Abstract:Objective To investigate the effect of luteolin,the active ingredient in the alcohol extract of Prunella vulgaris,on the proliferation and migration of optic nerve glioma(ONG)cells,and to reveal its potential mechanism of action for tumor treatment.Methods The cultured U87-MG glioma cells were grouped for treat-ment.The control group was treated with dimethyl sulfoxide,and the 10,20,40 and 60 μmol/L luteolin treatment groups were treated with 10,20,40 and 60 μmol/L luteolin,respectively.The temozolomide treatment group was treated with 100 μmol/L temozolomide.The proliferation,migration and colony formation ability of U87-MG cells in different treatment groups were detected by scratch assay,colony formation assay and cell counting kit-8 assay.Real-time fluorescent quantitative polymerase chain reaction and Western blotting were used to detect the mRNA and protein expression of phosphatidylinositol-3-kinase(PI3K)/protein kinase B(AKT)pathway-related genes,PI3K catalytic subunit γ(PIK3CG),AKT,vimentin and N-cadherin.Results Luteolin could significantly inhibit the migration,clonogenesis and proliferation of U87-MG glioma cells,and the differences were statistically significant compared with the control group(all P＜0.05).With the increase of luteolin concentration,the inhibitory effect was gradually enhanced,and the inhibitory effect of temozolomide group was significantly lower than that of luteolin group(all P＜0.05).The PI3K/AKT pathway gene PIK3CG mRNA expressions in glioma U87-MG cells treated with 10,20,40,60 μmol/L luteolin and temozolomide for 24 h were significantly lower than those in the control group[(0.236±0.016),(0.199±0.016),(0.143±0.058),(0.103±0.014),(0.458±0.014)vs(0.977±0.023)](all P＜0.05).With the increase of luteolin concentration,the expression of PIK3CG mRNA decreased gradually.Although the decrease of temozolomide group was not as great as that of luteolin group,the difference between temozolomide group and control group was more than 2 times.However,the expressions of AKT,vimentin and N-cadherin mRNA were not affected.Western blot results showed that compared with the control group,the expression level of PIK3CG protein in luteolin groups was also significantly decreased.The expression of PIK3CG protein in luteolin group was gradually decreased with the increase of luteolin concentration,and the expression of PIK3CG protein in temozolomide group was also decreased,but the reduction ratio was not as obvious as that in luteolin group.The results of this protein detection were consistent with the results of mRNA.Conclusion This study confirmed that luteolin can effectively inhibit the proliferation and migration of glioma cells,and may regulate the PI3K/AKT pathway through the low expression of PIK3CG,thereby affecting the proliferation and migration of ONG cells.This study provides an experimental basis for the treatment of ONG with luteolin from the alcohol extract of Prunella vulgaris,reveals the application value of luteolin as a potential drug for the treatment of ONG,and provides a solid theoretical basis for its clinical transformation.

Abstract:Objective To investigate the changes of cardiac indexes and cardiac function in pregnant women with pulmonary hypertension associated with congenital heart disease(CHD-PAH)during pregnancy and 6 months after delivery.Methods A total of 75 pregnant women with CHD-PAH who delivered in Beijing Anzhen Hospital,Capital Medical University from August 2018 to December 2022 were selected as the research objects.The pregnant women with CHD-PAH were grouped according to the results of prenatal echocardiography.According to pulmonary artery systolic pressure(SPAP),the patients were divided into mild group(41 cases),moderate group(22 cases)and severe group(12 cases).The pregnancy outcomes of the three groups were observed,and the changes of cardiac indexes and cardiac function during pregnancy and 6 months after delivery were analyzed.Results The gestational weeks of termination of pregnancy in the moderate group and the severe group were less than those in the mild group,the proportion of cesarean section and premature delivery were higher than those in the mild group,and the amount of postpartum hemorrhage in the severe group was more than that in the mild group(all P＜0.05).The birth weight of neonates in the severe group was lower than that in the mild group,the proportions of low birth weight infants in the moderate and severe groups was higher than that in the mild group,and the proportion of neonatal asphyxia in the severe group was higher than that in the mild group(all P＜0.05).The SPAP of the moderate and severe groups before pregnancy/early pregnancy,prenatal and 6 months after delivery were higher than those of the mild group(all P＜0.05),but there was no significant difference in SPAP among different time points within each group(all P＞0.05).There were no significant differences in left ventricular end-diastolic diameter,right atrial area and brain natriuretic peptide level among the three groups at each time point(all P＞0.05).The follow-up results showed that the cardiac function of 1 case in the moderate group and 4 cases in the severe group changed from grade Ⅲ-Ⅳ to grade Ⅰ-Ⅱ,and there was no significant difference in the proportion of grade Ⅰ-Ⅱ of cardiac function in the mild,moderate,and severe groups[100.0％(41/41),100.0％(22/22)and 91.7％(11/12)](P=0.70).The long-term follow-up proportion of cardiac function grade Ⅲ-Ⅳ in the severe group was lower than that in the prenatal period[91.7％(11/12)vs 41.7％(5/12)](P＜0.05).Conclusions The SPAP of pregnant women with severe CHD-PAH increases during pregnancy and decreases at 6 months after delivery,but it is still higher than the SPAP level of pregnancy/early pregnancy,and the cardiac function recovers well in long-term follow-up.The incidence of adverse maternal and fetal outcomes in pregnant women with severe CHD-PAH is high.The comprehensive use of cardiac diuretics,vasoactive agents and targeted drugs can effectively reduce the mortality of pregnant women with CHD-PAH,but patients with severe PAH are still contraindications to pregnancy,and it is recommended to avoid pregnancy.

Abstract:Objective To investigate the clinical characteristics,effective diagnosis and treatment methods and possible high risk factors of ovarian pregnancy,and to reduce misdiagnosis and missed diagnosis.Methods The clinical data of 32 patients with ovarian pregnancy diagnosed by surgery in Beijing Friendship Hospital,Capital Medical University from January 2013 to December 2023 were collected and analyzed.The related risk factors,surgical and pathological characteristics of the cases were analyzed,and the experience of diagnosis and treatment of ovarian pregnancy was summarized.Results Ovarian pregnancy could occur in all ages of childbearing age.The main clinical manifestations were amenorrhea,abdominal pain and vaginal bleeding.The preoperative clinical accurate diagnosis rate was low,and there were some cases of misdiagnosis.Eight cases were diagnosed with diseases other than ectopic pregnancy,such as intrauterine device displacement,pelvic inflammatory disease,and gastroenteritis,after visiting external hospitals or internal medicine departments.Before operation,only one case was clinically diagnosed as ovarian pregnancy,and the rest were diagnosed as tubal pregnancy.Thirty-one cases(96.9％)underwent gynecological ultrasound examination before operation.Only 2 cases described that the lesion was located in the ovary,and 3 cases suggested that the lesion was closely related to the ovary.There were also difficulties in intraoperative diagnosis:23 cases(71.9％)underwent laparoscopic exploration surgery,and 9 cases(28.1％)underwent laparotomy surgery.Twenty-one cases(65.6％)were clinically and pathologically consistent with ovarian pregnancy during and after surgery.Four cases(12.5％)showed no obvious villi during surgery,but corpus luteum was visible,suggesting ovarian corpus luteum rupture with pregnancy.Postoperative pathology suggested ovarian pregnancy,and the diagnosis of ovarian pregnancy was revised after surgery.Three cases(9.4％)showed ovarian rupture during surgery,with corpus luteum tissue visible around the rupture and no obvious chorionic tissue.Postoperative pathology suggested the presence of chorionic villi in abdominal hematoma,and both intraoperative and postoperative diagnoses considered ovarian pregnancy.Four cases(12.5％)underwent intraoperative exploration of both fallopian tubes,all of which were intact and showed ovarian rupture.No obvious corpus luteum rupture was observed during the operation,and the intraoperative diagnosis considered ovarian pregnancy rupture.All postoperative pathology showed no placental villi or trophoblast cells,and the postoperative chorionic gonadotropin(hCG)decreased satisfactorily.Ovarian pregnancy was still considered in the postoperative diagnosis.All patients underwent wedge resection of the affected ovary,and the patient's blood hCG decreased satisfactorily after surgery.No patients underwent secondary surgery.Conclusion Ovarian pregnancy is a rare type of emergency in obstetrics and gynecology,but intra-abdominal bleeding can endanger the life of pregnant women.Improving awareness and combining medical history,ultrasound examination,and blood hCG can improve preoperative diagnosis and treatment rates,so as to develop effective diagnosis and treatment plans more quickly.Laparoscopic ovarian wedge resection is safe and effective,and postoperative follow-up of blood hCG is necessary.

Abstract:Objective To investigate the effect of Mongolian medicine Eridun Wurile on prothrombotic state(PTS)and quality of life in elderly patients with hypertension.Methods From January 2023 to February 2024,60 elderly patients with hypertension were selected from the outpatient and inpatient Department of Mongolian Medicine,People's Hospital of Inner Mongolia Autonomous Region.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 amlodipine besylate tablets,and the observation group was treated with Mongolian medicine Eridun Wurile on the basis of the control group.Both groups were treated for 8 weeks.The levels of PTS molecular markers(four items of blood coagulation,D-dimer),quality of life scale scores,blood pressure and safety indicators were observed before and after treatment in the two groups.Results Among the 60 patients,1 case dropped out of the observation group,1 case was lost to follow-up in the control group,and 58 cases completed the trial,with a dropout rate of 3.3％(2/60).There were statistically significant differences in four items of coagulation and D-dimer before and after treatment in the observation group(all P＜0.05).After treatment,the differences of fibrinogen and D-dimer in the observation group were greater than those in the control group[1.46(1.23,1.85)g/L vs 0.06(0.02,0.14)g/L,0.16(0.13,0.22)mg/L vs 0.03(0.02,0.04)mg/L](both P＜0.05).There were statistically significant differences in systolic blood pressure and diastolic blood pressure in the two groups between before and after treatment(all P＜0.05).There were statistically significant differences in the scores of each dimension of the quality of life scale before and after treatment in the observation group(all P＜0.05).There were statistically significant differences in the scores difference before and after treatment of physiological symptoms,working status and interpersonal sensitivity between the two groups(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.313).Conclusions Mongolian medicine Eridun Wurile combined with amlodipine besylate tablets has a certain effect on the improvement of PTS molecular markers and quality of life in elderly patients with hypertension,and the improvement of fibrinogen,D-dimer,physiological symptoms,working status,interpersonal sensitivity and other indicators is significantly better than amlodipine besylate monotherapy.

Abstract:Objective To investigate the effect of Jianpi Buxue granules combined with trivitamins ferrous chewable tablets in the treatment of iron deficiency anemia during pregnancy.Methods A total of 168 patients with iron deficiency anemia during pregnancy admitted to the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Shaanxi University of Chinese Medicine from March 2022 to December 2023 were selected as the research objects.A total of 168 patients with iron deficiency anemia during pregnancy were divided into control group and observation group by random number table method,with 84 cases in each group.The control group was treated with tri vitamins ferrous chewable tablets,and the observation group was treated with Jianpi Buxue granule on the basis of the control group.Both groups were treated for 1 month.The therapeutic effects,anemia indexes,iron metabolism indexes,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.2％(80/84)vs 85.7％(72/84)](x2=4.421,P=0.035).After 1 month of treatment,the levels of hemoglobin,mean corpuscular volume and mean corpuscular hemoglobin in the two groups were higher/greater than those before treatment,and those in the observation group were higher/greater than those in the control group(all P＜0.05).After 1 month of treatment,the ferritin levels of the two groups were higher than those before treatment,and the serum soluble transferrin receptor and total iron binding capacity were lower than those before treatment;the ferritin level of the observation group was higher than that of the control group,and the serum soluble transferrin receptor and total iron binding capacity were lower than those of 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[7.1％(6/84)vs 4.8％(4/84)](x2=0.425,P=0.514).Conclusion Jianpi Buxue granule combined with trivitamins ferrous chewable tablets is more effective in the treatment of iron deficiency anemia during pregnancy,which can effectively improve hemoglobin,mean corpuscular volume and mean corpuscular hemoglobin level,supplement the body's iron reserve,improve iron metabolism indicators,and has few and mild adverse reactions.

Abstract:At present,with the increasing incidence of chronic diseases such as hypertension,diabetes,and renal failure,these adverse factors significantly promote the pathological process of coronary artery calcification(CAC).Although the technology of coronary intervention has made significant progress,CAC lesions are still a major challenge in the field of interventional therapy.This article discusses the mechanism of CAC and analyzes the characteristics of intimal calcification and outer membrane calcification.At the same time,the application characteristics of various imaging techniques in CAC imaging are systematically reviewed,including coronary CT angiography,coronary angiography,intravascular ultrasound,optical coherence tomography,etc.In addition,this article describes the application value of non-compliance balloon,ultra-high pressure non-compliance balloon,cutting balloon,rotational atherectomy,and endovascular lithotripsy in the treatment of different CAC lesions.The aim of this study is to provide a scientific and effective reference for interventional radiologists to manage CAC lesions.

Abstract:Serum uric acid is the end product of the metabolism of purine compounds in humans and apes.Some epidemiological studies have shown that elevated serum uric acid is associated with gout attack,cardiovascular disease(including hypertension,coronary atherosclerotic heart disease,atrial fibrillation),metabolic syndrome,insulin resistance,obesity,non-alcoholic fatty liver disease and chronic kidney disease.At the same time,a large number of studies have shown that serum uric acid is closely related to the occurrence and development of heart failure with preserved ejection fraction(HFpEF).Control of serum uric acid can improve the prognosis and survival rate of HFpEF patients.Clarifying the effect and related mechanism of serum uric acid on HFpEF has important clinical value for disease assessment and prognosis.

Abstract:Objective To investigate the relationship between serum syndecan-1(SDC-1)and peptidyl arginine deiminase2(PAD2)levels and the condition and prognosis of patients with septic shock(SS).Methods A total of 124 SS patients(SS group)admitted to the Department of Intensive Care Unit,the Fifth Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2024 and 53 healthy subjects(control group)in the same period were selected.SS patients were divided into mild SS group(33 cases),moderate SS group(42 cases)and severe SS group(49 cases)according to the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score.According to the 28 d prognosis,they were divided into death group and survival group.The levels of serum SDC-1 and PAD2 were detected by enzyme-linked immunosorbent assay.Spearman correlation coefficient was used to analyze the correlation between serum SDC-1,PAD2 levels and APACHE Ⅱ score in SS patients.With the prognosis of SS as the dependent variable,multivariate unconditional Logistic regression was used to determine the influencing factors.Receiver operating characteristic curve was drawn to evaluate the predictive value of serum SDC-1 and PAD2 levels on the death of SS patients.Results The levels of SDC-1 and PAD2 in SS group were higher than those in control group[(17.2±3.4)pg/L vs(9.5±2.1)pg/L,(43±6)μg/L 比(29±5)pg/L](both P＜0.001).The serum levels of SDC-1 and PAD2 in severe SS group were higher than those in moderate and mild SS groups,and those in moderate SS group were higher than those in mild SS group(all P＜0.001).The serum levels of SDC-1 and PAD2 in SS patients were positively correlated with APACHE Ⅱ score(rs=0.840,0.846,both P＜0.001).Among 124 SS patients,51 patients died(death group)and 73 patients survived(survival group)at 28 days.Logistic regression analysis showed that duration of mechanical ventilation ≥3 days,increased APACHE Ⅱ score,increased SDC-1 and PAD2 were independent risk factors for death in SS patients,and increased oxygenation index was an independent protective factor(all P＜0.05).The area under the ROC curve of the combination of serum SDC-1 and PAD2 in predicting the death of SS patients was 0.869,which was larger than 0.779 and 0.784 of serum SDC-1 and PAD2 alone(both P＜0.05).Conclusion The increased levels of serum SDC-1 and PAD2 are related to the aggravation and poor prognosis of SS patients.The combination of serum SDC-1 and PAD2 levels has a higher value in predicting the death of SS patients.

Abstract:Kawasaki disease is a systemic vasculitis disorder that commonly affects children,according to traditional Chinese medicine,the cause and mechanism of Kawasaki disease are due to internal invasion of warm toxin,insufficiency of vital energy,and disharmony of defensive and protective qi.In contrast,Western medicine believes that the onset of Kawasaki disease is related to disorders of the immune system and microbial infections.In recent years,the combination of traditional Chinese medicine and Western medicine has provided new ideas and choices for the treatment of Kawasaki disease,which is expected to further improve the treatment effect and quality of life for children.This paper aims to explore the application and clinical effects of the combination of traditional Chinese medicine and Western medicine in the treatment of Kawasaki disease by reviewing recent relevant litera-ture.It is hoped that this will provide reference for further in-depth research and clinical practice,promote early diagnosis and treatment of Kawasaki disease,and improve the quality of life of children.

Abstract:Although the treatment of ovarian cancer is constantly being optimized,surgery combined with chemotherapy is still the main treatment for epithelial ovarian cancer.The application of RO cytoreductive surgery combined with individualized chemotherapy has greatly improved the 5-year survival rate of some patients,but the 5-year survival rate of patients with advanced ovarian cancer is still lower than 30％.Resistance to chemotherapy is the main reason for the high mortality of ovarian cancer patients.Reversing the resistance of ovarian cancer is an urgent problem for clinical and scientific researchers.The mechanisms of drug resistance in ovarian cancer are complex,including drug transport,drug metabolism,apoptosis,DNA damage repair,epigenetic changes,etc.In addition,multidrug resistance,autophagy,tumor metabolic reorganization,immunity,and cancer stem cells also play an important role in ovarian cancer drug resistance.Based on the deep understanding of various drug resist-ance mechanisms,combination therapy has a wide application prospect in improving chemotherapy sensitivity and prognosis of patients.This article reviews the current research progress on the pathogenesis and treatment strategies of platinum-resistant ovarian cancer.

Abstract:Objective To explore the risk factors of cardiogenic shock(CS)in patients with acute exacer-bation of chronic heart failure(ACHF),and to construct and verify a Nomogram prediction model.Methods A total of 216 ACHF patients admitted to Second Affiliated Hospital of Naval Medical University from June 2022 to June 2024 were retrospectively selected.According to the presence or absence of CS,the patients were divided into CS group(38 cases)and non-CS group(178 cases).Multivariate Logistic regression was used to analyze the risk factors of ACHF patients with CS,and a Nomogram prediction model was constructed based on the risk factors.Consistency index,calibration curve and decision curve analysis were used to evaluate the prediction accuracy,fit degree and clinical utility of the Nomogram prediction model.Results Multivariate Logistic regression analysis showed that atrial fibrillation,tricuspid regurgitation,deteriorating renal function and high level of N-terminal pro-brain natriuretic peptide(NT-proBNP)were risk factors for CS in ACHF patients(all P＜0.05).The Nomogram prediction model was constructed based on Logistic regression risk factors,and it was verified that the prediction model showed good discrimination(the area under the curve was 0.893,with 95％confidence interval of 0.844 to 0.931,P＜0.05)and calibration(C-index was 0.902,mean absolute error was 0.003).Decision curve analysis showed that the net benefit of the prediction model was high,suggesting high clinical applicability.Conclusion Deterioration of renal function,atrial fibrillation,tricuspid regurgitation and high level of NT-proBNP are risk factors for CS in ACHF patients.The prediction model based on the above risk factors has high prediction accuracy and clinical applicability.

Abstract:Objective To investigate the median effective dose(ED50)of dezocine to inhibit the response to modified nasopharyngeal airway insertion during hysteroscopic surgery in elderly female patients when combined with remimazolam.Methods Twenty-eight patients,aged 60-75 years,American Society of Anesthesiologists grade Ⅱ-Ⅲ,scheduled for elective hysteroscopic surgery in Beijing Tongren Hospital,Capital Medical University from February to April 2024,were selected.Dezocine 0.15 mg/kg was injected,and 10 minutes later atropine 0.3 mg,dexamethasone 5 mg and remimazolam 0.3 mg/kg were injected intravenously.When the eyelash reflex disappeared and the patient's state index was less than 50,a fully lubricated modified nasopharyngeal airway was inserted through the nasal cavity.The dose of dezocine in the next patient was determined by sequential method.If there was a positive reaction when the nasopharyngeal airway was inserted,the dose of dezocine in the next patient was increased by 0.01 mg/kg,otherwise the dose of dezocine was decreased by 0.01 mg/kg.The first patient with a positive nasopharyngeal airway reaction was considered the first patient to enter the trial,and this process was repeated until seven turning points had been reached.The ED50 and 95％confidence interval of dezocine inhibiting response to modified nasopharyngeal airway insertion in elderly patients were calculated when combined with remimazolam.The occurrence of adverse reactions during induction was recorded.Results One patient was excluded from this study because of poor ventilation after insertion of the nasopharyngeal airway,which was changed to laryngeal mask airway during the operation.The remaining 27 patients completed the trial,and the ED50(95％confidence interval)of dezocine inhibiting response to modified nasopharyngeal airway insertion was 0.105(0.087-0.114)mg/kg when combined with remimazolam.No adverse reactions such as nasopharyngeal pain,hypoxemia,drowsiness,nausea and vomiting,and respiratory depression occurred in the enrolled patients.One patient had transient dizziness after extubation and recovered after full recovery in the recovery room.Conclusion When combined with 0.3 mg/kg remimazolam,the ED50(95％confidence interval)of dezocine inhibiting the modified nasopharyngeal airway insertion response is 0.105(0.087-0.114)mg/kg in elderly female patients during hysteroscopic surgery.

Abstract:Objective To analyze the effect of role stress on work engagement of emergency physicians in specialized tertiary comprehensive hospitals by improving organizational justice.To summarize the main experiences and practices from the aspects of emergency medicine talent team construction,discipline construction,and performance distribution,and to provide some suggestions for improving the work engagement of emergency physi-cians in public hospitals.Methods A random cluster sampling method was used to select emergency physicians from Beijing Anzhen Hospital,Capital Medical University and 7 other public tertiary hospitals in Beijing as the research objects.The survey was conducted by means of network electronic questionnaire,and 221 respondents with valid questionnaires were collected as the research objects(hereinafter referred to as subjects).The role stress,work engagement and organizational Justice scale were used to investigate the subjects.SPSS 22.0 was used for descriptive analysis and correlation analysis,and structural equation model was used to verify the theoretical research hypothesis(the negative correlation between role stress and work engagement of emergency physicians,and the moderating effect of organizational justice on the three-dimensional relationship between role stress and work engagement).Results Most of the 211 subjects were female,totaling 128 people,accounting for 57.92％.Most of the emergency physicians had higher education,with master's degree accounting for 48.87％,followed by university,accounting for 29.86％,the two accounted for more than 50.00％,and 75.11％of the subjects were ordinary workers without duties.The proportion of emergency specialists in subjects was 66.06％,and they were the main force engaged in specific emergency work.The results of structural equation model validation showed that the hypotheses were all valid.There was a strong negative correlation between role stress and work engagement in emergency physicians,and organizational justice moderated the relationship between role stress and work engagement.The standardized fit index was 0.812,and the standardized fit index was 0.862,indicating that the model fit was good.Conclusion There is still room for improvement in the work engagement of emergency physi-cians in specialized tertiary comprehensive hospitals,and improving their sense of organizational justice is the key link.Managers can adjust the impact of role stress on work engagement of emergency physicians by increasing salary,improving working environment and other organizational justice measures,so as to improve their work engagement level.

Abstract:This case report is of a patient with acute exacerbation of chronic obstructive pulmonary disease and multidrug resistant Pseudomonas aeruginosa infection.Moxalactam,ceftazidime and etimicin sulfate injection were given successively for anti-infective treatment,but the symptoms were not improved.Combined with the results of sputum culture suggesting Pseudomonas aeruginosa(mucoid type),the clinical pharmacist suggested adjusting the antibacterial drug to meropenem,and replacing sodium valproate sustained-release tablets with leveti-racetam tablets.Azithromycin tablets were added because the infection index of the patient was still high,although the infection index decreased after 3 d of treatment.After treatment,the symptoms and positive signs of the patient disappeared,and the patient was cured and discharged.Clinical pharmacists should actively communicate with clinicians according to the pharmacological effects,pharmacokinetics/pharmacodynamic characteristics of antibiotics,and auxiliary medication precautions in combination with the patient's condition and pathogenic characteristics,so as to develop personalized and accurate dosing regimens for patients and guide clinical rational drug use.

Abstract:Objective To investigate the efficacy of bare metal stent combined with endovascular aortic repair in the treatment of distal descending aortic dissection.Methods Six patients who underwent bare metal stent combined with endovascular aortic repair in the Department of Cardiovascular and Vascular Surgery,Affiliated Hospital of North Sichuan Medical College from April 2023 to April 2024 were selected.Among them,4 patients were Stanford type B aortic dissection,and 2 patients were Stanford type A aortic dissection treated after operation.All the 6 patients had thoracoabdominal aortic dissection,with obvious collapse of true lumen and malperfusion of distal organs.The clinical data of the patients were retrospectively analyzed.Methods,postoperative complications and vascular remodeling of distal descending aorta before and after bare-metal stent combined with endovascular aortic repair were analyzed.Results The operation was successfully completed in all 6 patients.The operation time was(113±28)min.There was no perioperative death.Three patients with Stanford type B dissection were treated with 1 covered stent and 1 bare metal stent.One patient diagnosed as aortic root aneurysm with type B aortic dissection was implanted with Fabulous stent system.In the 2 patients with Stanford type A aortic dissection,1 bare stent was reattached to the distal end of the stent during the first stage operation,and 1 covered stent and 1 bare metal stent were implanted in the other patient,without endoleak and stent migration.Follow-up CT angiog-raphy showed that the maximum diameter of the descending aorta was significantly decreased after operation,and the ratio of false lumen to true lumen was significantly decreased after operation(both P＜0.05).The true lumen of the distal descending aorta was dilated obviously,the vascular remodeling effect was satisfactory,and the poor perfusion of the distal organs was recovered.Conclusion Bare-metal stent combined with endovascular aortic repair is safe and feasible for the treatment of distal descending aortic dissection.The effect of vascular remodeling of the distal descending aorta is good,and it can effectively improve the distal organ malperfusion and reduce the incidence of postoperative adverse events.The early follow-up results are satisfactory.

Abstract:Objective To analyze the influence of different incision size and suture methods on the healing of calcaneal fracture incision,and to identify the independent factors affecting the healing of calcaneal incision.Methods This study was a contemporaneous parallel controlled clinical study.A total of 120 patients who underwent emergency open reduction and internal fixation of calcaneal fractures in Department of Orthopedics,Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2020 were selected as the research objects.According to the order of admission,they were divided into groups A(traditional lateral incision+intermittent mattress suture),B(traditional lateral incision+subcutaneous suture),C(traditional lateral incision+wound adhesive),D(limited incision+intermittent mattress suture),E(limited incision+subcutaneous suture),F(limited incision+wound adhesive),with 20 cases in each group.The suture time,drainage time,incision healing time,hospital stay and other clinical indicators were compared between the groups.Results The comparison between groups with the same incision method showed that the suture time and drainage time in group C were significantly shorter than those in groups A and B,and the suture time and drainage time in group F were signifi-cantly shorter than those in groups D and E.The drainage time in group E was significantly shorter than that in group D(all P＜0.05).The limited incision group was compared with the traditional incision group,the suture time in group D was significantly shorter than that in group A,and the suture time in group E was significantly shorter than that in group B(both P＜0.05).The comparison between groups with the same suture method showed that the drainage time of groups D,E,and F was shorter than that of groups A,B,and C,respectively.The wound healing time of group F was significantly shorter than that of group C(all P＜0.05).The results of correla-tion analysis showed that the incision size and suture method were correlated with drainage time(r=-0.360,-0.575,both P＜0.001)and wound healing time(r=-0.284,P=0.002;r=-0.203,P=0.026).In addition,the incision size and wound healing time were also correlated with the length of hospital stay(r=0.116,P=0.021;r=0.779,P＜0.001).The results of multiple linear regression analysis showed that the incision size and suture method were both independent factors affecting the drainage time(both P＜0.001),and the incision size was the only independent factor affecting the incision healing time(P=0.002).Conclusions Incision drainage time of calcaneal fractures is affected by incision size and suture method,while incision healing is only affected by incision size.The method of limited incision+wound adhesive has the advantages of shortening the drainage time and wound healing time.

Abstract:Objective To investigate the effect of echinoside on the proliferation,migration,invasion and angiogenesis of ovarian cancer cells and its possible mechanism.Methods Ovarian serous cancer cell line SKOV3 was used as the research subjects.Cell counting kit-8 was used to detect the effect of different concentrations of echinoside(0,6.25,12.5,25,50,100,200,400 μmol/L)on cell viability.SKOV3 cells were randomly divided into control group,low-dose echinacoside group(25 μmol/L),middle-dose echinacoside group(50 μmol/L),high-dose echinacoside group(100 μmol/L)and echinacoside high-dose+740Y-P(PI3K agonist,100 μmol/L)group.Colony formation assay,TUNEL staining and Transwell assay were used to detect cell proliferation,apoptosis,migration and invasion.Angiogenesis was detected by tube formation assay.Western blotting was used to detect the expressions of proliferation,apoptosis,invasion,angiogenesis and phosphatidylinositol-3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)pathway related proteins.Results The results of cell counting kit-8 showed that with the increase of echinoside concentration,the survival rate of SKOV3 cells decreased gradually,which were(100.0±5.5)％,(98.3±3.3)％,(93.3±3.4)％,(58.3±3.8)％,(42.4±4.6)％,(28.8±2.2)％,(19.4±3.4)％,(6.4±1.5)％,respectively,in a concentration dependent manner(P＜0.05).Compared with the control group,the number of SKOV3 cell colonies,migration,and invasive cells,the relative circular tubular structure formation ratio,the expression of cell proliferation antigen Ki-67,B-cell lymphoma 2(Bcl-2),N-cadherin,and vascular endothelial growth factor A(VEGFA),the phosphorylated(p)-PI3K/PI3K,p-AKT(S473)/AKT,p-AKT(T308)/AKT,and p-mTOR/mTOR ratios all gradually decreased in the low,medium,and high-dose echinacoside groups,while the apoptosis rate and expression of activate cysteine protease 3(Cleaved caspase 3),Bcl-2 related X protein(Bax),and E-cadherin gradually increased,showing a concentration-dependent effect,with statistically significant differences(all P＜0.05).Compared with the high-dose echinacoside group,the number of SKOV3 cell colonies,migration,and invasive cells,the relative circular tubular structure formation ratio,the expression of Ki-67,Bcl-2,N-cadherin,and VEGFA,the p-PI3K/PI3K,p-AKT(S473)/AKT,p-AKT(T308)/AKT,and p-mTOR/mTOR ratios all increased/rised in the echina-coside high-dose+740Y-P group,while the apoptosis rate and expression of Cleaved caspase 3,Bax,and E-cadherin all decreased,showing a statistically significant difference(all P＜0.05).Conclusion Echinoside can inhibit the proliferation,migration,invasion and angiogenesis of ovarian cancer cells,and its mechanism may be related to the inhibition of PI3K/AKT/mTOR signaling pathway.

Abstract:Objective To observe the clinical effect of standardized intravenous nutrition formula in premature infants.Methods A total of 162 premature infants who needed parenteral nutrition and were hospitalized in Beijing Shijitan Hospital,Capital Medical University from July 2015 to March 2020 were enrolled in this study.According to the random number table method,they were divided into conventional solution group(80 cases)and standard solution group(82 cases).They were treated with individualized intravenous nutrition formula and standard intravenous nutrition formula with added L-carnitine,respectively.The two groups were compared in terms of general data,clinical conditions at 6 weeks after birth,and the incidence of such as cholestasis,bronchopulmonary dysplasia,intracranial hemorrhage,and retinopathy of prematurity.Results After 2 weeks of treatment,the weight gain of the standard solution group was greater than that of the conventional solution group[(151±92)gvs(110±78)g](P=0.003).At 6 weeks after birth,the levels of direct bilirubin and bile acid in the standard solution group were lower than those in the conventional solution group[(18±10)μmol/L vs(26±15)μmol/L,(53±27)μmol/L vs(77±24)μmol/L](both P＜0.001).At 36 weeks of gestation,the incidence of bronchop-ulmonary dysplasia was lower in the standard solution group than in the conventional solution group[12.2％(10/82)vs 27.5％(22/80)](P＜0.05).There was no significant difference in the incidence of intracranial hemorrhage and retinopathy of prematurity between the two groups(both P＞0.05).Conclusion Compared with individualized intravenous nutrition prescription,the weight gain of premature infants receiving standardized intravenous nutrition formula is better after 2 weeks.The use of standardized intravenous nutrition formula with L-carnitine is beneficial to reduce the degree of cholestasis in premature infants.The use of standardized intravenous nutrition is beneficial to reduce the incidence of bronchopulmonary dysplasia in preterm infants.There is no significant difference in the incidence of intracranial hemorrhage and retinopathy of prematurity between the two groups.

Abstract:Objective To investigate the effect of Jinwugutong capsule in the treatment of primary osteo-porosis and evaluate the drug economy.Methods A total of 200 patients with primary osteoporosis in Zhengzhou Orthopaedic Hospital,Henan Province from June 2022 to June 2023 were selected.According to the random number table method,they were divided into the control group and the observation group,with 100 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Jinwugutong capsule on the basis of the control group.The two groups were evaluated and compared after 24 weeks of treatment.The traditional Chinese medicine syndrome score,low back pain and leg pain,activity of daily living scale(ADL)score,bone mineral density and bone metabolism indexes were compared between the two groups before and after treatment.The incidence of adverse reactions was compared between the two groups,and the differences in clinical efficacy between the two groups were analyzed.The short-term drug economy of the two groups was evaluated.Results At 4,12 and 24 weeks after treatment,the traditional Chinese medicine syndrome scores of the observation group were lower than those of the control group(all P＜0.05).After treatment,the pain scores and ADL scores of the two groups were lower than those before treatment,and the bone mineral density was higher than that before treatment.The pain scores and ADL scores of the observation group were lower than those of the control group,and the bone mineral density was higher than that of the control group(all P＜0.05).After treatment,the levels of serum calcium,osteocalcin and total N-terminal propeptide of type Ⅰ collagen in the two groups were higher than those before treatment,and the serum phosphorus level was lower than that before treatment.The levels of serum calcium,osteocalcin and total N-terminal propeptide of type Ⅰ collagen in the observation group were higher than those in the control group,and the serum phosphorus level was lower than that in the control group(all P＜0.05).The incidence of adverse reactions in the observation group was lower than that in the control group[2.0％(2/100)vs 14.0％(14/100)](P=0.002).The total effective rate of the observation group was higher than that of the control group[82.0％(82/100)vs 73.0％(73/100)](P=0.004).The cost-effectiveness ratio of the control group was 132.65,the effectiveness ratio of the observation group was 128.04,and the incremental cost-effectiveness ratio was 90.72.The treatment regimen in the observation group was more economical than that in the control group.Conclusion Jinwugutong capsule is effective in the treatment of primary osteoporosis,which can improve the traditional Chinese medicine syndrome score,relieve pain,improve bone metabolism,and is safe,reliable and more economical.

Abstract:The treatment of intracranial infection secondary to systemic lupus erythematosus is difficult and the mortality rate is high.The clinical data of 4 cases of secondary intracranial infection in patients with systemic lupus erythematosus are retrospectively analyzed and the related literature is reviewed.All the 4 patients were female,aged from 16 to 36 years.All patients were diagnosed with systemic lupus erythematosus and had secondary intracranial infection and cerebrospinal fluid circulation dysfunction,including 3 cases of hydrocephalus and 1 case of refractory intracranial hypertension.It is concluded that long-term cerebrospinal fluid drainage combined with anti-infection comprehensive treatment can greatly improve the prognosis and quality of life of patients with intracranial infection secondary to systemic lupus erythematosus.In order to provide experience and reference for clinical practice.