Abstract:In recent years,myosin light chain kinase(MLCK)has played a crucial role as an important regulator of the cytoskeleton and cell movement in various types of tumors.MLCK participates in regulating various biological processes,such as cell proliferation,migration,invasion,and apoptosis,through cell signal transduction in tumor development.Given the crucial role of MLCK in tumor development,it has been extensively studied as a potential therapeutic target,with the aim of developing therapeutic strategies to improve treatment efficacy and patient quality of life.This review summarizes the expression patterns,functional mechanisms,and potential clinical application value of MLCK in different types of tumors,and discusses the current status and future directions of MLCK as a potential therapeutic target,providing new ideas and strategies for clinical treatment.

Abstract:Objective To investigate the effects of dexmedetomidine on perioperative neurocognitive disorders and inflammatory mediators in patients undergoing laparoscopic colorectal cancer surgery.Methods A total of 76 patients who underwent laparoscopic colorectal cancer surgery in the Eighty-second Army Group Hospital of the Chinese People's Liberation Army from June 2021 to January 2023 were selected.According to the random number table method,the patients were divided into the control group and the observation group,with 38 cases in each group.The control group was given 0.9％sodium chloride injection by intravenous pump before anesthesia induction.The observation group was given dexmedetomidine intravenous pump before anesthesia induction.The cognitive function was compared between the two groups before anesthesia(T0),at recovery(T1),when leaving the postanesthesia care unit(T2)and 24 h after operation(T3).The levels of neurological function and inflammatory mediators in the two groups were detected.Results The Montreal Cognitive Assessment scores of the two groups at T1 and T2 were lower than those at T0,and the scores of the observation group were higher than those of the control group[(24.5±1.8)vs(22.4±2.2),(25.7±1.5)vs(23.3±2.0)](all P＜0.001).The levels of central nervous system specific protein β and neuron specific enolase at T1 and T2 in the two groups were higher than those at T0,and those in the observation group were lower than those in the control group(all P＜0.05).The levels of C-reactive protein,tumor necrosis factor-α and interleukin-6 at T,,T2 and T3 in the two groups were higher than those at T0,and those in the observation group were lower than those in the control group(all P＜0.05).Conclusion Dexmedetomidine can effectively improve cognitive function and neurological function and reduce the level of inflammatory mediators in patients undergoing laparoscopic colorectal cancer surgery.

Abstract:Objective To investigate the clinical effect of percutaneous curved vertebroplasty(PC VP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods The clinical data of 230 patients with OVCF who underwent surgical treatment in the Department of Orthopedics,Civil Aviation General Hospital from January 2020 to June 2023 were collected and retrospectively analyzed.According to the different surgical methods,they were divided into the control group(120 cases)and the observation group(110 cases).The control group was treated with traditional unilateral percutaneous vertebroplasty,and the observation group was treated with PCVP.The dosage and distribution of bone cement,visual analogue scale(VAS)scores of low back pain and Oswestry disability index(ODI)scores before operation and at 24 hours,3 months and 6 months after operation were compared between the two groups.Results The amount of bone cement and the excellent rate of bone cement distribution in the observation group were higher than those in the control group[(4.7±0.7)ml vs(3.4±0.7)ml,81.8％(90/110)vs 57.5％(69/120)](both P＜0.01).The VAS and ODI scores of the two groups at 24 hours,3 months and 6 months after operation were significantly lower than those before operation(all P＜0.05).However,there was no significant difference between the two groups after operation(all P＞0.05).Conclusions The two surgical methods in the treatment of OVCF can quickly relieve pain,improve the quality of life of patients,and the curative effect is reliable.PCVP and traditional surgery have similar efficacy.PCVP consumes more bone cement,has better bone cement distribution,and performs better in bone support.

Abstract:Complications after cardiac surgery are common and have a significant impact on the clinical prognosis of patients.Patients who need cardiovascular surgery due to heart disease are often complicated with ischemic heart disease,hypertension and diabetes.Therefore,these patients often need to take long-term renin-angiotensin system blockers,namely angiotensin-converting enzyme inhibitors(ACEI)and/or angiotensin Ⅱ receptor blockers(ARB)drugs.At present,there is no consensus on whether and when ACEI/ARB should be discontinued before surgery in patients with a history of long-term use of ACEI/ARB drugs.Published clinical trials and observational studies even have conflicting results.In this review,we will discuss the application of ACEI/ARB drugs in the perioperative period of cardiac surgery,focusing on the effect of their use on postoperative renal complications,in order to provide clear clinical guidance for patients taking these drugs.

Abstract:The morbidity and mortality of cardiovascular disease in patients with rheumatoid arthritis are significantly higher than those in the general population,and coronary atherosclerotic heart disease is one of the main causes of death in patients with rheumatoid arthritis.There are many reasons for rheumatoid arthritis complicated with coronary atherosclerotic heart disease,including traditional risk factors for coronary atherosclerotic heart disease and rheumatoid factor-mediated immune damage.This article mainly reviews the related research on the pathogenesis of rheumatoid arthritis complicated with coronary atherosclerotic heart disease,in order to provide ideas for the effective intervention of patients with rheumatoid arthritis complicated with coronary atherosclerotic heart disease.

Abstract:As a mental disease that seriously endangers people's physical and mental health,the incidence of depression is increasing year by year.As one of the common complications after surgery and anesthesia,postoperative depression has a negative impact on the postoperative rehabilitation process and medical burden of patients.Conventional antidepressants have the problem of delayed efficacy,which cannot achieve rapid remission of severe depression after surgery.In recent years,breakthroughs in the research of ketamine and its related compounds in the field of anti-depression have provided hope for rapid relief of postoperative depressive symptoms.This article systematically summarizes and discusses the research progress of ketamine and its enantiomers in the treatment of postoperative depression.

Abstract:Objective To investigate the changes of serum regenerative family member 3α(REG3A)and Orai calcium release-activated calcium regulator 1(ORAI1)levels in patients with severe acute pancreatitis(SAP)complicated with sepsis and their predictive value for prognosis.Methods A total of 175 SAP patients complicated with sepsis admitted to Banan Branch of Chongqing University Cancer Hospital from January 2021 to November 2023 were selected as the sepsis group,and 90 SAP patients without sepsis in the same hospital during the same period were selected as the non-sepsis group.The sepsis group was divided into death group and survival group according to the 90-day prognosis.Serum REG3A and ORAI1 levels were detected by enzyme-linked immu-nosorbent assay.Univariate analysis was performed on the death of SAP patients complicated with sepsis,and then multivariate unconditional Logistic regression model was established to analyze the influencing factors with the death of SAP patients complicated with sepsis as the dependent variable.Receiver operating characteristic curve was drawn to evaluate the value of serum REG3A and ORAI1 levels in predicting the death of SAP patients with sepsis.Results No patients dropped out of this study.The levels of serum REG3A and ORAI1 in sepsis group were higher than those in non-sepsis group[(20.3±4.6)μg/L vs(14.4±2.6)μg/L,(39±9)μg/L vs(25±6)μg/L](t=13.457,16.481,both P＜0.001).Univariate analysis showed that the severity of disease,sequential organ failure assessment score,acute physiology and chronic health evaluation Ⅱ score,procalcitonin,REG3 A and ORAI1 were related to the death of SAP patients with sepsis(all P＜0.05).Multivariate unconditional Logistic regression model analysis showed that septic shock,increased sequential organ failure assessment score,increased acute physiology and chronic health evaluation Ⅱ score,increased REG3A and ORAI1 were independent risk factors for death in SAP patients with sepsis(odds ratios=8.105,1.321,1.317,1.540,1.274,all P＜0.05).The area under the curve of serum REG3A combined with ORAI1 for predicting the death of SAP patients with sepsis was 0.893,which was larger than 0.780 and 0.783 of serum REG3A and ORAI1 levels alone(Z=3.990,3.770,both P＜0.001).Conclusion Serum REG3A and ORAI1 levels are increased in SAP patients with sepsis,and these changes are independent risk factors for death.Serum REG3A combined with ORAI1 levels have a high value in predicting the prognosis of SAP patients with sepsis.

Abstract:Objective To investigate the correlation of serum mammalian target of rapamycin(mTOR)level and immune function indexes with bromocriptine resistance in patients with pituitary prolactinoma.Methods A total of 120 patients with pituitary prolactinoma admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to May 2024 were selected as the research objects.According to the response to bromocriptine treatment,all patients were divided into sensitive group(78 cases)and resistant group(42 cases).The clinical data,serum mTOR level and immune function indexes of the two groups were compared.The correlation between serum mTOR and immune function indexes was analyzed.Generalized linear mixed model was constructed to analyze the relationship between serum mTOR,immune function indexes and bromocriptine resistance.Restricted cubic spline was used to analyze the dose-response relationship between serum mTOR,immune function indexes and bromocriptine resistance.Receiver operating characteristic curve was used to analyze the diagnostic efficacy of serum mTOR and immune function indexes in bromocriptine resistance.Results There was a significant negative correlation between mTOR level and CD3+,CD4+,and the CD4+/CD8+ratio,and a significant positive correlation between mTOR level and CD8+(all P＜0.05).The results of generalized linear mixed model analysis showed that with the increase of mTOR and CD8+,the risk of bromocriptine resistance in patients increased significantly,and with the increase of CD3+,CD4+,and CD4+/CD8+ratio,the risk of bromocriptine resistance in patients decreased significantly.The results of restricted cubic spline model showed that there was a significant nonlinear dose-response relationship between serum mTOR expression level and immune function indicators and bromocriptine resistance(P＜0.05).The area under the curve of serum mTOR combined with immune function indicators to predict the resistance of patients with bromocriptine was 0.896(95％confidence interval:0.627-0.985),and the sensitivity and specificity were 91.85％and 92.53％,respectively.Conclusion In patients with pituitary prolactinoma,there is a significant correlation between serum mTOR level and immune function indicators,and both of them have been identified as important risk factors for bromocriptine resistance.

Abstract:Objective To observe the effects of remimazolam on perioperative stress response and hemo-dynamics in patients undergoing radical resection of thyroid cancer.Methods A total of 102 patients with thyroid cancer who underwent elective radical resection in Shaanxi Provincial Cancer Hospital from December 2023 to May 2024 were selected.The patients were divided into control group and observation group by random number table method,with 51 cases in each group,and were given propofol and remimazolam anesthesia respectively.The stress response,hemodynamics,intraoperative status,sedation effect and adverse reactions of the two groups were analyzed.Results The levels of adrenocortical hormone and cortisol in the observation group were lower than those in the control group at the time of intubation,skin incision and the end of operation[adrenal cortex hormones:(41.6±7.3)ng/L vs(51.2±9.2)ng/L,(81.0±10.3)ng/L vs(90.1±12.3)ng/L,(66.1±11.1)ng/L vs(74.1±10.2)ng/L;cortisol:(268±51)nmol/L vs(338±66)nmol/L,(319±60)nmol/L vs(401±72)nmol/L,(291±62)nmol/L vs(364±70)nmol/L](all P＜0.05).Compared with the time when entering the room,the heart rate,mean arterial pressure and pulse oxygen saturation of the two groups decreased from immediately after tracheal intubation to the end of the operation,and the heart rate,mean arterial pressure and pulse oxygen saturation of the observation group were higher than those of the control group immediately after tracheal intubation(all P＜0.05).There was no significant difference in operation time and modified vigilance/sedation score at different time points between the two groups(all P＞0.05).The extubation time,stay time in post-anesthesia monitoring treatment room and recovery time of the observation group were shorter than those of the control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(x2=0.684,P=0.408).Conclusion Remimazolam has a good application effect in patients undergoing radical resection of thyroid cancer.Compared with propofol,remimazolam is more hemodynamic stable,can reduce the perioperative stress response,and will not affect the recovery from anesthesia.

Abstract:Inflammatory bowel disease(IBD)is a chronic recurrent non-specific disease of the gastroin-testinal tract,including ulcerative colitis and Crohn's disease.The pathogenesis of IBD includes genetic suscepti-bility,gut microbiota composition,impaired intestinal mucosal barrier function,and the role of intestinal immune response.At present,the main method of IBD treatment is drug therapy,but the drug therapy of IBD mainly plays a role by regulating the immune system,inhibiting inflammation,hindering the generation of immune cells and the expression of adhesion molecules.Some drugs have great adverse reactions,which greatly limits the treatment of IBD.The research of non-drug treatment has made great progress and brought new ideas for the treatment of IBD.This article reviews the research progress of non-drug treatment for IBD.

Abstract:Objective To analyze the medication rules of traditional Chinese medicine in the treatment of intervertebral disc degeneration(IVDD)based on data mining,and to explore the mechanism of core drug combi-nation in the treatment of IVDD using network pharmacology.Methods Apriori algorithm was used to analyze the association rules of the data based on CNKI,Wanfang database and VIP journal database.On this basis,the mechanism of core drugs in the treatment of IVDD was analyzed by network pharmacology,and the interaction between core components and key targets was verified by molecular docking.Results A total of 167 articles were included,and 52 compound formulas were screened,involving 109 Chinese herbs.Association rule analysis showed that the core drug combination was"safflower-peach kernel-Chuanxiong-Angelica".Network pharmacology analysis identified 27 core active ingredients,including quercetin,luteolin,kaempferol,baicalein,β-carotene,β-sitosterol,etc.There were 73 core targets,mainly vascular endothelial growth factor A(VEGFA),cellular tumor antigen p53(TP53),tumor necrosis factor(TNF),matrix metalloproteinase 9(MMP-9),etc.A total of 164 signaling pathways were involved,mainly interleukin-17 pathway,TNF signaling pathway,cancer signaling pathway,etc.Molecular docking results showed that the core targets predicted by network pharmacology could stably bind to the key active components of the core drug group.Conclusions Quercetin,luteolin,kaempferol,baicalin and other components in the drug combination of"safflower-peach kernel-Chuanxiong-Angelica"may be the material basis for the treatment of IVDD,which can act on VEGFA,TP53,TNF,MMP-9 and other targets.1t plays a role in the treatment of IVDD by regulating TNF signaling pathway,IL-17 signaling pathway,cancer signa-ling pathway and other pathways to reduce inflammatory response,control the apoptosis of nucleus pulposus cells,and regulate the metabolism of extracellular matrix.

Abstract:Objective To investigate the related factors affecting the surgical prognosis of patients with spontaneous supratentorial intracerebral hemorrhage(SSICH).Methods The clinical data of 294 patients with SSICH admitted to Department of Neurosurgery,Renmin Hospital of Wuhan University from December 2018 to October 2021 were retrospectively collected.According to the different surgical methods,the patients were divided into neuroendoscopy group(group A),drilling drainage group(group B)and craniotomy hematoma removal group(group C).The efficacy and major complications of the three procedures were recorded and analyzed,and the volume of hematoma and edema was quantitatively calculated based on 3D Slicer software.Univariate and multivariate Logistic regression analysis were used to screen the risk factors affecting the prognosis of patients.Results A total of 294 patients were enrolled in this study,including 126 patients in group A,98 patients in group B and 70 patients in group C.There were significant differences in hematoma clearance rate,operation time and Glasgow coma scale(GCS)score at discharge among the three groups(all P＜0.001),among which group A had the highest hematoma clearance rate and GCS score at discharge,and group B had the shortest operation time.In terms of postoperative complications,there were significant differences in the proportion of postoperative rebleeding,the diameter of edema zone on the 7th day,the accuracy of catheterization,and the removal time of drainage tube among the three groups(all P＜0.05).There were significant differences in postoperative residual hematoma volume and postoperative edema peak volume among the three groups(all P＜0.05),and the two were positively correlated(r=0.414,P＜0.001).Multivariate Logistic regression analysis showed that GCS score at admission,preoperative hematoma volume,irregular shape of hematoma on preoperative CT,time from onset to operation,poor postoperative blood pressure control,surgical method,bleeding site,postoperative cerebral edema and cerebral hemorrhage score were independent risk factors for the prognosis of SSICH(all P＜0.05).Conclusion Neuroendoscopy can effectively remove hematoma,reduce rebleeding and brain edema,screen independent risk factors affecting the prognosis of patients with SSICH,optimize treatment,and improve the overall prognosis of patients.

Abstract:Stroke is one of the leading causes of disability in the global adult population.The number of post-stroke patients requiring rehabilitation is growing every year.Traditional rehabilitation methods have limited effect on the recovery of limb motor function,especially for severe motor dysfunction.In recent years,emerging intelligent rehabilitation technologies,such as biofeedback technology,brain-computer interface technology,robot-assisted,wearable technology,remote rehabilitation and non-invasive brain stimulation,have become new options to improve patients' functional outcomes.With its advanced scientific and technological means,these technologies provide more personalized and comprehensive rehabilitation support for stroke patients,and effectively promote the recovery of motor function and the improvement of quality of life of patients.This article aims to review the research status of intelligent rehabilitation technology in recent years,so as to provide reference for future research direction and clinical application.

Abstract:As an increasingly serious global health disease,metabolic associated fatty liver disease(MAFLD)has a rising incidence in young people,which seriously endangers human health and brings heavy economic burden to social development.In recent years,it has been found that hepatocyte senescence plays a non-negligible role in promoting liver lipid deposition,aggravating liver injury,and causing lipid metabolism disorders.At present,a summary review on the in-depth mechanism and drug intervention of hepatocyte senescence affecting the course of MAFLD is still insufficient,and the development of clinical treatment strategies is relatively lagging behind.This article focuses on the research progress of the regulatory mechanism of hepatocyte senescence in MAFLD from the perspective of the regulation of autophagy,DNA methylation changes,ferroptosis,effects on liver regeneration and drug mechanisms.This article aims to provide a reference for in-depth basic research,and provide a new perspective and practical guidance for the clinical treatment and drug development of MAFLD.

Abstract:Objective To explore the pathogenic gene and mutation site of a patient with myxoid mitral valve disease and the family.Methods According to the results of whole exome sequencing in a patient with mitral regurgitation who had been admitted to the Valve Surgery Center,Beijing Anzhen Hospital,Capital Medical University due to myxoid mitral valve disease,blood samples were taken from the parents,brother and twin sister of the patient's family.Peripheral venous blood was collected to extract genomic DNA from the family members.Whole exome sequencing was performed on the proband's parents and siblings using a high-throughput sequencing platform.Suspected mutations were verified by Sanger sequencing in family members.Results Sequencing results showed that the proband and his sister had c.7819+1G＞A splice variant at the junction of exon 63 and intron 63 of the FBN1 gene.This mutation was a novel and pathogenic mutation.The myxoid mitral valve lesions in this family were syndromic.Conclusions FBN1 gene(NM000138.4)on chromosome 15 is the pathogenic gene.The c.7819+1 G＞A splice variant at the junction of exon 63 and intron 63 is reported for the first time in China and the third time in the world,which provides a basis for gene screening and treatment in the future.

Abstract:Exosomes are nanoscale vesicles and mediators of intercellular communication.Exosomes have attracted much attention due to their special biological effects and composition.Many studies have shown that exosomes regulate immune response,cell migration,cell differentiation,and tumor invasion.This article focuses on its anti-inflammatory and anti-aging mechanisms,because its complex mechanism can not only be used to eliminate inflammation,but also can reverse the aging of tissues and organs to a certain extent.Its clinical application prospect is very promising,and it can be applied to the brain,skin,heart and other fields,and is expected to solve many difficult and complicated diseases.

Abstract:Medical academic journals are the platforms for the dissemination and promotion of related scientific research achievements in the field of medicine and health in China,and their high-quality development is an important embodiment of national medical academic strength and international influence.After the founding of the People's Republic of China,the achievements of medical academic journals in China have attracted wide attention.Medical academic journals serve the country and society,and have made outstanding contributions in the dissemination of knowledge,talent cultivation,academic exchange,leading innovation,achievement transformation,and foreign exchanges.With the new requirements of the new era,the scientific and technological periodicals in China are constantly strengthening their influence,communication power and reputation.The majority of scientific and technological workers and medical academic journal publishers shoulder the mission,and there is a long way to go on how to keep the integrity and innovation,and produce new results.This paper summarizes and discusses the relevant elements involved in the high-quality development of medical academic journals.

Abstract:Objective To explore the willingness of cardiovascular disease patients with mild cognitive impairment(MCI)to use computerized cognitive training(CCT),so as to provide a reference for promoting the use of CCT in cardiovascular disease patients with MCI.Methods Using the method of descriptive qualitative research,a total of 16 cardiovascular disease patients with MCI who were hospitalized in Beijing Anzhen Hospital,Capital Medical University from June to September 2023 and met the inclusion criteria were selected as the interview objects by purposive sampling for semi-structured interviews.Colaizzi phenomenological data analysis method was used to analyze the data and refine the theme.Results This study identified the needs of 16 patients with cardiovascular disease and MCI for the use of CCT,and three themes were extracted:the patients'attitudes towards CCT;the factors that hinder the use of CCT;and the factors that promote the use of CCT.Conclusion Enhancing the awareness and training of cardiovascular disease patients with MCI on the use of CCT,providing more policy support,and offering assistance in using CCT can help increase the use of CCT among cardiovascular disease patients with MCI,thereby improving their cognitive function and quality of life.

Abstract:Cardiogenic shock(CS)is characterized by rapid progression and high mortality,which requires rapidly identification and management of the high-risk patients.The detection of plasma biomarkers is helpful for early risk identification of CS patients,so as to optimize treatment measures.In recent years,the role of new CS biomarkers in shock progression,disease course monitoring and death risk prediction has attracted clinical attention.These biomarkers include markers related to inflammation,immunity,endothelial function,and markers based on proteomics screening.This article reviews the research progress of several novel biomarkers of CS in shock risk assessment and prognosis prediction.

Abstract:Objective To investigate the effect of Jinqi Jiangtang tablets combined with liraglutide injection in the treatment of type 2 diabetes mellitus.Methods A total of 100 patients with type 2 diabetes mellitus who were treated in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine 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 50 cases in each group.The control group was treated with liraglutide injection,and the observation group was treated with Jinqi Jiangtang tablets combined with liraglutide injection.Both groups were treated for 3 months.The therapeutic effects,and glucose metabolism indexes before and after treatment,vascular endothelial function indexes and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group[96.0％(48/50)vs 82.0％(41/50)](P=0.025).After treatment,the levels of fasting blood glucose,glycated albumin and glycated hemoglobin in the two groups were lower than those before treatment,and the levels of fasting blood glucose,glycated albumin and glycated hemoglobin in the observation group were lower than those in the control group(all P＜0.05).After treatment,the levels of endothelin-1 in the two groups were lower than those before treatment,and the levels of calcitonin gene-related peptide(CGRP)and nitric oxide were higher than those before treatment.After treatment,the level of endothelin-1 in the observation group was lower than that in the control group,and the levels of CGRP and nitric oxide were higher 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=0.712).Conclusion Jinqi Jiangtang tablets combined with liraglutide injection has a good effect in the treatment of type 2 diabetes mellitus,which can improve the glucose metabolism and vascular endothelial function of patients,and has good safety.