Abstract:China is a country with a high incidence of liver cancer.Anti-angiogenesis is one of the important strategies for liver cancer treatment,but the problem of drug resistance results in the overall efficacy remaining unsatisfactory.Targeting liver cancer vascular normalization to improve the efficacy of immunotherapy,chemotherapy and other treatment methods has become a highly promising research hotspot at present.This paper expounds the concept and development course of tumor vascular normalization,emphasizes the core significance of the normaliza-tion time window,and systematically reviews the research progress of inducing liver cancer vascular normalization from two dimensions of clinical trials and preclinical studies.With the unique advantages of multi-target regulation and holistic modulation,traditional Chinese medicine not only has the potential to target angiogenesis balance and promote liver cancer vascular normalization,but also can indirectly induce vascular normalization by regulating the liver cancer microenvironment(including regulating macrophages,neutrophils,cancer-associated fibroblasts,etc.),and ultimately exert anti-liver cancer effects.

Abstract:Objective To evaluate the effect of patient management based on the concept of active health behavior on rehabilitation quality in elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention.Methods A total of 400 elderly patients with coronary atherosclerotic heart disease who un-derwent percutaneous coronary intervention and were admitted to Beijing Anzhen Hospital,Capital Medical University from December 2024 to May 2025 were enrolled as research subjects.They were randomly divided into control group and observation group,with 200 cases in each group.The control group received routine department management,while the observation group received systematic intervention guided by the concept of active health behavior on the basis of routine management.Both groups were followed up for 3 months.The differences in self-efficacy,quality of life,psychological state and incidence of cardiovascular adverse events were compared between the two groups.Results During the follow-up period,15 cases were lost to follow-up in the control group and 10 cases in the observation group,with 185 and 190 cases finally included respectively.At 1 month and 3 months after intervention,the scores related to self-efficacy,self-management ability,quality of life,cognition of disease-related risk factors,treatment compliance and active health behavior level in the observation group were significantly higher than those in the control group,while the scores related to psychological state were significantly lower than those in the control group(all P＜0.001).The total incidence of cardiovascular adverse events in the observation group was lower than that in the control group[16.3％(31/190)vs 47.6％(88/185)](x2=42.259,P＜0.001).Conclusions Patient management based on the concept of active health behavior can significantly improve the level of active health behavior,self-efficacy and self-management ability,optimize quality of life and mental health status,and reduce the incidence of cardiovascular adverse events in elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention.

Abstract:Objective To explore the clinical characteristics of rare hemolytic disease of newborn(HDN),and improve the understanding of rare HDN.Methods The clinical data of 8 children diagnosed with rare HDN in the Department of Pediatrics,Beijing Anzhen Hospital,Capital Medical University from July 2021 to July 2025 were retrospectively analyzed,including 4 cases of Rh blood group incompatibility hemolysis caused by combined anti-c and anti-E antibodies,3 cases of MN blood group incompatibility hemolysis including 1 case complicated with ABO blood group incompatibility hemolysis,and 1 case of Duffy blood group incompatibility hemolysis.Their clinical manifestations,laboratory examinations,treatments and outcomes were analyzed.Results All 4 children with Rh incompatibility hemolytic disease induced by combined anti-c and anti-E antibodies presented with hyperbilirubinemia and anemia,among whom 2 suffered from severe anemia and 1 was complicated with circulatory disturbance,with positive direct and indirect antiglobulin tests in all 4 cases.Hyperbilirubinemia and anemia occurred in all 3 children with MN hemolytic disease,and severe anemia and circulatory disturbance were found in the case complicated with ABO blood group incompatibility hemolysis.All 3 cases showed negative direct antiglobulin test and positive indirect antiglobulin test.Pathological jaundice and mild anemia occurred in the child with Duffy blood group incompatibility hemolytic disease.None of the 8 children received exchange transfusion,and all were discharged with improved conditions.Delayed hemolysis occurred one month after birth in the child complicated with MN and ABO blood group incompatibility hemolysis.Serum cardiac injury biomarkers including cardiac troponin I,creatine kinase isoenzyme,creatine kinase and lactate dehydrogenase were elevated at the onset of HDN in all 8 children.Except cardiac troponin I,the other three indicators decreased significantly during recovery period(P＜0.05).All cardiac troponin I levels returned to normal within 2 weeks to 1.5 months during follow-up.Conclusions Active screening of maternal and neonatal serum antibodies should be performed for neonates with high hemolytic risk and hemolytic manifestations to reduce missed diagnosis.Delayed hemolysis may occur in neonates with MN blood group incompatibility hemolytic disease,so regular follow-up is necessary.Symptoms of Duffy blood group incompatibility hemolysis are generally mild.Myocardial injury induced by HDN is mainly manifested as elevated serum myocardial enzymes,and cardiac troponin I takes the longest time to recover.

Abstract:Objective To develop and validate a multidimensional neuromotor function evaluation system suitable for clinical application in Chinese patients with spinal cord injury.Methods An initial item pool was established through systematic literature review and semi-structured interviews.The modified Delphi method with two rounds involving 24 experts was adopted for item screening.Item analysis,reliability and validity tests,and predictive validity evaluation were performed in 225,125 and 368 patients respectively.Results Item analysis showed satisfactory discriminatory ability of all items.Reliability analysis presented that the overall Cronbach's αcoefficient was 0.872,the intraclass correlation coefficient(ICC)for inter-rater reliability was 0.963,and the ICC for test-retest reliability was 0.945.Validity analysis revealed good construct validity with a cumulative variance contribution rate of 71.3％.The total score was highly correlated with the American Spinal Injury Association motor score and the spinal cord independence measure Ⅲ total score(r=0.784,0.853,respectively).Predictive validity analysis showed that the area under the curve of the system total score for predicting functional household ambulation at 6 months was 0.934,with an optimal cut-off value of 68 points(sensitivity 89.5％,specificity 86.1％).Patients stratified into low,medium and high rehabilitation potential groups according to the cut-off value showed a significant gradient in functional achievement rate(8.7％,47.1％,89.5％,P＜0.001).Conclusion The newly constructed evaluation system has favorable psychometric properties and excellent clinical predictive performance.It realizes the transition from"injury diagnosis"to"functional profiling",and can serve as a standardized tool for clinical rehabilitation assessment and decision-making.

Abstract:Objective To construct a therapeutic effect evaluation model for patients with patent foramen ovale(PFO)-related migraine based on imaging features and verify its efficacy.Methods A total of 60 patients with PFO-related migraine treated at the Second Affiliated Hospital of Xinjiang Medical University from January 2023 to June 2025 were enrolled.According to therapeutic effect,patients were divided into good effect group(35 cases)and poor effect group(25 cases).Baseline characteristics,biochemical and imaging indicators were collected and compared between the two groups.Cox proportional-hazards model and multivariate Logistic regression analysis were used to identify independent risk factors affecting the prognosis of patients with PFO-related migraine.A therapeutic effect evaluation model was established.The accuracy of the model was evaluated by Nomogram and calibration curve.Results There were significant differences in age,gender,visual aura,proportion of hyperhomocys-teinemia,risk of paradoxical embolism(RoPE)score,headache impact test score,international normalized ratio,homocysteine,number of white matter lesions,mean volume of white matter lesions,location of white matter lesions,demyelinating lesions,number of subcortical infarcts and right-to-left shunt grade between the two groups(all P＜0.05).Multivariate Cox regression analysis showed that age,visual aura,number of white matter lesions,mean volume of white matter lesions,location of white matter lesions,number of subcortical infarcts and RoPE score were independent risk factors for therapeutic effect in patients with PFO-related migraine.Harrell's C-index was 0.821(95％confidence interval:0.734-0.876).Nomogram and calibration curve showed good consistency between actual risk and model prediction.Conclusion The therapeutic effect evaluation model for patients with PFO-related migraine constructed based on neuroimaging features has high accuracy.

Abstract:In recent years,clinical statistics have shown that acute respiratory distress syndrome(ARDS)is associated with an extremely high mortality rate.In current clinical practice,the lungs of patients with severe ARDS mostly present as"baby lung"or"white lung",resulting in severe respiratory failure.Extracorporeal membrane oxygenation(ECMO)is a life-support technique that has shown important value in supporting patients with severe respiratory failure in recent years.Its core mechanism is to replace or partially replace lung function through extracorporeal circulation,effectively maintaining the patient's respiratory function and ultimately buying valuable time for the treatment of the primary disease of ARDS.Based on the relevant advances,clinical efficacy and prognostic factors of ECMO in the treatment of ARDS,this article systematically reviews and analyzes the relevant research progress at home and abroad,aiming to provide a theoretical basis and practical guidance for further optimizing the application of ECMO in ARDS.

Abstract:Objective To investigate the predictive value of triglyceride glucose-body mass index(TyG-BMI),a composite index of triglyceride-glucose index(TyG)and body mass index,for severe acute hypertriglyceridemic pancreatitis(HTG-AP).Methods Clinical data of 84 patients with HTG-AP hospitalized in the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from February 2015 to April 2025 were retrospectively collected.Patients were divided into severe group(27 cases)and non-severe group(57 cases)according to disease severity,and TyG-BMI of each patient was calculated.General data,TyG,TyG-BMI and laboratory indicators were compared between the two groups by univariate analysis.Binary multivariate Logistic regression was used to analyze independent influencing factors of severe HTG-AP,and receiver operating characteristic curve was used to evaluate the predictive value of each index for severe HTG-AP.Results Age in the severe group was significantly younger than that in the non-severe group,and body mass index,proportion of diabetes mellitus,TyG,TyG-BMI,triglyceride,blood glucose,C-reactive protein and D-dimer levels were signifi-cantly higher than those in the non-severe group(all P＜0.05).Binary multivariate Logistic regression analysis showed that TyG,TyG-BMI,body mass index and C-reactive protein were independent risk factors for predicting severe HTG-AP(all P＜0.05).The area under the curve of TyG-BMI for predicting severe HTG-AP was 0.956,with 95％confidence interval:0.919-0.994.The AUC of TyG-BMI combined with C-reactive protein for predicting severe HTG-AP was 0.991,with 95％confidence interval:0.976-1.000.Conclusion TyG-BMI can be used as an effective biomarker for predicting the severity of severe HTG-AP.

Abstract:Objective To explore the application value of individualized restraint management strategy in patients with delirium after cardiac and macrovascular surgery.Methods A total of 90 patients who developed postoperative delirium after cardiac and macrovascular surgery in Beijing Anzhen Hospital,Capital Medical University from July 2023 to March 2024 were retrospectively enrolled.According to the implementation time of management strategies,the patients were divided into pre-improvement group(July to September 2023),ongoing-improvement group(October to December 2023)and post-improvement group(January to March 2024).Based on the physical restraint assessment scale for intensive care unit patients,the individualized restraint management strategy implemented graded restraint and alternative measures combined with psychological counseling,family participation and empowerment.The severity of delirium,average use time of restraints and incidence of adverse events were compared among the three groups.Results A total of 90 patients with delirium after cardiac and macrovascular surgery were enrolled in this study,including 35 cases in the pre-improvement group,27 cases in the ongoing-improvement group and 28 cases in the post-improvement group.The severity of delirium among the three groups showed a significant downward trend with the advancement of management stages(r=-0.51,P＜0.001).The proportion of patients with mild delirium in the post-improvement group was significantly higher than that in the ongoing-improvement group and pre-improvement group,while the proportion of severe delirium was significantly lower than that in the pre-improvement group and ongoing-improvement group(all P＜0.001).The delirium severity score gradually decreased from(21.1±2.3)in the pre-improvement stage to(16.3±2.8)in the ongoing-improvement stage and(8.5±2.2)in the post-improvement stage(P＜0.001).Meanwhile,the average duration of restraint belt application was gradually shortened(P=0.025).The total incidence of adverse events in the three groups presented a gradual downward trend(P=0.144).Conclusions The individualized restraint management strategy can significantly reduce the severity of delirium,shorten the duration of restraint use,and decrease the incidence of adverse events in patients after cardiac and macrovascular surgery.

Abstract:Mixed adenoneuroendocrine carcinoma(MANEC)of the colorectum is a rare type of gastroin-testinal tumor,in which both adenocarcinoma and neuroendocrine carcinoma components should each account for at least 30％.MANEC is characterized by low incidence,high malignancy,strong invasiveness,early distant metastasis and poor prognosis.In addition,due to insufficient clinical understanding,early and accurate histopathological diagnosis is an important basis for individualized multidisciplinary comprehensive treatment.The diagnosis and treatment experience of 1 patient with MANEC is reported,and a literature review and discussion are conducted for clinical reference.

Abstract:Objective To investigate the relationship between serum insulin-like growth factor binding protein-1(IGFBP-1)and angiopoietin-like protein 4(ANGPTL-4)levels and sarcopenia in patients with liver cirrhosis,and their predictive value.Methods A total of 167 patients with liver cirrhosis admitted to the Department of Gastroenterology,Taiyuan Central Hospital,from January 2023 to July 2025(cirrhosis group)and 167 healthy volunteers(control group)during the same period were enrolled.Serum levels of IGFBP-1 and ANGPTL-4 were detected by enzyme-linked immunosorbent assay.According to the presence or absence of sarcopenia,patients with liver cirrhosis were divided into sarcopenia group and non-sarcopenia group.The factors associated with sarcopenia in cirrhotic patients and the predictive value of serum IGFBP-1 and ANGPTL-4 levels for sarcopenia were analyzed.Results Serum IGFBP-1 level was higher and ANGPTL-4 level was lower in the cirrhosis group than those in the control group[(30±5)μg/L vs(16±4)μg/L,(27±5)μg/L vs(40±5)μg/L](both P＜0.001).In cirrhotic patients,serum IGFBP-1 level was negatively correlated with appendicular skeletal muscle mass index,handgrip strength and 6-meter walking speed,and positively correlated with 5-time sit-up time,while the correlations of ANGPTL-4 level with the above indicators were opposite to those of IGFBP-1(all P＜0.001).Multivariate Logistic regression analysis showed that increased age,Child-Pugh class C liver function and elevated IGFBP-1 were independent risk factors for sarcopenia in cirrhotic patients,while increased body mass index and elevated ANGPTL-4 were independent protective factors(all P＜0.05).The areas under the curve of serum IGFBP-1,ANGPTL-4 and their combination for predicting sarcopenia in cirrhotic patients were 0.803,0.794 and 0.877,respectively.The area under the curve of the combined prediction was larger than that of single prediction(all P＜0.001).Conclusion Elevated serum IGFBP-1 and decreased ANGPTL-4 are associated with sarcopenia in cirrhotic patients.The combination of serum IGFBP-1 and ANGPTL-4 has high predictive value for sarcopenia.

Abstract:Gastrointestinal stromal tumor(GIST)is the most common soft tissue sarcoma,and its initia-tion and progression are mainly driven by activating mutations in KIT or platelet-derived growth factor receptor a gene.Although tyrosine kinase inhibitors represented by imatinib have significantly improved patient prognosis,the emergence of drug resistance suggests that intrinsic mutations in tumor cells alone cannot fully explain the biological heterogeneity and differential therapeutic outcomes of GIST.Recent studies have demonstrated that the tumor microenvironment(TME)plays a critical regulatory role in GIST progression,immune escape,and resistance to targeted therapy.This article systematically reviews the composition and functional characteristics of the GIST TME,focusing on the mechanisms of innate immune cells,adaptive immune cells,and stromal cells in tumor evolution and therapeutic response.Available evidence indicates that immune cells and stromal cells form a highly dynamic interaction network with tumor cells through immunosuppression,metabolic reprogramming,and extracel-lular matrix remodeling.This network collectively shapes the immune ecosystem of GIST and affects the efficacy of imatinib.Notably,targeted therapy can bidirectionally remodel the microenvironment,activating anti-tumor immunity while inducing immunosuppressive remodeling.Overall,the biological behavior and drug resistance of GIST result from the synergistic effects of intrinsic tumor signaling and the TME.An in-depth understanding of the dynamic characteristics of the GIST TME will facilitate the discovery of novel biomarkers and provide a theoretical basis for combination therapeutic strategies integrating targeted therapy with immunological and microenvironmental interventions.

Abstract:Objective To investigate the effects of transcutaneous acupoint electrical stimulation(TAES)combined with parenteral nutrition on gastrointestinal function and serum motilin and somatostatin levels in patients after laparoscopic radical gastrectomy(LRG)for gastric cancer.Methods A total of 90 patients who underwent LRG at Shanghai Hospital of Integrated Traditional Chinese and Western Medicine from January 2023 to December 2024 were selected and divided into the parenteral nutrition group and the combined group with 45 cases in each group using a random number table method.On the basis of conventional treatment,the parenteral nutrition group received central venous infusion of fat emulsion,amino acids(17)and glucose(11％)injection starting on the first day after surgery;the combined group was additionally treated with TAES on the basis of the parenteral nutrition group.Both groups were treated for 1 week.Gastrointestinal function,serological indicators,immune function indicators and the incidence of adverse reactions were compared between the two groups.Results The recovery time of bowel sounds,anal exhaust time and defecation time in the combined group were significantly shorter than those in the parenteral nutrition group(all P＜0.05).After treatment,the serum motilin levels in both groups were higher than those before treatment,and the level in the combined group was higher than that in the parenteral nutrition group;the serum somatostatin levels in both groups were lower than those before treatment,and the level in the combined group was lower than that in the parenteral nutrition group[between groups:(256±29)ng/L vs(231±25)ng/L,(16.9±1.5)ng/L vs(18.7±1.9)ng/L](all P＜0.05).After treatment,the CD4+level and CD4+/CD8+ratio in both groups were higher than those before treatment,and the indices in the combined group were higher than those in the parenteral nutrition group;the CD8+level in both groups was lower than that before treatment,and the level in the combined group was lower than that in the parenteral nutrition group(all P＜0.05).The incidence of adverse reactions in the combined group was lower than that in the parenteral nutrition group[6.7％(3/45)vs 24.4％(11/45)](P=0.042).Conclusions TAES combined with parenteral nutrition can effectively promote the recovery of postoperative gastrointestinal function,improve serum motilin and somatostatin levels,optimize the body's immune function and reduce the occurrence of adverse reactions in patients after LRG.

Abstract:Myocardial infarction is one of the leading causes of death worldwide.Evidence has shown that microRNA(miR)is a reliable biomarker matching cardiac troponin in myocardial infarction.MiRs are a class of highly conserved small non-coding RNAs composed of 20 to 24 nucleotides,which regulate post-transcriptional gene expression by binding to the 3' untranslated region of target genes,thus participating in many important physi-ological processes.This article reviews the relevant research on miRs and myocardial infarction in recent years,elaborates on the roles of miRs as biomarkers for myocardial infarction and in regulating cardiomyocyte apoptosis and proliferation,angiogenesis,fibroblast reprogramming,myocardial fibrosis,inflammatory response and other processes,aiming to provide new ideas for the diagnosis,prevention and treatment of myocardial infarction.

Abstract:Objective To investigate the expression of T-cell immunoglobulin mucin-3(TIM3)and galectin-9 in endometrial carcinoma and their relationship with recurrence and metastasis.Methods A total of 124 patients with endometrial carcinoma who underwent surgery in Shanxi Provincial People's Hospital from February 2019 to October 2021 were selected,and 124 patients with benign endometrial hyperplasia in the same hospital during the same period were selected as the control group.RNAscope technique was used to detect the expression of TIM3 and galectin-9,and the correlation between their expression and postoperative recurrence and metastasis was systematically analyzed.Results In endometrial carcinoma tissues,the positive expression rates of TIM3 and Galectin-9 were 37.1％(46/124)and 29.8％(37/124),respectively,while no expression of TIM3 and Galectin-9 was detected in benign endometrial hyperplasia tissues(0/124).In patients with endometrial carcinoma who developed postoperative recurrence or metastasis,the positive expression rates of TIM3 and Galectin-9 were significantly higher than those in patients without recurrence and metastasis(all P＜0.05).Recurrence and metastasis of endometrial carcinoma were associated with lymph node metastasis(P=0.010)and myometrial invasion(P=0.040).The area under the curve(AUC)of TIM3 in predicting recurrence and metastasis of endometrial carcinoma was 0.872(95％confidence interval:0.837-0.926),with a sensitivity of 86.7％and a specificity of 79.5％;the AUC value of Galectin-9 was 0.830(95％confidence interval:0.814-0.905),with a sensitivity of 90.3％and a specificity of 64.5％.Univariate and multivariate Cox regression analysis showed that positive expression of TIM3,positive expression of Galectin-9 and lymph node metastasis could be used as independent influencing factors for predicting recurrence and metastasis in patients with endometrial carcinoma(all P＜0.05).Conclusion TIM3 and Galectin-9 are specifically expressed in endometrial carcinoma tissues,and their high expression is significantly associated with the risk of postoperative recurrence and metastasis.

Abstract:Objective To investigate the relationship between hemoglobin,albumin,lymphocyte and platelet(HALP)index,lactate dehydrogenase to albumin ratio(LAR),monocyte to high-density lipoprotein cholesterol ratio(MHR)and prognosis in patients with sepsis-associated acute kidney injury(S-AKI).Methods A total of 100 patients with S-AKI admitted to Chongqing Emergency Medical Center from May 2023 to May 2025 were retrospectively enrolled.According to 28 d survival status during hospitalization,patients were divided into survival group(52 cases)and death group(48 cases).Clinical data and laboratory data of the two groups were collected,HALP index,LAR and MHR were calculated.The factors associated with 28 d in-hospital mortality and the predictive value of HALP index,LAR and MHR for 28 d in-hospital mortality were analyzed.Results The proportion of stage 3 AKI,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,vasoactive drugs and mechanical ventilation in death group were higher than those in survival group(all P＜0.05).HALP index in death group was lower than that in survival group[(23.0±2.5)vs(27.6±3.1)](t=-8.112,P＜0.001),while LAR and MHR were higher than those in survival group[(12.0±2.2)vs(7.3±1.6),(14.3±3.7)vs(9.3±2.3)](t=12.283,8.188,both P＜0.001).Multivariate Logistic regression analysis showed that high SOFA score,stage 3 AKI,high LAR and high MHR were independent risk factors for 28 d in-hospital mortality in S-AKI patients(all P＜0.05),while high HALP index was a protective factor(P＜0.05).The area under the curve of HALP index,LAR and MHR for predicting 28 d in-hospital mortality in S-AKI patients was 0.746,0.729 and 0.750,respectively,and the combined prediction was 0.883,which was higher than that of each single indicator(all P＜0.05).Conclusion The combina-tion of HALP index,LAR and MHR can effectively predict the risk of adverse outcomes in patients with S-AKI.

Abstract:Objective To explore the influencing factors for completion of full-course medication in young patients with first-episode breast cancer.Methods A total of 347 young patients with first-episode breast cancer treated at the First Affiliated Hospital with Nanjing Medical University from January 2021 to June 2024 were enrolled.Clinical data,disease cognition and social support were collected.Patients were divided into full-course medication completion group and non-completion group.Univariate analysis and Logistic regression were used to analyze influencing factors.Results Among 347 young patients with first-episode breast cancer,243 cases(70.0％)were in the full-course medication completion group,and 104 cases(30.0％)were in the non-completion group.Univariate analysis showed that completion of full-course medication was not associated with age,fertility status,pathological type,molecular subtype,or educational level(all P＞0.05),but was associated with marital status,clinical stage,monthly family income,disease cognition,social support,medication duration,adverse reactions,and post-treatment marriage/fertility intention(all P＜0.05).Logistic regression analysis revealed that divorced or widowed marital status[odds ratio(OR)=1.923,95％confidence interval(CI):1.165-3.174,P=0.011],monthly family income＜5 000 yuan(OR=2.582,95％CI:1.428-4.669,P=0.002),presence of adverse reactions(OR=2.761,95％CI:1.378-5.532,P=0.004),and no post-treatment marriage/fertility intention(OR=1.528,95％CI:1.009-2.314,P=0.045)were risk factors for non-completion of full-course medication.Good disease cognition(OR=0.403,95％CI:0.227-0.715,P=0.002)and high social support(OR=0.531,95％CI:0.368-0.766,P=0.001)were protective factors for completion of full-course medication.Conclusion Marital status,family income,adverse reactions,post-treatment marriage/fertility intention,disease cognition and social support are key factors affecting full-course medication completion.Targeted interventions should be adopted to improve adherence and prognosis.

Abstract:Objective To observe the clinical effect of immune checkpoint inhibitors combined with chemotherapy in patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma.Methods The medical records of 729 patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma admitted to Gansu Provincial Cancer Hospital from January 2021 to January 2025 were collected and retrospectively analyzed.According to different treatment regimens,they were divided into control group(361 cases,received conventional chemotherapy)and observation group(368 cases,received immune checkpoint inhibitors combined with chemo-therapy on the basis of control group).All patients were treated continuously for 3 months.The clinical efficacy,levels of tumor markers,immune function indexes and adverse reactions were compared between the two groups.Results The overall response rate and disease control rate[67.9％(250/368)vs 47.6％(172/361)]in the observation group were better than those in the control group(both P＜0.001).After treatment,the levels of carcinoembryonic antigen,carbohydrate antigen 72-4,carbohydrate antigen 199 and CD8+in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group;the levels of CD4+and CD4+/CD8+ratio 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).There were no significant differences in the incidence rates of grade Ⅰ-Ⅱ and Ⅲ-Ⅳ adverse reactions between the two groups(both P＞0.05).Conclusions For patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma,the application of immune checkpoint inhibitors on the basis of chemotherapy has better clinical efficacy,which can improve the disease control rate,reduce the levels of tumor markers,thereby improving the body's immune function with mild adverse reactions.

Abstract:Objective To analyze the influencing factors of major adverse cardiovascular events(MACE)in patients with coronary atherosclerotic heart disease(CHD)complicated by obstructive sleep apnea(OSA)based on monocyte to high-density lipoprotein cholesterol ratio(MHR),and to construct a risk prediction model.Methods A total of 289 patients with CHD complicated by OSA treated in Beijing Anzhen Hospital,Capital Medical University from September 2021 to September 2024 were enrolled and divided into MACE group(61 cases)and non-MACE group(228 cases)according to the occurrence of MACE.Binary Logistic regression was used to analyze the risk factors of MACE in patients with CHD complicated by OSA,and a prediction model was constructed based on the results.Results Binary Logistic regression analysis showed that smoking history,apnea-hypopnea index ≥ 15 events/h,high-sensitivity C-reactive protein ≥0.5 mg/L,N-terminal pro-B-type natriuretic peptide and MHR were risk factors for MACE in patients with CHD complicated by OSA(all P＜0.05),while high left ventricular ejection fraction was a protective factor(P＜0.05).The model was constructed using the above factors.Hosmer-Lemeshow goodness-of-fit test showed x2=6.223,P=0.622.The area under the curve(AUC)of the Logistic regression model for predicting MACE was 0.948,with sensitivity of 89.0％,specificity of 100.0％,and actual accuracy of 90.7％.The AUC of the validation group was 0.960,with sensitivity of 74.5％and specificity of 100.0％.Conclusion MHR is a risk factor for MACE in patients with CHD complicated by OSA.The risk prediction model constructed based on MHR and other risk factors has high predictive value.

Abstract:Objective To evaluate the effect of the monitoring and early warning system for acute flaccid paralysis(AFP)cases in a tertiary general hospital in Beijing,and to provide a reference for similar medical institutions.Methods Taking Beijing Anzhen Hospital,Capital Medical University as an example,the baseline data before optimization were the AFP monitoring and early warning data from January to June 2024,and the outcome data after optimization were the AFP monitoring and early warning data from January to June 2025.The differences in the number of monitoring and early warning pop-ups,disease types,early warning trigger rate and management process of the AFP case monitoring and early warning system before and after optimization were compared.Results After the system optimization,real-time pop-ups could be triggered when clinical doctors included 14 AFP disease keywords such as"nerve,paralysis,spinal cord"in the diagnosed disease types.A total of 113 pop-ups were triggered by clinical doctors from January to June 2025,an increase of 16.49％compared with the same period in 2024,involving an increase in disease types from 2 to 7.The number of visits by patients under 15 years old from January to June 2025 decreased by 22.92％compared with the same period in 2024,and the pop-up early warning trigger rate was 2.97‰,which was significantly higher than 1.96‰ in the same period in 2024(U=2.991,P＜0.01).In addition,the pop-up interface of the functional management department added the functions of recording the cause of early warning trigger,disposal basis and results,and simultaneously added the retrieval function of fuzzy diagnosis fields,supporting real-time retrieval of any diagnosis keywords in all departments of the hospital.Conclusion After the system optimization,the sensitivity of AFP case pop-up trigger is significantly improved,which helps to enhance clinicians' awareness of AFP case identification and reporting;the functional management department can realize permanent traceability of disposal records.The fuzzy diagnosis field retrieval function can not only reduce irrelevant pop-ups for clinicians and lighten their workload,but also improve retrieval efficiency,and provide a flexible keyword retrieval channel for the monitoring of various infectious diseases.

Abstract:Right heart failure following left ventricular assist device(LVAD)implantation is one of the key complications determining prognosis.With the gradual popularization of the third-generation magnetic levitation continuous-flow devices in China,preoperative ultrasound-based risk prediction of right heart failure and postoperative bedside ultrasound-centered real-time monitoring have become feasible approaches to reduce the incidence and mortality of right heart failure.Based on sorting out the application pattern and population characteristics of LVAD in China,this paper systematically summarizes the latest definition and classification of right heart failure,concludes the preoperative ultrasound predictors with good repeatability and accuracy,proposes the ultrasound sequence and follow-up time points for postoperative follow-up,and constructs an ultrasound-driven intervention decision-making process.The aim is to provide a set of diagnosis and treatment framework and follow-up reference for the multidisciplinary treatment team.