Abstract:Objective To investigate the effects of Sacubitril/Valsartan(SV)on serum agglutinin and Silent Information Regulator Transporter 6(SIRT6)in patients with coronary atherosclerotic heart disease(CAHD)complicated with acute heart failure(AHF).Methods One hundred and twenty-two patients with CAHD complicated with AHF admitted from January 2023 to May 2024 were selected and divided into control group(n=61)and observation group(n=61)by random number table method.Both groups were given conventional treatment,the control group was given Candesartan Cilexetil tablets,and the observation group was given SV.The clinical efficacy,disease-related indicators,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],myocardial injury indicators[N-terminal pro-B-type natriuretic peptide(NT-proBNP),high-sensitivity C reactive protein(hs-CRP)],agglutinin levels,SIRT6 levels,adverse reactions and major adverse cardiovascular events(MACE)were compared between the two groups.Results The total effective rate of the observation group[96.72%(59/61)]was higher than that of the control group[86.89%(53/61)](P<0.05).At 7 d after treatment,compared with the control group,the heart rate,systolic blood pressure and diastolic blood pressure in the observation group were lower,and the urine volume was higher(P<0.01).At 3 months after treatment,LVEDD,LVESD,NT-proBNP,hs-CRP,and agglutinin were lower,while LVEF and SIRT6 were higher in the observation group than in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After 3 months of follow-up,the incidence of MACE in the observation group was lower than that in the control group(P<0.05).Conclusion The early application of SV demonstrates a significant efficacy in patients with CAHD complicated with AHF,which can improve the hemodynamic status of the body,inhibit ventricular remodeling,regulate the levels of agglutinin and SIRT6,reduce myocardial injury,and reduce the risk of MACE,with a favorable safety profile.

Abstract:Bronchial asthma is a common chronic heterogeneous airway disease that is pathologically characterized by airway hyperresponsiveness and chronic inflammation.The pathogenesis of this disease is complex.Essentially,it is an airway inflammatory response driven by abnormal activation of the immune system.Its occurrence and development involve the participation of various immune cells and immune factors,including B lymphocytes,T lymphocytes,mast cells,macrophages and dendritic cells,as well as key cytokines such as interleukin(IL)-4,IL-5,IL-13,and interferon(IFN)-γ.And key cytokines such as interleukin(IL)-4,IL-5,IL-13 and interferon-γ.The complex interactions between these immune cells and mediators cause a series of pathological changes such as increased airway mucus secretion,smooth muscle contraction and airway remodeling,ultimately leading to the appearance of clinical symptoms,such as chest tightness,shortness of breath,wheezing and coughing.This article conducts systematically reviews current understanding of the immunological pathogenesis of bronchial asthma,thereby providing theoretical references for drug development and clinical diagnosis and treatment.

Abstract:Objective To investigate the effect of quercetin(QUE)on the Th1/Th2 immune balance in allergic rhinitis(AR)mice via regulating protein tyrosine kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Method We selected SPF-grade male BALB/c mice and constructed the AR mouse model through sensitization treatment.Seventy-two mice were randomly divided into the model group,the QUE-L group(50 mg/kg QUE by gavage),the QUE-M group(100 mg/kg QUE by gavage),the QUE-H group(200 mg/kg QUE by gavage),and the QUE-H+JAK2/STAT3 pathway activator Coumermycin A1 Group(200 mg/kg QUE by gavage+tail vein injection of 1 mg/kg Coumermycin A1),and normal mice were taken and only treated with 0.9 sodium chloride injection by intraperitoneal injection and nasal drip as the control group.The histopathological morphology of nasal mucosa in each group of mice was detected by HE staining.The levels of interferon-γ(IFN-γ),interleukin-4(IL-4),immunoglobulin E(IgE),interleukin-1β(IL-1β),interleukin-6(IL-6),and interleukin-8(IL-8)in the serum of mice in each group were detected by ELISA.The apoptosis rate of nasal mucosa tissue cells in each group was determined by the TUNEL method,and the protein expressions of JAK2 and STAT3 in the nasal mucosa tissues of mice in each group were detected by Western blot method.Results Compared with the control group,the model group had disorganized nasal mucosal epithelial cells,vasodilation,accompanied by severe inflammatory cell infiltration,presence of obvious pathological changes and decreased serum IFN-γ level(P<0.05).The levels of serum IL-4,IgE,IL-1β,IL-6,IL-8,the apoptosis rate of nasal mucosa tissue cells,and the protein expressions of p-JAK2/JAK2 and p-STAT3/STAT3 increased(P<0.05).The nasal mucosal epithelial cells of mice in the QUE-L group,QUE-M group and QUE-H group were arranged neatly compared with those in the model group.Vasodilation and inflammatory cell infiltration were significantly alleviated,the pathological changes were significantly reduced,and the serum IFN-γ level was increased(P<0.05).The levels of serum IL4,IgE,IL-1β,IL-6,and IL-8,the apoptosis rate of nasal mucosal tissue cells,and the protein expressions of p-JAK2/JAK2 and p-STAT3/STAT3 decreased(P<0.05).Compared with the QUE-H group,the QUE-H+Coumermycin A1 group had aggravated pathological changes,deteriorated inflammation levels and immune imbalance,and increased apoptosis rate of nasal mucosal tissue cells and protein expression in the JAK2/STAT3 pathway(P<0.05).Conclusion QUE may reverse the Th1/Th2 immune imbalance in AR mice by inhibiting the JAK2/STAT3 signaling pathway.

Abstract:Objective To investigate the clinical efficacy of low-dose Prednisone combined with Tacrolimus in children with refractory nephrotic syndrome(RNS).Methods A total of 106 children with RNS admitted from March 2022 to September 2023 were included and evenly divided into the monotherapy group and the combination therapy group according to the random number table method.The monotherapy group was given low-dose Prednisone tablets,while the combination therapy group was given low-dose Prednisone tablets combined with Tacrolimus.The differences in nailfold microcirculation indicators,lipid metabolism indicators,renal injury markers,clinical efficacy,and adverse reactions were compared between the two groups.Results The total effective rate of the combination therapy group was higher than that of the monotherapy group(P<0.05).At 3 months after treatment,the serum albumin,capillary flow velocity,input branch diameter and output branch diameter in the combination therapy group were all higher than those in the monotherapy group,while the levels of red blood cell aggregation,triglycerides,low-density lipoprotein cholesterol,total cholesterol,serum creatinine,24-hour urine protein quantification,neutrophil gelatin enzyme-associated lipocalin,retinol binding protein,α1-microglobulin,β-N-acetylglucosaminidase,and renal injury molecule-1 were all lower than those in the monotherapy group(P<0.05).The total incidence of adverse reactions in the combination therapy group was lower than that in the monotherapy group(P<0.05).Conclusion In the treatment of children with RNS,the combination of Tacrolimus and low-dose Prednisone can improve the microcirculation status and reduce renal injury markers,with remarkable effects.

Abstract:Objective To investigate the correlation between immune cells and the occurrence of cardiovascular disease(CVD)in patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),and to construct a risk prediction model.Methods A total of 280 HIV/AIDS patients treated from June 2024 to August 2025 were selected as the research subjects and divided into a training set(n=200)and a test set(n=80)at a ratio of 5:2.The patients in the training set were subdivided into a CVD subgroup(n=60)and a non-CVD subgroup(n=140)according to whether they developed CVD.The baseline characteristics and immune cells of the two groups were compared,and the longitudinal trajectory changes of immune cells in the CVD subgroup and the non-CVD subgroup were analyzed.LASSO regression analysis was used to screen the independent influencing factors of CVD,multivariate Logistic regression analysis was used to screen the independent risk factors for the occurrence of CVD,and a risk prediction nomogram model was constructed.The area under the receiver operating characteristic(ROC)curve(AUC),Hosmer-Lem show test,calibration curve,and decision curve were used to compare the risk prediction nomogram model with the general cardiovascular risk assessment model,to evaluate its discrimination,goodness-of-fit,and clinical utility.Results There were significant differences in the baseline characteristics and immune cells between the two groups(P<0.05).The longitudinal trajectory plots revealed that the CD4+count,CD8+count,and CD4+/CD8+level in the CVD group exhibited substantial fluctuations,while the trajectories of these parameters in the non-CVD group remained relatively stable.After LASSO regression analysis screened out 11 non-zero coefficient variables,multivariate logistic regression analysis showed that age,hypertension,total cholesterol,smoking,high-sensitivity C-reactive protein,CD4+count at the time of HIV diagnosis,CD8+count at the time of HIV diagnosis,and globulin were all independent influencing factors for the occurrence of CVD in HIV/AIDS patients(P<0.05).The AUC of the risk prediction nomogram model was 0.960 in the training set and 0.914 in the test set,indicating good discrimination of the model.The Hosmer-Lem show test and calibration curve showed good accuracy and consistency of the model,and the decision curve showed a high net benefit value,indicating good clinical utility.Conclusion The CVD risk in HIV/AIDS patients is jointly affected by immune dysfunction and traditional metabolic factors.The risk prediction nomogram model constructed significantly improves the accuracy of risk prediction of CVD and can provide a basis for early identification of high-risk patients and the formulation of individualized intervention strategies.

Abstract:Objective To analyze the changes of neutrophil-to-albumin ratio(NPAR),monocyte-to-lymphocyte ratio(MLR),neutrophil-to-lymphocyte ratio(NLR)and interleukin-17A(IL-17A)in patients with severe autoimmune encephalitis(AE)and the predictive value of their combined detection for prognosis.Methods A total of 105 patients with severe AE admitted from May 2021 to April 2025 were selected as the severe group.During the same period,35 patients with mild-to-moderate AE and 35 healthy controls were enrolled in a 3:1:1 ratio as the mild-to-moderate group and control group respectively.The levels of NPAR,MLR,NLR and IL-17A were compared among the three groups.Patients with severe AE were observed for one month.According to the prognosis of patients,they were divided into poor prognosis subgroup[modified Rankin scale(mRS)score≥3,n=31]and good prognosis subgroup(mRS score<3,n=74).The levels of NPAR,MLR,NLR and IL-17A in the two groups were compared,to analyze the correlation between NPAR,MLR,NLR and IL-17A levels and mRS score in patients with severe AE,and to evaluate the predictive value of combined detection of the four indicators for prognosis in these patients.Results The levels of NPAR,MLR,NLR and serum IL-17A in mild-to-moderate group and severe group were higher than those in control group,which were higher in the severe group than in the mild-to-moderate group(P<0.05).The course of disease in the poor prognosis group was longer than that in the good prognosis group,and the proportion of patients with γ-aminobutyric acid B receptor antibody and the levels of NPAR,MLR,NLR and serum IL-17A were higher than those in the good prognosis group(P<0.05).Higher levels of NPAR,MLR,NLR and serum IL-17A were all risk factors for poor prognosis of patients with severe AE(OR=2.445,4.319,2.502,1.791,P<0.05).The levels of NPAR,MLR,NLR and serum IL-17A were positively correlated with the mRS score of patients with severe AE(r=0.546,0.519,0.554,0.561,P<0.001).The area under the receiver operating characteristic(ROC)curve(AUC)of NPAR,MLR,NLR and IL-17A detected in combination in predicting the prognosis of patients with severe AE was higher than that of the four indicators detected alone(P<0.05).Conclusion The changes in NPAR,MLR,NLR and IL-17A levels in patients with AE were closely related to the severity and prognosis of the disease.In the meantime,higher levels of NPAR,MLR,NLR and serum IL-17A were risk factors for poor prognosis,and the combined detection of the four indicators could effectively improve the predictive value for prognosis in patients with severe AE.

Abstract:Objective To investigate the efficacy of Vericiguat combined with Sacubitril/Valsartan(Sac/Val)in the treatment of heart failure in elderly patients with dilated cardiomyopathy(DCM).Methods From January 2023 to January 2024,96 elderly patients with DCM and heart failure were selected and randomly divided into two groups by the random number table method,with 48 patients in each group.The control group was treated with Sac/Val,while the combination group was treated with Vericiguat combined with Sac/Val for a course of 3 months.The clinical efficacy,adverse reactions,parameters of cardiac structure and function[left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),stroke volume(SV)],myocardial injury indicators[N-terminal pro-brain natriuretic peptide(NT-proBNP),troponin I(cTnI),creatine kinase isoenzyme(CK-MB)],and serum miR-133a and miR-433 expression levels before and after treatment were compared between the two groups.The patients were followed up for 6 months to statistically analyze the occurrence of major adverse cardiovascular events(MACE).Results Compared with 77.08%(37/48)in the control group,the total effective rate of the combination group was significantly increased to 93.75%(45/48)after treatment(P<0.05).Compared with the control group,SV and LVEF increased,while LAD and LVEDD decreased in the combination group after treatment(P<0.05).Compared with the control group,the levels of serum NT-proBNP,cTnI,CK-MB and the expression levels of serum miR-133a and miR-433 in the combination group decreased after treatment(P<0.05).During the treatment period,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After a 6-month follow-up,there was no significant difference in the incidence of MACE between the two groups(P>0.05).Conclusion Vericiguat combined with Sac/Val has a definite therapeutic effect in the treatment of heart failure in elderly patients with DCM,which can reduce the levels of myocardial injury markers in patients,improve cardiac structure and function,and has favorable safety profile.It may be related to the regulation of miR-133a and miR-433 expression.

Abstract:Objective To analyze the clinical distribution,drug resistance characteristics,molecular prevalence,and impact of immunocompromised status on the infection rate of carbapenem-resistant Enterobacteriaceae(CRE)isolated from pediatric respiratory tract samples(sputum,bronchoalveolar lavage fluid).Methods A retrospective analysis was conducted on clinical data of hospitalized children from 2019 to 2023.A total of 1 235 non-repetitive strains of Enterobacteriaceae bacteria were obtained from pediactric respiratory tract samples.Drug susceptibility testing,multilocus sequencing typing(MLST),and resistance-related gene sequencing were performed on 100 isolated CRE strains,to study the clinical distribution,drug resistance characteristics,and molecular prevalence of CRE,and to further analyze the impact of immunocompromised status on the respiratory CRE infection rate in children.Results From 2019 to 2023,the detection rate of CRE in 1 235 strains of Enterobacteriaceae bacteria was 8.10%(100/1 235).Among them,51.0%(51/100)of CRE were isolated from the intensive care unit(ICU),of which 33.0%(33/100)were isolated from the Surgical ICU,18.0%(18/100)of CRE was isolated from the Medical ICU;32.0%(32/100)of CRE were isolated from Department of Neonatology,with the majority(74.0%)isolated from infants under 6 months of age.Of all pediatric patients,85.0%recovered and were discharged after treatment.Immunocompromised status was identified as an independent risk factor for CRE infection.Among 100 strains of CRE,Carbapenem-resistant Klebsiella pneumoniae(CRKP)was the most commonly detected strain,accounting for 88.0%(88/100),followed by Escherichia coli at 6.0%(6/100)and Enterobacter cloacae at 4.0%(4/100).CRE strains were highly resistant to carbapenems and cephalosporins,with prevalent resistance to amikacin,ciprofloxacin,and levofloxacin.However,their resistance rates were relatively low to tigecycline,colistin,minocycline,ceftazidime/avibactam,meropenem/vaborbactam,and imipenem/relebactam.The screening results of carbapenem resistance genes showed that blaKPC-2 was the most prevalent gene(74.0%),followed by blaNDM-1(14.0%)and blaNDM-5(11.0%).Molecular typing showed that ST11 type CRE was the dominant type,comprising 72.0%(72/100)and was the primary epidemic clone.Conclusions CRKP is the most prevalent CRE strain isolated from pediatric respiratory tract samples,primarily identified in the ICU,Department of Neonatology,and among infants under 6 months of age.Immunocompromised status is an independent risk factor for respiratory CRE infection in children.CRE generally has high resistance to antibacterial drugs,with blaKPC-2 being the dominant resistance genotype,and ST11 as the predominant multilocus sequence type.Clinical management should account for these characteristics to implement timely interventions and rational therapeutic strategies.

Abstract:Objective To analyze the clinical characteristics of immune checkpoint inhibitor(ICI)-related hepatotoxicity(ICIH)in cancer patients.Methods A retrospective analysis was conducted on clinical data of cancer patients with ICIH from January 2019 to December 2024.Patients with Grade 1-2 liver injury were defined as the mild group,and those with Grade 3-4 liver injury were defined as the severe group.Results Among 13 patients with ICIH,10(76.92%)were males and 3(23.08%)were females,with a mean age of 67.8±5.2 years.Twelve patients(92.3%)were aged 60 years or above.ICIH first occurred between cycle 1 and cycle 14 after initial treatment,with the highest incidence observed within cycles 1-5.Combination therapy(combination chemotherapy or targeted agents)was used in 10 patients(76.92%).Among the 13 patients,the distribution of liver injury grades was as follows:1 case of Grade 1(7.69%),2 cases of Grade 2(15.38%),5 cases of Grade 3(38.46%),and 5 cases of Grade 4(38.46%).Liver injury types included hepatocellular(38.46%),cholestatic(38.46%),and mixed(23.08%).After drug discontinuation and supportive care,9 patients(69.23%)fully recovered,2(15.38%)improved,and 2(15.38%)showed no improvement.No significant differences were observed between the mild and severe groups in terms of age,body mass index,baseline lymphocyte count,platelet count,neutrophil count,monocyte count,alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,alkaline phosphatase,lymphocyte-to-monocyte ratio,neutrophil-to-lymphocyte ratio,and platelet-to-lymphocyte ratio(P>0.05).Conclusion ICIH typically occurs within 1 to 5 cycles after ICI administration,with non-specific clinical manifestations,which lead to a diagnosis of exclusion.Despite a generally favorable prognosis,severe ICIH can be fatal,particularly in patients with primary liver cancer.Prompt discontinuation of ICIs and initiation of Corticosteroid therapy can lead to timely improvement of patient's condition.

Abstract:Psoriasis is a chronic,inflammatory,recurrent,and systemic disease mediated by immune dysregulation,which is often accompanied by psychological issues such as depression and anxiety.Recent research on the gut microbiota and depression and anxiety has made significant progress,with studies demonstrating that the gut microbiota plays a crucial role in the pathogenesis of psoriasis.Dysbiosis of the gut microbiota may be an important comorbidity mechanism linking psoriasis with depression and anxiety.This article summarizes the changes in the abundance of gut microbiota in patients with psoriasis and those with depression and anxiety,as well as how the gut microbiota influences this comorbidity through neural pathways and immune-endocrine pathways.It aims to provide novel perspectives for the study of the comorbidity mechanisms and clinical treatment of psoriasis and depression and anxiety.In the future,targeting the gut microbiota may enable the development of personalized treatments.

Abstract:Objective To investigate the effects of Remimazolam combined with Esketamine on cellular immunity,cognitive function,and sleep quality in elderly patients with lung cancer during surgery.Methods A total of 106 elderly lung cancer patients who underwent elective thoracoscopic lobectomy from September 2023 to March 2025 were selected and divided into the control group(n=53)and the research group(n=53)according to random number table method.The control group received Midazolam combined with Esketamine for general anesthesia,while the research group received Remimazolam combined with Esketamine for general anesthesia.The intraoperative and postoperative conditions,hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP)]before anesthesia induction(T0),at tracheal intubation(T1),at 1 min before one-lung ventilation(OLV)(T2),at skin incision(T3),at 1 h after OLV(T4),and immediately after extubation(T5),as well as pain and inflammatory factors[5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],cellular immunity[peripheral blood natural killer(NK)cells,CD3+,CD4+,CD4+/CD8+],the levels of serum interleukin(IL)-2,interferon-γ(IFN-γ),cognitive function[Mini-Mental State Examination(MMSE)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)],and recovery quality[Postoperative Quality of Recovery-15(QoR-15)score]were compared between the two groups of patients.The adverse reactions and complications were also compared between the two groups.Results There was no significant difference in duration of surgery,duration of anesthesia,intraoperative blood loss,and time to spontaneous breathing recovery of patients between the two groups(P>0.05).The total dosage of Sufentanil in the research group was less than that in the control group,and time to postoperative eye opening,duration of recovery room stay and length of postoperative hospitalization were shorter than those in the control group(P<0.05).At T0 and T5,there was no significant difference in HR and MAP between the two groups(P>0.05),and at T1-T4,HR and MAP in the research group were higher than those in the control group(P<0.05).At the time of recovery,the levels of serum 5-HT,PGE2,hs-CRP,and TNF-α in the research group were lower than those in the control group(P<0.05),and at the time of recovery,the peripheral blood NK cells,CD3+,CD4+,and CD4+/CD8+ratio,serum IL-2 and IFN-γ levels in the research group were higher than those in the control group(P<0.05).At 1 d after surgery,the MMSE and QoR-15 scores of the research group were higher than those of the control group,while the PSQI score was lower than that of the control group(P<0.05).The incidence of adverse reactions and complications in the research group[5.66%(3/53)and 3.77%(2/53)],was lower than that of the control group[18.87%(10/53)and 15.09%(8/53)](P<0.05).Conclusion The combination of Remimazolam and Esketamine in elderly patients undergoing thoracoscopic lobectomy can better maintain intraoperative hemodynamics,stabilize cellular immune function,reduce serum pain and inflammatory factor levels,improve postoperative cognitive function and sleep quality,reduce adverse reactions and complications,and promote postoperative recovery.

Abstract:Objective To investigate the prognostic value of mitochondrial autophagy-related genes(MRGs)in prostate cancer(PCa),and to reveal their regulatory relationship with interstitial epidermal transforming factor(C-Met)based on the Gene Expression Database(GEO).Methods Single-cell RNA sequencing(scRNA-seq)data of three PCa samples were obtained from the GSE153892 dataset of GEO,and MRGs were collected from the Genecards database and previous literature.The scRNA-seq data were processed and analyzed using the Seurat software package,including quality control,gene expression screening,cell type annotation,differentially expressed genes(DEGs)identification,and intersection analysis with MRGs.The transcriptome data of PCa and control samples were downloaded from the Cancer Genome Atlas Database(TCGA)-PRAD cohort,and differential expression analysis and copy number variation analysis were conducted.The non-negative matrix factorization algorithm is adopted to conduct cluster analysis on PCa samples to identify different PCa subtypes.A prognostic risk model based on intersection genes was constructed,and the predictive ability of the model was analyzed through Kaplan-Meier survival curve analysis and time-dependent receiver operating characteristic(ROC)curve analysis.Conduct independent prognostic analysis,construct a nomogram model based on risk scores and clinical characteristics,and evaluate its ability to predict patient survival rates.The possibility of immune infiltration and tumor immune escape in PCa samples was evaluated by using the single-sample Gene Set Enrichment analysis(ssGSEA)algorithm and the TIDE database.The relationship between intersection genes and C-Met expression was analyzed using Pearson correlation analysis.Results scRNA-seq data analysis identified five cell types including B lymphocytes,epithelial cells,monocytes,natural killer cells and T lymphocytes,and discovered the intersection genes that were highly expressed in different cell types.Through differential expression analysis,genes significantly related to the prognosis of PCa patients were screened out,and a prognostic risk model was constructed.Six genes such as ADH5 and CAT were retained through LASSO analysis.A diagnostic model was constructed and grouped.There was a significant difference in survival time between the two groups in the internal test set(P<0.05).ROC curve evaluation showed that the model had a good predictive ability for 1-,3-,and 5-year survival rates.The external test set verified that there was a statistically significant difference in the expression of intersection genes(P<0.05).Independent prognostic analysis identified T stage and risk score as independent prognostic factors.A nomogram model was constructed.Calibration curve and ROC curve analyses showed that the predictive ability of this model was superior to that of the simple risk model.ssGSEA analysis revealed differences in the abundance of immune cell inflammation and immune function scores between the two groups.Most immune cells,immune function,and risk scores were related to the modeling genes.There were significant differences in TIDE scores and multiple immune checkpoints between the high-risk and low-risk groups(P<0.05).BCAT2,DCXR,OGT and FUS were positively correlated with the expression of C-Met,while ADH5 and CAT were negatively correlated with the expression of C-Met(P<0.05).Conclusion The prognostic risk model based on intersection genes can effectively predict the prognosis of patients with PCa,and the risk score and T stage are independent prognostic factors for PCa.The correlation analysis of intersection genes and C-Met expression provides a new idea for the targeted therapy of PCa.

Abstract:Objective To investigate the clinical application value of detection of interleukin-6(IL-6),C reactive protein(CRP),and neutrophic-to-lymphocyte ratio(NLR)alone and in combination in the prognosis assessment of severe pneumonia(SP).Methods A total of 81 patients with SP admitted from December 2022 to December 2023 were selected as the research subjects.According to the discharge outcomes of the patients,they were divided into the survival group(n=62)and the death group(n=19).The general clinical data at admission and laboratory parameters of the two groups were collected and compared.The receiver operating characteristic(ROC)curve was used to analyze the value of serum IL-6,CRP and NLR detection in the prognosis assessment of SP.Results At admission,the pulse of the death group was higher than that of the survival group,while the systolic blood pressure(SBP)was lower than that of the survival group(P<0.05,P<0.01).The incidence of chest tightness in the death group at admission was significant higher than that in the survival group(P<0.05).Compared with the survival group,the number of lymphocyte counts and albumin levels in the death group were lower,while the percentage of neutrophils,NLR and procalcitonin were higher than those in the survival group(P<0.05,P<0.01).ROC curve analysis showed that the area under the curve(AUC)for predicting poor prognosis of SP by the combined detection of IL-6,CRP and NLR was 0.75,which was higher than that predicted by each indicator alone.Conclusion Compared with the detection of IL-6,CRP and NLR alone,the combined detection of the three has a more significant value in predicting the risk of death in patients with SP.It suggests that clinicians should promptly,comprehensively and dynamically monitor the above infection indicators during diagnosis and treatment,and take prompt and effective intervention measures to reduce the mortality rate of patients.

Abstract:Objective To analyze the effect of Roflumilast combined with Budesonide in the treatment of chronic bronchitis complicated with chronic obstructive pulmonary disease(COPD).Methods A total of 98 patients with chronic bronchitis complicated with COPD admitted from February 2023 to February 2025 were selected and divided into group A(n=49)and group B(n=49)by random number table method.Group A was given Budesonide,and group B was given Roflumilast combined with Budesonide.The clinical efficacy,symptom scores[Chronic Obstructive Pulmonary Disease Assessment Test(CAT),modified British medical research council(mMRC)],pulmonary function[forced vital capacity(FVC),peak exploratory flow(PEF),forced exploratory volume in one second(FEV1)],respiratory mechanics indexes[airway resistance(Raw),dynamic compliance(Cdyn),peak inspiratory pressure(PIP)],inflammatory factors[interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)],oxidative stress markers[8-iso-prostaglandin F2α(8-iso-PGF2α),malondialdehyde(MDA),super oxide dismutase(SOD),glutathione peroxidase(GSH-Px)],adverse reactions and prognosis were compared between the two groups.Results The total effective rate of group B[95.92%(47/49)]was higher than that of group A[83.67%(41/49)](P<0.05).After treatment,CAT,mMRC score,PIP,Raw,8-iso-PGF2α,MDA,hs-CRP,TNF-α and IL-8 in group B were lower than those in group A,while FVC,PEF,FEV1,Cdyn,SOD and GSH-Px were higher than those in group A(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The number of acute exacerbation in group B was less than that in group A at 3 and 6 months after treatment(P<0.01).Conclusion The combination therapy of Roflumilast and Budesonide is significantly effective in the treatment of chronic bronchitis complicated with COPD.It can alleviate clinical symptoms,improve patients'pulmonary function and respiratory mechanics,inhibit inflammation and oxidative stress response,and has a favorable safety profile and good prognosis.

Abstract:Objective To analyze the relationship between the expression levels of post-meiosis isolated protein 2(PMS-2)and p-glycoprotein(PGP)in gastric cancer tissues and clinicopathological characteristics,prognosis and immune function.Methods The clinical data of 100 patients with gastric cancer who visited the hospital from May 2018 to February 2022 were selected for retrospective analysis.All patients received radical surgical treatment.The expression levels of PGP and PMS-2 proteins in adjacent tissues and cancer tissues were determined by immunohistochemistry,and the correlations between the expression of PGP and PMS-2 proteins in cancer tissues and the clinicopathological characteristics and immune function of patients with gastric cancer were analyzed.The patients were followed up for 3 years after the operation to analyze the influencing factors of prognosis in patients with gastric cancer,as well as the correlation between the protein expressions of PGP and PMS-2 in cancer tissues and prognosis.Results The positive expression rates of PGP and PMS-2 proteins in cancer tissues were higher than those in adjacent tissues(P<0.05).Positive expression of PMS-2 and PGP protein was significantly associated with advanced clinical stage(stage Ⅲ),presence of lymph node metastasis,and poorer tumor differentiation(P<0.05).However,their expression showed no significant correlation with age,gender,Lauren classification,vascular invasion,or tumor diameter(P>0.05).The preoperative CD4+/CD8+levels of gastric cancer patients with positive expression of PMS-2 and PGP proteins were respectively lower than those of patients with negative expression of PMS-2 and PGP proteins(P<0.05).Cox multivariate regression analysis showed that clinical stage Ⅲ,degree of differentiation,distant metastasis,lymph node metastasis,positive expression of PMS2 protein,positive expression of PGP protein,and preoperative CD4+/CD8+were all influencing factors for the prognosis of patients with gastric cancer(P<0.05).After a 3-year follow-up,the survival curves of gastric cancer patients with negative expressions of PMS2 and PGP protein were respectively higher than those of patients with positive expressions of PMS-2 and PGP protein(P<0.05).Conclusion The expressions of PMS-2 and PGP proteins in gastric cancer tissues are closely associated with clinical stage,presence or absence of lymph node metastasis,degree of tumor differentiation,prognosis and preoperative CD4+/CD8+level.Moreover,patients with positive expressions of PMS-2 and PGP proteins have a worse prognosis.

Abstract:Objective To investigate the predictive efficacy of complete blood count(CBC)parameters for the prognosis of acute pancreatitis(AP),and to construct a machine learning model.Methods The clinical data of 120 patients with AP admitted from January 2021 to December 2024 were retrospectively analyzed.Based on the prognostic outcomes within 28 d of treatment,they were divided into the poor prognosis group and the good prognosis group.On the first day of admission,CBC parameters[red blood cell count,hemoglobin,hematocrit,white blood cell count,neutrophil count,lymphocyte count,monocyte count,red blood cell distribution width(RDW),platelet count,mean platelet volume,platelet distribution width,neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),lymphocyte/monocyte ratio(LMR)were detected in the two groups.The general data and CBC parameters of the two groups were compared.The clinical variables were screened using the Lasso regression equation.Four models,namely Support Vector Machine(SVM),logistic regression(LR),deep neural network(DNN),and Random Forest(RF),were constructed for external validation.The predictive efficacy of the four models for the prognosis of AP was evaluated by using the receiver operating characteristic(ROC)curve,the precision-recall(PR)curve,the calibration curve and the clinical decision curve.Results The APACHE Ⅱ score,bedside severity index score,proportion of vasoactive drug use,and proportion of severe hypoproteinemia in the poor prognosis group were all higher than those in the good prognosis group(P<0.01).The levels of RDW,NLR and PLR in the poor prognosis group were all higher than those in the good prognosis group,while the level of LMR was lower than that in the good prognosis group(P<0.01).The Lasso regression equation ultimately screened out four non-zero coefficient variables:NLR,RDW,APACHE Ⅱ score,and severe hypoproteinemia.Based on the above variables,SVM,LR,RF and DNN machine learning models were constructed.The RF model had the highest area under the ROC curve(AUC),PR AUC,accuracy rate and F1 score for predicting the prognosis of AP,and had the optimal comprehensive performance.The calibration curve showed that the curve of the RF model for predicting the prognosis of AP was relatively close to the ideal curve.The decision curve showed that when the threshold probability value of the RF model was 15%to 100%,it had a significance clinical net benefit rate.External validation also showed that the RF model had the optimal predictive efficacy.The calibration curve indicated that the predictive curve of the RF model for the prognosis of AP highly coincided with the actually observed curve.The decision curve showed that the RF model provided clinical net benefits to patients across the decision threshold range of 0 to 100%.Conclusion Machine learning models constructed based on CBC parameters can make relatively accurate predictions about the prognosis of AP.Among them,the RF model has the optimal predictive efficiency,which can be used as an auxiliary tool for clinical prediction of AP prognosis,and can also provide reference for clinical treatment.

Abstract:Objective To explore the predictive value of umbilical artery ultrasound blood flow parameters combined with the levels of serum miR-148a and miR-424-5p in pregnant women with preeclampsia for perinatal outcomes.Methods A total of 95 pregnant women with preeclampsia admitted from June 2020 to July 2023 were enrolled as the research group and divided into the poor outcome group(n=37)and the good outcome group(n=58)according to the perinatal outcomes.In addition,152 healthy pregnant women who underwent prenatal examinations during the same period were included as the control group.Color Doppler ultrasound examination was performed to determine umbilical artery blood flow parameters:resistance index(RI),pulpability index(PI),and the ratio of maximum systolic blood flow velocity to diastolic blood flow velocity(S/D).The relative expression levels of serum miR-148a and miR-424-5p were detected by real-time fluorescence quantitative PCR(RT-qPCR).Multivariate logistic regression was used to analyze the influencing factors of poor perinatal outcomes in pregnant women with preeclampsia.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of umbilical artery RI,PI,S/D and serum miR-148a and miR-424-5p for perinatal outcomes in pregnant women with preeclampsia.Results Compared with the control group,the expression levels of umbilical artery RI,PI,S/D and serum miR-424-5p in the research group all increased,while the expression level of serum miR148a decreased(P＜0.01).The proportions of perinatal infants with preterm birth,asphyxia,intrauterine growth restriction,low birth weight and the incidence of poor outcomes in the research group were all higher than those in the control group(P＜0.05).Compared with the good outcome group,the expression levels of umbilical artery RI,PI,S/D and serum miR-424-5p in the poor outcome group all increased,while the expression level of serum miR-148a decreased(P＜0.01).Umbilical artery RI,PI,S/D and serum miR-424-5p were all risk factors for poor perinatal outcomes,while serum miR-148a was a protective factor(P＜0.01).The area under the curve(AUC)of umbilical artery RI,PI,S/D combined with serum miR-148a and miR-424-5p for predicting poor perinatal outcomes in pregnant women with preeclampsia was significantly greater than that of RI(Z=3.489,P＜0.001),PI(Z=3.089,P＜0.001),and S/D(Z=3.296,P=0.001),miR-148a(Z=3.542,P＜0.001)and miR424-5p(Z=2.916,P=0.004)for prediction alone,and was also greater than that predicted by the combination of ultrasound blood flow parameters(RI,PI,S/D)(Z=2.457,P=0.014),and by the combination of serum miR-148a and miR-424-5p(Z=2.214,P=0.027).Conclusion The expression levels of umbilical artery RI,PI,S/D and serum miR-424-5p in pregnant women with preeclampsia are all increased,while the expression level of serum miR-148a is decreased,which is associated with poor perinatal outcomes.The combination of the above indicators has certain evaluation value for the perinatal outcomes of pregnant women with preeclampsia.

Abstract:Systemic lupus erythematosus(SLE)is an autoimmune disease caused by the immune system's abnormal attack on its own tissues.However,traditional anti-rheumatic drugs and biological agents have poor efficacy for some SLE patients and fail to achieve a sustained remission of the disease.Chimeric antigen receptor T lymphocyte(CAR-T)immunotherapy is currently a hot topic in cellular immunotherapy research,bringing new treatment options for SLE patients.CAR-T immunotherapy has shown faster and more durable efficacy in the clinical application of SLE,and is expected to achieve drug-free remission and reduce the occurrence of adverse events.This article expounds the preclinical and clinical research of CAR-T immunotherapy in SLE at present,and reviews the clinical effect,safety and feasibility of clinical application of CAR-T immunotherapy.

Abstract:By integrating existing research,this paper systematically analyzes the impact of exercise training in low-temperature environments on immune regulation and infection defense,in order to explore its potential benefits and risks.Strictly following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses:2020(PRISMA 2020)guidelines,multiple databases were systematically reviewed,to include original studies on the impact of exercise training in low-temperature environments on immune regulation and infection defense,and to evaluate the quality of the studies.The 25 included literature indicated that moderate-intensity exercise training in low-temperature environments could cause an increase in white blood cell count,neutrophils and natural killer cells,changes in both pro-inflammatory and anti-inflammatory factors,and predominant upregulation of most mucosal immunity level,as well as accelerated infection recovery in several studies.High-intensity exercise training in low-temperature environments has shown an immunosuppressive trend in individual studies,and physiological indicators such as body temperature,heart rate and metabolism have also been affected to varying degrees.This suggests that moderate-intensity exercise training in a low-temperature environment is conducive to enhancing immunity and preventing infection,which is of great significance for health management and occupational protection in cold climates.Reasonable control of exercise intensity and duration in a low-temperature environment is crucial for preventing immunosuppression.

Abstract:Objective To analyze the effect of serum lactate dehydrogenase(LDH)and β2-microglobulin(β2-MG)on therapeutic efficacy of the first-line chemotherapy regimen for Waldenström Macroglobulinemia(WM).Methods Data were collected from 113 WM patients admitted from March 2019 to February 2024.All patients completed the established first-line chemotherapy regimen and were divided into the response group(n=85)and the non-response group(n=28).The general data between the two groups were compared,with a focus on analyzing the risk factors for non-response to first-line chemotherapy in WM patients and evaluating the predictive value of serum LDH and β2-MG for the efficacy of first-line chemotherapy.Result The non-responsive group had a higher risk of prognosis based on International Prognostic Scoring System(IPSS),a higher rate of MYD88 L265P mutation,higher TP53 deletion/mutation ratio,and higher proportion of bone marrow lymphoplasmacytic cells,as well as higher serum LDH and β2-MG expression than the response group(P＜0.01).Multivariate logistic regression analysis revealed that risk factors for non-response to first-line chemotherapy in WM patients included a high-risk prognosis based on IPSS,an increased proportion of bone marrow lymphoplasmacytic cells,and higher rate of MYD88 L265P mutation and TP53 deletion/mutation,as well as elevated serum LDH and β2-MG levels(P＜0.05).The area under the curve of serum LDH and β2-MG for predicting the risk of non-response to first-line chemotherapy in WM patients was 0.796 and 0.783 respectively.Through interaction analysis,serum LDH and β2-MG had a positive interaction effect on non-response to chemotherapy in WM patients.Conclusion The non-response to first-line chemotherapy in WM patients is related to abnormal increase in serum LDH and β2-MG.Pre-chemotherapy detection of LDH and β2-MG level has certain predictive value for the risk of non-response to chemotherapy,and the simultaneous increase of both may lead to a higher risk of non-response to chemotherapy.