Abstract:Objective To explore the synergistic efficacy and safety of microwave ablation combined with bevacizumab in epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)-resistant advanced non-small cell lung cancer(NSCLC).Methods A retrospective analysis was performed on the clinical data of 82 patients with advanced non-squamous NSCLC who developed resistance to EGFR-TKI treatment and were admitted to Hainan Cancer Hospital from January 2022 to April 2025.According to the treatment regimens,the patients were divided into the combination group and the control group,with 41 cases in each group.The control group received pemetrexed/carboplatin chemotherapy,while the combination group was treated with microwave ablation plus bevacizumab combined with pemetrexed/carboplatin chemotherapy.The short-term efficacy,dynamic changes of serum tumor markers,long-term survival benefits and safety were compared between the two groups.Results The objective response rate and disease control rate in the combination group were significantly higher than those in the control group[65.8％(27/41)vs 34.2％(14/41),90.2％(37/41)vs 68.3％(28/41)](both P＜0.05).After treatment,the levels of carcinoembryonic antigen and cytokeratin 19 fragment in both groups were lower than those before treatment,and the levels in the combination group were significantly lower than those in the control group(all P＜0.05).The median progression-free survival(mPFS)in the combination group was 8.5 months(95％confidence interval:7.803-10.397),while that in the control group was 5.3 months(95％confidence interval:4.076-6.524).The mPFS in the combination group was significantly longer than that in the control group(hazard ratio=0.46,P＜0.01).There was no statistically significant difference in the incidence of grade 3 or above adverse reactions between the combination group and the control group(P＞0.05).Conclusion Microwave ablation combined with bevacizumab exerts a certain synergistic effect in patients with EGFR-TKI resistance,improves the response of tumor markers,prolongs PFS,and has a controllable safety profile,which provides a novel integrated treatment strategy for advanced NSCLC.

Abstract:Objective To investigate the effects of Danicopan,a complement factor D(CFD)inhibitor,on cardiac function,myocardial hypertrophy and myocardial fibrosis in mice after myocardial infarction(MI).Methods C57BL/6 mice were randomly divided into sham operation group,MI control group and MI+Danicopan group.MI model was established by ligating the left anterior descending coronary artery.From the day of operation,mice in the MI+Danicopan group were intraperitoneally injected with Danicopan(10 mg/kg),while those in the MI control group were injected with an equal volume of phosphate-buffered saline,twice a week for 3 consecutive weeks.Mice in the sham operation group only received thoracotomy without ligation of the left anterior descending coronary artery and no drug administration.After the intervention,echocardiography was performed to evaluate cardiac function.Cardiac tissues were collected for wheat germ agglutinin staining to observe the cross-sectional area of cardiomyocytes,and Masson's trichrome staining to analyze collagen deposition and calculate the percentage of fibrotic area.Results The left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)in the MI control group were significantly lower than those in the sham operation group[(21.3±1.7)％vs(68.3±2.4)％,(9.5±1.0)％vs(40.7±3.9)％],while the LVEF and LVFS in the MI+Danicopan group[(46.2±12.3)％,(23.0±7.3)％]were significantly higher than those in the MI control group(all P＜0.05).Pathological observations showed that Danicopan administration could significantly alleviate the degree of cardiomyocyte hypertrophy induced by MI and reduce the overall collagen volume fraction of myocardial tissue.Conclusion Danicopan,a CFD inhibitor,can significantly improve cardiac function,and alleviate pathological cardiomyocyte hypertrophy and interstitial fibrosis in mice with MI,suggesting that it may serve as a potential drug for the treatment of ventricular remodeling after MI.

Abstract:Objective To investigate the therapeutic effect of invasive-noninvasive sequential ventilation combined with bronchoscopic alveolar lavage on chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods A total of 58 patients with COPD complicated with respiratory failure admitted to the Department of Emergency and Department of Respiratory,the First Affiliated Hospital of Guilin Medical University from July 2021 to June 2023 were enrolled.The patients were divided into the control group and the observation group using the random number table method,with 29 cases in each group.The control group was treated with invasive-noninvasive sequential ventilation alone,while the observation group was treated with bronchoscopic alveolar lavage on the basis of the control group's regimen.Oxidative stress indexes,immune function indexes,pulmonary function indexes,diaphragmatic status,clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,the levels of superoxide dismutase and glutathione in both groups were signifi-cantly higher than those before treatment,and the levels in the observation group were significantly higher than those in the control group;the malondialdehyde levels in both groups were significantly lower than those before treatment,and the level in the observation group was significantly lower than that in the control group(all P＜0.05).The levels of CD3+,CD4+,and the CD4+/CD8+ratio in both groups were higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group;the CD8+levels in both groups were lower than those before treatment,and the level in the observation group was significantly lower than that in the control group(all P＜0.05).The forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC ratio,diaphragm thickening fraction and diaphragm excursion in both groups were signifi-cantly higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group(all P＜0.05).The total effective rate of the observation group was significantly higher than that of the control group[86.2％(25/29)vs 62.1％(18/29)](P＜0.05).The time to respiratory failure correction,mechanical ventilation time and length of hospital stay in the observation group were significantly shorter than those in the control group(all P＜0.05).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Invasive-noninvasive sequential ventilation combined with bronchoscopic alveolar lavage can significantly improve the therapeutic effect in patients with COPD complicated with respiratory failure,ameliorate oxidative stress and immune indexes,promote the recovery of diaphragmatic function,with high safety.

Abstract:Objective To investigate the correlation of serum microRNA-760(miR-760)and cytoplasmic polyadenylation element binding protein 2(CPEB2)expression with clinicopathological features and prognosis in children with acute lymphoblastic leukemia(ALL).Methods A total of 205 children with ALL admitted to Shaanxi Provincial People's Hospital from January 2020 to June 2022 were prospectively enrolled as the ALL group,and 103 healthy children during the same period were selected as the control group.The serum expression levels of miR-760 and CPEB2 mRNA were detected.The binding site between miR-760 and CPEB2 was predicted through an online database.Pearson correlation analysis was used to analyze the correlation between serum miR-760 and CPEB2 mRNA expression in children with ALL,and their relationship with clinicopathological features was also analyzed.The progression-free survival rate was compared among children with different serum expression levels of miR-760 and CPEB2 mRNA.Multivariate Cox regression analysis and receiver operating characteristic(ROC)curve were used to analyze the influencing factors for the prognosis of children with ALL and the predictive efficacy of serum miR-760 and CPEB2 mRNA expression for prognosis.Results The serum expression level of miR-760 in the ALL group was lower than that in the control group[(0.64±0.11)vs(1.01±0.17)],and the expression level of CPEB2 mRNA was higher than that in the control group[(1.33±0.30)vs(0.83±0.14)](all P＜0.001).A binding site of miR-760 was found at positions 2855-2861 of the 3'untranslated region of CPEB2.Serum miR-760 expression was negatively correlated with CPEB2 mRNA expression in children with ALL(r=-0.655,P＜0.001).There were statistically significant differences in the serum expression levels of miR-760 and CPEB2 mRNA among ALL children with different risk stratifications(all P＜0.001).The 3-year event-free survival rate of ALL children in the miR-760 high expression group was higher than that in the miR-760 low expression group,and the 3-year event-free survival rate in the CPEB2 mRNA high expression group was lower than that in the CPEB2 mRNA low expression group(all P＜0.05).Mixed lineage leukemia gene rearrangement,high-risk stratification and CPEB2 mRNA≥1.33 were independent risk factors for poor prognosis in children with ALL,while miR-760 ≥0.64 was an independent protective factor(all P＜0.05).The areas under the curve of serum miR-760,CPEB2 mRNA and their combination in predicting poor prognosis of children with ALL were 0.796,0.790 and 0.896,respectively.The combined detection was superior to the single detection of serum miR-760 or CPEB2 mRNA in predictive efficacy(all P＜0.05).Conclusion Serum miR-760 low expression and CPEB2 mRNA high expression are associated with adverse clinicopathological features and poor prognosis in children with ALL,and the combined detection of serum miR-760 and CPEB2 expression has a high predictive efficacy for the prognosis of these children.

Abstract:Objective To investigate the relationship between hemoglobin,albumin,lymphocyte and platelet(HALP)index,lactate dehydrogenase to albumin ratio(LAR),monocyte to high-density lipoprotein cholesterol ratio(MHR)and prognosis in patients with sepsis-associated acute kidney injury(S-AKI).Methods A total of 100 patients with S-AKI admitted to Chongqing Emergency Medical Center from May 2023 to May 2025 were retrospectively enrolled.According to 28 d survival status during hospitalization,patients were divided into survival group(52 cases)and death group(48 cases).Clinical data and laboratory data of the two groups were collected,HALP index,LAR and MHR were calculated.The factors associated with 28 d in-hospital mortality and the predictive value of HALP index,LAR and MHR for 28 d in-hospital mortality were analyzed.Results The proportion of stage 3 AKI,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,vasoactive drugs and mechanical ventilation in death group were higher than those in survival group(all P＜0.05).HALP index in death group was lower than that in survival group[(23.0±2.5)vs(27.6±3.1)](t=-8.112,P＜0.001),while LAR and MHR were higher than those in survival group[(12.0±2.2)vs(7.3±1.6),(14.3±3.7)vs(9.3±2.3)](t=12.283,8.188,both P＜0.001).Multivariate Logistic regression analysis showed that high SOFA score,stage 3 AKI,high LAR and high MHR were independent risk factors for 28 d in-hospital mortality in S-AKI patients(all P＜0.05),while high HALP index was a protective factor(P＜0.05).The area under the curve of HALP index,LAR and MHR for predicting 28 d in-hospital mortality in S-AKI patients was 0.746,0.729 and 0.750,respectively,and the combined prediction was 0.883,which was higher than that of each single indicator(all P＜0.05).Conclusion The combina-tion of HALP index,LAR and MHR can effectively predict the risk of adverse outcomes in patients with S-AKI.

Abstract:Objective To observe the clinical effect of immune checkpoint inhibitors combined with chemotherapy in patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma.Methods The medical records of 729 patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma admitted to Gansu Provincial Cancer Hospital from January 2021 to January 2025 were collected and retrospectively analyzed.According to different treatment regimens,they were divided into control group(361 cases,received conventional chemotherapy)and observation group(368 cases,received immune checkpoint inhibitors combined with chemo-therapy on the basis of control group).All patients were treated continuously for 3 months.The clinical efficacy,levels of tumor markers,immune function indexes and adverse reactions were compared between the two groups.Results The overall response rate and disease control rate[67.9％(250/368)vs 47.6％(172/361)]in the observation group were better than those in the control group(both P＜0.001).After treatment,the levels of carcinoembryonic antigen,carbohydrate antigen 72-4,carbohydrate antigen 199 and CD8+in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group;the levels of CD4+and CD4+/CD8+ratio in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).There were no significant differences in the incidence rates of grade Ⅰ-Ⅱ and Ⅲ-Ⅳ adverse reactions between the two groups(both P＞0.05).Conclusions For patients with advanced gastric cancer and gastroesophageal junction adenocarcinoma,the application of immune checkpoint inhibitors on the basis of chemotherapy has better clinical efficacy,which can improve the disease control rate,reduce the levels of tumor markers,thereby improving the body's immune function with mild adverse reactions.

Abstract:Objective To investigate the relationship between serum insulin-like growth factor binding protein-1(IGFBP-1)and angiopoietin-like protein 4(ANGPTL-4)levels and sarcopenia in patients with liver cirrhosis,and their predictive value.Methods A total of 167 patients with liver cirrhosis admitted to the Department of Gastroenterology,Taiyuan Central Hospital,from January 2023 to July 2025(cirrhosis group)and 167 healthy volunteers(control group)during the same period were enrolled.Serum levels of IGFBP-1 and ANGPTL-4 were detected by enzyme-linked immunosorbent assay.According to the presence or absence of sarcopenia,patients with liver cirrhosis were divided into sarcopenia group and non-sarcopenia group.The factors associated with sarcopenia in cirrhotic patients and the predictive value of serum IGFBP-1 and ANGPTL-4 levels for sarcopenia were analyzed.Results Serum IGFBP-1 level was higher and ANGPTL-4 level was lower in the cirrhosis group than those in the control group[(30±5)μg/L vs(16±4)μg/L,(27±5)μg/L vs(40±5)μg/L](both P＜0.001).In cirrhotic patients,serum IGFBP-1 level was negatively correlated with appendicular skeletal muscle mass index,handgrip strength and 6-meter walking speed,and positively correlated with 5-time sit-up time,while the correlations of ANGPTL-4 level with the above indicators were opposite to those of IGFBP-1(all P＜0.001).Multivariate Logistic regression analysis showed that increased age,Child-Pugh class C liver function and elevated IGFBP-1 were independent risk factors for sarcopenia in cirrhotic patients,while increased body mass index and elevated ANGPTL-4 were independent protective factors(all P＜0.05).The areas under the curve of serum IGFBP-1,ANGPTL-4 and their combination for predicting sarcopenia in cirrhotic patients were 0.803,0.794 and 0.877,respectively.The area under the curve of the combined prediction was larger than that of single prediction(all P＜0.001).Conclusion Elevated serum IGFBP-1 and decreased ANGPTL-4 are associated with sarcopenia in cirrhotic patients.The combination of serum IGFBP-1 and ANGPTL-4 has high predictive value for sarcopenia.

Abstract:Objective To investigate the expression of T-cell immunoglobulin mucin-3(TIM3)and galectin-9 in endometrial carcinoma and their relationship with recurrence and metastasis.Methods A total of 124 patients with endometrial carcinoma who underwent surgery in Shanxi Provincial People's Hospital from February 2019 to October 2021 were selected,and 124 patients with benign endometrial hyperplasia in the same hospital during the same period were selected as the control group.RNAscope technique was used to detect the expression of TIM3 and galectin-9,and the correlation between their expression and postoperative recurrence and metastasis was systematically analyzed.Results In endometrial carcinoma tissues,the positive expression rates of TIM3 and Galectin-9 were 37.1％(46/124)and 29.8％(37/124),respectively,while no expression of TIM3 and Galectin-9 was detected in benign endometrial hyperplasia tissues(0/124).In patients with endometrial carcinoma who developed postoperative recurrence or metastasis,the positive expression rates of TIM3 and Galectin-9 were significantly higher than those in patients without recurrence and metastasis(all P＜0.05).Recurrence and metastasis of endometrial carcinoma were associated with lymph node metastasis(P=0.010)and myometrial invasion(P=0.040).The area under the curve(AUC)of TIM3 in predicting recurrence and metastasis of endometrial carcinoma was 0.872(95％confidence interval:0.837-0.926),with a sensitivity of 86.7％and a specificity of 79.5％;the AUC value of Galectin-9 was 0.830(95％confidence interval:0.814-0.905),with a sensitivity of 90.3％and a specificity of 64.5％.Univariate and multivariate Cox regression analysis showed that positive expression of TIM3,positive expression of Galectin-9 and lymph node metastasis could be used as independent influencing factors for predicting recurrence and metastasis in patients with endometrial carcinoma(all P＜0.05).Conclusion TIM3 and Galectin-9 are specifically expressed in endometrial carcinoma tissues,and their high expression is significantly associated with the risk of postoperative recurrence and metastasis.

Abstract:Objective To investigate the effects of modified fascia iliaca compartment block combined with general anesthesia on intraoperative hemodynamics and recovery quality in children with femoral fracture at medium and high altitudes.Methods A total of 80 children undergoing elective femoral fracture surgery admitted to Qinghai Province Women & Children's Hospital from May 2023 to May 2025 were selected and divided into control group and observation group by random number table method,with 40 cases in each group.The control group received tracheal intubation general anesthesia,and the observation group received combined fascia iliaca compartment block on the basis of the control group.The intraoperative dosage of anesthetics,awakening time,extubation time and length of stay in post-anesthesia care unit(PACU)were recorded in both groups.Hemody-namic indicators(systolic blood pressure,diastolic blood pressure and heart rate)at different time points[before anesthesia(T0),5 min after intubation(T1),skin incision(T2),30 min after operation start(T3),end of operation(T4)]were compared between the two groups.The behavioral pain scale for children(FLACC)scores at different time points(transfer out of PACU,2 h,4 h and 12 h after operation)were compared between the two groups.The incidence of adverse reactions was statistically analyzed.Results With time extension,the changing trends of systolic blood pressure,diastolic blood pressure and heart rate were different between the two groups,and the observation group showed a smaller changing trend(all P＜0.05).Compared with the control group,the dosages of propofol and remifentanil in the observation group were lower[(287±29)mg vs(311±32)mg,(10.4±2.4)μgvs(12.8±2.5)μg](allP＜0.05).Compared with the control group,the FLACC scores in the observation group were lower at transfer out of PACU,2 h,4 h and 12 h after operation(all P＜0.05);with time extension,the FLACC scores in both groups first increased and then decreased,and the observation group showed a smaller changing trend(P＜0.05).Compared with the control group,the awakening time,extubation time and PACU stay time in the observation group were shorter[(53±5)min vs(57±5)min,(9±3)min vs(12±3)min,(31±5)min vs(35±5)min](all P＜0.05).There were no significant differences in the incidence of adverse reactions between the two groups(all P＞0.05).Conclusions Modified fascia iliaca compartment block combined with general anesthesia has significant effects on children with femoral fracture at medium and high altitudes,which is conducive to maintaining hemodynamic stability,reducing the dosage of anesthetics,promoting postoperative recovery,shortening awakening time,with high safety.

Abstract:Objective To explore the influencing factors for completion of full-course medication in young patients with first-episode breast cancer.Methods A total of 347 young patients with first-episode breast cancer treated at the First Affiliated Hospital with Nanjing Medical University from January 2021 to June 2024 were enrolled.Clinical data,disease cognition and social support were collected.Patients were divided into full-course medication completion group and non-completion group.Univariate analysis and Logistic regression were used to analyze influencing factors.Results Among 347 young patients with first-episode breast cancer,243 cases(70.0％)were in the full-course medication completion group,and 104 cases(30.0％)were in the non-completion group.Univariate analysis showed that completion of full-course medication was not associated with age,fertility status,pathological type,molecular subtype,or educational level(all P＞0.05),but was associated with marital status,clinical stage,monthly family income,disease cognition,social support,medication duration,adverse reactions,and post-treatment marriage/fertility intention(all P＜0.05).Logistic regression analysis revealed that divorced or widowed marital status[odds ratio(OR)=1.923,95％confidence interval(CI):1.165-3.174,P=0.011],monthly family income＜5 000 yuan(OR=2.582,95％CI:1.428-4.669,P=0.002),presence of adverse reactions(OR=2.761,95％CI:1.378-5.532,P=0.004),and no post-treatment marriage/fertility intention(OR=1.528,95％CI:1.009-2.314,P=0.045)were risk factors for non-completion of full-course medication.Good disease cognition(OR=0.403,95％CI:0.227-0.715,P=0.002)and high social support(OR=0.531,95％CI:0.368-0.766,P=0.001)were protective factors for completion of full-course medication.Conclusion Marital status,family income,adverse reactions,post-treatment marriage/fertility intention,disease cognition and social support are key factors affecting full-course medication completion.Targeted interventions should be adopted to improve adherence and prognosis.

Abstract:Objective To investigate the application of digital health education combined with cognitive behavioral therapy(CBT)and family support in elderly patients with coronary atherosclerotic heart disease(CHD),arrhythmia and cognitive impairment,and its effects on treatment compliance and sleep quality.Methods A prospective study was conducted.A total of 450 elderly patients with CHD,arrhythmia and cognitive impairment admitted to Beijing Anzhen Hospital,Capital Medical University from January 2023 to January 2025 were divided into control group and observation group by random number table method.The control group(227 cases)received routine intervention,and the observation group(223 cases)received digital health education combined with CBT and family support on the basis of routine intervention.The general data,arrhythmia,sleep,cognition,quality of life improvement and treatment compliance were analyzed between the two groups.Results After intervention,the duration and frequency of arrhythmia in both groups were shorter/decreased than those before intervention,and those in the observation group were shorter/lower than those in the control group(all P＜0.05).After interven-tion,the scores of Pittsburgh sleep quality index(PSQI)in both groups were lower than those before intervention,and the score in the observation group was lower than that in the control group(all P＜0.05).After intervention,the scores of Montreal cognitive assessment(MoCA)and 36-item short form health survey(SF-36)in both groups were higher than those before intervention,and the scores in the observation group were higher than those in the control group(all P＜0.05).The treatment compliance rate in the observation group was higher than that in the control group[96.0％(214/223)vs 81.5％(185/227)](P＜0.05).Conclusion Digital health education combined with CBT and family support can improve treatment compliance,reduce the duration and frequency of arrhythmia,improve sleep quality,cognitive function and quality of life in elderly patients with CHD,arrhythmia and cognitive impairment.

Abstract:Objective To investigate the relationship between soluble intercellular adhesion molecule-1(sICAM-1),low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(LDL-C/HDL-C)and slow flow/no-reflow after emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A prospective study was performed on 286 patients with acute STEMI admitted to Department of Emergency,Nanchong Central Hospital from January 2022 to January 2025.Patients with thrombolysis in myocardial infarction(TIMI)flow grade ≤ 2 after operation were assigned to the abnormal blood flow group,and those with TIMI grade 3 to the normal blood flow group.Clinical and laboratory data were compared between the two groups.Logistic regression analysis was used to identify risk factors for slow flow/no-reflow after PCI.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum sICAM-1 and LDL-C/HDL-C for slow flow/no-reflow.Results Among the 286 patients,231 were in the normal blood flow group and 55 in the abnormal blood flow group.The time from symptom onset to PCI was longer,and white blood cell count and neutrophil count were higher in the abnormal blood flow group than those in the normal blood flow group(all P＜0.05).Serum levels of sICAM-1 and LDL-C/HDL-C were significantly higher in the abnormal blood flow group than those in the normal blood flow group[(410±55)μg/L vs(361±49)μg/L,(2.9±0.8)vs(2.3±0.6)](t=6.583,5.526,both P＜0.001).Logistic regression analysis showed that elevated sICAM-1,LDL-C/HDL-C,time from onset to PCI,white blood cell count and neutrophil count were independent risk factors for slow flow/no-reflow after PCI(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of sICAM-1,LDL-C/HDL-C alone and in combination was 0.769,0.763 and 0.868,respectively.The AUC of the combined detection was significantly higher than that of single detection(Z=2.528,P=0.012;Z=2.926,P=0.003).Conclusion Abnormally elevated serum sICAM-1 and LDL-C/HDL-C are independent risk factors for slow flow/no-reflow in STEMI patients after PCI,and their combination has high predictive efficiency for slow flow/no-reflow.

Abstract:Objective To analyze the influencing factors of major adverse cardiovascular events(MACE)in patients with coronary atherosclerotic heart disease(CHD)complicated by obstructive sleep apnea(OSA)based on monocyte to high-density lipoprotein cholesterol ratio(MHR),and to construct a risk prediction model.Methods A total of 289 patients with CHD complicated by OSA treated in Beijing Anzhen Hospital,Capital Medical University from September 2021 to September 2024 were enrolled and divided into MACE group(61 cases)and non-MACE group(228 cases)according to the occurrence of MACE.Binary Logistic regression was used to analyze the risk factors of MACE in patients with CHD complicated by OSA,and a prediction model was constructed based on the results.Results Binary Logistic regression analysis showed that smoking history,apnea-hypopnea index ≥ 15 events/h,high-sensitivity C-reactive protein ≥0.5 mg/L,N-terminal pro-B-type natriuretic peptide and MHR were risk factors for MACE in patients with CHD complicated by OSA(all P＜0.05),while high left ventricular ejection fraction was a protective factor(P＜0.05).The model was constructed using the above factors.Hosmer-Lemeshow goodness-of-fit test showed x2=6.223,P=0.622.The area under the curve(AUC)of the Logistic regression model for predicting MACE was 0.948,with sensitivity of 89.0％,specificity of 100.0％,and actual accuracy of 90.7％.The AUC of the validation group was 0.960,with sensitivity of 74.5％and specificity of 100.0％.Conclusion MHR is a risk factor for MACE in patients with CHD complicated by OSA.The risk prediction model constructed based on MHR and other risk factors has high predictive value.

Abstract:China is a country with a high incidence of liver cancer.Anti-angiogenesis is one of the important strategies for liver cancer treatment,but the problem of drug resistance results in the overall efficacy remaining unsatisfactory.Targeting liver cancer vascular normalization to improve the efficacy of immunotherapy,chemotherapy and other treatment methods has become a highly promising research hotspot at present.This paper expounds the concept and development course of tumor vascular normalization,emphasizes the core significance of the normaliza-tion time window,and systematically reviews the research progress of inducing liver cancer vascular normalization from two dimensions of clinical trials and preclinical studies.With the unique advantages of multi-target regulation and holistic modulation,traditional Chinese medicine not only has the potential to target angiogenesis balance and promote liver cancer vascular normalization,but also can indirectly induce vascular normalization by regulating the liver cancer microenvironment(including regulating macrophages,neutrophils,cancer-associated fibroblasts,etc.),and ultimately exert anti-liver cancer effects.

Abstract:Cisplatin is a first-line chemotherapeutic agent for the treatment of various cancers,but its clinical application is limited due to its nephrotoxicity.Recent studies have found that cellular senescence plays a key role in the progression of cisplatin-induced acute kidney injury(AKI).Cellular senescence is characterized by irreversible cell cycle arrest,and senescent cells can form a senescence-associated secretory phenotype by secreting a variety of inflammatory and profibrotic factors,which alters the surrounding microenvironment and further drives the progression of AKI to chronic kidney disease.Therefore,targeted clearance of senescent cells may serve as a potential therapeutic target for renal protection during cisplatin treatment,while its specific mechanism remains unclear.This review aims to elaborate on the role of cellular senescence in cisplatin-induced AKI and renal fibrosis,hoping to provide a new theoretical basis for the prevention and treatment of cisplatin-induced toxic and side effects.

Abstract:Objective To evaluate the therapeutic effect of sivelestat sodium,a neutrophil elastase(NE)inhibitor,on sepsis-associated acute respiratory distress syndrome(ARDS)at high altitude areas.Methods A total of 56 patients with sepsis-associated ARDS at high altitudes admitted to the Department of Critical Care Medicine,Qinghai Provincial People's Hospital from August 2023 to August 2024 were enrolled and randomly divided into observation group(27 cases)and control group(29 cases)by random number table method.Both groups received standard ARDS treatment as needed,and the observation group was additionally treated with sivelestat sodium on the basis of standard treatment.Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,oxygenation index,procalcitonin,interleukin-6(IL-6),white blood cell count,high-sensitivity C-reactive protein(hs-CRP)levels on day 1 and day 7 after admission were compared between the two groups.NE level was detected by enzyme-linked immunosorbent assay.Results There were no significant differences in APACHE Ⅱ and SOFA scores between the two groups on day 1(both P＞0.05).On day 7,APACHE Ⅱ and SOFA scores in both groups were lower than those on day 1,and SOFA score in the observation group was lower than that in the control group(all P＜0.05).There was no signifi-cant difference in oxygenation index between the observation group and the control group on day 1[130(107,174)vs 159(113,190)](Z=-1.369,P=0.171).Onday7,oxygenation index in both groups were higher than those on day 1(both P＜0.001),and that in the observation group was higher than that in the control group[286(240,316)vs 230(197,264)](Z=-3.281,P＜0.001).On day 1,there were no significant differences in white blood cell count,procalcitonin,IL-6 and hs-CRP levels between the two groups(all P＞0.05).On day 7,the above indicators in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).On day 1,there was no significant difference in NE level between the observation group and the control group[(56±4)μg/L vs(56±5)μg/L](t=-0.364,P=0.717).On day 7,NE levels in both groups were lower than those on day 1(both P＜0.05),and that in the observation group was lower than that in the control group[(48±4)μg/L vs(54±5)μg/L](t=4.620,P＜0.001).Conclusion Sivelestat sodium can significantly improve oxygenation index,alleviate organ injury and inhibit excessive inflammatory response in patients with sepsis-associated ARDS at high altitudes.

Abstract:Xuezhikang is derived from red yeast rice and contains 13 natural statins(including non-crystalline lovastatin and its analogs)as well as a variety of bioactive components.It synergistically regulates the lipid profile and cholesterol metabolism by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A reductase and activating peroxi-some proliferator-activated receptor-related signaling pathways.Meanwhile,it exerts anti-inflammatory,antioxidant and vascular endothelial protective effects in the treatment of cardiovascular diseases by inhibiting nuclear factor-κB activation and promoting the nuclear translocation of nuclear factor E2-related factor 2.Both clinical studies and practice have shown that Xuezhikang can significantly reduce the levels of low-density lipoprotein cholesterol and triglycerides in patients,and alleviate inflammatory status and oxidative stress.It helps to reduce the risk of cardi-ovascular events and improve prognosis in high-risk cardiovascular populations with a history of diabetes,myocardial infarction and other comorbidities.As a monotherapy,it has a definite lipid-lowering effect;it can also be combined with statins or non-statin lipid-lowering drugs(such as ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors)for synergistic lipid-lowering in the treatment of cardiovascular diseases.Based on its good overall tolerability and multi-target action characteristics,Xuezhikang provides a clinically valuable therapeutic option for the primary and secondary prevention of cardiovascular diseases.

Abstract:Right heart failure following left ventricular assist device(LVAD)implantation is one of the key complications determining prognosis.With the gradual popularization of the third-generation magnetic levitation continuous-flow devices in China,preoperative ultrasound-based risk prediction of right heart failure and postoperative bedside ultrasound-centered real-time monitoring have become feasible approaches to reduce the incidence and mortality of right heart failure.Based on sorting out the application pattern and population characteristics of LVAD in China,this paper systematically summarizes the latest definition and classification of right heart failure,concludes the preoperative ultrasound predictors with good repeatability and accuracy,proposes the ultrasound sequence and follow-up time points for postoperative follow-up,and constructs an ultrasound-driven intervention decision-making process.The aim is to provide a set of diagnosis and treatment framework and follow-up reference for the multidisciplinary treatment team.

Abstract:Polycythemia vera(PV)is a malignant clonal myeloproliferative neoplasm of pluripotent hema-topoietic stem cells.It is characterized by a marked increase in red blood cells and elevated hemoglobin levels.The disease may progress to myelofibrosis in the late stage,and very few patients develop transformation to acute myeloid leukemia.Transformation of PV to acute promyelocytic leukemia(M3 type)has been reported,while transformation of PV to acute megakaryoblastic leukemia is rare.Here,we report a case of PV transformed into acute megakaryoblastic leukemia,and review the relevant literature to summarize the factors including the types,interval,medication history,routine blood parameters at leukemic transformation,age and other features of PV transformation to acute myeloid leukemia,aiming to better understand the influencing factors of leukemic transformation from PV to acute myeloid leukemia.The analysis showed that the median time to leukemic transformation in the long-term medication group was longer than that in the short-term medication group[104.0(84.2,129.0)months vs 54.0(48.5,78.0)months],with a statistically significant difference between the two groups(Z=-2.006,P=0.045).Kaplan-Meier survival curve analysis indicated no statistically significant difference in leukemia-free survival between the two groups(Log-rank x2=1.598,P=0.206).There was a strong positive correlation between platelet count and time to leukemic transformation(r=0.698,P=0.008),and a positive correlation between age and time to leukemic transformation(r=0.554,P=0.049).

Abstract:Objective To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with compound Congrong Yizhi capsules in the treatment of Parkinson's disease(PD)complicated with sleep disorders and its effects on serum levels of central nervous system-specific protein(S-100β)and regulated on activation,normal T cell expressed and secreted(RANTES).Methods A total of 88 patients with PD complicated with sleep disorders who were treated in the First Affiliated Hospital of Hebei North University from October 2023 to February 2024 were selected and divided into the control group and the observation group with 44 cases in each group by random number table method.The control group was treated with rTMS on the basis of conventional therapy,and the observation group was treated with compound Congrong Yizhi capsules on the basis of the control group's regimen.Sleep quality,quality of life,levels of inflammatory factors,serum levels of S-100β and RANTES,and clinical efficacy were compared between the two groups.Results After treatment,the Pittsburgh sleep quality index scores of both groups were lower than those before treatment(all P＜0.05),and the score of the observation group was lower than that of the control group[(7.5±0.9)vs(10.4±1.3)](P＜0.001).The unified PD rating scale scores and PD quality of life questionnaire scores of both groups were lower than those before treat-ment,and the scores of the observation group were lower than those of the control group(all P＜0.05).After treatment,the serum levels of tumor necrosis factor-α and interleukin-1β in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(all P＜0.05).The serum levels of S-100β and RANTES in both groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(all P＜0.05).The total clinical effective rate of the observation group was higher than that of the control group[97.7％(43/44)vs 81.8％(36/44)](P=0.014).Conclusion rTMS combined with compound Congrong Yizhi capsules has a good efficacy in the treatment of PD complicated with sleep disorders,which can improve sleep quality and quality of life,and reduce the levels of inflammatory factors as well as serum S-100β and RANTES.