Abstract:Objective:To investigate the effects and mechanisms of vortioxetine on the proliferation and migration of esophageal squamous cell cancer.Methods:CCK-8 assay was used to detect the viability of Eca109 and KYSE150 cells after treated with vortioxe-tine at different concentrations(0,2,4,6,8,10 μmol/L).Moreover,transwell and scratch assays were employed to evaluate the migra-tion of ESCC cells,plate colony formation assay was used to detect the proliferation.The differentially expressed genes were screened by TCGA database,AutoDock software was used to predict the binding of vortioxetine and cyclooxygenase-2(COX-2)protein.Further-more,the expression of COX-2 mRNA and protein were measured by RT-qPCR and Western blot,respectively.Results:The cell viabil-ity of Eca109 and KYSE150 decreased in a concentration-dependent manner after treatment with different concentrations of vortioxetine(P<0.05),and the semi-inhibitory concentrations(IC50)were 5.086 μmol/L and 5.179 μmol/L,respectively.Compared with the control group,the cell proliferation and migration of the vortioxetine group were reduced(P<0.05).In addition,vortioxetine could in-hibit the expression of COX-2 at mRNA and protein level(P<0.05).Conclusion:Vortioxetine inhibits the proliferation and migration of esophageal cancer cells probablly through COX-2 down-regulation.

Abstract:Objective:To describe the multi detector computed tomography(MDCT)findings of arterial occlusion of acute mes-enteric ischemia in an animal model and its correlation with the histopathological scoring system.Methods:18 New Zealand white rab-bits were divided into one control group and five ischemic groups.An acute intestinal ischemia injury model was established by ligating the rabbits'superior mesenteric artery(SMA).After ligation of the superior mesenteric artery at 0.5,1,2,4,and 6 hours,the five ische-mic groups underwent abdominal plain scan and enhanced MDCT examination,respectively.Observed the changes in imaging features of intestinal ischemic injury with prolonged ischemia time on MDCT,measured intestinal wall CT values on MDCT,and analyzed the corre-lation between intestinal wall CT values and histopathological scores of intestinal ischemic injury tissue(Park/Chiu score).Results:At the time point of ischemia no more than 2 hours(Park/Chiu score ranged from 0 to 5),absent or reduced BW enhancement,and effu-sion and dilation of bowel lumen(BL)were found on MDCT.At the time point of ischemia more than 4 hours(Park/Chiu score ranged from 4 to 7),except for the above two signs,BW thinning and pneumatosis intestinalis(PI)were found on MDCT.The attenuation val-ues at BW on the MDCT plain images(R=-0.56,95%CI:-0.77～-0.25,P=0.001),and venous phase enhanced images(R=-0.85,95%CI:-0.93～-0.71,P<0.001),and absolute enhancement values(R=-0.80,95%CI:-0.89～-0.64,P<0.001)were negatively correlated with the pathological score of intestinal ischemic injury tissue(Park/Chiu score).Conclusion:With the ischemia time prolongs and increasing Park/Chiu score,the qualitative imaging features of intestinal ischemia injury on MDCT in-crease,and the CT value of ischemic intestinal wall gradually decreases.The measurement of intestinal wall CT values and absolute en-hancement values on MDCT can be used as quantitative indicators to quantify the severity of intestinal ischemic injury.

Abstract:Objective:To explore the role of neutrophil extracellular traps(NETs)in promoting the secretion of inflammatory mediators by alveolar type epithelial cells(AECII).Methods:In 30 7 d born SD rats,blood was drawn from neutrophils(NE)and di-vided into control(control group),LPS and LPS+DNase groups according to different treatment methods.NETs formation was detec-ted by immunofluorescence in vitro.NETs and AECII were co-cultured,and divided into control group(control group),NETs group and NETs+DNase group according to cell suspension incubation method.AECII apoptosis was detected by flow method,the content of free deoxyribonucleic acid(cf-DNA)in coculture supernatants in each group was detected by fluorescence microarray,and the coculture su-pernatants of interleukin 6(IL-6),interleukin 8(IL-8)and tumor necrosis factor(TNF-α)in each group were determined using ELISA kit.And,the correlation between cf-DNA and IL-6,IL-8,and TNF-α was evaluated using Pearson correlation analysis.Results:According to immunofluorescence,mouse citrullinated histone H3(CitH3)and myeloperoxidase(MPO)were found in neutrophil in LPS and LPS+DNase group,CitH3 and MPO levels in LPS and LPS+DNase groups were higher than in the control group(P<0.05),and CitH3 and MPO in LPS+DNase group were lower than those in LPS group(P<0.05).After AECII apoptosis with NE and NETs,there was no significant difference between early and late apoptosis in the three groups(P＞0.05).The levels of cf-DNA,IL-6,IL-8,and TNF-α in NETs group and NETs+DNase group were higher than those of the control group(P<0.05),NETs+DNase group was lower than NETs group(P<0.05).The content of cf-DNA in cell culture supernatant was positively correlated with the levels of IL-6,IL-8,and TNF-α(r=0.432,0.387,0.326,P<0.05).Conclusion:AECII with NETs in the supernatants with NE,NETs could promote the secretion of inflammatory mediators such as IL-6,IL-8,and TNF-α.Moreover,the more NETs are generated,the more inflammatory mediators such as IL-6,IL-8,and TNF-α are secreted.

Abstract:Objective:To optimize contrast-enhanced computed tomography(CECT)image quality using Non-Local Means(NLM)denoising technology and construct a mortality risk prediction model for severe acute pancreatitis(SAP)patients based on his-togram parameters.Methods:Retrospective analysis of clinical,laboratory,and CECT data of 74 patients diagnosed with SAP.NLM de-noising was applied to arterial and portal venous phase images at different coefficient levels.Three-dimensional volumes of interest were manually delineated in pancreatic parenchyma on original and denoised images,followed by histogram parameter extraction.After univa-riate Logistic regression feature selection,binary Logistic regression models were built to predict SAP mortality risk and compared with clinical models and conventional CT models.Results:A total of 74 patients with SAP,of whom 27(36.5%)died.After applying NLM-based noise reduction to arterial phase and portal venous phase CECT images,8 histogram prediction models were constructed under dif-ferent noise coefficient levels.There was no significant difference in predictive performance among these histogram models(P＞0.05).Compared to conventional CT models and clinical models,the histogram models demonstrated higher accuracy in predicting mortality risk(P=0.009,P=0.048).The predictive performance of the clinical model and the conventional CT model was similar(P=0.699).Conclusion:CECT histogram parameters show significant clinical value in predicting mortality risk in SAP patients,maintaining stable performance under different noise coefficient levels after NLM denoising.Their noise robustness and quantitative a-nalysis advantages compensate for the limitations of conventional CT.

Abstract:Objective:To explore the clinical efficacy and complications of flexible ureteroscopy combined with flexible vacuum-assisted ureteral access sheath(FV-UAS)in the treatment of patients with incarcerated upper ureteral calculi(UDU)with diameter<1.5 cm.Methods:The clinical data of patients with incarcerated UDU with diameter<1.5 cm who received FV-UAS were retrospec-tively analyzed and the patients were included in study group(n=225).The clinical data of 227 patients who used common ureteral access sheath during flexible ureteroscopic lithotripsy were collected during the same period and the patients were set as control group.The perioperative indicators,surgical efficacy,serum levels of inflammatory factors and oxidation factors before surgery and at 3 days af-ter surgery and occurrence of complications were compared between groups.Results:The surgical time and hospitalization time in study group were shortened,and the intraoperative blood loss was reduced,and the stone clearance rate was risen compared with that in control group(P<0.05),and the total effective rate of surgical treatment was higher compared with that in control group(P<0.05).At 3 days after surgery,the levels of serum CRP,IL-10,TNF-α,MAD and AOPP in study group were lower than those in control group(P<0.05)while the levels of serum GSH-PX and SOD were higher than those in control group(P<0.05).The total incidence rate of post-operative complications in study group was lower than that in control group(P<0.05).Conclusion:FV-UAS for incarcerated UDU with diameter<1.5 cm can effectively enhance the clinical efficacy,educe stress reactions caused by surgical trauma,and reduce the postoperative complications.

Abstract:Objective:To explore the curative effect of Zixiandan combined with dipyridamole and its influences on levels of u-rine immunoglobulin G and β2 microglobulin in children with Henoch-Schonlein purpura.Methods:According to different treatment methods,80 children with Henoch-Schonlein purpura were divided into control group(n=40,routine comprehensive treatment+dipy-ridamole)and observation group(n=40,Zixiandan on basis of control group),the course of treatment was 7～14 days.Clinical cura-tive effect,scores of TCM syndromes,recovery time of symptoms,renal function and adverse reactions were compared between the two groups.Results:The effective rate of treatment was higher in observation group than in control group(95.00%vs.72.50%,P<0.05).After treatment,scores of TCM syndromes were lower in observation group than control group(P<0.05),disappearance time of lbuminuria,remission time of purpura,length of hospital stay,disappearance time of joint symptoms and remission time of ab-dominal pain were shorter in observation group(P<0.05),levels of urine β2-MG and IgG were lower in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Zixiandan combined with dipyridamole can improve TCM symptoms,reduce renal injury and promote recovery process in children with Henoch-Schonlein purpura,which has significant curative effect.

Abstract:Objective:To investigate the clinical efficacy of Tubridge and Pipeline flow diverting devices in treating complex in-tracranial aneurysms.Methods:The clinical data of 31 patients with complex intracranial aneurysms who received Pipeline flow divert-ing device were retrospectively analyzed,and the patients were enrolled as control group.The clinical data of 29 patients who adopted Tubridge flow diverting device during the same period were selected as observation group.According to the follow-up results at 6 months after surgery,the clinical efficacy,clinical symptom relief and aneurysm occlusion(OKM classification)were evaluated.The levels of brain injury markers[serum central nerve specific protein(S100B),neuron-specific enolase(NSE)]before surgery and at 6 months after surgery,and complications were compared between the two groups.Results:There were no significant differences in clinical effec-tive rate,total relief rate of clinical symptoms,total occlusion rate of aneurysms and levels of brain injury markers between the two groups(P＞0.05).The total incidence rate of complications in observation group was lower than that in control group(P<0.05).Conclusion:The above two devices for patients with complex intracranial aneurysms can effectively relieve the clinical symptoms and accelerate the occlusion of intracranial aneurysms,but Tubridge flow diverting device can better reduce the risk of postoperative compli-cations.

Abstract:Objective:To investigate the effect of engeleukin combined with metoprolol therapy on prealbumin,cardiac enzymes and ventricular remodelling in patients with coronary heart disease combined with heart failure.Methods:A total of 104 patients with coronary heart disease complicated by heart failure were divided into a control group and an observation group according to different treatment methods,with 52 cases in each group.Both groups received conventional treatments including positive inotropic therapy,diu-retics,and infection control.The control group was treated with metoprolol in addition to standard treatment,while the observation group received empagliflozin in conjunction with the treatment given to the control group,with a course of treatment of 6 months.The efficacy of treatment,serological indicators[prealbumin(PA),albumin(ALB),brain natriuretic peptide(BNP),cardiac troponin I(cTnI)],myocardial enzymes[lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase-MB(CK-MB)],Cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)]before and after 6 months of treatment,and the occurrence of adverse reactions were compared between the two groups.Re-sults:The treatment effectiveness rate of the observation group was higher than that of the control group(P<0.05).After6 months of treatment,the levels of PA,ALB and LVEF in the observation group were higher than those in the control group(P<0.05),and the levels of BNP,cTnⅠ,LDH,CK,CK-MB,LVEDD and LVESD were lower than those in the control group(P<0.05).There was no sig-nificant difference in the incidence of adverse reactions between the two groups of patients compared with each other(P＞0.05).Con-clusion:In the treatment of coronary heart disease combined with heart failure,the combination of Empagliflozin treatment can improve the therapeutic effect,facilitate the improvement of ventricular remodelling and cardiac function,with better safety.

Abstract:Objective:To explore the effect of different surgical methods on the repair of velopharyngeal insufficiency(VPI)af-ter cleft palate surgery.Methods:The clinical data of 94 patients with VPI after cleft palate surgery were retrospectively analyzed.45 patients who received Furlow double-opposing Z-plasty were included in Furlow group,and 49 patients who adopted Sommerlad levator veli palatini reconstruction were enrolled as Sommerlad group.The patients were followed up for 12 months after surgery,and the im-provement conditions of speech intelligibility,nasal resonance,nasal air leakage and velopharyngeal function were analyzed.Results:At 12 months after surgery,there was no statistically significant difference in the velopharyngeal closure rate between the Sommerlad group and the Furlow group(P＞0.05).The speech intelligibility and nasal resonance recovery degree in the Furlow group and the Sommer-lad group were better than those before surgery,and the above indicators in the former group were higher than those in the latter group(P<0.05).The audibility rate of postoperative nasal leakage in the Furlow group and the Sommerlad group was lower than that before surgery,and the audibility rate in the latter group was lower than that in the former group(P<0.05).Conclusion:Furlow double-op-posing Z-plasty for VPI after cleft palate surgery is more ideal in improving speech intelligibility and nasal resonance,while Sommerlad palatoplasty demonstrated superior improvement in speech outcomes and reduced nasal air emission rates compared to conventional tech-niques,with both parameters contributing to enhanced velopharyngeal function.Clinically,it is necessary to select the surgical method according to the actual situation of patients.

Abstract:Objective:To analyze the expressions and significances of CXC chemokine receptor 1(CXCR1),CXC chemokine ligand 8(CXCL8)and vascular endothelial growth factor(VEGF)in prostate cancer.Methods:95 patients with prostate cancer were enrolled.The cancer tissue and adjacent tissue samples were retained during radical resection.Immunohistochemistry was used to detect and compare the protein expressions of CXCR1,CXCL8 and VEGF in tissues,and the relationship between the expressions and tumor clinicopathology was analyzed.At 2 years of follow-up after surgery,the protein expressions of CXCR1,CXCL8 and VEGF in cancer tis-sues were compared among patients with different prognosis conditions.Kaplan-Meier method was used to analyze the relationship be-tween each protein expression and prognosis.Results:The protein positive expression rates of CXCR1,CXCL8 and VEGF in cancer tis-sues and death group were higher than those in adjacent tissues and survival group(P<0.05),respectively.The positive expression rates of CXCR1,CXCL8 and VEGF proteins in cancer tissues were correlated with differentiation degree,depth of invasion and TNM staging(P<0.05).At 2 years after surgery,the average overall survival time of patients with positive expressions of CXCR1,CXCL8 and VEGF in cancer tissues was lower than that of patients with negative expressions(P<0.05).Conclusion:The positive expres-sions of CXCR1,CXCL8 and VEGF are related to the occurrence and prognosis of prostate cancer,and they can be used for the diagno-sis and prognosis evaluation of prostate cancer.

Abstract:Objective:To examine the impact of the Evolocumab on early neurological deterioration(END)in patients with non-cardioembolic acute ischemic stroke(NCIS).Methods:A total of 110 patients diagnosed with NCIS and END were recruited as re-search subjects.All patients received standardized and systematic treatment protocols.Based on different therapeutic regimens,the pa-tients were categorized into two groups:the conventional group(n=55),which received standard dual antiplatelet therapy,and the ob-servation group(n=55),which received evolocumab in addition to the standard treatment regimen.The clinical efficacy,cerebral blood flow perfusion indicators[resistance index(RI),cerebral blood volume(CBV),and mean blood flow(Qmean)],levels of nerve func-tion reconstruction factors[nerve growth factor(NGF),gamma aminobutyric acid(GABA),and brain-derived neurotrophic factor(BDNF)],lipid metabolism indicators[apolipoprotein B(ApoB),low-density lipoprotein cholesterol(LDL-C)],and incidence of ad-verse reactions were compared between the two groups.Results:The total clinical efficacy rate in the observation group was higher than that in the conventional group(98.18%vs.85.45%,P<0.05).Post-treatment,the RI value in the observation group was lower than that in the conventional group(P<0.05).Additionally,post-treatment serum levels of CBV and Qmean,as well as NGF,GABA,and BDNF,were higher in the observation group compared to the conventional group(P<0.05).Conversely,post-treatment serum levels of Lp(a),ApoB,and LDL-C,and the total incidence of adverse reactions were lower in the observation group compared to the conventional group(P<0.05).Conclusion:Evolocumab enhances cerebral blood perfusion and facilitates neurological function recovery in NCIS patients with early END.Additionally,it regulates lipid metabolism and decreases the incidence of adverse reactions.

Abstract:Objective:To explore the application effect of the combination of formoterol,beclomethasone and glycopyrronium bro-mide in the treatment of patients with chronic obstructive pulmonary disease.Methods:104 patients with chronic obstructive pulmonary disease were selected and divided into 52 cases of the control group(adopting the double combination treatment of gronethammonium bromide+formoterol)and 52 cases of the observation group(on the basis of the control group+beclomethasone treatment)accord-ing to different treatment methods.All treatments lasted for 3 months.The treatment efficacy,pulmonary function indicators[forced ex-piratory volume in one second(FEV1),forced vital capacity(FVC)],arterial blood gas indicators[partial pressure of oxygen(PaO2),pH,partial pressure of carbon dioxide(PaCO2)],quality of life[6-minute walking distance and St.George's Respiratory Questionnaire(SGRQ)score],inflammatory factor[interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and C-reactive pro-tein(CRP)]levels before and 3 months after treatment,and record the occurrence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was higher than that in the control group(98.28%vs.84.62%,P<0.05).After 3 months of treatment,the FEV1,FVC,PaO2,pH,and 6-minute walking distance in both groups increased compared to before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).PaCO2,SGRQ score,IL-6,TNF-α,and CRP were reduced compared to before treatment(P<0.05),and the observation group was lower than the con-trol group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Con-clusion:The combination of formoterol,beclomethasone and griseofulvin in the treatment of patients with chronic obstructive pulmonary disease is effective in improving lung function,arterial blood gas,reducing inflammatory response and improving quality of life.

Abstract:Objective:To analyze the effects of retinal laser photocoagulation combined with Ranibizumab on optic disc parame-ters in patients with moderate diabetic macular edema(DME).Methods:110 DME patients were divided into a control group and a combined group based on different treatment protocols,with 55 cases in each group.The control group received retinal laser photocoagu-lation therapy,while the combined group received additional ranibizumab treatment on the basis of the control group.The clinical effica-cy,central macular thickness,visual acuity levels,and optic disc parameters before treatment and 3 months after treatment were com-pared between the two groups.Results:The combined group had an effective rate of 80.00%,which was higher than the control group's 58.18%(P<0.05).After 3 months of treatment,both groups showed improvements in central foveal retinal thickness and visual acui-ty levels(P<0.05),with the combined group performing better than the control group(P<0.05).After3 months of treatment,there were no significant differences in optic disc area and RPC blood flow density between the two groups(P＞0.05).The combined group had a larger disc margin area compared to the control group(P<0.05),and lower optic disc volume,mean cup/disc(C/D)ratio,ver-tical cup/disc(C/D)ratio,and average RNFL thickness compared to the control group(P<0.05).Conclusion:Retinal laser photo-coagulation combined with ranibizumab can be effectively applied in the treatment of moderate DME,which can effectively improve the patient's visual acuity and optic disc parameters.

Abstract:Objective:To develop a risk nomogram model and validate the predictive value of ultrasound elastography combined with miRNA-130b-3p(miRNA-130b-3p)and miR-146a expression in assessing renal injury among mammary cancer(MC)patients undergoing neoadjuvant chemotherapy.Methods:A total of 130 patients with mammary cancer(MC)who underwent neoadjuvant chemotherapy were selected,and regular blood routine and imaging reviews were conducted.According to the diagnostic and staging cri-teria of Kidney Disease:Improving Global Outcomes(KDIGO),renal injury was statistically analyzed and divided into a renal injury group(n=53)and an MC group(n=77).Clinical data from all patients were collected.Univariate and multivariate Logistic regres-sion analyses were performed to analyze the risk factors for renal injury in MC patients after neoadjuvant chemotherapy,and a nomogram risk prediction model was established and validated.Results:Univariate and multivariate Logistic regression analysis revealed that high-er cortical YM value,medullary YM value,and Emean value,as well as elevated miR-146a(high),mir-130b-3p(high),decreased eG-FR(low),and the presence of combined underlying diseases were risk factors for renal injury in MC patients after neoadjuvant chemo-therapy(P<0.05).The nomogram demonstrated that cortical YM value,medullary YM value,and Emean value were the most influen-tial factors for renal injury after neoadjuvant chemotherapy in MC patients,followed by increased expression of miR-146a and mir-130b-3p.The area under the ROC curve of the nomogram was0.842,with a sensitivity of 83.72%,specificity of 87.0%,and a C-index of 0.816.The H-L goodness-of-fit test results indicated no significant difference between predicted values and actual observed values(P＞0.05).Conclusion:The high YM value of the cortex,as well as the YM and Emean values of the medulla in ultrasound elastogra-phy parameters,along with the elevated expression levels of serum miRNA-130b-3p and miR-146a,serve as significant risk factors for renal injury in patients with mesangial proliferative glomerulonephritis after neoadjuvant chemotherapy.The established nomogram model incorporating these indicators effectively predicts the likelihood of renal injury in such patients.

Abstract:Objective:To investigate the clinical efficacy and drug safety of the Tiaoshu Huayu Formula in the treatment of pul-monary nodules in patients with blood stasis constitution.Methods:60 patients with pulmonary nodules and blood stasis constitution were selected and divided into the treatment group and the control group according to different treatment methods,with 30 cases in each group.The treatment group was treated with the Tiaoshu Huayu Formula for a treatment period of 3 months,while the control group re-ceived no intervention.Results:Between-group comparison showed that the total effective rate of pulmonary nodules in the treatment group was 33.33%,and the significant improvement rate of TCM syndrome was 66.67%,both of which were superior to those in the control group,with significant differences(P<0.01).Within-group comparison showed that after treatment,the diameter and cross-sec-tional area of pulmonary nodules decreased,and the syndrome score of blood stasis constitution reduced,with significant differences(P<0.01).Multivariate ordinal Logistic regression analysis indicated that disease duration,gender,and the nature of pulmonary nod-ules had significant effects on the therapeutic effect(P<0.05).Drug safety evaluation demonstrated that the Tiaoshu Huayu Formula had good safety.Conclusion:The Tiaoshu Huayu Formula can improve the symptoms related to blood stasis constitution in patients with pulmonary nodules,reduce the area of some pulmonary nodules,and has good safety.

Abstract:Objective:To observe serum C-reactive protein(CRP),amyloid A(SAA)and routine inflammatory parameters[neutrophil/lymphocyte ratio(NLR),systemic inflammatory response index(SIRI)]in children with influenza A,and to analyze the diagnostic value of the above indexes in children with influenza A.Methods:The clinical data of 219 cases of children with influenza A(observation group)were collected retrospectively,and 220 cases of children with non-influenza A admitted in the same hospital were selected as control group.The baseline data with the laboratory indexes of serum CRP,SAA,NLR,and SIRI,and analyzed the diagnostic value of these indexes in the infants with influenza A were compared between the two groups.Results:There was no significant differ-ence in verage body temperature at admission,gender,and WBC between the two groups(P＞0.05).Serum CRP and SAA concentra-tions as well as NLR and SIRI parameters of children in the observation group were higher than those in the control group(P<0.05).Logistic regression model was established,and the results showed that the expression of serum CRP,SAA,NLR,and SIRI was related to the children's development of influenza A,and the high expression of serum CRP,SAA,NLR,and SIRI may be a risk factor for the children's development of influenza A(P<0.05).The results of ROC curves showed that the AUCs of NLR,SIRI,CRP,and SAA for predicting the development of influenza A in children were more than 0.70,and the predictive efficacies of serum CRP(AUC=0.933,95%CI:0.905～0.951)and serum SAA(AUC=0.922,95%CI:0.901～0.948)were particularly favorable.And when predicting jointly,the AUC was 0.968(95%CI:0.946～0.980),which had significantly better diagnostic performance than the single items.Conclusion:CRP,SAA,NLR and SIRI have certain diagnostic value in children's influenza A.The combined detection of the four inde-xes can assist in the early diagnosis of influenza A in children,and is worthy of clincal promotion.

Abstract:Objective:To analyze the correlation between serum Irisin and microinflammatory state in non-dialysis patients with chronic kidney disease(CKD).Methods:146 patients in non-dialysis CKD group(102 cases in microinflammation group and 44 cases in non-inflammation group)and 68 subjects in healthy control group were included.The baseline data,inflammatory indicators and ser-um Irisin between groups and the differences in inflammatory indicators and serum Irisin under different microinflammatory states were analyzed.The correlation of serum Irisin with serum albumin(Alb),retinol binding protein(RBP),serum ferritin(SF),C-reactive protein(hs-CRP)and interleukin-6(IL-6)and the diagnostic value of serum Irisin level on microinflammatory state were analyzed.Results:The serum RBP,SF,hs-CRP and IL-6 changes in the non-dialysis CKD group was higher than those in the control group(P<0.05),and the microinflammatory group was higher than the non-inflammatory group(P<0.05).For serum Alb and Irisin levels,the non-dialysis CKD group was lower than the control group(P<0.05),and the microinflammatory group was lower than the non-inflam-matory group(P<0.05).Serum Irisin was negatively correlated with serum RBP,SF,hs-CRP and IL-6(r=-0.502,-0.634,-0.667,-0.689,P<0.05),and was positively correlated with serum Alb(r=0.613,P<0.05).The sensitivity and specificity of serum Irisin in diagnosing microinflammatory state were 91.18%and 79.55%,respectively.Conclusion:Serum Irisin level is negative-ly correlated with serum RBP,SF,hs-CRP and IL-6 levels,and is positively correlated with serum Alb level in non-dialysis CKD pa-tients,and it has diagnostic value on differentiating microinflammatory state.

Abstract:Objective:To investigate the correlation between serum brain-derived neurotrophic factor(BDNF),monocyte to HDL-C ratio(MHR)and post-stroke cognitive impairment(PSCI)in patients with acute ischemic stroke(AIS).Methods:96 patients with acute AIS were collected and divided into PSCI group(n=39,<26 points)and non-PSCI group(n=57,≥26 points)accord-ing to the Montreal Cognitive Assessment(MoCA)score at 3 months after stroke.The clinical data such as serum BDNF and MHR lev-els at admission were statistically compared between the two groups,and the receiver operating characteristic(ROC)curve of BDNF and MHR levels in predicting PSCI was drawn.Results:Compared with the non-PSCI group,the PSCI group was older,had shorter years of education,had a higher proportion of hypertension,and had lower serum BDNF and higher MHR levels,the differences were signifi-cant(P<0.05).Logistic regression analysis showed that age(OR=1.530),hypertension(OR=1.335),serum BDNF level(OR=0.755)and MHR(OR=1.645)were risk factors for PSCI in AIS patients(P<0.05).ROC curve analysis showed that the AUC of BDNF and MHR levels in predicting PSCI were 0.833 and 0.745,respectively,and the AUC of the combined diagnosis of the two was 0.882,which was greater than that of a single index(P<0.05).Conclusion:Serum BDNF and MHR are closely related to PSCI in AIS patients.Both indicators can predict the occurrence of PSCI,and the combined detection of the two can improve the predictive abili-ty.

Abstract:Objective:To study the related factors of futile recanalization after endovascular treatment(EVT)for cerebral infarc-tion and construct a Nomogram column chart risk prediction model.Methods:144 patients with cerebral infarction treated with EVT in-tervention were selected as the research subjects,the patients were divided into effective recanalization group(n=78)and futile reca-nalization group(n=66),which accorded to whether ineffective recanalization occurred.The levels of clinical characteristic were com-pared between the two groups of patients.The patients were randomly divided into training set(n=101)and testing set(n=43)by 7∶3 ratio.In the training set,the Lasso regression method was used to screen feature factors,the impact factor was analysed by Logistic multiple regression model,the R language was used to draw risk prediction model,and conduct validation.The receiver operating char-acteristic(ROC)was used to evaluate the accuracy of the model.Results:There were 48 cases experienced futile recanalization in the training set,the incidence rate was47.52%,while there were18 cases experienced futile recanalization in the testing set,the incidence rate was 41.86%.The results of Logistic multiple regression analysis showed that comorbidities of infection(β=1.566,95%CI=1.217～18.839,P=0.025)and the NIHSS score at discharge(β=0.949,95%CI=1.841～3.626,P<0.001)were high-risk fac-tors for futile recanalization after EVT in cerebral infarction.A Nomogram risk prediction model for futile recanalization after cerebral in-farction EVT were established,which based on Logistic multivariate analysis results.The ROC analysis showed that the AUC of Nomo-gram column chart to determine futile recanalization were 0.845 and 0.862 respectively in the training set and testing set.Conclusion:The futile recanalization after EVT in cerebral infarction are related to comorbidities of infection and NIHSS score at discharge.Based on these,a Nomogram prediction model is established,it has high accuracy in predicting futile recanalization.

Abstract:Objective:To analyze the predictive value of non-invasive left ventricular pressure-strain loop(LV-PSL)technology at different times on the prognosis of patients with multivessel coronary heart disease.Methods:All 108 patients with multi-vessel coro-nary artery disease were treated with coronary artery bypass grafting,and LV-PSL was examined before and 1 week after surgery.After 3 months of postoperative follow-up,the patients were divided into good prognosis group(n=74)and poor prognosis group(n=34)according to the incidence of postoperative major adverse cardiovascular events(MACE).The two groups were compared on general in-formation,left-ventricular global longitudinal strain(GLS)and myocardial work parameters.Logistic regression analysis was used for correlation analysis.The predictive efficacy of LV-PSL parameters was analyzed using the receiver operating characteristic(ROC)curve.Results:The levels of GLS and global waste work(GWW)in patients with multi-vessel coronary heart disease 1 week after sur-gery were lower than those before operation,and the overall work index(GWI),overall useful work(GCW)and overall work efficiency(GWE)were higher than those before surgery(P<0.05).Postoperative GWI,GCW and GWE in the poor prognosis group were lower than those in the good prognosis group,while GWW was higher than that in the good prognosis group(P<0.05).Logistic regression a-nalysis showed that GWI,GWE,and GWW were factors influencing the prognosis in patients with coronary heart disease and multivessel disease(P<0.05).The ROC curve showed that the areas under the curve(AUCs)of GWI,GWW and GWE were 0.628,0.695 and 0.827,showed that the AUC of GWE was the largest.Its sensitivity and specificity were 73.53%and 78.38%(P<0.05).Conclu-sion:The LV-PSL technique can be used for prognosis evaluation of patients with coronary heart disease and multivessel disease.GWI,GWW,and GWE at a week after surgery demonstrate relatively high predictive efficacy for the prognosis.

Abstract:Objective:To study the correlation between bone metabolism markers and clinical features of patients with multiple myeloma(MM)and their significance in efficacy judgment.Methods:A total of 112 MM patients were included as the study subjects,and the relevant data of clinical characteristics and the level of bone metabolic markers before and after treatment were collected,and the correlation between bone metabolic markers and clinical characteristics of MM patients was analyzed.The changes of bone metabo-lism markers in patients with different therapeutic effects were compared before and after treatment.Receiver operating characteristic curve(ROC)was drawn to evaluate the efficacy of serum P1NP,β-CTX and OCN-MID in MM patients at admission,1,2 and 4 treat-ment courses.Results:The level of β-CTX in IgD patients was higher than IgA,IgG and light chain patients,with statistically signifi-cant differences(P<0.05).The level of β-CTX in DS stage and ISS stage Ⅲ patients was higher than that in I stage and Ⅱ stage,stage Ⅱ＞stage I,the levels of P1NP and OCN-MID in stage III were lower than those in stage I and stage II.StageⅡ

Abstract:Objective:To investigate the long-term effects of retrograde intramedullary nailing and locking plate fixation in the treatment of distal femoral fracture in the elderly.Methods:According to different treatment methods,128 elderly patients were divided into the retrograde intramedullary nailing group(n=51)and the locking plate fixation group(n=77).Perioperative indicators were compared between the two groups.1 year of follow-up later,joint function,self-care ability,and the occurrence of complications in the two groups were compared.Results:Surgery time,intraoperative blood loss and surgical incision of the retrograde intramedullary nailing group were significantly shorter and less than those of the locking plate fixation group(P<0.05).The knee joint function scale(HSS),Babbitt index(BI),and activities of daily living(ADL)scores of the retrograde intramedullary nailing group were higher than those of the locking plate fixation group(P<0.05).The total incidence of complications in the retrograde intramedullary nailing group in 1 year after surgery was lower than that in the locking plate fixation group(P<0.05).Conclusion:Retrograde intramedullary nail-ing can effectively shorten surgery time,reduce intraoperative blood loss,shorten surgical incision,improve knee function,and enhance self-care ability of elderly patients with distal femoral fractures,with fewer complications.

Abstract:Objective:To explore the efficacy of Baihe Dihuang Decoction in the treatment of perimenopausal insomnia and its effect on sex hormones.Methods:122 patients with perimenopausal insomnia were divided into control group and observation group ac-cording to different treatment methods,56 cases in each group.The control group was treated with estazolam orally,and the observation group was treated with Baihe Dihuang Decoction.Continuous medication for 1 months.The total clinical effective rate,Sleep quality[Pittsburgh Sleep Quality Index(PSQI)],menopausal symptoms[Kupperman Scale],TCM syndrome scoreand serum sex hormones[estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)]levels were compared between the two groups.Re-sults:After treatment,the levels of PSQI score,Kupperman scale score,TCM syndrome score and serum FSH in observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the levels of serum E2 and LH be-tween the two groups(P＞0.05).The observation group had lower serum FSH levels(P<0.05).The total effective rate of the obser-vation group was higher than that of the control group(91.07%vs.73.21%,P<0.05).Conclusion:Modified Baihe Dihuang Decoc-tion can improve the sleep quality and perimenopausal symptoms of perimenopausal insomnia patients,regulate the expression of sex hormones.

Abstract:Objective:To explore the application effect of Loop-button plate internal fixation in the treatment of patients with an-kle inferior tibiofibular syndesmosis injury(ATSI).Methods:82 patients with ATSI were selected and divided into control group(n=41,cortical bone screw treatment)and observation group(n=41,Loop-button plate internal fixation treatment)by different treatment regimens.The differences in therapeutic effect,perioperative indicators,bone metabolism related factors,ankle function recovery,pain degree and incidence of complications were compared between groups.Results:There was no significant difference in the total effective rate of treatment between the two groups(P＞0.05).The surgical time,hospitalization time and bone healing time in observation group were shorter than those in control group(P<0.05).The levels of osteocalcin and bone alkaline phosphatase in the two groups were risen compared with those before surgery(P<0.05),and the levels in observation group were higher(P<0.05),and the level of β-type I collagen carboxy-terminal cross-linked peptide was reduced compared to before surgery(P<0.05),and the level was lower in observation group(P<0.05).Compared with control group,the postoperative American Orthopedic Foot and Ankle Society(AOFAS)score was higher(P<0.05)while the pain score was lower in observation group(P<0.05).The incidence of complications in obser-vationgroupwas7.32%,which was lower than24.39%in control group(P<0.05).Conclusion:The application of Loop-button plate internal fixation in patients with ATSI can shorten the surgical time and hospitalization time,promote the recovery of ankle func-tion,relieve the pain degree and reduce the incidence of complications.

Abstract:Objective:To investigate the correlation between fasting plasma glucose(FPG),body composition and gestational di-abetes mellitus(GDM)in early pregnancy,and to provide reference for early screening of GDM.Methods:The clinical data of 100 pa-tients with GDM(GDM group)were retrospectively analyzed,and 100 healthy pregnant women who received prenatal examination were selected as the control group.The differences of FPG and body composition indexes in early pregnancy between the two groups were compared.Logistic regression analysis was used to identify the risk factors of GDM,and the predictive value of each index was evalua-ted by receiver operating characteristic(ROC)curve.Results:Compared with the control group,the pre-pregnancy BMI,the proportion of family history of diabetes and the level of FPG in early pregnancy were higher in the GDM group(P<0.05).Compared with the control group,the body fat mass(BFM)and body fat percentage(PBF)in the GDM group were increased(P<0.05).There was no significant difference in other body composition indexes such as intracellular water(ICW),extracellular water(ECW),muscle mass(SLM)and FFM between the two groups(P＞0.05).Logistic regression analysis showed that pre-pregnancy BMI(OR=1.169),FPG level(OR=1.775),BFM(OR=1.247)and PBF(OR=1.190)were risk factors for GDM(P<0.05).ROC curve analysis showed that pre-pregnancy BMI and FPG,BFM and PBF levels in early pregnancy had certain predictive value for GDM,and their AUCs were 0.738,0.779,0.724 and 0.767,respectively,and the diagnostic AUC of FPG combined with PBF reached 0.854.Conclusion:FPG,body composition BFM and PBF in early pregnancy are risk factors for GDM,which can be used as indicators for early screening of GDM.

Abstract:Objective:To explore the independent risk factors of lymphatic leakage after laparoscopic radical gastrectomy for gas-tric cancer,andto construct a nomogram prediction model for lymphatic leakage.Methods:The clinical data of 279 patients with gastric cancer who underwent laparoscopic radical resection were retrospectively analyzed.The patients were divided into lymphatic leakage group(n=28)and non-lymphatic leakage group(n=251)according to whether lymphatic leakage occurred after operation.The differences of clinical data between the two groups were compared.Logistic regression analysis was used to establish the independent risk factors of lymphatic leakage after laparoscopic radical gastrectomy for gastric cancer.The above risk factors were used to construct a nomogram prediction model for lymphatic leakage after laparoscopic radical gastrectomy for gastric cancer,and the receiver operating characteristic(ROC)curve was drawn to verify the value of the model.Results:A total of 28 cases of lymph leakage occurred in 279 patients,with an incidence of 10.04%(28/279).The proportions of age≥60,preoperative neoadjuvant chemotherapy,tumor located in the cardia,T stage 3～4,combined organ resection,extended lymph node dissection(D2+)and non-use of somatostatin in the lym-phatic leakage group were higher than those in the non-lymphatic leakage group(P<0.05).The preoperative hemoglobin,postopera-tive hemoglobin and postoperative albumin levels in the lymphatic leakage group were lower than those in the non-lymphatic leakage group(P<0.05),and the operation time and the first anal exhaust time were longer than those in the non-lymphatic leakage group(P<0.05).Multivariate Logistic regression analysis showed that tumor located in the cardia,T stage 3～4,combined organ resection,extended lymph node dissection(D2+),low postoperative hemoglobin,low postoperative albumin and no use of somatostatin were inde-pendent risk factors for lymphatic leakage in patients undergoing laparoscopic radical gastrectomy(P<0.05).The area under the ROC curve(AUC)of the nomogram prediction model was 0.897(95%CI:0.864～0.924),and the sensitivity and specificity were 85.71%and 80.87%,respectively.Conclusion:Tumor located in the cardia,T stage 3～4,combined organ resection,extended lymph node dissection(D2+),low postoperative hemoglobin,low postoperative albumin and no use of somatostatin are closely related to the occur-rence of lymphatic leakage in patients undergoing laparoscopic radical gastrectomy.The nomogram prediction model based on the above factors can be used as an effective tool for clinical evaluation of lymphatic leakage after laparoscopic radical gastrectomy.

Abstract:Objective:To explore the clinical curative effect of Liangxue Huayu Mingmu Decoction in retinal vein obstruction(RVO)combined with macular edema(ME).Methods:A total of 80 patients(80 eyes)with RVO and ME were included in the study,and they were divided into experimental group and control group according to different treatment methods,with 40 cases in each group.The control group was given intravitreal injection of ranibizumab,while experimental group was treated with Liangxue Huayu Mingmu Decoction on basis of control group for 4 weeks.The curative effect on TCM syndromes,adverse reactions during treatment and changes of visual acuity were compared between the two groups.Results:The curative effect on TCM syndromes in experimental group was better than that in control group(P<0.05).After 1,2 and 4 weeks of treatment,LogMAR,CMT and intraocular pressure in exper-imental group were lower than those in control group(P<0.05).After 4 weeks of treatment,the mean deviation of visual field and vis-ual field index in experimental group were higher than those in control group(P<0.05).There was no significant difference in the in-cidence of adverse reactions between the two groups during treatment(P＞0.05).Conclusion:Liangxue Huayu Mingmu Decoction combined with intravitreal injection of ranibizumab can improve clinical curative effect,visual acuity and visual field defect,promote ME regression and control intraocular pressure in patients with RVO and ME,which has good safety.

Abstract:< positive >1 case data patient, male, 51 years old. He was admitted to the hospital in November 2023 because of "ocular mass found for more than 4 years, creatinine increased for more than 2 years, abdominal pain for 1 week". In September 2019, the patient was hospitalized in the Department of Ophthalmology due to a mass above the outer orbit of the left eye. Blood IgG4 0.684 g/l, but>10 s, corneal staining, blood and urine routine, liver and kidney function, kidney and pancreas color Doppler ultrasound showed no obvious abnormalities. Orbital MRI: soft tissue mass in the left lacrimal gland area with a maximum diameter of 3.4 cm. Color Doppler ultrasound showed bilateral submandibular gland enlargement.

Abstract:Objective:To investigate the impact of Hogan's staged nursing on lung function,cancer-related fatigue,self-efficacy,and perceived social support in patients undergoing thoracoscopic surgery for lung cancer.Methods:102 lung cancer patients who un-derwent thoracoscopic lobectomy were prospectively selected and divided into a control group(n=51)and an intervention group(n=51)according to different nursing methods.The control group received routine care,while the intervention group received Hogan's staged nursing.The intervention lasted for 2 months,and the lung function,cancer-related fatigue,self-efficacy,and perceived social support levels were compared between the two groups before and after the intervention.Results:After 2 months of intervention,the forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC)and maximum ventilation volume(MVV)of both groups of patients were higher than before intervention(P<0.05),and the intervention group was higher than the control group(P<0.05).The total scores of behavioral fatigue,emotional fatigue,somatosensory fatigue,cognitive fatigue,and revised Piper fatigue scale(RPFS)in both groups of patients were lower than before the intervention(P<0.05),and the intervention group was lower than the control group(P<0.05).The general self-efficacy scale(GSES)scores of both groups of patients were higher than before intervention(P<0.05),and the intervention group was higher than the control group(P<0.05).The dimensions of support within and outside the family,as well as the total score of the perceived social support scale(PSSS),were higher in both groups of patients than before the intervention(P<0.05),and the intervention group was higher than the control group(P<0.05).Conclusion:Hogan's stage nursing is beneficial for promoting postoperative lung function recovery,alleviating cancer-related fatigue,improving self-efficacy,and perceived social sup-port levels in patients undergoing thoracoscopic surgery for lung cancer.

Abstract:Objective:To explore the effect of exercise rehabilitation nursing under Newman system mode on the recovery of neu-rological function and limb motor function in patients with cerebral infarction.Methods:110 patients with cerebral infarction were divid-ed into control group(n=55)and observation group(n=55)according to different intervention methods.The control group was given routine exercise rehabilitation,and the observation group was given exercise rehabilitation under Newman system mode.The two groups were intervened for 3 months.The neurological function[National Institutes of Health Stroke Scale(NIHSS)and Scandinavian Stroke Scale(SSS)],limb motor function[Fugl-Meyer motor function assessment scale(FMA)],walking ability[step length,step width,step frequency and step speed],psychological state[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)],daily living ability[Barthel index(BI)]and quality of life[Chinese version of stroke-specific quality of life scale(SS-QOL)]were com-pared between the two groups before and after intervention.Results:After intervention,compared with the control group,the NIHSS score of the observation group was lower(P<0.05),and the SSS score was higher(P<0.05).Compared with the control group,the FMA upper limbs,lower limbs and total scores of the observation group were higher after intervention(P<0.05).The step length was longer,the step width was narrower,the step frequency and step speed were faster(P<0.05).Compared with the control group,the SAS and SDS scores of the observation group were lower(P<0.05),and the BI and SS-QOL scores were higher(P<0.05).Conclu-sion:The effect of exercise rehabilitation under the Newman system model on patients with cerebral infarction is significant.It has a pos-itive effect on improving the neurological function,limb motor function,walking ability and psychological state of patients,and can sig-nificantly improve the daily living ability and quality of life of patients.