Abstract:Objective To explore the relieving effect of filiform fire needle therapy on functional recovery and pain in patients with stage Ⅰ post-stroke shoulder hand syndrome.Methods A total of 97 patients with stage Ⅰ post-stroke shoulder hand syndrome were enrolled in this study and divided into two groups by random number table method.Both groups received conventional treatment and rehabilitation training.The control group(48 cases)was treated with extracorporeal shock wave therapy,while the treatment group(49 cases)was additionally given filiform fire needle therapy of traditional Chinese medicine on the basis of the control group.The clinical efficacy,shoulder joint function and range of motion,pain degree and serum biochemical indexes were compared between the two groups.Results There was no statistically significant difference in the total effective rate between the treatment group and the control group(P＞0.05).Compared with before treatment,the Fugl-Meyer assessment(FMA)scores increased and shoulder-hand syndrome scale(SHSS)scores decreased in both groups after treatment,with better outcomes in the treatment group.At the 1st and 2nd treatment cycles,the visual analogue scale(VAS)scores of the treatment group were lower than those of the control group.After treatment,the passive range of motion(PROM)of shoulder joint was elevated in both groups,serum levels of calcitonin gene-related peptide(CGRP)and nitric oxide(NO)increased,while levels of endothelin-1(ET-1),substance P(SP),bradykinin(BK)and hypoxia-inducible factor-1α(HIF-1α)decreased.The above changes were more obvious in the treatment group(P＜0.05).Conclusion Combined application of traditional Chinese medicine filiform fire needle therapy in patients with stage Ⅰ post-stroke shoulder hand syndrome can alleviate pain and systemic inflammation,and improve shoulder joint mobility.

Abstract:Objective To construct an extreme gradient boosting(XGBoost)model for cardiac dysfunction of multiple organ dysfunction syndrome(MODS)in patients with emergency severe multiple trauma,and to evaluate and verify the value of the prediction model.Methods The patients with emergency severe multiple trauma of Henan Provincial People's Hospital from January 2022 to June 2025 were retrospectively selected as the research objects.According to the ratio of 7∶3,they were divided into training set and validation set.The incidence of cardiac dysfunction in MODS was counted.According to whether they were complicated with cardiac dysfunction,they were divided into occurrence group and non-occurrence group.The clinical data of two groups in validation set and training set were collected.LASSO-logistic regression analysis was used to screen the influencing factors of cardiac dysfunction in MODS of patients with emergency severe multiple trauma.The prediction model was constructed based on XGBoost algorithm.The calibration curve,receiver operating characteristic(ROC)curve,and precision-recall(PR)curve were used to evaluate the predictive performance of the XGBoost prediction model.Results The incidence of cardiac dysfunction in MODS in 360 patients with severe multiple trauma was 31.11％(112/360).In the training set and validation set,the age,number of injured sites,proportion of patients with shock,proportion of patients with sepsis,injury severity score(ISS),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,D-dimer(D-D),C-reactive protein(CRP),lactate dehydrogenase(LDH),cardiac troponin Ⅰ(cTnI),B-type brain natriuretic peptide(BNP)and lactate(Lac)levels in the occurrence group were higher than those in the non-occurrence group,and the product of reverse shock index and Glasgow coma scale score(rSIG)was lower than that in the non-occurrence group,the differences were statistically significant(P＜0.05).LASSO-logistic regression analysis showed that age,combined shock,ISS,APACHE Ⅱ score,rSIG,D-D,CRP and Lac were independent influencing factors of cardiac dysfunction in MODS of patients with emergency severe multiple trauma(P＜0.05).The importance ranking of the top 8 factors screened by the XGBoost algorithm was APACHE Ⅱscore,Lac,ISS,age,rSIG,CRP,D-D,combined shock,and the prediction performance of the XGBoost model was the best.In the training set,the calibration curve showed that the calibration degree of the model was 0.862.ROC curve analysis showed that the area under the curve(AUC)of the model for predicting cardiac dysfunction in MODS of patients with emergency severe multiple trauma was 0.889(95％CI:0.846-0.932),the sensitivity was 85.19％,and the specificity was 80.12％.PR curve analysis showed that the average accuracy of the model was 0.819(95％CI:0.738-0.908).In the validation set,the calibration curve showed that the calibration degree of the model was 0.860.ROC curve analysis showed that the AUC of this model in predicting cardiac dysfunction in MODS of patients with emergency severe multiple trauma was 0.880(95％CI:0.799-0.961),with a sensitivity of 83.87％and a specificity of 80.52％.PR curve analysis showed that the average accuracy of the model was 0.837(95％CI:0.757-0.923),which confirmed that the model had good robustness.Conclusion The prediction model of APACHE Ⅱ score,Lac,ISS,age,rSIG,CRP,D-D and combined shock based on XGBoost algorithm is constructed,it can accurately predict the risk of cardiac dysfunction in MODS of patients with emergency severe multiple trauma,and provide a reliable decision support tool for early identification of high-risk patients and individualized intervention.

Abstract:Objective To analyze the predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP),neutrophil/hemoglobin ratio(NPHR)combined with global registry of acute coronary events(GRACE)score for new-onset acute heart failure after percutaneous coronary intervention(PCI)in elderly patients with acute myocardial infarction(AMI).Methods A total of 299 elderly patients with AMI who underwent PCI in Xinmi Hospital of Traditional Chinese Medicine from August 2023 to August 2025were selected.According to whether new acute heart failure occurred after PCI,they were divided into occurrence group(35 cases)and non-occurrence group(264 cases).Another 80 patients from September to November 2025 were selected as the validation set for prospective cohort validation.The baseline data and NT-proBNP,NPHR and GRACE scores before PCI were compared between the two groups.Multivariate logistic regression was used to analyze the effects of NT-proBNP,NPHR and GRACE scores on new-onset acute heart failure after PCI in elderly AMI patients.Receiver operating characteristic(ROC)curve was used to analyze the value of NT-proBNP,NPHR and GRACE in predicting new-onset acute heart failure after PCI in elderly AMI patients.The accuracy-recall(PR)curve was used to analyze the robustness of the combined performance in identifying positive categories.The calibration curve and clinical decision analysis curve were used to evaluate the calibration and clinical utility of the combined prediction.Results Patients with atrial fibrillation in the occurrence group were more than those in the non-occurrence group,and LVEF was lower than that in the non-occurrence group,the differences were statistically significant(P＜0.05).The scores of NT-proBNP,NPHR and GRACE in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P＜0.05).Multivariate logistic regression analysis showed that after adjusting for atrial fibrillation and left ventricular ejection fraction(LVEF),the increase of NT-proBNP,NPHR and GRACE score was still the related influencing factor of new acute heart failure after PCI in elderly patients with AMI(P＜0.05).ROC curve analysis showed that the area under the curve of the combined prediction of NT-proBNP,NPHR and GRACE score was 0.866,and its predictive efficiency was better than that of each index alone(P＜0.05).Further drawing of the PR curve showed that the PR-AUC of the combination of the three was 0.837(95％CI:0.818-0.897),suggesting that the recognition performance of the combination of the three in the positive category was robust.In the validation set,the area under the ROC curve of the combined prediction scheme was 0.860,which was not significantly different from that of the modeling set(0.866)(P＞0.05),suggesting that the model had good extrapolation performance.The calibration curve was drawn and showed that the joint prediction results of the three were in good agreement with the actual probability,suggesting that the model had good calibration.The clinical decision analysis curve was drawn and showed that the use of joint prediction to guide clinical could bring positive net benefits(threshold probability 0.13-0.63).Conclusion NT-proBNP,NPHR combined with GRACE score can improve the predictive value of new-onset acute heart failure after PCI in elderly patients with AMI,provide a new scheme for early identification of high-risk groups,which may help to optimize the allocation of medical resources and reduce the occurrence of acute heart failure.

Abstract:Objective To explore the synergistic effect of heat-sensitive moxibustion at Lianquan acupoint combined with chin-targeted anti-resistance(CTAR)training on swallowing function rehabilitation in patients with post-stroke dysphagia(PSD).Methods A total of 100 cases of patients with PSD treated in Zhumadian Hospital of Traditional Chinese Medicine from June 2023 to June 2025 were selected,and divided into three groups according to random number table method.All patients received conventional treatment and rehabilitation training.On this basis,33 patients in control group A received CTAR training,33 patients in control group B received heat-sensitive moxibustion at Lianquan acupoint,and 34 patients in combined group were given CTAR training plus heat-sensitive moxibustion at Lianquan acupoint.After 4 weeks of intervention,the clinical efficacy was observed,as well as the hyolaryngeal complex mobility,mean amplitude and duration of submental and infrahyoid muscles,swallowing function indexes[water swallowing test(WST),standardized swallowing assessment(SSA),Fujishima Ichiro swallowing scale(FILS)],nutritional status indicators[albumin(ALB),transferrin(TRF)and prealbumin(PA)]before intervention and after 4 weeks of intervention,and the incidence of complications were compared among the three groups.Results The total effective rate of combined group was 94.12％,which was higher than 69.70％of control group A and 72.73％of control group B(P＜0.05).After 4 weeks of intervention,the hyolaryngeal complex mobility in the combined group was significantly higher than that in the two control groups(P＜0.05).After 4 weeks of intervention,the mean amplitude of submental and infrahyoid muscles was higher,while their movement duration was shorter in the combined group(P＜0.05).After 4 weeks of intervention,the WST and SSA scores of the combined group were lower than that of control group A and control group B,and the FILS score was higher than that in control group A and control group B(P＜0.05).After 4 weeks of intervention,the serum levels of ALB,PA and TRF in combination group were higher than those in control group A and control group B(P＜0.05).After 6 months of follow-up after intervention,the incidence of complications in the combination group was 5.88％,showing no statistically significant difference compared with 24.24％in group A and 18.18％in group B(P＞0.05).Conclusion The CTAR training combined with heat-sensitive moxibustion at Lianquan acupoint can restore the swallowing function and improve the nutritional status of PSD patients with definite therapeutic effect and good safety.

Abstract:Objective To investigate the correlation between the change trajectory of D-dimer/cardiac troponin I(D-D/cTnI)ratio in peripheral blood and the clinical outcome of patients with emergency acute myocardial infarction(AMI).Methods A total of 180 patients with AMI admitted to Pingdingshan First People's Hospital from January 2024 to June 2025 were prospectively selected and treated with percutaneous coronary intervention(PCI).The ratio of D-D/cTnI in peripheral blood was measured before PCI,6 h after PCI and 48 h after PCI.The changes of D-D/cTnI ratio during perioperative period were statistically analyzed.The different trajectory groups of D-D/cTnI ratio during perioperative period were screened by establishing latent class trajectory model(LCTM).The clinical outcomes of AMI patients during hospitalization were statistically analyzed.The clinical data of patients with different clinical outcomes were compared.Multivariate logistic regression was used to analyze the effect of D-D/cTnI ratio change trajectory on the clinical outcome of AMI.Receiver operating characteristic(ROC)curve was used to analyze the value of D-D/cTnI ratio change trajectory in predicting the clinical outcome of AMI.Results The levels of D-D and cTnI in all patients increased slightly from before PCI to 6 h after PCI,and the ratio of D-D/cTnI decreased slightly,the levels of D-D and cTnI decreased significantly from 6 h after PCI to 48 h after PCI.The ratio of D-D/cTnI showed a significant upward trend,and the differences were statistically significant(P＜0.05).The LCTM model was constructed,and the model fitting was optimal when the three classification trajectories were identified.According to the optimal model,the D-D/cTnI ratio change trajectory was divided into three trajectory groups(T1 group:high-relatively high;T2 group:medium low-relatively high;T3 group:low-low).There were significant differences in Killip classification,global registry of acute coronary events(GRACE)score and perioperative D-D/cTnI ratio between the poor group and the good group(P＜0.05).Logistic regression analysis showed that after adjusting for confounding factors,the change trajectory of D-D/cTnI ratio was still a related influencing factor of clinical outcome of AMI(P＜0.05).The risk of poor outcome in T2 group and T3 group was 1.524 and 2.129 times higher than that in T1 group(P＜0.05).ROC curve showed that when the change of D-D/cTnI ratio showed a T3 trajectory,the area under the curve for predicting the adverse outcome of AMI was 0.907(0.855-0.945),the sensitivity was 82.93％,and the specificity was 98.56％.Conclusion The D-D/cTnI ratio of AMI patients has different change trajectories before and after PCI,and the risk of adverse outcome is higher when it shows a low-low change trajectory,and it has certain predictive value for adverse outcome.It can be used as an auxiliary method for clinical prediction of clinical outcome,which has certain guiding significance for subsequent clinical decision-making.

Abstract:Objective To analyze the effects of different feeding mode on the dynamic changes of gut microbial in vaginally delivered infant.Methods A total of 44 vaginally delivered infants in the First Affiliated Hospital of Zhengzhou University from July to August 2017 were enrolled in the study.According to feeding mode,they were divided into the exclusive breastfeeding group(27 cases)and the mixed feeding group(17 cases).Fecal samples were collected at 0 month(meconium)and 3,6,12 months postpartum,and the microbial community diversity and composition was analyzed through high throughput sequencing.Results(1)Compared with exclusive breastfeeding group,the relative abundance of Proteobacteria in mixed feeding group at 12 months significant reduction(Z=2.777,P=0.006).(2)In the two groups,except for mixed feeding group and exclusive breastfeeding group,which Klebsiella and Escherichia-Shigella were dominant respectively at 0 month,Bifidobacterium was dominant at the other three time points.At 0 month,the abundance of Collinsella was increased in mixed feeding group(Z=2.004,P=0.045).At 3 months,the abundance of Scardovia was increased in mixed feeding group(Z=2.778,P=0.006).At 12 months,the abundance of Klebsiella and Enterobacter were lower(Z=2.820,P=0.005;Z=2.560,P=0.011),while that of Blautia increased in mixed feeding group(Z=2.067,P=0.039).Conclusion Significant differences exist in the gut microbial community structure among vaginally delivered infants with different feeding mode.

Abstract:Objective To develop a social alienation scale for stroke patients and test its reliability and validity.Methods To construct the conceptual framework of social alienation for stroke patients,on this basis,the initial scale was formed through literature review,the qualitative interview,expert consultation and pre-investigation.From September to November 2023,a total of 381 stroke patients were investigated by convenient sampling method to test the reliability and validity of the scale.Results The social alienation scale for stroke patients included 22 items in 4 dimensions,including cognitive alienation,emotional alienation,behavioral alienation and physical alienation.Four common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 68.615％.The Cronbach's alpha coefficient,split-half reliability and test-retest reliability of the scale were 0.912,0.907 and 0.965,respectively.The scale-level content validity index was 0.95,and item-level content validity index was 0.83-1.00.Confirmatory factor analysis showed that the model fitted well and the factor structure of the skill was stable.Conclusion The social alienation scale for stroke patients has good reliability and validity,and can be utilized to assess the level of social alienation for stroke patients.

Abstract:Objective To investigate the effect of 3 D printing technology assisted flexible ureteroscopic holmium laser lithotripsy(FURL)in the treatment of calyceal diverticular calculi and its influence on surgical trauma index and renal function.Methods A total of 124 calyceal diverticulum calculi patients in the First Affiliated Hospital of Henan Medical University from May 2022 to August 2024 were selected and randomly divided into the 3D group and control group,with 62 cases in each group.The control group was treated with FURL,and the 3D group was treated with 3D printing technology to assist FURL.The stone clearance rate,operation and postoperative recovery were compared between the two groups,as well as the trauma indexes[norepinephrine(NE),cortisol(Cor),adrenocorticotropic hormone(ACTH),C-reactive protein(CRP)]and renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr),cystatin C(Cys-C),neutrophil gelatinase-associated lipocalin(NGAL)]before operation,1 day after operation and 3 days after operation.The incidence of postoperative complications during hospitalization was recorded,and the stone recurrence rate was counted after 1 year of follow-up.Results The stone clearance rate of 2-3 days after operation in the 3D group was 91.94％,which was higher than that in the control group(77.42％)(P＜0.05).The intraoperative blood loss of the 3D group was(25.27±5.13)mL,which was lower than that of the control group(38.19±6.44)mL.The operation time,postoperative ambulation time and hospitalization time were(44.81±7.26)min,(7.26±1.69)h and(3.48±0.80)d,respectively,which were less than those of the control group(57.43±10.02)min,(10.84±1.95)hand(4.27±0.92)d(P＜0.05).The levels of serum NE,Cor,ACTH,CRP,BUN,Scr,Cys-C and NGAL in the 3D group were lower than those in the control group before operation,1 d and 3 d after operation(P＜0.05).The incidence of postoperative complications during hospitalization and the recurrence rate of calculi within 1 year after operation in the 3D group were 3.23％and 3.33％,respectively,which were lower than 16.13％and 16.95％in the control group(P＜0.05).Conclusion 3 D printing technology assisted FURL in the treatment of caliceal diverticular calculi can improve the effect of stone removal,reduce the risk of postoperative recurrence,reduce surgical trauma and renal injury,reduce the incidence of complications,and facilitate early postoperative rehabilitation.

Abstract:Objective To explore the effect of pre-rehearsal medical doll intervention on preoperative anxiety and degree of cooperation of fiberoptic bronchoscopy in preschool and school-age young children.Methods A total of 86 preschool and school-age young children with interventional bronchoscopy admitted to Pingdingshan First People's Hospital from April 2023 to June 2025 were selected and randomly divided into two groups,with 43 cases in each group.Control group received routine nursing,and observation group received pre-rehearsal medical doll intervention on this basis.The modified Yale preoperative anxiety scale-short form(mYPAS-SF)score,children's medical fear scale(CMFS)score and degree of cooperation were compared between the two groups before and after intervention,and the complications of the children were counted.Results After intervention,the mYPAS-SF score of observation group was lower than that of control group(P＜0.05).After intervention,the CMFS score of observation group was lower than that of control group(P＜0.05).After intervention,the score of cooperation in observation group was higher than that in control group(P＜0.05).There was no significant difference in the incidence of complications between observation group(2.33％)and control group(4.65％)(P＞0.05).The total satisfaction rate of family members in observation group(97.67％)was higher than that in control group(76.74％)(P＜0.05).Conclusion The pre-rehearsal medical doll intervention can effectively alleviate the fear and anxiety of preschool and school-age young children before bronchoscopy intervention,and significantly enhance the degree of cooperation and improve the satisfaction of family members.

Abstract:Objective To analyze the application effect of detail intervention based on failure mode and effect analysis(FMEA)model in the intervention of unstable angina pectoris patients in the interventional operating room nursing.Methods A retrospective study was conducted to collect medical records of 60 patients with unstable angina pectoris who received routine intervention in the Cardiovascular Department of Henan Provincial People's Hospital from January to December 2022,and were included in the control group.The medical records of 60 patients with unstable angina pectoris who received detailed intervention based on FMEA mode in the Cardiovascular Department of Henan Provincial People's Hospital from January to December 2023 were collected and included in the observation group.The clinical data of all patients was kept intact.Patients' medical records were consulted.The psychological emotion,quality of life[generic quality of life inventory 74(GQOLI-74)],occurrence of adverse reactions,occurrence of risk events in interventional operating room,quality of nursing work in interventional operating room and nursing satisfaction of patients were compared between the two groups.Results After nursing,the positive emotion score,GQOLI-74 score,total score and various dimensions of nursing work quality in the intervention operating room,nursing satisfaction in the observation group were all higher than those in the control group,and the negative emotion score,incidence of adverse reactions,and incidence of risk events in the intervention operating room were all lower than those in the control group,with a statistical significant difference(P＜0.05).Conclusion Detail interventions based on the FMEA model can regulate the psychological emotions of patients with unstable angina pectoris,reduce the incidence of adverse reactions and risk events in the intervention operating room,improve the quality of nursing work in the intervention operating room and the quality of life of patients,and increase patient satisfaction.

Abstract:Objective To analyze the predictive value of a disintegrin and metalloproteinase with thrombospondin type 1 motif,member 13(ADAMTS13)and lactate dehydrogenase/albumin ratio(LAR)on the prognosis of patients with acute respiratory distress syndrome(ARDS)before the initiation of extracorporeal membrane oxygenation(ECMO).Methods A total of 182 ARDS patients undergoing ECMO in the First Affiliated Hospital of Zhengzhou University from September 2020 to March 2025 were selected to detect the levels of ADAMTS13 and LAR within 24 hours after admission.According to the oxygenation index(OI),the patients were divided into three subgroups.Spearman correlation coefficient was used to analyze the correlation between ADAMTS13,LAR and the severity of ARDS.According to the survival of ARDS patients in intensive care unit within 28 days,they were divided into poor prognosis group(67 cases)and good prognosis group(115 cases).The clinical data,ADAMTS13 and LAR before ECMO initiation were compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors of poor prognosis in ARDS patients receiving ECMO treatment.Receiver operating characteristic(ROC)curve and relative risk were used to analyze the predictive value and early warning effect of ADAMTS13 and LAR before ECMO initiation on the prognosis of ARDS.Results The OI,mean artery pressure(MAP)and ADAMTS13 in the good prognosis group were higher than the poor prognosis group,the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score and LAR in the good prognosis group were lower than those in the poor prognosis group(P＜0.05).There were statistically significant differences in APACHE Ⅱ score,SOFA score,ADAMTS13 and LAR among patients with different degrees of ARDS(P＜0.05).APACHE Ⅱ score,ARDS severity and SOFA score were negatively correlated with ADAMTS13 and positively correlated with LAR(P＜0.05).Before and after correction of APACHE Ⅱ score,OI and SOFA score,ADAMTS13 and LAR were independent influencing factors of poor prognosis in ARDS patients(P＜0.05).The area under the curve(AUC)of ADAMTS13 and LAR in predicting the prognosis of ARDS before ECMO initiation was 0.870(95％CI:0.812-0.915).ARDS patients with low ADAMTS13 level and high LAR level had a higher risk of poor prognosis(P＜0.05).Conclusion ADAMTS13 and LAR before the initiation of ECMO are significantly correlated with the severity of ARDS patients,and are predictors of the prognosis of ARDS patients.Combined detection can provide relevant information for clinical diagnosis,treatment and prognosis improvement.

Abstract:Objective To investigate the association between the level of hope among patients undergoing nephron-sparing surgery for renal tumors and the level of renal function preservation postoperatively,as well as the role of psychological resilience in this association.Methods From June 2024 to June 2025,80 patients who underwent nephron-sparing surgery for renal tumors and met the inclusion criteria were selected from the Department of Urology at Pingmei Shenma Medical Group General Hospital.Models 4 and 5 in the SPSS Process plugin were used to analyze the mediating role of different dimensions of psychological resilience in the association between hope levels and postoperative renal function preservation levels in patients who underwent nephron-sparing surgery for renal tumors.Results The mean score on the psychological resilience scale was(74.22±8.90)points,the mean score on the hope level scale was(29.53±6.48)points,and the estimated glomerular rate(eGFR)at 6 months post-surgery was(68.03±2.11)mL·min-1·1.73-1·m-2.Significant correlations were observed among hope level,psychological resilience,and postoperative eGFR(P＜0.05).Mediation analysis indicated that psychological resilience played a partial mediating role in the relationship between hope level and postoperative eGFR,accounting for 36.40％of the total effect.Specifically,the mediating proportions of the resilience,self-efficacy,and optimism dimensions were 15.47％(β=0.004,95％CI:0.001-0.005),16.83％(β=0.011,95％CI:0.005-0.018),and 42.66％(β=0.016,95％CI:0.009-0.024),respectively.All indirect effects were statistically significant(P＜0.05).Conclusion The various dimensions of psychological resilience play varying degrees of mediating roles in the association between hope levels and postoperative renal function preservation levels in patients undergoing nephron-sparing surgery for renal tumors.It is recommended to implement targeted intervention measures to enhance hope levels and psychological resilience in patients undergoing nephron-sparing surgery for renal tumors,thereby preventing adverse outcomes.

Abstract:Objective Bioinformatics analysis of colorectal cancer microarray data was used to screen differentially expressed genes in colorectal cancer and normal colon tissue cells,and to search for the key genes involved in the occurrence and development of colorectal cancer,so as to provide theoretical basis for exploring the molecular mechanism of colorectal cancer.Methods Colorectal cancer gene expression data sets GSE10950,GSE41328,GSE74602 were obtained from GEO database,and differentially expressed genes were screened by GEO2R analysis,and GO analysis and KEGG pathway enrichment analysis were performed on differentially expressed genes by DAVID online tools.The STRING database was used to analyze the protein interaction network of differentially expressed genes and screen key genes.The expression and prognosis of the above screened differential genes in colorectal cancer samples in the TCGA database were examined by GEPIA online tool.Results A total of 161 differentially expressed genes in colorectal cancer were screened.Eight core differentially expressed genes were identified by protein interaction network analysis,which were CXCL8,CXCL1,CXCL2,CXCL12,ANPEP,CLCA4,CLCA1 and GNG4.The differentially expressed genes were analyzed again using GEPIA2,and it was found that the expressions of CXCL8,CXCL2,and GNG4 in colorectal cancer tissues were higher than those in normal tissues,while the expression of CLCA1 in colorectal cancer tissues was lower than that in normal tissues.In addition,GNG4 varies in different stages of colorectal cancer,and its expression in stage Ⅲ and Ⅳ colorectal cancer tissues was higher than that in stage Ⅰ and Ⅱ.Survival analysis was conducted to reveal that the survival rates of colorectal cancer patients with high expression levels of CXCL2 and CLCA1 were higher than those with low expression levels,while the survival rate of colorectal cancer patients with high expression levels of GNG4 was lower than that of patients with low expression levels,and the differences were statistically significant(P＜0.05).Conclusion CXCL2,CLCA1 and GNG4 are influencing factors for the prognosis of colorectal cancer.Colorectal cancer patients with high expression of CXCL2 and CLCA1 have a better prognosis,while those with high expression of GNG4 have a poorer prognosis.It is of great significance for further research on the molecular mechanisms of the occurrence and progression of colorectal cancer and the screening of therapeutic targets.

Abstract:With the advancement of the medical treatment alliance and consortia model,enhancing the emergency service capabilities of township health centers has become an important task in the current reform of the medical and healthcare system.This paper analyzes the practical experience of tertiary hospitals managing county-level medical consortia,discusses issues such as the current status of emergency departments in grassroots units,lack of emergency equipment,insufficient emergency drills,poor service capabilities,and low patient demand for healthcare,and proposes corresponding countermeasures to improve the emergency response capabilities of grassroots units.Furthermore,it constructs a four-level medical service system spanning provinces,cities,towns,and villages,aiming to provide a reference for enhancing the emergency service capabilities of township health centers.

Abstract:Objective To explore the correlation between the levels of family with sequence similarity 98 member A(FAM98A)and geminin(GMNN)with pathological characteristics and prognosis of endometrial cancer patients.Methods A total of 94 patients with endometrial cancer admitted to the Second Affiliated Hospital of Zhengzhou University from July 2020 to July 2021 were selected as the study group.They were divided into survival and death patients based on their survival status after 3 years.Another 94 patients with benign tumors were selected as the control group.The expression levels of FAM98A and GMNN and the relative expression levels of FAM98A and GMNN in patients with different pathological features and prognoses of endometrial cancer were compared between the two groups.The correlation between the expression levels of FAM98A and GMNN and pathological features,as well as their predictive value for prognosis and mortality were analyzed.Results The relative expression levels of FAM98A and GMNN in the study group were higher than those in the control group(P＜0.05).The expression levels of FAM98A and GMNN in patients with lymph node metastasis were higher than those in patients without lymph node metastasis.The expression levels of FAM98A and GMNN in patients with stage Ⅰ-Ⅱ were lower than those in patients with stage Ⅲ-Ⅳ.The expression level of FAM98A in patients with muscle invasion depth＞1/2 muscle was higher than that in patients with muscle invasion depth＜1/2 muscle(P＜0.05).The expression levels of FAM98A and GMNN in patients who survived for 3 years were lower than those in patients who died(P＜0.05).The expression levels of FAM98A and GMNN were positively correlated with lymph node metastasis and TNM staging in endometrial cancer patients,and the expression level of FAM98A was positively correlated with the depth of myometrial invasion(P＜0.05).The area under the curve(AUC)of FAM98A,GMNN expression levels,and combined detection for predicting the mortality of endometrial cancer patients were 0.691,0.662,and 0.821,respectively(P＜0.05).Conclusion The levels of FAM98A and GMNN are closely related to lymph node metastasis,TNM staging,and prognosis in patients with endometrial cancer.Combined detection can provide effective reference for clinical prediction of endometrial cancer mortality.

Abstract:Objective To study the clinical efficacy of levosimendan in patients with acute exacerbation of chronic heart failure(ADHF)complicated with sleep disorders and its association with psychological state.Methods A retrospective study,99 patients with ADHF complicated with sleep disorders who were treated in Zhoukou Central Hospital from January 2021 to December 2023 were selected as the research subjects.According to the treatment regimens recorded in the medical record system,they were divided into the control group(44 cases,conventional treatment)and the study group(55 cases,treatment with levosimedan on the basis of the control group).The heart rate,6-minute walk test distance,serum indicators(brain natriuretic peptide(BNP),carbohydrate antigen 125(CA125),high-sensitivity C-reactive protein(hs-CRP),cardiac function[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac index(CI),left ventricular fractional shortenin(FS),and cardiac output(CO)],psychological state[(state anxiety inventory(S-AI)and trait anxiety inventory(T-AI)],sleep quality[(Pittsburgh sleep quality index(PSQI)],the incidence of adverse reactions and clinical efficacy of the two groups of patients before and after treatment were compared.The Pearson correlation analysis method was used to analyze the correlation between levosimendan and the scores of psychological state and sleep quality.Results Compared with before treatment,after treatment,the heart rate,CA125,BNP,hs-CRP,S-AI,T-AI and PSQI levels of the patients all decreased,the 6-minute walk test distance and various cardiac function indicators significantly increased(P＜0.05),and the improvement amplitude of the above indicators in the study group was greater than that in the control group(P＜0.05).The total incidence of adverse reactions in the study group was 9.09％(5/55),compared with 6.82％(3/44)in the control group,and the difference was not statistically significant(P＞0.05).The total effective rate of clinical treatment in the study group was 94.55％(52/55),which was higher than that in the control group(77.27％,34/44)(P＜0.05).The results of Pearson correlation analysis showed that the S-AI,T-AI and PSQI after treatment were negatively correlated with the combined levosimendan treatment(r=-0.470,-0.527,-0.503,P＜0.05),suggesting that levosimendan treatment was significantly correlated with psychological state and sleep quality.Conclusion Combined with levosimendan on the basis of conventional treatment can increase the improvement of heart rate,serum indicators,exercise tolerance,cardiac function,anxiety and sleep treatment,without significantly increasing clinical adverse reactions.

Abstract:Objective To compare the growth-promoting effects of different initial doses of recombinant human growth hormone(rhGH)in children with idiopathic short stature(ISS),and to provide evidence for optimizing initial dosing regimens in clinical practice.Methods A total of 60 children with ISS admitted to Xinyang People's Hospital from December 2019 to December 2023 were enrolled and randomly assigned to control group or observation group,with 30 cases in each group.The control group received rhGH at an initial daily dose of 0.15 IU·kg-1,while the observation group received 0.20 IU·kg-1,with subsequent dose adjustments according to growth response over a 1-year treatment period.Height,bone age and growth velocity were assessed before and after treatment.Serum levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)were measured.Adverse events were documented throughout the treatment period.Results Height,bone age and growth velocity increased in both groups after treatment,with significantly greater improvements observed in the observation group(P＜0.05).No significant differences in serum TSH,FT3 or FT4 levels were found within either group before and after treatment,nor between the two groups at each time point(P＞0.05).The overall incidence of adverse events in the observation group was slightly higher than that in the control group,but the difference was not statistically significant(P＞0.05).Conclusion An initial rhGH dose of 0.20 IU·kg-1·d-1 is more effective than 0.15 IU·kg-1·d-1 in promoting linear growth in children with ISS,without obvious interference with thyroid function.Long-term follow-up is warranted to confirm its safety and impact on adult height.

Abstract:Objective To analyze the changes and clinical significance of serum toll-like receptor 9(TLR9),γ-interferon(IFN-γ),and absolute value ratio of monocyte-to-lymphocyte(MLR)levels in children with Epstein-Barr virus(EBV)-associated infectious mononucleosis.Methods A retrospective study was conducted on 86 children with EBV-associated infectious mononucleosis admitted to Children's Hospital Affiliated of Zhengzhou University from February 2021 to December 2024 as the study group,and 86 healthy children who underwent physical examinations during the same period were selected as the control group.The levels of serum TLR9,IFN-γ,MLR,and white blood cell(WBC)count,as well as peripheral blood lymphocyte subsets,were compared between the two groups.The correlations between serum TLR9,IFN-γ,MLR levels and peripheral blood lymphocyte subsets and WBC levels were analyzed,and the diagnostic value of these indicators for EBV-associated infectious mononucleosis was evaluated.Results The levels of serum TLR9 and IFN-γ in the study group were significantly higher than those in the control group,while the serum MLR level was significantly lower(P＜0.05).The levels of peripheral blood CD3+,CD3+CD8+,and serum WBC in the study group were higher than those in the control group,while CD3+CD4+,CD4+/CD8+,and CD3-CD19+were lower(P＜0.05).Serum TLR9 and IFN-γ levels were positively correlated with CD3+,CD3+CD8+,and serum WBC levels,while serum MLR level was negatively correlated with them.Serum TLR9 and IFN-γ levels were negatively correlated with CD3+CD4+,CD4+/CD8+,and CD3-CD19+,while serum MLR level was positively correlated with them(P＜0.05).The area under the curve(AUC)for the combined detection of serum TLR9,IFN-γ,and MLR levels in diagnosing EBV-associated infectious mononucleosis was 0.904,and the Youden's index was 0.721(P＜0.05).Conclusion The levels of serum TLR9,IFN-γ,and MLR in children with EBV-associated infectious mononucleosis are closely related to their immune dysfunction.Combined detection of these indicators can provide effective reference for the clinical diagnosis of the disease.

Abstract:Objective To explore the impact of Kodály hand sign music therapy on children with autism spectrum disorder(ASD).Methods Using the random number table method,86 children with ASD who visited the Fifth Affiliated Hospital of Zhengzhou University from January 2023 to January 2025 were evenly divided into 2 groups.The control group(43 cases)received routine rehabilitation training intervention,while the observation group(43 cases)received Kodály hand sign music therapy intervention on this basis.The intervention lasted for 12 weeks.The scores of the childhood autism rating scale(CARS),the autism behavior checklist(ABC),the psycho-educational profile-third edition(PEP-3),and the social responsiveness scale(SRS)were compared between the two groups.Results After the intervention,the scores of CARS,ABC and SRS in both groups decreased,while the PEP-3 scores increased.Moreover,the scores of CARS,ABC and SRS in the observation group were lower and the PEP-3 score was higher after the intervention(P＜0.05).Conclusion The Kodály hand sign music therapy effectively alleviates the symptoms of loneliness and social disorders in children with ASD,and can promote the improvement of their behavioral and psychological development capabilities.

Abstract:Objective To explore the influence of traditional Chinese medicine(TCM)compress combined with fire dragon jar on the knee joint function and pain of patients with knee obstruction.Methods Eighty-six patients with knee obstruction hospitalized in Henan Provincial Hospital of TCM from January 2023 to May 2024 were selected and divided into a control group(43 cases)and an observation group(43 cases)using a random number table method.The control group received conventional rehabilitation training,while the observation group received TCM compress combined with fire dragon jar in addition to the conventional rehabilitation training.The knee joint function,pain,osteoarthritis index,and TCM syndrome scores of the two groups were compared.Results After intervention,the scores of knee joint function in both groups increased,and the scores of the observation group were higher than those of the control group(P＜0.05).After intervention,the pain and osteoarthritis index scores in both groups decreased,and the scores of the observation group were lower than those of the control group(P＜0.05).After intervention,the TCM syndrome scores in both groups decreased,and the scores of the observation group were lower than those of the control group(P＜0.05).Conclusion TCM compress combined with fire dragon jar can effectively improve the knee joint function of patients with knee obstruction,reduce their pain,improve their clinical symptoms,and contribute to the recovery of joint function.