Abstract:Objective To investigate the effect of Mongolian medicine Qingxue Bawei powder combined with amlodipine besylate on hemorheology and related indexes in patients with essential hypertension.Methods Patients with essential hypertension who were treated in People's Hospital of Inner Mongolia Autonomous Region from March 2021 to February 2023 were selected.According to the random number table method,they were divided into the observation group(31 cases)and the control group(29 cases).The control group was treated with amlodipine besylate tablets,and the observation group was treated with Qingxue Bawei powder on the basis of the control group.Both groups were treated for 30 d.The changes of hemorheology,blood lipid,homocysteine(Hcy),high-sensitive C-reaction protein(hs-CRP),blood pressure level and safety indexes were observed before and after treatment.Results After treatment,whole blood high-resection relative index,whole blood low-resection relative index,plasma viscosity and erythrocyte aggregation index in the observation group were improved compared with those before treatment,and the improvement of whole blood high-resection relative index and whole blood low-resection relative index were greater than those in the control group[3.04(0.89,5.51)vs 0.69(0.13,1.93),5.22(2.83,8.97)vs 2.64(1.34,5.19)](all P＜0.05).After treatment,the levels of high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),total cholesterol and triacylglycerol in the observation group were all improved compared with those before treatment,and the levels of HDL-C,LDL-C and triacylglycerol were improved more than those in the control group(all P＜0.05).After treatment,the levels of Hcy,hs-CRP,systolic blood pressure and diastolic blood pressure in the observation group were all improved,and the improvement of Hey,hs-CRP and diastolic blood pressure were greater than those in the control group(all P＜0.05).Before and after treatment,the blood routine and liver and kidney function indexes of the two groups were within the normal range,and there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Mongolian medicine Qingxue Bawei powder combined with amlodipine besylate has a certain improvement effect on hemorheology and related indicators in patients with essential hypertension,and the improvement effect is significantly better than amlodipine besylate alone.

Abstract:Objective To investigate the impacts of Chaihu decoction combined with escitalopram oxalate on psychological resilience,symptoms,and hormone level in patients with perimenopausal depression.Methods Totally 98 patients with perimenopausal depression admitted to Affiliated Hospital of Tianjin Institute of Traditional Chinese Medicine from June 2021 to November 2022 were enrolled.Patients were divided into control group and observation group,with 49 cases each,by the random number table method.The control group was treated with escitalopram oxalate,while the observation group was treated with Chaihu decoction based on the control group.Both groups were treated for 2 months.The psychological resilience,symptoms and serum levels of hormone,5-hydroxytryptamine and brain-derived neurotrophic factor(BDNF)were compared between the two groups before and after treatment.The clinical efficacy of patients was recorded.Results After treatment,the Connor-Davidson Resilience Scale score,levels of 5-hydroxytryptamine,BDNF,and estrogen in both groups were increased,and the above indicators in the observation group were higher than those in the control group[81(74,85)vs 73(70,77),(36.5±3.7)ng/L vs(32.2±3.4)ng/L,(18.7±1.9)ng/L vs(15.4±1.7)ng/L,(26.3±2.8)ng/L vs(22.1±2.4)ng/L](all P＜0.05).After treatment,the Kupperman score,Hamilton Depression Scale score,luteinizing hormone and follicle-stimulating hormone levels in both groups were obviously reduced,and the above indicators in the observation group were lower than those in the control group(all P＜0.05).Conclusion Chaihu decoction combined with escitalopram oxalate can effectively improve the psychological resilience level of patients with perimenopausal depression,alleviate symptoms,and reduce hormone level.

Abstract:Objective To observe the clinical effect of Yangxin Zhitong granule in the treatment of chronic stable angina pectoris with Qi deficiency and blood stasis syndrome and its effect on blood lipid and inflammatory factors.Methods A total of 130 patients with chronic stable angina pectoris of Qi deficiency and blood stasis syndrome in the First Affiliated Hospital,Heilongjiang University of Chinese Medicine from June 2021 to June 2024 were selected as the research objects,and they were divided into observation group and control group according to the random number table method,with 65 cases in each group.The control group was treated with standardized western medicine,and the observation group was treated with Yangxin Zhitong granule on the basis of the control group.Both groups were treated for 4 weeks.The changes of traditional Chinese medicine syndrome score and curative effect,angina symptom score and curative effect,blood lipid and inflammatory index were compared between the two groups.Results The total effective rate of TCM syndrome in the observation group was higher than that in the control group(P＜0.05).After treatment,the total score of TCM syndrome in the observation group was significantly lower than that in the control group(P＜0.05).After treatment,the frequency of angina attack,the duration of each pain,and the total score of angina symptoms in the two groups were lower/shorter than those before treatment,and the observation group was lower/shorter than the control group(all P＜0.05).The total effective rate of angina pectoris in the observation group was higher than that in the control group[77.8％(49/63)vs 62.3％(38/61)](x2=8.094,P=0.017).The total effective rate of electrocardiogram treatment in the observation group was higher than that in the control group(P＜0.05).After treatment,the levels of total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-sensitivity C-reactive protein and lipoprotein associated phospholipase A2 in the observation group were lower than those in the control group,and the level of high-density lipoprotein cholesterol was higher than that in the control group(all P＜0.05).There were no significant abnormalities in blood and urine routine,liver and kidney function before and after treatment in the two groups.Conclusion Yangxin Zhitong granule can significantly improve the clinical total effective rate of patients with chronic stable angina pectoris of Qi deficiency and blood stasis syndrome,effectively improve the symptoms of patients,play a role in lowering lipids and anti-inflammation,and improve the quality of life.

Abstract:Peritoneal metastasis in advanced gastric cancer is the most common form of distant metastasis in patients with poor prognosis.Neoadjuvant intraperitoneal combined with systemic chemotherapy(NIPS)and immunotherapy represented by programmed cell death protein 1 inhibitors have been gradually applied to the treatment of peritoneal metastasis of gastric cancer.In this study,two patients with advanced gastric cancer with peritoneal metastasis were reported.Laparoscopic exploration indicated peritoneal metastasis,and they were treated with oxaliplatin and tegafur,gimeracil and oteracil potassium combined with albumin-bound paclitaxel systemic and intraperitoneal chemotherapy,and sintilimab intravenous infusion for 4 cycles.After conversion therapy,the patient's imaging showed partial remission,and then laparoscopic exploration was performed,and no clear peritoneal metastasis was found in the exploration.The radical resection was successfully performed,and the postoperative pathology showed effective downstaging,and the patient recovered smoothly.The results indicate that NIPS combined with sintilimab is effective and safe in the conversion therapy of gastric cancer with peritoneal metastasis,but this mode needs more research to prove.

Abstract:Heart failure is one of the leading causes of death in many patients with cardiovascular diseases and threatens human health worldwide.With the continuous development of molecular biology technology,many forms of programmed cell death have been discovered recently,and related research involves many fields.Some studies have shown that some programmed cell death pathways are related to the mechanism of heart failure.This article reviews the molecular mechanisms of programmed cell death pathways such as autophagy,pyroptosis and ferroptosis in heart failure,and discusses the role of reported forms of programmed cell death in heart failure,in order to provide a new direction for understanding the mechanism of heart failure from the perspective of programmed cell death.

Abstract:Hemodialysis is the main treatment for end-stage renal disease.Before hemodialysis treatment,it is necessary to establish a vascular access and maintain stable and long-term blood flow to ensure the effect of hemodialysis treatment.At present,there is no ideal vascular access type.Clinically,vascular access types that can maintain long-term stable blood flow mainly include autogenous arteriovenous fistula,graft arteriovenous fistula and central venous catheter.The choice of different vascular access types may also cause different complications in patients with end-stage renal disease,and have different effects on the prognosis of patients.In order to better understand the effects of different vascular access types on the prognosis of patients with end-stage renal disease,this article reviews the selection of vascular access and its correlation with the prognosis of patients,so as to provide reference for the decision-making of vascular access types in patients with end-stage renal disease undergoing hemodialysis.

Abstract:Objective To explore the application value of metagenomic next-generation sequencing(mNGS)in the pathogen diagnosis of severe infectious diseases in pediatric intensive care unit(PICU).Methods A retrospective analysis was conducted on 86 pediatric patients admitted to the PICU of Guizhou Provincial People's Hospital from October 2021 to July 2023,all of whom underwent microbial culture and mNGS for severe infections.In total,113 specimens were submitted for examination.The differences in pathogen detection rate and pathogenic characteristics between mNGS and microbial culture were compared.Results A total of 113 samples were collected from 86 children.The total pathogen detection rate of mNGS was higher than that of microbial culture method[68.1％(77/113)vs 23.9％(27/113)](P＜0.05).In peripheral blood,sputum and cerebrospinal fluid samples,the pathogen detection rates of mNGS were higher than those of microbial culture method[65.0％(26/40)vs 25.0％(10/40),97.1％(34/35)vs 28.6％(10/35),37.5％(9/24)vs 12.5％(3/24)](all P＜0.05).The most common infection type detected by mNGS was mixed infection(26.5％,30/113),followed by bacterial infection(20.4％,23/113)and viral infection(17.7％,20/113).The most common infection type detected by microbial culture method was bacterial infection(17.7％,20/113),followed by fungal infection(4.4％,5/113).The detection rates of mixed infection and virus infection by mNGS method were higher than those by microbial culture method(both P＜0.05).The detection rates of mNGS for 1 pathogen,2 pathogens,3 or more pathogens,1 type of pathogen(the number of categories refers to bacteria,fungi,viruses,and other 4 categories),and 2 types of pathogens are all higher than those of microbial culture methods(all P＜0.05).31.4％(27/86)of the children had their treatment adjusted based on the results of mNGS and benefited from it.Conclusion mNGS has a higher detection rate than microbial culture in the diagnosis of infectious diseases in PICU,and it has obvious advantages in mixed infections and viral infections,which can be used as a supplement to microbial culture and guide clinical treatment.

Abstract:Objective To explore the risk factors and treatment outcomes of multidrug-resistant tuberculosis.Methods A total of 160 patients with multidrug-resistant tuberculosis in Hebei Chest Hospital from January 2022 to December 2023 were selected as the drug-resistant group,and 160 patients with sensitive tuberculosis during the same period were selected as the sensitive group.The drug-resistance group was divided into observation group and control group according to the random number table method,with 80 cases in each group.The control group was treated with the regimen without bedaquiline,and the observation group was treated with the regimen containing bedaquiline,both groups received continuous treatment for 24 weeks.The general data,efficacy and adverse reactions of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the risk factors of multidrug-resistant tuberculosis.Results There were significant differences in residence,marital status,anti-tuberculosis treatment history,tuberculosis cavity,tuberculosis contact history,and BCG vaccination history between the drug-resistance group and the sensitive group(all P＜0.05).The results of multivariate Logistic regression analysis showed that rural residence,married,anti-tuberculosis treatment history,tuberculosis cavity,tuberculosis contact history,and no BCG vaccination history were the risk factors for multidrug-resistant tuberculosis(all P＜0.05).There were no statistically significant differences in general data between the observation group and the control group(all P＞0.05).The total effective rate of the observation group was higher than that of the control group[86.2％(69/80)vs 70.0％(56/80)](x2=6.181,P=0.013).There was no significant differ-ence in the incidence of adverse reactions between the observation group and the control group[22.5％(18/80)vs 15.0％(12/80)](x2=1.477,P=0.224).Conclusion Rural residence,married,anti-tuberculosis treatment history,tuberculosis cavity,tuberculosis contact history and no BCG vaccination history are the risk factors for multidrug-resistant tuberculosis.Effective measures should be taken in time to avoid the occurrence of multidrug-resistant tuberculosis.Bedaquiline-containing regimen is effective and safe in the treatment of patients with multidrug-resistant tuberculosis.

Abstract:Objective To investigate the effect of venlafaxine and aripiprazole combined with cognitive behavioral therapy(CBT)on depression and its influence on prolactin level.Methods A total of 100 patients with depression admitted to Huzhou Third People's Hospital,Zhejiang Province from March 2020 to April 2022 were selected.According to the random number table method,they were divided into the control group and the observation group,with 50 cases in each group.The control group was treated with venlafaxine and aripiprazole,and the observation group was treated with CBT on the basis of the control group.Both groups were treated for 30 days.After treatment,the therapeutic effect,changes in prolactin level before and after treatment,changes in cognitive status and depressive symptoms,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[92.0％(46/50)vs 76.0％(38/50)](P＜0.05).The prolactin levels of the two groups after 2 and 4 weeks of treatment were lower than those before treatment,and the prolactin levels after 4 weeks of treatment were lower than those after 2 weeks of treatment,and the prolactin levels of the observation group after 2 and 4 weeks of treatment were lower than those of the control group[(41.4±3.9)μg/L vs(45.8±4.2)μg/L,(19.8±2.3)μg/L vs(25.7±2.2)μg/L](all P＜0.05).After treatment,the Repeatable Battery for the Assessment of Neuropsychological Status scores of both groups were higher than those before treatment,and those in the observation group were higher than those in the control group;the Hamilton Depression Scale and Somatization self-rating scale scores were lower than those before treatment,and those in the observation group were lower 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).Conclusions In the clinical treatment of patients with depression,the implementation of venlafaxine and aripiprazole combined with CBT can significantly improve the effect,reduce the level of prolactin,correct cognitive status,relieve adverse psychological and physical symptoms,and has safety.

Abstract:Objective To investigate the clinical effect of Lifei capsules combined with theophylline sustained-release tablets in the treatment of chronic asthmatic bronchitis.Methods A total of 90 patients with chronic asthmatic bronchitis admitted to Shanxi Cancer Hospital from March 2022 to December 2023 were selected as the research objects.According to the random number table method,90 patients were divided into the control group and the observation group,45 cases in each group.The control group was treated with theophylline sustained-release tablets on the basis of basic treatment,and the observation group was treated with Lifei capsules combined with theophylline sustained-release tablets on the basis of basic treatment.The total effective rate,improvement time of clinical symptoms,blood gas indexes,inflammatory factors and incidence of adverse drug reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[93.3％(42/45)vs 77.8％(35/45)](P=0.036).The improvement times of wheezing,cough and phlegm in the observation group were shorter than those in the control group(all P＜0.05).After treatment,the levels of arterial partial pressure of oxygen in the two groups were higher than those before treatment,and that in the observation group was higher than that in the control group.The levels of arterial partial pressure of carbon dioxide,C-reactive protein,interleukin-6 and procalcitonin were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P=0.609).Conclusion Lifei capsules combined with theophylline sustained-release tablets can achieve good clinical effect in the treatment of chronic asthmatic bronchitis,which can effectively improve the blood gas indexes and inflammatory response in the body,and has good safety.

Abstract:Objective To analyze the effect of ustekinumab combined with azathioprine on wound healing after anal fistula surgery for Crohn's disease.Methods A total of 80 patients with anal fistula surgery of Crohn's disease admitted to Lishui City Central Hospital,Zhejiang Province from April 2021 to July 2023 were selected as the research objects.They were divided into observation group and control group by random number table method,with 40 cases in each group.The control group was treated with azathioprine tablets,and the observation group was treated with ustekinumab injection on the basis of azathioprine tablets.After 24 weeks of treatment,the Crohn's disease activity index(CDAI)score,simplified endoscopy for Crohn's disease(SES-CD)score,clinical remission,inflammation,adverse reactions,wound healing,and quality of life were compared between the two groups.Results After treatment,the scores of CDAI and SES-CD in the observation group were lower than those in the control group,and the clinical remission in the observation group was better than that in the control group(all P＜0.05).After treatment,the levels of serum interleukin-12(IL-12),IL-23 and tumor necrosis factor-α in the observation group were significantly lower 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=0.809).After treatment,the total effective rate of wound healing in the observation group was higher than that in the control group[85.0％(34/40)vs 57.5％(23/40)](P=0.007).After treatment,the scores of physiological function,mental health,social function and emotional function in the observation group were significantly higher than those in the control group(all P＜0.05).Conclusion Ustekinumab combined with azathioprine can effectively promote postoperative wound healing,relieve the condition and improve the prognosis of patients with Crohn's disease undergoing anal fistula surgery.

Abstract:Objective To investigate the effect of unstable support surface core stability training(CST)on the rehabilitation of patients with thoracolumbar spinal fracture and incomplete spinal cord injury(ISCI).Methods A total of 96 patients with thoracolumbar spinal fracture with ISCI who underwent rehabilitation treat-ment in Sichuan Orthopedic Hospital from January 2019 to December 2022 were selected and divided into group A and group B by random number table method,with 48 cases in each group.Both groups received CST in sitting and recumbent positions.Group A was trained on an unstable support surface(training ball)and group B was trained on a stable support surface(training bed)for 8 weeks.The effects of improvement of American spinal injury association(ASIA)grading were evaluated before training and 10 weeks after training.Before training and 2,4,6,8 and 10 weeks after training,spinal cord independence measure(SCIM),functional independence measure(FIM)and walking index for spinal cord injury Ⅱ Scale(WISCI Ⅱ)scores were used to evaluate the recovery of spinal cord function in the two groups.The standing postural control ability and static balance ability of the two groups were evaluated,and the sagittal Cobb's angle of the injured vertebra was examined by X-ray film.Results At 10 weeks after training,the cases of grade B,C,and D in group A were 8,23 and 17,respectively,and those in group B were 11,30 and 7,respectively.The improvement of ASIA grading in group A was better than that in group B(P＜0.05).The SCIM,FIM and WISCI Ⅱ scores of group A were higher than those of group B at 4,6,8 and 10 weeks after training(all P＜0.05).The static eye opening trajectory length,static eye closing trajectory length,unit time trajectory length,dynamic stable trajectory length and dynamic time to reach the goal in group A were longer than those in group B(all P＜0.05).The Cobb's angle of group A was significantly smaller than that of group B at each time point(all P＜0.05).Conclusion The CST of unstable support surface can significantly improve the repair of spinal cord damage and walking function in patients with thoracolumbar spine fracture with ISCI.It can effectively promote the standing posture control ability of patients without the help of visual feedback.

Abstract:Objective To explore the clinical effect of acupuncture Xingshen four points combined with cognitive-motor dual task training(CMDT)in the treatment of cerebral infarction complicated with cognitive dysfunction.Methods A total of 96 patients with cerebral infarction combined with cognitive dysfunction admitted to the Second Affiliated Hospital of Hainan Medical College from August 2020 to August 2023 were selected and divided into control group and observation group by random number table method,with 48 cases in each group.On the basis of basic treatment,the control group was treated with CMDT for 4 weeks,and the observation group was treated with acupuncture Xingshen four points combined with CMDT for 4 weeks.The Montreal cognitive assess-ment(MoCA)score,Mini-mental state examination(MMSE)score,P300 amplitude and latency,national institutes of health stroke scale(NIHSS)score,neurotransmitter level and quality of life were compared between the two groups.Results After treatment,the MoCA and MMSE scores of the two groups were higher than those before treatment,and those of the observation group were higher than those of the control group(all P＜0.001).The P300 latencies of the two groups were shorter than those before treatment,and the observation group was shorter than that of the control group;the P300 amplitudes of the two groups were higher than those before treatment,and the observation group was higher than that of the control group(all P＜0.05).After treatment,the NIHSS scores of the two groups were lower than those before treatment,and the NIHSS score of the observation group was lower than that of the control group[(7.1±2.0)vs(10.3±2.6)](t=6.666,P＜0.001).The levels of serum acetylcholine and dopamine in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).After treatment,the activities of daily living scale scores of the two groups were higher than those before treatment,and the observation group was higher than the control group[(60±15)vs(53±13)](t=2.569,P=0.012).Conclusion Acupuncture Xingshen four points combined with CMDT can effectively correct neurotransmitter disorder,improve cognitive function and neurological function,and improve the quality of life in patients with cerebral infarction and cognitive impairment.

Abstract:Objective To investigate the effect of Yishen Huashi granule combined with semaglutide in the treatment of diabetic nephropathy(DN)and its effect on microinflammatory state of patients.Methods A total of 220 DN patients admitted to Peking University Third Hospital Qinhuangdao Hospital from January 2022 to December 2023 were selected as the research objects.According to the random number table method,they were divided into semaglutide group and combination group,with 110 cases in each group.The semaglutide group was treated with subcutaneous injection of semaglutide injection on the basis of conventional treatment,and the combined group was treated with Yishen Huashi granule on the basis of semaglutide group.The efficacy,glucose and lipid metabolism,renal function,oxidative stress,microinflammatory state indicators and adverse reactions were compared between the two groups.Results The total effective rate of the combination group was higher than that of the semaglutide group[93.6％(103/110)vs 83.6％(92/110)](P=0.019).After treatment,the levels of fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,total cholesterol,low-density lipoprotein cholesterol,serum creatinine,(β2-microglobulin,24 h urinary protein,malondialdehyde,high-sensitivity C-reactive protein,tumor necrosis factor-α and interleukin-6 in the two groups were lower than those before treatment,and those in the combination group were lower than those in the semaglutide group;the levels of high-density lipoprotein cholesterol,glutathione peroxidase and superoxide dismutase were higher than those before treatment,and those in combination group were higher than those in semaglutide group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.604).Conclusion Yishen Huashi granule combined with semaglutide is superior to semaglutide alone in the treatment of DN,which can effectively reduce blood glucose and lipid levels of patients,improve micro-inflammatory state,and has good safety.

Abstract:Objective To investigate the clinical effect of enhanced external counterpulsation in the treatment of angina pectoris with cardiac insufficiency and its influence on serum N-terminal pro-brain natriuretic peptide(NT-proBNP)level.Methods A total of 82 patients with angina pectoris and cardiac insufficiency who were diagnosed and treated in the People's Hospital of Jingmen,Hubei Province from April 2022 to April 2023 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 41 cases in each group.The control group was given conventional drug treatment.The observation group was treated with enhanced external counterpulsation on the basis of the control group.The grading of angina pectoris,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end diastolic diameter(LVEDD)],laboratory testing indicators[NT-proBNP,high-sensitivity C-reactive protein(hs-CRP),human galactose agglutinin 3(Galectin-3)]before and after treatment,and incidence of cardiovascular adverse events between two groups were compared.Results After treatment,the classification of angina pectoris in the observation group was better than that in the control group(Z=-6.933,P＜0.001).After treatment,LVEF of the two groups were higher than those before treatment,LVFS and LVEDD were lower than those before treatment,LVEF of the observation group was higher than that of the control group,LVFS and LVEDD were lower than those of the control group(all P＜0.05).After treatment,the NT-proBNP,hs-CRP,and Galectin-3 levels in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).The incidence of adverse cardiovascular events in the observation group was lower than that in the control group[4.9％(2/41)vs 22.0％(9/41)](P=0.023).Conclusion The effect of enhanced external counterpulsation in the treatment of patients with angina pectoris and cardiac insufficiency is significant,which can effectively improve the symptoms of angina pectoris and cardiac function,and reduce the levels of NT-proBNP and inflammatory factors.

Abstract:Objective To investigate the diagnostic and prognostic evaluation value of lung ultrasound combined with interleukin-23(IL-23)and interleukin-17 in neonatal infectious pneumonia.Methods A total of 124 neonates with infectious pneumonia admitted to Shijiazhuang People's Hospital,Hebei Province from June 2020 to August 2023 were selected as the pneumonia group.According to the neonatal critical illness score,they were divided into non-critical group(＞90,72 cases)and critical group(≤90,52 cases).Another 124 neonates hospitalized for jaundice without pulmonary complications during the same period were selected as the control group.According to the ultrasound examination and symptoms after 7 d of treatment,the neonates with infectious pneumonia were divided into good prognosis group and poor prognosis group.All children underwent lung ultrasound examination after admission to evaluate the lung ultrasound score,and the serum levels of IL-23 and IL-17 were measured by enzyme-linked immunosorbent assay.The lung ultrasound scores and serum levels of IL-23 and IL-17 in each group were compared.The receiver operating characteristic(ROC)curve was used to analyze the value of the above indexes in the diagnostic and prognostic evaluation of neonatal infectious pneumonia.Results The lung ultrasound score and serum levels of IL-23 and IL-17 in the pneumonia group were higher than those in the control group(all P＜0.05).The lung ultrasound score and serum levels of IL-23 and IL-17 in the critical group were significantly higher than those in the non-critical group(all P＜0.05).The lung ultrasound score and serum levels of IL-23 and IL-17 in the good prognosis group were significantly lower than those in the poor prognosis group(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of lung ultrasound score combined with IL-23 and IL-17 in the diagnosis of neonatal infectious pneumonia was 0.901,which was significantly larger than that of each index alone(Z=4.209,3.492,3.748,all P＜0.05).The AUC of the combination of the three indicators in evaluating the prognosis of neonatal infectious pneumonia was 0.954,which was significantly larger than that of each indicator alone(Z=2.472,2.048,2.839,all P＜0.05).Conclusion The lung ultrasound scores and serum levels of IL-23 and IL-17 were significantly increased in the neonates with infectious pneumonia,and the levels of them were closely related to the severity and prognosis of the disease.The combination of the three methods has better efficacy in the diagnosis and prognosis evaluation of neonatal infectious pneumonia.

Abstract:Objective To investigate the short-term efficacy of atorvastatin on patients with ischemic heart failure and its effect on the expression of ferroptosis signaling pathway related proteins.Methods A total of 124 patients with ischemic heart failure diagnosed in the First Affiliated Hospital of Hainan Medical University from January 2021 to October 2022 were selected.The patients were randomly divided into control group and observation group,with 62 cases in each group.The control group was treated with conventional drugs and interventional therapy,and the observation group was treated with atorvastatin on the basis of the control group.The incidence of major adverse cardiac events(MACE),heart failure indicators,oxidative stress indicators,blood lipid indicators and ferroptosis pathway proteins were compared between the two groups.Results The total incidence of MACE in the observation group was lower than that in the control group[6.5％(4/62)vs 19.4％(12/62)](x2=4.593,P=0.032).After 1 month of treatment,the left ventricular ejection fraction of the control group was higher than that before treatment,and the brain natriuretic peptide was lower than that before treatment;the left ventricular ejection fraction and superoxide dismutase in the observation group were higher than those before treatment,and the brain natriuretic peptide and malondialdehyde were lower than those before treatment;the superoxide dismutase in the observation group was higher than that in the control group,and the malondialdehyde was lower than that in the control group(all P＜0.05).After 1 month of treatment,the levels of total cholesterol,low-density lipoprotein cholesterol and lipoprotein a 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 1 month of treatment,the levels of nicotinamide adenine dinucleotide phosphate(NADPH)and glutathione,and the protein expression of glutathione peroxidase 4,quinone oxido-reductase 1 and solute carrier family 7 member 11 in the observation group were higher than those before treatment,and those in the observation group were higher than those in the control group;the levels of non-heme iron and the protein expression of NADPH oxidase 2 were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).Conclusion Routine use of atorvastatin in the treatment of ischemic heart failure can improve the short-term efficacy,which may be related to lowering blood lipids,anti-oxidative stress and inhibiting the active expression of ferroptosis signaling pathway.

Abstract:Objective To clarify the correlation between premature delivery and preterm premature rupture of membranes(PPROM)and reproductive tract infection(RTI)during pregnancy.Methods A total of 416 pregnant women with preterm or PPROM who received regular prenatal examination and delivered in Tongzhou Maternal &Child Health Hospital of Beijing from January 2021 to December 2022 were selected as the research objects.According to whether there was clear evidence of RTI pathogen during delivery(admission during delivery),the patients were divided into observation group(171 cases,with evidence)and control group(245 cases,without evidence).The relevant data of pregnant women were analyzed,and the incidence of vaginitis,PPROM,gestational age,delivery method,incidence of fetal intrauterine distress,pregnancy outcomes of pregnant women of different ages,and birth weight of newborns at the same gestational age were compared between two groups.Results Among 171 pregnant women in the observation group,the top 3 pathogens in routine vaginal secretions examination were 14 cases(8.2％)of Mycoplasma urealyticum infection,13 cases(7.6％)of bacterial vaginosis,and 10 cases(5.8％)of fungal vaginitis.The common pathogens of RTI cultured in bacteriology were Streptococcus agalactiae in 9 cases(5.3％),Candida albicans in 8 cases(4.7％),and Escherichia coli in 6 cases(3.5％).The proportion of vaginal inflammation in the observation group during early pregnancy was higher than that in the control group[18.7％(32/171)vs 11.4％(28/245)](P=0.042).There were statistically significant differences between the observation group and the control group in terms of PPROM incidence,gestational age,delivery method,and incidence of fetal intrauterine distress(all P＜0.05).There was no statistically significant difference in incidence of PPROM,RTI and fetal distress among pregnant women of different age groups(all P＞0.05).There was no statistically significant difference in the birth weight of newborns born at the same gestational age between the observation group and the control group(all P＞0.05).Conclusions Mycoplasma urealyticum,Streptococcus agalactis and Candida albicans are the main pathogenic bacteria of reproductive tract infection.Gestational RTI may increase the risk of premature delivery and PPROM,and gestational RTI may increase the adverse outcome of mother and child during pregnancy.

Abstract:Myasthenia gravis(MG)is an autoimmune-related neuromuscular disease characterized by muscle weakness and rapid fatigue.There are various treatment strategies for MG,including symptomatic treatment,immunomodulatory therapy,biological drug therapy,and the emerging neonatal Fc receptor antagonist intervention.The goal of treatment is to control symptoms and signs and achieve clinical remission or a minimally symptomatic state.This article reviews the various approaches to the current treatment of MG,including traditional immunosuppressive therapies such as steroids,antimetabolites,and calcineurin inhibitors,as well as biologic drugs that target specific targets,such as rituximab for B cells and eculizumab for the complement system.Although a variety of treatment modalities have been shown to be effective,there are still challenges in the treatment of MG,including the diversity of treatment evaluation methods,the uncertainty of long-term treatment outcomes,and the definition of the applicability of emerging drugs.At present,neonatal Fc receptor antagonists,as an emerging treatment method,have shown good clinical efficacy in the short term,but their long-term efficacy and safety still need to be further studied.In addition,the importance of individualized treatment strategies is becoming increasingly prominent when dealing with MG subtypes with specific autoantibodies.Emerging treatment methods are based on biological drugs and research on new targets of immune pathways in order to better meet the treatment needs of different patients.

Abstract:Valvular heart disease in China is usually caused by rheumatic heart disease.However,with increasingly improved public health conditions,the prevalence of rheumatic diseases has decreased substantially,and valvular diseases are now mostly caused by degenerative lesions,such as degenerative aortic stenosis.Although open surgical valve replacement via sternotomy provides a good clinical prognosis,this treatment method still carries a high surgical risk.Transcatheter aortic valve replacement(TAVR)is a minimally invasive method for the treatment of severe aortic stenosis.Because of its many advantages,it has become the first choice for patients with middle-to high-risk valve disease.At present,this new technology has attracted great attention in the cardiovascular field,leading to a new revolution in minimally invasive percutaneous cardiac intervention.This article reviews the technical introduction,clinical application and long-term effects of TAVR.