Abstract:Objective To investigate the predictive value of leptin and irisin for left ventricular systolic function(LVSF)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A retrospective analysis was conducted on 96 STEMI patients admitted to the Second Affiliated Hospital of Hebei North University from January 2021 to January 2024.Patients with left ventricular ejection fraction(LVEF)＜50％were included in the observation group(n=42),and those with LVEF≥50％were included in the control group(n=54).The correlation between leptin,irisin,and circumferential end-systolic stress(cESS)as well as myocardial energy expenditure(MEE)in patients with STEMI was analyzed.The independent correlations between leptin,irisin,and the risk of LVSF impairment were analyzed.A restricted cubic spline model was established to analyze the dose-response relationship between leptin,irisin,and the risk of LVSF impairment in STEMI patients.Results The results of multivariate Logistic regression analysis showed that a significant positive correlation was observed between leptin and cESS,MEE,while a significant negative correlation was found between irisin and cESS,MEE(all P＜0.001).Leptin exhibited an independent positive correlation,while irisin showed an independent negative correlation with LVSF impairment(both P＜0.05).There was a nonlinear dose-response relationship between leptin,irisin,and the risk of LVSF impairment.When leptin was ≤15 μg/L,the risk of LVSF impairment in STEMI patients increased with increasing leptin levels[odds ratio(OR)=1.517,95％confidence interval(CI):1.118-1.735,P＜0.001].When irisin was ≥0.89 mg/L,the risk of LVSF impairment in STEMI patients increased with decreasing irisin levels(OR=-1.593,95％CI:-2.818 to-1.326,P＜0.001).Conclusions Leptin has an independent positive correlation with LVSF impairment,while irisin shows an independent negative correlation.There exists a nonlinear dose-response relationship between leptin,irisin,and the risk of LVSF impairment.Specifically,when leptin is ≤15 μg/L,the risk of LVSF impairment in STEMI patients increases with increasing leptin levels;conversely,when irisin is ≥0.89 mg/L,the risk of LVSF impair-ment increases with decreasing irisin levels.

Abstract:Objective To investigate the value of echocardiography in the diagnosis of leaflet thrombosis after transcatheter aortic valve replacement(TAVR).Methods A total of 115 patients who successfully underwent TAVR in Beijing Anzhen Hospital,Capital Medical University from January 1,2023 to July 1,2023 were selected as the research objects.According to the presence or absence of subclinical leaflet thrombosis(SLT)after TAVR,the patients were divided into normal group(85 cases)and thrombosis group(30 cases).According to the degree of SLT,the thrombosis group was divided into mild SLT group(17 cases)and moderate to severe SLT group(13 cases).Left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),aortic valve peak velocity(Vmax),mean pressure gradient(MPG),aortic valve orifice area(AVA),amount of change in Vmax(△Vmax),amount of change in MPG(△MPG),amount of change in AVA(△AVA),rate of change in Vmax(△Vmax％),rate of change in MPG(△MPG％),and rate of change in AVA(△AVA％)were compared between the two groups.Receiver operating characteristic curve was used to analyze the influencing factors of moderate to severe SLT.Results There were no significant differences in LVEDD,LVEF,Vmax,MPG and AVA between the thrombosis group and the normal group(all P＞0.05).The △Vmax,△MPG,△Vmax％and △MPG％in the thrombosis group were higher than those in the normal group,while the △ AV A and △AVA％were lower than those in the normal group(all P＜0.05).There were no significant differences in LVEDD,LVEF,Vmax,MPG and AVA among the moderate to severe SLT group,mild SLT group and normal group(all P＞0.05).There were significant differences in △Vmax,△MPG,△AVA,△Vmax％and △MPG％among the moderate to severe SLT group,mild SLT group and normal group(all P＜0.05).The △Vmax,△MPG,△Vmax％and △MPG％in the moderate to severe SLT group were higher than those in the mild SLT group and the normal group,△AVA and△AVA％were lower than those in the normal group,and △AVA was lower than that in the mild SLT group(all P＜0.05).The results of receiver operating characteristic curve analysis showed that the areas under the curve of△Vmax＞77 cm/s,△MPG＞6 mmHg,△AVA≤-0.01 cm2,△Vmax％＞35％,and △MPG％＞143％for predicting moderate to severe SLT after TAVR were 0.754,0.733,0.726,0.784 and 0.788,respectively,and the specificity were 80.4％,73.5％,65.7％,70.6％and 90.2％,and the sensitivity were 61.5％,61.5％,76.9％,76.9％and 61.5％,respectively(all P＜0.05).Conclusion Echocardiography has a certain diagnostic value for the formation of moderate to severe SLT after TAVR.△Vmax,△MPG,△AVA,△Vmax％and △MPG％can provide a reference for the identification of moderate to severe SLT after TAVR with certain accuracy.

Abstract:Objective To analyze the influencing factors of bleeding after endoscopic submucosal dissection(ESD)in patients with early gastric cancer treated with antithrombotic therapy.Methods The clinical data of 40 patients with early gastric cancer who underwent ESD in the background of antithrombotic therapy in Zhangjiakou First Hospital,Hebei Province from January 2016 to December 2023 were retrospectively analyzed.According to the occurrence of bleeding after ESD,the patients were divided into non-bleeding group(34 cases)and bleeding group(6 cases).The incidence of bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy was counted.Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of bleeding.Results The incidence of bleeding after ESD was 15.0％(6/40)in 40 patients with early gastic cancer treated with antithrombotic therapy.Univariate analysis showed that tumor size,lesion depth and intraoperative blood loss were associated with postoperative bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy(all P＜0.05).Age,gender,diabetes mellitus and pathological type were not associated with postoperative bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy(all P＞0.05).The statistically significant factors(lesion depth,tumor size,intraoperative blood loss)in univariate analysis were included in Logistic multivariate analysis.The results showed that tumor size≥3 cm,submucosal lesions,intraoperative blood loss≥800 ml were risk factors for bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy(the odds ratios were 7.001,6.802,11.101;and the 95％confidence intervals were 1.502-32.592,1.464-31.615,and 1.931-63.852,respectively;all P＜0.05).Conclusion The bleeding after ESD in patients with early gastric cancer treated with antithrombotic therapy is affected by tumor size,lesion depth and intraoperative blood loss,which should be paid attention to in clinical practice.In order to reduce the risk of bleeding,careful consideration of antithrombotic therapy should be given in the preoperative evaluation and postoperative management.

Abstract:Objective To explore the relationship between the gene expression levels of TET methylcy-tosine dioxygenase 2(TET2)and DNA methyltransferase 3 A(DNMT3A)and the clinical classification and prognosis of patients with myelodysplastic syndromes(MDS).Methods A total of 97 patients with MDS admitted to Shijiazhuang People's Hospital,Heibei Province from January 2015 to December 2022 were retrospectively selected as the observation group,and 90 people without blood system diseases in the same hospital during the same period of physical examination were selected as the control group,and 87 patients with aplastic anemia were selected as the similar control group.The expression levels of TET2 and DNMT3A genes in the three groups were compared,and the differences of gene expression levels in patients with different MDS types and prognostic grades were compared.Results The expression level of TET2 gene in the observation group was lower than those in the control group and similar control group,and the expression level of DNMT3A gene was higher than those in the control group and similar control group(all P＜0.001).However,there was no significant difference between patients with different types of MDS(all P＞0.05).With the increase of prognosis risk,the expression level of TET2 gene showed an overall downward trend,and the expression level of DNMT3A gene showed an overall upward trend(all P＜0.001).The expression level of TET2 gene was negatively correlated with the poor prognosis of MDS(r=-0.664,P＜0.001),and the expression level of DNMT3A gene was positively correlated with the poor prognosis of MDS(r=0.639,P＜0.001).Conclusion The expression levels of TET2 and DNMT3A genes are not significantly different among different types of MDS,but are significantly related to the prognosis of MDS,and have reference significance for the prognosis of patients in clinic.

Abstract:Objective To investigate the clinical effect of Wenpi Chuzhang decoction in the treatment of gastrointestinal dysfunction of spleen Yang deficiency type.Methods According to the random number table method,50 patients with gastrointestinal dysfunction of spleen Yang deficiency type who were hospitalized in the Department of Critical Care Medicine,Hebei Provincial Hospital of Traditional Chinese Medicine from January 2021 to September 2022 were divided into observation group and control group,with 25 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Wenpi Chuzhang decoction on the basis of the control group.Both groups were treated for 7 d.The clinical efficacy,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,traditional Chinese medicine(TCM)syndrome score,gastroin-testinal function related indicators,inflammatory factor levels and adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was significantly higher than that of the control group[96.0％(24/25)vs 72.0％(18/25)](P＜0.05).After treatment,the APACHE Ⅱscore and TCM syndrome score of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P＜0.05).After treatment,the gastrointestinal dysfunction score,intra-abdominal pressure,abdominal circumference,and average gastric retention in the two groups were lower/less than those before treatment,and the above indexes in the observation group were lower/less than those in the control group(all P＜0.05).After treatment,the white blood cell count,tumor necrosis factor-α,and procalcitonin levels of the two groups were lower than those before treatment,and the levels of inflammatory factors in the observation group were lower than those in the control group(all P＜0.05).During the treatment period,there were no adverse reactions in the two groups,and the routine indexes of blood,urine,and stool remained normal.Conclusion Wenpi Chuzhang decoction is effective in the treatment of gastrointestinal dysfunction of spleen Yang deficiency type,which can improve gastrointestinal function and inhibit inflammatory factors.

Abstract:As the main artery of human blood circulation,the aorta undertakes the key function of trans-porting and distributing the blood pumped by the heart to various organs of the whole body.During blood flow,mechanical stresses are generated in the aorta,mainly including shear stress and mechanical stretch.Physiological mechanical stress maintains the physiological state of blood vessels,while pathological mechanical stress is closely related to the pathological changes of aortic diseases and is one of the risk factors for vascular events.Abnormal mechanical stress disrupts the normal function of endothelial cells and smooth muscle cells through a variety of mechanisms,thereby mediating the initiation and evolution of aortic diseases.This article reviews the latest progress in aortic mechanobiology,aiming to provide new ideas and directions for the prevention and treatment of aortic diseases.

Abstract:Objective To investigate the correlation between brachial-ankle pulse wave velocity(baPWV),cardio-ankle vascular index(CAVI),ankle-brachial vascular index(ABI)and early disease progression of acute cerebral infarction(ACI).Methods A total of 280 consecutive ACI patients hospitalized in the Department of Neurology,North China University of Science and Technology Affiliated Hospital from October 2023 to September 2024 were enrolled.According to the disease progression within 7 days of onset,the patients were divided into progression group(84 cases)and non-progression group(196 cases).The values of baPWV,CAVI and ABI were detected by arteriosclerosis monitoring device.The relationship between the three indexes and the early progression of ACI was analyzed,and the predictive value of the three indexes was discussed.Results The age,body mass index,fibrinogen,low-density lipoprotein cholesterol and lipoprotein associated phospholipase A2 in the progression group were higher/higher than those in the non-progression group(all P＜0.05).The baPWV and CAVI in the progression group were higher than those in the non-progression group,and ABI was lower than that in the non-progression group[(1 275±221)cm/s vs(919±124)cm/s,(10.8±0.8)vs(9.1±1.1),(0.82±0.10)vs(1.02±0.13)](t=13.901,14.729,13.076,all P＜0.001).Multivariate Logistic regression analysis showed that baPWV,CAVI,ABI,fibrinogen and lipoprotein-associated phospholipase A2 were independent influencing factors for early disease progression in patients with ACI(all P＜0.05).Among them,baPWV and CAVI were risk factors for the early progression of ACI,and ABI was a protective factor.Correlation analysis showed that baPWV and CAVI were positively correlated with the early progression of ACI(r=0.645,0.612,both P＜0.001),while ABI was negatively correlated with it(r=-0.621,P＜0.001).The area under the curve of baPWV,CAVI,ABI and their combination in predicting early disease progression were 0.906,0.886,0.891 and 0.946,respectively,and the combined detection of the three had higher predictive value.Conclusion The baPWV,CAVI and ABI are closely related to the early progression of ACI.The baPWV,CAVI and ABI all have predictive value for early disease progression in ACI patients,and the combined detection of the three has higher predictive value.

Abstract:Objective To investigate the effect of Lingyang Qingfei pill combined with piperacillin sodium and tazobactam sodium in the treatment of patients with severe pneumonia.Methods A total of 125 patients with severe pneumonia admitted to the General Hospital of the Northern Theater Command of Chinese People's Liberation Army from October 2020 to October 2023 were selected as the research objects.According to the random number table method,they were divided into the control group(62 cases)and the observation group(63 cases).All patients were given conventional treatment.The control group was treated with piperacillin sodium and tazobactam sodium,and the observation group was treated with Lingyang Qingfei pill on the basis of the control group.Both groups were treated for 14 days.The clinical efficacy,symptom disappearance time,pulmonary function index,inflammatory factor index and safety of the two groups were compared.Results The total effective rate of the observation group was significantly higher than that of the control group[96.8％(61/63)vs 74.2％(46/62)](x2=12.985,P＜0.001).After treatment,the antipyretic time,shortness of breath disappearance time,cough disappearance time and wet rales disappearance time of the observation group were shorter than those of the control group(all P＜0.05).After treatment,the forced vital capacity,forced expiratory volume in the first second and partial expiratory flow-volume 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＜0.05).After treatment,the levels of serum C-reactive protein,interleukin-6 and procalcitonin 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[7.9％(5/63)vs 4.8％(3/62)](x2=0.501,P=0.479).Conclusion Lingyang Qingfei pill combined with piperacillin sodium and tazobactam sodium has a good effect on severe pneumonia,which can relieve clinical symptoms,improve lung function,reduce inflammatory factors,and has good safety.

Abstract:Objective To explore the effect of probucol combined with atorvastatin in the treatment of acute cerebral infarction and its effect on patients' blood lipids.Methods A total of 96 patients with acute cerebral infarction admitted to the Shandong Provincial Third Hospital from January 2022 to January 2024 were selected.They were divided into observation group and control group according to the random number table method,with 48 cases in each group.The control group was given conventional treatment based on atorvastatin,and the observation group was treated with probucol tablets on the basis of the control group.All patients were treated for 12 weeks.The clinical efficacy,blood lipid indexes,ultrasound parameters of carotid plaque,inflammatory factors,and treatment safety were compared between the two groups.Results The total effective rate of the obser-vation group was higher than that of the control group[91.7％(44/48)vs 72.9％(35/48)](P=0.016).After treatment,the blood lipid indexes of the two groups were better than those before treatment,and the blood lipid indexes of the observation group were better than those of the control group(all P＜0.05).After treatment,the carotid intima-media thickness and vascular resistance index of the observation group were less than those of the control group,and the maximum systolic velocity and the maximum end-diastolic velocity were higher than those of the control group(all P＜0.05).After treatment,the levels of inflammatory factors matrix metalloproteinase-2,nucleotide-binding oligomerization domain-like receptor protein 3 and interleukin-1 β 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).Conclusion Probucol combined with atorvastatin has a good application effect on acute cerebral infarction,which can improve the blood lipid level of patients,stabilize the carotid plaque of patients,improve the carotid blood flow velocity,reduce the level of inflammatory factors,and has good treatment safety.

Abstract:Objective To investigate the effect of vidian neurectomy(VN)combined with anterior ethmoidal neurotomy(AEN)on olfaction and clinical efficacy in patients with chronic sinusitis complicated with allergic rhinitis(CRSwAR).Methods The medical records of 54 patients with moderate to severe CRSwAR with olfactory dysfunction who were treated in the Department of Otolaryngology,the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from December 2022 to December 2023 were retrospectively collected.The patients were divided into observation group(26 cases)and control group(28 cases)according to the specific operation conditions.The control group was treated with functional endoscopic sinus surgery,while the observation group was treated with unilateral VN and bilateral AEN on the basis of the control group.The percentage of eosinophils in peripheral blood(EOS％),the total score of Sniffin' sticks olfactory test,subjective symptom score[sinonasal outcome test(SNOT-22),rhinoconjunctivitis quality of life questionnaire(RQLQ)score],Lund-Kennedy score of nasal endoscopy and Lund-Mackay score of nasal cavity and paranasal sinus CT were compared between the two groups before and after surgery,and the changes of olfactory and nasal symptoms before and after operation were evaluated and analyzed.The factors affecting the total score of Sniffin' sticks olfactory test were analyzed by generalized mixed linear model,and the postoperative recurrence rate was compared between the two groups.Results Both groups of EOS％decreased over time(Pwithin group＜0.01),but no significant interaction was observed(Pinteraction=0.33).The analysis of within subject effects showed that the total score of Sniffin'sticks olfactory test changed over time(Pwithin group＜0.01),and the observation group showed a faster increase in scores compared to the control group(Pinteraction＜0.01).Both SNOT-22 and RQLQ scores had a temporal trend and interactive effects,and there was a significant difference in the treatment effect between the two groups in terms of the above scores(both Pinter group＜0.05).One year after surgery,the Lund-Kennedy scores of nasal endoscopy and nasal sinus CT in both groups were lower than before surgery,and the observation group had lower Lund-Kennedy scores of nasal endoscopy than the control group[(3.3±0.3)vs(4.7±3.0)](both P＜0.05).The results of general-ized linear mixed model analysis showed that the Lund-Kennedy score of nasal endoscopy had an effect on the total score of Sniffin' sticks olfactory test(P=0.001).The recurrence rate of the observation group was lower than that of the control group[7.7％(2/26)vs 32.1％(9/28)](P=0.026).Conclusion VN and AEN combined with functional endoscopic sinus surgery is beneficial to restore the olfactory function and nasal mucosal function of CRSwAR patients,and reduce the postoperative recurrence rate.

Abstract:Objective To investigate the effect of bevacizumab combined with Huaier granule in the treat-ment of non-small cell lung cancer.Methods A total of 84 patients with non-small cell lung cancer who were treated in Yan'an University Affiliated Hospital from January 2021 to October 2023 were included in this study.According to the random number table method,they were divided into the control group and the observation group,with 42 cases in each group.On the basis of conventional treatment,the control group was treated with bevacizumab injection,and the observation group was treated with bevacizumab injection combined with Huaier granule.Both groups were treated for 12 weeks.The clinical efficacy,traditional Chinese medicine symptom score,tumor markers,quality of life and adverse reactions were compared between the two groups.Results The disease control rate of the observation group was significantly higher than that of the control group[85.7％(36/42)vs 66.7％(28/42)](P=0.040).After treatment,the scores of chest tightness,cough,dry stool and chest pain 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).After treatment,the levels of carbohydrate antigen 125,pro-gastrin-releasing peptide and carcinoembryonic antigen 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).After treatment,the scores of physical function,social function,mental psychology and general feeling of 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).There was no significant difference in the incidence of nausea and vomiting,abnormal liver and kidney function,alopecia,skin reaction and toxic myelosuppression between the two groups(all P＞0.05).Conclusion Bevacizumab combined with Huaier granule in the treatment of non-small cell lung cancer has a good therapeutic effect,which can improve the traditional Chinese medicine symptoms,serum tumor markers and quality of life of patients.

Abstract:Breast cancer is one of the most common malignant tumors in women,which directly affects women's physical and mental health and quality of life.As an important part of breast cancer treatment,endocrine therapy can significantly improve the survival rate and quality of life of patients.However,in the process of endocrine therapy,the follow-up management of patients is often neglected,resulting in insufficient evaluation of treatment effect and lack of psychological support.At present,although some studies have explored the strategies of endocrine therapy for breast cancer,there is still a lack of systematic summary and analysis of the specific points of follow-up.This article introduces the role of estrogen in breast cancer and the mechanism of endocrine therapy,and comprehensively reviews the key points of follow-up in breast cancer patients with endocrine therapy,including therapeutic effect evaluation,complications monitoring,quality of life evaluation and psychological support.Through a comprehensive analysis of the relevant literature,this paper aims to provide clinicians with effective follow-up strategies to improve the prognosis and quality of life of patients,so as to provide a reference for the comprehensive management of breast cancer.

Abstract:Objective To investigate the effect of atorvastatin combined with metformin in the treatment of obese polycystic ovary syndrome.Methods A total of 150 patients with obese polycystic ovary syndrome admitted to Shaanxi Provincial People's Hospital from September 2021 to October 2023 were consecutively recruited.According to the random number table method,all cases were divided into observation group and control group,with 75 cases in each group.The control group was treated with metformin,and the observation group was treated with atorvastatin combined with metformin.The total clinical effective rate,physical indicators,sex hormone indicators,lipid metabolism indicators,insulin resistance indicators and adverse reactions of the two groups were recorded.Results The total effective rate of the observation group was higher than that of the control group[90.7％(68/75)vs 78.7％(59/75)](P=0.041).After treatment,the waist circumference and body mass index of the two groups were lower than those before treatment,and the observation group were lower than those of the control group(all P＜0.05).After treatment,the levels of serum testosterone,luteinizing hormone and estradiol in the observation group were lower than those in the control group,and the level of follicle-stimulating hormone was higher than that in the control group(all P＜0.05).After treatment,the lipid metabolism indexes of the two groups were significantly improved compared with those before treatment,and the levels of total cholesterol,triglyc-eride,and low-density lipoprotein cholesterol in the observation group were significantly lower than those in the control group,while the high-density lipoprotein cholesterol level was higher than that in the control group(all P＜0.05).After treatment,the insulin resistance indexes of the two groups were significantly decreased,and the fasting blood glucose,fasting insulin,and homeostasis model insulin resistance index of the observation group were significantly lower than those of the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.575).Conclusion Atorvastatin combined with metformin is effective in the treatment of obese polycystic ovary syndrome,which can reduce the level of physical indicators,improve the level of sex hormones,lipid metabolism and insulin resistance,and the treatment safety is good.

Abstract:Coronary atherosclerotic heart disease is still one of the major diseases affecting the global health burden.With the rapid development of society and the acceleration of the pace of life,the incidence of coronary atherosclerotic heart disease is on the rise in young people.The bidirectional effect of depression and coronary atherosclerotic heart disease has a certain impact on the occurrence,development and prognosis of coronary heart disease.This article reviews the current status and research progress of depression in patients with coronary atherosclerotic heart disease at home and abroad,especially for patients with premature coronary athero-sclerotic heart disease,and summarizes its epidemiology,pathogenesis and treatment methods,in order to provide a basis for the clinical diagnosis and treatment of patients with coronary atherosclerotic heart disease complicated with depression.

Abstract:Obstructive sleep apnea hypopnea syndrome(OSAHS)is a sleep disorder characterized by intermittent hypoxia,hypercapnia and sleep structure disorder caused by repeated upper airway obstruction,and is associated with cardio-cerebrovascular diseases and metabolic diseases,such as hypertension,coronary heart disease,diabetes,etc.In recent years,related studies have found that adiponectin is an adipokine with anti-inflammatory and anti-atherosclerotic effects.Many scholars have paid attention to the potential role of adiponectin in the occur-rence and development of OSAHS.It has been found that serum adiponectin levels are generally lower in patients with OSAHS,and this reduction correlates with disease severity and obesity.Continuous positive airway pressure treatment can increase serum adiponectin level and improve inflammatory state in patients with OSAHS to a certain extent,suggesting that adiponectin plays an important role in the pathogenesis of OSAHS.In addition,related studies have revealed that adiponectin gene polymorphism may affect its expression and function,thereby affecting the occurrence and development of OSAHS.This article reviews the latest research progress on the role of adipone-ctin in OSAHS and its genetic correlation,in order to provide new ideas and potential targets for the diagnosis and treatment of OSAHS.

Abstract:Objective To investigate the diagnostic value of serum apolipoprotein C1(APOC1),inter-leukin-6(IL-6)and squamous cell carcinoma antigen(SCC)in cervical cancer.Methods A total of 74 patients with cervical cancer who were treated in the Provincial Hospital Affiliated to Shandong First Medical University from April 2023 to June 2024 were selected as the cervical cancer group,and 60 healthy people were selected as the control group.The levels of APOC1,IL-6 and SCC in the two groups were compared,and the relationship between serum APOC1,IL-6 and SCC levels and clinicopathological parameters in patients with cervical cancer was analyzed.The receiver operating characteristic curve was used to evaluate the diagnostic value of single and combined detection of APOC1,IL-6 and SCC for cervical cancer,and the risk degree of cervical cancer in patients with different serum expression levels was compared.Results The levels of APOC1,IL-6 and SCC in cervical cancer group were higher than those in control group[89.00(64.67,169.17)mg/L vs 46.84(27.78,64.15)mg/L,65.49(39.88,125.20)ng/L vs 34.04(22.28,55.35)ng/L,1.81(1.03,4.03)μg/L vs 1.01(0.76,1.50)μg/L](Z=6.130,5.096,4.779,all P＜0.001).The serum APOC1 and IL-6 levels in International Federation of Gynecology and Obstetrics(FIGO)stage Ⅲ patients were significantly higher than those in FIGO stage Ⅰ-Ⅱpatients.The serum APOC1 level in poorly differentiated patients was significantly higher than that in moderately well differentiated patients.The SCC level in squamous cell carcinoma patients was higher than that in adenocarci-noma patients(all P＜0.05).The area under the curve of combined detection of APOC1,IL-6 and SCC in the diagnosis of cervical cancer was larger than that of any one of them alone(0.900 vs 0.809,0.757,0.741),and the sensitivity and specificity of combined detection of the three markers were also higher than those of single detection(all P＜0.05).The risk of cervical cancer in patients with high levels of APOC1,IL-6 and SCC was 9.76,5.94 and 3.92 times higher than those with low levels of APOC1,IL-6 and SCC.Conclusions The serum levels of APOC1,IL-6 and SCC are significantly increased in patients with cervical cancer.The serum levels have certain predictive value for tumor stage,tumor type and differentiation degree.The combined detection of APOC1,IL-6 and SCC can improve the diagnostic efficiency of cervical cancer.

Abstract:Infection can lead to the adverse progression of liver cirrhosis and increase the mortality rate,while the development of liver cirrhosis to the end stage will increase the susceptibility of patients to infection,thus forming a vicious circle.Patients with liver cirrhosis have impaired immune function,intestinal barrier dysfunc-tion,changes in the composition and function of intestinal flora,bacterial translocation,and are prone to infection.Antibiotics are the most commonly used means of anti-infection,but traditional empirical antibiotic therapy or irrational antibiotic use may promote the spread of multi-drug resistant bacteria,destroy intestinal microecology,and further increase the susceptibility to infection.Therefore,new methods for the prevention and treatment of liver cirrhosis complicated with infection need to be paid attention.This article aims to explore the relationship between liver cirrhosis complicated with infection and intestinal microecology,and focuses on the application of intestinal microecology regulation,such as probiotics,prebiotics,new antibiotics,intestinal metabolites,fecal microbiota transplantation and traditional Chinese medicine regulation in liver cirrhosis complicated with infection,in order to provide new ideas for the prevention and treatment of liver cirrhosis complicated with infection.

Abstract:Objective To explore the effect of intelligent pharmacist platform on patients'medication compliance.Methods A total of 500 patients with underlying diseases and taking drugs in the outpatient department of Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University from June 3 to December 3,2023 were randomly recruited.According to whether the intelligent pharmacist platform was used,the patients were divided into the non-intelligent pharmacist platform group(250 cases)and the intelligent pharmacist platform group(250 cases).The medication adherence was assessed by questionnaires covering the content of Morisky-Green scale and telephone follow-up,and the factors of medication adherence were analyzed.Results The medication compliance of patients aged 60-70 years old in the intelligent pharmacist platform group was the best,and the medication compliance of patients aged＜60 years old was the worst(all P＜0.05).In the intelligent pharmacist platform group,the medication compliance of patients with bachelor's degree or above was the best,and the medication compliance of patients with junior high school education was the worst;while,in the non-smart pharmacist platform group,the medication compliance of patients with college education was the best,and the medication compliance of patients with primary school education or below was the worst(all P＜0.05).The medication compliance of patients living alone in the intelligent pharmacist platform group was higher than that of patients living alone,and the medication compliance of patients living alone in the non-intelligent pharmacist platform group was better than that of patients living alone(both P＜0.05).The medication compliance of patients with ≥ 3 kinds of drugs was better than that of patients with＜3 kinds of drugs in both groups(both P＜0.05).Except for the item of age＞80 years old in this study,the scores of medication compliance of other influencing factors in the intelligent pharmacist platform group were higher than those in the non-intelligent pharmacist platform group,and the differences were statistically significant(all P＜0.01).The medication compliance score of the intelligent pharmacist platform group was significantly higher than that of the non-intelligent pharmacist platform group[(6.9±1.3)scores vs(4.8±2.2)(P＜0.001).Conclusion The application of intelligent pharmacist platform can improve the medication compliance of patients.

Abstract:Objective To explore the value of dulaglutide combined with Bifidobacterium quadruple live bacterial tablets in reducing the risk of cardiovascular diseases in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 60 patients with T2DM admitted to the Department of Endocrinology,Zhangjiakou First Hospital,Hebei Province from March 2021 to March 2022 were selected as the research objects.According to the random number table method,they were divided into control group and observation group,with 30 cases in each group.The control group was treated with conventional drugs,and the observation group was treated with dulaglutide combined with Bifidobacterium quadruple live bacterial tablets on the basis of the control group.Both groups received diet and exercise intervention.The blood glucose level,islet function index and inflammatory factor index of the two groups were detected,and the risk of cardiovascular disease was compared between the two groups.Results After treatment,the fasting blood glucose,glycosylated hemoglobin and average blood glucose levels of the two groups were lower than those before treatment,and the blood glucose level of the observation group was lower than that of the control group(all P＜0.05).After treatment,the steady-state model islet β cell function index,0.5 h insulin production index and 2 h insulin production index of the two groups were higher than those before treatment,and the steady-state model insulin resistance index was lower than that before treatment;compared with the control group,the observation group had greater changes(all P＜0.05).After treatment,the levels of interleukin-6,high-sensitivity C-reactive protein and lipopolysaccharide in the two groups were lower than those before treatment,and the levels of each index in the observation group were lower than those in the control group(all P＜0.05).After treatment,the Framingham risk score and 10-year risk of cardiovascular disease in the observation group were lower than those before treatment,and lower than those in the control group[(12.0±0.6)vs(13.1±0.8),(4.1±2.3)％vs(6.2±5.3)％](all P＜0.05).Conclusion Dulaglutide combined with Bifidobacterium quadruple live bacterial tablets in the treatment of T2DM can reduce insulin resistance,improve islet β cell function,control inflammatory response,and reduce the risk of cardiovascular events.

Abstract:Objective To explore the predictive value of growth differentiation factor-15(GDF-15)and alkaline phosphatase(ALP)levels on the degree of coronary artery disease in patients with coronary atherosclerotic heart disease(CHD).Methods A total of 140 patients hospitalized in the Department of Cardiovascular Medicine,Inner Mongolia People's Hospital from January 2021 to December 2023 were selected.According to the final diagnosis,they were divided into CHD with diabetes mellitus group(46 cases),CHD group(51 cases)and control group(43 cases of non CHD patients without obvious stenosis in coronary angiography).The levels of GDF-15,ALP,and Gensini score were compared,and the differences in the composition ratio of different ethnic among three groups of patients and the above indicators among different ethnic patients were compared.The relationship between GDF-15 and ALP levels and the risk of CHD,as well as their predictive value for the degree of coronary artery disease were analyzed.Results The GDF-15,ALP levels and Gensini score in CHD group and CHD with diabetes mellitus group were higher than those in control group,while those in CHD with diabetes mellitus group were higher than those in CHD group(all P＜0.05).There was no statistically significant difference in the proportion of different ethnicities among the three groups(P＞0.05).There was no statistically significant difference in GDF-15,ALP levels and Gensini score between Han and Mongolian patients(all P＞0.05).The results of Logistic regression analysis showed that the risk of CHD increased with an increase of the levels of GDF-15(odds ratio=2.356,95％confidence interval:1.608-3.451,P＜0.001)and ALP(odds ratio=1.117,95％confidence interval:1.019-1.225,P=0.019).The analysis of the receiver operating characteristic showed that,the area under the curve(AUC)for predicting the degree of coronary artery disease using GDF-15,ALP,and their combination were 0.929,0.796,and 0.939,respectively.The AUC predicted by the combination of GDF-15 and ALP was greater than that of a single indicator(both P＜0.05).Conclusions The expression levels of ALP and GDF-15 in patients with CHD increased and are related to diabetes mellitus and the degree of coronary artery disease.The combined detection of the two indexes has a good predictive value for the degree of coronary artery disease.