Abstract:Objective To study the safety and efficacy of ultrasound-guided superior laryngeal nerve block(SLNB)in endotracheal intubation with preserved spontaneous breathing.Methods Sixty patients requiring endotracheal intubation with preserved spontaneous breathing were randomly divided into the ultrasound-guided SLNB group(group L)and the supraglottic airway surface anesthesia group(group C),with 30 cases in each group.Patients in the group L underwent bilateral SLNB under ultrasound guidance with 2%lidocaine.In the group C,2%lidocaine was used successively for surface anesthesia of the pharynx,palatine tonsils,base of the tongue,epiglottis,piriform crypts and glottis.Both groups underwent surface anesthesia of the trachea through cricothyroid membrane puncture,and 1%tetracaine was selected as the drug.The main observation indicators included the nausea and choking cough scores when the laryngoscope was inserted to the root of the epiglottis(T2),immediately after the tracheal tube was inserted into the glottis(T3)and when the tube sleeve was inflated after the tracheal tube entered the trachea(T4).Secondary observation indicators included changes in mean arterial pressure(MAP),heart rate(HR),vocal cord movement,3 min after the patient entered the room(T0),before tracheal intubation(T1)and after tracheal intubation(T5).The incidence rates of sore throat score,postoperative nausea and vomiting,hoarseness,hematoma at the puncture site,infection and nerve injury,as well as patient satisfaction were also recorded.Results Compared with the group C,the nausea and choking cough scores were decreased at T2 and T3 in the group L(P<0.05),while there were no statistically significant differences in nausea and choking cough scores between the two groups at T4(P>0.05).There were no significant differences in MAP and HR before and after tracheal intubation between the two groups(P>0.05).Compared with the group C,the vocal cord activity was more conducive to the operation of tracheal intubation in the group L(P<0.01).At 24 hours after the operation,the postoperative sore throat score was decreased in patients of the group L(P<0.01),and the satisfaction score increased(P<0.05).In the group C,there was one case of postoperative nausea and vomiting.In the group L,there were 2 cases of postoperative nausea and vomiting,1 case of postoperative hoarseness.There was no significant difference in the incidence of adverse reactions between the two groups(3.3%vs.10.0%,χ2=1.071,P＞0.05).Conclusion The application of SLNB under ultrasound guidance can enhance the safety and effectiveness of patients during the process of endotracheal intubation with preserved spontaneous breathing,relieve nausea,choking cough and postoperative sore throat.

Abstract:Objective To investigate the effect of evodia delavonium decoction combined with dolasetron mesylate on the efficacy in patients of chemotherapy-induced vomiting.Methods A total of 116 patients with chemotherapy-induced vomiting admitted to our hospital from June 2023 to January 2025 were enrolled.Patients were divided into two groups with 58 cases in each group.The control group was treated with dolasetron mesylate for antiemetic,and the observation group was supplemented with evodia decoction on the basis of it.The treatment effects including complete remission rate and complete control rate of patients in the acute stage,delayed period and whole course of treatment were counted,and the degree of vomiting after treatment was evaluated.Serotonin(5-HT),immune function indicators,and liver and kidney function indicators before and after treatment were evaluated.Results Compared with the control group,the observation group showed an increased complete relief rate and complete control rate during the delayed phase and throughout the treatment(P＜0.05).There was significant difference in the degree of vomiting between the two groups(P＜0.05).Compared with the control group,5-HT levels decreased in the delayed phase of the observation group(P＜0.05).Compared with the control group,the levels of immunoglobulin A,immunoglobulin M and immunoglobulin G increased after treatment in the observation group(P＜0.05).There were no significant differences in blood urea nitrogen,creatinine,alanine aminotransferase and aspartate aminotransferase before and after treatment between both groups(P＞0.05),and there were no significant differences in these indicators between the two groups(P＞0.05).Conclusion Wuzhuyu decoction combined with dexamethasone can effectively relieve chemotherapy-induced vomiting,reduce the severity of vomiting and 5-HT levels,improve humoral immunity,and is safe and effective.

Abstract:Objective To elucidate the regulatory mechanism of xiebai san(XBS)and its combination with azithromycin(AZM)on LPS-induced acute lung injury(ALI)in juvenile rats.Methods Thirty rats were divided into the control group,the model group,the AZM group,the XBS group and the XBS combined with AZM(combined)group according to body weight by stratified random method,with 6 rats in each group.In addition to the control group,the other groups were treated with aerosol inhalation of LPS to establish the ALI model of young rats.Levels of superoxide dismutase(SOD),malondialdehyde(MDA)and catalase(CAT)in lung tissue were detected using biochemical kits.Serum interleukin(IL-6,IL-10 and IL-13)and nuclear factor-κB(NF-κB)were measured by enzyme-linked immunosorbent assay.Transcriptomic analysis was performed to identify differentially expressed genes(DEGs)in lung tissue,followed by enrichment analysis.Immunohistochemistry was used to assess cyclooxygenase-2(COX-2)and tumor necrosis factor-α(TNF-α)expression in lung tissue.Results Compared with the control group,the activities of SOD and CAT in lung tissue of rats decreased in the model group,and the content of MDA increased(P<0.05).Serum levels of IL-6,IL-10,IL-13 and NF-κB all increased(P<0.05).Compared with the model group,SOD and CAT activities in lung tissue significantly increased in the AZM group and the combined group(P＜0.05),while SOD activity increased and MDA content decreased in the XBS group.Serum inflammatory factors IL-6,IL-10 and IL-13 levels were significantly reduced in the AZM group,the XBS group and the combined group,with NF-κB levels also decreasing in the XBS group(P＜0.05).Transcriptomic analysis revealed that XBS and its combination with AZM alleviated ALI by modulating the IL-17 signaling pathway.Immunohistochemistry indicated significantly reduced COX-2 and TNF-α expression in the AZM group,the XBS group and the combined group compared to those of the model group.Conclusion XBS and its combination with azithromycin may ameliorate ALI in juvenile rats by regulating the IL-17 signaling pathway,oxidative stress,inflammatory responses and lung gene expression.

Abstract:Objective To investigate the clinical significance of serum interferon regulatory factor 1(IRF1)in rheumatoid arthritis(RA)patients.Methods Thirty patients with RA and 30 healthy individuals(control group)were included in this study.The serum levels of IRF1 and anti-cyclic citrullinated peptide(anti-CCP)antibody were detected by enzyme-linked immunosorbent assay.Assessment questionnaire(HAQ),interleukin-6(IL-6)and disease activity score(DAS)28-ESR were collected from the RA patients.Patients with RA received initial methotrexate(MTX)monotherapy(10-20 mg weekly)for 1-3 months.Disease activity was assessed using the DAS28-ESR at weeks 4 and 12,and the treatment regimen was adjusted if necessary.Short-term,low-dose corticosteroids or nonsteroidal anti-inflammatory drugs could be used concomitantly for rapid symptom relief.The serum levels of IRF1 and anti-CCP antibody were compared before and after treatment between the RA group and the control group.Spearman's correlation analysis was used to analyze the correlation between IRF1 and clinical and laboratory indicators of RA patients.The diagnostic value of IRF1 for RA was assessed by receiver operating characteristic(ROC)curve.Results Serum IRF1 and anti-CCP antibody levels were significantly higher in the RA group compared with those of the control group.No significant correlation was found between serum IRF1 concentration and anti-CCP antibodies,ESR,CRP,DAS28-ESR,TJC,SJC,VAS,HAQ,IL-6 and RF(P＞0.05).After receiving methotrexate treatment for 4 weeks,the serum IRF1 level of RA patients showed no significant change compared to baseline(P＞0.05).By the 12th week,the serum IRF1 level decreased significantly compared with that of treatment for 4 week and pre-treatment(P＜0.05).The area under ROC curve(AUC)of IRF1 and anti-CCP antibody combined for RA diagnosis was 0.968(95%CI:0.924-1.000),which was better than the single diagnosis of IRF1 or anti-CCP antibody(AUC was 0.831 and 0.852,respectively).Conclusion Serum IRF1 level is increased in RA patients.IRF1 has a certain diagnostic value in RA,and the combined diagnostic efficiency with anti-CCP antibody is higher.

Abstract:Objective To investigate the effect of red ginseng total saponins(RGTS)on cardiomyocyte apoptosis in dilated cardiomyopathy(DCM)mice by regulating microRNA-144-3p(miR-144-3p)/mitogen activated protein kinase 1(MAPK1)pathway.Methods The targeting relationship between miR-144-3p and MAPK1 was analyzed via dual luciferase reporter gene assay.Ten C57BL/6J mice were included as the control group,and the transgenic DCM mice were randomly assigned into the DCM group,the captopril group(CAP,10.1 mg/kg),the low-dose RGTS(L-RGTS)group,the high-dose RGTS(H-RGTS)group(gavage of 6 and 12 g/kg RGTS),the negative control(NC antagomir)group(gavage of 12 g/kg RGTS+tail vein injection of NC antagomir)and the miR-144-3p antagomir group(gavage of 12 g/kg RGTS+tail vein injection of miR-144-3p antagomir),each had 10 mice.The DCM group and the control group were given equal amount of physiological saline by gavage and tail vein injection,once a day for 8 weeks.Echocardiography was used to detect cardiac function in DCM mice.Quantitative real-time fluorescence PCR(qRT-PCR)was used to detect miR-144-3p and MAPK1 mRNA in myocardial tissue.HE staining was used to detect pathological changes in myocardial tissue.TUNEL staining was used to detect cardiomyocyte apoptosis.Western blot assay was used to measure Bax and MAPK1 protein expression in myocardial tissue.Results The control group had a regular arrangement of cardiomyocytes.The arrangement of cardiomyocytes in the DCM group was irregular,with visible cell swelling,necrosis and nuclear condensation.The cardiomyocyte arrangement was relatively regular,and cell swelling was not prominent in the CAP group,the L-RGTS group,the H-RGTS group and the NC antagomir group.The miR-144-3p antagomir group had irregular arrangement of cardiomyocytes.The dual-luciferase reporter gene assay confirmed that miR-144-3p can specifically and negatively regulate MAPK1.Compared with the control group,the left ventricular systolic inner diameter(LVESD),left ventricular diastolic end diameter(LVEDD),expression levels of MAPK1 mRNA and protein,Bax protein and cell apoptosis rate were all increased in the DCM group,while the left ventricular ejection fraction(LVEF),left ventricular short-axis shortening rate(LVFS),and expression level of miR-144-3p were decreased(P＜0.05).Compared with the DCM group,the expression levels of LVESD,LVEDD,MAPK1 mRNA and protein,Bax protein,as well as the apoptosis rate were all decreased in the CAP group,the L-RGTS group and the H-RGTS group,while the expression levels of LVEF,LVFS and miR-144-3p were increased(P＜0.05).Changes of the above indicators were more significant in the H-RGTS group than those in the L-RGTS group(P＜0.05).Compared with the H-RGTS group and the NC antagomir group,the changes of the above indicators were reversed in the miR-144-3p antagomir group(P＜0.05).Conclusion RGTS may regulate the miR-144-3p/MAPK1 pathway to inhibit cardiomyocyte apoptosis in DCM mice.

Abstract:Coronary heart disease(CHD)is a common clinical condition in cardiology,characterized by atherosclerotic lesions in coronary arteries leading to luminal stenosis or occlusion,which subsequently causes myocardial ischemia,hypoxia and even necrosis.Known risk factors only partially account for the pathogenesis of CHD,suggesting the involvement of other critical pathogenic mechanisms.Aldehyde dehydrogenase 2(ALDH2),as a key mitochondrial metabolic enzyme,is widely expressed in various tissues of human body.Its activity is significantly regulated by gene polymorphisms,especially demonstrating protective effects in cardiovascular diseases including heart failure and CHD.The pathogenesis of CHD involves the interaction of multiple factors,and its occurrence and development involve the interaction between genetic susceptibility and environmental risk factors.However,the specific mechanism by which ALDH2 plays a role in this has not yet been clarified.This review summarizes the potential molecular mechanisms between ALDH2 gene polymorphisms and the onset and progression of CHD,aiming to provide theoretical references for the prevention and treatment of CHD.

Abstract:Objective To investigate the differences of gene expression and metabolomics between K562 cells and their resistant counterpart,K562-G01 cells,and analyze the potential role of glutamate-ammonia ligase(GLUL)in regulating the drug resistance of K562-G01 cells.Methods K562 and resistant K562-G01 cells were cultured in vitro.Differentially expressed genes,metabolites and related pathways in the resistant cells were identified through transcriptomics and metabolomics.The association between transcriptomic and metabolomic pathways was analyzed to identify common signaling pathways.Differential gene expression was detected by qPCR and Western blot assay.Flow cytometry was employed to evaluate the effect of GLUL gene interference on cell apoptosis.Results Transcriptomic analysis showed that 2 423 genes were upregulated,and 3 321 genes were downregulated in K562-G01 cells.Metabolomic analysis revealed that 570 metabolites were upregulated and 779 were downregulated in K562-G01 cells.Transcriptomic and metabolomic association analysis indicated that alanine,aspartate and glutamate metabolism pathway were involved in the development of drug resistance in K562 cells.qPCR and Western blot results demonstrated that GLUL expression was upregulated in K562-G01 cells(P＜0.05).Further investigation showed that interfering with GLUL expression promoted apoptosis in both K562 and K562-G01 cells and enhanced the drug sensitivity to imatinib(P＜0.05).Conclusion Activation of alanine,aspartate and glutamate metabolism pathways may contribute to the drug resistance of K562-G01 cells.Interfering with GLUL expression significantly promotes apoptosis in drug resistant cells and enhances the sensitivity to chemotherapy drugs.

Abstract:Objective To analyze the clinical characteristics,diagnosis and treatment of congenital first branchial cleft cysts and fistulas in children,and to improve the understanding of congenital first branchial cleft anomalies(FBCA).Methods A retrospective analysis was conducted on the data of 15 children with congenital first branchial cleft cysts and fistulas,including gender,age,medical history,side of lesion,physical examination results,preoperative imaging features,treatment methods,complication and prognosis.Results In the 15 children,there were 11 males and 4 females,aged from 1 to 12 years with a mean age of 5.4±3.1 years.The disease duration ranged from 0.5 to 72 months(with a median duration of 4 months).All cases had unilateral involvement,including 6 on the left side and 9 on the right side.There were 10 cases of cysts and 5 cases of fistulas.Two cases were of Work type Ⅱ and 13 cases were of Work type Ⅰ.The main symptoms of the children were postauricular masses or recurrent postauricular infections.All children underwent preoperative MRI examination,which showed that the lesions presented isointense or slightly long T1 and long T2 signals,and were closely related to the parotid gland or external auditory canal.All children treated with surgery and successfully completed.The intraoperative findings were consistent with the preoperative MRI indications.Postoperative pathology confirmed that all cases were consistent with the pathological manifestations of congenital branchial cleft cysts or fistulas.During the follow-up period of 5 to 20 months,no recurrence was observed in any of the 15 children.Conclusion Congenital first branchial cleft malformations in children are clinically rare.MRI has good diagnostic value and accurate surgical mapping for this condition.Complete surgical resection of the lesion can prevent recurrence and is currently the most effective treatment method.

Abstract:Objective To explore the predictive value of cerebral oxygen saturation combined with brain natriuretic peptide for hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke(AIS).Methods The clinical data of 120 AIS patients treated with mechanical thrombectomy were retrospectively analyzed.All patients underwent head CT examination within 24 to 72 hours after the operation and were divided into the non-hemorrhagic transformation group(66 cases)and the hemorrhagic transformation group(54 cases)according to whether hemorrhagic transformation occurred.The differences in general information,laboratory test results,cerebral oxygen saturation and serum brain natriuretic peptide levels were compared between the two groups of patients.The receiver operating characteristic(ROC)curve was used to evaluate the value of cerebral oxygen saturation combined with serum brain natriuretic peptide in predicting hemorrhage transformation after mechanical thrombectomy in AIS patients.Pearson correlation analysis was used to analyze the relationship between cerebral oxygen saturation and serum brain natriuretic peptide.Multivariate Logistic regression was used to analyze the effects of cerebral oxygen saturation and serum brain natriuretic peptide on hemorrhage transformation after mechanical thrombectomy in patients with AIS.Results The atrial fibrillation,the time from onset to admission,the National Institutes of Health Stroke Scale(NIHSS)score at admission and the serum brain natriuretic peptide level were all higher in the hemorrhagic transformation group than those in the non-hemorrhagic transformation group(P＜0.05),and the cerebral oxygen saturation was lower in the hemorrhagic transformation group than that in the non-hemorrhagic transformation group(P＜0.05).The cerebral oxygen saturation was negatively correlated with serum brain natriuretic peptide in AIS patients(r=-0.469,P＜0.01).The optimal cut-off points of cerebral oxygen saturation combined with serum brain natriuretic peptide level for predicting hemorrhage transformation after mechanical thrombectomy in AIS patients were 55%and 239.91 ng/L,respectively.The area under the receiver operating characteristic(ROC)curve(AUC)was 0.800(95%CI:0.718-0.868)and 0.832(95%CI:0.753-0.894),respectively.The AUC increased to 0.882 during the combined detection(95%CI:0.810-0.934).Conclusion The decreased cerebral oxygen saturation and elevated serum brain natriuretic peptide levels are significantly associated with hemorrhage transformation after mechanical thrombectomy in AIS patients.The combination of the two has a higher predictive value and can be used as a reference index for clinical evaluation.

Abstract:Objective To analyze the risk factors and construct prediction model for acute biliary pancreatitis(ABP)complicated by common bile duct stones(CBDS).Methods A total of 105 patients with CBDS complicated by ABP were included as the ABP group,and another 105 CBDS patients without ABP were included as the non-ABP group.Clinical data of all patients were collected.Multivariate unconditional Logistic regression was used to identify the risk factors for CBDS complicated by ABP,and a nomogram predictive model was developed accordingly.The H-L test was used to evaluate the fit degree of the model.The predictive value was assessed by the receiver operating characteristic(ROC)curve.C-index analysis was used to predict the discriminatory ability of the model.Calibration curve was used to analyze and predict the accuracy of the model.The decision curve was used to analyze clinical benefits of the model.Results Logistic regression analysis showed that older age,diabetes,larger stone diameter,larger common bile duct diameter,higher neutrophil-to-lymphocyte ratio(NLR),elevated serum amylase(AMS)and higher C-reactive protein(CRP)levels were independent risk factors for CBDS complicated by ABP(P＜0.05).A nomogram predictive model was constructed based on these factors,and the H-L test showed good model fit(P>0.05).The ROC curve indicated an area under the curve(AUC)of 0.884,and the C-index was 0.884.The calibration curve demonstrated that the predicted probabilities were close to the ideal line,and the decision curve showed a wide range of net benefit.Conclusion The nomogram predictive model based on the identified risk factors for CBDS complicated by ABP shows good predictive performance.

Abstract:Objective To investigate the utility of tumor marker-based the response evaluation criteria in solid tumors(RECIST)RecistTM in assessing chemotherapy response in advanced ovarian cancer.Methods A total of 90 patients of treatment-naïve FIGO stage III-IV ovarian cancer(2013-2023)with baseline tumor markers>3×ULN were retrospectively analyzed.All patients were received≥2 cycles of platinum/taxane chemotherapy.Efficacy,progression-free survival(PFS)and overall survival(OS)were evaluated using RECIST and RecistTM.Cox regression analysis was conducted to analyze the influencing factors of disease progression and death in patients with ovarian cancer.Results The consistency of therapeutic effect evaluation was poor between RecistTM and RECIST(Kappa=0.105,P＜0.01).Under the RecistTM criteria,significant differences were observed in median tumor marker-related PFS(tmPFS)or OS between the tumor marker-related complete response(tmCR),tumor marker-related partial response(tmPR)and tumor marker-related stable disease+tumor marker-related progression disease(tmSD+tmPD)groups(PFS:14 vs.9 vs.2.0 months;OS:61 vs.31 vs.8 months;all P＜0.01).In contrast,no significant differences were observed in either median PFS or OS between different response groups according to RECIST(all P＞0.05).RecistTM demonstrated superior predictive performance for both progression(1-/3-year AUC:0.707 vs.0.540;0.722 vs.0.589,all P＜0.05)and mortality risk(2-/3-/5-year AUC:0.724 vs.0.551;0.702 vs.0.522;0.718 vs.0.535,all P＜0.05).Univariate and multivariable analysis indicated that the RecistTM criterion was an independent predictor of OS(P＜0.01).Conclusion RecistTM shows superior predictive performance compared to RECIST in predicting disease progression and survival outcomes in advanced ovarian cancer.

Abstract:Objective To explore the clinical efficacy of using bipolar electrocoagulation forceps to assist tonsillectomy in primary hospital.Methods Clinical data of 82 patients who underwent tonsillectomy in Department of Otolaryngology,Gannan Tibetan Autonomous Prefecture People's Hospital from November 2022 to November 2024 were collected and retrospectively analyzed.According to different tonsillectomy methods,patients were randomly divided into the control group(n=40)and the observation group(n=42).Patients in the control group were treated with traditional tonsillectomy,and patients in the observation group were treated with bipolar electrocoagulation forceps assisted tonsillectomy.Data regarding operation duration,intraoperative blood loss,postoperative white membrane shedding time,complications,length of hospital stay and hospitalization costs were collected for both groups.The Visual Analogue Scale(VAS)was employed to assess pharyngeal pain on the postoperative day 1,3 and 7 following tonsillectomy.Results Compared with the control group,the observation group exhibited a shorter operative duration and reduced intraoperative blood loss,although the time to white membrane detachment was prolonged.The VAS scores on the postoperative day 1,day 3 and day 7 were significantly lower in the observation group(P＜0.01).There was no significant difference in length of hospital stay between the two groups.However,the overall hospitalization cost was higher in the observation group(P＜0.01).There were no significant differences in the incidence of complications such as secondary hemorrhage,wound infection,or pharyngeal edema between the two groups.Conclusion Bipolar electrocoagulation forceps assisted tonsillectomy has the advantages of short surgical time,less intraoperative bleeding,mild postoperative pain and easy cost bearing.It is suitable for application in primary hospital or economically underdeveloped areas.

Abstract:The exertional heat stroke is one of the severe types,and it often occurs in people who engage in high-intensity training or heavy physical labor in high-temperature and high-humidity environments.This article retrospectively analyzed the clinical data of a patient with exertional heat stroke combined with multiple organ dysfunction syndrome.By adopting the multi-disciplinary treatment(MDT)model,the ICU organized neurology,nephrology,respiratory medicine,gastroenterology and cardiovascular medicine departments to provide assistance and participation.After the patient received rapid cooling,sedation,hemodialysis,fluid replacement,supplementation of coagulation factors,control of intracranial pressure,tracheal intubation and ventilator-assisted ventilation,anti-infection and other active treatments,the patient's condition improved and was discharged from the hospital after one month of in-hospital treatment.Two weeks after discharge,the patient returned to the outpatient clinic for a follow-up visit.The doctor provided guidance on medication and self-care measures.After one month of treatmemt,all the abnormal laboratory indicators caused by heat stroke returned to normal.The application of MDT strategy can effectively improve the prognosis of patients with exertional heat stroke combined with multiple organ failure.

Abstract:Objective To explore the factors affecting the risk of postoperative re-tearing in patients undergoing arthroscopic rotator cuff repair,and to construct a nomogram prediction model.Methods A total of 587 patients who underwent arthroscopic rotator cuff repair were divided into the training set(470 cases)and the validation set(117 cases).The training set was sub-divided into the re-tearing group and the healing group based on whether re-tearing occurred within 12 months after surgery.Clinical data were compared between the two groups.Multivariate Logistic regression analysis was used to identify the influencing factors of re-tearing,and a nomogram prediction model for re-tearing was constructed.The receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the model.The clinical decision curve was used to evaluate its clinical applicability.Results In the training set,re-tearing occurred in 97 cases(the re-tearing group)and healing was observed in 373 cases(the healing group).There were 23 cases of re-tearing in the validation set.Multivariate Logistic regression analysis results showed that age≥60 years,osteoporosis,length of tearing>3 cm,tendon retraction,fat infiltration≥grade 2 and use of corticosteroids were independent risk factors for re-tearing(P＜0.05).The C-index of the constructed nomogram model was 0.814(95%CI:0.810-0.819).The calibration curve and the ideal curve were close in both the training and validation sets.Internally validation using Bootstrap method found that the mean absolute errors were 0.011 and 0.027,respectively.Hosmer-Lemeshow test showed good goodness of fit(χ2=4.531,P=0.806).The clinical decision curve showed that the model had a significant positive net benefit.The area under the curve(AUC),sensitivity and specificity of the nomogram prediction model for predicting postoperative re-tearing in the training set were 0.818(95%CI:0.771-0.865),78.69%and 79.60%,which in the validation set were 0.807(95%CI:0.730-0.884),77.94%and 76.82%,respectively.Conclusion The nomogram model constructed based on risk factors can better predict the risk of re-tearing after arthroscopic repair.

Abstract:Objective To analyze the risk factors for the development of epilepsy in children with febrile convulsions based on Logistic regression and decision tree models and to construct a predictive model.Methods A total of 210 children with their first occurrence of febrile convulsion were selected and followed up for half a year(whether epilepsy occurred or not).Eventually,196 cases completed the follow-up,and 36 cases(18.37%)of children with febrile convulsions developed epilepsy.Children were divided into the epilepsy group(36 cases)and the non-epilepsy group(160 cases)based on whether they developed epilepsy or not.All children underwent the first electroencephalogram(EEG)examination within 72 hours after the febrile convulsion and a follow-up EEG examination three months later.The clinical data of the children were collected,including gender,age of onset,birth weight,maternal age at delivery,mode of delivery,anemia status,nature of the first convulsion,number of convulsions,status at the first convulsion,time from fever to the first convulsion,duration of convulsion(taking the longest value),family history of epilepsy and EEG results.Multivariate Logistic regression was used to analyze influencing factors of febrile convulsions developing into epilepsy.Modeler software was used to construct a decision tree risk prediction model for predicting the development of epilepsy in children with febrile convulsions.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)of different models was compared.Results Compared with the non-epilepsy group,there were higher proportion of complex febrile convulsions,the number of seizures was≥2 times,time from fever to the first convulsion was＜24 hours,duration of convulsion was≥15 minutes and abnormal EEG results were higher in the epilepsy group(P＜0.01).Multivariate Logistic regression analysis showed that complex febrile convulsions,the frequency of convulsions≥2 times,time from fever to the first convulsion＜24 hours,convulsion duration≥15 minutes and abnormal EEG were risk factors for the development of epilepsy in children with febrile convulsions(P＜0.05).The decision tree model selected the number of convulsions,time from fever to the first convulsion,nature of the first convulsion and EEG as important variables for the development of epilepsy in children with febrile convulsions were important variables for the development of epilepsy in children with febrile convulsions,and with information gains of 0.47,0.27,0.14 and 0.13,respectively.The AUC value of the multivariate Logistic model was 0.838(95%CI:0.764-0.911),and the AUC value of the decision tree model was 0.849(95%CI:0.780-0.916).There was no significant difference in AUC between the two models.Conclusion The method combining decision tree algorithm and Logistic regression model to identify the risk factors for the development of epilepsy in children with febrile convulsions has certain predictive value and can provide a reference for clinical practice.

Abstract:Objective To develop and validate the random forest model based on glycolipid metabolism and cardiometabolic index(CMI)and to predict the risk of diabetic kidney disease(DKD)combined with cardiac autonomic neuropathy(CAN)in patients with type 2 diabetes mellitus(T2DM).Methods A retrospective single-center study design was adopted.A total of 109 patients with DKD and CAN admitted between February 2023 and February 2025 were consecutively enrolled as the comorbidity group.Based on the baseline data of the case group,109 T2DM patients without DKD or CAN during the same period were selected in a 1∶1 matching ratio as the non-comorbidity group.The baseline characteristics of the two groups were compared.Binary Logistic regression was used to analyze the influencing factors for the occurrence of DKD combined with CAN in T2DM patients.A random forest model was constructed using the R software package(version 4.1.0),and a receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of the model.Results Binary Logistic regression revealed that the urinary albumin-to-creatinine ratio(UACR)>30 mg/g,elevated fasting plasma glucose(FPG),CMI,glycated hemoglobin(HbA1c)and triglyceride(TG)levels were risk factors for the development of DKD combined with CAN in T2DM patients,while estimated glomerular filtration rate(eGFR)and high-density lipoprotein cholesterol(HDL-C)were protective factors.Using the variable importance measure(%IncMSE)for scoring and feature importance ranking,the top three factors were CMI,HDL-C and FPG,with%IncMSE values of 26.700%,16.300%and 13.400%,respectively.Based on these influencing factors,the random forest model established to predict the occurrence of DKD combined with CAN in T2DM patients achieved an AUC of 0.849,a sensitivity of 0.862,a specificity of 0.730 and a Youden index of 0.592,with a 95%confidence interval of 0.738-0.933,demonstrating good predictive performance.Conclusion UACR>30 mg/g,elevated levels of FPG,CMI,HbA1c and TG,along with decreased levels of eGFR and HDL-C are risk factors for the occurrence of DKD combined with CAN in patients with T2DM,among which CMI is the key driver factor.

Abstract:Objective To analyze the risk factors for gingival invagination after orthodontic treatment for extraction of the first premolar and to construct a relevant prediction model.Methods A total of 272 patients(890 tooth extraction sites)who received orthodontic treatment in Taizhou Fourth People's Hospital were retrospectively collected as research objects.By means of the set apart method,they were randomly divided into the modeling cohort(n=218,including 692 tooth extraction sites)and the internal validation cohort(n=54,198 tooth extraction sites).Another 133 patients(with a total of 502 tooth extraction sites)who received orthodontic treatment in Nanjing Stomatological Hospital during the same period were selected as the external validation cohort.LASSO regression analysis was used to screen key variables.With the occurrence of gingival invagination as the dependent variable,multi-factor Logistic regression analysis was carried out.A nomogram prediction model was constructed based on independent risk factors,and its prediction performance was verified.Results In this study,405 patients with 1 392 extraction sites were included,and gingival invagination occurred in 862 extraction sites,with an incidence rate of 61.9%.A total of 9 key variables were screened in the LASSO regression analysis.Results of multifactorial analysis showed that the initiation of orthodontic treatment at≥2 weeks after extraction,thin gingival biotypic gingiva,the buccal bone thickness 4 mm from the apical CEJ root tip and the buccal bone thickness of the mid-root section of the root were independent risk factors for gingival invagination after orthodontic treatment of the first premolar(P＜0.05).Results of the subjects' work characteristic curves showed that the AUCs of the modelling cohort,the internal validation cohort and the external validation cohort were 0.813(95%CI:0.777-0.850),0.816(95%CI:0.745-0.888)and 0.815(95%CI:0.782-0.847),respectively.Results of the Hosmer-Lemeshow test showed that the χ2 for the modelling cohort,internal validation cohort and external validation cohort were 5.768(P=0.673),5.719(P=0.685)and 5.727(P=0.680),respectively,indicating good model fitting.Kappa analysis results showed that the Kappa values of the modeling queue,internal validation queue and external validation queue were all greater than 0.6,and the predicted results were highly consistent with the actual results.Conclusion Gingival recession after orthodontic treatment of the first premolar extraction is related to various factors such as orthodontic treatment time,gingival biotype and cheekbone thickness.The column-line diagram prediction model constructed based on the related risk factors can predict the occurrence of gingival invagination more accurately,which can provide a reference for the early prevention and treatment of gingival invagination.

Abstract:Objective To investigate the influence of compound Kushen injection combined with chemotherapy and bevacizumab on short-term efficacy and inflammatory factor levels in patients with ovarian cancer.Methods A retrospective study was conducted on 92 patients with ovarian cancer.Patients were divided into the control group(47 cases)and the observation group(45 cases)according to different treatment regimens.The control group was treated with paclitaxel+platinum+bevacizumab,while the observation group received the same regimen plus compound Kushen injection.The short-term efficacy,human epididymis protein 4(HE4),carbohydrate antigen 125(CA125),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1)and incidence of adverse reactions were compared before and after treatment between the two groups.Results The objective response rate was 80.0%in the observation group,which was higher than 59.6%in the control group(P＜0.05).After treatment,HE4,CA125,VEGF and TGF-β1 levels were significantly lower in the observation group than those in the control group(P＜0.05).There were no significant differences in incidence of gastrointestinal reactions,myelosuppression and liver/kidney function abnormalities between the two groups of patients(P＞0.05).Conclusion Compound Kushen injection combined with chemotherapy and bevacizumab has significant therapeutic efficacy and high safety in the treatment of patients with ovarian cancer.

Abstract:Objective To explore the value of serum copper/zinc ratio and lactate(LA)/albumin(ALB)ratio(LAR)combined with fecal calprotectin(FC)in evaluating the condition and treatment outcome of ulcerative colitis(UC).Methods A total of 154 patients with active UC were selected and divided into the mild activity group(45 cases),the moderate activity group(61 cases)and the severe activity group(48 cases)according to their disease condition.Based on the treatment outcome,patients were divided into the improved group(106 cases)and the unimproved group(48 cases).Laboratory indices such as serum copper/zinc ratio,LAR and FC were compared between groups.The relationship between these indices and the condition and treatment outcome of patients with UC was analyzed.Results Serum copper/zinc ratio,LAR and FC levels increased in sequence in the mild activity group,the moderate activity group and the severe activity group(P＜0.05).Compared with the mild activity group,serum prealbumin level was lower in the severe activity group(P＜0.05).Compared with the improved group,the unimproved group demonstrated higher serum copper/zinc ratio,LAR and FC levels(P＜0.05).Spearman correlation analysis showed that serum copper/zinc ratio,LAR and FC levels were positively correlated with UCEIS score in patients with UC(P＜0.05).Multivariate Logistic regression analysis showed that increased serum copper/zinc ratio,LAR and FC levels were risk factors for aggravation and unimproved treatment outcomes of UC(P＜0.05).The receiver operating characteristic(ROC)curve analysis showed that the areas under the curve(AUCs)of combination of serum copper/zinc ratio,LAR and FC in predicting aggravation and no improvement of UC were 0.949(95%CI:0.902-0.978)and 0.936(95%CI:0.885-0.969),respectively.Conclusion Serum copper/zinc ratio,LAR and FC can serve as reliable biomarkers for predicting the condition and treatment outcome of UC.Combined use of these indices can achieve better predictive efficacy.

Abstract:Objective To explore the influence of colquhounia root tablets on the clinical efficacy and inflammatory indicators in patients with moderate atopic dermatitis(AD).Methods A total of 80 patients with moderate AD were prospectively included in this study.Patients were randomly divided into the control group and the test group,with 40 patients in each group.Ultimately,33 patients in the control group and 32 in the test group were completed the study.The control group received oral hydroxyzine hydrochloride tablets and cetirizine hydrochloride capsules,and externally applied mometasone furoate cream and polymyxin B compound ointment.The test group received the same treatment along with oral Colquhounia root tablets(4 tablets per dose,3 doses per day).All patients underwent 8 weeks of treatment.Clinical response rates were evaluated in both groups.Before and after treatment,peripheral blood samples were taken to measure and calculate the neutrophil/lymphocyte ratio(NLR),eosinophil/lymphocyte ratio(ELR),monocyte/lymphocyte ratio(MLR),platelet/lymphocyte ratio(PLR)and serum total immunoglobulin E(IgE)levels.Additionally,eczema area and severity index(EASI),pruritus numeric rating scale(PP-NRS),investigator global assessment(IGA)and SCORAD scores were recorded.Results The clinical response rate was significantly higher in the test group than that of the control group(68.8%vs.39.4%,P=0.033).After treatment,the NLR and IgE levels were significantly lower in the test group than those of the control group(P<0.05).Furthermore,the reduction in clinical scores(EASI,IGA,SCORAD)were more significant in the test group compared to those of the control group(P<0.05).There was no significant difference in the incidence of adverse reaction events between the two groups during the treatment period(6.06%vs.9.38%,χ²=0.251,P=0.672).Conclusion Colquhounia root tablets show significant efficacy in treating moderate atopic dermatitis by improving clinical symptoms and reducing inflammatory markers,and have a relatively high overall safety.