Abstract:Objective To explore the clinical effect of warming acupuncture combined with Yiqi Tongluo recipe in the treatment of stroke of Qi deficiency and blood stasis type patients in the recovery stage and its influence on cerebral hemodynamics,serum phospholipase A2(PLA2)and homocysteine(Hcy)levels.Methods A total of 125 patients with stroke of Qi deficiency and blood stasis type in the recovery stage admitted to the First Hospital of Hunan University of Chinese Medicine from May 2022 to May 2024 were selected.According to the random number table method,they were divided into the control group(62 cases)and the observation group(63 cases).The control group was given routine treatment,and the observation group was treated with warming acupuncture combined with Yiqi Tongluo recipe on the basis of the control group.After two weeks of treatment,the efficacy of the two groups was evaluated,and the cerebral hemodynamic indexes,PLA2,Hey levels,neurological function-related factor levels and national institutes of health stroke scale(NIHSS)scores before and after treatment were compared.Results The total effective rate of the observation group was higher than that of the control group[93.6％(59/63)vs 80.6％(50/62)](P=0.030).After treatment,the cerebral vascular peripheral resistances of the two groups were lower than those before treatment,and that of the observation group was lower than that of the control group.The minimum blood flow and minimum blood flow velocity of the two groups were higher/faster than those before treatment,and those of the observation group were higher/faster than those of the control group(all P＜0.05).After treatment,the levels of serum PLA2 and Hey in the two groups were lower than those before treatment(both P＜0.05),and those in the observation group were lower than those in the control group[(16±4)mmol/L vs(19±5)mmol/L,(14.3±2.1)μmol/L vs(17.5±3.3)μmol/L](all P＜0.05).After treatment,the glial fibrillary acidic protein,neuron-specific enolase,myelin basic protein,brain-specific protein,heart-type fatty acid binding protein and NIHSS scores of the two groups after treatment were lower than those before treatment,and those of the observation group were lower than those of the control group(all P＜0.05).Conclusion Warming acupuncture combined with Yiqi Tongluo recipe can improve the curative effect of patients with stroke of Qi deficiency and blood stasis type in the recovery period,improve cerebral hemodynamics and neurological function,and reduce serum PLA2 and Hey levels.

Abstract:Objective To explore the computed tomography angiography(CTA)characteristics of athero-sclerotic plaques in the head and neck of patients with cerebral watershed infarction(CWI)and its correlation with ambulatory arterial stifness index(AASI).Methods The clinical data of 100 patients with CWI who were admitted to Beijing Aerospace General Hospital from March 2021 to March 2024 were retrospectively analyzed,and they were divided into acute CWI(ACWI)group(46 cases)and non-ACWI group(54 cases)according to the results of magnetic resonance diffusion-weighted imaging.Multiple Logistic regression method was used to analyze the association effects between risk factors and different stratification parameters.Multivariable linear regression(MLR)model was used to analyze the correlation.The receiver operating characteristic(ROC)curve was used to evaluate the predictive performance.Results Multivariate analysis showed that the degree of internal carotid artery(ICA)stenosis,middle cerebral artery(MCA)stenosis,number of diseased vessels,mean arterial pressure(MAP),fasting blood glucose(FBG),low-density lipoprotein cholesterol(LDL-C),AASI,carotid plaque(CP)burden,CP volume,and CP lipid core volume were all independent influencing factors for the occurrence of ACWI(all P＜0.05).MLR analysis showed that AASI was positively correlated with the degree of internal carotid artery stenosis,MCA stenosis,number of diseased vessel branches,CP load,CP volume,CP lipid core volume,fasting blood glucose,and LDL-C(all P＜0.05).There was a strong correlation between AASI and CP burden,volume,and lipid core volume(allPtrend＜0.05).ROC curve analysis showed that the combination of ICA and MCA stenosis degree+number of diseased blood vessels+CP burden+CP volume+CP lipid core volume+ASI had the highest area under the curve(0.924)and predictive value for predicting ACWI.Conclusions ICA and MCA stenosis degree,number of diseased vessel branches,AASI,CP burden,volume,lipid core volume,FBG,and LDL-C are all independent influencing factors for the occurrence of ACWI.In clinical practice,early diagnosis of ACWI patients can be achieved by combining head and neck CTA diagnostic results and related parameters with AASI.

Abstract:Acute myocardial infarction is a common cardiovascular emergency,usually caused by coronary artery occlusion,while that induced by non-obstructive coronary artery disease is relatively rare and prone to misdi-agnosis.This paper reports a case of a 44-year-old female patient with chest pain.Electrocardiogram showed ST-segment elevation,and coronary angiography indicated myocardial bridge of the anterior descending artery without significant stenosis.The patient subsequently developed severe complications such as cardiac tamponade and cardiac arrest,and improved after comprehensive rescue treatments including pericardiocentesis,cardiopulmo-nary resuscitation and extracorporeal membrane oxygenation.Combined with relevant literature,we discuss the pathogenesis,diagnosis and treatment strategies of acute non-obstructive myocardial infarction,aiming to improve clinicians' awareness of atypical myocardial infarction.

Abstract:Objective To investigate the longitudinal dynamic changes in cerebral gray matter volume in patients with persistent olfactory loss after upper respiratory tract infection(PURIPOL).Methods A total of 20 PURIPOL patients(8 males and 12 females,aged 41±11 years)with olfactory loss lasting more than 2 years who were treated at the olfactory and gustatory disorders diagnosis and treatment center of Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2024 were enrolled.Another 20 age-,gender-and education-matched healthy volunteers were recruited as the control group.Subjective and objective olfactory functions were evaluated by the Sniffin'sticks test(TDI score)and olfactory event-related potentials(oERPs),and cognitive function was screened by the mini-mental state examination(MMSE).Retrospective analysis was performed on the 3D-T1-weighted brain structural magnetic resonance imaging of PURIPOL patients at three stages:3-12 months,＞12-24 months and＞24 months after the onset of olfactory loss.Voxel-based morphometry(VBM)was used to compare the differences in gray matter volume between PURIPOL patients and the control group,and to observe the evolutionary law over time.Results The TDI score of the PURIPOL group was significantly lower than that of the control group[(5.7±3.1)vs(34.6±2.6)](P＜0.01).The oERPs of the PURIPOL group showed longer latencies and lower amplitudes of N1 and P2 waves than those of the control group(all P＜0.01).VBM analysis revealed that compared with the control group,the PURIPOL group had a significant reduction in gray matter volume in the right orbitofrontal cortex and left gyrus rectus at 3-12 months after olfactory loss;the gray matter volume in the right orbitofrontal cortex and bilateral gyrus rectus further decreased at＞12-24 months;and the scope of gray matter atrophy extended to the bilateral orbitofrontal cortex,bilateral gyrus rectus and right insula at＞24 months(FDR corrected,all P＜0.001).Conclusion Progressive reduction in gray matter volume exists in olfactory-related brain regions of PURIPOL patients,suggesting that long-term lack of olfactory input may lead to structural remodeling in the corresponding brain regions,which may be one of the important central mechanisms of persistent olfactory loss.

Abstract:Breast cancer is one of the most common malignant tumors in women.Although comprehensive treatment has significantly improved the survival rate,how to advance the prevention and control threshold and construct a disease prevention strategy with traditional Chinese medicine(TCM)characteristics remains a clinical difficulty and research hotspot.The"pathogenic deficient evil"theory in Huangdi Neijing holds that the onset of disease is a process in which the body's healthy Qi is insufficient to resist the invasion of pathogenic factors.Breast cancer is also the result of the mutual restriction and confrontation between healthy Qi and cancer toxin,and"pathogenic deficient evil"is one of the important pathogenesis of its occurrence and development,which is highly consistent with the immune escape and immunosuppressive microenvironment in modern tumor immunology.By systematically searching and sorting out the relevant literatures on"pathogenic deficient evil"and disease prevention in Huangdi Neijing and medical scholars of all dynasties,combined with clinical and basic research data on breast cancer epidemiology,molecular typing,tumor immune microenvironment and TCM intervention at home and abroad,this study adopted the methods of parallel reading,induction and theoretical integration to conduct isomorphic docking between the core propositions such as"deficiency as the root cause,pathogenic factors arising from deficiency,and deficiency complicated with excess"and the processes of immunoediting and immune escape.On this basis,the disease prevention strategies for breast cancer were systematically discussed from three levels:preventing disease before its onset,preventing disease progression after its onset,and preventing recurrence after recovery.A hierarchical prevention and control idea was proposed,which is based on constitution regulation and intervention of high-risk groups,and takes strengthening healthy Qi and eliminating pathogenic factors to improve the systemic and local immune microenvironment as the core.By sorting out the relevant studies on representative Qi-invigorating Chinese medicinal herbs such as Astragali Radix and Ganoderma,the possible mechanism by which they intervene in the"pathogenic deficient evil-immune escape"process through pathways such as programmed cell death protein 1/programmed cell death ligand 1 and transforming growth factor-β was explored.This study aims to construct a breast cancer prevention and treatment framework with isomorphic relationship between the"pathogenic deficient evil"theory and modern tumor immunology,and provide theoretical basis and ideas for building an integrated traditional Chinese and western medicine disease prevention model that can be embedded in the existing comprehensive treatment pathways.

Abstract:Xiaochaihu decoction,which is contained in Zhang Zhongjing's Treatise on Typhoid Fever of the Eastern Han Dynasty in China,consists of Chaihu,Scutellaria baicalensis,Pinellia ternata,Radix et Rhizoma Ginseng,Radix et Rhizoma Glycyrrhizae,Ginger and Jujubae,and its main effects are to reconcile Shao-Yang,harmonise the stomach and lower the rebelliousness,and support the positive and dispel the evil spirits.In clinical studies,it is mostly used in the treatment of chronic gastritis,gastroesophageal reflux disease,peptic ulcer,irritable bowel syndrome,chronic hepatitis B,digestive tract tumors and other digestive system diseases.Modern pharmacology shows that Xiaochaihu decoction has anti-inflammatory,anti-oxidation,mucosal barrier protection,antibacterial,immune regulation,anti-tumor and other pharmacological effects in the treatment of digestive diseases.This article summarizes the clinical research on the digestive system,the pharmacological components of each component of the formula in the treatment of digestive system diseases,and the animal experimental research of Xiaochaihu decoction,and discusses the compatibility of its pharmacological components,so as to provide reference for further research.

Abstract:Preeclampsia is one of the main causes of maternal mortality,and early identification,risk stratification,and targeted treatment strategies are effective measures to prevent preeclampsia and improve the clinical prognosis of patients with this condition.In recent years,with the deepening of research on vitamin D,more and more evidence has shown that sufficient and appropriate levels of vitamin D are of great significance for maintaining normal pregnancy and preventing the occurrence of preeclampsia.Vitamin D deficiency is not only associated with an increased risk of preeclampsia,but may also affect the progression and severity of the disease.However,further theoretical data is needed to support the study of its pathogenesis.Therefore,in-depth explora-tion of the mechanism of vitamin D in preeclampsia not only helps us better understand the pathogenesis of preeclampsia,but also provides ideas for developing new prevention and treatment strategies.

Abstract:Myocardial ischemia-reperfusion injury(MIRI)is a common and severe pathological process in cardiovascular diseases,which often leads to cardiomyocyte damage and dysfunction.In recent years,mitophagy,an important cellular autophagic mechanism,has attracted extensive attention in academic circles.Mitophagy not only plays a key role in maintaining intracellular mitochondrial homeostasis,but also affects cell survival,energy metabolism and oxidative stress response during MIRI.Existing studies have shown that mitophagy promotes cardiomyocyte survival and functional recovery by clearing damaged mitochondria,but its specific mechanism still needs further exploration.This article aims to review the latest research progress of mitophagy in MIRI,analyze its effects on cardiomyocyte survival and metabolism as well as its role in oxidative stress,so as to provide reference and guidance for future research.

Abstract:Pulmonary infectious diseases are among the primary causes of high morbidity and mortality worldwide.Their occurrence and progression are closely associated with the complex inflammatory responses of the body.Traditionally,research on pulmonary infections has largely relied on the detection of inflammatory factors in circulating blood.However,a growing body of evidence indicates that the inflammatory factor profile in the local respiratory tract(e.g.,bronchoalveolar lavage fluid,sputum,etc.)can more directly reflect the status of the pulmonary immune microenvironment,and its expression levels are both correlated with and significantly different from those of inflammatory factors in the blood.This article aims to review the recent research progress on the expression characteristics,dynamic changes,clinical significance and interaction of local respiratory tract and circulating blood inflammatory factors in common pulmonary infectious diseases such as community-acquired pneumonia,coronavirus disease 2019,hospital-acquired pneumonia/ventilator-associated pneumonia,and to explore their potential values in disease diagnosis,severity assessment,prognosis judgment and individualized treatment.

Abstract:Objective To analyze the application effect of ultrasound-guided quadratus lumborum block combined with general anesthesia in elderly patients undergoing laparoscopic radical nephrectomy.Methods Sixty elderly patients with renal cell carcinoma admitted to the First Affiliated Hospital of Hebei North University from August 2021 to August 2022 were selected.All patients underwent laparoscopic radical nephrectomy and were divided into G group and OSA group by random number table method.Patients in G group received conventional opioid general anesthesia,and patients in OSA group received ultrasound-guided quadratus lumborum block combined with opioid general anesthesia.The dosage of anesthetic drugs,sedative and analgesic effects,serum pain factor levels,sleep quality and cognitive function were compared between the two groups.Results The intraoperative consumptions of remifentanil and propofol in OSA group were significantly lower than that in G group[(1.12±0.22)mg vs(1.36±0.31)mg,(513±9)mg vs(533±9)mg],and the pressing times of analgesic pump and the requirement for rescue analgesia within 24 h after operation were significantly less/lower than those in G group[(3.3±0.8)times vs(7.6±1.0)times,13.3％(4/30)vs 36.7％(11/30)](all P＜0.05).The resting visual analogue scale(VAS)score and active VAS score in OSA group were lower than those in G group at 12,24 and 48 h after surgery,and the Ramsay sedation score was higher than that in G group(all P＜0.05).The serum levels of substance P,β-endorphin and nitric oxide in OSA group were lower than those in G group at 12,24 and 48 h after operation(all P＜0.05).The Mini-Mental State examination scores of OSA group were higher than those of G group at 12,24 and 48 h after operation,and the Pittsburgh sleep quality index scores were lower than those of G group(all P＜0.05).Conclusion Ultrasound-guided quadratus lumborum block combined with general anesthesia can reduce the use of anesthetic drugs,effectively regulate the expression of serum pain factors,have better sedative and analgesic effects,and reduce the impact of surgery on sleep quality and cognitive function in elderly patients undergoing laparoscopic radical nephrectomy.

Abstract:Uterine adenomyomatous polyp(AP),also known as polypoid adenomyoma,is a subtype of endometrial polyp characterized by the intermixture of smooth muscle fibers in the polyp stroma.Surgical resection is the mainstay of treatment.This article explores the clinical characteristics,diagnosis and treatment strategies,and fertility preservation of AP through a typical case.The patient was a 35-year-old female who first visited the hospital with the main complaints of"increased menstrual flow for 1 year and vaginal bleeding for 17 d".Hysteroscopy combined with pathological examination confirmed the diagnosis of AP.Later,she underwent multiple hysteroscopic surgeries,high-intensity focused ultrasound surgery,drug treatment,and uterine artery embolization,eventually developing severe intrauterine adhesions that significantly affected her fertility.The patient had no regular postoper-ative follow-up and experienced multiple recurrences.Literature review shows that AP lacks specific clinical symp-toms and has a high recurrence rate,which must be confirmed by hysteroscopy and pathological examination.

Abstract:Heart failure,as one of the most common chronic diseases in the elderly population,not only affects the physical health of patients,but also affects the quality of life of patients with a variety of complications,especially cognitive dysfunction.In recent years,the management of blood pressure in patients with heart failure has received increasing attention.Related studies have shown that there is a close correlation between blood pressure level and cognitive dysfunction.Hypertension,hypotension and blood pressure variability may have different degrees of impact on cognitive function,but the mechanism of these effects has not been fully elucidated.In addition,the effectiveness and adaptability of clinical interventions need to be further explored.This article aims to review the current status of blood pressure management in patients with heart failure,analyze its effects on cognitive function and potential physiological mechanisms,explore the existing problems in current research,and propose future research directions,in order to provide new ideas for improving the overall health of patients with heart failure.

Abstract:Objective To investigate the relationship between urinary albumin-to-creatinine ratio(UACR)and amino acid metabolism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 117 T2DM patients admitted to the Department of Endocrinology,Shuguang Hospital Affiliated to Shanghai University of Chinese Medicine from January to November 2021 were enrolled as research subjects.According to the UACR test results,the patients were divided into three groups:normal group(UACR≤30 mg/g,44 cases),microalbuminuria group(30 mg/g＜UACR ≤ 300 mg/g,41 cases),and macroalbuminuria group(UACR＞300 mg/g,32 cases).The general data and biochemical indicators of the three groups were compared.Spearman correlation analysis and multivariate Logistic regression analysis were used to analyze the relationship between UACR level and amino acid metabolism.Receiver operating characteristic(ROC)curve was used to evaluate the relationship between amino acids and UACR levels in each group.Results There were no significant differences in gender and age among the three groups(x2=3.011,P=0.222;Z=2.261,P=0.323).The difference in disease duration among the three groups was statistically significant(Z=34.356,P＜0.001).The levels of serum creatinine and blood urea nitrogen in the macroalbuminuria group were higher than those in the microalbuminuria group and the normal group,while the estimated glomerular filtration rate was lower than that in the microalbuminuria group and the normal group(all P＜0.05).There were significant differences in the levels of lysine,proline,threonine,citrulline,tyrosine and valine among the three groups(all P＜0.05).Spearman correlation analysis showed that UACR level was negatively correlated with the metabolic levels of lysine,threonine,tyrosine and valine(r=-0.215,-0.226,-0.363,-0.221,all P＜0.05),and positively correlated with the metabolic level of citrulline(r=0.424,P＜0.001).Multivariate Logistic regression analysis showed that high citrulline metabolic level was an influencing factor for the increase of UACR level(P＜0.001).ROC curve analysis showed that the area under the curve of citrulline in predicting the increase of UACR was 0.782(95％confidence interval:0.675-0.890,P＜0.001),with the optimal cut-off value of 40.615 μmol/L,sensitivity of 75.0％and specificity of 82.4％.Conclusion Serum citrulline is a sensitive marker for the increase of UACR in T2DM patients,which can well predict and evaluate the occurrence of diabetic nephropathy.

Abstract:Objective To investigate the risk factors for mortality within 30 d after gastrointestinal bleeding(GIB)in patients undergoing thoracotomy in cardiac surgery.Methods A total of 271 adult patients who under-went thoracotomy in the Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University and developed GIB within 30 d after surgery from January 2017 to January 2024 were retrospectively enrolled.All-cause mortality within 30 d after GIB was set as the primary endpoint.According to the occurrence of the primary endpoint event,the patients were divided into the survival group(149 cases)and the death group(122 cases).Univariate Logistic analysis was performed between the two groups,and then covariates were included to construct a multivariate Logistic model to identify the risk factors for mortality within 30 d after GIB.Results The proportions of female patients,peripheral vascular disease,European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ),rethoracotomy before bleeding,cerebrovascular disease before bleeding,pulmonary infection before bleeding,shock before bleeding,vasoactive drug support before bleeding,mechanical ventilation before bleeding,continuous renal replacement therapy before bleeding,intra-aortic balloon pump or extracorporeal membrane oxygenation before bleeding,red blood cell transfusion volume before bleeding,stable international normalized ratio(INR)before bleeding,and the first INR after bleeding in the death group were significantly higher than those in the survival group,while the proportion of hypertension,stable platelet count before bleeding,systolic blood pressure at the time of bleeding,and the first platelet count after bleeding in the death group were significantly lower than those in the survival group(all P＜0.05).Multivariate Logistic regression analysis showed that peripheral vascular disease was an independent risk factor for mortality within 30 d after GIB in patients undergoing thoracotomy in cardiac surgery(odds ratio=2.77,95％confidence interval:1.28-6.19,P=0.011).Every 10 mmHg increase in systolic blood pressure at the time of bleeding(1 mmHg=0.133 kPa,odds ratio=0.74,95％confidence interval:0.63-0.85,P＜0.001)and every 50 × 109/L increase in the first platelet count after bleeding(odds ratio=0.73,95％confidence interval:0.61-0.86,P＜0.001)were associated with a decreased risk of mortality.Conclusion In patients undergoing thoracotomy in cardiac surgery complicated with GIB,peripheral vascular disease is independently associated with an increased risk of mortality within 30 d after GIB,while higher systolic blood pressure at the time of bleeding and higher first platelet count after bleeding are associated with a decreased risk of mortality within 30 d after GIB.

Abstract:Objective To explore the evaluation value of serum Dickkopf-related protein 1(DKK-1)combined with apnea-hypopnea index(AHI)for acute ischemic stroke(AIS)risk in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 223 OSAHS patients treated in Yan'an University Affiliated Hospital from January 2021 to December 2024 were enrolled.According to the occurrence of AIS during follow-up,the patients were divided into the AIS group and non-AIS group.They were further divided into the high-expression group and low-expression group according to the serum DKK-1 level.Enzyme-linked immunosorbent assay was used to detect the serum DKK-1 level of all OSAHS patients.Meanwhile,the clinical data and AHI of all OSAHS patients were collected for comparison,and the evaluation value of serum DKK-1 and AHI for AIS risk in OSAHS patients was analyzed.Results All 223 patients completed the follow-up,including 182 cases in the non-AIS group and 41 cases in the AIS group.The age,proportion of atrial fibrillation,serum DKK-1 level and AHI in the AIS group were significantly higher than those in the non-AIS group(all P＜0.05).Multivariate Logistic regression model analysis showed that atrial fibrillation,high serum DKK-1 level and high AHI were risk factors for AIS in OSAHS patients(odds ratio=2.812,2.654,2.370,all P＜0.05).Receiver operating charac-teristic curve analysis showed that serum DKK-1 and AHI had good evaluation value for AIS risk in OSAHS patients,with the areas under the curve(AUC)of 0.766(95％confidence interval:0.662-0.869)and 0.763(95％confidence interval:0.666-0.860),respectively.The AUC of their combination was increased to 0.896(95％confidence interval:0.830-0.963),which was superior to that of each single index(both P＜0.05).The incidence of AIS and AHI in the DKK-1 high-expression group were significantly higher than those in the low-expression group[25.6％(21/82)vs 14.2％(20/141),(27±5)times/h vs(21±5)times/h](both P＜0.05).Conclusion High serum DKK-1 level and high AHI are risk factors for AIS in OSAHS patients,and the combination of serum DKK-1 and AHI has good evaluation value for AIS risk in OSAHS patients.

Abstract:Objective To investigate the efficacy of dexamethasone combined with dexmedetomidine in postoperative analgesia for elderly patients with hip fracture.Methods A total of 128 elderly patients with hip fracture admitted to the Eighth Affiliated Hospital of Southern Medical University from December 2023 to December 2024 were selected as the research objects.They were divided into the control group and the observation group according to the random number table method,with 64 cases in each group.The control group was pumped with dexmedetomidine before anesthesia induction;the observation group was pumped with dexmedetomidine combined with dexamethasone before anesthesia induction.The postoperative analgesia,awakening time,cognitive function,cerebral oxygen metabolism,renal function and adverse reactions were compared between the two groups.Results The time of the first pump pressing in the observation group was longer than that in the control group,the number of pump pressings and sufentanil dosage within 24 h after operation,and the VAS scores at 12 h,24 h and 48 h after operation were less/lower than those in the control group(all P＜0.05).The mini-mental state examination scores of both groups decreased at 24 h after operation and increased at 48 h and 72 h after operation,and the mini-mental state examination scores of the observation group at 24 h and 48 h after operation were higher than those of the control group(all P＜0.05).The levels of arterial oxygen content and jugular venous oxygen content in both groups decreased at 24 h after operation,and those in the observation group were higher than those in the control group(all P＜0.05).The levels of serum creatinine and blood urea nitrogen in both groups increased at 24 h after operation,and those in the observation group were 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 observation group and the control group[14.1％(9/64)vs 9.4％(6/64)](x2=0.680,P=0.410).Conclusion Dexamethasone combined with dexmedetomidine can improve the postoperative analgesic effect in elderly patients with hip fracture,reduce postoperative cognitive impairment,improve cerebral oxygen metabolism,alleviate renal damage,and has good safety.

Abstract:Indoxyl sulfate is a gut-derived protein binding uremic toxin.With the progressive reduction of renal filtration function in patients with chronic kidney disease(CKD),indoxyl sulfate accumulates in the body,which further aggravates the progress of CKD.This review discusses the effects of indoxyl sulfate on CKD,and discusses the effects of indoxyl sulfate on renal tubular epithelial cells in CKD patients from the aspects of oxidative stress,inflammatory response,and mitochondrial dysfunction,so as to provide ideas for protecting residual renal function in dialysis patients and delaying disease progression.

Abstract:Objective To establish a predictive model for CD34+cell collection efficacy during mobilization in patients with non-Hodgkin lymphoma(NHL)based on white blood cell count(WBC)and platelet count(PLT).Methods A total of 90 NHL patients who underwent peripheral blood stem cell(PBSC)collection at Zhejiang Provincial People's Hospital from January 2023 to January 2025 were retrospectively selected.The number of CD34+cells collected in a single apheresis was used as the criterion for poor/failed PBSC collection.Clinical data and blood index results of the patients were collected to analyze the risk factors for poor/failed PBSC collection in NHL patients.A predictive model was constructed based on the results of multivariate Logistic regression analysis,and the constructed model was evaluated.Results A total of 90 NHL patients were divided into the poor/failed PBSC collection group(31 cases)and the successful collection group(59 cases)according to the collection results.Compared with the successful collection group,the poor/failed collection group had a higher number of chemotherapy cycles and lower levels of WBC,PLT,and hemoglobin(all P＜0.05).Multivariate Logistic regression analysis showed that WBC,PLT were independent protective factors for poor/failed PBSC collection,and number of chemotherapy was an independent risk factor(all P＜0.05).The receiver operating characteristic curve indicated that the area under the curve of the nomogram model was 0.93.The Hosmer-Lemeshow goodness-of-fit test for the model yieldedx2=3.595 and P=0.892.Decision curve analysis demonstrated that the nomogram model could provide better clinical net benefits.Conclusion NHL patients with low WBC,low PLT,and more number of chemotherapy have an increased risk of poor/failed PBSC collection.The nomogram model established based on these factors exhibits good predictive value for the risk of poor/failed PBSC collection.

Abstract:Traumatic brain injury is a common nervous system injury,and its healing and repair are affected by many factors.The differentiation and maturation process of endogenous neural stem cells(eNSCs)after traumatic brain injury is of great significance for the rehabilitation of the nervous system.The local hypoxia,inflammation and cell death after traumatic brain injury can promote the activation and differentiation of eNSCs through multiple signaling pathways.Cytokines,microRNA,neuron-derived extracellular vesicles,and mitochondrial biosynthesis can be used as regulatory factors to make eNSCs differentiate into neurons and glial cells under specific conditions,and create a good microenvironment for nerve repair by regulating inflammatory response.The combination of tissue engineering technology and eNSCs can further effectively promote nerve regeneration and functional recovery.This article reviews the research progress of eNSCs differentiation and maturation in traumatic brain injury,focusing on its potential therapeutic mechanism and clinical application prospects,in order to provide reference and enlighten-ment for future research.

Abstract:Objective To investigate the clinical characteristics and related factors in patients with acute appendicitis of different pathological types.Methods A retrospective analysis was conducted on the clinical data of 2 482 patients diagnosed with acute appendicitis and undergoing surgical treatment in Linyi People's Hospital,Shandong Province from January 2018 to December 2023.Relevant data including age,gender,pathological type,complicated underlying diseases,fever degree,appendiceal location and history of appendicitis were collected.Multivariate Logistic regression analysis was used to identify the differential related factors in patients with acute appendicitis of different pathological types.Results The mean age of the 2 482 patients was(41±17)years old,ranging from 14 to 99 years old.Multivariate Logistic regression analysis showed that compared with gangrenous/perforated appendicitis,younger age and shorter appendiceal length were more likely to be associated with acute simple appendicitis,while complicated underlying diseases,absence of fever and history of appendicitis were more likely to be associated with gangrenous/perforated appendicitis(odds ratios=0.974,0.003,13.435,12.945,3.665,all P＜0.05).Compared with gangrenous/perforated appendicitis,shorter appendiceal length and specific appendiceal locations(retroileal,preileal,retrocecal,paracecal)were more likely to be associated with acute suppurative appendicitis,while complicated underlying diseases,absence of fever and specific appendiceal location(pelvic)were more likely to be associated with gangrenous/perforated appendicitis(odds ratios=0.095,＜0.001,0.001,0.001,0.004,2.765,3.978,202.520,all P＜0.05).Conclusion Younger age and shorter appen-diceal length are more likely to indicate acute simple appendicitis,while complicated underlying diseases may lead to gangrenous/perforated appendicitis even in the absence of fever.