Abstract:Objective To explore the relationship between motivation,perception of social support and adherence to cardiac rehabilitation(CR)in post-percutaneous coronary intervention(PCI)patients,and to provide reference for taking targeted measures to improve patients'adherence to rehabilitation.Methods A total of 319 post-PCI patients from three grade-A tertiary hospitals in Shaanxi and Xinjiang were investigated and analyzed by using general data survey method,CR scale,perceived social support scale,and CR adherence evaluation questionnaire.Results Post-PCI patients had a score of 73.59±6.50 for perception of social support,73.32±6.45 for motivation,and 27.86±4.33 for CR adherence.Post-PCI patients'perception of social support was positively correlated with motivation and CR adherence(both P＜0.01).Motivation partially mediated the relationship between perception of social support and CR adherence,and the mediating effect accounted for 27％of the total effect.Conclusion Perception of social support directly predicts CR adherence,and motivation plays a partial mediating role between them.Healthcare professionals can help patients establish a positive mindset by creating good social support,and then enhance their willingness to recover to improve their adherence.

Abstract:Reactive astrocytes are astrocytes that undergo morphological,molecular,and functional remodeling in response to central nervous system(CNS)injury,disease,or infection.In situations such as aging,injury,or neuroinflammation,activated microglia signaling with TNF-α,IL-1α,and C1q induces a neurotoxic astrocytic phenotype known as astrocytes A1 polarization,or reactive astrocytes.Reactive astrocytes down-regulate their supportive functions and secrete neurotoxic factors,complement factors such as C3,and chemokines like CXCL10,which may facilitate the recruitment of immune cells across the blood-brain barrier into the CNS.It is not clear whether fixed reactive astrocytes exist in fixed categories of neurological diseases,and if so,how to identify them?This article reviews the important role of reactive astrocytes in neurological diseases,in order to provide theoretical basis for exploring the pathological role of reactive astrocytes and targeted treatment of neurological diseases.

Abstract:Objective To investigate the species and geographical distribution characteristics of ticks in the Guanzhong Plain,and to determine the endemic characteristics and genetic diversity of ticks carrying Rickettsia and Anaplasma phagocytophilum(AP).Methods Tick samples were collected from May 2023 to July 2024 and DNA was extracted.Nested PCR was used to screen for Rickettsia and AP for further phylogenetic analysis.Results A total of 10 130 ticks were captured,and 219 ticks were selected for pathogen-carrying testing.Tick species identification confirmed that the detected ticks were Haemaphysalis longicornis.Pathogen detection results showed that the prevalence of Rickettsia and AP was 8.68％and 35.62％,respectively.Phylogenetic analysis showed that there were numerous variants of Rickettsia and AP in the Guanzhong Plain.The sequence of one Rickettsia strain did not cluster with the known reference sequence,suggesting that the strain may belong to a new variant strain.Conclusion The Guanzhong Plain has a high carrying rate of Rickettsia and AP,and these two pathogens can be divided into several different clades.This discovery reveals the potential diversity of their pathogenicity and provides a basis for further investigation of the pathogenicity of different clades.

Abstract:Objective To explore the active ingredients and pharmacological mechanisms of Decoction of Glehnia and Ophiopogon in the treatment of chronic obstructive pulmonary disease(COPD).Methods The potential active ingredients and targets of Decoction of Glehnia and Ophiopogon were searched through TCMSP and BATMAN-TCM databases.The targets of COPD were obtained through TTD,OMIM,and GeneCards databases.The interaction network of Chinese herbal medicine-component-common target-disease was constructed by Cytoscape 3.8.0 software to obtain the corresponding core components.The protein-protein interaction network of common targets and core targets were obtained through STRING 11.0 database.GO and KEGG pathway enrichment analyses were performed using the DAVID database.AutoDock Vina software was used for molecular docking validation of core components and core targets.Results A total of 224 potential active ingredients were obtained from Decoction of Glehnia and Ophiopogon.COPD was associated with 2 432 targets,and the potential active ingredients had 372 common targets with the disease.The core components included glabridin and medicarpin,while the core targets included STAT3,BCL2,HIF1,etc.KEGG enrichment analysis mainly involved inflammatory response and oxidative stress pathways.The molecular docking results showed that core components had good activity in binding to core targets.Conclusion The main mechanism of Decoction of Glehnia and Ophiopogon in treating COPD may be through the action of core components such as glabridin on targets such as IL6,laying a foundation for further elucidating the pharmacological substance basis and mechanism of action of Decoction of Glehnia and Ophiopogon.

Abstract:Objective To explore the mechanism of action of Huatan Maitong tablets in the treatment of H-type hypertension by using network pharmacology and molecular docking combined with artificial neural network,and to probe into scientific meaning of"blood and vein treatment".Methods The effective components of Huatan Maitong tablets were screened in multiple databases.The SwissTargetPrediction database was utilized to predict their corresponding targets.GeneCards database was used to screen the targets of H-type hypertension,and the intersection was selected through Venny 2.1.0.The"disease-effective components-targets"network was constructed using Cytoscape software to screen the core components.STRING database and Cytoscape software were used to construct the protein-protein interaction network to screen core targets.GO functional enrichment analysis and KEGG pathway enrichment analysis were performed using the DAVID database.Finally,molecular docking was performed on the receptor of the core targets and the ligand of the core active ingredients.Through literature search and case review,the TCM syndrome elements and medication rules of H-type hypertension were sorted out,and then an artificial neural network prescription-syndrome prediction model was constructed by Python to explore the corresponding relationship between the syndrome type of H-type hypertension and Huatan Maitong tablets.Results ①A total of 96 effective components and 1 029 predicted targets of Huatan Maitong tablets were screened.Ingredients associated with the disease were naringenin,β-sitosterol,baicalein and so on.There were 114 intersection targets of Huatan Maitong tables and H-type hypertension,and the top five core targets were AKT1,IL6,TNF,IL1B,and TLR4.②GO functional analysis mainly pointed to functions related to response to lipopolysaccharide,hypoxia,and inflammation.The results of KEGG enrichment analysis mainly included advanced glycation end products-receptor of advanced glycation end products(AGE-RAGE)signaling pathway,lipid and atherosclerosis pathway,fluid shear stress and atherosclerosis pathway.③Molecular docking showed that the main active ingredients had good affinity to core targets.④The syndrome elements with the highest frequency of H-type hypertension were"phlegm"and"blood stasis",and the frequency of Chinese herbal medicine collected from Huatan Maitong tablets was as follows:Gastrodia elata Blume 91 times,Pinellia ternata 89 times,Atractylodes macrocephala 70 times,Pheretima 24 times,Acorus tatarinowii 17 times,Exocarpium Citri Grandis 13 times,Hirudo nipponica 13 times,Polygala tenuifolia 9 times,Radix curcumae 8 times,Arisaema cum Bile 3 times,and Bombyx batryticatus 2 times.⑤ The prediction model of prescription-syndrome was constructed based on multi-layer perceptron.The accuracy of Huatan Maitong tablets-phlegm model was 0.81,and the accuracy of Huatan Maitong tablets-blood stasis model was 0.75.Conclusion Huatan Maitong tablets are mainly aimed at treating H-type hypertension with phlegm and stasis syndrome,and acts on multiple targets through naringenin,β-sitosterol,and baicalein to reduce oxidative stress and inflammation,regulate AGE-RAGE signaling pathway and lipid and atherosclerosis pathway,and play a role in the treatment of H-type hypertension.

Abstract:Objective To investigate the active ingredients and potential mechanisms of Huanglian Jiedu Decoction in treating myocardial ischemia/reperfusion injury(MI/RI)using network pharmacology and molecular docking techniques.Methods Compounds of Huanglian Jiedu Decoction were screened based on TCMSP and ETCM databases,and the targets of the candidate components were predicted based on the SwissTargetPrediction platform.OMIM,GeneCards,CTD,TTD,and PharmGKB database resources were integrated to collect disease targets related to MI/RI,and common targets of drugs and diseases were extracted by Venny online tool.Finally,Cytoscape 3.8.0 software was used to construct a three-dimensional interaction network model containing drug molecules,active ingredients,and disease targets.STRING database and Cytoscape 3.8.0 were used to establish a protein-protein interaction(PPI)network to identify core targets and construct the network map.GO and KEGG enrichment analyses were performed on the common targets using the R programming language.Molecular docking was verified by AutoDock Vina 1.2.5.Results A total of 85 active ingredients,193 drug targets,1 817 disease targets,and 125 common targets were identified in Huanglian Jiedu Decoction.The core active ingredients included berberine,baicalein,etc.Seven core targets,including IL-1β,TP53,AKT1,EGFR,JUN,FOS,and STAT1,were screened from the PPI network.GO analysis showed that it was mainly involved in biological processes,including oxidative stress and inflammatory responses,whereas KEGG analysis showed that it was mainly involved in signaling pathways such as TNF,HIF-1,apoptosis,NF-κB,and PI3K-Akt.Additionally,molecular docking results revealed that the binding energies of some active ingredients and core targets were＜-28.45 kJ/mol,suggesting strong binding affinities.Conclusion Huanglian Jiedu Decoction can protect cardiomyocytes by reducing oxidative stress,inflammatory response,and apoptosis caused by MI/RI through a multi-target and multi-pathway mechanism.This study provides a scientific basis for the clinical application of Huanglian Jiedu Decoction in treating MI/RI and lays a theoretical foundation for further experimental research and clinical trials.

Abstract:Objective To explore the intervention effect of transcranial direct current stimulation(tDCS)combined with n-back task on attentional blink(AB).Methods tDCS and 2-back task of space were used to intervene the AB performance of 60 male college students in an Air Force academy for 4 weeks,and the effects of the intervention were tested based on behavioral data and functional near-infrared spectroscopy(fNIRS).Results First,2-back task of space alone did not improve AB performance.Second,stimulating the left dorsal lateral prefrontal cortex(DLPFC)of the subjects with tDCS alone resulted in a certain degree of improvement in AB performance.Third,the combination of 2-back task of space and tDCS to stimulate the left DLPFC of the subjects achieved a more obvious intervention effect than tDCS alone.Fourth,the data of fNIRS showed that after the combined intervention,the mean oxygenated hemoglobin concentration in the left DLPFC region of the subjects increased significantly before AB task,while there was no significant change in the tDCS group and 2-back task of space group.Conclusion The combination of tDCS and n-back task can improve AB performance effectively,providing important technical references for improving AB of military pilots and other groups.

Abstract:Objective To investigate the changes in excitability of the bilateral primary motor cortex(M1)hand area after spinal cord injury(SCI)and its correlation with activities of daily living(ADL)and neuropathic pain(NP).Methods This study included 67 SCI patients(SCI group)who were admitted to the Department of Rehabilitation Medicine,Xijing Hospital,Air Force Medical University from March 2022 to March 2024.Single-pulse transcranial magnetic stimulation was used to detect motor evoked potentials(MEP)in the bilateral M1 hand area to evaluate excitability.The patients'ADL function was evaluated using the modified Barthel Index and the Spinal Cord Independence Measure(SCIM),while the severity of NP was assessed using the simplified Short-Form McGill Pain Questionnaire-2(SF-MPQ-2).The natural logarithm(LN)of the ratio of MEP amplitudes in the M1 hand area from the dominant to the non-dominant side was calculated to analyze its correlation with ADL and NP.Results Compared with the healthy group,SCI group showed significantly reduced MEP amplitudes(P＜0.01)and prolonged latencies in the bilateral M1 hand area(P＜0.01).Additionally,the LN(dominant side amplitude/non-dominant side amplitude)was reduced(P＜0.05).In SCI patients,LN values showed a significant positive correlation with the modified Barthel Index(r=0.250,P=0.041),SCIM score(r=0.263,P=0.033),and the SCIM indoor activity score(r=0.273,P=0.027).In NP patients,LN values were significantly higher and showed a positive correlation with SF-MPQ-2 pain score(r=0.276,P=0.047).Conclusion The excitability in the bilateral M1 hand area is significantly reduced in SCI patients.Furthermore,the degree of excitability asymmetry is closely related to ADL function and the severity of NP.Therefore,the degree of excitability asymmetry in the bilateral M1 hand area may serve as a potential marker for assessing ADL function and the severity of NP after SCI,and provide new targets for future intervention strategies.

Abstract:Sarcopenia,a degenerative disease of skeletal muscle closely associated with aging,severely affects people's quality of life and imposes a significant economic burden on society.In the past,the exercise prescriptions for sarcopenia were resistance exercise and moderate-intensity continuous training.High-intensity interval training(HIIT),as an emerging trend in exercise,has been gradually applied in the rehabilitation of various chronic diseases due to its short-duration and high-efficiency advantages.In this review,we focus on recent research regarding the application of HIIT in the treatment of sarcopenia.By analyzing recent literature,we elucidate the impact of HIIT on muscle mass,strength,and physical function in patients with sarcopenia,while also exploring its mechanisms of action and potential advantages,so as to provide a reference for further research and clinical application in this field.

Abstract:Colorectal cancer(CRC)is one of the most common malignant tumors globally.In the past few years,remarkable progress has been made in applying immune checkpoint inhibitors(ICIs)to treat CRC.However,for patients with microsatellite stable/mismatch repair-proficient metastatic CRC,monotherapy with ICIs has yet to demonstrate a clinical efficacy advantage.Studies have shown that anti-angiogenic drugs(AAD)can normalize tumor blood vessels,thereby improving immunosuppressive tumor microenvironment and transforming"cold tumors"into"hot tumors".This mechanism synergizes with ICIs and has been validated in clinical treatment of CRC.In view of this,this paper reviews the mechanism and clinical research progress of AAD combined with ICIs in the treatment of CRC,aiming to provide a scientific basis and reference for anti-angiogenesis combined with tumor immune-targeted therapy of CRC.

Abstract:As cancer research advances,its hallmark characteristics have been clearly defined.However,the molecular mechanisms underlying the systemic manifestations of tumors and their ultimate causes of mortality remain incompletely elucidated.The key to future research lies in revealing the interactions between tumors and distant organs,as well as how environmental factors and host physiology influence tumors and their hosts,which is critical for the prevention and treatment of cancer.This field of study centers on cancer as a systemic disease,covering aspects such as the driving forces of tumorigenesis and progression,the tumor microenvironment,the host's macro-immunological landscape,aging,metabolism and obesity,circadian rhythms,neuro-cancer interactions,and the host microbiome.In-depth investigation into the interaction between host genes and environmental factors will provide a theoretical foundation for cancer prevention,improvement of patients' quality of life,and enhancement of treatment efficacy.

Abstract:Intracranial pressure is an important physiological index of the brain.Scientific and reasonable monitoring of intracranial pressure can provide an effective basis for the prevention and treatment of craniocerebral diseases.The gold standard of intracranial pressure monitoring is invasive monitoring through intraventricular catheter,but it can lead to many complications.In order to replace invasive monitoring techniques,noninvasive intracranial pressure monitoring techniques have been widely studied and explored in recent decades.In this paper,the principle,advantages and disadvantages of current noninvasive intracranial pressure monitoring techniques are reviewed,and their feasibility and practicability are evaluated in order to provide effective reference experience for scientific research and treatment of craniocerebral diseases.Intraventricular catheters remain the gold standard in terms of accuracy,reliability,and treatment selectivity.With the advancement of science and technology,although noninvasive intracranial pressure monitoring methods are becoming more and more important,they still need to be further validated before they become an alternative to invasive monitoring methods.

Abstract:Objective To explore the differential characteristics of mitochondrial transcription factor A(TFAM)binding proteins during the occurrence and progression of hepatocellular carcinoma(HCC),and to offer a novel perspective and theoretical foundation for the pathogenic mechanism and therapeutic strategies of HCC.Methods The 4D-FastDIA quantitative proteomics technology was used to conduct a comprehensive analysis of HCC tissues and their paired adjacent non-cancerous tissue samples,screening out proteins that exhibit significant differences in binding with TFAM in HCC tissues.By means of bioinformatics,GO functional enrichment and KEGG pathway enrichment analyses were conducted for these differential binding proteins.At the cellular level,the interaction relationship between TFAM and key binding proteins was verified using co-immunoprecipitation and Western blotting.Moreover,the role of these key binding proteins in the proliferation of HCC cells was explored through EdU experiments.Results Proteomics analysis indicated that the proteins binding to TFAM in HCC cells were significantly enriched in signaling pathways related to cellular protein translation and translocation,purine and amide metabolic synthesis,cellular immune response and cell differentiation.Further,co-immunoprecipitation and Western blotting analyses demonstrated that in SNU-739 cells,TFAM interacted with anti-silencing function 1B histone chaperone(ASF1B),aldehyde dehydrogenase 1 family member L1(ALDH1L1),Ral-interacting protein(RBP1),BRG1-associated factor 180(PBRM1),and BRG1-associated factor 170(SMARCC2).In SNU-739 cells,interfering with the expression of ASF1B,RBP1,and SMARCC2 could inhibit cell proliferation(P＜0.01),while interfering with the expression of ALDH1L1 and PBRM1 promoted cell proliferation(P＜0.05).Conclusion Through preliminary screening and identification,it is discovered that TFAM-specific binding proteins ASF1B,ALDH1L1,RBP1,PBRM1,and SMARCC2 in HCC cells may become novel biomarkers in the occurrence and progression of HCC,and provide new research directions for the development of targeted therapeutic targets,which is of great clinical significance for improving the diagnosis,treatment and prognosis of HCC patients.

Abstract:Objective To explore core stakeholders and their interrelationships in centralized volume-based drug procurement policy from a supply chain perspective to provide a basis for policy optimization.Methods The study developed a pharmaceutical supply chain keyword questionnaire based on Mitchell scoring method and literature review to conduct preliminary stakeholder screening.A combined approach of the Delphi method(approval rate≥80％)and attribute scoring(＞6 points)was employed to identify core stakeholders in centralized volume-based drug procurement policy from a supply chain perspective through two rounds of expert consultations involving 29 specialists.Furthermore,correlation analysis of these core stakeholders was performed by combining the SCOR model.Results This study identified 10 core stakeholders.The Delphi method and attribute scoring jointly recognized:(1)production-related stakeholders—raw mat erial/equipment suppliers and pharmaceutical manufacturers;(2)procurement-related stakeholders—medical institutions participating in centralized procurement,distribution enterprises,and retail pharmacies;(3)usage-related stakeholders—physicians and patients;and(4)government agencies external to the centralized procurement supply chain.The Delphi method alone identified supporting enterprises for drug production,while attribute scoring specifically determined the procurement entities.Interrelationships existed among these core stakeholders.In production,suppliers and manufacturers jointly aligned with the"Make"process in the SCOR model,forming deep collaborations bound by quality standards and mutual trust.Regarding procurement,procurement entities and participating medical institutions corresponded to the"Plan"and"Source"processes in the SCOR model,engaging in negotiations over pricing and supply capacity.Under the centralized procurement platform model,medical institutions and distributors mapped to the"Deliver"process,with distributors and manufacturers operating under a binding mechanism.Conclusion The implementation entity of centralized volume-based drug procurement policy is pharmaceutical manufacturers.Post-implementation analysis of their market interactions with other core stakeholders reveals the necessity to establish a differentiated governance framework:production-side interventions emphasizing innovation incentives and cost-sharing mechanisms;procurement-side implementing digital supply chain management;And utilization-side establishing physician-patient collaborative decision-making platforms.This tripartite strategy ultimately synchronizes responsiveness across multiple supply chain nodes.

Abstract:Objective To investigate the protective effect and mechanism of salvianolate(SAL)on myocardial infarction(MI)in mice with diabetes.Methods Adult male C57BL/6J mice were set as the control group,and spontaneous type 2 diabetic mice(db/db)were divided into model group,positive drug group and SAL administration group(50,100,and 200 mg/kg),with 6 mice in each group.The left anterior descending coronary artery of the mice was ligated to establish an MI injury model.The drug was administered continuously for 7 d.Color Doppler ultrasound was used to evaluate the cardiac function indexes of mice.In addition,HE staining technology was used to detect the pathological damage of myocardial tissue.Von Willebrand factor(vWF),platelet endothelial cell adhesion molecule-1(PECAM-1),E-selectin,nitric oxide(NO),reactive oxygen species(ROS),interleukin-1 β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and other indicators in mouse serum were determined by ELISA.The mRNA and protein expression levels of vascular endothelial growth factor(VEGF),vascular endothelial growth factor receptor 2(VEGFR2),phosphatidylinositol 3-kinase(PI3K),and protein kinase B(Akt)in mouse myocardial tissue were measured using qRT-PCR and Western blotting techniques.Results Compared with the control group,the blood glucose and insulin levels in the model group were higher,and the pathological damage of myocardial tissue was more serious,with decreased left ventricular ejection fraction,left ventricular fractional shortening,and NO levels(all P＜0.01),increased left ventricular internal diameter at end-diastole,left ventricular internal diameter at end-systole,vWF,PEC AM-1,E-selectin,ROS,IL-1β,IL-6 and TNF-α(all P＜0.01),and increased mRNA and protein expressions of VEGF and VEGFR2 in stress(both P＜0.01).Compared with the model group,the positive drug group and the SAL administration group treated with different doses could significantly improve the above changes.Conclusion SAL can inhibit the inflammatory process,restore the damaged function of vascular endothelium,regulate VEGF/PI3K/Akt signaling pathway to improve cardiac function,and play a protective role after MI in diabetic mice.

Abstract:Objective To investigate the safety and efficacy of dexmedetomidine for postoperative analgesia in patients with obstructive jaundice.Methods Patients with obstructive jaundice undergoing laparotomy were randomly divided into dexmedetomidine group and sufentanil group.Dexmedetomidine group was treated with dexmedetomidine 200 μg+sufentanil 200 μg after surgery for patient-controlled intravenous analgesia(PCIA).Sufentanil group was treated with sufentanil 200 µg for PCIA,and the total amount of PCIA was 100 mL.The background dose for PCIA was 0.015 0 mL/(kg·h-1),and supplementary dose was 0.007 5 mL/kg.The primary endpoint was the actual number of PCIA in patients at 24 h after surgery,while the secondary endpoints included the Visual Analogue Scale(VAS)at rest or at cough at 24 h and 48 h after surgery,the number of effective PCIA at 24 h after surgery,the number of effective PCIA and actual PCIA at 48 h after surgery,the number of rescue analgesia,and the incidence of drowsiness,bradycardia,and nausea and vomiting within 24 and 48 h after surgery.Results The number of actual PCIA and effective PCIA at 24 h after surgery in the dexmedetomidine group was(9.5±8.2)and(8.0±6.4),respectively,which were significantly lower than those in the sufentanil group[(P=0.02,MD(95％CI)=-4.6(-7.4--0.8);P=0.01,MD(95％CI)=-3.9(-5.8--0.2)].The number of actual PCIA and effective PCIA at 48 h in the dexmedetomidine group was also significantly lower than that in the sufentanil group(P＜0.05).There was no significant difference in the VAS scores at rest and cough at 24 and 48 h after surgery between the dexmedetomidine group and the sufentanil group.There was also no difference in the number of rescue analgesia,bradycardia,drowsiness,and nausea and vomiting between the two groups.Conclusion Compared with sufentanil alone for analgesia,dexmedetomidine can be used as an adjunct for postoperative analgesia in patients with obstructive jaundice to improve analgesia without increasing the incidence of adverse effects.

Abstract:Objective To investigate the protective effect of short-peptide-based enteral nutrition(SPEN)on intestinal mucosal barrier function and its effect on secondary brain injury in mice with traumatic brain injury(TBI).Methods Male clean-grade C57BL/6 mice aged 8 to 12 weeks were divided into Sham group,TBI group and TBI+SPEN group.Mice in the TBI+SPEN group were given short-peptide powder(0.4 g/L)in drinking water immediately after modeling,while the other groups received sterile water during the same process.Firstly,behavioral changes of the three groups of mice were analyzed to determine the effect of SPEN on the prognosis of nerve function in TBI mice.Secondly,the changes of the structure and permeability in gut and the level of lipopolysaccharide(LPS)in blood were analyzed after TBI mice were given SPEN.In addition,the water content of brain tissues,the level of inflammatory factors and the activation of microglia were detected to determine the effect of SPEN on secondary brain injury after TBI.Results Compared with Sham group,the intestinal mucosal barrier structure was damaged,the permeability was increased,and the entry of LPS into blood and brain was increased in TBI group(P＜0.01).However,the damage could be effectively reversed in TBI+SPEN group.At the same time,the activation of microglia and the expression of inflammatory factors in brain tissue were reduced,and the neurological function was significantly improved.Conclusion Early SPEN can protect intestinal mucosal barrier function,reduce the entry of LPS into blood and brain,alleviate secondary brain injury and improve the prognosis of TBI mice.

Abstract:Objective To study the relationship between serum 25-hydroxyvitamin D3[25-(OH)D3],C-C motif chemokine ligand 5(CCL5),human cartilage glycoprotein-39[(HC-gp39),also know as YKL-40],D-dimer(D-D)levels and disease severity and prognosis in children with Mycoplasma pneumoniae infection.Methods The clinical data of 194 children with Mycoplasma pneumoniae infection admitted to Hangzhou First People's Hospital from January 2021 to September 2024 were selected as group B,and 50 healthy children who underwent health examination in our hospital during the same period were selected as group A.According to the severity of the disease in group B,they were divided into mild group(135 cases)and severe group(59 cases).According to their prognosis situation,they were divided into good prognosis group(144 cases)and poor prognosis group(50 cases).The serum 25-(OH)D3,CCL5,YKL-40 and D-D levels in children with Mycoplasma pneumoniae infection of different disease severities were compared,and their correlation and related factors affecting the prognosis of children with Mycoplasma pneumoniae infection were analyzed.The predictive value of serum 25-(OH)D3,CCL5,YKL-40 and D-D on the prognosis of children with Mycoplasma pneumoniae infection was further analyzed.Results Compared with group A,the serum 25-(OH)D3 level in group B was lower,and the serum CCL5,YKL-40 and D-D levels were higher(P＜0.01).Compared with mild group,the serum 25-(OH)D3 level in severe group was lower,and the serum CCL5,YKL-40 and D-D levels were higher(P＜0.01).The serum 25-(OH)D3 level was negatively correlated with the severity of Mycoplasma pneumoniae infection in children(r=-0.627,P＜0.01).The CCL5,YKL-40 and D-D levels were positively correlated with the severity of Mycoplasma pneumoniae infection in children(r=0.489,0.562,0.611,P＜0.01).The proportion of children with severe disease,pleural effusion,course of treatment≥7 d,peripheral white blood cell count,serum CCL5,YKL-40 and D-D levels in the poor prognosis group were higher than those in the good prognosis group,the use time of antibiotics was longer than that in the good prognosis group,and the serum 25-(OH)D3 level was lower than that in the good prognosis group(P＜0.01).Severe disease,pleural effusion,lower serum 25-(OH)D3 level,and higher serum CCL5,YKL-40 and D-D levels were all risk factors for poor prognosis in children with Mycoplasma pneumoniae infection(OR=1.735,1.900,1.770,1.723,1.637,1.863,P＜0.05).The area under the curve of serum 25-(OH)D3,CCL5,YKL-40 and D-D in predicting the prognosis of children with Mycoplasma pneumoniae infection was higher than that of the four alone(P＜0.01).Conclusion The serum 25-(OH)D3,CCL5,YKL-40 and D-D levels are closely related to the occurrence and severity of the disease in children with Mycoplasma pneumoniae infection.The risk factors for poor prognosis include severe disease,pleural effusion,lower serum 25-(OH)D3 level,and higher serum CCL5,YKL-40 and D-D levels.At the same time,serum 25-(OH)D3,CCL5,YKL-40 and D-D can effectively improve the predictive value for the prognosis of children with Mycoplasma pneumoniae infection.

Abstract:Objective To investigate the impact of closed reduction and proximal femoral nail antirotation(PFNA)on the stability and torsional resistance of intertrochanteric femoral fractures.Methods A total of 90 patients with intertrochanteric femoral fractures admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Zhejiang Chinese Medical University from September 2021 to February 2023 were selected as the study objects.They were divided into two groups according to random number table method.The control group was given dynamic hip screw fixation,and the observation group was given closed reduction and PFNA fixation.The study compared the surgical outcomes of the two groups,including fracture alignment,hip joint mobility,and postoperative complication rates six months after surgery;pain levels at 1,3,and 7 d after surgery[Numerical Rating Scale(NRS)];and motor function and activities of daily living before and 6 months after surgery[hip joint function(Harris Hip Score),Hospital for Special Surgery Knee Score(HSS),and activities of daily living(Barthel Index)].Additionally,three-dimensional finite element analysis was employed to measure displacement under vertical loads of 200,400,and 600 N,and torque resistance at 1 °,3 °,and 5 ° of torsion six months after surgery.Results The observation group demonstrated reduced hospital stay,operative duration,and time to fracture consolidation compared to the control group,with less intraoperative blood loss(P＜0.01).NRS scores of the observation group were lower than those of the control group at 1,3,and 7 d after surgery at rest and during exercise(P＜0.05).No significant difference in fracture alignment was observed between the two groups at six months after surgery(P＞0.05).Both groups experienced an increase in hip joint mobility,with the observation group demonstrating a more significant enhancement compared to the control group at six months after surgery(P＜0.05).Harris Hip Score,HSS and Barthel Index in both groups were increased,and the observation group achieved higher scores than the control group(P＜0.05).The observation group exhibited less displacement under vertical loads of 200,400 and 600 N and greater torque resistance at 1°,3°,and 5° of torsion compared to the control group(P＜0.05).The total incidence of complications,including implant loosening,displacement,and rotational instability,was lower in the observation group at six months after surgery(P＜0.05).Conclusion Closed reduction and PFNA fixation is an effective treatment for intertrochanteric femoral fractures,which can promote postoperative recovery,improve joint function,enhance stability and torsional resistance,and reduce incidence of postoperative complications.

Abstract:Objective To investigate the clinical efficacy of immediate intraoperative enrichment of stem cells combined with calcium sulfate-calcium phosphate composite artificial bone in the treatment of bone defects in children.Methods A retrospective analysis was conducted on 11 pediatric patients with bone defects admitted to the Department of Orthopaedics,Tangdu Hospital,Air Force Medical University from July 2015 to July 2024.The feasibility and advantages of integrating autologous bone marrow mesenchymal stem cells(BMSCs)into calcium sulfate-calcium phosphate composite artificial bone during surgery were analyzed.This was achieved through a screen-enrich-combine circulating system implemented intraoperatively.The immediate enrichment effect of BMSCs in calcium sulfate-calcium phosphate composite artificial bone particles and its repair effect on bone defects in children were analyzed.Bone healing was assessed utilizing Samantha X-ray scoring system.Additionally,the adjacent joint function and quality of life before and after surgery were evaluated by Paley score and SF-36 score.Results In vitro experiments demonstrated favorable biocompatibility of the artificial bone,with optimal cell viability after coculture with human BMSCs for an extended period.Autologous BMSCs exhibited high enrichment efficiency on the surface of calcium sulfate-calcium phosphate artificial bone particles,indicating its efficacy in the treatment of bone defects in children.A total of 11 pediatric patients were enrolled in this study,with a follow-up duration of(16.3±5.8)weeks.Postoperative observations revealed no complications such as infection,bleeding,repair failure,intractable pain,and fracture.The repair outcome of bone defects was deemed satisfactory.Conclusion Immediate intraoperative enrichment of autologous BMSCs into calcium sulfate-calcium phosphate composite artificial bone represents a mature clinical approach,which stands as a satisfactory and feasible method for bone defect repair in children.