Abstract:Objective To analyze the effect of ustekinumab combined with azathioprine on wound healing after anal fistula surgery for Crohn's disease.Methods A total of 80 patients with anal fistula surgery of Crohn's disease admitted to Lishui City Central Hospital,Zhejiang Province from April 2021 to July 2023 were selected as the research objects.They were divided into observation group and control group by random number table method,with 40 cases in each group.The control group was treated with azathioprine tablets,and the observation group was treated with ustekinumab injection on the basis of azathioprine tablets.After 24 weeks of treatment,the Crohn's disease activity index(CDAI)score,simplified endoscopy for Crohn's disease(SES-CD)score,clinical remission,inflammation,adverse reactions,wound healing,and quality of life were compared between the two groups.Results After treatment,the scores of CDAI and SES-CD in the observation group were lower than those in the control group,and the clinical remission in the observation group was better than that in the control group(all P＜0.05).After treatment,the levels of serum interleukin-12(IL-12),IL-23 and tumor necrosis factor-α in the observation group were significantly 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(P=0.809).After treatment,the total effective rate of wound healing in the observation group was higher than that in the control group[85.0％(34/40)vs 57.5％(23/40)](P=0.007).After treatment,the scores of physiological function,mental health,social function and emotional function in the observation group were significantly higher than those in the control group(all P＜0.05).Conclusion Ustekinumab combined with azathioprine can effectively promote postoperative wound healing,relieve the condition and improve the prognosis of patients with Crohn's disease undergoing anal fistula surgery.

Abstract:Objective To investigate the effect of Yishen Huashi granule combined with semaglutide in the treatment of diabetic nephropathy(DN)and its effect on microinflammatory state of patients.Methods A total of 220 DN patients admitted to Peking University Third Hospital Qinhuangdao Hospital from January 2022 to December 2023 were selected as the research objects.According to the random number table method,they were divided into semaglutide group and combination group,with 110 cases in each group.The semaglutide group was treated with subcutaneous injection of semaglutide injection on the basis of conventional treatment,and the combined group was treated with Yishen Huashi granule on the basis of semaglutide group.The efficacy,glucose and lipid metabolism,renal function,oxidative stress,microinflammatory state indicators and adverse reactions were compared between the two groups.Results The total effective rate of the combination group was higher than that of the semaglutide group[93.6％(103/110)vs 83.6％(92/110)](P=0.019).After treatment,the levels of fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,total cholesterol,low-density lipoprotein cholesterol,serum creatinine,(β2-microglobulin,24 h urinary protein,malondialdehyde,high-sensitivity C-reactive protein,tumor necrosis factor-α and interleukin-6 in the two groups were lower than those before treatment,and those in the combination group were lower than those in the semaglutide group;the levels of high-density lipoprotein cholesterol,glutathione peroxidase and superoxide dismutase were higher than those before treatment,and those in combination group were higher than those in semaglutide group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.604).Conclusion Yishen Huashi granule combined with semaglutide is superior to semaglutide alone in the treatment of DN,which can effectively reduce blood glucose and lipid levels of patients,improve micro-inflammatory state,and has good safety.

Abstract:Cardiogenic shock is a clinical syndrome caused by impaired heart pumping function leading to systemic hypoperfusion and tissue hypoxia,which is an important cause of death in patients with heart disease.Intra-aortic balloon pump and veno-arterial extracorporeal membrane oxygenation are the two main mechanical circulatory support devices used in the treatment of cardiogenic shock,which have become the"bridge"therapy to help patients through the risk period of cardiac decompensation.However,the optimal application time and clinical effect are still controversial.This article reviews the recent research on intra-aortic balloon counterpulsation and venous-artery extracorporeal membrane oxygenation in the treatment of cardiogenic shock.

Abstract:Valvular heart disease in China is usually caused by rheumatic heart disease.However,with increasingly improved public health conditions,the prevalence of rheumatic diseases has decreased substantially,and valvular diseases are now mostly caused by degenerative lesions,such as degenerative aortic stenosis.Although open surgical valve replacement via sternotomy provides a good clinical prognosis,this treatment method still carries a high surgical risk.Transcatheter aortic valve replacement(TAVR)is a minimally invasive method for the treatment of severe aortic stenosis.Because of its many advantages,it has become the first choice for patients with middle-to high-risk valve disease.At present,this new technology has attracted great attention in the cardiovascular field,leading to a new revolution in minimally invasive percutaneous cardiac intervention.This article reviews the technical introduction,clinical application and long-term effects of TAVR.

Abstract:Objective To observe the clinical effect of in-line mechanical insufflation-exsufflation(IL-MIE)technology in airway secretion management of patients with invasive mechanical ventilation after cardiac surgery.Methods A total of 65 patients with invasive mechanical ventilation after cardiac surgery with cardiopulmonary bypass in the Cardiac Surgical Intensive Care Unit,Beijing Anzhen Hospital,Capital Medical University from July 2015 to July 2020 were retrospectively selected.Among them,33 patients treated with conventional catheter suction(CS)were selected as the control group,and 32 patients treated with automated IL-MIE equipment on the basis of conventional CS treatment were selected as the observation group.The general data,respiratory and circulatory related indicators during treatment,clinical and prognostic related indicators of the two groups were compared.Results There were no significant differences in general data between the two groups(all P＞0.05).At 0 h after treatment,the heart rate of the observation group was lower than that of the control group;at 4 and 8 h after treatment,the arterial partial pressure of oxygen,oxygenation index and static compliance in the observation group were higher than those in the control group,and the airway plateau pressure and heart rate were lower than those in the control group(all P＜0.05).The number of CS treatment and the duration of mechanical ventilation in the observation group were less/shorter than those in the control group[0(0,0)time vs 3(1,4)times,20(17,22)h vs 24(19,26)h,Z=-7.081,-2.067,both P＜0.05].Conclusion IL-MIE can improve oxygenation index and airway compliance,reduce the duration of mechanical ventilation and maintain hemodynamic stability during airway management in patients after cardiac surgery by simulating physiological airway clearance.

Abstract:Objective To explore the hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor after transradial percutaneous coronary intervention(TRI).Methods From April 2021 to July 2022,295 patients who underwent coronary angiography or interventional therapy for coronary atherosclerotic heart disease in the fourth district of the Department of Cardiovascular Medicine,Jiangxi Provincial People's Hospital were selected.The patients were randomly divided into spiral radial artery compressor group(group A,99 cases),chitosan hemostatic sponge group(group B,98 cases),and chitosan hemostatic sponge combined with spiral radial artery compressor group(group C,98 cases).The three groups were treated with corresponding methods to stop bleeding.The postoperative radial artery complications and patient comfort were observed and recorded in the three groups.Results The incidence rates of postoperative bleeding in group A,group B,and group C were 13.1％(13/99),5.1％(5/98),and 3.1％(3/98),respectively,and there were significant differences in the incidence of postoperative bleeding,ecchymosis and acral swelling among the three groups(all P＜0.05).Group A was higher than group C in pairwise comparison(P＜0.05).The incidence of postoperative radial hematoma in group A was higher than that in group C(P=0.008).No severe limb swelling and other serious complications occurred in all patients.The comfort level of patients in group C was better than that in group A(P=0.004).Conclusion The overall hemostatic effect of chitosan hemostatic sponge combined with spiral radial artery compressor is better than that of spiral radial artery compressor and chitosan hemostatic sponge alone after TRI.It can reduce the incidence of postoperative vascular complications and improve the comfort of patients.It is a simple operation,high comfort,less complications,safe and reliable method of dressing hemostasis.

Abstract:Objective To evaluate the effect of improved modified buried vertical mattress sutures(MBVMS)technique in the healing and scar formation of chin trauma.Methods A total of 90 patients with chin trauma in Emergency Department of Plastic Surgery,Beijing Anzhen Hospital,Capital Medical University from February 2017 to June 2023 were selected.According to the random number table method,they were divided into the observation group(n=45)and the control group(n=45).After cleaning the wounds,the patients in the observation group were closed with improved MBVMS,and the patients in the control group were closed with conventional cosmetic suture.The patients in the two groups were all treated with silicone gel scab-removing ointment for about 3 months after removing the stitches.The wound healing of patients in the two groups was observed after 7 d of suture removal.The Vancouver Scar Scale(VSS),Visual Analogue Scale(VAS),Observer Scar Assessment Scale(OSAS),and Patient Scar Assessment Scale(PSAS)were used to evaluate the scar formation of patients in the two groups at 3 and 6 months after operation.Results Stitches were removed 7 d after operation.In the observation group,44 cases(97.8％)had grade A wound healing and 1 case(2.2％)had grade B wound healing.The wounds of the control group were all grade A healing.There was no statistically significant difference in the proportion of grade A healing between the observation group and the control group[97.8％(44/45)vs 100.0％(45/45)](P＞0.05).At 3 and 6 months after operation,the VSS,VAS,OSAS and PSAS scores of the observation group were lower than those of the control group(all P＜0.05).Conclusion The application of improved MBVMS technology in patients with chin trauma can not only ensure the safe wound healing,but also effectively improve the character of scar after wound healing,reduce postoperative scar hyperplasia,and achieve good cosmetic results.

Abstract:Objective To investigate the short-term efficacy of atorvastatin on patients with ischemic heart failure and its effect on the expression of ferroptosis signaling pathway related proteins.Methods A total of 124 patients with ischemic heart failure diagnosed in the First Affiliated Hospital of Hainan Medical University from January 2021 to October 2022 were selected.The patients were randomly divided into control group and observation group,with 62 cases in each group.The control group was treated with conventional drugs and interventional therapy,and the observation group was treated with atorvastatin on the basis of the control group.The incidence of major adverse cardiac events(MACE),heart failure indicators,oxidative stress indicators,blood lipid indicators and ferroptosis pathway proteins were compared between the two groups.Results The total incidence of MACE in the observation group was lower than that in the control group[6.5％(4/62)vs 19.4％(12/62)](x2=4.593,P=0.032).After 1 month of treatment,the left ventricular ejection fraction of the control group was higher than that before treatment,and the brain natriuretic peptide was lower than that before treatment;the left ventricular ejection fraction and superoxide dismutase in the observation group were higher than those before treatment,and the brain natriuretic peptide and malondialdehyde were lower than those before treatment;the superoxide dismutase in the observation group was higher than that in the control group,and the malondialdehyde was lower than that in the control group(all P＜0.05).After 1 month of treatment,the levels of total cholesterol,low-density lipoprotein cholesterol and lipoprotein a in the observation group were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After 1 month of treatment,the levels of nicotinamide adenine dinucleotide phosphate(NADPH)and glutathione,and the protein expression of glutathione peroxidase 4,quinone oxido-reductase 1 and solute carrier family 7 member 11 in the observation group were higher than those before treatment,and those in the observation group were higher than those in the control group;the levels of non-heme iron and the protein expression of NADPH oxidase 2 were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).Conclusion Routine use of atorvastatin in the treatment of ischemic heart failure can improve the short-term efficacy,which may be related to lowering blood lipids,anti-oxidative stress and inhibiting the active expression of ferroptosis signaling pathway.

Abstract:Objective To investigate the effects of Xuezhikang capsule combined with alirocumab on the degree of atherosclerosis and blood lipid levels in patients with atherosclerotic cardiovascular disease(ASCVD)intolerant to statins.Methods Eighty ASCVD patients with statin intolerance admitted to the Second Affiliated Hospital of Hebei University of Chinese Medicine from June 2022 to August 2024 were enrolled.According to random number table method,they were divided into observation group(41 cases)and control group(39 cases).The control group was treated with alirocumab.The observation group was treated with Xuezhikang capsule on the basis of the control group.Both groups were treated for 12 weeks.The degree of arteriosclerosis,blood lipid indexes,the standard-reaching rate of low-density lipoprotein cholesterol(LDL-C),the standard-reaching rate of LDL-C reduction＞50％,the incidence of adverse reactions and the total effective rate were compared between the two groups after treatment.Results After 4,8 and 12 weeks of treatment,the levels of LDL-C,triglyceride,total cholesterol,creatine kinase,glutamate,creatine kinase isoenzyme,cardio-ankle vascular index and brachial-ankle pulse wave velocity in the observation group were significantly lower than those in the control group;high density lipoprotein cholesterol,lipoprotein a,total bilirubin,aspartate aminotransferase,alanine aminotransferase,and ankle brachial index were higher than those in the control group(all P＜0.05).The compliance rate of LDL-C,the compliance rate of LDL-C reduction＞50％and the total effective rate in the observation group were higher than those in the control group[78.0％(32/41)vs 35.9％(14/39),95.1％(39/41)vs 41.0％(16/39),97.6％(40/41)vs 79.5％(31/39)](all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.107).Conclusion Xuezhikang capsule combined with alirocumab in the treatment of ASCVD patients with statin intolerance can significantly improve the degree of atherosclerosis and the rate of LDL-C reaching the standard,with significant clinical efficacy and high safety.

Abstract:Objective To observe the clinical effect of teneplase in the adjuvant treatment of acute lower extremity deep vein thrombosis(DVT)with catheter-directed thrombolysis(CDT).Methods A retrospective analysis was conducted on the clinical data of 104 patients with acute lower extremity DVT admitted to the Department of Vascular Surgery,Xuzhou Central Hospital from January 2022 to June 2023.Patients were classified into the combination group(50 cases)and the urokinase group(54 cases)based on different therapies.Postoperative venous patency score,venous patency rate,limb swelling reduction rate,thrombus clearance grade,urokinase dosage,thrombolysis time,hospital stay,and complications in two groups of patients were compared.Results The postoperative venous patency score of the combined group was lower than that of the urokinase group,and the postoperative venous patency rate and limb swelling reduction rate were both higher than those of the urokinase group[(1.6±1.0)vs(2.3±1.1),(79±13)％vs(68±15)％,(73±12)％vs(66±8)％],with statisti-cally significant differences(all P＜0.05).There was no statistically significant difference in thrombus clearance grading between the two groups(P＞0.05).The dosage of urokinase,thrombolysis time,and hospital stay of patients in the combination group were less/shorter than those in the urokinase group,and the differences were statistically significant(all P＜0.05).There was no statistically significant difference in the incidence of postoper-ative in two groups(P＞0.05).Conclusions Compared with the use of urokinase alone,the use of teneplase assisted urokinase for CDT treatment of acute lower extremity DVT can reduce the amount of urokinase dosage,and shorten thrombolysis time and hospital stay.The recent thrombolysis effect is certain and the operation is simple.

Abstract:Objective To explore the effect of glycyrrhizic acid preparation combined with anti-tuberculosis drugs in the treatment of patients with pulmonary tuberculosis and its preventive effect on liver injury.Methods A total of 120 patients with pulmonary tuberculosis in Chest Hospital of Guangxi Zhuang Autonomous Region from May 2021 to May 2023 were selected and divided into the control group(59 cases)and the observation group(61 cases)according to the random number table method.The control group was treated with basic anti-tuberculosis drugs(2HRZE/4HR),and the observation group was treated with glycyrrhizic acid preparation on the basis of the control group.Both groups were treated for 6 months.The degree of chest CT lesion absorption,inflammatory factors,serum markers of liver injury,incidence of drug-induced liver injury(DILI),and Child grade of liver function in patients with liver injury were compared between the two groups.Results The degree of chest CT absorption in the observation group was significantly better than that in the control group(P=0.003).After treatment,the levels of interferon-γ and interleukin-2 in the two groups were lower than those before treatment,and the level of interleukin-2 in the observation group was lower than that in the control group(all P＜0.05).After treatment,the alanine aminotransferase,aspartate aminotransferase and total bilirubin in the two groups were higher 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 DILI in the observation group was lower than that in the control group[8.2％(5/61)vs 22.0％(13/59)](P＜0.05).The Child grade of liver function in the observation group was better than that in the control group(P=0.016).Conclusion Glycyrrhizic acid preparation combined with anti-tuberculosis drugs in the treatment of pulmonary tuberculosis can promote the absorption of lesions,obtain better effect,and reduce the risk of DILI.

Abstract:Objective To investigate the relationship between the dynamic changes of vitamin D levels in early and midterm pregnancy and gestational diabetes mellitus(GDM).Methods A total of 650 pregnant who regular prenatal examination and delivery at Hefei First People's Hospital from January 2019 to December 2020 was selected for analysis.Serum 25-hydroxy vitamin D levels were measured during early and midterm pregnancy,pregnant women were divided into GDM group(67 cases)and non GDM group(583 cases)based on whether GDM was merged or not.The potential relationship between 25-hydroxy vitamin D level and GDM was explored.Results There were significant differences in age,pre-pregnancy body mass index,the level of 25-hydroxy vitamin D in early pregnancy and the average value of 25-hydroxy vitamin D in early and midterm pregnancy between the two groups(all P＜0.05).The results of binary Logistic regression analysis showed that the risk of GDM in the group with the highest level of 25-hydroxy vitamin D(group Q4)was 0.33 times(odds ratio=0.33,95％confidence interval:0.14-0.74,P＜0.05)to the group with the lowest level of 25-hydroxy vitamin D(group Q]).After adjusting the confounding factors such as age,pre-pregnancy body mass index,number of pregnancies and parturition,the correlation was still significant(P＜0.05).The results of restriction cubic spline showed that 25-hydroxy vitamin D in early pregnancy was negatively correlated with the risk of GDM(P=0.035).Conclusion The level of vitamin D in early pregnancy tends to increase with the increase of gestational weeks,and the adequate level of vitamin D in early pregnancy is related to the decreased risk of GDM.

Abstract:Objective To explore the influencing factors of quality of life of patients with gastrointestinal cancer in community and analyze the influence of patients'self-infusion on quality of life.Methods From January 2021 to January 2022,convenience sampling was used to select patients with gastrointestinal malignant tumors recorded in 5 community health service centers in Shijiazhuang,Hebei Province and diagnosed with esophageal cancer,gastric cancer and colorectal cancer in the Chinese Cancer Registry Information System as the research objects.The European organization for research and treatment of cancer quality of life questionnaire(EORTC QLQ-C30),self-infusion attention scale(SFAS)and self-designed general information questionnaire were used to investigate their quality of life and self-commitment.Results A total of 190 patients with gastrointestinal cancer were investigated in this study,and 185 valid questionnaires were collected,with an effective recovery rate of 97.4％.The survey of quality of life measurement scale showed that the total health status score of patients with gastrointestinal cancer in the community was(50.7±18.3),the highest score of cognitive function was(87.1±13.4),the lowest score of social function was(69.8±23.8),and the highest score of fatigue was 33.3(33.3,55.6).The SFAS survey showed that the total score of self-infusion of patients with gastrointestinal cancer in the community was(59.2±10.2).Spearman correlation analysis showed that the score of self-infusion was negatively correlated with the total health status score and the scores of physical,role,cognitive,emotional and social function in the functional domain,and positively correlated with the scores of fatigue,nausea and vomiting in the symptom domain and the scores of appetite loss and economic difficulty in the single item(all P＜0.05).The results of multiple linear regression analysis showed that marital status,education level,main caregiver,family monthly income and self-infusion were the influencing factors of the total health status of patients with digestive tract malignant tumors in the community(all P＜0.05).The receiver operating characteristic curve showed that the area under the curve of self-infusion score predicting the total health status score of patients was 0.716(95％confidence interval:0.642-0.789),the sensitivity was 61.9％,and the specificity was 73.6％.Conclusions The quality of life of patients with gastrointestinal cancer in the community is affected by many factors such as marital status,education level,main caregivers and so on.The self-infusion status is closely related to the quality of life of patients with gastroin-testinal cancer in the community,and has a certain predictive effect on the quality of life.

Abstract:Objective To observe the effect of Lichong Shengsui decoction(LCSSY)on autophagy in ovarian cancer by regulating adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)/uncoordinated 51 like kinase-1(ULK1)signaling pathway.Methods Ovarian cancer SKOV3 cells were cultured in vitro and serum containing LCSSY was prepared.SD rats were divided into blank control group and LCSSY low,medium and high dose groups by random number table method.Cell count kit-8 method was used to detect the proliferation inhibition rate of ovarian cancer SKOV3 cells.Western blotting was used to detect the expression of autophagy related proteins recombinant human autophagy effector protein(Beclin-1),ratio of human microtubule associated protein light chain 3 Ⅱ to mouse microtubule associated protein light chain 3 Ⅰ(LC3Ⅱ/Ⅰ),autophagy junction protein(P62),as well as AMPK/mTOR/ULK1 pathway related proteins.AMPK activator was used to verify its mechanism of action.Results At 24 and 48 h after administration,the inhibition rates of SKOV3 cell proliferation in the low,medium and high dose LCSSY groups were higher than those in the blank control group,and the inhibition degree was gradually strengthened with the increase of drug concentration(all P＜0.05).In addition,the inhibition rates of low dose LCSSY group and medium dose LCSSY group at 48 h were higher than those at 24 h(both P＜0.05).Compared with the blank control group,the expression of Beclin-1 and LC3 Ⅱ/Ⅰ was down-regulated in the low,medium,and high dose LCSSY groups in a dose-dependent manner[(0.98±0.02),(0.59±0.02),(0.55±0.02)vs(1.46±0.12);(4.45±0.21),(4.00±0.25),(2.95±0.21)vs(5.98±0.23);(0.67±0.02),(0.94±0.05),(1.53±0.13)vs(0.30±0.02)](all P＜0.05).Compared with the blank control group,the expression of AMPK and ULK1 was decreased,and the expression of mTOR complex 1 was increased in low,medium and high dose LCSSY groups in a dose-dependent manner(all P＜0.05).AMPK activator reversed the AMPK/mTOR/ULK1 signaling pathway,and compared with the high dose LCSSY group,the high dose of LCSSY combined with AMPK activator increased the protein expressions of AMPK and ULK1,while the protein expression of mTOR complex 1 decreased(all P＜0.05).Conclusion LCSSY may inhibit autophagy in ovarian cancer cells by regulating AMPK/mTOR/ULK1 signaling pathway.

Abstract:Objective To evaluate the efficacy and safety of internal floss assisted traction endoscopic submucosal dissection(ESD)for rectal neuroendocrine neoplasms(NEN).Methods The data of 34 patients with rectal NEN who underwent colonoscopy and received treatment at the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from January 2017 to June 2023 were retrospectively analyzed.According to the method of endoscopic surgery,the patients were divided into the dental floss traction ESD treatment group(10 cases)and the traditional ESD treatment group(24 cases).The operation time,surgical complications,postoperative histopathology,hospitalization time and hospitalization cost were compared between the two groups.Results The lesion was located 3-10 cm away from the anus,with a tumor diameter of 3-12 mm.Both lesions were single lesions,and there was no significant difference in the maximum diameter of tumors and the complete resection rate between the two groups(both P＞0.05).The operation time of the dental floss traction ESD treatment group was shorter than that of the traditional ESD treatment group[23.5(16.8,25.3)min vs 30.0(22.8,36.0)min](P=0.012).There were 2 cases(8.3％)of postoperative complications in the traditional ESD treatment group.There was no involvement of muscularis propria and lymphatic vessels in all patients.No postoperative pathology showed that the tumor was close to the cauterization margin in the dental floss traction ESD treatment group,while the postoperative pathology showed that the tumor was close to the burning margin in 5 cases(20.8％)in the traditional ESD treatment group.The hospitalization time of the dental floss traction ESD treatment group was shorter than that of the traditional ESD treatment group[6(5,7)d vs 8(7,11)d](P=0.002).There was no significant difference in hospitalization cost between the two groups(P=0.326).Conclusion Floss assisted ESD in the treatment of rectal NEN is a convenient surgical method,which is conducive to exposing the surgical field,improving the complete resection rate and reducing complications.

Abstract:Traditional oncology teaching has some shortcomings,such as lagging knowledge update,monotone teaching model,and difficulty in cultivating the interdisciplinary collaboration consciousness of clinicians,which can not meet the requirements of comprehensive quality of clinicians in the new era of tumor diagnosis and treatment.Under the multidisciplinary diagnosis and treatment(MDT)model,by forming a multidis-ciplinary consultation expert team,the most suitable individualized comprehensive treatment plan can be formulated for the patient according to the patient's tumor stage,preoperative various tumor markers and histopathological examination results,and it is of great significance to improve the treatment effect and prognosis of patients.The MDT model is mainly formulated around the problems in oncology teaching practice,including four parts:discipline modular integration,teaching method innovation,clinical practice and ideological and moral construction,and teacher team training.The practice shows that the MDT model-based oncology teaching reform and practice program can enhance students' comprehensive diagnosis and treatment ability,clinical decision-making ability and team cooperation ability,but there are still some defects in teacher collaboration and teaching evaluation.Therefore,it is proposed that through the integration of medicine and engineering or the combination of online and offline teaching models,together with the support of relevant policies,the reform of oncology teaching can be further deepened,the highland of oncology medical education can be built,and the construction of Healthy China can be promoted.

Abstract:Asthma is one of the common chronic non-communicable diseases in the world today,which is characterized by variable gas obstruction,causing dyspnea and wheezing.Eosinophilic airway inflammation is often considered to be the most influential diagnosable feature of chronic airway disease.Over the past decade,multiple monoclonal antibodies have been developed targeting this characteristic.Mainly including anti interleukin-5(IL-5)or IL-5 receptors α(mepolizumab,razumab,and benazizumab),IL-13(lebrikizumab and tralokinumab),IL-4 receptor α(monoclonal antibodies against dupilumab),immunoglobulin E(omalizumab),and thymic stromal resistance lymphatic hormone(tezepelumab)of monoclonal antibodies.This article reviews the pathogenesis of asthma and the progress of new anti-eosinophil drugs in the treatment of asthma.

Abstract:Objective To investigate the relationship between the ratio of non-high-density lipoprotein cholesterol(non-HDL-C)to high density lipoprotein cholesterol(HDL-C)and the prognosis of patients with non ST segment elevation acute coronary syndrome(NSTE-ACS)and chronic kidney disease(CKD)after coronary stent implantation.Methods This study retrospectively enrolled 565 NSTE-ACS patients with CKD who under-went successful coronary stent implantation in Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2020.They were divided into four groups based on non-HDL-C/HDL-C quartiles:group 1(non-HDL-C/HDL-C ≤2.32,n=141),group 2(2.32＜non-HDL-C/HDL-C ≤2.96,n=142),group 3(2.96＜non-HDL-C/HDL-C ≤3.78,n=141),group 4(non-HDL-C/HDL-C＞3.78,n=141).The patients were followed up for 3 years.The primary endpoint was major adverse cardiovascular events(MACE),including all-cause death,nonfatal myocardial infarction,and revascularization.Cox proportional hazards regression model,Kaplan-Meier curve,receiver operating characteristic curve,local weighted regression scatter smoothing method(Lowess)curve were used for statistical analysis.Results Cox proportional hazards regression model analysis showed that the risks of MACE[hazard ratio(HR)=2.06,95％confidence interval(CI):1.28-3.29,P=0.001],all-cause death(HR=2.09,95％CI:1.03-4.22,P=0.004),and repeat revascularization in group 4 were significantly higher than those in group 1.The Kaplan-Meier curve showed that the risk of MACE,all-cause mortality and repeat revascularization increased significantly with the increase of non-HDL-C/HDL-C quartiles(all Log-rank P＜0.05).The predictive ability of the non-HDL-C/HDL-C[the area under the curve(AUC)=0.68]was superior to HDL-C(AUC=0.60)and LDL-C(AUC=0.51).Lowess curve showed that non-HDL-C/HDL-C was positively correlated with MACE.Conclusions Increased levels of non-HDL-C/HDL-C significantly increase the risk of MACE,all-cause death and repeat revascularization in NSTE-ACS patients with CKD after coronary stent implantation,and it was better than HDL-C and LDL-C in predicting the risk of MACE.

Abstract:Objective To observe the effect of glucosamine hydrochloride tablets combined with traditional Chinese medicine preparations fragrant tablets in the prevention and treatment of mild to moderate knee osteoarthritis(KOA).Methods A total of 110 patients with mild to moderate KO A admitted to Sichuan Province Orthopedic Hospital from May 2021 to December 2023 were selected.They were completely randomized into conventional group and combination group,with 55 cases in each group.The conventional group was treated with glucosamine hydrochloride tablets,while the combination group was treated with traditional Chinese medicine preparations fragrant tablets in addition to the conventional group.The knee joint pain visual analogue scale(VAS)score,osteoarthritis index score of Western Ontario and McMaster Universities(WOMAC),knee joint function,daily living activity,clinical efficacy,and adverse reactions were compared between two groups.Results After treatment,the VAS scores of both groups were lower than those before treatment,and the combination group was significantly lower than the conventional group[(2.4±0.6)vs(3.2±1.3)],with a statistically significant difference(t=3.491,P=0.003).After treatment,the WOMAC score of the combined group was lower than that of the conventional group,and the range of motion score in the Lysholm knee joint function score was higher in the combined group than in the conventional group,with statistically significant differences(all P＜0.05).At 6 months of treatment,the activities of daily living score of the combination group was higher than that of the conventional group[(95±5)vs(77±5)],and the difference was statistically significant(t=19.986,P＜0.001).The total effective rate of the combined group was higher than that of the conventional group[90.9％(50/55)vs 76.4％(42/55)],and the difference was statistically significant(x2=4.251,P=0.039).No serious adverse reactions occurred in both groups.Conclusions The combination of glucosamine hydrochloride tablets and traditional Chinese medicine preparations fragrant tablets can effectively promote pain relief,improve activities of daily living and knee joint function,reduce limited knee joint mobility,and is safe and effective in the treatment of mild to moderate knee osteoarthritis.

Abstract:Objective To analyze the effect of lower limb robot in the treatment of lower limb movement disorders after stroke and its influence on walking and balance ability of patients.Methods A total of 110 patients with lower limb movement disorders after stroke who were hospitalized in the Second Affiliated Hospital of Air Force Military Medical University from January 2022 to November 2023 were selected.According to the random number table method,they were divided into the routine group and the observation group,with 55 cases in each group.The routine group was given routine rehabilitation training,and the observation group was given lower limb robot therapy on the basis of the routine group.The clinical efficacy,6-min walk test(6MWT)distance and Berg balance scale(BBS),simplified Fugl Meyer motor function scale(FMA),stroke specific quality of life scale(SS-QOL)scores,lower limb modified Ashworth scale(MAS)grading,levels of serum neuropeptide Y(NPY),brain-derived neurotrophic factor(BDNF),and nerve growth factor(NGF)were compared between the two groups.Results The total effective rate of the observation group was higher than that of the routine group[94.5％(52/55)vs 74.5％(41/55)](P=0.004).After treatment,the 6MWT distance,BBS,FMA and SS-QOL scores of the observation group were longer/higher than those of the routine group,the MAS grade was better than that of the routine group,the serum NPY level was lower than that of the routine group,and the serum BDNF and NGF levels were higher than those of the routine group(all P＜0.05).Conclusion Lower limb robot can effectively improve the walking ability,balance ability and motor ability of patients with lower limb movement disorders after stroke,down-regulate the expression of serum NPY,up-regulate the expression of serum BDNF and NGF,and improve the quality of life,with significant effects.