Abstract:Objective:To explore the effect and mechanism of miR-139-3p targeting secreted phosphoprotein 1(SPP1)on cis-diamminedichloroplatinum(DDP)in A549 lung cancer cells.Methods:A cisplatin(DDP)-resistant A549/DDP cell model was established via gradient concentration induction,validated by resistance index(IR=3.877)and IC50 determination.The re-sistant cells were divided into five groups:blank control,negative control,miR-139-3p mimic,SPP1 overexpression,and SPP1 knockdown.Multi-platform analyses were performed,including qPCR(miR-139-3p and SPP1 expression),Western blot(SPP1,p-AKT,and total AKT protein levels),CCK-8(proliferation and drug sensitivity),flow cytometry(apoptosis),and du-al-luciferase reporter assays(miR-139-3p/SPP1 interaction).Results:The cisplatin-resistant A549/DDP cells exhibited a signifi-cantly higher IC50 value compared to parental A549 cells(P<0.05),with a resistance index(IR)of 3.877.Quantitative PCR(qPCR)analysis revealed that miR-139-3p expression was markedly upregulated in the miR-139-3p mimic group versus the negative control group(P<0.05).Relative to the miR-139-3p mimic group,SPP1 mRNA levels were significantly elevated in the SPP1-overex-pression group and reduced in the SPP1-knockdown group(P<0.05).Western blotting confirmed corresponding changes in SPP1 pro-tein expression across these groups(P<0.05).CCK-8 assays demonstrated that miR-139-3p overexpression enhanced the proliferation inhibition rate and reduced the IC50 value compared to the negative control(P<0.05),whereas SPP1 overexpression reversed these effects,lowering the inhibition rate and increasing IC50(P<0.05).Compared with the miR-139-3p blank control,the luciferase activity of the wild-type SPP13'UTR luciferase reporter plasmid binding to miR-139-3p analog decreased(P<0.05),and the difference in the luciferase activity of the mutant SPP13'UTR luciferase reporter plasmid binding to miR-139-3p analog was not statistically significant(P>0.05).Compared with the negative control group,the protein expression level of p-AKT in miR-139-3p control group was signifi-cantly decreased(P<0.05),compared with the miR-139-3p control group and SPP1 knockdown group,the protein expression level of p-AKT in SPP1 overexpression group was significantly increased(P<0.05).Conclusion:Overexpression of miR-139-3p or knockdown of SPP1 could inhibit the proliferation of A549/DDP cells,enhance their sensitivity to cisplatin,and the mechanism may be related to the AKT signaling pathway.

Abstract:Objective:To explore the inhibitory effect and possible mechanism of Hedyotis diffusa polysaccharide(HDP)on human cutaneous squamous cell carcinoma transplanted tumors in nude mice.Methods:25 BALB/cA-nu nude mice were used to establish the transplanted tumor model of human cutaneous squamous cell carcinoma A431 cell line in nude mice.The nude mice with successful modeling(tumor diameter>4 mm after 5 days of inoculation)were randomly divided into 5 groups:nega-tive control group(Con),positive control group[fluorouracil(5-FU)group],low-,medium-and high-dose HDP groups(HDP-L,HDP-M,HDP-H),with 5 mice in each group.The 5-FU group was intraperitoneally injected with 10 mg/kg 5-FU,and the HDP-L,HDP-M and HDP-H groups were intraperitoneally injected with 50,100 and 200 mg/kg of HDP,and the Con group was injected with equal volume normal saline once a day.After 1 month of intervention,the volume,mass and tumor inhibition rate of transplanted tumors in each group were measured.The pathological manifestations were observed by HE staining,and immunohistochemistry was applied to detected the expression of Ki67.The Bcl-2,Bax,p-PI3K/PI3K and p-AKT/AKT were detected by Western blot.Results:HE results revealed that there were different degrees of tumor cell necrosis in various HDP groups and 5-FU group.Compared with Con group,the tumor volume,mass and number of Ki67 positive cells in HDP-M,HDP-H and 5-FU groups were decreased(P<0.05),and the p-PI3K/PI3K,p-AKT/AKT and Bcl-2 were reduced(P<0.05)while the Bax was enhanced(P<0.001).The tumor inhibition rate in 5-FU group was higher than that in the other groups(P<0.05),and the tumor inhibition rate in HDP-H group was higher than that in the other HDP groups(P<0.05).Com-pared with 5-FU group,the tumor volume,mass and number of Ki67 positive cells in HDP-L group were increased(P<0.05),and the p-PI3K/PI3K,p-AKT/AKT and Bcl-2 in tumor tissues in HDP-L and HDP-M groups were risen(P<0.05)while the Bax was lower(P<0.001).Conclusion:Within a certain concentration range,HDP can effectively inhibit the growth of cSCC-A431 transplanted tumors,and its role mechanism may be associated with the suppression of PI3K/AKT signaling pathway ac-tivation,down-regulation of Bcl-2 expression and up-regulation of Bax expression.

Abstract:Objective:To compare the value of cone-beam CT(CBCT)and spiral CT(SCT)in the diagnosis of tem-poromandibular joint disorders(TMJD).Methods:A total of 84 patients(168 joints)with suspected TMJD were selected as the research subjects.All patients underwent CBCT and SCT examinations.The width of the anterior,superior and posterior space of bilateral temporomandibular joints was measured,and the detection rates of condylar bone erosion,osteosclerosis,cystic de-generation,articular fossa flattening and osteophyte formation were evaluated.The clinical comprehensive diagnosis(symptoms+joint X-ray+MRI)was used as the gold standard,and the diagnostic efficacy indicators such as sensitivity and specificity were calculated.Results:There was no significant difference in the measured values of the left and right joint space between CBCT and SCT(P>0.05).The detection rate of bone erosion,cystic degeneration and osteophytes by CBCT was higher than that by SCT(P<0.05).Based on the gold standard,75 cases of TMJD were finally diagnosed in 84 cases,73 cases of TMJD were detected by CBCT,and 68 cases of TMJD were detected by SCT.The positive detection rate of TMJD by CBCT was higher than that by SCT(P<0.05).The sensitivity and accuracy of CBCT in the diagnosis of TMJD were better than those of SCT(P<0.05).Conclusion:CBCT and SCT have good consistency in the measurement of bilateral temporomandibular joint space,but CBCT significantly improves the detection ability of early bone lesions in TMJD and has higher diagnostic accuracy.

Abstract:Objective:To investigate the correlation between distribution of bone cement in vertebral body and degree of pain after percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fracture(OVCF).Methods:The clinical data of 150 patients with OVCF who received PVP were retrospectively analyzed.According to the bone cement distribution index(DI),they were divided into bone cement full dispersion group(n=96)and bone cement insufficient disper-sion group(n=54).The visual analogue scale(VAS),anterior vertebral height,kyphosis Cobb angle,bone mineral density and total incidence rate of postoperative complications were compared between the two groups of patients.Ordered Logistic regres-sion was used to analyze the correlation between bone cement DI and VAS,anterior vertebral height,kyphosis Cobb angle,bone mineral density and total incidence rate of postoperative complications.Results:The VAS score at 1 and 3 months after surgery in the two groups of patients was lower than that at 1 week after surgery(P<0.05),and the VAS score at each time point in bone cement full dispersion group was lower than that in bone cement insufficient dispersion group(P<0.05).The anterior vertebral height ratio in both groups of patients was enhanced at 1 and 3 months after surgery compared to 1 week after surgery(P<0.05).At 1 and 3 months after surgery,the kyphosis Cobb angle in bone cement insufficient dispersion group was reduced compared with that at 1 week after surgery(P<0.05),and there was no difference in the kyphosis Cobb angle in bone cement full dispersion group(P>0.05).The anterior vertebral height ratio and kyphosis Cobb angle at each time point after surgery in bone cement fill dispersion group were lower than those in bone cement insufficient dispersion group(P<0.05).Compared with 1 week after surgery,the bone mineral density in the two groups of patients was increased at 1 month and 3 months after surgery(P<0.05),and the bone mineral density in bone cement full dispersion group was higher than that in bone cement in-sufficient dispersion group at 1 month and 3 months after surgery(P<0.05).The total incidence rate of postoperative compli-cations in bone cement full dispersion group was lower than that in bone cement insufficient dispersion group(P<0.05).Cor-relation analysis showed that bone cement DI was negatively correlated with VAS score,kyphosis Cobb angle,bone mineral den-sity and total incidence rate of postoperative complications,and was positively correlated with anterior vertebral height(P<0.05).Conclusion:The distribution of bone cement in vertebral body is closely related to the degree of pain and recovery of ver-tebral function after PVP.

Abstract:Objective:To explore the value of lung ultrasound(LUS)score combined with peripheral blood procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)levels on evaluation of disease severity and prognosis of patients with acute respiratory distress syndrome(ARDS).Methods:109 patients with ARDS were selected.The disease severity and progno-sis of patients were grouped according to the Berlin criteria for ARDS.The baseline data were compared among mild group(n=24),moderate group(n=55)and severe group(n=30).According to the prognosis,they were divided into a survival group(n=68)and a death group(n=41).The differences in LUS score,peripheral blood PCT,CRP and IL-6 levels among the three groups and patients with different prognoses were analyzed,and the evaluation value of the above indexes on the disease severity and prognosis was analyzed.Results:There were statistical differences in prognosis and APACHE Ⅱ score among the three groups(P<0.05).The survival rate of patients in severe group was lower than that in moderate group(P<0.05),and the rate in moderate group was lower than that in mild group(P<0.05).The APACHE Ⅱ score of patients in severe group was higher than that in moderate group(P<0.05),and the score in moderate group was higher than that in mild group(P<0.05).The LUS score and peripheral blood PCT,CRP and IL-6 levels revealed statistical differences among ARDS patients with different disease severities(P<0.05).The severe group was higher than the moderate group(P<0.05),and the moder-ate group was higher than the mild group(P<0.05).Spearman analysis showed that LUS score and peripheral blood PCT,CRP and IL-6 in ARDS patients were positively correlated with disease severity(P<0.05).The LUS score,PCT,CRP and IL-6 in death group were higher than those in survival group(P<0.05).After Logistic regression analysis,it was found that A-PACHE Ⅱ score,LUS score,PCT,CRP,IL-6 and disease severity were the influencing factors of prognosis in patients with ARDS(P<0.05).ROC curve results showed that the areas under the ROC curves of LUS score,peripheral blood PCT,CRP and IL-6 and combined detection for predicting the death prognosis in ARDS patients were 0.778,0.781,0.864,0.856 and 0.982,and the sensitivities were 75.61％,78.05％,90.24％,80.49％and 92.68％,respectively.The combined detection value was higher.Conclusion:LUS score and peripheral blood PCT,CRP and IL-6 levels can effectively evaluate the disease severity of ARDS patients,and have reliable predictive value for prognosis of patients.

Abstract:Objective:To explore the efficacy of hyperbaric oxygen combined with stent implantation(CAS)in the treat-ment of cerebral infarction complicated with extracranial segment vascular stenosis,as well as its influence on the rehabilitation of limb function in patients.Methods:A total of 82 patients with cerebral infarction complicated with extracranial vascular ste-nosis were included in this study.They were divided into the combined group and the control group according to different treat-ment methods,with 41 cases in each group.The control group received CAS treatment,and the combined group received hyper-baric oxygen therapy on the basis of the control group.The clinical efficacy and muscle strength of the two groups of patients after treatment were compared,and the limb function and cognitive function scores of the two groups of patients before and af-ter treatment were also compared.Results:The total effective rate of the combined group was higher than that of the control group(97.56%vs.80.49%,P<0.05).After the treatment,the muscle strength classification of the combined group was bet-ter than that of the control group(P<0.05).The total scores of the upper limbs,lower limbs and FMA in the combined group and the control group after treatment were all higher than those before treatment(P<0.05),and the combined group was higher than the control group(P<0.05).The MMSE and MoCA scores of the combined group and the control group after treatment were both higher than those before treatment(P<0.05),and the combined group was higher than the control group(P<0.05).Conclusion:Hyperbaric oxygen combined with CAS has a definite therapeutic effect on cerebral infarction compli-cated with extracranial segment vascular stenosis.It can effectively improve the cognitive function of patients,and is also condu-cive to enhancing the muscle strength of patients,which has a positive effect on the rehabilitation of limb function of patients.

Abstract:Objective:To observe the effect of ultrasound-guided suprainguinal fascia iliaca compartment block(U-SFICB)with ropivacaine combined with different doses of nalbuphine on analgesia in elderly patients after total hip arthroplasty(THA).Methods:101 elderly patients with unilateral THA under general anesthesia were divided into four groups according to different anesthesia regimens:100 mg ropivacaine+normal saline group(R group,n=26),100 mg ropivacaine+10 mg nal-buphine group(LN group,n=25),and 100 mg ropivacaine+15 mg nalbuphine group(MN group,n=25),and 100 mg ropiv-acaine+20mg nalbuphine group(HN group,n=25),all were diluted to 30 mL with 0.9%sodium chloride injection.All four groups underwent U-SFICB in the post-anesthesia care unit(PACU),and sufentanil was used for patient-controlled intravenous analgesia after surgery.Comparison between groups of postoperative 4,8,12,24,and 48 h of resting and motion state of Numer-ical rating scale(NRS).Each group received 12 h preoperatively,12 and 24 h postoperatively,Interleukin 6(IL-6),Tumor nec-rosis factor-α(TNF-α),Interleukin 10(IL-10)concentration,the first start time of postoperative analgesia pump and 48 h of sufentanil use in each group,the early postoperative recovery of each group,and the occurrence of analgesia related adverse reac-tions 48 h after surgery were compared between groups.Results:Compared with R group and LN group,NRS score in MN and HN group was decreased at all time points(P<0.05),IL-6 and TNF-α concentrations were decreased at all time points(P<0.05),IL-10 concentrations were increased at all time points(P<0.05),and the start-up time of postoperative analgesia pump was significantly extended(P<0.05).The amount of sufentanil was significantly decreased 48 hours after operation(P<0.05).Compared with R group,LN group and HN group,the time of first anal exhaust and getting out of bed in MN group were significantly shortened(P<0.05).The incidence of adverse reactions was significantly decreased 48 h after operation(P<0.05).Compared with HN group,the start-up time of postoperative analgesic pump in MN group was significantly short-ened(P<0.05),and the overall incidence of adverse reactions was the lowest at 48 h after surgery(P<0.05).Conclusion:15 mg nalbuphine combined with ropivacaine can significantly prolong the duration of U-SFICB analgesia after THA in elderly pa-tients,and the first postoperative anal exhaust time and the first time of getting out of bed activity are the shortest,and the inci-dence of adverse reactions is the lowest within 48 hours after surgery,which can be clinically promoted and applied.

Abstract:Objective:To investigate the application effect of anti-vascular endothelial growth factor(VEGF)drugs in the treatment of exudative age-related macular degeneration.Methods:The clinical data of 110 patients with monocular exudative age-related macular degeneration were retrospectively analyzed.According to different medications,they were divided into con-bercept group(n=57,intravitreal injection of conbercept)and ranibizumab group(n=53,intravitreal injection of ranibizum-ab).The efficacy,ocular hemodynamics,OCT parameters and complications were compared between the two groups.Results:The total effective rate of treatment was 98.25%in conbercept group,which was higher than 88.68%in ranibizumab group(P<0.05).Compared with ranibizumab group,the PSV and EDV of central retinal artery and ocular artery and blood flow density of choroidal capillary layer in conbercept group were higher after treatment(P<0.05).The central macular thickness was thinner in conbercept group than that in ranibizumab group after treatment(P<0.05).There was no statistical difference in the total incidence rate of complications between groups(P>0.05).Conclusion:Anti-VEGF drugs can effectively treat exu-dative age-related macular degeneration.Conbercept has better efficacy,and it can better improve the ocular hemodynamics,cen-tral macular thickness and choroidal capillary layer blood flow density,with safety.

Abstract:Objective:To investigate the influence of noninvasive low forceps midwifery on delivery bleeding volume,deliv-ery time and postpartum pelvic floor muscle strength in singleton full-term pregnant women.Methods:Totally 201 primiparas who gave birth in the hospital were selected and divided into control group(Perineal lateral incision low position forceps assis-ted delivery,n=100)and study group(Non invasive low position forceps assisted delivery,n=101)according to the delivery modes accepted by puerperae.The duration of labor,hospital stay,bleeding volume,perineal injury status,postpartum pelvic floor muscle strength,and incidence rates of complications were recorded and compared between the two groups.Results:The time of second stage of labor,hospital stay and bleeding volume with(0.87±0.17)h,(3.97±0.62)d and(227.59±72.54)ml in the study group were shorter or less than(1.14±0.22)h,(5.22±1.18)d and(273.82±89.25)ml in the control group(P<0.05).The perineal integrity rate in the study group with 22.77％was higher than 7.00％in the control group(P<0.05)while the probabilities of lateral episiotomy and perineal Ⅱ laceration with 25.74％and 4.95％were lower than 39.00％and 4.95％in the control group(P<0.05).The pelvic floor muscle strength levels in the study group at 6,12 and 24 weeks af-ter delivery were higher than those in the control group(P<0.05).The probability of complications in the study group(9.90％)was lower compared with that in the control group(21.00％)(P<0.05).Conclusion:Noninvasive low forceps mid-wifery for singleton full-term pregnant women can effectively reduce the delivery bleeding volume,shorten the delivery time,improve the postpartum pelvic floor muscle strength and reduce the probability of complications.

Abstract:Objective:To analyze the application effect of percutaneous electrical acupoint stimulation combined with modified Qusuoshengji Powder in patients after perianal abscess surgery.Methods:A total of 120 patients with perianal abscess were selected and divided into two groups according to the treatment plan:the control group(percutaneous electrical acupoint stimulation)and the study group(percutaneous electrical acupoint stimulation+modified Qusu Shengji Powder),with 60 cases in each group and the treatment course was 14 days.The therapeutic effects,wound healing conditions,TCM syndrome scores,inflammatory factors,cellular immune balance and safety of the two groups were compared.Results:The total effective rate of the study group was higher than that of the con-trol group(P<0.05).The granulation tissue score of the study group was lower than that of the control group(P<0.05),the ap-pearance time of wound epithelium and the shedding time of necrotic flesh were both shorter than those of the control group(P<0.05),and the wound healing rate was higher than that of the control group(P<0.05).After treatment,the scores of TCM syndrome indicators and interferon-γ(IFN-γ)in both groups decreased(P<0.05),and the study group was lower than the control group(P<0.05).After treatment,interleukin 4(IL-4)and the ratio of IL-4/IFN-γ increased in both groups(P<0.05),and the study group was higher than the control group(P<0.05).There was no statistically significant difference in safety between the two groups(P>0.05).Conclusion:Percutaneous electrical acupoint stimulation combined with modified Qusuoshengji Powder for the treatment of pa-tients after perianal abscess surgery can promote wound healing,inhibit inflammatory responses and regulate immune balance.The ther-apeutic effect is remarkable and the safety is good.

Abstract:Objective:To investigate the application value and effects on event-related potential P300 of multi-sensory inte-gration training combined with virtual reality(VR)-assisted rehabilitation in children with sensory integration disorder.Meth-ods:98 children with sensory integration disorder were selected and divided into an observation group and a control group based on different intervention methods,with 49 patients in each group.The control group received multi-sensory integration training,while the observation group received multi-sensory integration training combined with virtual reality-assisted rehabilitation,with both groups undergoing continuous intervention for 12 weeks.The sensory integration abilities,behavioral problem factors[Conners Parent Symptom Questionnaire(CPRS-R)],attention status[Integrated Visual and Auditory Continuous Perform-ance Test(IVA-CPT)],balance ability,daily living activity capabilities[Functional Independence Measure for Children(WeeF-IM)],and event-related potential differences were compared between the two groups.Results:After the intervention,the obser-vation group showed higher scores compared to the control group in vestibular balance sensation,tactile defense function,prop-rioception,and learning ability(P<0.05),lower levels in behavioral problem factors including conduct behavior,learning prob-lems,mental disorders,impulsivity,anxiety,and hyperactivity index(P<0.05),lower scores in IVA-CPT attention assessment dimensions including auditory response control quotient,auditory attention quotient,visual response control quotient,visual at-tention quotient,comprehensive scale response control quotient,and comprehensive scale attention quotient(P<0.05).Com-pared with the control group,the single-leg standing times with eyes open and closed were longer in the observation group(P<0.05),balance beam walking time was shorter(P<0.05),WeeFIM scale scores were higher(P<0.05),P300 latency was lower(P<0.05)and wave amplitude levels were higher(P<0.05).Conclusion:Multi-sensory integration training combined with VR-assisted rehabilitation can effectively regulate sensory function,reduce behavioral problems,improve attention,enhance balance ability,and improve neural electrical activity in children with sensory integration disorder.

Abstract:Objective:To investigate the effects of metoprolol combined with aspirin on myocardial salvage and early major adverse cardiovascular events(MACE)in patients undergoing percutaneous coronary intervention(PCI)for acute myocardial infarction.Methods:120 patients with acute myocardial infarction were selected and divided into a control group and an observa-tion group based on the order of admission,with 60 cases in each group.Both groups received PCI treatment,the control group was given aspirin orally,while the observation group was given metoprolol combined with aspirin oral administration.The echo-cardiographic indicators,serum brain natriuretic peptide(BNP)and troponin I(cTnI)levels,coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT)],myocardial salvage status,and MACE occurrence within 30 days after PCI were compared before and after treatment in both groups.Results:After treatment,the left ventricular ejection fraction(LVEF)of both groups increased,while the left ventricular end-diastolic diameter(LVEDD)and left ventricu-lar end-systolic diameter(LVESD)decreased(P<0.05).The improvement in these indicators was more significant in the ob-servation group compared to the control group(P<0.05).After treatment,the serum BNP and cTnI levels in both groups de-creased,with the observation group showed lower levels than the control group(P<0.05).After treatment,the prothrombin time(PT)and activated partial thromboplastin time(APTT)in both groups were prolonged(P<0.05),with the observation group had a longer APTT than the control group(P<0.05).There was no significant difference in the volume of edematous myocardium between the two groups(P>0.05),but the salvageable myocardial volume and microscopically visible myocardial salvage index(MSI)in the observation group were greater than those in the control group(P<0.05).The early MACE inci-dence in the observation group was lower than that in the control group(P<0.05).Conclusion:Metoprolol combined with aspi-rin can effectively improve the myocardial salvage effect in patients undergoing PCI for acute myocardial infarction,reduce the early MACE incidence,and positively impact patient outcomes.

Abstract:Objective:To investigate the effects of semaglutide combined with empagliflozin on blood uric acid,oxidative stress,and glucolipid metabolism in patients with perimenopausal diabetes mellitus with metabolic syndrome.Methods:A total of 196 patients with perimenopausal diabetes mellitus with metabolic syndrome were selected as the study subjects and divided into groups according to the treatment measures adopted,among which the control group(n=98)was treated with metformin empagliflozin,and the observation group(n=98)was treated with semaglutide on the basis of the control group,with a treat-ment course of 6 months for both groups.Efficacy,blood glucose[fasting blood glucose(FPG),2-hour postprandial blood glu-cose(2hPG),and glycated hemoglobin(HbA1c)levels],blood lipids[total cholesterol(TC),low-density lipoprotein cholester-ol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)levels],blood uric acid,islet function[insulin resistance index(Homa-IR)],oxidative stress[lipid hydroperoxide(LHP)and superoxide dismutase(SOD)levels]and inflammation[inter-leukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)]were recorded and compared between the two groups.Results:The effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the levels of FPG,2hPG,HbA1c,TC,LDL-C,serum uric acid,HOMA-IR,LHP,IL-6,and TNF-α in the observation group were lower than those in the control group,while the levels of(HDL-C and SOD were higher than those in the control group(P<0.05).Conclusion:The efficacy of semaglutide combined with metformin and empagliflozin in the treatment of perimenopausal diabetes mellitus with metabolic syndrome is better,which is able to reduce the patient's blood uric acid level,optimize glucose and lipid metabolism,and improve the inflammation and stress state of the body,which is worthy of being promoted for use in the clinic.

Abstract:Objective:To analyze the distribution of peripheral blood B cell subsets in patients with systemic lupus erythe-matosus(SLE)and their clinical applications.Methods:52 SLE patients(SLE group),36 healthy controls(HC group)and 30 rheumatoid arthritis(RA group)patients were included.The percentage of B1,FOB,Breg and ABC cells in total B cells was measured by Flow cytometry.Diagnostic efficacy of individual and combined B cell subsets for SLE was evaluated via ROC curves.Clinical data on SLE activity score(SLEDAI),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),com-plement C3 and C4,immunoglobulin,and various autoantibodies from SLE patients were collected,and the correlations between the subsets percentage and these indicators were analyzed.Results:Compared to HC group,the percentage of B1,Breg,and ABC were higher in SLE group(P<0.05)and the percentage of FOB was lower(P<0.05).The percentage of B1,and Breg in SLE group were obviosly higher than those in RA group(P<0.05)and FOB was lower(P<0.05).There was no statistically sig-nificant difference in the proportion of cells in each subgroup between the RA group and the HC group(P>0.05).ROC curve analysis showed that all B cell subgroups had a certain diagnostic efficacy for SLE,and the combination of multiple subgroups had a higher diagnostic efficacy for SLE.The area under the curve(AUC)of 11 combinations for diagnosing SLE was 0.756～0.892(P<0.05),with(ABC+B1+Breg+FOB)combined was highest.Results of Assay of correlations showed that the per-centage of ABC cells positively correlated with the level of ESR(P<0.05,r=0.403).The percentage of Breg cells negatively correlated with the level of C3(P<0.05,r=-0.421)and positively correlated with the level of anti-dsDNA(P<0.05,r=0.488),anti-M2(P<0.05,r=0.604),SLEDAI(P<0.05,r=0.353).ABC and FOB were negatively correlated in the SLE group(P<0.05,r=-0.571),while there was no correlation between the two in the HC and RA groups(P>0.05).Conclu-sion:There are differences in the distribution of B cell subsets between SLE patients and the normal population.The combina-tion of single or multiple indicators has good diagnostic efficacy for SLE,and the distribution of subsets is correlated with multi-ple clinical and laboratory indicators,suggesting that it may have value in disease diagnosis and disease assessment.

Abstract:Objective:To investigate the predictive value of combining multimodal echocardiographic parameters with sero-logical indicators for major adverse cardiac events(MACE)following percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI),and to develop a LASSO-Logistic regression-based prediction model.Methods:A retrospec-tive analysis was performed on clinically relevant data from 80 AMI patients who underwent PCI,including 30 patients in the MACE group and 50 patients in the non-MACE group.The LASSO-Logistic regression method was employed to identify risk factors associated with MACE following PCI in AMI patients.Additionally,a receiver operating characteristic(ROC)curve was constructed to assess the predictive performance of the LASSO-Logistic regression model.Results:The development of the LASSO-Logistic regression model based on multimodal echocardiography and serological indicators revealed that advanced age,Killip class Ⅲ-Ⅳ,multiple coronary artery lesions,TIMI blood flow grade less than 2,elevated BNP levels,high LDL-C,re-duced LVEF,and increased WMSI were risk factors influencing the occurrence of MACE following PCI in AMI patients(P<0.05).The nomogram model was internally validated using the Bootstrap method,demonstrating an area under the ROC curve of 0.921,with a sensitivity of 93.16%and specificity of 90.83%.Conclusion:The LASSO-Logistic regression model,construc-ted using multimodal echocardiographic parameters in conjunction with serological indicators,demonstrates effective predictive capability for the risk of MACE following PCI in AMI patients and exhibits significant clinical utility.

Abstract:Objective:To investigate the efficacy of Transverse T-shaped crown amputation truncated crown extraction ver-sus bone chisel split crown extraction in the treatment of horizontal mandibular impaction.Methods:A retrospective analysis was conducted on the clinical data of 134 patients with horizontally impacted mandibular teeth.Grouped according to the actual treatment used,divided into the control group and the observation group,with 67 cases in each group.The control group was treated with bone chisel split crown extraction and the observation group was treated with Transverse T-shaped crown amputa-tion truncated crown extraction.The duration of surgery,degree of facial swelling,intraoperative bleeding,intraoperative open-ing,visual pain analog scale(VAS),interleukin 6(IL-6),tumor necrosis factor(TNF-α),malondialdehyde(MDA),superoxide dismutase(SOD),postoperative healing,and the occurrence of complications were recorded and compared between the two groups.Results:The observation group showed lower levels than the control group in surgical time,facial swelling,intraopera-tive blood loss,and intraoperative mouth opening(P<0.05).The observation group's VAS scores at 1,3,and 7 days postoper-atively were lower than the control group's(P<0.05).At 3 days postoperatively,the observation group had lower levels of IL-6,TNF-α,and MDA compared to the control group(P<0.05),and higher SOD levels(P<0.05).The observation group had a higher excellent healing rate than the control group(P<0.05).The observation group also had a lower complication rate than the control group(P<0.05).Conclusion:Compared with the bone chisel split crown extraction,the use of Transverse T-shaped crown amputation crown extraction for mandibular horizontal impaction can shorten the operation time,reduce the postoperative inflammation and stress reaction,and help reduce the patient's postoperative pain,which can help promote the postoperative wound healing,and the safety is better.

Abstract:Objective:To analyze the clinical efficacy of middle meningeal artery(MMA)embolization and analyze the in-fluencing factors for postoperative recurrence in patients with chronic subdural hematoma(CSDH).Methods:According to coin-tossing method,100 patients with CSDH were divided into group A(MMA embolization)and group B(minimally invasive puncture and drainage),50 cases in each group.All patients were followed up for 3 months after surgery.The thickness of sub-dural hematoma,surgical and postoperative rehabilitation(operation time,length of hospital stay,absorption rate of hematoma,midline improvement)before surgery,after surgery and at 3 months after surgery were compared between the two groups.At 3 months after surgery,patients were divided into recurrence group(n=15)and non-recurrence group(n=85)according to presence of absence of CSDH recurrence,basic clinical information,preoperative midline shift,treatment regimens,midline im-provement,days of atorvastatin and glucocorticoid treatment,scores of Glasgow Coma Scale(GCS)and modified Rankin Scale(MRS),and neutrophils in the two subgroups were compared.To systematically analyze potential factors of CSDH recurrence,binary Logistic regression analysis was applied in multivariate statistical modeling.Results:The comparison of hematoma thick-ness in group A before operation>after operation>3 months after operation,and that in group B before operation>3 months after operation>after operation showed significant differences(P<0.05).Compared between the two groups,the thickness of subdural hematoma in group A was higher than that in group B after operation,and it was lower than that in group B at 3 months after operation.There were significant differences between the two groups in terms of time,time and interaction(P<0.05).The length of hospital stay and operation time in group A were shorter than those in group B,absorption rate of hematoma and midline improvement were higher than those in group B at 3 months after surgery(P<0.05).The preoperative hematoma volume,midline shift and operation time in non-recurrence group were lower than those in recurrence group,and pro-portion of MMA embolization was higher than that in recurrence group(P<0.05).Logistic regression analysis showed that preoperative hematoma volume and midline shift were independent risk factors of recurrence in CSDH patients(P<0.05),while MMA embolization was a protective factor(P<0.05).Conclusion:MMA embolization can reduce thickness of subdural hematoma,shorten operation time and length of hospital stay,promote postoperative hematoma absorption and improve brain midline shift.Meanwhile,MMA embolization,preoperative hematoma volume and midline shift are influencing factors of recur-rence in CSDH patients.

Abstract:Objective:To explore the curative effect of clean-up treatment under otoendoscope combined with bifonazole cream in fungal otitis externa(FOE).Methods:According to different treatment methods,102 patients with FOE were divided into control group(clean-up treatment under otoendoscope combined with triamcinolone acetonide and econazole cream)and study group(clean-up treatment under otoendoscope combined with bifonazole cream),51 cases in each group.The curative effect,symptoms improvement,fungal clearance rate,incidence of adverse reactions and recurrence rate at different time points were compared between the two groups.Results:After treatment,total response rate and negative conversion rate of fungi in study group were higher than those in control group(P<0.05).The scores of symptom(ear pruritus,hearing loss,tinnitus and earache),positive rates of Aspergillus and Candida,incidence of adverse reactions and recurrence rates at 4 and 8 weeks af-ter withdrawal in study group were lower than those in control group(P<0.05).There was no significant difference in recur-rence rate between study group and control group at 2 weeks after withdrawal(4.00%vs.10.53%,P>0.05).Conclusion:Clean-up treatment under otoendoscope combined with bifonazole cream can improve curative effect in FOE patients and is wor-thy of clinical promotion and application.

Abstract:Objective:To investigate the effect of laparoscopic folding sutures on myometrial thickness,menstrual cycle and pregnancy outcome in patients with cesarean scar diverticula.Methods:A total of 84 patients with cesarean section scar divertic-ula were included as research subjects.Based on the treatment plan,they were divided into two groups:hysteroscopic group and hysteroscopic-laparoscopic combined group,with 42 cases in each group.The hysteroscopic group underwent hysteroscopic sur-gery,while the hysteroscopic-laparoscopic combined group received treatment using combined hysteroscopic-laparoscopic fold-ing suture technique.The treatment effectiveness rate,hospital stay,operative time,intraoperative blood loss,menstrual period,pregnancy status,diverticulum depth,diverticulum length,and improvement rate of uterine lower segment muscle layer thick-ness were recorded and compared between the two groups.Results:There was no statistically significant difference in the effec-tive treatment rates between the two groups(P>0.05).The combined hysteroscopic and laparoscopic group had longer hospi-tal stay,surgical time,and intraoperative blood loss compared to the hysteroscopic group(P<0.05).At 6 months postopera-tively,the menstrual period duration was lower in the combined group compared to the hysteroscopic group(P<0.05).The pregnancy rate and uterine lower segment muscle layer improvement rate were higher in the combined group than in the hyste-roscopic group(P<0.05).1 month after surgery,the diverticulum depth and length were lower in the combined group com-pared to the hysteroscopic group(P<0.05).Conclusion:Both hysteroscopic surgery and combined hysterolaparoscopic folding suture have better therapeutic effects on the treatment of cesarean section scar diverticulum,although the application of folding suture will increase the operation time and intraoperative bleeding,but this surgical method is beneficial to accelerate the im-provement of patients'menstruation,has a better effect on the repair of diverticulum repair,and helps to improve the pregnancy rate.

Abstract:Objective:To analyze the risk factors of mycoplasma pneumoniae pneumonia(MPP)complicated with lobar pneumonia in children,and to construct its nomogram prediction model.Methods:The clinical data of 322 children with MPP were retrospectively analyzed.According to the imaging diagnostic criteria,they were divided into concurrent group(n=179)and non-concurrent group(n=143).The general data,laboratory indicators at admission,imaging features and treatment infor-mation of all children were collected.The differences of the above data between the two groups were compared.Multivariate Lo-gistic regression analysis was used to screen out the independent risk factors of MPP children complicated with lobar pneumoni-a,and the nomogram model was constructed by R software.The receiver operating characteristic(ROC)curve was drawn to verify the predictive efficacy of the model.Results:Of the 322 children,179 had lobar pneumonia,with an incidence of 55.59%(179/322).Compared with the concurrent group,the non-concurrent group was older(P<0.05),the proportion of fever dura-tion≥7 d,pleural effusion,pulmonary consolidation involving more than 2 lobes and the levels of PCT,D-dimer,CRP,ESR and LDH were higher(P<0.05),and the time from onset to application of macrolides was longer(P<0.05).Multivariate Lo-gistic regression analysis showed that the duration of fever≥7 days(OR=1.752,95%CI:1.324～2.319),high level of CRP(OR=2.433,95%CI:1.529～3.871),high level of LDH(OR=1.933,95%CI:1.377～2.713),pleural effusion(OR=3.504,95%CI:1.535～7.998)and long time from onset to application of macrolides(OR=2.591,95%CI:1.408～4.766)were independent risk factors for lobar pneumonia in children with MPP(P<0.05).The area under the curve(AUC)of the nomogram prediction model ROC was 0.920,the sensitivity was 85.47%,and the specificity was 87.41%.Conclusion:Persis-tent fever,CRP and LDH levels,pleural effusion and the use of macrolides from onset to onset are closely related to lobar pneu-monia in children with MPP.The nomogram prediction model constructed based on this has good predictive efficacy after inter-nal verification.

Abstract:Objective:To develop and validate a clinical prediction model for assessing the risk of uterine fibroid occurrence based on serum vitamin D levels and other clinical characteristics.Methods:A retrospective analysis was conducted on 304 pa-tients with uterine leiomyomas and 184 healthy controls.They were divided into a training set(n=192)and a validation set(n=296)according to different time periods of data collection.Five machine learning(ML)predictive models were developed based on serum vitamin D levels and five other clinical features.The area under the curve(AUC)was used to evaluate the per-formance of the models,and external validation was performed to verify the models.Results:All five machine learning models demonstrated good predictive performance(AUC≥0.8).In external validation,the support vector machine(SVM)model ex-hibited superior predictive performance compared to other machine learning algorithms(AUC=0.941,95%CI:0.927～0.969,sensitivity=0.968,specificity=0.801,Brier score=0.148).Conclusion:The combination of serum vitamin D levels with five other clinical features shows promising potential for predicting the occurrence of uterine fibroids.Among the models tested,the support vector machine(SVM)model demonstrated the best predictive performance.

Abstract:Objective:To investigate the level of vitamin D in patients with intrahepatic cholestasis of pregnancy(ICP),and analyze the relationship between vitamin D level and ICP and pregnancy outcome.Methods:230 ICP patients were selected as case group and 327 normal pregnant women were selected as control group.General data,vitamin D levels,liver function and perinatal outcomes of the two groups were compared,and correlation analysis was performed.The predictive value of vitamin D levels in adverse pregnancy outcomes was analyzed using receiver operating characteristic curve(ROC).Results:There were sta-tistically significant differences in age,birth time,previous ICP history,symptoms,liver function,vitamin D level in late preg-nancy and pregnancy outcome between the two groups(P<0.05).There was no significant difference in the levels of serum vi-tamin D in the first trimester and the second trimester between the two groups(P>0.05).Correlation analysis showed that there was a negative correlation between serum vitamin D and serum total bile acid(TBA)in late pregnancy(r=-0.204,P<0.001).In ICP patients,the serum vitamin D level in the third trimester in the adverse pregnancy outcome group was lower than that in the non-adverse pregnancy outcome group,and the difference between the groups was statistically significant(P<0.05).ROC curve analysis showed that serum vitamin D level in late pregnancy had a certain predictive value for adverse preg-nancy outcomes in ICP patients(P<0.001).Conclusion:The serum vitamin D in the case group was lower than that in the con-trol group,and there was a negative correlation between vitamin D and TBA.The level of vitamin D in the late trimester of pregnant women in the case group has a certain predictive value for adverse pregnancy outcomes,and vitamin D supplementa-tion should be appropriately strengthened during pregnancy to improve maternal and infant outcomes.

Abstract:Objective:To explore and validate a nomogram for early prediction of bronchopulmonary dysplasia(BPD)in low birth weight infants borne earlier than 32 weeks.Methods:Preterm infants with a birth weight of less than 2 500 g and ges-tational age≤32 weeks were selected for retrospective analysis.The risk factors of BPD were analyzed,and its effectiveness was evaluated using the area under the receiver operating characteristic(ROC)curve,sensitivity,and specificity.Internal valida-tion of the model was conducted using Bootstrap resampling.Hosmer-Lemeshow test and decision curve analysis(DCA)were used for evaluating calibration and clinical applicability.Results:A total of 260 preterm infants were included in the study,with 79 cases in the BPD group and 181 cases in the non-BPD group.The results of the multivariate Logistic regression analysis showed that the lack of regular prenatal steroid use before maternal delivery(OR=3.317,95%CI:1.377～7.990),gestational age(OR=0.528,95%CI:0.401～0.695),neonatal respiratory distress syndrome(NRDS,OR=3.175,95%CI:1.529～6.593),and mechanical ventilation(OR=2.537,95%CI:1.215～5.300)were independent risk factors for BPD in preterm in-fants with low birth weight(P<0.05).Based on the results of the multivariate Logistic regression analysis,a nomogram model was established,with the area under the ROC curve being 0.836(95%CI:0.784～0.887).At a cutoff value of 0.293,the sen-sitivity was 0.810(95%CI:0.724～0.897),and the specificity was 0.779(95%CI:0.719～0.839),indicating that the model has good discriminative ability.The clinical effectiveness of the predictive model was assessed using the DCA,which showed that when the threshold probability for the modeling cohort was between 10%and 70%,there was a higher net benefit for the clinical prediction of infants.Conclusion:Maternal irregular use of hormones before delivery,gestational age,NRDS,and me-chanical ventilation in low birth weight infants borne earlier than 32 weeks increase the risk of BPD.The establishment of a no-mogram model provides clinicians with a visual tool for early identification of BPD.

Abstract:Objective:To investigate the relationship between serum angiopoietin-1(Ang-1)and Clara cell secretory pro-tein-16(CC-16)levels and the condition of neonates with acute respiratory distress syndrome(ARDS)and the predictive value of prognosis.Methods:136 neonates with ARDS were divided into mild group(n=41),moderate group(n=65)and severe group(n=30)according to the severity of the disease.According to the prognosis within 28 days,they were divided into sur-vival group(n=115)and death group(n=21).The differences of serum Ang-1 and CC-16 levels in each group were com-pared.Logistic regression model was used to analyze the influencing factors of 28-day prognosis of ARDS neonates.The receiver operating characteristic(ROC)curve was used to evaluate the clinical value of Ang-1 and CC-16 levels and their combined pre-diction of prognosis.Results:Compared with the survival group,the serum Ang-1 level in the death group was lower(P<0.05),and the CC-16 level was higher(P<0.05).The levels of serum Ang-1 and CC-16 in children with different severity were statistically different(P<0.05).The more severe the ARDS newborn was,the lower the serum Ang-1 level was(P<0.05),and the higher the CC-16 level was(P<0.05).Logistic regression analysis showed that gestational age(OR=0.853),5 min Apgar score(OR=0.802),serum Ang-1(OR=0.702)and CC-16(OR=2.389)were independent influencing factors for 28-day prognosis of ARDS neonates(P<0.05).ROC curve analysis showed that serum Ang-1 and CC-16 levels had certain predictive value for the prognosis of ARDS neonates,with AUC of 0.710 and 0.734,respectively.The AUC of the combination of the two was 0.788,which was higher than that of the single index(P<0.05).Conclusion:Serum Ang-1 and CC-16 are relat-ed to the condition of ARDS neonates and can be used as biomarkers for prognosis prediction.

Abstract:Objective:To investigate the therapeutic effect of compound Xueshuantong capsule combined with calcium do-besilate capsule in the treatment of non-proliferative diabetic retinopathy(DR).Methods:A total of 90 patients with non-prolif-erative DR were divided into control group and observation group according to different treatment methods,with 45 cases in each group.The two groups were treated with calcium dobesilate capsules and compound Xueshuantong soft capsules combined with calcium dobesilate capsules,respectively,for 12 weeks.Before and after treatment,the best corrected visual acuity(BC-VA),fundus hemorrhage area,fundus exudation area,number of retinal microaneurysms and central macular thickness(CMT)were detected,and the severity of diabetic retinopathy(DRSS)and TCM syndrome score were evaluated.The difference of cur-ative effect between the two groups was compared.Results:Compared with the control group,the total effective rate of the ob-servation group was higher(80.00%vs.60.00%),and the difference was significant(P<0.05).After treatment,compared with the control group,the BCVA of the observation group was higher(P<0.05),the fundus hemorrhage,exudation area,CMT,DRSS score and TCM syndrome score were lower(P<0.05),and the number of retinal microaneurysms was less(P<0.05).After treatment,the levels of serum VEGF and ET-1 in the observation group were lower than those in the control group(P<0.05).Conclusion:Calcium dobesilate capsule combined with compound Xueshuantong soft capsule in the treatment of non-proliferative DR can improve the curative effect,improve the visual acuity of patients,reduce microvascular injury and fun-dus pathological changes such as hemorrhage and exudation.

Abstract:Objective:To investigate the efficacy of celecoxib combined with aripiprazole in the treatment of schizophrenia and its effect on serum inflammatory factor levels.Methods:181 patients with schizophrenia were divided into control group(n=91)and observation group(n=90)according to different treatment methods.The control group was treated with aripiprazole and the observation group was treated with celecoxib combined with aripiprazole for a course of 8 weeks.Before and after treat-ment,the patients were assessed with Positive and Negative Syndrome Scale(PANSS)and Repeatable Battery for the Assess-ment of Neuropsychological Status(RBANS),and the levels of serum interleukin-6(IL-6),IL-1β and tumor necrosis factor-α(TNF-α)were detected.The efficacy and adverse reactions of the two groups were compared.Results:Compared with the con-trol group,the total effective rate of the observation group was higher(94.44%vs.76.67%,P<0.05).After treatment,com-pared with the control group,the positive factor score,negative factor score and PANSS total score of the observation group were lower(P<0.05),and the RBANS score of the observation group was higher(P<0.05).After treatment,the observation group had lower serum IL-6,IL-1β and TNF-α levels than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Celecoxib combined with aripiprazole in the treatment of schizophrenia can improve the mental symptoms and cognitive function of patients,and the mechanism of impro-ving the curative effect may be related to the reduction of inflammation level.

Abstract:Objective:To observe the influence of combination of hysteroscopy and acupoint application on postoperative pain and intestinal function recovery in patients with perimenopausal abnormal uterine bleeding.Methods:100 patients with peri-menopausal abnormal uterine bleeding were enrolled as study subjects,and were divided into study group(n=50)and control group(n=50)by means of different treatment methods.The control group was given hysteroscopy,whereas the study group received postoperative acupoint application on the basis of the control group.Both groups were treated for 2 days.The postoper-ative pain degree[visual analogue scale(VAS)],pain factors[substance P(SP),norepinephrine(NE)],gastrointestinal hor-mones[gastrin(GAS),motilin(MLT)],intestinal function recovery time(bowel sound recovery time,first exhaust time,first defecation time)and hospitalization time were compared between the two groups.Results:The VAS score in the study group at each time point after surgery(6 hours,1 and 2 days after surgery)was lower than that in the control group(P<0.05).At 1 day and 2 days after surgery,both groups showed higher levels of SP and NE compared to preoperative day 1,and the study group was lower than the control group(P<0.05).Both groups showed lower levels of GAS compared to preoperative day 1,and the study group was higher than the control group(P<0.05).MLT was higher than 1 day before surgery,and the study group was lower than the control group(P<0.05).The intestinal function recovery time and hospitalization time in study group were shorter than those in the control group.Conclusion:Hysteroscopy combined with acupoint application has a good re-lieving effect on postoperative pain in patients with perimenopausal abnormal uterine bleeding,and it can promote the recovery of postoperative intestinal function and shorten the hospitalization time.

Abstract:Objective:To explore on the therapeutic effect of rivaroxaban and dabigatran on left ventricular thrombus(LVT)patients after acute myocardial infarction(AMI).Methods:129 post AMI LVT patients who underwent emergency per-cutaneous coronary intervention(PCI)were divided into three groups according to different treatment methods:warfarin group(initial dose 2.5 mg,once a day,adjusted according to international standard ratio),rivaroxaban group(10 mg,once a day),and dabigatran group(110 mg,twice a day),with 43 patients in each group.The LVT dissolution rate,incidence rates of major ad-verse cardiovascular events(MACE),incidence rates of bleeding events,myocardial enzyme spectrum indexes[creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),troponin Ⅰ(cTnⅠ)]and liver function indexes were compared among the three groups of patients within 3 months.Results:The dissolution rate of LVT in rivaroxaban group and dabigatran group was higher than that in warfarin group(P<0.05).The incidence rates of MACE were lower in rivaroxaban group and dabigatran group than those in warfarin group(P<0.05),but there were no statistical differences between rivaroxaban group and dabigat-ran group(P>0.05).The total incidence rate of bleeding events in rivaroxaban group and dabigatran group was lower com-pared with that in warfarin group(P<0.05).After 7 days and 1 month of treatment,the myocardial enzyme spectrum indexes such as CK-MB,LDH and cTnⅠ were lower in rivaroxaban group and dabigatran group compared to warfarin group(P<0.05),but no statistical differences were shown between rivaroxaban group and dabigatran group(P>0.05).The differences in liver function indexes such as ALT,AST and TB were not statistically significant among the three groups of patients at each time point before and after treatment(P>0.05).Conclusion:Rivaroxaban and dabigatran are equally effective in treating LVT pa-tients after AMI,and both are superior to warfarin.Both drugs can promote LVT dissolution,reduce the risk of MACE and bleeding events,promote myocardial function recovery,and have good treatment safety.

Abstract:<正>1 病历资料患者，女，72岁，主因“间断头晕42年，加重8 d”于2020年12月9日以“高血压病3级(很高危)”入住中国中医科学院广安门医院综合科。患者高血压病史40余年，服药控制，近日血压波动较大，最高达205/120 mmHg。

Abstract:Objective:To explore the effect of intervention model based on self-efficacy theory on self-efficacy,anxiety and depression and cancer-related fatigue in patients with thyroid cancer after operation.Methods:100 patients with thyroid cancer were divided into control group and observation group according to different intervention methods,50 cases in each group.The control group received routine nursing intervention,and the observation group received nursing intervention based on self-effica-cy theory,all of which lasted until 3 months after discharge.The scores of cancer self-management efficacy scale(SUPPH),self-rating anxiety scale(SAS),self-rating depression scale(SDS),cancer-related fatigue scale(CFS)and cancer quality of life core scale(QLQ-C30)were compared between the two groups before and after intervention.Results:After intervention,com-pared with the control group,the scores of SUPPH and QLQ-C30 in the observation group were higher(P<0.05),and the scores of SAS,SDS and CFS were lower(P<0.05).Conclusion:The intervention model based on self-efficacy theory can im-prove the patients? self-efficacy level who with thyroid cancer after operation,reduce the level of anxiety,depression and cancer-related fatigue,and improve their quality of life.