Abstract:Objective To investigate the relationship between serum levels of heparin cofactor-Ⅱ(HC-Ⅱ)and dipeptidyl peptidase 4(DPP4)and coronary artery in-stent restenosis(ISR)after drug-coated balloon(DCB)dilation.Methods A total of 158 ISR patients who underwent DCB expansion in Yan'an University Affiliated Hospital from January 2021 to March 2023 were selected.The clinical data were collected,and the serum levels of HC-Ⅱ and DPP4 were detected by enzyme-linked immunosorbent assay.Taking ISR after DCB expansion in ISR patients as the dependent variable,a multivariate unconditional Logistic regression model was established to determine its influencing factors.Receiver operating characteristic(ROC)curve was drawn to evaluate the value of serum HC-Ⅱ and DPP4 levels in predicting ISR after DCB dilatation.Results After 1 year of follow-up,54 of 158 ISR patients(34.2％)with ISR after DCB expansion were included in the ISR group,and 104 patients were in the non-ISR group.Multivariate Logistic regression analysis showed that increased stenosis rate of the official carity,increased neutrophil to lymphocyte ratio and increased DPP4 were independent risk factors for ISR after DCB expansion,and increased HC-Ⅱ was an independent protective factor(all P＜0.05).The ROC curve showed that the area under the curve(AUC)of the combination of serum HC-Ⅱ and DPP4 levels in predicting ISR after DCB dilatation was 0.873,which was larger than 0.789 and 0.788 of HC-Ⅱ and DPP4 levels alone(all P＜0.05).Conclusion The decrease of serum HC-Ⅱ level and the increase of DPP4 level are closely related to ISR after DCB dilatation.The combination of serum HC-Ⅱ and DPP4 levels has a higher value in predicting coronary artery ISR after DCB dilatation in patients with ISR.

Abstract:Objective To investigate the relationship between serum purinergic receptor P2X7(P2RX7)and YTH structural domain N6-methyladenosine RNA binding protein 2(YTHDF2)and hemorrhagic transformation(HT)after intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods A total of 192 AIS patients admitted to Shaanxi Kangfu Hospital from January 2020 to December 2023 were selected as the AIS group(after thrombolysis,it was divided into hemorrhagic transformation group and non-hemorrhagic transformation group),and 150 healthy people in the same period were selected as the control group.Serum P2RX7 and YTHDF2 levels were detected by enzyme-linked immunosorbent assay.With HT after intravenous thrombolysis as the dependent variable,a Logistic regression model was established to determine the related factors of HT in AIS patients after intravenous thrombolysis.The receiver operating characteristic curve was drawn to evaluate the predictive value of serum P2RX7 and YTHDF2 levels for HT.Results The serum levels of P2RX7 and YTHDF2 in AIS group were higher than those in control group[(1.6±0.3)μg/L vs(1.2±0.3)μg/L,(1.32±0.26)μg/L vs(1.03±0.16)μg/L](both P＜0.001).The levels of serum P2RX7 and YTHDF2 in the hemorrhagic transformation group were higher than those in the non-hemorrhagic transformation group(both P＜0.001).Multivariate Logistic regression analysis model results showed that high National Institutes of Health Stroke Scale score,cardiogenic embolism,high P2RX7 level and high YTHDF2 level were independent risk factors for HT in AIS patients after intravenous thrombolysis(all P＜0.05).The area under the curve of serum P2RX7 combined with YTHDF2 for predicting hemorrhagic transformation was 0.886,which was larger than 0.780 and 0.784 predicted by P2RX7 or YTHDF2 alone(both P＜0.001).Conclusion Elevated serum P2RX7 and YTHDF2 levels are independent risk factors for HT in patients with AIS after intravenous thrombolysis,and serum P2RX7 combined with YTHDF2 detection has a high predictive value for HT.

Abstract:Gastric cancer is one of the most common malignant tumors in the digestive tract and is one of the leading causes of cancer-related death worldwide.Chemotherapy is the conventional treatment for advanced gastric cancer,and chemoresistance is an important reason for the poor prognosis of gastric cancer.Autophagy is a highly conserved metabolic process,which regulates the development and chemoresistance of gastric cancer.γ-aminobutyric acid type A receptor associated protein like 1(GABARAPL1)is a ubiquitin-like protein that plays an important role in autophagy.The axis of microRNA/long non-coding RNA/circular RNA-GABARAPL1 may play a key role in the development and chemoresistance of gastric cancer.In this review,the mechanism of autophagy regulated by GABARAPL1 and its role in the development and chemoresistance of gastric cancer are summarized in order to provide new ideas for the treatment of gastric cancer.

Abstract:Objective To explore the situation of pregnancy complicated with arrhythmia and its influence on the pregnancy outcome of pregnant women,in order to provide new ideas and theoretical basis for clinical practice.Methods The clinical data of 287 pregnant women who delivered in the Department of Obstetrics,Beijing Anzhen Hospital,Capital Medical University from January 1,2019 to December 31,2023 were collected and analyzed retrospectively.The pregnant women were divided into arrhythmia group(142 cases)and non-arrhythmia group(145 cases)according to whether they were complicated with arrhythmia.The differences in general data,laboratory tests indicators and pregnancy outcomes between the two groups were compared.Results The maternal age,pre-pregnancy body mass index,gravidity and prevalence of congenital heart disease in the arrhythmia group were greater/higher/more than those in the non-arrhythmia group,while the maternal height and gestational age were lower/less than those in the non-arrhythmia group(all P＜0.05).There were no significant differences in pre-pregnancy body weight and parity between the two groups(both P＞0.05).The levels of creatine kinase isoenzyme,high-density lipoprotein cholesterol and C-reactive protein in the arrhythmia group were higher than those in the non-arrhythmia group(all P＜0.05).There was no significant difference in total cholesterol and low-density lipoprotein cholesterol between the two groups(all P＞0.05).The rates of cesarean section,premature delivery and postpartum hemorrhage in the arrhythmia group were higher than those in the non-arrhythmia group,and the rate of natural delivery was lower than that in the non-arrhythmia group[82.4％(117/142)vs 17.2％(25/145),33.1％(47/142)vs0(0),17.6％(25/142)vs 0(0),17.6％(25/142)vs 82.8％(120/145)](all P＜0.05).Conclusion Pregnant women with arrhythmia have an increased risk of adverse pregnancy outcomes such as cesarean section,postpartum hemorrhage,and premature delivery,which should be paid attention to in clinical practice.

Abstract:Objective To observe the therapeutic effect of Anshen Buxin Liuwei pills combined with clopidogrel on patients with coronary atherosclerotic heart disease and angina pectoris(CHDA).Methods A total of 105 CHDA patients admitted to the Second Hospital of Heilongjiang Province from February 2023 to January 2024 were selected.According to the random number table method,they were divided into the control group(52 cases)and the observation group(53 cases).The control group was treated with clopidogrel on the basis of routine treatment,and the observation group was treated with Anshen Buxin Liuwei pills on the basis of the control group.Both groups were treated for 1 month.The clinical efficacy was evaluated after treatment,and the intervention and occurrence of angina pectoris,cardiac function index,hemorheology index,vascular endothelial function index 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[96.2％(51/53)vs 82.7％(43/52)](x2=5.126,P=0.024).After treatment,the single dosage of nitroglycerin,the number and duration of angina pectoris attack,left ventricular end-systolic diameter,plasma viscosity,whole blood high shear viscosity and low shear viscosity,and endothelin level in the two groups were less/shorter/smaller/lower than those before treatment,those in the observation group were less/shorter/smaller/lower than those in the control group,the left ventricular ejection fraction,cardiac output and nitric oxide levels were greater/higher than those before treatment,and those in the observation group were greater/higher 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 during the treatment[3.8％(2/53)vs 5.8％(3/52)](x2=0.191,P=0.663).Conclusions Anshen Buxin Liuwei pills combined with clopidogrel has good clinical effect in the treatment of CHDA,which can significantly reduce the incidence of angina pectoris,improve the cardiac function,hemorheology and vascular endothelial function of patients,and has good safety.

Abstract:Objective To investigate the effect of Yixintong tablets combined with atorvastatin in the treatment of hyperlipidemia.Methods A total of 102 patients with hyperlipidemia admitted to the Affiliated Hospital of Inner Mongolia Medical University from May 2021 to May 2024 were selected.According to the random number table method,they were divided into observation group and control group,with 51 cases in each group.The control group was treated with atorvastatin calcium tablets,and the observation group was treated with Yixintong tablets on the basis of the control group.The clinical efficacy,blood lipid index,vascular endothelial function,hemorheology index and treatment safety were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[92.2％(47/51)vs 74.5％(38/51)](P=0.017).After treatment,the levels of total cholesterol,triglyceride,low-density lipoprotein cholesterol,dimethyl-argenine,endothelin-1,whole blood viscosity,plasma viscosity,fibrinogen and hematocrit in the observation group were lower than those in the control group,and the level of high-density lipoprotein cholesterol was higher than that in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.505).Conclusion The effect of Yixintong tablets combined with atorvastatin in the treatment of hyperlipidemia is good,which can significantly reduce the blood lipid level of patients,improve the vascular endothelial function of patients,reduce blood viscosity,and the treatment safety is good.

Abstract:Objective To investigate the effect of traditional Chinese medicine therapy of Yiqi Wenyang Lishui on serum uric acid level in patients with chronic heart failure(CHF)complicated with hyperuricemia(HUA).Methods Totally 54 patients with CHF combined with HUA and Yang qi deficiency syndrome were selected from the Department of Cardiology,the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from May 2021 to April 2023.The patients were divided into the control group(24 cases,treated with conventional western medicine)and the observation group(30 cases,treated with Yiqi Wenyang Lishui on the basis of conventional western medicine)according to whether they took traditional Chinese medicine.The serum uric acid levels of the two groups were compared after treatment.The relationship between serum uric acid level and age,gender,left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)cardiac function classification,body mass index,whether complicated with hypertension,whether complicated with diabetes,whether with ischemic diseases history,whether taking anti-heart failure drugs,whether taking traditional Chinese medicine and other factors were analyzed.Results There was no significant difference in the level of uric acid between the two groups at baseline(P＞0.05).After treatment,the uric acid levels of the two groups were lower than those at baseline,and the decrease in the observation group was greater than that in the control group(all P＜0.05).After treatment,the serum uric acid level of the observation group decreased by 27.102 µmol/L more than that of the control group(β value was-27.102,95％confidence interval:-38.000--16.203,P＜0.001).The serum uric acid level of CHF patients with HUA was significantly positively correlated with age,LVEF,NYHA cardiac function classification,body mass index,and whether to take Yiqi Wenyang Lishui treatment traditional Chinese medicine(all P＜0.05).There was no significant correlation with gender,hypertension,diabetes,ischemic history,and use of anti-heart failure drugs(all P＞0.05).Conclusion Traditional Chinese medicine therapy of Yiqi Wenyang Lishui has a positive effect on improving serum uric acid level in CHF patients with HUA.

Abstract:Idiopathic pulmonary fibrosis(IPF)is a fatal lung disease characterized by progressive fibrosis of lung tissue,and its pathogenesis is not fully understood.Recent studies have found that a variety of signaling pathways play a key role in the occurrence and progression of IPF.Including transforming growth factor β,Wnt/β-catenin,mitogen-activated protein kinase,phosphatidylinositol 3 kinase/protein kinase B,Rho/Rho-associated kinase,Janus kinase/signal transducer and activator of transcription protein,mammalian target of rapamycin,etc.These pathways promote the process of pulmonary interstitial fibrosis by enhancing the proliferation,differentiation and extracellular matrix deposition of fibroblasts.However,many upstream and downstream signaling molecules have yet to be defined.In addition,cytokines such as vascular endothelial growth factor,fibroblast growth factor and platelet-derived growth factor also play an important role in the occurrence and development of IPF.An in-depth understanding of these signaling pathways and their interactions will help to provide new targets and strate-gies for early diagnosis and treatment of IPF.This article aims to summarize the current research progress and explore future research directions in order to provide a scientific basis for the clinical management of IPF.

Abstract:The human microecosystem plays an important role in regulating normal physiological functions and maintaining the stability of the internal environment.As an important immune organ of the human body,the liver is chronically exposed to the effects of circulating nutrients and endotoxin from the gut microbiota.The pathogenesis of autoimmune liver disease is not completely clear at present.In addition to autoimmune factors,in recent years,with the emergence of high-throughput sequencing and other technologies,through the continuous in-depth study of human microbiota,it has been found that gut and oral microbiota also play an important role in the occurrence,development and treatment of autoimmune liver disease.This article summarizes the characteristics of gut and oral microbiota in different autoimmune liver diseases and the positive therapeutic effect of regulating microbiota on autoimmune liver diseases.

Abstract:Neutrophilic asthma is often resistant to steroids and may progress to severe asthma.The key immune cell in neutrophilic asthma is T helper cell 17,which recruits neutrophils by secreting interleukin-17(IL-7)and promotes the occurrence and development of neutrophilic asthma.The nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome is an immunosensor complex composed of a variety of proteins,which plays a promoting role in the progression of neutrophilic asthma.Studies have shown that blocking NLRP3/IL-1 β/IL-17 signaling pathway has a certain effect on the treatment of this type of asthma.This article discusses the biological characteristics of NLRP3 inflammasome and its pathogenesis in neutrophilic asthma,and summarizes the research progress of targeting NLRP3 inflammasome in the treatment of neutrophilic asthma,aiming to provide a new perspective for the treatment of neutrophilic asthma.

Abstract:Objective To explore the risk factors of postoperative delirium in patients with severe multiple fracture trauma,and to establish and verify a nomogram model.Methods A total of 220 patients with severe multiple fracture trauma who were treated and operated in the 910th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army from January 2019 to December 2022 were selected as the modeling set.Another 94 patients with severe multiple fracture trauma from January to December 2023 were selected as the validation set.According to whether delirium occurred,the patients in the modeling set were divided into non-delirium group(147 cases)and delirium group(73 cases).The clinical data of non-delirium group and delirium group were compared.The risk factors of postoperative delirium were analyzed,and the accuracy of the nomogram model was established and verified.Results The age,injury severity(ISS)score,length of intensive care unit(ICU)stay,the proportions of patients with physical restraint,American Society of Anesthesiologists(ASA)gradeⅢ-Ⅳ,mechanical ventilation,and general anesthesia were significantly greater/higher in the delirium group than in the non-delirium group,and the preoperative albumin level was significantly lower in the delirium group than in the non-delirium group(all P＜0.05).Multivariate Logistic regression analysis showed that age ≥ 60 years,preoperative albumin ≤30 g/L,ASA grade Ⅲ-Ⅳ,ISS score ≥21,general anesthesia and ICU stay ≥9 days were independent risk factors for preoperative albumin(all P＜0.05).The receiver operating characteristic curve showed that the area under the curve of the modeling set and the validation set were 0.803(95％confidence interval:0.706-0.875)and 0.818(95％confidence interval:0.678-0.962),respectively,which showed good prediction accuracy.The calibration curve of the nomogram risk prediction model showed that the predictions of the modeling set and the validation set were in good agreement with the observations.The P values of Hosmer-Lemeshow test were 0.405 and 0.669,respectively,and the P values were not significant.Conclusion The nomogram risk prediction model based on age ≥60 years,preoperative albumin ≤30 g/L,ASA grade Ⅲ-Ⅳ,ISS score ≥21,general anesthesia and ICU stay ≥9 days has good accuracy in predicting postoperative delirium in patients with severe multiple fracture trauma,which can be used to guide clinical preventive intervention measures.

Abstract:Objective To investigate the relationship between antinuclear antibody,antinuclear antibody spectrum(ANAs),antiphospholipid antibodies(aPLs)and adverse pregnancy outcomes,and analyze the medication use.Methods The clinical data of 153 pregnant patients with positive antinuclear antibodies,ANAs or aPLs in the Second Affiliated Hospital of Kunming Medical University from January 2021 to May 2024 were retrospectively collected.The pregnancy outcomes were recorded,and the patients with adverse pregnancy outcomes were included in the observation group(80 cases),and the rest of the patients with good pregnancy outcomes were included in the control group(73 cases).The clinical data,antinuclear antibodies,ANAs,aPLs and medication during pregnancy were compared between the two groups.The binary Logistic regression model was used to analyze the risk factors of adverse pregnancy outcomes.Results There were significant differences in the history of previous pregnancy loss,gestational age,gravidity,proportion of cesarean section and neonatal admission to the neonatal department between the two groups(all P＜0.05).The positive rates of antinuclear antibody,anti-SSA antibody,anticardiolipin antibody,anti-β2 glycoprotein Ⅰ antibody(aβ2GPI)and antinuclear antibody combined with SSA in the observation group were higher than those in the control group(all P＜0.05).The proportion of drugs used during pregnancy in the observation group was lower than that in the control group[75.0％(60/80)vs 90.4％(66/73)](x2=6.238,P=0.013).Binary Logistic regression analysis showed that neonatal admission to the neonatal department,positive antinuclear antibody and positive aβ2GPI were risk factors for adverse pregnancy outcomes,and gestational age was a protective factor(all P＜0.05).Conclusion Abnormal antinuclear antibodies,ANAs and aPLs are found in pregnant patients.Early intervention and timely drug treatment should be used to reduce the occurrence of adverse pregnancy outcomes and ensure the safety of mother and child.

Abstract:Objective To investigate the causes and management measures of lower limb deep venous thrombosis(DVT)in patients undergoing urology surgery.Methods From June 2016 to June 2023,the clinical data of 58 patients with lower limb DVT after surgery at Department of Urology,Beijing Shijitan Hospital,Capital Medical University were retrospectively analyzed.The treatment results and prognosis were summarized.Results Of the 58 patients,50 cases(86.2％)were malignant tumors after resection.Thirty-nine cases(67.2％)were overweight or obese,and 30 cases(51.7％)were smokers.Among them,42 cases had no obvious clinical symptoms and were found during screening for D-dimer,and 16 cases had varying degrees of lower limb pain,swelling,limited mobility,pale skin,and positive gastrocnemius muscle grip test.All 58 patients were given bed rest,with the affected limb elevated by 20°-30°.Low molecular weight heparin calcium was administered subcuta-neously at a dose of 85 IU/kg every 12 h for a treatment period of 10-14 d.Warfarin was also administered orally at a dose of 3 mg/time once a day for the next 3 d.Warfarin was maintained for 3-6 months.All 58 patients were successfully treated with conservative treatment.One patient developed pulmonary embolism 2 d after operation and was treated with inferior vena cava filter implantation,and the thrombus disappeared 6 months later.All patients were followed up for(20±14)months,and no DVT recurrence,cerebral infarction and other serious complica-tions occurred.One patient with ureteral cancer died of cancer recurrence and metastasis 9 months after surgery.Conclusion The incidence of lower limb DVT after urological surgery is not low.The risk factors of lower limb DVT include radical resection of malignant tumors,obesity,smoking and so on.Postoperative detection of D-dimer level is beneficial to the early detection of lower limb DVT.Once lower limb DVT occurs,it should be treated actively.The effect of anticoagulation with low molecular weight heparin after operation is better.

Abstract:Objective To investigate the effects of lung protective ventilation strategy on perioperative lung compliance and oxygenation function in patients undergoing gynecological open surgery in plateau area.Methods Sixty patients who underwent gynecological open surgery in Qinghai Red Cross Hospital in the plateau region from December 2023 to December 2024 were selected.According to the random number table method,they were divided into conventional ventilation group(group C)and lung protective ventilation group(group L),with 30 cases in each group.In group C,the tidal volume was 10 ml/kg,and there was no positive end-expiratory pressure and lung recruitment maneuverduring the operation.In group L,the tidal volume was 6-8 ml/kg,positive end-expiratory pressure was 5 cmH2O,and lung recruitment maneuvers were performed every 30 minutes.The peak airway pressure,mean airway pressure,lung compliance and vital signs were compared between the two groups at 5 min after anesthesia induction intubation(T1),1 h after mechanical ventilation(T2)and before surgical extubation(T3).Arterial blood samples were collected at each time point for blood gas analysis.Arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),alveolo-arterial partial pressure of oxygen(PA-aDO2),oxygenation index and the ratio of dead space to tidal volume were compared.Results The levels of the end-tidal carbon dioxide partial pressure at T2 and T3 in group L were significantly higher than those in group C(both P＜0.05).The peak airway pressure and mean airway pressure at T2 and T3 in group L were significantly lower than those in group C,and the lung compliance was significantly higher than that in group C[(56±16)L/cmH2O vs(47±9)L/cmH2O,(56±16)L/cmH2O vs(46±9)L/cmH2O](all P＜0.05).Compared with T,,PaO2 and oxygenation index at T2 and T3 were significantly decreased in the two groups,PA-aDO2 and the ratio of ineffective cavity to tidal volume increased significantly,PaCO2 decreased significantly at T2 and T3 in group C,and PaCO2 increased significantly at T2 and T3 in group L(all P＜0.05).PaO2,PaCO2 and oxygenation index at T2 and T3 in group L were significantly higher than those in group C,while PA-aDO2 was significantly lower than that in group C(all P＜0.05).Conclusion Lung protective ventilation strategy can significantly improve perioperative lung compliance and oxygenation function in patients undergoing gynecological open surgery in plateau area,and reduce the incidence of postoperative pulmonary complications.

Abstract:Objective To explore the effects of levocarnitine combined with maintenance hemodialysis(MHD)on inflammatory factors levels and cardiac function in patients with chronic kidney disease(CKD).Methods A total of 106 CKD patients treated with dialysis in the First Affiliated Hospital of Hebei North University from June 2022 to September 2023 were prospectively selected as the research objects.According to the random number table method,they were divided into the control group and the observation group,with 53 cases in each group.The control group was treated with MHD,and the observation group was treated with levocarnitine combined with MHD.Both groups were treated for 3 months.The levels of inflammatory factors,renal function,cardiac function,Klotho protein and irisin before and after treatment were compared between the two groups,and the correlation between the levels of inflammatory factors and cardiac function indexes was analyzed.Results The improvement of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),left ventricular ejection fraction(LVEF),brain natriuretic peptide,cardiac output,Klotho protein and irisin levels in the observation group were better than those in the control group 3 months after treatment(all P＜0.05).At the same time,the levels of blood uric acid,blood urea nitrogen and serum creatinine in the observation group were lower than those in the control group at 1 month and 3 months after treatment(all P＜0.05).Pearson analysis showed that CRP was positively correlated with brain natriuretic peptide(all P＜0.05).TNF-α was negatively correlated with LVEF and cardiac output,and positively correlated with brain natriuretic peptide(all P＜0.05).IL-6 was negatively correlated with LVEF and cardiac output,and positively correlated with brain natriuretic peptide(all P＜0.05).The incidence of complications during dialysis in the observation group was lower than that in the control group[3.8％(2/53)vs 15.1％(8/53)](P=0.046).Conclusion Levocarnitine combined with MHD treatment in patients with CKD can better improve the inflammatory state,reduce the cardiac load,and reduce the incidence of dialysis-related complications.

Abstract:Objective To investigate the prognostic value of blood urea nitrogen to albumin ratio(BAR)in patients with acute myocardial infarction(AMI)complicated with ventricular arrhythmias(VA).Methods A total of 954 patients diagnosed with AMI complicated with VA in Beijing Anzhen Hospital,Capital Medical University from January 2019 to January 2024 were retrospectively selected.They were divided into survival group(696 cases)and death group(258 cases)according to death within 30 d.Logistic regression analysis and subgroup analysis were used to evaluate the correlation between BAR and 30 d mortality of patients,and a nomogram model was constructed.The receiver operating characteristic curve,Kolmogorov-Smirnov curve,calibration curve and learning curve were used for model evaluation.Results The BAR in the death group was higher than that in the survival group[13.8(8.6,20.3)vs 7.3(4.9,11.9)](P＜0.001).Logistic regression analysis showed that BAR＞8.45 was an independent risk factor for death within 30 d in patients with AMI and VA(all P＜0.05).In the training set,multivariate Logistic regression analysis showed that BAR＞8.45,age,systolic blood pressure,lactate dehydrogenase,respiratory rate,body temperature,acute kidney injury and stroke were independent risk factors for death within 30 d in AMI patients with VA(all P＜0.05).A nomogram model was constructed based on the above influencing factors.In the training set,validation set and test set,the area under the curve of the model was 0.81,0.80 and 0.79,respectively.The calibration curve and Kolmogorov-Smirnov curve suggested that the model had good fit and discrimination.Conclusion BAR is an independent risk factor for all-cause death within 30 d in AMI patients with VA.

Abstract:Objective To explore the cognition of chronic kidney disease patients on disease prognosis and traditional Chinese medicine treatment from the perspective of"knowledge,belief and action".Methods A total of 21 patients with chronic kidney disease who visited the Department of Nephrology Endocrinology,Dongzhimen Hospital,Beijing University of Chinese Medicine from January to February 2025 were interviewed by semi-structured in-depth interviews.The Colaizzi seven-step method was used to analyze and refine the data,and Maxqda 2022 software was used to assist data sorting and data coding.Results In this study,the data was saturated when the 21st patient was interviewed,including 8 males and 13 females,aged 29 to 76 years,and the course of disease was 3 to 420 months.The patients had insufficient cognition of the development and prognosis of the disease,and the recognition of traditional Chinese medicine treatment was high,and the advantages of traditional Chinese medicine treatment were prominent.They had high expectations and confidence in disease treatment,and traditional Chinese medicine treatment was widely accepted and trusted.Patients' self-management is biased,and their diet and daily life need to be standardized.Conclusion There is a contradiction among the ambiguity of patients' cognition of the disease and prognosis,their high confidence and high expectations in treatment,and the deviation of self-management behaviors.It is necessary to strengthen health education to improve the conflict between insufficient cognition and high expectations.Promoting the treatment of traditional Chinese medicine,giving full play to its characteristic advantages,constructing a collaborative intervention model of"cognition-belief-behavior",and forming a virtuous cycle of"knowledge,belief and action"can provide the wisdom of traditional Chinese medicine for the management of chronic diseases.

Abstract:Tic disorders are common neuropsychiatric disorders in children and adolescents.They are often accompanied by one or more comorbidities,which increase the difficulty of disease diagnosis and treatment and have become the focus of attention in recent years.Tic disorders comorbid with obsessive-compulsive disorder is a common comorbidity in clinical practice.Studies have shown that there is a complex bidirectional causal relationship between tic disorders and obsessive-compulsive disorder.Comorbid obsessive-compulsive disorder increases the complexity and difficulty of diagnosis and treatment of tic disorders,resulting in reduced clinical treatment effect and prolonged course of disease.It has become a major problem in the clinical treatment of tic disorders and an important cause of refractory tic disorders.It has attracted wide attention in the world,but there is relatively little attention in domestic academic circles.This article reviews the latest global literature on the clinical characteristics,etiology,pathogenesis and clinical treatment of tic disorders comorbid with obsessive-compulsive disorder,aiming to provide a reference for related research on tic disorders comorbid with obsessive-compulsive disorder.

Abstract:Objective To investigate the eradication rate and safety of bismuth-based quadruple therapy containing minocycline and levofloxacin in newly diagnosed patients with Helicobacter pylori(Hp)infection.Methods A total of 280 patients with Hp infection who were initially treated in Beijing Jishuitan Hospital,Capital Medical University from January 2022 to October 2023 were enrolled.According to the random number table method,they were divided into minocycline and levofloxacin group(observation group)and amoxicillin and clarithromycin group(control group),with 140 cases in each group.Both groups were combined with rabeprazole and bismuth potassium citrate to form a quadruple regimen for 14 days.The medication safety and compliance of patients were followed up for 3 to 5 days after the end of medication.Hp eradication rate was determined by 13C urea breath test after 4 to 12 weeks.Results Intention-to-treat(ITT)analysis(One case was excluded in the study due to refusal to take medication,afterwards 139 cases in the observation group and 140 cases in the control group)and protocol-following(PP)analysis(after removing the subsequently excluded patients,both the observation group and the control group had 134 cases)showed that the eradication rates of the observation group were higher than those of the control group[ITT analysis:92.1％(128/139)vs 80.7％(113/140),x2=7.667,P=0.006;PP analysis:95.5％(128/134)vs 84.3％(113/134),x2=9.267,P=0.002].Age,sex,body mass index,endoscopic findings and smoking had no significant effect on the eradication rate(all P＞0.05).The proportion of abnormal taste in the observation group was lower than that in the control group(P＜0.05).There was no significant difference in other adverse reactions between the two groups(all P＞0.05).Conclusion The bismuth-based quadruple therapy containing minocycline and levofloxacin has an ideal eradication rate,safety and compliance in Hp naive patients.

Abstract:Objective To explore the predictive value of alanine aminotransferase(ALT)jump combined with hepatitis B surface antigen(HBsAg)decline for functional cure in chronic hepatitis B(CHB)patients treated with nucleotide analogues(NAs)sequential pegylated interferon(Peg-IFN)and establish a prediction model.Methods CHB patients who visited the Affiliated Hospital of Xuzhou Medical University from July 2019 to December 2022,were HBsAg positive for more than 6 months,hepatitis B virus(HBV)DNA≤3.3 log10IU/ml and received NAs antiviral therapy for at least 1 year,combined with Peg-IFN for 48 weeks,were retrospectively enrolled.The analysis was based on the baseline to 12 weeks alanine aminotransferase(ALT)jump(2-fold increase from baseline)and HBsAg decline(decrease from baseline).HBsAg response was defined as HBsAg＜3.2 and a decrease of＞1.0 log10IU/ml at 24 weeks.HBsAg＜2.0 log10IU/ml at 48 weeks was used as the efficacy evaluation index,and the predictive factors of HBsAg response were analyzed and a prediction model was constructed.The receiver operating characteristic curve was used to evaluate the model fitting effect.Results A total of 145 CHB patients treated with NAs followed by Peg-IFN were included in the study.Forty of 50 HBsAg responders at 24 weeks had HBsAg＜2.0 log10IU/ml at 48 weeks of treatment,with a positive predictive value(PPV)of 80.0％,and 19 of them(38.0％)achieved HBsAg loss.Multivariate Logistic regression analysis showed that baseline HBsAg(odds ratio=11.306,95％confidence interval:3.959-32.288,P＜0.001),baseline to week 12 ALT jump(odds ratio=3.435,95％confidence interval:1.107-10.659,P=0.033),and HBsAg decreased at 12 weeks(odds ratio=54.775,95％confidence interval:5.941-505.028,P＜0.001)were independent predictors of HBsAg response.The prediction model was established as follows:Logit P=2.425 × baseline HBsAg+4.003 × HBsAg decreased+1.234 × ALT flared-5.776(BHA model),its area under the curve was 0.843,the standard error was 0.037,95％confidence interval:0.769-0.916,according to the calculation formula of Jorden index,the cutoff value of P value was determined to be 0.51,and the sensitivity and specificity of its diagnosis were 86.70％and 67.30％.Conclusion Baseline HBsAg level,ALT jump combined with HBsAg decline at 12 weeks of treat-ment are associated with HBsAg response in CHB patients treated with NAs sequential Peg-IFN.The prediction model constructed by the above indicators can screen out patients who are likely to achieve functional cure at 48 weeks of combination therapy.