Abstract:Objective To investigate the predictive effect of serum carbohydrate antigen 125(CA125)and human epididymis protein 4(HE4)on postoperative recurrence in patients with endometriosis(EMs).Methods A total of 95 EMs patients admitted to the Third Affiliated Hospital of Zhengzhou University from April 2020 to July 2023 were selected as the study subjects.According to the staging criteria of American Society for Reproductive Medicine(ASRM),95 EMs patients were divided into s tage Ⅰ-Ⅱ(n=35)and stage Ⅲ-Ⅳ(n=60).The levels of serum CA125 and HE4 in EMs patients with different ASRM stages were detected and compared.After one year of follow-up,the recurrence situation was statistically analyzed,and the general data and laboratory examination indexes(age,disease classification,parity,history of uterine cavity operation,postoperative dysmenorrhea,ASRM stage,preoperative serum CA125 level and preoperative serum HE4 level)were compared between the recurrence group and the non-recurrence group.Multivariate logistic regression was used to analyze the risk factors affecting postoperative recurrence of EMs.The receiver operating characteristic(ROC)curve was used to evaluate the value of serum CA125 and HE4 alone and in combination in predicting postoperative recurrence in EMs patients.Results The levels of serum CA125 and HE4 in patients with ASRM stage Ⅲ-Ⅳ were significantly higher than those in patients with ASRM stageⅠ-Ⅱ[CA125:(45.21±5.09)U/mL vs.(27.49±4.21)U/mL].HE4:(168.14±14.47)pmol/L vs.(143.25±12.25)pmol/L;t=17.403,8.541,P<0.001].There were 13 cases of recurrence one year after surgery and 82 cases without recurrence.The percentage of patients with postoperative dysmenorrhoea in the recurrence group(46.15％,6/13),the percentage of ASRM stage Ⅲ-Ⅳ(76.92％,10/13),and the preoperative serum CA125[(49.46±5.56)U/mL]and HE4 levels[(63.26±4.32)pmol/L]were higher than those in the non recurrence group[19.51％(16/82),30.49％(25/82),(36.96±4.23)U/mL,(50.97±2.27)pmol/L;χ2=4.475,10.398,t=9.464,15.677,P<0.05].There was no statistically significant difference between the two groups when comparing the age of the patients,disease staging,number of deliveries,and history of uterine surgery(P>0.05).Multivariate logistic analysis showed that postoperative dysmenorrhoea,ASRM stage Ⅲ-Ⅳ,and rising serum CA125 and HE4 levels were risk factors for postoperative recurrence of EMs(OR=6.215,5.786,5.295,4.869,P<0.05).As shown by the ROC curve,the sensitivity and specificity of the combined prediction of CA125 and HE4 for the postoperative recurrence risk of EMs patients were 89.47％and 89.12％,respectively,and the area under the curve(AUC)was 0.924,which were higher than that predicted by CA125 and HE4 alone(CA125:75.93％,81.49％,0.798,respectively;HE4:72.52％,79.86％,0.822).Conclusions The levels of CA125 and HE4 are highly expressed in patients with EMs stage Ⅲ-Ⅳ,and the combined monitoring of the changes of the above indicators can effectively evaluate the recurrence risk after EMs surgery,and provide a scientific basis for formulating individualized treatment plans.

Abstract:The dorsocervical fat pad refers to a soft tissue hyperplastic mass dominated by adipose tissue hyperplasia,which varies in size,hardness and softness,and occurs in the depression between the spinous process of the 7th cervical vertebra and the spinous process of the 1st thoracic vertebra on the midline of the nape and back.With the development of plastic,aesthetic and reconstructive surgery in China,there is a growing demand for improved medical interventions to enhance the aesthetic appearance of the neck.Therefore,the diagnosis and treatment of dorsocervical fat pad(commonly known as"Fugui Bao")hold significant potential for development.This article provides a review of the diagnosis and clinical management strategies for dorsocervical fat pads.

Abstract:Objective To analyze whether heart failure(HF)leads to an increase in myeloid-derived suppressor cells(MDSCs)in mice,and whether these expanded MDSCs are recruited into breast cancer tissues,thereby promoting tumor proliferation.Methods A mouse model of HF was established by isoproterenol(ISO)induction in mice bearing breast cancer.Cardiac function was assessed using M-mode echocardiography.Myocardial cell area was evaluated by hematoxylin-eosin(H&E)staining and wheat germ agglutinin(WGA)staining.The impact of HF on breast cancer development was assessed by comparing mammary tumor weight and volume,MDSC abundance,and their suppressive effect on T lymphocyte proliferation between the two groups.Results The tumor volume and weight in the ISO group were significantly greater than those in the control group(t=4.378 and 4.177,P<0.05).The content of MDSCs in the blood and tumor tissues of the ISO group was significantly higher than that in the control group,with a more pronounced increase in monocyte-type MDSCs within the tumor tissue(t=3.447,P<0.05).After co-culturing MDSCs recruited from the blood of HF mice with CD8+T lymphocytes,the proportion of proliferating CD8+T lymphocytes was 38.4%,indicating that MDSCs from HF mice significantly inhibited the T lymphocytes proliferation.Conclusions HF-induced expansion of MDSCs promotes breast cancer proliferation in mice,and HF-mediated alterations in immune function play a pivotal role in suppressing breast cancer progression.

Abstract:Objective To explore the distribution of pathogenic bacteria in pulmonary infection and the influencing factors in patients with stroke and diabetes mellitus.Methods A total of 262 patients with stroke and diabetes mellitus admitted to in the Second People's Hospital of Zhengzhou from January 2021 to January 2024 were selected.The patients were divided into the infection group(n=42)and the non-infection group(n=220)based on whether they had pulmonary infection.Sputum culture was performed on the patients in the infection group to isolate and identify the pathogenic bacteria.Multivariate stepwise logistic regression analysis was used to analyze the factors influencing pulmonary infection patients with stroke and diabetes.Results A total of 51 strains of pathogenic bacteria were detected from the specimens of 42 stroke patients complicated with diabetes and pulmonary infection,among which 37 strains were Gram-negative bacteria,with Klebsiella pneumoniae(27.45%)being the most prevalent.The age,fasting plasma glucose,white blood cell count and neutrophil count of the infection group were higher than those of the non-infection group,and the proportions of smoking history,diabetes duration≥5 years,consciousness disorder,dysphagia,hypoproteinemia,invasive procedures,and hospital stay≥14 days were higher in the infection group than in the non-infection group(P<0.05).Multivariate stepwise logistic regression analysis showed that diabetes duration≥5 years(OR=3.080,95%CI:1.451-6.538),dysphagia(OR=2.401,95%CI:1.440-4.005),hypoproteinemia(OR=2.467,95%CI:1.406-4.330),and invasive procedures(OR=3.228,95%CI:1.671-6.237)were independent risk factors for pulmonary infection in patients with stroke and diabetes mellitus(P<0.05).Conclusions The pathogens of pulmonary infection in stroke patients with diabetes mellitus are widely distributed and have many risk factors.It is necessary to strengthen high-risk monitoring and identify the pathogens as soon as possible for precise treatment.

Abstract:Objective To investigate the value of Xuebijing injection combined with and Sivelestat sodium therapy on protecting inflammatory factors and organ function in patients with severe pneumonia.Methods Clinical data of 95 patients with severe pneumonia admitted to the intensive care unit(ICU)of Zhengzhou Second People's Hospital from January to June 2023 were collected.Based on whether they received treatment with Xuebijing injection and sivelestat sodium,these patients were divided into the Xuebijing group(n=51)and the combination medication group(n=44,receiving both Xuebijing injection and Sivelestat sodium).Inflammatory markers[white blood cell(WBC)count,platelet(PLT)count,C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6)]and organ function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),urea,fibrinogen(FIB)]were compared between the two groups at baseline and at the endpoint(transfer out of ICU or death).Duration of mechanical ventilation,length of ICU stay,and mortality were also compared.Adverse reactions in both groups were recorded.Results At baseline,there was no statistical significance in serum inflammatory factors(WBC count,PLT,CRP,PCT,IL-6)and organ function indicators(ALT,AST,Cr,Urea,FIB)between the two groups(P>0.05).At the endpoint of treatment,the mean values of PCT in the Xuebijing group and the medication combination group were 0.19 ng/mL and 0.27 ng/mL respectively,which were significantly lower than baseline of 0.78 and 1.01 ng/mL(Z=-2.888 and-2.386 respectively,P<0.05).Similarly,the mean values of CRP decreased significantly to 46.20 mg/L and 59.03 mg/L from baseline of 94.53 mg/L and 98.71 mg/L(Z=-3.417 and-1.963 respectively,P<0.05).In the medication combination group,the mean IL-6 level decreased significantly from 64.0 pg/mL to 13.1 pg/mL(Z=-3.158,P<0.05),and the mean Urea level decreased from 5.89 mmol/L to 5.12 mmol/L(Z=-2.134,P<0.05).In contrast,the mean FIB level in the Xuebijing group increased significantly from 4.15 g/L to 5.95 g/L(Z=2.877,P<0.05).At the endpoint of treatment,the median levels of IL-6,Urea,and FIB in the medication combination group were significantly lower than those in the Xuebijing group[IL-6:13.1 pg/mL vs.30.5 pg/mL,Z=-1.660;Urea:5.12 mmol/L vs.5.67 mmol/L,Z=-1.732;FIB:4.39 g/L vs.5.95 g/L,Z=-2.439;P<0.05].The platelet count was significantly higher in the combination group compared to the Xuebijing group[164×10⁹/L vs.112×10⁹/L,Z=-1.885,P<0.05].Additionally,the duration of mechanical ventilation was significantly shorter in the medication combination group than in the Xuebijing group[(6.39±3.83)d vs.(7.76±2.72)d,t=-1.960,P<0.05].Conclusions Compared with Xuebijing injection alone,the combination therapy of Xuebijing injection and Sivelestat sodium significantly reduces inflammatory cytokine levels,provides greater protection to renal function and coagulation function,shortens the duration of mechanical ventilation,and demonstrates a favorable safety profile.

Abstract:Objective To investigate the expression of cerebrospinal fluid P73 protein and the receptor for advanced glycation end products(RAGE)in patients after traumatic brain injury(TBI)surgery and to evaluate their value in assessing cognitive function and prognosis.Methods A total of 181 traumatic brain injury patients admitted to Fenyang Hospital of Shanxi between July 2020 and October 2023 were enrolled.Based on their Mini-Mental State Examination(MMSE)scores one month post-surgery,they were divided into mild(n=79),moderate(n=62),and severe cognitive impairment groups(n=40).The expression levels of P73 protein and RAGE in the cerebrospinal fluid were compared among these groups.Pearson correlation analysis was used to assess the relationships between P73 protein,RAGE,and MMSE scores.At 12 months post-surgery,patient prognosis was categorized into good recovery,moderate disability,or severe disability groups according to the Glasgow Outcome Scale(GOS).General clinical data and laboratory indicators(including age,gender,hematoma volume,MMSE score,surgical approach,associated organ injury,shock,infection,postoperative sedation,postoperative analgesia,P73 protein,and RAGE)were compared among the prognosis groups.Multivariate ordinal logistic regression was employed to identify factors influencing post-TBI surgical prognosis.Results The expression levels of P73 protein and RAGE showed statistically significant differences among patients with varying degrees of cognitive function(P<0.001).The levels,in descending order,were as follows:the mild group[P73 protein:0.38±0.06,RAGE:(169.79±42.31)ng/mL],the moderate group[P73 protein:0.27±0.04,RAGE:(135.60±32.61)ng/mL],and the severe group[P73 protein:0.16±0.02,RAGE:(107.64±24.50)ng/mL].Pearson correlation analysis revealed positive correlations between P73 protein and MMSE scores(r=0.393,P<0.001),and between RAGE and MMSE scores(r=0.385,P<0.001).At the 12-month follow-up,the good recovery group exhibited higher levels of P73 protein(0.34±0.03),RAGE[(165.83±42.75)ng/mL],MMSE scores(20.52±1.39),and a greater proportion of patients with hematoma volume<30 mL[73.40%(69/94)]compared to the moderate disability group[P73 protein:0.25±0.06;RAGE:(130.37±31.16)ng/mL;MMSE:(13.25±1.71);proportion with hematoma<30 mL:54.55%(36/66)].These values in the good recovery group were also higher than those in the severe disability group[P73 protein:0.23±0.04;RAGE:(92.07±24.37)ng/mL;MMSE:(8.23±0.93);proportion with hematoma<30 mL:28.57%(6/21)].However,no statistically significant differences were observed among the three groups regarding age,gender,surgical approach,or the prevalence of associated organ injury,shock,infection,postoperative sedation,or analgesia(P>0.05).Multivariate logistic regression analysis showed haematoma volume(OR=4.869,95%CI:1.608-14.737),MMSE score(OR=2.130,95%CI:1.256-3.614),P73 protein(OR=5.333,95%CI:1.610-17.664),and RAGE(OR=5.053,95%CI:1.571-16.251)as risk factors for an unfavorable after TBI surgery.Conclusions The expression levels of P73 protein and RAGE in cerebrospinal fluid are closely related to the cognitive function and prognosis in TBI patients.Monitoring these biomarkers can provide valuable reference information for assessing cognitive impairment and predicting clinical outcomes.

Abstract:Objective To explore the clinical characteristics of gouty arthritis(GA)combined with syndrome of inappropriate secretion of antidiuretic hormone(SIADH),so as to improve clinicians'diagnosis and treatment level of this combination,effectively reduce the incidence of missed and misdiagnosis,and thereby improve patient prognosis and quality of life.Methods Eighteen patients diagnosed with GA and SIADH at Ningde Hospital Affiliated to Ningde Normal University between January 2015 and September 2024 were selected.General clinical data,including gender,age,clinical symptoms,and laboratory findings,were summarized.The trend of serum sodium levels in all patients was analyzed.Results All 18 patients were male,aged 54 to 84 years(mean 66.6±8.6).SIADH occurred following an acute GA attack.The clinical features of GA patients with SIADH included tophi(100.0%,18/18),polyarthritis(83.3%,15/18),and elevated interleukin-6(IL-6)(100.0%,18/18).Comorbidities included hypertension(14 cases),diabetes(4 cases),hyperlipidemia(10 cases),and metabolic syndrome(5 cases).Among these patients,16 presented with anorexia,nausea,or vomiting,2 exhibited mental abnormalities,and 3 reported headaches.Further analysis revealed a negative correlation between serum sodium levels and both IL-6 and C-reactive protein(CRP)levels(r=-0.975 and-0.928,respectively;P<0.05),suggesting a close association between hyponatremia and the severity of the inflammatory response.Following anti-inflammatory therapy and sodium supplementation,serum sodium levels normalized and symptoms gradually improved.Conclusions SIADH is a complication of acute GA attacks.It can occur in patients with severe gout presenting with tophi,polyarticular involvement,and significantly elevated IL-6 and CRP.Hyponatremia may also serve as an indicator of inflammatory arthritis,particularly GA.SIADH can be resolved with anti-inflammatory treatment.

Abstract:Objective To investigate the changes of serum levels of interleukin-17(IL-17),T-cell immunoglobulin and mucin domain-containing protein 4(TIM-4)and Toll-like receptor 7(TLR7)in patients with severe pneumonia and the clinic value in predicting prognosis.Methods A retrospective study was conducted on 154 patients with severe pneumonia admitted to Zhengzhou Second People's Hospital between January 2021 and December 2024.According to the prognosis status after 28 days of treatment,they were divided into a good prognosis group(n=93;condition unchanged,stabilized or improved)and a poor prognosis group(n=61;condition deteriorated,with multiple organ failure or death).General clinical data and serum levels of IL-17,TIM-4 and TLR7 at admission,and on the 3rd and 7th day after admission were compared between the two groups.Multivariate logistic regression analysis was used to identify factors influencing poor prognosis in severe pneumonia patients.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of serum IL-17,TIM-4 and TLR7 at admission in predicting poor prognosis.Results The proportion of patients using mechanical ventilation was significantly higher in the poor prognosis group than in the good prognosis group[67.21%(41/61)vs.40.86%(38/93);χ2=10.240,P<0.05].At admission,serum levels of IL-17(79.65±14.21)pg/mL,TIM-4(105.35±25.16)pg/mL and TLR7(68.26±9.67)ng/mL in the poor prognosis group were significantly higher than in the good prognosis group[(72.83±12.14)pg/mL,(86.95±19.64)pg/mL and(62.35±8.86)ng/mL;t=3.185,5.080,3.904,respectively,P<0.01].Serum IL-17,TIM-4 and TLR7 levels in poor prognosis group on the 3rd day and 7th day after admission were significantly higher than those in good prognosis group(on the 3rd day:t=17.962,11.826,6.398,on the 7rd day:t=25.670,22.028,12.671,P<0.05).Multivariate logistic regression analysis identified mechanical ventilation(OR=1.689,95%CI:1.229-2.320,P=0.001),IL-17(OR=2.705,95%CI:1.456-5.025,P=0.002),TIM-4(OR=3.155,95%CI:1.564-6.364,P=0.001),and TLR7(OR=1.622,95%CI:1.622-5.165,P<0.001)as independent risk factors for a poor prognosis.ROC curve analysis reveled that the areas under the curve(AUC)for predicting poor prognosis using serum IL-17,TIM-4,TLR7,and their combination were 0.641,0.744,0.685,and 0.834,respectively.The corresponding sensitivities were 49.18%,50.82%,54.10%,and 81.97%,and the specificities were 78.49%,89.25%,79.57%,and 76.34%.Conclusions Serum levels of IL-17,TIM-4 and TLR7 are significantly elevated in patients with a poor prognosis and are closely associated with clinical outcomes in severe pneumonia.The combined detection of these biomarkers provides the highest predictive efficacy for patient prognosis.

Abstract:Objective To explore the effectiveness of a multidisciplinary team(MDT)management model combined with quality control circles(QCC)activities in improving the rate of pathogen detection before antimicrobial therapy in hospitalized patients.Methods A total of 51,575 inpatients who received antimicrobial therapy at Shanghai Fourth People's Hospital between February 2023 and March 2024 were enrolled.Based on the implementation date(August 2023)of the MDT model and QCC activities,25,312 patients who received therapeutic antimicrobial from February to A ugust 2023 were assigned to the control group,and 26,263 patients who received therapeutic antimicrobial from September 2023 to March 2024 were assigned to the intervention group.The two groups were compared regarding the rate of pre-therapeutic pathogen detection,incidence of hospital-acquired infections,antimicrobial agent defined daily doses(DDDs),defined daily dose(DDD)compliance rate of departmental detection targets,clinicians'awareness of the pre-therapeutic pathogen detection policy,and the improvement capabilities and competency scores of QCC members.Results The pathogen detection rate before the use of therapeutic antibacterial drugs in the intervention group[70.05％(8,657/12,358)]was significantly higher than that in the control group[49.47％(6,257/12,649),χ2=1,100.453,P<0.05].The incidence of hospital-acquired infections with multidrug-resistant organisms was significantly lower in the intervention group[0.26％(69/26,263)]compared to the control group[0.34％(87/25,312);χ2=4.902,P<0.05].The antimicrobial use frequency(66,919),total patient-days(170,389 days),and DDDs per 100 patient-days(39.27)in the intervention group were all higher than those in the control group(60,156;162,267 days;37.07,respectively).The average improvement capability of the QCC team reached 74.94％,exceeding the preset target(50.26％).Conclusions The combination of MDT and QCC significantly improved the pre-therapeutic pathogen detection rate in hospitalized patients and reduced the risk of multidrug-resistant organism infections.This approach provides practical experience and holds promotional value for standardizing antimicrobial stewardship and infection prevention and control practices.

Abstract:Objective To investigate the clinical efficacy of platelet-rich plasma(PRP)combined with autologous ultra-thin skin graft transplantation in the treatment of chronic diabetic wounds.Methods Sixty patients with chronic diabetic wounds admitted to the Burn and Plastic Surgery Department of Beijing Fengtai You'anmen Hospital were selected from July 2021 to December 2022.They were randomly divided into an observation group(n=30)and a control group(n=30).The observation group prepared PRP with autologous blood and adopted the method of local spraying of PRP on the wound surface after debridement combined with autologous ultra-thin skin graft transplantation for repair,while the control group received autologous ultra-thin skin grafting after debridement.The survival status of skin grafts on postoperative days 3,7,and 14 were evaluated,the adhesion between the skin grafts and the wound were observed;observing whether the wound was infected,and the clinical efficacy of the two groups were calculated.The survival rate of the skin grafts and the healing time of the wound were calculated;adverse reactions during the treatment process were observed.Follow up for 3 months to observe the healing of the wound.Results No significant difference were observed between the two groups in terms of skin graft adherence rate and wound infection rate at 3 and 7 days(P>0.05).The skin graft adherence rate in the observation group after 14 days of treatment[96.67%(29/30)vs.70.00%(21/30);χ2=7.680,P<0.01]was significantly higher than that in the control group,and the wound infection rate was significantly lower than that in the control group[3.33(1/30)vs.26.67%(8/30);χ2=4.706,P<0.05].In the observation group,26 cases(86.67%)showed markedly effective,3 cases(10.00%)showed effective,and 1 case(3.33%)showed ineffective.In the control group,18 cases(60.00%)showed markedly effective,9 cases(30.00%)showed effective and 3 cases(10.00%)showed ineffective.The effect of skin grafting in the observation group was significantly better than that of the control group(Z=2.130,P<0.05).The healing time in the observation group was significantly shorter than that of the control group[(15.2±3.2)d vs.(24.5±4.8)d;t=8.200,P<0.001],14 days after the skin grafting,the graft survival rate in the observation group was significantly higher than the control group[(90.5±8.7)%vs.(63.5±12.3)%;t=-9.500,P<0.001].Conclusions PRP combined with autologous skin graft transplantation shows favorable efficacy in the treatment of diabetic chronic wounds,suggesting promising clinical application value.

Abstract:Objective To explore the current status,hot topics,and future trends in the diagnosis and treatment of pediatric burn scars through visual analysis of international literature on this subject.Methods Literature related to pediatric burn scars published between April 1999 and March 2025 was retrieved from the Web of Science Core Collection.CiteSpace6.4.R1 visualization software and bibliometric methods were employed to analyze keyword co-occurrence,author collaborations,institutional contributions,research hotspots,and frontiers in this field.Results A total of 319 articles were included.The annual publication volume showed a steady increase,peaking in 2017 and 2021(25 articles each)and reaching a low in 1999(2 articles),with an average annual output of 12 articles.The most prolific author was Kimble Roy(13 articles),and the leading institution was the University of Queensland(42 articles).The top 9 high-frequency keywords were:children,management,injury,quality of life,hypertrophic scars,epidemiology,scars,pediatric burns,therapy.Key clusters identified in the Web of Science included enzymatic debridement,burn scars,burn wound,burn injury,patient,and depression.Early international research focused on basic wound repair in pediatric burn scars,while recent studies emphasize precision treatment tailored to patients'holistic conditions.Conclusions International research on pediatric burn scars demonstrates both commonalities and variations in developmental trajectories and hotspots.The current research hotspots include precision treatment for pediatric burn scars(such as laser therapy)and personalized management of burned children.With advancements in precision medicine,global data sharing,and psychological rehabilitation support systems,future research will shift from scar repair to integrated functional and psychosocial recovery,enhancing long-term outcomes for affected children.

Abstract:Objective To investigate the impact of noise exposure on red blood cell metabolism using metabolomics technology,and to provide a reference for further research and exploration of the mechanisms underlying the impact of noise exposure on human health.Methods Eight male C57BL/6J mice were selected to establish a noise exposure model,and were subjected to noise stimulation at an intensity of 90-105 dB.Additionally,6 mice were chosen as the control group and housed in a box of the same specification but without additional sound output.Changes in body weight were monitored,and the plasma amylase,cholesterol,urea nitrogen,and creatine kinase were detected.Metabolomics analysis was performed to detect changes in red blood cell metabolism.Results After 10 consecutive days of noise exposure,the body weight of the exposed group decreased by 17.8%compared to the control group[(19.7±1.8)g vs.(23.9±1.9)g,t=4.317,P＜0.01].Compared with the control group,the noise-exposed group showed markedly elevated plasma levels of amylase[(917.6±86.1)U/L vs.(719.8±90.4)U/L,t=3.690,P＜0.01],cholesterol[(3.9±0.4)mmol/L vs.(3.1±0.4)mmol/L,t=3.569,P＜0.01],and urea nitrogen[(8.7±1.1)mmol/L vs.(6.2±1.0)mmol/L,t=3.698,P＜0.01],whereas the level of creatine kinase was significantly decreased[(877.8±383.3)U/L vs.(1 568.3±163.4)U/L,t=4.029,P＜0.01].Metabolomics analysis revealed that noise exposure led to significant decreases in erythrocyte sphingosine-1-phosphate and 6-hydroxymelatonin levels.These changes were associated with the down-regulation of multiple signaling pathways,including the Fcγ receptor-mediated phagocytosis,Apelin signaling pathway,phospholipase D signaling pathway,and calcium ion signaling pathway.Conclusions Short-term noise exposure can lead to a decrease in body weight and changes in red blood cell metabolism in mice,involving red blood cell metabolic pathways such as Fcγ receptor-mediated phagocytosis,Apelin signaling pathway,and calcium ion signaling pathway.This study provides new insights and experimental evidence for the prevention and management of non-specific damage caused by noise pollution.

Abstract:Objective:To investigate the correlation between hormone receptor expression and polyp morphology,pathological type and clinical symptoms in infertility patients with endometrial polyps(EP).Methods:A total of 91 infertility patients with EP treated in Nanyang Central Hospital from October 2020 to June 2023 were selected as the study objects.The expression levels of estrogen receptor(ER)and progesterone receptor(PR)were compared across different polyp morphological characteristics,pathological types,and clinical features(including symptoms,comorbidities,and age).Furthermore,risk factors influencing ER and PR expression in these patients were analyzed.Results:Among the 91 infertile patients with EP,the ER positivity rate was 74.73%(68/91)and PR positivity rate was 56.04%(51/91).In EP tissues,low ER expression was observed in 36 cases(39.56%),while high expression was found in 55 cases(60.44%),with the difference being statistically significant(χ²=7.934,P=0.004).For PR,low expression was observed in 60 cases(65.93%)and high expression in 31 cases(34.07%),with low expression being significantly more common than high expression(χ²=18.483,P＜0.001).There were differences in the polyp morphological features,pathological types,and clinical symptoms of EP among patients with different expression levels of ER and PR:long diameter≥2 cm,multiple polyps,and polyps located at the uterine fundus showed higher rates of high ER and PR expression compared to those with the long diameter＜2 cm,single polyps,or polyps located near the tubal orifice(ER:long diameter χ²=21.555,P＜0.001;number χ²=13.001,P＜0.001;location χ²=17.258,P＜0.001)(PR:long diameter χ²=5.154,P＜0.001;number χ²=10.513,P＜0.001;location χ²=8.057,P=0.004).The proportion of patients with simple functional polyps in those with high expression of ER and PR was significantly higher than that in those with low expression of each receptor(χ²=4.376,5.579,P＜0.05),and the proportion of patients with simple hyperplastic polyps in those with high expression of ER and PR was significantly higher than that in the low expression group of each receptor(χ²=4.234,5.909,P＜0.05).The proportion of patients with both functional and hyperplastic polyps in those with high expression of ER and PR was significantly lower than that in the low expression groups of each receptor,and the difference was statistically significant(χ²=17.343,23.123,P＜0.001).The proportion of patients with abnormal uterine bleeding,intermenstrual/postcoital bleeding,and hot flashes among those with high expression of ER and PR is higher than that of patients without the above symptoms(ER:abnormal uterine bleeding χ²=15.357,P＜0.001;intermenstrual/postcoital bleeding χ²=5.131,P=0.023;hot flashes χ²=12.551,P＜0.001)(PR:abnormal uterine bleeding χ²=20.353,P＜0.001;intermenstrual/postcoital bleeding χ²=7.893,P=0.004;hot flashes χ²=4.919,P=0.026).Patients without diabetes,hypertension,or age＜40 years exhibited a lower proportion among those with high ER and PR expression compared to those with diabetes,hypertension,or aged≥40 years(ER:diabetes χ²=7.115,P=0.007;hypertension χ²=5.519,P=0.018;age χ²=20.411,P＜0.001)(PR:diabetes χ²=22.802,P＜0.001;hypertension χ²=6.003,P=0.014;age χ²=19.408,P＜0.001).Multivariate logistic regression analysis identified the following as independent risk factors for high ER and PR expression in infertile patients with EP(P＜0.05):diabetes(OR:1.823,1.857),hypertension(OR:1.554,1.495),age≥40 years old(OR:1.849,1.812),polyp length diameter≥2 cm(OR:1.866,1.762),multiple polyp(OR:1.697,1.615),polyp location at the uterine fundus(OR:2.016,1.923),functional polyps(OR:2.147,2.097),hyperplastic polyp(OR:2.134,2.264),abnormal uterine bleeding(OR:1.487,1.521),intermenstrual or postcoital bleeding(OR:1.487,1.521),presence of hot flashes(OR:2.147,2.097).Conclusions:The expression of ER and PR in infertile patients with EP is associated with polyp morphology,pathological type,and clinical symptoms,which provides a new perspective for in-depth understanding of the pathogenesis of infertility with EP and the development of personalized treatment strategies.

Abstract:Objective:To investigate the relationship of serum glucose and lipid metabolism,sex hormones,anti-Müllerian hormone(AMH),homocysteine(HCY),and clinical pregnancy in overweight/obese infertile patients with polycystic ovary syndrome(PCOS).Methods:A retrospective analysis was conducted on 105 overweight/obese infertile patients with PCOS(study group)and 50 overweight/obese individuals without PCOS(control group)admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from Aug.2021 to Feb.2024.The two groups were compared in terms of glucose and lipid metabolism,serum sex hormones,AMH,and HCY levels.The study group was further divided into clinical pregnancy subgroup(n=55)and clinical non-pregnancy subgroup(n=50)based on follow-up outcomes.The correlation of various indicators,and their predictive value for pregnancy outcomes were analyzed.Results:The fasting plasma glucose(FPG),insulin resistance index(HOMA-IR),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),total cholesterol(TC),and triglyceride(TG)levels in the study group[(5.14±0.52)mmol/L,4.22±0.45,(2.06±0.27)g/L,(1.95±0.32)g/L,(6.11±0.65)mmol/L and(2.65±0.28)mmol/L]were significantly higher than those in the control group[(4.68±0.51)mmol/L,1.18±0.19,(1.84±0.21)g/L,(1.47±0.18)g/L,(4.82±0.53)mmol/L and(2.07±0.26)mmol/L;t=5.180,45.803,5.074,9.878,11.846,12.331,P＜0.001].High-density lipoprotein cholesterol(HDL-C)level in the study group[(0.89±0.10)mmol/L]was significantly lower than that in the control group[(1.03±0.15)mmol/L;t=6.885,P＜0.001].Serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),LH/FSH,testosterone(T),AMH and HCY levels in the study group[(6.24±0.65)mIU/mL,(9.85±1.02)mIU/mL,1.60±0.17,(0.78±0.10)ng/mL,(13.18±1.42)ng/mL and(11.84±1.26)μmol/L]were significantly higher than those in the control group[(4.89±0.52)mIU/mL,(7.63±0.79)mIU/mL,1.54±0.16,(0.55±0.13)ng/mL,(6.73±0.75)ng/mL and(6.57±0.68)μmol/L;t=12.851,13.566,2.093,12.114,30.144,27.686,P＜0.05].In the study group,serum AMH was positively correlated with LH/FSH and T(r=0.657,0.746,P＜0.05),and HCY was positively correlated with FSH and T(r=0.715,0.567,P＜0.05).The level of serum LH,LH/FSH,AMH and HCY in the clinical pregnancy subgroup[(9.55±0.97)mIU/mL,1.52±0.16,(12.88±1.41)ng/mL and(10.91±1.15)μmol/L]were significantly lower than those in the clinical non-pregnancy subgroup[(10.18±1.14)mIU/mL,1.63±0.17,(13.52±1.36)ng/mL and(12.86±1.34)μmol/L;t=3.568,3.921,2.362,9.348,P＜0.05].Elevated levels of LH/FSH,AMH and HCY are risk factors for clinical non-pregnancy in infertile patients with overweight and obese PCOS(OR=1.756,1.817,1.647,P＜0.05).The area under the ROC curve of the combined prediction of LH/FSH,AMH and HCY for clinical non-pregnancy in overweight/obese PCOS patients was 0.854,which was higher than the individual prediction results of each index(0.776,0.812,0.803).Conclusions:Overweight/obese infertile patients with PCOS have more severe disturbances in glucose and lipid metabolism as well as in sex hormone indicators.In addition,AMH and HCY levels are elevated in these patients.Both indicators are closely related to clinical pregnancy and worthy of detection.

Abstract:Objective:To investigate whether endothelial nitric oxide synthase(eNOS)is involved in the protective effects of estrogen(E2)on islet transplantation.Methods:(1)Optimization of application time and dose of E2:Male C57BL/6 mice were randomly divided into 4 groups:normal control group(n=12),diabetes model group(n=12),diabetes model+islet transplantation group(transplantation group,n=12),and diabetes model+islet transplantation+E2 treatment group(transplantation+E2 group,n=48).Mice in the transplantation+E2 group were given continuous E2 treatment(4.0 μg/d,subcutaneous injection,6 mice in each subgroup)for 1,3,7,and 14 days respectively to determine the optimal experimental time.In addition,mice in the transplantation+E2 group were given E2 treatment at doses of 0.2,2.0,4.0 and 20.0 μg/d respectively(for 14 consecutive days,subcutaneous injection,6 mice in each subgroup)to determine the optimal experimental dose.(2)Intervention experiment of endothelial nitric oxide synthase(eNOS)inhibitor:male C57BL/6 mice were randomly divided into 3 groups:transplantation group,transplantation+E2 group,and transplantation+E2+eNOS inhibitor Nω-nitro-L-arginine methyl ester hydrochloride group(transplantation+E2+L-NAME group),with 4 mice in each group.In the transplantation+E2 group,E2 sustained-release tablets(0.18 mg/tablet)were implanted subcutaneously in the neck,while in the transplantation+E2+L-NAME group,L-NAME inhibitor 50 mg/kg was injected intraperitoneally every day while E2 sustained-release tablets were implanted.Samples were collected after 14 days.During the experiment,the blood glucose level of mice was monitored,the glucose tolerance was detected,and the plasma insulin content was determined by enzyme-linked immunosorbent assay.The positive areas of eNOS,islet β cells and platelet endothelial cell adhesion molecule(CD31)in the grafts were analyzed by immunofluorescence staining.Results:E2 application time and dose optimization experiments showed that compared with the area under the curve of blood glucose level in the transplantation group[(553.50±37.38)dmmol/l],the area under the curve of blood glucose level in mice[(383.40±47.78)dmmol/l]was significantly reduced after 14 days of E2 treatment(t=2.848,P＜0.05),and the dose of 4.0 μg/d was the best;Using 4.0 μg/d dose of E2 for 14 days,compared with the transplantation group,the blood glucose level in the transplantation+E2 group was significantly reduced(t=3.112,P＜0.05),and the plasma insulin content and the positive area of islet β cells in the transplantation+E2 group were significantly increased(t=2.209,2.442,P＜0.05),the vascular density and eNOS positive area in the grafts were also significantly increased(t=2.131,2.205,P＞0.05).The results of L-NAME inhibitor intervention showed that compared with the transplantation+E2 group,glucose tolerance increased significantly after L-NAME intervention(t=5.871,P＜0.05),the positive area of transplated pancreatic beta cells was significantly reduced[(54.09±2.16)%in the transplantation+E2 group compared to(38.59±3.75)%in the transplantation+E2+L-NAME group,t=2.674,P＜0.05],the plasma insulin content and vascular density showed a decreasing trend(t=1.950,1.606,P＞0.05).Conclusions:E2 short-term treatment can effectively protect the survival and function of transplanted islets and promote vascular remodeling,and its mechanism may be related to eNOS signaling pathway.

Abstract:Objective:To explore the predictive value of fibrin degradation product(FDP)and D-dimer combined with thromboelastography(TEG)in the formation of portal vein thrombosis(PVT)in hepatitis B virus cirrhosis.Methods:A total of 230 hepatitis B virus cirrhosis treated at General Hospital of Jinshui District Zhengzhou City from March 2020 to April 2024 were enrolled.All patients underwent imaging examination for PVT diagnosis and were stratified into PVT group(n=81)and non-PVT group(n=149).The general data,plasma FDP,D-dimer and TEG parameters(reaction time,clot formation time,clotting angle)were compared between the two groups.The risk factors of PVT formation were analyzed by multivariate Logistic regression analysis.Moreover,the predictive value of FDP,D-dimer and TEG parameters for PVT formation in patients with hepatitis B virus cirrhosis was analyzed by the receiver operating characteristic(ROC)curve.Results:Among 230 patients with hepatitis B virus cirrhosis,81 cases(35.22%)were complicated with PVT.The proportion of patients with diabetes mellitus history in PVT group(34.57%,28/81)was higher than that in non-PVT group(20.80%,31/149)(P＜0.05).and the levels of plasma FDP[(11.51±1.89)mg/L vs.(10.81±1.82)mg/L],D-dimer[(1.07±0.19)mg/L vs.(0.95±0.17)mg/L]and TEG parameters[reaction time:(6.26±1.18)min vs.(5.51±0.97)min;clot formation time:(4.42±0.87)min vs.(3.63±0.62)min;clotting angle:(51.57±9.81)˚ vs.(48.69±9.06)˚]were statistically significant between the two groups(t=2.749,4.903,5.182,7.974,and 2.236 respectively,P＜0.05).Multivariate Logistic regression analysis showed that plasma FDP,D-dimer,reaction time and clot formation time were all risk factors for the formation of PVT in hepatitis B virus cirrhosis patients(P＜0.05).ROC curve analysis verified that area under the curve(AUC)of FDP,D-dimer,reaction time,clot formation time and combined detection of the four indicators for predicting PVT formation were 0.734,0.771,0.773,0.779 and 0.933,respectively.The predictive effect of the combined detection was the best.Compared with the prdictive effect of a single indicator,the differences were statistically significant(P＜0.05).Conclusions:The combined detection of FDP,D-dimer,TEG parameters(reaction time and clot formation time)demonstrates a higher predictive value for PVT formation in patients with hepatitis B virus cirrhosis than that predicted by a single index.

Abstract:Objective:To investigate the association of serum cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),tumor specific growth factor(TSGF)and squamous cell carcinoma antigen(SCCA)levels with lung cancer histologic sub-types and clinical stages,and to evaluate the diagnostic value of their combined detection.Methods:A total of 151 lung cancer patients admitted to Luohe Second People's Hospital from August 2021 to May 2024 were enrolled as the observation group,along with 134 healthy controls from routine health examinations during the same period.Serum CYFRA21-1,TSGF and SCCA were compared between the two groups.Serum CYFRA21-1,TSGF and SCCA in patients with different patho-logical types and clinical stages of lung cancer were compared.The diagnostic value of CYFRA21-1,TSGF and SCCA alone or in combination for lung cancer was analyzed by drawing the receiver operating characteristic(ROC)curve.Results:The levels of serum CYFRA21-1,TSGF and SCCA in the observation group were significantly higher than those in the control group[CYFRA21-1:(4.36±1.05)μg/L vs.(1.57±0.50)μg/L,t=28.061,P＜0.001;TSGF:(72.42±7.12)U/mL vs.(52.38±5.69)U/mL,t=26.029,P＜0.001;SCCA:(2.06±0.55)μg/L vs.(0.84±0.29)μg/L,t=22.994,P＜0.001].Serum CYFRA21-1 and SCCA gradually decreased in squamous cell carcinoma,adenocarcinoma and small cell lung cancer(P＜0.001),while serum TSGF gradually decreased in small cell lung cancer,squamous cell carcinoma and adenocarcinoma(P＜0.001).In addition,serum CYFRA21-1,TSGF and SCCA gradually increased with the increase of clinical stage(P＜0.001).The area under the curve(AUC)of the combined diagnosis of lung cancer by CYFRA21-1,TSGF and SCCA was 0.912,the sensitivity and specificity were 90.38%and 95.85%,respectively,which were higher than detection of CYFRA21-1,TSGF and SCCA alone(AUC:0.717,0.698 and 0.733,respectively,P＜0.001).Conclusions:The combined detection of CYFRA21-1,TSGF and SCCA in serum of lung cancer patients shows important clinical value in the diagnosis of lung cancer.Moreover,their levels are closely related to tumor type and stage,which is helpful to formulate more accurate treatment plan.

Abstract:Glucocorticoids(GCs),characterized by complex mechanisms and broad effects,are commonly used in clinical practice as anti-inflammatory and immunosuppressive agents and can be employed in the treatment of infectious diseases.They effectively alleviate excessive inflammatory responses triggered by infections,mitigate tissue damage,and improve patient symptoms and prognosis.The clinical application of glucocorticoids in treating acute infectious diseases remains a hot topic in research.This review summarizes the therapeutic use of glucocorticoids in common acute infectious diseases,including meningitis,community-acquired pneumonia(CAP),infectious myocarditis,sepsis,and septic shock.It also discusses clinical concerns regarding the safety and adverse effects associated with glucocorticoids therapy.

Abstract:Objective:To explore the relationship between the levels of red cell volume distribution width(RDW),neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP),D-dimer in peripheral blood and disease severity in patients with community-acquired pneumonia(CAP).Methods:A retrospective analysis was performed on the clinical data of 62 patients with CAP(CAP group)admitted to the First People's Hospital of Zhengzhou between January 2021 and June 2024.Additionally,30 healthy individuals who underwent health examinations at the same hospital during the same period were selected as the control group.The levels of RDW,NLR,CRP and D-dimer were measured in both groups.CAP patients were further divided into a severe group(n=29)and a non-severe group(n=33)based on their Clinical Pulmonary Infection Score(CPIS).Differences in the levels of RDW,NLR,CRP and D-dimer were compared between the two subgroups.Logistic regression analysis was used to examine the association between these indicators and disease severity,while receiver operating characteristic(ROC)curve analysis was employed to evaluate their predictive value for severe CAP.Results:Compared with the control group,the CAP group showed significantly higher levels of RDW,NLR,CRP,and D-dimer[RDW:(16.43±2.84)%vs.(13.11±1.44)%;NLR:5.21±2.44 vs.1.92±0.58;CRP:(41.76±17.69)mg/L vs.(1.40±0.87)mg/L;D-dimer:(2.03±0.84)mg/L vs.(0.77±0.33)mg/L;t=6.027,7.267,12.454,7.907,respectively;P＜0.001].Among CAP patients,the severe group exhibited higher levels of RDW,NLR,CRP,and D-dimer compared to the non-severe group[RDW:(16.51±2.49)%vs.(15.13±2.72)%;NLR:5.61±2.30 vs.3.98±2.27;CRP:(44.27±17.04)mg/L vs.(31.85±17.86)mg/L;D-dimer:(2.14±0.75)mg/L vs.(1.28±0.70)mg/L;t=2.073,2.804,2.791,4.668,respectively;P＜0.05].Logistic regression analysis showed that RDW,NLR,CRP and D-dimer were all independent risk factors for progression to severe CAP(RDW:OR=2.502,95%CI:1.200-5.217;NLR:OR=5.714,95%CI:1.679-19.453;CRP:OR=2.179,95%CI:1.413-3.361;D-dimer:OR=2.361,95%CI:1.388-4.015;P＜0.05).ROC curves analysis showed that area under the curve(AUC)for RDW,NLR,CRP,D-dimer,and their combination in detection severe CAP were 0.785,0.882,0.881,0.881 and 0.987,respectively(all P＜0.001).The combined detection of all four markers yielded the highest AUC,with high sensitivity and specificity.Conclusions:The levels of RDW,NLR,CRP and D-dimer in the peripheral blood are abnormally increased in CAP patients,and the increase is more significant in severe patients.The combined detection of the four indexes has a good predictive value for severe CAP.

Abstract:Objective:To analyze the expressions of Krüppel-like factor 5(KLF5),Yes-associated protein 1(YAP1)and E-cadherin in tumor tissues and adjacent tissues of patients with colon cancer,and to explore the relationship between their levels and lymph node metastasis.Methods:The clinical data of 450 patients with colon cancer admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from May 2021 to May 2024 were retrospectively analyzed.The colon cancer tissues and adjacent tissues samples of the patients were obtained through intraoperative resetion.The expressions of KLF5,YAP1 and E-cadherin were detected by immunohistochemical staining and Western blotting.The patients were divided into lymph node metastasis group(n=134)and non-lymph node metastasis group(n=316)according to whether lymph node metastasis occurred.The clinicopathological characteristics of the two groups were compared.To analyze the relationship between KLF5,YAP1,E-cadherin and lymph node metastasis and the influencing factors of lymph node metastasis in patients with colon cancer.Results:The positive expression rates of KLF5 and YAP1 in colon cancer tissues[65.65%(295/450)and 62.89%(283/450)]and the protein expression levels(2.89±0.53 and 3.11±0.75)were both higher than those in adjacent tissues[29.33%(132/450)],32.67%(147/450),1.08±0.31,1.02±0.33;χ2=118.394 and 82.367;t=62.534 and 54.108,P＜0.001].However,the positive expression rate of E-cadherin[38.00%(171/450)]and the protein expression level(0.68±0.12)in colon cancer tissues were lower than those in adjacent tissues[76.89%(346/450)and 0.97±0.23;χ2=139.197,t=23.714,P＜0.001].The proportions of patients with tumor diameter≥5 cm,low differentiation or undifferentiation and TNM stage Ⅲ-Ⅳ in lymph node metastasis group[44.03%(59/134),57.46%(77/134),and 39.55%(53/134)]were higher than those in non-lymph node metastasis group[32.28%(102/316),44.62%(141/316),28.80%(91/316);χ2=5.655,6.214,and 5.002(P＜0.05)].The protein levels of KLF5 and YAP1 in the lymph node metastasis group(3.52±0.51 and 3.65±0.67)were higher than those in non-metastasis group(2.62±0.40 and 2.88±0.37),t=20.044 and 15.591,P＜0.001),and positively correlated with lymph node metastasis(r=0.524 and 0.483,P＜0.001).The protein level of E-cadherin in the lymph node metastasis group was lower than that in the non-lymph node metastasis group(0.49±0.11 vs.0.76±0.15);t=18.798,P＜0.001),and it was negatively correlated with lymph node metastasis(r=-0.569,P＜0.001).The expression of KLF5 and YAP1 were independent risk factors for lymph node metastasis in patients with colon cancer,while E-cadherin protein expression was an independent protective factor(P＜0.05).Conclusions:KLF5,YAP1 and E-cadherin can be used as biomarkers to predict the prognosis of colon cancer.