Abstract:Objective To explore the hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor after transradial percutaneous coronary intervention(TRI).Methods From April 2021 to July 2022,295 patients who underwent coronary angiography or interventional therapy for coronary atherosclerotic heart disease in the fourth district of the Department of Cardiovascular Medicine,Jiangxi Provincial People's Hospital were selected.The patients were randomly divided into spiral radial artery compressor group(group A,99 cases),chitosan hemostatic sponge group(group B,98 cases),and chitosan hemostatic sponge combined with spiral radial artery compressor group(group C,98 cases).The three groups were treated with corresponding methods to stop bleeding.The postoperative radial artery complications and patient comfort were observed and recorded in the three groups.Results The incidence rates of postoperative bleeding in group A,group B,and group C were 13.1％(13/99),5.1％(5/98),and 3.1％(3/98),respectively,and there were significant differences in the incidence of postoperative bleeding,ecchymosis and acral swelling among the three groups(all P＜0.05).Group A was higher than group C in pairwise comparison(P＜0.05).The incidence of postoperative radial hematoma in group A was higher than that in group C(P=0.008).No severe limb swelling and other serious complications occurred in all patients.The comfort level of patients in group C was better than that in group A(P=0.004).Conclusion The overall hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor is better than that of spiral radial artery compressor and chitosan hemostatic sponge alone after TRI.It can reduce the incidence of postoperative vascular complications and improve the comfort of patients.It is a simple operation,high comfort,less complications,safe and reliable method of dressing hemostasis.

Abstract:Objective To observe the clinical effect of in-line mechanical insufflation-exsufflation(IL-MIE)technology in airway secretion management of patients with invasive mechanical ventilation after cardiac surgery.Methods A total of 65 patients with invasive mechanical ventilation after cardiac surgery with cardiopulmonary bypass in the Cardiac Surgical Intensive Care Unit,Beijing Anzhen Hospital,Capital Medical University from July 2015 to July 2020 were retrospectively selected.Among them,33 patients treated with conventional catheter suction(CS)were selected as the control group,and 32 patients treated with automated IL-MIE equipment on the basis of conventional CS treatment were selected as the observation group.The general data,respiratory and circulatory related indicators during treatment,clinical and prognostic related indicators of the two groups were compared.Results There were no significant differences in general data between the two groups(all P＞0.05).At 0 h after treatment,the heart rate of the observation group was lower than that of the control group;at 4 and 8 h after treatment,the arterial partial pressure of oxygen,oxygenation index and static compliance in the observation group were higher than those in the control group,and the airway plateau pressure and heart rate were lower than those in the control group(all P＜0.05).The number of CS treatment and the duration of mechanical ventilation in the observation group were less/shorter than those in the control group[0(0,0)time vs 3(1,4)times,20(17,22)h vs 24(19,26)h,Z=-7.081,-2.067,both P＜0.05].Conclusion IL-MIE can improve oxygenation index and airway compliance,reduce the duration of mechanical ventilation and maintain hemodynamic stability during airway management in patients after cardiac surgery by simulating physiological airway clearance.

Abstract:Objective To evaluate the effect of improved modified buried vertical mattress sutures(MBVMS)technique in the healing and scar formation of chin trauma.Methods A total of 90 patients with chin trauma in Emergency Department of Plastic Surgery,Beijing Anzhen Hospital,Capital Medical University from February 2017 to June 2023 were selected.According to the random number table method,they were divided into the observation group(n=45)and the control group(n=45).After cleaning the wounds,the patients in the observation group were closed with improved MBVMS,and the patients in the control group were closed with conventional cosmetic suture.The patients in the two groups were all treated with silicone gel scab-removing ointment for about 3 months after removing the stitches.The wound healing of patients in the two groups was observed after 7 d of suture removal.The Vancouver Scar Scale(VSS),Visual Analogue Scale(VAS),Observer Scar Assessment Scale(OSAS),and Patient Scar Assessment Scale(PSAS)were used to evaluate the scar formation of patients in the two groups at 3 and 6 months after operation.Results Stitches were removed 7 d after operation.In the observation group,44 cases(97.8％)had grade A wound healing and 1 case(2.2％)had grade B wound healing.The wounds of the control group were all grade A healing.There was no statistically significant difference in the proportion of grade A healing between the observation group and the control group[97.8％(44/45)vs 100.0％(45/45)](P＞0.05).At 3 and 6 months after operation,the VSS,VAS,OSAS and PSAS scores of the observation group were lower than those of the control group(all P＜0.05).Conclusion The application of improved MBVMS technology in patients with chin trauma can not only ensure the safe wound healing,but also effectively improve the character of scar after wound healing,reduce postoperative scar hyperplasia,and achieve good cosmetic results.

Abstract:Cardiogenic shock is a clinical syndrome caused by impaired heart pumping function leading to systemic hypoperfusion and tissue hypoxia,which is an important cause of death in patients with heart disease.Intra-aortic balloon pump and veno-arterial extracorporeal membrane oxygenation are the two main mechanical circulatory support devices used in the treatment of cardiogenic shock,which have become the"bridge"therapy to help patients through the risk period of cardiac decompensation.However,the optimal application time and clinical effect are still controversial.This article reviews the recent research on intra-aortic balloon counterpulsation and venous-artery extracorporeal membrane oxygenation in the treatment of cardiogenic shock.

Abstract:Cerebral small vessel disease(CSVD)has gradually become an important disease that threatens people's health and quality of life,mainly causing cognitive impairment,movement disorders,emotional disorders,urinary and fecal incontinence and other symptoms,with high disability and mortality.It has a high incidence in the elderly population and is related to the occurrence and recurrence of stroke,cognitive dysfunction and psycho-logical disorders.Although the physiological and pathological process of CSVD is still unclear,some studies have confirmed that inflammatory response plays a crucial role in the pathogenesis of CSVD.Therefore,by exploring the physiology and pathology of CSVD,we hope to find appropriate serum inflammatory biomarkers and potential therapeutic targets,so as to provide early warning for the progression and prognosis of CSVD.Therefore,this article reviews the research progress and potential therapeutic targets of serum inflammatory biomarkers in CSVD.

Abstract:Objective To evaluate the effects of cardiac rehabilitation training on cardiac function recovery and prognosis of patients with acute myocardial infarction after percutaneous coronary intervention(PCI)in cold areas of China.Methods A total of 1 914 patients diagnosed with acute ST-segment elevation myocardial infarction in the Department of Cardiology,Hegang People's Hospital,Heilongjiang Province from January 2016 to December 2023 were retrospectively enrolled in this study.All enrolled patients underwent primary coronary angiography and PCI.Patients were divided into rehabilitation training group(833 cases)and conventional treatment group(1 081 cases)according to whether they received cardiac rehabilitation training.The clinical data and in-hospital complications of the two groups were compared,and the results of cardiopulmonary exercise test after discharge of the rehabilitation training group were analyzed.The incidence of major adverse cardiovascular events(MACE)in 1 year of follow-up was compared between the two groups.Results The incidences of atrial and ventricular arrhythmia in the rehabili-tation training group was lower than those in the conventional treatment group(both P＜0.05).In the rehabilitation training group,patients were followed up at 1,3,6,and 12 months after discharge and underwent cardiopulmonary exercise testing.The results showed that the patients'power,heart rate,carbon dioxide output,oxygen intake,lung ventilation per minute,dead space ventilation ratio,end-tidal carbon dioxide partial pressure,carbohydrate metabolism percentage,cardiac output and stroke volume were significantly improvement compared to before(all P＜0.05).At 1-year follow-up,the incidence of MACE in the rehabilitation training group was significantly lower than that in the conventional treatment group[25.2％(210/833)vs 39.3％(425/1 081)](P＜0.001).Conclusion Cardiac rehabilitation training can effectively improve the recovery of cardiac function and prognosis of patients with acute myocardial infarction after PCI in cold areas of China.

Abstract:Objective To investigate the effect of the construction of standardized chest pain center on the treatment efficiency of emergency percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS)in Hotan area.Methods A total of 445 patients diagnosed with ACS in People's Hospital of Hotan Prefecture in Xinjiang Uygur Autonomous Region from January 2021 to April 2022 were retrospectively analyzed.All patients underwent emergency PCI.Among them,225 ACS patients who underwent emergency green channel mode(from January to August 2021)before standardized chest pain center certification were included in the control group.A total of 220 ACS patients who were admitted to the hospital after the certification of standardized chest pain center(from September 2021 to April 2022)were included in the observation group.The general information,the incidence of in-hospital major adverse cardiovascular events(MACE),the reperfusion treatment efficiency index of patients diagnosed with ST-segment elevation myocardial infarction(STEMI),the length of hospital stay,and hospitalization expenses were compared between the two groups.Results There was statistically significant difference in the proportion of patients with diabetes history between the two groups(P＜0.05).There was statis-tically significant difference in the incidence of in-hospital cardiogenic shock between the two groups(P＜0.05).The total incidence of in-hospital MACE in the observation group was significantly lower than that in the control group[10.9％(24/220)vs 17.8％(40/225)](P=0.039).The time from onset to first medical contact,the time from first medical contact to balloon dilatation,the ischemic time from door to balloon dilatation,and the activation time of catheterization laboratory in STEMI patients after the certification of standardized chest pain center were lower than those in STEMI patients under emergency green channel mode(all P＜0.05).The average hospitalization time and average hospitalization cost of the observation group were lower than those of the control group[(7.7±2.1)d vs(8.3±2.6)d,(28 353±9 071)yuan vs(30 163±10 203)yuan](both P＜0.05).Conclusion The construction of standardized chest pain center can effectively improve the efficiency of in-hospital treatment of ACS patients,reduce the time of myocardial ischemia,reduce the incidence of MACE,shorten the length of hospital stay,and save medical costs.

Abstract:Objective To investigate the prognostic value of heparin-binding protein,neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in patients with community-acquired pneumonia(CAP).Methods A total of 115 CAP patients admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University from November 2022 to November 2023 were selected as observa-tion objects.The patients were followed up for 28 days after discharge.According to the survival situation,the patients were divided into good prognosis group(94 cases)and poor prognosis group(21 cases).The general data and laboratory indexes of the two groups were collected and compared.Logistic regression was used to analyze the risk factors of poor prognosis in CAP patients.The receiver operating characteristic curve was used to analyze the value of heparin-binding protein,NLR,PLR alone and the combination of other indicators in evaluating the poor prognosis of CAP patients.Results There were no significant differences in gender,age,body mass index,smoking history,drinking history,diabetes mellitus history,diastolic blood pressure,systolic blood pressure,urea nitrogen,creatinine,alanine aminotransferase,aspartate aminotransferase between the two groups(all P＞0.05).The clinical pulmonary infection score,interleukin-6,C-reactive protein,procalcitonin,white blood cell count,heparin-binding protein,NLR and PLR in the poor prognosis group were higher than those in the good prognosis group(all P＜0.05).Multivariate Logistic regression analysis showed that clinical pulmonary infection score,interleukin-6,C-reactive protein,procalcitonin,white blood cell count,heparin-binding protein,NLR and PLR were all risk factors for poor prognosis of CAP patients(all P＜0.05).The results of receiver operating characteristic curve analysis showed that the area under the curve of heparin-binding protein,NLR,and PLR for evaluating the poor prognosis of CAP patients was 0.884,0.880,and 0.895,respectively,and the sensitivity was 0.714,0.762,and 0.810,respectively.The area under the curve of the three factors combined to evaluate the poor prognosis of CAP patients was 0.974,and the sensitivity was 0.905.Conclusion There are many and complex risk factors for poor prognosis of CAP patients.Heparin-binding protein,NLR and PLR have high value in the prognosis evaluation of CAP patients.

Abstract:Objective To investigate the effects of Xuezhikang capsule combined with alirocumab on the degree of atherosclerosis and blood lipid levels in patients with atherosclerotic cardiovascular disease(ASCVD)intolerant to statins.Methods Eighty ASCVD patients with statin intolerance admitted to the Second Affiliated Hospital of Hebei University of Chinese Medicine from June 2022 to August 2024 were enrolled.According to random number table method,they were divided into observation group(41 cases)and control group(39 cases).The control group was treated with alirocumab.The observation group was treated with Xuezhikang capsule on the basis of the control group.Both groups were treated for 12 weeks.The degree of arteriosclerosis,blood lipid indexes,the standard-reaching rate of low-density lipoprotein cholesterol(LDL-C),the standard-reaching rate of LDL-C reduction＞50％,the incidence of adverse reactions and the total effective rate were compared between the two groups after treatment.Results After 4,8 and 12 weeks of treatment,the levels of LDL-C,triglyceride,total cholesterol,creatine kinase,glutamate,creatine kinase isoenzyme,cardio-ankle vascular index and brachial-ankle pulse wave velocity in the observation group were significantly lower than those in the control group;high density lipoprotein cholesterol,lipoprotein a,total bilirubin,aspartate aminotransferase,alanine aminotransferase,and ankle brachial index were higher than those in the control group(all P＜0.05).The compliance rate of LDL-C,the compliance rate of LDL-C reduction＞50％and the total effective rate in the observation group were higher than those in the control group[78.0％(32/41)vs 35.9％(14/39),95.1％(39/41)vs 41.0％(16/39),97.6％(40/41)vs 79.5％(31/39)](all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.107).Conclusion Xuezhikang capsule combined with alirocumab in the treatment of ASCVD patients with statin intolerance can significantly improve the degree of atherosclerosis and the rate of LDL-C reaching the standard,with significant clinical efficacy and high safety.

Abstract:Objective To investigate the predictive value of preoperative circulating tumor DNA(ctDNA),red blood cell volume distribution width to platelet ratio(RPR)and neutrophil to lymphocyte ratio(NLR)in 3-year survival of patients with colorectal cancer after radical resection.Methods A total of 114 patients who underwent radical resection of colorectal cancer in Lanzhou Petrochemical General Hospital from March 2020 to March 2021 were selected as the colorectal cancer group.A total of 114 healthy volunteers were selected as the control group.The levels of ctDNA,RPR and NLR in peripheral blood were detected and calculated.All patients with colorectal cancer were followed up for 3 years after radical resection,and were divided into death group and survival group according to survival situation.The Kaplan-Meier method was used to analyze the relationship between the levels of ctDNA,RPR and NLR in peripheral blood and the 3-year survival of patients with colorectal cancer after radical resection.The receiver operating characteristic curve was used to analyze the predictive value of the combined detection of ctDNA,RPR and NLR in peripheral blood for the 3-year survival of patients with colorectal cancer after radical resection.Results The levels of ctDNA,RPR,and NLR in peripheral blood of patients with colorectal cancer were significantly higher than those in the control group(all P＜0.001).The levels of ctDNA,RPR and NLR in peripheral blood are related to TNM stage,differentiation degree,lymph node metastasis and carcinoembryonic antigen level(all P＜0.05).In this study,40 patients died(death group)and 74 patients survived(survival group).The levels of ctDNA,RPR and NLR in peripheral blood of patients in the death group were significantly higher than those in the survival group[(98±12)μg/L vs(79±12)μg/L,(0.19±0.05)vs(0.14±0.04),(2.8±0.4)vs(2.1±0.5)](t=8.221,5.825,7.384,all P＜0.001).The 3-year survival rates of patients in the high level group of ctDNA,RPR and NLR were lower than those in the low level group(all P＜0.05).The area under the receiver operating characteristic curve of the combined detection of ctDNA,RPR and NLR in predicting the 3-year survival of patients with colorectal cancer after radical resection was significantly larger than that of ctDNA,RPR and NLR alone(all P＜0.05).Conclusion The combination of ctDNA,RPR and NLR can be used as a predictor of survival in patients with colorectal cancer after radical resection.

Abstract:Objective To explore the influencing factors of quality of life of patients with gastrointestinal cancer in community and analyze the influence of patients'self-infusion on quality of life.Methods From January 2021 to January 2022,convenience sampling was used to select patients with gastrointestinal malignant tumors recorded in 5 community health service centers in Shijiazhuang,Hebei Province and diagnosed with esophageal cancer,gastric cancer and colorectal cancer in the Chinese Cancer Registry Information System as the research objects.The European organization for research and treatment of cancer quality of life questionnaire(EORTC QLQ-C30),self-infusion attention scale(SFAS)and self-designed general information questionnaire were used to investigate their quality of life and self-commitment.Results A total of 190 patients with gastrointestinal cancer were investigated in this study,and 185 valid questionnaires were collected,with an effective recovery rate of 97.4％.The survey of quality of life measurement scale showed that the total health status score of patients with gastrointestinal cancer in the community was(50.7±18.3),the highest score of cognitive function was(87.1±13.4),the lowest score of social function was(69.8±23.8),and the highest score of fatigue was 33.3(33.3,55.6).The SFAS survey showed that the total score of self-infusion of patients with gastrointestinal cancer in the community was(59.2±10.2).Spearman correlation analysis showed that the score of self-infusion was negatively correlated with the total health status score and the scores of physical,role,cognitive,emotional and social function in the functional domain,and positively correlated with the scores of fatigue,nausea and vomiting in the symptom domain and the scores of appetite loss and economic difficulty in the single item(all P＜0.05).The results of multiple linear regression analysis showed that marital status,education level,main caregiver,family monthly income and self-infusion were the influencing factors of the total health status of patients with digestive tract malignant tumors in the community(all P＜0.05).The receiver operating characteristic curve showed that the area under the curve of self-infusion score predicting the total health status score of patients was 0.716(95％confidence interval:0.642-0.789),the sensitivity was 61.9％,and the specificity was 73.6％.Conclusions The quality of life of patients with gastrointestinal cancer in the community is affected by many factors such as marital status,education level,main caregivers and so on.The self-infusion status is closely related to the quality of life of patients with gastroin-testinal cancer in the community,and has a certain predictive effect on the quality of life.

Abstract:Objective To observe the clinical effect of teneplase in the adjuvant treatment of acute lower extremity deep vein thrombosis(DVT)with catheter-directed thrombolysis(CDT).Methods A retrospective analysis was conducted on the clinical data of 104 patients with acute lower extremity DVT admitted to the Department of Vascular Surgery,Xuzhou Central Hospital from January 2022 to June 2023.Patients were classified into the combination group(50 cases)and the urokinase group(54 cases)based on different therapies.Postoperative venous patency score,venous patency rate,limb swelling reduction rate,thrombus clearance grade,urokinase dosage,thrombolysis time,hospital stay,and complications in two groups of patients were compared.Results The postoperative venous patency score of the combined group was lower than that of the urokinase group,and the postoperative venous patency rate and limb swelling reduction rate were both higher than those of the urokinase group[(1.6±1.0)vs(2.3±1.1),(79±13)％vs(68±15)％,(73±12)％vs(66±8)％],with statisti-cally significant differences(all P＜0.05).There was no statistically significant difference in thrombus clearance grading between the two groups(P＞0.05).The dosage of urokinase,thrombolysis time,and hospital stay of patients in the combination group were less/shorter than those in the urokinase group,and the differences were statistically significant(all P＜0.05).There was no statistically significant difference in the incidence of postoper-ative in two groups(P＞0.05).Conclusions Compared with the use of urokinase alone,the use of teneplase assisted urokinase for CDT treatment of acute lower extremity DVT can reduce the amount of urokinase dosage,and shorten thrombolysis time and hospital stay.The recent thrombolysis effect is certain and the operation is simple.

Abstract:Objective To investigate the relationship between the dynamic changes of vitamin D levels in early and midterm pregnancy and gestational diabetes mellitus(GDM).Methods A total of 650 pregnant who regular prenatal examination and delivery at Hefei First People's Hospital from January 2019 to December 2020 was selected for analysis.Serum 25-hydroxy vitamin D levels were measured during early and midterm pregnancy,pregnant women were divided into GDM group(67 cases)and non GDM group(583 cases)based on whether GDM was merged or not.The potential relationship between 25-hydroxy vitamin D level and GDM was explored.Results There were significant differences in age,pre-pregnancy body mass index,the level of 25-hydroxy vitamin D in early pregnancy and the average value of 25-hydroxy vitamin D in early and midterm pregnancy between the two groups(all P＜0.05).The results of binary Logistic regression analysis showed that the risk of GDM in the group with the highest level of 25-hydroxy vitamin D(group Q4)was 0.33 times(odds ratio=0.33,95％confidence interval:0.14-0.74,P＜0.05)to the group with the lowest level of 25-hydroxy vitamin D(group Q]).After adjusting the confounding factors such as age,pre-pregnancy body mass index,number of pregnancies and parturition,the correlation was still significant(P＜0.05).The results of restriction cubic spline showed that 25-hydroxy vitamin D in early pregnancy was negatively correlated with the risk of GDM(P=0.035).Conclusion The level of vitamin D in early pregnancy tends to increase with the increase of gestational weeks,and the adequate level of vitamin D in early pregnancy is related to the decreased risk of GDM.

Abstract:Atopic dermatitis(AD)is often associated with atopic comorbidities.With the increasing number of AD and atopic comorbidities,AD has become a major public health problem.Most studies believe that AD and its comorbidities occur in a chronological sequence,from AD and food allergy,to allergic rhinitis,and finally to asthma.This phenomenon is often referred to as atopic progression.At present,the mechanism of this atopic progression is not fully understood.This article reviews the research progress on the epidemiology of AD,its association with atopic comorbidity,risk factors,possible mechanisms of atopic comorbidity and its progression,as well as its prevention and treatment measures.

Abstract:Objective To observe the effect of Lichong Shengsui decoction(LCSSY)on autophagy in ovarian cancer by regulating adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)/uncoordinated 51 like kinase-1(ULK1)signaling pathway.Methods Ovarian cancer SKOV3 cells were cultured in vitro and serum containing LCSSY was prepared.SD rats were divided into blank control group and LCSSY low,medium and high dose groups by random number table method.Cell count kit-8 method was used to detect the proliferation inhibition rate of ovarian cancer SKOV3 cells.Western blotting was used to detect the expression of autophagy related proteins recombinant human autophagy effector protein(Beclin-1),ratio of human microtubule associated protein light chain 3 Ⅱ to mouse microtubule associated protein light chain 3 Ⅰ(LC3Ⅱ/Ⅰ),autophagy junction protein(P62),as well as AMPK/mTOR/ULK1 pathway related proteins.AMPK activator was used to verify its mechanism of action.Results At 24 and 48 h after administration,the inhibition rates of SKOV3 cell proliferation in the low,medium and high dose LCSSY groups were higher than those in the blank control group,and the inhibition degree was gradually strengthened with the increase of drug concentration(all P＜0.05).In addition,the inhibition rates of low dose LCSSY group and medium dose LCSSY group at 48 h were higher than those at 24 h(both P＜0.05).Compared with the blank control group,the expression of Beclin-1 and LC3 Ⅱ/Ⅰ was down-regulated in the low,medium,and high dose LCSSY groups in a dose-dependent manner[(0.98±0.02),(0.59±0.02),(0.55±0.02)vs(1.46±0.12);(4.45±0.21),(4.00±0.25),(2.95±0.21)vs(5.98±0.23);(0.67±0.02),(0.94±0.05),(1.53±0.13)vs(0.30±0.02)](all P＜0.05).Compared with the blank control group,the expression of AMPK and ULK1 was decreased,and the expression of mTOR complex 1 was increased in low,medium and high dose LCSSY groups in a dose-dependent manner(all P＜0.05).AMPK activator reversed the AMPK/mTOR/ULK1 signaling pathway,and compared with the high dose LCSSY group,the high dose of LCSSY combined with AMPK activator increased the protein expressions of AMPK and ULK1,while the protein expression of mTOR complex 1 decreased(all P＜0.05).Conclusion LCSSY may inhibit autophagy in ovarian cancer cells by regulating AMPK/mTOR/ULK1 signaling pathway.

Abstract:Objective To evaluate the efficacy and safety of internal floss assisted traction endoscopic submucosal dissection(ESD)for rectal neuroendocrine neoplasms(NEN).Methods The data of 34 patients with rectal NEN who underwent colonoscopy and received treatment at the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from January 2017 to June 2023 were retrospectively analyzed.According to the method of endoscopic surgery,the patients were divided into the dental floss traction ESD treatment group(10 cases)and the traditional ESD treatment group(24 cases).The operation time,surgical complications,postoperative histopathology,hospitalization time and hospitalization cost were compared between the two groups.Results The lesion was located 3-10 cm away from the anus,with a tumor diameter of 3-12 mm.Both lesions were single lesions,and there was no significant difference in the maximum diameter of tumors and the complete resection rate between the two groups(both P＞0.05).The operation time of the dental floss traction ESD treatment group was shorter than that of the traditional ESD treatment group[23.5(16.8,25.3)min vs 30.0(22.8,36.0)min](P=0.012).There were 2 cases(8.3％)of postoperative complications in the traditional ESD treatment group.There was no involvement of muscularis propria and lymphatic vessels in all patients.No postoperative pathology showed that the tumor was close to the cauterization margin in the dental floss traction ESD treatment group,while the postoperative pathology showed that the tumor was close to the burning margin in 5 cases(20.8％)in the traditional ESD treatment group.The hospitalization time of the dental floss traction ESD treatment group was shorter than that of the traditional ESD treatment group[6(5,7)d vs 8(7,11)d](P=0.002).There was no significant difference in hospitalization cost between the two groups(P=0.326).Conclusion Floss assisted ESD in the treatment of rectal NEN is a convenient surgical method,which is conducive to exposing the surgical field,improving the complete resection rate and reducing complications.

Abstract:Asthma is one of the common chronic non-communicable diseases in the world today,which is characterized by variable gas obstruction,causing dyspnea and wheezing.Eosinophilic airway inflammation is often considered to be the most influential diagnosable feature of chronic airway disease.Over the past decade,multiple monoclonal antibodies have been developed targeting this characteristic.Mainly including anti interleukin-5(IL-5)or IL-5 receptors α(mepolizumab,razumab,and benazizumab),IL-13(lebrikizumab and tralokinumab),IL-4 receptor α(monoclonal antibodies against dupilumab),immunoglobulin E(omalizumab),and thymic stromal resistance lymphatic hormone(tezepelumab)of monoclonal antibodies.This article reviews the pathogenesis of asthma and the progress of new anti-eosinophil drugs in the treatment of asthma.

Abstract:Objective To evaluate the efficacy of aspirin and new oral anticoagulants(NOACs)in the prevention of venous thromboembolism(VTE)and bleeding events after hip and knee arthroplasty in the elderly,and to analyze the related risk factors.Methods This study was a retrospective cohort study.A total of 1 032 elderly patients who underwent hip and knee arthroplasty in the First Affiliated Hospital of Guangxi University of Science and Technology from January 2018 to December 2022 were consecutively enrolled.According to the anticoagulant therapy regimen,the patients were divided into aspirin group(674 cases)and NOACs group(358 cases).The baseline data were matched 1∶1 by propensity score matching(PSM)method.Finally,a total of 652 patients were enrolled and divided into aspirin group(326 cases)and NOACs group(326 cases).The main outcome measures were VTE events and bleeding events within 90 d after surgery.Cox proportional hazards regression model was used to analyze the risk factors.Results There were no significant differences in baseline data and incidence of VTE events between the two groups before and after PSM matching(all P＞0.05).Before and after PSM matching,the incidence of bleeding events in the NOACs group was lower than that in the aspirin group[6.1％(22/358)vs 8.0％(54/674),4.9％(16/326)vs 8.3％(27/326)](all P＜0.05).Cox regression model analysis showed that male,knee replacement,chronic kidney disease,previous history of VTE,and anticar-diolipin antibodies or lupus anticoagulant were significant risk factors for VTE events(all P＜0.05).Age,cancer,chronic kidney disease,and length of hospital stay were all significant risk factors for bleeding events(all P＜0.05).Conclusions Aspirin and NOACs have similar efficacy in preventing VTE after hip and knee arthro-plasty in the elderly,and aspirin therapy has a higher risk of bleeding.Male sex,knee replacement,chronic kidney disease,previous history of VTE,and anticardiolipin antibodies or lupus anticoagulant are the main risk factors for VTE,while age,cancer,chronic kidney disease,and length of hospital stay are the main risk factors for bleeding events.

Abstract:Objective To analyze the effect of lower limb robot in the treatment of lower limb movement disorders after stroke and its influence on walking and balance ability of patients.Methods A total of 110 patients with lower limb movement disorders after stroke who were hospitalized in the Second Affiliated Hospital of Air Force Military Medical University from January 2022 to November 2023 were selected.According to the random number table method,they were divided into the routine group and the observation group,with 55 cases in each group.The routine group was given routine rehabilitation training,and the observation group was given lower limb robot therapy on the basis of the routine group.The clinical efficacy,6-min walk test(6MWT)distance and Berg balance scale(BBS),simplified Fugl Meyer motor function scale(FMA),stroke specific quality of life scale(SS-QOL)scores,lower limb modified Ashworth scale(MAS)grading,levels of serum neuropeptide Y(NPY),brain-derived neurotrophic factor(BDNF),and nerve growth factor(NGF)were compared between the two groups.Results The total effective rate of the observation group was higher than that of the routine group[94.5％(52/55)vs 74.5％(41/55)](P=0.004).After treatment,the 6MWT distance,BBS,FMA and SS-QOL scores of the observation group were longer/higher than those of the routine group,the MAS grade was better than that of the routine group,the serum NPY level was lower than that of the routine group,and the serum BDNF and NGF levels were higher than those of the routine group(all P＜0.05).Conclusion Lower limb robot can effectively improve the walking ability,balance ability and motor ability of patients with lower limb movement disorders after stroke,down-regulate the expression of serum NPY,up-regulate the expression of serum BDNF and NGF,and improve the quality of life,with significant effects.

Abstract:Objective To observe the clinical effect of Corbrin capsule combined with alisartan isoproxil tablets in the treatment of diabetic nephropathy.Methods A total of 90 patients with diabetic nephropathy who were hospitalized in Shaanxi Provincial People's Hospital from October 2021 to October 2023 were selected as the research objects.All patients were divided into control group and observation group according to the random number table method,with 45 cases in each group.The control group was given alisartan isoproxil tablets orally in addition to conventional treatment,while the observation group was given Corbrin capsule in addition to the control group's treatment.Both groups were treated for 3 months.The total effective rate,the levels of blood glucose,renal func-tion and inflammatory factors before and after treatment,and the incidence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.6％(43/45)vs 80.0％(36/45)](P=0.024).After treatment,glycosylated hemo-globin,fasting blood glucose,2 h postprandial blood glucose,serum creatinine,blood urea nitrogen,24 h urinary protein,interleukin-1[3,high-sensitivity C-reactive protein and interleukin-6 in the two 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).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[6.7％(3/45)vs 4.4％(2/45)](P=0.645).Conclusion Corbrin capsule combined with alisartanisoproxil tablets in the treatment of diabetic nephropathy has significant clinical effect and good safety.