Abstract:Objective To reveal the regulatory mechanism of microRNA(miR)during Chikungunya virus(CHIKV)infection and predict potential therapeutic drugs for CHIKV infection,this study integrating multi-omics analysis methods based on public multi-omics databases of CHIKV.Methods By analyzing multiple datasets(GSE49985,GSE49884,GSE143390)in the Gene Expression Omnibus database,the limma package of R language was used to identify differentially expressed messenger RNAs(DEmRNAs)and differentially expressed miRs(DEmiRs).The miRTarBase,miRDB and TargetScanHuman databases were applied to predict the target genes of DEmiRs,and the miR-mRNA negative regulatory network in CHIKV infection was constructed.Finally,potential therapeutic drugs were predicted based on the EpiMed platform,Connectivity Map database and high-throughput virtual screening.Results A total of 1134 DEmRNAs and 54 DEmiRs were identified in this study.Gene Ontology analysis showed that DEmRNAs were significantly involved in biological processes such as cell cycle,chromosome segregation and protein folding.Kyoto Encyclopedia of Genes and Genomes analysis indicated that DEmRNAs were enriched in pathways including viral infection,protein processing,lysosome and neurodegenerative diseases.The miR-mRNA negative regulatory network contained 29 pairs of up-regulated miR with down-regulated mRNA and 90 pairs of down-regulated miR with up-regulated mRNA.The maximal clique centrality algorithm in the cytoHubba plug-in of Cytoscape software was used to screen the predicted target genes and construct a sub-regulatory network.Through drug prediction,94 candidate drugs were identified by the EpiMed platform and 2907 candidate drugs were screened out by the Connectivity Map database.Comprehensive evaluation was performed via high-throughput virtual screening,and finally 5 potential therapeutic drugs associated with typical clinical symptoms of CHIKV infection were determined,including clonazepam,nevirapine,itracon-azole,pimecrolimus and meloxicam.Conclusions This study constructed the CHIKV infection-related miR-mRNA negative regulatory network and screened key genes,and further predicted 5 potential candidate drugs by combining drug repurposing and virtual screening,which provides systems biology clues and candidate resources for targeted intervention of CHIKV.

Abstract:Type 2 diabetes mellitus is a complex metabolic disease with an increasing prevalence year by year,and its various complications have attracted wide attention from researchers.Diabetic gastrointestinal dysfunction can present as hyperfunctional symptoms such as nausea,vomiting and diarrhea,or hypofunctional symptoms including early satiety,abdominal distension and constipation.These symptoms occur intermittently and alternately,often accompanied by psychological problems such as anxiety and depression,which seriously affect patients'quality of life.However,due to its non-fatal nature,this field has not received sufficient attention,and its pathogenesis remains incompletely clear.As the second largest genome of humans,gut microbiota plays an important role in the development of metabolic diseases,especially type 2 diabetes mellitus.This article reviews the relationship between gut microbiota and gastrointestinal dysfunction in type 2 diabetes mellitus,aiming to provide a scientific basis for improving diabetes-induced gastrointestinal dysfunction by targeting gut microbiota.

Abstract:Post-infarction ventricular septal rupture(PIVSR)is a rare but fatal mechanical complication of acute myocardial infarction(AMI).In the reperfusion era,its incidence has decreased to below 1％,yet once it occurs,the mortality rate remains extremely high(ranging from 40％to 90％).The core pathophysiology is the rupture of the transmural infarct zone,leading to left-to-right shunt and rapid hemodynamic deterioration.The clinical manifestation is mostly sudden exacerbation of the condition after AMI,accompanied by a new-onset cardiac murmur,and bedside echocardiography is the preferred diagnostic method.Treatment requires multidisciplinary collaboration,with individualized selection of medications,mechanical circulatory support(such as intra-aortic balloon pump,extracorporeal membrane oxygenation),and ultimately surgical repair or transcatheter closure as the definitive treatments.The timing of surgery is controversial and requires balancing hemodynamic stability and the degree of tissue fibrosis.The prognosis is extremely poor,affected by multiple factors such as advanced age,cardiogenic shock,rupture location and surgical timing.This paper summarizes and discusses the epidemiology,pathophysiology,diagnosis,treatment and prognosis of PIVSR to guide clinical practice.

Abstract:Objective To investigate the correlation between serum peroxisome proliferator-activated receptor γ coactivator 1α(PGC-1α)and soluble CD40 ligand(sCD40L)levels with cognitive impairment and their predictive value in patients with acute cerebral infarction(ACI)complicated with cerebral microbleeds.Methods A total of 291 patients with ACI complicated with cerebral microbleeds admitted to the Department of Neurology,363 Hospital from June 2021 to March 2025 were enrolled as research subjects.According to the presence or absence of cognitive impairment,the patients were divided into the cognitive impairment group(124 cases)and non-cognitive impairment group(167 cases).Serum levels of PGC-1α and sCD40L were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to identify the influencing factors for cognitive impairment in patients with ACI complicated with cerebral microbleeds.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the combined prediction model constructed based on PGC-1α and sCD40L for cognitive impairment in patients with ACI complicated with cerebral microb-leeds.Results The serum PGC-1α level in the cognitive impairment group was significantly lower than that in the non-cognitive impairment group[(0.58±0.12)μg/L vs(0.85±0.10)μg/L],while the serum sCD40L level was significantly higher than that in the non-cognitive impairment group[(330±59)ng/L vs(226±21)ng/L](both P＜0.001).Multivariate Logistic regression analysis showed that high National Institutes of Health Stroke Scale(NIHSS)score and high sCD40L level were risk factors for cognitive impairment in patients with ACI complicated with cerebral microbleeds,while high PGC-1α level was a protective factor(all P＜0.05).A combined prediction model for cognitive impairment in patients with ACI complicated with cerebral microbleeds was constructed based on the probability risk model derived from the above multivariate regression:Logit[P/(1-P)]=-0.166+0.141 × NIHSS score-0.536 × PGC-1α+0.716 × sCD40L.ROC analysis with the model value as the predictive effect size showed that the area under the curve of the combined prediction model was 0.828(95％confidence interval:0.673-0.988),with a sensitivity of 84.7％and specificity of 82.0％.Conclusion Decreased serum PGC-1α level and increased sCD40L level are associated with cognitive impairment in patients with ACI complicated with cerebral microbleeds.The combined prediction model constructed based on PGC-1α and sCD40L can well evaluate the risk of cognitive impairment in these patients.

Abstract:Post-traumatic osteomyelitis is an infectious lesion caused by pathogenic microorganisms invading and multiplying in bone tissue after trauma,with such clinical challenges as delayed diagnosis,refractory infection,difficult debridement planning and complex defect repair.At present,most patients have poor therapeutic outcomes due to delayed diagnosis and difficulty in controlling infection and surgical defects,so new diagnostic and therapeutic methods are urgently needed to improve prognosis.In view of this,this paper integrates the latest domestic and international research in recent years,focusing on the therapeutic advances in rapid diagnosis,antibacterial therapy and surgical reconstruction,aiming to provide new ideas for clinical practice and research.

Abstract:Objective To observe the effect of proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitor on lipoprotein(a)level in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 60 STEMI patients admitted to Liuzhou Workers'Hospital,Guangxi Zhuang Autonomous Region from January to July 2024 were enrolled.The patients were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.Both groups received standard treatment,and the observation group was subcutaneously injected with evolocumab 140 mg immediately after primary percutaneous coronary intervention(PPCI)on the basis of standard treatment.The levels of peripheral blood PCSK9 and lipoprotein(a)were measured before PPCI as well as on the 3rd,7th and 14th days after PPCI.The differences between the two groups were compared,and the correlation between PCSK9 and lipoprotein(a)was analyzed.Results On the 3rd,7th and 14th days after surgery,the serum PCSK9 concentrations in both groups were lower than those before surgery.Compared with the control group,the serum PCSK9 concentration in the observation group showed a faster and more significant downward trend,and the PCSK9 concentrations in the observation group were lower than those in the control group on the 3rd,7th and 14th days after surgery(all P＜0.05).On the 14th day after surgery,the lipoprotein(a)level in the observation group was significantly lower than that in the control group[169.5(108.3,194.7)mg/L vs 224.7(140.1,308.5)mg/L](Z=-4.482,P＜0.001).Spearman correlation analysis showed that serum PCSK9 concentration was significantly positively correlated with lipoprotein(a)concentration in STEMI patients(r=0.248,P＜0.001).Conclusion Administration of PCSK9 inhibitor within 24 hours after PPCI can significantly accelerate lipoprotein(a)metabolism,with a 33.8％reduction on the 14th day after surgery,which is significantly superior to standard treatment alone.The decrease of lipoprotein(a)presents a delayed acceleration mode and is closely related to the degree of PCSK9 inhibition,which provides a new path reference for precise residual risk management in patients with STEMI.

Abstract:Objective To evaluate the clinical efficacy of moist exposed burn ointment(MEBO)combined with triamcinolone acetonide and econazole nitrate cream in the treatment of severe incontinence-associated dermatitis(IAD)complicated with fungal infection.Methods Patients with severe I AD complicated with fungal infection who were treated in the Department of Rehabilitation Medicine,the First Affiliated Hospital of Guangxi University of Science and Technology from June 2021 to December 2023 were enrolled and divided into observation group and control group by random number table method.A total of 103 patients were finally included,with 48 cases in the control group and 55 cases in the observation group.The control group was treated with MEBO applied to the damaged skin and surrounding erythema;the observation group was treated with triamcinolone acetonide and econazole nitrate cream on the erythema around the skin lesions and MEBO on the damaged skin,for a total of 7 d.The skin lesion score and pain score before and after treatment were compared between the two groups,and the curative effect was calculated as the outcome of the study.Results In the control group,the skin lesion score on admission was(6.1±1.1),which decreased to(3.5±1.2)after treatment,with a difference of(2.6±1.8).In the observation group,the skin lesion score on admission was(6.1±1.2),which decreased to(2.2±1.2)after treatment,with a difference of(3.9±1.5).There was no significant difference in skin lesion score on admission between the two groups(P=0.878).The skin lesion score after treatment in the observation group was lower than that in the control group,and the difference in skin lesion score before and after treatment was greater than that in the control group(all P＜0.001).The total effective rate of the observation group was higher than that of the control group[89.1％(49/55)vs 56.2％(27/48)](P=0.002).In the control group,the pain score on admission was(5.1±1.6),which decreased to(3.2±1.6)after treatment,with a difference of(1.8±2.1).In the observation group,the pain score on admission was(4.8±1.5),which decreased to(2.1±1.1)after treatment,with a difference of(2.7±1.9).There was no significant difference in pain score on admission between the two groups(P=0.423).The pain score after treatment in the observation group was lower than that in the control group(P＜0.001),and the difference in pain score before and after treatment was greater than that in the control group(P=0.025).Conclusion MEBO combined with triamcinolone acetonide and econazole nitrate cream has a significant effect in the treatment of severe IAD complicated with fungal infection,which can improve skin lesions and relieve pain,providing an effective option for skin care and infection treatment in patients with severe IAD.

Abstract:Objective To investigate the value of different risk factors in health management for predicting the risk of atherosclerotic cardiovascular disease(ASCVD).Methods Data of 1 679 employees who underwent annual physical examination in a unit in Xi'an City,Shaanxi Province from February 1 to April 30,2023 were retrospectively analyzed.Relevant data were collected,and the included population was divided into low-risk,intermediate-risk,high-risk,very high-risk and ultra-high-risk groups according to the overall risk assessment process of ASCVD in Chinese adults.Low-risk and intermediate-risk were defined as non-high-risk,while high-risk,very high-risk and ultra-high-risk were defined as high-risk.General data were compared between high-risk and non-high-risk populations.Multivariate Logistic regression was used to analyze the relationship between emotional factors(anxiety/depression status),inflammatory indicators[systemic immune-inflammation index(SII),systemic inflammatory response index(SIRI)and systemic inflammation aggregation index(AISI)]and high ASCVD risk.Restricted cubic spline model was used to analyze the potential dose-response association between inflammatory indicators and high ASCVD risk.Receiver operating characteristic curve and De-long test were used to evaluate the diagnostic and predictive value of inflammatory indicators for high ASCVD risk.Results There were statistically significant differences between non-high-risk population(1 419 cases)and high-risk population(260 cases)in gender,age,SII,SIRI,AISI,anxiety score,depression score and other aspects(all P＜0.05).Multivariate Logistic regression analysis showed that after fully adjusting relevant variables,anxiety and depression scores were not associated with high ASCVD risk(all P＞0.05),while SII,SIRI and AISI were associated with high ASCVD risk(all P＜0.05).Restricted cubic spline model analysis showed a linear correlation between SII(Poverall＜0.001,Pnon-linear=0.074)and high risk,and nonlinear correlations between SIRI(Poverall＜0.001,Pnon-linear=0.024),AISI(Poverall＜0.001,Pnon-linear=0.006)and high risk.SII,SIRI and AISI all had predictive value for high ASCVD risk(all P＜0.05),with areas under the curve of 0.562,0.630 and 0.611,respectively.Conclusion The retrospective study of physical examination data suggests that emotional factors(to some extent)and complete blood cell-related inflammatory indexes have predictive value for high ASCVD risk.

Abstract:Objective To analyze the correlation between preoperative low-density lipoprotein cholesterol(LDL-C)and triple-negative breast cancer(TNBC),and to explore its predictive value for disease-free survival(DFS)and survival status of TNBC patients.Methods A total of 120 patients with TNBC,136 patients with benign breast tumors and 155 healthy physical examinees admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2010 to December 2020 were enrolled.General data of each group were compared.Receiver operating characteristic curve was used to determine the predictive value and optimal cut-off value of LDL-C for TNBC.Univariate and multivariate Cox regression analyses were applied to analyze the influencing factors of DFS and overall survival in TNBC patients.Results The LDL-C level in the TNBC group was significantly higher than those in the healthy examination group and benign breast tumor group[2.97(2.46,3.45)mmol/L vs 2.48(2.03,2.82),2.48(2.09,2.98)mmol/L](both P＜0.05).The area under the receiver operating characteristic curve of LDL-C for predicting TNBC was 0.711,and the optimal cut-off value was 2.83 mmol/L.TNBC patients were divided into low concentration group(＜2.83 mmol/L,50 cases)and high concentration group(≥2.83 mmol/L,70 cases)according to the cut-off value.LDL-C level was significantly correlated with age,menopausal and lymph node metastasis(all P＜0.05).Multivariate analysis showed that lymph node metastasis and LDL-C were independent risk factors for DFS and overall survival in TNBC patients(all P＜0.05).The survival rate of TNBC patients decreased with the increase of LDL-C level(P＜0.05).Conclusions TNBC patients have relatively elevated LDL-C levels.Both LDL-C and lymph node metastasis affect DFS and overall survival of TNBC patients,and LDL-C possesses important predictive value for the prognosis of TNBC.

Abstract:Objective To compare the clinical characteristics among patients with rheumatic autoimmune diseases(RADs)complicated with congenital heart disease(CHD),patients with isolated CHD and patients with isolated RADs,and to preliminarily explore the safety of immunosuppressants in the complicated population.Methods A total of 34 patients diagnosed with RADs complicated with CHD in The Second Hospital,Lanzhou University from March 2022 to June 2025 were retrospectively enrolled as the complicated group.According to a 1∶2 matching(based on age,gender,type of RADs and time of diagnosis),68 patients with isolated RADs without structural heart disease were selected as the control group(isolated RADs group)from the same period.Another 71 patients with isolated CHD(isolated CHD group)were enrolled in the same period.Baseline data,clinical symptoms,cardiac structure and function parameters,and adverse events were collected and compared among the three groups.Results Patients in the complicated group had diverse types of CHD but generally mild defects,and 91.2％(31/34)of them did not require cardiac intervention,which was in sharp contrast to the isolated CHD group,showing significant phenotypic differences.Cardiac structure and function evaluation showed that patients in the complicated group had more significant cardiac remodeling.The left ventricular end-diastolic diameter and main pulmonary artery diameter in the complicated group were significantly larger than those in the isolated CHD group[45.0(43.0,48.0)mm vs 44.0(41.0,46.0)mm,22.0(22.0,26.0)mm vs 22.0(20.0,23.0)mm](both P＜0.05).Meanwhile,the ejection fraction was significantly lower than that in the isolated CHD group 65％(63％,65％)vs 66％(64％,69％)](P＜0.05),and pulmonary artery systolic pressure was significantly higher than that in the isolated RADs group[27.5(25.0,35.0)mmHg vs 25.0(22.0,25.0)mmHg](P＜0.001).Among 30 patients in the complicated group treated with immunosuppressants,cardiac function indicators remained stable after a median follow-up of 15 months.The incidence of severe infection was 3.3％(1/30),and there were no treatment-related heart failure,thromboembolism or death events.Conclusion Cardiac defects in patients with RADs complicated with CHD are usually milder,and the vast majority do not require cardiac intervention.This is significantly different from the isolated CHD population admitted due to symptoms.In this context,immunosuppressive therapy for controlling RADs shows acceptable safety under close monitoring.A treatment strategy focusing on rheumatic immune disease management and individualized evaluation of cardiac intervention needs should be adopted for this special population.

Abstract:Objective To compare the efficacy and safety of percutaneous transluminal coronary angio-plasty(PTCA)alone,drug-eluting stents(DES)and drug-coated balloons(DCB)in patients with coronary atherosclerotic heart disease in the real world.Methods A retrospective cohort study was conducted.Patients with coronary heart disease who underwent interventional therapy in Baoding No.1 Central Hospital,Hebei Province from January 2022 to October 2024 were enrolled and divided into PTCA group,DES group and DCB group according to surgical methods.Propensity score matching was used to balance baseline data among groups at a ratio of 1∶1∶1,and finally 70 patients were included in each group.The primary efficacy endpoint was major adverse cardiovascular events(MACE,including cardiac death,non-fatal myocardial infarction and ischemia-driven target lesion revascularization)within 1 year after operation.Safety endpoints included bleeding academic research consortium type 2-5 bleeding and in-stent thrombosis.Results The surgical success rates were high in all three groups[92.9％(65/70)in PTCA group vs 97.1％(68/70)in DES group vs 98.6％(69/70)in DCB group,P=0.185].During follow-up,there was no significant difference in the incidence of MACE among PTCA group,DES group and DCB group[20.0％(14/70)vs 17.1％(12/70)vs 8.6％(6/70)](P=0.147).In terms of safety,the incidence of bleeding events was lower in PTCA group[10.0％(7/70)],and no in-stent thrombosis occurred.Multivariate Cox regression analysis showed that age(per 1-year increase),diabetes mellitus,acute coronary syndrome,lesion type(B2/C type)and target lesion vessel being left anterior descending artery were risk factors for MACE(all P＜0.05).Conclusion In real-world clinical practice,in a propensity score-matched cohort of coronary heart disease patients,PTCA alone,as a representative of the"intervention without implantation"concept,shows favorable application value in specific lesions.Its surgical success rate is comparable to that of DES and DCB,and it has safety advantages of lower bleeding risk and zero in-stent thrombosis.Revascularization strategies should be reasonably selected according to lesion characteristics and individual patient conditions,and PTCA remains an important treatment option for specific populations.

Abstract:Objective To investigate the clinical effect of transcutaneous electrical acupoint stimulation(TEAS)combined with auricular point pressing with beans in the treatment of postoperative pain in liver cancer patients after transarterial chemoembolization(TACE).Methods A total of 207 liver cancer patients who underwent TACE in the Second Affiliated Hospital of Naval Medical University from January to December 2023 were enrolled and divided into control group(103 cases,treated with TEAS)and observation group(104 cases,treated with auricular point pressing with beans on the basis of control group)according to random number table method.The clinical efficacy,postoperative pain degree,liver function indexes,quality of life and safety were compared between the two groups after different treatments.Results The total effective rate of the observation group was higher than that of the control group,with statistically significant difference[94.2％(98/104)vs 81.6％(84/103)](x2=7.832,P=0.005).At 7 d after operation,the visual analogue scale score,alanine aminotransferase,aspartate aminotransferase and total bilirubin levels in the observation group were lower than those in the control group,and the quality of life scale score of liver cancer patients was higher than that in the control group(all P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group(P＞0.05).Conclusion TEAS combined with auricular point pressing with beans has an outstanding effect in the treatment of postoperative pain in liver cancer patients after TACE,which can significantly reduce postoperative pain degree,improve liver function and quality of life with favorable safety.

Abstract:Objective To analyze the correlations of the expression levels of CXC chemokine receptor 3(CXCR3),CXC chemokine ligand 10(CXCL10)and CXCL11 with CD8+T cell differentiation and disease severity in patients with pulmonary tuberculosis.Methods A total of 107 patients with pulmonary tuberculosis treated in Hebei Chest Hospital from December 2022 to October 2023 were enrolled and divided into mild group(42 cases),moderate group(35 cases)and severe group(30 cases)according to disease severity.General clinical data were collected.Within 48 h after enrollment,the levels of CXC chemokines including CXCR3,CXCL10 and CXCL11,as well as CD8+T cell differentiation subset indicators such as naive T cells(Tn),central memory T cells(Tcm),effector memory T cells(Tem)and terminally differentiated effector T cells(Temra)were detected.Multiple linear regression,generalized additive model(GAM),ordered Logistic regression,receiver operating characteristic(ROC)curve,restricted cubic spline(RCS)and mediation effect analysis were adopted for correlation analysis.Results With the increase of disease severity in pulmonary tuberculosis patients,the levels of CXCR3,CXCL10,CXCL11,Temra,programmed cell death protein 1,T cell immunoglobulin and mucin domain-containing molecule 3,lymphocyte activation gene 3,tumor necrosis factor-α and interferon-γ increased gradually,while body mass index,Tn and Tcm levels decreased correspondingly(all P＜0.05).Multiple linear regression analysis showed that CXCR3,CXCL10 and CXCL11 were positively correlated with Temra levels(all P＜0.05),and negatively correlated with Tn and Tcm levels(all P＜0.05).Mediation effect analysis indicated that CXCR3,CXCL10 and CXCL11 exerted significant positive total effects on disease severity of pulmonary tuberculosis patients.Tn and Temra played partial mediating roles between CXCR3,CXCL10,CXCL11 and disease severity(all P＜0.05),and Tcm had a partial mediating effect between CXCR3 and disease severity(P＜0.05).ROC curve analysis revealed that CXCR3,CXCL10 and CXCL11 had good predictive efficacy for the progression from mild to moderate-severe pulmonary tuberculosis and from mild-moderate to severe pulmonary tuberculosis,and the combined detection of the three indicators achieved better predictive performance.RCS curve analysis showed that the risk of progressing to severe pulmonary tuberculosis increased linearly with the elevation of CXCR3,CXCL10 and CXCL11 levels(all P＜0.05).Conclusions The levels of CXCR3,CXCL10 and CXCL11 in pulmonary tuberculosis patients are closely correlated with CD8+T cell differentiation and disease severity.CXC chemokines have high predictive value for the severe progression of pulmonary tuberculosis,which are expected to serve as potential biomarkers and provide a new direction for immunotherapy of pulmonary tuberculosis.

Abstract:Objective To explore the effects of intermittent hypoxic exposure combined with aerobic exercise on physical function in overweight or obese children.Methods A total of 38 overweight or obese children(26 boys and 12 girls)were recruited in Beijing Xiaotangshan Hospital from July 2023 to August 2024.A self-controlled before-and-after study design was adopted.All participants received a 3-week intervention of intermittent hypoxic exposure combined with aerobic exercise.Changes in body weight,body mass index,fat mass,body fat percentage,blood lipids,serum uric acid and fatty liver status were compared before and after intervention.Results After intervention,the overall levels of body weight,body mass index,fat mass,body fat percentage,serum total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol and serum uric acid were significantly lower than those before intervention(all P＜0.05).Among the 38 children,16 cases were complicated with fatty liver(6 boys and 10 girls).Before intervention,the severity of fatty liver was mild in 3 cases(18.8％)and moderate in 13 cases(81.2％).After intervention,there were 5 cases without fatty liver(31.3％),10 mild cases(62.5％)and 1 moderate case(6.2％).The severity of fatty liver was significantly improved after intervention(Z=-2.646,P=0.008).Conclusion Intermittent hypoxic exposure combined with aerobic exercise can help improve body shape and regulate physical metabolic function in overweight or obese children.

Abstract:Objective To investigate the clinical effect of Feining granules combined with ambroxol hydrochloride in the treatment of acute exacerbation of chronic bronchitis and its influence on inflammatory factors.Methods A total of 105 patients with acute exacerbation of chronic bronchitis admitted to the First Affiliated Hospital of Wenzhou Medical University from April 2023 to June 2025 were selected for the study.Patients were divided into control group(52 cases)and observation group(53 cases)by random envelope method.The control group received intravenous ambroxol hydrochloride for injection,15 mg per time,twice a day.On the basis of the control group,the observation group was given oral Feining granules,5 g per time,three times a day,for 2 consecutive weeks.The clinical efficacy of the two groups was observed,and the remission time of clinical symptoms,pulmonary function indexes[forced expiratory volume in one second(FEV,),forced vital capacity(FVC),peak expiratory flow(PEF)and FEV1/FVC ratio],serum inflammatory factors[interleukin-4(IL-4),IL-6,IL-8 and tumor necrosis factor-α(TNF-α)]and adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation group was significantly higher than that of the control group[94.3％(50/53)vs 80.8％(42/52)](P=0.035).The remission time of cough,expectoration,wheezing and wheeze rales in the observation group was significantly shorter than that in the control group[(3.71±0.85)d vs(5.37±1.09)d,(3.46±0.45)d vs(4.65±0.71)d,(2.15±0.26)d vs(3.85±0.78)d,(1.96±0.34)d vs(3.12±0.59)d](all P＜0.001).After treatment,FEV1,PEF and FEV1/FVC ratio in both groups and FVC in observation group were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).After treatment,the serum levels of IL-4,IL-6,IL-8 and TNF-α in both groups were lower than those before treatment,and the serum inflammatory factor levels in the observation group were significantly lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.979).Conclusion The combination of Feining granules and ambroxol hydrochloride has an outstanding clinical effect on acute exacerbation of chronic bronchitis.It can shorten the remission time of clinical symptoms,improve pulmonary function and inflammatory response with high safety.

Abstract:Whipple's disease is a systemic infectious disease caused by the Gram-positive bacterium Tropheryma whipplei(TW).This article analyzed the clinical characteristics,auxiliary examinations,diagnosis and treatment process,and prognosis of a 5-month-old male infant with TW pneumonia,and reviewed relevant literature to improve pediatric clinicians' understanding of this disease.The infant presented with chronic cough.Tropheryma whipplei was detected by metagenomic next-generation sequencing of bronchoalveolar lavage fluid(BALF-mNGS).The patient improved after treatment with penicillin combined with compound sulfamethoxazole and achieved a favorable prognosis during regular follow-up.TW pulmonary infection lacks specific clinical manifestations and is difficult to detect by routine examinations.Early application of BALF-mNGS is recommended for pathogen identification,so as to conduct targeted anti-infection treatment timely,improve survival rate and reduce recurrence rate.

Abstract:Objective To explore the correlations of microRNA-214-3p(miR-214-3p)and long non-coding RNA MT1JP(lncRNA MT1JP)with clinicopathological features and prognosis in patients with cervical cancer.Methods A total of 116 patients with cervical cancer(cervical cancer group)and 100 healthy physical examinees(control group)admitted to Affiliated Hospital of Guangdong Medical University from June 2018 to June 2022 were retrospectively enrolled.The serum levels of miR-214-3p and lncRNA MT1JP were compared between the two groups,and their associations with clinicopathological parameters were analyzed.According to 3-year follow-up outcomes,enrolled patients were divided into death group(34 cases)and survival group(82 cases).Clinical data as well as miR-214-3p and lncRNA MT1JP levels were compared between subgroups.Multivariate Cox regression was performed to analyze the independent correlation of the two indicators with all-cause mortality risk.Restricted cubic spline(RCS)combined with threshold effect analysis was used to assess dose-response relationships.Pearson correlation test was adopted to evaluate the correlation between miR-214-3p and lncRNA MT1JP.Kaplan-Meier survival curves were plotted to compare survival rates stratified by different expression levels of the two biomarkers.Results Serum miR-214-3p was significantly upregulated while lncRNA MT1JP was downregulated in cervical cancer group relative to control group(both P＜0.05).The expression levels of miR-214-3p and lncRNA MT1JP were significantly correlated with depth of tumor invasion,lymph node metastasis,International Federation of Gynecology and Obstetrics(FIGO)stage,pathological grade,vascular invasion and tumor differentiation(all P＜0.05).Compared with survival group,death group presented higher proportion of patients with invasive depth over half of myometrium,lymph node metastasis,FIGO stage Ⅲ-Ⅳ,pathological grade G3 and poor differentiation,accompanied by elevated miR-214-3p and reduced lncRNA MT1JP(all P＜0.05).After adjusting for confounding factors,miR-214-3p and lncRNA MT1JP were independently correlated with mortality risk(both P＜0.001).miR-214-3p was negatively correlated with lncRNA MT1 JP(r=-0.426,P＜0.05).RCS analysis revealed a non-linear association between the two indicators and patient prognosis(both P＜0.001).The overall 3-year survival rate was 70.69％.Patients with miR-214-3p ≥1.23 had poorer 3-year survival than those with miR-214-3p＜1.23;patients with lncRNA MT1JP≤1.58 showed lower survival versus those with lncRNA MT1JP＞1.58(both P＜0.05).Conclusion Serum miR-214-3p is overexpressed and lncRNA MT1JP is underexpressed in cervical cancer patients.Both molecules are closely linked to multiple clinicopathological features related to tumor invasion and metastasis,and can serve as potential biomarkers for disease onset prediction and prognostic evaluation of cervical cancer.

Abstract:Objective To analyze the predictive value of serum chemerin level trajectory in the second and third trimesters for pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 210 GDM patients admitted to the Affiliated Hospital of Guizhou Medical University from January 2023 to July 2024 were enrolled as the GDM group,and 105 healthy pregnant women as the control group.Serum chemerin levels at 24 weeks,32 weeks of gestation and before delivery were compared between the two groups.Latent class trajectory modeling(LCTM)was used to identify subgroups with different serum chemerin trajectories in the GDM group.All GDM patients were followed up until delivery to record adverse pregnancy outcomes.Serum chemerin levels,baseline characteristics and incidence of adverse pregnancy outcomes were compared among different trajectory subgroups.Logistic regression was used to analyze the correlation between chemerin trajectory and adverse pregnancy outcomes.Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of chemerin trajectory for adverse pregnancy outcomes.Results Serum chemerin levels showed no significant change at 24 weeks,32 weeks and before delivery in the control group(P＞0.05),but decreased gradually in the GDM group(P＜0.001).Serum chemerin levels in the GDM group were significantly higher than those in the control group at all three time points(all P＜0.001).LCTM identified three optimal trajectory subgroups:T1(low to relatively low chemerin level,n=65),T2(moderately high to low level,n=92),and T3(persistently high level,n=53).The overall incidence of adverse pregnancy outcomes in the GDM group was 24.8％(52/210).Pre-pregnancy body mass index,2 h 75 g oral glucose tolerance test(OGTT)blood glucose,glycated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance,serum chemerin levels at all time points and adverse pregnancy outcome rate were highest in T3,followed by T2 and then T1(all P＜0.05).OGTT 2 h glucose,HbA1c and chemerin trajectory were independent risk factors for adverse pregnancy outcomes(all P＜0.05).After adjustment for OGTT 2 h glucose and HbA1c,chemerin trajectory remained an independent risk factor(P＜0.05).The area under the curve of persistently high chemerin trajectory for predicting adverse pregnancy outcomes was 0.852,with a sensitivity of 80.77％,specificity of 84.81％and Youden index of 0.656.Conclusions Serum chemerin trajectory in the second and third trimesters is significantly correlated with pregnancy outcomes in GDM patients.A persistently high chemerin level trajectory has high predictive efficacy for adverse pregnancy outcomes.

Abstract:Polycystic ovary syndrome(PCOS)is a common reproductive endocrine and metabolic disorder disease in women of childbearing age.Its etiology and pathophysiological mechanism have not been fully elucidated,and clinical management is challenging.In recent years,studies on the interaction between intestinal flora and host metabolism and endocrine have provided a new perspective for revealing the etiology and pathogenesis of PCOS.Intestinal flora may participate in the occurrence and development of PCOS through various pathways such as affecting intestinal barrier function,hormone metabolism,short-chain fatty acid production and inducing chronic inflamma-tion.Correspondingly,intervention strategies targeting intestinal microecological regulation(such as dietary intervention,prebiotics,probiotics and natural polyphenols)have shown potential in improving PCOS symptoms,which has been supported by preliminary evidence from animal experiments and initial clinical studies.This article systematically reviews the mechanism of intestinal flora dysbiosis in PCOS and the research progress of prevention and treatment strategies based on intestinal microecological regulation,aiming to provide theoretical reference and ideas for the development of new strategies for PCOS prevention and treatment.

Abstract:Objective To explore the impact of active telephone follow-up within 1 month after catheter ablation for atrial fibrillation(AF)on perioperative medication adherence,incidence of clinical outcome events and rehospitalization rates based on routine follow-up.Methods A retrospective cohort study was conducted.A total of 547 patients who underwent elective AF surgery at Beijing Anzhen Hospital,Capital Medical University in January 2025 were enrolled as the intervention group,receiving one active telephone follow-up within 1 month after surgery;893 patients who underwent elective surgery at our hospital in February 2025 were included as the control group,only receiving routine first outpatient follow-up at 3 months after surgery.The telephone follow-up included verifying understanding of medical advice,guiding medication administration,answering questions,evaluating postoperative recovery,identifying abnormal symptoms and providing medical guidance,and offering psychological support.The primary outcome was medication adherence at 6 months post operatively,and secondary outcomes included thromboembolic events,bleeding events and rehospitalization within 6 months postoperatively.Results In terms of medication adherence at 6 months postoperatively,the proportion of patients in the intervention group who continuously adhered to anticoagulant medication according to the CHA2DS2-VASc score was significantly higher than that in the control group[53.9％(295/547)vs 42.9％(383/893)](x2=16.598,P＜0.001);the propor-tion of patients in the intervention group who discontinued antiarrhythmic drugs as directed was significantly higher than that in the control group[82.8％(453/547)vs 77.5％(692/893)](x2=6.274,P=0.012).There was no significant difference in the incidence of thromboembolic and bleeding events between the two groups(both P＞0.05).In terms of rehospitalization,the incidence of outpatient visits for cardiovascular diseases in the intervention group was significantly higher than that in the control group[8.4％(46/547)vs 4.9％(44/893)](P=0.008).There were no significant differences between the two groups in the incidence of emergency visits for cardiovascular diseases(P=0.174),hospitalization for cardiovascular diseases(P=0.627),and re-visits or hospitalization for cardiovascular reasons(P=0.053).Conclusion Early active telephone follow-up after radiofrequency ablation for AF can significantly improve patients' adherence to anticoagulant and antiarrhythmic medications without increasing the risk of short-term adverse events.This follow-up model can serve as a supple-mentary method to routine outpatient follow-up.