Abstract:Objective:To explore the effect of RNA binding ZCCHC17 on proliferation,migration and invasion ability of hepato-cellular carcinoma(HCC).Methods:RT-qPCR and Western blot were used to detect the expression levels of the cell lines ZCCHC17 selected.Then,the proliferation,migration,and invasion ability of cell lines were examined by clonformation assay,CCK-8 assay,scratch assay and Transwell invasion assay.Results:ZCCHC 17 was lowly expressed in human normal liver cell line L02(P＞0.05),high ex-pression was observed in the Bel7404 hepatocellular carcinoma cell line(P＜0.05),and low expression was observed in the MH-CC97H hepatocellular carcinoma cell line was diminished after ZCCHC17 knockdown(P＞0.05).The results of clone formation assay and CCK-8 showed that the proliferation of Bel7404 cell lines was diminished after ZCCHC17 knockdown(P＜0.05),the scratch test results showed that the migration ability of Bel7404 cell lines decreased(P＜0.05),the Transwell experiment showed that the invasion ability of Bel7404 cell lines was weakened(P＜0.05).Conclusion:High expression of ZCCHC17 can promote the proliferation,migra-tion and invasion of hepatocellular carcinoma.

Abstract:Objective:To explore the molecular mechanism that palmitoyl acyltransferase 20(ZDHHC20)participates in the pathogenesis of colorectal cancer(CRC)through Palmitoylation modification to regulate 5-methylcytosine(m5C)reader Y-box binding proteinl(YBX1)protein stability,and improve mRNA m5C modification level.Methods:The expression of ZDHHC20 mRNA and pro-tein in CRC was analyzed by bioinformatics.Further analysis of the association among ZDHHC20 expression levels and the clinicopatho-logical features of CRC patients was performed.The expression level of ZDHHC20 in CRC cells was verified using RT-qPCR.A CCK-8 assay was used to detect the effect of ZDHHC20 on the proliferation of CRC cells.Transwell was used for cell invasion assays.The rela-tionship between the expression of ZDHHC20 and YBX1 in CRC and the palmitoylation site of YBX1 was investigated by bioinformatics database analysis.Palmitoylation protein was enriched by ABE method and Westernblot experiment was used to detect YBX1 palmitoyla-tion modification in CRC.Overexpression of ZDHHC20 was used to detect the palmitoylation modification level of YBX1.The Western blot was used to measure the stability of YBX1 protein under 2-BP and actinomycin.The influence of YBX1 on the proliferation and mi-gration of CRC cells was measured by CCK-8 and Transwell.LC-MS was used to analyze the impact of YBX1 on m5C modification level in CRC cells.Results:An upregulation of ZDHHC20 mRNA and protein were observed in the sample CRC cells and tissues(P＜0.05).ZDHHC20 expression was correlated with age,tumor stage and lymph node metastasis(P＜0.05).Overexpression of ZDHHC20 contributes to proliferation and invasion in CRC cells(P＜0.05).The expression between ZDHHC20 and YBX1 were posi-tively correlated(P＜0.05),and YBX1 had multiple palmitoylation modification site.YBX1 was a palmitoylated protein and ZDHHC20 could increase YBX1 palmitoylation modification level and improve the stability of YBX1 protein(P＜0.05).YBX1 could enhance CRC cell proliferation and invasion.Also YBX1 could improve m5C modification level in CRC(P＜0.05).Conclusion:ZDHHC20 can improve the stability of YBX1 protein through Palmitoylation modification and mRNA m5C modification level,and enhance CRC cell proliferation and invasion.

Abstract:Objective:To explore the molecular mechanisms of protective effects of glutathione(GSH)in mice with acetamino-phen-induced acute liver injury.Methods:120 mice were randomly divided into 3 groups:Control,APAP,GSH,with 40 in each group.After establishing the model,mice in the GSH groups were intraperitoneally injected with GSH(0.40 g/kg)for 3 days.Subsequently,liver tissue samples were collected.SWATH combined with liquid chromatography-tandem mass spectrometry was used to analyze the protein expression profile,and the differentially expressed proteins between APAP group and Control group,GSH group and APAP group were screened out.GO functional annotation and KEGG pathway enrichment analysis were performed for the above differential proteins.Protein interaction network(PPI)was constructed by String database and Cytoscape software,and the key proteins were verified by im-munohistochemical staining.Results:A total of 310 differentially expressed proteins were screened out between APAP group and Control group.A total of 172 differentially expressed proteins were screened out between the GSH group and the APAP group.The enrichment a-nalysis of the above differentially expressed proteins showed that the differential proteins were mainly enriched in the functions and pathways of nitrogen metabolism,fatty acid metabolism,and organic acid metabolism.Further analysis identified 17 differentially ex-pressed proteins between APAP group vs.Control group and GSH group vs.APAP group.Anxa5,Rgn,Tagln,Vim and Usp5 may be re-lated to apoptosis.Anxa5 and Rgn protein expression was higher in the APAP group than in the Control group(P＜0.05).In contrast,Anxa5 protein expression decreased and Rgn protein expression increased in the GSH group compared to the APAP group(P＜0.05),there was no statistically significant difference in Tagln,Vim,and Usp5(P＞0.05).Conclusion:GSH protects mice from APAP-in-duced liver injury by inhibiting cell apoptosis.Anxa5,Rgn,Tagln,Vim,and Usp5 are potential targets.

Abstract:Objective:To explore the effect of auricular point sticking combined with foot bath in promoting the postoperative re-covery of patients with adenomyopathy and the mechanism of analgesia and anti-anxiety.Methods:A total of 107 patients with adenomy-opathy who underwent high intensity focused ultrasound(HIFU)were divided into observation group(n=54)and control group(n=53)according to different intervention methods.Patients in the control group were given foot bath intervention after surgery.Observation group was given auricular point sticking intervention on the basis of control group after operation,and both groups were continuously in-tervened for 5 days.The VAS score,TCM syndrome score,mental state[Hospital Anxiety and Depression Scale(HADS)],number of sleep and wake times,serum neurotransmitters[β-endorphin(β-EP),5-hydroxytryptophan(5-HT)]and inflammatory factors[Inter-leukin-6(IL-6),soluble vascular cell adhesion molecule-1(sVCAM-1)],adverse reactions,and recurrence rate within 1 year were compared between the two groups.Results:At 1,3 and 5 d after surgery,the VAS scores in both groups decreased gradually,and the ob-servation group was lower than the control group(P＜0.05).After 5 days of treatment,TCM syndrome score and anxiety HADS(A)score were lower in both groups than those of 1 day after surgery(P＜0.05).The observation group was lower than the control group(P＜0.05).The number of sleep and wake times within 5 days after surgery in the observation group was lower than that in the control group(P＜0.005).After 5 days of treatment,the serum levels of β-EP and 5-HT in the two groups were higher than 1 day after surgery(P＜0.05),and the observation group was higher than the control group(P＜0.05).The levels of IL-6 and sVCAM-1 were lower than 1 day after surgery(P＜0.05),and the observation group was lower than the control group(P＜0.05).After 1 year of follow-up,there was no statistically significant difference in the recurrence rate between the two groups(P＞0.05).Conclusion:Auricular point stick-ing combined with foot bath can effectively promote the postoperative recovery of patients with adenomyopathy,reduce postoperative pain,improve clinical symptoms and anxiety,which may be related to the analgesic and anti-anxiety effects by regulating neurotransmit-ters and reducing the level of inflammatory factors,with good safety and not easy to relapse.

Abstract:Objective:To explore the influence of combination of sintilimab and platinum-based chemotherapy on immune inde-xes and survival cycle in patients with advanced gastric cancer(AGC).Methods:82 patients with AGC were included and divided into chemotherapy group(n=41,platinum therapy)and combined group(n=41,sintilimab+platinum therapy)according to different treatment regimens.21 days was one cycle,both groups were treated for 3 cycles,followed up for 1 year.The immune indicators[CD3+T cell,CD4+T cell,CD8+T cell and CD4+/CD8+T cell levels]and angiogenesis indexes[endostatin(ES),angiopoietin-2(Ang-2),vascular endothelial growth factor(VEGF)]before and after treatment,clinical efficacy and incidence rates of adverse reactions were compared between the two groups.Kaplan Merier was used to analyze the 1-year survival status of the two groups.Results:After treatment,compared with the chemotherapy group,the levels of CD3+,CD4+,CD4+/CD8+,ES,total effective rate and 1-year survival rate in the combined group were higher(P＜0.05)while the levels of CD8+,Ang-2 and VEGF were lower(P＜0.05).There were no statistical differences in adverse reactions between groups(P＞0.05).Conclusion:The application of sintilimab combined with plati-num-based chemotherapy for patients with AGC can reduce the influence of chemotherapy on immune function,inhibit the tumor angio-genesis,and enhance the clinical efficacy and survival rate,and it has safety.

Abstract:Objective:To explore the clinical effect of botulinum toxin type A combined with different parameters of CO2 frac-tional laser with different parameters on improving periorbital skin aging.Methods:A total of 108 patients with periorbital skin aging were enrolled as the research subjects.Both groups were given botulinum toxin type A combined with CO2 fractional laser.54 patients with parameters of 50 mJ and 8％were collected as group A,and 54 patients with parameters of 30 mJ and 4％were included in group B.The Global Aesthetic Improvement Scale(GAIS),skin images scores,skin barrier function,pain level[Visual Analogue Scale(VAS)]and incidence rates of complications were compared between groups.Results:At 6 months after treatment,the GAIS grading in group A was better than that in group B(P＜0.05).The skin images scores and transcutaneous water loss in both groups were lower than those before treatment(P＜0.05),and the indicators in group A were lower than those in group B(P＜0.05).The skin grease content and water content of stratum corneum were increased in both groups(P＜0.05),and the indicators in group A were higher than those in group B(P＜0.05).Immediately after treatment,the VAS score was higher in group A than that in group B(P＜0.05).There were no statistical differences in the incidence rates of complications between groups(P＞0.05).Conclusion:Botulinum toxin type A combined with 50 mJ,8％CO2 fractional laser can improve the overall cosmetic effect of patients,but the immediate postoperative pain level is higher.

Abstract:Objective:To investigate the correlation between ATP-binding cassette B subfamily 1 transporter(ABCB1)gene polymorphism and the efficacy of levetiracetam(LEV)in children with epilepsy.Methods;A total of 94 children with epilepsy were se-lected as the research subjects.According to the curative effect,they were divided into effective group(n=76)and ineffective group(n=18).Polymerase chain reaction and fluorescence in situ hybridization(PCR-FISH)were used to detect ABCBI genotypes in all children,and clinical data were collected.The clinical data and ABCBI genotype were compared between the two groups.Logistic regres-sion model was used to determine the risk factors of LEV treatment failure.Results;Compared with the effective group,the proportion of first onset as myoclonic type,seizure frequency,EEG abnormality and birth suffocation in the ineffective group were higher(P＜0.05).Compared with the effective group,the proportion of ABCB1 C3435 T TT type in the ineffective group was higher,and the frequency of T gene distribution was higher,the differences were statistically significant(P＜0.05).Logistic regression analysis showed that seizure frequency(OR=5.812),birth asphyxia(OR=3.274),and ABCB1 genotype(OR=7.675)were independent influencing factors of LEV efficacy in children with epilepsy(P＜0.05).The risk of treatment failure with TT genotype was higher than that with CC and CT genotypes.Conclusion:ABCB1 gene polymorphism is closely related to the efficacy of epilepsy in children.TT genotype may be a risk factor for LEV treatment failure.In addition,the risk of ineffective LEV treatment is higher in patients with higher seizure frequency and birth asphyxia.

Abstract:Objective:To compare the short-term and long-term curative effects of video-assisted thoracoscopic surgery(VATS)transthoracic internal fixation and traditional thoracotomy on patients with multiple rib fractures.Methods:The data of 106 patients with multiple rib fractures were retrospectively analyzed.The patients were classified into two groups by using to the different surgical meth-ods,including traditional group(traditional thoracotomy)and VATS group(VATS transthoracic internal fixation).The propensity score matching method(caliper=0.01,at a ratio of 1:1)was used to match the two groups.53 cases were finally obtained in each group.The perioperative indicators,incidence rates of complications,postoperative pain degree(VAS),disease recovery status and long-term curative effect were compared between groups.Results:The VATS group had shorter surgical time and total hospitalization time(P＜0.05),and the incidence rates of complications were lower(P＜0.05).At 5 and 7 days after surgery,the VAS score was de-creased with time(P＜0.05),and the VAS score in VATS group at 1,5,and 7 days after surgery was lower(P＜0.05).The fracture alignment rate,incision healing rate and excellent and good rate of postoperative effect were higher in VATS group(P＜0.05).Conclu-sion:Compared with traditional thoracotomy,VATS transthoracic internal fixation can more accurately locate the fracture,shorten the surgical time,promote the postoperative recovery of multiple rib fractures,with few postoperative complications and ideal long-term cura-tive effect,which is worthy of clinical application.

Abstract:Objective:To explore the efficacy of holmium laser enucleation of the prostate(HoLEP)in the treatment of benign prostatic hyperplasia(BPH)and the influence on serum prostate specific antigen(PSA)and erectile function of patients.Methods:A total of 98 BPH patients were selected as the study subjects,and they were divided into HoLEP group and TURP group according to dif-ferent surgical treatment methods,with 49 cases in each group.HoLEP group were treated with HoLEP,and TURP group were treated with TURP.The perioperative related indicators(surgical time,bleeding volume,catheterization time,bladder flushing time,and hospital stay),clinical efficacy,serum PSA level,erectile function[International Index of Erectile Function(IIEF-5)],urodynamic parameters[maximum urinary flow rate(Qmax),post voiding residual urine volume(PVR)]and incidence rates of complications were compared between the two groups.Results:The surgical time,bleeding volume,catheterization time,bladder flushing time,and hospital stay in Ho-LEP group were shorter or less than those in TURP group(P＜0.05).At 6 months after surgery,the total clinical efficacy was higher in HoLEP group than that in TURP group(P＜0.05).The PSA level and PVR in the two groups were decreased(P＜0.05),and the in-dicators in HoLEP group were lower than those in TURP group(P＜0.05).The IIEF-5 scores were declined in both groups(P＜0.05),and the HoLEP group had higher scores than the TURP group(P＜0.05).The Qmax in both groups was risen(P＜0.05),and the HoLEP group had higher Qmax(P＜0.05).The incidence rates of complications in HoLEP group were lower compared to TURP group(P＜0.05).Conclusion:HoLEP can enhance the clinical efficacy of patients with BPH,and can protect e-rectile function,and reduce PSA level and incidence rates of complications.

Abstract:Objective:To investigate the effect of hysteroscopic incision and excision of uterine adhesion on endometrial receptiv-ity.Methods:60 patients with moderate and severe uterine adhesions were divided into the study group and the control group according to the different treatment methods,30 cases in each group.Patients in the study group were treated we used a plasma electrode needle under hysteroscopy to just strip away adhesion.Whereas,the control group additionally required the use of an electrocution ring removal for scar excision.Endometrial receptivity indexes were evaluated by transvaginal ultrasound.Follow-up pregnancy outcome.Results:En-dometrial vascular index(VI)and vascular blood flow index(VFI)were higher in the study group than in the control group(P＜0.05).There was no statistically significant difference between the two group in intraoperative situation,post-operative hystero-scopic evaluation,menstrual recovery,endometrial type,blood flow pattern,endometrial thickness(ED),endometrial volume(EV)and blood flow index(FI)(P＞0.05),and no statistically dignificant difference in pregnancy outcome(P＞0.05).Conclusion:Under hysteroscopy,simple plasma electrode needle incision and electrocution ring removal could effectively restore uterine cavity morphology.The former is simpler than the latter,and has less influence on the blood flow parameters in endometrial receptivity.

Abstract:Objective:To investigate the efficacy and safety of calcium,niergoline combined with flunarizine in the treatment of peripheral vestibular vertigo.Methods:A total of 106 patients with peripheral vestibular vertigo were selected.They were divided into group A(Flunarizine,n=36),group B(Nyergoline+Flunarizine,n=35)and group C(calcium+Nyergoline+Flunarizine,n=35)according to different intervention methods,all groups were treated for 6 weeks.The degree of dizziness[dizziness handicap inven-tory(DHI)],dizziness symptoms[vertigo symptom scale-short form(VSS-SF),vestibular symptom index(VSI)scores],hemodynam-ic parameters[whole blood viscosity,hematocrit,vertebral artery mean velocity(Vm),basilar artery Vm],treatment effect,adverse re-actions during treatment and recurrence 6 months after treatment were compared among the groups before and after treatment.Results:After treatment,DHI scores,VSS-SF scores and VSI scores of physical,functional and emotional dimensions in group B and group C were lower than those in group A(P＜0.05).After treatment,the clinical effective rate of group B and group C was higher than that of group A(P＜0.05).After treatment,the whole blood viscosity and hematocrit of groups B and C were lower than those of group A(P＜0.05),and the Vm of vertebral artery and basilar artery were higher than those of group A(P＜0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P＞0.05).The recurrence rate of the three groups 6 months after treatment was significantly different(27.78％vs.25.71％vs.5.71％,P＜0.05).Conclusion:Calcium,niergoline combined with flunarizine is effective in the treatment of peripheral vestibular vertigo,and is beneficial to reduce the risk of disease recurrence.

Abstract:Objective:To explore the related factors of anemia in premature infants.Methods:410 premature infants were retro-spectively collected and divided into anemia group(n=153)and non-anemia group(n=257)based on whether anemia occurs or not.The general information such as collect sex,number of fetuses,conception,mode of delivery,premature rupture of membranes,maternal anemia,maternal cholestasis,gestational hypertension,gestational diabetes,gestational hypothyroidism,prenatal use of hormones,intrau-terine distress,cardiopulmonary resuscitation,preeclampsia,pulmonary surfactant use,mechanical ventilation,intravenous nutrition,neo-natal septicemia,neonatal respiratory distress syndrome,gestational age,birth weight,length of stay,birth hemoglobin content,birth red blood cell count,mechanical ventilation,pregnancy,number of births,maternal age,multivariate,pregnancy,number of births,and mater-nal age were compared between two groups.Logistic regression analysis was used to screen the independent influencing factors.Results:There were statistically significant difference in intrauterine distress,cardiopulmonary resuscitation,preeclampsia,neonatal sepsis,neo-natal respiratory distress syndrome,mechanical ventilation,pulmonary surfactant use,intravenous nutrition use,length of hospital stay,gestational age,mechanical ventilation time,birth hemoglobin content,birth weight,and birth red blood cell count between two groups(P＜0.05).There was no statistically significant difference in other data(P＞0.05).The results of Logistic regression analysis showed that the number of days in hospital,the use of parenteral nutrition and preeclampsia were the risk factors of anemia in premature infants(OR=1.105,2.424,5.113,P＜0.05),birth weight and hemoglobin content were protective factors for anemia in premature infants(OR=0.999,0.904,P＜0.05).Conclusion:Lower birth weight,lower birth hemoglobin content,longer hospital stay,pregnant women with preeclampsia and use of intravenous nutrition will increase the risk of anemia in premature infants.

Abstract:Objective:To investigate the efficacy and safety of unilateral biportal endoscopic(UBE)in the treatment of elderly patients with lumbar disc herniation(LDH)and degenerative scoliosis.Methods:90 elderly patients with LDH complicated with degen-erative scoliosis were selected,and they were divided into UBE group(n=45)and open group(n=45)according to different inter-vention methods.The indexes related to surgery and hospitalization,the Japanese Orthopaedic Association(JOA)lumbar function score,Oswestry Disability Index(ODI),intervertebral height,spinal canal area,lumbar scoliosis Cobb Angle,and visual analog score(VAS)were compared between the two groups.The incidence of complications during hospitalization was recorded and compared be-tween the two groups.Results:The intraoperative blood loss in UBE group was lower than that in open group(P＜0.05),and the first time of getting out of bed and the length of hospital stay were shorter than that in open group(P＜0.05).The operative time of UBE group was longer than that of open group(P＜0.05).3 months after surgery,there were no significant differences in JOA lumbar func-tion score,ODI,intervertebral height,vertebral canal area and Cobb Angle between the two groups(P＞0.05).The VAS scores in the UBE group were lower than those in the open group at 1 day and 3 months after surgery(P＜0.05).During hospitalization,the compli-cation rate in the UBE group was lower than that in the open group(P＜0.05).Conclusion:The efficacy of UBE in the treatment of elderly LDH complicated with degenerative scoliosis is comparable to that of traditional open surgery,but UBE is beneficial to reduce in-traoperative blood loss,relieve pain,promote postoperative recovery of patients,and reduce the risk of postoperative complications,but the operation time is relatively prolonged.

Abstract:Objective:To observe the efficacy of Augmented Lou Bei Er Chen Decoction in treating pulmonary nodule(PN)characterized by Qi stagnation and phlegm stasis with concomitant anxiety and depression based on the theory of"state-target syndrome differentiation".Methods:A retrospective analysis was conducted on the clinical data of 80 patients diagnosed with PN presenting Qi stagnation and phlegm stasis with anxiety and depression.These patients were divided into two groups:The control group,consisting of 40 participants,received Shu Gan Jie Yu Capsules.On the other hand,the treatment group,with also 40 participants,was administered Augmented Lou BeiEr Chen Decoction in addition to Shu Gan Jie Yu Capsules,the course of treatment was 3 months.Clinical efficacy,Traditional Chinese Medicine(TCM)syndrome scores,psychological states[assessed using the Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)],and adverse reactions were compared between the two groups at baseline and after 3 months of treatment.Results:After a 3-month treatment period,the treatment group exhibited a significant reduction in the maximum diameter of nodules compared to the control group(P＜0.05).Moreover,there was a notable discrepancy in clinical efficacy between the two groups post-treatment,with the treatment group demonstrating a higher overall clinical effective rate than the control group(47.50％vs.17.5％,P＜0.05).Following the 3-month treatment duration,both groups experienced decreases in SAS,SDS and TCM syndrome scores,these scores were consistently lower in the treatment group compared to those of the control group(P＜0.05).Importantly,sig-nificant differences were observed in TCM syndrome efficacy between the two groups after treatment,with a higher total effective rate of TCM syndrome efficacy found within the treatment group compared to that of the control group(P＜0.05).Notably,no statistically sig-nificant difference was detected regarding adverse reaction incidence between both groups(P＞0.05).Conclusion:Based on the theory of"state-target syndrome differentiation",Augmented Lou Bei Er Chen Decoction intervention in the treatment of PN with anxiety and depression demonstrates significant clinical efficacy and warrants further promotion.

Abstract:Objective:To explore the risk factors of blood glucose fluctuation and complications in patients with diabetes.Meth-ods:23 8 patients with type 2 diabetes were retrospectively selected for standardized diagnosis,treatment and follow-up.According to whether the diabetic patients had blood glucose fluctuation and diabetic complications,they were divided into blood glucose fluctuation group(n=54),non-blood glucose fluctuation group(n=184),and diabetic complication group(n=35),non-diabetic complication group(n=203).After 12-month follow-up,the risk factors of blood glucose fluctuation and complications in patients with diabetes were identified by univariate analysis and multivariate regression analysis.And establish a risk prediction model for the occurrence of blood glucose fluctuation and diabetes in patients with diabetes.Results:Univariate and multivariate regression analysis showed that male,smoking,course of disease,number of treatment lines,and higher levels of blood triglycerides(TG)were independent risk factors for causing blood glucose fluctuations in patients(P＜0.05).Age,male,smoking,course of disease,number of treatment lines,glycosylat-ed hemoglobin,higher TG and lower level of glomerular filtration rate(eGFR)were independent risk factors for diabetic complications(P＜0.05).Based on the risk factors,the risk prediction model of blood glucose fluctuation and diabetic complications in patients with diabetes were established.Through internal verification,the area under the curve calculated by ROC curve was 0.954 and 0.934,which proved that the prediction efficiency of the model was better.Conclusion:Male,smoking history,course of disease,number of treatment lines and TG level are independent risk factors for blood glucose fluctuation in patients.Age,male,smoking,course of disease,number of treatment lines,glycosylated hemoglobin,higher TG and lower eGFR levels are independent risk factors for diabetic complications.Based on the risk factors,the risk prediction model of blood glucose fluctuation and complications in patients with diabetes can be estab-lished,and the prediction efficiency of the model is good.

Abstract:Objective:To analyze and explore the correlation between serum homocysteine(Hcy),serum amyloid A(SAA),low/high-density lipoprotein cholesterol(LDL//HDL)and carotid plaques,prognosis in patients with acute cerebral infarction.Meth-ods:According to stability of carotid plaques,102 patients with acute cerebral infarction were divided into stable group(n=64)and unstable group(n=38).The peripheral blood indicators(Hcy,SAA and LDL/HDL),and carotid plaque stability(vulnerability scores)in the two groups were compared,and their correlation was analyzed.According to prognosis,patients were divided into good prognosis group(n=57)and poor prognosis group(n=45).The peripheral blood indicators(Hcy,SAA and LDL/HDL)were com-pared between the two groups,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of peripheral blood indicators on patient prognosis.Results:Hcy,SAA,LDL/HDL levels and vulnerability scores in stable group were lower than those in unstable group(P＜0.05).Spearman correlation analysis showed that the stability of carotid plaques was positively correlated with Hcy,SAA and LDL/HDL levels(P＜0.05).The levels of Hcy,SAA and LDL/HDL in good prognosis group were lower than those in poor prognosis group(P＜0.05).ROC curves analysis showed that area under the curve(AUC)values of Hcy,SAA and LDL/HDL for predicting prognosis were 0.788,0.796 and 0.676,respectively(P＜0.05).Conclusion:The levels of Hcy,SAA and LDL/HDL are correlated with the stability of carotid plaques in patients with acute cerebral infarction,which also have predictive value in prognosis.

Abstract:Objective:To investigate the effect of dapagliflozin combined with recombinant human brain natriuretic peptide(rh-BNP)in patients with acute heart failure(AHF)and its effects on serum related factors.Methods:104 patients with AHF were divided into control group and observation group according to different treatment methods,52 cases in each group.The control group was treated with rhBNP,and the observation group was treated with dapagliflozin combined with rhBNP.The curative effect was evaluated after 7 days of treatment.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),Kansas Cardiomyop-athy Questionnaire(KCCQ)score,serum N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin(cTnT),high-sensi-tivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)levels were compared between the two groups.The hospitalization time,in-hospital mortality,30-day readmission rate and adverse reactions of the two groups were statistically analyzed.Results:After treatment,the total effective rate of treatment of the observation group was higher than that of the control group(P＜0.05).Compared with the control group,the observation group had higher LVEF level,KCCQ score and lower LVEDD(P＜0.05),and the serum levels of NT-proBNP,cTnT,hs-CRP and IL-6 in the observation group were lower(P＜0.05).Compared with the control group,the hospitalization time of the observation group was shorter(P＜0.05),there was no significant difference in the incidence of in-hospital death,30-day readmission rate and adverse reactions between the two groups(P＞0.05).Conclusion:Dapagliflozin combined with rhBNP in patients with AHF can reduce inflammation,down-regulate serum NT-proBNP and cTnT levels,improve cardiac function,improve efficacy,and have good safety.

Abstract:Objective:To analyze the application of magnetic resonance imaging(MRI)diffusion weighted imaging(DWI)and dynamic contrast enhanced MRI(DCE-MRI)in the diagnosis of prostate cancer(PCA).Methods:105 patients with suspected PCA were selected as the research subjects,and they underwent DWI and DCE-MRI scanning.With pathological biopsy as the gold standard,Kappa consistency test was used to analyze the accuracy,sensitivity and specificity of DWI,DCE-MRI alone and their combined exami-nation in the diagnosis of PCA.Results:66 cases of PCA and 39 cases of benign prostatic lesions were detected by DWI respectively.The Kappa value of DWI and pathological biopsy in diagnosing PCA was 0.918.DCE-MRI detected 60 cases of PCA and 45 cases of benign prostatic lesions,and the Kappa value of PCA diagnosed by DCE-MRI and pathological biopsy was 0.761.The sensitivity and ac-curacy of DWI for PCA diagnosis were 95.59％and 96.19％,which were higher than 85.29％and 88.57％of DCE-MRI(x2=4.168,4.330,P=0.041,0.037).The Kappa value of DWI+DCE-MRI and pathological biopsy for PCA diagnosis was 0.937,and the sensitivity and accuracy were 98.53％and 97.14％,respectively.Conclusion:DWI has higher accuracy and sensitivity in the diagnosis of PCA than DCE-MRI,and the combined diagnosis of the two can up-regulate the diagnostic efficiency of prostate cancer to a certain extent.

Abstract:Objective:To investigate the therapeutic effect and mechanism analysis of nimergoline combined with transcutaneous auricular vagus nerve stimulation(taVNS)in the treatment of post-stroke cognitive impairment(PSCI).Methods:104 PSCI patients were selected as the study subjects and divided into a research group(n=52)and a control group(n=52)according to different treatment methods.The control group was given a conventional treatment plan,while the observation group was given a combination of nimergoline and taVNS on the basis of the control group.After 4 weeks of intervention,the levels of cognitive function,neurological func-tion,neurotransmitters,and inflammatory factors were compared between the two groups of patients.Results:After 4 weeks of interven-tion,compared with the control group,the research group showed an increase in MoCA scores in all dimensions(P＜0.05),a decrease in NIHSS scores,neuron-specific enolase(NSE)and S100 calcium binding protein β(S100β)levels(P＜0.05),an increase in ser-um 5-hydroxytryptamine(5-HT),dopamine(DA),and norepin ephrine(NE)levels(P＜0.05),and a decrease in serum interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels(P＜0.05).Conclusion:The combination of nimergo-line and taVNS has a definite therapeutic effect on PSCI,and it is speculated that its mechanism of action may be related to improving the levels of neurotransmitters and inflammatory factors.

Abstract:Objective:To explore the clinical efficacy of vitamin D-assisted methylphenidate in the treatment of children with be-nign epilepsy with centrotemporal spikes(BECTS)complicated with attention deficit hyperactivity disorder(ADHD).Methods:60 children with BECTS and ADHD were selected as the research subjects.According to the different treatment methods,they were divided into control group and combined group,30 cases in each group.The control group was treated with methylphenidate,and the observation group was treated with vitamin D combined with methylphenida,continuous treatment for 3 months.The clinical efficacy,clinical core symptoms[Conners Children's Behavioral Parent Questionnaire(PSQ)],cognitive function[Wechsler Intelligence Scale for Children-Ⅳ(WISC-Ⅳ),Mini-Mental State Examination(MMSE)],serum inflammatory factors[interleukin-6(IL-6),IL-1β,tumor necrosis factor-α(TNF-α)],EEG θ/β ratio and incidence of adverse reactions were compared between the two groups.Results:The total effec-tive rate of combined group was higher than that of the control group(93.33％vs.73.33％,P＜0.05).After 3 months of treatment,the PSQ scores of the two groups were decreased(P＜0.05),and the combined group was lower than the control group(P＜0.05).The scores of WISC-Ⅳ and MMSE of children in the two groups were increased(P＜0.05),and those in the combined group were higher than the control group(P＜0.05).The levels of serum inflammatory factors TNF-α,IL-1 β,IL-6 and EEG θ/β ratio of children in the two groups were decreased(P＜0.05),and those in the combined group were lower than those in the control group(P＜0.05).The total incidence of adverse reactions between the two groups had no significant difference(6.67％vs.13.33％,P＞0.05).Conclu-sion:Vitamin D supplementation on the basis of methylphenidate in the treatment of BECTS children with ADHD can improve the clini-cal efficacy,relieve the clinical core symptoms,improve the cognitive function,reduce the level of inflammation and EEG θ/β ratio,and has good safety.

Abstract:Objective:To explore the risk factors of failure of vaginal trial delivery and transfer to cesarean section in parturients with combined spinal-epidural analgesia,and to construct its nomogram prediction model.Methods:A total of 512 parturients who un-derwent combined spinal-epidural analgesia were included.According to the final delivery method,the patients were divided into vaginal delivery group(n=483)and cesarean section group(n=29).Multivariate Logistic regression analysis was used to establish the inde-pendent risk factors for the failure of vaginal trial production and conversion to cesarean section in parturients undergoing combined spi-nal-epidural analgesia.The nomogram prediction model was constructed,and the receiver operating characteristic(ROC)curve was used to verify the prediction efficiency of the model.Results:There were significant differences in age,BMI at delivery,amniotic fluid indexing,eclampsia and preeclampsia,gestational diabetes mellitus/gestational diabetes mellitus,lower uterine segment muscle wall thickness,Bishop score and HAD score between the two groups(P＜0.05).Logistic regression analysis showed that advanced age,high BMI at delivery,eclampsia and preeclampsia,low Bishop score and high HAD score were independent risk factors for conversion to ce-sarean section after failure of vaginal trial production in combined spinal-epidural analgesia(P＜0.05).ROC curve analysis showed that the nomogram model constructed based on the independent risk factors mentioned above predicted an AUC of 0.835(95％CI:0.800～0.866)for cesarean section during delivery with lumbar epidural analgesia,with a sensitivity and specificity of 89.66％and 67.08％,respectively.Conclusion:Advanced age,high BMI at delivery,combined with eclampsia and preeclampsia,low Bishop score and high HAD score are independent risk factors for conversion to cesarean section after failure of vaginal trial production in parturients undergoing combined spinal-epidural analgesia.The nomogram model constructed based on the above factors has good predictive value.

Abstract:Objective:To explore the influence of balloon eustachian tuboplasty(BET)combined with tympanotomy tube inser-tion(TTI)on auditory threshold and eustachian tube function in patients with refractory otitis media with effusion(OME).Methods:120 patients with refractory OME were selected as the research subjects.According to the different surgical methods,the patients were divided into TTI group(TTI+eustachian tube irrigation)and TTI+BET group(BET combined with TTI+eustachian tube irriga-tion),with 60 cases in each group.Both groups were followed up for 12 months after surgery.The clinical symptoms,complications,hearing threshold[air conduction(AC)threshold,bone conduction(BC)threshold]before surgery and at 1 month after surgery,eu-stachian tube function(ETDQ-7)and pain(VAS)before surgery and at 1,6 and 12 months after surgery and recurrence status after 1 year of follow-up were compared between the two groups.Results:The disappearance time of middle ear effusion,disappearance time of tinnitus and hearing recovery time in TTI+BET group were shorter than those in TTI group(P＜0.05).There was no statistically sig-nificant difference in the overall incidence of postoperative complications between the two groups(P＞0.05).At 1 month after surgery,AC and BC were decreased in both groups(P＜0.05),and the TTI+BET group had lower AC and BC than TTI group after treatment(P＜0.05).At 1,6 and 12 months after surgery,ETDQ-7 score and VAS score in both groups were lower than those before surgery(P＜0.05),and ETDQ-7 score and VAS score in TTI+BET group at each time period after surgery were lower than those in TTI group(P＜0.05).The recurrence rate was lower in TTI+BET group than that in TTI group(P＜0.05).Conclusion:BET combined with TTI and eustachian tube irrigation can improve the clinical efficacy,improve the eustachian tube dysfunction of refractory OME,and re-duce the hearing threshold,and it has low recurrence rate.

Abstract:Objective:To evaluate the sedative effect of different doses of dexmedetomidine(Dex)combined with remifentanil(REM)under continuous epidural anesthesia(CEA)in total knee anthroplasty(TKA).Methods:125 patients who received TKA were included and divided into group A(n=42),group B(n=42)and group C(n=41)according to the different doses of Dex dur-ing anesthesia.On the basis of CEA,the three groups were intravenously pumped with 0.4,0.6 and 0.8 μg/kg of Dex respectively,and they were combined with 0.5 μg/kg of REM.The vital signs[mean arterial pressure(MAP),heart rate(HR)],sedation degree[bis-pectral index(BIS)]and stress response[plasma cortisol(Cor)]at the time of entering the room(T0),CEA puncture(T,),skin in-cision(T2),during 1 hour of surgery(T3)and at the end of surgery(T4)were compared between the groups,and the adverse reac-tions were observed.Results:The MAP at T1～T4 in the three groups was lower than that at T0(P＜0.05).Except for no statistically significant difference in HR between group B and group A at T4(P＞0.05),the MAP and HR of patients in all other time points were as follows:group C＜group B＜group A(P＜0.05).At T1～T4,the BIS values of each group were lower than those at T0.At T,,the BIS values of group B and group C were lower than those of group A(P＜0.05),but there was no statistically significant difference in BIS values between group B and group C(P＞0.05).At time T2～T4,the BIS values of group C were lower than those of group B and group A(P＜0.05).There was no statistically significant difference in BIS values between group B and group A(P＞0.05).At T2 and T4,the Cor values of all groups of patients were lower than T0.At T2,the Cor values of group C were lower than those of group B and group A.At T4,the Cor values of group B and group C were lower than those of group A(P＜0.05),there was no statistically sig-nificant difference in the Cor values between group B and group C(P＞0.05).The total incidence of adverse reactions in group C was higher than that in group B(P＜0.05),there was no statistically significant difference between group A and group B and C(P＞0.05).Conclusion:0.6 pg/kg Dex combined with REM under CEA has a good sedative effect on patients with TKA,and it can im-prove the hemodynamics and reduce the stress response,and has high safety.

Abstract:Objective:To explore the serum 25-(OH)D levels of early pregnant women in Nanchong and their influencing fac-tors.Methods:1,098 pregnant women living in various regions of Nanchong were selected.The serum 25(OH)D values of early preg-nant women were detected by high performance liquid chromatography-tandem mass spectrometry.The present situation of vitamin D levels in pregnant women and their influencing factors were analyzed.Results:The serum 25-(OH)D level of pregnant women was 43.24±20.53 nmol/L in the early pregnancy.The deficiency rate was 67.85％.As individuals age,the levels of 25-(OH)D showed a gradual rise,peaking in the 35-year-old group.Compared with women without complications in the first trimester,the serum 25(OH)D level of early pregnant women after IVF-ET and with hypothyroidism or immune system diseases was higher(P＜0.05).The increase in body mass index(BMI)and the decrease in serum vitamin A concentration were risk factors for serum 25-(OH)D deficiency in early pregnancy(P＜0.05).Conclusion:The abnormal situation of vitamin among women in early pregnancy in Nanchong is the lack of ser-um 25(OH)D concentration.There are statistically significant differences in serum 25-(OH)D concentration in different ages,so indi-vidualized vitamin supplementation programs can be made for different pregnant women during prenatal examination.Maintaining the normal level of serum vitamin A concentration can reduce the risk of serum 25-(OH)D deficiency.

Abstract:Objective:To analyze the incidence and related factors of parenteral nutrition(PN)-associated cholestasis(PNAC)in extremely low birth weight infants.Methods:The clinical data of 305 extremely low birth weight infants who were received PN sup-portive treatment were collected retrospectively.The incidence of PNAC was calculated.Infants included were divided into the observa-tion group(with PNAC,n=54)and the control group(without PNAC,n=251).Information of the infants was collected,including gender,gestational age,delivery mode,birth weight,1 min and 5 min Apgar scores,complications(neonatal infection,neonatal anemia,etc.),length of hospital stay,feeding difficulties,PN start time,PN duration,cumulative dosage of amino acids,cumulative dosage of fat emulsion,and the levels of serum indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil)and total bile acid(TBA)]on 14 day after birth.Univariate analysis and multivariate analysis were conducted to screen the factors influencing the occurrence of PNAC in extremely low birth weight infants.Results:There were 54 cases of PNAC,with an inci-dence rate of 17.70％.Compared with the control group,gestational age and birth weight of the observation group were lower(P＜0.05).The proportion of neonatal infections,length of hospital stay,the proportion of feeding difficulties,PN duration,and the levels of ALT,AST,TBil and TBA in the observation group were higher and longer(P＜0.05).Logistic regression analysis showed that high birth weight was a protective factor,while PN duration and the levels of ALT,AST,TBil and TBA were independent risk factors for PNAC in extremely low birth weight infants(P＜0.05).Conclusion:Birth weight,PN duration and the levels of ALT,AST,TBil and TBA are helpful for evaluating and predicting the occurrence of PNAC in extremely low birth weight infants.

Abstract:Objective:To investigate the correlation of serum thyroid hormones and cortisol(COR)levels with clinical symp-toms in patients with paranoid schizophrenia.Methods:110 patients with paranoid schizophrenia were divided into positive group(n=55)and negative group(n=55)according to the clinical symptoms.In addition,55 healthy people who received physical examination during the same period were included in the control group.Positive and Negative Symptom Scale(PANSS)scores were evaluated and serum thyroid hormones[thyroid stimulating hormone(TSH),free thyroxine(FT4)and free triiodothyronine(FT3)]and COR were detected in the three groups of subjects,and the PANSS scores and levels of thyroid hormones and COR were compared.Pearson correla-tion analysis was used to analyze the correlation between thyroid hormones,COR and PANSS scores in positive group and negative group.Results:The scores of subscales and total score of PANSS in positive and negative groups were higher than those in control group(P＜0.05).The scores of positive symptom and general psychopathological symptom in positive group were higher than those in nega-tive group(P＜0.05)while the score of negative symptom was lower than that in negative group(P＜0.05).TSH level in positive and negative groups was lower(P＜0.05)while FT4,FT3 and COR levels were higher than those in control group(P＜0.05).TSH level in positive group was lower than that in negative group(P＜0.05),but FT4 and FT3 levels were not significantly different from those in negative group(P＞0.05),and COR level was higher than that in negative group(P＜0.05).TSH level in positive group was nega-tively correlated with positive symptom score(P＜0.05),TSH level in negative group was negatively correlated with negative symptom score(P＜0.05),and TSH level in positive and negative groups was negatively corr-elated with general psychopathological symptom score and total score of PANSS(P＜0.05).COR level in positive group was positively correlated with positive symptom score,general psychopathological symptom score and PANSS total score(P＜0.05).Conclusion:Patients with paranoid schizophrenia have abnormal thyroid function and stress function,and the abnormal stress function of patients with positive symptom is more obvious,and serum TSH and COR levels are related to the clinical symptoms of patients.

Abstract:< positive > 1 case report case 1: the patient, male, 34 years old, was found to have obvious splenomegaly due to abdominal distension, which was not suitable for out of hospital examination. The spleen was 8.2 cm below the rib, and B-ultrasound showed that the length of the spleen was 21.3 cm. After improving the conventional search for the cause of splenomegaly, the cause of splenomegaly could not be determined, and the patient had no other organ or system damage, so splenectomy was performed. Butterfly shaped erythema appeared on the face of the patient 10 days after surgery, so the examination of systemic lupus erythematosus (SLE) related immune indicators was improved.

Abstract:Objective:To investigate the effects of comprehensive nursing based on NRS2002 nutritional assessment on asthenia,nutritional status and ability of daily living in elderly patients with chronic heart failure combined with frailty.Methods:204 elderly pa-tients with chronic heart failure combined with frailty were included and divided into observation group and control group according to different intervention methods,with 102 cases in each group.The control group took routine nursing program,and the observation group took comprehensive nursing program based on NRS2002 nutritional assessment.The intervention time was 6 months,frailty,nutritional status,ability of daily living before and after intervention length of stay and readmission rate were compared between the two groups.Re-sults:After 6 months of intervention,the scores and total scores of somatic,psychological,and social frailty dimensions in Tilburg frailty indicator(TFI)of patients in the observation group was lower than the control group(P＜0.05).The serum albumin(Alb),prealbu-min(PA),transferrin(TF)and hemoglobin(Hb)levels in the observation group were higher than those in the control group(P＜0.05).The scores of the activity of daily living(ADL)in the observation group was higher than that in the control group(P＜0.05).The length of hospital stay in the observation group was shorter than that in the control group(P＜0.05),and the readmission rate dur-ing follow-up was lower than that in the control group(P＜0.05).Conclusion:Comprehensive nursing based on NRS2002 nutritional assessment can improve the frailty degree and nutritional status of elderly patients with chronic heart failure and frailty,improve their daily living ability,shorten the rehabilitation process,and reduce the risk of readmission.

Abstract:Objective:To explore the application effect of standardized nursing model based on evidence-based concept in high-flow humidified oxygen therapy(HFNC)for emergency elderly patients with pneumonia.Methods:A total of 160 elderly patients with pneumonia were selected as the study subjects.The patients were divided into control group(n=80)and observation group(n=80)according to different nursing methods.The control group was given HFNC nursing with routine nursing mode,and the observation group was given HFNC nursing with standardized nursing mode based on evidence-based concept.Both groups were intervened for 7 d.The differences of arterial blood gas indexes[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)],respiration,heart rate,oxygen saturation(SpO2),time of symptom improvement[normal body temperature time,lung moist rale weakening time,sputum thinning time and shortness of breath disappearance time]and adverse reactions were compared between the two groups.Results:After intervention,PaO2 and SpO2 increased in both groups(P＜0.05),and the observation group was higher(P＜0.05).PaCO2,respiration and heart rate decreased in both groups(P＜0.05),and the observation group was lower(P＜0.05).The normal temperature time,lung moist rale weakening time,sputum thinning time and shortness of breath disappearance time in the observation group were shorter than those in the control group(P＜0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P＜0.05).Conclusion:In emergency elderly patients with pneumonia HFNC,the standard-ized nursing model based on evidence-based concept can improve the blood gas index of patients,correct the symptoms of hypoxia,and promote the improvement of clinical symptoms and reduce the occurrence of adverse reactions of oxygen therapy.

Abstract:Objective:To investigate the effect of nursing model based on"Watson's theory of care"on kinesophobia,pain and functional recovery in patients undergoing total knee arthroplasty(TKA).Methods:A total of 100 patients treated with TKA were se-lected as study objects and they were divided into control group(n=50)and study group(n=50)according to different nursing mod-el.The control group adopted the routine nursing mode,and the research group adopted the nursing mode based on the"Watson's theory of care"on the basis of the control group.Postoperative pain,fear degree,knee function and daily living ability of the two groups were compared,and occurrence of complications 5 days after surgery were recorded.Results:The visual analogue scale(VAS)of the study group was lower than that of the control group at 12 h,1,3 and 5 d after surgery(P＜0.05).The score of Tampa kinetophobiascale(TSK)in the study group was lower than that in the control group at 1,3 and 5 d after surgery(P＜0.05),and the incidence of kine-tophobia in the study group was lower than that in the control group at 5 d after surgery(4.00％vs.18.00％,P＜0.05).At 3 and 5 d after surgery,the knee joint score(HSS)of the Hospital for Special Surgery in the study group was higher than that of the control group(P＜0.05).Activity of daily living(ADL)scores in the study group were higher than those in the control group at 3 and 5 d af-ter surgery(P＜0.05).The incidence of complications 5 d after operation in the study group was lower than that in the control group(16.00％vs.36.00％,P＜0.05).Conclusion:The nursing mode based on"Watson's theory of care"is beneficial to alleviate the postoperative pain of TKA patients,promote the recovery of knee function and daily living ability,and reduce the risk of postoperative kinesophobia and complications.