Abstract:Objective To investigate the clinical effect of Xuebijing combined with ulinastatin in the treatment of sepsis.Methods Totally 78 patients with sepsis admitted to Zhangjiakou First Hospital,Hebei Province from March 2022 to January 2024 were selected.Patients were divided into observation group and control group by random number table method,with 39 cases in each group.The control group received ulinastatin for injection on the basis of comprehensive treatment.The observation group was treated with Xuebijing injection on the basis of the control group.Both groups were treated for 1 week and followed up until discharge.The clinical efficacy,traditional Chinese Medicine syndrome scale(TCM)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,thromboelastography(TEG)parameters,serological indicators and adverse reactions were compared between the two groups.Results After treatment,the total clinical effective rate of the observation group was higher than that of the control group[94.9％(37/39)vs 79.5％(31/39)](x2=4.129,P=0.042).After treatment,the TCM,APACHE Ⅱ and SOFA scores of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P＜0.05).The TEG reaction time,coagulation time and maximum amplitude of thrombosis in the two groups were shorter/lower than those before treatment,and those in the observation group were shorter/lower than those in the control group(all P＜0.05).The levels of serum creatinine,cystatin C,procalcitonin,neutrophil gelatinase-associated lipocalin,kidney injury molecule 1,microRNA-223 and microRNA-155 in the two groups were lower than those before treatment,and those 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 two groups during treatment(P＞0.05).Conclusion Xuebijing combined with ulinastatin can improve the clinical symptoms and organ function of patients with sepsis,reduce the severity of the disease,stabilize TEG parameters,control the inflammatory response of the body,relieve kidney injury,with significant efficacy and good safety.

Abstract:Objective To observe the clinical effect of Yangxin Zhitong granule in the treatment of chronic stable angina pectoris with Qi deficiency and blood stasis syndrome and its effect on blood lipid and inflammatory factors.Methods A total of 130 patients with chronic stable angina pectoris of Qi deficiency and blood stasis syndrome in the First Affiliated Hospital,Heilongjiang University of Chinese Medicine from June 2021 to June 2024 were selected as the research objects,and they were divided into observation group and control group according to the random number table method,with 65 cases in each group.The control group was treated with standardized western medicine,and the observation group was treated with Yangxin Zhitong granule on the basis of the control group.Both groups were treated for 4 weeks.The changes of traditional Chinese medicine syndrome score and curative effect,angina symptom score and curative effect,blood lipid and inflammatory index were compared between the two groups.Results The total effective rate of TCM syndrome in the observation group was higher than that in the control group(P＜0.05).After treatment,the total score of TCM syndrome in the observation group was significantly lower than that in the control group(P＜0.05).After treatment,the frequency of angina attack,the duration of each pain,and the total score of angina symptoms in the two groups were lower/shorter than those before treatment,and the observation group was lower/shorter than the control group(all P＜0.05).The total effective rate of angina pectoris in the observation group was higher than that in the control group[77.8％(49/63)vs 62.3％(38/61)](x2=8.094,P=0.017).The total effective rate of electrocardiogram treatment in the observation group was higher than that in the control group(P＜0.05).After treatment,the levels of total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-sensitivity C-reactive protein and lipoprotein associated phospholipase A2 in the observation group were lower than those in the control group,and the level of high-density lipoprotein cholesterol was higher than that in the control group(all P＜0.05).There were no significant abnormalities in blood and urine routine,liver and kidney function before and after treatment in the two groups.Conclusion Yangxin Zhitong granule can significantly improve the clinical total effective rate of patients with chronic stable angina pectoris of Qi deficiency and blood stasis syndrome,effectively improve the symptoms of patients,play a role in lowering lipids and anti-inflammation,and improve the quality of life.

Abstract:Objective To investigate the clinical effect of Lifei capsules combined with theophylline sustained-release tablets in the treatment of chronic asthmatic bronchitis.Methods A total of 90 patients with chronic asthmatic bronchitis admitted to Shanxi Cancer Hospital from March 2022 to December 2023 were selected as the research objects.According to the random number table method,90 patients were divided into the control group and the observation group,45 cases in each group.The control group was treated with theophylline sustained-release tablets on the basis of basic treatment,and the observation group was treated with Lifei capsules combined with theophylline sustained-release tablets on the basis of basic treatment.The total effective rate,improvement time of clinical symptoms,blood gas indexes,inflammatory factors and incidence of adverse drug reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[93.3％(42/45)vs 77.8％(35/45)](P=0.036).The improvement times of wheezing,cough and phlegm in the observation group were shorter than those in the control group(all P＜0.05).After treatment,the levels of arterial partial pressure of oxygen in the two groups were higher than those before treatment,and that in the observation group was higher than that in the control group.The levels of arterial partial pressure of carbon dioxide,C-reactive protein,interleukin-6 and procalcitonin were lower than those before treatment,and those 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 drug reactions between the two groups(P=0.609).Conclusion Lifei capsules combined with theophylline sustained-release tablets can achieve good clinical effect in the treatment of chronic asthmatic bronchitis,which can effectively improve the blood gas indexes and inflammatory response in the body,and has good safety.

Abstract:Peritoneal metastasis in advanced gastric cancer is the most common form of distant metastasis in patients with poor prognosis.Neoadjuvant intraperitoneal combined with systemic chemotherapy(NIPS)and immunotherapy represented by programmed cell death protein 1 inhibitors have been gradually applied to the treatment of peritoneal metastasis of gastric cancer.In this study,two patients with advanced gastric cancer with peritoneal metastasis were reported.Laparoscopic exploration indicated peritoneal metastasis,and they were treated with oxaliplatin and tegafur,gimeracil and oteracil potassium combined with albumin-bound paclitaxel systemic and intraperitoneal chemotherapy,and sintilimab intravenous infusion for 4 cycles.After conversion therapy,the patient's imaging showed partial remission,and then laparoscopic exploration was performed,and no clear peritoneal metastasis was found in the exploration.The radical resection was successfully performed,and the postoperative pathology showed effective downstaging,and the patient recovered smoothly.The results indicate that NIPS combined with sintilimab is effective and safe in the conversion therapy of gastric cancer with peritoneal metastasis,but this mode needs more research to prove.

Abstract:Heart failure is one of the leading causes of death in many patients with cardiovascular diseases and threatens human health worldwide.With the continuous development of molecular biology technology,many forms of programmed cell death have been discovered recently,and related research involves many fields.Some studies have shown that some programmed cell death pathways are related to the mechanism of heart failure.This article reviews the molecular mechanisms of programmed cell death pathways such as autophagy,pyroptosis and ferroptosis in heart failure,and discusses the role of reported forms of programmed cell death in heart failure,in order to provide a new direction for understanding the mechanism of heart failure from the perspective of programmed cell death.

Abstract:Hemodialysis is the main treatment for end-stage renal disease.Before hemodialysis treatment,it is necessary to establish a vascular access and maintain stable and long-term blood flow to ensure the effect of hemodialysis treatment.At present,there is no ideal vascular access type.Clinically,vascular access types that can maintain long-term stable blood flow mainly include autogenous arteriovenous fistula,graft arteriovenous fistula and central venous catheter.The choice of different vascular access types may also cause different complications in patients with end-stage renal disease,and have different effects on the prognosis of patients.In order to better understand the effects of different vascular access types on the prognosis of patients with end-stage renal disease,this article reviews the selection of vascular access and its correlation with the prognosis of patients,so as to provide reference for the decision-making of vascular access types in patients with end-stage renal disease undergoing hemodialysis.

Abstract:Objective To investigate the safety and efficacy of remimazolam as adjunctive sedation during spinal puncture in patients undergoing knee replacement surgery.Methods Sixty patients who underwent knee joint replacement surgery under spinal anesthesia at Hainan General Hospital from March 2022 to May 2023 were selected.The American Association of Anesthesiologists graded them as Grade Ⅰ-Ⅲ and divided into three groups using a random number table method:control group(group C),remimazolam 0.04 mg/kg group(group R1)and remimazolam 0.06 mg/kg group(group R2),with 20 cases in each group.After positioning the left flexion position,all patients were slowly injected with normal saline and remimazolam 0.04 mg/kg and 0.06 mg/kg,respectively,and Lumbar puncture was performed under local anesthesia in the L2-3 space 1 minute later.Heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SpO2),modified observer's assessment of alertness/sedation(MOAA/S)score and patient satisfaction were recorded before administration and 1,2,3,4,5,6,7,8,9,10,15 min after administration.Results HR and MOAA/S scores at 2,3,4,5,6,7,8,9,10 min after administration in group R2 were lower than those in group C(all P＜0.05),and MAP at 4,5,6 min after administration in group R2 were lower than those in group C(all P＜0.05).The MOAA/S scores in group R2at2,3,4,5,6,7,8 min after administration were lower than those in group R1(all P＜0.05).HR at 3,4,5,6,7,8,9,10,15 min after administration in group R2 were lower than those before administration(all P＜0.05),and MAP at 4,5,6,7,8,9,10,15 min after administration in group R2 were lower than those before administration(all P＜0.05).MOAA/S scores at 2,3,4,5,6,7,8,9,10 min after administration in group R2 were lower than those before administration(all P＜0.05).There were no significant differences in SpO2 among the three groups at each time point(all P＞0.05).The very satisfied percentage of patients in group R2 were higher than those in group R1 and group C[90.0％(18/20)vs 60.0％(12/20),30.0％(6/20)](both P＜0.05).Conclusion The use of 0.06 mg/kg remimazolam has better sedative effect during spinal puncture in patients undergoing knee replacement,with little effect on respiratory depression,stable HR and blood pressure,and high safety.

Abstract:Objective To investigate the perioperative characteristics of blink reflex in patients with primary trigeminal neuralgia(PTN)undergoing percutaneous trigeminal gasserian ganglion balloon compression(PBC)and its relationship with long-term postoperative efficacy.Methods The clinical data of 150 PTN patients who underwent PBC in Hebei General Hospital from February to October 2020 were collected and retrospectively analyzed.All patients were evaluated for facial numbness and pain using the Barrow Neurological Institute painse-verity(BNI-P)and Barrow Neurological Institute facial numbness(BNI-N)at 1 d before surgery,1 d after surgery,and 1,3,6,and 12 months after surgery,respectively.Blink reflex testing(involving the latency and amplitude of conduction pathways R1,R2,and R2')was also performed.According to the follow-up results in the third year after surgery,the patients were divided into cure group(120 cases)and recurrence group(30 cases).The clinical data of the two groups were compared,and the Logistic regression method was used to analyze the influencing factors of the long-term prognosis of the patients,establish a prediction model,and evaluate the goodness of fit of the model.Results The BNI-P scores of patients at 1 d after surgery and at 1,3,6,and 12 months after surgery were significantly lower than that at 1 d before surgery(all P＜0.05).After PBC treatment,the latency of R1,R2,and R2'showed an overall decreasing trend,while the amplitude of R1,R2,and R2'showed an overall increasing trend(all P＜0.05).The results of the multivariate Logistic regression analysis incorporating the most comprehensive factors showed that body mass index(odds ratio=1.254,P=0.028),disease duration(odds ratio=1.072,P=0.008),preoperative BNI-P(odds ratio=2.189,P=0.040),preoperative R1,R2,and R2'latency(odds ratio=3.546,4.165,1.314;P=0.012,0.014,0.038),and preoperative R1,R2,and R2'amplitude(odds ratio=0.933,0.920,0.942;P=0.009,0.003,0.002)were all influencing factors for long-term prognosis.The Hosmer-Lemeshow test showed that the model had good goodness of fit(P=0.796).Conclusions PBC treatment of PTN patients can achieve good clinical efficacy,and the blink reflex indexes show a decreasing trend with the follow-up time,and there is a positive correlation between the symptoms of facial numbness.Individual factors,preoperative levels of BNI-P and blink reflex have important effects on the long-term efficacy of PTN patients after surgery.

Abstract:Objective To observe the efficacy and safety of gemcitabine or paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab as first-line treatment for advanced non-small cell lung cancer(NSCLC)without gene mutation.Methods Totally 120 patients with advanced NSCLC without gene mutation admitted to Chengdu Fifth People's Hospital,Sichuan Province from January 2022 to June 2023 were selected.They were divided into control group and observation group using a random number table method,with 60 cases in each group.The control group was treated with gemcitabine combined with lobaplatin and camrelizumab.The observation group was treated with paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab.The levels of serum squamous cell carcinoma associated antigen(SCC),cytokeratin 19 fragment antigen(CA21-1),transforming growth factor-β,(TGF-β1),serum CD3+,CD4+,CD8+and the ratio of CD4+/CD8+were compared between the two groups before and 14 d after treatment.The clinical efficacy and incidence of toxic side effects were compared between the two groups.Results After 14 d of treatment,the levels of SCC,CA21-1 and TGF-β1and CD8+in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group;the serum levels of CD3+,CD4+,and the ratio of CD4+/CD8+in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).The objective remission rate and disease control rate of the observation group were higher than those of the control group[45.0％(27/60)vs 28.3％(17/60),73.3％(44/60)vs 58.3％(35/60)](both P＜0.05).The incidences of granulocytopenia and thrombocytopenia in the observation group were lower than those in the control group,and the incidence of muscle/joint pain was higher than that in the control group[25.0％(15/60)vs 78.3％(47/60),30.0％(18/60)vs 66.7％(40/60),71.7％(43/60)vs 23.3％(14/60)](all P＜0.05),and there was no statistically significant difference in the incidence of nausea and vomiting between the two groups(P＞0.05).Conclusions Compared with gemcitabine combined with lobaplatin and camrelizumab,paclitaxel for injection(albumin bound)combined with lobaplatin and camrelizumab is more effective in the first-line treatment of advanced NSCLC without gene mutations,which can effectively reduce the level of tumor markers.It also has the advantages of low toxicity,little effect on the immune system,helping the recovery of T lymphocyte subsets,and reducing bone marrow suppression.

Abstract:Cervical cancer is one of the major threats to women's health worldwide,and although it is a cancer that can be effectively prevented through early screening and diagnosis,accurate diagnosis still faces challenges.This article reviews the etiology and epidemiology of cervical cancer and precancerous lesions,and systematically reviews the latest progress in the field of cervical cancer screening at home and abroad,aiming to provide clinicians with comprehensive advances in cervical cancer screening technology,promote early detection and treatment,and reduce the incidence and mortality of cervical cancer.

Abstract:Objective To evaluate the effects of cardiac rehabilitation training on cardiac function recovery and prognosis of patients with acute myocardial infarction after percutaneous coronary intervention(PCI)in cold areas of China.Methods A total of 1 914 patients diagnosed with acute ST-segment elevation myocardial infarction in the Department of Cardiology,Hegang People's Hospital,Heilongjiang Province from January 2016 to December 2023 were retrospectively enrolled in this study.All enrolled patients underwent primary coronary angiography and PCI.Patients were divided into rehabilitation training group(833 cases)and conventional treatment group(1 081 cases)according to whether they received cardiac rehabilitation training.The clinical data and in-hospital complications of the two groups were compared,and the results of cardiopulmonary exercise test after discharge of the rehabilitation training group were analyzed.The incidence of major adverse cardiovascular events(MACE)in 1 year of follow-up was compared between the two groups.Results The incidences of atrial and ventricular arrhythmia in the rehabili-tation training group was lower than those in the conventional treatment group(both P＜0.05).In the rehabilitation training group,patients were followed up at 1,3,6,and 12 months after discharge and underwent cardiopulmonary exercise testing.The results showed that the patients'power,heart rate,carbon dioxide output,oxygen intake,lung ventilation per minute,dead space ventilation ratio,end-tidal carbon dioxide partial pressure,carbohydrate metabolism percentage,cardiac output and stroke volume were significantly improvement compared to before(all P＜0.05).At 1-year follow-up,the incidence of MACE in the rehabilitation training group was significantly lower than that in the conventional treatment group[25.2％(210/833)vs 39.3％(425/1 081)](P＜0.001).Conclusion Cardiac rehabilitation training can effectively improve the recovery of cardiac function and prognosis of patients with acute myocardial infarction after PCI in cold areas of China.

Abstract:Objective To investigate the prognostic value of heparin-binding protein,neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in patients with community-acquired pneumonia(CAP).Methods A total of 115 CAP patients admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University from November 2022 to November 2023 were selected as observa-tion objects.The patients were followed up for 28 days after discharge.According to the survival situation,the patients were divided into good prognosis group(94 cases)and poor prognosis group(21 cases).The general data and laboratory indexes of the two groups were collected and compared.Logistic regression was used to analyze the risk factors of poor prognosis in CAP patients.The receiver operating characteristic curve was used to analyze the value of heparin-binding protein,NLR,PLR alone and the combination of other indicators in evaluating the poor prognosis of CAP patients.Results There were no significant differences in gender,age,body mass index,smoking history,drinking history,diabetes mellitus history,diastolic blood pressure,systolic blood pressure,urea nitrogen,creatinine,alanine aminotransferase,aspartate aminotransferase between the two groups(all P＞0.05).The clinical pulmonary infection score,interleukin-6,C-reactive protein,procalcitonin,white blood cell count,heparin-binding protein,NLR and PLR in the poor prognosis group were higher than those in the good prognosis group(all P＜0.05).Multivariate Logistic regression analysis showed that clinical pulmonary infection score,interleukin-6,C-reactive protein,procalcitonin,white blood cell count,heparin-binding protein,NLR and PLR were all risk factors for poor prognosis of CAP patients(all P＜0.05).The results of receiver operating characteristic curve analysis showed that the area under the curve of heparin-binding protein,NLR,and PLR for evaluating the poor prognosis of CAP patients was 0.884,0.880,and 0.895,respectively,and the sensitivity was 0.714,0.762,and 0.810,respectively.The area under the curve of the three factors combined to evaluate the poor prognosis of CAP patients was 0.974,and the sensitivity was 0.905.Conclusion There are many and complex risk factors for poor prognosis of CAP patients.Heparin-binding protein,NLR and PLR have high value in the prognosis evaluation of CAP patients.

Abstract:Cerebral small vessel disease(CSVD)has gradually become an important disease that threatens people's health and quality of life,mainly causing cognitive impairment,movement disorders,emotional disorders,urinary and fecal incontinence and other symptoms,with high disability and mortality.It has a high incidence in the elderly population and is related to the occurrence and recurrence of stroke,cognitive dysfunction and psycho-logical disorders.Although the physiological and pathological process of CSVD is still unclear,some studies have confirmed that inflammatory response plays a crucial role in the pathogenesis of CSVD.Therefore,by exploring the physiology and pathology of CSVD,we hope to find appropriate serum inflammatory biomarkers and potential therapeutic targets,so as to provide early warning for the progression and prognosis of CSVD.Therefore,this article reviews the research progress and potential therapeutic targets of serum inflammatory biomarkers in CSVD.

Abstract:Objective To investigate the effect of the construction of standardized chest pain center on the treatment efficiency of emergency percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS)in Hotan area.Methods A total of 445 patients diagnosed with ACS in People's Hospital of Hotan Prefecture in Xinjiang Uygur Autonomous Region from January 2021 to April 2022 were retrospectively analyzed.All patients underwent emergency PCI.Among them,225 ACS patients who underwent emergency green channel mode(from January to August 2021)before standardized chest pain center certification were included in the control group.A total of 220 ACS patients who were admitted to the hospital after the certification of standardized chest pain center(from September 2021 to April 2022)were included in the observation group.The general information,the incidence of in-hospital major adverse cardiovascular events(MACE),the reperfusion treatment efficiency index of patients diagnosed with ST-segment elevation myocardial infarction(STEMI),the length of hospital stay,and hospitalization expenses were compared between the two groups.Results There was statistically significant difference in the proportion of patients with diabetes history between the two groups(P＜0.05).There was statis-tically significant difference in the incidence of in-hospital cardiogenic shock between the two groups(P＜0.05).The total incidence of in-hospital MACE in the observation group was significantly lower than that in the control group[10.9％(24/220)vs 17.8％(40/225)](P=0.039).The time from onset to first medical contact,the time from first medical contact to balloon dilatation,the ischemic time from door to balloon dilatation,and the activation time of catheterization laboratory in STEMI patients after the certification of standardized chest pain center were lower than those in STEMI patients under emergency green channel mode(all P＜0.05).The average hospitalization time and average hospitalization cost of the observation group were lower than those of the control group[(7.7±2.1)d vs(8.3±2.6)d,(28 353±9 071)yuan vs(30 163±10 203)yuan](both P＜0.05).Conclusion The construction of standardized chest pain center can effectively improve the efficiency of in-hospital treatment of ACS patients,reduce the time of myocardial ischemia,reduce the incidence of MACE,shorten the length of hospital stay,and save medical costs.

Abstract:Objective To clarify the correlation between premature delivery and preterm premature rupture of membranes(PPROM)and reproductive tract infection(RTI)during pregnancy.Methods A total of 416 pregnant women with preterm or PPROM who received regular prenatal examination and delivered in Tongzhou Maternal &Child Health Hospital of Beijing from January 2021 to December 2022 were selected as the research objects.According to whether there was clear evidence of RTI pathogen during delivery(admission during delivery),the patients were divided into observation group(171 cases,with evidence)and control group(245 cases,without evidence).The relevant data of pregnant women were analyzed,and the incidence of vaginitis,PPROM,gestational age,delivery method,incidence of fetal intrauterine distress,pregnancy outcomes of pregnant women of different ages,and birth weight of newborns at the same gestational age were compared between two groups.Results Among 171 pregnant women in the observation group,the top 3 pathogens in routine vaginal secretions examination were 14 cases(8.2％)of Mycoplasma urealyticum infection,13 cases(7.6％)of bacterial vaginosis,and 10 cases(5.8％)of fungal vaginitis.The common pathogens of RTI cultured in bacteriology were Streptococcus agalactiae in 9 cases(5.3％),Candida albicans in 8 cases(4.7％),and Escherichia coli in 6 cases(3.5％).The proportion of vaginal inflammation in the observation group during early pregnancy was higher than that in the control group[18.7％(32/171)vs 11.4％(28/245)](P=0.042).There were statistically significant differences between the observation group and the control group in terms of PPROM incidence,gestational age,delivery method,and incidence of fetal intrauterine distress(all P＜0.05).There was no statistically significant difference in incidence of PPROM,RTI and fetal distress among pregnant women of different age groups(all P＞0.05).There was no statistically significant difference in the birth weight of newborns born at the same gestational age between the observation group and the control group(all P＞0.05).Conclusions Mycoplasma urealyticum,Streptococcus agalactis and Candida albicans are the main pathogenic bacteria of reproductive tract infection.Gestational RTI may increase the risk of premature delivery and PPROM,and gestational RTI may increase the adverse outcome of mother and child during pregnancy.

Abstract:Myasthenia gravis(MG)is an autoimmune-related neuromuscular disease characterized by muscle weakness and rapid fatigue.There are various treatment strategies for MG,including symptomatic treatment,immunomodulatory therapy,biological drug therapy,and the emerging neonatal Fc receptor antagonist intervention.The goal of treatment is to control symptoms and signs and achieve clinical remission or a minimally symptomatic state.This article reviews the various approaches to the current treatment of MG,including traditional immunosuppressive therapies such as steroids,antimetabolites,and calcineurin inhibitors,as well as biologic drugs that target specific targets,such as rituximab for B cells and eculizumab for the complement system.Although a variety of treatment modalities have been shown to be effective,there are still challenges in the treatment of MG,including the diversity of treatment evaluation methods,the uncertainty of long-term treatment outcomes,and the definition of the applicability of emerging drugs.At present,neonatal Fc receptor antagonists,as an emerging treatment method,have shown good clinical efficacy in the short term,but their long-term efficacy and safety still need to be further studied.In addition,the importance of individualized treatment strategies is becoming increasingly prominent when dealing with MG subtypes with specific autoantibodies.Emerging treatment methods are based on biological drugs and research on new targets of immune pathways in order to better meet the treatment needs of different patients.

Abstract:Objective To investigate the diagnostic and prognostic evaluation value of lung ultrasound combined with interleukin-23(IL-23)and interleukin-17 in neonatal infectious pneumonia.Methods A total of 124 neonates with infectious pneumonia admitted to Shijiazhuang People's Hospital,Hebei Province from June 2020 to August 2023 were selected as the pneumonia group.According to the neonatal critical illness score,they were divided into non-critical group(＞90,72 cases)and critical group(≤90,52 cases).Another 124 neonates hospitalized for jaundice without pulmonary complications during the same period were selected as the control group.According to the ultrasound examination and symptoms after 7 d of treatment,the neonates with infectious pneumonia were divided into good prognosis group and poor prognosis group.All children underwent lung ultrasound examination after admission to evaluate the lung ultrasound score,and the serum levels of IL-23 and IL-17 were measured by enzyme-linked immunosorbent assay.The lung ultrasound scores and serum levels of IL-23 and IL-17 in each group were compared.The receiver operating characteristic(ROC)curve was used to analyze the value of the above indexes in the diagnostic and prognostic evaluation of neonatal infectious pneumonia.Results The lung ultrasound score and serum levels of IL-23 and IL-17 in the pneumonia group were higher than those in the control group(all P＜0.05).The lung ultrasound score and serum levels of IL-23 and IL-17 in the critical group were significantly higher than those in the non-critical group(all P＜0.05).The lung ultrasound score and serum levels of IL-23 and IL-17 in the good prognosis group were significantly lower than those in the poor prognosis group(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of lung ultrasound score combined with IL-23 and IL-17 in the diagnosis of neonatal infectious pneumonia was 0.901,which was significantly larger than that of each index alone(Z=4.209,3.492,3.748,all P＜0.05).The AUC of the combination of the three indicators in evaluating the prognosis of neonatal infectious pneumonia was 0.954,which was significantly larger than that of each indicator alone(Z=2.472,2.048,2.839,all P＜0.05).Conclusion The lung ultrasound scores and serum levels of IL-23 and IL-17 were significantly increased in the neonates with infectious pneumonia,and the levels of them were closely related to the severity and prognosis of the disease.The combination of the three methods has better efficacy in the diagnosis and prognosis evaluation of neonatal infectious pneumonia.

Abstract:Objective To investigate the clinical effect of enhanced external counterpulsation in the treatment of angina pectoris with cardiac insufficiency and its influence on serum N-terminal pro-brain natriuretic peptide(NT-proBNP)level.Methods A total of 82 patients with angina pectoris and cardiac insufficiency who were diagnosed and treated in the People's Hospital of Jingmen,Hubei Province from April 2022 to April 2023 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 41 cases in each group.The control group was given conventional drug treatment.The observation group was treated with enhanced external counterpulsation on the basis of the control group.The grading of angina pectoris,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end diastolic diameter(LVEDD)],laboratory testing indicators[NT-proBNP,high-sensitivity C-reactive protein(hs-CRP),human galactose agglutinin 3(Galectin-3)]before and after treatment,and incidence of cardiovascular adverse events between two groups were compared.Results After treatment,the classification of angina pectoris in the observation group was better than that in the control group(Z=-6.933,P＜0.001).After treatment,LVEF of the two groups were higher than those before treatment,LVFS and LVEDD were lower than those before treatment,LVEF of the observation group was higher than that of the control group,LVFS and LVEDD were lower than those of the control group(all P＜0.05).After treatment,the NT-proBNP,hs-CRP,and Galectin-3 levels in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).The incidence of adverse cardiovascular events in the observation group was lower than that in the control group[4.9％(2/41)vs 22.0％(9/41)](P=0.023).Conclusion The effect of enhanced external counterpulsation in the treatment of patients with angina pectoris and cardiac insufficiency is significant,which can effectively improve the symptoms of angina pectoris and cardiac function,and reduce the levels of NT-proBNP and inflammatory factors.

Abstract:Objective To explore the clinical effect of acupuncture Xingshen four points combined with cognitive-motor dual task training(CMDT)in the treatment of cerebral infarction complicated with cognitive dysfunction.Methods A total of 96 patients with cerebral infarction combined with cognitive dysfunction admitted to the Second Affiliated Hospital of Hainan Medical College from August 2020 to August 2023 were selected and divided into control group and observation group by random number table method,with 48 cases in each group.On the basis of basic treatment,the control group was treated with CMDT for 4 weeks,and the observation group was treated with acupuncture Xingshen four points combined with CMDT for 4 weeks.The Montreal cognitive assess-ment(MoCA)score,Mini-mental state examination(MMSE)score,P300 amplitude and latency,national institutes of health stroke scale(NIHSS)score,neurotransmitter level and quality of life were compared between the two groups.Results After treatment,the MoCA and MMSE scores of the two groups were higher than those before treatment,and those of the observation group were higher than those of the control group(all P＜0.001).The P300 latencies of the two groups were shorter than those before treatment,and the observation group was shorter than that of the control group;the P300 amplitudes of the two groups were higher than those before treatment,and the observation group was higher than that of the control group(all P＜0.05).After treatment,the NIHSS scores of the two groups were lower than those before treatment,and the NIHSS score of the observation group was lower than that of the control group[(7.1±2.0)vs(10.3±2.6)](t=6.666,P＜0.001).The levels of serum acetylcholine and dopamine in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).After treatment,the activities of daily living scale scores of the two groups were higher than those before treatment,and the observation group was higher than the control group[(60±15)vs(53±13)](t=2.569,P=0.012).Conclusion Acupuncture Xingshen four points combined with CMDT can effectively correct neurotransmitter disorder,improve cognitive function and neurological function,and improve the quality of life in patients with cerebral infarction and cognitive impairment.

Abstract:Objective To investigate the effect of unstable support surface core stability training(CST)on the rehabilitation of patients with thoracolumbar spinal fracture and incomplete spinal cord injury(ISCI).Methods A total of 96 patients with thoracolumbar spinal fracture with ISCI who underwent rehabilitation treat-ment in Sichuan Orthopedic Hospital from January 2019 to December 2022 were selected and divided into group A and group B by random number table method,with 48 cases in each group.Both groups received CST in sitting and recumbent positions.Group A was trained on an unstable support surface(training ball)and group B was trained on a stable support surface(training bed)for 8 weeks.The effects of improvement of American spinal injury association(ASIA)grading were evaluated before training and 10 weeks after training.Before training and 2,4,6,8 and 10 weeks after training,spinal cord independence measure(SCIM),functional independence measure(FIM)and walking index for spinal cord injury Ⅱ Scale(WISCI Ⅱ)scores were used to evaluate the recovery of spinal cord function in the two groups.The standing postural control ability and static balance ability of the two groups were evaluated,and the sagittal Cobb's angle of the injured vertebra was examined by X-ray film.Results At 10 weeks after training,the cases of grade B,C,and D in group A were 8,23 and 17,respectively,and those in group B were 11,30 and 7,respectively.The improvement of ASIA grading in group A was better than that in group B(P＜0.05).The SCIM,FIM and WISCI Ⅱ scores of group A were higher than those of group B at 4,6,8 and 10 weeks after training(all P＜0.05).The static eye opening trajectory length,static eye closing trajectory length,unit time trajectory length,dynamic stable trajectory length and dynamic time to reach the goal in group A were longer than those in group B(all P＜0.05).The Cobb's angle of group A was significantly smaller than that of group B at each time point(all P＜0.05).Conclusion The CST of unstable support surface can significantly improve the repair of spinal cord damage and walking function in patients with thoracolumbar spine fracture with ISCI.It can effectively promote the standing posture control ability of patients without the help of visual feedback.