Abstract:Ischemic stroke(IS)is one of the most important diseases leading to death and long-term disability worldwide.In recent years,microRNA(miR),as an important gene expression regulator,has attracted extensive attention in its role in IS.MiR plays a variety of roles in stroke pathology and repair by regulating inflam-mation,apoptosis,blood-brain barrier permeability,neuronal survival and synaptic plasticity.Studies have shown that miR has bidirectional regulatory properties,which can not only aggravates ischemic brain damage(for example,miR-155,miR-34a),but also reduce brain damage and promote repair(for example,miR-21,miR-124,miR-132).In addition,miR plays a dynamic role in different stages and different pathological mechanisms of stroke,which provides a new perspective for the diagnosis and treatment of stroke.This review systematically summarized the mechanism of miR in IS,focusing on its regulatory role in inflammatory response,oxidative stress,apoptosis,blood-brain barrier injury and brain edema,and neural network repair.In addition,the limitations of current research were analyzed and future development directions were prospected.

Abstract:Objective To investigate the effect of BufeiHuoxue capsule combined with rock salt aerosol therapy on pneumoconiosis,and its influence on exercise endurance and lung function of patients.Methods A total of 87 pneumoconiosis patients admitted to the Third People's Hospital of Xinjiang Uygur Autonomous Region from February 2021 to June 2023 were selected.They were divided into observation group(44 cases)and control group(43 cases)by random number table method.The control group was given rock salt aerosol therapy on the basis of basic treatment.The observation group was treated with BufeiHuoxue capsule on the basis of the control group.The total effective rate,respiratory function,lung function index,serum biochemical index,exercise tolerance and safety were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[93.2％(41/44)vs 76.7％(33/43)](P＜0.05).After treatment,the St.George's Respiratory Questionnaire scores of the observation group and the control group were lower than those before treatment,and that of the observation group was lower than that of the control group[(52±6)vs(60±8)](P＜0.001).The forced expiratory volume and forced vital capacity levels in the first second of both groups were higher than before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).After treatment,the levels of interleukin-8 in the two groups were lower than those before treatment,and that in the observation group was lower than that in the control group;the levels of γ-interferon in the two groups were higher than those before treatment,and that in the observation group was higher than that in the control group(all P＜0.05).After treatment,the 6 min walk test distances of the observation group and the control group were longer than those before treatment,and the 6minwalk test distance of the observation group was longer than that of the control group[(366±39)m vs(331±35)m](P＜0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion BufeiHuoxue capsule combined with rock salt aerosol therapy can effectively improve the lung function and exercise endurance of pneumoconiosis patients.

Abstract:Objective To investigate the clinical effect of modified porous core decompression(CD)combined with vacuum sealing drainage(VSD)in the treatment of early avascular necrosis(AVN)of the femoral head in adults.Methods A total of 80 adult patients with early AVN admitted to the Affiliated Hospital of Hebei University of Engineering from May 2022 to January 2024 were retrospectively selected.According to the different surgical methods,they were divided into CD group(37 cases,treated with modified porous CD)and combined group(43 cases,treated with modified porous CD combined with VSD).The treatment effect,hip joint function,pain,hip joint activity and postoperative complications were compared between the two groups.Results The total effective rate of the combined group was higher than that of the CD group[95.3％(41/43)vs 81.1％(30/37)](x2=4.055,P=0.004).At 3,6,and 12 months after operation,the Harris hip scores of the combined group were higher than those of the CD group,and the visual analogue scale scores of pain were lower than those of the CD group(all P＜0.05).The range of motion of hip joint in the combined group was greater than that in the CD group at 6 months after operation(P＜0.05).The total incidence of long-term postoperative complications in the combined group was lower than that in the CD group[7.0％(3/43)vs 24.3％(9/37)](x2=4.694,P=0.030).Conclusion Modified porous CD combined with VSD has a good effect in the treatment of adult patients with early AVN,which can improve hip joint function,control disease progression,reduce pain,increase hip joint activity,and has high safety.

Abstract:Objective To investigate the correlation of peripheral blood pro-nerve growth factor(proNGF)and GATA binding protein 3(GATA3)with severity and cognitive function in patients with Parkinson's disease(PD).Methods A total of 158 patients with PD(PD group)admitted to the Fourth Affiliated Hospital of Nanjing Medical University from January 2020 to March 2023 and 80 healthy volunteers(control group)who had recently visited the hospital for physical examination were retrospectively selected.PD patients were divided into early stage group(Hoehn-Yahr stage 1 to 2.5,32 cases),middle stage group(Hoehn-Yahr stage 3,76 cases)and late stage group(Hoehn-Yahr stage 4 to 5,50 cases)according to the severity of the disease.According to their cognitive function,they were divided into PD dementia(PDD)group[PD cognitive rating scale(PD-CRS)score ≤73,37 cases],PD mild cognitive impairment(PD-MCI)group(PD-CRS score 74 to 80,68 cases)and normal cognitive group(PD-CRS score＞80,53 cases).The levels of proNGF and GATA3 in peripheral blood were detected.The correlation between proNGF and GATA3 levels in peripheral blood of patients with PD and Hoehn-Yahr stage was analyzed.Unconditional ordinal multinomial Logistic regression was used to analyze the relationship between peripheral blood proNGF and GATA3 levels and the development of cognitive impairment in PD patients.The receiver operating characteristic curve was used to analyze the predictive efficiency of peripheral blood proNGF and GATA3 levels on cognitive impairment.Results The level of proNGF in PD group was higher than that in control group,and the the level of GAT A3 was lower than that in control group(both P＜0.001).The level of proNGF in the late stage group,the middle stage group and the early stage group showed a downward trend,and the level of GATA3 showed an upward trend(all P＜0.001).The Hoehn-Yahr scale was positively correlated with the level of proNGF(r=0.775,P＜0.001)and negatively correlated with the level of GATA3(r=-0.780,P＜0.001)in PD patients.proNGF was an independent risk factor for cognitive impairment in PD patients,and GATA3 was an independent protective factor(all P＜0.001).The area under the curve of peripheral blood proNGF and GATA3 levels combined to evaluate cognitive impairment and PDD in PD patients was 0.873 and 0.868,which was larger than those of peripheral blood proNGF and GAT A3 levels alone(both P＜0.05).Conclusions Elevated levels of proNGF and decreased levels of GAT A3 in peripheral blood of PD patients are closely related to disease severity and cognitive impairment.The combination of proNGF and GATA3 levels in peripheral blood has a high energy efficiency in evaluating cognitive impairment and PDD in PD patients.

Abstract:Objective To investigate the association between dietary index of gut microbiota(DI-GM)and heart failure in a cross-sectional study.Methods The data of this study were collected from the United States National Health and Nutrition Examination Survey database 2007-2020.The inclusion criteria were 20-80 years old,33 665 subjects were included after excluding those missing information on heart failure,incomplete 2 d 24 h dietary recall,and missing data required for DI-GM calculation.DI-GM was calculated based on the data from two dietary retrospective interviews.Multivariate Logistic regression analysis was used to explore the relationship between DI-GM and heart failure.A restricted cubic spline model was constructed to determine the non-linear relationship between DI-GM and heart failure.Subgroup analysis by age,sex,etc.,and interaction was evaluated.Results A total of 33 665 participants were included in this study.The prevalence of heart failure was 3.3％(1 122 cases)and the weighted DI-GM score was 5(4,6).According to the presence or absence of heart failure,the patients were divided into heart failure group and non-heart failure group.There were significant differences in age,gender,race,education level,marital status,family income/poverty line,body mass index,health behavior,and disease history between the heart failure group and the non-heart failure group(all P＜0.05),and the weighted score of DI-GM in the heart failure group was lower than that in the non-heart failure group(P=0.002).The results of weighted multivariate Logistic regression analysis showed that after adjusting for covariates in different models,the increase in DI-GM was associated with a reduced risk of heart failure(all P＜0.05).The DI-GM subgroup analysis showed that the risk of heart failure decreased with the increase of scores(the P-values for trend were all less than 0.001).The restricted cubic spline model showed a linear association between DI-GM and the risk of heart failure(nonlinearity test P=0.522).Subgroup analysis showed no significant interaction between DI-GM and heart failure in each subgroup(all P＞0.05).Conclusion DI-GM is independently associated with the risk of heart failure,and high level of DI-GM has a protective effect on heart failure.

Abstract:Gastritis cystis profunda(GCP)is a rare clinical gastric submucosal lesion characterized by polypoid hyperplasia and cystic dilatation of gastric glands extending into the gastric submucosa.Due to the non-specific clinical symptoms and endoscopic findings,preoperative diagnosis is still difficult,and histopathological examination is necessary to make a definite diagnosis.This article reports a case of GCP diagnosed by histopathology after endoscopic mucosal dissection due to abdominal distension and pain.And report on its etiology and pathogenesis,clinical manifestations,imaging features,diagnosis and treatment,and review relevant literature to improve clinical physicians' understanding of the disease.

Abstract:Objective To analyze the value of magnetic resonance imaging(MRI)three-dimensional ultra-short echo time(UTE)sequence in the prognosis evaluation of non-small cell lung cancer(NSCLC).Methods A total of 220 patients with NSCLC admitted to Hengshui Second People's Hospital,Hebei Province from January 2020 to February 2024 were selected.All patients underwent conventional MRI and three-dimensional UTE sequence MRI.The results of pathological biopsy were used as the standard to analyze the diagnostic efficacy of conventional MRI and three-dimensional UTE sequence MRI in the clinical staging of NSCLC.After a 1-year follow-up,patients were divided into a good prognosis group(141 cases)and a poor prognosis group(79 cases).Data such as lung function,signal intensity(SIN)of UTE during full expiration,and UTE-T2* were compared between the two groups.The relationship between clinical indicators and prognosis of patients and the diagnostic value of UTE sequence in the prognosis of NSCLC were analyzed.Results Among 220 NSCLC patients,34 cases were diagnosed as TNM stage Ⅰ,70 cases as TNM stage Ⅱ and 116 cases as TNM stage Ⅲ A by pathological biopsy.The consistency between conventional MRI and pathological biopsy was 0.824(P＜0.05),and the con-sistency between the three-dimensional UTE sequence and pathological biopsy was 0.945(P＜0.05).SIN showed a downward trend and UTE-T2* showed an upward trend in TNM stage Ⅰ,Ⅱ and Ⅲ patients(all P＜0.001).Age,proportion of TNM stage Ⅲ A,tumor diameter,proportion of lymph node metastasis and UTE-T2* in the poor prognosis group were higher than those in the good prognosis group(all P＜0.01),and SIN was lower than that in the good prognosis group(P＜0.05).Binary Logistic regression analysis showed that age,TNM stage,tumor diameter,lymph node metastasis and UTE-T2*were risk factors for poor prognosis of NSCLC patients,and high SIN was a protective factor for poor prognosis of NSCLC patients(all P＜0.05).The receiver operating characteristic curve analysis showed that the area under the curve of the combination of SIN and UTE-T2*was 0.828,and the sensitivity and specificity were 89.97％and 80.14％,respectively.Conclusion MRI three-dimensional UTE sequence can effectively identify the clinical stage of NSCLC,and its quantitative parameters are related to the prognosis of NSCLC patients,which can be used for clinical diagnosis of NSCLC.

Abstract:Objective To analyze the effects of Bushen Huoxue Zhuanggu decoction on bone metabolism and bone mineral density in elderly patients with osteoporotic hip fracture after operation.Methods The clinical data of 60 elderly patients with osteoporotic hip fractures who underwent surgery in Dongzhimen Hospital,Beijing University of Chinese Medicine from February 2021 to December 2024 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,with 30 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Bushen Huoxue Zhuanggu decoction on the basis of the control group.Both groups were treated for 6 months.The efficacy of traditional Chinese medicine,bone mineral density,bone metabolism indexes before and after treatment,postoperative recovery and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group[96.7％(29/30)vs 73.3％(22/30)](P=0.030).After 6 months of treatment,the bone mineral densities of the two groups were higher than those before treatment,and the bone mineral densities of lumbar L2-L4,healthy femoral neck and Ward's triangle in the observation group were higher than those in the control group(all P＜0.05).Compared with before treatment,the indexes of bone metabolism in the two groups were decreased after 6 months of treatment,and the indexes of bone metabolism in the observation group were lower than those in the control group(all P＜0.05).The fracture healing time and hospitalization time of the observation group were shorter than those of the control group[(15.6±0.3)weeks vs(19.0±0.4)weeks,(41.3±6.2)d vs(48.1±6.0)d](all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group[16.7％(5/30)vs 10.0％(3/30)](P=0.704).Conclusion Bushen Huoxue Zhuanggu decoction can improve bone metabolism,increase bone mineral density and promote postoperative rehabilitation in elderly patients with osteoporotic hip fracture.In terms of safety,there was no significant difference in the incidence of adverse reactions between the two groups,but the observation group was slightly higher than the control group,which still needs to be further verified in a larger sample study.

Abstract:Objective To investigate the value of serum CC chemokine ligand 18(CCL-18)combined with systemic immune inflammation index(SII)in evaluating the prognosis of transcatheter arterial chemoembolization(TACE)in patients with advanced primary hepatocellular carcinoma(PHC).Methods The clinical data of 212 patients with intermediate and advanced PHC who underwent TACE intervention in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2021 to January 2024 were retrospectively analyzed.The patients were followed up for 12 months.According to the prognosis of TACE intervention,the patients were divided into the good prognosis group(120 cases)and the poor prognosis group(92 cases).The patients were divided into high CCL-18 group(108 cases),low CCL-18 group(104 cases),high SII group(107 cases)and low SII group(105 cases)according to the average value of the two indexes(7.96 ng/L,312.52).The survival rates of patients with advanced PHC and different expression levels of CCL-18 and SII before TACE were compared.Multivariate Logistic regression was used to analyze the independent influencing factors of the prognosis of patients with advanced PHC treated with TACE.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the value of serum CCL-18 combined with SII in evaluating the prognosis of TACE interventional therapy in patients with advanced PHC.Results The survival rates of the high CCL-18 group and the high SII group at 12 months after operation were significantly lower than those of the low CCL-18 group and the low SII group,respectively[49.1％(53/108)vs 64.4％(67/104),46.7％(50/107)vs 66.7％(70/105)](both P＜0.05).The results of multivariate Logistic regression analysis indicate that lymph node metastasis,Child-Pugh classification,alpha-fetoprotein,preoperative serum CCL-18 level,preoperative SII value,portal vein tumor thrombus,Barcelona clinical liver cancer staging,and targeted drug therapy are all independent factors affecting the prognosis of TACE interventional therapy for patients with advanced PHC(all P＜0.05).ROC curve analysis showed that the AUC of serum CCL-18 and SII alone and in combination were 0.715,0.738 and 0.838,respectively,and the combined application of serum CCL-18 and SII was more effective in evaluating the prognosis of TACE interventional treatment in patients with advanced PHC(P＜0.05).Conclusion Preoperative serum CCL-18 level and SII value are related to the prognosis of TACE interventional therapy in patients with advanced PHC.The combined detection of the two indicators can evaluate the prognosis of TACE interventional therapy in patients with advanced PHC.

Abstract:Objective To analyze the effect of psychological intervention under the solution-focused approach on the anxiety and depression scores and satisfaction of patients undergoing separable tether magnetically controlled capsule endoscopy.Methods Thirty patients who underwent separable tether magnetically controlled capsule endoscopy in Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from January to June 2024 were selected.According to the random number table method,they were divided into the control group and the observation group,with 15 cases in each group.The basic information,self-rating anxiety scale(SAS),self-rating depression scale(SDS)scores and satisfaction were compared between the two groups.Results There were no statistically significant differences in age,gender ratio,basic diseases,and the proportion of separable tether magnetically controlled capsule endoscopy results between the two groups(all P＞0.05).The SAS and SDS scores of the two groups after examination were lower than those before examination,and those of the observation group were lower than those of the control group[(29.8±1.9)vs(33.5±2.7),(31.5±3.1)vs(35.5±3.6)](all P＜0.01).In the control group,10 cases(66.7％)were very satisfied and 5 cases(33.3％)were basically satisfied.In the observation group,14 cases(93.3％)were very satisfied and 1 case(6.7％)was basically satisfied.There were no unsatisfied patients in the two groups,and the satisfaction of the observation group was better than that of the control group(x2=21.125,P＜0.001).Conclusion The psychological intervention under the solution-focused approach can improve the patients' state of mind,reduce anxiety and depression,and improve patient satisfaction in patients undergoing separable tether magnetically controlled capsule endoscopy.

Abstract:In order to expand the thinking of traditional Chinese medicine(TCM)in treating gastroesoph-ageal reflux disease(GERD),this article summarizes and discusses the research progress of TCM's syndrome differentiation and treatment of GERD from the perspective of lungs and kidneys,breaking through the traditional framework of treating GERD from the spleen,stomach,and liver.Based on the theoretical principles that the lungs govern descending and the kidneys govern water and fluid,this article explores the physiological and pathological connections between the lungs,kidneys,and stomach in TCM,and summarizes the treatment ideas of treating the lungs and stomach together,treating the kidneys and stomach together,and treating the lungs,kidneys,and stomach together.It also summarizes the therapeutic methods of nourishing earth to generate metal,reducing Qi and regulating the stomach;warming and replenishing kidney Yang,regulating kidney water;and harmonizing Yin and Yang.

Abstract:Both chronic inflammatory and immune processes play important roles in the development of coronary atherosclerotic heart disease.Studies have shown that colchicine can reduce major adverse cardiovascular events in elderly patients with coronary atherosclerotic heart disease.In addition to anti-inflammatory effects,colchicine also has a certain effect on immune function in elderly patients with coronary atherosclerotic heart disease,including effects on neutrophils and immune molecules.At the same time,colchicine also produces immune-related adverse reactions,increasing the occurrence and development of non-cardiovascular death,infec-tion,cancer and other diseases.This study aims to summarize the research progress on the effect of colchicine on immune function in elderly patients with coronary atherosclerotic heart disease,in order to provide ideas for the further rational application of colchicine in elderly patients with coronary atherosclerotic heart disease.

Abstract:With the aging of the population in China,the standardized training of geriatricians is required.Geriatric medical education is characterized by interdisciplinary,multiple medications,and complex assessment methods for geriatric syndromes.The traditional"academic"teaching method is difficult to form a complete knowledge chain for geriatric medical students,which is inconsistent with the"holism"and"integration thought"in modern medical education.The medical training model organ of system-based curriculum(OSBC)can integrate the knowledge of various disciplines horizontally and vertically,strengthen the correlation between basic disciplines and clinical courses,which is beneficial to the training of interdisciplinary composite talents and the improvement of humanistic quality.The application of OSBC in geriatric physician training conforms to the current reform direction of clinical medical education,which is of great significance to promote the progress of medical and health care.This article expounds the development status of OSBC education,the existing geriatric education model and the development prospect of OSBC in geriatric education.

Abstract:Objective To investigate the correlation between platelet to lymphocyte ratio(PLR)and disease activity in patients with rheumatoid arthritis(RA),and to evaluate its predictive value for disease activity in RA patients.Methods A total of 64 RA patients hospitalized in the Department of Rheumatology and Immunology,Shaanxi Provincial People's Hospital from June to December 2022 were enrolled.According to the disease activity index of 28 joints(DAS28-ESR)score based on erythrocyte sedimentation rate(ESR),patients were divided into low disease activity group(10 cases),moderate disease activity group(29 cases)and high disease activity group(25 cases).The clinical data and PLR levels of the three groups were compared,and the correlation between PLR and other indicators was analyzed.The risk factors for RA disease activity were determined by ordinal Logistic regression analysis,and the predictive value of PLR for disease activity was judged by receiver operating characteristic curve.Results The DAS28-ESR,tender joint count(TJC),swollen joint count,ESR,neutrophil count and PLR in the high disease activity group were higher than those in the low and moderate disease activity groups.The hemoglobin and cholinesterase in the high disease activity group were lower than those in the low and moderate disease activity groups(all P＜0.05).Correlation analysis showed that PLR was positively correlated with DAS28-ESR,ESR and platelet count,and negatively correlated with absolute lymphocyte count,hemoglobin,alanine aminotransferase and cholinesterase(all P＜0.05).Logistic regression analysis showed that TJC,ESR and PLR were risk factors for disease activity in RA patients(odds ratio=8.723,1.471,1.068,all P＜0.05).The area under the curve of PLR for predicting disease activity in RA patients was 0.712(95％confidence interval:0.567-0.857),the cut-off value was 212.95,the sensitivity was 56.0％,and the specificity was 94.9％.Conclusion PLR is related to the disease activity of RA patients.Combined with other related indicators,PLR can be used as an index to judge the disease activity,which has a suggestive effect on clinical practice.

Abstract:Objective To evaluate the role of lymphocyte subsets and cytokines in predicting the efficacy of immunotherapy in patients with advanced colorectal cancer,in order to provide effective clinical predictive tools for individualized treatment of patients with advanced colorectal cancer.Methods The clinical data of 52 patients with advanced colorectal cancer treated with programmed cell death receptor-1/programmed cell death receptor ligand-1 inhibitor in Suzhou Municipal Hospital,Jiangsu Province from October 2022 to April 2025 were collected and retrospectively analyzed.According to the response evaluation criteria in solid tumors,the patients were divided into complete response,partial response,stable disease and progressive disease.The patients with complete response,partial response and stable disease were classified into the control group(29 cases),and the patients with progressive disease were classified into the progression group(23 cases).The levels of lymphocyte subsets(regulatory T cells,CD3+,CD4+,CD8+,CD19+,natural killer cells)and cytokines[interleukin-2(IL-2),IL-4,IL-6,IL-10,tumor necrosis factor-α,interferon-γ]were compared between the two groups before and after treatment,and their correlation with the efficacy of immunotherapy was analyzed.Results The level of natural killer cells in the control group was significantly higher than that in the progression group before treatment[19.1％(14.6％,24.9％)vs 8.0％(7.2％,18.2％)](P=0.041).After treatment,IL-6 in the progression group was significantly higher than that before treatment,and IL-6 in the control group was significantly lower than that before treatment,and IL-6 in the control group was lower than that in the progression group[4.7(3.5,9.5)ng/L vs 17.3(14.7,47.4)ng/L](all P＜0.05).Through Pearson correlation analysis,it was found that IL-6 was negatively correlated with tumor progression(r=-0.489,P=0.003),suggesting that the higher the IL-6 level,the worse the treatment effect.Conclusion Natural killer cells and IL-6 have potential value in predicting the response of immunotherapy in patients with advanced colorectal cancer.Increased levels of natural killer cells are associated with better treatment response,whereas increased IL-6 may predict a worse prognosis.

Abstract:Objective To investigate the effects of different doses of recombinant human growth hormone(rhGH)on children with idiopathic short stature(ISS).Methods A total of 95 children with ISS admitted to the Affiliated Hospital of Hebei University from March 2022 to March 2023 were selected,and they were divided into low-dose group[31 cases,0.26 mg/(kg·d)],medium-dose group[32 cases,0.35 mg/(kg·d)]and high-dose group[32 cases,0.41 mg/(kg·d)]according to the random number table method.The growth status,growth factor levels,thyroid function,glucose and lipid metabolism indexes,bone metabolism indexes,and adverse reactions were compared among the three groups.Results After treatment,the height,growth rate,height standard deviation score,and levels of insulin-like growth factor binding protein 3(IGFBP-3)and insulin-like growth factor 1 of the three groups were higher than those before treatment,and those in the high-dose group were higher than those in the medium-dose group and the low-dose group(all P＜0.05).After treatment,there was no significant difference in thyroid function indexes of the three groups and before treatment,and there was no significant difference among the three groups(all P＞0.05).After treatment,the levels of fasting insulin,triglyceride,and low-density lipoprotein cholesterol of the three groups were lower than those before treatment(all P＜0.05),and there were no statistically significant differences in the glucose and lipid metabolism indexes among the three groups(all P＞0.05).After treatment,the levels of omentin-1 and bone alkaline phosphatase of the three groups were higher than those before treatment,and those of the high-dose group were higher than those of the middle-dose group and the low-dose group[(64±7)mg/L vs(57±7),(57±8)mg/L;(161±18)U/L vs(132±16),(130±17)U/L](all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion High-dose rhGH has a better effect in the treatment of children with ISS,which has a great effect on serum IGFBP-3 and omentin-1 levels,and the three doses have similar effects on glucose and lipid metabolism and thyroid function in children.

Abstract:The incidence of sarcopenia in maintenance hemodialysis(MHD)patients is significantly higher than that in the general population,which has a negative impact on the quality of life and prognosis of MHD patients.This article reviews the epidemiology,influencing factors,pathogenesis and intervention of sarcopenia in MHD patients,and points out that the influencing factors include insufficient exercise,malnutrition,intestinal flora imbalance,electrolyte imbalance,age and gender,and its pathogenesis involves protein metabolism disorder,inflammatory state,insulin resistance and neuromuscular junction dysfunction.Exercise training,nutritional support and drug therapy can be used for intervention.

Abstract:Objective To observe the clinical characteristics of in-hospital cardiac arrest(IHCA)in patients with acute myocardial infarction complicated with cardiogenic shock,and further analyze the risk of in-hospital death and discharge death after IHCA.Methods Consecutive patients with acute myocardial infarction complicated with cardiogenic shock admitted to the Critical Care Center,Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University from September 1,2021 to July 31,2024 were enrolled,and the patients who met the inclusion criteria were enrolled in a pure observational study.Patients were divided into groups according to whether IHCA events occurred during the treatment,and the clinical outcomes and clinical characteristics of patients in different groups were further observed and compared.The primary endpoint was in-hospital death.The secondary endpoints included in-hospital complications,all-cause death within 30 d after discharge and all-cause death within 1 year after discharge.Cox regression model was used to analyze the relationship between IHCA and the risk of in-hospital death,and modified Poisson regression was used to analyze the effect of IHCA on death at 30 d and 1 year after discharge.Results A total of 148 patients were selected in this study,of which 62 patients had IHCA(IHCA group),the incidence of IHCA was 41.9％,and the remaining 86 patients were included in the non-IHCA group.The proportion of male,blood lactate level,vasoactive drug score and gastrointestinal bleeding rate in IHCA group were significantly higher than those in non-IHCA group,and the left ventricular ejection fraction(LVEF)and the proportion of revascularization were significantly lower than those in non-IHCA group(all P＜0.05).The in-hospital mortality,30 d mortality,and 1-year mortality in the IHCA group were significantly higher than those in the non-IHCA group(all P＜0.05).Sixty-two IHCA patients were divided into shockable cardiac arrest(VFCA)group(47 cases)and non-shockable cardiac arrest(NVFCA)group(15 cases)according to the type of cardiac arrest.The 30 d mortality rate in the NVFCA group was significantly higher than that in the VFCA group(P＜0.05).Cox regression model analysis showed that compared with the non-IHCA group,the hazard ratio of in-hospital death in the IHCA group was 2.064(P=0.011).The results of modified Poisson regression analysis showed that compared with the non-IHCA group,the relative risk of death in the IHCA group was 1.606(P=0.003)at 30 d after discharge and 1.644(P=0.001)at 1 year after discharge.Compared with the VFCA group,the relative risk of death in the NVFCA group was 1.599(P=0.010)at 30 d after discharge and 1.369(P=0.070)at 1 year after discharge.Conclusion In patients with acute myocardial infarction complicated with cardiogenic shock,blood lactate level is higher,LVEF level and revascularization rate are lower in IHCA patients.IHCA increased the risk of in-hospital death,30 d death and 1-year death after discharge,and NVFCA increased the risk of 30 d death after discharge.

Abstract:Objective To explore the effect of Kangfuxin liquid combined with linezolid in the treatment of pulmonary tuberculosis in children.Methods A total of 188 children with pulmonary tuberculosis admitted to Qinghai Women and Children's Hospital from October 2023 to October 2024 were selected.According to the random number table method,they were divided into control group and combined group,with 94 cases in each group.On the basis of standardized treatment,the control group was treated with linezolid,and the combined group was treated with Kangfuxin liquid on the basis of the control group.The clinical efficacy,remission time,inflammatory factors,immune function and adverse reactions were compared between the two groups.Results The total effective rate of the combined group was higher than that of the control group[95.7％(90/94)vs 87.2％(82/94)](P=0.037).The cavity closure time,lesion absorption time,sputum culture negative time and acid-fast staining smear negative time of the combined group were shorter than those of the control group(all P＜0.05).After treatment,the levels of interferon-γ,interleukin-10 and high-sensitivity C-reactive protein in the combined group were lower than those in the control group(all P＜0.05).After treatment,the CD4+and CD4+/CD8+ratios in the combined group were higher than those in the control group,and CD8+was lower than that in the control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.194).Conclusion Kangfuxin liquid combined with linezolid is effective in the treatment of pulmonary tuberculosis in children,which can effectively shorten the remission time,reduce the expression of inflammatory factors,improve immune function,and has good safety.

Abstract:Diabetes,as a common chronic metabolic disease in clinical practice,is characterized by a high incidence rate,a long treatment cycle and many complications.The low cure rate of diabetic wounds is the main reason for the high disability and mortality rate of patients,which has a serious impact on the physical and mental health and quality of life of patients.Therefore,how to improve the cure rate of diabetic wounds has become an urgent problem to be solved.Cell necrotizing apoptosis is one of the research hotspots in recent years.As a novel programmed cell death pathway,it is involved in various inflammatory responses.Studies have shown that necrotizing apoptosis of cells is involved in the pathogenesis of diabetes and plays an extremely important role in the healing of diabetic wounds.Factors such as tumor necrosis factor-α,receptor-interacting serine-threonine protein 1/3,and mixed lineage kinase ligands are the main proteins regulating the signaling pathway of cell necrotizing apoptosis and also affect the healing of diabetes and its complications.This article elaborates on the research of cell necrotizing apoptosis and surface-related proteins and their mechanism of action in diabetic wounds,providing a reference for the clinical treatment of diabetic wounds.