Abstract:Takayasu arteritis is a systemic vasculitis characterized by chronic nonspecific inflammation of the aorta and its major branches.Current clinical guidelines recommend the use of high-dose glucocorticoids combined with immunosuppressants to achieve remission induction,dose reduction and disease control.Although the international and domestic guidelines for the diagnosis and treatment of Takayasu arteritis list a variety of immunosuppressive agents for the initial treatment stage,no clear drug preferred regimen has been established.This article systematically reviews the efficacy and safety characteristics of immunosuppressive agents commonly used in clinical practice in the treatment of Takayasu arteritis,in order to provide reference for clinical decision-making and reasonable selection of immunosuppressive agents.

Abstract:Objective To explore the relationship between novel coronavirus infection(COVID-19)and electrocardiographic abnormalities,so as to provide evidence for the early diagnosis and treatment of COVID-19-related myocardial injury.Methods A retrospective parallel controlled study was conducted.A total of 1 801 outpatients who underwent electrocardiography without COVID-19 admitted to Beijing Anzhen Hospital,Capital Medical University from December 7 to December 14,2021 were enrolled as the non-infected group,and 631 outpatients with confirmed COVID-19 receiving electrocardiographic examination from December 7 to December 14,2022 were enrolled as the infected group.General electrocardiographic indicators such as P wave and QRS wave,electrocardiographic diagnosis,and the incidence of arrhythmia were compared between the two groups.Subgroup analysis was performed according to the presence or absence of arrhythmia.Results There were no significant differences in age and gender between the infected group and the non-infected group(both P＞0.05).The P wave duration,PR interval,QRS duration,QT interval and QTc interval in the infected group were significantly prolonged compared with the non-infected group(all P＜0.05).The proportion of sinus rhythm in the infected group was lower[74.3％(469/631)vs 80.5％(1 449/1 801)](P＜0.05),while the proportions of sinus tachycardia and atrial fibrillation were higher[7.0％(44/631)vs 3.8％(69/1 801),6.2％(39/631)vs 3.9％(70/1 801)](both P＜0.05).Subgroup analysis showed that among patients with sinus rhythm,P wave duration,PR interval,QRS duration and QTc interval in infected patients were significantly longer than those in non-infected patients(all P＜0.05);among patients with arrhythmia,the average heart rate of infected patients was significantly higher than that of non-infected patients(P＜0.05).Conclusion COVID-19 can induce significant but relatively mild electrocardiographic abnormalities,including mild prolongation of conduction intervals,slight widening of QTc interval,and increased incidence of arrhythmias such as atrial fibrillation.

Abstract:Objective To evaluate the effect of patient management based on the concept of active health behavior on rehabilitation quality in elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention.Methods A total of 400 elderly patients with coronary atherosclerotic heart disease who un-derwent percutaneous coronary intervention and were admitted to Beijing Anzhen Hospital,Capital Medical University from December 2024 to May 2025 were enrolled as research subjects.They were randomly divided into control group and observation group,with 200 cases in each group.The control group received routine department management,while the observation group received systematic intervention guided by the concept of active health behavior on the basis of routine management.Both groups were followed up for 3 months.The differences in self-efficacy,quality of life,psychological state and incidence of cardiovascular adverse events were compared between the two groups.Results During the follow-up period,15 cases were lost to follow-up in the control group and 10 cases in the observation group,with 185 and 190 cases finally included respectively.At 1 month and 3 months after intervention,the scores related to self-efficacy,self-management ability,quality of life,cognition of disease-related risk factors,treatment compliance and active health behavior level in the observation group were significantly higher than those in the control group,while the scores related to psychological state were significantly lower than those in the control group(all P＜0.001).The total incidence of cardiovascular adverse events in the observation group was lower than that in the control group[16.3％(31/190)vs 47.6％(88/185)](x2=42.259,P＜0.001).Conclusions Patient management based on the concept of active health behavior can significantly improve the level of active health behavior,self-efficacy and self-management ability,optimize quality of life and mental health status,and reduce the incidence of cardiovascular adverse events in elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention.

Abstract:Objective To explore the application value of individualized restraint management strategy in patients with delirium after cardiac and macrovascular surgery.Methods A total of 90 patients who developed postoperative delirium after cardiac and macrovascular surgery in Beijing Anzhen Hospital,Capital Medical University from July 2023 to March 2024 were retrospectively enrolled.According to the implementation time of management strategies,the patients were divided into pre-improvement group(July to September 2023),ongoing-improvement group(October to December 2023)and post-improvement group(January to March 2024).Based on the physical restraint assessment scale for intensive care unit patients,the individualized restraint management strategy implemented graded restraint and alternative measures combined with psychological counseling,family participation and empowerment.The severity of delirium,average use time of restraints and incidence of adverse events were compared among the three groups.Results A total of 90 patients with delirium after cardiac and macrovascular surgery were enrolled in this study,including 35 cases in the pre-improvement group,27 cases in the ongoing-improvement group and 28 cases in the post-improvement group.The severity of delirium among the three groups showed a significant downward trend with the advancement of management stages(r=-0.51,P＜0.001).The proportion of patients with mild delirium in the post-improvement group was significantly higher than that in the ongoing-improvement group and pre-improvement group,while the proportion of severe delirium was significantly lower than that in the pre-improvement group and ongoing-improvement group(all P＜0.001).The delirium severity score gradually decreased from(21.1±2.3)in the pre-improvement stage to(16.3±2.8)in the ongoing-improvement stage and(8.5±2.2)in the post-improvement stage(P＜0.001).Meanwhile,the average duration of restraint belt application was gradually shortened(P=0.025).The total incidence of adverse events in the three groups presented a gradual downward trend(P=0.144).Conclusions The individualized restraint management strategy can significantly reduce the severity of delirium,shorten the duration of restraint use,and decrease the incidence of adverse events in patients after cardiac and macrovascular surgery.

Abstract:Objective To investigate the influencing factors of bleeding after peripherally inserted central catheter(PICC)placement in patients with cardiovascular diseases,and to clarify the causal association and mediating effect.Methods Medical records of 319 cardiovascular disease patients who underwent PICC placement in Beijing Anzhen Hospital,Capital Medical University from October 2024 to August 2025 were retrospectively collected.Patients were divided into bleeding group(61 cases)and non-bleeding group(258 cases)according to bleeding status.Demographic data,disease diagnosis,medication and other information were collected.With bleeding after PICC placement as the outcome variable,independent risk factors and pathways were identified by multivariate Logistic regression,causal association and mediation analysis.Results There were significant differences in puncture site,proportion of atrial fibrillation,thrombocytopenia,proportion of combined rheumatic heart disease,history of valve replacement surgery,platelet count,D-dimer and fibrinogen levels between the two groups(all P＜0.05).Multivariate Logistic regression analysis showed that thrombocytopenia,atrial fibrillation and history of valve replacement surgery were independent risk factors for PICC-related bleeding,while elevated D-dimer level and puncture at basilic vein were protective factors(all P＜0.05).Mediation analysis showed that platelet count was an important mediator between thrombocytopenia and PICC-related bleeding.Thrombocytopenia could indirectly increase bleeding risk by reducing platelet count,with an indirect effect value of 0.065(95％confidence interval:0.008-0.126).There was a non-linear association between platelet count and bleeding risk after PICC placement,and the bleeding risk increased significantly when platelet count was lower than 200 × 109/L.Conclusions Thrombocytopenia,atrial fibrillation,history of valve replacement surgery,lower D-dimer level and non-basilic vein puncture are closely related to bleeding risk after PICC placement in cardiovascular disease patients.Platelet count plays a partial mediating role in the association between thrombocytopenia and PICC-related bleeding,and a level below 200 × 109/L increases the bleeding risk.

Abstract:Objective To observe the efficacy,safety and anti-inflammatory effect of Qishen granules in the treatment of heart failure with preserved ejection fraction(HFpEF).Methods A total of 80 HFpEF patients admitted to Dongzhimen Hospital,Beijing University of Chinese Medicine from December 2023 to October 2024 were selected.The patients were divided into observation group and control group by block randomization,with 40 cases in each group.All patients were given standard heart failure treatment,and the control group and the observation group were treated with placebo and Qishen granules,respectively,for 12 weeks.The decline rate of N-terminal pro-brain natriuretic peptide(NT-proBNP),New York Heart Association(NYHA)functional class,Kansas City Cardiomyopathy Questionnaire(KCCQ-12)score,traditional Chinese medicine syndrome score,6 min walk test(6MWT)distance,echocardiographic indicators,inflammatory exploratory indicators and safety evaluation were compared between the two groups.Results There were no significant differences in general data between the two groups(all P＞0.05).After 12 weeks of treatment,the levels of NT-proBNP,high-sensitivity C-reactive protein,soluble tumor suppressor 2,and tumor necrosis factor-α in the observation group were lower than those in the control group[(921±212)ng/L vs(1 054±305)ng/L,(3.2±1.3)mg/L vs(4.1±2.0)mg/L,(19±4)ng/L vs(21±4)ng/L,(34±8)mg/L vs(40±10)mg/L],and the effective decline rate of NT-proBNP,the total effective rate of cardiac function improvement,and 6MWT distance were higher/longer than those in the control group[60.0％(24/40)vs 37.5％(15/40),67.5％(27/40)vs 35.0％(14/40),(348±62)m vs(315±51)m](all P＜0.05).After 8 and 12 weeks of treatment,the KCCQ-12 scores of the observation group were higher than those of the control group,and the traditional Chinese medicine syndrome scores were lower than those of the control group(all P＜0.05).There were no significant differences in the safety indicators between the two groups(all P＞0.05).Conclusion Qishen granules can improve the rate of NT-proBNP decline in patients with HFpEF,improve cardiac function,exercise tolerance and quality of life,reduce the levels of inflammatory factors,and has good safety.

Abstract:Objective To study the expression level of serum microRNA(miR)-155 in children with neonatal septicemia,and to explore its correlation with the balance of T helper cell 17/regulatory T cell(Th17/Treg).Methods A total of 24 children with neonatal septicemia admitted to the Department of Neonatology,Fuzhou First General Hospital Affiliated with Fujian Medical University from January to December 2023 were selected as the sepsis group,and 22 healthy neonates delivered in the same hospital during the same period were selected as the control group.The general clinical data and laboratory test indicators of the two groups were collected and compared.The level of serum miR-155 was detected by real-time fluorescent quantitative polymerase chain reaction,and the levels of Th17 and Treg in peripheral blood were detected by flow cytometry.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of serum miR-155 for neonatal sepsis,and the correlation between serum miR-155 and Th17,Treg and Th17/Treg ratio in peripheral blood was analyzed by Pearson method.Results The proportion of mothers with perinatal infection,peripheral white blood cell count,percentage of neutrophils,C-reactive protein,interleukin-6,procalcitonin,and blood lactic acid levels in the sepsis group were significantly higher than those in the control group(all P＜0.05).The 10 min Apgar score,peripheral blood total bilirubin,direct bilirubin and indirect bilirubin levels were significantly lower than those of the control group(all P＜0.05).The expression level of miR-155,Th17 level and Th17/Treg ratio of neonates in sepsis group were significantly higher than those in control group,while the peripheral blood Treg level was significantly lower than that in control group[(1.47±0.27)vs(1.00±0.35),(3.16±0.89)％vs(1.43±0.42)％,(15.36±4.54)vs(2.74±1.07),(0.21±0.09)％vs(0.58±0.18)％](all P＜0.001).The area under the curve value of serum miR-155 in the diagnosis of neonatal sepsis was 0.845.In the sepsis group,serum miR-155 was positively correlated with C-reactive protein,interleukin-6,procalcitonin,Th17 in peripheral blood and Th17/Treg ratio(all P＜0.05).Conclusion Serum miR-155 and the proportion of Th17/Treg cells in peripheral blood of children with neonatal septicemia are significantly increased,and there is a significant positive correlation between them,and they jointly promote the inflammatory response in peripheral blood of neonates with sepsis.

Abstract:Objective To investigate the effects of dexmedetomidine combined with sevoflurane on cerebral oxygen metabolism and immune function in patients with primary hepatocellular carcinoma(PHC)undergoing hepatectomy.Methods A total of 120 patients with PHC admitted to Inner Mongolia People's Hospital from January 2023 to December 2024 were selected as the research objects,and they were divided into control group and observation group by random number table method,with 60 cases in each group.All patients were treated with hepatectomy.The control group was treated with sevoflurane anesthesia,and the observation group was treated with dexmedetomidine combined with sevoflurane anesthesia.Heart rate,mean arterial pressure(MAP),pulse oxygen saturation(SpO2),systolic blood pressure and diastolic blood pressure were compared between the two groups before anesthesia(To),immediately after operation(T,),12 h after operation(T2)and 24 h after operation(T3).The quality of recovery,sedation and pain scores,visual analogue scale scores and blood loss were compared between the two groups.The cerebral oxygen metabolism indexes during operation and 3 d after operation,immune function indexes before operation and 3 d after operation,and the incidence of adverse reactions were compared between the two groups.Results With time,heart rate gradually decreased,MAP,systolic blood pressure and diastolic blood pressure increased first and then decreased,SpO2 decreased first and then increased in the two groups.SpO2 at T2,T3 was higher and heart rate,MAP,systolic blood pressure and diastolic blood pressure at T1,T2,T3 were lower in the observation group than in the control group(all P＜0.05).The recovery time of spontaneous breathing,the time of calling eyes opening,the visual analogue scale score,and the amount of bleeding in the observation group were significantly shorter/lower/less than those in the control group,and the Ramsay sedation score was significantly higher than that in the control group(all P＜0.05).Three days after operation,jugular venous oxygen saturation of the two groups were higher than those during operation,and arteriovenous oxygen content difference in neck(AVDO2)was lower than that during operation,and jugular venous oxygen saturation,cerebral oxygen extraction rate and AVDO2 of the observation group were lower than those of the control group(all P＜0.05).Three days after operation,the CD3+,CD4+,interleukin-6 and C-reactive protein of the two groups were lower than those before operation,and the CD3+and CD4+of the observation group were higher than those of the control group,and the interleukin-6 and C-reactive protein were lower than those of the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[5.0％(3/60)vs 11.7％(7/60)](x2=1.098,P=0.295).Conclusion Dexmedetomidine combined with sevoflurane anesthesia in the treatment of PHC patients undergoing hepatectomy can improve the quality of recovery,reduce the impact on cerebral oxygen metabolism,and improve immune function.

Abstract:Gastrointestinal stromal tumor(GIST)is the most common soft tissue sarcoma,and its initia-tion and progression are mainly driven by activating mutations in KIT or platelet-derived growth factor receptor a gene.Although tyrosine kinase inhibitors represented by imatinib have significantly improved patient prognosis,the emergence of drug resistance suggests that intrinsic mutations in tumor cells alone cannot fully explain the biological heterogeneity and differential therapeutic outcomes of GIST.Recent studies have demonstrated that the tumor microenvironment(TME)plays a critical regulatory role in GIST progression,immune escape,and resistance to targeted therapy.This article systematically reviews the composition and functional characteristics of the GIST TME,focusing on the mechanisms of innate immune cells,adaptive immune cells,and stromal cells in tumor evolution and therapeutic response.Available evidence indicates that immune cells and stromal cells form a highly dynamic interaction network with tumor cells through immunosuppression,metabolic reprogramming,and extracel-lular matrix remodeling.This network collectively shapes the immune ecosystem of GIST and affects the efficacy of imatinib.Notably,targeted therapy can bidirectionally remodel the microenvironment,activating anti-tumor immunity while inducing immunosuppressive remodeling.Overall,the biological behavior and drug resistance of GIST result from the synergistic effects of intrinsic tumor signaling and the TME.An in-depth understanding of the dynamic characteristics of the GIST TME will facilitate the discovery of novel biomarkers and provide a theoretical basis for combination therapeutic strategies integrating targeted therapy with immunological and microenvironmental interventions.

Abstract:The occurrence and development of atherosclerosis are closely related to the phenotypic hetero-geneity of vascular smooth muscle cells(VSMCs).Studies have shown that VSMCs exhibit remarkable plasticity and can transdifferentiate into multiple phenotypes in the plaque microenvironment,participating in plaque forma-tion.This process is regulated at multiple levels,including transcription factors,epigenetics,and signaling path-ways.During plaque progression,VSMCs play a dual role:they can either stabilize plaques or exacerbate plaque instability.Therefore,targeted regulation of VSMC phenotypic transition has become a novel therapeutic strategy.In the future,it is necessary to combine spatial omics and other technologies to further clarify their dynamic evolu-tion and promote clinical translation.

Abstract:Myocardial infarction is one of the leading causes of death worldwide.Evidence has shown that microRNA(miR)is a reliable biomarker matching cardiac troponin in myocardial infarction.MiRs are a class of highly conserved small non-coding RNAs composed of 20 to 24 nucleotides,which regulate post-transcriptional gene expression by binding to the 3' untranslated region of target genes,thus participating in many important physi-ological processes.This article reviews the relevant research on miRs and myocardial infarction in recent years,elaborates on the roles of miRs as biomarkers for myocardial infarction and in regulating cardiomyocyte apoptosis and proliferation,angiogenesis,fibroblast reprogramming,myocardial fibrosis,inflammatory response and other processes,aiming to provide new ideas for the diagnosis,prevention and treatment of myocardial infarction.

Abstract:Mixed adenoneuroendocrine carcinoma(MANEC)of the colorectum is a rare type of gastroin-testinal tumor,in which both adenocarcinoma and neuroendocrine carcinoma components should each account for at least 30％.MANEC is characterized by low incidence,high malignancy,strong invasiveness,early distant metastasis and poor prognosis.In addition,due to insufficient clinical understanding,early and accurate histopathological diagnosis is an important basis for individualized multidisciplinary comprehensive treatment.The diagnosis and treatment experience of 1 patient with MANEC is reported,and a literature review and discussion are conducted for clinical reference.

Abstract:Objective To investigate the effects of transcutaneous acupoint electrical stimulation(TAES)combined with parenteral nutrition on gastrointestinal function and serum motilin and somatostatin levels in patients after laparoscopic radical gastrectomy(LRG)for gastric cancer.Methods A total of 90 patients who underwent LRG at Shanghai Hospital of Integrated Traditional Chinese and Western Medicine from January 2023 to December 2024 were selected and divided into the parenteral nutrition group and the combined group with 45 cases in each group using a random number table method.On the basis of conventional treatment,the parenteral nutrition group received central venous infusion of fat emulsion,amino acids(17)and glucose(11％)injection starting on the first day after surgery;the combined group was additionally treated with TAES on the basis of the parenteral nutrition group.Both groups were treated for 1 week.Gastrointestinal function,serological indicators,immune function indicators and the incidence of adverse reactions were compared between the two groups.Results The recovery time of bowel sounds,anal exhaust time and defecation time in the combined group were significantly shorter than those in the parenteral nutrition group(all P＜0.05).After treatment,the serum motilin levels in both groups were higher than those before treatment,and the level in the combined group was higher than that in the parenteral nutrition group;the serum somatostatin levels in both groups were lower than those before treatment,and the level in the combined group was lower than that in the parenteral nutrition group[between groups:(256±29)ng/L vs(231±25)ng/L,(16.9±1.5)ng/L vs(18.7±1.9)ng/L](all P＜0.05).After treatment,the CD4+level and CD4+/CD8+ratio in both groups were higher than those before treatment,and the indices in the combined group were higher than those in the parenteral nutrition group;the CD8+level in both groups was lower than that before treatment,and the level in the combined group was lower than that in the parenteral nutrition group(all P＜0.05).The incidence of adverse reactions in the combined group was lower than that in the parenteral nutrition group[6.7％(3/45)vs 24.4％(11/45)](P=0.042).Conclusions TAES combined with parenteral nutrition can effectively promote the recovery of postoperative gastrointestinal function,improve serum motilin and somatostatin levels,optimize the body's immune function and reduce the occurrence of adverse reactions in patients after LRG.

Abstract:Objective To investigate the efficacy of Shenxiong glucose injection combined with benidipine in the treatment of angina pectoris of coronary atherosclerotic heart disease and its effects on serum levels of pentraxin 3(PTX-3)and inducible nitric oxide synthase(iNOS).Methods A total of 148 patients with angina pectoris of coronary atherosclerotic heart disease admitted to Nanjing Integrated Traditional Chinese and Western Medicine Hospital from January 2021 to December 2022 were selected and divided into the control group and the combined group with 74 cases in each group by random number table method.The control group was treated with benidipine,and the combined group was treated with Shenxiong glucose injection on the basis of the control group.Both groups were treated for 14 d.The therapeutic efficacy,cardiac function,quality of life,levels of inflammatory markers and adverse reactions were compared between the two groups after treatment.Results The total effective rate of the combined group was higher than that of the control group[96.0％(71/74)vs 82.4％(61/74)](P=0.008).After treatment,the cardiac output,left ventricular ejection fraction and cardiac index of the combined group were all higher than those of the control group(all P＜0.05).After treatment,the Seattle angina question-naire(SAQ)scores of both groups were higher than those before treatment,and the SAQ score of the combined group was higher than that of the control group[(428±57)vs(391±49)](all P＜0.05).After treatment,the serum levels of PTX-3,iNOS and interleukin-6 in the combined group were all lower than those in the control group(all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.547).Conclusion Shenxiong glucose injection combined with benidipine has a significant efficacy in the treatment of angina pectoris of coronary atherosclerotic heart disease,which can obviously improve cardiac function and quality of life of patients,effectively regulate the levels of inflammatory markers,and has few adverse reactions.

Abstract:Acute myeloid leukemia(AML)is a highly heterogeneous malignant hematologic neoplasm,and its occurrence and development are closely related to abnormal regulation of gene expression.In recent years,the role of epitranscriptomics,especially RNA modification,in the pathogenesis of AML has attracted increasing attention.This review focuses on three key RNA chemical modifications-N6-methyladenosine(m6A),5-methyl-cytosine(m5C)and 7-methylguanosine(m7G),and systematically elaborates their regulatory networks,biological functions and clinical significance in AML.This paper summarizes the basic characteristics of m6A,m5C and m7G modifications,and focuses on how these modifications and their regulators affect the stability,splicing,nuclear export and translation efficiency of target messenger RNAs,thereby regulating the expression of oncogenes,tumor suppressor genes and signaling pathways related to AML,and ultimately driving the proliferation,self-renewal,differentiation arrest and chemoresistance of leukemia cells.In conclusion,this review aims to reveal the complex regulatory role of RNA modifications in AML,discuss the value of related regulators as novel molecular markers and potential therapeutic targets,and provide new perspectives for understanding the pathogenesis of the disease and developing new diagnosis and treatment strategies.

Abstract:Objective To observe the clinical efficacy of spring pediatric growth plaster combined with lifestyle regulation in the treatment of short stature children.Methods A randomized controlled trial was conducted.A total of 440 children with short stature admitted to The First Affiliated Hospital of Anhui Medical University North District,Qingyang County Hospital of Traditional Chinese Medicine,Anhui Province and Huangshan Huaze Hospital of Integrated Traditional Chinese and Western Medicine,Anhui Province from January to March 2023 and January to March 2024 were enrolled.The subjects were divided into control group and treatment group by random number table method,with 220 cases in each group.The control group received lifestyle regulation including exercise,sleep and nutritional intervention;on this basis,the treatment group was additionally treated with spring pediatric growth plaster.The total effective rate,height growth,monthly growth rate,traditional Chinese medicine syndrome score and adverse reactions were compared between the two groups.Results The total effective rate of the treatment group was significantly higher than that of the control group[62.7％(138/220)vs 47.2％(104/220)](P＜0.001),with obviously better curative effect(P=0.004).The height growth and monthly growth rate in the treatment group were significantly higher than those in the control group[(1.34±0.71)cm vs(0.82±0.56)cm,(0.67±0.36)cm/month vs(0.41±0.28)cm/month](both P＜0.001).After treatment,the traditional Chinese medicine syndrome score of the treatment group was markedly lower than that of the control group(P＜0.001).In the treatment group,10 children presented skin redness accompanied by pruritus at the initial stage of treatment,which was quickly relieved by external application of desonide cream without affecting subsequent application.No adverse reactions occurred in the control group.Conclusion Spring pediatric growth plaster combined with lifestyle regulation has definite curative effect on short stature children with spleen and kidney deficiency syndrome,which can significantly improve traditional Chinese medicine symptoms and increase height growth and monthly growth rate.

Abstract:This article reports the 8-year follow-up and therapeutic observation of one elderly patient with type 2 diabetic nephropathy.The patient was diagnosed with diabetic nephropathy[chronic kidney disease(CKD)stage G3a and A2]at the initial visit,accompanied by hypertension,dyslipidemia,hyperuricemia and obesity.Insulin combined with dipeptidyl peptidase Ⅳ inhibitor was initially administered to control blood glucose,which was later adjusted to canagliflozin,a sodium-glucose cotransporter 2 inhibitor(SGLT2i);the antihypertensive regimen was adjusted to perindopril,an angiotensin-converting enzyme inhibitor(ACEI),combined with sustained-release nifedipine,a calcium channel blocker(CCB);lipid-lowering therapy was adjusted to atorvastatin combined with ezetimibe;allopurinol was used to reduce serum uric acid.In accordance with the recommendations of the Chinese guidelines for the prevention and treatment of type 2 diabetes mellitus,the comprehensive control targets for this patient were glycated hemoglobin(HbA1c)＜7.5％,blood pressure＜130/80 mmHg and low-density lipoprotein cholesterol(LDL-C)＜1.8 mmol/L,so as to halt renal function deterioration.During the continuous 8-year follow-up treatment from 2018 to 2025,the patient's disease indicators were significantly improved:HbA1c decreased from 9.2％to 7.9％,blood pressure dropped from 140/80 mmHg to 131/73 mmHg,LDL-C declined from 2.7 mmol/L to 1.4 mmol/L,serum uric acid returned to normal,and the urinary albumin/creatinine ratio fell from 33.2 mg/g to 14.4 mg/g,with the CKD stage improved from A2 to A1.The estimated glomerular filtration rate(eGFR)remained stable at 37.1-38.8 ml/(min·1.73 m2)in the recent 3 years,reaching 38.0 ml/(min·1.73 m2)in 2025.The eGFR only decreased by 16.7 ml/(min·1.73 m2)over the 8 years,with an average annual decline of merely 2.1 ml/(min·1.73 m2),indicating that renal function deterioration was markedly halted.The comprehensive therapeutic regimen of this patient based on SGLT2i for hypoglycemia,ACEI combined with CCB for hypertension,and statin combined with cholesterol absorption inhibitor for dyslipidemia significantly improved multiple indicators including HbA1c,blood pressure and LDL-C,and retarded the deterioration of renal function caused by diabetic nephropathy.

Abstract:With the continuous rise in the incidence of cardiovascular diseases,exploring biomarkers with higher comprehensive predictive value has become a hotspot in clinical research.The serum uric acid to high-density lipoprotein cholesterol ratio(UHR)is a novel composite serological indicator that combines serum uric acid with high-density lipoprotein cholesterol.Compared with traditional single indicators,UHR not only overcomes the limitations of individual indexes,but also can more comprehensively and dynamically reflect the complex glucose and lipid metabolism imbalance and systemic chronic inflammatory state in the human body.This paper systematically integrates clinical research evidence on the correlation between UHR and various cardiovascular diseases,and analyzes the underlying pathophysiological basis.By exploring the correlation of UHR in cardiovascular event risk stratification,early clinical screening and disease progression monitoring,this paper evaluates its clinical feasibility as a non-invasive,low-cost and easily accessible biomarker,so as to provide evidence-based support for further optimizing the management strategy and early intervention targets of cardiovascular diseases.

Abstract:Diabetic peripheral neuropathy(DPN)is one of the most common and severe complications in diabetic patients,which significantly affects patients' quality of life and prognosis.The pathogenesis of DPN involves metabolic disorder,oxidative stress,inflammatory response and nerve injury,and its molecular mecha-nism remains not fully clarified.Caveolin-1 is a key structural protein of cell membrane caveolae,which is widely involved in cell signal transduction,membrane structure regulation and metabolic processes.Accumulating studies have demonstrated that caveolin-1 plays an important role in neuroprotection,inflammatory regulation and metabolic homeostasis,and its abnormal expression and function are closely associated with the occurrence and progression of DPN.This article systematically reviews the mechanism and regulatory signaling pathways of caveolin-1 in DPN,and analyzes its research progress and value as a potential therapeutic target,aiming to provide new theoretical basis and strategic reference for mechanism exploration and clinical intervention of DPN.

Abstract:Acute pancreatitis is a common acute abdomen in clinical practice.Most patients have a good prognosis,while a small number of patients suffer from a severe and life-threatening condition with a certain risk of death,and the mortality rate caused by this disease ranges from 5％to 10％.One important cause of death in these patients is secondary peripancreatic infection.This article reviews the research progress on the etiology,common clinical manifestations,clinical diagnostic criteria,and subsequent prevention and treatment of secondary intra-abdominal infection in acute pancreatitis,so as to improve our understanding of secondary intra-abdominal infection,provide ideas for clinical prevention and treatment,and thereby reduce patient mortality.