Abstract:Objective To investigate the relationship between serum levels of interleukin-17(IL-17)and matrix metalloproteinase-13(MMP-13)and progression-free survival(PFS)and overall survival in patients with multiple myeloma in partial remission.Methods A total of 105 patients with multiple myeloma who achieved partial remission after clinical treatment in Zhejiang Provincial People's Hospital from June 2019 to May 2021 were selected as the research objects.The clinical data of the patients were collected,and the serum levels of IL-17 and MMP-13 were detected.All patients were followed up regularly after discharge to calculate survival,PFS and overall survival.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum IL-17 and MMP-13 levels for the prognosis of patients with partial remission.According to the optimal cut-off value of ROC,the patients were divided into high IL-17 group and low IL-17 group,high MMP-13 group and low MMP-13 group.PFS and overall survival were compared between groups.Cox regression analysis model was used to analyze the influencing factors of PFS and overall survival in patients with multiple myeloma.Results At the end of the follow-up,77 of 105 patients survived and 28 died,with an overall survival rate of 73.3％(77/105)and a mortality rate of 26.7％(28/105).ROC curve analysis showed that the best cut-off value of IL-17 to predict the prognosis of death in patients with multiple myeloma at partial remission was 30.85 ng/L,the area under the curve(AUC)=0.780,and the best cut-off value of MMP-13 to predict the prognosis of death in patients with multiple myeloma was 10.68 ng/L,AUC=0.738.The PFS and overall survival of the high IL-17 group were shorter than those of the low IL-17 group[(19±4)months vs(29±5)months,(36±6)months vs(50±6)months](t=12.000,11.545,both P＜0.001).The PFS and overall survival of the high MMP-13 group were shorter than those of the low MMP-13 group[(21±4)months vs(27±5)months,(38±6)months vs(47±7)months](t=7.719,7.128,both P＜0.001).Multivariate Cox regression analysis showed that lactate dehydrogenase,β2-microglobulin,IL-17,MMP-13,age,1q amplification,and 17p-were the influencing factors of PFS in patients with multiple myeloma(all P＜0.05).β2-microglobulin,IL-17,MMP-13,age,1q amplification,and 17p-were the influencing factors of overall survival(all P＜0.05).Conclusion The serum levels of IL-17 and MMP-13 in patients with multiple myeloma during partial remission are related to PFS and overall survival,which can be used as an intermediate stage indicator to evaluate the prognosis of patients.

Abstract:Objective To analyze the effect of dexmedetomidine combined with laryngeal mask general anesthesia on cerebral oxygen supply and demand balance in patients undergoing acute anterior circulation large vessel occlusion thrombectomy.Methods A total of 95 patients who underwent acute anterior circulation large vessel occlusion thrombectomy in Lishui People's Hospital,Zhejiang Province from December 2022 to December 2024 were included.According to the random number table method,they were divided into an observation group(47 cases)and a control group(48 cases).The control group received general anesthesia with laryngeal mask,while the observation group received intravenous infusion of dexmedetomidine hydrochloride injection at the beginning of the surgery on the basis of general anesthesia with laryngeal mask.The intraoperative clinical indexes of the two groups were compared,such as the mean arterial pressure(MAP),heart rate and pulse oxygen saturation(SpO2)levels of the two groups were recorded before anesthesia induction(T0),after anesthesia induction(T1),15 min during surgery(T2)and after surgery(T3).The blood oxygen saturation(SjvO2),cerebral oxygen uptake rate(CERO2),arterial oxygen content(CaO2)and internal carotid vein oxygen content(CjvO2)of the two groups were compared at T0,T3 and 24 h after surgery(T4).The national institutes of health stroke scale(NIHSS)scores of the two groups before and after surgery were analyzed.Results The time from puncture to vascular recanalization and the number of thrombectomy in the observation group were shorter/less than those in the control group,and the first recanalization rate was higher than that in the control group(all P＜0.05).The MAP and heart rate of T,,T2 and T3 in the two groups decreased first and then increased,but the MAP and heart rate of T1 and T2 in the observation group were higher than those in the control group(all P＜0.05).There were no time,group and interaction effects on SpO2 of patients in the two groups(all P＞0.05).The SjvO2,CaO2 and CjvO2 of T0,T3 and T4 in the two groups decreased first and then increased,and CERO2 increased first and then decreased,but the SjvO2,CaO2,and CjvO2 of T3 in the observation group were higher than those in the control group,and CERO2 was lower than that in the control group(all P＜0.05).There was no significant difference in NIHSS score between the observation group and the control group before operation[(17.2±2.6)vs(17.2±2.8)](t=0.145,P=0.885).The NIHSS scores of the two groups at 48 h after operation were lower than those before operation,and the NIHSS scores of the observation group were lower than those of the control group[(9.6±1.2)vs(12.4±1.5)](t=10.208,P＜0.001).Conclusion The combination of dexmedetomidine and laryngeal mask general anesthesia can improve intraoperative clinical indicators,stabilize hemodynamics,balance cerebral oxygen supply and demand,and reduce neurological damage in patients undergoing acute anterior circulation large vessel occlusion thrombectomy.

Abstract:Inverted formin 2(INF2),a member of the formin family with dual functions of actin polymeri-zation and depolymerization,has attracted increasing attention in tumorigenesis and development in recent years.By regulating mitochondrial dynamics,cytoskeleton remodeling,organelle interaction and other processes,INF2 exerts complex roles in various malignant tumors.This paper reviews the functional mechanisms of INF2 in different types of tumors and its potential clinical application value,and also discusses the research status and future development direction of INF2 as a potential therapeutic target,aiming to provide new ideas and strategies for clinical treatment.

Abstract:Objective To explore the clinical efficacy of arthroscopic debridement in the treatment of shoulder joint tuberculosis.Methods A retrospective analysis was performed on the clinical data of 73 patients with shoulder joint tuberculosis who underwent surgical treatment at Cangzhou Central Hospital,Hebei Province from April 2014 to April 2023.Standard anti-tuberculosis drug therapy was administered before and after surgery.The patients were divided into arthroscopic group(38 cases,treated with shoulder arthroscopy)and open surgery group(35 cases,treated with open debridement)according to the surgical method.Re-examinations were conducted preoperatively,3 months postoperatively,and 2 years postoperatively.Disease stability and recurrence were evaluated by X-ray and magnetic resonance imaging examinations.The improvement of shoulder joint function was assessed using the visual analogue scale(VAS)score,University of California,Los Angeles(UCLA)shoulder score,and Constant-Murley score.C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)were recorded preoperatively,3 months postoperatively,and 2 years postoperatively to evaluate the inflammatory control.Results All 73 patients completed the follow-up.The early postoperative recurrence rate was 2.6％(1/38)in the arthroscopic group and 5.7％(2/35)in the open surgery group,but no statistically significant difference in recurrence rate was found between the two groups under the sample size of this study(P>0.05).There were no statistically significant differences in VAS scores between the two groups preoperatively,3 months postoperatively,or 2 years postoperatively(all P>0.05).At 3 months postoperatively,the UCLA shoulder score and Constant-Murley score in the arthroscopic group were significantly higher than those in the open surgery group[25(21,26)vs 20(19,23),60(51,69)vs 52(47,58),respectively](both P<0.05).The CRP and ESR levels in both groups at 3 months and 2 years postoperatively were significantly lower than those preoperatively(all P<0.05),but there were no statistically significant differences in CRP and ESR levels between the two groups preoperatively,3 months postoperatively,or 2 years postoperatively(all P>0.05).Conclusion Arthroscopic debridement combined with anti-tuberculosis drug therapy can achieve satisfactory clinical outcomes in the treatment of shoulder joint tuberculosis,especially with certain advantages in short-term postoperative functional rehabilitation,but appropriate indications need to be strictly grasped.

Abstract:Objective To investigate the relationship between intraoperative hypotension load(HL)and 7 d postoperative composite adverse outcomes[MOFD-7,defined as the requirement for mechanical ventilation(invasive or non-invasive),hemodynamic support with vasoactive agents,or continuous renal replacement therapy on the 7th postoperative day,or death within 7 d after surgery]in patients undergoing open surgical repair(OSR)for ruptured abdominal aortic aneurysm(rAAA).Methods A retrospective analysis was conducted on 50 patients with rAAA who underwent OSR in Beijing Anzhen Hospital,Capital Medical University from August 2005 to November 2020.HL was defined as the cumulative area under the curve of mean arterial pressure(MAP)<65 mmHg(1 mmHg=0.133 kPa).Patients were divided into the non-MOFD-7 group(30 cases)and the MOFD-7 development group(20 cases)according to the occurrence of MOFD-7.Logistic regression analysis and receiver operating characteristic(ROC)curve were used to analyze the relationship between HL and MOFD-7,with MOFD-7 as the primary outcome.Results The incidence of MOFD-7 was 40.0％(20/50)among the 50 rAAA patients undergoing OSR,and the 30 d all-cause mortality was 10.0％(5/50),and all deaths occurred in the MOFD-7 development group.The proportion of preoperative hemorrhagic shock,preoperative serum creatinine and lactic acid levels in the MOFD-7 development group were significantly higher than those in the non-MOFD-7 group(all P<0.05).In terms of perioperative management,HL,norepinephrine equivalent,and the first postoperative lactic acid level in the MOFD-7 development group were significantly higher than those in the non-MOFD-7 group;intraoperative fluid infusion volume,intraoperative blood loss,and intraoperative blood transfusion volume(including intraoperative red blood cell transfusion volume and intraoperative plasma transfusion volume)in the MOFD-7 development group were significantly greater than those in the non-MOFD-7 group(all P<0.05).Multivariate Logistic regression analysis showed that after adjusting for age,gender,preoperative serum creatinine and preoperative lactic acid,HL(per 100 mmHg·min increase)was still independently associated with MOFD-7(odds ratio=1.298,95％confidence interval:1.034-1.630,P=0.025).The area under the curve of HL alone and the multivariate model for predicting MOFD-7 were 0.770 and 0.870,respectively.Restricted cubic spline analysis indicated an approximately monotonic increasing relationship between HL and the risk of MOFD-7;when HL exceeded approximately 75 mmHg·min,the risk of adverse outcomes increased significantly with further elevation of HL.Conclusion In patients undergoing OSR for rAAA,a higher intraoperative HL is associated with an increased risk of MOFD-7.Perioperative management should aim to minimize HL to improve early prognosis.

Abstract:Objective To investigate the effect of dapagliflozin combined with sacubitril/valsartan sodium on ventricular remodeling in patients with heart failure with reduced ejection fraction(HFrEF).Methods A total of 120 HFrEF patients admitted to Baotou Central Hospital of Inner Mongolia Autonomous Region from April 2023 to March 2024 were selected and divided into observation group(60 cases)and control group(60 cases)according to the random number table method.A double-blind,placebo-controlled design was adopted.Both groups received standard drug treatment.On this basis,the control group was treated with sacubitril/valsartan sodium+placebo,and the observation group was treated with sacubitril/valsartan sodium+dapagliflozin,with continuous treatment for 12 months.The clinical efficacy,ventricular remodeling and cardiac function[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),interventricular septal end-diastolic thickness(IVST),early/late diastolic maximum flow velocity of mitral valve(E/A)],exercise capacity and quality of life[6 min walk test distance,minnesota living with heart failure questionnaire(MLHFQ)score],myocardial injury and myocardial fibrosis indexes[N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),laminin(LN),procollagen Ⅲ peptide(PⅢP)],as well as serum levels of soluble suppression of tumorigenicity 2(sST2),pentraxin 3(PTX-3)and inflammatory indexes[C-reactive protein(CRP),interleukin-6(IL-6),IL-1β,tumor necrosis factor-α(TNF-α)],and the incidence of clinical adverse events during treatment were compared between the two groups.Results The clinical effective rate of the observation group was higher than that of the control group[95.0％(57/60)vs 83.3％(50/60)](P=0.040).Compared with before treatment,after treatment,LVEDD,LVESD and IVST decreased,serum levels of NT-proBNP,cTnI,LN,PⅢP,CRP,IL-6,IL-1βand TNF-αreduced in both groups,with the observation group lower than the control group;LVEF and E/A increased,with the observation group higher than the control group(all P<0.05).Compared with before treatment,after treatment,6 min walk test distance increased and MLHFQ score decreased in both groups,with the observation group having longer walk distance and lower score than the control group(all P<0.05).Compared with before treatment,after treatment,serum sST2 and PTX-3 levels decreased in both groups[observation group:(19±4)μg/L vs(48±10)μg/L,(3.1±0.6)ng/L vs(5.8±0.9)ng/L;control group:(24±3)μg/L vs(48±8)μg/L,(3.6±0.7)ng/L vs(5.9±0.8)ng/L],with the observation group lower than the control group(all P<0.05).During treatment,there was no significant difference in the total incidence of cardiovascular adverse events between the two groups(P=0.752).Conclusion Dapagliflozin combined with sacubitril/valsartan sodium in the treatment of patients with HFrEF can effectively inhibit ventricular remodeling,reduce myocardial injury and inflammatory response,significantly improve cardiac function,and enhance exercise tolerance and quality of life.

Abstract:Objective To investigate the effect of bismuth-containing quadruple therapy with amoxicillin and clarithromycin on liver function in patients with Helicobacter pylori(Hp)infection complicated with non-alcoholic simple fatty liver(NAFL).Methods A prospective clinical study was conducted.Patients with Hp infection who were admitted to Beijing Jishuitan Hospital,Capital Medical University from October 2023 to October 2024 were enrolled and divided into the NAFL group and the non-liver disease group according to the presence or absence of NAFL.All patients received 14 d bismuth-containing quadruple therapy with amoxicillin and clarithromycin for Hp eradication.The Hp eradication rate,changes in liver function indexes before and after treatment,and incidence of adverse reactions were compared between the two groups.Results A total of 103 patients were initially enrolled in the study,among whom 3 patients were excluded due to skin rash,complicated pulmonary infection and traumatic surgery respectively,with 100 patients finally included in the observation,50 cases in each of the NAFL group and the non-liver disease group.There were no significant differences in gender,age and Hp eradication rate between the two groups(all P>0.05).The body mass index(BMI)of the NAFL group was significantly higher than that of the non-liver disease group[(26±3)kg/m2 vs(23±3)kg/m2](P<0.001).The liver function indexes of both groups did not exceed 3 times the upper limit of the normal value before and after treatment.After treatment,the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in both groups were signifi-cantly higher than those before treatment(both P<0.05),while there were no significant differences in alkaline phosphatase and gamma-glutamyl transferase(GGT)before and after treatment in both groups(all P>0.05).There were no significant differences in the changes of liver function indexes before and after Hp eradication treatment between the two groups(all P>0.05).The incidence of abnormal liver function after treatment in the NAFL group was significantly higher than that in the non-liver disease group[30.0％(15/50)vs 10.0％(5/50)](P=0.012).Univariate analysis showed that BMI,pre-treatment ALT,AST and GGT were influencing factors for abnormal liver function after treatment(all P<0.05).Multivariate Logistic regression analysis showed that BMI was the only independent influencing factor(odds ratio=1.369,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05),which were mainly digestive system reactions such as taste disturbance,nausea,epigastric discomfort and diarrhea,with no serious adverse reactions reported.Conclusion Bismuth-containing quadruple therapy with amoxicillin and clarithromycin can cause liver injury mainly characterized by elevated ALT and AST levels regardless of the presence or absence of liver disease,and there is no significant difference in the elevation ranges of ALT and AST between the two groups.The incidence of abnormal liver function after treatment in NAFL patients is significantly higher than that in non-liver disease patients,and increased BMI is an important influencing factor for abnormal liver function after treatment.It is recommended that close monitoring of liver function should be performed during and after treatment in patients with high BMI.

Abstract:Objective To explore the effect of buccal acupuncture combined with rehabilitation training on the rehabilitation of patients after anterior cruciate ligament injury reconstruction.Methods A total of 106 patients who underwent anterior cruciate ligament injury reconstruction in General Hospital of the Northern Warzone of the Chinese People's Liberation Army from February 2023 to February 2025 were enrolled.They were randomly divided into the control group and the observation group by block randomization,with 53 cases in each group.During the treatment,4 patients in each group were excluded due to failure to perform rehabilitation training on time,and 49 patients were actually included in each group.The control group was treated with rehabilitation training alone,while the observation group was treated with buccal acupuncture on the basis of the control group's regimen.The primary efficacy indicators[knee joint Lysholm score,international knee documentation committee(IKDC)score,visual analogue scale(VAS)score for pain,and knee joint range of motion],secondary efficacy indicators[knee joint function(affected knee swelling value,thigh circumference difference value),peak torque of knee extension and flexion of the affected side]and clinical efficacy were observed before and after treatment in both groups.Results After treatment,the knee joint Lysholm score,IKDC score,knee joint range of motion,as well as the peak torque of knee extension and flexion of the affected side in both groups were significantly higher/greater than those before treatment,and the above indicators in the observation group were significantly higher/greater than those in the control group[knee joint Lysholm score:(72±5)vs(66±7);IKDC score:(80±7)vs(70±12);knee joint range of motion,external rotation:(38.5±5.6)°vs(30.6±6.1)°;internal rotation:(29.4±3.1)°vs(25.5±3.3)°;flexion and extension:(121.9±18.2)°vs(105.7±19.2)°;peak torque of knee extension of the affected side:(46±8)N·m vs(34±10)N·m;peak torque of knee flexion:(49±10)N·m vs(37±11)N·m](all P<0.05).After treatment,the VAS score for pain,affected knee swelling value and thigh circumference difference value in both groups were significantly lower/less than those before treatment,and the above indicators in the observation group were significantly lower/less than those in the control group(all P<0.05).The total effective rate of the observation group was significantly higher than that of the control group[95.9％(47/49)vs 85.7％(42/49)](P<0.05).Conclusion Buccal acupuncture combined with rehabilitation training can effectively promote the rehabilitation of patients after anterior cruciate ligament injury reconstruction with significant clinical efficacy.

Abstract:Hyperlipidemia is a common type of metabolic disease,which can be categorized into the scope of"greasy lipid"and"turbid lipid"according to its clinical characteristics.Its core pathogenesis of"intermingled phlegm and blood stasis"profoundly reveals the dynamic evolution process of the disease from internal accumulation of turbid lipid,generation of phlegm turbidity,internal retention of blood stasis to the final intermingling of phlegm and blood stasis.With the rapid development of modern molecular biology,systems biology and other disciplines,explaining the scientific connotation of"intermingled phlegm and blood stasis"from the biological perspective has become a frontier and hotspot in integrated traditional Chinese and western medicine research.This review system-atically summarizes the research progress on the correlation between the pathogenesis of"intermingled phlegm and blood stasis"and fields such as lipid metabolism disorder,inflammatory response,intestinal flora imbalance and hemodynamic changes in modern medicine.Meanwhile,it analyzes the controversies existing in this research field,including the ambiguous biological definition of"phlegm"and "stasis",the disconnection between animal models and clinical practice,the dilemma of integrating micro indicators with macro syndromes,and the challenges in analyzing the multi-target mechanism of action of traditional Chinese medicine compound prescriptions,aiming to lay a certain theoretical foundation for subsequent clinical research.

Abstract:Objective To explore the predictive value of serum complement C3a receptor 1(C3AR1)combined with the international society on thrombosis and haemostasis-septic coagulopathy(ISTH-SIC)score for the prognosis of children with septic coagulopathy(SIC).Methods A total of 150 SIC children(SIC group)and 75 children with simple sepsis(simple sepsis group)admitted to Xuzhou Children's Hospital,Jiangsu Province from January 2021 to February 2025 were prospectively selected at a ratio of 2:1.Serum C3AR1 levels were detected and ISTH-SIC scores were calculated.Spearman correlation analysis was used to evaluate the correlation between serum C3AR1 levels and ISTH-SIC scores in SIC children.According to the 28 d prognosis,SIC children were divided into death group and survival group.Multivariate Logistic regression analysis was used to identify the influencing factors of prognosis in SIC children.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum C3AR1 combined with ISTH-SIC score for the prognosis of SIC children.Results Serum C3AR1 level and ISTH-SIC score in the SIC group were significantly higher than those in the simple sepsis group[6.31(4.02,9.13)μg/L vs 2.38(1.53,3.43)μg/L,5.00(4.00,6.00)vs 2.00(1.00,3.00),respectively](both P<0.001).Serum C3AR1 level was positively correlated with ISTH-SIC score in SIC children(rs=0.728,P<0.001).Among the 150 SIC children,52 died within 28 d after admission(death group,52 cases)and 98 survived(survival group),with a mortality rate of 34.7％(52/150).Multivariate Logistic regression analysis showed that international normalized ratio,pediatric sequential organ failure assessment score,C3 AR1,and ISTH-SIC score were independent risk factors for death in SIC children(all P<0.05).ROC curve analysis revealed that the area under the curve of serum C3 AR1 alone,ISTH-SIC score alone,and their combination for predicting the prognosis of SIC children was 0.828,0.737 and 0.903,respectively.The combined predictive value was superior to that of serum C3AR1 alone or ISTH-SIC score alone(all P<0.05).Conclusion Elevated serum C3AR1 level and ISTH-SIC score are associated with poor prognosis in children with SIC,and the combination of serum C3AR1 and ISTH-SIC score has high predictive value for poor prognosis.

Abstract:Objective To investigate the effect of allicin on reversing the resistance of NDM-1-type carbapenem-resistant Klebsiella pneumoniae(CRKP)to meropenem.Methods Five CRKP strains isolated from clinical specimens of People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were selected,including 4 blaNDM-1-carrying CRKP strains(CRKP1-CRKP4)and 1 blaNDM-1-non-carrying CRKP strain(CRKP5,negative control).The checkerboard microdilution method was used to screen traditional Chinese medicine monomers(shikonin,myricetin,baicalin,luteolin,allicin)that could reverse the resistance of NDM-1-type CRKP to meropenem,which was further confirmed by concentration cumulative bacteriostatic rate.The standard broth microdilution method was used to verify the reversing effect of allicin on 4 NDM-1-type CRKP strains with different multilocus sequence typing(MLST).Next-generation sequencing technology was employed to detect the MLST typing and antibiotic resistance gene carriage of clinically isolated strains.Results Among the 5 traditional Chinese medicine monomers screened in this experiment,when allicin was combined with meropenem,the fractional inhibitory concentration index(FIC)against CRKP1 was≤0.5,indicating a synergistic effect between allicin and meropenem on CRKP1.Allicin exhibited a reversing effect on 4 NDM-1-type CRKP strains with different MLST types.After the combination of allicin and meropenem,the FIC of the 4 NDM-1-type CRKP strains was≤0.5,suggesting that the combination of allicin and meropenem had a synergistic effect on all 4 NDM-1-type CRKP strains.Antibiotic resistance gene analysis of NDM-1-type CRKP showed that strains CRKP1-4 all carried the blaNDM-1 gene,but their MLST types were different:CRKP1-4 were ST23,ST219,ST63-1 LV,and ST15,respectively,indicating low relatedness among these strains.Conclusion Allicin can reverse the resistance of NDM-1-type CRKP to meropenem,providing a new idea for the clinical treatment of NDM-1-type CRKP infections.

Abstract:Objective To detect the mRNA expression level of LAYN gene in gastric cancer tissues and analyze its correlation with immune cell infiltration in cancer tissues and its relationship with disease progression.Methods A prospective follow-up study was conducted.A total of 112 gastric cancer patients who underwent surgical treatment at the First Affiliated Hospital of Xinjiang Medical University from May 2022 to February 2023 were selected.All patients were divided into progression group and non-progression group according to whether disease progression occurred during the follow-up period.Clinical and laboratory data were compared between the two groups.Cox regression analysis was used to identify factors associated with gastric cancer progression.Pearson correlation analysis was applied to evaluate the correlation between LAYN gene mRNA expression level in gastric cancer tissues and the degree of immune cell infiltration.Kaplan-Meier survival curves were plotted to analyze the risk of disease progression in patients with different LAYN gene Mrna expression levels.Results After excluding 6 lost-to-follow-up patients,76 out of the remaining 106 patients developed disease progression,thus divided into progression group(76 cases)and non-progression group(30 cases),at the same time,normal gastric tissue adjacent to the patient's cancer was used as control(control group).Statistically significant differences were observed between the two groups in clinical stage,differentiation degree,and LAYN gene Mrna expression level(all P<0.05).Cox regression analysis showed that LAYN gene Mrna expression level(hazard ratio=1.551),clinical stage(hazard ratio=5.476),and differentiation degree(hazard ratio=6.675)were independently associated with gastric cancer progression(all P<0.05).In the progression group,the infiltration proportions of CD+8 T cells,CD+4 T cells,and macrophages in gastric cancer tissues were significantly higher than those in the non-progression group and control group,while the infiltration proportion of dendritic cells was lower than that in the non-progression group and control group(all P<0.05).There were statistically significant differences in the infiltration proportions of CD+8 T cells,CD+4 T cells,macrophages,and dendritic cells between the non-progression group and control group(all P<0.05).Pearson correlation analysis revealed that LAYN gene Mrna expression level was positively correlated with the infiltration degrees of CD+8 T cells and macrophages in tumor tissues(r=0.558,P=0.022;r=0.401,P=0.016,respectively)and negatively correlated with the infiltration degree of dendritic cells(r=-0.423,P=0.019).Using the median Mrna expression level of LAYN gene in gastric cancer tissues as the cutoff value,Kaplan-Meier survival analysis showed that patients with high LAYN gene Mrna expression had a significantly higher risk of disease progression than those with low LAYN gene Mrna expression(log-rank χ2=5.784,P=0.008).Conclusion Gastric cancer patients with high Mrna expression of LAYN gene in gastric cancer tissues have a higher risk of disease progression,and the Mrna expression level of LAYN gene in gastric cancer tissues is correlated with the infiltration level of immune cells in cancer tissues.

Abstract:Sleep disorders and cognitive impairment have become non-negligible public health issues.Epidemiological data indicate that sleep disorders are an important risk factor for cognitive impairment,but the underlying mechanism remains unclear.Comprehensive studies have shown that sleep disorders may regulate synapse-related signaling pathways,interfere with the synaptic pruning function of glial cells,induce an imbalance in neurotransmitter and receptor systems,disrupt normal neural oscillations,and impair synaptic plasticity.These effects further weaken the information processing and circuit integration capabilities of cognition-related brain regions such as the hippocampus and prefrontal cortex,ultimately manifesting as cognitive deficits dominated by memory impairment.Therefore,clarifying how sleep disorders affect synaptic plasticity is a key link in revealing the mechanism of sleep disorder-induced cognitive impairment.This review will discuss the aforementioned aspects,aiming to provide a comprehensive perspective for understanding the synaptic plasticity mechanism under-lying cognitive impairment caused by sleep disorders.

Abstract:Transcatheter aortic valve replacement(TAVR)has become an important method for the treatment of severe aortic stenosis.During postoperative follow-up,echocardiography plays a crucial role as a non-invasive and repeatable imaging technique.This article reviews the application value of echocardiography in follow-up after TAVR,focusing on the evolution of postoperative echocardiographic parameters,their prognostic significance,and the evaluation of valve-related complications by echocardiography.

Abstract:Objective To investigate the clinical efficacy of Ludangshen oral liquid combined with ginger-separated moxibustion in treating immune hypofunction in patients with advanced non-small cell lung cancer(NSCLC)after chemotherapy.Methods A total of 120 patients with immune hypofunction after chemotherapy for advanced NSCLC who were treated in Cancer Hospital,Chinese Academy of Medical Sciences from February 2024 to February 2025 were enrolled as research subjects.They were randomly divided into the control group and the observation group using the envelope method,with 60 cases in each group.The control group was treated with ginger-separated moxibustion on the basis of symptomatic and supportive treatment,while the observation group was treated with Ludangshen oral liquid combined with the regimen of the control group.Both groups were treated continuously for 1 month.The clinical efficacy,Piper fatigue scale scores,Karnofsky performance status(KPS)scores,immune function indexes,traditional Chinese medicine(TCM)syndrome scores and incidence of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was significantly higher than that of the control group[85.0％(51/60)vs 76.7％(46/60)](P=0.027).After treatment,the Piper fatigue scale scores,CD+8 ratio,scores of TCM syndrome primary symptoms,secondary symptoms and total scores in both the observation group and the control group were signifi-cantly lower than those before treatment,and the indexes in the observation group were significantly lower than those in the control group;while the KPS scores,CD+3,CD+4,natural killer cell ratio and CD+4/CD+8 ratio were significantly higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group(all P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group[36.7％(22/60)vs 48.3％(29/60)](P=0.196).Conclusion Ludangshen oral liquid combined with ginger-separated moxibustion can effectively improve the therapeutic effect in patients with immune hypofunction after chemotherapy for advanced NSCLC,relieve cancer-related fatigue,improve quality of life,enhance immune function,and has high clinical safety.

Abstract:Hypertension is closely associated with common mental disorders such as anxiety disorder,depression,schizophrenia and bipolar disorder.However,systematic summaries are still lacking regarding the interaction mechanisms,related influencing factors and intervention and screening methods of hypertension and common mental disorders.Therefore,this paper elaborates on the pathophysiological mechanisms and various influencing factors of hypertension and mental disorders in detail,revealing the association between hypertension and common mental disorders.On this basis,it systematically summarizes a series of intervention,diagnosis and treatment measures adopted in the field of chronic disease management at home and abroad,aiming to explore new ideas and approaches for constructing an innovative management model for comorbidity of hypertension and mental disorders,provide a more systematic and comprehensive reference for clinical practice,optimize management strategies,reduce the incidence of comorbidity and improve the quality of life of patients.

Abstract:Diabetic ulcer is one of the common complications of diabetes,characterized by high mortality,high amputation rate and high recurrence rate.Endoplasmic reticulum stress(ERS)is a physiological regulation for the body to maintain cellular homeostasis,while inflammation is a self-immune response of the body to clear necrotic substances.Under physiological conditions,a certain degree of ERS and inflammation are beneficial to cell neogenesis.During the pathogenesis of diabetic ulcer,the high glucose environment and excessive inflammation lead to the continuous enhancement of ERS,and the resulting series of downstream pathological reactions are the key factors for the non-healing of diabetic ulcer.In recent years,studies have found that the crosstalk between ERS and inflammation is closely related to the healing of diabetic ulcer.ERS participates in the healing of diabetic ulcer by affecting macrophage polarization,nuclear factor κB pathway and NOD-like receptor protein 3 inflammasome.Literature shows that ERS inhibitors,Chinese medicine monomers,Chinese medicine compound prescriptions and emerging technical therapies can improve the healing of diabetic ulcer by regulating the interaction between ERS and inflammation.Based on this,this article reviews the research progress on the molecular mechanism and drug targets of the interaction between ERS and inflammation in diabetic ulcer,in order to provide new ideas for the treatment of diabetic ulcer.

Abstract:This paper explores the roles of lactic acid and its derived lactylation modification in macro-phage polarization and bone healing.It elaborates on how lactic acid regulates the transformation of macrophages from the M1 to M2 phenotype through metabolic reprogramming and signaling pathways,and further discusses the important significance of this process in the inflammatory,reparative and remodeling phases of fracture healing.In addition,the paper describes the special manifestations of macrophage polarization under pathological conditions such as hypoxia in the fracture microenvironment and osteoporosis.At the mechanistic level,it not only summarizes histone lactylation modification,but also reveals how non-histone lactylation modification(e.g.,pyruvate kinase M2)directly regulates the expression of bone healing-related genes,including the regulation of osteoclast resorption and osteoblast differentiation.This paper emphasizes the potential of lactic acid and lactylation modification as therapeutic targets for bone healing,and proposes future research directions for improving bone repair efficacy by regulating macrophage polarization,providing an innovative strategy for the treatment of non-union fractures.

Abstract:Objective To investigate the relationship between soluble intercellular adhesion molecule-1(sICAM-1),low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(LDL-C/HDL-C)and slow flow/no-reflow after emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A prospective study was performed on 286 patients with acute STEMI admitted to Department of Emergency,Nanchong Central Hospital from January 2022 to January 2025.Patients with thrombolysis in myocardial infarction(TIMI)flow grade ≤ 2 after operation were assigned to the abnormal blood flow group,and those with TIMI grade 3 to the normal blood flow group.Clinical and laboratory data were compared between the two groups.Logistic regression analysis was used to identify risk factors for slow flow/no-reflow after PCI.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum sICAM-1 and LDL-C/HDL-C for slow flow/no-reflow.Results Among the 286 patients,231 were in the normal blood flow group and 55 in the abnormal blood flow group.The time from symptom onset to PCI was longer,and white blood cell count and neutrophil count were higher in the abnormal blood flow group than those in the normal blood flow group(all P＜0.05).Serum levels of sICAM-1 and LDL-C/HDL-C were significantly higher in the abnormal blood flow group than those in the normal blood flow group[(410±55)μg/L vs(361±49)μg/L,(2.9±0.8)vs(2.3±0.6)](t=6.583,5.526,both P＜0.001).Logistic regression analysis showed that elevated sICAM-1,LDL-C/HDL-C,time from onset to PCI,white blood cell count and neutrophil count were independent risk factors for slow flow/no-reflow after PCI(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of sICAM-1,LDL-C/HDL-C alone and in combination was 0.769,0.763 and 0.868,respectively.The AUC of the combined detection was significantly higher than that of single detection(Z=2.528,P=0.012;Z=2.926,P=0.003).Conclusion Abnormally elevated serum sICAM-1 and LDL-C/HDL-C are independent risk factors for slow flow/no-reflow in STEMI patients after PCI,and their combination has high predictive efficiency for slow flow/no-reflow.

Abstract:Objective To investigate the application of digital health education combined with cognitive behavioral therapy(CBT)and family support in elderly patients with coronary atherosclerotic heart disease(CHD),arrhythmia and cognitive impairment,and its effects on treatment compliance and sleep quality.Methods A prospective study was conducted.A total of 450 elderly patients with CHD,arrhythmia and cognitive impairment admitted to Beijing Anzhen Hospital,Capital Medical University from January 2023 to January 2025 were divided into control group and observation group by random number table method.The control group(227 cases)received routine intervention,and the observation group(223 cases)received digital health education combined with CBT and family support on the basis of routine intervention.The general data,arrhythmia,sleep,cognition,quality of life improvement and treatment compliance were analyzed between the two groups.Results After intervention,the duration and frequency of arrhythmia in both groups were shorter/decreased than those before intervention,and those in the observation group were shorter/lower than those in the control group(all P＜0.05).After interven-tion,the scores of Pittsburgh sleep quality index(PSQI)in both groups were lower than those before intervention,and the score in the observation group was lower than that in the control group(all P＜0.05).After intervention,the scores of Montreal cognitive assessment(MoCA)and 36-item short form health survey(SF-36)in both groups were higher than those before intervention,and the scores in the observation group were higher than those in the control group(all P＜0.05).The treatment compliance rate in the observation group was higher than that in the control group[96.0％(214/223)vs 81.5％(185/227)](P＜0.05).Conclusion Digital health education combined with CBT and family support can improve treatment compliance,reduce the duration and frequency of arrhythmia,improve sleep quality,cognitive function and quality of life in elderly patients with CHD,arrhythmia and cognitive impairment.