Abstract:Objective To explore latent classification characteristics of cognitive function,sleep quality and emotional status in patients with coronary atherosclerotic heart disease,and analyze relevant influencing factors.Methods A total of 5 413 patients with coronary atherosclerotic heart disease admitted to Beijing Anzhen Hospital,Capital Medical University from December 2021 to April 2023 were enrolled.Latent profile analysis was performed to identify latent subgroups based on cognitive function,sleep quality and emotional status.Montreal cognitive assessment,pittsburgh sleep quality index,self-rating anxiety scale and self-rating depression scale were applied to evaluate cognitive function,sleep quality,anxiety and depression respectively.Multinomial Logistic regression was used to analyze influencing factors of each subgroup.Results All subjects were divided into three latent subgroups:stable adaptation group(2 800 cases,51.7％),transitional risk group(2 371 cases,43.8％)and high-symptom-burden group(242 cases,4.5％).There were statistically significant differences in gender,educational attainment,history of cerebrovascular disease,smoking status,drinking status,body mass index and age among the three groups(all P＜0.05).There were significant differences in the total scores of the Montreal cognitive assessment,pittsburgh sleep quality index,self-rating anxiety scale and self-rating depression scale,as well as the proportions of mild cognitive impairment,abnormal sleep quality,anxiety and depression among the three groups(all P＜0.05).Multivariate Logistic regression revealed that advanced age,female sex,cerebrovascular disease history and low body weight were independent predictors for classification into the high-symptom-burden group;increased age(odds ratio=1.014,95％confidence interval:1.008-1.020,P＜0.001),female gender(odds ratio=0.766,95％confidence interval:0.662-0.886,P＜0.001)and non-drinking habit(odds ratio=1.267,95％confidence interval:1.053-1.526,P=0.012)were independent influencing factors for inclusion in the transitional risk group.Conclusion Obvious heterogeneity exists in cognitive function,sleep quality and emotional status among coronary atherosclerotic heart disease patients.Clinical nursing should screen high-risk populations including elderly,female,low body mass index and patients complicated with cerebrovascular diseases,and carry out individualized precise interventions corresponding to different profile characteristics so as to improve clinical prognosis.

Abstract:Ischemia-reperfusion injury(IRI)is a key bottleneck in the clinical treatment of major diseases such as acute myocardial infarction,stroke and organ transplantation.Traditional theories hold that IRI is mainly mediated by oxidative stress and is a passive process of tissue damage.However,with the advancement of molecular biological techniques,the diversity and complexity of programmed cell death(PCD)have been gradually revealed.Current studies have confirmed that cell death during IRI is not mediated through a single pathway,but rather involves a pathological process regulated by multiple modes of cell death,including apoptosis,necroptosis,pyroptosis,ferroptosis,autophagy,panoptosis,cuproptosisand disulfidptosis.This paper systematically reviews the core molecular mechanisms and potential targeted intervention strategies of the above PCD modes in IRI,aiming to deeply analyze the pathological essence of IRI and provide a theoretical basis for optimizing clinical prevention and treatment plans and improving patient prognosis.

Abstract:Objective To investigate the diagnostic efficacy of multicolor probe melting curve analysis(MMCA)for drug resistance to six antituberculosis drugs,and to explore the influencing factors and predictive value of multidrug-resistant pulmonary tuberculosis(MDR-TB).Methods A total of 1 724 patients suspected to be tuberculosis who were hospitalized and treated in Hebei Chest Hospital from January 2024 to March 2025 were enrolled as study subjects.Early morning sputum samples were collected for Mycobacterium tuberculosis(MTB)culture,and 574 samples were identified as MTB-positive by mycobacteria growth indicator tube 960 system(MGIT960)rapid liquid MTB culture system.MMCA and MGIT960 rapid liquid MTB culture were used to detect drug resistance to six antituberculosis drugs including rifampicin,isoniazid,ethambutol,streptomycin,levofloxacin and moxifloxacin,respectively,and the diagnostic efficacy of MMCA for the six drugs was analyzed.Patients were divided into MDR-TB group and non-MDR-TB group according to the diagnostic results.Clinical data were compared between the two groups.Multivariate Logistic regression model was used to analyze the influencing factors of MDR-TB,and receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model.Results Taking MGIT960 rapid liquid MTB culture as the gold standard for drug resistance diagnosis,the sensitivities of MMCA for detecting rifampicin,isoniazid,ethambutol,streptomycin,levofloxacin and moxifloxacin were 95.24％,94.87％,92.75％,96.97％,92.42％and 89.47％,respectively;the specificities were 98.52％,97.37％,98.02％,98.74％,97.64％and 95.74％,respectively;and the Kappa values of consistency analysis were 0.941,0.917,0.880,0.946,0.861 and 0.758,respectively.A total of 136 patients were diagnosed with MDR-TB and 438 with non-MDR-TB by MGIT960 rapid liquid MTB culture.Multivariate Logistic regression analysis showed that residence,treatment history,tuberculosis contact history and tuberculous cavity were independent risk factors for MDR-TB.A regression equation was established based on these factors,and the area under the curve of the model for predicting MDR-TB was 0.843(95％confidence interval:0.805-0.882),with a sensitivity of 66.20％and a specificity of 87.00％.Conclusion MMCA shows favorable diagnostic efficacy in detecting drug resistance to rifampicin,isoniazid,ethambutol,streptomycin,levofloxacin and moxifloxacin,and is easy to operate,facilitating rapid screening of MDR-TB.The coexistence of rural residence,retreatment,tuberculosis contact history and tuberculous cavity strongly suggests MDR-TB.

Abstract:Objective To explore the effects of Tongdu Tiaofu method combined with Zaoren Ningshen capsules on arousal level and serum melatonin content in insomnia patients with heart-spleen deficiency syndrome.Methods A total of 96 insomnia patients treated at Shanxi Traditional Chinese Medical Hospital from September 2024 to September 2025 were selected as research subjects.Patients were divided into control group and observation group according to random number table method,with 48 cases in each group.The control group was treated with Zaoren Ningshen capsules,and the observation group was additionally treated with Tongdu Tiaofu method on the basis of the control group.The therapeutic effects,scores of traditional Chinese medicine(TCM)syndrome scale,Pittsburgh Sleep Quality Index(PSQI),Athens Insomnia Scale(AIS),Hyperarousal Scale(HAS),Hamilton Anxiety Scale(HAMA)before treatment,2 weeks after treatment,4 weeks after treatment and 4 weeks after the end of treatment,as well as serum levels of melatonin,cortisol,vasoactive intestinal peptide(VIP)and orexin A before and after treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.8％(46/48)vs 81.2％(39/48)](x2=5.031,P=0.025).At 2 weeks after treatment,4 weeks after treatment and 4 weeks after the end of treatment,TCM syndrome scores,PSQI,HAS and AIS scores in the observation group were significantly lower than those in the control group(all P＜0.05).At 4 weeks after treatment and 4 weeks after the end of treatment,HAMA scores in the observation group were significantly lower than those in the control group(both P＜0.05).After treatment,melatonin levels in both groups were higher than those before treatment,and the observation group was higher than the control group;levels of cortisol,VIP and orexin A in both groups were lower than those before treatment,and the observa-tion group were lower than the control group(all P＜0.05).Conclusion Tongdu Tiaofu method combined with Zaoren Ningshen capsules has definite efficacy in the treatment of insomnia with heart-spleen deficiency syndrome.It can effectively improve patients' TCM syndromes,sleep quality and anxiety state,regulate the body's arousal level,and exert therapeutic effects by affecting serum levels of related hormones and neuropeptides.

Abstract:Lupus nephritis(LN)is the most severe and common end-organ manifestation of systemic lupus erythematosus.Renal involvement occurs in 35％-60％of patients,and at least 20％of patients with LN progress to chronic kidney disease.Due to its complex pathogenesis,the therapeutic effect of LN is unsatisfactory.Traditional treatment regimens based on glucocorticoids and broad-spectrum immunosuppressants have problems such as insufficient response,high recurrence rate and long-term toxicity.In recent years,based on the in-depth understanding of the immune pathogenesis of LN,a variety of novel biological agents and small-molecule drugs targeting specific pathways are in the late stage of research and development.In randomized controlled trials,all these drugs combined with standard treatment are superior to standard treatment alone in achieving renal response,bringing new hope for the treatment of LN.This article systematically reviews the latest progress in biological targeted therapy for LN.

Abstract:Objective To explore the clinical characteristics and surgical treatment of ovarian torsion in children and adolescents,and to evaluate the changing trend of surgical strategies.Methods A retrospective analysis was performed on the clinical features,surgical modalities and pathological findings of children and adoles-cents with a confirmed diagnosis of ovarian torsion who underwent surgical treatment in Shanxi Children's Hospital from January 2017 to December 2024.Results A total of 158 surgically confirmed cases of ovarian torsion in children and adolescents were enrolled.The age distribution presented a bimodal pattern,with peaks in infancy and menarche period.The main clinical manifestations included abdominal pain,nausea and vomiting,accounting for 88.0％(139/158),38.6％(61/158)and 31.0％(49/158)respectively.Most neonatal cases were identified as abdominal masses during prenatal examination and confirmed surgically after birth.Ultrasound was the primary imaging modality;among 151 patients receiving ultrasound examination,117 cases(77.5％)were preoperatively diagnosed with ovarian torsion.The application rate of laparoscopy increased from 27.3％(3/11)in 2017 to 87.0％(20/23)in 2024,while the oophorectomy rate decreased from 72.7％(8/11)in 2017 to 26.1％(6/23)in 2024.Most cases of ovarian torsion complicated with adnexal masses were of benign pathological types.Conclusion Ovarian torsion in children and adolescents is more common in early infancy and around puberty with non-specific clinical symptoms.Transabdominal and pelvic ultrasound serves as the main diagnostic method.Ovarian torsion combined with ovarian masses is frequently encountered in this population,and most associated masses are benign lesions.The intraoperative oophorectomy rate has gradually declined,while the application rate of laparoscopy has remained at a relatively high and stable level in recent years.

Abstract:Objective To analyze the influencing factors of cardiovascular composite endpoint events in patients with chronic heart failure(CHF).Methods The clinical data of 108 patients with CHF in Anqing First People's Hospital of Anhui Medical University from January 2022 to January 2025 were retrospectively analyzed.According to the occurrence of cardiovascular composite endpoint events,the patients were divided into the occurrence group and the non-occurrence group,and the clinical data of the two groups were collected and compared.Logistic regression analysis was used to analyze the influencing factors of cardiovascular composite endpoint events in CHF patients,and a nomogram was drawn to evaluate the predictive value of related influencing factors in the occurrence of cardiovascular composite endpoint events in CHF patients.Results Of the 108 CHF patients,87 cases(80.6％)had no cardiovascular composite endpoint events and were enrolled in the non-occurrence group,15 cases(13.9％)had repeat revascularization,5 cases(4.6％)died from any cause,1 case(0.9％)had myocardial infarction,and a total of 21 cases(19.4％)were enrolled in the occurrence group.Logistic regression analysis showed that age,baseline circulating endothelial cell specific molecule 1(Endocan),free fatty acid(FFA)level,self-perceived burden scale(SPBS)and Mental vulnerability questionnaire(MVQ)scores were the influencing factors of cardio-vascular composite endpoint events in CHF patients(all P＜0.05).By drawing the nomogram,it was found that the above influencing factors had a high value in predicting the occurrence of cardiovascular composite endpoint events in CHF.The consistency index of the nomogram was 0.85(95％confidence interval:0.74-0.95),which showed good consistency and predictive ability and high accuracy of the model.Conclusion Age,baseline Endocan,FFA levels,SPBS and MVQ scores can affect the risk of cardiovascular composite endpoint events in patients with CHF,and their combined prediction has high application value.

Abstract:Objective To study the expression of long non-coding RNA chromatin associated RNA 10(CAR10)and 3-phosphoinositol-dependent protein kinase 1(PDPK1)in cervical cancer tissues and analyze the evaluation value of both for the prognosis of patients.Method A total of 136 patients with cervical cancer who were treated at Xinjiang Medical University Affiliated Cancer Hospital from January 2019 to February 2021 were selected.The relative expression levels of CAR10 and PDPK1 mRNA in cervical cancer tissues were detected by real-time fluorescence quantitative polymerase chain reaction.The correlation between CAR10 and PDPK1 mRNA was analyzed.Log-rank test was used to compare the survival curves of cervical cancer patients with different CAR10 and PDPK1 mRNA expression groups.Cox regression model was used to screen the prognostic factors of cervical cancer patients.Results The relative expression levels of CAR10 and PDPK1 mRNA in cervical cancer tissues were higher than those in adjacent tissues[(3.14±0.52)vs(1.01±0.28),(4.0±0.5)vs(1.1±0.3)](both P＜0.001).There was a positive correlation between CAR10 and PDPK1 mRNA expression in cervical cancer(r=0.789,95％confidence interval:0.347-0.897,P＜0.001).The mRNA levels of CAR10 and PDPK1 in international federation of gynecology and obstetrics(FIGO)stage Ⅰ B2-Ⅱ A2 cervical cancer were higher than those in stage Ⅰ A1-Ⅰ B1 patients(all P＜0.001).Log-rank test showed that the 3-year survival rate of different CAR10 and PDPK1 mRNA expression groups was statistically significant(all P＜0.05).Multivariate Cox regression analysis showed that FIGO stage Ⅰ B2-Ⅱ A2,high CAR10 mRNA and high PDPK1 mRNA were risk factors affecting the prognosis of cervical cancer patients(all P＜0.05).Conclusion The expressions of CAR10 and PDPK1 mRNA are significantly up-regulated in cervical cancer tissues,which are involved in the pro-gression of cervical cancer and are tumor markers for evaluating the prognosis of patients.

Abstract:Objective To evaluate and analyze the rationality of clinical application of Kanglaite injection,in order to provide reference for the rational use of Kanglaite injection.Methods From the electronic medical record system of Chaohu Hospital of Anhui Medical University,120 medical records using Kanglaite injection from January to April(before the special review)and 120 medical records from September to December 2023(after the special review)were randomly selected for retrospective analysis.The gender,age,clinical department,clinical diagnosis,treatment course,usage and dosage of the patients were statistically analyzed,the use rule was analyzed,and the rationality of clinical use was evaluated.The rationality data of the drug application before and after the special review were compared.Results Before the special review,the oncology department had the highest number of 120 hospitalized patients who received Kanglaite injection,with 77 cases(64.2％),followed by the respiratory department with 41 cases(34.2％);non-small cell lung cancer was the most commonly diagnosed disease(77 cases,accounting for 64.2％),followed by primary liver cancer(10 cases,accounting for 8.3％).The indications for use were consistent with the drug instructions.The route of administration of Kanglaite injection was intravenous drip,and the frequency of administration was once a day,which was in line with the recommendation of the instructions.There were 108 cases(90.0％)with a single dose of 200 ml,which met the recommendation of the manufacturer's instructions.Four patients(3.3％)had abnormal fat metabolism,which was a contraindication.The proportion of off-label use without indications in 120 patients after the special review was significantly lower than that before the special review,and the proportion of reasonable medication course was significantly higher than that before the special review[13.3％(16/120)vs 27.5％(33/120),25.0％(30/120)vs 1.7％(2/120)](both P＜0.05).No contraindications were found after the special review.Conclusions There are some unreasonable phenomena in the clinical use of Kanglaite injection,mainly manifested as off-label indication,short course of medication,and small single dose.Clinicians should strictly follow the drug instructions and relevant guidelines to improve the rationality of clinical use of Kanglaite injection.

Abstract:Objective To observe the effects of remimazolam on stress response,serum inflammatory factors and postoperative short-term quality of recovery in elderly patients with one-lung ventilation.Methods Sixty patients who underwent thoracoscopic radical lung cancer surgery in the First Affiliated Hospital of Hebei North University from August 2023 to August 2024 were selected.The patients were divided into group P and group R according to the random number table method,with 30 cases in each group.Group P was given propofol and remifentanil anesthesia,group R was given remimazolam and remifentanil anesthesia.The heart rate,mean arterial pressure(MAP),blood oxygen saturation,and bispectral index(BIS)were monitored and recorded before anesthesia(T1),intubation(T2),skin incision(T3),at the end of operation(T4),and extubation(T5).The occurrence of hypotension,bradycardia,hypertension and the use of vasoactive drugs during operation were recorded.The pain mediators were compared between the two groups before operation and 24 h after operation.Inflammatory mediators and stress response indexes were measured before operation,at the end of operation,and at 6 and 24 h after operation.The quality of recovery 15-item(QoR-15)scale scores were recorded before induction of anesthesia and at 24 and 72 h after operation.Results The heart rate and MAP at T4 in group R were higher than those in group P,and BIS at T5 was lower than that in group P(all P＜0.05).The incidence of hypotension,bradycardia and the use of vasoactive drugs in group R were lower than those in group P[10.0％(3/30)vs 50.0％(15/30),0(0)vs 26.6％(8/30),26.6％(8/30)vs 83.3％(25/30)](all P＜0.05).At 24 h after operation,the levels of high-mobility protein B1 protein in the two groups were lower than those before operation,and those in group R were lower than those in group P.The levels of prostaglandin E2 and 5-hydroxytryptamine in the two groups were higher than those before operation,and those in group R were higher than those in group P(all P＜0.05).The levels of C-reactive protein and interleukin-6 in the two groups were higher than those before operation immediately after operation and at 6 and 24 h after operation,but those in group R were lower than those in group P at each time point(all P＜0.05).The cortisol levels immediately after operation and 6 h after operation were higher than those before operation in both groups,but those in group R were lower than those in group P at each time point(all P＜0.05).The total QoR-15 scores at 24 h and 72 h after operation were lower than those before anesthesia induction in both groups,but those in group R were higher than those in group P(all P＜0.05).Conclusion Remimazolam can maintain hemodynamic stability and reduce the incidence of adverse cardiovascular events in elderly patients undergoing thoracoscopic radical resection of lung cancer.At the same time,it can inhibit the release of pain mediators and inflammatory factors,which is beneficial to reduce the postoperative stress response of elderly patients and improve the quality of postoperative recovery.

Abstract:Objective To evaluate the clinical efficacy of Tongxinluo capsule combined with enhanced external counterpulsation(EECP)in patients with ischemic cardiomyopathy and heart failure.Methods A total of 188 patients with ischemic cardiomyopathy and heart failure who were hospitalized in the Department of Cardiovascular Medicine,the First Affiliated Hospital of Hebei North University from May 2021 to June 2023 were selected.The patients were divided into control group and observation group by block randomization method,with 94 cases in each group.The control group was treated with conventional western medicine combined with EECP,and the observation group was treated with Tongxinluo capsule on the basis of the control group.Both groups were treated for 8 weeks.The traditional Chinese medicine syndrome scores,hemodynamic indicators(cardiac output,cardiac index,stroke volume),cardiac function indicators[left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)],and safety were compared between the two groups before and after treatment.Results The traditional Chinese medicine syndrome scores of the two groups at 8 weeks of treatment were lower than those before treatment,and those of the observa-tion group were lower than those of the control group[(9.4±2.3)vs(11.7±2.8)](all P＜0.05).The cardiac output,cardiac index and stroke volume of the two groups at 8 weeks of treatment were higher than those before treatment,and those of the observation group were higher than those of the control group(all P＜0.05).After 8 weeks of treatment,LVESD and LVEDD of the two groups were lower than those before treatment,and LVEF was higher than that before treatment,and LVESD and LVEDD of the observation group were lower than those of the control group,and LVEF was higher than that of the control group(all P＜0.05).During the treatment and observation period,there was no significant difference in the incidence of nausea and vomiting,insomnia,and abdominal discomfort between the two groups(all P＞0.05).Conclusion Tongxinluo capsule combined with EECP in the treatment of patients with ischemic cardiomyopathy and heart failure can improve the traditional Chinese medicine syndrome score,hemodynamics and cardiac function indexes,and has good safety.

Abstract:Objective To analyze the clinical characteristics of pain in rheumatology outpatients.Methods A total of 739 outpatients from the Department of Rheumatology and Immunology,the First Affiliated Hospital of Anhui Medical University from January 2019 to June 2022 were selected for pain assessment question-naire survey.The distribution of pain degree,sleep disorders caused by pain,and pain location were analyzed.The differences of pain degree[visual analog scale(VAS)scores],pain location,and pain complications among different diseases were compared,and the related factors of moderate to severe pain were analyzed.Results Of the 739 patients,517 cases(70.0％)had pain,including 198 cases(26.8％)with mild pain(VAS score 1-3),215 cases(29.1％)with moderate pain(VAS score 4-6),and 104 cases(14.1％)with severe pain(VAS score 7-10).Among the 739 patients,245 cases(33.2％)had sleep disorders caused by pain,mainly included 129 cases(17.5％)had poor sleep quality,57 cases(7.7％)had difficulty falling asleep,and 54 cases(7.3％)woke up with pain or woke up early.Totally 197 patients(26.7％)were in the outpatient clinic due to pain in both hands,followed by 152 patients(20.6％)with knee pain.Among 517 patients with pain,73 cases(14.1％)were complicated with hypertension.There was a statistically significant difference in the proportion of hypertension among the diseases with pain(P＜0.001).There was a statistically significant difference in the degree of pain between patients with rheumatic diseases of different diseases(P＜0.001).There were statistically significant differences in the distribution proportions of low back pain,leg pain,hip pain,knee pain,upper limb pain,and shoulder pain among rheumatic patients with different diseases(all P＜0.05).Logistic regression analysis showed that knee pain,low back pain,leg and foot pain,cervical pain,shoulder pain,hip and hip pain,and upper limb pain were the relevant factors causing moderate to severe pain(all P＜0.05).Conclusion In this study,70.0％of outpatients in rheumatology and Immunology Department had pain,43.2％of patients had moderate to severe pain,and 33.2％of patients had sleep disorders due to pain,suggesting that we should pay attention to the pain of outpatients in rheumatology and Immunology Department.

Abstract:Objective To investigate the effect of methylprednisolone pulse therapy combined with mouse nerve growth factor on visual acuity and autoimmune antibodies levels in patients with acute optic neuritis.Methods A total of 122 patients with acute optic neuritis admitted to Affiliated Hospital of Hebei University from July 2023 to June 2024 were selected as the research objects.According to the random number table method,they were divided into the control group(61 cases)and the observation group(61 cases).Both groups were given conventional treatment first,the control group was given mouse nerve growth factor,and the observation group was given methylprednisolone pulse therapy on the basis of the control group,both groups were treated for 4 weeks.The curative effect,visual acuity,visual function index,visual field defect value,autoimmune antibody,visual evoked potential,incidence of adverse reactions and recurrence rate were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[91.8％(56/61)vs 77.0％(47/61)](x2=5.050,P=0.025).After treatment,the visual acuity,visual function index and P100 wave amplitude of the two groups were higher/greater than those before treatment,and those of the observation group were higher/greater than those of the control group;the visual field defect value,positive rate of myelin oligoden-drocyte glycoprotein,positive rate of aquaporin 4,and P100 wave latency in the two groups were lower/shorter than those before treatment,and those in the observation group were lower/shorter 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(x2=0.684,P=0.408).The recurrence rate of the observation group was lower than that of the control group[8.2％(5/61)vs 21.3％(13/61)](x2=4.171,P=0.041).Conclusion Methylprednisolone pulse therapy combined with mouse nerve growth factor has a significant effect on acute optic neuritis,which can effectively improve visual acuity,improve the function of the optic nerve,and reduce the immune response.

Abstract:Objective To investigate the effect of dexamethasone combined with intraoperative gastroin-testinal decompression on postoperative nausea and vomiting in patients with Baska laryngeal mask airway positive pressure ventilation.Methods A total of 240 patients undergoing laparoscopic cholecystectomy with Baska laryn-geal mask positive pressure ventilation in Panzhihua Central Hospital,Sichuan Province from December 2023 to June 2024 were selected.They were randomly divided into blank control group(group A),dexamethasone group(group B),gastrointestinal decompression group(group C)and dexamethasone combined with gastrointestinal decompression group(group D),with 60 cases in each group.Before anesthesia induction,dexamethasone 4 mg was injected intravenously in group B and D.after laryngeal mask implantation,sputum suction tubes were placed in group C and D for gastrointestinal decompression.The areas of gastric antrum were measured and calculated by ultrasound before anesthesia induction(T0),after successful laryngeal mask implantation(T1),and after removal of laryngeal mask(T2).The general information and anesthesia operation,the changes of antral area at T0,T1,and T2,and the occurrence of flatulence,nausea,vomiting,sore throat,and hoarseness at 1,6,and 24 h after operation were observed and compared among the four groups.Results There were no statistically significant differences in general information,operation conditions,and antral areas at T0 and T1 among the four groups(all P＞0.05).At T2,the areas of gastric antrum in group A and B were significantly larger than those in group C and D.The incidences of flatulence,nausea and vomiting at 1 and 6 h after operation and the incidence of nausea at 24 h after operation were significantly different among the four groups(all P＜0.05).The incidences of nausea and vomiting at 1 and 6 h after surgery,gastric distension at 6 h after surgery[1 h after surgery:15.0％(9/60)vs 36.7％(22/60),10.0％(6/60)vs 30.0％(18/60);6 h after surgery:10.0％(6/60)vs 51.7％(31/60),8.3％(5/60)vs 51.7％(31/60)],and nausea at 24 h after surgery[6.7％(4/60)vs 26.7％(16/60)]in Group D were all lower than those in Group A(all P＜0.05).Conclusion Dexamethasone combined with intraoperative gastrointestinal decompression can reduce the incidence of nausea and vomiting at 1 and 6 h after Baska laryngeal mask airway positive pressure ventilation,gastric bloating at 6 h after surgery,and nausea at 24 h after surgery.

Abstract:Objective To explore the predictive value of combining metabolic syndrome(MS),systemic inflammation index(SIRI)and fibrinogen/albumin ratio(FAR)in the prognosis of triple-negative breast cancer(TNBC),construct a scoring system and verify its predictive value for the prognosis of TNBC.Methods A total of 252 TNBC patients treated in the Affiliated Hospital of Chengde Medical University and the First Hospital of Hebei Medical University from January to December 2019 were selected as the training set,and 98 TNBC patients treated in the two hospitals from January to April 2020 were selected as the validation set.In the training set,48 patients with MS were included in the observation group,and 204 patients without MS were included in the control group.The patients were followed up for 3 years to record the occurrence of adverse events.MS,FAR and SIRI scoring systems were constructed and their predictive efficacy was evaluated.Results There were no significant differences in baseline data between the training set and the validation set(all P＞0.05).There were statistically significant differences in the levels of systolic blood pressure,diastolic blood pressure,body mass index,triglyceride,high-density lipoprotein,blood glucose,and the proportions of diabetes,hypertension,and adverse outcomes between the observation group and the control group(all P＜0.001).The results of univariate Cox regression analysis showed that SIRI and MS were risk factors for the poor outcome of TNBC patients,and FAR was a protec-tive factor for the poor outcome of TNBC patients(all P＜0.05).Receiver operating characteristic curve analysis results showed that the area under the curve of SIRI was 0.853,the area under the curve of FAR was 0.787,and the area under the curve of the scoring system was 0.886.Conclusion MS,FAR and SIRI are independent predictors of poor prognosis in TNBC,and the scoring system constructed by them can improve the prediction efficiency of poor prognosis.

Abstract:Objective To investigate the value of echocardiography in the preoperative diagnosis of primary right ventricular tumors.Methods The clinical manifestations and echocardiographic features of 30 patients with primary right ventricular tumors diagnosed by surgical pathology in Beijing Anzhen Hospital,Capital Medical University from April 2016 to January 2024 were retrospectively analyzed.With the pathological results as the gold standard,the coincidence rate of echocardiography in the pathological diagnosis of primary right ventricular tumors was analyzed.Results Among 30 patients with primary right ventricular tumors,postoperative pathological results showed that 24 cases(80.0％)were benign tumors and 6 cases(20.0％)were malignant tumors.Benign tumors included 11 cases of myxoma,6 cases of fibroma,4 cases of rhabdomyoma,1 case of mature teratoma,1 case of papillary elastofibroma and 1 case of lipoleiomyoma.Malignant tumors included undifferentiated pleomorphic sarcoma,angiosarcoma,synovial sarcoma,myxofibrosarcoma,leiomyosarcoma,and malignant hemangioendothelioma in 1 case each.The coincidence rate between preoperative ultrasound diagnosis and postoperative pathological diagnosis was 36.7％(11/30).The ultrasound features of myxoma were highly specific,and the coincidence rate of ultrasound diagnosis was 9/11.The characteristic manifestations of myxoma included:moderate echo,irregular shape,lobulated shape,pedicle attachment,loose structure,large activity,shape changes with the rhythm cycle,and the tumor was embedded into the valve orifice to varying degrees during diastole,and secondary stenosis.There were no pedicles in 6 cases of malignant tumors,while 15 cases(62.5％)of benign tumors had pedicles.There was significant difference between the two groups(P=0.017).The ultrasound echocardiographic features were compared between the benign and malignant tumor groups.In the malignant tumor group,there were 5 cases of irregular morphology,4 cases of pericardial effusion,5 cases of poor mobility,5 cases of unclear boundaries,4 cases of tricuspid regurgitation,and 2 cases of right ventricular outflow tract obstruction.In the benign tumor group,there were 6 cases(25.0％)with irregular morphology,4 cases(16.7％)with pericardial effusion,7 cases(29.2％)with poor mobility,5 cases(20.8％)with unclear boundaries,11 cases(45.8％)with tricuspid regurgitation,and 7 cases(29.2％)with right ventricular outflow tract obstruction.There were statistically significant differences in the proportion of irregular morphology,concomitant pericardial effusion,poor mobility,and unclear boundaries between the two groups(P=0.016,0.029,0.026,0.009).There was no statistically significant difference in the proportion of tricuspid regurgitation and right ventricular outflow tract obstruction(P=0.651,1.000).Conclusion Primary right ventricular tumors are mostly benign tumors.Echocardiography can find the space-occupying lesions in the cardiac cavity,provide the location,size,shape and boundary of the tumor,and also indicate whether the cardiac tumor has an impact on hemodynamics.Combined with the clinical characteristics of patients and echocardiography characteristics,preliminary pathological nature can be determined.It has a certain value in preoperative diagnosis of primary right ventricular tumors.

Abstract:Objective To explore the effect of air pollution exposure on the incidence of stroke.Methods From January 1,2023 to December 31,2024,time series data from four community surveillance points in Beijing were used for analysis,with urban and rural residents of Beijing as the research population.Daily air pollutant concentrations(PM2.5,PM10,sulfur dioxide,carbon monoxide,ozone,nitrogen dioxide)and meteoro-logical data were collected.A time-stratified case-crossover design and a Poisson-like regression model were used to estimate the association between air pollutants and stroke events.Results A total of 1 100 stroke patients were registered during the study period.Concentrations of PM2.5 and PM10 varied significantly between monitoring sites and between days.The results showed that the exposure to PM2.5 and PM10 significantly increased the risk of stroke events.The peak effect of PM2.5 appeared in the lag period of 3-5 d,and the peak effect of PM10 appeared in the lag period of 4-7 d.For every 10 μg/m3 increase in PM2.5 concentration,the relative risk of stroke was 1.022(95％confidence interval:1.008-1.039),and the lag period was 0-7 d.For every 10 μg/m3 increase in PM10 concentration,the relative risk of stroke was 1.027(95％confidence interval:1.008-1.055),and the lag period was 0-12 d.Conclusion The results of this study showed that environmental pollutants,especially PM2.5 and PM10,were significantly associated with stroke events.These findings suggest the impor-tance of air quality management in reducing the risk of stroke.

Abstract:Objective To evaluate the clinical efficacy and safety of Zhenzhu Tongluo pill in the treatment of pain caused by spinal cord,root nerve and cauda equina nerve compression.Methods A randomized,double-blind,placebo-controlled trial was conducted to select 160 patients aged 25-65 years who were diagnosed with pain caused by spinal cord,root nerve,or cauda equina nerve compression and treated at the First Affiliated Hospital of Zhengzhou University from August to October 2024.The patients were randomly divided into the observation group and the control group by computer randomization method,with 80 cases in each group.The observation group was given Zhenzhu Tongluo pill on the basis of conventional medication,and the control group was given placebo on the basis of conventional medication.The course of treatment was 12 weeks for both groups.The visual analogue scale(VAS)score,modified Japanese Orthopaedic Association Evaluation of Treatment Score(mJOA),Short Form Health Survey(SF-36)scores,pain relief time,efficacy and safety were compared between the two groups before and after treatment.Results After 4,8 and 12 weeks of treatment,the VAS scores of the two groups were lower than those before treatment,the mJOA scores were higher than those before treatment,the VAS scores of the obser-vation group at each time point were significantly lower than those of the control group,and the mJOA scores were higher than those of the control group(all P＜0.05).After 12 weeks of treatment,the SF-36 scores of the two groups were higher than those before treatment,and the SF-36 score of the observation group was significantly higher than that of the control group(all P＜0.05).The pain relief time of the observation group was significantly shorter than that of the control group(P＜0.001).The total effective rate of the observation group was significantly higher than that of the control group[83.8％(67/80)vs 38.8％(31/80)](P＜0.001).Before and after treatment,the blood routine,urine routine,liver and kidney function,and coagulation function of patients in the two groups were within the normal range.Conclusion Zhenzhu Tongluo pill has significant effect and good safety in the treatment of pain caused by spinal cord,root nerve or cauda equina nerve compression,which provides a strong basis for clinical treatment.

Abstract:The most common persistent type of atrial tachycardia is atrial fibrillation,and cardiac dysfunc-tion and stroke are the major risks for patients.In recent years,with the continuous monitoring of atrial electrical activity by cardiac implantable electronic devices(CIEDs),an early asymptomatic atrial fibrillation,called subclinical atrial fibrillation,has been found,which leads to an increased risk of thromboembolism.It was previ-ously only found after the occurrence of complications such as ischemic stroke or congestive heart failure.This review will discuss the definition,incidence,risk factors,stroke relationship,and anticoagulation of subclinical atrial fibrillation associated with CIEDs,and summarize its progress.

Abstract:Objective To explore the clinical value of endoscopic ultrasonography combined with inflammatory markers in the differential diagnosis of gastric stromal tumor and gastric leiomyoma.Methods From January 2017 to April 2024,at the Department of Gastroenterology,the First Hospital of Lanzhou University,the clinical data of 152 patients who underwent endoscopic treatment and were confirmed as gastric stromal tumor or leiomyoma by postoperative pathology were retrospectively selected.There were 86 cases of gastric stromal tumor(gastric stromal tumor group)and 66 cases of gastric leiomyoma(gastric leiomyoma group).The baseline data,endoscopic ultra-sound characteristics and inflammation-related indicators of the two groups were compared.Binary Logistic regres-sion was used to analyze the independent diagnostic factors of gastric stromal tumor and gastric leiomyoma.The receiver operating characteristic curve was used to analyze the diagnostic efficacy of single index and combination for gastric stromal tumor and gastric leiomyoma.Results The age of patients in gastric stromal tumor group was significantly older than that in gastric leiomyoma group[58(53,64)years vs 54(47,59)years](Z=-3.438,P=0.001).There were significant differences in tumor size,tumor location,internal echo properties and echo uniformity between the two groups(all P＜0.05).The platelet to lymphocyte ratio(PLR)and neutrophil to lymphocyte ratio in gastric leiomyoma group were lower than those in gastric stromal tumor group,and the lympho-cyte to monocyte ratio(LMR)was higher than that in gastric stromal tumor group(all P＜0.05).Multivariate binary Logistic regression analysis showed that age,tumor size,tumor location,PLR and LMR were independent diagnostic factors(all P＜0.05).The results of receiver operating characteristic curve analysis showed that the area under the curve of age,tumor size,tumor location,PLR,LMR and the combination of the five indicators were 0.337,0.309,0.424,0.378,0.670,0.856,respectively.The diagnostic efficacy of the combination of the five indicators for gastric stromal tumor and gastric leiomyoma was significantly better than that of each single indicator.Conclusion The combined model of endoscopic ultrasonography features and inflammatory indicators can significantly improve the efficacy of preoperative differential diagnosis of gastric stromal tumors and gastric leiomyoma,and provide a reliable basis for clinical diagnosis.