Abstract:Objective To investigate the clinical effect and safety of Jianpi Xiaoji decoction combined with atorvastatin in the treatment of breast cancer patients with hyperlipidemia related to endocrine therapy.Methods The clinical data of 113 breast cancer patients with endocrine therapy related hyperlipidemia admitted to Guangxi Medical University Cancer Hospital from January 2022 to December 2024 were retrospectively analyzed.The patients were divided into observation group(57 cases,Jianpi Xiaoji decoction combined with atorvastatin treatment)and control group(56 cases,atorvastatin treatment alone)according to the different lipid-lowering treatment regimens on the basis of basic intervention.Both groups received 28 days of intervention.The blood lipids,liver and kidney function indexes,symptom scores,brief health status survey scale(SF-36),adverse reactions,and efficacy in blood lipids and traditional Chinese medicine syndromes were compared between the two groups before and after treatment.Results After treatment,the levels of total cholesterol,low-density lipoprotein cholesterol,apolipoprotein B and lipoprotein a in the observation group were lower than those in the control group,and the level of apolipoprotein A1 was higher than that in the control group[(4.12±0.68)mmol/L vs(5.89±0.71)mmol/L,(2.92±0.58)mmol/L vs(3.78±0.61)mmol/L,(0.68±0.15)g/L vs(0.92±0.16)g/L,(224±72)mg/L vs(278±75)mg/L,(1.62±0.25)g/L vs(1.48±0.23)g/L](all P＜0.05).After treat-ment,the level of alanine aminotransferase and the symptom scores of fatigue and insomnia in the observation group were lower than those in the control group,and the scores of the core dimensions of SF-36 such as physiological function,body pain,vitality and general health were higher than those in the control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.420).The total effective rate of blood lipid and traditional Chinese medicine syndrome in the observation group was higher than that in the control group(both P＜0.05).Conclusion Compared with atorvastatin alone,Jianpi Xiaoji decoction combined with atorvastatin can further improve dyslipidemia in breast cancer patients with endocrine therapy related hyperlipidemia,reduce the potential risk of liver injury,and improve the quality of life.

Abstract:Objective To investigate the clinical application of a new centrally visible eye dressing.Methods Using the convenient sampling method,50 working doctors and 198 patients on the first day after surgery in the ophthalmology day ward of Beijing Tongren Hospital,Capital Medical University from July to August 2024 were selected as the research objects.The patients who voluntarily chose the new centrally visible eye dressing were in group A(189 cases),and the patients who voluntarily chose the traditional dressing were in group B(9 cases).The number of people who chose,reasons for choosing and satisfaction with the use of the two groups were recorded.Results All the doctors chose the new centrally visible eye dressing.The reasons for choosing the new centrally visible eye dressing were easy to use(46 cases,92.0％),good air permeability(47 cases,94.0％),safety and fall prevention(41 cases,82.0％),reducing patients' fear of the dark(45 cases,90.0％),and easy to observe the ocular surface(44 cases,88.0％).One hundred and eighty-nine of 198 patients independently selected the new centrally visible eye dressing.The reasons for selection included easy use(167 cases,88.4％),good air permeability(164 cases,86.8％),safety and fall prevention(159 cases,84.1％),reducing patients' fear of the dark(168 cases,88.9％),and easy to observe the ocular surface(172 cases,91.0％).The reason for choosing traditional dressings in 9 cases was that the eyes could be fully rested by covering them completely.The satisfaction score of group A was significantly higher than that of group B[(24.4±1.3)vs(21.6±1.9)](t=4.450,P=0.001).Conclusion The new type of centrally visible eye dressing is preferred by doctors and patients much more than traditional eye dressings.It has the advantages of easy to use,safe and fall prevention,reducing patients' fear of the dark,easy for doctors and nurses to observe the ocular surface,and improves the satisfaction rate of patients and doctors.

Abstract:Objective To investigate the efficacy and cost-effectiveness of unilateral fully covered metal stents and bilateral plastic stents in endoscopic drainage for malignant hilar bile duct obstruction(HMBO).Methods Patients who underwent endoscopic retrograde cholangiopancreatography and biliary stent placement due to unresectable HMBO(Bismuth type Ⅱ-Ⅳ)in the Second Hospital,Lanzhou University from May 2020 to May 2024 were retrospectively collected.A total of 76 patients were enrolled and divided into unilateral fully covered metal stent group(group A,31 cases)and bilateral plastic stent group(group B,45 cases).The primary outcome was clinical success rate,and the secondary outcome was stent patency time,hospital stay,and surgery-related costs.Results There was no significant difference in clinical success rate and length of hospital stay between the two groups(all P＞0.05).The stent patency time of group A was longer than that of group B[Bismuth type Ⅱ-Ⅲ:(180±118)d vs(92±70)d;Bismuth type Ⅳ:(210±122)d vs(85±61)d],and the surgery-related cost was higher than that of group B[Bismuth type Ⅱ-Ⅲ:(49±15)thousand yuan vs(29±10)thousand yuan;Bismuth Ⅳ type:(50±16)thousand yuan vs(25±8)thousand yuan](all P＜0.05).Conclusions Endoscopic stent drainage is an effective palliative treatment for HMBO.Unilateral fully covered metal stent drainage has certain advantages in stent patency time,and bilateral plastic stent drainage has certain advantages in hospitalization cost,but more large sample clinical studies are needed to further confirm.

Abstract:Objective To investigate the effect of allicin on reversing the resistance of NDM-1-type carbapenem-resistant Klebsiella pneumoniae(CRKP)to meropenem.Methods Five CRKP strains isolated from clinical specimens of People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine were selected,including 4 blaNDM-1-carrying CRKP strains(CRKP1-CRKP4)and 1 blaNDM-1-non-carrying CRKP strain(CRKP5,negative control).The checkerboard microdilution method was used to screen traditional Chinese medicine monomers(shikonin,myricetin,baicalin,luteolin,allicin)that could reverse the resistance of NDM-1-type CRKP to meropenem,which was further confirmed by concentration cumulative bacteriostatic rate.The standard broth microdilution method was used to verify the reversing effect of allicin on 4 NDM-1-type CRKP strains with different multilocus sequence typing(MLST).Next-generation sequencing technology was employed to detect the MLST typing and antibiotic resistance gene carriage of clinically isolated strains.Results Among the 5 traditional Chinese medicine monomers screened in this experiment,when allicin was combined with meropenem,the fractional inhibitory concentration index(FIC)against CRKP1 was≤0.5,indicating a synergistic effect between allicin and meropenem on CRKP1.Allicin exhibited a reversing effect on 4 NDM-1-type CRKP strains with different MLST types.After the combination of allicin and meropenem,the FIC of the 4 NDM-1-type CRKP strains was≤0.5,suggesting that the combination of allicin and meropenem had a synergistic effect on all 4 NDM-1-type CRKP strains.Antibiotic resistance gene analysis of NDM-1-type CRKP showed that strains CRKP1-4 all carried the blaNDM-1 gene,but their MLST types were different:CRKP1-4 were ST23,ST219,ST63-1 LV,and ST15,respectively,indicating low relatedness among these strains.Conclusion Allicin can reverse the resistance of NDM-1-type CRKP to meropenem,providing a new idea for the clinical treatment of NDM-1-type CRKP infections.

Abstract:Objective To explore the effect of buccal acupuncture combined with rehabilitation training on the rehabilitation of patients after anterior cruciate ligament injury reconstruction.Methods A total of 106 patients who underwent anterior cruciate ligament injury reconstruction in General Hospital of the Northern Warzone of the Chinese People's Liberation Army from February 2023 to February 2025 were enrolled.They were randomly divided into the control group and the observation group by block randomization,with 53 cases in each group.During the treatment,4 patients in each group were excluded due to failure to perform rehabilitation training on time,and 49 patients were actually included in each group.The control group was treated with rehabilitation training alone,while the observation group was treated with buccal acupuncture on the basis of the control group's regimen.The primary efficacy indicators[knee joint Lysholm score,international knee documentation committee(IKDC)score,visual analogue scale(VAS)score for pain,and knee joint range of motion],secondary efficacy indicators[knee joint function(affected knee swelling value,thigh circumference difference value),peak torque of knee extension and flexion of the affected side]and clinical efficacy were observed before and after treatment in both groups.Results After treatment,the knee joint Lysholm score,IKDC score,knee joint range of motion,as well as the peak torque of knee extension and flexion of the affected side in both groups were significantly higher/greater than those before treatment,and the above indicators in the observation group were significantly higher/greater than those in the control group[knee joint Lysholm score:(72±5)vs(66±7);IKDC score:(80±7)vs(70±12);knee joint range of motion,external rotation:(38.5±5.6)°vs(30.6±6.1)°;internal rotation:(29.4±3.1)°vs(25.5±3.3)°;flexion and extension:(121.9±18.2)°vs(105.7±19.2)°;peak torque of knee extension of the affected side:(46±8)N·m vs(34±10)N·m;peak torque of knee flexion:(49±10)N·m vs(37±11)N·m](all P<0.05).After treatment,the VAS score for pain,affected knee swelling value and thigh circumference difference value in both groups were significantly lower/less than those before treatment,and the above indicators in the observation group were significantly lower/less 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[95.9％(47/49)vs 85.7％(42/49)](P<0.05).Conclusion Buccal acupuncture combined with rehabilitation training can effectively promote the rehabilitation of patients after anterior cruciate ligament injury reconstruction with significant clinical efficacy.

Abstract:Diabetic ulcer is one of the common complications of diabetes,characterized by high mortality,high amputation rate and high recurrence rate.Endoplasmic reticulum stress(ERS)is a physiological regulation for the body to maintain cellular homeostasis,while inflammation is a self-immune response of the body to clear necrotic substances.Under physiological conditions,a certain degree of ERS and inflammation are beneficial to cell neogenesis.During the pathogenesis of diabetic ulcer,the high glucose environment and excessive inflammation lead to the continuous enhancement of ERS,and the resulting series of downstream pathological reactions are the key factors for the non-healing of diabetic ulcer.In recent years,studies have found that the crosstalk between ERS and inflammation is closely related to the healing of diabetic ulcer.ERS participates in the healing of diabetic ulcer by affecting macrophage polarization,nuclear factor κB pathway and NOD-like receptor protein 3 inflammasome.Literature shows that ERS inhibitors,Chinese medicine monomers,Chinese medicine compound prescriptions and emerging technical therapies can improve the healing of diabetic ulcer by regulating the interaction between ERS and inflammation.Based on this,this article reviews the research progress on the molecular mechanism and drug targets of the interaction between ERS and inflammation in diabetic ulcer,in order to provide new ideas for the treatment of diabetic ulcer.

Abstract:Hyperlipidemia is a common type of metabolic disease,which can be categorized into the scope of"greasy lipid"and"turbid lipid"according to its clinical characteristics.Its core pathogenesis of"intermingled phlegm and blood stasis"profoundly reveals the dynamic evolution process of the disease from internal accumulation of turbid lipid,generation of phlegm turbidity,internal retention of blood stasis to the final intermingling of phlegm and blood stasis.With the rapid development of modern molecular biology,systems biology and other disciplines,explaining the scientific connotation of"intermingled phlegm and blood stasis"from the biological perspective has become a frontier and hotspot in integrated traditional Chinese and western medicine research.This review system-atically summarizes the research progress on the correlation between the pathogenesis of"intermingled phlegm and blood stasis"and fields such as lipid metabolism disorder,inflammatory response,intestinal flora imbalance and hemodynamic changes in modern medicine.Meanwhile,it analyzes the controversies existing in this research field,including the ambiguous biological definition of"phlegm"and "stasis",the disconnection between animal models and clinical practice,the dilemma of integrating micro indicators with macro syndromes,and the challenges in analyzing the multi-target mechanism of action of traditional Chinese medicine compound prescriptions,aiming to lay a certain theoretical foundation for subsequent clinical research.

Abstract:Hypertension is closely associated with common mental disorders such as anxiety disorder,depression,schizophrenia and bipolar disorder.However,systematic summaries are still lacking regarding the interaction mechanisms,related influencing factors and intervention and screening methods of hypertension and common mental disorders.Therefore,this paper elaborates on the pathophysiological mechanisms and various influencing factors of hypertension and mental disorders in detail,revealing the association between hypertension and common mental disorders.On this basis,it systematically summarizes a series of intervention,diagnosis and treatment measures adopted in the field of chronic disease management at home and abroad,aiming to explore new ideas and approaches for constructing an innovative management model for comorbidity of hypertension and mental disorders,provide a more systematic and comprehensive reference for clinical practice,optimize management strategies,reduce the incidence of comorbidity and improve the quality of life of patients.

Abstract:Transcatheter aortic valve replacement(TAVR)has become an important method for the treatment of severe aortic stenosis.During postoperative follow-up,echocardiography plays a crucial role as a non-invasive and repeatable imaging technique.This article reviews the application value of echocardiography in follow-up after TAVR,focusing on the evolution of postoperative echocardiographic parameters,their prognostic significance,and the evaluation of valve-related complications by echocardiography.

Abstract:Pulmonary arterial hypertension(PAH)is a kind of cardiovascular disease characterized by progressive proliferation of small pulmonary arteries leading to increased pulmonary vascular pressure and resistance,which leads to right heart failure and even global heart failure.Currently,PAH-targeted drugs used in clinical practice mainly include endothelin receptor antagonists,phosphodiesterase 5 inhibitors,guanylate cyclase agonists,prostacyclin analogues and their receptor agonists,etc.Clinically,for patients with negative acute vasodilator tests,single or two or more targeted drugs are selected for treatment according to the course of disease and risk stratification.A number of studies at home and abroad have shown that the combination therapy of targeted drugs has significant value for improving the existing symptoms and delaying the progression of the disease,but the relevant research data in children with PAH are still limited.This review will discuss the prognosis and limitations of combination therapy with targeted drugs for PAH in children.

Abstract:Monocyte chemoattractant protein-inducible protein l(MCPIP1),named after the induction of monocyte chemoattractant protein 1,belongs to the ZC3H12 gene family.It contains a zinc finger domain,a PIN domain and a deubiquitination domain.It is involved in the regulation and development of many inflammation through endonuclease activity,deubiquitinating enzyme activity and transcription factor function.In lung tissue,MCPIP1 plays an anti-inflammatory effect mainly by degrading the mRNA of inflammatory factors and deubiquitinizing the key proteins of nuclear factor-κB pathway,and participates in the occurrence and development of pneumonia,bronchial asthma,acute lung injury/acute respiratory distress syndrome,pulmonary fibrosis,lung cancer and other lung diseases.The aim of this study is to explore the mechanism of MCPIP1 in lung diseases and its relationship with lung diseases,in order to provide a new target for the treatment of lung diseases.

Abstract:The incidence of heart failure with preserved ejection fraction(HFpEF)is increasing year by year,accounting for nearly 50％of the total number of patients with heart failure,and it has become a hot and difficult research topic in the cardiovascular field.Currently,diuretic,sodium-glucose cotransporter 2 inhibitor,aldosterone-receptor antagonist,renin-angiotensin system inhibitor and etiological screening are the main drug treatments for HFpEF,while the traditional drug evidence for the treatment of heart failure is limited.HFpEF has strong heterogeneity,complex pathogenesis,and few effective drugs.Therefore,it is of great clinical significance to actively strengthen the treatment of HFpEF.This article reviews the clinical trials of drugs recommended by the guidelines and research hotspots in the treatment of HFpEF in recent years,in order to provide reference for the treatment and future research of HFpEF.

Abstract:Objective To investigate the enthusiasm of medical staff to participate in accredited medical cooperation projects and its influencing factors,so as to provide reference for further encouraging medical staff to participate in such projects and improving their work enthusiasm.Methods This study used a questionnaire survey method,and it was expected that multivariate analysis would identify key factors to inform policy making.Based on the"medical staff deployment enthusiasm scale"developed earlier by the research group,335 medical staff from Beijing Anzhen Hospital,Capital Medical University were surveyed.Descriptive analysis,single factor analysis and multiple linear regression were used to study the medical staff's deployment enthusiasm and its influencing factors.Results A total of 335 questionnaires were distributed and 335 valid questionnaires were recovered,with an effective rate of 100％.The scoring rate of the"interpersonal relationship factor subscale"was the highest,while the scoring rates of the"objective factors of deployment projects"and"career planning"were relatively low.The scores of ≤ 30 years old,31-40 years old,41-50 years old and 51-60 years old were(110±20),(107±17),(103±16)and(68±18),respectively.The results of single factor analysis showed that there were significant differences in the scores of medical staff's deployment enthusiasm among different ages(P＜0.05).Conclusion Medical staff are generally willing to participate in the deployment project.It is recommended to take employees as the main body,and take goals,problems and needs as the guidance,formulate and improve policies and support measures for hospital assignment,enhance the enthusiasm of medical staff to participate in the assign-ment,and continue to promote the sinking of advantageous medical resources,so as to help the construction of healthy China.

Abstract:The Ⅲ degree atrioventricular block refers to complete atrioventricular separation caused by the inability of the excitation from the atrium to downtransmit to the ventricle.The symptoms depend on the speed of the ventricular rate.If the ventricular rate is slow,there may be no obvious symptoms,but if the ventricular rate is very slow,dizziness,fatigue,syncope,and even cardiac arrest may occur.A 71-year-old male patient with a history of myocardial infarction was reported.After taking levamlodipine besylate tablets for 2 d,he developed amaurosis and Ⅲ degree atrioventricular block.The cause was considered to be adverse reactions caused by levam-lodipine besylate tablets.Sinus rhythm was restored 1 week after discontinuation of levamlodipine besylate tablets.The clinical data of the patient were analyzed,and the correlation of adverse reactions was evaluated.It was considered that levamlodipine besylate tablets caused Ⅲ degree atrioventricular block.It is suggested that we should be alert to the occurrence of adverse reactions of Ⅲ degree atrioventricular block in clinical application of this drug and improve the safety of medication.

Abstract:Objective To study the clinical effect and safety of Jiejing Suoquan decoction combined with mirabegron in the treatment of bladder spasm after transurethral resection of the prostate(TURP).Methods A total of 70 patients with bladder spasm after TURP in the Department of Urology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from January to October 2024 were selected retrospectively.According to the postoperative treatment methods,the patients were divided into the control group(only treated with mirabegron,35 cases)and the observation group(treated with mirabegron combined with Jiejing Suoquan decoction,35 cases).The bladder spasm during catheterization,international prostate symptom score,overactive bladder score and quality of life score before and after treatment,the total effective rate of treatment and the incidence of adverse reactions were compared between the two groups.Results The number of bladder spasm,the duration of spasm,the score of spasm pain,the number of urgency and the number of abnormal manifestations related to urinary catheter in the observation group were less than those in the control group(all P＜0.05).After treatment,the international prostate symptom score,overactive bladder symptom score and quality of life score 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).The total effective rate of the observation group was significantly higher than that of the control group[94.3％(33/35)vs 74.3％(26/35)](x2=5.285,P=0.022).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Jiejing Suoquan decoction combined with mirabegron is effective in the treatment of bladder spasm after TURP,which can reduce the frequency of bladder spasm to a greater extent,shorten the duration of spasm,relieve discomfort symptoms,and has high safety.

Abstract:Objective To investigate the effect of bismuth-containing quadruple therapy with amoxicillin and clarithromycin on liver function in patients with Helicobacter pylori(Hp)infection complicated with non-alcoholic simple fatty liver(NAFL).Methods A prospective clinical study was conducted.Patients with Hp infection who were admitted to Beijing Jishuitan Hospital,Capital Medical University from October 2023 to October 2024 were enrolled and divided into the NAFL group and the non-liver disease group according to the presence or absence of NAFL.All patients received 14 d bismuth-containing quadruple therapy with amoxicillin and clarithromycin for Hp eradication.The Hp eradication rate,changes in liver function indexes before and after treatment,and incidence of adverse reactions were compared between the two groups.Results A total of 103 patients were initially enrolled in the study,among whom 3 patients were excluded due to skin rash,complicated pulmonary infection and traumatic surgery respectively,with 100 patients finally included in the observation,50 cases in each of the NAFL group and the non-liver disease group.There were no significant differences in gender,age and Hp eradication rate between the two groups(all P>0.05).The body mass index(BMI)of the NAFL group was significantly higher than that of the non-liver disease group[(26±3)kg/m2 vs(23±3)kg/m2](P<0.001).The liver function indexes of both groups did not exceed 3 times the upper limit of the normal value before and after treatment.After treatment,the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in both groups were signifi-cantly higher than those before treatment(both P<0.05),while there were no significant differences in alkaline phosphatase and gamma-glutamyl transferase(GGT)before and after treatment in both groups(all P>0.05).There were no significant differences in the changes of liver function indexes before and after Hp eradication treatment between the two groups(all P>0.05).The incidence of abnormal liver function after treatment in the NAFL group was significantly higher than that in the non-liver disease group[30.0％(15/50)vs 10.0％(5/50)](P=0.012).Univariate analysis showed that BMI,pre-treatment ALT,AST and GGT were influencing factors for abnormal liver function after treatment(all P<0.05).Multivariate Logistic regression analysis showed that BMI was the only independent influencing factor(odds ratio=1.369,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05),which were mainly digestive system reactions such as taste disturbance,nausea,epigastric discomfort and diarrhea,with no serious adverse reactions reported.Conclusion Bismuth-containing quadruple therapy with amoxicillin and clarithromycin can cause liver injury mainly characterized by elevated ALT and AST levels regardless of the presence or absence of liver disease,and there is no significant difference in the elevation ranges of ALT and AST between the two groups.The incidence of abnormal liver function after treatment in NAFL patients is significantly higher than that in non-liver disease patients,and increased BMI is an important influencing factor for abnormal liver function after treatment.It is recommended that close monitoring of liver function should be performed during and after treatment in patients with high BMI.

Abstract:Objective To detect the mRNA expression level of LAYN gene in gastric cancer tissues and analyze its correlation with immune cell infiltration in cancer tissues and its relationship with disease progression.Methods A prospective follow-up study was conducted.A total of 112 gastric cancer patients who underwent surgical treatment at the First Affiliated Hospital of Xinjiang Medical University from May 2022 to February 2023 were selected.All patients were divided into progression group and non-progression group according to whether disease progression occurred during the follow-up period.Clinical and laboratory data were compared between the two groups.Cox regression analysis was used to identify factors associated with gastric cancer progression.Pearson correlation analysis was applied to evaluate the correlation between LAYN gene mRNA expression level in gastric cancer tissues and the degree of immune cell infiltration.Kaplan-Meier survival curves were plotted to analyze the risk of disease progression in patients with different LAYN gene Mrna expression levels.Results After excluding 6 lost-to-follow-up patients,76 out of the remaining 106 patients developed disease progression,thus divided into progression group(76 cases)and non-progression group(30 cases),at the same time,normal gastric tissue adjacent to the patient's cancer was used as control(control group).Statistically significant differences were observed between the two groups in clinical stage,differentiation degree,and LAYN gene Mrna expression level(all P<0.05).Cox regression analysis showed that LAYN gene Mrna expression level(hazard ratio=1.551),clinical stage(hazard ratio=5.476),and differentiation degree(hazard ratio=6.675)were independently associated with gastric cancer progression(all P<0.05).In the progression group,the infiltration proportions of CD+8 T cells,CD+4 T cells,and macrophages in gastric cancer tissues were significantly higher than those in the non-progression group and control group,while the infiltration proportion of dendritic cells was lower than that in the non-progression group and control group(all P<0.05).There were statistically significant differences in the infiltration proportions of CD+8 T cells,CD+4 T cells,macrophages,and dendritic cells between the non-progression group and control group(all P<0.05).Pearson correlation analysis revealed that LAYN gene Mrna expression level was positively correlated with the infiltration degrees of CD+8 T cells and macrophages in tumor tissues(r=0.558,P=0.022;r=0.401,P=0.016,respectively)and negatively correlated with the infiltration degree of dendritic cells(r=-0.423,P=0.019).Using the median Mrna expression level of LAYN gene in gastric cancer tissues as the cutoff value,Kaplan-Meier survival analysis showed that patients with high LAYN gene Mrna expression had a significantly higher risk of disease progression than those with low LAYN gene Mrna expression(log-rank χ2=5.784,P=0.008).Conclusion Gastric cancer patients with high Mrna expression of LAYN gene in gastric cancer tissues have a higher risk of disease progression,and the Mrna expression level of LAYN gene in gastric cancer tissues is correlated with the infiltration level of immune cells in cancer tissues.

Abstract:Objective To explore the clinical efficacy of arthroscopic debridement in the treatment of shoulder joint tuberculosis.Methods A retrospective analysis was performed on the clinical data of 73 patients with shoulder joint tuberculosis who underwent surgical treatment at Cangzhou Central Hospital,Hebei Province from April 2014 to April 2023.Standard anti-tuberculosis drug therapy was administered before and after surgery.The patients were divided into arthroscopic group(38 cases,treated with shoulder arthroscopy)and open surgery group(35 cases,treated with open debridement)according to the surgical method.Re-examinations were conducted preoperatively,3 months postoperatively,and 2 years postoperatively.Disease stability and recurrence were evaluated by X-ray and magnetic resonance imaging examinations.The improvement of shoulder joint function was assessed using the visual analogue scale(VAS)score,University of California,Los Angeles(UCLA)shoulder score,and Constant-Murley score.C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)were recorded preoperatively,3 months postoperatively,and 2 years postoperatively to evaluate the inflammatory control.Results All 73 patients completed the follow-up.The early postoperative recurrence rate was 2.6％(1/38)in the arthroscopic group and 5.7％(2/35)in the open surgery group,but no statistically significant difference in recurrence rate was found between the two groups under the sample size of this study(P>0.05).There were no statistically significant differences in VAS scores between the two groups preoperatively,3 months postoperatively,or 2 years postoperatively(all P>0.05).At 3 months postoperatively,the UCLA shoulder score and Constant-Murley score in the arthroscopic group were significantly higher than those in the open surgery group[25(21,26)vs 20(19,23),60(51,69)vs 52(47,58),respectively](both P<0.05).The CRP and ESR levels in both groups at 3 months and 2 years postoperatively were significantly lower than those preoperatively(all P<0.05),but there were no statistically significant differences in CRP and ESR levels between the two groups preoperatively,3 months postoperatively,or 2 years postoperatively(all P>0.05).Conclusion Arthroscopic debridement combined with anti-tuberculosis drug therapy can achieve satisfactory clinical outcomes in the treatment of shoulder joint tuberculosis,especially with certain advantages in short-term postoperative functional rehabilitation,but appropriate indications need to be strictly grasped.

Abstract:Objective To investigate the clinical efficacy of Ludangshen oral liquid combined with ginger-separated moxibustion in treating immune hypofunction in patients with advanced non-small cell lung cancer(NSCLC)after chemotherapy.Methods A total of 120 patients with immune hypofunction after chemotherapy for advanced NSCLC who were treated in Cancer Hospital,Chinese Academy of Medical Sciences from February 2024 to February 2025 were enrolled as research subjects.They were randomly divided into the control group and the observation group using the envelope method,with 60 cases in each group.The control group was treated with ginger-separated moxibustion on the basis of symptomatic and supportive treatment,while the observation group was treated with Ludangshen oral liquid combined with the regimen of the control group.Both groups were treated continuously for 1 month.The clinical efficacy,Piper fatigue scale scores,Karnofsky performance status(KPS)scores,immune function indexes,traditional Chinese medicine(TCM)syndrome scores and incidence of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was significantly higher than that of the control group[85.0％(51/60)vs 76.7％(46/60)](P=0.027).After treatment,the Piper fatigue scale scores,CD+8 ratio,scores of TCM syndrome primary symptoms,secondary symptoms and total scores in both the observation group and the control group were signifi-cantly lower than those before treatment,and the indexes in the observation group were significantly lower than those in the control group;while the KPS scores,CD+3,CD+4,natural killer cell ratio and CD+4/CD+8 ratio were significantly 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).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group[36.7％(22/60)vs 48.3％(29/60)](P=0.196).Conclusion Ludangshen oral liquid combined with ginger-separated moxibustion can effectively improve the therapeutic effect in patients with immune hypofunction after chemotherapy for advanced NSCLC,relieve cancer-related fatigue,improve quality of life,enhance immune function,and has high clinical safety.

Abstract:Objective To explore the predictive value of serum complement C3a receptor 1(C3AR1)combined with the international society on thrombosis and haemostasis-septic coagulopathy(ISTH-SIC)score for the prognosis of children with septic coagulopathy(SIC).Methods A total of 150 SIC children(SIC group)and 75 children with simple sepsis(simple sepsis group)admitted to Xuzhou Children's Hospital,Jiangsu Province from January 2021 to February 2025 were prospectively selected at a ratio of 2:1.Serum C3AR1 levels were detected and ISTH-SIC scores were calculated.Spearman correlation analysis was used to evaluate the correlation between serum C3AR1 levels and ISTH-SIC scores in SIC children.According to the 28 d prognosis,SIC children were divided into death group and survival group.Multivariate Logistic regression analysis was used to identify the influencing factors of prognosis in SIC children.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum C3AR1 combined with ISTH-SIC score for the prognosis of SIC children.Results Serum C3AR1 level and ISTH-SIC score in the SIC group were significantly higher than those in the simple sepsis group[6.31(4.02,9.13)μg/L vs 2.38(1.53,3.43)μg/L,5.00(4.00,6.00)vs 2.00(1.00,3.00),respectively](both P<0.001).Serum C3AR1 level was positively correlated with ISTH-SIC score in SIC children(rs=0.728,P<0.001).Among the 150 SIC children,52 died within 28 d after admission(death group,52 cases)and 98 survived(survival group),with a mortality rate of 34.7％(52/150).Multivariate Logistic regression analysis showed that international normalized ratio,pediatric sequential organ failure assessment score,C3 AR1,and ISTH-SIC score were independent risk factors for death in SIC children(all P<0.05).ROC curve analysis revealed that the area under the curve of serum C3 AR1 alone,ISTH-SIC score alone,and their combination for predicting the prognosis of SIC children was 0.828,0.737 and 0.903,respectively.The combined predictive value was superior to that of serum C3AR1 alone or ISTH-SIC score alone(all P<0.05).Conclusion Elevated serum C3AR1 level and ISTH-SIC score are associated with poor prognosis in children with SIC,and the combination of serum C3AR1 and ISTH-SIC score has high predictive value for poor prognosis.