invasive prenatal screening.

Analysis of a Case of Renal Infarction Caused by Thrombosis of Renal Artery

gongjinwei — 2026/7/6 17:28:41

Renal infarction is a rare entity that presents similarly to other common renal conditions such as nephrolithiasis, which can often result in a missed or delayed diagnosis.resulting in irreversible impairment of kidney function, or serious complications. There is no accepted protocol for the diagnosis and treatment of renal artery thrombosis, and early diagnosis and appropriate treatment are key to rapid recovery.

Exploring the Impact of Functional Electrical Stimulation Combined with Scalp Acupuncture on Forelimb Motor Function in Cerebral Infarction Rats Based on the SIRT1/PGC-1α Mitochondrial Biogenesis Pathway

蔡元雨,常永霞,李姣,马秋云 — 2026/7/6 15:46:02

Objective To investigate the effects of functional electrical stimulation (FES) combined with scalp stimulation on forelimb motor function in rats with cerebral infarction, and to explore its possible mechanism of action based on the silencing information regulatory factor 1 (SIRT1)/peroxisome proliferator activated receptor gamma co activator factor 1 alpha (PGC-1 alpha) mitochondrial biosynthesis pathway. Method 120 8-week-old rats were randomly divided into a control group, a model group, a scalp acupuncture group, an FES group, and a combination group (scalp acupuncture+FES), with 24 rats in each group. Constructing a rat model of cerebral infarction by improving the suture method. The Zea Longa score was used to evaluate neurological function, and the forelimb placement experiment was conducted to evaluate the motor function and neurological recovery of the forelimbs. The infarct volume was observed by 2,3,5-triphenyltetrazolium chloride (TTC) staining, and the hippocampal neuron structure and pathological changes were observed by hematoxylin eosin (HE) staining. Enzyme linked immunosorbent assay was used to detect serum inflammatory factor levels, a reagent kit was used to detect oxidative stress-related indicators in hippocampal tissue, transmission electron microscopy was used to observe mitochondrial morphology changes in hippocampal tissue, and Western blotting was used to detect SIRT1 and PGC-1 α protein levels in hippocampal tissue. Results Compared with the control group, the Zea Longa score of rats in the model group increased, the number of forelimb strides increased, the volume of cerebral infarction increased, the degree of hippocampal tissue damage worsened, the levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF - α), interleukin-1 β (IL-1 β), and malondialdehyde (MDA) increased, the level of superoxide dismutase (SOD) decreased, the degree of mitochondrial damage worsened, and the expression levels of SIRT1 and PGC-1 α proteins decreased, with statistical significance (P<0.05). Compared with the model group, the rats in the scalp acupuncture group, FES group, and combination group showed a decrease in Zea Longa scores, a reduction in the number of forelimb strides, a decrease in cerebral infarction volume, a reduction in hippocampal tissue damage, a decrease in IL-6, TNF - α, IL-1 β, MDA levels, an increase in SOD levels, a reduction in mitochondrial damage, and an increase in SIRT1 and PGC-1 α protein expression levels, with statistical significance (P<0.05). Moreover, the changes in the above indicators in the combination group were significantly higher than those in the scalp acupuncture group and FES group (P<0.05). Conclusion The combination of FES and scalp acupuncture can improve hippocampal tissue damage and promote the recovery of forelimb motor function in rats with cerebral infarction. The mechanism may be related to the activation of the SIRT1/PGC-1 α mitochondrial biosynthesis pathway, reducing inflammation and oxidative stress levels, and improving mitochondrial function.

A Machine Learning Framework for Predicting Nosocomial?Escherichia coli?Infections in Cervical Cancer

Shan Wulin,Kan Jinsong,Peng Wenju,Xu Xinxin,Zhang Jiayun — 2026/7/6 15:41:28

Objective This study sought to characterize the pathogen distribution of hospital-acquired infections in patients with gynecological malignancies and to develop a predictive model for infections caused by the predominant agent,?Escherichia coli, thereby guiding antimicrobial therapy and improving risk stratification. Methods We performed a retrospective analysis of clinical and microbiological data from 146 patients with gynecological malignancies. The study characterized the distribution of pathogenic isolates and the antibiotic resistance profile of the primary pathogen,?Escherichia coli. Subsequently, we identified risk factors for?Escherichia coli?infection and developed a predictive model, which was constructed and evaluated using both multivariate logistic regression and machine learning algorithms. All statistical analyses were conducted using R (version 4.3.2) and i-Research software. Results A total of 180 pathogenic isolates were identified, predominantly from midstream urine specimens (118/180, 65.56%). Gram-negative bacteria constituted 80.56% (145/180) of the isolates and were overwhelmingly dominated by?Escherichia coli, which represented 70.34% (102/145) of Gram-negative isolates and 56.67% (102/180) of all pathogens. Antimicrobial susceptibility testing of?E. coli?revealed high resistance rates (> 55%) to ceftriaxone, ciprofloxacin, trimethoprim-sulfamethoxazole, and levofloxacin, in contrast to minimal resistance (< 10%) to carbapenems, piperacillin-tazobactam, nitrofurantoin, and amikacin. As an initial logistic regression identified a significant association between?Escherichia coli?infection and midstream urine sample type (P = 0.004), we focused subsequent model development on this cohort. Univariate and multivariate regression analyses indicated that?Escherichia coli?infection was significantly associated with tumour type, total white blood cell count, Lpa and qualitative urinary nitrite test results (P?< 0.05), and was also associated with urinary bacterial count. A predictive model for?infection was subsequently developed using these indicators through multiple machine learning approaches. The decision tree and logistic regression models demonstrated stable performance, with area under the curve values of 0.84 and 0.82 for the training and test sets of the decision tree model, respectively, and 0.78 and 0.74 for the logistic regression model, respectively. Furthermore, the model's calibration curve demonstrated excellent agreement, indicating that the predicted risk aligned closely with the observed risk. Its clinical utility was further validated by decision curve analysis, which showed that the model yielded a superior net benefit across a clinically relevant threshold probability range (10-80%) compared to the treat-all and treat-none strategies, affirming its potential for practical implementation. Conclusions In summary, our analysis establishes that hospital-acquired infections in gynecological oncology patients are predominantly urinary tract infections caused by Gram-negative bacteria, with?Escherichia coli?as the predominant etiological agent. To address this, we constructed a machine learning prediction model based on readily available clinical parameters, which demonstrated high discriminatory power for identifying?Escherichia coli?in midstream urine samples. This model provides a clinically applicable tool for the early identification of high-risk patients and to guide targeted antibiotic therapy, with significant potential to curb antimicrobial resistance and improve patient outcomes.

From Contraindication to Individualization: Interpretation of New Advances in Domestic and International Guidelines on Menopausal Hormone Therapy for Women After Malignant Tumors

Li Xia,wangyu,Zhang Jing,Zhao Rong Wei — 2026/7/6 11:00:25

With continuous innovations in early diagnosis techniques and comprehensive treatment protocols for malignant tumors, the survival period of patients following standardized treatment has been significantly prolonged. Consequently, menopause-related health issues triggered by iatrogenic ovarian failure have become a core concern affecting the long-term quality of life for survivors. Due to potential risks of tumor recurrence, Menopausal Hormone Therapy (MHT) was long classified as an absolute contraindication for women after female malignancies. However, in recent years, high-quality evidence-based data from large-sample cohort studies, meta-analyses, and multicenter randomized controlled trials have continued to emerge. Authoritative institutions, including the International Menopause Society, The North American Menopause Society, and the Obstetrics and Gynecology Branch of the Chinese Medical Association, have successively updated their guidelines, driving a paradigm shift in MHT from "comprehensive prohibition" to "risk stratification and individualized precision application." his article systematically reviews the key updates in recent domestic and international core guidelines. It focuses on analyzing the definition of indications, the rationale for relaxing contraindications, optimization strategies for medication regimens, and the safety evidence chain for Menopausal Hormone Therapy (MHT) following surgeries for common female malignancies, including breast, endometrial, ovarian, and cervical cancers. Furthermore, it deeply elucidates the logical evolution of MHT from an absolute contraindication to individualized application, while supplementing detailed clinical operations and the management of special populations. Ultimately, this work aims to provide a reference path with both evidence-based basis and practical value for the standardized implementation of menopausal health management in female cancer survivors.

Study on the Correlation Between Clinical Characteristics and Prognosis in Endometrial Carcinoma with Molecular Classification

xushuo — 2026/7/6 10:59:08

Objective To investigate the correlation between clinical characteristic spectrum and survival outcomes in endometrial carcinoma patients with different molecular subtypes. Methods A total of 260 patients with endometrial carcinoma who underwent surgical treatment and had complete clinical data in Henan Provincial People's Hospital from July 2020 to December 2024 were enrolled. The clinical characteristic spectrum was collected, including age at onset, reproductive history, comorbidities, body mass index (BMI), serum tumor markers, as well as postoperative pathological parameters such as histological type, FIGO stage, histological grade, lymph node metastasis, myometrial invasion, lymphovascular space invasion and immunohistochemical indicators. Molecular typing was determined by Next Generation Sequencing (NGS). Results There were statistically significant differences in reproductive history, BMI, serum CA724 level, histological type, lymphovascular space invasion, histological grade, Ki-67 positive expression and postoperative adjuvant therapy among endometrial carcinoma patients with distinct molecular subtypes (P<0.05). Significant differences were observed in 30-month progression-free survival and overall survival across POLEmut, NSMP, MMRd and p53abn subtypes (P<0.05). Conclusion The molecular subtypes of endometrial carcinoma were correlated with clinical features including reproductive history, BMI, serum CA724, histological type, lymphovascular space invasion, histological grade, Ki-67 positivity and postoperative adjuvant therapy. Patients had disparate prognoses according to molecular classification: the POLEmut subtype exhibited the most favorable prognosis and the p53abn subtype the worst, whereas the NSMP and MMRd subtypes had intermediate prognoses. No statistically significant prognostic difference was found between MMRd and NSMP subtypes.

MiR-182-5p promotes endometrial cancer by inhibiting MTSS1

tangshiqian, — 2026/7/6 10:55:48

Objective This study aims to elucidate the role of miR-182-5p in the progression of endometrial cancer and to clarify their relationship with downstream target genes in endometrial cancer (EC).Methods The expression of miR-182-5p was up-regulated or down-regulated in normal endometrial cells and a panel of EC cell lines (Ishikawa, HEC-1-A, and KLE) through transfection. Subsequent changes in malignant phenotypes, including proliferation, invasion, and migration were evaluated using MTT, transwell invasion, and scratch assays. Bioinformatics tools predicted candidate targets of miR-182-5p , the expression levels of these targets in normal endometrial cells and endometrial cancer cell lines were detected by RT?PCR and Western blot. The specific molecular interaction between miR-182-5p and its target was further validated via a dual-luciferase reporter system. Results Compared with normal cells, a significant elevation of miR?182?5p was observed in EC?derived cells. Transfection with the miR?182?5p mimic significantly facilitated the aggressive traits of EC cells, whereas its inhibitor exerted the opposite effects. Subsequent investigations pinpointed MTSS1 as a direct target of miR?182?5p, luciferase reporter assays validated their direct binding, and a negative correlation was demonstrated between their expression levels.Conclusion MiR-182-5p may promote the progression of endometrial cancer (EC) in endometrial lesions by inhibiting MTSS1.

Study on the Mechanism of Mongolian Medicinal Panzeria alaschanica Kupr. in Promoting Apoptosis of Endometriotic Stromal Cells by Inhibiting PI3K/AKT Signaling Pathway

TianManXue — 2026/7/6 10:51:15

［］ Objective To investigate the effects of Mongolian medicinal herb Panzeria alaschanica Kupr (PA) on the proliferation, migration, invasion, and apoptosis of immortalized human endometrial stromal cells (St-T1b), and to explore its regulatory mechanism on the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway. Methods St-T1b cells were randomly divided into a blank control group (0 mg/mL PA), three PA treatment groups (2, 4, and 8 mg/mL), a PI3K activator 740Y-P alone treatment group, and a combined treatment group (8 mg/mL PA plus 740Y-P). Cell viability was detected by CCK-8 assay. The protein expression levels of PI3K, AKT, p-PI3K, and p-AKT were measured by Western blotting. Mitochondrial membrane potential was detected using JC-1 fluorescent probe staining. Cell apoptosis rate was determined by Calcein-AM/7-AAD double staining. Cell migration and invasion abilities were evaluated by Transwell assay. The relative mRNA expression levels of Bcl-2 associated X protein (Bax), B-cell lymphoma 2 (Bcl-2), matrix metalloproteinase 2 (MMP-2), and matrix metalloproteinase 9 (MMP-9) were detected by RT-qPCR. Rescue experiments with 740Y-P were performed to verify the mediating role of the PI3K/AKT signaling pathway. Results PA significantly inhibited the viability of St-T1b cells in a concentration-dependent manner (P < 0.05). Compared with the blank control group, PA (2, 4, 8 mg/mL) significantly decreased the protein expression levels of p-PI3K and p-AKT, reduced mitochondrial membrane potential, suppressed cell migration and invasion, and downregulated the mRNA expression levels of Bcl-2, MMP-2, and MMP-9 in a concentration-dependent manner (P < 0.05). Meanwhile, the apoptosis rate and Bax mRNA expression were significantly increased in a concentration-dependent manner (P < 0.05). Compared with the blank control group, the 740Y-P alone group showed significantly elevated protein expression of p-PI3K and p-AKT, increased mitochondrial membrane potential, and upregulated mRNA expression of Bcl-2, MMP-2, and MMP-9 (P < 0.05), whereas the apoptosis rate and Bax mRNA expression were markedly decreased (P < 0.05). Compared with the 8 mg/mL PA group, the combined treatment group exhibited significantly increased p-PI3K and p-AKT protein expression, elevated mitochondrial membrane potential, enhanced migration and invasion abilities, and upregulated Bcl-2, MMP-2, and MMP-9 mRNA expression (P < 0.05), accompanied by significantly reduced apoptosis rate and Bax mRNA expression (P < 0.05). Conclusion PA can significantly inhibit the proliferation, migration, and invasion of St-T1b cells and promote apoptosis. Its mechanism may be related to the regulation of the PI3K/AKT signaling pathway.

Analysis of Reproductive Prognosis After Hysteroscopic Surgery for Diffuse Uterine

张生澎 — 2026/7/6 10:46:55

Objective To analyze the reproductive prognosis of patients with diffuse uterine leiomyomatosis (DUL) after hysteroscopic myomectomy (HM). Methods A retrospective analysis was conducted on the clinical data of patients with DUL and fertility requirements who underwent HM at the Department of Gynecology, Beijing Tiantan Hospital, Capital Medical University, from August 2019 to May 2025. The effectiveness, safety, and pregnancy outcomes of HM for DUL patients were evaluated. Results A total of 43 DUL patients were included in this study. Among them, 38 cases (38/43, 88.37%) primarily presented with increased menstrual volume and prolonged menstruation, while only 5 cases (5/43, 11.63%) showed no obvious symptoms. The total number of surgeries performed was 108, with a median of 2.0 (1.0, 3.0) procedures per patient. During secondary hysteroscopy, intrauterine adhesion was observed in 17 cases (39.53%, 17/43). Intraoperative complications occurred in 4 cases, including 2 cases of hypokalemia and 2 cases of transurethral resection of prostate (TURP) syndrome. No complications such as uterine perforation, massive hemorrhage, or postoperative infection were reported. The menstrual improvement rate at 3 months postoperatively was 90.70% (39/43), while 4 patients showed no significant improvement, with 1 patient opting for hysterectomy. Postoperative pregnancy was achieved in 14 cases (32.56%, 14/43), with a median time to pregnancy of 3 (3, 20.5) months. The live birth rate was 71.43% (10/14), with 1 case of premature delivery (7.14%, 1/14) and 9 cases of full-term delivery (64.29%, 9/14). Conclusion For DUL patients with fertility requirements, staged HM is a feasible minimally invasive strategy that can effectively improve symptoms and uterine morphology, potentially enabling some patients to achieve their reproductive goals. However, attention should be paid to managing intraoperative fluid overload with electrolyte disorders and postoperative intrauterine adhesion-related issues.

Clinical value of serum HOXA10, GM-CSF, and CPEB1 in predicting pregnancy outcomes in patients with polycystic ovary syndrome combined with infertility after in vitro fertilization embryo transfer

纪雯雯 — 2026/7/3 16:10:49

Objective: To explore the clinical value of serum homobox A10 (HOXA10), granulocyte-macrophage colony-stimulating factor (GM-CSF), and cytoplasmic polyadenylation element binding protein 1 (CPEB1) in predicting pregnancy outcomes after in vitro fertilization embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS) combined with infertility.

Efficacy of levosimendan in patients with acute decompensated heart failure assessed by critical care ultrasound

LINJING,,,, — 2026/7/3 16:06:53

Objective To analyze the efficacy of levosimendan in patients with acute decompensated heart failure (ADHF) using critical care ultrasound. Methods This retrospective study enrolled 156 ADHF patients hospitalized in the Department of Cardiology at The People's Hospital of Guangxi Zhuang Autonomous Region between September 2020 and December 2021. Patients were divided into a control group (n=82) and a levosimendan group (n=74) based on whether they received levosimendan during hospitalization. Changes in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular end-diastolic diameter (LVEDD), left atrial diameter (LAD), left ventricular ejection fraction (LVEF), and lung ultrasound B-line counts were compared between the two groups before and after treatment. In-hospital mortality, all-cause mortality at 1 and 6 months post-discharge, and the heart failure rehospitalization rate at 6 months post-discharge were also compared. Multivariable Cox regression analysis was used to assess the relationship between B-line count and primary endpoint events. Results Compared with before treatment, both groups showed significant reductions in NT-proBNP and B-line counts, and an increase in LVEF after treatment (P < 0.05). In the levosimendan group, LVEDD significantly decreased after treatment (P < 0.05). After treatment, the reductions in NT-proBNP and lung ultrasound B-line counts were significantly greater in the levosimendan group than in the control group (P<0.05). The heart failure rehospitalization rate at 6 months was significantly lower in the levosimendan group than in the control group (P < 0.05). Multivariable Cox regression analysis showed that a B-line count ≥3 was an independent risk factor for heart failure rehospitalization within 6 months after discharge. Conclusion The addition of levosimendan to conventional therapy significantly improves cardiac function, reduces pulmonary congestion, and lowers the 6-month heart failure rehospitalization rate in patients with ADHF, without increasing short-term all-cause mortality. Critical care ultrasound assessment provides valuable objective evidence for treatment decisions and prognosis evaluation in ADHF and is worthy of clinical promotion.

Efficacy of ambulatory hlebectomy versus foam sclerotherapy as an adjunct to endovenous laser ablation for varicose ulcer of lower

兰照平,杨旗 — 2026/6/22 16:11:07

Objective To explore the short-term efficacy and long-term prognosis of endovenous laser ablation (EVLA) combined with ambulatory phlebectomy versus EVLA combined with foam sclerotherapy in treatment of varicose ulcer of lower extremity. Methods A randomized controlled trial was conducted on 100 patients with varicose ulcer of lower extremity admitted between August 2021 and March 2024. Participants were divided into two groups using randomization : Group A (n=50) received EVLA + ambulatory phlebectomy, while Group B (n=50) received EVLA + foam sclerotherapy. Perioperative parameters, Venous Clinical Severity Score (VCSS), hemodynamic indices, ulcer healing rates, complication rates, and recurrence rates were analyzed. Results Group B showed superior outcomes in operative time, intraoperative blood loss, hospital stay, and postoperative wound healing time (P < 0.05). Repeated-measures ANOVA revealed significant time, intergroup, and interaction effects for VCSS and hemodynamic indices (P < 0.05). Both groups exhibited reduced VCSS at 3 and 6 months postoperatively (P < 0.05), with further reduction at 6 months (P < 0.05). Group B had lower VCSS than Group A at both timepoints (P < 0.05). Hemodynamic parameters (plasma viscosity, low-shear whole blood viscosity, venous peak velocity) significantly favored Group B (P < 0.05). Group B achieved higher complete ulcer healing rates at 1 and 3 months (P < 0.05), though no intergroup difference existed by 6 months (P > 0.05). Complication rates were comparable (18.00% vs. 8.00%, P > 0.05), with zero recurrences at 12-month follow-up. Conclusion Compared with EVLA combined with ambulatory phlebectomy, EVLA plus foam sclerotherapy demonstrates superior short-term outcomes in promoting recovery, improving hemodynamics, and accelerating early ulcer healing. However, both combination strategies show comparable long-term efficacy (final healing rate/recurrence rate) and safety profiles.

Application of Modified Flat Mesh in Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair

胡行前,缪小飞,王彤,闫树盛 — 2026/6/22 12:05:04

Objective: To evaluate the feasibility and short-term clinical efficacy of a self-designed modified flat mesh in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. Methods: A retrospective analysis was performed on the clinical data of 116 patients with inguinal hernia admitted to our center from May 2022 to June 2024, comprising 4 females and 112 males with a mean age of (58.5±14.2) years. All patients underwent TEP under general anesthesia with the intraoperative placement of an individually trimmed Jiali mesh. This modified mesh was designed to conform to the anatomical structure of the retropubic space (space of Retzius). Perioperative outcomes, including operative time, intraoperative blood loss, postoperative complications (e.g., seroma, chronic pain), and recurrence, were analyzed. Results: All 116 procedures were successfully completed. The mean operative time was (33±12) min, and intraoperative blood loss was (20±10) mL. During a follow-up period of 3 to 24 months, postoperative seroma occurred in 9 cases, which resolved following conservative management; chronic pain was reported in 7 cases, which improved after symptomatic treatment. No hernia recurrence was observed. Conclusion: The modified flat mesh features a tongue-shaped tail that extends deep into the space of Retzius. Upon pneumoperitoneum release, the mesh obtains physical support from the bladder, effectively preventing displacement. Additionally, intraoperative personalized trimming avoids mesh folding and curling. Consequently, this technique demonstrates favorable clinical efficacy in preventing recurrence and possesses significant clinical feasibility.

Application of cationic polyethyleneimine in gene transfection

limingyang,, — 2026/6/22 11:57:28

Objective: To evaluate the potential of bPEI1800-C12 cationic polymer carrier for muscle transfection using polyethyleneimine (PEI) as the carrier. Methods: bPEI1800-C12/DNA complex nanoparticles were prepared by complex co-precipitation method. The formulation process was screened, and the physicochemical properties were evaluated. The optimal scheme was selected to prepare the complex nanoparticle, and in vitro cell transfection experiments were conducted to investigate the effects of different cell numbers and different preparation media on cell uptake; after establishing and validating the rat lower limb ischemia model, the bPEI1800-C12/DNA complex nanoparticles, PEGylated bPEI-C12/pGL4.50 nanoparticles, and in vivo-jet PEI/pGL4.50 nanoparticles were observed by bioluminescence imaging to investigate the transfection efficiency and gene expression in vivo through different administration routes and methods. Objective：To utilize cationic polyethyleneimine (bPEI1800-C12) as the carrier and recombinant hepatocyte growth factor naked plasmid (NL003) as the target gene to evaluate the potential of bPEI1800-C12 cationic polymer carrier for muscle transfection, and to provide a new approach for the treatment of lower extremity peripheral arterial disease. Methods：bPEI1800-C12/NL003 composite nanoparticles were prepared by complex coacervation. The formulation process was screened, and the physicochemical properties were evaluated. The optimal formulation was selected to prepare the composite nanoparticle, and in vitro cell transfection experiments were conducted to investigate the effects of different cell numbers and different preparation media on cell uptake. A control experiment was also performed with recombinant hepatocyte growth factor naked plasmid (NL003) injection. Results：bPEI-C12/NL003 nanoparticles could be taken up by rat skeletal muscle myoblasts and express the corresponding protein. The preparation medium had a certain impact on nanoparticle uptake. HBS and Hanks were selected as the preparation medium. When the cell number was between 8W and 20W, it basically had no effect on cell uptake. To facilitate observation, the effect of bPEI1800-C12 encapsulating pGL4.50 luciferase reporter gene on the transfection efficiency of rat skeletal muscle myoblasts was investigated using the bioluminescence method. It was observed that the bioluminescence intensity of the bPEI1800-C12/pGL4.50 group nanoparticles was significantly increased. Conclusion：There was a statistically significant difference compared with the pGL4.50 group (***P < 0.001), indicating that the transfection efficiency of the plasmid in vitro was significantly improved after encapsulation by bPEI1800-C12.

Expression of IER3 in Circulating Tumor Cells of Colorectal Cancer and Its Correlation with Apoptosis, Recurrence and Metastasis

w\韦春莹 — 2026/6/16 10:23:59

Abstract Objective: To investigate the expression characteristics of Immediate Early Response 3 (IER3) in colorectal cancer (CRC) tissues and circulating tumor cells (CTCs), analyze its relationship with tumor cell apoptosis, clinicopathological parameters, risk of recurrence and metastasis, and patient prognosis, and evaluate the potential of IER3 as a biomarker for predicting CRC prognosis and recurrence-metastasis risk. Methods: A total of 63 CRC patients meeting the inclusion and exclusion criteria were enrolled. Cancer and adjacent normal tissues were collected; IER3 protein expression was detected by immunohistochemistry, and IER3 mRNA level was measured by qRTPCR. Peripheral blood samples were obtained preoperatively and postoperatively. The number and classification of CTCs in peripheral blood were detected using the CanPatrol? technique, and IER3 mRNA expression in CTCs was examined by in situ hybridization. Tumor apoptosis was assessed by terminal deoxynucleotidyl transferasemediated dUTP nickend labeling (TUNEL). The correlations between IER3 expression and tumor apoptosis, disease recurrence, metastasis risk, and prognosis were analyzed. Statistical analysis was performed using SPSS 26.0, with P<0.05 defined as the threshold for statistical significance. Results: (1)The expression of IER3 protein in colorectal cancer tissues is higher than that in adjacent non-cancerous tissues (P < 0.05). (2) The difference in IER3 mRNA expression in colorectal cancer tissues is correlated with the degree of tumor apoptosis, and the difference is statistically significant (P < 0.05), but it is not correlated with gender, age, or clinicopathological parameters. (3) The expression of IER3 mRNA in colorectal cancer tissues is not correlated with the number and type of CTCs, nor with the number and type of IER3-positive CTCs before and after surgery. (4) IER3+ mesenchymal CTCs are correlated with vascular invasion, lymph node metastasis, distant metastasis, TNM stage, and tumor recurrence and metastasis (P < 0.05). (5) The expression of IER3 protein, the degree of tumor tissue apoptosis, and the expression of IER3 gene in CTCs are not correlated with tumor recurrence and metastasis. (6) Patients with a postoperative IER3（+） epithelial CTC count ≥ 1 have shorter overall survival and poorer prognosis. Conclusion: IER3 is highly expressed in CRC tissues and is associated with tumor apoptosis. Different subtypes of IER3positive CTCs can serve as indicators for evaluating tumor invasiveness and prognostic prediction, and are expected to become potential biomarkers for risk stratification of recurrence and metastasis, precise prognostic evaluation, and individualized therapy in colorectal cancer.

The relationship between serum ALCAM， B7-H4， S100A4 and different degrees of lesions and postoperative recurrence in patients with chronic sinusitis and nasal polyps

蔡东波 — 2026/6/11 16:33:57

Objective: To investigate the relationship between the expression levels of serum activated leukocyte cell adhesion molecule (ALCAM), B7-H4, and S100A4 in patients with chronic sinusitis with nasal polyps (CRSwNP) and the severity of the disease and postoperative recurrence. Methods: A total of 173 patients with chronic sinusitis (CRS) admitted to our hospital from January 2020 to December 2022 were included as the study subjects. They were grouped into CRSwNP group (100 cases) and CRSsNP group (73 cases) based on the presence or absence of nasal polyps. CRSwNP patients were further assigned into two groups based on whether they experienced recurrence within one year after surgery, with 36 cases in the recurrence group and 64 cases in the non recurrence group. The clinical and pathological characteristics of the subjects were collected and analyzed. Multifactorial logistic regression model to analyse the relationship between ALCAM, B7-H4, S100A4 and postoperative recurrence in CRSwNP patients. Enzyme linked immunosorbent assay was applied to detect the expression levels of serum ALCAM,B7-H4,and S100A4. Pearson correlation was applied to analyze the correlation between serum ALCAM,B7-H4,S100A4 expression and sinus CT Lund-Mackay score. The predictive value of serum ALCAM,B7-H4,S100A4 expression levels, and sinus CT Lund-Mackay scores for postoperative recurrence in patients with CRSwNP was analysed using subject operating characteristic (ROC) curves. Results: Compared with CRSsNP patients, the expression levels of serum ALCAM,B7-H4,and S100A4 in CRSwNP patients were obviously higher (P<0.05), the sinus CT Lund-Mackay score, serum ALCAM, B7-H4,and S100A4 expression levels in the recurrence group were higher than those in the non recurrence group (P<0.05). Serum ALCAM (OR=1.584), B7-H4 (OR=1.379), and S100A4 (OR=1.695) levels were risk factors for postoperative recurrence in patients with CRSwNP (P<0.05).Compared with the mild group, serum ALCAM, B7-H4, and S100A4 expression levels were significantly higher in CRSwNP patients in the moderate and severe groups (P<0.05), and the severe group was significantly higher than the moderate group. Serum ALCAM, B7-H4, and S100A4 expression levels were positively correlated with sinus CT Lund-Mackay scores (rALCAM=0.436, rB7-H4=0.528, rS100A4=0.561, P<0.05). The area under the curve (AUC) of serum ALCAM, B7-H4, S100A4, and sinus CT Lund-Mackay scores individually predicted postoperative recurrence in patients with CRSwNP was 0.851, 0.853, 0.849, and 0.741, respectively, and that of the combined assay was 0.967, which was superior to that of their respective individual predictions (Z combined-ALCAM = 2.988, Z combined-S100A4 = 2.878, Z combined-B7-H4 = 2.791, Z combined-sinus CT Lund-Mackay score = 4.738, P<0.05). Conclusion:The expression levels of serum ALCAM,B7-H4,and S100A4 are all elevated in patients with recurrent CRSwNP after surgery,and their expression levels are positively correlated with the severity of the disease,which can assist in predicting postoperative recurrence in CRSwNP patients.

Curative effect of Guben Qushi Huayu Formula combined with febuxostat and its influences on oxidative stress in patients with gouty nephropathy

辛婕琛 — 2026/6/11 16:32:28

Objective To explore clinical curative effect of Guben Qushi Huayu Formula combined with febuxostat and analyze its influences on oxidative stress in patients with gouty nephropathy (GN). Methods In the prospective and randomized controlled study, 106 patients with GN of dampness-turbidity stasis obstruction type in Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine were enrolled between January 2022 and January 2025. According to random number table method, they were divided into control group (febuxostat, 53 cases) and observation group (Guben Qushi Huayu Formula combined with febuxostat, 53 cases). All patients were treated for 3 months. The clinical curative effect and adverse reactions in the two groups were observed. The scores of TCM syndromes, renal function indexes [estimated glomerular filtration rate (eGFR), serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA)], urinary protein indexes [urinary β2-microglobulin (Uβ2-MG), urinary albumin creatinine ratio (UACR), 24h urine protein quantification (24hUTP)] and oxidative stress indexes [superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px)] were compared between the two groups before and after treatment. Results: After treatment, scores of main syndromes (joint pain, swelling, skin numbness, difficulty in flexion and extension) in observation group were (0.94±0.26) points, (1.03±0.28) points, (1.08±0.31) points and (0.92±0.25) points, lower than those in control group [(1.86±0.50) points, (1.54±0.41) points, (1.63±0.43) points, (1.49±0.40) points; P<0.05]. After treatment, levels of serum Scr, BUN, UA and MDA in observation group were (92.49±11.13) μmol/L, (7.36±2.04) mmol/L, (362.18±18.17) μmol/L and (4.65±1.22) nmol/mL, lower than those in control group [(103.54±10.02) μmol/L, (10.28±2.19) mmol/L, (405.79±20.41) μmol/L, (6.37±1.18) nmol/mL], while levels of eGFR, SOD and GSH-Px were (68.50±4.32) mL/min/1.73m2, (93.49±8.17) U/mL and (178.32±19.40) U/L, higher than those in control group [(61.17±4.22) mL/min/1.73m2, (85.75±8.06) U/mL, (151.12±16.43) U/L; P<0.05]. After treatment, levels of Uβ2-MG, UACR and 24hUTP were decreased in both groups, which were lower in observation group than control group [(1.21±0.31) vs (2.28±0.54) mg/L, (470.82±28.93) vs (628.51±30.19) mg/g, (1.01±0.29) vs (1.42±0.33) g/24h; P<0.05]. The total response rate of clinical treatment in observation group was higher than that in control group (94.34% vs 81.13%, P<0.05). There was no significant difference in total incidence of adverse reactions between the two groups (15.09% vs 11.32%, P>0.05). Conclusion:? Compared with with febuxostat alone, Guben Qushi Huayu Formula combined with febuxostat may be better in terms of improving clinical syndromes and renal function, and alleviate oxidative stress in patients with GN of dampness-turbidity stasis obstruction type, which has good safety.

The relationship between miR-181a-5p, miR-132-5p with the condition and prognosis of patients with diabetic nephropathy

王莉 — 2026/6/11 16:30:55

Objective: To explore the relationship between microRNA-181a-5p (miR-181a-5p), microRNA-132-5p (miR-132-5p) with the condition and prognosis of patients with diabetic nephropathy (DN). Methods: From April 2021 to April 2024, 121 DN patients were marked as the DN group and assigned into a good prognosis group (96 cases) and a poor prognosis group (25 cases) based on their 1-year prognosis. Meantime, 119 patients with simple diabetes were included in the simple diabetes group, and 116 individuals who underwent health check ups were included as the control group. Real-time fluorescence quantitative PCR was used to detect serum miR-181a-5p and miR-132-5p. The degree of renal pathological damage in DN patients was evaluated, and clinical data such as blood urea nitrogen (BUN), blood uric acid, and blood creatinine (Scr) were recorded. Spearman method was used to analyze correlation. Multivariate logistic regression analysis was used to screen for independent influencing factors. ROC curve was plotted to construct a poor prognosis prediction model. DeLong test was used to compare AUC. Results: Compared with the control group and the simple diabetes group, the serum miR-181a-5p and miR-132-5p in DN group were lower (P<0.05). As the degree of renal pathological damage in DN patients worsened, serum miR-181a-5p and miR-132-5p gradually decreased (P<0.05). Serum miR-181a-5p and miR-132-5p were negatively correlated with glomerular grading, interstitial inflammation score, and the interstitial fibrosis and tubular atrophy (IFTA) score (P<0.05). Compared with the good prognosis group, the poor prognosis group had higher Scr and lower serum miR-181a-5p and miR-132-5p (P<0.05). MiR-181a-5p and miR-132-5p were independent protective factors for poor prognosis in DN patients (P<0.05). The AUC values of miR-181a-5p, miR-132-5p alone, and their combination in predicting poor prognosis in DN patients were 0.838, 0.821, and 0.954, respectively, with the combined AUC being relatively high (Z=2.278, 2.612, P<0.05). Conclusion: Serum miR-181a-5p and miR-132-5p are prominently decreased in DN patients. The two are closely related to disease progression and prognosis, and can jointly predict poor prognosis of DN.

Association between the timing of dexamethasone intervention in controlled ovarian stimulation cycles and assisted reproductive outcomes

zhang ling — 2026/6/11 16:29:05

Objective:?To investigate the effect of dexamethasone acetate (DXM) on suppressing premature serum progesterone (P) elevation during controlled ovarian stimulation (COS) and compare the impact of different intervention timings on assisted reproductive outcomes.?Methods: A retrospective analysis was conducted on 450 patients who underwent their first in vitro fertilization-embryo transfer (IVF-ET) using the long-acting follicular phase long protocol from January 2022 to June 2024. Patients were divided into a non-intervention group (Group A, n=117) and a DXM intervention group (Group B, n=333). Group B was further subdivided based on the timing of DXM addition: early addition (Group B1, added at Gn initiation, n=205), mid addition (Group B2, added after 6 days of Gn use or when the leading follicle diameter reached 10-14 mm, n=54), and late addition (Group B3, added when the leading follicle diameter >16 mm or serum P ≥1 ng/ml, n=74). General characteristics, COS parameters, laboratory indicators, and clinical outcomes were compared among the four groups.?Results:No statistically significant differences were found in general characteristics among the four groups (P > 0.05). The total Gn dosage and duration of stimulation in Group B1 were significantly lower than those in Group A (P < 0.05). On the trigger day, serum estradiol (E2) levels in Group A were significantly lower than those in the other three groups. Serum P levels in Groups A and B1 were similar and both were significantly lower than those in Groups B2 and B3 (P < 0.05). The fresh embryo transfer rate in Group A (78.63%) and Group B1 (73.17%) was significantly higher than that in Group B2 (59.26%). Group B1 showed the highest trend in clinical pregnancy rate (69.29%) and live birth rate (56.67%), but the differences between groups were not statistically significant (P > 0.05).?Conclusion： In COS cycles using the long-acting follicular phase long protocol, early addition of DXM can effectively control progesterone levels, reduce Gn dosage and stimulation duration, and increase the fresh embryo transfer rate, thereby potentially improving assisted reproductive outcomes.

Diagnostic and Therapeutic Characteristics and Clinical Reflections on Malignant Tumors Complicating Pregnancy

Song Zhao-li — 2026/6/10 5:31:49

As malignant tumors become more prevalent among younger populations, the incidence of malignancy in pregnancy has risen, posing a complex clinical challenge in obstetrics. The core dilemma lies in balancing maternal oncological treatment and fetal safety. This article systematically discusses the diagnosis and treatment strategies based on clinical practice and updated guidelines. Physiological changes during pregnancy can easily be confused with early tumor symptoms, resulting in delayed diagnosis and advanced staging. The key to early diagnosis is the accurate identification of abnormal signals, including pre-pregnancy screening for high-risk individuals and stratified assessment during pregnancy, with pathological biopsy as the gold standard for confirmation. Imaging examinations follow the ALARA principle. Ultrasound and gadolinium-free MRI are the first choices, while ionizing radiation studies are strictly restricted. Treatment prioritizes maternal safety, with the second trimester being the optimal window for surgery and chemotherapy. Chemotherapy should be avoided in the first trimester; low-risk agents such as anthracyclines and platinum-based drugs are recommended, whereas teratogenic medications are contraindicated. Radiotherapy is generally contraindicated and only cautiously administered in rare exceptional cases. The entire management relies on multidisciplinary team (MDT) collaboration to develop individualized plans. Delivery requires comprehensive evaluation of maternal and fetal conditions, followed by timely initiation of oncological treatment postpartum and long-term follow-up of both maternal and child health. Standardized diagnosis and treatment combined with an MDT model can improve maternal and fetal outcomes and provide safety assurance for women of reproductive age.

Impact of Domestic Pet Exposure on Allergic Diseases in Children: A Retrospective Cohort Study

王月娇,,, — 2026/6/9 16:03:30

【】Objective To investigate the impact of domestic pet exposure on children with allergic diseases sensitized to animal dander, further clarifying the relationship between pet exposure and pediatric allergic diseases, and to provide evidence for clinical diagnosis and treatment. Methods Children with allergic diseases who underwent serum-specific immunoglobulin E (sIgE) testing for inhaled allergens and tested positive for animal dander (including cat/dog dander or mixed animal dander) at the Pediatric Clinic of Beijing Tsinghua Changgung Hospital from December 2017 to December 2024 were retrospectively enrolled. Participants were divided into a domestic pet-exposed group (n=162) and a non-exposed group (n=237) based on pet exposure history. General clinical data and allergy-related indicators were compared between the two groups, and multivariate logistic regression analysis was performed to explore the association between pet exposure and allergic diseases. Results Among 399 children sensitized to animal dander, 40.6% had domestic pets. Compared to the non-exposed group, the pet-exposed group showed significantly lower prevalence of bronchial asthma (35.8% vs. 47.7%, P=0.019), the pet-exposed group exhibited a significantly older age at diagnosis of allergic diseases compared to the non-pet-exposed group [median (IQR): 6.8 (4.0–9.73) years vs. 5.0 (3.2–8.0) years,P= 0.002]., lower serum total IgE levels [median (IQR): 279 (131–508) vs. 352 (148.75–723.25) kU/L,P=0.039], and a reduced proportion of mixed sensitization to ≥2 other inhaled allergens (42.6% vs. 59.1%, P=0.020). Multivariate analysis revealed that domestic pet exposure had a lower risk of developing bronchial asthma (OR=0.641, 95%CI: 0.409–1.007). Children with a family history of allergic diseases (such as in parents or other relatives) had a higher risk of developing bronchial asthma(OR=1.827, 95%CI: 1.143–2.919). Conclusion Early-life domestic pet exposure is significantly associated with reduced risk of bronchial asthma, delayed onset of allergic diseases, lower total IgE levels, and decreased polysensitization in children sensitized to animal dander. A family history of allergic diseases is strongly linked to increased asthma risk in children.

Siglec-15 regulates hepatocellular carcinoma proliferation and migration through the EGFR/PI3K/AKT pathway

guan lulu,houshuting,lei xiaotian,,tian mengmeng,wen xuejun — 2026/6/9 16:01:38

【】 Objective: Investigating the regulation of hepatocellular carcinoma proliferation and migration by sialic acid-binding immunoglobulin-like lectin-15 (Siglec-15) through modulation of the EGFR/PI3K/AKT pathway. Methods: qRT-PCR and Western blot assays were performed to detect the expression of Siglec-15 and EGFR in normal hepatocyte L02 cells and hepatocellular carcinoma cell lines HEPG2, SMMC-7721, and BEL-7402. qRT-PCR was used to assess the transfection efficiency of Siglec-15 and EGFR in HEPG2 cells following siRNA knockdown. Bioinformatics analysis using the GEPIA2 database was performed to examine Siglec-15 and EGFR expression in hepatocellular carcinoma and adjacent normal liver tissues. Further prediction of potential regulatory relationships between Siglec-15 and EGFR was performed using the GeneMANIA website. The hepatocellular carcinoma cell line HEPG2 was divided into the following groups: Siglec15-NC, si-Siglec-15, EGFR-NC, si-EGFR, si-Siglec-15+EGFR-NC, and si-Siglec-15+si-EGFR. Western blot analysis was used to detect the expression levels of Siglec-15, EGFR/PI3K/AKT pathway proteins via Western blot. MTT, Annexin V-FITC/PI, cell scratch, and Transwell assays were performed to evaluate the effects of Siglec-15, the EGFR/PI3K/AKT pathway, and their combined interaction on hepatocellular carcinoma cell proliferation and migration following transfection. Results: Siglec-15 expression levels were significantly higher in SMMC-7721, BEL-7402, and HEPG2 cells compared to L02 cells (P<0.001). EGFR expression levels were significantly higher in all three hepatocellular carcinoma cell lines compared to L02 cells (P<0.001). The HEPG2 hepatocellular carcinoma cell line was selected for subsequent experiments. Successful transfection of si-RNA to knock down Siglec-15 and si-RNA to knock down EGFR was achieved in the HEPG2 cell line. Knocking down Siglec-15 inhibited HCC cell proliferation and migration while promoting HCC cell apoptosis. Knocking down EGFR similarly inhibited HCC cell proliferation and migration and promoted HCC cell apoptosis. Siglec-15 and EGFR were highly expressed in HCC tissues but lowly expressed in adjacent non-cancerous liver tissues. Low expression of Siglec-15 and EGFR synergistically inhibited HCC cell proliferation and migration by regulating the activation of the PI3K/AKT pathway.Concluion:Siglec-15 is highly expressed in HCC cells, and EGFR is highly expressed in HCC cells, and there is a positive regulatory relationship between the two. Siglec-15 reglutes the proliferation and migration of hepatocellular carcinoma cells through the EGFR/PI3K/AKT pathway.

Immunological Imbalance of Th17/Treg Cells in Epstein-Barr Virus-Associated Diseases

yangpengli — 2026/6/8 9:33:09

Epstein-Barr virus (EBV), a double-stranded DNA virus belonging to the herpesvirus family, is associated with a variety of diseases, including infectious mononucleosis, chronic active EBV infection, EBV-associated hemophagocytic lymphohistiocytosis, and EBV-related autoimmune disorders. Primary EBV infection predominantly occurs in children aged 3 to 5 years. Recent studies have demonstrated that the dysregulation of T helper 17 (Th17) and regulatory T (Treg) cell balance plays a crucial role in the pathogenesis of EBV-associated diseases. Th17 cells secrete pro-inflammatory cytokines, such as IL-17, contributing to inflammatory responses and tissue damage, whereas Treg cells maintain immune homeostasis through immunosuppressive mechanisms. EBV infection disrupts Th17/Treg equilibrium by modulating host immune responses, leading to immune dysfunction. This imbalance facilitates viral persistence and promotes disease progression.This article reviews the characteristics of EBV, the functional roles of Th17 and Treg cells, the mechanisms underlying EBV-induced immune dysregulation, and recent advances in the understanding of EBV-associated diseases.

Research Progress of Ferroptosis in Cardiovascular Diseases

Huyaoshi,Luzhengde, — 2026/6/8 9:32:26

Cell death plays a crucial role in the pathophysiological processes of diseases, and in-depth dissection of its mechanisms and regulatory networks holds significant scientific importance. Ferroptosis, a novel form of regulated cell death, is characterized by the accumulation of iron-dependent lipid peroxidation. Recent studies have shown that ferroptosis is involved in the pathological processes of various cardiovascular diseases and may serve as a potential therapeutic target. This review systematically summarizes the key molecular regulatory mechanisms of ferroptosis, with a focus on its pathological roles in cardiovascular diseases and its translational medical value, aiming to provide new theoretical basis for the prevention and treatment of related diseases.

Advances in the study of oncolytic viruses in the treatment of hepatocellular carcinoma

yangtao, — 2026/6/8 9:31:44

Hepatocellular carcinoma (HCC) ranks among the most lethal malignant tumours globally, presenting a significant challenge in China due to its high incidence rate and the considerable limitations of current treatment approaches. Oncolytic viruses (OVs) have demonstrated superior efficacy in the treatment of HCC in recent years. This paper reviews the characteristics of OVs, encompassing their antitumour mechanisms, preclinical trials, clinical evaluations, and combination therapies with other treatments. It explores the potential of different types of oncolytic viruses in the treatment of HCC and outlines future development directions for OVs in the field of HCC therapy.

A case of cryptococcal meningitis with vertigo as the initial manifestation was tortuous diagnosis

Jiang Xiaorong,,quehongfang,Wu Xianbin — 2026/6/8 9:30:41

This paper reports a case of tortuous diagnosis of cryptococcal meningitis with vertigo as the initial manifestation.

A case of desmoid-type fibromatosis of the periosteum misdiagnosed as ovarian tumor

Jinyijun,Linxiaojing,yangjie, — 2026/6/5 20:22:24

A This article reports a case of desmoid-type fibromatosis of the periosteum misdiagnosed as ovarian tumor.

A Consistency Analysis of Early Esophageal Cancer Diagnosis Using Endocytoscopy and Magnifying Endoscopy with NBI Compared to Pathological Biopsy Results

周杨 — 2026/6/5 20:19:28

Objective: Early diagnosis of esophageal cancer is critical for improving patients" survival rates and quality of life. Traditional pathological biopsies have limitations such as sampling errors, while endoscopic techniques offer more intuitive diagnostic information. This study compared the consistency of endocytoscopy (EC) and magnifying endoscopy with narrow-band imaging (ME-NBI) with pathological biopsy results in early esophageal cancer diagnosis. Methods: This single-center, prospective, double-blind randomized controlled trial included 180 patients with suspected esophageal lesions detected by white-light endoscopy (WLE) at the Endoscopy Center of Cangzhou People"s Hospital between June 2022 and April 2025. Patients were randomly assigned to EC (n=94) and ME-NBI (n=86) groups. Diagnostic results from both groups were compared to pathological biopsy results. Results: EC showed a total consistency rate of 88.3%, significantly higher than ME-NBI"s 77.9% (P=0.042), with Kappa values of 0.82 and 0.68, respectively. EC achieved a 90.0% consistency rate for small lesions (≤1cm), compared to ME-NBI"s 70.8% (P=0.042). ME-NBI was more reliable for deep infiltration (sm3) assessment (Kappa=0.87 vs. EC"s 0.82). Conclusion: EC demonstrates significantly higher consistency with pathological biopsy results in early esophageal cancer diagnosis than ME-NBI, particularly for small lesions. The two techniques are complementary, and their combined use can enhance diagnostic accuracy.

Effects of Ozone Autohemotherapy on Inflammatory Response and Red Blood Cell Protection During On-pump Coronary Artery Bypass Grafting

linzhonglin,, — 2026/6/5 20:17:38

Objective: To evaluate the protective effect of ozone autohemotherapy on inflammatory response and red blood cell injury during on-pump coronary artery bypass grafting (CABG), and to explore its influence on perioperative clinical outcomes. Methods: A total of 100 patients undergoing on-pump CABG from October 2024 to December 2025 were enrolled. This study was approved by the Ethics Committee of the Affiliated Hospital of Guangdong Medical University, and all patients provided written informed consent. Patients were divided into an intervention group and a control group (50 cases each). The intervention group received 100 mL of ozone-treated autologous blood reinfusion within 30 minutes after the initiation of cardiopulmonary bypass (CPB), while the control group received routine CPB management. Results: After CPB, inflammatory factor levels in the intervention group were significantly lower than those in the control group (P<0.001). The oxidative stress index MDA was significantly reduced (P<0.001), while the activities of antioxidant enzymes SOD and GSH-Px were increased (P<0.01). The intervention group showed reduced red blood cell hemolysis rates, better morphological preservation, and higher band 3 membrane protein relative optical density (P<0.01). At 24 hours postoperatively, PaO? was significantly higher in the intervention group (P<0.001). ICU stay (3.24±0.48 days vs 3.61±0.51 days, P=0.001) and hospital stay (10.43±1.35 days vs 11.02±1.41 days, P=0.045) were significantly shorter in the intervention group. Conclusion: Ozone autohemotherapy can effectively inhibit the perioperative inflammatory response during on-pump CABG, reduce erythrocyte oxidative damage and membrane structural destruction, improve postoperative pulmonary function, and shorten hospital stay.

Clinical Efficacy And Safety Observation Of Intra-Articular Injection Of Concentrated Growth Factor In The Treatment Of Knee Osteoarthritis

lan xiaowen,,,,,, — 2026/6/5 20:13:38

Objective To evaluate the clinical efficacy and safety of concentrated growth factor (CGF) intra-articular injections for the treatment of knee osteoarthritis (KOA). Methods A retrospective analysis was conducted on the clinical data of 253 patients with KOA admitted to the Guangxi Zhuang Autonomous Region People’s Hospital from January 2018 to December 2024. Among them, 122 patients who received intra-articular CGF injections were assigned to the observation group, while 131 patients who received intra-articular sodium hyaluronate (HA) injections were assigned to the control group. We compared pain severity [Visual Analogue Scale (VAS) scores] and knee function (WOMAC scores and Lysholm Knee Score) between the two groups at baseline (T0) and 3 months (T3) and 6 months (T6) post-treatment. We also compared the recurrence rates of KOA within 6 months post-treatment between the two groups. The incidence of adverse reactions during the treatment and follow-up periods was observed. Results After treatment, both groups showed a significant downward trend in VAS and WOMAC scores (P < 0.05) and a significant upward trend in the Lysholm Knee Range of Motion Score (P < 0.05). At time points T3 and T6, the VAS and WOMAC scores in the observation group were lower than those in the control group, while the Lysholm Knee Score was higher than that in the HA group, with statistically significant differences (P < 0.05). Within 6 months of treatment, the recurrence rate of KOA in the observation group was significantly lower than that in the control group (9.84% vs. 51.91%; χ2 = 51.714, P < 0.001). Thirteen patients (10.66%) in the observation group and 18 patients (13.74%) in the control group reported mild pain or swelling at the injection site, both of which resolved spontaneously. No serious adverse events were observed in either group during treatment or follow-up. Conclusion Intra-articular injection of CGF for the treatment of KOA yields good clinical outcomes, with a low recurrence rate and good safety profile, and is worthy of clinical recommendation.

Analysis of pathogen Characteristics in Children with Infectious Diarrhea at a Hospital in Guilin

qinwenzhen — 2026/6/5 15:59:14

[Abstract] Objective To investigate the etiological composition and epidemiological characteristics of infectious diarrhea among children in Guilin City from 2022 to 2025, providing a basis for the treatment and prevention of childhood diarrheal diseases in this region. Methods Information on diarrheal cases and stool samples were collected from children attending a hospital in Guilin between March 2022 and March 2025. Pathogen detection targeted 5 viruses and 6 categories of pathogenic bacteria. Bacterial isolation followed conventional culture and identification procedures, while viral detection utilized the Polymerase Chain Reaction (PCR) method. Antimicrobial susceptibility testing was performed on isolated Salmonella and diarrheagenic Escherichia coli (DEC) strains, and whole-genome sequencing was conducted on a subset of Salmonella isolates. Statistical analyses employed the Chi-square test or Fisher's exact test, with a P-value < 0.05 considered statistically significant. Results Of the 1,186 samples tested, pathogens were detected in 577 cases, resulting in an overall positive detection rate of 48.65%. The bacterial detection rate was 15.77% (187/1186), the viral detection rate was 32.88% (390/1186), and mixed bacterial–viral co-detection was observed in 7.34% (87/1186) of samples. The rates of virus–virus co-detection and bacterium–bacterium co-detection were 3.88% (46/1186) and 0.59% (7/1186), respectively. Pathogen detection rates varied significantly by season (P < 0.05): Rotavirus showed higher prevalence in winter and spring, whereas Salmonella was more common in summer and autumn. Detection rates also differed significantly across age groups (P < 0.05), with the highest positivity rate observed in children aged 1-3 years. Antimicrobial susceptibility testing of 63 Salmonella and 49 DEC isolates revealed the following resistance rates in Salmonella: ampicillin (73.01%), cefotaxime (38.10%), and trimethoprim-sulfamethoxazole (49.20%). Corresponding resistance rates in DEC were 59.18%, 36.73%, and 32.65%, respectively. All isolates remained susceptible to tigecycline, ertapenem, imipenem, and meropenem. Whole-genome sequencing of 37 Salmonella isolates identified the aminoglycoside resistance gene aac(6')-Iaa in all strains. Other prevalent resistance genes included the β-lactamase gene TEM-1B (26 strains, 70.27%) and the sulfonamide resistance gene sul2 (23 strains, 62.16%). Virulence gene profiling of 49 DEC isolates indicated that eae (typical of EPEC) and aaiC (typical of EAEC) were the most common genes detected. Conclusion Infectious diarrhea among children in Guilin exhibits distinct age-related and seasonal patterns, with a regional-specific pathogen profile. Clinical management and public health strategies should be tailored accordingly based on these characteristics.

Clinical Efficacy of Levonorgestrel-Releasing Intrauterine System versus Dydrogesterone in Perimenopausal Women with Endometrial Hyperplasia Without Atypia

zhaoyi — 2026/6/5 15:27:43

Objective To evaluate the clinical efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS) versus dydrogesterone for the treatment of perimenopausal patients with endometrial hyperplasia without atypia.Methods A total of 71 patients pathologically diagnosed with endometrial hyperplasia without atypia were recruited from Beijing Tiantan Hospital between June 2022 and June 2025. All participants were allocated to the LNG-IUS group (n=37) receiving LNG-IUS insertion and the dydrogesterone group (n=34) treated with oral dydrogesterone. Clinical efficacy, menstrual characteristics, endometrial thickness and adverse reaction profiles were compared between the two groups.Results Significant improvements in menstrual duration and endometrial thickness were observed after treatment in both groups (P<0.05). Baseline menstrual duration and endometrial thickness were comparable between the two groups (P>0.05). After intervention, both parameters were markedly reduced in the two groups, with significantly lower values in the LNG-IUS group relative to the dydrogesterone group (P<0.001). Although the LNG-IUS group exhibited a higher overall response rate and a lower incidence of adverse reactions than the dydrogesterone group, the differences did not reach statistical significance (P>0.05).Conclusion Both LNG-IUS and dydrogesterone can effectively alleviate menstrual abnormalities and reduce endometrial thickness in patients with endometrial hyperplasia without atypia. LNG-IUS yields better clinical efficacy and safety profiles with a higher therapeutic response rate and fewer adverse events, making it a preferable option in clinical practice.

Decoding and Functional Remodeling Strategies for Tumor Immune

瞿梓泉 — 2026/6/3 9:50:21

The clinical efficacy of cancer immunotherapy is profoundly constrained by the pronounced spatial heterogeneity of the tumor microenvironment (TME), particularly the presence of immune "cold" zones—encompassing "desert" niches characterized by a deficiency in chemotactic signaling and "excluded" niches sustained by physical or metabolic barriers. Advancements in spatial transcriptomics (ST) have empowered the resolution of the spatial topological architecture governing immune evasion at sub-cellular and single-cell scales. By systematically integrating recent clinical evidence with multi-omic datasets, it was found that the maturation gradient and spatial distribution of tertiary lymphoid structures (TLSs) serve as the core determinants of effector cell infiltration efficiency. In addition, the spatial evolution of regulatory (Treg-rich) and fibrosis-associated TLS constitutes a critical nexus driving the transition from immune-excluded to immune-cold phenotypes. Therefore, here we propose that characterization of the tumor immune microenvironment should shift from a simple "spatial description" to a "functional spatial intervention" model. By leveraging epigenetic remodeling, targeted metabolic blockade, and the induction of high endothelial venules (HEVs), it is expected to reconstruct an immuno-permissive microenvironment, thereby providing a scientific theoretical basis based on spatial biology to overcome resistance in solid tumor immunotherapy.

Accuracy of AI-based Preoperative Planning System in Predicting Prosthesis Size for Total Knee Arthroplasty: -A Retrospective Study of 412 Cases Using AIJOINT System

2026/6/3 9:48:46

Objective To evaluate the accuracy of the AIJOINT system in predicting implant size for total knee arthroplasty (TKA) and to analyze the influencing factors. Methods Consecutive patients undergoing primary TKA at the Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University between January and December 2025 were retrospectively included. Preoperative planning was performed using the AIJOINT system. The primary outcome was prediction accuracy (exact match or within ±1 size). Agreement was assessed using Cohen's weighted Kappa (κw), with 95% CIs calculated by bootstrap resampling. Multivariate logistic regression models were constructed separately for femoral and tibial component exact matching as dependent variables, with variables showing P<0.10 in univariate analysis entered into the model. Independent predictors were identified by backward stepwise selection, and results were expressed as odds ratios (OR) with 95% confidence intervals (CI). Results A total of 412 patients were included, with a mean age of 67.5±7.9 years and 67.9% female. The AI system achieved exact prediction accuracy of 72.8% (κw=0.751, 95%CI: 0.710–0.792) for femoral components and 70.1% (κw=0.723, 95%CI: 0.681–0.765) for tibial components; within ±1 size, the accuracy was 92.0% for femur and 91.0% for tibia. Multivariate analysis showed that mild deformity (OR=6.00, 95%CI: 3.11–11.57, P<0.001) and moderate deformity (OR=2.42, 95%CI: 1.24–4.72, P=0.010) compared with severe deformity, as well as female sex (OR=1.57, 95%CI: 1.02–2.42, P=0.041), were independent predictors for femoral component accuracy; for tibial components, mild deformity (OR=2.53, 95%CI: 1.40–4.56, P=0.002), moderate deformity (OR=1.86, 95%CI: 1.02–3.40, P=0.045), and female sex (OR=1.47, 95%CI: 1.01–2.14, P=0.047) were likewise independent predictors, all showing a dose-response trend. Conclusions AI-based preoperative planning demonstrates high accuracy in predicting implant size for TKA in a Chinese population, with within ±1 size accuracy of 92.0% for femoral components and 91.0% for tibial components. Deformity severity is the strongest independent factor associated with prediction accuracy, with both mild (femoral OR=6.00, tibial OR=2.53) and moderate deformity (femoral OR=2.42, tibial OR=1.86) outperforming severe deformity in a dose-response pattern. Female sex is likewise an independent factor (femoral OR=1.57, tibial OR=1.47). Prediction accuracy is significantly reduced in patients with severe deformity, warranting more cautious interpretation of AI predictions in this population.

EGFL9 enhances the proliferative, invasive, and migratory capacities of hepatocellular carcinoma (HCC) cells through activation of the EGFR/PI3K/AKT/mTOR signaling pathway

Feng Jingyang,Li Ziye,Shen Xiaobao,Wang Bailin, — 2026/6/2 16:26:20

Objective: To analyze the specific molecular mechanisms through which epidermal growth factor-like domain 9 (EGFL9) promotes hepatocellular carcinoma (HCC) proliferation, invasion, and migration via the EGFR/PI3K/AKT/mTOR signaling pathway. Methods: Lentivirus-mediated siRNA technology was employed to establish EGFL9-knockdown HCC cell lines (Huh-7 and SNU-449) targeting two distinct genomic sites. Cellular proliferation, apoptosis, migration, and invasion capabilities were evaluated using MTT assays, apoptosis detection, and Transwell assays. Western blotting was performed to examine expression and phosphorylation levels of key EGFR/PI3K/AKT/mTOR pathway components in both EGFL9-knockdown and EGFL9-overexpressing cells , as well as in corresponding subcutaneous xenograft tumor tissues. Pre-established EGFL9-overexpressing Huh-7 cells were treated with EGFR and AKT inhibitors, respectively, followed by reassessment of proliferative and migratory capacities through functional assays and corresponding pathway protein expression changes via Western blotting. Results: RT-qPCR analysis demonstrated over 80% suppression efficiency of EGFL9 expression in both Huh-7 and SNU-449 HCC cell lines with dual-targeting knockdown. Functional assays revealed that EGFL9 knockdown significantly inhibited proliferative, invasive, and migratory capacities while promoting apoptosis in both HCC cell lines. Western blot analysis indicated that EGFL9 knockdown substantially reduced phosphorylation levels of EGFR, PI3K, AKT, and mTOR proteins without affecting their total expression levels. Conversely, EGFL9-overexpressing Huh-7 cells maintained comparable total protein expression but exhibited markedly elevated phosphorylation levels of these pathway components relative to controls. Both EGFR and AKT inhibitor treatments significantly diminished pathway protein phosphorylation and correspondingly attenuated proliferative and migratory capacities in EGFL9-overexpressing Huh-7 cells. Conclusion: EGFL9 may enhance HCC cell proliferation, invasion, and migration capabilities through the EGFR-PI3K-AKT-mTOR signaling pathway, suggesting its potential as a novel therapeutic target for hepatocellular carcinoma.

Wu Xian1.2, Xu Jiaxuan1, Luo Ke1.2, Tang Rixin1, Ban Zhihong1, Tang Huamin1Emergency Department, International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine (Nanning 530001)? 2. Graduate School, Guangxi University of Chinese Medicine (Nanning 530201)? Phone: 15607718824

吴显 — 2026/6/1 10:43:55

Objective: Exploring the targets and molecular mechanisms of Xuefu Zhuyu Tang in treating traumatic brain injury based on network pharmacology and molecular docking.Methods From November to December 2024, the active ingredients of Xuefu Zhuyu Tang were retrieved from the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform, and the intersection targets of traumatic brain injury targets and Xuefu Zhuyu Tang treatment for traumatic brain injury were obtained using the GeneCards database. The STRING platform was used to construct protein interaction network information, and Cytoscape 3.10.2 software was used for network information topology calculation to screen core targets and components. Metascape platform was used for gene ontology functional enrichment analysis and Kyoto gene and genome database pathway enrichment analysis, and Python 3.8 software was imported to draw bubble plots. Perform molecular docking using AutoDock 1.5.6 software to predict the binding performance between core components and core targets.Results Select 33 intersecting targets for the treatment of traumatic brain injury with Xuefuzhuyu Tang. The core components are quercetin, luteolin, β - sitosterol, kaempferol, and baicalein. The core proteins are BCL2, AKT1, JUN, CASP3, MMP9, which are rich in MAPK signaling pathway, PI3K-Akt signaling pathway, TNF signaling pathway, AGE-RAGE signaling pathway in diabetes complications, HIF-1 signaling pathway in fluid shear stress and atherosclerosis, apoptotic IL-17 signaling pathway, lipid and atherosclerosis, and inflammatory bowel disease signaling pathway. Research has shown that the molecular docking binding potentials of combinations of β - sitosterol, quercetin, baicalein, kaempferol, and luteolin with AKT, as well as combinations of β - sitosterol and baicalein with BCL, are all below -5.0 Kcal/mol.Conclusion Xuefu Zhuyu Tang may achieve therapeutic effects on traumatic brain injury by regulating key protein targets such as BCL2, AKT1, JUN, CASP3, and MMP9 in inflammatory bowel disease through the MAPK signaling pathway, PI3K Akt signaling pathway, TNF signaling pathway, etc., exerting its synergistic potential in anti-inflammatory, anti apoptotic, improving oxidative stress, promoting blood-brain barrier repair, and regulating immune response.

Comparison of MAKO Robotic Assistance and Conventional Instruments on Joint Line Height in Total Knee Arthroplasty: A 1:1 Propensity Score Matched Study

Dong Ziyang,,Tian Hua,Wang Xinguang,Zheng Yuhang — 2026/5/22 10:11:53

目的：全膝关节置换术（total knee arthroplasty, TKA）的关节线（joint line, JL）高度和髌骨位置偏移可能导致疼痛和关节力学改变。我们开展了一项回顾性队列研究，旨在比较MAKO手术机器人与传统器械辅助TKA对JL高度变化、髌骨位置及下肢力线的影响。方法：回顾性纳入了2021年1月至2023年12月期间接受Stryker假体植入行全膝关节置换手术的患者，并将接受MAKO手术机器人辅助手术的患者作为机器人组，将接受传统器械辅助手术的患者作为传统组，并采用1:1倾向评分匹配以平衡潜在偏倚。主要结局指标为术后JL高度。次要结局指标包括手术时间、髌骨位置、下肢力线等。结果：在倾向评分匹配后，一共纳入了160例患者进行统计分析，其中MAKO组80例，传统组80例。MAKO组比传统组JL高度变化更小（高度变化，-0.58 mm vs 0.93 mm，p < 0.001；绝对值，2.15 mm vs 2.20 mm，p = 0.826；位置异常率，16.3% vs 26.3%，p = 0.122；过度上移率，7.5% vs 20.0%，p = 0.022）。两组患者髌骨位置异常的比例无显著差异（p = 0.291）。MAKO组相比传统组术后髋-膝-踝角偏离值改善但差异无统计学意义（2.54°vs. 3.27°, p = 0.058），而股骨远端外侧角和胫骨近端内侧角偏离值和异常比例两组无显著差异（p ＞ 0.05）。MAKO手术机器人辅助手术比传统器械辅助手术时间长约8 min，但差异无统计学意义（p ＞ 0.05）。结论：本研究验证了MAKO膝关节系统在全膝关节置换术中可更好恢复JL高度和髌骨高度。

Comparative study of short-term efficacy between robot-assisted functional alignment total knee arthroplasty and conventional total knee arthroplasty

石泽锋,, — 2026/5/22 10:11:21

Objective To compare the short-term outcomes of robot-assisted functional alignment in total knee arthroplasty (FA-RTKA) versus conventional mechanical alignment in total knee arthroplasty (MA-TKA). Methods A retrospective analysis was conducted on clinical and imaging data from 94 patients (97 knees) who underwent total knee arthroplasty (TKA) in the People’s Hospital of Guangxi Zhuang Autonomous Region from March 2023 to September 2025. All the patients were divided into two groups based on the surgical technique, including the FA-RTKA group (46 cases, 48 knees) and the MA-TKA group (48 cases, 49 knees). Surgical-related indicators were compared between the two groups, including operative time, perioperative blood loss, and soft tissue release extent. Imaging parameters were analyzed according to the coronal plane alignment classification of the knee joint (CPAK), including arithmetic hip-knee-ankle angle (aHKA), joint line inclination (JLO), and CPAK phenotype. Clinical outcomes were evaluated at 1, 3, 6 months postoperatively using the 2011 American Knee Society Score (2011KSS) and the Forgotten Joint Score (FJS-12). Results The FA-RTKA group exhibited significantly longer operative time (P＜0.05), less perioperative blood loss (P＜0.05), and markedly lower soft tissue release rates (P＜0.05) compared with the MA-TKA group. The proportion of patients maintaining preoperative alignment status in terms of JLO and CPAK classification was higher in the FA-RTKA group (P＜0.05). The FA-RTKA group demonstrated superior outcomes compared with the MA-TKA group at 1 month postoperatively, with higher objective and subjective scores on the 2011 KSS scale (P＜0.05). At 3 months, the FA-RTKA group showed better subjective KSS scores, WOMAC scores, and FJS-12 scores (P＜0.05), while the FJS-12 score at 6 months remained statistically superior (P＜0.05). Conclusion Compared with MA-TKA, FA-RTKA can reduce perioperative blood loss and minimize soft tissue dissection. This technique exhibits advantages in restoring the knee joint's inherent phenotype and joint line inclination, thus leading to superior early clinical efficacy.

Follow-up Analysis of Regular Enzyme Replacement Therapy for Fabry Disease

baiyunhuan,,, — 2026/5/18 11:38:13

Objective: To analyze the clinical data of 5 patients with Fabry disease receiving regular enzyme replacement therapy (ERT) and evaluate the treatment efficacy. Methods: Retrospective analysis of clinical data from 5 Fabry disease patients undergoing regular ERT at our hospital between August 2021 and October 2025. Statistical analysis was performed using SPSS 25.0 software. Quantitative data were expressed as mean ± standard deviation. Paired t-tests were used for pre-and post-treatment comparisons, with P<0.05 indicating statistically significant differences. Clinical data (pre-treatment): 5 males, initial onset age 8.8±3.7 years, diagnosis age 25.6±14.1 years, neuropathic pain (5 cases), hypohidrosis (5 cases), cardiac involvement (5 cases), renal impairment (4 cases), stroke (3 cases), decreased lung function (4 cases), diarrhea (2 cases), ocular damage (2 cases), hearing loss (2 cases). All patients showed decreased α-GalA enzyme activity (0.28-0.45 μmol h?1 L?1) and elevated Lyso-glutaminase-3 (Lyso-GL-3) levels (57.19-357.9ng/ml), with confirmed GLA gene mutations. Treatment: Agalsidase α (0.2 mg/kg every two weeks) in 4 cases, Agalsidase β (1.0 mg/kg every two weeks) in 1 case, with treatment duration ranging from 33 to 48 months. Follow-up (33-48 months): No deaths reported. 2 cases showed no significant organ damage; 1 case had mild cerebral infarction, 3 cases demonstrated mild myocardial thickening, and 2 cases exhibited marked reduction in proteinuria. All patients showed a marked decrease in Lyso-GL-3 levels, with five demonstrating significant improvement in quality of life scores and one developing a new cerebral hemorrhage. Early diagnosis and treatment of Fabry disease are crucial, as enzyme replacement therapy can alleviate severe organ damage and reduce mortality.

Effect of Liposomal doxorubicin+cyclophosphamide+albumin bound paclitaxel on related growth factors and tumor markers in breast cancer patients

liyong — 2026/5/18 11:14:41

Objective ?To analyze the effect of Liposomal doxorubicin+cyclophosphamide+albumin bound paclitaxel on related growth factors and tumor markers in breast cancer patients. Methods ?The breast cancer patients (88 cases) received in our hospital from June 2022 to June 2023 were collected as research objects, and they were further divided into the control group (44 cases) and the observation group (44 cases) according to the random number table method. The control group was treated with epirubicin+cyclophosphamide+docetaxel, while the observation group was treated with Liposomal doxorubicin+cyclophosphamide+albumin bound paclitaxel. Compare the efficacy, growth factor levels, immune function, tumor marker levels, and incidence of adverse reactions between two groups. Results ?The incidence of adverse reactions in the observation group was lower than that in the control group, and the total effective rate and remission rate were higher than those in the control group (P<0.05). After treatment, the levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), carcinoembryonic antigen (CEA), tissue polypeptide specific antigen (TPS), carbohydrate antigen 153 (CA153), and CD8+in both groups decreased (P<0.05), while the levels of CD4+, CD3+, and CD4+/CD8+increased (P<0.05), and the observation group was superior to the control group (P<0.05).? Conclusion ?LD+CTX+ABX has significant therapeutic effects on BC, improves immune function, has a low incidence of adverse reactions, and is safe.

Recent research progress of renal fibrosis in diabetes nephropathyWang Jing,Xiong Fei

wangjing, — 2026/5/14 8:38:54

Diabetic nephropathy (DN) is a major microvascular complication of diabetes. Renal fibrosis is the core pathological feature driving its progression to end-stage renal disease. This systematic review summarizes the primary pathogenic mechanisms of diabetic nephropathy and renal fibrosis, including the roles of oxidative stress, inflammatory responses, key cytokines, and related signaling pathways (such as TGF-β/Smad, PI3K/Akt, Wnt/β-catenin, etc.). In the realm of therapeutic progress, this paper offers a comprehensive overview of conventional targeted intervention strategies and an in-depth exploration of the mechanisms of emerging therapeutic targets, such as vitamin D receptors and the NLRP3 inflammasome. It systematically analyzes the distinctive advantages of multi-component, multi-target regulation strategies in traditional Chinese medicine. This review aims to provide a theoretical foundation for clinical anti-fibrosis treatment and to expand the future treatment options for DN.

CBX2 promotes colorectal cancer progression and 5-FU resistance by upregulating EphA3 to activate the PI3K/AKT/mTOR pathway

Hou Qiyan,Mo Chongde,Tang Yi,Yu Zehao,,Zhao Jiehua — 2026/5/12 15:37:21

Objective ?To investigate the role of Chromatin Box Protein 2 (CBX2) in colorectal cancer (CRC) progression and 5-FU resistance. Methods? Database and clinical data were analyzed to examine CBX2 expression in CRC, its association with clinical-pathological features, and its impact on patient prognosis. CBX2 expression in CRC samples was detected via immunohistochemistry, Western blotting, and qRT-PCR. Established CBX2 knockdown and overexpression cell models to evaluate their effects on CRC proliferation, migration, invasion, and 5-FU sensitivity via CCK-8 assays, cell proliferation tests, and Transwell experiments. Employed bioinformatics analysis and validated through cellular experiments to investigate CBX2"s regulation of the EphA3/PI3K/AKT/mTOR pathway in CRC, as well as its influence on CRC biological behavior and 5-FU sensitivity. Animal experiments examined CBX2"s impact on CRC cell tumorigenicity in vivo. Results ?CBX2 was significantly overexpressed in CRC tissues, correlated with tumor differentiation grade and lymph node metastasis, and served as an independent prognostic risk factor. Downregulating CBX2 inhibited CRC cell proliferation, migration, and invasion while enhancing 5-FU sensitivity; CBX2 overexpression produced opposite effects. CBX2 upregulates EphA3 through direct binding. Downregulating CBX2 reduces EphA3 expression and inhibits the PI3K/AKT/mTOR pathway, thereby suppressing CRC cell proliferation, migration, invasion, and enhancing 5-FU sensitivity. CBX2 promotes CRC tumorigenesis in nude mice. Conclusion CBX2 promotes CRC progression and 5-FU resistance by activating the PI3K/AKT/mTOR pathway through EphA3 protein upregulation. It represents a potential therapeutic target for CRC and may serve as a prognostic and chemoresponsiveness biomarker.

Current Status and Influencing Factors of Supportive Care Needs Among Patients Receiving Maintenance Hemodialysis

Liu Rui,Wang Haojie,Zhang Lu, — 2026/5/11 17:40:23

[Abstract] Objective To investigate the current status of supportive care needs and their influencing factors among patients undergoing maintenance hemodialysis (MHD), and to provide evidence for the early identification of patients with high supportive care needs and the development of individualized clinical interventions. Methods Using a convenience sampling method, outpatient hemodialysis patients undergoing MHD at Wuchang Hospital Affiliated to Wuhan University of Science and Technology from March to July 2025 were recruited as the study participants. Data were collected using a general information questionnaire, the Supportive Care Needs Survey–Short Form 34 (SCNS-SF34), the End-Stage Renal Disease Maintenance Hemodialysis Patient Treatment Adherence Scale, the Hamilton Anxiety Scale (HAMA), and the Hamilton Depression Scale (HAMD). Pearson correlation analysis was used to examine the correlations among supportive care needs, anxiety and depression, and treatment adherence in patients undergoing MHD. Multiple linear regression analysis was performed to identify the factors influencing supportive care needs in patients with MHD. Results There were statistically significant differences in SCNS-SF34 scores among patients undergoing MHD with different ages, educational levels, employment status, and average monthly income (P < 0.05). The total score of SCNS-SF34 among the 200 patients undergoing MHD was (78.98±14.86). Supportive care needs in patients undergoing MHD were positively correlated with HAMA scores (r = 0.774, P < 0.001) and HAMD scores (r = 0.322, P < 0.001). Treatment adherence was negatively correlated with HAMA scores (r = -0.346, P < 0.001) and HAMD scores (r = -0.224, P = 0.001). In addition, supportive care needs were negatively correlated with treatment adherence (r = -0.466, P < 0.001). Multivariate analysis showed that age, education level, work or study status, anxiety level, and treatment adherence were significant influencing factors of supportive care needs in patients undergoing MHD (P < 0.05). Conclusion Patients undergoing MHD have unmet supportive care needs, which are influenced by age, education level, work or study status, anxiety level, and treatment adherence. These findings provide evidence for clinical healthcare professionals to accurately identify differences in supportive care needs among MHD patients and may help further optimize the care service system for this population.

Analysis of the distribution characteristics and influencing factors of sodium valproate in the serum of 2514 children with epilepsy

杨妮 — 2026/5/11 17:39:10

Objective: To explore the factors affecting the serum valproic acid (VPA) levels in children with epilepsy and their correlation efficacy, so as to provide a reference for guiding the drug treatment of children with epilepsy. Methods: The serum VPA levels of 2,514 children epilepsy were measured by fluorescence immunoassay. The effects of age, gender, dose and other factors on the VPA levels and their relationship with efficacy were. Results: Among the children with epilepsy, 936 (37.2%) had VPA blood levels below the therapeutic window, 41 (56.4%) were within the therapeutic window, and 159 (6.3%) were above the therapeutic window. Age and dose had effect on the serum VPA levels (P<0.05), while gender had no effect (P>0.05). There was a significant in efficacy among different serum VPA levels (P<0.05). Conclusion: There is a large individual difference in the serum VPA levels, which affected by the children"s age, gender, and dose. In order to achieve personalized drug treatment, routine monitoring of the serum drug concentration should be conducted.

Value of spectral CT single-energy imaging combined with miR-146a in predicting the formation of deep venous thrombosis in the lower extremities of patients after vascular surgery

dingxiang — 2026/5/11 17:37:36

Objective ?To explore the value of spectral CT single-energy imaging combined with microRNA (miR)-146a in predicting deep vein thrombosis (DVT) in the lower extremities of patients after vascular surgery. Methods ?A total of 258 patients who underwent vascular surgery in Suzhou Hospital Affiliated to Nanjing University Medical School (Suzhou Science and Technology City Hospital) from January 2022 to November 2024 were selected. They were divided into the DVT group (n=50) and the N-DVT group (n=208) based on the occurrence of DVT in the lower extremities three months after surgery. The general information, spectral CT single-energy imaging parameters, and serum miR-146a levels of the two groups were compared. LASSO was used to screen variables, and logistic regression equations were used to analyze the influencing factors of DVT occurrence in the lower extremities. Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) were plotted to analyze the predictive value of CT single-energy imaging parameters and serum miR-146a levels for DVT occurrence in the lower extremities. Results The levels of thrombin time (TT), D-dimer (D-D), and fibrinogen (Fib) in the DVT group were higher than those in the N-DVT group (P<0.05). The CT values of the inferior vena cava, femoral vein, and popliteal vein at 40-70 KeV in the DVT group were higher than those in the N-DVT group, while the serum miR-146a level was lower (P<0.05). The LASSO regression algorithm identified the following variables as influencing factors for the occurrence of DVT in the lower extremities: CT values of the inferior vena cava, femoral vein, and popliteal vein at 40-70 KeV, and miR-146a. Logistic regression analysis showed that these variables were all significant predictors of DVT in the lower extremities (P<0.05). The AUC of the combined prediction model, which includes CT values of the inferior vena cava, femoral vein, and popliteal vein at 40-70 KeV and miR-146a, was 0.897, significantly higher than that of each individual indicator alone (P<0.05). Conclusion Spectral CT single-energy imaging combined with miR-146a shows a certain correlation with the presence of DVT in the lower extremities of patients after vascular surgery. Furthermore, the combination of CT values and miR-146a at 40-70 KeV in the inferior vena cava, femoral vein, and popliteal vein has good predictive value for postoperative DVT in patients.

MLMT Analysis of 142 Cryptococcus neoformans var. grubii Isolates from Geographically Diverse Regions

hetingting,luqin,shirongxing,,zhujian — 2026/5/9 18:32:56

Objective: To analyze multilocus microsatellite typing (MLMT) genotypic diversity and regional distribution characteristics of 142 Cryptococcus neoformans var. grubii isolates from different regions. Methods: DNA was extracted from strains collected in China, Japan, and Brazil. MLMT was performed using CNG1 (TA), CNG2 (GA), and CNG3 (CAT) microsatellite loci. Genotypes were determined by sequence analysis using Chromas software. The Simpson index was used to assess genotypic diversity. Low-frequency genotypes were grouped into categories. CNG3 (CAT) microsatellite loci. Genotypes were determined by counting motif repeats using Chromas software, and genotypic diversity was assessed using the Simpson index. Low-frequency genotypes were grouped into an “other” category (for those with a total frequency <5). Regional differences in genotype distribution were compared using chi-square or Fisher's exact tests. Results: 142 strains were classified into 17 MLMT genotypes. China detected 7 types (MLMT-14, 16, 17, 29, 34, 39, 40), Japan 2 types (MLMT-2, 17), and Brazil 13 types (MLMT-2, 12-14, 17, 31-38). The Simpson indices for the three regions were 0.32 for China, 0.15 for Japan, and 0.82 for Brazil. East Asian strains (China and Japan) showed a lower index (D=0.58). Brazil exhibited significantly higher genotype diversity than East Asia, with statistically significant differences in genotype distribution between regions (P<0.05). Genotype distributions in China and Japan were consistent (P=0.287). Significant differences (p<0.05) were observed in genotype distribution between clinical and environmental strains among the 142 isolates. Clinical strains predominantly exhibited genotypes MLMT-13 and 17, while environmental strains showed MLMT-17 and 36 as the main genotypes. Genotypes MLMT-2 and 34 were neutral in both clinical and environmental isolates. Conclusion: The MLMT method offers high resolution, simplicity, speed, and low cost. This study demonstrated regional variation in genotypic diversity of Cryptococcus neoformans var. glubii through MLMT analysis. East Asia predominantly exhibited the MLMT-17 genotype, while Brazil primarily showed the MLMT-36 genotype. Brazil exhibited high genetic diversity, with significant differences in genotypic distribution patterns between regions. Future studies should incorporate larger samples and multifactorial analyses to investigate the interaction between geography and origin, or conduct in-depth functional analyses of genotypes 13, 17, and 36.

Building a New Paradigm of Intelligent Diagnosis and Treatment for Knee Osteotomy Based on Artificial Intelligence and Multimodal Data Fusion

Pei Zhiwei,,, — 2026/5/9 18:19:55

Knee osteotomy is a key joint-preserving technique for treating unicompartmental osteoarthritis and correcting lower limb alignment. It includes various procedures, such as high tibial osteotomy (HTO, open-wedge and closed-wedge), distal femoral osteotomy (DFO), and combined two-level osteotomy. Traditional diagnostic and treatment methods rely on limited experience and two-dimensional imaging analysis when addressing the critical clinical decision of "how to select and plan the optimal procedure for a specific patient." They cannot uniformly quantify and compare the complex three-dimensional biomechanical changes and corresponding risks of complications associated with different procedures. The rapid development of artificial intelligence and multimodal data fusion technologies offers new opportunities to address this challenge, enabling comprehensive precision in preoperative planning, risk warning, and postoperative management. This article focuses on a novel intelligent diagnostic and treatment paradigm. It leverages comprehensive patient data—including anatomical, biomechanical, and clinical information—to establish an intelligent decision support system capable of simulating, evaluating, and optimizing different osteotomy strategies. This system aims to achieve personalized procedure selection, quantitative prediction of surgical risks, precise planning and execution of surgery, and postoperative prognosis prediction tailored to specific procedures. The article highlights its advantages, specific technical pathways, and key challenges in multi-procedure decision-making, complication prevention, complex biomechanical simulation, precise surgical implementation, and individualized outcome prediction. It also envisions its potential to advance the digitalization and precision of joint-preserving surgeries.

Study on the Role and Mechanism of Melatonin in Preeclamptic Trophoblast Cells Based on the NLRP3 Signaling Pathway

pan ziyang — 2026/5/9 10:04:21

Objective:?This study investigates the impact and mechanism of melatonin on preeclampsia based on the NLRP3 signaling pathway. Methods:?The HTR8/SVneo cell line was used to simulate an in vitro preeclampsia cell model through hypoxia treatment. the CCK8 assay was used to examine the effects of melatonin on HTR8/SVneo cells. Three concentrations (0.1, 0.5, and 1 mM) were selected as the subsequent treatment doses. The HTR8/SVneo cells were divided into: control group, hypoxia group, hypoxia + low-dose melatonin group, hypoxia + medium-dose melatonin group, hypoxia + high-dose melatonin group. Flow cytometry was used to detect the apoptosis of cells in each group; Transwell assay was employed to assess the invasive ability of cells in each group; qPCR was used to detect the mRNA expression levels of key factors in the inflammasome pathway, including NLRP3, ASC, Caspase-1, and IL-1β, in each group of cells; WB was used to detect the protein levels of key factors in the inflammasome pathway, including NLRP3, ASC, Caspase-1, and IL-1β, in each group of cells. Results:?Melatonin at concentrations below 1 mM showed no significant effect on the proliferation of HTR8/SVneo cells. The apoptosis rate in the hypoxia group was significantly higher than that in the control group, while the melatonin-treated group exhibited a significantly reduced apoptosis rate. The cell invasion rate in the hypoxia group was significantly lower than that in the control group, while the cell invasion rate in the melatonin-treated group significantly increased, with the effect becoming more pronounced as the dose increased. The mRNA and protein expressions of NLRP3, ASC, Caspase-1, and IL-1β were significantly increased in the hypoxia group, while these factors were markedly reduced in the melatonin-treated group. Conclusion:?Melatonin can reduce the production of inflammatory factors, thereby decreasing the pyroptosis rate of preeclamptic trophoblast cells and enhancing their invasive ability. The mechanism of action is associated with the inhibition of the NLRP3 signaling pathway.

Clinical and genetic analysis of 10 cases of mitochondrial disease in childrenCUI Qing-yang₁^, TANG Jun_²^, LI Jianwei_³

崔清洋,李建伟,唐军 — 2026/5/8 16:23:18

Objective To study the clinical phenotype and genetic variation characteristics of mitochondrial diseases in children. Methods From May 2020 to February 2025, 17 cases of children with mitochondrial disease diagnosed by gene were retrospectively analyzed, and the results of MRI and gene detection were collected, and the clinical outcomes of discharged children were followed up. Results A total of 18 cases (12 males and 6 females) were included, including 9 cases with neonatal onset. 14 cases of primary mitochondrial disease, including 11 cases caused by nuclear gene variation; 4 cases of secondary mitochondrial disease. The clinical phenotype of 18 children with mitochondrial disease is diverse, and the most common one is hyperlactate. Conclusion There is no specificity in the phenotype of mitochondrial diseases in children, and hyperlactate may be the most common phenotype. Positive genetic testing can make a definite diagnosis, and symptomatic and supportive treatment is more suitable for children.

Clinical Observation on Modified Jisheng Shenqi Decoction Combined with Acupoint injection of Astragalus Injection in the Treatment of Compensatory Stage of hepatitis B Cirrhosis

HAN Lu,LI Zepeng,LIN Jun,WANG Wenshuai,WEI Xuelian,WU Chan,YU Junying — 2026/5/8 16:22:25

Objective To observe the clinical efficacy of treating viral hepatitis B-related cirrhosis with a combination of Modified Jisheng Shenqi Decoction and acupoint injection of Astragalus membranaceus injection. Methods Between January 2024 and January 2025, a total of 94 patients diagnosed with viral hepatitis B-induced cirrhosis and admitted to Liuzhou Traditional Chinese Medicine Hospital were enrolled as research participants. These patients were randomly assigned to either a control group or an observation group using a random number table method, with each group comprising 47 patients.The control group underwent conventional medical treatment, whereas the observation group received an additional regimen consisting of Modified Jisheng Shenqi Decoction combined with acupoint injections of Astragalus injection, in addition to the treatment given to the control group. Both groups were treated continuously for 12 weeks. Comparisons were made between the two groups regarding quality of life scores, Child-Turcotte-Pugh (CTP) scores, liver stiffness measurements (LSM), and biochemical indicators before and after treatment. Additionally, the incidence of adverse reactions during the treatment period was documented for both groups. Results Out of the 94 patients, five withdrew from the study for various reasons during the treatment period, with two from the control group and three from the observation group. Compared to pre-treatment levels, both groups demonstrated a significant increase in Chronic Liver Disease Questionnaire (CLDQ) scores (P < 0.05), along with notable decreases in Child-Turcotte-Pugh (CTP) scores, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), hyaluronic acid (HA), laminin (LN), type III procollagen peptide (PC-III), and type IV collagen (IV-C) levels (P < 0.05). Additionally, there was a significant reduction in prothrombin time (PT) (P < 0.05). In comparison to pre-treatment values, the observation group exhibited a significant decrease in LSM (P < 0.05), whereas the control group showed a significant increase in albumin (ALB) levels (P < 0.05). After treatment, the observation group had significantly higher CLDQ scores and significantly lower LSM, ALT, AST, TBIL, HA, LN, PC-III, and IV-C levels compared to the control group (P < 0.05). No serious adverse reactions were reported in either group during the treatment period. Conclusion The combined therapy of Modified Jisheng Shenqi Decoction and acupoint injection with Astragalus membranaceus injection has shown remarkable efficacy in treating patients with hepatitis B virus-related cirrhosis, effectively improving liver function, alleviating liver fibrosis, and enhancing patients' quality of life.

ybrid surgical treatment for coronary heart disease with type II right aortic arch and Kommerell diverticulum:one case report

王惠,张勇,郑德志 — 2026/5/8 8:24:35

Objective To analyze the clinical experience of a patient with Kommerell diverticulum of type II right aortic arch in coronary heart disease treated by hybrid surgery. Methods To analyze the clinical effect of cardiothoracic hybrid surgery in a case of coronary heart disease with Kommerell diverticulum of type II right aortic arch in 960th Hospital of PLA. Results The blood flow of the artificial vessels and coronary artery bypass vessels was unobstructed after surgery. The blood circulation of the left common carotid artery, the right common carotid artery and the right subclavicular artery were unobstructed. The stent was in good position without displacement or obvious internal leakage, and the Kommerell diverticulum was completely covered. Conclusion Hybrid surgery can be used to treat Kommerell diverticulum with right aortic arch type II.

Research progress on cell transition in the onset and development of endometriosis-related fibrosis

CAI Heng,CHEN Keyun,HE Junbing,HE Yao’e,,LI Lingli,LIAN Yanchun,WEN Jinjuan — 2026/5/7 18:03:49

Endometriosis can essentially be characterized as a repeated tissue injury and repair (ReTIAR). Fibrosis is the primary pathological feature of endometriosis. The core lies in the excessive deposition of extracellular matrix components produced by myofibroblasts derived from cell-cell transformations such as epithelial-mesenchymal transition, fibroblast-myofibroblast transition, and macrophage-myofibroblast transition fibroblast , which leads to permanent scar formation and loss of normal tissue structure and function. This article aims to explore the influence of cell-cell transition on the disease progression of fibrosis in endometriosis and the factors regulating cell-cell transformation involved in the fibrosis of endometriosis, with the expectation of providing research ideas for the pathogenesis of endometriosis.

A CASE REPORT OF SEGMENTAL COLONIC HYPOGANGLIONOSIS IN CHILDREN AND LITERATURE REVIEW

陈伟玉,邓富强,温露华,杨海 — 2026/5/7 9:09:10

Objective：Summary of the clinical features of segmental colonic hypoganglionosis in children. Methods：The clinical data of a child with segmental colonic hypoganglionosis admitted to the Pediatric Surgery Department of Meizhou People’s Hospital were collected and retrospectively analyzed and summarized and literature review. Results:The patient underwent non-drag-out subtotal colon resection and recto-ascending colon anastomosis. The patient was followed up for six months after the operation, with no defecation patterns and no dirty feces, and a weight gain of 4Kg in half a year. Conclusion: When the disease of segmental colonic hypoganglionosis is extensive in the colon and normal ganglion cells are found in rectal biopsy, non-pull-out subtotal colon resection and recto-ascending colon anastomosis can be performed to obtain a satisfactory prognosis.

Analysis of clinical characteristics of 30 Cases of Mycoplasma pneumoniae-Induced Arthritis in ChildrenMA Wenjing, CAO Lanfang. Department of Pediatrics, Jiading Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201800, China

Cao Lanfang,马文静 — 2026/5/6 16:08:55

ObjectiveSTo analyze the clinical characteristics of Mycoplasma pneumoniae-induced arthritis in children, and to provide theoretical basis for early clinical identification and standardized treatment of the disease. MethodsSThe clinical data of 30 pediatric patients withSMycoplasma pneumoniae-induced arthritis who were admitted to the Department of Pediatrics of Jiading Branch, Ren Ji Hospital of Shanghai Jiao Tong University School of Medicine from January 1, 2024 and June 30, 2025. A retrospective analysis was conducted to assess the clinical characteristics, imaging changes, managements, and treatment outcomes. ResultsS1.Among the 30 patients, 11 are males and 19 are females, with a ratio of about 1:2. The age range was 1.5 to 13 years, with a mean age of 8.2±2.41 years; The onset age was mainly concentrated in the school-age. 2. The initial symptoms were mainly joint pain(100%, 30cases). Asymmetric involvement chiefly affected the lower limbs, particularly the knees (80%, 24 cases), hips (40%, 12 cases), and ankles (36.7%, 11 cases). 3. The MSUS findings of affected joints mainly included joint cavity effusion(43 joints,59.7%) and synovitis(33 joints,45.8%). The MRI findings of affected joints mainly included joint cavity effusion(33 joints,56.9%). No significant bone destruction was detected. 4. At baseline, the mean JADAS27 score was 7.95(IQR：7.4), reflecting disease activity level. Management strategies comprised antimicrobial therapy targeting pathogen clearance and vascular protection, with adjunct glucocorticoids administered in select cases. This intervention led to a statistically significant reduction in the JADAS27 score to 1.05(IQR：3.74)post-treatment. Moreover, 20 children exhibited essentially complete resolution of joint symptoms at the 6-month follow-up, and no notable complications were recorded. ConclusionSThe onset age of Mycoplasma pneumoniae-induced arthritis is concentrated in school age, with more females than males. It is characterized by asymmetric pain in the large joints of the lower limbs, with imaging studies primarily revealing joint effusion and synovitis. Early recognition and targeted intervention are crucial for improving prognosis.

The efficacy of combination therapy of roflumilast tablets and fluticasone furoate, umeclidinium and vilanterol inhalation powder in treating acute exacerbation of chronic obstructive pulmonary disease and its impact on serum MCP-1 and IL-8

王琴琴 — 2026/5/6 16:07:59

Objective: To investigate the efficacy of combination therapy of roflumilast tablets and fluticasone furoate, umeclidinium and vilanterol inhalation powder in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients, and its impacts on serum monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) in patients. Methods: Totally 200 patients with AECOPD accepted by our hospital from February 2022 to February 2024 were used as the study subjects and stochastically assigned into a control group of 100 cases (treated with fluticasone furoate, umeclidinium and vilanterol inhalation powder) and a combined group of 100 cases (treated with roflumilast tablets and fluticasone furoate, umeclidinium and vilanterol inhalation powder). The efficacy, blood gas analysis, blood oxygen saturation (SaO2)], serum factors [MCP-1, IL-8, C-reactive protein (CRP)], pulmonary function, and untoward drug reactions of the two groups were compared. Results: The combined group had a greater overall effective rate (97.00%) than control group (88.00%) (P<0.05). After treatment, the PaCO2, MCP-1, CRP, and IL-8 in the combined group were lower than those in the control group, while the SaO2, PaO2, FEV1, FVC, and PEF were higher than those in the control group (P<0.05). Conclusion: The combination of roflumilast tablets and fluticasone furoate, umeclidinium and vilanterol inhalation powder is highly effective in treating AECOPD patients. It can prominently improve blood gas analysis levels and lung function, reduce inflammatory factors , and has certain safety.

Value of serum Ki-67 and AFP levels combined with vaginal ultrasound in differentiating mature ovarian teratoma

丁鹍 — 2026/5/6 16:06:53

Objective: To analyze the value of serum AFP and Ki-67 levels combined with vaginal ultrasound in the differential diagnosis of mature ovarian teratoma. Methods: A total of 135 patients with ovarian teratoma admitted to our hospital from January 2023 to July 2024 were selected as the research subjects. According to the postoperative pathological types, they were divided into two groups: the mature ovarian teratoma group (n=108) and the immature ovarian teratoma group (n=27) for a case-control study. All patients underwent vaginal ultrasound detection. The vaginal ultrasound results, serum AFP and Ki-67 expression levels of the two groups were compared. Logistic regression was used to analyze the risk factors influencing mature ovarian teratoma; The application value of vaginal ultrasound, serum AFP and Ki-67 levels in the differential diagnosis of patients with mature ovarian teratoma was analyzed by drawing the ROC curve. Results: Comparison of age, E2, LH and FSH between the two groups (P < 0.05); Moreover, compared with the immature ovarian teratoma group, the endometrial thickness, 3D-PDA parameters, serum AFP and Ki-67 levels of patients in the mature ovarian teratoma group were all decreased, while the spiral artery blood flow and the pulsatility index and resistance index of the uterine artery were increased, and the differences were statistically significant (P < 0.05).Logistic regression analysis showed that age, E2, LH, FSH, spiral artery blood flow, uterine artery, endothelial thickness, 3D-PDA parameters, AFP, and Ki-67 were risk factors for the development of mature teratoma of the ovary (P < 0.05).ROC curve analysis showed that the combined diagnosis of mature teratoma of the ovary by vaginal ultrasound, serum AFP, and Ki-67 had the had the highest value (P < 0.05). Conclusions: The expression of vaginal ultrasound index, serum AFP and Ki-67 levels are abnormal in patients with mature ovarian teratoma. ROC curve analysis shows that the diagnostic value of vaginal ultrasound, serum AFP and Ki-67 in the differential diagnosis of mature ovarian teratoma is higher than that of single detection, and the combination of vaginal ultrasound, serum AFP and Ki-67 can be used in clinic.

Evidence-Based Guideline for Cardiac Rehabilitation Based on the ICF

2026/4/28 9:48:13

This guideline is developed based on the theoretical framework of the International Classification of Functioning, Disability and Health, combined with the current best evidence-based medical evidence, to systematically construct the assessment, intervention and management protocols of cardiac rehabilitation. It covers key components including the application of ICF core sets in cardiac rehabilitation, the selection and criteria of functional assessment tools, risk stratification criteria, as well as individualized intervention and management. This guideline aims to provide clinicians with standardized and systematic practical guidance, so as to improve the quality of cardiac rehabilitation services and patients' functional outcomes.

Functional characteristics of diverse muscle groups in the elderly fall - prone population: A principal component and cluster analysis approach

chenhaili,dingning,,lujunhao,shengyunlu,wangkaiming,wangyichun — 2026/4/28 9:47:10

Objective: To extract key muscle function regions and classify elderly patients prone to falls through principal component analysis (PCA) and cluster analysis, providing a basis for clinical individualized rehabilitation interventions. Methods: A total of 265 elderly patients hospitalized at The First Affiliated Hospital with Nanjing Medical University from 2018 to 2023 were enrolled. Twelve indicators were collected, including radial muscle strength, ulnar muscle strength, abdominal muscle strength, lumbar muscle strength, posterior tibial muscle strength, posterior fibular muscle strength, medial and lateral gastrocnemius muscle strength, as well as age, height, weight, and BMI. Principal component analysis was performed using SPSS 22.0 software to extract key components, and cluster analysis was employed to classify patients. Results: PCA identified four principal components with eigenvalues>1: upper body muscle group (radial, ulnar, abdominal, height), lower body muscle group (posterior tibial, posterior fibular, weight, BMI), distal lower limb muscle group (medial and lateral gastrocnemius), and lumbar muscle group (lumbar muscle group, age), contributing cumulatively 69.0% of the variance. Cluster analysis divided patients into 2 major categories and 4 subcategories, with significant differences in muscle function distribution among categories. ROC curve analysis showed that single muscle component had a lower AUC for fall prediction, while comprehensive indicator prediction demonstrated superior efficacy (AUC=0.734, sensitivity 74%, specificity 69%). Conclusion: The principal component analysis and cluster analysis can effectively identify the functional characteristics and individual differences of muscle groups in elderly patients prone to falls, provide an objective evaluation of the functional status of muscle groups in various parts, predict potential risks, and offer data support for developing personalized muscle strength training and fall prevention plans.

Recommendations for Standardization of Voriconazole Blood Concentration Detection by Liquid Chromatography-Tandem Mass Spectrometry.

陈晓宇,黎涛,李岩,刘代华,蒙光义,叶冬梅 — 2026/4/21 11:22:03

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is an analytical technique that combines the high separation efficiency of liquid chromatography with the high selectivity and sensitivity of mass spectrometry. It is widely used for therapeutic drug monitoring and is commonly employed to determine voriconazole concentrations in plasma samples. Although this method offers high accuracy,specificity,and resolution,there can be some degree of variability in results due to various factors,including instruments,chromatographic columns,reagents,calibrators,methodologies and performance validations,environmental conditions,and personnel,both within and between laboratories. To standardize the operation procedure of voriconazole plasma concentration detection by LC-MS/MS,based on the existing clinical mass spectrometry assay-related guidance documents and clinical practice literature,suggestions were made in terms of standard substances,internal standard selection,sample pretreatment methods,chromatographic conditions,mass spectrometry parameters,method validation,sample requirements,personnel management,quality control,and reference intervals. To establish a standardized protocol for detecting voriconazole plasma concentrations using LC-MS/MS in Guangxi,to improve the accuracy and stability of voriconazole test results. This consensus seeks to ensure consistency and comparability of results across different operators,testing times,instruments,and laboratories.

Comparison of the Efficacy of Different Drugs in the Treatment of Moderate to Severe Atopic Dermatitis

CHEN Haodong,HAO Jinqi,TIAN Limin,TU Yagaer, — 2026/4/21 8:46:43

Objective To compare the efficacy differences of various drugs in patients with moderate to severe atopic dermatitis (AD) and the changes over time, in order to provide better references for clinical treatment.Methods A total of 206 patients with moderate to severe atopic dermatitis (AD) who visited the dermatology outpatient department of the First Affiliated Hospital of Baotou Medical College from January 2024 to June 2025 were selected as the research subjects. According to the treatment plan, the patients were divided into the dupilumab (Dup) group (55 cases), the Janus kinase (JAKi) inhibitor group (40 cases), the short-course systemic glucocorticoids plus antihistamines (GC + Anti-His) group (60 cases), and the Anti-His group (51 cases). At weeks 0, 2, 4, 8, and 12 of the treatment, each group evaluated the scoring atopic dermatitis (SCORAD), eczema area and severity index (EASI), investigators global assessment (IGA), numerical rating scale (NRS) , the AD control tool (ADCT) , and the quality of life score. Adverse reactions during the treatment period were also recorded.Given the different age indications of dupilumab and JAK inhibitors (JAK inhibitors approved for patients aged ≥12 years), which might result in imbalanced age distribution across groups, sensitivity analyses restricted to patients aged ≥12 years were additionally performed. Furthermore, generalized estimating equations (GEE) were applied with age included as a continuous covariate to assess the robustness of the findings. Results All four groups showed improvement in each outcome over time. Both the time effect and the time-by-group interaction were statistically significant (all P<0.001). Overall, the JAKi group exhibited the greatest magnitude of improvement. The Dup group improved more steadily and showed better maintenance of the improvement trend. The GC+Anti-His group improved rapidly in the early phase (weeks 2–4), but some outcomes showed a rebound trend later. The Anti-His group demonstrated relatively limited improvement. The supplementary analysis results indicated that age had no significant independent impact on each outcome indicator (P > 0.05). In terms of safety, a total of 12 patients experienced adverse reaction events, all of which were mild and did not lead to drug discontinuation.Conclusion In real-world treatment of moderate-to-severe AD, targeted therapies (JAK inhibitors and biologics) yielded overall superior efficacy with a more stable improvement trajectory. Short-course systemic glucocorticoids combined with antihistamines provided rapid early symptom relief, but durability of benefit was relatively limited. Antihistamine monotherapy was associated with minimal improvement.

Calcium–Succinate Nanoparticles Induce Pyroptosis-Like Cell Death in Hepatocellular Carcinoma via Metabolic–Ion Regulation

ZhouNiqiang — 2026/4/21 8:30:06

Objective To prepare a pH-responsive calcium–succinate nanoparticle system (PCS NPs) and to investigate its potential mechanism in inducing pyroptosis in hepatocellular carcinoma through combined metabolic interference and disruption of ionic homeostasis.Methods PEGylated calcium succinate nanoparticles (PCS NPs) were constructed by the microemulsion method, with Hepa1-6 hepatocellular carcinoma cells employed as the in vitro model. The physicochemical properties of PCS NPs were characterized by 1H-NMR and FT-IR spectroscopy. Cellular cytotoxicity was evaluated using the CCK-8 assay and Calcein-AM/propidium iodide (PI) live/dead staining. Intracellular Ca2+ levels, mitochondrial membrane potential, reactive oxygen species (ROS) generation, and intracellular pH variations were dynamically monitored using Fluo-8 AM, JC-1, DCFH-DA, and BCECF-AM fluorescent probes, respectively, to elucidate the potential mechanisms underlying PCS NPs-induced hepatocellular carcinoma cell death.The expression of pyroptosis-associated marker proteins NLRP3, Cleaved Caspase-1 （p10 subunit), GSDMD-N was detected by Western blot to evaluate the involvement of related signaling pathways at the protein level. Results Characterization results confirmed the successful preparation of PCS NPs, which exhibited a significant increase in Ca2+ release under acidic conditions and could be efficiently internalized by Hepa1-6 cells. The CCK-8 assay demonstrated that PCS NPs markedly inhibited cell viability. Calcein-AM/PI staining revealed characteristic cellular swelling and membrane rupture, indicative of pyroptosis.Western blot analysis revealed upregulated expression of NLRP3 inflammasome, the p10 cleavage subunit of activated Caspase-1 (Cleaved Caspase-1 p10), and the N-terminal fragment of GSDMD (GSDMD-N), confirming the involvement of the canonical pyroptosis pathway. Following cellular uptake, PCS NPs induced intracellular Ca2+ release, which was accompanied by mitochondrial depolarization,elevated ROS production,and cytoplasmic acidification.Conclusion In this study, a pH-responsive PCS NPs system capable of releasing Ca2＋and succinate under acidic conditions was successfully constructed.The PCS NPs cantrigger pyroptosis characterized by Caspase-1 activation (p10 subunit) generation and GSDMD-N cleavage through the synergistic effects of succinate-mediated metabolic interference and Ca2+-inducedionic homeostasis imbalance. Collectively, these findings indicate that the interplay between metabolic perturbation and ionic imbalance may play a critical role in hepatocellular carcinoma cell death, providing an experimental basis for further mechanistic investigations and in vivo validation. 【Keywords】Calcium-succinate nanoparticles; Hepatocellular carcinoma; Pyroptosis; Metabolic disruption; Ion homeostasis

Correlation analysis between repetitive transcranial magnetic stimulation combined with brain-computer interface to regulate RMS value of rectus femoris and lower limb motor function in patients with incomplete spinal cord injury

xiaoguihua — 2026/4/21 8:22:58

Objective: To investigate the correlation between repetitive transcranial magnetic stimulation ( rTMS ) combined with brain-computer interface ( BCI ) to regulate the root mean square ( RMS ) of rectus femoris surface electromyography ( sEMG ) and lower limb motor function in patients with incomplete spinal cord injury ( iSCI ). Methods : This study included150 patients with iSCI admitted to our hospital between June 2023 and August 2025. The patients were divided into three groups based on their treatment regimens, with 50 patients in each group: The Combined Group received rTMS combined with BCI and conventional rehabilitation; the rTMS Group received rTMS combined with sham BCI and conventional rehabilitation; the Conventional Group received sham rTMS combined with sham BCI and conventional rehabilitation intervention. Surface electromyography (sEMG) measured the root mean square (RMS) values of the rectus femoris muscle during different contraction states. Transcranial magnetic stimulation (TMS) assessed corticospinal tract excitability, while simultaneously detecting the motor unit potential (MUP) of the rectus femoris and nerve conduction velocity (NCV) of the lower limbs. Lower limb motor function was evaluated using the ASIA, FMA-LE, and BBS scales, with functional improvement at the 3-month follow-up used to classify recovery subgroups. Correlation analysis, ROC curves, and decision curve analysis were employed to determine the predictive efficacy of rectus femoris RMS values for lower limb motor recovery in iSCI patients.Results:Following intervention, the RMS of the rectus femoris muscle during active contraction significantly increased and the RMS during rest significantly decreased at different time points across all groups (P < 0.05). At 4 weeks, 8 weeks, and 3-month follow-up, the RMS of the rectus femoris muscle during active contraction at 60°knee extension was significantly higher in the combined group than in the rTMS group and the conventional group (P < 0.05). At 8 weeks post-intervention, the combined group exhibited lower RMT, higher MEP amplitude, and superior MEP latency, lower limb NCV, and greater MUP amplitude of the rectus femoris compared to the other two groups (P < 0.05 ). Post-intervention, ASIA, FMA-LE, and BBS scores increased continuously across all three groups, with the combined group showing significantly higher scores at 4 weeks, 8 weeks, and 3-month follow-up (P < 0.05). The combined group also demonstrated a higher rate of good motor function recovery at 3-month follow-up (P < 0.05). Pearson correlation analysis revealed that the RMS of the rectus femoris muscle during active contraction was positively correlated with ASIA, FMA-LE, BBS, and MEP amplitude, and negatively correlated with RMT (P <0.001). ROC curve analysis indicated that at 8 weeks post-intervention, the AUC for predicting favorable lower limb motor function recovery based on RMS alone was 0.896, increasing to 0.943 when combined with MEP amplitude. Decision curve analysis demonstrated positive net benefit across a wide range of thresholds, highlighting the clinical utility of this composite indicator.Conclusion: The RMS value of rectus femoris in iSCI patients was significantly correlated with the recovery of lower limb motor function. The RMS of knee extension 60°active contraction was the core electrophysiological evaluation index, and the combined MEP amplitude detection had higher predictive value.

The impact of hand rehabilitation robot training based on mirror therapy on hand function in stroke hemiplegic patients: An fNIRS study

梁智蓉,欧阳胜璋,蒲心语,王丛笑,郄淑燕,张晓颖 — 2026/4/21 8:22:27

Objective: To observe the impact of hand rehabilitation robot training based on mirror therapy on hand function in stroke patients with hemiplegia, and to explore its neural mechanism by combining functional near-infrared spectroscopy (fNIRS) technology. Methods: Thirty stroke hemiplegia patients admitted to our hospital from April 2025 to October 2025 were selected and randomly divided into an experimental group and a control group, with 15 patients in each group. The control group received conventional rehabilitation therapy (including occupational therapy and traditional mirror therapy), while the experimental group received additional mirror therapy hand rehabilitation robot training based on electromyography recognition on top of conventional rehabilitation therapy. Both groups underwent continuous treatment for 4 weeks. Before and after treatment, the upper limb motor function was assessed using the Fugl-Meyer Assessment of Motor Function Upper Extremity (FMA-UE), the ability of daily living activities was assessed using the Modified Barthel Index (MBI), and the activation of the cerebral cortex was detected using fNIRS. Results: After 4 weeks of treatment, both groups showed significant improvements in FMA-UE and MBI scores compared to before treatment (P<0.001). When comparing the changes in FMA-UE scores between the two groups, the experimental group demonstrated superiority over the control group, with the difference being statistically significant (P<0.001). Additionally, the MBI scores of the experimental group were higher than those of the control group (P<0.05). fNIRS results indicated that the experimental group exhibited significantly higher oxygenated hemoglobin beta values in brain regions such as the dorsolateral prefrontal cortex, premotor and supplementary motor areas, primary somatosensory cortex, frontal pole, and frontal eye fields compared to the control group (P<0.05). Conclusion: Hand rehabilitation robot training based on mirror therapy can more effectively improve hand function and activities of daily living in stroke hemiplegic patients. The mechanism may be related to the synergistic activation and functional remodeling of brain regions involved in motor planning, sensory integration, and cognitive control.

Analysis of Perinatal Risk Factors for Neonatal Cow's Milk Protein Allergy

JING Lianfang,,LU Siliang,QIU Yanmei,WEI Zhe,WU Kemou,ZHONG Hanlu — 2026/4/15 11:39:50

Objective： To examine the association between perinatal factors and neonatal cow’s milk protein allergy (CMPA) and identify independent risk factors., thereby providing a basis for early clinical prevention and management. Methods ：This retrospective study enrolled neonates admitted to the Department of Neonatology, Guangxi Maternal and Child Health Hospital from January 2023 to April 2025. Cases were matched with controls by gestational age (1:2), resulting in 307 CMPA patients and 621 controls. Perinatal data were collected and analyzed using logistic regression. Results： Multivariate analysis identified low birth weight (aOR=8.09) and formula feeding (aOR=6.17) as the strongest risk factors for CMPA (both P<0.001). Mixed feeding (aOR=3.67), family history of allergy (aOR=2.79), cesarean delivery (aOR=1.80), and perinatal antibiotic exposure (aOR=1.58) were also independent risk factors (all P<0.05). Conclusion： CMPA is influenced by multiple perinatal factors. Risk-based management—including promoting breastfeeding, judicious antibiotic use, and optimized perinatal care—may help reduce the incidence of CMPA in high-risk neonates.

Analysis of the Efficacy and Aesthetic Advantages of single-incision laparoscopic surgery compared with conventional three-incision laparoscopic surgery for unilateral inguinal hernia.

shaojianlin — 2026/4/8 9:12:50

Objective To investigate the efficacy and aesthetic advantages of single-port laparoscopic transabdominal preperitoneal hernioplasty（SILS-TAPP） compared with multiple-port laparoscopic transabdominal preperitoneal hernioplasty（MP-TAPP）. Methods A total of 121 patients with unilateral inguinal hernia who underwent TAPP in the Department of Gastrointestinal Surgery of the Jilin Province People’ Hospital from January 2024 to January 2025 were included in this study. Of these, 61patients underwent SILS-TAPP, while 60 patients underwent MP-TAPP. Baseline data and perioperative indicators were compared between the two groups. Results There were no statistically significant differences (P < 0.05), between the two groups of patients in terms of baseline data such as age, gender, body mass index (BMI), hernia side, and preoperative inflammatory factor levels, as well as intraoperative blood loss and postoperative complication rate. The operation time of the SILS-TAPP group was slightly longer than that of the MP-TAPP group, and the difference was statistically significant (P < 0.05). However, in the SILS-TAPP group, the time to first ambulation after surgery was shorter, the frequency of postoperative analgesic use was lower, the inflammatory level at 48 hours after surgery was lower, the length of hospital stay was shorter, and the score of postoperative cosmetic satisfaction was higher. All the above differences were statistically significant (P < 0.05). Conclusion Single-port laparoscopy for the treatment of unilateral inguinal hernia not only ensures surgical safety but also significantly accelerates postoperative recovery and improves the cosmetic effect.

Screening of new predictive biomarkers related to the efficacy and thoracic radiation toxicity of radio-chemotherapy in non-small cell lung cancer using genomic profiling

Liu Yuanxiang — 2026/4/8 9:12:07

【】 Objective: To identify genes in genomic profiling that can serve as predictive biomarkers for chemoradiotherapy (CRT) efficacy and thoracic radiation toxicity in non-small cell lung cancer (NSCLC). Methods: A total of 55 patients with III stage NSCLC who received radical CRT (dCRT) at our single center between March 2022 and March 2024 were prospectively and consecutively enrolled, including 41 squamous cell carcinoma (SCC) patients and others with adenocarcinoma (ADC). Cell-free DNA (cfDNA) was collected and prepared from all patients. cfDNA library preparation was performed using the Agilent SureSelect Human All Exome V4 Kit and Twist Human Core Exome Kit. Whole exome sequencing (WES) was conducted on the Illumina Hiseq 4000 platform. Single-nucleotide variants (SNVs) or indels with base quality＜30, cfDNA sample coverage depth＜20, read count＜3, or mapping to both DNA strands were filtered out. Tumor mutation burden (TMB) was calculated by summing all base substitutions and indels in the coding regions of target genes. Tumor fraction (TF) was estimated from cfDNA WES data using FACETS, with TF% = 2/(1/allele frequency+1). Droplet digital polymerase chain reaction (ddPCR) was performed using the PrimePCR? ddPCR? Mutation Detection Kit to assess mutant allele frequency. All patients were followed up, and radiation-induced injuries were evaluated according to the toxicity criteria of the Radiation Therapy Oncology Group (RTOG). Results: During follow-up, 42 patients (76.36%) experienced disease progression, and 18 (32.73%) died from cancer-related causes. A total of 21 patients (38.18%) developed ≥ grade 2 toxic reactions during treatment, including 17 with ≥ grade 2 radiation pneumonitis and 6 with radiation esophagitis. A total of 110 paired cfDNA samples underwent WES, with mean TF values of 36.30% before and 50.30% after dCRT. The number of somatic SNVs was correlated with TF% (rho=0.257, P=0.033) and tumor diameter (rho=0.274, P=0.025). WES showed a strong correlation with variant allele frequency measured by ddPCR (rho=0.971, P＜0.001). Univariate and LASSO-Cox regression analyses identified smoking history (OR=2.265, P=0.036), ataxia telangiectasia mutated (ATM) gene (OR=2.074, P=0.042), Kelch like ECH associated protein 1 (KEAP1) gene (OR=2.585, P=0.014), and mixed lineage leukemia 2 (MLL2) gene (OR=3.202, P=0.011) to construct a predictive model for disease-free survival after dCRT. Patients with ATM, KEAP1, or MLL2 mutations had shorter median progression-free survival than wild-type counterparts: 8.08 months vs. 11.04 months (P=0.008), 7.79 months vs. 11.04 months (P=0.001), and 5.95 months vs. 9.67 months (P＜0.001), respectively. Enrichment analysis identified zinc-finger protein 217 (ZNF217) and DNA polymerase delta 1 catalytic subunit (POLD1) as genes associated with thoracic radiation injury. ZNF217 or POLD1 mutations increased the risk of ≥ grade 2 thoracic radiation injury by 5.325-fold (95%CI: 1.098～25.827, P=0.038) and 9.756-fold (95%CI: 1.670～57.008, P=0.011), respectively. Conclusion: Clinicians are advised to exercise extra caution when administering radiotherapy to unresectable III stage NSCLC patients with ATM, KEAP1, MLL2, ZNF217, or POLD1 gene mutations.

Analysis of Influencing Factors for Major Pathological Response to Neoadjuvant Therapy in Limited-Stage Small Cell Lung Cancer

车南颖,程雨婷,林海峰,刘帅,宋利伟,王冲,杨磊,姚恒,支修益 — 2026/4/8 9:11:21

Objective This study aims to identify the factors influencing major pathological response (MPR) following neoadjuvant therapy in patients undergoing surgery for limited-stage small cell lung cancer (LS-SCLC). The goal is to provide evidence to enhance the prediction of pathological responses and to aid in the development of personalized neoadjuvant treatment protocols in clinical settings. Methods A retrospective analysis was performed on a cohort of 43 patients diagnosed with LS-SCLC who underwent neoadjuvant therapy followed by surgical intervention, with comprehensive pathological response data available. This study was conducted at Beijing Chest Hospital, Capital Medical University, from March 2018 to February 2024. Data collected included clinical baseline characteristics, details of neoadjuvant therapy regimens, and imaging and pathological evaluations. Patients were categorized into two groups based on the achievement of MPR: the MPR group and the non-MPR group. To identify independent factors influencing MPR, both univariate and multivariate logistic regression analyses were employed. Differences in survival and recurrence rates between the two groups were assessed using the Log-rank test, and recurrence-related risk factors were examined through Cox regression analysis. Results Among the cohort of 43 patients, 24 individuals (55.81%) achieved MPR, while 19 individuals (44.19%) did not. Univariate analysis identified that baseline N stage, neoadjuvant therapy regimen, smoking index, and tumor volume reduction rate were significantly associated with MPR (P<0.05). Following adjustment for confounding variables using multivariate logistic regression, the tumor volume reduction rate emerged as an independent predictor of MPR (OR=55.799, 95%CI: 1.091-2853.128, P=0.045). Cox regression analysis showed that MPR was an independent influencing factor for tumor recurrence in LS-SCLC (HR=0.045, 95%CI: 0.005–0.423, P=0.007). Conclusion Among patients with limited-stage small cell lung cancer who achieved MPR following neoadjuvant therapy, the proportion receiving combined neoadjuvant chemotherapy and immunotherapy was higher compared to those receiving neoadjuvant chemotherapy alone. The tumor volume reduction rate is an independent determinant for achieving MPR post-neoadjuvant therapy; specifically, a higher reduction rate correlates with an increased likelihood of achieving MPR. The findings of this study may serve as a reference for predicting clinical pathological response and for the development of individualized neoadjuvant treatment regimens.

The diagnostic value of serum LTBP2 and CKAP4 levels in differentiating benign and malignant solitary pulmonary nodules

李艳梅 — 2026/4/3 10:57:47

Objective: To investigate the levels of latent transforming growth factor beta-binding protein 2 (LTBP2) and cytoskeleton-associated protein 4(CKAP4) in the serum of patients with isolated pulmonary nodules and analyze their clinical diagnostic value in distinguishing between benign and malignant diseases. Methods: From March 2021 to March 2024, 140 patients with isolated pulmonary nodules diagnosed in our hospital were collected. Among them, 68 patients with benign lesions were included in the control group, and the other 72 patients with malignant lesions were included in the experimental group. Serum were obtained from the two groups, and general clinical data were collected and organized. Enzyme linked immunosorbent assay was applied to detect the levels of LTBP2 and CKAP4. The differences and changes in serum levels of LTBP2 and CKAP4 of two groups were analyzed. Logistic regression was applied to analyze the influencing factors of benign and malignant solitary pulmonary nodules. ROC curve was applied to analyze the value of serum LTBP2 and CKAP4 levels in the clinical diagnosis of benign and malignant solitary pulmonary nodules. Results: The levels of LTBP2 and CKAP4 in the serum of the experimental group were higher than those in the control group (P<0.05). The level of LTBP2 in serum was positively correlated with the level of CKAP4 (r=0.485, P<0.01). There was a obvious difference in the diagnosis of benign and malignant solitary pulmonary nodules among nodules in different locations (P<0.05). The levels of LTBP2 and CKAP4 were independent risk factors for malignant lesions in isolated pulmonary nodules (P<0.05). The area under the ROC curve for diagnosing solitary pulmonary nodules patients with serum LTBP2 was 0.865, with sensitivity and specificity of 69.44% and 85.29%, respectively. The area under the ROC curve of serum CKAP4 was 0.872, with sensitivity and specificity of 77.78% and 79.41%, respectively. The AUC of the combined diagnosis of the two was 0.939, with a sensitivity and specificity of 94.44% and 75.00%, respectively, which were better than their individual diagnoses (Z combination - LTBP2=2.225, Z combination - CKAP4=1.980, P=0.026, P=0.047). Conclusion: The levels of LTBP2 and CKAP4 in the serum of patients with malignant lesions in solitary pulmonary nodules are obviously higher than those in patients with benign lesions, and the combined detection of LTBP2 and CKAP4 is of great significance for the clinical diagnosis of benign and malignant solitary pulmonary nodules.

Correlation Analysis Between Differentially Expressed Genes Associated with Cardiovascular and Cerebrovascular Diseases and Cell Death-Related Genes

李瑞芳,刘龙,刘智俊,徐庶钦 — 2026/4/3 10:33:07

Objective: To explore the shared characteristics of differentially expressed genes (DEGs) between myocardial infarction (MI) and stroke, and to further integrate single-cell transcriptomic data to uncover the cell-type-specific distribution of cell death pathways, revealing the potential mechanisms linking cardiovascular and cerebrovascular diseases with programmed cell death. Methods: Transcriptomic datasets for MI (GSE66360) and stroke (GSE16561) were retrieved from the Gene Expression Omnibus (GEO) database. Differential expression analysis was conducted using the limma package, and volcano plots were generated. Common DEGs were identified through Venn diagram analysis. Functional enrichment analysis, including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG), was performed using the clusterProfiler package. DEGs enriched in GO term GO:0032760 (positive regulation of tumor necrosis factor production) and KEGG pathway hsa04613 (neutrophil extracellular trap formation) were selected for correlation analysis with a curated set of cell death-related genes. Scatter plots were generated to visualize the correlations. Additionally, single-cell transcriptomic data from a mouse MCAO model (GSE174574) were analyzed to determine the spatial and cellular distribution of pyroptosis-related genes and to validate bulk RNA-seq findings. Results: A substantial number of DEGs were identified in both the MI and stroke datasets. Venn analysis revealed a subset of DEGs common to both conditions. GO and KEGG enrichment analyses highlighted GO:0032760 and KEGG:hsa04613 as key pathways implicated in disease mechanisms. Correlation analysis showed that several key genes within these pathways were strongly associated with cell death-related genes (Pearson’s R > 0.6), suggesting their potential involvement in disease progression via cell death mechanisms. Single-cell analysis revealed that pyroptosis signatures were predominantly enriched in monocytes and microglia in the MCAO model, with higher expression levels compared to controls, consistent with the bulk RNA-seq results. Conclusion: The shared DEGs between MI and stroke are mainly involved in TNF signaling and NETs formation, showing significant correlations with pyroptosis pathway genes.

A Study on the effects of Garcinone C on oxidative damage in nasopharyngeal carcinoma cells and the related mechanisms

Bi ao zhen,Guo yu lin,Hu jing wen,,Yin fu qiang,Zhao ming,zhao wen ya — 2026/4/3 10:07:20

Objective To investigate the effects of the natural product Garcinone C on oxidative damage in nasopharyngeal carcinoma cells and the underlying mechanisms. Methods Nasopharyngeal carcinoma cell lines HONE1 and HK1 were cultured in vitro and treated with Garcinone C at concentrations of 0 μmol/L, 5 μmol/L, and 7.5 μmol/L. The content of malondialdehyde (MDA), a lipid peroxidation product, was measured using a microplate reader. Intracellular lipid peroxidation levels were assessed by flow cytometry combined with BODIPY 581/591 C11 probe staining. Immunofluorescence assay was used to detect the nuclear expression of γ-H2A.X, a marker protein of DNA damage. Western blot was employed to analyze the expression levels of oxidative damage?related proteins, including γ-H2A.X, RAD50, p53, and KEAP1. Results Following Garcinone C treatment, both HONE1 and HK1 cells exhibited significantly increased MDA content and lipid peroxidation levels (P < 0.05), along with a marked elevation in nuclear γ-H2A.X expression (P < 0.05). The protein expression levels of γ-H2A.X and p53 were significantly upregulated (P < 0.05), whereas KEAP1 and RAD50 protein expression levels were significantly downregulated (P < 0.05). Conclusion Garcinone C exerts anti?tumor effects by inducing oxidative damage in nasopharyngeal carcinoma cells and may serve as a promising lead compound for the treatment of nasopharyngeal carcinoma.

Mechanism of GSDMD-mediated pyroptosis and its research progress in non-small cell lung cancer

youxiu — 2026/4/3 10:06:42

Objective: Globally, lung cancer has the highest incidence and mortality rates among primary cancers, and it is also a major public - health issue that urgently needs to be addressed in China. Pyroptosis is a new form of programmed cell death. In recent years, studies have found that gasdermin D (GSDMD), as a key effector molecule of pyroptosis, is closely related to the occurrence and development of tumors. The high expression of GSDMD plays a significant role in the occurrence, development, treatment, drug resistance, and prognosis of non - small cell lung cancer. Based on the above research background, this paper briefly introduces pyroptosis and reviews the research progress of GSDMD in regulating pyroptosis of non - small cell lung cancer cells, aiming to provide a reference for subsequent related research.

Advances in Unilateral Biportal Endoscopic Technique and Its Application in the Treatment of Highly Displaced Lumbar Disc Herniation

Liu pengju — 2026/4/3 10:05:57

The Unilateral Biportal Endoscopic (UBE) technique is a minimally invasive spine technique that has developed rapidly in recent years. Its core feature is to establish two independent channels on the same side of the spine for visual field and instrument operation, respectively. Compared with traditional open surgery, UBE has the advantages of shorter operation time, less blood loss, faster postoperative recovery, and satisfactory results in the treatment of lumbar disc herniation (LDH), which has gradually become one of the important minimally invasive methods in clinical practice. With the aging of the population and the change of lifestyle, the incidence of LDH is on the rise, which seriously affects the quality of life of patients. This article provides a detailed introduction to the UBE technique, and based on this, provides a review of the application of UBE in the treatment of highly displaced LDH.

Research Progress on the Impact of Gut dysbiosis on Rheumatoid Arthritis

Shao Xing Qin — 2026/4/3 10:05:12

Rheumatoid arthritis is a chronic systemic immune-mediated disease caused by genetic and environmental factors. It is typically characterized by the production of autoantibodies, leading to symmetrical joint lesions in the periphery. Clinically, it is mainly manifested by swelling, morning stiffness, and persistent joint pain. A series of studies have shown that the composition of the intestinal microbiota in patients with rheumatoid arthritis differs significantly compared to healthy controls.This article elaborates on the impact of gut dysbiosis and intestinal flora metabolites on the pathogenesis and prognosis of RA, further exploring the correlation between the two. This provides new ideas for subsequent treatment research.

One case presented with MALT lymphoma of the digestive tract with otolaryngology symptoms

huang qin,, — 2026/4/2 16:14:52

This article reports a case of gastrointestinal MALT lymphoma presented with otolaryngology symptoms.

Cervical Rhabdomyosarcoma：A Case Report

陈秋燕,Dai Shifen,Yang Haikun — 2026/4/2 15:38:46

This paper reports a case of cervical rhabdomyosarcoma.

Effect of abdominal breathing training combined with electrical stimulation and manual massage on postpartum pelvic floor myofascial pain

黄瑜 — 2026/4/2 9:50:18

(1.Obstetrics Department, Shenzhen Guangming District People"s Hospital Shenzhen, Guangdong Province, 518107; 2. Emergency and Critical Care Medicine Department, Shenzhen Guangming District People"s Hospital, Shenzhen, Guangdong Province, 518107)

::Objective To evaluate the improvement effect of abdominal breathing training combined with electrical stimulation and manual massage on postpartum pelvic floor muscle fascia pain. Methods A retrospective analysis was conducted on 200 patients with postpartum pelvic floor myofascial pain who were treated at the obstetric outpatient department of Shenzhen Guangming District People's Hospital from October 2023 to June 2025. They were divided into the experimental group and the control group according to different treatment methods, with 100 cases in each group. The control group was given 4 weeks of electrical stimulation and manual massage treatment intervention. The experimental group was given a 4-week intervention of abdominal breathing training combined with electrical stimulation and manual massage. The pelvic floor muscle functions, Visual Analogue Scale (VAS) scores, the number of positive pain trigger and therapeutic effects before and after treatment were compared between the two groups of patients. Results Compared with the indicators before the intervention, the pelvic floor function indicators, pain scores, number of trigger points and other indicators of the two groups of patients after the intervention were significantly improved (P < 0.05). After the intervention, the VAS score and the number of positive pain trigger in the experimental group were both lower than those in the control group (P < 0.05). After the intervention, the rapid contraction force of the pelvic floor muscles in the experimental group was higher than that in the control group (P < 0.05), and the rapid contraction relaxation time, tense contraction relaxation time and post-resting amplitude were all lower than those in the control group (P < 0.05). There was no statistically significant difference in pelvic floor muscle endurance and contractility between the two groups (P > 0.05). The total effective rate of the experimental group at 3 months of follow-up after intervention was higher than that of the control group (P < 0.05). Conclusion The abdominal breathing training combined with electrical stimulation and manual massage for postpartum pelvic floor fascia pain can significantly improve the pelvic floor muscle function of patients after childbirth, effectively relieve pain and reduce the range of pain. The therapeutic effect is excellent and has high clinical application value, which is worthy of wide promotion. [Key words] Pelvic floor myofascial pain; Postpartum; Abdominal breathing; Electrical stimulation; Manual massage；

Analysis on the prevalence and influencing factors of dyslipidemia in different populations in Guangxi

邓惠天,黄金梅,蒋小云,罗水英,毛玮,唐美艳,滕有明,许晶晶,钟延旭 — 2026/4/2 9:48:41

Objective ?To investigate the prevalence and influencing factors of dyslipidemia among adults in Guangxi in 2023, providing scientific evidence for prevention and control strategies. Methods ?From November 2022 to December 2023, a multi-stage stratified cluster random sampling method was used to select 6,231 residents aged 18 years and older in Guangxi. Participants completed questionnaires, physical examinations, and laboratory tests. Data were analyzed using R 4.4.2 software, including χ2 tests and multivariable logistic regression. Results ?The age-standardized prevalence of dyslipidemia among adults in Guangxi was 46.0%, with age-standardized prevalence rates of hypercholesterolemia, hypertriglyceridemia, low high-density lipoprotein cholesterol, and high low-density lipoprotein cholesterol of 21.3%, 16.2%, 22.4%, and 14.8%, respectively. Multivariable logistic regression analysis indicated that females had a lower risk of dyslipidemia than males (OR = 0.67, P = 0.002). Age 45–59 years (OR = 1.63), ≥60 years (OR = 1.36), rural residence (OR = 1.26), daily smoking (OR = 1.54), overweight (OR = 2.60), obesity (OR = 3.81), hypertension (OR = 1.34), and diabetes (OR = 1.43) were all significantly associated with an increased risk of dyslipidemia (all P < 0.05). Conclusion ?In 2023, the prevalence of dyslipidemia among adults in Guangxi was relatively high. Targeted lifestyle interventions should focus on males, individuals aged 45 years and older, rural residents, smokers, overweight/obese individuals, and those with chronic diseases to control risk factors and reduce the burden of dyslipidemia.

Observation on the effect of neuromuscular electrical stimulation in the treatment of postpartum rectus abdominis diastasis and its influence on the Young's modulus index of shear wave elastography

潘焕贵 — 2026/4/2 8:57:54

Objective To observe the effect of neuromuscular electrical stimulation in the treatment of postpartum rectus abdominis diastasis (DRA) and analyze its influence on the Young's modulus index of shear wave elastography (SWE). Methods A total of 80 postpartum DRA patients admitted to Liuzhou Railway Central Hospital from January 2022 to March 2024 were recruited and divided into a control group and an observation group by random number table method, with 40 cases in each group. The observation group received neuromuscular electrical stimulation treatment, while the control group received postpartum abdominal belt intervention. The rehabilitation treatment time for both groups was 10 days.High-frequency ultrasound was used to measure the distances between the rectus abdominis muscles (IRD) 2 cm above the umbilicus, 5 cm above the umbilicus, at the umbilicus plane and 2 cm below the umbilicus in the resting and flexed states of the patients, and the thickness of the bilateral rectus abdominis muscles was recorded.The Young's modulus index of the umbilical plane of the rectus abdominis muscle was measured by SWE. Including the average value of right tissue elasticity (Emean R), the maximum value of right tissue elasticity (Emax R), the minimum value of right tissue elasticity (Emin R), the average value of left tissue elasticity (Emean L), the maximum value of left tissue elasticity (Emax L), and the minimum value of left tissue elasticity (Emin L). Compare the clinical efficacy of the two groups.Results After treatment, the IRD 2 cm above the umbilicus, 5 cm above the umbilicus, umbilical plane and 2 cm below the umbilicus in the observation group at rest and flexion states were all smaller than those in the control group,The thickness of bilateral rectus abdominis muscles and the Young's modulus indicators of each SWE were all greater than those in the control group,and the difference was statistically significant(P<0.05). The overall clinical effective rate of the observation group after treatment was significantly higher than that of the control group [87.50% vs 65.00%, χ2=5.591, P=0.018] . Conclusion Neuromuscular electrical stimulation therapy can effectively improve the morphology and mechanical properties of the rectus abdominis in postpartum DRA patients. High-frequency ultrasound combined with SWE provides objective indicators for clinical efficacy evaluation.. [Keywords] High-frequency ultrasound; Shear wave elastography; Neuromuscular electrical stimulation; Postpartum diastasis recti abdominis

Study on the correlation between serum ALKBH5, FKBP5 with Th17/Treg imbalance and tocolysis outcomes in patients with recurrent miscarriage

lijing — 2026/4/2 8:57:17

Objective: To investigate the correlation between serum ALKB homologous protein 5 (ALKBH5), FK506 binding protein 5 (FKBP5), Th17/Treg imbalance, and tocolysis outcomes in patients with recurrent spontaneous abortion (RSA). Methods: From January 2022 to January 2024, 100 patients with RSA admitted to Handan First Hospital were enrolled as the observation subjects (RSA group). According to the tocolysis outcomes, they were further divided into the tocolysis success group (67 cases) and the tocolysis failure group (33 cases). Another 100 healthy pregnant women who underwent prenatal check-ups were enrolled as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of ALKBH5 and FKBP5. The Pearson correlation analysis was applied to assess the correlations between serum ALKBH5, FKBP5 and the values of Th17, Treg, and Th17/Treg. Multivariate logistic regression was used to analyze the related factors that affected the tocolysis failure of RSA patients. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of serum ALKBH5 and FKBP5 for tocolysis failure in RSA patients. Results: Compared with the control group, the RSA group had higher serum Th17 levels, FKBP5 concentrations, and Th17/Treg ratios, but lower ALKBH5 concentrations and Treg levels (P<0.05). In RSA patients, serum ALKBH5 was negatively correlated with Th17 levels and Th17/Treg ratios, and positively correlated with Treg levels (P<0.05); serum FKBP5 was positively correlated with Th17 levels and Th17/Treg ratios, and negatively correlated with Treg levels (P<0.05). Compared with the group with successful foetal preservation, the group with failed foetal preservation had higher menstrual disorders, impaired fasting glucose, the percentage of patients with autoimmune abnormalities, Th17/Treg values and serum Th17 and FKBP5 levels than the group with successful foetal preservation, and lower ALKBH5 and Treg levels than the group with successful foetal preservation (P<0.05). Lasso analysis identified three predictors: Th17/Treg ratio, ALKBH5, and FKBP5. Among them, ALKBH5 was a protective factor against tocolysis failure in RSA, while Th17/Treg ratio and FKBP5 were risk factors for tocolysis failure (P<0.05). The AUC values of serum ALKBH5 and FKBP5 for predicting tocolysis outcome of RSA were 0.818 and 0.817, respectively. The AUC value of their joint prediction was 0.906, indicating a higher predictive value (ZALKBH5 - joint=2.092, ZFKBP5 - joint=2.451, P<0.05). Conclusion: Serum ALKBH5 is decreased and FKBP5 is increased in RSA. The abnormal expression of both is related to Treg/Th17 imbalance and tocolysis failure.

Tubridge flow diverter for the treatment of medium to large IVADAs: a single-center experience compared to the Pipeline device

龙强友 — 2026/4/2 8:55:23

Objective ? To investigate the efficacy of the Tubridge flow diverter (TFD) and Pipeline embolization device (PED) in the treatment of medium to large intracranial vertebral artery dissecting aneurysms (IVADAs). Methods ?The clinical data of 87 patients with medium to large IVADAs treated with tubridge flow deflector in our hospital from January 2019 to December 2024 were collected. These patients were divided into the TFD group (n=42) and the PED group (n=45) based on the type of flow-directing device used. The TFD group underwent implantation of TFD during neurointervention, while the PED group underwent implantation of PED during neurointervention. The surgical conditions, postoperative aneurysm occlusion, and parent artery stenosis of the two groups were observed. The clinical prognosis of patients was assessed using the modified Rankin Scale (mRS) at discharge, one month after surgery, and at the last follow-up. The perioperative complications of patients were also statistically analyzed. Results ? There were no significant differences in operation duration, postoperative hospitalization duration, and average stent quantity between the two groups (P>0.05). There were no significant differences in OKM grading and parent artery stenosis rate between the two groups immediately after surgery and at the last follow-up (P>0.05). There were also no significant differences in mRS scores between the two groups at discharge, one month after surgery, and at the last follow-up (P>0.05). The perioperative complication rate in the TFD group was 16.67% (7/42), which was not significantly different from that in the PED group 6.67% (3/45) (P>0.05). Conclusion Both the Tubridge flow diverter and the Pipeline embolization device can achieve good prognosis and safety in the treatment of patients with medium to large IVADAs.

A Case of 48, XXYY Syndrome Complicated with Metabolic Syndrome

陶珊珊 — 2026/3/31 10:16:52

【】　Objective　To investigate the clinical characteristics and underlying mechanisms of 48, XXYY syndrome complicated with metabolic syndrome, and to improve awareness and understanding of this rare disease. Methods　The clinical manifestations, laboratory findings, and imaging characteristics of one patient with 48, XXYY syndrome complicated with metabolic syndrome were retrospectively analyzed, and a literature review was conducted. Results　The patient with 48, XXYY syndrome presented with tall stature, slender limbs, and central obesity. Serum levels of follicle?stimulating hormone (FSH) and luteinizing hormone (LH) were elevated, while testosterone and free androgen index (FAI) were decreased. The patient also had small testicular volume, azoospermia, and was complicated with type 2 diabetes, dyslipidemia, and metabolic dysfunction?associated fatty liver disease (MAFLD). Conclusion　Patients with 48, XXYY syndrome exhibit hypergonadotropic hypogonadism and are often complicated with severe metabolic disorders. We suggest that early screening for metabolic syndrome?related indicators and targeted comprehensive management should be implemented in patients with 48, XXYY syndrome.

A case of fertility preservation in adolescent patient with very severe aplasia snemia and review of relevant literature

tanghuihe — 2026/3/30 15:20:42

Objective To review a diagnosis and treatment process for a case of adolescent patient with very severe aplasia snemia(VSAA), To explore the strategies and safety of fertility preservation in adolescent females through ovarian tissue cryopreservation (OTC) combined with in vitro maturation (IVM) of oocytess.Method The diagnosis and treatment data of a adolescent patient with very severe aplasia snemia(VSAA) who was admitted to the People's Hospital of Guangxi Zhuang Autonomous Region in July 2025 and planned to undergo hematopoietic stem cell transplantation (HSCT) were collected. The patient underwent fertility preservation through ovarian tissue cryopreservation (OTC) combined with in vitro maturation (IVM) of oocytes. Domestic and foreign literature reports on fertility preservation were retrieved, and the diagnosis and fertility preservation situation of the patient were analyzed.Results After ovarian tissue extraction, a total of 3 cumulus-oocyte complexes (COCs) and 10 ovarian cortex pieces were obtained through puncture and aspiration. After IVM for 48 h, a total of 2 MⅡ oocytes were frozen by vitrification.Conclusion For the adolescent girls facing HSCT urgently, cryopreserving ovarian tissue in combination with retrieving immature oocytes followed by IVM may preserve the fertility of patients to the greatest extent in a short period of time, as well as improve the therapeutic effect of fertility preservation in patients.

Expression of the IER3 Gene in Rectal Cancer and Its Association with Clinicopathological Characteristics and Prognosis

李松霖,韦春莹,韦党生,钟晓刚,周日忠 — 2026/3/25 15:49:31

Objective: To detect the expression of the IER3 gene and its protein in rectal cancer tissues, and to analyze its relationship with clinicopathological characteristics and prognosis in patients with rectal cancer.Methods: (1) Immunohistochemistry was used to detect IER3 protein expression, qPCR was used to detect IER3 mRNA expression, and the CanPatrol? technique was employed to detect preoperative circulating tumor cells (CTCs). Data analysis was performed to evaluate the correlation between IER3 expression and rectal cancer pathological features, preoperative CTC count, and CTC subtypes. Prognosis was assessed through follow-up and survival analysis.Results: The mRNA and protein expression levels of the IER3 gene were significantly higher in rectal cancer tissues compared to adjacent normal tissues (P < 0.05). The differential expression of IER3 mRNA was positively correlated with tumor size (P < 0.05) and showed a trend toward correlation with vascular invasion, though this was not statistically significant (P = 0.06). No significant correlations were observed with gender, age, T stage, N stage, TNM stage, or nerve invasion. IER3 protein expression was correlated with the counts of preoperative mixed-type CTCs and preoperative epithelial-type (E-type) CTCs (P < 0.05). Preoperative CTC count was correlated with CEA levels? (P < 0.05). Survival analysis indicated no direct correlation between IER3 protein or mRNA expression in rectal cancer tissues and patient prognosis (P > 0.05).Conclusion: This study demonstrates that IER3 gene expression is significantly upregulated at both the mRNA and protein levels in rectal cancer tissues and correlates with clinicopathological features such as tumor size and specific CTC subtypes. These findings suggest a potential role for IER3 in the adaptive survival of CTCs, although the underlying mechanisms require further investigation.

Outcomes of IVF/ICSI Cycles and Recurrence in Borderline Ovarian Tumor Patients of Different Histological Types After Fertility-Sparing SurgeryYujie Li1, Jialin Wu1, Wenchao Sun2, Jingjie Li1

李晶洁,李玉洁,孙文超,吴佳琳 — 2026/3/19 16:55:47

Objective To compare ovarian stimulation response, embryological outcomes, and pregnancy outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in patients with serous versus mucinous borderline ovarian tumors (BOTs) after fertility-sparing surgery (FSS), and to evaluate the safety of ovarian stimulation with respect to tumor recurrence. Methods We retrospectively reviewed clinical data of BOT patients who underwent IVF/ICSI after FSS at our center between May 2010 and May 2023. Patients were classified into a serous BOT (SBOT) group and a mucinous BOT (MBOT) group according to postoperative pathology. To reduce confounding, inverse probability of treatment weighting (IPTW) was applied to balance key baseline characteristics, including age, antral follicle count, and surgical procedure. Ovarian stimulation parameters (stimulation duration, gonadotropin dose, number of oocytes retrieved), embryological outcomes (number/rate of two-pronuclear [2PN] fertilization, number/rate of high-quality embryos, number/rate of transferable embryos), and pregnancy outcomes (live birth rate per started cycle) were compared. Recurrence during follow-up was recorded, and multivariable logistic regression was performed to identify factors associated with recurrence. Results After IPTW adjustment, no significant differences were observed between the two groups in stimulation duration, total gonadotropin dose, number of oocytes retrieved, number of 2PN fertilizations, number of high-quality embryos, or number of transferable embryos. The live birth rate per started cycle was 27.1% in the SBOT group and 11.3% in the MBOT group, with no statistically significant difference. During follow-up, five recurrences occurred: the recurrence rate was 10.53% (4/38) in the SBOT group and 5.56% (1/18) in the MBOT group, with no significant difference between groups (P=0.542). Multivariable analysis indicated that histological type was not an independent risk factor for recurrence. Conclusions Among BOT patients undergoing IVF/ICSI after FSS, SBOT and MBOT showed comparable ovarian stimulation responses, embryological performance, and pregnancy outcomes. Under standardized surgical management and follow-up, ovarian stimulation did not appear to increase recurrence risk across histological types. Therefore, histological subtype alone should not be used to restrict assisted reproductive technology (ART); clinical decisions should integrate tumor stage, surgical completeness, and individual ovarian reserve to develop personalized fertility treatment and follow-up strategies.

First successful ovarian tissue transplantation in China after childhood cryopreservation: A case report and literature review

2026/3/18 17:10:34

Objective To investigate the feasibility and effectiveness of ovarian tissue cryopreservation in childhood followed by transplantation for restoring ovarian endocrine function and inducing pubertal development. Methods A retrospective analysis was conducted on a case of hemophagocytic syndrome. The patient underwent unilateral ovarian tissue cryopreservation at the age of 7 years before hematopoietic stem cell transplantation. After transplantation, she developed ovarian failure and failed to initiate puberty. At the age of 12 years, autologous transplantation of the cryopreserved ovarian tissue was performed. Postoperative follow-up included assessment of endocrine hormone levels, uterine development, and pubertal characteristics. Results Four months after ovarian tissue transplantation, follicle-stimulating hormone levels significantly decreased and uterine volume markedly increased, indicating recovery of ovarian endocrine function. Menarche occurred 8 months post-transplantation, accompanied by breast and vulvar development. Ultrasound examination showed multiple follicles within the graft. Both bone mineral density and height growth showed significant improvement compared to pre-transplantation levels, demonstrating successful induction of puberty. Conclusion Ovarian tissue cryopreservation in pre-pubertal girls followed by long-term cryopreservation and subsequent autologous transplantation can effectively restore ovarian endocrine function and induce puberty. This approach provides a critical strategy for fertility and endocrine protection in pediatric patients undergoing gonadotoxic treatments.

Strategies for Female Fertility Preservation: Interpretation of Technical Options and Indications – Current Status, Challenges, and Future Perspectives

陈士岭 — 2026/3/18 15:55:22

With the increasing survival rates of malignant tumors, the overall trend toward delayed marriage and childbearing, and advances in the diagnosis and treatment of immune, metabolic, and genetic diseases, female fertility preservation (FP) has emerged as a pivotal interdisciplinary field spanning reproductive medicine, oncology, hematology, immunology, metabolomics, clinical genetics, and related specialties. Currently, a structured technical framework for female FP has been established, centered on embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation and transplantation (OTCP). Drawing on authoritative domestic and international guidelines and evidence-based medical research, this article systematically reviews the current clinical application status, advantages, and limitations of female FP technologies. It provides an in-depth interpretation of the indication spectrum—ranging from disease-related needs to social demand—with the aim of developing an individualized selection strategy characterized by population stratification, demand orientation, and technology adaptation [3]. Furthermore, the article examines core challenges currently faced in the field, including technical controversies, limited clinical accessibility, insufficient multidisciplinary team (MDT) coordination, and ethical and legal dilemmas. Finally, it outlines future directions in technological innovation, system optimization, and policy support. This review is intended to serve as a reference for standardized and precise clinical decision-making and to contribute to the healthy development of female fertility preservation in China.

Research and Advances in Fertility Preservation Laboratory Techniques

2026/3/18 15:36:09

With the advancement in malignant tumor therapies and the remarkable improvement in survival rates among young patients, coupled with the trend of delayed childbearing due to social factors, fertility preservation (FP) has become a crucial component of reproductive medicine. This review aims to systematically elucidate the current status and future trends of FP technologies from the perspective of?core laboratory techniques. It focuses on analyzing the principles, standardized procedures, and efficacy evaluation systems of gamete (sperm and oocytes) and embryo cryopreservation, with?vitrification?as the gold standard. It also delves into the unique challenges and post-thaw strategies associated with gonadal tissue cryopreservation, such as?ovarian and testicular tissues. Furthermore, the potential and bottlenecks of cutting-edge laboratory strategies, including?in vitro maturation (IVM) of oocytes, in vitro follicle culture (IVFC), and?stem cell-based in vitro gametogenesis (IVG), are reviewed. Finally, perspectives are provided on the future direction of FP technologies towards?automation, intelligence, and personalized precision.

A study of serum miRNA-210, miRNA-124 and miRNA-195 levels in relation to nuclear magnetic total load score and cognitive function in patients with cerebral small vessel disease

zhouguangning — 2026/3/12 10:46:13

Objective: The aim of this study was to investigate the relationship between serum microRibonucleic Acid (miRNA)-210, miRNA-124, and miRNA-195 levels and Magnetic Irradiation of Nuclear (MIR) Total Load Score and Cognitive Function in patients with Cerebral Small Vessel Disease (CSVD). Methods: In this study, 90 CSVD patients who were treated in our hospital from March 2023 to December 2024 were retrospectively selected as the experimental group, and another 30 physically examined healthy people were selected as the control group in the same period. According to the MRI total load score of CSVD patients, the experimental group was divided into a mild load group (n=65, 0 < MRI total load score <2) and a moderately severe load group (n=25, 2 ≤ MRI total load score <4). Based on the MMSE scores of the CSVD patients, the experimental group was divided into the cognitively normal group (n=59, 27 ≤ MMSE score <30) and the cognitively impaired group (n=31, 0 < MMSE score <27). Serum miRNA-210, miRNA-124 and miRNA-195 expression levels were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) in each group; Spearman correlation method was used to analyze the correlation between serum miRNA-210, miRNA-124 and miRNA-195 levels and MRI total load score and cognitive function; one-way and one-way correlation methods were used to analyze the correlation between serum miRNA-210, miRNA-124 and miRNA-195 levels and MRI total load score and cognitive function. The correlation between serum miRNA-210, miRNA-124 and miRNA-195 levels and MRI total load score and cognitive function was analyzed by Spearman's correlation method; independent risk factors affecting cognitive function of CSVD patients were evaluated by using unifactorial and multifactorial logistic regression modeling; and the predictive efficacy of serum miRNA-210, miRNA-124 and miRNA-195 in cognitive function of CSVD patients was assessed by using the area under the curve (AUC) of the work characteristics (ROC) of the subjects. Results: The expression levels of miRNA-210, miRNA-124 and miRNA-195 in the serum of CSVD patients in the experimental group were significantly lower than those in the control group (P < 0.05); the levels of these three miRNAs in CSVD patients in the moderate-heavy load group were significantly lower than those in the light load group (P < 0.05); the levels of miRNA-210, miRNA-124 and miRNA-195 in the cognitive dysfunction group were significantly lower than those in the mild load group. miRNA-210, miRNA-124 and miRNA-195 levels in CSVD patients in the cognitive dysfunction group were also significantly lower than those in the normal cognitive function group (P < 0.05); further analysis by the Spearman correlation method showed that the expression levels of these three miRNAs were significantly negatively correlated with the MIR total load scores (r = -0.529, -0.692, and -0.536, P < 0.05) and significantly positively correlated with MMSE score was significantly positively correlated (r = 0.659, 0.672, 0.620, P < 0.05); multifactorial logistic regression analysis showed that miRNA-210, miRNA-124, and miRNA-195 levels were independent protective factors (P < 0.05); ROC results showed that serum miRNA-210, miRNA-124, and miRNA-195 levels jointly predicted cognitive function in CSVD patients with an AUC of 0.964, a sensitivity of 96.77%, and a specificity of 78.14%. The AUC of the combined prediction was significantly higher than that of miRNA-210 (Z=4.157, P<0.001) and miRNA-195 (Z=4.583, P<0.001) when they were used alone (P<0.05), and the difference in the prediction with miRNA-124 (Z=1.518, P＞0.05) was not statistically significant. Conclusion: Serum miRNA-210, miRNA-124 and miRNA-195 levels were significantly down-regulated in CSVD patients, and their expression levels were significantly correlated with the MRI total load score and cognitive function, which can be used as an effective bioindicator for diagnosing cognitive function in CSVD patients.

The effect of binocular visual perception training on tertiary visual function and stereoscopic vision in children with intermittent exotropia after surgery

吕碧,,, — 2026/3/12 8:48:45

Objective To explore the effect of postoperative binocular visual perception training on the recovery of visual function and stereoscopic vision in children with intermittent exotropia (IE). Methods The research subjects were selected from postoperative children with IE who received treatment in our hospital. The inclusion period was from October 2020 to January 2024, with a total of 132 cases included. They were divided into the conventional group (66 cases) and the visual perception training group (66 cases), and the grouping method used was a random number table. The conventional group received routine training after surgery, while the visual perception training group received binocular visual perception training after surgery. Both groups underwent continuous training for three months. The therapeutic effects at 3 months after surgery, level 3 visual function, integration scope and results of visual perception and stereoscopic examination before and 3 months after surgery of two groups were compared. Results 3 months after surgery, the rate of total effective of the visual perception training group (95.45%) was higher than the conventional group (78.79%) (P<0.05). Compared with preoperative results, at 3 months after surgery, the proportion of Grade III children, as well as those with distant stereoscopy and Titmus near stereoscopy, increased in both groups of Grade III visual function. Moreover, compared with the conventional group, the visual perception training group had a higher proportion; The fusion range of the visual perception training group increased, and compared with the conventional group, the visual perception training group were higher (P<0.05). Conclusion Training in binocular visual perception could effectively improve the fusion range of children with IE after surgery, improve their tertiary visual function and stereoscopic vision, and thus promote treatment effectiveness.

Efficacy and Influencing Factors of Cyclophosphamide in the Treatment of Anti-synthetase Syndrome-Associated Interstitial Lung Disease

Xue Ding Ying,, — 2026/3/11 10:40:10

Objective To investigate the efficacy of cyclophosphamide (CTX) in the treatment of patients with antisynthetase syndrome-associated interstitial lung disease (ASS-ILD) and its effect on lung function. Methods This was a multicenter retrospective cohort study that included 111 patients with ASS-ILD diagnosed from January 2020 to May 2024, who were divided into a CTX group (49 patients) and a non-CTX group (62 patients, other immunosuppressants such as tacrolimus or mycophenolate mofetil) according to the initial treatment regimen. Baseline clinical data and lung function follow-up data at 6-12 months after treatment were collected and compared between the two groups. Comparisons of efficacy between groups were performed using the independent samples t-test or Mann-Whitney U test, and categorical variables were tested using the chi-square test or Fisher exact test. In addition, patients in the CTX group were further stratified and analyzed with subgroup comparisons based on serological antibodies (Jo-1 positive vs. Jo-1 negative) and baseline lung function (FVC% <70% vs. ≥70%), and within-group pre- and post-treatment changes in lung function were assessed using paired t-tests. Results Patients in the CTX group showed significant improvement in FVC% from baseline, which was significantly higher than that in the non-CTX group (P=0.039). Post-treatment DLCO% improvement was not statistically different between the two groups (P=0.079).The daily dose of prednisone at 1 year in the CTX group was significantly lower than that in the non-CTX group [5.00 (2.50, 10.00) mg vs. 7.50 (6.00,15.00) mg, P<0.001]. Subgroup analysis showed that the group with severely impaired lung function at baseline (FVC%<70%) responded better to CTX treatment, with a significantly higher improvement in FVC% than that in the group with preserved lung function ( P=0.042).The Jo-1-positive group showed a more pronounced response to CTX treatment, with a higher improvement in lung function than that in the Jo-1-negative group. However, it did not reach statistical significance ( P=0.506). There was no statistically significant difference in the incidence of adverse events between the two groups ( P=0.472). Conclusion CTX significantly improves lung function and reduces glucocorticoid dosage in patients with ASS-ILD, especially in those with poor baseline lung function (FVC%<70%). positive antibody to Jo-1 may predict a better CTX response, but its clinical significance needs to be further investigated. response, but its clinical significance needs further validation. The present study supports CTX as a first-line immunotherapeutic option for ASS-ILD, especially in progressive cases.

Effect of circadian rhythm-directed timing optimization breathing training on pulmonary function recovery in children with pneumonia

AI ER KEN Aierken,CHEN Xumei, — 2026/3/10 11:25:34

Objective To construct a circadian rhythm-oriented time-sequence optimized respiratory training program and evaluate its effect on children with pneumonia. Methods: A total of 78 children with pneumonia aged 3-10 years old were selected from August to September 2025 in the pediatric ward of a tertiary A hospital in Xinjiang as the research objects, and were randomly divided into experimental group (39 cases) and control group (39 cases) by randomized controlled design. The control group received conventional breathing training. The differences in lung function, duration of cough and sputum, disappearance of pulmonary rales, length of hospital stay, and adherence to respiratory training were compared between the two groups. Results: After intervention, the lung function of the children in the experimental group was improved compared with the control group, and the difference was statistically significant (P<0.05). The duration of cough and sputum, the time of disappearance of pulmonary rales and the length of hospitalization were all improved, and the differences were statistically significant (P<0.05). The exercise standard compliance rate in the experimental group was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: This study combines routine breathing training with diurnal physiological characteristics to form a standardized process of "three periods and six steps" breathing training that is easy for nurses to implement and easy for children to accept, which can effectively improve the lung function of children with pneumonia, improve their compliance with respiratory training, shorten the cough and sputum production, the disappearance of pulmonary rales and the length of hospitalization, and provide a time-series management plan that can be directly generalized for clinical nursing practice.

A Retrospective Clinicopathological Analysis of 656 Cases of Major Salivary Gland Tumors

Wang ZhiFa — 2026/3/10 11:19:47

【Objective】 To elucidate the incidence and constituent ratios of major salivary gland tumors and to provide evidence for clinical diagnosis and treatment. 【Methods】A total of 656 cases of major salivary gland tumors pathologically confirmed between January 2000 and December 2020 were collected from the Department of Stomatology, General Hospital of Southern Theater Command, PLA. Histopathological typing followed the 4th edition of the WHO Classification of Tumours of the Head and Neck: Salivary Gland Tumours. A database was constructed with Microsoft Excel and analyzed with SPSS 27.0. Patients were stratified by age into pediatric (≤14 years), young (15–34 years), middle-aged and elderly (35–64 years), and elderly (≥65 years) groups. Retrospective comparisons were performed with respect to tumor type, anatomic site, and patient sex. 【Results】 Benign tumors outnumbered malignant tumors in every age group, with an overall benign-to-malignant ratio of approximately 2.43:1. The three most common benign tumors were pleomorphic adenoma [46.88% (218/465)], Warthin tumor [33.33% (155/465)], and basal cell adenoma [5.59% (26/465)], with pleomorphic adenoma accounting for [33.34% (218/656)] of all tumors. Among malignant tumors, the leading entities were adenoid cystic carcinoma [25.65% (49/191)], mucoepidermoid carcinoma [18.85% (36/191)], and acinic cell carcinoma [13.09% (25/191)]. The overall male-to-female ratio was 1.69:1. The parotid gland was the most frequently involved site [83.08% (545/656)], with a left-to-right ratio of 0.95:1. Most patients presented in middle-aged and elderly (35–64 years) [54.42% (357/656)] and young (15–34 years) [24.54% (161/656)] age groups. 【Conclusion】 Major salivary gland tumors are more common in males than in females. The parotid gland is the predominant site. Pleomorphic adenoma is the most frequent tumor overall, whereas adenoid cystic carcinoma is the most common malignancy. The majority of patients are seen in middle-aged and elderly populations.

Clinical Application Progress of Ovarian Tissue Cryopreservation and Transplantation in Leukemia Patients

CHENG Jiaojiao,DU Juan,GU Muqing,JIN Fengyu, — 2026/3/9 16:44:07

Ovarian tissue cryopreservation and transplantation (OTCT) has been widely validated for its efficacy and safety, and has become a routine clinical technique. For leukemia patients scheduled to undergo hematopoietic stem cell transplantation (HSCT), the preconditioning regimen before HSCT can cause severe and irreversible damage to ovarian function, thereby affecting their fertility potential and ovarian endocrine function. Therefore, OTCT holds significant clinical importance for this population. However, the potential risk of reintroducing leukemia cells through the transplanted ovarian cortical fragments remains a key safety concern limiting the widespread application of this technique in such patients. This article systematically reviews the application of ovarian tissue cryopreservation in leukemia patients, assesses the risk of leukemia cell transmission through ovarian tissue transplantation, and evaluates the outcomes of cryopreserved ovarian tissue transplantation in leukemia survivors, aiming to provide valuable references and guidance for clinical decision-making and practice.

Construct a predictive model for the risk of intracranial aneurysm rupture during craniotomy clipping, and validating its efficacy based on morphology, hemodynamic parameters and clinical factors

wangshengjun — 2026/3/9 9:56:55

Objective ? To construct a predictive model for the risk of intracranial aneurysm (IA) rupture during craniotomy clipping based on morphology, hemodynamic parameters and clinical factors, and to verify its predictive efficacy. Methods ?A total of 330 patients with IA admitted to Xingtai Central Hospital from January 2020 to April 2025 were selected as the research objects. They were divided into training set and validation set according to the ratio of 7:3. The training set and validation set were divided into ruptured group and unruptured group according to whether IA rupture occurred during craniotomy clipping. Computer tomography angiography (CTA) was performed before operation. The morphological parameters of aneurysms [maximum diameter of aneurysm, length of aneurysm, width of aneurysm, width of aneurysm neck, diameter of parent artery, ratio of maximum diameter of aneurysm to width of aneurysm neck (AR), ratio of maximum length of aneurysm to diameter of parent artery (SR) ] and hemodynamic parameters [ mean wall shear stress gradient (WSSGA), oscillatory shear index (OSI), normalized surface maximum shear stress (NWSSM)] were obtained. Clinical data were collected to construct Logistic regression equation (LR) model and extreme gradient boosting (XGBoost) model. The predictive efficacy and accuracy of the two models were evaluated by receiver operating characteristic curve (ROC) and calibration curve. Results ?The incidence of IA rupture during craniotomy clipping was 38.10 % (88/231) in 231 IA patients in the training set. The proportion of hypertension, intracranial atherosclerosis, systemic inflammatory response index (SIRI), maximum diameter of aneurysm, AR, SR, WSSGA and OSI in the rupture group of training set and validation set were higher than those in the unruptured group, and NWSSM was lower than that in the unruptured group (P<0.05). OSI, SIRI, SR, NWSSM, AR and intracranial atherosclerosis were independent influencing factors of IA rupture during craniotomy clipping (P<0.05). The ROC curve showed that the area under the curve (AUC) of the XGBoost model in the training set and the validation set was 0.915 (95%CI: 0.875-0.955) and 0.911 (95%CI: 0.867-0.956), respectively, which were higher than the AUC of the LR model 0.838 (95%CI: 0.780-0.897) and 0.843 (95%CI: 0.784-0.901). The calibration curve showed that the XGBoost model had higher prediction accuracy than the LR model in the training set and the validation set.

New Standards for the Management of Extrahepatic Cholangiocarcinoma: Core Recommendations of the EASL Guidelines and Key Points in Clinical PracticeHu Kuan1, Duan Zhihua1, Zhou Junyu1, Wang Ziquan2, Wang Xiaohui1, Duan Wenbin1, Duan Xiaohui1, Chen Botao1

Duan Wenbin,Duan Xiaohui,duanzhihua,hukuan,Wang Ziquan,Wang Xiaohui,Zhou Junyu — 2026/3/9 9:22:16

The "EASL Clinical Practice Guidelines on the Management of Extrahepatic Cholangiocarcinoma" (2025) was developed by a multidisciplinary panel of experts in pathology, radiology, oncology, and hepatobiliary surgery, based on systematic evidence review and extensive clinical experience. This authoritative guideline comprehensively addresses the classification, epidemiology, high-risk population surveillance, diagnosis, treatment, and follow-up of extrahepatic cholangiocarcinoma, providing detailed recommendations for the entire care continuum from early screening to palliative management in advanced disease. Understanding and adopting these guidelines will help improve the standardization and quality of extrahepatic cholangiocarcinoma management in China, ultimately delivering higher-quality care and better outcomes for patients.

Fertility Preservation in Female Cancer Patients: An Interpretation of the American Society of Clinical Oncology Guideline Update（2025）

luozhuoye — 2026/3/9 9:14:48

The American Society of Clinical Oncology (ASCO) has published an updated guideline on fertility preservation in cancer patients in 2025. This guideline consolidates a decade of evidence to provide comprehensive, stratified, and actionable strategies for preserving fertility in individuals undergoing cancer treatment. While reinforcing the 2018 edition"s focus on early intervention, the updated guideline further emphasizes the integration of fertility preservation into the continuum of cancer survivorship care. It refines the clinical pathways and decision-making frameworks for established methods such as embryo or oocyte cryopreservation and ovarian tissue cryopreservation, while strongly advocating for multidisciplinary collaboration and individualized patient counseling. This article provides a detailed interpretation of the guideline updates pertaining specifically to female patients, aiming to inform and enhance clinical practice.

Research Progress on NETs-Mediated Pathophysiology and Clinical Application Transformation of AIS

pudan,pukuairong,wangyaxin,yangzhongcun,yinlimin,yuxiaochao,zahngyixin, — 2026/3/6 17:15:46

Acute ischemic stroke (AIS) is a serious thrombotic disease with high morbidity, high disability rate and high mortality. Its pathogenesis is complex, and thrombosis and aseptic inflammation constitute the core pathological process. Neutrophil Extracellular Traps (NETs) are fibrous networks released by activated neutrophils, which not only participate in host pathogen defense responses, but also play a key role in the pathological process of thrombotic diseases. Recent research have demonstrated that NETs exacerbate the progression and worsening of AIS by initiating and amplifying thromboinflammatory cascades, thereby inducing cerebral tissue damage. This review synthesizes current research advances on NETs in AIS, provides an in-depth examination of the pathogenic mechanisms of NETs in AIS pathophysiology, and elaborates on the theoretical foundations and strategic frameworks for NETs-targeted clinical interventions and prognostic applications in AIS management.

Based on Hcy,hs-CRP/ALB and TyG index to construct a nomogram model for predicting the risk of progressive ischemic stroke

青云 — 2026/3/6 10:48:38

Objective To construct and validate a nomogram prediction model based on Hcy, hs-CRP/ALB and TyG index for predicting the risk of progressive ischemic stroke. Methods A total of 331 patients with acute ischemic stroke admitted to the Department of Neurology, Bayannur City Hospital from January 2020 to December 2020 were retrospectively enrolled. The were divided into a PIS group and a non-PIS group based on whether their condition progressed during hospitalization. Univariate and multivariate Logistic regression analyses were used to identify influencing factors for PIS.The R software was used to construct the nomogram prediction model. The model’s discriminative ability was evaluated receiver operating characteristic(ROC) curve.The Hosmer-Lemeshow test and calibration curve were used to access the model’s goodness-of-fit and calibration.Clinical decision curve analysis was used to evaluate the model’s clinical benefit. Results Compared with the non-PIS group, the PIS group showed statistically significant differences in history of diabetes, NIHSS score on admission, TOAST classification, degree of vascular stenosis, neutrophil count, Hcy, fibrinogen, hs-CRP/ALB, and TyG index (P＜0.05). Multivariate Logistic regression showed revealed that history of diabetes, NIHSS score on admission, TOAST classification(large artery athersclerosis), severe vascular stenosis, vascular occlusion, Hcy, hs-CRP/ALB, and TyG index were independent risk factors for PIS(P＜0.05).ROC curve analysis showed an area under the curve of 0.910 (95%CI：0.8724-0.9477）indicating good discriminative ability. Internal validation using the Bootstrap method showed good agreement between the predicted curve and the actual curve on the calibration plot. The Hosmer-Lemeshow goodness-of-fit test indicated good fit for thee nomogram model(P = 0.30). The decision curve analysis results showed that net benefit was achieved when the threshold probability was 0.05-0.99. Conclusion history of diabetes, NIHSS score on admission, TOAST classification(large artery athersclerosis), severe vascular stenosis, vascular occlusion, Hcy, hs-CRP/ALB, and TyG index were independent risk factors for PIS. The nomogram model constructed based on these factors can accurately predict the risk of PIS and has clinical utility.

Analysis of the effect of the small incision approach through the lateral rectus abdominis muscle in the treatment of pelvic acetabular fractures based on pelvic function and surgical stress indexes

chenruixing — 2026/3/6 10:47:52

Objective: To observe the effect of the small incision approach through the lateral rectus abdominis muscle in the treatment of pelvic acetabular fractures. Methods: From April 2021 to December 2023, 86 cases of pelvic acetabular fractures admitted to our hospital were collected and randomly divided into the rectus abdominis muscle group (43 cases, small incision approach through the lateral rectus abdominis muscle) and the control group (43 cases, ilioinguinal approach). The perioperative indicators of the two groups of patients were recorded, the surgical stress indicators were measured, the reduction satisfaction and pelvic function were evaluated, and the complications such as incision infection and lower extremity venous thrombosis were counted. Results: The exposure time of fracture end, intraoperative blood loss, operation time and postoperative hospital stay in the rectus abdominis group were lower than those in the control group (P＜0.05). The serum norepinephrine (NE) and cortisol (Cor) levels in the rectus abdominis group were significantly lower than those in the control group 1 day after surgery (P＜0.05). The satisfactory rate of fracture reduction in the rectus abdominis group was significantly higher than that in the control group (P＜0.05). The Majeed pelvic function score in the rectus abdominis group was significantly higher than that in the control group 3 months after surgery (P＜0.05), and there was no significant difference in the Majeed pelvic function score between the group and the control group 6 months and 12 months after surgery (P＞0.05). The total incidence of complications such as incision infection and lower extremity venous thrombosis in the rectus abdominis group was significantly lower than that in the control group (P＜0.05). Conclusion: Compared with the traditional ilioinguinal approach, the small incision approach through the lateral rectus abdominis muscle has the advantages of less trauma and faster postoperative recovery in the treatment of pelvic acetabular fractures, which can improve the satisfaction of postoperative reduction and is conducive to the early recovery of pelvic function in patients. It also has less surgical stress and fewer postoperative complications, so it can be given priority.

Impacts of constraint-induced aphasia therapy combined with repetitive transcranial magnetic stimulation on aphasia quotient and language communication skills in patients with post-stroke aphasia

王雅洁 — 2026/3/4 15:28:01

Objective To investigate the impacts of constraint-induced aphasia therapy combined with repetitive transcranial magnetic stimulation on aphasia quotient and language communication skills in patients with post-stroke aphasia (PSA). Methods A total of 160 PSA patients admitted to our hospital from March 2021 to July 2023 were collected. Using a random number table method, the patients were separated into a constraint induction group (80 cases) and a combined group (80 cases). Patients in the constraint induction group were treated with constraint induction language therapy, while patients in the combined group were treated with constraint induction language therapy combined with repeated transcranial magnetic stimulation. Both groups were treated continuously for 4 weeks. The clinical efficacy, Western Aphasia Battery (WAB), aphasia quotient (AQ), Functional Independence Measure (FIM) score, Communication Activities of Daily Living (CADL) score, and Montreal Cognitive Assessment Scale (MoCA) score were compared between the two groups after treatment. Results After treatment, the total clinical effective rate of the combined group was 93.75%, which was obviously higher than the 82.50% of the constraint induction group (P<0.05). After treatment, the WAB (self speaking, listening comprehension, retelling, naming), AQ index, FIM communication sub item score, CADL score, and MoCA score in both groups were obviously improved (P<0.05), and the combined group was higher than the constraint induction group (P<0.05). Conclusion The combination of constraint-induced aphasia therapy and repetitive transcranial magnetic stimulation has a obvious therapeutic effect on PSA, which can improve the clinical efficacy of patients, improve their aphasia quotient, speech function, daily communication ability, and cognitive function.

Research Progress of Biological Therapy in the Treatment of Patellofemoral Osteoarthritis

jiashuwei — 2026/3/4 11:38:26

Patellofemoral osteoarthritis is a common degenerative knee joint disease in middle-aged and elderly individuals, primarily manifested as anterior knee pain and difficulty in climbing stairs. Its incidence is increasing year by year, severely affecting patients" quality of life and placing a heavy economic burden on society. Although a variety of treatment methods are available, no current approach can halt the progression of the disease, repair the degenerated cartilage, or effectively relieve symptoms. Biological therapies, which function through mechanisms such as promoting cartilage regeneration, modulating immune responses, reducing inflammatory reactions, and secreting various bioactive substances, have gradually become a research hotspot in the treatment of patellofemoral osteoarthritis. This paper conducts a comparative analysis of existing studies on various biological therapies, including mesenchymal stem cells and exosomes, aiming to elucidate their respective advantages and disadvantages and provide a reference for clinical treatment of patellofemoral osteoarthritis.

Lifestyle Intervention, Treatment, and Remission of Adult Type 2 Diabetes Mellitus and Prediabetes: Interpretation of the Clinical Practice Guidelines of the American College of Lifestyle MedicineLiu Jingtao1, Tan Lixin2, Geng Lijuan2, Xu Zhangrong3, Zhang Lili?

耿丽娟,刘敬涛,谈力欣,许樟荣,张莉莉 — 2026/3/4 8:38:41

This article provides an in-depth interpretation of the Clinical Practice Guidelines for Lifestyle Intervention, Treatment, and Remission of Adult Type 2 Diabetes Mellitus and Prediabetes: American College of Lifestyle Medicine, systematically analyzing the world’s first type 2 diabetes management guideline centered on the six pillars of lifestyle intervention. Combined with the current status of diabetes prevention and control in China, it compares the latest domestic and foreign research findings, explores the applicability and implementation paths of the guideline’s recommendations in the Chinese population, and provides a standardized and operable practical framework for diabetes remission.

A case of Tenofovir Disoproxil Fumarate-associated hypophosphatemic osteomalacia diagnosed through the integration of SPECT/CT bone scintigraphy and laboratory tests

Ding Yueyun,Shi Dedao, — 2026/3/3 17:54:17

This paper reports a case of Tenofovir Disoproxil Fumarate-associated hypophosphatemic osteomalacia diagnosed through the integration of SPECT/CT bone scintigraphy and laboratory tests.

The diagnostic value of the combination of color ultrasound with serum GP73 and MUC2 in identifying benign and malignant breast masses

王颖 — 2026/3/3 11:55:47

Objective: To explore the differential diagnostic value of color Doppler ultrasound (CDU) combined with serum Golgi protein 73 (GP73) and mucin 2 (MUC2) detection for benign and malignant breast masses. Methods: A total of 132 female patients with breast tumors who were treated and operated in our hospital from February 2022 to February 2024 were selected. According to the postoperative pathological results, the patients were grouped into a benign disease group of 53 cases and a breast cancer group of 79 cases. All patients underwent CDU examination, and the pulsatility index (PI), maximum blood flow velocity (Vmax), and blood flow resistance index (RI) within tumors of the two groups were compared. ELISA method was applied to measure the expression levels of serum GP73 and MUC2. ROC curve was used to analyze the diagnostic value of serum GP73 and MUC2 expression levels in breast cancer. Kappa test was used to analyze the consistency between CDU with the combined diagnoses and individual diagnose and the combined diagnosis of serum GP73, MUC2 for breast cancer and pathological results. Results: There was a statistically significant difference between the benign lesion group in terms of mass morphology, borders, and blood flow when compared with the breast cancer group (P<0.05). The PI, RI and Vmax values in breast cancer group were greatly higher than those in benign disease group (P<0.05), and the expression levels of GP73 and MUC2 in serum were greatly higher than those in benign disease group (P<0.05). The area under the curve (AUC), sensitivity and specificity of serum GP73 in diagnosing breast cancer were 0.798, 70.89% and 83.02% respectively; the AUC, sensitivity and specificity of serum MUC2 in diagnosing breast cancer were 0.839, 83.54% and 77.36% respectively. The consistency analysis between the results of CDU and serum GP73, MUC2 single and combined examinations and pathological results showed that the Kappa values were 0.710, 0.517, 0.607, and 0.858, respectively (P<0.05). The sensitivity, accuracy and negative predictive value of CDU combined with serum GP73 and MUC2 in the diagnosis of breast cancer were higher than individual diagnoses of CDU, serum GP73 and MUC2 (P<0.05). Conclusion: Serum GP73 and MUC2 levels in breast cancer patients are elevated. CDU combined with serum GP73 and MUC2 can improve the sensitivity, accuracy and negative predictive value of diagnosis of breast cancer, which is of high value in differentiating benign and malignant breast masses.

Anesthetic management of a super-elderly patient with myasthenia gravis undergoing femoral head replacement under combined spinal-epidural anesthesia

huangjingxiang,,Liu Yong,Yi Qianglin — 2026/3/3 10:27:55

This paper reports on the anesthetic management of a 94-year-old super-elderly female MG patient undergoing right artificial femoral head replacement under combined spinal-epidural anesthesia.

Interpretation of the Clinical Pathway for Fertility Preservation in Gynecological Malignancies (2025 Edition)

叶, — 2026/2/24 8:48:41

With the increasing incidence of malignancies among younger populations and significant improvements in survival rates, fertility preservation in reproductive-age patients with gynecological cancers has become a core issue at the intersection of reproductive health and oncological treatment. The Clinical Pathway for Fertility Preservation in Gynecological Malignancies (2025 Edition) has been developed in response to this need, providing authoritative and systematic guidance for clinical practice. This article aims to interpret two key sections of the pathway-the"Patient Selection Pathway"and the"Implementation Pathway for Fertility Preservation Measures."It explores precision-based patient selection strategies and individualized fertility preservation approaches for the three major gynecological malignancies: cervical cancer, endometrial cancer, and ovarian malignancies. The goal is to enhance the standardization of fertility preservation and provide reference and guidance for clinical practice.

Fisher Discriminant function of CT Parameters in the Differential Diagnosis of Thymoma and Anterior Mediastinal Cyst

程远大,卢礼卿,王思聪,杨宇琦,张春芳 — 2026/2/13 16:41:08

Objective: To evaluate the utility of a Fisher discriminant function derived from CT parameters for differentiating between thymoma and anterior mediastinal cysts. Methods: A retrospective analysis was conducted on clinical and pathological data from patients who underwent surgical resection at the Department of Thoracic Surgery,Xiangya Hospital, Central South University, between January 2015 and June 2025, with pathologically confirmed anterior mediastinal cysts (including thymic cysts and bronchogenic cysts) or thymoma. The ratios of non-enhanced and enhanced CT attenuation values of the tumors to those of the aorta were calculated. Intergroup comparisons were performed using one-way ANOVA with Bonferroni correction. Develop and validate a Fisher discriminant function based on statistically significant CT parameters. Results: A total of 236 patients were included, consisting of 159 thymomas, 54 thymic cysts, and 23 bronchogenic cysts. No significant difference in age distribution was observed among the three groups (P = 0.183). Compared with the thymoma and thymic cyst groups, the bronchogenic cyst group had a higher proportion of female patients (P’ < 0.001). Lobulated morphology was more frequent in thymomas than in the two cyst groups (P’ < 0.01). Both thymomas and bronchogenic cysts exhibited higher non-enhanced and enhanced CT values, as well as higher CT ratios, compared to thymic cysts (P’ < 0.001). However, bronchogenic cysts showed lower enhanced CT values and ratios than thymomas (P’< 0.001). The CT enhancement values were significantly lower in both cyst groups than in the thymoma group (P’ < 0.001). Significant variables identified by univariate analysis were used to construct two Fisher discriminant functions: D? = 0.245 × gender + 0.782 × shape + 0.644 × fat gap – 0.344 × enhanced CT value + 97.228 × enhanced CT ratio + 0.059 × enhancement value – 9.357, D? = 0.970 × gender + 0.583 × shape + 0.903 × fat gap – 0.094 × enhanced CT value + 4.749 × enhanced CT ratio + 0.110 × enhancement value + 0.546,Cross-validation of the model derived from these functions yielded an accuracy of 95.8%. Conclusion: The discriminative prediction model established based on CT parameters has a high diagnostic value in differentiating thymoma from anterior mediastinal cysts.

Efficacy of Multimodal Integrated Assessment in Predicting Early Tibial Component Loosening After Unicompartmental Knee Arthroplasty in Elderly Patients with Osteoporosis

李江波 — 2026/2/12 8:19:05

Objective To investigate factors associated with early tibial component loosening after unicompartmental knee arthroplasty (UKA) in elderly patients with osteoporosis, and to develop a nomogram for early risk prediction to facilitate postoperative risk stratification.Methods A single-center retrospective cohort study was conducted, including 125 elderly patients with osteoporosis who underwent unicompartmental knee arthroplasty (UKA) for knee osteoarthritis between May 2023 and January 2025. Among these patients, 21 developed early tibial component loosening (loosening group), while 104 showed no signs of loosening (non-loosening group). Within 3 months preoperatively, proximal tibial volumetric bone mineral density (vBMD) was measured using quantitative computed tomography (QCT), and serum calcium, phosphorus, and bone turnover markers (β-CTX, P1NP, N-MID osteocalcin, BALP, etc.) were assessed. Postoperatively, radiostereometric analysis (RSA) was used to obtain three-dimensional tibial component migration parameters, including maximum total point motion (MTPM), and patients were followed for 24 months. Intergroup comparisons were performed using the t-test and χ2 test. Independent predictors were identified by multivariable logistic regression. A nomogram was constructed based on independent predictors and internally validated using bootstrap resampling (1,000 iterations). Predictive performance was evaluated with the receiver operating characteristic (ROC) curve.Results No significant differences were observed in baseline characteristics between the two groups. Compared with the non-loosening group, the loosening group had significantly greater RSA MTPM (0.93±0.47 vs 0.58±0.23 mm, P<0.001), lower proximal tibial vBMD on QCT (71.68±17.36 vs 87.12±20.72 mg/cm3, P<0.001), and higher β-CTX levels (0.49±0.15 vs 0.35±0.12 ng/mL, P<0.001). Multivariable logistic regression demonstrated that RSA MTPM (OR=3.32, 95%CI: 2.11–5.21, P<0.001) and β-CTX (OR=1.13, 95%CI: 1.06–1.20, P<0.001) were independent risk factors, whereas QCT-derived proximal tibial vBMD was an independent protective factor (OR=0.63, 95%CI: 0.44–0.82, P=0.001). The nomogram incorporating these three variables achieved a C-index of 0.785 on internal validation, with an AUC of 0.792 on ROC analysis. Decision curve analysis indicated a favorable clinical net benefit when the threshold probability ranged from 0.15 to 0.38.Conclusion Proximal tibial vBMD assessed by QCT, early tibial component migration quantified by RSA (MTPM), and the bone resorption marker β-CTX are closely associated with early tibial component loosening after UKA in elderly osteoporotic patients. The nomogram based on these factors shows good discrimination and potential clinical utility, and may support risk prediction and stratified early interventions after UKA.

Research progress in the diagnosis and treatment of cystic brain metastases

Wang Zhen — 2026/2/9 10:32:49

Cystic metastases are relatively rare among intracranial secondary malignancies, and because cystic metastases are generally large in size and have obvious mass effect, the clinical symptoms are severe and the prognosis is poor, and there is no standard treatment for this disease. Therefore, how to optimize the treatment plan, improve the quality of life of patients, prolong the survival time, and improve their long-term prognosis are the challenges faced by clinicians.

Summary of the best evidence for early postoperative ambulation in patients with lumbar degenerative disease

黄婵裕,黄秋鸿,宁胜玉,韦佳妮,杨思思,应燕萍 — 2026/2/9 10:30:18

Objective To systematically search the literature and summarize the best evidence for early postoperative ambulation in patients with lumbar degenerative diseases, in order to provide evidence-based basis for early ambulation in patients with lumbar degenerative diseases. Methods The literature related to early postoperative ambulation of patients with lumbar degenerative diseases was systematically searched, the quality of the included literature was evaluated, and evidence that met the quality standards was extracted. Results A total of 12 articles were included, including 3 guidelines, 5 expert consensus articles, 2 systematic reviews, and 2 randomized controlled trials; they were summarized into 7 dimensions and 24 pieces of evidence, including pre-rehabilitation, pain management, gastrointestinal and nutrition management. Management, sleep management, pre-assessment of off-bed activities, content of off-bed activities, and off-bed safety management.Conclusion The evidence included in this study will provide evidence-based basis for standardizing early postoperative ambulation of patients with lumbar degenerative diseases. The application of evidence should be combined with clinical reality, patients should be comprehensively evaluated, and personalized early ambulation plan should be formulated.

Clinical Efficacy of Gelatin Sponge-rhBMP-2 Composite Bioactive Material via

hanxu,huxiao,luochuan,pengxingrui,wangxiandi,xietainhang, — 2026/2/9 10:21:20

Objective To evaluate the safety and effectiveness of the “sandwich” technique—using a gelatin sponge wrapped and secured with absorbable sutures to cover the cage—during oblique lumbar interbody fusion (OLIF) in preventing graft leakage and maintaining clinical outcomes. Methods A retrospective analysis was conducted on 92 patients with lumbar degenerative diseases who underwent single-level OLIF at our institution from November 2017 to November 2018. The cohort included 41 males and 51 females, with a mean age of (59.9 ± 10.6)years. Operative time, intraoperative blood loss, and length of hospital stay were recorded. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Radiological evaluations included disc height (DH) measured preoperatively, postoperative day 1, and 12 months after surgery, as well as fusion status and cage subsidence at 12 months. Cage subsidence was graded using the Marchi percentage-based system, and interbody fusion was assessed according to the Bridwell grading criteria. Results All 92 procedures were completed successfully without artificial bone migration, leakage, or neurological complications. The mean operative time was (88.3 ± 12.0) minutes, intraoperative blood loss was (35.9 ± 9.5) mL, and median hospital stay was [4 (3, 4)] days. All patients were followed for at least 12 months. ODI scores improved significantly from (37.8 ± 5.5) preoperatively to (12.7 ± 3.0) at the final follow-up (P < 0.05). Low-back pain VAS scores decreased from (7.0 ± 1.1) to (2.1 ± 0.6) (P < 0.05), and leg pain VAS scores decreased from (6.6 ± 1.4) to (1.7 ± 0.8) (P < 0.05). Postoperative imaging demonstrated restoration of DH at postoperative day 1 with sustained maintenance at 12 months. The fusion rate was 93.5%, and the cage subsidence rate was 18.5%. Conclusion Intraoperative use of a rhBMP-2–composited bioactive bone graft substitute with a “sandwich” encapsulation technique during OLIF demonstrated favorable safety and feasibility. This approach is simple to perform, time-efficient, and associated with a low complication profile. While preserving the efficiency of minimally invasive surgery, it achieved satisfactory clinical outcomes and radiographic results.

Research progress on the mechanism of multi-target regulation of chitooligosaccharide in type 2 diabetes mellitus

dingyabin,weixiaomei, — 2026/2/6 17:56:27

Type 2 diabetes mellitus (T2DM), as a global health challenge, involves pathological mechanisms such as insulin resistance (IR), dysregulation of glucose and lipid metabolism, and intestinal flora imbalance. Studies have shown that Chitooligosaccharide (COS) derived from marine sources possess multiple biological activities, including anti-inflammation, antioxidation, improvement of glucose and lipid metabolism, and regulation of the intestinal microbiota. This article reviews the multi-target synergistic mechanism of COS and its derivatives in anti-diabetes, providing theoretical support for the construction of targeted nutritional intervention programs and highlighting their clinical transformation value in the comprehensive treatment system of diabetes.

Observation of the Clinical Efficacy of spinal fine-tuning manipulation combined with Cervical Triad for Patients with Cervical Type Cervical Spondylosis

袁雷 — 2026/2/6 17:54:43

Objective: To investigate the effect of spinal fine-tuning manipulation + neck three needles in treating neck-type cervical spondylosis (NTCS) and its impacts on cervical spine function and range of motion. Methods: A total of 132 patients with NTCS admitted to our hospital were prospectively selected and randomly divided into a single group and a combination group, with 66 cases in each group. The single group was treated with spinal fine-tuning manipulation, and the combined group was added with neck three needles. The total effective rate, pain level, cervical spine function, cervical spine mobility, serum biochemical indexes and quality of life were compared between the two groups. Results: The total effective rate of combined group (93.94%) was obviously higher than that of single group (74.24%) (P<0.05); the Visual Analogue Score (VAS) score and Neck Disability Index (NDI) were obviously lower than those of single group (P<0.05). The angles of left-right rotation, forward flexion and extension in combined group were obviously higher than those in single group (P<0.05). The level of nitric oxide (NO) in combined group was significantly higher than that in single group (P<0.05), the level of serum endothelin (ET), ADL score and recurrence rate in combined group were significantly lower than that in single group (P<0.05). Conclusion: NTCS patients can effectively reduce neck pain response and enhance cervical spine function after receiving spinal fine-tuning manipulation + neck three needles regimen, with ideal effect and high clinical application value.

Study on the mechanism of action of Daotan Tang in treating hypertension based on network pharmacology and molecular docking

龙远雄 — 2026/2/6 17:50:11

Objective Study the mechanism of action of Daotan Tang in treating hypertension based on network pharmacology methods.Methods Using TCMSP and GeneCards databases, obtain the active ingredients and potential targets of Daotan Tang, as well as hypertension related targets, and analyze the intersection targets. Construct protein-protein interaction network (PPI) and compound target network, screen key active ingredients and core targets. Molecular docking was used to calculate the binding energy between key components and targets, and the intersection targets were analyzed for GO function and KEGG pathway enrichment using the DAVID database.Results Daotan Tang has 53 components and 130 targets, among which 53 components and 110 targets are related to hypertension; Fifteen key compounds and 26 core target genes were screened, and the top four core targets with the highest degree values showed good binding affinity with the top four key compounds. The treatment of hypertension with Daotan Tang mainly affects 146 biological processes and 95 pathways.Conclusion

A case of uterine intramural pregnancy

guanxia,,, — 2026/2/6 15:11:24

Objective To explore the diagnosis, differential diagnosis, and treatment plan of intramural pregnancy (IMP) in the uterus, in order to provide reference for the diagnosis and treatment of IMP. Method A retrospective analysis was conducted on the treatment process of a patient with IMP admitted to our hospital, including medical history, relevant examinations, etiology, treatment process, and review of relevant literature. Result Transvaginal ultrasound diagnosed IMP and conservative treatment with methotrexate was used. After 86 days of treatment, the level of human chorionic gonadotropin decreased to normal; After 336 days of treatment, the lump significantly shrank. After more than a year of follow-up, the patient's menstrual period was normal. Conclusion Transvaginal ultrasound can provide very clear images of the endometrial muscular junction, with simple operation and rapid and accurate results, making it an important diagnostic method for IMP.

Regulatory B cell subsets participate in the inflammatory response of diabetes retinopathy

柯笛扬 — 2026/2/6 9:46:52

Objective: To analyze the expression of regulatory B cells (Bregs) and their related cytokines in diabetic mice and patients, and to explore their role in diabetic retinopathy (DR). Methods: A STZ mouse model was established with 6 mice in the control group and 6 in the experimental group. Optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) were used to observe fundus changes. Spleen and whole blood cells were collected, and Bregs subpopulations were detected using flow cytometry. Plasma samples from 16 DR patients diagnosed at the Department of Ophthalmology, Guangxi Zhuang Autonomous Region People"s Hospital from April 2020 to August 2024 were collected, and ELISA was used to quantitatively detect the levels of major anti-inflammatory cytokines IL-10, PD-L1, and TGF-β secreted by Bregs. Results: The proportion of Bregs in the peripheral immune system of DR mice was significantly reduced, and the levels of Bregs-related anti-inflammatory factors IL-10 and PD-L1 in the plasma of DR patients were negatively correlated with disease progression. Conclusion: Bregs, as anti-inflammatory cells, participate in the immune-inflammatory response of DR.

Effect of the Method of Activating Qi and Promoting Blood Circulation with Jingxue Yuanli Needles Combined with Small Needle-knife Treatment on Wrist Joint Function and Prognosis of Patients with Stenosing Tenosynovitis of the Styloid Process of the Radius

Liuguangyu, — 2026/2/6 9:46:05

Objective Explore and analyze the influence of the method of activating qi and promoting blood circulation with Jingxue Yuanli needles combined with small needle - knife treatment on the wrist joint function and prognosis of patients with stenosing tenosynovitis of the styloid process of the radius. Methods A total of 106 patients with De Quervain's tenosynovitis who were treated in our hospital from February 2022 to February 2024 were selected as the research objects. They were randomly divided into a control group (n = 53, treated with small needle-knife) and a study group (n = 53, treated with the method of activating qi and promoting blood circulation with Jingxue Yuanli needles combined with small needle-knife treatment) by the random number generation method. The TCM syndrome scores, wrist joint function indicators and prognosis of the two groups of patients were compared and analyzed. Results After treatment, the total TCM syndrome score of the study group was lower than that of the control group (P < 0.05). After treatment, the Cooney wrist joint score and wrist joint range of motion (flexion and extension, ulnar deviation, radial deviation) of the study group were higher than those of the control group (P < 0.05). There was no significant difference in the recurrence rate and the incidence of adverse reactions between the two groups of patients with De Quervain's tenosynovitis (P < 0.05). Conclusion The treatment method combining the technique of activating qi and promoting blood circulation with Jingxue Yuanli needles at acupoints and small needle-knife therapy can effectively improve the traditional Chinese medicine syndromes of patients with stenosing tenosynovitis of the styloid process of the radius, enhance the function of the wrist joint, and has good treatment safety and prognosis.

Research Progress on Homocysteine in Osteoporosis

蒋尚堃,李立钧,李新华,杨斓 — 2026/2/5 16:55:52

Abstract:? Osteoporosis (OP) is a globally prevalent skeletal disease, imposing a substantial health and economic burden on society. Homocysteine (Hcy), a sulfur-containing amino acid metabolic intermediate, has been established as an independent risk factor for cardiovascular and cerebrovascular diseases when its plasma levels are elevated (i.e., hyperhomocysteinemia, HHcy). In recent years, the research focus has expanded to the skeletal system, revealing that HHcy is closely associated with decreased bone mineral density, disordered bone metabolism, and increased fracture risk. However, its specific mechanisms of action and clinical significance remain controversial. This article aims to systematically review the research progress on the association between Hcy and osteoporosis. Firstly, it synthesizes epidemiological evidence to clarify the complex relationship between Hcy levels, bone mineral density, and fracture risk. Secondly, it delves into the molecular and cellular biological mechanisms, focusing on analyzing the core role of Hcy in disrupting bone metabolic homeostasis through pathways such as inducing oxidative stress, inflammatory responses, and interfering with specific signaling pathways. Furthermore, the article reviews the influence of genetic polymorphisms (e.g., the MTHFR gene) and B-vitamin status on this association, and evaluates the potential and challenges of preventing and treating osteoporosis by lowering Hcy levels through nutritional (e.g., folic acid, vitamin B12 supplementation) and pharmacological interventions. This review aims to provide a comprehensive perspective for a deeper understanding of the role of Hcy in the pathogenesis of osteoporosis and to offer a theoretical basis for developing new prevention and treatment strategies.

Expression of miR-515-5p and HOXB13 in non-small cell lung cancer serum and its relationship with patient prognosis

魏晓群 — 2026/2/5 9:21:41

Objective: To investigate the expression of micro ribonucleic acid (miR)-515-5p, homology box protein B13 (HOXB13) in the serum of non-small cell lung cancer and its relationship with patient prognosis.Methods: 118 NSCLC patients admitted between July 2019 and July 2021 (as the study group) were selected, and another 118 healthy medical check-ups during the same period (as the control group); serum miR-515-5p, HOXB13 expression levels were detected by qRT-PCR; Pearson"s method was used to analyse the serum miR-515-5p, HOXB13 correlation; the relationship between serum miR-515-5p, HOXB13 and the prognosis of NSCLC patients was analysed by Kaplan-Meier survival curve; the influencing factors of the prognosis of NSCLC patients were analysed by multifactorial COX regression. Results: The serum miR-515-5p expression level of the study group was significantly lower than that of the control group (P < 0.05), and the HOXB13 expression level was significantly higher than that of the control group (P < 0.05). According to Pearson correlation analysis, serum miR-515-5p and HOXB13 levels in the study group were negatively correlated (r=-0.742, P<0.05). The expression of miR-515-5p and HOXB13 in the study group was correlated with the clinicopathological characteristics (TNM stage, differentiation degree, lymph node metastasis) (P < 0.05). The 3-year survival rate of the patients with high miR-515-5p expression was higher than that of the patients with low expression (χ2 = 36.627, P < 0.05), and that of the patients with high HOXB13 expression was lower than that of the patients with low expression (χ2 = 12.755, P < 0.05). Compared with the good prognosis group, the serum miR-515-5p expression level was significantly lower (P < 0.05) and HOXB13 expression level was significantly higher (P < 0.05) in the poor prognosis group.There were prominent differences between good prognosis group and the poor prognosis group in TNM staging, differentiation, and lymph node metastasis (P<0.05). Multivariate Cox regression analysis showed that HOXB13, TNM staging, differentiation, and lymph node metastasis were prognostic risk factors of NSCLC patients (P<0.05), while miR-515-5p was a protective factor (P<0.05). Conclusion: Serum expression levels of miR-515-5p were significantly lower and HOXB13 significantly higher in non-small cell lung cancer, both of which were associated with clinicopathological characteristics of the patients as well as their prognosis.

Study on the relationship between the expression of miR-23b-3p, miR-218-5p and epithelial mesenchymal transformation, clinicopathological parameters and prognosis in cervical squamous cell carcinoma

Liu Shan-shan — 2026/2/4 8:43:03

Objective To investigate the relationship between the expression of miR-23b-3p, miR-218-5p and epithelial mesenchymal transformation (EMT), clinicopathological parameters and prognosis in cervical squamous cell carcinoma. Methods 121 patients with cervical squamous cell carcinoma admitted to our hospital from June 2016 to June 2019 were selected, and the surgically resected cancerous tissues and adjacent cancerous tissues were taken. miR-23b-3p, miR-218-5p and EMT-related genes epithelial cadherin (E-cadherin) and Vimentin (Vimentin) were detected by Real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Pearson analyzed the correlation between miR-23b-3p, miR-218-5p and E-cadherin and Vimentin. Kaplan-Meier method was used to plot the survival curve, and univariate and multivariate Cox regression analysis of factors affecting the prognosis of cervical squamous cell carcinoma. Results The expression of miR-23b-3p, miR-218-5p and E-cadherin in cervical squamous cell carcinoma tissues was lower than that in adjacent cancerous tissues (P<0.05), and the expression of Vimentin was higher than that in adjacent cancerous tissues (P<0.05). The expressions of miR-23b-3p and miR-218-5p in cervical squamous cell carcinoma tissues were positively correlated with the expression of E-cadherin (P<0.05), and negatively correlated with the expression of Vimentin (P<0.05). The expression of miR-23b-3p and miR-218-5p in cervical squamous cell carcinoma tissues with International Federation of Gynecology and Obstetrics (FIGO) stage IIA, low differentiation, myographic invasion depth >1/2, lymph node metastasis were lower than those in FIGO stage I, medium high differentiation, myographic invasion depth ≤1/2, and no lymph node metastasis (P<0. 05). The 5-year overall survival (OS) rate of patients with low-expression mi-23b-3p and miR-218-5p was lower than that of patients with high-expression mi-23b-3p and miR-218-5p (P<0.05). Lymph node metastasis were risk factors for poor prognosis in patients with cervical squamous cell carcinoma (P<0.05), and over expression of Vimentin, miR-23b-3p and miR-218-5p were protective factors (P<0.05). Conclusion The low expression of miR-23b-3p and miR-218-5p in cervical squamous cell carcinoma is related to malignant clinicopathological parameters and low survival rate. miR-23b-3p and miR-218-5p may be involved in the progression of cervical squamous cell carcinoma through EMT process.

The Protective Effect of Reduced Glutathione (GSH) on Pristane-Induced Diffuse Alveolar Hemorrhage (DAH) in MiceLian Shaopan, Lu Conghua, Lin Caiyu, Li Li, Dai Huanzi,

LI LI,Lian Shaopan,Lin Caiyu,Lu Conghua,Shi Chenjun,Zhou Ying — 2026/2/3 16:12:35

Objective: To explore the protective effect and mechanism of reduced glutathione (GSH) on pristane-induced diffuse alveolar hemorrhage (DAH) in mice. Methods: In vivo experiment, 6-10 week-old female C57BL/6J mice were injected intraperitoneally with 0.5 mL Pristane to establish the DAH model. On the 3rd, 6th, 9th, and 12th days, 100 mg/kg GSH was injected intraperitoneally. On day 14, lung tissue pathology was observed via HE staining, and the levels of inflammatory cytokines (TNF-α, IL-6, IL-1β) in bronchoalveolar lavage fluid (BALF) were measured by ELISA. In vitro experiment, MLE-12 cells were treated with 400 μM β-CD-Pristane. Cell morphology and density were observed under a microscope, cell viability was assessed using the CCK8 assay, and gene expression changes were analyzed via whole transcriptome sequencing (RNA-seq). After exogenous supplementation with 10 mM GSH, cell proliferation was evaluated using the EdU assay, and reactive oxygen species (ROS) levels were detected using the superoxide anion fluorescent probe (DHE). Results: In vivo experiments demonstrated that Pristane treatment induced varying degrees of hemorrhage in mouse lungs, significantly increased DAH scores in lung tissue HE staining (P < 0.01), markedly reduced body weight (P < 0.01), and significantly elevated levels of inflammatory cytokines TNF-α, IL-6, and IL-1β in BALF (P < 0.01). In vitro experiments showed that β-CD-Pristane treatment reduced MLE-12 cell numbers, altered cell morphology, and significantly decreased cell viability (P < 0.01). RNA-seq combined with KEGG and GO analyses suggested that cell damage might be mediated through glutathione metabolism and inflammatory pathways. GSH intervention restored MLE-12 cell proliferation capacity (P < 0.01) and significantly reduced intracellular ROS levels (P < 0.05). Further in vivo experiments confirmed that GSH intervention significantly decreased the percentage of hemorrhage in lung pathology and DAH scores (P < 0.05), increased body weight (P < 0.05), and significantly reduced levels of inflammatory cytokines TNF-α, IL-6, and IL-1β in BALF (P < 0.05). Conclusion: GSH significantly attenuates Pristane-induced DAH in mice and alleviates lung tissue inflammation, potentially through mechanisms involving GSH-mediated improvement of oxidative stress and promotion of alveolar epithelial cell proliferation.

AI-Driven Multidimensional Self-Efficacy Nursing: A Clinical Study to Improve Coping Strategies and Treatment Adherence in Lung Cancer Patients with Chemotherapy-Induced Myelosuppression

fujianghong, — 2026/2/2 11:26:42

Objective: To explore the impact of AI-assisted multidimensional self-efficacy–enhancing nursing on treatment adherence, coping strategies, and self-efficacy among lung cancer patients experiencing chemotherapy-induced myelosuppression., and to assess the efficacy of AI-driven adherence prediction models in enhancing clinical nursing decision-making.
Methods: Sixty-eight patients were enrolled and stratified using a machine learning–based Random Forest adherence prediction model into a control group and an AI-based multidimensional self-efficacy nursing group (n=34 each). Standard nursing was provided to both groups, while the AI group additionally received AI-supported behavioral monitoring, predictive analysis, and individualized nursing intervention. SCSQ, GSES scores, and treatment adherence were compared before and after intervention. ROC analysis was used to evaluate model performance.
The AI group demonstrated significantly enhanced positive coping mechanisms and reduced negative coping strategies, with a notable increase in General Self-Efficacy Scale (GSES) scores compared to the control group, as evidenced by P<0.01. The AI group demonstrated a significant improvement in adherence rates, reaching 91.18% compared to the control group"s 70.59% (P<0.05), aligning with the positive effects observed in studies utilizing self-efficacy interventions in patient care. The AI-based prediction model demonstrated robust performance with an AUC of 0.87, indicating its potential in medical applications.
Conclusion: AI-assisted multidimensional self-efficacy nursing significantly improves coping ability, self-efficacy, and treatment adherence in lung cancer patients with chemotherapy-induced myelosuppression and supports intelligent precision nursing.

Interpretation of ESMO Guidance on the Use of Large Language Models in Clinical Practice (ELCAP)

liuhu,niuniu — 2026/1/23 16:41:04

Large language models (LLMs), as a core technology of artificial intelligence, have rapidly integrated into oncology clinical practice, bringing opportunities along with challenges. The European Society for Medical Oncology (ESMO) released its first guidance on the use of LLMs in oncology—ESMO Guidance on the Use of Large Language Models in Clinical Practice (ELCAP) in 2025. Developed by 20 experts through literature review and Delphi consensus process, the guidance categorizes LLM applications into three types: patient-facing systems (Type 1), healthcare professional-facing systems (Type 2), and background systems (Type 3). Type 1 systems include symptom query chatbots, patient education, lifestyle tracking, administrative support, and emotional support, emphasizing integration into supervised pathways to avoid hallucination risks and privacy issues; Type 2 systems cover clinical decision support, multilingual communication, document drafting, education, and professional development, requiring human oversight for validation to prevent automation bias and liability issues; Type 3 systems involve data extraction, alert systems, ambient AI scribes, clinical trial matching, billing, and research prediction, needing continuous monitoring to prevent model drift and errors from incomplete data. The guidance developed 24 consensus statements, providing practical "do"s" and "don"ts," emphasizing human oversight, data privacy protection, ethical standards, and regulatory compliance. From the perspective of an oncology artificial intelligence medical-engineering integration expert, this article provides a comprehensive interpretation of the ELCAP guidance, summarizing its background, methodology, framework classifications, example applications, opportunities and challenges, consensus statements, and implementation considerations. Combined with the actual situation of oncology in China, it proposes localization suggestions to provide reference for Chinese oncology healthcare professionals, promote the safe and effective integration of LLMs, and advance the intelligent transformation of oncology care. Future initiatives should concentrate on forward-looking validation and multi-center trials of proactive AI models to realize the objectives of precision oncology.

Advances in the Application of Artificial Intelligence in Clinical Medicine

shenweixi — 2026/1/21 16:18:28

Artificial intelligence (AI), as an emerging technology, has profoundly impacted the field of clinical medicine. Since its proposal in the 1950s, AI has undergone multiple waves of development. In recent years, the healthcare industry has witnessed rapid advancements in AI applications, driven by big data, enhanced computing power, and algorithmic breakthroughs, including deep learning and natural language processing. These technologies have significantly accelerated the development of AI in areas such as diagnostic precision, treatment personalization, drug discovery, and resource management. Internationally, the United States and the European Union lead, with the The FDA has approved a significant number of AI medical devices, with the latest data indicating that as of October 2023, the agency has cleared 692 AI/ML medical devices for use. and The EU AI Act, a comprehensive legislation, aims to categorize and regulate AI applications based on their risk levels, imposing strict regulations on high-risk applications such as those in healthcare, education, and finance, while banning applications like social scoring systems and facial recognition technology that could infringe on privacy and lead to discrimination.. Domestically, the Chinese government promotes the "AI + Healthcare" initiative, with AI-assisted diagnosis covering grassroots medical institutions by 2025, playing a key role in tumor screening, drug discovery, and epidemic management. This review summarizes the domestic and international progress in AI applications in clinical medicine, covering technical AI"s application in healthcare spans foundational technologies, diverse application areas such as diagnostic assistance and drug development, and faces challenges including ethical considerations and data privacy. Future trends indicate a promising yet complex landscape. It emphasizes that AI should be human-centered, ensuring safety, reliability, and fairness to promote precision medicine. To ensure the comprehensive integration and sustainable development of AI in clinical practice, it is imperative to bolster multicenter validation, promote data sharing, and refine regulatory frameworks.

AI-Driven Time-Series Analysis of Endothelial Cell Mechanosignaling and Its Med-Eng Integration Application in Pan-Cancer Prognosis

牛牛 — 2026/1/21 15:34:11

Objective: Wall Shear Stress (WSS) is the critical mechanical signal determining endothelial cell (EC) phenotype and vascular homeostasis, where low-flow/oscillatory shear (LFSS/OS) induces pro-atherosclerotic gene programs. A systematic, cross-dataset, and time-dependent comparison of transcriptional responses is relatively lacking. This study aimed to integrate public transcriptomic data and utilize Long Short-Term Memory (LSTM) network modeling to systematically analyze the transcriptional responses and time-series dynamics of ECs under Static (ST), Oscillatory Shear (OS), and Pulsatile Shear (PS) conditions. We established an LFSS gene signature and evaluated its prognostic value in pan-cancer cohorts to demonstrate the Med-Eng integration of AI in mechanobiology and oncology. Methods: Three human GEO transcriptomic datasets were integrated, and differentially expressed genes (DEGs) were identified via Stouffer"s weighted Z-method meta-analysis. Functional enrichment (GO/Reactome/Hallmark) and k-means clustering were performed on DEGs. The LFSS signature was quantified using GSVA in TCGA pan-cancer cohorts for Kaplan-Meier survival analysis, Cox regression, and correlation with core tumor microenvironment pathways. Crucially, an LSTM model was constructed, benchmarked against RF and SVR, to assess its performance and generalization ability in time-series prediction across cell types and stimulus conditions. Results: Meta-analysis identified stable DEGs, with shared across all three cohorts. Upregulated genes were enriched in Cell Cycle, DNA Replication, and G2M Checkpoint; downregulated genes focused on Bile Acid and Xenobiotic Metabolism. Time-series clustering showed OS activated DNA Replication Initiation and Chromosome Segregation, while PS induced DNA Damage Repair and Genome Stability Maintenance. The LFSS signature was significantly associated with Overall Survival in 13 cancer types and positively correlated with Hypoxia, Angiogenesis, and other Signaling. The LSTM model consistently outperformed baseline models in all time-series prediction tasks, demonstrating superior robustness and generalization. Conclusion: Through AI-driven time-series analysis, we revealed the LFSS-induced pro-pathological EC transcriptional program and established a core molecular marker linking vascular mechanics and the tumor micro-environment. The LSTM deep learning model provides a robust AI tool for predicting complex mechano-stress dynamics, laying the foundation for future Med-Eng integrated personalized vascular mechanical regulation strategies.

Prediction of Prognosis in Bladder Cancer Patients Based on Deep Learning Features Extracted from Tumor Regions in HE Stained Slides

he yi feng,luo guan shui,,zheng zong tai — 2026/1/16 16:24:19

Objective: This study aims to develop a prognostic prediction model for bladder cancer patients based on deep learning features extracted from tumor regions in hematoxylin and eosin (HE) stained slides and to validate its cross-center generalizability, providing a personalized prognostic tool for bladder cancer patients. Methods: This study integrates data from the TCGA bladder cancer database and bladder cancer patients from the Department of Urology at The Affiliated Guangdong Second Provincial General Hospital of Jinan University. Tumor regions were annotated by experienced pathologists, and deep learning model ResNet50 was used for transfer learning to extract deep features from HE-stained slide images. A total of 14,336 features were extracted, and univariate Cox analysis was used to select prognostic-related features. Key features were further selected using the LASSO method to construct a risk scoring model for bladder cancer patients. The prognostic value of the model was validated using Kaplan-Meier survival analysis, and a visual nomogram was constructed by integrating the selected features with the M stage through multivariate Cox regression to predict the patient's survival probability. Results: Both TCGA and our center data demonstrated significant survival differences between the high-risk and low-risk groups based on the risk score (P < 0.001 for both). Multivariate Cox regression analysis identified the risk score and M stage as independent prognostic factors for bladder cancer. The visual nomogram integrating the M stage and deep learning feature-based risk score showed high concordance between the predicted 1-year, 3-year, and 5-year survival rates and the actual observed survival rates. Conclusion: The prognostic prediction model based on deep learning features extracted from HE-stained slide images shows excellent predictive performance and provides an accurate, personalized prognostic assessment tool for clinical use. The model demonstrated good cross-center generalizability in validation studies, offering significant clinical application value. Future research may optimize and expand the sample size to improve the model's accuracy and stability, promoting its clinical application in bladder cancer decision-making.

Construction of the emerging hypertension management center model and its impact on rehabilitation after external and intracranial arterial bypass transplantation in patients with Moyamoya disease

liuxingju,sunxiaorong,xuerui — 2026/1/13 17:33:54

；Objective:To investigate the impact of hospital-community collaborative intelligent management model on blood pressure control and neurological function recovery after extracranial-intracranial arterial bypass surgery in patients with Moyamoya disease. Methods: A retrospective cohort study was conducted, including 247 patients with Moyamoya disease who underwent extracranial-intracranial artery bypass grafting at our hospital from January 2022 to December 2023. The study was divided into two groups based on the implementation time of the hospital"s hypertension management model: the control group (January 2022 — September 2022, n=94) received routine postoperative management from neurosurgery; the experimental group (October 2022 — December 2023, n=89) received a hospital-community collaborative intelligent management model, which included multidisciplinary collaboration, 24-hour ambulatory blood pressure monitoring, remote data collection via smart devices, and a two-way referral system. The observation indicators included systolic blood pressure levels at different postoperative time points (discharge, 1 week post-discharge, 4 weeks, 12 weeks), KPS (Karnofsky Performance Status), mRS (modified Rankin scale), and WHOQOL-BREF (Functional Assessment of Language and Speech). Differences between the groups were compared using repeated measures ANOVA and independent samples t-tests. Results: The systolic blood pressure of the experimental group at 12 weeks post-discharge (120.59±13.22 mmHg) was significantly lower than that of the control group (125.61±14.99 mmHg, P<0.05); the KPS scores of the experimental group at 4 weeks and 12 weeks post-discharge were significantly higher than those of the control group (P<0.05), while the mRS scores were significantly lower (P<0. 05); The language function scores of the experimental group were significantly better than those of the control group 12 weeks after discharge (P<0.05). The quality of life scores in all dimensions were significantly higher in the experimental group than in the control group (P<0.05). Conclusion: The hospital-community collaborative intelligent management model can effectively improve blood pressure control levels in postoperative Moyamoya disease patients, promote long-term neurological recovery, enhance quality of life, and provide new strategies for individualized postoperative blood pressure management.

Baicalein mitigates iron overload-induced cardiomyocyte injury via Keap1/Nrf2/HO-1 pathwayXingjiang Long, Jiaofeng Qin, Jiaogui Huang

huangxiangui,longxingjiang,qinjiapfeng — 2026/1/9 17:32:46

Objective To explore the effects of baicalein (BAL) on iron overload-induced rat H9c2 cardiomyocytes through targeting Kelch-like ECH-associated protein 1 (Keap1)/erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway. Methods CCK-8 method appraised the viability of H9c2 cells after being treated by varying concentrations of ferric citrate (FAC; 0, 50, 100 and 200 μM) to select the optimum induction dose of FAC. After pretreatment with varying concentrations of BAL (3, 10 and 30 μM), HO-1 inhibitor SnPP or Nrf2 inhibitor ML385, H9c2 cells were exposed to 200 μM FAC. CCK-8 method assayed cell viability. RT-qPCR analyzed the expression of inflammatory mediators. DCFH-DA staining detected ROS level. Related kits measured oxidative stress levels. Iron assay kit examined iron content. Immunofluorescence staining detected 4-hydroxynonenal (4-HNE) and glutathione peroxidase 4 (GPX4) expression. Western blot analyzed the expression of ferroptosis- and Keap1/Nrf2/HO-1 pathway-related proteins. R

Correlation Study between Blood Concentration of Polymyxin B and Risk of Acute Kidney Injury

chen xiao yu,,liboren,li yan,tan si tao,wei ru hua,wei shui lin,zhang li — 2026/1/9 17:31:36

Objective:By collecting and analyzing the blood drug concentration data of patients treated with polymyxin B and integrating the monitoring results of the patients" renal function, this study explores the potential correlation between the blood drug concentration level of polymyxin B and the risk of AKI occurrence. Methods:Using a retrospective cohort study design, we selected inpatients who received polymyxin B treatment and had their polymyxin B steady-state trough concentrations monitored at a certain hospital from April 1, 2024, to August 8, 2024. We recorded the patients" polymyxin B serum concentrations and clinical information, and used single-factor and binary Logistic regression analysis to identify risk factors for renal dysfunction. We also drew ROC curves to predict clinical outcomes. Results: 53 patients were included as effective cases, and the median serum concentration of polymyxin B was 1.86 (1.40, 2.32) mg·L-1; the results of binary Logistic regression analysis showed that serum concentration of polymyxin B and urea were independent risk factors for renal dysfunction (P < 0.05); ROC curves were drawn, and when the serum concentration of polymyxin B was 3.18?mg·L-1, the area under the ROC curve was maximum (0.734), the sensitivity was 0.654, the specificity was 0.778, and the Youden index was 0.432. Conclusion:After patients received Polymyxin B treatment, their serum creatinine and serum urea levels both increased significantly, and the occurrence of renal impairment was closely related to the blood concentration of Polymyxin B. It is recommended to optimize patient treatment outcomes and reduce the occurrence of adverse reactions by precisely monitoring and adjusting the blood concentration of Polymyxin B to balance its antibacterial efficacy and potential nephrotoxicity.

Influencing Factors of Adverse Reactions to High-Dose Methotrexate in the Treatment of Childhood Acute Lymphoblastic Leukemia

CHEN Zhao-Hui,DAI Yan,HUANG Jin-Xian,,LI Qin,LI Xin-Ye,MA Hong-Yan,TANG Hui-He — 2026/1/9 17:30:26

Objective: To explore the influencing factors of adverse drug reactions (ADR) in children with acute lymphoblastic leukemia (ALL) treated with high-dose methotrexate (HD-MTX), and to provide reference for clinical medication safety.Methods: The clinical data and blood drug concentrations of 321 HD-MTX chemotherapy sessions in 74 children with ALL admitted to the pediatric department of our hospital from 2017 to 2020 were analyzed retrospectively. The association between adverse reactions and their related factors was investigated.Results: During HD-MTX treatment, the most common adverse reaction was myelosuppression (62.62%), followed by gastrointestinal reactions (32.09%) and oral mucositis (30.53%). Univariate analysis showed that age was a risk factor for delayed MTX excretion at 44 hours and 68 hours (the older the age, the higher the risk); fusion genes and risk stratification were risk factors for delayed MTX excretion at 44 hours, and the incidence of liver damage and infection was higher in this group; the incidence of oral mucositis was higher in patients with delayed MTX excretion at 68 hours.Multivariate analysis indicated that the ETV6/RUNX1 fusion gene was a risk factor for delayed MTX excretion at 44 hours.Conclusion: For children with ALL receiving standardized HD-MTX treatment, combining blood drug concentration monitoring, calcium folinate (CF) rescue therapy, and effective ADR prevention and control measures can reduce the risk of adverse reactions within a certain range.

A Modified Thyroid Fine-Needle Aspiration Biopsy Technique and Its Application

乐岭,杨斯涵,张俊杰,张瑜,郑乔君 — 2026/1/9 17:29:36

Objective To investigate the clinical benefits of a modified fine-needle aspiration (FNA) method for thyroid nodule puncture. Method? A total of 325 patients who underwent ultrasound-guided fine needle aspiration cytology (US-FNAC) at the Central Theater Command General Hospital from March 2023 to July 2024 were enrolled and randomly divided into a control group (160 cases) and an experimental group (165 cases). The control group underwent the conventional single-needle multi-point puncture non-aspiration method, while the experimental group received the following modifications: 1) sequential puncture with dual needles, 2) multi-point rotation and lifting of the fine needle within the nodule, and 3) syringe negative pressure aspiration. General clinical data, nodule ultrasound characteristics, specimen adequacy rates, and adverse events were compared between the two groups. Results The study included 92 males and 233 females, with a mean age of (46.47 ± 14.40) years. No statistically significant differences were observed between the two groups in age, gender, nodule location, maximum diameter, or calcification. Compared with the control group, the experimental group demonstrated a significantly higher specimen adequacy rate (92.1% vs. 81.9%, P<0.01) and elevated postoperative pain scores (P<0.001). No statistically significant differences were found in postoperative hypertension, tachycardia, or hemorrhage (P> 0.05). Conclusion ?The modified FNA technique significantly improves specimen adequacy for cytological examination of thyroid nodules, with a slight increase in local pain.

Study on the relationship between serum 25(OH)D and HSP70 levels and PCOS types

Qiu Yunlin,Tong Yinyin,Wang Shilian,Xu Anli,,Zhu Li — 2026/1/9 8:08:55

Objective: To explore differences in serum levels of 25-hydroxyvitamin D [25(OH)D] and heat shock protein 70 (HSP70) among infertile patients with different phenotypes of polycystic ovary syndrome (PCOS). Methods: A total of 200 infertile patients with PCOS (study group) and 50 infertile patients with tubal factors (control group) were enrolled. Based on the Rotterdam criteria, PCOS patients were further classified into four phenotypes (A, B, C, and D). Clinical data were collected, and serum levels of 25(OH)D and HSP70 were measured. Comparative analyses were performed between and within groups. Results: Compared with the control group, the study group exhibited significantly higher body mass index (BMI), luteinizing hormone (LH), testosterone (T), and HSP70 levels (all P < 0.05), while follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), and 25(OH)D levels were significantly lower (all P < 0.05). Among the four PCOS phenotypes, significant differences were observed in serum LH, FSH, T, AMH, and HSP70 levels (all P < 0.05), whereas no significant differences were found in age, duration of infertility, BMI, estradiol (E2), or 25(OH)D levels (all P > 0.05). Conclusion: Serum 25(OH)D deficiency represents a ?shared pathological feature? across all PCOS phenotypes in infertile patients, while elevated HSP70 levels may serve as a ?specific biomarker? for hyperandrogenic PCOS (types A/B). This provides novel serological evidence for precision phenotyping diagnosis and/or vitamin D supplementation therapy in PCOS-related infertility.

Efficacy of vibration sputum expulsion combined with high-flow nasal cannula oxygen therapy on patients with acute exacerbation of chronic obstructive pulmonary disease and its impacts on blood gas indicators, lung function, and inflammation levels

任重远 — 2026/1/9 8:08:20

Objective To investigate the efficacy of vibration sputum expulsion combined with high-flow nasal cannula oxygen therapy (HFNC) in the treatment of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its effects on blood gas indexes, lung function and inflammation levels. Methods A total of 216 patients with AECOPD diagnosed in our hospital from June 2022 to October 2023 were randomly assigned to the combination group (n=108) and the humidified oxygen therapy group (n=108). The humidified oxygen therapy group was treated with HFNC, and the combined group was treated with vibration sputum expulsion. The clinical efficacy, blood gas indexes [partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and oxygen saturation (SpO2)], pulmonary function indexes [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory volume in one second as a percentage of lung capacity (FEV1/FVC), peak expiratory flow (PEF)], inflammatory factor indexes [interleukin-6 (IL-6), serum calcitonin (PCT), C-reactive protein (CRP)], quality of life [COPD Assessment Test (CAT), St. George"s Respiratory Questionnaire (SGRQ), Modified British Medical Research Council (mMRC)] and adverse reactions were compared. Results The total effective rate of the combined group (87.96%) was greatly higher than that of the humidified oxygen therapy group (76.85%) (P<0.05). After treatment, the levels of PaO2, SpO2, FEV1, FVC, FEV1/FVC, and PEF were greatly increased in both groups (P<0.05), and the combined group was greatly higher than the humidified oxygen therapy group (P<0.05). The PaCO2, IL-6, PCT, CRP, CAT score, SGRQ score and mMRC of the two groups were greatly reduced, and the combined group was lower than that of the humidified oxygen therapy group (P<0.05). There was no great difference in the incidence of adverse reactions between the combined group and the humidified oxygen therapy group (P>0.05). Conclusion: The combination of vibration sputum expulsion and HFNC has a great therapeutic effect on AECOPD patients, which can greatly improve blood gas indicators, enhance lung function, reduce inflammatory factor levels, and improve quality of life. Its clinical application is ideal.

The Expression and Predictive Value of D-D, 25 (OH) D, LMR, IL-6 Combined Test in Sepsis

FANG Weihua,HUANG Qiuli,LIU Shuangqing,,XIE Tao,YANG Wei,YU Shengyang,ZHANG Ling — 2026/1/9 8:07:39

Objective To investigate the expression and predictive value of D-dimer (D-D), 25 hydroxyvitamin D [25(OH)D], lymphocyte/monocyte (LMR), interleukin-6 (IL-6) combined test in sepsis. Methods 55 sepsis patients admitted to our hospital from June 2022 to June 2024 were selected as the observation group, 50 systemic inflammatory response (SIRS) patients were selected as the inflammation group, and 50 healthy individuals were selected as the control group during the same period. Collect and organize general information, compare the D-D, 25(OH)D, LMR, and IL-6 levels of the three groups; Follow up for 3 months, analyze the mortality status of the observation group, and divide them into survival group and death group based on survival status. Compare the differences in 4 indicators between groups, draw receiver operating characteristic curves (ROC) to analyze the effectiveness of 4 indicators in predicting the death of sepsis patients, and logistic regression to analyze the impact of 4 indicators on the death of sepsis patients. Results The SOFA score (9.92 ± 1.34), D-D (2.77 ± 0.78) mg/L, and IL-6 (84.62 ± 21.95) ng/L in the observation group were higher than those in the inflammation group (3.03 ± 0.59), (1.06 ± 0.42) mg/L, and (23.96 ± 8.08) ng/L, while the control group (1.06 ± 0.27), (0.62 ± 0.21) mg/L, and (2.97 ± 0.57) ng/L; 25(OH)D (20.34 ± 3.69) ng/L and LMR (4.35 ± 0.71) were lower in the inflammation group (28.75 ± 3.92) ng/L and (5.42 ± 0.65), compared to the control group (41.13 ± 2.76) ng/L and (7.11 ± 1.09), with statistically significant differences (t=1484.940, 238.510, 495.720, 465.240, 144.300, P<0.05). Among the 55 patients in the observation group, 15 (27.27%) died; 40 cases (72.73%) survived. The SOFA score (11.24 ± 1.52), D-D (3.63 ± 0.92) mg/L, and IL-6 (95.11 ± 25.65) ng/L in the death group were all higher than those in the survival group (9.43 ± 1.27) points, (2.45 ± 0.73) mg/L, and (80.69 ± 20.56) ng/L; 25(OH)D (16.96 ± 2.78) ng/L and LMR (3.87 ± 0.68) were lower than those in the survival group (21.61 ± 4.03) ng/L and (4.53 ± 0.72), and the difference was statistically significant (t=4.459, 4.967, 2.163, 4.106, 3.072, P<0.05). The efficacy AUC of the combination of D-D, 25(OH)D, LMR, and IL-6 in predicting sepsis induced death was 0.834 (95% CI: 0.759~0.909), which was superior to a single indicator (P<0.05). Elevated SOFA score (OR=3.677, 95% CI: 1.587~5.767) and high expression of D-D (OR=3.908, 95% CI: 1.627~6.189), as well as high expression of IL-6 (OR=3.086, 95% CI: 1.695~4.477), are risk factors for sepsis induced death. High expression of 25(OH)D (OR=0.326, 95% CI: 0.218~0.434) and LMR (OR=0.347, 95% CI: 0.237~0.457) are protective factors (P<0.05). Conclusion D-D and IL-6 are highly expressed in sepsis and sepsis related death patients, and elevated levels are risk factors for death in sepsis patients; 25(OH)D and LMR show low expression in sepsis and sepsis related deaths, while elevated levels are protective factors for sepsis related deaths; Combining four indicators for predicting the prognosis of sepsis can improve the accuracy of the results.

Effects of Parent-Targeted Group/Individual CBT with Family Early Intervention on Children with Autism Spectrum Disorder

Meng Lu Lu — 2026/1/6 18:12:30

【】? Objective?? The aim of this study is to investigate the clinical efficacy of group and individual cognitive behavioral therapy (GCBT/ICBT) combined with family early intervention training and single family early intervention training on children with autism spectrum disorder.Methods????????????? ? A total of 100 children with ASD who came to the hospital for treatment between January 2024 ~ February 2025 were randomly selected. They were randomly divided into three groups: study 1 group? (n=34), study 2 group? (n=33) , and control group (n=33). All three groups received standardized early family intervention. Group 1 additionally underwent parent-group cognitive behavioral therapy (CBT), while Group 2 combined the intervention with individual CBT for parents.The outcomes were assessed using multiple scales: the Gesell Developmental Schedule (GDS), Autism Behavior Checklist (ABC), Self-Rating Anxiety Scale (SAS), Autism Treatment Evaluation Checklist (ATEC), and Tool for Measuring Parenting Self-Efficacy (TOPSE).Results? Post-intervention, both study groups showed greater improvement in the ATEC, ABC, and Gesell scales compared to the control group (all P<0.01), with Study Group 1 outperforming Study Group 2 (P<0.05). Additionally, both study groups demonstrated significantly better outcomes in anxiety relief and parenting efficacy compared to the control group (all P<0.01), with Study Group 1 again surpassing Study Group 2 (P<0.05).

The correlation between serum D-dimer, BAFF, E2 levels and the outcome of frozen embryo transfer in patients with endometriosis combined and infertility

丰程文 — 2026/1/6 18:11:20

Objective: To investigate the correlation between serum levels of D-dimer (D-D), B cell lymphocyte activating factor (BAFF), estradiol (E2) and the outcome of frozen embryo transfer (FET) in patients with endometriosis (EMs) combined with infertility. Methods: From August 2022 to August 2024, 116 patients with EMs infertility admitted to our hospital were regarded as the research subjects. According to the FET outcome, they were assigned into FET success group (n=64) and FET failure group (n=52). Clinical data were compared from the two groups. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of D-D, BAFF, and E2. Multivariate logistic regression was used to analyze the influencing factors of FET outcomes in patients with EMs infertility. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of serum D-D, BAFF, and E2 for FET failure in patients with EMs infertility. Results: The levels of serum D-D, BAFF, and E2 in the FET failure group were greatly higher than those in the FET success group (P<0.05). Elevated levels of serum D-D, BAFF, and E2 were independent risk factors for FET failure in EMs infertility patients (all P<0.05). The AUC values of serum D-D, BAFF, and E2 levels alone and in combination for predicting FET failure in EMs infertility patients were 0.907, 0.863, 0.838, and 0.972, respectively. The combined prediction was superior to individual predictions (Z combination - D-D=2.875, P=0.004, Z combination - BAFF=3.205, P=0.001, Z combination - E2=3.791, P<0.001). Conclusion: Elevated levels of serum D-D, BAFF, and E2 in patients with EMs infertility are risk factors for FET failure. Combined detection of serum levels can accurately predict FET outcomes in EMs infertility patients and has high clinical value.

Research Advances in Precision Medicine for Advanced Thyroid Cancer

dengchao, — 2026/1/5 17:52:20

Advanced thyroid cancer poses a significant clinical challenge due to the limited efficacy of traditional treatments. This article discusses how precision medicine is driving the development of targeted and immunotherapy through molecular subtyping. Molecular targeted therapies target genes such as VEGF, BRAF, RET, and NTRK, with drugs like lenvatinib and pralatinib extending progression-free survival in patients, though issues of drug resistance remain unresolved; Immunotherapy focuses on PD-1/PD-L1 inhibitors, which show synergistic potential when combined with targeted therapy or radioactive iodine, but overall efficacy requires optimization. Currently, multi-targeted and highly selective inhibitors have been approved, and immune checkpoint inhibitors demonstrate exploratory value in specific pathological subtypes. Future efforts should focus on developing highly selective targeted drugs and exploring combination therapy modalities to achieve comprehensive precision management throughout the disease course and improve patient outcomes.

Research progress on the mechanism of adipose tissue phenotypic transformation in metabolic diseases

dingyabin,weixiaomei, — 2026/1/4 17:05:34

Metabolic diseases, such as obesity, diabetes, fatty liver, hypertension, and cancer, are escalating at an alarming pace, severely undermining people's health. Consequently, the exploration of effective treatments for these diseases has emerged as a prominent research focus. Centering on the pivotal role of adipose tissue phenotypic transformation in regulating metabolic diseases, this paper delves into its mechanisms and implications. Research findings indicate that promoting adipose browning can significantly alleviate insulin resistance and rectify energy metabolic disorders. Conversely, adipose whitening exacerbates inflammatory responses, thereby accelerating the progression of metabolic diseases. Additionally, inhibiting adipose browning may restrict tumor energy supply, potentially offering a novel approach for cancer adjuvant therapy.

Research progress on Nur77 in the pathogenesis of acute respiratory distress syndrome

liang ye jin,zhong jin mei — 2026/1/4 16:24:24

[Abstract]：Acute Respiratory Distress Syndrome (ARDS) is a life-threatening critical condition frequently encountered in intensive care units, is primarily characterized by pulmonary inflammatory responses and disruption of the alveolar-capillary barrier. This disruption leads to fluid leakage into the alveoli,resulting in pulmonary edema and hypoxemia. In recent years, the study of orphan nuclear receptor Nur77 in the pathogenesis of ARDS has attracted more and more attention. As a transcription factor, Nur77 is widely distributed in various tissues and cells. It exhibits expression modulated by diverseexternal stimuli, It participates in the disease process by regulating metabolic reprogramming, immune homeostasis balance, and inflammatory signaling transduction.This article reviews the current understanding of Nur77's involvement in the pathogenesis of ARDS.

Preoperative cranial traction combined with posterior occipitocervical fixation fusion for treatment of atlas fracture and dislocation combined with Klippel Feil syndrome: a case report and literature review

陈志武,管瑶姬,胡斌,罗平,王攀,向忠,张萌 — 2026/1/4 16:20:39

This paper reports a case of preoperative cranial traction combined with posterior occipitocervical fixation fusion for the treatment of atlanteal fracture and dislocation combined with Klippel Feil syndrome.

Analysis of the Efficacy and Safety of Rituximab in the Treatment of Adult Focal Segmental Glomerulosclerosis

guanlisi — 2025/12/24 9:44:49

Objective To evaluate the efficacy and safety of rituximab (RTX) in adult patients with refractory primary focal segmental glomerulosclerosis (FSGS).Methods A retrospective analysis was conducted on adult patients diagnosed with refractory primary FSGS who received RTX treatment in the Department of Nephrology，People's Hospital of Guangxi Zhuang Autonomous Region from January 1，2021 to July 31，2025. Clinical data were collected from hospital medical records.Results A total of 14 adult patients with refractory primary FSGS were included. The median age at the first RTX treatment was 37.5 (range：23-72) years. 9 patients were treated?with a single-dose of RTX，and all patients underwent regular follow-up. At the 6-month follow-up，9 patients achieved complete remission，and 5 patients achieved partial remission，yielding a complete remission rate of 100%. Three patients with steroid-resistant FSGS showed rapid clinical improvement after RTX treatment and achieved complete remission by the 6th month. All three overweight patients and one obese patient who received with single-dose RTX all achieved complete clinical remission at 6 months without any drug-related adverse events. Conclusion single-dose RTX regimen is effective not only for adults with steroid-dependent or frequently relapsing FSGS but also applicable to steroid-resistant FSGS. The therapeutic response to single-dose RTX may show no significant difference between overweight/obese patients and those with normal or lower body weight. Close follow-up is required after RTX treatment，with emphasis on infection prevention.

Exploring the potential molecular mechanism of Nafurafine against Chronic Kidney Disease-associated pruritus based on network pharmacology and molecular docking techniques

LI Jing,LI Wenge,SHI Jingxuan,WANG Xu,ZHANG Zheng, — 2025/12/16 9:41:00

Objective To explore the mechanism of nafurafine in the treatment of CKD-ap based on network pharmacology. Methods The basic information and targets of nafurafine were obtained by ChemicalBook platform, SwissTargetPrediction and GeneCards database, and the related targets of CKD and Pruritus were screened by GeneCards and CTD database. The data update of related platforms and databases ends in January 2024. A protein-protein interaction (PPI) network was constructed. The common target was enriched and analyzed by gene ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG). Results A total of 100 targets, 4277 CKD-related genes, 4091 Pruritus-related genes and 49 drug-disease common target genes were obtained. There are 9 core targets in PPI network. A total of 933 enrichment results were obtained by GO enrichment analysis, among which BP was mainly involved in phosphorylation, transmembrane receptor protein tyrosine kinase signal pathway, cell response to nitrogen compounds, etc. CC was mainly involved in receptor complex, synapse, IA phosphatidylinositol 3-kinase complex, and MF was mainly involved in protein kinase activity, alcohol receptor phosphotransferase activity, kinase activity and so on. A total of 139 signal pathways were obtained by KEGG enrichment analysis, which were mainly involved in EGFR tyrosine kinase inhibitor resistance, PI3K-Akt signal pathway, ErbB signal pathway and so on. Conclusion This study preliminarily verifies that nafurafine can treat CKD-ap through multiple targets and pathways, which provides a theoretical basis for further study of nafurafine.

Application evaluation of antifungal susceptibility by the new Vitek 2 AST-YS08 yeast card among Non Candida albicans

Weiming LIU,,Heping XU,Yanqing ZHENG — 2025/12/12 17:56:53

Objective To evaluate the agreement of antifungal susceptibility VITEK 2 YS-08 among non-Candida albicans(NACs), providing experimental basis for its clinical application. Methods A total of 159 strains of NAC isolated from sterile sites, including 93 strains of C. parapsilosis complex, 28 strains of C. tropicalis, 18 strains of C. glabrata complex, 18 strains of Meyerozyma guilliermondii, 2 strains of Pichia kudriavzevii. After resuscitation, strains were re-identified by Vitek MS mass spectrometry system. Minimum inhibitory concentrations (MICs) of NAC were tested in parallel using Sensititre YeastOne (SYO) and YS-08 cards, with susceptibility interpretation following the CLSI-M60 standard. Taking SYO results as the reference, the agreement of Vitek-2 YS08 interpretation was compared, and essential agreement (EA), categorical agreement (CA), very major error (VME), major error (ME), and minor error (mE) were calculated.. Results Compared with SYO, Vitek-2 YS08 showed overall EA of 92–100% and CA of 87–94% for NAC strains against five antifungal drugs. The best CA was observed for flucytosine (100%) and voriconazole (99%). VME of YS08 for caspofungin was associated with Candida parapsilosis complex. Conclusion The Vitek-2 YS08 method features simple operation and easy automation, demonstrating excellent categorical agreement in AST results for NAC against flucytosine, micafungin, fluconazole, caspofungin, and voriconazole. It exhibits good clinical application value and reliability. However, it should be noted that supplementary methods are required to test the MIC of fluconazole for Candida glabrata and Meyerozyma guilliermondii.

Exploration of different fixation methods of Modified Nuss bar in the non-thoracoscopic assisted Nuss procedure for pectus excavatumAi Yan, Li Lin-feng, Li Xi-zhe, Wang Si-cong, Yang Yu-qi, Cheng Yuan-da

艾燕,程远大,李林峰,李曦哲,王思聪,杨宇琦 — 2025/12/12 11:37:25

Objective To explore the application effect of the modified Nuss steel plate without the assistance of thoracoscopy and the necessity of wire fixation in Nuss procedure for pectus excavatum (PE). Methods A retrospective analysis was conducted on the clinical data of patients who underwent PE surgery using the modified Nuss steel plate at the Department of Thoracic Surgery of Xiangya Hospital Central South University from July 2021 to December 2023. The patients were divided into the no-fixation group, the unilateral fixation group, and the bilateral fixation group based on whether steel wire was used for fixation and the method of fixation. The clinical data of the three groups were compared. Results A total of 53 patients with PE were included in the study, comprising 45 males and 8 females. The median age was 15 years, with a median Haller index of 3.86. 11 patients (20.75%) did not use wire fixation, 15 patients (28.30%) used unilateral wire fixation, and 27 patients (50.94%) used bilateral wire fixation. The median follow-up time was 17 months. 51 patients had a follow-up period of one year, and 15 patients had a follow-up period of two years. The overall complication rate was 28.30%. The satisfaction rates for outcomes at 1 month, 1 year, and 2 years after surgery were 92.45%, 90.20%, and 80.00% respectively. A total of 47 patients were included in the inter-group comparison analysis. There were statistically significant differences in the preoperative PE index and the operation duration among the three groups (P < 0.05). Moreover, the operation duration of the group without wire fixation was significantly shorter than that of the bilateral fixation group (P < 0.05). However, there were no differences among the three groups in terms of postoperative pain score, hospital stay, postoperative complications, and outcome satisfaction (P > 0.05).Conclusions The modified Nuss plate has a certain corrective effect. Non-thoracoscopic assistance and non-wire fixation are potentially feasible. The necessity of wire fixation and how to optimize wire fixation are worthy of further prospective large-sample clinical research.

Interpretation of similarities and differences in Cyclic vomiting syndrome guidelines at home and abroadWangJian, XuXiwei

王健, — 2025/12/12 9:58:55

Cyclic vomiting syndrome (CVS) in children has a prevalence rate of 1.9%-2.3% among children. It is characterized by recurrent vomiting, which seriously affects children's quality of life. Children with this syndrome often require frequent emergency treatments or hospitalization, directly impacting their study and life. Due to the unclear pathogenesis of CVS and the lack of treatment plans supported by evidence-based evidence, there is a lack of consistency and standardization in clinical treatment. In 2025, China released the "Guidelines for the Treatment of Cyclic Vomiting Syndrome in Children (2025)" for the first time to guide and standardize the clinical treatment practice of pediatric CVS in China. In the same year, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) released the "Guidelines for the Management of Cyclic Vomiting Syndrome in Children (2025)" to replace the 2008 version of recommendations on CVS. This article mainly analyzes and interprets the similarities and differences between the two guidelines, so as to provide a theoretical basis for clinical work.

Advances in the Complex Immunopathogenesis of Polymyositis and Multi-target Therapies Breakdown and rationale

majingshu — 2025/12/12 9:57:51

Polymyositis (PM) is a rare, heterogeneous autoimmune disorder characterized primarily by symmetric proximal muscle weakness as its main clinical manifestation, which can impact patients' quality of life and life expectancy. Its etiology and pathogenesis are complex and highly heterogeneous, involving multiple levels and pathways, including genetic susceptibility, environmental triggers, and the immune system. This review aims to systematically delineate the key genetic factors, immune pathways and their interaction networks involved in PM, explore the multiple potential therapeutic targets resulting from these, and assess the progress, challenges, and clinical significance in exploring current and future multi-target therapeutic strategies.

Multi-modal therapy for regulating the microenvironment of gynecological malignancies mediated by hyperthermic intraperitoneal chemotherapy

DUANSHIQIAN,,WENSHIYU,YANGJIANG — 2025/12/12 9:55:42

The global disease burden of cervical cancer, endometrial cancer and ovarian cancer continues to increase, and the age spectrum of their onset shows a significant trend of getting younger.As an emerging therapeutic strategy, Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has been proven to significantly improve the prognostic outcomes of patients with advanced, recurrent or metastatic gynecological malignancies by constructing a synergistic system of thermochemotherapy.However, the benefits it brings are mainly reflected in ovarian cancer patients who have undergone Interval Cytoreductive Surgery (IDS).Given that the influence of HIPEC on the Tumor Microenvironment (TME) is the key mechanism by which it functions, it is necessary to conduct in-depth research on this mechanism in order to enable HIPEC to play a more important role in the treatment of gynecological malignant tumors, expand a wider range of application scenarios, and provide more precise and personalized treatment plans for patients.This article will focus on the mechanism of HIPEC in the treatment of gynecological malignant tumors, as well as the latest progress and prospects of the combined application of this therapy with immunotherapy, targeted therapy, etc., providing a comprehensive theoretical basis and practical reference for clinical treatment.

Primary Squamous Cell Carcinoma of the Breast: A Case Report and Comprehensive Literature Review

wenxuzhi,,, — 2025/12/10 12:10:36

Primary Squamous Cell Carcinoma of the Breast (PSCCB) is a rare and aggressive type of breast cancer with low incidence and nonspecific clinical manifestations, making its diagnosis challenging. This article presents a case of PSCCB treated at the Cancer Center of Nanjing University Medical School Affiliated Hospital and reviews related literature and reports to analyze the clinical features, pathological characteristics, diagnostic methods, treatment plans, and prognosis of PSCCB, aiming to enhance the awareness and diagnostic and therapeutic capabilities of clinicians for this rare disease.

A case of percutaneous puncture combined with endoscopic cryoprecipitate perfusion for the treatment of giant emphysematous bulla

wenyouli,xiangna — 2025/12/8 19:49:27

This case report reports a successful case of percutaneous puncture combined with endoscopic cryoprecipitate perfusion for the treatment of giant emphysematous bulla.

Effect of serplulimab on T cell function, clinical efficacy and safety in patients with NSCLC

Yang Xiuyuan, — 2025/12/8 19:46:35

Objective? To investigate the impact of serplulimab on the functionality of T cells, as well as its clinical effectiveness and safety profile in individuals diagnosed with non-small cell lung cancer (NSCLC). Methods? 86 patients diagnosed with NSCLC received treatment at our hospital between December 2022 and September 2023. They were categorized into two groups: the serplulimab group (n = 30) and the conventional chemotherapy group (n = 56). The conventional chemotherapy group underwent platinum-based synchronous chemotherapy, while the serplulimab group received additional serplulimab. Each patient completed 2 consecutive treatment cycles, with one cycle administered every 3 weeks. The study compared the alterations and variances in T lymphocyte subsets and tumor markers between the two groups before and after treatment. Clinical efficacy was assessed using RECIST1.1 criteria. A one-year follow-up was conducted to analyze discrepancies in survival rates and the occurrence of treatment-related adverse reactions between the groups. Results? Following the intervention, the mean serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, CA19-9, and cytokeratin 19 fragment antigen 21mur1 (CYFRA21-1) exhibited a decrease compared to pre-treatment levels in both groups (P < 0.05), with no statistically significant variance observed between the two groups (P > 0.05). Moreover, post-intervention, the average proportion of CD4+T cells and the CD4+T/CD8+T ratio in the treatment cohort showed an elevation from pre-treatment levels and compared favorably to those in the standard chemotherapy cohort (P < 0.05). Noteworthy improvements were noted in the objective remission rate, disease control rate, and average progression-free survival period in the serplulimab group in comparison to the standard chemotherapy group (P < 0.05). There was no notable variance observed in both the frequency and intensity of adverse reactions between the treatment cohort and the conventional chemotherapy group (P > 0.05). Conclusion? The combination of serplulimab with chemotherapy demonstrates favorable clinical efficacy in treating patients with NSCLC by enhancing the immune function of T lymphocytes and decreasing serum tumor marker levels. This treatment approach not only extends patient survival time but also ensures excellent clinical safety, indicating its potential for wider clinical application.

Association of Bronchoalveolar Lavage Fluid and Serum IL-17A, ICAM-1, and MUC5AC Levels with Airway Mucus Plug and Clinical Prognosis in Children with Mycoplasma pneumoniae Pneumonia

LI Fang — 2025/12/8 19:44:54

Objective　To investigate the relationship between levels of interleukin-17A (IL-17A), intercellular adhesion molecule-1 (ICAM-1), and mucin 5AC (MUC5AC) in bronchoalveolar lavage fluid (BALF) and serum, and airway mucus plug (AMP) and clinical prognosis in children with Mycoplasma pneumoniae pneumonia (MPP).Methods　A total of 249 children with MPP who underwent bronchoscopy and bronchoalveolar lavage in our hospital from October 2020 to October 2024 were prospectively enrolled. According to the presence of AMP, patients were divided into the AMP group (n=83) and the non-AMP group (n=166). The levels of IL-17A, ICAM-1, and MUC5AC in BALF and serum were compared between the two groups. The diagnostic efficacy of these markers for MPP combined with AMP was evaluated using receiver operating characteristic (ROC) curve analysis. According to prognosis, children in the AMP group were divided into good and poor prognosis groups. Clinical data were collected, and univariate and multivariate logistic regression analyses were conducted to identify factors influencing poor prognosis. ROC analysis was used to evaluate the predictive value of BALF and serum IL-17A, ICAM-1, and MUC5AC levels for poor prognosis.Results　Compared with the non-AMP group, children in the AMP group had significantly elevated levels of IL-17A, ICAM-1, and MUC5AC in both BALF and serum (P < 0.05). ROC curve analysis showed that the areas under the curve (AUCs) of BALF IL-17A, ICAM-1, and MUC5AC for diagnosing AMP in children with MPP were 0.825, 0.817, and 0.847, respectively, and the combined detection yielded an AUC of 0.936, which was significantly higher than any single indicator alone (P < 0.05). For serum IL-17A, ICAM-1, and MUC5AC, the AUCs were 0.777, 0.765, and 0.783, respectively, and the combined detection reached an AUC of 0.905, which was significantly higher than any single indicator alone (P < 0.05). Among the 83 children with MPP complicated by AMP, the incidence of poor clinical prognosis at 28 days was 36.14% (30/83). Univariate analysis indicated that duration of fever, lactate dehydrogenase (LDH), and BALF/serum levels of IL-17A, ICAM-1, and MUC5AC were associated with prognosis (P < 0.05). Multivariate logistic regression revealed that elevated levels of IL-17A, ICAM-1, and MUC5AC in both BALF and serum were independent risk factors for poor prognosis in children with MPP and AMP (P < 0.05). ROC curve analysis further showed that the AUCs for predicting poor prognosis using BALF IL-17A, ICAM-1, and MUC5AC levels were 0.836, 0.807, and 0.817, respectively, with a combined AUC of 0.960, which was significantly higher than any single indicator alone (P < 0.05). Similarly, the AUCs for serum IL-17A, ICAM-1, and MUC5AC levels were 0.788, 0.774, and 0.777, respectively, with a combined AUC of 0.907, which was significantly higher than any single indicator alone (P < 0.05).Conclusion　Elevated levels of IL-17A, ICAM-1, and MUC5AC in BALF and serum are associated with AMP and poor clinical prognosis in children with MPP. The combination of the three biomarkers offers high diagnostic and predictive efficacy for AMP and poor prognosis. While the combined detection in BALF provides higher accuracy and predictive value, the serum-based combined detection although slightly less effective is easier to perform, less invasive, and highly reproducible, making it a practical choice depending on the clinical condition of the child.

Study on the Relationship between Serum miR-27b-3p and miR-142-5p Levels and the disease Progression of clear cell renal Cell carcinoma and poor prognosis after retroperitoneal laparoscopic partial nephrectomy

ZHANG Yuan — 2025/12/8 19:42:40

Objective To investigate the relationship between serum microrNA (miR) -27b-3p and Mir-142-5p levels and the disease progression of clear cell renal cell carcinoma (ccRCC) and the poor prognosis after retroperitoneal laparoscopic partial nephrectomy (RLPN). Methods: 110 patients with ccRCC who underwent RLPN in our hospital from January 2020 to February 2022 (ccRCC group) and 55 healthy individuals who underwent physical examinations during the same period (control group) were selected, the patients with ccRCC were divided into poor prognosis group andgood prognosis group according to the 3-year follow-up results. Serum miR-27b-3p and miR-142-5p levels were detected by real-time fluorescence quantitative polymerase chain reaction, and the relationship between the two and the disease progression of ccRCC was analyzed. patients with ccRCC were divided into high and low expression groups according to the mean serum miR-27b-3p and miR-142-5p levels, the progression-free survival curves of patients with ccRCC with different serum miR-27b-3p and miR-142-5p levels were plotted by the K-M method. Multivariate Cox regression analysis was used to analyze the relationship between serum miR-27b-3p and miR-142-5p levels and the poor prognosis after RLPN in patients with ccRCC. The receiver operating characteristic (ROC) curve was used to analyze the predictive efficiency of serum miR-27b-3p and miR-142-5p levels for poor prognosis in patients with ccRCC after RLPN. Results: Compared with the control group, serum miR-27b-3p level in the ccRCC group decreased, and miR-142-5p level increased (P < 0.05). Serum miR-27b-3p and miR-142-5p levels were related to the TNM stage and Fuhrman grade of patients with ccRCC (P < 0.05). 3-year poor prognosis rate of 110 patients with ccRCC after RLPN was 23.64% (26/110), and the 3-year progression-free survival rate was 76.36% (84/110). The 3-year progression-free survival rate of patients with ccRCC with high miR-27b-3p level was higher than that of patients with low miR-27b-3p level, and the 3-year progression-free survival rate of patients with ccRCC with high miR-142-5p levels was lower than that of patients with low miR-142-5p levels (P < 0.05). Stage T2, Fuhrman grade Ⅲ - Ⅳ, and high miR-142-5p were risk factors for poor prognosis after RLPN in patients with ccRCC, while high miR-27b-3p was a protective factor (P < 0.05). The areas under the curves of serum miR-27b-3p and miR-142-5p levels and their combined prediction of poor prognosis after RLPN in patients with ccRCC were 0.840, 0.845, and 0.933, respectively (P < 0.05). Conclusion: Serum miR-27b-3p decreased and miR-142-5p levels increased in patients with ccRCC, which are associated with disease progression and poor prognosis after RLPN, the combined levels of serum miR-27b-3p and miR-142-5p have a higher predictive efficiency for poor prognosis in patients with ccRCC after RLPN.

Analysis of Plaque Characteristics between Small and Large Infarction Lesions in the Middle Cerebral Artery Perfusion Area Using 3.0T HR-VW-MRI Technology

张凤令 — 2025/12/8 15:29:52

Background: Currently, the plaque characteristics leading to different types of subcortical infarctions remain unclear. This study employed 3.0T high - resolution vessel - wall magnetic resonance imaging (HR - VW - MRI) technology to explore the differences in plaque characteristics between small subcortical infarctions (SSI) and large subcortical infarctions (LSI) in the perfusion area of the middle cerebral artery (MCA).Methods: This was a retrospective analysis of 63 patients with acute ischemic stroke in the MCA perfusion area at Beijing Geriatric Hospital. The average age of the patients was 60.90±10.65 years, and 52 of them were male. All patients underwent whole - brain HR - VW - MRI examination. According to the diffusion - weighted imaging (DWI) images of conventional MRI, the patients were divided into the SSI group and the LSI group. The plaque location, the number of involved quadrants, intra - plaque hemorrhage, plaque burden (PB), vascular remodeling patterns (positive or negative), and degree of stenosis were analyzed and compared between the two groups.Results: Among 53 patients, 42 cases (66.67%) were classified into the SSI group, and 21 cases (33.33%) were in the LSI group. In the SSI group, the proportion of plaques involving only one quadrant was significantly higher, and most of these plaques were located on the upper or ventral wall of the MCA. There were no significant differences between the two groups in terms of the proportion of plaques involving two or more quadrants, plaque distribution, and PB. The incidence of intra - plaque hemorrhage in the LSI group was significantly higher than that in the SSI group, and the difference was statistically significant. In both groups, most plaques showed positive remodeling, and the proportions of positive remodeling patterns were similar. In addition, the incidence of mild stenosis (<50%) was significantly higher in the SSI group.Conclusion: Both SSI and LSI may be closely related to intracranial atherosclerosis. However, in SSI patients, the plaque formation involves fewer quadrants, has relatively less intra - plaque hemorrhage, and the degree of vascular stenosis is relatively lower.

Influence of ALB, IVIG, and ATG Infusion on Blood Transfusion Compatibility Testing

taishengfei — 2025/12/8 15:29:04

Objective To analyze the impact of intravenous infusion of human albumin (ALB), intravenous immunoglobulin (IVIG), and rabbit anti-human thymocyte immunoglobulin (ATG) on transfusion compatibility test results in patients, and to explore the optimal transfusion strategy. Methods Specimens from 34 patients admitted to our department between January 2022 and December 2023, who exhibited incompatible cross-matching, positive unexpected antibody screening, or ABO blood group discrepancies due to ALB, IVIG, or ATG infusion, were collected. Tests including blood typing, cross-matching, unexpected antibody screening, unexpected antibody identification, direct antiglobulin test (DAT), and elution tests were performed using the microcolumn gel method. Results Among 10 patients infused with human albumin, anti-A was detected via elution tests in 5 type A and 2 type AB patients, anti-B was eluted in 1 type B patient, agglutination with reverse typing B cells occurred in 1 type B patient, and both anti-A and anti-B were eluted in 1 type AB patient. Among 18 patients infused with IVIG, anti-A was detected via elution tests in 8 type A patients, agglutination with reverse typing A cells occurred in 3 type A patients, anti-A was eluted in 5 type AB patients, both anti-A and anti-B were eluted in 1 type AB patient, and agglutination with reverse typing A cells occurred in 1 type AB patient. All 6 patients infused with ATG developed nonspecific antibodies. Conclusion Infusion of ALB, IVIG, or ATG in patients may lead to positive DAT or unexpected antibody screening, ABO blood group discrepancies, or incompatible cross-matching, interfering with ABO blood typing and cross-matching. In such cases, it is recommended to prioritize same-type blood matching. If donors compatible by both antiglobulin and saline methods are available, same-type red blood cells should be transfused; otherwise, O-type washed red blood cells should be administered.

The role and molecular mechanism of HMGN1 in acute kidney injury based on the NLRP3 inflammatory pathway

查艳,林鑫,罗宇涵,邵兴琴,谢莹,袁静,张浪 — 2025/12/8 15:27:16

Objective To investigate the Regulatory Role of the NOD-like Receptor Family Pyrin Domain Containing 3 (NLRP3) Inflammasome in Acute Kidney Injury (AKI) Mediated by High Mobility Group Nucleosome-Binding Protein 1 (HMGN1) and Its Downstream Toll-like Receptor 4 (TLR4)–Nuclear Factor Kappa-B (NF-κB) Signaling Pathway. Methods A mouse model of acute kidney injury (AKI) induced by ischemia-reperfusion (I/R) was established using the bilateral renal pedicle clamping method. The mice were randomly divided into three groups: the control group, the AKI group, and the CRID3 intervention group (treated with cytokine release inhibitory drug 3 (CRID3), an NLRP3 inhibitor). Renal function was assessed by measuring serum levels of blood urea nitrogen (BUN), serum creatinine (Scr), and cystatin C. Pathological changes in renal tissues were observed using hematoxylin-eosin (HE), Masson, and Sirius red staining. The protein expression levels of HMGN1, NLRP3, and TLR4 were detected by immunohistochemistry and Western blot. Serum levels of inflammatory cytokines interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were quantified by enzyme-linked immunosorbent assay (ELISA). Results Compared with the control group, the AKI group exhibited significantly elevated serum levels of BUN, Scr, and cystatin C (P<0.05), aggravated renal pathological damage (including tubular necrosis, inflammatory cell infiltration, and interstitial fibrosis), upregulated protein expression of HMGN1, NLRP3, and TLR4 (P<0.05), and increased serum levels of IL-1β, IL-6, and TNF-α (P<0.05). In contrast, the CRID3 group showed decreased BUN, Scr, and cystatin C levels (P<0.05), alleviated renal pathological injury, downregulated expression of HMGN1, NLRP3, and TLR4, and reduced levels of renal inflammatory cytokines compared with the AKI group. Conclusion The NLRP3 inflammasome participates in the pathological process of AKI by regulating HMGN1 expression and the downstream TLR4 signaling pathway. Inhibition of NLRP3 improves renal function, mitigates renal pathological injury, and suppresses inflammatory responses, highlighting NLRP3 as a potential therapeutic target for AKI.

Individualized Treatment of Clopidogrel in Ischemic Stroke Patients Guided by Gene Polymorphism and Platelet Aggregation Detection LI Zhao-quan, HUANG Jin-shi, LI Tao, et al. Clinical pharmacology discipline, Wuzhou Gongren Honspital, Wuzhou 543000, China

Li Zhaoquan — 2025/12/3 17:21:35

Objective To explore the effect of the prognosis of individualized treatment of clopidogrel guided by gene polymorphism and platelet aggregation detection in ischemic stroke patients. Methods A total of 120 Han patients with ischemic stroke in the department of neurology of Gongren Hospital of Wuzhou from January 2022 to January 2024 were enrolled. 60 cases were taken as the study group, which received individualized treatment based on the gene polymorphism and adenosine diphosphate (ADP) inducing platelet aggregation detection, another 60 cases were taken as the control group and treated with conventional dual-antiplatelet therapy of ischemic stroke. All patients were followed up for 1 year. The incidence of Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) were recorded. The effects of the prognosis of ischemic stroke were compared between the study group and the control group, different gene polymorphism types, and risk factors. Results The patients of CYP2C19 (*2 *3 *17) UM/EM, IM, and PM genotype were 26 cases, 26 cases and 8 cases, respectively; for the ABCB1 C3435T GG, GA, and AA genotype were 29 cases, 23 cases and 8 cases respectively; and for the CES1 G143 gene genotype, all 60 cases were CC. Compared with the control group, the overall incidence of MACCE in the study group was significantly decreased (p = 0.0021). And there was no statistically significant (p > 0.05) between CYP2C19 UM/EM genotype and IM/PM genotype, neither between ABCB1 C3435T GG genotype and GA/AA genotype. Further analysis indicated that compared with the control group with risk factors such as hypertension, smoking history, drinking history, age ≥ 60 years old, and NIHSS ≥ 3 at admission, the incidence of MACCE in the study group were lower (p < 0.05). Conclusion Individualized treatment of clopidogrel guided by CYP2C19, ABCB1, CES1 gene polymorphisms and platelet aggregation detection can reduce the risk of MACCE of ischemic stroke patients, which providing a theoretical basis for individualized treatment and prognosis for ischemic stroke.

Interpretation of the Consensus Report by the American Diabetes Association on the Necessity of Screening and Early Intervention for Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD) in Diabetic PatientsWang Yun₁^Zhang Lili₂^{Xu Zhangrong}_³

wangyun,, — 2025/12/2 13:07:40

In May 2025, the journal Diabetes Care published an important article titled "Metabolic Dysfuncion-Associated Steatotic Liver Disease(MASLD) in People With Diabetes:The Need for Screening and Early Intervention.A Consensus Report of the American Diabetes Association". This consensus explains the reasons for the name change of MASLD, how to conduct risk stratification, current treatment and long-term monitoring, and the importance of cross-professional team management of the disease. The author, based on recent domestic and international expert consensuses and clinical guidelines on diabetes mellitus complicated with metabolic associated fatty liver disease, provides a deep interpretation of this article. It is hoped that by enhancing the awareness of MASLD and its related disease risks, liver fibrosis screening will be widely adopted, and early diagnosis and standardized management of MASLD in patients with prediabetes and type 2 diabetes mellitus will be achieved.

IgA Nephropathy Precision Medicine: Frontiers in Epidemiology and Pathogenesis

zhou rui jia — 2025/11/28 9:08:38

IgA nephropathy (IgAN), also known as Berger's disease, is a glomerular disease characterized by the deposition of IgA or IgA immune complexes in the glomerular mesangial area. It is currently the most common primary glomerular disease worldwide. The epidemiological features of IgAN are complex and diverse due to geographic, racial, gender, and age differences, highlighting the crucial roles of genetic and environmental factors in IgAN. Recent breakthroughs in mechanistic research have identified the imbalance in the production and clearance of Gd-IgA1 immune complexes, driven by mucosal immune dysregulation, as the central link in IgAN pathogenesis. This leads to IgA-specific deposition in the mesangium and complement activation, resulting from the interplay of genetic, environmental, and immune factors. Furthermore, a newly proposed hypothesis regarding anti-mesangial cell autoantibodies has expanded the multidimensional perspective on the etiology of IgAN. This article systematically integrates cutting-edge evidence on the epidemiology and pathogenesis of IgAN, thereby providing a theoretical basis for individualized IgAN treatment.

Artificial Intelligence Empowers Kidney Disease Research: Mechanism Exploration and Treatment Optimization

Meng Ling Zhang — 2025/11/27 10:19:35

Kidney diseases represent a major burden on global public health, with their incidence and mortality rates continuing to rise. The rapid development of artificial intelligence (AI) has provided revolutionary tools for exploring the mechanisms of kidney diseases and optimizing clinical treatments. This review outlines the primary types of kidney diseases and their complex pathogenic mechanisms, while highlighting the limitations of traditional research methods. Subsequently, it elaborates on the applications of AI in multi-omics data analysis, renal pathology image recognition, big data-driven risk prediction, and the mechanistic analysis of rare kidney diseases. In the context of clinical treatment, AI supports early screening, personalized nutrition and dialysis optimization, prognosis management, and kidney transplant matching, thereby significantly enhancing diagnostic accuracy and patient outcomes. Finally, it analyzes the challenges faced by AI and prospects the future roles of multimodal integration, federated learning, and large language models in precision medicine for kidney diseases.

Hypertension Management in Chronic Kidney Disease: Adherence to Intensive Blood Pressure Control and Long Time in Target Range

Shuwen Zhou — 2025/11/27 10:16:21

Recent large-scale evidence-based clinical trials published in top international journals have confirmed that intensive blood pressure control can effectively reduce mortality and cardiovascular events in hypertensive patients. However, its impact on renal outcomes remains controversial. Researches indicate that intensive blood pressure reduction may increase the risk of adverse renal events in the short term, while long-term observation suggests a potential to delay the progression of chronic kidney disease (CKD). The renoprotective effect of strict blood pressure control is more pronounced in patients with proteinuria and advanced CKD stages, indicating that CKD patients with different clinical characteristics may obtain differential renal benefits from intensive blood pressure control strategies. Antihypertensive therapy should aim not only at achieving single-time target goals but also at extending the time-in-target range (TTR). In China, the low rate of blood pressure control in CKD patients means the role of hypertension in promoting kidney disease progression is not effectively managed. By elaborating on the comprehensive benefits of antihypertensive therapy for CKD patients and based on the latest clinical research and international guidelines, this paper emphasizes the need to not only improve blood pressure control rates but also strive for intensive blood pressure management and long-term target achievement.

The Rho kinase signaling pathway participates in the oxidative damage and apoptosis of renal tubular cells caused by high uric acid by regulating mitochondrial dynamin/biosynthesis genes

Li Jiachang,yuhan ma, — 2025/11/24 17:02:55

Objective This article aims to explore the expression and role of Rho kinase (ROCK) in nephropathy with hyperuricemia, and to investigate whether the Rho kinase signaling pathway regulates oxidative damage and apoptosis of renal tubules in hyperuricemia through the mitochondrial pathway and the related mechanisms. Methods According to different treatment methods, human renal tubular epithelial cells (HK-2 cells) were divided into five groups: Normal group (blank control group), UA group (hyperuricemia stimulation group), UA+ fasudil group (ROCK inhibitor), UA+ROCK1 si-RNA group (ROCK1 gene silencing group), UA+sc-siRNA group (negative control group). After each group completed the culture, the expression levels of mitochondrial-related proteins in cells of each group were detected by Western blotting and real-time quantitative PCR, and the differences among different groups were analyzed and compared. Results The study revealed that uric acid significantly upregulated the expression of MYPT1 in HK-2 cells, suggesting an increase in Rho kinase activity. The transcription of manganese superoxide dismutase (MnSOD2) in uric acid-induced HK-2 cells also significantly increased, while the pretreatment with fasudil significantly inhibited this change. In addition, the MnSOD2 mRNA in HK-2 cells transfected with ROCK1 siRNA was significantly reduced, indicating that the Rho kinase signaling pathway is closely related to uric acid-induced oxidative damage. Further analysis revealed that the regulation of mitochondrial motility proteins and biogenic genes by the Rho kinase pathway also affected the apoptosis process of cells. Conclusion This study indicates that Rho kinase plays a significant role in HK-2 cells induced by hyperuricemia and may promote the progression of hyperuricemic nephropathy by regulating mitochondrial oxidative damage and apoptosis. Fasudil, as an inhibitor of Rho kinase, may provide a new therapeutic target for the prevention and treatment of kidney diseases.

Completed response postpone among nucleoside (acid) analogues treated patients of chronic HBV-infection in immune tolerance status

lufengmin — 2025/11/24 7:57:09

The clinical significance of expanding antiviral therapy for patients with chronic hepatitis B virus (HBV) infection is to minimize the potential occurrence of severe liver inflammation, and consequently, reduce the risk of cirrhosis and liver failure, and to reduce the risk of hepatocellular carcinoma in the long term. It is expected that more ‘immune-tolerant’ chronic HBV-infected patients will be enrolled in antiviral therapy after the currant antiviral therapeutic strategy expanded. Distinguished from low-level viremia (LLV), which occurs in chronic hepatitis B (CHB) patients with poor response to nucleos(t)ide analogue (NAs) antiviral therapy, patients in the histological immune tolerance phase have no/minimal liver damage, as indicted by the biochemical markers of liver injury, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), being below the upper limit of normal, no or mild liver tissue inflammation or hepatic fibrosis, and high baseline HBV DNA levels. This is likely due to the lack of inflammatory immune-mediated clearance of infected hepatocytes and subsequent active compensatory hepatocyte proliferation. Consequently, one should expect delay in achieving completed virological response to antiviral therapy in NAs, which the authors propose to refer to as complete response postponement (CRP), rather than LLV. Distinguishing between the two definitions will help clinicians avoid doubts about the efficacy of antiviral therapy due to prolonged periods of sustained positive viral testing, and will help patients cope with hesitancy to initiate antiviral therapy.

Effectiveness of Neoadjuvant Chemotherapy with/without PD-1 Inhibitors in Locally Advanced HNSCC: a retrospective cohort study

jiao zan,,,,, — 2025/11/21 17:54:26

Objective: To evaluate the therapeutic efficacy of adding PD-1 inhibitors to neoadjuvant chemotherapy in patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC) and its impact on overall survival (OS) and progression-free survival (PFS). Methods: Clinicopathological data of 140 LA HNSCC patients treated at Sun Yat-sen University Cancer Center between 2012 and 2023 were retrospectively analyzed. Patients were divided into the immuno-chemotherapy group (TPI, n=118) and the chemotherapy-only group (TP, n=22). Primary endpoints were OS and PFS, while secondary endpoints included objective response rate (ORR) and pathological complete response (pCR). Baseline characteristics were balanced using propensity score overlap weighting. Survival analyses were conducted using the Kaplan-Meier method, and Cox proportional hazards models was used for multivariate analyses. Results: The median follow-up time was 23.4 months. Patients receiving PD-1 inhibitors showed significantly improved OS (HR=0.24, 95% CI: 0.07–0.76, P=0.016) and PFS (HR=0.34, 95% CI: 0.12–0.94, P=0.037) compared with those receiving chemotherapy alone. Multivariate Cox analysis identified the addition of PD-1 inhibitors as the only independent factor associated with enhanced OS and PFS. Furthermore, the immuno-chemotherapy group exhibited a higher objective response rate (65.25% vs. 40.91%, P=0.031), along with higher rates of pathological downstaging (64.41% vs. 36.36%, P=0.014) and a trend toward higher pCR (37.29% vs. 13.64%, P=0.031). Conclusion: The addition of PD-1 inhibitors to neoadjuvant chemotherapy significantly improves OS and PFS in patients with LA HNSCC. These findings support incorporating PD-1 inhibitors into neoadjuvant treatment regimens and warrant further prospective studies to confirm and optimize this strategy.

Analysis of influencing factors for postpartum urinary retention in non-epidural primiparous women after vaginal delivery

鞠蕊,兰雪丽,张娥,赵越 — 2025/11/20 8:21:26

Objective To investigate the influencing factors of postpartum urinary retention (PUR) in non-parturient analgesic primiparous women with vaginal delivery, and to provide a basis for clinical prevention and intervention. Methods A total of 105 primiparous women with non-parturient analgesia and vaginal delivery received from a tertiary hospital from December 2021 to December 2024 were selected as the research subjects, and were divided into 70 cases in the non-urinary retention group and 35 cases in the urinary retention group according to whether they occurred. The general, clinical and pregnancy data of the two groups were retrospectively analyzed, and multivariate logistic regression was used to analyze the independent risk factors affecting the occurrence. Results Univariate analysis showed that there were differences in labor time, pre-pregnancy weight, and hematoma between the two groups (P<0.05). Multivariate logistic regression analysis showed that gestational diabetes mellitus (OR=8.191, 95%CI: 1.249-53.702), gestational age (OR=2.032, 95%CI: 1.017-4.061), forceps midwifery (OR=6.687, 95%CI: 1.286-34.764), postpartum hemorrhage (OR=1.012, 95%CI: 1.000-1.024), and excessive weight gain during pregnancy (OR=19.645, 95%CI: 2.734-141.141), duration of first stage of labor (OR=1.255, 95%CI: 1.021-1.542), and duration of second stage of labor (OR=1.250, 95%CI: 1.020-1.532) were independent risk factors for the occurrence of PUR after vaginal delivery in nonpartisan analgesic primiparous women (P<0.05). The area under the ROC curve AUC=0.748 (95%CI: 0.652–0.843) (P <0.05)。 Conclusion The occurrence of postpartum urinary retention in non-parturial analgesic primiparous women with vaginal delivery is affected by a variety of factors, among which gestational diabetes, large gestational age, forceps delivery, postpartum hemorrhage, excessive weight gain during pregnancy, and prolonged labor are the main risk factors. Corresponding prevention and intervention measures should be taken according to these factors to reduce the incidence of PUR and ensure the smooth recovery of mothers.

Clinical outcome of different Gutenberg ultrasonographic patterns under hysteroscopy Hysteroscopy for the patients of adenomyosis

Li Jinghua,Zhang Luping,Zhang Shengpeng — 2025/11/19 8:23:51

Objective To explore the clinical outcome and feasibility of a novel hysteroscopic levonorgestrel-releasing intrauterine system (LNG-IUS) non-suture fixation for the adenomyosis patients. Methods From January 2024 to March 2025, clinical data of patients who underwent LNG-IUS non-suture fixation in gynecology department of Beijing Tiantan Hospital, Capital Medical University were retrospectively analyzed. Basic demographic data, clinical symptoms, operation time, surgical complications, postoperative LNG-IUS expulsion, and other follow-up information were reviewed. Results A total of 44 patients were included in this study, 17 patients had a history of LNG-IUS expulsion and 7 patients had a history of displacement. The average uterine cavity depth is 10.58±1.03 cm and the median volume of the uterus is130.31ml（IQR：90.60-174.04）. The average operation time is 14.54 ±5.01min, the average blood loss is 4.59±3.34 mL. There was no transurethral resection of prostate syndrome, uterine perforation, massive bleeding, or postoperative infection. The average follow-up time after operation was 7.0±1.2 months, and no LNG-IUS expulsion occurred. The Pictorial Blood Loss Assessment Chart of hypermenorrhea, volume of the uterus and Visual Analogue Scale of dysmenorrhea postoperation were significantly less than preoperation. The effective rate of dysmenorrhea was 90.91%(40 /44), and for those with hypermenorrhea, the postoperative effective rate was 95.45% (42/44). Conclusion Hysteroscopic LNG-IUS non-suture fixation-knot button suspention is a safe and effective operation, particularly suitable for adenomyosis patients with a large uterine cavity who have previously experienced LNG-IUS expulsion. This surgical procedure is simple, minimally invasive, with a short operation time, less bleeding and a quick postoperative recovery. It is worthy of clinical application.

the Effects of Different Maneuvers on Intravaginal Pressure

罗穗豫,, — 2025/11/17 10:01:26

Objective: To investigate the effects of different maneuvers on intravaginal pressure. Methods: A total of 163 patients who underwent pelvic floor function examination in our hospital from June 2024 to August 2024 were included. Intravaginal pressure (IVP) was measured at rest in supine position and during different maneuvers in the same order: abdominal muscles electrical stimulation, crunch, forceful coughing, and bearing down. Result: The intravaginal pressure is the highest during forceful coughing(111.02±15.37) cmH2O,, followed by bearing down(97.72±11.35) cmH2O, crunch(87.15±10.72) cmH2O, and abdominal muscles electrical stimulation(78.95±7.98) cmH2O, respectively. There are significant statistical differences between the above mentioned conditions and supine position (75.72±7.85 cmH2O).(all P < 0.001). IVPs generated by five different maneuvers were higher in SUI and Obese group compared to Non-SUI and Non-obese group. Conclusion: Forceful coughing and bearing down appear to generate greater pressure to the pelvic floor. It is important to avoid forceful coughing and keep regular defecation in daily life. Abdominal muscles electrical stimulation presents less risk than crunch to the pelvic floor and maybe a promising treatment to diastasis decti abdominis.

PGRMC1 mediates the differential effects of various progestogens on breast cancer proliferation ZHAO Yue1, JU Rui1, XIE Dan1, ZHANG Zheng1, ZHU Jianguo1, ZHANG E1, LI Li3.

赵越, — 2025/11/17 9:55:03

Objective This study aims to investigate the differential effects of progesterone receptor membrane component 1 (PGRMC1) on the proliferation of breast cancer xenografts under stimulation by progesterone and norethisterone (NET) using an in vivo nude mouse model. Methods Thirty-six female BALB/c nude mice were randomly divided into two groups: the MCF7/HA-PGRMC1 group (inoculated with breast cancer cells stably overexpressing PGRMC1, n=18) and the MCF7/HA-Vector group (inoculated with empty vector-transfected cells, n=18). All nude mice received a subcutaneous estradiol (E2) slow-release pellet (0.72 mg/60 d) implanted in the neck 24 hours before cell inoculation, and were injected bilaterally in the chest wall with cell suspension (1×10? cells/150 μL). When tumor volume reached approximately 100 mm3, the mice in each group were further divided into three subgroups (n=6/subgroup), implanted with placebo (10 mg/60 d), NET (10 mg/60 d), or progesterone (10 mg/60 d) slow-release pellets. Tumor proliferation was continuously observed and recorded, and tumor growth curves were plotted. After 45 days, tumor tissues were completely excised, and immunohistochemical staining was performed to detect PGRMC1 and Ki67 expression in the xenograft tissues. Results In vivo, a sequential combination of NET and E2 also significantly increased the tumor growth of MCF7/HA-PGRMC1 cells(P<0.05); empty vector cells did not respond to NET(P>0.05). Addition of NET or progesterone did not triggered a proliferative response of MCF7/HA-Vector cells(P>0.05). Ki67 abundance by immunohistochemical staining, the elevated PGRMC1 level was related to the expression of ki67 (r=0.892, P=0.014). Conclusion We could demonstrate that E2 cotreatment with NET increases the tumor growth of human breast cancer cells that overexpress PGRMC1 but not with progesterone in vivo. This finding provides key experimental evidence for selecting the type of progestin in clinical hormone therapy (HT).

Efficacy of Combined Uterine "Peach-like" Hysteroplasty and Levonorgestrel-Releasing Intrauterine System for Adenomyosis

Yan Zhenzhen — 2025/11/14 17:35:39

Objective To analyze the efficacy of the "Uterine Peach Technique" combined with the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis. Methods Sixty patients with uterine adenomyoma treated at Henan Provincial People’s Hospital between January 2023 and June 2024 were enrolled as study subjects. Based on patient preference, they were divided into a control group and a study group, with 30 patients in each group. The control group underwent laparoscopic uterine lesion resection, while the study group received the "Uterine Peach Technique" combined with LNG-IUS. Clinical outcomes were compared between the two groups. Results After treatment, the study group showed significantly lower operative time, intraoperative blood loss, postoperative uterine volume, and visual analog scale (VAS) scores for dysmenorrhea compared to the control group, with statistically significant differences (PS< 0.05). No statistically significant difference was observed in hospital stay duration between the groups (PS> 0.05). Conclusion Compared with laparoscopic adenomyomectomy, the "Peach-like" hysteroplasty demonstrated shorter operative time and reduced intraoperative blood loss. When combined with levonorgestrel-releasing intrauterine system (LNG-IUS), this approach resulted in greater postoperative uterine volume reduction and more significant symptom improvement in hypermenorrhea and dysmenorrhea.

RMedical recommendations for female fertility with endometriosis and adenomyosis —— domestic and international guidelines interpretation.

鞠蕊, — 2025/11/14 9:57:44

Endometriosis and adenomyosis are prevalent chronic gynecological conditions affecting women of reproductive age, characterized primarily by pain, infertility, and pelvic masses. These conditions exert a prolonged influence on fertility through various mechanisms, including the reduction of ovarian reserve, alterations in the immune system and pelvic anatomy, decreased endometrial receptivity, and iatrogenic damage associated with surgical interventions, ultimately leading to infertility. This article offers a thorough analysis of the latest national and international guidelines and expert consensus, based on evidence-based research, to systematically delineate diagnostic and therapeutic strategies pertinent to fertility in women with endometriosis and adenomyosis who seek to conceive. It aims to provide a comprehensive resource for enhancing understanding and informing clinical practice concerning these conditions.

Progress and Consensus Interpretation of Fertility Preservation Measures in Pediatric Hematopoietic Stem Cell Transplantation at Home and Abroad

qinmaoquan,,Yangjun — 2025/11/13 8:33:53

Hematopoietic stem cell transplantation (HSCT) has become a crucial treatment option for various malignant and non-malignant hematological diseases in children over recent years. However, the conditioning protocols that precede transplantation, including chemotherapy and radiation therapy, can lead to irreversible damage to the gonadal function in these young patients, potentially impacting their future fertility. Consequently, the implementation of fertility preservation strategies is of significant importance in pediatric HSCT. Research in this area is steadily increasing both domestically and internationally, yet challenges remain, including inconsistent technical applications and ethical dilemmas. This article seeks to review the latest advancements in fertility preservation measures for pediatric HSCT, with a particular focus on the "Expert Consensus on Fertility Preservation for Female Patients Undergoing Hematopoietic Stem Cell Transplantation" published in 2022. It will analyze the current state of existing technologies in clinical practice, the ethical issues encountered, and future directions for development, aiming to provide valuable insights and guidance for clinical practitioner

Impact of Chemotherapy on Prognosis of Patients with Metastatic Nasopharyngeal Carcinoma: A Retrospective Study

qinyangda — 2025/11/11 17:57:05

Objective: To evaluate the impact of chemotherapy on the prognosis of patients with metastatic nasopharyngeal carcinoma (NPC), and to assess the influence of metastatic sites, chemotherapy regimens, and treatment cycles on patient survival.

The expression characteristics of CD38 and CD138 in the endometrium of patients with failed IVF-ET implantation and their correlation with chronic endometritis

MiaoJun,,, — 2025/11/7 17:54:39

Objective To investigate the expression characteristics of CD38 and CD138 in the endometrium of patients with failed IVF-ET implantation and their correlation with chronic endometritis (CE). Methods This study included 114 patients who underwent in vitro fertilization-embryo transfer (IVF-ET) at the Reproductive Medicine Center of Changzhou Maternity and Child Health Care Hospital from April 2023 to September 2024 but were unable to achieve a successful pregnancy. All patients underwent hysteroscopy to obtain pathological tissue samples of the endometrium.Pathological staining and immunohistochemical analysis were performed on the endometrial tissues from the 114 patients to assess the expression of CD38 and CD138. We analyzed the expression levels of CD38 and CD138 in the endometrium of patients with IVF-ET implantation failure and explored their association with chronic endometritis (CE).The positive rates of CD38 and CD138 in the patients were statistically calculated, and the improvement in pregnancy rates following doxycycline treatment among positive patients was compared. Results A retrospective analysis of clinical data from 114 patients with IVF-ET implantation failure was conducted. Based on the expression status of CD38 and CD138, the patients were divided into four groups: CD38+CD138+, CD38+CD138-, CD38-CD138+, and CD38-CD138-. The incidence of chronic endometritis (CE) and the pathological features of the endometrium were compared among the groups. Among 114 patients, the incidence rate of CE was 38.60% (44/114).The incidence of CE in the double positive group (CD38+CD138+) was significantly higher than in the other groups, at 70.50% (p < 0.01). The double negative group (CD38-CD138-) had the highest proportion of normal endometrium, at 55%, with a significant difference (p < 0.01).Doxycycline treatment was administered to 94 patients, with 48 patients achieving pregnancy during follow-up, resulting in a pregnancy rate of 51.06%. Among them, 39 patients had pathological indications of endometritis, with 15 pregnancies during follow-up, leading to a pregnancy rate of 38.46%, which was significantly lower than the 60% pregnancy rate (33/55) observed in patients without endometritis (χ2 = 4.24, P = 0.04). Meanwhile, the pregnancy rate after doxycycline treatment in the double-positive group (CD38+ CD138+) was 35.29%, which was significantly lower than that in the CD38+ CD138- group at 67.57% and the CD38? CD138+ group at 52.17%. The differences were statistically significant (χ2=7.51, P=0.02). Conclusion The positivity of CD38 and CD138 is highly correlated with chronic endometritis (CE) in patients with IVF implantation failure, suggesting that CD38 and CD138 may serve as potential biomarkers for endometrial inflammation and pathological abnormalities. The pregnancy rate in patients with chronic endometritis is significantly lower than that of patients without chronic endometritis, indicating that CE may reduce the success rate of IVF-ET.Although doxycycline has some therapeutic effects for patients with endometritis, the pregnancy rates remain low. This suggests that antibiotic treatment may be insufficient to fully reverse the negative impact of endometritis on pregnancy outcomes, highlighting the need for more proactive and individualized treatment strategies to improve these outcomes.

Preliminary exploration of the application effect of AIoT based wearable devices for stroke walking in the rehabilitation training of ischemic stroke patients

wanglei — 2025/11/7 16:49:07

Objective: To analyze the application effect of stroke walking wearable devices based on artificial intelligence Internet of Things (AIoT) technology in the rehabilitation training of ischemic stroke patients. Method: This study used a prospective analysis method and a random number table to divide 100 ischemic stroke patients admitted to our hospital from January 2023 to December 2024 into a control group and an observation group, with 50 patients in each group. The control group patients received routine rehabilitation training from therapists, while the observation group used AIoT based stroke walking wearable devices for walking training in addition to routine rehabilitation training. Compare the Holden walking function grading, lower limb modified Ashworth muscle tone grading, lower limb Brunnstrom grading, joint range of motion, and gait between two groups of patients within 3 days before treatment and 1 month after treatment. Result: There was no significant difference (p>0.05) in Holden walking function grading, lower limb modified Ashworth muscle tone grading, lower limb Brunnstrom grading, joint range of motion, and gait between the two groups before treatment. After one month of treatment, Holden walking function grading, lower limb modified Ashworth muscle tone grading, lower limb Brunnstrom grading, joint range of motion, and gait between the two groups improved compared to before treatment, and the observation group was better than the control group, with significance (p<0.05). Conclusion: AIoT based walking wearable devices for stroke rehabilitation training can improve the walking condition, lower limb muscle tone, lower limb function, and joint mobility of patients with ischemic stroke to a certain extent.

The therapeutic effect research of anomoside B4 on androgenetic alopecia in mice

Chenxiate,,Gaoxiang,liuxiaoyan,Wangqinqin,Xiexiaoyun,Yangshilin,Yuanrenyikun — 2025/11/7 12:31:59

Objective To study the therapeutic effect and mechanism of Pulsatilla pulsatilla saponin B4 (Anemoside B4,B4) on androgen alopecia (Androgenetic alopecia, AGA) model mice. Methods 8 normal male C57BL/6 mice were taken as blank and fed normally without any treatment. Forty C57BL/6 male AGA model mice were randomly divided into model group, B4 solution low, medium and high treatment group, 5% minoxidil positive drug group, 8 mice in each group. The AGA alopecia model was maintained by applying testosterone (Testosterone, T) solution (10 mg/kg?d-1) on the neck and back of mice in model group and treatment groups. The model group was coated with 20% glycerol solution (0.2 mL, Bid). B4 solution low, medium and high treatment groups were given 5 mg/mL, 10 mg/mL and 20 mg/mL B4 solution (0.2 mL, Bid), respectively. The positive drug group was given 5% minoxidil tincture (0.1 mL, Bid) for 23 days. The changes of hair and skin hair follicles were observed. The serum levels of T, estradiol (Estradiol, E2) and type II-5 were determined The content of -α reductase (Type II 5-α reductase, 5AR2) and the ratio of T/E2, and the protein content of transforming growth factor-β1 (Transforming growth factor-β1, TGF-β1), tumor necrosis factor-α (Anti-tumor necrosis factor-α, TNF-α), interleukin-1β (Interleukin-1β, IL-1β), interleukin-6 (Interleukin-6, IL-6), malondialdehyde (Malondialdehyde, MDA) and superoxide dismutase (Superoxide dismutase, SOD) in the skin tissue of neck and back of mice. SOD activity value. Results After 23 days of administration, the number of hair follicles increased significantly (P < 0.001) and the volume of hair follicles increased. The contents of T (P < 0.01) and 5AR2 (P < 0.001) were significantly decreased, the content of E2 (P < 0.001) was significantly increased, and the ratio of T/E2 (P < 0.05) was decreased. The expression levels of inflammatory factors such as TGF-β1 (P < 0.01), TNF-α (P < 0.001), IL-6 (P < 0.001), IL-1β (P < 0.05) and oxidative factor MDA (P < 0.05) in the skin of mice were significantly decreased; The difference of SOD content was not sig nificant, but it tended to increase. Conclusion B4 may have therapeutic effects on AGA by regulating serum hormone balance and inhibiting scalp inflammation and oxidative stress Keywords Androgenic alopecia; Anemoside B4; Anti-inflammation; Anti-oxidation

Analysis of Maternal-Fetal Outcomes and Influencing Factors after Extracorporeal Circulation Cardiac Surgery during Pregnancy

2025/11/7 10:40:39

To study the maternal and fetal outcomes of patients undergoing CPB cardiac surgery during pregnancy and explore the factors influencing fetal death outcomes. Methods A retrospective analysis was conducted on 56 patients who underwent CPB cardiac surgery during pregnancy at Guangdong Provincial People's Hospital from 2010 to 2023. The patients were divided into two groups based on whether the fetus died after the cardiac surgery: the fetus survival group and the fetus death group.Results Among the 56 cases of surgeries, no maternal death occurred. However, 11 cases of fetal loss occurred. Comparing the clinical data of the two groups of patients (surviving and deceased), there were statistically significant differences in operation time, CPB time, intraoperative blood loss, perioperative blood transfusion, and perioperative use of atosiban (P < 0.05).Conclusions When performing CPB cardiac surgery during pregnancy, in order to reduce the fetal mortality rate, the operation time and CPB time should be shortened, intraoperative bleeding should be reduced, the probability of blood transfusion should be lowered, and the usage rate of atosiban should be increased.

High expression of IGF2BP1 affects paclitaxel resistance in ovarian cancer

CHEN Xiao-ying,,YU Yue — 2025/11/6 15:38:49

Objective: To investigate the impact of insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) overexpression on paclitaxel resistance in ovarian cancer cells. Methods: The correlation between IGF2BP1 expression levels and prognosis in ovarian cancer patients was analyzed using the Kaplan-Meier Plotter database. The ROC Plotter database examined the relationship between IGF2BP1 expression levels and paclitaxel resistance in ovarian cancer . Real-time quantitative PCR (RT-qPCR) was used to assess IGF2BP1 expression in ovarian cancer-sensitive cells and paclitaxel-resistant cells. IGF2BP1-overexpressing cell lines were established in paclitaxel-resistant ovarian cancer cells (SKOV3-R) by lentiviral transfection, and the CCK-8 assay evaluated the changes in paclitaxel resistance. Co-expression analysis of IGF2BP1 with ovarian cancer-related genes was conducted using the TCGA and CPTAC databases. Pathway enrichment analysis was performed on genes co-expressed with IGF2BP1 using the KOBAS database. Cell cycle changes were detected by flow cytometry. Western blotting was used to evaluate the impact of IGF2BP1 overexpression on the expression of cell cycle-related proteins in paclitaxel-resistant ovarian cancer cells. Results: Kaplan-Meier Plotter database analysis revealed that high IGF2BP1 expression was significantly associated with poor overall survival (OS) and progression-free survival (PFS) in ovarian cancer patients. ROC Plotter database analysis indicated that IGF2BP1 could serve as a potential predictive marker for paclitaxel resistance. RT-qPCR results showed that IGF2BP1 was significantly overexpressed in paclitaxel-resistant ovarian cancer cells, and overexpression of IGF2BP1 enhanced the resistance of ovarian cancer cells to paclitaxel. Co-expression analysis demonstrated a significant correlation between IGF2BP1 and several cell cycle regulatory factors at both mRNA and protein levels. Pathway enrichment analysis suggested that IGF2BP1 may regulate paclitaxel resistance in ovarian cancer through key pathways such as the cell cycle and p53 signaling. Western blot analysis revealed significant changes in cell cycle-regulatory proteins, such as GSK-3β, CDK7, and CCNA2, following IGF2BP1 overexpression in paclitaxel-resistant ovarian cancer cells. Conclusion: IGF2BP1 may promote paclitaxel resistance in ovarian cancer by upregulating cell cycle-related factors. Its overexpression is closely associated with poor prognosis in ovarian cancer patients.

Research Progress on pathological mechanisms and clinical application value of ocular motor abnormalities in Parkinson's disease

laijiongyao,moqi — 2025/11/6 10:31:08

Parkinson"s disease (PD) is a common neurodegenerative disorder with insidious onset, posing challenges for early diagnosis and treatment. Ocular motor abnormalities, as an important window reflecting central nervous system dysfunction, have shown promising application prospects in PD research. This review systematically summarizes the abnormal eye movement characteristics and potential pathological mechanisms in PD patients, and further explores their translational application value in key fields such as PD diagnosis and differential diagnosis, symptom assessment, and treatment response monitoring.

Research advances in the effects of general anesthesia drugs on brain development in infants and young children

jinhua,qinweifeng,shizhaoling,shiwenpu,sunxude, — 2025/11/6 10:30:06

With the widespread use of general anesthesia in infant and young child patients, the impact of general anesthesia drugs on developing brain function has become one of the primary and cutting-edge issues of public concern. Clinical population studies have shown that prolonged and repeated exposure to general anesthetic drugs in early life may lead to long-term cognitive and behavioral impairment in infants and young children, Some studies also indicate that the risk of learning disabilities, attention deficit disorders and other diseases significantly increases after long-term and multiple exposures to general anesthetic drugs. A large number of animal studies have demonstrated that neurotoxic mechanisms such as apoptosis, mitochondrial dysfunction and oxidative stress caused by early exposure to general anesthetic drugs are important reasons for long-term cognitive and behavioral impairment. By summarizing the current research results on the effects of general anesthesia drugs on brain development of infants and young children, we can promote the understanding of the potential neurotoxicity mechanisms, provide references for the application of general anesthesia drugs during the developmental period of infants and young children, and ensure their healthy development.

Research progress on the effect of exercise training on cardiac autonomic nerve function in type 2 diabetes mellitus

贾严严,徐少勇 — 2025/11/6 10:29:00

[Abstract] Cardiac autonomic neuropathy in diabetes is a common complication of type 2 diabetes mellitus, which seriously affects the quality of life and life span of patients. Exercise training, as an economical and effective intervention, has significant effects in preventing and delaying the progression of cardiac autonomic neuropathy, as well as improving cardiac autonomic nervous function. Exercise training can improve cardiac autonomic nervous system function by improving heart rate variability, activating baroreceptor reflexes, and enhancing post exercise heart rate recovery. This article summarized the research progress of the effect of exercise on cardiac autonomic nervous function in type 2 diabetes mellitus.

Efficacy of Xiaotong Anshen Formula in adjuvant treatment of gouty nephropathy with damp heat accumulation syndrome

lili — 2025/11/6 10:27:38

Objective To investigate the curative effect of modified Xiaotong Anshen Formula combined with Western medicine on dampness-heat accumulation syndrome of gouty nephropathy, and to analyze its influence on TCM syndrome score, renal function, blood uric acid related indexes, phosphatidylinositol 3 kinase (PI3K)/threonine kinase (AKT)/nuclear factor κB (NF-κB) pathway. Methods A total of 106 patients with gouty nephropathy admitted to our hospital from April 2021 to March 2024 were prospectively selected and assigned to a Western medicine group (conventional Western medicine treatment) and a combined group (modified Xiaotong Anshen Formula + conventional Western medicine treatment) by random number table method, with 53 cases in each group. The efficacy of the two groups were compared, as well as the TCM syndrome score and renal function index [urea nitrogen, blood creatinine, 24 h urinary protein quantitative (24 h-UTP), β2 microglobulin (β2-mg)], blood uric acid-related indicators (blood uric acid, erythrocyte sedimentation rate), and levels of proteins related to the PI3K/AKT/NF-κB pathway [phosphorylated PI3K (p-PI3K), phosphorylated AKT (p-AKT), phosphorylated NF-κB (p-NF-κB)] before and after treatment. The adverse reactions of the two groups were compared. Results The total effective rate in the combined group was higher than that in the Western medicine group (P<0.05); the TCM syndrome score in the combined group after treatment was lower than that in the Western medicine group (P<0.05); the levels of blood urea nitrogen, serum creatinine, 24 h-UTP, and β2-MG in the combined group after treatment were lower than those in the Western medicine group (P<0.05); the levels of blood uric acid and ESR in the combined group after treatment were lower than those in the Western medicine group (P<0.05); the levels of p-PI3K, p-AKT, and p-NF-κB in the combined group after treatment were lower than those in the Western medicine group (P<0.05); there was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion The combination of modified Xiaotong Anshen Formula and Western medicine has a definite therapeutic effect on gouty nephropathy, improving clinical symptoms, blood uric acid-related indicators, promoting renal function recovery, and ameliorating the PI3K/AKT/NF-κB pathway, with good safety.

Association Between Epstein-Barr Virus Infection and Severity of Connective Tissue Disease-Associated Interstitial Lung Disease with Immune Imbalance

MA, — 2025/11/6 10:25:19

Objective To investigate the impact of Epstein-Barr virus (EBV) infection-mediated immune imbalance on the pathogenesis of connective tissue disease-associated interstitial lung disease (CTD-ILD). Methods A cohort of 63 CTD-ILD patients, 45 CTD-alone patients, and 45 healthy controls enrolled at Xiangyang Central Hospital (September 2023-January 2025) were studied. Peripheral blood EBV-DNA load was quantified by real-time PCR. T lymphocyte subsets (CD4+, CD8+ proportions, CD4+/CD8+ ratio) were analyzed via flow cytometry. Serum Th1/Th2 cytokines (IFN-γ, IL-4) were measured by ELISA. CTD-ILD patients were stratified into EBV(+) and EBV(-) groups based on EBV-DNA load. Pulmonary function (FVC%, DLCO%), high-resolution CT (HRCT) scores, and immune parameters were compared between subgroups. Pearson correlation analyzed variable associations. Results The EBV infection rate was significantly higher in the CTD-ILD group compared to the CTD group and the healthy control group (all P < 0.05). This was accompanied by decreased CD4+ levels, decreased CD4+/CD8+ ratio, and increased IL-4 levels. Among CTD-ILD patients, the EBV positivity rate in the immunosuppressant user group (35.7%) showed no statistically significant difference compared to the non-user group (33.3%). However, the EBV(+) group had significantly worse pulmonary function indices (FVC%, DLCO%) (P < 0.001) and significantly higher HRCT scores (P < 0.001) compared to the EBV(-) group. Correlation analysis revealed that CD4+/CD8+ ratio and IFN-γ levels were positively correlated with FVC% and DLCO% (r=0.557, r=0.543; r=0.518, r=0.405, respectively) and negatively correlated with HRCT score (r=-0.578; r=-0.416, respectively). Conclusion EBV infection is significantly associated with CTD-ILD severity (reduced lung function, elevated HRCT scores). This may involve Th1/Th2 polarization shift (increased IL-4, decreased IFN-γ) and CD4+/CD8+ ratio imbalance, collectively promoting CTD-ILD progression.

Effect of nursing of syndrome elements based on the integration theory of health behavior change on patients with gastrointestinal dysfunction in acute pancreatitis

C,W,,X — 2025/11/5 10:53:45

Objective To explore the influence of the nursing system of syndrome elements based on the integration theory of healthy behavior change on patients with gastrointestinal dysfunction in acute pancreatitis. Methods 120 patients with gastrointestinal dysfunction of acute pancreatitis who were treated in our hospital from June 2022 to March 2024 were selected as the research object. 58 patients who took routine nursing intervention measures before August 2023 were included in the routine nursing group, and 62 patients who took the syndrome elements nursing system based on the integration theory of health behavior change in August 2023 were included in the improved nursing group. The clinical indicators, gastrointestinal hormone levels, disease cognition, self-management and quality of life of the two groups were compared. Results The recovery time of bowel sounds, the relief time of abdominal pain, the first time of anal exhaust and the first time of spontaneous defecation in the improved intervention group were lower than those in the conventional intervention group (P<0.05).After 2 weeks of intervention, the levels of D- lactic acid and DAO in the improved nursing group were lower than those in the routine intervention group, while the levels of MTL and GAS were higher than those in the routine intervention group (P < 0.05). After 2 weeks of intervention, the BIPQ score of the improved nursing group was lower than that of the routine intervention group, and the scores of ESCA and SF-36 were higher than that of the routine intervention group (P<0.05). Conclusion The nursing system of syndrome elements based on the integration theory of health behavior change can quickly improve the gastrointestinal function of patients with gastrointestinal dysfunction in acute pancreatitis, reduce the level of gastrointestinal hormones, enhance patients" cognitive ability and self-management ability, and improve their quality of life.

Reflection on the experience of misdiagnosis of a nasopharyngeal carcinoma patient presenting with paralytic strabismus

zouxi — 2025/11/5 10:14:03

This article reported a case of paralytic esotropia caused by nasopharyngeal carcinoma. Patient, female, 41 years old. The patient sought medical attention due to diplopia for one month. Eye specialist examination shows insufficient left eye abduction. Head CT scan showed a soft tissue mass at the top of the nasopharynx and left posterior part of the nasal cavity. Head MRI showed a lacunar ischemic lesion in the white matter area of the left frontal lobe and changes in left mastoiditis. Blood examination showed anti cytomegalovirus antibodies and EB virus antibodies are strongly positive. Inquiring about medical history, the patient complained of nasal congestion and runny nose for over six months. Therefore, patients was advised to further consult the rhinolaryngology departmen. After an appointment for electronic nasopharyngoscopy examination, the pathological diagnosis was nasopharyngeal carcinoma through examination and biopsy. After diagnosis, the patient belongs to T2N0M0 stage.

A case of Ohtahara syndrome caused by DMXL2 Gene Mutation

KangXi — 2025/11/4 15:56:22

This paper reports a case of Ohtahara syndrome caused by DMXL2 gene insertion-deletion mutation.

Analysis of Complications and Their Risk Factors After Tubeless Thymoma Resection: A Retrospective Study Based on 80 Cases

XU YI — 2025/10/17 16:54:36

Objective: To investigate the incidence of postoperative complications and identify independent risk factors following tubeless thymoma resection, thereby providing evidence for optimizing perioperative management. Methods: A retrospective analysis was conducted of 80 patients who underwent tubeless thymoma resection at Nanxishan Hospital of Guangxi Zhuang Autonomous Region between January 2021 and July 2025. Demographic characteristics, surgical parameters, and postoperative complications were collected. Potential risk factors were first screened by univariate analysis and subsequently included in a multivariate logistic regression model to determine independent predictors. Results: The overall incidence of postoperative complications was 13.75% (11/80). The most common complications were arrhythmia (6.25%) and incision fat liquefaction (3.75%). Univariate analysis revealed that tumor size, Masaoka–Koga stage, myasthenia gravis, surgical approach, and operative time were significantly associated with postoperative complications (P<0.05). Multivariate logistic regression identified larger tumor size, thoracoscopic approach, concomitant myasthenia gravis, and prolonged operative time as independent risk factors for complications. Conclusion: Tubeless thymoma resection is generally safe and feasible; however, patients with larger tumors, thoracoscopic procedures, concomitant myasthenia gravis, or longer operative time are at higher risk of postoperative complications. Enhanced preoperative assessment and perioperative management should be emphasized in these high-risk patients to reduce complication rates.

Diagnosis and Management of Pre-Myasthenic Crisis Following Thymectomy with Phrenic Nerve Resection: A Case Report

feng yong,qin xue,,song shi yuan,wang lin lin — 2025/10/17 16:11:53

This article reports a case of diagnosis and management of pre-myasthenic crisis following thymectomy with phrenic nerve resection.

Exploration of salvage thymectomy during myasthenia gravis crisis period under specific conditions

Liu Yangchun,, — 2025/10/17 15:42:37

[Abstract] Objective To evaluate the feasibility and safety of extended thymectomy as a salvage procedure during myasthenic crisis (MC) under specific clinical conditions, and to explore the potential mechanisms for shortening the crisis course.Methods A retrospective review was conducted of 12 patients who underwent salvage extended thymectomy during MC in the Department of Thoracic Surgery at our hospital from November 2016 to May 2024. There were 5 males and 7 females, all classified as modified Osserman type III, with positive acetylcholine receptor antibodies. Baseline treatment included pyridostigmine and prednisone, combined with adjunctive therapies such as plasma exchange and intravenous immunoglobulin. Preoperative respiratory support consisted of noninvasive ventilation in 1 case and invasive mechanical ventilation in 11 cases, including 3 with tracheostomy (2 cases with preoperative ventilation for 22 and 44 days, and postoperative ventilation for 15 and 35 days, respectively).Results All 12 patients successfully underwent extended thymectomy during MC. Postoperative complications included 1 case of recurrent laryngeal nerve injury complicated by aspiration pneumonia, resulting in respiratory failure and death, and 1 case of tracheal tube obstruction leading to cardiac arrest; despite resuscitation, this patient developed hypoxic encephalopathy and treatment was withdrawn by the family. The remaining 10 patients were discharged safely, and all achieved myasthenia gravis remission at 6-month follow-up.Conclusions When performed under conditions with a dedicated thoracic surgery ICU, multidisciplinary collaboration, and extensive MC management experience, extended thymectomy during MC can be considered a salvage therapeutic option with certain feasibility, though surgical risks remain.

Thymectomy as a Treatment for Myasthenia Gravis: A Review of Recent Advances

kaung zhenyu,,luliqing,,,zhuquan — 2025/10/16 8:45:36

Abstract： Myasthenia Gravis (MG) is an autoimmune disease mediated by thymic abnormalities. Thymectomy stands as a core treatment, and its clinical value has been confirmed by landmark studies like the MGTX trial. It significantly improves clinical outcomes for patients with AChR-Ab-positive generalized MG, reduces reliance on immunosuppressants, and increases long-term remission rates. With advancements in minimally invasive techniques such as thoracoscopy and robotic surgery, the procedure has entered a new era of being safer and promoting faster recovery, now widely accepted as the standard of care. Early thymectomy is now the consensus recommendation for patients with early-onset, AChR-Ab-positive generalized MG. However, its application in special populations—including those with ocular MG, MuSK-Ab-positive MG, as well as late-onset/elderly and juvenile patients—remains controversial and requires individualized assessment. The future direction lies in establishing precision decision-making models based on patient subtypes and biomarkers, and conducting large-scale studies to define its precise role across different MG subtypes. This will optimize surgical timing and patient selection to achieve personalized treatment.

Comparison of Efficacy Between Subxiphoid and Lateral Thoracic Approaches for Da Vinci Robotic-Assisted Thoracoscopic Surgery in Treating Anterior Mediastinal Tumors

周一凡 — 2025/10/16 8:44:24

Objective: To compare the surgical efficacy of Da Vinci Robot-Assisted Thoracoscopic Surgery (RATS) via the subxiphoid approach versus the lateral thoracic approach for treating anterior mediastinal tumors. Methods: A retrospective analysis was conducted on 50 patients who underwent RATS for anterior mediastinal tumor resection at Guangxi Zhuang Autonomous Region People’s Hospital from July 2021 to June 2025. Patients were divided into the subxiphoid group (n=30) and the lateral thoracic group (n=20). Perioperative outcomes were compared between groups. Results: All surgeries were successfully completed. Compared with the subxiphoid group, the lateral thoracic group had significantly shorter operative time, less intraoperative blood loss, and shorter chest tube duration (P<0.05). No significant differences were observed in 48-hour postoperative drainage volume, pain scores within 3 days, C-reactive protein levels, or white blood cell counts (P>0.05). Postoperative hospital stay was shorter in the lateral thoracic group (P<0.05), while total hospitalization costs showed no significant difference (P>0.05). Conclusion: For Da Vinci RATS resection of anterior mediastinal tumors, RATS via the lateral thoracic approach offers advantages over the subxiphoid approach by reducing operative time, blood loss, chest tube duration, and hospital stay.

Title: Initial Experience with Postoperative Hyperthermic Intrathoracic Perfusion in Stage III/IV Thymoma: A Safety and Short-Term Efficacy Analysis of 17 Cases

2025/10/15 8:17:53

Abstract Objective: To evaluate the safety and short-term efficacy of hyperthermic intrathoracic perfusion (HIPEC) combined with maximal cytoreductive surgery in patients with stage III or IV thymoma, following resection of all macroscopic intrathoracic metastatic lesions. Methods: A retrospective analysis was conducted on 17 patients with stage III/IV thymoma treated at our institution between June 2022 and July 2025. All patients underwent maximal cytoreductive surgery (resection of all macroscopically visible intrathoracic lesions), followed immediately by HIPEC (46-48°C normal saline, 60 minutes per session, once daily, for 3-5 sessions). Perioperative complications, adverse events, recurrence patterns, and survival outcomes were recorded. Follow-up ranged from 1 to 38 months. Results: Sixteen patients successfully completed 3-5 sessions of HIPEC. One patient underwent only the intraoperative HIPEC session and declined further postoperative sessions due to significant discomfort. Regarding safety: No treatment-related deaths or severe adverse events occurred. The primary adverse event was mild chest tightness/discomfort during treatment (10/16, 62.5%). No significant cardiac, pulmonary, hepatic toxicity, HIPEC-related hemorrhage, infection, or anastomotic leaks were observed. Regarding efficacy: Given the relatively short follow-up period (maximum ~3 years, mostly <1 year), overall survival (OS) and progression-free survival (PFS) data are immature. The current OS rate is 100%, and the PFS rate is 88.2%. By August 2025, two patients (12.5%) experienced intrathoracic seeding recurrence, both with stage IVA disease. Conclusion: For patients with stage III/IV thymoma, HIPEC following maximal cytoreductive surgery is a potentially valuable treatment approach with a favorable safety profile, low complication rates, and manageable adverse events. However, due to the limited sample size and medium-term follow-up (≤4 years), its efficacy in delaying recurrence or improving long-term survival remains uncertain. Larger studies with longer follow-up are needed for validation. HIPEC, as a locoregional control modality, demonstrates significant research potential and value in suppressing intrathoracic seeding metastasis of thymoma, warranting further investigation.

Chinese Expert Consensus on the Diagnosis and Treatment of Chylous Ascites After Lymphadenectomy for Gynecological Malignancies (2025)

FanJiangtao,ShenYang,WangJiandong,WangYingmei,ZhangShiqian,ZhangShiyu,ZhangYi — 2025/10/13 17:25:39

Chylous ascites is a rare but serious complication after lymph node resection for gynecological malignancies. Its occurrence is closely related to high-level para-aortic lymph node resection, laparoscopic operation, and perioperative malnutrition. The clinical diagnosis should be based on criteria such as chylous drainage (≥200 mL/d) with a triglyceride (TG) level exceeding 200 mg/dL. A stepwise therapeutic approach is recommended: conservative management (dietary modification combined with pharmacological therapy) as the first-line treatment, followed by lymphangiography ± embolization for refractory cases, and surgical ligation or lymphovenous anastomosis for persistent leaks. Emphasis is placed on prevention through comprehensive measures such as meticulous intraoperative operation, application of biological agents, and delayed extubation after surgery. The development of this consensus provides an evidence-based foundation for the standardized clinical management of chylous leakage following lymph node dissection in gynecologic malignancies.

Research on the Impact of Integrated Neuromuscular Training on the Surface Electromyogram of the Lower Limbs, Serum GABA, NSE, and Glu in Patients with Spastic Hemiplegia of the Lower Limbs after Stroke

荆兴泉 — 2025/10/11 17:36:55

Objective: To explore the impact of integrated neuromuscular training on the surface electromyogram of the lower limbs, and the levels of serum gamma-aminobutyric acid (GABA), neuron-specific enolase (NSE), and glutamic acid (Glu) in patients with spastic hemiplegia of the lower limbs after stroke. Methods: A total of 100 patients diagnosed with spastic hemiplegia of the lower limbs after stroke from January 2021 to December 2024 were selected as the research subjects. According to the random number table method, they were divided into a control group (n=50) and a study group (n=50). Patients in the control group received conventional rehabilitation treatment, while those in the study group underwent integrated neuromuscular training. Before and after treatment, the root mean square (RMS), integrated electromyography (iEMG), median frequency (MF), and mean power frequency (MPF) were collected using a surface electromyography instrument. The National Institute of Health Stroke Scale (NIHSS) was used to assess the severity of neurological deficits in patients, the Clinic Spasticity Index (CSI) was used to evaluate the degree of limb spasticity in patients after stroke, the 10-Meter Walk Test (10MWT) was used to assess the lower limb motor function and walking ability of patients, the Berg Balance Scale (BBS) was used to evaluate the balance function of patients, and the Fugl-Meyer Assessment (FMA) was used to assess the limb motor function of patients. The Functional Independence Measure (FIM) was used to evaluate patients' activities of daily living and their dependence on the help of others, the Modified Barthel Index (MBI) was used to assess patients' activities of daily living, and the Hospital Anxiety and Depression Scale (HADS) was used to evaluate patients' anxiety and depression emotional states. ELISA was used to detect the levels of GABA, NSE, and Glu. Results: Before treatment, there were no differences in general information, electromyogram indicators (RMS, iEMG, MF, MPF), neurological function and lower limb motor function (NIHSS score, CSI score, 10MWT, BBS score, FMA score), psychological state and quality of life (FIM score, MBI score, HADS score), as well as the levels of GABA, NSE, and Glu between the two groups. After treatment, the total effective rate of treatment in the study group (96.00%) was higher than that in the control group (82.00%) (P<0.05). After treatment, the NIHSS score, CSI score, 10MWT, HADS score, RMS, and GABA level decreased, and the decrease in the study group was more significant (P<0.05). After treatment, the BBS score, FMA score, FIM score, MBI score, iEMG, MF, MPF, and the levels of NSE and Glu all increased, and the increase in the study group was more significant (P<0.05). Conclusion: After integrated neuromuscular training for patients with spastic hemiplegia of the lower limbs after stroke, the data of the surface electromyogram of the lower limbs and the levels of serum GABA, NSE, and Glu tend to be normal, which can effectively improve patients' neurological function, lower limb motor function, and psychological state, providing effective support for clinical treatment.

Exploration of the Mechanisms of the CO External Fixation Technique Promotes Fracture Healing Based on Traditional Chinese OrthopedicsLIU Fei₁^{LI Xiaomin}₁^{LI Rui}₁^{DAI Junze}₁^{CHENG Yongzhong}₁^{WANG Chaolu}_¹

刘飞, — 2025/10/11 16:51:57

The CO external fixation technique represents an innovative development based on traditional Chinese orthopedics, demonstrating excellent clinical efficacy in the treatment of limb fractures and aligning with the biomechanical principles of fracture healing. However, the molecular biological mechanisms by which CO external fixation promotes fracture healing remain unclear. This paper explores the underlying traditional Chinese medicine theories and biomechanical principles of the CO external fixation technique, investigating its mechanisms in promoting the osteogenic differentiation of mesenchymal stem cells and the vascularization of endothelial progenitor cells. Additionally, it summarizes the potential signaling pathways involved, providing new insights for the scientific approach to traditional Chinese treatment of fractures and experimental research on CO external fixation.

Long Non-coding RNA SNHG16 Regulates Radiation Resistance in Breast Cancer by Binding to STAU1 Protein and Inhibiting PRKN mRNA Stability

Rui Zhong — 2025/10/11 11:02:24

Objective Treatment failure due to tumor radioresistance is one of the major causes of breast cancer mortality. This study reveals the regulation of breast cancer radiation by the key molecule SNHG16 through metabolic pathways, which has translational medicine and scientific significance for the development of corresponding therapeutic intervention targets for breast cancer. Methods The expression of SNHG16 in breast cancer tissues and cells was analysed by TCGA database and RT-qPCR. MDA-MB-231 and MCF-7 cells with high SNHG16 expression were selected for transfection and divided into NC group and si-SNHG16 group. Logarithmic growth phase cells were taken after transfection for 48 h. Cell proliferation was detected by CCK8, apoptosis was detected by flow cytometry, cell invasion was detected by Transwell assay, cell radiosensitivity was responded to by CCK8 assay, and glucose uptake was determined by Glucose Uptake Colourimetric Assay Kit, and RIP-binding mRNA degradation and stability assay experiments were used to validate the SNHG16/SNHG16/ SNHG16/STAU1/PRKN modification. Animal experiments were performed to verify the effect of SNHG16 on radioresistance. Results SNHG16 was highly expressed in breast cancer tissues and cells, and knockdown of SNHG16 reversed the proliferation, apoptosis, invasion and radioresistance of breast cancer cells; at the same time, knockdown of SNHG16 could inhibit the reprogramming of glucose metabolism in breast cancer, and RIP experiments confirmed that there was an interaction between STAU1 and PRKN mRNA, whereas knockdown of SNHG16 attenuated the interaction relationship, and knockdown of SNHG16 attenuated this interaction, and knockdown of STAU1 also increased the stability of PRKN mRNA. In vivo results also showed that knockdown of SNHG16 reversed radioresistance. Conclusion SNHG16, which is highly expressed in breast cancer cells, binds to STAU1 and inhibits the stability and expression of PRKN mRNA via a post-transcriptional modification pathway, which in turn affects glycometabolic reprogramming and ultimately promotes radioresistance in breast cancer.

90% effective dose of midazolam oral mucosal administration for sedation in infants weighing less than 5kg for head MRI examination: A biased-coin design up-and-down sequential allocation trial

Lan Jiangli,, — 2025/10/9 17:31:26

Objective To investigate the 90% effective dose of midazolam oral mucosal administration for sedation for head MRI in infants <5 kg. Methods? A prospective sequential study based on the biased coin design up-and-down sequential method (BCD-UDM) was conducted sequentially in infants <5 kg under sedation for head MRI. The dose of midazolam oral mucosal application was 0.15 mg kg-1 in the first case, and the dose of midazolam oral mucosal application in subsequent cases was determined by the sedation examination of the previous case; if the previous case failed to be sedated, the dose of midazolam used in that child was increased by one unit (0.05 mg kg-1); if the previous case succeeded in being sedated, the dose of midazolam used in that child was subjected to a biased the dose of midazolam used in the previous case was randomized by coin, with the dose remaining unchanged or decreasing by one unit of dose until the 45 cases were successfully sedated, and the 90% effective dose (ED90) and its 95% confidence interval (CI), the extrapolated 95% effective dose (ED95) and its 95% CI, and the 99% effective dose ( ED99) and its 95% CI. Results? Fifty-three children were included, of whom 45 were successfully sedated and 8 were unsuccessfully sedated, with an ED90 of 0.295 mg kg-1 with a 95% CI of 0.236-0.335 mg kg-1, an ED95 of 0.325 mg kg-1 with a 95% CI of 0.289-0.345 mg kg-1 and an ED99 of 0.347 mg kg-1 with a 95% CI 0.340-0.364 mg kg-1. Conclusion? The ED90 for oral mucosal administration of midazolam for sedation for cranial MRI in infants less than 5 kg was 0.295 mg kg-1.

A Qualitative Study on the Influencing Factors of Kinesiophobia in Patients after Kidney Transplantation

liao haiying,tonghongyan,,xu xiaosong,yangqing,zhan qinglin — 2025/10/9 17:00:17

ObjectiveTo deeply explore the influencing factors of kinesiophobia in patients after kidney transplantation, providing a reference for the exercise rehabilitation intervention of this group.MethodsThrough purposive sampling, 15 patients with kinesiophobia after kidney transplantation who were hospitalized in a tertiary hospital in Chongqing from November 2024 to January 2025 were selected. A descriptive qualitative research method was used for semi - structured interviews, and the content analysis method was adopted to analyze, summarize, and refine themes from the interview data. ResultsA total of 2 major themes, namely individual internal factors and external system factors, and 8 sub - themes were refined.Conclusion

Constructing a column chart model for predicting postoperative delirium in esophageal cancer resection patients based on plasma total cholesterol levels

gao shengrun, — 2025/10/9 10:45:32

Objective: Based on preoperative plasma total cholesterol levels in non hyperlipidemic patients, this study aims to explore the risk factors for postoperative delirium (POD) in esophageal cancer resection patients, construct a predictive model, develop targeted plans, early intervention and prevention, and improve the quality of life of patients. Method: A retrospective collection was conducted on the perioperative electronic medical records of 187 patients who underwent esophagectomy at the PLA 960 Hospital from January 2022 to December 2023, with complete records of postoperative delirium treatment. According to the occurrence of postoperative delirium within one week, they were divided into delirium group and non delirium group. Univariate analysis of baseline data between two groups; Determine the independent risk factors for POD in esophageal cancer resection patients through multi factor logistics analysis and construct a column chart model. Draw the working characteristic curve of the subjects and calculate the area under the curve and 95% confidence interval to test the predictive performance of the model. The delirium group had lower levels of plasma total cholesterol and low-density lipoprotein compared to the non delirium group, longer anesthesia time, and coronary heart disease as a risk factor. Dexmedetomidine can reduce the occurrence of postoperative delirium. Low plasma total cholesterol levels and intraoperative blood pressure are independent risk factors, while dexmedetomidine is a protective factor. Based on this, a column chart model was constructed to predict the ROC curve area, 95% confidence interval, sensitivity, and specificity of POD, which were 0.900, 0.831-0.969, 75%, and 93.9%, respectively. Conclusion: In non hyperlipidemic patients, preoperative low cholesterol levels and intraoperative hypotension are independent risk factors for delirium after esophageal cancer resection, while dexmedetomidine is a protective factor. The column chart model constructed based on this has good predictive value for POD.

Analysis of the efficacy of family rehabilitation combined with cognitive training and neurodevelopmental therapy in the treatment of infants with global developmental delay

li lie wang — 2025/9/30 18:20:23

Objective: To explore the efficacy of cognitive training combined with neurodevelopmental therapy family rehabilitation in improving the development of infants with global developmental delay. Methods: A total of 50 children with global developmental delay diagnosed and treated in the Children"s Rehabilitation Treatment Department of the People"s Hospital of Guangxi Zhuang Autonomous Region were selected and randomly divided into a control group and an observation group of 25 cases each. The control group received neurodevelopmental therapy, and the observation group received cognitive training on the basis of the control group.Evaluate the children"s developmental quotient levels before and after treatment and compare the intervention effects. Results: The developmental quotient of the two groups of children after 3 months of treatment was significantly higher than that of 1 month of treatment and before treatment, and the difference was statistically significant (P<0.05); the developmental quotient of the two groups of children after 1 month of treatment was significantly higher than that before treatment, and the difference was statistically significant (P<0.05). After 3 months of treatment, the development quotients of each energy area in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). Conclusion: Cognitive training combined with neurodevelopmental therapy and family rehabilitation can effectively improve the development level of infants with global developmental delay.

Analysis of clinical phenotype and gene variation in 21 cases of neonatal convulsionCUI Qing-yang₁^,ZHAO Hai-ai₁^, WANG Wei-wei_¹,LI Zhen-zhen_¹,SHANG Yun,₁^SUN Ya-zhou,₁HUANG Shui-xia_²

cuiqingyang,huangshuixia,lizhenzhen,shangyun,sunyazhou,wangweiwei,zhaohaihai — 2025/9/30 18:19:05

Objective To study the clinical features and gene variation of unexplained neonatal convulsion. Methods From September 2018 to October 2024, neonatal children admitted to the Department of Neonatology of the First Affiliated Hospital of Xinxiang Medical College and the Department of Neonatology of Luoyang Maternal and Child Health Hospital with clinical diagnosis of neonatal convulsion but unknown causes were retrospectively analyzed. Blood tandem mass spectrometry, urine gas chromatography-mass spectrometry and whole exon gene detection results were collected. The clinical outcomes of discharged children were followed up. Results A total of 21 cases were included, including 7 males and 14 females, all of whom were diagnosed with convulsion as the first symptom. There were no abnormalities in blood tandem mass spectrometry and urine gas chromatography-mass spectrometry in 21 cases. There were 7 benign familial neonatal convulsions caused by KCNQ2, KCNQ3 and SCN2A gene variants, 12 developmental and epileptic encephalopathy caused by KCNA2, KCNQ2, CNPY3 and ATP6V1A gene variants, and 2 lost to follow-up. Seven patients died, ranging from 10 days to 5 months after birth, all of whom were children with developmental epileptic encephalopathy. Conclusion Gene detection is helpful to judge the prognosis of neonatal convulsion, and found that CNPY3 and ATP6V1A gene variation caused development and epileptic encephalopathy, which enriched the gene spectrum of development and epileptic encephalopathy.

Factors Influencing Poor Outcomes and Risk Quantification in Acute Hypoxemic Respiratory Failure Patients Receiving Venturi Mask Oxygen Therapy

江龙 — 2025/9/30 18:17:53

Objective: This study aims to identify factors associated with poor outcomes in patients with acute hypoxemic respiratory failure (AHRF) undergoing Venturi mask oxygen therapy and to develop a risk quantification nomogram model. Methods: 203 AHRF patients admitted to Anqing Traditional Chinese Medicine Hospital from November 2021 to April 2024 were selected. Based on their clinical outcomes, patients were categorized into a poor outcome group and a good outcome group. Demographic and clinical data were compared between the groups, and a logistic regression model was used to identify independent predictors of poor outcomes. A regression equation and a risk quantification nomogram model were then established. The model’s predictive performance was assessed internally using a receiver operating characteristic (ROC) curve, while calibration and decision curves evaluated its calibration accuracy and clinical utility. Results: Among the 203 patients, the poor outcome rate was 28.08%. Logistic regression analysis identified age (OR=1.754, 95% CI: 1.040~2.958), fever (OR=2.274, 95% CI: 1.170~4.419), sepsis (OR=1.635, 95% CI: 1.093~2.446), and the APACHE II score (OR=2.373, 95% CI: 1.535~3.669) as risk factors for poor outcomes in AHRF patients receiving Venturi mask oxygen therapy (P<0.05). Conversely, the ROX index after 1 hour of treatment (OR=0.556, 95% CI: 0.364~0.849) was found to be a protective factor (P<0.05). Based on these independent factors, we established a Logistic regression equation: Y=?16.076+0.562X1+0.822X2+0.492X3+0.864X4?0.587X5, and constructed a risk quantification nomogram model. The ROC analysis revealed that the model’s area under the curve (AUC) for predicting poor outcomes was 0.925 (95% CI: 0.880~0.957, Z=22.892, P<0.001), with a sensitivity of 92.98% and a specificity of 85.62%. The Hosmer-Lemeshow test showed no significant difference between predicted and actual probabilities (χ2=0.859, P=0.354). Decision curve analysis demonstrated clinical net benefit within a risk threshold range of 0.05~0.81. Conclusion: Advanced age, fever, sepsis, and a high APACHE II score are risk factors for poor outcomes in AHRF patients receiving Venturi mask oxygen therapy, whereas a higher ROX index after 1 hour of treatment serves as a protective factor. The developed risk quantification nomogram model exhibits robust clinical efficacy.

Study on the application of time-lapse imaging technology to monitor embryonic direct cleavage and its occurrence period in the assessment of developmental potentiall

2025/9/30 18:16:48

Objective? To explore the effects of direct cleavage and its different occurrence periods on embryonic developmental potential and pregnancy outcomes. Methods A retrospective analysis was conducted on 601 in vitro fertilization treatment cycles monitored by time-lapse imaging technology. The embryos were first divided into a normal cleavage group and a direct cleavage group according to the embryo cleavage pattern. The subgroups were then divided according to the different periods of direct cleavage. The developmental potential and clinical pregnancy outcomes of the embryos in different groups were compared. Results Compared with the normal cleavage group, the D3 high-quality embryo rate, D6 blastocyst formation rate, D6 high-quality blastocyst formation rate and D6 freezeable blastocyst formation rate in the direct cleavage group were significantly decreased (P<0.05); The D6 high-quality blastocyst formation rate and freezable blastocyst formation rate in the DC1 group, DC2 group and DC3 group were significantly lower than those in the normal cleavage group (P<0.05); compared with the DC2 group and DC3 group, the D3 high-quality embryo rate, D6 blastocyst formation rate, D6 high-quality blastocyst formation rate and D6 freezeable blastocyst formation rate in the DC1 group were significantly decreased (P<0.05); the biochemical pregnancy rate, clinical pregnancy rate, implantation rate and live birth rate of the normal cleavage transplantation group were significantly higher than those of the DC1 transplantation group and DC2/3 transplantation group (P<0.05). Conclusion Direct cleavage significantly reduces the developmental potential of embryos. The earlier the direct cleavage occurs, the more serious the negative impact on embryonic development. Time-lapse imaging technology to monitor embryonic direct cleavage is a valuable indicator for embryo selection and developmental potential assessment.

Diagnostic Value of Ultra-High b-Value ADC Image Analysis Combined with PSAd for Lesions in the Central Gland Region of the Prostate with PI-RADS Scores of 3-5

Yefei — 2025/9/30 18:15:06

Abstract: Objective: To evaluate the diagnostic value of combined ultra-high b-value DWI parameters (ADCmin, ADCmean, RD) and prostate-specific antigen density (PSAd) in differentiating PI-RADS 3-5 central gland prostate cancer (CGPCa) from benign prostatic hyperplasia (BPH). Methods: A retrospective analysis was conducted on PSA and imaging data from 54 CGPCa patients and 52 BPH patients. Differences in ADCmin, ADCmean, RD, and PSAd were compared. A logistic regression combined model was constructed, and ROC curves were used to assess diagnostic performance. Results: The ADCmin and ADCmean values in the CGPCa group were significantly lower than those in the BPH group, while RD and PSAd were significantly higher (P<0.01). Among single parameters, the AUCs (95% confidence intervals) for ADCmin, ADCmean, RD, PSA, and PSAd in individual diagnosis were 0.864 (0.791-0.936), 0.827 (0.747-0.906), 0.874 (0.806-0.941), 0.790 (0.703-0.877), and 0.851 (0.775-0.928), respectively. The combined model of ADCmin+RD+PSAd achieved an AUC of 0.918 (0.866-0.970), significantly higher than any single parameter (DeLong test, P<0.05).Conclusion: The combined diagnostic model of ADCmin+RD+ PSAd demonstrates significant advantages in differentiating CGPCa from BPH.It can significantly enhance diagnostic performance for lesions in the central gland area of the prostate, which is challenging in clinical practice, providing a novel imaging evaluation strategy for accurately differentiating CGPCa from BPH.

Predictive gain value and significance of PLR and GMP-140 in predicting intra-abdominal rebleeding after after thoracotomy for emergency thoracoabdominal injuries

wudinghua — 2025/9/30 18:13:38

Objective To explore the predictive value and significance of platelet-lymphocyte ratio (PLR) and platelet alpha-granule membrane protein-140 (GMP-140) in predicting intra-abdominal rebleeding after thoracotomy for emergency thoracoabdominal injuries. Methods A total of 205 patients with emergency thoracotomy for thoracoabdominal injuries admitted to our hospital from September 2021 to June 2023 were selected. The patients were divided into a rebleeding group and a non-rebleeding group based on the intra-abdominal rebleeding after thoracotomy. The clinical data and preoperative PLR and GMP-140 levels of the two groups were compared, and the factors affecting postoperative intra-abdominal rebleeding were analyzed using multivariate logistic regression analysis. The correlation between PLR, GMP-140, and postoperative intra-abdominal rebleeding was analyzed using smooth fitting curve analysis. The receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive value of traditional schemes [injury severity score (ISS score), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB)] and new schemes (PLR, GMP-140) for predicting postoperative intra-abdominal rebleeding. Results The ISS score, PT, APTT, and FIB in the rebleeding group were higher than those in the non-rebleeding group (P<0.05); the PLR and GMP-140 levels in the rebleeding group were significantly higher than those in the non-rebleeding group before surgery, and the differences were statistically significant (P<0.05); Multivariate Logistic regression analysis showed that ISS score, PT, APTT, FIB, PLR, and GMP-140 were all related factors affecting postoperative intra-abdominal rebleeding (P<0.05); Smooth fitting curve analysis showed that after correcting for ISS score, PT, APTT, FIB, and D-D, PLR and GMP-140 still had a positive linear correlation with postoperative intra-abdominal rebleeding (P trend <0.05, P nonlinear >0.05); ROC analysis showed that the AUCs of traditional ISS score, PT, APTT, FIB, and their combination for predicting postoperative intra-abdominal rebleeding were 0.728, 0.714, 0.733, 0.722, and 0.826, respectively (P<0.05); the AUCs of PLR, GMP-140, and their combined prediction of postoperative intra-abdominal rebleeding were 0.729, 0.761, 0.851, and 0.923, respectively (P<0.05); the AUC of traditional combination was significantly greater than that of ISS score, PT, APTT, and FIB (Z=2.159, 2.405, 2.025, 2.293, P=0.031, 0.016, 0.043, 0.022); the AUC of the new combination was significantly greater than that of PLR and GMP-140 (Z=2.037, 2.135, P=0.042, 0.033); the AUC of the traditional + new combination was greater than that of the traditional combination and the new combination (Z=2.785, 2.153, P=0.005, 0.031). Conclusion PLR and GMP-140 are associated with the risk of intra-abdominal rebleeding after thoracotomy for emergency thoracoabdominal injuries. In traditional prediction schemes, the introduction of new PLR and GMP-140 has gained value in predicting the risk of rebleeding, providing guidance for clinical management and intervention.

Progress in imaging research of visceral pleural invasion in lung cancer

黄子康,李思叶,沈君,徐滨,于越洋,朱玉春 — 2025/9/30 18:10:28

Lung cancer remains the leading cause of cancer death in humans worldwide. Visceral pleural invasion (VPI) directly affects the clinical staging and survival prognosis of early lung cancer patients. VPI refers to tumor cells infiltrating beyond the elastic fibers of the pleura. Imaging examination has the advantages of comprehensiveness, non-invasive, and good reproducibility, playing an important role in preoperative evaluation of VPI status in lung cancer. This article provides a systematic review of recent imaging studies on the prediction of VPI using CT features, PET/CT, and radiomics.

Research progress of the role of B lymphocytes in the pathogenesis of minimal change disease

xing xueqi — 2025/9/30 18:08:58

Minimal change disease （MCD） is a glomerular disease, with mild glomerular lesions under light microscope, and lack of immune complex depositions on pathological tissues. Under electron microscope, it is characterized by diffuse foot process fusion, which is generally considered to be caused by T lymphocytes dysfunction. However, in recent years, B lymphocyte depletion agent-rituximab （RTX） can induce MCD remission, suggestting that B lymphocytes play an important role in the occurrence and development of MCD. At present, the mechanism of B lymphocytes in MCD has been widely concerned, including B lymphocytes producing autoantibodies against podocytes, secreting related cytokines and interacting with T lymphocytes. This article reviews the mechanism of B lymphocytes in the development of MCD.

A case report of moderately differentiated endometrioid adenocarcinoma with fertility-sparing treatment and birth of a second child

Chenshudan,,Hesili,Liruizhen — 2025/9/30 18:05:56

This paper report a case of a patient with moderately differentiated (G2) endometrioid adenocarcinoma who successfully delivered two children following fertility-sparing treatment.

Advances in Local and Systemic Treatments for Recurrent Hepatocellular Carcinoma

Hu Ding,Huang Jiwei, — 2025/9/16 10:46:28

Recurrent hepatocellular carcinoma (rHCC) represents the primary obstacle to long-term survival in patients with primary hepatocellular carcinoma (HCC) following initial treatment, with a recurrence rate of up to 70% within five years. This review systematically summarizes the latest advances in local and systemic therapies for rHCC. Local therapies encompass repeat hepatectomy, salvage liver transplantation, radiofrequency ablation, microwave ablation, transarterial chemoembolization, transarterial radioembolization, hepatic arterial infusion chemotherapy, as well as emerging modalities such as stereotactic body radiation therapy and proton beam therapy. Systemic therapies, including targeted therapy and immunotherapy, have improved the prognosis for patients with advanced or extrahepatic disease.

The value of ALBI grade in the clinical prognosis of hilar cholangiocarcinoma after radical resection

qianchun行 — 2025/9/14 15:52:07

Objective: To investigate the predictive value of ALBI (albumin-bilirubin）grade for the prognosis of patients with Hilar Cholangiocarcinoma (HCCA) after radical resection. Methods: Clinical data were collected from 115 patients diagnosed with Hilar Cholangiocarcinoma who underwent surgical treatment and were pathologically confirmed after surgery at the Second Affiliated Hospital of Kunming Medical University between July 2015 and December 2022. According to the preoperative last measurement of albumin and bilirubin to calculate ALBI, there were 95 patients in the preoperative ALBI grade 1-2 group and 20 patients in the preoperative ALBI grade 3 group.Survival rates were estimated using the Kaplan-Meier method, and differences between groups were compared using the Log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards regression model. Results: The median DFS (Disease-Free Survival) was 23 months (95% CI: 19.6-26.4) in preoperative ALBI grade 1–2 group and 10 months (95% CI: 5.6-14.4) in the preoperative ALBI grade 3 group (P = 0.014). The median OS (Overall Survival) was 36 months (95% CI: 24.2-47.8) in the preoperative ALBI grade 1-2 group and 17 months (95% CI: 14.8-19.2) in the preoperative ALBI grade 3 group (P < 0.001). Univariate analysis showed that higher preoperative ALBI grade, presence of vascular tumor thrombus, and higher TNM (Tumor, Node, Metastasis) stage were associated with worse DFS and OS in HCCA patients after radical resection. Multivariate Cox analysis indicated that higher preoperative ALBI grade combined with vascular tumor thrombus and higher TNM stage were independent risk factors for worse DFS, while higher preoperative ALBI grade and higher TNM stage were independent risk factors for worse OS. Conclusion: The ALBI score has predictive value for the prognosis of HCCA patients after radical resection.

Clinical efficacy of steam medicine cupping therapy in the treatment of opioid-related constipation in patients with cancer pain

Dongfangping,Lijiuli,Sangguanglin,Wuwenxin,Zhangyuxuan — 2025/9/14 15:50:58

Objective To explore the clinical effect of steam medicine cupping therapy in the treatment of opioid-induced constipation (OIC) in cancer pain patients. Methods A total of 68 hospitalized cancer pain patients with OIC at Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from October 2024 to April 2025 were recruited. Patients were randomly assigned, using a random number table, into a control group (n = 34) receiving conventional care and an intervention group (n = 34) receiving steam medicine cupping therapy in addition to conventional care. Outcomes included complete spontaneous bowel movements (CSBMs), bristol stool form scale (BSFS), bowel sound frequency, Patient Assessment of Constipation Symptoms (PAC-SYM), Patient Assessment of Constipation Quality of Life (PAC-QOL), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores to evaluate clinical efficacy. Results After four interventions, the CSBMs and BSFS in both groups were higher than those before treatment, and the intervention group was even higher. The difference was statistically significant (P<0.05). The total scores of the PAC-SYM, PAC-QOL, SAS and SDS scales in both groups were lower than those before treatment, and the scores in the intervention group were even lower (P<0.05). After each intervention, the intestinal rumbling frequency in both groups was more than that before the intervention, and it was even higher in the intervention group (P<0.05). Conclusion The steam medicine cupping therapy can significantly improve OIC and related symptoms in cancer pain patients and enhances quality of life.

Comparison of Efficacy and Safety Between Laparoscopic and Open Intention-to-Cure Radical Resection for Gallbladder Cancer

zhengkai — 2025/9/14 15:49:30

Objective To investigate the efficacy and safety of laparoscopic versus open radical resection for gallbladder cancer, providing evidence-based guidance for clinical treatment selection. Methods Clinical data from 150 patients undergoing radical resection for gallbladder cancer at the Second Affiliated Hospital of Kunming Medical University between January 2017 and December 2022 were retrospectively analyzed. Patients were divided into a laparoscopic group (n=48) and an open group (n=102). Propensity score matching was used to balance baseline differences. Differences in perioperative indicators, oncological outcomes, and survival prognosis between groups were compared. Cox regression analysis identified independent prognostic risk factors. Results Matching achieved balanced baseline characteristics. The laparoscopic group demonstrated lower intraoperative blood loss and shorter postoperative hospital stays (P<0.05). Survival analysis revealed no significant difference in overall survival between the laparoscopic and open groups for GBC patients with T3 or lower stages (P≥0.05). Cox regression indicated that concomitant gallbladder stones and T3 staging were independent risk factors affecting postoperative prognosis (P<0.05), while laparoscopic surgery itself was not an independent risk factor (P≥0.05). Conclusion Laparoscopic radical resection for gallbladder cancer demonstrates comparable efficacy to open surgery in carefully selected patients with T3 or lower disease stages, with favorable safety profiles. However, further validation through high-quality evidence-based studies is warranted.

Development of an Integrative Traditional Chinese and Western Medicine Nutritional Support Health Education Program for Colon Cancer Based on PG-SGA

Xie Qing — 2025/9/12 17:25:16

[Abstract:] Objective To construct a PG-SGA-based health education program for integrated traditional Chinese and Western medicine (TCM-WM) nutritional support in patients with colon cancer.Methods The initial draft of the PG-SGA-based TCM-WM nutritional support health education program was formulated through literature review and group discussions. The Delphi method was employed to conduct correspondence with 14 selected experts. Entries of the program were modified, added, or deleted based on expert feedback to determine the final version.Results The questionnaire recovery rates for the two rounds of expert correspondence were 100% and 93.3%, respectively. After two rounds, the expert authority coefficients (Cr) were 0.765 and 0.766, and the Kendall"s W values were 0.184 and 0.164 (all *P* < 0.01), respectively. The finalized program comprises 6 first-level indicators, 19 second-level indicators, and 57 third-level indicators.Conclusion Experts demonstrated high levels of enthusiasm and authority in constructing this PG-SGA-based TCM-WM nutritional support health education program, with good consistency in their opinions. The program exhibits reliability and scientific rigor. The integrated TCM-WM nutritional support scheme provides a scientific, reliable, and operational framework for nutritional support practice in colon cancer patients. The diversified health education model offers practical and varied channels for health education, providing valuable guidance for effectively improving patients" nutritional status and quality of life, as well as enhancing compliance among patients and their families.

The influence of remimazolam combined with nerve block on hemodynamics and postoperative cognitive function in elderly patients undergoing general anesthesia for laparoscopic colorectal tumor surgery

zhangyu — 2025/9/12 17:14:47

To explore the effects of remimazolam combined with nerve block on intraoperative hemodynamics and postoperative cognitive function in elderly patients undergoing laparoscopic colorectal tumor surgery under general anesthesia.Methods A total of 120 elderly patients who underwent elective laparoscopic colorectal tumor surgery at the People's Hospital of Guangxi Zhuang Autonomous Region from June 2023 to December 2024 were selected and equally divided into four groups according to the random number table method: the general anesthesia alone group (Group G)，the general anesthesia combined with nerve block group (Group N)，the general anesthesia combined with remimazolam group (Group R)，and the general anesthesia combined with remimazolam and nerve block group (Group RN). Groups R and RN received a continuous infusion of remimazolam until the end of the surgery. Groups N and RN underwent bilateral rectus sheath block and transversus abdominis plane block after induction of anesthesia. All four groups of patients received the same anesthesia induction and maintenance protocols.Mean arterial pressure (MAP)and heart rate (HR)were recorded at 10 minutes before anesthesia induction (T0)，at the time of tracheal intubation (T1)，5 minutes after intubation (T2)，1 hour after the start of surgery (T3)，and at the end of surgery (T4). With the T0 time point as the baseline，the changes in mean arterial pressure and heart rate at each time point compared with T0 were calculated，denoted as ΔMAP and ΔHR，respectively. The Mini-Mental State Examination (MMSE)scores of the patients were compared 1 day before surgery，3 days after surgery and 7 days after surgeryand the incidence of postoperative cognitive dysfunction (POCD) was calculated according to the MMSE scoring criteria. Results The ΔMAP and ΔHR of the RN group, R group at T1 and T2 were lower than those of the G group and N group (P < 0.05)，and the ΔMAP and ΔHR of the RN group at T3 and T4 were lower than those of the R group， N group and G group (P < 0.05)；(2) On the 3rd and 7th day after surgery，the MMSE scores of the R group and RN group were higher than those of the G group and N group (P < 0.05)，and there was no statistically significant difference in the incidence of POCD among the four groups (P > 0.05)； (3) There was no statistically significant difference in the incidence of adverse reactions among the four groups (P > 0.05). Conclusion In laparoscopic colorectal malignant tumor surgery for elderly patients, the application of remimazolam combined with nerve block on the basis of conventional anesthesia is conducive to maintaining stable intraoperative hemodynamics, improving postoperative cognitive function in elderly patients, and does not increase the incidence of adverse reactions, with high safety.[Keywords] Remimazolam；Nerveblock；Hemodynamic；Postoperative cognitive dysfunction .

Analysis of cone-beam breast computed tomography imaging features of central and peripheral Intraductal Papilloma

FENG XIAN MEI,HUANG Lei,WEI Wei,,ZHENG Zhongtao — 2025/9/12 16:53:33

[Abstract] Objective To investigate the differences in the imaging features of cone beam breast CT (CBBCT) between central and peripheral breast papillomas (IDP) and to evaluate the application value of CBBCT in preoperative differential diagnosis. Methods A total of 96 patients (57 with central type and 39 with peripheral type) were recruited from patients with IDP confirmed by surgical pathology and preoperative CBBCT scanning, and the CBBCT imaging characteristics and related measurement parameters of the two groups were compared. Results Compared with the peripheral type, the distance between the anterior edge of the central IDP lesion and the base of the nipple was closer (1.1±1.0cm vs. 3.8±1.9cm, P?0.001), the proportion of the long axis consistent with the mammary duct was higher (84.21% vs. 51.28%, P?0.001), and the standardized CT values of non-contrast scanning and enhanced CT of each stage were higher than those of peripheral type (P?0.05). There were no significant differences in IDP between the two groups in terms of maximum lesion diameter, enhancement type, ductal dilation, perilesional vascular signs, enhancement rate and TDC type (P?0.05). Both of them were dominated by smooth margins, round/oval, and uniformly strengthened masses, and the TDC was mainly plateau type (75.00%). Conclusion There are some differences in the CBBCT imaging features between central and peripheral IDP, especially in the location of the lesion (distance from the base of the nipple), the morphology of the lesion (the consistency between the long axis and the duct), and the degree of enhancement (the difference of standardized CT value), which are helpful for the diagnosis of preoperative IDP typing.

Comparison of the effects of SPECT-CT and conventional CT-guided iodine-125 seeds on salivary gland function and prognosis survival in patients with iodine-refractory thyroid cancer

袁辉 — 2025/9/8 15:51:02

Objective To compare the effects of SPECT-CT and conventional CT-guided iodine-125 seeds on salivary gland function and prognosis of patients with radioiodine-refractory differentiated thyroid cancer (RAIR-DTC). Methods A prospective study was conducted on 116 patients with RAIR-DTC in our hospital from February 2016 to February 2019. They were randomly divided into an observation group (58 cases) and a control group (58 cases) using a random number table method. The control group underwent routine CT-guided iodine-125 seeds implantation, while the observation group underwent SPECT-CT-guided iodine-125 seeds implantation. The clinical efficacy, salivary gland function [maximum concentration rate (MAR) and maximum secretion rate (MSR) after acid stimulation of parotid and submandibular glands], quality of life, adverse reactions, and prognosis survival were compared between the two groups. Results The disease control rate of the observation group after 6 months of treatment was 94.83%, which was higher than that of the control group (82.76%) (P<0.05). Three and six months after treatment, the MAR and MSR of the parotid and submandibular glands in the observation group were higher than those in the control group (P<0.05). At 3 and 6 months after treatment, the quality of life score in the observation group was higher than that in the control group (P<0.05). The incidence of adverse reactions in the observation group was 5.17%, which was significantly lower than that in the control group (18.97%) (P<0.05). The 5-year survival rate of the observation group was 89.66%, which was higher than that of the control group (75.86%) (P<0.05). Conclusion Compared with conventional CT-guided iodine-125 particle therapy, SPECT-CT-guided iodine-125 particle therapy for RAIR-DTC patients has a precise therapeutic effect, can effectively improve the patient"s salivary gland function and quality of life, and prolong the patient"s prognosis with a 5-year survival rate.

Clinical Efficacy Study of the Combination of Flexible Negative Pressure Suction Sheath and Intelligent Pressure-Controlled Suction Sheath in Ureteroscopic Laser Lithotripsy for Treating Upper Urinary Tract Stones < 2cm

2025/9/5 16:12:16

Objective: To explore the clinical efficacy of combining a flexible negative pressure suction sheath and the medical intelligent pressure-controlled suction sheath with ureteroscopic laser lithotripsy for the treatment of upper urinary tract stones smaller than 2 cm in diameter. Methods: Clinical data were collected from patients who underwent ureteroscopic laser lithotripsy for renal or upper ureteral stones at the Department of Urology in our hospital from June 2023 to June 2024. A total of 160 cases were included, all with stones smaller than 2 cm. Patients were randomly divided into two groups using a random number table，with 80 patients in the flexible negative pressure suction sheath group, and 80 patients in the medical intelligent pressure-controlled suction sheath group. We analyzed and compared the general data, including age, and recorded outcomes such as operation time, WBC before and after surgery, CRP, PCT after surgery, postoperative fever rate (T>37.5°C), duration of hospital stay, stone clearance rate at 1 and 3 months after surgery. Statistical analysis was conducted using SPSS 26.0, with frequency data expressed using counts and the chi-square test, and normally distributed data presented as mean ± standard deviation (x? ± s). Comparison between the two groups was performed using t-tests, while non-normally distributed data were expressed as quartiles [p50(p25, p75)] and compared using the non-parametric Mann-Whitney U test, with a significance level of α=0.05. Results: No significant difference were observed between the two groups in general data (p > 0.05). The stone clearance rate at 1 month after surgery was 83.8% in the flexible negative pressure suction sheath group and 70% in the medical intelligent pressure-controlled suction sheath group, showing a statistically significant difference (P < 0.05). The stone clearance rate at 3 months after surgery was 93.75% in the flexible negative pressure suction sheath group and 88.75% in the medical intelligent pressure-controlled suction sheath group, with no statistically significant difference (P > 0.05). The surgery duration was significantly longer in the flexible negative pressure suction sheath group compared to the medical intelligent pressure-controlled suction sheath group (P < 0.05). The postoperative white blood cell count and CRP in the medical intelligent pressure-controlled suction sheath group were significantly lower than those in the flexible negative pressure suction sheath group. There were no significant differences between the two groups in terms of preoperative white blood cell count, postoperative procalcitonin, hospital stay, or postoperative complications (renal perinephric hematoma) (p > 0.05). Six patients in the medical intelligent pressure-controlled suction sheath group developed postoperative fever, while five patients in the flexible negative pressure suction sheath group developed postoperative fever, with no significant difference (p > 0.05). Conclusions: The flexible negative pressure suction sheath can improve stone clearance rate and safety in ureteroscopic laser lithotripsy for treating upper urinary tract stones, making it worthy of clinical promotion. Additionally, the combination of the flexible negative pressure suction sheath combined and the intelligent pressure control system in retrograde intrarenal surgery shows good clinical efficacy in the treatment of upper urinary tract calculi. However, further prospective studies are needed to explore its wide applicability.

The relationship between peripheral blood SEMA3A, SEMA4D, risk classification and prognosis in children with acute lymphoblastic leukemia

Tang Chang-chao — 2025/9/5 15:52:13

Objective: To explore the relationship between peripheral blood signal element 3A (SEMA3A), signal element 4D (SEMA4D), risk classification, and prognosis in children with acute lymphoblastic leukemia (ALL). Method: 128 children with ALL who were admitted to our hospital from March 2019 to March 2023 were selected, the children were divided into high risk group, medium risk group, and low risk group according to the risk classification, peripheral blood SEMA3A, SEMA4D of the three groups were measured. The children were divided into poor prognosis group and good prognosis group according to the prognosis, the baseline data and SEMA3A and SEMA4D levels of the two groups were compared, the related factors of poor prognosis in children with ALL and the predictive value of peripheral blood SEMA3A and SEMA4D levels for poor prognosis in children were analyzed. Results The peripheral blood SEMA4D in low risk group, medium risk group, and high risk group increased in sequence, while SEMA3A in peripheral blood decreased in sequence (P<0.05). SEMA3A was negatively correlated with the risk classification of children with ALL, while SEMA4D was positively correlated with the risk classification of children with ALL (P<0.05). High age, high white blood cell count (WBC), high SEMA4D, T-ALL immunological classification, and high-risk classification were risk factors for poor prognosis of children with ALL, while high SEMA3A was a protective factor (P<0.05). The individual and combined detection of SEMA3A and SEMA4D have certain predictive value for the prognosis of children with ALL [area under the curve (AUC) of 0.807, 0.816, 0.842, respectively], and the AUC of combined detection was higher. Conclusion: SEMA3A and SEMA4D in peripheral blood of children with ALL are closely related to risk classification and prognosis. SEMA3A decrease and SEMA4D increase can increase the risk of poor prognosis.

Advances in biomechanics using three-dimensional finite element analysis in different fields of dentistry

CHEN Ji,CHU Kejia,LIU Shu, — 2025/9/5 15:25:23

Three-dimensional finite element analysis is an effective tool for in vitro studies of human mechanical behavior, which offers high reproducibility and strong comparability, and provides important guidance for clinical practice. Numerous biomechanical problems exist in stomatology. With the continuous update of treatment concepts and the ongoing advancement of biomechanical technologies, the application of finite element analysis in the field of oral biomechanics has become increasingly widespread. This paper reviews recent advancements in the application of three-dimensional finite element analysis in biomechanical research across orthodontics, prosthodontics, oral medicine, and oral and maxillofacial surgery, while also offering a prospective outlook on its future applications in oral biomechanics.

Umbilical +1-port laparoscopic VICRYL baseball suture for the treatment of giant uterine fibroids ≥10 cm: compared with four-port method

赵艳红 — 2025/9/5 12:07:36

Objective To explore the treatment of giant uterine fibroids ≥10 cm using the umbilical +1 port laparoscopic VICRYL baseball suture method compared with the four-port method. Methods A total of 104 patients with giant uterine fibroids were selected in Langfang People's Hospital from September 2021 to June 2023 for a retrospective study. The patients were divided into four-port group and umbilical+1-port group according to the differences of surgical methods, 52 cases each. The four-port group underwent conventional four-port laparoscopic myomectomy, while the umbilical +1 port group underwent umbilical +1 port laparoscopic VICRYL baseball suture myomectomy. The intraoperative and postoperative indicators, postoperative visual analog scale (VAS) scores, perioperative trauma stress indicators [superoxide dismutase (SOD), reactive oxygen species (ROS), C-reactive protein (CRP), glutathione peroxidase (GSH-Px)], incision satisfaction, and complications were compared between the two groups. Results There was no significant difference in intraoperative bleeding and hospital stay between the umbilical+1-port group and the four-port group (P>0.05). The operation time of the umbilical+1-port group was shorter than that of the four-port group, the time of anal exhaust and the first time of getting out of bed in the umbilical +1 port group were earlier than those in the four-port group (P<0.05). The VAS scores at 6 h, 9 h, 12 h, 24 h, and 32 h after surgery were lower in the umbilical +1 port group than in the four-port group (P<0.05). The CRP and ROS levels in the umbilical +1 port group were lower than those in the four-port group on postoperative day 1 and 3, while the GSH-Px and SOD levels were higher than those in the four-port group (P<0.05). The satisfaction rate of the umbilical +1 port group was higher than that of the four-port group (P<0.05). Compared with four-port group, there was no significant difference in the total incidence of complications in the umbilical +1 port group (P>0.05). Conclusion The umbilical +1 port laparoscopic VICRYL baseball suture method for the treatment of giant uterine fibroids ≥10 cm is safe and feasible, can reduce postoperative pain, facilitate early postoperative rehabilitation, and improve patient satisfaction with incisions.

The relationship between serum miR-128-3p and miR-211-5p levels with the degree of EEG abnormalities in epilepsy patientsYuhaiyan, Kong Hui, Wang Rui*

yuhaiyan — 2025/9/5 12:07:04

Objective: To investigate the relationship between serum miR-128-3p and miR-211-5p levels with the degree of electroencephalogram (EEG) abnormalities in epilepsy patients. Methods: From March 2022 to June 2023, 120 epilepsy patients admitted to our hospital were regarded as the study group, and another 120 healthy individuals who underwent physical examinations at our hospital were included as the control group. According to the degree of EEG abnormality in epileptic patients, it can be divided into mild EEG abnormality (n=41), moderate EEG abnormality (n=46) and severe EEG abnormality (n=33). The qRT-PCR method was applied to measure the expression levels of serum miR-128-3p and miR-211-5p. Spearman method was applied to analyze the correlation between serum miR-128-3p and miR-211-5p levels and EEG abnormalities in epilepsy patients. The diagnostic efficacy of serum miR-128-3p and miR-211-5p for EEG abnormalities was analyzed by plotting receiver operating characteristic (ROC) curves. Results: Compared with the control group, the expression levels of serum miR-128-3p and miR-211-5p in the study group were lower (t=8.793,8.052, P<0.05). With the severity of epilepsy patients with different EEG abnormalities, the expression levels of serum miR-128-3p and miR-211-5p in patients with mild abnormality, moderate abnormality and severe abnormality gradually decreased, with statistical significance (F=10.516, 8.528, P<0.05). The expression levels of serum miR-128-3p and miR-211-5p in epilepsy patients were negatively correlated with the degree of EEG abnormalities (rs=-0.484, -0.579, P<0.05). ROC showed that the AUC increased to 0.847 (95% CI: 0.770~0.906) when serum miR-128-3p and miR-211-5p were combined to diagnose the abnormal degree of EEG, which was better than that when serum miR-128-3p and miR-211-5p were separately diagnosed (Z combination - miR-128-3p=2.850, P=0.004, Z combination - miR-211-5p=2.562, P=0.010), with a sensitivity of 81.82%, specificity of 79.31%, and Youden index of 0.611. Conclusion: The serum levels of miR-128-3p and miR-211-5p in epileptic patients are decreased, which is negatively correlated with the degree of EEG abnormality. The combination of them can better diagnose the degree of EEG abnormality and is expected to become a new target for epilepsy treatment.

The application progress of digital technology in the diagnosis and treatment of OSA

Shi Yulin,,, — 2025/9/4 16:49:42

The rapid evolution of digital technology has brought about a revolutionary change in the diagnosis and treatment of Obstructive Sleep Apnea Syndrome (OSA). This review focuses on the application progress of digital technology in the diagnosis and treatment of OSA, including remote monitoring supported by the Internet of Things, automatic diagnosis assisted by artificial intelligence, wearable technology, and digital imaging technology. These innovative technologies not only enhance the accuracy and convenience of diagnosis but also optimize treatment plans, significantly improving the quality of life for patients. Despite challenges in data security and technology dissemination, digital technology shows tremendous potential in OSA management and indicates a significant shift in future diagnostic and treatment paradigms.

The relationship between the expression of KIF18B and ASF1B in endometrial cancer tissues with pathological characteristics and prognosis

叶小琳 — 2025/9/4 11:57:04

Objective: To investigate the expression of kinesin family member 18 B (KIF18B) and anti-silencing function 1B (ASF1B) in endometrial cancer (EC) tissues, and analyze their relationship with clinical pathological features and prognosis. Methods: Clinical data, adjacent tissues, and EC tissues of 226 EC patients in our hospital from July 2016to July 2021 were collected. Real-time fluorescence quantitative PCR was applied to detect the levels of KIF18B mRNA and ASF1B mRNA in adjacent cancer tissues and EC tissues. Immunohistochemistry staining was applied to detect the levels of KIF18B and ASF1B proteins in adjacent and EC tissues. TCGA database and CPTAC database were applied to retrieve the expression of KIF18B, ASF1B mRNA and protein in EC. Kaplan-Meier method was applied to analyze the differences in 3-year survival prognosis among EC patients with different levels of KIF18B and ASF1B proteins. Cox regression was applied to analyze the prognostic factors of EC patients. Results: The real-time fluorescence quantitative PCR method in this study showed that the levels of KIF18B mRNA and ASF1B mRNA in EC tissues were higher than those in adjacent tissues (P<0.05). The TCGA database results showed that the levels of KIF18B mRNA and ASF1B mRNA in EC tissues were higher than those in normal tissues (P<0.05). The results of immunohistochemical staining in this study showed that the positive rates of KIF18B protein and ASF1B protein in EC tissues were higher than those in adjacent tissues (P<0.05). The results of the CPTAC database showed that there was no statistically obvious difference in the level of KIF18B protein between EC tissue and normal tissue (P>0.05), while the level of ASF1B protein in EC tissue was higher than that in normal tissue (P<0.05). The proportions of muscle infiltration depth ≥ 1/2, FIGO stage III, and lymph node metastasis in EC patients with KIF18B positive expression and ASF1B positive expression were higher than those in EC patients with KIF18B negative expression and ASF1B negative expression (P<0.05). The 3-year survival rates of EC patients with KIF18B negative expression and ASF1B negative expression were higher than those of EC patients with KIF18B positive expression and ASF1B positive expression (P<0.05). FIGO stage III, KIF18B positive expression, and ASF1B positive expression were independent risk factors for 3-year mortality in EC patients (P<0.05). Conclusion: KIF18B and ASF1B are both highly expressed in EC tissues, and they are closely related to muscle infiltration depth, FIGO staging, lymph node metastasis, and 3-year prognosis, which may become new prognostic markers for EC.

Clinical translation and treatment progress related to apolipoprotein

Liumengyu,Zhangjie, — 2025/9/4 11:23:01

【Abstract】Apolipoprotein is an important structural and functional component of plasma lipoprotein, which affects lipid transport and metabolism in the human body. Several important clinically relevant apolipoproteins include Apolipoprotein A-I, Apolipoprotein B, Apolipoprotein C-Ⅱ, Apolipoprotein C-Ⅲ,Apolipoprotein E, and Apolipoprotein (a). In this review, we discussed how these apolipoprotein proteins participate in and regulate lipoprotein metabolism and clinical translation and treatment progress in cardiovascular diseases.

Esophageal web in an elderly female: a case report

刘衡,罗欣语,梅俏,王思琦 — 2025/9/3 17:55:43

Esophageal web

Rhabdomyolysis Induced by Diquat Poisoning: A Case Report

张叶鑫, — 2025/9/3 17:43:16

A 17-year-old female patient experienced nausea, vomiting, dizziness, and a burning throat pain after ingesting approximately 60ml of diquat solution. She initially received symptomatic treatment, including gastric lavage, acid inhibition, and stomach protection, at a local hospital. Seven hours later, due to the severity of her condition, she was transferred to our hospital. Immediate poisoning detection revealed a blood diquat concentration of 1.4mg/L. The qualitative test for diquat her urine was positive, while paraquat was not detected. Upon admission, the patient exhibited pain, swelling, and tenderness in her lower limbs, unpalpable abdominal pain, and increased levels of creatine kinase and myoglobin. She was diagnosed with rhabdomyolysis syndrome induced by acute diquat poisoning. The primary treatments included hemoperfusion and continuous renal replacement therapy (CRRT), supplemented by adsorption, catharsis, fluid infusion, diuresis, anti-oxidation, hormone therapy for shock, and organ protection measures. When her vital signs stabilized, intermittent dialysis was performed. The patient fully recovered and was discharged after 30 days. Reports of successfully treating rhabdomyolysis resulting from diquat poisoning are rare.

Ferroptosis-Related Alternative Splicing Signatures as Potential Biomarkers for Predicting Prognosis and Therapy Response in Gastric Cancer

Xiaopeng Fan,Lei Guo,,Yuxi Li,Zhiyong Li — 2025/9/3 17:24:48

Objective: To investigate the prognostic value of ferroptosis-related alternative splicing (FRAs) in gastric cancer (GC) and its impact on the tumor microenvironment (TME) and response to immunotherapy. Methods: Based on transcriptomic data of GC from the TCGA database, alternative splicing (AS) events related to ferroptosis were screened. A prognostic model was constructed using LASSO regression and multivariate Cox regression analysis. The predictive ability and molecular mechanisms of the model were validated through functional enrichment analysis, immune cell infiltration assessment, and in vitro experiments. Results: A prognostic model based on 12 significant AS events stratified GC patients into high-risk and low-risk groups. The low-risk group exhibited immune activation characteristics, significantly improved prognosis (p<0.001), and a higher likelihood of benefiting from targeted therapy and immunotherapy. In vitro experiments demonstrated that high expression of the splicing factor SF3A2 enhanced ferroptosis resistance and promoted cell proliferation. Conclusions: The FRAs prognostic model constructed in this study demonstrates significant advantages in predicting the prognosis of GC patients. It reveals differences in the immune microenvironment and drug responses, providing a potential basis for developing personalized treatment strategies.

ZHOU Ying1,SHU Tian-Kun1,NIE Huiyong2*,WANG Shuang1, QUAN Pei1, HUANG Jing1

zhouying — 2025/9/2 16:25:39

Objective To evaluate the effect of tetracaine endotracheal surface anesthesia combined with laryngeal mask airway general anesthesia under bright vision in bronchoscopy.Methods A total of 160 patients who underwent bronchoscopy in the General Hospital of Weapons Industry from June 2024 to December 2024 were randomly divided into group D (tetracaine) and group L (lidocaine),with 80 cases in each group.After anesthesia induction,tetracaine was sprayed into the subglottic airway for topical anesthesia in group D,and lidocaine was sprayed into the L group.HR,MBP and SpO2 were recorded before anesthesia (T0),1 min after examination (T1),5 min after examination (T2),and 2 min after laryngeal mask removal (T3).The adverse reactions such as coughing and itchy airway were recorded during the operation.The addition of etomidate and propofol mixture and remifentanil were recorded.Results The MAP of group L at T1 and T2 was significantly higher than that at T0 (92.6±8.5 mmHg vs 88.4±9.4 mmHg,93.5±6.6 mmHg vs 88.4±9.4 mmHg),and the difference was statistically significant (P<0.05). The MAP of group D at T1 and T2 was significantly lower than that of group L (86.6±6.3 mmHg vs 92.6±8.5 mmHg,87.6±7.4 mmHg vs 93.5±6.6 mmHg),and the difference was statistically significant (P<0.05).HR at T1 and T2 in group L was significantly faster than that at T0 (85.6±16.5 times /min vs 73.6±10.5 times /min, 88.7±11.6 times /min vs 73.6±10.5 times /min),and the difference was statistically significant (P<0.05).The HR of group D at T1 and T2 was significantly lower than that of group L (73.5±14.4 times /min vs 85.6±16.5 times /min,72.5±10.2 times /min vs 88.7±11.6 times /min),and the difference was statistically significant (P<0.05).Compared with group L,the incidence of intraoperative bucking,resuscitation cough and airway itchiness in group D were significantly reduced [63 (78.8%) bucking free vs 32 (40.0%),56 (70.0%) cough free vs 48 (60.0%),6(7.5%) airway itchiness vs 22(27.5%)].The difference was statistically significant (P<0.05).The incidence of hypertension and arrhythmia in group D was lower than that in group L (11.3% vs 26.3%,10.0% vs 31.3%),and the difference was statistically significant (P<0.05).The supplemental rate of etomidate propofol mixture and remifentanil in group D was lower than that in group L (31.3% vs 91.3%,33.8% vs 97.5%),and the difference was statistically significant (P<0.05).Conclusion Endotracheal tetracaine surface anesthesia combined with laryngeal mask airway general anesthesia under bright vision can effectively inhibit the cardiovascular stress response of bronchoscopy,reduce the incidence of intraoperative airway reaction and postoperative complications,which is worthy of clinical application.

Expression of key Genes in the TCR Signaling Pathway in Patients with Sepsis Related Acute Respiratory Distress Syndrome　ZENG Xiaoliang 1,YANG Hui 1,YANG Yanli 3,PENG Liang1,ZHANG Jianfeng 2*

zengxiaoliang — 2025/9/2 15:54:10

【】 Objective To understand the expression and significance of key genes cluster of differentiation 247(CD247),linker for activation of T-Cell(LAT)andIL2 inducible T-Cell kinase(ITK)in the T cell receptor(TCR) signaling pathway in peripheral blood peripheral blood mononuclear cell(PBMC)of patients with sepsis associated acute respiratory distress syndrome(ARDS). Method 22 patients with sepsis related acute respiratory distress syndrome admitted to the intensive care unit of the Second Affiliated Hospital of Guangxi Medical University from March 2022 to November 2022 were selected as the case group,and 21 healthy volunteers were selected as the control group for the study. Extracted peripheral blood PBMC and detected the expression of key genes CD247,LAT and ITK in the TCR signaling pathway using real-time polymerase chain reaction(Real-time PCR)；detected the expression of serum inflammatory factors interleukin 6(IL-6),interleukin 17A(IL-17A)and interleukin 10(IL-10)using the enzyme-linked immunosorbentassay(ELISA) method；Giemsa staining was used to observe the inflammatory cells in the alveolar lavage fluid；and the bicinchoninic acid(BCA) protein assay kit was used to determine the total protein content in the supernatant of the alveolar lavage fluid. Result Compared with the control group,the expression of CD247,LAT and ITK genes in PBMC decreased in the case group (P<0.001)；the expression of IL-6,IL-10 and IL-17A in serum was increased (P=0.031,0.016,0.035). In the case group,a large number of inflammatory cells were found in the alveolar lavage fluid,with significant increases in neutrophils,macrophages,lymphocytes,and red blood cell infiltration,as well as necrosis and shedding of alveolar epithelial cells. Compared with healthy individuals (70 μg/ml),the total protein content of the alveolar lavage fluid in the case group (2936.51±2118.01 μg/ml) significantly increased. Conclusion Immunosuppression and inflammatory response coexist in the course of sepsis related acute respiratory distress syndrome. The decreased expression of CD247,LAT and ITK genes in peripheral blood may be related to the decrease of T lymphocytes,indicating that T lymphocytes play an important role in immune regulation and inflammatory response in sepsis related acute respiratory distress syndrome.

Interpretation of Guangxi local standard "Technical Specifications for ultrasound-guided needle-knife Therapy"

wangcheng — 2025/8/28 11:01:47

Ultrasound-guided acupotomy, as an innovative treatment method combining modern imaging technology and traditional Chinese medicine acupotomy, has been widely used in Guangxi Zhuang Autonomous Region in recent years. In order to regulate the operation of this technology and ensure the safety of patients and the effectiveness of treatment, in June 2024, the Market Supervision Administration of Guangxi Zhuang Autonomous Region issued the Technical Specification for Ultrasound-Guided Needle Knife Therapy (hereinafter referred to as the "Specification"). It provides comprehensive, systematic and authoritative guidance for medical institutions in the administrative region of Guangxi Zhuang Autonomous Region to carry out this treatment operation. This report will analyze the specification in detail from the aspects of the background and significance of the release, the content and characteristics of the main specifications, and focus on interpreting the technical points in the implementation of the technical specifications for ultrasound-guided acupotomology therapy, so as to help medical institutions and their managers better understand and apply the specifications to carry out their work.

Rapid health technical evaluation of the effectiveness, safety and economy of tenofovir in blocking mother-to-child transmission of HBV

liu xiaoxia, — 2025/8/15 17:41:12

ABSTRACT OBJECTIVE To evaluate the efficacy, safety and economy of tenofovir compared with other oral nucleotide analotes (NAs) in blocking mother-to-child transmission of chronic hepatitis B (CHB) by rapid Health technology assessment (HTA), and to provide reference for clinical rational drug use. METHODS PubMed, Cochrane Library, Embase, CNKI, Wanfang and VIP databases were systematically searched, as well as the official website of the Health Technology Assessment Agency and related databases. A comprehensive health technology evaluation report, systematic review/meta-analysis and pharmacoeconomic studies on the clinical efficacy and safety of tenofovir blocking HBV mother-to-child transmission were summarized and analyzed. RESULTS A total of 15 literatures were included, including 11 systematic reviews/meta-analyses and 4 pharmacoeconomic studies. The results showed that tenofovir was better than lamivudine and Tibivudine in inhibiting HBV virus replication in mothers and blocking HBV transmission from mother to child. Safety studies showed that the overall incidence of tenofovir and serious adverse events was not statistically significant compared with lamivudine and Tibivudine. Results of pharmacoeconomic evaluation Tenofovir has economic advantages in South Africa and China. CONCLUSIONS Tenofovir is more effective than lamivudine and Tibivudine in blocking HBV mother-to-child transmission, and its safety is comparable to other NAs, showing economic advantages in South Africa and China. KEYWORDS Tenofovir；chronic hepatitis B；health technology assessment；pregnant woman

Clinical features of Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism in 11 children Fan Yuhong, Li Junli, Su Xuewen (Inner Mongolia Autonomous Region People"s Hospital,Inner Mongolia University People"s Hospital,hohhot,010000,China)

fanyuhong,, — 2025/8/15 17:37:30

Objective To study the clinical features and prognosis of Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism in children. Methods The clinical data and follow-up results of 11 children with Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism from May 2023 to May 2024 were retrospectively analyzed. Results The median age of the 11 patients(5 boys and 6 girls) was 8 years old. All of them had fever and cough, 3 had wheezing, 5 had chest pain, 4 had difficulty breathing, 8 had pleural effusion, 1 had pneumothorax and mediastinal emphysema, 5 had atelectasis, 1 had lung necrosis, and 6 had significantly reduced respiratory sounds. Blood D-dimer levels were elevated to varying degrees in all children. Pulmonary CTA showed pulmonary embolism and consolidation in different lobes of the lung in 10 children. Three cases received one bronchoscopy treatment, three cases received two bronchoscopy treatments, three cases received immunoglobulin support treatment, and 11 cases received doxycycline treatment, Methylprednisolone and low molecular weight heparin calcium therapy. During follow-up, 4 cases had residual bronchiolitis obliterans, while the rest had a good prognosis. Conclusions Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism is usually characterized by cough, fever, chest pain, and difficulty breathing, accompanied by elevated levels of CRP and D-dimer. They are easy to combine with pleural effusion and other organ injuries. Active anti-infective, anti-inflammatory, and anticoagulant treatment should be performed as soon as possible, and bronchoscopy and immunoglobulin support therapy should be performed if necessary. Most of patients have a good prognosis, while a few may have residual bronchiolitis obliterans.

Impact of an intervention program based on the FOCUS program on patients with AL and their family primary caregivers

穆赫孜, — 2025/8/12 18:23:47

Objective To explore the impact of the FOCUS program on cognitive appraisals, coping styles, family resilience, and quality of life of AL patients and their family primary caregivers. Methods Sixty-four pairs of AL patients and their family primary caregivers who met the NAF criteria were selected as the study subjects and randomly divided into two groups, 32 pairs in each group. The control group adopts conventional care + follow-up, and the experimental group adopts conventional care + FOCUS program + follow-up, and the intervention time is 12 weeks. Compare the changes in cognitive appraisals, coping styles, family resilience, and quality of life of patients and their family primary caregivers in the two groups before and after the intervention. Results After the intervention, the family resilience and quality of life scores of patients and their family primary caregivers in the experimental group were significantly higher than those in the control group, and the difference was statistically significant (P

Analysis of the clinical characteristics of severe and critical mycoplasma pneumoniae pneumonia in children of different Ages

Ren Xue, — 2025/8/12 17:53:11

Objective To explore the clinical characteristics of children with severe and critical mycoplasma pneumoniae pneumonia of different Ages in order to provide theoretical basis for early clinical identification and standardized treatment. Methods A retrospective analysis was conducted on the clinical data of 83 children with severe and critical mycoplasma pneumoniae pneumonia in the pediatric intensive care unit of Shengjing Hospital of China Medical University from October 2023 to June 2024. The children were divided into the infant group (23 cases), the preschool group (17 cases), and the school-age group (43 cases) based on age. Results All the children had coughing, and 96.39% of them also had fever; 26.51% of the children experienced wheezing, and those with wheezing were mostly in the infant group, while older children mostly presented with breathing difficulties. Children with severe and critical mycoplasma pneumoniae pneumonia have significantly higher levels of neutrophils/lymphocytes and C-reactive protein compared with the normal values. However, procalcitonin、 interleukin-6 do not show significant increases. Chest imaging mostly presents with large patchy consolidation shadows, followed by bronchiolitis manifestations. The imaging manifestations vary among different age groups. Most children have extrapulmonary complications. 25.30% of the patients had co-infection with other viruses, and adenovirus infection being the most common. The course of the disease with co-infection was significantly prolonged. The delay in the treatment with anti-mycoplasma drugs and the resistance to macrolide antibiotics are the main factors for the occurrence of severe and critical mycoplasma pneumoniae pneumonia. Under the effectively controlled of mycoplasma pneumoniae, the application of conventional-dose glucocorticoids in most children can prevent the progression of the disease in a short period of time. After effective treatment all the children were recovered，a few children had sequela. Conclusions Children of three groups share some common clinical features, but also have their unique clinical characteristics for each age group. Early identification and timely implementation of targeted preventive measures can lead to a better prognosis.

Mechanism of Danggui Shaoyao Powder in the treatment of premature ovarian insufficiency based on network pharmacology and molecular docking

CHEN Yang,WANG Jing,XIA Xiao-yan,ZHANG Xiao-juan, — 2025/8/12 12:06:46

Objective:Network pharmacology was used to predict the drug components, target and signaling pathways of Danggui Shaoyao Powder in the treatment of early onset ovarian insufficiency (POI), and the mechanism of action of Danggui Shaoyao Powder in the treatment of POI was studied by experiment.Methods:The active components of Danggui Shaoyao Powder were screened through tcmsp platform, and the drug targets were obtained by importing them into UniProt database. POI was set as the keyword to mine the disease targets in OMIM, drugbank and genecards databases. The intersection core targets were taken from Venn website and imported into string and metascape platforms respectively to obtain protein mutual network, go function analysis and KEGG pathway enrichment analysis,network mapping using Cytoscape software;The POI rat model was induced by intraperitoneal injection of CTX solution. The normal group, model group, Danggui Shaoyao Powder group and GnRHa group were set up. The ovarian histological structure of rats in each group was observed, and the levels of FSH, E2 and AMH were detected by ELISA. Western blot and RT-PCR were used to detect the expression of TGFβ1-Smad2 signaling pathway.Results: Network pharmacological through screening 110 drug targets, 1190 disease targets, 52 core targets, 4442 genes for GO function analysis, and 374 signal pathways for KEGG pathway enrichment analysis were obtained.The results of animal experiments showed that Danggui Shaoyao Powder reversed the levels of serum FSH, E2 and AMH, and the expression of TGFβ1-Smad2 signaling pathway related proteins and mRNA in POI rats.Conclusion:Danggui Shaoyao Powder has multi-component, multi-target and multi biological signal pathway effects, which may through the TGFβ1-Smad2 signaling pathway play a therapeutic role by activating granulosa cell proliferation and differentiation, inhibiting follicular apoptosis and atresia, promoting follicular growth and development, protecting ovarian function, and providing guidance for the follow-up treatment of POI.

Observation on the Efficacy of Transcutaneous Acupoint Stimulation with a Medium-Frequency Electrotherapy Device Combined with Intratympanic Injection of Methylprednisolone for the Treatment of Sudden Sensorineural Hearing Loss

刘洪峰,田春辉,张亚猛 — 2025/8/8 17:57:46

Abstract: Objective: To investigate the efficacy of transcutaneous acupoint stimulation using a medium-frequency electrotherapy device combined with intratympanic injection of methylprednisolone for the treatment of sudden sensorineural hearing loss. Methods: We selected clinical data from 120 patients with sudden sensorineural hearing loss treated in our hospital's otorhinolaryngology department from June 2023 to November 2024. According to a random number table method, the patients were divided into two groups: the methylprednisolone group and the combination group, with 60 cases in each group. The methylprednisolone group received intratympanic injections of methylprednisolone, while the combination group received transcutaneous acupoint stimulation therapy using a medium-frequency electrotherapy device in addition to the treatment in the methylprednisolone group. We compared the clinical efficacy, average hearing thresholds, tinnitus handicap inventory scores, vertigo rating scale scores, speech recognition test scores, haemorheological indices, and adverse reactions between the two groups. Results: After 2 weeks of treatment, the total effective rate in the combined group was 95.00%, significantly higher than the 83.33% in the methylprednisolone group (P<0.05). The average hearing threshold and tinnitus handicap inventory scores in the combined group were lower than those in the methylprednisolone group, with significant differences (P<0.05). The dizziness rating scale scores in the combined group were lower than those in the methylprednisolone group, while the speech recognition test scores were higher, with significant differences (P<0.05). The whole blood viscosity, low shear whole blood viscosity, plasma viscosity, haematocrit, and red blood cell aggregation index in the combined group were lower than those in the methylprednisolone group, but the red blood cell deformability index was higher, with significant differences (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The combination of transcutaneous acupoint stimulation with a medium-frequency electrotherapy device and intratympanic injection of methylprednisolone shows significant efficacy in the treatment of sudden sensorineural hearing loss, effectively improving hearing levels and blood rheology indicators, alleviating dizziness symptoms, and not resulting in any new severe adverse reactions.

The expression of ANP32B and RAB10 in the bone marrow of children with acute myeloid leukemia and their relationship with clinical pathological characteristics and prognosisHe Min-hui1, Yang Chao2, Zhang Xiao-dong2, Zhang Xian-hui3

贺敏慧 — 2025/8/8 17:56:35

Objective To investigate the expression of acid nuclear phosphoprotein 32 family member B (ANP32B) and RAS oncogene family member 10 (RAB10) in the bone marrow of children with acute myeloid leukemia (AML) and their relationship with clinical pathological characteristics and prognosis. Method: 96 children with AML treated in our hospital from March 2019 to March 2021 were selected. 50 children with nonmalignant hematological diseases confirmed by bone marrow puncture during the same period as the control group. QPCR was used to detect the expression levels of ANP32B mRNA and RAB10 mRNA in bone marrow. The differential expression of ANP32B mRNA and RAB10 mRNA in bone marrow of AML children with different clinical characteristics were compared. Kaplan Meier curve analysis was conducted to analyze the prognostic differences of AML children with various ANP32B mRNA and RAB10 mRNA expression. Univariate and Multivariate Cox regression analysis were conducted to analyze the risk factors affecting the prognosis of children with AML. Results The relative expression levels of ANP32B mRNA (3.12 ± 0.43 vs. 1.05 ± 0.22) and RAB10 mRNA (2.85 ± 0.37 vs. 0.95 ± 0.21) in the AML group were significantly higher than those in the control group (t=31.898, 33.569, both P<0.05). The expression of ANP32B mRNA and RAB10 mRNA in the bone marrow of AML children was related to complete remission in the first course of treatment and risk classification. AML children with incomplete remission in the first course and high-risk classification have significantly increased expression of ANP32B mRNA and RAB10 mRNA (both P<0.05). The 3-year overall survival rates of AML patients in the ANP32B mRNA high expression group and RAB10 mRNA high expression group were 52.17% (24/46) and 42.55% (20/47), respectively, which were lower than those in the ANP32B mRNA low expression group and RAB10 mRNA low expression group, which were 80.00% (40/50) and 89.80% (44/49), respectively (Log Rank χ2=9.420, 19.720,both P<0.05). The risk stratification of high-risk, incomplete response in the first course of treatment, high ANP32B mRNA, and high RAB10 mRNA were all factors affecting poor prognosis in children with AML (all P<0.05). Conclusion: The increased expression of ANP32B mRNA and RAB10 mRNA in the bone marrow of children with AML are related to risk stratification, complete remission in the first course of treatment, and are biomarkers for evaluating the prognosis of AML children.

Application value of collateral circulation grading based on magnetic resonance DSC-PWI raw data in patients with acute anterior circulation large vascular occlusion stroke

严达 — 2025/8/8 15:50:32

Objective:To explore the feasibility of evaluating collateral circulation in patients with acute anterior circulation large vascular occlusion stroke based on magnetic resonance DSC-PWI raw data. Methods: A total of 114 patients with acute ischemic stroke caused by occlusive lesions of the unilateral internal carotid or the M1/M2 segment of the middle cerebral artery were collected. The collateral circulation of the magnetic resonance DSC-PWI raw data was graded by ASITN/SIR grading system. Interobserver reliability and intermethod agreement between DSC-PWI raw data and DSA for collateral grading were tested. Correlation between the collateral grading of DSC-PWI raw data and DSA was tested too. The imaging indexes of the groups with good and poor collateral circulation were compared. The correlation between ASITN/SIR collateral circulation grading and imaging indexes were analyzed. Results:The interobserver reliability for collateral grading of DSC-PWI raw data was excellent (K=0.821,P＜0.01). The intermethod agreement for collateral grading between DSC-PWI raw data and DSA was good in 76 patients (K=0.801,P＜0.05). Correlation between the collateral grading of DSC-PWI raw data and DSA was good (r=0.884,P＜0.01). Infarct volumes and perfusion deficits with good collateral circulation were both smaller than those with poor collateral circulation (P<0.01), and the mismatch ratio between the perfusion deficits and Infarct volumes area was greater than that with poor collateral circulation，and the differences were statistically significant.The correlation between the ASITN/SIR collateral grading of DSC-PWI raw data and infarct core volume was moderate (r=-0.613,P<0.01), but the correlation with perfusion deficits volume and mismatch ratio was both weak. Conclusion:ASITN/SIR grading based on DSC-PWI raw data can be used to evaluate the collateral circulation in patients with acute ischemic stroke caused by occlusive lesions of the anterior circulation.

The rehabilitation effect of free water drinking training combined with low-frequency pulse electrical stimulation on post-stroke swallowing disorders and its impact on neurological function and serum BDNF level

游菲,钟秀文 — 2025/8/8 15:50:03

Objective: To investigate the rehabilitation effect of free water drinking training combined with low-frequency pulse electrical stimulation on post-stroke swallowing disorders and its impact on neurological function and serum brain-derived neurotrophic factor (BDNF) level. Methods: From March 2022 to March 2024, 112 patients with post-stroke swallowing disorders admitted to our hospital were regarded as the observation subjects and assigned into a combination group (n=56) and a control group (n=56) according to the admission order. The control group received low-frequency pulsed electrical stimulation therapy, while the combination group received free water training rehabilitation on the top of the control group. Two groups were compared in terms of rehabilitation effect, the Chinese version of the Dysphagia Handicap Index (DHI), Eating Disorder Quality of Life Scale (EDQoL), Barthel Index, Eating Assessment Tool-10 (EAT-10), video fluoroscopic swallowing study (VFSS), serum BDNF, substance P (SP), neuron specific enolase (NSE), nerve growth factor (NGF), and S100β protein levels before and after treatment. Results: The total effective rate of rehabilitation in the combination group was higher than that in the control group (P<0.05). After treatment, the DHI, EDQoL, EAT-10 scores, serum S100β, and NSE decreased in both groups, while Barthel index, VFSS index, BDNF, SP, and NGF increased, the combination group was superior to the control group (P<0.05). Conclusion: Free water drinking training combined with low-frequency pulse electrical stimulation is beneficial for improving the quality of life of patients with post-stroke swallowing disorders, promoting neurological function recovery, increasing serum BDNF level, and achieving good rehabilitation effects.

The relationship between serum SALL4 and HOXB7 expression and disease severity and prognosis in patients with myelodysplastic syndrome

柴利娟,张伟伟 — 2025/8/8 15:49:30

Objective: To investigate the relationship between the expression of serum spalt-like transcription factor 4 (SALL4) and homeobox B7 (HOXB7) in patients with myelodysplastic syndrome (MDS) and the severity and prognosis of the disease. Methods: From March 2019 to March 2023, 116 MDS patients accepted by our hospital were regarded as the study subjects (MDS group). According to the IPSS-R score, the patients were assigned into low-to-medium risk group (≤ 4.5 points, 45 cases), high-risk group (4.5-6 points, 37 cases), and extremely high-risk group (>6 points, 34 cases). According to their survival status, they were assigned into a survival group (71 cases) and a death group (45 cases). 120 healthy individuals from our hospital"s physical examination center were randomly used as the control group. Multivariate Cox regression was used to analyze the mortality factors of MDS patients. ROC curve was used to analyze the predictive efficacy of serum SALL4 and HOXB7 alone and in combination for mortality within one year in MDS patients. Results: Compared with the control group, the levels of serum SALL4 and HOXB7 were greatly higher in the MDS group (P<0.05). The levels of serum SALL4 and HOXB7 in the high-risk group and extremely high-risk group were higher than those in the low-to-medium risk group, and the levels of serum SALL4 and HOXB7 in the extremely high-risk group were higher than those in the high-risk group (P<0.05). The proportion of patients with IPSS scores>6 points in the serum SALL4 and HOXB7 high expression groups was higher than that in the serum SALL4 and HOXB7 low expression group (P<0.05). The survival rate of patients with high serum SALL4 and HOXB7 expression was greatly lower than that of patients with low expression (χ2=18.452, 27.643, P<0.01). The proportion of patients with IPSS score>6 points and the levels of serum SALL4 and HOXB in the death group were higher than those in the survival group (P<0.05). IPSS score, HOXB7, and SALL4 were risk factors for mortality within 1 year in MDS patients (P<0.05). The AUC values of serum SALL4 and HOXB7 alone and in combination for predicting mortality within one year in MDS patients were 0.832, 0.827, and 0.920, respectively. The combination of the two had the highest predictive value (ZSALL4 - combination=2.924, ZHOXB7 - combination=3.183, P<0.05). Conclusion: The levels of serum SALL4 and HOXB7 are elevated in MDS patients. They are closely related to the progression and poor prognosis of MDS, and are potential prognostic diagnostic markers for MDS.

Innovative Thyroidectomy Technique: A Case Series Analysis of the Da Vinci Robotic System Via Transoral Vestibular and Bilateral Axillary Breast Approaches

赵华栋 — 2025/8/8 15:47:50

Traditional thyroidectomy can lead to conspicuous surgical scars, which significantly affect the quality of life and aesthetics of patients after the operation. We report that five patients with papillary thyroid cancer (PTC) underwent central neck dissection (CND) and lateral neck dissection (LND) through robotic thyroidectomy combined with the oral vestibular approach to the thyroid (TORTVA) and bilateral axillar-mammary approach (BABA). The average operation time was (444.6 ± 82.9) min. The average total number of positive/recurrent cases was (5 ± 2)/(15.6 ± 8.6) in the central neck, and the average total number of positive/recurrent cases was (3 ± 1.4)/(20.4 ± 8.3) in the lateral neck. This double approach thyroidectomy assisted by Da Vinci is safe and reliable, can completely eliminate the lesions and lymph nodes, and the patients have a good postoperative recovery, which can provide patients with high aesthetic requirements with a good postoperative quality of life and appearance satisfaction.

Clinical Features, Diagnosis, and Management of Pediatric Mycoplasma pneumoniae Infections

shangziru — 2025/8/8 10:16:51

Mycoplasma pneumoniae (MP) is a major pathogen of community-acquired pneumonia (CAP) in children and adolescents. In recent years, the incidence of MP infection has shown an increasing trend, accompanied by a rising detection rate of macrolide-resistant M. pneumoniae (MRMP), which poses significant challenges to clinical diagnosis and treatment. MP infection presents with a wide spectrum of clinical manifestations, and some patients may progress to severe pneumonia with extrapulmonary involvement. Current diagnostic methods include polymerase chain reaction (PCR), serological assays, multiplex PCR, and metagenomic next-generation sequencing (mNGS), all of which facilitate early detection and etiological confirmation. Macrolides remain the first-line treatment; however, in patients with documented resistance mutations identified by nucleic acid testing and poor clinical response to macrolide therapy, alternative agents such as tetracyclines or fluoroquinolones may be considered based on disease severity. Some children with refractory MP pneumonia respond well to adjunctive therapies such as corticosteroids and intravenous immunoglobulin (IVIG). This review, based on the latest evidence-based guidelines and expert consensus, provides a comprehensive overview of the epidemiology, pathogenesis, clinical features, diagnostic advances, antimicrobial resistance mechanisms, and therapeutic strategies of MP infection, aiming to inform clinical practice and guide future research.

Focus on the diagnosis and treatment of severe mycoplasma pneumoniae pneumonia in children

zhangyucai — 2025/8/8 10:03:42

述评约稿

Efficacy Analysis of Combined Endarterectomy and Endovascular Therapy in Patients with Chronic Internal Carotid Artery Occlusion Classified as Hasan Types A and B

张晓杰 — 2025/8/7 10:22:41

Objective To investigate the efficacy and safety of combined endarterectomy and endovascular therapy in patients with chronic internal carotid artery occlusion (CICAO) classified as Hasan types A and B. Methods A retrospective analysis was conducted on clinical data from 34 patients with Hasan type A/B CICAO treated at the Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, between June 2020 and June 2024. Diagnosis was confirmed via digital subtraction angiography (DSA), revealing "conical" or "blunt" occlusion stump morphology. Preoperative imaging evaluations and standardized medication were completed. All patients underwent combined endarterectomy and endovascular therapy. Efficacy and safety were assessed by recording vascular recanalization rates and perioperative complications. At 6-month follow-up, neurological recovery (modified Rankin scale, mRS) and vascular patency were evaluated to determine short-term prognosis. Results Successful recanalization was achieved in 28 patients (82.3%), while 6 cases failed. Perioperative complications occurred in 6 patients: hyperperfusion syndrome (1 case), carotid-cavernous fistula (2 cases), and vascular dissection (3 cases). At 6-month follow-up, among the 28 recanalized patients, 25 showed favorable prognosis (mRS 0–2) and 3 had poor outcomes (mRS 3–5). Postoperative clinical symptoms improved in 18 patients, remained unchanged in 8, and worsened in 2. Two patients developed restenosis of the internal carotid artery at 6 months. Conclusion Combined endarterectomy and endovascular therapy demonstrates high success rates, low perioperative complication risks, and favorable neurological and vascular outcomes in patients with Hasan type A/B CICAO. This dual-modality approach appears safe and effective, though further validation through randomized controlled trials with larger cohorts is warranted.

Clinical study on serum Ficolin-3, CD4+/CD8+ ratio combine with NLR in prognosis evaluation of children with mycoplasma pneumoniae pneumonia combine with EB virus infection

Sun Hui — 2025/8/6 9:31:43

Objective: To explore the clinical value of serum ficolin-3 (Ficolin-3), CD4+/CD8+ ratio combine with neutrophil/lymphocyte ratio (NLR) in prognosis evaluation of children with mycoplasma pneumoniae pneumonia (MPP) combine with EB virus (EBV) infection. Methods: 146 children with MPP combine with EBV infection who were admitted to our hospital from January 2021 to May 2023 were prospectively selected as MPP combine with EBV group, 100 children with simple MPP who were admitted to our hospital during the same period were selected as MPP group and 100 healthy children in outpatient physical examination were selected as control group. Serum Ficolin-3, CD4+/CD8+ ratio and NLR were detected and compared between three groups. Children with MPP combine with EBV infection were followed up for 12 months after discharge, the influencing factors of prognosis in children with MPP combine with EBV infection were analyzed by multivariate Logistic regression model, the prognostic value of serum Ficolin-3, CD4+/CD8+ ratio and NLR in children with MPP combine with EBV infection was analyzed by receiver operating characteristic (ROC) curve. Results: Serum Ficolin-3, NLR in MPP combine with EBV group were significantly higher than those in MPP group and control group (P<0.05), CD4+/CD8+ ratio was significantly lower than that in MPP group and control group (P<0.05). Serum Ficolin-3 increased, CD4+/CD8+ ratio decreased, NLR increased, severe MPP, and lung shadow≥2/3 lobes were risk factors for poor prognosis in children with MPP combine with EBV infection (P<0.05). The area under the curve (AUC) of combine detection of serum Ficolin-3, CD4+/CD8+ ratio and NLR in predicting the poor prognosis of children with MPP combine with EBV infection was better than that of single index detection. Conclusion: Serum Ficolin-3, NLR are abnormally increase in children with MPP combine with EBV infection, and CD4+/CD8+ ratio is decrease, which are related to the poor prognosis of children, the combine detection of the three is helpful to assist in evaluating the risk of poor prognosis in children with MPP combine with EBV infection.

Clinical observation of extracorporeal membrane oxygenation in the treatment of fulminant Mycoplasma pneumoniae pneumonia in ChildrenDepartment of Critical Care Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200062, China

Chenrongxin,,Shanyijun,Doujiaying,Hunting,Zhangyucai,Zhouyiping,Zhuguangyao — 2025/8/4 10:07:34

Objective To analyze the clinical efficacy and safety of extracorporeal membrane oxygenation (ECMO) salvage treatment for Pediatrics fulminant mycoplasma pneumoniae pneumonia (PFMPP) in children. Methods A retrospective study was conducted on 14 children with PFMPP who were admitted to the Department of Critical Care Medicine of Shanghai Children"s Hospital and treated with ECMO from January 2017 to December 2019. The basic information of the children patients, clinical and imaging features, initial parameters of mechanical ventilation and ECMO, complications and prognosis and other clinical data were summarized, and descriptive statistical methods were adopted. Results Fourteen children with FMPP were treated with ECMO, with a median age of 45 (25, 84) months. Among them, 8 cases received venous-arterial extracorporeal membrane oxygenation (VA ECMO) support, and 6 cases received veno-venous extracorporeal membrane oxygenation (VV ECMO) support. The median duration of the disease course before ECMO was 12 (9, 17) days, the median duration of mechanical ventilation before ECMO was 65 (20, 138) hours. The median pre-ECMO oxygenation index (P/F) was 62 (53, 68) mmHg, and the median oxygenation index (OI) was 28 (23, 45). Before the initiation of ECMO, the blood D-dimer levels of all children were elevated, with a median value of 3.9 (2.4, 10.7) mg/L. The median running time of ECMO was 141 (96, 171) hours, and 11 cases (78.6%) were treated with combined blood purification. There were 5 cases (35.7%) of ECMO complications, of which one cases was cerebral infarction, one cases was massive oral bleeding at the site of dental caries, one cases was membrane oxygenator and pipeline embolism, and two case was hemothorax. Among the 14 children, 9 cases (64.3%) had mixed infections. Two cases died of multiple organ failure respectively due to combined adenovirus infection and secondary Acinetobacter baumannii infection. Conclusion ECMO is an effective treatment for children with cardiopulmonary failure due to FMMP. However, the incidence of bleeding and coagulation complications is high, and combined infection may lead to a poor prognosis for children with FMPP.

Plant-derived exosome-like nanovesicles: Potential and Progress in Cancer Treatment

huanghongcai, — 2025/8/1 15:46:18

.Plant-derived exosome-like nanovesicles (PDNVs) are nanoscale vesicles secreted by plant cells, containing lipids, RNAs, proteins, and diverse phytochemicals. Recent studies have demonstrated their therapeutic potential in various disease treatments. Herbal medicine-derived exosome-like nanovesicles (HMDNVs) show particular promise for cancer therapy. This review systematically examines research advances in PDNVs' anticancer applications.

Research Progress on the Impact of Various Exercise Modalities on Glucose and Lipid

ranyuqin,songxu,songzhicong,zhangxihai — 2025/7/31 18:34:52

AThe objective of this systematic review is to meticulously delineate the impact of diverse physical activity paradigms on glucose and lipid metabolism, while concurrently elucidating their underlying mechanistic actions. This undertaking is propelled by the urgent necessity to furnish evidence - based exercise guidelines for individuals manifesting dysregulations in glucose and lipid metabolism pathways.In the contemporary milieu, characterized by the pervasiveness of deleterious lifestyle choices, the disruption of glucose and lipid homeostasis, along with the concomitant metabolic derangements, has emerged as a formidable challenge to public health. This review comprehensively evaluates the efficacy of an extensive spectrum of physical training modalities. These include aerobic exercises, resistance training, high - intensity interval training (HIIT), and traditional exercise forms, in ameliorating glucose and lipid metabolic functions.A synthesis of extant research underscores that these diverse exercise modalities are effective in augmenting metabolic profiles and reducing the risk of metabolic diseases. Specifically, aerobic exercises enhance glucose and lipid metabolism by augmenting glucose utilization and insulin sensitivity. Resistance training promotes improved glycemic control and dyslipidemia management through enhanced muscular uptake of glucose and lipids. The combination of aerobic and resistance training exhibits synergistic advantages in glycemic regulation and the mitigation of diabetes - associated cardiovascular risks. High - intensity interval training is commended for its time - efficiency and cardiopulmonary - enhancing attributes. Traditional exercises are particularly advantageous for the geriatric population, owing to their holistic approach to health and well - being.

A Rare Case of Extracranial Schwannoma of the Hypoglossal Nerve Located in the Submaxillary Space Characterized with painless mass in the neck

Han Leng,,,, — 2025/7/31 18:34:06

This paper reports a case of hypoglossal schwannoma in the extracranial segment, characterized only by a painless mass in the neck, and the relevant literatures were also analyzed. The clinical manifestations, diagnosis, differential diagnosis, and treatment of hypoglossal schwannoma in the extracranial segment are discussed in order to improve the diagnosis and treatment of hypoglossal schwannoma in the extracranial segment.

Monitoring, Investigation and Research on Birth Defects of Perinatal Infants in Nanning City, Guangxi from 2017 to 2023

2025/7/31 15:53:12

Objective To analyze the occurrence characteristics and trends of birth defects in Nanning, Guangxi Zhuang Autonomous Region from 2017 to 2023, and to provide a scientific basis for scientifically preventing and controlling birth defects, promoting maternal and child health, and improving the quality of birth. Methods Descriptive analysis was performed on birth defect case data reported by various midwifery institutions in Nanning from 2017 to 2023. Results From 2017 to 2023, there were 720,715 perinatal infants in Nanning, and 21,888 cases of birth defects were found. The total incidence of birth defects was 322.13 per 10,000. The overall incidence showed an upward trend year by year (χ2=13536.00, P < 0.001). The birth defect rate of male infants was 298.64 per 10,000, higher than that of female infants (233.93 per 10,000, 2= 245.16, P < 0.001). The birth defect rate in urban areas was higher than that in rural areas (χ2= 9020.48, P < 0.001). There was a statistically significant difference in the incidence of birth defects among different age groups of parturients (χ2=256.17, P < 0.001). The incidence of birth defects in the offspring of mothers aged ≥ 35 years (350.15 per 10,000) was higher than that of younger mothers. The top 10 birth defects in perinatal infants accounted for 92.04% of all birth defect cases. From 2017 to 2023, the incidence of congenital heart disease fluctuated between 50.32 per 10,000 and 330.48 per 10,000, ranking as the first most common birth defect. Severe thalassemia first appeared in the top 10 birth defect rates in 2019 and ranked steadily at 9th place from 2019 to 2020. The number of major birth defects leading to death or disability generally showed a decreasing trend, accounting for 12.54% - 23.49% of all birth defects. Conclusion From 2017 to 2021, the incidence of birth defects in perinatal infants in Nanning showed an overall upward trend, with differences in gender, urban-rural distribution, and maternal age. The increase in incidence may be related to the implementation of the two-child policy, improvements in prenatal screening and diagnostic technology capabilities, and increased monitoring levels. It is recommended to actively carry out health education and improve the city's birth defect prevention and control management system, thereby enhancing maternal and child health and improving the quality of birth.

Current status of Candida auris infection and progress of single-cell sequencing research

DengChaonan — 2025/7/18 11:56:03

Candida auris is an emerging, multidrug-resistant fungal pathogen that has spread rapidly worldwide since it was first identified in Japan in 2009 and has become a major public health challenge. This article reviews the epidemiological status, clinical characteristics, prevention and control strategies of Candida auris infection, and the application progress of single-cell sequencing technology in research, aiming to comprehensively understand the severe situation of Candida auris infection and the new opportunities that single-cell sequencing technology may bring to its research.

Advances in the Diagnosis and Treatment of Cryptococcosis

liuqi — 2025/7/17 16:17:42

Cryptococcosis is a globally significant fungal infectious disease primarily caused bySCryptococcus neoformansSandSCryptococcus gattii, posing severe threats to immunocompromised populations, particularly those with HIV infection. Multilocus sequence typing (MLST) is the predominant method for cryptococcal strain typing, withSC. neoformansSST5 being the most prevalent sequence type. In diagnostics, conventional techniques such as India ink staining and fungal culture exhibit distinct advantages and limitations, while emerging molecular biological methods offer novel options for rapid diagnosis. The mechanisms of cryptococcal drug resistance are complex, primarily involving target gene mutations (e.g.,SERG11,SFCY2), chromosomal ploidy variations, and activation of stress response pathways. For treatment, amphotericin B combined with flucytosine remains the first-line regimen. However, growing drug resistance has spurred exploration of novel targets (e.g., virulence factors, stress-regulatory proteins) and therapeutic agents (e.g., Gwt1 inhibitor APX001, tetrazole VT-1598), with immunotherapy and combination strategies also demonstrating potential. This review synthesizes recent advances in cryptococcal typing methods, diagnostic approaches, resistance mechanisms, and emerging therapies, aiming to provide new insights for the diagnosis and treatment of cryptococcosis.

Clinical characteristics of Talaromyces marneffei infection in HIV-negative patients, strain clustering and in vitro antifungal susceptibilityLiang Liang1, Jie Jiang1, Wenlong Duan2,Xingchun Chen1

Duan Wen Long,Jiang Jie,Liang liang — 2025/7/17 8:47:44

[Abstract] Objective To investigate the clinical characteristics, strain phylogenetic clustering relationships, and the minimum inhibitory concentrations (MICs) of 9 antifungal drugs against the yeast phase of Talaromyces marneffei (Tm) in vitro among HIV-negative patients infected with Tm. Methods The data of 32 HIV-negative patients infected with Tm from the People's Hospital of Guangxi Zhuang Autonomous Region between January 2020 and May 2025 were analyzed. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used for strain identification and clustering analysis, and the microbroth dilution method was employed to detect the MICs. Results Blood (50.0%, 16/32) and tracheal aspirates (15.6%, 5/32) were the most common specimens for Tm. The median age of the patients was 59 years (range: 27 - 84 years), and the main underlying diseases were diabetes (28.1%, 9/32) and chronic hepatitis B (21.9%, 7/32). 65.6% (21/32) of the patients had an agricultural background, and the main manifestations were fever (71.9%, 23/32) and respiratory symptoms (68.8%, 22/32). Laboratory findings revealed a median peripheral blood white blood cell count of 18.2×10?/L (IQR: 1.34-38.66×10?/L), a median C-reactive protein (CRP) level of 154.3 mg/L (IQR:7-630mg/L),and the positive rate of fungal glucan detection was 82.6% (23/32).MALDI-TOF MS identification of Tm yielded a mean log score of 2.07 ± 0.09, with 100% concordance rate (32/32 strains) compared to morphological identification.The clustering analysis showed that the strains belonged to two major clusters. The MIC90 values of voriconazole, isavuconazole, itraconazole, posaconazole, flucytosine, amphotericin B, fluconazole, caspofungin, and micafungin were≤0.015μg/mL,≤0.015μg/mL,0.12μg/mL,0.12μg/mL, 0.25μg/mL, 1.0μg/mL, 4.0μg/mL,4.0μg/mL,and≥8.0μg/mL,respectively. Conclusion Non-HIV Tm patients are mostly middle-aged and elderly immunosuppressed individuals, and their clinical manifestations are non-specific. The combined detection of inflammatory markers and fungal glucan is beneficial for early diagnosis. Clinically, screening for autoantibodies in Tm patients should be strengthened. MALDI-TOF MS can be used for the rapid identification and clustering analysis of Tm. Amphotericin B, itraconazole, and voriconazole can be used as empirical treatment drugs.

Rapid Identification of Carbapenemase Genotypes in Klebsiella pneumoniae Using Nucleic Acid Mass Spectrometry Technology

Deng Xinyi,,Liang Xinyi,Song Shuang,Sun Jingfang,Ye Lin,Zhao Shulong — 2025/7/17 8:44:37

Objective:STo establish a method for rapid identification of carbapenemase genotypes of Klebsiella pneumonia based on MALDI-TOF MS. Methods:SA total of 56 non-redundant carbapenem-resistantSKlebsiella pneumoniaeS(CRKP) strains isolated from the Affiliated Hospital of Xuzhou Medical University between 2021 and 2023 were collected. Bacterial identification and antimicrobial susceptibility analysis were performed using MALDI-TOF MS and VITEK-2 Compact. Specific single-base extension primers were designed, and a multiplex PCR combined with nucleic acid mass spectrometry was employed to detect characteristic peaks of carbapenemase gene subtypes in a single reaction system. PCR results served as the gold standard to validate detection accuracy.Results:SPCR analysis revealed that among the 56 CRKP strains, 14 carried KPC, 14 carried NDM, 14 carried OXA-48, and 14 were co-producers of KPC+NDM. The nucleic acid mass spectrometry method achieved an accuracy rate of 98.21% (55/56), with no cross-interference observed among the characteristic peaks of different subtypes. The detection accuracy for KPC, OXA-48, and co-production types reached 100%, while only one NDM strain was misidentified as NDM+OXA-48 co-production. Antimicrobial susceptibility testing demonstrated that KPC and NDM strains exhibited 100% resistance to imipenem, whereas OXA-48 strains were fully susceptible.Conclusion:SNucleic acid mass spectrometry enables efficient and accurate identification of carbapenemase gene subtypes in CRKP, demonstrating high concordance with PCR results. This method provides a reliable tool for rapid genotyping and antimicrobial resistance surveillance in clinical settings.

Updates and Interpretation of the CLSI M100 Document 2025 Edition

lixiang,,zhanglijun,zhangqiuying,zhucongzhi — 2025/7/16 16:54:48

The CLSI M100 document is a critical guideline for clinical microbiology antimicrobial susceptibility testing (AST). Its compiling committee includes multidisciplinary experts from microbiology laboratories, government agencies, healthcare providers and educators, the pharmaceutical industry, and microbiological diagnostics, providing essential reference support for clinical infection management. The 2025 edition of the CLSI M100 (Edition 35) was released in late January this year. Compared to the previous M100 Ed34, the new version introduces updates in several areas. Below, we summarize and interpret six key changes relevant to daily microbiology laboratory workflows.

Study on predictive factors and risk assessment model of multiple myeloma patients complicated with nervous system damage

米秋雯 — 2025/7/15 10:01:38

Objective: To explore the predictive factors of multiple myeloma (MM) patients complicated with nervous system damage, and to construct a risk assessment Nomogram model and verify its effectiveness. Method: The clinical data of 202 MM patients admitted to our hospital from October 2019 to October 2023 were retrospectively analyzed, they were divided into occurrence group and the non-occurrence group according to whether there was nervous system damage. The clinical data of the two groups were compared, and the influencing factors of MM complicated with nervous system damage were analyzed by multivariate Logistic regression model. A Nomogram model of MM complicated with nervous system damage was constructed by R software, and receiver operating characteristic curve (ROC) and calibration curve were drawn to verify the prediction efficiency of the model for the risk of MM complicated with nervous system damage. Results: The incidence of nervous system damage in MM was 42.57%. Compared with the non-occurrence group, the patient in occurrence group was older (P < 0.05), and lactate dehydrogenase (LDH), C- reactive protein (CRP), monoclonal immunoglobulin (Ig) G, β2 microglobulin (β2-MG), proportion of international staging system(ISS) stage III account were higher (P < 0.05), and the activated partial thromboplastin time (APTT) and prothrombin time (PT) were shorter (P < 0.05), and hemoglobin and albumin were lower (P < 0.05). Age, LDH, IgG, APTT, PT, hemoglobin, and ISS staging were the influencing factors of nervous system damage in MM (P < 0.05). The above factors were used as risk predictors to construct Nomogram model. The area under the curve, sensitivity and specificity of ROC curve display model to predict the occurrence of MM nervous system damage were 0.917 (95% CI: 0.861 ~ 0.956), 95.35% and 87.85%, respectively. The calibration curve showed that the predicted probability of the model was close to the actual probability, and the Hosmer-Lemeshow goodness of fit test showed that it was well fitted (χ2=1.912, P=0.306), when the threshold probability of model prediction was 18%~93%, 94%~96% and 97%~100%, the clinical net benefit can be obtained. Conclusion: Age, LDH, IgG, APTT, PT, hemoglobin, and ISS stage are predictors of nervous system damage in MM, and the Nomogram model based on this is effective in predicting the risk of nervous system damage in MM.

Accurately defining occult HBV infection is beneficial for the management of chronic hepatitis B patients with functional cure

lufengmin,, — 2025/7/15 8:51:36

Occult HBV infection (OBI) is characterized by negative serum HBsAg but positive HBV DNA in serum and/or liver tissue, emphasizing the low-level presence of hepatitis B virus (HBV) in the body. In contrast, occult hepatitis B (OHB) focuses more on the disease state of hepatitis B, building upon OBI with additional manifestations such as liver inflammation and more active viral replication compared to OBI. Clinically, there are controversies between OBI and OHB regarding definitional boundaries, clinical significance and risk assessment, disease progression, and immune status. This article will outline the key points of contention between OBI and OHB, explore the differences in clinical risks associated with OBI from various sources, and analyze the mechanism by which cccDNA persists in the liver tissue of functionally cured patients even after HBV-specific immunity has been restored following antiviral therapy. This aims to clarify the true state of chronic hepatitis B functional cure and the long-term management strategies for cured patients.

Expert Consensus on the Clinical Diagnosis and Treatment of Transfusion-Associated Graft-versus-Host Disease (2025 Edition)

ZHOUJICHENG — 2025/7/14 17:09:57

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare but extremely serious transfusion complication. The Editorial Committee of the "Expert Consensus on the Clinical Diagnosis and Treatment of Transfusion-Associated Graft-versus-Host Disease (2025 Edition)" organized experts in China from fields including transfusion medicine, hematology, and gastroenterology, etc., to formulate the "Expert Consensus on the Clinical Diagnosis and Treatment of Transfusion-Associated Graft-versus-Host Disease (2025 Edition)", and put forward consensus opinions on the auxiliary examinations of TA-GVHD, the diagnosis and differential diagnosis of TA-GVHD, as well as the prevention and treatment strategies.

Advances in the Research and Application of Adipose-Derived Stem Cells (ADSCs) Transplantation for Tissue and Organ Injury Repair

zuoyuer — 2025/7/11 11:20:57

Adipose-Derived Stem Cells (ADSCs) are multipotentench mesymal stem cells isolated from adipose tissue. Since their first successful isolation in 2001, ADSCs have gradually become a research focus in the fields of regenerative medicine and immune regulation. ADSCs not only possess multidirectional differentiation potential, but also significantly inhibit transplant rejection and induce immune tolerance through various mechanisms, including the secretion of multiple immune regulatory factors, exosome-mediated signaling, and direct cell-to-cell contact. In recent years, it has been discovered that ADSCs can reshape the immune microenvironment by modulating the functions of T cells, B cells, dendritic cells (DCs), and macrophages. Additionally, the immunosuppressive capacity of ADSCs can be enhanced through genetic editing and pre-treatment techniques. This article systematically reviews the research progress of ADSCs in multiple application fields, including the nervous system, cardiovascular system, skin and tissues, as well as clinical application advancements, aiming to provide theoretical support for research in this area.

Clinical data analysis of 176 children with central airway stenosis

tangsixiang,,, — 2025/7/10 12:00:19

Objective: To analyze the clinical data of 176 children with central airway stenosis. Methods: A retrospective analysis was conducted on the clinical data of 176 children with central airway stenosis admitted to the First Affiliated Hospital of Guangzhou Medical University from January 2018 to December 2023, including general conditions, causes and locations of central airway stenosis, results of pulmonary function tests, blood gas analysis, clinical manifestations, and CT and bronchoscopy results at admission. Results: Among the 176 children with central airway stenosis, 120 were male (68.18%) and 56 were female (31.82%), with a median age of 17 (9, 37) months. The main causes of congenital central airway stenosis (24.43%) were congenital airway malformations (17.61%), while the main causes of acquired central airway stenosis (75.57%) were tracheal intubation or tracheotomy (35.23%), airway foreign bodies (17.61%), and infections (15.91%). In children with central airway stenosis, subglottic stenosis (39.77%) and right main bronchus and right intermediate bronchus stenosis (38.07%) were the most common. Pulmonary ventilation function tests in 7 children all indicated varying degrees of obstructive ventilatory dysfunction. Blood gas analysis in 109 children showed that 44 (40.37%) had decreased oxygen partial pressure (PaO2), 35 (32.11%) had increased carbon dioxide partial pressure (PaCO2), 29 (26.61%) had decreased hydrogen ion concentration index (pH), 38 (34.86%) had increased actual bicarbonate ion concentration, and 22 (20.18%) had increased base excess. The main clinical manifestations were cough, wheezing, tracheal tug, and shortness of breath. The detection rate of central airway stenosis by CT was 80.46%. Conclusion: There are differences in the main causes of central airway stenosis among different age groups and locations. In this study, iatrogenic injury (tracheal intubation/tracheotomy) was the primary cause. It is recommended that clinical prevention and treatment strategies be targeted at different ages and stenosis locations, with particular attention to the prevention and management of iatrogenic injury.

The application of repetitive transcranial magnetic stimulation in the treatment of gambling disorders

孙蕴怡, — 2025/7/8 11:55:53

Gambling Disorder (GD) is a psychiatric behavioral disorder characterized by persistent or recurrent gambling behaviors that cause significant distress and harm to individuals in terms of personal health, economic consequences, and social impacts. Currently, a substantial proportion of GD patients do not achieve effective relief through pharmacological or psychological treatments, which not only damages their health but also imposes a heavy burden on families and society. In recent years, non-invasive transcranial magnetic stimulation technology has shown some progress in treating GD, with research demonstrating its effectiveness in reducing craving, alleviating mood, and decreasing gambling behavior. However, there remains controversy in the academic community regarding the selection and determination of key parameters such as stimulation targets, stimulation modes, and stimulation duration. This article systematically reviews the application of repetitive transcranial magnetic stimulation in treating GD, di

Expression and Clinical Significance of Peripheral Blood 8-OHdG and SDF-1 in Neonatal Respiratory Distress Syndrome

杨利君 — 2025/7/8 10:56:14

Objective To investigate the expression and clinical significance of peripheral blood 8-hydroxy-2"-deoxyguanosine (8-OHdG) and stromal cell-derived factor-1 (SDF-1) in neonates with respiratory distress syndrome (NRDS). Methods A total of 108 neonates with NRDS (NRDS group) admitted to Shangluo Central Hospital from July 2021 to May 2024 and 52 healthy neonates (control group) were selected. The NRDS group was further categorized by disease severity into mild (22 cases), moderate (50 cases), and severe NRDS groups (36 cases) and by prognosis into a survival group (81 cases) and a mortality group (27 cases). Peripheral blood levels of 8-OHdG and SDF-1 were measured using enzyme-linked immunosorbent assay (ELISA). Logistic regression and ROC curve analyses were conducted to evaluate the relationship and predictive efficacy of 8-OHdG and SDF-1 levels in relation to NRDS prognosis. Results Compared to the control group [(3.70±1.47 ng/ml), (8.23±1.32 ng/ml)], levels of peripheral blood 8-OHdG [(13.81±3.90 ng/ml)] and SDF-1 [(12.46±1.62 ng/ml)] were significantly elevated in the NRDS group (t＝23.661, 16.439; all P＜0.05). 8-OHdG levels [(9.58±2.57 ng/ml), (12.91±2.44 ng/ml), (17.65±2.59 ng/ml)] and SDF-1 levels [(10.59±1.02 ng/ml), (12.20±0.98 ng/ml), (13.98±1.16 ng/ml)] progressively increased across the mild, moderate, and severe NRDS groups (F＝140.326, 143.512; all P＜0.05). Compared to the survival group [(12.69±3.40 ng/ml), (12.02±1.44 ng/ml)], the mortality group showed significantly higher levels of 8-OHdG [(17.19±3.38 ng/ml)] and SDF-1 [(13.80±1.36 ng/ml)] (t＝5.973, 5.648; all P＜0.05). Severe NRDS, elevated 8-OHdG, and elevated SDF-1 were identified as independent risk factors for mortality in NRDS [OR (95%CI) = 16.137 (1.758 to 148.097), 1.705 (1.288 to 2.258), 4.120 (1.911 to 8.884)]. The combined predictive efficacy of 8-OHdG and SDF-1 levels for NRDS mortality was reflected by an AUC of 0.925 (95%CI: 0.859–0.967), which was higher than that of 8-OHdG (0.819, 95%CI: 0.733 to 0.886) and SDF-1 (0.801, 95%CI: 0.713 to 0.872) individually (Z＝2.924, 3.053; all P＜0.05). Conclusion Elevated peripheral blood levels of 8-OHdG and SDF-1 in neonates with NRDS are associated with increased disease severity and mortality risk. Combined 8-OHdG and SDF-1 levels provide strong predictive value for NRDS prognosis.

Clinicopathological data analysis of 85 cases of mesothelioma in a single center

黄波,刘曼,马思源 — 2025/7/8 10:55:31

Objective The clinicopathological data of 85 cases of mesothelioma in a single-center were analyzed. Methods The clinicopathological data of 85 mesothelioma cases admitted to Liaoning Cancer Hospital &Institute from April 2003 to April 2021 were retrospectively analyzed.Results The?male?to?female?ratio of mesothelioma?was 0.98: 1. The median age was 60 years. Pleural mesothelioma and peritoneal mesothelioma accounted for 70.59% and 29.41% respectively. Epithelioid, sarcomatoid and biphasic accounted for 65.88%, 10.59% and 23.53%, respectively. The differences of pathological histopathological?types were related to disease sites (P=0.008) . The survival time of mesothelioma ranged from 3 to 32 months, with the median survival time of 16.00 months. Pathological histopathological types, lymph node metastasis and treatments were prognostic factors for mesothelioma. (P<0.05). Epithelioid mesothelioma was mainly tubulopapillary (53.57%) , low grade and high grade accounted for 51.79% and 48.21%, respectively. The differences of pathological histological grading were related to lymph node metastasis (P=0.018). The median survival time of low grade and high grade was 22.00 months and 16.00 months, respectively (P>0.05). Conclusions Among 85 cases of mesothelioma, pleura was more common than peritoneum. The pathological histopathological types were most epithelioid and least sarcomatoid. Patients with epithelioid mesothelioma have the best survival prognosis, and patients with lymph node metastasis have a poor prognosis. Surgery combined with chemotherapy has the best treatment effect. Epithelioid have a variety of pathological histological subtypes, mainly tubulopapillary, the proportion of high grade and low grade was similar, and the median survival time of low grade patients was longer.

The impact of proactive multifaceted thermal insulation measures on mother and child in late preterm cesarean section.

weiyanfen, — 2025/7/7 17:28:36

Abstract: Objective: To investigate the impact of multiple warming measures on mother and child during late preterm cesarean section. Methods: A total of 200 cases of cesarean section under spinal anesthesia delivered at Guangxi Zhuang Autonomous Region People's Hospital from January 2022 to May 2024 were collected as the research subjects. They were randomly divided into research group and control group , each with 100 cases. The control group adopted conventional warming measures, while the research group, on the basis of conventional warming, adopted multiple warming measures. The two groups were compared for different time points of blood glucose, body temperature, oxygen saturation, blood loss,surgical time, intraoperative shivering, and hypothermia incidence; postoperative recovery situation; and neonatal indicators.To analyze the effect of warming measures on intraoperative body temperature, factors affecting body temperature, and maternal and fetal outcomes in cesarean delivery. Results: The research group had higher body temperature, preoperative blood glucose, and oxygen saturation at the time of entering the operating room, the start of anesthesia, 30 minutes after anesthesia, at the time of fetal delivery, half an hour after the start of the operation, at the end of the operation, and 30 minutes after returning to the ward, which were statistically significant compared to the control group (p<0.05).surgical time, the time for the research group to get out of bed, the time of anal gas emission, and the length of hospital stay were shorter than those of the control group, with statistical significance (p<0.05). The incidence of shivering, hypothermia, and postpartum bleeding in the research group was lower than that in the control group, with statistical significance (p<0.05). The neonatal rectal temperature within 15 minutes after birth, umbilical artery blood gas analysis, and blood glucose in the research group were higher than those in the control group, with statistical significance (p<0.05).The single-factor results affecting the occurrence of intraoperative hypothermia showed that the amount of intraoperative bleeding, operation time, preoperative blood glucose, and whether or not chills were statistically significant (P<0.05); Logistic regression analysis showed that the amount of intraoperative bleeding and operation time were the factors affecting the occurrence of intraoperative hypothermia; the ROC-AUC of the established prediction model was 0. 912 (0.839-0.985), the sensitivity The ROC-AUC of the prediction model was 0.912 (0.839-0.985), the sensitivity was 91.4% and the specificity was 71.4%. Conclusion: Active adoption of multiple warming measures by the mother during and after late preterm cesarean section can reduce the incidence of hypothermia, decrease blood loss, shorten the operation time，lower the incidence of maternal hypoglycemia, promote rapid postoperative recovery of the mother, improve neonatal physiological indicators, and is worth promoting.

Study on the restorative effect of strontium-loaded nanotubularized pure titanium implants on alveolar bone defects

hejiahuan — 2025/7/7 17:26:11

[Objective] To investigate the repair performance of pure titanium implants loaded with strontium nanotubes for alveolar bone defects. [Method] The strontium nanotube coating (strontium nanotube group) was constructed on the surface of pure titanium implant by anodic oxidation and hydroheat treatment, and the simple nanotube-based implant (nanotube group) and the untreated smooth pure titanium implant (blank group) were prepared. The components of implant surface elements were analyzed using the energy spectrum analysis tool embedded in electron microscope. Scanning electron microscopy was used to observe the implant surface morphology, and atomic force microscopy was used to detect the implant surface roughness. Histological evaluation was performed by microCT, Masson and immunohistochemistry. [Result] Compared with the blank group, Ti content decreased and O content and F content increased on the surface of the nanotube group, while Ti content decreased and O content and Sr content increased on the surface of the strontium-loaded nanotube group. Compared with the blank group, the surface roughness of the implants in the nanotube group and the strontium-loaded nanotube group was significantly increased. At 4 weeks after operation, BV/TV, BS/BV and Tb.Th in the nanotube group and the strontium-loaded nanotube group were significantly increased compared with the blank group. At 12 weeks after surgery, BV/TV, BS/BV and Tb.Th were significantly increased in the strontium-loaded nanotube group compared with the blank group, but there was no significant difference in the nanotube group. After 12 weeks of implantation, compared with the blank group, the OPN and BMP2 positive staining area of the bone defect site of rats in the nanotube group increased, and the OPN and BMP2 positive staining area of the bone defect site of rats in the strontium nanotube group increased significantly more than that in the nanotube group. [Conclusion] Pure titanium implants loaded with strontium nanotubes can promote the repair ability of alveolar bone defects.

Surgical treatment of thoracic giant tumor: a report of 33 cases

Lu Weiqiang,Ma Runyang,Miao Libin,Ren Dewang,Wang Zhiyuan — 2025/7/7 10:30:47

Objective: To explore the clinical features and surgical treatment effects of thoracic giant tumors, and study the special treatment experience for the perioperative process. Method: A retrospective analysis was conducted on the clinical data of 33 patients with thoracic giant tumor who underwent thoracic surgery at Aerospace Center Hospital from March 2015 to June 2023. Results: 17 cases were completely resected, the others were subtotal resected. Simple resection was performed in 19 cases, combined with Superior vena cava plasty in 4 cases and pulmonary resection in 5 cases. 19 cases were longitudinally cleaved sternum through median incision, lateral thoracotomy in 7 cases, low cervical arc incision in 3 cases, minimally invasive thoracoscopy surgery in 3 cases, low cervical arc incision with median longitudinal sternum incision in 1 case. Intraoperative bleeding ranged from 100-8000 ml. There were 2 cases of postoperative Pulmonary edema after preventive measures against relapsing Pulmonary edema, of which 1 case died of multiple organ failure, the other was cured and discharged. All other patients were cured and discharged after surgery. Conclusion: Patients with thoracic giant tumor are often in a serious condition. Surgical resection is the main treatment method, which can make most patients obtain good long-term efficacy and quality of life. However, due to the particularity of giant tumor in the thoracic cavity, adequate assessment and preparation should be carried out before the operation. Pay attention to ensuring the safety of major vessels and important organs during operation, and preventing serious complications after operation.

Relationship between serum β-HB, HbA1c and cognitive function in children with diabetic ketoacidosis complicated with cerebral edema

FAN Aihong,MI Yanru,ZHANG Liguang — 2025/7/7 10:29:49

Objective: To investigate the relationship between serum β-hydroxybutyric acid (β-HB), glycated hemoglobin (HbA1c) and cognitive function in children with diabetic ketoacidosis (DKA) complicated with cerebral edema. Methods: 148 children with DKA combined with cerebral edema who were admitted to our hospital from March 2020 to March 2023 were screened. The cognitive function of the children was assessed by the fourth edition of the Wechsler Intelligence Scale for Children (WISC-Ⅳ), and the children were divided into the disabled group (n=26) and the normal group (n=122) according to whether cognitive dysfunction occurred. The clinical data of the two groups were compared, and the correlation between serum β-HB, HbA1c and WISC-Ⅳ score was analyzed by Pearson correlation analysis. The risk factors of cognitive dysfunction in children with DKA complicated with cerebral edema were analyzed by multivariate Logistic regression. Results: The fasting blood glucose (FPG), lactic acid (Lac), total cholesterol (TC), HbA1c and serum β-HB levels in the disabled group were higher than those in the normal group, while the blood sodium and pH levels were lower than those in the normal group, with statistical significance (P < 0.05). By Pearson correlation analysis, serum β-HB, HbA1c were negatively correlated with WISC-Ⅳ scores (r=-0.648, -0.726, P < 0.05). Logistic regression analysis model showed that HbA1c was an independent risk factor for cognitive dysfunction, while serum sodium and serum β-HB were protective factors for cognitive dysfunction (P < 0.05).Conclusion: The high levels of serum β-HB and HbA1c in children with DKA combined with cerebral edema were significantly negatively correlated with WISC-Ⅳ score, among which serum β-HB was a protective factor for cognitive dysfunction in children, and HbA1c was a risk factor.

Clinical effect of estrogen combined with Zhuang acupuncture therapy in the treatment of Thin Endometrium infertility during frozen-thawed embryo transfer

(CHI Yan,,HUANG Tai-shuai,LIU Li-ling,QIN Jie — 2025/7/7 10:28:56

Objective: To observe the clinical effect of estrogen combined with Zhuang acupuncture therapy in the treatment of thin endometrium infertility during frozen-thawed embryo transfer. Methods: By using prospective research methods, a total of 120 patients with thin endometrium infertility during frozen-thawed embryo transfer in our hospital from March 2022 to June 2024 were selected and randomized into a control group of 60 cases and a combined treatment group of 60 cases. The control group was treated with estrogen only, while the combined treatment group was given estrogen and Zhuang acupuncture therapy. The endometrial thickness, related estrogen levels, endometrial blood flow grading and pregnancy outcome of the two groups of patients before and after treatment were observed and compared. Results: After treatment, the endometrial thickness and endometrial blood flow grading of the combined treatment group were better than those of the control group (P<0.05). In addition, clinical pregnancy rate, implantation rate of the combined treatment group with compared to those of the control group were found significant difference(P＜0.05). Conclusion: Estrogen combined with Zhuang acupuncture therapy may be an effective treatment for the patients with thin endometrium infertility during frozen-thawed embryo transfer.

Validity composition identification on transdermal absorption of Nanhu gelata and it’s clinical observation of external treatment in rheumatoid arthritis

袁毅 — 2025/7/7 10:27:33

Objective To identify the active ingredients in transdermal absorption of Nanhu gel and observe the clinical efficacy on acute active rheumatoid arthritis (RA). Methods A modified Franz diffusion device was used to identify the active components in the transdermal absorption solution by using thin-layer chromatography as the barrier medium and 75% ethanol solution as the receiving medium. A total of 60 RA patients, admitted from May 2017 to December 2021, were selected as the study subjects, and divided into blank gel group, Nanhu gelata group, and futalin group with 20 patients in each group by prospective randomized single-blind control study method. On the basis of unified treatment, the affected area was coated with blank gel, Nanhu gelata and futalin ointment. General data were recorded, and the efficacy was assessed once during the screening period and once after one week. Results i. In TLC, the transdermal absorbing solution showed the same color spots at the same position as the emodin reference substance, the serotonin reference substance, and the myrrh control reference substance. ii. There was no significant difference in gender, age and condition among the three groups (P> 0.05). iii. There was no significant difference in sedimentation (ESR) between the three groups (F=0.716, P=0.608); no difference in C-reactive protein (CRP) (F=0.628, P=0.572). iv. Pain scores decreased significantly before and after treatment: H=12.64, P=0.000, which showed significant difference, and the Nanhu gelata difference was greater than that of futalin group (P<0.05). v.Comparison of peridiameter difference: F=14.62, significant difference (P<0.05).v. Comparison of onset time: H=7.368, P<0.05, statistically significant. vii. The total response rate of the blank gel group was 90%, which was higher than the 80% rate in the futalin group, which was statistically significant (=12.466, P=0.029). viii. Three groups of drug-induced adverse events in the whole treatment process, blank gel group, Nanhu gel group and futalin group were 0 cases. Conclusion The active ingredient of Nanhu Gel can penetrate the skin. Nanhu gel can effectively reduce the pain and swelling symptoms of RA patients, relieve the acute onset symptoms better than butalin gel, and has no obvious impact on liver and kidney function. It is safe and effective, and is worthy of clinical use.

Clinical features and risk factors of ulcerative colitis complicated with CMV infection

liujiaxin,surong,wangfang,yangjiali,,zhanglina,zhaoguihong — 2025/7/7 10:26:45

Objective To investigate the clinical features and risk factors of cytomegalovirus (CMV) infection in patients with ulcerative colitis (UC). Methods Patients diagnosed with UC in the Department of Gastroenterology, General Hospital of Ningxia Medical University from January 2018 to June 2024 and underwent CMV testing were divided into CMV-positive group and CMV-negative group according to whether they were infected with CMV. The general clinical data, laboratory tests, endoscopic manifestations and treatment regimens of the two groups were retrospectively analyzed and compared. The risk factors of UC complicated with CMV infection were explored through univariate and multivariate statistical analysis. Results A total of 228 UC patients were enrolled, including 22 patients(9.65%) in the CMV-positive group and 206 patients(90.35%) in the CMV-negative group. The disease severity of the CMV-positive group was heavier than that of the CMV-negative group, and the severe UC was the main disease (P<0.05). The rate of glucocorticoid and antibiotic use in the first month of onset was higher in the CMV-positive group than that in the CMV-negative group (P<0.05), and the proportion of febrile patients, endoscopic deep ulcers, irregular ulcers, and glucocorticoids in the CMV-positive group were higher than those in the CMV-negative group (P<0.05). The levels of hemoglobin (Hb) and serum albumin (ALB) in the CMV-positive group were lower than those in the CMV-negative group (P<0.05), and the levels of neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were higher than those in the CMV-negative group (P<0.05). Multivariate Logistic regression analysis showed that the use of glucocorticoids within one month before the onset (OR=4.356, P=0.037) and deep chisel ulcer (OR=11.977, P<0.001) were risk factors for CMV infection, and Hb≥100g/L (OR=0.951, P<0.001) were protective factors for CMV infection.Conclusion Patients with severe UC are more likely to be co-infected with CMV. Recent use of glucocorticoids, deep gouge ulcers, and Hb < 100 g/L may be risk factors for CMV infection, and enhanced monitoring and prompt antiviral therapy are required in these patients.

Cuproptosis and Its Progress in Osteosarcoma

Du Yanli,Li Xinye,,汪屹,Wang Peigeng,Wang Xuanhui,Xiong Xifeng — 2025/7/4 18:18:20

Osteosarcoma is composed of neoplastic osteoblasts and osteoid tissue and is the most common primary malignant tumor occurring in osteogenic mesenchymal tissue, which not only has a high degree of malignancy, but also has a very poor prognosis and seriously threatens the health and life of adolescents and children. Osteosarcoma is pathologically characterized by the formation of immature osteoid stroma by tumor cells, however its key pathomechanism has not been fully elucidated. In recent years, it has been suggested that pharmacological reduction of intratumoral copper levels may enhance anticancer immunotherapy. Copper-dead Cuprotosis is a novel copper-dependent mode of programmed cell death that is induced by excessively accumulated lipid peroxide. Copper death involves copper dependence, accumulation of fatty acylated proteins and reduction of Fe-S cluster proteins, which play an important role in the development and regulation of osteosarcoma. This article reviews the molecular mechanism, signaling pathway, marker gene and prognosis of copper death in osteosarcoma, in order to provide new ideas and protocols for the diagnosis and treatment of osteosarcoma.

Foreign body in the common bile duct causing stone : a case report

chenchangzhi, — 2025/7/4 15:54:46

病例报告

A case report of revision total hip arthroplasty with restrictive liner for recurrent dislocation after dual mobility total hip arthroplasty

huangchunyi — 2025/7/4 15:54:01

病案报告

Evaluation of the effect of enhanced recovery after surgery in children with congenital choledochal cyst during perioperative period

王文美 — 2025/7/1 11:40:23

【】 Objective:Evaluation of the effect of enhanced recovery after surgery in children with congenital choledochal cyst during perioperative period.Methods: A total of 103 children with congenital choledochal cyst admitted to pediatric surgery Department of our hospital from March 2015 to December 2023 were selected.The control group was divided into control group and observation group according to whether the concept of rapid rehabilitation was applied. The control group underwent laparoscopic surgery alone, more according to traditional surgical concepts, while the observation group underwent rapid rehabilitation surgery concept + laparoscopic surgery, with 58 cases in the control group and 45 cases in the observation group.The intraoperative and postoperative clinical and laboratory indexes of the two groups were compared: white blood cell count (WBC) at 24h/ 3d/ 2w after surgery, reactive protein (CRP) at 24h/ 3d/ 2w after surgery, intestinal sound recovery time after surgery, length of hospital stay after surgery, total hospitalization cost, incidence of complications, 30-day readmission rate and family satisfaction of the children.Results: There were no significant differences in mean age, body weight, preoperative WBC, preoperative CRP, preoperative hemoglobin (Hb), preoperative albumin (ALB) and preoperative albumin (PAB) between the two groups (P>0.05).The differences of postoperative 24hWBC, 24hCRP and postoperative 3dCRP between the two groups were statistically significant (P<0.05).The comparison of 3dWBC and Hb after operation showed no statistical significance (P>0.05).There were no significant differences in 2wWBC, CRP, Hb, ALB and PAB.There were no significant differences in operation time and intraoperative blood loss between the two groups (P>0.05).In the observation group, postoperative bowel sound recovery time, postoperative hospitalization time and hospitalization cost were significantly shortened, and the difference was statistically significant (P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).All the children in the two groups were discharged from hospital after recovery, and the number of readmissions within 30 days was 0. The readmission rate was not clinically compared.The overall satisfaction score of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).Conclusion: ERAS concept is safe, effective and feasible during perioperative application in children with congenital choledochal cyst, which can reduce short-term postoperative inflammatory response, increase comfort level, shorten discomfort time, relieve discomfort degree, reduce hospitalization cost and improve satisfaction. Therefore, ERAS concept has clear clinical application value and is worthy of further research and promotion.

Experience in Diagnosis and Treatment of Portal Vein Cavernous Transformation Complicating Congenital Choledochal Cyst Surgery and Literature Review

liaosiqi — 2025/6/23 10:27:49

Objective Discuss the diagnosis and treatment experience of children with cavernous transformation of the portal vein (CTPV) for congenital congenital choledochal cyst (CCC) based on literature review.Methods Retrospective analysis of the clinical data and postoperative follow-up of 2 children with postoperative CTPV after surgery for CCC treated at the Hunan Children's Hospital, and a summary and analysis of relevant literature.Results Case 1, female, 6 years and 9 months old, underwent radical surgery for CCC at another hospital more than 4 years ago. Case 2, female, 11 years and 7 months old, underwent radical surgery for CCC at another hospital more than 10 years ago. Both patients were emergently admitted with gastrointestinal bleeding and diagnosed with CTPV. In both cases, intraoperative angiography indicated that the main portal vein was occluded, so a "portal vein sagittal part to main portal vein shunt (Rex procedure)" was performed, and postoperative measurements showed that the portal vein pressure had dropped to the normal range. A total of 6 pediatric cases were included in the literature collection. Among them, 5 cases underwent Rex surgery, and 1 case underwent percutaneous transhepatic angioplasty.Among the pediatric patients who underwent the Rex shunt procedure, one case developed shunt occlusion, while the remaining five exhibited favorable postoperative recovery. Conclusion CTPV is a rare complication after surgery for CCC. When performing radical surgery for CCC, it is important to protect the portal vein to reduce the risk. Once symptoms such as gastrointestinal bleeding or splenomegaly occur, the Rex procedure has proven efficacy and is recommended as the first choice to restore portal vein inflow to the liver.

Application of Child Life Specialist in ERAS after Laparoscopic Appendectomy for Children Based on RCT Study

Chang Li,Jin Zhu,Tan Xianqun,Zhao Qing, — 2025/6/22 10:04:17

Objective This study aims to explore the differences in the efficacy of child life specialist and traditional nursing interventions in the treatment of acute appendicitis in children undergoing laparoscopic appendectomy by randomized controlled trials (RCTs). Methods Children with acute appendicitis who underwent laparoscopic appendectomy at the Affiliated Hospital of Zunyi Medical University from November 2022 to November 2024 were randomly divided into a control group (n=105) and an experimental group (n=103). The control group received traditional nursing interventions; the experimental group received child life specialist on the basis of routine nursing. The Yale Preoperative Anxiety Scale and the State-Trait Anxiety Inventory were used to compare preoperative anxiety levels in children and their parents between the two groups. The Wong-Baker Faces Pain Rating Scale and the Visual Analog Scale were used to assess postoperative pain levels in patients. ERAS (Enhanced Recovery After Surgery) and satisfaction-related indicators were also recorded for both groups. Results The experimental group, which received f child life specialist, had lower preoperative anxiety scores for both children and their parents, as well as lower postoperative pain scores at 6h, 12h, and 24h, compared to the control group receiving traditional nursing interventions. The differences were statistically significant (P<0.05). Comparison of ERAS and satisfaction-related data between the experimental and control groups showed significant differences in first postoperative feeding time [(17.44±2.33) h vs. (21.03±3.85) h], flatus time [(16.01±2.33) h vs. (19.70±3.76) h], length of hospital stay [(6.18±0.79) d vs. (8.47±2.44) d], and satisfaction scores [(98.04±1.26) vs. (93.30±2.46)], (P<0.05). There was no difference in complicate rates between the two groups (P>0.05). Conclusion Child life specialists have a significant effect in the application of ERAS for children with acute appendicitis. It can effectively reduce anxiety levels in patients and their families, alleviate postoperative pain, promote postoperative flatus and early feeding, shorten hospital stays, and improve family satisfaction.

A Comparative Study on the Efficacy of Uni-portal and Three-port Thoracoscopy in the Treatment of Pediatric Extralobar Pulmonary Sequestration

wu yurui,,郑启鹏, — 2025/6/20 11:19:23

Objective: To compare the clinical efficacy of uniportal and traditional three - port thoracoscopy in treating pediatric extralobar pulmonary sequestration (EPS), providing evidence for optimizing surgical approaches. Methods: In this retrospective cohort study, 107 pediatric EPS patients from Capital Center for Children's Health, Capital Medical University (Jan 2017 - Jan 2025) were divided into uniportal (20 cases) and three - port groups (87 cases). Baseline data, surgical duration, intraoperative blood loss, postoperative hospital stay, analgesic use rate, and complications were compared and statistically analyzed to evaluate the safety and efficacy of the two surgical methods. Results: No baseline differences were found between the groups (P>0.05). The uniportal group had shorter surgical duration (30 min vs.50 min, P=0.008), shorter postoperative hospital stay (2 d vs.3 d, P=0.041), and lower same - day analgesic use rate (5.0% vs.26.4%, P=0.040). Neither group had thoracotomy conversion, intraoperative transfusion, or severe complications. The three - port group had 1 wound infection and 1 rib injury case, while the uniportal group had no such complications (P>0.05). Conclusion: Uniportal thorcopyacos for pediatric EPS is safe and effective, with advantages like shorter operation time, faster recovery, less pain, and better cosmesis. It can be preferred and promoted but should be decided based on surgeons' experience and individual patient conditions.

Clinical characteristics and prognostic evaluation of prenatally diagnosed cystic biliary atresia

关茜思,,,,, — 2025/6/20 8:59:15

Objective This study aims to systematically review and analyze the clinical characteristics and prognosis associated with prenatal diagnoses of cystic biliary atresia. Method Cases of prenatal diagnosis of cystic biliary atresia admitted to the Women and Children"s Medical Center, affiliated with Guangzhou Medical University, between June 1, 2016, and June 1, 2024, were collected for analysis. The clinical characteristics and prognostic outcomes of these cases were examined. Based on intraoperative imaging findings, the cases were categorized into two groups: type I CBA and type III CBA. Result The mean gestational age at which the hepatic portal cyst was initially identified via prenatal ultrasound was 22.95 ± 4.96 weeks. The mean age at the time of surgery was 43.65 ± 16.05 days. The incidence of postoperative cholangitis was 55.00%, while the jaundice clearance rate at three months post-surgery was 73.68%. The rate of persistent jaundice clearance was 75.00%, the autologous liver survival rate was 66.67%, the liver transplantation rate was 20.00%, and the mortality rate was 13.33%. Based on intraoperative imaging findings, 9 cases were categorized into the type I CBA group, and 11 cases were categorized into the type III CBA group. The maximum diameter of cysts, as measured by the initial prenatal ultra7.41%sound, was significantly larger in the type I CBA group compared to the type III CBA group (P<0.05). No statistically significant differences were observed between the two groups concerning baseline characteristics, preoperative biochemical indicators, surgical conditions, postoperative pathology, duration of postoperative hospitalization, and prognosis (P>0.05). Conclusion Prenatal diagnosis of cystic biliary atresia cases can provide early treatment after birth and may have a better prognosis. There is no significant difference in clinical characteristics and postoperative outcomes between type I CBA and type III CBA patients diagnosed prenatally.

Applications and advancements of artificial intelligence in pediatric surgery

Fang Erhu, — 2025/6/20 8:59:01

Artificial Intelligence (AI), as one of the most rapidly advancing fields in contemporary technology, is systematically reshaping operational paradigms across industries and driving profound transformations in industrial structures. The rapid development of AI within the medical field presents new opportunities for the diagnosis and treatment of pediatric surgical conditions. This article focuses on the current application status of AI in pediatric surgery, introduces the research and application advancements of AI in pediatric surgery both domestically and internationally, and explores the potential innovations and challenges that AI technologies may bring to the diagnosis and treatment of pediatric surgery. In the future, general medical AI large language models (e.g., DeepSeek) hold significant potential in Chinese medical information processing and educational support. However, overcoming data bottlenecks and undergoing clinical validation are essential to achieve their deep integration and value realization in pediatric surgery.

Completely Single Incision Laparoscopic Treatment of Congenital Choledochal Cyst in Children: Analysis of 41 Cases from a Single Center

fanxia,huanghuang,lifei,,qinzhijie,,zhangjie,zhouzhou,zhuangyize — 2025/6/20 8:58:32

Objective? To investigate the feasibility and safety of Total single-incision laparoscopic cyst excision and Roux-en-Y Hepaticojejunostomy for the treatment of choledochal cysts in children. Methods We reviewed 97 children who underwent Single-incision laparoscopic hepaticojejunostomy (SILH) from January 2018 to March 2023. Patients were divided into two groups based on the surgical approach: the Total Single-incision laparoscopic hepaticojejunostomy group (TSILH, n=41) and the SILH group(n=56). We compared the gender, age, cyst type, cyst size, operation time, intraoperative bleeding, postoperative hospital stay, postoperative feeding time, and intraoperative and postoperative complication rates between the two groups. Results All children underwent single-incision laparoscopic cyst excision and Roux-en-Y Hepaticojejunostomy without conversion to open surgery or conventional three or four-port laparoscopic surgery. The operation time in the TSILH group (195.60±13.75 min) was longer than that in the SILH group (173.20±34.38 min), and the difference was statistically significant (P＜0.05). In addition, the time of jejunojejunostomy in the TSILH group (65.75±8.02 min) was significantly longer than that in the SILH group (36.88±5.43 min), and the difference was statistically significant (P＜0.05). However, there were no differences between the two groups in terms of intraoperative bleeding (7.86±0.75 ml and 9.58±0.68 ml, respectively), postoperative feeding time (2.93±0.54 d and 2.94±0.59 d, respectively), time of removal of abdominal drainage tube (4.18±0.77 d and 4.25±0.79 d, respectively), postoperative hospital stay (7.46±0.92 d and 8.06±2.06 d, respectively), and intraoperative and postoperative complication rates. Conclusion Total single-incision laparoscopic cyst excision and Roux-en-Y Hepaticojejunostomy is a safe and feasible treatment for pediatric choledochal cysts. However, the overall operation time is longer than SILH and requires a better laparoscopic anastomosis technique from the operator.

Progress Of a Surgical Risk Assessment System For Hip Fractures In The Elderly Based On Several Scoring Systems

lan xiaowen, — 2025/6/10 9:54:38

The incidence of hip fractures in the elderly population is relatively high in traumatic diseases, and surgery is currently the preferred treatment method. Elderly patients often have multiple underlying diseases, which significantly increases the risk of surgery. Choosing an appropriate evaluation model is of great significance for predicting the risk of complications and death in patients. This article provides a review of the research progress on the risk assessment system for elderly hip fracture surgery based on several scoring systems.

Impact of Non-Invasive Prenatal Testing on the Detection of Triple X Syndrome and Associated Pregnancy Outcomes: An Ethical Analysis

ZHANG PENG — 2025/6/9 15:51:34

Objective This retrospective study aims to evaluate the impact of non-invasive prenatal testing (NIPT) on the detection rate of triple X syndrome (47,XXX) in prenatal diagnosis, analyze the pregnancy outcomes of prenatally diagnosed 47,XXX cases, and examine the ethical implications of NIPT screening for 47,XXX. Methods A retrospective analysis was conducted on 17,211 prenatal diagnosis cases from 2005 to 2023. Using 2015 as the cutoff year for NIPT implementation, we compared the detection rates of sex chromosome aneuploidies (SCAs), including 47,XXX, before and after the adoption of NIPT. The indications for prenatal diagnosis of 47,XXX after NIPT implementation were analyzed, along with the tracking of pregnancy outcomes for confirmed 47,XXX cases. Results After the implementation of NIPT, the overall detection rate of SCAs increased from 0.35% to 1.35%, while the detection rate of 47,XXX increased from 0.07% to 0.24%. NIPT became the primary indication for prenatal diagnosis of SCAs, accounting for 40.79% of cases, with 40.74% of 47,XXX cases detected through NIPT. The detection rate of 47,XXX was significantly correlated with the NIPT testing volume (r = 0.830, p < 0.01) and the mean maternal age (r = 0.719, p < 0.01). Among the 134 SCA-positive cases, the overall pregnancy termination rate was 52.99%. Among all SCA-positive cases, the termination rate for 47,XXX cases was the highest, reaching 70.83%. Conclusion NIPT has significantly improved the detection rate of 47,XXX syndrome. However, its application in screening and diagnosis raises complex ethical challenges. Genetic counselors should provide detailed and balanced counseling to pregnant women diagnosed with fetal 47,XXX to reduce unnecessary pregnancy terminations caused by misconceptions.Efforts should focus on balancing the benefits of technological advancements with ethical considerations by improving counseling and education for pregnant women regarding prenatal screening and diagnosis.

Progress in diagnosis and treatment of OSA in children

yangyong, — 2025/6/9 10:36:52

Obstructive sleep apnea (OSA) is a high incidence and a serious hazard in children, but due to the overall awareness of society, the lack of an effective screening mechanism and convenient means of diagnosis, the disease has not yet been adequately diagnosed in the effective population. In the past few years, although there has been some progress in the diagnosis and management of this disease, there are still many controversies. In this paper, the pathogenesis, evaluation, diagnosis and treatment of the disease are reviewed and prospectively, in order to provide valuable reference for the diagnosis and treatment of children with OSA.

Clinical characterization of 36 cases of autoimmune encephalitis in children

Shao Xian Li,Wang Qian Yun,Xu Li,Zhang Fan, — 2025/6/6 17:08:49

Objective To analyze the clinical characteristics of autoimmune encephalitis (AE) in children. Methods A retrospective analysis was conducted on clinical data from 36 pediatric patients diagnosed with autoimmune encephalitis (AE) admitted to the Department of Pediatrics at our hospital between May 2020 and September 2024. Clinical manifestations, diagnostic test results, treatment regimens, and prognosis outcomes were systematically evaluated. Results Among the 36 pediatric cases, 20 (55.56%) were male and 16 (44.44%) were female. The minimum age of onset was 1 year, the maximum age of onset was 13 years and 6 months, and the mean age of onset was 7.21±3.88 years. Acute onset of disease (<1 week) was observed in 16 (44.44%) cases and subacute onset of disease (1 week~3 months) in 20 (55.56%) cases. 21 children (58.33%) exhibited preceding infectious prodrome prior to disease manifestation.The cerebrospinal fluid (CSF) was basically normal in character and clarity in 36 children. 21 children (58.33%) had an increased number of nucleated cells in the CSF (>5×106/L), 3 children (8.33%) had elevated chloride in the CSF (>130 mmol/L), 14 children (38.89%) had abnormal CSF proteins, and 7 children (19.44%) had CSF glucose abnormalities. No pathogenic infections were detected in the CSF specimens of all children. 36 children were positive for anti-N-methyl-D-aspartate receptor (NMDAR) antibody in 10 cases (27.78%), anti-myelin oligodendrocyte glycoprotein (MOG) antibody in 7 cases (19.44%), and anti-contactin-associated-like protein 2 (CASPR2) antibody in 6 cases (16.67%). 28 (77.78%) children had varying degrees of electroencephalogram (EEG) abnormalities. 35 children underwent cranial MRI, of which 14 (40.00%) showed abnormalities. 68.75% (22/35) of the children who received immunotherapy recovered completely without neuropsychiatric sequelae. Conclusion School age is the peak incidence of AE in children.The clinical presentation is mostly acute or subacute in onset, often with a history of antecedent infection.Seizures are the most common symptom. Anti-NMDAR encephalitis accounts for the highest proportion of AE in children.The rate of EEG abnormalities in children with AE is high, but lacks specificity. Early standardized immunotherapy is effective in most children with AE.

Improved the xiphoid process and rib arch under the incision and inflatable xiphoid process down into the clinical curative effect of road thymic tumor resection

Chen Xiaofeng,Ma Xingang,Wang Xingang,Wang Yanbing,Yan Yingguang,Yuan Xin — 2025/6/6 17:08:12

Objective: To analyze and compare the therapeutic effects of inflatable subxiphoid approach resection and modified subxiphoid and subcostal incision in patients with thymic tumors. Methods: In June 2021 to February 2024 in our hospital surgery, 80 patients were divided into according to the approach to the control group (n = 38) and observation group (n = 42).Control group patients use inflatable xiphoid process down into the way of road thymic tumor resection, observation group of patients using improved under the xiphoid process and under the rib arch incision thymic tumor resection.The general data, surgery-related indicators, pulmonary function indicators, inflammatory factor levels, VAS scores in different time periods, the frequency of analgesic pump use, clinical efficacy and postoperative adverse reactions were compared between the two groups. Results: Indicators related to the operation compared with control group, the observation group were reduced, statistically significant difference (P < 0.05); Compared to the control group, the FVC and FEV1 levels of the observation group were increased, ESR, CRP and IL-6 were decreased, the difference was statistically significant (P < 0.05). Observation group VAS score 4 h, 12 h, 24 h after surgery were lower than the control group, the observation group analgesic pump use worsening adverse reaction is low, the clinical total effective rate is higher, the difference was statistically significant (P < 0.05). Conclusions: Thymic tumor resection and inflatable xiphoid process down into road, modified subxiphoid and subcostal incision is more effective in the treatment of thymic tumors, which can significantly shorten the operative time and intraoperative blood flow, improve the clinical efficacy of patients, and reduce the incidence of adverse reactions.

Research progress on the role of IL-36 in rheumatoid arthritis and interstitial lung disease

张泰华 — 2025/6/6 11:21:55

Interleukin-36 (IL-36) is a member of the interleukin-1 (IL-1) super family and plays roles in inflammation, fibrosis, and immune regulation. Current research has found that IL-36 is correlated with the occurrence and development of rheumatoid arthritis (RA) and interstitial lung disease (ILD).This article will review the biological characteristics of IL-36, including its structure and cellular origin, as well as its role in rheumatoid arthritis and interstitial lung disease. In order to prevent and treat rheumatoid arthritis-associated interstitial lung disease (RA-ILD), further investigate its specific mechanisms, develop drugs targeting the IL-36 pathway, and conduct clinical trials to broaden our horizons.

The Role of Splicing Factor DDX3Y in Promoting Proliferation of Male Gastric Cancer through the IL-6/JAK/STAT3 Signaling Pathway and Preliminary Mechanistic Study

2025/6/6 11:20:39

Objective To explore the mechanistic role of downregulation of splicing factor DDX3Y in promoting proliferation of male gastric cancer and organoid growth. Methods Based on analysis from the GEPIA database, the expression level of DDX3Y in gastric cancer tissues and adjacent normal tissues was assessed. The relationship between DDX3Y expression and patient prognosis was analyzed using the Kaplan-Meier Plotter database. Gastric cancer tissues and adjacent normal tissues (＞5 cm) were collected from male gastric cancer patients treated at the First Affiliated Hospital of Soochow University, and immunohistochemical staining was performed. Human immortalized gastric mucosal epithelial cells (GES-1) and male-derived gastric cancer cell lines (SNU-1, NUGC-3, KATOIII, MKN74, HGC-27, NCI-N87) were cultured. The expression level of DDX3Y in different cell lines was detected using Western blotting. SNU-1 and HGC-27 cells were transduced with lentivirus to construct DDX3Y-overexpressing and DDX3Y-knockdown cell lines, and EdU cell proliferation assays were performed. Gastric cancer organoids were established from tumor tissues of male gastric cancer patients, and lentiviral transduction was used to generate organoids with high or low DDX3Y expression. The effect of the IL-6/JAK/STAT3 pathway inhibitor tofacitinib on organoid diameter and viability was analyzed. The RBPmap online tool was used to predict the potential binding interaction between DDX3Y and IL-6 precursor mRNA. Results The GEPIA database analysis showed that DDX3Y mRNA expression was significantly higher in adjacent normal tissues compared to gastric cancer tissues (P < 0.05). According to the Kaplan-Meier Plotter database, patients with high DDX3Y mRNA expression had a significantly better prognosis than those with low expression (2=7.9, P = 0.005). Compared with the human immortalized gastric mucosal epithelial cell line GES-1, DDX3Y was significantly upregulated in HGC-27 (P < 0.05); while in comparison to HGC-27, DDX3Y expression was lower in SNU-1 (P < 0.05). Western blot results showed that in SNU-1, DDX3Y protein levels in the OE-DDX3Y group were significantly higher than those in the Vector group (P < 0.05); in HGC-27, the shDDX3Y-1 group showed significantly lower DDX3Y protein expression than the shNC group (P < 0.05). Fluorescence microscopy revealed that in the SNU-1 cell line, the proportion of EdU-positive cells in the DDX3Y overexpression group was significantly lower than in the control group (P < 0.05); whereas in the HGC-27 cell line, the DDX3Y knockdown group had a significantly higher proportion of EdU-positive cells compared to the control (P < 0.05). Bright-field images of organoids showed that compared to the Vector group, the OE-DDX3Y group had significantly smaller organoid diameters (P < 0.05) and reduced viability (P < 0.05); compared to the OE-DDX3Y group, the OE-DDX3Y + Tofa (tofacitinib) group showed further reduced diameters (P < 0.05) and viability (P < 0.05). Conversely, the shDDX3Y group had larger organoid diameters (P < 0.05) and higher viability (P < 0.05) than the shNC group; compared with the shDDX3Y group, the shDDX3Y + Tofa group showed significantly smaller organoid diameters (P < 0.05) and decreased viability (P < 0.05). Finally, predictions using the RBPmap online tool suggested that DDX3Y is highly likely to bind to IL-6 precursor mRNA (Z score > 3, indicating a significant binding signal). Conclusion Downregulation of splicing factor DDX3Y promotes male gastric cancer proliferation and organoid growth by regulating the alternative splicing of IL-6, thereby enhancing tumor proliferation through the IL-6/JAK/STAT3 signaling pathway.

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包佩玲,王璐璐,郑威 — 2025/6/5 16:21:05

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Clinical study of reversible posterior encephalopathy syndrome in eight children with renal diseaseYANG Qin, FENG Shi-pin,Department of Pediatric nephrology,Chengdu Women"s and Children"s Central Hospital,School of Medicine ,University of Electronic Science and Technology of China, Chengdu, Sichuan 610073, China

冯仕品,杨琴 — 2025/6/5 16:09:47

Objective To summarise and analyse the clinical features of children with nephropathy associated with reversible posterior encephalopathy syndrome (PRES), and to review the relevant literature. Methods The clinical data of 8 children with nephropathy complicating PRES? of our hospital from August 2017 to August 2024 were retrospectively analysed,Results? All cases included in the study had used glucocorticoids, and 7 cases had used immunosuppressants. The main clinical manifestations were hypertension, headache, convulsion, impaired consciousness, and visual impairment. MRI showed that the lesions mainly involved the parietal occipital cortex and subcortical layer (7 cases), and partially involved the frontal lobe (5 cases), temporal lobe (2 cases), semiovale center (2 cases), and bilateral ventricles (1 case). After symptomatic treatments, both clinical manifestations and MRI were improved,and there were no relapses during the follow-up period.Conclusion Children with kidney disease can be complicated by PRES. Its occurrence is related to primary disease, hypertension, hormone and immunosuppressant application. Cranial MRI is helpful for early diagnosis and timely and reasonable treatment, which can minimize neurological damage.

Single-port endoscopic nipple-sparing mastectomy with implant reconstruction for breast cancer

邓丁梅,邓润枢,何广宁,温润耀,叶娴,袁泳锨 — 2025/6/5 16:08:49

Objective: This study aimed to compare the clinical outcomes and tumor marker changes between single-port endoscopic and conventional open surgery in nipple-sparing mastectomy (NSM) combined with implant breast reconstruction for breast cancer. The study also evaluated the feasibility and oncological safety of the procedures. Methods: A retrospective analysis was conducted on data from 101 breast cancer patients treated between August 2020 and August 2023. Of these, 39 patients underwent single-port endoscopic NSM with implant reconstruction, while 62 patients received conventional open surgery. Key comparisons included operative time, intraoperative blood loss, postoperative complications, serum tumor marker levels (CEA, CA19-9, CA125, and CA15-3) before and 3 months after surgery, and subjective cosmetic outcomes. Results: The operative time for the endoscopic group was significantly shorter than that of the open surgery group (193.97±62.61 minutes vs. 219.55±51.45 minutes, P=0.028). Intraoperative blood loss was also reduced in the endoscopic group (35±12.09 ml vs. 67.67±24.86 ml, P<0.001). The incidence of postoperative complications was 20.5% in the endoscopic group and 22.5% in the open surgery group, with no statistically significant difference (P>0.05). At the 3-month postoperative follow-up, there were no significant differences between the two groups in serum tumor marker levels (P>0.05). However, the subjective cosmetic outcomes were significantly better in the endoscopic group, with an excellent-to-good rate of 84.6% compared to 73.6% in the open surgery group (P=0.012). Conclusion: Single-port endoscopic NSM combined with implant reconstruction offers advantages over conventional open surgery in terms of reduced surgical trauma and superior cosmetic outcomes. The tumor marker analysis further suggests that this minimally invasive approach maintains good oncological safety, making it a feasible alternative to open surgery for selected breast cancer patients.

A clinical study of independent risk factors and predictors of poor prognosis in patients with cerebral infarction associated with malignant tumors

Cen Geng-yu,Huang Qiu-hui,Liang huo,,Lu Qiu-hong,Wang xue — 2025/6/5 16:07:57

Objective: To investigate the risk factors and predictors of short-term poor prognosis in patients with malignant tumor-related cerebral infarction. Methods: The patients with malignant tumor-related cerebral infarction hospitalized in the First Affiliated Hospital of Guangxi Medical University from January 2012 to January 2022 were continuously collected and divided into poor prognosis group (mRS > 2 points) and good prognosis group (mRS≤2 points) according to the modified Ranking Scale (mRS) at discharge. The clinical and laboratory data of the two groups were analyzed by univariate analysis and binary logistic regression analysis. Results: A total of 83 patients with malignancy related cerebral infarction were included (43 patients in the poor prognosis group). Platelet count decreased (OR=0.991, 95%CI 0.983-0.998, P =0.019) and serum prealbumin level decreased (OR=0.990, 95%CI: 0.981 ~ 0.999, P =0.022) and increased SIRI value (OR=1.285, 95%CI: 1.027 ~ 1.607, P =0.028) were independent risk factors for poor short-term prognosis, respectively. The AUC of the combined predictor constructed by the above three independent risk factors was as follows: 0.800 (95%CI:0.703 ~ 0.900, P < 0.001), sensitivity (0.744) and specificity (0.800). Conclusion: Increased SIRI value, decreased platelet count and decreased serum prealbumin level are independent risk factors for poor short-term prognosis in patients with malignant tumor-related cerebral infarction, and the combined predictors constructed from the three have good predictive value for the short term poor prognosis in patients with malignant tumor-related cerebral infarction.

Expression of PIM2 and PFKFB3 in Non-small cell lung cancer tissue and their relationship with clinical pathological features and prognosis of patients

Wei Jiali, — 2025/6/5 15:57:49

Objective: To investigate the expression of proviral integration site 2 (PIM2) and 6-phosphofructokinase-2/fructose-2,6-bisphosphatase 3 (PFKFB3) in non-small cell lung cancer tissue and their relationship with clinical pathological features and prognosis of patients. Methods: Ninety-eight patients with non-small cell lung cancer who underwent surgery in our hospital from January 2020 to March 2021 were selected. The cancer tissue and adjacent tissues excised during surgery were collected, and the clinical and pathological features of the patients were collected and analyzed. Multivariate Cox regression was applied to analyze the factors affecting the prognosis of non-small cell lung cancer patients. Kaplan-Meier curve was plotted to analyze the relationship between the expression levels of PIM2 and PFKFB3 with the survival status of non-small cell lung cancer patients. Results: PIM2 and PFKFB3 were both brownish yellow in the cytoplasm of cancer tissue, and their positive expression rates in cancer tissues were obviously higher than in adjacent tissues (P<0.05). The expression levels of PIM2 and PFKFB3 were related to the clinical stage, lymph node metastasis, and differentiation degree of patients (P<0.05), but not to age, gender, tumor diameter and pathology type (P>0.05). There were statistical differences between the death group and the survival group in terms of lymph node metastasis, differentiation degree, PIM2, and PFKFB3 expression levels (P<0.05). The occurrence of lymph node metastasis, degree of low differentiation, positive expression of PIM2, and positive expression of PFKFB3 were all risk factors affecting poor prognosis of patients (P<0.05). The one-year survival rate of non-small cell lung cancer patients was 55.10%(53/98) and the survival rate of PIM2 negative expression patients (20/28,71.43%) was obviously higher than that of positive expression patients(33/70,47.14%)(χ2=5.777，P=0.016). The survival rate of PFKFB3 negative expression patient (22/31,70.96%) was obviously higher than that of positive expression patients (31/67,46.27%)(χ2=5.422，P=0.020). Conclusion: PIM2 and PFKFB3 are positively expressed in non-small cell lung cancer tissues, and have a certain correlation with clinical pathological features and prognosis.

A case of inflammation associated with cerebral amyloid angiopathy and literature review

Lilei,, — 2025/6/5 11:37:08

Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a rare perivascular inflammatory disease.The clinical manifestations mainly include progressive cognitive and behavioral decline, epilepsy, headache, and focal neurological deficits.The pathogenesis is still unclear, and there are few reports in China. Clinicians have limited knowledge of this disease. Here we report a patient diagnosed as likely having CAA-ri.By sharing this case, the aim is to help clinicians recognize, diagnose and treat CAA-ri earlier so as to improve patient prognosis.

Effect of autonomic function on perioperative prognosis of gastric cancer patients. Xu Pengyan1^{, Nan Haiou}1^{, Cai Yuling}1^{, Li Jiayu}1, Ge Miaomiao1^{, Wang Gang}1^{, Jiang Zhiwei}1^.Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu 210009,China)

徐鹏演 — 2025/6/5 9:42:57

Objective To explore the effect of autonomic function on perioperative outcomes in patients with gastric cancer. Methods Retrospective analysis of the clinical data of 72 cases of patients who underwent radical gastric cancer surgery at the General Surgery Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine from November 2022 to May 2024. The normal range of the standard deviation of NN intervals is usually (141±39)ms.According to the level of SDNN on the first day of the preoperative period, they were divided into the group with low SDNN level group and SDNN normal group.Records were recorded to compare the postoperative recovery, inflammation, and changes in body composition between the two groups. Results The postoperative recovery of the two groups showed that time to first flatus, time tolerability of liquid food, postoperative drainage tube removal time, VAS score on the first day after surgery and postoperative hospitalization days in the normal SDNN group were lower than those in the low SDNN level group (P<0.05). The perioperative inflammatory indexes of the two groups showed that the inflammatory indexes WCB and IL-6 in the normal SDNN group were lower than those in the low SDNN group on the 3rd day after surgery (P<0.05). There was no significant difference in perioperative body composition between the two groups. Conclusion Autonomic nerve function is closely associated with the short-term prognosis after laparoscopic radical gastrectomy for gastric cancer. In clinical practice, attention should be paid to the status of autonomic nerve function for early identification and early warning.

Research progress of oxidative stress in the pathogenesis of rheumatoid arthritis and depression

Cheng Fangfang,Wang Ting-ting,,Yi Menglin — 2025/5/14 11:44:15

Depression is a common disabling complication of rheumatoid arthritis (RA), and both have some common risk factors and pathological mechanisms. Oxidative stress refers to excessive production of oxygen free radicals or insufficient antioxidant defense system in the body, which causes DNA mutation, lipid peroxidation and protein oxidation, leading to inflammation and neuronal apoptosis. Studies have found that oxidative stress plays an important role in the pathological mechanisms of RA and depression. This article reviews the role of oxidative stress in the comorbidity of RA and depression, in order to provide new ideas and methods for the treatment of the comorbidity of the two.

Efficacy of repetitive transcranial magnetic stimulation combined with conventional training regimen on post-stroke articulation disorder and its impacts on acoustic indexes and daily living ability

方琛君 — 2025/5/14 10:03:21

Objective To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with conventional training regimen in treating post-stroke articulation disorder and its effects on acoustic indexes and daily living ability. Methods A total of 126 patients with post-stroke dysarthrodia were randomly divided, and the conventional group was given conventional training regimen intervention, and rTMS group was given rTMS combined with conventional training regimen intervention. The efficacy, and the changes in acoustic indexes and daily living ability before and after treatment were compared between the two groups. Results The total effective rate of rTMS group was 90.48%, which was greatly higher than that of the conventional group (74.60%) (P<0.05). After treatment, the scores of all dimensions of the modified Frenchay dysarthria scale in both groups were significantly higher than before treatment, and the rTMS group were higher than the conventional group (P<0.05). After treatment, the loudness and articulation of sound in 2 groups were higher than before treatment, and the longest sound duration was longer than before treatment, and the rTMS group was better than the conventional group. (P<0.05). After treatment, the modified Barthel Index Scale (MBI) score of 2 groups was higher than that before treatment, and the rTMS group was higher than the conventional group (P<0.05). Conclusion: The combination of rTMS and conventional training regimen can achieve great therapeutic effects on patients with post-stroke articulation disorder, effectively reduce the severity of articulation disorder, prolong the longest duration, and improve voice loudness, articulation clarity and daily living ability.

Research Progress in the Transformation of Myeloproliferative Neoplasms with TP53 Gene Abnormality into Leukemia

Bao Xiao Jing — 2025/5/13 8:38:21

Myeloproliferative neoplasms (MPNs) with TP53 mutations have a risk of transformation to acute myeloid leukemia (AML), and show the characteristics of recurrent copy number variation and DNA damage during progression, with unique erythroid biased differentiation in the context of JAK2 mutations, and the activation in BMP2/SMAD pathway and the change of CEBPA/GATA1 expression ratio have been found in megakaryo-erythroid progenitor cells. When TP53 gene is completely inactive and a certain mutation load is reached, it can occur leukemia transformation, chronic inflammation and immune escape may be the important driving factors for TP53 gene mutation cells to obtain dominant clones in the process. At present, allogeneic hematopoietic stem cell transplantation is still the only way to completely cure the progression of the disease. This article aims to review the molecular biological characteristics and clinical research progress of MPNs with TP53 gene mutation in leukemia transformation.

Analysis of Pathogenicity and Drug Resistance Characteristics of Diarrhea Causing Escherichia coli in Children with Diarrhea at a Hospital in Guilin City

qinwenzhen — 2025/5/9 9:25:09

[Abstract] Objective To investigate the etiological characteristics and drug resistance of diarrheagenic Escherichia coli (E. coli) isolated from 0-14 years old children with diarrhea in Guilin. Methods Fecal samples were collected from Guilin Maternal and Child Health Hospital Children's Outpatient Department with diarrhea, and Escherichia coli was isolated and cultured. Multiplex PCR was used to detect the virulence genes of the strains to determine the pathogenic types of different diarrheagenic Escherichia coli, and the antibiotic sensitivity of the strains was determined by Minimum Inhibitory Concentration（MIC） method. Results Forty-nine diarrhea-causing E. coli strains were detected from 793 stool samples of children aged 0-14 years with diarrhea from 2022 to 2023, with a detection rate of 6.17%. EAEC (48.98%) and EPEC (46.93%) were the main pathogenic types of diarrheagenic E. coli. Only 1 case of stIa and stIb gene ETEC and 1 case of Shiga toxin 2f subtype (stx2f) gene STEC were detected, and no EIEC was detected. Among these 49 strains, ampicillin had the highest resistance rate（59.18%）, followed by cefazolin（36.73%） and compound sulfamethoxazole（32.65%）. 40.81% of the strains were resistant to more than 3 antibiotics. Conclusions EAEC and EPEC were the main pathogens of diarrheal Escherichia coli in children under 14 years old in Guilin, and STEC of Shiga toxin 2f subtype was detected, and there were multi-drug resistant strains. Therefore, attention should be paid to the rational use of clinical antibiotics and the emergence and change of highly pathogenic bacteria such as STEC.

Clearance effect of three dialysis modes on β2 microglobulin and C-reactive protein in patients with renal failure

gaoxiumei — 2025/5/9 9:23:45

Objective To investigate the effect of high throughput hemodialysis (HFHD), hemodialysis filtration (HDF) and maintenance hemodialysis (CHD) on the clearance of β2 microglobulin and C-reactive protein in patients with renal failure.Methods A total of 100 patients with renal failure in the hospital from January 2021 to December 2022 were included and divided into CHD group (33 cases), HDF group (33 cases) and HFHD group (34 cases) according to different dialysis modes. All three groups were dialysis for 6 months. Small molecular indexes related to renal function (creatinine, urea nitrogen, phosphorus), medium and large molecular indexes related to renal function (albumin, β2 microglobulin, C-reactive protein) and oxidative stress indexes (malondialdehyde, superoxide dismutase, catalase, thioredoxin) were compared between the three groups before and after dialysis, and the complications of the two groups were analyzed.Results After dialysis, the levels of creatinine, urea nitrogen and phosphorus in three groups were lower than before dialysis (P < 0.05), but there was no significant difference in the reduction rates of creatinine, urea nitrogen and phosphorus among three groups (P > 0.05). After dialysis, albumin in the three groups was higher than that before dialysis, and β2 microglobulin and C-reactive protein in the three groups were lower than that before dialysis (P < 0.05), and the difference of albumin, β2 microglobulin and C-reactive protein in the HDF group was greater than that in the CHD group and HFHD group (P < 0.05). After dialysis, the levels of malondialdehyde in the three groups were lower than before dialysis, and the levels of superoxide dismutase, catalase and thidoredoxin in the three groups were higher than before dialysis (P < 0.05), and the difference in the levels of malondialdehyde, superoxide dismutase, catalase and thidoredoxin in the HDF group was greater than that in the CHD group and HFHD group (P < 0.05). There was no significant difference in complications among the three groups (P > 0.05).Conclusion HFHD, HDF and CHD are all effective methods for the clinical treatment of patients with renal failure, among which HDF is more effective in regulating the medium and macromolecular indexes related to renal function and improving the oxidative stress state, and does not increase the incidence of complications.

Study on the mechanism of action of Garcinone E in inhibiting the growth and autophagy function of ovarian cancer cells

Sun-Xuemei — 2025/5/9 9:22:54

Objective To explore the effect and mechanism of anti-tumour natural product Garcinone E on autophagy function of ovarian cancer cells. Methods The cell viability of HeyA8 and SKOV3 ovarian cancer cells treated with different concentrations of Garcinone E was detected by CCK-8 assay. MDC staining assay was applied to detect autophagic vesicle formation in HeyA8 and SKOV3 cells. HeyA8 and SKOV3 cell lines stably transfected with stubRFP-sensGFP-LC3 lentivirus were constructed to detect changes in autophagic flux in HeyA8 and SKOV3 cells. Lysosomal staining assay was applied to detect changes in lysosomal co-localisation with SensGFP-LC3 in HeyA8 and SKOV3 cells. Western blot assay was applied to detect the changes of HeyA8 and SKOV3 cell cycle-related proteins [cyclin-dependent protein kinase inhibitor 1A (p21), cyclin-dependent kinase 4 (CDK4), cyclin-dependent kinase 7 (CDK7)] and autophagy-related proteins [protein kinase (AKT), microtubule-associated protein 1 light chain 3B (LC3B), ubiquitin binding protein p62 (SQSTM1/p62)]. Results After treatment with Garcinone E, the viability of HeyA8 and SKOV3 cells was decreased (P < 0. 05), and the half inhibition rate (IC50) was 3.32 ± 0.14 μmol/L and 4.12 ± 0.35 μmol/L, respectively. MDC staining assay revealed that the number of intracellular autophagic vesicles was increased in the Garcinone E-induced cells. Fluorescence microscopy revealed that Garcinone E blocked the intracellular autophagic flux in HeyA8 and SKOV3 cells stably transfected with stubRFP-sensGFP-LC3 lentivirus. Lysosomal staining assay showed that Garcinone E blocked the binding of autophagic vesicles to lysosomes.Western blot results showed that Garcinone E intervention up-regulated the expression levels of LC3B and SQSTM1/p62 proteins in HeyA8 and SKOV3 cells (P < 0.05) and down-regulated the expression levels of Akt protein (P < 0.05) . In addition, Garcinone E intervention promoted the expression level of p21 protein (P < 0.05), and down-regulated the expression level of CDK4 and CDK7 protein (P < 0.05). Conclusion Garcinone E can inhibit the autophagic flux of ovarian cancer cells and block the cell cycle, which has an anti-ovarian cancer effect and can be used as a lead drug in the development of chemotherapeutic drugs for ovarian cancer.

Advances in the relationship between IL-1β and psoriasis

Liu Hongjie, — 2025/5/9 8:45:23

The pathogenesis of psoriasis is not yet fully elucidated, and it is currently believed that immunological mechanisms play an important role in its pathogenesis. Il-1β belongs to the IL-1 family, which has powerful pro-inflammatory effects, and some studies have shown that its expression is increased in psoriatic lesions and plays an important role in the pathophysiology of psoriasis. The IL-1β gene is polymorphic, and its polymorphism affects the transcription and expression of IL-1β and is thought to be closely related to psoriasis. This paper mainly reviews the relationship between IL-1β and its gene polymorphisms, and psoriasis.

Clinicalpathological Analysis of 5 cases of Aggressive NK cell leukemia

GUO Wenwen,,LIU Xia,LUO Yu,MO Xianglan — 2025/5/8 11:11:45

Objective To investigate the clinicopathological characteristics of aggressive NK cell leukemia(ANKL).Methods The clinical and pathologic findings of 5 cases of ANKL were retrospectively analyzed．Immunohistochemical staining and in situ hybridization were carried out ,and the literature was reviewed.Results 4 males and 1 female were included in this study, with a median age of 47 years (range, 16-85 years). High fever was common in patients (5/5), accompanied by hepatosplenomegaly (4/5), elevated lactate dehydrogenase (5/5), decreased peripheral blood cells (5/5), coagulation dysfunction and other changes. Histologically ,the tumor cells in bone marrow biopsy were medium-sized and showed interstitial infiltration, apoptotic bodies and focal necrosis were presented. The bone marrow smear showed that the atypical cells were round or irregular, with medium cytoplasm, round or dark blue, pseudopodia or tailing, and a small amount of particles. Tumor cells of all cases showed CD3 and CD56 positivity . All cases were positive for the cytotoxic markers.In situ hybridization detection shows that the tumor cells were diffusely positive for EBER. 1 patients received chemotherapy, 4 patient declined the treatments.The median overall survival is only 1 months .Conclusion ANKL is a systemic proliferative lesion of NK cell tumor, which is closely related to EB virus and presents an explosive clinical process. Familiar with the clinicopathological features of ANKL is helpful for the differential diagnosis of ANKL from other mature T-cell and NK cell lymphoma/leukemia.

Clinical effect of pulsed radiofrequency combined with intravenous infusion of lidocaine in the treatment of acute herpes zoster and prevention of postherpetic neuralgia

cahng xindong,qian chenhuiyu,tang ming,, — 2025/5/8 11:10:38

Objective: To investigate the clinical effect of Pulsed radiofrequency stimulation (PRF) combined with intravenous infusion of lidocaine for patients with acute herptic neuralgia (AHN). The incidence of postherpetic neuralgia (PHN) was also observed. Methods: A total of 60 AHN patients admitted to the Department of interventional vascular pain, Hefei Hospital Affiliated to Anhui Medical University from April 2023 to June 2024 were prospectively included. The mean age of patients was 68.27±8.93 years. According to the difference of treatment methods, they were divided into two groups: the experimental group received PRF combined with intravenous infusion of lidocaine; The control group was treated with PRF combined with intravenous saline. Before both groups were admitted, visual analogue scale (VAS) and Hospital Anxiety and Depression Scale (Hospital Anxiety and Depression Scale) at 3 days, 1 week, 1 month and 3 months after PRF. HADS, Neuropathic Pain Screening Scale score (ID-PAIN), and Pittsburgh Sleep Quality Index (PSQI). The use of tramadol after PRF and various adverse reactions were also recorded. And statistical analysis. Results: After receiving the corresponding treatment, the pain degree of the two groups was better than that before surgery, and the pain score at each time point was statistically different from that before surgery (P < 0.05). After 1 week of treatment, the VAS scores of the two groups began to show statistical differences (P < 0.05). After 1 month and 3 months, the number of patients developing PHN in the experimental group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: PRF combined with lidocaine (PRF + Lido) is more effective than PRF alone in the treatment of AHN. In addition, the combination treatment regimen has a more positive and significant effect in preventing AHN from developing into PHN. No serious adverse reactions were observed during the whole course of treatment.

Exploring the Efficacy of Laparoscopic Fowler-Stephens Staged Orchidopexy via the Direct Inguinal Triangle Approach for High-Riding Cryptorchidism Based on Propensity Score Matching

曹庆伟,鹿洪亭,王倩,杨槟伊 — 2025/5/8 11:07:28

Objective? To explore the therapeutic effect of laparoscopic Fowler-Stephens staged orchidopexy through the direct inguinal triangle approach for high-position cryptorchidism based on propensity score matching (PSM). Methods ?A retrospective analysis was conducted on 187 children with cryptorchidism (testicles not palpable on the body surface) treated in the pediatric surgery department of Linyi Central Hospital from February 2020 to February 2024. Among them, 89 cases undergoing laparoscopic orchidopexy through the direct inguinal triangle approach were used as the control group, and 98 cases undergoing laparoscopic Fowler-Stephens staged surgery through the direct inguinal triangle approach were used as the observation group. After PSM, the preoperative and postoperative testicular volume, treatment effect, postoperative complications, and changes in sex hormone levels and testicular function before and after surgery in the two groups of children were compared. Results ?After PSM, a total of 75 pairs of data were successfully matched. There was no significant difference in the change of testicular volume and treatment efficiency between the two groups before and after surgery (P>0.05); there was no significant statistical difference in the incidence of postoperative complications between the two groups (P>0.05); compared with before surgery, the levels of FSH and E2 in both groups were significantly reduced, and the level of T was significantly increased after surgery (P<0.05), and the levels of AMH and INHB in both groups were significantly increased after surgery (P<0.05). Conclusion ?Laparoscopic Fowler-Stephens staged orchidopexy through the direct inguinal triangle approach is safe, effective, and has the advantage of fewer postoperative complications in the treatment of high-position cryptorchidism.

Research on the correlation between vaginal dysbiosis and the intrauterine adhesions

FAN Jieru,,JIANG Kuncheng,SHU Changfa,ZHAO Xingping — 2025/5/8 11:06:40

Objective: By analyzing the difference of vaginal microbiota composition between patients with Intrauterine adhesion (IUA) and control group, the correlation of dysregulation of female microflora and IUA was investigated. Methods: Thirty patients diagnosed with IUA by hysteroscopy in the Third Xiangya Hospital of Central South University from January 1, 2022 to May 31, 2022 were selected as the study group, and another 30 women who underwent hysteroscopy but did not have IUA (non-IUA) during the same period were selected as the control group. Clinical data of all participants were collected, and leucorrhea samples with vaginal interruption were collected. 16S rDNA quantitative polymerase chain reaction and pyrosequencing were used to identify and detect the bacterial load and flora in the samples, and the measured data were screened and processed by biogenic analysis. Results: The species richness and species diversity of vaginal flora in IUA patients were lower than those in non-IUA patients. At the phylum level, firmicutes accounted for a higher proportion of most samples from IUA patients compared to non-IUA, but bacterial diversity decreased significantly. Actinobacteria, Bacteroidetes, Proteobacteria, Fusobacteria and pontomyces were significantly lower than those in non-IUA group. At the genus level, the proportion of Lactobacillus pnagus Lj928 and Klebsiella in samples of IUA patients was significantly higher than that of non-IUA patients, while the proportion of Mirabella, Bifidobacterium, monomonas and Prevotella in samples of IUA patients was significantly lower than that of non-IUA patients. Conclusion: The richness and diversity of vaginal flora in patients with IUA decreased significantly, suggesting that the formation of IUA may be related to the imbalance of vaginal flora, and improving the vaginal flora in IUA patients may improve the condition and prognosis of IUA patients.

Correlation analysis of intra-articular injection of platelet-rich plasma (PRP) with postoperative traumatic arthritis in Schatzker type V and VI tibial plateau fractures

wangjizhu,wangzhifeng, — 2025/5/8 9:49:53

OBJECTIVE: To assess the clinical efficacy of intra-articular platelet-rich plasma (PRP) injections on postoperative traumatic arthritis in Schatzker type V and VI tibial plateau fractures.METHODS: This study enrolled forty patients with Schatzker type V and VI tibial plateau fractures admitted to the Department of Traumatology and Orthopaedics at the First Affiliated Hospital of Baotou Medical College between January 2023 and December 2024. Patients were randomly assigned to two groups: the experimental group, which received an intra-articular injection of 10 ml PRP, and the control group, which received an intra-articular injection of 10 ml saline. The study aimed to compare interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) levels in joint fluid at 3, 5, and 7 weeks postoperatively, as well as the Hospital for Special Surgery Knee Score (HSS).RESULTS: Levels of IL-1β, IL-6, and TNF-α in the joint fluid of the experimental group were significantly lower than those in the control group at 3, 5, and 7 weeks postoperatively (P<0.05). Additionally, the Hospital for Special Surgery Knee Score (HSS) was higher in the experimental group compared to the control group across all assessed domains, including function, muscle strength, pain, flexion deformity, mobility, stability, and total score (P<0.05).CONCLUSION: Intra-articular PRP injections decreased the incidence of postoperative traumatic arthritis following Schatzker V and VI tibial plateau fractures by reducing inflammatory factors within the knee joint and enhancing knee joint function, thereby facilitating the early recovery of joint function.

Rapid Diagnosis of Guinea Pig Ear Nocardiosis Pneumonia by Nanopore Sequencing: A Case Report

Song Chang,,,, — 2025/5/7 10:27:11

This study reports a case of a 60-year-old female patient who was admitted due to hemoptysis and sputum production for two months. Rapid diagnosis using nanopore sequencing technology revealed guinea pig ear nocardiosis pneumonia. The patient had no common high-risk factors such as immunodeficiency or structural lung disease. Prior to admission, the patient had been diagnosed with bacterial pneumonia but experienced adverse reactions after treatment with compound sulfamethoxazole. Nanopore sequencing identified an infection with Nocardia brasiliensis, and treatment was switched to linezolid. The patient's condition stabilized, and she was discharged.

The Efficacy Observation of Transurethral 1470 Laser Prostatectomy with Small-piece Removal without Morcellation for the Treatment of High-Risk Benign Prostatic Hyperplasia

Xiangping Li,,, — 2025/5/6 15:43:07

Objective To evaluate the clinical efficacy and safety of transurethral 1470 nm laser prostatectomy with small-piece removal without morcellation for the treatment of high-risk benign prostatic hyperplasia (BPH). Methods A total of 100 consecutive high-risk BPH patients treated between July 2023 and July 2024 were included in the study and divided into an observation group (n = 50) and a control group (n = 50) according to the surgical approach. The observation group underwent transurethral prostatectomy via 1470 nm laser piecemeal resection of the prostate, while the control group underwent 1470 nm laser enucleation of the prostate (LEP) following with tissue morcellation to fragment the prostate tissue. The age, prostate volume, post-void residual urine volume, maximum urinary flow rate, International Prostate Symptom Score (IPSS), and quality of life (QOL) were recorded. Surgical time, changes in hemoglobin levels preoperatively and on the first postoperative day, irrigation fluid volume, duration of catheter irrigation and retention, and IPSS and QOL at three months post-treatment were compared. Complications occurring within three months postoperatively were also followed. Results The observation group had significantly shorter surgical times and lower intraoperative irrigation fluid volumes than the control group (P < 0.05). There were no significant differences between the groups regarding intraoperative blood loss, duration of catheter irrigation and retention, IPSS, QOL, and the incidence of urinary tract infections, gross hematuria, urinary retention, and incontinence three months postoperatively (P > 0.05). Conclusion Transurethral prostatectomy via 1470 nm laser piecemeal resection of the prostate is an effective and safe approach for treating high-risk BPH. The tissue morcellation-free procedure can simplify the surgery and effectively shorten the surgical time compared to the enucleation method.

Papillary thyroid carcinoma with distant bone metastases as the primary manifestation: One case report

OU ZHOU, — 2025/5/6 15:42:23

Objective Review the diagnosis and treatment of a case of papillary thyroid carcinoma with distant bone metastasis as the primary manifestation,summarize the diagnosis and treatment of this disease combined with relevant domestic and foreign literature,so as to provide a certain reference for clinical diagnosis and treatment. Methods The preoperative fine needle puncture, gene detection and postoperative pathological characteristics of the patient were reviewed and analyzed, and the characteristics of the disease were summarized by discussion and analysis combined with relevant literature. Conclusion Bone metastasis of papillary thyroid carcinoma is rare, and the prognosis is often poor, and the clinical diagnosis and treatment is difficult, therefore, preoperative examination should be perfected as far as possible and multidisciplinary evaluation should be carried out.Surgery is the preferred treatment for bone metastasis of papillary thyroid carcinoma.

The progress of Low-Concentration Atropine in the Treatment of Myopia

qindecheng — 2025/4/15 10:03:56

Myopia is a major vision problem worldwide, and its incidence rate is increasing year by year, especially among children and adolescents. In recent years, low-concentration atropine has attracted widespread attention in the field of myopia control due to its effectiveness and fewer side effects. This paper reviews the mechanism of action and clinical application research progress of low-concentration atropine in the treatment of myopia, and explores its future development direction.

Research progress on volume assessment methods in hemodialysis patients

Xu Ting — 2025/4/15 10:03:01

Volume disorder is common in hemodialysis patients and is the main driving factor of cardiovascular disease morbidity and mortality. Therefore, accurate assessment of body volume status is very important for hemodialysis patients. In recent years, ultrasound, bioelectrical impedance analysis, biomarkers and other capacity evaluation methods have been paid more and more attention in clinic, but each method has its own limitations and scope of application, which is not perfect. This paper summarizes the current methods to evaluate the volume status, in order to provide a reference basis for the volume management of hemodialysis patients.

Effect of magnetic stimulation neuromodulation combined with botulinum toxin type A on lower limb walking ability in children with spastic diplegia

qiuaizhen,,wangli,wuye,zhangmengran — 2025/4/15 10:01:53

Abstract: Objective To study the effect of magnetic stimulation of neuromodulated T12-L1 nerve roots to enhance the stability of the core group combined with botulinum toxin type A intramuscular injection on the improvement of lower limb walking ability in children with spastic diplegia. Methods During June 2023 and June 2024, sixty children with bilateral spastic cerebral palsy were admitted to Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University, which were randomly divided into a control group (30 cases) and an observation group (30 cases) using a random number table method. The control group received intramuscular injection of type A botulinum toxin and comprehensive rehabilitation training. The observation group received repeated peripheral magnetic stimulation of the core muscles in addition to the control group. We compared the results of Pediatric Balance Scale (PBS), Gross Motor Function Measure (GMFM-88) D and E zone scores, and One-Minute Walk Test, (1MWT) before treatment and at 3 months of treatment. Results Before treatment, there was no statistically significant difference in the above scores between the two groups of children (P>0.05). In both groups of children, the aforementioned indicators showed improvement after 3 months of treatment compared to before treatment within the group. The differences between the control group and the observation group were statistically significant (P< 0.05). Conclusion Core muscle group magnetic stimulation neuromodulation therapy applied to children with spastic diplegia after botulinum toxin type A myotoxin injection further improves walking ability.

Effect of musculoskeletal ultrasound interventional PRP in postoperative rehabilitation of external humeral epicondylitis and its influence on upper limb function, elbow joint function, pain degree and inflammatory state

朱丽娜 — 2025/4/15 10:00:56

.Objective: To investigate the effect of musculoskeletal ultrasound (PRP) in the postoperative rehabilitation of external humeral epicondylitis (LE) and the effect of PRP on upper limb function, elbow joint function, pain degree and inflammation.Methods: A total of 106 patients with LE who underwent arthroscopic radiofrequency ablation in Tangshan Second Hospital from March 2022 to March 2023 were selected and divided into control group (53 cases) and study group (53 cases) by random number table method to conduct a prospective study. The control group received routine rehabilitation training after surgery, and the study group received PRP therapy combined with musculoskeletal ultrasound. Postoperative pain degree [NRS], serum inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], Mayo elbow joint function (MEPS) score, upper limb function score (DASH), painless grip strength (PFG), ability of daily living (ADL) score, good and good rate of elbow function recovery, complication rate of postoperative pain was compared between the two groups. Results: The NRS scores of the study group were lower than those of the control group at the second and fourth week after operation (P < 0.05). The serum levels of CRP, IL-6 and TNF-α in the study group were lower than those in the control group at the 2nd and 4th week after surgery (P < 0.05). The MEPS score of the study group was higher than that of the control group at the 2nd and 4th week after surgery, and the DASH score was lower than that of the control group (P < 0.05). PFG and ADL scores of the study group were higher than those of the control group at the 2nd and 4th week after surgery (P < 0.05); The excellent and good rate of elbow joint function recovery at 6 months in the study group (92.45%) was higher than that in the control group (77.36%) (P < 0.05). There were no complications such as incision infection, vascular and nerve injury, local swelling of elbow joint and pain aggravation during postoperative rehabilitation in both groups.Conclusion: Musculoskeletal ultrasound can significantly improve the postoperative rehabilitation of LE patients with PRP, further improve the upper limb function, elbow joint function, reduce pain, reduce inflammation, safe and reliable.

Expression and clinical significance of miR-129-5p and CBX4 in liver cancer tissue

季晓磊,, — 2025/4/8 18:23:18

Objective: To analyze the expression of microRNA-129-5p (miR-129-5p) and chromobox homolog 4 (CBX4) in liver cancer tissues, and their relationship with clinical pathological characteristics and prognosis. Methods: From August 2018 to August 2021, liver cancer tissues, adjacent tissues, and clinical data were collected from 120 liver cancer patients in our hospital. Real-time fluorescence quantitative PCR was applied to detect miR-129-5p and CBX4 mRNA levels. Immunohistochemical staining was applied to detect the level of CBX4 protein. The CPTAC database and GEPIA database in UALCAN were used to search for the expression of CBX4 protein in liver cancer. The targetScanHuman website was applied to search for the targeted regulatory relationship between miR-129-5p and CBX4. Pearson method was applied to analyze the correlation between miR-129-5p and CBX4 mRNA levels in liver cancer tissues. Kaplan-Meier method was applied to analyze the relationship between miR-129-5p, CBX4 levels in liver cancer tissues and the 3-year survival rate of patients. Univariate and multivariate Cox regressions were applied to analyze the factors affecting the 3-year survival rate of liver cancer patients. Results: The level of miR-129-5p in liver cancer tissue was lower than that in adjacent tissues, and the level of CBX4 mRNA was higher than that in adjacent tissues (P<0.05). The search results from CPTAC and GEPIA databases showed that the expression of CBX4 protein in hepatocellular carcinoma (LIHC) tissues was obviously higher than that in normal tissues (P<0.05). In this study, the positive rate of CBX4 protein expression in liver cancer tissues (65.00%, 78/120) was obviously higher than that in adjacent tissues (24.17%, 29/120) (P<0.05). The search results from the targetScanHuman website showed that miR-129-5p had a targeted regulatory relationship with CBX4. In this study, miR-129-5p was negatively correlated with CBX4 mRNA level in liver cancer tissues (r=-0.676, P<0.05). The proportions of patients with TNM stage III+IV, pathological grade III+IV, and vascular invasion in the miR-129-5p low expression group and CBX4 positive expression group were higher than those in the miR-129-5p high expression group and CBX4 negative expression group, respectively (P<0.05). The 3-year survival rate of miR-129-5p low expression liver cancer patients was lower than that of miR-129-5p high expression patients (P<0.05), while the 3-year survival rate of CBX4 negative expression liver cancer patients was higher than that of CBX4 positive expression patients (P<0.05). High expression of miR-129-5p was a protective factor for 3-year mortality in liver cancer patients, while positive expression of CBX4 and TNM stage III+IV were independent risk factors for 3-year mortality in liver cancer patients (P<0.05). Conclusion: MiR-129-5p is lowly expressed and CBX4 is highly expressed in liver cancer tissues, and the expression levels of both are related to the prognosis of patients.

A Study on the Characteristics of Ultrasound Images of Common Pulmonary Diseases in Newborns

. Kunming Medical University — 2025/4/8 15:36:18

Objective To analyze the ultrasound imaging characteristics of common lung diseases in newborns and provide the ultrasound imaging basis for common lung diseases in newborns. Method: 466 newborns who met the research criteria from March 2018 to January 2024 were selected as the research subjects, and the ultrasound imaging characteristics of common lung diseases in newborns were analyzed, summarized, and concluded. Result The ultrasound characteristics of normal lungs in newborns were as follows: the pleural and A-lines were smooth, clear and regular, the A-line was equidistant and parallel to the pleural line, and there was pulmonary slippage. Early B-line and/or comet tail sign may exist, with a mean duration of 67.28-221.75 hours; Under M-mode ultrasound, normal lung imaging shows a typical beach sign. The ultrasound features of transient tachypnea (TTN) in newborns include: pleural line abnormalities, disappearance or reduction of A-line, beach sign, B-line, comet tail sign, AIS, dense B-line, white lung, bilateral lung points, pleural effusion, lung islands, and no signs of lung consolidation or pneumothorax. In the early stage of non pulmonary disease newborns, B-line and/or comet tail signs also exist, and TTN cannot be diagnosed solely based on B-line and/or comet tail signs; The younger the gestational age of TTN patients, the higher the incidence rate, and TTN can also occur in full-term infants. The comparison of the duration of B-line and comet tail sign between TTN and normal children showed that the duration of TTN group was longer than that of the control group, and the difference was statistically significant (P<0.05). NRDS、ARDS、 The ultrasound features of neonatal pneumonia (PN), neonatal pulmonary hemorrhage, and bronchopulmonary dysplasia (BPD) include at least one of pulmonary consolidation, fragmentation, ground glass, snowflake, pulmonary pulsation, or beach sign, and may include B-line and/or comet tail sign, alveolar interstitial syndrome (AIS) and/or dense B-line, bipulmonary dots, pleural line abnormalities, disappearance or reduction of A-line, and pleural effusion. The ultrasound imaging of neonatal atelectasis shows pulmonary consolidation, but no bilateral lung points or pleural effusion were observed. The ultrasound characteristics of neonatal pneumothorax are: it must have abnormal lung slip (disappearance), stratospheric sign, and may have lung spots. Conclusion: A disease can have multiple ultrasound manifestations simultaneously, and one ultrasound manifestation can be seen in multiple diseases. LUS ultrasound imaging needs to be combined with clinical case characteristics for diagnosis.

Construction and validation of a predictive model for delayed wound healing nomogram after abdominal surgery

赵强 — 2025/4/8 9:18:08

Objective To construct and validate a predictive model for delayed wound healing column charts after abdominal surgery.. Methods Clinical data of 635 patients admitted to Affiliated Hospital of Jiangsu University from August 1, 2023 to August 1, 2024 were retrospectively analyzed.All patients were divided into a training set (444 patients) and a validation set (191 patients) in a ratio of 7:3.The training set patients were categorized into normal healing group (322 patients) and delayed healing group (122 patients) based on wound healing.The independent variables were screened by LASSO regression, and a multifactorial logistic regression was used to analyze the factors affecting delayed wound healing after abdominal surgery and to establish a column-line graphical prediction model.The discrimination, calibration, and clinical benefit of the model were assessed by Receiver Operating Characteristic (ROC) curve, calibration curve, and clinical decision curve analyses, respectively. Results The eight independent variables screened by LASSO regression were hemoglobin, total protein, wound area, history of diabetes mellitus, presence of infection after 2 weeks postoperatively, presence of chemotherapy in the 3 months prior to surgery, smoking history, and type of surgery. The results of multifactorial logistic regression analysis showed that larger wound area, having a history of diabetes, infection after 2 weeks postoperatively, having chemotherapy in the 3 months before surgery, and having a history of smoking were independent risk factors for delayed wound healing after abdominal surgery (P < 0.05), and higher hemoglobin and higher total protein were independent protective factors for delayed wound healing after abdominal surgery (P < 0.05).A column-line graphical prediction model for delayed wound healing after abdominal surgery was constructed based on seven influencing factors.The results of the ROC curve showed that the AUC (95% CI) of the model in the training set was 0.950 (0.926~0.975), with a sensitivity of 92.60% and a specificity of 87.90%, and the AUC (95% CI) of the model in the validation set was 0.945 (0.900 ~0.990), with a sensitivity of 96.00% and a specificity of 87.20%, with good discrimination.The calibration curves showed that the probability of the model predicting the risk of delayed wound healing after abdominal surgery was basically consistent with the actual probability, with good calibration.The results of the Hosmer-Lemeshow goodness-of-fit test (Training set:χ2 =4.805, P=0.778; Validation set:χ2=0.402, P=0.818) proved that the model had a good fit. The results of the clinical decision curve analysis showed the good applicability of the model in the clinic. Conclusion A column chart prediction model for delayed wound healing after abdominal surgery constructed on the basis of seven influencing factors, including hemoglobin, total protein, wound area, history of diabetes mellitus, presence or absence of infection after 2 weeks postoperatively, presence or absence of chemotherapy in the 3 months before surgery, history of smoking, and type of surgery, had a good predictive value.

Analysis of the clinical outcomes of emergency oocyte vitrification

Fang-qiang Gong,,,, — 2025/4/7 17:45:57

Objective To explorating and evaluating the impact of the oocyte vitrification freezing technology on embryo quality and developmental potential in assisted reproductive technology (ART). Methods The clinical data of 55 cycles who emergency oocyte vitrification in the reproductive hospitol of Guangxi zhuang autonomous region because of male failing to ejaculate or inability to come to the hospital for ejaculating on the day of oocyte retrieval from April 2010 to May 2023 were retrospectively analyzed.And 230 fresh ICSI-ET were selected randomly as the observation group.The reasons for emergency oocyte vitrification were analyzed，the fertilization、clinical pregnancy outcomes and neonatal outcomes were compared between the two groups. Results The causes of oocyte vitrification included no viable sperm(40%) and family emergency events(49.09%, of which, 34.55% were unable to come to the hospital because of COVID-19) on the day of oocyte retrieval. The recovery rate of oocytes was 88.88% after 43 cycles thawing.There were no significant differences in the rate of fertilization, the rate of normal cleavage, the rate of available embryo, the rate of implantation, the rate of clinical pregnancy, the rate of ectopic pregnancy, the rate of the live birth，the average of delivery gestational age, the average of newborn birth weight and birth defect rate in the oocyte freezing group (P>0.05). The rate of high-quality embryo rate in the oocyte freezing group was significantly lower than those in the observation group,While miscarriage rate in the oocyte freezing group was significantly higher than that in the observation group (P＜0.05). Conclusions Although emergency oocyte vitrification and resuscitation may cause slightly damage to oocytes, the embryonic development potential is still objective, and clinical outcomes similar to fresh oocytes can be obtained.Vitrification of oocytes could be used as a remedy for no available sperm on the day of oocyte retrieval and a method of preservation of female fertility.

Study of Brain Structural in Patients with obstructive Magnetic Resonance Imaging

YE Yuan — 2025/4/7 17:45:25

Objective:In this sleep apnea Based on Resting-state Functional , the correlation between cognitive function and Functional Magnetic Resonance Imaging (fMRI) parameters and its neural mechanism were explored by combining the scores of cognitive function in Osa patients with gray matter structure data. Methods: 1:35 subjects in OSA group and 34 subjects in normal control group matched by sex, age and education. The volume changes of gray matter in OSA patients and normal controls were obtained by voxel morphology (VBM) based on three-dimensional high-resolution T1 structural image data, and the difference of gray matter volume between two groups was detected by double-sample t-test, and perform multiple comparison corrections. The correlation between gray matter volume and cognitive function score and clinical parameters was analyzed by Spearman correlation. Result: Compared with the normal control group, the volume of gray matter in the left and right superior temporal gyrus, Thalamus, right superior frontal gyrus, left posterior central gyrus and right anterior central gyrus decreased in OSA Group, no increase in brain volume was found in OSA group. There was a positive correlation between right superior temporal gyrus volume and MMSE score (r = 0.028, p = 0.046) in Osa group. The volume of right superior frontal gyrus was positively correlated with MoCa score (r = 0.380, p = 0.011) .

Advances in the etiology and management of dental erosion with gastroesophageal reflux disease

huziling,,,,,,,,,, — 2025/4/3 17:41:39

Reflux dental erosion is an irreversible softening and demineralisation destruction of tooth hard tissues that occurs during the non-bacterial acid-chemical induction of reflux of gastric contents into the oral cavity, and is poorly diagnosed clinically with consistency and accuracy. Reflux erosion and bruxism are strongly correlated, and the two exert a synergistic effect that can destroy the entire dentition. Due to the progressive nature of the disease, early intervention to protect the structural integrity of the teeth is emphasised. This article reviews the epidemiology, etiology and pathogenesis, diagnostic points, and therapeutic research advances in order to provide ideas for the early recognition and diagnosis of this disease.

Effects of goals-activity-motor-enrichment therapy on upper-limb function in pre-school children of cerebral palsy with spastic hemiplegia

Li FengYan,,Li He,Li YiQing,Wang Yan,Xu XiaoMeng,Zhang Chen — 2025/4/3 16:00:15

Objective: to investigate the effect of using goals-activity-motor-enrichment (GAME) therapy as a treatment on rehabilitation of upper-limb function of pre-school children with spastic hemiplegia cerebral palsy. Methods: 50 pre-school children with spastic hemiplegia cerebral palsy visited Department of Rehabilitation, Beijing Children’s Hospital during August 2023 to July 2024 were randomly selected and divided into control group (n=25) and observation group (n=25) and the therapy lasted 3 months. Both groups combined hospital and home rehabilitation with participation of their parents under the instruction of occupational therapist. Control group received traditional constraint-induced movement therapy (CIMT) while observation group accepted active movements according to GAME theory. The function of affected upper-limbs and self-care abilities were evaluated by upper extremities functional test (UEFT) and pediatric evaluation disability inventory (PEDI) at the beginning and the end of the therapy. The increased scores in UEFT and PEDI among assessments were considered as training effects. Results: Comparing UEFT and PEDI scores of the end to the beginning of therapy, both groups received obviously improved (All P<0.00). Comparing to control group, both of UEFT and PEDI scores manifested significantly improved in observation group when treatment finished, while UEFT scores (t=-2.228, P=0.031) and PEDI scores (t=-2.214, P=0.032). Conclusion: Making active training plan for pre-school children with spastic hemiplegia cerebral palsy according to GAME theory can help them getting better upper-limb function and self-care abilities.

Significance of the transverse acetabular ligament in reconstructing the center of rotation in total hip arthroplasty. Huang CY1, Sun FR2*,Li Bo1, Su Feng SS1, Ye HY1,Cheng GG. 1Medical College,Wuhan University of Science and Technology,Wuhan 430000, Hubei, CHINA; 2 Huangshi Central Hospital, Huangshi, 435000, Hubei, CHINA

huangchunyi,,, — 2025/4/3 15:59:25

Objective: To investigate the significance of the transverse acetabular ligament in reconstructing the rotation center in total hip arthroplasty (THA).Methods: A retrospective analysis was conducted on 126 patients who underwent elective hip arthroplasty at the Central Hospital of Huangshi City from January 2022 to October 2023. The patients were divided into two groups based on different acetabular prosthesis positioning methods: a reference acetabular transverse ligament group (observation group) consisting of 64 cases, and a manual visual estimation method group (control group) consisting of 62 cases. The surgical time, intraoperative blood loss, reconstruction of the rotational center of the hip joint prosthesis after surgery were compared between the two groups. Additionally, the Harris hip joint scores before and six months after surgery were compared between the two groups, as well as the rates of excellent outcomes and complications after surgery.Results: The surgical time and intraoperative blood loss of the observation group were (144.78±16.07) min and (360.47±77.26) ml, respectively, which were both lower than those of the control group, (156.90±17.46) min and (390.48±75.93) ml, with statistically significant differences (P<0.05). The Harris scores of the observation group at 1 month and 6 months after surgery were (81.47±4.441) points and (90.08±4.24) points, respectively, higher than those of the control group, which were (79.87±4.45) points and (90.03±4.96 ) points; there was a statistically significant difference in the score at 1 month postoperatively between the two groups(P<0 .05). The rotation centers of both groups mainly concentrated in the inner upper quadrant of the coordinate system, with relative displacement towards the medial side and upward compared to anatomical rotation centers.In terms of horizontal displacement within 5mm and vertical displacement within 3mm,the observation group had statistical differences from that in control group(39 cases [60 .9%] vs25 cases [40.3%], P <0 .05);the average vertical direction displacement for observation group was less than that for control group,(3.06±1.35 ) mm vs(3.78±1.87 ) mm,with statistically significant differences(P <0 .05).Conclusion: The reference acetabular transverse ligament is an effective method for reconstructing the rotational center of the hip joint during surgery. Compared to the manual positioning rod implantation method, it has shorter operation time, higher accuracy, and simpler operation, which is more beneficial for early patient recovery.

A study on the effects of Garcinone C on lysosomal damage of nasopharyngeal carcinoma cells and their related mechanisms

daiyiping,,sunxuemei,wangchunlai,yinfuqiang,zhangjinyan — 2025/4/3 15:58:27

Objective To investigate the effects of Garcinone C on lysosomal damage of nasopharyngeal carcinoma cells (NPCs) and their related mechanisms．Methods Garcinone C were used to treat HONE1 and S18 cells. The cell viability was detected by CCK-8 method. The cathepsin D (CTSD) level was detected by immunofluorescence assay. The activity of acid phosphatase (ACP) was detected by Enzyme Labeling Instrument. Lysosomal damage was evaluated by lysosomal-associated membrane protein 1 (LAMP1)-Galectin-3 co-localization staining. Western Blot assay was used to detect the expression levels of CTSD, LAMP1, Galectin-3, Ras-associated protein Rab-7a (Rab7), Vesicle-associated membrane protein 8 (VAMP8) in HONE1 and S18 cells. Results Garcinone C significantly inhibit the proliferation of NPCs ( P ＜ 0. 05 ). Garcinone C intervention promoted the up-regulate and leakage of CTSD, inhibiting the activity of ACP ( P ＜ 0. 05 ), and increased the colocalization of LAMP1 and Galectin-3 in HONE1 and S18 cells. Garcinone C could up-regulate the expression levels of CTSD, LAMP1, Galectin-3 and Rab7 proteins ( P ＜ 0. 05 ), and down-regulate VAMP8 protein in NPCs ( P ＜ 0. 05 ). Conclusion Garcinone C may play a role in the treatment of nasopharyngeal carcinoma by damaging the lysosomes of NPCs, which has application prospects, and is expected to be a candidate lead compound for chemotherapy drug development in nasopharyngeal carcinoma.

Effects of Ginkgo biloba extract EGb761 on the cisplatin chemosensitivity of colorectal cancer cells regulated by Sphk1NING Qi-ting, CHEN Xingmei, HUAND Shanpei, ZHU Liye, QIU Xinze, LIU Shiquan

ChenXingmei,HuangShanpei,,NingQiting,QiuXinze,ZhuLiye — 2025/4/3 15:57:33

To investigate the effect of Ginkgo biloba extract (EGb761) on the expression of Sphk1 and the chemosensitivity of colorectal cancer cells to cisplatin. Methods EGb761 and cisplatin (DDP) were used to intervene in human colorectal cancer cell line RKO, and the effect of EGb761 on the sensitivity of RKO cells to cisplatin chemotherapy was detected by CCK-8 assay. RKO cells were randomly grouped into control group, EGb761 group, DDP group and EGb761+DDP group, real-time fluorescence quantitative PCR and Western blotting to detect the expression of apoptosis-related proteins, and flow cytometry to determine apoptosis in each group. The effect of different concentrations of EGb761 on Sphk1 expression in RKO cells was detected by Western blotting. A stable RKO cell line with low expression of Sphk1 was constructed, and the effect of knocking down Sphk1 and EGb761 on cisplatin chemotherapy sensitivity was detected by CCK-8 method. The effect of combination of EGb761 and DDP on apoptosis protein expression in knocked-down Sphk1 cells was detected by Western blotting. CB-DOCK2 was used to dock the main active components of Ginkgo biloba leaves with Sphk1 to verify the binding activity. Results EGb761 inhibited the proliferation of colorectal cancer cells , and enhanced the chemosensitivity of colorectal cancer cells to cisplatin (P<0.01). Compared with the control group, EGb761 and DDP can inhibit the expression of Bcl2, enhance the expression of Caspase3 and increase the apoptosis rate, and the combined application of EGb761 and DDP is more effective than EGB761 or DDP alone(P<0.05). EGb761 inhibited the expression of Sphk1 protein in colorectal cancer cells (P<0.01). Knockdown of Sphk1 and Ginkgo biloba extract EGb761 enhances cisplatin chemosensitivity in colorectal cancer, and both have synergistic effect (P<0.05). Compared with single Sphk1(-) group, DDP group and EGb761 group, the expression of Bcl2 and Caspase3 in Sphk1(-)+EGb761+DDP group was the most significant. Molecular docking results showed that the main active components of Ginkgo biloba had stable binding ability with Sphk1. Conclusion Ginkgo biloba extract EGb761 may promote apoptosis by inhibiting the expression of Sphk1, thereby enhancing chemosensitivity to cisplatin in colorectal cancer cells.

SMARCA4 deficient undifferentiated tumor in the chest: a case report and literature review

huangyongta,,tangzhenling — 2025/4/3 15:24:31

Objective To explore the clinical and pathological characteristics of SMARCA4 deficient undifferentiated tumor (SMARCA4 UT), with the aim of improving our understanding of SMARCA4 UT. Method Collect clinical and pathological data of one case of SMARCA4-UT, retrospectively analyze its clinical characteristics, genetic changes, morphological features, and immunohistochemical phenotype, and review the literature. Result SMARCA4-UT is more common in smoking males, with multiple nodular lesions in the chest cavity. CT shows multiple nodules of varying sizes with slightly higher density in the chest cavity. Under the microscope, the tumor presents a solid structure with cells arranged in a nest like pattern, unclear boundaries, and focal coagulation necrosis. The cell adhesion is poor, appearing as epithelioid or polygonal, with striated like cells visible, often exhibiting apoptosis and active nuclear fission. Mutations in the SMARCA4 gene and loss of BRGl expression are characteristic changes in SMARCA4 UT. Immunohistochemistry showed diffuse positive staining for SOX2, CD34, and SALL4, accompanied by overexpression of P53. Conclusion SMARCA4-UT belongs to highly invasive malignant tumors, with a short clinical course, poor prognosis, and poor conventional chemotherapy efficacy. EZH2 inhibitors and PD-L1 blockers have certain therapeutic effects. Familiarity with its clinical and pathological features helps in the differential diagnosis of other chest malignancies.

One Case of Acute Generalized Exanthematous Pustulosis Following Cefoperazone-Sulbactam Treatment in a Burn Patient

huyiping,liyumin,liuchangling,wangjinlun,xiaokui,zhangjinli,,chenziang — 2025/4/3 8:30:17

This paper reports a case of acute generalized exanthematous pustulosis (AGEP) in a burn patient following treatment with cefoperazone-sulbactam. The patient, an elderly female, was hospitalized due to gas flame burns and was treated with cefoperazone-sulbactam for infection control. After the treatment, the patient developed erythema that started on the face, neck, and perineum and gradually spread to the trunk and limbs, with pustules the size of rice grains on the erythematous base, accompanied by fever. After discontinuing cefoperazone-sulbactam, the patient"s symptoms gradually improved, and the pustules subsided. This case suggests that cefoperazone-sulbactam may induce AGEP in burn patients, and clinicians should be vigilant for potential cutaneous adverse reactions when using this drug.

Meta analysis of risk factors of pregnancy diabetes complicated with preeclampsia

邓斯琪,何伶俐,贾晓宙 — 2025/3/12 17:02:45

Objective To clarify the risk factors for preeclampsia in GDM pregnant women through meta-analysis, and provide scientific basis for clinical prevention and treatment. Method Computer retrieval of literature on risk factors for GDM associated preeclampsia from databases such as China National Knowledge Infrastructure (CNKI), VIP, CBM, Wanfang, Pubmed, Embase, EBSCO, Web of Science, and Cochrane Library. The retrieval period was from database establishment to March 2024. Two researchers independently screened literature, extracted data, and conducted quality evaluations, using Revman 5.3 and Stata 16.0 software for data analysis. Result A total of 13 articles were included, including 4999 study subjects. The meta-analysis results showed that family history of hypertension, BMI, TC, concomitant gestational hypertension, and blood glucose control were risk factors for preeclampsia in GDM patients ( P<0.05). Conclusion Diabetes complicating preeclampsia in pregnancy is affected by multiple risk factors. Medical s

Efficacy and significance of combined detection of sputum HNP-1, HNP-2 and LL-37 in predicting acute exacerbation of bronchiectasis

niweibo — 2025/3/12 15:13:41

Objective To investigate the efficacy and significance of combined detection of neutrophil peptide-1 (HNP-1), neutrophil peptide-2 (HNP-2) and antimicrobial peptide LL-37 in predicting acute exacerbation of bronchiectasis in sputum. Methods A total of 129 patients with stable bronchiectasis admitted to our hospital from September 2021 to June 2023 were divided into occurrence group and non-occurrence group according to whether acute exacerbation occurred within 6 months. Baseline data, sputum HNP-1, HNP-2 and LL-37 levels of the two groups were compared, and the data were statistically analyzed. Results The smoking history, the proportion of diabetic patients and the E-FACED score in the developing group were higher than those in the non-developing group, and the estimated FEV1 % was lower than those in the non-developing group (P < 0.05). The sputum HNP-1, HNP-2 and LL-37 in the occurrence group were higher than those in the non-occurrence group (P < 0.05). Sputum HNP-1, HNP-2 and LL-37 were positively correlated with E-FACED score, and negatively correlated with FEV1 in expected value % (P < 0.001). HNP-1, HNP-2 and LL-37 were independent risk factors for acute exacerbation of bronchiectasis (P < 0.05). Combined detection of sputum HNP-1, HNP-2 and LL-37 predicted acute exacerbation of bronchiectasis with an AUC of 0.908 (95%CI: 0.845-0.952), which was greater than that of single HNP-1, HNP-2 and LL-37, and the sensitivity of combined detection was 75.00%, the specificity was 93.83% (P < 0.05). Conclusion Sputum HNP-1, HNP-2 and LL-37 are associated with acute exacerbation of bronchiectasis. Combined detection of the three can improve the ability to predict acute exacerbation of bronchiectasis, and provide quantitative decision support for clinical risk stratification and personalized management of bronchiectasis.

Predictive Value of CALLY Index Combined with NLR for the Development and Severity of Refractory Mycoplasma pneumoniae Pneumonia in Children

Zhu Yuxin — 2025/3/11 11:57:50

Objective: Refractory Mycoplasma pneumoniae pneumonia is a severe type of community-acquired pneumonia in children. Early identification of high-risk children and timely intervention are crucial for improving prognosis. This study aimed to investigate the predictive value of the CALLY index (albumin × lymphocyte count / C-reactive protein) combined with the neutrophil-to-lymphocyte ratio for the development and severity of RMPP in children. Methods: We retrospectively analyzed the clinical data of 236 children with Mycoplasma pneumoniae pneumonia admitted to our hospital from January 2023 to June 2024. They were divided into RMPP (n=82) and non-RMPP (n=154) groups based on the presence or absence of refractory features. Demographic data, clinical characteristics, and laboratory indicators were collected. The differences in CALLY index and NLR between the two groups were compared. Logistic regression analysis was used to analyze the risk factors for RMPP. Receiver operating characteristic curve analysis was used to evaluate the predictive value of the CALLY index, NLR, and their combination for RMPP development and the need for mechanical ventilation. Results: The CALLY index was significantly lower in the RMPP group than in the non-RMPP group (0.73±0.26 vs 1.02±0.31, t=-7.224, P<0.001), while the NLR was significantly higher in the RMPP group (5.1±2.3 vs 2.6±1.1, t=11.293, P<0.05). Logistic regression analysis showed that an elevated CALLY index was a protective factor for RMPP (OR=0.845, 95%CI: 0.739-0.965), while an elevated NLR was a risk factor (OR=1.784, 95%CI: 1.237-2.574). ROC curve analysis showed that the CALLY index, NLR, and their combination could effectively predict children with RMPP (AUCs were 0.732, 0.892, and 0.927, respectively), with the combined detection having higher efficacy. In predicting the need for mechanical ventilation, the CALLY index, NLR, and their combination also had high predictive values, with AUCs of 0.722, 0.795, and 0.828, respectively, and the combined detection had a better predictive value than either alone. Conclusions: The CALLY index combined with NLR can be used as an effective indicator to predict the development and severity of RMPP in children. It can help to identify high-risk children early, guide clinical decision-making, and improve prognosis.

The construction and validation of a predictive model for facial nerve function outcomes after acoustic neuroma surgery

郐国虎 — 2025/3/7 19:13:37

Objective To explore the construction and validation of a predictive model for postoperative facial nerve function (FNF) outcomes in patients with acoustic neurilemoma (AN).Methods A total of 124 patients with AN treated in the Department of Neurosurgery, the First Affiliated Hospital of Xinjiang Medical University, from September 2020 to December 2023, were included in the study. The Lasso regression and random forest (RF) methods in R language were used for variable selection, and the AUC values of the two methods were compared to determine the final variables to be included. Finally, a nomogram was constructed based on the outcome variable and internally validated.Results Compared between the good and poor prognosis groups of postoperative FNF in AN patients, there were statistically significant differences in age, tumor texture, degree of adhesion between the tumor and the facial nerve, tumor diameter, and the anterior and posterior size lengths of the tumor (P<0.05). Through variable selection using Lasso regression and RF methods and comparing the AUC values, the final variables included were: age, tumor texture, tumor growth direction (anterior size of the tumor), tumor diameter, and the degree of adhesion between the tumor and the facial nerve. A nomogram was constructed using these five variables and internally validated: the AUC value of the ROC curve was 0.9259 (95% CI: 0.8779-0.9739), indicating good predictive performance of the model; the calibration curve also fit well with the expected and actual probabilities. For Decision Curve Analysis (DCA), at thresholds ranging from 5% to 65%, the model was above the None and All lines, indicating its clinical utility.

Network pharmacology-based analysis on the mechanism of Houttuynia cordata Thunb. in bacterial keratitis and fungal keratitis

Lu Hong-long,,Zou Lian-Jia — 2025/3/7 15:52:12

Objective Using network pharmacology to explore the potential molecular mechanisms of Houttuynia cordata in the treatment of bacterial and fungal keratitis. Methods The main chemical components of Houttuynia cordata Thunb were obtained through the TCMSP database and chemical databases. The action targets of the chemical components of Houttuynia cordata Thunb were obtained through the Swiss Target Prediction and TargetNet databases. Gene name conversion was carried out on the targets using the Uniprot database. The potential targets of bacterial and fungal keratitis were obtained using the Gene Cards database and the DisGeNET database. The protein-protein interaction (PPI) network and the "Houttuynia cordata-target-disease network" were constructed using the STRING database and Cytoscape software. The DAVID database was used to perform GO enrichment analysis and KEGG pathway enrichment analysis on the intersection targets of Houttuynia cordata to predict its mechanism of action. Results Fourteen active components were found in Houttuynia cordata Thunb, corresponding to 858 targets. Among these, 70 common target genes were related to bacterial keratitis and 52 were related to fungal keratitis. In bacterial keratitis, 1732 biological processes, 134 molecular functions, 56 cellular components, and 10 signaling pathways were involved. In fungal keratitis, 1571 biological processes, 112 molecular functions, 56 cellular components, and 10 signaling pathways were involved. Conclusion The therapeutic effects of Houttuynia cordata Thunb can be exerted through multiple pathways including hypoxia-inducible factor 1 (HIF-1), NF-κB, MAPK, PI3K/AKT, and calcium signaling pathway. This is achieved by targeting various elements such as IL6, TNF, VEGFA, and NOS3.

Clinical analysis of pleurodesis for young patients with primary spontaneous pneumothorax

李佳 — 2025/3/7 15:50:50

【】Objective To explore the clinical effectiveness and safety of pleurodesis for the treatment of primary spontaneous pneumothorax in young patients. Methods The clinical data of 187 young patients with spontaneous pneumothorax undergoing video-assisted thoracoscopic bullectomy in Guangdong Provincial Hospital of Chinese Medicine between January 2014 and December 2022 were retrospectively analyzed. According to different pleurodesis methods, the patients were divided into three groups including pleural abrasion (n=50), talc poudrage pleurodesis (n=67) and no pleurodesis (n=70). The perioperative complication, adverse event and recurrence rate were compared among three groups. Results Intraoperative blood loss was significantly more in pleural abrasion group than in talc poudrage pleurodesis and no pleurodesis group (P<0.05). The talc poudrage pleurodesis group showed statistically significant higher ratio of analgesic drug use, more thoracic drainage volume, more indwelling time of thoracic drainage tube, and longer hospital stay than the other two groups (P<0.05). A second surgery due to thoracic bleeding occurred in two cases of pleural abrasion group, and five cases of talc poudrage pleurodesis group presented pleural effusion in four weeks after surgery. Recurrence incidence rate were comparable among three groups (P>0.05). Conclusion Pleurodesis did not prevent the recurrence of spontaneous pneumothorax in young patients with the treatment of video-assisted thoracoscopic bullectomy, but it was associated with the risk of complication and adverse event.

Study of anatomical parameters of CT Mimics 3D reconstruction to predict the stability of internal bone mass in posterior joint after internal fixation with palmar plate alone

CHANG JUNTAO — 2025/3/7 15:49:51

Objective To study the value of three-dimensional anatomical parameters reconstructed by computerized tomography Interactive Medical Image control system (CT Mimics) in predicting the stability of internal bone mass in dorsal joint after internal fixation with palmar-plate alone. Methods A total of 165 patients with distal radius fractures who underwent simple palmar plate internal fixation in Chongqing Jiulongpo District Hospital of Traditional Chinese Medicine from September 2021 to June 2023 were retrospectively selected, all of which were combined with internal bone mass in the dorsal joint. The bone mass displacement in the dorsal joint was divided into displaced group (30 cases) and undisplaced group (135 cases) according to the 2nd day after surgery and outpatient follow-up. The baseline data of the two groups and the anatomical parameters of preoperative CT Mimics 3D reconstruction were compared. The influence of preoperative anatomical parameters on postoperative stability of bone mass in the dorsal joint was analyzed by multivariate Logistic regression. The predictive value of preoperative anatomical parameters on postoperative bone mass displacement in the dorsal joint was analyzed by receiver operating characteristic (ROC) curve. Pearson analyzed the correlation between preoperative anatomic parameters and postoperative displacement distance of bone mass in the dorsal joint. Results The proportion of AO type C3 in the displaced group was 63.33% higher than that in the non-displaced group (44.44%), and the difference was statistically significant (P < 0.05). The bone volume, the transverse to longitudinal ratio and the transverse width [(687.34±195.22) mm3, (1.12±0.14), (8.07±1.24) mm] in the displaced group were smaller than those in the non-displaced group [(990.61±284.37) mm3, (1.39±0.17), (10.95±2.28) mm]. The total displacement distance of bone mass before operation [(10.32±1.25) mm] was greater than that of the non-displacement group [(7.25±1.46) mm] (P < 0.05). AO classification C3 (OR=3.216, 95%CI: 1.254-8.247) and total displacement distance of bone mass before surgery (OR=1.432, 95%CI: 1.025-2.001) were independent risk factors for postoperative displacement of bone mass in the dorsal joint. Bone mass volume (OR=0.377, 95%CI: 0.188 ~ 0.755), transverse bone mass ratio (OR=0.445, 95%CI: 0.244 ~ 0.813) and transverse bone mass width (OR=0.384, 95%CI: 0.163 ~ 0.904) were independent protective factors, and the difference was statistically significant (P < 0.05). After adjusting for AO classification, bone mass volume (OR=0.283, 95%CI: 0.135-0.668), bone mass transverse ratio (OR=0.391, 95%CI: 0.229-0.668), transverse width of bone mass (OR=0.288, 95%CI: 0.120-0.689), total displacement distance of bone mass before surgery (OR=1.363, 95%CI: 1.007 ~ 1.846) were still independently correlated with the stability of bone mass after surgery, and the difference was statistically significant (P < 0.05). The AUC 0.790 (95%CI: 0.720 ~ 0.850) of the transverse and longitudinal ratio of bone mass predicted postoperative bone mass displacement in the dorsal joint was the largest, and the AUC of the combined prediction was 0.912 (95%CI: 0.859 ~ 0.951), the sensitivity was 86.67%, the difference was statistically significant (P < 0.05). Conclusion Among the anatomical parameters of CT Mimics 3D reconstruction, bone mass volume, bone mass ratio, bone mass transverse width, and total displacement distance of bone mass before operation are independently correlated with the stability of bone mass in the dorsal joint after internal fixation with volar plate. Combined application has certain predictive value for postoperative bone mass displacement, and can be used as one of the effective methods for clinical evaluation of postoperative bone mass stability.

Analysis of the efficacy and mechanism of high-frequency rTMS in the M1 region combined with low-frequency rTMS in the SMA region assisted by medication for the treatment of Parkinson's disease in elderly patients based on neurotransmitters and CT cerebral blood perfusion

zhangruijuan — 2025/3/7 15:48:02

Objective To investigate the efficacy and mechanism of high-frequency combined with low-frequency repetitive transcranial magnetic stimulation (rTMS) in the contralateral primary motor cortex (M1) and bilateral supplementary motor areas (SMA) on the side of symptom onset, based on neurotransmitter and CT cerebral blood perfusion analysis, to assist drug treatment for elderly Parkinson"s disease. Methods According to the 1:1 and random number table method, 106 elderly tremor-dominant Parkinson"s disease patients admitted to our hospital from September 2021 to June 2023 were divided into a drug group and a combination group, with 53 cases in each group. Both groups were given Pramipexole tablets, and on this basis, the drug group was given sham stimulation + memantine, while the combination group was given transcranial magnetic stimulation + memantine. The two groups were compared in terms of unified Parkinson"s disease rating scale scores (UPDRS), mini-mental state examination scale (MMSE), Hamilton anxiety/depression scale (HAMA/HAMD) scores, P300 amplitude and latency, neurotransmitters [dopamine, serotonin, glutamate, gamma-aminobutyric acid (GABA)], cerebral blood flow perfusion, and adverse reactions. Results After treatment, the UPDRS-II, UPDRS-III, and total UPDRS scores, HAMA, HAMD scores, and P300 latency in the combined group were lower than those in the drug group (P<0.05). After treatment, the MMSE score, P300 amplitude, dopamine, serotonin, glutamate, GABA, and temporal lobe, parietal lobe, frontal lobe, and basal ganglia cerebral blood perfusion were higher than those in the drug group (P<0.05). Conclusion High-frequency transcranial magnetic stimulation of the M1 region and low-frequency stimulation of the SMA region, in conjunction with medication, can improve motor and non-motor symptoms, regulate neurotransmitter levels, increase cerebral blood flow, and is highly safe for treating tremor-dominant Parkinson"s disease in the elderly.

Invasive Fibromatosis of the Mesentery: A Case Report

Cao Jin,,,胃、疝与腹壁外科,,,, — 2025/3/6 10:14:41

mesentericfibromatosis (MF) is a rare benign invasive tumor. After surgical resection, there is still the possibility of local infiltration and recurrence [1]. Its incidence is low, accounting for less than 1% of abdominal tumors. The age of onset is mostly between 20 and 40 years old, mainly female [2]. The cause of the disease is unknown. Clinically, male patients are more rare. This article reported a male MF case admitted to our department as follows.

Multiple endocrine neoplasia type 2A: two cases report and literature review

ganbangjia,,oukeru — 2025/3/5 17:12:26

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Research progress on etiology, pathogenesis and treatment of microinflammatory state in diabetic nephropathy

PAN XINYU,, — 2025/3/4 16:06:34

Diabetic nephropathy (DN) is one of the common clinical complications of diabetes. The course of the disease is difficult to cure, and alternative therapy is needed in the later stage.. At present, the pathogenesis of DN is unclear and effective treatment is still lacking. In recent years, it has been found that microinflammation plays an important role in the progression of DN disease. Western medicine believes that the pathogenesis of DN microinflammation is related to endoplasmic reticulum stress, intestinal flora disorder, abnormal activation of renin-angiotensin system , and disorder of glucose and lipid metabolism, etc. Anti-inflammatory therapy has become a new idea and method for the treatment of diabetic nephropathy. Traditional Chinese medicine practitioners believe that micro-inflammation of DN is related to "stasis heat", "dampness turbidness" and "dampness heat" in traditional Chinese medicine. In terms of treatment, drug treatment and external treatment of traditional Chinese medicine are used through dialectical classification. By collecting and collating the literature on DN microinflammation at home and abroad in recent years, the author elaborated the understanding of traditional Chinese and western medicine scholars on the etiology, pathogenesis and treatment of DN microinflammation, in order to provide reference for the research on the progress of the treatment of DN microinflammation.

Research progress on the correlation between triglyceride glucose index and chronic kidney disease

DengMeiqiu,DuYingying,Liang Meiyuan,Tangsheng, — 2025/3/4 16:05:19

The incidence rate of chronic kidney disease (CKD) is on the rise year by year and has become a global public health problem. Optimizing CKD management strategies and improving the level of prevention and treatment are essential to control the occurrence and development of CKD and reduce the incidence of end-stage renal failure. In recent years, the correlation between metabolic disorders and CKD has become a key focus in the field of kidney disease prevention and treatment. Insulin resistance (IR) is one of the key factors in the occurrence and development of CKD, and the triglyceride glucose (TyG) index is easily obtainable in clinical practice. As an alternative biomarker for IR and a potential biomarker for predicting CKD, it is gradually receiving attention. This article provides a review of the research progress on the correlation between TyG index and CKD.

Effects of maternal age at the time of oocyte cryopreservation on embryo development and clinical pregnancy outcomes.

huqingyun,,,,, — 2025/3/4 16:02:58

[Abstract] Objective To observe the effects of maternal age at frozen oocytes on the outcomes of embryo and clinical pregnancy of oocyte cryopreservation. Methods A retrospective study was performed on the clinical data of patients who underwent oocyte vitrification freezing, followed by thawing and intracytoplasmic sperm injection (ICSI) in the Reproductive Center of Women's Hospital of Nanjing Medical University from January 2013 to May 2024. The patients were divided into two groups based on their age at frozen oocytes: a group aged < 35 years and a group aged ≥ 35 years. To compare the general information, embryonic development, clinical pregnancy and neonatal outcomes between the two groups. Results BMI (21.50 vs. 23.50) and LH level on HCG day (1.78 vs. 3.00) in ≥ 35years group were significantly higher than those in < 35 years group (P< 0.05); there were no significant differences in oocyte survival rate, normal fertilization rate, oocyte degeneration rate afer ICSI, 2 pronucleus cleavage rate, available embryo rate and blastocyst formation rate between the two groups after oocyte resuscitation (P> 0.05), The rate of fresh embryo cycle implantation, clinical pregnancy rate of fresh embryo and cumulative clinical pregnancy rate of ≥ 35 years group had a downward trend, but there was no statistical difference (P> 0.05). The fresh embryo live birth rate (46.94% vs. 15.38%) and cumulative live birth rate (44.44% vs. 23.53%) in ≥ 35 years group were significantly decreased (P< 0.05). There were no significant differences in gestational age, newborn sex, newborn weight, low birth weight rate and macrosomia incidence between the two groups (P> 0.05). Conclusions The increase in the age of oocytes freezing in women leads to a decrease in the live birth rate after embryo transfer, which may be related to the decrease in the quality of frozen oocytes in older women.

Clinical efficacy analysis of percutaneous endocardial septal radiofrequency ablation for the treatment of hypertrophic obstructive cardiomyopathy

luanmingwei,,, — 2025/3/4 16:00:55

Objective? To investigate the clinical efficacy of percutaneous endocardial septal radiofrequency ablation (PESA) in the treatment of hypertrophic obstructive heart disease (HOCM). Method? A retrospective analysis was conducted on the clinical data of 11 patients with hypertrophic obstructive cardiomyopathy admitted to the Cardiovascular Department of Yantai Yuhuangding Hospital from September 2020 to June 2022. The changes of echocardiography, Kansas City Cardiomyopathy Quality of Life Scale (KCCQ), 5-year Sudden Death Risk Score (SCDI) , postoperative conduction block, pericardial effusion, ventricular septal rupture and other complications before operation, 1-3 days, 1-3 months, and 6-9 months after operation were analyzed to explore the effectiveness and safety of PESA surgery. Result? Among the 11 patients with hypertrophic obstructive heart disease, there were 9 females, with an average age of 64.00 ± 10.20 years. Compared with preoperative level, left ventricular outflow tract pressure gradient 6-9 months after operation [(23.00 ± 4.78mmHg) vs(77.25 ± 9.14), P<0.05]decreased. Furthermore, NYHA class [(1.36 ± 0.50) vs (2.64 ± 0.50), P<0.05] and SCDI score[(1.37 ± 0.49) vs (3.09 ± 1.81), P=0.056] also decreased.KCCQ score increased [(88.94 ± 6.47) vs. (55.50 ± 22.19), P<0.05]. After a follow-up of 7.45 ± 2.50 months, 11 patients all survived. One case of complete left bundle branch block and one case of atrial premature contraction were observed during postoperative follow-up. Conclusion? Percutaneous endocardial septal radiofrequency ablation can significantly improve patients" clinical symptoms, enhance their quality of life, and the occurrence of surgical complications is seldom rare.This surgery provides a safe and effective option for the treatment of hypertrophic obstructive cardiomyopathy.

Progress in clinical application of pericapsular nerve block of hip joint

qianqing — 2025/3/3 9:57:51

The pericapsular nerve group (PENG) block is an emerging regional analgesia technique developed in recent years, primarily used for perioperative analgesia in hip surgeries. With deeper research into this technique, its unique advantages have gradually been revealed, leading to an expansion of its clinical applications. This article provides a review of the research progress on the clinical applications of PENG block.

Meta-analysis of the Effects of Continuous Glucose Monitoring on Glucose Management in Adult Patients with Type 1 Diabetes Mellitus

程爽,,,, — 2025/2/17 11:39:53

[Abstract] Objective To systematically evaluate the intervention effect of continuous glucose monitoring on glucose management in adult patients with type 1 diabetes mellitus. Methods Randomized controlled trials of continuous glucose monitoring interventions on glucose management in adult patients with type 1 diabetes mellitus were searched in PubMed、Embase、Web of Science、the Cochrane Library、CNKI，Wanfang Data，and VIP databases, and the timeframe for searching was from the establishment of each database to May 2024. The quality of the included literature was assessed according to the Cochrane Risk of Bias Assessment Tool(RoB 2.0)，and Meta-analysis of outcome indicators was performed using RevMan 5.4 software.Results Eleven randomized controlled trials，including 1319 type 1 diabetes patients，were finally included. Meta-analysis showed that CGM intervention could effectively reduce the HbA1c level of type 1 diabetes patients（WMD=-0.18，95%CI：-0.34~-0.02，P=0.03）; For CGM related parameters, compared with the control group, it can significantly reduce the TIR level（WMD=6.33，95%CI：3.29~9.37，P<0.01）and CV level（WMD=-5.12，95%CI：-5.84~-4.41，P<0.01） of type 1 diabetes patients, and can also improve TBR、TAR、SD、MAGE and other parameters; However, the satisfaction with diabetes treatment（WMD=0.83，95%CI：-2.44~4.10，P=0.62）, Clarke score of impaired hypoglycemia awareness（WMD=-0.16，95%CI：-0.48~0.16，P=0.33）, and fear of hypoglycemia（WMD=0.34，95%CI：-4.59~5.27，P=0.89） were not significantly improved; At the same time, compared with the control group, the incidence of severe hypoglycemia events in the CGM group was lower, and the difference was statistically significant（WMD=0.47，95%CI：0.31~0.71，P<0.01）. Conclusion: Continuous glucose monitoring can improve HbA1c level and CGM glucose management related parameters in adult patients with type 1 diabetes, and can reduce the incidence of serious hypoglycemia events, but it has no effect on diabetes treatment satisfaction, impaired hypoglycemia awareness and hypoglycemia fear.

The relationship between blood carbon dioxide partial pressure and blood lactic acid and gastrointestinal bleeding in ECMO patients

Chen Wan,,Shen Yin,朱良峰 — 2025/2/10 11:38:44

objective To investigate the relationship between blood carbon dioxide and blood lactic acid in patients with ECMO and gastrointestinal bleeding during ECMO support. Methods The clinical data of 94 patients who underwent ECMO treatment at the People"s Hospital of Guangxi Zhuang Autonomous Region between January 2020 and December 2022 were retrospectively analyzed. According to whether gastrointestinal bleeding occurred during hospitalization, the patients were divided into bleeding group and non-bleeding group. The baseline data of patients in the two groups at admission, the changes of blood partial pressure of carbon dioxide and blood lactic acid before ECMO treatment and 24h after ECMO treatment were compared, and the influencing factors of gastrointestinal bleeding in patients were screened by logistic regression. ROC analysis showed that the sensitivity and specificity of serum carbon dioxide > 42.52 ( mmHg ) at 24 h after ECMO in predicting gastrointestinal bleeding were 28.6 % and 97.4 %, respectively. The sensitivity and specificity of blood lactic acid > 5.22 ( mmol / L ) at 24 h after ECMO were 42.9 % and 86.3 %, respectively. The sensitivity and specificity of the combination of the two were 71.4 % and 79.5 %, respectively, which had certain predictive value. Results There were 21 patients ( 22.34 % ) with gastrointestinal bleeding during ECMO life support. There was no significant difference in ECMO mode, age, gender, combined disease, white blood cell count, hemoglobin count, platelet count, serum albumin and serum creatinine between the two groups before ECMO treatment ( P > 0.05 ). There was no significant difference in VIS index, mean arterial pressure, blood carbon dioxide partial pressure and blood lactic acid before ECMO ( P > 0.05 ). After 24 hours of ECMO support, the blood carbon dioxide partial pressure and blood lactic acid value in the bleeding group were higher than those in the non-bleeding group ( P? 5.22 ( mmol / L ) at 24 h after ECMO. Conclusion The blood carbon dioxide partial pressure and blood lactic acid at 24 h after ECMO are independent risk factors for gastrointestinal bleeding in patients with ECMO. They can be used as early predictors of gastrointestinal bleeding in patients with ECMO. It is of great clinical significance to reduce the occurrence of gastrointestinal bleeding in ECMO and improve the survival rate.

Study on radiological anatomical parameters of right atrial appendage in patients with chronic sinus arrhythmia

LIWEIJUN,,,, — 2025/2/8 17:42:44

Objective To investigate the image anatomy characteristics of the right atrial appendage(RAA) in pacemaker implantation, and to further understand the opening, bottom and spatial location of right atrial appendage, so as to guide the implantation location of electrode and improve the success rate of pacing therapy. Subjects and methods 74 patients with bradyarrhythmia or conduction abnormality diagnosed by electrocardiogram and suppose to be implanted with permanent pacemaker (case group) and 46 patients without signs of cardiovascular disease, ECG and color Doppler echocardiography without obvious structural and functional abnormalities (control group) were randomly selected, 128row CT cardiography was performed.The distance from second rib notching to the basilar part of RAA in coronal view,the oblique vertical diameter,the axial angle, sagittal angle, left—right diameter and perimeter were all measured by the Philips IntelliSpace Portal Workstation software.Results there were significant differences in axial angle (7.42 ±3.06) and sagittal angle (48.67 ±5.09) between the case group and the control group (6.21 ±2.17) and sagittal angle (51.49 ±5.21). According to stratification analysis,There were significant differences in axial angle, sagittal angle and left—right diameter between the two groups. In addition, the difference of oblique vertical diameter between the two groups was statistically significant among female subjects.Conclusion our present study,which performed by 128-row multidetector cardiac computed tomography and detecting the distance from second rib notching to the basilar part of RAA in coronal view,the oblique vertical diameter,the axial angle, sagittal angle, left—right diameter and perimeter,is able to guiding the pacemaker implantation and improve the success rate of electrode implantation.

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Lijunfeng,Shanchangxing — 2025/2/8 15:30:19

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Clinical study on the combined ratio of melatonin and procalcitonin to predict the risk of acute kidney injury in patients with sepsis

LIU Shulin,YUAN Yuting,YUAN Yuan — 2025/2/8 11:30:24

Objective: To investigate the value of melatonin-to-procalcitonin ratio (MLT/PCT) in predicting acute kidney injury in patients with sepsis. Methods: A retrospective analysis was conducted on 110 patients with sepsis admitted to our hospital from January 2021 to December 2023. Patients were divided into AKI group (n=49) and non-AKI group (n=61) based on the occurrence of AKI. Clinical data were collected, and serum MLT, PCT levels, and MLT/PCT ratio were compared between the two groups. Logistic regression analysis was used to identify independent risk factors for AKI, and receiver operating characteristic curves were plotted to evaluate the predictive efficacy of MLT/PCT. The correlation between MLT/PCT and APACHE II score was also analyzed. Kaplan-Meier survival curves were generated based on the 28-day survival status to analyze the difference in mortality between patients with different MLT/PCT levels. Results: Serum MLT levels were significantly lower, while PCT levels and APACHE II scores were significantly higher in the AKI group compared to the non-AKI group (P < 0.05). MLT/PCT ratio was negatively correlated with APACHE II score (r=-0.368, P<0.01). Multivariate logistic regression analysis showed that after adjusting for covariates, elevated MLT/PCT was an independent protective factor for AKI in patients with sepsis (OR=0.485, 95%CI: 0.270~0.869, P < 0.05). ROC curve analysis showed that the area under the curve of MLT/PCT for predicting AKI risk was 0.920 (95%CI: 0.853~0.963), which was superior to individual indicators and indicated good predictive efficacy. Survival curve analysis showed that the 28-day cumulative mortality rate was significantly higher in the low MLT/PCT group (<3.3, n=55) compared to the high MLT/PCT group (≥3.3, n=55). Conclusion: MLT/PCT ratio can serve as a good predictor of AKI risk in patients with sepsis, which may help clinicians identify high-risk patients early and take timely interventions.

Analysis of clinical efficacy of diquafosol sodium combined with fluometholone in the treatment of dry eye

liyue,,,, — 2025/2/8 11:29:15

Objective To observe the therapeutic effect of diquafosol sodium (DQS) combined with fluometholone on dry eye syndrome. Methods A total of 76 patients (76 eyes) with dry eye were selected from the People"s Hospital of Guangxi Zhuang Autonomous Region from July 2022 to April 2023. They were randomly divided into control group and observation group. The control group (38 patients, 38 eyes) received sodium hyaluronate combined with fluorometholone treatment, while the observation group (38 patients, 38 eyes) received diquafosol sodium combined with fluorometholone treatment. Both groups were treated continuously for 1 month, Swith fluorometholone used for 7 days.S The following indexes were measured before and 1 month after treatment: fluorescein breakup time (FBUT), ocular surface disease index (OSDI) score, Schirmer Ⅰ test (SIt) and fluorescein breakup time (FBUT), corneal fluorescein staining (CFS), tear meniscus height (TMH), first noninvasive breakup time (F-NIBUT), average-noninvasive breakup time (A-NIBUT), meibomian gland opening score, meibomian gland grading score and meibomian gland secretion trait score. These indicators were used to evaluate the efficacy of the two treatments. Results There were no significant differences in data between the two groups before the intervention. (P＞0.05). After 1 months of medication, the results of OSDI, FBUT, FBUT, F-NIBUT, A-NIBUT, meibomian gland opening score and meibomian gland secretion trait score in 2 groups were significantly improved compared with before treatment (P＜0.001). The results of CFS, F-NITBUT and A-NITBUT in the observation group were significantly better than control group(P＜0.05). After 1 month of medication, there was no significant difference in SIT and TMH between the control group compared with baseline (P＞0.05), while there was significant improvement in the observation group compared with baseline (P ＜ 0.001). After 1 month of medication, there was no significant difference between control group and observation group in meibomian gland grading score (P＞0.05). Conclusions Diquafosol sodium eye drops combined with fluorometholone eye drops not only effectively improve the clinical symptoms and signs of patients with dry eye syndrome, but also have better efficacy than sodium hyaluronate eye drops combined with fluorometholone eye drops. It is worthy of clinical application and promotion.

Constructing a nomogram model for OSAHS combined with coronary heart disease based on the four-variable screening tool

Ayiguzaili Maimaitimin,,Gulimire Aimaiti,Liang Zeyu,Qiu Xuan,Yao Yanli — 2025/2/8 11:28:19

Objective Aim to explore the predictive factors of OSAHS complicated with coronary heart disease, and construct a column chart model of OSAHS complicated with coronary heart disease based on the four-variable screening tool and traditional risk factors. Method 1224 patients with suspected coronary heart disease and diagnosed OSAHS who were hospitalized at the First Affiliated Hospital of Xinjiang Medical University from February 2020 to March 2024 were selected.. Randomly divided into a training set (n=857) and a validation set (n=367) in a 7:3 ratio, the training set was divided into a coronary heart disease group (n=277) and a non coronary heart disease group (n=580) based on the degree of coronary artery stenosis. Use LASSO regression, univariate logistic regression and multivariate logistic regression to determine the risk factors for coronary heart disease, and establish a predictive model based on this, and draw a column chart. Use the area under the curve (AUC), calibration curve, Hosmer Lemeshow test, and decision curve (DCA) to evaluate the discrimination, calibration, and clinical effectiveness of the model. Results Multivariate logistic regression results indicated that the following factors are risk factors for coronary heart disease in patients with obstructive sleep apnea (OSAHS): The score of four-variable screening tool≥10.5, male, age≥45 years,history of hypertension, BMI≥25kg/m2 , AHI≥30 times/hour (P<0.05), and a column chart prediction model is constructed based on the above variables. The AUC values of the model in the training set and validation set are 0.793 (95%:CI 0.762-0.824) and 0.795 (95% CI:0.749-0.840), respectively. The calibration curve and Hosmer Lemeshow test showed that the model had good calibration (training set: chi square=7.46, P=0.590; validation set: chi square=12.15, P=0.205; P>0.05). The decision curve also validated the clinical applicability of the prediction model. Conclusion The score of four-variable screening tool≥10.5, male, age≥45 years, history of hypertension, BMI≥25kg/m2, and AHI≥30 times/hour are independent influencing factors for the occurrence of coronary heart disease in OSAHS patients. Based on this, a nomogram prediction model was constructed. The prediction model based on four-variable screening tool has better clinical application value than traditional risk factor models for predicting coronary heart disease in OSAHS patients.

Effects of Neurac technology and TMS vestibular reflex on lower limb muscle strength, trunk stability and walking function recovery in patients with hemiplegia after stroke

wudan — 2025/2/8 11:27:22

Objective To explore the effects of neuromuscular activation (Neurac) combined with transcranial magnetic stimulation (TMS) vestibular reflex on lower limb muscle strength, trunk stability and walking function recovery in patients with hemiplegia after stroke. Methods A total of 123 patients with post-stroke hemiplegia admitted to Beijing Rehabilitation Hospital of the Capital Medical University? from January 2022 to August 2023 were selected and divided into 3 groups with 41 cases in each group by random number table method. All the patients were given routine rehabilitation training, control group 1 was given Neurac technology, control group 2 was given TMS vestibular reflex, and the observation group was given Neurac technology combined with TMS vestibular reflex for 4 consecutive weeks. Trunk stability, walking function parameters, surface electromyography [root mean square value of biceps and triceps (RMS)], lower limb muscle strength, upper and lower limb motor ability [Fugl-Meyer Motor Function Rating Scale (FMA)] ,body balance function [Postural Control Scale (PASS), Brunel Balance Scale (BBS)] and Quality of life (SS-QOL) score before and after intervention in 3 groups were observed. Results After 4 weeks of intervention, the length, area and average velocity of the observation group were lower than those of control group 2 and control group 1 (P < 0.05). After 4 weeks of intervention, the walking speed, step frequency, stride length ratio and FMA, BBS, PASS and SS-QOL scores in observation group were higher than those in control group 1 and control group 2 (P < 0.05), but there was no significant difference between control group 1 and control group 2 (P > 0.05). After 4 weeks of intervention, the elbow flexion RMS and elbow extension RMS and lower limb muscle strength of biceps and triceps in observation group were higher than those in control group 1 and control group 2 (P < 0.05), but there was no significant difference between control group 1 and control group 2 (P > 0.05). Conclusion Neurac technology combined with TMS vestibular reflex in patients with hemiplegia after stroke can enhance the muscle strength of the upper and lower limbs, improve the stability and balance of the body, and thus enhance the walking ability and improve the quality of life.

Establishment the reference interval of amino acid profiles of health adults in Shanghai area based on the HPLC-MS/MS method

Hu Yao,Zhan Yingying,,Zhao Yangyang,Zhu Xuan — 2025/2/8 11:26:21

Objective This study aimed to develop an effective high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) method for measuring free amino acids in human plasma. The performance of the HPLC-MS/MS method was thoroughly validated, and the reference interval of amino acid profiles of health adults in Shanghai was determined. Methods The study included 341 healthy individuals aged 18-80 from Huashan hospital of Fudan University in Shanghai, consisted of 170 males and 171 females. The concentrations of 28 amino acids were determined using HPLC-MS/MS method. The reference interval of amino acids in plasma was established following WS/T402-2012 standards. Results Verification of the precision, accuracy, the lower limit of quantitation (LLOQ), linear range, contamination rate, and sample stability of the HPLC-MS/MS method for amino acids determination all meet the corresponding requirements. The reference interval for 28 amino acids in the plasma of healthy individuals in Shanghai was established. The Level of amino acids in males were significantly higher than in females (P<0.05). The established reference intervals were also validated and met WS/T402-2012 standards. Conclusion In this study, the reference interval of 28 plasma amino acids in healthy adults in Shanghai area was established and verified, which provided the basis for clinical diagnosis and treatment.

Research Progress on Sonodynamic Therapy for Osteomyelitis

liu li yang,yuan yu gang — 2025/2/7 17:53:27

Osteomyelitis is an infectious inflammation of deep tissues caused by a bacterial infection; persistent infection leads to lysis and necrosis of bone tissue, and its treatment is complicated by the emergence of drug-resistant strains of bacteria and the formation of biofilms.Sonodynamic therapy (SDT), as an emerging anti-infective method, utilizes ultrasound to activate acoustic sensitizers to generate reactive oxygen species (ROS), which effectively kills bacteria and disrupts their biofilm, and is highly effective in treating infections caused by drug-resistant bacteria.This paper reviews the antimicrobial mechanism of SDT, systematically discusses the research progress of different acoustic sensitizers based SDT in the treatment of bacterial infections, summarizes the current challenges and provides an outlook for future research on antimicrobial SDT.

New advances in the diagnosis and treatment of refractory gout

LI Guo,,WANG Peng,YU Ling,ZHANG Quanbo — 2025/2/7 12:46:34

Patients with refractory gout (RG) tend to be more severely ill, have poorer outcomes, suffer from recurrent acute attacks, and are more prone to joint destruction and dysfunction, which seriously affect their quality of life. The Guidelines for the Diagnosis and management of Hyperglycemia and Gout in China(2019) proposed a standard diagnostic criteria of refractory gout for the first time. In recent years, new understanding has been gained in the study of clinical features and risk factors of refractory gout. At the same time, new progress has been made in therapeutic drug research. In this paper, we review the definition, diagnosis, clinical features, and drug treatment of refractory gout, with a view to providing reference for the clinical diagnosis and treatment of refractory gout.

Research Progress on the Antiplatelet Function and Thrombosis of Traditional Chinese Medicine

guwei — 2025/2/7 12:45:40

Platelets play important role in the process of thrombosis, especially in arterial thrombosis. Given that existing antithrombotic drugs have more or less adverse reactions, it is of great significance to explore and study new drug candidates for the clinical treatment of thrombosis-related diseases in this context. This article reviews some representative traditional Chinese medicines that regulate platelet function with anti-thrombotic effects and their mechanisms. Further research on the specific mechanisms of action of traditional Chinese medicines on platelet function and thrombosis will have important clinical significance to the treatment of platelet dysfunction and thrombotic diseases.

Pregnancy complicated with abdominal wall giant aggressive fibromatosis: a case report and literature review

宋敏,,,, — 2025/2/7 12:40:16

Aggressive fibromatosis (AF) is a rare local invasive tumor with monoclonal fibroblast proliferation, which has a high recurrence rate and rarely malignant transformation. Affected by factors such as hormone levels, pregnancy may lead to the progression or recurrence of AF. due to the lack of specificity of clinical symptoms, signs and imaging findings, early diagnosis of AF in pregnancy is difficult, and it is easy to be misdiagnosed as fibrosarcoma, leiomyosarcoma and other malignant diseases, resulting in patients giving up pregnancy and even accepting excessive surgical treatment. This paper retrospectively analyzed the diagnosis and treatment of a patient with pregnancy complicated with abdominal wall giant invasive fibromatosis admitted to the gynecology ward of the Affiliated Hospital of Guizhou Medical University, in order to improve the diagnosis and treatment of pregnancy complicated with abdominal wall AF.

A novel MYO7A mutation identificated in a Chinese family with late-onset autosomal dominant nonsyndromic sensorineural hearing loss

CHEN Biyan,HE Sheng,QIN Zailong,WEN Chunxiu,YANG Qi,YI Shang,ZUO Yangjin — 2025/2/7 12:39:24

Objective To indentify the pathogenic mutation in a family with autosomal dominant nonsyndromic hearing loss, providing the evidence for diagnosis of other family members. Methods We collected the clinical data and audiological examination of the proband and family members. The target genes and mutations were identified by whole exome sequencing in the proband, and the MYO7A gene of the proband and family members was verified by Sanger sequencing. Results The 16-year-old proband was diagnosed as bilateral severe sensorineural hearing loss by pure-tone audiometry. There were 18 patients with post-lingual progressive hearing loss in the proband’s father and paternal family members. The onset ages varied among individuals and differed between families. Compared to the patients in generations III, IV, and V, there was a clear trend of genetic anticipation. The average pure-tone audiometric thresholds in both ears of the proband were 83 dBHL (air conduction); bone conduction showed no response at maximum intensities across all frequencies, with more pronounced losses in the mid-to-high frequency ranges. We identified a nucleotide transition heterozygous c.689C>T (p.Ala230Val) in exon 7 of MYO7A gene by whole exome sequencing in the proband. We also verified the c.689C>T heterozygous in the proband and other family members with hearing loss by Sanger sequencing. Conclusion This study reports a case of hereditary non-syndromic hearing loss caused by the p.Ala230Val mutation of MYO7A gene in a Chinese pedigree, which enriching the mutation spectrum of hearing loss in our country, discovering the unique genetic anticipation of this mutation in our pedigree.

The expression and clinical application value of serum CNPY2 in gastric cancer

CHEN Lan-lan,JU Ying,LIU Duanrui,LIU Yiqing,LIU Yun,,ZHANG Peili — 2025/2/7 12:38:18

[Abstract] Objective To analyze the expression and clinical application value of serum Canopy fibroblast growth factor signaling regulator 2 (CNPY2) in gastric cancer. Methods Clinical data of 65 gastric cancer (GC) patients hospitalized in the Department of Gastrointestinal Surgery of the Provincial Hospital of the First Medical University of Shandong, China from December 2023 to September 2024 were collected.Among them, 39 cases of early GC (TNM stage I) and 26 cases of progressive GC (6 cases of TNM stage II, 17 cases of TNM stage III and 3 cases of TNM stage IV) were selected. Another 43 cases of patients with benign gastric diseases in the same period of time in our hospital were selected as the benign group, as well as 52 cases of volunteers with physical examination and health as the control group.Serum CNPY2, carcinoembryonic antigen (CEA), and glycan antigen 199 (CA199) levels were detectedThe diagnostic efficacy of serum CNPY2, CEA, and CA199 for GC and early GC was analyzed by the receiver operating characteristic (ROC) curve..Results The levels of CNPY2 and CEA were higher in the GC group than in the benign and control groups, and the level of CA199 was higher than that in the control group, and the differences were statistically significant (P < 0.05).The levels of CNPY2 and CA199 were higher in patients with TNM stage II+III+IV GC than in patients with TNM stage I GC, and the level of CNPY2 was higher in patients with poorly differentiated GC than in patients with moderately or highly differentiated GC, and the level of human epidermal growth factor receptor?2 (HER2)-negative GC patients had higher serum CEA levels than HER2-positive GC patients, and the differences were statistically significant (P < 0.05).The results of the ROC curve analysis showed that the combination of serum CNPY2, CEA, and CA199 in the diagnosis of GC [AUC (95% CI) = 0.885 (0.823-0.947), P < 0.05] and earlyGC [AUC (95% CI) = 0.857 (0.780 -0.933), P < 0.05] had higher efficacy. Conclusion Serum CNPY2 levels were significantly elevated in patients with GC, and the combined detection of serum CNPY2, CEA, and CA199 could improve the diagnostic efficacy of GC and early GC.

Expression and Clinical Significance of Peripheral Blood Claudin-5 and JKAP in Patients with Parkinson's Disease

边娜,, — 2025/2/7 12:37:21

Objective To investigate the expression and clinical significance of peripheral blood Claudin-5 and c-Jun N-terminal kinase-associated protein (JKAP) in patients with Parkinson's disease (PD). Methods A total of 85 PD patients (PD group) treated at the Department of Neurology, Baoji People's Hospital, from January 2021 to July 2024, and 85 healthy volunteers (control group) were selected. PD patients were divided according to disease severity (Hoehn-Yahr staging) into early PD group (stages 1 to 2.5, 17 cases), mid-stage PD group (stage 3, 41 cases), and late-stage PD group (stages 4 to 5, 27 cases). Based on cognitive function [PD-cognitive rating scale (PD-CRS)], patients were further divided into a normal cognition group (>80 points, 28 cases), PD-MCI group (74 to 80 points, 37 cases), and PDD group (≤73 points, 20 cases). Peripheral blood Claudin-5 and JKAP levels were measured using enzyme-linked immunosorbent assay. Spearman correlation analysis was conducted to assess the relationship between Hoehn-Yahr staging and peripheral blood Claudin-5 and JKAP levels in PD patients. Multivariate ordinal Logistic regression was used to analyze the association between peripheral blood Claudin-5, JKAP levels, and cognitive impairment in PD patients. ROC curve analysis was performed to evaluate the predictive efficacy of peripheral blood Claudin-5 and JKAP levels for cognitive impairment and PDD in PD patients. Results Compared to the control group, peripheral blood Claudin-5 levels were significantly higher, and JKAP levels were significantly lower in the PD group (P<0.05). Claudin-5 levels progressively increased, and JKAP levels progressively decreased across early, mid, and late-stage PD groups (P<0.05). Hoehn-Yahr staging was positively correlated with Claudin-5 levels and negatively correlated with JKAP levels (P<0.05). Disease duration, Hoehn-Yahr staging, and Claudin-5 levels increased, while JKAP levels decreased from the normal cognition group to the PD-MCI and PDD groups (P<0.05). After adjusting for confounding factors, high Claudin-5 was identified as an independent risk factor for cognitive impairment in PD patients, while high JKAP was an independent protective factor (P<0.05). The combined evaluation of peripheral blood Claudin-5 and JKAP levels for cognitive impairment and PDD had an area under the curve of 0.894 and 0.901, respectively, higher than the individual evaluation by Claudin-5 (0.794, 0.787) or JKAP (0.778, 0.776) (P<0.05). Conclusion Elevated peripheral blood Claudin-5 and decreased JKAP levels in PD patients are closely related to disease progression and cognitive impairment. The combined evaluation of Claudin-5 and JKAP levels shows high efficacy in assessing cognitive impairment and PDD in PD patients.

A case of proliferating trichilemmal tumor occurring in the breast

liujialiang, — 2025/1/20 11:03:54

This article reports the diagnosis of a case of proliferating trichilemmal tumor (PTT) in the breast, and summarizes its clinical and pathological characteristics through literature review. The aim is to improve the understanding of rare parts of this disease and reduce misdiagnosis and missed diagnosis. The patient is a 50 year old female who sought medical attention due to the discovery of a left breast mass and occasional pain. The pathological examination results after breast lesion resection showed that Hair derived skin appendage tumor, combined with morphology and immunohistochemistry, conforms to PTT. Tumor cells express pan-CK, P63, CK5/6, and some express GATA-3, CD117, P40, CK8/18, Not expressing PR, ER, AR, GCDFP-15, CK20, Ki-67 proliferation index is 20%.

Application of endoscopic sentinel lymph node biopsy in breast cancer

huangdong,weiwensong, — 2025/1/20 11:02:11

Breast cancer is one of the most common malignant tumors in women, and the status of axillary lymph nodes is very important for the clinical staging, treatment strategy and prognosis evaluation of breast cancer. Although the traditional open sentinel lymph node biopsy is effective in the diagnosis of axillary lymph nodes in early breast cancer, it may leave a large postoperative scar and a long recovery period, which affects the daily quality of life of patients to a certain extent. With the continuous progress of endoscopic technology, endoscopic sentinel lymph node biopsy is increasingly used in the treatment of breast cancer, and it shows a wide application prospect in the surgical treatment of breast cancer with its advantages of precision and minimally invasive, rapid recovery and better aesthetic effect. In this paper, the application progress of endoscopic sentinel lymph node biopsy in breast cancer is summarized as follows, aiming to provide strategic reference for clinical diagnosis and treatment, and provide more accurate and minimally invasive treatment options for breast cancer patients.

Study on the application effect of elastic band resistance training combined with dietary adjustment mode in elderly patients with chronic obstructive pulmonary diseaseYIN Hui MA Ying

尹辉 — 2025/1/17 8:49:27

Objective: To explore the application effect of elastic band resistance training combined with dietary adjustment mode in elderly patients with chronic obstructive pulmonary disease (COPD), provide a new nursing mode for elderly COPD patients, and improve the treatment effect and quality of life of patients. Method: A prospective randomized controlled study was conducted on 120 elderly COPD patients admitted to our hospital from May 2023 to May 2024. According to the inclusion criteria, patients were randomly assigned based on their admission time and divided into an elastic band resistance training combined with dietary adjustment group (n=60) and a conventional group (n=60). The lung function, muscle strength, psychological status, exercise endurance, and quality of life were compared between the two groups before and after intervention. Result: After intervention, both groups showed an increase in FVC, FEV1, FEV1/FVC, and PaO2, while PaCO2 decreased slightly; Grip strength and muscle mass have both increased, and the sitting time has decreased after 5 attempts; Both groups showed a decrease in SAS and SDS; 6MWT showed an increase, while CAT and mMRC scores decreased. The overall effect evaluation showed that the combination of elastic band resistance training and dietary adjustment group was superior to the conventional group (P<0.05). Conclusion: The combination of elastic band resistance training and dietary adjustment mode can enhance patients" lung function, improve their muscle strength, alleviate their negative emotions, and effectively improve their exercise endurance and quality of life. This method can be promoted in the nursing of patients with chronic obstructive pulmonary disease in the future.

Clinical research progress of facial lifting combined with facial fat filling surgery in facial rejuvenation

陈伟华,朱田雨 — 2025/1/17 8:20:40

The age-related facial aging problem caused by facial soft tissue sagging and volume loss has always been an important part of facial rejuvenation treatment. The treatment of facial rejuvenation gradually tends to combine facial lifting surgery and facial fat filling surgery. Facial lifting surgery mainly solves the problems of sagging and sagging facial skin, while facial fat filling surgery can restore the loss of facial volume and improve skin texture. This combined surgery can solve facial sagging and increase facial volume under the same treatment course, which can improve the overall appearance of facial aging and target the treatment of local aging problems. This review summarizes the relevant applications of facial lift surgery combined with facial fat filling surgery in facial rejuvenation, providing guidance for the clinical application of combined surgery in facial rejuvenation treatment in the future.

Application progress of autologous platelet-rich plasma in respiratory diseases

He Ya-yun,,Huang Min,Li Xiao-peng,Yuan Shou-qing — 2025/1/16 8:39:35

Platelet-rich plasma (PRP) is rich in high concentration of platelets and a variety of cytokines, which has the properties of anti-inflammation, promoting cell proliferation and tissue repair.Currently, PRP has been extensively utilized in stomatology, orthopedics, plastic surgery, otolaryngology and other domains, demonstrating remarkable efficacy and high safety. Autologous PRP, which is extracted from the patient's own plasma, poses no risk of immune rejection or disease transmission. In recent years, autologous PRP has been gradually applied to the treatment of respiratory diseases such as bronchial fistula, bronchial hemorrhage, chronic obstructive pulmonary disease(COPD), inhalation lung injury, and novel coronavirus infection, and has shown certain clinical efficacy. This article reviews the preparation of PRP and its application in respiratory diseases,in order to provide new treatment methods for respiratory diseases and promote the application of PRP in respiratory diseases.

Analysing change in initial visits of children and adolescents in outpatient clinics of a psychiatric hospital in Guangxi from 2014 to 2023

FAN Xiying,FANG Hui,HUANG Shujin,LI Jinxiu,LV Xiaoping,NONG Yuxian,SONG Li, — 2025/1/15 16:22:57

Objective To investigate the changes in the first diagnosis of children and adolescents in outpatient clinics of a psychiatric specialty hospital in Guangxi. Methods Collecting the clinical data retrospectively from 37,177 children and adolescents who first attended the outpatient clinic of the Fifth People's Hospital of Nanning from January 2014 to December 2023. Categorizing the diagnoses of the patients who visited the clinic according to the reference of International Classification of Diseases-10th edition (ICD-10). Analyzing the statistics on the composition of diagnoses for each disease per year, calculating the average rate of increase, and examining the trend of change disease diagnosis by chi-square trend. Results The average annual composition ratios of outpatient children and adolescent for each type of first diagnoses from 2014 to 2023 were as follow: F30-F39 (27.89%), counseling (23.51%), F20-F29 (12.03%), F40-F48 (9.83%), F00-F09 (9.75%), F90-F98 (6.32%), Other (5.63%), visits for mental health problems (2.04%), F70-F79 (1.37%), and F50-F59 (1.17%). The composition ratios of F00-F09, F20-F29, F50-F59, F70-F79, Other, and counseling visits decline, with an average rate of decline in the composition ratios of 7.20%, 49.06%, 7.41%, 25.98%, 7.41%, and 4.80%, respectively. The composition ratios of F30-F39, F40-F48, and visits for mental health problems showed an upward trend, with an average rate of increase in the composition ratio of 26.95%, 15.97%, and 51.12%, respectively. Moreover, the chi-square test of trend suggested that the differences were all statistically significant (p<0.05). In the F30-F39 category, the average annual component ratios were as follow: depressive episodes (80.12%), other types of mood [affective] disorders (12.64%), bipolar disorder (5.18%), and manic episodes (2.06%). The manic episode and bipolar disorder composition ratios performed a declining tendency, with an average rate of decline in the composition ratio of 10.49% and 17.99%. In contrast, the depressive episode and other types of mood [affective] disorders composition ratios revealed an upward trend, with an average rate of increase in the composition ratio of 32.08% and 16.97%. Meanwhile, the chi-square test for trend indicated that the difference was statistically significant in all cases (P<0.05). Conclusion From 2014 to 2023, there was a significant increase in the composition ratio of children and adolescents' outpatient visits for mental health problems and F30-F39 disorders, and a decrease in the composition ratio of traditional psychiatric disorders, such as schizophrenia, in the hospital's outpatient clinics. Mental health services for children and adolescents with problems such as emotional internalization should be targeted and strengthened in the future.

Distribution of alleles and haploid polymorphisms of HLA-A, B, C, DRB1 and DQB1 in single-center Han population of renal transplantation recipients

邵长峰,,, — 2025/1/14 18:02:26

[Abstract] Objective To investigate the distribution and haploid polymorphism of HLA-A, -B、-C、-DRB1、-DQB1alleles in single center of Han population renal transplant recipients in our hospital. Methods HLA-A, -B、-C、-DRB1、-DQB1were detected by sequence specific oligonucleotide probe- polymerase chain reaction (PCR-SSO) in 1470 Han Chinese kidney transplant recipients from June 2019 to December 2022 in our hospital. Allele frequencies of HLA-A, -B, -C, -DRB1, -DQB1 were calculated by direct counting. The allele frequencies of HLA-A, -B、-C、-DRB1、-DQB1were calculated by Arlequin3.5.2.2 software. Hardy-Weinberg equilibrium test was performed for each gene locus. Results A total of 216 alleles were detected in 1470 samples, among which 36, 86, 33, 40 and 21 alleles were detected for HLA-A, B, C, DRB1 and DQB1, respectively. The observed values of HLA-A, B and C alleles were in line with Hardy-Weinberg equilibrium, while the observed values of HLA-DRB1 and DQB1 alleles were in line with Hardy-Weinberg equilibrium, which deviated from Hardy-Weinberg equilibrium. In our single center population of kidney transplant recipients, a total of 452 haploid pairs of HLA-A~ HLA-B, 219 haploid pairs of HLA-B~HLA-C, 666 haploid pairs of HLA-A~HLA-B~HLA-C, 551 haploid pairs of HLA-B~HLA- DRB1, 91 haploid pairs of HLA-DRB1~HLA-DQB1, 1367 haploid pairs of HLA-A~HLA-B~ HLA-C~HLA- DRB1, and 1434 haploid pairs of HLA-A~HLA-B~ HLA-C~HLA- DRB1~HLA-DQB1.There were 110 pairs of common haplotypes with haplotype frequency > 1%. Conclusion HLA-A * 30:01B * 13:02C *06:02 DRB1* 07:01DQB1 *02:02 haplotype frequency was the highest in the single center renal transplant recipients in our hospital. It provides population reference data for the study of HLA matching donor probability and recipient population genetics in renal transplant population. It has important clinical significance for the matching of renal transplant patients in single center area of our hospital.

A case of mild phenotype Alport syndrome caused by COL4A5 mutations

王霄轩 — 2025/1/14 8:48:37

Alport syndrome is a hereditary glomerular basement membrane disease presenting with decreased renal function, ocular abnormalities, and hearing loss due to gene COL4A3, COL4A4, and COL4A5 mutations, which encode type IV collagen. Unlike thin basement membrane nephropathy, Alport syndrome has a poor prognosis. In patients with X-linked Alport syndrome type 1 due to COL4A5 mutations, 90% of men will enter end-stage renal disease at age 40 years with a poor prognosis. In this article, we report a 44-year-old male patient with Alport syndrome who had a slow and mild course of nephropathy. The patient presented with urinary occult blood, intermittent proteinuria, and hypertension without the typical clinical manifestations associated with Alport syndrome such as sensorineural deafness. Renal biopsy showed diffuse thinning of the basement membrane on electron microscopy, consistent with the pathologic manifestations of thin basement membrane nephropathy. However, genetic testing revealed a mutation in the COL4A5 gene on the X chromosome in this patient with X-linked Alport syndrome type 1. This case is atypical of Alport syndrome because the patient""s mutated gene happens to be located in the COL4A5 gene on the X chromosome, spanning bases 3581 to 3598, and the clinical presentation is mild.

chronic granulomatous disease caused by NCF2 novel gene mutation: a case report

Ji Lina,Song Lin,Wang Jian, — 2025/1/13 16:41:46

A female patient aged 2 months was admitted to our hospital in March 2023 due to diarrhea and bloody stool for more than 3 months. The patient developed lymphadenitis and tuberculosis after BCG vaccination. The examination of neutrophil phagocytosis was positive during hospitalization. The results of gene sequencing indicated that there was c.1275G>A in exon13 of NCF2 gene (exon13, NM_000433.4), which led to amino acid change P.RP425ter, and was diagnosed as chronic granulomatosis disease.

Analysis of congenital heart disease deaths in children under 5 years old in Guangxi from 2017 to 2022

huangxuhua,liuxianghong,,weijishan,zhangyuxing — 2025/1/10 17:19:42

[Abstract] Objective Exploring the mortality rate of congenital heart disease in Guangxi's under 5-year-olds is the objective of this paper. Methods Analyze the data of congenital heart disease deaths among children under 5 years old in Guangxi from 2017 to 2022.In Guangxi. Results The mortality rate of congenital heart disease among children under 5 years old between 2017 and 2022 was 34.44 per 100,000, with 57.04% of those fatalities being attributed to infants, particularly those born within seven days. The proportion of newborns who died were born in county-level hospitals was the highest (52.10%), and the death of children under 5 years old mainly occurred in hospitals (47.92%). Most of them received inpatient treatment before death (73.96%), and Provincial (or Municipal) Hospitals (60.50%) were the most important diagnosis and treatment institutions.Conclusion In Guangxi, the mortality rate of congenital heart disease among children aged 5 and under has been steadily decreasing over the last six years. It is necessary to improve pregnancy risk assessment and intrauterine transport, continuously improve prenatal screening and diagnosis levels, carry out screening for congenital heart disease among newborns, and achieve early screening, early diagnosis, early intervention, and early recovery, in order to minimize deaths caused by congenital heart disease.

Analysis of the correlation between sex abstinence days with semen quality and sperm function parameters in infertile males

2025/1/10 17:19:06

Objective To explore the effect of sex abstinence days on semen quality and sperm function in infertile males with low sperm motility. Methods 192 infertile males clinically diagnosed as asthenospermia were divided into three groups according to the days of sex abstinence. The abstinence days for males in group A is less than or equal to 2 days, that of group B is 3-4 days, and that of group C is more than or equal to 5 days. Patients collected fresh semen through masturbation. The semen was optimized using density gradient centrifugation combined with upstream methods. The semen quality, sperm morphology and sperm DNA fragmentation rate before and after optimization were detected. The correlation between sex abstinence days and semen quality parameters and function parameters were analyzed. Results Before the semen optimization method, the days of sex abstinence were significantly positively correlated with semen volume, total sperm count and sperm DNA fragmentation rate (SDF) (r=0.225, P=0.002；r=0.200, P=0.016；r=0.226, P=0.006). The semen volume, total sperm count, total progressive motile sperm count and sperm SDF in group A were significantly lower than those in group B and group C (P<0.05). The SDF in group B was lower than that in group C (P<0.05). After the semen optimization method, the number of days of abstinence was only positively correlated with SDF. The SDF of group A was significantly lower than that of group B and group C (P<0.05). Conclusion Male abstinence days were positively correlated with semen volume, total sperm count and sperm DNA fragmentation rate. Shortening abstinence period could significantly reduce sperm DNA fragmentation rate in infertile males with low sperm motility.

Analysis of risk factors for frailty in geriatric hip fracture patients based on QCT

CHEN Zhi-fang,MA Kang-kang,YU Xiao-hong — 2025/1/10 17:13:57

Objective To analyze the risk factors for frailty in the elderly hip fracture patients based on the characteristics of bone metabolism such as QCT. Methods A retrospective study of 267 elderly patients with hip fracture who were treated at the emergency department of Beijing Jishuitan Hospital between September 2021 and November 2021. Frailty scale (FRAIL) and nutritional risk screening method 2002(NRS -2002) were used for Frailty assessment and Nutritional risk screening respectively. The volume bone mineral density(vBMD)of hip was measured by Quantitative CT(Quantitative CT，QCT). Data on demographics, comorbidities, Body mass index , calf circumference, biochemical markers of bone metabolism were collected. The patients were divided into frail group and non- frail group. Results　There were 110 cases of frailty（41.2%）,69cases with nutritional risk (25.8%) and 50cases with frailty combined with nutritional risk (18.7%).univariate analysis showed that there were significant differences in age, nutritional risk, BMI, calf circumference, CCI（Charlson Comorbidity Index ）>2, the trabecula vBMD of the total hip （ THTvBMD）， femoral neck （ FNTvBMD）， intertrochanter （ ITTvBMD）, 25 hydroxyvitamin D3[25-(OH)D3], total procollagen type 1 N-terminal propeptide (tP1NP), β isomer of C-terminal cross-linking telopeptide of type 1 collagen (β-CTX) , fibrinogen prealbumin ratio (FPR)between the two groups. Multivariate logistic regression analysis showed that aging, malnutrition ,CCI>2,thick calf circumference，low THTvBMD, 25-(OH)D3 and high levelβ-CTX,FPR were risk factors of frailty in elderly with hip fracture (P < 0.05).Conclusion Frailty is common in older patients with hip fracture . In the frail population，the trabecular vBMD of each hip region of interest decreased significantly. Advanced age, multimorbidity, malnutrition, thick calf circumference, low level of THTvBMD, 25-(OH)D3 and increasedβ-CTX , FPR were risk factors for frailty.

Clinical study of ultrasound-guided posterior branch of cervical nerve combined with pulse radiofrequency of cervical shoulder muscle for cervical nerve posterior branch of neck and shoulder pain

yangfan — 2025/1/10 16:50:38

Objective To compare the clinical efficacy of ultrasound-guided posterior medial branch of cervical nerve combined with pulse radiofrequency of cervical shoulder muscle and ultrasound-guided posterior medial branch of cervical nerve pulsed radiofrequency in the treatment of patients with cervical nerve posterior branch neck and shoulder pain. [Methods] From January 2019 to October 2021, 72 patients diagnosed with cervical nerve posterior branch neck and shoulder pain, aged 43 -- 81 years, including 49 males and 23 females, were collected and divided into radiofrequency therapy group (group A, n=36) and combined radiofrequency therapy group (group B, n=36) according to treatment methods. Both groups received pulse radiofrequency therapy under ultrasound guidance. Group A received pulse radiofrequency therapy with posterior medial branch of cervical nerve, and group B received pulse radiofrequency therapy with posterior medial branch of cervical nerve combined with cervical shoulder muscle. VAS score, NDI score and excellent and good rate of the last follow-up were recorded before treatment, 1 day, 1 week, 1 month, 3 months and 6 months after treatment. [Results] There was no significant difference in gender, age, course of disease and pain site between the two groups (P> 0.05). Compared with before treatment, VAS score and NDI score of group A and group B were decreased at each time point after surgery, and the difference was statistically significant (P< 0.05). Compared with group A, VAS score and NDI score of group B were lower 3 months and 6 months after surgery, and the differences were statistically significant (P< 0.05). The excellent and good rate of group B was 88.9% higher than that of group A 63.9% at 6 months after treatment, and the difference was statistically significant (P< 0.05).[Conclusion] Ultrasound-guided posterior branch of cervical nerve combined with pulse radiofrequency of cervical shoulder muscle can significantly improve pain in patients with cervical shoulder pain derived from posterior branch of cervical nerve, and it is safe and effective.

The Cuproptosis-Related Long Noncoding RNA Signature Predicts Prognosis, Immunotherapy and drug sensitivity analysis in lung adenocarcinoma

菅若男 — 2025/1/10 10:49:22

Objective To find new targets for the diagnosis, prognosis, immunotherapy and chemotherapy drug finding of lung adenocarcinoma (LUAD) based on cuproptosis-Related lncRNA and construct an effective prediction model, so as to supplement the treatment strategy of LUAD. Methods: LUAD data were downloaded from TCGA database, and cuproptosis-Related lncRNA were obtained by R. Univariate Cox, Lasso and multivariate Cox regression analysis were used to construct the LUAD prognostic model. The entire TCGA-LUAD dataset was randomly divided into training and validation groups at a 1:1 ratio. Kaplan-Meier analysis, ROC curve and principal component analysis were used to evaluate the model, and the model was integrated with clinicopathological features. Cox regression analysis was used to identify independent prognostic factors and a nomogram was established. The tumor Immune Dysfunction and Exclusion algorithm (TIDE) was used to predict the response to immunosuppressive therapy (ICI) in patients with high and low risk of LUAD. The relationship between antineoplastic drugs and prognostic risk score was analyzed by multi-omics database of tumor drug sensitivity. CASC15, the most significant HR among the 7 lncrnas constructed by the risk model, was selected for experimental verification. The expression of CASC15 in A549 and H1975 cell lines and the expression of CASC15 after transfection were detected by PCR. CCK8 assay, plate colony formation assay and Transwell assay were used to detect the effect of CASC15 on cell growth, cell colony formation ability, migration and invasion. Results Univariate Cox regression analysis showed that 25 lncRNAs were related to the prognosis of cuproptosis, and Lasso regression analysis screened out 12 lncRNAs. Multivariate Cox regression analysis identified 7 lncRNAs (AC090948.1, AL353804.1, AP000302.1, AC007613.1, CASC15, AC026356.1 and AL161431.1) to construct the prognostic risk model. The data set was divided into low-risk group and high-risk group by risk score, and the overallsurvival (OS) of patients in high-risk group was significantly lower than that in low-risk group (P<0.05). The prognostic risk model had a good performance in predicting the 1 -, 3 -, and 5-year survival of LUAD patients (AUC values were 0.688, 0.689, and 0.686, respectively). The risk score could be used as an independent prognostic factor for LUAD patients (P<0.01), and the nomogram confirmed that the model had good prognostic prediction ability. This prognostic model was also significantly correlated with immune cells (p < 0.05), and patients with low risk of LUAD had lower TIDE scores than those with high risk of LUAD (p < 0.05). At the same time, high-risk patients were more sensitive to 9 kinds of chemotherapy drugs (including cisplatin, paclitaxel, docetaxel, 5-fluorouracil, vinorelbine, camptothecin, gemcitabine, gefitinib, and ceritinib) (p < 0.05). CASC15 could promote the proliferation, migration and invasion of A549 and H1975 cells. Conclusion The prognostic risk model composed of 7 cuproptosis-Related lncRNAs is an independent prognostic factor for LUAD, which can effectively predict the survival prognosis of LUAD patients. Among them, the prognostic model provides a new theoretical basis for the selection of immunotherapy or conventional chemotherapy drugs for LUAD patients, which can largely assist the clinical establishment of individualized treatment.

Mechano-growth factor promotes the proliferation, migration, and differentiation of cartilage endplate stem cells through the ERK signaling pathway

Li Haoxi,Li Zhuhai,Mo Kaiqi,Peng Guanlu,,Wu Chunlan,Yao Shuyu,yu chengqiang — 2025/1/10 10:19:20

Objective ：mechano-growth factor (MGF) is expressed in a variety of tissues and can promote the proliferation and migration of mechano-effector cells. In this study, we investigated the role of MGF in promoting the proliferation and migration of human cartilage endplate‐derived stem cells (CESCs) and its potential mechanism.Methods: CCK8 was used to evaluate the effect of MGF on the proliferation of CESCs. The migration and invasion of CESCs were evaluated by Transwell assay. The expression levels of differentiation-related molecules, ERK and phosphorylated ERK were detected by qPCR and Western blot.Results: CCK8 and Transwell detection results showed that MGF promoted the proliferation and migration of CESCs in a dose-dependent manner, with the most significant effect at 4.5 ng/mL concentration (P < 0.05). When combined with ERK inhibitor PD98059, the proliferative effect of MGF was significantly decreased (P < 0.001). In addition, when treated with insulin-like growth factor 1 (IGF-1R) inhibitor PQ401, the migration promoting effect of MGF was also significantly reduced (P < 0.001). Western blot results showed that the expression level of phosphorylated ERK in CESCs was significantly increased after MGF treatment (P < 0.001), while the expression level of phosphorylated ERK was significantly decreased after IGF-1R inhibitor PQ401 treatment (P < 0.001).Conclusion: MGF promotes the proliferation and migration of CESCs by inducing the expression of phosphorylated ERK.

Expression of serum SCUBE1 and αvβ3 in patients with coronary heart disease and their relationship with clopidogrel resistance after PCI

陈娟,,,, — 2025/1/10 9:22:54

Objective: To investigate the expression of signal peptide-CUB-EGF-like domain-containing protein 1 (SCUBE1) and integrin αvβ3 in the serum of patients with coronary heart disease (CHD) and their relationship with clopidogrel resistance after percutaneous coronary intervention (PCI). Methods: From March 2022 to September 2023, 164 patients diagnosed with CHD in our hospital were collected and included in the CHD group, according to whether clopidogrel resistance occurred after PCI, there were 41 cases in the drug resistant group and 123 cases in the sensitive group. Another 150 healthy examinees in our hospital were collected and included in the control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect serum SCUBE1 and αvβ3 levels preoperative, immediate postoperative, and 48 hours postoperative of PCI in the control group and CHD group. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum SCUBE1 and αvβ3 levels for clopidogrel resistance in CHD patients after PCI treatment; multivariate Logistic analysis was applied to analyze the influencing factors of clopidogrel resistance after PCI treatment. Results: Compared with the control group, the serum levels of SCUBE1 and αvβ3 in the CHD group (preoperative, immediate postoperative, and 48 hours postoperative) were greatly increased (P<0.05), and there were great differences in serum SCUBE1 and αvβ3 levels at different time points in the CHD group (P<0.05). The WBC, PLT, and MPV of the drug resistant group were higher than those of the sensitive group (P<0.05). Compared with the sensitive group, the serum levels of SCUBE1 and αvβ3 in the drug resistant group (preoperative, immediate postoperative, and 48 hours postoperative) were greatly increased (P<0.05); there were great differences in serum SCUBE1 and αvβ3 levels between the sensitive group and the drug resistant group at different time points (P<0.05). The AUC of preoperative serum SCUBE1, αvβ3, and combined prediction of clopidogrel resistance in CHD patients was 0.797, 0.799, and 0.899, respectively, the AUC of combined prediction was greatly higher than that of the two alone (Zcombined prediction-SCUBE1=2.672, Zcombined prediction-αvβ3=2.466, P<0.05). Multivariate Logistic analysis found that PLT, MPV, preoperative SCUBE1, and αvβ3 were independent risk factors for clopidogrel resistance in CHD patients after PCI (P<0.05). Conclusion: The serum levels of SCUBE1 and αvβ3 in CHD patients increase, and preoperative serum SCUBE1 and αvβ3 contribute to the prediction of clopidogrel resistance, which are risk factors for clopidogrel resistance after PCI.

Correlation between MTHFR and PROC gene polymorphisms and thrombosis in patients with malignant tumors

cuiyingxue,,,,,, — 2025/1/10 9:21:51

Abstract: Objective To investigate the correlation between MTHFR and PROC gene polymorphisms and thrombosis in patients with malignant tumors. Methods A total of 227 patients with malignant tumors enrolled in the Affiliated Cancer Hospital of Xinjiang Medical University from November 2023 to February 2024 were enrolled as the study subjects, including 47 patients with VTE as the VTE group and 180 patients without VTE as the control group. The gene polymorphisms at MTHFR rs1801133 and PROC rs199469469 were observed, and their correlation with VTE was analyzed. Results The probability of VTE in diabetic patients was higher than that in non-diabetic patients, and the difference was statistically significant (P < 0.05). There were no significant differences in the clinical data of age, gender, smoking history, drinking history, coronary heart disease history, hypertension history, operation history, chemoradiotherapy history, intravenous catheterization history and tumor stage between the two groups (all P > 0.05). The D-dimer level and the allele frequency of MTHFR rs1801133 site A in VTE group were significantly higher than those in control group (all P < 0.05). There was no significant difference in genotype of PROC rs199469469 between the two groups (P > 0.05).Conclusion The polymorphism of rs1801133G/A gene in MTHFR gene is associated with the occurrence of VTE in patients with malignant tumors, and allele A carriers have a higher risk of VTE. PROC rs199469469 gene polymorphism may not be a risk factor for VTE formation in patients with malignant tumors. In addition, there is a history of diabetes mellitus, and elevated D-dimer levels are also associated with VTE formation.

The Surgical Outcomes of 144 Cases of Perennial Allergic Rhinitis with Nasal Anatomical Variations and/or Inflammation

xujunfang — 2024/12/17 17:53:40

Objective? To investigate the clinical efficacy of high-selective vidian nerve branch resection combined with septoplasty and submucosal partial resection of the inferior turbinate bone in the treatment of perennial allergic rhinitis.Methods? From December 2021 to December 2023, 144 patients with perennial allergic rhinitis, who had poor response to medical treatment and were accompanied by nasal anatomical variations and/or inflammation, were selected for this study. Based on different surgical treatments, the study subjects were divided into a control group (n=73) and an observation group (n=71). The control group underwent submucosal partial resection of the inferior turbinate bone or septoplasty combined with submucosal partial resection of the inferior turbinate bone. The observation group underwent high-selective vidian nerve branch resection combined with submucosal partial resection of the inferior turbinate bone or high-selective vidian nerve branch resection combined with septoplasty and submucosal partial resection of the inferior turbinate bone. Clinical symptoms were scored using the Visual Analog Scale (VAS), and the occurrence of complications was monitored.Results? For patients with perennial allergic rhinitis who had poor response to medical treatment and were accompanied by nasal anatomical variations and/or inflammation, the use of high-selective vidian nerve branch resection combined with septoplasty and submucosal partial resection of the inferior turbinate bone showed significant improvement in both short-term and long-term outcomes. Postoperative symptom scores significantly decreased, with an overall efficacy rate of 98.59%. No severe complications such as dry eyes or bleeding were observed in the observation group.Conclusion? High-selective vidian nerve branch resection combined with septoplasty and submucosal partial resection of the inferior turbinate bone is an effective and safe treatment for perennial allergic rhinitis, demonstrating significant clinical efficacy.

Research progress of microgranular dermal implantation in the treatment of chronic difficult-to-heal wounds

ZhangFuyin Zhang — 2024/12/16 16:16:25

Chronic hard-to-heal wounds are defined as wounds that fail to enter the normal healing phase within the expected time or have a significant delay in healing after treatment. A wound is considered chronic when there is no visible sign of healing within 3 months or when healing progresses slowly. Chronic wounds are often associated with a complex of persistent infections, long-term inflammatory responses, ischemia, and neuropathy, which together inhibit the normal healing process and result in a stagnation of the wound in a pathologic healing state. The number of such patients is increasing, and it is difficult to achieve ideal results using traditional methods. Autologous microparticle skin implantation, a rapidly developing technique in recent years, has been widely used in the repair of chronic hard-to-heal wounds because of its advantages of rapid wound closure and large expansion ratio. There is still a lack of large-scale clinical data to verify its long-term effectiveness and wide applicability. This article provides a review of the research progress of particulate dermal implantation in the treatment of chronic difficult-to-heal wounds.

Effects of cardiopulmonary rehabilitation training combined with EECP on cardiopulmonary reserve function, vascular endothelial function and exercise tolerance in patients with COPD and non-high-risk stable angina pectoris

孙晓静,,,,, — 2024/12/11 10:49:04

Objective:? To explore the effects of cardiopulmonary rehabilitation training combined with enhanced external counterpulsation (EECP) on cardiopulmonary reserve function, vascular endothelial function and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) and non-high-risk stable angina pectoris. Methods: A total of 80 patients with COPD and non-high-risk stable angina pectoris were enrolled and randomly divided into control group (n=40) and observation group (n=40) between January 2020 and June 2022. The control group was given basic treatment and cardiopulmonary rehabilitation training, while observation group was additionally treated with EECP. The cardiopulmonary reserve function, vascular endothelial function, exercise tolerance, angina attack and quality of life in the two groups were compared. Results: After intervention, forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC), maximal voluntary ventilation (MVV) and left ventricular ejection fraction (LVEF) in both groups were increased, which were higher in observation group (P<0.05). After intervention, nitric oxide (NO) was increased, while levels of endothelin-1 (ET-1) and endothelial cell specific molecule-1 (Endocan-1) were decreased in both groups. NO was higher in observation group than control group, while levels of ET-1 and Endocan-1 were lower in observation group (P<0.05). After intervention, total exercise time, exercise tolerance and spending time of ST segment depression by 0.1mV were increased, while downward amplitude of ST segment was decreased in both groups. The total exercise time, exercise tolerance and spending time of ST segment depression by 0.1mV were longer in observation group than control group, and downward amplitude of ST segment was lower in observation group (P<0.05). After intervention, frequency and intensity of angina attacks were decreased, and scores of Seattle Angina Questionnaire (SAQ) were increased in both groups. The frequency and intensity of angina attacks were lower in observation group than control group, and SAQ score was higher in observation group (P<0.05). After intervention, scores of World Health Organization Quality of Life-BREF (WHOQOL-BREF) in physiological and psychological fields were decreased in both groups, which were lower in observation group (P<0.05), but there was no significant change in scores of environmental and social relations fields (P>0.05). Conclusion: Cardiopulmonary rehabilitation training combined with EECP can effectively improve cardiopulmonary reserve function, vascular endothelial function and exercise tolerance in patients with COPD and non-high-risk stable angin pectorisa, alleviate angina attack and improve quality of life.

Effect and mechanism of ulinastatin on postoperative delirium in elderly patients undergoing total hip arthroplasty

张训功 — 2024/12/10 17:03:15

[Abstract] Objective To investigate the effect and mechanism of ulinastatin on postoperative delirium (POD) in elderly patients undergoing total hip arthroplasty (THA). Methods A total of 192 elderly patients scheduled for THA at the Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital) from August 2022 to December 2023 were recruited. Using a random number table, patients were divided into the ulinastatin group (Group U) and the normal saline group (Group N), with 96 patients in each group. Group U received intravenous infusion of ulinastatin at 5000 U/kg 10 minutes before anesthesia induction, which continued until the end of the surgery, while Group N received intravenous infusion of the same volume of normal saline at the same rate until the end of the surgery. The occurrence of POD was assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) within 3 days after surgery. Blood samples were collected from the internal jugular vein 48 hours after surgery, and peripheral blood mononuclear cells (PBMCs) were extracted using a modified Ficoll density gradient centrifugation method. The concentrations of intracellular ferrous ions (Fe2+), malondialdehyde (MDA) content, and superoxide dismutase (SOD) activity in PBMCs were measured using colorimetric methods. Western blot was used to determine the expression of acyl-CoA synthetase long-chain family member 4 (ACSL4) and glutathione peroxidase 4 (GPX4) in PBMCs. Clinical data of the patients were collected. Results Within 3 days after surgery, 19 patients (20.21%) in Group U and 33 patients (35.48%) in Group N developed POD. The incidence of POD was significantly lower in Group U compared to Group N (P<0.05). There were no significant differences in the severity scores and duration of POD between the two groups (P>0.05). Compared to Group N, the postoperative hospital stay was significantly shorter in Group U (P<0.05). There were no significant differences in surgery duration, total anesthesia time, blood loss, fluid intake, or PACU stay between the two groups (P>0.05). Compared to Group N, Group U had lower concentrations of Fe2+ and MDA, higher SOD activity, lower expression of ACSL4 protein, and higher expression of GPX4 protein in PBMCs 48 hours after surgery, with statistically significant differences (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). Conclusion Ulinastatin attenuates POD in elderly patients undergoing THA by inhibiting ferroptosis in PBMCs.

Investigation of insomnia in elderly inpatients and analysis of influencing factors: An application of a comprehensive assessment system for elderly patients developed by a hospital in Yunnan Province

戴靖榕,,,,, — 2024/12/10 17:00:20

Abstract：Objective An independent geriatric comprehensive assessment system was used to investigate the insomnia status of elderly inpatients in a number of hospitals in Yunnan province, and its influencing factors were analyzed. Methods A total of 1635 elderly patients (≥60 years old) from September 2018 to June 2022 were selected as the study objects. The self-developed "comprehensive geriatric assessment system" was used to conduct comprehensive geriatric assessment on newly admitted patients, and the patients were divided into no insomnia group, suspected insomnia group and insomnia group according to the ALS. The potential insomnia and its independent influencing factors were analyzed. Results Among 1635 hospitalized elderly patients, 506 cases (34.0%) had no insomnia, 596 cases (36.5%) had potential insomnia and 483 cases (29.5%) had insomnia. Daily living ability, anxiety status, depression status, nutritional status, constipation, chronic pain, debilitation status, balance and gait function were independent factors of potential insomnia (P < 0.05). Education, daily living ability, anxiety, depression, nutrition, family care index, social support, delirium, balance and gait function were the independent influencing factors of insomnia (P < 0.05). Conclusion The prevalence of insomnia in the elderly is high. The intervention of insomnia should not only rely on drugs, but should pay attention to the screening and management of education, daily living ability, anxiety, depression, nutrition, family care index, social support, delirium, constipation, chronic pain, frailness, balance and gait function.

Effect of ultrasound-guided C5 or C6 nerve root block combined with superficial cervical plexus block or clavipectoral fascial plane Block for the surgery of the clavicle fracture.

Lipeihan — 2024/12/10 16:59:24

Objective To compare the application of ultrasound-guided superficial cervical plexus block(SCPB) combined with C5 nerve root block (NRB)or clavipectoral fascial plane block(CPB) for the surgery of the clavicle fracture. Methods Sixty patients undergoing the open surgical fixation for unilateral clavicle fracture in our hospital from March 2021 to December 2023,with ASA grade Ⅰ to Ⅱ, aged 18-75 years,BMI≤ 35kg/m2,were prospectively selected.They were divided into SCPB combined with C5-NRB group (group Observe) and SCPB with CPB group (group Control)by the random number table method. All patents were administrated with 0.05 mg/kg Midazolam intravenously after entering the room, followed by 0.1 μg/kg Sufentanil. CNRB and SCPB were performed under the guidance of ultrasound with 0.5% ropivacaine 5ml at each target nerve area,but CPB with 10ml. If the VAS score of pain during surgery was ≥4 scores, Sufentanil 0.1 μg/kg was injected intravenously. Changes in mean arterial pressure (MAP) and heart rate (HR) at the following three time points: preanesthesia (T0), at the beginning of the surgery (T1) and the time of fracture reduction (T2) were recorded separately. The sensory block of the skin covering the fractural clavicle was confirmed by a pinprick at 30 min after block and the pain intensity was recorded. The requirements of sufentanil and propofol during surgery were recorded.The VAS score of pain was recorded at 4, 12 and 24 h after surgery, and the time to first taking of analgesics after surgery was recorded. The moter function of the affected-side upper limb was assessed at 30 min after block, and 4h and 12h and 24h after surgery using the modified Bromage score (MBS).The complications sush as intoxication of local anesthetics, stellate ganglion block, recurrent laryngeal nerve block and phrenic nerve block were recorded. Results There was no significant difference in HR、MAP between the two groups (P>0.05). The requirements of sufentanil and propofol in group Observe was significantly lower than that in group Control (P<0.05). The pain VAS scores at 4, 12 and 24 h after surgery was significantly lower than that in group Control (P<0.05). There was no significant difference in the time to first taking of analgesics after surgery between the two groups(P>0.05). The MBS scores of the affected-side upper limb at 30 min after block, and 4h and 12h after surgery were not significantly different in the two groups(P>0.05). Conclusions In comparison to the application of ultrasound-guided SCPB combined with C5-NRB, The SCPB combined with CPB requires additional sedative and analgesic drugs to provide good anesthesia for patients with clavicle fracture, but the motor function of the affected-side upper limb and minimal possibility of phrenic nerve block can be preserved in both groups.

The treatment progress of allergic bronchopulmonary aspergillosis

chenxiaoxue,lixiaoyao,yangxing,yuminghui,,zhangmingxian — 2024/12/9 16:38:09

Allergic bronchopulmonary aspergillosis (ABPA) is an allergic inflammatory lung disease caused by an immune response to aspergillus antigens (mainly Aspergillus fumigatus), characterized by recurrent, uncontrollable wheezing, coughing, sputum production, markedly elevated total IgE in the serum, and pulmonary infiltrates and proximal bronchial dilatation. The treatment of ABPA includes glucocorticoids, antifungal drugs, and biological agents, and untreated patients may progress to progressive respiratory failure and death. In China, many clinicians lack awareness of the treatment of ABPA, and there are problems with non-standardized treatment. This review summarizes the progress in the treatment of ABPA to further enhance the awareness of medical workers and improve the treatment of this disease.

Research advances on pharmacological effects and mechanisms of nordihydroguaiaretic acid

gao haijun,mo xiaojin,yang lijuan, — 2024/12/9 15:32:12

Normethyl dihydroguisic acid (NDGA) is a compound extracted from the evergreen shrub fork lara. NDGA is used in the food processing industry because it is found to be antioxidant-resistant. NDGA has also been confirmed to have biological functions, such as immune regulation, antibacterial, antiviral, anti-tumor, anti-angiogenic, anti-reproductive and anti-fibrotic functions, suggesting the important potential value of NDGA in the treatment of diseases. There is no systematic summary of the role and mechanism of NDGA in disease treatment. This paper summarizes the research progress of the pharmacological effect and mechanism of NDGA.

Analysis of influencing factors of perioperative symptom groups in patients with bladder cancer and study on structural equation model

刘蓉蓉 — 2024/12/9 10:37:30

Objective Based on the structural equation model, to explore and analyze the factors affecting the perioperative symptom groups of patients with bladder cancer. Methods 150 patients with bladder cancer who underwent surgical treatment in our hospital from April 2022 to April 2023 were included as the research object, and were divided into asymptomatic group (n=60) and symptomatic group (n=90) according to whether there were complications. The clinical data of patients were collected and analyzed retrospectively, and the independent influencing factors of perioperative symptoms of bladder cancer patients were determined by univariate and multivariate Logistic regression analysis, and then a structural equation model was constructed by using the determined independent influencing factors, and the correlation among the variables in the model was analyzed. Results The age of symptomatic group, the number of people with diabetes history, ASA classification and postoperative hospitalization time were higher than those of asymptomatic group, and the difference was statistically significant (P < 0.05). Logistics regression analysis showed that age, diabetes history, ASA grade and postoperative hospital stay were all risk factors for symptom groups in patients with bladder cancer during perioperative period (OR > 1, P < 0.05). The structural equation model of perioperative symptom group of bladder cancer patients was established. The results showed that the total effects of age, diabetes history, ASA grade and postoperative hospitalization time on the perioperative symptom group level of bladder cancer patients were -0.049, -0.137, 0.060, 0.018 and 0.201 respectively. The goodness of fit test results of the model: χ2=36.405, freedom =10, χ2/ freedom =3.640, P < 0.001, which is in line with the reference standard; After optimization, the goodness-of-fit index of the model is 0.927, and the comparative fitting index is 0.991, which shows that the model and the data are well fitted. Conclusion The factors influencing perioperative symptom groups of bladder cancer patients include age, diabetes history, ASA grade and postoperative hospitalization time.

Advances in single-cell sequencing to explore patient-derived organoids in pancreatic adenocarcinoma disease

xuyingcui — 2024/12/9 10:35:44

Objective: To address whether patient-derived organoid (PDO) models can act as disease model substitutes for patients, and what is the maximum molecular extent to which they replace the original patient"s tumor, single-cell RNA sequencing(scRNA-seq) analyses were used to gain insights into the nature of the preclinical models and to facilitate precision medicine for pancreatic cancer patients. Methods: Relevant scRNA-seq datasets from publicly available pancreatic cancer and clinical data were collected,after quality control, downscaling, clustering, and cellular annotation, differential gene expression analyses, GO, KEGG enrichment analyses, cellular communication analyses, and survival prognostic analyses were used to explore the composition and distribution of immune cells on primary tumors and PDO, to screen for significantly differentially expressed genes, as well as immune cell interactions, etc. Results: We successfully identified 22 cell populations and further classified them into 11 different cell types, we did a preliminary study on the interactions between immune cells, and the analysis yielded that neutrophils as well as the TGF-β signaling pathway dominated in all aspects, and the survival analysis yielded that the increase of FFAR2, and RASGEF1C in pancreatic cancer could inhibit tumor growth. Conclusion: Primary tumors and organoids appear heterogeneous in the proportionate distribution of immune cell types, and neutrophils have an active intercellular interaction in the TGF-β signaling pathway in cellular communication, which provides a new therapeutic target for the immunotherapy of pancreatic cancer, and lays a new theoretical foundation for the development of organoids.

Bioinformatics analysis of DEGs in patients with early recurrence of liver cancer and its prognostic significance

Liang Meng,,,,, — 2024/12/9 10:32:31

Objective To analyze the expression patterns of differentially expressed genes (DEGs) identified from early recurrent hepatocellular carcinoma (HCC) patients in The Cancer Genome Atlas (TCGA) HCC samples, evaluate the key biological functions and signaling pathways associated with these DEGs, construct a protein-protein interaction (PPI) network, and assess their impact on the prognosis of HCC patients.Methods DEGs screened from early recurrent HCC patients in clinical research were utilized; by bioinformatically mining paired tumor and adjacent normal samples data from TCGA database, the differential expression of DEGs between HCC and matched samples was analyzed. KEGG and Gene Ontology (GO) enrichment analyses were performed on DEGs from early recurrent HCC patients to investigate potential connections with related biological pathways linked to early recurrence of HCC. A PPI network for DEGs from early recurrent HCC patients was built using the STRING database to understand the roles of interacting proteins in relevant biological processes. Kaplan-Meier survival curves and Cox proportional hazards regression models were employed to evaluate the prognostic value of DEGs in HCC patients" overall survival.Results All of the DEGs from early recurrent HCC patients were differentially expressed in HCC tissues, where IL23A, TP63, ALOX15B, BUB1, CCL20, PTK7, MMP9, GAGE2A, DMBT1, and FOXM1 showed significantly higher expression in HCC tissues compared to non-tumor adjacent tissues (P < 0.01), while MPO, IL1B, CXCR2, and CLEC4C were downregulated in HCC tissues (P < 0.01). KEGG/GO analysis revealed that DEGs from early recurrent HCC patients were enriched in TNF signaling pathway, IL-17 signaling pathway, and rheumatoid arthritis-related pathways. The PPI network indicated 17 direct interactions among DEGs, with an average local clustering coefficient of 0.592 and a significant PPI enrichment P-value of 0.000173; the top five interacting protein pairs were MPO-MMP9, CCL20-IL1B, CCL20-CXCR2, MMP9-IL1B, and IL1B-MPO. In HCC tissues, BUB1 expression was highly correlated with FOXM1 expression (r = 0.91, P < 0.001), and IL1B was moderately correlated with MMP9 and CXCR2 expressions (r = 0.55, r = 0.51, P < 0.001). High expression groups of BUB1, MMP9, and FOXM1 exhibited significantly different survival times compared to low expression groups (HR > 1, P < 0.05). Univariate and multivariate Cox regression analyses both suggested that high expression of CCL20 and MMP9 was associated with poor overall survival prognosis (HR = 1.545, P = 0.021; HR = 1.663, P = 0.008).Conclusion The majority of DEGs identified from early recurrent HCC patients are specifically overexpressed in HCC tissues and primarily involved in inflammation and immune response-related pathways. There is a strong correlation between BUB1 and FOXM1 expression in HCC. High expression of BUB1, MMP9, FOXM1, and CCL20 is associated with unfavorable prognosis in HCC. CCL20 and MMP9 can serve as independent prognostic biomarkers for overall survival in HCC patients.

Interpretable machine learning diagnostic toolfor chronic kidney disease based on blood vessel density

hongyiyi,huxiangyu,lanlin,leidaizai,,yangyingxia,yekun — 2024/12/9 10:31:20

Objective To develop an interpretable machine learning diagnostic tool for chronic kidney disease (CKD) based on vessel density, aiming to facilitate early diagnosis and personalized treatment of CKD. Methods Recruited 105 patients with chronic kidney disease treated at the People’s Hospital of Guangxi Zhuang Autonomous Region in Nanning from February 2022 to December 2023, as well as 66 healthy control group, obtaining vessel density indicators including whole superficial capillary plexus (SCP) vessel density, upper SCP vessel density, lower SCP vessel density, SCP vessel density based on Early Treatment Diabetic Retinopathy Study (ETDRS) subfields, whole deep capillary plexus (DCP) vessel density, upper DCP vessel density, lower DCP vessel density, and DCP vessel density based on ETDRS subfields using optical coherence tomography angiography(OCTA). A random forest model was then utilized to establish an accurate and effective CKD diagnostic model. Feature importance analysis and the Shapley method were employed to provide model interpretability and personalized treatment recommendations. Results The whole SCP vessel density, upper SCP vessel density was higher in CKD patients than in the control group (P<0.05). The model’s accuracy is 86.96%, AUC is 0.97, sensitivity is 100.00%, and specificity is 72.72%. Upper DCP blood flow density, the whole SCP blood flow density, SCP blood flow density based on ETDRS partition, lower DCP blood flow density, the whole DCP blood flow density and upper DCP blood flow density are important variables worth considering in the predictive model. Conclusion Vessel density can be utilized to construct an accurate CKD diagnostic tool using machine learning methods.

Effectiveness of bacterial lysis products in allergic rhinitis in children and modulation of IFN-γ and IL-4 cytokinesXie Tianhong, Zhu Wenya, Wang Shifei (Department of Otolaryngology, Zunyi Medical University Affiliated Hospital, Zunyi 363000, Guizhou)

谢天宏, — 2024/12/9 10:29:59

Objective: To investigate the effect of bacterial lysis products in children with allergic rhinitis and the regulation of IFN-γ and IL-4 cytokines. Methods:60 children diagnosed with allergic rhinitis in the ENT outpatient clinic of the hospital from January 2023 to January 2024 were selected and divided into 2 groups (treatment group and control group) using the randomized numeric table method, with 30 cases in each group.The children in the 2 groups were treated with relevant medication or immunotherapy according to the guidelines, with the addition of bacteriolytic products in the treatment group, and the 2 groups were treated with serum IFN-γ and IL-4 cytokine assays before and 3 months after treatment, respectively, and the symptoms and signs scores and assessment of the improvement of concomitant diseases. Gamma and IL-4 cytokine tests, serum-specific IgE tests, symptom and sign scores, and assessment of improvement of concomitant diseases were performed in both groups before and after 3 months of treatment, respectively.Results: The total effective rate of treatment in the treatment group was 96.67%, which was higher than that of 73.33% in the control group (P<0.05); the serum INF-γ levels of children with allergic rhinitis in the 2 groups were increased after treatment, and the IL-4 levels were decreased in both groups (P<0.05); the INF-γ levels of the treatment group were higher than that of the control group, and the IL-4 levels were lower than that of the control group (P<0.05); the serum-specific IgE levels of the 2 groups were decreased in both groups (P<0.05); the serum-specific IgE levels of the treatment group were lower than that of the control group (P<0.05); the serum-specific IgE levels of the 2 groups were decreased in the 2 groups after treatment. Serum-specific IgE levels were reduced in both groups (P<0.05), and serum-specific IgE levels in the treatment group were lower than those in the control group (P<0.05); symptoms and signs scores were reduced in both groups of children with allergic rhinitis after treatment (P<0.05), and the symptoms and signs scores in the treatment group were lower than those in the control group (P<0.05); and the rates of the treatment group and the adverse reactions were 20.00%, 23.33%, and 23.33%, respectively, and the differences were small when comparing the two groups (P<0.05). , the difference between the 2 groups was small (P>0.05).Conclusion: Bacterial lysis products can effectively enhance the clinical therapeutic effect of allergic rhinitis in children, increase the serum INF-γ level of children, reduce the level of IL-4 and IgE, and improve the clinical symptoms of children, with a high degree of safety.

One case of hepatic sinus obstruction syndrome was successfully diagnosed and treated

wangyong,zhanghongli — 2024/12/6 16:26:16

无

Nursing care of a lung cancer patient with intrapericardial left pneumonectomy under cardiopulmonary bypass after neoadjuvant therapy

wangruiya, — 2024/12/6 16:23:12

病例报道不需要英文摘要

Discussing the clinical application value of laparoscopic debridement of pregnancy lesions in unruptured cornual pregnancy II

yangyangfan — 2024/11/8 10:59:50

[ Abstract ] Objective : To explore the application value of laparoscopic pregnancy lesion clearance in unruptured cornual pregnancy II. Methods: A retrospective analysis was conducted on 20 patients with unruptured cornual pregnancy II who were considered as cornual pregnancy before operation in People’s Hospital of Guangxi Zhuang Autonomous Region from October 2016 to October 2021 and were diagnosed as cornual pregnancy by laparoscopy during operation. Patients were analyzed for intraoperative bleeding, surgical time, postoperative complications, and postoperative HCG decline, and postoperative follow-up pregnancy.Results : 20 patients with cornual pregnancy underwent laparoscopic debridement of pregnancy lesions, the average amount of bleeding was 54 ml, the average operation time was 78.7 min, there were no complications such as uterine perforation and peripheral organ injury. The average postoperative vaginal bleeding time was 4.5 days, and the menstruation was not affected.The later follow-up, 11 patients (except 4 cases of contraception and 5 cases were lost to visit), 6 patients were successfully pregnant and delivered, After successful follow-up, except for 4 patients with contraception, 6 cases were successfully pregnant again and the pregnancy rate reached 54.5 %. Conclusion: Laparoscopic pregnancy lesion clearance can better protect the endometrium, retain the integrity of the myometrium, and reduce the risk of reoperation, which has certain clinical application value for the treatment of cornual pregnancy.

Preliminary study of clinical application of transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic

HUANGYIN,,, — 2024/11/8 10:59:20

Objective Cholelithiasis is a common disease. It is worthy exploring the efficacy and safety of absorbable cllips in transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery. Method A retrospective analysis was performed on the clinical data of 7 patients undergoing transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery in Department of Gastroenterology, Guangxi Zhuang Autonomous Region People's Hospital from August 2020 to August 2021. Result 7 patients were successfully operated. The operation time was 121~275 min. The intraoperative blood loss was 0~25ml. 4~10 absorbable clamps were used during the operation. The closure time of gallbladder was 29~93min. The time of first anal exhaust or defecation after operation was 24~36h. Slight postoperative pain occurred in 2 cases, which could be relieved by themselves. In hospital time was 6 to 10 days，no postoperative fever occurred in all patients and no complications such as bile leakage and poor closure occurred during hospitalization. In follow up for half year, the gallbladder function of 7 patients was evaluated by trans-abdominal color doppler ultrasound or CT. Among them, 1 case found residual stones and 1 case had stone recurrence. Conclusion Transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery and the use of absorbable clips in gallbladder incision are safe and feasible in clinical practice.

Preliminary study on the expression of TSC22D1 protein in oropharyngeal squamous cell carcinoma

2024/11/8 10:58:32

Objective To explore the mechanism of tumor suppressor genes TSC22D1 expression in oropharyngeal squamous cell carcinoma (OPSCC) and its possibility as a susceptibility marker for OPSCC by comparing its expression in normal oropharyngeal tissues and HPV-related and non-related OPSCC. Methods Fifty-five cases of OPSCC were collected and 11 cases of tonsillitis were used as normal controls. Immunohistochemical staining was used to detect the expression of TSC22D1 and p16. Results TSC22D1 was continuously expressed in the normal tonsillar reticular epithelium, the basal layer of the transition zone and the columnar epithelial area at the opening of Von Ebner's glandular duct at the tongue base, while it was only scattered in the basal layer of the normal tongue mucosa epithelium. The positive rate of TSC22D1 in OPSCC patients was 45.5%(25/55), among which the poor differentiation OPSCC group was higher than the moderate and high differentiation group (P=0.036), and the tonsillitis group was higher than the tonsil cancer group (P=0.034). However, its expression was not significantly correlated to HPV (p16+) (P=0.498). Conclusion TSC22D1 may be a susceptible region markers of OPSCC, and its expression is decreased during oropharyngeal canceration, but its expression is increased during cancer development.

A case of venous sinus thrombosis in children caused by cystathione-β-synthase gene deficiency

Li Hui — 2024/11/7 17:20:11

个案报道无摘要

Research progress of interstitial lung disease in children

Li Hong-wei — 2024/11/7 17:08:27

Child interstitial lung disease (chILD) is a group of complex and significantly heterogeneous diseases that primarily affect the lung interstitium in children, leading to severe respiratory distress and decreased lung function, which significantly impacts their growth and development. As understanding of this disease deepens, recent studies have continuously revealed its diverse causes and clinical manifestations; however, early diagnosis and effective treatment of children's interstitial lung disease still face many challenges. Existing diagnostic methods include imaging examinations and lung biopsies, but due to the diversity of the disease, it is often difficult to provide clear diagnostic evidence. Furthermore, the choice of treatment strategies needs to be adjusted based on specific causes and individual patient circumstances. Current treatment methods include medication, respiratory support, and lung transplantation, but the effectiveness and safety of these measures still require further validation. This article aims to systematically review the causes, clinical manifestations, diagnostic methods, and treatment strategies of children's interstitial lung disease through a comprehensive analysis of existing literature, and to explore future research directions, with the hope of providing references for improving the prognosis of pediatric patients.

Clinical Value of Iterative Model Reconstruction Combined with Low Voltage in Assessing Mesenteric Artery

meng yuan yi — 2024/11/7 11:22:38

Objective? To explore the feasibility of iterative model reconstruction combined with low voltage in assessing mesenteric artery. Methods? 60 patients underwent total abdominal CTA examination in our hospital were collected and divided into control group (group A,N=30),randomly, and experimental group (group B, N=30). Patients in group A were scanned with 120kV tube voltage and reconstructed with iDose4, patients in group B were scanned with 100kV tube voltage and reconstructed with IMR.The image noise,signal to noise radio(SNR),contrast to noise ratio(CNR) and clinical scores of collateral vessels between two groups were compared as well as the CT volume dose index(CTDIVOL),dose length product(DLP) and effective dose(ED) of patients.Results? the image noise,the CTDIVOL,DLP and ED in group B were lower than in A,while the image SNR,CNR and clinical scores were higher.Conclusion? Iterative model reconstruction combined with low tube voltage can improve image quality of mesenteric artery and decrease ED of patients,which is worthy of clinical application.

Effect of Cognitive Behavioral Therapy on Chronic Insomnia Patients with Different Personality Traits

FANGCHAO,HUJIN,SHANGYUANHAO,WANGYING,WANGZIYUN — 2024/11/7 11:21:49

Objective To explore the effects of Cognitive Behavioral Therapy for insomnia (CBTI) on the sleep quality of patients with chronic insomnia disorder with different personality traits. Methods From January, 2018 to August, 2021, 60 patients with chronic insomnia disorders, treated with CBTI, were enrolled in the Sleep Medicine Center of the Second People's Hospital of Guizhou Province. Based on the results of the Eysenck Personality Questionnaire (EPQ) assessment, with a T-score of >56.7 on one of the three dimensional factors, the patients were divided into the EPQ neuroticism group, the EPQ extraversion group, and the EPQ psychoticism group, and 20 cases in each group were cumulatively included according to the nadir criteria for the 8-week CBTI. A self-administered general demographic questionnaire was used to investigate the basic information of the patients. Before and 3-month follow-up after CBTI treatment, sleep diaries and polysomnography (PSG) were used to assess the subjective and objective sleep parameters and to detect the serum cortisol hormone concentrations of the three groups of patients. Results After treatment and three months after treatment, the?sleep?latency?(SL)?and?wake?after?sleep?onset?(WASO)?of?the?sleep?diary?of?the?EPQ? extraversion?group?and?the?EPQ?psychotic?group?were?lower?and?the?sleep?efficiency?(SE)?as?well?as?the?total?sleep?time?(TST)?were?higher?compared?with?those?of?the?pre-treatment?group,?and?the?difference?was?statistically?significant?(P<0.05);in?the?comparison?between?groups,?the?sleep?diary?of?the?EPQ?extraversion?group?and?the?EPQ?psychotic?group?of?SL?and?WASO?were?lower?than that?of?EPQ?neuroticism?group(P<0.05); while?TST?and?SE?were?higher?than?that?of?EPQ neuroticism?group?(P<0.05). WASO and Percentage of sleep N2 period (N2 )were shorter in PSG parameters in EPQ extraversion group than before, and SE,Percentage of sleep N3 period (N3),TST and Percentage of sleep REM period were increased than before (all P<0.05), TST, SE,, N3 were higher in EPQ psychoticism group than before treatment, and WASO was shorter after treatment (all P<0.05); After treatment, N2 and REM were elevated in the extraversion group compared to the neuroticism group；between groups, WASO were shortened in the EPQ psychotic group compared with the EPQ neurotic group, while SE,N2and N3 were elevated, with statistically significant differences (P<0.05). Cortisol concentration was elevated in the EPQ neurotic group after treatment, and was reduced in the psychotic group after treatment (P<0.05); however, the differences in cortiso1 concentration between the three groups were not statistically significant (P>0.05). Conclusion The effect of CBTI treatment on the sleep quality in patients with chronic insomnia disorders of different personality traits had significant differences, and it is more effective for insomnia patients with psychotic and extroverted personality traits.

The expression and clinical significance of LncRNA RPPH1 and AGR3 in colorectal cancer tissue

平胜 — 2024/11/7 11:20:59

Objective To analyze the expression and clinical significance of long chain non coding RNA (LncRNA) RPPH1 and pre gradient protein 3 (AGR3) in colorectal cancer (CRC). Method: A retrospective analysis was conducted on the clinical data of 98 CRC patients who visited our hospital from January 2017 to January 2020. RT-qPCR was used to analyze the expression of LncRNA RPPH1 in tissues. Immunohistochemical method was used to detect the expression of AGR3 in tissues. The impact of LncRNA RPPH1 and AGR3 expression in CRC cancer tissue on patient prognosis were analyzed statistically. Results The expression of LncRNA RPPH1 (3.11 ± 0.36 vs 1.02 ± 0.25) and AGR3 (63.27% vs 10.20%) in CRC cancer tissue were higher than that in adjacent tissues (t/2=47.026, 63.307, P<0.001). There was a positive correlation between the expression of LncRNA RPPH1 and AGR3 in cancer tissue (Rs=0.712, P=0.000). The expression of LncRNA RPPH1 and AGR3 in TNM stage III, low differentiation degree, and lymph node metastasis CRC was significantly higher (P<0.05). The overall 3-year survival rates of the LncRNA RPPH1 high expression and low expression groups were 45.83% (22/48) and 80.00% (40/50), respectively. The difference in survival curves between the two groups was statistically significant (Log Rank 2=9.222, P=0.002). The overall 3-year survival rates of the AGR3 positive and negative groups were 51.56% (33/64) and 85.29% (29/34), respectively. The difference in survival curves between the two groups was statistically significant (Log Rank 2=8.090, P=0.005). Tumor TNM stage, lymph node metastasis, LncRNA RPPH1, and AGR3 were factors affecting the prognosis of CRC patients. Conclusion: The increased expression of LncRNA RPPH1 and AGR3 in CRC are associated with adverse clinical and pathological features and prognosis, and are new tumor markers for CRC.

Application of complex bone graft fusion in posterior atlantoaxial fixation and fusion for patients with type IIC odontoid fracture

hongqingnan — 2024/11/7 11:20:23

Objective To investigate the application effect of complex bone graft fusion in posterior atlantoaxial fixation and fusion surgery for patients with type IIC odontoid fracture. Methods A retrospective study was conducted on 95 patients with type IIC odontoid fractures in our hospital from January 2020 to October 2022. Patients were divided into groups based on different surgical approaches. Forty-seven patients who underwent posterior atlantoaxial screw reduction and internal fixation combined with iliac bone grafting were included in the control group, and 48 patients who underwent posterior atlantoaxial screw reduction and internal fixation combined with transposition of the atlantoaxial spinous process muscle vascular complex were included in the observation group. Surgery-related indices, postoperative fracture healing, stability and atlantoaxial rotation, complications and pre- and post-surgical pain (VAS) and spinal cord injury (ASIA), and changes in functional recovery [cervical spine function (JOA), cervical spine dysfunction index (NDI)] were observed in the two groups. Results The operation time and fracture healing time in the observation group were shorter than those in the control group, and the intraoperative blood loss was less than that in the control group (P<0.05). Six months after surgery, the fracture healing rate in the observation group was 93.75%, which was higher than that in the control group (76.60%) (P<0.05). At 3 and 6 months after operation, VAS scores in both groups were lower than those before operation (P < 0.05), but there was no significant difference between the two groups (P > 0.05). At 3 and 6 months after operation, there was no significant difference in ASIA score between the two groups, and no significant change between the two groups (P > 0.05). 3 and 6 months after operation, NDI score of observation group was lower than control group, JOA score was higher than control group (P < 0.05); The incidence of complications in the observation group was 4.17% compared with 14.89% in the control group (P > 0.05). Conclusion Posterior atlantoaxial screw reduction and internal fixation, followed by bone graft fusion of the muscle-vascular complex of the posterior atlantoaxial spinous process, can shorten the operation time, reduce intraoperative bleeding, promote fracture healing in patients with type IIC odontoid fractures, and restore the physiological function of the cervical spine as early as possible.

The progress of cold atmospheric plasma in skin wound healing research

ZhaoChaoYue — 2024/11/1 17:57:28

The skin wound healing is an important subject which has been paid attention to and improved in medical field for a long time. With the advances of technology, Cold plasma medicine provides a new therapeutic strategy for skin wound healing due to its unique advantages. In this paper, the concept, classification, generation and application of cold plasma are briefly reviewed. In addition, the roles of cold plasma and its molecular mechanisms in coagulation stage, inflammatory stage, migration/proliferation stage and remodeling stage in wound healing were also reviewed.

Advances in the study of systemic immune inflammatory index (SII) and diabetes-related complications

CHEN Ruifang,NIU Di,,XIAO Mingzhi,ZHANG Junshao,ZHANG Xiaowei — 2024/11/1 16:43:02

Diabetes-related complications are a serious threat to human health globally, including diabetic nephropathy, diabetic retinopathy, diabetic macrovascular disease, diabetic peripheral neuropathy, and other complications associated with diabetes, and the prognosis and adverse outcomes for patients are generally poor.Inflammation is a potential pathogenetic mechanism for diabetes-related complications, and there is a growing body of research on inflammatory markers and diabetes-related complications.The Systemic Immune Inflammatory Index (SII) is a novel inflammatory marker that integrates neutrophils, lymphocytes and platelets to more accurately assess the inflammatory state of the body.This review summarises the latest research advances in SII and diabetes-related complications.

Establishment of a risk prediction model of uterine arcuate artery ultrasound parameters for dangerous placenta previa postpartum hemorrhage based on logistic regression

Huang Qiaoru — 2024/11/1 16:41:59

Objective Ultrasonography of the uterine arcuate artery was performed on pregnant women with dangerous placenta previa (PPP), and the risk prediction model of ultrasound parameters on postpartum hemorrhage was established based on Logistic regression.Methods A total of 103 PPP pregnant women who planned to give birth in our hospital from June 2019 to June 2022 were selected to track their postpartum hemorrhage.According to the amount of postpartum hemorrhage, they were divided into observation group (hemorrhage within 24 hours after delivery ≥ 1000ml) and control group (hemorrhage within 24 hours after delivery <1000ml).The data and ultrasound parameters of the uterine arcuate artery were compared between the two groups.Logistic multivariate analysis was performed on postpartum hemorrhage, and a risk prediction model was established and evaluated.The value of risk model for predicting postpartum hemorrhage was judged by drawing receiver operating characteristic curve (ROC).Results The PSV in the observation group was higher than that in the control group, while the RI and PI in the observation group were lower than those in the control group (P<0.05).Uterine arcuate artery ultrasound parameters PSV, RI and PI were the influencing factors of postpartum hemorrhage (P<0.05). The logistic regression model was established: logit(P) = -40.002+1.386×PSV-0.926×RI-0.783×PI, with good fit. According to the fitted model, the AUC for predicting postpartum hemorrhage was 0.860, and it was greater than that predicted by a single index of PSV (χ₂^{=2.355, P=0.019), RI (χ}₂^{=2.332, P=0.020), and PI (χ}₂^{=2.472, P=0.013).}Conclusion The establishment of a risk prediction model of uterine arcuate artery ultrasound parameters for postpartum hemorrhage in PPP based on Logistic regression can effectively determine the risk of postpartum hemorrhage in patients, and it is helpful for early clinical prevention and treatment.

Effect of hyperbaric oxygen combined with Yangxue Jieyu Xingnao decoction on sleep quality in patients with sleep disorders after acute cerebral infarction

吴小培 — 2024/11/1 10:07:41

Objective To explore the effect of hyperbaric oxygen combined with Yangxue Jieyu Xingnao decoction on sleep quality in patients with sleep disorders after acute cerebral infarction. Methods: A total of 160 patients with sleep disorders after acute cerebral infarction were randomly assigned into two groups. The conventional group was treated with hyperbaric oxygen, while the traditional Chinese medicine group was treated with hyperbaric oxygen combined with Yangxue Jieyu Xingnao decoction. The therapeutic effects of the two groups were compared. Results The total effective rate of the traditional Chinese medicine group was 93.75%, higher than that of the conventional group at 78.75% (P<0.05). Comparison of sleep quality: After treatment, the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) scores of the traditional Chinese medicine group were lower than those of the conventional group (P<0.05). Comparison of sleep breathing monitoring indicators showed that the total sleep time (TST) and rapid eye movement sleep time (REM) of the traditional Chinese medicine group were longer than those of the conventional group, and the sleep latency time (SL) was shorter than that of the conventional group (P<0.05). The levels of serum norepinephrine (NE) and serotonin (5-HT) were higher than the conventional group (P<0.05). Conclusion: The combination of hyperbaric oxygen and Yangxue Jieyu Xingnao decoction can effectively improve sleep quality, get good safety, and make up for the shortcomings of a single treatment method for patients with sleep disorders after acute cerebral infarction.

Expression of 7-miRNA in patients with osteosarcoma and their impact on prognosis

刘琦 — 2024/11/1 10:05:09

Objective: To identify of the expressions of 7-miRNA in patients with osteosarcoma and their impact on prognosis. Methods: Differentially expressed genes (DEGs) in GSE70367 and GSE69470 data sets were analyzed by bioinformatics. Sixty-three samples were collected from our hospital from August 2019 to January 2023 to verify the relative expression levels of DEGs in OS tissue and adjacent normal tissue samples, and collect clinical data and overall survival time of corresponding patients. Results: Bioinformatics analysis identified 8 mirnas that met the criteria, including miR-543, miR-495-3p, miR-433-3p, miR-381-3p, miR-301a-3p, miR-199b-5p, miR-125b-5p, and miR-218. The relative expression levels of miR-543, miR-495-3p and miR-125b-5p in OS tissues were significantly lower than those in adjacent normal tissues. The relative expression levels of miR-433-3p, miR-381-3p, miR-301a-3p and miR-199b-5p were higher than those of para-cancer normal tissues (P＜0.001). However, there was no difference in the expression of miR-218 in the tissue samples. Patients with OS whose relative expression level of miR-543≤2.87, miR-433-3p＞0.84, and miR-199b-5p＞4.83 had TNM stage III+IV, higher probability of metastasis/recurrence or death (P＜0.05). Patients with OS whose relative expression level of miR-495-3p≤3.08, miR-381-3p＞2.93, and miR-301a-3p＞4.95 had a higher probability of metastasis/recurrence or death (P＜0.05). Patients with OS whose relative expression level of miR-125b-5p≤3.28 had TNM stage III +IV, and the probability of death was higher (P＜0.05). According to Kaplan-Meier method and Log-rank test results, Patients with OS of whose miR-543 relative expression≤2.87/miR-495-3p relative expression≤3.08/miR-433-3p relative expression＞0.84/miR-381-3p relative expression＞2.93/miR-301a-3p relative expression＞4.95/miR-199b-5p relative expression level＞4.83/miR-125b-5p relative expression level≤3.28 had lower median overall survival (P＜0.05). Conclusion: miR-543, miR-495-3p, miR-433-3p, miR-381-3p, miR-301a-3p, miR-199b-5p, miR-125b-5p are related to the proliferation, migration and invasion of OS cells and the survival prognosis of patients with OS.

Value of osteopontin in nasal secretions in diagnosis of eosinophilic chronic sinusitis with nasal polyps

刘, — 2024/11/1 10:03:55

Objective To evaluate the diagnostic utility of osteopontin (OPN) in nasal secretions for eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP). Methods A cohort of 80 patients diagnosed with CRSwNP who underwent endoscopic sinus surgery at Renmin Hospital of Wuhan University from January to June 2023, along with 30 patients undergoing septoplasty as a control group, were recruited. Patients with CRSwNP were categorized into eosinophilic (eCRSwNP) and non-eosinophilic (neCRSwNP) groups, each consisting of 40 cases. Levels of OPN in nasal secretions were assessed, and clinical data were collected. Pearson correlation analysis was employed to investigate the correlation between OPN levels in nasal secretions and clinical parameters. The diagnostic value of OPN for eCRSwNP was analyzed using the receiver operating characteristic (ROC) curve. Results Compared to the control group, both eCRSwNP and neCRSwNP groups exhibited significantly elevated levels of OPN in nasal polyp tissues and secretions, with eCRSwNP showing higher OPN levels than neCRSwNP, which was statistically significant (P < 0.05). OPN levels in nasal secretions were positively correlated with peripheral blood eosinophil count (r = 0.715, P < 0.001), percentage of peripheral blood eosinophils (r = 0.571, P < 0.001), tissue eosinophil count (r = 0.521, P < 0.001), Lund-Mackay score (r = 0.421, P = 0.006), and Lund-Kennedy score (r = 0.386, P = 0.013). The eCRSwNP group had higher peripheral blood eosinophil count, percentage, Lund-Mackay score, and Lund-Kennedy score than the neCRSwNP group, with statistically significant differences (P < 0.05). However, there was no significant difference in serum total IgE, nasal fractional exhaled nitric oxide (FnNO), and visual analog scale (VAS) scores between the two groups (P > 0.05). ROC curve analysis indicated that OPN levels in nasal secretions, peripheral blood eosinophil count, percentage, Lund-Mackay score, and Lund-Kennedy score all contributed to the diagnosis of eCRSwNP, with OPN levels demonstrating superior diagnostic efficacy [AUC (95% CI) = 0.837 (0.763–0.997), P < 0.001], with a sensitivity and specificity of 95.42% and 65.37%, respectively. Conclusion OPN levels in nasal secretions are beneficial for the diagnosis of eCRSwNP.

Extrahepatic cholangiocarcinoma with colorectal cancer: a case report

Li Xuesong,, — 2024/10/31 9:57:41

Effect of Shenqi Qiangjing decoction on semen quality and IVF outcome in patients with oligoasthenozoospermia

chenqigui,,, — 2024/10/15 17:48:55

Objective To investigate the effects of Shenqi Qiangjing decoction and L-carnitine on semen quality and IVF outcome in patients with oligoasthenozoospermia. Methods 209 patients with oligoasthenozoospermia were divided into the Shenqi Qiangjing decoction group and the L-carnitine group according to different clinical medication regimen. All patients were assisted with IVF after 3 months of treatment. The general clinical data, semen quality and IVF outcome of the two groups were compared. Results (1) After 3 months of treatment with Shenqi Qiangjing decoction, the sperm acrosome integrity rate of patients with oligoasthenozoospermia was significantly higher than before treatment, and the sperm DNA fragmentation index was significantly lower than before treatment(P<0.05).After 3 months of treatment with L-carnitine, the sperm progressive motility was significantly higher than before treatment, and the sperm DNA fragmentation index was significantly lower than before treatment(P<0.05).The sperm acrosome integrity rate in the Shenqi Qiangjing decoction group (after treatment) was significantly higher than that in the L-carnitine group(P<0.05), and the sperm DNA fragmentation index in the Shenqi Qiangjing decoction group (after treatment) was significantly lower than that in the L-carnitine group(P<0.05).There was no significant difference in the sperm concentration, total sperm count, sperm progressive motility and normal sperm morphology rate between the two groups(P>0.05).(2)The fertilization rate and excellent embryo rate in the Shenqi Qiangjing decoction group were significantly better than those in the L-carnitine group (P<0.05), but there was no significant difference in cleavage rate and clinical pregnancy rate between the two groups (P>0.05). (3) A total of 202 fresh transplant cycles, 1925 eggs, 1548 fertilized eggs, 532 high quality embryos and 97 clinical pregnancies were obtained (including 50 in the Shenqi Qiangjing decoction group and 47 in the L-carnitine group).Conclusion Shenqi Qiangjing decoction can improve the semen quality of patients with oligoasthenozoospermia and optimize the outcome of assisted pregnancy, which is superior to L-carnitine.

Research progress in targeted therapy for HER2-positive breast cancer

wuyou — 2024/10/12 15:40:11

Abstract: Breast cancer is an important cause of death in female cancer patients, and also the highest incidence of malignant tumors in women worldwide. Among them, the incidence of HER2-positive breast cancer accounted for 20%~30% of the overall incidence of breast cancer, and compared with other molecularly typed breast cancers, HER2-positive breast cancer had a poor prognosis and was prone to recurrence and metastasis. Therefore, in recent years, HER2-positive breast cancer treatment has attracted much attention, especially a variety of anti- HER2-targeted drug therapy, such as specific monoclonal antibody (trastuzumab, pertuzumab, etc.) treatment, tyrosine kinase inhibitors (lapatinib, nilatinib, pyrrotinib, etc.) treatment, [ ] antibody conjugated drugs (Trastuzumab Emtansine, Trastuzumab Deruxtecan, etc.) treatment, because it significantly improves the therapeutic effect of HER2-positive breast cancer patients, it shows great clinical application prospect, and related research progress is rapid. This article reviews the research progress of targeted therapy for HER2-positive breast cancer, aiming to provide theoretical basis for the treatment of HER2-positive breast cancer and guide clinical treatment.

Research progress of oral gastrointestinal contrast-enhanced ultrasound for evaluating the function of gastric motility and gastric emptying affected by different diseases

LIU Yanzhou,,, — 2024/10/11 11:25:45

Different diseases can lead to gastrointestinal dysfunction, resulting in gastrointestinal symptoms that have an impact on the function of gastric motility and gastric emptying, and it effect the life quality of the patients seriously. Therefore, it is important to evaluate the function of gastric motility and gastric emptying of the patients for the guidance of clinical treatment, evaluation of effectiveness, and prediction of prognosis. Oral gastrointestinal contrast-enhanced ultrasound (OCUS) is one of the emerging imaging methods in recent years, and the application of it in the field of gastric motility and gastric emptying is gradually maturing. This paper reviews the research process of OCUS for evaluating the function of gastric motility and gastric emptying affected by different diseases.

Mechanism of BanShi CuLuanZhuYun Decoction in the Treatment of Polycystic Ovarian Syndrome Based on Network Pharmacology and Macromolecular Docking Technology

yue xiao lei, — 2024/10/10 10:43:45

Objective To explore the mechanism of BanShi CuLuanZhuYun Decoction (CLZYD) in the treatment of polycystic ovarian syndrome (PCOS) based on network pharmacology and macromolecular docking technology. Methods The active compounds and targets of every drug in CLZYD were retrieved in the TCMSP and BATMANTCM databases. The targets of PCOS were retrieved in GeneCards, DisGeNET, UniProt and Drugbank databases. A Venn diagram for common targets of diseases and drugs was established. The Cytoscape software was used to construct a drug-compound-target-disease network, and the STRING database was used to construct a protein-protein interaction (PPI) network. The Gene Ontology (GO) function enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were realized on the Metascape platform. At last, the core targets and the core active compounds were verified by macromolecular docking. Results 184 active compounds, 362 drug targets ,1807 disease targets and 165 drug-disease common targets were obtained. According to the drug-compound-target-disease network, the core compounds included quercetin, kaempferol, beta-sitosterol, etc. According to the PPI network analysis, the core targets included RAC-alpha serine/threonine-protein kinase (AKT1), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), interleukin-1 beta (IL-1β), cellular tumor antigen p53 (TP53), etc. The therapeutic mechanism might be related to pathways such as pathways in cancer, AGE/RAGE signaling pathway and PI3K/AKT signaling pathway. Macromolecular docking showed that quercetin, kaempferol, and beta-sitosterol had good binding activity with AKT1, TNF-α, IL-6, IL-1β, and TP53. Conclusion CLZYD can exert therapeutic effects on PCOS through multiple compounds, targets, and pathways.

Research Progress of Vitamin D in Pathogenesis and Treatment of Migraine

changweizun,,, — 2024/10/9 17:49:57

Migraine is a common clinical nervous system disease, because it onsets with moderate to severe headache, attracts recurrently and can cause disability，leading to serious burdens on the migraine patients, their family and whole society. Current studies have shown that multiple mechanisms are involved in the attack of migraine. As a steroid hormone, vitamin D plays an important role in various life activities in the human body. In recent years, more and more studies have shown an association between vitamin D deficiency and migraine, and vitamin D as a therapeutic agent，has been used in clinical trials of migraine. This article reviews the research progress of vitamin D in the pathogenesis and clinical treatment of migraine, aiming to provide guidance for the prevention and treatment of migraine.

The Prognostic Value of Different Glucose Indexs in Early Sepsis Patients

zuo yan yan — 2024/10/9 16:11:47

Objective To study the prognostic value of different glucose indexs in patients with early stage of sepsis, and to analyze risk factors influencing mortality in patients with sepsis admitted to intensive care unit (ICU). Methods The electronic medical records of sepsis patients admitted to the ICU of the Fourth People's Hospital of Langfang from January 2018 to January 2024 were retrospectively collected. According to the outcome, the patients were divided into survival group and death group, and the demographic data, infection site, disease severity, blood glucose level and other related indicators of the two groups were compared. Receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of immediate blood glucose, 24-hour blood glucose fluctuation (coefficient of variation CV) and stress hyperglycemia ratio (SHR) in ICU sepsis. Multivariate Logistic regression models were used to screen independent risk factors for death in patients with sepsis in ICU. Results Among 251 patients with sepsis in ICU, 165 (65.7%) were male, with an average age of 51.9 years. Of 251 patients with sepsis, 165 survived and 86 died when transferred out of ICU, with a mortality rate of 34.4%. Compared with the survival group, patients in the death group were older, had higher blood glucose values such as CV, SHR, Apach-II score and SOFA score in the early stage of sepsis, had a larger proportion of vasoactive drugs and kidney replacement therapy requirement, and had a longer mechanical ventilation time (P<0.05). The area under ROC curve of different glucose indexs, such as CV, SHR and CV combined SHR for predicting death in ICU sepsis patients were 0.559, 0.589, 0.625 and 0.664, respectively. The results suggested that the predictive value of CV combined SHR for death in ICU sepsis patients was higher than that of single index. Logistic regression analysis showed that Apach-II score, SHR, use of vasoactive drugs and renal replacement therapy were risk factors for death in ICU sepsis patients (p<0.05). Conclusions Both CV and SHR can be used as predictors of death in ICU patients with sepsis, and CV combined with SHR has higher predictive value for death in ICU patients with sepsis than a single index. The higher the SHR, the greater the risk of death in ICU, SHR was an independent risk factor for death in patients with sepsis in ICU.

Comparative study of IMR reconstruction and iDose4 iterative reconstruction techniques on the quality of low dose left atrial pulmonary vein CTA images

DU Guoxiang,LI Min,LU Bingfeng,LIANG Zhimei,,LUO Yingyi — 2024/10/9 16:10:38

Abstract Objective: To compare the effect of IMR and iDose4 reconstruction on the image quality of low dose left atrial pulmonary vein CTA. Methods: 30 patients with atrial fibrillation in our hospital were examined by low-dose left atrial pulmonary vein CTA with tube voltage of 80kV and tube current of 350mA. After scanning, IMR and iDose4 algorithms were used to reconstruct, The image quality of the two groups was scored subjectively, and the CT values of the left atrium, the left and right upper and lower pulmonary veins opening and the fat of the chest wall of the same layer were measured, as well as the SD values of background noise. The signal-to-noise ratio of the left atrium and the left and right upper and lower pulmonary veins was calculated. By comparing the noise ratio, the two groups of images were scored subjectively by two attending radiologists.SPSS22.0 software was used to analyze the difference of image quality between the two groups. Results: The two attending radiologists had a high consistency in the subjective evaluation of the two groups of images, with Kappa values of 0.885 and 0.873, P < 0.001. The IMR group had a higher subjective score of image quality than iDose4 group, and the difference was statistically significant (P < 0.05).Left atrium, RSPV, RIPV, LSPV, LIPV image noise IMR group was lower than iDose4 group, SNR and contrast SNR were higher than iDose4 group, and the difference was statistically significant.There was no significant difference in the values of left atrium, RSPV, RIPV, LSPV and LIPVCT between the two groups. Conclusions: Compared with iDose4 reconstruction, IMR can significantly reduce noise and improve image quality for low dose left atrial pulmonary vein CTA images.

Clinicopathological features and prognosis analysis of ovarian sex cord tumor with annular tubules

CHEN TING,Dingxinyao,,WANG CONG,YANG JING,ZHANG YUE — 2024/10/9 10:19:12

Objective To explore the clinical and pathological features, diagnosis, treatment, and prognosis of ovarian sex cord tumor with annular tubules (SCTAT). Methods We report a case of recurrent SCTAT without Peutz-Jeghers syndrome (PJS) treated at our center, as well as SCTAT cases in the SEER database, and discuss the clinical features, diagnosis, treatment and prognosis of SCTAT in the context of literatures. Results The patient with SCTAT was initially mis-diagnosed with granulosa cell tumor and underwent right salpingo-oophorectomy at a local hospital when she was 40 years old. After 60 months, she experienced a tumor recurrence and received optimal debulking surgery and subsequent adjuvant chemotherapy. During surgery, a retroperitoneum tumor measuring 25cm was found, which was closely related to the pancreas, duodenum, abdominal aorta and inferior vena cava. Additionally, another three tumors were found to be distributed along the right pelvic funnel ligament. After 24 months of follow-up, the patient had no recurrence, and overall survival (OS) was 84 months. After retrieving the SEER database from 1992 to 2019, a total of 5 patients with SCTAT, 3 with stage III-IV and 2 with stage IA, were treated and followed up, 2 died, and the median OS was 38 months. Conclusions Ovarian SCTAT is a rare sex cord tumor characterized by low malignant potential and late recurrence. Surgery is the mainstay treatment for both primary and recurrent tumors. More case reports are warranted to enable clinicians better understand its clinical and pathological features, and establish appropriate treatment strategies.

Experimental study on transferrin receptor magnetic resonance tracing of iron metabolism in rat brainZhang Yesen ,Li Ning,Shang Yuchun,et al. Department of Neurosurgery, The First Afliated Hospital of Bengbu Medical University, Bengbu 233004, China

张业森 — 2024/10/9 9:13:39

【Objective】 To explore a new method for drug monitoring of iron metabolism in Alzheimer"s disease by transferring transferrin receptor gene into rat brain and using specific probes to trace iron transport on magnetic resonance imaging.【Methods】 The rats were divided into virus transfection group and normal control group.Normal saline was injected into both sides of the brain in the normal group,Lentiviral vector TfR and empty vector were respectively stereotactic injected to the left brain and right brain of rat in sterile conditions. Tf-USPIO was injected through femoral vein two weeks later. MRI examination was performed to the transfected cells after 1 day and finally RT-PCR was used to detect the expression of TfR,immunofluorescence staining and Prussian blue staining were carried out by using tissue sections. 【Results】The expression of TfR gene in the virus group was significantly higher than that in the empty vector side and normal brain tissue group by Real-time Quantitative PCR, and the difference was statistically significant (P<0.05)., and combined with Tf-USPIO for imaging in magnetic resonance imaging. Immunofluorescence staining indicated that transferrin receptor in brain tissue cell was expressed on cell membrane. Prussian blue staining indicated a large number of blue iron particles gather in cells which have been transfected. 【Conclusion】 Transferrin receptor transfected brain can be combined with its specific Tf-USPIO probe and tracked in magnetic resonance imaging, which provides a new non-invasive monitoring method for the next treatment of Alzheimer"s disease.

Clinical study of intravenous lidocaine for improving rebound pain after brachial plexus block

李佳英,翟瑞瑞,赵亚杰,周脉涛 — 2024/10/9 9:12:38

Objective To investigate the effects of low dose intravenous lidocaine on rebound pain after brachial plexus block. Methods A total of 80 patients with unilateral upper limb fracture under brachial plexus block anesthesia were selected for open reduction and internal fixation. The patients were divided into two groups by random number table method: Group C with normal saline and group L with intravenous lidocaine, with 40 cases in each group. The occurrence and duration of rebound pain, analgesic pump drug consumption, sensory block time, remedial analgesia and adverse reactions within 48h after nerve block administration were recorded. Numerical Rating Scale (NRS) of resting and active status were recorded before surgery and 8, 12, 24, and 48 h after nerve block administration. Results Compared with the preoperative results, the NRS scores at rest and activity at 8 and 48 h after nerve block in group C were decreased, the NRS scores at rest and activity at 8, 12 and 48 h after nerve block in group L were decreased (P<0.05). Compared with group C, the incidence and duration of rebound pain at 48 h after nerve block were decreased in group L, the consumption of analgesic pump drugs was decreased, the remedial analgesic rate was lower, the resting NRS score at 12 h and 24 h after nerve block was decreased, and the NRS score at 12h activity was decreased (P<0.05).Conclusion Low dose intravenous infusion of lidocaine can reduce the incidence and duration of rebound pain after brachial plexus block, reduce the consumption of postoperative analgesic pump drugs and the recovery rate of analgesia, which is conducive to the recovery of patients, and the adverse reactions are mild.

Imaging classification of pulmonary ground-glass opacity based on thin--section CT scanning of the chest.SU Lei ,ZHANG Yi, GAO Yan, WEI Bing, LI Yuan-bo, WANG Tengteng,QIAN Kun, ZHANG Peilong,WANG Lei-ming.Department of Thoracic Surgery, Xuan Wu Hospital of Capital Medical University, Beijing 100053,China.

苏雷,,,, — 2024/10/9 9:11:43

Objective To analyze the correspondence of imaging characteristics and pathological results in patients with ground-glass opacity (GGO). Methods The imaging classification and CTR value of 1541 patients with pulmonary GGO treated in our hospital from January 2020 to December 2022 were analyzed with postoperative pathological results. Results The average age of 1541 patients was 58.1±11.2 years old, including 513 males (33.3%) and 1028 females (66.7%). There were 2005 GGO lesions in 1541 patients, and the mean maximum diameter of GGO lesions was 13.21±7.9mm. There were 248 cases of type I GGO (12.4%), 682 cases of type II GGO (34.0%), 862 cases of type III and 213 cases of type IV, respectively (43.0% and 10.6%). There were 950 cases of GGO with CTR=0 (47.4%), 616 cases of 1≤CTR<30 (30.7%), 314 cases of 30≤CTR<70 (15.7%), and 125 cases of CTR≥70 (6.2%). The average observation time was 11.2±18.7 months. Postoperative pathological reports: 186 cases of benign GGO lesions (9.3%), 743 cases of preinvasive lesions (37.1%), 434 cases of microinvasive adenocarcinoma (21.6%), 629 cases of invasive lung cancer (31.4%), and 13 cases of other malignant tumors (0.6%). Multivariate regression analysis showed that among the influencing factors of postoperative pathological nature, patient gender, GGO diameter, GGO type, and CTR were important factors affecting the nature of GGO. Conclusion The GGO classification based on TSCT is helpful for clinicians to evaluate the risk of early lung cancer with GGO as the main imaging manifestation.

Study on the protective effect of dexmedetomidine combined with opioid analgesics on cardiopulmonary bypass in perioperative cardiac surgery GONG Zheng, SONG Si-ming, LU Liu-yu,JIANG Yu-hua, LI Jun, MA Li. Department of Anesthesology,The People,s Hospital of Guangxi Autonomous Region;GONG Zheng,Guangxi Medical University ,Nanning 530021,China.

龚拯 — 2024/10/9 8:53:04

Objective To observe the effect of dexmedetomidine combined with sufentanil or fentanyl on perioperative organ protection in patients undergoing cardiac surgery, so as to provide clinical guidance for the rational application of anesthetic drugs. Methods A total of 120 patients undergoing heart valve replacement with cardiopulmonary bypass were selected in my Hospital . All patients were divided into sufentanil group (S group), fentanyl group (F group), dexmedetomidine + sufentanil group (SD group) and dexmedetomidine + fentanyl group (FD group) used by random number table method, with 30 cases in each group. Observe and analyze the following indicators: situation of surgery, the use of anesthetic analgesics and intraoperative vasoactive drugs were recorded. Moreover, at preoperatively (T0), postoperative day 1 (T1), postoperative 3 days (T2), and postoperative 7 days (T3), the expression of inflammatory factors such as WBC, N%, hs-CRP, and the expression of creatine kinase MB (CK-MB), troponin (cTnl) were detect,And calculate the oxygenation index (OI) and alveolar-arterial oxygen pressure difference P(A-aDO2). Results There was no statistical significance in the general conditions of the 4 groups (P>0.05); To compared the use of anesthetic drugs in 4 groups, the dose of sufentanil in the SD group was lower than that in the S group, the dose of sufentanil in the FD group was lower than that in the F group（P<0.05）, and the dose of propofol and midazolam were lower than other 3 groups; The blood WBC, N%, CRP, and hs-CRP levels were lower in the SD group and the FD group than in the S group and the F group at the time of T1, T2 and T3 (P<0.05). At the time of T1, the CRP and hs-CRP levels in the SD group were lower than those in the FD group(P<0.05). The blood WBC, blood N%, CRP, and hs-CRP levels in the SD group were lower than those in the FD group at T2 and T3 (P<0.05). The above indexes of T1, T2 and T3 were higher than those of T0 before surgery (P<0.05); To compare the protective effects of organ injury in 4 groups, at the time of T1, T2 and T3, SD and FD group had lower level of CK-MB, cTnI than group S and F group (P<0.05). At the time of T1, the cTnI level in the SD group was lower than that in the FD group (P<0.05). The levels of CK-MB and cTnI in the SD group were better than those in the FD group at the T2 time point (P<0.05). At the time of T3, the levels of CK-MB in the SD group were lower than those in the FD group (P<0.05),and the level of OI was lower than T0(P<0.05). The level of P(A-aDO2) at T1 in 4 groups were higher than T0, while the level of P(A-aDO2) at T2 and T3 in 4 groups were higher than T0 (P<0.05). Conclusion Dexmedetomidine combined with sufentanil or fentanyl regimen can reduce the inflammatory stress response of the body and has a certain clinical protective effect on cardiopulmonary injuries, and dexmedetomidine combined with sufentanil regimen is more effective, but its mechanism of action needs further study.

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Chen kai bi, — 2024/10/8 17:36:42

The expression of serum CBLL1, MMP3 in acute ischemic stroke patients and their relationship with post thrombolytic hemorrhage transformation and prognosis

靳洪文,穆晓春,佘碧霞 — 2024/10/8 17:35:15

Objective To analyze the expression of serum CBL oncogene like 1 (CBLL1), matrix metalloproteinase 3 (MMP3) in with acute ischemic stroke (AIS) patients and their relationship with post thrombolytic hemorrhage transformation and prognosis. Method: 264 AIS patients from January 2020 to December 2022 were selected as the AIS group. According to the occurrence of HT, they were divided into an HT group of 42 cases and a non-HT group of 222 cases. AIS patients were divided into a poor prognosis group (63 cases) and a good prognosis group (201 cases). 60 healthy people were taken as the control group. Enzyme linked immunosorbent assay was used to detect serum levels of CBLL1 and MMP3. Logistic regression analysis and ROC were performed to analyze the value of serum CBLL1 and MMP3 in assessing HT in AIS patients. Result The serum levels of CBLL1 and MMP3 in the AIS group were (42.84 ± 8.63) μ g/L, (62.17 ± 10.59) μ g/L, higher than those in the control group (11.13 ± 2.25), (20.75 ± 5.26) (t=28.213, 29.456, P=0.000, 0.000). The serum levels of CBLL1 and MMP3 in the poor prognosis group were (56.62 ± 9.24) μ g/L, (77.61 ± 11.67) μ g/L, which were higher than those in the good prognosis group (38.52 ± 8.17) μ g/L, (57.33 ± 10.12) μ g/L (t=14.861, 13.282, P=0.000, 0.000). Compared with the non-HT group, The NIHSS score, serum CBLL1, and MMP3 of AIS patients in the HT group were higher (P<0.05). NIHSS score, serum CBLL1, and MMP3 were risk factors for HT in AIS patients. The area under the curve (95% CI) of the combined use of serum CBLL1 and MMP3 for evaluating HT in AIS patients after thrombolysis were 0.936 (0.892-0.965), respectively, which were larger than serum CBLL1. MMP3 alone was detected at 0.832 (0.791-0.866) and 0.816 (0.784-0.840) (Z=4.542, 4.886, P=0.000, 0.000). Conclusion: The elevated levels of serum CBLL1 and MMP3 in AIS patients are related to post thrombolytic HT and prognosis. The combination of the two has high evaluation value for post thrombolytic HT in AIS patients.

Efficacy of CAEPFS in the treatment of grade Ⅱ ~ Ⅲ hemorrhoids and its effect on anal function and quality of life

shijie — 2024/10/8 17:33:47

Objective To explore the efficacy of transparent cap assisted endoscopic injection of laurosinol foam hardener (CAEPFS) in the treatment of grade Ⅱ ~ Ⅲ internal hemorrhoids, and to analyze its effect on anal function and quality of life. Methods A total of 98 patients with grade Ⅱ ~ Ⅲ hemorrhoids treated with CAEPFS in Changan Hospital from October 2022 to October 2023 were selected and divided into conventional dose group (n=49) and high dose group (n=49) by random number table method. The injection dose of laurofoam hardener in the conventional dose group was 0.5-2.0 ml/ injection site, and the injection dose of laurofoam hardener in the high dose group was > 2.0 ~ 4.0 ml/ injection site. The therapeutic effect and related indexes of the two groups were compared 7 days after operation. Serum inflammatory factor levels, maximum rectal tolerance dose (MTV), rectal resting pressure (RRP), maximum rectal systolic pressure (MSP), anal stool control function, sensory function, and quality of life of the two groups were compared before and after treatment [EuroQol five-dimensional Questionnaire (EQ-5D)]. Complications and recurrence were compared between the two groups. Results There was no significant difference in the total effective rate between the two groups (97.96% vs. 93.88%, P > 0.05). The cure rate of the high-dose group was higher than that of the conventional dose group (79.59% vs. 59.18%, P < 0.05). The injection volume of high-dose group was higher than that of conventional dose group, and the hospital stay was shorter than that of conventional dose group (P < 0.05). The serum levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) were (3.26±0.95) ng/L, (6.49±1.56) mg/L and (5.24±1.63) ng/L, respectively, in the high-dose group 3 months after treatment. It was lower than (4.81±1.24) ng/L, (8.20±1.74) mg/L, (7.08±1.92) ng/L in conventional dose group (P < 0.05); MTV and MSP of the high-dose group were (216.53±28.74) ml and (196.10±21.53) ml, respectively, and (127.53±15.26) mmHg and (120.56±14.75) mmHg, respectively, before and 3 months after treatment. RRP was (6.52±0.78) mmHg and (7.18±1.12) mmHg, respectively. MTV was (213.79±26.88) ml and (198.42±22.75) ml before and 3 months after treatment in the conventional dose group, respectively. MSP was (128.29±16.04) mmHg, (121.19±15.12) mmHg, RRP was (6.46±0.81) mmHg, (7.02±1.05) mmHg, and MTV and MSP were lower than before 3 months after treatment. RRP was higher than that before treatment (P < 0.05), but there was no significant difference between the two groups (P > 0.05). The scores of anal stool control and sensory function were (0.79±0.24) points and (0.79±0.21) points in the high-dose group 3 months after treatment, which were lower than those in the conventional dose group (0.92±0.28) points and (0.95±0.25) points. The score of EQ-5D [(0.91±0.04) points] was higher than that of conventional dose group [(0.85±0.06) points] (P < 0.05). There was no significant difference in the total incidence of postoperative complications between the two groups (P > 0.05). The recurrence rate of high dose group was 0.00%, which was lower than that of conventional dose group (12.24%) (P < 0.05). Conclusion CAEPFS has a certain therapeutic effect in the treatment of grade Ⅱ ~ Ⅲ hemorrhoids. Compared with conventional dose, high-dose foam hardener of laurosinol can improve the cure rate, inhibit inflammatory response, promote anorectal kinetic recovery, improve anal function, improve quality of life, reduce recurrence rate, and have certain safety.

Construction of Nomogram Prediction Model for Hemodialysis Complicated with Pulmonary Infection in Patients with diabetes Nephropathy

李婧 — 2024/10/8 8:57:56

Objective To explore the risk factors of pulmonary infection in patients with diabetes nephropathy after hemodialysis and construct a Nomogram prediction model. Methods Retrospective analysis was used to select 252 patients with diabetes nephropathy who were treated with hemodialysis in our hospital from July 2019 to June 2022 as the study subjects. According to whether they were complicated with pulmonary infection, they were divided into infected group (n=46) and uninfected group (n=206). Compare the medical record data of the two groups of patients, through independent sample t-test and χ 2 Test and analyze the related indicators that affect the pulmonary infection in patients with diabetes nephropathy after hemodialysis treatment; The ROC curve was analyzed by MedCalc software for the measurement indicators with statistical significance, to explore its predictive value for pulmonary infection in patients with diabetes nephropathy after hemodialysis treatment; Logistic regression analysis was used to analyze the independent risk factors of pulmonary infection in patients with diabetes nephropathy after hemodialysis; R language software 4.0 "rms" package was used to build the Nomogram prediction model of diabetes nephropathy patients complicated with pulmonary infection after hemodialysis treatment, and the correction and decision curve were used to carry out internal verification of the Nomogram prediction model and clinical prediction efficiency evaluation. Results There were significant differences between the two groups in age, duration of diabetes, volume load, renal decompensation, ALB, FBG, HbA1c, Hb, Cys-c, hs CRP (P<0.05). AUC of age, course of diabetes, ALB, FBG, Hb, Cys-c, and hs CRP were 0.669, 0.735, 0.880, 0.876, 0.670, 0.832, and 0.857, respectively. The optimal cutoff values were 61 years old, 7.85 years old, 33 g/L, 9.65 mmol/L, 76.49 g/L, 4.82 mg/L, and 6.97 mg/L, respectively. Age, volume load, decompensation period of renal function, ALB, FBG, Cys-c, hs CRP are independent risk factors for pulmonary infection after hemodialysis in patients with diabetes nephropathy. The correction curve of Nomogram prediction model is close to the original curve and ideal curve. The C-index is 0.687 (95% CI: 0.653-0.759), and the model has a high fitting degree; The threshold of Nomogram prediction model is more than 0.23, which can provide clinical net income, and the clinical net income is higher than age, volume load, renal function decompensation period, ALB, FBG, Cys-c, hs-CRP. Conclusion This study constructed a Nomogram prediction model based on the independent risk factors of pulmonary infection in diabetes nephropathy patients after hemodialysis treatment, that is, age, capacity load, decompensation period of renal function, ALB, FBG, Cys-c, hs CRP, to provide reference for clinical nursing of diabetes nephropathy patients undergoing hemodialysis, so as to develop personalized nursing interventions to reduce the incidence rate of pulmonary infection and poor prognosis, Alleviate the patient's pain.

Relationship between serum sCD73, S100A8/A9 and clinicopathological features and prognosis of patients with advanced endometrial cancer treated with PD1/PDL1 inhibitorsJia Tian-han1, Shao Kai2, Yang Fan3, Cai Yu-jie1, Yang Li-yuan1*

Jia Tian-han,,, — 2024/8/30 18:36:03

[Abstract] Objective: To explore the relationship between serum soluble CD73 (sCD73), S100 calcium binding protein A8/A9 (S100A8/A9) and the clinicopathological features and prognosis of patients with advanced endometrial cancer treated with programmed death receptor 1 (PD1)/programmed death ligand 1 (PDL1) inhibitors. Methods: 142 patients with advanced endometrial cancer treated with PD1/PDL1 inhibitors in our hospital from March 2020 to February 2021 were selected as the study subjects. The cut-off values of high and low expression of serum sCD73 and S100A8/A9 were analyzed by receiver operating characteristic (ROC) curve, and the differences of clinicopathological features between high and low expression groups of serum sCD73 and S100A8/A9 were analyzed. The 3-year overall survival (OS) of high expression and low expression of serum sCD73 and S100A8/A9 were compared by Kaplan-Meier survival curve analysis. The prognostic factors of patients with advanced endometrial cancer treated with PD1/PDL1 inhibitors were analyzed by univariate and multivariate COX risk proportional regression models. Results: The serum levels of sCD73 and S100A8/A9 in survival group were lower than those in death group (P<0.05). The results of ROC curve showed that, the area under the curve (AUC) of sCD73 and S100A8/A9 were 0.884 and 0.818, respectively, and the optimal cut-off values were 5.295μg/L and 3.055μg/mL, respectively. The proportion of highly differentiated individuals in low sCD73 group is significantly higher than that of poorly differentiated individuals (P<0.05). The proportion of highly differentiated individuals in high S100A8/A9 group was significantly higher than that of poorly differentiated individuals (P<0.05). The 3-year OS of patients with low sCD73 expression was significantly higher than that of patients with high sCD73 expression (Log rank=91.367, P<0.001). The 3-year OS of patients with low S100A8/A9 expression was significantly higher than that of patients with high S100A8/A9 expression (Log rank=69.852, P<0.001).Multivariate COX analysis showed that, high levels of serum sCD73 and S100A8/A9 were independent risk factors for poor prognosis in patients with advanced endometrial cancer treated with PD1/PDL1 inhibitors (P<0.05). Conclusion: The increase of serum sCD73 and S100A8/A9 levels are closely related to the poor differentiation and poor prognosis of patients with advanced endometrial cancer treated with PD1/PDL1 inhibitors, and the high levels of serum sCD73 and S100A8/A9 are independent risk factors for poor 3-year OS.

Retrospective analysis of the detections of the seven respiratory viruses in children with acute respiratory tract infections from Zhongshan area of Guangdong from 2016 to 2022

黄仁 — 2024/8/30 18:35:18

Objective To investigate the detections of the seven respiratory viruses in children with acute respiratory tract infections (ARTI) in Zhongshan area of Guangdong province,aiming to provide a reference for clinical diagnosis and treatment. Methods The clinical data of children with ARTI undergoing the viral antigen detections of throat swabs aged above 28 days but below 14 years old in Zhongshan Boai Hospital from January 2016 to December 2022 was investigated retrospectively. Results 11210 cases were detected with at least one virus in 49116 specimens among 7 years(22.82%).The positive rate of children aged above 28 days but below 1 year old was highest (28.94%,4734/16359 cases), and the positive rate decreased with the age growth(P<0.001).Totally 11462 viruses were detected.The detection rates were 13.84% for respiratory syncytial virus (RSV),3.14% for influenza virus (IFV) A,2.45% for human Adenovirus(HAdV),1.76% for human parainfluenza virus (HPIV) 3,1.15% for IFV-B, 0.68% for HPIV-1 and 0.32% for HPIV-2.The differences?of the detection rates of the 7 viruses in different years and different seasons were statistically significant respectively(all P<0.001).The detection rate of RSV was highest in 2020(19.15%) and lowest in 2022(7.74%).The RSV was mainly detected in summer and winter.The detection rates of HPIV-2 in different age groups were not significantly different(P=0.510),while the detection rates of the rest viruses were significantly different in different age groups respectively(all P<0.001).RSV(22.32%) and HPIV-3(2.90%) were mainly detected in children aged above 28 days but below 1 year old.The detection rates of IFV-A and IFV-B increased significantly with age growth.The detection rate of HAdV was highest in children aged 3~ < 6 years old(4.30%).There were not significantly different in the detection rates of HPIV-1 and HPIV-2 among children with different diseases respectively(all P>0.05),while the detection rates of the rest viruses were significantly different in different diseases respectively(all P<0.001).RSV was mainly detected in children with acute asthmatic bronchitis,while IFV-A,HAdV and IFV-B had the highest detection rates in children with acute upper respiratory tract infections. Conclusions RSV,IFV-A and HAdV are the main viruses in children with ARTI in Zhongshan area of Guangdong Province.The viruses are mainly detected from infants.The distributions of the viruses were different in years, seasons,ages and diseases.

Study on the effect of warm acupuncture combined with platelet-rich plasma intrauterine perfusion on the pregnancy outcome of freeze-thaw embryo transfer in patients with thin endometrium

linchunlian,, — 2024/8/30 18:34:33

Objective To explore the influence of warm acupuncture and moxibustion combined with platelet-rich plasma (PRP) intrauterine perfusion on endometrial thickness and pregnancy outcome of frozen-thawed embryo transfer in patients with thin endometrium of kidney deficiency and blood stasis type, to provide a theoretical basis and a new way for the treatment of thin endometrium. Methods From January 2020 to December 2022, 154 patients who underwent in vitro fertilization and embryo transfer at the Reproductive Medicine Center of Qinzhou Maternal and Child Health Hospital were diagnosed with thin endometrium of kidney deficiency and blood stasis type by combining traditional Chinese and Western medicine, and currently have four or more embryos remaining and plan to undergo frozen and thawed embryo transfer. Based on the treatment method, the patients were divided into four groups: A, B, C, and D. Group A showed that the endometrium was still thin after receiving artificial cycle treatment. A total of 27 patients were informed through communication that there was a risk of transfer failure and recommended canceling the cycle, but it still required frozen-thawed embryo transfer. Group B was treated with hormone replacement cycle warm acupuncture and moxibustion, group C was treated with hormone replacement cycle intrauterine perfusion of platelet-rich plasma, and group D was treated with hormone replacement cycle warm acupuncture and moxibustion+intrauterine perfusion of platelet-rich plasma. The previous cycle of treatment in groups B, C, and D was used as a self-control to compare the endometrial thickness on the conversion day before and after treatment in groups B, C, and D; Compare the endometrial thickness, clinical pregnancy rate, early abortion rate, embryo implantation rate, and other indicators on the conversion day in groups A, B, C, and D. Results There were no significant differences in age, previous pregnancy times, infertility years, BMI, AMH, basal endometrial thickness, basal FSH, basal LH, basal E2 among the four groups (P>0.05), and the groups were comparable. After treatment, the intima of patients in groups B, C, and D increased compared to the previous cycle, with a statistically significant difference (P<0.05). There was no statistically significant difference in the number of embryos transferred between groups A, B, C, and D (P>0.05). The endometrial thickness of group D was thicker than that of groups A, B, and C on the conversion day among the four groups, and there was a statistical difference (P<0.05). The clinical pregnancy rate (55.6%) and biochemical pregnancy rate (61.10%) in group D were higher than those in the other three groups (P<0.05). Among the four groups of patients, the clinical pregnancy rate (55.6%) and biochemical pregnancy rate (61.10%) in Group D were higher than those in the other three groups (P<0.05), as shown in Table 5. The early abortion rate among the four groups was the highest in Group A (100.00%) and the lowest in Group C (5.00%), but there was no statistical difference (P<0.05). Conclusion Warm acupuncture and moxibustion, platelet-rich plasma perfusion, warm acupuncture, and moxibustion combined with platelet-rich plasma intrauterine perfusion can improve the endometrial thickness of patients with thin endometrium, but warm acupuncture and moxibustion combined with platelet-rich plasma intrauterine perfusion can significantly improve the clinical pregnancy rate of patients with kidney deficiency and blood stasis.

The therapeutic effect of transplantation of Ologen collagen matrix and corneal limbal stem cells on pterygium

Wu Qin, — 2024/8/30 18:33:47

Objective: In order to improve eye function and refractive status, to explore the clinical efficacy of Ologen collagen matrix implantation and corneal limbal stem cell transplantation in patients with pterygium. Method: 180 patients with pterygium were selected as the research subjects and randomly divided into two groups using the number table method. They were treated with pterygium excision surgery combined with Ologen collagen matrix implantation method and pterygium excision surgery combined with corneal limbal stem cell transplantation method, respectively. International standard visual acuity chart and Zeiss iolmaster 700, corneal astigmatism assessment for refractive status; Tear secretion and tear film rupture were observed to observe tear film function; Observation of treatment comfort, statistics of wound healing and effective rate.Result: There were interactions between different time points and time points of UCVA, CAD, BUT, SIT in each group of patients (FUCVA group=542.100, PUCVA group<0.001, FUCVA time=87.750, PUCVA time<0.001, FUCVA group<0.001) × Time=21.190, PUCVA inter group × Time<0.001; FCAD inter group=678.000, PCAD inter group<0.001, FCAD time=69.460, PCAD time<0.001, FCAD inter group × Time=20.750, PCAD inter group × Time<0.001; FBUT inter group=874.000, PBUT inter group<0.001, FBUT time=574.400, PBUT time<0.001, FBUT inter group × Time=152.200, between PBUT groups × Time<0.001; FSIT inter group=998.700, PSIT inter group<0.001, FSIT time=657.300, PSIT time<0.001, FSIT inter group × Time=172.200, PSIT inter group × Time<0.001); The corneal limbal stem cell transplantation combined with surgery group showed an increase in comfort and healing efficiency, a shortened wound healing time, and a decrease in recurrence rate at 6 months after surgery (X2=6.207, P=0.013). Conclusion: This article innovatively proposes to perform corneal limbal stem cell transplantation and Ologen collagen matrix implantation in patients with pterygium, with corneal limbal stem cell transplantation having a more significant clinical effect.

Risk Factors for Deep Venous Thrombosis in Ambulatory Patients with Lung Cancer: Establishment and Validation of a Nomogram

CHANG Xindong,FANG Qingqing,HE Mingfei,TANG Ming, — 2024/8/30 18:32:55

Objective This study aimed to establish and validate an individualized Nomogram model for predicting the risk of deep venous thrombosis (DVT) in ambulatory patients with lung cancer. Method A retrospective analysis was conducted on clinical data from 330 hospitalized lung cancer patients between January 2022 and January 2023. These patients were divided into two groups, the DVT group (33 cases) and the non-DVT group (297 cases), based on whether they complicated with DVT. LASSO regression and multivariable Logistic regression were used to identify independent risk factors for DVT among ambulatory lung cancer patients. Subsequently, a Nomogram model was constructed based on these identified factors, and internal validation was conducted to evaluate the accuracy, consistency, and clinical utility of the model. Result Smoking history, hypertension, use of anti-angiogenic drug, D-dimer levels, and albumin levels were identified as independent predictors of DVT in ambulatory lung cancer patients (P < 0.05), then a Nomogram model was established based on these factors. The receiver operating characteristic curve (ROC) of the Nomogram model had an area under curve (AUC) value of 0.881(95% CI: 0.811-0.950); Hosmer-Lemeshow goodness of fit test yielded non-significance（χ2=7.484, P=0.486）and the calibration curve displayed good consistency between the predicted results and the actual observed outcomes. According to decision curve analysis (DCA), the predictive model held considerable clinical application potential within the threshold probability range of 0.07 to 0.95. The clinical impact curve (CIC) showed that within the threshold probability range, the number of DVT patients predicted by the model consistently exceeded the actual number of DVT patients. Conclusion The Nomogram model constructed based on the above-mentioned five influential factors demonstrated both excellent predictive capability and clinical practicality for assessing the risk of DVT in ambulatory lung cancer patients.

Transcriptomics-based reveals molecular signaling pathways in rheumatoid arthritis combined with osteoporosis

Jian Congcong,Wang Huan,Wang Tingting,,Yang Li,Zeng Fanxin — 2024/8/30 16:36:45

Osteoporosis (OP) is one of the most common comorbidities of rheumatoid arthritis (RA). RA combined with OP can exacerbate bone destruction, increase the risk of fractures, reduce patients' quality of life, and increase social burden. The etiology is complex and the pathogenesis is not fully understood. The treatment of RA combined with OP is currently a difficult point in clinical work. Transcriptome technology provides a new means to understand gene regulation and various biological processes, identify key genes and signaling pathways, and promote the development of disease diagnosis and treatment. This article provides a review of the research progress on the RA combined with OP signaling pathway based on transcriptomics.

Progress in clinical studies of TyG index

Guo Peijun,Han Yunbiao,,,, — 2024/8/30 11:54:17

TyG index is a biomarker of IR, which is closely related to the metabolic changes of the body, and metabolic changes often occur in the early stage and progression of a variety of diseases, which makes TyG index one of the indicators for the assessment and prediction of certain diseases. By monitoring the changes of TyG index, metabolic abnormalities can be detected early, which can help early intervention and treatment, and reduce the incidence and progression of related diseases. Therefore, TyG index has an important clinical value and can be used as one of the important bases for disease prediction and evaluation in the future. By summarizing the relevant literature, this paper hopes to provide some help for the clinical application of this index in the future.

The application and advances of stem cell therapy in treating acute myocardial infarction

LV Yong-bo, — 2024/8/30 11:53:29

Acute myocardial infarction is caused by various causes (obstructive or non-obstructive) which lead to a sharp reduction or interruption of blood supply to the heart, resulting in severe and persistent ischemia of the corresponding myocardium, ultimately causing necrosis of cardiomyocytes. Due to its potential of multilineage differentiation and self-renewal, stem cell therapy has been widely used for cardiac regeneration after myocardial infarction. In this review, we propose to fully review this topic from five aspects: the origin of stem cell therapy, the commonly used stem cell types, the existing problems, the mechanism of action and new strategies for improving stem cell therapy.

Effects of continuous nursing on quality of life in patients with targeted tumor therapy: a meta-analysis

胡丽莎 — 2024/8/30 11:52:15

Objective: To systematically explore the impact of continuous care on the quality of life of targeted therapy patients, and provide evidence-based basis for the care of tumor targeted therapy patients. Method: A randomized controlled trial was conducted to search for the effects of continuous care on the quality of life of targeted treatment patients in Cochrane Library, EMbase, PubMed, CINAHL, SinoMed, Web of Science,VIP, CNKI, Wanfang, World Oncology Network, and the National Cancer Comprehensive Network of the United States. From the establishment of the database to October 1, 2022, retrieval will begin. Independently screen, evaluate, extract, and summarize literature by three evidence-based practice teams from hospitals, while conducting meta-analysis using RevMan 5.3 software. The results： A total of 10 articles were included, with a total of 795 patients.The results of meta-analysis indicate that continuous care can significantly improve social function [SMD=1.47,95% CI (1.00,1.93), Z=6.19, P<0.01], physical function [SMD=1.77,95% CI (1.22,2.32), Z=6.33, P<0.01], emotional function [SMD=0.89,95% CI (0.51,1.28), Z=4.54, P<0.01], cognitive function [SMD=0.89,95% CI (0.51,1.28), Z=4.54, P<0.01] Role function [SMD=1.13,95% CI (0.21,2.05), Z=2.40, P=0.02] and comprehensive function [SMD=1.05,95% CI (0.68,1.43), Z=5.30, P<0.01]. Conclusion: Continuing care can improve the quality of life of tumor targeted treatment patients, and enhance their social, physical, emotional, cognitive, role, and comprehensive functions. At present, there is insufficient evidence for continuing care research on targeted therapy, and the sample size and research quality need to be improved. High quality randomized controlled trials are needed for validation in the future.

Acute suppurative thyroiditis with massive abscess formation: A case report

huan,linweipeng,linyaqi,luoguang,,wangweilong — 2024/8/30 11:51:16

Acute suppurative thyroiditis (AST) is a rare non-specific infectious disease in clinical practice. It is atypical at the early stage of onset. Its clinical manifestations are similar to those of subacute thyroiditis (SAT) and other diseases, which is likely to lead to misdiagnosis and mistreatment. However, as the disease progresses, it will form abscess, with serious consequences such as systemic poisoning symptoms, painful mass in the neck, and even suffocation due to compression of the trachea. Therefore, improving clinical understanding of this disease is of great significance. We report a case of acute suppurative thyroiditis with typical clinical manifestations and massive abscess formation, and review the literature for analysis and discussion.

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zhumei — 2024/8/30 11:50:32

Impacts of active circulatory breathing technology combined with high-flow humidified oxygen therapy on respiratory muscle function and aspiration in stroke patients undergoing tracheotomy

WANG Ling — 2024/8/30 11:49:45

Objective To investigate the impacts of active circulatory breathing technology combined with high-flow humidified oxygen therapy on respiratory muscle function and aspiration in stroke patients undergoing tracheotomy. Methods A total of 70 stroke patients with tracheotomy who were hospitalized in our hospital from May 2022 to May 2023 were collected and randomly separated into a combined group and a reference group according to the number table method. The reference group received high-flow humidified oxygen therapy, while the combined group received active circulatory breathing technology combined with high-flow humidified oxygen therapy. The sputum viscosity, respiratory muscle function, lung function, Rosenbek leakage aspiration scale (PAS), and functional independence measurement (FIM) scale scores were compared between the two groups. Results After intervention, the proportion of sputum viscosity grade I~II in the combined group increased, and the combined group(54.29%) was higher than the reference group(28.57%); the proportion of patients with grade III-IV decreased, and the combined group(45.71%) was lower than the reference group(71.43%) (P<0.05); after intervention, the maximum expiratory pressure (MEP) and maximum inspiratory pressure (MIP) of both groups increased, and the combined group[(74.05±6.64) cmH2O, (76.73±6.81) cmH2O] were higher than the reference group (P<0.05); after intervention, the forced expiratory volume in first second (FEV1), peak expiratory flow rate (PEF), and FEV1/FVC of both groups increased, and the combined group[(2.74±0.43)L, (3.28±0.47)L, (83.54±9.15)%] were higher than the reference group [(1.68±0.40)L, (2.67±0.43)L, (62.92±9.30)%](P<0.05); after intervention, the PAS scores of both groups decreased, and the combined group(1.74±0.40) scores was lower than the reference group(2.51±0.47)scores; both groups showed an increase in FIM score, and the combined group(78.34±4.35)scores was higher than the reference group(70.54±4.17) scores (P<0.05). Conclusion The combination of active circulatory breathing technology and high-flow humidified oxygen therapy can improve respiratory muscle function and lung function, reduce sputum viscosity, reduce aspiration, and improve patients' quality of life.

Investigate the effects of iron overload on T lymphocyte subsets and survival in newly diagnosed myelodysplastic syndromes

duanlixiang,jiaoxiaolin,liliang,mayaofang,taoyongming,yuwenjun,zhaodan — 2024/8/30 11:49:01

Objective To investigate the effects of iron overload on T lymphocyte subsets and survival in newly diagnosed myelodysplastic syndromes (MDS). Methods We conducted a retrospective analysis of 58 newly diagnosed MDS patients who were treated in the hospital from January 2018 to December 2023. According to ferritin≥1000ng/ml, the patients were divided into iron overload group and non-iron overload group. Clinical data of the two groups were collected. Serum ferritin, transferrin saturation, T lymphocyte subsets and survival outcomes. Results Iron metabolism indexes had significant differences between the two groups (P < 0.05). CD3+, CD4+ and CD8+T lymphocyte count were significantly decreased in iron overload group compared with non-iron overload group (P < 0.05). The median survival time of iron overload group was shorter than non-iron overload group (P=0.020). Cox regression analysis suggested that iron overload and IPSS-R were independent predictors of survival in MDS patients. Conclusion Iron overload can selectively affect peripheral blood T lymphocytes, iron overload may be one of the poor prognostic factors in newly diagnosed MDS.

Attention Bias Characteristics of Depression-prone and its Relationship with Rumination in Wilson Disease.

闻晓 — 2024/8/30 11:48:18

[Abstract] Objective To investigate the attention bias characteristics of negative emotion processing and its relationship with rumination in patients with Wilson disease. Methods 40 inpatients with Wilson's disease were evaluated by Beck Depression Inventory and Ruminative Responses Scale, and emotional processing attention bias experiment was conducted by emotional stroop paradigm. Results In WD patients, the response times measured under the positive, negative and neutral words in the depression group were significantly higher than the nondepression group and the differences were statistically significant (all P<0.05). Correlation analysis showed that the mean score of Beck Depression Inventory and in WD patients were positively correlated with the mean score of rumination (38.0±11.2), symptom rumination (19.8±6.4), obsessive thinking (10.0±3.4) and introspection (8.0±2.9) (r＝0.750, 0.766, 0.686, 0.324, all P<0.001), in addition, the response times of negative and neutral words were positively associated with rumination and symptom rumination (P<0.05). Multiple linear regression analysis showed that the average score of Beck Depression Inventory were the influencing factors for the measured responses to positive, negative and neutral emotion words (P<0.05) . Conclusion In Wilson's disease, depression can lead to pay too much attention to negative emotions, showing that the more severe the depression, the more likely the individuals will show attention bias to negative emotions, and the attention bias is the cognitive mechanism of rumination.

陈远洋，伍宏琪,蒋柯,徐贺辰，邹小华(通信作者) — 2024/8/30 11:47:28
【Objective】 Comparison of the effects of applying remimazolam and propofol, respectively, in combination with sufentanil on the quality of postoperative recovery in elderly patients requiring gastroscopy. 【Methods】In this study, 134 elderly patients who were scheduled to undergo painless gastroscopy between January 2022 and June 2022 were screened and randomly divided into two groups of 67 patients each, with sufentanil and remimazolam used in Group A and sufentanil and propofol used in Group B.. In both groups, sufentanil 0.15 μg/kg was injected intravenously before the start of gastroscopy, and the administration time was 30 s. After 3 min,remimazolam 0.15 mg/kg or propofol 1.5 mg/kg was injected intravenously and the administration time was 1 min. After the end of the administration, the MOAA/S scores were evaluated every 30 S. Gastroscopy was carried out after the patients" MOAA/S scores ≤ 3 points. The quality of postoperative recovery was compared between the two groups according to the QoR-15 scale, as well as the time of gastroscopy operation, the efficiency of sedation, the onset time and the awakening time of the two groups, the mean arterial blood pressure at the time of entry into the operating room (T1), the start of sufentanil administration (T2), the start of remimazolam/propofol administration (T3), at the time of microscope removal (T4), 3min after microscope removal (T5), 5min after microscope removal (T6), and the mean arterial blood pressure after microscope withdrawal ( T7); changes in mean arterial blood pressure (MAP), heart rate (HR), and oxygen saturation (SpO2), and respiratory rate (RR); and vasoactive drug use, number of anesthetic additions, and adverse events in the 3 groups.【Results】The sedation efficiency of the two groups was 100%, and there was no difference in the time of gastroscopy operation, onset of action, and awakening time between the two groups (P > 0.05).Comparison of the scores on the QoR-15 scale on the first postoperative day between the two groups, ① the overall score of the remimazolam group was higher than that of the propofol group ,(P < 0.01).② In the five dimensions of the QoR-15 scale in the five dimensions of the QoR-15 scale, the remimazolam group scored higher than the propofol group in pain, physical comfort and physical independence, the emotional state score of the propofol group was higher than that of the remimazolam group (P < 0.01), and there was no significant difference between the two in the psychological support score (P > 0.05). ③ The number of people who reached the excellent grade was higher in the remimazolam group than in the propofol group(P < 0.001). Comparison of HR (heart rate), MAP (mean arterial pressure), SpO2 (oxygen saturation) and RR (respiratory rate) between the two groups at T1, T2, T3, T4, T5, T6 and T7 time points, ① There were differences in MAP and SpO2 at different time points (P < 0.05); ② There were differences in MAP, SpO2 and HR between the two groups (P < 0.05); ③ There was a trend of MAP, HR, MAP, HR, SpO2, and RR in the 2 groups were different (P < 0.05), and the trend was smaller in the remimazolam group than in the propofol group. Comparison of the incidence of adverse reactions in the 2 groups: ① the incidence of adverse events other than somatic reactions in group A was lower than that in group B (P < 0.05); ② the incidence of total adverse reactions in group A was lower than that in group B (P < 0.001). Comparison of the number of drug additions and the use of vasoactive drugs: ① The number of vasoactive drugs used in Group A was lower than that in Group B (P < 0.05) ② The number of drug additions in Group A were lower than that in Group B(P < 0.05).【Conclusions】0.15 mg/kg remimazolam combined with 0.15 μg/kg sufentanil in elderly patients requiring painless gastroscopy can obtain effective sedation, stabilize intraoperative hemodynamics, reduce the incidence of intraoperative adverse events, and improve the quality of their postoperative recovery.

The anti-photoaging effect of dental pulp stem cells-conditioned medium combined with LDH nanomaterials on HaCaT cells

QIU Liuliu,, — 2024/8/30 11:46:29

Objective To investigate the effect of dental pulp stem cells-conditioned medium(DPSCs-CM) combined with LDH nanomaterials on photoaged human immortalized keratinocytes(HaCaT cells) and explore the underlying mechanism. Methods The DPSCs-CM was prepared. The LDH nanomaterials were synthesized and characterized. Except for the control group and model group, HaCaT cells were pretreated with DPSCs-CM, LDH nanomaterials(LDH), or DPSCs-CM combined with LDH nanomaterials(DPSCs-CM+LDH) for 24 hours. After pretreatment, except for the control group, the rest of the HaCaT cells were exposed to medium-wave ultraviolet(UVB) radiation. Immediately post irradiation, the malonaldehyde(MDA) content, superoxide dismutase(SOD) activity and reactive oxygen species(ROS) levels in the HaCaT cells of each group were measured using the corresponding detection kit, and the migration ability of HaCaT cells in each group was detected by cell scratch assay. After 72 hours irradiation, the expression levels of p53 and p16 proteins in the HaCaT cells of each group were detected by Western Blot. Results The LDH nanomaterials with good stability and dispersibility were successfully synthesized. In vitro functional experiments showed that HaCaT cells pretreated with DPSCs-CM combined with LDH nanomaterials(DPSCs-CM+LDH) exhibited reduced levels of ROS and content of MDA, increased SOD activity, improved migration ability, and decreased expression levels of p53 and p16 proteins in the cells after receiving UVB irradiation (P<0.01).　Conclusion Pretreatment with DPSCs-CM combined with LDH nanomaterials can enhance the efficacy of DPSCs-CM alone in counteracting photoaging of HaCaT cells, providing a new direction for in vitro research on anti-skin photoaging.

Investigation and analysis of the prevalence rate of infection in a geriatrics hospital from 2013 to 2022

weijinhua,, — 2024/8/22 10:13:47

Abstract: Objective The trend of nosocomial infection in a geriatric specialty was analyzed, the utilization rate of antibacterial drugs, bacterial culture and examination rate of inpatients were understood through cross-sectional study, and the correlation of nosocomial infection trend was analyzed, so as to provide reference for determining the key points of nosocomial infection prevention and control and provide basis for scientific prevention and control. Methods From 2013 to 2022, a retrospective analysis was conducted on the prevalence of nosocomial infection among all hospitalized patients on a single day in July each year for 10 consecutive years, using a cross-sectional investigation method combining bedside survey and medical records. Cross-sectional analysis was conducted to analyze the prevalence rate of infection, infection site, Infectious agent and utilization rate of antibacterial agent. The data were checked, summarized and analyzed statistically by the sensory department. Results From 2013 to 2022, the average morbidity rate of hospital was 2.01%, the difference was statistically significant (χ2 = 37.46, P < 0.05). The nosocomial infection rate showed a decreasing trend, and the difference was statistically significant (χ2 =36.98, P < 0.05). The prevalence of infection was mainly in medicine and surgery. The infection rate was higher in the lower respiratory tract infection, followed by urinary tract infection and upper respiratory tract infection. The pathogens detected in nosocomial infection were mainly Gram-negative bacteria. The second was gram-positive bacteria; Then there are fungi and other pathogens. Conclusion The cross-sectional survey of infection in the past 10 years showed that the incidence of nosocomial infection in the hospital showed a downward trend, and the infection prevention and control work had achieved certain results. Lower respiratory tract and urinary tract infections are the most common high-incidence sites in elderly patients.

Research progress on the mechanism of distraction osteogenesis

Ding Si Cheng, — 2024/8/20 10:59:51

Distraction osteogenesis plays an irreplaceable role in the treatment of bone defects, but how mechanical stretch promotes bone tissue regeneration has always been a mystery. This review describes the whole process of sensing, transduction, transmission and response of MC3T3-E1 cells to mechanical stretch from the cellular level, revealing the possibility of mechanical stretch promoting bone tissue regeneration mechanism. This review can provide some help for the development of biotechnology including gene engineering, protein engineering, cell engineering, etc., and contribute to the research and development of targeted drugs in clinical disease treatment.

Analysis of the Therapeutic Effect of Acostream Thrombectomy System in the Treatment of Lower Limb Deep Vein Thrombosis Combined with Iliac Vein Compression Syndrome

Li Jingjing,Pang Hongyong,Suo Feifei,Tian Ke,Zhai Gang — 2024/8/13 10:06:37

Objective To explore t he clinical efficacy and safety of the AcoStream thrombectomy system for the treatment of lower limb deep vein thrombosis (LDVT) combined with iliac vein compression syndrome (IVCS). Method: A total of 71 patients with acute LDVT combined with IVCS who were treated at the hospital from June 2020 to December 2022 were collected and analyzed. According to the surgical plan, they were divided into an observation group (n=29 treated with Acostream thrombus clearing system combined with CDT) and a control group (CDT n=42 treated with single pure catheter contact thrombolysis). Compare and analyze the therapeutic effects of surgical treatment for LDVT combined with IVCS between two groups of patients, and compare the therapeutic indicators, including thrombus clearance rate, thigh circumference difference before and after surgery, calf circumference difference, Villalta score, etc; Compare perioperative related indicators, including changes in hemoglobin before and after surgery, postoperative use of urokinase, length of hospital stay, and time to D-dimer peak. Results After a follow-up of 6-12 months, the thrombus clearance rate in the observation group was higher than that in the control group, with a statistical difference (P<0.05); The level of thrombolysis in the observation group was better than that in the control group, with a statistically significant difference (P<0.05). There was no statistically significant difference (P>0.05) in the preoperative circumference of the legs between the two groups of patients. Six months after surgery, the difference in circumference of the legs between the two groups was smaller than before surgery, and the difference was statistically significant (P<0.01); The Villalta score comparison showed that the observation group was lower than the control group, and the difference was statistically significant (P<0.05). In other perioperative comparisons, the observation group had a lower postoperative use of urokinase compared to the control group (P<0.01), and a shorter hospital stay compared to the control group, with a statistically significant difference (P<0.01). The changes in hemoglobin before and after surgery were significantly higher in the observation group than in the control group (P<0.01), but no severe anemia events occurred; The peak time of D-dimer after surgery was earlier in the observation group than in the control group (P<0.01). Conclusion: The combination of Acostream thrombus clearance system and CDT in the treatment of LDVT combined with IVCS has a high degree of thrombus clearance, significant postoperative symptom relief, fast recovery, low dosage of thrombolytic drugs, short thrombolysis course, and short hospital stay, which has significant advantages.

The effect of testicular cancer antigen OY-TES-1 expression on the polarization of M2 macrophages in glioblastoma

liangguo,luobin,nongweixia,,zengzhaoyue,zhangqingmei,zhaozhenkai — 2024/8/12 17:37:26

Objective Investigating the impact of OY-TES-1 expression in glioblastoma on M2 polarization of macrophages.Methods By analyzing the correlation between OY-TES-1 and macrophage-associated phenotypic markers in glioblastoma using bioinformatics, stable knockdown of OY-TES-1 in U251 glioblastoma cell line was achieved using SH-RNA technology. Knockdown efficiency was detected using qRT-PCR and protein immunoblotting, resulting in U251-SH-NC and U251-SH-OY-TES-1 cell lines. The conditioned medium was collected after culturing U251-SH-OY-TES-1 cells in serum-free DMEM medium for 48 hours and used as the experimental medium, while U251-SH-NC was used as the control. THP-1 cells were cultured in a mixture of the two conditioned media and 1640 complete medium at a ratio of 1:1, divided into the experimental group SH-OY-TES-1 and the control group SH-NC. Changes in the secretion of TGF-β and IL-10 were detected using ELISA at 0, 2, and 4 days, and the morphology of the cells in both groups was observed under a microscope after 4 days. CD206 was detected using flow cytometry.Result The ELISA results showed that the levels of TGF-β and IL-10 in the supernatant of both groups increased over time. On day 0, compared to the control group, there was no significant difference in IL-10 levels in the experimental group, but there was a statistically significant decrease in TGF-β levels (P＜0.05). On day 2, the experimental group had lower levels of TGF-β compared to the control group, with a statistically significant difference (P＜0.01), but there was no statistical difference in IL-10 levels. On day 4, the experimental group had lower levels of IL-10 and TGF-β in the supernatant compared to the control group, with statistically significant differences (IL-10: P＜0.05, TGF-β: P＜0.001). Under microscopic observation, compared to the control group, the experimental group had a lower proportion of adherent cells and M2-type cells with elongated bipolar morphology. Flow cytometry analysis of M2 macrophages showed a decrease in CD206 expression on the surface of THP-1 cells in the experimental group compared to the control group, with a statistically significant difference (P＜0.01).Conclusion Expression of OY-TES-1 in glioblastoma promotes polarization of M2 macrophages.

Application Of Group Social Intervention Combined With Targeted Family Intervention In Children With Autism Spectrum Disorder

GONGTIANTIAN, — 2024/8/12 11:23:16

【Abstract 】Objective: To observe the effects of group social intervention combined with targeted family intervention on the social and cognitive abilities of children with Autism Spectrum Disorder (ASD).Method:A total of 52 children with autism spectrum disorder who met the inclusion criteria were selected as the study subjects, and were divided into study group (26 cases) and control group (26 cases) according to random number table method. The control group received routine group social intervention training, and the study group received accurate family intervention based on routine group social intervention training. Before treatment and 6 months after treatment, the children in the 2 groups were respectively treated with Psychoeducational Scale 3 (PEP-3 scale), Autism Efficacy Assessment Scale (ATEC Scale), Childhood Autism Rating Scale (CARS Scale), Neuropsychological development Scale for children aged 0 to 6 years (Child Heart Scale), and parent Anxiety Self-rating Scale (self-rating Scale) Anxiety Scale (SAS) rating.result:Before treatment, there were no significant differences in general information and related scales between the two groups (P>0.05). After treatment, the total score of ATEC, CARS and SAS in 2 groups were lower than before treatment, and the study group was significantly lower than the control group, the difference was significant (P<0.05). The scores of PEP-3, adaptability of child heart scale, language and social behavior in 2 groups were higher than those before treatment, and the study group was significantly higher than the control group, the difference was significant (P<0.05). After treatment, there was no statistical significance in gross motor and fine motor scores (P>0.05).Conclusion:Group social intervention combined with targeted family intervention can improve the social, cognitive and self-care ability of children with ASD.

Meta-analysis of tumor mutation burden in predicting the efficacy of immune checkpoint inhibitors in patients with gastrointestinal cancer

赖祥丽 — 2024/8/12 9:36:08

Objective: To systematically evaluate the predictive effect of Tumor mutation burden (TMB) on the efficacy of immunotherapy in patients with gastrointestinal cancer. Methods: PubMed, Web of Science and Cochrane Library were searched for articles published in the 2021 from inception to December, objective response rate (Orr) , progression-free survival (PFS) and overall survival (OS) were evaluated objectively. Results: A total of 12 articles were included in this study, including 1126 patients with gastrointestinal malignancies who received immunotherapy, patients with high TMB had longer overall survival than those with low TMB (HR = 0.71,95% CI: 0.51,0.97, P = 0.031) , while the former had a higher objective response rate (OR = 4.22,95% CI: 2.58,6.90, P = 0.000) , however, there was no significant difference in progression-free survival between the two groups (HR = 0.77,95% CI: 0.48,1.23, P = 0.276) . Conclusion: High tumor mutational load may be beneficial to the objective response rate and prolong the overall survival in patients with gastrointestinal cancer receiving immunotherapy, tumor mutation burden can be used as a predictor of the response to immunotherapy in patients with gastrointestinal cancer.

Clinical Research on the Treatment of Seminal Vesicle Diseases by MRI Localization of Seminal Vesicle with F4.8 Visual Puncture Ultramicroscope? Feng Zou, Guofei Zhang,? Wansong Zhang,et al.? Department of Urology Surgery, The Seventh Affiliated Hospital of Southern Medical University,foshan528244,China

zoufeng — 2024/8/9 17:35:18

Objective? To investigate the clinical value of MRI location of seminal vesicle with F4.8 visual puncture ultramicroscope in the treatment.Methods A total of 17 patients with hematospermia with the inclusion and exclusion criteria who were hospitalized in the Department of Urology, the Seventh Affiliated Hospital of Southern Medical University from January 2021 to March 2023 were selected. Before surgery, magnetic resonance imaging of seminal vesicle was conducted, seminal vesicle examination and surgical treatment were performed by visual puncture ultramicroscope, then perioperative conditions were recorded with the follow up of postoperative symptom improvement and postoperative complications.Results All the 17 patients underwent the examination of seminal vesicle and surgical treatment. The operation time was 43-57 minutes, and the average operation time was (48.65±4.94) minutes. There were 3 cases of intracapsular stones, 8 cases of seminal vesicle stones, 1 case of seminal vesicle cyst, 2 cases of ejaculatory duct cyst, 1 case of seminal vesicle polyp and 2 cases of seminal vesiculitis. There was no rectal injury, external urethral sphincter injury or peripheral organ injury during the operation. Three months after the operation, there was no blood sperm, with 97.6% improvement rate of lower abdominal distending pain and ejaculatory pain. Reexamination of semen analysis (semen red blood cells, white blood cells) and semen berry sugar were in the normal reference value range, without retrograde ejaculation, urinary incontinence, urinary dysfunction, sexual dysfunction and epididymitis complications.Conclusion The treatment of seminal vesicle diseases with F4.8 visual puncture ultramicroscope has the advantages of less trauma, fewer complications and good clinical effect, which can replace the traditional seminal vesicle in clinical application.

Phenotype and genotype analysis of PRRT2 gene mutation-related epilepsy

2024/8/9 11:03:44

Objective To summarize the clinical phenotype and genotype characteristics in children with PRRT2 gene mutation-related epilepsy. Methods The clinical data of 17 children with PRRT2 gene mutation-related epilepsy were retrospectively analyzed. Results ① Among the 17 cases, 9 were male and 8 were female. The median onset age was 5 months. 5 patients had a family history of epilepsy. ② There were various types of epileptic seizures, and a cluster seizures was observed in 10 cases at the initial stage of disease. 8 cases were diagnosed as benign infantile epilepsy (BIE), 4 cases were benign familial infantile epilepsy (BFIE), 1 case was infantile spasms (IS), and 1 case was BFIE + paroxysmal motor-induced dyskinesia (PKD). ③ Most of the patients were well controlled by using one kind of anti-epileptic drug. The last follow-up age ranged from 7 months to 5 years and 3 months, 16 cases were seizure free, and 1 case still had seizures. 4 ceses had cognitive retardation. ④ The results of genetic examination showed that 8 cases were deletion and 9 cases were frameshift mutation in PRRT2 gene, of which 8 cases were c.640_641insC; 7 cases were familial hereditary mutations, 2 cases were de novo mutations. Conclusion The majority of epilepsy caused by PRRT2 gene mutation has onset within 6 months after birth, and cluster seizures are the prominent features at the beginning of the disease. There are various types of epileptic seizures and different phenotypes. Antiepileptic drug monotherapy can effectively control epileptic seizures. A small number of children have different degrees of cognitive retardation. c.640_641insC may be the hot spot mutation site of PRRT2 gene.

Application of open preperitoneal repair in small umbilical hernia in adults

Yang yingxin,, — 2024/8/9 11:03:16

Objective To investigate the clinical effect of open preperitoneal repair using polypropylene flat sheets in the treatment of small umbilical hernia in adults Methods From January 2018 to October 2022 in our department, 88 adult patients with umbilical hernia whose defect diameter is less than 2cm were divided into an open preperitoneal repair group (n=42) and a traditional suture repair group (n=46) according to the random number table. The clinical data and observation results of the two groups were retrospectively analyzed by observing the operation time, intraoperative bleeding, postoperative pain score, postoperative incision healing grade, hospital stay, postoperative serum swelling, local paresthesia, chronic pain and postoperative hernia recurrence in the two groups, and the differences in short-term and long-term clinical effects were compared. Results All 88 patients successfully completed the operation, and there was no statistical difference between the two groups in blood loss during operation, pain score on the 3rd day, wound healing grade, grade of incision healing after operation, hospital stay, postoperative seroma，local paresthesia and chronic pain (all P>0.05). There were statistical differences in operation time, pain scores on the 1st and 2nd day after operation and postoperative recurrence(all P<0.05). Conclusion The open preperitoneal repair for umbilical hernia less than 2cm in adults increases the operation time, but it is recommended because of mild pain in the early postoperative period, low postoperative recurrence rate and no increase in short-term and long-term complications.

The value of HROX index in the early stage of severe pneumonia in children

BAI Zhen-Jiang,CHEN Ying-Qing,,SHI Jin-Jin,YAN Qiu-Li,ZHANG Fang-Yuan — 2024/8/9 11:02:41

To investigate the value of HROX index in the early stage of severe pneumonia in children.Methods A retrospective analysis was conducted on 98 hospitalized children with severe pneumonia in our hospital from February 2020 to December 2022, who were assigned to the severe pneumonia group. During the same period, 100 children with common pneumonia were randomly selected to be assigned to the common pneumonia group.Clinical data of the two groups of children were collected after admission, and HROX was calculated to explore its diagnostic value in severe pneumonia, and its correlation with clinical intervention such as the need for oxygen therapy was analyzed. Results The CRP, PCT, IL-6, LDH and D-dimer levels in the severe pneumonia group were higher than those in the common pneumonia group (P<0.05). The HROX index in the severe pneumonia group was 54.08±22.89, which was significantly higher than that in the common pneumonia group (25.84±7.07) (P<0.001).Multivariate logistic regression analysis showed that serum PCT (OR=1.570; 95% CI, 1.142 2.157; P=0.005), IL-6 (OR=1.028; 95% CI, 1.001 1.057; P=0.042), D-dimer (OR=18.697; 95% CI, OR=18.697; 95% CI, 1.091 320.405; P=0.043), and HROX (OR=1.211; 95% CI, 1.038-1.414; P=0.0150) were independent risk factors for the occurrence of severe pneumonia (P<0.05).The areas under the curves of serum PCT, IL-6, D-dimer, and HROX were 0.981, 0.896, 0.826, and 0.907, respectively. The area under the ROC curve of HROX for oxygen inhalation intervention in children was 0.902 (P<0.05).Conclusions The HROX index has certain reference value in early diagnosis of severe pneumonia and determining whether children need oxygen therapy.

Mutation of FZD4 gene in patients with FEVR

岑超,龚立艳,何俐莹,黎琦,李春梅,刘娅,陶雪莹,周文轲 — 2024/8/9 11:02:08

Objective: To review the pathogenic genes and their potential in children with familial exudative vitreoretinopathy (FEVR). To analyze the mutation type and frequency of FZD4 gene in different regions, and to analyze the relationship between genotype and phenotype. Step by step to expand the genetic database of FEVR diseases. Methods: A total of 300 children from 90 families in Chongqing area and 49 children from 16 families in Xinjiang area were included in this study. Retinal imaging system RetcamIII was used for fundus photography in all patients. Peripheral blood was collected from all patients, and 10 gene coding exon regions were sequenced. Results: There were 4 progenitors (4.44%) with FZD4 gene mutation in Chongqing and 1 progenitors (6.25%) with FZD4 gene mutation in Xinjiang. There was no statistical difference in FZD4 gene mutation rate between Chongqing and Xinjiang, and no statistical difference in gene mutation rate between different genders and different nationalities (P>0.05). In the 4 cases of children with FZD4 gene mutation detected in Chongqing area, binocular disease was observed. In the stages of FEVR, stage 1 3 eyes (37.5%), stage 2A 3 eyes (37.5%), stage 2B 2 eyes (25%), and stage 3, 4 and 5 did not appear. Conclusion: Early screening of neonatal eye disease combined with genetic testing can achieve early detection and treatment of FEVR disease, and reduce the incidence of blindness in children. Mastering the relationship between genotype and phenotype helps to properly provide necessary information for genetic counseling, explore possible means of gene therapy, and cooperate with prenatal fetal genetic diagnosis is of great significance for the prevention of FEVR.

The Best Evidence Summary of Remote training for pulmonary rehabilitation for stable chronic obstructive pulmonary disease patient

曹译丹,刘金霞,覃玉兰,张馨 — 2024/8/7 16:12:06

Objective: To retrieve, evaluate, and integrate the best evidence on remote pulmonary rehabilitation training for patients with stable chronic obstructive pulmonary disease (COPD). Methods:Databases such as Yitong, American Chest Association, CNKI, Wanfang database, UpToDate, BMJ Best Practice, Pubmed, and Web of Science were searched to extract relevant evidence about remote pulmonary rehabilitation training for stable patients with chronic obstructive pulmonary disease at home and abroad. The search time limit was the database establishment until January 1,2024. Quality evaluation, evidence extraction, and summary of the included literature were performed by two investigators. Results: A total of 18 articles were included: 2 guidelines, 1 evidence summary, 6 meta-analyses and systematic reviews, 8 randomized controlled trials, and 1 cohort study. In total, 40 pieces of evidence were identified and categorized into 11 groups: definition, significance, suitable population, setting, multidisciplinary team, telemedicine promotion, remote pulmonary rehabilitation measures, outcome evaluation, monitoring and follow-up, evaluation indicators, and the effects of remote rehabilitation. Conclusion: The study summarized the best evidence on remote pulmonary rehabilitation training for patients with stable COPD and formed specific recommendations. These findings provide evidence-based guidance for clinicians to develop remote pulmonary rehabilitation training programs.

Research progress on minimally invasive surgical treatment of congenital pulmonary airway malformation in children

dao ya,,,,, — 2024/8/7 8:35:27

Congenital pulmonary airway malformation is a rare congenital cystic lung disease. In recent years, with the development of ultrasound resolution technology, its detection rate has shown an upward trend. Congenital pulmonary airway malformation carries the risk of repeated lung infections and malignant transformation, and timely surgical treatment is crucial. Minimally invasive surgery has gradually become the preferred surgical method due to its advantages of minimal trauma and fast recovery. This article reviews the research progress of minimally invasive surgery for the treatment of congenital pulmonary airway malformations.

Research progress of splicing factor PTBP1 in digestive tumors

Li Dongbao,,Zhou Yajing — 2024/8/7 8:34:52

Dysregulation of RNA splicing is one of the important molecular pathological features of tumors, which is closely related to the abnormal expression of splicing factors. Polyrimidine tract binding protein 1 (PTBP1) is a member of the hnRNP family of splicing factors. It is involved in the occurrence and progression of a variety of tumors by regulating proliferation, migration, invasion, autophagy, apoptosis, immune surveillance and metabolic reprogramming. It is a potential clinical application target of digestive tract tumors. As a key splicing factor, PTBP1 regulates the splicing and mRNA stability of target gene precursor mRNA. The novel molecular mechanism of PTBP1 regulating alternative splicing has been further elucidated in gastrointestinal tumors. The purpose of this article is to discuss the role and mechanism of PTBP1 in different digestive system tumors, and to review how it affects the occurrence and development of tumors and how it affects gene therapy and immunotherapy strategies, so as to provide a basis for its further clinical transformation application.

Research advancements in the factors influencing the efficacy of night-wearing orthokeratology lenses in preventing and controlling myopia

Diao chun li,Lai wei xia,,Wu xi xi — 2024/8/6 16:42:32

The incidence rate of myopia is high, and it shows a trend of younger age and higher number. The intervention methods for myopia prevention and control include medication intervention, optical intervention, behavioral intervention, and environmental intervention. Corneal reshaping (OK) lenses are optical products that can effectively prevent and control myopia. Myopic individuals can achieve good naked eye vision by wearing OK glasses at night, without the need for frame glasses during the day, and can effectively delay the growth of the eye axis. Although the effectiveness and acceptance of OK lenses in myopia prevention and control are relatively high, there are individual differences among different wearers, making it difficult to guarantee the effectiveness of myopia prevention and control. This article provides a review of the research progress on factors affecting the prevention and control of myopia with night wearing corneal reshaping lenses.

Connective tissue disease, iron deficiency anemia with idiopathic intracranial hypertension: a case report and literature review

冯潇潇,蒋欣,刘兰兰,吕佩源,齐国松,王晶晶 — 2024/8/6 9:49:49

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Robot-assisted secondary laparoscopic pheochromocytoma resection in children under general anesthesia: a case report

唐小林 — 2024/8/6 9:49:16

Different from the characteristics of traditional pheochromocytoma, pediatric pheochromocytoma is mainly characterized by the 10%-90% rules. Surgical resection of the tumor under general anesthesia is the radical treatment of pheochromocytoma. The regulation of hemodynamics is still a difficult management point for anesthesiologists, and intra-abdominal adhesions need to be considered in the secondary operation. Robotic surgery can reduce the pulling and squeezing of the tumor as much as possible to avoid life-threatening cardiovascular reactions. Therefore, adequate preparation before surgery and reasonable and timely application of vasoactive drugs during surgery are the key elements to ensure hemodynamic stability.

A study on CD4+ CD25+, CD8+ CD28+ in peripheral blood in predicting the prognosis of patients with cervical cancer after laparoscopic radical resection

HUA Hai-qin,HUANG Dan,曾海荣,ZHANG Jian-jun — 2024/7/15 16:07:11

Objective To analyze the value of CD4+ CD25+, CD8+ CD28+ levels in peripheral blood in predicting the risk of poor prognosis of patients with cervical cancer (CC) after laparoscopic radical resection. Methods A retrospective analysis was conducted, the data of 43 CC patients with poor prognosis (mortality, metastasis and recurrence) 3 years after receiving laparoscopic radical resection in our hospital from September 2018 to September 2020 were collected and included in the poor prognosis group; the data of 43 CC patients with good prognosis 3 years after receiving laparoscopic radical resection were collected and included into the good prognosis group; the levels of CD4+ CD25+, CD8+ CD28+ in peripheral blood of patients were detected before operation, the relationship between the preoperative CD4+ CD25+, CD8+ CD28+ levels in peripheral blood and the prognosis of patients with CC after laparoscopic radical resection and the value in predicting the risk of poor prognosis were mainly analyzed. Results The levels of CD4+CD25+, carcinoembryonic antigen (CEA), carbohydrate protein 125 (CA125) in poor prognosis group were higher than those in good prognosis group, while the levels of CD8+CD28+ were lower than those in good prognosis group (P<0.05); Logistic regression analysis suggested that elevated levels of serum CEA, CA125 and peripheral blood CD4+CD25+ levels might be risk factors for poor prognosis of CC patients undergoing laparoscopic radical surgery (OR>1, P<0.05), the increased levels of CD8+CD28+ might be a protective factor for poor prognosis of CC patients after laparoscopic radical resection (OR<1, P<0.05); ROC curve was drawn and found that the AUC of single and combined detection of CD4+ CD25+, CD8+ CD28+ in peripheral blood in predicting the risk of poor prognosis in patients with CC after laparoscopic radical resection were all >0.80, which had certain predictive value; bivariate Spearman linear correlation test showed that there was a negative correlation between CD4+ CD25+ and CD8+ CD28+ levels in peripheral blood of CC patients (rs<0, P<0.05). Conclusion The poor prognosis of CC patients after laparoscopic radical resection may be related to the increase of CD4+CD25+ levels and the decrease of CD8+CD28+ levels in peripheral blood, the levels of CD4+ CD25+, CD8+ CD28+ in peripheral blood has certain value in predicting the poor prognosis of CC patients after laparoscopic radical resection.

Influence of positive reproductive tract infection detection on expressions of MMP-2 and MMP-9 and pregnancy outcomes in pregnant women with term/preterm premature rupture of membranesLi Jie 1, Cheng Mumo 2, Chen Lingling 1, Jie Zonglin 1, Yan Xinyu 1, Zhang Zhijun 1*

李洁,, — 2024/7/15 11:52:52

Objective To analyze the influence of positive reproductive tract infection detection on the expressions of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) and and pregnancy outcomes in pregnant women with term/preterm premature rupture of membranes (PROM). Methods 110 pregnant women with PROM from June 2021 to June 2023 were selected and classified into pPROM infection group, pPROM non-infection group, tPROM infection group and tPROM non-infection group according to the presence or absence of reproductive tract infection and gestational age. The general data, expression levels of MMP-2 and MMP-9 in cervical secretions, complications and maternal-infant prognosis were compared among the four groups of pregnant women, and the relationship between the levels of MMP-2 and MMP-9 in cervical secretions and poor maternal-infant prognosis was analyzed. Results Among the 110 pregnant women with PROM, 68 cases (61.82%) were positive for reproductive tract infection, including 56 cases of single infection and 12 cases of mixed infection. There were no statistical differences in age, gravidity, body mass index (BMI), and smoking and drinking history among pPROM infection group, pPROM non-infection group, tPROM infection group and tPROM non-infection group (P>0.05). The levels of MMP-2 and MMP-9 in pPROM infection group and tPROM infection group were higher than those in tPROM non-infection group and pPROM non-infection group (P<0.05), but the differences in MMP-2 and MMP-9 were not statistically significant between pPROM infection group and tPROM infection group and between pPROM non-infection group and tPROM non-infection group (P>0.05). The incidence rates of chorioamnionitis in pPROM infection group, pPROM non-infection group, tPROM infection group and tPROM non-infection group was 32.35% (11/34), 15.38% (4/26), 11.76% (4/34) and 0.00% (0/16) respectively (χ2=9.538, P=0.023). The incidence rate of chorioamnionitis in pPROM infection group was higher than that in tPROM infection group and tPROM non-infection group (P<0.05). The total incidence rate of postpartum hemorrhage, puerperal infection, neonatal asphyxia, neonatal infection and neonatal pathological jaundice in pPROM infection group was higher than that in tPROM non-infection group and pPROM non-infection group (P<0.05). According to the maternal-infant prognosis, the patients were divided into good prognosis group (n=79) and poor prognosis group (n=31). The expression levels of MMP-2 and MMP-9 in cervical secretions in poor prognosis group were significantly higher than those in good prognosis group. Logistic multivariate regression analysis showed that reproductive tract infection and MMP-2 and MMP-9 in cervical secretions of PROM pregnant women were independent influencing factors of poor maternal-infant prognosis (P<0.05). Conclusion Whether it is term or preterm PROM, reproductive tract infection can significantly increase the levels of MMP-2 and MMP-9 in cervical secretions, and it is closely related to poor maternal-infant prognosis. Reproductive tract infection and MMP-2 and MMP-9 levels are independent influencing factors for poor maternal-infant prognosis of term/preterm PROM.

18F-FDG PET/CT imaging standard uptake value (SUV) measurement technology, influencing factors and clinical applicationsTang Qingyan1 , ZhouQing2, ShenJun3,XuBin 2, Zhu Yuchun 2 *

沈君,汤青燕,周青；徐滨,朱玉春 — 2024/7/11 16:17:26

18F-deoxyglucose （FDG）PET/CT has a wide range of clinical applications，and standardized uptake value (SUV) is an important semi-quantitative index.It is of great significance for the early diagnosis and differential diagnosis of the disease, prediction of the early response of tumor treatment and the monitoring of efficacy, this review summarizes the measurement technology, influencing factors and clinical applications of SUV in PET/CT imaging, in order to provide better help for clinical setting.

Ultrasonographic study of the thickness of gastrointestinal wall blood sludge in patients with heart failure

郑烨 — 2024/7/11 15:30:54

Objective To investigate the changes in gastric and intestinal wall thickness and the submucosal layer of gastric wall in patients with heart failure measured by ultrasound and to explore its correlation with parameters of cardiac function. Methods A prospective evaluation was made,32 patients with heart failure formed the study group and 33 cases made up the control group.The thickness of the gastric wall, submucosal layer of the gastric wall, intestinal wall and the width of the inferior vena cava, hepatic vein, portal vein and superior mesenteric vein were measured by ultrasound and compared between the two groups.Cardiac function indicators, including left ventricular ejection fraction (LVEF), right ventricular tricuspid annular plane systolic excursion(TAPSE) and pulmonary artery systolic pressure, were recorded in the heart failure group, and the correlation between the thickness of the gastric wall and intestinal wall and the width of the abdominal veins and cardiac function indicators were analysed among the patients in the heart failure group. Results The thickness of the gastric wall, the thickness of the submucosal layer of the gastric wall and the thickness of the intestinal wall of the patients in the heart failure group were all thickened, and the widths of the inferior vena cava, the hepatic vein, the portal vein, and the superior mesenteric vein were widened compared with those of the control group, and the differences were statistically significant (P<0.05).The thickness of the gastric wall, the thickness of the submucosa of the gastric wall, and the thickness of the intestinal wall in the heart failure group were all negatively correlated with TAPSE.The thickness of the gastric wall in the heart failure group was positively correlated with the width of the portal vein.The thickness of the submucosa of gastric wall and the thickness of the intestinal wall in the heart failure group were positively correlated with the inferior vena cava, the hepatic vein, and the portal vein, and the differences were statistically significant (P<0.05). Conclusions Ultrasound can be used to assess the thickness of the gastrointestinal wall and submucosal layer of the gastric wall in people with heart failure in very real time, and can be used as an imaging tool to assess the degree of gastrointestinal wall blood sludge in people with heart failure.

Application of ultrasound-guided "bowtie sign" fasiliac block technique in postoperative analgesia of hip joint

WangHui — 2024/7/11 8:52:27

Objective: To investigate the effect of ultrasound-guided "bow tie" iliac block technique in postoperative hip analgesia. Methods: using prospective study, extracted from January 2020 to May 2023 during Tongling city people's hospital of Anhui province a total of 60 patients with hip surgery, according to the random number method is divided into two groups, 30 people, which accept postoperative intravenous control analgesia, control group, on the basis of the automatic group ascending ultrasound guide "bowtie sign" iliac fascia block technique for the iliac fascia block group. The baseline data of all selected participants were collected, observing the postoperative opioid dose, departure time and hospitalization time, and Harris score of the two groups; after 2 h (2 h, T0), 6 h (T1), 12 h (T2), 24 h, 28 h (T3) and 48 h (T4); compare the analgesic pump control presses, sleep satisfaction, analgesia and satisfaction, and counting the postoperative complication rate in the two groups. Results: Sex, age of both groupsASA classify, Height, body mass index, blood pressure, heart rate, smoking, alcohol consumption, hypertension, diabetes, and operation time and other baseline data were entered into statistics for processing analysis, None were statistically significant (P> 0.05), Suggesting that the two groups are comparable; The dose of additional opioid at 48h in the fasiliac block group was significantly less than that in the continence group, The isolation time and hospital time were shorter than the automatic control group (P <0. 05), However, there was no statistical difference in Harris scores at discharge (P> 0.05); The difference in pain scores between the two groups at T0 was meaningless (P> 0. 05); However, the PVAS and IVAS scores showed a decreasing trend with time, Among them, the PVAS and IVAS pain scores were significantly different in the fasiliac block group compared with the automatic control group, Significant lower in the fascia iliac block group (P <0. 05); Significant difference between T 1 and T 4 between the two groups, In the fasiliac block group had significantly analgesic analgesia than the intercostal nerve block group, The difference was statistically significant (P <0. 05); The total sleep satisfaction and analgesia at 24h and 48h after surgery were higher in the cia iliac block group, The difference was statistically significant (P <0. 05); Comparison of the postoperative complication rates between the two groups, There was no statistically significant difference (P> 0.05). Conclusion: postoperative ultrasound guide "bowtie sign" iliofascial block used in patients with hip surgery postoperative analgesic effect better, analgesia duration longer, effectively reduce the use of opioid dose, improve patients postoperative sleep and analgesia satisfaction, to postoperative rehabilitation, and does not increase the risk of complications, can yet be regarded as a safe and feasible analgesia scheme.

Research progress of exosome detection in the diagnosis and treatment of bone tumors||HU Yong-sheng, ZHANG Xiao-xuan,SHONG Xing-hua. Spine Surgery Department, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, China

huyongsheng,,zhang xiao xuan — 2024/7/9 17:35:59

Abstract: Body fluid examination has become an important research direction in the field of cancer. Liquid biopsy includes the detection of circulating free DNA (cfDNA), circulating tumor cells (CTCs), and exosomes. Exosomes are found to be stored in a variety of physiological environments, such as serum, saliva, urine and other life activities in the Body fluid, they can not only carry proteins, nucleotides, can also carry viruses, and can promote material exchange and information transmission between cell. The mRNA, miRNA and other genomic proteins produced by tumor cells are not only derived from the mother tumor, but also have specific tumor specificity, which makes them play a key role in the discovery, diagnosis and prevention of tumors.

Relationship between serum lncRNA-Xist, lncRNA-MALAT1 and insulin resistance and pregnancy outcome after ovulation induction in infertility patients with polycystic ovary syndrome

Lei Jin-mei, — 2024/7/9 16:04:17

Abstract: Objective To investigate the relationship between serum long-chain non-coding ribonucleic acid (lncRNA) -X inactive specific transcript (Xist), lncRNA-lung adenocarcinoma metastasis-associated transcript 1 (MALAT1) and insulin resistance and pregnancy outcome after ovulation induction in infertility patients with polycystic ovary syndrome (PCOS). Methods PCOS infertility patients (PCOS infertility group, n=125) and healthy women (healthy group, n=125) who underwent ovulation induction in our hospital from February 2020 to January 2022 were selected as the research objects. Serum lncRNA-Xist, lncRNA-MALAT1 expression levels and insulin resistance index (HOMA-IR) were compared between two groups, the correlation between HOMA-IR and serum lncRNA-Xist, lncRNA-MALAT1 expression levels were analyzed by Pearson method. Patients were divided into pregnancy group and non-pregnancy group according to the clinical pregnancy of PCOS infertility patients after treatment, the differences of serum lncRNA-Xist, lncRNA-MALAT1 expression levels and baseline data between two groups were compared, the related factors of non-pregnancy were analyzed by multivariate Cox regression. Results Compared with healthy group, the serum lncRNA-Xist expression level and HOMA-IR in PCOS infertility group were higher, and the lncRNA-MALAT1 expression level was lower (P<0.05). Pearson correlation analysis showed that, HOMA-IR was positively correlated with serum lncRNA-Xist expression level (r=0.689, P<0.05), and negatively correlated with serum lncRNA-MALAT1 expression level (r=-0.771, P<0.05). 125 patients received a total of 303 ovulation induction cycles, the pregnancy rates of the first to third cycles were 14.40% (18/125), 16.00% (16/100) and 25.64% (20/78) respectively, the overall cycle pregnancy rate was 17.82% (54/303), the cumulative clinical pregnancy rate was 43.20% (54/125), and the cumulative live birth rate was 35.20% (44/125 ). The age, body mass index (BMI), infertility years, fasting insulin (FINS), HOMA-IR, basal luteinizing hormone (LH), basal testosterone (T), luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio, serum lncRNA-Xist level and the proportion of PCOS type D in non-pregnant group were higher than those in pregnant group, and the expression levels of serum anti-Mullerian hormone (AMH) and lncRNA-MALAT1 were lower than those in pregnant group (P<0.05). Multivariate Cox regression analysis showed that, increased LH/FSH and lncRNA-Xist, decreased AMH and lncRNA-MALAT1 were risk factors for non-pregnancy (P<0.05). Conclusion The high expression of serum lncRNA-Xist and the low expression of lncRNA-MALAT1 in PCOS infertility patients, and the increase of serum lncRNA-Xist and the decrease of lncRNA-MALAT1 are closely relate to insulin resistance and no pregnancy after ovulation induction.

Effect of preoperative NPRI on the short-term complications in patients with colorectal cancer undergoing laparoscopic radical resection and analysis on its influencing factorsXia Yong1, Hu Haoran2, Zhou Yaxing3, Yuan Yin3*, Wang Honggang3

夏勇,, — 2024/7/9 15:53:10

Objective: To explore the impact and predictive value of preoperative NPRI on the short-term complications in patients with colorectal cancer undergoing laparoscopic radical resection. Methods: Clinical data of 302 patients with colorectal cancer undergoing laparoscopic radical resection from June 2015 to June 2017 were collected, and they were divided into complication group and uncomplicated group according to whether there were postoperative complications. Univariate and multivariate analysis were applied to influence patient risk factors for postoperative complications. Next, the predictive efficacy of NPRI for postoperative complications was explored through the ROC curve, and the optimal NPRI cut-off value was found to discuss the relationship between NPRI and the clinical characteristics of patients. Finally, the Clavien-Dindo complication grading system was used to study which complications NPRI could predict. Results: Combined previous abdominal surgery, operative time, CEA, NPRI and NLR were independent risk factors for postoperative complications in patients with colorectal cancer. The optimal cut-off value for NPRI was 3.94, and the high level of NPRI was correlated with the patient's age, preoperative hemoglobin, operation time, location tumor, tumor diameter, and tumor pathological stage. Finally, by introducing the Clavien-Dindo classification of complications, it was found that preoperative NPRI was closely related to postoperative complications, which can better predict the occurrence of common and serious complications. Conclusions: Preoperative NPRI≥3.94 is an independent risk factor for short-term complications after laparoscopic radical resection of colorectal cancer, which can predict the occurrence of common and severe complications.

Transarterial chemoembolization by using CalliSpheres drug-eluting beads combined with Lipiodol Emulsion for the treatment of huge hepatocellular carcinoma: study on its short- term efficacy and safety

苗颖,裴圣林,赵昌 — 2024/7/9 11:17:36

Objective? To analyzethe short-term efficacy and safety of transarterial chemoembolization by using CalliSpheres drug-eluting beads combined with lipiodol emulsion for the treatment of huge hepatocellular carcinoma. Methods? The patients with massive liver cancer who received DEB-TACE combined with C-TACE were selected as the observation group, and the patients with massive liver cancer who received DEB-TACE alone were selected as the control group. The modified response evaluation criteria in solid tumors (mRECIST) were used to evaluate the short-term curative effect of the two groups of patients,and the Chi-square or Fisher exact count method was used for statistical analysis.The blood routine, liver function, kidney function, blood coagulation function biochemical indicators and postoperative adverse reactions and complications were compared between the two groups of patients for safety comparison. Results? From August 2017 to September 2020, A total of 44 patients with massive liver cancer were collected, including 27 in the observation group and 17 in the control group.The objective response rate (ORR) at 1 month of the observation group and control group was 66.7%, 70.5% respectively, and the disease control rate (DCR) was 85.1%, 88.2% respectively. The ORR at 3 months of the 2 groups was 51.8%, 47.0% respectively, and the DCR was 66.7%, 58.8% respectively,there was no statistically significant difference between the two groups (P>0.05). The levels of TBIL, ALT and AST in the observation group were significantly increased and ALB were significantly decreased on the one day after operation (P<0.05). The levels of ALT and AST in the control group were significantly increased on the one day after operation (P<0.05). The levels of WBC in the 2 groups were significantly increased (P<0.05). Both groups of patients had postoperative embolic syndrome, including abdominal pain, fever, nausea and vomiting, among which the incidence of abdominal pain in the observation group was significantly higher than that in the control group (P<0.05), and one case of bone marrow suppression occurred in the observation group, and all complications were alleviated by treatment.Conclusion? The short-term efficacy and safety were equivalent in patients treated with double-loaded group and single-loaded group.

The mechanism of RhoA/Cofilin pathway disrupting hippocampal synaptic plasticity involved in learning and memory impairment caused by aluminum poisoning

2024/7/8 17:52:04

Objective To observe the effects of RhoA/Cofilin pathway on hippocampal synaptic plasticity, and to explore the mechanism of RhoA/Cofilin pathway destroying hippocampal synaptic plasticity and participating in learning and memory impairment caused by aluminum poisoning. Methods The experiment was set up as blank control group, aluminum poisoning model group and RhoA inhibitor group. The rats in the aluminum poisoning model group were injected intraperitoneally with maltol aluminum solution, and the RhoA inhibitor group was injected intraperitoneally with 40mg/kg Rhosin hydrochloride. Morris water maze was used to detect the learning and memory ability of rats, the ultrastructure of synapses in CA1 region of hippocampus was observed by transmission electron microscopy, and the gene expression of RhoA, Cofilin, PSD-95 and SYN were detected by RT-PCR and immunohistochemistry, respectively. Results Morris water maze test showed that the latency of aluminum poisoning model group was increased compared with blank control group, and the latency of RhoA inhibitor group was shorter than that of aluminum poisoning model group (P＜0.05 or P＜0.01 or P＜0.001）. The number of synapses decreased, the thickness of postsynaptic dense material decreased, and the width of synaptic gap narrowed in the aluminum poisoning model group. The RhoA inhibitor group showed an increase in the number of synapses, the thickness of postsynaptic dense matter, and the width of the synaptic gap compared with the aluminum poisoning model group (P＜0.05 or P＜0.01 or P＜0.001）. Compared with blank control group, RhoA mRNA expression in hippocampus of aluminum poisoning model group increased, while Cofilin, PSD-95 and SYN mRNA expression decreased. Compared with aluminum poisoning model group, RhoA mRNA expression in RhoA inhibitor group was decreased, while Cofilin, PSD-95, SYN mRNA expression was increased(P＜0.05 or P＜0.01 or P＜0.001）. Immunohistochemistry showed that RhoA-positive cells increased in CA1 region of hippocampus, while Cofilin, PSD-95 and SYN positive cells decreased. Compared with aluminum poisoning model group, RhoA inhibitor group showed a lower RhoA positive cell rate, while SYN, PSD-95 and Cofilin positive cell rate increased(P＜0.05 or P＜0.01）. Conclusion After aluminum poisoning, hippocampal synaptic plasticity can be damaged through RhoA/Cofilin signaling pathway, thus affecting learning and memory ability, which may be one of the mechanisms of learning and memory impairment caused by aluminum poisoning.

Influence of ultrasound-guided intertransverse process block and thoracic paravertebral nerve block on perioperative analgesia in double port video-assisted thoracoscopic surgery

chenqian,duhaiyun,,zhouxinyue — 2024/7/5 17:42:01

Objective To compare the efficacy and safety of ultrasound-guided unilateral double-shot intertransverse process block (ITPB) with thoracic paravertebral nerve block (PVB) in perioperative analgesia of double port video-assisted thoracoscopic surgery. Methods Seventy patients who were scheduled for thoracoscopic surgery under general anethesia,were randomly divided into ITPB group (Group I,n=35)and PVB group(Group P,n=35). After anesthesia induction ,patients in group I were given ultrasound-guided ITPB and group P were given PVB. The main outcome measure was morphine-equivalent consumption from time of extubation until 24 h postoperatively . Secondary outcome measures included the changes in heart rate and mean arterial pressure before and after skin incision, intraoperative analgesic consumption, VAS scores at 30 min, 4, 8, 16, 24 h after surgery and at rest and cough, the number of analgesic pump compressions and the times of remedial analgesia at 24 h postoperatively, the incidence of puncture hematoma, intraoperative hypotension, postoperative nausea and vomiting. Results Double-shot ITPB can provide effective analgesia that is not inferior to PVB after double port video-assisted thoracoscopic surgery(P<0.001), and can also inhibit intraoperative circulatory fluctuations during skin resection, the test results are statistically non-inferior(P<0.05). The number of puncture hematoma in group I was less than that in group P (P<0.05). There was no significant differences in intraoperative analgesic dosage, incidence of hypotension, postoperative pain VAS scores and postoperative nausea and vomiting between the two groups(P＞0.05). Conclusion The analgesic effect of ITPB in perioperative analgesia of double-port thoracoscopic surgery is not inferior to PVB, with lower incidence of puncture hematoma. ITPB can be used as an effective and safer alternative therapy for PVB in the perioperative analgesia of double-port video-assisted thoracoscopic surgery.

Analysis of clinical significance of 23 genetic deafness mutations in prenatal sequential carrier screening

李珊珊,,, — 2024/7/5 16:39:23

[Abstract] Objective To evaluate the clinical application value of detecting 23 genetic variation loci of hereditary deafness in prenatal carrier screening. Methods A total of 9391 pregnant women in early pregnancy were recruited and 23 common pathogenic mutation loci in genetic deafness genes GJB2, SLC26A4, GJB3 and 12SrRNA were detected by microfluidic chip method, and their carrying frequency in pregnant women was analyzed. The spouses of pregnant women with positive mutation sites of GJB2 gene and SLC26A4 gene were sequentially screened with targeted high-throughput sequencing for the same pathogenic genes, and informed selection was made for prenatal genetic diagnosis when both spouses were found to have heterogenic mutation sites of the same gene. Pregnant women with GJB3 and 12SrRNA mutations were further given genetic counseling and follow-up testing. Results Among the 9391 pregnant women, 1000 were found to be carriers of hereditary deafness gene mutation, and the total detection rate was 10.648% (1000/9391). The carrying rates of GJB2, SLC26A4, GJB3 and mitochondrial 12SrRNA mutations were 7.912% (743/9391), 1.991% (187/9391), 0.277% (26/9391) and 0.149% (14/9391), respectively. The mutation positive cases were verified by Sanger sequencing, and the coincidence rate was 99.80% (1000/1002), among which 4 cases were detected with c.35 del G heterozygous mutation of GJB2 gene, and 2 cases were c.35 G>T heterozygous mutation by Sanger sequencing. The spouses of 293 GJB2 or/and SLC26A4 gene mutation carriers selected sequential screening, among which 4 couples were found to carry disease-causing mutation sites on the same gene, and all of them were informed about prenatal diagnosis. Two affected fetuses were detected, and the remaining 2 fetuses were found to carry heterozygous mutations by sequencing and chose to continue pregnancy. Conclusion Prenatal sequential deafness carrier screening not only screens the carriers of hereditary deafness gene mutations, but also finds individuals with drug-induced deafness sensitivity, so as to achieve early diagnosis, early intervention and timely warning of deafness fetuses.

Value of pre-treatment HALP score, prognostic nutritional index, and inflammatory indicators in predicting the prognosis of advanced clear cell renal cell carcinoma

江琴 — 2024/7/4 15:53:51

Objective To explore the value of pre-treatment HALP score, prognostic nutritional index (PNI), and related inflammatory indicators in predicting the prognosis of patients with advanced clear cell renal cell carcinoma (ccRCC). Method A retrospective analysis was conducted on 130 patients with advanced clear cell renal cell carcinoma admitted to Taihe Hospital of Shiyan City from 2010 to 2018. Patient medical records were collected retrospectively, and survival status was followed up until December 30, 2022. ROC curve analysis was used to predict the clinical outcomes and calculate the area under the curve (AUC) and the best cut-off of HALP score, SII, and PNI. Kaplan-Meier method was used to draw survival curves, and Log rank test and Cox regression analysis were used to analyze the influencing factors of prognosis. Results The follow-up time was 61.00 (54.25, 71.00) months, with a mortality rate of 30.00% during the follow-up period. The overall survival time (OS) and progression free survival time (PFS) were 52.00 (41.75, 60.00) months and 49.50 (37.00, 56.00) months, respectively. The 3-year overall survival rate and progression free survival rate of patients were 85.38% and 79.23%, respectively. The AUC predicted by HALP score, SII, and PNI were 0.921, 0.899, and 0.902, respectively, with the best cut-off of 48.1, 544.9, and 44.4, respectively. Cox regression showed that HALP score, neutrophil to lymphocyte ratio (NLR), PNI, and treatment method were related to patients’ OS. The HR (95% CI) for HALP score<48.1, PNI<44.4, NLR<3.05, and surgery+immunotherapy or immunotherapy were 7.756 (2.332-25.794), 3.988 (1.402-11.346), 0.327 (0.114-0.941), 0.018 (0.005-0.074), and 0.045 (0.013-0.161), respectively. The HALP score, NLR, PNI, KPS score, and treatment method are related to patients’ PFS. The HR (95% CI) for HALP score<48.1, PNI<44.4, KPS<70, NLR<3.05, and surgery+immunotherapy or immunotherapy are 6.827 (2.091-22.283), 6.444 (2.133-19.467), 2.844 (1.209-6.689), 0.295 (0.106-0.824), 0.023 (0.006-0.085), and 0.072 (0.023-0.226), respectively. Conclusion The prognosis of advanced ccRCC may be related to the nutritional, immune, and inflammatory status of patients. HALP score, PNI, NLR, KPS score, and treatment methods are important influencing factors for patients’ prognosis.

To examine the use of 18F-FP-CIT PET-CT imaging and 18F-DOPA PET-CT imaging in the early detection and severity of Parkinson"s disease

Deng Yujiao,,Tang yazhou,Xiong Chanyu — 2024/7/4 11:30:45

Objective:To investigate the use of these two imaging agent types in early identification and severity of Parkinson"s disease (PD), and to compare the changes of 18F-FP-CIT and 18F-DOPA PET in PET-CT imaging of PD.Methods: The study included 119 patients with a clinical diagnosis of Parkinson"s disease and 28 healthy participants who were admitted to the outpatient neurology department of Sichuan Provincial People"s Hospital between January 1, 2022, and March 1, 2023. The analysis and comparison of the uptake index differences between the contralateral and onset putamen and the caudate nucleus was done centered on the Hoehn-Yahr stage (H-Y stage) and various imaging agents used to diagnose Parkinson"s disease. Comparisons and analysis were done between the UPDRS III motor score, striatal uptake index, PD progression, and disease severity. Results:The putamen and caudate nucleus uptake indices in the 18F-FP-CIT and 18F-DOPA groups were both lower than in the normal control group. In contrast to the early PD group, the striatal uptake index was considerably lower in both the middle and late PD groups. The putamen and caudate nucleus uptake indexes were negatively attributed with the illness course, H-Y stage, and UPDRS-III of PD patients. . Conclusion:18F-DOPA and 18F-FP-CIT PET/CT imaging can identify Parkinson"s disease patients from healthy controls, show the degeneration of dopaminergic neurons that occur in the brains of PD patients, offer an imaging foundation for PD patients of varying severity, and be a successful instrument for PD early diagnosis.

Application of convolutional neural networks in the detection and auxiliary diagnosis of diseases in stomatology

luyang,Lu zhiyuan,wei zhihao,,xu yimin,zhou mengyuan — 2024/7/4 11:01:43

Convolutional neural networks (CNNs) have demonstrated exceptional performance in the field of image recognition, making them a prominent method in artificial intelligence. In the field of stomatology, CNNs have garnered significant attention as they exhibit high efficacy in dental endodontics, periodontology, oral surgery, orthodontics, and oral implantology. These capabilities enable clinicians to develop comprehensive treatment plans. This paper provides an overview of the advancements made by CNNs in detecting and assisting with the diagnosis of stomatological diseases. It also analyzes current research limitations and proposes future directions for investigation while aiming to establish personalized medicine that integrates prevention, screening, diagnosis, treatment, and rehabilitation.

A case of 17q12 microdeletion syndrome

Gao Bin,,, — 2024/7/3 12:13:25

17q12 microdeletion syndrome is a rare chromosomal aberration disorder with complex and diverse clinical phenotypes. Typically, this syndrome can have a variable combination of three common phenotypes: congenital structural abnormalities of the renal urinary tract, maturity-onset diabetes type 5 (MODY5) in adolescents, and neurodevelopmental or neuropsychiatric disorders. In addition, patients may also have hypomagnesemia, hypocalcemia, genitourinary tract abnormalities and hyperparathyroidism. Due to the relatively few reports of this syndrome in China, clinicians may have limited knowledge of this syndrome, so misdiagnosis can easily occur. This article retrospectively reported a young female patient with 17q12 chromosome microdeletion syndrome who was admitted to The University of Hong Kong-Shenzhen Hospital in March 2021. A 2-year follow-up was conducted to dynamically monitor the patient's biochemical indicators and adjust the treatment regimen to improve clinicians' understanding and treatment experience of this syndrome.

Patient With Internal Jugular Central Vein Catheterization And Extubation Distress Syndrome: Reflection on A Rare Case And Literature Review

gengjie,,,, — 2024/7/1 8:15:31

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Exploration and practice of the construction of the whole life cycle health science popularization system in public hospitals under the background of active health

黄冬清,黄小娟,黄小知,李卫,梁新,罗怡欢,罗颖华,杨建荣 — 2024/6/25 17:20:27

Health science popularization is a key means to improve the health literacy of the whole population. To further promote the popularization of health science knowledge and disseminate the concept of proactive health, Guangxi Zhuang Autonomous Region People's Hospital has made an exploration on how to build a health life-cycle science popularization system in public hospitals. This paper elaborates on the core elements, construction requirements, operation and management mode of the health science popularization system. At the same time, this paper also makes the strategy analysis of how to build science resource sharing information platform, formulate science standards, build health science base and application promotion. By exploring the construction of a whole-life cycle health science popularization system in public hospitals under the background of proactive health, we aim to provide reference for further promoting the national health science popularization.

Team STEPPS model in the treatment of neonates with noninvasive positive pressure ventilation

王晓梅 — 2024/6/21 9:08:34

Objective To explore the application effect of Team STEPPS model in the treatment process of neonatal noninvasive positive pressure ventilation (NIPPV). Methods The 120 neonates treated with NIPPV were divided into 60 cases in the control group and 60 cases in the observation group according to the order of time of admission; the control group implemented routine care, and the observation group implemented nursing management based on the STEPPS team model. Results The NIPPV ventilation time and hospitalization time of the children in the observation group were significantly shorter than those in the control group ( P<0.05), the incidence of adverse events of NIPPV in the observation group was significantly lower than that of the control group ( P<0.05), and the degree of cooperation of healthcare personnel in the observation group was higher than that of the control group ( P<0.05). Conclusion Implementing nursing management based on the Team STEPPS model during neonatal NIPPV treatment ensures the effectiveness of respiratory support therapy, shortens treatment time reduces the incidence of adverse events, and improves healthcare collaboration

Research Advances in the Role of NETs and Vascular Endothelial Damage in Autoimmune Diseases

zhangwei — 2024/6/19 8:43:06

As a crucial barrier for maintaining the homeostasis between the intravascular and extravascular environments, damage to the vascular endothelium can lead to the extravasation and accumulation of plasma components in surrounding tissues, forming the pathological basis for various diseases. In recent years, the pivotal role of Neutrophil Extracellular Traps (NETs) in vascular barrier injury has gradually garnered attention. This article provides a comprehensive overview of NET formation, release, and their impact on vascular endothelial barrier function. Additionally, it delves into the role of NETs in the development and progression of autoimmune diseases. By gaining a deeper understanding of the relationship between NETs and vascular barrier injury, we hope to uncover new insights that could pave the way for innovative prevention and treatment strategies for autoimmune diseases.

Role of exosomal miR-155 in regulating M1-type macrophage polarization in podocytes in lupus nephritis

xuluyao, — 2024/6/17 10:04:30

Exploring the role of exosomal miR-155 in regulating macrophage polarization to modulate podocyte injury and its possible mechanism of action. Methods: Macrophages were transfected with miR-155mimics/NC, miR-155inihibitor/NC, miR-155 cell lines were constructed, and cellular exosomes were isolated. Flow cytometry was used to detect the ratio of M1/M2 type macrophages. macrophages were co-cultured with podocytes for 12h and 48h by Transwell method, and changes in the expression of miR-155 in macrophages were detected by RT-qPCR; the expression of the M1-type marker protein IL-6 and the M2-type marker protein IL-10 in macrophages, and the expression of the marker protein in podocytes, were detected by Western blot. Synaptoporin and Nephrin protein expression levels; ELISA to detect the expression levels of inflammatory factors IL-1β, IL-10 in podocytes. Tunel staining for detection of apoptosis in podocytes.Results: Successful construction of miR-155 macrophages and isolation of cellular exosomes. miR-155 macrophages differentiated into M1 phenotype in a significantly higher proportion than cells in the normal group （P< 0.01）; miR-155 expression was significantly increased or decreased 24h after transfection with miR-155 mimics or miR-155 inhibitor （P< 0.05）; miR- 155 mimics up-regulated the expression of macrophage M1-type factor IL-6（P< 0.05） and inhibited the expression of macrophage M2-type factor IL-10 （P< 0.05）, and promoted the decrease of protein and mRNA expression of podocyte Synaptoporin, Nephrin, and IL-10, and elevated the expression of IL-1β （P<0.05）. And transfection of miR-155 inhibitor had the opposite effect on macrophage and foot cell mRNA and protein as miR-155 mimics. Confocal results showed foot cell apoptosis consistent with Western blot, RT-PCR, ELISA results.Conclusions: High expression of iR-155 induces macrophage polarization of M1-type proinflammatory factors that trigger podocyte injury through exosome-mediated triggering, whereas low expression of miR-155 reverses changes in cellular protein and mRNA expression and attenuates podocyte injury.

Advances in the Application of PET/CT Radiomics in Esophageal CancerYU Ling-yun,HAN Shuo,LIU Yuan-kui,XU Yang-yang,WANG Meng-die,LIU Zhi-xiang. Department of Nuclear Medicine, Affiliated Hospital of Weifang Medical University,Weifang 261031, China

刘志翔,余凌云 — 2024/6/12 17:59:45

With the improvement of people"s living standards, esophageal cancer (esophageal cancer,EC), as a common malignant tumor of the upper digestive system, has become a major global health problem with its morbidity and mortality increasing year by year in the world. The early detection rate of esophageal cancer is low and the prognosis is poor. Most patients are already in the mid to late stage of the disease when they are diagnosed.Therefore, early diagnosis of esophageal cancer and the formulation of a reasonable treatment plan play a very important role in improving the prognosis of patients. Neoadjuvant therapy combined with surgical treatment has become the standard treatment for locally advanced esophageal cancer. However, the therapeutic effect and prognosis of patients with EC vary from person to person. PET/CT Radiomics can quantify and deeply analyze the high-throughput feature image data, and then establish a clinical prediction model, which can open up a new way to improve the treatment strategy and evaluate the prognosis of EC patients, and provide a new perspective for medical imaging research. This article mainly reviews the application and research progress of PET/CT Radiomics in the clinical diagnosis, staging, curative effect evaluation and prognosis prediction of esophageal carcinoma.

Network Meta-Analysis on the Impact of Acupoint Therapy on Endometriosis: Focusing on the Efficacy Evaluation of Traditional Chinese Medicine External Therapy

Du Zifei,He Shenglan,Lv Hang,,Yuan Xiaoyi — 2024/6/12 17:58:59

Objective: To systematically assess the efficacy of Traditional Chinese Medicine (TCM) external therapy, with a focus on acupoint therapy, in conjunction with pharmacological treatments from both Chinese and Western medicine for managing endometriosis (EMT). Methods: This network meta-analysis searched for relevant randomized controlled trials (RCTs) available up to June 1, 2023, across major databases including PubMed, The Cochrane Library, and EMbase. The inclusion criteria targeted EMT patients undergoing interventions such as conventional Western medication, Chinese herbal medicine, acupoint therapy, and their combinations. Results: The analysis incorporated 66 RCTs, involving a total of 5,172 patients. Findings demonstrated that the combination of Western medication and acupoint therapy significantly reduced serum CA125 levels, showing superiority over the use of Chinese herbal medicine alone (-10.02, [-18.92, -1.16]). Regarding the suppression of PGF2?? levels, the amalgamation of Western medication and acupoint therapy exhibited superior outcomes compared to monotherapy with Chinese herbal medicine (150.13, [40.01, 251.79]), Western medication alone (196.73, [117.72, 278.46]), acupoint therapy alone (181.69, [92.06, 271.36]), a combination of Chinese medicine and acupoint therapy (141.58, [46.37, 228.42]), and a triple combination of Chinese medicine, Western medicine, and acupoint therapy (-133.76, [-220.23, -43.79]). However, no statistically significant differences were observed in the improvement of other biomarkers such as E2, FSH, LH, and VAS scores across different treatment groups. Conclusion: Acupoint therapy, as an adjunctive treatment modality, effectively enhances the improvement of key indicators in EMT.

Comparison of the efficacy of endoscopic thoracic sympathicotomy in the treatment of palmarShyperhidrosis

Liu Baodong,Wang Tengteng,Zhang Peilong, — 2024/6/11 16:43:57

Objective To compare the efficacy of bilateral thoracoscopic T3 and T4 sympathicotomy in treating primary palmar hyperhidrosis. Methods Clinical data of 125 patients with primary palmar hyperhidrosis (PPH) who underwent thoracoscopic sympathectomy in the Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University from January 2017 to March 2023 were retrospectively collected. Patients were divided into two groups based on the level of sympathectomy: T3 group (60 cases) and T4 group (65 cases). The T3 group underwent bilateral thoracoscopic T3 sympathicotomy, while the T4 group underwent bilateral thoracoscopic T4 sympathicotomy. Clinical data, PPH recurrence rates at different time points postoperatively, compensatory hyperhidrosis (CH) occurrence, and patient satisfaction with the surgery at 12 months postoperatively were compared between the two groups.. Result There were no statistically significant differences in age, gender, family history, duration of symptoms, PPH grading, surgical time, postoperative complications, and length of hospital stay between the two groups (P > 0.05), and the surgical effectiveness rate was 100% in both groups. The PPH recurrence rates at 1 month, 6 months, and 12 months postoperatively did not differ significantly between the two groups (P > 0.05). At 1 month postoperatively, there were no statistically significant differences in CH occurrence rate and severity between the two groups (P > 0.05). However, at 6 and 12 months postoperatively, the CH occurrence rate in the T3 group was significantly higher than that in the T4 group (P < 0.05), and there were statistically significant differences in CH severity between the two groups (P < 0.05). There was no statistically significant difference in patient satisfaction with the surgery between the two groups at 12 months postoperatively (P > 0.05).Conclusion Bilateral thoracoscopic T3 and T4 sympathicotomy are both effective in treating PPH. Compared with bilateral T4 sympathicotomy, bilateral T3 sympathicotomy results in a higher incidence of CS at 6 and 12 months postoperatively.

Study on the treatment and anti-inflammatory effect of Ziyuglycoside I on knee osteoarthritis in rats

wangzhewei — 2024/6/11 16:43:22

[Abstract] Objective Investigating the mechanism of Ziyuglycoside I on knee osteoarthritis in rats . Methods 8 SD male lactating rats and 24 SD male rats were selected. Suckling mouse chondrocytes were extracted, and the cell proliferation rate was detected by CCK-8 assay to determine the optimal drug concentration. Chondrocytes were randomly divided into control, inflammation, and treatment groups; the control group was cultured in complete medium, the inflammation group was cultured in medium containing 10 μg/mL interleukin-1β (IL-1β), and the treatment group was cultured in medium containing 10 μg/mL IL-1β and optimal concentration of elm Ziyuglycoside I. The chondrocytes were then cultured in medium containing 10 μg/mL IL-1β and optimal concentration of elm Ziyuglycoside I. The chondrocytes were then randomly divided into control, inflammation and treatment groups. Calcein-AM/PI staining was used to observe the growth of chondrocytes in each group. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression of interleukin-6 (IL-6) and matrix metalloproteinase 13 (MMP13) mRNA in chondrocytes in each group. The rats were randomly divided into control group, inflammation group and treatment group, 8 rats in each group. An osteoarthritis model was established for the inflammation group and control group, and 4 weeks after the modeling was completed, the joint cavities of the inflammation group and control group were injected with equal volume of saline, and the joint cavities of the treatment group were injected with the optimal concentration of 100 μL of Ziyuglycoside I solution. The tissue structure of the knee joints of each group was observed by HE staining and senna O-solid green staining. Immunohistochemical staining was used to observe the expression of IL-6 and MMP13 proteins in the knee joint tissues of each group. Results The results of CCK-8 assay showed that all the experimental concentrations did not show obvious cytotoxicity, and the highest proliferation rate of chondrocytes was observed when the concentration of Ziyuglycoside I was 20 mg/L, and the difference was statistically significant (P<0.05). Calcein-AM/PI staining results showed that the cell proliferation rate was lower in the inflammation group and treatment group than in the control group, and higher in the treatment group than in the inflammation group, with statistically significant differences (P<0.05). qRT-PCR results showed that the relative expression of IL-6 and MMP13 mRNA was higher in the inflammation group and the treatment group than in the control group, and the relative expression of IL-6 and MMP13 mRNA in the treatment group was lower than in the inflammation group, with statistically significant differences (P < 0.05). mRNA relative expression was lower than that of the inflammation group, and the difference was statistically significant (P < 0.05). The results of HE staining and senna O-solid green staining showed that the knee joint tissue structure of the control group was more complete than that of the inflammation group and the treatment group, and the knee joint tissue damage of the treatment group was reduced compared with that of the inflammation group. Immunohistochemical staining results showed that compared with the three experimental groups, the control group had the lowest positive expression rate of IL-6 and MMP13 proteins, while the treatment group was lower than the inflammation group, and the differences were all statistically significant (P<0.05). Conclusion Ziyuglycoside I showed anti-inflammatory properties in the treatment of osteoarthritis of the knee in rats and has some medicinal potential.

Establishment and research progress of animal models of oral cancer

liuyan,wanglu,xufeng — 2024/6/11 15:55:38

Oral cancer is the most common type of malignant tumor in the head and neck region. Due to its special location and high degree of malignancy, it can cause defects in the soft and hard tissues of the oral and maxillofacial region, resulting in the loss of speech, chewing, swallowing and other functions, which seriously affects the quality of life of the patients, and even causes death. For this reason, researchers have established animal models of oral cancer similar to human oral cancer, and they utilized them to study the etiology、development、infiltration and metastasis mechanisms of oral cancer, so as to provide a basis for the diagnosis and treatment of oral cancer，thus the role of accurate animal models in oral cancer research is irreplaceable. This study briefly introduces the construction methods of the animal model of oral cancer and their application in establishing animal models of oral cancer.

The impact of VR-based brain vision training on visual function defects and visual quality in glaucoma patients

zhouyu — 2024/6/11 8:57:34

ur hospital from March 2021 to February 2023 were selected, and were divided into a study group (n=49) and a conventional group (n=49) using a random number table method. The conventional group was given routine visual function training, and the research group was given brain visual training based on virtual reality technology on the basis of the conventional group. The visual acuity, iOP, visual function impairment, retinal?nerve?fiberlayer?thickness (RNFL), Disc volume (DV), visual quality [25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25)], and quality of life [glaucoma quality of Life Questionnaire (GQL-15)] of the two groups were compared. Results After 1 month and 3 months of training, the visual acuity of the study group was higher than that of the conventional group, and the iOP was lower than that of the conventional group (P < 0.05). After 3 months of training, the rates of visual impairment such as inhibition, perceptual eye position, stereovision, fixation stability and visual noise in the study group were lower than those in the conventional group (P < 0.05). After 1 month and 3 months of training, the scores of each dimension of the NEI-VFQ-25, RNFL, and DV in the study group were higher than those in the conventional group, and the score of GQL-15 was lower than that of the conventional group (P < 0.05). Conclusion Brain vision training based on virtual reality technology can improve the visual acuity and visual function of patients with glaucoma, reduce the intraocular pressure of patients, and improve the visual quality and quality of life of patients.

Application of traditional Chinese medicine Constitution in laparoscopic intubation under general anesthesia TANG Xiao-xiao, PENG Li ,ZHANG Yong-chao .Department of Anesthesiology, Nanning Hospital of Traditional Chinese Medicine, Nanning 530000, China

汤晓骁 — 2024/6/7 16:27:25

Objective To study the application of traditional Chinese medicine dialectics in laparoscopic intubation under general anesthesia, and to investigate whether there are differences in blood pressure, heart rate and intraoperative dosage of propofol in patients with different physique types induced by general anesthesia. Methods 119 cases of laparoscopic surgery in Nanning Hospital of Traditional Chinese Medicine from January 2019 to September 2022 who met the inclusion criteria were selected and divided into three groups according to the Classification and judgment of Traditional Chinese Medicine Physique, namely peace and quality, Yang deficiency and Qi deficiency. Blood pressure and heart rate during induction of general anesthesia, intraoperative propofol dosage and adverse reactions of patients were recorded. Results The mean arterial pressure of intubation induced by general anesthesia was lower in Qi-deficiency group than in Yang-deficiency group, and the difference was statistically significant. The dosage of propofol in normal and Yang deficiency groups was higher than that in qi deficiency groups, and the difference was statistically significant. The incidence of adverse reactions in Qi deficiency group was higher than that in peaceful and Yang deficiency group. Conclusion The dosage of propofol in laparoscopic intubation under general anesthesia is different in patients with different constitutions of traditional Chinese medicine.

Relationship between serum TRAIL level and immunotherapy response, emphysema, and prognosis in patients with advanced NSCLC

张雅君 — 2024/6/7 11:02:21

Objective To investigate the relationship between serum tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) level and immunotherapy response, emphysema and prognosis in patients with advanced non-small cell lung cancer (NSCLC). Methods The clinical data of 70 patients with advanced NSCLC admitted to the oncology department of the hospital from March 2019 to May 2020 were retrospectively collected. The serum TRAIL level was determined by enzyme-linked immunosorbent assay. Immunotherapy response was assessed by objective response rate and disease control rate. According to RECIST 1.1, objective response included complete response (CR) and partial response (PR). Clinical benefits included CR, PR, and stable disease for at least 6 months. Results The serum TRAIL level in NSCLC patients was 18.15 (12.09, 27.46) pg/mL. The serum TRAIL level in patients with objective response was significantly higher than that in patients without objective response [27.77 (23.13, 39.13) vs. 12.36 (8.76, 18.15), Z=-4.508, P<0.001]. Similarly, serum TRAIL levels in clinically beneficial patients were significantly higher than those in clinically unbeneficial patients [23.13 (16.99, 30.63) vs. 11.75 (8.76, 15.56), Z=-4.887, P<0.001]. By Spearman rank correlation analysis, serum TRAIL level was positively correlated with 1-second forced expiratory volume/forced vital capacity ratio, but negatively correlated with total emphysema ratio and focal lobar emphysema ratio (LER) (P<0.05). Multivariate logistic regression analysis showed that the risk of non-response to immunotherapy was significantly increased in patients with serum TRAIL level <18.15pg/mL, and this independent correlation remained after further adjustment for other confounding factors (P<0.05). The AUC for predicting objective resolution or clinical benefit of serum TRAIL levels was 0.833 (95%CI:0.722-0.945) and 0.858 (95%CI:0.770-0.945), respectively. Survival curve analysis showed that the median PFS and median OS were shorter in serum TRAIL <18.15pg/mL (P<0.05). Conclusion Low serum TRAIL level is associated with a high risk of non-response to immunotherapy in advanced NSCLC and increased emphysema and poor prognosis. Serum TRAIL level may be a candidate biomarker for predicting immunotherapy response and prognosis in advanced NSCLC.

He Chenhui, Wang Silu, Lei Yue, Zhao Lei*Reproductive Medicine Center, Taihe Hospital, Shiyan City, Hubei Province 442000

何晨晖,,, — 2024/6/7 9:50:31

Abstract Objective: To investigate the effects of different progesterone administration regimens on endometrial susceptibility and pregnancy outcomes in patients with freeze-thaw embryo transfer (FET), and to compare the treatment costs. Methods: A retrospective study was conducted. 376 infertile patients who underwent preimplantation genetic testing (PGT) -FET in the reproductive Center of our hospital from August 2020 to July 2022 were selected as the research objects, and their clinical data were collected. The patients were divided into two groups according to the progesterone administration regimen: Group A (n=182, oral progesterone capsules), group B (n=194, vaginal administration of progesterone softgel capsules), Endometrial receptivity indexes (including endometrial thickness and uterine arterial hemodynamics parameters (resistance index (RI), pulsation index (PI) and peak systolic/end-diastolic flow rate (S/D)), pregnancy outcomes and treatment costs were compared between the two groups. There were no significant differences in age, body mass index (BMI), basal follicle stimulating hormone (bFSH), basal luteinizing hormone (bLH), basal estradiol (bE2) and basal progesterone (bP) between the two groups (P>0.05). There were no significant differences between the two groups on HCG day LH, HCG day E2, HCG day P, number of eggs harvested, number of MⅡ eggs, endometrial thickness on transplantation day, number of transplanted blastocysts and rate of transplanted high-quality blastocysts (P>0.05), while there were no significant differences between the two groups on HCG day and transplantation day as well as uterine artery S/D, RI and PI (P>0.05). There were no significant differences in the biochemical pregnancy rate, clinical pregnancy rate, early abortion rate and continued pregnancy rate between the two groups (P>0.05). The rate of early vaginal bleeding and late vaginal bleeding in group A was lower than that in group B (P<0.05). The ratio of prim-effect in group A was 6.78, which was lower than that in group B (8.56, P<0.05). Conclusion The clinical effect and protective effect of oral progesterone capsule on endometrial receptivity of PGT-FET patients are similar to that of progesterone softgel capsule, but the former can reduce vaginal bleeding and treatment cost.

Sedation of patients with short-term mechanical ventilation after elective surgery

Qiao Li,Wang Zheng,Yuan Hongxun,Zhao Huiying — 2024/6/6 16:06:42

Objective:To explore the effects of different sedatives on hemodynamics, plasma catecholamine and delirium in patients with short-term mechanical assisted ventilation after elective surgery in ICU.

The impact of applying CPAP on respiratory function in patients undergoing thoracoscopic pulmonary surgery

huangyuting,mali,moyijie, — 2024/6/5 17:22:13

［Abstract］Objective: To study the impact of continuous positive airway pressure ventilation (CPAP) on oxygenation and the incidence of postoperative complications in patients undergoing thoracoscopic lung surgery under single lung ventilation.Methods: Sixty patients undergoing thoracoscopic lung surgery at the People's Hospital of Guangxi Zhuang Autonomous Region were selected. They were randomly divided into two groups, the observation group (O group) and the control group (C group), with 30 patients in each group. Patients with ASA grade II or III and aged 35 to 65 years were included. In the observation group (O group), continuous positive airway pressure ventilation was applied to the non-ventilated lung during single lung ventilation with a pressure of 5 cm H2O. In the control group (C group), no intervention was performed on the non-ventilated lung during single lung ventilation. Arterial blood gas analysis was performed at three time points: bilateral lung ventilation for 20 minutes (T0), single lung ventilation for 30 minutes (T1), and single lung ventilation for 1 hour (T2), to compare the oxygenation index (PaO2/FiO2) between the two groups. The neutrophil ratio and white blood cell count were recorded before and after surgery in both groups. The occurrence of pulmonary complications within 72 hours of surgery, such as re-expansion pulmonary edema, pneumonia, and atelectasis, was also recorded.Results: Compared with the control group (C group), the O group had significantly higher PaO2/FiO2 at 30 and 60 minutes of single lung ventilation (P<0.05). The neutrophil ratio and white blood cell count in the O group were significantly higher after surgery than before surgery (P<0.01). The overall incidence of postoperative pulmonary complications, such as re-expansion pulmonary edema, pneumonia, and atelectasis, was significantly lower in the O group than in the C group (P<0.05).Conclusion: During single lung ventilation, implementing CPAP on the operative lung in patients undergoing thoracoscopic lung surgery can effectively improve oxygenation and reduce the incidence of postoperative pulmonary complications.

Exploring the characteristics and fine sub domains of mild cognitive impairment in middle-aged and young adults with high white matter signal intensity based on transcranial Doppler imaging

tangtieyu,,yanyidan,yangsuxin,zhangyu,zhangteng,zhaoli — 2024/6/5 17:21:16

Objective: To explore the evaluation and predictive value of transcranial Doppler (TCD) in mild cognitive impairment (MCI) in middle-aged and young patients with white matter hyperintensities (WMH). Method: Seventy patients with high white matter signal intensity were enrolled and divided into the MCI group (n=36) and the control group (n=34) with a cutoff score of 25 on the Montreal Cognitive Assessment (MOCA). Clinical data were collected and compared between the two groups in terms of baseline cognitive function, cognitive subdomain scores, TCD values, and the correlation between TCD values and clinical data and cognitive scale scores. Draw receiver operating characteristic (ROC) curves to analyze the value of TCD parameters in diagnosing mild cognitive impairment. Result: There was no statistically significant difference in baseline data between the MCI group and the control group. There were statistical differences in scores between the two groups in the sub domains of memory, language, execution, and visual space. Compared with the group with normal cognitive function, the MCI group had higher middle cerebral artery (MCA) pulse index (PI), maximum and average blood flow velocity of the anterior cerebral artery, and the differences were statistically significant. Logistic regression analysis showed that MCA PI is an independent factor associated with mild cognitive impairment. By comparing the MCA PI of patients in the MCI group and the control group, the ROC curve was plotted, showing an area under the ROC curve of 0.668 (95% CI=0.531-0.806, P=0.026). When the MCA PI was 0.86, the sensitivity was 63.6% and the specificity was 63.0%. Conclusion: The cognitive sub domains of language, visual space, memory, execution, attention, and processing speed all decreased in middle-aged and young MCI subjects with high white matter signal intensity. MCA PI can provide certain diagnostic value for mild cognitive impairment in young adults with high white matter signal intensity.

Anti-iglon5 antibody associated encephalopathy: case report and literature review

chenwenhong,luyian,mojinfang,panfengjin,shilingli,qinlixia,zhaomingming — 2024/6/5 9:54:43

Anti-ig lon5 antibody associated encephalopathy is a rare autoimmune disease of the central nervous system. The median age of onset is about 60 years old, and individual clinical manifestations vary greatly. The most prominent clinical features are sleep disorders, gait abnormalities and spherical symptoms, and the imaging findings of the nervous system and routine biochemical changes of cerebrospinal fluid are not obvious or specific.Its diagnosis mainly depends on the detection of anti-IGlon5 antibody in serum and/or cerebrospinal fluid, which is easy to be confused with neurodegenerative diseases and delay the diagnosis.In this paper, a case of antiiglon5 antibeti-related encephalopathy with sleep disorder as the first symptom was reported in the Department of Sleep Medicine of the People's Hospital of Guangxi Zhuang Autonomous Region. The patient's history, signs, related auxiliary examination, diagnosis, treatment and follow-up were analyzed.At the same time, combined with the relevant literature in the past, this paper discusses the epidemiology, mechanism, symptoms and signs, laboratory examination, imaging features, diagnosis and treatment of encephalopathy associated with anti-ig LON5 antibody.

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CHENSHIFEI,,, — 2024/6/5 9:52:42

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Application effect of constraint reduction scheme based on eCASH concept in limb restraint of patients with mechanical ventilation in ICU

2024/5/31 9:59:19

Objective To explore the application effect of constraint reduction scheme based on eCASH (early comfort using analgesia,minimal sedatives and maximal humane care) concept in limb restraint of patients with mechanical ventilation in intensive care unit ( ICU ). Methods By different hospitalization time groups, ICU patients admitted from September 2020 to April 2021 were used as the control group, and ICU patients admitted from May 2021 to December 2021 were used as the observation group with 54 patients in each group. The control group adopted the routine physical restraint care process in the ICU, and the observation group adopted the restraint reduction scheme based on the eCASH concept. The rates of physical restraint, incidence of unscheduled extubation, incidence of acral edema and delusion were compared; the duration of physical restraint, mechanical ventilation and ICU stay were recorded and the patient satisfaction was evaluated. Results The physical restraint rate, the incidence of limb edema and delirium in the observation group were lower than those in the control group ( P < 0.05 ); The physical restraint time, mechanical ventilation time and ICU hospitalization time in the observation group were shorter than those in the control group ( P < 0.05 ). Conclusions The restraint reduction scheme based on the eCASH concept can effectively reduce the physical restraint rate, limb edema and delirium rate of ICU patients with mechanical ventilation, shorten the physical restraint time and mechanical ventilation time, and has high safety, which is worthy of clinical application.

Clinical features and CT imaging analysis of 7 cases of lymphocytic interstitial pneumonia

刘思球 — 2024/5/16 15:05:59

[Abstract] Objective To investigate the imaging features of idiopathic lymphatic interstitial pneumonia (LIP), and to improve the understanding and diagnosis of the disease. Materials and Methods The clinical and imaging data of 7 cases of pathologically confirmed LIP were retrospectively analyzed. All cases underwent chest thin-section CT examination. Results There were 7 cases of LIP, all of them were female, 4 cases of LIP showed diffuse patchy ground-glass opacities, 3 cases were accompanied by grids and small nodules; 3 cases showed patchy ground-glass opacities distributed in focal areas Density shadow, 1 case partially mixed with small nodular shadow. 5 cases had multiple thin-walled cavities containing air sacs. 4 cases were accompanied by mediastinal lymph node enlargement. Conclusion LIP is a rare disease, which tends to occur in female patients with Sjogren's syndrome. When lung HRCT shows patchy ground-glass opacity and multiple cystic changes, it is highly suggestive of LIP.

Advances in radiotherapy combined with immunotherapy for esophageal cancer

liuqianlin, — 2024/5/11 11:03:04

Abstract: Esophageal cancer (EC) is a common and lethal malignant tumour. Traditional treatments include surgical resection, radiotherapy and chemotherapy, however these treatments have limited efficacy and high side effects. With the rapid development of immunotherapy, more and more studies are beginning to explore the potential of radiotherapy combined with immunotherapy in oesophageal cancer. The aim of this review is to summarize the progressions of current research on radiotherapy combined with immunotherapy in oesophageal cancer. Firstly, the synergistic mechanism of radiotherapy combined with immunotherapy for oesophageal cancer is introduced. Secondly, the efficacy and safety of radiotherapy combined with immunotherapy in the treatment of oesophageal cancer are evaluated by reviewing existing clinical trials and prospective studies. Finally, the current problems and challenges of radiotherapy combined with immunotherapy in oesophageal cancer treatment are discussed, and the directions and prospects for future research are proposed. Taken together, these findings suggest that radiotherapy combined with immunotherapy in esophageal cancer has great potential, but further research and clinical validation to prove this works.

Protective Effects of Sangzhi Alkaloid Tablets on Obesity in Mice and Their Impact on Gut Microbiota

caolei,,,, — 2024/5/11 9:44:07

[Abstract] Objective To investigate the protective effects of morus alba alkaloid on obese mice and their impact on the intestinal microbiota. Methods SPF-grade C57BL/6 male mice were induced into an obese model through a 12-week high-sugar, high-fat diet. They were then stratified by body weight and randomly assigned to model (M), positive control (PC), low-dose Morus Branch Total Alkaloid tablets (SZ-L), medium-dose SZ-A (SZ-M), and high-dose SZ-A (SZ-H) groups, each containing 10 mice. An additional 10 normal mice were designated as the blank group (N group). The N and M groups received distilled water orally, the PC group received simvastatin suspension (2.6 mg/kg), and the SZ-L, SZ-M, and SZ-H groups were orally administered SZ-A at doses of 20 mg/kg, 40 mg/kg, and 80 mg/kg, respectively, for 12 weeks. Comparative analyses were conducted on Lee’s index, body weight, adipose tissue wet weight, biochemical indicators, intestinal microbiota α and β diversity, and relative abundance among the groups. Results Compared to the M group, all doses of SZ-A significantly reduced Lee’s index, body weight, eWAT, iWAT, BAT, TC, and TG levels (P < 0.05),. Additionally, in the SZ-H group, eWAT, iWAT, and BAT levels were significantly lower than in the PC and SZ-L groups (P < 0.05), and LDL-C levels were significantly lower than in the M group (P < 0.05). The Ace index in the SZ-H group was significantly higher than in the M, PC, and SZ-L groups (P < 0.05), while the Chao index was significantly higher than in the PC and SZ-L groups (P < 0.05), and the Shannon index was significantly higher than in the M, PC, SZ-L, and SZ-M groups (P < 0.05). Coverage results showed that the coverage of each group's community approached 1. PCoA analysis indicated good separation among the N, M, PC, and SZ-A groups, with a greater distance between the N and M groups, and the community structure of the SZ-A groups gradually trending towards that of the N group. NMDS analysis showed a stress value of 0.131 < 0.2. At the phylum level, compared to the N group, the relative abundance of Firmicutes, Desulfobacterota, and Patescibacteria was significantly higher (P < 0.05) in the M group, while Bacteroidota was significantly lower (P < 0.05). Compared to the M group, the SZ-H group exhibited significantly lower relative Firmicutes and Patescibacteria (P < 0.05), and significantly higher Bacteroidota (P < 0.05). At the genus level, compared to the M group, the SZ-H group showed significantly higher norank_f_Muribaculaceae (P < 0.05), while unclassified_f_Lachnospiraceae, norank_f_norank_o_Clostridia_UCG-014, and Desulfovibrio were significantly lower (P < 0.05). Conclusion SZ-A partially mitigates weight gain induced by a high-fat diet, reduces fat accumulation and expansion of white adipose tissue, improves lipid metabolism, regulates the disrupted intestinal microbiota structure induced by a high-fat diet, enhances microbial species diversity, and increases the relative abundance of specific microbial species. Further validation of the exact mechanism is still needed in the future.

Differential diagnostic value of serum circulating tumor cells and integrin β1 for benign and malignant intraductal lesions with pathological nipple discharge

张腾 — 2024/5/10 15:51:25

Objective: To explore the differential diagnostic value of serum circulating tumor cells (CTC) and integrin β1 (ITGβ1) for benign and malignant intraductal lesions with pathological nipple discharge (PND). Methods: A total of 212 PND patients who received treatment in our hospital and Bei Jing Chao-Yang Hospital,Capital Medical University from January 22 to September 23 were collected, according to the pathological examination results, they were separated into a malignant lesion group of 25 cases and a benign lesion group of 187 cases. Clinical data of PND patients were collected, subtraction enrichment and immunostainingfluorescence in situ hybridization (SE-iFISH) technique was applied to detect the level of CTCs in PND patients, enzyme linked immunosorbent assay (ELISA) was applied to detect ITGβ1 level. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of CTCs and ITGβ1 for malignant lesions in PND patients. Multivariate Logistic regression was applied to analyze the influencing factors of malignant lesions in PND patients. Results: The proportions of age>50 years old, BMI>24 kg/m2, menopause, blood sample discharge, and breast masses in the malignant lesion group were higher than those in the benign lesion group (P<0.05). Compared with the benign lesion group, the levels of CTCs and ITGβ1 in the malignant lesion group were obviously increased (P<0.05). The AUC predicted by CTCs and ITGβ1 for malignant lesions in PND patients was 0.828 and 0.868, respectively, the AUC detected by the combination of the two was 0.961, obviously higher than that predicted by the two alone (ZCTCs=2.625, ZITGβ1=2.330, P<0.05). Age>50 years old, BMI>24 kg/m2, blood sample overflow, CTCs, and ITGβ1 were independent risk factors for malignant lesions in PND patients. Conclusion: The levels of CTCs and ITGβ1 are elevated in patients with PND malignant lesions, and both have high diagnostic value for PND malignant lesions.

Impact of the ratio of number of follicles 16-18 mm in diameter/number of follicles greater than or equal to 14 mm on HCG day on FET outcomes in PCOS patients on antagonist regimens

Peng Lijun,, — 2024/5/9 16:48:00

Objective: To investigate the influence of ratio of 16-18mm follicles to total follicles on human chorionic gonadotropin (HCG) trigger day on IVF/ICSI outcome in polycystic ovary syndrome (PCOS) women who received GnRH-ant protocol for controlled ovarian hyperstimulation (COH).Methods: Women with PCOS (n=776) who underwent the GnRH-ant protocol for COH and underwent FET between January 2016 and December 2021 were stratified as group A (Ratio < 0.43, n=262) , group B (0.43 ≤ Ratio < 0.56, n=267) and Group C (Ratio ≥ 0.56, n=247) according to the ratio of 16-18mm follicles to total follicles on the HCG trigger day. The baseline characteristics, outcomes of COH and the first frozen embryo transfer (FET) cycle were compared between group A, B and C.Results: Group B had higher levels of Baseline LH and LH/FSH compared with Groups A and C (P < 0.05). Group A had the highest total Gn dose (P < 0.05) and the lowest E2 levels on the HCG trigger day (P < 0.05) compared with Groups B and C. The number of retrieved oocytes, normally fertilized oocytes (2PN), fertilized oocytes, blastocyst, and transferable embryos were significantly higher in Groups B and C compared to Group A (P < 0.05). The blastocyst formation rate in Group C was significantly higher than that in Groups A and B (P < 0.05). There were no significant differences among three groups in high-quality blastocyst rate, number of embryos transferred, embryo implantation rate, biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, and live birth rate (P > 0.05). Conclusion: 16-18mm follicles to total follicles ratio on HCG trigger day could be an indicator of clinical outcomes in women with PCOS undergoing GnRH-ant protocols and the ratio ≥0.56 may be the better condition for more retrieved oocytes, 2PN oocytes, fertilized oocytes, blastocyst, and transferable embryos.

The expression and clinical significance of YTHDF1 and EIF3C in epithelial ovarian cancer

陈婷,冯世香,王光慧,张佳,赵娜 — 2024/5/9 16:45:56

Objective To investigate the expression and clinical significance of the YTH domain N6-methyladenine RNA binding protein 1 (YTHDF1) and eukaryotic translation initiation factor 3C (EIF3C) in epithelial ovarian cancer (EOC). Method: A retrospective analysis was conducted on 130 EOC patients who were initially diagnosed and treated between January 2016 and January 2020, with 70 normal ovarian tissues treated with surgery for benign ovarian cysts as the control group. Immunohistochemistry was used to detect the expression of YTHDF1 and EIF3C in tissues. The correlation between YTHDF1 and EIF3C expression was analyzed using Spearman rank correlation analysis. The impact of YTHDF1 and EIF3C expression on the survival prognosis of EOC patients was analyzed using Log rank test and Kaplan Meier survival analysis. Using Cox risk regression model to analyze the risk factors affecting the prognosis of EOC patients. Results The positive rates of YTHDF1 and EIF3C in EOC cancer tissue were 61.54% (80/130) and 63.08% (82/130), respectively, which were higher than those in normal ovarian tissue by 11.43% (8/70) and 14.29% (10/70), with statistically significant differences（χ2=46.368, 43.606, P=0.000, 0.000). There was a significant positive correlation between YTHDF1 and EIF3C expression in EOC cancer tissue (r=0.715, P=0.000). The positive rates of YTHDF1 and EIF3C in EOC cancer tissues with FIGO stage III, pathological grade III, and lymph node metastasis were higher than those in stages I-II, pathological grade I-II and no lymph node metastasis in cancer tissues, and the differences were statistically significant (P<0.05). The 3-year overall survival rates of the YTHDF1 positive and negative groups were 58.75% (47/80) and 78.00% (39/50), respectively. The 3-year overall survival rates of EIF3C positive and negative groups were 56.10% (46/82) and 83.33% (40/48), respectively. The 3-year cumulative survival rate of the YTHDF1 positive group and EIF3C positive group was significantly lower than that of the YTHDF1 negative group and EIF3C negative group (Log Rank χ2=6.120,10.610, P=0.013, 0.001). YTHDF1, EIF3C, FIGO staging, pathological grading, lymph node metastasis, and CA125 were independent factors that affect the prognosis of EOC patients. Conclusion: The increased expression of YTHDF1 and EIF3C in EOC cancer tissue are associated with adverse clinical and pathological features, and are potential tumor marker for EOC prognosis evaluation.

The prognostic value of Fib, FDP, D-D combined with PLT count in traumatic coagulopathy

langdi,lihaisheng,mayongxin,qianjing,wangyaxin,yangwendi,zhanghongwei, — 2024/5/8 16:54:24

Objective Investigating the clinical prognostic value of FDP, D-Dimer, and Fib combined with PLT count in traumatic coagulopathy (TIC). Methods A retrospective analysis was conducted on data from 182 patients with multiple injuries admitted to the Emergency Department of the First People"s Hospital of Kunming City from February 2020 to February 2023. Based on whether the patients developed traumatic coagulopathy (TIC), they were divided into two groups: TIC group (85 cases, with 59 survivors and 26 deaths) and non-TIC group (97 cases). Clinical data between the two groups were compared, and the predictive value of initial FDP, D-Dimer, and PLT count in TIC patients" prognosis was explored through multivariable logistic regression analysis. Finally, ROC curves were used to compare the predictive value of initial FDP, D-Dimer, Fib, PLT count, and combined detection for mortality within 30 days after admission in TIC patients. Results Compared with the non-TIC group, patients in the TIC group had significantly higher initial ISS scores, PT, PTR, INR, APTT, TT, FDP, and D-Dimer levels upon admission (P<0.05), while Fib, Hb, and PLT counts were significantly lower (P<0.05). Multivariate analysis indicated a significant correlation between initial FDP, D-Dimer, PLT count, and TIC. According to the ROC curve analysis of the initial values, FDP, D-Dimer, FDP/Fib, and D-Dimer/Fib showed predictive value for the prognosis of TIC, with the largest area under the curve (AUC) being 0.757 for D-Dimer. Conclusions FDP, D-Dimer, and PLT count are independent risk factors that affect mortality in TIC patients. The initial values of FDP, D-Dimer, FDP/Fib, and D-Dimer/Fib upon admission have good predictive value for the prognosis of TIC patients within 30 days.

The expression and clinicopathological significance of miR-4516 in nasopharyngeal carcinoma

huangyongta,,,,, — 2024/5/8 15:29:45

[Abstract] Objective To investigate the expression level of miR-4516 in nasopharyngeal carcinoma(NPC) and its relationship between metastasis and prognosis.Methods The expression levels of miR-4516 were measured in 60 cases NPC and 15 cases of nasopharygeal mucosa via real time RT-PCR. The relationships between the expression intensity of miR-4516 and clinicopathological parameters were analyzed.Kaplan-Meier survival curve was used to analyze the effect of miR-4516 expression on the 5-years overall survival rate of patients after surgery, and ROC curve was used to analyze the predictive value of miR-4516 expression in early diagnosis of NPC metastasis.Results The expression level of miR-4516 in NPC was notably higher compared with those of nasopharygeal mucosa. The higher expression of miR-4516 in NPC was proved to be positively correlated with neoplasm metastasis（P=0.037）, but not with gender, age, tumor location,T stage and clinical stage.The 5-years overall survival rate of patients with low expression of miR-4516 was significantly higher than that of patients with high expression of miR-4516 (P=0.040); The area under the ROC curve of miR-4516 to predict the metastasis of NPC was 0.696 (95% CI: 0.541～0.851,P=0.037).Conclusions The expression of miR-4516 is aberrantly up-regulated in NPC，and can be used as a molecular marker to predict metastasis and prognosis of NPC.

A meta-analysis of platelet-rich plasma in the treatment for Alopecia Areata

Fang qiang,Jiang yuwei,Liang wen,Liao haiquan, — 2024/5/8 9:25:18

【】Objective: To evaluate the clinical efficacy and safety of platelet-rich plasma in the treatment of alopecia areata. Methods: Relevant trials from CNKI ,Wanfang Data ,VIP, Sinomed,PubMed,EMBASE,Cochrane Library,Web of science were searched until April,2023. The studies containing PRP in the treatment of AA were included. The methodological quality of trials was assessed independently using bias risk according to the Cochrane Collaboration. All data were analyzed using Review Manager 5.4. SALT score was used as the effect index. RESULTS : 7 studies were included. After treatment with PRP for AA, the hair was significantly improved, SALT score decreased.(SALT score before-after? SMD=-1.13；95%CI,-2.04～-0.22；??=0.01；PRP vs triamcinolone acetonide SMD=-0.41；95%CI,-1.22～0.4；??=0.33),No serious treatment-related adverse reactions were found. Conclusion: PRP is safe and effective for the treatment of AA.

The study on the expression of miR-145-5p in colorectal cancer and its regulation mechanism on GTPBP2 gene

wangyongfu,, — 2024/5/8 9:24:09

Abstract] Objective To explore the expression of miR-145-5p in colorectal cancer tissues and cells, as well as its mechanism of regulating colorectal cancer through the GTP binding protein 2 (GTPBP2). Methods The real-time quantitative PCR (qPCR) was used to detect the expression levels of miR-145-5p and GTPBP2 mRNA in 44 colorectal cancer tissues and their corresponding paracancerous tissues, colorectal cancer cells（HCT116）, and human normal colorectal mucosa cells(FHC）. The dual luciferase reporter gene experiments were used to verify the targeting relationship between miR-145-5p and GTPBP2 gene. miR-145-5p mimics and its negative control（mimic-NC） , GTPBP2 overexpression plasmid vector (pcDNA3.1-GTPBP2) and its blank vector (pcDNA3.1-Vector) were transfected into HCT116 cells, and divided into blank group, mimics-NC+pcDNA3.1-Vector group, miR-145-5p mimics group, pcDNA3.1-GTPBP2 group and pcDNA3.1-GTPBP2+miR-145-5p mimics group.The qPCR was used to detect the expression levels of miR-145-5p and GTPBP2 mRNA in each group, and Western blot was used to detect the expression level of GTPBP2 in each group. Results The expression level of miR-145-5p in colorectal cancer tissues and cells was significantly lower than that in paracancerous tissues and human normal colorectal mucosa cellss , and its expression level in colorectal cancer tissues was related to lymph node metastasis, distant metastasis, TNM stage in colorectal cancer patients (all P < 0.05).The expression level of GTPBP2 mRNA in colorectal cancer tissues and cells was significantly higher than that in paracancerous tissues and human normal colorectal mucosa cellss ; The expression level of GTPBP2 in colorectal cancer cells was significantly higher than that in human normal colorectal mucosa cellss . The expression level of miR-145-5p and GTPBP2 mRNA in colorectal cancer tissues showed negative correlation (r = -0.5028, P = 0.0005).The dual luciferase reporter gene experiments confirmed the targeting relationship between miR-145-5p and GTPBP2. Overexpression of miR-145-5p could upregulate the expression level of miR-145-5p in HCT116 cells, while the expression level of GTPBP2 mRNA and GTPBP2 were downregulated. Conclusion The expression level of miR-145-5p is low in colorectal cancer. Overexpression of miR-145-5p can downregulate the expression level of GTPBP2 mRNA and GTPBP2,suggesting that miR-145-5p may affect the occurrence and development of colorectal cancer by regulating GTPBP2 expression.

Single cell RNA sequencing and functional subset analysis of human umbilical cord mesenchymal stem cells

qi yu xin,zhang bing jun, — 2024/5/8 9:22:45

Objective To compare the stemness, osteogenesis, chondrogenesis and inflammation reduction of human umbilical cord mesenchymal stem cells (hUCMSCs) from different people. Classify hUCMSCs into subpopulations and find functional heterogeneity between subpopulations.Methods Two kinds of hUCMSCs were obtained from Zhengzhou Aobo Cell Medicine Laboratory, and the stemness genes (Sox2, Nanog) of the two kinds of hUCMSCs were detected by real-time quantitative polymerase chain reaction (qPCR). Osteogenic induction was performed on two kinds of hUCMSCs. The expression of osteogenic gene (Alp) was detected three days later, alkaline phosphatase staining was performed 7 days later, and alizarin red staining was performed 14 days later. Two kinds of hUCMSCs were induced into cartilage, and the expression of chondrogenic genes (Col2, Acan) was detected 7 days later. Rat chondrocytes were stimulated with 10ng/ml interleukin-1 β (IL-1 β) for 24 hours. After co-culture with two kinds of hUCMSCs, the effects on chondrocyte synthesis (Acan) and catabolism (Mmp3) gene expression were detected. hUCMSCs were subgrouped by single cell transcriptome sequencing technique, and the heat map and enrichment signal pathways of marker genes in each subgroup were systematically described.Results There was a highly significant difference in the expression of stemness genes (Sox2, Nanog) between the two kinds of hUCMSCs (P<0.01), there was a highly significant difference in the expression of the osteogenic gene (Alp) (P<0.01), alkaline phosphatase and Alizarin red staining showed differences, and the expression of chondrogenic genes (Col2, Acan) was significantly different (P<0.05). Under inflammation, there was no significant difference in the expression of chondrocyte synthesis gene (Acan) between the two kinds of hUCMSCs (P>0.05), but there was a highly significant difference in the expression of catabolic gene (Mmp3) (P<0.01). hUCMSCs can be divided into three subgroups by single cell sequencing technology, the C1 subpopulation mainly expresses osteogenesis and inflammation-reducing genes, the C2 subpopulation mainly expresses stemness genes, and the C3 subpopulation mainly expresses cell cycle-related genes.Conclusion The osteogenic, chondrogenic and anti-inflammatory abilities of hUCMSCs from different human sources are different, which may be due to the heterogeneity of hUCMSCs. Through single cell sequencing and other techniques to thoroughly understand the characteristics and mechanism of MSCs, and to accurately operate it in order to benefit patients scientifically.

Prediction model of IL-13, D-dimer and MUC5AC on airway blockage in children with mycoplasma pneumonia treated by mechanical expectoration

xufeifei — 2024/5/8 8:30:10

Abstract: Objective To study the prediction model of IL-13, D-dimer and MUC5AC on airway blockage in children with mycoplasma pneumonia treated by mechanical expectoration. Methods A total of 122 children with mycoplasma pneumonia admitted to our hospital from March 2020 to November 2022 were selected, including 78 males and 44 females; the age range was 2 to 8 years old, and the mean age was (5.43±1.30) years old; the course of disease ranged from 9 to 22 days, with a mean course of (15.78±3.02) days. The patients were divided into airway obstruction group (n=38) and non-airway obstruction group (n=84) by bronchoscopy. The serum levels of IL-13, D-dimer and MUC5AC were compared between the two groups, the baseline data of children with mycoplasma pneumonia were analyzed by univariate analysis, and the influencing factors of airway obstruction in children with mycoplasma pneumonia were determined by Logistic regression analysis. The diagnostic efficacy of IL-13, D-dimer and MUC5AC for airway obstruction was evaluated by ROC curve, and R software was used to establish the airway blockage prediction model. Results Serum IL-13(45.19±5.11 vs 35.87±4.83, t=9.693, P=0.000), DD(2.38±0.37 vs 1.23±0.40, t=15.044, P=0.000) and MUC5AC(40.33±3.05 vs 15.09±2.87, t=44.113, P=0.000) in the airway obstruction group were significantly higher than those in non-airway obstruction group. There were statistically significant differences in age, hospital stay length, heat course, body temperature, pleural fluid, cumulative number of lung lobe, atelectasis,

Progress in pyroptosis in rheumatoid arthritis

王佳妮 — 2024/5/7 17:40:58

Rheumatoid arthritis is an autoimmune disease characterized by synovial inflammation and progressive joint destruction.The pathogenesis of the disease is still unclear, but pyroptosis, as a newly discovered programmed cell death in recent years, has been confirmed to promote the development of rheumatoid arthritis through pro-inflammatory mediators released by intracellular kinase interactions, and some proprietary Chinese medicines can treat rheumatoid arthritis through pyroptosis. Therefore, in-depth study of the specific mechanism of pyroptosis is expected to provide potential targets for the treatment of rheumatoid arthritis and the development of new clinical drugs.

A case of twin pregnancy complicated with type A aortic dissection in pregnant women

ChenSheng,DengMao,, — 2024/5/7 17:40:23

Aortic dissection (AD) is a clinical emergency and critical condition with acute onset, dangerous condition, high mortality rate, and high surgical risk. The incidence rate of the disease is high in spring and winter, and it mainly occurs in men aged 50-70 years, and in pregnant women under 40 years old. In clinical practice, type A acute aortic dissection (TAAD) during pregnancy is very rare. According to statistics, the incidence of pregnancy combined with AD accounts for about 0.1% of all AD, but its mortality rate can reach 50%, which poses a great threat to the lives of mothers and fetuses. Due to the low incidence rate and clinical experience of pregnancy with TAAD, there is no optimal clinical management decision-making scheme for such patients. A case of twin pregnant woman with TAAD was admitted to our hospital, and the report is as follows.

Advancements in the Study of Hypoxia-Inducible Factor 1-alpha's Regulatory Effects on Energy Metabolism in Macrophages Infected by Mycobacterium Tuberculosis

Li Chaowei,Xu Junfa, — 2024/5/7 8:34:47

Macrophages, as integral components of the body's immune system, directly influence the host's ability to clear Mycobacterium tuberculosis (Mtb) through energy metabolism. Hypoxia-inducible factor 1-alpha (HIF-1α) serves as a central orchestrator in the immune response against Mtb by regulating energy metabolic pathways within macro-phages. This review presents a comprehensive synthesis of the alterations occurring in macrophage energy metabolism during tuberculosis infection, emphasizing the pivotal role of HIF-1α in this process. A thorough comprehension of macrophage metabolic pathways and their implications in tuberculosis infection offers promising avenues for the development of innovative therapeutic strategies targeting this disease.

A case of ingestive sharp foreign body wandering into the lungs

zhanxia — 2024/5/6 15:33:15

Ingestive foreign bodies occur in the digestive tract, while inhalation foreign bodies occur in the respiratory tract. However, ingestive foreign bodies can migrate to nearby areas or even into the lungs, especially the more common fishbone foreign body, which requires differential diagnosis. This article presents a case of pulmonary lesion discovered due to phlegm and blood. CT scan highly suspected foreign body, bronchoscopy ruled out inhalation foreign body, and thoracic surgery confirmed fishbone foreign body. Therefore, this article analyzes and discusses this case and related literature.

Research progress between inflammatory cytokines and the development of obstructive sleep apnea

Li Dongyang, — 2024/4/19 17:47:49

Obstructive sleep apnea ( OSA) is a common sleep-related respiratory disease. Chronic intermittent hypoxia can lead to systemic inflammation and activation of various inflammatory pathways aggravating the severity of OSA. Inflammatory cytokines are a class of cell signaling molecules that transmit information through the means of autocrine, paracrine and endocrine. OSA is closely associated with systemic inflammation and inflammatory cytokines. Inflammatory cytokines including TNF-α, IL-10, IL-1β, IL-6, IL-8, IL-33 and IL-17 have all been confirmed to contribute to the pathogenesis of OSA and promote the reactivation of inflammatory pathways. The paper reviews the research progress between inflammatory cytokines and the development of obstructive sleep apnea in recent years.

Effect of ventricular-arterial coupling of etomidate and ciprofol on induction of general anesthesia in elderly hypertensive patients.

黄静翔,luojianhua — 2024/4/10 17:04:05

Objective analysis of the effects of etomidate and ciprofol on ventricular-arterial coupling during the induction of general anesthesia in elderly hypertensive patients. Methods Fifty-seven elderly hypertensive patients who underwent surgical treatment with general anesthesia at Guangzhou Red Cross Hospital from May 2023 to November 2023 were recruited and divided into the etomidate group (group E, 28 patients) and the ciprofol group (group C, 29 patients) using a randomized numerical table method.Record the average arterial pressure (MAP), heart rate (HR), left ventricle stroke volume (SV), effective arterial elastance (Ea), left ventricle end-systolic elastance (Ees), and Ea / Ees of two groups of patients before anesthesia induction (T0), 1 minute after anesthesia induction (T1), 2 minutes after anesthesia induction (T2), before tracheal intubation (T3), and 1 minute after tracheal intubation (T4).The postoperative extubation time, post-anesthesia care unit（PACU）recovery time, incidence of adverse events,use of atropine,phenylephrine and the number of patients with Ea / Ees>1.0 before tracheal intubation were recorded in both groups. Results Compared with T0, in group E,Ea / Ees increased at T1~T3, MAP, HR and SV decreased at T1~T3, HR increased at T4, Ea increased at T1 and T2, Ees decreased at T2~T4;in group C,Ea / Ees increased at T1~T4, MAP, HR, SV and Ees decreased at T1~T4, Ea increased at T1~T3 and decreased at T4,all differences were statistically significant(p<0.05).Compared with group C, groups E had higher HR and SV at T1-T4, lower Ea / Ees at T1-T4, higher MAP at T3 and T4, higher Ees at T1, T3, and T4, and lower Ea at T2,all differences were statistically significant(p<0.05).There were no statistically significant differences in postoperative extubation time, PACU recovery time, incidence of adverse events and use of atropine before tracheal intubation between the two groups（P >0.05）.Before tracheal intubation, the proportion of phenylephrine use and Ea / Ees > 1.0 in group C was significantly higher than that in group E, all differences were statistically significant(p<0.05). Conclusion Both etomidate and ciprofol have good safety profiles in elderly hypertensive patients during anesthesia induction,but etomidate can better maintain the ventricular-arterial coupling and hemodynamic stability.

TGF- β signaling affects osteogenic differentiation of mesenchymal stem cells derived from Odontogenic Myxoma

陈盛,陈星霖,秦海燕,孙国文,童昕,王忠山 — 2024/4/10 11:42:58

Objective To investigate the effect of TGF-β signaling on osteogenic differentiation of mesenchymal stem cells from Odontogenic myxoma (OMMSCs). Methods CBCT examination and postoperative pathological examination were performed in two patients with suspected odontogenic myxoma. The tissues of odontogenic myxoma and bone marrow of jaw were collected and cultured. The cells were identified by cell proliferation assay, flow cytometry and alizarin red staining. After 7 days of osteogenic culture, RT-qPCR was performed to analyze the expression of TGF-β signaling pathway and osteogenic related genes in OMMSCs and JBMSCs. Small molecule drugs SB431542 and TGF-β1 were added in osteogenic culture, and alizarin red staining was used to detect the in vitro results of osteogenic differentiation. Results The patient was confirmed as odontogenic myxoma by imaging and histological results. The isolated and cultured adherent cells had spindle shape, expressed MSC surface markers, and had osteogenic differentiation ability, conforming to the definition of MSC. Compared with JBMSCs, OMMSCs showed higher self-renewal capacity ability. PCR results showed that TGF-β / Smad signal-related genes were highly expressed in OMMSCSs, but expression of osteogenesis related genes (OPN) was decreased. Alizarin red staining showed that SB431542 could significantly promote the in vitro osteogenic differentiation of OMMSCs, and TGF-β1 could inhibit the in vitro osteogenic differentiation of OMMSCs, with statistical difference. Conclusions In this study, mesenchymal stem cells from odontogenic myxoma were successfully isolated and identified. It was found that TGF-β signaling related genes were highly expressed in OMMSC, and inhibition of TGF-β signal could enhance the in vitro osteogenic ability of OMMSCs, which is expected to be achieved by regulating TGF- β Signal pathway improves bone defects in odontogenic myxoma.

Progress on transcranial direct current stimulation on lower limb motor dysfunction after stroke Qian Duan,Wenyin Liu,Department of Rehabilitation, The Eighth People"s Hospital of Shanghai, Shanghai200105, China; Lin Zhang, Department of General Medicine, Kangqiao Community Health Service Center, Shanghai 201315,China )

DUAN,, — 2024/4/10 11:24:57

Lower limb motor dysfunction is a common sequela of stroke patients. In recent years,significantly impacting their quality of life and daily functional abilities. Transcranial direct current stimulation (tDCS), as a new non-invasive neuroregulation treatment technique, has received widespread attention and become a research hotspot. It is applied to improve gait balance disorders in the lower limbs after a stroke.In this article, we summarize the recent progress on the application of transcranial direct current stimulation for lower extremity motor dysfunction after stroke, and the possibility to promote the clinical use of tDCS for patients with lower extremity motor dysfunction after stroke in the future.

Correlation of Left Atrial Appendage opening parameters determined by preoperative CT Left Atrial Appendage imaging in patients with atrial fibrillation with the size of the occluders placed during Left Atrial Appendage Occlusion and analysis of the factors influencing the occurrence of peri‐device leak around instruments

柴夏宁,丁金祥,高楠琳,王杰,王新文,杨敏,赵继敏 — 2024/4/10 9:52:57

[Abstract] Objective To analyze the correlation between the left atrial appendage (LAA) opening parameters determined by preoperative computed tomography (CT) left atrial appendage imaging in patients with atrial fibrillation (AF) and the size of the placed occluders during Left Atrial Appendage Occlusion (LAAO), and the factors influencing the occurrence of peri‐device leak (PDL) in the postoperative period. Methods To retrospectively analyze the clinical data of 83 patients with nonvalvular AF who successfully implemented LAAO from January 2019 to December 2022 in the Second Hospital of Shanxi Medical University. They were divided into PDL group (23 cases) and no-PDL group (60 cases) according to the occurrence of PDL after surgery. Clinical data and LAA opening parameters were compared between the two groups. Pearson correlation was used to analyze the association between LAA opening parameters and the size of the placed occluders intraoperatively in LAAO.Logistic regression was used to analyze the risk factors for developing PDL after LAAO. Results The age of patients in the PDL group was significantly younger than that of the no-PDL group (P < 0.05), and the differences between the two groups in terms of gender and comorbid underlying diseases were not statistically significant (P > 0.05). The long diameter, short diameter, circumference, and area of the LAA opening in the PDL group were greater than those in the no-PDL group, and the difference was statistically significant (P < 0.05).Pearson correlation analysis showed that the long diameter, short diameter, circumference, and area of the LAA opening in the no-PDL group were positively correlated with the size of the placed occluders (P < 0.05).The results of multivariate logistic regression analysis showed that younger age and larger short diameter of LAA opening were independent risk factors promoting the occurrence of PDL after LAAO (P < 0.05). Conclusion CT left atrial appendage imaging can show the position of the postoperative occluders as well as the occurrence of PDL, and all LAA opening parameters are positively correlated with occluders size, with younger age and larger short diameter of LAA opening being independent risk factors promoting the occurrence of PDL after LAAO.

Research progress on the prevention and treatment of co-morbidities of type 2 diabetes and heart failure

张红 — 2024/4/9 17:00:35

In recent years, the prevalence of type 2 diabetes mellitus (T2DM) and heart failure (HF) has been increasing significantly. The two diseases often coexist, and patients with co-morbidities suffer from poorer quality of life as well as a poorer prognosis than patients with a single chronic disease. Therefore, early identification and prevention of patients with either of these conditions are crucial. This article mainly elaborates on the research progress of comorbidity of HF and T2DM from the risk factors, pathophysiological mechanisms, and pharmacological treatment, to help clinical physicians identify high-risk single-disease patients early and implement effective drug interventions to improve disease prognosis.

Analysis of the correlation between postoperative complications of vestibular schwannoma and obesity.

liwenzhuang — 2024/4/9 9:16:22

Objective To explore the correlation between postoperative complications of vestibular schwannoma(VS) and obesity. Methods Clinical and imaging data of 377 VS patients who underwent posterior approach to the sigmoid sinus for surgical treatment at the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University from June 2013 to June 2023 were retrospectively analyzed. Patients were categorized into obese group (BMI ≥28 kg/m2) (91 cases) and non-obese group (BMI <28 kg/m2) (286 cases) based on preoperative BMI. Univariate and multivariate analyses were performed using relevant statistical methods to discuss the correlation between postoperative complications of VS and BMI. Results A total of 377 patients were included, with a maximum BMI of 45.0 kg/m2, a minimum of 16.0 kg/m2, and a mean of 25.2 kg/m2. Univariate analysis showed that increased BMI was associated with postoperative cerebrospinal fluid leakage (p=0.011) and secondary surgery (p<0.005) after VS, where the incidence of cerebrospinal fluid leakage was 9.9% and 2.8% in the obese and non-obese groups, respectively.There was no correlation between BMI and postoperative intracranial infections, incision infections, deep vein thrombosis, intracranial hemorrhage and other complications after VS. Multifactorial logistic regression showed that increased BMI was an independent risk factor for postoperative cerebrospinal fluid leakage (OR=1.168, P=0.004) and secondary surgery (OR=1.160, P=0.003) after VS. Conclusion Increased BMI was strongly associated with cerebrospinal fluid leakage and secondary surgery after VS, but not with intracranial infection, incision infection, deep vein thrombosis, intracranial hemorrhage, and other complications.

Clinical and SDHx gene variant analysis of three Chinese pedigrees affected with hereditary head and neck paragangliomaGeng Jia1,3, Mailudan Ainiwaer1,2, Lu Yu1,3, Chen Fei1,2

Geng Jia,Lu Yu,Mailudan Ainiwaer — 2024/4/9 9:14:20

Object: To analyze the clinical and genetic characteristics of three Chinese pedigrees affected with head and neck paraganglioma. Methods: Three patient diagnoses at Department of Otolaryngology, Head and Neck surgery of West China Hospital from 2022 to 2023 were selected as the study subjects. Genomic DNA was extracted from peripheral blood samples of the probands and family members. Whole genome sequencing (WGS) was carried out to detected pathological variants of probands. Sanger sequencing was used for validating the candidate variant among the pedigrees. Results: The three pedigrees were diagnosed with heterozygous variants of? NM_003002.4:c.1A>G, c.274G>T in SDHD gene, and NM_003000.3:c.689G>A in SDHB gene, respectively. Conclusion: Genetic testing can clarify the molecular basis for head and neck paraganglioma and provide suggestions for clinical prognosis, screening strategy and genetic counseling.

Clinical efficacy of repeated transcranial magnetic stimulation assisted Citalopram hydrobromide in the treatment of sleep disorders after stroke and its influence on negative emotion and motor threshold

李静妍 — 2024/4/8 17:03:58

Objective To analyze the effects of repeated transcranial magnetic stimulation (rTMS) assisted Citalopram hydrobromide therapy on negative mood and motor threshold (MT) in patients with post-stroke sleep disorder (PSSD). Methods 94 patients with PSSD admitted to our hospital from April 2021 to January 2023 were divided into 2 groups with 47 cases each. The control group was treated with citalopram hydrobromide, and the combination group was treated with rTMS combined with Citalopram hydrobromide. The efficacy, sleep quality [Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI)], negative mood [Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)], MT, inflammatory factors [Tumor Necrosis Factor-α (TNF-α), interleukin-6 (IL-6), IL-2] levels were compared between the two groups. Results After 8 weeks of treatment, the total effective rate of the combined group (95.74%) was higher than that of the control group (78.72%) (P < 0.05). After 4 and 8 weeks of treatment, PSQI, ISI, BAI and BDI scores of the combined group were lower than those of the control group (P < 0.05); After 4 and 8 weeks of treatment, MT in combination group was higher than that in control group (P < 0.05). After 4 and 8 weeks of treatment, the levels of IL-6, TNF-α and IL-2 in combination group were lower than those in control group (P < 0.05). Conclusion rTMS combined with Citalopram hydrobromide is effective in the treatment of PSDD, which can reduce inflammation, increase MT, and improve sleep disorders and negative emotions.

Relationship between serum hexokinase-1 antibody and visual improvement after anti-VEGF treatment in patients with ischemic retinal vein occlusion

Wang Xizhe — 2024/4/8 17:02:49

Objective To evaluate whether the baseline serum hexokinase-1 antibody be related to the visual improvement of patients with ischemic retinal vein occlusion (RVO) after anti-vascular endothelial growth factor (VEGF) treatment. Methods From June 2017 to February 2020, 53 patients (53 eyes in total) with macular edema secondary to ischemic RVO (RVO-ME) [23 patients with central retinal vein occlusion (CRVO) and 30 patients with branch retinal vein occlusion (BRVO)] and 30 patients with senile cataract (control group) were investigated. Baseline serum was collected and hexokinase 1 antibody titers were measured. RVO patients received intravitreal injection of anti-VEGF drugs. Optical coherence tomography images were obtained at the time of follow-up visit every 3 months. Results Before treatment, the baseline serum hexokinase 1 antibody titer of RVO-ME patients was significantly higher than that of the control group (0.148 ± 0.097 AU vs. 0.062 ± 0.083 AU, P＜0.001), and the serum hexokinase 1 antibody titer of CRVO patients was slightly higher than that of BRVO patients (0.189 ± 0.096 AU vs. 0.118 ± 0.088 AU, P=0.007). The baseline serum hexokinase-1 antibody titer of RVO-ME patients was related to logMAR BCVA and the transverse length of interrupted ellipsoid zones of photoreceptors (EZ) line at baseline (P＜0.05). After 12 months of treatment, the titer of the autoantibody was only related to the improvement of BCVA and the shortening of the transverse length of the interrupted EZ band (P＜0.05). Multiple linear regression analysis showed that logMAR BCVA was only related to baseline BCVA at 12 months (P＜0.001). In addition, logMAR BCVA and baseline serum hexokinase 1 antibody titers were related to the improvement of BCVA at 12 months (P＜0.05). Conclusion Hexokinase-1 antibody is a new serum biomarker, which can predict the better visual improvement of of RVO-ME patients after anti-VEGF treatment.

Pancreatic metastatic renal clear cell carcinoma:a case report

liurongjun — 2024/4/8 9:47:36

Pancreatic metastatic renal clear cell carcinoma is rare, more than 50% of patients are asymptomatic, and tumors are usually detected during follow-up examination after surgery for primary lesions. At present, the diagnosis is mainly based on imaging tests. The main treatment option for pancreatic metastatic renal clear cell carcinoma is surgery. In this paper, the case data of a patient with pancreatic metastases in renal clear cell carcinoma are reported, and the clinical characteristics, diagnosis and treatment are analyzed in combination with relevant literature.

Community hospital ultrasonic diagnosis of ectopic intra-thyroidal thymus in children：a case report

zhouhaiyan — 2024/4/7 17:45:04

Ectopic intra-thyroidal thymus is rare, mostly found by chance, easily misdiagnosed as thyroid malignant tumor. Ultrasound is helpful to improve the clinical diagnostic accuracy and provide valuable imaging information for the diagnosis and treatment of children.

Effect of retinal photocoagulation on accommodation in myopic patients LI Wen-tao, WEN Yan-mei, ZHONG Li-ai,ZHANG Run-mei,YANG Zi-ying, DUAN Na, LIAO Rui. Depatment of optholmology, Huizhou Third People’s Hospital, Guangzhou Medical University, Huizhou 516000, China

李文涛 — 2024/4/7 17:43:55

［］ Objective To investigate the effect of retinal photocoagulation on accommodation in myopic patients. Methods This study was a prospective cohort study. A total of 40 myopic patients with retinal degeneration or tear who were about to have refractive surgery were randomly selected in this study. Their accommodation indexed and visual acuity of the same eyes were measured prior to the retinal photocoagulation and once a week for the next month. The accommodative indexes included were the amplitude of accommodation (AMP), positive and negative relative accommodation (NRA/PRA) and accommodative response (BCC) . Results All the patients had normal accommodation before laser photocoagulation. There were no significant changes in visual acuity( far and near visual acuity) and BCC between pre-treatment and post-treatment. The AMP、NRA and the absolute value of PRA decreased significantly at 1 week after laser photocoagulation (P<0.05), and then recovered gradually. Among them, NRA recovered to the pre-photocoagulation level at 2 weeks after the treatment, PRA recovered to the pre-photocoagulation level at 3 weeks after the treatment, AMP did not recover to the pre-photocoagulation level even at 1 month after the treatment. Conclusion Retinal photocoagulation can cause decline of AMP、NRA and the absolute value of PRA in myopic patients in 1 week and then recover gradually. It is recommended that for the myopic patients who have undergone the retinal photocoagulation, the refractive surgery should be arranged at 3 weeks or later after the treatment .

Analysis of the association between FTO, GSDMD and gastric cancer metastasis and its mechanism of action

2024/4/7 17:42:46

Objective To investigate the correlation between fat mass and obesity-associated protein (FTO) and gasdermin D (GSDMD) expression in gastric cancer tissues, and the effect of FTO regulation of GSDMD on gastric cancer cell migration. Methods The TIMER 2.0 online database was used to analyze the expression of FTO and GSDMD in pan-carcinoma. Collected tissue samples from 45 cases of gastric cancer patients and corresponding paracancerous tissue samples who underwent surgery in the Second Affiliated Hospital of Guangxi Medical University from January 2022 to March 2023, and collected clinical data of corresponding patients. The expression of FTO and GSDMD in tissues was detected by immunohistochemical staining, and the correlation between the two and its association with the clinicopathological features of patients was analyzed. A stable low-expression FTO cell line for gastric cancer AGS cells was constructed, and the expression of GSDMD mRNA in FTO low-expression cell line was detected by real-time quantitative polymerase chain reaction (RT-qPCR). Cell scratch and cell migration experiments were used to investigate the effect of low expression FTO on gastric cancer cell migration. Results The results of TIMER 2.0 database and immunohistochemistry showed that FTO and GSDMD were highly expressed in gastric cancer tissues, and the difference was statistically significant (P<0.05); Both FTO and GSDMD high expression groups were closely associated with tumor invasion depth and lymph node metastasis (P<0.05). The results of Kappa consistency analysis showed that the expressions of FTO and GSDMD were consistent in gastric cancer (P=0.012). RT-qPCR showed that the expression of GSDMD mRNA was significantly inhibited by inhibition of FTO expression (t=40.68, P<0.0001). Compared with the control group, the scratch healing rate and migration number of gastric cancer cells in the low-expression FTO group were significantly reduced, and the difference was statistically significant (t=10.25, P=0.0005; t=4.571, P=0.0103). Conclusion FTO may promote the metastasis of gastric cancer cells by regulating the expression of GSDMD.

SNHG3 promotes migration, invasion, and epithelial-mesenchymal transition of hepatocellular carcinoma cells through the miR-186-5p/ZEB1 axisCHEN Xiaolan, SU Yayong, LIU Shangping, WANG Lihui, XU Chengrun#(The 909th Hospital of the People"s Liberation Army, Zhangzhou, 363100; #Corresponding Author:xcrun18@sina.com)

陈小兰 — 2024/4/7 17:40:33

Objective Increasing evidence has shown that long non-coding RNA(LncRNA) is involved in the occurrence and development of hepatocellular carcinoma(HCC). However, little is known about the oncogenic mechanism of lncRNA small nucleolar RNA host gene 3 (SNHG3) in HCC. The aim of this study is to investigate whether SNHG3 promotes the migration, invasion and epithelial-mesenchymal transition of HCC by regulating miR-186-5p/zinc finger E-box binding homeobox 1(ZEB1). Methods HepG2 cells were transfected with small interfering RNA (siRNA) to knock down SNHG3 or pcDNA3.1+/SNHG3 to overexpress SNHG3, and real-time fluorescence quantitative PCR (qRT-PCR) was used to detect whether the transfection was successful. HepG2 cell proliferation was detected by colony formation assay. Scratch wound healing assay was used to detect the migration rate of HepG2 cells. Transwell assay was used to detect the number of HepG2 cell invasion. Dual-luciferase reporter assay was used to verify the targeting relationship between SNHG3 and miR-186-5p or miR-186-5p and ZEB1. qRT-PCR and Western blot were used to detect the mRNA and protein expressions of SNHG3, miR-186-5p, ZEB1, E-cadherin, N-cadherin, MMP2, Vimentin, MMP9 and Snail. Results The results showed that the expression of SNHG3 in HCC tissues was significantly higher than that in normal tissues, and the survival rate of patients with high SNHG3 expression was significantly lower than that of patients with low SNHG3 expression (p=0.00033). Overexpression of SNHG3 induced overexpression of ZEB1 to promote the proliferation, invasion, migration and epithelial-mesenchymal transition of HepG2 cells, while SNHG3 knockout down-regulated the expression of ZEB1 to inhibit the invasion, migration and epithelial-mesenchymal transition of HepG2 cells. Conclusion SNHG3 promotes the migration, invasion and epithelial-mesenchymal transition of hepatocellular carcinoma cells by regulating miR-186-5p/ZEB1, indicating that SNHG3 is a potential treatment target for HCC.

Research progress of tumor infiltrating natural killer cells in immunotherapy

黄琰菁,莫安薇,王亮,许薇 — 2024/3/25 17:33:59

Natural killer (NK) cells are innate lymphocytes with strong cytotoxicity and activity. Immunotherapy based on NK cells has achieved remarkable curative effect in the treatment of hematological tumors, but the curative effect in the treatment of solid malignant tumors is low. This article provides a review of the function, phenotype, and research progress of NK cells in tumor immunotherapy.

The Effect of Baseball Bat-like Gastric Tube on Anastomotic Leakage after McKeown Esophagectomy

ZOU Xin-yi — 2024/3/25 16:58:53

Objective To investigate the effect of baseball bat-like gastric tube on anastomotic leakage after McKeown esophagectomy. Methods The clinical data of 160 patients with esophageal cancer admitted to the First Affiliated Hospital of Soochow University from May 1, 2022 to May 1, 2023 were included in this study. These patients were divided into two groups according to the way of gastric-tube fabrication, the baseball bat-like gastric tube group and the typical gastric tube group. The general data and the incidence of postoperative complications such as esophageal anastomosis leakage between the two groups were recorded for analysis. In patients who were diagnosed with anastomosis leakage, the fever peak, duration of feaver, leukocytes peak, duration of leukocyte hypercapnia, the time of leakage diagnosis, and the presence of mediastinal abscess (manifestation of intrathoracic anastomosis leakage) were also recorded for comparison. Results The incidence of anastomosis leakage was lower in the baseball bat-like gastric tube group than in the typical gastric tube group, and the difference was statistically significant (χ2=4.335,P=0.037). In patients who were diagnosed with anastomosis leakage, the fever peak, leukocyte peak, leukocyte high duration, and incidence of mediastinal abscess (manifestation of intrathoracic anastomosis leakage) was significantly higher in patients in the baseball bat-like gastric tube group than in the typical gastric tube group, and the difference was statistically significant (t=3.147,P=0.004；t=2.227,P=0.034；t=2.644,P=0.013；P=0.027). Conclusion Making a baseball bat-like gastric tube during McKeown esophagectomy procedure helps to reduce the incidence of anastomosis leakage, but it increases the incidence of intrathoracic anastomosis leakage.

Developments in the Treatment of Metabolic Dysfuntion-associated Steatotic Liver Disease

LI Fu-jian,SONG Huai-yu — 2024/3/25 16:17:05

Metabolic dysfunction-associated steatotic liver disease (MASLD) has developed into one of the global chronic liver diseases and is a serious threat to people's health. However, the pathogenesis of MASLD is complex and no specific therapeutic drugs are available. In recent years, more pathogenesis and corresponding treatment options have been proposed as research continues to advance. The article mainly summarizes the new research results in recent years, involving research progress of lifestyle, drug treatment, and surgical treatment.

Study on Optimization of Magnetic Resonance GRE-T2*WI Sequence Parameters in Patients with Acute Stroke

Li Yanhua — 2024/3/25 10:34:18

Objective: To investigate the application value of magnetic resonance GRE-T2*WI sequence in patients with acute stroke. Method: 50 patients with AIS were treated in our hospital, including 38 males and 12 females, aged from 41 to 92 years old, with an average age of 65.5 ±5.9 years. Each patient was examined by GRE-T2*WI using four parameters, and four groups of images were obtained.Group A was the control group, group B reduced matrix and incentive times, group C adopted parallel acquisition technique and reduced incentive times, TR and TE,D group further reduced TR and TE on the basis of group C；The scanning time, image quality score, SNR and CNR of the four groups of images were compared.Result:There were significant differences in image quality score, SNR and CNR among the four groups (P < 0.05). The scanning time of Groups A to D were 81s, 40s, 15s and 11s, respectively, and the image quality scores were 3.79±0.19, 3.54±0.18, 3.12±0.26, 1.85±0.40,There was significant difference in image quality score between group C ? D (P < 0.05). There was no significant difference in image quality scores between group C A and group C B (P > 0.05). SNR in Group D was the highest, There was significant difference in SNR between group C group A and group C group B (P < 0.05), There was no significant difference in SNR between group C ? D (P > 0.05).The CNR of group C was the highest, There was no significant difference in CNR between group C An and group C D, There was significant difference in CNR between group C B (P < 0.05). Conclusion: GRE-T2*WI scanning time was shortened after parameter optimization and the image quality met the diagnostic requirements. It had greater application value for patients with acute stroke who needed urgent treatment.

Research progress in the biomechanical treatment of postural plagiocephaly

YANG ning,Ye xin — 2024/3/23 13:46:15

Postural plagiocephaly is a disease of abnormal cranial morphology in infants and young children, which can lead to abnormal biological force lines. Based on the biomechanics mechanism and long-term hazards of postural plagiocephaly, this paper reviewed the finite element analysis of infant cranial mechanics and various mechanical treatment methods, seeking the basis for carrying out the method of cranial orthosis, and providing a review basis for expanding techniques of cranial orthosis treatment in the future.

胰腺实性假乳头瘤伴肝转移1例

江敏芝, — 2024/3/20 10:02:55

胰腺实性假乳头瘤伴肝转移1例

Effects of maternal gestational diabetes mellitus on left ventricular function in the newborn

Huang Peilv,Lu Anfeng — 2024/3/19 9:41:25

Objective To investigate the effects of maternal gestational diabetes mellitus(GDM) on left ventricular myocardial mechanics in the newborn. Methods From January 2022 to July 2022, full-term infants of GDM mothers admitted to the neonatal department of our hospital were selected as the GDM group(98 cases) and full-term infants with non-GDM mothers during the same period were selected as the control group(383 cases). According to whether blood glucose level of their mothers was up to standard, neonates in GDM group were divided into up to standard group （63 cases）and not up to standard group（35 cases）. Two-dimensional tracking imaging was used to measure ventricular septal thickness and strain at each segment during the systolic peak of the ventricular septum in both groups and serum myocardial enzyme levels of CK、CK-MB、LDH、cTnI were collected.Their strain at each segment during the systolic peak of the ventricular septum, ventricular septal thickness and serum myocardial enzyme levels of CK、CK-MB、LDH、cTnI were compared between the two groups. Results No significant differences in CK、CK-MB、LDH、cTnI between the two groups（P＞0.05）. The thickness of ventricular septum in the GDM group were greater than the control group,the differences were statistically significant （P＜0.05）.The strain at each segment during the systolic peak of the ventricular septum in the GDM group were lower than those in the control group （P＜0.05）. The thickness of ventricular septum in the not up to standard group were greater than those in the up to standard group（P＜0.05）.The strain at each segment during the systolic peak of the ventricular septum in the not up to standard group were lower than those in the up to standard group（P＜0.05）. Conclusions Neonates of mother with GDM have thicker of ventricular septum as well as left ventricular myocardial mechanical changes,and the degree of changes was more significant in the not up to standard group. Much attention should be paid to the perinatal health care of GDM mothers, so that their blood glucose during pregnancy can be well controlled to reduce the adverse effects on neonatal left ventricular function.

Blood flow restriction training with different contraction modalities on medial femoral muscle function in patients with knee osteoarthritis and morphological effectsLI Peng-cheng,CHEN Xiao-xia,CHEN Yue-feng,LI Wei-ren,HUANG Li,YAO Na.Kunming Hospital of Traditional Chinese Medicine Rehabilitation Department, Kunming 650011,China

陈小霞,陈岳峰,黄丽,李鹏程,李维仁,姚娜 — 2024/3/19 9:39:22

To observe the effects of blood flow restriction training with different contraction modes on the function and morphology of medial femoral muscle in patients with knee osteoarthritis. Methods: 108 patients hospitalized with osteoarthritis of the knee joint from June 2021 to June 2023 were selected and divided into treatment group A, treatment group B and control group according to the method of randomized numerical table, with 36 cases in each group. The control group was given conventional isometric contraction training of the medial femoral muscle, treatment group A was given blood flow restriction training on the basis of the control group, and treatment group B was given isometric contraction training of the medial femoral muscle under blood flow restriction. Before and after 3 weeks of treatment, the knee pain was scored by visual analog scoring method, the thigh muscle circumference was measured by soft ruler and the thickness of the medial femoral muscle was measured by musculoskeletal ultrasound, and the iEMG and RMS of the medial femoral muscle were measured by surface electromyography analysis system, etc. Results: after 3 weeks of treatment: ①VAS score, thigh muscle circumference, and thickness of the medial femoral muscle were statistically significant differences between the treatment group A and control group. control group, the difference between treatment group A and treatment group B was statistically significant (P < 0.05); ② Comparison of iEMG and RMS of the medial femoral muscle, the difference between treatment group A and control group was statistically significant (P < 0.05); the difference between treatment group B and treatment group A was statistically significant (P < 0.05). Conclusion: ① Blood flow restriction training can effectively improve the pain, increase muscle thickness, circumference and muscle recruitment ability of patients with knee osteoarthritis; ② Under the condition of blood flow restriction, isotonic contraction is superior to isometric contraction, etc. in improving the pain of patients with knee osteoarthritis and in increasing the muscle thickness of the medial femoris muscle and the muscle circumference, and contraction is superior to isotonic contraction in improving the muscle recruitment ability.

Correlation study of serum uric acid level and characteristics of culprit vascular plaque in patients with acute coronary syndrome——— Research based on OCT

Liu Wei-feng,Ren Meng-meng,Su Xiu-tian,Yu Liang-liang, — 2024/3/19 9:38:21

[Abstract] Objective To investigate the correlation between serum uric acid (sUA) level and the plaque characteristics of coronary culprit vessels in patients with acute coronary syndrome (ACS), and to provide a theoretical basis for the clinical treatment of patients with ACS.Methods Patients diagnosed with ACS and underwent coronary angiography and OCT in the Department of Cardiovascular Medicine of Yantai Yuhuangding Hospital affiliated to Qingdao University from January 2018 to October 2022 were collected. ACS patients were classified into high uric acid group (sUA 6mg / dl) and low uric acid group (sUA <6 mg/dl), and the baseline clinical data, preoperative examination data, coronary angiography data and OCT image results of the two groups were compared. Results The proportion of men with high sUA, physical index, and proportion of hyperlipidemia were significantly higher than the low sUA group; age difference between the two groups (P <0.05). The levels of hemoglobin, creatinine, triglycerides, lipid protein A and homocysteine were significantly higher in the high sUA group than in the low sUA group; the rate of collateral circulation formation was significantly lower than that in the low sUA group (P <0.05). The rate of luminal stenosis, proximal lumen reference area, red thrombosis, and macrophage infiltration were significantly higher in the high sUA group than in the low sUA group (P <0.05).Multivariate regression analysis of the effect of sUA on the characteristics of coronary artery plaques in ACS patients showed that the risk of red thrombosis increased by 1.490 times for every 1mg/dL(60umol/L) increase in sUA level. The risk of macrophage infiltration was 1.278 times higher. Conclusion Higher sUA level was an independent predictor of increased risk of red thrombosis and macrophage infiltration.

Correlation of serum miR-133a and thyroid hormone levels changes in newly diagnosed hyperthyroidism patients

Huang Baole — 2024/3/19 9:37:18

Objective To investigate the significance and correlation of thyroid hormone changes and serum microRNA (miR) -133a level in newly diagnosed hyperthyroidism patients. Methods From October 2020 to August 2022, 100 patients with newly diagnosed dominant hyperthyroidism in the Department of Endocrinology of our hospital were selected as the hyperthyroidism group, of which 28 patients received standard methimazole treatment. Another 100 healthy subjects were selected as control group. The clinical data of gender, age, thyroid hormone, liver function and biochemical indexes were collected for all subjects. Real-time fluorescence quantitative PCR was used to detect the serum expression of miR-133a, whose correlations with changes in thyroid hormone levels were analyzed. Results At the time of enrollment, the expression level of miR-133a in serum of hyperthyroidism group was significantly lower than that of the control group [0.62 (0.53, 0.74) vs. 1.03 (0.88, 1.14), Z=-9.796, P＜0.001]. The area under the receiver operating characteristic curve of serum miR-133a for differentiating the hyperthyroidism group from the control group was 0.901 (95% CI: 0.859～0.943), and the best sensitivity and specificity were 79.0% and 87.0%. The results of correlation analysis showed that serum miR-133a was positively correlated with total cholesterol (TC) and thyrotropin (TSH) in hyperthyroidism group, and negatively correlated with serum free triiodothyronine (FT3) level (P＜0.05). After 2 months of treatment with methimazole, the levels of serum FT3 and free thyroxine (FT4) in 28 patients decreased significantly (P＜0.001), while the expression of miR-133a [0.67 (0.55, 0.74) vs. 0.97 (0.81, 1.06), Z=-3.962, P＜0.001], TC, triglyceride, low density lipoprotein cholesterol and TSH levels increased significantly (P＜0.05). In addition, the increase of serum miR-133a expression level was significantly correlated with the decrease of FT3 (r=-0.728, P＜0.001) and FT4 (r=-0.377, P=0.048). Conclusion The expression level of serum miR-133a in patients with hyperthyroidism is generally lower, which may be related to the pathogenesis of lipid metabolism disorder caused by thyroid hormone elevation.

Application of MHC-II combined with MHC-I immunohistochemical staining technique in the diagnosis of idiopathic inflammatory myopathy

duojianying — 2024/3/19 9:36:02

Objective To investigate the application of MHC-II combined with MHC-I immunohistochemical staining in the diagnosis of idiopathic inflammatory myopathy by comparing the MHC-I and MHC-II immunohistochemical staining results of different types of myopathy. Methods A total of 29 samples of the most representative idiopathic inflammatory myopathies (IIM) and non-inflammatory myopathies (NIM) were selected from the samples of muscle biopsy in the Department of Neurology, Xuanwu Hospital from 2010 to 2018. The former included 5 cases of myositis (DM), 5 cases of polymyositis (PM), 5 cases of inclusion body myositis (IBM), 5 cases of necrotic myopathy (NAM), the latter including 5 cases of muscular dystrophy (MD) and 4 cases of dysferlinopathy were treated with MHC-I and II immunohistochemical staining. Results In this experiment, the positive rate of MHC-I immunohistochemical staining in PM, DM and IBM group was 100%, the positive rate of MHC-I immunohistochemical staining in NAM and MD group was 80%, and the positive rate of MHC-I immunohistochemical staining in dysferlinopathy group was 20 %; the positive rate of MHC-II immunohistochemical staining in PM and IBM group was 40% and 50%, and the other groups were negative for MHC-II staining. Conclusion MHC-II staining has higher specificity than MHC-I staining in IIM and NIM groups. MHC-II combined with MHC-I immunohistochemical staining technique has certain clinical significance for the diagnosis of different types of myopathy

Analysis of surgical effects of Da Vinci robot surgery via subxiphoid approach and thoracoscopic surgery via subxiphoid approach in the treatment of anterior mediastinal diseases

lixiangwei,liusongtao,luojinlong,shenbin,sunsiyuan,sunzhendong,xuruihong — 2024/3/19 9:34:53

【Abstract】Objective To investigate the safety, stability and clinical efficacy of da Vinci robot-assisted thoracoscopic anterior mediastinal tumor resection via subxiphoid approach. Methods The clinical data of 56 patients with anterior mediastinal tumor treated in the People’s Hospital of Guangxi Zhuang Autonomous Region from January 2020 to January 2023 were analyzed retrospectively. Divided into the da Vinci robot group (RATS group, n = 20) and the thoracoscopic group (VATS group, n=36) according to different surgical approaches. T he operative time, intraoperative blood loss, 48h drainage, indwelling time of drainage tube, postoperative hospital stay, total hospitalization cost, postoperative complications and postoperative VAS score were compared between the two groups. Results All operations were successful. The operative time were shorter in the RATS group [(105.50±19.5)min] than those in the VATS group[(123.36±28.50)min], and the difference was statistically significant (P<0.05). The VAS scores of the RATS group on the 1st, 2nd and 3rd day after operation were lower than those in the VATS group, and the difference was statistically significant (P<0.05). In VATS group and RATS group, intraoperative blood loss was (24.03 ±34.89) ml vs (12.50 ±5.46) ml, 48 h drainage volume (225.28 ±233.08) ml vs (134.29 ±124.82) ml, drainage tube indwelling time (4.08 ±3.90) d vs (3.57 ±1.56) d, postoperative hospital stay (7.47 ±7.80) d vs (5.57 ±2.28), total hospitalization cost (3.20 ±2.49) ten thousand yuan vs (4.43 ±1.17) ten thousand yuan, there was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion The da Vinci robot-assisted thoracoscopic anterior mediastinal tumor resection via subxiphoid approach is safe and feasible. Its surgical safety and stability are the same as those of thoracoscopic surgery via subxiphoid approach with less injury and higher safety, which is conducive to rapid postoperative recovery.

Comparison of different surgical approaches and postoperative blood CTCs in patients with early papillary thyroid carcinoma

2024/3/19 9:33:49

Objective To compare traditional open radical surgery, trans axillary approach, and tans vestibular- submental approach in papillary thyroid carcinoma (PTC) patients with early stage, and to investigate the effects of the three different surgical approaches on circulating tumor cells (CTCs) in postoperative blood. Methods 109 patients with early PTC in our department from 2017 to 2022 were selected, all had CTCs within three days after operation, including 78 with traditional open surgery, 14 through axillary approach and 17 through vestibular- submental approach. The surgical approaches, circulating tumor cells and their classification [epithelial,epithelial/mesenchymal (mixed phenotypic), mesenchymal CTCs] in the postoperative blood were recorded. Results The difference of bleeding volume, number of lymph nodes and bleeding volume were significant, P < 0.05, in which the patients of the traditional open surgery (19.64 ± 15.25 ml) group had the longest postoperative hospital stay (3.63 ± 1.81 d), and the most lymph nodes in the central region (9.31 ± 6.06). Patients with the trans vestibular-submental approach had the least blood loss (7.18±4.17ml) and the shortest postoperative hospital stay (2.24±0.44d). The positive rate of total CTCs in the three groups was high, 86.24% (94 / 109). There was no significant difference in the positive rate of CTCs in the blood within three days after different surgical approaches, P> 0.05. The median difference of total CTCs (X2= 8.69, p=0.01) and mixed CTCs (X2= 13.06, p=0.00) were significant. Among them, postoperative total CTCs [16 (0 – 71)] and mixed CTCs [3.00 (0 – 65)] were the highest in the vestibular-submental approach. The surgical approach was positively correlated with the total CTCs and mixed CTCs in the blood of patients after early PTC, P <0.05. The amount of blood loss was negatively correlated with the total CTCs and the number of mixed CTCs in the patient's blood, and with whether the mixed CTCs were positive, P < 0.05. Conclusion The three approaches for early PTC were safe, with fewer complications and quick recovery, and each has its own advantages and disadvantages. Different surgical approaches affect the number and positive rate of postoperative CTCs in early PTC patients, and it is easier to bring mixed CTCs into the blood through trans vestibule-submental approach.

A case report of ileum metastasis of gastric cancer

baozhen,chencaiyun,,ouyangpeng — 2024/3/19 9:11:38

Effectiveness of mHealth application for gestational diabetes patients:A Meta-analysis

Li Ya-Ming,Liao Rong,,Yang Hui — 2024/3/14 17:37:04

【】 Objective? To systematically evaluate the effects of mobile medical treatment on pregnant women with diabetes . Methods? We searched databases including PubMed, The excerpta medical database (Embase), Cochrane library, nursing full-text journal database (CINAHL), Web of Science, Chinese journal full text database, Wanfang database Randomized controlled trial on the application effect of mobile medicine on pregnant women with diabetes in the Weibo journal resource integration service platform. The search period is from the establishment of the database to December 2022. Meta analysis was conducted using Revman 5.4 software. Results? A total of 11 articles were included, including 1403 patients. Meta analysis results showed that mobile healthcare can reduce fasting blood glucose levels [MD=-0.14, 95% CI (-0.26, -0.01), P=0 04]. Improve glycosylated hemoglobin [MD=-0.58, 95% CI (-0.65, -0.51), P<0.00001]. When mobile medicine is combined with diet guidance, it is beneficial to control weight gain during pregnancy [MD=-1.55, 95% CI (-1.81, -1.30), P<0.00001]. It has no significant effect on improving blood pressure indicators of diabetes patients during pregnancy. Systolic blood pressure[MD=0.39,95%CI(-2.16,1.39),P=0.67], diastolic blood pressure [MD=-1.14,95%CI(-2.60,0.32), the difference was not statistically significant. Conclusion? mHealth application can improve multiple outcome indicators of patients with gestational diabetes, and the effect is significant. In the future, high-quality large sample randomized controlled trials are still needed for further research.

Repetive peripheral magnetic stimulation on the median nerve can improve the effectiveness therapy for hemiplegic children with cerebral palsyWANG Min1 QIU Aizhen1? WU Ye1*JI Qianqian1

wangmin — 2024/3/12 9:29:31

Objective:To study the effect of median nerve magnetic stimulation on upper limb function especially hand function in children with spastic hemiplegia.Methods: Sixty children with spastic hemiplegia were divided into control group (30 cases) and study group (30 cases) by random number table method. Both groups received conventional rehabilitation treatment,? The study group performed median nerve magnetic stimulation on the basis of routine rehabilitation treatment, and before rehabilitation treatment;The control group received median nerve pseudo-stimulation on the basis of conventional rehabilitation treatment. Caroll upper limb function test (UEFT), Block Test and Fudan Infant Hand Function Assessment (Mini-MACS) were used to evaluate the effects of spastic hemiplegia before treatment and 4 weeks after treatment.Results:After 4 weeks of treatment, UEFT gripping function score [control group (18.29±3.16), study group (24.67±2.87)], Block Test score [control group (10.03±3.15), study group (15.73±3.99)] and Mini-MACS score were statistically different between the two groups (P<0.05); There was no significant difference in UEFT coordination score between control group (10.64±1.76) and study group (10.10±1.77) after treatment (P>0.05); UEFT grip function, Mini-MACS, and Block Tests improved significantly in the study group compared to the control group (P<0.05).Conclusion:Median nerve magnetic stimulation combined with rehabilitation therapy is more effective than rehabilitation therapy in improving hand function in children with spastic hemiplegia.

Effects of illumination intensity on diopter, retinal structure and the expressions of Lumican and MMP-2 in scleral tissues of guinea pigs with myopia

符俊达,贾娜,孙轶军,杨婉晨,朱海萍 — 2024/3/12 9:28:43

Objective: To explore the effects of illumination intensity on diopter, retinal structure and the expressions of Lumican and matrix metalloproteinase-2 (MMP-2) in scleral tissues of guinea pigs with optical defocus myopia. Methods:The 3-week-old guinea pigs with different genders were enrolled, and the guinea pigs with right-eye optical defocus low to moderate myopia were induced by concave lens. Among them, 60 guinea pigs were randomly selected and divided into group A (daily outdoor sunniness for 3h/d, 60,000 lux), group B (daily cool outdoor place for 3h, 10000 lux), group C (daily north window of the room for 3h, 2000 lux) and group D (daily normal feeding in the room, 300 lux), 15 cases in each group. In rest of the time, all guinea pigs were given the same indoor feeding. The biological parameters of eyes (axial length, diopter) were compared. The retinal tissue injury was observed by TUNEL staining and transmission electron microscopy. The expressions of Lumican and MMP-2 in scleral tissues were detected. Results: Before illumination, there was no significant difference in diopter and axial length of right eye (modeling eye) in different groups (P>0.05). After 6 months of illumination, there were significant differences in diopter and axial length in different groups (P<0.05). In the four groups, changes of axial length were the fewest, and myopia progression was the slowest in group A. There was different degree of pathological damage in the retina in all groups. The number of apoptosis cells in retina was the least, and the pathological damage was the mildest in group A. Compared with group D, Lumican expression was increased, while MMP-2 expression was decreased in group A and group B. Lumican expression was the highest, while MMP-2 expression was the lowest in group A (P<0.05). Conclusion: High outdoor illumination intensity can up-regulate Lumican expression and down-regulate MMP-2 expression in scleral tissues, stabilize scleral structure in guinea pigs, which can slow down the growth of eye axis and myopia progression.

Comparison of clinical characteristics and prognosis of different inflammatory phenotypes of AECOPD patients

刘娟,秦艳,王丽君,祝雅静 — 2024/3/12 9:27:57

Objective To explore the clinical characteristics and prognosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with different inflammatory phenotypes. Methods A total of 255 patients with AECOPD admitted to the Department of Respiratory Medicine, Subei People’s Hospital, from January 2021 to April 2022 were selected as the study subjects. According to the initial peripheral blood cell count results at admission, the patients were divided into eosinophil group (87 cases), neutrophil group (92 cases), mixed granulocyte group (30 cases) and agranulocytosis group (46 cases). The clinical characteristics and readmission rates of acute exacerbation within one year after discharge were compared among the four groups. Results There were statistically significant differences in WBC, EOS%, EOS, NE%, NE, LY%, LY, NLR, CRP, PCT and ALB levels among the four groups (P<0.05). The neutrophil group showed higher WBC, NE%, NE, NLR, CRP and PCT, and lower EOS%, EOS, LY%, LY and ALB levels compared with the eosinophil group. Meanwhile, the mixed granulocyte group had higher WBC, NE%, NE and NLR, and lower LY%, LY and ALB levels than those in the eosinophil group, and had higher EOS% and EOS levels than those in the neutrophil group. Compared with the neutrophil and mixed granulocyte groups, the agranulopenia group demonstrated lower WBC, NE%, NE, NLR and PCT, and higher LY% and LY levels. In addition, EOS% and EOS levels in the agranulopenia group were lower than those in the eosinophil and mixed granulocyte groups, while CRP level was lower than that in the neutrophil group, with statistically significant differences (P<0.05). There were statistically significant differences in the pulmonary function indexes among the four groups (P<0.05). The neutrophil group showed lower FEV1%pred and FEV1/FVC levels compared to the eosinophil group. Moreover, FEV1%pred and FEV1/FVC levels in the agranulopenia group were higher than those in the neutrophil group, while FEV1/FVC level was higher than that in the mixed granulocyte group, and the differences were statistically significant (P<0.05). There were also statistically significant differences in the length of hospitalization, utilization rates of intravenous corticosteroids and antibiotics among the four groups (P<0.05). The neutrophil group displayed longer length of hospitalization and higher utilization rates of intravenous corticosteroids than those in the eosinophil group, and higher utilization rates of antibiotics than those in the eosinophil and agranulopenia groups, with statistically significant differences (P<0.05). The Kaplan-Meier survival curves showed that the readmission rates of acute exacerbation presented a significantly decreasing trend among the neutrophil, mixed granulocyte, agranulocytosis and eosinophil groups, with 61.06%, 54.78%, 45.23% and 42.89% respectively, and the log-rank test revealed a statistically significant difference (?2=10.816, P=0.013). Conclusions There are significant differences in the inflammation indexes, nutritional status, pulmonary function, length of hospitalization, therapeutic effect and prognosis among the AECOPD patients with four inflammatory phenotypes based on peripheral blood cell counts. AECOPD patients with neutrophilic type demonstrate more severe clinical features and have a higher readmission rate of acute exacerbation within one year after discharge than those with eosinophilic type.

Characteristics and prognostic analysis of SMARCA4 deficient non-small cell lung cancer

汤誉 — 2024/3/12 9:26:36

Objective To explore the clinical and pathological characteristics and prognostic factors of SMARCA4 deficient non-small cell lung cancer (NSCLC). Method A retrospective analysis was conducted on the clinical data of 106 NSCLC patients admitted to our hospital from January 2016 to June 2021. In addition, 212 NSCLC patients with SMARCA4positivity confirmed by pathology were selected as the control group using random sampling method. Clinical, pathological data, and 2-year survival of patients were collected. The Cox proportional risk model identify independent risk factors affecting OS in SMARCA4 deficient NSCLC patients. The Kaplan Meier survival curve were used to compare the 2-year survival difference between the SMARCA4 deletion group and the non SMARCA4 deletion group. Results Compared with the non-SMARCA4 deletion group, the SMARCA4 deletion group had older age, higher proportion of males, smoking history, larger tumors, higher Ki-67 index, higher proportion of adrenal metastasis, higher proportion of lymph node metastasis and other site metastasis, lower proportion of EGFR mutations, lower proportion of squamous cell carcinoma, and higher proportion of poorly differentiated carcinoma (all P<0.05). Nineteen patients underwent next-generation sequencing (NGS) testing, with an average tumor mutation burden of 10.43 Muts/Mb. The RG1 protein was completely absent in 95.28% of patients in the SMARCA4 deficiency group. 91.80% were CK7 positive, 90.43% were CK5/6 negative, 77.78% were TTF-1 negative, 82.07% were p65 negative, 66.66% were CD34 negative, and 56.52% were SALL4 protein negative. The mOS of non-SMARCA4 deficient NSCLC patients was 21.665 months (95% CI: 20.981-22.349), which was inferior to the 2-year survival of SMARCA4 deficient patients (?2=126.837, P<0.001). Male (HR=4.124,95% CI=1.384-12.28), age (HR=1.227,95% CI=1.024-1.469), smoking history (HR=2.240,95% CI=1.291-3.885), and tumor size (HR=1.447,95% CI=1.119-1.870) are independent risk factors affecting 2-year survival in SMARCA4 deficient NSCLC patients. Conclusion: SMARCA4 deficient NSCLC is a different type of tumor from non SMARCA4 deficient NSCLC, with poor prognosis and high tumor invasiveness in patients. The efficacy of immunotherapy combined with chemotherapy needs to be observed for a longer period of time.

Technical discussion and scheme selection of nephron sparing surgery for giant renal hamartoma

Yakun,,, — 2024/3/5 9:39:49

[abstract] objective: to explore the technique and choice of nephron sparing surgery for giant renal hamartoma. Methods: 35 cases of giant renal hamartoma treated in our department from January 2015 to June 2022 were collected and underwent nephron sparing surgery. Open or laparoscopic resection of the tumor through abdominal approach while retaining enough renal parenchyma. The preoperative serum creatinine was (61.80 ±13.75) μ mol/L. 24 cases were examined by renal ECT and renal function test. The mean GFR of the affected kidney was (51.6 ±5.7ml ·min-1)-1. Results: all the operations were completed successfully, there was no conversion, no rupture and bleeding. The operation time was (139.8 ±54.9) min and the blood loss was (279.7 ±310.4) ml. The cold ischemia time of 22 cases of open surgery was (36.4 ±13.9) min,13. The warm ischemia time of laparoscopic surgery was (26.4 ±4.9) min. Serum creatinine was reexamined within 3-5 days after operation. (69.99 ±17.54) μ mol/L. The postoperative extubation time was 4.8 ±1.6d, the postoperative hospital stay was 6.7d. The renal ECT score of renal function examination was performed in 18 cases. The mean GFR of the affected kidney was (37.3 ±8.1ml ·min-1)-1, which was significantly different from that before operation. During the follow-up of 46.1 ±26.9months, the renal function was normal and no tumor recurrence was found. Conclusion: nephron sparing surgery for giant renal hamartoma is safe in the center of mature technology and is of great significance for patients.

The role of environmental enrichment in children with autism spectrum disorders and advancements in its application

yangxiaozhen — 2024/2/19 8:06:12

Autism spectrum disorders (ASDs) are a group of neurodevelopmental disorders whose prevalence is increasing year by year and for which there are no medications to treat the core symptoms of ASD. A increasing body of research examines the role that environmental influences play in neurodevelopment because inherent genetic elements are not controlled.The article outlines the potential mechanisms of influence of the enriched environment and the situational intervention model developed based on this theory in the treatment of ASD interventions in China, providing new therapeutic strategies and targets for ASD-related disorders.

Effect of β1 blocker on prevention and treatment of septic cardiomyopathy HU Sheng-hui, YAO Li-ying, WEI Wei, GAO Yan. Graduate School, the Fourth Affiliated Hospital of Harbin Medical University, Harbin 15000, China

hushenghui — 2024/2/19 8:05:44

Septic cardiomyopathy is a reversible myocardial injury caused by sepsis. It is a non-ischemic acute cardiac dysfunction and can significantly increase the mortality of patients with sepsis. At present, the clinical understanding of septic cardiomyopathy is insufficient, and its treatment effect has been poor. It has been reported in the literature that β1 receptor blockers have anti-stress, anti-oxidation, immune regulation and cell death inhibition, and have potential protective effects on myocardium, but their actual use is controversial. This review aims to comprehensively elaborate the mechanism of β1 blockers protecting myocardium in sepsis and the current clinical application of β1 blockers, so as to provide some help for further research and standard clinical application.

Analysis of the status quo and influencing factors of expectant sadness in young and middle-aged cancer patients undergoing chemotherapy

LAN Jie,LIN xue,lu lingling — 2024/2/19 8:04:54

Objective To understand the current situation of expectant sadness in young and middle-aged cancer patients undergoing chemotherapy and analyze its influencing factors. Methods The convenient sampling method was used to select the young and middle-aged cancer chemotherapy patients in a third-class A hospital in Guangxi Province as the survey objects. The general data questionnaire, the cancer patients" expected sadness scale, the family resilience assessment scale, and the social support assessment scale were used to investigate. The single factor analysis and multiple linear regression were used to analyze the influencing factors of the expected sadness level of young and middle-aged cancer chemotherapy patients. Results The average score of expected sadness of young and middle-aged cancer patients undergoing chemotherapy was (38.40±5.85), which was lower than the middle level. The results of multiple linear regression analysis showed that family monthly income per capita, pain response, family resilience, and social support score were the influencing factors of the expected sadness of young and middle-aged cancer patients undergoing chemotherapy (P<0.05). Conclusion It is urgent to pay attention to the expected sadness of young and middle-aged cancer patients undergoing chemotherapy, and formulate systematic and effective intervention strategies to reduce their expected sadness level in combination with their family monthly income per capita, pain response, family resilience, and social support level.

1.2.3 QPCR

cao yusheng,,,,,, — 2024/2/8 17:26:29

Objective Analyzing the relationship between miR-3189-3p and prognosis of colorectal cancer and its mechanism of action. Methods Analysis of miR-3189-3p expression differences in tumor and normal tissues and the impact of miR-3189-3p expression levels on patient prognosis through the online databases; Real-time fluorescence quantitative PCR (QPCR) was used to determine the overexpression efficiency of miR-3189-3p after transfection with miR-3189-3p mimics; cell scratch assay and Transwell assay were performed to assess the effect of miR-3189-3p on the cell migration and invasion ability of colorectal cancer cell line LOVO; Protein blotting assay to analyze changes in expression of key proteins for epithelial-mesenchymal transition (EMT) after overexpression of miR-3189-3p. Results After overexpression of miR-3189-3p, the migration and invasion ability of LOVO was reduced compared with the control group, and the expression of EMT key protein vimentin and N-cadherin was decreased compared with the control group. Conclusion miR-3189-3p is strongly associated with survival prognosis of colorectal cancer patients and metastasis, invasion, and epithelial-mesenchymal transition of colorectal cancer.

Comparion of early postoperative visual quality in patients with low myopia without astigmatism between SMILE and WG-FS-LASIK

kong min — 2024/2/8 17:25:58

[Abstract] Objective To observe the effect of SMILE and WG-FS-LASIK on early postoperative visual quality in patients with low myopia without astigmatism. Methods Together 15 patients (30 eyes) who underwent SMILE surgery and 15 patients (30 eyes) who underwent WG-FS-LASIK surgery in the Science Optics Center of the People's Hospital of Guangxi Zhuang Autonomous Region from March to June 2022, were selected, all patients had no astigmatism before operation and the best corrected visual acuity require for the minimum spherical lens degree was less than - 3.00D. UCVA, total aberrations including coma, trefoil and spherical aberration, objective scattering index (OSI), MTF cut-off frequency (MTFcutoff), Strehl ratio (SR), and predictable contrast vision (PVA) , including PVA 100%, PVA 20%, and PVA 9%, were measured before and 1 day, 1 week and 1 month after surgery in all patients. The measured data were statistically analyzed. Results There was no significant difference in UCVA, spherical mirror degree, OSI, MTFcutoff, SR, PVA, coma, trefoil and spherical aberration between the two groups before operation (P>0.05). There was no statistically significant difference between the two groups at different time points in spherical equivalent, UCVA, MTFcutoff, SR, PVA 100%, PVA 20%, trefoil and spherical aberration (P>0.05); There was statistically significant difference of OSI and PVA 9% between group comparison (P<0.05), The difference among OSI, SR and PVA 9％ at 4 time points have statistically significant (P<0.05), MTFcutoff group and time interaction have statistical significance (P<0.05); There also was statistically significant difference of coma aberration between group comparison (P<0.05), The difference among coma, trefoil and spherical aberration at 4 time points also have statistically significant (P<0.05), coma aberration group and time interaction have statistical significance (P<0.05). Conclusion Both SMILE and WG-FS-LASIK can improve the early postoperative visual quality of patients with low myopia without astigmatic. WG-FS-LASIK has better visual recovery than SMILE in the early postoperative period, and better visual quality at night.

Research progress on the role of intestinal flora and its metabolites in the occurrence and prevention of RSA

袁雪娇 — 2024/2/8 17:08:03

The incidence of recurrent spontaneous abortion (RSA) is about 5 % in women of childbearing age, which seriously affects family harmony and women "s physical and mental health. The types and quantities of intestinal flora in healthy adults are in a dynamic balance. The stable state of intestinal flora can reflect the health status of the body. The disorder of intestinal flora will affect the occurrence and development of various reproductive endocrine diseases, and the composition of maternal intestinal flora changes significantly during pregnancy. Therefore, this article mainly discusses the clinical significance of RSA prevention and treatment, the influence of intestinal flora and its metabolites on RSA, the influence of intestinal flora on reproductive endocrine diseases, which further leads to RSA, and the improvement of RSA pregnancy outcome through intervention therapy such as diet, traditional Chinese medicine and exogenous intestinal flora. It provides a new direction for the diagnosis and treatment of RSA and a new idea for improving pregnancy outcome.

A case of pulmonary mucormycosis and literature review

褚衍彪,高薇,李艳,庞龙滨,裴凤艳 — 2024/2/8 15:34:24

Objective: To improve the understanding of pulmonary mucormycosis by analyzing the clinical features of the disease. Methods: The clinical manifestations, onset history, examination and treatment process and prognosis of one case of pulmonary mucormycosis admitted to our department were reported, and to analyze the clinical features, diagnosis and treatment and prognosis . Results: The patient was confirmed by histopathological examination of lung lesions, and his condition improved after combined antifungal therapy. Conclusion: The early diagnosis of Mucormyces pulmonary is difficult, and when the effect of antibacterial therapy or general antifungal therapy is not good, histopathological biopsy and culture should be performed as soon as possible, and antifungal treatment should be performed in time after diagnosis.

A case of thyroid carcinoma implanted by needle trace after fine needle aspiration

duqingyun,huangchi,,zengzheng — 2024/2/8 15:33:52

At present, fine needle aspiration has become an accepted method to evaluate the benign and malignant thyroid nodules. Although the seeding rate of tumor cells along the needle path after fine needle aspiration is very low, the occurrence of this situation is unpredictable. We report a patient who showed tumor spread only two months after fine needle aspiration. A forty-nine year old woman developed a cervical mass following a fine needle thyroid biopsy. After surgical removal of the mass, the histopathological diagnosis was papillary thyroid carcinoma. The site of the metastasis suggests that tumor seeding was likely caused by fine needle biopsy. Therefore, although fine needle aspiration is an effective tool for the diagnosis of thyroid nodules, it is necessary to have a certain awareness of its potential complications.

Current status and evaluation of literature on rat models of primary liver cancer

徐亮 — 2024/2/8 15:32:58

Literature Research Objective: To familiarize yourself with the current research status of rat modeling methods for primary liver cancer, and provide useful guidance for establishing standardized rat models of the disease. Methods: Using the Chinese search terms "primary liver cancer" and "rat model", the relevant literature published from January 2006 to December 2021 was searched using CNKI and Wanfang database. The modeling methods, types and doses of modeling drugs, modeling cycle, and post modeling evaluation included in the literature were analyzed. Results: A total of 115 valid articles were included in this study. The most commonly used animal model was Wistar rats, with 7 types of modeling inducers and 6 main modeling methods. The modeling cycle ranged from 10 to 24 weeks. The most commonly used modeling drug is an aqueous solution prepared with diethyl nitrite (DEN), accounting for 63.5%; The most commonly used method of modeling is the DEN free drinking method, accounting for 36.3%; In terms of post modeling evaluation, objective evaluation was the main method, accounting for 48.7%. Conclusion: There are various forms of animal modeling drugs, methods, and evaluation for primary liver cancer in China, and there is no unified standard. However, the rat model of liver cancer induced by carbon tetrachloride (CCL4)+DEN subcutaneous injection+free drinking has the advantages of simple operation, short modeling cycle, and high modeling rate, which is worth promoting. Using joint evaluation for post modeling evaluation can observe the behavioral changes during carcinogenesis in rats, and dynamically analyze the process of hepatocarcinogenesis in rats and the pathological changes of the liver in rats on images. A convincing model of primary liver cancer in rats has been constructed.

The value of the FIRST simplified frailty scale in assessing real-world patients with newly diagnosed multiple myeloma

yaoqiong — 2024/2/8 15:32:24

［］ Objective To investigate the predictive value of the FIRST simplified frailty scale in patients with newly diagnosed multiple myeloma in a real-world setting.Methods Retrospective analysis of clinical data of 131 newly diagnosed multiple myeloma patients admitted to the Third Hospital of Shanxi Medical University from July 2014 to December 2021.They were divided into frail and non-frail groups according to the First simplified frailty scale.The best efficacy response,cumulative incidence of early grade ≥3 infection,mortality within 1 year and overall survival during treatment were statistically analysed in the two groups.A subgroup analysis was also performed for patients receiving bortezomib-based regimens.Results 131 patients were included in the analysis,according to the FIRST frailty score,50 (38.17%) and 81 (61.83%) in the frailty and non-frailty groups, respectively.18(36.00%) and 37(45.68%) achieved ≥very good partial remission (VGPR) in the frail and non-frail groups,respectively,but the difference was not statistically significant (P＞0.05); the cumulative incidence of early (within 4 months) grade ≥3 infections was 26 (52. 00%) and 27 (33.33%),respectively,and the 1-year mortality rates were 10 (20.00%) and 6 (7.41%),respectively,with statistically significant differences (P＜0.05).Median overall survival (OS) was significantly lower in the frail group than in the non-frail group at 36 versus 81 months (HR：2.088；95%CI：1.205-3.619;P=0.003);median progression-free survival time was significantly lower in the frail group than in the non- frail group,16 and 34months,respectively (HR=2.392；95%CI：1.748-3.273;P＜0.001). In the subgroup analysis of 100 cases treated with bortezomib based induction therapy,38 (38.00%) and 62 (62.00%) cases were in the frail and non-frail groups,respectively.The efficacy of ≥VGPR was 12 (31.58%) and 30 (48.39%) in the frailty and non-frailty groups,respectively,but the difference was not statistically significant (P＞0.05); the cumulative incidence of early (within 4 months) grade ≥3 infection was 20 (52. 63%) and 20 (32.26%),respectively,with statistically significant differences (P＜0.05),and mortality within 1 year was 8 (21.05%) and 5 (8.06%),respectively,but the difference was not statistically significant (P＞0.05).Median OS was significantly lower in the frail group than in the non-frail group,34 and 84months,respectively (HR:3.210;95%CI：1.578-6.532;P<0.001);median progression-free survival time was significantly lower in the frail group than in the non-frail group,15 and 33months,respectively (HR=2.478;95%CI:1.775-3.460;P<0.001). Conclusion The FIRST simplified frailty scale is applicable to real-world newly diagnosed multiple myeloma (NDMM) patients and can be used in clinical practice.

Wharton’s jelly-modified electrospun artificial vascular scaffold to promote vascular regeneration

Jiang Tingbo — 2024/2/8 15:31:34

Objective This study aims to explore the feasibility of using Wharton"s Jelly (WJ)-modified Polycaprolactone (PCL) electrospun artificial vascular scaffolds in promoting vascular reconstruction. Methods The WJ tissue was decellularized using trypsin, and the efficiency of decellularization was validated through histological staining (including H E, DAPI, Safranin-O, Toluidine blue, Sirius red, and Alcian blue staining) and biochemical component analysis (DNA content, GAG content, and hydroxyproline content) to assess the differences in biochemical composition before and after decellularization. Additionally, the levels of bioactive factors (including VEGF, PDGF, TGF-β1, and FGF-2) in WJ tissue were quantitatively analyzed using ELISA kits to evaluate changes before and after decellularization. Subsequently, the processed WJ was mixed with PCL to prepare the electrospinning solution, and the tubular WJ/PCL electrospun artificial vascular scaffolds were fabricated using electrospinning technology. The nanofiber structure was evaluated through macroscopic observation, scanning electron microscopy (SEM) observation, and quantitative analysis of fiber diameter distribution. From a chemical composition perspective, Fourier-transform infrared spectroscopy (FTIR) was employed to confirm the successful blending of WJ and PCL. The biomechanical properties, including compression stress-strain curve, ultimate tensile stress, and elongation at break, were evaluated using compression testing. Blood compatibility was validated through co-culture with arterial blood for 30 minutes, and the ability to inhibit platelet deposition was quantitatively assessed using lactate dehydrogenase assay kits. Results The results demonstrated that trypsin decellularization effectively removed nuclear components from the WJ matrix while preserving the majority of biochemical components, including GAGs, proteins, fibers, hyaluronic acid, and hydroxyproline, as well as bioactive factors such as VEGF, PDGF, TGF-β1, and FGF-2. Macroscopic and SEM observations confirmed the typical nanofiber structure of the electrospun WJ/PCL artificial vascular scaffold. FTIR analysis verified the presence of characteristic peaks of both WJ and PCL in the electrospun scaffold. Furthermore, the WJ/PCL electrospun artificial vascular scaffold exhibited excellent biomechanical properties, blood compatibility, and efficient inhibition of platelet adhesion. Conclusion WJ is an ideal natural material source that can be combined with synthetic materials like PCL to fabricate electrospun artificial vascular scaffolds with desirable biological properties.

Effects of remimazolam on postoperative delirium and early clinical prognosis in elderly patients undergoing herat valve replacement surgery by extracorporeal circulation

樊青,,, — 2024/2/8 15:30:52

[Abstract] Objective To investigate the effects of remimazolam for induction and maintenance of general anesthesia on postoperative delirium in elderly patients undergoing heart valve replacement surgery by cardiopulmonary bypass (CPB). Methods A total of 334 elderly patients aged 65 to 79 years who were selected for heart valve replacement surgery by CPB in the operating room of our hospital were recruited, and divided into remimazolam group (group R) and propofol group (group P), 167 cases in each group, according to the random number table method. Remimazolam 0.2-0.3 mg/kg was injected intravenously during anesthesia induction in the group R, and remimazolam 0.5-1.0 mg·kg-1·h-1 was pumped intravenously during anesthesia maintenance; the patients of the group P was intravenously injected with propofol 1.0-2.0 mg/kg during anesthesia induction, and intravenous infusion of propofol 4-10 mg·kg-1·h-1 was administrating during anesthesia maintenance. The rest of the anesthesia induction and maintenance were the same between the two groups. POD was assessed by the intensive care unit (ICU) consciousness disturbance assessment method (CAM-ICU) within 3 days after the operation. The time of recovery from anesthesia, the time of tracheal catheter removal, the time of stay in intensive care unit (ICU) and the time of hospitalization were recorded. The incidence rate of intraoperative and postoperative complications including sinus bradycardia or hypotension/hypertension, postoperative infection, etc. were recorded. Results Within 3 days after surgery, there were 55 cases (34.4%) of POD in the R group and 47 cases (29.6%) of POD in the P group. There were 105 cases (65.6%) and 112 cases (70.4%) without POD in the R and P groups, respectively. There was no statistically significant difference in the incidence rate of POD between the groups (P>0.05). There was no statistically significant difference in the severity and average duration of POD between the two groups of patients (P>0.05). Compared with the group P, the recovery time of anesthesia, the time of tracheal catheter removal and the length of ICU stay in the group R were significantly shorter (P<0.05). There was no significant difference in postoperative hospital stay between the two groups (P>0.05). Compared with the group P, the incidences of sinus bradycardia and hypotension during operation in the group R were significantly decreased (P<0.05). Conclusion Compared with propofol, remimazolam does not increase the incidence of POD during induction and maintenance of general anesthesia in elderly patients undergoing heart valve replacement surgery by CPB.

Predictive value of TyG index, GLR and combined BISAP score for severity of hypertriglyceridemic acute pancreatitis LI Shuang-ping, TIAN Xia,BAO Sachula,,et al. Medical? College,Wuhan University of Science and Technology,Wuhan 430065,China

li shuangping,, — 2024/2/8 15:30:26

Objective To explore the correlation between TyG index, GLR and the severity of HTG-AP, and to assess the early predictive value of TyG index, GLR and combined BISAP score on the severity of HTG-AP. Methods The clinical data of 166 HTG-AP patients admitted to the Third Hospital of Wuhan City from 2018 to 2023 were retrospectively collected and divided into severe and non-severe groups according to the grading of the severity of pancreatitis, and the general data and laboratory test results of the two groups were compared. Measurement data were compared by two independent samples t-test or Mann-Whitney U-test, and count data were expressed as number of cases or percentage, andχ2 test was used for comparison between the two groups. Binary logistic regression was used to analyse the independent risk factors of severe HTG-AP, Spearman correlation test was used to analyse the correlation between the variables and severe HTG-AP, and the predictive efficacy of the calculated relevant indexes was assessed by using the work characteristic curve of the subjects. Results There was no statistically significant difference between the two groups in terms of age, gender, smoking history, and drinking history (P > 0.05), and the proportion of patients with a history of hypertension and diabetes and the length of hospitalisation in the critical group were significantly higher than those in the non-critical group (P < 0.05). The differences in the levels of WBC, NEUT, MONO, HGB, ALB, TBIL, BUN, Cre, K, Na, and Cl between the two groups were not statistically significant (P > 0.05), and the levels of LYM and Ca of the patients in the critical group were lower than those in the non-critical group (P < 0.05), and the levels of RDW, D-Dimer, CRP, GLU, TC, TG, HDL-C , LDL-C, TyG index, GLR, and BISAP levels were significantly higher than those of patients in the non-critical group, and the difference was statistically significant (P < 0.05). TyG index, GLR, and BISAP were independent risk factors for the development of severe HTG-AP in patients, and TyG index, GLR, BISAP, BISAP combined with TyG, and BISAP combined with GLR were associated with severe HTG-AP were significantly positively correlated (all P < 0.05), with correlation coefficients of 0.389, 0.409, 0.546, 0.595, and 0.599, respectively.The areas under the curve for TyG index, GLR, BISAP, BISAP combined with TyG, and BISAP combined with GLR for the prediction of severe HTG-AP were 0.741 (95% CI = 0.662-0.820 ), 0.753 (95%CI=0.677-0.830),0.798(95%CI=0.720-0.876),0.869(95% CI=0.810-0.927), 0.871 (95% CI=0.814-0.927).Conclusion TyG index and GLR were correlated with HTG-AP severity, and TyG index, GLR and combined BISAP score had high early predictive value for HTG-AP severity.

Clinicopathological features and immunohistochemical analysis of 9 patients with lung adenocarcinoma with sign-ring cell morphology

Hai-ying GONG,Fang HE,Li-ping HE,Shun-hai JIAN,,Xiu-li JIN,Cai-liang WU — 2024/2/8 15:29:57

Objective: To investigate the clinicopathological features, immunohistochemical phenotypes and prognostic factors of lung adenocarcinoma with signet-ring cell morphology, and to improve the understanding of this tumor. Methods: The clinical data of 9 patients with signet-ring cell form lung adenocarcinoma admitted to the hospital from January 2013 to December 2019 were retrospectively analyzed, and their pathological features, immunohistochemical features and prognostic factors were analyzed. Results: The median age of the 9 patients was 53 years old, the tumor diameter was 1.6 ~ 6.7cm, and 7 patients had lymph node metastasis. Clinical stages: 1 case in stage I, 1 case in stage II, 5 cases in stage III and 2 cases in stage IV. The proportion of signet-ring cell components in 5 patients was between 10% and 80%, and the remaining 4 cases were simple signet-ring cell carcinoma. Immunohistochemical results showed that the immunophenotypes of TTF-1(+), CDX-2(-) and CK7+/CK20- were 100%, 8 patients (88.9%) were Napsin-A positive, 5 patients underwent surgical resection, 1 patient lost the opportunity for surgery, and 3 patients received non-surgical treatment. At present, there are no surviving patients, and the survival rate may be related to TNM stage and tumor metastasis. Conclusion: Lung adenocarcinoma with signet-ring cell morphology is a very rare type of adenocarcinoma, the diagnosis is mainly based on pathology and immunohistochemistry, and there is no standard treatment regimen at present. Therefore, further research on lung adenocarcinoma with signet-ring cell morphology may be able to find new and potentially effective treatment regimens to improve the prognosis of patients.

Application of robot-assisted highly selective puncture technique in percutaneous vertebroplasty

Meng Lingxin,Shi Yan,Song Huawei,Wei Zhiling — 2024/2/8 15:29:30

【】 Objective To explore the application effect of percutaneous vertebroplasty assisted by robot. Methods A total of 70 patients diagnosed as osteoporotic vertebral compression fracture were selected from our hospital, and the treatment time ranged from January 2019 to January 2022. Both groups were treated with percutaneous vertebroplasty, and the observation group was assisted by robot, while the control group was assisted by C-arm fluoroscopy. The general data, times of fluoroscopy during operation, time spent in operation, invisible blood loss during operation, VAS score before and after operation, ODI score, JOA score, Cobb angle of vertebral body and postoperative complications were compared between the two groups. Results There were significant differences between the two groups in the times of fluoroscopy, the time of operation and the data of invisible blood loss (P < 0.05). After operation, the VAS score (2.38 0.91) and ODI score (4.38 1.01) in the observation group were lower (P < 0.05). After operation, the JOA score in the observation group was higher (24.68 5.71) (P < 0.05). After the operation, the Cobb angle of vertebral body in the observation group was lower (7.22 1.27) (P < 0.05). The postoperative complications were lower in the observation group (1 case) (P < 0.05). Conclusion Patients with osteoporotic vertebral compression fracture can choose robot-assisted high-selective puncture technique for surgery, which can effectively promote the smooth operation, improve the lumbar function of patients, and reduce the impact of low back pain on patients" normal life, and the operation safety is high. This method is worth popularizing.

The application of nafamostat mesilate in continuous blood purification for patients with high bleeding risk

Hu Kunlin,Lu wenting,Mo Li,Pang Jing,Ren Yanwen,Xiang Shulin, — 2024/1/24 8:13:45

Objective To observe the anticoagulant effect of naproxat mesylate (NM) on continuous blood purification (CBP) in patients with high bleeding risk. Method Thirty-four critically ill patients requiring CBP treatment admitted to the Department of Intensive Care Medicine of the hospital from January 2023 to March 2023 were recruited and divided into NM group (10 cases), sodium citrate group (10 cases) and low molecular weight heparin group (14 cases) according to the use of anticoagulants. Filter life and the occurrence of clinically significant bleeding events and other adverse events were compared among the three groups. Results The filter life of NM group, sodium citrate group and low molecular weight heparin group was 40.00 (17.00, 51.00) h, 36.00 (22.00,60.00) h and 51.00 (45.00,61.50) h, respectively, and there was no statistical significance in the filter life of the three groups (χ2=2.096, P=0.351). During the anticoagulation process, no clinically significant bleeding events occurred in the NM group, while 3 patients (30.00%) in the sodium citrate group and 4 patients (28.57%) in the low molecular weight heparin group, respectively, with statistically significant differences in the incidence of clinically significant bleeding events among the three groups (χ2=14.171, P=0.001). Secondary thrombocytopenia occurred in 6 cases of low molecular weight heparin group. Anaphylaxis, hyperkalemia and agranulocytosis related to NM infusion were not observed in the NM group. The main adverse reactions of sodium citrate group were accumulation of citric acid and citric acidosis, and no adverse reactions were observed . No thromboembolic events were observed in all three groups. Conclusion The anticoagulant effect of NM is comparable to that of sodium citrate and low molecular weight heparin, and the incidence of clinically significant bleeding events is lower, and the safety of application in patients with high blood risk is good.

Investigation of quality of life and analysis of influencing factors in different bone mass

Huang DongQing,,,,,, — 2024/1/16 15:22:10

Objective To investigate the quality of life of people with different bone mass and analyze the factors of osteoporosis. Methods to select a 3 armour hospital health management center for bone mineral density detection of 280 elderly people as the research object, according to the results are divided into normal bone mass, bone mass, osteoporosis three groups, and apply the quality of life scale (SF-36) compare the different quality of life, and discusses the influencing factors of the quality of life of osteoporosis people. Results The scores of all dimensions in the SF-36 scale were lower than those of normal bone mass. Univariate correlation analysis showed that the correlation of physical health, health change, drinking tea, pain and nutritional status (P <0.05), and mental health score with rheumatoid arthritis history, pain, income, health change and nutritional status (P <0.05). Multivariate regression analysis showed that physical health in osteoporosis population quality of life was negatively correlated with pain, positively correlated with health change and nutritional status; mental health was negatively correlated with pain and positively correlated with nutritional status. Conclusion The quality of life of osteoporosis patients is lower than normal people, and pain, health change and nutritional status are the influencing factors of the quality of life of osteoporosis patients. Intervention in these aspects should be strengthened to improve the quality of life of middle-aged and elderly people with osteoporosis.

Application of Endo Fascial Closure System in Pediatric Thoracoscopic Diaphragm Surgery Jian Ziwei, Wang Bingjie, Chen Wenyou, et al. Department of Pediatric Surgery, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou 363000, ChinaCorresponding author: Chen Wenyou, E-mail: chenwy0596@163.com

简紫微, — 2024/1/12 16:18:53

Objective To investigate the effective and safety of Endo Fascial Closure System in children with thoracoscopic diaphragm surgery. Methods From January 2019 to December 2021, 5 cases of diaphragmatic hernia and 1 case of diaphragmatic distension were treated by thoracoscopic treatment. Diaphragmatic repair and diaphragmatic folding were performed with the assistance of Endo Fascial Closure System uring operation. Results The surgical process was smooth, and thoracic drainage tubes were placed after the surgery. Four newborns needed ventilator assistance after the surgery. A newborn with chromosomal abnormalities developed recurrent pneumothorax and wheezing 2 days after the removal of the thoracic drainage tube and tracheal intubation. The tube was re inserted and pulmonary hemorrhage occurred. The patient"s family requested automatic discharge 24 days after the surgery. The remaining 3 newborns underwent mechanical assisted ventilation for 2-5 days after surgery, with an average of 3.67 days. The remaining 7 cases underwent thoracic drainage tube removal 2 to 11 days after surgery, with an average of 4.4 days; The postoperative hospitalization time was 8-17 days, with an average of 11.8 days. Before discharge, no abnormalities were found on the chest X-ray. Follow up for six months to one year showed no recurrence.

DTI study on the effect of arcuate tract microstructure change on mild cognitive function

HAN Song-lin, — 2024/1/12 16:18:04

Objective To investigate the effect of arcuate tract microstructure on mild cognitive function in patients with lacunar cerebral infarction by Diffusion tensor imaging technique（DTI） . Methods From September 2022 to June 2023, 60 patients and 20 healthy volunteers with lacunar cerebral infarction in the Arcuate fasciculi（AF） walking area were collected in the outpatient department of Shuangyashan People's Hospital. Age 50-70 years old with a matching educational level (≥6 years of education). All patients underwent nuclear magnetic head scan plus DTI examination. Patients with mild cognitive impairment initially diagnosed by radiologists according to the Montreal Cognitive Assessment Form and diagnosed by clinicians were classified as the Mild cognitive impairment（MCI） group, that is, the MoCA score was ≥16 and <26; patients without mild cognitive impairment were classified as the non-MCI group, that is, the MoCA score was ≥26, and healthy volunteers were classified as the control group. Anova or t test were used to compare the Anisotropy fraction（FA）, Apparent dispersion coefficient（ADC） and Mean dispersion（MD） values of different MoCA rating groups in the ipsilateral arcuate tract. The parameters of the same arcuate bundle in different lesions and the left and right arcuate bundle in different number of lumen were compared between the MCI group and the non-MCI group. Results The comparison of parameters of left and right arcuate fascicles between different MoCA evaluation groups and control groups showed that there were statistically significant differences among FA, MD and ADC levels (P<0.05). The comparison of DTI dispersion parameters between the left and right arcuate tract lesions in MCI group and non-MCI group showed that the level of FA parameter decreased with the increase of lesions, and the difference between groups was statistically significant (P<0.05). Among them, the MD parameter levels of left and right arcuate tract in non-MCI group increased with the increase of lesions, and the difference between groups was statistically significant (P<0.05). The comparison of MoCA scores among different lesions showed that with the increase of the number of lesions, the MoCA scores decreased, and the two comparison differences were statistically significant (P<0.05). Conclusion Compared with the MCI group, the damage degree of arcuate tract was lower in the non-MCI group. The MD parameters of left and right arcuate tract in non-MCI group increased with the increase of lesions, and the overall diffusion level and diffusion resistance of lesions increased. The higher the number of luminal lesions, the lower the FA value, the more serious the arcuate tract injury and the lower the MOCA value. The results show that the change of arcuate tract microstructure in patients with lacunar cerebral infarction is correlated with mild cognitive impairment, which can be used as an important reference index and method to prevent and evaluate mild cognitive impairment.

Relationship between serum amyloid A and diffusion capacity and exercise limitation in elderly patients with COPD

欧阳 — 2024/1/12 16:16:35

Objective: To analyze the correlation between serum amyloid A (SAA) and pulmonary diffusion capacity and exercise limitation in elderly patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 188 COPD patients aged 60-80 years who were admitted to our hospital from January 2020 to July 2021 were enrolled. All patients were evaluated by pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET). Transfer factor for carbon monoxide< lower limits of normal (LLN) was included into abnormal diffusion group, and ≥LLN was included into normal diffusion group. The level of SAA was measured by enzyme-linked immunosorbent assay (ELISA) . Results: The SAA level in abnormal diffusion group was significantly higher than that in normal diffusion group (135.09±58.05 vs. 78.10±32.81 ng/mL, P < 0.001). According to receiver operating characteristic curve analysis, the area under curve of SAA level in differential diagnosis of elderly COPD with abnormal diffusion capacity was 0.797. Multivariate analysis showed that the SAA level in abnormal diffusion group increased by 0.417 (95%CI: -0.013-0.005) ng/mL and 0.418 (95%CI: -0.210-0.088) ng/mL for each unit decrease in the percentage of forced expiratory volume in 1 second (FEV1)z-score and standardized percent predicted FEV1, respectively (P < 0.001). Pearson analysis showed that SAA level in COPD patients was negatively correlated with peak oxygen uptake (VO2peak) (r=-0.512, P < 0.001). Conclusion: In COPD, SAA is associated with FEV1Z-score, and detection of SAA helps to distinguish elderly COPD with or without abnormal diffusion capacity. In addition, high SAA level were inversely correlated with VO2peak, suggesting that the mechanism leading to reduced FEV1 may help explain exercise limitation in elderly COPD patients with abnormal diffusion capacity.

Value of serum eosinophil chemotactic factor and human β-defensin-1 in the differential diagnosis of active pulmonary tuberculosis and its relationship with clinical efficacyQiu Guo-yuan1, Feng Jing1, Gong Cheng-li1, Dai Shi-qiong2, Leng Wen-hua3, Yang Wen-juan1★

Qiu Guo-yuan — 2024/1/12 16:15:31

活动性肺结核(active pulmonary tuberculosis,ATB)是由指结核分枝杆菌(mycobacterium tuberculosis,MTB)引起的肺部疾病,临床表现为发热、乏力、咳嗽、咳痰或咯血等,ATB处于活性期且具有较强的传染性[1]。潜伏结核感染(latent tuberculosis infection,LTBI)同样由感染MTB引起,但X线显示胸片正常或临床无明显症状及传染性,LTBI中有部分患者为活动性肺结核,易与ATB发生误诊的情况,需要与ATB进行有效鉴别[2]。临床常用的诊断方法中,痰涂片检测便捷,但灵敏度不理想,阳性率仅为30%左右；MTB DNA检测易受到标本取材不当、聚合酶链式反应抑制物等的影响,漏诊率较高[3]。血清学指标无创、客观、简便等优势在多种疾病的诊断、指导治疗中意义重大。因此寻找灵敏、高效的鉴别ATB、LTBI的血清学指标对指导MTB治疗同样具有重要意义。

Semi-quantitative assessment based on CCTA high-risk plaque characteristics to predict abnormal coronary flow reserve fraction in patients with obstructive coronary artery disease

CHEN Rong,CUI Shujun,JIA Peng,PANG Zhiying,,YANG Fei,YANG Yue,YANG Zhixiang — 2024/1/12 16:14:26

Objective To investigate the predictive efficacy of the stenosis degree by coronary CT angiography (CCTA) combined with semi quantitative assessment of high-risk plaque characteristics in patients with obstructive coronary heart disease (CAD). Methods The patients who were diagnosed with CAD and underwent CCTA in the first affiliated hospital of Hebei North University from January 2017 to June 2019 were enrolled in this study. All culprit vessels were divided into FFRCT abnormal group (FFRCT≤0.8) and FFRCT normal group (FFRCT>0.8). The characteristics of high-risk plaque and the incidence of abnormal FFRCT were compared between the two groups. The relationship between the degree of coronary stenosis, the characteristics of high-risk plaque and the abnormality of FFRCT, and its predictive efficacy were evaluated. Results 205 culprit vessels in 139 patients were analyzed in this study. The incidence of severe stenosis, PR and LAP in abnormal FFRCT group was higher than that in normal FFRCT group (P<0.01). The incidence of abnormal FFRCT in patients with severe coronary stenosis was higher than that in patients with moderate coronary stenosis (P<0.001). The incidence of abnormal FFRCT in coronary arteries with PR and LAP was significantly increased (P<0.001). Severe coronary stenosis, LAP and PR were independent predictors of FFRCT abnormalities (P<0.05). The area under the curve was 0.721 (95% CI: 0.654 to 0.781) for the model of severe coronary stenosis alone and 0.809 (95% CI: 0.748 to 0.860) for the model of severe coronary stenosis combined with high-risk plaque. The combination of severe coronary stenosis and high-risk plaque was significantly higher than that of its single use for the predictive efficacy of abnormal FFRCT (P<0.001), mainly due to the improvement of diagnostic sensitivity and negative predictive value Conclusion CCTA severe coronary stenosis and high-risk plaque characteristics are predictors of abnormal FFRCT, and the combined application can better identify the abnormal hemodynamics.

Predictive Value of GRACE Score Combined with White Blood Cell Count to Mean Platelet Volume Ratio for In-Hospital MACE in STEMI Patients Following Emergency PCI

zhang wan yao, — 2024/1/12 16:13:10

[Abstract] Objective This study assesses the combined predictive value of the global registry of acute coronary events (GRACE) score with the white blood cell count to mean platelet volume ratio (WMR) for in-hospital major adverse cardiovascular events (MACE) in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing their first emergency percutaneous coronary intervention (PCI). Methods A retrospective analysis of 349 STEMI patients who underwent initial emergency PCI from January 2021 to March 2022 at Xiangyang Central Hospital was conducted. Patients were categorized into a MACE group (n=47) and a non-MACE group (n=302) based on in-hospital MACE occurrence. Utilizing ROC curve analysis to determine the optimal cutoff value, patients were further stratified into low GRACE+low WMR (n=184), low GRACE+high WMR (n=52), high GRACE+low WMR (n=56), and high GRACE+high WMR (n=57) groups. The predictive capacity of combined GRACE score and WMR for MACE was evaluated through multifactorial Cox regression analysis and ROC curve assessment. Results The results of multifactorial Cox regression analysis showed that high GRACE score, high WMR, low GRACE+high WMR, high GRACE+low WMR, and high GRACE+high WMR were independent risk factors for in-hospital MACE (P<0.05). In addition, FPG, ALT, AST, and NLR were also independent risk factors for MACE formation (P<0.05). ROC curve analysis demonstrated that the combination of GRACE score and WMR [AUC(95%CI)=0.824 (0.750-0.897), P<0.001] had superior predictive performance for MACE compared to the GRACE score or WMR alone. Conclusion Combining the GRACE score with WMR enhances the predictive accuracy for in-hospital MACE in STEMI patients post-PCI. This integrative measure may assist clinicians in more precise risk stratification and informed decision-making.

Advances in the study of bone marrow derived mesenchymal stem cell therapy for osteoarthritis

liuyuhang — 2024/1/12 15:57:00

Osteoarthritis (OA) is one of the most prevalent and highly disabling diseases worldwide, characterized by lesions involving the entire joint, including cartilage degeneration, bone remodeling, bone fragmentation, and synovial inflammation. None of the current non-surgical treatments for OA can stop the progression of OA. Bone marrow derived mesenchymal stem cells (BMMSCs) are pluripotent stem cells derived from bone marrow that have good ability of multidirectional differentiation and self-renewal, with the ability of multidirectional differentiation, self-proliferation, endocrine and paracrine factors to regulate cell and tissue proliferation, apoptosis, and immune response, etc. They play the role of inducing cell proliferation, stimulating angiogenesis, protecting cells from apoptosis and immune regulation. BMMSCs have been increasingly used in the treatment of OA. This article reviews the latest research progress of BMMSCs in the treatment of osteoarthritis in recent years.

Combination of neutrophil to lymphocyte ratio, hypersensitive C-reactive protein and Chitinase 3 like 1 predicts stroke-associated pneumonia in patients with acute cerebral infarction

yubaiyang — 2024/1/12 15:44:24

Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR), hypersensitive C-reactive protein (hs-CRP) combined with Chitinase 3 like 1 (CHI3L1) for stroke-associated pneumonia (SAP) in patients with acute cerebral infarction (ACI). Methods A total of 487 patients with ACI were enrolled prospectively from August 2020 to March 2022. The clinical characteristics were collected, and levels of NLR, hs-CRP and CHI3L1 were detected. The clinical characteristics as well as laboratory data between SAP group and non-SAP group were compared. Multivariate logistic regression analyses were performed to explore the independent influencing factors of SAP. The receiver operating characteristic (ROC) curves were used to analyze the individual and combined predictive values of NLR, hs-CRP as well as CHI3L1 on SAP. Results Among the 487 ACI patients, 139 patients (28.5%) developed SAP. Multivariate logistic regression analysis showed that diastolic blood pressure at admission, baseline NIHSS score, dysphagia, NLR, hs-CRP and CHI3L1 were independent influencing factors of SAP in patients with ACI after adjusting for confounding factors (all P<0.05). ROC curve analysis showed that the areas under the curve of NLR, hs-CRP, CHI3L1 and their combination for predicting SAP were 0.756, 0.705, 0.760 and 0.825, respectively. When the three inflammatory markers were combined to predict SAP, the area under the curve was significantly higher than that of any single inflammatory marker (all P<0.05). Conclusion NLR, hs-CRP and CHI3L1 might be considered as useful inflammatory markers to predict SAP in ACI patients, and the combination of the three had a better predictive value.

Expression of engul fmentand cell mobility3 in pancreatic carcinoma and its clinical significance

贾富鑫,,, — 2024/1/12 15:43:12

Objective To analyze the expression of engul fmentand cell mobility3(ELMO3) in pancreatic carcinoma and its clinical significance.Methods In 128 surgical specimens of pancreatic carcinoma tissue and normal pancreatic tissue, the ELMO3 protein expressions were determined by immunohistochemical staining and western blot. The relations of ELMO3 protein expression with the clinicopathologic factors and postoperative survival of the pancreatic carcinoma patients were analyzed, and the factors affecting the survival rates of the patients were also analyzed by statistical methods.Results The positive expression rate of ELMO3 in 128 cases of pancreatic carcinoma was 83.6%, which was significantly higher than that of paracancer tissues (P<0.05).The ELMO3 expression was significantly associated with differentiation, tumor diameter, TNM stages, and lymph node metastasis (all P<0.05).The 1-year cumulative survival rate and median survival time of patients with positive ELMO3 expression were significantly lower than that of patients with negative ELMO3 expression. TNM stage（P=0.000）, distant metastasis（P=0.016）and ELMO3 expression（P=0.000）were independent factors for the prognostic of patients, respectively. Conclusion The high expression of ELMO3 protein is related to the clinicopathological factors and poor prognosis of pancreatic carcinoma, which can be used as a new index to evaluate the progression and prognosis of pancreatic carcinoma patients.

Effects of CircFoxo3 on cardiomyocyte apoptosis in rats with heart failure by regulating miR-130a-5p/TEAD1 axis

曹彦花 — 2024/1/12 15:41:37

Objective To investigate the effect of circular RNA forkhead box protein O3 (CircFoxo3) on cardiomyocyte apoptosis in rats with heart failure (HF) by regulating the miR-130a-5p/TEA domain transcription factor 1 (TEAD1) axis. Methods: SD rats were separated into control group, HF group, si-NC group, si-CircFoxo3 group, agomir NC group, miR-130a-5p agomir group, si-CircFoxo3+antagomir NC group, and si-CircFoxo3+miR-130a-5p antagomir NC group, with 18 rats in each group. Except for the control group, rats in all other groups were required to construct HF rat models by intraperitoneal injection of doxorubicin hydrochloride. After successful modeling, medication was administered once every 3 days for 3 weeks. QRT-PCR was applied to detect the expression of CircFoxo3 and miR-130a-5p in myocardial tissue; color Doppler ultrasound was applied to detect the changes of left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), and left ventricular ejection fraction (LVEF) in rats; ELISA method was applied to detect the levels of human stromelysin-2 (ST2) and N-terminal pro-brain natriuretic peptide (NT-pro BNP) in serum; HE staining was applied to detect pathological changes in rat myocardial tissue; TUNEL staining was applied to detect cardiomyocyte apoptosis; Western blot was applied to detect the protein expression of TEAD1, Bcl-2-associated X protein (Bax), B-cell lymphoma-2 (Bcl-2), and cleaved aspartate-specific cysteine protease-3 (Cleaved-caspase-3) in myocardial tissue; double luciferase reporter gene experiment was applied to verify the relationship between CircFoxo3 and miR-130a-5p, and between miR-130a-5p and TEAD1. Results Compared with the control group, the myocardial tissue of rats in the HF group showed severe pathological damage, the LVESD, LVEDD, the expression of CircFoxo3, the protein expression of TEAD1, Bax, Cleaved-caspase-3 in myocardial tissue, the levels of ST2 and NT-pro BNP in serum, and cardiomyocyte apoptosis rate increased, the LVEF, the expression of miR-130a-5p, and the protein expression of Bcl-2 decreased (P<0.05); compared with the HF group and si-NC group, the pathological damage of myocardial tissue in the si-CircFoxo3 group was reduced, the LVESD, LVEDD, the expression of CircFoxo3, the protein expression of TEAD1, Bax, Cleaved-caspase-3 in myocardial tissue, the levels of ST2 and NT-pro BNP in serum, and cardiomyocyte apoptosis rate decreased, the LVEF, the expression of miR-130a-5p, and the protein expression of Bcl-2 increased (P<0.05); compared with the HF group and agomir NC group, the myocardial tissue pathological damage of rats in the miR-130a-5p agomir group was improved, the LVESD, LVEDD, the protein expression of TEAD1, Bax, Cleaved-caspase-3 in myocardial tissue, the levels of ST2 and NT-pro BNP in serum, and cardiomyocyte apoptosis rate decreased, the LVEF, the expression of miR-130a-5p, and the protein expression of Bcl-2 increased (P<0.05); compared with the si-CircFoxo3 group and si-CircFoxo3+antagomir NC group, the myocardial tissue pathological damage in the si-CircFoxo3+miR-130a-5p antagomir group was exacerbated, the LVESD, LVEDD, the protein expression of TEAD1, Bax, Cleaved-caspase-3 in myocardial tissue, the levels of ST2 and NT-pro BNP in serum, and cardiomyocyte apoptosis rate increased, the LVEF, the expression of miR-130a-5p, and the protein expression of Bcl-2 decreased (P<0.05). CircFoxo3 had a targeting relationship with miR-130a-5p, and miR-130a-5p had a targeting relationship with TEAD1. Conclusion Silencing CircFoxo3 may inhibit the expression of TEAD1 through sponge up regulation of miR-130a-5p, thereby inhibiting cardiomyocyte apoptosis in HF rats.

Research progress on the pathogenesis and carcinogenesis of colorectal polyps in type 2 diabetes mellitus

yangteng — 2024/1/12 15:33:28

In recent years, with the increasing incidence of colorectal cancer, colorectal cancer has become the third most common malignant tumor in the world, and colorectal polyps, which are recognized as precancerous lesions, have also attracted wide attention. Diabetes, one of the "three high", is a risk factor for intestinal polyps, which increases the risk of various tumors, including colorectal cancer, and also affects people's health.Based on a review of the existing studies on diabetes and colorectal polyps, this paper summarized the mechanism by which diabetes may affect the occurrence and progression of colorectal polyps, and listed the possible preventive drugs that have been studied more frequently in recent years, so as to provide theoretical basis for the prevention and treatment of colorectal cancer, the development of more related drugs and the guidance of clinical treatment strategies.

Research progress on maxillary skeletal expansion in adults with transverse maxillary deficiency WANG hua, College of Stomatology of Guizhou Medical Universlty,Guiyang,55001,China

wanghua — 2024/1/12 15:32:34

Maxillary skeletal expander (MSE)is one of the methods for treat maxillary transverse deficiency(MTD). The adult patients who have passed their developmental peak and completed their growth phase choose the effective treatment approach is MSE.According to the development phase of the mid-palatal suture and the goal of maxillary expansion,the patients choose different treatment methods . In this paper,we review the classification of MSE，operational approach，therapeutic effect, shortcomings and so on,The article summarize its research progress at domestic and foreign,It provides a reference for the clinical workers to choose the treatment plan reasonably and effectively.

Abdominal pain caused by foreign body incarceration in the stomach for 4 months：A Case Report

侯向红,,, — 2024/1/12 15:31:36

Bone marrow metastasis of breast cancer with bone pain and anemia as the first manifestation: a case report and literature review

zhongchengming — 2024/1/12 15:30:11

Breast cancer represents the most prevalent malignancy among women globally. Patients with advanced-stage breast cancer frequently experience distant metastases; however, bone marrow involvement is relatively uncommon. The occurrence of bone marrow metastasis typically indicates a poorer prognosis. Clinical manifestations of breast cancer with initial presentations of bone pain and anemia due to bone marrow metastasis are exceptionally rare, and the literature on this subject is scarce. This article provides an analytical report on the diagnostic and therapeutic process of a patient with breast cancer involving bone marrow metastasis, aiming to serve as a reference for the clinical medical community.

doi:10.3969/j.issn.1674-3806.2022.00.00Effect analysis of combined application of three detection methods in diagnosis of mycobacterial infection

p>Lei Zhen,Tang Liusheng #,Yang Xiaobing,Zhou Ming — 2023/12/11 16:49:43

Objective To explore the diagnostic value of PCR fluorescence probe method, liquid culture method and direct smear fluorescence staining method in the detection of Mycobacterium. Methods From January 2021 to April 2021, 104 patients with suspected mycobacterial infection in Chest Hospital of Guangxi Zhuang Autonomous Region were selected as the research objects. The BD960 liquid culture method was used as the reference to evaluate the detection efficiency of PCR-fluorescence probe method and direct smear fluorescence staining method in parallel detection of mycobacteria.Results In the specimens of 104 patients with suspected mycobacterial disease, the sensitivity, specificity and coincidence rate of PCR-fluorescent probe method for detecting mycobacteria were 58.0%, 95.7% and 83.6%, respectively, with BD960 liquid culture method as the reference. , the sensitivity, specificity and coincidence rate of direct smear fluorescence staining were 55.9%, 100.0% and 85.6%, respectively. kappa were 0.595 and 0.63, respectively. There was no significant difference between the detection results of PCR-fluorescent probe method and BD960 liquid culture method (x2=2.924, P=0.08,), while the detection results of direct smear fluorescence staining method and BD960 liquid culture method Compared the results, the difference was statistically significant (x2=5.697, P=0.017,) Conclusions The three detection methods have good consistency. The PCR-fluorescent probe method and the BD960 liquid culture method have similar test efficiency in the detection of mycobacteria, and can quickly diagnose MTB and NTM. However, when MTB and NTM grow together, only MTB can be expressed, which has detection limitations, and the sensitivity is still not ideal, which needs to be further improved. The detection rate of direct smear fluorescence staining is low, but the detection method is simple, rapid and cheap, which is suitable for primary laboratory identification.

Study on the influencing factors of sarcopenia in elderly patients with type 2 diabetes mellitus

lixiang,huangjiaqin,shilimei,tianrong,wangyudong,zenglin,zhangyanping,zhouyajie — 2023/12/11 10:01:16

Objective To investigate the occurrence status and influencing factors of type 2 diabetes mellitus (T2DM) complicated with sarcopenia in elderly patients. Methods A total of 420 elderly T2DM patients admitted to the geriatric endocrinology department of a Class III Grade A hospital in Nanning City from January to June 2022 were selected by convenience sampling method. The general data, muscle strength and muscle mass of the patients were investigated. Univariate analysis and binary logistic regression were used to analyze the influencing factors of sarcopenia in elderly patients with T2DM. Results A total of 382 elderly patients with T2DM were enrolled, including 92 cases of sarcopenia, with an incidence of 24.1%, and 290 cases of non-sarcopenia.. Binary logistic regression analysis showed that age, sex, education, exercise habits, diabetes course, body mass index, peripheral neuropathy, low bone mass and osteoporosis were the factors affecting the elderly patients with T2DM complicated with sarcopenia (P < 0.05). Conclusion Elderly patients with T2DM complicated with sarcopenia are affected by multiple factors, so it is necessary to strengthen knowledge education, improve exercise habits, do a good job in weight management and chronic disease management to prevent and improve the occurrence and development of sarcopenia.

Prevention and treatment measures progress of oral diseases in autistic children

heyangyan, — 2023/12/8 15:28:57

Because of its unique physiological and behavioral characteristics，the oral cares of the children with autism will bring more difficulties when compared with the cares of healthy children it can not be ignored. In recent years, there have been many studies on oral prevention and treatment of children with autism at home and abroad, and a new field of multidisciplinary integration has been developed. This paper reviews the following aspects related to children with autism, including its epidemiology of oral diseases, prevention and treatment measures

Research progress on the involvement of histone lactylation in regulating tissue damage repair in inflammatory diseases TANG Yu-jiao,LIU Ru-xin,BAI Xue,CHEN Meng-fei,ZHANG Ling.People"s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China

baixue,chenmengfei,liuruxin,tangyujiao — 2023/12/8 15:16:46

Accumulating evidence of research suggests that the pathophysiological mechanisms of inflammatory diseases involve epigenetic regulation. Post-translational modifications of histones are an important part of epigenetics, and histone lactylation derived from lactate is a novel post-translational modification of histones discovered in recent years. Immune cells, including macrophages, play an important role in the tissue damage repair in inflammatory diseases, and histone lactylation modifications as epigenetic modifications mediate the regulation of immune cell repair genes expression, glycolytic genes expression and immune cell programmed death, thus participating in the regulation of tissue damage repair in inflammatory diseases. Here we review the role of histone lactylation in tissue damage repair in inflammatory diseases, and explore the relevant mechanisms of histone lactylation modification in the pathophysiological process of tissue damage repair in inflammatory diseases, as well as the possible anti-inflammatory treatment approaches.

Research progress of adjuvant endocrine therapy for perimenopausal hormone receptor-positive breast cancer

Luan Biqing — 2023/12/8 15:13:06

Adjuvant endocrine therapy (AET) is an effective treatment strategy for patients with hormone receptor-positive breast cancer that can achieve significant survival benefits and reduce the risk of recurrence. To determine the most appropriate treatment strategy, adjuvant endocrine therapy for early breast cancer should consider a patient’s risk of disease recurrence and menopausal status at the time of diagnosis. Perimenopausal women are at high risk of breast cancer. This article focuses on the research progress of AET in perimenopausal hormone receptor-positive breast cancer patients.

Successful detection of duodenal adenocarcinoma by oral contrast-enhanced ultrasonography：A case report

liuke, — 2023/12/8 15:09:08

Primary duodenal adenocarcinoma is a rare clinical case, which occurs in the elderly over 60 years old, and more men than women. There are no typical symptoms in the early clinical stage, and the elderly are often accompanied by circulatory or respiratory diseases and cannot meet the requirements of endoscopy. At the same time, some patients are resistant to endoscopy, so the disease is often not diagnosed early and the disease is delayed. This article reports a 75-year-old female patient who successfully detected adenocarcinoma of the duodenal bulbous junction by oral gastrointestinal contrast-enhanced ultrasonography, and explored the application value of oral gastrointestinal ultrasonography in the screening of gastrointestinal diseases in elderly patients .

Sj?gren’s Syndrome Complicated With T Large Granular Lymphocytic Leukemia: a Case Report

宋晓燕 — 2023/12/8 15:08:06

Objective To summarize the diagnosis and treatment of Sj?gren’s syndrome complicated with T large granular lymphocytic leukemia. Method A case was investigated retrospectively. Result The patient was a 66-year-old woman with a history of dry mouth and dry eyes for many years.The symptoms were not significantly improved after irregular drug treatment.When she came to the hospital,there was a decrease in blood cells.The diagnosis of Sj?gren’s syndrome was made by improving the anti-nuclear antibody spectrum and lip gland biopsy.T-LGLL was diagnosed by bone marrow cell morphology,immunotyping,detecting of large granular lymphocyte and T cell receptor.After administration of drugs ,the peripheral blood cells showed an upward trend. Conclusion Attention should be paid to the association between SS and T-LGLL.The patient with SS accompanied by hematopenia is necessary to improve the bone marrow puncture and other tests to determine whether there is any hematological system disease.

Birth weight and placental weight percentile charts in Guangxi

陈欢,陈昭霞,冯宝莹,李剑,缪丽梅,潘平山,彭振仁,丘小霞,覃钰芹,韦红卫,袁培 — 2023/12/8 9:14:32

Objective We aim to provide up-to-date local birth weight and placental weight percentile charts. Methods 13,298 Singleton pregnancies were collected and extracted at Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from May, 2019 to December, 2021. Gestational age and gender specific percentile charts for birth weight and placental weight were generated using GAMLSS package in R. Results Gestational age specific birth weight and placental weight percentile charts were generated from 6264 newborn males and 5467 females, respectively. In comparison with the China’s 2020 standard and the INTERGROWTH-21st standard, our birth weight charts were different in the 10th and the 90th percentiles. The fast developmental phase of placenta occurred earlier in male infants than that in females. Conclusions Birth weight charts should be applied with local reference. The kinetics of placental development were different between genders.

The relationship between the expression of DNMT1 and lncRNA MEG3 in serum and the pathogenesis of Parkinson's disease

马颖, — 2023/12/8 9:10:22

[Abstract] Objective: To investigate the expression of DNA methyltransferase 1 (DNMT1) and long non-coding RNA human maternally expressed gene 3 (LncRNA MEG3) in patients with Parkinson's disease and their diagnostic value. Methods: A total of 106 patients with Parkinson's disease diagnosed and treated by the department of neurology in our hospital from March 2020 to January 23 were regarded as the Parkinson's disease group, another 103 healthy people were regarded as the health group. The level of serum DNMT1 was detected by enzyme-linked immunosorbent assay (ELISA), the level of serum lncRNA MEG3 was detected by real-time fluorescence quantitative PCR (qRT-PCR); Pearson correlation analysis was applied to examine the correlation between serum DNMT1, lncRNA MEG3 levels and clinical data in patients with Parkinson's disease; receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of serum DNMT1 and lncRNA MEG3 levels for Parkinson's disease, the area under the curve (AUC) was compared with Z test; multivariate Logistic regression was applied to analyze the factors affecting the onset of Parkinson's disease. Results: The expression level of LncRNA MEG3, and TC, TG and LDL-C in Parkinson's disease group were lower than those in healthy group, and the expression level of DNMT1 was higher than that in healthy group (P<0.05). Serum DNMT1 was negatively correlated with TC, TG and LDL-C in patients with Parkinson's disease, and positively correlated with UPDRS I score, UPDRS II score, UPDRS III score and H-Y stage (P<0.05); LncRNA MEG3 was positively correlated with TC, TG and LDL-C, and negatively correlated with UPDRS I score, UPDRS II score, UPDRS III score and H-Y stage (P<0.05). The AUC of DNMT1 and lncRNA MEG3 alone and in combination for the diagnosis of Parkinson's disease was 0.858, 0.827 and 0.906, respectively. DNMT1 was an independent risk factor affecting the onset of Parkinson's disease, and lncRNA MEG3 was a protective factor affecting the onset of Parkinson's disease (P<0.05). Conclusion: DNMT1 is highly expressed and lncRNA MEG3 and is low expressed in the serum of patients with Parkinson's disease, respectively. The combination of the two can be used as auxiliary biomarkers for the diagnosis of Parkinson's disease.

Clinical application of orbital color doppler imaging in diagnosis of central retinal artery occlusion

Chan-Juan Huang,Pei-Jing Li, — 2023/12/8 9:08:19

Objective To investigate the clinical value of orbital color doppler imaging (OCDI) in the diagnosis of central retinal artery occlusion. Methods Clinical data of 34 patients (34 eyes) with central retinal artery occlusion admitted to the Second Affiliated Hospital of Army Medical University from January 2015 to September 2021 were selected, including 15 patients (15 eyes) aged < 60 years old and 19 patients (19 eyes) aged ≥60 years old. Another 30 healthy subjects (30 eyes) were included as control group. The hemodynamics indexes of the central retinal artery in the affected eye and the healthy eye were detected by OCDI, including peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI) and pulsatility index (PI). Kappa consistency test was used to analyze the consistency between fluorescein fundus angiography (FFA) and OCDI. The clinical features of patients with central retinal artery occlusion whose OCDI was negative were analyzed. Results The PSV and EDV levels in the affected eye were lower than those in the healthy eye, and the RI and PI levels were higher than those in the healthy eye, the difference was statistically significant (P < 0.05). In patients with central retinal artery occlusion aged ≥60 years, the PI level in the affected eye was significantly higher than that in the control group (P < 0.05), but there was no significant difference between the PI level and that in the healthy eye (P > 0.05). There was no significant difference in PSV, EDV and RI among the affected eye, healthy eye and healthy control group (P > 0.05). For the patients <60 years old with central retinal artery occlusion, the levels of PSV and EDV in the affected eye were significantly lower than those in the healthy eye and the normal control group (P < 0.05), and the levels of PI and RI were higher than those in the control group (P < 0.05), but there was no statistical significance between the patients and the healthy eye (P > 0.05). The results of Kappa consistency test showed that OCDI and FFA had good consistency in the diagnosis of central retinal artery occlusion (Kappa=0.807, P < 0.001). The time from onset to treatment of OCDI negative patients was later than that of positive patients (P < 0.05), but there was no significant difference in PSV, EDV and RI between the affected eye and the healthy eye (P > 0.05). Conclusion The hemodynamics of central retinal artery in patients with central retinal artery occlusion are significantly changed. OCDI examination is helpful for early diagnosis of central retinal artery occlusion.

Predictive analysis of acute radiation-induced skin injury in breast cancer patients treated with hypofractionated radiotherapy after breast-conserving surgery

li na,shao rui li,wangjianting,wangjing,wangxiaohong,xiongwei — 2023/12/8 9:05:20

Objective: To construct a risk prediction model for acute radiation-induced skin injury in breast cancer patients treated with hypofractionated radiotherapy after breast-conserving surgery, and to verify its prediction efficiency.Methods: A total of 186 breast cancer patients who underwent hypofractionated radiotherapy after breast-conserving surgery in Tangshan People"s Hospital from October 2020 to September 2022 were selected. They were randomly divided into model group (119 cases) and validation group (67 cases). The model group was divided into injury group and non-injury group according to whether radiation-induced skin injury occurred or not. Logistic risk regression analysis was used to analyze the risk factors. The risk prediction model was constructed according to the weight of risk factors, and the receiver operating characteristic curve (ROC) was used to verify its efficacy.Results: Among the 119 patients with breast cancer treated with hypofractionated radiotherapy after breast-conserving surgery in the model group,79 patients had grade 1 acute radiation-induced skin injury and 10 patients had grade 2 acute radiation-induced skin injury, with an incidence of 74.79% (89/119).These patients were included in the injury group, and the remaining 30 were included in the no-injury group.Compared with the non-injury group, the proportion of patients with body mass index (BMI) ≥28 kg/m², history of diabetes, tumor T2 stage, triple-negative type, and sequential tumor bed electron beam boost radiotherapy, CD4⁺T lymphocyte apoptosis rate, and hemoglobin level were higher in the injury group (P < 0.05). Logistic risk regression model showed that BMI, history of diabetes, T stage of tumor, triple-negative type, radiotherapy form, CD4⁺T lymphocyte apoptosis rate and hemoglobin were risk factors for acute radiation-induced skin injury (P < 0.05). There were 6, 24, and 59 cases of low, medium, and high-risk radiation-induced skin injury in the model group, and 2, 10, and 25 cases in the validation group, respectively. The ROC curve of the risk prediction model for acute radiation-induced skin injury in the model group showed that the AUC was 0.933, the sensitivity and specificity were 92.1% and 93.3%, respectively. The ROC curve for predicting acute radiation-induced skin injury in the validation group showed that the AUC was 0.886, the sensitivity and specificity were 91.9% and 86.7%, respectively.Hosmer-Lemeshow test showed that both had high goodness of fit (χ2=85.142, P=0.056; χ2=75.129, P=0.059; χ2=78.533, P=0.057).Conclusion: BMI, history of diabetes, tumor T stage, triple-negative type, radiotherapy form, CD4⁺T lymphocyte apoptosis rate and hemoglobin are all risk factors for acute radiation-induced skin injury after breast-conserving surgery for breast cancer. The risk prediction model constructed according to the weight of risk factors can quantitatively evaluate the risk of acute radiation-induced skin injury and has high predictive efficiency.

GUO Cai-Ru LIU Xin-Xin NIU Yu-Jie JIA Fu-xinLuoyang Central Hospital Affiliated to Zhengzhou University, Henan International Joint Laboratory of Tumor Cell Immunity and Regenerative Medicine, Tumor Immunity and Biomaterials Advanced Medical Center? Zhengzhou University, Department of Hepato-pancreatico-biliary Surgery, Luoyang, 471009, China

guocairu,jiafuxin,liuxinxin,niuyujie — 2023/12/8 8:56:23

[ ABSTRACT ] Objective To explore the protective effect and possible mechanism of exosomes derived from human adipose derived mesenchymal stem cells (Exosome-HADSCs) combined with astragalus polysaccharide (APS) on myocardial cell injury induced by Cobalt(II) chloride (CoCl2). Methods Extract exosomes from HADSCs cultured in vitro and identify them using electron microscopy and western blotting.The experiment was divided into control group, Exo group, APS group, and Exo+APS group. The effects of Exosome-HADSCs combined with APS on the angiogenesis and migration of umbilical vein endothelial cells (HUVECs) were analyzed by angiogenesis and scratch experiments. And an in vitro model of CoCl2 injury in AC16 myocardial cells was established, which was divided into control group, CoCl2 injury group, CoCl2 injury+Exo group, CoCl2 injury+APS group and CoCl2 injury+Exo+APS group. With the Exosome-HADSCs combined with APS, the survival rate of AC16 cells injured by CoCl2 in each group was measured by Cell Counting Kit-8 (CCK8). The apoptosis of cardiomyocytes in each group was observed by tunel staining. Western blot was used to detect changes in apoptosis related proteins Bax, caspase-3, and Bcl2 in each group, as well as the involvement of PI3K/Akt signaling pathway. Results Compared with the Control group, the number of vascular grids formed in the Exo+APS group significantly increased (P<0.01), and the cell migration rate of HUVECs in the Exo+APS group was were significantly improved [(65.45% ± 1.63)% vs (93.36% ± 0.70)%, P＜0.01]. Compared with CoCl2 injury group, Exosome-HADSCs combined with APS group significantly improved the survival rate of AC16 cells [(57.96 ± 1.27)% vs (82.08 ± 0.82)%, P＜0.05] and reduced the apoptosis rate of AC16 cells [(35.24 ± 3.53)% vs (8.68 ± 1.61)%, P<0.01]. Compared with the CoCl2 injury group, the expression of apoptosis related proteins of Bax and Caspase-3 protein in the CoCl2 injury+Exo+APS group were down-regulated significantly (P<0.01), while the anti-apoptotic protein Bcl2 was significantly up-regulated (P<0.01). Moreover, the expression levels of PI3K, p-PI3K, and Akt were significantly increased (P<0.01) after the treatment of Exosome-HADSCs combined with APS. Conclusion Exosome-HADSCs combined with APS has an obvious protective effect on AC16 myocardial cell injury, mainly by promoting angiogenesis and endothelial cell migration, reducing myocardial cell apoptosis. At least partially achieved through the PI3K/Akt signaling pathway. The combination of the two is more effective than using either alone, and possibly through the PI3K/Akt signaling pathway.

Identification of diagnostic genes in Rheumatoid arthritis and immune infiltration analysis based on bioinformatics and machine learning

HE Hong-ni,LI Ling-qin,,ZHANG Yan-ni,ZHOU Rui-jiao — 2023/12/8 8:53:21

Objective: To explore the diagnostic genes and immune infiltration in Rheumatoid arthritis by using bioinformatics and machine learning technology, to provide new ideas for the diagnosis and treatment of RA. Methods: The gene expression profiles were downloaded from the Gene Expression Omnibus (GEO) database. GSE55235 and GSE77298 were used as the training set dataset, and GSE55457 was used as the independent validation set dataset. The differentially expressed genes(DEGs)were identified by R Software, and gene ontology (GO) and gene pathway enrichment (KEGG) enrichment analysis of these DEGs. Furthermore, SVM-RFE, LASSO regression and Random Forest machine learning algorithms were used to screen diagnostic genes, while external validation and Receiver Operating Curve (ROC) analysis were performed. Finally, the xCell method was used to calculate the infiltration of immune cell types in the RA. Results：A total of 704 DEGs were obtained, enrichment analysis revealed that the RA was mainly involved in leukocyte mediated immunity、activation of immune response、leukocyte migration、lymphocyte mediated immunity immune effector process, and inflammatory pathways, such as Chemokine signaling pathway、Leishmaniasis、Rheumatoid arthritis and Staphylococcus aureus infection. Machine learning identified CXCL13、LRRC15、SDC1 and YBX3 as core genes with good diagnostic and predictive efficacy. Finally, Immune infiltration results showed that the expression of B cells、CD4+T cells、dendritic cells and monocytes were upregulated in the RA. Conclusion：Multiple genes and pathways are involved in the pathogenesis of RA. CXCL13、LRRC15、SDC1 and YBX3 may be the potential biomarkers for the diagnosis and prediction of RA, Moreover, B cells、CD4+T cells、dendritic cells and monocytes may be important in the development of RA.

Value of contrast-enhanced ultrasound combined with fecal calprotectin in evaluating the activity of Crohn's disease

chenjing — 2023/12/8 8:50:41

Objective To explore the value of contrast enhanced ultrasound (CEUS) combined with fecal calprotectin (FC) in evaluating the activity of Crohn"s disease (CD).Methods This retrospective study assessed 45 Crohn"s disease patients who was diagnosed in the University of Hong Kong- Shenzhen hospital from January 2021 to June 2023. According to Crohn"s disease activity index (CDAI), there were 18 cases in remission stage and 27 cases in active stage. All patients were examined by intestinal ultrasound and contrast-enhanced ultrasound, while the concentration of FC was measured at the same time. The relationship between peak intensity (PI), area under curve (AUC) of CEUS parameters, FC concentration and disease activity were analyzed. Results The CEUS parameters (PI, AUC) of CD patients in active stage were higher than those in remission stage(P＜0.05), and the FC concentration was significantly higher than that in remission stage(P＜0.05). With the increase of CD disease activity, CEUS parameters and FC concentration showed an obvious upward trend, which was positively correlated with CDAI score (P＜0.05). The CEUS parameters (PI, AUC) and the area under the curve of FC alone in diagnosing CD active period are 0.766, 0.811 and 0.735, respectively. The best cutoff values are 31.37, 2627.29 and 113.85. The area under the curve of CEUS combined with FC was 0.815, which was better than that of CEUS or FC alone(P＜0.05). Conclusion The changes of CEUS parameters (PI and AUC) and FC concentration were strongly related to the disease activity of CD patients. Combination of CEUS parameters and FC concentration can effectively evaluate the disease activity in CD patients.

The expression of ADAMTS13 in patients with acute cerebral infarction after intravenous thrombolysis

Gao Zhili,Huang Shuxuan,Jiang Bingjian,Jiao Xue,,Liu Yuping,Lu Huanhuan — 2023/12/8 8:48:23

Objective To study the dynamic changes of A disintegrin and metalloproteinase with a thrombospondin type 1 motif member 13 (ADAMTS13), and to investigate the effect and significance of ADAMTS13 in patients with acute cerebral infarction (ACI) after intravenous thrombolysis with rt-PA. Methods 83 patients(NIHSS <15) with ACI who received intravenous thrombolysis with rt-PA in the Department of Neurology, Guangxi Zhuang Autonomous Region People"s Hospital from January 2020 to December 2021 were collected in this study. Patients were divided into two groups by the severity of disease according to NIHSS score, the mild group(NIHSS≤5) and the moderate group(5

The expression and clinical prognostic value of GPR15 and HMGA1 in colorectal cancer tissue

胡杰,潘荣延,王鹏辉 — 2023/12/6 16:04:36

Objective To investigate the expression and clinical prognostic value of orphan receptor G protein coupled receptor 15 (GPR15) and high mobility group protein group A1 (HMGA1) in colorectal cancer (CRC) tissue. Method: 89 CRC patients who were diagnosed and treated in our hospital from January 2019 to January 2020 were selected. Immunohistochemistry was used to detect the GPR15 and HMGA1 expression in cancer and adjacent tissues. The relationship between GPR15, HMGA1 expression and clinical pathological features were analyzed. Kaplan Meier curve analysis was used to analyze the differences in survival rates among CRC patients with different GPR15 and HMGA1 expression levels. Multivariate Cox regression analysis was used to analyze factors affecting the prognosis of CRC. Results The positive rates of GPR15 and HMGA1 in CRC cancer tissues were 67.42% (60/89) and 69.66% (62/89), which were higher than those in adjacent tissues by 8.99% (8/89) and 12.36% (11/89), with statistically significant differences (2=64.347, 60.402, P=0.000, 0.000). The positive rates of GPR15 and HMGA1 in CRC cancer tissues with TNM stage III, low differentiation, and combined lymph node metastasis were higher than those in stage I-II, high differentiation, and non-lymph node metastasis cancer tissues, respectively (all P<0.05). The 3-year survival rates of the GPR15 positive group and the negative group were 46.67% (28/60) and 86.21% (25/29), respectively; The 3-year survival rates of the HMGA1 positive group and the negative group were 48.39% (30/62) and 85.19% (23/27), respectively. The 3-year cumulative survival rate of the GPR15 positive group and HMGA1 positive group was significantly lower than that of the GPR15 negative group and HMGA1 negative group, with statistically significant differences (Log rank 2=9.124, 10.140, P=0.003, 0.001). Tumor TNM stage III, low differentiation, combined lymph node metastasis, GPR15 positive, and HMGA1 positive were independent risk factors affecting the poor prognosis of CRC patients. Conclusion: The increased expression of GPR15 and HMGA1 in CRC are related to the adverse clinical and pathological characteristics of CRC, and may be new prognostic indicators for CRC patients.

The relationship between serum lncRNA ROR and miR-145 levels and the occurrence of atrial fibrillation in patients with chronic heart failure and their predictive value analysis

吴海涛,, — 2023/12/6 16:02:25

Objective To investigate the relationship between serum long non-coding RNA (lncRNA) ROR and microRNA (miRNA) 145 levels and the occurrence of atrial fibrillation (AF) in patients with chronic heart failure (CHF) and their predictive value. Methods 108 CHF patients who were admitted to Handan First Hospital from March 2019 to December 2022 were selected as study subjects. Patients were divided into AF group (n=46 cases) and non-AF group (n=62 cases) according to the presence or absence of AF. And 50 healthy people who underwent physical examination in our hospital were selected as healthy group. The clinical data of CHF patients were collected. Cardiac function indexes [left atrial diameter (LAD), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD)] of CHF patients were detected by echocardiography. The levels of serum lncRNA ROR and miR-145 were detected by real-time quantitative polymerase chain reaction (qRT-PCR). The correlation between lncRNA ROR, miR-145 levels and cardiac function indexes were analyzed by Pearson correlation analysis. The influencing factors of AF in CHF patients were analyzed by multivariate Logistic regression model. The predictive value of lncRNA ROR and miR-145 for AF in CHF patients were analyzed by receiver operating characteristic (ROC) curve. Results There were significant differences in New York Heart Association (NYHA) cardiac function classification, LAD, LVEF, LVEDD and LVESD between AF group and non-AF group (P<0.05). Compared with healthy group, the level of lncRNA ROR in non-AF group and AF group was up-regulated, and AF group was higher than non-AF group, the difference was statistically significant (P<0.05). The level of miR-145 in non-AF group and AF group was down-regulated, and AF group was lower than that in non-AF group, the difference was statistically significant (P<0.05). Pearson correlation analysis showed that, serum lncRNA ROR level was positively correlated with LAD, LVEDD and LVESD, and negatively correlated with LVEF (P<0.05). The level of miR-145 was negatively correlated with LAD, LVEDD and LVESD, and positively correlated with LVEF (P<0.05). Multivariate Logistic regression analysis showed that, NYHA cardiac function grade IV, decreased LVEF, up-regulated serum lncRNA ROR and down-regulated miR-145 were risk factors for AF in CHF patients (P<0.05). ROC curve showed that, the area under the curve (AUC) of serum lncRNA ROR, miR-145 alone and combined detection in predicting AF was 0.699, 0.750 and 0.814 respectively, and the predictive efficiency was higher than that of single detection. Conclusion The level of serum lncRNA ROR in CHF patients is up-regulate and the level of miR-145 is down-regulate, which is closely relate to the occurrence of AF, tthe combine detection of the two has a high predictive value for the occurrence of AF.

The mechanism and research progress of Vonoprazan in treatment of Helicobacter pylori infectionZENG Lin,NIE Gang,Department of Gastroenterology,University-Town Hospital of Chongqing Medical University,Chongqing 400000,China

ZENG LIN — 2023/11/8 8:42:38

Helicobacter pylori (Hp) infection is associated with various diseases such as chronic gastritis, peptic ulcer, gastric MALT lymphoma and gastric cancer,etc, and all patients infected with Hp should be given eradication treatment. As the improvement of global antibiotic resistance, the eradication rate of Helicobacter pylori has decreased year by year, so the new Hp eradication plan needs to be excavated.Vonoprazan,which is a novel potassium-competitive acid blockers (P-CABs), has strong, stable and long-lasting acid-suppressive effects.Patients with antibiotic resistance can also achieve a good effect. Its treatment as an alternative therapy has gradually received serious attention.This article exactly expounds the mechanism of action, pharmacological properties and the therapeutic research status of vonoprazan, aiming to provide a reference for the clinical application of Hp eradication therapy in China.

Research progress on the rapeutic methods of promoting angiogenesis in ischemic heart disease

zhangxue — 2023/11/8 8:37:56

ischemic heart disease (IHD), also known as coronary heart disease, comprises a group of diseases caused by coronary artery stenosis or obstruction. Disorders of energy metabolism can occur in cardiomyocytes due to the resulting restricted blood flow to the heart, lack of oxygen or blood. If the blood supply is not promptly restored, many functional cardiomyocytes will die, potentially leading to fatal arrhythmias. Ischemic heart disease (IHD) is the leading cause of death worldwide. Despite significant advances in medical, interventional, and surgical treatments for this disease, the worldwide prevalence of IHD urgently requires innovative treatments. Induction of angiogenesis and revascularization remain crucial. In the past, stem cell transplantation to induce angiogenesis to repair ischemic myocardium has emerged as an innovative alternative. Therapeutic angiogenesis has been the most promising therapy for the treatment of ischemic diseases, enabling the reconstruction of ischemic heart tissue, reducing the progression of tissue infarction, and avoiding invasive surgical procedures or tissue / organ transplantation. In recent years, clinical studies have shown that exosomes also have protective effects against IHD by attenuating myocardial ischemia-reperfusion injury, promoting angiogenesis, inhibiting fibrosis, and promoting cardiac regeneration, among other effects. Therefore, ongoing research on promoting angiogenesis may provide new options for the treatment of ischemic heart disease. This article reviews traditional treatments for IHD, highlighting advances and challenges in potentially promoting angiogenesis for medical applications.

Role of m6A demethylase FTO in lipid metabolism

GUO Xue-Ying,HUANG Chun-Xiao — 2023/11/8 8:34:32

The fat mass and obesity-associated protein (FTO) is identified as the first mRNA N6-methyladenosine (m6A) demethylase that regulates body mass index and obesity.??FTO regulates the transcription, translation and maturation of mRNAs of lipid-metabolism regulators, such as PPARγ, miRNA130, C/EBPβ and miRNA155 via m6A demethylation.??In adipose tissue, FTO participates in the process of m6A demethylation that promotes adipogenesis and inhibits lipolysis.??In the liver, FTO overexpression usually leads to lipid overaccumulation and related diseases such as nonalcoholic fatty liver disease (NAFLD).??In addition, overexpression of FTO could lead to lipid disorder in diabetic patients. Meanwhile studies have demonstrated that abnormal expression of FTO affects lipid uptake and metabolism disorders in other tissue, which leads to occurrence of related metabolic diseases.This review aims to clarify the role and related mechanisms of FTO in lipid metabolism via summarizing the biological process of FTO-mediated modification of m6A demethylation, and to provide new ideas and insights for the treatment and diagnosis of dyslipidemia-related diseases.

Anesthesia of cesarean section assisted by ECMO in a patient with Eisenmenger syndrome

朱丽娜 — 2023/11/8 8:25:09

Eisenmenger's syndrome (ES) is a pathophysiological syndrome in which the pulmonary vascular resistance increases due to various left-to-right shunt congenital heart disease, which makes the pulmonary artery pressure reach or exceed the systemic circulation pressure, resulting in bidirectional or reverse shunt of blood through the abnormal pathways in the heart or in the heart. Pregnancies with Eisenmenger syndrome are at high risk of death and should be terminated as soon as possible. There are few literature reports about pregnancy complicated with Eisenmenger syndrome at home and abroad, and less than 30 cases related to anesthesia have been reported in China. This paper reports the treatment and anesthesia management of a woman with Eisenmenger syndrome complicated with severe pulmonary hypertension (systolic blood pressure 168mm Hg). The puerpera had acute left heart failure, respiratory failure and hypoxemia before surgery. Due to the critical condition of the patient, it was very easy to have pulmonary hypertension crisis. Therefore, after multidisciplinary consultation, cesarean section under the aid of extracorporeal membrane oxygenation (ECMO) was performed under general anesthesia. Although the patient successfully survived the perianaesthesia period, he died from pulmonary infection and multiple organ failure 41d after surgery. In order to improve the survival rate, early termination of pregnancy should be made under multidisciplinary cooperation, and postoperative monitoring and treatment should be strengthened.

A case of neonatal pseudoaldosteronia misdiagnosed as congenital adrenocortical hyperplasia

ZhaoWanjun — 2023/11/8 8:19:07

A case of neonatal pseudoaldosteronia misdiagnosed as congenital adrenocortical hyperplasia was reported.Thirteen days after birth, hyponatremia, hypochloremia and hyperkalemia were found in the premure girl, the treatment effect of hydrocortisone supplement was not effective.During hospitalization, The child was diagnosed with Pseudohypoaldosteronism Type 1 (PHA1) because of Copy number variations (CNV) improved the existence of heterozygous deletion variations in chr4:148968002-149035453, including NR3C2 gene.She was followed up to 11 months after discharge.This mutation is a new heterozygous deletion mutation that has not been reported in the human gene Mutation database. PHA is often misdiagnosed as congenital adrenal hyperplasia due to the presence of hyponatremia and hyperkalemia. Therefore, the clinical data and discussion of this child are reported as follows, so as to improve the understanding and identification of this disease.

Effect of H3cit mediated by PAD4 on acute kidney injury in sepsis mice

Wang Ziqiang,Wei Zefeng,Zhang Ruicheng,Zheng Jinhua — 2023/11/7 18:21:18

Objective: To investigate the role and mechanism of histone H3 (H3cit) mediated by arginine deiminase 4 (PAD4) citrate in acute kidney injury (AKI) of sepsis mice. Methods: Thirty C57BL/6J mice were randomly divided into control group, model group and administration group, with 10 mice in each group. The experimental group was gavage with BB-Cl-amidine (PAD4 inhibitor) for 7 days, and the other two groups were gavage with normal saline of the same volume. After 7 days, mice in model group and administration group were intraperitoneally injected with LPS to induce AKI model. The mice were killed 24 h later, and the contents of serum creatinine (SCr), urea nitrogen (BUN) and H3cit, urinary microalbumin/urinary creatinine (UALb /Cr) ratio, and malondialdehyde (MDA) and superoxide dismutase (SOD) contents in renal tissue of each group were detected. The correlation between SCr, BUN, UALb /Cr and H3cit was compared. HE staining was used to detect kidney injury, western blot was used to detect the expression levels of PAD4 and H3cit. HEK293T cells were pretreated with BB-Cl-amidine and added with LPS. Then the cells were divided into blank group, LPS group and LPS+BB-Cl-amidine group. Western blot was used to detect the expression levels of PAD4 and H3cit, and CCK-8 was used to detect cell proliferation. Results: Compared with the control group, the contents of SCr, BUN and H3cit in serum, the proportion of UALb /Cr in urine, MDA content in renal tissue was increased, while SOD content decreased, and the pathological injury of kidney was aggravated, the expressions of PAD4 and H3cit protein were increased in model group. Compared with the model group, the contents of SCr, BUN and H3cit in serum, the proportion of UALb /Cr in urine, the content of MDA in renal tissue were decreased, while the content of SOD in kidney tissue were increased, the pathological injury of kidney was relieved, and the expression of H3cit protein was decreased in the administration group. H3cit content was positively correlated with SCr, BUN and UALb /Cr levels. Compared with blank group, the expression of PAD4 and H3cit protein in LPS group was increased, and the cell proliferation level was decreased. Compared with LPS group, H3cit protein expression was decreased and cell proliferation was increased in LPS+BB-Cl-amidine group. Conclusion: Sepsis mice promote AKI development through PAD4-mediated H3cit, and inhibition of PAD4 activity can effectively reduce kidney cell damage and relieve the symptoms of AKI disease in sepsis mice.

Clinical efficacy and safety of drug-loaded spheroids transarterial chemoembolization combined with systemic antitumor regimen in the treatment of unresectable primary liver cancer

congpeng,liangguodong, — 2023/11/7 18:19:47

Objective To investigate the clinical efficacy and safety of drug-loaded spheroid transarterial chemoembolization (DEB-TACE) combined with systemic antitumor regimen in the treatment of unresectable primary liver cancer. Methods The clinical data of 99 cases of unresectable primary liver cancer who received DEB-TACE with or without systemic anti-tumor regimen in Nanchong Central Hospital from January 2021 to December 2022 were retrospectively collected, and divided into control group: 44 cases in DEB-TACE treatment group. Combination group: 24 cases in DEB-TACE combined with targeted therapy group, 16 cases in DEB-TACE combined immunotherapy group, and 15 cases in DEB-TACE combined immunotargeted therapy group. The clinical efficacy, survival time and adverse effects of the control group and the combination group were compared. Results The objective response rate, disease control rate, overall survival time and progression-free survival time of the combined group were better than those in the control group, and the difference was statistically significant (P<0.05), and the patients in the combination group and the control group had embolic syndrome, fatigue, transient abnormalities of liver function before and after treatment, and the difference was not statistically significant (P>0.05), and compared with the control group, the combination group had unique adverse reactions related to the treatment drug, and the difference was statistically significant (P<0.05). Conclusion DEB-TACE combined with systemic therapy has good clinical efficacy, does not increase the rate of adverse events, and has high safety, which provides a new treatment idea for patients with intermediate and advanced primary liver cancer.

Effectiveness of Glisson tip transected precision hepatectomy in paediatric liver tumour surgery

chenjinyu, — 2023/11/7 18:17:57

Abstract: Objective To discuss the experience of performing Glisson tip transection precision hepatectomy in surgery for primary liver tumours in children.Methods The clinical data of children admitted to our general surgery department from October 2019 to October 2022 with paediatric primary liver tumours treated in parallel with surgery were analysed and described.Results Eighteen children with primary liver tumours were operated on according to the Glisson tip transected precision hepatectomy. The mean operative time was (204.5 ± 46.8) min, the mean intraoperative bleeding was (245.7 ± 56.8) mL and the mean intraoperative blood transfusion was (200.8 ± 50.5) mL. One case of low-flow bile leak occurred postoperatively and was healed by conservative treatment with drainage. The rest of the children had no postoperative complications such as bleeding, infection, liver failure or thromboembolism.Preoperatively, there were statistically significant differences in LDH, WBC, PLT and TB when comparing children with benign and malignant liver tumours. In seven children with hepatoblastoma, there was a statistically significant difference in serum AFP found at the initial diagnosis and 1 week after surgery. At post-operative follow-up from 2 months to 34 months, 10 children with benign tumors were found to be similar in height, weight and mental development to children in the same age group, with no recurrence of tumors and a survival rate of 100%. 7 children with hepatoblastoma, 5 with PRETEXT stages I and II, achieved complete remission, and 2 with PRETEXT stage III underwent surgery after completing chemotherapy. The overall survival rate of the children with HB was 71.4%. 1 case of hepatocellular liver cancer was in fair general condition at the end of the follow-up period and had not recurred. Conclusion Glissonean pedicle transaction method hepatectomy is a safe, simple and effective surgical procedure in paediatric primary liver tumour surgery. Keywords: Paediatric; Primary liver tumour; Hepatectomy; Glissonean pedicle transaction met

Comparison of therapeutic effects between deltoid and deltoid-pectoralis major interstitial approaches in the treatment of elderly proximal humerus fracturesZhao Huanrong1, Ma Zhihua1, Ma Junjun2, Fu Hongwei1, Li Junye1, Ma Zhongying1

赵焕融 — 2023/11/7 11:47:03

Objective To compare the curative effect of the treatment of proximal humeral fractures in the elderly by deltoid and pectoralis major approaches. Methods 50 elderly patients with proximal humeral fracture were retrospectively analyzed. According to the type of operation, they were divided into two groups: the control group (operated by the deltoid pectoralis major approach) and the experimental group (operated by the deltoid approach). Each group had 25 patients. The operation time, intraoperative bleeding, fracture healing time, wound healing time, postoperative complications, postoperative function score, wound pain score, etc. were compared between the two groups. Results The operation time, intraoperative blood loss and wound healing time in the experimental group were significantly lower than those in the control group, with significant differences between the groups (P<0.05); There was no significant difference in fracture healing time and hospitalization time between the two groups (P>0.05); The Constant Murley shoulder joint function score of patients in both groups increased significantly 7 days and 3 months after operation, and VAS pain score decreased. The VAS score and Constant Murley score of the shoulder joint in the experimental group were better than those in the control group immediately after operation and 7 days after operation (P<0.05); There was no significant difference between the two groups in VAS score and Constant Murley score 3 months after operation (P>0.05). The complication rate of the experimental group was 12.00% (3/25), which was lower than that of the control group (16.00% (4/25). There was no significant difference between the groups (?) 2= 0.000，P=1.000）。 Conclusion The treatment of proximal humeral fracture through deltoid approach, especially for the classification of large tubercle fracture, can reduce surgical trauma, reduce intraoperative bleeding, relieve wound pain, shorten wound healing time, and facilitate early postoperative functional exercise and improve shoulder joint function.

Clinical Characteristics and Risk Factors of Bone Erosion in Gout Patients

Zhang Fuyun, — 2023/11/7 11:45:30

Objective?To analyze the clinical characteristics and risk factors of bone erosion in gout patients. Methods?A retrospective analysis was conducted on the clinical data of 590 gout patients treated in the Department of Rheumatology, Yantai Yuhuangding Hospital affiliated to Qingdao University from January 2022 to February 2023. According to whether bone erosion occurred under ultrasound, the patients were divided into bone erosion group and non-bone erosion group, and the clinical characteristics of gout patients with bone erosion were analyzed. Multivariate logistic regression analysis was done for the risk factors, and ROC was drawn to evaluate the predictive value of risk factors for bone erosion in gout patients. Results?A total of 590 gout patients were included in the study, including 577 males (97.80%). 223 cases (37.80%) had bone erosion. The first metatarsophalangeal joint (74.43%) was the most frequently involved site, and the single joint (65.92%) was mainly involved. Age, course of disease, number of attacks, red blood cell distribution width, urea, creatinine, cystatin C, erythrocyte sedimentation rate, C-reactive proteinSin the bone erosion group were significantly higher than those in the non-bone erosion group (P<0.05), while hemoglobin was significantly lower (P<0.05). Multivariate analysis showed that duration of disease[OR=1.739, 95%CI(1.560, 1.938), P=0.000], number of attacks[OR=1.222, 95%CI(1.024, 1.457), P=0.026] and cystatin C [OR=4.292, 95%CI(1.444, 12.759),P=0.009]were the independent risk factors for bone erosion in gout patients. The highest level of AUC was 0.932, the sensitivity was 86.1%, and the specificity was 88.3%, which were observed when the 3 items were combined. Conclusions?The first metatarsophalangeal joint is the most common joint in gout patients with bone erosion. Patients with prolonged disease course, frequent attacks and elevated cystatin C levels should be actively intervened to prevent disease progression.

Selection of surgical methods and efficacy evaluation of recurrent lumbar intervertebral disc herniation , HU Yong-sheng , ZHANG Xiao-xuan , SHONG Xing-hua , TIAN Hui-zhong , ZHENG Jun-tao , XIE Jiang

胡永胜,,,,, — 2023/11/7 11:43:57

［］ Objective To explore the surgical treatment of recurrent lumbar disc herniation and evaluate the curative effect. Method? Retrospective analysis was performed on 73 patients with recurrent lumbar disc herniation treated from October 2017 to August 2021, including 40 males and 33 females. There were 31 patients undergoing posterior intervertebral disc herniation (group A) and 42 patients undergoing posterior intervertebral disc herniation + intervertebral fusion (group B). There were no significant differences in gender, body mass index, surgical segment, preoperative visual analog scale (VAS) and dysfunction scale (ODI) (P > 0.05). Surgical time, intraoperative blood loss, cerebrospinal fluid leakage and bed time of patients in the two groups were recorded, and VAS and ODI scores at different time points were recorded.?? Results There were statistical significance in operation time, intraoperative blood loss and bed time between the two groups (P<0.05), but no statistical significance in cerebrospinal fluid leakage between the two groups (P > 0.05). VAS score and ODI score at 3 days, 3 months, 6 months and the last follow-up were statistically significant compared with those before operation (P<0.05). There was no statistical significance between the two groups at different time nodes (P > 0.05). There was no statistical significance in the satisfaction rate of group A (74.19%) and group B (71.43%) (P > 0.05). Conclusion Both posterior intervertebral disc nucleus pulposus excision and posterior intervertebral fusion are effective surgical treatments for recurrent lumbar disc herniation, with definite clinical effect, and posterior intervertebral disc nucleus pulposus excision has advantages.

Analysis of the effect of subcutaneous tissue plastic surgery combined with superductive suture in preventing scarring after thyroid surgery

chenjiahua — 2023/11/7 11:41:47

Objective To investigate the clinical effect of subcutaneous tissue plastic surgery combined with superductive suture in preventing incision scarring after open thyroid surgery. Method A total of 400 patients who underwent thyroid surgery in Nanxishan Hospital of Guangxi Zhuang Autonomous Region were selected and voluntarily enrolled, and the patients who met the enrollment conditions were divided into control group and experimental group by random number method, with 200 cases each.Control group: The subcutaneous tissue was sutured with 4-0 absorbable suture VICRYL Plus intermittent suture, The skin is bonded with medical adhesives.Experimental group: Before suturing the subcutaneous tissue, the V-shaped incision of the subcutaneous tissue was cut into a trapezoidal incision with COVIDIEN FORCE FX-8C (power 15W), the subcutaneous tissue was sutured with 4-0 absorbable suture VICRYL Plus,The skin is bonded with medical adhesives.Results The pain of patients at 24 hours and 48 hours after surgery was compared, the healing grade of the incision after surgery was compared, and the occurrence of flap edema after surgery was compared. The scar index was assessed using the Vancouver Scar Assessment Scale 6 months and 1 year after surgery. Conclusion In thyroid surgery, postoperative scarring can be reduced by cutting the V-incision into a trapezoidal incision followed by subcutaneous superductive sutures.

Application value analysis of serum testosterone, estradiol and testosterone/estradiol ratio in the assessment of spermatogenic dysfunction

Ganxianyou,He Yongzhi,Ling Xiaobin,Wei Tinglv,Xu KongRong,Yang Man — 2023/10/16 18:01:38

Objective To compare the difference of serum testosterone, estradiol and testosterone/estradiol ratio in patients with different degrees of spermatogenic dysfunction and the men with normal semen quality, to explore its application value in the evaluation of male spermatogenic dysfunction. Methods Patients with spermatogenic dysfunction were divided into three groups : mild oligospermia group, severe oligospermia group and non-obstructive azoospermia group (each group had 150 cases),300 cases with normal semen quality as control group; Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), estradiol (E2), sex hormone binding protein (SHBG) and albumin (ALB) were measured for each man. Free testosterone (FT) was calculated using the formula recommended by the International Society for the Study of Elderly Men (ISSAM), and TT/ E2 and FT/ E2 ratios were also calculated. The percentile values of different hormones in the control group were analyzed. The 5th percentile value of TT and FT was taken as the lower limit of reference , and the 20th percentile value of TT/ E2 and FT/ E2 was taken as the therapeutic limit value. Non-parametric Kruskal-Wallis H test was used to analyze the differences of parameters (TT, FT, E2, TT/ E2 and FT/ E2) between the groups with spermatogenic dysfunction and the control group. Results The mean value of TT and FT in control group were 504.5ng/dl and 10.28ng/dl, and the 5th percentile value were 273 ng/dl and 6.7 ng/dl, respectively. TT/ E2 and FT/ E2 (TT: ng/dl; E2: ng/L) mean values were 15.75 and 0.32, 95% interval values were 7.01-35.8 and 0.17-0.66, and the 20th percentile values were 10.06 and 0.23, respectively. There were significant differences in TT, FT, E2, TT/ E2 and FT/ E2 among all groups (P=0.000). Compared with the control group, serum testosterone decreased with the severity of spermatogenic dysfunction, and FT values were significantly different among all groups (P<0.001). TT/ E2 and FT/ E2 decreased with the severity of spermatogenesis dysfunction, and the difference between severe oligospermia group and NOA group was significant (P<0.001). The value of E2 decreased with the severity of spermatogenesis dysfunction, and the NOA group significantly decreased compared with the normal semen group, while the mild oligospermia group and the severe oligospermia group had no statistical difference compared with the normal semen group. Conclusions: Serum FT is an important indicator in the evaluation of spermatogenic dysfunction. The lower limit of TT and FT reference values were 273 ng/dl and 6.7 ng/dl, respectively. T/ E2 ratio is an important index reflecting the balance of serum T and E2 in patients with spermatogenic dysfunction. T/ E2<10 can be used as the therapeutic limit value. The evaluation of the above indexes can provide a theoretical basis for the treatment of spermatogenic dysfunction.

Effects of neuromuscular electrical stimulation combined with programmed lower limbs training on postoperative fracture healing and recovery of motor function in elderly patients with intertrochanteric fractures

Murong Gao,Li Wei,Ye Wang,Mei Qing Yu — 2023/10/16 17:59:45

Objective: To explore the effects of neuromuscular electrical stimulation combined with programmed lower limbs training on postoperative fracture healing and recovery of motor function in elderly patients with intertrochanteric fractures. Methods: A total of 86 elderly patients with intertrochanteric fractures undergoing surgical treatment were enrolled between January 2019 and September 2021. According to simple number table method, they were randomly divided into control group (43 cases, routine rehabilitation training) and observation group (43 cases, neuromuscular electrical stimulation combined with programmed lower limbs training). The fracture healing, complications, pain, joint function, bone metabolism, recovery of motor function and quality of life were compared between the two groups. Results: The fracture healing time,leaving bed time, partial weight-bearing time and complete weight-bearing time in observation group were shorter than those in control group (P<0.05), and incidence of postoperative complications was 4.65%, lower than that in control group (P<0.05). After surgery, difference in scores of visual analogue scale (VAS) and hip Harris, Brthel index (BI), osteocalcin (OC), type I procollagen propeptide (PINP) and C-terminal telopeptides of type I collagen (CTX) between the two groups was not statistically significant (P>0.05). At 1 week, 3 months and 6 months after surgery, VAS scores in observation group were lower than those in control group, Harris scores and BI were higher than those in control group (P<0.05). At 3 and 6 months after surgery, levels of OC and PINP in observation group were higher than those in control group, while CTX level was lower than that in control group (P<0.05). Conclusion: Neuromuscular electrical stimulation combined with programmed lower limbs training can significantly promote postoperative fracture healing and recovery of motor function in elderly patients with intertrochanteric fractures, reduce complications, improve hip function and quality of life, which may play roles by regulating bone metabolism.

Research progress of peptidyl-prolyl cis/trans isomerase NIMA-interacting 1 in hepatocellular carcinoma

huang li — 2023/10/16 16:45:47

Peptidyl-prolyl cis/trans isomerase NIMA-interacting 1 (PIN1) was abnormally expressed in hepatocellular carcinoma, and played an important role in the proliferation, invasion, apoptosis and angiogenesis of hepatocellular carcinoma as a tumor catalytic molecule. Therefore, this paper will review the molecular structure and function of PIN1，expression of PIN1 in hepatocellular carcinoma and its role in the occurrence and development of hepatocellular carcinoma.

Research progress of TLR2/TLR4-NF-κB signaling pathway in gout

baidongxue,Li Jing — 2023/10/16 16:43:39

Gout is caused by the increase of blood uric acid concentration and the deposition of sodium urate crystals in joints, tendons and surrounding tissues, which leads to intermittent attacks of inflammatory joint disease. Toll-like receptors is one of the pattern recognition receptors in the innate immune system. It has been proved that gouty arthritis is caused by the interaction between MSU crystals and macrophages in the blood, which leads to the chemotaxis and aggregation of neutrophils,thus activating TLR2/TLR4-NF-κB signal pathway and releasing inflammatory factors and proteases such as IL-1 β, IL-6 and TNF- α, leading to the occurrence and development of gouty arthritis.Taking gout and TLR2/TLR4-NF-κB signal pathway as the main line,this paper reviews the correlation between TLR2/TLR4-NF-κB signal pathway and gout and the treatment methods targeted by TLR2/TLR4-NF-κB signal pathway.

Research progress on the relationship between Corynebacterium kryloniae and cystic neutrophilic Granuloma Mastitis

cuitianyue,zhangshengchu, — 2023/10/16 16:38:41

Cystic neutrophilic Granuloma Mastitis (CNGM) is a rare subtype of Granuloma Mastitis (GM), It contains sparse Gram positive bacteria(GPB), these bacteria are easily overlooked or overlooked. This article mainly reviews the important role of Corynebacterium klebsiella in the occurrence and development of cystic neutrophilic Granuloma and Mastitis disease, and the research progress in this field so far, to provide new ideas for clinical comprehensive understanding of the pathogenesis of the disease and targeted diagnosis and treatment.

Risk factors analysis and prediction model of central venous catheter-related thrombosis in patients with malignant tumors：A single-center retrospective clinical study

wangxuexing — 2023/10/16 16:34:58

Objective?To study the main risk factors of central venous catheter-related thrombosis ( CRT ) in patients with malignant tumors and establish a risk prediction model.?Methods A total of 2096 tumor patients who underwent central venous catheters in the Third Affiliated Hospital of Kunming Medical University from January 2019 toJune 2022 were selected as the study subjects. According to whether CRT was formed after catheterization, the patients were divided into an observation group ( CRT formation group ) and a control group ( no CRT formation group ).Record and compare the differences of related indexes between the two groups. Multivariate logistic regression was used to analyze the independent risk factors affecting the formation of CRT in patients, and a line chart prediction model was established. The diagnostic value of receiver operating characteristic curve ( ROC curve ) and calibration graph analysis model was used.?Results The incidence of central venous CRT in patients with malignant tumor catheterization was 8.50% (178/2096 ). Further multivariate logistic regression analysis showed that tumor staging, concurrent infection, hormone use, hyperlipidemia, thrombosis ( hypercoagulable state ) history, and D2 aggregates were independent risk factors for central venous CRT in tumor patients. According to the results of the multi-factor analysis, the prediction model of the line chart was constructed, and the ROC curve was drawn to evaluate the prediction ability of the line chart. The area under the ROC curve ( AUC ) was 0.856, and the 95 % CI was 0.824-0.889, P < 0.001. The calibration curve shows that the predicted probability of occurrence of the CRT plot model of central vein in patients with malignant tumor is in good agreement with the actual probability of occurrence.Based on the results of Bootstrap self-help method for internal verification, the C index is 0.824, and the calibration plots and clinical decision curves showed that the column line graph model prediction has a good clinical application..Conclusion The established line chart prediction model can better predict the occurrence of CRT formation with superior clinical value,The line chart prediction model established in this study can better predict the occurrence of CRT formation with superior clinical value, but it still needs to be verified and improved by multi-center and prospective studies.

The prognostic value of macrophage phenotype and cell classification in bronchoalveolar lavage fluid for children with MPP complicated with airway mucus embolism

仇有喜,杨丽微,杨松 — 2023/10/16 16:34:06

Abstract: Objective To study the cell classification and levels of inflammatory factors in bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumoniae pneumonia (MPP) complicated with airway mucus embolism, and to explore their clinical prognostic value. Method: 160 children with MPP who underwent bronchoalveolar lavage in our hospital from February 2018 to February 2022 were selected as the study subjects. Based on the presence of airway mucus embolism, the MPP group was divided into an MPP combined with airway mucus embolism group (n=78) and MPP group (n=90). According to the imaging examination results at the 2-month course of the disease, the children in the MPP combined with airway mucus embolism group were divided into the pneumonia absorption slow group (n=35) and the pneumonia complete absorption group (n=43). The cell classification in BALF were determined by Rayleigh Giemsa staining method. Enzyme linked immunosorbent assay was used to detect the levels of interleukin (IL) -2, IL-8, IL-4, and IL-10 in BALF. Multivariate logistic regression analysis were used to analyze factors affecting slow absorption of pneumonia in children with MPP complicated with airway mucus embolism. Receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic value of various indicators for slow absorption of pneumonia in children with MPP combined with airway mucus embolism. Results The levels of macrophages, IL-4, and IL-10 in BALF of the MPP combined with airway mucus thrombus group were lower than those of the pure MPP group, while the levels of neutrophils, IL-2, and IL-8 were higher than those of the pure MPP group (t=5.303-22.732, P<0.05). In group of MPP combined with airway mucus thrombus, BALF macrophages showed a significant positive correlation with IL-4 and IL-10, and a significant negative correlation with IL-2 and IL-8 (all P<0.05); BALF Neutrophils showed a significant negative correlation with IL-4 and IL-10, and a significant positive correlation with IL-2 and IL-8 (P<0.05). Long fever duration, decreased macrophage, and increased neutrophils in BALF were independent risk factors affecting the slow absorption of pneumonia in children with MPP and airway mucus embolism. The area under the curve (95% CI) of the combined evaluation of fever time, macrophage count in BALF, and neutrophils for slow absorption of pneumonia in children with MPP and airway mucus embolism was 0.905 (0.861-0.949), which was greater than the single indicators 0.763 (0.711-0.802), 0.824 (0.761-0.864), and 0.790 (0.751-0.836). (Z=7.338, 4.021, 5.891, P=0.000, 0.000, 0.000). Conclusion: In MPP children combined with airway mucus embolism, there is a decrease in macrophages and an increase in neutrophils in BALF. Both of them are related to the levels of inflammatory factors in BALF. The combination of fever duration, macrophage count, and neutrophils has high evaluation value for slow absorption of pneumonia in MPP children combined with airway mucus embolism.

Analysis of SARS-Cov-2 infection in liver transplant recipients: a single-center clinical study

Huang Fan,Qiu Jian,Wang Guo-bin,Wang Wei,Wu Ruo-lin,Ye Zheng-hui,Zhang Xing-hua — 2023/10/16 15:25:39

Objective To investigate the situation and prognosis of SARS-Cov-2 infection in liver transplant recipients. Methods The differences in infection, prognosis, and symptoms of postacute sequelae of SARS-CoV-2 infection in infected liver transplant recipients (9 cases) and uninfected liver transplant recipients (10 cases) and common infected patients (19 cases) were retrospectively analyzed, and the influence of treatment methods on their prognosis was explored. Results Compared with other groups, hepatic insufficiency was more severe, the level of immune response was lower, and the clinical symptoms in the postacute sequelae of SARS-CoV-2 infection were more significant, and the difference was statistically significant (P＜0.01). Vaccination, antiviral use, and prone ventilation were statistically significant in improving liver function in liver transplant recipients (P＜0.01). Conclusion After liver transplant recipients are infected with SARS-CoV-2, hepatic insufficiency is more serious, the level of immune response is lower, vaccination, antiviral drugs and prone ventilation can help improve the prognosis, and there are still significant clinical symptoms in the postacute sequelae of SARS-CoV-2 infection.

Experience of treatment of 8 cases of COVID-19 after liver transplantation

zhang long — 2023/10/16 15:23:50

Objective: To summarize the experience of diagnosis and treatment of COVID-19 pneumonia in liver transplantation recipients. Methods: The clinical data of the patients who were diagnosed and treated in our department from December 2022 to January 2023 were retrospectively analyzed and discussed in combination with the literature. Results: Eight patients were diagnosed with COVID-19 pneumonia and treated in our department after transplantation. Among them, there were 3 cases of common type, 5 cases of severe type, and no severe cases. All patients were cured and discharged. The hospital stay was 5-21 days. One patient had persistent low fever and Inconspicuous oxygenation improvement after discharge. After being hospitalized again, he recovered and discharged. There was no case of progression from normal/severe type to severe/critical type. Conclusion: The patients after liver transplantation are susceptible to COVID-19 pneumonia, and there are high risk factors for progression to severe cases. Scientific and reasonable diagnosis and treatment can achieve satisfactory results.

A case report of primary signet-ring cell carcinoma of cervix

AOJIXING,LIUGUOHUA,ZHANGJIANFEI — 2023/10/13 16:27:27

Objective：The occurrence of primary signet cell carcinoma of cervix is extremely rare, with low morbidity rate, severe malignancy and inadequate reported studies. Here we present one case of primary signet cell carcinoma of cervix in our hospital and review the reported cases worldwide, aiming to provide references for the diagnosis and treatment of primary signet cell carcinoma of cervix. Case presentation: We present one case of a 66 years-old woman, whose chief complaint is vaginal discharge for 2 months. The initial gynecological examination showed a bulky cervical mass and the pelvic MRI indicated a maximum diameter of 8.3cm of the tumor. The primary pathological analysis from cervical biopsy revealed a poorly differentiated adenocarcinoma with a signet-ring cell appearance. After interventional therapy and chemotherapy, the patient received surgery of radical hysterectomy. While after the surgery, the patient received unaccomplished chemotherapy and radiotherapy, with a follow-up survival of 22 months. Discussion and conclusion: The therapeutic strategy should be individualized for primary signet ring cell carcinoma of the cervix. Considering our own case, neoadjuvant interventional therapy and chemotherapy might make easier way for radical surgery. Post-surgical chemoradiotherapy due to high risk factors might help prevent the recurrence of disease and prolong survival outcome.

Two cases of malignant solid tumor secondary to aplastic anemia

guwei,hu haibo,, — 2023/10/13 16:24:17

Aplastic anemia is a common disease with debilitating hematopoietic function of bone marrow, and its pathogenesis is not fully understood until now. The disease can develop into myelodysplastic syndrome or acute myeloid leukemia, and it is also related to paroxysmal sleep hemoglobinuria. However, there are few literatures on secondary malignant solid tumor in clinical practice. Now, 2 cases of aplastic anemia complicated with malignant solid tumor admitted to our hospital are reported as follows.

The relationship between miR-630 and the occurrence and development of renal clear cell carcinoma and its relationship with apoptosis

谭超 — 2023/10/13 16:20:01

Abstract: Objective To explore the relationship between miR-630 and the occurrence and development of renal clear cell carcinoma (ccRCC) and its relationship with apoptosis. Methods A total of 86 ccRCC patients were clinically collected. The level of miR-630 in tumor tissue and paracancerous tissue was detected by RT-qPCR. The relationship with pathological features of ccRCC was analyzed. Correlation analysis was used to explore the correlation between miR-630 and apoptosis marker proteins Caspase3 and Bcl2 in ccRCC tissues. 786-O cells were divided into NC group, miR-630 mimic group and miR-630 inhibitor group. The effects of control, overexpression and inhibition of miR-630 on cell viability, apoptosis rate and expression of apoptosis marker proteins were detected, respectively. Results The level of miR-630 in ccRCC tissues was significantly higher than that in adjacent tissues (P<0.05). The expression level of miR-630 was independent of gender and age, and high level of miR-630 was associated with larger tumor diameter, higher clinical stage and lymphatic metastasis (P<0.05). Compared with normal tissues, Caspase3 protein was significantly decreased and Bcl2 protein level was significantly increased in ccRCC (P<0.05). miR-630 was negatively correlated with Caspase3 and

Effect of Zhuangyi Jingjin Massage on Cell Apoptosis and Analgesic Mechanism in Neuropathic Pain Rats

陈立,梁英业,卢栋明,苏梦洁,唐宏亮,王天翊 — 2023/10/13 16:19:16

Objective: To explore the effect of massage on cell death and its analgesic mechanism in rats with neuropathic pain (NPP) based on the theory of Zhuangyi Jingjin. Methods: 45 SD rats were randomly divided into 5 groups: model group, normal group, Zhuangyi Jingjin massage group, sham massage group and sham operation group, with 9 rats in each group. Except the normal group and the sham operation group, the L5 spinal nerve ligation model (SNL model) was established in the other three groups. The latent period (PWTL) and the threshold of mechanical foot contraction (PWMT) of rats in each group were measured before operation (0d), 1d, 3d and 14d after operation; The sham massage group and the massage group were intervened from the first day after operation for 14 consecutive days, and the other three groups were not intervened, and were observed for 14 days; On the 14th day after operation, the expression level of caspase-1 protein in the dorsal horn of L4-6 spinal cord was detected by qPCR, the content of serum IL-18 was detected by ELISA, and the expression level of lactate dehydrogenase (LDH) was detected by microplate method.Results: ① There was no statistically significant difference in PWMT and PWTL of rats in each group before operation; The PWMT and PWTL in other groups were lower than those in the normal group on the 1st and 3rd day after operation (* P<0.05); On the 14th day after operation, the PWMT and PWTL of the model group and the sham massage group were lower than those of the normal group (* P<0.05), while the PWMT and PWTL of the Zhuangyi Jingjin massage group were higher than those of the model group and the sham massage group (# P<0.05), the difference was statistically significant. ② On the 14th day after operation, the expression levels of caspase-1 in spinal cord tissue and IL-18 and LDH in serum of the model group were higher than those of the normal group (P. Conclusion: Zhuangyi Jingjin Massage can reduce the pain sensitivity of SNL model rats, and its mechanism is related to down-regulating the expression of caspase-1 protein in the dorsal horn of the spinal cord, reducing the release of LDH and IL-18, the markers of cell death, and blocking the immune inflammatory reaction mediated by it.

Clinical effect of cervical sternocleidomastoid anterior approach in the treatment of unilateral thyroid cancer

唐杰, — 2023/10/13 16:18:03

Objective: To investigate the clinical effect of cervical sternocleidomastoid muscle anterior approach in the treatment of thyroid cancer compared with traditional median incision and non-inflatable axillary endoscopic approach. Methods: A retrospective analysis of 97 patients with unilateral thyroid cancer admitted to our hospital from 2022-08-01 to 2022-12-31 was performed, and they were divided into three groups according to different surgical methods. Among them, 24 cases in the cervical group used the cervical sternocleidomastoid muscle anterior approach, 50 cases in the median group used the traditional median incision approach, and 23 cases in the endoscopic group used the non-inflatable axillary approach. The intraoperative and postoperative related indicators of the three groups were observed and compared. Results: There was no significant difference in the number of intraoperative lymph nodes dissected and the number of lymph node metastases in the three groups (P > 0.05). Compared with the median group, there were no significant differences in operation time, intraoperative bleeding volume and postoperative drainage volume in the cervical group (P > 0.05), but the values in both groups were lower than those in the endoscopic group (P < 0.05). The hospital stay in the cervical Compared with the median group, there was no significant difference in pain score (VAS) on the first day after operation in the cervical side group (P > 0.05), but both were significantly lower than those in the endoscopic group (P < 0.05). The cosmetic effect score (NSS) of the cervical side group at 3 months after operation was slightly lower than that of the endoscopic group (P > 0.05); however, both were significantly higher than those in the median group (P < 0.05). The incidence of postoperative complications in the cervical side group (8.3%) was statistically significant compared with the median group (34.0%) (P < 0.05), and there was no significant difference compared with the endoscopic group (21.7%) (P > 0.05). Conclusion: Compared with the traditional median incision and non-inflatable axillary approach, the sternocleidomastoid muscle anterior approach can ensure that the operation is completed under the premise of safety, and at the same time, it takes into account the cosmetic effect of the operation and reduces the postoperative complications of patients. It is a safe and effective surgical approach for thyroid cancer, which is worthy of clinical promotion.

Relationship between serum sCXCL16 level and renal insufficiency and insulin resistance in T2DM patients

曾真 — 2023/10/13 16:16:19

Objective To investigate the relationship between serum soluble CXC chemokine ligand 16 (sCXCL16) level and renal insufficiency and insulin resistance in elderly patients with type 2 diabetes mellitus (T2DM).Methods A total of 55 DKD patients and 54 T2DM patients admitted to our hospital from April 2018 to July 2021 were selected as the research objects, and 55 healthy subjects in our hospital were selected as the control group, and the serum sCXCL16 levels of the three groups were compared. Multivariate Logistic regression model was used to analyze the relationship between serum sCXCL16 level and the risk of renal insufficiency in T2DM patients. Spearman method was used to evaluate the correlation among indicators. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum sCXCL level in T2DM renal insufficiency.Results The levels of serum sCXCL16 in DKD group and T2DM group were higher than those in control group, while serum sCXCL16 in DKD group were significantly higher than those in T2DM group (P＜0.05). For DKD patients, serum sCXCL16 level in the macroalbuminuria subgroup was higher than that in the microalbuminuria subgroup (P＜0.001). Multivariate Logistic regression analysis showed that serum sCXCL16＞18.50ng/mL was an independent risk factor for renal insufficiency in elderly T2DM patients (P＜0.05). Serum sCXCL16 level was positively correlated with HOMA-IR, BUN, Cr and UAE (P＜0.05). The area under ROC curve of serum sCXCL16 level on the risk of DKD was 0.866 (95%CI: 0.801-0.931), corresponding cut-off value was 10.60, specificity was 50.0%, sensitivity was 94.5%.Conclusion Elevated serum sCXCL16 level in elderly T2DM patients is closely related to renal insufficiency and insulin resistance, and high level of sCXCL16 may be a risk factor for DKD and play a key role in its progressive development.

Analysis of clinical pregnancy outcomes and influencing factors of single cleavage stage and single blastocyst stage embryo transfer following fresh transfer

huang dong mei,huang ling,huang ying qin,liang lin,wen qian qian,yin mei — 2023/9/26 15:40:46

Objective To investigate the clinical outcome and influencing factors of fresh single embryo transfer (SET) in IVF/ICSI cycles. Methods The clinical data of patients who underwent a total of 5543 cycles of cleavage stage and blastocyst stage SET from October 2002 to October 2020 were analyzed retrospectively. According to the timing of embryo transfer, the two groups were divided into Day 3 group and Day 5 group. A total of 1024 pairs of new samples were obtained by propensity score matching (PSM). The basic data and clinical outcomes of the two groups were compared. The factors influencing the clinical outcome of SET cycle were analyzed by binary logistic regression. Results The total clinical pregnancy rate in SET cycle was 48.13% , the total live birth rate was 39.49% and the total multiple birth rate was 2.89%. After PSM, the clinical pregnancy rate (37.21% vs. 49.51%) and live birth rate (28.61% vs. 40.53%) in D3 group and D5 group were compared, and the differences were statistically significant (P < 0.05). Multivariate regression analysis showed that the age of the mother and stage of embryonic development were both independent factors influencing the clinical pregnancy rate and live birth rate of SET. Further analysis showed that there was no significant difference in clinical pregnancy rate (54.55% vs. 54.76%) and live birth rate (49.09% vs. 47.21%) between D3 group and D5 group with age ≤30 years and the number of high-quality embryos > 3 (P > 0.05). Conclusion The selection of single cleavage stage and single blastocyst stage transfer in Fresh cycle can obtain better clinical pregnancy rate and live birth rate, and significantly reduce the risk of multiple pregnancy. The clinical pregnancy rate and live birth rate of single cleavage stage transfer can be similar to that of single blastocyst stage transfer in suitable population.

CT-guided minimally invasive puncture and external ventricular drainage combined with lumbar cistern drainage in the treatment of hypertensive cerebellar hemorrhageZhong xiang qiu Liu qian Hezhou Chinese Medicine Hospital

钟向球 — 2023/9/19 17:50:15

【】 objective to observe the effect of CT-guided minimally invasive puncture drainage and external ventricular drainage combined with lumbar cistern drainage in the treatment of hypertensive cerebellar hemorrhage. Methods 30 patients with hypertensive cerebellar hemorrhage in our hospital were treated by preoperative CT localization, external drainage of Hematoma puncture and lumbar cistern drainage, and lumbar cistern drainage was performed 2 days after operation. The clearance and recovery of Hematoma were observed. Results: 1 case died and 7 cases were disabled, including 5 cases with mild disability, 2 cases with severe disability and 22 cases with better recovery. Conclusion CT-guided minimally invasive puncture and external ventricular drainage combined with lumbar cistern drainage in the treatment of hypertensive cerebellar hemorrhage rupture into the ventricle can rapidly reduce intracranial pressure, accelerate the clearance of Hematoma, reconstruct the circulation of cerebrospinal fluid, and save lives, improve prognosis.

Mechanism study of circ-FOXM1 reducing the inhibitory effect of crizotinib on lung cancer cells by activating PI3K/AKT signaling pathway

夏延贞 — 2023/9/19 9:05:25

Objective To explore the role of circ-FOXM1 in crizotinib resistance of lung cancer cells and its related mechanism. Methods Quantitative real-time PCR (qRT-PCR) was used to detect the expression of circ-FOXM1 in BEAS-2B, H2228, H2228/CR cells. The expression of circ-FOXM1 was overexpressed, and H2228 cells were divided into pcDNA3.1 group and pcDNA3.1-circ-FOXM1 group. The expression of circ-FOXM1 was inhibited, and H2228/CR cells were divided into si-NC group and si-circ-FOXM1 group. Methyl Thiazolyl Tetrazolium (MTT) was used to detect IC50 of crizotinib. After crizotinib treatment, flow cytometry was used to detect apoptosis rate. Transwell was used to detect cell migration. Western blot was used to detect the protein expression levels of phosphorylated phosphatidylinositol 3 kinase (p-PI3K), phosphatidylinositol 3 kinase (PI3K), phosphorylated protein kinase B (p-AKT) and protein kinase B (AKT). Results The expression level of circ-FOXM1 in H2228/CR cells was significantly higher than that in H2228 cells, and the expression level of circ-FOXM1 in H2228 cells was significantly higher than that in BEAS-2B cells (P<0.05). The IC50 of crizotinib in pcDNA3.1-circ-FOXM1 group was significantly higher than that in pcDNA3.1 group (P<0.05). The IC50 of crizotinib in si-circ-FOXM1 group was significantly lower than that in si-NC group (P<0.05). After crizotinib treatment, the apoptosis rate of pcDNA3.1-circ-FOXM1 group was significantly lower than that of pcDNA3.1 group, and the migration number, p-PI3K/PI3K ratio and p-AKT/AKT ratio were significantly higher than that of pcDNA3.1 group (P<0.05), the apoptosis rate of si-circ-FOXM1 group was significantly higher than that of si-NC group, and the migration number, p-PI3K/PI3K ratio and p-AKT/AKT ratio were significantly lower than that of si-NC group (P<0.05). Conclusion circ-FOXM1 may reduce the inhibitory effect of crizotinib on lung cancer cells by activating PI3K/AKT signaling pathway.

Effect analysis for different severity of obstructive sleep apnea treated with oral appliance

Rao Mingcong,, — 2023/9/11 17:17:34

Objective：Therapy of oral appliance for obstructive sleep apnea(OSA) had been known to be effective,but there was few studies on efficacy of oral appliance to different severity OSA. This paper investigated changes of respiratory and sleep parameters of polysomnography (PSG) on different severity obstructive sleep apnea (OSA) before and after treatment with mandibular advancement oral appliance and detece oral appliance effect for OSA on respiration and sleep. Methods： according to the inclusion criteria, 57 OSA patients [male 49, female 25, average age [(45.5±10.6) years] were selected and divided into three groups according to the severity: 18 mild, 18 moderate, and 21 severe. They received PSG check before and after oral appliance treatment. 17 primary snoring cases were chosen to be control group and received PSG check without treatment.Sleeping and respiratory parameters on PSG were compared in three different severity OSA groups before and after oral appliance and among three OSA groups and control group. Results: (1) After treatment, the percentage of N3 (deep sleep stage) in mild group increased from (4.72±6.02) % to (8.73±7.92) %, and the awakening index in moderate group decreased from (1.17±0.96) time/hour to (0.81±0.68) time/hour, the difference was statistically significant (P < 0.05). There was no significant difference in sleep parameters in severe group before and after treatment (P > 0.05). (2)The respiratory parameters in OSA groups were significantly improved after treatment. (3) Compared with primary noring group, was N1 stage percentage of mild to moderate OSA higher, but there was no significant difference on sleep structure in severe group before treatment. There was no significant difference in sleep parameters among OSA groups after treatment. (4) Nocturnal hypoxemia still existed in three OSA groups, it was lowest in severe group after treatment, but it was significantly improved compared with one before treatment. Conclusion: Oral appliance treatment can promote sleep improvement in mild and moderat OSA patients. Respiratory parameters on different severity OSA patients can be improved after treatment, but night hypoxemia probably exists.

To investigate the relationship between mild cognitive impairment and serum ENO1Ab in patients with Hashimoto's thyroiditis

WangYue — 2023/9/11 8:58:30

Objective: To investigate the relationship between mild cognitive impairment and serum α-enolase antibody (ENO1Ab) in patients with Hashimoto"s ? thyroiditis (HT). Methods: A total of 98 patients with Hashimoto"s thyroiditis were [ ]divided into 55 cases in the normal cognitive function group (nMCI group) and 43 cases in the mild cognitive impairment group (MCI group) according to the Simple Mental State Assessment Scale (MMSE). Enzyme-linked immunosorbent assay (ELISA) detected serum ENO1Ab levels, Pearson and Spearman correlated analysis of the correlation between MMSE scores and clinical indicators, logistic regression analysis of risk factors for MCI, and ROC curve to evaluate the diagnostic value of ENO1Ab for MCI. Results: The age, TPOAb and ENO1Ab of the MCI group were significantly higher than those in the nMCI group, and the education level of the MCI group was significantly lower than that in the nMCI group, and the differences were statistically significant (P<0.05). MMSE scores were negatively correlated with age, TPOAb, and ENO1Ab levels (r<0, P<0.05). Logistic regression showed age, TPOAb, and ENO1Ab were the influencing factors of MCI in HT patients (P<0.05). The ROC curve results showed that ENO1Ab predicted the area under the curve (AUC) of MCI of 0.745, with a sensitivity of 62.80% and a specificity of 76.40%. Conclusion: Patients with normal thyroiditis Hashimoto have mild cognitive impairment independent of thyroid hormone levels and are related to TPOAb and ENO1Ab, the higher the levels of TPOAb and ENO1Ab, the greater the risk of MCI.

Effects of infiltration between the popliteal artery and capsule of the posterior knee block through distal approach on perioperative hemodynamics and recovery quality in elderly patients undergoing total knee arthroplasty

白延斌,李玲霞,刘艳玲,苏鸿莉 — 2023/9/11 8:56:43

[Abstract] Objective To explore the effects of infiltration between the popliteal artery and capsule of the posterior knee block (IPACK) through distal approach on perioperative hemodynamics and recovery quality in elderly patients undergoing total knee arthroplasty (TKA). Methods A total of 84 elderly patients undergoing elective TKA in the hospital were enrolled between October 2019 and October 2021. According to random number table method, they were divided into study group (n=42) and control group (n=42). The control group underwent IPACK through proximal approach, while study group underwent IPACK through distal approach. All underwent adductor canal block after IPACK. The perioperative hemodynamics, recovery quality, postoperative analgesia effect, knee range of motion and adverse reactions were compared between the two groups. Results After block (T1), at 10 minutes after the start of surgery (T2), joint replacement (T3) and after surgery (T4), MAP and HR in study group were lower than those in control group (P<0.05). The recovery qualityt was better than those in control group (P<0.05). At 12h, 24h and 48h after surgery, VAS scores at exercise and rest state in study group were lower than those in control group (P<0.05), and knee range of motion was greater than that in control group (P<0.05). Conclusion IPACK through distal approach can effectively regulate perioperative hemodynamics and improve recovery quality in elderly patients undergoing TKA, with significant postoperative analgesia effect and few effects on knee motor function.

Observation on the curative effect of Yuyingsan external application combined with diclofenac sodium sustained-release tablets on pain caused by subacute thyroiditis

于向慧 — 2023/9/11 8:54:19

Objective ：To explore the clinical efficacy of Yuyingsan combined with diclofenac sodium in the treatment of pain caused by subacute thyroiditis (SAT) and its influence on the levels of pain mediators and C-reactive protein (CRP) in patients' serum. Methods：In this prospective, randomized, single-blind, controlled study, 100 patients with PAIN caused by SAT admitted to the Department of Endocrinology of our hospital from December 2020 to July 2021 were selected and divided into observation group and control group with 50 patients in each group by random number table method. The control group was orally treated with diclofenac sodium sustained release tablets, and on this basis, the observation group was treated with External application of Yuyingsan. All subjects were treated for 2 consecutive weeks.The primary end points (time to thyroid pain disappear), secondary end points (disease efficacy, time to fever, ESR, thyroid function, pain mediators, CRP and recurrence rate) and adverse reactions were observed.results：Primary endpoint: The disappearance time of thyroid pain in the observation group was shorter than that in the control group, and the difference was statistically significant. Secondary end points: The total effective rate in the observation group [98.0% (49/50)] was higher than that in the control group [84.0% (42/50)], and the difference was statistically significant. The antipyretic time of the observation group was shorter than that of the control group, and the difference was statistically significant. Compared with before treatment, ESR and serum free triiodothyronine (FT3) and free thyroxine (FT4) levels in 2 groups decreased after treatment, and serum thyroid stimulating hormone (TSH) concentration increased, the difference was statistically significant. And after treatment, the above indicators of the observation group were better than the control group, the difference was statistically significant. After treatment, the concentrations of serum pain mediators [prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT), bradykinin (BK)] and CRP in 2 groups were decreased compared with those before treatment, and the difference was statistically significant. After treatment, the levels of serum PGE2, 5-HT, BK and CRP in the observation group were lower than those in the control group, the differences were statistically significant. The recurrence rate of the observation group was 2.9% (1/35), lower than that of the control group (20.0% (4/20)), but the difference was not statistically significant (P>0.05). Safety indicators: There was no statistical significance in the adverse reaction rate between the observation group and the control group [6.0% (3/50) vs 4.0% (2/50)] (P>0.05).conclusion：External application of Yuying Powder combined with diclofenac sodium sustained release tablet has a good overall efficacy in the treatment of pain caused by SAT, which can safely, effectively and rapidly relieve patients' symptoms such as pain, promote the recovery of thyroid function, reduce the risk of recurrence, and effectively down-regulate the expression levels of PGE2, 5-HT, BK and CRP in blood.

Research progress of Traditional Chinese Medicine(TCM) external treatment of myofascitis

lian zhan xiong,,wang cheng,, — 2023/9/7 16:38:22

Myofascitis is aseptic inflammation of the skeletal muscle system,widely exist in sub-health population.The main clinical manifestations are pain points, painful nodules and tensioning muscle bands,while the main treatments are oral or topical non-steroidal anti-inflammatory drugs, physical therapy, etc.,but the symptoms were proned to relapse,long-term administration may cause gastrointestinal reactions,which seriously affects the quality of life and work efficiency of patients.In recent years,There have been a lot of studies on the efficacy of Traditional Chinese medicine(TCM) on myofascitis,there are quite different, which bring advantages and disadvantages exist on each other.This article reviews the research progress of external treatment of myofascitis by TCM.

Application and research progress of artificial intelligence in spinal orthopedic surgery

李成 — 2023/9/7 16:35:36

Artificial intelligence (AI) has shown more and more powerful influence and application prospects in orthopaedics, and spinal orthopaedic surgery is the end-stage treatment of spinal deformities. Spinal orthopedic surgery is highly invasive, risky, and complicated.AI can reduce surgical complications and improve surgical outcomes based on patient and treatment options, and can also analyze risk factors associated with specific surgical patients to predict complications and outcomes, as well as design smarter implants. This article reviews the application of artificial intelligence in spinal orthopedic surgery and summarizes its research progress.

Advances in non-operative treatment of multiple pulmonary nodules

chuheng,haowenshuo,lilun,lizongqi,qitao,wangshumin, — 2023/9/7 16:33:29

Lung cancer is by far one of the malignant tumors with the highest morbidity and mortality in the world. With the improvement in people's health awareness, increasing attention has been paid to early screening of lung cancer. Multiple pulmonary nodules(MPNs) are closely associated with multiple primary lung cancer(MPLC). MPNs are usually found during low-dose spiral CT screening for lung cancer, meanwhile the detection rate in the population is rising year by year. At present, the optimal strategy for the treatment of MPNs is controversial. Surgery remains the primary therapeutic modality, while other non-operative treatments, including radiotherapy, local ablation, molecular targeted therapy, immunotherapy and chemotherapy could also provide more options for suitable patients. This article reviews the recent literature on non-operative treatments of MPNs, and overviews the indications, merits and demerits of these methods.

A case of pseudomyxoma peritonei with inguinal hernia as the only manifestation

Fan Shi-jia,LI Cheng-long,LU Tai-liang,PENG Wei,WAN Yu-zhi — 2023/9/7 16:30:04

Pseudomyxoma peritonei (PMP) is a clinically rare malignant tumor with a lack of specificity in early clinical manifestations, which is very likely to cause misdiagnosis and underdiagnosis and seriously affect the prognosis of patients. We report a case of PMP with inguinal hernia as the only manifestation.

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Luofuxing — 2023/9/7 16:28:33

Application value of soft channel drainage assisted by dynamic precise positioning software in hypertensive cerebral hemorrhage

唐海涛,, — 2023/9/7 12:02:15

Abstract: Objective To investigate the application value of soft channel drainage assisted by dynamic precise positioning software in hypertensive cerebral hemorrhage (HICH). Methods A total of 254 patients with HICH admitted to the neurosurgery Department of Daqing Oilfield General Hospital from January 2020 to May 2022 were retrospectively selected. The patients were divided into two groups according to different methods of hematoma localization. The control group (124 cases) was based on traditional craniocerebral CT plain scan puncture and drainage. The experimental group (130 cases) was guided by multi-slice spiral CT scanning combined with mobile phone dynamic precise positioning software. The efficacy, hematoma volume, extubation time, hospital stay, degree of neurological impairment, independent living ability, neurological prognosis and complications were compared between the two groups. Results The total effective rate of the experimental group was higher than that of the control group (93.1% vs 81.4%, P < 0.05), the hematoma volume of the experimental group was lower than that of the control group (P < 0.01), and the extubation time and hospital stay were shorter than that of the control group (P < 0.01). At the time of discharge, the Chinese Stroke clinical neurological Impairment Scale (CSS) score was lower than that before surgery (P < 0.01), and the daily living Ability Scale (BI) index was higher than that before surgery (P < 0.01). The CSS score of the experimental group was lower than that of the control group (P < 0.01), and the BI index was higher than that of the control group (P < 0.01). The Glasgow prognosis (GOS) score of the experimental group was higher than that of the control group (P < 0.01), and the incidence of pulmonary infection was lower than that of the control group (P < 0.05). Conclusion Dynamic precise positioning software-assisted soft channel drainage technology is helpful for rapid hematoma drainage, promote postoperative neurological function recovery, improve clinical efficacy, and improve the neurological prognosis and independent living ability of patients with HICH.

Clinical value of different pretreatment balloons in the treatment of coronary artery disease patients with drug-coated balloons

赵殿儒 — 2023/9/7 12:01:11

Abstract: Objective To investigate the application value of different pretreatment balloon in the treatment of coronary artery disease with drug-coated balloon (DCB). Methods A total of 150 patients with oronary heart disease angina pectoris treated with DCB in Cangzhou People's Hospital from October 2020 to October 2021 were selected and divided into three groups, A, B and C by random number table, with 50 cases in each group. Non-compliant balloon, spinous balloon and cut balloon were pretreated respectively before DCB was placed. Coronary angiography was performed before surgery, immediately after surgery, 6 months after surgery, and 12 months after surgery. The success rate of interventional therapy, operation time, one-time pass rate of balloon, elastic shrinkage rate, TIMI level 3 immediately after surgery, occurrence of vascular dissection and emergency target vessel reconstruction, minimum diameter and coronary stenosis rate, target vessel restenosis, and incidence of major adverse cardiovascular events (MACE) were compared among the three groups. Results The success rate of interventional therapy immediately, 6 months and 12 months after operation in group C was higher than that in group A and B (P < 0.017). The proportion of TIMI level 3 immediately after operation in group C was higher than that in group A and B (P < 0.017), the incidence of elastic retraction rate, vascular dissection and emergency target vessel reconstruction in group C and group B was lower than that in group A (P < 0.017, P < 0.05), but the one-time pass rate in group C was lower than that in group A and B (P < 0.017). The operation time of group C was longer than that of group A and B (P < 0.05). The minimum inner diameter of the three groups decreased gradually, and the coronary stenosis rate increased gradually (P < 0.05). The minimum inner diameter of group C was larger than that of group A and B at 3 and 6 months after surgery, and the coronary stenosis rate was lower than that of group A and B (P < 0.05). The incidence of target vessel restenosis and MACE in group C was lower than that in group A (P < 0.017). Conclusion Compared with non-compliant and spinous balloon, predilation of cut balloon can reduce the incidence of vascular dissection and elastic retraction rate, improve the immediate effect of coronary intervention, maintain the obstruction of the lesion lumen, and reduce the risk of target vessel restenosis and MACE.

Study on miR-138-5p affects the resistance of breast cancer cells to tamoxifen by regulating autophagy

p FontSize=''.''>姚浩明,李英 — 2023/9/7 11:59:48

[Abstract] Objective: To analyze the effect of miR-138-5p on tamoxifen (TAM) resistance in breast cancer cells and explore its mechanism. Methods: Breast cancer cell line MCF-7 and TAM resistant cell line MCF-7 / TAM were cultured in vitro and divided into four groups: normal control group, resistant control group, LV-NC group and LV-miR-138-5p mimic group, TAM with the final concentration of 1 × 10-7mol / l was given after 12 hours of lentivirus transfection, the relative expression level of miR-138-5p was detected by real-time quantitative PCR (qRT-PCR), MTT and flow cytometry were used to detect the rate of cell proliferation inhibition and apoptosis respectively, the number of autophagic bodies was detected by MDC staining, and Western blot was used to detect the protein relative expression levels of LC3Ⅱ, Beclin-1 and Bcl-2 in each group. Results: Compared with the normal control group, the miR-138-5p, proliferation inhibition rate, apoptosis rate and Bcl-2 protein expression level in the drug-resistant control group and LV-NC group were significantly lower, and the expression levels of protein LC3Ⅱ and Beclin-1, and the number of autophagy bodies were higher (P < 0.05); After overexpression of the miR-138-5p, proliferation inhibition rate, apoptosis rate and the expression level of protein Bcl-2 were higher, and the expression levels of protein LC3Ⅱ and Beclin-1, and the number of autophagy bodies were lower (P < 0.05). Conclusions: Up-regulation of miR-138-5p may decrease the resistance of breast cancer cells to tamoxifen by inhibiting autophagy.

Effect of sivelestat sodium on perioperative acute lung injury in patients with acute Stanford type A aortic dissection surgery

刘斯卿,马红霞,吴光玲,周俊辉 — 2023/9/7 10:59:19

[Abstract] Objective To investigate the effect of sivelestat sodium on perioperative acute lung injury (ALI) in patients with acute Stanford type A aortic dissection (AAAD). Methods A total of 80 patients who underwent AAAD surgery in the emergency room of our hospital from December 2021 to June 2022 were recruited. The patients were divided into sivelestat sodium group (group S) and ulinastatin group (group U) according to the random number table method, with 40 cases in each group. The patients in the group S were infused with civelestat sodium injection at a rate of 0.2 mg·kg-1·h-1 intravenously 10 minutes before anesthesia until the mechanical ventilation was weaned off. The patients in the group U were given intravenous ulinastatin at a dose of 20000 U/kg at 10 minutes before anesthesia until the end of mechanical ventilation. Radial blood was collected before skin incision (T1) after induction of anesthesia, immediately after the operation (T2), 24 h (T3) and 48 h (T4) after operation, blood gas analysis was performed, and the alveolar-arterial oxygen partial pressure difference (PA-a DO2), alveolar oxygenation index (OI) and respiratory index (RI) were calculated. Central venous blood was drawn from T1 to T4, and serum inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8)] concentrations were determined. Peripheral venous blood was drawn 1 day before operation and 1 day and 3 days after operation, and white blood cell count (WBC), neutrophils count (NEUT), neutrophil percentage (NEUT%) and the concentration of C-reactive protein (CRP) were measured. The duration of mechanical ventilation, intensive care unit (ICU) stay, incidence of postoperative pulmonary complications (PPCs), length of hospital stay and all-cause mortality within 90 days were recorded. Results Compared with T1, PA-a DO2 and RI of both of the groups were increased at T2-4, and OI was decreased (P<0.05); compared with the group U, PA-a DO2 and RI were both decreased, and OI was increased (P<0.05) at T2-4 in the group S. The concentrations of serum TNF-α, IL-6 and IL-8 in both groups at T2-4 were significantly higher than those at T1 (P<0.05), but the indexes in the group S was significantly lower than those in the group U (P<0.05). The white blood cell count, neutrophil count and percentage of neutrophils in the two groups at 1 d and 3 d after operation were all higher than those at 1 d before operation, but those in group S were significantly lower than those in the group U (P<0.05). Compared with the group U, the duration of mechanical ventilation, intensive care unit (ICU) stay were significantly shortened in the group S (P<0.05). The incidences of postoperative hypercapnia, hypoxemia, new pulmonary rales and bronchospasm were significantly decreased (P<0.05) in the group S, compared with the group U. There was no significant difference in length of hospital stay between the two groups (P>0.05). During the 90-day follow-up period after surgery, 2 patients in each group died after surgery. Conclusion Sivelestat sodium can inhibit the inflammatory response in patients with AAAD surgery, reduce perioperative ALI, lower the incidence of PPCs, and improve the early prognosis of patients.

Construction and function verification of a shRNA lentiviral vector targeting to RelA gene

霍云飞,,, — 2023/9/7 10:57:43

Objective The present paper aimed to inhibit the expression of RelA (p65) in liver cancer by short hairpin RNAs(shRNAs) with lentiviral vector. Methods Three pairs of RNA interference sequences targeting RelA gene were designed , and their corresponding shRNA sequences were synthesized. After annealing of shRNA to form double-stranded oligo sequence, the recombinant plasmid was constructed by gene recombination technique. the correct recombinant plasmid was used after PCR and sequencing identification of the colony for lentivirus packaging and titer determination. The lentivirus with the best interference effect on RelA gene in HepG2 cell line was screened by Western Blot and qRT-PCR, and the effect of Lenti-shRelA on cell viability was detected by CCK-8.. Results The results of enzyme digestion showed that the vector was linear, and the positive clones were obtained by colony PCR after gel recovery. Positive clones and sequencing results showed that each recombinant lentivirus vector was consistent with the designed reference sequence, suggesting that the recombinant lentivirus was successfully constructed. The titers of Y4056、Y21318、Y21319 and Y21320 were 3.51×108 TU/mL, 2.97×108 TU/mL, 2.51×108 TU/mL and 3.20×108 TU/mL, respectively. After lentivirus Lenti-shRelA (Y21318, Y21319, Y21320) was infected with HepG2 cells, Western Blot and qRT-PCR results showed that Y21320 had the best interference effect on RelA gene in HepG2 cell line. CCK-8 showed that RelA knockdown significantly inhibited cell viability. Conclusion In this study, the shRNA lentiviral vector targeting RelA gene was successfully constructed, which can effectively down-regulate the expression of RelA in HepG2 cells and inhibit cell proliferation, laying a foundation for further research on the mechanism of RelA in the occurrence and development of liver cancer.

Retrospective analysis of 35 cases of pyoderma gangrena

Li Yu-Qiu,Pan Nan-Nan,Wang Jing,XiZhi,XuWen-Ying — 2023/8/23 17:24:50

【 Abstract 】 Objective To investigate the clinical features and treatment of pyoderma gangrena (PG). Methods From May 2013 to May 2021, 35 patients with pyoderma gangrena treated in the people's Hospital of Guangxi Zhuang Autonomous Region were retrospectively analyzed in terms of their general information, causes, rash distribution, rash morphology, misdiagnosis, complications and treated diseases. Results The male to female ratio was 2.9:1, and the age was 29-72 years, with an average age of (41.5±8.5) years. 15 patients had definite predisposing factors, including trauma in 11 cases, insect bite in 3 cases and drug abuse in 1 case. Among the 35 patients, 32 cases (91.42%) were ulcer type, 2 cases were bullous type, 1 case was pustular type, and 0 cases were proliferative type. The most frequently misdiagnosed disease was infectious ulcer (91.43%). Skin lesions are usually 2 or more. There were 23 cases (65.71%) of skin lesions in the lower limbs, mostly in the calves. 8 patients (22.86%) were found to have concurrent or subsequent systemic diseases, including 5 patients (14.29%) with inflammatory bowel disease, 2 patients (5.71%) with multiple arthritis, and 1 patient (2.86%) with leukemia. Patients without complications or inflammatory bowel disease had a better prognosis, while patients with hematological diseases had a worse prognosis. All patients were treated with a combination of topical and systemic medications. Systemic treatment is based on the size of lesions and complications, prednisone 0.5-1mg/kg/d. After infection was slightly controlled, 28 patients were subsequently given cyclosporine 2.5-5mg/kg/d.Conclusion The clinical manifestations of PG are varied, and it is easy to be misdiagnosed in the early stage of disease onset. Moderate to high dose corticosteroids can effectively control PG, and combined corticosteroid therapy with cyclosporine is safe and effective.

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xinman — 2023/8/17 10:00:05

Objective To explore the effect of early rising nursing in children with congenital anorectal malformation after operation based on systematic intestinal management model. Methods after strictly implementing the acceptance and discharge standard, 43 children with congenital anorectal malformation who were admitted to our hospital from February 2018 to September 2021 were prospectively selected and divided into two groups according to the random number table method. 21 cases in the control group were given routine nursing intervention, and 22 cases in the observation group were given intervention based on the systematic intestinal management model on the basis of the control group. The anal function, defecation function and medical compliance behavior of the two groups were observed. Results after the follow-up, the frequency of defecation, the character of defecation, feces, rectal sensation, the ability to control defecation, the ability to distinguish formed stool, loose stool or gas, and the need for treatment in the observation group were all higher than those in the control group (p<0.05); The excellent and good rate of the observation group (90.90%) was higher than that of the control group (57.15%) (p<0.05); The observation group insisted on anal dilatation, strict diet, defecation training and medication management scores were higher than those of the control group (p<0.05). Conclusion the application of systematic intestinal management model in the early postoperative care of children with congenital anorectal malformation can improve the compliance behavior and accelerate the establishment of children"s anal and bowel function.

Impact of CircSEPT9 on malignant biological behavior of glioma cells by regulating miR-650/HSPB1 axis

duxiaomeng,lijinqiu,renchengbo,songxiao,wangcong,zhangzhilin,zouniandong — 2023/8/14 18:19:40

[Abstract] Objective To investigate the impact of circular RNA (CircRNA) SEPT9 on the malignant biological behavior of glioma cells by regulating miR-650/HSPB1 axis. Methods The expression of CircSEPT9, miR-650 and HSPB1 in glioma tissues, adjacent tissues, human normal glial cells HEB and glioma cell lines LN18, SW1088 and U251 were detected by qRT-PCR and Western blot respectively; U251 cells were divided into control group (NC group), si-NC group, si-CircSEPT9 group, mimic NC group, miR-650 mimic group, si-CircSEPT9+inhibitor NC group, si-CircSEPT9+miR-650 inhibitor group, si-CircSEPT9+pcDNA group, and si-CircSEPT9+pcDNA-HSPB1 group, the expression of CircSEPT9 and miR-650 was detected by qRT-PCR; Western blot was applied to detect the expression of HSPB1, CyclinD1 D1, aspartate specific Caspase-3, matrix metalloproteinase (MMP-2) and MMP-9; double luciferase gene experiment was applied to verify the relationship between CircSEPT9 and miR-650, miR-650 and HSPB1. Results In glioma tissues and cells, CircSEPT9 and HSPB1 proteins were highly expressed, while miR-650 protein was low expressed. In U251 cells, the levels of CircSEPT9 and HSPB1 proteins were the highest, and the expression of miR-650 protein was the lowest (P<0.05), therefore, U251 cells were selected as the study object; compared with the si-NC group, the expression of CircSEPT9 and HSPB1 proteins in the si-CircSEPT9 group decreased, and the expression of miR-650 increased (P<0.05); compared with the mimic NC group, the expression of HSPB1 protein decreased, and the expression of miR-650 increased (P<0.05); compared with the si-CircSEPT9+inhibitor NC group, the expression of miR-650 decreased and the expression of HSPB1 protein increased (P<0.05); compared with the si-CircSEPT9 group and the si-CircSEPT9+pcDNA group, the expression of HSPB1 protein increased (P<0.05); silencing CircSEPT9 or overexpressing miR-650 was able to inhibit U251 cell proliferation, invasion, migration, cyclinD1, MMP-2, MMP-9 protein expression, and promote cell apoptosis and Caspase-3 protein expression; down-regulation of miR-650 or overexpression of HSPB1 was able to attenuate the inhibition of silencing CircSEPT9 on U251 cell proliferation, invasion and migration and the promotion of apoptosis; CircSEPT9 had a targeting relationship with miR-650, miR-650 and HSPB1. Conclusion Silencing CircSEPT9 may inhibit the expression of HSPB1 by up-regulating miR-650 through spongification, thereby inhibiting the proliferation, migration and invasion of U251 cells and promoting apoptosis.

Analysis of multicenter epidemiological characteristics of children with acute respiratory tract infection due to RSV in Hainan Province from 2012 to 2021

2023/8/14 18:18:59

Objective: To analyze the epidemiological characteristics（season, age, gender, mixed infection and clinical manifestations, etc.) of children with acute respiratory tract infection（ARTI）due to respiratory syncytial virus (RSV) in Hainan area，so as to provide reference for prevention and treatment of RSV infection in children. Methods: The serum IgM antibodies of RSV, Legionella pneumophila, Chlamydia pneumoniae, adenovirus, Mycoplasma pneumoniae, Q fever Rickettsia, parainfluenza virus, influenza A virus and influenza B virus in children with ARTIs who were hospitalized in pediatrics of six hospitals in Hainan Province from March 2012 to December 2021 were detected by indirect immunofluorescence method. The serum RSV-IgM positive was defined as RSV infection. The epidemiological and clinical data of RSV infected cases were analyzed retrospectively. Results：From March 2012 to December 2021, 59312 children with ARTI in pediatrics of 6 hospitals in Hainan Province met the inclusion criteria, with a an average RSV IgM positive rate of 2.07% (1226/59312). The positive rates of RSV IgM from 2012 to 2021 were 1.90%, 0.88%, 0.49%, 0.38%, 1.18%, 4.46%, 5.20%, 2.63%, 0.86% and 0.88%，respectively. The positive rates of RSV IgM in 2017 and 2018 were significantly higher than those in other years (P<0.05). The positive rate of RSV IgM in male children (2.21%) was significantly higher than that in female children (1.82%) (P<0.05). In terms of age distribution, the positive rates of RSV IgM in infancy, early childhood, preschool and school age were 4.46%, 1.14%, 0.65% and 0.50%，respectively. Compared with other groups, the positive rates of RSV IgM in infant group were the highest (P<0.001)，there was no difference in the positive rates between pre-school age group and school age group（P>0.05）. In terms of seasonal distribution, the positive rates of RSV IgM was higher in spring and summer in Hainan Province（P<0.05）. RSV infection combined with positive IgM of another pathogen accounted for 31.89%（459 cases), combined with positive IgM of another two pathogens accounted for 21.78%（267 cases). RSV infection was mostly found in pneumonia (83.12%), and the main clinical symptoms were cough (86.38%), fever (56.36%)，nasal congestion and runny nose (43.64%)，wheezing and Shortness of breath (18.84%). Conclusions: The average positive rate of RSV-IgM in hospitalized children with ARTIs in Hainan Province from 2012 to 2021 was 2.07%, and RSV infection fluctuated periodically, with an epidemic trend in 2017 and 2018. In Hainan Province, the incidence of RSV infection in summer was the highest and the lowest in autumn. RSV infection was found in all age groups, with the highest infection rate in infancy and the lowest in school-age. The infection rate of RSV in boys was higher than that in girls. RSV infection was often associated with one another pathogen, which was more common in mycoplasma pneumoniae. RSV infection was common in pneumonia, and the main clinical symptoms were cough, fever, runny nose, stuffy nose, wheezing and shortness of breath.

The role of Caveolin-1/VEGF signaling pathway in promoting angiogenesis of Edaravone in the treatment of ischemic stroke

Wangwensheng Wangyue — 2023/8/14 18:17:55

Objective To investigate the effect of edaravone on Caveolin-1/VEGF signaling pathway and angiogenesis in the treatment of ischemic stroke. Methods 60 SD rats, 12 were randomly selected as Sham group, and the rest of rats were used for ischemic stroke model construction. After 24 hours, the rats were tested for neurological scores and then randomly divided into ischemic stroke group, Edaravone group (5 mg/kg), inhibitor group (2 mg/kg), Edaravone + inhibitor group (5 mg/kg + 2 mg/kg). All drugs were administrated through tail vein injection for 14 days. TTC staining was used to detect the area of ??cerebral infarction, Morris water maze was used to detect cognitive function, immunofluorescence co-staining was used to detect the co-expressions of Caveolin-1 and CD34, and Western blot was used to detect the expression of Caveolin-1 and VEGF. Results Compared with Sham group, neurological function scores, escape latency and platform crossing times increased in ischemic stroke group (P<0.05). In addition, the average fluorescence intensity of Caveolin-1 and CD34 increased (P<0.05), and the expression of Caveolin-1 and VEGF increased (P<0.05). At the same time, compared with the ischemic stroke group, the neurological function score and escape latency decreased (P<0.05) and the number of crossing platforms was increased (P<0.05) in Edaravone group. Further study showed that the cerebral infarction area of rats in Edaravone group decreased (P<0.05), the co-expressions of Caveolin-1 and CD34 increased (P<0.05), and the expression of Caveolin-1 and VEGF further increased (P<0.05). Finally, compared with Edaravone group, the protein expressions of Caveolin-1 and VEGF decreased in inhibitor group and Edaravone + inhibitor group, and the co-expressions of Caveolin-1 and CD34 decreased (P<0.05), which resulted in increased cerebral infarct area and escape latency in rats. Conclusion The anti-ischemic stroke effect of Edaravone is related to the activation of Caveolin-1/VEGF signaling pathway, and through promoting neuroangiogenesis, restoring blood supply to ischemic area, alleviating nerve function injury and improving cognitive function in rats.

Characteristics of pediatric Clostridium difficile infection and analysis of risk factors for recurrence

caorong,, — 2023/8/14 18:16:57

Objective To analyze the clinical characteristics of pediatric Clostridium difficile infection (CDI) and evaluate the risk factors for recurrence. Methods We conducted a retrospective cohort study of 138 pediatric patients diagnosed with a primary infection with Clostridium difficile in Department of Gastroenterology and Hepatology of Shanghai Children"s Hospital from September 2014 to October 2022. All patients were divided into two groups, according to the absence or presence of recurrences. Epidemiology, symptoms, signs, and laboratory examinations during the hospital stay were collected and compared between non-recurrence and recurrence patients using T-test or Fisher’s exact test. The binary logistic regression analysis was used to analyzed the risk factors for recurrence. Results There were 81 boys and 57 girls of all children with initial CDI. The median age of these patients was 4.8 years (range1.8-9.3 years). 39 children (28.26%) were suffering a recurrence compared with that of 99 (71.74%) of non-recurrence group. Univariable analysis found that the recurrence group had a higher proportion of pseudomembranous colitis [33.33% (13/39) vs. 9.09% (9/99), c₂⁼12.27, P < 0.001)] and healthcare-associated higher rates [51.28% (20/39) vs. 25.25% (25/99), c₂⁼8.626, P = 0.003)] compared with the non-recurrence group. Multivariable analysis showed that pseudomembranous colitis (OR = 0.227, 95% CI: 0.085-0.608, P = 0.003) and healthcare-associated CDI (OR = 2.756, 95% CI: 1.229-6.179, P =0.014) were significantly associated with recurrent CDI in children. Conclusions Recurrence was significantly associated with the risk factors of pseudomembranous colitis and healthcare-associated CDI in pediatric inpatients.

Research Progress in Eeffect of Combined Drugs on the Safety of High-dose Methotrexate in Acute Lymphoblastic Leukemia in Children

CHEN Xiao-yu,DAI Yan,SUN Hui-jing,WEI Si-rou — 2023/8/14 17:45:31

Methotrexate (methotrexate,MTX) is a dihydrofolate reductase inhibitor, clinical high-dose of methotrexate shock therapy for the preventive treatment of extractrexary leukemia. In clinical applications, Large doses of methotrexate are often used with other drugs, such as antibiotics, proton pump inhibitors, and non-steroidal anti-inflammatory drugs that may lead to pharmacokinetic changes in methotrexate and affect the safety of methotrexate medication. In recent years, several cases have reported a correlation between delayed methotrexate excretion and co-administration. In this paper, we review and analyse the situation of high-dose methotrexate co-administration and the mechanism of influence to improve the safety of methotrexate clinical application.

A review study on drug therapy for refractory heart failure

chengke — 2023/8/14 17:44:40

In recent years, the incidence rate of refractory heart failure (RHF) has increased significantly, and RHF patients have serious clinical symptoms, poor quality of life and poor prognosis. Despite the continuous enrichment of modern medical treatment methods, the treatment of RHF has always been a challenge. In order to better improve the prognosis of RHF patients, this article will review the current research progress on RHF drug therapy.

Research progress of colorectal cancer diagnostic markers

LIU yiqing,,Zhao shiyu — 2023/8/14 17:43:55

According to global cancer statistics, colorectal cancer is the third most common cancer in the world and the second leading cause of cancer-related deaths. As a malignant tumor of the gastrointestinal system, colorectal cancer, due to its insidious onset and lack of specific clinical symptoms and signs, is usually in the middle to late stage when diagnosed, which poses a serious threat to human life and health and seriously affects people's quality of life. The prognosis of colorectal cancer patients varies significantly according to their stages. Early diagnosis of colorectal cancer can improve the survival of patients and reduce their mortality rate. Therefore, early screening and diagnosis can identify high-risk patients and enhance follow-up. In this paper, stool markers, blood markers and liquid biopsies are described in detail to improve patient prognosis and assist in clinical adjustment of treatment plans.

Malignant melanoma arising in an ovarian mature teratoma with ectopic pregnancy : a case report

xutiantian — 2023/8/13 16:47:14

Malignant melanoma arising in an ovarian mature teratoma is exceedingly rare and occurs most frequently in postmenopausal women with an average age of 51.5 years. We reported a case of primary malignant melanoma of the ovary arising in a mature teratoma. The patient was a young woman with ectopic pregnancy and her symptoms was not obvious. The clinical symptoms and age of onset were atypical, and we demonstrated junctional activity of melanocytes showing malignant transformation .These were rare manifestations of a rare disease. The diagnosis of the tumor is mainly based on postoperative pathology, and the prognosis is poor, and there is no treatment guideline at present. We analyzed the Clinicopathologic features of the patient and reviewed the relevant literature to explore the occurrence, development, pathological diagnosis, treatment and prognosis of the disease, so as to improve the understanding of the disease by pathologists and clinicians.

Catheter radiofrequency ablation of mirror dextrocardia with paroxysmal atrial fibrillation in 2 cases under different guidance

jiameixue — 2023/8/13 16:46:27

Case 1: A 48-year-old male patient suffered from palpitation and chest tightness for 4 months and continued for 10 days. Four months ago, sustained atrial fibrillation with fast ventricular rate and dextral heart was confirmed by dynamic electrocardiogram. After hospitalization, it turned into sinus rhythm. After discharge, amiodarone was taken orally. 10 days ago, paroxysmal atrial fibrillation was found by dynamic electrocardiogram. The preoperative ECG, chest CT, echocardiography, and enhanced cardiac CT + three-dimensional reconstruction all found that the patient was in dextrocardia, among which the chest CT indicated that abdominal organs were in reverse position. With the guidance of CARTO3 three-dimensional navigation system and pressure catheter, the C-arm "mirror method" was used intraoperatively to isolate pulmonary veins by electroanatomical mapping. Case 2: The 63-year-old male patient had recurrent palpitation for half a year. External hospital outpatient electrocardiogram confirmed paroxysmal atrial fibrillation. Preoperative ECG, chest CT and echocardiography showed dextrocardia, and chest CT showed visceral inversion. Preoperative preventive classics esophagus echocardiography screening check but cannot tolerate left auricle thrombus, consider possible internal inversion, congenital deformities of the esophagus, considering patients long-term oral, cutting class full of anticoagulation, hence suggest surgery center cavity guided by ultrasound heart (Intracardiacechocardiography, ICE), Pulmonary veins were isolated by electroanatomical ablation guided by pressure catheter on CARTO3 3D navigation system.

Relationship between serum A1AT level and non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

zena, — 2023/8/10 20:32:33

Objective to explore the serum α1 antitryspin level in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease(NAFLD) and its clinical significance. Methods A total of 117 patients with type 2 diabetes mellitus complicated with NAFLD treated in our hospital from March 2019 to September 2020 were collected as case group, and 80 patients with simple type 2 diabetes mellitus (type 2 diabetes mellitus group) and 80 healthy volunteers (control group) were selected as control subjects. The demographic data and laboratory examination indicators were collected. Meanwhile, the patients of case group were evaluated by NAFLD liver fibrosis score (NAFLDFS). The serum A1AT level was detected by immunoturbidimetry. Multivariate logistic regression was used to analyze the influencing factors of NAFLD in patients with type 2 diabetes mellitus. ROC curve was drawn to evaluate the diagnostic value of serum A1AT for NAFLD in patients with type 2 diabetes mellitus. Pearson’s product moment correlation was used to analyze the correlation between serum A1AT and NAFLDFS. Results The FPG, FINS, HOMA-IR, TC, TG, AST, ALT, LFC and A1AT levels in case group and type 2 diabetes mullitus group were higher than those in control group, and which in case group were higher than those in type 2 diabetes mullitus group (P<0.05). The results of multivariate logistic regression showed that the elevated levels of FPG, FINS, HOMA-IR, TG, LFC and A1AT were independent risk factors for NAFLD in patients with type 2 diabetes mullitus (OR=1.265, 1.463, 1.359, 1.16, 1.587, 1.636; P<<0.05). ROC curve showed that the AUC of serum A1AT in diagnosis NAFLD was 0.793 (95%CI: 0.758~0.829; P=0.000), and the sensitivity and specificity were 0.81 and 0.69, respectively. Pearson product moment correlation analysis showed that serum A1AT was associated with NAFLDFS in patients with type 2 diabetes mellitus complicated with NAFLD (0.692, P<0.05). Conclusion Serum A1AT is up-regulated in patients with type 2 diabetes mellitus complicated with NAFLD. Early detection of A1AT can be used as a biochemical marker for clinical diagnosis of NAFLD in patients with type 2 diabetes mullitus and evaluation of the the degree of liver fibrosis.

Expression and clinical significance of Foxp3 and IL-15 in local tissue of perianal abscess

张立 — 2023/8/10 19:52:45

Objective: To analyze the expression levels of forkhead box protein 3 (Foxp3) and interleukin (IL-15) in abscess wall tissues, and to explore their correlation with clinicopathological features and prognosis of perianal abscess patients. Methods: From January 2019 to July 2020, 98 patients with perianal abscess accepted by our hospital were regarded as the research objects, and the abscess wall tissue and normal tissue around the abscess wall were collected during the operation. The expressions of Foxp3 and IL-15 in local tissues were detected by immunohistochemical staining. Cox univariate and multivariate models were applied to analyze the risk factors affecting the prognosis of patients with perianal abscess. Results: The positive expression rates of Foxp3 and IL-15 in abscess wall tissue were higher than those in normal tissue (P<0.05). The protein expressions of Foxp3 and IL-15 in abscess wall tissue were related to abscess diameter, healing time and anal fistula (P<0.05). The postoperative recurrence rates of Foxp3 protein-negative and IL-15 protein-negative patients were lower than those of Foxp3 protein-positive and IL-15 protein-positive patients (P<0.05). Multivariate COX regression analysis showed that the positive expression of anal fistula, Foxp3 and IL-15 were the risk factors for the recurrence of perianal abscess (P<0.05). Conclusion: The expressions of Foxp3 and IL-15 in abscess wall tissue are increased, and they are closely related to the clinicopathological characteristics and prognosis of patients.

Effect of preoperative aerosol inhalation of penehyclidine on non-ventilated lung injury during one-lung ventilation

kang xu ming,ni kun qiang,wu shaung ting — 2023/8/10 19:50:49

[Abstract] Objective To investigate the effect of preoperative aerosol inhalation of penehyclidine on non-ventilated lung injury during one-lung ventilation. Methods Sixty patients who underwent elective thoracoscopic radical resection of lung cancer in the operating room of our hospital were recruited, and randomly assigned to C group (C group, n=30) and penehyclidine hydrochloride group (PHC group, n=30). At the onset of anesthesia induction, patients in the C group inhaled ipratropium bromide (0.5 mg/2 ml ipratropium bromide+4 ml normal saline) by aerosol inhalation. Patients in the PHC group inhaled penehyclidine hydrochloride (0.5 mg/0.5 ml of penehyclidine hydrochloride+5.5 ml of normal saline). Blood was drawn from the radial artery, and arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) were detected at the onset of induction of general anesthesia (T0), 0.5 hours and minutes after the start of OLV (T1), 1 hour (T2) and 2 hours (T3). After the operation, the excised lung cancer tissue was retained, and the normal lung tissue specimens around the tumor were excised for pathological examination to evaluate the lung injury and calculate the lung injury score. The apoptosis of lung tissue was assessed by TUNEL method and the apoptosis index (AI) was calculated. The expression levels of marker proteins of apoptosis and autophagy in lung tissue were determined by Western blot. Results The light microscope showed that the lung tissue in the C group changed significantly in morphology and the structure was significantly damaged, while the lung tissue damage in the PHC group was significantly reduced. Compared with the C group, PaO2 were significantly increased (all P<0.05) and PaCO2 were significantly decreased (all P<0.05) at T1-3 in the PHC group. Compared with the C group, the lung injury score, AI, the expression of Bcl-2-associated X protein (Bax), microtubuleassociated protein 1 light chain 3-Ⅱ and autophagy marker protein Beclin-1 protein and the ratio of LC3-Ⅱ/LC3-Ⅰ in lung tissue were decreased significantly (all P<0.05), and the expression of B-cell lymphoma-2 (Bcl-2), LC3-Ⅰ protein and the ratio of Bcl-2/Bax in lung tissue were significantly increased (all P<0.05) in the PHC group. Conclusion Preoperative aerosol inhalation of penehyclidine hydrochloride can alleviate the non-ventilated lung injury during OLV, and the inhibition of lung tissue apoptosis and autophagy plays an important role.

Effect of triglyceride-rich lipoprotein cholesterol on clinical outcomes in elderly non-diabetic STEMI patients undergoing coronary angiography and PCI

hanxiaojuan, — 2023/8/10 19:49:33

Objective To investigate the effect of triglyceride-rich lipoproteins (TGRLs) on the clinical outcome of non-diabetic ST-segment elevation myocardial infarction (STEMI) in elderly patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). Methods The medical records of 311 elderly patients with non-diabetic STEMI admitted to the Department of Cardiology from February 2018 to October 2020 were retrospectively analyzed. Blood samples were collected before PCI and TGRLs levels were tested. All STEMI patients were followed up at 1, 6, 12, and 24 months after PCI to record major adverse cardiovascular events (MACE) and survival. Results The TGRLs level of all patients was 0.60 (0.53, 0.84) mmol/L, and they were divided into two groups according to the baseline TGRLs level. The MACE and all-cause mortality of patients in the high level group (>0.60 mmol/L) were higher than those in the low level group (≤0.60 mmol/L) during the 2-year follow-up period (P<0.001).COX regression analysis showed that TGRLs were independent predictors of MACE and all-cause death (P<0.05). TGRLs levels were effective in predicting MACE or all-cause death at 2-year follow-up, and the areas under the receiver operating characteristic curve were 0.825 and 0.910, respectively. When the cut-off value was 0.835mmol/L or 0.885mmol/L, the corresponding sensitivity and specificity were 73.3%, 79.7% and 83.3%, 86.7%, respectively. This was supported by Kaplan-Meier survival curves and log rank x2 tests, which showed shorter Mace-free survival and overall survival in the TGRLs high level group than in the low level group (P<0.001). Conclusion High TGRLs levels are associated with a higher risk of MACE development and death in older non-diabetic STEMI patients receiving CAG and PCI, and may be a strong predictor of adverse clinical outcomes.

Clinical characteristics of patients with ineffective esophageal motility

鲁瑶瑶 — 2023/8/10 19:47:23

Obstractive To investigate the clinical characteristics of ineffective esophageal motility (IEM) diagnosed based on the Chicago classification Version 4.0. Methods Patients who underwent both high-resolution esophageal manometry (HRM) and 24-hour pH monitoring at West China Hospital of Sichuan University from July 2021 to July 2022 with HRM diagnosis of normal esophageal motility or IEM were included. The demographic characteristics, esophageal manometry data, acid exposure time percentile (AET), clinical symptoms and response to proton pump inhibitors (PPIs) treatment were compared between the two groups. Results A total of 338 cases, including 264 cases of normal HRM and 74 cases of IEM, were included. In IEM group, the abnormal total AET (36.5% vs 20.5%, p=0.004), abnormal upright AET (35.1% vs 20.8%, p=0.011), abnormal supine AET (25.7% vs 13.3%, p =0.013) were significantly higher than those in normal HRM group. There was no significant difference in clinical symptoms between patients with IEM and normal esophageal motility. No significant difference in PPIs response was observed between patients with IEM and normal HRM (p >0.05). Conclusion IEM is related to increased esophageal acid exposure but without any specific clinical manifestations. There are no differences in PPIs response between IEM and normal esophageal motility.

无

HEFEI — 2023/7/30 13:41:50

Objective To explore the guiding significance of "Expert consensus on blood management for postpartum hemorrhage (2022 edition)" on the treatment of severe postpartum hemorrhage(SPPH).Methods Collect the clinical data of 108 cases of SPPH in our hospital from 2012 to 2020, and analyze the impact of violating the infusion indications of fresh frozen plasma (FFP) and red blood cell (RBC) on SPPH. Group A, B and C were determined to have violated 0, 1 and ≥ 2 FFP infusion indications, and Group D and E were determined to have violated 0, ≥ 1 RBC infusion indications.Results ①The median of blood loss, RBC and FFP transfusions in group C were significantly higher than those in group A and group B（ 1700（813）ml VS 1000ml、1100（358）ml，6.0（4.0）u VS 0.0（0.0）u、2.0（4.0）u,4.0（10.3）u VS 0.0（0.0）u、0.0（0.0）u,P all<0.001）.②RBC infusion rate of group C was significantly higher than that of group A and group B, and RBC infusion rate of group B was significantly higher than that of group A（100.0% VS 22.7%、66.7%，66.7% VS 22.7%,P all<0.001）.FFP infusion rate in group C was significantly higher than that in group A and B（68.1% VS 13.6%、20.0%,P all<0.05）.③The median of blood loss, RBC transfusion and FFP transfusion in group E was significantly higher than that in group D[2500（2250）ml VS 1200（600）ml,P<0.05,10.8（13.0）u VS 4.0（5.0）u,P<0.001;12.0（21.0）u VS 0.0（3.3）u ,P<0.001].④RBC and FFP transfusion rates in group E were significantly higher than those in group D(95.5% VS 69.8%, P < 0.05; 86.4% VS 36.1%, P<0.001).⑤The mortality of group E was significantly higher than that of group D (9.1% VS 0, P<0.05).Conclusion Violation of consensus on RBC and FFP transfusion indications can lead to increased blood loss and transfusion in PPH, and may even lead to maternal death.

Clinical effect of retractable aseptic irrigator in arthroscopic knee surgery

曾海涓 — 2023/7/17 16:14:55

Objective To observe the clinical effect of retractable aseptic irrigator in arthroscopic knee surgery. Methods A total of 120 patients who were hospitalized in the orthopedics department of our hospital and needed arthroscopic knee surgery were selected as the research objects. They were divided into observation group and control group by random number table method, with 60 cases in each group. The observation group used self-designed retractable aseptic irrigation rack combined with 3L medical aseptic protective sleeve in arthroscopic knee surgery, while the control group used conventional drainage bag and drainage tube combined with 3L medical aseptic protective sleeve in arthroscopic knee surgery. The size of sterile area during arthroscopic knee surgery, the contamination of sterile area during surgery, the time spent cleaning instruments by nurses after surgery, and the satisfaction of surgeons and nurses were compared between the two groups. Results The sterile area of arthroscopic knee surgery in the observation group was greater than that in the control group (P < 0.05), the incidence of contamination of sterile area and operating doctor's operating clothes in the observation group was lower than that in the control group (P < 0.05), and the cleaning time of postoperative instrument nurses in the observation group was lower than that in the control group (P < 0.05). The satisfaction of surgeons and nurses in observation group was higher than that in control group (P < 0.05). Conclusion The use of retractable aseptic irrigating rack combined with 3L medical aseptic protective sheath in arthroscopic knee surgery can expand the sterile area of surgery, facilitate the operation of surgeons, effectively avoid intraoperative aseptic area and surgical clothes of surgeons contaminated by isoosmotic flushing solution, shorten the cleaning time of postoperative instruments and nurses, save time and effort, and win the recognition of surgeons and nurses. Increased satisfaction.

Research status of the application of robotic NOSES surgery in the treatment of rectal cancer

dongchencheng — 2023/7/17 8:58:47

Since the report of the first case of Da Vinci robotic total mesorectal resection (TME) for rectal cancer, the application of Da Vinci robotic surgery in the treatment of rectal cancer has been gradually developed at home and abroad, but auxiliary incisions are still needed when extracting specimens. This goes against the surgeon’s pursuit of minimally invasive surgery. With the rise of natural orifice specimen extraction surgery (NOSES), the combination of the Da Vinci robotic surgery system and NOSES has achieved good clinical results in the field of rectal surgery, which is of great benefit to patients and surgeons. There are broad development prospects in the treatment of rectal cancer in the future.

ITGB4 in aged papillary thyroid carcinoma tissue (130 cases)

Li Zujin,, — 2023/7/10 15:17:49

Objective: To investigate the expression of integrin β4 (ITGB4) protein in elderly papillary thyroid carcinoma. Methods: A total of 80 elderly patients with papillary thyroid cancer treated in Haikou Hospital of Traditional Chinese Medicine from August 2019 to August 2020 were selected, and another 50 patients with nodular goiter treated in our hospital during the same period were selected as the control study. The expression of ITGB4 protein was detected by immunohistochemical staining in the surgically resected cancer tissues, adjacent tissues and nodular goiter lesions. Results: Compared with nodular goiter and adjacent tissues, ITGB4 protein expression was higher in papillary thyroid carcinoma tissues (P < 0.05). Compared with stage ⅰ and ⅱ patients, the relative expression of ITGB4 protein in stage ⅲ and ⅳ patients was higher (P < 0.05). Compared with patients without lymph node metastasis, the relative expression of ITGB4 protein in patients with lymph node metastasis was higher (P < 0.05). Compared with well-differentiated patients, the relative expression of ITGB4 protein in moderately differentiated elderly patients with papillary thyroid carcinoma was higher (P < 0.05). Compared with moderately differentiated patients, the relative expression of ITGB4 protein in poorly differentiated elderly patients with papillary thyroid carcinoma was higher (P < 0.05). Conclusion: The expression of ITGB4 protein is abnormally high in elderly papillary thyroid carcinoma, and its expression changes are correlated with TNM stage, lymph node metastasis and differentiation degree. ITGB4 is involved in the development and evolution of papillary thyroid carcinoma.

Expression of von Willebrand factor in serum and skin tissue of patients with psoriasis and its clinical significance

赵文华 — 2023/7/10 15:17:29

Objective To evaluate the expression of von Willebrand factor (vWF) in serum and skin tissue of patients with psoriasis and its clinical significance.Methods The subjects were 30 patients with psoriasis vulgaris of different severity and 30 age-matched healthy controls.Serum vWF levels were measured by ELISA. The expression of von Willebrand factor (VWF) was detected by immunohistochemical staining.Results The serum vWF level in patients with psoriasis was significantly higher than that in the control (P<0.05). The expression intensity of vWF in psoriasis patients was significantly higher than that in controls; In the dermis of psoriasis patients, the expression of vWF in inflammatory cells and endothelial cells was also higher than that in controls (all P < 0.05). Correlation analysis showed that there was a correlation between serum vWF level and PASI score (r = 0.432; P = 0.010), but there was no correlation between serum vWF level and its immunohistochemical expression intensity in dermis and epidermis.Conclusion There was a correlation between serum vWF level and PASI score in patients with psoriasis.

Countermeasures and effects of continuous / recurrent reoperation for secondary hyperparathyroidism

廖丹 — 2023/7/10 15:17:18

Countermeasures and effects of continuous / recurrent reoperation for secondary hyperparathyroidism LIAO Dan，Liu Deguo, Li Qishang．Department of Thyroid and Breast Surgery，the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine，Nanning 530023，China [Abstract] Objective To investigate the hyperparathyroidism secondary to chronic kidney disease (secondary hyperparathyroidism, SHPT) Countermeasures and effects of continuous / recurrence. Methods The clinical data of 20 patients with continuous / recurrent reoperation after SHPT were analyzed retrospectively, to summarize the indications for recurrence / continuous reoperation of SHPT, the method of preoperative parathyroid imaging localization, surgical method, application of intraoperative parathyroid hormone (iPTH) determination, and parathyroid probe resection strategy. Compared with postoperative symptoms, iPTH, blood calcium, and blood phosphorus in reoperated patients. Results The resection of 32 parathyroid lesions in 20 patients, and the sensitivity of localization with CT scan was 93.55% (29 / 31. Bone pain and itchy skin symptoms disappeared after surgery. Compared with preoperative levels, postoperative iPTH, blood calcium and blood phosphorus levels were significantly reduced (P <0.01), 20 patients had no severe hypocalcemia and other complications, and no SHPT recurrence / continued at 6 months and 12 months of follow-up. Conclusion Combined with multiple imaging examinations and multidisciplinary doctors, we can improve the accuracy of parathyroid localization before reoperation. Total parathyroid resection is used in recurrent / continuous cases of SHPT, and the treatment effect is good. [Key words] Secondary hyperparathyroidism; persistent; recurrence; parathyroidectomy; reoperation

Clinical efficacy of anlotinib combined with PD-1 inhibitor in treating advanced non-small cell lung cancer and its influence on the expression of serum VEGF and MMP-2 in patients

高航,, — 2023/7/10 15:17:05

[Abstract] Objective: To investigate the clinical efficacy of anlotinib combined with PD-1 inhibitor in treating advanced non-small cell lung cancer and its influence on the expression of serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) in patients. Methods: The clinical data of 110 patients with advanced non-small cell lung cancer treated in our hospital from February 2018 to February 2022 were retrospectively analyzed. And grouped into the combination therapy group and the anti-PD-1 therapy group according to different treatment methods (n=55). The anti-PD-1 therapy group was treated with immune drugs, and the combination therapy group was treated with anlotinib + immune drugs, both groups took 21 days as a treatment cycle, and the drug was stopped for 7 days after each treatment cycle. The two groups were treated for three cycles in total. The serum VEGF and MMP-2 levels, clinical efficacy and harmful reactions were compared between the two groups. Results: After 1 week, 1 month, and 3 months of treatment, the levels of serum VEGF and MMP-2 in the two groups were obviously decreased, and those in the combination therapy group were lower (P<0.05); the objective response rate (ORR) and disease control rate (DCR) (45.45%, 90.91%) in the combination therapy group were obviously higher than those in the anti-PD-1 therapy group (23.64%, 76.36%) (P<0.05); there was no obvious difference in the incidence of harmful reactions between the two groups (P>0.05). Conclusion: Anlotinib combined with PD-1 inhibitor has a obvious curative effect on patients with advanced non-small cell lung cancer, and can reduce the expression levels of VEGF and MMP-2, with high safety.

Application of a Congo red staining for frozen nerve section in pathological diagnosis for Peripheral Neuropathy

duojianying,,,,, — 2023/7/10 15:16:53

Objective By observing the influence of different staining time and section thickness on the staining results, the best conditions for Congo red staining of frozen nerve sections were explored, providing a good reference for the pathological diagnosis of amyloidosis peripheral neuropathy. Methods Nerve biopsy specimens from patients with confirmed amyloidosis peripheral neuropathy were selected, and Highman Congo red staining was performed with frozen sections of 6um and 8um thickness at the staining conditions of 5min, 10min, 15min and 20min, respectively. The staining results were observed by ordinary microscope, birefringent polarized light microscope and Immunofluorescence microscope. Results Under the condition of 10-20 min staining, the deposition of specific materials could be observed in the slices of both thickness, but the brick red color was stronger and became purplish red under the condition of 20min.The color intensity of 6um and 8um sections increased with the increase of section thickness under the same staining time. The results of 6um sections were not good after staining for 5min, while the results of 8um sections were better after staining for 15min. The results of staining under light microscope and fluorescence microscope were easier to determine. Conclusion Staining with 8μm section thickness for 15min was a suitable Congo red staining condition for frozen nerve specimens, and this staining method could play a good role in the pathological diagnosis of amyloid peripheral neuropathy instead of paraffin section.

A clinical analysis of surgical outcomes of vaginal cuff closure by two different pathways in laparoscopic hysterectomy

Feng Yilan,HUANG Weirong — 2023/7/7 15:13:11

Objective To study the surgical outcomes of vaginal cuff closure by two different pathways in laparoscopic hysterectomy. Methods A retrospective analysis of clinic data of 341 patients of gynecological diseases undergone laparoscopic hysterectomy was performed ,in the People’s Hospital of Guangxi Zhuang Autonomous Region between 2016.01 and 2019.12, and the patients were divided into vaginal cuff closure by transvaginal group(Transvaginal Group) and that by laparoscopic group(Laparoscopic Group). Both of two groups of operative related indexes [(mean operative time, the volume of mean blood loss)], postoperative conditions and complications related parameters (postoperative mean hospital days, resuture for postoperative hemorrhages of vaginal cuff, pelvic infection, rehospitalization within one month postoperatively, vaginal cuff dehiscence and urinary system injure) were compared. Results Three hundreds and forty-one patients were included in this study (98 in Transvaginal Group,243 in Laparoscopic Group). The mean operative time and the volume of mean blood loss were not identified to be different significantly(p>0.05) between two groups. Postoperative conditions and complications related parameters(postoperative mean hospital days, resuture for postoperative hemorrhages of vaginal cuff, pelvic infection, rehospitalization within one month postoperatively, and vaginal cuff dehiscence) were different significantly(p<0.05). Postoperative vaginal cuff polyps of Transvaginal Group and Laparoscopic Group in postoperative 3 months were 11cases,6cases respectively(p=0.002), when in postoperative 6 months those were 5cases,2cases respectively(p=0.023), and there was significant difference to be identified according to the follow-up. Conclusion The incidence of postoperative pelvic infection, vaginal cuff dehiscence and polyps by Laparoscopic vaginal cuff closure directly during laparoscopic hysterectomy is lower than that by transvaginal, and it deserves recommendation and advance research in clinical practice.

Correlation analysis of AC007278.2, MX2 expression level in peripheral blood with disease activity and complement level in patients with systemic lupus erythematosus

fangli, — 2023/7/7 15:12:17

systemic lupus erythematosus; Disease activity; Long strand non coding RNA AC007278.2; MX dynein like GTPase 2; Complement C3; Complement C4

Expression of serum miR-139-5p and VEGFR-1 in patients with acute coronary syndrome and their correlation with short-term prognosis

高彦琳,,, — 2023/7/7 15:10:56

Objective: To observe the expression and prognosis of serum microRNA-139-5p (miR-139-5p) and vascular endothelial growth factor receptor 1 (VEGFR-1) in patients with acute coronary syndrome (ACS) correlation. Methods: A total of 204 patients who underwent coronary angiography in our hospital were selected and divided into: unstable angina pectoris group (UAP group, 100 cases) and acute myocardial infarction group (AMI group ,76 cases) according to the medical history, related examinations and coronary angiography results. and normal angiography group (Control group ,8 cases). Serum levels of miR-139-5p and VEGFR-1 were detected in patients; all patients were followed up for an average of 6 months, and the occurrence of short-term major adverse cardiac events (MACE) in the two groups was evaluated. Results: The levels of serum miR-139-5p in the AMI group and UAP group were significantly higher than those in the Control group (P<0.05), and the level of VEGFR-1 was significantly lower than that in the Control group (P<0.05). There was a significant negative correlation between -139-5p and VEGFR-1 (r=-0.189, P=0.01). After an average follow-up of 6 months, it was found that the level of serum miR-139-5p in the MACE group was significantly different from that in the non-MACE group (P<0.05); Cox proportional hazards regression showed that miR-139-5p was a risk factor affecting the occurrence of MACE in ACS patients; The KM survival curve showed that the level of miR-139-5p was positively correlated with the incidence of MACE. Conclusion: ACS patients have higher levels of miR-139-5p and lower levels of VEGFR-1; serum miR-139-5p and VEGFR-1 in ACS patients have a linear negative correlation; miR-139-5p levels are associated with MACE in ACS patients Positive correlation; elevated miR-139-5p can predict the risk of MACE in patients.

The relationship between metabolic parameters of PET-CT and biological behavior of lung adenocarcinoma and its value in early assessment of brain metastases

Yang Wenjing — 2023/7/7 15:09:01

Objective To investigate the relationship between metabolic parameters of positron emission tomography/computed tomography (PET-CT) and the biological behavior of lung adenocarcinoma and the value of early assessment of brain metastases.Methods A total of 103 patients with lung adenocarcinoma in our hospital from February 2020 to April 2022 were selected as the research subjects, and all of them underwent PET-CT examination.The maximum lesion standard uptake value (SUVmax value) and the maximum lean body mass standardized uptake value (SULmax value) of patients with different lung adenocarcinoma biological behaviors were compared.According to the presence or absence of brain metastasis, the patients were divided into a metastasis group and a non-metastasis group. Univariate and multivariate Logistic regression was used to analyze the influencing factors of brain metastasis.The nomogram was used to analyze the evaluation value of SUVmax and SULmax for brain metastases, and decision curve analysis (DCA) was performed.Results Lymph node metastasis, depth of infiltration and degree of differentiation were related to the SUVmax and SULmax values of the lesions (P<0.05).The depth of invasion, SUVmax value and SULmax value were all independent influencing factors of brain metastasis in patients with lung adenocarcinoma (P<0.05).Logistic regression model was used to screen out the depth of invasion, SUVmax value and SULmax value to construct a nomogram prediction model for brain metastases in patients with lung adenocarcinoma. SUVmax value and SULmax value had high predictive value for brain metastases in patients with lung adenocarcinoma, and the consistency indices were 0.785 and 0.811, respectively.Calibration curve analysis showed that the prediction model predicted brain metastases was in good agreement with actual brain metastases, with a mean absolute error of 0.028 within the acceptable range.After comparing different models by DCA, within the threshold range of 0.35 to 0.71, the net benefit rate of SULmax in evaluating brain metastases in patients with lung adenocarcinoma was better than that of SUVmax.Conclusion PET-CT metabolic parameters are closely related to the biological behaviors of lung adenocarcinoma, such as lymph node metastasis, depth of invasion, and degree of differentiation. In addition, higher SUVmax and SULmax values will increase the risk of brain metastases in patients. Clinically, PET-CT examinations can be used to assess patients" brain metastases as soon as possible, so as to provide treatment for clinical treatment and improve the benefits of patients.

Correlation of serum HIF-1α level with symptomatic intracerebral hemorrhage and prognosis after intravenous thrombolysis in acute ischemic stroke

chendong,, — 2023/7/7 15:07:26

Objective: To analyze the correlation between serum hypoxia inducible factor 1α (HIF-1α) level and symptomatic cerebral hemorrhage (sICH) and prognosis in patients with acute ischemic stroke (AIS) after intravenous thrombolysis. Methods: 229 AIS patients who received thrombolysis therapy with rt-PA in our hospital from January 2019 to February 2021 were enrolled. The occurrence of sICH after treatment was followed up, and the patients were divided into sICH group (n=25) and non-SICH group (n=204). Functional outcomes at 3 months after treatment were assessed using a modified Rankin scale (mRS). Serum HIF-1α levels were determined by sandwich enzyme-linked immunosorbent assay. Results: The serum HIF-1α level in sICH group was significantly higher than that in non-SICH group (P < 0.05). Univariate and multivariate model analysis showed that serum HIF-1α level was independently correlated with sICH risk when serum HIF-1α > 1.50 ng/mL (P<0.05). According the receiver operating characteristic, the area under the curve of serum HIF-1α predicted the occurrence of sICH in AIS patients was 0.886 (95%CI: 0.815-0.957). Spearman rank correlation analysis showed that serum HIF-1α level was associated with NIHSS score at baseline (rs =0.201, P < 0.001), infarct volume (rs =0.191, P=0.001), and mRS score at 3 months (rs =0.137, P=0.038). Serum HIF-1α level in AIS patients with good prognosis group were significantly lower than those in AIS patients of poor prognosis group [1.26 (0.91, 1.85) vs. 1.63 (126,2.21) ng/mL, P=0.017]. Conclusion: Elevated baseline serum HIF-1α level were associated with an increased risk of secondary sICH within 36 hours of intravenous thrombolytic rt-PA in AIS patients and poor short-term prognosis.

Research progress of ferroptosis in prevention and treatment of osteosarcoma

LI Ming — 2023/7/5 15:13:19

Osteosarcoma (OS) is a kind of primary malignant bone tumor that is prone to occur in children and adolescents. Its traditional treatment is mainly multi-drug chemotherapy. In the past 30 years, due to the problem of drug resistance to chemotherapy drugs, the treatment effect and survival rate of OS patients have not improved significantly. Therefore, it is particularly urgent to explore new therapeutic targets for OS and carry out relevant research on drug resistance to OS chemotherapy. Ferroptosis, an iron-dependent, non-apoptotic, new type of programmed cell death, is characterized by the accumulation of lipid reactive oxygen species. At present, relevant studies have confirmed that ferroptosis plays an important role in the treatment, prognosis and reduction of drug resistance of OS. Based on the above research background, the research progress of ferroptosis in OS was summarized in this paper in order to provide theoretical basis for the prevention and treatment of OS.

New Developments in the Treatment of Thin Endometrium within the Assisted Reproductive Technology

TIAN Jing — 2023/7/5 15:09:55

A thin endometrium is generally defined as endometrial thickness below the appropriate threshold, and is an important indicator to assess endometrial receptivity. There was no consensus on the definition of thin or thick endometrium, and its impacts on pregnancy outcomes were unclear. Thin endometrium are characterized by decreased expression of estrogen receptor, poor growth of glandular epithelium, high uterine blood flow impedance, decreased expression of vascular endothelial growth factor. The main causes include infection, uterine cavity operation, abnormal uterine morphology, drug effect, etc. Thin endometrium can also be caused by unknown causes in some patients. In clinical treatment, combination therapy is generally adopted, various methods have certain positive effects, but the therapeutic effect is controversial. On the basis of traditional treatment, new technologies such as growth hormone, granulocyte colony-stimulating factor, stem cell transplantation and so on are emerging constantly, and comprehensive treatment such as traditional Chinese medicine, acupuncture and neuromuscular electrical stimulation is also gradually attracting attention.

Primary diffuse large B-cell lymphoma of lung with respiratory system as the primary presentation: a case report

Jiang Yanqiu,, — 2023/7/5 15:07:26

Primary pulmonary lymphoma（PPL）is rare malignant disease with a low incidence,it may cause misdiagnosis because of non-specific clinical and radiological presentation.In this case,a 75-year-old women was admitted because of nonspecific respiratory symptoms and a large mass on the computed tomography scan suggestive of primary lung cancer.Finally,she was diagnosed with primary pulmonary lymphoma(diffuse large B cell lymphoma) by positron emission tomography-computed tomography(PET-CT),transbronchial lung biopsy,bone marrow puncture and biopsy.The patient was given 6 cycles of R-CHOP chemotherapy and has been well.This article reports a case of primary B-cell lymphoma in order to emphasize that differential diagnosis of primary pulmonary lymphoma should be considered to reduce misdiagnosis and timely treatment should be given to improve the survival rate of patients with respiratory system as the first manifestation and lung mass as the imaging manifestation.

Repair of perineal radiation ulcer with FMS and VAC assisted flap: case report

wangsisi — 2023/7/5 15:04:01

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Effects of Qili Qiangxin capsule on impedance cardiogram, serum PIIINP and BNP in heart failure patients

gaoyan — 2023/7/3 17:13:12

Objective: Analysis the effects of Qili Qiangxin capsule on transthoracic impedance cardiogram (ICG), serum type III procollagen amino-terminal peptide (PIIINP) and brain natriuretic peptide (BNP) in chronic heart failure (CHF) patients. Methods: Patients over 60 years old with CHF admitted to our hospital between January 2020 and December 2021 were randomly assigned to receive placebo (control group, n=69) or Qili Qiangxin capsule (observation group, n=70), plus standard medicine for CHF, using sealed envelope method. The primary end points were clinical symptoms and improvement in the New York Heart Association grade. Efficacy was rated as significant, effective, ineffective, or aggravated. Secondary end points included complex cardiac events (CCEs), echocardiography, ICG, serum BNP, PIIINP levels, and changes in quality of life. Results: The total effective rate of observation group and control group was 71.02% (49/69) and 91.43% (64/70), respectively. The clinical efficacy of observation group was better than control group (Z=-3.269, P=0.001). Before treatment, there were no significant differences in ICG, echocardiography and serum BNP and PIIINP levels between the two groups (P > 0.05). After treatment, the levels of serum BNP, PIIINP and ICG indexes in the observation group were improved compared with those before treatment (P < 0.05), and the levels of serum BNP, PIIINP, the content of chest fluid and the ratio of contraction time in the observation group were lower than those in the control group (P < 0.05). Meanwhile, stroke index, left cardiac function, cardiac output and cardiac function index were higher than those in control group (P < 0.05). The incidence of CCEs in observation group was lower than that in control group (18.57% vs. 33.33%, P=0.047). After treatment, the Minnesota Heart Failure Quality of Life Questionnaire scores in both groups were lower than those before treatment (P < 0.05), and the improvement in the observation group was more significant than that in the control group (27.0±11.39 points vs. 31.50±12.73 points, P=0.030). Kaplan-Meier survival curve and Log Rank 2 test showed that the median CCEs-free survival time in the observation group was significantly longer than that in the control group (23.0 months vs.16.8 months, 2=4.198, P=0.040). Conclusion: Qili Qiangxin capsule further reduced serum BNP and PIIINP levels and improved cardiac hemodynamics in the context of standard treatment. Our data further support Qili Qiangxin capsule for combination treatment of CHF in the elderly.

Research progress of noninvasive imaging methods for evaluating myocardial viability in patients with AMI

钟昌莉 — 2023/6/13 17:25:44

The incidence and mortality of acute myocardial infarction (AMI) are increasing year by year. The application of revascularization can effectively relieve the symptoms of AMI patients, but the cardiac function of some patients is not improved after percutaneous coronary intervention.Evaluation of viable myocardium is particularly important for the selection of treatment strategies, evaluation of efficacy and prognosis of patients with acute myocardial infarction. Non-invasive imaging is a reliable method to evaluate viable myocardium.This article reviews the characteristics of noninvasive imaging methods for detecting viable myocardium and their correlation.

Research Progress Of Novel Renal Biomarkers In Identification And Prognosis Of AKI In Patients With Cirrhosis

ｈａｕｎｇｘｕｅｌｉａｎ, — 2023/6/8 16:06:08

Acute kidney injury (AKI) is common in advanced liver cirrhosis, mainly including prenephric azotemia, hepatorenal syndrome and acute tubular necrosis.The evaluation of renal function and the differentiation between renal function damage and structural damage are the key points of treatment. The change of serum creatinine (Scr) level is still the gold standard for the diagnosis of AKI in cirrhosis.However, in this population, the role of Scr in evaluating renal function is limited. The new biomarkers are expected to provide effective diagnosis, differential diagnosis and prognosis evaluation for patients with liver cirrhosis with AKI.This article reviews the recent studies on renal biomarkers of AKI in cirrhosis from the perspectives of diagnosis, etiology differentiation and clinical prognosis prediction.

Study on the reference range of thyroid TSH in healthy adults in Jincheng Jiang District of He chi City

Meng Enji,Ren Qingming,Qin Yuqi,Wei Jiao,Wei Lifei,Wu Kun △ — 2023/6/7 10:19:32

Objective To determine the reference range of normal TSH values in Jinchengjiang District healthy adults. Methods According to the recommendations of the American Society of Clinical Biochemistry (NACB) , the thyroid-related data of two hundred and seventy-three healthy adults who underwent physical examination in our hospital from January 2015 to August 2022 were collected for statistical analysis.Results The normal values of TSH in Jinchengjiang District healthy adults were measured by MAGLUMI chemiluminescence analyzer, ranging from 0.48 to 4.26 μIU/ml. The reference range of normal value of TSH was close to the normal value provided by the manufacturer, but the range was narrow. The reference range of normal value of TSH was related to sex, but not to age. Normal TSH values ranged from 0.49 to 4.42 μIU/ml in men and from 0.47 to 4.09 μIU/ml in women. Conclusions According to the 2007 Guidelines for the Diagnosis and Treatment of Thyroid Diseases in China, it is suggested that each laboratory should establish a local reference range for normal TSH values. This study has determined the reference range of normal thyroid TSH values for healthy adults in Jinchengjiang District, Hechi City, and has more accuracy in the diagnosis of various thyroid diseases.

Value of exercise stress echocardiography parameters combined with serum soluble tumor inhibin 2/left atrial volume index ratio in diagnosis of diastolic heart failure

王伟, — 2023/6/7 10:18:31

Abstract: Objective To investigate the value of exercise stress echocardiography parameters combined with serum soluble tumorigenic statin 2 (sST2)/left atrial Volume index (LAVI) ratio in the diagnosis of diastolic heart failure (DHF). Methods A total of 120 patients with chronic heart failure admitted to the Department of Cardiology of our hospital from October 2020 to October 2022 were selected. 53 patients were clinically diagnosed as DHF (DHF group) and 67 patients were clinically diagnosed as non-DHF (non-DHF group). All patients were tested by exercise load echocardiography to obtain the left atrial volume index (LAVI), the ratio of mitral annulus diastolic velocity (E)/mitral annulus mean early diastolic velocity (e') at rest and load, and the serum sST2 level were detected.The variation amplitude of E/e 'at load and rest (△E/e')，ratio of sST2/LAVI were calculated. Pearson analyzed the correlation of echocardiographic parameters under resting and load conditions, sST2/LAVI ratio with left ventricular end-diastolic pressure (LVEDP) and pulmonary capillary wedge pressure (PCWP). Receiver Operating characteristic curve (ROC) was used to analyze the value of echocardiographic parameters under resting and load conditions and sST2/LAVI ratio in the differential diagnosis of DHF. Results The load E/e' ratio in DHF group was higher than that in resting state (P < 0.01), and higher than that in non-DHF group (P < 0.01). The △E/e' ratio and sST2/ LAVI ratio in DHF group were significantly higher than those in non-DHF group (P < 0.01). △E/e' ratio was strongly positively correlated with PCWP and LVEDP (P < 0.01), sST2/ LAVI ratio was strongly negatively correlated with PCWP and LVEDP (P < 0.01), load E/e' ratio, LAVI was moderately positively correlated with PCWP and LVEDP (P < 0.01). There was a weak positive correlation between resting E/e' ratio and PCWP and LVEDP (P < 0.05), and a weak negative correlation between sST2 and PCWP and LVEDP (P < 0.05).△E/e' ratio differential diagnosis DHF area under the curve was 0.837, higher than load E/e' ratio and resting E/e' ratio (P < 0.05), sST2/ LAVI ratio differential diagnosis DHF area under the curve was 0.804, higher than sST2, LAVI (P < 0.05). The area under the curve of the differential diagnosis of DHF by the combined ratio of △E/e' and sST2/ LAVI was 0.950, which was higher than that of △E/e' and sST2/ LAVI alone (P < 0.05). Conclusion The ratio of △E/e' and sST2/LAVI in DHF patients is significantly increased and the ratio of sST2/LAVI is significantly decreased, which is strongly correlated with both LVEDP and PCWP. The combination of △E/e' and SST2 /LAVI has high efficacy in differentiating DHF.

Relationship between eIF4E3 and prognosis and immune infiltration of hepatocellular carcinoma

zuling — 2023/6/7 10:17:03

objective to investigate the expression and biological function of eIF4E3 in human hepatocellular carcinoma (HCC) and its relationship with prognosis and immune infiltration. Methods: multiple gene expression databases were used to analyze the difference of eIF4E3 expression between hepatocellular carcinoma (LIHC) and normal liver tissues. UALCAN database was used to analyze the relationship between eIF4E3 transcription level and protein expression and different clinicopathological features of LIHC. GSCA database and Kaplan-Meier Plotter were used for survival analysis. The co-expression genes of eIF4E3 were explored by Linked Omics database, and their co-expression genes were analyzed by gene ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG). TISIDB database, Sanger Box database, GEPIA database and TIMER database were used to analyze the relationship between eIF4E3 and immune infiltration in tumor microenvironment. Kaplan-Meier Plotter was used to map the prognosis under different immune conditions. Results the expression level of eIF4E3 in LIHC was significantly lower than that in matched normal liver tissues (P < 0.0001). In the two databases, the overexpression of eIF4E3 was significantly correlated with better survival. Functional enrichment analysis showed that the function of eIF4E3 was concentrated in the adhesion process and cell cycle, and was related to the immune response of LIHC. The expression of eIF4E3 affects the exudation level and prognosis of CD4+T and CD8+T cells, macrophages, neutrophils and dendritic cells in LIHC. EIF4E3 is positively correlated with the four immune checkpoint genes. In addition, mutations in TP53 can lead to low expression of eIF4E3 (P=4.13E-2). These results suggest that eIF4E3 is related to the prognosis and immune infiltration of hepatocellular carcinoma, which lays a foundation for further study of the immunomodulatory role of eIF4E3 in hepatocellular carcinoma. Conclusion eIF4E3 is a potential tumor suppressor gene, which may affect the prognosis by inducing immune infiltration of hepatocellular carcinoma. It is expected to become a new prognostic biomarker and therapeutic target of hepatocellular carcinoma.

Clinical Observation of Different Wavelength Lasers in Treating Severe Non-proliferative Diabetic Retinopathy

Chen Meng ping,Duan Na,Liao Rui — 2023/6/7 10:15:31

Objective Observe the clinical efficacy of 561 nm and 532 nm laser photocoagulation in treating severe non-proliferative diabetic retinopathy. Methods From June 2021 to August 2022, 46 cases (82 eyes) of patients with severe non- proliferative diabetic retinopathy who underwent retinal photocoagulation were randomly divided into two groups, 23 cases (42 eyes) in the observation group (561 nm laser treatment group) and 23 cases (40 eyes) in the control group (532 nm laser treatment group).Compare the best corrected vision, average central macular thickness, retinal nerve fiber layer (RNFL) thickness, vitreous hemorrhage, and neovascularization after treatment between the two groups. Results There was no significant difference between the two groups in terms of general information (P>0.05).After treatment, 36 eyes (85.71%) in the observation group and 33 eyes (82.50%) in the control group improved their vision. There was no significant difference in BCVA between the two groups at different time points (P>0.05);After treatment, the CMT between the two groups at different time points had significant difference(P<0.05); CMT was detected 6 months after treatment, and the observation group was (188.00±12.26)um,the control group was (199.13±6.59) um. After treatment, the RNFL of the two groups at different time points had significant difference(P<0.05); The average RNFL thickness was measured 6 months after treatment, and the observation group was (96.80±8.37)um,the control group was (90.52±10.31)um.Conclusion 561nm laser photocoagulation is safe and effective in the treatment of severe nonproliferative diabetes retinopathy. It can effectively control the progression of the disease, and has little effect on the thickness of the macular and the thickness of the nerve fiber layer, which is conducive in the preservation of visual function.

Research progress on correlation between systemic immune inflammatory index and cardiovascular disease

liuting — 2023/6/6 15:58:16

Inflammation is closely associated with cardiovascular disease, and research on inflammatory biomarkers has attracted widespread interest. Systemic Immunoinflammatory Index (SII) is a novel inflammatory marker that integrates neutrophils, lymphocytes and platelets, and can reflect the balance of systemic inflammation and local immunity more comprehensively. Recent studies have found that SII is closely related to the occurrence, development and prognosis of cardiovascular disease, and its potential clinical application value has attracted more and more attention from clinicians.This paper reviews the research progress on the relationship between SII and cardiovascular diseases.

Normotensive Primary Aldosteronism: A Case Report

黄怡静,, — 2023/6/6 15:56:08

A 36-year-old Chinese female was admitted to hospital with the chief complaint of hypokalemia. It was difficult to raise her serum potassium to normal level after potassium supplementation.Laboratory examination showed that the patient had elevated urinary potassium level and elevated aldosterone to renin ratio(ARR).Confirmatory tests were conducted and the diagonsis of primary aldosteronism was made. An abdominal computed tomography scan revealed a mass in her left adrenal gland. Left adrenalectomy were performed and her postoperative potassium level and ARR became normal.Her blood pressure maintained normal before and after the operation.

Rare Type Ⅱ Residual Horn Pregnancy: A Case Report and Review of Related Literature

songbingbing,zhao kongyuan — 2023/6/6 15:49:27

Objective To investigate the etiology, diagnosis and treatment of type II cornual remnant pregnancy.Methods The clinical data of a case of type II rudimentary horn pregnancy admitted to the Affiliated Hospital of Qingdao University were analyzed retrospectively. The diagnosis, treatment and follow-up were reported, and the literature was reviewed.Results Ultrasonography showed residual horn pregnancy. After admission,laparoscopic residual horn hysterectomy+right salpingectomy+hysteroscopy+salpingostomy under general anesthesia. Postoperative pathology was consistent with pregnancy changes, follow-up serum β- The hCG decreased to normal and the treatment was successful. Conclusion Type II rudimentary horn pregnancy is rare in clinical practice, and B-ultrasound can assist in diagnosis. Early operation before rupture of residual horn uterus can significantly improve the treatment and prognosis, and avoid the life-threatening outcome of massive hemorrhage. Hysteroscopy at the same time during the operation can visually confirm the type of residual horn uterus, eliminate the possibility of normal pregnancy with developing unilateral horn uterus, avoid missed diagnosis, misdiagnosis, etc., which is conducive to determining the cause of disease. Timely adjust and formulate individualized treatment plan during the operation, and shorten the treatment time.

Effect of cognitive-behavioral therapy combined with escitalopram on postoperative delirium in elderly patients with preoperative anxiety before laparoscopic radical resection of colorectal cancer

BAO Xufan,XIA Jichang,xue ling,ZOU Xu — 2023/6/2 18:04:00

[Abstract] Objective To explore the effects of cognitive behavioral therapy (CBT) combined with escitalopram on postoperative delirium (POD) in elderly patients with preoperative anxiety undergoing laparoscopic radical resection of colorectal cancer. Methods A total of 110 elderly patients aged 65 to 80 years who underwent laparoscopic radical resection of colorectal cancer in the hospital from November 2021 to August 2022 were recruited, with American Society of Anesthesiologists (ASA) physical status classification II-III and Hamilton Anxiety Rating Scale (HAMA) score ≥ 14 points. According to the random number table method, patients were divided into control group and observation group, with 55 cases in each group. The control group was given escitalopram from the day of admission to 1 day before surgery, and the observation group was given escitalopram combined with CBT. The main indicator was the incidence of POD within 3 days after surgery. Secondary indicators included HAMA scores at 1 day before surgery, 1 day, 3 days, and 7 days after surgery, Numerical Rating Scale (NRS) and Ramsay sedation scores within 48 hours after surgery, incidence of adverse events after surgery, and QoR-15 scores at 1 day and 2 days after surgery. The time to first ambulation and length of hospital stay were recorded. Results Compared with the day of admission, the HAMA scores of both groups showed a downward trend. The observation group had a greater reduction in HAMA score than the control group. The HAMA scores of the observation group were lower than those of the control group at 1 day before surgery and 1 day, 3 days, and 7 days after surgery, with significant differences (P<0.05). The NRS scores of both groups decreased after surgery, and the Ramsay sedation scores increased, but the differences between the two groups were not statistically significant (P>0.05). Within 3 days after surgery, 17 cases (30.91%) in the control group and 6 cases (10.91%) in the observation group had POD, with significant differences (χ2=6.652, P=0.010). There was no significant difference in the severity and duration of POD between the two groups (P>0.05). The QoR-15 scores of the observation group were significantly higher than those of the control group at 1 day and 2 days after surgery (P<0.05). The time to first ambulation of the observation group was earlier than that of the control group, with significant differences (P<0.05). There was no significant difference in length of hospital stay between the two groups (P>0.05). The incidence of nausea and vomiting in the observation group was lower than that in the control group at 2 days after surgery, with significant differences (P<0.05). The overall incidence of adverse events in the control group was significantly higher than that in the observation group (92.73% vs. 65.45%; χ2=12.369, P<0.001). Conclusion CBT combined with escitalopram can alleviate perioperative anxiety in elderly patients undergoing laparoscopic radical resection of colorectal cancer and reduce the incidence of POD.

Analysis of the medium to long-term efficacy of preserving the left colonic artery during laparoscopic NOSES for colorectal cancer

Fu Chuan-Chuan,,,, — 2023/6/2 18:02:24

To investigate the medium to long-term clinical efficacy of preserving the left colic artery (LCA) during laparoscopic natural orifice specimen extraction surgery (NOSES) for colorectal cancer. Methods The clinical data of 155 patients with rectal cancer or sigmoid colon cancer who underwent laparoscopic NOSES in Sichuan Cancer Hospital from July 2016 to December 2021 were retrospectively analyzed. Patients were divided into two groups according to whether the LCA was preserved intraoperatively. The rates of recurrence and/or metastasis and medium to long-term survival of patients were compared between the two groups. Results There were 80 patients in the LCA-preserving group and 75 patients in the non-LCA-preserving group, and 2 patients in each group were lost to follow-up. The median follow-up time was 31（4~ 71） months. The recurrence and/or metastasis rates were 5.1% versus 9.5% in the LCA-preserving and non-LCA-preserving groups, respectively. The mortality rates in the two groups were 2.5% versus 2.7%, respectively, and the differences were not significant between the two groups (P> 0.05). The 2-year disease-free survival (DFS) rates after surgery in the two groups were 93.5% versus 96.9%, the 3-year DFS rates were 93.5% versus 89.3%, and the 5-year DFS rates were 93.5% versus 87.1%, respectively, and the differences of DFS rates were not significant between the two groups (P> 0.05). The 2-year overall survival (OS) rates after surgery in the two groups were 97.5% versus 100.0%, the 3-year OS rates were 93.6% versus 98.0%, and the 5-year OS rates were 93.6% versus 94.1%, respectively, and the differences of OS rates were not significant as well (P> 0.05). Conclusion Preserving the LCA while completely removing the root lymph nodes of the inferior mesenteric artery does not affect the patient's medium to long-term oncologic outcome, as long as surgical oncologic principles are strictly followed during laparoscopic NOSES for colorectal cancer.

Changes and clinical significance of sestrin2 and mTORC1 in synovial tissue of patients with osteoarthritis

付道通, — 2023/6/2 17:58:02

Objective: To explore the relationship between the levels of sestrin 2 and mammalian target of rapamycin complex 1 (mTORC1) in synovial tissue and the prognosis of patients with osteoarthritis. Methods: A total of 120 patients with osteoarthritis who were treated in our hospital from October 2019 to October 2022 were included in the study, according to the prognosis, there were 31 cases in the poor prognosis group and 89 cases in the good prognosis group. The levels of sestrin2 mRNA and mTORC1 mRNA in synovial tissue were detected by real-time fluorescent quantitative PCR (qRT-PCR), the levels of interleukin-8 (IL-8), IL-6 and tumor necrosis factor-α (TNF-α) were measured by enzyme linked immunosorbent assay (ELISA); Pearson correlation analysis was applied to examine the correlation between sestrin2 mRNA, mTORC1 mRNA and inflammatory markers in synovial tissue of patients with poor prognosis of osteoarthritis; the ROC curve was drawn to analyze the predictive value of the levels of sestrin2 mRNA and mTORC1 mRNA in synovial tissue for the prognosis of osteoarthritis; and Logistic regression analysis was applied to examine the influencing factors of poor prognosis in patients with osteoarthritis. Results: The levels of mTORC1 mRNA, IL-8, IL-6 and TNF-α in the poor prognosis group were obviously higher than those in the good prognosis group, the level of sestrin2 mRNA was obviously lower than that in the good prognosis group (P<0.05). The level of sestrin2 mRNA in synovial tissue of patients with poor prognosis of osteoarthritis was negatively correlated with the levels of IL-8, IL-6 and TNF-α in synovial fluid (P<0.05), the level of mTORC1 mRNA was positively correlated with the levels of IL-8, IL-6 and TNF-α (P<0.05). The AUC of poor prognosis of osteoarthritis predicted by sestrin2 mRNA and mTORC1 mRNA in synovial tissue alone or in combination was 0.817, 0.813 and 0.906, respectively. MTORC1 mRNA was an independent risk factor for poor prognosis in patients with osteoarthritis (P<0.05), and the expression of sestrin2 mRNA was a protective factor for poor prognosis in patients with osteoarthritis (P<0.05). Conclusion: Synovial tissue sestrin2 mRNA and mTORC1 mRNA can be used as important auxiliary indexes for the prognosis evaluation of patients with osteoarthritis.

The predictive value of postoperative lactate dehydrogenase for the short-term outcome of acute type A aortic dissection

Chen tao,Hu shuxin,Li jun — 2023/6/2 17:55:47

Objective To investigate the predictive value of lactate dehydrogenase (LDH) in the short-term outcome of patients with acute type A aortic dissection (ATAAD) undergoing cardiopulmonary bypass.Methods The clinical data of 272 patients with ATAAD undergoing surgical treatment under extracorporeal circulation who were hospitalized in Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology from October 2020 to December 2021 were retrospectively analyzed. Among them, 201 were male and 71 were female, aged from 21 to 77 years, with onset and admission within 14 days. The LDH of patients within 24 hours after surgery was collected, and according to the status of patients at discharge collected by the medical record system, they were divided into recent good outcomes and recent adverse outcomes. Results Postoperative LDH was an independent predictor of short-term adverse outcomes after ATAAD cardiopulmonary bypass. According to the analysis of receiver operating characteristic (ROC) curve of subjects, the optimal threshold for predicting adverse outcomes of hospitalization by postoperative LDH is 608.00 μ Mol/l (sensitivity: 74%, specificity: 68%), area under the curve was 0.752 (95% CI 0.670, 0.834). Conclusion: Postoperative LDH can predict short-term adverse outcomes in patients with ATAAD after cardiopulmonary bypass.

The relationship between preoperative platelet lymphocyte ratio and non sentinel lymph node metastasis in invasive breast cancer

huangkai — 2023/6/2 17:53:05

Objective The purpose of this study was to determine whether preoperative platelet lymphocyte ratio (PLR) can be used as a predictor of non SLN metastasis in early breast cancer patients. Methods: The clinical data of patients with early breast cancer who received treatment in the hospital from January 2013 to January 2022 were retrospectively analyzed. Data of patient demography, tumor variables and PLR were collected, and multivariable logistic regression was used to analyze the factors of non sentinel lymph node metastasis. The predictive efficacy of platelet lymphocyte lymphocyte ratio (PLR) on non SLN metastasis in early breast cancer patients was determined by the ROC curve measured by area under the curve (AUC).Results: According to the ROC curve results, PLR=134.8546 was the best cutoff point to be divided into high and low groups for comparison, and only the non sentinel lymph node metastasis status had statistical significance in the high and low groups. A univariate analysis of the clinicopathological characteristics of 280 patients with breast cancer undergoing sentinel lymph node biopsy showed that the number of sentinel lymph node metastasis, tumor size, HER2 status, vascular invasion status and non sentinel lymph node metastasis were statistically correlated. Multivariate logistic analysis showed that the number of SLN metastasis, vascular infiltration status, HER2 status, and PLR were independent risk factors for non SLN metastasis, and the lower the PLR (P=0.030, OR=1.69,95% CI=1.05-2.72), the higher the risk of non SLN metastasis.Conclusion: Pretreatment PLR is a useful diagnostic tool for predicting non SLN metastasis.

Correlation between root curvature of impacted anterior maxillary teeth and labial and palatal bone cortex based on CBCT

tangyun, — 2023/5/25 15:28:38

Objective To investigate the correlation between the distance from the root tip to the labial and palatal bone cortices and the curvature of the roots of the impacted anterior maxillary teeth.Methods A total of 71 cases of CBCT of impacted anterior maxillary teeth were selected, including 39 impacted canines and 32 impacted incisors, of which 20 impacted incisors completed treatment. According to Nolla's method, the completed impacted incisors were divided into early and late groups (n=10, in each group). The root length, root curvature, distance from the root tip to the labial bone surface, and distance from the root tip to the palatal bone surface were measured using Dolphin software. Pearson correlation analysis was used to analyze the correlation between the apical to labial and palatal bone cortical distances and the root curvature of maxillary impacted canines and incisors.Results Root curvature decreased and root length increased after treatment of the impacted incisors compared with before treatment, with statistically significant differences (P < 0.05). Root curvature decreased and root length increased in the early group after treatment compared with that before treatment, with statistically significant differences (P < 0.05). There was no significant change in root curvature and root length before and after treatment in the late group, and the difference was not statistically significant (P > 0.05). Pearson correlation analysis displayed that the root curvature of the impacted maxillary incisor was negatively correlated with the distance from the root tip to the labial bone cortex (P < 0.05) and positively correlated with the distance from the palatal bone cortex (P < 0.05); the change in root curvature before and after orthodontic treatment in the incisor group was positively correlated with the change in the distance from the root tip to the palatal bone cortex (P < 0.05). There was a negative correlation with the change in labial cortical distance (P < 0.05).

Sodium salicylate can lead to SGN injury by enhancing oxidative stress

Zhu Xiaoting — 2023/5/18 10:06:17

[Abstract] Objective To observe the changes of oxidative stress(OS) level in SGN after the action of sodium salicylate (SS) on spiral ganglion neuron (SGN) of rat cochlea. Methods The SD rats were randomly divided into three groups, namely, normal control group, SS group, and SS+N-acetyl-L-cysteine (NAC) group. The cochlear organs were treated with 5 mM SS for 48 h after culturing SGN for 48 h; or by acute isolation of SGN, primary culture for 48 h and treatment with 1 mM, 5 mM SS, 5 mM SS combined with 100 uM NAC for 48 h, respectively; the control group was not treated; immunofluorescence staining was used to locate the major production sites of Reactive Oxygen Species (ROS) in the cochlear organs; the average fluorescence intensity of ROS fluorescent probe DCFH-DA in SGN of rats in each group was detected and quantified by fluorescence staining; the survival rate of SGN cells was detected by CCK8 method. Results In cochlear organ culture, after SS treatment, immunofluorescence staining showed that ROS fluorescence was enhanced and mainly expressed in SGN, while the fluorescence intensity in other cells was not significantly changed. To further quantify fluorescence intensity, fluorescence staining showed a higher average ROS fluorescence intensity with the increase in SS concentration in primary cultured SGN (P<0.0001), and ROS average fluorescence intensity was decreased compared with that in the SS group after the addition of ROS inhibitor NAC (P<0.0001). The results of CCK8 method showed that the cell viability of the SS group was decreased by 41.34% compared with that of the control group (P < 0.001), and the cell viability of the SS group was increased by 36.05% after the addition of NAC (P < 0.001). Conclusion 1. SS specifically enhances the oxidative stress level of SGN in a dose-dependent manner; 2. Oxidative stress inhibitor NAC can reduce the oxidative stress level of SGN and reverse the SS-induced SGN injury.

Crown root ratio: Research Progress in orthodontic treatment

luojiaqin — 2023/5/11 17:08:12

Normal crown root ratio is an important index to judge the stability of teeth in alveolar bone, whether they have good oral function and long-term stability after various treatments in clinical orthodontic treatment. Understanding the definition, measurement methods, measurement tools, clinical application and influencing factors of crown root ratio in clinical practice will help orthodontists to achieve safe and efficient tooth movement and obtain stable correction effect in the correction of dental and jaw deformities. This topic is discussed here.

Risk Factors and Predictors of Mycoplasma Pneumoniae Necrotizing Pneumonia in Children

wang zhilong — 2023/5/8 16:16:42

Objective To investigate the risk factors and predictors of Mycoplasma pneumoniae necrotizing pneumonia(MPNP) in children. Methods A retrospective study was conducted to collect children admitted to the Respiratory Department of Shanxi Children's Hospital from January 2021 to December 2022 who were diagnosed with severe mycoplasma pneumoniae pneumonia. The children were divided into NP group (50 cases) and non-NP group (101 cases). The general data, laboratory indexes, chest CT, bronchoscopy findings and treatment of the two groups were compared and analyzed. The indicators with statistically significant differences in univariate analysis were used for multivariate Logistic regression analysis to obtain the independent predictors of MPNP. Receiver operating characteristic (ROC) curve was used to calculate the cut-off value of the independent predictors. Results The course of disease before admission, length of fever and length of stay in the NP group were longer than those in the non-NP group, and the differences were statistically significant (P<0.05). The white blood cell count, neutrophil, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, D-dimer, pleural effusion, pleural thickening, rice-water-like turbidity of bronchoalveolar lavage fluid, use of other antibiotics, and use of low molecular weight heparin calcium were higher in the NP group than in the non-NP group. The total protein, albumin and prealbumin in the NP group were lower than those in the non-NP group, and the differences in the above indicators were statistically significant (P<0.05). White blood cell count, D-dimer, prealbumin and rice-water-like turbidity of bronchoalveolar lavage fluid were independent predictors of MPNP. The areas under the ROC curve were 0.775, 0.873, 0.676, and 0.635, respectively. White blood cell count, D-dimer and prealbumin cut off values were 10.17×109/L, 2.35 mg/L and 94.00 mg/L, respectively. Conclusions White blood cell count >10.17×109/L, D-dimer >2.35mg/L, prealbumin <94.00mg/L, and rice-water-like turbidity of bronchoalveolar lavage fluid are independent predictors of MPNP, among which D-dimer has the greatest predictive value.

Advances of Phenotypic Heterogeneity of Myeloproliferative Neoplasms in the Context of JAK2 Mutation

Xiang Danhong — 2023/5/6 11:24:09

BCR-ABL-negative myeloproliferative neoplasms (MPNs) are a group of chronic blood cancer, characterized by the clonal myeloproliferation. The mutation of JAK2V617F as one of the major diagnostic criteria, is common in MPNs, which effect the phenotypic heterogeneity in MPNs by mutation allele burden. Except that, epigenetic modifications, immune disfunction, signal transduction, lifestyle and other factors also play a role in phenotypic heterogeneity. Here, we focus on the mutation of JAK2V617F and summarize the recent advances in phenotypic heterogeneity of MPNs.

Research Progress of Non-motor Symptom Assessment Scales for Parkinson"s Disease

Lin Zhao,Zhao Hong — 2023/5/6 11:19:32

Parkinson's disease (PD) is one of the most common neurodegenerative disease,Its incidence is gradually increasing with the exacerbation of the aging population nowadays. The clinical manifestation of PD includes four classic motor symptoms and many non-motor symptoms. Non-motor symptoms of PD are drawing more attention than ever before, making it a hot topic in the field of research on PD. It is generally believed that non-motor symptoms of PD can appear simultaneously or earlier than motor symptoms and seriously affect the quality of life of patients. Therefore, the effective assessment of non-motor symptoms of PD is helpful for the early recognition and severity assessment of non-motor symptoms of patients and is crucial for improving the quality of life of patients. Rating scales are the primary means of assessing non-motor symptoms in PD patients. We review the non-motor symptom rating scales commonly used in clinical practice, so as to provide help for the management of non-motor symptoms in PD patients.

Social Isolation and Associatcd Factors in decompensated patients with liver cirrhosis

wei su yu — 2023/5/6 11:11:51

【Abstract】Objective To understand the status of social isolation in decompensated patients with liver cirrhosis and analyze its influencing factors, so as to provide a basis for improving the status of social isolation in patients. Methods A total of 168 patients with decompensated liver cirrhosis in the Gastroenterology Department of this hospital from January 2021 to October 2022 were selected as the study subjects by using the convenience sampling method.All subjects were investigated by the General Information Questionnaire,Lubben Social Network Scale-6(LSNS-6),Family APGAR Index (APGAR)，Hospital Anxiety and Depression Scale(HADS),Multiple linear regression analysis was used to analyze the influencing factors. Results The LSNS-6 score of patients with decompensated liver cirrhosis was (12.88±4.45), 91 cases (54.17%) had social isolation, 70 cases (41.67%) had family isolation, and 86 cases (51.19%) had friend isolation. The results of stepwise regression analysis showed that age, place of residence, education level, medical payment method, Child-Pugh classification of liver function, family care index, anxiety and depression were the main influencing factors of social isolation in the patients (P <0.05), together explaining 54.7% of the variation in social isolation. Conclusion The incidence of social isolation in decompensated patients with liver cirrhosis is relatively high, and there are many influencing factors, We should pay attention to and intervene on related influencing factors to delay the disease progression and improve their quality of life.

Lymphoepithelial carcinoma of nasolacrimal duct: a case report and literature review

likaihu — 2023/5/6 11:07:00

A case report and literature review ：Multiple myeloma progression to secondary plasma cell leukemia

Linzhifeng,,, — 2023/5/6 11:00:46

Objective To explore the influencing factors, clinical manifestations, diagnosis of plasma cell leukemia (PCL) secondary to multiple myeloma (MM), as well as the prognosis of patients with proteasome inhibitor combined with dexamethasone maintenance therapy after autologous hematopoietic stem cell transplantation, and review the relevant literature. Methods A patient with PCL secondary to MM was selected, the case data were analyzed and the relevant literature was reviewed. Results The patient was diagnosed with IgG-κ multiple myeloma. Genetic testing showed IGH translocation (positive rate was 55%), and creatinine increased progressively at the onset. After the first course of BTD chemotherapy, secondary plasma cell leukemia occurred. Peripheral plasma cells were 41%, continued to complete 6 cycles of BTD induction therapy, the efficacy was evaluated as VGPR, repeated fever during the period, perianal swabs showed multidrug-resistant Klebsiella pneumoniae, and sensitive antibiotics were added according to the drug susceptibility results, and then re-examination The perianal swab turned negative. Autologous hematopoietic stem cell transplantation was performed in our hospital, and then maintained treatment with "proteasome inhibitor combined with dexamethasone". The patient has a good prognosis and is still being followed up. Conclusion Secondary plasma cell leukemia occurs during the treatment of multiple myeloma, which mostly indicates the change of the condition and poor prognosis. The prognosis of this patient is good at present, which suggests that the treatment based on bortezomib is very effective. Combined with ASCT consolidation and maintenance treatment of "proteasome inhibitor combined with dexamethasone" can reduce the early mortality and prolong the total survival time (OS).

A retrospective study of simultaneous treatment of multiple pulmonary nodules in two lungs by single-port thoracoscopy

yuanxiaolong — 2023/5/5 17:43:47

【 Abstract】 Objective: To investigate the application of single thoracoscopic simultaneous treatment of multiple pulmonary nodules in both lungs. Methods: The clinical data of 24 patients with multiple pulmonary nodules in both lungs treated by single-port thoracoscopic lobectomy/sublobectomy were retrospectively analyzed from January 2020 to December 2021 in the Department of Thoracic and Cardiac Surgery, Dongying Hospital of Traditional Chinese Medicine (Dongying Shengli Hospital). There were 15 males and 9 females, aged 51 to 79 (64.5±8.4) years. Among them, 0 cases had bilateral lobectomy, 3 cases had one lung lobe + one sublung lobe, and 21 cases had bilateral sublung lobe. Results: All the patients successfully completed the operation and were discharged. The operation time was 90 ~ 254 (162.1±50.9) min, the postoperative hospitalization time was 4 ~ 13 (7.1±2.3) d, the postoperative thoracic drainage tube time was 2 ~ 4 (2.8±0.8) d, the postoperative complications included 2 cases of pulmonary infection, 1 case of poor wound healing, 4 cases of cough discomfort, 4 cases of postoperative dyspnea discomfort, and no death occurred during the hospitalization. Conclusion: It is feasible to treat multiple pulmonary nodules in both lungs with single thoracoscope and the therapeutic effect is satisfactory.

Application value of acute gastrointestinal injury score combined with high sensitivity C-reactive protein/serum albumin ratio in Hypertriglyceridemic acute pancreatitis

刘翠华,刘纪宁,盛洁,喻洪 — 2023/5/5 17:42:42

Abstract: Objective To investigate the value of AGI score combined with high sensitivity C-reactive protein/serum albumin (hs -CRP /Alb) ratio in the evaluation and recurrence prediction of emergency patients with hypertriglycerideemic acute pancreatitis (HTG-AP). Methods From June 2019 to June 2022, 89 HTG-AP patients (HTG-AP group) and 50 healthy volunteers (control group) admitted to our hospital were selected. According to the 2012 Atlanta Criteria, HTG-AP patients were divided into mild acute pancreatitis (MAP) group (32 cases), moderate to severe acute pancreatitis (MSAP) group (38 cases), and severe acute pancreatitis (SAP) group (19 cases). Followed-up HTG-AP patients within 3 months after discharge, Logistic regression analysis risk factors of disease recurrence of HTG-AP patients within 3 months after discharge. Receiver operating characteristic curve (ROC) was used to predict the recurrence of HG-AP patients within 3 months after discharge. Results AGI score, serum hs-CRP and hs-CRP/Alb ratio in HTG-AP group were higher than those in control group (P < 0.01), and serum Alb level was lower than that in control group (P < 0.01). AGI score, serum hs-CRP and hs-CRP/Alb ratio in SAP group were higher than those in MSAP group and MAP group (P < 0.05), and serum Alb level was lower than those in MSAP group and MAP group (P < 0.05). Among the 89 HTG-AP patients, 5 were lost to follow-up, 29 relapsed, and 55 did not relapse. TG, AGI score and hs-CRP/Alb ratio were risk factors for relapse in HTG-AP patients within 3 months after discharge (P < 0.05). The area under the curve of TG, AGI score and hs-CRP /Alb ratio predicted the recurrence of HTG -AP patients within 3 months after discharge was 0.804, 0.786 and 0.725, and the area under the curve of combined prediction was 0.965, which was higher than TG, AGI score and hs-CRP /Alb ratio alone (z=3.359,3.604,3.530, P < 0.05). Conclusion The increase of AGI score and hs-CRP /Alb ratio are associated with the aggravation of HTG-AP and relapse, and the combination of TG, AGI score and hs -CRP /Alb ratio has a high value in the evaluation of the relapse of HTG-AP.

Comparison of effects of different suture techniques on residual ovarian reserve in patients undergoing laparoscopic ovarian cystectomy

刘媛媛 — 2023/5/5 17:41:22

Objective: To compare the effects of different suture techniques on residual ovarian reserve in patients undergoing laparoscopic ovarian cystectomy, in order to improve the prognosis of patients with ovarian cysts. Methods: Using prospective analysis research methods, 120 patients with ovarian cysts who came to our hospital for treatment from April 2017 to October 2019 were studied. A random number table was given and divided into intracapsular multi-point continuous suture group (group A), base continuous U-shaped suture group (group B), extracapsular continuous suture group (C group), extracapsular interrupted suture group (D group) , 30 cases in each group. The operation time and intraoperative blood loss of the four groups of patients were recorded and compared, and the four groups of patients were recorded and compared before operation (T1), 1 month after operation (T2), 3 months after operation (T3), and 6 after operation. Estradiol (E2), progesterone (P), follicle stimulating hormone (FSH), luteinizing hormone (LH) and the number of antral follicles measured by vaginal color Doppler ultrasound (F0) at the month (T4) and 1 year (T5) ), ovarian artery peak systolic flow velocity (PSV), diastolic low value flow velocity (EDV), calculated resistance index (RI), pulsatility index (PI) for comparison. Results: Compared with group B, the operation time and intraoperative blood loss of patients in group A, C, and D were increased. Compared with group D, the operation time and intraoperative blood loss of patients in group A, B, and C were increased. The difference was significant (p<0.05); E2, P, and vaginal color Doppler ultrasound F0 of patients in each group from T1 to T5 , PSV levels first decreased and then increased, reaching the lowest value at T3 (p<0.05); compared with group B, the E2, P, and vaginal color Doppler F0 and PSV levels of patients in groups A, C, and D at different times Compared with group D, E2, P and vaginal color Doppler ultrasound F0 and PSV levels of patients in group A, group B, and group C increased at different times, and the difference was significant (p<0.05); each group of T1～T5 The patients’ FSH, LH, and vaginal color Doppler ultrasound RI and PI levels increased first and then decreased, reaching a peak at T3 (p<0.05); compared with group B, patients in groups A, C, and D had FSH and LH at different times And vaginal color Doppler ultrasound RI and PI levels increased. Compared with group D, FSH, LH and vaginal color Doppler ultrasound RI and PI levels of patients in group A, B, and C decreased at different times, and the difference was significant (p< 0.05). Conclusion: Different suture techniques used in laparoscopic ovarian cyst removal can restore ovarian reserve within half a year after surgery, but the continuous U-shaped suture at the base of the base is easy to operate and has better hemostatic effect, and postoperative ovarian reserve Function recovery is faster.

Research on the Mechanism of Cnidii Fructus-Psoralea Fructus in Treatment of Bone Metastasis of Breast Cancer Based on Network Pharmacology

kechanghu,, — 2023/5/5 17:39:27

Objective To predict the mechanism of cnidii fructus-psoralea fructus in breast cancer based on network pharmacology. Methods The chemical ingredients of drugs were collected by TCMSP、BATMAN-TCM database, while Swiss Target Prediction were used to predict the corresponding targets of ingredients. The targets of bone metastasis of breast cancer were retrieved in GeneCards, and OMIM database. Venny 2.1 online software was used to obtain the common targets of drugs-disease, and then the “drug-compound-target-disease” network diagram was constructed by using the software Cytoscape 3.8.2. The STRING database was used to draw the PPI network, and the perform GO function and KEGG pathway enrichment analysis were carried out through DAVID database. Results The 40 active components of cnidii fructus-psoralea fructus can regulate 99 targets and 147 pathways to treat bone metastasis of breast cancer. Diosmetin, (E)-2,3-bis(2-keto-7-methoxy-chromen-8-yl)acrolein, isobavachin, cniforin B, bavachin, cniforin A, O-acetylcolumbianetin, bavachinin, xanthoxylin N, O-isovalerylcolum bianetin, ostruthin, osthol and other active compounds, which can mediate pathways in cancer, endocrine resistance, PI3K-Akt, proteoglycans in cancer, microRNAs in cancer, central carbon metabolism in cancer, prolactin, cellular senescence, apoptosis, AGE-RAGE signaling pathway in diabetic complications, Ras, MAPK, and other signaling pathways through EGFR, AKT1, SRC, STAT3, JUN, CCND1, CASP3, ESR1, ERBB2, TNF and other key target proteins. Conclusion Cnidii fructus-psoralea fructus can participate in the treatment of bone metastasis of breast cancer through multiple components, targets and pathways, which provides a theoretical basis for the clinical application of cnidii fructus-psoralea fructus and the mechanism of its treatment of bone metastasis of breast cancer.

Efficacy of prednisone combined with azithromycin sequential therapy in the treatment of severe Mycoplasma pneumoniae pneumonia in children and its effect on serum TLR4/MyD88/NF-κB signaling pathway related proteins and downstream inflammatory factors

严慧 — 2023/5/5 17:38:20

To investigate the efficacy of prednisone combined with azithromycin sequential therapy in the treatment of severe Mycoplasma pneumoniae pneumonia in children and its effect on serum TLR4/MyD88/NF-κB signaling pathway related proteins and downstream inflammatory factors. Methods：This research mainly in January 2019 to June 2022 treated 120 cases of children with severe pneumonia mycoplasma pneumonia as the research object, using the envelope method, the above patients were randomly divided into observation group and control group, two groups of patients were taking azithromycin treatment, the observation group of patients based on the joint to prednisone treatment, two groups of patients were treated for 4 weeks. The therapeutic effect, CIPS score, TLR4/MyD88/NF-κB signaling pathway-related proteins and inflammatory indicators were compared between the two groups. Result：The recovery time of body temperature, relief time of cough, relief time of expectoration, relief time of wheezing, disappearance time of pulmonary rales and hospital stay in the observation group were shorter than those in the control group (P < 0.05). After treatment, two groups of patients' body temperature, white blood cell count, airway secretions, oxygenation, chest X-ray and sputum culture and total score were significantly lower, and the observation group of patients with body temperature and white blood cell count, airway secretions, oxygenation, chest X-ray and sputum culture and total score was significantly lower than control group (P < 0.05); TLR4, MyD88 and NF-κB in the two groups were significantly decreased, and the TLR4, MyD88 and NF-κB in the observation group were significantly lower than those in the control group (P < 0.05). The CRP, IL-6 and PCT of the two groups were significantly decreased, and the CRP, IL-6 and PCT of the observation group were significantly lower than those of the control group (P < 0.05). Conclusion：Sequential prednisone combined with azithromycin therapy in the treatment of severe Mycoplasma pneumoniae pneumonia in children can significantly improve the therapeutic effect of patients by down-regulating the levels of TLR4/MyD88/NF-κB signaling pathway related proteins and downstream inflammatory factors in serum.

Imatinib combined with IFN α- Evaluation of therapeutic effect of 2b on patients with advanced chronic myeloid leukemia and its effect on serum MMP-2, Sall4 mRNA and AGP

王晖 — 2023/5/5 17:37:08

Objective: To explore the effect of imatinib combined with IFN α- Evaluation of therapeutic effect of 2b on patients with advanced chronic myeloid leukemia and its effect on serum matrix metalloproteinase-2 (MMP-2), Sall4 mRNA and protein expression α 1-acid glycoprotein (AGP). Methods: The 9 0 patients with accelerated CML inpatients admitted from January 2016 to January 2 0 2 1 were selected as the research subjects . All patients were randomly divided into study group (imatinib combined with IFN) α- There were 45 cases in each group. The complete cytogenetic remission rate (ccyr), complete hematological remission rate (CHr) and major molecular biological remission rate (MMR) were observed after the end of treatment. The serum levels of interleukin-6 (IL-6), prostaglandin E2 (pge-2), alkaline phosphatase (ALP) and MMP-2 were detected by enzyme-linked immunosorbent assay (ELISA). Real time fluorescent quantitative (RQ-PCR) was used to detect Sall4 mRNA expression. AGP was detected by immunonephelometry. The adverse reactions during the treatment were observed. Results: the ccyr (11.11%) and MMR (2.22%) of the study group were lower than those of the control group (31.11%) and (13.33%). The difference between the two groups was statistically significant (2 = 5.404, 3.873, P < 0.05), and the Chr (86.67%) of the study group was significantly lower than that of the control group The difference was statistically significant (2 = 10.601, P < 0.05); After treatment, IL-6 in the study group was (5. 69 1 ± 1.24）pg /ml、PGE-2（53.22 ± 12.03）pg /ml、ALP（66.03 ± 13.22）U /L、MMP-2（2.80 ± 0.52） μ G / l was lower than that of the control group (8. 80 0 ± 2.09）pg /ml、（63.06 ± 12.22）pg /ml、（80.22 ± 13.07）U /L、（3.81 ± 0.55） μ g /L（t=8.585，3.849，5.120，8.951，P＜0.05）； After treatment, Sall4 mRNA in study group was (8. 22 2 ± 33)%, which was lower than that of the control group (13. 06 2 ± 3.04）%（t=8.477，P＜0.05）； After treatment, the level of AGP in the study group was (0. 52 0 ± 12) g / L, which was lower than that of the control group (0. 65 0 ± 0.11）g/L（t=5.357，P＜0.05）； 22% in the study group was higher than 6. 67% in the control group (3 / 45) (2 = 4. 406, P < 0. 05). Conclusion: Imatinib combined with IFN α- Conclusion: compared with imatinib alone, imatinib is more effective in the treatment of CML in accelerated phase, and can reduce the levels of MMP-2, Sall4 mRNA and AGP, which can alleviate the disease, but may increase the incidence of hematological adverse reactions.

Analysis of prognostic factors in patients with gallbladder cancer after radical resection and construction and validation of the nomogram for survival prediction

WEI Zhen-kang — 2023/5/5 17:35:48

[Abstract] Objective To analyze the prognostic factors of patients with gallbladder cancer (GBC) after radical resection and construct a nomogram that can predict the prognosis of patients and verify the model. Methods From The SEER （Surveillance, Epidemiology, and End Results ）database extracted clinical characteristics of patients undergoing radical gallbladder cancer operation from 2006 to 2015 as the training set. Data of patients undergoing radical resection from 2015 to 2020 in Anhui Provincial Hospital were collected as validation set. Through univariate and multivariate cox regression analysis of the training set data, the independent risk factors affecting the prognosis of patients after radical gallbladder cancer surgery were screened, and a nomogram model was built based on the independent risk factors. The Bootstrap method was used for 1000 times sampling to verify the model internally, and then the validation set data was used to verify the model externally. Results Univariate and multivariate Cox analysis showed that age, level of differentiation, diameter of tumor, number of positive lymph nodes, number of lymph nodes detected, TNM stage, T stage, N stage and M stage were the relevant factors affecting postoperative survival of patients with gallbladder cancer (P < 0.05). Among them, age, diameter of tumor, number of lymph nodes detected, TNM stage, T stage and N stage were independent factors affecting postoperative survival of patients with gallbladder cancer (P < 0.05), a nomogram was constructed to predict the 1, 2, and 3-year overall survival rates of patients with GBC after radical resection base on the independent risk factors. The C-index of the nomogram is 0.740（95％CI:0.720-0.760）in the training group and the C-index is 0.707（95％CI:0.627-0.787）in the validation group. The calibration curve shows that the predictive power of the model is in good agreement with the actual condition. Conclusion The nomogram model based on SEER database has high accuracy and stability in predicting the 1, 2, and 3-year overall survival rates of patients with GBC after radical resection, which can provide certain guiding significance for clinical workers in practical work. [Key words] Gallbladder cancer; Radical resection; Nomogram; Prognosis; SEER database

Altered low-frequency fluctuation amplitude brain function in patients with first-episode depression accompanied by negative perfectionism

陈雁菁,范春华,李卫晖,刘萍,易思婕,周瀛 — 2023/4/24 9:31:26

Objective To investigate the differences in whole brain activity between patients with and without negative perfectionism first-episode depression using the low frequency fluctuation amplitude (ALFF) method. Methods Forty-four first-episode depression patients, 11 males and 33 females, aged 24.64±5.31 years, recruited in 2020-2022 were included, and the patients were divided into depression with negative perfectionism group (NPD group, n=24) and depression without negative perfectionism group (NNPD group, n=20) according to the total score of negative perfectionism on the Chinese Frost Multidimensional Perfectionism Scale (CFMPS). Independent sample t-test analysis was used to compare the differences in ALFF values between the two groups, and Pearson correlation analysis was performed between the extracted ALFF values of brain regions with statistically significant differences and the total score of negative perfectionism on the CFMPS scale and the total score of the Hamilton Depression Scale (HAMD17). Results Compared with the depressed without negative perfectionism group, the depressed with negative perfectionism group had significantly higher ALFF values in the right middle frontal gyrus, right inferior parietal marginal angular gyrus, right insula, left inferior temporal gyrus, and left middle temporal gyrus, and significantly lower ALFF values in the left paracentral lobule, left middle frontal gyrus, left superior marginal gyrus, left triangular inferior frontal gyrus, and left insular cap frontal gyrus. Correlation analysis showed that the right middle frontal gyrus ALFF value was negatively correlated with the total negative perfectionism score (r=-0.531, P=0.008) and with the total HAMD17 scale score (r=-0.477, P=0.018). Conclusion Depression accompanied by negative perfectionism patients had abnormal brain functions than those without negative perfectionism, and these abnormalities were mainly in the frontal, temporal, and parietal lobes, which are related to emotion and cognition, and the weaker the compensatory function of the right middle frontal gyrus, the more prominent the negative perfectionism and the greater the severity of depression.

Research Progress of miR-4516 in Malignant Tumors

Yinwu — 2023/4/12 15:56:04

MicroRNAs（miRNAs）are a group of small noncoding RNAs, which play the key roles in the biological process of malignant tumors. MiR-4516 , one of the main members of miRNAs, is abnormally expressed in a variety of tumors and is closely related to tumor invasion , metastasis, prognosis and sensitivity to chemical drugs, which has important clinical research value. This article summarizes the research progress of miR-4516 in digestive system neoplasm, glioblastoma, breast cancer, retinoblastoma and thyroid cancer, aiming to provide reference for understanding the role of miR-4516 in malignant tumors and conducting further research.

Effect of normal range CD4+T cells on insulin resistance in type 2 diabetic subjects

zhangzhenhua — 2023/4/10 15:40:32

Objective To investigate the relationship between CD4+T cell level in normal range and insulin resistance（IR）in patients with T2DM. Methods A total of 269 patients with T2DM hospitalized patients were selected. they were divided into four groups according to their normal range of CD4+T cell levels. A group: 414～670 cell/μl，B group：671～927 cell/μl，C group：928～1183 cell/μl，D group 1184～1440cell/μl. All participants were asked to complete a questionnaire. Essential informations including inflammatory cytokines(INF-γ，IL-17), TC, TG, CRP, etc. we tested blood glu-cose, insulin in oral glucose tolerance test(OGTT). We calculated steady-state model to assess the insulin secretion index (HOMA-β), steady-state model to assess the ins-ulin resistance index (HOMA-IR). Matsuda index was evaluated ins-ulin sensitivity(ISIM). Results There were no significant differences in HOMA-β， between the four groups（P>0. 05）, There were significant differences in HbA1c, FPG, HOMA-IR, CRP, INF-γ, IL-17 between the four groups and showed an upward trend（P<0. 05）. There were significant differences in ISIM between the four groups and showed an downward trend（P<0. 05）. correlation analysis showed that HOMA-IR was positively correlated with CD4+T cell, HbA1c, CRP, FPG，IL-17, INF-γ and negatively correlated with ISIM. Multiple stepwise regression analysis showed that CD4+T cell, FPG，IL-17, INF-γ were the influencing factors of HOMA?IR. Conclusion In T2DM patients with normal range of CD4+T cell levels, the higher the CD4+T cell level, the higher IL-17, INF-γ, the higher IR, and the lower the peripheral tissue insulin sensitivity.

Correlation of serum Cystatin C levels with ineffective recanalization after mechanical thrombectomy in patients with large vessel occlusion in the anterior circulation

LI Guanyi — 2023/4/10 15:38:23

Abstract: Objective To investigate the predictive value of serum cystatin C (Cystatin C, Cys C) level in patients with acute ischemic stroke with anterior circulation large-vessel occlusion. Methods A retrospective analysis was performed on the complete arterial recanalization after mechanical embolectomy in patients with acute ischemic stroke with anterior circulation large-vessel occlusion admitted from February 2019 to May 2022. 3 months after surgery, patients with complete recanalization were scored according to the modified Rankin Scale (mRS), and divided into 2 groups according to mRS score, mRS score <3 for effective recanalization group, mRS score ≥3 for ineffective recanalization group, compared the general data of the two groups, and logistic regression analysis was used to determine the risk factors for futile recanalization after mechanical thrombectomy in patients with anterior circulation large-vessel occlusion. The predictive value of Cys C for futile recanalization in patients undergoing mechanical thrombectomy was evaluated by using the Receiver Operator Characteristic (ROC) curve. Results Among the 110 patients, 49 patients were in the effective recanalization group and 61 in the futile recanalization group, and after multivariate regression analysis, the Cys C level, NIHSS score and collateral circulation status were independent risk factors for futile recanalization after mechanical thrombectomy in patients with anterior circulation large-vessel occlusion. The area under the curve where serum Cys C level at admission predicts ineffective recanalization after mechanical thrombectomy is 0. 955（95% CI：0. 922~0. 988), the best cut-off value 0. 935 mg/L, with a sensitivity of 82.0% and a specificity of 93.9%. Conclusion Serum Cys C level on admission is associated with futile recanalization after mechanical thrombectomy in patients with acute ischemic stroke with anterior circulation large-vessel occlusion, and the higher the serum Cys C level, the higher the incidence of futile recanalization.

Association of serum IL-33 levels with bone turnover markers and fracture risk in elderly postmenopausal women with osteoporosis

Yin Le,, — 2023/4/10 15:36:04

Objective: To investigate the effect of serum interleukin 33 (IL-33) level on bone turnover markers expression and fracture risk in elderly postmenopausal women with osteoporosis.Methods: A total of 277 elderly women with post-menopausal osteoporosis (PMO) who suffered fragility fractures due to falls and were admitted to our hospital from June 2019 to March 2021 were selected as the fracture group, and 250 elderly women with PMO who had no fracture records during the same period were included as the control group. Serum IL-33 levels were compared between the two groups. Spearman method was used to analyze the relationship between serum IL-33 level and other serological indicators in the fracture group, and multivariate Logistic regression was used to analyze the risk factors affecting the fracture in PMO women. The area under curve (AUC) and the optimal cut-off value of fractures in PMO women were predicted by using the receiver operating characteristic (ROC) curve of serum IL-33 level.Results: The levels of serum parathyroid hormone (PTH), C-terminal telopeptide of type 1 collagen (CTX-1), procollagen type 1 N-terminal propeptide (P1NP), osteocalcin (OC) and bone-specific alkaline phosphatase (BALP) in fracture group were significantly higher than those in control group. The serum 25-hydroxyvitamin D [25(OH)D] level and bone mineral density (BMD) (T-value) were lower than those of control group (P<0.05). Spearman method analysis showed that serum IL-33 was positive correlation with serum 25(OH)D (rs=0.158, P=0.009), and with serum CTX-1 (rs=-0.233, P < 0.001), OC (rs=-0.357, P < 0.001), PTH (rs=-0.326, P < 0.001). Multivariate Logistic regression analysis showed that serum IL-33 level and BMD (T-value) were independent protective factors for fracture risk in PMO women (P < 0.05). By ROC curve analysis, the AUC of serum IL-33 level were 0.976 (95%CI: 0.965-0.986) and cut-off value was 6.57 pg/mL, the sensitivity and specificity were 94.8% and 91.3%, respectively.Conclusion: The decrease of serum IL-33 level in women with PMO may be an independent risk factor leading to the increased risk of fracture, and the detection of serum IL-33 level has certain reference value for predicting the risk of fracture in women with PMO.

Analysis of Health-Related Physical Fitness Level and Influencing Factors in Patients with Recurrent Nasopharyngeal Carcinoma1_^stAffiliated Hospital of Guangxi Medical University,

王毅 — 2023/4/10 12:01:33

Objective: To understand the health-related physical fitness level and difference of rNPC patients, and analyze its influencing factors. Methods: The data were collected with the general situation questionnaire and the health fitness assessment form for cancer patients. Single factor analysis and multiple linear regression analysis were performed with SPSS 25.0.Results: The overall score of health-related physical fitness of rNPC patients was 103.11 ± 18.75 (total score range 69.0~175.0); There was a significant difference in the level of health fitness among different characteristic groups (P<0.05); Multivariate analysis showed that age, tumor stage, fear of disease progression, nutritional risk, frequency of physical exercise, duration of each exercise and sleep quality were the main factors affecting the health-related physical fitness level of rNPC patients, R2= 0.715, F=36.326, P ＜0.001.Conclusions: The health fitness level of rNPC patients is generally low. However, due to the differences in individual demographic characteristics, disease conditions, psychology, living habits and other factors, the patient groups among different characteristic groups show different health fitness levels. This discovery will provide basis and inspiration for further exploring the impact mechanism of various influencing factors and formulating nursing interventions.

Gut microbiota altered in Parkinson"s disease with depressionand its Metabolic Fuction Prediction

任腾竹, — 2023/3/31 11:49:10

Objective To investigate the structure of gut microbiota and metabolic function pathway of Parkinson’s disease（PD） with depression (DPD). Methods Ninety-five PD patients who were hospitalized in the Guangdong second provincial general hospital from June 2021 to October 2022 and 43 healthy volunteers were analyzed fecal bacterial composition by using 16S rRNA high-throughput sequencing technology as well as explored function pathway with PICRUSt2. Results Compared with HC group, the α diversity of DPD group and NDPD group was higher, and the difference was statistically significant (P<0.05).β diversity analysis based on Bray-Curtis distance matrix and Weighted UniFrac analysis showed that the composition of intestinal flora at the genus level was significantly different between the DPD group and the NDPD group (P=0.022，R=0.111；P=0.036，R=0.084).The abundance of Actinobacteria and Synergistetes in DPD group increased compared with HC group and NDPD group, and the difference was statistically significant, but there was no significant difference between DPD group and NDPD group (DPD vs NDPD, P=0.4661; DPD vs HC, P = 0.0061; NDPD vs HC, P=0.0827) (DPD vs NDPD, P=0.9866; DPD vs HC, P= 0.0181; NDPD vs HC, P=0.0082).The abundance of Bacteroidetes in HC group and DPD group was significantly higher than that in NDPD group, but there was no significant difference between DPD and HC group (DPD vs NDPD, P=0.0468; DPD vs HC, P = 0.3326; NDPD vs HC, P=0.0012).According to Linear Discriminant Analysis(LDA), at the taxonomic level of genus, bacteria from the genera Alistipes, Anaerotruncus, Dielma, Holdemania, Cloacibacillus and Collinsella were significantly more abundant in DPD. The functional pathway of microbiota were also significantly different between two groups. The two pathways which were carbon fixation in photosynthetic organisms and antifolate resisitance in DPD patients were more than NDPD and controls. Conclusion These findings suggest that the intestinal microbiome is altered in DPD compared with NDPD and HC. The intestinal microbiome characteristic of DPD patients may be involved in the pathogenesis of the disease through protein acylation and antifolate resistance.

Diabetic Retinopathy Detection using Pre-trained Swin Transformer Model

Wang Gang,柳明杰,王善志,朱永俊 — 2023/3/31 11:47:29

Objective To use the Swin Transformer model to detect the severity of diabetic retinopathy in patients based on their retinal fundus images. Methods Based on the APTOS 2019 public dataset, the OpenCV image processing library is used to augment the data by changing the brightness, flipping different angles and equalizing the histogram. A total of 9160 color fundus images are obtained as a complete dataset. Build the pre-trained Swin Transformer model to classify the lesion level of the pictures, and compare it with the training results of the four pre-trained Vision Transformer, EfficientNetV2, GoogLeNet and ResNet-50 neural network models. In addition, the impact of pre-training on the model is compared with the non-pre-trained Swin Transformer model with random initialization parameters. Results The quadratic weighted Kappa=0.977, AUC=0.996, the accuracy rate reaches 94.6%, compare with Vision Transformer, EfficientNetV2, GoogLeNet and ResNet-50 models, the accuracy rate are increased by 1.9%, 2.3%, 5.4% and 7.1% respectively; Compare with the non-pre-trained Swin Transformer model, the accuracy rate is increased by 4.4%, and the number of epochs is reduced by nearly 400 times. Conclusions It verifies the high accuracy, effectiveness and good robustness of the pre-trained Swin Transformer model, which has great significance for clinical diagnosis.

Study on expression relationship between lncRNA TUG1 and miR-26a in placental tissue of preeclampsia

张婵 — 2023/3/29 15:16:58

[Abstract] Objective: To measure the expression levels of long non-coding RNA taurine up-regulated gene 1 (lncRNA TUG1) and microRNA-26a (miR-26a) in placental tissue of patients with preeclampsia (PE), and to analyze the clinical role of the two in PE patients. Methods: In this study, 100 patients who were newly diagnosed with PE in the Obstetrics and Gynecology Department of our hospital from May 2019 to May 2021 were regarded as the PE group, including 49 cases of mild PE group and 51 cases of severe PE group. 100 healthy pregnant women served as a control group. Placental tissue samples were collected during cesarean delivery, the expression levels of lncRNA TUG1 and miR-26a in placental tissue were measured by real-time fluorescence quantitative (qRT-PCR) technology; the differences in the expression levels of lncRNA TUG1 and miR-26a between the control group and the PE group, and between the mild PE group and the severe PE group were analyzed and compared; the association between the expression levels of lncRNA TUG1 and miR-26a and the clinical characteristics of PE patients, respectively, and the association between the expression levels of lncRNA TUG1 and miR-26a in PE patients were analyzed by Pearson method. Results: The expression level of lncRNA TUG1 in placenta tissue of PE group was obviously lower than control group, and the expression level of miR-26a in placenta tissue of PE group was obviously higher than control group (P<0.05); the expression level of lncRNA TUG1 in the severe PE group was obviously lower than mild PE group, while the expression level of miR-26a was obviously higher than mild PE group (P<0.05); the expression level of lncRNA TUG1 in placental tissue was negatively correlated with systolic blood pressure, diastolic blood pressure and urinary protein level in PE patients (r=-0.617, P<0.05; r=-0.685, P<0.05; r=-0.688, P<0.05), the expression level of miR-26a was positively correlated with systolic blood pressure, diastolic blood pressure and urinary protein level in PE patients (r=0.587, P<0.05; r=0.436, P<0.05; r=0.461, P<0.05); there was a negative correlation between the expression levels of lncRNA TUG1 and miR-26a in placental tissue of PE patients (r=-0.592, P<0.05). Conclusion: LncRNA TUG1 is lowly expressed in PE placenta tissue, while miR-26a is highly expressed. They may be related to the pathogenesis of PE and may be related to the clinical severity of PE patients. LncRNA TUG1 may be involved in the development of PE by targeting miR-26a.

Preliminary study on the correlation between salivary cortisol level and periodontal status in patients with coronary heart disease

程雨 — 2023/3/29 15:16:07

Objective：To explore the possible correlation between coronary heart disease and periodontal disease by cortisol level.Methods:A total of 89 patients in the Department of Cardiovascular Medicine of Chaohu Hospital Affiliated to Anhui Medical University were selected and divided into coronary heart disease group and non-coronary heart disease group. Saliva cortisol levels were measured by enzyme-linked immunosorbent assay (ELISA), and periodontal conditions were examined.Periodontal health status was evaluated by periodontal bleeding index (BI), periodontal probing depth (PD), loss of attachment (AL), calculus index (CI) and Oral Health Impact Scale (OHIP-14).Results: There was no significant difference in the general condition between the CHD group and the non-CHD group, but there was a significant difference in the periodontal condition (P<0.05). The salivary cortisol level of the CHD group was significantly higher than that of the non-crown group (P<0.01).After periodontal treatment, cortisol level decreased and periodontal condition improved in non-crown group (P<0.05).Conclusions: (1) The salivary cortisol level of patients with coronary heart disease is higher than that of patients without coronary heart disease, and the periodontal condition is worse.(2) Increased salivary cortisol level is a risk factor for coronary heart disease. Periodontal treatment may reduce cortisol level and reduce the risk of coronary heart disease.(3) Salivary cortisol may be a new risk factor indicator for coronary heart disease.

Summary of cases and approach of total thoracoscopic cardiac surgery

jiangwei,lisicong,luojinlong,weikequan,zhangze — 2023/3/29 15:15:01

Objective To summarize the clinical experience and approach of total thoracoscopic cardiac surgery ．Methods We retrospectively analyzed 206 cases who underwent the completely thoracoscopic cardiac surgery in our department from January 2013 to May 2021.These patsummarize the clinical experiences of cardiac surgery ients included 109 cases with atrial septal defect in which 32 cases were combined with moderate to severe tricuspid regurgitation; 58 cases with mitral valve disease in which 28 cases were combined with moderate to severe tricuspid regurgitation and 6 cases were combined with thrombus; 22 cases with isolated tricuspid regurgitation; 17 cases of left atrial myxoma ．Results All the operations were performed successfully．There was no perioperative mortality，postoperative residua l leakage，perivalvular leakage，and reexploration for postoperative bleeding，but 1 case of enlarged incision was changed to thoracoscopic assisted small incision．The mean extraeorporeal circulation and cross-clamping time were (140.3±64.7) min and (98.1±56.3) min，respectively．Postoperative ventilation support time was (16.4 ±10.3) h．The mean volume of chest drainage was(598 ±210) ml．Patients were discharged from the hospital in(12.6 ±4.7)d postoperatively．There were 56．8％ of patients (117／206 ) received no blood transfusion．Follow-up time ranged from 1 m- onth to 60 months，and all patients were in 4class I／II defined by scores of New York Heart Association ( NYHA )．Conclusion Complete thoracoscopic cardiac surgery is less invasive, easily accept, quicker recovery and more feasible, and worthy of clinical promotion.

Correlation analysis of the features of carotid siphon anatomy and the intracranial ruptured aneurysms by CT angiography

Yang Xiao, — 2023/3/29 15:13:45

[Abstract] Objective:The objective of this study was to explore the correlation between the features of carotid siphon anatomy and the ruptured intracranial aneurysms. Methods: From October 2019 to November 2021, the clinical data of 172 patients with intracranial aneurysms diagnosed by CT angiography in our hospital according to the inclusion criteria were analyzed retrospectively. The patients were divided into the ruptured aneurysm group and the unruptured aneurysm group. A history of hypertension, diabetes, smoking, and alcohol consumption was collected for each group. We recorded the shape, location, and calcification of the parent artery. Then we measured the long diameter of the aneurysm, aneurysm neck diameter, the parent artery diameter, aneurysm tilt angle, aneurysm blood flow into the angle, and the angle of anterior bend angle, posterior bend angle, anterosuperior bend angle, and the angle of the petrous bone segment. The correlation between the parameters and ruptured intracranial aneurysms was analyzed by the univariate analysis and Logistic regression analysis.Results: The results showed that aneurysms with irregular shapes are more likely to rupture(P<0.05). The anterior bend angle (37.02° ± 13.83°) and anterosuperior bend angle (109.06° ± 21.89°) of the ruptured aneurysm group were greater than those of the unruptured aneurysm group (20.92° ± 5.78°, 102.64° ± 16.90°), and the difference was statistically significant (P<0.05). The results showed that irregular aneurysm morphology increased the risk of aneurysm rupture (OR=5.72, 95% CI: 1.98-16.53; P=0.001). Moreover, it was also found that the greater the angle of the anterior bend of the internal carotid siphon, the higher the risk of aneurysm rupture (OR=1.195, 95% CI: 1.12-1.27; P<0.01). The ROC curve analysis showed that the anterior bend angle of 29.38° was the best diagnostic cut-off value. The area under the curve (AUC) was 0.864; the sensitivity was 73.1%, and the specificity was 90.5%.Conclusions: Irregular aneurysms morphology and the anterior bend angle of the carotid siphon were independent risk factors for the rupture of intracranial aneurysms. The chance of aneurysm rupture increased significantly when the morphology of aneurysms was more irregular and the anterior bend angle was greater than 29.38°.

Effect of Garcinone E on the migration and invasion of nasopharyngeal carcinoma S18 cells and its related mechanism

Wei Dan,Yin Fuqiang,Zhang Han — 2023/3/29 15:12:14

Objective To investigate the effect of garcinone E, an extract of Mangostema mangostema peel, on the migration and invasion of nasopharyngeal carcinoma S18 cells and its antitumor mechanism. Methods After treatment of S18 cells with different concentrations of garcinone E, cell viability was measured by CCK-8 assay. Transwell assay was used to examine the migration and invasion ability of S18 cells. Western blot was performed to detect the expression levels of metastasis-related TIMP1, TIMP2, MMP-2 and MMP-9, cell cycle-related proteins p21, CDK2, CDK6, CDK7and Cyclin B1 and autophagy-associated proteins LC3B, p62/SQSTM1, Beclin-1 and Atg3 in S18 cells. Results CCK-8 assay showed that garcinone E significantly suppressed cell viability with an IC50 of 2.876 ± 0.06 μmol/L for S18 cells. Transwell results indicated that garcinone E significantly inhibited the migration and invasion of S18 cells. Western blot data suggested that garcinone E significantly enhanced the protein expression levels of TIMP1, TIMP2, p21, LC3B, p62/SQSTM1, Beclin-1 and Atg3, and dramatically diminished the protein expression levels of MMP-2, MMP-9, CDK2, CDK6, CDK7 and Cyclin B1. Conclusion Garcinone E inhibited metastasis, induced cell cycle arrest and blocked autophagy in nasopharyngeal carcinoma S18 cells.

Research progress on the relationship between NUP210 and malignant tumors

wu weiquan — 2023/3/28 17:38:09

Nucleoporin 210 is a nuclear pore membrane glycoprotein involved in constituting the nuclear pore complexes.Traditionally,NUP210 is only involved in the assembly of nuclear pore complexes and the breakdown of the nuclear membrane,but recent studies have found that it is associated with some other biological functions,such as gene expression regulation , which is linked to the occurrence and progression of malignant tumors. This article reviews the research progress of NUP210 and malignant tumors in recent years.

Advance in bronchoscopic alveolar lavage in diagnosis and treatment of pulmonary infection in patients with traumatic brain injury

QIU Hao,RUAN Chi-yi,TANG Zheng-neng,WANG Dong-kun — 2023/3/28 17:37:14

Due to complex pathophysiological changes, patients with traumatic brain injury (TBI) are often complicated with pulmonary infection, patients with pulmonary infection have poor prognosis, high mortality, the diagnosis and treatment are very difficult. With the development of endoscopic technology, fiberbronchoscopy has been widely used in the diagnosis and treatment of severe pulmonary infection, as well as in patients with TBI complicated with pulmonary infection. This article reviews the relevant domestic and foreign literatures in recent years , summarizing the causes and pathological mechanisms of pulmonary infection in TBI patients, and advance in the diagnosis and treatment of pulmonary infection in TBI patients with fibrobronchoscopy, in order to provide reference for the treatment of pulmonary infection in TBI patients.

A case of dyskeratosis congenita caused by mutation of TINF2 gene

bianya,,, — 2023/3/28 17:36:03

Three-line cytopenias were first found in a 4-year-old male child at 3 years and 13 days, mainly manifesting as moderate anemia, severe thrombocytopenia, and agranulocytosis. Bone marrow aspirate results suggest aplastic anemia. During hospitalization, gamma globulin and methylprednisolone sodium succinate were infused, and cyclosporine and stanozolol tablets were administered orally outside the hospital. Afterwards, the child developed blurred vision and progressively decreased visual acuity. Regular monitoring of children's blood routine showed repeated low platelets and hemoglobin, and the hospital repeated transfusion of leukocyte-depleted red blood cell suspension and platelet therapy. Bone marrow aspiration was performed again, but aplastic anemia was still suggested. Further genetic testing showed that the child had a TINF2 gene mutation, which was caused by self-mutation, so the diagnosis of dyskeratosis congenita was considered. After regular follow-up of the child, it was found that the child gradually developed finger (toe) atrophy, abnormal skin pigmentation and oral leukoplakia. This article reports a case of dyskeratosis congenita in a child with aplastic anemia as the first manifestation, and summarizes the genetics, clinical manifestations, diagnosis and treatment of the disease ,which can provide references for the early diagnosis, treatment and follow-up research of the disease.

Cervical lymph node metastasis of prostate adenocarcinoma accompanied thyroid cancer as the first symptom :A case report and literature review

Peng Lilin,Yang Bo,Zhong Lijuan — 2023/3/28 17:34:56

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Clinical study of minimally invasive puncture combined with middle meningeal artery embolization in the treatment of chronic subdural hematomaCao Demao, Duan xiaochun , Zhu Jinglong

曹德茂, — 2023/3/10 17:03:44

Objective To investigate the effect of minimally invasive puncture combined with middle meningeal artery embolization in the treatment of chronic subdural hematoma.SMethods 52 patients with unilateral chronic subdural hematoma were retrospectively analyzed. The experimental group was treated with minimally invasive puncture combined with middle meningeal artery embolization, while the control group was treated with minimally invasive puncture.SThe patients were followed up for 3 months, The absorption of residual hematoma 3 months after operation and the number of cases undergoing reoperation were counted, and Markwalder"s grading was evaluated 3 months after surgery.SResults There were no statistically significant differences between the experimental group and the control group in gender, age, hematoma density, hematoma volume, hematoma thickness, midline deviation and Markwalder"s grade (P>0.05);SThe experimental group was better than the control group in residual hematoma absorption rate and Markwalder"s grading (P<0.05), the number of reoperation cases was less than the control group.SConclusion The treatment of chronic subdural hematoma is diversified. Puncture combined with middle meningeal artery embolization can effectively promote the absorption of residual hematoma, reduce the risk of reoperation and improve the neurological function of patients, which has the value of further research and promotion.

Chinese clinical expert consensus on surgical treatment of myasthenia gravis: An interpretationLIU Baodong

刘宝东 — 2023/3/8 9:15:17

Chinese clinical expert consensus on surgical treatment of myasthenia gravis has been published in 2022. This article focuses on the clinical classification, surgical basis, preoperative preparation, surgical indications, surgical methods, postoperative management and postoperative outcome of myasthenia gravis.

Progress in clinical treatment of thalassemia

LI Hong-mian,LONG Xi-gui,QIN Ting — 2023/3/7 12:21:56

Thalassemia is the most common anemic disease of globin synthesis defect in southern China. It is an autosomal recessive inheritance disease. The pathogenesis is the genetic variation leads to an imbalance in the synthesis ratio of hemoglobin α chain and β chain, and the clinical manifestations are abnormalities such as chronic hemolytic anemia and iron overload. Thalassemia not only affects the quality of life of patients, but also brings a heavy economic burden to the affected families. The current treatment methods include blood transfusion combined with iron removal therapy, drug therapy, hematopoietic stem cell transplantation, and hepcidin-related therapy. The progress of clinical treatment of thalassemia is summarized as follows to provide reference for clinical treatment.

Application of Rh antigen typing and irregular blood group antibody screening in precision blood transfusion

张东敏, — 2023/3/6 16:43:08

Objective: to develop the detection technology of Rh (D, C, C, e and E) blood group antigen, and to explore the feasibility of the application of Rh (D, C, C, e and E) five antigen detection in precision blood transfusion by using blood transfusion information management software system statistics. Methods: blood transfusion cases without Rh (D, C, C, e and E) blood group antigen detection between January 1, 2019 and August 31, 2020 were taken as the control group, and blood transfusion cases with Rh (D, C, C, e and E) blood group antigen detection between September 1, 2020 and September 30, 2021 were taken as the experimental group. The ABO blood group and Rh (D, C, C, e and E) five blood group antigens and irregular antibodies were detected by anti human globulin card method on the red blood cell samples of blood donors before warehousing, and the test results were input into the blood transfusion information management software system, and the blood was warehoused; Before cross matching, the samples of blood recipients were tested for ABO blood group and Rh (D, C, C, e and E) five blood group antigens and irregular antibodies, and the test results were uploaded to the blood transfusion information management system. The computer recognition technology was used to automatically match the blood bags of ABO blood group and Rh (D, C, C, e and E) five blood group antigens for the blood recipients in the experimental group, and the cross matching test was carried out with saline method and anti human globulin card method, Realize clinical accurate blood transfusion. Results: after the implementation of this blood transfusion scheme in our hospital, except for the emergency rescue of blood receiving patients and AB blood group patients with less blood consumption, the blood transfusion of ABO blood group and Rh (D, C, C, e and E) five blood group antigens can be achieved, and no adverse reactions of blood transfusion have been observed; Patients with multiple blood transfusions or a history of blood transfusion had significantly lower irregular antibody positive blood type, the time spent in difficult blood matching, the number of white blood suspended red blood cells transfused, and the average hospital stay of patients were lower than those in the control group. Conclusion: the development of Rh blood group antigen detection technology to achieve clinical accurate blood transfusion can not only avoid the generation of irregular antibodies stimulated by heterotypic antigens in Rh blood group system, but also reduce the occurrence of adverse reactions in clinical blood transfusion; It improves the ability of the laboratory to solve difficult blood matching, improves the safety of clinical blood transfusion treatment, avoids the waste of blood resources, reduces the hospitalization time of patients, improves the satisfaction of patients, and is worthy of clinical application.

Safety and efficacy of left bundle branch pacing for severe atrioventricular block

Hu changxing,Huang huating,Ji qingwei,luzhengde,Shiying,Shilei,Zhang shu — 2023/3/6 16:42:07

Obstract：Objective: To evaluate the safety and efficacy of left bundle branch pacing in the treatment of severe atrioventricular block. Methods: 60 patients with grade II type II atrioventricular block (AVB) or grade III AVB were enrolled from March 2019 to January 2020 from the Department of Cardiology. Those study subjects were randomly divided into left bundle branch pacing（LBBP） group (n = 30) and right ventricular outflow tract pacing（RVOTP）group (n = 30). All subjects were followed up at 1st month, 3rd month and 6th month after operation. The QRS wave width was measured by ECG, the left ventricular end-diastolic diameter(LVEDd), the left ventricular ejection fraction(LVEF) and ventricular septal perforation were evaluated by Doppler echocardiography, chest X-ray was used to determine the position of Pacemaker electrode. Results:Compared with during operation, the lead impedance of pacemaker of two groups were significantly decreased at different follow-up time points, meanwhile, the QRS wave width of LBBP group was much narrower than that of RVOTP group(P < 0.05). The ventricular electrode capture threshold in LBBP group was lower than that in rvotp group (P < 0.05). There was no significant difference in R wave amplitude and electrode impedance between the two groups at the same time point (P > 0.05).neither lead dislodgement no pocket inftection was found in two groups.Whereas 1 ventricular septal perforation and 1 septal vascular injury were found in LBBP group, there was no significant difference between two groups. Conclusion: LBBP is safe and effective in the treatment of patients with atrioventricular block, which is worthy of clinical promotion.

Correlation analysis between neutrophils to high-density lipoprotein cholesterol ratio and the severity of acute coronary syndromes

Huang jing — 2023/3/6 16:40:51

Objective To explore the relationship between neutrophils to HDL-C ratio and severity of coronary artery stenosis in patients with ACS. Methods Ａ Total of 270 patients with acute coronary syndrome admitted to the Department of Cardiology of Subei people's Hospital from May 2021 to may 2022 were retrospectively selected. According to the results of Gensini score, they were divided into low GS group (Gensini score ≤ 48, 130 cases) and high GS group (Gensini score > 48, 140 cases). Gensini score was used to evaluate the severity of acute coronary syndrome; Multivariate logistic regression was used to analyze the independent influencing factors of high Gensini score; Spearman correlation was used to analyze the correlation between NHR and Gensini score; the ROC curve was used to evaluate the predictive value of NHR on the severity of coronary artery disease in ACS patients. Results The independent influencing factors of high Gensini score are diabetes, lym, ALB and NHR; NHR was positively correlated with Gensini score (r = 0.449, P < 0.001); The ROC curve showed that when NHR was 7.395, the specificity and sensitivity of predicting coronary stenosis were 83.1% and 51.4%, respectively; The areas under the ROC curve was 0.710. Conclusion NHR is positively correlated with the coronary artery stenosis degree,which has a certain predictive value for the severity of coronary artery stenosis in patients with ACS.

Value analysis of improved ABCD2 score combined with serum adenosine deaminase level in differential diagnosis of posterior circulation cerebral infarction with isolated vertigo onset

任云 — 2023/3/6 16:39:40

Abstract: Objective To investigate the value of improved ABCD2 score combined with serum adenosine deaminase (ADA) level in the differential diagnosis of posterior circulating cerebral infarction (PCS) with isolated vertigo. Methods A total of 129 PCS patients with isolated vertigo (PCS group) and 130 patients with peripheral vestibular vertigo (control group) were selected from neurology Department of our hospital from September 2019 to September 2022. All patients were evaluated by improved ABCD2 score to detect serum ADA level. To analyze the value of improved ABCD2 score combined with ADA in identification of PCS with isolated vertigo onset. Results Improved ABCD2 score and serum ADA level in PCS group were higher than those in control group (P < 0.05). High LDL-C, diabetes, improved ABCD2 score and ADA were risk factors for isolated vertigo (P < 0.05). The areas under the curve of PCS diagnosed by improved ABCD2 score and ADA were 0.936 and 0.845, respectively. The areas under the curve of PCS diagnosed by combined improved ABCD2 score and ADA were 0.974, higher than those diagnosed by improved ABCD2 score and ADA alone (P < 0.05). Conclusion Improved ABCD2 score and serum ADA level were significantly higher in PCS patients with isolated vertigo onset, and the combination of the two indexes could improve the efficacy of PCS identification.

Clinical Efficacy Evaluation of Microwave Therapy combined with Sodium Aescinate in the Treatment of Herpes Zoster

LI Xiao-bin,LIU Xuan,QIN Wei-jing,QUAN Dong,SU Zhi,TAN Tingting,ZHANG Wei — 2023/3/6 16:38:41

Objective To evaluate the effect of microwave therapy combined with sodium aescinate on pain, skin lesion and quality of life in patients with herpes zoster and its prevention of post-herpetic neuralgia. Methods 120 patients with herpes zoster who were hospitalized in our hospital from September 2018 to March 2022 were randomly divided into control group and experimental group. The control group was given antiviral and neurotrophic treatment, and the experimental group was given microwave treatment and sodium aescinate in addition to the antiviral and neurotrophic therapy. The differences of Dermatology Life quality Index ( DLQI ), Numerical Rating Scale ( NRS ) and Verbal Rating Scale ( VRS ) between the two groups were analyzed at 1 week and 2 weeks after treatment. The differences in pain relief time, scab formation time and skin lesion recovery time between the two groups were evaluated, as well as the proportion of post-herpetic neuralgia after 4 weeks of treatment. Results There was no significant difference in the general condition between the two groups ( P > 0.05 ). The scores of DQLI, NRS and VRS in the two groups decreased significantly at 1 week and 2 weeks of treatment ( P < 0.05 ). The scores of DQLI, NRS and VRS in the experimental group were lower than those in the control group at 1 week and 2 weeks of treatment ( P < 0.05 ). The pain relief time, scab formation time and skin lesion recovery time in the experimental group were earlier than those in the control group ( P < 0.05 ). There was no significant difference in the proportion of post-herpetic neuralgia between the two groups after 4 weeks of treatment ( P > 0.05 ). Conclusions Microwave therapy combined with sodium aescinate can alleviate the pain degree of herpes zoster, shorten the time of pain relief, promote herpes scab and skin lesion healing, and improve the quality of life of patients. Whether this therapy can reduce the occurrence of post-herpetic neuralgia still needs further study.

Association of serum free light chain with early improvement of cardiac function and prognosis after PCI in patients with STEMI

meng jun jun,wuzhenli — 2023/3/6 16:37:41

Objective To investigate the correlation between serum polyclonal combined free light chain (cFLC) and early improvement of cardiac function and prognosis after emergency percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).Methods A total of 332 STEMI patients who underwent successful PCI in our hospital from June 2018 to May 2020 were enrolled. In addition, 162 non-coronary heart disease patients were recruited as the control group at a ratio of 2:1. N-Latex FLC system and scattering turbidimetric method were used to determine the serum cFLC level at admission, 72h, 7d and 30d after onset. Follow-up was performed after PCI, echocardiography was performed 24h and 3 months after admission, and major adverse cardiovascular events (MACEs) were recorded. Results During the observation period, the serum cFLC level of STEMI patients gradually increased, reaching the peak value on the 7th day of onset, at this time, the serum cFLC level was significantly higher than that of the control group (P＜0.001). According to the median value of serum cFLC on the 7th day of onset (0.66mg/L), STEMI patients were divided into low cFLC level subgroup and high cFLC level subgroup. The serum cFLC level on the 7th day of onset was positively correlated with SYNTAX score and peak cardiac troponin I (cTnI) in STEMI patients (P＜0.05). After 3 months, left ventricular ejection fraction (LVEF) improved in the low-cFLC subgroup (P＜0.001), but not in the high-cFLC subgroup (P=0.544). Patients in the high cFLC level subgroup had a slightly lower LVEF than those in the low CFLC level subgroup at 3 months after surgery, and the proportion of patients with LVEF≤50% was higher (P＜0.001). The change of LVEF was negatively correlated with the serum cFLC level on the 7th day of onset (P＜0.001). COX regression analysis showed that serum cFLC on the 7th day of onset was an independent risk factor for MACEs (P＜0.001), and the area under receiver operating characteristic curve for predicting MACEs was 0.924 (95%CI: 0.889～0.960). Conclusion Early elevated serum cFLC levels in acute STEMI patients are associated with poor improvement in left ventricular function after PCI and with the risk of MACEs, thus cFLC has the potential to be a novel biomarker for left ventricular dysfunction.

The correlation between plasma fibrinogen level and perivascular space enlargement in lacunar cerebral infarction

郑,,邵, — 2023/3/6 16:36:43

【Abstract】 Objective To investigate the relationship between plasma fibrinogen level and perivascular space enlargement in lacunar cerebral infarction. Methods 172 patients with lacunar cerebral infarction with expanded perivascular space admitted to the Department of Neurology of the Second People's Hospital of Lianyungang City from January 2021 to June 2022 were retrospectively included. The number and severity of EPVS were assessed by cranial MRI. They were divided into basal ganglia region (BG-EPVS), central semiovale region (CSO-EPVS) mild group (grade 0-1: ≤10) and moderate and severe group (grade 2-4: >10), and compared the general data of the two groups. Multivariate Logistic regression model was used to analyze the relationship between plasma fibrinogen level and EPVS. Results A total of 172 patients were included in this study, including 57 cases in the mild group of BG-EPVS, 115 cases in the moderate and severe group, 100 cases in the mild group of CSO-EPVS, and 72 cases in the moderate and severe group. There were statistically significant differences in age, hypertension, TC, HDL and fibrinogen water (all P<0.05). Plasma fibrinogen level in moderate to severe group (4.090.69g/L) was significantly higher than that in mild group (3.650.58g/L). The difference was statistically significant (t=-4.146, P < 0.001). There was no significant difference in plasma fibrinogen level between mild and moderate to severe CSO-EPVS groups (P = 0.314). Multivariate Logistic regression analysis showed that age(OR = 1.047, 95%CI: 1.010-1.085, P = 0.011), hypertension (OR = 0.413, 95%CI: 0.174-0.981, P = 0.045), fibrinogen level (OR = 2.312, 95%CI: 1.286-4.157, P = 0.005) was an independent risk factor for moderate to severe BG-EPVS. Spearman correlation analysis showed that plasma fibrinogen level was positively correlated with the severity of BG-EPVS (r = 0.315, P<0.001). Conclusion Plasma fibrinogen level is positively correlated with the severity of BG-EPVS in lacunar infarction patients, and is an independent risk factor for moderate to severe BG-EPVS.

Low expression of LAMC3 affects paclitaxel resistance in ovarian cancer

夏莲萍 — 2023/3/6 16:35:26

Objective To investigate the effect of LAMC3 low expression on paclitaxel (PTX) resistance in ovarian cancer (OC), and further elucidate the relationship and molecular pathway of LAMC3 with PTX resistance in OC. Methods Western blot was used to detect the expression of LAMC3 in PTX-resistant OC cells HeyA8-R (H-R) and its parent cells HeyA8 (H). Stable transfected cell lines interfered with LAMC3 were constructed by lentiviral transfection. CCK-8 assay was used to detect the half maximal inhibitory concentration of cells to PTX (IC50). The cell clone formation ability was measured by plate clone formation assay. The expression levels of key pathway proteins were also detected by western blot. Results LAMC3 was significantly downregulated in OC PTX-resistant cells H-R and H-R-C3 shRNA3 compared with its parent cells H and control cells H-R-C3 Scramble. Low expression of LAMC3 not only reduced the resistance to PTX but also decreased the clone formation ability of PTX-resistant OC cells under a certain concentration of PTX treatment. The results of Western blot showed that the low level of LAMC3 could affect the expression levels of key proteins such as multidrug resistance, cell cycle and cell apoptosis under the concentration gradient treatment of PTX. Conclusion Low expression of LAMC3 may reduce the resistance of PTX-resistant OC cells to PTX by affecting multidrug resistance, cell cycle, and cell apoptosis, suggesting that LAMC3 may become a new potential target for drug resistance research in OC.

Research progress on neutrophil extracellular traps in colorectal cancer

党春萍 — 2023/3/3 11:54:54

Neutrophil extracellular traps (NETs) are fibrous structures released by neutrophils. The formation process is called NETosis. Recent studies have found that NETs can promote the proliferation, metastasis and recurrence of colorectal cancer. It is closely related to the prognosis of colorectal cancer. In this paper, the relationship between NETs and colorectal cancer was systematically reviewed to further understand the mechanism and clinical value of NETs in colorectal cancer. It provides new ideas for the treatment strategy and prognosis of colorectal cancer.

Research progress of M2 macrophages in pulmonary fibrosis

pidingnan — 2023/3/3 11:53:59

Pulmonary fibrosis is an interstitial lung disease caused by excessive deposition of extracellular matrix, which leads to the destruction of lung structure and scar formation. M2 macrophages are innate immune cells that can regulate tissue repair after damage by secreting a variety of pro-fibrotic mediators and play an important role in the pathogenesis of pulmonary fibrosis.This paper summarizes the latest research progress on the effect of M2 macrophages on the pathogenesis of pulmonary fibrosis, which provides a reference for the related research of M2 macrophages in pulmonary fibrosis and clinical ideas for anti-fibrosis treatment by targeting and regulating M2 macrophages.

Analysis of the influence of clinical path type early rehabilitation training on aspiration pneumonia and aspiration pneumonia in patients after TBI

张昭贤,朱旭 — 2023/3/3 11:53:22

Objective: To analyze the influence of clinical path type early rehabilitation training on aspiration and aspiration pneumonia after TBI. Methods: 88 patients with TBI admitted in our hospital from January 2020 to March 2021 were selected as cases. They were randomly divided into two groups, 44 cases in each group. The control group was treated with routine nursing intervention, and the observation group was treated with clinical path type early rehabilitation training. The intervention effects of the two groups were compared. Results: The incidences of aspiration in the observation group were 22.73% lower than those in the control group (50.00%), and the incidences of aspiration pneumonia were 18.18% lower than those in the control group (43.18%), with significant differences (P<0.05). After intervention, the scores of bad mood, motor function and quality of life in the observation group were better than those in the control group (P<0.05). Conclusion: The clinical path early rehabilitation training for patients after TBI has a good effect, significantly reducing the incidence of aspiration and aspiration pneumonia, and is feasible for clinical application.

One case of thyroid carcinoma with pulmonary mycobacterium avium infection

lilongmin,, — 2023/3/3 11:52:40

We report a case of thyroid cancer after surgery and 131I treatment. CT scan revealed progressive enlargement of nodules in the left upper lobe. PET/CT showed elevated metabolism nodules in the upper lobe of the left lung, which was considered as primary lung cancer. The pulmonary nodules were resected, and the postoperative histopathological examination combined with molecular pathological examination resulted in the diagnosis of pulmonary non-tuberculous mycobacterium (Mycobacterium avium) disease. Through the analysis of this case, the aim is to improve doctors' understanding of this disease and avoid misdiagnosis.

A case of early-infantile-onset developmental and epileptic encephalopathy due to ALG13 gene variant

yanshuang — 2023/3/3 11:51:57

The 2 years’ clinical data of a child with early-infantile-onset developmental and epileptic encephalopathy caused by ALG13 gene mutation admitted to the neurology department of Wuhan Children"s Hospital for 2 years were retrospectively analyzed. The 7 months old female patient was admitted to the hospital due to the discovery of the backward wing for 2-3 months. The onset was the spasm, accompanied by delayed psychomotor development. The electroencephalogram showed a slightly slow dominant rhythm in the occipital region and multifocal discharge. The heterozygous missense mutation at the c.320A>G (p.N107S) site was a spontaneous mutation. The patient was poorly controlled by a variety of antiepileptic drugs (vigabatrin, topiramate, levetiracetam, and lamotrigine), but controlled by the addition of perampanel. For children with early onset developmental and epileptic encephalopathy or developmental disabilities, genetic testing should be performed as soon as possible to help clarify the diagnosis and prognosis.

Clinical analysis of interventional therapy in children with patent foramen ovale:21 cases report

gaoqinling,liyinfeng,liuhaibin,liuwenlong,mayunxia,孙胜涛,张庆彪 — 2023/2/16 15:50:49

Objective To analyse the indication for interventional therapy in children with patent foramen ovale(PFO). Methods A total of 21 pediatric cases of PFO treated by intervention therapy from January 2017 to Desember 2018 in Linyi People’s Hospital were analysed. Results There were 7 cases of migraine symptoms disappeared among 9 ones.The symptoms of 6 children with chest discomfort and palpitation disappeared completely. Transthoracic echocardiography(TTE) showed the diameter of the right atrium(RA )and right ventricular(RV) were reduced after the procedure in 1 month,1 month，3 months，6 months and 12 months（P＜0.05）. Conclusions The indication for interventional therapy in Children with PFO is PFO diameter more than 3 mm(including 3 mm) and accompanied by migraine or chest discomfort ,palpitation ,and with ASD.

Clinical Observation of Biofeedback Combined with Prucalopride in the Treatment of Senile Patients with Functional ConstipationChen Xiuqin, Pan Shubo, Dou Wenhuan, Sun Jie, Shi Xiaohua

程秀琴,窦文欢,潘淑波,孙洁 — 2023/2/15 17:04:17

Objective To explore the efficacy and safety of biofeedback combined with prucalopride in the treatment of senile patients with functional constipation. Methods From July 2019 to Dec 2021,a total of 84 senile patients with functional constipation met Rome IV criteria were enrolled in this study．All cases were divided into observation group and control group equally by random number table method. Observation group was given biofeedback therapy. Both of groups were given prucalopride 2mg orally before breakfast for 6 weeks continuously. The clinical efficacy, constipation score,SCBM score, recurrence rate and adverse reactions were compared between 2 groups. Results The total effective rate of observation group was 83.3%,which was significantly higher than that of control group(61.9％),with statistical significance(P＜0.05). There was no statistical significance for constipation score and SCBM score before treatment between 2 groups(P＞0.05).Those indexes of observation group after 6 weeks of treatment were significantly better than those of control group at the same time,with statistical significance(P＜0.05). The recurrence rate of observation group was (11.9%),which was significantly lower than that of control group(28.6%),with statistical significance(P＜0.05).No significant ADR was observed in 2 groups. Conclusion Biofeedback combined with prucalopride in the treatment of senile patients with functional constipation could be an effective method with low recurrence rate.

Effects of obstructive sleep apnea hypopnea syndrome on maternal and infant outcome in pregnant women

liuli,zhanglimin — 2023/2/15 17:01:31

Objective To explore the effect of obstructive sleep apnea hypopnea syndrome（OSAHS）on the outcome of pregnant women. Methods 156 pregnant women were screened for respiratory and sleep disorders，and according to the results above the women were assigned into OSAHS group（n=42）and non-OSAHS group（n=112）.The clinical characteristics，delivery outcome and neonatal outcome of the two groups were compared. Results (1) The proportion of obese pregnant women in the pre-pregnancy, second trimester and third trimester (BMI≥28) in OSAHS group (respectively 33.3%, 29.1%, 72.7%) was higher than that in non-OSAHS group (respectively 3.5%, 2.7%, 35.9%)(p<0.05). (2) The incidence of hypertensive disorder of pregnancy（HDP）, gestational diabetes mellitus（GDM）, fetal growth restriction(FGR), still birth and preterm birth in OSAHS group (respectively 47.6%, 47.6%, 9.5%, 4.8%, 16.7%) were significantly higher than those in non-OSAHS group (respectively 8.8%, 29.8%, 1.8%, 0, 5.3%)( P < 0.05), and there was no significant difference in the incidence of oligohydramnios, cesarean section and postpartum hemorrhage between the two groups (P>0.05). (3) The incidence of low birth weight infants in the OSAHS group (8.8%) was lower than that in the non-OSAHS group (28.6%) (P<0.05), and there was no significant difference in the outcome of neonatal asphyxia between the two groups (respectively 2.4% and 0.9%) (P>0.05). Conclusions OSAHS of pregnant women is closely related to the occurrence of HDP, GDM, FGR, still birth, preterm birth and low birth weight infants. Therefore, the knowledge of dissemination and screening about OSAHS during pregnancy should be strengthened, and the maternal and infant outcome should be improved through life-style changes and medical intervention when necessary.

Laparoscopic cysticu duct V cuting and molding treat type II Mirizzi syndrome

tianye — 2023/2/15 16:54:23

[Abstract] Objective To explore the method and clinical experience of Laparoscopic cysticu duct V cuting and molding in the treatment of type II Mirizzi syndrome. Methods The clinical data of 6 patients with Type II Mirizzi syndrome treated in the department of hepatobiliary Surgery of Taizhou People's Hospital from January 2019 to January 2022 were retrospectively analyzed, and the diagnostic methods, surgical methods, and long-term treatment results were analyzed. Results All the 6 patients underwent Laparoscopic cysticu duct V cuting and molding to repair biliary duct defects, choledochoscopy, and T tube decompression. No intraoperative biliary tract injury, no postoperative biliary leakage, no recurrence of stones, small gallbladder and biliary tract stenosis up to now. Conclusion Laparoscopic cysticu duct V cuting and molding for type II Mirizzi syndrome has a good therapeutic effect.

Advances in molecular mechanism of ovarian hyperstimulation syndrome,WANG TIan,MO Shao-kang,WANG Ling.The first Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,China;Reproductive Medicine Centre, JLSO 940 Hospital,Lanzhou 730050,China

wangtian — 2023/2/14 16:42:17

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious iatrogenic complications in assisted reproductive technology.?In the process of controlled ovulation stimulation, some patients will develop ovarian hyperstimulation syndrome, which affects the clinical outcome of assisted reproductive technology treatment, increases the psychological and economic burden of patients, and endangers the life safety of patients in severe cases.?Therefore, the study on the molecular mechanism of ovarian hyperstimulation syndrome is of great guiding significance for clinical prevention and treatment.With the in-depth study of OHSS, the traditional theory believes that the occurrence of OHSS is related to vascular endothelial growth factor (VEGF), interleukin, tumor necrosis factor (TNF) and so on.Recent studies have found that the occurrence of OHSS is also related to angiopoietin (ANGPT), platelet-derived growth factor (PDGF), melatonin and exosomes.This article reviews the recent progress of molecular mechanisms related to the occurrence of OHSS, systematically expounds how each molecule affects and mediates the occurrence of OHSS, and provides a theoretical basis for the prevention and treatment of ovarian hyperstimulation syndrome.

Progress in mechanism of brutton tyrosine kinase inhibitor induced atrial fibrillation

高士豪 — 2023/2/14 16:39:58

Bruton's tyrosine kinase (BTK) inhibitors can inhibit the growth of B cell related malignancies by targeting BTK in the B cell receptor pathway. However, during the use of BTK inhibitors, some patients developed drug-related atrial fibrillation (AF) . As the most common type of arrhythmia, it is particularly important to study the mechanism of its occurrence and development in the treatment of heart related diseases. By exploring the mechanism of inducing AF during the use of BTK inhibitors, a new idea is provided for the study of the pathogenesis of atrial fibrillation. This article reviews the mechanism of AF induced by BTK inhibitors.

Research Progress on The Mechanism of Adenosine Receptor in Affective DisorderFeng Dan? Zhang Biao Tang Ming Zhi Liu Hai Jing*

feng dan — 2023/2/14 16:37:23

Affective Disorder (AD) is a kind of mental disorder with high incidence,its pathogenesis is very complicated，It is of great significance for basic research and clinical treatment of affective disorder to find out the relevant pathogenesis of affective disorder.Adenosine receptor plays an important role in affective disorder,this article systematically reviewed the mechanism of adenosine receptors in depression, anxiety and other affective disorders.

Effects of pre-pregnancy ACI health services and cognitive behavioral intervention in perinatal health care

张婷婷, — 2023/2/14 16:32:41

Objective To explore the effects of pre-pregnancy assessment, counseling and intervention (ACI) health services and cognitive behavioral intervention in perinatal health care and prevention of group B streptococcus infection. Methods Using random number table method, 260 women who were planning to become pregnant and admitted to the department of reproductive health of the hospital from March 2018 to March 2019 were divided into observation group (125 cases) and control group (135 cases). The control group received routine pre-pregnancy education, while the observation group received pre-pregnancy ACI health services and cognitive behavioral intervention. The pregnancy knowledge, attitude and practice scores, and self-efficacy scores were recorded. The implementation of antenatal care, incidences of GBS infection and adverse pregnancy outcomes were statistically analyzed. Results After the intervention, the pregnancy-related knowledge, attitude and practice scores, and self-efficacy score of the observation group were significantly higher than those of the control group (P<0.05). The average number of production checkups in the observation group was significantly larger than that in the control group. The registration rate in early pregnancy and screening rate of high-risk pregnancy were higher than those in the control group (P<0.05). The GBS infection rate and the overall incidence of adverse pregnancy outcomes in the observation group were lower than those in the control group (P<0.05). Conclusion Pre-pregnancy ACI health services combined with cognitive behavioral intervention can improve pregnancy knowledge, attitude and practice as well as self-management efficiency of pregnant women while reducing the occurrence of GBS infection and adverse pregnancy outcomes.

Laparoscopy combined with choledochoscopy in the treatment of rare bile duct variations complicated with intrahepatic bile duct stones and literature review.

Le wenjin,Peng Tao,Yang Yanliang,Zhang Tiequan,Zuo Hongping — 2023/2/14 16:28:03

Objective To evaluate the feasibility and clinical value of laparoscopy combined with choledochoscopy in the treatment of bile duct variation complicated with intrahepatic bile duct stones．To analysis of the relationship between bile duct variation, iatrogenic bile duct injury and bile duct stones. Methods The clinical data of a case of laparoscopic combined with choledochoscopy for rare bile duct variation confluence into the right anterior branch hepatic duct with right intrahepatic bile duct stone formation and hilar bile duct stenosis completed in our hospital in October 2021 were retrospectively analyzed． Results The operation time was about 341 min，and the intraoperative blood loss was 50 ml．No blood transfusion was performed during the operation． The T-tube was removed after a T-tube angiogram for patient in the 3rd postoperative month. The patient was followed up for 6 months and no stone recurrence was found on abdominal CT． Conclusion Bile duct variation is associated with iatrogenic bile duct injury and stone formation. When the variant hepatobiliary duct is complicated with stones and strictures, its clinical diagnosis and surgical management are quite difficult. Laparoscopy combined with choledochoscopy is feasible in the treatment of bile duct variation complicated with intrahepatic bile duct stones and bile duct stricture, but the long-term efficacy needs to be supported by large multi-center data of multiple cases.

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骆文志,王雅娟 — 2023/2/14 16:25:51

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Effect of Levofloxacin Prophylaxis on Bloodstream Infection in Children With Acute Lymphoblastic Leukemia

CHU Jinhua,LIU Kangkang,TANG Yunyun — 2023/2/14 15:56:03

Objective To study the efficacy of preventive levofloxacin in reducing bloodstream infection (BSI) during induction therapy (CAT) in children with acute lymphoblastic leukemia (ALL), and guide clinical treatment. Method Collect the case data of children with ALL diagnosed and treated in the Department of Pediatric Hematology and Oncology of the Second Affiliated Hospital of Anhui Medical University from January 2015 to August 2022. Among them, 60 children who used levofloxacin prophylactically during CAT were taken as the prevention group, and 264 children who did not receive preventive treatment were taken as the control group. Compare the two groups of BSI, febrile neutropenia (FN), clinically documented infection (CDI) Inflammatory index and antibiotic use. Result During CAT, the incidences of BSI, FN, CDI and severe infection in the prevention group were 5.00%vs14.40%, 58.30%vs78.00%, 65.00%vs85.60% and 3.30%vs17.00%, respectively, compared with the control group(P＜0.05); In the prevention group, the PCT value was lower, and hospitalization duration were shorter(P＜0.05); The incidence of using≥3 kinds of antibiotics after infection in the prevention group and the control group was 20.0%vs 48.1%, in which the exposure rates of cephalosporins and macrolides were 58.30%vs75.80% and 8.30% vs 29.20%, respectively. The average duration of antibiotic use after infection was 7 days and 8 days (P＜0.05). Conclusion The prophylactic use of levofloxacin can significantly reduce the incidence of BSI, FN, CDI, and severe infection during CAT, reduce the types and duration of combined use of empirically treated antibiotics after infection, reduce the exposure of cephalosporins and macrolides, reduce the risk of respiratory tract infection, and there is no obvious adverse reaction.

To evaluate the value of iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification (IDEAL-IQ) sequence in the diagnosis of osteoporotic (OP)

黄国强¹,黄玉龙²,刘豪¹,唐启英¹,王福南¹,朱柳红¹ — 2023/2/14 15:54:34

Objective: To evaluate the value of iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification (IDEAL-IQ) sequence in the diagnosis of osteoporotic (OP).Methods: Forty patients with OP were enrolled in the retrospective study. All patients underwent both MR examination with IDEA-IQ sequence and bone mineral density examination. The fat fraction (FF) and bone mineral density (T) values were measured on L1-4 vertebrals of all patients, respectively. According to the measured bone density, 40 patients were divided into 2 groups: normalgroup (n=20) and OP group (n=20). Spearman correlation analysis was applied to analyze the correlation between T and FF values, and receiver operating characteristic (ROC) curve was performed to analyze the diagnostic efficiency of FF values.Results: The OP group showed statistically higher FF and lower T values, compared with the normal group (P<0.05). FF value was negatively correlated with T value （R=﹣0.642, P<0.05）.The ROC curve analysis showed that the AUC of FF value in diagnosing OP was 0.922, with an optimal cut-off value of50.42% (88.1% sensitivity; 82.6% specificity; 0.707 Youden index). Conclusion: The FF value derived from IDEAL- IQ canevaluate vertebral bone density of patients with OP, which is valuable for the diagnosis of OP.

The Effect of different ventilation strategies on mechanical power and inflammatory factor levels in patients undergoing laparoscopic colorectal cancer surgery

王佐焕 — 2023/2/14 15:53:26

[Abstract Objective] To observe the effects of different ventilation strategies on mechanical power（MP）and inflammatory factor levels in laparoscopic colorectal cancer surgery. Methods Of 60 patients, aged of 50-80yr, with BMI 19-30kg/m2 and ASA II-III grade, were selected. They were randomly divided into (group V) and (group P). Group V was routine ventilation and group P was lung protection ventilation. Ventilation parameters after anesthesia induction, that group V was treated with tidal volume of 9ml/kg and PEEP=0cmH2O, while group P was adopted with tidal volume of 7ml/kg and PEEP=5cmH2O, and other settings were same. Peak airway pressure (Ppeak), airway plateau pressure (Pplat) and pulmonary dynamic compliance (Cdyn) was recorded and after endotracheal intubation 5 min (T1), after establishment of CO2 pneumoperitoneum 10 min (T2) and 60 min (T3), and after pneumoperitoneum disappeared and returned to supine position 10 min (T4) and mechanical power (MP) were calculated. Radial artery blood were collected at T1-T3 and PACU for blood gas analysis, and pH, PaO2, PaCO2, oxygenation index(OI) and alveolar - arterial oxygen differential (PA-aO2) were recorded, the concentrations of lung Clara cell secretory protein (CC-16), Interleukin-6 (IL-6) and of Neutrophil elastase (NE) in serum were measured at T1, T3 and immediately after operation respectively. Results MP in the two groups increased at T2-4, and the concentrations of serum CC-16, IL-6 and NE increased at T3 and after operation (P<0.05); Compared with the group V, MP in group P was lower at T2-4, and the concentrations of serum CC-16, IL-6 and NE were lower at T3 and after operation (P<0.05); The total mechanical power during pneumoperitoneum was correlated with the concentration changes of serum CC-16, IL-6 and NE (P<0.05). Conclusion The effect of ventilation mode in group P on mechanical power and inflammatory factor levels was less.

Exploring the changes in vitamin D concentrations and the role of vitamin D in children with simple obesity

Cao Zhongqiang,Changes Xuening,He Peiling,Li Shihan,Mei Hong,Wang Yuanyuan — 2023/2/14 15:51:11

Objective The analysis of serum vitamin D (Vit D) levels in children with simple obesity was used to analyse its association with indicators related to obesity metabolism and its role. Methods Fifty cases of children with simple obesity and 50 cases of normal weight children, aged 7-14 years, were recruited for the study. The obese group was given a comprehensive weight reduction intervention for 3 months, and Vit D concentrations and related indicators were measured before and after the intervention. Pearson correlation and regression analysis were used for statistical analysis. Result 1. Vit D levels were lower in obese children than in the normal group, but the difference was not statistically significant (P>0.05). 2. Pearson correlation analysis: Vit D was negatively correlated with waist circumference (WC), BMI and insulin resistance index, et al. 3. Multiple linear regression analysis Vit D levels were negatively correlated with △LDL(low-density lipoprotein Cholesterol) [β= -(95% CI: -0.047 to -0.003), P=0.029]; △Vit D was negatively correlated with △WC [β=-1.019 (95% CI: -1.758 to -0.28), P=0.008) and △FBG(Fasting blood glucose) [β=-0.05 (95%CI: -0.09~-0.01) , P=0.016]. Conclusion Vit D is closely related to metabolic markers in children with simple obesity, and a decrease in Vit D can affect metabolism and weight loss in obese children.

Construction and mechanism of sorafenib-resistant hepatocellular carcinoma cell line

黄雪莲,黎凤炎,王文娟,夏雨艳 — 2023/2/14 15:49:50

Objective To construct sorafenib-resistant hepatocellular carcinoma cell lines and explore their biological characteristics and potential drug resistance mechanisms. Methods Detection of the reliability of origin of wild-type HepG2 and Huh7 cell lines using short tandem repeat genes; CCK8 assay to detect the effect of drugs on cell proliferation inhibition; wound healing assay to assess cell migration ability; flow cytometry analysis of cell apoptosis; Western blotting and real-time quantitative RT-PCR were used to detect the protein or mRNA expression of apoptosis-related factor Caspase3 and autophagy marker molecules P62 and LC3. Results The Sorafenib-resistant liver cancer models of HepG2 and Huh7 were obtained by increasing the concentration method. The inhibitory effect of sorafenib on the proliferation of drug-resistant strains and wild strains was concentration-dependent, and increased with the increase of sorafenib concentration. Under the same concentration of sorafenib, drug-resistant strains had higher anti-apoptosis and migration abilities than wild strains. Further experiments showed that compared with the wild strain, the expression of Caspase3 and P62 in the drug-resistant strain was down-regulated, and the expression of LC3 was up-regulated. Conclusion HepG2 and Huh7 sorafenib-resistant hepatocellular carcinoma cell lines were successfully constructed, and the drug-resistant strains had stronger anti-apoptosis, anti-inhibition and migration abilities and higher levels of autophagy, which were provided a theoretical model and basis for overcoming the resistance of liver cancer cells to sorafenib.

Effect of Garcinone C on senescence, migration and invasion of Nasopharyngeal carcinoma HK1 and HONE1 cells

Wei Dan,Yin Fuqiang,Zhang Han — 2023/1/29 15:48:26

Objective To investigate the effects of Garcinone C on senescence, migration and invasion of nasopharyngeal carcinoma cells and explore the mechanism of action. Methods Gradient concentrations of Garcinone C were applied to treat HONE1 cells, and then senescent cells were detected by β-galactosidase staining. To indicate the effect of Garcinone C on migration and invasion of HK1 and HONE1 cells, Transwell assays were performed. Western blot was conducted to examinate the expression levels of epithelial-mesenchymal transition (EMT) associated proteins E-Cadherin, N-Cadherin and tissue inhibitor of matrix metalloproteinase 2 (TIMP2). As well as the expression levels of ferroptosis related proteins ferritin heavy polypeptide 1 (FTH1) and solute carrier family 7 member 11(xCT /SLC7A11)were expressed by western blot. Results β-galactosidase staining showed that the senescence rate of HONE1 cells was significantly increased after Garcinone C treatment, compared with the control group. Transwell assays indicated that Garcinone C markedly inhibited the ability of migration and invasion in both HK1 and HONE1 cells. Western blot analysis showed that Garcinone C upregulated the expression levels of E-Cadherin and TIMP2, and downregulated the expression level of N-Cadherin, FTH1 and xCT. Conclusion Garcinone C significantly inhibited the migration and invasion of nasopharyngeal carcinoma HK1 and HONE1 cells, and induced senescence of HONE1 cells. Ferroptosis was also induced in HK1 and HONE1 cells with the application of Garcinone C.

Clinical effect of preventive resin restoration on permanent molars of three restorative materials SHI Chun-mei,HUANG Cheng-cheng, LUO Ju-fen,OU Xiao-li, LIANG Qun.People’s Hospital of Guangxi Zhuang Autonomous Regien,Nanning 530021,China

黄程成,,,,SHI Chun-mei — 2023/1/16 10:27:40

Objective The aim of this research was to evaluate the clinical effect of Dyad Flow self-adhesive flowable composite(DF) and Beautifil Flow Plus F03 conventional flowable composite (F03) in the application of preventive resin restoration(PRR) in fissure caries molars.Methods 184 permanent molars with occlusal pit and fissure caries were selected. The teeth were randomly assigned to following two groups： Group A: Dyad Flow self-adhesive flowable composite(experimental group)；Group B：Beautifil Flow Plus F03 flowable composite(control group). After occlusal caries had been removed, the cavity was stored with the above-mentioned materials. Meanwhile, the operation time of each tooth was recorded by assistants. The modified USPHS criteria was used to evaluate postoperative efficacy. Kruskal-Wallis and Kapaln-Meier tests serve for statistical analyses by SPSS 22.0 (P=0.05).Results 91.8% teeth were follow up time ranged from 1 to 3 years. There was no significant difference between 2 groups in retention rate, marginal discoloration and surface texture within 24 months. 6 months after restoration the secondary caries rates in the F03 group was lower than the DF group. Restoration survival rates DF = 82.3%；F03 = 91.8% ,P ＞ 0.05.The differences in operation time between the both groups were statistically significant (P < 0.05).Conclusion The use of DF shows great features in clinical application , and more indications must be investigated further with in vitro and in vivo trials.

Value of capillary index score in cases selection for mechanical thrombectomy due to anterior circulation large vessel occlusion

杨明昊 — 2023/1/10 16:58:30

Objective To explore the value of capillary index score (CIS) in cases screening for mechanical thrombectomy due to anterior circulation large vessel occlusion (LVO). Methods Patients who underwent mechanical thrombectomy for acute anterior circulation LVO between January 2016 and July 2021 were enrolled. CIS scoring was calculated based on preoperative digital subtraction angiography, scores of 0~1 was defined as poor CIS (pCIS) and 2~3 was defined as favorable CIS (fCIS). Clinical characteristics and outcomes were compared between the two groups. Exploring the risk factor for unfavorable outcome and malignant brain edema after mechanical thrombectomy. Results A total of 106 patients were included in the study, of whom 44 (41.51%) patients had poor CIS and 62 (58.49%) had favorable CIS. The proportion of patients with hypertension (P=0.040) and coronary heart disease (P<0.040) as well as Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (P<0.001) in pCIS group were significantly lower than those in fCIS group. National Institutes of Health Stroke Scale (NIHSS) score at admission (P=0.005), the proportion of rescue therapy (P<0.001), the proportion of unfavorable outcome (81.82% vs 41.94%, P<0.001) and large cerebral edema after thrombectomy (63.64% vs 12.90%, P<0.001) as well as 90 day mortality (43.18% vs 16.13%, P=0.002) in pCIS group were significantly higher than those in fCIS group. Multivariate logistic regression analysis showed that pCIS was an independent risk factor for unfavorable outcome (P=0.002) and malignant brain edema (P<0.001) after mechanical thrombectomy in anterior circulation LVO patients. Conclusion Anterior circulation LVO patients with poor CIS have an unfavorable outcome and a high proportion of malignant brain edema after mechanical thrombectomy, which should be cautiously considered.

Value of VI-RADS score in myometrial invasion of bladder cancer

chuyulu — 2023/1/10 16:57:43

Objective To study the value of bladder imaging reporting and data system (VI-RADS) combined with multi-parameter magnetic resonance (mp-MRI) in the myometrial invasion of bladder cancer. Methods Methods 59 patients of Chuzhou Hospital of Anhui Medical University from May 2018 to July 2022, patients were divided into myometrial invasive bladder cancer (MIBC) and non-myometrial invasive bladder cancer (NMIBC). Two imaging doctors independently scored the scoring criteria of VI-RADS, and compared the score of VI-RADS and pathological results to evaluate the diagnostic value of VI-RADS score and mp-MRI on MIBC. The effectiveness of the infiltration in the diagnosis of VI-RADS score was analyzed using the subject working characteristic (ROC) curve. Results The VI-RADS scores were well (compliance rate was 81.67%, kappa value =0.755, P <0.001). ROC curve analysis showed that when the VI-RADS score was 3.5, the area under the curve of MIBC was 0.880 (95%CI 0.790-0.971), the maximum yoden index was 0.584, the sensitivity was 63.64%, and the specificity was 94.74%. Conclusion The accuracy of VI-RADS score for bladder cancer is worth clinical promotion.

Effect of intravitreal injection of anti - vascular endothelial growth factor (vegf) on wet senile macular degeneration and its effect on patients with inflammatory cytokines

谢琦莲 — 2023/1/10 16:57:00

To observe the efficacy of intravitreal injection of anti-vascular endothelial growth factor (VEGF) ranibizumab in the treatment of wet age-related macular degeneration (wAMD) and its effect on the inflammatory factors in the patient's aqueous humor. Methods: We prospectively selected 112 patients (112 eyes) of wAMD in our hospital from January 2018 to September 2020 as the research subjects, and randomly divided them into two groups by using a digital table. 56 patients were given intravitreal injection of anti-VEGF ranibizumab The treated patients were set as the VEGF group, and the 56 patients who were given photodynamic therapy (PDT) were set as the PDT group. Before treatment and 3 months after treatment, the ophthalmology-related indicators were checked, and the aqueous humor was taken to check the inflammatory factors, and the two groups were compared. Before treatment, 3 months and 6 months after treatment, visual changes were recorded, and complications were recorded in the two groups. Results: The IOP, CNV and CMT of the two groups were lower than those before treatment at 3 months after treatment, and the difference was statistically significant (P＜0.05), but there was no difference in IOP, CNV, CMT between the two groups before treatment and 3 months after treatment Statistical significance (P>0.05). The levels of TNF-α and IL-6 in the VEGF group 3 months after treatment were lower than before treatment, and lower than those in the PDT group, the difference was statistically significant (P<0.05). The percentages of improved, stable, and decreased vision in the PDT group were 71.43%, 23.21%, and 5.36% after 3 months of treatment; 73.21%, 25.00%, and 1.78% in the VEGF group, and the differences were not statistically significant (P>0.05). 6 months after treatment, the visual acuity improvement rate of the VEGF group was 69.64%, and the visual acuity improvement rate of the PDT group was 50.50%. The visual acuity improvement rate of the VEGF group was significantly higher than that of the PDT group, and the difference was statistically significant (P<0.05). The incidence of complications in the two groups was 7.14%, and the difference was not statistically significant (P>0.05). Conclusion: Compared with photodynamic therapy, anti-VEGF intravitreal injection therapy can effectively control the condition of wAMD, eliminate or reduce the inflammatory response of aqueous humor, and improve the vision of patients.

Application of computerized digital preoperative planning for the placement of pedicle screws with severe lumbar degeneration

Wang Xiaozhen,,,, — 2023/1/10 16:55:56

Objective: To evaluate the value of computerized digital planning technique with Mimics Software for the placement of pedicle screws in severe degenerative lumbar facet joints. Methods: 47 patients with lumbar spinal stenosis and/or lumbar degenerative spondylolisthesis received TLIF surgery from May 2018 to May 2020，and 22 patients were selected as the observation group that theirs spine were revealed to 3D reconstruction visual mode by Mimics Software for simulating the placement of screws and planning the route before surgery. The length, diameter and angle of the screws, the height of the intervertebral space, the length of the rod were measured, so as to guide the placement of screw-rod internal fixation during operation. Another 25 patients were selected as the control group which with conventional methods to place the screws. Observable Indicators postoperative were analyzed and compared between two groups. Results: The number of screws in the observation group was 152, and 172 in control group. The operation time, amount of bleeding, radiation times were lower than those in the control group (P<0.05). The success rate of screws placement once was 87.79% (151/172) in control group, and 98.03% (149/152) in observation group which were higher(P<0.05). The accuracy was evaluated by Gertzbein-Robbins Grading system according to the CT scanning of the lumbar spine. There was no significant difference in accuracy of pedicle screws(P>0.05) between two groups. Conclusion: The placement of pedicle screws with severe lumbar facet joints degeneration is difficult which because of abnormal anatomy structure. The computerized digital measurement and planning is important reference value for providing symbols in TLIF, which can help to reduce the operation time, the amount of blood loss and the radiation time, and also improve the success rate of screws placement. Keywords: Lumbar; Severe facet joint degeneration; Three-dimensional reconstruction; Pedicle screw; Preoperation planning

Clinical application of bundle nursing on patients with extracorporeal membrane oxygenation combined with prone position ventilation.

yangqi — 2023/1/6 17:23:49

Objective: To evaluate the clinical effect of cluster nursing intervention for patients with extracorporeal membrane oxygenation combined with prone ventilation. Methods: from January 2019 to December 2020, 30 patients with extracorporeal membrane oxygenation combined with prone ventilation in the EICU were randomly divided into control group observation group, 15 cases in each group. The control group performed general nursing routines. The observation group was given bundled nursing interventions on this basis. The two groups of patients after nursing the status of various indicators were analyzed and compared. Results: The physiological indexes, the incidence of adverse events and nursing satisfaction in the observation group were significantly better than the control group. The difference was statistically significant(P<0.05)．Conclusion: Bundling care has positive significance for patients with extracorporeal membrane oxygenation combined with prone ventilation.

A case report of chronic wound repair in a patient with Pancytopenia caused by rheumatoid arthritisa

wangzhe — 2023/1/6 17:23:37

On September 19, 2020, a 56 year old female patient with pancytopenia and chronic wound caused by rheumatoid arthritis was treated in Guangzhou Red Cross Hospital Affiliated to Jinan University. After immunosuppressive treatment, rehydration and metachysis, application of cell stimulating drugs, improvement of microcirculation, adjustment of enteral nutrition and other comprehensive treatments to improve the general condition, local treatment is debridement and dressing change, flushing and using vacuum sealing drainage to make the wound generate fresh granulation, skin graft was performed, and postoperative anti infection, prevention of bleeding and nutritional support were treated. Finally, the skin graft survived and the wound was closed, the quality of life of patients was significantly improved. This case suggests that active and effective perioperative management and surgical treatment can repair the chronic wound and improve the prognosis in patients with pancytopenia caused by high activity rheumatoid arthritis.

Gitelman syndrome complicated with Graves disease: a case report and literature review

刘海波, — 2023/1/6 17:23:19

Gitelman syndrome (GS) is an autosomal recessive renal tubular salt loss disease, which is caused by SLC12A3 gene mutation on the long arm of chromosome 16. Hypokalemia is the most common clinical manifestation, and gene detection is the gold standard for diagnosis.Hypokalemia can also occur in patients with Graves disease due to extracellular potassium influx. The combination of the two diseases is clinically rare. It is necessary to carefully identify and give symptomatic treatment as soon as possible to improve the condition and prognosis.At the same time, combined with the latest literature, this paper expounds the pathogenesis, diagnosis and treatment progress of Gitelman syndrome, so as to better recognize and treat the disease.

Advances in investigating cGAS-STING signaling and intestinal barrier dysfunction in sepsis

高薇薇 — 2023/1/6 15:18:24

At the time of sepsis, cyclic GMP-Amp synthase-stimulator of interferon genes (CGAS-STING) signal pathway is activated and mediates inflammation and interferon-Ⅰ (IFN-Ⅰ) reaction. It can induce the destruction of tight junctions(TJs) and the death of Intestinal Epithelial Cells (IECs), which leads to the destruction of intestinal barrier integrity, it also can block autophagy and induce the formation of nod-like receptor protein 3 (NLRP3)inflammasome，which aggravates the intestinal inflammatory reaction, and finally leads to intestinal barrier dysfunction, resulting in intestinal permeability change and intestinal flora imbalance, causing bacteria and toxic products to migrate into the blood circulation, causing and aggravating sepsis and sepsis multiple organ dysfunction.Therefore, a deep understanding of the activation and mechanism of cGAS-STING signaling pathway during sepsis is of positive and far-reaching significance for improving intestinal barrier dysfunction in sepsis. In this paper, the activation of cGAS-STING signaling pathway, the relationship between cGAS-STING signaling pathway and intestinal inflammation in sepsis, and the influence of cGAS-STING signaling pathway on intestinal barrier function were reviewed in order to provide ideas and references for targeted therapy based on the interaction between cGAS-STING signaling pathway and intestinal barrier function in sepsis.

Research progress in the application of time-lapse imaging in in vitro fertilization-embryo transfer

wangshikai — 2023/1/6 15:17:36

The most effective method to reduce multiple pregnancies in in vitro fertilization-embryo transfer cycles (IVF-ET) is selective single embryo transfer, and assessing the developmental potential of embryos remains one of the most critical steps. Currently, most of the assessment of embryonic developmental potential is performed by static assessment systems, which are based on the morphology of the embryo and have certain subjectivity and limitations. With the widespread use of time-lapse imaging monitoring technology (Time-lapse), a comprehensive assessment can be performed by morphokinetic parameters and embryo cleavage patterns, which not only provides more valuable parameters for assessing embryonic developmental potential, but also overcomes the limitations of static assessment. This article will review the research progress of time-lapse in IVF-ET.

Recent advances in the role of lipoprotein a in atherosclerotic cardiovascular disease

Liu Guangzhong,LouQi,Wang Hong — 2023/1/6 15:16:06

The increase of lipoprotein (a) [Lp (a)] level is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD), such as coronary heart disease (CAD), stroke, peripheral arterial disease and calcified aortic stenosis (CAVS). Existing research evidence suggests that even if the level of low-density lipoprotein cholesterol (LDL-C) is controlled within the ideal range, high Lp (a) level will still increase the risk of ASCVD. However, there is some confusion about the comprehensive understanding of Lp (a). This paper will summarize the guidelines and suggestions at home and abroad from the cut-off point, detection population, pathogenic mechanism and treatment strategy of Lp (a) leading to the increase of CVD risk, and focus on the new progress of treatment with high Lp (a) level, in order to provide effective guidance for clinical work.

Clinical study on analgesic effect of Erector Spinae Plane Block with two approaches after Thoracoscopic lobectomy

wangjie — 2023/1/5 11:42:10

Objective To compare the analgesic effects of two different approaches of Erector spinae plane block (ESPB) after thoracoscopic surgery, and to provide evidence for clinical selection of ESPB pathways. Methods Ninety patients undergoing elective thoracoscopic lobectomy were randomly divided into three groups (n=30) : group E was the deep surface of erector spinae and transversal space block group (approach 1); Group R was the rhomboid muscle and erector spinae space block group (approach 2); Group C was the control group. Visual analogue scale (VAS) was used to observe and record the pain degree of patients at rest and when active or coughing at 6h (T1), 12h (T2), 24 h (T3) and 48 h (T4) after operation. The postoperative remedial analgesia and the incidence of adverse reactions were compared between the groups. Results The analgesic effect of group E at T1, T2 and T3 was better than that of groups R and C (P<0.05), the analgesic effect of group R was better than that of group C at T1 (P<0.05); Under postoperative activity or cough, the analgesic effect of group E at T1, T2 and T3 was better than that of groups R and C (P<0.05), the analgesic effect of group R was better than that of group C at T1 and T2 (P<0.05); At T4, there was no significant difference among the three groups (P>0.05). Compared with group C, the number of remedial analgesia within 48 hours after operation in groups E and R was decreased and the satisfaction score of analgesia was increased (P<0.05); Compared with group R, the number of remedial analgesia was decreased and the satisfaction score of analgesia was increased in group E (P<0.05). Conclusions Two different approaches of ESPB can alleviate postoperative pain and reduce the use of postoperative analgesic drugs to a certain extent, with fewer intraoperative and postoperative complications, and approach 1 is the best approach for analgesic effect.

Expression and clinical significance of Hsa_circ_0001785 in serum of breast cancer patients

zhuangxiaoxu — 2023/1/5 11:41:17

Objective: To explore the expression and clinical significance of hsa_circ_0001785 in serum of breast cancer patients. Methods: Serum hsa_circ_0001785 was detected by Q-PCR. The relative expression of hsa_circ_0001785 was analyzed by t-test. The relative expression of hsa_circ_0001785 was correlated with benign and malignant breast tumors and other clinical features; The diagnostic value of hsa_circ_0001785 in breast cancer was performed using ROC curve. Results: The relative expression level of hsa_circ_0001785 in breast cancer patients was higher than that of the other two groups(P < 0.05); There was no significant difference of hsa_circ_0001785 between the benign group and the health control group (P > 0.05). Hsa_ circ_ 0001785 had the same diagnostic ability as CEA in breast cancer, and had better diagnostic accuracy (AUC = 0.780). The relative expression of hsa_ circ_0001785 was not correlated with tumor type, TMN stage, distant metastasis and lymph node involvement. Conclusion: Hsa_ circ_ 0001785 high expression in malignant group has potential to become a molecular marker for breast cancer diagnosis.

Clinical Observation of Treating Chronic Rhinitis with Heat Accumulation through Lung by Press-needle Combined with Traditional Chinese Medicine

qiuxinying,,wuyongjun, — 2023/1/5 11:39:48

[Abstract] Objective To observe the clinical effect of press-needle combined with traditional Chinese medicine in the treatment of chronic rhinitis with heat accumulation through lung. Methods 60 patients diagnosed as chronic rhinitis of the pulmonary transfebrile type were divided into observation group and control group, 30 cases in each group. The observation group was treated with press needle combined with oral Chinese medicine, while the western medicine control group was treated with budesonide nasal spray for 28 days. The quantitative scores of symptoms and signs on D14 and D28 were compared between the two groups before and after treatment, and the clinical efficacy was evaluated. Results After treatment, the quantitative scores of symptoms and signs in the two groups were lower than those before treatment (P < 0.05), and there was no significant difference in the quantitative scores of symptoms and signs in D14 and D28 between the two groups after treatment. The total effective rate was 90% (27/30) in the observation group and 93% (28/30) in the control group. Conclusion Press-needle combined with traditional Chinese medicine has a good clinical effect in the treatment of chronic rhinitis with heat accumulation through lung, and the effect is comparable to budesonide nasal spray.

In vitro anti-HIV-1 activity of Mango(Mangifera indica L.) leaves extract

王倩,,, — 2023/1/5 11:38:51

Objective In this study, we aimed to reseach the cytotoxicity and anti-HIV-1 activity of mango(Mangifera indica L.) leaves extract in vitro and provide reference basis for the development of traditional Chinese medicine resources for AIDS treatment. Methods The cytotoxicity of the extract on TZM-bl and MT2 cells was evaluated by ATP assay. TZM-bl-HIV-1IIIB and MT2-HIV-1IIIB cell infection models were established to evaluate the anti-HIV-1 activity by detecting the expression of luciferase activity. Meanwhile, the inhibition of cytopathic effect (CPE) in MT2-HIV-1IIIB cell infection model was observed. Furthermore, the half cytotoxic concentration (CC50) was calculated to determine the cytotoxicity of the extract in vitro. The half inhibitory concentration (IC50) was calculated to determine the inhibitory activity of the extract on HIV-1 replication. And the drug selection index (SI) was calculated according to CC50 and IC50. Results Our results revealed that Mango(Mangifera indica L.) leaves extract showed dose-dependent anti-HIV-1 activity in different cell infection models. In TZM-bl-HIV-1IIIB model, the CC50 was 320.00±29.44 μg·mL-1, the IC50 was 8.86±0.26 μg·mL-1, and SI was 36.14. In MT-2-HIV-1IIIB model, the CC50 was 174.13±22.36μg·mL-1, the IC50 was 15.23±9.99μg·mL-1, and the SI was 11.44. Moreover, the cytopathic effect induced by HIV-1 was inhibited significantly by the extract in MT-2-HIV-1ⅢB model. Conclusion The traditional Chinese herbal medicine mango(Mangifera indica L.) leaves extract shows low cytotoxicity in vitro and remarkable anti-HIV-1 activity, which has potential development and utilization value.

Clinical Comparative study in the endoscopic Repair of tympanic membrane perforation with different Materials

zhangxiaodong, — 2023/1/5 11:37:31

Objective To compare the clinical effect of tympanic membrane perforation repair with different materials．Methods A total of 71 patients(71 ears) with tympanic membrane perforation repaired under endoscope ．All The patients were divided into three groups according to the repair material. 10 cases used temporal muscle fascia as repair material, 41 cases used tragus cartilage and 20 cases used tragus perichondrium．The operation station,the effect of hearing improvement after operation as well as the success rate of tympanic membrane repair were compared between the three groups．Results All the patients had been followed up for at least 6 months．The success rate of tympanic membrane repair of the group used tragus cartilage as material were less than the other two groups(p<0.05).There were no significant differences between all the groups in the operation time, postoperative average air-bone gap(ABG)and average air conduction hearing threshold (PTA)(p<0.05). The length of hospital stay of the group used tragus perichondrium as material were longer than the other two groups(p<0.05)．Conclusion Among the materials for tympanoplasty repair under otoendoscopy ,the tragus perichondrium cartilage has shorter operation time and good postoperative effect, which will reduce the rate of postoperative reperforation, and easy to operation and popularize.

Analysis of common problems in Chinese medical statistics

余军 — 2022/12/28 8:43:15

Research progress on gestational diabetes mellitus and intestinal microflora changes

caoyuzhi — 2022/12/9 8:16:37

Gestational diabetes mellitus (GDM) is one of the common complications of pregnancy, which manifests as abnormal glucose metabolism during pregnancy and causes serious effects on mother and child. Physiological changes in the number and type of intestinal flora occur during pregnancy, and numerous studies have shown that changes in the diversity and abundance of intestinal flora are potential contributors to the development of gestational diabetes. In this paper, we review the literature on the altered flora of women with gestational diabetes mellitus, focusing on the potential pathogenesis of GDM and ideas for the prevention and treatment of GDM.

Research progress in the treatment of myocardial infarction with mesenchymal stem cell transplantation

liushuheng — 2022/12/9 8:15:07

Coronary atherosclerosis heart disease is the most common type of organ lesions caused by atherosclerosis, among which myocardial infarction caused by myocardial ischemia, hypoxia or necrosis caused by coronary artery stenosis or occlusion poses a serious threat to human health, myocardial reperfusion therapy can open the occlusion of coronary artery, to save the dying myocardial or myocardial infarction narrow scope, reduce infarction myocardial remodeling, However, due to the limitation of reperfusion time, the influence of myocardial ischemia-reperfusion injury, and the risk of post-stent thrombosis cannot completely solve the problem of heart injury. In recent years, more and more preclinical and clinical evidences show that mesenchymal stem cell transplantation has achieved certain effects in the treatment of myocardial infarction, but there are still some problems and controversies. This article reviews the biological characteristics, mechanism of action, problems and prospects of mesenchymal stem cells.

Application of Individualized Rehabilitation Guidance Based on Relying on Medical Consortium in Elderly Patients After Hip Replacement

朱尚媚 — 2022/12/9 8:13:15

Objective To explore the effect of individualized rehabilitation guidance based on medical consortium in elderly patients undergoing hip replacement. Methods A total of 85 patients who underwent hip arthroplasty in the Chancheng District Central Hospital of Foshan City from May 2018 to May 2020 were selected. They were divided into groups based on the community, and 43 patients in 7 communities that established a medical consortium with this hospital were selected. Patients were set as observation group, and 42 patients in 7 communities who had not established medical consortium with our hospital were set as control group. Both groups received routine nursing and rehabilitation guidance during hospitalization. The control group received outpatient follow-up at 1, 3, and 6 months after discharge. The observation group carried out individualized rehabilitation guidance based on the medical consortium. The hip joint function, daily living ability and nursing satisfaction were compared between the two groups. Results There was no significant difference in hip function and modified Barthel index (MBI) score between the two groups at discharge (P>0.05); the observation group had hip function score (88.39±6.57) score and MBI score 6 months after discharge. 85.59±7.40) points and overall nursing satisfaction rate (93.02%) were higher than those of the control group, and the difference was statistically significant (P<0.05). Conclusion Individualized rehabilitation guidance based on the medical consortium can improve hip function and daily living ability of elderly patients undergoing hip replacement surgery, and increase nursing satisfaction. It is worthy of promotion.

Two cases of cryptococcal meningitis after splenectomy and literature review

Zhao Ya — 2022/12/9 8:12:13

Splenectomy is an important treatment for traumatic splenoid rupture, portal hypertension hypersplenism, hematologic diseases and splenoid mass lesions, but complications after splenectomy have attracted the attention of clinicians, among which the dangerous infection after splenectomy infection (OPSI) is high, and most of the serious infection pathogens are capsular bacteria such as Streptococcus pneumoniae. Clinical cases of cryptococcal meningitis due to cryptococcal infection invading the central nervous system after splenectomy are rare, and if not detected in time, it may cause serious consequences. In this paper, two patients with post-splenectomy who are not AIDS-related cryptococcal meningitis are reported, and their clinical symptoms, diagnosis and treatment are analyzed, which is intended to provide a reference for clinicians to diagnose and treat non-AIDS-associated cryptococcal meningitis in splenectomy patients.

Clinical analysis of breast cancer with signet ring cell differentiation: a case report

jingaopei — 2022/12/9 8:11:06

The main pathological type of breast cancer is invasive non-specific cancer, while primary breast cancer with signet ring cell differentiation is very rare. This paper discusses a case of breast invasive lobular carcinoma with signet ring cell differentiation treated in the Affiliated Hospital of Yanbian University, reports the diagnosis and treatment of the patient, and reviews and summarizes the disease in combination with previous relevant reports and literature.

Advances in research of corneal changes in diabetic patients by confocal microscopy

chenlifei,chenqi,huanghui,limin — 2022/12/8 9:30:15

The in vivo confocal microscopy can detect the morphological structure of the corneal cells in a rapid, non-invasive and high-resolution manner, which is crucial in the diagnosis of corneal lesions. The incidence of diabetes is getting higher and higher, and its serious complications not only affect the quality of life of patients, but also cause severe economic pressure on families and society. Many scholars at home and abroad use confocal microscopy to observe the tissue changes of the cornea in diabetic patients. This article reviews this issue.

Comparison of mechanical thrombectomy and thrombolysis in the treatment of intermediate/high risk acute pulmonary embolism

2022/12/8 9:28:46

Objective To compare the clinical efficacy and safety of AngioJet mechanical thrombectomy and catheter thrombectomy combined with thrombolysis in the treatment of intermediate/high risk acute pulmonary embolism. Methods The clinical data of 36 patients with intermediate and high risk acute pulmonary embolism (APE) were retrospectively analyzed. AngioJet mechanical thrombectomy therapy was performed in 12 cases (thrombectomy group), catheter thrombectomy combined with thrombolysis therapy in 24 cases (thrombolysis group). The technical success rate, treatment success rate, intraoperative operation time, urokinase dosage, blood oxygen saturation (SpO2), incidence of arrhythmia, pulmonary vascular injury, renal impairment, and bleeding were compared between the two groups. Results The technical success rate of thrombolysis group vs. thrombolysis group was 91.7% (11/12) vs.95.8% (23/24), without statistical significance (P>0.05). The success rate of treatment (discharge) in thrombolysis group vs. thrombolysis group was 75.0% (9/12) vs.79.2% (19/24), with no statistical significance (P>0.05). The intraoperative operation time of thrombolysis group vs. thrombolysis group was (357) min vs. (185) min, with statistical significance (P<0.05). The dosage of urokinase in thrombectomy group vs. thrombolytic group was (62) million IU vs. (205) million IU, with statistical significance (P<0.05). There were significant differences in blood oxygen saturation (SpO2) between the two groups (P<0.05). There were no significant differences in the incidence of pulmonary vascular injury, renal dysfunction and PE recurrence (P>0.05). Incidence of arrhythmias (sudden bradycardia, ventricular tachycardia, sinus or ventricular tachycardia, etc.) The thrombolysis group was 25.0% (3/12) vs.12.5% (3/24), with statistical significance (P<0.05). The incidence of bleeding in mechanical thrombectomy group was 0.0%vs.33.3% (8/24) in thrombolysis group, with statistical significance(P<0.05). Conclusion AngioJet mechanical thrombectomy and thrombectomy alone is an effective minimally invasive therapy for intermediate/high risk acute pulmonary embolism. For those with bleeding tendency, mechanical thrombectomy has more advantages in safety. Gentle, brief and careful operation can improve the safety of mechanical thrombectomy or catheterization.

Clinical efficacy of percutaneous reduction and screw fixation for the treatment of displaced intra-articular calcaneal fractures

Fang Bing,, — 2022/12/8 9:18:44

ABSTRACT Objective：To investigate the clinical efficacy of percutaneous reduction and screw fixation for the treatment of displaced intra-articular calcaneal fractures．Methods：Outcome analysis of patients from August 2020 to October 2021 with displaced intra-articular calcaneal fractures using percutaneous reduction and screw fixation: a retrospective case-series study. There were 22 patients (25 foots), 19 males (22 foots) and 5 females (3 foots)，ranging in age from 29 to 71 years old，with an average age of (46.8±7.6) years old. According to the Sanders classification, 13 foots were classified as typeⅡand 13 as type Ⅲ. The operation time, intra-operative management and postoperative complications were recorded. B?hler angle, Gissane angle, length, width, height of the calcaneus and visual analogue score (VAS) were measured at preoperative days and post-operative 2 days. The American orthopedic Foot & ankle society (AOFAS) ankle and hindfoot scale and Maryland Foot Score were recorded at final follow-up to evaluate clinical and functional outcomes. Results：All the patients were followed up，and the duration ranged from 12 to 28 months with a mean of （22.3±5.3） months． B?hler angle, Gissane angle, length, width, height of the calcaneus were significantly improved compared to preoperative values（P＜0.05). The VAS decreased from 7(6-8) to 4(3-5)(Z=-0.45，P＜0.05) . At final follow-up, the AOFAS ankle and hindfoot scale were 91.4±6.5 points and Maryland Foot Score was 93.4±4.9. According to AOFAS ankle and hindfoot scale and Maryland Foot Score, the result in excellent in 16 foots, good in 9. Conclusion: The percutaneous reduction and screw fixation is a minimally invasive, safe, and effective surgical technique for the treatment of displaced intra-articular calcaneal fractures. The patient satisfaction is significantly higher for the treatment. However, due to some limitations of reduction of articular surface, further surgical technique is required to improved.

The role and mechanism of Hippo/ MST1 in perioperative neurocognitive impairment

zhanqiaozhi — 2022/12/8 9:15:50

Objective To investigate the role of MST1 activation in perioperative neurocognitive impairment (PND) and its mechanism. Methods The expression of P-MST1 and MST1 protein in the hippocampus of PND mice after operation was detected by Western blot. The animal model of PND was established by intramedullary nailing of tibial fracture, and the learning and memory ability of elderly mice was evaluated by water maze test. Secondly, the improvement effect of XMU-MP-1 on PND mice and the expression of inflammatory factors in the hippocampus were observed by inhibiting MST1 activation by intraperitoneal injection of XMU-MP-1. Forty 14-month-old C57BL/6J mice were randomly divided into Sham group, PND group, PND+Vehicle group and PND+XMU-MP-1 group, with 10 mice in each group. The expressions of MST1 and P-MST1 were detected by Western blot, and the expressions of inflammatory factors TNF-A and IL-1β were detected by ELISA. In space exploration experiment, escape latency, percentage of stay time in target quadrant and entry times of escape platform were selected as detection indexes to evaluate the memory function ability of mice. Results The results of water maze space exploration experiment showed that the escape latency of aged PND mice was significantly prolonged at 1, 5 and 7 days after operation (P<0.01), the percentage of stay time in target quadrant was significantly decreased (P<0.01), and the number of escape platform entry was also significantly decreased (P<0.01). There were no significant differences in escape latency, percentage of residence time in target quadrant and entry times of escape platform in aged PND mice on the 14th day after operation (P>0.05). During the experiment, there was no significant difference in swimming speed of mice. Western blot results showed that MST1 was abnormally phosphorylated in the hippocampus of aged PND model mice, and p-MST1 level increased 1, 5 and 7 days after surgery (P<0.01). The increase of P-MST1 was more obvious on the 7th day after surgery, and the protein expression level of P-MST1 decreased on the 14th day after surgery. However, the expression level of total MST1 protein did not change. After inhibiting MST1 phosphorylation by intraperitoneal injection of XMU-MP-1, the results of water maze spatial exploration test showed that the escape latency of PND+XMU-MP group was shortened (P<0.05), the percentage of retention time in target quadrant was increased (P<0.05), and the number of escape platform entry was increased (P<0.05). Westernblot results showed that p-mst1 protein expression level in PND+ xmu-mp-1 group was significantly decreased (P<0.01). These results indicated that intraperitoneal injection of XMU-MP-1 successfully inhibited the activation of MST1 in Hippo signaling pathway. The expression of inflammatory factors in hippocampus was detected by ELISA, and the experimental results showed that the expression levels of TNF-A and IL-1β in PND+XMU-MP-1 group were significantly decreased (P<0.05). Conclusion: Hippo/MST1 is abnormally activated in PND model in elderly mice, and p-MST1 expression level is increased. Inhibition of P-MST1 expression may further improve cognitive impairment in elderly PND mice by down-regulating the expression of inflammatory factors in the hippocampus, suggesting that Hippo/MST1 activation plays an important role in the pathogenesis of PND.

Retrospective analysis of the analgesic effect of different doses of sufentanil combined with ropivacaine on labor process and maternal and infant outcomes

Liu Guodong — 2022/12/2 11:46:13

【Abstract】Objective The purpose of this study was to investigate the analgesic effect of different doses of sufentanil combined with ropivacaine for labor analgesia and its influence on labor process and maternal and infant outcomes. Methods A retrospective analysis was conducted on 210 full-term primiparas with single birth who were hospitalized in Tangshan maternal and child health hospital from January 2017 to August 2020 and were divided into three groups according to the concentration of labor analgesia drugs, Group A: sufentanil 0.3 μg/ml combined with 0.1% ropivacaine; group B: sufentanil 0.4 μg/ml combined with 0.1% ropivacaine; group C: sufentanil 0.5 μg/ml combined with 0.1% ropivacaine. The general information, pain at different time points before and after the onset of analgesia, motor ability of lower limbs, labor process and related indicators of maternal and neonatal outcomes were compared among the three groups. Results Compared with T0, the VAS scores of three groups after labor analgesia were significantly decreased (P < 0.05). Compared with Group A, VAS scores of Group B and Group C at T1-T3 were significantly lower, and the times of patient-controlled analgesia of analgesia pump were significantly reduced, and the first stage of labor in Group C was significantly prolonged (P < 0.05). Compared with Group B, VAS score at T1-T3 in Group C was significantly lower, the number of times of patient-controlled analgesia with analgesia pump was significantly reduced, and the first stage of labor was significantly prolonged (P < 0.05). Conclusion Sufentanil from 0.3 μg/mll to 0.5 μg/ml combined with 0.1% ropivacaine can be safely and effectively applied to labor analgesia, among which 0.4 μg/mll sufentanil combined with 0.1% ropivacaine has satisfactory analgesic effect and has little impact on labor process, so it is recommended for clinical use.

Clinical study on the relationship between the expression of centromere protein L and the recurrence of hepatocellular carcinoma after liver transplantation

fangjian,huangqian,,,ruanmei,,xialei,,,zhoulili — 2022/12/2 11:45:14

Objective: To study the clinical value of centromere protein L (CENPL) in the recurrence of hepatocellular carcinoma after liver transplantation. Methods: A total of 93 patients with liver cancer recurrence after liver transplantation were selected (REC group), and 46 non-recurrence patients who underwent simultaneous surgery and were matched for gender and age were selected as the control group (CON group). Immunohistochemical staining was performed on liver transplantation specimens to observe the expression of CENPL, and the correlation analysis with the clinicopathological parameters of patients, including demographic data, transplantation parameters, etc., was used to analyze the risk factors of recurrence patients and survival curve analysis. The value of CENPL expression in recurrence-free survival (RFS) of patients. Results: 68.8% of patients in REC group had high expression of CENPL, while the proportion of high expression in CON group was 41.3%, and the difference was statistically significant (p=0.0019). COX regression model showed that CENPL expression (p=0.0032) and CNLC stage (p=0.013) were independent risk factors for recurrence. Kaplan-Meier survival curve analysis showed that the CENPL high expression group showed shorter RFS than the low expression group (Log-rank test, p=0.0023; Gehan-Breslow-Wilcoxon test, p=0.0002). Conclusion: CENPL is a biomarker for the recurrence of liver cancer in patients after liver transplantation, and the detection of its expression has important reference value for predicting recurrence.

Experimental study of icariin optimizing adipose-derived stem cells to promote the survival of ultra-long random skin flaps in rats

LIANG Zhi-jie,,,, — 2022/12/2 11:44:02

Objective To explore the effect and mechanisms of Icarin (ICA) to optimize rat adipose stem cells (rASCs) in promoting the survival of ultra-long random skin flaps. Methods To isolate and culture rASCs, and identify their surface factors' expression and multilineage differentiation ability. Western Blot (WB) was used to assess the protein expression of angiogenesis factors (VEGF、PDGF-BB、FGF-2、IGF-2) in rASCs stimulated by ICA at different concentrations (0-10μM). To establish rat models of ultralong random skin flap, and to inject PBS (Ctrl group), rASCs (rASCs group), and rASCs treated with 1μM ICA (ICA+rASCs group) into the pedicle of the flaps respectively. Then evaluate the surcival rate of flaps at 7d、14d and 28d after the operation. After 28d the survivor tissue of flap was dissected, to compare the microvessel density (MVD) and collagen content (%) in each group by histological detection. And the protein expression of angiogenesis factors in flap tissue is detected by WB. Results rASCs had the ability of adipogenic, osteogenesis, and cartilage differentiation. Flow cytometry experiments showed that rASCs had high expression of CD29 and CD44, and low expression of CD45. WB test suggested that 1μM and 10μM ICA could significantly improve the expression of angiogenesis factors in rASCs. Animal experiments showed that at 7d and 14d after the operation, compared with the control group, rASCs and ICA pretreated rASCs could improve flap survival rate (P<0.05), but there was no significant difference between these two groups. However, there was no significant difference in flap survival rate between rASCs group and the control group, while there was still a statistical difference between ICA+rASCs group and the control group (P<0.05) at 28d. HE staining showed that compared with the control group, the dermal fibers were more compact in the rASCs group and the ICA+rASCs group. The collagen content, MVD, and the expression of angiogenesis factors in the flap tissue were significantly higher in rASCs group and the ICA+rASCs group (P<0.05). In addition, the collagen content, MVD, and the expression of VEGF and PDGF-BB in the ICA+rASCs group were significantly higher than those in rASCs group(P<0.05). Conclusion ICA can enhance the expression of angiogenesis factors in rASCs, which may be the mechanism of ICA optimizing rASCs to promote the survival of ultra-long random skin flaps in rat models.

Expression of hsa_circ_0021350 and its clinical significance in glioma

Zou Xiaoqiong — 2022/12/2 11:42:52

[Abstract] Objective To investigate the expression and clinical significance of hsa_circ_0021350 in glioma, preliminarily evaluate the possibility of its application in diagnosis and treatment of glioma. Methods The Divergent Primer of hsa_circ_0021350 was designed. Firstly, RNase R digestion combined with RT-PCR was used to verify the circular character of hsa_circ_0021350, and TA clone sequencing was used to identify the specificity of the Divergent Primer for qRT-PCR amplification. Then the expression of hsa_circ_0021350 in 40 glioma tissues and 4 glioma cell lines (SF126, A172, U87-MG and SF763) was detected by qRT-PCR, and the relationship between hsa_circ_0021350 expression and clinicopathological parameters was statistically analyzed. Results Hsa_circ_0021350 was circular and resistant to RNase R digestion. The designed Divergent Primer has the specificity of hsa_circ_0021350. The expression levels of hsa_circ_0021350 in glioma tissues and cell lines detected by the Divergent Primer were significantly higher than those in normal brain tissues (P<0.001), and the expression of hsa_circ_0021350 in high-grade gliomas (WHO III-IV) was higher than that in low-grade gliomas (WHO I-II) (P<0.05). Further statistical analysis showed that the expression of hsa_circ_0021350 was positively correlated with KI67 expression in glioma patients (P< 0.01), but not related to age, gender, tumor size, KPS score, P53, EMA, GFAP, MGMT, etc. Conclusions The expression of Hsa_circ_0021350 was significantly up-regulated in gliomas, especially in high-grade gliomas, and it was related to tumor proliferation factor KI6, implying that hsa_circ_0021350 may be a potential molecular target for glioma diagnosis and treatment.

Down-regulation of miR-27a alleviates acute lung injury in rats by myocardial ischemia-reperfusion

guwenyu, — 2022/12/2 11:41:25

Objective To evaluate the protective effect of miR-27a down-regulation on acute lung injury in rats by myocardial ischemia-reperfusion. Methods Forty adult rats of 8-12 weeks were divided into four groups:sham surgery group (SP group), model group (I/R group), miR-27a inhibitor group (anta-27a+ I/R group), and blank control group (NC+I/R group). The rats modle of acute lung injury induced by MI/R was esdablished by ligation of coronary artery branch. Rats in the anta-27a+I/R and NC+I/R groups were intravenous injected with antagomir-27a and antagomir-NC for 3 consecutive days before molding. Rats in IR group subject to reperfusion for 120 min after 30 min ischemia. Rats in the SP group underwent thoracotomy without artery ligation. After 120 min of reperfusion, lung tissue was collected quickly, the ratio of wet and dry weight (W/D) was measured, and lung organization pathological changes were observed under the HE staining. SOD and MDA levels in lung tissue were determined by colorimetry. Interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in serum and lung tissue were measured by ELISA. Results Compared with the SP group, rats in the I/R , the NC+I/R and anta-27a+I/R groups had severe lung injury, including increased lung W/D ratio, increased MDA level, decreased SOD activity, and increased serum and lung tissue IL-6 and TNF-α(P＜0.05). Compared with the I/R group, the pathological injury of lung tissue was reduced, in anta-27a+I/R group, lung W/D ratio was decreased, MDA level was decreased, SOD activity was raised and serum and lung tissue IL-6 and TNF-α were decreased(P＜0.05). Conclusion Low expression of miR-27a can alleviate the acute lung injury caused by myocardial ischemia and reperfusion in rat by reducing inflammation response and oxidative stress.

Advances in perioperative rehabilitation of breast cancer

覃兰惠, — 2022/11/27 15:49:37

Breast cancer is the most common malignant tumor in women.Surgical resection is the main comprehensive treatment of breast cancer at present.For a variety of postoperative complications of breast cancer after surgery , early rehabilitation are needed.In order to improve the quality of life of breast cancer patients, the postoperative complications and the present situation of perioperative rehabilitation was reviewed.

Analysis of risk factors of deep vein thrombosis after renal malignancy surgery and establishment of predictive model

Li Jing — 2022/11/11 11:56:48

Objective To investigate the risk factors of deep vein thrombosis after renal malignancy surgery and establish a predictive model. Methods The clinical data of 342 patients with renal malignancy who received surgery at the Department of Urology, First People’s Hospital of Jinan during January 2016 to December 2021 were retrospectively analyzed. According to whether deep vein thrombosis occurred during hospitalization, the patients were separated into case group and control group. The clinical data of the two groups, such as gender and age, were compared and analyzed in a single-factor analysis. The factors with significant differences between two groups were substituted into binary logistic regression analysis for independent risk factor test. Predictive model was established and the nomogram was drawn to predict the occurrence of deep vein thrombosis after renal malignancy surgery. The calibration curve, receiver operating characteristic curve and decision curve analysis were drawn to further verify the accuracy of the prediction model. Results Age, gender, surgery duration, D-dimer and hypersensitive C-reactive protein level were the independent risk factors of deep vein thrombosis after renal malignancy surgery. The predictive model nomogram was constructed, and the scoring system was further developed. The area under the receiver operating characteristic curve was 0.855. Conclusion The predictive model established in this study has good accuracy, which can provide a reference for the prevention of deep vein thrombosis after renal malignancy surgery.

The impact of ABCB1 Genetic Polymorphisms on the Concentration of Imatinib in Chronic Myeloid Leukemia and Gastrointestinal Stromal Tumor Patients: a Meta-analysis

陈杰,陈孝,夏延哲,尹纪元 — 2022/11/7 15:31:38

Objective To systematically evaluate the effect of ABCB1 polymorphisms on imatinib plasma concentration in chronic myeloid leukemia and gastrointestinal stromal tumor patients, and to provide evidence for guiding clinical individualized medication. Methods PubMed, EMBASE, Web of Sciences, Scopus, CNKI and Wanfang database were searched. Studies that investigated the association of ABCB1 C1236T、G2677T/A、C3435T polymorphisms with the concentration of imatinib-treated patients were collected from January 2000 to September 2022. Literature screening and data extraction were performed according to the inclusion and exclusion criteria. Meta-analysis was performed by using Review Manager 5.4. Results A total of 7 studies on the association between ABCB1 and imatinib plasma concentration were included (including 873 patients). Meta-analysis showed statistically significant difference in the concentration of imatinib between the carriers of T allele and the carriers of C allele in the ABCB1 C1236T allelic model [WMD = 97.44 ng/mL，P=0.03], and between the homozygotes+heterozygotes carriers and wild-type carriers in the G2677T/A dominant model [WMD = 318.27 ng/mL，P<0.0001], and no significant different imatinib concentration was found in C3435T polymorphism. Conclusion ABCB1 C1236T and G2677T/A polymorphisms were associated with the concentration of imatinib, and mutated variants were related to the increase of imatinib blood concentration.

Research progress in the technology and method of bacterial antimicrobials resistance and antimicrobial resistance gene detection

姜桂来,俞莞茜,郁舒阳,周宇轩,周哲敏 — 2022/11/7 11:06:26

The overuse of antimicrobials accelerates the development of bacterial resistance. At present, bacterial resistance has become one of the important factors threatening global public health. Bacterial antimicrobial resistance detection techniques include classical methods of broth dilution, agar dilution, disk diffusion and concentration gradient. Subsequently, a series of physical-chemical methods and molecular biology detection techniques appeared, including microfluidic image detection, time-of-flight mass spectrometry and other techniques. With the update of high-throughput sequencing technology, and the development and improvement of various bacterial antimicrobial resistance gene databases, new technologies have been gradually applied in the field of bacterial antimicrobial resistance detection such as whole genome sequencing, metagenomic sequencing and microbial single-cell transcriptome sequencing. In this paper, the methods of bacterial antimicrobial resistance detection are divided into three categories: traditional classical methods, molecular biology techniques and high-throughput sequencing techniques, and this paper introduces the principles, advantages, and limitations of the technologies above. Reviewing and reflecting on current techniques and methods for bacterial resistance detection is essential for regulating the use of antimicrobials and also provides new technical support for the prevention and monitoring of clinical super-resistant bacteria.

Retrospectively analysis of the clinical features and treatment of 40 juvenile polyps in children

覃益,消化内科 — 2022/11/4 17:19:02

Objetive To investigate the clinical features of juvenile polyps in children and the clinical value of endoscopic mucosal resection(EMR).Methods This was aretrospective medical record review of 40 children with juvenile polyps managed form January 2017 to May 2021 in Liuzhou Maternity and Child Healthcare Hospital.Results In the 40 children with juvenile polyp,with a male predominance (M/F ratio, 3.4:1).Most children (n=36, 90.00%) presented with hematochezia associated.The most common polyp locations were the rectum (n=23,57.50% ) and the sigmoid colon (n=12,30.00%), Most common pathology types were Yamad Ⅲ(n=11，27.50％) and Ⅳ(n=19，47.50％).Endoscopic mucosal resection(EMR) was performed successfully in 37patients(n=37,92.50% ). All polyps were consistent with the pathological characteristics of juvenile polyps. the follow-up that there were 2 cases(n=2,5.00% ) had bleeding at 10 days after operation. No cases had serious complications such as infection,perforation and massive hemorrhag. And clinical symptoms disappear wothin 2 months.There were 22cases(n=22,55.00% ) review colonoscopy and no recurrence was found.Conclusions Juvenile polyps main clinical symptom is hematochezia and mostly at rectum and sigmoid. The transabdominal ultrasound is an effective method to judge the size, the location,the internal blood supply of the polyps and if there is a intussusception.The EMR technique plus metal clamp therapy juvenile polyps，has high safety, obvious curative effect and it is worth of clinical application。

Diagnosis and correlation analysis of ADC value and rADC in clinically significant prostate cancer

Nie Yang-ping,Yuan Shuai — 2022/11/4 17:16:10

Objective To explore the clinical application value of magnetic resonance apparent diffusion coefficient(ADC) and ADC ratio in diagnosis of prostate cancer, and analyze their correlation with Gleason grade. Methods 62 patients with prostate cancer diagnosed and treated in our hospital were collected from January 2018 to December 2021, all of which were confirmed as cancer by surgery or needle biopsy. According to the Gleason score, the patients were separated into two groups: medium-high risk group(n=37) and low-risk group(n=25). ADC values of cancer lesion, the contralateral of cancer lesion, urine in bladder and gluteus maximus were measured in all patients, and the corresponding rADC cancer lesion contralateral, rADC bladder and rADC gluteus maximus were calculated. Spearman correlation was used to test the relationship between ADC value, rADC and Gleason grade. Receiver operating characteristic(ROC) curve was used to evaluate the clinical value of ADC and rADC in diagnosing prostate cancer. Results ADC value and rADC were lower in the medium-high risk group than in the low-risk group, the differences were statistically significant(P＜0.05). ADC value, rADC cancer lesion contralateral, rADC bladder and rADC gluteus maximus were negatively correlated with Gleason grade(r=-0.639, -0.578, -0.640, -0.603, P＜0.05). ROC curve found that the area under curve (AUC), sensitivity and specificity of ADC and rADC in diagnosing prostate cancer were 0.810, 81.08%, 72.00% and 0.815, 78.38%, 76.00%, respectively. Conclusion ADC value and rADC can distinguish low-risk from medium-high-risk prostate cancer to a certain degree, and are correlated with Gleason grade, which can be used as effective predictors for preoperative evaluation of biological characteristics of prostate cancer.

Clinical study and therapeutic effect observation of percutaneous spinal endoscopy "isolation zone" technique in the treatment of discogenic low back pain.

wang lu — 2022/11/4 17:14:08

Objective: To explore the surgical strategy and clinical effects of the "isolation zone" technique for the treatment of discogenic low back pain under percutaneous spinal endoscopy.Methods: From September 2017 to September 2020, the author treated patients with intervertebral discogenic low back pain with lateral approach percutaneous spinal endoscopic surgery under local anesthesia. Neuralization and corresponding segmental nerve roots are decompressed throughout the process, forming an "isolation zone" around the nerve root without contact with the nucleus pulposus and annulus fibrosus. The visual analogue scale (Visual Analogue Scale, VAS) and Oswestry Disability Index (ODI) of low back pain and pain around the buttocks were recorded before and 1, 3, 6, and 12 months after the operation, and the modified MacNab criteria were evaluated. curative effect. A total of 45 patients completed surgery and received complete postoperative follow-up.Result: The 45 patients in this group all completed the operation successfully. There was no patient who could not tolerate the pain of local anesthesia and was forced to interrupt. The operation time was 65 to 125 minutes, with an average of 94.71±17.67 minutes. The average follow-up time for all patients was 12-18 months. , An average of 13.6±1.9months, the VAS scores for lower back pain and pain around the hips were 6.95±1.02 before surgery, 2. 64±0.71 at 1 month after surgery, 1.80±0.54 at 3 months after surgery, and at 6 months after surgery 1.42±0.50, 12 months after surgery, 1.27±0.45; Oswsetry dysfunction index was 72.84±5.95 before surgery, 35.11±5.30 at 1 month after surgery, 25.22±4.85 at 3 months after surgery, and 6 months after surgery It was 16.78±4.63, and it was 10.91±2.36 after 12 months. The VAS score and ODI index of low back pain, lower limb pain at different time points after operation were significantly improved compared with that before operation (P<0.01). The effect of modified MacNab was excellent in 24 cases, good in 13 cases, and fair in 8 cases. The excellent and good rate was 82.22%. Among them, 1 patient developed femoral nerve palsy after endoscopic surgery, and was given a conservative treatment plan for neurotrophic therapy, acupuncture and moxibustion, and functional exercise. The symptoms disappeared 4 weeks after the operation. One patient developed neck and back pain during the operation and was considered as a class. The hypertension of the spinal cord was treated with removal of water pressure and oxygen inhalation, and the symptoms disappeared after 30 minutes. There were no serious surgical complications such as permanent nerve damage and intervertebral space infection in all cases. Conclusion: Percutaneous spinal endoscopic "isolation zone" technology is a minimally invasive spinal surgery technique for the treatment of discogenic low back pain with safe operation and satisfactory clinical results. Preoperative transforaminal nerve block is responsible for discogenic low back pain Segment determination is an effective means of preoperative diagnostic judgment.

New progress of liquid biopsy in diagnosis and treatment of breast cancer

沈嘉悦 — 2022/11/4 17:09:34

Breast cancer is the most common malignant tumor in women in our country, and it is also the focal point of research on female malignancies worldwide. The incidence of breast cancer in China is increasing year by year, which seriously threatens women's health. As an emerging detection technology, liquid biopsy is mainly used to take samples of patients' blood, urine, saliva and other body fluids by a non-invasive or minimally invasive way to detect cancer markers for diagnosis, prognosis assessment and follow-up. Under the mode of accurate diagnosis and treatment of breast cancer, liquid biopsy technique for the early diagnosis and individualized treatment, improving the prognosis of breast cancer has important clinical significance. This paper introduces the research progress of liquid biopsy in breast cancer from the aspects of circulating tumor cells, circulating tumor DNA and microRNA, aiming to provide new ideas and options for individualized and precise treatment of breast cancer.

Research progress of magnetic resonance imaging in adolescent non-suicidal NSSIAuthor：YouXinRui¹CaoRuiXiang² Bai Yan² LuoZhi²Wang Meiyun^2*

baiyan,caoruixiang,luozhi,youxinrui — 2022/11/4 17:01:58

Non-suicidal self-injury (NSSI) is a kind of behavior that deliberately hurts oneself without the purpose of ending one"s life. All kinds of behaviors are rejected by society.S The incidence of NSSI in adolescents is about 27%, which is closely related to depression and other mental disorders.SAt present, the pathogenesis of NSSI is unclear.SPrevious studies have indicated that NSSI adolescents had abnormal brain structure and brain function, multimodal magnetic resonance imaging can provide abundant information for NSSI behavior from different angles, and has important value in NSSI mechanism research, this paper aimed to multimodal brain MRI in NSSI action and imaging studies for review,It provides reference for further research in the future.

Permanent carotid-basilar artery anastomosis: a report of three cases

杨潇 — 2022/11/4 16:56:17

The persistent carotid-basilar artery anastomosis included persistent trigeminal artery (PTA ) , persistent otic artery (POA ) , persistent hypoglossal artery (PHA) and anterior atlanto-intersegmental artery (PIA) , which are rare cerebral vascular variations. In recent years, CT angiography (CTA) , which has been widely used in clinical practice, has significantly increased the detection rate of this type of vascular dysplasia. POA is the earliest vessel to disappear in the original carotid-basilar Anastomosis, so it is extremely rare and there is no reported data on the incidence of POA. Therefore, only the remaining three variants were reported in this study.

A situation analysis of delay in diagnosis of children with 11β-hydroxylase deficiency treatment for five years

ruanwen — 2022/11/4 16:54:19

11β-hydroxylase deficiency is the second common type of congenitaladrenal hyperplasia after 21 hydroxylase deficiency (21-OHD), which is mainly manifested as low renin hypertension,hypokalemia and male precocious puberty or female masculinization caused by hyperandrogenemia. The disease needs lifelong treatment, if the diagnosis delay or improper treatment, can cause peripheral precocious puberty and then central precocious puberty、short stature、gonadal adrenal residue tumor and impaired reproductive function, at present only part of the domestic research proposed 11-hydroxylase deficiency new gene reports, no long-term comprehensive treatment。This paper reports that a case with 11-hydroxylase deficiency aged 8 years of bone age has been diagnosed by hydrocortisone treatment with growth hormone and letrozole for nearly 5 years.After 5 years of treatment, the difference between bone age and age of the child changed from more than 5 years at initial diagnosis to more than 4 years, the height distance of bone age was 3 percentile from 19.4cm to 6cm at initial diagnosis, and the lag of bone age height was significantly improved.At present, the child is 7 years and 5 months old, the bone age is 12 years old, and the testis began to increase, but the GnRH stimulation test indicates that the center has not been fully started, indicating that the comprehensive treatment has significantly improved the child's condition, and also indicates that the newborn screening of the disease is very important. Once the treatment is delayed, the cost is high, and can only be relatively improve the prognosis.

Potential mechanism of Spatholobus Suberectus Dunn in the treatment of aplastic anemia based on network pharmacology

tan hong di — 2022/11/3 15:33:15

Objective To explore the potential mechanism of Spatholobus Suberectus Dunn in the treatment of aplastic anemia (AA) by using network pharmacology. Methods The effective chemical ingredients and targets gene of Spatholobus Suberectus Dunn were obtained through TCMSP. Search AA related genes with the help of Genecards database. The key targets of effective chemical ingredients and AA were screened by using the Software VENNY 2.1. The protein interactions network was constructed by using STRING database. The key targets were enriched by GO enrichment and KEGG pathway based on DAVID online tool. Finally, the Cytoscape 3.2.1 software was used to construct the active component-target-pathway-disease network. Results 24 active components and 21 key targets of Spatholobus Suberectus Dunn were screened by database; 1052 items were obtained by go enrichment analysis, including 1012 biological processes, 13 cell components and 27 molecular functions; 70 signaling pathways were obtained by KEGG pathway enrichment analysis, which involved apoptosis, p53 signaling pathway, AGE-RAGE signaling pathway in diabetic complications, and pathways related to viral, cancer, infectious diseases et. Conclusion This study preliminarily revealed that Spatholobus Suberectus Dunn can treat AA through multi-component, multi-target and multi-pathway action, which provides new ideas for the potential effective research direction and lays a foundation for further exploring the mechanism of Spatholobus Suberectus Dunn in the treatment of AA.

Efficacy analysis of decitabine combined with venetoclax regimen and decitabine combined with CAG regimen in the treatment of elderly patients with newly treated acute myeloid leukemia

张诗佳 — 2022/11/3 15:32:34

Objective to compare the clinical efficacy and safety ofdecitabine combined with venetoclax regimen and decitabine combined with CAG regimen in the treatment of elderly patients with Acute Myeloid Leukemia (AML) who are not suitable for intensive chemotherapy.Methods:Twenty nine elderly patients admitted in Jingzhou Hospital from May 2016 to February 2022,who were newly diagnosed with AML and not suitable for intensive chemotherapy,were retrospectively analyzed. They were divided into two groups:decitabine + venetoclax Group (N = 17) ,and decitabine + CAG Group (N = 12),the complete remission rate,overall response rate,survival rate and side effects were compared between the two groups.Results: The composite complete remission rate(CR+CRi) were 70.6% and 50% , respectively；and the overall response rate (ORR) was 76.5% and 66.7% , respectively；The median survival time was 10.7 months and 8.6 months, and the event-free survival time was 8.8 months and 5.8 months, respectively, with no significant difference (p > 0.05) . The main adverse reactions were myelosuppression, infection and hemorrhage (p > 0.05) , followed by gastrointestinal reaction (p > 0.05) .Conclusion: Both the regimen of decitabine combined with venetoclax and the regimen of decitabine combined with CAG can be used as effective regimens for the elderly patients with AML who are not suitable for intensive chemotherapy. There was no significant difference in efficacy and safety between the two regimens.

Diagnostic value and misdiagnosis of thyroid nodules by conventional ultrasound combined with contrast-enhanced ultrasound

韦柳, — 2022/11/3 15:31:35

0bjective To evaluate the value of conventional ultrasound combined with contrast-enhanced ultrasound(CEUS) in the diagnosis of thyroid nodul,and analyze the characteristics and causes of misdiagnosis of nodules in combined diagnosis. Methhods Conventional ultrasound and CEUS data of 522 patients with thyroid nodules confirmed by pathology were retrospectively analyzed,to compare the diagnostic efficacy of conventional ultrasound combined with CEUS in benign and malignant thyroid nodules,and the features of conventional ultrasound combined with CEUS in 53 cases of nodules misdiagnosed in combined diagnosis were analyzed and the causes of misdiagnosis were discussed. Results The specificity,sensitivityand accuracy of conventional ultrasound combined with CEUS were 87.1%、94.1%、89.8%,which were higher than 81.2%、84.7%、82.5% of conventional ultrasound . The difference was of statistical significance (all P<0.05). In 53 cases of misdiagnosis, 41 cases of benign nodules were misdiagnosed as malignant nodules and 12 cases of malignant nodules were misdiagnosed as benign nodules. All misdiagnosed benign nodules had equal or more than two of the following characteristics: low level echo、aspect ratio≥1、obscure boundary、irregularSin shape、capsular invasion、microcalcification and so on,the misdiagnosed malignant nodules showed CEUS features of isoenhancement and hyperenhancement. Conclusion Conventional ultrasound combined with CEUS can improve the diagnostic value of thyroid nodules,however benign and malignant nodules overlap in conventional ultrasound and CEUS characteristics to a certain extent, which often leads to misdiagnosis.

Analysis of risk factors for postoperative survival and recurrence of patients with intermediate- and high- risk gastrointestinal stromal tumors patients

Ju Houqiong,Liu Dongning,Lu Weijie,Yu Honngxin,Zhong Chonghan — 2022/11/3 15:30:45

Objective To analyze the risk factors for postoperative survival and recurrence of patients with intermediate- and high-risk gastrointestinal stromal tumors (GIST), and to find individualized treatment for patients with GIST. Methods A retrospective review analysis of clinicopathological and follow-up data of 370 patients with gastrointestinal stromal tumors treated from January 2012 to December 2021, Statistical analysis was performed using SPSS 26.0 software. Survival curves were plotted using Kaplan-Meier method. Log-rank test was used for univariate analysis. COX regression equation was used for multivariate analysis. P<0.05 indicated that the difference was statistically significant. Results The patients ’ age, risk grade, Ki-67 index, , cell morphology and whether receiving targeted therapy were significantly different from the 3-year and 5-year overall survival (OS) (P<0.05). The age, risk grade, surgical radical degree and mitotic count cell morphology, and whether receiving targeted therapy are independent risk factors for recurrence-free survival ( RFS ) in GIST patients.The risk classification,cell morphology and whether receiving targeted therapy are independent prognostic factors for 3-year and 5-year OS in patients with GIST. There was no difference in postoperative prognosis between laparoscopic and open surgery patients with stromal tumors. The longer the targeted therapy time, the higher the 3-year, 5-year OS and RFS of patients, the better the prognosis, with statistical significance. Conclusions The risk classification, cell morphology and whether receiving targeted therapy are related to the overall survival of patients with gastrointestinal stromal tumors after surgery. The longer the treatment time, the better the prognosis (P<0.05). However, whether patients with intermediate-risk stromal tumors received targeted therapy after surgery was not related to the prognosis of patients (P>0.05).

Preliminary study on the expression and regulation of HIF1A and MAGED4 in human glioma

2022/10/12 9:54:25

Objective: To investigate the expression of hypoxia-inducible factor 1A (HIF1A) and melanoma-associated antigen D4 (MAGED4) in human glioma, and to analyze the effect of HIF1A on the expression of MAGED4. Methods: Gene Expression Profiling Interactive Analysis (GEPIA) database was used to collect data from 681 glioma samples and 207 normal brain tissue samples to analyze the expression levels of MAGED4 and HIF1A mRNA. The mRNA-seq_693 dataset and corresponding clinical information were downloaded from the Chinese glioma genome atlas (CGGA) database, and the correlation and clinical significance of HIF1A and MAGED4 expression were analyzed. An in vitro hypoxic environment was simulated using cobalt chloride, and HIF1A mRNA expression was downregulated in glioma cells under hypoxia, and MAGED4 expression was detected by qPCR and western blotting. Results: GEPIA database analysis showed that the mRNA expression levels of MAGED4 and HIF1A in glioma tissue were higher than those in normal brain tissue, and the difference was statistically significant ( P<0.05). CGGA database analysis showed that the expressions between HIF1A and MAGED4 were positively correlated, and the difference was statistically significant (r=0.322, P<0.05); the expression level of MAGED4 was correlated with patient’s age and IDH mutation (P<0.05), and was correlated with patient’s gender, tumor Type, WHO classification, methylation status of MGMT promoter and other clinical indicators were not significantly correlated (P<0.05); HIF1A expression level was not significantly correlated with these clinical indicators (P<0.05). The expression of HIF1A was down-regulated in U87-MG and U251 cells, and the mRNA and protein expressions of MAGED4 were significantly down-regulated. Conclusion: Both HIF1A and MAGED4 are highly expressed in gliomas, and their expressions are positively correlated; HIF1A could regulate the expression of MAGED4 in glioma cells.

Research progress of obesity-related glomerulopathy

wangcongxiu — 2022/10/10 9:57:58

In recent years, the number of obesity is increasing in China. Kidney is one of the target organs of obesity. The pathogenesis of obesity-related glomerulopathy is complex and not fully understood, which is mainly related to renal hemodynamic disorder, renin-angiotensin-aldosterone system activation, adipokines disorder, inflammation, insulin resistance and intestinal flora disorder. At present, the main treatment methods of ORG are weight loss and RAAS inhibitors to reduce proteinuria and delay progression to end-stage renal disease. Sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists and melatonin may be potential therapeutic drugs for this disease, but it still needs long-term clinical trials to confirm.

Analysis of influencing factors on recurrence of femoropopliteal arteriosclerosis obliterans after interventional therapy

jiaxu — 2022/10/10 9:04:14

Objective To investigate the factors affecting the recurrence of femoropopliteal arteriosclerosis obliterans (ASO) after interventional surgery. Methods The clinical data of 96 patients with femoropopliteal ASO who received interventional treatment in The Second People's Hospital of Hefei from May 2018 to February 2020 were collected. The postoperative vascular patency of the patients was evaluated during 24 months of outpatient and telephone follow-up. Univariate analysis method was used to evaluated the clinical and laboratory indicators and imaging data of the both groups. Binary logistic regression analysis method was used to analyzed the risk factors for recurrence after interventional surgery, and the receiver operating characteristic curve (ROC) was used to analyze the relevant variables to predict the risk of recurrence and find the optimal critical value. Result The recurrence rate was 44.8% (43/96) 2 years after interventional therapy. Univariate analysis showed that TASC Ⅱ typing, monocyte, red blood cell distribution width, glucose,cystatin C and homocysteine were the risk factors for postoperative recurrence (P < 0.05); Multivariate binary Logistic regression showed that TASC Ⅱ typing(OR=3.334,95%Cl=1.579~7.039,P=0.002)and cystatin C (OR=3.108,95%Cl=1.149~8.406,P=0.025)were independent risk factors for postoperative recurrence, and mean corpuscular volume (OR=0.895,95%Cl=0.806~0.995,P=0.040)was independent protective factor (P < 0.05); The combined ROC curve of TASC Ⅱ typing, cystatin C and mean corpuscular volume was plotted with recurrence after intervention as outcome index. The area under curve(AUC) was 0.776, which suggested that it carried higher accuracy in predicting the recurrence after interventional surgery. Conclusion TASC Ⅱ typing and cystatin C combined with mean corpuscular volume can predict the prognosis of patients. The risk of recurrence after intervention can be reduced by increasing mean corpuscular volume or reducing cystatin C.

Clinical significance of pre-treatment blood inflammatory markers in the diagnosis and staging of cervical cancer

Huang Fei-Feng,Liu Zi-Yu,Xiong Chun-Qiu — 2022/9/30 15:51:22

Objective To determine the role of inflammatory markers in the diagnosis and staging of cervical cancer. Methods We collected data from medical files of 94 patients with cervical cancer operated at the Maternal and Child Health Hospital of Guangxi Zhuang Region from January 2017 to December 2020. We also selected 94 health examiners as controls during the same period. The C-reactive protein/albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were evaluated for the diagnosis and staging of cervical cancer. Results NLR and PLR were significantly higher in the cervical cancer group (both P < 0.05), while albumin and PNI were significantly lower in the cervical cancer group (both P < 0.05). Furthermore, PLR was significantly higher in cervical adenocarcinoma group than in the squamous carcinoma group (P = 0.034). PLT and PLR differed with tumor sizes (P = 0.007, P = 0.057), and these differences were significant with different stages (both P < 0.05). The area under the curve (AUC) of PLR (AUC = 0.608) and CAR (AUC = 0.617) was higher than that of NLR (AUC = 0.578), though not in a significantly different way (all P > 0.05). PLR, NLR, and CAR produced a greater net AUC than individual PLR, NLR, and CAR (AUC = 0.630). Conclusion PLR can be used as a reference index for the clinical staging of cervical cancer. Preoperative PLR, NLR, and CAR have a probable utility in the diagnosis of cervical cancer.

Clinical characteristics and treatment of patients with autoimmune hemolytic anemia secondary to thalassemia

廖桂萍,周亚丽 — 2022/9/30 15:50:29

Objective This study investigated the clinical characteristics and optional treatment for patients with autoimmune hemolytic anemia (AIHA) secondary to thalassemia. Methods Patients diagnosed with AIHA secondary to thalassemia major or thalassemia intermedia from January 2009 to December 2020 were retrospectively investigated. Clinical characteristics, treatment, and outcomes of these patients were surveyed. Effects of different treatments were analyzed. Results Forty-two patients were included. Decreased levels of hemoglobin and shortened intervals of blood transfusion were the commonest manifestations. Standard and high dosages of glucocorticosteroid were prescribed to 20 and 12 patients, respectively. Complete response (CR) ratio (83.3% vs. 75.0%) and overall response ratio (91.7% vs. 95.0%) showed no significant difference between these two groups. One case was splenectomized directly because of megalosplenia complicated and reached CR. Nine patients received no treatment, among them three reached spontaneous CR. Three patients refractory to firstline glucocorticosteroid were treated with splenectomy and reached CR. Conclusion: Coomb`s test should be performed in patients with thalassemia in cases of aggravated hemolysis or shorter transfusion intervals. Glucocorticosteroid should be prescribed when AIHA was assured. Splenectomy may be considered in patients relapsed or refractory to first line treatment.

Prognostic value of inflammatory indexes in patients with esophageal squamous cell carcinoma undergoing radical radiochemotherapy

liuzihao — 2022/9/30 15:49:46

Objective To observe the prognostic value of various inflammatory indexes in patients with esophageal squamous cell carcinoma undergoing radical radiotherapy and chemotherapy. Methods 154 patients with esophageal cancer treated in our hospital from January 2016 to December 2017 were selected. The best cutoff values of SII, PNI, NLR, PLR and LMR for overall survival were calculated according to the receiver operating characteristic curve (ROC). According to the area under the ROC curve, the ability of SII, NLR, PLR, LMR and PNI to predict the prognosis of patients was compared. The clinicopathological features of the enrolled patients were analyzed,Kaplan-Meier method was used to draw the survival curve and log rank method was used to test the difference of survival rate between groups. Cox proportional hazards model was used for multi factor and single factor analysis. A nomogram prediction model for survival using R language. Results The best cutoff values of SII, NLR, PLR, LMR and PNI were 794.8, 3.25, 125.65, 4.65 and 46.05 respectively. SII, NLR and PLR were related to the prognosis of patients with esophageal squamous cell carcinoma undergoing radical radiotherapy and chemotherapy (P<0.05). High ECoG score (1-2), T stage (Ⅲ - Ⅳ), lymph node metastasis (yes) and high SII (> 794.8) were independent factors affecting the prognosis of patients. The C-index of the resulting nomogram prediction model was 0.796, (95% CI: 0.757-0.871). Conclusion SII is an independent factor affecting the prognosis of patients with esophageal squamous cell carcinoma undergoing radical radiochemotherapy. The prediction model based on SII and other indicators has good accuracy, differentiation and clinical application value.

Predictive role of pre-treatment D-dimer levels in post-thrombotic syndrome of the lower extremity deep veins

Che Xing,Dai Xiang,Li Caiying,Wang Honggang,Zhang Yu,Zhao Yinghai — 2022/9/30 15:48:48

【Abstract】 Objective To investigate the predictive role of pre-treatment D-dimer levels in post-thrombotic syndrome of the lower extremity deep veins. Methods Patients with DVT seen from January 2016 to December 2020 were retrospectively collected and followed up for 1 year developed PTS. clinical data of patients were registered while pre-treatment D-dimer levels were collected. The pre-treatment D-dimer optimal cut-off point was determined by the ROC curve Youden index, and prognostic factors affecting PTS were analyzed using univariate and multifactorial logistic regression models. Results The optimal pre-treatment D-dimer level for PTS in patients with DVT was 3.645 mg/L. Univariate and multifactorial analyses found that BMI ≥ 24 kg/m2, iliofemoral vein thrombosis, and D-dimer ≥ 3.645 mg/L were more likely to result in PTS. Conclusion Pre-treatment D-dimer levels in patients with DVT were good predictors of PTS, and pre-treatment D-dimer levels ≥3.645 mg/L were an independent risk factor for the development of PTS.

Research Progress of Myocardial Injury Caused by Limb Ischemia-Reperfusion in Diabetes

xuziqing,xueyang,zhangjie — 2022/9/30 9:38:02

Because the body is in the internal environment of hyperglycemia for a long time, when suffering from limb ischemia reperfusion (IR), the tissues and organs of diabetic patients are more likely to be damaged compared with non-diabetic patients, and the degree of damage will be more serious. In recent years, many scholars have done a lot of research on this phenomenon and made some progress. This article will review the current situation, prevention and treatment of myocardial injury caused by limb IR in patients with diabetes.

microRNA in pathogenesis and therapeutic effect of psoriasis

Li Xin,Qin Qunshi,Wei Guanjing,Xie Zhi — 2022/9/30 9:37:06

Psoriasis is a common chronic, recurrent, inflammatory disease mediated by immune factors. At present, the etiology and pathogenesis are not clear. microRNA (miRNA) plays an important role in the development and regulation of the immune system and the pathogenesis of psoriasis. This review will focus on miRNA involved in the pathogenesis of psoriasis and the therapeutic effects of miRNA on psoriasis. [key word] miRNA; Psoriasis; pathogenesis

The Influence of Continuous Care on Quality of Life and Mental Condition of Hemodialysis Patients with Diabetic Nephropathy

汪妮,熊浪,周波 — 2022/9/30 9:36:12

Objective: This study aims to discuss about the influence of continuous care on quality of life and mental condition of hemodialysis patients with diabetic nephropathy.Methods: Eighty hemodialysis patients with diabetic nephropathy treated from January 2018to June 2020 in our department were selected as subjects, with 40 patients in control group given routine nursing care, and 40 patients in observation group given continuous care on the basis of routine nursing care, to compare quality of life, mental condition and improvement of self-care ability of two groups of patients after 3 months of intervention.Results: The quality of life of patients in the observation group was better than that of patients in the control group, and the difference was statistically significant (P＜0.05); Zung anxiety scale (SAS) and depression scale (SDS) were used to evaluate the mental condition of patients, the results showed that the score of SAS and SDS of the two groups of patients had no significant different before intervention (P＞0.05), and the score of SAS and SDS of patients in the observation group was higher than that of patients in the control group (P＜0.05); and the self-care ability of patients in the observation group was significantly higher than that of patients in the control group (P＜0.05). Conclusions: Continuous care of hemodialysis patients with diabetic nephropathy can improve the quality of life, anxiety, depression and self-care ability of patients. It is worthy of clinical promotion.

The anesthesia experience of a patient with giant hepatocellular carcinoma complicated with type Ⅲa HVTT/ICVTT

yang wei — 2022/9/30 9:35:33

The anesthesia experience of a patient with giant hepatocellular carcinoma complicated with type Ⅲa HVTT/ICVTT

Primary sjogren's syndrome complicated with lung adenocarcinoma and cirrhosis: a case report

heyanfang,Wang Li, — 2022/9/30 9:33:36

To provide reference for early diagnosis and treatment of primary sjogren's syndrome complicated with lung adenocarcinoma and cirrhosis, a case of primary sjogren's syndrome complicated with lung adenocarcinoma and cirrhosis was reported.

A preliminary study of urine metabolism in patients with infectious kidney stones

HE Zhen,JIN Shan,QIAO Peng-fei,Yu Ming-jie — 2022/9/27 17:59:48

Objective To analyze and study the metabolic abnormalities and clinical significance of patients with infectious kidney stones. Methods We analyzed clinical datum of 87 patients with infectious kidney stones who received treatment in the urology of your institution from January 2015 to January 2018. These patients were divided into two groups in this study: one group includes 32 cases with simple infectious kidney stones (magnesium ammonium phosphate +/carbonate apatite); the other contains 55 cases with mixed infectious kidney stones (magnesium ammonium phosphate +/carbonate apatite and calcium oxalate). The results of blood biochemistry, urine routine, urine culture and 24h urine quantitative analysis of the two groups were compared.

Study the effect of Apolipoprotein E4 genotype on cerebral blood flow in Alzheimer's disease by Transcranial Doppler

Chenchunchun,Guoqiwen,Qiuguozhen,Xuchunyan — 2022/9/27 17:58:44

Objective: To study the effect of apolipoprotein E (APOE) 4 genotype on cerebral blood flow in Alzheimer’s disease (AD) by using transcranial doppler (TCD). Methods: 31 patients with AD received in cognitive impairment ward of neurology department of Luohu District People's Hospital from April 2020 to April 2021 were selected as the research group, and 25 elderly patients with normal cognitive function were selected as the control group. The cognitive function was assessed by the minimental state examination (MMSE), and the mean blood flow velocity (MFV) and pulsatility index (PI) of the intracranial arteries were detected by TCD.Then analyzed the characteristics of cerebral blood flow in AD patients. Fluorescence quantitative PCR method was used to detect the APOE genotype in AD patients. And then analyzed the effect of APOE4 genotype on cerebral blood flow in AD patients. Results: 1. There was no significant difference in gender, age and years of education between the two groups (p>0.05). The MMSE score in the study group was significantly lower than that in the control group (p < 0.05). 2. The MFV and PI of each intracranial artery in the study group were significantly lower and higer than that in the control group respectively (p ＜ 0.05), and the MFV of the intracranial arteries were positively correlated with the MMSE score, while the PI of the intracranial arteries was negatively correlated with MMSE score. 3. The area under the receiver operator characteristic curve (ROC) curve of the hemodynamic parameters of the probed and intracranial arteries were all >0.7. 4.The MMSE score of APOE E4 group was lower than that of E2+E3 group (p<0.05). and the MFV and PI of each intracranial artery in APOE E4 group were significantly lower and higher than those in E2+E3 group (p < 0.05). Conclusion: AD patients had cerebral hemodynamic changes characterized by decreased MFV and increased PI, and the severity of cognitive impairment is significantly correlated with cerebral hemodynamic changes, carrying APOE E4 genotype could cause more severe cognitive impairment, and changes in cerebral blood flow.

Comparison of combined localization method and transverse localization method in minimally invasive resection of breast masses

李之令 — 2022/9/27 17:57:38

Objective:To explore the application of combined localization method and transverse localization method in minimally invasive treatment of breast masses and compare their advantages and disadvantages.Methods: Retrospective analysis of the clinical data of 648 patients undergoing vacuum-assisted minimally invasive breast resection in our hospital from March 2021 to April 2022 under local anesthesia.According to the random number table method, 306 cases were randomly divided into transverse positioning (group A) and 342 cases were randomly divided into combined positioning (group B).The two groups, condition in preoperative, intraoperative and postoperative

Clinical study on the treatment of severe diabetic macular edema by repeated 577nm micropulse laserLIU lu-hong, HUANG kong-qian, LI min, et al. Research center of Ophthalmology, Guangxi Academy of Medical Sciences Department of Ophthalmology, The People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China.

huang kong-qian,li min,liu luhong — 2022/9/27 17:56:53

[Abstract] Objective To investigate the clinical effect of repeated 577nm micropulse laser on severe diabetic macular edema. Methods 60 eyes of 60 patients diagnosed with severe diabetic macular edema in our hospital from December 2015 to December 2019 were selected and randomly divided into two groups. Observation group (30 eyes, 30 cases) received the second micropulse laser treatment 6 weeks after the first one, and the control group (30 eyes) received only one micropulse laser treatment. The changes of best corrected visual acuity (BCVA) [LogMAR] and central macular thickness(CMT) were compared between the two groups before and after treatment, and the continuous changes of outer retina and the occurrence of side effects such as ocular hypertension, anterior chamber inflammation, subretinal neovascuarization and fibrosis were observed after treatment. Results After treatment, the BCVA was significantly improved and CMT was obviously decreased in both groups compared with before surgery (all P <0.05). Compared with the two groups, BCVA and CMT in the observation group were markedly improved at 12 weeks after surgery compared with the control group (all P <0.05). Conclusion 577nm micropulse laser can reduce the CMT of severe DME and increase BCVA, but repeated application of 577nm micropulse laser has better therapeutic effect, and there are no adverse reactions and complications.

Effect of perioperative esketamine on postoperative delirium in elderly patients undergoing esophageal cancer radical surgery

王妮 — 2022/9/27 17:55:40

[Abstract] Objective To explore the effect of perioperative esketamine on postoperative delirium (POD) in elderly patients undergoing esophageal cancer radical surgery. Methods Eighty elderly patients undergoing esophageal cancer radical surgery in the operating room of our hospital from February 2021 to December 2021 were enrolled, regardless of gender, aged 65-80 years old, and with American Society of Anesthesiologists (ASA) class II to III. The subjects were allocated into esketamine group (group E) and opioids group (group O), with 40 subjects per group, according to a random number table method. At the beginning of anesthesia induction, group E was given intravenous esketamine 0.5 mg/kg. During the maintenance of anesthesia, the rate of administration of esketamine was 0.5 mg·kg-1·h-1, and was stopped 30 minutes before the operation, and immediately after the operation, patient controlled intravenous analgesia (PCIA) pump was set, esketamine 1.0 mg/kg + sufentanil 50 μg + butorphanol 12 mg + tropisetron 10 mg were added to the analgesic pump, and diluted to 100 ml with normal saline. In group O, sufentanil was injected intravenously with 0.2-0.4 μg/kg, and remifentanil was administered at a rate of 0.1-0.3 μg·kg-1·min-1 and was stopped 5 minutes before the operation, and sufentanil was added to the PCIA pump, and fentanyl 100 μg + butorphanol 12 mg + tropisetron 10 mg were diluted with normal saline to 100 ml. Central venous blood was drawn at 10 minutes before induction of anesthesia (T0), when the operation finished (T1), and 1 d (T2), 2 d (T3) and 3 d (T4) after operation, and the concentration of nerve injury marker-specific protein 100β (S100β protein) and neuron-specific enolase (NSE) in serum were measured. Central venous blood was drawn 1 day before operation and 1 day and 3 days after operation, and the concentrations of serum inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured. The evaluation of POD was performed by the intensive care unit (ICU)-consciousness assessment method (CAM-ICU) within 3 days after operation. The intraoperative dosage of propofol and stay time of postanesthesia care unit (PACU) were recorded. Results All patients successfully completed the trial. A total of 13 patients (32.5%) in the group O developed POD within 3 days after surgery, and 27 patients (67.5%) did not develop POD. A total of 5 patients (12.5%) in the group E developed POD within 3 days after surgery, and 35 patients (87.5%) did not develop POD. From T1 to T4, the levels of serological nerve injury markers S100β and NSE were significantly increased in both groups (P<0.05). The serum levels of TNF-α, IL-6 and IL-8 in the two groups were significantly increased on the 1st and 3rd days after the operation compared with those on the 1st day before the operation (P<0.05), but the levels in the group E was significantly lower than those in the O group (P<0.05). From T1 to T4, compared with the group O, the levels of serological nerve injury markers S100β and NSE in the group E were significantly decreased (P<0.05). Compared with the group O, the intraoperative propofol dosage and PACU stay time were significantly decreased in the group E (P<0.05). Conclusion Perioperative administration of esketamine can reduce the levels of serological nerve injury markers S100β and NSE in elderly patients undergoing Esophageal cancer radical surgery, and lower the incidence of POD, and the anti-inflammatory effect man be the possible mechanism.

Summary of best evidence for nucleic acid collection of COVID-19

Cai luyao,Chen shunli,Chen yingyi,Tang lingyu — 2022/9/9 9:09:09

Objective To search, evaluate and summarize of the best evidence of nucleic acid collection for novel Coronavirus(COVID-19).Methods We searched OVID-JBI, Up To Date, BMJ Best Practice, Cochrane Library, Embase, World Health Organization,Guidelines International Network(GIN),Centers for Disease Control and Prevention(CDC),Public Health England(PHE),Pubmed，CNKI，Wanfang，VIP，CBM and National Health Commission of the People's Republic of China to collect literatures on nucleic acid sample collection of novel Coronavirus, including guidelines, best practice, evidence summary, expert consensus, system evaluation, etc. Two researchers trained in evidence-based nursing independently assessed the quality of included literatures and extracted data. Results A total of 21 papers were enrolled, including 9 guidelines，1 best practice, 8 expert consensuses, 1 evidence summay, 1 review and 1 systematic review. 33 pieces of evidence were summarized from six aspects: specimen collection requirements, collection methods, specimen preservation, specimen transport, occupational protection and result report. Conclusions This study summarized the best evidence of nucleic acid sample collection, provided evidence-based basis for clinical medical staff to implement the standardized operation of nucleic acid sample collection, improving the accuracy of nucleic acid sample collection and management, and timely and effective assistance in the prevention and control of COVID-19.

Research progress in the application of Early Essential Newborn Care

HUANG Fang,LIANG Chun-yan,LIANG Ying-fu — 2022/9/8 9:55:22

Standardized application of basic health care technology in early neonatal period can effectively improve the prognosis of mothers and infants. This paper reviews the origin, development and application of the basic health care technology for early newborns in China, and puts forward some thoughts and prospects.

The effect of hyperuricemia on chronic kidney disease

Lan Shu-zhen — 2022/9/8 9:54:02

Chronic kidney disease (CKD) is a highly prevalent and dangerous disease, and early detection and intervention of its risk factors are crucial for its treatment. Hyperuricemia is a common complication and comorbidity of CKD, which is not only a complication of renal decompensation but also a risk factor for the progression of renal function decline. CKD may be accelerated by hyperuricemia through pro-inflammatory effects, induction of oxidative stress and mitochondrial dysfunction, pro-angiopathy, pro-fibrosis, "2-hit" model and other mechanisms. Relevant clinical studies have shown that uric acid-lowering therapy can delay CKD progression, but some studies have reached different conclusions. In this article, we discuss the effect of hyperuricemia on the development of CKD, the pathogenic mechanisms, and the effect of uric acid-lowering therapy on CKD.

Postoperative cognitive dysfunction after cardiac surgery under cardiopulmonary bypass

xiejielin — 2022/9/7 16:33:14

This article reviews the risk factors, pathogenesis, diagnostic markers and prevention measures of brain injury after cardiac surgery under cardiopulmonary bypass, the objective is to understand brain injury after cardiac surgery,to provide the basis for clinical diagnosis and treatment, improve the short-term and long-term prognosis of patients after cardiac surgery.

Follicular lymphoma with ascites as the main clinical mainfestation:A case report

huanglijun,,,, — 2022/9/7 16:32:24

Objective: To explore the special clinical practice of follicular cell lymphoma and provide the basis for early diagnosis; Methods: A case in July 2021 was analyzed retrospective: 1 case of follicular lymphoma with ascites was found.Conclusion: Follicular lymphoma needs multidisciplinary diagnosis and treatment.

Mandibular Ameloblastoma Treated with decompression：A Case Report

Cui Yan — 2022/9/7 16:27:18

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Evaluation of bilateral uterine artery blood flow parameters combined with early diastolic notch in early pregnancyThe clinical value of recurrent miscarriage

Zhangying — 2022/9/6 17:57:38

Objective To investigate the clinical value of bilateral uterine artery blood flow parameters in early pregnancy combined with early diastolic notch in the evaluation of recurrent miscarriage. Methods 40 cases of recurrent miscarriage admitted to our hospital from August 2020 to August 2021 were selected as the observation group, and 40 cases of normal pregnancy during the same period were selected as the control group. The Voluson 730 Pro color Doppler ultrasound system was used for inspection to obtain the peak systolic flow rate/end diastolic flow rate (S/D) value, uterine artery pulsatility index (PI) value, and uterine artery resistance index (RI) on both sides of the uterine artery. ) Value, and focus on observing the appearance of notches in the early diastole, comparing the two groups of bilateral uterine artery blood flow parameters,Count the two groups of early diastolic notches, that is, the appearance rate of the high resistance blood flow spectrum of the middle uterine artery during the color Doppler ultrasound examination of the uterine artery in the first trimester, and draw the S/D value of the bilateral uterine artery blood flow parameter to evaluate the adverse pregnancy outcome of pregnant women with recurrent miscarriage Calculate the ROC curve and calculate the AUC area, and count whether there is an early diastolic notch and the adverse pregnancy outcome.Results The S/D value, PI value and RI value of the observation group were higher than those of the control group (P<0.05). The early diastolic notch appearance rate in the observation group was significantly higher than that of the control group (P<0.05). The bilateral uterine artery blood flow parameters Combined with early diastolic notch to evaluate the adverse pregnancy outcome of pregnant women with recurrent miscarriage, the AUC area = 0.6921. Conclusion The implementation of bilateral uterine artery blood flow parameters combined with early diastolic notch detection for patients with recurrent miscarriage can effectively predict adverse pregnancy outcomes and help guide clinical treatment.

Analysis of influencing factors of metabolic syndrome in residents of 10 counties (districts) in Guangxi

ChenYuZhu,DongMo,LiXiaoPeng,luWuTao,QinQiuLan,ZhouWeiWen — 2022/9/6 17:57:05

Objective To analyze the influencing factors of metabolic syndrome (MS) in urban and rural residents of Guangxi, and to provide scientific basis for the formulation of targeted prevention and treatment of MS. Methods Adopting multi-stage cluster random sampling method, A total of 2469 residents aged 18 and above in 10 counties (districts) of Guangxi were selected for questionnaire survey, physical measurement and laboratory test. Results A total of 574 patients with metabolic syndrome were detected, and the prevalence was 23.2%, 29.2% in urban residents and 20.8% in rural areas, which was significantly higher than that in urban areas (P < 0.05). There were statistically significant differences in age, sex, ethnicity, education level, marital status, smoking, alcohol consumption, family history of diabetes and coronary heart disease, BMI and TC between MS group and non-MS group (P < 0.05). The intake of cereals in urban metabolic syndrome patients was different from that in normal population, and the difference was statistically significant (P<0.05). Binary logistic regression analysis showed that gender (OR=1.755), age, family history of diabetes (OR=1.776), BMI and occupation were the influencing factors of MS. Conclusion The occurrence of MS in urban and rural residents of Guangxi is related to dietary factors, population gender, age, family history of diabetes, BMI and occupation, etc. Early screening and health education should be carried out for the population to develop good dietary behavior and lifestyle, so as to effectively prevent MS.

Clinical study of the therapeutic effect of abdominal needle on swallowing disorder after stroke

JIN Xin,,, — 2022/9/6 17:56:36

Objective The effect of abdominal needle combined with conventional swallowing rehabilitation training on swallowing function, hyoid laryngeal complex mobility, pharyngeal contraction rate, and upper esophageal sphincter opening in patients after stroke.Methods The 60 patients were divided into control and observation groups, with 30 patients each.The control group only underwent regular swallowing rehabilitation training, and the experimental group received abdominal needle treatment on this basis. Both groups were treated for 4 weeks to observe the changes of VFSS score, glossal laryngeal complex mobility, pharyngeal cavity contraction rate and upper esophageal sphincter opening in the two groups before and after treatment.Results After 4 weeks of treatment, the VFSS score was higher than that of control patients, the total response rate was higher than that of control group, and there were significant differences between groups (P <0.05).After 4 weeks of treatment, the mobility of the lingual laryngeal complex increased compared with the previous group and the observed group was greater than the control group (P <0.05).The openness of the upper esophageal sphincter was improved compared with the previous group, and the observed group was greater than the control group (P <0.05).The contraction rate was lower compared with the previous group and lower than the control group (P <0.05).Conclusion he abdominal needle combined with routine swallowing rehabilitation training in swallowing dysfunction after stroke can significantly promote the improvement of swallowing function.Moreover, after the digital analysis of dysphagia, it is found that the abdominal needle combined with routine swallowing rehabilitation training can improve the mobility of the hyoid laryngeal complex and the opening of the upper esophageal sphincter, and reduce the rate of the contraction of the pharyngeal cavity.

A study of application value in patients with connective tissue disease complicated with interstitial lung disease left ventricular myocardial work by ultrasonic pressure-strain loop

shenjie — 2022/9/6 17:55:56

[Abstract] Objective To investigate the value of pressure-strain loop(PSL) for assessment of left ventricular myocardial work in patients with connective tissue disease complicated with interstitial lung disease（CTD-ILD）. Methods Twenty-eight patients diagnosed with CTD-ILD and twenty-eight healthy sex and age matched controls were enrolled. Blood pressure measurements and conventional transthoracic cardiac ultrasound were completed for all subjects,and myocardial work parameters of LV were evaluated using PSL to obtain parameters,including global work index (GWI), global constructive work (GCW) and global wasted work (GWW)，global work efficiency (GWE)。The difference of myocardial work parameters between the two groups was compared。Results Compared with control group,CTD-ILD group had Increased GWW significantly(P<0.05). Moreover, GLS, GWE, GWI, GCW were significantly lower than those of control group (P<0.05). GWI，GWE were significantly related to GLS(P<0.05).Conclution PSL can well quantitative assess- ment of left ventricular myocardial work in patients with CTD-ILD, which provides a new reference information for clinical management of patients.

Effects of early enteral nutrition on prognosis in patients with acute Stanford type A aortic dissection

Che Liling,,, — 2022/9/6 10:34:56

Objective: To investigate the effects of early enteral nutrition on gastrointestinal function, nutritional status and postoperative complications in patients with acute Stanford type A aortic dissection. Methods: 72 patients with acute Stanford type A aortic dissection admitted to extracardiac ICU from August 2020 to December 2021 were randomly divided into study group and control group, with 36 cases in each group. The study group was treated with nasogastric enteral nutrition and the control group was treated with nasogastric enteral nutrition. The differences of feeding tolerance, nutritional status and clinical prognosis between the two groups were compared. Results: the general clinical data of the two groups had no statistical difference and were comparable (P > 0.05). In terms of feeding tolerance, the incidence of abdominal distention (t=4.126, p=0.042), reflux (t=4.6, p=0.032) and gastric retention in the study group were lower than those in the control group. In terms of nutritional status, on the fifth day of enteral nutrition, serum albumin was significantly higher than that of the control group (t = -3.555, P = 0.001), and serum prealbumin was significantly higher than that of the control group (t = -4.164, P = < 0.05). In terms of clinical prognosis, the incidence of aspiration pneumonia and incision infection in this study was lower than that in the control group due to the sample size. Conclusion: compared with nasogastric enteral nutrition, early nasogastric enteral nutrition support can effectively improve the feeding tolerance and nutritional status of patients with acute Stanford type A aortic dissection, so as to promote the perioperative recovery process and improve the clinical prognosis.

Aseptic and tumor-free operation skills of laparoscopic resection of lower colorectal cancer with specimen eversion and body-outside resection

Zhao Xiao-Fang — 2022/9/6 10:34:23

To discuss the aseptic and tumor-free skills of laparoscopic natural orifice specimen extraction surgery (NOSES) for lower rectal cancer with specimen eversion and body-outside resection and to investigate its medium and long-term clinical effects. Methods The clinical data of 67 patients with rectal cancer who underwent laparoscopic lower anterior resection by means of specimen eversion and body-outside removal from January 2017 to December 2021 in Sichuan Cancer Hospital were retrospectively analyzed. The operation time, blood loss, postoperative complications, hospital stay, and status of tumor recurrence and metastasis were analyzed. Results All operations of 67 patients were completed successfully, with average operative time 320.1 min (200 ~ 590 min), intraoperative bleeding 64.3 ml (5 ~ 300 ml). The average flatus time postoperative was 21.9 h (1 ~ 88 h). Anastomotic leakage occurred in 1 case (1.5%) post operation, urinary retention occurred in 3 cases (4.5%), and incomplete intestinal obstruction occurred in 5 cases (7.5%). All of them recovered after conservative treatment. The average hospital stay was 10.6 d (7 ~ 26 d). The average follow-up period was 33.8 m (6 ~ 65 m). Pelvic recurrence was found in 1 case (1.6%), distant metastasis was found in 5 cases (7.8%), of them 4 cases (6.3%) died, and the rest have survived so far. Conclusion Laparoscopic lower anterior resection with specimen eversion and body-outside removal has the advantages of minimal invasion, fast recovery and promising clinical effects. As long as the indications are strictly controlled before the operation, the principle of asepsis and tumor-free is strictly observed during the operation, and the key operating skills are mastered, the abdominal cavity pollution can be effectively avoided and the risk of iatrogenic spread of tumor can be reduced.

Preliminary study on the value of CT small bowel imaging in the diagnosis of moderate to severe Crohn's disease

HE Jiangtao,Wang Wei,XUE Zhenlong — 2022/9/6 10:33:50

Objective To analyze the independent risk factors of CT small bowel imaging (CTE) in the diagnosis of moderate to severe Crohn's disease (CD) .Methods The clinical and CT examination data of CD patients admitted to the Affiliated Hospital of Yangzhou University and confirmed by clinical endoscopy and pathology were collected. According to the score of Crohn's disease activity index (CDAI), the patients were divided into remission to mild active group (patients in remission and mild stage) and moderate to severe stage group (patients in moderate and severe stage). The CTE signs of the two groups were analyzed, and a binary logistic regression model was established to evaluate the specific indexes. Results 60 patients with CD completed the examination of CT and CDAI, including 29 patients with moderate to remission to mild active group and 26 patients with moderate to severe stage of CD. The analysis of CTE signs showed that there were significant differences between the two groups in intestinal wall thickness, CT value of intestinal wall in arterial phase, CT value of intestinal wall in venous phase, layered enhancement of intestinal wall, increased mesenteric fat density and increased mesenteric straight small vessels (comb sign) (P < 0.05); Binary logistic regression analysis showed that the three parameters of intestinal wall thickness (or = 3.470 CI: 1.178 ~ 10.223), CT value of venous intestinal wall (or = 1.289 CI: 1.067 ~ 1.557) and stratified enhancement of intestinal wall (or = 6.784 CI: 1.027 ~ 44.759) were the Independent parameters to distinguish the two groups. Conclusion Intestinal wall thickness, stratified enhancement of intestinal wall and average CT value in portal vein phase are independent risk factors for the diagnosis of moderate and severe CD patients, which is helpful to identify the activity of CD.

A multicenter retrospective study on clinical features of prostate cancer in Xinjiang in the past 10 yearsWang Wenguang 1 Wang Chenyu 2 Bi Xing 3 Li Qianyue 4 Song Hongwen 1 Asmu Jiang · Abula 1 Hou Yakun 1 Wang Yujie 1

王文光 — 2022/9/6 10:33:18

【Abstract】Objective To study the clinical characteristics of prostate cancer in Xinjiang in the past 10 years. Methods From January 2010 to June 2021, the relevant data of 2151 patients with prostate cancer who were treated in the First Affiliated Hospital of Xinjiang Medical University, the People's Hospital of Xinjiang Uygur Autonomous Region, the Cancer Hospital Affiliated to Xinjiang Medical University, and the General Hospital of Xinjiang Production and Construction Corps Corps were selected. , to analyze the clinical characteristics. Results The age distribution of patients in this group was 41-96 years old, with an average age of (71.81±8.20) years old. Distributed in patients aged 70-79 years, the most, 1030 cases (47.89%). From the perspective of time distribution, the number of cases showed an increasing trend year by year. The most common clinical manifestations were dysuria, accounting for 43.75%. In terms of prostate volume, between the ages of 50 and 90, the volume increases with age. The median of PSA detection value was 54.68ng/ml, and the Gleason score was mostly 8 in 593 cases (27.57%). There were 877 patients (40.77%) with distant metastases, among which 641 patients (73.09%) had bone metastases. There were 101 cases (23.06%) of positive margins, and 373 cases (17.38%) of vascular and nerve infiltration were found. Judging from the comparison of clinical characteristics of different ethnic groups, Uyghur patients were younger at the time of initial diagnosis; the prostate volume was larger; and the PSA level was higher. The PSA of Han patients is more at 10-20ng/ml; the PSA of Uygur patients is more than 20ng/ml. From the point of view of the first symptoms, the Han patients are more likely to have an elevated PSA during physical examination, while the Uyghur patients are more likely to seek medical treatment for urinary retention and dysuria. Visceral metastases are more common in Han patients; bone metastases are more common in Uygur patients. In terms of tumor staging, localized prostate cancer in Han people is more common than that in Uyghur patients, and local progression and distant metastasis are more common in Uyghur patients. Among the patients with distant metastases, more Uygurs choose pure endocrine therapy, and more Han patients choose systemic therapy. The rest of the indicators are no different. Conclusion The incidence of prostate cancer in Xinjiang has its own regular characteristics. Compared with the Han nationality, Uygur patients with prostate cancer have more obvious clinical characteristics. Further research is needed to reveal the difference nature of clinical phenomena.

Clinical data analysis of TKI Discontinuation in patients with chronic myeloid leukemia in chronic phase

Chen Dan,Huang Jian,Jin Keyi,Wang Shengjie,Zhang Lan,Zheng Yan,Zhu Xiaoqiong — 2022/9/6 10:32:47

Objective: To investigate the clinical characteristics and data of tyrosine kinase inhibitor (TKI) withdrawal in patients with chronic myelogenous leukemia in chronic phase (CML-CP), then to analyse the influencing factors. Methods: All patients with CML-CP who met the drug discontinuation criteria and succeeded in TKI discontinuing in the Fourth Affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed from March 2015 to August 2021 and the related literature was reviewed. Results: Hitherto there are 8 CML patients in our hospital who have met the TKI discontinuation criteria, including 4 males (50%) and 4 female(50%),with a median age of 49 (31-69) years old. First line: There are 3(37.5%) patients choosing the first-generation TKI original drugs and 4(50.0%) patients choosing first-generation TKI generic drugs,with 1 (22.5%) patient choosing second-generation TKI (nilotinib). The median treatment time before discontinuation is 95（48-146） months, and the median time of maintaining molecular response 4.0(MR4.0) and above is 60（24-144） months. So far the treatment-free response (TFR) rate is 50%, and the TFR rate in patients of using the second-generation of TKI in the first-line, the original drug and the generic drug in the first generation of TKI was 100%,66.7%,25.0% . Conclusion: The TFR rate of CML patients in our hospital after drug withdrawal was consistent with foreign reports. The TFR rate of patients using the first-line second-generation TKI was the highest, and the TFR rate of patients using the first-line first-generation TKI original drugs was 66.7%, which was higher than foreign reports.

Expressions of TRAF6 and OTUD5 in colorectal cancer and their clinical significances CHEN Da,WU Jiang-ni,WEI Er-dan,et al. Department of Gastroenterology,the Second Affiliated Hospital of Guangxi Medical University,Nan-ning 530007,China

CHEN Da,,,, — 2022/9/6 10:31:55

Objective To analyze the expression of tumor necrosis factor receptor-associated factor 6 (TRAF6) and ovarian tumor domain protein deubiquitinase 5 (OTUD5) in colorectal cancer (CRC), and to explore their roles in the development and progression of colorectal cancer. Methods The immunohistochemical method was used to detect the expression of TRAF6 and OTUD5 in CRC and its adjacent tissues, and RT-qPCR was used to detect the expression of TRAF6 and OTUD5 mRNA in CRC cells and normal colonic epithelial cells. To investigate the correlation between TRAF6 mRNA expression and OTUD5 mRNA expression, the HT29 cell line overexpressing TRAF6 was constructed by genetic engineering.Results (1) Theimmunohistochemical results showed that TRAF6 and OTUD5 were mainly expressed in the cytoplasm and membrane of glandular epithelium. The positive rate of TRAF6 expression in CRC was 84%, which was significantly higher than that in normal group (P<0.01). The positive expression rate of OTUD5 in CRC was 46%, which was significantly lower than that in normal group (P<0.05). Clinicopathological analysis showed that the expression levels of TRAF6 and OTUD5 were significantly correlated with distant metastasis of CRC. (2) RT-qPCR results showed that the expression level of TRAF6 mRNA in CRC cells was significantly higher than that in normal colon epithelial cells (P<0.01), while the expression level of OTUD5 mRNA in CRC cells was significantly lower than that in normal colon epithelial cells (P<0.01). (3) The cell experimental results showed that upregulation of TRAF6 expression in HT29 cells significantly reduced the expression level of OTUD5 mRNA (P<0.01).Conclusion TRAF6 may be involved in the occurrence, development and metastasis of colorectal cancer by inhibiting the expression of OTUD5 gene.

Comparison of high flow nasal cannula and non-invasive ventilation in acute respiratory failure

FENG Guanghong,QIN Zhiqiang — 2022/8/12 10:46:37

Respiratory failure is a common critical ill. High flow nasal cannula oxygen (HFNC) and non-invasive ventilation (NIV) play key roles in treatment of respiratory failure. Both HFNC and NIV can improve parameters of blood gas analysis and reduce work of breath. Clinical studies have confirmed that HFNC is similar effective to NIV in treatment of hypoxemic respiratory failure, but use of HFNC in hypercapnic respiratory failure needs more clinical research evidence.

Effect of hemoglobinopathies on the dectection of Glycolated hemoglobin

李友琼 — 2022/8/10 15:28:37

Hemoglobinopathy is the most common genetic disease in southern China and the main cause of poor quality of life for patients. Moreover, it can cause abortion and stillbirth. Glycolated hemoglobin is one of the screening indicators of diabetes, and as the gold standard to reflect the control of blood glucose in diabetic patients. There are interferences in detection of HbA1C for patients with hemoglobinopathies, which may be related to the methods. Studies have shown that detection of glycolated hemoglobin by capillary electrophoresis can be used to screen for hemoglobinopathy. It is a new screening method for hemoglobinpathy.

Progress in the study of the action and mechanism of Mesenchymal stem cell exosomes

Yu Jing — 2022/8/10 15:28:00

Mesenchymal stem cells (MSCs) have the ability to differentiate and paracrine biologically active factors, and are widely used in clinical cell therapy. MSCs have functions such as immune regulation, anti-inflammatory, angiogenesis and anti-apoptosis. The exosomes derived from MSCs can not only carry the genetic information of MSCs, but are also easier to store and maintain functions than MSCs, which is beneficial to the repair and regeneration of various tissues after injury. This article reviews the research progress of mesenchymal stem cell exosomes from the aspects of mesenchymal stem cell therapy, MSCs exosomes characteristics and biological functions, and the mechanism of MSCs exosomes in different diseases, and discusses MSCs exosomes application prospect as an alternative cell therapy .

Research progress on the pathogenesis of metabolic associated fatty liver disease and its correlation with intestinal fungi

谢娇娇 — 2022/8/10 15:27:22

Abstract:??The threat of metabolic associated fatty liver disease (MAFLD) to human health cannot be ignored. The discussion on the pathogenesis of MAFLD in modern medicine has never been stopped. The strike theory is the basic theory of the mechanism and has been recognized by everyone.??Insulin can be used as the initial stage of MAFLD, lipid toxicity theory and inflammatory response are the key links, and adipokine is the driving link. Genetic polymorphism and epigenetics have discussed the pathogenesis of MAFLD from the perspective of genetics.??Liver damage caused by intestinal dysbiosis based on the enteric-liver axis theory has been a hot topic in MAFLD research in recent years. Different from intestinal bacteria, there are few studies on the role of intestinal fungi in the occurrence and development of NAFLD. In this review, we reviewed the pathogenesis of MAFLD and its relationship with intestinal fungal community, and discussed the mechanisms by which bacterial community may influence disease progression. Strategies to control gut microbiota may be developed to treat or prevent liver disease.

Effect of group mindfulness-based stress reduction intervention on negative emotions and stigma of patients with maintenance hemodialysis

maqian — 2022/8/10 15:26:46

To explore the effect of groupmindfulness-based stress reduction intervention on patients with maintenance hemodialysis (MHD). Methods 74 patients with MHD were randomly divided into control group (n=37, routine nursing) and observation group (n=37, group mindfulness-based stress reduction intervention on the basis of control group). Negative emotions [Hospital Anxiety and Depression Scale (HADS)], stigma [Social Impact Scale (SIS)] and quality of life [KDQOL-SFTM 1.3 Scale (KDQ)] of two groups were compared before intervention and after 8w of intervention. Results After 8w of intervention, scores of HADS and SIS of two groups were obviously lower than those before intervention, and scores of observation group were significantly lower than those of control group (P<0.05). KDQ scores of two groups were markedly higher than those before intervention, and scores in observation group were significantly higher than those in control group (P<0.05). Conclusion Group mindfulness-based stress reduction intervention can help relieve negative emotions and stigma of patients with MHD, and can also obviouslyimprove quality of life, with high clinical promotion significance.

A case of severe Epstein-Barr virus associated hemophagocytic syndrome in an adult

marongxia — 2022/8/10 15:26:05

【Summary】Hemophagocytic syndrome is a rare histiocytic disease, and its early manifestations lack specificity, which can easily lead to misdiagnosis and delay treatment opportunities. This paper retrospectively analyzes the clinical data, diagnosis and treatment of a patient diagnosed with Epstein-Barr virus-associated hemophagocytic syndrome (EBV-HLH), and reviews the literature based on the current research progress of EBV-HLH, so that clinicians can identify EBV-HLH early , to achieve early diagnosis, early treatment, and strive for survival opportunities for patients.

Gitelman syndrome caused by new mutation of SLC12A3 gene: a case report and literature review

chenqiaoyun — 2022/8/10 15:18:55

The clinical data of a recently treated Gitelman syndrome (GS) patient was analyzed, with a medical history of 7 years. The laboratory results showed that the patient had hypokalemia, hypomagnesemia, hypocalcemia and metabolic alkalosis, and was complicated with high renin activity. The related genes of the patient and his parents were sequenced, and finally the diagnosis of hypokalemia was confirmed by gene testing, and the hypokalemia was effectively treated. At the same time, a new mutation site of SLC12A3 gene mutation was found, which enriched GS.

Title: Long-term efficacy of perioperative comprehensive rehabilitation intervention on upper limb function of breast cancer patients_*Wan Cao₁, Quanqing Zou₂, Lanhui Qin₁, Huaping Liang₁, Hongxu Lu₁, Jianrong Yang₂_△

Department of Rehabilitation Medicine,yangjianrong — 2022/8/4 16:47:05

BACKGROUND: Dysfunction of the upper limb is a common complication following radical mastectomy. Early perioperative comprehensive rehabilitation intervention contributes to the functional recovery of the affected upper limb. AIM: To evaluate the long-term efficacy of perioperative comprehensive rehabilitation intervention on the function of upper limbs in patients who underwent radical mastectomy. METHODS: A total of 85 patients who underwent radical mastectomy were randomly divided into rehabilitation group and control group. Patients in the control group received routine rehabilitation education after surgery. Patients in the rehabilitation group received rehabilitation education and perioperative progressive comprehensive rehabilitation treatment. The patients were subjected to the assessment of active range of motion of bilateral upper limb shoulder, bilateral arm circumference, and Constant score before surgery, and 1 month, 3 months, 12 months after surgery. RESULTS: The active range of motion of shoulder joints, the incidence of lymphedema and the Constant scores were improved gradually over time. The active range of motion including forward flexion, abduction, extension, and Constant scores were significantly improved in the rehabilitation group than those in the control group at 1 month, 3 months and 12 months after surgery (p<0.05). The incidence of lymphedema on the affected side was lower at 1, 3 and 12 months after surgery in the rehabilitation group compared to the control group, but the difference was not significant (p>0.05). CONCLUSION: The perioperative progressive comprehensive rehabilitation intervention for breast cancer significantly improves Constant scores and the active range of motion of the shoulder joint after radical mastectomy, and promotes long-term recovery of upper limb function.

Effect of nerve loosening combined with muscle energy technique on cervical spondylopathy of radiculopathy? CHEN Hong-bo,YAO Na,SONG Yan-ping,CHEN Qi-gang.Kunming Hospital of Traditional Chinese Medicine Rehabilitation Department, Kunming 650505,China;FENG Yu. Yunnan University of Chinese Medicine,Kunming 650500,China

CHEN Hong-bo,,, — 2022/8/4 16:46:04

Objective To investigate the clinical effect of nerve loosening combined with muscle energy technique in the treatment of cervical spondylotic radiculopathy. Methods A total of 62 patients with cervical spondylotic radiculopathy treated in Kunming Hospital of Traditional Chinese Medicine from January 2021 to November 2021 were selected as the research subjects, and were divided into observation group and control group by random number table method, with 31 patients in each group.The control group received routine rehabilitation combined with nerve loosening, and the observation group added muscle energy technology on the basis of the control group.The pain improvement degree [visual analogue scale (VAS) score], cervical function recovery [neck disability index,(NDI)] and clinical efficacy were compared between the two groups before and after 2 weeks of treatment.Results Before treatment, there was no significant difference in VAS score and NDI score between the two groups (P>0.05).After 2 weeks of treatment, VAS score and NDI index of 2 groups were significantly lower than those before treatment (P<0.05), and VAS score and NDI index of observation group were lower than those of control group, the difference was statistically significant (P<0.05).After 2 weeks, the clinical effective rate of the observation group was 93.55% higher than that of the control group (74.19%), the difference was statistically significant (P<0.05).Conclusions Nerve loosening combined with muscle energy technique can relieve the pain of radiculopathy and improve cervical dysfunction, which has good clinical effect and is worthy of clinical application.

Clinical Characteristics of 143 Cases with Primary Malignant Tumor of the DuodenumJIANG D,LIANG X,LIANG Z H,HUANG Z N*(Department of Gastroenterology of The First Affiliated Hospital of Guangxi Medical University,Nanning,530021)

jiang dan,liang xian,liang zhi hai — 2022/8/4 16:44:37

Objective: To explore the clinical features, diagnosis and treatment methods of primary malignant tumor of the duodenum(PMTD). Methods: Retrospective analysis of clinical, pathologic and laboratory data of 143 patients with PMTD admitted to the First Affiliated Hospital of GuangXi Medical University from January 2012 to June 2019，and analyze the risk factors for poor prognosis. Results: In totally 143 patients, the anatomical site of tumor was mainly in the descending part (120/143 cases, 83.92%), followed by the ball part (16/143 cases, 11.18%). The symptoms were mainly jaundice (59.44%), abdominal pain (51.75%). Positive diagnostic rate of gastroduodenal endoscopy, endoscopic ultrasonography(EUS) and Encoscopic Retrograde Cholangio-Pancreatography(ERCP) was 88.24%, 98.38%, 95.83%. The positive rate of carbohydrate antigen199(CA199)(46.15%) was significantly higher than that of carcinoembryonic antigen(CEA), alpha fetoprotein(AFP) and carbohydrate antigen125(CA125). Multivariate analysis showed that the duration time of onset to diagnosis, lymph node metastasis and tumor differentiation were the risk factors for the prognosis of patients with PMTD(P<0.05). Conclusions: The main symptoms of PMTD are jaundice and abdominal pain. The PMTD are mainly occurred in the descending part of duodenum. The positive diagnosis rate of PMTD with digestive endoscopy is higher than other methods. The duration time from onset to diagnosis confirm, lymph node metastasis and tumor differentiation are risk factors for prognosis of PMTD.

Predictive value of FeNO combined with small airway function in asthmatic airway hyperresponsiveness

FAN Longmei,HAN Guojing,MENG Song,ZHANG Wei — 2022/8/4 16:43:50

Objective To investigate the predictive value of fractional exhaled nitric oxide (FeNO) combined with small airway function on airway hyperreactivity in patients with bronchial provocation test (BPT) positive asthma, and to provide a simple and safe method for clinical airway hyperreactivity evaluation. Methods A total of 60 patients with asthma who were newly diagnosed in the respiratory Outpatient department of the First Center of chinese PLA General Hospital from September in 2019 to March in 2022 were selected. Among them, 30 patients with positive bronchial dilation test were selected as the BDT positive group. The bronchial dilation test was negative, and the positive bronchial provocation test(30 cases) was BPT positive group. Thirty non-asthmatic patients with asthma-related symptoms and negative bronchial dilation test and bronchial provocation test were selected as the BPT negative group. General data, FeNO and lung function parameters were compared in each group. ROC curve was used to detect the predictive value of FeNO and small airway function indicators (MMEF%, FEF75%, FEF50%) alone and in combination for airway hyperreactivity in asthmatic patients with bronchial provocation test positive. Results There was no statistical difference in general data among the three groups (P>0.05). FeNO values in the BDT positive group and the BPT positive group were higher than those in the BPT negative group (P<0.05), and there was no statistical significance between the BDT positive group and the BPT positive group (P>0.05). The lung function indexes in the BDT positive group were lower than those in the BPT negative group (P<0.05), and the small airway function indexes MMEF%, FEF75%, FEF50% in the BPT positive group were lower than those in the BPT negative group (P<0.05). The incidence of small airway dysfunction was the lowest in the BPT negative group, and the difference was statistically significant compared with the BDT positive group and BPT positive group (P<0.05). The area under ROC curve (AUC) of FeNO and small airway function indexes (MMEF%, FEF75%, FEF50%) were 0.754,0.727,0.674,0.779, respectively.After FeNO was combined with small airway function indexes, the area under the curve increased compared with the index alone. FeNO combined with FEF50% had the highest AUC and sensitivity, and FeNO combined with MMEF% had the highest specificity. Conclusion FeNO combined with small airway function has predictive value for airway hyperresponsiveness in asthmatic patients, and can be used as a supplementary tool for early diagnosis of mild asthma.

The effectiveness of acupoint injection by oxytocin for preventing postpartum hemorrhage

PAN Ya-jing,Yangjinfei — 2022/8/4 16:04:19

【Abstract】 Objective: To explore the curative effect of acupoint injection of oxytocin in preventing postpartum hemorrhage t and analysis of the preventive effect of acupoint injection of oxytocin on postpartum hemorrhage. Methods: A total of 150 pregnant women with uterine inertia who were hospitalized for delivery in Guigang Hospital of Traditional Chinese Medicine from February 2019 to October 2020 were selected. According to the random number table method, they were divided into the control group of 80 cases and the study group of 70 cases. Observation and recording of 2h and 24h postpartum hemorrhage volume of two groups of pregnant women, detecting the hemoglobin and red blood cell counts of the two groups of prenatal and 24 hours after postpartum. Results: The bleeding volume at 2h and 24h postpartum in the study group was less than that in the control group（P<0.05）；The hemoglobin and red blood cell counts at 24 h postpartum in the study group were significantly higher than those in the control group (P<0.05). Conclusion: Injecting oxytocin at Hegu point can effectively enhance the strength of postpartum uterine contractions, reduced incidence of postpartum hemorrhage due to uterine inertia,and determining the appropriate dose and effective time of oxytocin for Hegu acupoint injection.

The treatment effect of modified subcutaneous tunnel external drainage of lumbar cistern on the patients of brain tumors

li dan — 2022/8/4 16:03:15

Objective To explore treatment effect of modified subcutaneous tunnel external drainage of lumbar cistern on the patients of brain tumors. Methodes A total of 78 patients with brain tumors who were treated in Affiliated Cancer Hospital and Institute of Guangzhou Medical University from Aug 2014 to Jul 2021 were enrolled in study and randomly divided into the study group with 40 cases and the control group with 38 cases.The cases of modified subcutaneous tunnel external drainage were used as observation group,and the control group was treated with external drainage of lumbar cistern.Observe and compare the two groups in intracranial infection,cerebrospinal fluid leakage，catheter displacement，unplanned extubation,daily average volume of cerebrospinal fluid drainage and other aspects of change. Results The observation group of 40 cases using the modified subcutaneous tunnel catheter catheterization method in the cases of cerebrospinal fluid leakage in the point of puncture,catheter of displacement and unplanned extubation were significantly lower than control group,the difference was statistically significant (p＜0.05).The incidence rate of intracranial infection was lower than control group,but no statistically significant difference (p＞0.05).There was no statistically significant difference in daily average drainage volume of cerebrospinal fluid between two groups (p＞0.05).Conclusion The modified subcutaneous tunnel external drainage of lumbar cistern has the advantages of few camplications,and safe drainage,which is an effective method and worthy to be promoted in hospital.

Department of Gynecology, The Affiliated Changzhou No.2 People"s Hospital of Nanjing Medical University, Changzhou 213000, China

钟阿红 — 2022/8/4 16:02:19

Objective: To investigate the diagnosis，differential diagnosis and treatment of low grade appendiceal mucinous neoplasm in women and ovarian neoplasms Methods: This article reports a retrospective analysis of 13 women with low grade appendiceal mucinous neoplasm treated in Changzhou No.2 People's Hospital from 2010 to 2019. The clinical manifestations, auxiliary examination and treatment were summarized. Results: The clinical manifestations of appendiceal mucinous neoplasm are not typical. Most patients have abdominal pain (61.5%) and abdominal mass (23.1%) as the most common symptoms, which are similar to the clinical manifestations of advanced ovarian cancer. In the past 10 years, 15.4% of patients with low grade appendiceal mucinous neoplasm were misdiagnosed as gynecological tumors and underwent surgical treatment. A total of 7 patients underwent ultrasonography before surgery, 3 cases of appendix origin（the correct rate of judging the origin of the mass from the appendix was 42.9%）, and 2 cases of ovarian origin, 2 cases were unknown origin. There were 2 cases of ovaries, 2 cases of unknown origin; a total of 10 patients underwent CT examination before surgery, 5 cases of appendix origin（the correct rate of judging the origin of the mass from the appendix was 50%）, and 2 cases of ovarian origin, 3 cases were unknown origin, P> 0.05, the difference was not statistically significant. CEA, AFP, CA-125 and CA-l99 were detected in 13 patients before operation. The positive rate of CEA was 30.8%, CA-l25 was 23.1%, CA-l99 was 15.4%, and AFP was 0, P> 0.05, the difference was not statistically significant. Conclusion: For first symptoms for middle-aged and old women patients with abdominal pain or bag piece, if the diagnosis of ovarian cancer is not enough, the possibility of appendiceal mucinous neoplasm disease should be considered, ultrasound (accuracy rate 42.9%) and CT (accuracy rate 50%) and other imaging examinations have certain reference significance for clarifying the nature and source of the mass. Surgical exploration should be performed in time. If necessary, surgical consultation should be performed before and during the operation. Frozen sections should be performed during the operation to help early diagnosis and treatment，which is an important measure to avoid misdiagnosis.

Effects of short-interval second ejaculation on semen quality and spermatozoa dynamic parameters

chenliangshi,,,,,,, — 2022/8/4 16:01:22

Objective To investigate the effect of short-interval second ejaculation on semen quality and spermatozoa dynamic parameters.Methods Couples who received in vitro fertilization treatment were selected. On the day of oocyte collection, the man had a short-interval second ejaculation within 2h after the first ejaculation. According to the number of sperm collection, they were divided into first ejaculation group and short-interval second ejaculation group. The differences of semen quality and spermatozoa dynamic parameters between the two groups were compared.Result 65 patients were included in this study. The success rate of short-interval second ejaculation was 90.77% (59/65); The semen volume in the short-interval second ejaculation group was lower than the first ejaculation group (P<0.001). The concentration of progressive?motility?spermatozoa and the percentage of Grade A/B spermatozoa in the short-term secondary sperm extraction group were higher than the first ejaculation group (P<0.05); The velocity curve , linear velocity, average path velocity, percentage of progressive orientation and percentage of whipping frequency of spermatozoa in the short-interval second ejaculation group were significantly higher than first ejaculation group (P<0.05).Conclusion Short-interval second ejaculation can significantly improve semen quality and spermatozoa dynamic parameters, which has a certain clinical value.

Analysis of influencing factors for preparation of platelet concentrate by new improved buffy coat method

LIU Xinchen,XIONG Zhigao,YANG Xiaoluo — 2022/8/4 15:59:48

Objective To explore the influencing factors of platelet concentrate preparation and improve the quality of platelet concentrate. Methods The effects of different centrifugation procedures, different volume of whole blood on the quality of platelet concentrate were compared. The preparation procedure of the new innovating buffy coat method has been determined. Quality of Platelet which prepared by methods of PRP, innovating buffy coat and new innovating buffy coat were compared. Results The platelet recovery rate of centrifugation scheme 6 was higher than that of centrifugation schemes 1, 2, 4 and 8, and the platelet recovery rate was higher, differences all has statistical significance (P< 0.05). The red blood cell mixture and platelet recovery rate of PC preparation from 400mL whole blood group was higher than that from 300mL whole blood group, and the difference was statistically significant (P < 0.05). The amount of PC red blood cells and white blood cell mixture prepared by the new innovating buffy coat method is lower than that of the PRP method , and the platelet recovery rate is higher than that of the PRP method and the innovating buffy coat method, and the differences were statistically significant (P < 0.05). Conclusion The centrifugation plan 6 for PC preparation (the new innovating buffy coat method) from 400 mL whole blood has a high platelet recovery rate and low red blood cell and white blood cell mixing relatively, which can be used for the separation and preparation of PC in blood centers and blood banks.

A study on the application of lip retraction breathing training in the surgical adaptation of vitrectomy patients

陈小芬,梁丽芬,廖欣,陆忠烈,满平仪,薛燕雄,杨珂 — 2022/7/13 15:36:48

Objective To investigate the effects of lip reduction breathing training on anxiety, physiological stress response and intraoperative cooperation compliance in patients undergoing vitrectomy surgery. Methods One hundred patients admitted to our hospital for vitrectomy surgery by the same surgeon from August 2019 to l 2021 were selected and randomly divided into a control group (conventional care) and an experimental group (conventional care + lip reduction breathing training) according to numbers. In the experimental group, the patients were cared for with lip reduction breathing training nursing measures under simulated surgical scenarios on the basis of conventional care. The heart rate, respiratory rate, blood pressure and oxygen saturation, the number of intraoperative interruptions, the duration of surgery and the number of cancelled surgical stations were recorded at the time of admission, after disinfection of auxiliary towels, at the time of post-ball injection, at the beginning of surgery, 30 min after the beginning of surgery and 1 h after the beginning of surgery for patients in both groups. Patients were given anxiety self-assessment scale (SAS) assessment when they were notified of surgery and after training, and a postoperative surgical adaptation scale and satisfaction questionnaire were given to vitrectomy patients to compare intraoperative cooperation and changes in anxiety, physiological stress response and satisfaction with care before and after care between the two groups . The intraoperative cooperation compliance and nursing satisfaction of patients in the experimental group were better than those in the control group, and the difference was statistically significant (P<0.05); the SAS scores after respiratory training in the experimental group were lower than those in the control group, and the difference was statistically significant (P<0.05); the heart rate, systolic blood pressure, and diastolic blood pressure of patients in the experimental group from room admission to anesthesia were significantly lower than those in the control group, especially during post-ball injection anesthesia. The difference was statistically significant (P<0.05); the difference in oxygen saturation between the two groups was not statistically significant (P>O.05). Conclusion The effective preoperative lip retraction breathing training can significantly relieve anxiety and reduce the patient"s adverse intraoperative stress reaction, especially in the posterior bulbar nerve anesthesia, the nurse led the patient to do lip retraction breathing, the effect is more obvious, proper respiratory care of the patient to help the patient through the adjustment of breathing to relieve anxiety with surgery, is to ensure the success of ophthalmic local anesthesia surgery, worthy of clinical promotion.

Research advances in the prevention and treatment of nausea and vomiting after total hip or knee arthroplasty

Huang Xiao,,, — 2022/7/6 16:49:22

Total hip/knee arthroplasty (THA/TKA) is an effective way to treat with end-stage hip/knee diseases. With the growing maturity of THA and TKA, comfortable rehabilitation has become a common goal for doctors and patients. Due to severe postoperative pain, anesthetic effect, postoperative anemia, analgesic drug application and other factors, postoperative nausea and vomiting (PONV) is a common complication following THA and TKA. PONV can seriously affect patients" subjective feelings, and resulting in decrease in patient satisfaction and increase in healthcare costs, which is one of the main causes of prolonged hospital stay. Therefore, the prophylaxis and ultimate management of PONV are crucial for optimal patient outcomes, this paper focuses on the domestic and foreign literature on the prevention and treatment of PONA in recent years, and summarize and expound the occurrence mechanism, influencing factors, basic preventive measures and drug prevention measures of nausea and vomiting after THA and TKA. We are aiming to explore how to assess the risk of nausea and vomiting after THA/TKA and carry out effective prevention and control measures, provide some reference for clinical treatment and research.

Research of MTA1 and Gynecological malignant tumor

songzhen — 2022/7/6 16:48:17

Tumor metastasis associated gene(MTA) is a newly discovered gene family related to tumor progression, of which MTA1 is one of the main members. It is overexpressed in a variety of tumors, which is closely related to tumor invasion, metastasis and prognosis, and has important clinical research value. This article reviews the structure and function of MTA1 and its research in gynecological tumors.

Research progress on the role of chronic stress in vascular intimal hyperplasia and its molecular mechanism

2022/7/6 16:47:44

Vascular intimal hyperplasia is the basic pathophysiological feature of a variety of vascular proliferative diseases, and chronic stress can induce vascular intimal hyperplasia. In recent years, the role of chronic stress（CS）on intimal hyperplasia and the study of intimal hyperplasia caused by cathepsin S(CatS)and cathepsin K(CatK) related signaling pathways is increasing,and the relationship between the two has attracted more and more attention.This article reviews the research progress on the role of chronic stress in vascular intimal hyperplasia and its molecular mechanism.

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zhong xiao fang — 2022/7/6 16:47:14

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杨惠芳 — 2022/7/6 16:46:48

Comparison of clinical effects of two different types of disposable circumcision suture devices in circumcision

likui,li zhong kun,liu yun long,sun yan bo,wang feng yao — 2022/7/6 16:46:19

Objective: This study aimed to investigate the clinical outcome of two different types of disposable circumcision suture devices in circumcision and compare their advantages and disadvantages. Methods: From August 2019 to October 2021, clinical data from 230 patients undergoing circumcision with a disposable circumcision suture device (DCSD) were analyzed retrospectively. According to the different types of circumcision sutures, they were divided into observation group and control group. In the observation group, 129 patients were treated with DCSD and sutured with single-wide staple stitching. In the control group, 101 patients were treated with DCSD sutured with anastomotic staples combined with spacer sutures.?The operation time, intraoperative blood loss, pain scores at 2h postoperatively, pain scores of the first dressing change, the degree of edema at 10 days after the operation, the time of complete nail removal, the cases of incomplete nail removal at 1 month after the operation, and the incidence of postoperative hematoma, postoperative infection, and incision dehiscence were compared. Patient satisfaction was assessed at 3 months after the operation.?Results: There was no significant difference between the two groups in operation time, intraoperative bleeding and 2h postoperative pain score (P> 0.05). The pain score at the first dressing change and the degree of edema 10 days after surgery were significantly lower in the observation group than in the control group(P<0.05). The results of the complete nail removal time and the cases of incomplete nail removal at 1 month after the operation showed that the control group was significantly better than the observation group (P<0.05). There were no significant differences in the incidence of postoperative hematoma and incision dehiscence between the two groups (P>0.05). The incidence of postoperative infection in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in patient satisfaction at 3 months after surgery between the two groups (P>0.05). ?Conclusion: Compared with the pure wide nail group, the nail united?gasket group significantly improved the situation of nail removal, but the disadvantage was that the rate of short-term edema and infection was higher, and the pain score during dressing change was higher. However, the long-term effects of the two groups were similar.

Application of intravenous anesthesia through precava in Bama-mini pigs for medium and/or minor operation

deng dazhi,li pingping — 2022/7/6 16:45:49

Objective To establish a simple total-intravenous anesthesia way for medium and/or minor operation of Bama-mini pig(BM pig). Methods Human central venous catheters were inserted 8 ~ 10cm depth into precava of BM pigs through the supraclavicular fossa as protocol for convenient blood drawing and intravenous injection 10 ~ 15 minutes after BM pigs had been intramuscularly injected 5mg midazolam injection. 20mg propofol medium/long chain fat emulsion injection combined with 2μg Sufentanil injection were intravenously injected through precava catheters, followed by 20~40mg/h Propofol medium/long chain fat emulsion intravenous injection to maintain anesthesia; Oxygen inhalation was carried out and Rectal temperature, electrocardiograph (ECG) and pulse oxygen saturation (SpO2) were monitored during the period of anesthesia. results Minor and/or medium operations for 15 BM pigs range from 1to 3 hours such as gastroscopic exploratory cholecyst incision, endoscopic internal orifice irrigation of appendix, and electrocoagulation of the middle cerebral artery through frontotemporal approach were successfully completed with reliable anesthesia effects and stable vital signs shown as following : rectal temperature 38.3~ 38.9℃, heart rate 76 ~ 107 beats/min, respiration rate 13 ~ 42 beats/min, SPO2 95 ~ 100%. conclusion The new total-intravenous anesthesia way without endotracheal intubation via propofol medium and long chain fat emulsion injection combined with Sufentanil injection through precava provides convenience for medium and/or minor operation of BM pig.

The relationship between the expression of serum CXCL10 and the level of peripheral blood CD27+ CD4+ T cells in patients with pulmonary tuberculosis

LI Jianjun — 2022/7/6 16:45:10

Objective: To investigate the relationships between the expressions of chemokine ligand 10 (CXCL10), its ligand CXCR3 and the level of CD27+ CD4+ double positive T lymphocytes in peripheral blood. Methods: From April 2019 to April 2021, 96 patients with pulmonary tuberculosis in our hospital were selected as the study objects (pulmonary tuberculosis group), and 100 healthy volunteers were selected as the control group, the expression levels of CXCL10, CXCR3, interferon gamma (IFN-γ) and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay (ELISA), the level of CD27+ CD4+ T cells in PBMC was detected by flow cytometry, the levels of CXCL10 and CXCR3 in serum and their correlations with the levels of CD27+ CD4+ T cells, IFN-γ in serum and TNF-α in PBMC were analyzed by Pearson method, and the diagnostic values of serum CXCL10 and CXCR3 levels in patients with pulmonary tuberculosis were analyzed by ROC. Results: Compared with the control group, the levels of serum CXCL10, CXCR3, IFN-γ and TNF-α in patients with pulmonary tuberculosis were significantly increased (t = 33.967, 37.202, 11.075, 30.515, all P = 0.000), and the proportion of CD27+ CD4+ T cells in PBMC was significantly decreased (t = 31.997, P = 0.000). Pearson correlation score showed that serum CXCL10 was positively correlated with CXCR3, IFN-γ, TNF-α levels (r = 0.494, 0.746, 0.565, all P = 0.000), and negatively correlated with the proportion of CD27+ CD4+ T cells in PBMC (r = -0.499, P = 0.000); serum CXCR3 level was positively correlated with serum IFN-γ and TNF-α levels (r = 0.590, 0.504, P = 0.000), and negatively correlated with the proportion of CD27+ CD4+ T cells in PBMC (r = -0.545, P = 0.000). The areas under curve (AUC) of serum CXCL10 and CXCR3 in the diagnosis of pulmonary tuberculosis were 0.825, 0.820, the cutoff values were 105.53ng/l, 295.72ng/l, the sensitivities were 84.00% and 83.00% respectively, and the specificities were 83.30% and 81.20% respectively. The AUC of combination in the diagnosis of pulmonary tuberculosis was 0.938, the sensitivity and specificity were 94.00% and 91.70%, respectively, and the diagnostic efficacy was better than that of single index. Conclusions: The level of serum CXCL10 and its ligand CXCR3 in patients with pulmonary tuberculosis is upregulated significantly, which is related to abnormal lymphocyte level.

The effect of regulating IAP on maternal and infant outcomes in pregnant women with streptococcus agalactiae colonization

linRong — 2022/7/6 16:44:22

Objective To investigate the effect of intrapartum antibiotic prophylaxis on maternal and infant outcomes in pregnant women colonized with group B Streptococcus.Methods The clinical data of 176 cases of pregnant women with group B Streptococcus who regular antenatal examined and vaginal trial delivered in our hospital from January 2021 to December 2021 were retrospectively analyzed.Antibiotic prophylaxis after labor or rupture of membranes.According to whether ?the use of antibiotics is standardized,124 cases were divided into IAP standard group (observation group) and 52 cases were not IAP standard group (control group).Blood routine examination + C-reactive protein (CRP) was performed within 24 hours after birth.The incidence of amniotic fluid contamination and chorioamnitis,WBC count, neutrophil ratio and C-reactive protein, 1-minute Apgar score and birth weight, neonatal admission to NICU, neonatal asphyxia, neonatal infection, neonatal pneumonia and neonatal septicemia were compared between the two groups.Results There was no significant difference in the incidence of amniotic fluid contamination and chorioamnitis between the observation group and the control group (P> 0.05), and the white blood cell count and neutrophil ratio in neonates were lower than those in control group,the difference was statistically significant (P＜0.05).There was no significant difference in C-reactive protein between the two groups (P > 0.05).The incidence of neonatal ICU admission, neonatal pneumonia and neonatal septicemia in the observation group was lower than that in the control group (P＜0.05).There were no significant differences in birth weight, one-minute Apgar score, incidence of neonatal infection and neonatal asphyxia between the two groups (P>0.05).Conclusions Standard intrapartum antibiotic prophylaxis can reduce the adverse outcomes of neonates in pregnant women with group B Streptococcus colonization during the third trimester.

Expression and clinical prognostic significance of NY-SAR-35 in colorectal cancer

2022/7/6 16:43:11

Objective To detect the expression of cancer/testis (CT) antigens NY-SAR-35 in colorectal cancer (CRC) and evaluate its clinicopathological and prognostic significance. Methods 59 paired CRC and corresponding adjacent normal tissues were collected to detect the expression of NY-SAR-35 by Reverse Transcription Polymerase Chain Reaction (RT-PCR). Subsequently, the relationship between NY-SAR-35 expression and clinicalpathological parameters were statistically analyzed. Furthermore, Kaplan-Meier survival curves were plotted and independent prognostic factors were analyzed by multivariate cox regression analysis. Result The positive rates for NY-SAR-35 mRNA expression in colorectal cancer tissues (35.59%, 21/59) were significantly higher than that in para-cancerous tissue (13.56%, 8/59) and the difference was statistically significant (P<0.05). NY-SAR-35 mRNA expression was significantly associated with tumor size and survival state, but not with gender, age, tumor location, CEA level, tumor infiltration depth, lymph node metastasis, distant metastasis, TNM stage, histological type and tumor differentiation. Furthermore, Kaplan-Meier survival curves showed that CRC patients with no NY-SAR-35 expression had longer overall survival than those with positive NY-SAR-35 expression（57.24 vs 40.71，P<0.05 ). Cox regression analysis found tumor invasion depth, lymph node metastasis, distant metastasis and NY-SAR-35 expression were identified as independent prognostic factors for CRC (P＜0.05). Conclusion NY-SAR-35 was upregulated and associated with poor prognosis in patients with CRC, suggesting that NY-SAR-35 may act as a potential biomarker and therapeutic target for CRC .

Analysis of risk factors for large-area cerebral infarction after neurosurgical aneurysm surgeryZHU Guangsheng,HUANG Huixia,CHEN Bing,SU Yijia,MO Yongbao,HUANG Xinchao,YANG Jun,LIAO Zhihong,YI Chunjun

zhuguangsheng — 2022/7/5 11:10:02

Objective To nvestigate the risk factors of cerebral infarction in patients after aneurysm surgery, and to improve the cognition of clinicians on the disease. Methods The clinical data of 238 patients with neurosurgical aneurysms in our hospital were retrospectively analyzed, and the number of patients with cerebral infarction after operation was counted. Univariate and multivariate logistic regression analysis were performed on the patients with cerebral infarction, and SPSS 20.0 software was used for statistical analysis. Results Of the 238 patients, 13 had cerebral infarction; univariate analysis showed that WFNS grade IV or V, Fisher grade 4, aneurysm size, size ratio, MSA, irregular neck, clip repositioning, temporary clipping and IOR were the risk factors for cerebral infarction (p<0.05). Multivariate analysis showed that aneurysm size and irregular neck were independent risk factors for cerebral infarction (p< 0.05). Conclusion Aneurysm size and irregular neck are the risk factors of cerebral infarction after operation. Clinically, we should pay attention to the size and neck shape of aneurysm according to the specific situation, which can effectively prevent cerebral infarction after intracranial aneurysm operation, and it is worth further application and promotion.

Detection on Change of Dentognathic Tissue in Adult Skeletal II Class Malocclusion with Extractic Camouflage Fixed treatment

wang ling — 2022/7/5 11:09:14

Objective: To compare changes of soft and hard tissue, long axis of tooth after extractic camouflage fixed treatment for adults skeletal II malocclusion.

The correlation between triglyceride-glucose index control and in-stent restenosis of the coronary artery

陈玲玲 — 2022/7/5 10:50:46

Objective To investigate the association of triglyceride-glucose(TyG) index control and in-stent restenosis(ISR) in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 243 patients with coronary heart disease who underwent PCI and underwent follow-up angiography ranging from 6 to 12 months after PCI were selected,according to the results of coronary angiography, they were divided into in-stent restenosis group (n=45) and non in-stent restenosis group (n=198).The general clinical data,coronary angiography results,laboratory indexes before the first PCI and during the reexamination of angiography were compared between the two groups.ROC curve was used to analyze the predictive critical value of TyG index for in-stent restenosis after PCI was 9.04, AUC was 0.742 (95%CI: 0.678 ~ 0.806, P<0.001), sensitivity was 87%, specificity was 60%.Logistic regression was used to analyze the predictors of in-stent restenosis in patients with coronary heart disease.Results Before the first PCI, the TyG index of ISR group was significantly higher than non-ISR group (9.45±0.40 VS 9.00±0.71,P<0.001)；during the reexamination of angiography,TyG index of theISR group was significantly higher than non-ISR group (9.30±0.31 VS 8.66±0.81,P<0.001). Multivariate logistic regression analysis showed that smoking (OR:6.172,95%CI: 2.609-14.599; P<0.001), diabetes mellitus (OR:3.323,95%CI: 1.442-7.658; P=0.005)and TyG index was not up to standard (OR:5.331,95%CI: 1.838-15.463; P=0.002) were the independent risk factor for ISR in patients with coronary heart disease.Conclusion TyG index may be an independent predictor of in-stent restenosis in patients with coronary heart disease after PCI,controlling TyG index level of patients after PCI may reduce the occurrence of in-stent restenosis.

Application and clinical effects of the femoral artery combined with innominate artery and left common carotid artery cannulation in the treatment of acute type A aortic dissection

wangchen — 2022/7/5 10:50:13

【Abstract】 Objective To explore the application and clinical effects of femoral artery combined with innominate artery and left common carotid artery?cannulation in patients with acute type A aortic dissection. Methods 62 patients with acute type A aortic dissection in our hospital from April 2021 to April 2022 were selected.?They were divided?into 2 group：26 patients underwent the cannulation of the femoral artery combined with innominate artery and left common carotid artery[22 males and 4 females with the age of 25 to 70 (49.231 ±11.843) years old] and 36 patients underwent the femoral artery combined with innominate artery[31 males and 5 females with the age of 27 to 77 (52.167 ±10.887) years] to establish cardiopulmonary bypass (CPB).The preoperative basic data,intraoperative data and early postoperative results were compared between the two groups. Result The time of circulatory arrest, the awakening time, the ventilator support time, the ICU time, the time of postoperative hospital stay, the postoperative drainage,the indwelling time of thoracic drainage tube and the platelet transfusion in the observation group were lower than those in the control group (p < 0.05). The incidence of postoperative brain complications and abnormal renal function were lower than those in the control group (p < 0.05). Conclusion Femoral artery combined with innominate artery and left common carotid artery cannulation is a safe and effective way to establish cardiopulmonary bypass in the treatment of acute type A aortic dissection, which can reduce the time of circulatory arrest while ensuring sufficient blood supply to the brain during the operation. it can effectively reduce the incidence of postoperative complications, decrease the time of postoperative hospital stay and improve the prognosis of patients.

Expression of atrial natriuretic peptide in physiological cardiac hypertrophy and its comparison with pathological cardiac hypertrophy Li Zhengkuan, Sun Zhan, Bao Yali,Malikizat Abdurixit. Department of Pathophysiology, School of Basic Medicine, Xinjiang Medical University, Urumchi,830000,China

Bao Yali,li zhengkuan,Malikizat Abdurixit — 2022/7/5 10:49:27

Objective To analyze the expression differences of atrial natriuretic peptide (ANP) in physiological and pathological cardiac hypertrophy, and explore its role in cardiac hypertrophy.Methods Rats were randomly divided into control group (CON), isoproterenol group (ISO) and exercise group (EXE), with 5 rats in each group,.Two animal models of physiological cardiac hypertrophy and pathological cardiac hypertrophy were constructed and cardiac tissue was extracted. . Western-Blot assay and immunohistochemical staining were used to detect the expression of ANP in each group.Results ANP was mainly expressed in the cytoplasm of myocardial fibers, and the expression of ANP in ISO was significantly higher than that in EXE and CON (P<0.05).Conclusion The expression of ANP in pathological cardiac hypertrophy was significantly higher than that in physiological cardiac hypertrophy. ANP can be used as an auxiliary index to distinguish physiological and pathological myocardial hypertrophy and assist in the diagnosis of pathological myocardial hypertrophy

Advances in the study of helicobacter pylori infection and vascular lesions in type 2 diabetes mellitus Chen jun-an

chen jun an — 2022/6/9 16:41:00

Helicobacter pylori (Hp) infection is one of the major global public health threats，Hp infection has a higher infection rate in patients with type 2 diabetes,Hp infection is one of the risk factors for macrovascular disease in type 2 diabetes mellitus.Hp infection plays a role in the occurrence and development of various macrovascular lesions in type 2 diabetes by increasing the level of C-reactive protein and homocysteine, destroying vascular endothelial cells, changing the level of blood lipid, increasing the concentration of homocysteine and changing the coagulation status.

Keywords:Allergic Rhinitis; ILC2; GATA3;microRNA-155

huangxueying,Li Rongrong,Tang Fengzhu,zhang Shaojie — 2022/6/9 16:40:32

Type Ⅱ inherent immune cells (ILC2)were stimulated to produce TH2 cytokines, promote allergic rhinitis late phase reaction。microRNA155(miR-155) in the development of the immune system and mature immune cells differentiation and play a crucial role in maintaining immune function.GATA3 is the ability to promote ILC2 mature of transcription factors, and in cancer research, GATA3 ?is the target gene of miR-155.In this paper, we reviewed the ILC2 transcription factor GATA3 and mir-155, which are involved in nasal mucosa of allergic rhinitis, in order to further understand the pathogenesis of type Ⅱ innate immune cells.

Application of Magnetic Responsive Nanomaterials in bone tissue engineering

Li Dongtai,Su Zhiwen,Wu Deguang,Wu Youhui — 2022/6/9 16:40:02

Biomaterials have gradually became bone tissue substitutes, which provide new ideas for treatment of bone defects and fracture nonunion in recent years. However,conventional nanoparticles have shortcoming including leading to cell adhesion damage, causing cytotoxicity. Thus, preparing nano-bio materials with high efficiency and low side effects has become a hot research topic with great significance in the field of tissue engineering. Interestingly, magnetic nanoparticles can provide magnetic stimulation for bone regeneration,and the electromagnetic field is a kind of non-invasive physical therapy to promote bone repair.Magnetic responsive nanomaterials have widely research and application in the biomedical field.This articles reviews the preparation,classification and application of magnetic responsive nanomaterials in bone tissue engineering.

The neck implantation after endoscopic thyroid papillary carcinoma operation via breast approach: a case report

chenwenjin — 2022/6/9 16:39:12

Background: Implantation metastasis of well-differentiated thyroid carcinoma is rare,e and is usually found in patients with widespread disseminated diseases. Endoscopic technique has become an acceptable method for the treatment of thyroid nodules. Implantation and diffusion of tumor cells in thyroid nodules rarely occur, but when this happens, it is obvious in many years after operation. We report a patient who developed tumor spread in the wound cavity only one year after surgery. Abstract: A 62-year-old male developed a neck mass one year after endoscopic thyroid nodule surgery. Not actively treated at that time. Three years after the operation, the first fine needle puncture under the guidance of ultrasound made cytological diagnosis on the neck mass, and confirmed the papillary thyroid carcinoma, which was further confirmed by surgical anatomy of the mass. After skin and muscle examination, linear tumors were found, and cytological diagnosis showed papillary thyroid carcinoma. After surgical resection, histopathological diagnosis confirmed that the nodule was papillary carcinoma. Metastatic deposits occur in skin and muscle. The linear arrangement and transfer of sites means that the implantation is probably caused by the first operation. Conclusion: Endoscopic thyroid surgery is an effective way to treat thyroid nodules, but surgeons should be aware of the potential risks of tumor seeding after thyroid surgery, provide consultation to patients in this regard, and propose alternative medical strategies to control local seeding of thyroid tissue.

A case report：SLE complicated with bone and joint tuberculosis, cold abscess and panniculitis

Liu Wen — 2022/6/9 16:35:55

SLE is an autoimmune connective tissue disease that can lead to multiple organ injury. Compared with the general population, the incidence rate of tuberculosis in SLE patients is higher. The location of SLE complicated with tuberculosis infection is hidden. Bone and joint tuberculosis is common in extrapulmonary tuberculosis, and cold abscess is a common complication. Latent tuberculosis infection is an important cause of panniculitis. Panniculitis can also be one of the early symptoms of tuberculosis infection. This paper reports a case of SLE complicated with bone and joint tuberculosis, cold abscess and panniculitis. The patient was treated with antituberculous drugs. Finally, he was discharged after his condition improved.

Effect of multi-mode heat preservation on hypothermia during resuscitation after percutaneous nephroscopy

郭先才,李佳雨 — 2022/6/9 16:34:28

Objective: To investigate the effect of multi-mode heat preservation nursing intervention on patients with low body temperature after percutaneous nephroscopy. Methods:select 120 patients with hypothermia after percutaneous nephrolithotomy in our hospital from january 2017 to december 2019, and patients were divided into control group, observation I group and observation II group by random digital table method. The control group used blanket heat preservation indoor temperature control, observation I group used indoor temperature control circulation intravenous infusion warm surgical cotton cloth to wrap limb blanket heat preservation, observation II group used indoor temperature control blanket heat preservation bed side warm air machine warm mattress for heat preservation, each group 40 cases. The effects of rewarming were analyzed by observing the vital signs, consciousness and time of postoperative anaesthesia resuscitation. Results: I, II and control groups were compared. Results showed that the recovery time of muscle strength (F=6.306, PF=0.003), spontaneous respiration （Z=10.656，P=0.005), extubation time （Z=14.027，P=0.001), resuscitation time （F=7.117，P=0.001） and shivering score (Z=24.774，P<0.001). restlessness（Z=245.555，P<0.001）the incidence of chills（2=17.505，P<0.001） and restlessness（2=39.941，P<0.001）were statistically significant （P<0.05）. but there was no significant difference in the time of opening eyes (P>0.05). Conclusion: The multi-mode heat preservation method of heating mattress by bedside heater is more helpful to reduce the stress response of patients with low body temperature after percutaneous nephroscopy and improve the quality and comfort of resuscitation.

The application value of the inferior vena cava collapse index in the Sfluid therapy of pulmonary hemorrhage in preterm infants with mechanical ventilation.Jin Hongjuan, lui Xiaoyan,huangying,zhuang deyi

jinhongjuan — 2022/6/9 8:27:39

Objective To explore the application value of the inferior vena cava collapse index in the Sfluid therapy of pulmonary hemorrhage in preterm infants with mechanical ventilation. Methods 22 premature infants hospitalized in the neonatal intensive care unit of Xiamen children"s Hospital from July 2018 to June 2020 with pulmonary hemorrhage were selected as the experimental group. On the basis of routine treatment, the volume status was evaluated in combination with ivc-ci dynamic evaluation to guide fluid treatment. 24 premature infants with pulmonary hemorrhage who met the inclusion criteria and did not measure ivc-ci from July 2016 to June 2018 were used as the control group..Comparing the fluid intake and the time spent on improving heart rate, lactic acid, oxygenation index of the two groups during the observation period.Results The fluid intake at 6h, 6-24h and 24-48h after pulmonary hemorrhage occurred in 22 infants in the experimental group were respectively (64±6 )ml/kg,(71±8)ml/kg and(102±10)ml/kg.In the control group, the fluid intake of 24 infants with pulmonary hemorrhage at 6h, 6-24h, and 24-48h after pulmonary hemorrhage was (60±4)ml/kg,(93±4)ml/kg,(105±9)ml/kg, respectively. The P values of the two groups at the same time were 0.013, 0.000, 0.361, the difference of liquid intake of 6h and 6 -24h after pulmonary hemorrhage were statistically significant.The time taken to improve the he lactic acid and oxygenation index of the experimental group were(26.4±6.7)h 、(22.6±5.8) h, respectively, and the time taken to improve the lactic acid and oxygenation index of the control group were (38.5±6.7)h、(27.0±5.0)h, the P value between the two groups were 0.015 and 0.009, the difference was statistically significant. Conclusion The measurement of IVC-CI under the guidance of ultrasound can dynamically assess volume status, guide fluid therapy in a targeted manner, and contribute to the recovery of the disease.

A discussion of the extent of skull resection when scalp squamous cell carcinoma invades the periosteum

CaoYun,Linyue,WenBo,XuYuwei — 2022/6/8 9:21:38

From 2010 to December 2020, Gulou Clinical Medical College affiliated to Nanjing University of Traditional Chinese Medicine , treated thirteen patients with head squamous cell carcinoma invading the periosteum. Objective: To study the methods to reduce tumor recurrence when scalp squamous cell carcinoma invades the periosteum. Methods: By sorting out the case, imaging, and pathological data of the enrolled patients, we use the surgical treatments including skin tumor resection,skull outer plate grinding,local flap transfer and skin grafting. Results: Both patients recovered well after the operation,and were followed up for one year.10 patients were in good living condition, no signs of recurrence and metastasis, and the curative effect was satisfactory. One patient had multiple recurrences and metastases, and died half a year later; two patients had poor survival in the graft area, and healed well after the second-stage operation. Conclusion: When scalp squamous cell carcinoma invades the periosteum, partial or complete removal of the outer skull plate can effectively reduce tumor recurrence.

Association between 25(OH)Vit D₃ , glycocholic acid and bile acid levels and adverse pregnancy outcomes in in women with intrahepatic cholestasis of pregnancy

huanghongping,huangyulin,liweiqing,lihuichan — 2022/6/7 17:54:35

ABSTRACT Objective: To investigate the association between serum glycocholic acid (CG), bile acid (TBA), liver enzymes and the 25(OH)Vit D3 and disease of intrahepatic cholestasis of pregnancy (ICP). Methods: According to the diagnostic criteria of ICP, 153 patients with ICP were included, divided into mild ICP (114 cases) and severe ICP (39 cases). One hundred and fifty three healthy pregnant women were included as control group. Serum levels of CG, TBA, liver enzyme and 25(OH)Vit D3 were test, the pregnancy outcomes of both ICP and normal pregnancy were prospectively tracked. Results: The levels of CG, TBA and liver enzymes in ICP group were significantly higher than those in control group. As the severity of the disease increased, the levels of the above indicators also increased. The levels of 25(OH)Vit D3 were just the opposite. All comparison differences were statistically significant (all p were values <0.001). The levels between CG, TBA and 25(OH)Vit D3 in pregnant women were negatively correlated (r values were -0.611 and -0.489, respectively, and p values were both <0.001). This prospective cohort study showed that the gestational age of ICP pregnant women was smaller than that of the healthy control group, and the incidence of adverse pregnancy outcomes in the ICP group was much higher than that in the control group. The differences were statistically significant (all p values <0.05). Conclusions: The levels of CG, TBA and liver enzymes in ICP women are higher than those in healthy pregnant women. The levels of 25(OH)Vit D3 in ICP women are lower than those in healthy pregnant women. High levels of CG, TBA and low levels of 25(OH)Vit D3 have an adverse effect on perinatal pregnant outcomes.

Study on the Mechanism of Ganoderma Lucidium on Immunoregulatory Based on Network Pharmacology and Molecular Docking

QIN Jun-liang — 2022/6/7 17:54:05

Objective To explore the mechanism of Ganoderma lucidium in regulating immunity based on network pharmacology and molecular docking. Methods The active components of Ganoderma lucidium were searched by TCMSP，and the target prediction of the active components was made by Swiss Target Prediction database, immune-related targets were obtained through GeneCards, DrugBank, OMIM ,TDD and PharmGKB databases，and drug targets and disease targets were integrated to obtain intersection targets．Cytoscape software was used to construct the drug-active ingredient-action target-disease network diagram and screen the core components. STRING platform was used to construct the PPI network and screen the core proteins.GO enrichment and KEGG pathway enrichment of the key targets by R project software. Molecular docking technique were used to realize the molecular docking of core component-core protein.Results A total of 43 active components，499 action targets，12454 disease-related targets and 483 drug-disease intersection targets were retrieved．KEGG analysis showed that divalent inorganic cation homeostasis，calcium ion homeostasis，cellular calcium ion homeostasis，and other signal pathways.GO analysis showed that the overlapping genes were mainly concentrated in regulation of lipid metabolic process，phosphorylation peptidyl-serine，peptidyl-serine modification and so on.The results of molecular docking showed that the main core components and core proteins had good binding activity．Conclusion In this study, the related active components of Ganoderma lucidium and its potential mechanism in regulating of immunity were predicted by network pharmacology, which provides a new sight for the further study of the mechanism of Ganoderma lucidium in regulating of immunity．

Preparation, characterization and biocompatibility of polylactide-co-glycolide microspheres loaded with parathyroid hormone-related protein(PLGA-PTHrP)

Huang Zhen,Liu jinjing,Long Guiyue,Zhou Qqiangqiang — 2022/6/7 17:52:51

Objective: Prepare polylactide-co-glycolide (PLGA) microspheres and explore the characterization of PLGA microspheres loaded with parathyroid hormone-related protein (PTHrP) Methods: The empty PLGA microspheres were prepared by double emulsion-solvent evaporation method. PTHrP were loaded on the empty PLGA microspheres by soaking empty PLGA microspheres in the different concentrations of PTHrP solution. PLGA microspheres loaded with effective concentration of PTHrP were prepared by freeze-drying method. The surface morphology and average particle size of PLGA microspheres were observed by SEM scanning electron microscopy. BCA kit and microplate reader were used to detect the protein release curve. PLGA-PTHrP were co-cultured with rat whole bone marrow cells, then Cell Counting Kit-8(CCK-8) were used to detect the effect of PLGA-PTHrP MPs on the osteogenic ability of whole bone marrow cells. Results: The empty PLGA microspheres made by W/O/W double emulsion-solvent evaporation method were spherical or kind of spherical with round surface, and its average size were 56.7±7.2 μm. The in vitro PTHrP release experiment showed that The release rate of protein were faster in the first 100 hours. The total release time lasted for 300 hours.PLGA-PTHrP MPs could release about 87.3% protein of the total. CCK-8 showed PLGA-PTHrP MPs had no significantly effect on the proliferation activity of whole bone marrow cells. CONCLUSION: The PLGA empty microspheres can be successfully made by W/O/W double emulsion-solvent evaporation method, and PLGA-PTHrP sustained-release system made by freeze-drying method maintain a sustained release effect.

Conversion to hip arthroplasty after failed PFNA for intertrochanteric femur fractures：a short-term follow-up

李富林 — 2022/6/7 9:16:05

Objective To analyze the effect of hip arthroplasty in the treatment of femoral intertrochanteric fractures after proximal femoral nail antirotations(PFNA)for short-term follow-up. Methods A retrospective analysis was performed from October 2014 to January 2019 on 21 patients with failed intertrochanteric fracture internal fixation after hip arthroplasty, incluing 8 cases underwent total hip arthroplasty and 13 cases underwent femoral head replacement. The operation time, intraoperative blood loss, postoperative drainage volume, transfusion rate, related complications, and Harris score during follow-up were recorded to evaluate the efficacy and follow-up X-rays were served as the survival of the prosthesis. Results The operation time was 92-168 minutes, with an average of 120 minutes. The intraoperative bleeding was 300-780 mL, with an average of 520 mL and the postoperative drainage was 180-560 mL, with an average of 320 mL. During the operation, 2 cases had iatrogenic fracture, 12 cases had blood transfusion, 1 case had superficial infection of incision, 3 cases had lower limb intramuscular venous thrombosis, nobody had deep venous thrombosis(DVT), pulmonary embolism(PE) or no dislocation,19 patients were followed up for 1 to 3 years. At the last follow-up, one infected patient did not relapse. X-ray films of all patients showed no loosening or fracture of the prosthesis, and the Harris score of hip joints was significantly improved compared with that before surgery (P <0.05).

Comparison of the effects of Mirena and Dain-35 on prevention of recurrence after transcervial resection of endometrial polypsWuWanying? department of Gynecology , WuZhou Red Cross Hospital 543002

wuwanying — 2022/6/7 9:14:57

Objective: To analyze the effects of Mirena and Dain-35 on preventing recurrence after endometrial polyps.Methods：61 patients with endometrial polyps were treated with hysteroscopic polypectomy,.Thirty patients were treated with Mirena after hysteroscopic polypectomy,Set to Group A.Thirty-one patients were treated with Daine-35 after polyps,Set to Group B?.Both groups were followed for 12 months after treatment, comparing the recurrence rate of endometrial polyps, endometrial thickness, adverse reactions and therapeutic effects of 2 groups.Results Group B had lower efficiency, There were significant differences between the two groups 。Group A had lower recurrence rate and adverse reaction rate than Group B.The thickness of the endometrium of 2 groups was lower than the day before operation. There was no significant difference in the thickness Of endometrium between the two groups Three months after the operations .There were significant differences in the endometrial thickness between the two groups in the follow-ups 6 months and 12 months after (P<0.05).Conclusion The application of Mirena or Dain-35 after endometrial polyps can both effectively reduce the recurrence rate of endometrial polyps .However, the adverse reactions of Mirena are lower, it is worthy to promote in the use of clinical.

Expression of CEA in serum of gastric cancer patients with different AFP expression and its clinical significance

Luan Likun — 2022/6/7 9:13:20

OBJECTIVE: To investigate the expression of CEA in gastric cancer (GC) patients under different AFP status and its clinical significance. Methods: The clinical data of 346 patients with GC admitted to The Third Affiliated Hospital of Kunming Medical University from January 2012 to December 2017 were retrospectively analyzed. Patients were divided into two groups: AFP-positive gastric cancer (AFPGC) and AFP-negative gastric cancer (non-AFPGC). The clinicopathological characteristics, CEA and other tumor marker expressions were compared between the two groups by Chi-square test or Fisher"s exact probability method, overall survival was compared by Kaplan-Meier method. According to the expression of CEA, the above two groups of patients were divided into two subgroups, CEA normal group and CEA abnormal group, the clinicopathological characteristics, CA125, CA199 and CA724 expression, and overall survival were compared between the two subgroups. Results: There were 28 AFPGC patients, accounting for 8.12% of the total number of patients. The AFPGC and non-AFPGC groups showed no significant difference in the age, gender, T, N, M, clinicopathological stage, tumor cell differentiation, pathological type (P > 0.05), and overall survival (P = 0.3386). Patients with high CEA expression in the AFPGC group (14/28, 50%) was significantly higher than that in non-AFPGC group (96/318, 30.19%) (χ_² = 4.685, P = 0.031). In AFPGC patients, there was no significant difference in age, gender, T, N, M, clinicopathological stage, tumor cell differentiation, pathological type, and the expression of tumor markers between the CEA normal and abnormal groups (P > 0.05) , CEA expression did not affect the overall survival in AFPGC patients (P = 0.6050). In non-AFPGC patients, the number of the patients with male (P = 0.002); T3/4 (P = 0.01), N (+) (P = 0.038), stage III/IV (P = 0.009), CA199, CA724 (P <0.001) and CA724 (P <0.001) was significantly higher in CEA abnormal group than those in CEA normal group (P = 0.0243). Conclusion: The expression of CEA in AFPGC patients is higher than that in non-AFPGC patients, the expression CEA do not affect the overall survival between the two groups. The high expression of CEA can indicate that non-AFPGC patients with abnormally high expression of CA199 and CA724, worse T, N, clinical stage and survival prognosis. This conclusion has certain guiding significance for the establishment of gastric cancer sub-types based on the combined detection of AFP and CEA, clinical prognosis guidance, chemotherapy strategy selection and efficacy prediction.

Comparison of three - lead electrocardiogram and pulse oximetry to measure neonatal heart rate in early postnatal period

lizhichao, — 2022/6/7 9:10:46

Objective To compare the difference between three-lead electrocardiography (ECG) and pulse oximetry (PO) in the measurement of heart rate(HR) in early postnatal period. Methods The neonatal ECG and PO were placed at the same time after birth, recorded by video and analyzed. The time of applying ECG and PO, the time of obtaining stable HR and the time to obtain stable HR from arrival to resuscitaire were compared. The proportion of obtaining stable HR was compared, and the changes of HR in both neonates were observed within 10 min after birth. Results The time of applying ECG and PO were 22(20,25) and 11(9,13)s, respectively, and the difference was statistically significant (P＜0.001). The time to obtain steady HR was 3(2,4) and 17(13,20)s, respectively, and the difference was statistically significant (P＜0.001). The time to obtain stable HR from arrival to resuscitaire was 26(22,27) and 28(25,32)s, respectively, and the difference was statistically significant (P＜0.05). In VBW infants, the placement time of ECG and PO was 29(27,31) and 15(14,17)s, respectively, and the difference was statistically significant (P＜0.001); The time to obtain steady HR was 2(1,3) and 16(14,18)s, respectively, and the difference was statistically significant (P＜0.001); The time to obtain stable HR from arrival to resuscitaire was 31(29,34) and 32(29,34) s, respectively, and the difference was not statistically significant (P>0.05). In the first 30 s, the proportion of stable HR obtained from ECG and PO was 79.1%(68/86) and 62.8%(54/86), respectively, χ2 value was 5.527, P=0.019, the difference was statistically significant. During the 10 min before birth, the HR measured by PO increased gradually, while the HR measured by ECG remained stable. The HR of PO was significantly lower than that of ECG in the first 6 min postpartum (P<0.05). Conclusions The time required to obtain stable HR in ECG is shorter than that in PO, and the proportion of stable HR in the first 30 s is higher than that in PO. In the first 6 min of postpartum, the HR measured by PO was underestimated compared with that of ECG.

The diagnostic value of combined detection of neutrophil to lymphocyte ratio and fibrinogen in gastric cancer

Cao Chenliang — 2022/5/28 18:16:21

【Abstract】 Objective To investigate the diagnostic value of combined detection of neutrophil to lymphocyte ratio (NLR) and fibrinogen (FIB) in gastric cancer.Methods 116 patients with gastric cancer admitted to our hospital between June 2019 and March 2022 were selected as the gastric cancer group, and 82 healthy people who were examined in our hospital during the same period were selected as the control group. To examine the levels of NLR and FIB of the two groups. ROC curve was used to further analyze and compare the diagnostic value of NLR and FIB alone or in combination. Results The levels of NLR and FIB in gastric cancer group were higher than those in healthy control group（P<0.001）, and the differences were statistically significant. ROC curve analysis showed that AUC of NLR, FIB, combination of the two indicators for the diagnosis of gastric cancer were 0.692、0.650 and 0.738, respectively. The sensitivity of combined diagnosis was 69.80%, which was higher than that of single diagnosis (66.40% and 43.10%). Conclusion NLR and FIB have certain value in the diagnosis of gastric cancer. The combined detection of NLR and FIB can improve the diagnostic efficiency of gastric cancer and contribute to the improvement of the early screening rate of gastric cancer.

Application of phase angle in nutritional evaluation of hemodialysis patients in Hainan

liunan,,,, — 2022/5/28 17:39:58

Objective：To evaluate the application value of phase angle (PA) in nutritional assessment of hemodialysis patients. Methods：A total of 98 hemodialysis patients were selected from the Department of Nephrology, the First Affiliated Hospital of Hainan Medical University from January 2019 to December 2020. Malnutrition inflammation score (MIS) and phase angle were measured. Taking MIS as the gold standard for malnutrition diagno- sis, the receiver operating characteristic curve (ROC) was drawn to evaluate the consistency of diagnosis. The correlation between PA and weight, upper arm muscle cir- cumference (AMC) and other clinical parameters was analyzed by Spearman bivariate linear correlation test. Results： The incidence of malnutrition in HD was 90.82%; the area under ROC curve (AUC) of no mild malnutrition、 mild to moderate malnutrition 、and moderate to severe malnutrition evaluated by PA (50 kHz) were 0.902、0.665 and 0.702 respectively, the sensitivity were 85.29%、80.00% and 90.00% respectively, the specificity were 88.89%、73.53% and 57.78% respectively, and the critical value of PA were 5.25° 、4.65°and 3.82° respectively. PA was negatively correlated with age (P<0.05), and positively correlated with weight, AMC, albumin, prealbumin, total iron binding capacity and transferrin (P<0.05). Conclusion： The incidence of malnutrition is high in hemodialysis patients with endstage renal disease; PA and MIS had good agreement in assessing malnutrition in HD patients; PA was positively correlated with weight, AMC, albumin, prealbumin, total iron binding capacity and transferrin, which can be used for malnutrition assessment.

Clinical analysis and significance of prenatal diagnosis of chromosomal translocation couples

易凤梅 — 2022/5/28 17:27:39

【Abstract】 Objective:Toexplore the influence ofchromosomal translocationon population fertility，and to provide reproductive guidance.Methods:17 chromosomal translocation carriers couples were prenatal diagnosed from January 2018 to ?December 2021, in our medical genetic center , and all of them were underwent chromosome karyotype and chromosome microarray analysis (CMA) and pregnancy outcome follow-up. Results:Among the 17 chromosomal translocation carriers couples, there were 14cases of maternal chromosomal translocation , and 3 cases of paternalchromosomal translocation ；there were 14 cases of a history of fetal stop or fetal structural abnormality, 1 case had abnormal fetal structure in the first pregnancy, and 2 cases were preimplantation genetic tests of embryos in the first pregnancy；there were 15 cases of involving 2 nonhomologous chromosomes, and 3 cases of involving more than 3 complex chromosomal rearrangements.Among the prenatal diagnosis of fetal nuclear type and CMA, there were 7 cases of unbalanced translocation, 9 cases of balanced translocation, and 1 case of normal nuclear type was performed as preimplantation genetic test (PGT).Amongpregnancy outcome, there were8 cases being induced labor，and 9 cases of normal delivery.Conclusion:there are a high risk of adverse pregnancy outcomes among chromosomal translocation carriers, and prenatal diagnosis should be performed to exclude unbalanced translocation . For recurrent miscarriage, preimplantation genetic testing (PGT) or artificial insemination (male chromosomal ectopic carry) can be selected to obtain normal offspring, in order to reduce the occurrence of birth defects.

Application of sensory nerve quantitative detector in clinical curative effect of cervical spondylotic radiculopathy

gaoxin — 2022/5/23 17:07:51

Objective:To observe the clinical effect of sensory nerve quantitative detector in cervical spondylotic radiculopathy；Methods: According to the random number table method, 120 patients were divided into two groups, 60 in each group. 55 cases in the treatment group and 53 cases in the control group were completed.The CPT value of the affected upper limb was measured by quantitative sensory testing before and after treatment.Result: The CTP values of C6, C7 and C8 affected nerve roots of the two groups before treatment showed no statistical difference at 2000Hz, 250Hz and 5Hz. After treatment, there were statistical differences between the two groups, and the treatment group was better than the control group.Conclusion:The application of sensory nerve quantitative detector can well evaluate the clinical efficacy of cervical spondylotic radiculopathy.

Effect of sugammadex on postoperative pulmonary complications in aged patients undergoing thoracoscopic radical resection of lung cancerWang Xiaojing, Xie Yaxian, Dang Xiaoyan, Meng Xianhui, Zhou Junhui

党晓艳,王晓静,谢雅娴,周俊辉 — 2022/5/18 17:41:04

【Abstract】Objective To evaluate the effect of sugammadex for neuromuscular block reversal on postoperative pulmonary complications (PPCs) in elderly patients with thoracoscopic radical resection of lung cancer. Methods A total of 100 elderly patients underwent thoracoscopic radical resection of lung cancer, aged 65-79 years, divided into 2 groups by a random number table method: neostigmine group (N group) and sugammadex group (S group), 50 patients per group. At the end of the operation, sugammadex 2 mg/kg was intravenously injected when four consecutive stimulation (TOF) counts ≥2 (whether or not spontaneous breathing) in group S, and neostigmine 0.04 mg/kg + atropine 0.01 mg/kg was administered when the patient had spontaneous breathing in group N. The incidence of PPCs was recorded within 72 h after operation in both of groups. At the time of 1 and 2 d after operation，the rehabilitation quality score scale-15 (QoR-15) was used to evaluate the early rehabilitation quality of the patients. The white blood cells and neutrophils were recorded at 1 d before surgery，1 d and 3 d after surgery. The difference of the stay time in the post-anaesthesia recovery room (PACU) and the postoperative hospital stay between the two groups were compared and analyzed. Results The incidence of PPCs in group N was 34.0% within 72 hours after surgery, and 14.0% in group S. The incidence of PPCs in group S was lower than that in group N (P<0.05). The white blood cell count, neutrophil count and neutrophil percentage of patients in group N and S at 1 and 3 days after surgery were significantly higher than those at 1 day before surgery (P<0.05). The white blood cell count, neutrophil count and percentage of neutrophils in group S were significantly lower than those in group N at 1 and 3 days after surgery (P<0.05). PACU stay time and postoperative hospital stay in S group were significantly shorter than those in N group (P>0.05). Sinus bradycardia occurred in 3 cases in group S, dry mouth occurred in 9 cases, nausea and vomiting occurred in 2 cases, and sinus bradycardia, dry mouth, nausea and vomiting occurred in 12 cases, 21 cases and 10 cases in group N, respectively. The comparison between groups indicated that the incidence of group S was significantly lower than that of group N (P>0.05). Compared with group N, the QoR-15 scores of group S were increased on the 1st and 2nd day after operation (P<0.05). Conclusion Sugammadex for neuromuscular block reversal can lower the incidence of PPCs and be beneficial to early postoperative rehabilitation for elderly patients with thoracoscopic radical resection of lung cancer.

Clinical features of 144 middle aged and elderly women patients with insomnia under the dialectical concept of traditional Chinese Medicine

李小攀,陆静珏,孟凡萍,沈定毅 — 2022/5/11 9:09:35

【Abstract】：Objective To analyze the clinical characteristics of insomnia in middle-aged and elderly women treated by TCM，and to provide support for the rehabilitation treatment of insomnia in middle-aged and elderly women.Methods This study collected insomnia patients from March 1, 2016 to January 31, 2020，Data were obtained from Shanghai Seventh People's Hospital，involving 144 women at age 45 to 75,Age，Including insomnia related symptoms, disease location, syndrome differentiation and medication frequency were analyzed.Results In 144 patients, the average age was 59.43 ± 7.96 years old, 69 patients aged 45-60 years old, accounting for 47.92%, 75 patients aged 60-75 years old, accounting for 52.08%;The characteristics of insomnia in middle-aged and elderly women were easy to wake up (55.56%), difficult to sleep (53.47%) and early to wake up (20.83%);The main accompanying symptoms were epigastric discomfort (59.03%), dizziness (53.47%) and chest tightness (52.08%);The main causes of insomnia were spleen (60.42%), heart (50.00%) and liver (43.75%). The main causes were Qi deficiency (42.36%), Qi stagnation (31.25%) and phlegm dampness (20.83%);In the syndrome differentiation of insomnia, the syndrome of heart and liver fire excess was 28.47%, the syndrome of heart and spleen deficiency was 18.75%, and the syndrome of phlegm dampness blocking collaterals was 11.81%;The distribution of insomnia syndrome types in different age groups was statistically different (P=0.001). Conclusion Insomnia in middle-aged and elderly women is related to the decline of physiological function and the deficiency of Zang Fu organs. Early intervention and early diagnosis and treatment are conducive to the prevention and treatment of senile intractable insomnia.

Imaging research progress of tendon regeneration after autologous hamstring tendon transplantation

huangxiaoli — 2022/5/10 16:08:23

Anterior cruciate ligament reconstruction with autologous hamstring tendons is a popular method for the treatment of Anterior cruciate ligament injury of knee joint. It is believed that most of the tendons can be regenerated in situ or even used as grafts for secondary reconstruction. This article reviews the imaging research progress of regenerated tendon.

The current status and prospect of conversion therapy for hepatocellular carcinoma

qinjianlun — 2022/5/10 16:07:36

Primary liver cancer is one of the most common malignancies. The early diagnosis of hepatocellular carcinoma (HCC) is difficult. Conversion therapy of HCC is to transform unresectable hepatocellular carcinoma into resectable HCC and then excise it surgically. In recent years, TKI/VEGF targeted therapy represented by sorafenib, lenvatinib, apatinib, bevacizumab and immune checkpoint inhibitors therapy represented by PD-1 / PD-L1 have made a major breakthrough in the treatment of advanced HCC. Some patients with advanced HCC have regained the opportunity of operation and benefited from the progress of local treatment represented by hepatic artery infusion chemotherapy (HAIC). These results have led to the rapid development of conversion therapy for HCC. Therefore, standardized conversion therapy is not only a research hotspot, but also an urgent problem to be solved and explored. This review focuses on this and summarizes the relevant progress and current situation.

Research advances in the medical treatment of radiation proctitis

lin lili — 2022/5/10 16:06:36

Radiation proctitis is rectal damage caused by radiation treatment of pelvic and retroperitoneal malignant tumors, which seriously affects the disease prognosis and quality of life of cancer patients. Acute radiation proctitis is self-limiting and the symptoms can be relieved after stopping radiotherapy. Only a small percentage of patients have severe prolonged disease. As clinical treatment is mostly symptomatic, this article focuses on a review of advances in the medical treatment of radiation proctitis.

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huangdongyan,zhaorenfeng — 2022/5/10 16:05:47

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A case of Rendu Osler Weber disease complicated with duodenal ulcer

Liu Yao — 2022/5/10 16:04:44

HHT is also known as Rendu-Osler-Weber disease, and is an autosomal dominant inherited disease. It is manifested by extensive subcutaneous, mucosal and visceral telangiectasia, with an incidence rate of 1~2/10000[2]. Three pathogenic genes are known to be associated with HHT: endoglin1 gene (Eng) on chromosome 9q34, ALK1 (activin receptor like kinase 1) gene on chromosome 12q11 ~ q14, and smda4 gene on chromosome 18q21, all of which are associated with TGF- β (transforming growth factor) β） The molecular biological basis of HHT is TGF- β Abnormal vascular development caused by signal transduction disorder.

Difference and agreement of myopic anterior chamber depth and white-to-white corneal diameter measured by IOLMaster 700 ，Pentacam and Orbscan

蒋莉,李兰建,吕健 — 2022/5/9 17:57:12

Objective To analyze the difference and agreement of myopic white-to-white corneal diameter (WTW)and anterior chamber depth (ACD) by IOLMaster700, Pentacam and Orbscan. Methods Cross-sectional study. A total of 102 eyes of 51 myopic patients who underwent ICL implantation in Guangxi Zhuang Autonomous Region People's hospital during April to December 2019 were recruited. The WTWand ACD were measured with IOLMaster700, Pentacam and Orbscan before operation. The difference and agreement between the measurements were evaluated by ANOVA, LSD test, Intraclass correlation coefficient and Bland-Altman analysis. Results Significant difference was found in WTW [(11.91±0.31)vs. (11.42±0.29) vs. (11.36±0.27) mm; F=111.956，P＜0.001]. There was no difference among devices in measuring the ACD [(3.12±0.17)vs. (3.11±0.17)vs. (3.09±0.17)；F=0.870，P=0.420] . And WTW measured by IOLmaster700 was significantly different from Pentacam and Orbscan (all P＜0.05). But there was no significantly differences between Pentacam and Orbscan (P=0.153). Intraclass correlation coefficient was 0.790~0.966．Bland-Altman analysis showed that satisfactory agreement was observed in the WTW measured by Pentacam and Orbscan, but the consistency between IOLMaster700 and Pentacam, and between IOLMaster700 and Orbscan is unsatisfactory. The 95% limits of agreement of IOLMaster700 and Pentacam, IOLMaster700 and Orbscan, Pentacam and Orbscan were -0.09~0.11mm, -0.07~0.14mm and -0.07~0.11mm respectively. All three devices show good agreement in biometry of ACD of myopia patients. Conclusion There was no significant difference in the measurement of WTW between Pentacam and Orbscan but the consistency between IOLMaster700 and Pentacam, and between IOLMaster700 and Orbscan is unsatisfactory. The three devices show good agreement in biometry of ACD of myopia patients.

Discussion of Relationship Between Social Life Abilities of Children With Functional Dysarthria And Their Intellectual Development Levels

LIU Wenlong,LIU Xiaoying — 2022/5/9 17:20:26

[Objective] To understand the advances of social life abilities of children with functional dysarthria, their intellectual development levels and their relationships. [Method] The social life ability and intellectual development level of 87 children with functional dysarthria were evaluated using infant-junior school student social life ability scale and check sheet of neuropsychological development for children of 0-6 years old, and then the correlation of these two results were analyzed. [Result] The overall level of social life abilities of 87 children with functional dysarthria and each grading of ability were primarily normal, of which, the top three items graded as margin and defect were communication (31%), self-management (28.7%) and operations (20.7%), and there were statistically significant differences among distributions of grading of social life abilities (x2=29.05, P＜0.01); development of various abilities of intellectual development was unbalanced, of which, the fine movement were mainly graded as margin (27 cases) and low (28 cases), cases graded as margin and low in language, adaptability and social behavior occupied 52.8%, 49.4% and 48.3%, respectively, the gross motors were mainly graded as normal (66 cases) (75.9%), and there were statistically significant differences among distributions of intellectual development grading (x2=36.95, P＜0.01). The assessment results with check sheet of neuropsychological development for children of 0-6 years old had a significant correlation with assessment results with infant-junior school student social life ability scale (P＜0.05 and P＜0.01). [Conclusion] The children suffering from functional dysarthria did not only manifest dysarthria, and their social life abilities and intellectual development levels were impacted and closely correlated.

The effect of multi-mode neuroelectrophysiological monitoring in intraspinal occupying surgery

wei xiao fei — 2022/5/9 17:19:37

Objective To analyzethe clinical effect of multi-mode neuroelectrophysiological monitoring technology in the operation of patients with intraspinal occupying lesions. Methods 45 patients with intraspinal mass were resected, including 23 patients (experimental group) who received intraoperative neuroelectrophysiological monitoring, and 22 patients (control group). The function of nerve and spinal cord and the effect of surgical resection were compared between the two groups. Results All 45 cases were followed up completely. The improvement rate of intraspinal mass lesion resection, McCormick grading and JOA score in the experimental group were better than those in the control group ,the difference is statistically significant.(P < 0.05). None of the patients in the experimental group had neuro-related complications, and 1 patient had numbness of right thigh after surgery without improvement of intraoperative alarm.Conclusion Neuroelectrophysiological monitoring can improve the effect of intraspinal space occupying surgical resection, contribute to the recovery of postoperative nerve function, and reduce the incidence of complications.

Clinicopathological features and prognosis of gastrointestinal adenocarcinoma with abdominal wall implantation metastasis

侯国旗,唐燕 — 2022/5/9 17:15:50

Objective To investigate the clinicopathological features and prognosis of gastrointestinal adenocarcinoma with abdominal wall implantation metastasis. Methords Eleven patients from Weihai central hospital from July 2017 to December 2020 who were diagnosed gastrointestinal adenocarcinoma with abdominal wall metastasis were collected. The clinical history, histopathological features and prognosis of the patients were analyzed retrospectively. Results Among the 11 patients, 4 cases were gastric cancer and 7 cases were intestinal cancer. The primary tumors were moderately or poorly differentiated adenocarcinoma, and some were accompanied by mucinous adenocarcinoma; The lesions were mainly located in distal stomach (4 cases, accounting for 100.00%) and right colon (5 cases, accounting for 71.43%). The main pathological stage was T3 or above (8 cases, 72.73%), most of them had lymph node metastasis (7 cases, 63.64%); The histopathological structure of metastatic tumor is almost the same as that of primary tumor. There was no significant difference between the time of abdominal wall metastasis and whether radiotherapy and chemotherapy were performed after gastrointestinal surgery; No significant correlation was found between the survival time after secondary operation and the operation method or whether radiotherapy and chemotherapy were performed after operation. Conclusions Gastrointestinal adenocarcinoma is the most common metastatic tumor in the abdominal wall, and its histological morphology is consistent with that of the primary tumor. The poor differentiation and pathological stage of the primary tumor suggest that the tumor develops into advanced stage. It is recommended that regular follow-up physical examination should be conducted after gastrointestinal surgery in order to find early implant metastases and appropriate treatment plans should be formulated according to the patient's histopathological examination and general condition.

Study on serum heparanase and LOX-1 expression level and its correlation in patients with chronic heart failure

王诗琪 — 2022/5/7 17:15:13

objective To study the changes of serum heparanase (HPSE) and LOX-1 before and after standardized treatment in patients with acute decompensation heart failure (ADHF), and analyze the correlation and clinical significance between the two and NT-proBNP. Methods Fifty ADHF patients hospitalized in the Department of Cardiology, The First Affiliated Hospital of Baotou Medical College from May 2019 to December 2020 were selected as the experimental group. During the same period, 30 patients with normal cardiac function were randomly selected as the control group. The serum HPSE, LOX-1 and NT-proBNP levels of all the subjects were determined, and the HPSE, LOX-1 and NT-proBNP levels of the patients in the experimental group were determined again after standardized treatment. Statistical test and correlation analysis were conducted to analyze the changes of serum HPSE and LOX-1 in the experimental group before and after treatment, and compare the serum HPSE and LOX-1 levels between the experimental group and the control group before treatment, and compare the serum HPSE and LOX-1 levels between the experimental group and the control group after treatment, and through Peason correlation analysis,explore the correlation of serum HPSE, LOX-1, NT-proBNP in the experimental group. Results (1) The levels of serum HPSE and LOX-1 before treatment were significantly higher than after treatment, the differences were statistically significant (P < 0.05). (2) The levels of serum HPSE and LOX-1 before treatment were significantly higher than those in the control group, the differences were statistically significant (P < 0.05); (3) There were no significant differences in serum HPSE and LOX-1 levels after treatment compared with the control group (P > 0.05). (4) There are positive correlations between HPSE, LOX-1 and NT-proBNP in the experimental group. Conclusion (1) The levels of serum HPSE and LOX-1 in ADHF patients before treatment are significantly higher than those after treatment, suggesting that the two are involved in the occurrence and development of heart failure. (2) The levels of HPSE and LOX-1 in ADHF patients are significantly higher than those in patients with normal heart function, suggesting that they can be used as predictors of chronic heart failure. (3) After standardized treatment, serum HPSE and LOX-1 of ADHF patients can be reduced to the same level as that of patients with normal cardiac function, which provides theoretical support for clinical diagnosis and prognosis judgment. (4) Serum HPSE, LOX-1 and NT-proBNP in ADHF patients are positively correlated, suggesting that serum HPSE, LOX-1 and NT-proBNP may have the same clinical significance in evaluating the efficacy of heart failure.

Sedation Effect Of White Noise Combined With Chloral Hydrate In Lumbar Puncture Of Neonates? YOU Min-yi,HUANG Ren,KANG Si-mei,RUAN Wan-fen.Department of Neonatology,Shunde Hospital of Southern Medical University(The First People’s Hospital of Shunde),Foshan 528300,China

尤敏仪 — 2022/5/7 17:10:27

【Abstract】 Objective:To study the sedative effect of white noise combined with chloral hydrate on neonatal lumbar puncture.Methods:70 neonates requiring lumbar puncture examination were included and randomly divided into control group (chloral hydrate group, 35 cases) and experimental group (white noise + chloral hydrate group, 35 cases) according to different sedation intervention methods.Brussels sedation score, NIPS pain score during lumbar puncture, vital signs, success rate of lumbar puncture and adverse reactions were observed, and the sedation effect of the two methods were compared.Results: 1. Brussels sedation scores in both groups showed a downward trend with the time after intervention (P<0.05), but there was no significant difference between the two groups (P>0.05).Brussels sedation score and NIPS pain score in the experimental group were significantly lower than those in the control group (P<0.05).2. The heart rate, respiration and upper pressure of the two groups showed a downward trend with the progress of time after intervention, while the oxygen saturation showed an upward trend (P<0.05).The decreasing trend of heart rate and respiration in the experimental group was more obvious than that in the control group (P<0.05), and there was no significant difference in 5 vital signs between the two groups (P>0.05).3.The success rate of lumbar puncture in experimental group was higher than that in control group, but the difference was not statistically significant (P>0.05).There were no adverse reactions in both groups.Conclusion: White noise combined with chloral hydrate has significant sedative effect in lumbar puncture of neonates, which is safe and has popularization value.

Expression profile of sncRNAs in the inflammatory state of human bone marrow mesenchymal stem cells induced by TNF-α

lu yan qing,peng jian ping,wang chuan dong,zhou xing — 2022/5/7 17:07:55

Objective The pro-inflammatory cytokine tumor necrosis factor alpha (TNF-α) inhibits the osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs), however, the mechanism of small non-coding RNAs (sncRNAs) in the process remains elusive. This study aimed to investigate the role of TNF-α on regulating the expression of sncRNAs in hBMSCs. Methods HBMSCs were isolated and cultured in vitro, stimulated with TNF-α (10ng/ml) for 24h. Total RNA was extracted and high-throughput RNA sequencing (small RNA-seq) was conducted to detect the expression of sncRNAs. The small RNA-seq results were further validated using quantitative real-time PCR. Results (1) After TNF-α stimulation, 5 miRNAs were up-regulated and 4 miRNAs were down-regulated (P<0.05); (2) After TNF-α stimulation, 4 piRNAs were upregulated (P<0.05); (3) After TNF-α stimulation, 13 snoRNAs were down-regulated (P<0.05); (4) After TNF-α stimulation, 1 snRNA was downregulated (P<0.05). Conclusion Overall, TNF-α could regulate the expression of many sncRNAs in hBMSCs, which in turn affect osteogenic differentiation of hBMSCs.

Efficacy of DC-CIK immunotherapy combined with chemotherapy in advanced lung cancer and the effect on patients" serum miR-137 and miR-155

dulingyu,hubowen — 2022/4/26 8:47:57

To analyze the effect of dendritic cell-cytokine-induced killer cell (DC-CIK) immunotherapy combined with chemotherapy in advanced lung cancer and its effects on patient tumor markers and survival cycle.Methods: Retrospective analysis of the clinical data of 83 patients with advanced lung cancer from January 2020 to January 2021, according to their treatment method, the patients were divided into combination group and 43 patients in chemotherapy group, DC-CIK immunotherapy combined chemotherapy and chemotherapy group underwent chemotherapy.Compared with the clinical efficacy, the levels of the tumor marker cancer embryo antigen (CEA), the cytokeratin 19 fragment (Cyfra21-1), the immune function indicators CD3 +, CD4 +, natural killer cells (NK) levels, and the patient survival cycle of the two groups.Results: There were no significant difference between objective efficiency (ORR), disease control rate (DCR) and the chemotherapy group (P> 0.05).After treatment, the levels of CEA and Cyfra21-1 were reduced in both groups (P <0.05), and in the combined group, the CEA and Cyfra21-1 levels were lower than in the chemotherapy group (P <0.05).After treatment, the levels of CD3 +, CD4 +, and NK cells were increased in the combination group (P <0.05), and the levels of CD3 +, CD4 +, and NK cells were higher than in the chemotherapy group (P <0.05).After treatment, the levels of miR-137 and miR-155 were decreased in both groups (P <0.05), and in the combined group, the miR-137 and miR-155 levels were lower than in the chemotherapy group (P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05).The combined progression-free survival (PFS) and overall survival (OS) were longer than in the chemotherapy group (P <0.05).Conclusions: DC-CIK immunotherapy combined with chemotherapy can reduce the levels of CEA, Cyfra21-1, the tumor markers in advanced lung cancer patients, improve their immune function, and prolong the survival cycle of patients.

Effect of LncRNA HULC on miRNA differential expression profile and ceRNA regulatory network in hepatocarcinoma cells

guanlulu,,,,, — 2022/4/22 10:21:18

Objective After LncRNA HULC siRNA intervention, hepatoma cell line Bel-7402 was used to detect the differential expression of miRNA and the changes of related target gene to explore the effect of LncRNA HULC on miRNA differential expression profile and competitive endogenous RNA (ceRNA) regulatory network of liver cancer cells. Methods HULC siRNA was transfected instantaneously into human liver cancer cell line Bel-7402 to reduce the expression of HULC. High-throughput sequencing selected miRNAs with different expressions and predicted new miRNAs based on reference genomes. qRT-PCR was used to detect the HULC gene and verify differential miRNA expression. Gene enrichment analysis and target gene related pathway prediction to study the potential function of these genes. Results The HULC gene in liver cancer cell lines was knocked down and nine differentially expressed genes were selected by high-throughput sequencing.5 genes were down-regulated and 4 genes were up-regulated. The new miRNAs were scored by miRDEEP2, and the higher the value, the better the result. Fifteen new genes with higher score were selected. According to the results of gene enrichment analysis, the molecular functions of the down-regulated miRNA target genes were related to the activities of serine tRNA ligase, protein kinase, cationic channel and calcium transporter ATPase. The target genes of the up-regulated miRNA were related to selenocysteine lyase activity, peroxisomal mechanism targeting signal-1 binding, peroxisomal targeting sequence binding, protein N-tail binding, tumor necrosis factor receptor superfamily binding, etc. The miRNA-target gene network and functional networks were significantly enriched revealed the association of interaction between miRNA and target genes, as well as correlation between functional. Conclusions LncRNA HULC plays a role in regulating multiple differentially expressed miRNAs in HCC, and may play a key role in the production and development of liver cancer through the regulation of network mode by ceRNA.

Advances in research on Lactobacillus rhamnosus GG in cardiovascular disease

韦,Li Zehua — 2022/4/18 8:49:58

The growing burden of cardiovascular disease is a major global health challenge. Acculumating evidence have shown that gut dysbiosis and metabolic imbalance are important factors that promote the development of cardiovascular disease, and targeting the gut microbiota is a potentially effective strategy to reduce cardiovascular disease morbidity and mortality. The rise of probiotic therapy in recent years has provided new ideas for the prevention and treatment of cardiovascular diseases. Lactobacillus rhamnosus GG (LGG)，the most powerful model probiotics with known probiotic functions，has shown great potential in the prevention and treatment of LGG. The author reviewed the research progress of LGG in cardiovascular diseases in recent years.

Surgical treatment of congenital aneurysm of right atrial appendage complicated with patent foramen ovale: A rare case report

YAN Nuo,ZHAO Shuaishuai — 2022/4/12 10:01:00

Right atrial appendage aneurysm(RAAA) is a rare congenital cardiac abnormality thought to be caused by dysplasia of the muscular wall of the right atrial（RA）and right atrial appendage(RAA). Although frequently considered a relatively benign disorder , this lesion may be associated with atrial dysrhythmias, severe tricuspid regurgitation, thrombus formation and even sudden death。A case of right atrial appendage aneurysm with patent foramen ovale（PFO） was admitted to our hospital. The surgical treatment measures are now reported as follows for clinical reference.

A case of lymphoepithelioma-like carcinoma of peritoneal cavity

huangmin,王珺平 — 2022/4/12 10:00:03

病例报告无摘要

Application of dexmedetomidine pretreatment in intracranial aneurysm clipping

陈伟涛 — 2022/4/7 17:47:17

Objective To explore the clinical value of dexmedetomidine pretreatment in intracranial aneurysm clipping. Methods From June 2019 to May 2021, 80 patients with intracranial aneurysms underwent open aneurysm clipping under general anesthesia under tracheal intubation were selected in this hospital. According to the random number table method, they were divided into two groups, with 40 cases in each group. In the observation group, dexmedetomidine was injected intravenously before anesthesia induction tracheal intubation, and the control group was treated with the same amount of 0.9% normal saline as a blank control. Compare the cerebral oxygen metabolism indexes at the end of the two groups, such as intracranial pressure, cerebral perfusion pressure and cerebral oxygen uptake rate, and count the amounts of propofol, remifentanil and sevoflurane during the operations of the two groups, and compare the two groups' operation centers Rate, systolic and diastolic blood pressure levels. Results At the end of the operation, the observation group's cerebral oxygen metabolism indexes: intracranial pressure was lower than the control group (P<0.05), cerebral perfusion pressure and cerebral oxygen uptake rate were higher than the control group (P<0.05), the observation group intraoperative propofol The dosage of remifentanil and sevoflurane was significantly less than that of the control group (P<0.05). The operation center rate of the observation group was slower than that of the control group (P<0.05), and the systolic blood pressure and diastolic blood pressure were lower than those of the control group (P<0.05). 0.05). Conclusion Dexmedetomidine pretreatment for intracranial aneurysm clipping surgery can improve brain perfusion, reduce the amount of anesthetics, and better maintain the stability of intraoperative vital signs to a certain extent.

Clinical efficacy of drug castration in treatment of prostate cancer complicated by urinary retention

凌凯南,, — 2022/4/7 17:46:37

[Abstract] Objective: To evaluate the efficacy of drug castration in treatment of prostate cancer complicated by urinary retention.Methods:Clinical data of 32 patients having urinary retention with prostate cancer in Jiangbin Hospital of Guangxi Zhuang Autonomous Region from June 2017 to June 2020 was retrospectively reviewed.These 32 patientsunderwent Urethral catheterization and received Drug castration comb-ined with α-blocker.Successful urethral catheterization rate,Intern-ational Prostate Symptom Score(IPSS),Quality of Life(QOL) score,Maxi-mum flow rate(Qmax) and Prosate Volume(PV) variation were observd.Re-sults:After 16 weeks'LHRH analogue treatment,26 patients could urina-te voluntarily,accounting for 81.25%.In these 26 patients,IPSS was 32.6±3.3,and QOL was 4.9±0.9 before treatment;After successfully remo-ving the cystosmy catheter, IPSS was 17.6±4.3,QOL was 2.6±0.5 and t test showed that P<0.001;Qmax was improved to 11.1±2.8ml/s from 1.2±0.3ml/s PV of These 28 patients(28/32) was 76±15.8ml before treatment and PV was 43±10.2ml 12 weeks after,There showed significant improvement.Conclusions:The clinical outcome of drug castration and high risk patients having uriary retention with prostate cancer is definite.

Clinical analysis of 211 postmenopausal women with vaginal bleeding

anhuimeng — 2022/4/7 17:45:35

【Abstract】Objectivs: To?evaluate?the?value?of?hysteroscopy?and ultrasonography in the diagnosis of postmenopausal bleeding (PMB) women with endometrial malignancies. Methods: We respectively analyzed 211 patients with postmenopausal bleeding who were naturely postmenopausal?,and attended gynecology of Second Hospital Affiliated to Lanzhou University receiving surgeries from September 2015 to September 2017. According to the pathological examination results,the patients were divided into the group of endometrial non-malignant tumor and the group of endometrial malignant tumor. The differences of general clinical characteristics between the two groups were analyzed by statistical method.The diagnostic accuracy of hysteroscopy and B-ultrasound for postmenopausal vaginal bleeding patients were calculated respectively. The ROC curves were used to compare the diagnostic efficiency of the two methods.And we used the areas under the ROC curve(AUC) to assess the diagnostic efficacy of endometrial thickness on endometrial cancer, and to investigate the ideal cut-off value of endometrial thickness predicting endometrial malignant neoplasms according to statistical results. Results: ① Comparison of general clinical characteristics between benign and malignant patients: Comparing the group of endometrial malignant tumors with the group of nonmalignant tumors, the average age,the period of menopause , the average thickness of endometrium, hypertension and diabetes were significant differences（P﹤0.05）. There was no significant differience(p=0.055)of the average menopause age.② The sensitivity of hysteroscopy in the diagnosis of endometrial malignant tumor was 96.61%. The specificity was 96.71%. The positive predictive value（PPV）was 91.94%.The negative predictive value(NPV) was 98.66%. And the accuracy was 96.68%. The sensitivity of ultrasound in the diagnosis of endometrial malignant tumor was 11.86%. The specificity was 96.05%. The positive predictive value（PPV）was 53.85%.The negative predictive value(NPV) was 73.74%. And the accuracy was 72.51%.③ROC on endometrial thickness for endometrial carcinoma yielded the AUC 0.877. When the Cut-off is 3.5mm,the sensitivity is 100%,and the specificity is 42.8%. Conclusions: Old ages,long duration of menopause and abnormal endometrial thickeness, hypertension or diabetes are risk factors for endometrial malignancy. Endometrial thickness has moderate diagnostic accuracy for endometrial malignant neoplasms.The ideal cut-off of endometrial thickness is 3.5mm.

Research progress on the effect of reactive oxygen species on sperm ultrastructure

wangling,,zhangxiyan — 2022/4/1 15:51:48

Reactive oxygen species (ROS), a by-product of aerobic respiration and metabolism, is an integral part of sperm development physiology, capacitation and function. When the concentration of reactive oxygen species exceeds the buffering capacity of antioxidants, oxidative stress will occur, which may have a negative impact on the ultrastructure, morphology and function of sperm.The related mechanism of active oxygen-induced male infertility is that the ultraphysiological level of active oxygen damages the ultrastructure of sperm, including lipid peroxidation, increased DNA damage, decreased sperm motility caused by mitochondrial damage, abnormal sperm-related parameters and decreased oocyte-sperm fusion.In this paper, the research status of the influence of reactive oxygen species on sperm ultrastructure is reviewed, in order to provide possible theoretical basis for clinical treatment of male infertility.

Research progression of NLRP3inflammasome in ARDS

dong jue — 2022/4/1 15:50:45

Acute respiratory distress syndrome （ARDS）is one of the most common critical diseases,NLRP3 inflammasome is an important component of innate immune system， involved in inflammation progression. This review focus on NLRP3 inflammasome and its role in ARDS.

DLX3 and Syncytin in Gestational Diabetes Mellitus Expression and significance in peripheral blood and placenta

Fangxiang,Lanjiao,Lijing,邬华,Wuhaomin — 2022/4/1 15:49:43

Objective: To investigate the expression and significance of DLX3 and Syncytin in peripheral blood and placenta of gestational diabetes mellitus patients. Methods: 30 cases of gestational diabetes mellitus were selected as the experimental group and 30 cases of normal pregnant women as the control group. The values of DLX3 and Syncytin in peripheral blood and placenta were detected by ELISA and RT-PCR respectively. Results: Compared with the normal control group, the weight gain during pregnancy, the expression of DLX3 and the blood glucose level of OGTT in the experimental group were significantly higher than those in the control group. DLX3 is a high risk factor of gestational diabetes mellitus with statistical significance. Gestational diabetes mellitus is related to the blood glucose level of DLX3 and OGTT at each time point. Conclusion: DLX3 is a high risk factor of gestational diabetes mellitus, and plays a certain role in the pathogenesis of gestational diabetes mellitus.

The Combination of 3D Mirror Printing with MIPPO Technology in Treatment of Median Clavicle Fracture in Adults

HAO Lian-sheng,LIU Shi-kai,MU Sheng-kai — 2022/4/1 15:48:52

Objective:To compare the clinical efficacy of 3D image printing combined with MIPPO technology and traditional open reduction and internal fixation in the treatment of adult middle clavicle fracture.Methods:Methods forty-eight patients with displaced mid-clavicle fracture admitted to the second Department of Bone trauma, Liaocheng Hospital of Traditional Chinese Medicine from June 2020 to May 2021 were selected and randomly divided into observation group and control group, with 24 cases in each group. The observation group was treated with 3D image printing combined with MIPPO technology. The control group was treated with traditional open reduction. Operation time, incision length, intraoperative blood loss, times of fluoroscopy, fracture healing time and postoperative complications were compared between the two groups. Constant shoulder score was used to evaluate the efficacy 6 months after surgery, and the clinical efficacy of the two treatment methods was summarized.Results: All 48 patients were followed up for 6 months. The operative time, incision length, intraoperative blood loss, fluoroscopy times and fracture healing time in the observation group were shorter than those in the control group (P <0.05). There were no significant differences in the incidence of postoperative complications and Constant shoulder score 6 months after surgery between the two groups (P> 0.05).Conclusion: Both 3D mirror printing combined with MIPPO technology and traditional open reduction and internal fixation can effectively treat the fracture of the middle clavicle, but 3D mirror printing combined with MIPPO technology has the advantages of small trauma, short operation time, less intraoperative blood loss, less intraoperative fluoroscopy, and fast fracture healing.

Diagnostic value of D-dimer detection combined with caprini score in pulmonary embolism

方年新 — 2022/4/1 15:47:53

Objective To analyze the diagnostic value of D-Dimer (D-D) combined with Caprini score in Pulmonary embolism (PE).Methods Sixty patients with PE in our hospital from September 2019 to may 2021 were selected as PE group, and 60 non PE patients in the same department in the same period were selected as the control group. D-D level, caprini score, coagulation function, vascular endothelial function and inflammatory reaction were compared between the two groups; Draw ROC curve, analyzed D-D level, Caprini score and the value of joint diagnosis of PE; Pearson was used to analyze the correlation between D-D level, Caprini score and coagulation function and inflammatory response in PE patients. Results The serum D-D level and Caprini score in PE group were higher than those in control group (P < 0.05); The results of ROC curve showed that the AUC of serum D-D level, caprini score and their combination in predicting the occurrence of PE were 0.847 (95% CI: 0.777-0.917), 0.948 (95% CI: 0.912-0.984) and 0.992 (95% CI: 0.982-1.000), respectively; The levels of APTT, PT and FIB in PE group were lower than those in control group, and WBC and CRP in PE group were lower than those in control group (P < 0.05);Pearson correlation analysis showed that D-D level and Caprini score were positively correlated with WBC and CRP (P < 0.05), and negatively correlated with APTT, Pt and FIB (r < 0, P < 0.05).Conclusions Serum D-D level combined with Caprini score can improve the diagnostic efficacy of PE, and their levels are closely related to coagulation function and inflammatory response in patients with PE.

Screening molecular markers related to cervical cancer immunity based on bioinformatics

luoyongjin,, — 2022/4/1 15:46:43

Objective: To search for molecular markers related to cervical cancer immunity based on bioinformatics method. Methods: The cervical cancer microarray dataset (GSE63514) was downloaded from the Gene Expression Compilation (GEO) database and the TCGA database. Immunological and matrix scores were performed on TCGA dataset by R language ESTIMATE algorithm. The relationship between the score and prognosis of cervical cancer was analyzed by R language, and the differential genes were screened out according to the level of immunity score. The differential genes of the up-down immunity score and the differential genes of the GEO dataset were combined and intersected by Venn diagram. Gene body (GO), KEGG signal pathway enrichment analysis and GSEA enrichment analysis were performed on the combined genes to construct protein-protein interaction network, screen Hub genes, and analyze the relationship between key genes and immune cell infiltration. Differential expression of key genes and poor prognosis of patients were validated using GEPIA2 and UALCAN. Results: Based on the results of ESTIMATE algorithm, 5-year survival rate of patients with high immunity score was higher. The difference analysis of samples with high and low immunity score was conducted, and 1063 differential genes were obtained. The GEO dataset (GSE63514) was analyzed to obtain 1903 differential genes, and 7 down-regulated genes and 100 up-regulated genes were obtained after intersection of the two. GO enrichment analysis of 107 genes suggested that the differential genes were involved in the biological function of immune regulation. KEGG and GSEA enrichment analysis showed that the differential genes were mainly enriched in cytokine receptor interactions and cellular adhesion molecular pathways. Thirteen key genes including CXCL9 were screened out through protein-protein interaction network. Correlation analysis of immune cells and key genes showed that genes were significantly correlated with B cells, T cells and other immune cells. Based on the survival information of cervical cancer patients in TCGA, we found that only SELL and CXCL9 were correlated with the prognosis of cervical cancer patients through survival analysis. Through online verification, it was found that CXCL9 was highly expressed in cervical cancer tissues, and its expression level was positively correlated with the survival rate of patients (p<0.05). Conclusion: Differentially expressed genes of cervical cancer participate in the immune regulation process and have significant correlation with immune cells. CXCL9 is highly expressed in cervical cancer, which is correlated with the prognosis of cervical cancer patients. It may be a potential prognostic immune molecule marker in patients with cervical cancer. Key words: bioinformatics; ESTIMATE; Cervical cancer; Immune cell; Molecular marker.

Comparison of Six Staining Methods for bone tissue during Distraction Osteogenesis

zhaozhenchen, — 2022/4/1 15:44:06

Objective：To compare the advantages and disadvantages of six staining methods for bone tissue at various stages of canine distraction osteogenesis. Method：Three groups of canine mandibular distraction osteogenic areas at the pre-, mid-, and late stages of distraction osteogenesis were stained by hematoxylin eosin staining (H&E), Masson staining, methylene blue-acidic magenta staining, calcium salt staining (von kossa method and modified alizarin red S method), and modified safranin-O fast green staining on consecutive sections, and the effects of staining were compared. Results：HE staining could observe the basic structure of the distraction osteogenic zone, and Masson staining showed sharp color contrast and clear structure, which could clearly distinguish collagen fibers from muscle fibers and mature bone from new bone. The modified safranin-O fast green staining and the methylene blue acidic magenta staining were poorly differentiated for the assessment of the early and middle distraction areas, while the staining of the later distraction areas could be clearly distinguished between the von kossa method and the modified alizarin red staining method because the specimens were decalcified. Conclusion： Masson staining was better in all periods, and modified red O solid green staining and methylene blue acidic magenta staining were only suitable for the comparison of osteogenesis in the late distraction osteogenic region, and calcium salt staining was not suitable for the staining of tissue sections after decalcification.

Effect of lncRNA GHET1 on proliferation, migration and invasion of gastric cancer MGC-803 cells and its possible mechanism

程若溪,唐沐希 — 2022/4/1 15:43:07

Objective To investigate the effect of long non coding RNA (lncrna) ghet1 on the proliferation, migration and invasion of human gastric cancer MGC-803 cells and its possible mechanism. Methods gastric cancer MGC-803 cell line was used as the experimental object. The cells stably expressed by lentivirus vector were constructed: ghet1 overexpression group(GHET1-mimic)and its negative control group(mimic-NC),ghet1 interference group(GHET1-inhibitor)and its negative control group(inhibitor-NC). The transfection effect of each group was verified by real-time fluorescence quantitative polymerase chain reaction (QRT PCR), The effects of ghet1 on the proliferation, migration and invasion of MGC-803 cells were detected by cell proliferation assay (CCK-8 method), cell migration and invasion assay (Transwell chamber), and the expression of microrna105 (mir-105) was detected by QRT PCR. Results the expression of ghet1 in GHET1-mimic group was significantly higher than that in mimic-NC group (P < 0.001); The expression of ghet1 in GHET1-inhibitor group was lower than that in inhibitor-NC group (P < 0.001). Compared with mimic-NC group, the proliferation, migration and number of invasive cells in GHET1-mimic group were significantly increased (P < 0.05);Compared with inhibitor-NC group, the proliferation, migration and number of invasive cells in GHET1-inhibitor group were significantly reduced (P < 0.05). The expression of mir-105 in GHET1-mimic group was lower than that in mimic-NC group (P < 0.05); The expression of mir-105 in GHET1-inhibitor group was higher than that in inhibitor-NC group (P < 0.05). Conclusion ghet1 can promote the proliferation, migration and invasion of gastric cancer MGC803 Cells, and its mechanism may be related to the expression level of mir-105.

Effect of rhythm control on prognosis of patients with heart failure with preserved ejection fraction and atrial fibrillationDu Chunyu,Hu Liqun

duchunyu,lihongqi — 2022/4/1 15:42:14

Objective: To investigate the effect of rhythm control on the prognosis of patients with HFpEF and AF. Method: 150 patients with HFpEF and AF were followed up and their clinical data were analyzed retrospectively. A total of 75 patients in the rhythm control group received radiofrequency ablation or antiarrhythmic drug therapy to maintain sinus rhythm, and a total of 75 patients in the heart rate control group received heart rate control therapy. The differences of clinical outcomes between the two groups were analyzed and compared. Result: There was no significant difference between the baseline data of the two groups (P > 0.05). Twelve patients died within the 24-month median follow-up period, of which 9 died of cardiovascular disease and 3 died of other causes. There was no statistically significant difference in all-cause and cardiovascular mortality between the two groups (P > 0.05). Among the 24 patients who were hospitalized due to heart failure during the 24-month median follow-up period, the incidence of heart failure hospitalization in the rhythm control group was significantly lower than that in the heart rate control group (P < 0.05), and the HR was 0.296; The incidence of cardiovascular death and hospitalizations for heart failure in the rhythm control group was also significantly lower (P < 0.05) than in the heart rate control group with a conforming outcome and an HR of 0.350. The NT-proBNP and LAVI values in the rhythm control group were significantly decreased after 12-month follow-up (P < 0.05), while the LVEF and E/E' values after 12-month follow-up were not significantly different from those at baseline (P > 0.05). The LAVI of the heart rate control group was significantly reduced after 12 months of follow-up (P < 0.05), and there were no significant differences from baseline in serum BNP, LVEF, and E/E' after 12 months of follow-up (P > 0.05). Conclusion: Restoring and maintaining sinus rhythm is associated with a reduced risk of cardiovascular death or a compound outcome of hospitalization for HF in patients with patients with HFpEF and AF.

Research progress of FIGO stage IIIC of cervical cancer

chen bo — 2022/3/21 16:58:20

The staging of tumors is of great significance in guiding treatment and judging prognosis.In 2018, the International Federation of Gynecology and Obstetrics (FIGO) released new staging criteria for cervical cancer, which for the first time included pelvic and para-aortic lymph node metastasis in the staging and classified it as stage IIIC separately. There are controversies regarding the rationality of directly classifying lymph node metastasis as stage IIIC, the lack of uniform standards for the determination of imaging examinations, the controversies in the treatment of this stage, and the problems in prognostic judgment. In this paper, we review the above-mentioned issues of stage IIIC cervical cancer and related studies in domestic and international clinical practice.

Research progress in the diagnosis of distal symmetric polyneuropathy

wang jinxiu — 2022/3/18 16:40:39

Diabetes can cause a variety of chronic complications, the most common of which is neuropathy, which affects the whole nervous system and is most common in distal symmetric polyneuropathy. The etiology of DSPN is complicated. It may be related to vascular diseases such as atherosclerosis microvascular disease, metabolic process, autoimmune mechanism and growth factors. Patients with early clinical manifestations are not obvious, when the course of disease more than 10 years prone to obvious neuropathic findings. At present, clinical diagnosis is mainly based on history collection, quantitative sensory examination, combined with scale evaluation, neuroelectrophysiology and nerve fiber morphology. In addition, the medical community is also actively exploring the relationship between imaging examination methods and serological indicators and DSPN, providing more reference value for the auxiliary diagnosis of DSPN. This review will focus on the research progress of DSPN diagnostic methods.

Two cases of fatal mushroom poisoning with cardiac arrest as the main symptom and literature review

humiao — 2022/3/15 8:46:15

Poisonous mushrooms, also known as toadstools , belong to large fungi. Acute poisoning caused by accidental consumption of poisonous mushrooms is a common disease in the Department of Emergency and Critical Care Medicine. Its pathogenic mechanism is complicated. There are no specific antidote drugs and effective treatments. Means, the risk of death is extremely high. According to statistics, the overall mortality rate of mushroom poisoning in my country is 11.69% to 42.30%, which is significantly higher than that in Europe and the United States [1]. In the past, there are more reports of poisonous mushroom poisoning in the literature, while the lethal poisonous mushroom poisoning is less. In order to further understand the clinical characteristics of lethal poisonous mushroom poisoning and improve its diagnosis and treatment level, we retrospectively analyzed the June 2020 People’s Hospital of Guangxi Zhuang Autonomous Region The diagnosis and treatment process and follow-up results of the 2 admitted patients, combined with the published literature, are summarized. The report is as follows.

Wegener’s granulomatosis : a case report with literature review

liuchao, — 2022/3/15 8:42:51

Objective To comprehend the classic and rare clinical manifestation and the diagnosis of Wegener’s granulomatosis, and improve the diagnostic level. Methods A 61-year-old male with Wegener’s granulomatosis was reported and the relative literature was reviewed. Result The etiology of Wegener’s granulomatosis is unknown. Most patients with Wegener’s granulomatosis presented with manifold manifestation, accompanied with several damaged organs featured .with necrotic granuloma and necrotic vasculitis. Prednisone and immunosuppressive agents is the main therapeutic strategy. Conclusion Wegener’s granulomatosis, with unclear etiology and multiple clinical manifestations is often diagnosed incorrectly. Herein, clinical manifestation, biochemistry, iconography and pathology need to be combined to make a perfect diagnosis.

The influence of prenatal antibiotics exposure on intestinal microbiota in late preterm infants

ZHUYUNLEI — 2022/3/8 15:34:28

Objective To investigate the effect of prenatal antibiotics exposure on intestinal microbiota in late preterm infants. Methods Thirteen late preterm infants with gestational age of 340/7 to 366/7 weeks were included and divided into two groups：control group (n = 8) and antibiotic group (n = 5)，according to whether they were exposed to antibiotics before delivery. Fecal samples were collected at Days 3,7 and 14 after birth, respectively to extract bacterial DNA. The microbial community diversity and composition was analyzed through sequencing V3-V4 region of 16SrRNA with Illumina high-throughput sequencing technology. Results (1) The shannon index increased in both groups with age, and the Shannon index in the antibiotic group is always lower than control group. The difference was statistically significant at days 3 (p= 0.007).(2) With the increasing of age, the Proteobacteria in the control group gradually decreased and Firmicutes gradually increased. In the antibiotic group, the Proteobacteria gradually increased, and the Firmicutes gradually decreased. Compared with the two groups, the Firmicutes in the antibiotic group was significantly lower than control group at days 14 (P=0.047);(3) Compared with the control group, the genus was single in the antibiotic group, the colonization of multiple symbiotic bacteria was delayed, and the relative abundance of Parabacteroides was significantly higher than that in the control group at days 3 ( P=0.037).Conclusion Prenatal antibiotics exposure can notably affect the colonization of intestinal flora in late preterm infants, and reduce the diversity of intestinal microbiota.

The effect of plasma NT-proBNP level on prognosis of patients with advanced non-small cell lung cancer

高绍英,郝云霞,辛林泽 — 2022/3/8 11:23:19

Objective To quantitatively evaluate the effect of NT-proBNP level on the outcomes of patients with advanced non-small cell lung cancer（NSCLC）. Methods The clinical data of 128 cases of NSCLC（ⅢB and Ⅳ）patients in our hospital from January 2013 to June 2016 were retrospectively reviewed. Kaplan-Meier method was used for survival analysis, and Cox proportional-hazards regression model was used for univariate and multivariate analysis. Results （1）The overall 5-year survival rate was 7.81%.（2）Kaplan?Meier analysis demonstrated that patients with stage IV, NT-proBNP＞654.5ng/L, combined with COPD, Cyfra21-1>3.5μg/L, and combined with pleural effusion exhibited significantly shorter survival times（P<0.05）.（3）Multivariate Cox regression analysis showed that pathological type, clinical stage and the higher level of NT-proBNP were risk factors for survival times of patients with advanced NSCLC（P<0.01）. Conclusion The elevated level of NT-proBNP may be an important independent risk factor for the prognosis of advanced NSCLC.

Analysis of the therapeutic effect of intracavitary interventional therapy on patients with TASC II C and D lower extremity arteriosclerosis obliterans

lijing,,,, — 2022/3/8 11:21:48

objective: To evaluate the efficacy of Intracavitary interventional therapy for the treatment of TASC II C and D lesions in arteriosclerosis obliterans.Methods: retrospectively analyzed the clinical outcomes of 52 patients with arteriosclerosis obliterans with 57 affected limbs of TASC II class C and D who underwent Intracavitary interventional therapy in our department from January 2017 to August 2019, and counted the procedure success rate, hospital complication rate, two-year patency rate, and target lesion revascularization rate.Results: A total of 52 patients with 57 affected limbs received Intracavitary interventional therapy, of which 54 limbs were successfully operated, 2 limbs were unsuccessfully opened after repeated attempts, 1 limb was discontinued due to acute left heart failure during the operation, and 3 limbs were transferred to orthopedics for amputation, with a technical success rate of 94.74% (54/57). The rate of perioperative complications was 3.85%, and the mortality rate was 0%. 8 affected limbs underwent the second intracavitary intervention in our department during the follow-up because of the aggravation of lower limb ischemic symptoms. The postoperative dorsalis pedis artery ABI 0.79±0.16 was significantly higher than the preoperative 0.27±0.09 (P<0.05) The findings were statistically significant. In patients followed up at 1, 3, 6, 12, 18, and 24 months after surgery, the first-stage patency rates were 100%, 97.96%, 93.88%, 78.72%, 77.78%, and 68.18%. the second-stage patency rates at 12 and 24 months were 95.35% and 94.44%.Conclusion: Intracavitary interventional therapy is an effective and safe treatment for long-segment, more serious arteriosclerosis obliterans, with high repeatability and success rate, but at least one outflow tract at the distal end of the affected limb must be required. The choice of intracavitary interventional treatment strategy still requires a larger sample of data and a longer period of statistical observation to determine.

Predictive value of carotid artery intima-media thickness combined with homocysteine on the severity of white matter degeneration

陈家镒,孔令通,吕田明 — 2022/3/8 11:18:51

Objective To investigate the correlation between carotid intima-media thickness (cIMT), blood homocysteine (Hcy) and the severity of white matter degeneration (WML). Methods Patients with WML confirmed by cranial MRI were collected retrospectively and clinical data of patients were analyzed. The independent risk factors of moderate to severe WML were determined by univariate analysis and binary logistic regression analysis. The receiver operating characteristic (ROC) curve was used to determine the predictive value of moderate to severe WML. Result There were significant differences in age, gender, hypertension, diabetes, coronary heart disease, total cholesterol, triglyceride, very low density lipoprotein, Hcy, left and right cIMT between mild WHL group and moderate to severe WHL group (p <0.05). After adjusting for compounding factors, age, hypertension, diabetes, Hcy and right cIMT were independent risk factors for moderate to severe WML. ROC curve showed that the right cIMT had a predictive sensitivity of 59.76%, specificity of 69.77%, Hcy had a predictive sensitivity of 65.09%, specificity of 80.62%, and the right cIMT combined with Hcy had a predictive probability of 69.23%, specificity of 77.52%. Conclusion In patients with WML, age, hypertension, diabetes, Hcy and right cIMT are independent risk factors for moderate to severe WML. cIMT combined with Hcy can improve the predictive value of WML.

Advances in surgical treatment of thoracolumbar kyphosis in ankylosing spondylitis

wuyoucai — 2022/3/7 15:37:05

Ankylosing spondylitis is a chronic inflammatory rheumatic disease mainly involving the axial bone. AS can cause progressive osteogenic changes of spinal ligaments and eventually lead to rigid kyphosis.Rigid kyphosis often leads to thoracolumbar kyphosis, especially thoracolumbar kyphosis. Surgical osteotomy is the main treatment for thoracolumbar kyphosis caused by AS.With the continuous development of science and technology, osteotomy methods continue to develop in the direction of minimally invasive.In this paper, the surgical treatment of thoracolumbar kyphosis of ankylosing spondylitis is reviewed.This article provides a reference for the selection of osteotomy methods in the treatment of ankylosing spondylitis.

Research progress of VEGFR1 on the protective function of cardiac ischemia/reperfusion injury

Huang Luying — 2022/3/7 15:36:28

Vascular Endothelial Growth Factor Receptor 1 (VEGFR1) is a transmembrane transport receptor, which is mainly related to the secretion of VEGF family cytokines; in the formation of blood vessels, vascular endothelial cell migration and other life foundations. They all play an important role in the activities. In the case of cardiac ischemia/reperfusion injury, the injury can be reduced by regulating oxidative stress, inhibiting cardiomyocyte apoptosis, and promoting vascular regeneration. This article describes the protective effect of VEGFR1 in ischemia/reperfusion, and hopes that the target of VEGFR1 will be more rationally applied to patients with myocardial ischemia in the future, to obtain a better treatment effect.

Clinical observation of multimodal analgesia in patients after orthopedic operation on lower limb

chenxi — 2022/3/7 15:35:36

Objective To observe the efficacy of multimodal analgesia in patients after orthopedic operation in shank．Methods Sixty patients scheduled for orthopedic operation in shank(combined tibia plateau，tibiofibula，ankle fractures)，were randomly divided into two postoperative analgesia groups(n=30 each)，the multimodal analgesia group(group M) and the combining?drugs intravenous analgesia group(group I)．group M adopted ultrasound guided combined adductor canal block and popliteal sciatic nerve block+intravenous analgesia pump；group I adopted the combining?drugs intravenous analgesia pump．Rest and movement numeric rating scales(NRS)、Ramsay sedation score、manual muscle testing(MMT) were observed at 6 h、12h、24h and 48h after operation．The dizziness、headache、mausea and vomiting were assessed after operation．The patient，s satisfaction of postoperative analgesia was recorded and assessed．Results The NRS at 6 h、12h、24h and 48h in group M was lower than group I（P＜0.05）;The incidence of dizziness and headache in group M was lower than group I（P＜0.05）;The patient，s satisfaction of postoperative analgesia in group M was higher than group I（P＜0.05）．Conclusion the multimodal analgesia adopt ultrasound guided combined adductor canal block and popliteal sciatic nerve block+intravenous analgesia pump has better than the combining?drugs intravenous analgesia pump，reduce postoperative dizziness and headache，also has higher patient，s satisfaction．

Guangxi Region Deafness Gene Mutation And Cochlear Postoperative Efficacy Correlation Studies

2022/3/4 17:48:45

To explore the deafness gene mutations in Guangxi region and the correlation of curative effect after cochlear implantation, to provide a reference for evaluation of cochlear postoperative curative effect. Methods From July 2012 to December 2019, 104 patients with preverbal deafness who underwent cochlear implantation in Guangxi and deafness gene testing in our hospital were selected. They were grouped according to whether there were gene mutations. Using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating(SIR) to evaluate the postoperative efficacy of the patients at 3,6 and 12 months after surgery. Results Among the 104 patients,14(13.46%) patients were found to have deafness gene mutations, 2(1.92%) case with GJB2 gene mutations, including 1 with c.235delC homozygous mutation, the rest 1 case is c.299delC heterozygous mutations, and 10(9.62%) cases with SLC26A4 gene mutations, 8 cases for c.IVS7-2A > G heterozygous mutation, 2 cases of c.919-2A>G/c.1614+5G>A compound gene mutation. OTOF gene c.1273C>T/c.4994T>C compound gene mutation 1(0.92%) case and TRIOBP gene c.5185-2A>G/c.3299C>A compound gene mutation 1(0.92%) case. Two groups of 6 and 12 months postoperatively in patients with CAP, SIR stage were significantly higher than 3 months after surgery(P <0.05).The 12 months postoperatively CAP and SIR scores were higher than the 6 months(P <0.05).Mutation group with the mutation postoperative 3, 6, 12 months CAP, SIR classification were no obvious difference（P>0.05）. Conclusion Cochlear implant can significantly improve the hearing of patients with prelingual deafness, but deafness gene mutations have no significant correlation with the short-term postoperative efficacy of cochlear implant.

Application of Sun's Procedure in elderly patients with acute Stanford type A aortic dissection

luo jinlong,,, — 2022/3/4 17:47:54

Objective To explore the application value of Sun's procedure（total aortic arch replacement with stent elephant trunk）in elderly patients with acute Stanford A type aortic dissection．Methods From September 2018 to September 2019，44 consecutive patients of acute Stanford type A aortic dissection in the hospital were included in the study. All Patients, treated with Sun's Procedure, were under general anesthesia with DHCA（deep hypothermic circulatory arrest）and unilateral selective cerebral perfusion. The patients were divided into two groups according to their age. The patients with age≥60 were divided into the elderly group(n=9), andthose with the age<60 were divided into the young group(n=35). The intraoperative and postoperative conditions and the risk of adverse events were compared between the two groups.Results There was no significant difference between the two groups in the time from onset to operation, cardiopulmonary bypass，aortic occlusion and DHCA time (P>0.05).The ICU stay and total hospital stay in the elderly group were significantly longer than those in the younger group (P<0.05). There was no significant difference in postoperative adverse events between the two groups (P>0.05) . Conclusion The risk of adverse events in elderly patients with acute Stanford A aortic dissection after sun's procedure was similar to that of young patients, but had longer ICU stay and total hospital-stay.

Therapeutic effect of atorvastatin on chronic endometritis in rats and Its related factors

邓荣,李艳慧,秦蓉燕,覃韦丽,王嘉伟,谢昕,赵蕴肖 — 2022/3/4 17:47:08

Objective To study the therapeutic effect and mechanism of atorvastatin on chronic endometritis in rats. Methods Thirty-two female SD rats were randomly divided into 4 groups: Sham group,model group,low and high doses of atorvastatin groups(10mg/kg, 20mg/kg). chronic endometritis in rats was induced by injection of phenol mucilage suspension into the uterus. After 14 days of oral administration, the pathological changes of rat uterus were observed by hematoxylin and eosin (HE). Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect the mRNA expression levels of interleukin-1β(IL1-β) and matrix metalloproteinase-9(MMP-9) in rat uterus. The protein expressions of IL1-βand MMP-9 in rat uterus were detected by immunohistochemical method. Results The results of HE staining showed that the pathological scores of epithelial cell proliferation, degeneration and necrosis, and inflammatory cell infiltration in the endometrium of atorvastatin high-dose group rats were significantly decreased compared with those in the model group (P < 0.05). RT-qPCR showed that compared with the model group, the expression levels of IL1-β and MMP-9 mRNA in rat uterus of atorvastat in low dose and high dose groups were significantly decreased (P<0.001). IHC results showed that compared with the model group, the expression of IL-1β protein in endometrium of atorvastatin low-dose and high-dose groups was significantly decreased (P<0.01, P<0.001), and the expression of MMP-9 protein was significantly decreased (P<0.05, P<0.001). Conclusion Atorvastatin can improve the inflammatory response by down-regulating the expressions of IL1-βand MMP-9 in the chronic endometritis rats．

Research Progress on the mechanism and therapeutic application of TRPV1 mediated pain

chengxutao — 2022/3/4 15:36:31

Transient receptor potential vanilloid 1 (TRPV1) has attracted much attention since its first successful cloning as a nociceptor closely related to pain, and its molecular structure, physiological function, distribution characteristics, activation and inhibition have been widely studied. Its involvement in inflammation and lipid oxidation is also closely related to pain. A variety of endogenous and exogenous sensitizers or inhibitors can modulate the sensitivity of TRPV1 channel, thereby mediating pain transmission; TRPV1 may also lead to the ablation of nociceptors by enhancing intracellular calcium overload, which may be a potential effective approach in the treatment of pain. The aim of this article is to review the research progress on the mechanism and application of TRPV1 in mediating pain.

Laser ablation combined with small incision in the treatment of giant breast fibroadenoma: a report of 4 cases

Peng Xiaolin,Zhao Lu — 2022/2/24 16:35:33

Objective: To investigate the feasibility and safety of laser ablation combined with small incision surgery in the treatment of giant breast fibroadenoma. Methods: The clinical data of 4 patients with giant breast fibroadenoma were analyzed retrospectively, who were treated by laser ablation combined with small incision in the Seventh affiliated Hospital of Southern Medical University between July 2021 and October 2021. Results: In four young female patients (mean age 22.75 years), a single giant hypoechoic nodule in the breast with maximum diameter over 5.0 cm and BI-RADS grade 4 was detected by preoperative ultrasound. After preoperative evaluation, ultrasound-guided laser ablation was used to reduce the volume of breast tumor and block its blood flow, and then the tumor was completely removed by annular areola small incision. The operation process is smooth, the intraoperative bleeding is less, the postoperative scar is small, and the patient satisfaction is high. The postoperative pathology was breast fibroadenoma. Conclusions: Ultrasound-guided laser ablation assisted by annular areolar mini incision surgery for the treatment of giant breast fibroadenoma is safe and feasible, which is beneficial to the postoperative recovery of patients and improves the cosmetic outcome, and is worthy of clinical promotion and application.

The effect of chiropractic and massage combined with acupuncture on lumbar spine function and back muscle mechanics in patients with lumbar intervertebral disc herniation

梁宁军 — 2022/2/24 10:45:07

Objective To investigate the effect of chiropractic and massage combined with acupuncture on the function of lumbar spine and the mechanical effects of lumbar back muscles in patients with lumbar disc herniation. Methods A total of 90 LDH patients admitted to our hospital from May 2018 to March 2021 were selected and divided into two groups by random number table method, with 45 cases in each group. The control group received chiropractic manipulation, and the observation group received acupuncture therapy. Both groups were treated for 4 weeks. The clinical efficacy, lumbar function, pain degree, quality of life and the mechanical effects of back muscles were evaluated in the two groups. Results The total clinical effective rate of the observation group was higher than that of the control group. The Japanese Orthopaedic Association Assessment Treatment Score (JOA), Health Survey Summary (SF-36) score and the surface electromyography value (AEMG) of the straightening process were higher than those of the control group. Visual simulation The VAS score and AEMG during flexion were lower than those of the control group, and the difference was statistically significant (P<0.05). Conclusion The application of chiropractic manipulation combined with acupuncture in patients with LDH can relieve pain, improve the mechanical effects of back muscles and lumbar spine function, improve the quality of life, and benefit the prognosis of patients.

Imaging of Thrombi and Assessment of Left Atrial Appendage Function: Contrast Enhanced Transoesophageal Echocardiography

liuzhiyue, — 2022/2/23 18:16:54

[ABSTRACT]Objective To explore the role of contrast-enhanced transesophageal echocardiography (TEE) in assessing left atrial appendage (LAA) function and thrombus uncertainty in patients with atrial fibrillation (AF) before radiofrequency catheter ablation (RFCA). Methods A total of 20 patients with atrial fibrillation who were to undergo RFCA were enrolled in West China hospital from October 2020 to December 2020. Routine echocardiography, TEE and contrasted-enhanced TEE were performed on all subjects. We assessed the emptying and filling velocity of LAA, and the uncertainty rate of LAA thrombosis. The intraoperative and postoperative related thromboembolic events were followed up for 3 months. Results 1. Before RFCA in patients with atrial fibrillation, the emptying and filling velocity of the LAA by enhanced TEE was significantly higher than that by non-enhanced TEE (emptying velocity 0.48±0.16 VS 0.40±0.14 m/s, P＜0.001; filling velocity 0.51±0.18 VS 0.42±0.16 m/s, P＜0.001). There were 10 patients with LAA emptying velocity ≤0.35m/s in non-enhanced whereas 3 patients after enhanced（P＜0.05）. 2.No thromboembolic events occurred in all patients during operation, or 3 days and 3 months after RFCA. 3.5 patients were observed with spontaneous echo contrast and uncertain thrombus in LAA by standard TTE, whilst 3 patients with suspected filling defect or poor filling in LAA by three-dimensional CT reconstruction, and no obvious filling defect was observed in the LAA after contrast. Conclusions Contrast-enhanced TTE may be able to reduce the uncertainty in the diagnosis of LAA thrombosis.

The effect of cold agglutination on the results of hematology analysis

CHEN DEDONG,CHEN YAN,CHEN YAN,CUI ZHAOLEI,GAO YANNI — 2022/2/11 10:28:26

Objective To investigate the effect of erythrocyte cold agglutination on the detection parameters of blood cell analysis and its treatment methods. Methods 73 cold agglutination samples from December 2017 to February 2020 were included into this study.The blood routine tests before and after 37℃ warm water bath were carried out with automatic hematological analyzer (SysmexXN-9000), and then the results of relevant parameters were compared. Results There was significant difference in RBC, HCT, MCV, MCH, MCHC and WBC before and after water bath in 73 cold agglutination specimens (P<0.05), but there was no significant difference in Hb and PLT before and after water bath (P>0.05).Conclusions Cold agglutination will distort the results of RBC, HCT, MCV, MCH, MCHC and WBC; Hb and PLT were not disturbed by cold agglutination. During hematology analysis, inspectors should strengthen quality control, timely find cold agglutination samples, eliminate interference through detection after 37℃ water bath, and pay attention to heat preservation during transportation; MCHC can be used as an objective evaluation index in the process of identifying and correcting cold agglutination interference with blood cell analysis results.

Expression and clinical significance of CDX2 and MUC2 in intestinal metaplasia of gastric mucosa

Liu Fei,Wang Zheng,Yang Jiali,,Zhang Lina — 2022/2/11 10:27:46

Abstract: Objective: To investigate the expression and clinical significance of caudal related homeobox transcription factor 2 (CDX2) and mucin 2 (MUC2) in intestinal metaplasia of gastric mucosa. Methods: use immunohistochemistry to detecte the expression of CDX2 and MUC2 in 152 cases of different gastric mucosa, and investigated the relationship between the expression of CDX2 and MUC2 in intestinal metaplasia of gastric mucosa and HP infection. Results: 1. The positive expression rates of CDX2 and MUC2 in intestinal metaplasia were relatively high, and there were significant different from gastric mucosa intraepithelial neoplasia and gastric cancer (P < 0.05). 2. In intestinal metaplasia with HP positive gastric mucosa, the positive expression rate of CDX2 was significantly higher than that of HP negative tissues (P < 0.05); the positive expression rate of MUC2 was not significantly correlated with HP infection (P > 0.05). 3. The positive expression rates of CDX2 and MUC2 in HP positive gastric mucosa intestinal metaplasia tissues were higher than those in HP positive gastritis tissues (P < 0.05). Conclusion: the positive expression rate of CDX2 and MUC2 in intestinal metaplasia gastric mucosa is significantly higher than that in other gastric mucosal lesions. HP infection may induce intestinal metaplasia by inducing the expression of CDX2.

Treatment strategy and current status of NAFLD related hepatocellular carcinoma

谢思 — 2022/2/11 8:27:09

The incidence of hepatocellular carcinoma (HCC) is high, and hepatitis B virus (HBV) and hepatitis C virus (HCV) are the main causes of HCC. In recent years, the prevalence of metabolic diseases such as obesity and type 2 diabetes in the global population has accelerated the occurrence of non-alcoholic fatty liver disease (NAFLD), resulting in the occurrence of NAFLD-HCC (NAFLD-HCC) increasing year by year. However, it remains unclear whether NAFLD-HCC and virus-related HCC have similar pathogenesis, prevention, surveillance, and treatment strategies. This review will sort out the above problems and provide reference for the prevention and treatment of NAFLD-HCC.

Clinical status of endometriosis combined with early recurrent spontaneous abortion

Jiang Zhifeng — 2022/2/10 17:00:51

Endometriosis is a common hormone-dependent disease in gynecology, which occurs in women of childbearing age. The clinical manifestations are dysmenorrhea and infertility, and there are few clinical reports of early recurrent spontaneous abortion. the pathogenesis of endometriosis is unknown. In recent years, the results show that the occurrence of endometriosis combined with early recurrent spontaneous abortion is related to immune regulation disorder, inflammatory reaction, elevated prostaglandin level, prethrombotic state, endocrine disorder and psychological factors. Clinical attention should be paid to the examination and diagnosis of endometriosis in patients with early recurrent spontaneous abortion and active treatment.

Adcances of rehabilitation therapy in total knee arthroplasty Li Xiufang,Jia Fu,Yin Mengxing. (Yunnan University of Traditional Chinese Medicine)

li xiufang,Yin Mengxing — 2022/2/10 16:58:52

Knee joint is a load-bearing joint of human body, and its injury has brought serious influence to people's life and work. Rehabilitation training after total knee arthroplasty (TKA) can accelerate the recovery of joint function and improve the quality of life of patients. At present, there are many methods of postoperative rehabilitation treatment, but the rehabilitation treatment of TKA is uneven and lack of pertinence. This article reviewed the research progress of rehabilitation treatment after TKA.

Research progress on the role of FOXA in malignant tumors of digestive system

huang yang yuan — 2022/2/10 16:55:50

FOXA, also known as forkbox transcription factor A (ForkheadboxA), was originally found and extracted from rat hepatocytes and divided into FOXA1 (HNF3 α), FOXA2 (HNF3 β) and FOXA3 (HNF3 γ). It plays an important role in embryonic development, metabolism, differentiation, growth and so on. Recently, many studies have shown that FOXA plays an important regulatory role in tumor metabolism, proliferation, extension and metastasis, especially in the process of EMT. This paper focuses on the research progress of FOXA in digestive tract malignant tumors.

Ovarian growth teratoma syndrome: a case analysis and literature review

Yin Qihui — 2022/2/10 16:52:07

Objective To provide help for clinicians, a case of ovarian growth teratoma syndrome (GTS) was reported and the related literature was reviewed. Methods The course of diagnosis and treatment of a 29-year-old GTS patient who has been diagnosed at Qilu Hospital of Shandong University, and the relevant literature of GTS was reviewed on PubMed. Results The patient received chemotherapy after the initial immature teratoma (IMT) operation, the pelvic mass with normal tumor markers was found in 3 months after surgery. The patient was diagnosed as GTS and underwent operation. Recurrence was found 1 month after secondary operation. Conclusion After the chemotherapy of IMT, the possibility of GTS should be considered when the mass was found in the body and the tumor marker was normal. A complete resection is warranted in order to prevent progression and offer a better prognosis. Fertility-sparing surgery is recommended for women of child-bearing age if conditions allow. Long-term follow-up after surgery is very important.

Application of Angiojet mechanical thrombus aspiration for middle/high risk acute pulmonary embolism

魏立春,,,,, — 2022/2/10 16:50:13

Objective To investigate the efficacy and safety of Angiojet mechanical thrombus aspiration for middle/high risk acute pulmonary embolism. Methods The clinical data of 18 cases were retrospectively analyzed in high-risk patients with acute pulmonary embolism (APE) and all patients were treated by AngioJet mechanical thrombus suction technique, perioperative specification of anticoagulant therapy, observe the patient's postoperative clinical symptoms improvement, technical success rate, treatment success rate, average pulmonary artery pressure, blood oxygen saturation (SpO2), the dosage of urokinase, the incidence of arrhythmia, the incidence of pulmonary vascular injury, changes of serum creatinine, incidence of bleeding and PE recurrence rates, incidence of chronic thromboembolic pulmonary hypertension (CTEPH), etc. Results The technical success rate of 18 patients was 100%, the improvement rate of clinical symptoms was 83.3% (15/18), and the success rate of treatment was 94.4% (17/18). The average pulmonary artery pressure was 102mmHg lower than that before surgery, SpO2 was 82% higher than that before surgery, and the amount of urokinase was 102million Unit. The incidence of arrhythmia was 11.1% (2/18), no pulmonary vascular injury was observed, serum creatinine showed no significant change compared with the preoperative level (P=0.056), and the incidence of bleeding was 27.8% (5/18), all of which were slight bleeding. The average follow-up of 92 (3~15) months showed no PE recurrence and no CTEPH. Conclusion Angiojet mechanical thrombus aspiration is a safe and effective minimally invasive method for middle/high risk acute pulmonary embolism. Normative, gentle operation and rapid aspiration of thrombus are helpful to further improve the safety of surgery and improve the prognosis of patients.

Promote of resveratrol on the apoptosis of prostatic cancer PC-3 Cells

郭巍,李家萱 — 2022/2/10 12:01:00

Abstact: Object To observe the effect of resveratrol (Res) on the proliferation, apoptosis, and expression of apoptosis-related genes in human prostatic cancer cell PC-3.Methods PC-3 cells treated with dimethyl sulfoxide were used as the control group, the experimental-A/-B/-C/-D groups were managed by 12.5、25、50、100μmol/L Res solution respectively，5% fetal bovine serum complete culture solution of equal volume was added to the control group. After 48 hours of continuous culture, the MTT method was used to measure the inhibition rate of cell proliferation, The changes of cell nuclei were observed under microscope by PI fluorescence staining. Flow cytometry was used to detect apoptosis rates of PC-3, and real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of Caspase-3,Caspase-8,Caspase-9, Bax and Bcl-2 , and Wesern Blot was used to detect the expression of Caspase-3, Bax and Bcl-2.Results 72h after treatment, the cell proliferration rates of experimental-A/-B/-C/-D groups were（7.84±1.43）%、（27.17±1.26）%、（45.73±1.95）% and（63.87±2.16）% by MTT.The results of PI fluorescence staining showed that there was a change of aoptosis in the PC-3 cells in the experimental group. 48 h after treatment, the apoptosis rates of PC-3 experimental A、B、C、D groups were（1.35±0.14）%、（5.17±1.47）%、（10.74±2.32）%、（21.16±3.38）%，all higher than that of control group （0.84±0.24）%（P<0.05）. The results of qRT-PCR showed that Res could increase the Caspase-3, Caspase-8, caspase-9 and Bax expression in experimental-C/-D groups, all higher than that of control group（P＜0.05）, and decrease the bcl-2 expression in experimental-C/-D groups, all lower than that of control group（P＜0.05）. The results of Wesern Blot showed that Res could increase the Caspase-3 and Bax expression in experimental-B/-C/-D groups, all higher than that of control group（P＜0.05）, and decrease the bcl-2 expression in experimental-B/-C/-D groups, all lower than that of control group（P＜0.05）.Conclusion Res inhibits proliferation and promotes apoptosis of human prostatic cancer PC-3 cell, and its mechanism may be related to the regulation of caspase-3 /Bax/ bcl-2 apoptotic signaling pathway.

Effect of continuous iliac fascial space block under multi-mode analgesia in orthopedic surgery under general anesthesia

Chen Cuiping,Li Dasui,Liang Guangbin,Yan Zhenyi — 2022/2/10 11:57:58

Objective To analyze the effect of continuous iliac fascial space block under multimodal analgesia in general anesthesia orthopedic surgery Methods A total of 100 surgical patients admitted to the orthopedics department of our hospital from May 2019 to May 2021 were selected and divided into two groups according to the random number table method, with 50 cases in each group. The control group performed traditional continuous iliac fascial space block, the observationstudy The group received continuous iliac fascial space block under multi-modal analgesia. The two groups were compared hemodynamics (SBP, DBP, MAP, HR), operation-related indicators (operation time, postoperative recovery time, consciousness recovery time), Cognitive function (MMSE score), analgesic effect (VAS score), sedative effect (Ramsay score), and occurrence of adverse reactions. Results There were no significant changes in SBP, DBP, MAP, and HR between the two groups at T1 and T0, and the difference was not statistically significant (P>0.05). The levels of various indicators at T2 and T3 increased, but fell back at T4 , Basically close to the T0 time point level, but the observationstudy group has a smaller tendency to rise and fluctuate, and recovery is faster (P<0.05); the postoperative wake-up time and consciousness recovery time of the observationstudy group are shorter than those of the control group (P<0.05); At 24h, the MMSE scores of the two groups decreased, and the decrease of the observationstudy group was small (P<0.05); after 2h, 12h, 24h, and 48h, the VAS score and Ramsay score of the two groups showed a downward trend, and the observationstudy group was lower than the control group (P＜0.05); There was no statistically significant difference between the two groups of adverse reactions (P＞0.05).Conclusion Continuous iliofascial space block under multi-mode analgesia is helpful to stabilize the Hemodynamics, improve the effect of sedation and analgesia, promote postoperative recovery, improve postoperative cognitive function, and have lower side effects.

Correlation analysis of corneal nerve fibers and inflammatory changes with dry eye symptoms in Sjogren

chenlifei,hewenjing,lanqianqian,yangzhao — 2022/2/9 17:47:54

Objective: The In vivo confocal microscopy(IVCM) was used to observe and compare the degree of corneal subbasal nerve fibers lesions and inflammatory infiltration in patients with Sjogren""s syndrome(SS) and healthy people, and to analyze the correlation between them and dry eye symptoms. METHODS: The morphology of corneal subbasal nerve fibers and the density of Langerhans cells in the central area of cornea of 22 cases (44 eyes) patients with SS (observation group) and 22 cases (44 eyes) healthy people (control group) were observed by IVCM, meanwhile, tear break-up time (BUT), Schirmer ""s test Ⅰ(Schirmer""s I test ,STⅠ), and tear meniscus height (TMH) were recorded,the correlation between them and OSDI was analyzed. RESULTS: Compared with the control group, the diameter of nerve fibers in the observation group was thinner, both the number of beads and the density of Langerhans cells were increased, both STI and TMH were decreased, and the OSDI score was increased, the difference was statistically significant (P < 0.05). Pearson correlation analysis: In the observation group ,the OSDI score was correlated with BUT (r = -0.34, P < 0.05), STI (r = -0.35, P < 0.05), nerve fiber diameter (r = -0.42, P < 0.05), and Langerhans cell density (r = 0.54, P < 0.05), but not correlated with TMH (r = 0.246, P = 0.06) and the number of nerve fiber beads (r = -0.06, P = 0.69). CONCLUSION: IVCM can directly observe the morphology of the nerve fibers and the infiltration degree of Langerhans cells in cornea. In the cornea of SS patients, the diameter of the nerve fibers becomes thinner, the number of beads increases, the density of Langerhans cells increases, the morphological changes of nerve fibers and the infiltration degree of Langerhans cells are correlated with the clinical symptoms of dry eye.

Effect of controlled low central venous pressure under goal-directed fluid therapy on bleeding and tissue perfusion in spine surgery

Huanghaoran,Liangbing — 2022/2/9 17:47:05

OBJECTIVE: To observe the effects of controlled low central venous pressure technique performed under goal-directed fluid therapy on bleeding as well as tissue perfusion indexes in patients undergoing spinal surgery. METHODS: Fifty-nine patients with ASA grade I-II were selected for lumbar spine transforaminal posterior decompression implant fusion (involving 1 lumbar segment) under elective general anesthesia. They were randomly divided into 3 groups: 19 cases in the goal-directed group (Group G), 20 cases in the controlled low central venous pressure group (Group L), and 20 cases in the controlled low central venous pressure group under goal-directed fluid therapy (Group LG). All three groups used the same general anesthesia method with static inhalation. group G used goal-directed fluid therapy (GDFT) throughout the surgery, and intraoperative fluid infusion was guided by the target of variability per beat volume (SVV), cardiac index (CI), and mean arterial pressure (MAP); group L maintained central venous pressure (CVP) <5 cmH2O in the pre-decompression phase, and gradually adjusted the dose of vasoactive drugs according to CVP. In the LG group, goal-directed fluid therapy was adopted throughout, with controlled low central venous pressure only in the pre-decompression phase and rapid infusion of crystalloid and colloid fluid after decompression of the spinal canal to restore CVP to normal. HR, MAP, CI, CVP were recorded after induction (supine position) (T1), before lumbar canal decompression (prone position) (T2), completion of canal decompression (T3), end of surgery (T4), and when leaving PACU (T5); total fluid intake, crystalloid fluid intake, colloid fluid intake, and bleeding volume were recorded. Central venous blood and radial arterial blood gas were collected at each time point, and ScvO2 and central venous carbon dioxide partial pressure, arterial carbon dioxide partial pressure and lactate (Lac) were measured, and the corresponding arteriovenous carbon dioxide partial pressure difference (Pcv-aCO2) was calculated, and oxygen supply index, oxygen consumption index, and oxygen uptake rate were calculated. Results: (1) Changes in inlet and outlet volume: the total fluid intake in the LG group was reduced compared with that in the G group, and the bleeding volume in the LG and L groups was significantly reduced compared with that in the G group (P<0.05); (2) Changes in perfusion indexes: Pcv-aCO2 was reduced and blood lactate was significantly reduced in the G and LG groups compared with the L group at T4 and T5 time points (P<0.05), and there was no significant change in ScvO2. (3) Changes in circulatory indexes: PP, MAP, and CI were higher in LG and G groups compared with L group at T2 and T3 time points. Conclusion: 1, Controlled hypocentral venous pressure performed in spinal surgery along with goal-directed fluid therapy resulted in less bleeding and better tissue perfusion than hypocentral venous pressure or goal-directed fluid therapy alone.2. The results of the study suggest that the low central venous pressure technique reduces patient bleeding more than the goal-directed fluid therapy technique, but that goal-directed fluid therapy is more advantageous in improving perfusion. 3. CI is more informative than CVP in predicting patient bleeding.

The expression and significance of MiR-200b and miR-655 in patientswith ulcerative colitis

HE Simin,HU Lingjiao,LI Xiaoyan,LUO Wenjie,ZHANG Hailian,ZHANG Jing,ZHAO Lei — 2022/2/9 17:45:50

Objective To detect the expression of miR-200b and miR-655 in the serum and intestinal mucosal tissues of patients with ulcerative colitis (UC),and to explore the relationship between them and UC endoscopic mobility. Methods We selected 38 patients with UC (20 patients in the active stage under endoscopy, 18 patients in the healing stage) who had been diagnosed in the Gastroenterology Department of Nanxishan Hospital, Guangxi Zhuang Autonomous Region and 20 healthy persons as the research objects. Fluorescence quantitative polymerase chain reaction technology was used to detect the expression of miR-200b and miR-655 in the intestinal mucosal tissues and serum of each group, to explore the relationship between miRNAs and UC endoscopic staging, and to determine whether serum miR-200b and miR-655 could be regarded as non Invasive indicators reflect the healing of the intestinal mucosa of UC patients. Results The expressions of miR-200b and miR-655 in the intestinal mucosa of UC patients were significantly lower than those of the control groups (P<0.05), but their expression in each phase of UC groups has no significant difference (P>0.05). The expression of miR-200b and miR-655 in the serum of patients with active UC under endoscopy was higher than that in the control groups (P<0.05), but there was little difference between the healing groups and the control groups (P>0.05) . Conclusion Our study suggested that the expression of miR-200b and miR-655 in serum can not replace colonoscopy to reflect the healing stage of intestinal mucosa in patients with UC.

The influence of Atorvastatin and rosuvastatin on the recurrence rate and atrial electrical remodeling after radiofrequency ablation of paroxysmal atrial fibrillationGu Yunfei,Zhang Xuan,Duan Kadan,Xue Guohua,Guo Yubing,Wu Pengyu,QI Yujie,Chen Weigang,Tian Tian

谷云飞 — 2022/2/9 17:43:49

Objective To investigate the effects of lipophilic and hydrophilic statins on the recurrence and atrial electrical remodeling after radiofrequency ablation of paroxysmal atrial fibrillation. Methods A total of 120 patients with paroxysmal atrial fibrillation who underwent radiofrequency ablation at the atrial fibrillation center of Luoyang Central Hospital affiliated to Zhengzhou University from January 2019 to June 2020 were divided into atorvastatin, rosuvastatin and no statin treatment groups , the recurrence of atrial fibrillation after radiofrequency ablation in different groups and changes in blood lipids and P wave dispersion of electrocardiogram were observed.The primary end point was the recurrence rate after radiofrequency ablation of atrial fibrillation, and the secondary end point was the effect of hydrophilic and lipophilic statins on the P wave dispersion of the electrocardiogram. Results There was no significant difference in the proportion of recurrence between the three groups at the 6-month follow-up (20% Vs 25% Vs 30%, P=0.58). The P wave dispersion in the atorvastatin group decreased after treatment (39.5±9.1 Vs 36.5± 9.4, P=0.02), there was no difference in the other two groups. Conclusion There is no difference in the short-term recurrence rate of different statin treatments, but the decrease of P wave dispersion in the atorvastatin group is more obvious, suggesting that lipophilic statin-atorvastatin may reduce the recurrence of atrial fibrillation by improving atrial electrical remodeling.

Research progress of obstructive sleep apnea with lung cancer

代丽萍,房怡菲 — 2022/1/14 16:11:45

Obstructive sleep Apnea forms a periodic hypoxia-reoxygenation cycle, or intermittent hypoxia (IH), during nighttime sleep. Lung cancer is the most common malignant tumor with poor prognosis. In recent years, more and more studies have explored the effect of OSA in lung cancer, suggesting that OSA can enhance the proliferation, invasion and migration of lung cancer cells. This may be related to the increase of HIF-1α and PD-L1 expression in lung cancer cells induced by OSA. This article reviews the relationship between obstructive sleep apnea and lung cancer and the potential mechanisms that affect lung cancer, and makes a summary of cell and animal models that simulating OSA like intermittent hypoxia with lung cancer.

Correlation of intraoperative brain tissue oxygen saturation and nerve damage markers with postoperative delirium in patients undergoing heart surgery

gao jie,zhou jun hui — 2022/1/14 15:10:24

[Abstract] Objective To explore the correlation between intraoperative regional cerebral oxygen saturation (rScO2) and nerve damage markers and postoperative delirium (POD) in patients undergoing heartsurgery. Methods A total of 60 patients undergoing heart valve replacement surgery under cardiopulmonary bypass(CPB) in the operating room of Henan Provincial Hospital from January 2020 to June 2021 were enrolled, regardless of gender, aged35-64years old, weighed 58.0-90.0kg, with American Association of Anesthesiologists (ASA) classification with Ⅱ～Ⅲ. A near infrared spectrometer (NIRS) was used to continuously monitor the bilateral rScO2 of the patients during surgery. Central venous blood was drawn at 10 minutes before induction of anesthesia (T0), 10 minutes after induction of anesthesia (T1), immediately after CPB started (T2), when CPB ended (T3), at the end of the operation (T4), and when exiting Intensive Care Unit (ICU) (T5), 1 d (T6), 2 d (T7) and 3 d (T8) after operation, and the concentration of nerve injury marker-specific protein 100β (S100β protein) and neuron-specific enolase (NSE) in serum were measured. Follow up was performed on postoperative 3rd to evaluate the occurrence of POD.The intraoperative rScO2 value and the serum S100β protein and NSE concentrations were compared between the POD group and the NND (no-POD) group. The changes of intraoperative rScO2 value and the concentration of serum S100β protein and NSEin the POD group and NPOD group was compared. The risk factors of POD and its correlation with the intraoperative rScO2, serum S100β protein and NSE concentration was analyzed. Results Three patients were excluded from the study.A total of 15patients (26.3%) developed POD (POD group), and 42 patients (73.7%) did not develop POD (NPOD group) on postoperative 3rd. Compared with the NPOD group, the minimum mean arterial pressure duringCPB and the minimum rSO2C duringCPB were significantly reduced (P < 0.05), the maximum da-rSO2C during CPB was significantly increased (P < 0.05), and duration of da-rSO2C > 50% during CPB, duration of da-rSO2C > 40% during CPB, duration of rSO2C reduction >25% , rSO2C <50% during CPB, rSO2C <40% during CPB, duration of da-rSO2C > 50% duringCPB and duration of da-rSO2C > 40% duringCPB were significantly prolonged (P<0.05) in the POD group. At T0-8, the serum nerve injury markers S100β and NSE levels in POD group were significantly higher, compared with NPOD group. Logistic regression analysis showed that the reduction of rSO2C more than 25% during CPB (P = 0.033), during of rSO2C <40% during CPB (P = 0.007), duration of da-rSO2C > 50% during CPB process time (P = 0.001) and the levels of serum S100β and NSE at T8 (P = 0.022, P = 0.012) were risk factors of POD. Conclusion The duration of the reduction of rSO2C > 25% , the duration of rSO2C < 40% and the duration of da-rSO2C > 50% during CPB were the risk factors of POD in patients undergoing heart surgery under CPB. Significantly increased levels of serum nerve injury markers S100β and NSE were related to POD.

Experimental Study on the Analgesic and Anti-inflammatory Effects of Bagui Analgesic Ointment on Mice

Zhang Yanju,Zhao Lijuan — 2022/1/14 8:59:04

Objective: To study and observe the analgesic and anti-inflammatory effects of Bagui Analgesic Ointment(BAO) in mice. Methods: Bagui Analgesic Powder was prepared into BAO The mice were divided into blank group, Voltaren group and BAO group. The mice were induced by mouse hot plank, acetic acid writhing test, analgesia and Xylene-induced ear swelling experiment. The analgesic and anti-inflammatory effects of BAO were observes. Results: The experimental results of the hot plate method showed that Voltarin and BAO can significantly prolong the pain threshold at 15min, 30min and 45min after administration (P<0.05); at 15min and 30min, there was no statistically significant difference in the pass threshold between the Voltarin group and the BAO group (P>0.05); at 45 minutes, the voltarin group had significantly better pain-inhibiting effects than the BAO group (P<0.05). The results of the acetic acid writhing method showed that both Voltaren and BAO could inhibit the writhing reaction of mice, and the efficacy of the two groups was similar (P>0.05). The experimental results of xylene-induced ear swelling in mice showed that compared with the blank group, the low-dose Guizhitong ointment group had a poor effect on inhibiting ear swelling in mice (P>0.05), while the Voltarin group, high-dose and middle-dose BAO group had higher swelling inhibition rate (P<0.05); compared with the Voltaren group, the high-dose BAO group had no significant difference in the auricle swelling inhibition rate (P>0.05), while he auricle swelling inhibition rate of middle-dose group was low (P<0.05). Conclusion: BAO and Voltarin ointment have similar analgesic effects, and the anti-inflammatory effect of high-dose BAO is equivalent to that of Voltarin ointment.

Experience in diagnosis and treatment of bladder carcinosarcoma and literature analysis

An Sensheng,Niu Zhihong — 2022/1/14 8:50:30

[Abstract] Objective：To investigate the diagnosis, treatment and prognosis of carcinosarcoma of the bladder through a case report of carcinosarcoma of bladder and literature review.Methods: Retrospective analysis a case of carcinosarcoma of the bladder treated in Shandong Provincial Hospital in May 2020. Discuss the clinical manifestations, imaging features, pathological features and treatment progress. Results: the patient was hospitalized with hematuria, and underwent TURBT when cystoscopy showed huge bladder tumor. Postoperative pathology showed bladder carcinosarcoma. Two weeks later, laparoscopic radical cystectomy and ileal bladder replacement were performed.Conclusion: Carcinosarcoma of the urinary bladder is a very rare and aggressive subtype of bladder cancer with poor prognosis.Radical cystectomy is the main treatment. The effect of postoperative comprehensive treatment was not ideal and the prognosis is poor.

Application of cardiopulmonary ultrasound guided liquid management in ICU patients of after cardiac surgery

李霞 — 2022/1/11 16:50:24

Objective To explore whether liquid management under cardiopulmonary ultrasound guidance can improve the prognosis of patients after cardiac surgery． Methods 50 patients of postoperative were selected from ICU in our hospital during June 2020 to March 2021．all patients were randomized divided into two groups，the central venous pressure liquid management group and the cardiopulmonary ultrasound guided liquid management group． The heart rate, breathe rate, mean arterial pressure, oxygenation index, lactic acid, infusion volume and blood transfusion after 24 hours and reoperation， mechanical ventricular duration，ICU stay hospital stay and 28-day mortality were collected and compared between the two groups．Results There was no significant difference in basic data between the two groups（p>0.05），There was no significant difference in lactic acid, reoperation and 28-day mortality between the two groups（p>0.05），There was significant difference in heart rate, breathe rate, mean arterial pressure, oxygenation index, infusion volume and blood transfusion after 24 hours and mechanical ventricular duration，ICU stay hospital stay between the two groups（p<0.05）． Conclusion The cardiopulmonary ultrasonic guidance method is more beneficial to the implementation of postoperative cardiac surgery patients in intensive care unit．

Correlation and significances of MAGED4 and CORO1C expression in glioma

zhangyuan — 2022/1/11 15:13:24

Abstract Objective Detecting the expression of tumor-associated antigen MAGED4 and actin-binding protein CORO1C to explore the correlation and clinical significances of MAGED4 and CORO1C in glioma. Methods Firstly, the expression levels of MAGED4 and CORO1C were analyzed using glioma database of GEPIA. Secondly, 62 glioma tissues and 11 normal brain tissues collected were used to verify the expressions of MAGED4 and CORO1C by RT-qPCR and analyzed the correlation between MAGED4 and CORO1C.Furthermore, the expression of CORO1C was observed after the silence of MAGED4 by siRNA in glioma cell lines. Lastly, the relationships between the expression of MAGED4 and CORO1C with clinicopathological parameters of glioma patients were statistically analyzed. Results GEPIA showed that both MAGED4 and CORO1C were highly expressed in glioma tissues. RT-qPCR found that the expression levels of MAGED4 mRNA and CORO1C mRNA in glioma tissues were 3.038- and 3.713- fold higher than those in normal brain tissues respectively. And there was a significant positive correlation between the expression levels of MAGED4 mRNA and CORO1C mRNA (r = 0. 848, P＜0. 01). Furthermore, siRNA confirmed that the silence of MAGED4 mRNA down-regulated the expression of CORO1C mRNA in glioma cell lines (P＜0. 05). In addition, Statistical analysis revealed?that the expressions of MAGED4 mRNA and CORO1C mRNA had no significant relationship with clinicopathological parameters such as gender, age, WHO grade, pathological type, KPS, tumor size and the expression of Ki-67, GFAP, S-100 and Vimentin in glioma patients (P>0.05). Conclusion MAGED4 and CORO1C was positively?correlated and highly expressed in glioma, suggesting that they may play important roles in the development and progression of glioma together, and have the potential to become the targets for molecular targeted therapy of glioma.

Comparison of minimally invasive versus open Sweet esophagectomy in the treatment of adenocarcinoma the esophagogastric junction

Lihuan — 2022/1/11 12:35:40

Objective: To observe the impact of minimally invasive and open Sweet esophagectomy on the short-term and long-term prognosis of Siewert type II adenocarcinoma of the esophagogastric junction. Methods: From March 2015 to September 2017, a total of 137 patients with Siewert type II adenocarcinoma of the esophagogastric junction underwent surgery in our hospital were collected. 38 patients received minimally invasive Sweet esophagectomy (MISE) and 99 patients received open Sweet esophagectomy (OSE). T test or χ2 test would be used to compare the clinicopathologic factors, short-term efficacy and recurrence between groups, as for the ranked data, Mann-Whitney test would be available, and the 3-year survival rate was tested by the log-rank. Results: The preoperative characteristics of the two groups were comparable. The MISE group had less intraoperative blood loss (119.74 ± 45.82 vs 147.47 ± 74.36 ml, P = 0.034), better total number of lymph node dissection, as well as the number of abdominal lymph node dissection than OSE, but the operation time was longer (249.58 ± 59.43 vs 196.78 ± 52.86 min, P < 0.001). The MISE group had lower postoperative complications, faster patient recovery, and shorter hospital stay. There was no significant difference in 3-year survival rate (MISE 68% vs OSE 58%, P = 0.575), as well as recurrence. Conclusion: MISE can’t improve the prognosis of patients, but the short-term efficacy is superior to OSE, which is conducive to the rapid recovery of patients.

Application and research of transesophageal echocardiography (TEE) in anesthesia for cardiopulmonary bypass surgery

CHE Longtong,,,,,, — 2022/1/11 12:34:58

To Objective: To analyze the clinical value of TEE monitoring during CPB cardiac surgery anesthesia in patients with heart disease. Methoded: Select 35 heart disease patients who underwent CPB cardiac surgery in our hospital from February 2019 to February 2021. TEE monitoring was performed before and during the operation, the effect of the operation was evaluated, and the heart recovery and the gas volume before CPB shutdown were observed. Grading. Compare lactic acid and MAP at different times. Compare SV, FAC, CI, AVTI before and after surgery. Resulted: Preoperative TEE monitoring found 1 case of moderate tricuspid regurgitation with an annulus diameter of more than 40 cm, which was confirmed by surgery and was treated with tricuspid valvuloplasty. Although 1 case was diagnosed as moderate regurgitation before operation, TEE showed mild regurgitation during the operation. The patient's heart valve structure was good and lacked the support of clinical signs, so targeted treatment was not performed. After the operation, the valve leaflets of 35 patients were able to move normally, no paravalvular leakage was found, and the heart regained until the CPB stopped for an average of (25.26±5.01) minutes, and the patients had no complications. In 35 patients, 6 cases were grade 1, 10 cases were grade 2, and 5 cases were grade 3 after heart relapse; 8 cases were grade 0 and 6 cases were grade 1 before CPB shutdown. Comparison of lactate and MAP at T0, T1, T2, and T3, P>0.05 (no statistical difference). The postoperative CI, AVTI, FAC, and SV were all higher than those before the operation, P<0.05 (the difference was statistically significant). Conclusion: TEE during CPB cardiac surgery anesthesia in patients with heart disease can accurately evaluate valve conditions and surgical results, and has important guiding significance in many aspects such as heart exhaust and CPB shutdown.

The analysis of 16 cases of portal vein thrombosis after hepatectomy

Chen Bao-jun,Tong Xuan,Xiang Can-hong — 2022/1/11 12:34:23

Objective: To explore the risk factors, diagnosis, treatment and preventive measures of portal vein thrombosis after hepatectomy. Methods: We retrospectively reviewed 16 medical records of patients who had undergone hepatic resection for various diseases from February 2015 to February 2021 in Beijing Tsinghua Changgung Hospital and described their clinical features. Results: The diagnosis time of portal vein thrombosis after hepatectomy was from 1 to 24 days, with an average of 9 days after hepatectomy, some patients had no clinical manifestations, some patients had clinical symptoms such as fever, abdominal pain, abdominal distension, ascites and jaundice, and some patients developed liver failure or even death. After anticoagulation, thrombolysis and operation, 8 patients were discharged and 8 patients died. Conclusion: The etiologies of portal vein thrombosis after hepatectomy are various, mainly diagnosed by enhanced CT, and its treatment methods are varied, including anticoagulation, thrombolysis, thrombectomy and so on. At present, there is no clear prediction and prevention protocol after hepatectomy. Early detection and treatment are the keys to improve the prognosis of patients.

Role of combined speckle-tracking echocardiography and detection of miR-30a in evaluation of recent prognosis in patients with ACS

chai renjie,,,zhao juan — 2022/1/11 12:33:49

Objective To investigate the predictive value of recent prognosis in patients with acute coronary syndrome （ACS）by speckle-tracking echocardiography （STE） combined with miR-30a. Methods 252 patients with ACS，divided into recent good prognosis group （n=199）and poor prognosis group （n=53），were randomly selected. The patients were detected LV-GLS by STE and plasma miR-30a by real-time PCR. Relation of LV-GLS and plasma miR-30a were analyzed by Pearson correlation. Whether LV-GLS and plasma miR-30a could be independent predictor of ACS with poor prognosis or not was analyzed by Logistic regression. The value of combined diagnosis was analyzed by receiver operating characteristic curve(ROCcurve). Results Compared with good prognosis group ,LV-GLS and plasma miR-30a increased in poor prognosis group [(-16.26±1.81)% vs （-11.49±2.72）%， (10.74±1.23) 2-ΔΔct*104 vs（12.42±1.88）2-ΔΔct*104，P <0.05]. Pearson correlation analysis indicated that damaged LV-GLS was positively associated with the level of plasma miR-30a in ACS（r=0.418,P=0.000）. Damaged LV-GLS and upregulation of plasma miR-30a were independent predictor of ACS with poor prognosis（OR=1.42 and 2.20，P<0.05）.ROC curves showed that the underlying areas of LV-GLS ,miR-30a,and the combined detection were 0.921, 0.825 and 0.949,respectively. The sensitivity of LV-GLS ,miR-30a,and the combined detection in evaluating prognosis were 88.7%，81.1% and 88.7%,respectively. The specificity, of LV-GLS ,miR-30a,and the combined detection in evaluating prognosis were 94.5%，88.9% and 95.5%,respectively. . Conclusion STE compared with plasma miR-30a have predictive value of evaluation of recent prognosis in patients with ACS.

Genome-scale screening gene promoter methylation biomarkers in adenoma using Infinium Human Methylation 450 BeadChips

He Chungang — 2022/1/11 12:33:11

Purpose: To screen gene promoter methylation biomarkers in colorectal adenomas by using Illumina’s Infinium Human Methylation 450 BeadChip arrays combined with bioinformatics?analysis. Methods: Illumina’s Infinium Human Methylation 450 BeadChip arrays and bioinformatics?analysis were used to screen gene promoter methylation biomarkers in 9 advanced adenomas and 20 normal colorectal tissue. Results: According to |Δβ| value≥0.4, we found 1870 differential CpG methylation biomarkers in gene promoter regions, of which containing 929 differential promoter methylation genes（DPMGs）, and with 1524 hypermethylated sites and 346 hypomethylated sites, respectively. Go analysis showed that DPMGs mainly enrichment at the following annotate categorys for top three terms：biological?process (chemical synaptic transmission，nervous system development, extracellular matrix organization), molecular function (extracellular matrix structural constituent, RNA polymerase II regulatory region sequence-specific DNA binding, sequence-specific DNA binding)， cellular component (plasma membrane，proteinaceous extracellular matrix，integral component of plasma membrane). KEGG_Pathyway analysis show that DPMGs mainly participate in the top three signal transduction pathways： Neuroactive ligand-receptor interaction, Nicotine addiction，Calcium signaling pathway. Conclusion: Genome-scale screening gene promoter methylation biomarkers in advanced adenoma may provide the possibility for further study of the pathogenesis and early diagnosis of colorectal adenoma.

Correlation and significance of MAGED4 and CANX expression in glioma

XIEHUAN,,, — 2022/1/11 12:32:08

[Abstract] Objective To detect the expression of tumor-associated antigen MAGED4 and endoplasmic reticulum stress-related protein CANX in human gliomas, analyze their clinical significance and explore the relationship between them. Methods The expression of MAGED4 and CANX in human glioma tissues was pre-analyzed by GEPIA database, then the expression of MAGED4 and CANX in 62 glioma tissues was verified by RT-qPCR to understand the relationship between the expression of MAGED4 and CANX and the clinicopathological indexes of glioma patients, the correlation between them was analyzed. SiRNA technique was used to silence the expression of MAGED4 in glioma cell lines SF126 and U251 to know the effect of MAGED4 on the expression of CANX. Results GEPIA database showed that MAGED4 and CANX were highly expressed in glioma tissues(P<0.01), and the results of RT-qPCR verification showed that the expression levels of MAGED4 mRNA and CANX mRNA were 3.04- and 2.96- fold higher than those in normal brain tissues, respectively, and there was significant difference between the two groups(P<0.05), but the mRNA expression of MAGED4 and CANX was not related to many clinicopathological parameters in glioma patients(P>0.05). The results of correlation analysis showed that there was a highly positive correlation between the expression of MAGED4 and CANX in glioma tissues(r=0.84, P<0.001), further siRNA confirmed that the expression of CANX mRNA in glioma cell lines SF126 and U251 decreased with the silencing of MAGED4 mRNA(P<0. 05). Conclusion There is a positive correlation and high expression of MAGED4 and CANX in human gliomas, suggesting that they play an important role in the occurrence and development of gliomas and may be potential targets for immunotherapy of gliomas.

Research progress on the correlation between IL-1 and postmenopausal osteoporosisFeng Yu1? Yao Na1? Li Pengcheng 2? Chen Hongbo2? Song Yanping2 Zhang Jin2 Geng Chunmei2 Chen Qigang2*

俸玉,,,,, — 2022/1/10 17:14:37

Postmenopausal osteoporosis (Postmenopausal osteoporosis, PMOP) is a kind of the rising incidence of Postmenopausal women general bony disease, its pathogenesis is discussed and according to the mechanism, to find the method of prevention and treatment of Postmenopausal osteoporosis is an important problem urgently to be solved in global public health.In recent years, interleukin-1 (IL-1) has been found to play an important role in PMOP development.In order to better prevent and treat postmenopausal osteoporosis, this paper will summarize the relevant mechanism of IL-1 in postmenopausal osteoporosis, so as to provide theoretical basis, thinking and new ideas for the establishment of a new PMOP prevention strategy and the study of relevant molecular mechanisms.

Correlation Between Gut Microbiota and Insulin Resistance in Aging

Xiang Fang,Lina Chang,Zhongying Wang — 2022/1/10 17:13:47

Type 2 Diabetes Mellitus (T2DM) and Alzheimer's Disease (AD) are age-related diseases which share some common risk factors. As one of the most popular life science research fields in recent years, the Gut microbiota participates in the regulation of insulin physiological functions through a variety of metabolites, and it plays a vital role in the occurrence and development of Insulin Resistance(IR). Herein, we discuss the internal relationship between the intestinal flora metabolites and the pathogenesis of T2DM and AD from the perspective of IR to provide references for the prevention and treatment of related diseases.

Study of the effect of probiotics on intestinal flora in paitients with primary immune thrombocytopenia based on 16S r DNA

黄晓春 — 2022/1/10 17:13:07

Objective Based on 16S rDNA high-throughput sequencing technology to explore the changes of gut microbiota and the effect of probiotic intervention in patients with refractory primary immune thrombocytopenia (ITP). Methods 20 patients with refractory ITP were randomly divided into probiotics group and control group with 10 patients in each group. The levels of tumor necrosis factor-α (TNF-α)、interferon-γ(IFN- γ)and interleukin-6 (IL-6) were determined before and after 8 weeks of therapy. The abundance of Bifidobacterium, Lactobacillus, Escherichia coli and coprococcus were also evaluated . 12 were healthy individual controls. Results After treatment , the patients in probiotics group had higher platelet count than those in the control group after therapy（t=-2.245,p=0.038）.Before treatment, the abundance of Bifidobacterium and Lactobacillus in the ITP group were lower than those in the healthy control group ( t= 4.178, P=,0.000；t=5.980，P= 0.000 ), while the abundance of Escherichia. coli was much higher(t= -2.147，P=0.040 ). After treatment, the Lactococcus abundance and bifidobacterium abundance obviously increased (t =-4.092,P= 0.003; t=-6.188, P =0.000), while Escherichia. coli abundance reduced( t=2.330, P=0.045). Conclusion The intestinal flora of refractory ITP patients were disordered. Use of probiotics may change the prognosis of ITP ．

Application prospect of 3D printing polyetheretherketone stent in auricle reconstruction

hanxing,wudi — 2022/1/10 17:11:54

Polyetheretherketone (PEEK) is a kind of polymer with many potential applications in the medical field. With the development of 3D printing technology, it can not only print out personalized implants according to the patient's condition, but also has the necessary properties as implants, These two advantages indicate that it is expected to replace the traditional repair materials in the field of auricle repair and reconstruction. The purpose of this review is to analyze the excellent properties of 3D printing material polyetheretherketone (PEEK) as an implant, and to prospect its application prospect in auricle reconstruction.

Study on the correlation between prenatal diagnosis of fetal limbmalformation and chromosomal abnormality

lixinze,,,,, — 2021/12/25 17:43:05

Abstract: Objective To investigate the correlation between prenatal ultrasound diagnosis of limb deformity and chromosomal karyotype abnormality. Methods ：230 cases of limb deformity detected in different gestational age in our hospital were selected as the research subjects, 56 of them underwent chromosome karyotype analysis, and compared the results of chromosome karyotype analysis of high-risk fetuses in the same period, and compared with the results of follow-up, postpartum radiological diagnosis and specimen results after labor induction. Results ：① Out of 20515 fetuses, 230 cases had limb deformity, with an incidence rate of 1.1%. There were 301 deformities in total, 208 deformities were found at 20-24 weeks, 55 deformities were found at 14-19 weeks, accounting for 69.1% and 18.2%, respectively. The combined detection rate of deformities at 14-24 weeks was 87.3%. ②After labor induction and delivery, the coincidence rate of prenatal ultrasound diagnosis was 90.2%, the missed diagnosis rate was 9.8%, and the misdiagnosis rate was 2.1%. and multiple fingers (toes) accounted for 40.6%. ③ The chromosome karyotype analysis was performed between the fetuses with limb malformations and those with high-risk fetuses, and the difference between the groups with abnormal chromosome 18 and 21 was statistically significant (P < 0.05). Conclusion：Prenatal ultrasound has a high detection rate for fetal limb malformations in the middle pregnancy, but it is still difficult to detect microdeformities such as polydactyl and syndactyl. At the same time, limb malformations, especially some specific structures, are correlated with chromosomal abnormalities, which can be used as an important index for fetal invasive chromosome screening.

Leptin inhibits the growth of Talaromyces marneffei through the TLR2/6 signaling pathway

CHEN Jie,CHEN Rong-feng,CHEN Xiu,TANG Qiao,WANG Xin-wei,WEI Wu-di,WEN Liu-fang — 2021/12/25 15:56:03

Abstract：Objective To investigate whether leptin can inhibit the proliferation of Talaromyces marneffei(T. marneffei) and clarify its possible regulatory signaling pathway. Methods THP-1 cells were cultured to logarithmic growth phase, and 50ng/ml PMA stimulated THP-1 cells to differentiate into macrophages. By setting the concentration gradient, the optimal leptin concentration was selected. The THP-1-derived macrophages were co-cultured with T. marneffei for 6 hours and?then?washed?away the non-phagocytized spores. Leptin was added into the experimental group and?culture medium was added to?the control?group. Samples were collected 48 hours later. The antibacterial effect of Leptin was detected by CFU, and the cytokine level in the TLRs signaling pathway was detected by RT-qPCR. Results Leptin can inhibit the growth of T. marneffei in the range of?1μg/ml?to 15μg/ml,?the most?obvious?concentration?being?5μg/ml. The mRNA expression levels of TLR2 and TLR6 in experimental group were significantly higher than those in the control group, but the mRNA changes of TLR3, TLR4 and TLR7 had no statistical significance between the two groups.. The mRNA expression of MyD88, MAPK1 and IL1β increased and the expression of IL6 decreased in the experimental group, which were statistically significant. In addition, there was no significant difference in the expression level of MIP1α and TNFα mRNA. Conclusion leptin can inhibit the proliferation of T. marneffe in THP-1 derived macrophages, which may be due to the activation of TLR2/6-MYD88-MAPK1 signaling pathway to increase the expression of inflammatory factors.

Research progress of venous-to-arterial carbon dioxide partial pressure difference in the treatment of septic shock

linxuezhen — 2021/12/10 16:20:19

Sepsis and septic shock are important clinical problems in emergency and critical care medicine.Septic shock has a very high morbidity and mortality in critically ill patients. Venous-to-arterial carbon dioxide partial pressure difference(Pv-aCO2) is closely related to the guidance of fluid resuscitation in septic shock, the assessment of tissue oxygen supply and demand, the assessment of critical condition and prognosis.In this paper,we review the research progress of Pv-aCO2 in the treatment of septic shock

Research progress of PCSK9 inhibitor in ischemic stroke

田小冰 — 2021/12/10 16:19:10

Elevated level of low-density lipoprotein C (LDL-C) is an important risk factor for the atherosclerosis process, and lowering LDL-C level can effectively reduce the risk of cardiovascular disease. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to improve the prognosis of patients with cardiovascular disease and widely used for the treatment of coronary atherosclerotic heart disease at acute phase or its secondary prevention in clinical practice. However, its application in ischemic stroke and its impact on stroke prognosis are not yet clear. The aim of this article is to review and analyze the progress of research on the PCSK9 inhibitors in ischemic stroke.

Research Progress of Gut Microbiota in Pathogenesis of Insomnia DisorderFan Xiaoxuan, Zhao Bin, Zhang Qingqing, Wang Yuan, Ma Wenbin

范晓萱,王媛,张青青,赵斌 — 2021/12/10 16:18:08

Insomnia disorder is one of the common sleep disorders, which is closely related to stress and mood. Insomnia disorder can cause disorders of the gut microbiota, which can be affected the behavior of the host by the gut-brain axis immunity, neuroendocrine and vagus nerves pathways. In recent years, studies have found that the gut microbiota can cause insomnia disorder by participating in the regulation of the GABA system, activating the HPA axis, and affecting the circadian rhythm. This review aims to explore the possible pathogenesis of gut microbiota involved in the occurrence and development of insomnia disorder. Understanding the relationship between gut microbiota and insomnia disorder will open up new strategies for the diagnosis and treatment of insomnia disorder.

Application of Anesthesia Consciousness Index in Clinical Anesthesia

Zhang yani — 2021/12/10 16:16:59

Depth of anesthesia (DOA) monitoring is one of the most important problems in clinical anesthesia. Good depth of anesthesia (DOA) monitoring is helpful to stabilize intraoperative hemodynamics, reduce the amount of anaesthetics, shorten postoperative recovery time, and reduce the incidence of intraoperative adverse reactions and postoperative complications. In recent years, with the progress of science and technology, various anesthesia depth monitoring methods have been widely used in clinical anesthesia, such as bispectral index (BIS), auditory evoked potentials (AEP), Narcotrend index (NI), entropy index, index of consciousness (IOC), anesthesia consciousness index (Ai), among which Ai is a new anesthesia depth monitoring indicators independently developed in China. This paper reviews the clinical application of Ai in general anesthesia surgery, including the basic principle, clinical application, advantages and limitations, providing evidence for the future application of Ai in clinical anesthesia.

The analysis on the influence of golden hour body temperature of the admission day on the clinical outcome of very low birth weight infantsHu Qiongyan, Huang Xiongzhi, Sun Yi, Liang Zhenhua, Liang Xuxia

胡琼燕,黄,, — 2021/12/10 16:14:35

本刊护理论文不用英文摘要

One case：cystic pulmonary benign metastatic leiomyoma

zhang yu — 2021/12/10 16:13:52

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liuzhijie — 2021/12/10 16:00:06

Clinical characteristics of diabetic foot and its related factors

tanxiaoyan — 2021/12/10 15:58:47

Objective Investigating the characteristics and relevant risk factors of the diabetic foot to provide references for the development of interventions to prevent diabetic foot. Methods A total of 730 diabetes patients admitted to The People’s Hospital of Guangxi Zhuang Autonomous Region from January 2019 to December 2019 were enrolled into the study. These patients were classified into diabetic foot (88 patients) and non-diabetic foot group (642 patients) based on whether their foot was infected or not. The characteristic and risk factors of diabetic foot ulcer were analyzed by univariate and multivariate analysis. Results Compared with the non-diabetic foot group, the diabetic foot group had longer duration of diabetes, higher albumin levels, higher 24-hour urinary albumin, and more complicated diabetic nephropathy, retinopathy, lower extremity vascular disease, and peripheral neuropathy (p＜0.05). Multivariate logistic regression analysis showed that concomitant lower extremity vascular disease (OR=2.21) was a risk factor for diabetic foot in diabetic patients, and a higher level of serum albumin level (OR=0.90) was a protective factor (P<0.05). Moreover, paired analysis showed that the level of diabetic foot’s TcpO2 (shin) , local perfusion index (humerus side) and ABI (humerus side) was significantly higher than that of the normal foot (p＜0.05). Conclusion For the diabetes patients with risk factors of diabetic foot who had lower extremity vascular disease and low serum albumin level should receive education, improve patients risk awareness and self-care ability to prevent the occurrence of diabetic foot.

Observe the influence of BMI index before pregnancy and the rate of weight gain in the second and third trimester of pregnancy on fetal development

胡晓芹 — 2021/12/10 10:46:35

Objective To analyze the effect of weight gain on fetal development at specific stages of pregnancy. Methods Prospectively selected 1820 pregnant women who had undergone routine perinatal examination and gave birth at the Maternal and Child Health Hospital of Tengzhou City, Shandong Province from October 2016 to October 2020, and collected basic demographic characteristics, information on antenatal examinations, pregnancy outcomes, and neonatal complications Use SPSS 25.0 statistical software to analyze the data and analyze the data. Logistic regression model is used to analyze the correlation between the pre-pregnancy BMI index and the weight gain of pregnant women at specific stages of pregnancy and fetal development, and calculate the OR (95% CI) value. Results Pre-pregnancy low body weight (OR=6.089, 95% CI: 4.075～9.099) is a risk factor for infants smaller than gestational age; pre-pregnancy overweight (OR=5.746, 95% CI: 3.974～8.309) and obesity (OR=17.874, 95% CI) ：11.072～28.856) is a risk factor for babies larger than gestational age; it is also a risk factor for giant babies [pre-pregnancy overweight (OR=5.799, 95% CI: 3.895～8.636), obesity before pregnancy (OR=11.779, 95% CI: 7.096～ 19.554)]; the second trimester (OR=4838, 95% CI: 3.479～6.728), the third trimester (OR＝2.461, 95% CI: 1.800～3.64) the weight gain exceeding IOM standard is greater than the risk factor of gestational age infants, and it is also Risk factors for giant babies [weight gain in the second trimester exceeds the IOM standard (OR=1.496, 95% CI: 1.059-2.113), weight gain in the third trimester exceeds the IOM standard (OR=1.812, 95% CI: 1.279-2.567)]. Conclusion Pre-pregnancy BMI index and mid-pregnancy and post-pregnancy weight gain have a greater impact on fetal development. Clinically, targeted intervention should be given at a specific stage according to the physical fitness of pregnant women to ensure the rationality of weight gain during pregnancy and further promote the healthy development of the fetus.

The relationship between adverse pregnancy outcomes and D-dimer concentration in the third trimester of pregnancy

GONG Tian-liu,WEI Hai-tang — 2021/12/9 11:25:14

Objective　 To explore The relationship between adverse pregnancy outcomes and D-dimer concentration in the third trimester . Methods A retrospective study was 　 carried out in 612 healthy pregnant women who examined and delivered in our hospital from January to June in 2019, including 263 cases in adverse pregnancy outcomes group(study group) , 349 cases in healthy group(control group). The D-dimer concentration in the third trimester between the two groups were compared. And to further compare the D-dimer concentration in the third trimester among the postpartum hemorrhage group ,placental abruption group, severe preeelampsia group and other group in the study group. Results The D-dimer concentration in the adverse pregnancy outcomes group was significantly higher than that of the healthy group (P ＜ 0.05). There was significant difference among the groups in the study group (P ＜ 0.05). Further more, kW rank sum test is used for multiple comparison ,The D-dimer concentration of postpartum hemorrhage group ,placental abruption group and severe preeelampsia group were all significantly higher than that of the other group (P ＜ 0.05). There was no significant difference among the postpartum hemorrhage group ,placental abruption group and severe preeelampsia group (P>0.05).Conclusions D-dimer concentration in pregnant women should be intensively monitored, because The adverse pregnancy outcomes are positively correlated with D-dimer concentration. Among them, postpartum hemorrhage, placental abruption and severe preeclampsia were more significantly correlated with the increase of D-dimer than other adverse pregnancy outcomes.

Correlation of thromboelastography with coagulation function,inflammatory and hemorheology in patients with lower extremity fractures

黄惠妮,廖湘成,罗瑞献,莫柱宁,阳子骥,朱春丽 — 2021/12/9 10:34:07

Objective To investigate and compare the correlation between thromboelastography(TEG) and coagulation function, inflammatory and hemorrheology index of patients with lower extremity fractures during perioperative．Methods From November 2018 to July 2020，a retrospective study was carried out on 81 lower extremity fracture patients admitted to the Department of Orthopedics, Guangxi Zhuang Autonomous Region People's Hospital . General data of patients during hospitalization, TEG(R value, K value, α-angle, MA value) and routine coagulation function index (PT, APTT, FIB, PLT), inflammatory index [C-reactive protein (CRP) ,White blood cell count (WBC)] and hemorheology index [ESR, hematocrit (HCT)] were collected. Pearson correlation coefficient was used to analyze the correlation between TEG and conventional coagulation function index, hemorheology index, inflammatory index. Results Correlation analysis showed that APTT, FIB level were significantly positively correlated with R value and MA value respectively (r values were 0.287, 0.319, 0.310 and 0.550 respectively, P<0.01), PLT was significantly positively correlated with α Angle and MA (r values were 0.347 and 0.626 respectively, P<0. 01), significantly negatively correlated with K value (r =-0.318, P<0.01); CRP level was significantly positively correlated with MA value (r= 0.351, P<0. 01); The ESR of patients with lower extremity fractures was positively correlated with R value, α Angle, MA (r values were 0.300, 0.258 and 0.691 respectively, P<0.01); There was a significant negative correlation between HCT and MA value, α Angle (r values were -0.431and -0.420 respectively, P<0.01), which was significantly positively correlated with K value (r = 0.471, P<0.01). Conclusion The thromboelastography of patients with lower extremity fractures has a certain correlation with coagulation parameters，CRP， and hemorheology indicators，and it has practical implications for assessing coagulation，inflammation，and hemorheological status in patients with lower extremity fractures．

A Randomized Controlled Study on the Efficacy of Jiawei Zhizhu Powder Application on Shenque Point to Assist the Treatment of Antibiotic-related Diarrhea in Children

钟伟恩 — 2021/12/9 10:33:17

Objective To observe the clinical efficacy of Jiawei Zhizhu Powder applied to Shenque acupoint to assist in the treatment of children with antibiotic-related diarrhea. Methods The patients with diarrhea after antibiotics in the outpatient and inpatient departments of Lianjiang People’s Hospital from January 2020 to January 2021 were selected as the research objects, and were divided into a control group (40 cases) and an observation group (40 cases) according to a simple randomization method. The control group took Saccharomyces boulardii + montmorillonite powder; the treatment group used Jiawei Zhizhu powder on the basis of the control group to apply Shenque acupoint to compare the improvement degree of diarrhea between the two groups. Results After treatment, the number of diarrhea and the duration of diarrhea in the treatment group were lower than those in the control group, and the difference was statistically significant (P<0.05); after treatment, the curative effect of the treatment group was better than the control group, and the difference was statistically significant (P<0.05). Conclusion Modified Zhizhu Powder applied to Shenque acupoint has a better effect in the treatment of children with antibiotic-related diarrhea, and it is worthy of clinical application.

Effect of remifentanil combined with etomidate and propofol closed loop target induction on hemodynamics in patients with hypertensionon

fengyanchun,,, — 2021/12/9 10:32:14

【Abstract】 Objective To investigate the effects of different doses of remifentanil combined with etomidate and propofol closed-loop target induction on hemodynamics in patients with hypertensionon.Methods 90 patients with hypertension under general anesthesia and endotracheal intubation were enrolled, age ranged from 48 to 65 years,ASA II,were randomly divided into three groups:remifentanil 4ng/ml(R1)group, remifentanil 5ng/ml(R2)group, remifentanil 6ng/ml(R3)group, 30 cases in each group.The double-channel anesthesia depth closed-loop controlled injection system was connected. After the effect-chamber concentration of remifentanil reached 2 ng/ mL, etomidate 0.15 mg/kg was rapidly injected intravenously and the plasma target-controlled closed-loop loop of propofol 1.5ug/mL was started.After CSI of the three groups reached below 60, vecuronium was injected 0.1mg/kg.Two minutes before endotracheal intubation, the target concentration of remifentanil was set as 4ng/ml in R1 group, 5ng/ml in R2 group and 6ng/ml in R3 group.All the three groups were intubated 3 minutes after vecuronium injection.After completion of intubation, the target concentration of remifentanil was adjusted to 2ng/ml.SBP, DBP, MAP, HR and SpO2 at baseline (T0), loss of consciousness (T1), endotracheal intubation (T2), 1min after endotracheal intubation (T3) and 5min after endotracheal intubation (T4) were recorded in the three groups.Time at T1, concentration and dosage of propofol effector chamber at T1 and T2, adverse reactions during induction and application of vasoactive drugs.Results All patients lost consciousness for about 1min, no injection pain, and few adverse reactions.There was no statistical significance in the concentration and dosage of propofol in the effect chamber of T2 among the three groups(P>0.05).Comparison of MAP and HR among the three groups showed no statistical significance (P>0.05).The incidence of blood pressure reduction was higher in the R3 group, which was statistically significant compared with the R1 group (P<0.05).The incidence of intubation reaction in R1 group was high, which was statistically significant compared with R2 and R3 groups (P<0.05).There was no statistical significance in the comparison of vasoactive drug application among the three groups (P>0.05).Conclusions The sedation induced by the three groups of remifentanil combined with etomidate and propofol closed-loop target was ideal, with few adverse reactions. However, 5ng/ml remifentanil is more suitable for patients with hypertension, with stable hemodynamics and less intubation response.

Interventional thrombolysis via anterior tibial vein approach for acute deep venous thrombosis of lower extremity

孙振阳 — 2021/12/9 10:31:11

Objective　To investigate the efficacy and safety of interventional thrombolysis through anterior tibial vein approach in the treatment of acute lower extremity deep venous thrombosis. Method 39 patients with acute deep venous thrombosis of lower extremity were treated by percutaneous puncture of anterior tibial vein under the protection of inferior vena cava filter. Unifuse catheter was inserted into the deep venous thrombosis segment, and urokinase was continuously pumped. Results The success rate of this group was 90.69 % ( 39 / 43 ). There were no severe nerve injury, bleeding and hematoma complications at the puncture site. The circumference difference of the thigh and the crus, the venous patency were significantly different before and after thrombolysis ( p < 0.01 ). The average venous patency rate was (57.24±11.57)%. 32 cases (82.05 % ) were followed up for 3 - 12 months, the preservation rate of valve was 87.4 %.There was no recurrence of thrombosis and pulmonary embolism during follow – up period. Conclusion Thrombolysis via anterior tibial vein approach for acute deep venous thrombosis of lower extremity is safe and effective with high success rate and few complications. It is worthy of clinical application.

Phenotype and genotype analysis with SCN8A gene mutation-related epilepsy

LINMENG — 2021/12/9 10:28:57

［］ Objective To explore the clinical phenotype and gene mutation characteristics of epilepsy associated with SCN8A gene mutation. Methods Clinical data and gene detection results of 8 children with SCN8A gene mutation verified by Sanger were analyzed. Results Among 8 cases, case 3(p.V216A) were of intermediate epilepsy encephalopathy phenotype, case 2(p.T1773I), case

Effects of Acorus calamus on neurotransmitter content and behavior in the brain of depressed rats

fujia,, — 2021/12/9 10:27:28

[Abstract] Objective To study the effects of different doses of Acorus calamus on neurotransmitter content and behavioural effects in rats. Methods Five SD male rats were randomly selected as the blank group, and the rest were divided into five groups: model group, fluoxetine group [1.8 mg/(kg.d)] and Chinese calamus low, medium and high dose groups [5 ml/(kg.d), 10 ml/(kg.d), 20 ml/(kg.d)]. At the end of the moulding administration, behavioural tests were performed and the levels of dopamine (DA) and pentazocine (5-HT) in the brain tissue of each group were measured by enzyme-linked immunosorbent assay (ELISA). Results Behavioural results: compared with the blank group, the immobility time at all time points during forced swimming was significantly increased in the model group (P < 0.05), and the total score of the open-field experiment and the ratio of time to enter the open arm (OT/TT) were significantly decreased in the model group (P < 0.05); compared with the model group, the immobility time at all time points during forced swimming was significantly decreased in the calamus and fluoxetine groups (P < 0.05), and the total score of the open-field experiment and the ratio of time to enter the open arm (OT/TT) were significantly decreased in the model group (P < 0.05). The total score and OT/TT were significantly higher in the open-field experiment (P＜0.05). The expression of dopamine (DA) and pentraxin (5-HT) in the brain of rats in the model group was down-regulated after 21 d of modeling compared with that in the blank group (P<0.05); the expression of dopamine (DA) and pentraxin (5-HT) in the brain of rats in the calamus high-dose group and fluoxetine group was increased compared with that in the model group (P<0.05). Conclusion Acorus calamus may produce antidepressant effects by increasing neurotransmitters in brain tissue.

Clinical study on the new treatment of cesarean scar diverticulum by hysteroscopy combined with laparoscopy Zhang Tongyan, Zhang Qiang, Xiao Yalin, et al. HanDan Central Hospital, HanDan, 056001,China

xiaoyalin,zhangqiang,zhangtongyan — 2021/12/8 15:34:32

Objective Comparing the clinical effect of two kinds of laparoscopic repair with hysteroscopy in the treatment of cesarean scar diverticulum (CSD). Methods The 26 cases of CSD patients who were treated at the Han Dan Central hospital between January 2015 and December 2019 were randomly divided into a study group and a control group. The study group repaired the CSD by using the hysteroscope to excise the scar diverticulum joint laparoscope to fold and stitch the lower myometrium. The control group resected the uterine scarring by the guide of the hysteroscope then stitched the lower myometrium. The clinical effect was compared between the surgery time, the amount of bleeding in the operation, the time of hospitalization after surgery, and the recovery after surgery of the two groups of patients. Results There was no significant difference in the duration of surgery, the time of hospitalization after surgery, and the recovery of the weak lower myometrium after surgery (P＞0.05), while the amount of bleeding in the surgery in the study group was lower than in the control group (P＜0.05). Conclusion Treating the CSD by using the hysteroscope to excise the scar diverticulum joint laparoscope to fold and stitch the lower myometrium is effective. Meanwhile, the operation of surgery is easier to master, the damage during the surgery is more limited, and the effect after surgery is better, which makes it a new efficient method.

Clinicopathological features and the expression of PD-L1 in lymphoepithelioma－like carcinoma

PENG Li-lin,YANG Bo,ZHONG Li-juan,ZHOU Ren-yu — 2021/12/8 15:32:18

Objectives To investigate the clinicopathological features and the expression of programmed death ligand-1 (PD-L1) in lymphoepithelioma-like carcinoma (LELC). Methods 15 cases of LELC with complete clinical data and pathological diagnosis were collected from the First Affiliated Hospital of Jinan University between January 2010 and May 2021. The expression of PD-L1，pan-CK, P40, LCA, Syn and Ki-67 was detected by immunohistochemistry, and the small RNA encoded by Epstein-Barr virus (EBV) (EBER) was detected by in situ hybridization staining. All of these cases were performed follow-up study. Results Among 15 LELC cases, there were 5 males and 10 females. Their ages ranged 28 to 81 years, median age 60 years. Thereinto, 10 cases were derived from lung, 3 cases were derived from salivary gland, 1 case was derived from renal pelvis and 1case was derived from nasal cavity, respectively. Mophologically, tumor cells were shown polygonal or irregular features and undifferentiated or poorly differentiated characteristics and nesting or syncytial distribution. The nucleus is round, oval or irregular, with obvious eosinophilic nucleolus. Abundant infiltration of lymphocytes and plasma were visible in stroma. Immunohistochemical staining showed that tumor cells were positive for pan-CK and P40 in all cases. Stromal lymphocytes were positive for LCA. The expression of Ki-67 was positive in approximately 40% of tumor cells and PD-L1 expression was intensively positive in tumor cells of 10 cases. 14 samples were positive for EBER in situ hybridization and 1 sample was negative. During the follow-up to May 17, 2021, 13 patients were survived and 2 patients were lost follow-up. Conclusion LELC is a rarely malignant tumor, which is more common in lung than in other organs. Most of lesions were associated with EB virus infection, but EBER expression was negative in urinary LELC. High expression of PD-L1 was detected in most tumor cells of LELC, indicating that most patients may benefit from immunotherapy with immune checkpoint inhibitors and thus acquiring a better clinical prognosis.

Silibinin relieve oleic acid-induced lipid accumulation by enhance autophagy in HepG2 cells

肖素军, — 2021/11/4 17:58:00

Abstract Objjective: Construct a model of fatty degeneration of HepG2 cells induced by oleic acid, and explore that silibinin can alleviate the lipid deposition of HepG2 cells by regulating autophagy. Methods: Experimental groups : control group, oleic acid group, oleic acid + silibinin group, oleic acid + chloroquine + silibinin group, oleic acid + chloroquine group. HepG2 cells were stimulated with 0.4mM oleic acid for 24h to construct a steatosis model, 60μM chloroquine pretreated for 1h to inhibit autophagy, oil red O staining and triglyceride detection to assess the lipid deposition of cells, Western-Blot to detect autophagy marker protein expression. Results：Oil red O staining showed that the number of intracellularly stained lipid droplets in HepG2 cells in the oleic acid group was significantly higher than that in the control group, and the triglyceride content was significantly higher than that in the control group (P<0.01). After the addition of silibinin, intracellular staining of lipid droplets decreased, and the detection of triglycerides indicated that silibinin could significantly alleviate the increase in TG content caused by oleic acid; However, after oleic acid stimulation, pretreatment with autophagy inhibitor chloroquine for 1 h, and then stimulated with silibinin for 24 h, significant lipid deposition appeared in HepG2 cells, and the content of TG was higher than that in the oleic acid plus silibinin group (P<0.01). WB results showed that the expression ratio of LC3Ⅱ/LC3Ⅰin the oleic acid group decreased (P<0.01), the expression ratio of LC3Ⅱ/LCⅠincreased after silibinin treatment (P<0.05); Compared with the oleic acid group and the oleic acid + silibinin group, the LC3Ⅱ/LC3Ⅰexpression in the oleic acid + chloroquine + silibinin group significantly increased (P<0.01). Conclusion: 0.4mM oleic acid can effectively cause fatty degeneration of HepG2 cells; Silybin can improve the lipid deposition caused by oleic acid by enhancing autophagy in HepG2 cells.

The expression and significance of NDUFA4L2 in glioma tissues

Chen yuanbing,Li chunya,Liang yinhua,Tang miao — 2021/11/4 16:47:30

Abstract: Objective To investigate the expression of NDUFA4L2 in gliomas and related clinical significance. Methods The TCGA and CGGA databases were used to analyze the mRNA expression of NDUFA4L2 in glioma and its relationship with the clinical pathological grade and prognosis of the patient. The glioma specimens of different WHO grades were further collected for immunohistochemical detection to verify the presence of NDUFA4L2 in the glioma. Differences in protein expression in different grades of tumors. And the clinical specimens and follow-up data of 62 patients with glioma were selected, and RT-PCR method was used to detect the expression of NDUFA4L2 in glioma and its relationship with prognosis. Results By analyzing the TCGA and CGGA databases, it was found that the expression of NDUFA4L2 in glioma tissues increased with the increase of the WHO grade (p<0.05). High expression of NDUFA4L2 indicates a shorter survival period for patients. The results in the clinical specimen verification are consistent with the above-mentioned bio-reliability analysis. Conclusion The expression of NDUFA4L2 in glioma tissue is related to the pathological stage and prognosis, and it may be a potential tumor marker of glioma.

Evaluation of the efficacy of Brostrom-Gould procedure combined with arthroscopic in the treatment of chronic ankle instability

wangwei — 2021/11/4 16:46:03

【Abstract】 Objective To explore the efficacy of Brostrom-Gould procedure combined with arthroscopic in the treatment of chronic lateral ankle instability.Methods A retrospective study was conducted to analyze the clinical data of 30 patients with Chronic Ankle Instability (CAI) admitted from July 2018 to July 2019.There were 23 males and 7 females，aging from 18 to 55 years (average 32.7±9.6 years) , with an averaged disease course of 16.0±3.1 (range 10-21) months.All patients received Brostrom-Gould procedure combined with arthroscopic.The Visual Analogue Score(VAS) ,drawer test ,Inversion stress test,American Foot and Ankle Surgery Association (Amertcan Orthopaedic Foot&Ankle Society, AOFAS) Ankle-Hindfoot Score,Karlsson-Peterson ankle function score and Talus tilt angle were analyzed and compared before operation ,6 weeks after operation and 12months after operation.Results All 30 patients were followed up with a mean period of 16.0±3.1 months (range 12-20 months).The talus tilt angle improved from（6.8±0.9）° before operation to（4.4±0.5）° at 6 weeks after operation，and（3.5±0.5）°at 12months after operation，with significant difference(P<0.01).The VAS score improved from （4.5±1.0）points before operation to（1.5±0.6）points at 6 weeks after operation and （0.6±0.6）points at 12months after operation,with significant difference(P<0.01). The Karlsson-Peterson ankle function score improved from(58.7±2.7)points before operation to(84.4±3.8) points at 6 weeks after operation，and(90.7±3.1)points at 12months after operation,with significant difference(P<0.01).The AOFAS Ankle-Hindfoot scores improved from(61.6±9.0)points before operation to(80.1±7.2)points at 6 weeks after operation,and(85.6±6.5)points at 12months after operation,with significant difference(P<0.01).Conclusion Brostrom-Gould procedure combined with arthroscopic has a satisfactory effect on the treatment of chronic lateral ankle instability, and the recovery of ankle joint function is good.

Comparative analysis of ultrasound findings and clinicopathological features of 123 cases of granulomatous lobular mastitis

Linyun — 2021/11/4 16:44:24

Objective To analyze the ultrasound manifestations of granulomatous lobular mastitis (GLM) and explore the clinical application value of ultrasound in the diagnosis of GLM. Methods A retrospective analysis of 123 patients with GLM in the Department of Breast and Extrathoracic Breast in our hospital from January 2018 to October 2020 were diagnosed by needle biopsy or surgical pathological examination. The undergraduate room performed ultrasound examination on the included patients and analyzed the ultrasound findings and test result. Results According to statistics, a total of 123 cases were detected by ultrasound examination, specifically: 13 cases of nodular type (10.32%), 18 cases of mass type (14.29%), 33 cases of abscess type (26.19%), and 59 cases of hypoechoic zone type. (46.83%); the incidence of skin involvement, the incidence of axillary lymphadenopathy and the size of the lesions in patients with different types were statistically significant (P<0.05); patients with different types can show morphology on ultrasound Irregularities, uneven edges, no calcification features, the difference was not statistically significant (P>0.05); but in the peripheral echo, blood flow signal and sinus imaging manifestations, the difference was statistically significant (P<0.05). Conclusion The effect of ultrasound examination on patients with GLM is significant, and there are also large differences in ultrasound performance and pathological characteristics of different types, which can provide a scientific basis for the diagnosis and treatment of clinical diseases.

A single center study on the distribution and drug resistance of pathogenic bacteria in hematology department from 2010 to 2019

zhou wei — 2021/11/4 16:42:59

Objective To study the distribution and drug resistance of pathogenic bacteria in single?center hematology department between January 2010 and December 2019, and provides the basis of the pathogenic bacteria and strategies for clinical anti-infective treatment.Methods A retrospective analysis method was used to isolate the clinical strains of hematology patients from January 2010 to December 2019 in hematology department of guangzhou first people's hospital. The drug susceptibility test was conducted by paper diffusion method, and the distribution and drug susceptibility data of pathogenic bacteria were analyzed with WHONET5.6 software. The chi-square test was used to compare the distribution of pathogenic bacteria in patients with severe aplastic anemia and hematological malignancies. Results The distribution of diseases included 374 cases of severe aplastic anemia (SAA), 281 cases of acute myeloid leukemia (AML), 115 cases of acute lymphocytic leukemia (ALL), 85 cases of myelodysplastic syndrome (MDS), 71 cases of multiple myeloma (MM), 70 cases of non-Hodgkin's lymphoma (NHL), 14 cases of idiopathic thrombocytopenic purpura (ITP), 10 cases of paroxysmal hemoglobinuria (PHN), and 201 cases of other kinds of hematological disease or infectious disease. A total of 1221 strains of bacteria were isolated. The overall distribution of pathogenic bacteria was dominated by Gram-negative bacteria. The infection rates of gram-negative bacteria and gram-positive bacteria were 65.8% and 34.2%, respectively. The top six pathogenic bacterias were: Escherichia coli accounted for 16.9% (207 strains), klebsiella pneumonia accounted for 15.8% (193 strains), pseudomonas aeruginosa accounted for 10.2% (124 strains), stenotrophomonas maltophilia accounted for 6.5% (79 strains), hemolysis staphylococcus aureus and acinetobacter baumannii accounted for 3.5% (43 strains). Non-fermentative bacteria accounted for 35.2% of Gram-negative bacteria (283 strains/803 strains). Pathogenic bacteria were mainly distributed in sputum, blood, urine specimens, such as respiratory secretions (phlegm, throat swab, alveolar lavage) accounted for 29.3% (358 strains), blood accounted for 25.9% (316 strains). The detection rates of MRSA (methicillin-resistant Staphylococcus aureus) and MRCNS (methicillin-resistant coagulase-negative Staphylococcus) were 20.5% and 90.3%, respectively. One case of vancomycin-resistant Staphylococcus aureus and three cases of vancomycin-resistant coagulase-negative Staphylococcus and one case of vancomycin-resistant Enterococcus. The top six gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Acinetobacter baumannii and Salmonella typhi. The detection rate of ESBLs (extended-spectrum-beta-lactamase) in Escherichia coli and Klebsiella pneumoniae was 61.0% and 58.0%, respectively, and the resistance of ESBLs-producing strains to most antibacterial drugs was higher than that of non-ESBLs-producing strains. Escherichia coli and Klebsiella pneumoniae remained highly sensitive to carbapenems antibiotics, and imipenem resistance rates were 3.4% and 4.6%, respectively, less than 5%.The resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 17.8% and 14.6%, respectively. The incidence of Enterococcus faecium and Staphylococcus aureus was higher in hematological malignancies group (P < 0.05). The incidences of CRE is increasing year by year. Conclusions Patients with hematological diseases had a higher risk of bacterial infections. The infections occurred most in patients with hematologic malignancies and severe aplastic anemia, gram-negative bacteria was still the main pathogenics of infection in patients with hematological diseases, Among them, Enterobacteriaceae has the highest proportion, and the respiratory tract and blood flow is the main infection site. The overall drug resistance rate of bacteria in the department of hematology in our hospital is lower than that of 2019 China Bacterial Resistance Surveillance Network (CHINET) reported. Patients with co-infection of hematological diseases should undergo a pathogenic examination in time. According to the distribution characteristics and bacterial pathogens in our hospital, the drugs should be used empirically, and the drugs should be adjusted to the follow-up drug susceptibility results, so as to effectively control infection and prevent the development of drug resistance.

Clinical study of active vitamin D combined with nutritional vitamin D in patients with idiopathic membranous nephropathy

deng mei qiu,liao xin,luo xiao juan,zeng yuan yuan — 2021/11/4 16:41:55

Objective Observation on the clinical efficacy of active vitamin D combined with nutritional vitamin D in patients with idiopathic membranous nephropathy for 6 months, and to provide a new basis for clinical diagnosis and treatment of IMN. Methods According to the received vitamin D regimen, 34 patients were divided into VDRA group (calcitriol 0.25μg/qd) and 26 patients in combination group (calcitriol 0.25μg/qd, vitamin D2 soft capsule 5000IU/qd). We detected laboratory indexes such as 24-hour urinary protein, albumin and 25 (OH) D before and after treatment, to compare the efficacy and safety of two vitamin D regimens. Result 24-hour urinary protein in the combination group was significantly lower than that in the VDRA group, and 25 (OH) D was significantly higher than that in the VDRA group (P <0.05); The overall response rate of the combination group was significantly higher than that of the VDRA group(P <0.05); The incidence of rehospitalization and the incidence of fatigue were significantly lower than that in the VDRA group (P <0.05). Conclusions (1) Treatment of IMN patients with VDRA combined with NVD can effectively reduce 24-hour urinary protein and increase the level of 25 (OH) D. The overall response rate is higher than that of VDRA alone. (2) Hypercalcemia and vitamin D poisoning were not found in the patients treated with VDRA combined with NVD. Compared with VDRA alone, rehospitalization and fatigue can be reduced.

Based on Network Pharmacology and Molecular Docking to Explore the Mechanism of Qingjie Huagong Decoction(QJHGF) in the treatment of Severe Acute Pancreatitis

黄梦瑶,江柳庆,刘锟荣,彭晓鹏,秦百君,谭琦,杨昕 — 2021/11/4 16:40:53

Objective: Based on network pharmacology and molecular docking technology to explore the components and mechanisms by the treatment of QJHGF for severe acute pancreatitis. Method: Tcmsp database was used to search for the active components and action targets of QJHGF prescription. The network diagram of drug component target and disease was constructed by using Cytoscape. GO and KEGG analysis were carried by David and R software. Molecular docking was carried by autodock Vina .Outcome: A total of 202 active components and 225 potential targets were screened out in QJHGF, in which 210 targets related to sap. The enrichment analysis of target pathway showed that QJHGF might play a role in inflammatory factors, apoptosis and other pathways; molecular docking showed that the main active components in QJHGF had good combination with keytarget. Conclusion: QJHGF may play the role of anti-inflammatory, regulating cell apoptosis and improving energy metabolism through p53、PI3K-Akt signaling pathway to treat severe acute pancreatitis.

Progress of different treatment regimens for patients with coronary heart disease with multiple vessel complicated with diabetes

mengxiangyu — 2021/11/4 11:24:37

At present, the number of cardiovascular patients in China is about 290 million, among which about 11 million are patients with coronary heart disease [1]. Excluding other risk factors, patients with diabetes had a two-fold increased risk of adverse cardiovascular outcomes compared with those without diabetes. However, as a serious type of CORONARY heart disease, when multi-vessel disease is accompanied by diabetes， because diabetes can affect the patency rate after different revascularization and the risk and severity of perioperative complications .With the progress and richness of the treatment methods for multi-vessel lesions and diabetes, the current clinical treatment concept for patients with coronary artery disease with multi-vessel lesions and diabetes has made great progress. This paper will focus on the development and current research hotspots of various treatment options for patients with multi-vessel disease complicated with diabetes.

Research progress in the pathogenesis and targeted therapy of endometriosis-related ovarian cancer

zhaojing — 2021/11/4 11:23:40

Endometriosis（ES）, manifested as pelvic pain, infertility or adnexa mass，is a clinically common female disease. It has always been considered as a potential risk factor for the development of endometriosis-associated ovarian cancer (EAOC), EAOC is epithelial ovarian cancer (EOC) subgroup, mainly including endometriosis-like and clear cell subtypes. Although the incidence of EAOC in patients with endometriosis has increased, our understanding of the risk factors and mechanisms about this disease is still incomplete. We reviewed the progress of EAOC's molecular and genetic research, and discussed the current targeted therapy of EAOC in clinical application, so as to gain a deeper understanding of EAOC..

Research progress of educational intervention methods of autism spectrum disorders in children

LI Ai-wen — 2021/11/4 11:22:35

Autism Spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by different degrees of social communication disorders, narrow interest, stereotyped and repetitive behaviors, and sensory and perceptual abnormalities. The incidence of ASD has been increasing rapidly in recent years. As the cause of ASD is unknown, there is currently no specific drug therapy for the core symptoms of ASD. Special education intervention training can improve the symptoms of children with ASD and shorten the gap with normal children. This paper reviews the commonly used methods of ASD education intervention and training in recent years.

Research progress on the limits of orthodontic treatment for adolescent skeletal Class II malocclusion.

tanshenghuan,zhongrongbin — 2021/11/4 11:21:43

Skeletal Class II malocclusion is a common malocclusion in adolescence. The effect of orthodontic treatment is closely related to the growth potential and the severity of skeletal discrepancy. In this paper, the characteristics and orthodontic treatment of skeletal Class II malocclusion , the craniomaxillofacial features recommended to be treated with orthognathic surgery, the limits of tooth movement and the characteristics of soft tissue changes were reviewed, so as to provide the basis for clinical selection of orthodontic treatment cases and prediction of correction effect, as well as the informed consent of doctors and patients before treatment.

Insertion of Long head of biceps tendon with calcific tendinitis: one case report

Liangjianming — 2021/11/4 11:14:05

Insertion of Long head of biceps tendon with calcific tendinitis

A case of implantation of leadless pacemaker with third-degree atrioventricular block after transcatheter aortic valve replacement

崔腾飞 — 2021/11/4 11:13:18

Transcatheter aortic valve replacement (TAVR) is the first-line treatment for severe aortic stenosis. Conduction block is a common complication after TAVR. For patients with high-grade atrioventricular block, timely pacing therapy can reduce the mortality rate and improve the prognosis. This article reports a case of a third-degree atrioventricular block implantation of a leadless pacemaker after TAVR in an elderly patient, and a review of related literature.

Analysis of Vitamin D Nutrition Status and its correlation with glycolipid metabolism in medical examination group

LI Wei,PANG Yu,WU Chao-chun — 2021/11/4 11:12:36

Objective To study the nutritional status of vitamin D in medical examination group in Nanning, and analyze its correlation with blood lipids, blood sugar. Methods Data of gender, age, BMI, FPG, TC, TG, LDLC, HDLC and serum vitamin D levels were obtained from 494 physical examinees in May-August 2019. The nutritional status of vitamin D in different gender and age groups, the difference in blood lipid and blood glucose with different vitamin D nutritional status, the correlation between total vitamin D and all indexes were analyzed. Results 42.71% of the examinees were with normal total vitamin D level, while deficiency was observed in the others. Men (at 74.68/59.27-90.56 nmol/L) had higher level than women (at 63.85/50.48-79.24 nmol/L) in total vitamin D, which was statistically significant (P=0.000). There was a significant difference in total vitamin D levels in different age groups. There were no significant differences in BMI, FPG, TC, TG, HDLC and LDLC between groups with different vitamin D nutritional status. Correlation analysis showed that total vitamin D level was positively correlated with age(r=0.266, P=0.000),but not correlated with BMI、FPG、TC、TG、HDLC and LDLC. Conclusions Medical examination group had high detection rate with vitamin D deficiency. The nutritional status of vitamin D varies in different age and gender. Young people especially women are advised to take vitamin D supplementation more active.

Clinical application of Pranoprofen combined with Mydrin-P in vitrectomy for proliferative diabetic retinopathy

Chen Feng-hua,pengkai,qiuxu,Yan Ai-min — 2021/10/20 14:57:04

Objective To observe the effect of Pranoprofen combined with Mydrin-P on pupil size in proliferative diabetic retinal vitrectomy. Methods 126 eyes of 89 patients who underwent vitrectomy in our ophthalmology department from April 2020 to May 2021 due to proliferative diabetic retinopathy were randomly divided into experimental group and control group with 63 eyes each. The experimental group started to use Pranoprofen on the first day after anti-VEGF operation, consecutively followed by three days and Mydrin-P was used to dilate the pupils half an hour before the operation; in the control group, after anti-VEGF operation, Mydrin-P was used to dilate the pupils only half an hour before the operation. The pupil size was measured before the operation, 1h during the operation, and at the end of the operation(≥2h), and the average pupil area size at each time point of the two groups was compared. Results The average area pupil area of the experimental group was dilated pupils between the two group before operation was statistically significant (P＜0.05); At 1h after the operation, the average pupil area of the experimental group and the control group were compared with the preoperative, there was no statistically significant difference (P＞0.05), but the average pupil area of the experimental group was significantly larger than that of the control group, and the difference was statistically significant (P＜0.05). At the end of operation (≥2h), the average pupil area of the experimental group and the control group were compared with the preoperative, the difference was statistically significant (P＜0.05). But the average pupil area of the experimental group was significantly smaller than that of the control group, the difference between the two groups was statistically significant (P＜0.05). Conclusion Pranoprofen can effectively inhibit myosis during vitrectomy for proliferative diabetic retinopathy. Combined with Mydrin-P, it can maintain long-term mydriasis during the operation and create a good vision for the operation.

Progress in research on atherosclerosis and vascular cognitive impairment

Song Xin-yu — 2021/10/13 8:30:10

Cognitive impairment is a syndrome with various causes and is mainly characterized by damage on learning and practicing abilities. Cognitive impairment always accompanied with abnormal emotions and mental processes, increases the risk for elder people. Vascular cognitive impairment(VCI) is a dysfunction caused by cerebrovascular disease or the risk factors of it. Studies have shown that atherosclerosis is one of the main risk factors for vascular cognitive impairment. In this article, we will review the correlation, pathological mechanism, treatment and prevention of atherosclerosis and vascular cognitive impairment, and provide new ideas on prevention and treatment of the disease.

Correlation between thyroid nodules and type 2 diabetes mellitus

陈明明 — 2021/10/13 8:29:02

Type 2 diabetes and thyroid nodules are common diseases of endocrine metabolism. In recent years, many studies have shown that thyroid nodules incidence rate is higher in patients with type 2 diabetes. Analysis of risk factors for thyroid nodules in type 2 diabetes patients shows that there is close relationship between the two. This paper reviews the recent five years' research on the relationship between type 2 diabetes and thyroid nodules. Hope to provide inspiration and comprehensive theoretical basis for later scholars.

Mechanism?and?research?progress?of?exosome in?microenvironment?of?nasopharyngeal?carcinoma

zhongyuxiao — 2021/10/13 8:27:59

Nasopharyngeal?carcinoma?is?a?malignant?tumor?originating?from?nasopharyngeal?epithelium,?and?the?microenvironment?of?nasopharyngeal?carcinoma?is?the?key?factor?affecting?its?growth?and?metastasis.?A?large?number?of?functional?proteins,?mRNA、miRNA、DNA?fragments?and?other?bioactive?substances?carried?by?exosomes?in?the?microenvironment?can?regulate?the?migration,?invasion?and?formation?of?blood?vessels?of?tumor?cells?through?different?mechanisms?of?action,?and?can?also?affect?the?hypoxic?environment.?Therefore,?exploring?the?important?exosomes?and?its?signaling?pathway?mechanism?in?microenvironment?is?of?great?value?in?understanding?the?treatment?and?prognosis?evaluation?of?nasopharyngeal?carcinoma.?This?article?reviews?the?related?exosmes?of?nasopharyngeal?carcinoma?microenvironment?and?its?mechanism?and?research?progress?in?regulating?tumor?through?different?modes?of?action.

Research advances of high intensity focused ultrasound in clinical application

傅晓凤,司星 — 2021/10/13 8:26:28

Ultrasonic examination is a safe, effective, cheap and widely used diagnostic tool. The emergence of High Intensity Focused Ultrasound (HIFU) makes therapeutic ultrasound a reality. At present, HIFU has been widely used to treat benign and malignant lesions of various solid organs and provided a new treatment choice for patients who rejects or are not suitable for surgery. Therefore, in this review, we summarize the research progresses of the treatment principles, application modes and usual and potential clinical applications of HIFU.

A case report of hyperplasia and prolapse of gastric antrum glands to duodenum with actinomycete infection attach literaturereview

hongshanshan — 2021/10/13 8:25:31

In this paper, we analyzed the clinical features and diagnosis of a rare case of gastric antrum gland hyperplasia prolapse to duodenum accompanied by actinomycete infection, and reviewed the relevant literature.The aim is to improve clinical doctors' understanding of digestive tract actinomycete infection and avoid misdiagnosis and mistreatment.

Fracture of occipital condylar: A report of 2 cases and Literature Review.

liumengjun — 2021/10/13 8:24:26

Occipital condyle fracture (OCF)as a rare disease in clinical, often occurs in severe brain injury, due to destabilization of the craniocervical junction, as a result of delayed diagnosis, often lead to nerve injury, neck pain, even life-threatening. The 2 cases who were followed up for 2 years in our department are reported as follows, and the relevant methods of diagnosis and treatment are reviewed through literature search to provide reference for clinical practice.

Pathological characteristics of gastrointestinal stromal tumor with smooth muscle differentiation

chenlingfeng,chenzihan,qinyaping,tangjuan,taohaiqun,wujinfeng — 2021/10/13 8:23:33

Objective To investigate the clinicopathological characteristics of gastrointestinal stromal tumors (GISTs) with smooth muscle differentiation. Method The Immunohistochemical S-P method was used to detect the expression of H-caldesmon, Desmin and SMMHC in gastrointestinal stromal tumors. Results H-caldesmon, Desmin and SMMHC were expressed in different degrees in GIST. Among them, H-caldesmon showed the highest positive rate of 46.1% (30/65), and the lowest positive rate of 9.2% (6/65), the positive rate of Desmin was 10.7% (7/65). Conclusion GIST with smooth muscle differentiation is more common in patients with low mitotic index, low risk grade and smaller tumor size, suggesting that GIST with smooth muscle differentiation may have a good prognosis.

Correlation and Consistency of Two Different Methods for Detecting Coagulation Function in Patients with Lower Extremity Deep Venous Thrombosis

PAN Shengquan,ZHANG Haodang — 2021/10/13 8:22:44

Objective To investigate the correlation and consistency between Thrombelastography (TEG) and routine coagulation test in patients with deep venous thrombosis (DVT). Methods 87 inpatients with DVT of the interventional Department of Hefei hospital affiliated to Anhui Medical University from September 2017 to January 2021 were retrospectively reviewed. The clinical data of thromboelastography and routine coagulation test were collected, and the detection results of 2 different methods were statistically analyzed. Results There was correlation between the TEG and routine coagulation test with all P＜0.05. R time was positively correlated with PT and APTT ( r = 0.231, 0.395) .K was positively correlated with APTT ( r = 0.237) ,but negatively correlated with FIB and PLT (r=-0.521, -0.43). α-angle was positively correlated with FIB and PLT (r=0.542, 0.471). Moreover, MA were positively correlated with FIB and PLT (r = 0.674, 0.596). The Kappa values of MA in thrombelastometry with PLT, FIB were respectively 0.148, 0.210 (both P＜0.05). Discussion For DVT patients, TEG and routine coagulation test showed significant correlation, but the consistency between them was poor, so the 2 kinds of methods can not be replaced for each other. TEG provides additional information besides routine coagulation test, which is worth further clinical application.

Clinical significance of tumor markers esm-1, mmp-2 and mmp-9 in differentiating benign and malignant pleural effusion

GU Jiasheng,LIU Qingfeng,TAO Zhuoyan,WU Weidong — 2021/10/12 11:15:34

Objective To investigate the expression and clinical significance of endothelial cell specific molecule-1(ESM-1), matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9(MMP-9) in benign and malignant pleural effusion. Methods Ninety-nine patients with pleural effusion were selected, of which 53 were malignant pleural effusion and 46 were benign pleural effusion. The expression levels of ESM-1, MMP-2 and MMP-9 in the collected pleural effusion were detected by ELISA. Results The expressions of ESM-1, MMP-2 and MMP-9 in the malignant pleural effusion group were significantly higher than those in the benign group (P<0.01). Pathological type and primary tumor size were risk factors affecting the expression levels of ESM-1,MMP-2 and MMP-9.Only MMP-2 and MMP-9 were associated with distant organ metastasis. ROC curve analysis showed that we obtained the optimal critical values of ESM-1 (40.11ng/mL), MMP-2 (446.69ng/mL) and MMP-9 (145.56ng/mL) for the identification of benign and malignant pleural effusion with corresponding sensitivity (84.9%, 77.4%, 83.0%) and specificity (78.3%, 84.8%, 73.9%).The area under the curve of MMP-2 (0.894) was significantly larger than ESM-1 (0.861) and MMP-9 (0.865)(P<0.01).The sensitivity, specificity and area under the curve were 86.8%, 87.0% and 0.928 respectively. Conclusion The expression levels of ESM-1, MMP-2 and MMP-9 in malignant pleural effusion were significantly increased. ESM-1, MMP-2 and MMP-9 in pleural effusion may be valuable auxiliary means of traditional diagnostic tools in excluding malignant tumors. The combined detection of the three can effectively improve the diagnostic rate of benign and malignant pleural effusion.

Analysis of preoperative risk factors for high-risk prostate cancer with positive lymph nodes

Asimujiang Abula,Song Hongwen,Wang Jixin,Wang Yujie,Yan Shenshen — 2021/10/12 11:14:42

Objective: To explore the preoperative risk factors of high-risk prostate cancer with positive lymph nodes.Method: Collected the clinical data of 105 high-risk prostate cancer patients who underwent laparoscopic radical prostatectomy and Extended pelvic lymph node dissection in our hospital in the past 5 years. According to their postoperative pathological data,they were divided into lymph node positive group 14 cases and lymph node negative group 91 cases, Univariate analysis of age, body mass index (BMI), prostate specific antigen (PSA), Gleason score (GS)of biopsy, Percentage of positive biopsy cores (PPBC), cube root of prostate volume and clinical stage (cT). Univariate analysis showed that there were statistical differences and the factors with clinical significance were included in the binary logistic regression, and those with statistical differences after regression analysis are drawn nomogram.Result: Univariate analysis showed that GS, PPBC and cT were statistically different; The results of binary Logistic regression showed that there was a statistical difference in PSA, GS, cT and the cube root of prostate volume. The prediction model was further established, and the prediction C-index of the column graph was 0.902. The results showed that cT and GS had high predictive value. When GS>7 and cT>T2c, the prognosis of patients could be preliminarily evaluated..Conclusion: PSA, GS, cT and the cube root of prostate volume have predictive value for lymph node positivity, and cT and GS have higher predictive value.

Effect of Laparoscopic Ovarian Cystectomy and Laparotomy on Postoperative Recovery and Ovarian Function of Patients with Ovarian Cyst

林梅 — 2021/10/12 11:13:54

Objective To investigate the effects of laparoscopic ovarian cystectomy and open surgery on postoperative rehabilitation and ovarian function of patients with ovarian cysts. Methods A total of 84 patients with ovarian cysts treated in our hospital from February 2018 to February 2020 were selected and divided into two groups according to the random number table method, each with 42 cases. The control group was treated with open surgery, and the observation group was treated with laparoscopic ovarian cystectomy. The clinical indicators, ovarian function indicators [estrogen (E2), follicle stimulating hormone (FSH), anti-Müllerian hormone (AMH)], recurrence rate and pregnancy rate were compared between the two groups. Results The intraoperative blood loss of the observation group was (67.23±10.05) ml, which was less than that of the control group. The operation time (62.30±8.25) min, the time to get out of bed (31.08±4.18) h and the hospitalization time (5.42±1.17) d were shorter than those of the control group , The recurrence rate (4.76%) was lower than that of the control group, and the pregnancy rate (71.43%) was higher than that of the control group. There was a statistical difference (P<0.05); there was no statistical difference in the levels of E2, FSH and AMH between the two groups before surgery ( P>0.05); E2 (128.62±26.08) pg/ml and AMH level (6.97±1.75) ng/ml in the observation group were higher than the control group, and the FSH level (7.01±1.38) mIU/L was lower than the control group. Statistical difference (P<0.05). Conclusion Laparoscopic ovarian cystectomy for ovarian cysts is less traumatic and can meet the needs of patients for early recovery after surgery, reduce the impact on ovarian function, reduce the recurrence rate of the disease, and increase the pregnancy rate.

The compare research of Fulmiant type 1 diabetes and non-fulmiant type 1 diebetesZHOU shao-bi QIU Jun-lin ,(1.Department of Emergency of the Ninth Affiliated Hospital of Guangxi Medical University,2.Department of Endocrinology Metabolism of the Ninth Affiliated Hospital of Guangxi Medical University,Beihai 536000,China)

Zhou shao-bi — 2021/10/12 11:12:46

Objective To improve the diagnosis and treatment of fulminant type 1 diabetes mellitus (FTlDM).Methods 64 patients with first onset type 1 diabetes who were treated in the emergency department of the Ninth Affiliated Hospital of Guangxi Medical University from October 2003 to December 2019 were divided into FT1DM patients and non-fulminant type 1 diabetes (NFT1DM) patients according to the type of diabetes, and their clinical data were compared.Patients with NFT1DM were evaluated by HbA1c (≤8.7%, > 8.7%) and c-peptide ( lt;0.17nmol/L,≥0.17nmol/L), course of disease (≤1 week, > 1 week) were divided into different subgroups for comparative study.Results The age, creatinine, urea nitrogen and potassium levels of FTlDM patients were higher than those of NFT1DM patients.The course, HbA1c, fasting C-peptide and postprandial C-peptide levels were lower than those of NFT1DM patients.After NFT1DM was divided into the short course group and the long course group, the age, serum potassium, creatinine and urea nitrogen of the long course group were lower than those of the FT1DM group.HbA1c, fasting C-peptide and serum potassium were higher than THOSE of FT1DM.Serum potassium, creatinine and urea nitrogen in the short course group were lower than those in FT1DM group, while HbA1c, fasting C-peptide and serum potassium were higher than those in FT1DM group.The rest of the comparisons were not statistically significant.After NFT1DM was divided into low-C-peptide group and high-C-peptide group, the age, serum potassium, creatinine and urea nitrogen of the low-C-peptide group were lower than those of the FT1DM group.HbA1c was higher than FT1DM.Blood glucose and potassium were lower in the high C-peptide group than in the other two groups, and HbA1c was higher in the low C-peptide group than in the other two groups.Serum potassium, creatinine and urea nitrogen in the high C-peptide group were lower than those in the FT1DM group, and the remaining comparison showed no statistical significance.After NFT1DM was divided into low HbA1c group and high HbA1c group, the age, serum potassium, creatinine and urea nitrogen of the high HbA1c group were lower than those of the FT1DM group.The course of disease, HbA1c, fasting C-peptide and serum potassium were higher.Fasting C-peptide was higher and serum potassium was lower than FT1DM in the low HbA1c group.The rest of the comparisons were not statistically significant.Conclusion: FT1DM patients have unique characteristics compared with NFT1DM patients.NFT1DM patients in the low HbA1c group were similar to FTlDM patients

The role and mechanism of berberine in reversing oxaliplatin resistance in human colon cancer cells

chenlin,,,,,,,, — 2021/10/12 11:11:43

Objective: To investigate the effect and mechanism of berberine in reversing oxaliplatin (OXA) resistance in human colon cancer cells (THC-8307/OXA). Methods: Human colon cancer OXA-resistant cells THC-8307/OXA were divided into Control group, OXA group and Ber+OXA group, then different concentrations of berberine (5, 10, 20 g/mL) and OXA (20 g/mL) were added according to the experimental design. The cell morphology was observed under phase-contrast microscopy. Cell survival rate was determined by MTT assay, Flow cytometry was used to detect apoptosis and RT-qPCR was used to evaluate the relative expression of MDR-1. P-gp, PI3K, Akt and p-Akt protein were evaluated by Western blot. Results: Compared with the OXA group, the cell survival rate and the expression of MDR-1, P-gp, PI3K and p-Akt/Akt were significantly decreased, but the apoptosis rate was significantly increased in the Ber (5, 10, 20 μg/mL)+OXA group (P＜0.05), while the effect of Ber (10, 20 μg/mL)+OXA group was significantly higher than that effect of the Ber (5 μg/mL)+OXA group, Ber (20 μg/mL)+OXA group was significantly higher than that effect of the Ber (10 μg/mL) +OXA group. The result of OXA group showed no significant difference compared with the Control group (P＞0.05). Conclusion: Berberine reverses the OXA resistance of THC-8307/OXA cells by down-regulating P-gp expression, which may be related to PI3K/Akt signaling pathway.

Therapeutic Evaluation in Treating Type 2 Diabetes Mellitus of Qi－Yin Deficiencywith Shenqi Jiangtang Prescription Combined with Metformin Sustained-release Tablets

bai hongxia,gao yunfeng,,,, — 2021/10/12 11:10:40

Objective The objective is to observe the clinical efficacy of Shenqi Jiangtang Prescription combined with Metformin Sustained-release Tablets in treating Type 2 Diabetes Mellitus of Qi－Yin deficiency and its influence on syndrome integral , body mass index (MBI), low density lipoprotein(LDL-C) and homocysteine (Hcy) Type 2 Diabetes Mellitus of Qi－Yin deficiency. Methods From December 1, 2019, the patients with Type 2 Diabetes Mellitus of Qi－Yin deficiency divided into the control group and the study group. A total of 40 eligible patients were enrolled in both groups by November 2, 2020. The subjects in control group were treated with Metformin Sustained-release Tabletsa while the subjects of the other group were treated with Shenqi Jiangtang Prescription on the basis of the control group. During the treatment, there are 4 weeks in a course and the two groups of subjects were all treated for 2 courses continuously. The fasting plasma glucose (FPG), 2h blood glucose (2hPG), glycosylated hemoglobin (HbA1C), low density lipoprotein(LDL-C) levels and homocysteine (Hcy) were measured before and after treatment of the 2 groups. The syndrome integral and body mass index (MBI) of the two group before and after treatment were calculated. The clinical efficacy and adverse reactions in the two groups were compared. Results The total effective rate of the study group was 87.50％,which was significantly higher than 50.00％of the control group(P＜0.05)．After treatment,the levels of FPG、2hPG、HbA1C、MBI、LDL-C、Hcy all significantly decreased in the two groups (P＜0．05),and the decreases in the study group were significantly more than those of the control group (P＜0．05)．There was no significant difference in the incidence rate of adverse reactions between the two groups (P＞0．05). Conclusion Shenqi jiangtang Prescription combined with Metformin Sustained-release Tablets in treating Type 2 Diabetes Mellitus of Qi－Yin deficiency has significant efficacy with high safety,which is worthy of clinical promotion．

Relationship of LncRNA-ENST00000414355 in serum and hypertension and its’ risk factors: a case-control study

zhou zhiheng — 2021/10/12 11:09:24

Objective To explore the expression of LncRNA-ENST00000414355 in serum, and to investigate relationship of LncRNA-ENST00000414355 and essential hypertension and its’ risk factors. Methods 360 patients with hypertension were selected as case group and 360 healthy people were selected as control group by 1:1 matching method. The clinical information and blood samples of all the objects were collected, and the blood biochemical index and the expression of LncRNA-ENST00000414355 in serum were detected by RT-qPCR. Results: The expression of LncRNA-ENST00000414355 of serum was markedly up-regulated in patients with hypertension comparing with the healthy volunteers’(7.154±0.868 vs 1.147±0.451, P < 0.01）. There were positive correlation between the expression of LncRNA-ENST00000414355 and the systolic pressure（r=0.547,P<0.001）, diastolic blood pressure(r=0.418,P<0.001）,BMI（r=0.517，P<0.001）, TC（r=0.681,P<0.001）, LDL（r=0.714,P<0.001）. Multiple Logistics regression analyses showed that smoking (OR=2.231), BMI(OR=1.994), TC(OR=1.278) and LncRNA-ENST00000414355(OR=2.057) were the main risk factors for hypertension. Conclusion: Results indicated that serum LncRNA-ENST00000414355 level up-regulated in primary hypertension，which were correlated with blood pressure and blood lipid in hypertension patients. LncRNA-ENST00000414355 may be a potential new molecular marker for primary hypertension.

3D printing of lumbar nerve root variation model to simulate the change of the area of kambin triangle

黄国秀,江建中,罗翔,谢兆林 — 2021/10/12 11:07:54

Objective: To explore the application value of 3D printed LumbarSnerveSroot anomalies model in the area change of the kambin triangle in the Percutaneous transforaminal endoscopic discectomy.

Clinical analysis of 47 cases of abdominal wall endometriosis

Ma Lanfang — 2021/10/12 11:06:13

：Objective To investigate the clinical features and management of abdominal wall endometriosis (AWE). Methods The data of 47 cases of AWE receiving surgical treatment from January 2015 to December 2020 in the Guiyang Maternity and Child Health Care Hospital were retrospectively analyzed and summarized. Results Mean age of cases was ( 32.17 ± 4.45) years. Each patient had undergone caesarean section. 32 cases (68.09%) had cesarean section once, 15 cases (31.91%) had cesarean section twice. 16 patients (34.04%) received cesarean section in our hospital, and 31 patients (65.96%) received cesarean section in other hospitals. There were 43 cases (91.49%) with transverse incision and 4 cases (8.51%) with longitudinal incision. The mean incubation period of AWE was 34.98±25.34 months. 37 cases (78.72%) complained pain symptoms and all patients complained presence of a mass. The location of mass was mostly on the left and right sides of the transverse incision of cesarean section, accounting for 82.98%. 42 cases (89.36%) had lesions detected by B ultrasound examination. The average value of CA125 was 23.52±12.81 U/ mL detected in 29 cases. All cases underwent surgical resection of lesions. The mean diameter of the resected lesion was 2.55±0.85 cm. The locations of the lesions during surgery were found invading the muscular layer and the fascia layer in 72.34%. During follow-up period, 6 cases recurred, and the postoperative recurrence rate was 12.77%. Conclusion AWE has typical clinical presentation,and a combination of history and B ultrasound examination could detect AWE easily. Complete resection is the primary treatment for AWE, the key to the treatment of this disease is to remove the lesion thoroughly during operation. Iatrogenic AWE should be prevented. Standardized management mode and close follow-up can be established after operation.

A qualitative study on the real experiences of patients with low intention to use heart failure mobile medical application/LAN Chunhan,QIU Xiaoqin, SHEN Mao,XIAO Xi ,LI Jinlian

蓝春晗,lijinlian,qiuxiaoqin,xiaoxi — 2021/9/13 17:01:31

Objective To explore the real feelings and the reasons of patients with low intention to use heart failure mobile medical app providing the basis for improving app strategies. Methods 11 patients who stopped using app in the middle of the study were interviewed in a semi-structured way, and Colaizzi"s seven step analysis was used to analyze the data. Results the five themes of social demography, personal innovation, perceived ease of use, limited perceived usefulness and negative psychological experience were analyzed. Conclusion medical staff should regularly review and test the experience of patients with heart failure using mobile medical platform, improve user experience from system operation, interface design, information support and other aspects, improve the professionalism and accuracy of mobile medical app, strengthen health education of patients, so as to improve the willingness to use, and better implement out of hospital management of patients with heart failure based on mobile medical.

Observation on the effect of invasive mechanical ventilation combined with budesonide vibrating sieve atomization inhalation in the treatment of infant with severe pneumonia

qingkunli — 2021/9/13 17:00:45

[Abstract]Objective: To investigate the effect of invasive mechanical ventilation combined with budesonide vibrating sieve atomization inhalation on infants and young children with severe pneumonia. Methods: A total of 180 infants with severe pneumonia were randomly divided into control group and intervention group, 90 cases in each group. Both groups were given conventional treatment, in which, the control group was given atomization inhalation of 3ml-0.9% sodium chloride solution,twice a day;the intervention group was given budesonide 1ml dissolved in 2ml normal saline, using vibrating sieve, twice a day. Both groups continued treatment for 7 days. The changes in sputum viscosity, blood oxygen saturation, blood gas indicators, ventilator monitoring indicators during atomization, mechanical ventilation time and hospitalization time in children's intensive care unit (PICU) were compared between the two groups. Results: after 7 days of treatment, the improvement of sputum viscosity in the intervention group was better than that of the control group. The oxygen partial pressure and blood oxygen saturation were significantly higher than those of the control group, and the carbon dioxide partial pressure was significantly lower than that of the control group. The differences were statistically significant, both P<0.05; The mechanical ventilation time and PICU hospitalization time in the intervention group were shorter than those in the control group, both P<0.05; Compared with this group before atomization, the effect of vibrating sieve atomizer on children with mechanical ventilation was less. There was no significant difference in tidal volume, respiratory frequency and airway peak pressure before and during atomization (P > 0.05). Conclusion: the effect of invasive mechanical ventilation combined with budesonide vibrating sieve atomization inhalation on infants with severe pneumonia is significant, which can effectively improve the sputum viscosity, reduce the inflammatory reaction, and shorten the duration of mechanical ventilation and PICU in children. [Key words] Budesonide；Invasive mechanical ventilation; Puerpera；Shaker hole atomization；Infants and young children.

Simultaneous determination of emodin and chrysophanol in Hemorrhoids Fistula Lotion by HP LCMENG Li-bin,PAN Hong-ping. Department of Pharmacy, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021,China

蒙丽斌, — 2021/9/13 16:36:30

[ ] Objective To establish a method for the simultaneous determination of emodin and chrysophanol in Hemorrhoids Fistula Lotion by high-performance liquid chromatography (HPLC) and to provide the basis for the quality evaluation of the preparation. Methods The contents of emodin and chrysophanol in Hemorrhoids Fistula Lotion were simultaneously determined by HPLC. A chromatographic column of Eclipse XDB-C18　(4.6mm×250mm,5μm ) was used. Methanol-0.1% phosphoric acid aqueous solution (80：20,V/V) was used as mobile phase at a flow rate of 0.8 ml/min, and the detection wavelength was set at 540nm. The column temperature was 25 ° C and the injection volume was 10 μ L. Results There was a good linear relationship between emodin injection volume and its peak area in a range of 0.82～4.09μg (R=0.9999), and there was a good linear relationship between chrysophanol injection volume and its peak area in a range of 2.37～19.72μg (R=0.9999), with the average recovery rates of emodin and chrysophanol being 98.80% and 102.5% respectively, and the relative standard deviations ( RSD) of emodin and chrysophanol being 0.19% (n=6) and 0.02% (n=6) respectively. Conclusion The method has the advantages of simple operation, accuracy, good recovery rate, high precision and good repeatability, and rapid analysis. It can be used for the quality control of Hemorrhoids Fistula Lotion.

The expression of GOLPH3 and VEGF in lung adenocarcinoma and the clinical significance

ZANG Zhiyi — 2021/9/13 16:35:14

Objection: To explore the expression and clinical significance of Golgi phosphoprotein 3 (GOLPH3) and vascular endothelial growth factor (VEGF) in lung adenocarcinoma.Methods: The clinicopathological data of 66 patients with lung adenocarcinoma who underwent surgical treatment from January 2015 to June 2017 in the Department of Thoracic Surgery, Wuxi Clinical College of Anhui Medical University, were collected to analyze the relationship between the expression of GOLPH3 and VEGF and clinicopathological data and patient prognosis.Results: The positive expression rate of GOLPH3 and VEGF in lung adenocarcinoma tissue was significantly higher than that in adjacent tissues (P＜0.05). COX regression analysis showed TNM staging (HR=2.110, 95%CI=1.048-4.250, P＜0.05), high expression of VEGF (HR=2.136, 95%CI=1.039-4.391, P＜0.05) and high expression of GOLPH3 (HR =2.239, 95%CI=1.075-4.661, P<0.05) is an independent risk factor affecting patient survival.Conclusion: The high expression of GOLPH3 and VEGF in lung adenocarcinoma may promote tumor development and metastasis, and suggest a poor prognosis. TNM staging, high expression of VEGF and high expression of GOLPH3 are independent risk factors that affect the survival rate of patients.

Analysis of the effect of pharmaceutical intervention in the rational use of traditional Chinese medicine injection

许琳, — 2021/9/10 16:59:11

Objective To explore the effect of pharmaceutical intervention in the rational use of traditional Chinese medicine injection. Methods From January 2019 to December 2019, 160 patients who need traditional Chinese medicine injection in the hospital were randomly divided into the observation group and the control group, 80 cases in each group. The control group was treated with traditional Chinese medicine injection, and the observation group increased pharmaceutical intervention on the basis of traditional Chinese medicine injection. The rationality of drug use, hospitalization cost, traditional Chinese medicine injection cost, DDDs and adverse reactions were compared between the two groups. Result There were significant differences between the two groups (P < 0.05). The cost of hospitalization, traditional Chinese medicine injection and DDDs in the observation group were significantly lower than those in the control group (P < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion Pharmaceutical intervention can improve the rational use rate of traditional Chinese medicine injection, reduce the cost of treatment, and improve the safety of drug use, which is worthy of clinical promotion.

Analysis of clinical efficacy of intravenous gamma globulin in children with typical and incomplete Kawasaki disease

何丽影 — 2021/9/10 16:58:21

Objective To investigate the clinical efficacy of intravenous gamma globulin in the treatment of children with typical and incomplete Kawasaki disease. Methods A total of 86 children with Kawasaki disease admitted to our hospital from February 2018 to May 2020 were selected and divided into two groups according to the type of disease. 52 cases of incomplete Kawasaki disease were set as the incomplete group, and 34 cases of typical Kawasaki disease were set. For the typical group, the two groups of children were treated with intravenous gamma globulin + oral aspirin on the basis of conventional treatment. The hospitalization time, clinical symptoms improvement time, blood indicators, and incidence of coronary artery disease were compared between the two groups. Results The incomplete group’s hospitalization time, mucosal congestion subsided, lymph node swelling improvement time, antipyretic time, rash subsiding time, hand and foot swelling subsiding time were shorter than the typical group, and there were statistical differences (P<0.05); blood indicators before treatment between the two groups , Compared with the incidence of coronary artery disease, there is no statistical difference (P>0.05). After treatment, the C-reactive protein (CRP), platelets, white blood cells, erythrocyte sedimentation rate, and the incidence of coronary artery disease in the incomplete group are lower than those of the typical group. There are statistics Academic difference (P<0.05). Conclusion The effect of intravenous gamma globulin in the treatment of children with incomplete Kawasaki disease is better than that of children with typical Kawasaki disease. It can shorten the clinical improvement time and hospital stay, improve blood indicators, and reduce the incidence of coronary artery disease.

Observation of curative effect of Ultrasonic atomization with heat and oxygenation in acute exacerbation of chronic obstructive pulmonary disease

chencaiming — 2021/9/10 16:57:26

Objective To investigate the effect of Ultrasonic atomization with heat and oxygenation in acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods From April 2018 to August 2019, 60 cases with AECOPD were randomly divided into the control group and the study group,30 cases in each group. The control group received traditional oxygen atomization, while the study group received ultrasonic atomization with heat and oxygenation. The chronic obstructive pulmonary disease assessment test (CAT), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), FEV1%pred were analyzed. Result Before treatment,there was no significant difference between the two groups of CAT, PaO2, PaCO2, and FEV1%pred (P>0.05). After treatment, the CAT and PaCO2 of the study group were lower than the control group, and PaO2, FEV1%pred of the study group were higher than the control group. The difference was statistically significant (P<0.05). Conclusions Implement of ultrasonic atomization with heat and oxygenation for the patients with AECOPD can increase clinical efficacy.

Effect of cerebral collateral circulation on prognosis of the patients with intravenous thrombolysis HUANG Guang-jian, GAO Wen, QIN Hui-xun,et al. Department of Neurology,The People^’s Hospital of Liuzhou,Liuzhou, Guangxi Zhuang Autonomous Region 545006,China

2021/9/10 16:56:28

Objective To use the DSA to evaluate the cerebral collateral circulation and analyze its effect on prognosis of the patients with acute ischemic stroke treated with intravenous thrombolysis. Methods The clinical data of 121 patients enrolled in the stroke center of our hospital from January 2018 to December 2019 who received intravenous thrombolysis therapy and DSA examination were collected and analyzed. According to the DSA results, the patients were divided into two groups: the good collateral circulation compensation (53 cases,grade 3-4) and the poor collateral circulation compensation (68 cases,grade 0-2). Results The volume of cerebral infarction in the group with good collateral circulation compensation was significantly smaller than that in the poor group (p＜0.05), and the complications of hemorrhage after thrombolysis were also lower in the good group (p＜0.05). Compared with those before thrombolysis, the NIHSS scores in the two groups were significantly reduced assessed after thrombolysis at7 days、3 months and 6 months (all p＜0.05). Also,the ADL scores of patients in both groups were significantly increased at 7 days, 3 months and 6 months after thrombolysis (all p < 0.05). Compared with the group with poor collateral circulation compensation, the NIHSS scores of the good group assessed before thrombolysis and after thrombolysis at 7 days、3 months and 6 months were significantly lower than the poor group (all p < 0.05).Meanwhile, the ADL scores of the good group assessed before thrombolysis and after thrombolysis at 7 days、3 months and 6 months were significantly higher than the poor group (all P < 0.05). Conclusion Collateral circulation has an important influence on the efficacy and prognosis of intravenous thrombolysis in patients with acute cerebral infarction. And the good collateral circulation can significantly improve the patients’ prognosis.

Correlation between galectin-3 and the new onset of atrial fibrillation in patients with acute myocardial infarction during hospitalization

liqingkuan,, — 2021/9/10 16:55:25

[ABSTRACT] Aim:This study was designed to investigate the correlation between serum galectin-3 (Gal-3) levels and the new onset of atrial fibrillation in patients with acute myocardial infarction(AMI). Methods: This study included 30 patients who developed new onset atrial fibrillation after AMI.Thirty patients that who don’t devoloped new onset atrial fibrillation after AMI were recruited as control group.General clinical datas of all the subjects were collected,the concentration of serum Gal-3,N-terminal Pro-B-Type?Natriuretic?Peptid(NT-proBNP) were assayed.And the left atrial diameters were dectected by Ecocardiography.Results:The levels of serum Gal-3 were significantly higher in patients who developed the new onset atrial fibrillation afte AMI than the patients in control group (P＜0. 05).Serum Gal-3 levels were positively correlated with NT-proBNP and the left atrail diameters (all P＜0. 05).Logistic regression analysis showed that high plasma levevl of Gal-3(OR=2.72,95% CI:1.33-5.54)was risk factor for new-onset AF.Conclusion: The level of serum Gal-3 is closely related to the new onset of AF in patients with AMI during hospitalization,and may be used as a predictor of atrial fibrillation in patients with AMI.

Etiological composition and trend of metabolic-abnormalities in 5773 hospitalized patients with hypertension

Liu Yuping,,,, — 2021/9/10 16:54:26

Objective To analyze the etiology, composition and general trend of hypertension patients hospitalized in the first Affiliated Hospital of Guangxi Medical University from 2013 to 2018, and to provide reference for the prevention and treatment of hypertension. Methods The age, sex, etiology and metabolic abnormality of hypertensive patients in the first Affiliated Hospital of Guangxi Medical University from January 2013 to October 2018 were analyzed retrospectively. Results (1) There were 5773 patients with hypertension, including 4376 cases of primary hypertension (75.8%) and 1397 cases of secondary hypertension (24.2%). (2) Among the 1397 cases of secondary hypertension, primary aldosteronism accounted for the highest proportion (46%). (3) The patients with high TG, low HDL, mixed hyperlipidemia, abnormal blood glucose metabolism and obesity in the primary hypertension group were higher than those in the secondary hypertension group (P<0.05). Conclusion (1) Essential hypertension is still the main cause of hypertension, but secondary hypertension occupies an important proportion, and hypertension often has multiple metabolic abnormalities, and should be routinely screened and early intervention. (2) Primary aldosteronism has the highest detection rate in the secondary hypertension group. For patients with hypertension, hypokalemia, and adrenal gland occupation, we should be alert to the possibility of primary aldosteronism.

Clinical Features of Pediatric Crohn

Ruofei Gao,Yaqiong Guo,Jing Yu — 2021/9/10 16:53:18

Objective: To evaluate the Clinical Features of crohn's disease with perianal disease in children. Methods: The clinical data of thirty-eight children diagnosed with crohn's disease and met the inclusion criteria in our hospital from January 2015 to January 2020 were retrospectively analyzed. The enrolled patients were divided into the perianal disease group and the non-perianal disease group . Records included the general information of children, perianal lesions and other complications, laboratory examinations, imaging examinations, endoscopy,PCDAI and other information. Results: the incidence of perianal lesions was 39.5% (n = 15), the ratio of male and female was 4:1; the average age of diagnosis was (9.32 ± 4.44) years old, which was less than that of patients without perianal lesions (12.33 ± 1.47) years old（P=0.048）; The alb of perianal lesion group was significantly lower than that of non perianal lesion group（P=0.031）. Conclusion: young male CD children are more likely to have perianal lesions, and the nutritional level of children with PD is significantly lower.

Clinical analysis of treatment of branchial Fistula or cyst by endoscopic electrocauterization or fistulectomy

李荣荣 — 2021/9/10 16:51:52

【Abstract 】 Objective: To retrospectively analyze and compare the efficacy and safety of traditional neck lymphadenectomy and electrocautery or fistulectomy for branchial fistula or cyst. Methods: The clinical data of 20 patients with branchial fistula or cyst infection from March 2018 to April 2021 in our department were collected. The time of operation and the amount of intraoperative bleeding were analyzed statistically, the effectiveness and safety of surgical treatment was evaluated, and postoperative complications and recurrence were followed up by telephone. Results: There was no significant difference between the two groups (p = 0.343, p = 0.812) in duration of illness and number of previous treatments time. The operation time of traditional operation group and endoscopic operation group were 66.60 ± 113.4031 and 75.30 ± 46.5834, p = 0.048, the difference was statistically significant. The mean value of intraoperative bleeding was 48.20 ± 56.8640 and 6.20 ± 4.9621, p = 0.022, the difference was statistically significant. The time of stay at hospital was 14.70 ± 5.8510 and 13.40 ± 3.9497, respectively, p = 0.224. There was no significant difference between them.During follow-up of 20 cases, 1 case recurred in Open Operation Group and 1 case had postoperative infection in endoscope-assisted Operation Group. Conclusion: Electric coagulation and cauterization or fistulectomy combined with electronic gastroscopy is effective in the treatment of branchial fistula or cyst infection. Compared with traditional neck lymph node dissection, it can significantly shorten the operation time and reduce intraoperative bleeding.

Research progress of Invasive Micropapillary Carcinoma in BreastLi Qiu-yun,Qin Yan,Yang Hua-wei,Department of Breast Surgery,Guangxi Medical University Cancer Hospital,Nanning 530021,China

LiQiuYun, — 2021/9/10 16:50:13

Invasive micropapillary carcinoma of the breast (IMPC) is a rare subtype of breast cancer, accounting for about 3.0%-8% of breast cancers. Although the disease is well understood by pathologists in China, IMPC still faces some problems in clinical practice. Because of its rarity, there is no standard treatment strategy internationally, but given its high rate of vascular invasion and lymph node metastasis as well as its high local recurrence rate, more and more scholars are exploring its pathological mechanisms and treatment options. A brief review of the current status of research on the clinicopathological features and prognostic factors associated with invasive micropapillary carcinoma of the breast is presented.

Current status of surgical treatment of secondary hyperparathyroidism

Liang Bin, — 2021/9/10 16:46:19

Secondary hyperparathyroidism (SHPT) is a common complication with high incidence in patients with end-stage chronic kidney disease. Patients with advanced SHPT often develop drug resistance and require surgical treatment. Surgery can significantly relieve symptoms such as bone pain and skin itching in SHPT patients. It can also improve physical and mental health, improve quality of life, and reduce disease-related mortality. The mainly surgical methods of SHPT include total parathyroidectomy, subtotal parathyroidectomy, total parathyroidectomy with autotransplantation and so on, but there is no consensus on the choice of various surgical methods. Based on the domestic and foreign literature, this paper summarizes the current status of surgical treatment of SHPT in order to provide reference for clinical practice.

Research progress of non-coding RNA in gout

蒋雅琼,康龙丽,刘晓丽,马福才,杨丽华,杨旭 — 2021/9/10 16:41:11

Non-coding RNA (ncRNA) have been shown to play an important role in normal physiological processes and diseases. In recent years, ncRNA related studies have been extremely hot. NcRNAs have been shown to be involved in the regulation of various inflammatory diseases. and can be used as biomarkers for disease diagnosis and prognosis. Gout is a common inflammatory joint disease. In this paper, the current research progress of ncRNA in gout is reviewed. MiRNA and lncRNA may play a role in regulating the pathogenesis of gout through a variety of pathways, and targeting ncRNA may be an effective strategy for the treatment of gout.

Risk factors of liver injury after cardiopulmonary bypass

fujiayu — 2021/9/10 16:31:59

Cardiopulmonary bypass (CPB) is the guarantee of cardiac surgery. It can provide a relatively bloodless surgical field for the operator. At the same time, the visceral blood flow will be reduced. Ischemia and hypoxia of important organs will lead to systemic inflammatory reaction, in which liver injury can not be ignored.Objective to find the best way to reduce liver injury by analyzing the risk factors of perioperative patients.

A case report of acute perforation caused by DENALI? inferior vena cava filter

崔安明 — 2021/9/10 16:26:57

Deep vein thrombosis of the lower extremities is common in elderly patients with long-term bed rest and trauma. In the acute stage, emboli are prone to fall off to the pulmonary artery to form pulmonary embolism, which is life-threatening. In addition to anticoagulation and thrombolysis, clinical treatment often takes the inferior vena cava The filter is inserted to prevent pulmonary embolism. The technique of inferior vena cava filter implantation is mature, but in actual operation, related risks can still occur, and even serious complications can occur.

A novel compound heterozygous mutation of the CLCNKB gene in an adult with classic Bartter syndrome

Chen Yanni,Feng Changmei,Zhang Haibin — 2021/9/10 16:25:00

The clinical data of patient with classic Bartter syndrome（BS）were retrospectively reviewed，and genetic testing was performed in the patients and her parents. CLCNKB c.1093delC+c.877G>A was found to be a new compound heterozygous mutation novel mutation in CLCNKB gene，which may lead to the occurrence of classic Bartter syndrome.

Clinical study of double-incision triple surgery on primary angle-closure glaucoma with cataract

刘曦 — 2021/9/10 16:19:37

To analyze the clinical effects of double-incision triple surgery on primary angle-closure glaucoma with cataract. Methods The clinical data of 112 patients undergoing surgical treatment in our hospital due to primary glaucoma with cataract from August 2017 to August 2019 were included for retrospective analysis. The patients were grouped according to different surgical methods, of which 62 cases (67 eyes) were given triple surgery of double-incision phacoemulsification + aspheric intraocular lens implantation + trabeculectomy and were included in observation group, and 50 cases (54 eyes) were given triple surgery of single-incision phacoemulsification + aspheric intraocular lens implantation + trabeculectomy and were included in control group. The visual acuity and intraocular pressure (best corrected visual acuity, intraocular pressure value), central anterior chamber depth and angle opening degree, average area and average density of corneal endothelial cells, postoperative filtering bleb formation and occurrence of complications were compared between the two groups before surgery and at 3 months after surgery. Results At 6 months after surgery, the uncorrected visual acuity and best corrected visual acuity in the two groups were improved compared with those before surgery (P<0.05) while the intraocular pressure was decreased compared with that before surgery (P<0.05), but there were no statistical difference between the two groups after surgery (P>0.05). The central anterior chamber depth and angle opening degree in the two groups were higher than those before surgery (P<0.05), and the two indexes in observation group were higher than those in control group (P<0.05). The average area of corneal endothelial cells in the two groups was increased compared with that before surgery, but the area in observation group was lower than that in control group, and the average density was decreased compared with that before surgery, but the density in observation group was higher than that in control group (P<0.05). The functional filtering bleb formation rate in observation group was higher than that in control group (P<0.05), and there were no statistically significant differences in the incidence rates of postoperative complications between the two groups (P>0.05). Conclusion Single-incision and double-incision procedures for triple surgery of primary glaucoma with cataract both are safe and effective. However, double-incision triple surgery can reduce the loss of corneal endothelial cells and is more conducive to the formation of postoperative functional filtering bleb.

Serum NLR, PCT and lactate acid levels in prediction clinical risk scales of community-acquired pneumonia

曾笑寒 — 2021/9/10 16:18:26

[Abstract]Objective To calculate neutrophil count/lymphocyte count (NLR), detect serum procalcitonin (PCT) and lactate acid levels in patients diagnosed with community-acquired pneumonia (CAP). A CURB65 score was used for stratified assessment of disease risk in CAP patients within 24 hours after admission. Methods According to the CURB65 score, 282 patients with clinical diagnosis of CAP were included. Blood samples were collected and detected, NLR value was calculated. At the same time, peripheral blood PCT and lactate acid levels were detected. The Chi-square test or Fisher’s exact tests were used to compare categorical variables.The Student t test was used for continuous variables. Nonparametric test Mann Whitney U test was used to analyze the results of NLR, PCT and lactic acid levels, Categorical variables are presented as average (interquartile range) [M (P25～P75 )] . The correlation between the two variables was analyzed using pearson’s correlation. A receiver operating characteristic curve (ROC) was used to compare the diagnostic efficacy of NLR, PCT, and lactic acid, and the area under the curve (AUC) was used to judge the diagnostic effect. All test results were detected with P<0.05 as statistically significant. Results The results of NLR, PCT and lactic acid in patients with high-risk of CAP were higher than those in low-risk patients, and the differences were statistically significant (all of P values were <0.001). NLR, PCT and lactic acid had a good correlation with CURB65 score (all of P values were <0.001). The three indicators had a good prediction effect on the disease risk of CAP. PCT is the best independent predictive factor. A 1.25 ng/ml was the best cutoff value of PCT to predict the risk scale of CAP, the AUC was 0.948. The sensitivity and specificity were up to 84.4% and 94.3%, respectively. Conclusions NLR, PCT and lactic acid are good biomarkers to predict the risk stratification of CAP, among them PCT is the best indicator.

Efficacy of ultrasound-guided radiofrequency ablation in the treatment of arthrogenic low back pain

邓致远,杨帆 — 2021/9/10 16:16:57

[Abstract] Objective: To investigate the clinical effect and effectiveness of ultrasound-guided radiofrequency ablation in the treatment of lumbar arthrogenic low back pain. Method: 60 patients with lumbar arthrogenic low back pain were randomly divided into control group (30 cases) and treatment group ( 30 cases). The control group was treated with nerve block of spinal never for low back pain. The treatment group was treated with ultrasound-guided radiofrequency ablation of spinal never for low back pain. VAS score and Oswestry Disability Index (ODI) score were recorded before treatment and after 24 h, one week, one month and three months of treatment . The curative effect of the two groups was compared after 6 months of treatment . Results: Before and after 24h of treatment, VAS score and ODI score of control group and treatment group decreased significantly (P < 0.05). But one week, one month and three months after operation, VAS score and ODI score of treatment group were significantly lower than those of control group (P < 0.05). After 6 months, the excellent and good rate of treatment group was 83.33% , which was significantly higher than 30% in control group (P < 0.05). Conclusions: Ultrasound-guided radiofrequency ablation of the posterior branch of lumbar spinal nerve has a good effect in the treatment of lumbar arthrogenic low back pain, and it is worthy of clinical application.

the CT manstetation of different conditions

黄耀 — 2021/9/10 16:15:29

objectives：To discuss the relationship between CT features and immune conditions in patients with pulmonary cryptococcosis. Methods: We retrospectively reviewed CT findings of 48 patients with pulmonary cryptococcosis, including 23 immunocompetent and 25 immunocompromised patients. The lesion distribution,classification and accompanied signs between two groups were compared, the clinical findings and contact history besides.Results: Cough and expectoration were common physical signs of lung and fever was more in immunocompromised group.The distribution of lesions was predominately peripheral in immunocompetent group, while the distribution of lesions was predominately peripheral and diffuse in immunocompromised group. Nodules or masses were more common in immunocompetent group while consolidations or mixed lesions were more common in immunocompromised group.In accompanied signs,halo sign, air bronchogram and cavity were more common in pulmonary cryptococcosis. Conciusions: The CT findings of pulmonary cryptococcosis were closely related to immune status.But there were some similarities in nodule margin、enhancement manners and so on.Recognition of these similarities and diffierences is helpful to early diagnosis of pulmonary cryptococcosis.

Research Progress on the Correlative Mechanism of Serum Magnesium Level and Depression

dingyameng,yuanbo — 2021/8/6 17:02:08

Magnesium is one of the important cations in the human body, which it not only plays an important role in human metabolism and nerve conduction, but also a key role in regulating the biochemical changes of the brain, Magnesium levels can affect several neural pathways related to the development of depression. When the body is deficient in magnesium, a series of personality changes can appear, including cold, depression, irritability, confusion, anxiety and mental disorders etc. Studies had confirmed that the supplemental magnesium can improve depression, alleviate anxiety and emotions, but the mechanisms of serum magnesium how to affect people's emotional are unclear. In recent years, the relationship between serum magnesium levels and depression research has been poured out. Therefore, this review aims to discuss the present situation and progress of related research.

Research progress of Non-tuberculous mycobacterial Pulmonary disease

Jin Cong — 2021/8/6 16:56:37

In recent years，the global prevalence of non‐tuberculous mycobacteria（NTM）disease has been increasing. NTM disease has become a common disease and a public health problem that threatens human health.NTM mainly involves the lung, NTM pulmonary disease lacks specific clinical symptoms and signs, and it is difficult to distinguish it from other diseases. Many clinicians often ignore the existence of NTM pulmonary disease,which is prone to misdiagnosis or missed diagnosis. In order to improve the clinical diagnosis and treatment of NTM pulmonary disease, this article reviews the definition, epidemiology and risk factors, pathogenesis and pathological changes, diagnosis，treatment and prevention.

Epidemiological characteristics of trauma patients in emergency departmentLi zhe,Lv liwen,Shen yin

li zhe — 2021/8/5 10:54:03

［］　Objective　 To explore the epidemiological characteristics of emergency trauma patients and provide scientific basis for trauma prevention and treatment. Methods　 From January 2016 to January 2020, the data of trauma patients treated in the emergency department of Guangxi Zhuang Autonomous Region People"s hospital were collected, and the gender, age, time, location, mechanism and severity of the patients were analyzed. Results　In this study, a total of 5012 trauma patients were collected, including 3570 males (71.2%) and 1442 females (28.8%). The time of trauma was unevenly distributed in different months. In October, the incidence of trauma was more, accounting for 9.4%. At least 1853 cases (36.97%) of limbs and pelvis, 1003 cases (20.01%) of head and neck, 877 cases (17.5%) of chest and 778 cases (15.52%) of abdomen, 501 cases (10.00%) of facial injuries were mainly caused by head and neck injuries, and 1936 cases (38.63%) were traffic injuries. Conclusion The epidemiological characteristics of the emergency trauma patients in this area are that young and middle-aged men are more common, the proportion of the wounded is the highest in October every year, traffic injury is the main cause of injury and the main cause of death of the emergency trauma patients

Effects of Kangai injection combined with chemotherapy on immune function and quality of life in patients with lung squamous cell carcinoma

HUANG Zhong,LI Shujun,LIN Yanming,LIU Meilian,PENG Xiaoxia — 2021/8/4 8:36:30

Objective To investigate the effect of Kang'ai injection combined with chemotherapy on immune function and quality of life in patients with advanced lung squamous cell carcinoma. Methods 94 patients with advanced lung squamous cell carcinoma in the affiliated Hospital of Guangdong Medical University from July 2017 to October 2020 were randomly divided into control group (n=45) and observation group (n=49).The control group received cisplatin plus gemcitabine chemotherapy.The observation group were treated with Kang'ai injection on the basis of the control group. The clinical efficacy, T cell count, quality of life score and adverse reactions of chemotherapy were compared between the two groups. Results After treatment, the objective response rate of the observation group was significantly higher than that of the control group(P <0.05).The disease control rate of the observation group was higher than that of the control group, but there was no significant difference(P >0.05).The KPS scores of the observation group were significantly higher than that of the control group after treatment(P <0.05).The total number of T lymphocytes, absolute value of T helper cells and absolute value of T suppressor cells in the observation group were significantly higher than that in the control group(P <0.05).The incidence of adverse reactions in the observation group was lower than that in the control group, there was significant difference in the incidence of nausea and vomiting, thrombocytopenia and leukopenia (P <0.05), but there was no significant difference in the incidence of liver function damage, rash and fever(P >0.05). Conclusion Kang'ai injection combined with chemotherapy may improve the immune function and quality of life of patients with advanced lung squamous cell carcinoma.It may reduce adverse reactions, thus improve the clinical efficacy ,which may be worthy of clinical promotion.

Clinical application of in vivo confocal microscopy in evaluating the morphological changes of corneal nerves in type 2 diabetic patients

CHEN Li-fei,CHEN Qi,HUANG Hui,SHEN Chao-lan — 2021/8/4 8:32:15

［］ Objective To explore the clinical application of vivo confocal microscopy in evaluating the morphological changes of corneal nerves in type 2 diabetic patients. Methods 180 patients with type 2 diabetes were selected as the experimental group. Among them, 90 patients with non-diabetic retinopathy (NDR) had 90 eyes (NDR group), and 90 patients with diabetic retinopathy (DR) had 90 eyes (DR). Group), compared with 90 eyes of 90 cases of normal control group.Using in vivo confocal microscopy (IVCM) HRT-Ⅲ (Heidelberg Retina Tomograph -Ⅲ) to measure the corneal central nerve fiber of all subjects. Corneal nerve fiber density( CNFD), corneal nerve branch density (CNBD), and corneal nerve fiber length (CNFL) were tested to compare and analyze the differences among the three groups . Results The density of corneal nerve fibers in the NDR group was (20.1±5.1) n/mm² and that in the DR group was (15.7±4.6) n/mm². The density of corneal nerve fibers in both groups was lower than that in the normal control group ( 27.36±9.8)n/mm² ( P＜0.05); the nerve branch density of the NDR group is (21.2±9.8)n/mm², the nerve branch density of the DR group is (16.6±9.8)n/mm², both groups The density of corneal nerve branches was lower than that of the normal control group (27.9±12.1) n/mm² (P＜0.05); the nerve fiber length in the NDR group was (12.3±4.7) mm/mm², and that of the DR group The length of nerve fiber was (9.9±4.5) mm/mm², which was lower than that of the normal control group by (15.1±4.3) mm/mm² (P<0.05); among diabetic patients, corneal nerve fiber density in DR patients , nerve branch density, and nerve fiber length were all lower than those of NDR patients (all P<0.05). Conclusion Confocal corneal microscopy can quickly, non-invasively and accurately detect the early changes of corneal nerve fibers in diabetic patients, and can provide objective scientific evidence for the prevention and intervention of diabetic nephropathy or diabetic retinopathy.

1 case of pregnancy with ring peritoneal and literature review

佘娟, — 2021/8/4 8:31:05

Retroperitoneal pregnancy is a very rare ectopic pregnancy, which is easily missed and misdiagnosed clinically. A retrospective analysis of the clinical data of a patient with retroperitoneal pregnancy admitted to the gynecology department of our hospital and a review of relevant literatures were conducted to summarize the pathogenesis, clinical characteristics and treatment of retroperitoneal pregnancy.

Primary cryoglobulinemia with renal injury in thrombotic microangiopathy ：A case report and literature review

Cai Xiao-yue,Huang Cui-ping,Yan Huai-rong,Yang Mei — 2021/8/4 8:30:32

Primary croglobulinemia is a rare disease.The common pathological type of renal injury is membranous proliferative glomerulonephritis Primary cryoglobulinemia with thrombotic microangiopathy is even rarer. A case of recurrent cutaneous purpura was diagnosed as primary cryoglobulinemia complicated with renal injury in thrombotic microangiopathy.Combined with the literature review in order to improve awareness of the disease.

EEG monitoring was used to evaluate the prognosis of patients withcoma after the operation ofcerebralhemorrhage???? Deng Chun-yan,Wang Yu-tao,Liu jiang,Zhang yun-dong,Guo Yang-jun,Neurological Disease Center, the Third Affillated Hospital of CQMU, Chongqing 401120

deng chun yan,,, — 2021/8/4 8:29:28

Objective To investigate the relationship between the EEG characteristics and prognosis of patients with?coma after the operation of?cerebral?hemorrhage, so as to provide a new reference method for early prognosis. Methods: Collected patients with supratentorial spontaneous intracerebral hemorrhage with coma within 72 hours,and performed hematoma removal surgery in the Intensive Care Unit of the Department of Neurological Diseases in the Third Affiliated Hospital of CQMU from April 2016 to April 2020, the clinical prognosis of patients after 90 days followed-up, all patients recorded the clinical data and monitored EEG after 14 days, using single factor to analysis the clinical data and the relationship between brain electrical characteristics and prognosis. Results: GOS-E score of postoperative cerebral hemorrhage after 90 days was not related to age, sex, risk factors, the position of hematoma , but was related to larger hematoma volume (≥51 ml) and lower GCS score. The good prognosis of EEG had a higher GOS-E score at 90 days follow-up, while the patients with EEG response and EEG sleep wave had a higher GOS-E score at 90 days follow-up. Conclusion: EEG is an objective indicator to predict the prognosis of patients with coma after the operation of cerebral hemorrhage. It is still necessary to explore the specific EEG activities after brain injury, so as to more accurately predict the prognosis of patients with?coma after the operation of?cerebral?hemorrhage。

The application of single port laparoscopic total hysterectomy in benign uterine disease

Chen fuchun,Lin Shuping,Rao Yanyan,Wang fan — 2021/8/4 8:28:58

Objective Through the comparative study of single port laparoscopic hysterectomy(SPL-H) and traditional total laparoscopic hysterectomy(LTH),to explore the effectiveness and safety of single port laparoscopic in the use of hysterectomy for benign uterine diseases. Methods: The clinical data of 80 patients with benign uterine diseases in the Department of Obstetrics and Gynecology of Affiliated Longyan First Hospital of Fujian Medical University,from July 2019 to May 2020 were retrospectively analyzed. The operative measures (operative time, intraoperative blood loss, the 1_^st day VAS pain score after operation, hospital cost, postoperative hospital stay),postoperative complications(introduction of The Clavien-Dindo Classification), were compared. Results: There was no significant differences in regard of intraoperative blood loss , hospital stay, The incidence of clavien-dindo Ⅰ and ⅠI(P>0.05). The operation time of SPL-H group was 139.25±19.03min, which was longer than that of the traditional LTH group 110.13±17.63min, the difference was statistically significant, P<0.05. the 1_^st day VAS pain score after operation in the SPL-H group was 1 (1,2), which was lower than that of the traditional LTH group 2 (1, 3) , P<0.05.the hospital cost in SPL-H group ( 20942(19844.75,22052.5)yuan)was higher than that of in traditional LTH group(19874.5(19236.45,20142)yuan).Conclusions: The application of single port laparoscopic total hysterectomy in benign uterine disease is safe and effective with minimally postoperative wound, the pain is relieved in the mean time. It has a good value in promotion and application.

Effect of single syringe gas liquid exchange on rebleeding after vitrectomy for diabetic retinopathy

Liang Yong-sun,Liu Jiao-lian,Yang Yong,Zhong Xin — 2021/8/4 8:28:09

【Abstract】 Objective To investigate the effect of single syringe gas-liquid exchange in the treatment of rebleeding after vitrectomy for diabetic retinopathy. Methods Thirty patients with vitreous rebleeding after vitrectomy for proliferative diabetic retinopathy were treated with vitreous cavity gas-liquid exchange in sitting or prone position with a single syringe. Visual acuity, lens condition, fundus and intraocular pressure of the patients were observed.Results The postoperative visual acuity of the patients was significantly improved, and the difference was statistically significant (P < 0.01). Conclusion The patients with vitreous rebleeding after vitrectomy for diabetic retinopathy should be treated with intravitreal gas-liquid exchange with a single syringe. The operation is safe and effective.

Screening and diagnosis results analysis of 24384 newborns with short-chain acyl-CoA dehydrogenase deficiency in Zigong

He Yi,Hu Qin,Jin Chao,Ye Qiang — 2021/8/4 8:27:38

: Objective To analyze the incidence of short-chain acyl-CoA dehydrogenase deficiency (SCADD) in newborns in Zigong City, and to explore the clinical characteristics and gene mutation characteristics of the children. Methods Tandem mass spectrometry was used to detect the level of acylcarnitine in fully breastfed newborns 72 hours after birth. Those who were positive in the initial screening and re-examination were analyzed by urine organic acid analysis and high-precision next-generation sequencing (NGS) to confirm the diagnosis. Results A total of 24384 newborns were screened in Zigong City from March 2018 to February 2021, of which 12,713 were males and 11,671 were females. 15 cases were initially positive, and the initial positive rate was 0.062%; 1 child with SCADD was diagnosed The incidence of SCADD was 1/24384; the clinical manifestations of the children were not significantly abnormal. Tandem mass spectrometry showed that the blood butyrylcarnitine (C4) and the ratios of blood butyrylcarnitine (C4) and acetylcarnitine (C2) and propionylcarnitine (C3) were all increased. Gene sequencing of metabolic diseases in this family: it was found that the child had two ACADS gene mutations, one with known mutation c. 1031A>G, one unreported mutation c.293A>G, and SLC22A5 gene c.428C occurred at the same time. >T mutation. ACADS gene c. 293A> G and SLC22A5 gene c. 428C>T mutations were derived from his father, and ACADS gene c. 1031A>G mutations were derived from his mother. Both known mutations are pathogenic mutations. The child took L-carnitine and vitamin B2 daily. After more than a month, the child was given dietary guidance. The follow-up showed no clinical symptoms, and the physical and mental development were normal. Conclusion The incidence of SCADD in Zigong City is 1/24384, which is significantly higher than other regions in my country. Early diagnosis of SCADD children can effectively provide a basis for follow-up clinical treatment and genetic counseling.

Effectiveness of hip joint muscle strength training in patellofemoral pain syndrome patients

李卫星 — 2021/8/4 8:27:05

Objective: To study the effectiveness of hip joint muscle strength training in patellofemoral pain syndrome (PFPS) patients. Methods: 60 PFPS patients treated from June 2018 to June 2019 in our hospital were chosen and grouped by picking method. 30 cases of receiving the physiotherapy were set as reference group; 30 cases of receiving the physiotherapy and hip joint muscle strength training were set as treatment group. Upon admission to hospital and after training (after 6w of training), anterior knee pain scale (AKPS), visual analogue scale (VAS), peak torque (PT) of bending and stretching were applied to appraise the knee joint function and patient’s pain degree. Results: After training, AKPS scores in the treatment group were higher than those upon admission and reference group (P＜0.05); VAS scores in the treatment group were lower than those upon admission and reference group (P＜0.05); bending and stretching PT values in the treatment group were higher than those upon admission and reference group (P＜0.05). Conclusion: The hip joint muscle strength training can improve the knee joint function and relieve the pain degree for PFPS patients.

Relationship between systemic immune inflammatory index and postoperative recurrence of colorectal cancer

HuShiqi — 2021/8/4 8:25:38

Aim To explore the correlation between systemic immune inflammation index (SⅡ) and postoperative recurrence in colorectal cancer patients. Methods The clinical data of postoperative colorectal cancer patients treated in our hospital from January 2016 to June 2020 were collected retrospectively. Using the ROC curve to obtain the best cutoff value of the SⅡ,the patients were divided into high SⅡ group and low SⅡ group according to the best cutoff value, and the relapse-free survival time of the two groups was compared. Using Kaplan-Meier single-factor, multi-factor COX regression analysis of the correlation between SⅡ and recurrence. Results The best cutoff value of SⅡ was 655.68,54 in high SⅡ group and 64 in low SⅡ group. The RFS of patients in low SⅡ group was significantly better than that in high SⅡ group, and the difference was statistically significant.(P<0.001) Using Kaplan-Meier single-factor analysis showed that white blood cell(WBC)、neutrophile granulocyte(N)、mononuclear cells(M)、SⅡ、NLR、PLR、LMR、Ki-67 expression level and CA199 were associated with postoperative recurrence of colorectal cancer.(P<0.05)Using multi-factor COX regression analysis showed that SⅡ and CA199 were independent risk factors for postoperative recurrence of colorectal cancer patients.(P<0.05)Conclusion Systemic immune inflammation index may be a good evaluation RFS for postoperative patients with colorectal cancer. The low SⅡ before postoperative chemotherapy indicates the prolongation of tumor recurrence and may have a better prognosis.

Analysis of the relationship between the characteristics of tongue image and TCM Syndrome Types in patients with atopic dermatitis

LI YANFANG — 2021/8/4 8:24:00

Objective To investigate the correlation between the characteristics of tongue image and TCM Syndrome Types in patients with atopic dermatitis (AD).Methods 130 patients with atopic dermatitis were selected as the observation group,40 cases of physical examination in the same period were selected as healthy control group，The observation group was divided into blood-defificient wind-drying type(n=36), dampness-heat accumulation type (n=45)and spleen-defificient dampness-storage type (n=49)，analyzing the differences of tongue diagnosis parameters in patients with atopic dermatitis under different syndromes.Results The R component value of the observation group was smaller than that of the healthy control group (P < 0.01),There were no significant difference in B and G component value The H value of dampness-heat accumulation group was higher than that of healthy control group (P < 0.05);the R and B components of the blood-defificient wind-drying group were higher than those of the other two observation groups (P < 0.05);there was no significant difference in G component among the three groups;there was significant difference in H value among the three groups (P < 0.01).Conclusion The tongue color of the patients with blood-defificient wind-drying type was significantly different from that of the normal people and other syndrome types, the RGB value and HSI value of tongue diagnosis image are relatively objective and effective diagnostic indicators of AD dialectical classification, which has certain clinical significance.

Research on the effect of erythromycin on the osteogenesis of MC3T3-E1 cells stimulated by polymethylmethacrylate wear particles. Liu Zige. Department of Orthopaedics, General Hospital of Ningxia Medical University, NingXia 750004 China

刘子歌,,, — 2021/8/4 8:23:22

Objective This study aimed to investigate the effect of erythromycin on the osteogenesis of MC3T3-E1 embryonic osteoblasts stimulated by polymethylmethacrylate (PMMA) particles and its underlying mechanism. Methods MC3T3-E1 cells were pretreated with different concentrations of erythromycin, and then stimulated with PMMA (1mg/mL). Cell viability was evaluated by the lactate dehydrogenase (LDH) release test. The degree of cell differentiation is assessed by alkaline phosphatase (ALP). The gene expression of Runx2, Osterix, OCN and NF-κB p65 was measured by RT-PCR. Results PMMA particles stimulation can significantly reduce the cell viability and osteogenic function of MC3T3-E1, while erythromycin can effectively alleviate the effects of PMMA particles on the proliferation, viability and differentiation of MC3T3-E1 cells; cell viability, by changing Runx2, The expression of Osterix and OCN osteoblast differentiation-related proteins and NF-κB affect the osteogenic differentiation of MC3T3-E1 cells; erythromycin can effectively alleviate the effects of PMMA particles on the reproduction, viability and differentiation of MC3T3-E1 cells. Conclusion Erythromycin reduces the viability and osteogenic differentiation of PMMA wear particles on MC3T3-E1 embryonic osteoblasts, partly by down-regulating the NF-κB signal transduction pathway. Erythromycin can significantly improve the above effects, and has a protective effect on the inhibition of MC3T3-E1 osteogenic differentiation under the stimulation of PMMA wear particles.

Construction and identification of short hairpin RNA plasmids targeting human PDK1 gene and its silencing effect in PC-3 cell

Hao Nan — 2021/8/4 8:22:25

Objective The aim of this study was to construct RNA interference (RNAi) lentiviral vector particles targeting the human PDK1 gene. Methods A short hairpin RNA (shRNA) targeting the human PDK1 gene was designed, synthesized and transfected into 293T cells. Identify the shRNA sequence exhibiting the inhibition efficiency; based on this, recombinant lentiviral plasmids were constructed and co?transfected into 293T cells with packaging plasmids for the production of lentiviral particles. Results The virus titer was calculated to be 1×108TU/mL. qRT-PCR results showed that the PDK1 mRNA expression level of the LV3-PDK1-shRNA group was significantly lower than the negative control group and the blank group, with the inhibition rate of 88%. Conclusions RNAi lentiviral vector particles targeting the human PDK1 gene was successfully obtained in the present study, which laid the foundation for the further research on the role of PDK1 in prostate cancer cell models.

Research status of the relationship between metabolic dysfunction -associated fatty liver disease and metabolic syndrome

cailianying,liangyunxiao,songhuaiyu,wangwenjuan — 2021/7/21 9:50:50

Metabolic dysfunction-associated fatty liver disease is a group of highly heterogeneous diseases closely related to metabolic dysfunction, while metabolic syndrome is a group of syndromes with central obesity, dyslipidemia, hypertension, diabetes, or impaired glucose tolerance. MAFLD is generally considered to be the hepatic manifestation of metabolic syndrome, and insulin resistance is considered to be the key link between MAFLD and metabolic syndrome. The change in the prevalence of Metabolic dysfunction-associated fatty liver is parallel to the epidemic trend of metabolic syndrome, ?which continues to increase in incidence, and they are mutually causal, which together lead to the occurrence of metabolic cardiovascular and liver complications, evolving into A major clinical public health challenge worldwide. Lifestyle intervention is the cornerstone of prevention and treatment, and multi-disciplinary team is a new model for management of patients with MAFLD and metabolic syndrome in the future.

Cross suture closure technique of the abdominal wound following loop stoma reversal

wudongbo,yangshengfu — 2021/7/8 16:09:24

［Abstract］Objective To introduce the experience of Cross suture closure technique in loop stoma reversal．Methods This prospective trial enrolled 38 patients who underwent stoma reversal with a new cross suture closure from February 2019 to October 2020 in Yulin Red Cross Hospital.The operation time,blooding volume,incision pain score and incision infection rate were recorded.The main procedures are listed as followings: an oval circle incision around 0.2 cm away from the edge of the stoma was designed,four triangle incisions were made at the 3,6,9,and 12 o"clock.After intestinal anastomosis,the intestine was incorporated into the abdominal cavity and the fascial closure was achieved masse continuously.Placed a circumferential absorbable subcuticular suture in the wound edge and pulled it toward the center of the wound,leaving a small residual hole of 0.2cm in the center of the wound,leaving a drainage strip in the hole.Interrupted sutured the medium of cruciform edge.Results The median operative time was 50 min( 30~85 min) ,median blood loss was 20 ml( 15~30 ml),median postoperative hospital stay was 8.6 days( 5~14 days).There was only two patients( 5.3% ) with surgical site infection postoperative.Followed up for 1 month after operation,no added wound complications occurred and patients were satisfied with the wound recovery.Conclusion Cross suture closure might be a relatively safe and feasible technique for stoma reversal,and might lower the wound tension,shorter postoperative hospital stay with a significant short-term effect.

The correlation between SARS-COV-2 antibody and re-positive nucleic acid of SARS-CoV-2 after negative-transforming

黄宇璐,蒋柳结,王慧玲,王晓刚△ — 2021/7/8 16:08:47

Objective: To explore the correlation between antibody levels?and the recurrence of testing positive for SARS-CoV-2?infection?in the patients after being discharged. Methods: The patients were divided into study group?(re-positive group) and control group (negative group)?depending on the recurrence of sars-cov-2 infection, based on which a comparison was performed in the levels of IgM and IgG between the two groups. Results: There was no significant difference observed between the two?group in terms of IgM level (P > 0.05). Apart from that, the level of IgG in re-positive group was shown to be significantly lower compared to the negative group (P < 0.05). Conclusion: The SARS-CoV-2 infected patients?with a?low IgG level are susceptible to virus conversion?after being discharged from hospital.?The level of IgG at the time of discharge can be referenced as a predictor for the recurrence of testing positive for SARS-CoV-2?infection after hospitalized treatment.

Application Value of Transthoracic Echocardiography in the Diagnosis of De Bakey Classification of Acute Aortic DissectionLU Zhongzhi Pan Yan

luzhongzhi — 2021/7/8 16:08:11

Objective To explore the application of transthoracic echocardiography in the diagnosis of acute aortic dissection De Bakey classification Use value.Methods A review of 71 patients diagnosed with aortic dissection by emergency transthoracic echocardiography in the People"s Hospital of Guangxi Zhuang Autonomous Region from June 2015 to June 2020, and analyze the diagnosis and details of acute aortic dissection by transthoracic echocardiography Accuracy of chemical typing.Results The coincidence rate between preoperative ultrasound diagnosis and intraoperative diagnosis or CT angiography in 71 patients with aortic dissection was 94.36% (67/71). The coincidence rates of De Bakey type I, De Bakey type II and De Bakey type III in the preoperative ultrasound diagnostic classification were 95.4% (42/44), 81.81% (9/11), and 87.05% (14/16), respectively. 44 cases of De Bakey type I, accounting for 61.97% (44/71), 11 cases of De Bakey II, accounting for 15.49% (11/71), and 16 cases of De Bakey III, accounting for 22.53% (16/71) . There were 58 patients with a history of hypertension, accounting for 81.69% (58/71); 7 cases of Marfan syndrome, accounting for 9.86% (7/71); 29 cases of aortic valve disease, accounting for 40.85% (29/71); 11 cases of thrombosis formed in the wall of the aortic false lumen, accounting for 15.49% (11/71); 23 cases with left ventricular enlargement, accounting for 32.39% (23/71). 41 cases of aorta widening, accounting for 57.74% (41/71). There were 20 cases involving the branch vessels of the aorta, accounting for 28.17% (20/71).Conclusion Emergency transthoracic echocardiography has a high coincidence rate in the De Bakey classification of acute aortic dissection, and it has an important guiding role in the selection of clinical treatment and surgical procedures.

Circulating interleukin-38, Th1, Th2 and Th17 levels in patients with coronary artery disease

2021/7/8 16:07:25

Objective: The aim of the present study was to investigate whether circulating intrleukin (IL)-38 levels change in coronary artery disease (CAD) and determine the relationship between IL-38 and both effector CD4+ T cells and other clinical parameters. Methods: One hundred and twenty patients with CAD including 40 patients with SAP, 40 patients with UAP and 40 patients with AMI,

CLCA1 expression in colorectal cancer and its gene set enrichment analysis

LIANG Zhi-hai,LUO Shi-bo,QIU Xin-ze,WU Jiang-ni — 2021/7/8 16:06:41

Objective: To investigate the expression of CLCA1 in colorectal cancer and its relationship with clinicopathological features and prognosis. Methods: Immunohistochemistry staining was used to analyzed the expression of CLCA1 protein in colorectal cancer tissues. CLCA1 mRNA expression data were downloaded from the Cancer Genome Atlas (TCGA), GSEA software as tool to perform gene expression profile analysis of different CLCA1 phenotypes. R language used to analyze the differential expression of CLCA1 gene in colorectal cancer and its relationship with clinicopathological characteristics. Results: The Immunohistochemical staining scores of normal tissue adjacent to cancer group and cancer tissue group were (5.65±0.49) scores, and (2.46±1.09) scores, respectively (P＜0.05). CLCA1 mRNA and protein were low expression in colorectal cancer tissues (P＜0.05), CLCA1 negatively correlated with clinical stage (P=0.016), N stage (P=0.027), and M stage (P=0.026). Patients with higher CLCA1 expression had longer overall survival (P=0.004) and lower recurrence rate (P=0.010). Gene set enrichment analysis found CLCA1 is related to oncogenes such as STK33 and AKT. Conclusion: CLCA1 is down-regulated in colorectal cancer tissues and is related to the clinicopathological characteristics and prognosis of patients, it can be used as a potential therapeutic target and diagnostic marker for colorectal cancer.

Research progress of Metrnl and myocardial ischemia reperfusion injury

MI Yong-cheng — 2021/7/7 10:34:06

As a new adipose factor, Metrnl is widely distributed in human body. Myocardial ischemia-reperfusion injury (MIRI) caused by revascularization after myocardial ischemia seriously affects the treatment prognosis of patients with acute myocardial infarction(AMI), and Metrnl is closely related to the improvement of MIRI. This article reviews the research progress on the relationship between Metrnl and MIRI.

Progress in the phenotype and gene modifiers of spinal muscular atrophy

Wu — 2021/7/7 10:32:59

Spinal muscular atrophy ( SMA) is a common autosomal recessive hereditary disease caused by mutation of the survival motor function 1 (SMN1) gene. Growing evidence demonstrates that SMA is a multi-system disorder including the cardiovascular, alimentary system, metabolic system and urogenital system besides neuromuscular system. There are different clinical manifestations in patients with the same pathogenic mutation, showing the existence of genetic and environmental factors, such as SMN2 copies, NAIP copies, H4F5 copies, the overexpression of the ZRP1 and PLS protein, the down-regulation of NCALD. It provides references for genetic counseling and prognosis assessment, and can be used as new therapeutic targets. This article reviews multi-system injury and gene modifiers, in order to raise awareness of SMA.

Discovery, development and clinical application of angiotensin 2 receptors

liqian,luoyifeng,wuzimeng — 2021/7/7 10:29:21

Angiotensin type 2 receptor (AT2R) is a renin-angiotensin system (RAS) receptor that has not been fully revealed. In recent years, scholars have paid more and more attention to the potential of this receptor in clinical applications. At the same time, this receptor is also one of the key damage factors of the recent pandemic of COVID-19, but the discovery and latest progress of this receptor have not yet been reviewed. This article focuses on the discovery, development and clinical application of angiotensin type 2 receptors. A review to provide ideas for clinical indications.

Application research of goal-oriented evidence-based nursing in the management of severe pneumonia mechanical ventilation

冯金玲 — 2021/7/7 10:27:36

Objective To observe the effect of goal-oriented evidence-based nursing in the management of mechanical ventilation for severe pneumonia. Methods 40 cases of severe pneumonia admitted to our hospital before and after the implementation of goal-oriented evidence-based care (September-December 2019) and after implementation (January-April 2020) were used as research samples. Set as the control group and the test group. The control group received routine nursing for severe pneumonia. On this basis, the test group used the goal-oriented evidence-based nursing intervention for respiratory tract management to compare the observation indexes of the two groups after intervention. Results The incidence of respiratory accidents and complications, and the improvement time of clinical symptoms of patients with severe pneumonia in the experimental group after intervention were significantly shorter than those of the control group, and the total effective rate of treatment was significantly higher than that of the control group (P<0.05). Conclusion 　 The use of goal-oriented evidence-based nursing to manage severe pneumonia patients with mechanical ventilation can significantly improve the safety and effectiveness of mechanical ventilation in such cases.

Ultrasound-guided erector spinae plane block for shoulder and back mass resection：one case report

HAO Lei,SONG Xiaoqian — 2021/7/7 10:25:48

Objective The aim is to report the feasibility of ultrasound-guided erector spinae plane block for shoulder and back mass removal, and to seek a safe, effective and low-cost anesthesia method.Methods A huge lipoma of the shoulder and back was admitted to the surgical department of Taicang Hospital of Traditional Chinese Medicine in July 2019.Results Ultrasound-guided erector spinae plane block was applied to patients with shoulder and back lipoma resection with stable disease signs, satisfactory analgesia, and low postoperative pain score.Conclusion The ultrasound-guided erector spinae plane block can be used to achieve sufficient intraoperative analgesia in shoulder and back lipoma surgery, which is safe and effective in this case, and the cost is significantly lower than general anesthesia.

维持性血液透析患者并发双侧股四头肌肌腱断裂个案报道

wangjielian — 2021/7/7 10:24:44

自发性双侧股四头肌肌腱断裂国内少有报道，终末期肾病的患者由于全身代谢异常会导致肌腱组织变性，会发生自发性股四头肌肌腱断裂。临床上容易误诊或漏诊，错过最佳治疗时机而影响术后膝关节功能恢复。本文1例维持性血液透析患者并发双侧股四头肌肌腱断裂的患者，术后双膝关节功能恢复良好，现报告如下。

Comparison of neoadjuvant endocrine and neoadjuvant chemotherapy in hormone receptor positive and HER2 negative breast cancer

zhengtao — 2021/7/7 9:54:55

Objective: To evaluate the efficacy of neoadjuvant therapy for hormone receptor positive / HER2 negative (HR+/HER2-) breast cancer. Methods: The clinical and pathological data of 40 patients with HR+/HER2- breast cancer who received neoadjuvant therapy and surgery from July 2018 to July 2020 were analyzed retrospectively. They were divided into observation group（n=20） and control group(n=20) according to the mode of treatment. The observation group was given neoadjuvant endocrine therapy and the control group was given neoadjuvant chemotherapy. The observation group was treated with letrozole or tamoxifen, 28 days as a cycle, for a total of 4-6 cycles, and those without progression continued to take the drug to 24 weeks, and the control group was treated with doxorubicin, cyclophosphamide and docetaxel after 8 cycles of chemotherapy. The clinical efficacy, Ki-67 changes, serum CA153 changes, PEPI score and side effects were compared between the two groups. Results: The objective response rate of the observation group was slightly lower than that of the control group, but the difference was not significant (P > 0.05), and the decrease rate of Ki-67 in the observation group was significantly higher than that of the control group, and the difference was statistically significant (P < 0.05). After treatment, the content of serum CA153 in the observation group was significantly lower than that in the control group (P < 0.05). The rate of PEPI score in the high risk group in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). The rate of toxicity and side effects in the observation group was lower than that in the control group, and the difference between them was statistically significant (P < 0.05). Conclusion: Neoadjuvant endocrine therapy and neoadjuvant chemotherapy have similar efficacy in patients with HR+/HER2- breast cancer, and the safety is better than it.

Clinical application of modified rotary Scarf osteotomy in the treatment of moderate and severe hallux valgus

xiyinhui,xuhailin — 2021/7/7 9:53:49

Objective To analyze the clinical effect of modified rotary Scarf osteotomy in the treatment of moderate and severe hallux valgus.Methods A total of 33 patients (51 feet) with moderate or severe hallux valgus who were hospitalized in the Department of Orthopedics and Traumatology of Beijing Miyun District Hospital of Traditional Chinese Medicine from July 2017 to July 2018 were selected as the subjects. All patients were compared with the position of HVA, IMA and sesamoid bone on X-ray, and the AOFAS and VAS scores during preoperative and final follow-up by using the method of rotary Scarf osteotomy.Results The IMA and HVA after surgery were significantly lower than before surgery, and the difference was statistically significant (P < 0.05). The sesamoid bone position was improved compared with before surgery, and the AOFAS and VAS scores in the last follow-up were significantly improved compared with before surgery.Conclusion The treatment of moderate and severe hallux valgus deformity is satisfactory and effective.

Expression and significance of neutrophil gelatinase-associated lipocalin and matrix metalloproteinase-9 in peripheral blood of patients with COPD

陈小兵,李刚,李果,梁晓彤,陶维 — 2021/7/7 9:51:03

Objective To investigate the expression of neutrophil gelatinase-associated lipocalin (NGAL) and matrix metalloproteinase-9 (MMP-9) genes in peripheral blood mononuclear cells of patients with chronic obstructive pulmonary disease (COPD) at different stages and analyze its clinical significance. Methods The prospective study included 25 patients with acute exacerbation of COPD (AECOPD group), 80 patients with stable COPD (SCOPD group), and 40 healthy subjects (control group) during the same period. According to the comprehensive evaluation results, the SCOPD group Patients were divided into low-risk group B and high-risk group D. Peripheral venous blood samples were collected from all subjects on an empty stomach in the early morning. After mononuclear cells were isolated and extracted, real-time fluorescent quantitative PCR technology was used to detect the expression levels of NGAL mRNA and MMP-9 mRNA genes in each group. At the same time, the relationship between NGAL mRNA and MMP-9 mRNA and its correlation with clinical indicators such as quality index, smoking index, blood routine and lung function were analyzed. Results (1)The relative expression levels of NGAL mRNA and MMP-9 mRNA genes in the AECOPD group were 0.008(0.003, 0.045), 0.011(0.004, 0.029), which were higher than those of the SCOPD group 0.005(0.001, 0.013), 0.004(0.002, 0.010) and the control Group 0.002(0.001, 0.004), 0.002(0.001, 0.003); and the relative expression levels of NGAL mRNA and MMP-9 mRNA genes in the SCOPD group were higher than those in the control group, and the differences were statistically significant (P<0.01). (2) The relative expression levels of NGAL mRNA and MMP-9 mRNA genes in high-risk group D were 0.006(0.003,0.019) and 0.008(0.002,0.024), which were higher than those in low-risk group B 0.003(0.001,0.007) and 0.004(0.002,0.007), and the difference was statistically significant(P<0.05). (3) The relative expression levels of NGAL mRNA and MMP-9 mRNA in AECOPD group and SCOPD group were significantly positively correlated, and the correlation was statistically significant (r=0.831, P<0.01; r=0.764, P<0.01). (4) The relative expression of NGAL mRNA and MMP-9 mRNA genes in the SCOPD group was negatively correlated with lung function FEV1%pred, and the correlation was statistically significant (r=-0.416, P<0.01; r=-0.312, P<0.05). (5) The relative expression of NGAL mRNA and MMP-9 mRNA genes in the AECOPD group and SCOPD group was positively correlated with the total number of peripheral blood white blood cells, the total number of neutrophils and the percentage of neutrophils, and the correlations were statistically significant(P<0.05); there was no significant correlation with clinical indicators such as quality index, smoking index, FEV1/FVC(all P>0.05). Conclusion NGAL and MMP-9 are likely to participate in the occurrence and development of COPD, and their relative gene expression may become a new indicator for evaluating the severity of COPD.

Progress of ultrasound intervention、gene detection and other new technologies in the diagnosis of thyroid nodules

YU Lulu — 2021/6/9 11:23:26

Ultrasound-guided fine needle aspiration cytology(US-FNAC)is currently recognized as the first choice for preoperative differentiation of benign and malignant thyroid nodules.Due to the limitations of cytological diagnosis and other factors, about 20% -30% of the nodules cannot get a definite diagnosis.In recent years, it has been reported that the combination of US-FNAC and other methods can further improve the diagnostic efficiency.This paper reviews the research progress of US-FNAC combined with gene detection, contrast-enhanced ultrasound and elastography

Role of TLRs in islet β - cell injury in type 1 diabetes mellitus

CHEN Huan-huan,SONG Chao-jie,TANG Cong — 2021/6/9 11:22:42

Toll like receptors (TLRs) are a kind of pattern recognition receptors, which can recognize various types of pathogen related molecular patterns. The signal transduction mediated by TLRs plays an important role in inflammatory response. Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by islet β - cell injury, and its pathogenesis has not been fully understood. At present, changes of TLRs have been observed in T1DM. Abnormal TLRs signal transduction pathway changes immune homeostasis and pathological damage, leading to autoimmune response. This paper reviews the structure, signal transduction pathway of TLRs and its relationship with T1DM.

Research Progress on the Pathogenesis of Cholangiocarcinoma caused by Clonorchiasis

XIE Hong-dan — 2021/6/9 11:21:58

Clonorchiasis is a kind of food-borne parasitic disease with great harmfulness. There are about 35 million people infected with clonorchiasis in the world, and at least 1.1 billion people are at risk of infection. Cholangiocarcinoma is (CCA) the most serious complication caused by long-term infection of Clonorchis sinensis, so the WHO International Cancer Research Agency has listed clonorchiasis as a class I carcinogenic pathogen of CCA. In recent years, many scholars have done corresponding clinical and experimental studies on the carcinogenic mechanism of liver fluke infection, but so far its carcinogenic mechanism is not very clear. This article reviews the pathogenesis of CCA caused by clonorchiasis.

Research progress in endoscopicSmanagementSofSgastric varices.

guoxianwen — 2021/6/9 11:21:13

Patients with gastric varices bleed easily, and the mortality rate is high. The current treatment of gastric varices has not been standardized. In this review，we discuss the etiology,classification,and treatment options of gastric variceal. Discussion of treatment is focus on emerging endoscopic interventions. Although endoscopic injection of synthetic glues is the most widely used therapy for gastric varices,it is associated with various complications,including systemic embolization and recurrent bleeding. Recently, the treatment of gastric varices under the guidance of endoscopic ultrasonography（EUS） has become a promising new method with high technology, clinical success rate and low recurrence rate, and it is worthy of clinical promotion.

MRI findings of endometrial carcinosarcoma: a case report

li xiang,xiang lu,xiong jing xian,yang ran,zhen yan ling — 2021/6/9 11:20:03

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lianxianglin,, — 2021/6/9 11:19:19

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Correlation between the level of lipoprotein-related phospholipase A2 and arteriosclerosis obliterans severity

KANGHAIHAN,LIFEI,LIANGXIAODAN,MUNIRE`YUEMAIER,WUCHENGWEN — 2021/6/9 11:18:39

Objective To investigate the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2) level in patients with arteriosclerosis obliterans(ASO), and to evaluate the clinical significance. Methods 108 cases of patients were collected from November 2018 to January 2019 in our hospital, and divided into two groups according to the result of ankle-brachial index（ABI）：the control group，n=32(non- arteriosclerosis obliterans), and the study group，n=76(patients with arteriosclerosis obliterans). The baseline data and laboratory data needed to be compared between two groups，and the study group underwent the dual-source CT angiography (CTA) examination. Results The age, gender and smoking history of the two groups were statistically significant (P<0.05); Compared with control group, the level of Lp-PLA2 and Hcy of the study group were higher, the difference was statistically significant (P<0.05); Multivariate logisticLogistic regression analysis indicated that the age and Lp-PLA2 are risk factors for ASO.regression indicated that the Lp-PLA2 was a risk factor for ASO patients, and the correlation analysis showed that the Lp-PLA2 level of the study group was positively correlated with the severity of ASO. Conclusion Lp-PLA2 is a risk factor affecting the occurrence of ASO, and the increase of serum Lp-PLA2 level is related to the aggravation of ASO.

Different relationship between serum folic acid and risk of cardio-cerebro vascular disease and related deaths by sex

Yang zhikang — 2021/6/9 11:17:48

[Abstract] Objective To investigate the relationship between folic acid level and the risk of cardio-cerebro vascular disease (CVD) and related deaths in both men and women. Methods A total of 1,791 residents aged ≧15 years in Emin County, Xinjiang were selected by multi-stage random sampling method. From 2016.01 to 2019.12, through field investigation, telephone follow-up, household survey and hospitalization records of local county hospital, the incidence of CVD and related deaths and long-term drug used were investigated, and finally 1,678 people (male:727 and female:960) completed the study (missing?rate: 5.8%). Folic acid levels were divided into groups 1, 2 and 3 from low to high, and multivariate Cox regression was used to analyze the relationship between folic acid levels and the risk of CVD and death among different genders. Result In the total population, the risk of CVD and related deaths (RR) in group 1 was 1.56 times that in group 2 (95%CI:1.03-2.38; P<0.05), and 1.49 times that in group 3 (95%CI:0.96-2.30; P>0.05), and the ratio in males was 1.34 times (95%CI:0.77-2.34; P>0.05) and 2.57 times (95%CI:1.29-5.10; P<0.05), and in females it was 2.11 times (95%CI:1.09-4.07; P<0.05) and 1.15 times (95%CI:0.63-2.07; P>0.05). Further more, in women, the risk of CVD and related deaths in group 3 was 1.84 times that in group 2 (95%CI:1.03-3.29; P<0.05). Conclusion Low folic acid is associated with an increased risk of CVD and related deaths, and high folic acid also associated with the increased risk in women.

SIGNIFICANCE OF SERUM COAGULATION AND INFECTION INDICATORS IN THE DIAGNOSIS OF CHRONIC PROSTHETIC JOINT INFECTIONAuthor: Zhang Yongchao¹,Huang Jincheng², Zhang Xinan³, Liu Yuntao³, Lian Hongkai³

黄金承,刘云涛,张新安 — 2021/6/9 11:16:49

【Objective】To compare the significance of serum coagulation and infection indicators C-reactive protein, erythrocyte sedimentation rate, fibrinogen, D-dimer, and platelets in the diagnosis of chronic prosthetic joint infection(PJI)after hip and knee arthroplasty.【Methods】 A retrospective analysis was conducted on 149 patients admitted to Zhengzhou Central Hospital Affiliated To Zhengzhou University from 2018 to 2021, including 102 patients who underwent the primary total hip or knee arthroplasty and no infection was found in the hospital after re-examination(control group without infection),47 patients who would receive the first stage of revision for chronic PJI(chronic PJI group). The level of preoperative serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fibrinogen (FBG), D - Dimer (D - Dimer), platelet count (PLT) and the ratio of platelet to platelet mean platelet volume (MPV) were collected. The receiver operator curve (ROC) was used to analyze the diagnostic efficacy of CRP, ESR, FBG, D-Dimer, and platelets in chronic PJI.【Results】 CRP, ESR, FBG, D-Dimer, PLT and PLT/MPV levels in the chronic PJI group were significantly higher than in the control group without infection (P < 0.05). The ROC analysis showed that the area under the curve of CRP, ESR, FBG, D-Dimer, PLT, and PLT/MPV were 0.892、0.888、0.873、0.835、0.666 and 0.686 respectively. The optimal CRP threshold was 5.100mg/L, sensitivity was 0.925, and specificity was 0.833. The optimal ESR threshold was 30.000mm/L, sensitivity was 0.809, and specificity was 0.882.The optimal FBG threshold was 3.900g/L, sensitivity was 0.809, and specificity was 0.873. The optimum threshold value of D-Dimer was 0.640mg/L, sensitivity was 0.891, and specificity was 0.696. The optimal threshold of PLT was 239.000*10⁹/L, sensitivity was 0.638, and specificity was 0.628. The optimal threshold of PLT/MPV was 31.515, sensitivity was 0.532, and specificity was 0.804. 【Conclusion】 In the diagnosis of chronic PJI, the efficacy of serum FBG, D-Dimer, CRP and ESR is basically equal, and all of them are better than PLT and PLT/MPV.

Construction and analysis of ceRNA regulatory network in chromophobe renal cell carcinoma

2021/6/9 11:09:04

Construction and analysis of competitive endogenous RNAs regulatory network in chromophobe renal cell carcinoma LI Bing-ying, LIU Chang, LI Feng, et al. Department of histology and Embryology, Guangxi Medical University, Nanning 530021, China [Abstract] Objective To construct a competitive endogenous RNAs regulatory network for chromophobe renal cell carcinoma (CRCC), and to screen out messenger RNA (mRNA) , long non-coding RNA(lncRNA) and micro RNA (miRNA) related to the prognosis of CRCC, so as to a theoretical basis for the diagnosis and prognosis of CRCC. Methods The transcriptome data of CRCC samples (65 cases) and normal kidney specimens (24 cases) were extracted from the Cancer Genome Atlas（TCGA）database, and the differentially expressed (DE) lncRNA, miRNA and mRNA were screened under the condition of false discovery rate (FDR) < 0.05 and the absolute value of the change in multiple of logarithmic differential expression (log2|FC|)＞2. Based on these, the ceRNA regulatory network was constructed.The Kaplan-Meier method was used to explore the factors related to the prognosis of CRCC patients, and based on this, the protein-protein interaction (PPI) network was further constructed, and Gene Ontology(Go) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis was performed. Results A total of 3679 DElncRNA, 297 DEmiRNA and 5914 DEmRNA were screened.The down-regulated mRNA ceRNA network contained 95 DEmiRNA, 268 DEmRNA, and 737 DElncRNA; the up-regulated mRNA ceRNA network contained 85 DEmiRNA, 234 DEmRNA, and 924 DElncRNA. Kaplan-Meier analysis screened out 3 DEmRNAs (DEPDC1, SLC7A11 and E2F7) and 1 DEmiRNA (miR-26b-5P) were associated with the prognosis of CRCC (P<0.05).The PPI network constructed with DEPDC1, SLC7A11 and E2F7 contained a total of 8 mRNAs (TOP2A, DEPDC1, SLC3A2, E2F8, SLC7A11, E2F1, TP53 and E2F7) that participated in protein interactions. The enrichment analysis of GO and KEGG showed that these interaction proteins function mainly enriched in DNA damage response, P53-mediated cell tissue and promoter specific binding, iron death, bladder cancer, non-small cell carcinoma, chronic myeloid leukemia and other disease signaling pathways. Conclusion In this study, the key RNAs related to CRCC prognosis are screened out by constructing the ceRNA regulatory network of CRCC, which provides a theoretical basis for the diagnosis and treatment of CRCC. [Key words] Chromophobe renal cell carcinoma (CRCC); Competitive endogenous RNAs (ceRNA) regulatory network; Messenger RNA (mRNA); Long non-coding RNA(lncRNA); Micro RNA (miRNA)

Expression and significance of tumor-associated antigen MAGE-D4 in hepatocellular carcinoma

2021/6/9 11:08:05

Objective To detect the expression of tumor-associated antigen MAGE-D4 in hepatocellularScarcinoma (HCC), and analyze its clinical significance in terms of patient clinical indicators, expression of related gene and survival. Methods First, based on The Cancer Genome Atlas (TCGA), UALCAN was used to analyze the expression of MAGE-D4 mRNA in HCC and expression-related genes, TIMER 2.0 was also used for survival analysis. Then, 70 HCC tissues and 30 adjacent tissues were collected and Immunohistochemistry (IHC) was used to detect the expression of MAGE-D4 protein and analyze its relationship with clinical indicators of the patients. Results In the TCGA database, the expression of MAGE-D4 mRNA in HCC was significantly higher than that in normal liver tissues (P < 0.001), which was strongly positively correlated with AFP expression; in addition, survival analysis showed that the cumulative survival rate of HCC patients with low expression of MAGE-D4 mRNA was significantly higher than that of HCC patients with high expression (HR = 1.26, P < 0.05). Further IHC results confirmed that the expression of MAGE-D4 protein in 48.57% (34/70) HCC tissues was significantly higher than that in adjacent tissues (P < 0.05). And the expression of MAGE-D4 protein is related to the pathological grade of HCC patients, while MAGE-D4 protein is mainly located in the cytoplasm and nucleus. Conclusion The abnormally high expression of MAGE-D4 in HCC may play an important role in the tumorigenesis and development of HCC, and it is expected to become a potential therapeutic target and prognostic marker for HCC.

The value of percutaneous choledochoscope in the removal of peripancreatic infectious necrosis in severe pancreatitis

Jiang Hancheng,Jiang Shuiming,Lu Haiming,Zhou Min — 2021/6/9 11:07:06

Objective To summarize the value of percutaneous choledochoscope in the removal of peripancreatic infectious necrosis (IPN) in severe pancreatitis. Methods Retrospective analysis of 12 patients (observation group) with percutaneous pancreatic necrosis tissue cleared by electronic choledochoscope under direct vision using PCD sinus gradual expansion using PCD sinus tract dilatation from January 2016 to March 2019 in our hospital. Peripheral pancreatic infectious necrosis removal in 10 patients (control group). results The effective rate of removing pancreatic infectious necrosis in both groups was 100%, while the incidence of pancreatic fistula in the observation group was 25% VS 20% in the control group p> 0.05, which was not statistically significant. The incidence of bleeding was 16.67% VS the control group 0, P <0.05 has obvious statistical significance, no intestinal fistula occurred in the two groups, and 3 cases in the control group had residual pus cavity after the second operation, and the residual cavity rate was 30%VS observation group 0, P <0.05 had significant statistical significance, the average hospitalization cost in the observation group was reduced by 65,000, the average hospitalization time was shortened by 12 days, and P <0.05 was significantly statistically significant. No recurrence was observed for up to 2 years in the two groups. Conclusion Observation group has the advantages of clear debridement under the direct vision of endoscope. It has the advantages of less trauma, fast recovery, strong repeatability, low cost, short hospital stay, and fewer complications. The treatment effect is good, and the technology requires The equipment is simple and can be performed even at the bedside, which is easy for patients to accept. It has gradually replaced the traditional open surgery in clinical work, which is worthy of clinical promotion and application.

Plasma cell myeloma presented as tubulointerstitial nephritis

liu mengmeng,,,, — 2021/6/9 11:06:04

Objective To investigate the pathological features of plasma cell myeloma presented as tubulointerstitial nephritis. Methods A case of plasma cell myeloma presented as tubulointerstitial nephritis was analyzed in regards to the clinical manifestations, histopathology and characteristics under electron microscope, and related literatures were reviewed. Results A 34-year-old man presented with fatigue and nausea.The clinical diagnosis was acute renal insufficiency.A renal biopsy showed interstitial nephritis and monoclonal k freelight chain was identified by immunohistochemistry. There were sediment-like deposits on both sides of the glomerulus and tubule basement memybrane under electron microscope.Plasma cell myeloma was comfirmed with bone marrow examination. Conclusion Plasma cell myeloma can cause multiple organ damage. A comprehensive assessment with histopathology,immunohistochemistry and electron microscope are very important to avoid missed diagnosis and mistreatment.

Effect of butylphthalide injection on NIHSS score and cerebral blood flow velocity in hemiplegia hand with acute cerebral infarction

chenbin — 2021/6/9 11:05:20

Objective: To investigate the effect of butylphthalide injection on NIHSS score and cerebral blood flow velocity in hemiplegic hand patients with acute cerebral infarction. Methods: 80 cases of hemiplegic hand patients with acute cerebral infarction admitted to our hospital from March 2019 to March 2020 were selected and divided into control group and study group with the proportion of 1:1 according to the random number table method, each group has 40 cases. The patients in the study group were treated with sodium butylphthalide and chloride injection. The degree of neurological deficit (NIHSS score), cerebral blood flow (peak velocity (VP) and average velocity (VM) of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA)) were compared between the two groups before treatment, 10 days after treatment and 20 days after treatment. At the same time, the adverse reactions of the two groups were recorded. Results after 20 days of treatment, the total effective rate of the study group was 92.50%, which was significantly higher than that of the control group (75.00%) (P < 0.05). After 10 days and 20 days of treatment, NIHSS scores of the two groups decreased significantly, VP and VM of ACA, MCA and PCA increased significantly (P < 0.05), and the above indexes of the study group were significantly different from those of the control group (P < 0.05). No significant adverse reactions occurred in both groups. Conclusion butylphthalide injection has a significant clinical effect on hemiplegic hand with acute cerebral infarction. It can effectively improve the degree of nerve defect and the ability of daily behavior of hemiplegic hand with acute cerebral infarction. It is safe and worthy of clinical application.

Cone beam CT quantitative analysis for adult patients with osseous Ⅱ class wrong jaw orthodontic compensatory before and after treatment Maxillary anterior tooth root resorption

高娟,,,,, — 2021/6/9 11:04:34

Purpose: Using cone beam CT (cone beam computed tomography, CBCT) 3 d reconstruction of quantitative analysis for adult patients with osseous Ⅱ class fault compensation before and after orthodontic treatment of maxillary incisor, lateral incisor and pointed fang root absorption. Methods: In November 2016 to November 2018 for orthodontic compensatory treatment of adult osseous Ⅱ wrong micromaxillary deformity cases, 30 cases of male 17, female 13, with an average age of 25, use of CBCT Mimics20.0 software data multiplanar reconstruction, adjustment of coronary, axial and sagittal axis, selected by cutting edge and root teeth long axis of the longest sagittal section measuring maxillary incisor, lateral incisor, the change of teeth root before and after the treatment.Comparison before and after treatment of maxillary incisor, tip and lateral incisor fang volume change of root and root absorption percentage difference, prompt the adult patients with osseous Ⅱ class wrong orthodontic treatment of maxillary first fang root absorption. Results: The volume of central incisors, lateral incisors and incisors decreased significantly after orthodontic compensation treatment.There was significant difference in volume change of 0.05. After compensatory treatment, the absorption percentage of lateral incisors, central incisors and incisors was significantly different, P<0.05, there was no statistical significance between the absorption percentage of central incisors and incisors, P>0.05. Conclusion: Adult osseous Ⅱ class wrong jaw in the process of orthodontic compensatory treatment, upper jaw before fang root are relatively obvious absorption, in which the incisor to absorb the most significant, cut side fang root absorption times, fangs to absorb at least, need to cause enough attention in the clinical treatment.

Clinical study on the effect of intestinal microecologics combined with glutamine on immune function in patients with colorectal cancer

wanglong,yahanqing — 2021/6/9 11:03:36

Objective To investigate the effect of intestinal microecologics combined with glutamine on immune function of postoperative patients with colorectal cancer. Methods Sixty patients with colorectal cancer who were eligible for inclusion in our department from July 2018 to May 2019 were randomly divided into the experimental group and the control group, with 30 patients in each group. The control group received conventional preoperative intestinal preparation (oral compound polyethylene glycol or mechanical cleaning enema) and conventional symptomatic supportive treatment after surgery. Experimental group received daily oral intestinal probiotics ((bifidobacterium quadruple slice and lactulose) and glutamine in preoperative 3 days, with no traditional preoperative bowel preparation, and postoperative day 1 to 7 days in addition to conventional treatment, and to the oral intestinal probiotics ((bifidobacterium quadruple slice) and glutamine. The levels of humoral immunity index (IgA) and cellular immunity index (CD3, CD4, CD8, CD4/CD8) were monitored postoperative and on the 3rd and 7th day after surgery, which were compared between the two groups. Results The values of IgA, CD3, CD4 and CD4/CD8 in 2 groups on the 3rd and 7th days after surgery were significantly lower than those before surgery(P<0.05), while the decrease was more obvious in the control group than in the experimental group, and the difference was statistically significant(P<0.05). IgA, CD3, CD4, CD8, and CD4/CD8 recovered further in both groups on the 7th day after operation, but was faster in the experimental group (P<0.05) Conclusions Combined application of intestinal microecologics and glutamine can effectively promote the recovery of postoperative immune function in patients with colorectal cancer

The value of combined detection of saliva miRNA-144 and miRNA-21 in the differential diagnosis of esophageal carcinoma

gujiasheng,, — 2021/6/9 11:02:32

[Objective]: To evaluate the expression level of miRNA-144 and miRNA-21 in saliva, and to determine the value of combined detection of miRNA-144 and miRNA-21 in the differential diagnosis of esophageal cancer. [Methods]: The saliva of 85 esophageal cancer patients over 60 years old treated in the Department of Cardiothoracic surgery of Guangzhou Red Cross Hospital from January 2015 to May 2019 and the saliva of 32 healthy elderly volunteers over 60 years old in the local community were collected. The expression levels of miRNA-144 and miRNA-21 in saliva of the two groups were detected by PCR technique in aseptic test tube. For the patients who received simple conservative treatment, the expression of two kinds of miRNA in saliva was followed up 3 months later to judge the stability of the expression.[Results] The expression levels of miRNA-144 and miRNA-21 in saliva of esophageal cancer group were significantly higher than those of control group (P < 0.05). And with the increase of the grade of esophageal cancer, the expression level of both increased progressively. In the saliva of patients with esophageal cancer, when the cutoff value of miRNA-21 was 13.5 μ g / ml, the area under the curve was 0.785, and the specificity and sensitivity were 57.6% and 87.1%, respectively.When the cutoff value of miRNA-144 in saliva was 107.0 μ g / ml, the area under the curve was 0.777, the specificity and sensitivity were 81.8% and 64.7%, respectively. When the two were used for joint detection, the specificity was 75.3%, the sensitivity was88.1%, and the area under the curve was 0.851. [conclusion]: The expression of miRNA-21 and miRNA-144 in saliva of patients with esophageal cancer is significantly increased, the combination of the two detection methods has a more ideal detection efficiency, and the degree of expression is stable, so the combined detection of miRNA-21 and miRNA-144 can be used as a new method and means for early screening of esophageal cancer.

[DOI]

chenlihua — 2021/6/9 11:00:54
Objective To explore the effect of prourokinase combined with tirofiban on the prevention of slow flow/no-reflow (SF/NR) phenomenon through the interventional approach of intracoronary treatment of high thrombotic load ASTEMI patients with emergency PCI-stent implantation. Methods The patients with high thrombotic load ASTEMI who underwent emergency PCI stent implantation who were admitted to the Department of Cardiology, Zhangjiajie People's Hospital from 2017-09-01 to 2020-06-30 were selected and randomly divided into study group and control group. Both groups of patients received emergency PCI-stent implantation treatment. In the study group, tirofiban was administered via the coronary artery and prourokinase was simultaneously administered; in the control group, only tirofiban was administered via the coronary artery. In both groups, nitroglycerin was used to prevent coronary artery spasm. Observe the myocardial infarction thrombolysis or antithrombotic treatment TIMI blood flow grading before and after treatment, and the cardiac function index (LVESD, LVEF, FS, LVEDD) level before discharge from the postoperative period to the patient’s discharge. At the same time, observe the patient’s intraoperative bleeding events and before discharge. The occurrence of adverse cardiovascular and cerebrovascular events. Results After stent implantation, the proportion of SF/NR patients in the study group was less than that in the control group (P<0.05), and the number of patients with TIMI blood flow level 3 in the study group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05) ). The comparison of the incidence of accidental bleeding events and adverse cardiovascular and cerebrovascular events between the two groups of patients during surgery and before discharge showed no significant difference (P>0.05); comparison of postoperative cardiac function indexes (LVEF, LVEDD, LVESD, FS) P value Both were >0.05, there was no significant difference between the two groups. Conclusion In ASTEMI patients undergoing emergency PCI stent placement, intracoronary prourokinase combined with tirofiban can help significantly improve the blood perfusion of patients with high thrombotic load undergoing stenting. This method significantly reduces the incidence of SF/NR, has fewer adverse reactions, good safety, and brings more benefits to STEMI patients.

Research progress of obstructive sleep apnea syndrome and coronary heart disease

huangbing,zhangxi — 2021/5/11 8:52:59

Obstructive sleep apnea syndrome (OSAS) has been repeatedly identified as an important independent risk factor for coronary heart disease (CHD), affecting the occurrence and development of CHD. The mechanism is not fully understood, and may be related to intermittent hypoxia, sympathetic nerve activation, oxidative stress, hypercoagulability, inflammatory response, endothelial dysfunction, metabolic abnormalities, etc. Whether continuous positive pressure ventilation has a positive effect on CHD remains controversial. In this review, the key aspects of the classification and diagnosis of OSAS are summarized, the possible mechanisms of OSAS involvement in CHD are discussed, the current evidence on the effect of continuous positive pressure ventilation on CHD is reviewed, and the prospects for the treatment of patients with CHD complicated with OSAS are proposed.

The clinical application of lidocaine and its brief mechanism

SHOU Yun-Feng — 2021/5/8 18:32:10

Lidocaine is an intermediate-acting local anesthetic of the aminoamide type and a sodium channel blocker. In addition to local anesthesia, regional anesthesia, and antiarrhythmic treatment, the clinical application of lidocaine is still very extensive, and its clinical application and brief mechanism are summarized below.

Progress of cough dysfunction after stroke

李毅 — 2021/5/8 18:31:35

Cough dysfunction is a common complication after stroke, leading to an increased risk of pneumonia and poor prognosis. By understanding the risk factors for cough dysfunction after stroke, it is of great significance to take effective interventions in high-risk patients at an early stage. This paper reviews the risk factors of cough dysfunction after stroke, the correlation between cough and the risk of pneumonia, the correlation between cough and respiratory dysfunction, and common rehabilitation treatment.

A Case Report of extramammary paget's disease and literature review

liujialing — 2021/5/8 18:30:59

A 78-year-old male had suffered from perineal erythema and itching for more than 3 years. The diagnosis of extramammary paget's disease was made by histopathology and immunohistochemical method.

A case report of harlequin?color change in newborn

fangyu — 2021/5/8 18:30:16

objective: to investigate the clinical features of harlequin color change (HCC) in newborns.Methods: the clinical data of a case of newborn harlequin color change admitted to our hospital were analyzed and the cases reported at home and abroad were analyzed and summarized.Results: neonate harlequin color change is a benign skin color change, self-limited, presenting side torso and/or limb color change, may be related to hypothalamus immaturity, capillary systolic instability, onset may be related to premature delivery, hyoxemia history, gravity change, pain stimulation, or not.

Analysis of spirometry measurements and target heart rate arrival and maintaining time during exercise challenge test in asthmatic and suspected asthmatic children

Huang Jun — 2021/5/8 18:29:30

Objective To analyze the variation of spirometry measurements with time and the effect of target heart rate arrival and maintaining time on the decline of spirometry measurements in children's exercise challenge test(ECT). Methods Data were collected retrospectively from 60 asthmatic and suspected asthmatic children and they all finished bicycle ergometer ECT successfully between November 2016 and September 2020 in Children’s Hospital Affiliated to Chongqing Medical University. A decrease of≥10% in FEV1 was considered as positive test. Basic data and spirometry measurements were obtained before and after the test. Childen were divided into two groups according to target heart rate arrival time≤4min and＞4min, and two groups according to maintaining time≥4min and＜4min. The spirometry measurements decline among two groups and the changes of spirometry measurements with time were analyzed. Results 11 subjects (18.33%) were considered ECT positive and 49 subjects (81.67%) were negative among 60 children. The target heart rate maintaining time in the positive group was significantly longer than that in the negative group(P＜0.05). The large and small airway parameters decreased differently after exercise, and gradually recovered from 20min. The decline of large airway parameters (FVC, FEV1, PEF, and FEF25) in target heart rate maintaining time≥4min group was higher than that in＜4min group (all P < 0.05). Conclusion The large and small airway contract differently after exercise, and gradually recovered from 20min. And the target heart rate maintaining time will affect the large airway constriction. Pediatricians should focus on whether children meet the requirements of the guidelines such as target heart rate maintaining time to evaluate the reliability and applicability of the results, which is helpful for clinical diagnosis and treatment plan.

Distribution and drug resistance analysis of nosocomial and community-based Escherichia coli infections our hospital from 2017 to 2019

黄聪,王玉沐 — 2021/5/8 18:28:50

Objective To analyze the situation of hospital infection and community infection of Escherichia coli in Department of general surgery, and to explore its drug resistance, so as to provide theoretical basis for rational drug use in clinical practice. Methods The Escherichia coli isolated from clinical specimens of patients in general surgery department from 2017 to 2019 was selected as the research object, which was divided into hospital infection group and community infection group. The incidence of nosocomial infection, sample distribution and multi drug resistance of Escherichia coli were analyzed, and the drug resistance rate of Escherichia coli to common antibiotics was compared between the two groups. Results The results showed that 32 strains of Escherichia coli (17.78%) were nosocomial infection in general surgery department; The incidence of Escherichia coli infection and nosocomial infection increased with the increase of years (P<0.05); wound drainage fluid was the most frequently detected specimen of Escherichia coli; Compared with community-acquired Escherichia coli, nosocomial Escherichia coli is more prone to multidrug resistance(P<0.05), And the resistance rate to carbapenems, cephalosporins and fluoroquinolones is higher (P<0.05); The resistance rates of ESBLs producing Escherichia coli to imipenem and tobramycin were higher (P<0.05). Conclusion Nosocomial infection and community-acquired Escherichia coli are sensitive to cefoxitin and Amikacin. Carbapenem, cefoxitin, and Amikacin can be used as the first choice for the treatment of ESBLs Escherichia coli infection. We should actively implement the prevention and control measures of multidrug-resistant bacteria, and reasonably select antibiotics according to the patient's condition, drug sensitivity and economic situation, so as to prevent the spread of Escherichia coli in the hospital.

Performance evaluation of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA reagent by multiple real-time fluorescence RT-PCR one-step methodHan Long,Li Hongyan, Yue Xi,Yin Han, Zhao Xiaomin,Sun Yanping

韩龙,,,, — 2021/5/8 18:27:56

Objective To evaluate the performance of a novel coronavirus (SARS-CoV-2) multiple fluorescent RT-PCR nucleic acid detection reagent. Methods According to the requirements of CNAS-GL039 "Molecular Diagnostic Test Procedure Performance Verification Guidelines" and combined with reagent instructions, the four performance indicators of reagent precision, minimum detection limit, negative-positive coincidence rate and anti-interference ability were verified and evaluated. Results In the intra-assay precision test, the CV of SARS-CoV-2 high value sample (1.00E+05copies/ml) N gene and ORFlab gene CV were 3.31% and 2.42% respectively; low value sample (1.00E+03copies/ml) N The CV of gene and ORFlab gene were 2.56% and 2.21%, respectively. In the inter-batch precision test, the N gene and ORFlab gene CV of high value samples were 3.75% and 2.69%, respectively; the N gene and ORFlab gene CV of low value samples were 2.78%, respectively , 2.39%, the coefficient of variation CV within and between batches are both <5.0%. For 5 concentrations (1.00E+05copies/ml,1.00E+04copies/ml,1.00E+03copies/ml,5.00E+02copies/ml,2.50E+02copies/ml) SARS-CoV-2 RNA positive sample N gene The gene detection rate of ORFlab and ORFlab is 100%, and the minimum detection limit is 250 copies/ml. Both the negative and positive coincidence rates were 100%. SARS-CoV-2 and common antiviral, antibacterial drugs, respiratory viruses and bacteria (dexamethasone, budesonide, ribavirin, ceftriaxone, azithromycin, tobramycin, staphylococcus aureus, type A There was no interference reaction between influenza virus, influenza B virus, rhinovirus. The interference group and the control group N gene, ORF1ab gene and RNase P internal reference gene showed specific amplification, the total CV of FAM channel was 1.75%, and the total CV of VIC channel It was 2.08%, and no non-specific amplification was found in the interference group. Conclusion The performance indicators of this reagent meet the standard, with good precision and sensitivity, high coincidence rate of negative and positive, and strong anti-interference ability. It can meet the testing requirements of laboratories and provide a reference for enterprises to continuously improve the quality of reagents.

Effect of bowel preparation quality with different timing of bowel preparation for colonoscopy

HUANG Caiyun,LAI Yadong,LIN Shuhui,LIU Linyong,ZHAO Meiyan — 2021/5/8 18:27:05

Objective To evaluate the effect of bowel preparation at different times of bowel preparation for colonoscopy. Method A total of 130 non-anesthetic outpatient and inpatient patients who underwent colonoscopy in our hospital from October 2019 to January 2020 were collected and divided into group A and group B according to appointment order by prospective study. Group A received oral colon cleaner from 5:00 am to 7:00am and completed colonoscopy in the morning. Group B received oral colon cleaner from 10:00 am to 12:00 am and completed colonoscopy in the afternoon. The Boston bowel preparation scale (BBPS) score and intestinal cavity bubble score were performed by the same experienced endoscope doctor after the examination, and the occurrence of adverse reactions in patients during intestinal preparation was recorded. Results Bowel preparation and colonoscopy were completed in all 130 patients. The total score of BBPS and the BBPS score of each segment of intestinal duct in group A were significantly higher than that in group B (P <0.05), the score of intestinal cavity bubbles in group A was significantly lower than that in group B (P <0.05), the incidence of abdominal distension in group A was significantly lower than that in group B (P <0.05), and the difference of other adverse reactions between the two groups was not statistically significant (P >0.05). Conclusion Colonoscopy with colon cleaner from 5:00 am to 7:00 am has good effect on bowel preparation and less adverse reactions, which is conducive to better detection of lesions and successful completion of colonoscopy.

Experience in treatment of chronic lacrimal canaliculitis with retrograde squeeze to remove stones combined with lacrimal tube implantation

潘淑玲 — 2021/5/8 18:26:20

Objective To summarize the surgical effect and treatment experience of retrograde squeeze to remove stones combined with lacrimal tube implantation for chronic lacrimal canaliculitis. Methods A retrospective analysis of 35 patients with chronic lacrimal canaliculitis treated in our hospital from June 2018 to December 2020, of which 10 were upper lacrimal ductitis and 25 were lower lacrimal ductitis.None of them combined with chronic dacryocystitis. The clinical symptoms and signs of all patients were recorded. All patients underwent retrograde squeeze to remove stones combined with lacrimal tube implantation under local anesthesia. Antibiotic eye drops were given to flush the lacrimal duct and conjunctival sac for three days after operation.The silicone tube was removed one month after surgery.The postoperative observation time：1week、1month and 3 months after operation. The improvement of symptoms,the morphology of lacrimal canaliculi and the results of lacrimal irrigation were observed and analysed. Results After treatment,35 patients were discharged without complications.The results at 3 months after operation showed that: The symptoms gradually disappeared in all patents.The morphology of lacrimal canaliculi: 30 cases tended to be normal,2 cases had incomplete obstruction and 3 cases were still in the state of expansion and hypertrophy. The results of lacrimal irrigation: 30 eyes were passable,5 eyes were not completely passable.The clinical cure rate was 85.71%.Conclusion Retrograde squeeze to remove stones combined with lacrimal tube implantation is effective in the treatment of chronic canaliculitis, which can effectively solve the symptoms of purulence and has little damage to the lacrimal passage. However, it is necessary to master the indications before operation, to remove the stones as much as possible during the operation, to avoid damaging the lacrimal duct mucosa during the intubation, and to strengthen the application of sensitive antibiotics postoperatively.

the influence of the quantitative grading system of pelvic organ prolapse (POP-Q) on the pelvic floor injury after different delivery

zhangjihong — 2021/5/8 18:25:22

To explore the influence of the quantitative grading system of pelvic organ prolapse (POP-Q) on the pelvic floor injury after different delivery. Methods: the primipara of Obstetrics and gynecology in our hospital were randomly selected. According to the mode of delivery, the subjects were divided into two groups: cesarean section group and vaginal delivery group. Each group had 120 patients. Cesarean section was set as the observation group and vaginal delivery group as the control group. At the 6th week after delivery, the two groups of primipara were tested for pelvic floor function, POP-Q score, pelvic floor electric diagnosis and the incidence of stress urinary incontinence (SUI) were recorded. Results: (1) the POP-Q scores of the observation group were better than those of the control group in the following aspects: the middle line of the anterior wall of the vagina was 3cm away from the edge of the hymen (AA), the farthest distance of the anterior wall of the vagina from the edge of the hymen (BA), the middle line of the posterior wall of the vagina was 3cm away from the edge of the hymen (AP), the farthest distance of the posterior wall of the vagina from the hymen (BP), the length of the genital cleft (GH), the length of the perineum body (PB), and the total length of the vagina (TVL) The difference was statistically significant (P<0.05), but there was no significant difference between the two groups at point d (P>0.05). (2) The rate of prolapse of anterior vaginal wall (45.4%) and posterior vaginal wall (32.4%) in the observation group were lower than that in the control group (85.9% and 63.6%) (P<0.05); the rate of uterine prolapse (5.7%) was not significantly different from that in the control group (8.1%) (P> 0.05). (3) There was no significant difference between the two groups (P> 0.05). (4) There was no significant difference between the two groups (P > 0.05). Conclusion: there is no significant difference in the rate of uterine prolapse and the incidence of Sui between the two delivery methods. Combined with POP-Q score, cesarean section has less impact on the pelvic floor function.

Effects of stress hyperglycemia on cerebral hemorrhage after craniotomy and hematoma removal

2021/5/6 16:11:58

Objective To investigate the effect of stress-induced hyperglycemia on the removal of cerebral hemorrhage after craniotomy. Methods To retrospectively analyze the data of patients who underwent craniotomy after intracerebral hemorrhage, collect the clinical data of 131 patients from January 2018 to December 2019, and divide them into stress hyperglycemia group and non-stress hyperglycemia group according to whether stress hyperglycemia occurs In the acute hyperglycemia group, 62 cases were in the stress hyperglycemia group and 69 cases were in the non-stress hyperglycemia group. The differences in clinical data between the two groups were compared. Results There was no significant difference in age, sex ratio, preoperative blood loss, preoperative coagulation function, and preoperative platelet count between the two groups (P>0.05). Compared with the non-stress hyperglycemia group, the postoperative ICU admission time accounted for higher proportion of total hospital stay, the chance of intracranial infections was higher, the risk of rebleeding was higher, and the GOS prognosis score was lower, higher mortality rate in 30 days (P<0.05). Conclusion Stress hyperglycemia can cause adverse outcomes after cerebral hemorrhage after craniotomy and hematoma removal, which should be paid clinical attention.