Abstract:This article reports the successful management of a patient with drug-induced liver injury(DILI)secondary to anti-tuberculosis medications.The patient was admitted due to progressive jaundice,abdominal distension,and fatigue lasting for 1 week.Artificial liver support therapy combining plasma exchange with double plasma molecular adsorption system was administered on the 2nd and 4th days after admission,respectively.Meanwhile,the anti-tuberculosis regimen was adjusted to isoniazid 0.3 g once daily+rifampicin 0.3 g once daily(reduced dose)+pyrazinamide 1.0 g once daily+ethambutol 0.75 g once daily,and liver function was well-tolerated during follow-up re-evaluations.After two sessions of artificial liver therapy,the patient's total bilirubin decreased from 384.2 μmol/L to 76.9 μmol/L,coagulation function returned to normal,and symptoms of jaundice and abdominal distension were significantly alleviated.The results suggest that for patients with severe anti-tuberculosis-related DILI,early artificial liver support combined with an individualized anti-tuberculosis treatment regimen can effectively improve clinical outcomes.

Abstract:Peripheral nerve injury leads to loss of skeletal muscle function and weakness of the musculo-skeletal system,which seriously affects the quality of life and brings economic burden to families and society.Mitochondrial dysfunction is an important factor leading to denervated muscle atrophy.Traditional Chinese medicine(TCM)has attracted wide attention from scholars at home and abroad due to its advantages of high safety and few adverse reactions.TCM treats skeletal muscle atrophy by regulating mitochondrial biogenesis,mitochondrial dynamics and autophagy,inhibiting inflammation and reducing oxidative stress.Based on mitochondrial dysfunction,this paper summarizes the relevant research on TCM intervention in denervated muscle atrophy in recent years,aiming to provide new ideas for TCM treatment of skeletal muscle atrophy.

Abstract:Cardiovascular-kidney-metabolic syndrome(referred to as cardiorenal metabolic syndrome)is a complex syndrome characterized by the interweaving of cardiovascular disease,chronic kidney disease,and metabolic disorders.Its core lies in the formation of a vicious cycle between the heart,kidney and metabolic system.Therefore,its drug treatment needs to uphold the concept of"heart-kidney-metabolic multi-disease co-treatment".This article reviews the concept,pathophysiological mechanism of cardiorenal metabolic syndrome and the drugs with evidence-based medical evidence of cardiorenal benefits,in order to provide theoretical support for the treatment of cardiorenal metabolic syndrome.

Abstract:Objective To investigate the clinical efficacy of betahistine combined with Xuanyunning tablets in the treatment of post-stroke vertigo in elderly patients.Methods A total of 384 elderly patients with post-stroke vertigo admitted to the Department of Neurology,Changzhi People's Hospital,Shanxi Province from September 2022 to October 2024 were selected.According to the random number table method,they were divided into the control group and the observation group,with 192 cases in each group.The control group was treated with betahistine mesylate tablets,and the observation group was treated with Xuanyunning tablets on the basis of the control group.Both groups were treated for 21 d.The clinical efficacy,vertigo disability rating scale,vertigo symptom scale,Chinese version of concise health survey scale score,hemodynamic indicators and 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[84.9％(163/192)vs 72.4％(139/192)](x2=8.932,P=0.003).After treatment,the scores of vertigo disability rating scale and vertigo symptom scale in the observation group were lower than those in the control group,and the scores of the Chinese version of the concise health survey scale were higher than those in the control group(all P＜0.05).After treatment,the peak systolic blood flow velocity of anterior cerebral artery and vertebrobasilar artery in the two groups were significantly higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(x2=0.046,P=0.830).Conclusion Betahistine combined with Xuanyunning tablets can effectively improve the clinical symptoms of post-stroke vertigo in elderly patients,and the combined treatment is better than single drug treatment.

Abstract:Objective To investigate the clinical effect of modified porous core decompression(CD)combined with vacuum sealing drainage(VSD)in the treatment of early avascular necrosis(AVN)of the femoral head in adults.Methods A total of 80 adult patients with early AVN admitted to the Affiliated Hospital of Hebei University of Engineering from May 2022 to January 2024 were retrospectively selected.According to the different surgical methods,they were divided into CD group(37 cases,treated with modified porous CD)and combined group(43 cases,treated with modified porous CD combined with VSD).The treatment effect,hip joint function,pain,hip joint activity and postoperative complications were compared between the two groups.Results The total effective rate of the combined group was higher than that of the CD group[95.3％(41/43)vs 81.1％(30/37)](x2=4.055,P=0.004).At 3,6,and 12 months after operation,the Harris hip scores of the combined group were higher than those of the CD group,and the visual analogue scale scores of pain were lower than those of the CD group(all P＜0.05).The range of motion of hip joint in the combined group was greater than that in the CD group at 6 months after operation(P＜0.05).The total incidence of long-term postoperative complications in the combined group was lower than that in the CD group[7.0％(3/43)vs 24.3％(9/37)](x2=4.694,P=0.030).Conclusion Modified porous CD combined with VSD has a good effect in the treatment of adult patients with early AVN,which can improve hip joint function,control disease progression,reduce pain,increase hip joint activity,and has high safety.

Abstract:Objective To investigate the association between nocturnal systolic blood pressure(nSBP)and estimated glomerular filtration rate(eGFR)in hypertensive patients with heart failure with preserved ejection fraction(HFpEF).Methods A total of 305 hypertensive patients with HFpEF in the Second Hospital,Lanzhou University from December 1,2017 to June 30,2024 were retrospectively selected.According to nSBP,the patients were divided into high-nSBP group(222 cases),middle-nSBP group(69 cases),and low-nSBP group(14 cases).The clinical data of the three groups were compared,Pearson or Spearman model was used for correlation analysis,and multivariate linear regression was used to analyze the independent risk factors affecting eGFR.Results Systolic blood pressure and diastolic blood pressure in the low-nSBP group and the middle-nSBP group were lower than those in the high-nSBP group at each time point,and nSBP in the low-nSBP group was lower than that in the middle-nSBP group(all P＜0.05).The level of serum creatinine in the middle-nSBP group was lower than that in the high-nSBP group and low-nSBP group,and the level of eGFR was higher than that in the high-nSBP group and low-nSBP group(all P＜0.05).eGFR was negatively correlated with age,serum uric acid and serum creatinine(r=-0.247,-0.205,-0.606,all P＜0.05),and positively correlated with body mass index,heart rate and daytime diastolic blood pressure in hypertensive patients with HFpEF(r=0.179,0.173,0.116,all P＜0.05).Age,serum creatinine,the ratio of mitral E velocity to early diastolic mitral annular velocity,and nSBP were independent risk factors for eGFR(all P＜0.05).Conclusion In patients with hypertension and HFpEF,either high or low nSBP will lead to a decrease in eGFR.

Abstract:Objective To study the expression of long non-coding RNA chromatin associated RNA 10(CAR10)and 3-phosphoinositol-dependent protein kinase 1(PDPK1)in cervical cancer tissues and analyze the evaluation value of both for the prognosis of patients.Method A total of 136 patients with cervical cancer who were treated at Xinjiang Medical University Affiliated Cancer Hospital from January 2019 to February 2021 were selected.The relative expression levels of CAR10 and PDPK1 mRNA in cervical cancer tissues were detected by real-time fluorescence quantitative polymerase chain reaction.The correlation between CAR10 and PDPK1 mRNA was analyzed.Log-rank test was used to compare the survival curves of cervical cancer patients with different CAR10 and PDPK1 mRNA expression groups.Cox regression model was used to screen the prognostic factors of cervical cancer patients.Results The relative expression levels of CAR10 and PDPK1 mRNA in cervical cancer tissues were higher than those in adjacent tissues[(3.14±0.52)vs(1.01±0.28),(4.0±0.5)vs(1.1±0.3)](both P＜0.001).There was a positive correlation between CAR10 and PDPK1 mRNA expression in cervical cancer(r=0.789,95％confidence interval:0.347-0.897,P＜0.001).The mRNA levels of CAR10 and PDPK1 in international federation of gynecology and obstetrics(FIGO)stage Ⅰ B2-Ⅱ A2 cervical cancer were higher than those in stage Ⅰ A1-Ⅰ B1 patients(all P＜0.001).Log-rank test showed that the 3-year survival rate of different CAR10 and PDPK1 mRNA expression groups was statistically significant(all P＜0.05).Multivariate Cox regression analysis showed that FIGO stage Ⅰ B2-Ⅱ A2,high CAR10 mRNA and high PDPK1 mRNA were risk factors affecting the prognosis of cervical cancer patients(all P＜0.05).Conclusion The expressions of CAR10 and PDPK1 mRNA are significantly up-regulated in cervical cancer tissues,which are involved in the pro-gression of cervical cancer and are tumor markers for evaluating the prognosis of patients.

Abstract:Objective To observe the clinical characteristics of in-hospital cardiac arrest(IHCA)in patients with acute myocardial infarction complicated with cardiogenic shock,and further analyze the risk of in-hospital death and discharge death after IHCA.Methods Consecutive patients with acute myocardial infarction complicated with cardiogenic shock admitted to the Critical Care Center,Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University from September 1,2021 to July 31,2024 were enrolled,and the patients who met the inclusion criteria were enrolled in a pure observational study.Patients were divided into groups according to whether IHCA events occurred during the treatment,and the clinical outcomes and clinical characteristics of patients in different groups were further observed and compared.The primary endpoint was in-hospital death.The secondary endpoints included in-hospital complications,all-cause death within 30 d after discharge and all-cause death within 1 year after discharge.Cox regression model was used to analyze the relationship between IHCA and the risk of in-hospital death,and modified Poisson regression was used to analyze the effect of IHCA on death at 30 d and 1 year after discharge.Results A total of 148 patients were selected in this study,of which 62 patients had IHCA(IHCA group),the incidence of IHCA was 41.9％,and the remaining 86 patients were included in the non-IHCA group.The proportion of male,blood lactate level,vasoactive drug score and gastrointestinal bleeding rate in IHCA group were significantly higher than those in non-IHCA group,and the left ventricular ejection fraction(LVEF)and the proportion of revascularization were significantly lower than those in non-IHCA group(all P＜0.05).The in-hospital mortality,30 d mortality,and 1-year mortality in the IHCA group were significantly higher than those in the non-IHCA group(all P＜0.05).Sixty-two IHCA patients were divided into shockable cardiac arrest(VFCA)group(47 cases)and non-shockable cardiac arrest(NVFCA)group(15 cases)according to the type of cardiac arrest.The 30 d mortality rate in the NVFCA group was significantly higher than that in the VFCA group(P＜0.05).Cox regression model analysis showed that compared with the non-IHCA group,the hazard ratio of in-hospital death in the IHCA group was 2.064(P=0.011).The results of modified Poisson regression analysis showed that compared with the non-IHCA group,the relative risk of death in the IHCA group was 1.606(P=0.003)at 30 d after discharge and 1.644(P=0.001)at 1 year after discharge.Compared with the VFCA group,the relative risk of death in the NVFCA group was 1.599(P=0.010)at 30 d after discharge and 1.369(P=0.070)at 1 year after discharge.Conclusion In patients with acute myocardial infarction complicated with cardiogenic shock,blood lactate level is higher,LVEF level and revascularization rate are lower in IHCA patients.IHCA increased the risk of in-hospital death,30 d death and 1-year death after discharge,and NVFCA increased the risk of 30 d death after discharge.

Abstract:Ankylosing spondylitis(AS)is an autoimmune disease characterized by immune disorder,chronic inflammation and abnormal bone metabolism,with the imbalance of T helper 17(Th17)/regulatory T(Treg)cells as the core,and its main clinical manifestations include inflammatory back pain and spinal ankylosis.This article systematically reviews relevant domestic and foreign literatures to explore the theoretical basis and mechanism of Duhuo Jisheng decoction in intervening AS.From the perspective of traditional Chinese medicine theory,this prescription is derived from Beiji Qianjin Yaofang,with the core effects of dispelling wind-dampness,relieving arthralgia,tonifying the liver and kidney,and nourishing Qi and blood,which is consistent with the pathogenesis of AS that"kidney deficiency and Du meridian insufficiency are the root cause,and wind-cold-dampness stasis are the superficial factors".From the perspective of modern mechanism,it repairs the Th17/Treg balance through the synergistic effect of multiple components and multiple targets:it not only downregulates the proportion of Th1 7 cells and the expression of retinoic acid receptor-related orphan receptor γt,and reduces the secretion of the proinflammatory factor interleukin-17(IL-17),but also upregulates the proportion of Treg cells and the expres-sion of forkhead box P3,and increases the release of the anti-inflammatory factor IL-10.Meanwhile,it targets and regulates upstream signaling pathways such as Janus kinase/signal transducer and activator of transcription and nuclear factor-κB,thereby inhibiting the inflammatory cascade reaction and improving pathological bone metabolism.However,current studies still have problems such as the disconnection between mechanism and clinical transformation and insufficient level of clinical evidence.In the future,it is necessary to promote its precise application through multi-center,large-sample randomized controlled trials and the construction of individualized diagnosis and treatment models,so as to provide a theoretical basis for the integrated Chinese and Western medicine treatment of AS.

Abstract:Objective To analyze the influencing factors for bronchospasm in patients with chronic heart failure(CHF)during metoprolol treatment.Methods A total of 284 CHF patients treated with metoprolol who were admitted to the Affiliated Hospital of Jiangsu University from January 2022 to December 2024 were enrolled as research subjects.According to the occurrence of bronchospasm during treatment,the patients were divided into the bronchospasm group and the non-bronchospasm group,and the clinical data of the patients were collected.Univariate and multivariate Logistic regression analyses were used to screen the independent influencing factors of bronchospasm.A visual nomogram was constructed by R software,and the discrimination ability,calibration and clinical validity of the visual nomogram were evaluated by receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis.Results A total of 284 CHF patients treated with metoprolol were included in this study,and 43 patients developed bronchospasm during treatment,with an incidence rate of 15.1％(43/284).There were statistically significant differences in age,smoking status,history of asthma,complicated chronic obstructive pulmonary disease(COPD),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC)ratio and brain natriuretic peptide(BNP)level between the bronchospasm group and the non-bronchospasm group(all P＜0.05).Multivariate Logistic regression analysis showed that age(odds ratio=1.114,95％confidence interval:1.054-1.178,P＜0.001),smoking(odds ratio=2.839,95％confidence interval:1.266-6.362,P=0.011),history of asthma(odds ratio=3.631,95％confidence interval:1.228-10.737,P=0.020),compli-cated COPD(odds ratio=5.008,95％confidence interval:2.095-11.968,P＜0.001)and BNP level(odds ratio=1.011,95％confidence interval:1.005-1.017,P＜0.001)were independent risk factors for bronchos-pasm in CHF patients during metoprolol treatment,while FEV1/FVC ratio(odds ratio=0.926,95％confidence interval:0.889-0.965,P＜0.001)was an independent protective factor.The area under the curve of the constructed visual nomogram was 0.860(95％confidence interval:0.797-0.923).The calibration curve had a high coincidence with the ideal diagonal line(Hosmer-Lemeshow testx2=7.243,P=0.511),and the decision curve showed a high net benefit value in the threshold probability range of 0-98％.Conclusion Age,smoking,history of asthma,complicated COPD,FEV1/FVC ratio and BNP level are independent influencing factors for bronchospasm in CHF patients during metoprolol treatment.The visual nomogram constructed in this study has good clinical practicability,which can provide a reference for early identification of high-risk patients and optimiza-tion of medication management.

Abstract:Type 2 diabetes mellitus is a complex metabolic disease with an increasing prevalence year by year,and its various complications have attracted wide attention from researchers.Diabetic gastrointestinal dysfunction can present as hyperfunctional symptoms such as nausea,vomiting and diarrhea,or hypofunctional symptoms including early satiety,abdominal distension and constipation.These symptoms occur intermittently and alternately,often accompanied by psychological problems such as anxiety and depression,which seriously affect patients'quality of life.However,due to its non-fatal nature,this field has not received sufficient attention,and its pathogenesis remains incompletely clear.As the second largest genome of humans,gut microbiota plays an important role in the development of metabolic diseases,especially type 2 diabetes mellitus.This article reviews the relationship between gut microbiota and gastrointestinal dysfunction in type 2 diabetes mellitus,aiming to provide a scientific basis for improving diabetes-induced gastrointestinal dysfunction by targeting gut microbiota.

Abstract:Post-traumatic osteomyelitis is an infectious lesion caused by pathogenic microorganisms invading and multiplying in bone tissue after trauma,with such clinical challenges as delayed diagnosis,refractory infection,difficult debridement planning and complex defect repair.At present,most patients have poor therapeutic outcomes due to delayed diagnosis and difficulty in controlling infection and surgical defects,so new diagnostic and therapeutic methods are urgently needed to improve prognosis.In view of this,this paper integrates the latest domestic and international research in recent years,focusing on the therapeutic advances in rapid diagnosis,antibacterial therapy and surgical reconstruction,aiming to provide new ideas for clinical practice and research.

Abstract:Objective To explore the predictive value of serum heat shock protein 90α(HSP90α),annexin A3(ANXA3)combined with tumor-infiltrating lymphocytes(TILs)for the efficacy of neoadjuvant chemo-therapy(NAC)in breast cancer patients.Methods A total of 234 breast cancer patients(all receiving NAC)admitted to Qinghai Red Cross Hospital from April 2022 to February 2025 were prospectively enrolled.They were divided into an effective group and an ineffective group according to the efficacy of NAC.The serum levels of HSP90α and ANXA3 were detected by enzyme-linked immunosorbent assay,and the proportion of TILs was evaluated after hematoxylin-eosin staining.Logistic regression was used to analyze the influencing factors of NAC efficacy in breast cancer.Receiver operating characteristic curve was used to analyze the predictive value of serum HSP90α,ANXA3 combined with TILs for NAC efficacy in breast cancer.Results The serum levels of HSP90α and ANXA3 in the ineffective group were significantly higher than those in the effective group[(4.5±1.0)μg/L vs(2.9±1.0)μg/L,(6.0±1.1)μg/L vs(4.4±1.0)μg/L],while the TILs proportion was significantly lower than that in the effective group[(16.2±2.2)％vs(52.4±3.4)％](all P＜0.05).The areas under the curve(AUC)of serum HSP90α,ANXA3 and TILs for predicting NAC efficacy in breast cancer were 0.751,0.825 and 0.815,respectively,and the AUC of the combination of the three was 0.920,which was significantly higher than that of each single index(Z=2.701,2.742,2.757,all P＜0.05).HSP90α,ANXA3 and TILs were all correlated with molecular subtype,lymph node status and human epidermal growth factor receptor 2(HER-2)status of breast cancer patients(all P＜0.05).Logistic regression analysis showed that lymph node status,HER-2 status,HSP90α and ANXA3 were risk factors for NAC efficacy in breast cancer,while TILs was a protective factor(all P＜0.05).Conclusion The serum levels of HSP90α,ANXA3 and TILs in breast cancer patients show abnormal changes.Lymph node status,HER-2 status,HSP90α,ANXA3 and TILs are influencing factors of NAC efficacy in breast cancer,and the combination of HSP90α,ANXA3 and TILs has a certain predictive value for NAC efficacy in breast cancer patients.

Abstract:Objective To investigate the efficacy of vitamin D drops combined with cetirizine in the treatment of children with asthma in remission stage after acute exacerbation and its effect on immune function.Methods A total of 110 children with acute exacerbation of asthma admitted to Hebei Children's Hospital from January 2023 to January 2024 were enrolled and divided into the control group and the observation group according to the random number table method,with 55 cases in each group.At remission stage after acute exacerbation,on the basis of conventional treatment,the control group was treated with oral cetirizine,while the observation group was treated with vitamin D on the basis of control group.The general data,clinical efficacy,immune function indexes,pulmonary function-related indexes,serum 25-hydroxyvitamin D3 level,immunoglobulin E(IgE)level,remission of acute asthma exacerbation and asthma attacks and medical visits during treatment were compared between the two groups.Results There were no statistically significant differences in general data between the two groups(all P＞0.05).The total effective rate of the observation group was significantly higher than that of the control group[94.6％(52/55)vs 72.7％(40/55)](x2=9.565,P=0.002).After treatment,the levels of CD4+,CD4+/CD8+,forced expiratory volume in one second,forced vital capacity,peak expiratory flow,serum 25-hydroxyvitamin D3 and childhood asthma control test scores in both groups were significantly higher than those before treatment,and the above indexes in the observation group were significantly higher than those in the control group;the levels of CD8+and IgE in both groups were significantly lower than those before treatment,and the above indexes in the observation group were significantly lower than those in the control group(all P＜0.05).During the treatment period,the frequency of acute asthma exacerbation,unscheduled visits and hospitalization in the observation group were significantly lower than those in the control group(all P＜0.05).Conclusion Vitamin D combined with cetirizine has a significant therapeutic effect on children with asthma in remission stage after acute exacerbation,which can improve the immune function and pulmonary function of children.

Abstract:Objective To analyze patients admitted to the hospital for acute pulmonary embolism,and to describe the clinical characteristics and in-hospital outcomes of patients with or without cancer.Methods The clinical data of 1 931 patients with acute pulmonary embolism admitted to the First Affiliated Hospital of Henan University of Science & Technology from July 2011 to February 2023 were retrospectively analyzed.According to the presence or absence of cancer,they were divided into cancer group(307 cases)and non-cancer group(1 624 cases).Clinical characteristics and in-hospital outcomes were compared between the two groups.Results The proportions of dyspnea,chest pain,syncope and fever in the cancer group were lower than those in the non-cancer group(all P＜0.05).The proportion of patients without clinical symptoms in the cancer group(19.9％)was about three times higher than that in the non-cancer group(7.4％,P＜0.001).In terms of European Society of Cardiology risk stratification of pulmonary embolism,there was no significant difference in the proportion of high risk between the two groups(P=0.214).There were significant differences in international normalized ratio,prothrombin time ratio,prothrombin activity,prothrombin time and fibrinogen between the two groups(all P＜0.05).The predicted in-hospital mortality was 14.7％(45/307)in cancer group and 8.3％(135/1 624)in non-cancer group,and the difference between the two groups was statistically significant(x2=12.298,P＜0.001).Conclusions The proportion of patients with no clinical symptoms in the cancer group was approximately three times higher than that in the non-cancer group,and in addition to a more severe hypercoagulable state,the absence of clinical symptoms may be an important cause of poor prognosis.

Abstract:Objective To investigate the effect of Netrin-1 overexpressing macrophage-derived exosomes(N-Exos)on angiogenesis and nerve repair after sciatic nerve injury in type 2 diabetes mellitus(T2DM)mice.Methods Bone marrow-derived macrophages(BMDMs)were isolated from the lower limb bone marrow of mice,and adenovirus transfection was used to induce Netrin-1 overexpression in BMDMs.The phenotype of macrophages after Netrin-1 overexpression was detected,and their exosomes were extracted and identified by transmission electron microscopy,nanoparticle tracking analysis and Western blot.Human umbilical vein endothelial cells(HUVECs)were co-cultured with N-Exos under high-glucose conditions in vitro to detect the effects of N-Exos on the proliferation,apoptosis,migration and tube formation abilities of HUVECs.Eighteen 8-week-old male C57BL/KsJ-db/db mice were randomly divided into three groups:the sciatic nerve injury group(control group),the exosome treatment group(Exos group),and the Netrin-1 overexpressing exosome treatment group(N-Exos group).A sciatic nerve injury model of T2DM mice was established to evaluate the effect of N-Exos on nerve repair after sciatic nerve injury in T2DM mice.Results The cell proliferation rate in the N-Exos group was higher than that in the Exos group and the control group,the 24 h scratch healing rate of HUVECs in the N-Exos group was higher than that in the Exos group and the control group,and the relative cumulative length of tube formation of HUVECs co-cultured with N-Exos was longer than that in the Exos group and the control group(all P＜0.05).TUNEL staining results showed that the number of apoptotic HUVECs was the largest in the control group and the smallest in the N-Exos group.In vivo experiments on T2DM mice confirmed that the relative fluorescence intensity of tumor necrosis factor-α in the injured sciatic nerve in the N-Exos group was lower than that in the control group and the Exos group,the relative fluorescence intensities of myelin basic protein and neurofilament protein were both higher than those in the control group and the Exos group,and the relative fluorescence intensity of CD31 in the injured nerve in the N-Exos group was higher than that in the control group and the Exos group.At 14 d after surgery,the gastrocnemius muscle atrophy index of mice in the N-Exos group was significantly lower than that in the Exos group and the control group[(15.7±1.0)％vs(20.5±0.8)％,(25.7±2.5)％](P=0.001).Conclusion N-Exos can promote angiogenesis and nerve repair after peripheral nerve injury in T2DM mice,which provides new ideas and a theoretical basis for the clinical treatment of peripheral nerve injury in diabetic patients.

Abstract:Gastritis cystis profunda(GCP)is a rare clinical gastric submucosal lesion characterized by polypoid hyperplasia and cystic dilatation of gastric glands extending into the gastric submucosa.Due to the non-specific clinical symptoms and endoscopic findings,preoperative diagnosis is still difficult,and histopathological examination is necessary to make a definite diagnosis.This article reports a case of GCP diagnosed by histopathology after endoscopic mucosal dissection due to abdominal distension and pain.And report on its etiology and pathogenesis,clinical manifestations,imaging features,diagnosis and treatment,and review relevant literature to improve clinical physicians' understanding of the disease.

Abstract:Objective To investigate the correlation between platelet to lymphocyte ratio(PLR)and disease activity in patients with rheumatoid arthritis(RA),and to evaluate its predictive value for disease activity in RA patients.Methods A total of 64 RA patients hospitalized in the Department of Rheumatology and Immunology,Shaanxi Provincial People's Hospital from June to December 2022 were enrolled.According to the disease activity index of 28 joints(DAS28-ESR)score based on erythrocyte sedimentation rate(ESR),patients were divided into low disease activity group(10 cases),moderate disease activity group(29 cases)and high disease activity group(25 cases).The clinical data and PLR levels of the three groups were compared,and the correlation between PLR and other indicators was analyzed.The risk factors for RA disease activity were determined by ordinal Logistic regression analysis,and the predictive value of PLR for disease activity was judged by receiver operating characteristic curve.Results The DAS28-ESR,tender joint count(TJC),swollen joint count,ESR,neutrophil count and PLR in the high disease activity group were higher than those in the low and moderate disease activity groups.The hemoglobin and cholinesterase in the high disease activity group were lower than those in the low and moderate disease activity groups(all P＜0.05).Correlation analysis showed that PLR was positively correlated with DAS28-ESR,ESR and platelet count,and negatively correlated with absolute lymphocyte count,hemoglobin,alanine aminotransferase and cholinesterase(all P＜0.05).Logistic regression analysis showed that TJC,ESR and PLR were risk factors for disease activity in RA patients(odds ratio=8.723,1.471,1.068,all P＜0.05).The area under the curve of PLR for predicting disease activity in RA patients was 0.712(95％confidence interval:0.567-0.857),the cut-off value was 212.95,the sensitivity was 56.0％,and the specificity was 94.9％.Conclusion PLR is related to the disease activity of RA patients.Combined with other related indicators,PLR can be used as an index to judge the disease activity,which has a suggestive effect on clinical practice.

Abstract:Objective To evaluate the role of lymphocyte subsets and cytokines in predicting the efficacy of immunotherapy in patients with advanced colorectal cancer,in order to provide effective clinical predictive tools for individualized treatment of patients with advanced colorectal cancer.Methods The clinical data of 52 patients with advanced colorectal cancer treated with programmed cell death receptor-1/programmed cell death receptor ligand-1 inhibitor in Suzhou Municipal Hospital,Jiangsu Province from October 2022 to April 2025 were collected and retrospectively analyzed.According to the response evaluation criteria in solid tumors,the patients were divided into complete response,partial response,stable disease and progressive disease.The patients with complete response,partial response and stable disease were classified into the control group(29 cases),and the patients with progressive disease were classified into the progression group(23 cases).The levels of lymphocyte subsets(regulatory T cells,CD3+,CD4+,CD8+,CD19+,natural killer cells)and cytokines[interleukin-2(IL-2),IL-4,IL-6,IL-10,tumor necrosis factor-α,interferon-γ]were compared between the two groups before and after treatment,and their correlation with the efficacy of immunotherapy was analyzed.Results The level of natural killer cells in the control group was significantly higher than that in the progression group before treatment[19.1％(14.6％,24.9％)vs 8.0％(7.2％,18.2％)](P=0.041).After treatment,IL-6 in the progression group was significantly higher than that before treatment,and IL-6 in the control group was significantly lower than that before treatment,and IL-6 in the control group was lower than that in the progression group[4.7(3.5,9.5)ng/L vs 17.3(14.7,47.4)ng/L](all P＜0.05).Through Pearson correlation analysis,it was found that IL-6 was negatively correlated with tumor progression(r=-0.489,P=0.003),suggesting that the higher the IL-6 level,the worse the treatment effect.Conclusion Natural killer cells and IL-6 have potential value in predicting the response of immunotherapy in patients with advanced colorectal cancer.Increased levels of natural killer cells are associated with better treatment response,whereas increased IL-6 may predict a worse prognosis.

Abstract:Objective To investigate the effect of BufeiHuoxue capsule combined with rock salt aerosol therapy on pneumoconiosis,and its influence on exercise endurance and lung function of patients.Methods A total of 87 pneumoconiosis patients admitted to the Third People's Hospital of Xinjiang Uygur Autonomous Region from February 2021 to June 2023 were selected.They were divided into observation group(44 cases)and control group(43 cases)by random number table method.The control group was given rock salt aerosol therapy on the basis of basic treatment.The observation group was treated with BufeiHuoxue capsule on the basis of the control group.The total effective rate,respiratory function,lung function index,serum biochemical index,exercise tolerance and safety were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[93.2％(41/44)vs 76.7％(33/43)](P＜0.05).After treatment,the St.George's Respiratory Questionnaire scores of the observation group and the control group were lower than those before treatment,and that of the observation group was lower than that of the control group[(52±6)vs(60±8)](P＜0.001).The forced expiratory volume and forced vital capacity levels in the first second of both groups were higher than before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).After treatment,the levels of interleukin-8 in the two groups were lower than those before treatment,and that in the observation group was lower than that in the control group;the levels of γ-interferon in the two groups were higher than those before treatment,and that in the observation group was higher than that in the control group(all P＜0.05).After treatment,the 6 min walk test distances of the observation group and the control group were longer than those before treatment,and the 6minwalk test distance of the observation group was longer than that of the control group[(366±39)m vs(331±35)m](P＜0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion BufeiHuoxue capsule combined with rock salt aerosol therapy can effectively improve the lung function and exercise endurance of pneumoconiosis patients.