Abstract:Objective To investigate the mutation of α-thalassemia/X-linked mental retardation syndrome(ATRX)and telomerase reverse transcriptase(TERT)gene in different types of gliomas,and to analyze the relationship between ATRX and TERT gene mutation and the prognosis of patients.Methods The clinical data of 117 patients with newly diagnosed glioma admitted to the Affiliated Hospital of Xuzhou Medical University from September 2021 to September 2024 were retrospectively analyzed.According to the postoperative pathological type,the patients were divided into glioblastoma group(61 cases),oligodendroglioma group(29 cases)and astrocytoma group(27 cases).The general clinical data and the positive rate of ATRX and TERT promoter mutation in each group were compared.Multivariate Cox regression model was used to analyze the factors affecting the prognosis of glioma patients.Kaplan-Meier survival curve was used to analyze the correlation between ATRX and TERT gene mutation and the prognosis of patients.Results The ATRX expression rates of oligodendroglioma group and astrocytoma group were higher than that of glioblastoma group[65.5％(19/29),63.0％(17/27)vs 36.1％(22/61)],the TERT promoter mutation rate in astrocytoma group was lower than those in glioblastoma group and oligodendro-glioma group[25.9％(7/27)vs 62.3％(38/61),79.3％(23/29)](all P＜0.05).Multivariate Cox regression analysis showed that ATRX and TERT promoter mutation were related factors affecting the prognosis of glioma patients(P＜0.05).Kaplan-Meier survival analysis showed that patients with ATRX loss had a shorter overall survival than those with ATRX expression[(29.1±1.3)months vs(34.2±0.8)months](Log-rank x2=4.835,P=0.028).The overall survival of patients with TERT promoter mutation was shorter than that of patients without TERT promoter mutation[(28.4±1.2)months vs(34.9±0.8)months](Log-rank x2=7.307,P=0.007).Conclusion ATRX expression and TERT promoter mutation are different in different types of gliomas.Loss of ATRX expression and TERT promoter mutation have a certain impact on the prognosis of glioma patients.

Abstract:Objective To investigate the relationship between DNA ploidy in sputum cells and pathological characteristics,clinical stage,progression and prognosis of lung cancer patients.Methods A total of 162 patients with primary lung cancer confirmed by cytology or histopathology in Department of Oncology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine from May 2019 to June 2021 were selected.The patients were classified according to age,gender,radiotherapy and chemotherapy,smoking history,family history,pathological type,stage,recurrence and metastasis.The patients were followed up by medical history,physical examination and imaging examination until December 2024.Thex2 test was used to analyze the correlation between DNA ploidy of sputum cells and clinicopathological types,stages and progression of lung cancer.Cox multivariate analysis was used to analyze the correlation between factors such as DNA ploidy of sputum cells and the prognosis of lung cancer.Kaplan-Meier method was used to analyze the survival related to DNA ploidy results of sputum cells.Results There was no significant difference in the incidence of abnormal DNA ploidy in lung cancer patients with different histological types(x2=1.194,P=0.551).The incidence of abnormal DNA ploidy in advanced lung cancer patients was higher than that in early stage patients[66.7％(44/66)vs 40.6％(39/96)](x2=10.616,P=0.001).The incidence of abnormal DNA ploidy in patients with recurrence and metastasis was 66.2％(51/77),and that in patients without recurrence and metastasis was 37.6％(32/85),the difference was statistically significan(x2=13.214,P＜0.001).Cox multivariate analysis showed that radiotherapy(hazard ratio=0.429,95％confidence interval:0.252-0.731,P=0.002)was a protective factor for the prognosis of patients with lung cancer,while positive sputum cell DNA ploidy results(hazard ratio=3.065,95％confidence interval:1.830-5.135,P＜0.001)and smoking history(hazard ratio=4.467,95％confidence interval:2.606-7.657,P＜0.001)were risk factors for the prognosis of patients with lung cancer.The results of Kaplan-Meier survival analysis showed that the patients with positive DNA ploidy expression in sputum cells had a lower survival rate than those with negative DNA ploidy expression,and the difference between the two survival curves was statistically significant(x2=18.387,P=0.003).Conclusion Sputum DNA ploidy analysis is an objective,reproducible and easy to be accepted by patients.Sputum DNA ploidy analysis has good clinical significance for the screening,progression and prognosis evaluation of patients with lung cancer,and can be used as an effective detection method for the diagnosis and prognosis of patients with lung cancer together with other diagnostic methods.

Abstract:Objective To investigate the effect of the CXC chemokine receptor-2(CXCR2)small-molecule inhibitor AZD5069 on myocardial ischemia-reperfusion(IR)injury(IRI)and its underlying mechanisms.Methods C57BL/6 mice were used to establish a myocardial IR model,and they were randomly divided into control group and observation group(10 mice each).The control group was given 0.5％sodium carboxymethyl cellulose solution(solvent control)daily,and the observation group was given AZD5069 10 mg/kg daily and dissolved in 0.5％sodium carboxymethyl cellulose.In addition,6 mice were selected as the sham operation group for thoracotomy without ligation of the left anterior descending coronary artery.Cardiac function indexes were dynamically evaluated at 24 h,72 h and 28 days after surgery by echocardiography in small animals.Sirius red staining was performed with paraffin-embedded heart tissue sections to quantify the degree of myocardial fibrosis.Evans blue/TTC double staining(EB/TTC)was used to distinguish myocardial ischemic and non-ischemic areas,and viable and non-viable areas.The mechanism of action of AZD5069 was elucidated by RNA transcriptome sequencing of myocardial tissues.Results At 24 h,72 h and 28 days after operation,the left ventricular ejection fraction in the observation group was higher than that in the control group[(48.0±5.5)％vs(35.3±3.0)％,(55.8±5.1)％vs(40.9±4.1)％,(54.9±5.4)％vs(43.9±7.9)％](all P＜0.05).On the 28th day after IR surgery,there was a statistically significant difference in myocardial collagen volume scores between the observation group,the control group and the sham operation group(P＜0.001),and that in the control group was higher than that in the sham operation group,and that in the observation group was lower than that in the control group(both P＜0.05).The results of EB/TTC quantitative analysis showed that the ratio of myocardial pale infarct area/ischemia area at risk in the observation group was lower than that in the control group(P＜0.05).RNA transcriptome sequencing results showed that the genes that were significantly up-regulated AZD5069 mainly included CXC motif chemokine ligand 1,serum amyloid A3 and Krüppel-like factor 2.Conclusion The small-molecule CXCR2 antagonist AZD5069 demonstrates potential in mitigating myocardial ischemia-reperfusion injury through dual mechanisms of anti-inflammatory action and metabolic modulation,thereby proposing a novel therapeutic paradigm for post-infarction cardioprotection in clinical settings.

Abstract:The prevalence and mortality of cardiovascular disease in China are increasing year by year,and the number of patients undergoing coronary artery bypass grafting is increasing year by year.It is essential to actively implement postoperative cardiac rehabilitation.The core link of the current consensus on cardiac rehabilitation is exercise rehabilitation,and traditional Chinese medicine also has its own unique advantages in cardiac rehabilitation.This article reviews the research progress of traditional Chinese medicine on bleeding,infection,pain and other common complications after coronary artery bypass grafting.

Abstract:Stroke is currently one of the most common causes of death in the world.The mammalian forkhead box(Fox)O1 plays important roles in the occurrence and development of stroke,such as inducing cell death and inflammatory response,inhibiting oxidative damage,affecting the blood-brain barrier,and regulating hepatic gluconeogenesis.In view of these roles of FoxO1 in the occurrence and development of stroke,different measures and treatments have been adopted,but the role and mechanism of FoxO1 remain elusive and even contradictory.Therefore,the identification of these effects and their mechanisms will further reveal the FoxO1 signal transduction and related targeted drugs,and then provide an important method or basis for the prevention and treatment of stroke.This article reviews the research progress of FoxO1 in the pathogenesis of stroke and its mechanism.

Abstract:Objective To investigate the effect of drug-coated balloon catheter on late lumen loss and adverse cardiovascular events in patients with de novo coronary small vessel disease.Methods A total of 256 patients with de novo small vessel coronary artery disease who underwent percutaneous coronary intervention in 14 hospitals in China from March to June 2021 were selected as the postoperative group.The basic data,hospitalization related examination and operation information of the patients were collected,and the follow-up angiography was performed at 9 months after operation to record the late lumen loss in the affected segment and the rate of target lesion restenosis.A total of 194 patients were followed up for 1 year(follow-up group).The patient-related cardiovascular clinical composite endpoint(POCE)and device oriented composite endpoint(DOCE)were observed.Results The mean age of the study subjects was(63±9)years,the preoperative minimum lumen diameter was(0.62±0.25)mm,the preoperative stenosis degree was(70±11)％,the preoperative reference vessel diameter was(2.1±0.3)mm,the preoperative lesion length was(11±5)mm,and 247 cases(96.5％)were thrombolysis in myocardial infarction trial flow grade Ⅲ.There were significant differences in the minimum lumen diameter in the segment,the degree of residual stenosis in the segment,the minimum lumen diameter in the balloon dilatation segment,and the degree of residual stenosis in the balloon dilatation segment between the postoperative group and the follow-up group(all P＜0.001).Multivariate Cox regression analysis showed that late segmental lumen loss was an independent risk factor for POCE and DOCE after adjusting for related risk factors(gender,age,systolic blood pressure,diastolic blood pressure,heart rate,low-density lipoprotein cholesterol,total cholesterol,triglyceride,and serum creatinine)at 1 year follow-up(both P＜0.001).Conclusion Increased late lumen loss after drug-coated balloon catheter treatment of de novo coronary small vessel disease may be an independent risk factor for adverse cardiovascular events.

Abstract:Objective To investigate the effects of remifentanil general anesthesia combined with thoracic paravertebral nerve block on analgesic effect and immune-inflammatory response in elderly patients undergoing renal cancer surgery.Methods A total of 146 elderly renal cancer patients undergoing elective retroperitoneal laparoscopic radical nephrectomy at Inner Mongolia People's Hospital from February 2024 to July 2025 were enrolled.They were divided into control group and observation group by random number table method,with 73 cases in each group.The control group received remifentanil-based general anesthesia,and the observation group received remifentanil-based general anesthesia combined with thoracic paravertebral nerve block.The analgesic effect,mean arterial pressure(MAP),heart rate,immune function indexes,natural killer cells and inflammatory factors at different time points,as well as the incidence of adverse reactions were compared between the two groups.Results There were significant inter-group,time and interaction effects in visual analogue scale(VAS)scores at different states between the two groups(all P＜0.05),and the VAS scores at 12 h,24 h and 48 h after operation in the observation group were lower than those in the control group(all P＜0.05).There were signifi-cant inter-group,time and interaction effects in MAP and heart rate at different time points between the two groups(all P＜0.05),and MAP and heart rate at skin incision in the observation group were lower than those in the control group(all P＜0.05).There were significant inter-group and time effects in CD3+,CD4+,CD8+,CD4+/CD8+ratio and natural killer cells at different time points between the two groups(all P＜0.05).At 24 h after operation,the levels of CD3+,CD4+,CD4+/CD8+ratio and natural killer cells in the observation group were higher than those in the control group,while the level of CDs+was lower(all P＜0.05).There were significant inter-group and time effects in inflammatory factors at different time points between the two groups(all P＜0.05),and the levels of inflammatory factors at 24 h after operation in the observation group were lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[6.8％(5/73)vs 5.5％(4/73)](x2＜0.001,P=1.000).Conclusions Remifentanil general anesthesia combined with thoracic paravertebral nerve block has obvious analgesic effect in elderly patients undergoing renal cancer surgery,which can effectively improve immune function,inhibit inflammatory response and enhance the safety of surgery in elderly renal cancer patients.

Abstract:Objective To investigate the clinical value of atherogenic index of plasma(AIP)in predicting lean metabolic-associated fatty liver disease(MAFLD).Methods Physical examinees who underwent health examination at The Affiliated Hospital of Inner Mongolia Medical University from January 2024 to January 2025 were enrolled.General and laboratory data were compared between patients with lean MAFLD(observation group)and lean healthy examinees(control group).Multivariate Logistic regression analysis was used to analyze factors associated with lean MAFLD in individuals with body mass index(BMI)＜23 kg/m2.Receiver operating charac-teristic curve was drawn to analyze the clinical value of each index in predicting lean MAFLD.The incidence of lean MAFLD was compared between high AIP group and low AIP group.Results A total of 56 patients with lean MAFLD(observation group)and 214 lean healthy examinees(control group)were screened.There were signifi-cant differences in age,gender,BMI,systolic blood pressure,diastolic blood pressure,alanine aminotransferase(ALT),aspartate aminotransferase,γ-glutamyl transferase,alkaline phosphatase,renal function,blood lipid,fasting blood glucose and AIP between the observation group and the control group(all P＜0.05).Multivariate Logistic regression analysis showed that age,gender,BMI,ALT and AIP were independent influencing factors for MAFLD in individuals with BMI＜23 kg/m2(all P＜0.05).The area under the curve(AUC)of combined prediction of lean MAFLD by BMI,ALT and AIP was 0.904,which was higher than that of single index prediction(Z=3.476,3.625,3.029;P=0.018,0.013,0.020).The incidence of lean MAFLD in high AIP group was higher than that in low AIP group[43.3％(42/97)vs 8.1％(14/173)](x2=46.863,P＜0.001).Conclusion AIP is an independent risk factor for MAFLD in individuals with BMI＜23 kg/m2.Combination of AIP,BMI and ALT has high clinical value in predicting MAFLD in individuals with BMI＜23 kg/m2.

Abstract:Objective To analyze the effects of the interaction between serum nucleotide-binding oligome-rization domain-like receptor protein 3(NLRP3)and heat shock protein 70(Hsp70)on cognitive impairment in elderly patients with minor ischemic stroke(MIS).Methods A total of 219 elderly MIS patients admitted to the First Affiliated Hospital of Hebei North University from December 2024 to May 2025 were enrolled.Cognitive func-tion was assessed using the Montreal cognitive assessment scale 3 months after onset.Patients were divided into cognitive impairment group and non-cognitive impairment group.Serum NLRP3 and Hsp70 levels were compared between the two groups.Pearson correlation was used to analyze the correlation between serum NLRP3 and Hsp70.Logistic regression was used to analyze the relationship between serum NLRP3,Hsp70 and cognitive impairment.The interaction between NLRP3 and Hsp70 on cognitive impairment was analyzed.Receiver operating characteristic(ROC)curve and decision curve analysis were used to evaluate the predictive value of serum NLRP3 and Hsp70 for cognitive impairment in elderly MIS patients.Results Serum NLRP3 level in the cognitive impairment group was significantly higher than that in the non-cognitive impairment group[(137±13)ng/L vs(109±9)ng/L],and Hsp70 level was significantly lower[(22±4)μg/L vs(30±6)μg/L](both P＜0.05).Pearson correlation analysis showed that serum NLRP3 level was negatively correlated with serum Hsp70 level(r=-0.843,P＜0.05).Logistic regression analysis showed that age and serum NLRP3 were risk factors for cognitive impairment in elderly MIS patients,while education years and Hsp70 were protective factors(all P＜0.05).Interaction analysis showed that after adjusting for confounding factors,compared with low NLRP3+high Hsp70 group,the risk of cognitive impairment in high NLRP3+low Hsp70 group increased to 10.326 times.Serum NLRP3 and Hsp70 had a syner-gistic interaction effect on the risk of cognitive impairment(P＜0.05).ROC curve showed that the area under the curve of combined serum NLRP3 and Hsp70 prediction was 0.895,which was higher than that of single indicator(all P＜0.05).Decision curve showed that within the risk threshold of 0.01-0.99,the net benefit rate of combined detection of serum NLRP3 and Hsp70 was higher than that of single detection.Conclusion Serum NLRP3 is a risk factor and Hsp70 is a protective factor for cognitive impairment in elderly MIS patients.They have a synergistic interaction effect on cognitive impairment,and combined detection can improve the predictive value for the risk of cognitive impairment.

Abstract:Objective To analyze the differences in arterial partial pressure of carbon dioxide(PaCO2)and the incidence of central sleep apnea(CSA)in patients with chronic heart failure(CHF)at different altitudes,and to explore the related influencing factors for the occurrence of CSA.Methods A total of 78 CHF patients admitted from January 2022 to March 2025 were enrolled,including 48 cases from the Third People's Hospital of Chengdu,Sichuan Province(residents living at a mean altitude of 500 m,low-altitude group)and 30 cases from Litang County People's Hospital,Sichuan Province(residents living continuously at an altitude of 3 900-4 100 m for≥5 years,high-altitude group).The clinical data and relevant clinical indicators of the patients were collected.Multivariate Logistic regression analysis was used to screen the independent risk factors for CSA.Two-way analysis of variance was adopted to evaluate the effects of PaCO2 and altitude on the central sleep apnea index(CSAI),micro-arousal index(MAI)and Epworth sleepiness scale(ESS)score.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive efficacy of PaCO2 for CSA in CHF patients with different heart failure locations at different altitudes.Results Multivariate Logistic regression analysis showed that left heart failure,left ventricular ejection fraction ≤40％,PaCO2 ≤38 mmHg and tricuspid annular systolic excursion ≤12 mm were all independent risk factors for CSA(all P＜0.05).Regardless of PaCO2 levels,there were statistically significant differences in CSAI and ESS scores between the different altitude groups(all P＜0.001).CSAI and ESS scores increased gradually with the elevation of altitude,and there was an interactive effect of altitude and PaCO2 on CSAI(all P＜0.001).Regardless of altitude,there was a statistically significant difference in MAI between the different PaCO2 groups(P＜0.001).MAI increased gradually with the rise of PaCO2,and altitude and PaCO2 had an interactive effect on CSAI(P＜0.001).ROC curve analysis showed that when PaCO2 ≤36.8 mmHg,the area under the curve(AUC)for predicting CSA in patients with left heart failure was 0.918;when PaCO2 ≤35.2 mmHg,the AUC for predicting CSA in patients with right heart failure was 1.000.For patients in the high-altitude area,when PaCO2 ≤36.9 mmHg,the AUC for predicting CSA in patients with left heart failure was 0.964;when PaCO236.0 mmHg,the AUC for predicting CSA in patients with right heart failure was 0.972.Conclusion Altitude and PaCO2 have an interactive effect on CSA-related indicators in CHF patients.The risk of CSA is higher in the high-altitude environment,and PaCO2 can serve as an important indicator for predicting CSA.

Abstract:Objective To investigate the predictive value of C-reactive protein-triglyceride-glucose index(CTI)for major adverse cardiovascular and cerebrovascular events(MACCE)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods A total of 431 STEMI patients who underwent emergency PCI in Beijing Tiantan Hospital,Capital Medical University from October 2022 to October 2024 were retrospectively enrolled.According to tertiles of CTI,patients were divided into low CTI group(CTI＜5.01,144 cases),middle CTI group(5.01 ≤CTI＜5.56,143 cases)and high CTI group(CTI≥5.56,144 cases).Demographic data,past medical history,laboratory examinations and interventional procedure-related data were collected.The median follow-up time was 28 months,and the primary endpoint was the occurrence of MACCE.MACCE-free survival rates among different CTI groups were analyzed.Cox proportional hazards regression model was used to evaluate the association between CTI and MACCE.Restricted cubic spline(RCS)was applied to analyze the dose-response relationship,and subgroup interaction analysis was performed.Results Survival analysis showed that the incidence of MACCE in the low CTI group was significantly lower than that in the middle and high CTI groups(P=0.039).Cox regression analysis revealed that after adjustment for multiple confounders,each 1-unit increase in CTI as a continuous variable was associated with a 59％increased risk of MACCE(P=0.006);the risks of MACCE in the middle and high CTI groups were 1.94 times(P=0.032)and 2.08 times(P=0.018)that in the low CTI group,respectively.RCS curve indicated a positive correlation between CTI and MACCE risk without significant nonlinearity(Poverall=0.022,Pnonlinear=0.898).Subgroup analysis showed a significant interaction between hypertension history and CTI(P=0.002).The associ-ation between elevated CTI and higher MACCE risk was stronger in patients with hypertension(hazard ratio=3.51,P＜0.001),but not significant in those without hypertension.Conclusion CTI level is associated with the occurrence of MACCE in STEMI patients after emergency PCI,and can be used as a reference index for clinical evaluation of prognostic risk.

Abstract:Knee osteoarthritis is a common chronic disease characterized by cartilage degeneration and synovial fibrosis,and its traditional Chinese medicine syndrome differentiation involves homeostasis imbalance of multiple Zang-Fu organs.The theory of"regulating the middle energizer and restoring balance"takes regulating the spleen and stomach of the middle energizer as the core,and restores the dynamic balance of human body functions by regulating Qi,blood,Yin,Yang,cold,heat,deficiency and excess of the body.The"gut-joint axis"theory mainly focuses on the intestinal flora imbalance that releases pro-inflammatory cytokines and produces inflammatory metabolites,leading to a state of systemic chronic inflammation,which in turn induces or aggravates knee osteoarthritis.This paper aims to discuss the consistency of the two theories and provide new ideas for the diagnosis and treatment of knee osteoarthritis.

Abstract:As a common gynecological malignancy,cervical cancer is mainly associated with persistent human papillomavirus(HPV)infection.However,there are significant individual differences in the proportion of infected individuals progressing to cancer,suggesting that host genetic factors play a key role in the occurrence and development of the disease.This article reviews various gene polymorphisms affecting cervical cancer susceptibility and their mechanisms.Human leukocyte antigen gene polymorphisms regulate cellular immune responses by affecting the efficiency of antigen presentation.Variations in genes related to innate immunity and inflammatory response can alter the body's ability to clear HPV and inhibit tumors.Polymorphisms of cell cycle regulation and DNA repair genes X-ray repair cross-complementing protein 1 and 3 may lead to decreased repair capacity.High expression of tumor-associated gene breast cancer susceptibility gene 1 interacting protein C-terminal helicase 1 can promote tumor progression through the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin pathway.The deletion type of detoxification metabolism gene glutathione S-transferase M1 weakens the body's detoxification and antioxidant functions,increasing the risk of disease.These genetic variations interact with HPV infection and inflammatory microenvironment,jointly forming a complex genetic susceptibility background of cervical cancer,and providing an important molecular basis for disease risk prediction,high-risk screening,and individualized prevention and treatment.

Abstract:Objective To investigate the effects of proprioceptive neuromuscular facilitation combined with balance training on limb stability,postural adjustment ability and fall risk in patients with brain injury.Methods A total of 98 patients with brain injury admitted to Beijing Rehabilitation Hospital,Capital Medical University from March 2024 to February 2025 were selected and divided into balance training group(received balance training)and neuromuscular facilitation group(received proprioceptive neuromuscular facilitation combined with balance training)according to the random number table method,with 49 cases in each group.Limb stability,postural adjustment ability,fall risk,rehabilitation training compliance and muscle strength were compared between the two groups before and after intervention.Results After intervention,the scores of Fugl-Meyer assessment scale,Tinetti balance and gait scale and rehabilitation training compliance in the neuromuscular facili-tation group were higher than those in the balance training group,while the score of Morse fall assessment scale was lower than that in the balance training group(all P＜0.05).The proportions of grade 0 and grade 1 muscle strength in the medical research council scale in the neuromuscular facilitation group were lower than those in the balance training group[0(0/49)vs 12.2％(6/49),4.1％(2/49)vs 32.7％(16/49)],and the proportions of grade 4 and grade 5 muscle strength were higher than those in the balance training group[24.5％(12/49)vs 6.1％(3/49),14.3％(7/49)vs 2.0％(1/49)](all P＜0.05).Conclusion The comprehensive therapy of proprioceptive neuromuscular facilitation combined with balance training is significantly better than single balance training in the rehabilitation of patients with brain injury,which can more effectively improve limb stability and postural adjustment ability,reduce fall risk,improve muscle strength grade,and achieve higher rehabilitation training compliance.

Abstract:Objective To investigate the effects of enteral nutrition suspension combined with bifidobacterium triple viable capsules on intestinal flora and T helper cell 17/regulatory T cell(Th17/Treg)cytokines in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with type Ⅱ respiratory failure.Methods A total of 205 elderly patients with AECOPD complicated with type Ⅱ respiratory failure admitted to Nanjing Hospital Affiliated to Nanjing Medical University from August 2023 to March 2025 were enrolled.They were divided into control group(102 cases)and treatment group(103 cases)by random envelope method.The control group received early enteral nutrition,while the treatment group was additionally given bifidobacterium triple viable capsules on the basis of early enteral nutrition.Both groups were treated continuously for 10 d.The clinical efficacy of the two groups was observed,and the nutritional indicators,intestinal flora,serum Th17/Treg cytokines and adverse reactions before and after treatment were compared.Results The total clinical effective rate of the treatment group was significantly higher than that of the control group[95.1％(98/103)vs 85.3％(87/102)](P＜0.05).In terms of nutritional indicators,the levels of albumin,total protein and hemoglobin in both groups were significantly increased after treatment compared with those before treatment,and the levels in the treatment group were significantly higher than those in the control group(all P＜0.05).Intestinal flora analysis showed that compared with before treatment,the abundance of beneficial bacteria(Bifidobacterium,Lactobacillus acidophilus)in both groups was significantly increased after treatment,while the abundance of harmful bacteria(Escherichia coli,Enterococcus)showed an opposite change;comparison between groups further confirmed that the treatment group was significantly better than the control group in optimizing flora structure(all P＜0.05).Compared with before treatment,the serum levels of interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)in both groups were significantly decreased after treatment,while the levels of IL-10 and IL-35 were significantly increased.Meanwhile,the serum levels of IL-17 and TNF-α in the treatment group were significantly lower than those in the control group,and the levels of IL-10 and IL-35 were significantly higher than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P＞0.05).Conclusion Early enteral nutrition combined with bifidobacterium triple viable capsules can effectively improve the clinical efficacy of elderly patients with AECOPD complicated with type Ⅱ respiratory failure,improve nutritional indicators and intestinal flora,regulate Th17/Treg cytokines,with good safety.

Abstract:Objective To evaluate the association between long-term exposure to different particle sizes[fine particulate matter(PM2.5),inhalable particulate matter(PM10)]and cardiovascular disease(CVD)risk in middle-aged and elderly individuals with metabolic syndrome(MS).Methods Based on the 2011-2018 data from the China Health and Retirement Longitudinal Study,1 959 participants aged ≥60 years were enrolled and divided into non-CVD group(1 445 cases)and CVD group(514 cases)according to CVD status.MS status was classified based on relevant metabolic indicators.Individual exposure levels were estimated using annual average concentrations of PM2.5 and PM10.Participants were divided into four groups(Q1-Q4)according to quartiles of particulate matter concentration,with Q,as the lowest exposure group(control)and Q4 as the highest exposure group,to compare risks at different exposure levels.Cox proportional hazards regression model was applied to assess the effects of PM2.5 and PM10 on CVD incidence risk,and restricted cubic spline was used to analyze the dose-response relationship between average particulate matter concentration and CVD incidence risk.Results High exposure to PM2.5 and PM10 was both significantly associated with elevated CVD incidence risk(both P＜0.05).After stepwise adjustment for sociodemographic factors,lifestyle,physiological indicators and past medical history in multiple models,the independent association of CVD risk remained significant in the Q4 group for PM2.5(hazard ratio=1.60,95％confidence interval:1.22-2.08);a consistent trend was observed for PM10,with significant dose-response relationships in both.Restricted cubic spline analysis showed that the associations of PM2.5 and PM10 concentrations with CVD were significant in non-MS individuals(P=0.009 6,0.001 5)but not significant in MS individuals(both P＞0.05).Conclusions Exposure to PM2.5 and PM10 is positively correlated with CVD incidence risk in middle-aged and elderly individuals.This association exhibits a"ceiling effect"in MS individuals and is more significant in non-MS individuals,suggesting that both may be independent risk factors for CVD.

Abstract:As the terminal stage of cardiovascular diseases,chronic heart failure(CHF)has become a global public health challenge due to its high mortality,readmission rate and medical burden.The early 3 months after discharge is a period of variable condition and high risk for heart failure patients,with a high incidence of death and readmission.In this regard,the 2018 Chinese guidelines for the diagnosis and treatment of heart failure proposed the concept of the"vulnerable phase"of heart failure.Under the guidance of the traditional Chinese medicine theory of"preventing disease before its onset",combined with the characteristics of dynamic evolution of syndromes,constructing an early warning system for the vulnerable phase of heart failure to conduct early risk warning and monitoring for this phase provides a new idea for the integrated prevention and treatment of traditional Chinese and western medicine.

Abstract:Spinocerebellar ataxia type 3(SCA3)is an autosomal dominant neurodegenerative disease and one of the most common neurogenetic degenerative disorders.The core pathogenic factor is the abnormal expansion of CAG trinucleotide repeat sequences in the ATXN3 gene,which leads to the accumulation of mutant ataxin-3 protein.Its pathogenesis has not been fully elucidated,and there is no effective therapeutic drug available.Mitochondrial dysfunction is a key pathological mechanism of SCA3.This article focuses on the role of mitochondrial dysfunction in SCA3.Mitochondrial dysfunction in SC A3 is characterized by bioenergetic defects such as decreased membrane potential,elevated reactive oxygen species and reduced adenosine triphosphate production.The underlying mechanisms involve the interference of mutant ataxin-3 with mitophagy by affecting the deubiquitination of voltage-dependent anion channel 1,a vicious cycle formed by oxidative stress and mitochondrial damage,imbalance of mitochondrial quality control,and tissue-specific susceptibility of apoptotic pathways.In-depth study of these mechanisms is of great significance for the development of therapeutic strategies.Future multi-dimensional target research focusing on mitochondrial protection and metabolic regulation may provide new translational directions for the treatment of SCA3.This article reviews the research progress on the role and underlying mechanisms of mitochondrial dysfunction in SC A3.

Abstract:Comorbidity in the elderly is one of the global research hotspots at present.Respiratory sarcopenia comorbid with lung cancer in the elderly seriously impairs the therapeutic efficacy and tolerance of patients,exacerbates their quality of life and functional status,and even directly increases the risk of death.The demand for long-term medical and nursing management brings enormous pressure to the medical system.At present,the pathogenesis of the comorbidity of these two diseases remains unclear.This article introduces the epidemiological status of respiratory sarcopenia comorbid with lung cancer in the elderly,analyzes the pathogenesis of lung cancer complicated with respiratory sarcopenia and the common risk factors of the two diseases,and summarizes the intervention measures to improve respiratory muscle strength and increase muscle mass.It is expected to provide a reference for medical staff in the research and management of respiratory sarcopenia comorbid with lung cancer in the elderly,thereby improving the prognosis and optimizing the quality of life of elderly patients with lung cancer.

Abstract:Objective To reveal the regulatory mechanism of microRNA(miR)during Chikungunya virus(CHIKV)infection and predict potential therapeutic drugs for CHIKV infection,this study integrating multi-omics analysis methods based on public multi-omics databases of CHIKV.Methods By analyzing multiple datasets(GSE49985,GSE49884,GSE143390)in the Gene Expression Omnibus database,the limma package of R language was used to identify differentially expressed messenger RNAs(DEmRNAs)and differentially expressed miRs(DEmiRs).The miRTarBase,miRDB and TargetScanHuman databases were applied to predict the target genes of DEmiRs,and the miR-mRNA negative regulatory network in CHIKV infection was constructed.Finally,potential therapeutic drugs were predicted based on the EpiMed platform,Connectivity Map database and high-throughput virtual screening.Results A total of 1134 DEmRNAs and 54 DEmiRs were identified in this study.Gene Ontology analysis showed that DEmRNAs were significantly involved in biological processes such as cell cycle,chromosome segregation and protein folding.Kyoto Encyclopedia of Genes and Genomes analysis indicated that DEmRNAs were enriched in pathways including viral infection,protein processing,lysosome and neurodegenerative diseases.The miR-mRNA negative regulatory network contained 29 pairs of up-regulated miR with down-regulated mRNA and 90 pairs of down-regulated miR with up-regulated mRNA.The maximal clique centrality algorithm in the cytoHubba plug-in of Cytoscape software was used to screen the predicted target genes and construct a sub-regulatory network.Through drug prediction,94 candidate drugs were identified by the EpiMed platform and 2907 candidate drugs were screened out by the Connectivity Map database.Comprehensive evaluation was performed via high-throughput virtual screening,and finally 5 potential therapeutic drugs associated with typical clinical symptoms of CHIKV infection were determined,including clonazepam,nevirapine,itracon-azole,pimecrolimus and meloxicam.Conclusions This study constructed the CHIKV infection-related miR-mRNA negative regulatory network and screened key genes,and further predicted 5 potential candidate drugs by combining drug repurposing and virtual screening,which provides systems biology clues and candidate resources for targeted intervention of CHIKV.