Abstract:Objective To observe the clinical effect of acupuncture combined with traditional Chinese medicine hot compress at Sishi hour on post-stroke shoulder-hand syndrome(SHS),and its influence on pain score of affected limb,hemorheology and upper limb function.Methods This was a prospective randomized controlled trial.A total of 126 patients with post-stroke SHS admitted to the First Hospital of Hunan University of Chinese Medicine from January 2023 to August 2025 were enrolled.Patients were randomly divided into control group and observation group by random number table method,with 63 cases in each group.One patient in the control group withdrew voluntarily,and 62 cases were finally included.The control group received conventional medication and rehabilitation training,while the observation group was treated with conventional medication and acupuncture combined with traditional Chinese medicine hot compress.Both groups were treated for 8 consecutive weeks.The visual analogue scale(VAS)score,Fugl-Meyer upper limb motor function(U-FMA)score,SHS assessment scale(SHSS)score,traditional Chinese medicine syndrome score,clinical efficacy,root mean square of surface electromyography(sEMG)of upper limb muscles,hemorheological indexes and adverse reactions were compared between the two groups.Results After treatment,the VAS score,SHSS score,traditional Chinese medicine syndrome score,plasma viscosity,whole blood low-shear viscosity and platelet aggregation rate in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).The U-FMA score and root mean square of upper limb muscle sEMG 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).The total effective rate of the observation group was higher than that of the control group[90.5％(57/63)vs 77.4％(48/62)](x2=3.964,P=0.046).There was no significant difference in the incidence of adverse reactions between the two groups(P=1.000).Conclusion Acupuncture combined with traditional Chinese medicine hot compress at Sishi hour can improve hemorheology,relieve pain of affected limb and promote the recovery of upper limb function in patients with post-stroke SHS.

Abstract:Objective To explore the value of serum intestinal fatty acid binding protein(IFABP)combined with D-lactate and ultrasonic score in evaluating the severity of acute gastrointestinal injury(AGI).Methods A prospective study was conducted on 106 patients with AGI admitted to Nanping First Hospital Affiliated to Fujian Medical University from December 2023 to December 2025.The patients were divided into mild group(grade Ⅰ and Ⅱ)and moderate-severe group(grade Ⅲ and Ⅳ)according to the injury degree.All patients underwent detection of serum IFABP and D-lactate as well as abdominal ultrasonography,with ultrasonic scores recorded.Logistic regression analysis and receiver operating characteristic(ROC)curve were used to explore the evaluation value of serum IFABP,D-lactate combined with ultrasonic score for AGI severity.Results Among 106 AGI patients,there were 45 cases(42.4％)of grade Ⅰ,37 cases(34.9％)of grade Ⅱ,22 cases(20.7％)of grade Ⅲ,and 2 cases(1.9％)of grade Ⅳ.The levels of serum IFABP and D-lactate in the moderate-severe group were higher than those in the mild group[(156±42)ng/L vs(106±37)ng/L,(9.6±3.9)mg/L vs(6.3±2.6)mg/L](all P＜0.001),and the proportion of ultrasonic score＞2 was higher than that in the mild group[70.8％(17/24)vs 35.4％(29/82)](P=0.002).The sequential organ failure assessment(SOFA)score and proportion of vasoactive drug use in the moderate-severe group were higher,while the albumin level was lower than those in the mild group(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum IFABP,D-lactate,ultrasonic score alone and their combination for evaluating AGI severity were 0.816,0.748,0.677 and 0.908 respectively.The AUC of the combined three indicators was higher than that of D-lactate and ultrasonic score(Z=2.280,P=0.011;Z=3.177,P=0.001),and there was no significant difference compared with the AUC of serum IFABP(Z=1.503,P=0.067).Multivariate Logistic analysis showed that SOFA score,albumin,vasoactive drugs,serum IFABP,D-lactate and ultrasonic score were independent influencing factors of AGI severity(P＜0.05).Conclusion Serum IFABP combined with D-lactate and ultrasonic score has high value in evaluating the severity of AGI.

Abstract:Objective To investigate the predictive value of left atrial pressure(LAP)on recurrence after catheter ablation in patients with atrial fibrillation complicated by heart failure with preserved ejection fraction(HFpEF).Methods A total of 233 patients with atrial fibrillation complicated by HFpEF who were hospitalized for the first time in Xiangyang Central Hospital,Hubei University of Arts and Science from January 2022 to August 2024,underwent successful catheter ablation and completed follow-up were retrospectively enrolled.According to whether atrial fibrillation recurred during follow-up,patients were divided into non-recurrence group(182 cases)and recurrence group(51 cases).Baseline data were compared between the two groups.Univariate and multivariate Logistic regression analyses were used to identify independent predictors of recurrence,and receiver operating characteristic(ROC)curve was applied to evaluate the predictive efficacy of each indicator.Results There were significant differences in left atrial anterior-posterior diameter,left atrial volume,preoperative LAP and postoperative LAP between the two groups(all P＜0.05).Univariate analysis showed that left atrial anterior-posterior diameter,preoperative LAP,postoperative LAP and left atrial volume were significant predictors of atrial fibrillation recurrence(all P＜0.05).Multivariate analysis showed that preoperative LAP,postoperative LAP,left atrial anterior-posterior diameter and left atrial volume were independent predictors for atrial fibrillation recurrence(all P＜0.05).ROC curve analysis showed that the areas under the curve of preoperative LAP,postoperative LAP,left atrial anterior-posterior diameter,left atrial volume and the combination of the four indicators were 0.864,0.834,0.724,0.804 and 0.923,respectively,and the combined prediction of the four indicators was the best.Conclusion LAP is an independent predictor of atrial fibrillation recurrence after catheter ablation in patients with atrial fibrillation complicated by HFpEF.Combined with left atrial anterior-posterior diameter and left atrial volume,it can further improve the prediction accuracy,which is helpful to identify high-risk patients and guide postoperative management.

Abstract:Ventricular remodeling after myocardial infarction is a key pathological process in the progres-sion of heart failure,in which abnormal activation of the Wnt/β-catenin signaling pathway is the core molecular mechanism driving this process.As a broad-spectrum antifibrotic drug,pirfenidone has shown great potential in cardioprotection,but its specific molecular mechanism has not been fully elucidated.Therefore,this article aims to explore the effect of pirfenidone on inhibiting ventricular remodeling by regulating the Wnt/β-catenin signaling pathway,so as to provide a new perspective for cardioprotection.

Abstract:Thioredoxin interacting protein,also known as vitamin D3 upregulated protein,is an inhibitor of the thioredoxin system.In recent years,numerous studies have confirmed that thioredoxin interacting protein is involved in multiple pathophysiological processes such as oxidative stress,inflammatory response,pyroptosis,and metabolic disorders,and is associated with the occurrence and development of various cardiovascular diseases including atherosclerosis,hypertension,heart failure,diabetic cardiomyopathy,and myocardial ischemia/reperfusion injury.This article aims to elaborate the research progress of thioredoxin interacting protein in the field of cardio-vascular diseases in recent years.

Abstract:Objective To investigate the changes and clinical significance of lysyl oxidase-like protein 2(LOXL2),chemokine ligand-18(CCL-18)and chitinase-like protein 40(YKL-40)levels in patients with connective tissue disease complicated with interstitial lung disease(CTD-ILD)before and after treatment.Methods A total of 90 patients with CTD-ILD admitted to the outpatient and inpatient Departments of Rheumatology and Immunology of The First Affiliated Hospital of Hebei North University from January 2022 to January 2023 were enrolled as observation group.Meanwhile,30 patients with simple connective tissue disease were set as case control group and 30 healthy subjects as healthy control group.According to pulmonary high-resolution CT(HRCT)scores before and after treatment,the 90 patients in the observation group were divided into improved group(38 cases),stable group(31 cases)and deteriorated group(21 cases).The levels of LOXL2,CCL-18,YKL-40 and HRCT scores were compared among all groups before treatment and 12 months after treatment.Spearman correlation analysis was used to analyze the correlation between serum LOXL2,CCL-18,YKL-40 levels and HRCT scores.Receiver operating characteristic(ROC)curve was established to analyze the predictive value of LOXL2,CCL-18 and YKL-40 levels before and after treatment for disease deterioration in CTD-ILD patients.Results Before treatment,the levels of LOXL2,CCL-18,YKL-40,SP-D and KL-6 in the observation group were higher than those in the case control group and healthy control group;the levels of the above indicators in the case control group were higher than those in the healthy control group(all P＜0.05).Before treatment and 12 months after treatment,the levels of LOXL2,CCL-18,YKL-40,SP-D,KL-6 and HRCT scores in the deteriorated group were higher than those in the stable group and improved group,and those in the stable group were higher than those in the improved group(all P＜0.05).In the improved group,the levels of LOXL2,CCL-18,YKL-40,SP-D,KL-6 and HRCT scores at 12 months after treatment were lower than those before treatment(all P＜0.05).Before treatment,LOXL2,CCL-18 and YKL-40 were positively correlated with HRCT scores(r=0.872,0.705,0.617,all P＜0.05).At 12 months after treatment,LOXL2,CCL-18 and YKL-40 were also positively correlated with HRCT scores(r=0.462,0.507,0.481,all P＜0.05).Before treatment,the area under the curve(AUC)of LOXL2,CCL-18 and YKL-40 for predicting disease deterioration in CTD-ILD patients was 0.871,0.880 and 0.792 respectively,and the AUC of combined prediction was 0.960,which was higher than that of single indicator prediction.At 12 months after treatment,the AUC of LOXL2,CCL-18 and YKL-40 for predicting disease deterio-ration was 0.862,0.869 and 0.761 respectively,and the AUC of combined prediction was 0.960,superior to single indicator prediction.Conclusions Serum LOXL2,CCL-18 and YKL-40 are highly expressed in CTD-ILD patients,which are among the pathogenic factors of ILD.Serum LOXL2,CCL-18 and YKL-40 are conducive to the early diagnosis of CTD-ILD and have important value in evaluating disease changes after treatment.

Abstract:Objective To explore the value of TWIST1 gene methylation level in the diagnosis and recurrence detection of bladder cancer patients.Methods A total of 119 patients with bladder cancer and other non-neoplastic diseases admitted to Beijing Anzhen Hospital,Capital Medical University from February to July 2025 were randomly enrolled.The preoperative urinary TWIST1 gene methylation level was compared with postop-erative pathological results,and the value of TWIST1 gene methylation level in the diagnosis and recurrence monitoring of clinical bladder cancer patients was analyzed.Results Among the 119 enrolled patients,65 cases were pathologically confirmed as bladder cancer and 54 cases were non-neoplastic patients.The comparison between postoperative pathological results and urinary TWIST1 gene methylation results showed that urinary TWIST1 gene methylation could reflect the tumor status in most patients.The sensitivity,specificity,positive predictive value and negative predictive value for the diagnosis of bladder cancer were 76.9％,81.5％,83.3％and 74.6％respectively.The diagnostic sensitivity and specificity were 73.5％and 86.5％in male patients,and 87.5％and 70.6％in female patients.In recurrence monitoring,TWIST1 gene methylation detection showed a specificity of 96.0％,a positive predictive value of 92.9％and a sensitivity of 72.2％.The area under the curve of TWIST1 gene methylation detection for diagnosing bladder cancer was 0.864(95％confidence interval:0.796-0.930).Conclusion Urinary TWIST1 gene methylation detection has important value for the diagnosis and recurrence monitoring of bladder cancer.

Abstract:Objective To explore the correlation of serum adipokine progranulin(PGRN)and resistin with inflammatory markers and nutritional indicators in elderly chronic heart failure(ECHF)patients complicated with frailty,and to analyze their diagnostic value.Methods A total of 203 ECHF patients admitted to The Second Hospital of Heilongjiang Province from March 2022 to June 2025 were enrolled as the ECHF group,and 184 age-and gender-matched community residents were selected as the control group.Levels of PGRN and resistin were detected.ECHF patients were further divided into frailty subgroup and non-frailty subgroup according to the complication of frailty.Serum levels of PGRN,resistin and inflammatory markers including interleukin-1 β(IL-1 β),IL-6 and tumor necrosis factor-α(TNF-α)were detected,and nutritional risk screening 2002(NRS 2002)score in the ECHF patients was calculated.Pearson correlation analysis was used to analyze the correlations of serum PGRN and resistin with inflammatory markers and nutritional indicators in ECHF patients complicated with frailty.The influencing factors of frailty in ECHF patients and the diagnostic value of serum PGRN and resistin were analyzed.Results Compared with the control group,serum levels of PGRN and resistin in the ECHF group were increased[(66±17)μg/L vs(44±9)μg/L,(8.1±2.7)μg/L vs(4.2±1.4)μg/L](all P＜0.001).Serum PGRN and resistin were positively correlated with IL-1 β,IL-6,TNF-α and NRS 2002 score in ECHF patients complicated with frailty(all P＜0.001).Advanced age(odds ratio=1.128,P=0.001),prolonged course of heart failure(odds ratio=1.302,P=0.009),New York Heart Association functional class Ⅳ(odds ratio=4.104,P=0.037),elevated PGRN(odds ratio=1.111,P＜0.001)and elevated resistin(odds ratio=1.775,P＜0.001)were independent risk factors for frailty in ECHF patients.The area under the curve of PGRN alone,resistin alone,and their combination for diagnosing frailty in ECHF patients was 0.794,0.807 and 0.898 respectively,and the combined diagnosis showed the optimal efficacy(all P＜0.05).Conclusion The elevated serum levels of PGRN and resistin in ECHF patients complicated with frailty are related to enhanced inflammatory response and malnutrition.The combined detection of serum PGRN and resistin has high diagnostic value for frailty complicated with ECHF.

Abstract:As the most aggressive subtype of breast cancer,triple-negative breast cancer(TNBC)poses great challenges to clinical treatment due to the lack of clear molecular targets and high heterogeneity.As an emerging three-dimensional cell culture model,organoid technology can highly simulate the tissue structure,genetic characteristics and microenvironmental interaction of tumors in vitro,providing a revolutionary tool for basic research,drug screening and clinical transformation of TNBC.This paper systematically reviews the basic principles and development process of organoid technology,focusing on the application potential of organoids in drug sensitivity,novel drug screening and mechanism research of TNBC.Meanwhile,this paper also summarizes the controversies and challenges faced by organoids and prospects their future development directions.By integrating existing research evidence,this paper aims to clarify how organoid technology promotes the research of TNBC and provide theoretical basis and practical guidance for its clinical application.

Abstract:Objective To investigate the effects of remifentanil general anesthesia combined with thoracic paravertebral nerve block on analgesic effect and immune-inflammatory response in elderly patients undergoing renal cancer surgery.Methods A total of 146 elderly renal cancer patients undergoing elective retroperitoneal laparoscopic radical nephrectomy at Inner Mongolia People's Hospital from February 2024 to July 2025 were enrolled.They were divided into control group and observation group by random number table method,with 73 cases in each group.The control group received remifentanil-based general anesthesia,and the observation group received remifentanil-based general anesthesia combined with thoracic paravertebral nerve block.The analgesic effect,mean arterial pressure(MAP),heart rate,immune function indexes,natural killer cells and inflammatory factors at different time points,as well as the incidence of adverse reactions were compared between the two groups.Results There were significant inter-group,time and interaction effects in visual analogue scale(VAS)scores at different states between the two groups(all P＜0.05),and the VAS scores at 12 h,24 h and 48 h after operation in the observation group were lower than those in the control group(all P＜0.05).There were signifi-cant inter-group,time and interaction effects in MAP and heart rate at different time points between the two groups(all P＜0.05),and MAP and heart rate at skin incision in the observation group were lower than those in the control group(all P＜0.05).There were significant inter-group and time effects in CD3+,CD4+,CD8+,CD4+/CD8+ratio and natural killer cells at different time points between the two groups(all P＜0.05).At 24 h after operation,the levels of CD3+,CD4+,CD4+/CD8+ratio and natural killer cells in the observation group were higher than those in the control group,while the level of CDs+was lower(all P＜0.05).There were significant inter-group and time effects in inflammatory factors at different time points between the two groups(all P＜0.05),and the levels of inflammatory factors at 24 h after operation in the observation group were lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[6.8％(5/73)vs 5.5％(4/73)](x2＜0.001,P=1.000).Conclusions Remifentanil general anesthesia combined with thoracic paravertebral nerve block has obvious analgesic effect in elderly patients undergoing renal cancer surgery,which can effectively improve immune function,inhibit inflammatory response and enhance the safety of surgery in elderly renal cancer patients.

Abstract:Objective To investigate the predictive value of plasma platelet factor 4(PF4)and chemokine CX3C receptor 1(CX3CR1)for deep vein thrombosis(DVT)after cesarean section in patients with severe preeclampsia.Methods A total of 302 patients with severe preeclampsia who underwent cesarean section at Shanxi Children's Hospital from March 2020 to December 2024 were prospectively enrolled.According to the occurrence of DVT within 2 weeks after operation,the patients were divided into DVT group(72 cases)and non-DVT group(230 cases).Plasma levels of PF4 and CX3CR1 were measured preoperatively in all patients,and clinical data as well as laboratory indicators including fibrinogen and D-dimer were collected and compared.Pearson correlation analysis method was used to analyze the correlation of PF4 and CX3CR1 with fibrinogen and D-dimer.Multivariate Logistic regression analysis was performed to identify the risk factors of DVT after cesarean section in patients with severe preeclampsia.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of PF4 and CX3CR1 for postoperative DVT.Results Body mass index,proportion of gesta-tional diabetes mellitus,proportion of prolonged bed rest for fetal preservation,fibrinogen and D-dimer levels in DVT group were significantly higher than those in non-DVT group(all P＜0.05).Plasma levels of PF4 and CX3CR1 in DVT group were significantly higher than those in non-DVT group[(6.3±1.9)μg/L vs(3.0±0.7)μg/L,(82±16)ng/L vs(43±10)ng/L](t=22.274,25.139,both P＜0.001).Plasma levels of PF4 and CX3CR1 were positively correlated with fibrinogen and D-dimer in DVT group(all P＜0.001).Multivariate Logistic regression analysis showed that gestational diabetes mellitus,high body mass index,high PF4 and high CX3CR1 were independent risk factors for DVT after cesarean section in patients with severe preeclampsia(all P＜0.05).The area under the curve(AUC)of PF4 and CX3CR1 alone for predicting postoperative DVT was higher than that of gestational diabetes mellitus and body mass index,respectively,and the AUC of the combined prediction of PF4 and CX3CR1 was higher than that of each single indicator(all P＜0.05).Conclusions High preoperative plasma levels of PF4 and CX3CR1 are associated with the occurrence of postoperative DVT in patients with severe preeclampsia.The combination of PF4 and CX3CR1 has high value in predicting the risk of postoperative DVT.

Abstract:Objective To evaluate the association between long-term exposure to different particle sizes[fine particulate matter(PM2.5),inhalable particulate matter(PM10)]and cardiovascular disease(CVD)risk in middle-aged and elderly individuals with metabolic syndrome(MS).Methods Based on the 2011-2018 data from the China Health and Retirement Longitudinal Study,1 959 participants aged ≥60 years were enrolled and divided into non-CVD group(1 445 cases)and CVD group(514 cases)according to CVD status.MS status was classified based on relevant metabolic indicators.Individual exposure levels were estimated using annual average concentrations of PM2.5 and PM10.Participants were divided into four groups(Q1-Q4)according to quartiles of particulate matter concentration,with Q,as the lowest exposure group(control)and Q4 as the highest exposure group,to compare risks at different exposure levels.Cox proportional hazards regression model was applied to assess the effects of PM2.5 and PM10 on CVD incidence risk,and restricted cubic spline was used to analyze the dose-response relationship between average particulate matter concentration and CVD incidence risk.Results High exposure to PM2.5 and PM10 was both significantly associated with elevated CVD incidence risk(both P＜0.05).After stepwise adjustment for sociodemographic factors,lifestyle,physiological indicators and past medical history in multiple models,the independent association of CVD risk remained significant in the Q4 group for PM2.5(hazard ratio=1.60,95％confidence interval:1.22-2.08);a consistent trend was observed for PM10,with significant dose-response relationships in both.Restricted cubic spline analysis showed that the associations of PM2.5 and PM10 concentrations with CVD were significant in non-MS individuals(P=0.009 6,0.001 5)but not significant in MS individuals(both P＞0.05).Conclusions Exposure to PM2.5 and PM10 is positively correlated with CVD incidence risk in middle-aged and elderly individuals.This association exhibits a"ceiling effect"in MS individuals and is more significant in non-MS individuals,suggesting that both may be independent risk factors for CVD.

Abstract:Objective To investigate the effects of proprioceptive neuromuscular facilitation combined with balance training on limb stability,postural adjustment ability and fall risk in patients with brain injury.Methods A total of 98 patients with brain injury admitted to Beijing Rehabilitation Hospital,Capital Medical University from March 2024 to February 2025 were selected and divided into balance training group(received balance training)and neuromuscular facilitation group(received proprioceptive neuromuscular facilitation combined with balance training)according to the random number table method,with 49 cases in each group.Limb stability,postural adjustment ability,fall risk,rehabilitation training compliance and muscle strength were compared between the two groups before and after intervention.Results After intervention,the scores of Fugl-Meyer assessment scale,Tinetti balance and gait scale and rehabilitation training compliance in the neuromuscular facili-tation group were higher than those in the balance training group,while the score of Morse fall assessment scale was lower than that in the balance training group(all P＜0.05).The proportions of grade 0 and grade 1 muscle strength in the medical research council scale in the neuromuscular facilitation group were lower than those in the balance training group[0(0/49)vs 12.2％(6/49),4.1％(2/49)vs 32.7％(16/49)],and the proportions of grade 4 and grade 5 muscle strength were higher than those in the balance training group[24.5％(12/49)vs 6.1％(3/49),14.3％(7/49)vs 2.0％(1/49)](all P＜0.05).Conclusion The comprehensive therapy of proprioceptive neuromuscular facilitation combined with balance training is significantly better than single balance training in the rehabilitation of patients with brain injury,which can more effectively improve limb stability and postural adjustment ability,reduce fall risk,improve muscle strength grade,and achieve higher rehabilitation training compliance.

Abstract:Objective To analyze the differences in arterial partial pressure of carbon dioxide(PaCO2)and the incidence of central sleep apnea(CSA)in patients with chronic heart failure(CHF)at different altitudes,and to explore the related influencing factors for the occurrence of CSA.Methods A total of 78 CHF patients admitted from January 2022 to March 2025 were enrolled,including 48 cases from the Third People's Hospital of Chengdu,Sichuan Province(residents living at a mean altitude of 500 m,low-altitude group)and 30 cases from Litang County People's Hospital,Sichuan Province(residents living continuously at an altitude of 3 900-4 100 m for≥5 years,high-altitude group).The clinical data and relevant clinical indicators of the patients were collected.Multivariate Logistic regression analysis was used to screen the independent risk factors for CSA.Two-way analysis of variance was adopted to evaluate the effects of PaCO2 and altitude on the central sleep apnea index(CSAI),micro-arousal index(MAI)and Epworth sleepiness scale(ESS)score.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive efficacy of PaCO2 for CSA in CHF patients with different heart failure locations at different altitudes.Results Multivariate Logistic regression analysis showed that left heart failure,left ventricular ejection fraction ≤40％,PaCO2 ≤38 mmHg and tricuspid annular systolic excursion ≤12 mm were all independent risk factors for CSA(all P＜0.05).Regardless of PaCO2 levels,there were statistically significant differences in CSAI and ESS scores between the different altitude groups(all P＜0.001).CSAI and ESS scores increased gradually with the elevation of altitude,and there was an interactive effect of altitude and PaCO2 on CSAI(all P＜0.001).Regardless of altitude,there was a statistically significant difference in MAI between the different PaCO2 groups(P＜0.001).MAI increased gradually with the rise of PaCO2,and altitude and PaCO2 had an interactive effect on CSAI(P＜0.001).ROC curve analysis showed that when PaCO2 ≤36.8 mmHg,the area under the curve(AUC)for predicting CSA in patients with left heart failure was 0.918;when PaCO2 ≤35.2 mmHg,the AUC for predicting CSA in patients with right heart failure was 1.000.For patients in the high-altitude area,when PaCO2 ≤36.9 mmHg,the AUC for predicting CSA in patients with left heart failure was 0.964;when PaCO236.0 mmHg,the AUC for predicting CSA in patients with right heart failure was 0.972.Conclusion Altitude and PaCO2 have an interactive effect on CSA-related indicators in CHF patients.The risk of CSA is higher in the high-altitude environment,and PaCO2 can serve as an important indicator for predicting CSA.

Abstract:Pulsed field ablation(PFA)is a non-thermal catheter ablation technique based on irreversible electroporation.With its unique tissue selectivity and safety,PFA has become a research hotspot in the field of arrhythmia treatment.This technology induces irreversible perforation of myocardial cell membranes through high-frequency electric pulses,and achieves targeted myocardial ablation while avoiding damage to adjacent tissues by utilizing the difference in tolerance thresholds to pulsed electric fields between myocardial cells and other tissues(such as blood vessels,nerves,and esophagus).Systematically summarizing the research progress of PFA plant models is crucial for clarifying the biophysical mechanism of PFA,optimizing pulse parameters and ablation strate-gies,and preventing potential complications.This article reviews the research progress of PFA plant models,aiming to provide a theoretical basis for the clinical translation and application expansion of this technology.

Abstract:Magnetocardiography is a high-precision,non-invasive,non-contact detection and analysis technique for magnetic field signals of cardiac electrical activity.Compared with conventional electrocardiography,magnetocardiography has higher temporal and spatial resolution and is not interfered by heterogeneous conduction of human tissues,which can more directly reflect the real electrical activity of cardiomyocytes.In recent years,with the advancement of detection technology and signal analysis methods,magnetocardiography has shown unique value in the mechanistic research,clinical diagnosis,lesion localization,evaluation of therapeutic effect and prognosis of arrhythmias,as well as screening for fetal arrhythmias.This article systematically reviews the physical principles and examination methods of magnetocardiography,focuses on its latest application progress in arrhythmias.Meanwhile,it analyzes the current technical challenges and clinical limitations of magnetocardiography,and prospects its future development directions.

Abstract:Objective To investigate the predictive value of C-reactive protein-triglyceride-glucose index(CTI)for major adverse cardiovascular and cerebrovascular events(MACCE)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods A total of 431 STEMI patients who underwent emergency PCI in Beijing Tiantan Hospital,Capital Medical University from October 2022 to October 2024 were retrospectively enrolled.According to tertiles of CTI,patients were divided into low CTI group(CTI＜5.01,144 cases),middle CTI group(5.01 ≤CTI＜5.56,143 cases)and high CTI group(CTI≥5.56,144 cases).Demographic data,past medical history,laboratory examinations and interventional procedure-related data were collected.The median follow-up time was 28 months,and the primary endpoint was the occurrence of MACCE.MACCE-free survival rates among different CTI groups were analyzed.Cox proportional hazards regression model was used to evaluate the association between CTI and MACCE.Restricted cubic spline(RCS)was applied to analyze the dose-response relationship,and subgroup interaction analysis was performed.Results Survival analysis showed that the incidence of MACCE in the low CTI group was significantly lower than that in the middle and high CTI groups(P=0.039).Cox regression analysis revealed that after adjustment for multiple confounders,each 1-unit increase in CTI as a continuous variable was associated with a 59％increased risk of MACCE(P=0.006);the risks of MACCE in the middle and high CTI groups were 1.94 times(P=0.032)and 2.08 times(P=0.018)that in the low CTI group,respectively.RCS curve indicated a positive correlation between CTI and MACCE risk without significant nonlinearity(Poverall=0.022,Pnonlinear=0.898).Subgroup analysis showed a significant interaction between hypertension history and CTI(P=0.002).The associ-ation between elevated CTI and higher MACCE risk was stronger in patients with hypertension(hazard ratio=3.51,P＜0.001),but not significant in those without hypertension.Conclusion CTI level is associated with the occurrence of MACCE in STEMI patients after emergency PCI,and can be used as a reference index for clinical evaluation of prognostic risk.

Abstract:Objective To analyze the influencing factors for bronchospasm in patients with chronic heart failure(CHF)during metoprolol treatment.Methods A total of 284 CHF patients treated with metoprolol who were admitted to the Affiliated Hospital of Jiangsu University from January 2022 to December 2024 were enrolled as research subjects.According to the occurrence of bronchospasm during treatment,the patients were divided into the bronchospasm group and the non-bronchospasm group,and the clinical data of the patients were collected.Univariate and multivariate Logistic regression analyses were used to screen the independent influencing factors of bronchospasm.A visual nomogram was constructed by R software,and the discrimination ability,calibration and clinical validity of the visual nomogram were evaluated by receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis.Results A total of 284 CHF patients treated with metoprolol were included in this study,and 43 patients developed bronchospasm during treatment,with an incidence rate of 15.1％(43/284).There were statistically significant differences in age,smoking status,history of asthma,complicated chronic obstructive pulmonary disease(COPD),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC)ratio and brain natriuretic peptide(BNP)level between the bronchospasm group and the non-bronchospasm group(all P＜0.05).Multivariate Logistic regression analysis showed that age(odds ratio=1.114,95％confidence interval:1.054-1.178,P＜0.001),smoking(odds ratio=2.839,95％confidence interval:1.266-6.362,P=0.011),history of asthma(odds ratio=3.631,95％confidence interval:1.228-10.737,P=0.020),compli-cated COPD(odds ratio=5.008,95％confidence interval:2.095-11.968,P＜0.001)and BNP level(odds ratio=1.011,95％confidence interval:1.005-1.017,P＜0.001)were independent risk factors for bronchos-pasm in CHF patients during metoprolol treatment,while FEV1/FVC ratio(odds ratio=0.926,95％confidence interval:0.889-0.965,P＜0.001)was an independent protective factor.The area under the curve of the constructed visual nomogram was 0.860(95％confidence interval:0.797-0.923).The calibration curve had a high coincidence with the ideal diagonal line(Hosmer-Lemeshow testx2=7.243,P=0.511),and the decision curve showed a high net benefit value in the threshold probability range of 0-98％.Conclusion Age,smoking,history of asthma,complicated COPD,FEV1/FVC ratio and BNP level are independent influencing factors for bronchospasm in CHF patients during metoprolol treatment.The visual nomogram constructed in this study has good clinical practicability,which can provide a reference for early identification of high-risk patients and optimiza-tion of medication management.

Abstract:As a common gynecological malignancy,cervical cancer is mainly associated with persistent human papillomavirus(HPV)infection.However,there are significant individual differences in the proportion of infected individuals progressing to cancer,suggesting that host genetic factors play a key role in the occurrence and development of the disease.This article reviews various gene polymorphisms affecting cervical cancer susceptibility and their mechanisms.Human leukocyte antigen gene polymorphisms regulate cellular immune responses by affecting the efficiency of antigen presentation.Variations in genes related to innate immunity and inflammatory response can alter the body's ability to clear HPV and inhibit tumors.Polymorphisms of cell cycle regulation and DNA repair genes X-ray repair cross-complementing protein 1 and 3 may lead to decreased repair capacity.High expression of tumor-associated gene breast cancer susceptibility gene 1 interacting protein C-terminal helicase 1 can promote tumor progression through the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway.The deletion type of detoxification metabolism gene glutathione S-transferase M1 weakens the body's detoxification and antioxidant functions,increasing the risk of disease.These genetic variations interact with HPV infection and inflammatory microenvironment,jointly forming a complex genetic susceptibility background of cervical cancer,and providing an important molecular basis for disease risk prediction,high-risk screening,and individualized prevention and treatment.

Abstract:As the terminal stage of cardiovascular diseases,chronic heart failure(CHF)has become a global public health challenge due to its high mortality,readmission rate and medical burden.The early 3 months after discharge is a period of variable condition and high risk for heart failure patients,with a high incidence of death and readmission.In this regard,the 2018 Chinese guidelines for the diagnosis and treatment of heart failure proposed the concept of the"vulnerable phase"of heart failure.Under the guidance of the traditional Chinese medicine theory of"preventing disease before its onset",combined with the characteristics of dynamic evolution of syndromes,constructing an early warning system for the vulnerable phase of heart failure to conduct early risk warning and monitoring for this phase provides a new idea for the integrated prevention and treatment of traditional Chinese and western medicine.