Abstract:Objective To investigate the species identification and drug resistance of non-tuberculous mycobacteria(NTM).Methods A total of 189 NTM isolates from 189 patients with NTM disease admitted to Hebei Chest Hospital from January 2021 to December 2023 were selected,and the species identification was carried out.The distribution of bacterial infection in patients with different genders and ages was analyzed,and the drug resistance of main NTM infected strains to common drugs was analyzed.Results Among the 189 NTM strains analyzed,the proportion of Mycobacterium intracellulare was the highest(52.9％),followed by Mycobacterium kansasii(22.2％),Mycobacterium abscessus(16.4％),Mycobacterium avium(5.3％),Mycobacterium gordonae(1.1％),Mycobacterium fortuitum(1.1％),Mycobacterium chelonae(0.5％)and Mycobacterium massiliense(0.5％).There were significant differences in the distribution of species in NTM patients with different genders and ages(both P＜0.001).The drug resistance rates of Mycobacterium intracellulare,Mycobacterium abscessus and Mycobacterium avium to isoniazid,rifampicin,ethambutol,streptomycin,kanamycin,capreomycin,p-aminosalicyl acid and ofloxacin were high,and the drug resistance rates of Mycobacterium kansasii to rifampicin and other drugs were low.Conclusions Mycobacterium intracellulare,Mycobacterium kansasii,Mycobacterium abscessus and Mycobacterium avium were common NTM strains in Hebei Chest Hospital.The distribution of NTM strains showed certain age and gender characteristics,and there were some differences in drug resistance among different NTM strains.It is necessary to strengthen the analysis of species distribution and drug resistance to guide clinical medication.

Abstract:Objective To explore the role of spliceosome inhibitor combined with epigenetic remodeling drugs in myocardial reprogramming.Methods One-day-old C57BL/6J mice were divided into dimethyl sulfoxide(DMSO)group,CRFV(a core small-molecule drug for transdifferentiation,abbreviated as CRFV)group,and CRFV+PLaB(a spliceosome inhibitor)group,with 3 mice in each group.Mouse cardiac fibroblasts were extracted for transcriptome sequencing.The differentially expressed genes were analyzed based on P-value and expression change,and some differentially expressed genes were verified by real-time quantitative polymerase chain reaction.Functional enrichment analysis and signaling pathway enrichment analysis of significantly up-regulated and down-regulated genes were performed to reveal the functional regulation of drug treatment on fibroblasts,respec-tively.Results Transcriptome sequencing analysis showed that the heart-related genes Tnnt2,Actn2,Myh6,and Gata4 were significantly increased,and the fibroblast-related genes Col1a1,Col1a2,and S100a4 were significantly decreased in primary cardiac fibroblasts treated with combined drugs for 7 d.Enrichment analysis showed that up-regulated genes were closely related to actin filament formation and cell morphogenesis.Down-regulated genes were related to extracellular matrix formation and cardiac hypertrophy.Real-time fluorescence quantitative results showed that the expression of fibroblast-specific markers(Col1a1 and Col1a2)was decreased,and the expression of cardiomyocyte-specific markers(Tnnt2,Actn2,and Myh6)was significantly increased.Conclusion Spliceosome inhibitor and epigenetic remodeling drugs promote the reprogramming of cardiac fibroblasts into cardiomyocyte-like cells.

Abstract:The diagnosis and treatment of aortic diseases has always been the focus of research in the cardio-vascular field.The small aortic annulus brings great challenges to the treatment of aortic diseases and is closely related to the poor prognosis of patients.At present,there is no consensus on the surgical treatment of small aortic annulus at home and abroad.For this special group,the existing treatment methods including aortic root enlargement,transcatheter aortic valve replacement,stentless biological valve,aortic-free valve and new technology have been developed to improve valve hemodynamics and clinical outcomes.However,there are controversies on the choice of treatment methods and valves,and there is also a lack of long-term clinical evidence for the application of new technology.The purpose of this review is to summarize the latest progress in surgical treatment of small aortic valve,and to explore the surgical treatment strategy and application prospect of new techniques for small aortic annulus.

Abstract:Objective To explore the predictive value of thyroid hormone sensitivity indicators for postop-erative recurrence and metastasis of differentiated thyroid cancer(DTC)in the elderly.Methods A total of 106 elderly patients with DTC after surgery admitted to Peking University First Hospital Taiyuan Hospital from June 2019 to April 2020 were retrospectively selected.The patients were divided into recurrence and metastasis group(observation group,19 cases)and non-recurrence and metastasis group(control group,87 cases)according to whether recurrence and metastasis occurred 3 years after operation.Logistic regression model was used to analyze the influencing factors,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of thyroid hormone sensitivity indicators for postoperative recurrence and metastasis in elderly DTC patients.Results There were significant differences in TNM staging,postoperative 131I treatment,surgical methods,the proportion of postoperative thyroid-stimulating hormone(TSH)therapy,the levels of free triiodothyronine,TSH,thyroid stimulating hormone index(TSHI),thyroid-stimulating hormone resistance index(TT4RI),and thyroid feedback Quantile-based index(TFQI)between the two groups(all P＜0.05).Binary Logistic regression analysis showed that stage Ⅲ-Ⅳ,TSH,TSHI,TT4RI,TFQI,postoperative 131I treatment,total thyroidectomy,and no postoperative TSH therapy were risk factors for postoperative recurrence and metastasis in elderly DTC patients(all P＜0.05).ROC curve analysis showed that the area under the curve of thyroid hormone sensitivity indicators TSHI,TT4RI and TFQI combined to predict postoperative recurrence and metastasis of DTC patients was 0.977(95％confidence interval:0.937-0.999).Conclusions The combination of thyroid hormone sensitivity indicators TSHI,TT4RI and TFQI has high accuracy and predictive value in predicting postoperative recurrence and metastasis in elderly DTC patients,which can be used as effective indicators for clinical prediction of postoperative recurrence and metastasis in elderly DTC patients.

Abstract:Objective To analyze the efficacy and safety of switching bevacizumab in patients with rat sarcoma(RAS)wild-type metastatic colorectal cancer(mCRC)who could not tolerate the skin toxicity of cetuximab in the first-line treatment.Methods A total of 143 patients with RAS wild-type mCRC who received two-drug chemotherapy combined with cetuximab as first-line treatment and completed at least one efficacy evaluation without disease progression in the Affiliated Hospital of Xuzhou Medical University from January 2018 to July 2023 were retrospectively selected.The observation group was the patients who could not tolerate the skin toxicity of cetuximab and switched to bevacizumab-based treatment,and the control group was the patients who could continue to receive cetuximab.The efficacy and safety of the two groups were compared.Results After propensity score matching,the median progression-free survival of the observation group and the control group were 10.5 months(95％confidence interval:9.3-11.7 months)and 10.8 months(95％confidence interval:9.4-12.2 months),respectively,and there was no significant difference between the two groups(P=0.28).The median overall survival was 27.1 months(95％confidence interval:22.9-31.3 months)and 33.5 months(95％confidence interval:25.9-4 1.0 months),respectively,and there was no significant difference between the two groups(P=0.17).During the treatment,the proportion of skin toxicity in the observation group was lower than that in the control group(P＜0.05),and there was no significant difference in the incidence of other adverse reactions between the two groups(all P＞0.05).Conclusion Switching to bevacizumab is also a treatment option for patients with RAS wild-type mCRC who cannot tolerate cetuximab skin toxicity during first-line therapy.

Abstract:Objective To investigate the predictive value of serum long non-coding RNA(lncRNA)HOX transcript antisense RNA(HOTAIR)and small nucleolar RNA host gene 16(SNHG16)expression on coronary no-reflow(CNR)during percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 80 AMI patients who underwent PCI in Qingdao Municipal Hospital,Shandong Province from May 2020 to December 2023 were selected.According to the occurrence of CNR,AMI patients were divided into CNR group(18 cases)and coronary reflow group(62 cases).The serum levels of lncRNA HOTAIR and lncRNA SNHG16 were detected before PCI.The clinical data of the two groups were compared,and the influ-encing factors of CNR during PCI were analyzed.The receiver operating characteristic curve was used to analyze the value of lncRNA HOTAIR and lncRNA SNHG16 in predicting CNR in AMI patients during PCI.Results The time from onset to PCI ≥6 h,the proportion of lesion vessel length ≥20 mm,and the expression level of serum lncRNA SNHG16 in the CNR group were higher than those in the coronary reflow group,and the expression level of serum lncRNA HOTAIR was lower than that in the coronary reflow group(all P＜0.05).Logistic regression analysis showed that the length of diseased vessels ≥20 mm and high lncRNA SNHG16 were risk factors for CNR in AMI patients undergoing PCI,and high lncRNA HOTAIR was a protective factor for CNR in AMI patients undergoing PCI(all P＜0.05).The area under the curve of lncRNA HOTAIR and lncRNA SNHG16 in predicting CNR in AMI patients during PCI was 0.726 and 0.735,respectively,and the area under the curve of the combination of lncrna HOTAIR and lncrna SNHG16 was 0.947,which was higher than that of single prediction(Z=2.560,P=0.011;Z=3.035,P=0.002).Conclusion The decreased expression of lncRNA HOTAIR in AMI patients,and the increased expression of lncRNA SNHG16 is related to the CNR during PCI,which can be used as a marker to predict the CNR during PCI.

Abstract:Objective To investigate the effect of compound Taxus capsule combined with vinorelbine+cisplatin(NP)regimen in the treatment of advanced non-small cell lung cancer(NSCLC)and its influence on tumor markers and immune function.Methods A total of 104 patients with advanced NSCLC admitted to Chinese People's Liberation Army Northern Theater General Hospital from June 2022 to January 2024 were prospectively selected.According to the random number table method,they were divided into observation group and control group,with 52 cases in each group.The control group was treated with NP regimen,and the observation group was treated with compound Taxus capsule on the basis of the control group.Both groups were treated for 6 courses.The clinical efficacy,tumor markers,immune function,quality of life and safety were compared between the two groups.Results The objective remission rate and disease control rate of the observation group were higher than those of the control group[38.5％(20/52)vs 19.2％(10/52)and 78.8％(32/52)vs 40.4％(21/52)](both P＜0.05).After treatment,the serum carcinoembryonic antigen,cytokeratin 19 fragment antigen and squamous cell carcinoma antigen in the observation group were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the levels of CD3+and CD4+and CD4+/CD8+ratio in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group,and the CD8+level was lower than that before treatment,and that in the observation group was lower than that in the control group(all P＜0.05).After treatment,the scores of the lung cancer quality of life scale in the observation group were higher than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The effect of compound Taxus capsule combined with NP regimen in the treatment of advanced NSCLC is satisfactory,which can reduce the level of tumor markers,improve the immune function of patients,and improve the quality of life of patients.

Abstract:Objective To analyze the application effect of ultrasound-guided quadratus lumborum block combined with general anesthesia in elderly patients undergoing laparoscopic radical nephrectomy.Methods Sixty elderly patients with renal cell carcinoma admitted to the First Affiliated Hospital of Hebei North University from August 2021 to August 2022 were selected.All patients underwent laparoscopic radical nephrectomy and were divided into G group and OSA group by random number table method.Patients in G group received conventional opioid general anesthesia,and patients in OSA group received ultrasound-guided quadratus lumborum block combined with opioid general anesthesia.The dosage of anesthetic drugs,sedative and analgesic effects,serum pain factor levels,sleep quality and cognitive function were compared between the two groups.Results The intraoperative consumptions of remifentanil and propofol in OSA group were significantly lower than that in G group[(1.12±0.22)mg vs(1.36±0.31)mg,(513±9)mg vs(533±9)mg],and the pressing times of analgesic pump and the requirement for rescue analgesia within 24 h after operation were significantly less/lower than those in G group[(3.3±0.8)times vs(7.6±1.0)times,13.3％(4/30)vs 36.7％(11/30)](all P＜0.05).The resting visual analogue scale(VAS)score and active VAS score in OSA group were lower than those in G group at 12,24 and 48 h after surgery,and the Ramsay sedation score was higher than that in G group(all P＜0.05).The serum levels of substance P,β-endorphin and nitric oxide in OSA group were lower than those in G group at 12,24 and 48 h after operation(all P＜0.05).The Mini-Mental State examination scores of OSA group were higher than those of G group at 12,24 and 48 h after operation,and the Pittsburgh sleep quality index scores were lower than those of G group(all P＜0.05).Conclusion Ultrasound-guided quadratus lumborum block combined with general anesthesia can reduce the use of anesthetic drugs,effectively regulate the expression of serum pain factors,have better sedative and analgesic effects,and reduce the impact of surgery on sleep quality and cognitive function in elderly patients undergoing laparoscopic radical nephrectomy.

Abstract:Objective To investigate the value of protocadherin alpha 4(PCDHA4)gene methylation detection in cervical cancer screening,and to provide a new method and basis for the early diagnosis of cervical cancer.Methods From September 2019 to June 2024,the cervical exfoliated cells of 186 female patients[included 90 cases of cervical intraepithelial neoplasia(CIN)grade 1(CIN 1 group),34 cases of CIN grade 2(CIN 2 group),28 cases of CIN grade 3(CIN 3 group),and 34 cases of cervical cancer(cervical cancer group)]and 52 healthy women(control group)who were treated in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were collected.Then the genomic DNA was extracted for human papilloma virus(HPV)detection and PCDHA4 gene methylation-specific PCR detection,and the diagnostic performance of PCDHA4 gene methylation detection in cervical cancer or precancerous lesions was analyzed.Results The positive rate of PCDHA4 gene methylation in CIN 3 and cervical cancer was significantly higher than that in CIN 2,CIN 1 and control group[89.3％(25/28),94.1％(32/34)vs 61.8％(21/34),36.7％(33/90),40.4％(21/52)],and the differences between the groups were statistically significant(all P＜0.05).The PCDHA4 △Ct in CIN 2,CIN 3 and cervical cancer group was significantly lower than that in CIN 1 and control group,and the difference between groups was statistically significant(all P＜0.05).The performance of PCDHA4 △Ct(when the cut-off was 6.34,the sensitivity was 64.6％,and the specificity was 91.5％)in the diagnosis of CIN grade 2 and above lesions was significantly better than of Thinprep cytologic test(TCT),HPV16/18,hrHPV and PCDHA4(all P＜0.05).The performance of PCDHA4 △Ct(when the cut-off was 5.45,the sensitivity was 74.2％and the specificity was 92.6％)in the diagnosis of CIN grade 3 and above lesions was also significantly better than that of TCT,HPV16/18,hrHPV and PCDHA4(all P＜0.05).PCDHA4 △Ct had better performance than TCT as a triage for non-16/18 hrHPV-positive women(all P＜0.05).Conclusions The detection of PCDHA4 gene methylation can serve as a potential biomarker for cervical cancer screening,which is helpful for the triage of hrHPV-positive population,and is of great significance for the early diagnosis of cervical cancer.

Abstract:Objective To investigate the changes and diagnostic value of serum neuropeptide FF receptor 2(NPFFR2),Zonulin and X-box binding protein 1(XBP1)in patients with preeclampsia(PE).Methods A total of 58 PE patients(PE group)and 59 healthy pregnant women(control group)in the First Affiliated Hospital of Harbin Medical University from December 2021 to December 2023 were selected as the research subjects.According to the clinical symptoms of PE patients,the PE group was divided into mild group(31 cases)and severe group(27 cases).The clinical data and serum indexes of the research subjects were compared.Multivariate Logistic regression was used to analyze the influencing factors of PE.The receiver operating characteristic curve was used to evaluate the value of serum NPFFR2,Zonulin and XBP1 in the diagnosis of PE.Results The serum levels of NPFFR2,Zonulin and XBP1 in the PE group were higher than those in the control group(all P＜0.05).Multivariate Logistic regression analysis showed that serum NPFFR2,Zonulin and XBP1 levels were influencing factors for PE(all P＜0.05).The area under the curve(AUC)of NPFFR2,Zonulin,and XBP1 in the diagnosis of PE were 0.789,0.798,and 0.801,respectively.The AUC of combined diagnosis of PE was 0.912,and the AUC of combined diagnosis was higher than that of individual diagnosis(all P＜0.05).The serum levels of NPFFR2,fibronectin and XBP1 in the severe group were higher than those in the mild group(all P＜0.05).Conclusion The serum levels of NPFFR2,Zonulin and XBP1 in PE patients are increased,and the combined diagnosis of PE has a high efficacy,which can assist clinical diagnosis.

Abstract:Objective To explore the computed tomography angiography(CTA)characteristics of athero-sclerotic plaques in the head and neck of patients with cerebral watershed infarction(CWI)and its correlation with ambulatory arterial stifness index(AASI).Methods The clinical data of 100 patients with CWI who were admitted to Beijing Aerospace General Hospital from March 2021 to March 2024 were retrospectively analyzed,and they were divided into acute CWI(ACWI)group(46 cases)and non-ACWI group(54 cases)according to the results of magnetic resonance diffusion-weighted imaging.Multiple Logistic regression method was used to analyze the association effects between risk factors and different stratification parameters.Multivariable linear regression(MLR)model was used to analyze the correlation.The receiver operating characteristic(ROC)curve was used to evaluate the predictive performance.Results Multivariate analysis showed that the degree of internal carotid artery(ICA)stenosis,middle cerebral artery(MCA)stenosis,number of diseased vessels,mean arterial pressure(MAP),fasting blood glucose(FBG),low-density lipoprotein cholesterol(LDL-C),AASI,carotid plaque(CP)burden,CP volume,and CP lipid core volume were all independent influencing factors for the occurrence of ACWI(all P＜0.05).MLR analysis showed that AASI was positively correlated with the degree of internal carotid artery stenosis,MCA stenosis,number of diseased vessel branches,CP load,CP volume,CP lipid core volume,fasting blood glucose,and LDL-C(all P＜0.05).There was a strong correlation between AASI and CP burden,volume,and lipid core volume(allPtrend＜0.05).ROC curve analysis showed that the combination of ICA and MCA stenosis degree+number of diseased blood vessels+CP burden+CP volume+CP lipid core volume+ASI had the highest area under the curve(0.924)and predictive value for predicting ACWI.Conclusions ICA and MCA stenosis degree,number of diseased vessel branches,AASI,CP burden,volume,lipid core volume,FBG,and LDL-C are all independent influencing factors for the occurrence of ACWI.In clinical practice,early diagnosis of ACWI patients can be achieved by combining head and neck CTA diagnostic results and related parameters with AASI.

Abstract:Objective To evaluate the efficacy of catheter ablation for atrial fibrillation in elderly patients.Methods Patients aged 75 years or older were enrolled from the China Atrial Fibrillation Registry Study from August 2011 to December 2022.Patients were divided into ablation group and non-ablation group according to whether they received ablation at baseline.The primary endpoint was the composite endpoint of cardiovascular death and cardiovascular hospitalization.The secondary endpoints included cardiovascular death,cardiovascular hospitalization,embolic events and recurrence of atrial fibrillation.The Kaplan-Meier method was used to draw the survival curve.Multivariate Cox regression and overlapping weighted analysis were used to evaluate the relationship between ablation and endpoint.Results A total of 2 912 patients were enrolled,including 976 in the ablation group and 1 936 in the non-ablation group.Survival curve analysis showed that the risk of cardiovascular death or cardiovascular hospitalization in the ablation group was lower than that in the non-ablation group(hazard ratio=0.68,95％confidence interval:0.60-0.76,Log-rank P＜0.001).During the follow-up of 35.2(14.7,64.5)months,1 418 patients had cardiovascular death or cardiovascular hospitalization,and the incidence was 13.7/100 patient-years.The incidence was 10.4/100 patient-years in the ablation group and 15.2/100 patient-years in the non-ablation group.Catheter ablation was associated with a significantly lower composite risk of cardiovascular death or cardio-vascular hospitalization after adjustment for confounders(hazard ratio=0.82,95％confidence interval:0.72-0.93,P=0.003),with similar results in overlap-weighted analyses.In addition,catheter ablation was signifi-cantly associated with reduced risks of cardiovascular death(hazard ratio=0.38,overlap-weighted hazard ratio=0.35,both P＜0.001)and recurrence of atrial fibrillation(hazard ratio=0.30,overlap-weighted hazard ratio=0.28,both P＜0.001).Conclusion In older patients with atrial fibrillation,catheter ablation is associated with a lower risk of cardiovascular death or cardiovascular hospitalization and a lower risk of atrial fibrillation recurrence.

Abstract:Objective To investigate the correlation between serum syndecan-1(SDC-1)and peptidy-larginine deiminase 2(PAD2)levels and short-term poor prognosis in patients with sepsis.Methods A total of 150 patients with sepsis admitted to Anhui Provincial Hospital from January 2022 to December 2024 were selected as the observation group,and 150 healthy people in the same period were selected as the control group.The serum levels of SDC-1 and PAD2 were compared between the two groups.The patients with sepsis were divided into poor prognosis group and good prognosis group according to the 28 d survival.The correlation between serum SDC-1,PAD2 and the risk of short-term poor prognosis in patients with sepsis was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of related indicators for short-term poor prognosis in patients with sepsis.Results The serum levels of SDC-1 and PAD2 in the observation group were higher than those in the control group[(240±50)μg/L vs(126±26)μg/L,(39±15)μg/L vs(10±4)μg/L](both P＜0.001).Among 150 patients with sepsis,46 patients(30.7％)died within 28 d and were classified into the poor prognosis group,and the remaining 104 patients were classified into the good prognosis group.The serum levels of SDC-1 and PAD2 in the poor prognosis group were higher than those in the good prognosis group[(274±46)μg/L vs(225±40)μg/L,(49±18)μg/L vs(35±12)μg/L](both P＜0.001).Restricted cubic spline analysis showed that the correlation strength between serum SDC-1 and PAD2 levels and the risk of short-term poor prognosis in patients with sepsis showed an approximate J-type non-linear dose-response relationship.Thiex2 Phi coefficient correlation and binomial correlation test showed that serum SDC-1 and PAD2 levels were positively correlated with the risk of short-term poor prognosis in patients with sepsis(all P＜0.001).ROC curve analysis showed that the area under the curve of SDC-1 and PAD2 in predicting the risk of short-term poor prognosis in patients with sepsis was 0.858 and 0.760,respectively.Conclusion The levels of serum SDC-1 and PAD2 in patients with sepsis are abnormally increased,and both of them are positively correlated with short-term poor prognosis of patients,which can be used to predict short-term poor prognosis of such patients.

Abstract:M1 macrophages and T helper cell 17(Th17)play an important regulatory role in the immune microenvironment.Both of them have a profound impact on immune response,inflammatory response and the occurrence and development of autoimmune diseases.In recent years,with the in-depth understanding of the immune system,the study of M1 macrophages and Th 17 cells has gradually become a hot topic.However,there are still many unsolved mysteries in the specific mechanism,mutual regulatory relationship and clinical application of the two in different disease models.This article reviews the latest research progress of M1 macrophages and Th17 in the regulation of immune microenvironment,focusing on the mechanism of action of both in a variety of diseases,and discussing the limitations of current research and possible future research directions,in order to provide certain reference for future basic research and clinical immunotherapy.

Abstract:Objective To investigate the influencing factors of macrophage accumulation in culprit lesions in patients with premature coronary atherosclerotic heart disease.Methods A total of 143 patients(≤45 years old)with premature coronary atherosclerotic heart disease who underwent coronary angiography and optical coherence tomography(OCT)in Qingdao Municipal Hospital,Shandong Province from October 2021 to October 2024 were retrospectively enrolled.Univariate and multivariate Logistic regression methods were used to analyze the independent predictors of macrophage accumulation under OCT in patients with premature coronary atherosclerotic heart disease.Results Among 143 patients with premature coronary atherosclerotic heart disease who underwent OCT examination,macrophage accumulation was found in 83(58.0％)culprit lesions.The positive influencing factors of macrophage aggregation in culprits lesions included smoking(P=0.002),hypertension(P＜0.001)and hypercholesterolemia(P=0.003),and the negative influencing factors included aspirin(P=0.024)and statins(P=0.007).Factors with P＜0.1 in univariate analysis were included in multivariate analysis.After adjusting for other risk factors,hypertension(odds ratio=4.555,95％confidence interval:2.058-10.084,P＜0.001),smoking(odds ratio=3.479,95％confidence interval:1.537-7.873,P=0.003)and hypercholesterolemia(odds ratio=5.364,95％confidence interval:1.634-17.608,P=0.006)were still independent predictors of macrophage accumulation in patients with premature coronary atherosclerotic heart disease,while diabetes had a related trend although the difference was not statistically significant(P=0.057).Conclusion Hypertension,smoking and hypercholesterolemia are independent predictors of macrophage accumulation in culprit lesions in patients with premature coronary atherosclerotic heart disease.

Abstract:Objective To investigate the clinical effect of metformin combined with camrelizumab and transcatheter arterial chemoembolization(TACE)in the treatment of patients with advanced hepatocellular carcinoma complicated with type 2 diabetes mellitus(T2 DM).Methods The clinical data of 82 patients with advanced hepatocellular carcinoma and T2DM who were treated in the 940th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from January 2018 to December 2022 were retrospectively analyzed.According to different treatment methods,the patients were divided into metformin group(42 cases)and control group(40 cases).The control group was treated with camrelizumab and TACE combined with non-metformin hypoglycemic drugs.The metformin group was treated with camrelizumab and TACE combined with metformin.The differences in immune function,biochemical indexes,tumor markers,efficacy and safety between the two groups were compared.Results After treatment,the levels of CD3+,CD4+T lymphocytes,CD4+/CD8+ratio,natural killer cell ratio,Interferon-γ,tumor necrosis factor-α,and interleukin-2 in the metformin group were all higher than those in the control group;the proportion of CD8+T lymphocytes,expression levels of interleukin-6 and programmed cell death receptor-1,aspartate aminotransferase,total bilirubin,alkaline phosphatase,aspartate aminotransferase to platelet ratio index,alpha fetoprotein levels,and positive rate of circulating tumor DNA were all lower than those in the control group(all P＜0.05).The objective response rate and disease control rate were significantly higher in the metformin group than those in the control group[61.9％(26/42)vs 30.0％(12/40),90.5％(38/42)vs 67.5％(27/40)](both P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(all P＞0.05).Conclusion Metformin combined with camrelizumab and TACE can significantly improve the immune function,liver function and metabolic status of hepatocellular carcinoma patients with T2 DM,reduce tumor activity,and has good safety.

Abstract:Objective To study the expression level of serum microRNA(miR)-155 in children with neonatal septicemia,and to explore its correlation with the balance of T helper cell 17/regulatory T cell(Th17/Treg).Methods A total of 24 children with neonatal septicemia admitted to the Department of Neonatology,Fuzhou First General Hospital Affiliated with Fujian Medical University from January to December 2023 were selected as the sepsis group,and 22 healthy neonates delivered in the same hospital during the same period were selected as the control group.The general clinical data and laboratory test indicators of the two groups were collected and compared.The level of serum miR-155 was detected by real-time fluorescent quantitative polymerase chain reaction,and the levels of Th17 and Treg in peripheral blood were detected by flow cytometry.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of serum miR-155 for neonatal sepsis,and the correlation between serum miR-155 and Th17,Treg and Th17/Treg ratio in peripheral blood was analyzed by Pearson method.Results The proportion of mothers with perinatal infection,peripheral white blood cell count,percentage of neutrophils,C-reactive protein,interleukin-6,procalcitonin,and blood lactic acid levels in the sepsis group were significantly higher than those in the control group(all P＜0.05).The 10 min Apgar score,peripheral blood total bilirubin,direct bilirubin and indirect bilirubin levels were significantly lower than those of the control group(all P＜0.05).The expression level of miR-155,Th17 level and Th17/Treg ratio of neonates in sepsis group were significantly higher than those in control group,while the peripheral blood Treg level was significantly lower than that in control group[(1.47±0.27)vs(1.00±0.35),(3.16±0.89)％vs(1.43±0.42)％,(15.36±4.54)vs(2.74±1.07),(0.21±0.09)％vs(0.58±0.18)％](all P＜0.001).The area under the curve value of serum miR-155 in the diagnosis of neonatal sepsis was 0.845.In the sepsis group,serum miR-155 was positively correlated with C-reactive protein,interleukin-6,procalcitonin,Th17 in peripheral blood and Th17/Treg ratio(all P＜0.05).Conclusion Serum miR-155 and the proportion of Th17/Treg cells in peripheral blood of children with neonatal septicemia are significantly increased,and there is a significant positive correlation between them,and they jointly promote the inflammatory response in peripheral blood of neonates with sepsis.

Abstract:Objective To investigate the effect of hypercapnia ventilation mode on elderly patients undergoing laparoscopic radical resection of colorectal cancer on the basis of goal-directed fluid therapy,and to observe the changes of intraoperative regional cerebral oxygen saturation and postoperative cognitive function.Methods A total of 60 elderly patients scheduled for elective laparoscopic radical resection of colorectal cancer in the First Affiliated Hospital of Hebei North University from July 2023 to June 2024 were selected.They were divided into a control group and an observation group by random number table method,with 30 cases in each group.Both groups received fluid replacement under the guidance of goal-directed fluid therapy.Respiratory parameters were adjusted to maintain intraoperative arterial partial pressure of carbon dioxide(PaCO2)at 35-45 mmHg and pH 7.35-7.45 in the control group,while in the observation group,PaCO2 was maintained at 46-55 mmHg and pH 7.25-7.35.The general data,PaCO2 at different time points[preoperatively(T0),5 min before pneumoperitoneum(T1),20 min after pneumoperitoneum(T2),1 h after pneumoperitoneum(T3),2 h after pneumoperitoneum(T4),and 20 min after the end of pneumoperitoneum(T5)],intraoperative regional cerebral oxygen saturation(rSO2),results of arterial blood gas analysis,cerebral oxygen metabolism indicators,serum cognitive function indicators,and early postoperative cognitive function indicators were compared between the two groups.Results There were no statistically significant differences in general data between the two groups(all P＞0.05).Compared with T0,PaCO2 and rSO2 in the observation group increased,while pH decreased at T2-T5(all P＜0.05).PaCO2 and rSO2 at T2-T4 in the observation group were higher than those in the control group;pH at T2-T5 in the observation group were lower than those in the control group(all P＜0.05).At 1 h after pneumoperitoneum,the internal jugular venous oxygen saturation in the observation group was higher than that in the control group,while the arterial-internal jugular venous oxygen content difference and cerebral oxygen extraction rate were lower than those in the control group(all P＜0.05).The level of brain-derived neurotrophic factor on the first day after surgery in the observation group was higher than that in the control group,and the levels of neuron-specific enolase and homocysteine were lower than those in the control group(all P＜0.05).Compared with the day before surgery,the Mini-Mental State Examination(MMSE)scores of both groups decreased on the first day after surgery;the MMSE score of the observation group on the first day after surgery was higher than that of the control group(all P＜0.05).The incidence of postoperative cognitive dysfunction in the observation group was lower than that in the control group[10.0％(3/30)vs 36.7％(11/30)](P＜0.05).Conclusion On the basis of goal-directed fluid therapy,the application of permissive hypercapnia ventilation mode in elderly patients undergoing laparoscopic radical resection of colorectal cancer can increase cerebral blood flow,elevate rSO2,reduce cerebral oxygen metabolism level,mitigate cognitive function impairment,and contribute to the rapid postoperative recovery of patients.

Abstract:Objective To investigate the clinical application of a new centrally visible eye dressing.Methods Using the convenient sampling method,50 working doctors and 198 patients on the first day after surgery in the ophthalmology day ward of Beijing Tongren Hospital,Capital Medical University from July to August 2024 were selected as the research objects.The patients who voluntarily chose the new centrally visible eye dressing were in group A(189 cases),and the patients who voluntarily chose the traditional dressing were in group B(9 cases).The number of people who chose,reasons for choosing and satisfaction with the use of the two groups were recorded.Results All the doctors chose the new centrally visible eye dressing.The reasons for choosing the new centrally visible eye dressing were easy to use(46 cases,92.0％),good air permeability(47 cases,94.0％),safety and fall prevention(41 cases,82.0％),reducing patients' fear of the dark(45 cases,90.0％),and easy to observe the ocular surface(44 cases,88.0％).One hundred and eighty-nine of 198 patients independently selected the new centrally visible eye dressing.The reasons for selection included easy use(167 cases,88.4％),good air permeability(164 cases,86.8％),safety and fall prevention(159 cases,84.1％),reducing patients' fear of the dark(168 cases,88.9％),and easy to observe the ocular surface(172 cases,91.0％).The reason for choosing traditional dressings in 9 cases was that the eyes could be fully rested by covering them completely.The satisfaction score of group A was significantly higher than that of group B[(24.4±1.3)vs(21.6±1.9)](t=4.450,P=0.001).Conclusion The new type of centrally visible eye dressing is preferred by doctors and patients much more than traditional eye dressings.It has the advantages of easy to use,safe and fall prevention,reducing patients' fear of the dark,easy for doctors and nurses to observe the ocular surface,and improves the satisfaction rate of patients and doctors.

Abstract:Monocyte chemoattractant protein-inducible protein l(MCPIP1),named after the induction of monocyte chemoattractant protein 1,belongs to the ZC3H12 gene family.It contains a zinc finger domain,a PIN domain and a deubiquitination domain.It is involved in the regulation and development of many inflammation through endonuclease activity,deubiquitinating enzyme activity and transcription factor function.In lung tissue,MCPIP1 plays an anti-inflammatory effect mainly by degrading the mRNA of inflammatory factors and deubiquitinizing the key proteins of nuclear factor-κB pathway,and participates in the occurrence and development of pneumonia,bronchial asthma,acute lung injury/acute respiratory distress syndrome,pulmonary fibrosis,lung cancer and other lung diseases.The aim of this study is to explore the mechanism of MCPIP1 in lung diseases and its relationship with lung diseases,in order to provide a new target for the treatment of lung diseases.