Abstract:Objective:To explore the improvement effect of scutellarin(SCU)on bleomycin(BLM)-induced pulmonary fi-brosis in mice and to analyze potential action mechanism of SCU based on transforming growth factor-β1(TGF-β1)/Smads sig-naling pathways.Methods:The models of pulmonary fibrosis mice were constructed by intratracheal injection of BLM,and they were divided into blank group,SCU group,BLM group and BLM+SCU group.After 21 d of intervention,growth status,patho-logical changes of lung tissues,levels of inflammatory factors,expressions of pulmonary fibrosis markers proteins and mRNA levels of TGF-β1,Smad2,Smad3 and Smad7 in different groups were observed.Results:Compared with blank group and SCU group,scores of alveolar inflammation and pulmonary fibrosis,levels of interleukin-6(IL-6),IL-1β,tumor necrosis factor-α(TNF-α)and hydroxyproline(HYP),expressions of α-SMA,Collagen I and Fibronectin proteins in lung tissues,mRNA levels of TGF-β1 and Smad2/3/7 were increased in BLM group(P<0.05).The above indexes in BLM+SCU group were all lower than those in BLM group(P<0.05).Conclusion:SCU can improve BLM-induced pulmonary fibrosis and inflammatory response of lung tissues in mice.The improvement mechanism may be related to the down-regulation of TGF-β1/Smads pathways.

Abstract:Objective:To investigate the genetic polymorphism of 19 X-STRs loci in the Beichuan Qiang and Xichang Yi ethnic groups in Sichuan Province,evaluate their forensic application value,and analyze their population structure.Methods:Dry blood spot samples were collected from 246 unrelated individuals(188 males and 58 females)of the Beichuan Qiang ethnic group and 281 unrelated individuals(116 males and 165 females)of the Xichang Yi ethnic group.The dry blood spot samples were directly amplified using the MicroreaderTM19X ID System kit,and the PCR products were subjected to capillary electro-phoresis using an ABI3500 genetic analyzer,GeneMapper?ID-X software automatically classifies.Results:A total of 150 alleles were detected in the Beichuan Qiang ethnic group,with a frequency range of 0.003 3～0.828 9.In the Xichang Yi ethnic group,a total of 164 alleles were detected,with a frequency range of 0.002 2～0.800 4.After statistical testing,the gene frequency dis-tribution of the two ethnic minority groups conform to Hardy Weinberg equilibrium law(P>0.05),and after Bonferroni correc-tion,there were no loci with linkage disequilibrium.In the Beichuan Qiang ethnic group,the combined discrimination power for males(PDM)and combined discrimination power for females(PDF)were 0.999 999 999 945 624 and 0.999 999 999 999 999 993 22,re-spectively.The combined mean exclusion chance in duos(MECD)and mean exclusion chance in trios(MECT)were 0.999 999 591 813 975 and 0.999 999 999 465 296,respectively.In the Yi ethnic group of Xichang,the combined discrimination power for males(PDM)and combined discrimination power for females(PDF)were 0.999 999 999 873 529 and 1,respectively.The combined mean exclusion chance in duos(MECD)and mean exclusion chance in trios(MECT)were 0.999 999 284 224 924 and 0.999 999 998 931 424,respec-tively.Conclusion:The MicroreaderTM19X ID fluorescence detection kit has a high overall polymorphism and good discriminatory ability in the Beichuan Qiang and Xichang Yi populations,and can serve as a powerful supplement and verification method for parental relation-ships and individual identification.

Abstract:Objective:To explore the effect and potential mechanisms of CC chemokine ligand 8(CCL8)in cutaneous squa-mous cell carcinoma(CSCC).Methods:Collecting human skin squamous cell carcinoma tissue and normal skin tissue,and detect the expression of CCL8 through tissue immunofluorescence staining.After overexpression or inhibition of CCL8 in human skin squamous cell carcinoma cell line A431 using construction of myc-CCL8 overexpression plasmid or CCL8 siRNAs,cell viability,migration and invasion ability were detected.The expression levels of cell Epithelial-Mesenchymal Transition(EMT)related proteins(E-cadherin,ZO-1,SNAIL,N-cadherin)and JAK1/STAT3 pathway was detected by Western blot experiment.Re-sults:Compared with barely expressed in normal skin tissue,CCL8 was increased expressed in CSCC tissue(P<0.05).CCL8 could significantly promote the proliferation,migration,and invasion ability of A431 cells(P<0.05).CCL8 could remarkably activate the JAK1/STAT3 pathway in A431 cells,upregulate the expression of SNAIL and N-cadherin proteins,and downregu-late the expression of E-cadherin and ZO-1 proteins(P<0.05).Conclusion:CCL8 is up-regulated expressed in CSCC cells and can promote the EMT process of CSCC cells through the JAK1/STAT3 pathway,thereby facilitating CSCC cell proliferation,migration,and invasion,which provides ideas for clinical treatment of CSCC.

Abstract:Objective:To investigate the expression level of B3GNT5 in gastric cancer(GC)tissues and its correlation with clinicopathological parameters and patient prognosis.Methods:The expression difference of B3GNT5 in GC tissues versus adja-cent non-tumor tissues was analyzed using the GEPIA2 database,Kaplan-Meier Plotter database,and TCGA database.Its corre-lation with patient survival was also explored.Tissue samples and clinical data were collected from 85 GC patients.Immunohis-tochemistry(IHC)was used to detect B3GNT5 expression differences between GC tissues and adjacent non-tumor tissues.The correlation between B3GNT5 expression level and the clinicopathological characteristics of GC was analyzed.Results:Bioinfor-matics analysis showed that B3GNT5 was highly expressed in GC tissues and lowly expressed in adjacent non-tumor tissues,with a statistically significant difference(P<0.05).High expression of B3GNT5 was associated with poorer overall survival(OS)and recurrence-free survival(RFS)in GC patients(P<0.05).Pathological IHC revealed that B3GNT5 expression level was higher in GC tissues compared to adjacent non-tumor tissues.B3GNT5 expression level showed correlations with tumor in-vasion depth,lymph node,and TNM stagemetastasis(P<0.05).Kaplan-Meier survival analysis and Cox regression model a-nalysis indicated that B3GNT5 was an independent risk factor for prognosis assessment in GC(P<0.05).Conclusion:High ex-pression of B3GNT5 in gastric cancer is associated with poor prognosis and may serve as a potential biomarker for prognostic assessment in GC.

Abstract:Objective:To investigate the effects of combining visual function training with different optical correction mo-dalities on ocular accommodative function and refractive-related parameters in myopic children and adolescents,aiming to evalu-ate their combined efficacy in myopia control and prevention.Methods:This study enrolled 120 patients(240 eyes)meeting in-clusion criteria,they were divided into 6 groups according to different correction methods:single-vision lenses(SVL),defocus incorporated multiple segments(DIMS),orthokeratology(OK),and their respective combinations with vision training(SCVT,DCVT,OCVT),with 20 patients(40 eyes)in each group.Optical correction groups wore lenses only,while combined groups received additional accommodative training.Changes in axial length(AL),anterior chamber depth(ACD),mean keratometry(Km),accommodative amplitude(AMP),accommodative facility(AF),positive relative accommodation(PRA),and negative relative accommodation(NRA)were assessed before intervention and 3 and 6 months after intervention treatment.Results:Af-ter the intervention,in optical correction groups,SVL showed no significant changes,DIMS improved AF(P<0.05),OK im-proved AMP,AF,PRA,and reduced ACD,Km(P<0.05).In combined groups,SCVT improved AMP,AF(P<0.05),DCVT improved AMP,AF,PRA,NRA(P<0.05),OCVT improved AMP,AF,PRA,NRA,and reduced ACD,Km(P<0.05).Com-bined groups showed better AL control and AMP,AF,PRA improvements than in optical correction groups(P<0.05).A-mong combined groups,DCVT and OCVT outperformed SCVT in AMP,AF,PRA improvements(P<0.05),OCVT sur-passed DCVT in AMP improvements(P<0.05).After 6 months of intervention,AL growth was OCVT

Abstract:Objective:To investigate the clinical efficacy of bronchoscopic alveolar lavage as an adjuvant therapy for severe Mycoplasma pneumoniae pneumonia(SMPP)in children,and analyze its impact on peripheral blood C-reactive protein(CRP)and procalcitonin(PCT)levels.Methods:A total of 160 children with SMPP were enrolled in the study.Using different treat-ment regimens,they were assigned to the control group and the observation group,80 cases in each group.The groups received conventional treatment and bronchoscopic alveolar lavage assisted conventional treatment,respectively.The duration of clinical symptoms,clinical efficacy,peripheral blood CRP and PCT levels,and complication rate were compared between the two groups.Results:Inter-group comparisons found that the duration of clinical symptoms was shorter in the observation group(P<0.05).The overall clinical effective rate was higher in the observation group(P<0.05).After 2 weeks of treatment,pe-ripheral blood CRP and PCT levels in both groups decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(3.75%vs.12.50%,P<0.05).Conclusion:Bronchoscopic alveolar lavage as an adjuvant therapy can achieve significant therapeutic effects on SMPP in children.It can shorten the duration of clinical symptoms,lower peripheral blood CRP and PCT levels,and reduce complication risk.

Abstract:Objective:To explore the cytokine expression levels in cerebrospinal fluid(CSF)of patients with neurosyphilis(NS)and evaluate their diagnostic value for NS.Methods:A total of 194 syphilis patients were included for this study,inclu-ding 41 patients with NS and 153 patients with non-neurosyphilis(NNS).All participants underwent lumbar puncture.Gener-al information(age,sex)and CSF laboratory test results,including white blood cell count,protein,chloride,Pandy's test,cyto-kines[tumor necrosis factor-alpha(TNF-α),interferon-gamma(IFN-γ),interleukin-2(IL-2),IL-4,IL-6,IL-10,IL-17A]were collected and compared between the two groups.Spearman correlation analysis was performed to examine the correlation be-tween CSF cytokines and white blood cell count and protein levels.Multivariate Logistic regression analysis was used to identi-fy independent predictors,and receiver operating characteristic(ROC)curves were plotted to assess diagnostic performance.Results:NS patients showed higher levels of age,positive Pandy's test,white blood cell count,protein concentration,TNF-α,IFN-γ,IL-2,IL-4,IL-6,IL-10,and IL-17A compared to NNS patients(P<0.05).TNF-α,IFN-γ,IL-2,IL-4,IL-6,IL-10,and IL-17A were positively correlated with both CSF white blood cell count and protein concentration(P<0.05).Multivariate Lo-gistic regression revealed that IL-6,IL-10,and IL-17A(OR=1.112,1.114,1.235)were independent predictors of NS(P<0.05).The areas under the curve(AUC)for IL-6,IL-10,and IL-17A were 0.903,0.893,and 0.844,respectively,and the com-bined AUC for all three indicators was 0.936.Conclusion:The expression levels of multiple cytokines in the CSF of NS pa-tients are elevated and positively correlated with CSF white blood cell count and protein concentration.IL-6,IL-10,and IL-17A can serve as auxiliary diagnostic indicators for NS.

Abstract:Objective:To investigate the effects of oxybuprocaine hydrochloride gel combined with propacetamol on cardio-vascular stress,anaesthesia and haemodynamics in patients undergoing laparoscopic cholecystocholedochotomy.Methods:80 pa-tients undergoing elective laparoscopic cholecystocholangiography were selected as study subjects and divided into a control group and a combined group based on different anesthesia protocols used during the operation,with 40 cases in each group.The control group received propacetamol intravenous injection,and the combined group received topical anesthesia with oxybupro-caine hydrochloride gel in addition to the treatment given to the control group.The operation time,anesthesia time,recovery time,extubation time,blood oxygen saturation(SaO2),heart rate(HR),mean arterial pressure(MAP),catecholamines,corti-sol,blood glucose,pain[Visual Analog Scale(VAS)],and the incidence of adverse reactions were recorded and compared be-tween the two groups.Results:There were no significant differences in operation time,anesthesia time,emergence time,and ex-tubation time between the two groups of patients(P>0.05).At 15 and 30 min post-extubation,both HR and MAP were lower in the combination group compared to the control group(P<0.05).On postoperative day 1,catecholamines,cortisol,and blood glucose levels were elevated in both groups,but the levels were lower in the combination group compared to the control group(P<0.05).VAS scores were lower in the combination group compared to the control group immediately after extubation,and at 15 min and 30 min post-extubation(P<0.05).The incidence of adverse reactions was lower in the combination group com-pared to the control group(P<0.05).Conclusion:In laparoscopic cholecystobiliary choledochotomy,compared with propaceta-mol anaesthesia alone,combined with oxybuprocaine hydrochloride gel anaesthesia is more conducive to reducing the degree of postoperative pain and haemodynamic fluctuations of the patient,and can effectively inhibit the patient's level of postoperative cardiovascular stress response,which can help to increase the degree of patient's tolerance to catheterisation.

Abstract:Objective:To explore the effect and mechanism of Huanglong Zhike Granules in the treatment of cough variant asthma in children based on macrophage polarization.Methods:160 children with cough variant asthma were divided into a con-trol group and an experimental group,with 80 cases in each group.The control group was given montelukast sodium chewable tablets and Huanglong Zhike Granules placebo,and the experimental group was given montelukast sodium chewable tablets and Huanglong Zhike Granules,both groups received continuous treatment for 4 weeks.After treatment,the clinical efficacy was e-valuated by changes in cough severity score,TCM syndrome score,pulmonary function indicators,and airway anatomical indica-tors.The proportions of M1 and M2 macrophages in peripheral blood and the expression levels of macrophage polarization marker genes before and after treatment were compared between the two groups.The occurrence of complications such as drowsiness and diarrhea during the treatment period was statistically analyzed.Results:After treatment,the cough severity score and TCM syndrome score in the experimental group were lower than those in the control group,and FEV1,FVC,FEV1/FVC,and PEF were higher than those in the control group(P<0.05).After treatment,the airway wall thickness,basement mem-brane thickness,and total airway wall area in the experimental group were smaller than those in the control group(P<0.05).After treatment,the proportion of M1 macrophages in the experimental group was lower than that in the control group,and the proportion of M2 macrophages was higher than that in the control group(P<0.05).After treatment,the mRNA expression levels of Arg-1,iNOS,CD80,and CD163 in the experimental group were lower than those in the control group(P<0.05).Dur-ing the treatment period,1 case of headache occurred in the experimental group,with an incidence of adverse reactions of 1.25%,1 case of drowsiness and 1 case of diarrhea occurred in the control group,with an incidence of adverse reactions of 2.50%.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Huanglong Zhike Granules can treat cough variant asthma in children by regulating macrophage polarization,and can reduce cough severity and improve lung function and airway function.

Abstract:Objective:To compare the efficacy and safety of different approaches of percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures(OVCFs).Methods:A total of 180 patients with OVCFs treated by PVP were collected and divided into two groups according to different surgical approaches.Among them,88 patients under-went unilateral pedicle approach PVP as unilateral approach group,and 92 patients underwent bilateral pedicle approach PVP as bilateral approach group.The visual analogue scale(VAS)pain score and Oswestry disability index(ODI)were evaluated be-fore operation,1 month and 12 months after operation,and the anterior vertebral height and kyphosis Cobb angle were meas-ured.The operation related indexes and complications of the two groups were compared.Results:Compared with the bilateral approach group,the unilateral approach group had shorter operation time(P<0.05),less intraoperative blood loss and fluoros-copy times(P<0.05),and lower bone cement volume(P<0.05).The VAS score and ODI index of the two groups at 1 month and 12 months after operation were lower than those before operation(P<0.05).The height of the anterior edge of the injured vertebra and the Cobb angle of the kyphosis were improved compared with those before operation(P<0.05).There was no significant difference in VAS score,ODI index and above imaging parameters between the two groups before and after operation(P>0.05).The incidence of bone cement leakage in the unilateral approach group was 13.64%,and the incidence of bone cement leakage in the bilateral approach group was 17.39%,there was no significant difference between the two groups(P>0.05).Conclusion:Unilateral pedicle approach PVP can achieve similar efficacy as bilateral pedicle approach PVP.Com-pared with bilateral approach surgery,unilateral approach surgery has the advantages of shorter operation time and less radia-tion damage.

Abstract:Objective:To explore the effect of combined use of esketamine and ropivacaine in ultrasound-guided axillary brachial plexus block(BPB).Methods:A retrospective analysis was conducted on the clinical data of 130 patients.They were di-vided into the control group(64 cases receiving general anesthesia)and the observation group(66 cases receiving ultrasound-guided axillary BPB with esketamine and ropivacaine on the basis of general anesthesia)according to different anesthesia meth-ods.The pain,postoperative condition,hemodynamic indices,and adverse reactions were compared between the two groups.Re-sults:The Visual Analog Scale(VAS)scores of both groups reached the highest at 12 h postoperatively and then decreased over time,and the observation group was lower than the control group(P<0.05).Inter-group comparisons found that postoperative extubation time and awakening time of the observation group were shorter.The time of using patient-controlled intravenous an-algesia(PCIA)for the first time was longer,and effective compressions were fewer in the observation group(P<0.05).The incidence of dizziness in the observation group was higher(P=0.033).There was no statistically significant difference in the o-verall incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined use of esketamine and ropi-vacaine can achieve good analgesic and postoperative effects,without influence on patient hemodynamics or increase in postoper-ative adverse reactions.It can be used for clinical promotion.

Abstract:Objective:To investigate the early predictive value of combining umbilical cord blood flow dynamics parameters with placental function indicators in the second trimester of pregnancy for fetal growth restriction(FGR)in assisted reproduc-tive technology(ART)pregnancies,and to develop and validate a predictive model.Methods:A total of 317 singleton pregnant women who successfully achieved ART-assisted pregnancies and maintained ongoing pregnancies were enrolled and followed up until delivery.Based on the occurrence of FGR,the participants were categorized into the FGR group(n=41)and the non-FGR group(n=276).At 20～24 weeks of gestation,baseline characteristics,umbilical artery hemodynamic parameters[peak systol-ic velocity(S),end-diastolic velocity(D),S/D ratio,resistance index(RI),pulsatility index(PI),peak systolic velocity(Vs),end-diastolic velocity(Vd)]and placental function indicators[24-hour urinary estriol,serum human placental lactogen(hPL),fetal movement counts within 2 hours]were systematically collected.Independent predictors were screened using LASSO-Lo-gistic regression to construct a combined prediction model.The model's discriminative ability was evaluated using the receiver operating characteristic(ROC)curve.Internal validation assessing stability was performed using the Bootstrap method.Clinical decision curve analysis(DCA)was employed to evaluate clinical utility.Results:Through LASSO-logistic regression analysis,the optimal model was achieved with λ=0.074.The findings indicated that elevated S/D ratios,increased Resistance Index(RI),higher Pulsatility Index(PI),reduced serum hPL levels,low 24-hour urinary estriol levels,and fewer than 6 fetal move-ments within two hours were significant risk factors influencing FGR following successful assisted reproductive pregnancies(P<0.05).The nomogram model was internally validated using the Bootstrap method,with the area under the ROC curve for the LASSO-Logistic prediction model being 0.871.Furthermore,the Hosmer-Lemeshow test demonstrated that the mean abso-lute error between the actual values and the calibration curve was 0.03(χ2=0.162,P=0.872).Conclusion:The LASSO re-gression model,constructed based on mid-trimester umbilical artery hemodynamic parameters(S/D ratio,RI,PI),serum hPL,24-hour urinary estriol,and fetal movement counts<6 within 2 hours,demonstrates good early predictive value for FGR in ART pregnancies.This model exhibits stability and strong clinical utility,providing significant evidence-based support for indi-vidualized fetal surveillance and early intervention in ART pregnancies.

Abstract:Objective:To investigate the predictive value of peripheral blood platelet-to-lymphocyte ratio(PLR)combined with modified trauma score(RTS)for 28-day prognosis in emergency trauma patients.Methods:The clinical data of 108 pa-tients with emergency trauma were retrospectively analyzed.According to the 28-day prognosis,the patients were divided into survival group(n=91)and death group(n=17).The general data and laboratory indexes such as white blood cell count and PLR were compared between the two groups.Logistic regression analysis was used to determine the risk factors of prognosis.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of related indicators for the 28-day prognosis of patients.Results:Compared with the survival group,the proportion of emergency mechanical ventilation in the death group was increased(P<0.05),the RTS score was decreased(P<0.05),and the injury severity score(ISS)was in-creased(P<0.05).Compared with the survival group,the platelet count and PLR in the death group decreased(P<0.05).There was no significant difference in other routine laboratory indexes between the two groups(P>0.05).Logistic regression analysis showed that emergency mechanical ventilation(OR=4.591),RTS score(OR=0.708)and PLR(OR=0.776)were independent factors affecting the 28-day prognosis of patients(P<0.05).ROC curve analysis showed that both PLR and RTS scores had certain predictive ability for 28-day death in emergency trauma patients,with AUC of 0.764 and 0.736,respectively.The AUC of the combination of the two was 0.822,which was higher than that of the single index(P<0.05).Conclusion:Pe-ripheral blood PLR and RTS scores are closely related to the 28-day prognosis of emergency trauma patients,and the combina-tion of the two can better predict the prognosis of patients.

Abstract:Objective:To explore the correlation between the naples prognostic score(NPS)and the clinicopathological characteristics and prognosis of patients with newly diagnosed Colorectal Cancer(CRC).Methods:The clinicopathological char-acteristics and prognosis data of 188 diagnosed CRC patients were collected.The cumulative NPS score was calculated based on the pre-treatment serum ALB(<4 g/dL:1 point,≥4 g/dL:0 point),TC(≤180 mg/dL:1 point,>180 mg/dL:0 point),NLR(>2.96:1 point,≤2.96:0 point),and LMR(≤4.44:1 point,>4.44:0 point).The patients were divided into Group A(0 points),Group B(1～2 points),and Group C(3～4 points),and the differences in clinicopathological characteristics and prognosis among the three groups were analyzed.Results:There were statistically significant differences in age,maximum tumor diameter,neurovascular invasion,perivascular invasion,liver metastasis,CA-125,TNM stage,and post-treatment compli-cations among the NPS groups(P<0.05).Univariate Cox analysis showed that NPS was significantly associated with OS(HR=2.477,95%CI:1.468～4.181,P=0.001).After controlling for confounding factors,multivariate analysis showed that NPS remained an independent prognostic factor(HR=2.359,95%CI:1.368～4.067,P=0.002).The K-M curve based on 3-year OS indicated that the prognosis of the high NPS group(Group C)was worse.The ROC curve showed that NPS(AUC=0.691)had better predictive efficacy compared with PNI,SIS,NLR,and LMR,and the NPS+TNM combined model(AUC=0.833)was superior to the single TNM staging(AUC=0.792),It had a good calibration ability.Conclusion:NPS can identify newly diagnosed CRC patients with high inflammatory load and poor nutritional status.It is an independent risk factor for poor prognosis.Its predictive efficacy is higher than that of the classic predictive scores PNI,SIS,NLR,and LMR.When used in combination with TNM,it can further optimize stratified management and provide certain value for clinical diagnosis and treat-ment before treatment.

Abstract:Objective:To investigate the influence of different doses of esomeprazole during bismuth quadruple regimen on the eradication rate of Helicobacter pylori(Hp)and the levels of serum gastrointestinal hormones and interleukin-17(IL-17)levels in patients with peptic ulcer.Methods:A total of 122 patients with Hp infection and peptic ulcer were enrolled,and they were treated with bismuth quadruple therapy.According to different treatment plans(high and low doses of esomeprazole),pa-tients were divided into a high-dose group and a standard dose group,with 61 cases in each group.The clinical efficacy,Hp erad-ication rate,serum gastrointestinal hormones and inflammatory indexes before and after treatment and adverse drug reactions were compared between the two groups.Results:The clinical efficacy in high-dose group was higher than that in the standard-dose group(P<0.05).PP analysis and ITT analysis showed that the eradication rate of Hp in the high-dose group was higher than that in the standard-dose group(P<0.05).After treatment,serum gastrin,IL-17,IL-6 and CRP levels in the two groups were decreased(P<0.05)while serum motilin level was increased(P<0.05),and the gastrin,IL-17,IL-6 and CRP levels in the high-dose group were lower than those in the standard-dose group(P<0.05)while the motilin level was higher than that in the standard-dose group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of high-dose esomeprazole at a dose of 40 mg/time in the bismuth quadrup-le therapy for the treatment of peptic ulcers is more effective than the standard dose of esomeprazole at a dose of 20 mg/time,with higher Hp eradication rate and higher safety,and has clinical application value.

Abstract:Objective:To investigate the efficacy of bilateral cerebellar high-frequency repetitive transcranial magnetic stim-ulation(rTMS)combined with Beckman oropharyngeal rehabilitation exercises for dysphagia after stroke.Methods:83 patients with dysphagia following stroke were divided into an observation group(n=42)and a control group(n=41)according to dif-ferent treatment methods.The control group received Beckman oropharyngeal rehabilitation therapy,and the observation group received bilateral cerebellar high-frequency rTMS in addition to Beckman oropharyngeal rehabilitation therapy for the same du-ration,both groups were treated for 4 weeks.The two groups were compared in terms of swallowing function[Kubota Water Swallowing Test,Eating Assessment Tool-10(EAT-10),Standard Swallowing Assessment(SSA)],swallowing time parame-ters,hyoid-laryngeal complex excursion,surface electromyography(sEMG)maximum amplitude and duration,fiberoptic endo-scopic evaluation of swallowing(FEES)findings,and Swallowing Quality of Life(SWAL-QOL)scores.Results:After treat-ment,the Kubota Water Drinking Test scores,EAT-10 scores,and SSA scores of both groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).The oral transit time and swal-lowing reaction time of both groups were shorter than those before treatment(P<0.05),and the observation group was shor-ter than the control group(P<0.05).The hyoid-laryngeal complex movement,including the maximum hyoid elevation,maxi-mum hyoid anterior movement,maximum laryngeal elevation,and maximum laryngeal anterior movement,in both groups in-creased compared to before treatment(P<0.05),and the observation group was greater than the control group(P<0.05).The sEMG amplitude of both groups decreased compared to before treatment(P<0.05),and the duration shortened compared to before treatment(P<0.05),with the observation group was lower than the control group(P<0.05).The proportion of vo-cal cord paralysis,nasopharyngeal reflux,saliva stasis,and aspiration in FEES evaluation were all lower in the observation group compared to the control group(P<0.05).The SWAL-QOL scores of both groups increased compared to before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).Conclusion:Bilateral cerebellar high-fre-quency rTMS combined with Beckman oral-pharyngeal rehabilitation significantly improves post-stroke dysphagia,reduces swallowing-related complications,and enhances quality of life through the synergistic effect of neuromodulation and functional training.

Abstract:Objective:To establish reference ranges for placental thickness in singleton pregnancies based on the 95%bilat-eral percentile confidence intervals.Methods:A total of 483 healthy singleton pregnant women,aged 20～40 years,were enrolled as study participants based on predefined inclusion and exclusion criteria.These women received routine antenatal surveillance and ultimately delivered at the Affiliated Hospital of North Sichuan Medical College.Maternal demographic data and placental thickness measurements were collected at the following gestational intervals:11～13+6 weeks,20～24+6 weeks,28～31+6 weeks,and 37～40+6 weeks.Reference ranges for sonographically measured placental thickness across gestational periods were established by using the 95th percentile method with bilateral confidence intervals[M(P2.5,P97.5)].Results:The sonographic measurements of placental thickness in normal singleton pregnancies were as follows:11～13+6 weeks:14.00(10.00～20.00)mm,20～24+6 weeks:25.00(19.00～36.00)mm,28～31+6 weeks:32.00(24.00～42.00)mm,37～40+6 weeks:36.00(27.00～46.00)mm.Conclusion:The sonographic reference ranges of placental thickness in normal singleton pregnancy provide reference basis for management of high-risk pregnancies.

Abstract:Objective:To investigate the correlation between serum amyloid A protein(SAA)and growth differentiation factor-15(GDF-15)levels and the severity and prognosis of elderly patients with sepsis.Methods:80 elderly patients with sepsis were selected as the research subjects.According to the severity of sepsis,they were divided into sepsis group(n=36)and sep-tic shock group(n=44).According to the 28-day survival,the patients were divided into survival group(n=58)and death group(n=22).At the same time,healthy elderly people were selected as the control group(n=60).The serum indicators of SAA,GDF-15,white blood cell count(WBC),and neutrophil count(NEU)levels among different groups of subjects were com-pared,as well as the sequential organ failure score(SOFA)and acute physiology and chronic health status Ⅱ(APACHE Ⅱ)scores for different severity levels of sepsis.Spearman correlation analysis was used to analyze the correlation between serum in-dicators and SOFA and APACHE Ⅱ scores in sepsis patients,multivariate Logistic regression was used to analyze the factors affecting 28 day mortality in elderly sepsis patients,the predictive value of Receiver Operating Characteristic(ROC)curve was used to analyze the 28 day mortality in elderly sepsis patients.Results:Compared with the control group,the levels of SAA,GDF-15,WBC and NEU in septic shock group and sepsis group were increased(P<0.05).Compared with the sepsis group,the SOFA score,APACHE Ⅱ score,SAA,GDF-15,WBC and NEU levels in the septic shock group were increased(P<0.05).Spearman correlation analysis showed that SAA and GDF-15 levels were positively correlated with SOFA score(r=0.784,r=0.816,P<0.05)and APACHE Ⅱ score(r=0.757,r=0.793,P<0.05).Compared with the survival group,the SOFA score,APACHE Ⅱ score,SAA,GDF-15,WBC and NEU levels in the death group were increased(P<0.05).Multivariate Lo-gistic regression analysis showed that SAA(OR=1.551,P=0.003)and GDF-15(OR=1.826,P=0.001)were independent risk factors for 28-day death in elderly patients with sepsis.ROC curve analysis showed that the area under curve(AUC)of SAA for predicting 28-day mortality was 0.774,the AUC of GDF-15 was 0.806,and the AUC of the combined prediction was increased to 0.853.Conclusion:Serum SAA and GDF-15 levels are positively correlated with the severity of sepsis in elderly pa-tients,and the combination of the two has a high predictive value for the 28-day prognosis of patients.

Abstract:Objective:To compare the clinical effect of chest-breast and subclavian approach endoscopic treatment of unilat-eral thyroid carcinoma.Methods:Clinical data of 105 patients undergoing endoscopic thyroid surgery from March 2022 to Au-gust 2024 were retrospectively analyzed.According to the surgical methods,they were divided into thoracic breast approach en-doscopic thyroid surgery group(n=50)and subclavian approach endoscopic thyroid surgery group(n=55).The general condi-tion,operation related indexes and 3 months follow-up of the two groups were analyzed statistically by χ2 test,t test,Mann-Whitney test and CUSUM learning curve chart.Results:There were no significant differences in tumor size(7.28±4.73)vs.(7.36±4.40)mm,number of lymph nodes cleared(6.12±3.67)vs.(6.76±4.44),number of lymph node metastasis(1.88±2.67)vs.(1.15±1.75),postoperative cosmetic satisfaction between chest-breast and subclavian approach groups(P>0.05).There was significant difference in age(33.82±6.06)vs.(40.24±11.35)years old,time of operation(123±17.04)vs.(100.35±22.08)min and postoperative neck function(P<0.05).Conclusion:Transthoracic and subclavian endoscopic thy-roid surgery are both safe and feasible,with the same aesthetic satisfaction of incision.The operation time is short and the oper-ation is easy to master through the subclavian approach,and the cervical function is better protected through the natural muscle space approach of the side neck.

Abstract:Objective:To explore the efficacy of iroot SP and AH-Plus during root canal therapy.Methods:130 patients with pulpitis and periapical periodontitis were divided into iroot SP group(n=66,77 teeth)and AH-Plus group(n=66,75 teeth)by different treatment regimens.All affected teeth were mechanically prepared to F2 using protaper gold under the rub-ber barrier,and performed root canal filling after chemical preparation with 1%sodium hypochlorite solution,and the iroot SP group used iroot SP+hot gutta-percha vertical condensation,and the AH-Plus group adopted AH-Plus+hot gutta-percha verti-cal condensation.All patients were followed up for 3 months after treatment.The clinical efficacy,percussion pain and occlusal pain occurrence,root filling density(number of void area,percentage of void area),and periodontal conditions(gingival sulcus bleeding index score and dental plaque index score)were compared between the two groups.Results:After treatment,the total effective rate revealed no statistical significance between groups(P>0.05).The incidence rates of percussion pain and occlusal pain in iroot SP group were lower than those in AH-Plus group(P<0.05).The scores of gingival sulcus bleeding index and plaque index in the two groups were reduced(P<0.05),and the above scores were lower in iroot SP group than those in AH-Plus group(P<0.05).There was no statistical significance in the number of void area and percentage of void area between iro-ot SP group and AH-Plus group(P>0.05).Conclusion:Both iroot SP and AH-Plus root canal filling show good clinical effica-cy and root filling fitting.Compared with AH-Plus,iroot SP root canal filling therapy can more effectively relieve the percussion pain and occlusal pain of patients with dental pulp disease,and improve the periodontal conditions.

Abstract:Objective:To investigate the factors affecting the efficacy of stage Ⅰ tympanoplasty for chronic otitis media.Methods:A total of 120 patients with chronic otitis media were selected as the research subjects.All patients underwent One-Stage Tympanoplasty.According to the evaluation of air-bone gap(ABG)at 6 months post-operation,postoperative ABG≤20 dB was defined as good hearing recovery,and postoperative ABG>20 dB was defined as poor hearing recovery,patients were divided into two groups based on their hearing recovery status.Single-factor analysis and multivariate Logistic regression analysis were used to further screen for independent factors affecting the effect of hearing recovery.Results:Among the 120 eli-gible patients,there were 85 cases in the good hearing recovery group and 35 cases in the poor hearing recovery group,respec-tively,with a treatment effectiveness rate of 70.8％.There were no significant differences in gender,age,body mass index,le-sion distribution,pathological classification,personal history,and distribution of underlying comorbidities between the two groups of patients(P>0.05).The average postoperative AC and ABG of the group with good recovery were(43.95±7.24)dB and(15.21±3.07)dB,respectively,which were lower than those of the group with poor recovery(P<0.05).The propor-tion of patients with unobstructed Eustachian tube,normal tympanic mucosa,intact stapes structure,and presence of tympanic membrane tension tendon in the well recovered group was higher than that in the poorly recovered group.The proportion of pa-tients with ossicular chain lesions was lower than that in the poorly recovered group(P<0.05).The results of multiple Logistic regression analysis showed that intact stapes structure,presence of tympanic membrane tension tendon,and unobstructed Eustachian tube were independent influencing factors for good hearing recovery(OR>1,P<0.05).Conclusion:One stage tympanoplasty is an effective method for treating chronic otitis media.The intact structure of the stapes,the presence of the tympanic membrane tension tendon,and the patency of the Eustachian tube are independent factors affecting good postoperative hearing recovery.

Abstract:Objective:To compare the clinical efficacy of copper-nickel-titanium(Cu-Ni-Ti)and conventional nickel-titani-um(Ni-Ti)archwires during orthodontic alignment.Methods:72 first-time orthodontic patients were selected as the research subjects and divided into a study group(Cu-Ni-Ti)and a control group(Ni-Ti)according to different treatment materials.In-tercanine/intermolar widths,maxillary Little's Irregularity Index(LII),and VAS pain scores(24 h post-activation)were recor-ded at baseline(T0),3 months(T1),and finishing archwire stage(T2).Treatment duration and unscheduled visits were ana-lyzed.Results:There were no statistically significant differences in treatment duration or improvement in dental arch morpholog-ical parameters between the two groups(P>0.05).Patients in the study group demonstrated lower initial 24-hour VAS pain scores and required fewer clinical appointments compared to the control group(P<0.05).However,intergroup differences in pain scores at both T1 and T2 stages showed no statistical significance(P>0.05).Conclusion:Cu-Ni-Ti have shown advantages in reducing initial pain and fewer clinical appointments,and can be used as one of the options for initial archwires during ortho-dontic alignment.

Abstract:Objective:To investigate the factors associated with the recurrence of(atrial fibrillation,AF)1 year after(Ra-diofrequency ablation,RFA),and to construct a predictive model and evaluate its clinical performance.Methods:A total of 228 AF patients who were underwent their first cardiac RFA were included as the research subjects.The patients were divided into a development set and a validation set.Univariate and multivariate Logistic regression analyses were employed to identify inde-pendent risk factors for recurrence after RFA using the included variables.A nomogram model for predicting 1-year recurrence after RFA was constructed using R software.Finally,the model was validated and evaluated through concordance statistics,cali-bration plots,and decision curve analysis,respectively.Results:Multivariate Logistic regression analysis revealed that the type of atrial fibrillation(OR=0.107,95%CI:0.034～0.299,P<0.001),hypertension(OR=2.844,95%CI:1.064～8.117,P=0.042),subclinical thyroid dysfunction(OR=12.786,95%CI:2.063～86.374,P=0.007),Left Atrial Diameter(LAD,OR=1.178,95%CI:1.052～1.335,P=0.006),and Lipoprotein(a)[Lp(a),OR=1.002,95%CI:1.001～1.004,P=0.008]were all independent risk factors for AF recurrence 1 year after RFA.The nomogram developed based on these factors demonstrated a concordance index of 0.846(95%CI:0.785～0.905)in the development set for predicting AF recurrence 1 year after RFA,and a concordance index of 0.744(95%CI:0.601～0.890)in the validation set.Internal validation of the model through 1,000 bootstrap resampling showed that the calibration curve indicated a good agreement between the nomogram's predicted out-comes and the observed outcomes.Decision curve analysis suggested that the nomogram exhibited good predictive ability in both the development and validation sets.Conclusion:The nomogram model constructed based on atrial fibrillation type,LAD,hyper-tension,subclinical thyroid dysfunction,and Lp(a)demonstrates good discrimination and accuracy.It has certain predictive val-ue for atrial fibrillation recurrence one year after RFA,and aids clinicians in formulating individualized patient recurrence risk assessments.

Abstract:Functional constipation(FC)is a common gastrointestinal motility disorder,and clinical treatment often focu-ses on promoting bowel movements and obstruction,but there is insufficient exploration of qi stagnation.This article was based on the theory of"Five Stagnation"in the Huangdi Neijing,systematically explored the intrinsic connection between the patho-logical stagnation state of the imbalance of qi,blood,yin and yang in the five internal organs and functional constipation.With the core of the five methods of reaching(Da),releasing(Fa),draining(Duo),discharging(Xie),and breaking(Zhe),it provid-ed a holistic guidance for the diagnosis and treatment of functional constipation in traditional Chinese medicine,proposed the treatment concept of"regulating stagnation before unblocking the bowels and regulated the internal organs when treating the intestines",broadening the diagnosis and treatment ideas of functional constipation.

Abstract:Objective:From the perspective of multi-level governance,understand the influence of family support for medi-cal interns on the quality and efficiency of internships,analyze the key influencing factors therein,and propose countermeasures.Methods:In May 2025,a total of 372 medical Interns from a provincial medical college in Sichuan Province were selected using stratified random sampling.A questionnaire survey was conducted utilizing three instruments:a general information question-naire,the Self-assessment Scale of Internship Quality and Efficiency,and the Family Support Self-rating Scale.The impact of family support on internship quality and efficiency were analyzed.Results:The mean score for internship quality and efficiency a-mong medicine students was 77.91±10.95 points,while the mean score for the Family Support Self-rating Scale was 11.31±2.62 points.Multiple linear regression analysis revealed that satisfaction with the integration of theory and practice,emotional support intensity,consistency between post-graduation destinations and family expectations,economic support intensity,and fre-quency of internship burnout were the main factors affecting the quality and effectiveness of internships(P<0.05).Conclusion:The quality and efficiency of internships for medicine students are at a moderate level.During the internship teaching process,particular attention should be given to interns experiencing low satisfaction with the integration of theory and practice,poor a-lignment between post-graduation destinations and family expectations,high internship burnout frequency,insufficient economic support,and inadequate emotional support.

Abstract:1 case data the patient, female, 83 years old, was admitted to the Department of Cardiology, Affiliated Hospital of North Sichuan Medical College on July 26, 2022 for further diagnosis and treatment because of "dyspnea for 1 D", and a large amount of pericardial effusion was found during chest CT examination in other hospitals, without chest pain, chest tightness and other discomfort during the course of the disease. Past history: the patient was diagnosed as "after intravenous thrombolytic therapy for acute cerebral infarction" in the Department of Neurology on July 11, 2022; History of diabetes mellitus; There was no history of syncope, family sudden death and heart disease; No history of drug allergy.

Abstract:Thymoma is a relatively common tumor type with unique clinicopathological characteristics among < positive > anterior mediastinal tumors. As a kind of thymic epithelial tumor, B3 thymoma has certain invasiveness, which can cause invasion to important surrounding tissues and organs, resulting in complex disease and increased treatment difficulty [1-2]. When the tumor invades the right upper lung, ascending aorta, superior vena cava and other key structures, not only the difficulty of surgical resection is greatly increased, but also the risk of bleeding is significantly increased. At the same time, it has a serious impact on the patients' cardiopulmonary function and general condition, which brings great challenges to clinical diagnosis and treatment [3].

Abstract:Objective: to construct the evaluation index system of perioperative nursing quality for patients with Hirschsprung's disease, so as to optimize nursing management, meet patients' personalized needs, ensure continuous and efficient nursing services, and promote patients' rehabilitation. Methods: Based on the "structure process result" model, this study constructed the evaluation index system of perioperative nursing quality for patients with Hirschsprung's disease by integrating literature analysis, Delphi expert consultation and analytic hierarchy process, and completed the determination of the weight of each index. Results: the recovery rate of the two questionnaires was 100%, the authority coefficient was 0.908 and 0.917, and the variation coefficient was 0.051 ～ 0.215 and 0.051 ～ 0.229, respectively; The Kendall concordance coefficients were 0.299 and 0.332 (p<0.05), and the consistency coefficients of indicators at all levels were 0.033, 0.034, 0.039, all <0.100. The construction system includes 3 primary indicators, 10 secondary indicators and 55 tertiary indicators. Conclusion: the constructed evaluation index system of perioperative nursing quality for patients with Hirschsprung's disease is scientific and practical, and can objectively evaluate the perioperative nursing quality of patients with Hirschsprung's disease.