Abstract:Objective To analyze the relationships between serum levels of mucosa-associated lymphoid tissue lym-phoma translocation protein 1(MALT1)and soluble cluster of differentiation 146(sCD146)and the severity of acute exac-erbation of chronic obstructive pulmonary disease(AECOPD)as well as the occurrence of pulmonary embolism(PE).Methods A total of 120 AECOPD patients were included as the AECOPD group,and 120 patients with stable COPD(SCOPD)during the same period were included as the SCOPD group.Serum MALT1 and sCD146 levels were measured using enzyme-linked immunosorbent assay.Based on disease severity,AECOPD patients were divided into mild,moder-ate,and severe AECOPD subgroups.Spearman correlation analysis was used to examine the association between serum MALT1 and sCD146 levels and disease severity in AECOPD patients.Patients were further categorized into PE and non-PE groups based on the occurrence of PE after admission.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive performance of serum MALT1 and sCD146 levels for PE in AECOPD patients.Results Com-pared with the SCOPD group,the serum MALT1 level increased and the sCD146 level decreased in the AECOPD group(both P<0.05).The levels of serum MALT1 and sCD146 in the mild AECOPD group were 2.11(1.51,2.77)ng/mL and 48.29(43.23,55.17)ng/mL,respectively.The levels of serum MALT1 and sCD146 in the moderate AECOPD group were 3.88(3.21,4.67)ng/mL and 36.05(31.86,39.50)ng/mL,respectively.The levels of serum MALT1 and sCD146 in the severe AECOPD group were 5.44(5.00,5.98)ng/mL and 25.47(24.39,27.11)ng/mL,respectively.There were significant differences between groups(all P<0.05).The level of serum MALT1 in AECOPD patients was posi-tively correlated with the severity of the disease,and the level of sCD146 was negatively correlated with the severity of the disease(r=0.749,-0.777,both P<0.05).Compared with the non-PE group,serum MALT1 level increased and sCD146 level decreased in the PE group(both P<0.05).The area under the curve of serum MALT1 level in predicting PE in AE-COPD patients was 0.780(95%CI:0.695-0.851).The sensitivity and specificity of serum MALT1 level in predicting PE in AECOPD patients were 0.616 and 0.809,respectively.The area under the curve of serum sCD146 level in predicting PE in AECOPD patients was 0.787(95%CI:0.703-0.857),and the sensitivity and specificity in predicting PE in AECO-PD patients were 0.849 and 0.617,respectively.The area under the curve of serum MALT1 combined with sCD146 in pre-dicting PE in AECOPD patients was 0.867(95%CI:0.793-0.922);the sensitivity and specificity of serum MALT1 com-bined with sCD146 in predicting PE in AECOPD patients were 0.849 and 0.787,respectively.Conclusions Serum MALT1 level increases and sCD146 level decreases in patients with AECOPD,which is related to the severity of the dis-ease.The detection of serum MALT1 and sCD146 levels is helpful for the prediction of AECOPD complicated with PE.

Abstract:Objective To compare the rational use of perioperative antibiotics in general surgery patients undergoing class Ⅰ incisions before and after the in-depth involvement of clinical pharmacists in refined management.Methods A total of 351 antibiotic use records from patients undergoing class I incision general surgery were included,comprising 99 cases before management(May to October 2022),122 cases in the first year after management(May to October 2023),and 130 cases in the second year after management(May to October 2024).A refined management model based on a pre-prescription review system was applied,in which clinical pharmacists performed pre-prescription review according to class I incision antibiotic use rules,combined with real-time intervention,post-prescription evaluation,periodic assessment,and training.The rationality of perioperative antibiotic use before and after management was compared.Results In the first year after management,the rates of rational use regarding antibiotic indication,drug selection,timing of administra-tion,treatment duration,and dosage improved from 29.29%,66.67%,46.46%,67.68%,and 75.76%before manage-ment to 82.79%,86.07%,81.15%,90.98%,and 89.34%,respectively,with statistically significant differences(all P<0.01).In the second year after management,these rates further increased to 90.77%,91.54%,88.46%,95.38%,and 99.23%,all differences reaching statistical significance(all P<0.01).No significant difference was observed in the rationality of repeated medication use before and after treatment(P>0.05).Compared with pre-management,the use of in-appropriate antibiotics,including quinolones,third-generation cephalosporins,penicillins,and nitroimidazoles,de-creased after management,with quinolones showing the most marked reduction(all P<0.05).Conclusion The in-depth involvement of clinical pharmacists in refined management significantly improved perioperative antibiotic use in general surgery patients with class Ⅰ incisions,reduced inappropriate prescriptions,and ensured safe and rational medi-cation.

Abstract:Objective To analyze the influencing factors for 90-day survival in patients with hepatitis B virus-relat-ed acute-on-chronic liver failure(HBV-ACLF)and to construct a prediction model.Methods A total of 370 HBV-ACLF patients were divided into two groups based on their 90-day survival status:284 survivors and 86 non-survivors.Clinical and laboratory data of the patients were collected,including age,gender,white blood cell count(WBC),neutro-phil count,lymphocyte count,prothrombin activity(PTA),activated partial thromboplastin time(APTT),α-L-fucosi-dase(AFU),albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),direct bilirubin(DBIL),creatinine(Cr),serum sodium(Na),triglycerides(TG),cystatin C(CysC),concur-rent hepatic encephalopathy,and concurrent ascites.Univariate and multivariate Logistic regression analyses were used to identify the independent influencing factors for 90-day survival in HBV-ACLF patients.SPSS 27.0 statistical software was used to construct the prediction model for 90-day survival in HBV-ACLF patients.The area under the receiver operating characteristic(ROC)curve(AUC)was used to compare the predictive performance of the new model with that of classical prediction models,including the Model for End-Stage Liver Disease(MELD)score,MELD-Na score,and MELD 3.0 score.The Hosmer-Lemeshow test was applied to evaluate the goodness of fit of each prediction model,and the Brier score was used to comprehensively assess the accuracy of each model.Results Age,DBIL,and PTA were identified as inde-pendent influencing factors for 90-day survival in HBV-ACLF patients(all P<0.05).The constructed prediction model for 90-day survival in HBV-ACLF patients was defined as:PI=0.062×age(years)+0.004×DBIL(μmol/L)-0.055×PTA(s)-0.239.Compared with the classical prediction models,the new model exhibited the highest AUC and Hosmer-Lemeshow test P-value,as well as the lowest Brier score.Conclusions Age,DBIL and PTA are independent influenc-ing factors for 90-day survival in HBV-ACLF patients.A prediction model for 90-day survival in HBV-ACLF patients is successfully constructed,and this new model shows better predictive performance than the classical models.

Abstract:Objective To analyze the relationship between the modified Nutrition Risk in the Critically Ill(mNU-TRIC)score and the risk of 28-day mortality after ICU admission in patients with sepsis.Methods A total of 1,051 ICU patients with a diagnosis of sepsis from the Medical Information Mart for Intensive Care Ⅳ(MIMIC-Ⅳ)database(2009-2022)were selected.These patients were admitted to the ICU for the first time and were divided into the survival group(n=862)and non-survival group(n=189)based on 28-day mortality.Covariates previously indicated to be associated with sep-sis mortality were extracted,including demographic variables,comorbidities,disease severity scores,therapeutic inter-ventions,and laboratory results.The mNUTRIC score was calculated for both groups.Variables showing statistically sig-nificant differences in univariate analysis were treated as confounders and included in a multivariate Logistic regression model to analyze the association between the mNUTRIC score and 28-day mortality after adjusting for these confounders.A restricted cubic splines(RCS)model was used to analyze the relationship between the mNUTRIC score and the risk of 28-day mortality.A piecewise Logistic regression model was employed for breakpoint analysis to identify the risk threshold,examining the threshold effect of the mNUTRIC score on 28-day mortality risk.Results The mNUTRIC score was signifi-cantly higher in the non-survival group(5.01±1.85)than in the survival group(3.91±1.96)(P<0.05).The non-sur-vival group had significantly higher age,Sequential Organ Failure Assessment(SOFA)score,Acute Physiology Score Ⅲ(APS Ⅲ),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,white blood cell count,neutrophil count,anion gap,lactate,aspartate aminotransferase,creatinine,blood urea nitrogen,and proportions of hypertension and myocardial infarction(all P<0.05).Conversely,albumin level,lymphocyte count,total cholesterol,hemoglobin,red blood cell count,and proportions of malignancies,chronic bronchitis,coronary heart disease,and chronic obstructive pulmonary disease were significantly lower in the non-survival group(all P<0.05).The mNUTRIC score showed a positive correlation with the risk of 28-day mortality after ICU admission[OR(95％CI)=1.26(1.13-1.39),P<0.05].The re-lationship between the mNUTRIC score and the risk of 28-day mortality exhibited an S-shaped nonlinear pattern(P<0.05).The risk threshold for the mNUTRIC score regarding 28-day mortality risk was 5.86.When the mNUTRIC score was≤5.86,each 1-point increase in the score was associated with a 40％increase in the risk of 28-day mortality.When the mNUTRIC score was>5.86,each 1-point increase was associated with a 4％increase in the risk of 28-day mortality.Conclusions The mNUTRIC score is positively and nonlinearly associated with the risk of 28-day mortality after ICU ad-mission in patients with sepsis,demonstrating an S-shaped curve.The risk threshold for the mNUTRIC score is 5.86.The mortality risk increases steeply when the score is below or equal to this threshold,while the increase in mortality risk is more gradual when the score exceeds it.

Abstract:Objective To analyze research hotspots and development trends in the application of machine learning(ML)in the field of atrial fibrillation(AF).Methods Literature related to ML in AF from January 1,2014,to Decem-ber 31,2024,was retrieved from the Web of Science database.A total of 880 publications were finally included,compris-ing 779 articles and 101 reviews.CiteSpace software(version 6.4.R1)was used to perform cluster analysis on these 880 publications,and we examined the characteristics including publication volume,contributing countries/institutions/au-thors,cited authors/journals/articles,as well as keyword co-occurrence,clustering,and burst detection.Results The r² of the publication growth regression curve was 0.9563,indicating an exponential increase in ML-related AF literature.Publications were relatively scarce from 2014 to 2017,followed by explosive growth after 2018,with 2024 having the high-est output.China,the USA,and the UK were the top three contributing countries.The top five contributing institutions were University of London,Harvard University,Mayo Clinic,University of Liverpool,and Liverpool Heart and Chest Hos-pital.Gregory Y.H.Lip(University of Liverpool)was the most prolific author,while Gerhard Hindricks was the most fre-quently cited author.Frontiers in Cardiovascular Medicine published the most articles,Circulation was the most cited jour-nal,and Cardiovascular Research had the highest centrality.Among the top 10 cited references,three were from the USA,two from Germany,and one each from Denmark,China,the UK,Canada,and Greece.Excluding two AF guidelines,the remaining eight research articles all utilized deep learning models.The top five highest-frequency keywords were atrial fi-brillation,machine learning,risk,artificial intelligence,and catheter ablation.Keyword clustering yielded seven clus-ters,primarily focusing on four aspects:machine learning methodologies,data sources,risk assessment,and clinical deci-sion-making.The keyword with the strongest and longest burst intensity was"arrhythmia",while bursts for"risk predic-tion"and"expression"persisted from their onset to the present.Conclusions Research interest in applying ML to AF is increasing annually.Current hotspots concentrate on deep learning models,electrocardiogram and imaging feature analy-sis,and disease prediction/identification.Future research is likely to focus on key areas such as genetic prediction of AF,patient risk prediction,and prognosis following catheter ablation.

Abstract:Objective To analyze the population change trend,population characteristics and blood sample test re-sults of voluntary blood donors aged 56-60 year in Jinan region,to clarify their blood donation potential and blood safety,and to provide data support for optimizing recruitment strategies and supplementing blood supply.Methods A total of 5,796 voluntary blood donors aged 56-60 years who donated blood voluntarily at Jinan Blood Supply and Security Center from July 1,2012 to June 30,2024 were selected as the research subjects.Data including the total number of voluntary blood donors,the number and frequency of blood donors aged 56-60,and their proportions relative to the total number and fre-quency of voluntary blood donors during the same period were collected to reflect the population change trend.Meanwhile,demographic characteristics such as gender,educational level and occupation,as well as the disqualification rate of blood sample tests were also gathered.Results From July 2012 to June 2024,the number,frequency and corresponding pro-portions of voluntary blood donors aged 56-60 years in Jinan region showed an overall upward trend.Specifically,the pro-portion of the number of donors aged 56-60 years increased from 0.54%in the period of July 2012-June 2013 to 1.54%in July 2023-June 2024,and the proportion of donation frequency of this age group rose from 0.58%to 2.12%during the same time frame.Among these donors,the proportion of males was higher than that of females.In terms of educational composition,those with primary school education accounted for the lowest proportion,while the proportions of those with junior high school,senior high school or technical secondary school,and college education or above were relatively bal-anced.Regarding occupation distribution,the proportion of other occupations was the highest;farmers and workers consti-tuted the core occupational groups,while public servants,company employees and medical staff accounted for relatively low proportions.A total of 46 cases of blood samples were disqualified,with an overall disqualification rate of 7.94%.Among the disqualification causes,the disqualification rate of alanine aminotransferase(ALT)was 3.45%,that of hepati-tis B virus(HBV)1.55%,that of hepatitis C virus(HCV)0.86%,that of treponema pallidum(TP)2.76%,and that of human immunodeficiency virus(HIV)0%.Conclusion From July 2012 to June 2024,the scale of voluntary blood do-nors aged 56-60 years in Jinan region expanded steadily with stable population characteristics and high blood safety,indi-cating a strong potential to serve as a supplementary source of blood supply.

Abstract:Objective To observe the application effectiveness of manual extrusion of fat granules for thinning bulky flaps(subcutaneous fat thickness≥2 cm)in hand and foot reconstruction,providing a safe and effective method for prima-ry flap thinning during reconstruction.Methods Fourteen patients undergoing free flap transplantation for hand and foot reconstruction were included.Intraoperatively,the harvested free flaps all had a subcutaneous fat thickness≥2 cm and were subjected to primary thinning using the manual fat granule extrusion method.The specific procedures:first,the free flap was harvested on the deep fascia,followed by radial incisions in the superficial fascia around the perforators;then,ei-ther before or after pedicle division,the flap was manually squeezed to extrude fat granules,thinning the flap to a subcuta-neous fat thickness≤0.5 cm.The time required for the flap thinning procedure,the subcutaneous fat thickness after thin-ning,intraoperative intractable vascular spasm,as well as vascular crisis and skin ecchymosis within 7 days postopera-tively were observed and recorded.Flap survival was followed up in the outpatient clinic within 1 month postoperatively.Results In all 14 patients,thinning of the bulky flap was completed within 20 minutes.After thinning,the subcutane-ous fat thickness was≤0.5 cm in all cases,and no major vascular branches were sacrificed during the manual extrusion of fat granules.No cases of intractable vascular spasm occurred intraoperatively.Within 7 days postoperatively,there were no complications such as vascular crisis,partial necrosis,or ecchymosis.At the 1-month follow-up,all flaps survived.Conclusion In the hand and foot reconstruction,the manual extrusion of fat granules for thinning bulky flaps is a safe and effective method for primary flap thinning.

Abstract:Objective To synthesize and verify a matrix metalloproteinase-9(MMP9)-targeting peptide for lung squamous cell carcinoma,aiming to develop a novel MMP9-targeting peptide.Methods The crystal structures of MMP9 and its ligand were obtained from the Protein Data Bank(PDB)and optimized using Molecular Operating Environment soft-ware.Molecular docking was performed to identify interaction sites between MMP9 and its ligand.Key residues(Tyr49,Ser50,and Asn55)were confirmed using the London dG scoring function(S score).A template peptide was selected and mutated,followed by protein-protein docking to screen six candidate peptides with the lowest S scores.After synthetic fea-sibility assessment,three candidate peptides were selected for synthesis along with the template peptide.The purity and structure of the four synthesized peptides were characterized by high-performance liquid chromatography(HPLC).Human lung squamous cell carcinoma cells(NCI-H226)were divided into five groups:SP-template peptide group,SP-1 peptide group,SP-2 peptide group,SP-3 peptide group,and control group(treated with MMP9 antibody and fluorescent pep-tide).Fluorescence images were acquired,and fluorescence intensity was analyzed using ImageJ software to evaluate the affinity of the candidate peptides for NCI-H226 cells.Results Four target peptides were successfully synthesized,with their structures validated by mass spectrometry and purity levels exceeding 95%.The fluorescence intensities of the SP-template peptide group,SP-1 peptide group,SP-2 peptide group,SP-3 peptide group,and control group were 1.48±0.15,1.14±0.12,1.85±0.07,0.68±0.20,and 1.00±0.13,respectively,with the SP-2 peptide group exhibiting significantly higher fluorescence intensity than all other groups(all P<0.05).Conclusions The novel MMP9-targeting peptide SP-2 was successfully synthesized.The synthesized peptide was verified to have the correct structure and high puri-ty,and it demonstrated high binding affinity toward human lung squamous cell carcinoma cells.

Abstract:Objective To investigate the relationships between serum levels of lactate dehydrogenase(LDH),inter-leukin-1β(IL-1β),IL-6,IL-8 and clinical characteristics in patients with small cell lung cancer(SCLC).Methods For-ty-two newly diagnosed SCLC patients unsuitable for surgical treatment were prospectively enrolled.The serum LDH level was measured using an automatic biochemical analyzer.Serum levels of IL-1β,IL-6,and IL-8 were determined by en-zyme-linked immunosorbent assay(ELISA).The relationships between these serum markers and clinical characteristics(age,gender,disease stage,smoking history,sites and number of metastases)were analyzed.Results Serum LDH lev-els were significantly higher in patients aged≥60 years,those with extensive-stage disease,those with liver metastases,and those with lymph node metastases than in patients aged<60 years,those with limited-stage disease,those without liver metastases,and those without lymph node metastases,respectively(all P<0.05).A positive correlation was observed be-tween the serum LDH level and the number of metastatic sites(r=0.468,P=0.002).Female patients exhibited signifi-cantly higher serum IL-1β levels than male patients(P<0.05).The serum IL-6 level was significantly higher in patients with extensive-stage disease than in those with limited-stage disease(P<0.05).No statistically significant difference was found in serum IL-8 levels among patients of different clinical characteristics(P>0.05).No significant differences were found in serum IL-1β,IL-6,or IL-8 levels among patients with different serum LDH levels.Similarly,no significant dif-ference was found in serum LDH level among patients with different serum levels of IL-1β,IL-6,and IL-8(all P>0.05).Conclusions The serum LDH levels increase in patients with extensive disease,liver metastasis,and lymph node metas-tasis,and rise with the increase of metastatic sites.The serum IL-6 level is elevated in patients with extensive disease,and the serum IL-1β level varies among patients of different genders.These indicators can reflect the disease progression of SCLC and provide certain references for disease assessment.

Abstract:Objective To explore the diagnostic efficacy of serum Caveolin-1(Cav-1)and soluble hemoglobin scav-enger receptor(sCD163)levels in children with Mycoplasma pneumoniae pneumonia(MPP)complicated with bacterial in-fection.Methods Totally 105 children with MPP were divided into the bacterial infection group of 30 cases and non-bac-terial infection group of 75 cases based on the sputum culture results of the children.Enzyme linked immunosorbent assay was used to detect serum Cav-1 and sCD163 in the pediatric patients of the two groups.The receiver operating characteris-tic(ROC)curve was used to evaluate the predictive value of serum Cav-1 and sCD163 levels for bacterial infection in MPP children.Results The serum levels of Cav-1 and sCD163 in the bacterial infection group were(6.67±1.26)μg/L and(156.69±18.94)pg/mL,respectively.The serum levels of Cav-1 and sCD163 in the non-bacterial infection group were(8.52±1.39)μg/L and(134.78±14.66)pg/mL,respectively;there were significant differences between these two groups(both P<0.05).The area under the curve for diagnosing MPP with bacterial infection using serum Cav-1 level was 0.808(95%CI:0.722-0.895).When the cut-off value was 8.16 μg/L,the sensitivity and specificity for diagnosing MPP with bacterial infection were 90.00%and 62.70%,respectively;the area under the curve for diagnosing MPP with bacterial infection using serum sCD163 level was 0.785(95%CI:0.684-0.885).When the cut-off value was 144.16 pg/mL,the sensitivity and specificity for diagnosing MPP with bacterial infection were 66.70%and 85.30%,respectively.The area under the curve of serum Cav-1 combined with sCD163 levels for diagnosing MPP with bacterial infection was 0.904(95%CI:0.849-0.958),with a sensitivity of 93.33%and specificity of 80.00%for the diagnosis of MPP with bacterial infection.Conclusions The serum Cav-1 level decreases and the sCD163 level increases in children with MPP complicated with bacterial infection.The combined detection of the two has a higher diagnostic efficacy for children with MPP combined with bacterial infection.

Abstract:Objective To observe the effect of early growth response factor 1(EGR1)on the expression of cupropto-sis-related genes in THP-1-derived foam cells and to explore its underlying mechanism.Methods The human monocyte cell line THP-1 was first differentiated into THP-1-derived macrophages using phorbol ester(PMA),followed by treatment with oxidized low-density lipoprotein(ox-LDL)to induce differentiation into THP-1-derived foam cells.Cell morphology was observed after Oil Red O staining.RT-qPCR was used to detect the mRNA expression of autophagy markers[microtu-bule-associated protein 1 light chain 3(LC3)and p62]and cuproptosis-related genes[ferredoxin 1(FDX1)and dihydroli-poamide S-acetyltransferase(DLAT)]in THP-1-derived macrophages(control group),THP-1-derived foam cells(model group),THP-1-derived foam cells transfected with the EGR1 overexpression plasmid LV-OE-EGR1(overexpression group),THP-1-derived foam cells transfected with the EGR1 knockdown plasmid si-EGR1(knockdown group),and THP-1-derived foam cells transfected with si-EGR1 and treated with the autophagy inhibitor chloroquine(CQ)(knockdown+autophagy inhibition group).Western blotting was performed to detect the protein levels of autophagy markers and cupro-ptosis-related proteins in the respective groups.Results Under microscopic examination,red or orange lipid droplets were observed in the cytoplasm,indicating successful construction of the THP-1-derived foam cell model.Compared with the control group,the model group showed increased relative expression levels of LC3 mRNA and protein(all P<0.05),while the relative expression levels of p62,FDX1,and DLAT mRNA and protein decreased(all P<0.05).Compared with the model group,the overexpression group exhibited decreased relative expression levels of LC3 mRNA and protein(all P<0.05)and increased relative expression levels of p62,FDX1,and DLAT mRNA and protein(all P<0.05).In contrast,the knockdown group showed increased relative expression levels of LC3 mRNA and protein(all P<0.05)and decreased relative expression levels of p62,FDX1,and DLAT mRNA and protein(all P<0.05).Compared with the knockdown group,the knockdown+autophagy inhibition group demonstrated decreased relative expression levels of LC3 mRNA and protein(all P<0.05)and increased relative expression levels of p62,FDX1,and DLAT mRNA and protein(all P<0.05).Conclusion EGR1 can regulate the expression of cuproptosis-related genes FDX1 and DLAT in THP-1-derived foam cells through the autophagy pathway.

Abstract:Objective To analyze the prognostic factors of primary extranodal diffuse large B-cell lymphoma(PE-DLBCL).Methods Totally 151 patients with PE-DLBCL who received first-line systemic treatment were retrospectively selected.The clinical data,including age,gender,clinical stage,presence of systemic B symptoms,Eastern Cooperative Oncology Group(ECOG)performance status,the number of extranodal sites involved,primary site,International Prognos-tic Index(IPI)score,hemoglobin(HGB)level,serum albumin(ALB)level,lactate dehydrogenase(LDH)level,β2-mi-croglobulin(β2-MG)level,Ki-67 index,cell-of-origin subtype,double-expressor lymphoma(DEL)phenotype,treatment regimens,and clinical outcomes were collected.Patients were followed up.Based on survival status,the Kaplan-Meier method was used to plot survival curves and we calculated the 3-year overall survival(OS)rate and progression-free surviv-al(PFS)rate.Univariate analysis was performed using the Log-Rank test,and multivariate analysis was conducted using the Cox proportional hazards model.Results Among the 151 patients,97 survived,39 died,and 15 were not evaluable for disease status due to lack of systematic examination.The 3-year PFS rate was(66.9±4.6)%,and the 3-year OS rate was(74.2±4.5)%.Univariate analysis showed that factors significantly associated with the 3-year PFS rate included age>60 years,bone marrow involvement,primary site in the gastrointestinal tract,primary central nervous system(CNS)lymphoma,IPI score>2,HGB<110 g/L,elevated LDH,non-germinal center B-cell-like(non-GCB)subtype,DEL phenotype,and failure to achieve complete remission(CR)after 4 treatment cycles(all P<0.05).Factors significantly as-sociated with the 3-year OS rate included age>60 years,involvement of≥2 extranodal sites,bone marrow involvement,primary site in the gastrointestinal tract,primary CNS lymphoma,IPI score>2,HGB<110 g/L,non-GCB subtype,DEL phenotype,and failure to achieve CR after 4 treatment cycles(all P<0.05).Multivariate analysis indicated that bone mar-row involvement and primary CNS lymphoma were independent risk factors for the 3-year PFS rate(both P<0.05).Mean-while,primary CNS lymphoma,HGB<110 g/L,non-GCB subtype,and DEL phenotype were independent risk factors for the 3-year OS rate(all P<0.05).Conclusions Bone marrow involvement,primary CNS lymphoma,HGB<110 g/L,non-GCB subtype,and DEL phenotype,etc.are significant prognostic factors in patients with PE-DLBCL,and they can serve as reference indicators for prognostic evaluation.

Abstract:Transcoronary pacing(TCP)has evolved over nearly four decades from a simple intraoperative emergency support technique into a therapeutic modality that integrates precise treatment with electrophysiological assessment.Early TCP relied on conventional coronary guidewires,resulting in unstable pacing thresholds and limited application scenarios.With advancements such as insulated guidewire structural modifications and the introduction of operational strategies like the"dual-wire"technique,its pacing efficacy and controllability have significantly improved,facilitating a shift from"pas-sive rescue"to"active intervention".TCP has also demonstrated unique advantages in diverse areas,ranging from myocar-dial viability assessment and precision guidance for cardiac resynchronization therapy to pacing support for complex percu-taneous coronary intervention(PCI),as well as in cross-disciplinary fields such as neurointervention and cardio-oncology.Concurrently,the progress made in the cross-disciplinary research of TCP and materials science,artificial intelligence,and interventional electrophysiology has established a tripartite development framework for TCP:structural optimization-functional expansion-intelligent enhancement.This framework highlights its potential in fields like myocardial repair and multimodal mapping.Overall,TCP is transitioning from a mere"tool"to a versatile"platform",poised to play an increas-ingly important role in panvascular disease management and interventional cardiology.

Abstract:Objective To evaluate the predictive value of the systemic immune-inflammation index(SII),N-termi-nal pro-brain natriuretic peptide(NT-proBNP),and left ventricular ejection fraction(LVEF)for major adverse cardiovas-cular events(MACE)in patients with heart failure with reduced ejection fraction(HFrEF).Methods A total of 210 HFrEF patients were included and divided into the MACE group(67 cases)and non-MACE group(143 cases)based on the occurrence of MACE during follow-up.General data from both groups were collected and balanced using propensity score matching(PSM),resulting in 58 matched pairs(58 cases in the MACE group and 58 in the non-MACE group)for subsequent analysis.Clinical data,including fasting blood glucose,hemoglobin,SII,troponin,NT-proBNP,serum creat-inine,blood urea nitrogen,and LVEF,were collected and compared between the two groups after PSM.Multivariate Cox regression analysis was used to identify factors influencing MACE in HFrEF patients,and receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive performance of these factors.Results After PSM,the MACE group had significantly higher levels of SII,troponin,and NT-proBNP,and a lower level of LVEF than the non-MACE group(all P<0.05).Multivariate Cox regression analysis indicated that SII,NT-proBNP,and LVEF were indepen-dent predictors of MACE in HFrEF patients(all P<0.05).The area under the ROC curve(AUC)for SII in predicting MACE was 0.829,with a sensitivity of 0.881 and specificity of 0.811.The AUC for NT-proBNP was 0.780,with a sensi-tivity of 0.776 and specificity of 0.804.The AUC for LVEF was 0.782,with a sensitivity of 0.821 and specificity of 0.811.The combined prediction model of SII,NT-proBNP,and LVEF achieved an AUC of 0.902,with a sensitivity of 0.970 and specificity of 0.783.Conclusions SII,NT-proBNP,and LVEF are independent predictors of MACE in HFrEF patients.The combination of these three markers demonstrates high predictive efficacy for MACE in this patient population.

Abstract:Stress urinary incontinence(SUI)is a common pelvic floor dysfunction in women,severely affecting quali-ty of life.While conventional therapies provide symptomatic relief,they often fail to repair the underlying damage to the urethral sphincter and pelvic support structures.With advances in regenerative medicine,bone marrow-derived mesenchy-mal stem cells(BMSCs)and their secreted exosomes have emerged as a promising therapeutic direction for SUI,owing to their abilities to promote tissue regeneration,improve pelvic support,and modulate the inflammatory microenvironment.Evidence indicates that BMSCs facilitate repair through differentiation and paracrine actions,and their efficacy can be fur-ther enhanced via engineering strategies like genetic modification or biomaterial combination.Exosomes derived from BM-SCs serve as a potent cell-free therapy,regulating inflammation and improving tissue elasticity.Preconditioning BMSCs(e.g.,under hypoxia or with inflammatory factors)can significantly alter exosomal composition and bioactivity,boosting their anti-inflammatory,anti-fibrotic,and regenerative potential.Despite promising progress,clinical translation faces challenges related to cell sourcing,delivery methods,engraftment efficiency,safety,quality control,and ethical issues,warranting further systematic investigation to provide theoretical basis and practical reference for the treatment of female SUI.

Abstract:Atherosclerosis(AS)is a chronic inflammatory vascular disease and also the core pathological basis of most cardiovascular diseases.Endothelial cells,as a single layer of cells in the inner lining of blood vessels,play a prima-ry barrier role in maintaining the integrity of the vascular endothelium,regulating vascular tension,anti-inflammation,and anti-thrombosis,etc.Therefore,endothelial dysfunction is a key factor in the initiation of AS.Research indicates that en-dothelial dysfunction,which leads to the onset and progression of AS,is promoted by factors as oxidative stress,inflamma-tory responses,programmed cell death and cellular senescence.The active ingredients of traditional Chinese medicine ex-hibit multi-target therapeutic potential against AS.Phenethyl alcohol glycosides,saponins,flavonoids,and alkaloids from traditional Chinese medicine exert effects against AS through multiple pathways and mechanisms.These include antioxi-dant and anti-inflammatory activities,inhibition of endothelial cell apoptosis and pyroptosis,and improvement of endotheli-al barrier function.This review provides traditional Chinese medicine as a promising therapeutic strategy for AS.

Abstract:Atherosclerosis(AS)is one of the important factors causing cardiovascular diseases,and its incidence rate has been continuously rising with population aging and changes in lifestyles.Honghua(carthamus tinctorius)is a tradition-al Chinese medicine with the efficacy of promoting blood circulation and removing blood stasis.It contains a variety of ac-tive ingredients that can exert anti-AS effects through multiple targets and pathways.Studies have shown that ingredients such as safflower yellow,hydroxy-safflower yellow A,kaempferol,quercetin,and safflower polysaccharides can interfere with the development and progression of AS through various mechanisms,including regulating lipid metabolism,inhibiting inflammatory responses,resisting oxidative stress,suppressing the proliferation and migration of vascular smooth muscle cells,inhibiting the apoptosis of vascular endothelial cells,anti-aging,and reducing platelet aggregation.In addition,as a multi-component medicinal material,Honghua may exhibit synergistic effects among its different active components,which jointly enhance the overall anti-AS effect.A systematic review of the anti-AS mechanism of Honghua is helpful to provide a reference basis for its further clinical transformation and application.

Abstract:Ovarian granulosa cells(GCs)are important"mediators"that influence follicular development and play a crucial role in maintaining oocyte growth,hormone secretion,and the homeostasis of the ovarian microenvironment.Fer-roptosis is a novel form of programmed cell death characterized by iron-dependent lipid peroxidation,and it plays an impor-tant role in GC injury and ovarian aging.Ferroptosis of GCs can lead to poor follicular development,thereby reducing oo-cyte quality and ultimately causing diminished ovarian reserve(DOR).Studies have shown that iron metabolism imbal-ance,abnormal lipid peroxidation,dysfunction of the antioxidant defense system,and dysregulation of non-coding RNA(ncRNA)can all induce GC ferroptosis and accelerate the development and progression of DOR.Therefore,inhibiting fer-roptosis by regulating iron metabolism,lipid metabolism,and the antioxidant system in GCs may serve as an effective inter-vention strategy to delay or reverse DOR.This provides a theoretical basis for further exploring the molecular mechanisms of DOR and offers potential directions for developing targeted interventions and novel therapeutic approaches.

Abstract:Objective To observe the clinical efficacy and safety of benralizumab in the treatment of severe eosino-philic asthma(SEA).Methods Ten SEA patients were enrolled and treated with benralizumab combined with back-ground medication for 4 courses.The forced expiratory volume in one second(FEV1),blood eosinophil count(BEC),asthma control questionnaire-5(ACQ-5)score,fractional exhaled nitric oxide at 50 mL/s(FeNO50),the incidence of asth-ma exacerbations and adverse drug reactions were observed and compared before benralizumab treatment(V1)and at week 16 of benralizumab treatment(V5).Results At V1,the FEV1,BEC,ACQ-5 score and FeNO50 of the 10 SEA patients were 1.70(1.27,2.23)L,0.8(0.62,1.32)×10⁹/L,1.35(0.80,2.45)points and 31.00(26.00,58.25)μg/L,respectively;at V5,the corresponding indexes were 1.89(1.45,2.86)L,0,0.50(0.15,1.20)points and 35.00(18.25,58.50)μg/L,respectively.Compared with V1,the FEV1 at V5 was significantly higher(P<0.05),while the BEC and ACQ-5 score were significantly lower(both P<0.05).Among the 10 patients,1 case experienced an asthma ex-acerbation during treatment,which was associated with influenza A infection,and the symptoms resolved after symptomat-ic treatment.Four patients developed chills and fever on the night of the first medication administration,and the symptoms resolved spontaneously after 2-4 hours without severe allergic reactions,headache,aggravated nasopharyngitis or other ad-verse events.Conclusions Benralizumab combined with background medication achieves favorable efficacy in the treat-ment of SEA.It can effectively reduce BEC,improve lung function and stably control asthma symptoms,with mild adverse reactions in patients.

Abstract:Objective To construct a prediction model for poor grognosis of children with refractory Mycoplasma pneumoniae pneumonia(RMPP)based on serum levels of serum amyloid A to C-reactive protein ratio(SAA/CRP)and ret-inol-binding protein(RBP).Methods A total of 198 children with RMPP were enrolled,and their serum levels of SAA/CRP and RBP were measured.Based on the prognosis at 28 days after admission,the children were divided into the poor prognosis group and good prognosis group.Relevant clinical data were collected.Multivariate Logistic regression analysis was used to identify factors influencing poor prognosis and to construct a prediction model.The receiver operating charac-teristic(ROC)curve analysis was employed to evaluate the predictive value of individual indicators and the prediction mod-el for poor prognosis in RMPP children.Internal validation was performed using the Bootstrap method.Results At 28 days after admission,the incidence of poor prognosis among the 198 RMPP children was 30.30%(60/198).Compared with the good prognosis group,the poor prognosis group had a higher proportion of severe cases,longer duration of fever and oxygen therapy,elevated serum SAA/CRP levels,and decreased RBP levels(all P<0.05).Multivariate regression analysis revealed that the duration of fever,severe RMPP,long duration of oxygen therapy,and high SAA/CRP were inde-pendent risk factors for poor prognosis in RMPP children,while high RBP was an independent protective factor(all P<0.05).Based on these independent factors,a prediction model was constructed,and the regression equation was:Logit(P)=-10.707+0.347×duration of fever+1.811×disease severity+0.765×duration of oxygen therapy+1.085×SAA/CRP-0.258×RBP.The area under the ROC curve(AUC)for the model was 0.920,which was higher than the AUCs for duration of fever(0.674),disease severity(0.696),duration of oxygen therapy(0.682),SAA/CRP(0.755),and RBP(0.747)alone(all P<0.05).The Hosmer-Lemeshow test showed χ²=6.320,P=0.611,indicat-ing good model fit.Internal validation using 1000 Bootstrap resamples showed that the prediction model had a C-index of 0.920,indicating high discrimination and stability.Conclusions Elevated serum SAA/CRP levels and decreased RBP levels are associated with poor prognosis in children with RMPP.The prediction model developed based on these factors demonstrates high predictive efficacy.