Abstract:Stroke is currently one of the most common causes of death in the world.The mammalian forkhead box(Fox)O1 plays important roles in the occurrence and development of stroke,such as inducing cell death and inflammatory response,inhibiting oxidative damage,affecting the blood-brain barrier,and regulating hepatic gluconeogenesis.In view of these roles of FoxO1 in the occurrence and development of stroke,different measures and treatments have been adopted,but the role and mechanism of FoxO1 remain elusive and even contradictory.Therefore,the identification of these effects and their mechanisms will further reveal the FoxO1 signal transduction and related targeted drugs,and then provide an important method or basis for the prevention and treatment of stroke.This article reviews the research progress of FoxO1 in the pathogenesis of stroke and its mechanism.

Abstract:Objective To analyze the current status of randomized controlled trials(RCT)of exercise therapy in the treatment of chronic kidney disease(CKD),and to provide suggestions for the evaluation method of clinical effect of exercise therapy in the treatment of CKD.Methods A number of Chinese and English databases were systematically searched for RCT of exercise intervention in CKD from the establishment of the database to March 2025.The characteristics of the literature were extracted,and the selection of outcome indicators of RCT of exercise intervention in CKD was analyzed.Results A total of 52 articles were included,involving 58 outcome indicators that appeared twice or more,and a total of 406 reports were reported.The outcome indicators included renal function(66 times,16.3％),exercise ability test(34 times,8.4％),physical function performance(60 times,14.8％),risk factors(135 times,33.2％),and pathogenesis related indicators(66 times,16.3％),questionnaires and scales(20 times,4.9％),and safety indicators(25 times,6.2％).Conclusion The outcome indicators of RCT on exercise intervention in CKD have some problems,such as large selection differences,some outcome indicators need to be improved,and less attention is paid to clinical symptoms and mental health.Future research should be committed to building a core index set to make the selection of indicators scientific,representative and clinical practicability,and improve the rigor of outcome indicators.

Abstract:The prevalence and mortality of cardiovascular disease in China are increasing year by year,and the number of patients undergoing coronary artery bypass grafting is increasing year by year.It is essential to actively implement postoperative cardiac rehabilitation.The core link of the current consensus on cardiac rehabilitation is exercise rehabilitation,and traditional Chinese medicine also has its own unique advantages in cardiac rehabilitation.This article reviews the research progress of traditional Chinese medicine on bleeding,infection,pain and other common complications after coronary artery bypass grafting.

Abstract:Objective To explore the risk factors of early enteral nutrition(EEN)intolerance in elderly patients with severe pneumonia,and to construct and verify a nomogram model.Methods A total of 209 elderly patients with severe pneumonia in The Second Affiliated Hospital of Naval Medical University of Chinese People's Liberation Army from January 2023 to January 2025 were selected.EEN tolerance of patients was recorded.According to the presence or absence of EEN intolerance symptoms,the patients were divided into tolerance group and intolerance group.The risk factors of EEN intolerance were analyzed and a nomogram was drawn.The receiver operating characteristic curve was used to test the predictive efficacy of the nomogram model.Results Among 209 elderly patients with severe pneumonia,86 cases had EEN intolerance.The incidence was 41.1％(86/209).Among the patients with EEN intolerance,74.4％(64/86)had single symptom,mainly diarrhea,gastric retention and abdominal distension,25.6％(22/86)had two or more symptoms,and EEN intolerance mainly occurred on the first and second day of the implementation of EEN.Old age,late start of enteral nutrition,high clinical pulmonary infection score(CPIS),long duration of mechanical ventilation and intermittent injection were independent risk factors for EEN intolerance in elderly patients with severe pneumonia(all P＜0.05).The prediction model of EEN intolerance in elderly patients with severe pneumonia was constructed according to the influencing factors screened from the results of Logistic regression analysis.Logit(P)=-15.541+0.923 × age+0.966 × initiation time of enteral nutrition+0.854 × CPIS+0.338 × mechanical ventilation time-0.959 × feeding mode.Hosmer-Lemeshow goodness of fit test showed that x2=4.138,degree of freedom=8,P=0.830.The nomogram showed that when the sum of the scores of each influencing factor was more than 144,the risk of EEN intolerance was more than 80％.The consistency index of the nomogram model was 0.888,and the area under the curve for predicting EEN intolerance in elderly patients with severe pneumonia was 0.888(95％confidence interval:0.837-0.927).Conclusion The risk factors of EEN intolerance in elderly patients with severe pneumonia include old age,late start time of enteral nutrition,high CPIS,long duration of mechanical ventilation and intermittent injection.The nomogram model based on the above influencing factors has a high predictive efficiency for EEN intolerance in elderly patients with severe pneumonia,which is helpful for medical staff to accurately identify high-risk groups.It has guiding significance for the improvement of nutrition management strategy.

Abstract:Cardiogenic shock is a serious and fatal complication of acute myocardial infarction.About 5％-10％of patients with acute myocardial infarction will develop cardiogenic shock,and the mortality rate is as high as 40％-50％.Timely and effective revascularization can maximize the rescue of ischemic myocardium,restore heart pump function,and significantly improve the survival rate of patients.Percutaneous coronary interven-tion is currently the main revascularization method.In percutaneous coronary intervention,the choice of vascular approach has an important impact on the prognosis of patients and the incidence of complications.At present,radial artery and femoral artery are commonly used interventional access.Radial artery approach has significant advantages in reducing bleeding complications,but femoral artery approach still plays an irreplaceable role in complex operations and mechanical support.Most access studies recommend that radial access should be preferred when conditions permit,and femoral access should be selected in certain circumstances,but the best access for patients with cardiogenic shock is still inconclusive.This article will briefly review the related research and clinical practice of the choice of percutaneous coronary intervention approach in patients with acute myocardial infarction complicated with cardiogenic shock.

Abstract:Objective To explore the SMOTE algorithm based epilepsy risk prediction model after successful resuscitation of cardiac arrest.Methods A total of 200 patients with successful resuscitation of cardiac arrest admitted to the 910th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army from October 2016 to October 2023 were retrospectively collected as observation objects.According to whether epilepsy occurred after successful resuscitation,the patients were divided into epilepsy group(50 cases)and non-epilepsy group(150 cases).Data of the subjects were collected and analyzed.Univariate and multivariate Logistic regression analysis were used to screen the risk factors of epilepsy after successful resuscitation of cardiac arrest,and then the SMOTE algorithm was used to reconstruct the original data set of influencing factors to obtain the risk early warning model and verify its predictive efficiency.Results There were 50 cases of epilepsy after successful resuscitation in 200 cases of cardiac arrest,and the incidence was 25.0％.Multivariate Logistic regression analysis showed that age,history of epilepsy,intracranial infection,cardiovascular and cerebrovascular diseases,and hypoxic-ischemic brain injury were risk factors for epilepsy after successful resuscitation of cardiac arrest(all P＜0.05).The original early warning model P1=1.107X1+1.221X2+1.025X3+1.227X4+1.162X5-3.909 was obtained.Hosmer-Lemeshow test results showed that the model had a good fit(coefficient of determination R2=0.418,P=0.599).The early warning model based on the SMOTE algorithm was P2=1.212X1+1.351X2+1.208X3+1.357X4+1.271X5-4.241.The Hosmer-Lemeshow test results indicated that the model had a good fit(coefficient of determination R2=0.617,P=0.833).The results of receiver operating characteristic curve analysis showed that the area under the curve of the original warning model P1 was 0.791,and the area under the curve of the early warning model P2 was 0.825.Conclusion The SMOTE early warning model is better than the original warning model,and can accurately predict epilepsy after successful resuscitation of cardiac arrest.

Abstract:Objective To explore the characteristics of QRS complex duration in patients with atrial fibril-lation and its relationship with recurrence after radiofrequency catheter ablation(RFCA).Methods A total of 188 patients with atrial fibrillation who underwent RFCA at Mianyang 404 Hospital from May 2022 to October 2024 were selected retrospectively.According to whether recurrence occurred within 3 months after surgery,the patients were divided into the recurrence group(n=52)and non-recurrence group(n=136).General data,QRS complex duration,ultrasonic parameters,and admission routine blood test indicators of the patients were collected.A hierarchical regression model was used to analyze the effects of different clinical characteristics on QRS complex duration.Multivariate Logistic regression was applied to analyze risk factors.Stratified interaction analysis was conducted to explore the effect of gender on the relationship between QRS complex duration and recurrence after RFCA.Receiver operating characteristic(ROC)curve was used to evaluate diagnostic efficacy.Restricted cubic spline(RCS)was employed to analyze the dose-response relationship between QRS complex duration and the risk of recurrence after RFCA.Results Hierarchical regression analysis showed that electrocardiographic f-wave pattern,brain natriuretic peptide(BNP),homocysteine(Hey),left atrial diameter(LAD),and left ventricular ejection fraction(LVEF)all had significant effects on QRS complex duration(all P＜0.05).Multivariate analysis revealed that electrocardiographic f-wave pattern,BNP,Hey,QRS complex duration,LAD,and LVEF were independent influencing factors for recurrence in atrial fibrillation patients after RFCA(all P＜0.05).Interaction test analysis indicated that gender had no impact on the relationship between QRS complex duration and recurrence after RFCA(Pinteraction＞0.05).The risk of postoperative recurrence in the high-risk group of QRS complex duration(＞150 ms)was 68.8％(22/32),with an interval likelihood ratio of 4.400.ROC curve analysis results showed that the area under the curve of QRS complex duration for diagnosing the risk of recurrence after RFCA was 0.753.RCS analysis demonstrated that there was a non-linear dose-response relationship between QRS complex duration and the risk of recurrence in atrial fibrillation patients after RFCA(P＜0.05).Conclusions Prolonged QRS complex duration is an independent risk factor for recurrence in patients with atrial fibrillation after RFCA.Preoperative measurement of QRS complex duration can effectively identify high-risk patients and provide a reference for individualized postoperative management.

Abstract:Objective To explore the application and operation analysis of umbrella type spray tube and original straight head spray tube in endoscopic hemostasis with medical glue in patients with upper gastrointestinal bleeding.Methods A total of 202 patients with upper gastrointestinal bleeding who underwent endoscopic hemo-stasis with medical glue in Beijing Anzhen Hospital,Capital Medical University from January 2022 to December 2024 were retrospectively analyzed.According to the spray tube used,they were divided into straight head spray tube group(control group,147 cases)and hemostatic umbrella spray tube group(observation group,55 cases).The spraying effect data and endoscopic blockage of the two groups were analyzed.Results There was no significant difference in the treatment examination time between the observation group and the control group(P＞0.05).The spraying and observation time of the observation group was longer than that of the control group(P＜0.001).In the observation group,after spraying medical glue on the bleeding site of duodenal bulb ulcer and cardia laceration,the umbrella was retracted into the outer sheath tube,and the wound after spraying could be clearly observed.In the control group,after spraying medical glue,the lens was blurred,and the lens was withdrawn immediately.There were 52 cases of excellent lens clarity and 3 cases of good lens clarity in the observation group after medical glue spraying,there were 76 cases of excellent lens clarity,22 cases of good lens clarity and 49 cases of poor lens clarity in the control group,and the difference between the two groups was statistically significant(x2=31.954,P＜0.001).The proportion of rubber tube blockage in the observation group was lower than that in the control group[0(0/55)vs 7.5％(11/147)](x2=4.362,P=0.037).In recent 3 years,the number of endoscopic repairs due to the blockage of medical glue after spraying in the control group was 11 times,and the cost was 54 893 yuan.The medical glue was not blocked in the observation group,and the cost was 0 yuan.Conclusions The umbrella type spray tube used in endoscope can clearly observe the spraying effect of medical glue on the wound after bleeding,and the plug rate in the lumen and maintenance cost are lower than those of the control group.

Abstract:Lymph node calcification in the parotid gland region is a rare chronic secondary disease with potential clinical significance.This article reports a case of a 41-year-old female patient with left parotid gland region lymph node calcification,who presented with a mass in the left preauricular area for 30 years.The patient had no obvious symptoms in the early stage and sought medical attention recently due to occasional pain.Imaging examinations suggested a calcified nodule in the left parotid gland,and intraoperative and postoperative pathology further confirmed lymph node calcification in the parotid gland region.Open surgical treatment was performed,and the patient recovered well postoperatively.The uniqueness of this case lies in its long disease course and rare anatomical location.The diagnosis and treatment of such diseases require a comprehensive consideration of patient symptoms,lesion characteristics,and pathological results.This report aims to provide a therapeutic reference for clinicians when encountering similar rare cases.

Abstract:Objective To explore the impact of non-matching nucleic acid extraction reagents on human papillomavirus(HPV)genotyping results.Methods A total of 171 cervical exfoliated cell samples were collected from female patients who visited the Department of Gynecology,Dongzhimen Hospital,Beijing University of Chinese Medicine from March to April 2025.HPV DNA was extracted by manual boiling method and magnetic bead method(automatic nucleic acid extraction using non-matching nucleic acid extraction reagents),respectively.Fluorescence quantitative polymerase chain reaction was performed to detect HPV genotypes.The negative coincidence rate,positive coincidence rate,and total coincidence rate of nucleic acid detection results obtained by different extraction methods were analyzed,as well as their impacts on single infection,multiple infections of HPV subtypes,and sample viral load.Results The negative coincidence rate and positive coincidence rate of the detection results by the two methods were 100.0％(128/128)and 93.0％(40/43),respectively,with a total coincidence rate of 97.1％(166/171).Consistency analysis of gene subtypes and internal reference in 43 positive samples showed that the automatic nucleic acid extraction method did not cause a significant increase in the internal reference Ct value due to the reduced sample volume.Kendall's concordance coefficient test showed statistical significance(both P＜0.001),indicating consistency between the two extraction methods.The Kendall's concord-ance coefficients were 0.953 and 0.943,respectively,suggesting a strong degree of consistency.Analysis of the viral load of samples extracted by the two methods showed that consistent results and an increase of 1 order of magnitude accounted for 84.0％(42/50).Conclusion Compared with the manual boiling method,the magnetic bead method(automatic nucleic acid extraction with non-matching reagents)can obtain HPV DNA solutions with higher concentration and purity,which is more suitable for laboratory promotion and application.

Abstract:Purple urine bag syndrome is a rare clinical condition with an incompletely clarified pathogenesis,and there is currently a lack of systematic and effective treatment methods.As a novel therapeutic approach,ultrasound combined with bladder irrigation has potential advantages in improving local bladder circulation,reducing inflammatory responses,and promoting tissue repair.This article reports a case of purple urine bag syndrome in a patient with long-term indwelling urinary catheterization due to cervical spine fracture complicated by complete paralysis,aiming to provide clinical reference.Ultrasound combined with bladder irrigation was adopted,and changes in urine bag color,routine urine test indicators,and urine properties were recorded before and after treatment.After 1 week of treatment,the purple color of the patient's urine bag disappeared,the urine color lightened,flocculent substances decreased,bacterial count dropped,urine odor vanished,and the symptoms improved significantly.

Abstract:Objective To analyze the different clinical characteristics and laboratory indicators of respiratory tract infections in children caused by influenza B,adenovirus,and respiratory syncytial virus.Methods A total of 668 children who visited the outpatient department or were hospitalized in Beijing Friendship Hospital,Capital Medical University from December 2023 to March 2024 were selected as the research subjects.According to the results of etiological nucleic acid detection,they were divided into influenza B group(259 cases),adenovirus group(216 cases),and respiratory syncytial virus group(193 cases).The clinical symptoms,laboratory indicators,and lymphocyte subset indicators of the three groups were compared.Results There were statistically significant differences in the proportions of moderate fever,high fever,sore throat,wheezing,vomiting,abdominal pain,headache,and concurrent Mycoplasma infection among the three groups(all P<0.05).There were statistically significant differences in white blood cell count,neutrophil count,lymphocyte count,monocyte count,and platelet count among the three groups(all P<0.05).There were statistically significant differences in CD+3,CD+8,CD+4,and CD+16 levels among the influenza B group,adenovirus group,and respiratory syncytial virus group[(1.86±0.25)vs(2.09±0.53),(2.14±0.46);(0.47±0.11)vs(1.02±0.26),(1.07±0.19);(1.25±0.38)vs(0.67±0.19),(1.18±0.35);(0.51±0.13)vs(0.54±0.07),(0.30±0.06)](all P<0.05).Conclusion After infection with the three viruses,children have common clinical manifestations and laboratory indicators of viral infection,as well as distinct manifestations and characteristics specific to each virus.

Abstract:Objective To compare the efficacy and safety of moxifloxacin and omadacycline in the treatment of adult Mycoplasma pneumoniae pneumonia(MPP).Methods The clinical data of 139 adult MPP patients admitted to Beijing Ditan Hospital,Capital Medical University,from August to December 2024 were retrospectively collected.Among them,73 cases were treated with omadacycline(observation group)and 66 cases with moxifloxacin(control group).The clinical indicators,antipyretic time,symptom remission rate,improvement of pulmonary imaging and safety of the two groups were analyzed.Results After treatment,the levels of white blood cell count,neutrophil/lymphocyte ratio,C-reactive protein,procalcitonin,serum amyloid A and interleukin-6 in both groups were significantly better than those before treatment(all P<0.05),while there were no statistically significant differences between the two groups(all P>0.05).The antipyretic time in the observation group was shorter than that in the control group[(1.3±0.5)d vs(2.1±0.8)d](P=0.02).There was no significant difference in the total effective rate between the observation group and the control group[91.8％(67/73)vs 90.9％(60/66)](P=0.85).After 1 and 4 weeks of treatment,there were no significant differences in the imaging absorption rate between the two groups(both P>0.05).During the treatment period,the incidence of adverse reactions in the observation group was lower than that in the control group[2.7％(2/73)vs 12.1％(8/66)](χ2=7.93,P<0.01).Conclusion Omadacycline has comparable efficacy to moxifloxacin in the treatment of adult MPP,with the advantage of better safety.

Abstract:Objective To investigate the clinical efficacy of Xiao'er Xuanfei Zhike granules combined with ceftazidime in the treatment of children with bronchopneumonia.Methods A total of 126 children with bronchopneumonia who were treated in Wuhan Hospital of Traditional Chinese Medicine from April 2021 to September 2023 were enrolled and divided into the control group and the observation group according to the random number table method,with 63 cases in each group.The control group was given intravenous drip of ceftazidime for injection at a dose of 50 mg/kg,twice a day.On the basis of the control group's regimen,the observation group was additionally treated with Xiao'er Xuanfei Zhike granules,1 bag each time for children aged 5-7 years old and 1.5 bags each time for children aged 8-11 years old,taken orally three times a day.Both groups were treated continuously for 7 d.The clinical efficacy,symptom relief time,pulmonary function indexes before and after treatment,serum inflammatory markers and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The relief times of asthma,cough,fever and disappearance time of pulmonary rales in the observation group were significantly shorter than those in the control group[(3.3±0.5)d vs(4.5±0.5)d,(4.1±0.7)d vs(5.1±0.8)d,(2.1±0.4)d vs(3.2±0.6)d,(4.2±0.6)d vs(5.4±0.8)d](all P<0.001).After treatment,the pulmonary function indexes of both groups were significantly higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group(all P<0.05).After treatment,the serum inflammatory markers of both groups were significantly lower than those before treatment,and the markers in the observation group were significantly lower than those in the control group(all P<0.05).In the control group,1 case of nausea and vomiting and 1 case of abdominal pain occurred,with the incidence of adverse reactions being 3.2％(2/63).In the observation group,1 case of diarrhea and 2 cases of nausea and vomiting occurred,with the incidence of adverse reactions being 4.8％(3/63).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Xiao'er Xuanfei Zhike granules combined with ceftazidime has a reliable therapeutic effect in the treatment of children with bronchopneumonia,which is helpful to relieve clinical symptoms,improve pulmonary function,reduce inflammatory response,and has good safety.

Abstract:Objective To investigate the clinical characteristics of ectopic pregnancy in plateau area.Methods A total of 283 patients with ectopic pregnancy admitted to Department of Gynecology,Lhasa People's Hospital,Tibet Autonomous Region from December 2021 to December 2024 were retrospectively selected,including 192 cases of tubal pregnancy,7 cases of cornual pregnancy,11 cases of uterine scar pregnancy,5 cases of ovarian pregnancy,and 68 cases of unspecified location.The clinical data of the patients were retrospectively analyzed.Results The average age of 283 patients was(31±6)years old,of which219 patients(77.4％)were Tibetan,66 patients(23.3％)were from areas with altitude≥4 000 m,121 patients(42.8％)had a history of abortion,101 patients(35.7％)had a history of pelvic surgery,27 patients(9.5％)had a history of ectopic pregnancy,and 26 patients(9.2％)with intrauterine device placement.A total of 203 cases of 283 patients were treated with laparoscopic or open surgery,including 43 cases(21.2％)with rupture and hemorrhagic shock symptoms,which were included in the combined shock group,including 35 cases(81.4％)of Tibetan patients,11 cases(25.6％)from altitude≥4 000 m,and the remaining 160 cases were included in the non combined shock group.There were no significant differences in age,pregnancy,parity,number of miscarriages,history of ectopic pregnancy,history of pelvic surgery,altitude≥4 000 m,and proportion of Tibetans between the two groups(all P>0.05).The intraoperative blood volume,blood loss,and total effusion volume in the combined shock group were greater than those in the non combined shock group,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower than those in the non combined shock group(all P<0.05).The bleeding volume of patients with ectopic pregnancy rupture hemorrhagic shock was 2 100(1 550,2 550)ml,and the preop-erative hemoglobin value of some patients was still within the normal range.Conclusion The occurrence of ectopic pregnancy complicated with hemorrhagic shock at high altitude has nothing to do with nationality,altitude of living area,number of miscarriages,ectopic pregnancy history or pelvic surgery history.The intraoperative blood volume,blood loss,and total effusion volume of the combined shock group were larger,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower.Due to the compensatory increase of hemoglobin in patients with hypoxia in plateau area,the hemoglobin value of patients with ectopic pregnancy in plateau area often cannot reflect the severity of the disease.It is necessary to pay attention to dynamic monitoring changes and make decisions as soon as possible combined with other examination methods.

Abstract:Heart failure is a syndrome caused by abnormalities in cardiac structure or function,leading to decreased cardiac output or elevated intracardiac pressure,with fluid retention as one of its core pathological mechanisms.Accurate assessment of volume status is crucial for alleviating patient symptoms and reducing the risk of readmission.Traditional volume assessment methods,such as physical examination,natriuretic peptide testing,and right heart catheterization,have limitations.This includes in accuracies invasiveness,or high operational costs.The inferior vena cava(IVC)is the largest-diameter venous system in the human body,and its morphological and dynamic changes can reflect the body's hemodynamic status.In recent years,ultrasound-based measurement of IVC diameter and calculation of IVC variability have provided a non-invasive tool for assessing intravascular volume status and guiding fluid management.With the standardization of assessment protocols and technological advance-ments,the clinical value of IVC parameters in individualized fluid management for patients with heart failure has become increasingly prominent.

Abstract:Objective To explore the correlation and predictive value of the aggregate index of systemic inflammation(AISI)with hypertension in non-overweight or non-obese population.Methods A total of 8 920 non-overweight or non-obese adults who underwent health checkups at Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 1,2021 to September 30,2024 were enrolled.They were divided into hypertension group and control group(non-hypertensive population)according to the presence of hypertension.Due to the skewed distribution of AISI,logarithmic transformation(Log2)was performed for subsequent analysis,and baseline characteristics were observed with hypertension status as the grouping basis.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of AISI for hypertension in non-overweight or non-obese population.Results Among 8 920 non-overweight or non-obese subjects,1 289 were hypertensive patients(hypertension group)and the rest were non-hypertensive(control group).The hypertension group had significantly higher levels of age,body mass index,total cholesterol,triglycerides,low-density lipoprotein cholesterol,fasting blood glucose,serum creatinine,serum uric acid,and Log2 AISI(all P<0.05).In addition,there were statistically significant differences between the two groups in the proportions of drinking history,diabetes mellitus,kidney disease history,other cardio-cerebrovascular disease history,and family history of hypertension(all P<0.05).In the continuous variable analysis,Model 1 without covariate adjustment showed that for each 1-unit increase in Log2 AISI in non-overweight or non-obese individuals,the risk of hypertension increased by 24％.This association remained significant even after full adjustment for covariates(both P<0.001).In the categorical variable analysis,Model 1 without covariate adjustment revealed that individuals in the highest quartile of Log2 AISI had a significantly higher risk of hypertension than those in the lowest quartile,and this association persisted in the fully adjusted Model 3(both P<0.001).ROC curve analysis showed that the area under the curve of Log2 AISI for predicting the risk of hypertension in non-overweight or non-obese population was 0.615(95％confidence interval:0.599-0.629).Conclusion In the non-overweight or non-obese population,AISI is significantly non-linearly and positively correlated with the risk of hypertension and has good predictive efficacy,which can be used for the early diagnosis of hypertension in non-overweight or non-obese individuals.

Abstract:Objective To analyze the improving effect of Sanfu plaster combined with Jiuwei Gujin capsules on immune function in patients with bronchial asthma in remission stage.Methods A total of 103 patients with bronchial asthma in remission stage admitted to Shanxi Traditional Chinese Medicine Hospital from January 2023 to December 2024 were selected as the research objects.They were divided into control group(51 cases)and observation group(52 cases)by random number table method.The control group was treated with budesonide and formoterol fumarate powder for inhalation,while the observation group was treated with Sanfu plaster combined with Jiuwei Gujin capsules on the basis of the control group.Both groups received continuous treatment for 30 d.The clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,disease control status,inflammatory and immune indicators were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[94.2％(49/52)vs 80.4％(41/51)](χ2=4.471,P=0.034).After treatment,the TCM syndrome scores,eosinophil,fractional exhaled nitric oxide,high-sensitivity C-reactive protein and immunoglobulin E levels in both groups were lower than those before treatment,and those in the obser-vation group were lower than those in the control group;the asthma control test scores and immunoglobulin A levels in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P<0.05).Conclusion Sanfu plaster combined with Jiuwei Gujin capsules in adjuvant therapy of patients with bronchial asthma in remission stage can effectively improve TCM syndromes and disease control,with definite clinical efficacy,reduce inflammatory response and regulate immune function.

Abstract:Objective To analyze the diagnostic value of combined detection of serum interleukin-33(IL-33),leukotriene B4(LTB4)and a disintegrin and metalloproteinase 17(ADAM17)in elderly patients with chronic atrophic gastritis(CAG).Methods A retrospective study was conducted on 219 elderly patients who underwent gastroscopy due to abdominal discomfort at the 904th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from September 2022 to September 2024.According to the pathological biopsy results,the patients were divided into CAG group(122 cases)and non-CAG group(97 cases).The CAG group was further subdivided into mild group(36 cases),moderate group(41 cases)and severe group(45 cases)based on the histological grading of gastric mucosal atrophy.Serum levels of IL-33,LTB4 and ADAM17 were detected.Pearson correlation analysis was used to evaluate the correlations between serum IL-33,LTB4 and ADAM17 in CAG patients.The relationships between serum IL-33,LTB4,ADAM17 levels and clinicopathological characteristics of CAG patients were analyzed.Receiver operating characteristic(ROC)curve was used to assess the diagnostic value of single and combined detection of serum IL-33,LTB4 and ADAM17 for elderly CAG.Results Serum levels of IL-33,LTB4,and ADAM17 in the CAGgroup were significantly higher than those in the non-CAG group(all P<0.001).Serum levels of IL-33,LTB4,and ADAM17 showed a gradual upward trend in the mild,moderate,and severe groups(all P<0.05).Pearson correlation analysis revealed that IL-33 was positively correlated with LTB4(r=0.551,P<0.001),IL-33 with ADAM17(r=0.581,P<0.001),and LTB4 with ADAM17(r=0.443,P<0.001).The expressions of serum IL-33,LTB4,and ADAM17 were associated with gastric mucosal atrophy,intestinal metaplasia,chronic inflammation,and dysplasia in CAG patients(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)for the diagnosis of CAG by single detection of serum IL-33,LTB4,ADAM17,and their combined detection was 0.868,0.829,0.758,and 0.908,respectively.The AUC of the combined detection was higher than that of each single indicator(all P<0.05).Conclusion The serum expressions of IL-33,LTB4,and ADAM17 in elderly CAG patients increase with the aggravation of the disease.The combined detection of these three indicators can effectively diagnose elderly CAG patients with different disease severity,providing effective guidance for their early diagnosis,timely treatment,and prevention of further gastric mucosal atrophy.

Abstract:Objective To compare the postoperative safety,recovery quality,and economic burden of tracheal intubation general anesthesia for pediatric oral surgery between outpatient and inpatient settings.Methods A total of 426 children(213 cases in the outpatient group and 213 cases in the inpatient group)admitted to Hospital of Stomatology,Fujian Medical University from November 2022 to August 2025 were retrospectively enrolled.The outpatient group consisted of children who met the ambulatory surgery criteria and were discharged on the same day,while the inpatient group was observed for≥24 h.The primary endpoint was the unplanned medical interven-tion rate within 24 h after surgery(unplanned revisit rate in the outpatient group;unplanned intervention escalation rate in the inpatient group).Secondary endpoints included perioperative complications,pain scores,parental satisfaction,and economic costs,compared between groups;while,multivariate regression analysis was used to adjust for confounding factors such as surgical type.Results No unplanned medical interventions occurred within 24 h after surgery in either group.There were no statistically significant differences between the two groups in the incidence of intraoperative hypoxemia,airway spasm,postoperative complications,parental satisfaction with pain control,or overall satisfaction(all P>0.05).The out-of-pocket anesthesia cost in the outpatient group was significantly higher than that in the inpatient group[(1 668±224)yuan vs(837±79)yuan](P<0.001).Conclusion The outpatient setting is comparable to the inpatient setting in terms of safety for tracheal intubation general anesthesia in pediatric oral surgery,and equivalent family satisfaction with pain management can be achieved.However,due to restrictions in medical insurance policies,the proportion of out-of-pocket expenses in the outpatient setting is significantly higher,which may restrict its clinical promotion.