Abstract:Objective To observe the clinical effect of Corbrin capsule combined with alisartan isoproxil tablets in the treatment of diabetic nephropathy.Methods A total of 90 patients with diabetic nephropathy who were hospitalized in Shaanxi Provincial People's Hospital from October 2021 to October 2023 were selected as the research objects.All patients were divided into control group and observation group according to the random number table method,with 45 cases in each group.The control group was given alisartan isoproxil tablets orally in addition to conventional treatment,while the observation group was given Corbrin capsule in addition to the control group's treatment.Both groups were treated for 3 months.The total effective rate,the levels of blood glucose,renal func-tion and inflammatory factors before and after treatment,and the incidence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.6％(43/45)vs 80.0％(36/45)](P=0.024).After treatment,glycosylated hemo-globin,fasting blood glucose,2 h postprandial blood glucose,serum creatinine,blood urea nitrogen,24 h urinary protein,interleukin-1[3,high-sensitivity C-reactive protein and interleukin-6 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 observation group and the control group[6.7％(3/45)vs 4.4％(2/45)](P=0.645).Conclusion Corbrin capsule combined with alisartanisoproxil tablets in the treatment of diabetic nephropathy has significant clinical effect and good safety.

Abstract:Objective To investigate the predictive value of preoperative circulating tumor DNA(ctDNA),red blood cell volume distribution width to platelet ratio(RPR)and neutrophil to lymphocyte ratio(NLR)in 3-year survival of patients with colorectal cancer after radical resection.Methods A total of 114 patients who underwent radical resection of colorectal cancer in Lanzhou Petrochemical General Hospital from March 2020 to March 2021 were selected as the colorectal cancer group.A total of 114 healthy volunteers were selected as the control group.The levels of ctDNA,RPR and NLR in peripheral blood were detected and calculated.All patients with colorectal cancer were followed up for 3 years after radical resection,and were divided into death group and survival group according to survival situation.The Kaplan-Meier method was used to analyze the relationship between the levels of ctDNA,RPR and NLR in peripheral blood and the 3-year survival of patients with colorectal cancer after radical resection.The receiver operating characteristic curve was used to analyze the predictive value of the combined detection of ctDNA,RPR and NLR in peripheral blood for the 3-year survival of patients with colorectal cancer after radical resection.Results The levels of ctDNA,RPR,and NLR in peripheral blood of patients with colorectal cancer were significantly higher than those in the control group(all P＜0.001).The levels of ctDNA,RPR and NLR in peripheral blood are related to TNM stage,differentiation degree,lymph node metastasis and carcinoembryonic antigen level(all P＜0.05).In this study,40 patients died(death group)and 74 patients survived(survival group).The levels of ctDNA,RPR and NLR in peripheral blood of patients in the death group were significantly higher than those in the survival group[(98±12)μg/L vs(79±12)μg/L,(0.19±0.05)vs(0.14±0.04),(2.8±0.4)vs(2.1±0.5)](t=8.221,5.825,7.384,all P＜0.001).The 3-year survival rates of patients in the high level group of ctDNA,RPR and NLR were lower than those in the low level group(all P＜0.05).The area under the receiver operating characteristic curve of the combined detection of ctDNA,RPR and NLR in predicting the 3-year survival of patients with colorectal cancer after radical resection was significantly larger than that of ctDNA,RPR and NLR alone(all P＜0.05).Conclusion The combination of ctDNA,RPR and NLR can be used as a predictor of survival in patients with colorectal cancer after radical resection.

Abstract:The emergence of immune checkpoint inhibitors(ICI)marks the arrival of a new era in cancer immunotherapy,bringing unprecedented long-term survival benefits to cancer patients.ICI is currently widely used in multi-line treatment of cancer,but a large amount of clinical data shows that it may also lead to the occurrence of immune-related adverse events(irAEs)while bringing therapeutic benefits.Among them,ICI-related hypothy-roidism(irH)is one of the most common irAEs.Because it has a hidden onset and the disease progresses relatively slowly,it is often missed in clinical practice.Severe cases may lead to mucous edema coma,heart failure,and respiratory failure,which pose significant challenges for treatment and prognosis.Therefore,it is crucial to correctly understand and effectively manage irH to improve the safety and prognosis of cancer patients.This article will provide a comprehensive review of irH,including its pathogenesis,risk factors,diagnostic criteria,modern medical treatment,and Chinese medicine intervention.

Abstract:Chronic hepatitis B is a global epidemic disease.It is caused by hepatitis B virus infection and can develop into liver disease at different stages such as cirrhosis,liver failure,and hepatocellular carcinoma.At present,chronic hepatitis B cirrhosis is mainly treated with antiviral therapy,combined with immunotherapy and liver protective therapy.Antiviral drugs can inhibit virus replication and alleviate disease progression.Liver protec-tive therapy mainly reduces liver injury by anti-oxidation,anti-inflamumation and promoting hepatocyte regenera-tion.Emerging therapeutic approaches such as gene editing technology,immunotherapy drugs,immune agents combined with antiviral drugs,and RNA interference therapy have also shown great potential in pre-clinical and clinical studies.In this paper,the current research progress of drugs for chronic hepatitis B cirrhosis is summa-rized,and the research progress,mechanism and clinical application prospect of these treatment methods are discussed in detail.

Abstract:Objective To evaluate the efficacy of aspirin and new oral anticoagulants(NOACs)in the prevention of venous thromboembolism(VTE)and bleeding events after hip and knee arthroplasty in the elderly,and to analyze the related risk factors.Methods This study was a retrospective cohort study.A total of 1 032 elderly patients who underwent hip and knee arthroplasty in the First Affiliated Hospital of Guangxi University of Science and Technology from January 2018 to December 2022 were consecutively enrolled.According to the anticoagulant therapy regimen,the patients were divided into aspirin group(674 cases)and NOACs group(358 cases).The baseline data were matched 1∶1 by propensity score matching(PSM)method.Finally,a total of 652 patients were enrolled and divided into aspirin group(326 cases)and NOACs group(326 cases).The main outcome measures were VTE events and bleeding events within 90 d after surgery.Cox proportional hazards regression model was used to analyze the risk factors.Results There were no significant differences in baseline data and incidence of VTE events between the two groups before and after PSM matching(all P＞0.05).Before and after PSM matching,the incidence of bleeding events in the NOACs group was lower than that in the aspirin group[6.1％(22/358)vs 8.0％(54/674),4.9％(16/326)vs 8.3％(27/326)](all P＜0.05).Cox regression model analysis showed that male,knee replacement,chronic kidney disease,previous history of VTE,and anticar-diolipin antibodies or lupus anticoagulant were significant risk factors for VTE events(all P＜0.05).Age,cancer,chronic kidney disease,and length of hospital stay were all significant risk factors for bleeding events(all P＜0.05).Conclusions Aspirin and NOACs have similar efficacy in preventing VTE after hip and knee arthro-plasty in the elderly,and aspirin therapy has a higher risk of bleeding.Male sex,knee replacement,chronic kidney disease,previous history of VTE,and anticardiolipin antibodies or lupus anticoagulant are the main risk factors for VTE,while age,cancer,chronic kidney disease,and length of hospital stay are the main risk factors for bleeding events.

Abstract:Atopic dermatitis(AD)is often associated with atopic comorbidities.With the increasing number of AD and atopic comorbidities,AD has become a major public health problem.Most studies believe that AD and its comorbidities occur in a chronological sequence,from AD and food allergy,to allergic rhinitis,and finally to asthma.This phenomenon is often referred to as atopic progression.At present,the mechanism of this atopic progression is not fully understood.This article reviews the research progress on the epidemiology of AD,its association with atopic comorbidity,risk factors,possible mechanisms of atopic comorbidity and its progression,as well as its prevention and treatment measures.

Abstract:Objective To compare the clinical effect of rifampicin and rifapentine in the treatment of elderly patients with pulmonary tuberculosis.Methods The clinical data of 218 elderly patients with pulmonary tuberculosis admitted to the Department of Tuberculosis,Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from January 2020 to December 2022 were retrospectively collected and analyzed.Patients were divided into rifampicin group(109 cases)and rifapentine group(109 cases)according to different drugs.Both groups received conventional anti-tuberculosis treatment.The patients in the rifampicin group were treated with rifampicin on the basis of conventional treatment,and the patients in the rifapentine group were treated with rifapentine on the basis of conventional treatment.All patients were treated for 6 to 12 months.The clinical baseline data,adverse reactions,medication compliance and efficacy were compared between the two groups.Results There were no significant differences in clinical baseline data between the two groups(all P＞0.05).The incidence of adverse reactions in rifampicin group was higher than that in rifapentine group[17.4％(19/109)vs 8.2％(9/109)](x2=4.098,P=0.043).The Morisky medication adherence scale score of the rifampicin group was higher than that of the rifapentine group(P＜0.05).The success rate of rifampicin group was higher than that of rifapentine group(P＞0.05).Conclusion Rifapentine and rifampicin have similar efficacy in the treatment of elderly pulmonary tuberculosis,and with high safety.Rifapentine can be used instead of rifampicin in the selection of anti-tuberculosis regimens for elderly pulmonary tuberculosis.

Abstract:Objective To analyze the clinical application value of serum 25-hydroxy vitamin D[25-(OH)D]and interleukin-6(IL-6)in patients with type 2 diabetes mellitus(T2 DM)complicated with different degrees of non-alcoholic fatty liver disease(NAFLD).Methods From January to December 2023,90 inpatients and outpatients with T2DM or T2DM combined with NAFLD(case group)in the First Hospital of Harbin,Heilongjiang Province and 30 healthy people in the same period were selected as the research objects.In this study,30 healthy people who underwent physical examination during the same period were set as group A.The case group was divided into group B,group C and group D according to the results of liver color Doppler ultrasound and liver function test,with 30 cases in each group.Group B was T2DM without NAFLD,group C was T2DM with NAFLD but without abnormal liver function,and group D was T2DM with NAFLD and abnormal liver function.The changes of25-(OH)D and IL-6 levels in each group were compared,and the correlation between them and related metabolic indexes was analyzed.Results The levels of serum 25-(OH)D in group D were significantly lower than those in group A,group B and group C,while the levels of serum IL-6 in group D were significantly higher than those in groups A,B and C[(12.3±5.9)μg/L vs(23.7±2.5),(20.0±5.2),(16.0±3.1)μg/L;(12.9±4.8)ng/Lvs(3.8±2.0),(5.5±3.0),(8.0±5.3)ng/L](all P＜0.05).The levels of serum 25-(OH)D in group C were lower than those in group A and group B,while the levels of serum IL-6 were higher than those in group A and group B(all P＜0.05).The level of serum 25-(OH)D in group B was lower than that in group A(P＜0.05).Serum 25-(OH)D level was negatively correlated with IL-6,body weight,body mass index,waist circumference,hip circumference,systolic blood pressure,glycosylated hemoglobin(HbA1c),fasting blood glucose,2 h postprandial blood glucose(2 hPG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(γ-GGT),total cholesterol,triglyceride,fasting insulin(FINS),and homeo-stasis model assessment insulin resistance index(HOMA-IR)(all P＜0.05).IL-6 level was positively correlated with body weight,body mass index,waist circumference,hip circumference,HbA1c,fasting blood glucose,2 hPG,ALT,AST,γ-GGT,total cholesterol,triglyceride,β2-microglobulin,serum creatinine,FINS and HOMA-IR(all P＜0.05).Conclusions The level of serum 25-(OH)D is significantly decreased and the level of IL-6 is significantly increased in T2DM patients with NAFLD.Serum 25-(OH)D and IL-6 levels are related to a number of metabolic indicators.Combined detection of the two indicators is helpful for early monitoring of the disease and timely taking measures to prevent or delay the occurrence and development of T2DM combined with NAFLD.

Abstract:Objective To investigate the correlation between pan-immune inflammation value(PIIV)and left ventricular remodeling and poor prognosis in elderly patients with chronic heart failure.Methods This study was a retrospective analysis.A total of 150 elderly patients with chronic heart failure admitted to the 908th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from January 2020 to December 2021 were collected as the chronic heart failure group.In addition,150 relatively healthy elderly volunteers who under-went physical examination in our hospital during the same period were collected as the control group.The chronic heart failure group was further divided into subgroups according to the level of PIIV.The differences in clinical data between the different groups were compared,and the correlation between PIIV and related indicators of ventricular remodeling and its efficacy in predicting left ventricular remodeling in elderly patients with chronic heart failure were analyzed.At the same time,the related factors of left ventricular remodeling in elderly patients with chronic heart failure were analyzed.Results The PIIV of patients in the chronic heart failure group was significantly higher than that in the control group[687.4(472.1,856.9)vs 305.1(185.4,440.6)](P＜0.05).According to the median of PIIV in the chronic heart failure group,the patients in the chronic heart failure group were divided into low PIIV group(PIIV≤687.4,n=75)and high PIIV group(PIIV＞687.4,n=75).The incidence of left ventricular remodeling,left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)in the high PIIV group were higher/greater than those in the low PIIV group,and left ventricular ejection fraction(LVEF)in the high PIIV group was lower than that in the low PIIV group[61.3％(46/75)vs 41.3％(31/75),(198±17)ml vs(186±12)ml,(230±15)ml vs(219±14)ml,(42±11)％vs(47±8)％](all P＜0.05).The rates of recurrent heart failure and cardiac rehospitalization in the high PIIV group were higher than those in the low PIIV group[54.7％(41/75)vs 33.3％(25/75),41.3％(31/75)vs 22.7％(17/75)](both P＜0.05).PIIV was significantly positively correlated with LVESV and LVEDV(r=0.502,0.542,both P＜0.001),and negatively correlated with LVEF(r=-0.533,P＜0.001).The area under the receiver operating characteristic curve of PIIV for predicting left ventricular remodeling in elderly patients with chronic heart failure was 0.869,with a 95％confidence interval of 0.822-0.916.Multivariate COX regression analysis showed that PIIV,New York Heart Association functional class and N-terminal pro-brain natriuretic peptide were the influencing factors of left ventricular remodeling in patients with chronic heart failure(all P＜0.05).Conclusion PIIV has a good predictive value for left ventricular remodeling in elderly patients with chronic heart failure.

Abstract:Objective To investigate the impact of chronic obstructive pulmonary disease(COPD)on the occurrence of thrombotic events and recurrence after radiofrequency ablation in patients with atrial fibrillation.Methods Totally 80 atrial fibrillation patients with COPD(COPD group)and 80 atrial fibrillation patients without COPD(control group)admitted to Qinghai Red Cross Hospital from January 2020 to January 2024 were selected.The occurrence of thrombotic events and the score of atrial fibrillation thrombosis risk-VASc(CHA2DS2-VASc)in the two groups were recorded.All patients underwent radiofrequency ablation.The patients were divided into recurrence group and non-recurrence group according to the recurrence of atrial fibrillation after radiofrequency ablation.The factors affecting the recurrence of atrial fibrillation after radiofrequency ablation were analyzed.Results The total incidence of thrombotic events,the proportion of CHA2DS2-VASc score ≥2,and the postoper-ative recurrence rate in the COPD group were higher than those in the control group[20.0％(16/80)vs 8.8％(7/80),22.5％(18/80)vs 10.0％(8/80),53.8％(43/80)vs 26.2％(21/80)](all P＜0.05).A total of 64 patients had recurrence and 96 patients had no recurrence.The body mass index,the proportion of type 2 diabetes mellitus and COPD in the recurrence group were higher than those in the non-recurrence group.The duration of atrial fibrillation and the left atrial anteroposterior diameter were longer than those in the non-recurrence group,and the left ventricular ejection fraction was lower in the recurrence group than that in the non-recurrence group(all P＜0.05).A longer course of atrial fibrillation and COPD were the risk factors for recurrence of atrial fibrilla-tion after radiofrequency ablation(odds ratio=3.762,2.656,both P＜0.001).Conclusions The incidence of thrombotic events and the recurrence rate after radiofrequency ablation of atrial fibrillation in patients with COPD are higher.COPD is a risk factor for the recurrence of atrial fibrillation after radiofrequency ablation.

Abstract:Inflammation and immune problems are important mechanisms that cause many diseases.Drug therapy is the main approach,which has the advantages of convenient use,low cost,and obvious therapeutic effects,but also has risks of organ damage,such as liver and kidney,and adverse drug reactions.Other treatment methods need to be explored.Lidocaine is a commonly used local anesthetic,which has recently received attention in the research of inflammatory and immune diseases.Studies have shown that lidocaine can alleviate inflammation and pain symptoms and regulate immune system function to improve inflammatory diseases and inhibit the development of immune diseases.This review summarizes the pharmacological mechanisms,clinical applications(especially in inflammatory and immune diseases),and safety and effectiveness of lidocaine,providing reference for further research and application of lidocaine.

Abstract:Objective To observe the clinical effect of Yifei Jianpi granule combined with doxofylline in the treatment of chronic bronchitis of lung spleen Qi deficiency type.Methods The clinical data of 118 patients with chronic bronchitis of lung spleen Qi deficiency type admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2021 to October 2023 were retrospectively collected and analyzed.According to different treatment regimens,they were divided into observation group(59 cases)and control group(59 cases).The control group was treated with doxofylline tablets on the basis of basic intervention,and the observation group was treated with Yifei Jianpi granules on the basis of the control group.The clinical efficacy,traditional Chinese medicine syndrome score,inflammatory factors,immune function index levels,and treatment safety were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[91.5％(54/59)vs 78.0％(46/59)](P=0.041).After treatment,the traditional Chinese medicine syndrome scores,levels of interleukin-17A,CXC chemokine ligand 9 and monocyte chemoattractant protein 4 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).After treatment,the CD3+,CD4+,and CD4+/CD8+ratios in both groups were higher than those before treatment,and those in observation group were higher than those in control group;CD8+was lower than that before treatment,and that in observation group was lower than that in control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.542).Conclusion Yifei Jianpi granule combined with doxofylline has significant clinical effect in the treatment of chronic bronchitis of lung spleen Qi deficiency type,which can reduce the main traditional Chinese medicine syndromes of patients,reduce the levels of inflammatory factors,improve the immune function of patients,and has good safety.

Abstract:Objective To investigate the clinical effect of Tongguan Yixin decoction in the treatment of vasospastic angina(VSA).Methods Totally 96 patients with VSA visited to Hangzhou Traditional Chinese Medicine Hospital,Zhejiang Province from September 2022 to September 2023 were selected and divided into the observation group and the control group adopting a simplified random grouping method,both 48 cases.The control group was treated with western treatment and the observation group was treated with Tongguan Yixin decoction.Both groups were treated for 2 months.During the treatment,2 cases were dropped out of the control group and 2 cases were dropped out of the observation group.Angina pectoris attack,traditional Chinese medicine(TCM)syndrome score,vascular endothelial function,Seattle Angina Pectoris Scale(SAQ)score,myocardial microcircu-lation index(corrected time flow frame count of left circumflex branch,anterior descending branch and right crown)and clinical effect were observed in the two groups before and after treatment.Results After treatment,TCM syndrome score,serum malondialdehyde level,angina pectoris attack frequency,angina pectoris duration,left circumflex branch correction time flow frame count,anterior descending branch correction time flow frame count,right crown correction time flow frame count levels in the two groups were lower/less/shorter than before treatment,and the observation group was lower than the control group(all P＜0.05).After treatment,the levels of serum nitric oxide,superoxide dismutase and SAQ scores in the two groups were higher than those before treatment,and the observation group was higher than the control group(all P＜0.05).After treatment,the total effective rate in the observation group was higher than that in the control group[95.6％(44/46)vs 82.6％(38/46)](P＜0.05).Conclusion Tongguan Yixin decoction can improve vascular endothelial function and myocardial microcirculation in patients with coronary spastic angina.

Abstract:Objective To investigate the clinical effect of Nocardia rubrum cell wall skeleton(Nr-CWS)topical treatment on women with cervical high-risk human papillomavirus(HR-HPV)persistent infection.Methods A total of 120 female patients with persistent cervical HR-HPV infection(≥ 1 year)who visited the gynecological clinic of Beijing Anzhen Hospital,Capital Medical University from January 2021 to August 2023 were collected,and the clinical data of the patients were collected for retrospective analysis.According to the patients'preferred treatment method,they were divided into observation group and control group,with 60 cases in each group.The control group was given lifestyle intervention,including healthy lifestyle,appropriate exercise,enhance body resistance;the patients in the observation group were treated with external application of Nr-CWS on the basis of immunity intervention,10 times as a course of treatment.The efficacy of the two groups was evaluated at 6 and 12 months after treatment.Results At 6 and 12 months after treatment,the total effective rate of the observation group was significantly higher than that of the control group[63.3％(38/60)vs 18.3％(11/60),73.3％(44/60)vs 35.0％(21/60)](all P＜0.05).There was no statistically significant difference in the efficacy(total effective rate)of different subtypes of persistent HR-HPV patients in the observation group at 6 and 12 months after treatment(all P＞0.05).Conclusion Topical Nr-CWS is effective in the treatment of persistent cervical HR-HPV infection in women.

Abstract:Objective To analyze the effect of salidroside on the expression levels of serum proline hydroxylase 2(PHD2),protein phosphatase 2A(PP2A),and mitogen activated protein kinase(MAPK)in patients with rheumatoid arthritis(RA).Methods A total of 96 RA patients admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine from December 2022 to July 2023 were selected.They were randomly divided into control group and observation group according to the random number table,with 48 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with salidroside in addition to conventional western medicine,all for 3 months.The traditional Chinese medicine syndrome scores,clinical symptoms and signs,laboratory indicators[including erythrocyte sedimentation rates(ESR),C-reactive protein(CRP),rheumatoid factor(RF),anti cyclic citrulline peptide antibody(anti-CCP)],clinical efficacy,Health Assessment Questionnaire(HAQ)and Disease Activity Score 28(DAS28)scores and serum PHD2,PP2A,MAPK levels and gene expressions,before and after treatment,as well as adverse reactions was compared.Results After treatment,the scores of the main and secondary symptoms 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).After treatment,the clinical symptoms and signs of the observation group were milder than those of the control group,and the levels of ESR,CRP,RF,and anti-CCP were lower than those of the control group(all P＜0.05).The total effective rate of the observation group was higher than that of the control group[95.8％(46/48)vs 80.4％(37/46)](P=0.020).After treatment,the HAQ and DAS28 scores in the observation group were lower than those in the control group[(5.0±1.0)vs(7.2±1.2),(3.1±0.5)vs(4.1±0.7)](t=9.528,7.444,both P＜0.001).After treatment,the levels and gene expression of PHD2 and MAPK in the observation group were lower than those in the control group,while the level and gene expression of PP2A were higher than those in the control group(all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.528).Conclusion The treatment of RA with salidroside can enhance clinical efficacy,alleviate patients'symptoms,improve laboratory indicators,and be safe.It is speculated that it is related to the decrease of PHD2 and MAPK expression and the increase of PP2A expression.

Abstract:Acute myocardial infarction complicated by cardiogenic shock is a serious and life-threatening condition with high mortality.In recent years,emergency percutaneous coronary intervention(PCI)assisted by extracorporeal membrane oxygenation(ECMO)has made some progress in the treatment of these patients.ECMO can provide effective cardiopulmonary support for patients,maintain circulatory stability,and create conditions for emergency PCI.Recently,multidisciplinary cooperation has been strengthened in clinical practice,and several medical centers have successfully carried out ECMO-assisted emergency PCI,which has significantly improved the survival rate and prognosis of patients.In addition,with the continuous development of technology,there are more in-depth studies and understandings on the treatment timing,indications and postoperative complications manage-ment of ECMO-assisted emergency PCI.However,this treatment mode still faces many challenges,such as high treatment cost,technical complexity and possible complications,which still need to be further solved.This review summarizes the recent studies on ECMO combined with PCI in the treatment of acute myocardial infarction compli-cated with cardiogenic shock,in order to further improve the effectiveness and safety of this treatment mode,and bring more survival hope for patients.

Abstract:Objective To investigate the value of regional cerebral oxygen saturation(rScO2)combined with serum soluble triggering receptor expressed on myeloid cells 2(sTREM-2)in the diagnosis of sepsis-associated encephalopathy(SAE).Methods A total of 197 patients with sepsis admitted to the Intensive Care Unit of Jiamusi Central Hospital,Heilongjiang Province from January 2021 to October 2023 were selected.According to the occurrence of SAE in the hospital,the patients were divided into SAE group(80 cases)and non-SAE group(117 cases).The clinical data,rScO2 and serum sTREM-2 levels were compared between the two groups.Logistic regression method was used to analyze the risk factors of SAE.The receiver operating characteristic curve was used to analyze the diagnostic value of rScO2 combined with serum sTREM-2 for SAE.Results The proportion of septic shock,sequential organ failure assessment(SOFA)score,and blood lactate level in the SAE group were higher than those in the non-SAE group,and the heart rate and respiratory rate were faster than those in the non-SAE group(all P＜0.05).The rScO2 in SAE group was lower than that in non-SAE group[(0.57±0.11)vs(0.67±0.06)],and the serum sTREM-2 level was higher than that in non-SAE group[(25±4)ng/L vs(21±4)ng/L](t=-7.222,7.869,both P＜0.05).Logistic regression analysis showed that septic shock,increased SOFA score,increased heart rate,increased blood lactic acid,and increased sTREM-2 were independent risk factors for SAE,and increased rScO2 was an independent protective factor(all P＜0.05).The receiver operating characteristic curve showed that the Youden index of rScO2,serum sTREM-2 and their combination were 0.454,0.452 and 0.575,respectively,and the combination of the two had the highest diagnostic value.Conclusions Decreased rScO2 and increased serum sTREM-2 level are independently associated with the occurrence of SAE.The combination of rScO2 and serum sTREM-2 level has a high diagnostic value for SAE.

Abstract:Rheumatoid arthritis is an autoimmune disease,which can cause the involvement of multiple organs and systems such as bones and joints.Elderly patients with rheumatoid arthritis have the characteristics of organ dysfunction,low immune system function,and more complications,which lead to an increased incidence of infection.Patients with infection are difficult to treat,have a poor prognosis,and have a high mortality rate.Therefore,it is of great clinical significance to explore the relationship between elderly rheumatoid arthritis and infection.This article reviews the risk factors of elderly rheumatoid arthritis complicated with infection,in order to improve the understanding of elderly rheumatoid arthritis complicated with infection.

Abstract:Objective To observe serum angiopoietin-2(Ang-2)and stress-induced protein 2(Sesn2)levels in patients with acute ischemic stroke(AIS)after intravenous thrombolysis and their correlation with clinical prognosis.Methods A total of 105 AIS patients who received intravenous thrombolytic therapy in Baiyun Hospital Affiliated to Guizhou Medical University from August 2022 to March 2024 were prospectively selected.Serum Ang-2 and Sesn2 levels were measured at admission,and the prognosis was evaluated 3 months after thrombolysis.The levels of serum Ang-2 and Sesn2 in patients with different severity and prognosis were compared,and the relationship between serum Ang-2 and Sesn2 and the clinical prognosis of AIS patients was analyzed.Results The serum Ang-2 and Sesn2 in the severe group(30 cases)were higher than those in the moderate-severe group(46 cases)and the moderate group(29 cases)[(32±6)ng/L vs(29±5),(24±5)ng/L,(16±3)μg/L vs(12±4),(10±3)μg/L],and the moderate-severe group were higher than the moderate group(all P＜0.05).At 3 months after thrombolysis,45 of 105 patients had poor prognosis.The levels of serum Ang-2,Sesn2 and D-dimer and the proportion of patients with severe disease severity in the poor prognosis group were higher than those in the good prognosis group(all P＜0.05).Multivariate Logistic regression analysis showed that severe disease,D-dimer,Ang-2 and Sesn2 were independent prognostic factors(all P＜0.05).The restricted cubic spline analysis showed that the serum Ang-2 and Sesn2 levels were positively correlated with the prognosis of AIS patients in a non-linear dose-response relationship(both P＜0.05),and there was a positive interaction between serum Ang-2 and Sesn2 on the prognosis of AIS patients(the cut-off values were 28.18 ng/L and 12.61 μg/L,respectively).The nomogram showed that the concordance index of the model with serum Ang-2,Sesn2,D-dimer and disease severity was 0.975(95％confidence interval:0.951-0.999),and the discrimination was good.When the decision curve was drawn,the net earning rate of the decision curve drawn by serum Ang-2,Sesn2,and D-dimer level was higher,and the maximum net earning rate was 0.429.Conclusions The more severe the disease,the higher the serum Ang-2 and Sesn2 levels.When the serum Ang-2 and Sesn2 levels were higher than 28.18 ng/L and 12.61 μg/L respectively before treatment,the clinical prognosis might be poor and high risk.The serum Ang-2 and Sesn2 levels combined with disease severity and D-dimer levels can improve the predictive value for the clinical prognosis of AIS.

Abstract:Fractures often result in broken blood vessels and soft tissue damage,ischemia,hypoxia,and oxidative stress.Reactive oxygen species act as second messengers to activate signal transduction pathways during oxidative stress.In the presence of reactive oxygen species,Abnormal mitochondrial oxidative stress,Kelch-like epichlorohydrin related protein 1/nuclear factor E2-related factor 2/antioxidant response element signaling pathway,nuclear factor-κB signaling pathway and silent mating type information regulator 2 homologous protein 1 forkhead box transcription factor O signaling pathway can regulate the proliferation and apoptosis of osteoblasts and osteoclasts.It can affect the process of fracture healing.In recent years,the research on mitochondrial function has been on the rise,and the related research on oxidative stress-related signaling pathways and fracture healing has been progressing.Further study on the targets and mechanisms of mitochondrial oxidative stress and related signal transduction can further understand the osteogenic differentiation,osteoblast activity and osteoclast apoptosis of bone marrow mesenchymal stem cells,and provide theoretical basis for the treatment of clinical fractures.