Abstract:Airway management is an important part of anesthesia.Unpredictable difficult airway can lead to serious consequences,such as hypoxemia and brain death,so airway assessment before anesthesia is particularly important.Machine learning and deep learning have better performance than traditional methods(such as modified Maholobian classification,thyromental distance,etc.)in establishing difficult airway prediction models.Machine learning algorithms can keenly find nonlinear relationships between variables.Deep learning algorithms,especially convolutional neural networks and their variants,have significantly improved prediction accuracy and efficiency by automatically analyzing multimodal data.This article focuses on the application of machine learning and deep learning technology in difficult airway assessment,in order to improve the safety of anesthesia.

Abstract:Objective To investigate the clinical effect of different doses of Xuebijing combined with linezolid in the treatment of patients with severe pneumonia and its influence on T helper cell 17(Th17),regulatory T cell(Treg)cytokines and blood gas indexes.Methods A total of 136 patients with severe pneumonia admitted to the First Affiliated Hospital of Xi'an Jiaotong University from March 2022 to March 2025 were selected as the research objects.According to the random envelope drawing method,the patients were divided into control group and observation group,with 68 cases in each group.Both groups received conventional treatment.The control group was treated with small dose of Xuebijing injection combined with linezolid tablets,and the observation group was treated with large dose of Xuebijing injection combined with linezolid tablets.Both groups were treated for 7 d.The clinical efficacy,mechanical ventilation time and hospitalization time,blood gas analysis indexes,serum Th17 and Treg cytokines,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[94.1％(64/68)vs 82.4％(56/68)](x2=4.533,P=0.033).The mechanical ventilation time and intensive care unit length of stay in the observation group were significantly lower than those in the control group(both P＜0.05).After treatment,the levels of blood oxygen saturation,arterial partial pressure of oxygen,interleukin-10 and transforming growth factor-β in the two groups were higher than those before treatment,and the levels of arterial partial pressure of carbon dioxide,interleukin-17 and tumor necrosis factor-α were lower than those before treatment,and the improvement degree of blood gas analysis indexes,Th17 and Treg cytokines in the observation group was significantly better than that in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Large dose of Xuebijing injection combined with linezolid tablets can regulate the levels of Th17 and Treg cytokines,effectively treat patients with severe pneumonia,shorten the time of mechanical ventilation and hospitalization,improve blood gas indexes,and have better clinical efficacy.

Abstract:Objective To investigate the expression of cyclin-dependent kinase inhibitor 2 A(CDKN2A)and B lymphocyte-induced mature protein 1(Blimp-1)in cervical high-grade squamous intraepithelial lesion(HSIL)and their relationship with the progression of HSIL.Methods A total of 815 patients with HSIL who underwent cervical conization in Shanxi Children's Hospital from January 2019 to January 2022 were selected.According to the postoperative pathological results,the patients were divided into progressive group and non-progressive group.The surgically resected cervical tissues were taken to detect the expression of CDKN2A mRNA and Blimp-1 mRNA.Pearson method was used to analyze the correlation between CDKN2A mRNA and Blimp-1 mRNA.Multivariate Logistic regression was used to analyze the risk factors for the progression of HSIL.Receiver operating characteristic curve was used to analyze the value of CDKN2A mRNA and Blimp-1 mRNA in the diagnosis of HSIL progression.Results Among 815 patients with HSIL,97 cases(11.9％)were confirmed to progress to cervical cancer by postoperative pathology,which was the progressive group,and the remaining 718 cases(88.1％)were the non-progressive group.The expression level of CDKN2A mRNA in cervical tissue of progressive group was lower than that of non-progressive group[(0.53±0.13)vs(1.43±0.27)],and the expression level of Blimp-1 mRNA was higher than that of non-progressive group[(2.65±0.71)vs(1.27±0.24)](all P＜0.001).The expression of CDKN2A mRNA was negatively correlated with the expression of Blimp-1 mRNA in cervical tissues(r=-0.650,P＜0.05).Human papillomavirus 16/18 infection,cervical intraepithelial neoplasia grade 3 and high expression of Blimp-1 mRNA were risk factors for HSIL progression to cervical cancer(all P＜0.05),and high expression of CDKN2A mRNA was a protective factor(P＜0.05).The area under the curve of CDKN2A mRNA and Blimp-1 mRNA in the diagnosis of HSIL progression was 0.777 and 0.759,respectively.The area under the curve of combined diagnosis was 0.920,which was higher than that of single diagnosis(both P＜0.05).Conclusion Low expression of CDKN2A mRNA and high expression of Blimp-1 mRNA in cervical tissues are risk factors for the progression of HSIL to cervical cancer.The combination of CDKN2A mRNA and Blimp-1 mRNA can predict the risk of HSIL progression.

Abstract:Objective To investigate the effects of different concentrations of cyclosporine on metabolism of blood glucose,blood lipid,uric acid,etc and renal function in patients with aplastic anemia.Methods A total of 143 patients with aplastic anemia treated with cyclosporine in the First Affiliated Hospital of Harbin Medical University from January 2021 to January 2024 were selected.According to the different blood drug concentration monitoring time,they were divided into 1 month after treatment group(group A,31 cases),3 months after treatment group(group B,34 cases)and 6 months after treatment group(group C,42 cases)and 12 months after treatment group(group D,36 cases).The blood concentration of cyclosporine,blood glucose,blood lipid,serum creatinine and uric acid of patients in different groups were collected,and the correlation between the blood concentration of cyclosporine and each index was analyzed.Results The blood concentrations of cyclosporine in groups A,B,C,and D were(193±28),(214±19),(188±28),and(176±26)μg/L,respectively.The blood concentration of cyclosporine in group B was higher than those in groups A,C,and D(P＜0.05).There were statistically significant differences in the levels of blood glucose,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,and creatinine among the four groups(all P＜0.05),and there was no statistically significant difference in the level of uric acid(P＞0.05).The results of correlation analysis showed that blood glucose,triglyceride,low-density lipoprotein cholesterol and creatinine were positively correlated with the blood concentration of cyclosporine,high-density lipoprotein cholesterol was negatively correlated with the blood concentration of cyclosporine(all P＜0.05),while total cholesterol and uric acid levels were not correlated with the blood concentration of cyclosporine(both P＞0.05).Conclusions The plasma concentration of cyclosporine has an effect on blood glucose,lipid metabolism and renal function in patients with aplastic anemia,but has no effect on uric acid metabolism.

Abstract:Cardiovascular disease is a major threat to human health.Its core pathophysiological features are endothelial dysfunction,which is manifested as decreased vasodilation ability,hemodynamic abnormalities,and accelerated progression of atherosclerosis.Trimetazidine can effectively improve endothelial dysfunction by optimizing energy metabolism,improving hemodynamics,reducing oxidative stress,inhibiting inflammatory response,and regulating angiogenesis,and is widely used in the treatment of a variety of cardiovascular diseases.This article reviews the mechanism of trimetazidine and its latest research progress in improving endothelial dysfunction related to cardiovascular disease,so as to provide new strategies and evidence for better clinical application of trimetazidine.

Abstract:Objective To investigate the clinical effect of Shenkang injection combined with levosimendan on patients with early acute kidney injury(AKI)after coronary artery bypass grafting(CABG).Methods A total of 110 patients with early AKI after CABG admitted to General Hospital of Northern Theater Command of Chinese People's Liberation Army from February 2023 to September 2024 were selected.According to the random number table method,they were divided into control group and observation group,with 55 cases in each group.The control group was treated with levosimendan injection on the basis of conventional comprehensive treatment,and the observation group was treated with Shenkang injection on the basis of the control group.The clinical efficacy,cardiac function,renal function,inflammatory indicators and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[94.5％(52/55)vs 80.0％(44/55)](P=0.022).After treatment,the left ventricular fractional shortening,left ventricular ejection fraction,and glomerular filtration rate of the two groups were higher than those before treatment,and those of the observation group were higher than those of the control group.The levels of 24 h urine protein,urine microprotein,serum creatinine,blood urea nitrogen,interleukin-6(IL-6),IL-8,and IL-18 of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=1.000).Conclusion Shenkang injection combined with levosimendan in the treatment of patients with early AKI after CABG is effective,which can improve the heart and kidney function of patients,effectively inhibit the inflammatory response in the body,and is safe and reliable in clinical application.

Abstract:Objective To investigate the clinical efficacy and safety of different platinum-based chemotherapy regimens combined with slulizumab as first-line treatment for extensive-stage small cell lung cancer(ES-SCLC).Methods A total of 118 patients with ES-SCLC admitted to the Affiliated Hospital of Xuzhou Medical University from October 1,2022 to September 30,2024 were retrospectively selected.According to the different chemothera-py regimens,they were divided into lobaplatin group(65 cases)and carboplatin group(53 cases).The patients in the lobaplatin group were treated with lobaplatin combined with etoposide and slulizumab,and the patients in the carboplatin group were treated with carboplatin combined with etoposide and slulizumab,every 21 days as a cycle.The patients in the two groups were treated for 4 cycles.The general data,short-term efficacy,long-term efficacy,and adverse reactions of the two groups were compared.Results There were no significant differences in gender,age,smoking history,Eastern Cooperative Oncology Group performance status scale score,liver metastasis,brain metastasis,bone metastasis,adrenal metastasis,and thoracic radiotherapy between the two groups(all P＞0.05).There was no significant difference in objective response rate and disease control rate between lobaplatin group and carboplatin group[64.6％(42/65)vs 69.8％(37/53),83.1％(54/65)vs 88.7％(47/53)](x2=0.356,P=0.551;x2=0.743,P=0.389).There were no significant differences in progression-free survival and overall survival between the two groups(both P＞0.05).The incidences of nausea and vomiting and allergic reactions in the lobaplatin group were lower than those in the carboplatin group(both P＜0.05).Conclusion Lobaplatin combined with etoposide and slulizumab and carboplatin combined with etoposide and slulizumab are effective in the first-line treatment of ES-SCLC.The incidence of nausea and vomiting and allergic reactions in the lobaplatin group is lower than that in the carboplatin group.

Abstract:Objective To investigate the clinical effect and safety of modified Buyang Huanwu decoction combined with chemotherapy in the treatment of advanced triple negative breast cancer(TNBC).Methods The clinical data of 162 hospitalized patients diagnosed with advanced TNBC and received chemotherapy in China-Japan Friendship Hospital from January 2021 to January 2024 were retrospectively analyzed.According to the different treatment regimens,the patients were divided into simple chemotherapy group(treated with albumin-bound paclitaxel,eutidrone or capecitabine standard chemotherapy)and integrated traditional Chinese and western medicine treatment group(treated with modified Buyang Huanwu decoction combined with standard chemotherapy),with 81 cases in each group.The clinical efficacy,adverse reactions and quality of life in terms of pain were observed after treatment.Results The proportion of stable disease and disease control rate in the integrated traditional Chinese and western medicine treatment group were higher than those in the simple chemotherapy group[24.5％(19/81)vs 12.3％(10/81),69.1％(56/81)vs 50.6％(41/81)](both P＜0.05).The progression-free survival of the integrated traditional Chinese and western medicine treatment group was longer than that of the simple chemotherapy group[(4.6±1.9)months vs(4.0±1.6)months](P＜0.05).After 3 months of treatment,the total effective rate of peripheral neurotoxicity in the integrated traditional Chinese and western medicine treatment group was higher than that in the simple chemotherapy group[91.8％(45/49)vs 90.8％(59/65)](P＜0.05).After the last chemotherapy and at the 3-month follow-up,the pain numerical rating scale score of the integrated traditional Chinese and western medicine treatment group was lower than that of the simple chemotherapy group[(1.2±0.8)vs(2.9±1.0),(1.4±0.7)vs(2.5±1.2)](both P＜0.05).Conclusion Buyang Huanwu decoction combined with chemotherapy has a good clinical effect in the treatment of advanced TNBC,and it can significantly reduce chemotherapy-related peripheral neurotoxicity and improve the quality of life of patients with advanced TNBC.

Abstract:Hyperuricemia is a common metabolic disease,mainly caused by factors such as purine metabolism disorders in the human body,reduced or excessive excretion of uric acid,etc.Long-term high uric acid levels not only can lead to gout attacks but also may cause chronic damage to the kidney,affecting the quality of life of patients.Drug therapy remains the preferred treatment for hyperuricemia.Although clinical therapeutic drugs can control some conditions,there are still many deficiencies.This article reviews the research progress of drugs related to the treatment of hyperuricemia,and introduces and discusses new uric acid-lowering drugs,hoping to provide references for clinical medication and new drug development.

Abstract:Objective To investigate the application value of profile blood lipid combined with CT angiography(CTA)in the diagnosis of carotid plaque in patients with cerebral infarction.Methods A total of 200 patients with cerebral infarction admitted to the Department of Neurology,Zhangjiakou First Hospital,Hebei Province from May 2021 to December 2022 were selected as the observation group,and 100 healthy people who underwent physical examination during the same period were selected as the control group.According to the results of digital subtraction angiography,the patients in the observation group were divided into plaque group(108 cases)and non-plaque group(92 cases).Gender,age,smoking history,hypertension,diabetes,heart disease history,kidney disease history,and blood lipid indexes were collected and compared.The results of digital subtraction angiography were used as the gold standard to evaluate the efficacy of CTA alone and combined with blood lipid indexes in the diagnosis of carotid plaque.Results There were no statistically significant differences in baseline data between the observation group and the control group(all P＞0.05).The levels of serum matrix metalloproteinase-9(MMP-9),total cholesterol,triglyceride and low-density lipoprotein cholesterol(LDL-C)in the observation group were higher than those in the control group,and the levels of tissue inhibitor of metalloproteinase-1(TIMP-1)and high-density lipoprotein cholesterol(HDL-C)were lower than those in the control group(all P＜0.05).The levels of serum MMP-9,total cholesterol,triglyceride and LDL-C in the plaque group were higher than those in the non-plaque group,and the levels of TIMP-1 and HDL-C in the plaque group were lower than those in the non-plaque group(all P＜0.05).Multivariate Logistic regression showed that MMP-9 and triglyceride were independent risk factors for carotid plaque,and TIMP-1 was protective factor(all P＜0.05).The area under the curve(AUC)of CTA combined with serum MMP-9,TIMP-1,total cholesterol,triglyceride,HDL-C and LDL-C in the diagnosis of carotid plaque was 0.993.The AUC of CTA combined with serum MMP-9 and TIMP-1 in the diagnosis of carotid plaque was 0.981.The AUC of CTA alone in the diagnosis of carotid plaque was 0.935,and the diagnostic efficacy of combined diagnosis was higher than that of CTA alone.Conclusion Blood lipid profile combined with CTA,MMP-9 and TIMP-1 can significantly improve the diagnostic efficiency of carotid plaque in patients with cerebral infarction,provide a more comprehensive and accurate diagnostic basis for clinical practice,and contribute to early intervention and individualized treatment of cerebral infarction.

Abstract:Objective To investigate the efficacy and prognosis of paclitaxel for injection(albumin-bound)combined with pyrotinib in the treatment of human epidermal growth factor receptor 2(HER-2)positive breast cancer with lung metastasis.Methods A total of 80 patients with HER-2 positive breast cancer and lung metastasis admitted to the Department of Oncology,Cangzhou Central Hospital,Hebei Medical University from January 2023 to January 2024 were selected.According to the random number table method,they were divided into the control group and the observation group,with 40 cases in each group.The control group was treated with paclitaxel for injection(albumin-bound)intravenous injection,and the observation group was treated with pyrotinib on the basis of the control group,with 21 d as a treatment cycle,a total of 4 cycles of treatment.The therapeutic effects of the two groups were evaluated.The levels of T lymphocyte subsets and serum tumor markers carcinoem-bryonic antigen and carbohydrate antigen 153(CA153)were detected by flow cytometry and chemiluminescence immunoassay before and after treatment,respectively.The quality of life of the two groups before and after treatment was evaluated according to the Quality of life of Chemobiological Therapy scale for Cancer patients in China(QLQ-CCC).The adverse reactions during treatment and the overall survival rate of the two groups after 1-year follow-up were recorded.Results The disease control rate of the observation group was higher than that of the control group[95.0％(38/40)vs 77.5％(31/40)](P=0.023).Before treatment,there were no significant differences in the levels of immune indexes,carcinoembryonic antigen and CA153 between the two groups(all P＞0.05).After treatment,the level of CD8+cells in the observation group was lower than that in the control group,while the levels of CD4+,CD3+cells and CD4+/CD8+ratio were higher than those in the control group(all P＜0.05).After treatment,the levels of CEA and CA153 in the two groups were significantly lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the QLQ-CCC scores of the two groups were significantly higher than those before treatment,and that in the observation group was significantly higher than that in the control group[(83±9)vs(72±8)](all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.157).At the end of follow-up in May 2025,the survival rate of the observation group was 95.0％(38/40),and the survival rate of the control group was 77.5％(31/40).There was statistically significant difference in the survival curve between the two groups(Log-rank x2=5.165,P=0.023).Conclusion Paclitaxel for injection(albumin-bound)combined with pyrotinib in the treatment of HER-2 positive breast cancer with lung metastasis has a significant effect,which can effectively regulate cellular immune function,reduce serum tumor marker levels,improve the quality of life of patients,improve the prognosis of patients,and the adverse reactions can be managed and tolerated,with good safety.

Abstract:Objective To analyze the current status of randomized controlled trials(RCT)of exercise therapy in the treatment of chronic kidney disease(CKD),and to provide suggestions for the evaluation method of clinical effect of exercise therapy in the treatment of CKD.Methods A number of Chinese and English databases were systematically searched for RCT of exercise intervention in CKD from the establishment of the database to March 2025.The characteristics of the literature were extracted,and the selection of outcome indicators of RCT of exercise intervention in CKD was analyzed.Results A total of 52 articles were included,involving 58 outcome indicators that appeared twice or more,and a total of 406 reports were reported.The outcome indicators included renal function(66 times,16.3％),exercise ability test(34 times,8.4％),physical function performance(60 times,14.8％),risk factors(135 times,33.2％),and pathogenesis related indicators(66 times,16.3％),questionnaires and scales(20 times,4.9％),and safety indicators(25 times,6.2％).Conclusion The outcome indicators of RCT on exercise intervention in CKD have some problems,such as large selection differences,some outcome indicators need to be improved,and less attention is paid to clinical symptoms and mental health.Future research should be committed to building a core index set to make the selection of indicators scientific,representative and clinical practicability,and improve the rigor of outcome indicators.

Abstract:Objective To investigate the effect of the timing of camrelizumab intervention on the tumor response rate,immune function and survival prognosis of patients with locally advanced unresectable non-small cell lung cancer(NSCLC)undergoing radiotherapy.Methods A total of 140 patients with NSCLC treated with concurrent chemoradiotherapy(carboplatin,pemetrexed and camrelizumab)in Shandong Provincial General Hospital of the Chinese People's Armed Police Force from January 2018 to February 2020 were retrospectively selected.According to the timing of camrelizumab intervention,the patients were divided into the control group and the observation group,with 70 cases in each group.The control group was treated with camrelizumab from days 42 to 60 after radiotherapy.The observation group received camrelizumab from day 1 to 21 after the end of radiotherapy.The tumor response rate,immune function,overall survival,progression-free survival and adverse reactions were compared between the two groups.Results After 2 cycles of treatment,there were significant differences in partial response rate,disease progression rate and objective response rate between the two groups(all P＜0.05).After 4 cycles of treatment,there were significant differences in the complete remission rate,stable disease rate and objective response rate between the two groups(all P＜0.05).After 2 and 4 cycles of treatment,the CD4+and CD4+/CD8+ratio of the two groups showed an upward trend,and those of the observation group were higher than those of the control group at each time point.The CD8+in the two groups showed a downward trend,and those of the observation group were lower than those of the control group at each time point(all P＜0.05).After 4 cycles of treatment,the expression levels of natural killer cells in the two groups were higher than those before treatment;after 2 cycles of treatment,those in the observation group were higher than those in the control group(all P＜0.05).After 48 months of follow-up,the overall survival and progression-free survival of the observation group were longer than those of the control group[(37±4)months vs(29±6)months,(31±3)months vs(24±4)months](all P＜0.001).Kaplan-Meier survival curve showed that the cumulative survival rate of the observation group was higher than that of the control group(Log-rank x2=24.873,P＜0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Camrelizumab can improve the tumor response rate,immune function and survival prognosis of patients with locally advanced unresectable NSCLC after radiotherapy.

Abstract:Objective To investigate the effect of Kanglaite injection/soft capsule sequential combined immunotherapy on the survival and immune function of patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 123 patients with advanced NSCLC admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from June 2022 to June 2023 were selected as the research objects.The patients were divided into groups A,B and C by random number table method,with 41 cases in each group.The patients in group A were treated with immunotherapy and other conventional treatment,the patients in group B were treated with Kanglaite injection on the basis of group A,and the patients in group C were treated with Kanglaite soft capsule on the basis of group B,with 21 d as a course of treatment.The patients in the three groups were treated for 3 consecutive courses.The clinical efficacy,tumor marker levels,immune function indexes,quality of life scores,survival cycle,and incidence of adverse reactions were compared among the three groups.Results According to the exclusion criteria,2 cases were excluded from group A,2 cases from group B,and 1 case from group C,respectively.Finally,there were 39 cases in group A,39 cases in group B,and 40 cases in group C.The objective response rate and disease control rate in group C were higher than those in group A[50.0％(20/40)vs 30.8％(12/39),70.0％(28/40)vs 48.7％(19/39)](both P＜0.05).After treatment,the levels of tumor markers in the three groups were lower than those before treatment,and those in group C were lower than those in group A and group B,and those in group B were lower than those in group A(all P＜0.05).After treatment,the immune function indexes of patients in group A were better than those before treatment,CD4+,CD8+,CD4+/CD8+of patients in group B and group C were better than those before treatment,and those in group C were better than those in group A and group B,and those in group B were better than those in group A(all P＜0.05).After treatment,the quality of life scores of the three groups were higher than those before treatment.The scores of quality of life in group C and group B were higher than those in group A,and the scores of physiological status,social and family status,functional status and lung cancer related symptoms in group C were higher than those in group B(all P＜0.05).There were no significant differences in the median time to progression,median progression-free survival and median overall survival among the three groups(all P＞0.05).The incidences of adverse reactions in group B and group C were lower than that in group A(x2=6.129,P=0.046).Conclusion Kanglaite injection/soft capsule sequential combined immunotherapy has a significant effect on patients with advanced NSCLC,which can reduce the level of tumor markers,improve immune function,improve the quality of life,prolong the survival period of patients,and reduce the incidence of adverse reactions.

Abstract:Objective To explore the mechanism of estradiol tablets/estradiol and dydrogesterone tablets(femoston)regulating hypothalamic-pituitary-ovarian(HPO)axis to improve ovarian reserve and endometrial receptivity in premature ovarian failure mice with chronic psychological stress.Methods Thirty female Kunming mice aged 8 weeks were completely randomly divided into control group,model group and treatment group,with 10 mice in each group.The model of premature ovarian failure and chronic psychological stress was established in the model group and the treatment group.The treatment group was given femoston by gavage for 4 weeks,and the control group and the model group were given normal saline by gavage.The levels of serum sex hormones,pathological changes of ovarian and uterine tissues,the content of leukemia inhibitory factor(LIF)and the expression of HPO axis related genes in endometrial tissues were detected and compared.Results Compared with the control group,the levels of serum follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in the model group were increased,and the level of estradiol was decreased.The number of ovarian antral follicles decreased and the stromal cells proliferated.The endometrium became thinner,the number of glands decreased and irregular,and the level of LIF decreased.The gene expressions of FSHβ and LHβ were increased,while the gene expressions of gonadotropin-releasing hormone(GnRH),estrogen receptor α(ERα)and estrogen receptor β(ERβ)were decreased(all P＜0.05).Compared with the model group,the levels of FSH and LH in the treatment group were decreased,and the level of estradiol was increased.The number of primary ovarian follicles was increased,and the proliferation of stromal cells was alleviated.The endometrial thickness,glandular structure and LIF level were increased.The gene expression of FSHβ and LHβ decreased,while the gene expression of GnRH,ERα and ERβ increased(all P＜0.05).Conclusion Femoston can regulate HPO axis and improve ovarian reserve and endom-etrial receptivity in mice with premature ovarian failure combined with chronic psychological stress.

Abstract:Objective To explore the efficacy of Xiaozhiling injection in the treatment of constipation in patients with rectal hyposensitivity.Methods A retrospective analysis was conducted on 54 patients with outlet obstructive constipation(rectal mucosal prolapse)who were admitted to Department of Anorectum,Guang'anmen Hospital,China Academy of Chinese Medical Sciences from January 2021 to January 2024 and underwent submucosal Xiaozhiling injection.Rectal sensory threshold was measured by the balloon method before surgery and at 1,2,and 6 months after surgery,while patients were asked to complete the Constipation Assessment Scale(CAS)for self-rating before surgery and at 1,2,6,and 12 months after surgery.Results At 1 and 2 months after surgery,the patients' sensory threshold,initial defecation desire volume,and maximum tolerance volume were all lower than those before surgery(all P＜0.05),while at 6 months after surgery,the sensory threshold,initial defecation desire volume,and maximum tolerance volume were all higher than those at 2 months after surgery(all P＜0.05).At 1,2,6,and 12 months after surgery,the patients' CAS scores were all lower than those before surgery[(3.7±1.0),(3.9±1.1),(4.6±1.4),(5.4±1.4)vs(12.3±1.7)](F=278.700,P＜0.001).Additionally,the CAS score at 12 months after surgery was higher than that at 1,2,and 6 months after surgery(all P＜0.05).Conclusion Submucosal injection of Xiaozhiling is effective for constipation in patients with rectal hyposensitivity,and its therapeutic effect lasts for a relatively long time.

Abstract:Parkinson's disease is often accompanied by severe sleep disorders,which seriously affect the quality of life of patients.Apopmorphine is a dopamine receptor agonist and shows good prospects in the treatment of Parkinson's disease.Existing studies have shown that apopmorphine can effectively regulate dopamine function,thereby improving problems such as sleep structure disorders and circadian rhythm imbalances.However,at present,systematic research on its specific mechanism of action and clinical application is still relatively limited.This article aims to review the application progress of apopmorphine in sleep disorders of Parkinson's disease,explore its mechanism of action,clinical research results and future research directions,with the expectation of providing references for clinical practice.

Abstract:Objective To analyze the influencing factors of poor coronary collateral circulation(CCC)formation in patients with acute coronary syndrome(ACS)and its effect on prognosis.Methods A total of 260 ACS patients admitted to 3201 Hospital from January 2021 to December 2023 were selected and divided into poor formation group and good formation group according to CCC formation.The clinical data of ACS patients were collected,and the incidence of major adverse cardiovascular events(MACE)was calculated after 1 year of follow-up.Univariate analysis was used to analyze the factors of poor CCC in ACS patients,LASSO regression was used to screen the related variables affecting poor CCC in ACS patients,and multivariate Logistic regression analysis was used to determine the independent influencing factors.Based on this,a nomogram prediction model for poor CCC in ACS patients was constructed.By testing the fit of the H-L model,the receiver operating characteristic(ROC)curve was plotted to evaluate the predictive ability of the model,the C-index was used to evaluate the ability to discriminate,the calibration curve was used to evaluate consistency,and the decision curve was used to evaluate the clinical decision value.Results The rate of poor CCC formation in 260 ACS patients was 63.5％(165/260).Multivariate Logistic regression analysis showed that diabetes,high atherogenic index of plasma(AIP)and high neutrophil-to-lymphocyte ratio(NLR)were independent risk factors for poor CCC formation in ACS patients,while right coronary artery,multi-vessel disease and high Gensini score were independent protective factors(all P＜0.05).Based on the above influencing factors,a nomogram model was established as follows:Logit(P)=0.876+1.292 × diabetes-1.176 × culprit vessel-1.785 × number of diseased vessels-0.028 × Gensini Score+0.423 × AIP+0.424 × NLR,with a non-significant H-L test(P＞0.05).The ROC curve analysis results showed that the area under the curve of the nomogram model predicting poor CCC formation in ACS patients was 0.887(95％confidence interval:0.842-0.923),with sensitivity and specificity of 81.8％and 83.2％,respectively.After 1 000 bootstrap self sampling resampling for internal validation,the C-index was 0.888(95％confidence interval:0.883-0.893).The calibration curve showed that the predicted probability was well fitted to the ideal curve,and the decision curve showed that when the threshold probability was greater than 0.15,the net clinical benefit was greater than 0.After 1 year of follow-up,the incidence of MACE in the poor formation group was higher than that in the good formation group[33.9％(56/165)vs 21.1％(20/95)](P＜0.05).Conclusion Diabetes,culprit vessel,number of diseased vessels,Gensini score,AIP and NLR are independent influencing factors for poor CCC in ACS patients.The nomogram model based on this has good predictive value,and poor CCC can increase the incidence of MACE.

Abstract:Objective To explore the influencing factors of sarcopenia in elderly patients with chronic heart failure(CHF),and to construct a nomogram prediction model for predicting the risk of sarcopenia.Methods A total of 200 elderly patients with CHF admitted to the Ninth Medical Center of Chinese PLA General Hospital from July 2023 to January 2025 were selected.According to the occurrence of sarcopenia,patients were divided into sarcopenia group(50 cases)and non-sarcopenia group(150 cases),and the data were collected and recorded.LASSO regression analysis and multivariate Logistic regression analysis were used to screen the independent predictors of sarcopenia in elderly CHF patients.A model was constructed based on LASSO-Logistic regression analysis,and a nomogram was drawn by R software.The calibration curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the nomogram model calibration.The receiver operating characteristic(ROC)curve was used to evaluate the discrimination of the nomogram model.Clinical decision curve analysis was used to evaluate the clinical validity of the nomogram model.Results There were significant differences in age,body mass index,proportion of hyper-tension,diabetes mellitus,left ventricular ejection fraction,New York Heart Association(NYHA)classification,albumin,hemoglobin,appendicular skeletal muscle mass,6 m pace and grip strength between the non-sarcopenia group and the sarcopenia group(all P＜0.05).LASSO-Logistic regression analysis showed that age ≥75 years,lower body mass index,diabetes mellitus,NYHA grade Ⅲ-Ⅳ and lower albumin were independent predictors of sarcopenia in elderly patients with CHF.According to the above factors,a nomogram model for predicting sarcopenia in elderly patients with CHF was constructed.The calibration curve showed that the consistency between the observed value and the predicted value was high,and the Hosmer-Lemeshow goodness of fit test showed x2=0.427,P=0.600.ROC curve results showed that the area under the curve of the model was 0.958(95％confidence interval:0.934-0.982),and the calibration and discrimination of the model were good.Clinical decision curve analysis was used to evaluate the clinical effectiveness of the nomogram model.When the threshold probability range was set to 0.03-0.95,patients could benefit from the nomogram model.Conclusion Age ≥75 years,lower body mass index,diabetes mellitus,NYHA grade Ⅲ-Ⅳ and lower albumin are independent predictors of sarcopenia in elderly CHF patients.The nomogram model based on the above factors can effectively predict the risk of sarcopenia in elderly CHF patients.

Abstract:Advanced ovarian cancer has a high risk of recurrence and high mortality,which seriously threatens women's health.Standardized maintenance treatment can control or delay tumor recurrence,thereby improving the quality of life and prolonging the survival time of patients.This consensus is compiled based on the principle of evidence-based medicine,combined with the latest relevant research evidence at home and abroad,and in accordance with the systematic patient management concept of"assessment,support,control,care,and life",and widely solicited opinions from experts in related fields in many parts of the country,aiming to provide a reference for the clinical practice of integrated traditional Chinese and western medicine in maintenance treatment of ovarian cancer.