Abstract:Objective To explore the predictive value of serum T cell immunoglobulin and mucin domain-containing molecule 3(Tim-3)and macrophage inflammatory protein-1α(MIP-1α)for central nervous system infection(CNSI)after craniotomy in patients with severe traumatic brain injury(sTBI).Methods A total of 300 sTBI patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2023 to June 2025 were selected.According to the occurrence of postoperative CNSI,the patients were divided into infection group(53 cases)and non-infection group(247 cases).Multivariate Logistic regression analysis was used to identify the factors associated with postoperative CNSI,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value.Results The proportions of patients with cerebrospinal fluid leakage,diabetes mellitus,skull base fracture,and operation time ≥ 3 h,as well as serum Tim-3 mRNA and MIP-1α levels in the infection group were significantly higher than those in the non-infection group(all P＜0.05).Tim-3 mRNA,MIP-1α,cerebrospinal fluid leakage,skull base fracture,and operation time ≥3 h were independent risk factors for postoperative CNSI in patients(all P＜0.05).The area under the curve of serum Tim-3 mRNA alone,MIP-1α alone,and their combination for predicting concurrent CNSI was 0.753,0.762,and 0.852,respectively.The combined prediction of the two indicators was superior to each single indicator(both P＜0.05).Conclusion High expressions of serum Tim-3 mRNA and MIP-1α increase the risk of postoperative CNSI in sTBI patients undergoing craniotomy,and their combined detection has certain clinical value for predicting postoperative CNSI in these patients.

Abstract:Objective To explore the impact of non-matching nucleic acid extraction reagents on human papillomavirus(HPV)genotyping results.Methods A total of 171 cervical exfoliated cell samples were collected from female patients who visited the Department of Gynecology,Dongzhimen Hospital,Beijing University of Chinese Medicine from March to April 2025.HPV DNA was extracted by manual boiling method and magnetic bead method(automatic nucleic acid extraction using non-matching nucleic acid extraction reagents),respectively.Fluorescence quantitative polymerase chain reaction was performed to detect HPV genotypes.The negative coincidence rate,positive coincidence rate,and total coincidence rate of nucleic acid detection results obtained by different extraction methods were analyzed,as well as their impacts on single infection,multiple infections of HPV subtypes,and sample viral load.Results The negative coincidence rate and positive coincidence rate of the detection results by the two methods were 100.0％(128/128)and 93.0％(40/43),respectively,with a total coincidence rate of 97.1％(166/171).Consistency analysis of gene subtypes and internal reference in 43 positive samples showed that the automatic nucleic acid extraction method did not cause a significant increase in the internal reference Ct value due to the reduced sample volume.Kendall's concordance coefficient test showed statistical significance(both P＜0.001),indicating consistency between the two extraction methods.The Kendall's concord-ance coefficients were 0.953 and 0.943,respectively,suggesting a strong degree of consistency.Analysis of the viral load of samples extracted by the two methods showed that consistent results and an increase of 1 order of magnitude accounted for 84.0％(42/50).Conclusion Compared with the manual boiling method,the magnetic bead method(automatic nucleic acid extraction with non-matching reagents)can obtain HPV DNA solutions with higher concentration and purity,which is more suitable for laboratory promotion and application.

Abstract:Objective To investigate the clinical effect of Xinnao Liantong capsule combined with diltiazem hydrochloride tablets in the treatment of stable angina pectoris.Methods A total of 118 patients with stable angina pectoris who were treated in Cangzhou Hospital of Integrated TCM-WM·Hebei from September 2022 to March 2024 were selected as the research objects.Patients were divided into control group(59 cases)and observation group(59 cases)by simple random grouping method.All patients received conventional treatment of stable angina pectoris.Patients in the control group were treated with diltiazem hydrochloride tablets,and patients in the observation group were treated with Xinnao Liantong capsule on the basis of the control group.All patients were treated for 8 weeks.The clinical efficacy,frequency and duration of angina pectoris,cardiac function indexes,hemorheology 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[94.9％(56/59)vs 81.4％(48/59)](x2=5.187,P=0.023).After treatment,the frequency and duration of angina pectoris,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,and red blood cell aggregation index in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group[(1.8±0.4)times/week vs(3.8±0.7)times/week,(1.8±0.3)min vs(3.6±0.7)min,(55.7±2.5)mm vs(58.0±2.6)mm,(31.0±5.0)mm vs(37.6±5.9)mm,(1.4±0.2)mPa/s vs(1.6±0.3)mPa/s,(4.7±0.6)mPa/s vs(5.9±0.7)mPa/s,(9.2±1.1)mPa/s vs(11.1±1.4)mPa/s,(4.3±1.0)％vs(6.0±1.1)％](all P＜0.05).After treatment,the left ventricular ejection fraction of the two groups was higher than that before treatment,and that of the observation group was higher than that of the control group[(56.4±3.2)％vs(49.6±3.0)％](all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion On the basis of conventional treatment,Xinnao Liantong capsule combined with diltiazem hydrochloride tablets is more effective than diltiazem hydrochloride tablets in the treatment of stable angina pectoris,relieves angina pectoris attack,improves cardiac function and hemorheology,and has high drug safety.

Abstract:Objective To explore the optimal prescription of task-oriented upper limb rehabilitation robot for upper limb motor function recovery in hemiplegic patients at the synergistic movement stage after stroke.Methods A total of 112 patients with upper limb hemiplegia after stroke at the synergistic movement stage,who were hospitalized in the Department of Rehabilitation Medicine,the First Affiliated Hospital of Anhui Medical University from April 1,2024 to April 30,2025,were selected.The patients were divided into control group,observation group A,observation group B,and observation group C by random number table method,with 28 cases in each group.The control group received routine rehabilitation training on the basis of basic drug treatment,while observation groups A,B,and C received low-intensity,moderate-intensity,and high-intensity task-oriented upper limb rehabilitation robot training respectively on the basis of basic drug treatment,with an intervention cycle of 4 weeks.The upper limb spasticity[modified Ashworth scale(MAS)score],upper limb motor function[Fugl-Meyer assessment of upper extremity(FMA-UE)score],range of motion,and trajectory tracking error were compared among the groups before intervention(T0),at 2 weeks of intervention(T1),and at 4 weeks of intervention(T2).Linear regression analysis and restricted cubic spline(RCS)model were used to conduct a dose-response analysis between the intensity of rehabilitation exercise training and the improvement of upper limb function.Results Overall analysis showed that the MAS score,FMA-UE score,flexor co-activation rate,Brunnstrom stage,motor space range,and trajectory tracking error in each group improved significantly over time,with statistically significant differences between groups and interaction effects(all P＜0.05).Further comparisons revealed that in observation groups A,B,and C,the MAS score and flexor co-activation rate[observation group A at T0,T,,and T2:(79±4)％,(74±6)％,(67±5)％respectively;observation group B:(79±7)％,(68±7)％,(61±4)％respectively;observation group C:(81±6)％,(77±4)％,(69±6)％respectively]decreased gradually,while the FMA-UE score and motor space range increased progressively,and the trajectory error decreased stepwise(all P＜0.05).The control group also showed certain improvements at T2 compared with T0(all P＜0.05),but the magnitude was less than that of the observation groups.At T1 and T2,all observation groups outperformed the control group(all P＜0.05),with observation group B showing the most significant improvements,which were superior to those of groups A and C(all P＜0.05),while no statistically significant differences were found between group A and group C(all P＞0.05).The Brunnstrom stage showed the most significant improvement in group B at T2.RCS analysis revealed an inverted U-shaped relationship between intervention intensity and FMA-UE score,with the moderate-intensity group achieving the optimal intervention effect.Conclusion Rehabilitation training based on task-oriented upper limb rehabilitation robot can significantly improve upper limb spasticity and motor function,reduce flexor co-activation rate,increase range of motion,and decrease trajectory tracking error in hemiplegic patients at the synergistic movement stage after stroke.The optimal rehabilitation training prescription is 30 minutes per session,5 times a week.

Abstract:Objective To explore the application and operation analysis of umbrella type spray tube and original straight head spray tube in endoscopic hemostasis with medical glue in patients with upper gastrointestinal bleeding.Methods A total of 202 patients with upper gastrointestinal bleeding who underwent endoscopic hemo-stasis with medical glue in Beijing Anzhen Hospital,Capital Medical University from January 2022 to December 2024 were retrospectively analyzed.According to the spray tube used,they were divided into straight head spray tube group(control group,147 cases)and hemostatic umbrella spray tube group(observation group,55 cases).The spraying effect data and endoscopic blockage of the two groups were analyzed.Results There was no significant difference in the treatment examination time between the observation group and the control group(P＞0.05).The spraying and observation time of the observation group was longer than that of the control group(P＜0.001).In the observation group,after spraying medical glue on the bleeding site of duodenal bulb ulcer and cardia laceration,the umbrella was retracted into the outer sheath tube,and the wound after spraying could be clearly observed.In the control group,after spraying medical glue,the lens was blurred,and the lens was withdrawn immediately.There were 52 cases of excellent lens clarity and 3 cases of good lens clarity in the observation group after medical glue spraying,there were 76 cases of excellent lens clarity,22 cases of good lens clarity and 49 cases of poor lens clarity in the control group,and the difference between the two groups was statistically significant(x2=31.954,P＜0.001).The proportion of rubber tube blockage in the observation group was lower than that in the control group[0(0/55)vs 7.5％(11/147)](x2=4.362,P=0.037).In recent 3 years,the number of endoscopic repairs due to the blockage of medical glue after spraying in the control group was 11 times,and the cost was 54 893 yuan.The medical glue was not blocked in the observation group,and the cost was 0 yuan.Conclusions The umbrella type spray tube used in endoscope can clearly observe the spraying effect of medical glue on the wound after bleeding,and the plug rate in the lumen and maintenance cost are lower than those of the control group.

Abstract:Objective To explore the clinical characteristics and risk factors of cognitive impairment in coronary atherosclerotic heart disease(CHD)patients of different age groups.Methods A prospective cohort study was conducted,enrolling a total of 9 893 CHD patients who visited Beijing Anzhen Hospital,Capital Medical University from December 2021 to April 2023.The patients were divided into middle-aged group(45-59 years old,4 121 cases)and elderly group(≥60 years old,5 772 cases)according to age.Cognitive function was assessed using the mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA).Sleep quality was evaluated by the pittsburgh sleep quality index(PSQI),and anxiety and depression status were assessed with the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),respectively.Multivariate Logistic regression analysis was used to identify the risk factors for cognitive impairment in CHD patients.Results The prevalence of cognitive impairment in the middle-aged group was lower than that in the elderly group[33.9％(1 396/4 121)vs 55.6％(3 210/5 772)](P＜0.001).The proportion of poor sleep quality in the middle-aged group was lower than that in the elderly group(P＜0.001).There were no statistically significant differences in SAS and SDS scores between the middle-aged and elderly groups(both P＞0.05).The results of multivariate Logistic regression analysis showed that advanced age,female gender,cerebral infarction,myocardial infarction,poor sleep quality,anxiety,and depression were significantly associated with an increased risk of cognitive impairment(all P＜0.05).Subgroup analysis by age revealed that in the middle-aged group,female gender,diabetes mellitus,cerebral infarction,myocardial infarction,poor sleep quality,and depression were independent risk factors for cognitive impairment;in the elderly group,female gender,cerebral infarction,myocardial infarction,poor sleep quality,anxiety,and depression were independent risk factors for cognitive impairment(all P＜0.05).Conclusion The prevalence of cognitive impairment is relatively high in patients with CHD.Advanced age,cerebral infarction,myocardial infarction,insomnia,anxiety,and depression can exacerbate cognitive impairment in CHD patients.Approximately one-third of middle-aged CHD patients have cognitive impairment,and their risk factors differ from those of elderly patients.Diabetes mellitus can increase the severity of cognitive impairment in middle-aged patients but has no significant effect on elderly patients;anxiety is not a risk factor for cognitive impairment in middle-aged patients but can significantly increase the risk in elderly patients.

Abstract:Objective To investigate the expression and clinical significance of C-C motif chemokine ligand 19(CCL19)and soluble differentiation cluster 163(sCD163)in peripheral blood of patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure(RF).Methods A total of 196 COPD patients with RF admitted to the Department of Respiratory Medicine,the Fourth Affiliated Hospital of Nanjing Medical University from January 2022 to February 2025 were selected as the COPD with RF group,98 COPD patients without RF admitted during the same period were selected as the simple COPD group,and 98 healthy volunteers were selected as the control group.According to the prognosis of COPD patients with RF at 28 d after admission,they were divided into poor prognosis group and good prognosis group.The levels of CCL19 and sCD163 in peripheral blood were detected by enzyme-linked immunosorbent assay.The relationship between the levels of CCL19 and sCD163 in peripheral blood and the prognosis of COPD patients with RF and its predictive efficacy were analyzed.Results The levels of CCL19 and sCD163 in the control group,the simple COPD group,and the COPD with RF group increased in sequence(all P＜0.001).The 28 d poor prognosis rate of COPD patients with RF was 35.7％(70/196).Age,severity of disease,number of acute exacerbations in the past year,forced expiratory volume in first second as a percentage of predicted value(FEV1％),dyspnea grade,CCL19 and sCD163 were associated with the prognosis of COPD patients with RF(all P＜0.05).Multivariate Logistic regression analysis showed that severe disease,increased number of acute exacerbations in the past year,high CCL19 level and high sCD163 level were independent risk factors for poor prognosis in COPD patients with RF,and high FEV1％was an independent protective factor(all P＜0.05).The receiver operating characteristic curve showed that the area under the curve of peripheral blood CCL19,sCD163 levels and their combination to predict the prognosis of COPD patients with RF were 0.776,0.791 and 0.879,respectively,and the combination of the two was better than their single prediction efficiency(all P＜0.05).Conclusion The increased levels of CCL19 and sCD163 in peripheral blood are related to the aggravation and poor prognosis of COPD patients with RF,and the combination of the two has a high predictive effect on the prognosis.

Abstract:Objective To explore the characteristics of QRS complex duration in patients with atrial fibril-lation and its relationship with recurrence after radiofrequency catheter ablation(RFCA).Methods A total of 188 patients with atrial fibrillation who underwent RFCA at Mianyang 404 Hospital from May 2022 to October 2024 were selected retrospectively.According to whether recurrence occurred within 3 months after surgery,the patients were divided into the recurrence group(n=52)and non-recurrence group(n=136).General data,QRS complex duration,ultrasonic parameters,and admission routine blood test indicators of the patients were collected.A hierarchical regression model was used to analyze the effects of different clinical characteristics on QRS complex duration.Multivariate Logistic regression was applied to analyze risk factors.Stratified interaction analysis was conducted to explore the effect of gender on the relationship between QRS complex duration and recurrence after RFCA.Receiver operating characteristic(ROC)curve was used to evaluate diagnostic efficacy.Restricted cubic spline(RCS)was employed to analyze the dose-response relationship between QRS complex duration and the risk of recurrence after RFCA.Results Hierarchical regression analysis showed that electrocardiographic f-wave pattern,brain natriuretic peptide(BNP),homocysteine(Hey),left atrial diameter(LAD),and left ventricular ejection fraction(LVEF)all had significant effects on QRS complex duration(all P＜0.05).Multivariate analysis revealed that electrocardiographic f-wave pattern,BNP,Hey,QRS complex duration,LAD,and LVEF were independent influencing factors for recurrence in atrial fibrillation patients after RFCA(all P＜0.05).Interaction test analysis indicated that gender had no impact on the relationship between QRS complex duration and recurrence after RFCA(Pinteraction＞0.05).The risk of postoperative recurrence in the high-risk group of QRS complex duration(＞150 ms)was 68.8％(22/32),with an interval likelihood ratio of 4.400.ROC curve analysis results showed that the area under the curve of QRS complex duration for diagnosing the risk of recurrence after RFCA was 0.753.RCS analysis demonstrated that there was a non-linear dose-response relationship between QRS complex duration and the risk of recurrence in atrial fibrillation patients after RFCA(P＜0.05).Conclusions Prolonged QRS complex duration is an independent risk factor for recurrence in patients with atrial fibrillation after RFCA.Preoperative measurement of QRS complex duration can effectively identify high-risk patients and provide a reference for individualized postoperative management.

Abstract:Objective To analyze the effect of psychological intervention under the solution-focused approach on the anxiety and depression scores and satisfaction of patients undergoing separable tether magnetically controlled capsule endoscopy.Methods Thirty patients who underwent separable tether magnetically controlled capsule endoscopy in Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from January to June 2024 were selected.According to the random number table method,they were divided into the control group and the observation group,with 15 cases in each group.The basic information,self-rating anxiety scale(SAS),self-rating depression scale(SDS)scores and satisfaction were compared between the two groups.Results There were no statistically significant differences in age,gender ratio,basic diseases,and the proportion of separable tether magnetically controlled capsule endoscopy results between the two groups(all P＞0.05).The SAS and SDS scores of the two groups after examination were lower than those before examination,and those of the observation group were lower than those of the control group[(29.8±1.9)vs(33.5±2.7),(31.5±3.1)vs(35.5±3.6)](all P＜0.01).In the control group,10 cases(66.7％)were very satisfied and 5 cases(33.3％)were basically satisfied.In the observation group,14 cases(93.3％)were very satisfied and 1 case(6.7％)was basically satisfied.There were no unsatisfied patients in the two groups,and the satisfaction of the observation group was better than that of the control group(x2=21.125,P＜0.001).Conclusion The psychological intervention under the solution-focused approach can improve the patients' state of mind,reduce anxiety and depression,and improve patient satisfaction in patients undergoing separable tether magnetically controlled capsule endoscopy.

Abstract:Objective To investigate the value of serum CC chemokine ligand 18(CCL-18)combined with systemic immune inflammation index(SII)in evaluating the prognosis of transcatheter arterial chemoembolization(TACE)in patients with advanced primary hepatocellular carcinoma(PHC).Methods The clinical data of 212 patients with intermediate and advanced PHC who underwent TACE intervention in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2021 to January 2024 were retrospectively analyzed.The patients were followed up for 12 months.According to the prognosis of TACE intervention,the patients were divided into the good prognosis group(120 cases)and the poor prognosis group(92 cases).The patients were divided into high CCL-18 group(108 cases),low CCL-18 group(104 cases),high SII group(107 cases)and low SII group(105 cases)according to the average value of the two indexes(7.96 ng/L,312.52).The survival rates of patients with advanced PHC and different expression levels of CCL-18 and SII before TACE were compared.Multivariate Logistic regression was used to analyze the independent influencing factors of the prognosis of patients with advanced PHC treated with TACE.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the value of serum CCL-18 combined with SII in evaluating the prognosis of TACE interventional therapy in patients with advanced PHC.Results The survival rates of the high CCL-18 group and the high SII group at 12 months after operation were significantly lower than those of the low CCL-18 group and the low SII group,respectively[49.1％(53/108)vs 64.4％(67/104),46.7％(50/107)vs 66.7％(70/105)](both P＜0.05).The results of multivariate Logistic regression analysis indicate that lymph node metastasis,Child-Pugh classification,alpha-fetoprotein,preoperative serum CCL-18 level,preoperative SII value,portal vein tumor thrombus,Barcelona clinical liver cancer staging,and targeted drug therapy are all independent factors affecting the prognosis of TACE interventional therapy for patients with advanced PHC(all P＜0.05).ROC curve analysis showed that the AUC of serum CCL-18 and SII alone and in combination were 0.715,0.738 and 0.838,respectively,and the combined application of serum CCL-18 and SII was more effective in evaluating the prognosis of TACE interventional treatment in patients with advanced PHC(P＜0.05).Conclusion Preoperative serum CCL-18 level and SII value are related to the prognosis of TACE interventional therapy in patients with advanced PHC.The combined detection of the two indicators can evaluate the prognosis of TACE interventional therapy in patients with advanced PHC.

Abstract:Objective To measure the medical resource redundancy status in public hospitals and its impact on medical expenses,so as to provide theoretical and practical basis for managers to effectively measure and utilize redundant resources to reasonably control medical expenses.Methods Based on the organizational redun-dancy theory,a total of 34 tertiary public general hospitals in Beijing from 2018 to 2022 were selected as the research objects.The ratio method was used to measure the redundancy status of bed,doctor and nurse resources,and a panel model was constructed to empirically analyze the impact of medical resource redundancy on medical expenses.Results 44.12％-58.82％of the hospitals were in a non-redundant state,20.59％-47.06％were in a low-redundant state,and 5.88％-23.53％were in a high-redundant state.There was a positive linear relationship between redundant resources and average cost per visit.The redundant resources of doctors and beds had a U-shaped relationship with average cost per case,while the redundant resources of nurses had an inverted S-shaped relationship with average cost per case.Conclusions Some tertiary public general hospitals in Beijing have medical resource redundancy,and when the redundant resources increase to a certain range,medical expenses will increase.Public hospitals should adhere to their public welfare,scientifically allocate resources on the basis of fully measuring medical needs,prevent excessive growth of medical resources,reasonably control medical expenses,and assume corresponding social responsibilities.

Abstract:Purple urine bag syndrome is a rare clinical condition with an incompletely clarified pathogenesis,and there is currently a lack of systematic and effective treatment methods.As a novel therapeutic approach,ultrasound combined with bladder irrigation has potential advantages in improving local bladder circulation,reducing inflammatory responses,and promoting tissue repair.This article reports a case of purple urine bag syndrome in a patient with long-term indwelling urinary catheterization due to cervical spine fracture complicated by complete paralysis,aiming to provide clinical reference.Ultrasound combined with bladder irrigation was adopted,and changes in urine bag color,routine urine test indicators,and urine properties were recorded before and after treatment.After 1 week of treatment,the purple color of the patient's urine bag disappeared,the urine color lightened,flocculent substances decreased,bacterial count dropped,urine odor vanished,and the symptoms improved significantly.

Abstract:Primary gastrointestinal stromal tumor(GIST)of the liver is extremely rare,and accurate diagnosis is challenging.A 52-year-old female patient with primary hepatic GIST was reported.The patient was admitted to the hospital due to a liver mass detected by physical examination without obvious clinical symptoms.She had a history of duodenal surgery and neurofibromatosis type 1(NF1).Laboratory tests showed normal tumor markers and liver function,and imaging showed a solid mass in the right lobe of the liver.Preoperative gastrointestinal endoscopy was normal.After elective partial hepatectomy under general anesthesia,the patient was pathologically diagnosed with spindle cell type GIST.Immunohistochemical staining showed c-Kit,CD34,CD117 and DOG-1 were positive.Imatinib was given as adjuvant therapy after surgery,and the drug was stopped after 1 year.There was no recurrence during the follow-up of 10 years.Primary hepatic GIST should be diagnosed by imaging,pathology and immunohistochemistry,and the possibility of metastasis should be excluded.Surgical resection combined with imatinib adjuvant therapy is effective.In addition,the relationship between NF1 and primary hepatic GIST needs to be further studied.This article reviews the relevant literature to provide some reference value for the clinical diagnosis,treatment and prognosis of this disease.

Abstract:Heart failure is a syndrome caused by abnormalities in cardiac structure or function,leading to decreased cardiac output or elevated intracardiac pressure,with fluid retention as one of its core pathological mechanisms.Accurate assessment of volume status is crucial for alleviating patient symptoms and reducing the risk of readmission.Traditional volume assessment methods,such as physical examination,natriuretic peptide testing,and right heart catheterization,have limitations.This includes in accuracies invasiveness,or high operational costs.The inferior vena cava(IVC)is the largest-diameter venous system in the human body,and its morphological and dynamic changes can reflect the body's hemodynamic status.In recent years,ultrasound-based measurement of IVC diameter and calculation of IVC variability have provided a non-invasive tool for assessing intravascular volume status and guiding fluid management.With the standardization of assessment protocols and technological advance-ments,the clinical value of IVC parameters in individualized fluid management for patients with heart failure has become increasingly prominent.

Abstract:Objective To analyze the effects of Bushen Huoxue Zhuanggu decoction on bone metabolism and bone mineral density in elderly patients with osteoporotic hip fracture after operation.Methods The clinical data of 60 elderly patients with osteoporotic hip fractures who underwent surgery in Dongzhimen Hospital,Beijing University of Chinese Medicine from February 2021 to December 2024 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,with 30 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Bushen Huoxue Zhuanggu decoction on the basis of the control group.Both groups were treated for 6 months.The efficacy of traditional Chinese medicine,bone mineral density,bone metabolism indexes before and after treatment,postoperative recovery 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[96.7％(29/30)vs 73.3％(22/30)](P=0.030).After 6 months of treatment,the bone mineral densities of the two groups were higher than those before treatment,and the bone mineral densities of lumbar L2-L4,healthy femoral neck and Ward's triangle in the observation group were higher than those in the control group(all P＜0.05).Compared with before treatment,the indexes of bone metabolism in the two groups were decreased after 6 months of treatment,and the indexes of bone metabolism in the observation group were lower than those in the control group(all P＜0.05).The fracture healing time and hospitalization time of the observation group were shorter than those of the control group[(15.6±0.3)weeks vs(19.0±0.4)weeks,(41.3±6.2)d vs(48.1±6.0)d](all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group[16.7％(5/30)vs 10.0％(3/30)](P=0.704).Conclusion Bushen Huoxue Zhuanggu decoction can improve bone metabolism,increase bone mineral density and promote postoperative rehabilitation in elderly patients with osteoporotic hip fracture.In terms of safety,there was no significant difference in the incidence of adverse reactions between the two groups,but the observation group was slightly higher than the control group,which still needs to be further verified in a larger sample study.

Abstract:In order to expand the thinking of traditional Chinese medicine(TCM)in treating gastroesoph-ageal reflux disease(GERD),this article summarizes and discusses the research progress of TCM's syndrome differentiation and treatment of GERD from the perspective of lungs and kidneys,breaking through the traditional framework of treating GERD from the spleen,stomach,and liver.Based on the theoretical principles that the lungs govern descending and the kidneys govern water and fluid,this article explores the physiological and pathological connections between the lungs,kidneys,and stomach in TCM,and summarizes the treatment ideas of treating the lungs and stomach together,treating the kidneys and stomach together,and treating the lungs,kidneys,and stomach together.It also summarizes the therapeutic methods of nourishing earth to generate metal,reducing Qi and regulating the stomach;warming and replenishing kidney Yang,regulating kidney water;and harmonizing Yin and Yang.

Abstract:Cholangiocarcinoma,as a hepatobiliary malignant tumor with poor prognosis,still faces severe challenges in its diagnosis and treatment strategy.In cholangiocarcinoma,abnormally expressed long non-coding RNA(lncRNA)can regulate the malignant behavior of tumors through a variety of mechanisms,including interacting with functional proteins,participating in the competitive endogenous RNA regulatory network,activating oncogenic signaling pathways,and metabolic reprogramming.In addition,lncRNA not only regulate the malignant biological behavior of cholangiocarcinoma cells,but also participate in the reprogramming of the tumor microenvironment through exosomes.Exosomes can also be discharged into body fluids such as serum or bile,which provides a new tool for the diagnosis and prognosis of cholangiocarcinoma.This review summarizes the research progress of lncRNA in cholangiocarcinoma in recent years,and puts forward prospects for the molecular mechanism of cholan-giocarcinoma development.

Abstract:Both chronic inflammatory and immune processes play important roles in the development of coronary atherosclerotic heart disease.Studies have shown that colchicine can reduce major adverse cardiovascular events in elderly patients with coronary atherosclerotic heart disease.In addition to anti-inflammatory effects,colchicine also has a certain effect on immune function in elderly patients with coronary atherosclerotic heart disease,including effects on neutrophils and immune molecules.At the same time,colchicine also produces immune-related adverse reactions,increasing the occurrence and development of non-cardiovascular death,infec-tion,cancer and other diseases.This study aims to summarize the research progress on the effect of colchicine on immune function in elderly patients with coronary atherosclerotic heart disease,in order to provide ideas for the further rational application of colchicine in elderly patients with coronary atherosclerotic heart disease.

Abstract:Objective To investigate the clinical characteristics of ectopic pregnancy in plateau area.Methods A total of 283 patients with ectopic pregnancy admitted to Department of Gynecology,Lhasa People's Hospital,Tibet Autonomous Region from December 2021 to December 2024 were retrospectively selected,including 192 cases of tubal pregnancy,7 cases of cornual pregnancy,11 cases of uterine scar pregnancy,5 cases of ovarian pregnancy,and 68 cases of unspecified location.The clinical data of the patients were retrospectively analyzed.Results The average age of 283 patients was(31±6)years old,of which219 patients(77.4％)were Tibetan,66 patients(23.3％)were from areas with altitude≥4 000 m,121 patients(42.8％)had a history of abortion,101 patients(35.7％)had a history of pelvic surgery,27 patients(9.5％)had a history of ectopic pregnancy,and 26 patients(9.2％)with intrauterine device placement.A total of 203 cases of 283 patients were treated with laparoscopic or open surgery,including 43 cases(21.2％)with rupture and hemorrhagic shock symptoms,which were included in the combined shock group,including 35 cases(81.4％)of Tibetan patients,11 cases(25.6％)from altitude≥4 000 m,and the remaining 160 cases were included in the non combined shock group.There were no significant differences in age,pregnancy,parity,number of miscarriages,history of ectopic pregnancy,history of pelvic surgery,altitude≥4 000 m,and proportion of Tibetans between the two groups(all P>0.05).The intraoperative blood volume,blood loss,and total effusion volume in the combined shock group were greater than those in the non combined shock group,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower than those in the non combined shock group(all P<0.05).The bleeding volume of patients with ectopic pregnancy rupture hemorrhagic shock was 2 100(1 550,2 550)ml,and the preop-erative hemoglobin value of some patients was still within the normal range.Conclusion The occurrence of ectopic pregnancy complicated with hemorrhagic shock at high altitude has nothing to do with nationality,altitude of living area,number of miscarriages,ectopic pregnancy history or pelvic surgery history.The intraoperative blood volume,blood loss,and total effusion volume of the combined shock group were larger,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower.Due to the compensatory increase of hemoglobin in patients with hypoxia in plateau area,the hemoglobin value of patients with ectopic pregnancy in plateau area often cannot reflect the severity of the disease.It is necessary to pay attention to dynamic monitoring changes and make decisions as soon as possible combined with other examination methods.

Abstract:Objective To analyze the improving effect of Sanfu plaster combined with Jiuwei Gujin capsules on immune function in patients with bronchial asthma in remission stage.Methods A total of 103 patients with bronchial asthma in remission stage admitted to Shanxi Traditional Chinese Medicine Hospital from January 2023 to December 2024 were selected as the research objects.They were divided into control group(51 cases)and observation group(52 cases)by random number table method.The control group was treated with budesonide and formoterol fumarate powder for inhalation,while the observation group was treated with Sanfu plaster combined with Jiuwei Gujin capsules on the basis of the control group.Both groups received continuous treatment for 30 d.The clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,disease control status,inflammatory and immune indicators were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[94.2％(49/52)vs 80.4％(41/51)](χ2=4.471,P=0.034).After treatment,the TCM syndrome scores,eosinophil,fractional exhaled nitric oxide,high-sensitivity C-reactive protein and immunoglobulin E levels in both groups were lower than those before treatment,and those in the obser-vation group were lower than those in the control group;the asthma control test scores and immunoglobulin A levels in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P<0.05).Conclusion Sanfu plaster combined with Jiuwei Gujin capsules in adjuvant therapy of patients with bronchial asthma in remission stage can effectively improve TCM syndromes and disease control,with definite clinical efficacy,reduce inflammatory response and regulate immune function.