Abstract:Objective:To explore the effect of lipoxygenase 15B(ALOX15B)on the transformation of Ana-1 macrophages into foam cells and its mechanism.Methods:12 patients with atherosclerosis were selected as the research subjects.The relationship be-tween the level of ALOX15B and pathological features was analyzed by Oil Red O staining and immunohistochemical methods.shRNA and CRISPR/Cas9 techniques were used to construct ALOX15B down-regulated cells(shALOX15B)and ALOX15B up-regulated cells(oeALOX15B),respectively.Foam cells were obtained by treating macrophages with oxidized low-density lipoproteins.The Oil Red O staining was used to detect the intracellular lipid accumulation.Western blot was used to detect the protein levels of ALOX15B and HIF-1α.The mRNA levels of inflammatory factors NF-κB,IL-1β,IL-6 and IL-10 were analyzed by RT-qPCR.Results:Atherosclerotic plaques were formed by the accumulation of foam cells.ALOX15B expression was decreased in atherosclerotic plaque compared with normal blood vessels.Oil Red O staining revealed that ALOX15B deficiency significantly increased lipid accumulation in macrophages.Compared with the shRen group,the expression of HIF-1α protein and the mRNA levels of pro-inflammatory factors NF-κB,IL-1 β and IL-6 in shALOX15B cells were significantly increased,while the IL-10 was significantly decreased.ALOX15B upregulation can reverse the changes caused by ALOX15B deficiency.Hypoxic treatment of oeALOX15B cells could reverse the abnormally changed levels of HIF-1α and inflammatory factors NF-κB,IL-1 β,IL-6,and IL-10.Conclusion:ALOX15 B is abnormally low expressed in atherosclerotic tissues.ALOX15B may affect the transformation of macrophages into foam cells by regulating HIF-1α.

Abstract:Objective:To explore regulatory effect of oridonin(Ori)-mediated NLRP3 inflammasome on seizure susceptibility in PTZ-induced chronic epileptic mice.Methods:Chronic epilepsy was induced in mice using pentylenetetrazol(PTZ),and the mice were treated with different doses of Ori.Behavioral changes(seizure severity,latency,and frequency)were observed before and after treat-ment.Hippocampal tissues were examined using HE staining,and the expression levels of NLRP3 and related proteins were detected by Western blot.Results:Behavioral results showed that Ori treatment prolonged seizure latency,reduced seizure severity,and decreased the frequency of spontaneous seizures,particularly in the medium-and high-dose groups.HE staining and Western blot results were con-sistent with the behavioral findings.Ori treatment alleviated epilepsy-induced pathological damage,reduced inflammatory infiltration,and downregulated the expression levels of NLRP3 and related proteins in the brain.Conclusion:Ori may regulate epilepsy susceptibility by inhibiting the NLRP3 inflammasome pathway,suggesting that Ori has a protective effect against epilepsy.

Abstract:Objective:To explore whether the renin antagonist SPH3127 inhibits angiotensin Ⅱ(Ang Ⅱ),Ang Ⅱ inhibits the ex-pression of transforming growth factor-β1(TGF-β1)and downregulates the transduction of the TGF-β/Smads signaling pathway,achie-ving a protective effect against hypertensive kidney injury.Methods:75 male SD rats were randomly divided into sham surgery group,model group,SPH3127 group,SB431542 group(TGF-β1 specific inhibitor),and valsartan group.Except for the sham surgery group,the other four groups were prepared with two kidneys one clip(2K1C)surgery method to establish a hypertension model.After success-ful modeling,the abdominal aorta serum and kidney tissue of the rats were continuously intervened for 4 weeks.ELISA was used to de-tect serum Ang Ⅱ and renal function indicators(creatinine,urea nitrogen concentration).HE staining,Sirius red staining,TUNEL and WT1 co staining were performed on kidney tissue for morphological observation.RT-qPCR and Western blot were used to detect TGF-β1,Smad3,and Smad7 mRNA in rat kidney tissue and the relative expression level of proteins,respectively.Results:After suc-cessful modeling,compared with the sham surgery group,the systolic blood pressure(SBP)of the tail artery in the model group,SPH3127 group,SB431542 group,and valsartan group increased(P＜0.05),but there was no statistically significant difference in SBP among these four groups(P＞0.05).After drug intervention,compared with the model group rats,the SPH3127 group,SB431542 group,and valsartan group all showed a decrease in SBP,Ang Ⅱ concentration,serum creatinine concentration,and urea nitrogen con-centration,degree of glomerular atrophy,collagen fiber deposition,podocyte apoptosis,TGF-β/Smads mRNA and protein expression lev-els(P＜0.05).Compared with the SPH3127 group,the SB431542 group showed a decrease in TGF-β/Smads mRNA and protein ex-pression levels(P＜0.05),an increase in SBP,Ang Ⅱ,and urea nitrogen concentrations(P＜0.05),an increase in collagen fiber dep-osition(P＜0.05),and an increase in podocyte apoptosis levels.Conclusion:SPH3127 can alleviate renal podocyte apoptosis and fi-brosis caused by hypertension by inhibiting the TGF-β/Smads signaling pathway by suppressing AngⅡ levels.

Abstract:Objective:To investigate the efficacy of thulium laser combined with tip-bendable suction ureteral access sheath in the treatment of 1～3 cm kidney stones,and analyze the risk factors for postoperative infection.Methods:A retrospective analysis was conducted on the data of 156 patients with 1～3 cm kidney stones,including an observation group(n=76,treated with thulium laser combined with tip-bendable suction ureteral access sheath)and a control group(n=80,treated with thulium laser combined with tradi-tional negative pressure sheath).The perioperative indicators and stone clearance rate(SFR)of the two groups of patients were com-pared and analyzed to explore the risk factors for postoperative infection.Results:Compared with the control group,the observation group had shorter surgery time,higher postoperative 1-day SFR,and lower incidence of postoperative complications(P＜0.05),while there was no difference in hospitalization days and postoperative 1-month SFR(P＞0.05).Both groups showed an increase in white blood cells,procalcitonin,and interleukin-6 after surgery(P＜0.05),but the observation group was lower than the control group(P＜0.05).Multiple Logistic regression showed that surgical time,stone size＞2 cm,and residual stone size on the first day after surgery were independent risk factors for postoperative infection(P＜0.05).Conclusion:The use of thulium laser combined with a tip-flexible terminal suction ureteral access sheath can improve short-term SFR,reduce surgical time,and have fewer postoperative complications.Surgical time,stones larger than 2 cm,and residual stones on the first day after surgery are independent risk factors for postoperative in-fection.

Abstract:Objective:To analyze the clinical efficacy of laparoscopy with choledochoscopy for lithotomy+primary duct closure(PDC)on elderly common bile duct stones(CBDS)with gallbladder stones.Methods:102 elderly patients with CBDS and gallbladder stones in the hospital were retrospectively collected.According to different treatment regimens,the enrolled patients were divided into group A(laparoscopy with choledochoscopy for lithotomy+PDC therapy,n=51)and group B(laparoscopy with choledochoscopy for lithotomy+T tube drainage,n=51).The surgery-related indicators,liver function and inflammatory stress indicators at 72 h after sur-gery were compared between groups of patients,and the incidence rates of complications and postoperative review conditions were recor-ded in the two groups of patients.Results:The surgical time,anal exhaust time and hospital stay in the group A were shorter than those in the group B(P＜0.05),and the total hospitalization cost was less than that in the group B(P＜0.05).The levels of ALP and TBIL in both groups were lower at 72 h after surgery than those before surgery(P＜0.05)while the levels of IL-6,CRP,E and Cor were higher than those before surgery(P＜0.05),but the levels of the above indicators were lower in the group A than those in the group B(P＜0.05).There were no statistical differences in the total incidence rate of complications and postoperative review conditions be-tween the two groups(P＞0.05).Conclusion:The long-term effects of PDC and T tube drainage during laparoscopy with choledochos-copy for lithotomy are similar in the treatment of elderly CBDS with gallbladder stones,but PDC has more advantages in shortening sur-gical time and hospital stay,promoting postoperative recovery and improving liver function and inflammatory stress response.

Abstract:Objective:To explore the prevalence of hypertension and prehypertension and its influencing factors in young and middle-aged healthy people in Nanchong Central Hospital.Methods:46,740 middle-aged and young adults(18～44 years old as young adults,45～59 years old as middle-aged adults)were selected as the research objects.They were divided into hypertension group(n=11,751),prehypertension group(n=17,522),and normal blood pressure group(n=17,467)according to blood pressure values.The differences in age,gender,height,weight,blood pressure,blood glucose,lipid and uric acid among groups were compared.Multivariate Logistic regression model was used to analyze the influencing factors of hypertension and prehypertension.Results:The total population of the study was 46,740 young and middle-aged patients,including 11,751 patients with hypertension and 17,522 patients with prehy-pertension.The prevalence rate of hypertension and prehypertension was 62.6％.The prevalence of hypertension was higher in males than in females(71.3％ vs.28.7％,P＜0.05),and higher in middle-aged group than in young group(74.7％vs.25.3％,P＜0.05).The prevalence of prehypertension was higher in men than in women(62.1％ vs.37.9％,P＜0.05)and higher in middle-aged group than in young group(55.2％ vs.44.8％,P＜0.05).In addition,the mean values of body mass index,total cholesterol,low den-sity lipoprotein cholesterol,triglyceride,fasting blood glucose,serum creatinine and uric acid in hypertension group were higher than those in prehypertension group,and both groups were higher than those in normal blood pressure group(P＜0.05).The high density lipoprotein cholesterol in the hypertension group was lower than the prehypertension group and the normal blood pressure group,and the prehypertension group was lower than the normal blood pressure group(P＜0.05).The detection rate of overweight and obesity in hy-pertension group with abnormal blood glucose,lipid and uric acid metabolism was higher than that in prehypertension group,and both groups were higher than that in normal blood pressure group(P＜0.05).Logistic analysis showed that male,middle age,overweight/o-besity,hyperglycemia,hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia and hyperuricemia were independent risk fac-tors for hypertension and prehypertension(P＜0.05).Conclusion:The prevalence rates of hypertension and prehypertension were higher in young and middle-aged healthy people in Nanchong Central Hospital.Male,middle-aged,overweight/obesity,hyperglycemia,hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia and hyperuricemia were closely related to the incidence of hyperten-sion and prehypertension in young and middle-aged healthy people.Male,middle-aged,overweight/obesity are the strongest risk factors.Early intervention should be helpful for the prevention and control of hypertension in young and middle-aged people.

Abstract:Objective:To screen the key risk factors for secondary scapulohumeral periarthritis in patients with rotator cuff tear based on LASSO-Logistic regression analysis,construct a visual nomogram prediction model,and evaluate the discrimination and calibra-tion of the model through internal or external verification,so as to provide an individualized risk assessment tool for clinical practice.Methods:The clinical data of 84 patients with rotator cuff injury(including 30 patients with secondary scapulohumeral periarthritis and 54 patients without secondary scapulohumeral periarthritis)were retrospectively analyzed.Logistic regression analysis was employed to identify risk factors for secondary scapulohumeral periarthritis in patients with rotator cuff injury,and the predictive weights were visual-ized using a nomogram.The receiver operating characteristic(ROC)curve and DeLong test were utilized to assess the predictive per-formance of the model for secondary scapulohumeral periarthritis in patients with rotator cuff injury.Results:The results of LASSO-Lo-gistic regression analysis showed that Degenerative injury,diabetes mellitus,Goutallier classification(grade Ⅲ-Ⅳ),tear size(large),Patte classification(grade Ⅲ),joint capsule thickness(thick),high expression of C-reactive protein(CRP)and erythrocyte sedimen-tation rate(ESR),low expression of 25-hydroxyvitamin D[25(OH)D]were the risk factors of secondary scapulohumeral periarthritis in patients with rotator cuff injury Factors(P＜0.05).The nomogram analysis revealed that the Goutallier grade(grades Ⅲ-Ⅳ),tear size(large),Patte grade(grade Ⅲ),and joint capsule thickness(thick)were the most significant factors influencing secondary scapu-lohumeral periarthritis in patients with rotator cuff injuries.These were followed by degenerative damage,diabetes mellitus,high levels of CRP and ESR expression,and low levels of 25(OH)D expression.The area under the ROC curve of the nomogram was 0.891.Delong test results showed that the learning set and test set were 0.943 and 0.952,respectively,and there was no significant difference between the predicted value and the actual observed value(P＞0.05).Conclusion:The nomogram model based on LASSO-Logistic regression analysis has a good predictive effect on secondary scapulohumeral periarthritis in patients with rotator cuff injury.

Abstract:Objective:To develop and validate a risk nomogram model that investigates the predictive value of quantitative pa-rameters from contrast-enhanced ultrasound in combination with carcinoembryonic antigen(CEA)and carbohydrate antigen(CA19-9)for postoperative acute renal failure(ARF)following colorectal cancer surgery.Methods:A total of 50 patients with postoperative ARF(study group)and 52 patients without postoperative ARF(control group)who underwent radical resection of colorectal cancer were en-rolled.All patients underwent contrast-enhanced ultrasound examination,blood routine examination,etc.Quantitative parameters of con-trast-enhanced ultrasound,CEA and CA19-9 levels were collected.Univariate and multivariate Logistic regression analyses were per-formed to identify the risk factors associated with ARF following colorectal cancer surgery,and a nomogram risk prediction model was developed and validated.Results:The results of univariate analysis and Logistic regression analysis demonstrated that elevated levels of peak intensity(PI),area under the curve(AUC),mean transit time(MTT),time to Peak(TTP)delay,glomerular filtration rate(eG-FR),as well as high expression of serum CEA and CA19-9,were identified as significant risk factors for postoperative ARF in patients with colorectal cancer(P＜0.05).The nomogram revealed that abnormal values of PI,TTP,MTT,and AUC were the most robust pre-dictors for postoperative ARF in patients with colorectal cancer,followed by high expression of serum CEA and CA19-9.Internal valida-tion using computer simulation resampling through the Bootstrap method was employed to validate the nomogram model.The verification results indicated an area under the ROC curve of 0.870 for the nomogram,with a sensitivity of 80.26％ and specificity of 86.70％.The C-index was calculated as 0.816,while the H-L goodness-of-fit test showed no significant difference between predicted values and actu-al observations(x2=4.116,P=0.468).Conclusion:Abnormal quantitative parameters of contrast-enhanced ultrasound and high ex-pression of serum CEA and CA19-9 are risk factors for postoperative ARF in patients with colorectal cancer.The nomogram model,con-structed based on these factors,demonstrates effective predictive capability for assessing the risk of postoperative ARF in patients with colorectal cancer.

Abstract:Objective:To explore the relationship of rate pressure product(RPP)changes with coronary artery lesion degree and lesion count in patients with coronary heart disease.Methods:83 patients with coronary heart disease were selected as the coronary heart disease group,and they were divided into mild group(n=48)and severe group(n=35)according to the degree of lesions.Ac-cording to the number of lesions,they were divided into single vessel lesion group(n=43)and multi vessel lesion group(n=40).An-other 50 volunteers who underwent health check ups during the same period were selected as the control group.The differences in heart rate(HR),systolic blood pressure(SBP),and RPP were compared between coronary heart disease group and control group.The static RPP and dynamic peak RPP of patients with different degrees and numbers of coronary artery lesions were compared.Receiver operating characteristic(ROC)analysis was used to assess the predictive efficacy of RPP for different degrees and numbers of lesions.Results:The static RPP and dynamic peak RPP in the coronary heart disease group were higher than those in the control group(P＜0.05).The static RPP and dynamic peak RPP of the mild group were lower than those of the severe group(P＜0.05).ROC curve analysis showed that the sensitivity,specificity,and AUC of static RPP and dynamic peak RPP for patients with different degrees of coronary artery dis-ease were 77.14％,66.67％,0.768,and 74.29％,93.75％,and 0.869,respectively.The sensitivity,specificity,and AUC of static RPP and dynamic RPP for patients with different numbers of coronary artery lesions were 71.59％,97.50％,0.673 and 100.00％,23.26％,0.726,respectively.Conclusion:The RPP in patients with coronary heart disease is increased during the exercise test,,and it is closely related to coronary artery lesion degree and lesion count.

Abstract:Objective:To explore fetal protection effect of progesterone combined with lymphocytes immunotherapy(LIT)and its influences on estrogen and progesterone and coagulation indexes in unexplained recurrent spontaneous abortion(URSA).Methods:A total of 110 URSA patients were divided into control group(n=55,progesterone+HCG)and observation group(n=55,progester-one+LIT)according to the different treatment plan.The pregnancy outcomes,improvement of clinical symptoms,progesterone[human chorionic gonadotropin(HCG),progesterone(P),estradiol(E2)],uterine arterial blood flow resistance[peak systolic velocity/end diastolic velocity(S/D),pulsatility index(PI),resistance index(RI)],coagulation indexes[fibrinogen(FIB),D-dimer(D-D),acti-vated partial thromboplastin time(APTT)]and cytokines[interferon-γ(IFN-γ),interleukin-4(IL-4),helper cell subsets(Th1/Th2)]were compared between the two groups.Results:The success rates of fetal protection in observation group was higher than that in control group(83.64％ vs.61.81％,P＜0.05).The disappearance time of symptoms(lumbago,lower abdominal pain,vaginal bleed-ing)in observation group was shorter than that in control group(P＜0.05).Compared with control group,levels of HCG,P,E2,APTT and IL-4 were higher(P＜0.05),while S/D,PI,RI,FIB,D-D,IFN-γ and Th1/Th2 were lower in observation group(P＜0.05).Con-clusion:LIT combined with progesterone can increase success rate of fetal protection in URSA patients,improve clinical symptoms,reg-ulate levels of estrogen and progesterone,coagulation function and immune function.

Abstract:Objective:To explore the effect of multi-disciplinary combined prosthesis in the treatment of anterior tooth defect im-plantation and its impact on oral function.Methods:300 patients with anterior tooth defect implantation and repair were included as the study objects,and were evenly divided according to different treatment methods,with 150 cases in each group.The control group re-ceived conventional repair treatment,and the observation group received oral multidisciplinary combined repair treatment,both groups were followed up for 6 months.The aesthetic effects[Red Aesthetics Index(WES)and White Aesthetics Indes(PES)scores],oral function scores(language and chewing function,tooth mobility scores),levels of inflammatory factors[tumor necrosis factor alpha(TNF-α),interleukin-10(IL-10),and IL-6],and incidence of complications before and 6 months after treatment were compared be-tween the two groups.Results:The aesthetic effect scores of WES and PES in observation group were higher than the control group(P＜0.05).After treatment,the masticatory and language function scores in the observation group were higher than the control group,and the tooth mobility score score was lower than the control group(P＜0.05).After treatment,the levels of TNF-α,IL-10,IL-6,and total incidence of complications in the observation group were lower than those in the control group(P＜0.05).Conclusion:The effect of multi-disciplinary dental joint repair is obvious in patients with anterior tooth defect implantation,which can guarantee the oral aes-thetic effect,improve the oral function and effectively prevent complications,and can be widely used in clinic.

Abstract:Objective:To explore the short-term clinical efficacy of primary total knee arthroplasty(TKA)under the Enhanced Recovery After Surgery(ERAS)protocol in patients with varying degrees of knee varus deformity.Methods:A total of 120 patients who underwent TKA for knee osteoarthritis with varus deformity were selected.Perioperative management was based on the ERAS protocol.Based on the preoperative hip-knee-ankle angle(HKA),the patients were divided into three groups:Group A(varus angle≤10°),Group B(10°＜varus angle≤15°),and Group C(15°＜varus angle ≤ 20°),with 40 patients in each group.The clinical scores and lower limb alignment were compared among the three groups.Results:All 120 patients were followed up for 6～9 months,with a mean duration of(7.54±0.92)months.Significant intergroup differences were observed in the surgical duration among the three groups(P＜0.05),while no significant differences were found in other perioperative indicators across the groups(P＞0.05).Postop-eratively,all three groups showed significant improvements in VAS scores,HSS scores,range of motion(ROM)of the knee,the Knee Society Knee and Function Score compared to preoperative levels(P＜0.05).At both the preoperative and 30-day postoperative follow-up,statistically significant differences in VAS scores were observed among the three groups,with Group A was lower than Groups B and C(P＜0.05),and Group B was lower than Group C(P＜0.05).ROM,the Knee Society Knee and Function Score in Group A were better than those in Groups B and C(P＜0.05),and Group B was better than Group C(P＜0.05).However,at the 6-month postoper-ative follow-up,no statistically significant differences were found in these score metrics among the three groups(P＞0.05).In terms of imaging,all three groups demonstrated significant improvements in the HKA angle and femorotibial angle(FTA)postoperatively com-pared to preoperative levels(P＜0.05).At both the preoperative and 30-day postoperative follow-up,statistically significant differences in the HKA angles were observed among the three groups(P＜0 05),with Group A was better than Groups B and C(P＜0.05),and Group B was better than Group C(P＜0.05).FT A angles in Group A was less than that in Groups B and C,and Group B was less than Group C(P＜0.05).No statistically significant differences were found in the overall complication rates among the groups(P＞0.05).Conclusion:Based on short-term follow-up results,TKA under the ERAS concept demonstrates favorable outcomes for patients with knee osteoarthritis and varus deformity of varying severity.The severity of preoperative varus deformity significantly impacts both preop-erative knee function and postoperative lower limb alignment after TKA,but has a relatively minor effect on postoperative knee pain,function,and range of motion.

Abstract:Objective:To study the effect of integrated fixation and separate fixation in the treatment of femoral shaft fracture with ipsilateral femoral neck fracture.Methods:108 patients with femoral shaft fracture complicated with ipsilateral femoral neck frac-ture were selected as the research subjects.According to the surgical methods of the patients,they were divided into integrated fixation group(n=57)and separate fixation group(n=51).The perioperative related indicators of the two groups were compared.The hip function Harris score and fracture healing time at 1 year after surgery and postoperative complications were counted.Results:The surgi-cal time of patients in separate fixation group was longer than that in integrated fixation group,and the intraoperative blood loss and intr-aoperative fluoroscopy frequency were more than those in integrated fixation group(P＜0.05).There were no statistical differences in the healing time of femoral neck fracture and shaft fracture,the excellent and good rate of Harris score at 1 year after surgery,and the incidence rates of complications such as incomplete fracture union and knee pain or stiffness revealed between the two groups(P＞0.05).The poor rate of postoperative femoral neck deformity or fracture nonunion in patients with preoperative femoral neck displace-ment after integrated fixation was higher than that in patients with separate fixation(P＜0.05).Conclusion:Both integrated fixation and separate fixation in the femoral shaft and ipsilateral femoral neck fracture have good results,but for patients with significant femoral neck displacement before surgery,separate fixation is recommended to reduce the risk of poor femoral union.

Abstract:Objective:To evaluate the clinical efficacy of sirolimus-eluting stents in conjunction with low molecular weight hepa-rin for the interventional treatment of coronary heart disease(CHD)in elderly patients,and to assess both short-term and long-term out-comes following a 12-month follow-up period.Methods:A total of 114 elderly patients with coronary heart disease(CHD)who under-went percutaneous coronary intervention(PCI)were divided into a control group(n=57)and an experimental group(n=57)based on differing treatment protocols.Patients in the control group received sirolimus-eluting stents during PCI,while those in the experimen-tal group received low molecular weight heparin in addition to the standard treatment regimen.Throughout the study period,cardiac function indices,coronary perfusion recovery,and myocardial marker levels were systematically recorded for both groups.Additionally,subjects were followed up for 12 months to evaluate both short-term and long-term prognostic outcomes.Results:After treatment,the levels of left ventricular ejection fraction(LVEF),maximum oxygen uptake(VO2max),and 6-minute walk test(6MWT)in both groups exhibited improvements compared to pre-treatment values.Furthermore,the study group demonstrated greater improvement than the con-trol group(P＜0.05).After 24 hours of treatment,there was no occurrence of the no-reflow phenomenon in either group.The study group exhibited a higher proportion of TIMI blood flow grade 3 compared to the control group,while experiencing lower incidences of slow blood flow and CTFC(P＜0.05).After treatment,the levels of serum Myoglobin(MYO),Creatine Kinase-MB(CK-MB),and Cardiac Troponin(cTn)in both groups exhibited a decrease compared to pre-treatment levels,with the study group demonstrating a greater reduction than the control group(P＜0.05).There was no significant disparity observed in the proportion of patients with poor short-term prognosis between the two groups(P＞0.05).The study group exhibited a lower rate of poor long-term prognosis at 10.53％,compared to 28.07％ in the control group,which was found to be statistically significant(P＜0.05).Conclusion:The com-bination of sirolimus-eluting stents and low molecular weight heparin demonstrates superior efficacy in the interventional treatment of CHD in elderly patients,enhances long-term prognosis,and exhibits clinical application value.

Abstract:Objective:To investigate the efficacy of sheath-guided thrombectomy combined with large diameter high-pressure balloon angioplasty in treating arteriovenous graft(AVG)occlusion.Methods:90 patients with AVG occlusion were divided into a con-trol group(n=45)and an observation group(n=45)according to the surgical method.The control group underwent surgical Fogarty catheter thrombectomy combined with small diameter high-pressure balloon angioplasty,while the observation group underwent sheath-guided thrombectomy combined with large diameter high-pressure balloon angioplasty.The flow restoration time,length of hospital stay,treatment costs,technical success rate,clinical success rate,primary patency rates at 3 and 6 months post-treatment,internal fistula blood flow,and complication rates were compared between the two groups.Results:In the observation group,the blood flow restoration time was not statistically different from that in the control group(P＞0.05),with a shorter hospital stay(P＜0.05)and lower treat-ment costs(P＜0.05).The technical success rate and clinical success rate of the observation group were not statistically different from those of the control group(P＞0.05).The initial patency rate at 3 months post-treatment in the observation group was not statistically different from that in the control group(P＞0.05),but the internal fistula blood flow was greater than that in the control group(P＜0.05),the initial patency rate and internal fistula blood flow at 6 months post-treatment were higher than those in the control group(P＜0.05).There was no statistically significant difference in the incidence of vascular rupture between the two groups(P＞0.05),the rates of graft infection and symptomatic pulmonary embolism were lower in the observation group(P＜0.05).Conclu-sion:Sheath-guided thrombectomy combined with large diameter high-pressure balloon angioplasty is relatively more effective in treating AVG occlusion,improving initial patency rates and internal fistula blood flow,reducing graft infection and symptomatic pulmonary em-bolism,and offering lower treatment costs.

Abstract:Objective:To analyze the expressions and clinical significance of serum heat shock protein 90 α(HSP90 α)and thymidine kinase 1(TK1)in patients with primary lung cancer.Methods:The medical records of 101 patients with primary lung canc-er,50 patients with benign pulmonary nodules and 50 healthy volunteers with physical examination were retrospectively analyzed,and they were included in groups A,B and C respectively.Serum levels of HSP90 α and TK1 were observed in the three groups.ROC curve was drawn to analyze the diagnostic efficiency of serum HSP90 α and TK1 on primary lung cancer.The levels of serum HSP90 α and TK1 were observed among primary lung cancer patients with different pathological features,and Spearman correlation analysis was per-formed.Results:Serum HSP90 α and TK1 levels in group A were higher than those in groups B and C(P＜0.05),but no obvious differences were shown between group B and group C(P＞0.05).The areas under ROC curves(AUCs)of serum HSP90 α and TK1 levels for the diagnosis of primary lung cancer were 0.951 and 0.879 respectively.According to correlation analysis,lymph node metas-tasis and tumor staging in patients with primary lung cancer were positively correlated with serum HSP90 α and TK1 levels(P＜0.05).Conclusion:Serum HSP90 α and TK1 are highly expressed in patients with primary lung cancer,and have high value in the diagnosis of primary lung cancer,and their levels are related to lymph node metastasis and tumor staging.

Abstract:Objective:To explore the efficacy of simvastatin combined with acetylcysteine in the treatment of Bronchial Asthma(BA)and the effect on airway inflammation in patients.Methods:A retrospective analysis of clinical date was conducted on 122 BA patients,who were divided into the experimental group and the control group according to different treatment methods,with 61 cases in each group.The control group received routine treatment and took N-acetylcysteine tablets at the same time,while the experimental group received simvastatin tablets on the basis of the control group.The therapeutic effects,serological indexes[hypersensitive C-reac-tive protein(hs-CRP),Interleukin-6(IL-6)and Eosinophils(EOS)],airway inflammation indicators[Fractional exhaled nitric oxide(FeNO),Alveolar nitric oxide concentration CaNO)]and Asthma Control indicators[Asthma Control Test(ACT),number of asthma attacks]after 2 months of treatment were compared between the two groups.Results:The total effective rate of 96.72％in the experi-mental group was higher than 78.69％in the control group(P＜0.05).Before treatment,there were no significant differences in sero-logical indexes,airway inflammation indexes and asthma control indexes between the two groups(P＞0.05).Compared with before treatment,serological indexes and airway inflammation indexes were decreased in both groups after treatment(P＜0.05),ACT score was increased(P＜0.05),and the number of asthma attacks was decreased(P＜0.05).After treatment,serological and airway inflam-mation indexes of the experimental group were lower than those of the control group(P＜0.05),ACT score was higher than that of the control group(P＜0.05),and the number of asthma attacks was lower than that of the control group(P＜0.05).Conclusion:Simvas-tatin combined with acetylcysteine is effective in the treatment of BA,which can effectively reduce the level of inflammation in patients,relieve airway inflammation,and help control the progression of the disease.

Abstract:Objective:To compare the efficacy of autofluorescence imaging of cervical lesions(AFI)and colposcopy in the di-agnosis of precancerous lesions and cervical cancer,and evaluate their clinical application value.Methods:100 high-risk patients with cervical lesions were selected for diagnosis using AFI technology and colposcopy.The histopathological results were used as the gold standard to compare and analyze the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and ac-curacy of the two methods.ROC curve analysis was used to compare the AUC differences between the two techniques,and the examina-tion time of the two detection techniques was recorded.Results:Among 100 high-risk patients with cervical lesions,histopathological di-agnosis showed 3 casesof cervical cancer,24 cases of high-grade squamous intraepithelial lesions(HSIL),29 cases of low-grade squa-mous intraepithelial lesions(LSIL),and 44 other cases.AFI testing showed 2 cases of cervical cancer,25 cases of HSIL,37 cases of LSIL,and 36 other cases,and vaginal examination showed 3 cases of cervical cancer,24 cases of HSIL,35 cases of LSIL,and 38 other cases.This study proposed that HSIL and above lesions(HSIL+)were positive,while LSIL and others were negative,there was no sta-tistically significant difference in sensitivity,specificity,PPV,NPV,accuracy and AUC of positive AFI diagnosis compared to colposcopy(P＞0.05).The average duration of AFI was(52.67±12.83)s,significantly shorter than that of colposcopy(272.46±38.44)s(P＜0.05).Conclusion:The diagnostic value of AFI for HSIL+is comparable to traditional colposcopy,and it has the advantages of easy operation,fast detection,and real-time visualization.It can be used as an auxiliary or supplementary tool for HSIL+screening.

Abstract:Objective:To explore the changes and predictive value of blood uric acid(BUA),lipid metabolism and vitamin D in elderly patients with spinal degenerative changes complicated with osteoporosis.Methods:Retrospective analysis was performed on 112 elderly inpatients with spinal degenerative changes in the hospital.54 patients with osteoporosis were included in group A and 58 pa-tients without osteoporosis were enrolled as group B.The differences in BUA,lipid metabolism[total cholesterol (TC),triglyceride(TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol(LDL-C)]and 25-hydroxyvitamin D[25(OH)D]in the two groups were observed.Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the above indicators on elderly spinal degenerative changes with osteoporosis.Results:Compared with group B,the levels of BUA,TC,TG and LDL-C in group A were higher,while the levels of HDL-C and 25(OH)D were lower(P＜0.05).ROC curve analysis showed that the areas under the ROC curves (AUCs)of BUA,TC,TG,HDL-C,LDL-C and 25(OH)D were 0.876,0.792,0.770,0.880,0.797 and 0.917,respectively.Conclusion:Serum BUA,TC,TG and LDL-C in elderly patients with spinal degenerative changes and osteoporosis are at high levels while HDL-C and 25(OH)D are at low levels.The above indicators have certain predictive value on eld-erly spinal degenerative changes with osteoporosis.

Abstract:Objective:To explore the curative effect of Bushen Huoxue decoction combined with chitosan injection on patients with knee osteoarthritis(KOA)after arthroscopic surgery.Methods:A total of 116 patients with KOA were divided into control group and observation group according to different postoperative intervention schemes,with 58 cases in each group.Both groups underwent ar-throscopic debridement,after operation,the control group was treated with intra-articular injection of chitosan,and the observation group was treated with Bushen Huoxue Decoction combined with intra-articular injection of chitosan for 4 weeks.The efficacy,pain score,knee swelling value,knee function[knee flexion,osteoarthritis index scale (WOMAC),Lysholm score],ultrasound indexes of knee joint[joint effusion thickness,synovial thickness]and serum inflammatory factors[interleukin-6(IL-6),interleukin-1 β(IL-1β),tumor necrosis factor-α(TNF-α)]were compared between the two groups.Results:After 4 weeks of treatment,compared with the control group,the total effective rate of the observation group was higher(P＜0.05).Compared with the control group,the VAS score,swelling value,WOMAC score and joint effusion thickness,synovial thickness in the observation group were lower(P＜0.05),and the knee flexion and Lysholm score were higher(P＜0.05).The levels of serum IL-6,IL-1 β and TNF-α in the observation group were lower than those in the control group(P＜0.05).Conclusion:Bushen Huoxue Decoction combined with chitosan injection can improve the curative effect after KOA operation,promote pain relief and knee joint function recovery,reduce inflammation.

Abstract:Objective:To explore the application of histogram of apparent diffusion coefficient (ADC) in differentiation benign and malignant breast lesions.Methods:A total of 58 patients with breast mass lesions confirmed by pathology were enrolled.They were divided into a benign lesion group(n=26)and a malignant lesion group(n=32)according to the benign and malignant nature of the lesions.DWI imaging was performed before operation and ADC map were generated.The ADC histogram analysis were computed on the histogram analysis software,and the differences of ADC histogram parameters of benign and malignant breast lesions were compared,and the receiver operating characteristic(ROC)curve was used to evaluate the differential diagnostic efficacy.Results:The mean,mini-mum,25％,50％,75％ percentile of ADC value and skewness values of malignant tumors were lower than benign tumors(P＜0.05),while there was no statistical difference between the 90％ percentile,maximum and kurtosis values of ADC values between benign and malignant tumors(P＞0.05).Conclusion:Histogram analysis of ADC can help distinguish between benign and malignant breast le-sions,with 25％ percentiles having the highest differential diagnosis value.

Abstract:Objective:To explore the effect of Lava Ultimate porcelain onlay and cast porcelain onlay on repairing teeth defects and its influence on gingival crevicular fluid inflammatory indicators and long-term preservation rate.Methods:The clinical data of 122 patients with teeth defects were retrospectively analyzed.They were divided into ultimate porcelain group and cast porcelain group ac-cording to the different treatment methods,with 61 cases in each group.The ultimate porcelain group was treated with Lava Ultimate porcelain onlay repair,while the cast porcelain group adopted cast porcelain onlay repair.The differences in periodontal conditions and gingival crevicular fluid inflammatory indicators before repair and after 6 months of repair and repair effect and pink esthetic score after 2 years of repair were compared between both groups.Results:After 6 months of repair,the periodontal conditions and gingival crevicu-lar fluid inflammatory indicators in both groups were improved(P＜0.05),but there were no significant differences between the two groups(P＞0.05).After 2 years of repair,the tooth integrity and soft tissue shape in ultimate porcelain group were better than those in cast porcelain group(P＜0.05),and the soft tissue color was better in cast porcelain group than that in ultimate porcelain group(P＜0.05).Conclusion:Both Lava Ultimate porcelain and cast porcelain onlays have good effects on repairing teeth defects and can improve the periodontal conditions and gingival inflammatpry response,but cast porcelain onlay has better color,while Lava Ultimate porcelain onlay has better tooth integrity and soft tissue shape,and suitable repair materials can be selected according to patients' wishes.

Abstract:Objective:To explore the application effects of low-temperature plasma radiofrequency ablation combined with ozone and collagenase in patients with cervical disc herniation.Methods:A total of 90 patients with cervical disc herniation who were treated were selected and divided into a study group and a control group according to different treatment methods,with 45 cases in each group.The study group received treatment using low-temperature plasma radiofrequency ablation combined with ozone and collagenase,while the control group was treated with low-temperature plasma radiofrequency ablation combined with ozone.The Visual Analogue Scale(VAS)scores before and after surgery were compared between the two groups.The Japanese Orthopaedic Association(JOA)scale was used to evaluate cervical vertebra function in patients before and after surgery,and the excellent rate of the treatments between the two groups was compared.Results:All patients completed at least 6 months of follow-up.There were no statistically significant differences in VAS and JOA scores between the two groups before surgery and at 1 month post-surgery(P＞0.05).At 3 and 6 months post-surger-y,the VAS and JOA scores in the study group were better than those in the control group(P＜0.05).At 6 months post-surgery,the ex-cellent treatment rate in the study group was 93.33％,which was higher than the 75.56％in the control group(P＜0.05).Conclu-sion:The combination of low-temperature plasma radiofrequency ablation with ozone and collagenase for the treatment of patients with cervical disc herniation can enhance the treatment effectiveness,yielding better results than low-temperature plasma radiofrequency ab-lation combined with ozone injection alone.

Abstract:Objective:To investigate the efficacy and prognosis of concurrent radiochemotherapy in locally advanced esophageal cancer,and analyze the influencing factors.Methods:A total of 120 patients with locally advanced esophageal cancer who underwent concurrent radiochemotherapy were selected.The short-term efficacy and long-term prognosis of concurrent radiochemotherapy were e-valuated.Logistic regression analysis was used to explore factors influencing short-term efficacy.Kaplan-Meier survival analysis and COX regression analysis were used to explore factors influencing long-term prognosis.Results:There was complete remission in 23 cases(19.17％),partial remission in 64 cases(53.33％).The objective remission rate was 72.50％.Logistic regression analysis showed that proportions of T4 stage,lymph node metastasis and well differentiation in the non-remission group were higher than those in the re-mission group(P＜0.05).T4 stage(OR:3.337,95％CI:1.308～8.515),lymph node metastasis(OR:4.216,95％ CI:1.457～12.199)and well differentiation(OR:5.772,95％ CI:2.162～15.409)were risk factors for no remission after concurrent radioche-motherapy(P＜0.05).The patients were followed up for 5.8～60.0 months,with a median follow-up period of 37.4 months,73 pa-tients(60.83％)died and 47 patients(39.17％)survived.Kaplan-Meier survival analysis showed that T3 stage(44.23％)was higher than T4 stage(17.96％),and without lymph node metastasis(58.76％)was higher than lymph node metastasis(16.99％).The cumulative survival rate of patients with high differentiation(51.37％),moderate differentiation(22.06％),and poor differentia-tion(5.68％)decreased in order(P＜0.05).COX regression analysis showed that T4 stage(HR:2.219,95％CI:1.142～4.312),lymph node metastasis(HR:2.809,95％CI:1.246～6.337),and poor differentiation(HR:3.360,95％ CI:1.458～7.744)were risk factors for poor prognosis in patients with locally advanced esophageal cancer(P＜0.05).Conclusion:Concurrent radiochemother-apy is an effective method for treating locally advanced esophageal cancer.T staging,lymph node metastasis status and differentiation degree are influencing factors on the efficacy of concurrent radiochemotherapy.T4 stage,lymph node metastasis and poor differentiation are more likely to lead to poor prognosis.

Abstract:Objective:To investigate the effect of endoscopic rotatable repeated opening and closing soft tissue clip or metal tita-nium clip combined with local application of hemocoagulase in treating upper gastrointestinal bleeding(UGIB).Methods:The clinical data of 97 patients with UGIB were retrospectively analyzed.The enrolled patients were classified into soft tissue clip group(n=51)and metal titanium clip group(n=46)by adopting different endoscopic hemostatic clips.The soft tissue clip group was given endoscop-ic rotatable repeated opening and closing soft tissue clip,while the metal titanium clip group was treated with endoscopic metal titanium clip,and the patients of both groups were treated with gastric tube perfusion with 1 mL serrapeptide hemocoagulase mixed with 10 mL of physiological saline.The hemostatic effect,surgical related indexes,recovery conditions and blood related indexes before and after treat-ment were compared,and the incidence rates of complications in the two groups were counted.Results:The rebleeding rate in soft tissue clip group was better than that in metal titanium clip group(P＜0.05).The number of hemostatic clips used,intraoperative blood loss,hemostatic clip shedding time and hospital stay were better in soft tissue clip group than those in metal titanium clip group(P＜0.05).There was no statistically significant difference in surgical reoperation rate and recovery between the two groups(P＞0.05).After treat-ment,the platelet aggregation rate,hemoglobin and fibrinogen in the two groups were risen(P＜0.05),and the indexes in soft tissue clip group were higher than those in metal titanium clip group(P＜0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion:Endoscopic rotatable repeated opening and closing soft tis-sue clip is more effective in the treatment of UGIB.It has better hemostatic effect,slightly lower complications and surgical reoperation rate than metal titanium clip.

Abstract:Objective:To explore the risk factors affecting the short-term prognosis in patients with acute kidney injury(AKI),and to construct a risk prediction model and verify it.Methods:A total of 228 patients with AKI were chosen and split into modeling group(n=182)and verification group(n=46).The risk factors were determined by single factor and binary Logistic regression analy-sis,and the nomogram model was developed.And its effectiveness was evaluated using the ROC,calibration,and DCA curves.Results:Poor short-term prognosis occurred in 45 patients(24.73％)in the modeling group and 11 patients(23.91％)in the validation group.Platelet,blood urea nitrogen,serum creatinine,serum potassium,renal replacement therapy and length of stay were independent risk factors of poor short-term prognosis in patients with AKI.The AUC of the nomogram model in the modeling group was 0.975(95％ CI:O.956～0.994),and the AUC of the validation group was 0.930(95％ CI:O.858～1.000).The calibration curve analysis showed that the model fitted well.The net income of each range of the threshold probability value of the DCA curve analysis was greater than 0.Conclusion:The nomogram model has a good predictive ability for the short-term poor prognosis of AKI patients and can provide reference for medical staff to evaluate the short-term poor prognosis of AKI.

Abstract:< positive >1 case data the patient, a 57 year old female, was admitted to the Department of Hematology of the Affiliated Hospital of North Sichuan Medical College on February 18, 2022 because of "abdominal pain and fatigue for 1 month and thrombocytopenia for 20 days". The patient had intermittent pain in the upper abdomen without clear inducement 1 month ago, accompanied by fatigue and occasional dizziness. 20 days ago, the blood routine of the patient outside the hospital showed that the platelet was 44 × 10-9 / L, hemoglobin was 120 g / L, total bilirubin was 42.2 μ mol/l, indirect bilirubin was 30.9 μ mol/l, and the abdominal pain was alleviated after the treatment of acute gastroenteritis, but there was still intermittent abdominal pain. The blood routine reexamination showed that the platelet was 29 × 10-9 / L, hemoglobin was 115 g / L. the effect of platelet raising capsule outside the hospital was poor, so he was admitted to the hospital. The patient has no vegetarian and partial eating habits, long-term constipation, no significant change in body mass, and has a history of gastritis for 10+ years. She usually has acid regurgitation, hiccups, heartburn, and abdominal distension. She has felt tongue pain, anxiety, and insomnia when eating for nearly 1 year, has suicidal tendencies, and occasionally has multiple joint pain and finger numbness.

Abstract:Objective:To explore the effect of spiritual care intervention on psychological resilience,anxiety and depression,fear of disease progression and quality of life in patients with cervical cancer after operation.Methods:A total of 156 patients with cervical cancer who underwent surgical treatment were divided into control group(n=78)and observation group(n=78)according to differ-ent nursing methods.The control group received routine nursing after operation,and the observation group received spiritual care after operation.Both groups were intervened for 6 weeks.The changes of psychological resilience[Connor-Davidson Resilience Scale(CD-RISC)],anxiety and depression levels[Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)],fear of disease pro-gression[Fear of Disease Progression Scale(FoP-Q-SF)]and quality of life[Cervical Cancer Quality of Life Scale(FACT-Cx)]were compared between the two groups before and after intervention.Results:After intervention,the total score of CD-RISC and the scores of each dimension in the two groups increased(P＜0.05),and those in the observation group were higher(P＜0.05).The scores of SAS and SDS in the two groups decreased(P＜0.05),and those in the observation group were lower(P＜0.05).After intervention,the FoP-Q-SF scores of the two groups decreased(P＜0.05),and the observation group was lower(P＜0.05).The total score of FACT-Cx and the scores of each dimension in the two groups increased(P＜0.05),and those in the observation group were higher(P＜0.05).Conclusion:Spiritual care intervention can effectively improve the psychological resilience of patients after cervical cancer surgery,re-duce anxiety,depression and fear of disease progression,and improve the quality of life.

Abstract:Objective:To explore the application effect of postoperative nursing intervention based on hierarchy of needs theory in patients undergoing laparoscopic hysterectomy.Methods:103 patients undergoing laparoscopic hysterectomy were divided into control group and observation group according to different postoperative nursing intervention methods.51 patients who received routine postoper-ative nursing intervention were divided into control group,and 52 patients who received postoperative nursing intervention based on hier-archy of needs theory were divided into observation group.The postoperative recovery,negative emotions[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)],coping style[simple coping style scale(SCSQ)]and self-care ability[self-care abili-ty scale(ESCA)]before and after intervention were compared between the two groups.Results:The postoperative recovery of the obser-vation group was faster than that of the control group(P＜0.05).Compared with the control group,the anxiety and depression scores in the observation group were lower after intervention(P＜0.05).After intervention,the positive coping scores of the two groups in-creased,the negative coping scores decreased,and the observation group was higher(P＜0.05).Compared with the control group,the scores of self-care ability in the observation group were higher(P＜0.05).Conclusion:Postoperative nursing intervention based on hi-erarchy of needs theory can promote the postoperative recovery of patients undergoing laparoscopic hysterectomy,improve their negative emotions and coping styles,and improve their self-care ability.