Abstract:Cardiovascular disease is a major threat to human health.Its core pathophysiological features are endothelial dysfunction,which is manifested as decreased vasodilation ability,hemodynamic abnormalities,and accelerated progression of atherosclerosis.Trimetazidine can effectively improve endothelial dysfunction by optimizing energy metabolism,improving hemodynamics,reducing oxidative stress,inhibiting inflammatory response,and regulating angiogenesis,and is widely used in the treatment of a variety of cardiovascular diseases.This article reviews the mechanism of trimetazidine and its latest research progress in improving endothelial dysfunction related to cardiovascular disease,so as to provide new strategies and evidence for better clinical application of trimetazidine.

Abstract:Objective To investigate the effects of different concentrations of cyclosporine on metabolism of blood glucose,blood lipid,uric acid,etc and renal function in patients with aplastic anemia.Methods A total of 143 patients with aplastic anemia treated with cyclosporine in the First Affiliated Hospital of Harbin Medical University from January 2021 to January 2024 were selected.According to the different blood drug concentration monitoring time,they were divided into 1 month after treatment group(group A,31 cases),3 months after treatment group(group B,34 cases)and 6 months after treatment group(group C,42 cases)and 12 months after treatment group(group D,36 cases).The blood concentration of cyclosporine,blood glucose,blood lipid,serum creatinine and uric acid of patients in different groups were collected,and the correlation between the blood concentration of cyclosporine and each index was analyzed.Results The blood concentrations of cyclosporine in groups A,B,C,and D were(193±28),(214±19),(188±28),and(176±26)μg/L,respectively.The blood concentration of cyclosporine in group B was higher than those in groups A,C,and D(P＜0.05).There were statistically significant differences in the levels of blood glucose,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,and creatinine among the four groups(all P＜0.05),and there was no statistically significant difference in the level of uric acid(P＞0.05).The results of correlation analysis showed that blood glucose,triglyceride,low-density lipoprotein cholesterol and creatinine were positively correlated with the blood concentration of cyclosporine,high-density lipoprotein cholesterol was negatively correlated with the blood concentration of cyclosporine(all P＜0.05),while total cholesterol and uric acid levels were not correlated with the blood concentration of cyclosporine(both P＞0.05).Conclusions The plasma concentration of cyclosporine has an effect on blood glucose,lipid metabolism and renal function in patients with aplastic anemia,but has no effect on uric acid metabolism.

Abstract:Objective To investigate the application value of profile blood lipid combined with CT angiography(CTA)in the diagnosis of carotid plaque in patients with cerebral infarction.Methods A total of 200 patients with cerebral infarction admitted to the Department of Neurology,Zhangjiakou First Hospital,Hebei Province from May 2021 to December 2022 were selected as the observation group,and 100 healthy people who underwent physical examination during the same period were selected as the control group.According to the results of digital subtraction angiography,the patients in the observation group were divided into plaque group(108 cases)and non-plaque group(92 cases).Gender,age,smoking history,hypertension,diabetes,heart disease history,kidney disease history,and blood lipid indexes were collected and compared.The results of digital subtraction angiography were used as the gold standard to evaluate the efficacy of CTA alone and combined with blood lipid indexes in the diagnosis of carotid plaque.Results There were no statistically significant differences in baseline data between the observation group and the control group(all P＞0.05).The levels of serum matrix metalloproteinase-9(MMP-9),total cholesterol,triglyceride and low-density lipoprotein cholesterol(LDL-C)in the observation group were higher than those in the control group,and the levels of tissue inhibitor of metalloproteinase-1(TIMP-1)and high-density lipoprotein cholesterol(HDL-C)were lower than those in the control group(all P＜0.05).The levels of serum MMP-9,total cholesterol,triglyceride and LDL-C in the plaque group were higher than those in the non-plaque group,and the levels of TIMP-1 and HDL-C in the plaque group were lower than those in the non-plaque group(all P＜0.05).Multivariate Logistic regression showed that MMP-9 and triglyceride were independent risk factors for carotid plaque,and TIMP-1 was protective factor(all P＜0.05).The area under the curve(AUC)of CTA combined with serum MMP-9,TIMP-1,total cholesterol,triglyceride,HDL-C and LDL-C in the diagnosis of carotid plaque was 0.993.The AUC of CTA combined with serum MMP-9 and TIMP-1 in the diagnosis of carotid plaque was 0.981.The AUC of CTA alone in the diagnosis of carotid plaque was 0.935,and the diagnostic efficacy of combined diagnosis was higher than that of CTA alone.Conclusion Blood lipid profile combined with CTA,MMP-9 and TIMP-1 can significantly improve the diagnostic efficiency of carotid plaque in patients with cerebral infarction,provide a more comprehensive and accurate diagnostic basis for clinical practice,and contribute to early intervention and individualized treatment of cerebral infarction.

Abstract:Objective To investigate the clinical efficacy and safety of different platinum-based chemotherapy regimens combined with slulizumab as first-line treatment for extensive-stage small cell lung cancer(ES-SCLC).Methods A total of 118 patients with ES-SCLC admitted to the Affiliated Hospital of Xuzhou Medical University from October 1,2022 to September 30,2024 were retrospectively selected.According to the different chemothera-py regimens,they were divided into lobaplatin group(65 cases)and carboplatin group(53 cases).The patients in the lobaplatin group were treated with lobaplatin combined with etoposide and slulizumab,and the patients in the carboplatin group were treated with carboplatin combined with etoposide and slulizumab,every 21 days as a cycle.The patients in the two groups were treated for 4 cycles.The general data,short-term efficacy,long-term efficacy,and adverse reactions of the two groups were compared.Results There were no significant differences in gender,age,smoking history,Eastern Cooperative Oncology Group performance status scale score,liver metastasis,brain metastasis,bone metastasis,adrenal metastasis,and thoracic radiotherapy between the two groups(all P＞0.05).There was no significant difference in objective response rate and disease control rate between lobaplatin group and carboplatin group[64.6％(42/65)vs 69.8％(37/53),83.1％(54/65)vs 88.7％(47/53)](x2=0.356,P=0.551;x2=0.743,P=0.389).There were no significant differences in progression-free survival and overall survival between the two groups(both P＞0.05).The incidences of nausea and vomiting and allergic reactions in the lobaplatin group were lower than those in the carboplatin group(both P＜0.05).Conclusion Lobaplatin combined with etoposide and slulizumab and carboplatin combined with etoposide and slulizumab are effective in the first-line treatment of ES-SCLC.The incidence of nausea and vomiting and allergic reactions in the lobaplatin group is lower than that in the carboplatin group.

Abstract:Bronchial asthma is a global health problem with chronic airway inflammation as the core pathological feature.The clinical manifestations are wheezing,dyspnea and cough,and the pathological features include airway hyperresponsiveness,reversible airflow limitation and clinical heterogeneity.Airway epithelium is the first line of defense against external stimuli,and its barrier damage can lead to increased allergen penetration,activate cellular immunity,trigger inflammatory cascades,and exacerbate airway remodeling.Studies have shown that autophagy has a dual role in the regulation of airway inflammation.Long non-coding RNA MALAT1 was significantly up-regulated in peripheral blood and lung tissues of asthmatic patients.In asthma model,silencing MALAT1 can reduce the expression of autophagy-related proteins,inhibit neutrophil infiltration and inflammatory response,and improve airway pathological characteristics.In the future,it is necessary to further analyze the specific regulatory network of MALAT1 in autophagy and inflammation,and to explore its clinical application potential as a molecular marker or therapeutic target combined with high-throughput technology,so as to lay a theoretical foundation for the precise intervention of autophagy-related respiratory diseases.

Abstract:Airway management is an important part of anesthesia.Unpredictable difficult airway can lead to serious consequences,such as hypoxemia and brain death,so airway assessment before anesthesia is particularly important.Machine learning and deep learning have better performance than traditional methods(such as modified Maholobian classification,thyromental distance,etc.)in establishing difficult airway prediction models.Machine learning algorithms can keenly find nonlinear relationships between variables.Deep learning algorithms,especially convolutional neural networks and their variants,have significantly improved prediction accuracy and efficiency by automatically analyzing multimodal data.This article focuses on the application of machine learning and deep learning technology in difficult airway assessment,in order to improve the safety of anesthesia.

Abstract:Objective To investigate the difference of organ dysfunction between surgical and non-surgical patients with sepsis.Methods A total of 219 patients with sepsis admitted to the Department of Critical Care Medicine,Guangdong Provincial Hospital of Traditional Chinese Medicine from January 1,2021 to January 1,2024 were retrospectively selected as the research objects.According to whether they received surgical treatment,they were divided into surgery group(71 cases)and non-surgery group(148 cases).Univariate analysis was used to screen out the factors with significant differences between surgical and non-surgical patients with sepsis,and multivariate Logistic analysis was used to analyze the influencing factors of non-surgical patients with sepsis.The Kaplan-Meier method was used to draw the survival analysis curve of patients with sepsis in the surgery group and the non-surgery group,and the influence of different surgical types on the survival rate of patients with sepsis was analyzed.The survival group and death group of patients with sepsis in the surgery group and the non-surgery group were analyzed.Results There were statistically significant differences in the proportions of pulmonary infection,digestive tract infection,blood infection,skin and soft tissue infection,hypertension,cerebrovascular disease,chronic kidney disease,and malignant tumors between the two groups(all P＜0.05).There were significant differences in sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)score,vasopressin use proportion,white blood cell count,prothrombin time,activated partial thromboplastin time(APTT),SOFA liver subscore,serum total bilirubin,SOFA circulation subscore,and vasopressin treatment days between the two groups(all P＜0.05).Multivariate Logistic regression analysis showed that APTT,SOFA liver subscore and SOFA cardiovascular subscore were negatively correlated with non-surgical sepsis(odds ratio=0.969,0.587,0.724,all P＜0.05).The survival rate of emergency surgery was significantly lower than that of limited surgery(x2=4.089,P=0.043).Subgroup analysis showed that SOFA score,APACHEⅡ score,SOFA renal subscore,the use of mechanical ventilation and renal replacement therapy on the first day in the surgery group were all influencing factors for in-hospital mortality(all P＜0.05).SOFA score,APACHE Ⅱ score,SOFA respiratory subscore,SOFA central subscore,the use of mechanical ventilation and renal replacement therapy on the first day were the influencing factors of in-hospital mortality in non-surgery group(all P＜0.05).Conclusions Compared with non-surgical sepsis patients,surgical sepsis patients show more severe organ dysfunction on admission to the intensive care unit,mainly in the cardiovascular system and liver system,but there is no significant difference in short-term prognosis between the two groups.

Abstract:The onset of premature ovarian insufficiency is insidious,which is a disease state manifested by ovarian insufficiency at a certain stage.Without timely intervention,it will further develop into premature ovarian failure,which seriously affects women's physical and mental health.Traditional Chinese medicine has a long history and rich experience in the treatment of this disease,and has formed a variety of treatment ideas and methods.Based on the thought of"prevention before disease onset"in traditional Chinese medicine,this article discusses the prevention and treatment of premature ovarian insufficiency from the aspects of"prevention before disease onset","controlling development of existing disease"and"prevention of recurrence after recovery".For example,"prevention before disease onset"emphasizes"strengthening and consolidating body resistance"and"preventing the cause of the disease before it occurs"."Controlling development of existing disease"emphasizes the transmission of premature ovarian insufficiency,the rule of medication,and the syndrome differentiation of traditional Chinese medicine.Daily protection and rehabilitation treatment of the disease were emphasized in the"prevention of recur-rence after recovery",in order to provide new ideas and methods for the prevention and treatment of the disease with traditional Chinese medicine.

Abstract:Objective To investigate the effects of butylphthalide sodium chloride injection combined with edaravone dexborneol concentrated solution for injection on neurological function and cerebral blood flow in patients with acute cerebral infarction(ACI).Methods A total of 89 ACI patients admitted to Nanjing Central Hospital,Jiangsu Province from June 2022 to December 2024 were selected and divided into a control group(44 cases)and an observation group(45 cases)according to the random number table method.On the basis of conventional treatment,the control group was treated with butylphthalide sodium chloride injection,and the observation group was treated with butylphthalide sodium chloride injection plus edaravone dexborneol concentrated solution for injection,with both groups receiving treatment for 2 weeks.The cerebral blood flow status and serum indexes[serum central nervous system-specific protein(S-100β),C-reactive protein(CRP)]levels before and after treatment were compared between the two groups,the prognosis[modified Rankin Scale(mRS)score]within 1 year after treatment was evaluated,and the incidence of adverse reactions after medication was compared between the two groups.Results After treatment,the mean blood flow velocities of the middle cerebral artery,vertebral artery and basilar artery in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).After treatment,the serum levels of S-100β and CRP in both groups were lower than those before treatment(all P＜0.05),and those in the observation group were lower than those in the control group[(0.49±0.14)μg/L vs(0.65±0.17)μg/L,(0.81±0.25)mg/L vs(0.94±0.22)mg/L](all P＜0.05).After treatment,the mRS scores of both groups showed a gradual downward trend,and the mRS scores of the observation group at 3 months,6 months and 1 year after treatment were lower than those of the control group(all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The combined treatment of butylphthalide sodium chloride and edaravone dexborneol can effectively promote the recovery of neurological function,accelerate the improvement of cerebral blood flow velocity,significantly reduce the levels of inflammatory indexes in ACI patients.

Abstract:Objective To investigate the clinical effect of different doses of Xuebijing combined with linezolid in the treatment of patients with severe pneumonia and its influence on T helper cell 17(Th17),regulatory T cell(Treg)cytokines and blood gas indexes.Methods A total of 136 patients with severe pneumonia admitted to the First Affiliated Hospital of Xi'an Jiaotong University from March 2022 to March 2025 were selected as the research objects.According to the random envelope drawing method,the patients were divided into control group and observation group,with 68 cases in each group.Both groups received conventional treatment.The control group was treated with small dose of Xuebijing injection combined with linezolid tablets,and the observation group was treated with large dose of Xuebijing injection combined with linezolid tablets.Both groups were treated for 7 d.The clinical efficacy,mechanical ventilation time and hospitalization time,blood gas analysis indexes,serum Th17 and Treg cytokines,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[94.1％(64/68)vs 82.4％(56/68)](x2=4.533,P=0.033).The mechanical ventilation time and intensive care unit length of stay in the observation group were significantly lower than those in the control group(both P＜0.05).After treatment,the levels of blood oxygen saturation,arterial partial pressure of oxygen,interleukin-10 and transforming growth factor-β in the two groups were higher than those before treatment,and the levels of arterial partial pressure of carbon dioxide,interleukin-17 and tumor necrosis factor-α were lower than those before treatment,and the improvement degree of blood gas analysis indexes,Th17 and Treg cytokines in the observation group was significantly better than that in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Large dose of Xuebijing injection combined with linezolid tablets can regulate the levels of Th17 and Treg cytokines,effectively treat patients with severe pneumonia,shorten the time of mechanical ventilation and hospitalization,improve blood gas indexes,and have better clinical efficacy.

Abstract:Objective To investigate the effect of drug-coated balloon catheter on late lumen loss and adverse cardiovascular events in patients with de novo coronary small vessel disease.Methods A total of 256 patients with de novo small vessel coronary artery disease who underwent percutaneous coronary intervention in 14 hospitals in China from March to June 2021 were selected as the postoperative group.The basic data,hospitalization related examination and operation information of the patients were collected,and the follow-up angiography was performed at 9 months after operation to record the late lumen loss in the affected segment and the rate of target lesion restenosis.A total of 194 patients were followed up for 1 year(follow-up group).The patient-related cardiovascular clinical composite endpoint(POCE)and device oriented composite endpoint(DOCE)were observed.Results The mean age of the study subjects was(63±9)years,the preoperative minimum lumen diameter was(0.62±0.25)mm,the preoperative stenosis degree was(70±11)％,the preoperative reference vessel diameter was(2.1±0.3)mm,the preoperative lesion length was(11±5)mm,and 247 cases(96.5％)were thrombolysis in myocardial infarction trial flow grade Ⅲ.There were significant differences in the minimum lumen diameter in the segment,the degree of residual stenosis in the segment,the minimum lumen diameter in the balloon dilatation segment,and the degree of residual stenosis in the balloon dilatation segment between the postoperative group and the follow-up group(all P＜0.001).Multivariate Cox regression analysis showed that late segmental lumen loss was an independent risk factor for POCE and DOCE after adjusting for related risk factors(gender,age,systolic blood pressure,diastolic blood pressure,heart rate,low-density lipoprotein cholesterol,total cholesterol,triglyceride,and serum creatinine)at 1 year follow-up(both P＜0.001).Conclusion Increased late lumen loss after drug-coated balloon catheter treatment of de novo coronary small vessel disease may be an independent risk factor for adverse cardiovascular events.

Abstract:Objective To investigate the mutation of α-thalassemia/X-linked mental retardation syndrome(ATRX)and telomerase reverse transcriptase(TERT)gene in different types of gliomas,and to analyze the relationship between ATRX and TERT gene mutation and the prognosis of patients.Methods The clinical data of 117 patients with newly diagnosed glioma admitted to the Affiliated Hospital of Xuzhou Medical University from September 2021 to September 2024 were retrospectively analyzed.According to the postoperative pathological type,the patients were divided into glioblastoma group(61 cases),oligodendroglioma group(29 cases)and astrocytoma group(27 cases).The general clinical data and the positive rate of ATRX and TERT promoter mutation in each group were compared.Multivariate Cox regression model was used to analyze the factors affecting the prognosis of glioma patients.Kaplan-Meier survival curve was used to analyze the correlation between ATRX and TERT gene mutation and the prognosis of patients.Results The ATRX expression rates of oligodendroglioma group and astrocytoma group were higher than that of glioblastoma group[65.5％(19/29),63.0％(17/27)vs 36.1％(22/61)],the TERT promoter mutation rate in astrocytoma group was lower than those in glioblastoma group and oligodendro-glioma group[25.9％(7/27)vs 62.3％(38/61),79.3％(23/29)](all P＜0.05).Multivariate Cox regression analysis showed that ATRX and TERT promoter mutation were related factors affecting the prognosis of glioma patients(P＜0.05).Kaplan-Meier survival analysis showed that patients with ATRX loss had a shorter overall survival than those with ATRX expression[(29.1±1.3)months vs(34.2±0.8)months](Log-rank x2=4.835,P=0.028).The overall survival of patients with TERT promoter mutation was shorter than that of patients without TERT promoter mutation[(28.4±1.2)months vs(34.9±0.8)months](Log-rank x2=7.307,P=0.007).Conclusion ATRX expression and TERT promoter mutation are different in different types of gliomas.Loss of ATRX expression and TERT promoter mutation have a certain impact on the prognosis of glioma patients.

Abstract:Objective To investigate the effect of Kanglaite injection/soft capsule sequential combined immunotherapy on the survival and immune function of patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 123 patients with advanced NSCLC admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from June 2022 to June 2023 were selected as the research objects.The patients were divided into groups A,B and C by random number table method,with 41 cases in each group.The patients in group A were treated with immunotherapy and other conventional treatment,the patients in group B were treated with Kanglaite injection on the basis of group A,and the patients in group C were treated with Kanglaite soft capsule on the basis of group B,with 21 d as a course of treatment.The patients in the three groups were treated for 3 consecutive courses.The clinical efficacy,tumor marker levels,immune function indexes,quality of life scores,survival cycle,and incidence of adverse reactions were compared among the three groups.Results According to the exclusion criteria,2 cases were excluded from group A,2 cases from group B,and 1 case from group C,respectively.Finally,there were 39 cases in group A,39 cases in group B,and 40 cases in group C.The objective response rate and disease control rate in group C were higher than those in group A[50.0％(20/40)vs 30.8％(12/39),70.0％(28/40)vs 48.7％(19/39)](both P＜0.05).After treatment,the levels of tumor markers in the three groups were lower than those before treatment,and those in group C were lower than those in group A and group B,and those in group B were lower than those in group A(all P＜0.05).After treatment,the immune function indexes of patients in group A were better than those before treatment,CD4+,CD8+,CD4+/CD8+of patients in group B and group C were better than those before treatment,and those in group C were better than those in group A and group B,and those in group B were better than those in group A(all P＜0.05).After treatment,the quality of life scores of the three groups were higher than those before treatment.The scores of quality of life in group C and group B were higher than those in group A,and the scores of physiological status,social and family status,functional status and lung cancer related symptoms in group C were higher than those in group B(all P＜0.05).There were no significant differences in the median time to progression,median progression-free survival and median overall survival among the three groups(all P＞0.05).The incidences of adverse reactions in group B and group C were lower than that in group A(x2=6.129,P=0.046).Conclusion Kanglaite injection/soft capsule sequential combined immunotherapy has a significant effect on patients with advanced NSCLC,which can reduce the level of tumor markers,improve immune function,improve the quality of life,prolong the survival period of patients,and reduce the incidence of adverse reactions.

Abstract:Objective To analyze the influencing factors of poor coronary collateral circulation(CCC)formation in patients with acute coronary syndrome(ACS)and its effect on prognosis.Methods A total of 260 ACS patients admitted to 3201 Hospital from January 2021 to December 2023 were selected and divided into poor formation group and good formation group according to CCC formation.The clinical data of ACS patients were collected,and the incidence of major adverse cardiovascular events(MACE)was calculated after 1 year of follow-up.Univariate analysis was used to analyze the factors of poor CCC in ACS patients,LASSO regression was used to screen the related variables affecting poor CCC in ACS patients,and multivariate Logistic regression analysis was used to determine the independent influencing factors.Based on this,a nomogram prediction model for poor CCC in ACS patients was constructed.By testing the fit of the H-L model,the receiver operating characteristic(ROC)curve was plotted to evaluate the predictive ability of the model,the C-index was used to evaluate the ability to discriminate,the calibration curve was used to evaluate consistency,and the decision curve was used to evaluate the clinical decision value.Results The rate of poor CCC formation in 260 ACS patients was 63.5％(165/260).Multivariate Logistic regression analysis showed that diabetes,high atherogenic index of plasma(AIP)and high neutrophil-to-lymphocyte ratio(NLR)were independent risk factors for poor CCC formation in ACS patients,while right coronary artery,multi-vessel disease and high Gensini score were independent protective factors(all P＜0.05).Based on the above influencing factors,a nomogram model was established as follows:Logit(P)=0.876+1.292 × diabetes-1.176 × culprit vessel-1.785 × number of diseased vessels-0.028 × Gensini Score+0.423 × AIP+0.424 × NLR,with a non-significant H-L test(P＞0.05).The ROC curve analysis results showed that the area under the curve of the nomogram model predicting poor CCC formation in ACS patients was 0.887(95％confidence interval:0.842-0.923),with sensitivity and specificity of 81.8％and 83.2％,respectively.After 1 000 bootstrap self sampling resampling for internal validation,the C-index was 0.888(95％confidence interval:0.883-0.893).The calibration curve showed that the predicted probability was well fitted to the ideal curve,and the decision curve showed that when the threshold probability was greater than 0.15,the net clinical benefit was greater than 0.After 1 year of follow-up,the incidence of MACE in the poor formation group was higher than that in the good formation group[33.9％(56/165)vs 21.1％(20/95)](P＜0.05).Conclusion Diabetes,culprit vessel,number of diseased vessels,Gensini score,AIP and NLR are independent influencing factors for poor CCC in ACS patients.The nomogram model based on this has good predictive value,and poor CCC can increase the incidence of MACE.

Abstract:Objective To explore the influencing factors of sarcopenia in elderly patients with chronic heart failure(CHF),and to construct a nomogram prediction model for predicting the risk of sarcopenia.Methods A total of 200 elderly patients with CHF admitted to the Ninth Medical Center of Chinese PLA General Hospital from July 2023 to January 2025 were selected.According to the occurrence of sarcopenia,patients were divided into sarcopenia group(50 cases)and non-sarcopenia group(150 cases),and the data were collected and recorded.LASSO regression analysis and multivariate Logistic regression analysis were used to screen the independent predictors of sarcopenia in elderly CHF patients.A model was constructed based on LASSO-Logistic regression analysis,and a nomogram was drawn by R software.The calibration curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the nomogram model calibration.The receiver operating characteristic(ROC)curve was used to evaluate the discrimination of the nomogram model.Clinical decision curve analysis was used to evaluate the clinical validity of the nomogram model.Results There were significant differences in age,body mass index,proportion of hyper-tension,diabetes mellitus,left ventricular ejection fraction,New York Heart Association(NYHA)classification,albumin,hemoglobin,appendicular skeletal muscle mass,6 m pace and grip strength between the non-sarcopenia group and the sarcopenia group(all P＜0.05).LASSO-Logistic regression analysis showed that age ≥75 years,lower body mass index,diabetes mellitus,NYHA grade Ⅲ-Ⅳ and lower albumin were independent predictors of sarcopenia in elderly patients with CHF.According to the above factors,a nomogram model for predicting sarcopenia in elderly patients with CHF was constructed.The calibration curve showed that the consistency between the observed value and the predicted value was high,and the Hosmer-Lemeshow goodness of fit test showed x2=0.427,P=0.600.ROC curve results showed that the area under the curve of the model was 0.958(95％confidence interval:0.934-0.982),and the calibration and discrimination of the model were good.Clinical decision curve analysis was used to evaluate the clinical effectiveness of the nomogram model.When the threshold probability range was set to 0.03-0.95,patients could benefit from the nomogram model.Conclusion Age ≥75 years,lower body mass index,diabetes mellitus,NYHA grade Ⅲ-Ⅳ and lower albumin are independent predictors of sarcopenia in elderly CHF patients.The nomogram model based on the above factors can effectively predict the risk of sarcopenia in elderly CHF patients.

Abstract:Objective To investigate the effect of the CXC chemokine receptor-2(CXCR2)small-molecule inhibitor AZD5069 on myocardial ischemia-reperfusion(IR)injury(IRI)and its underlying mechanisms.Methods C57BL/6 mice were used to establish a myocardial IR model,and they were randomly divided into control group and observation group(10 mice each).The control group was given 0.5％sodium carboxymethyl cellulose solution(solvent control)daily,and the observation group was given AZD5069 10 mg/kg daily and dissolved in 0.5％sodium carboxymethyl cellulose.In addition,6 mice were selected as the sham operation group for thoracotomy without ligation of the left anterior descending coronary artery.Cardiac function indexes were dynamically evaluated at 24 h,72 h and 28 days after surgery by echocardiography in small animals.Sirius red staining was performed with paraffin-embedded heart tissue sections to quantify the degree of myocardial fibrosis.Evans blue/TTC double staining(EB/TTC)was used to distinguish myocardial ischemic and non-ischemic areas,and viable and non-viable areas.The mechanism of action of AZD5069 was elucidated by RNA transcriptome sequencing of myocardial tissues.Results At 24 h,72 h and 28 days after operation,the left ventricular ejection fraction in the observation group was higher than that in the control group[(48.0±5.5)％vs(35.3±3.0)％,(55.8±5.1)％vs(40.9±4.1)％,(54.9±5.4)％vs(43.9±7.9)％](all P＜0.05).On the 28th day after IR surgery,there was a statistically significant difference in myocardial collagen volume scores between the observation group,the control group and the sham operation group(P＜0.001),and that in the control group was higher than that in the sham operation group,and that in the observation group was lower than that in the control group(both P＜0.05).The results of EB/TTC quantitative analysis showed that the ratio of myocardial pale infarct area/ischemia area at risk in the observation group was lower than that in the control group(P＜0.05).RNA transcriptome sequencing results showed that the genes that were significantly up-regulated AZD5069 mainly included CXC motif chemokine ligand 1,serum amyloid A3 and Krüppel-like factor 2.Conclusion The small-molecule CXCR2 antagonist AZD5069 demonstrates potential in mitigating myocardial ischemia-reperfusion injury through dual mechanisms of anti-inflammatory action and metabolic modulation,thereby proposing a novel therapeutic paradigm for post-infarction cardioprotection in clinical settings.

Abstract:Parkinson's disease is often accompanied by severe sleep disorders,which seriously affect the quality of life of patients.Apopmorphine is a dopamine receptor agonist and shows good prospects in the treatment of Parkinson's disease.Existing studies have shown that apopmorphine can effectively regulate dopamine function,thereby improving problems such as sleep structure disorders and circadian rhythm imbalances.However,at present,systematic research on its specific mechanism of action and clinical application is still relatively limited.This article aims to review the application progress of apopmorphine in sleep disorders of Parkinson's disease,explore its mechanism of action,clinical research results and future research directions,with the expectation of providing references for clinical practice.

Abstract:Objective To investigate the relationship between DNA ploidy in sputum cells and pathological characteristics,clinical stage,progression and prognosis of lung cancer patients.Methods A total of 162 patients with primary lung cancer confirmed by cytology or histopathology in Department of Oncology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine from May 2019 to June 2021 were selected.The patients were classified according to age,gender,radiotherapy and chemotherapy,smoking history,family history,pathological type,stage,recurrence and metastasis.The patients were followed up by medical history,physical examination and imaging examination until December 2024.Thex2 test was used to analyze the correlation between DNA ploidy of sputum cells and clinicopathological types,stages and progression of lung cancer.Cox multivariate analysis was used to analyze the correlation between factors such as DNA ploidy of sputum cells and the prognosis of lung cancer.Kaplan-Meier method was used to analyze the survival related to DNA ploidy results of sputum cells.Results There was no significant difference in the incidence of abnormal DNA ploidy in lung cancer patients with different histological types(x2=1.194,P=0.551).The incidence of abnormal DNA ploidy in advanced lung cancer patients was higher than that in early stage patients[66.7％(44/66)vs 40.6％(39/96)](x2=10.616,P=0.001).The incidence of abnormal DNA ploidy in patients with recurrence and metastasis was 66.2％(51/77),and that in patients without recurrence and metastasis was 37.6％(32/85),the difference was statistically significan(x2=13.214,P＜0.001).Cox multivariate analysis showed that radiotherapy(hazard ratio=0.429,95％confidence interval:0.252-0.731,P=0.002)was a protective factor for the prognosis of patients with lung cancer,while positive sputum cell DNA ploidy results(hazard ratio=3.065,95％confidence interval:1.830-5.135,P＜0.001)and smoking history(hazard ratio=4.467,95％confidence interval:2.606-7.657,P＜0.001)were risk factors for the prognosis of patients with lung cancer.The results of Kaplan-Meier survival analysis showed that the patients with positive DNA ploidy expression in sputum cells had a lower survival rate than those with negative DNA ploidy expression,and the difference between the two survival curves was statistically significant(x2=18.387,P=0.003).Conclusion Sputum DNA ploidy analysis is an objective,reproducible and easy to be accepted by patients.Sputum DNA ploidy analysis has good clinical significance for the screening,progression and prognosis evaluation of patients with lung cancer,and can be used as an effective detection method for the diagnosis and prognosis of patients with lung cancer together with other diagnostic methods.

Abstract:Advanced ovarian cancer has a high risk of recurrence and high mortality,which seriously threatens women's health.Standardized maintenance treatment can control or delay tumor recurrence,thereby improving the quality of life and prolonging the survival time of patients.This consensus is compiled based on the principle of evidence-based medicine,combined with the latest relevant research evidence at home and abroad,and in accordance with the systematic patient management concept of"assessment,support,control,care,and life",and widely solicited opinions from experts in related fields in many parts of the country,aiming to provide a reference for the clinical practice of integrated traditional Chinese and western medicine in maintenance treatment of ovarian cancer.

Abstract:Objective To explore the mechanism of estradiol tablets/estradiol and dydrogesterone tablets(femoston)regulating hypothalamic-pituitary-ovarian(HPO)axis to improve ovarian reserve and endometrial receptivity in premature ovarian failure mice with chronic psychological stress.Methods Thirty female Kunming mice aged 8 weeks were completely randomly divided into control group,model group and treatment group,with 10 mice in each group.The model of premature ovarian failure and chronic psychological stress was established in the model group and the treatment group.The treatment group was given femoston by gavage for 4 weeks,and the control group and the model group were given normal saline by gavage.The levels of serum sex hormones,pathological changes of ovarian and uterine tissues,the content of leukemia inhibitory factor(LIF)and the expression of HPO axis related genes in endometrial tissues were detected and compared.Results Compared with the control group,the levels of serum follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in the model group were increased,and the level of estradiol was decreased.The number of ovarian antral follicles decreased and the stromal cells proliferated.The endometrium became thinner,the number of glands decreased and irregular,and the level of LIF decreased.The gene expressions of FSHβ and LHβ were increased,while the gene expressions of gonadotropin-releasing hormone(GnRH),estrogen receptor α(ERα)and estrogen receptor β(ERβ)were decreased(all P＜0.05).Compared with the model group,the levels of FSH and LH in the treatment group were decreased,and the level of estradiol was increased.The number of primary ovarian follicles was increased,and the proliferation of stromal cells was alleviated.The endometrial thickness,glandular structure and LIF level were increased.The gene expression of FSHβ and LHβ decreased,while the gene expression of GnRH,ERα and ERβ increased(all P＜0.05).Conclusion Femoston can regulate HPO axis and improve ovarian reserve and endom-etrial receptivity in mice with premature ovarian failure combined with chronic psychological stress.