Abstract:Objective To systematically evaluate the clinical efficacy and safety of traditional Chinese medicine compound prescriptions for strengthening the spleen and eliminating dampness combined with Western medicine in the treat-ment of obese type 2 diabetes,and to provide evidence-based evidence for clinical application.Methods Databases such as China National Knowledge Infrastructure(CNKI),Wanfang,VIP,CBM,and PubMed were searched to include randomized controlled trials(RCTs)comparing the combination of traditional Chinese medicine compound prescriptions for strengthening the spleen and eliminating dampness with Western medicine(experimental group)versus Western medicine alone(control group)in the treatment of obese type 2 diabetes.The Cochrane Risk of Bias tool was used to assess the quality of the litera-ture.Meta-analysis was performed using RevMan 5.4 software.Effect sizes included odds ratio(OR),mean difference(MD),and 95％confidence interval(CI).Heterogeneity and publication bias were analyzed.Results A total of 26 Chinese-language articles(2523 patients)were included.Meta-analysis showed that the clinical efficacy of the experimental group was signifi-cantly better than that of the control group(OR=4.87,95％CI:3.60-6.60,P＜0.001).After treatment,the experimental group showed significantly lower levels of fasting plasma glucose(MD=-0.89,95％CI:-1.18 to-0.60,P＜0.001),2-hour postpran-dial glucose(MD=-0.99,95％CI:-1.45 to-0.52,P＜0.001),total cholesterol(TC)(MD=-0.57,95％CI:-0.75 to-0.38,P＜0.001),triglycerides(TG)(MD=-0.33,95％CI:-0.59 to-0.17,P＜0.001),low-density lipoprotein cholesterol(LDL-C)(MD=-0.38,95％CI:-0.52 to-0.24,P＜0.001),body mass index(BMI)(MD=-1.15,95％CI:-1.50 to-0.81,P＜0.001),waist-to-hip ratio(WHR)(MD=-0.07,95％CI:-0.12 to-0.01,P=0.03),and homeostasis model assessment of insulin resist-ance(HOMA-IR)(MD=-1.38,95％CI.-1.65 to-1.11,P＜0.001).The homeostasis model assessment of β-cell function(HOMA-β)was significantly higher in the experimental group than in the control group(MD=8.53,95％CI:2.47-14.57,P=0.006).In terms of safety,there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The combination of traditional Chinese medicine compound prescriptions for strengthening the spleen and eliminating dampness with Western medicine is superior to Western medicine alone in improving clinical efficacy,glycolipid metabolism,obesity-related indicators,and pancreatic β-cell function in patients with obese type 2 diabetes,with good safety.Affected by the quality and heterogeneity of the included studies,more high-quality RCTs are needed for further verification.

Abstract:Objective To explore the predictive value of serum growth differentiation factor-15(GDF-15)and S100 calcium binding protein A12(S100A12)for upper gastrointestinal bleeding(UGIB)in elderly patients with peptic ulcer(PU).Methods A total of 112 patients with PU admitted to the Geriatric Department of Nanjing Tongren Hospital from March 2023 to March 2025 were selected as the PU group.Based on whether they had concomitant upper gastrointestinal bleeding(UGIB),they were divided into a concomitant subgroup and a non-concomitant subgroup.In addition,60 healthy individuals who underwent physical examinations were selected as the healthy control group.ELISA assay for serum GDF-15 and S100A12 levels.Comparison of serum GDF-15 and S100A12 levels between groups.Multifactorial Logistic regression analysis of factors influencing the incidence of UGIB in patients with PU.Relative risk analysis of serum GDF-15 and S100A12 levels on the incidence of UGIB in patients with PU.Plotting ROC curve to analyze the predictive value of serum GDF-15 and S100A12 levels for UGIB in patients with PU.Results Serum GDF-15 and S100A12 levels were higher in the PU group than in the healthy control group(t/P=22.258/＜0.001,16.540/＜0.001).Hemoglobin levels were significantly lower in the concurrent subgroup than in the non-concurrent subgroup,while serum GDF-15 and S100A12 levels were significantly higher in the concurrent subgroup than in the non-concurrent subgroup(t/P=9.274/＜0.001,6.110/＜0.001,5.473/＜0.001).Ele-vated serum GDF-15 levels[OR(95％CI)=6.487(3.345-12.582)]and high S100A12 levels[OR(95％CI)=7.304(4.252-12.546)]are risk factors for UGIB in PU patients,while high hemoglobin levels[OR(95％CI)=0.415(0.272-0.632)]are protective factors for UGIB in PU patients.Serum GDF-15,Patients with high levels of serum GDF-15 and S100A12 who de-veloped UGIB had a 2.734-fold(95％CI:1.514-4.936)and 4.162-fold(95％CI:2.102-8.241)higher risk of developing UGIB compared to patients with low levels of serum GDF-15 and S100A12 who developed UGIB(P＜0.001 for both).The AUC values for predicting UGIB in PU patients using serum GDF-15,S100A12,and the combination of both were 0.816,0.811,and 0.915,respectively.The combination of both was superior to each individually in predicting UGIB in PU patients(Z=3.220,2.490;P=0.001,0.013).Conclusion Serum GDF-15 and S100A12 are clearly elevated in patients with PU compli-cated with UGIB,and the combination of serum GDF-15 and S100A12 has high value in predicting PU complicated with UGIB.

Abstract:Objective To investigate the expression of prostaglandin-endoperoxide synthase 1(PTGS1)and myosin light chain 4(MYL4)in peripheral blood of patients with atrial fibrillation(AF),and their correlation with thromboembolic(TE)risk.Methods A prospective study enrolled 125 AF patients admitted to the Cardiovascular Center of Yan'an Universi-ty Affiliated Hospital from January 2022 to February 2024(AF group)and 125 age-and sex-matched healthy volunteers(con-trol group)at a 1∶1 ratio.AF patients were followed for 1 year and divided into TE and non-TE subgroups according to the occurrence of TE events.Peripheral blood PTGS1 and MYL4 levels were measured by enzyme-linked immunosorbent assay.Spearman correlation analysis was performed to assess the relationship between PTGS1,MYL4 levels and CHA2DS2-VASc scores in AF patients.Multivariate logistic regression and receiver operating characteristic(ROC)curve analysis were used to evaluate the association and predictive value of PTGS1 and MYL4 levels for TE risk in AF patients.Results Compared with the control group,AF patients exhibited higher PTGS1 and lower MYL4 levels in peripheral blood(t=13.543,-12.316;both P＜0.001).During the 1-year follow-up,the incidence of TE events in AF patients was 30.40％(38/125).Compared with the non-TE subgroup,patients in the TE subgroup were older,had a higher prevalence of diabetes,heart failure,prior IS/TIA,higher CHA2DS2-VASc scores,elevated PTGS1,and decreased MYL4 levels(x2/t=3.010,4.848,7.430,10.944,8.009,5.796,-5.738;P=0.003,0.028,0.006,0.001,＜0.001,＜0.001,＜0.001).PTGS1 levels were positively correlated with CHA2DS2-VASc scores,while MYL4 levels were negatively correlated(rs=0.702,-0.678;both P＜0.001).Advanced age,pri-or IS/TIA,high CHA2DS2-VASc score,and elevated PTGS1 were independent risk factors for TE in AF patients,whereas higher MYL4 was an independent protective factor[OR(95％CI)=1.154(1.035-1.286),3.663(1.578-8.500),1.857(1.316-2.620),2.335(1.481-3.681),0.864(0.801-0.931)].The area under the curve(AUC)for PTGS1,MYL4,and their combina-tion in predicting TE risk were 0.812,0.775,and 0.894,respectively,with the combined prediction significantly superior to ei-ther marker alone(Z=2.726,3.367;both P＜0.001).Conclusion Elevated peripheral blood PTGS1 and decreased MYL4 lev-els are associated with increased TE risk in AF patients.The combined assessment of PTGS1 and MYL4 provides higher pre-dictive efficacy for TE events.

Abstract:Non-alcoholic fatty liver disease(NAFLD),one of the most prevalent chronic liver diseases worldwide,has complex etiology and lacks effective treatment.Recent studies have shown that mitochondrial oxidative stress plays a key role in the development of NAFLD.The review presents the sources and biological basis of mitochondrial oxidative stress,systematically elucidates its mechanisms of mediating liver damage through multiple pathways such as inflammatory activation,programmed cell death,and autophagy dysfunction,and summarizes the current main intervention strategies targe-ting this process,including antioxidants,mitochondrial-targeted drugs,natural bioactive compounds,and signaling pathway regulation.On this basis,we further compared the action levels and mechanistic differences among various intervention strate-gies,analyzed the challenges faced by current research and proposed future research priorities and directions,with the aim of providing theoretical support and research ideas for the mechanism research and intervention strategies of NAFLD.

Abstract:Objective To explore the predictive value of electrocardiogram(ECG)combined with serum interleukin-33(IL-33)and angiopoietin-like protein 3(ANGPTL3)for the occurrence of major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 110 AMI patients treated in the Department of Cardiology of the First Affiliated Hospital of Xi'an Jiaotong University from Au-gust 2021 to December 2024 were selected as the study subjects.Based on the 6-month follow-up results after PCI,they were divided into a MACE group(n=32)and a non-MACE group(n=78).Serum levels of IL-33 and ANGPTL3 were measured using ELISA.Logistic regression analysis was used to analyze the factors influencing the occurrence of MACE.Receiver oper-ating characteristic(ROC)curve analysis was employed to evaluate the predictive value of ECG combined with serum IL-33 and ANGPTL3 for MACE in AMI patients after PCI.Results Compared with the non-MACE group,the MACE group had older age,longer time from onset to PCI treatment,higher proportion of patients with ≥ 3 diseased vessels,higher proportion of left main coronary artery as the culprit vessel,and lower proportion of pre-onset antiplatelet drug use(x2/t/P=1.991/0.049,4.156/＜0.001,7.678/0.006,4.250/0.039,4.198/0.040,respectively).The incidence of ECG T-wave inversion and serum levels of IL-33 and ANGPTL3 in the MACE group were significantly higher than those in the non-MACE group(x2/t/P=16.206/0.013,6.209/＜0.001,6.021/＜0.001,respectively).Older age,longer time from onset to PCI treatment,higher proportion of ≥3 diseased vessels,lower proportion of pre-onset antiplatelet drug use,presence of T-wave inversion,and elevated serum levels of IL-33 and ANGPTL3 were identified as risk factors for MACE in AMI patients after PCI[odds ratio(OR)(95％confi-dence interval,95％CI)=1.233(0.755-1.981),1.642(0.886-3.044),1.549(0.852-2.816),1.573(0.981-2.523),0.420(0.121-1.455),1.994(1.067-3.726),respectively].The area under the curve(AUC)of ECG combined with serum IL-33 and ANGPTL3 for predicting MACE in AMI patients after PCI was 0.986,which was superior to the predictive value of each sin-gle indicator alone(AUC of ECG=0.865,Z value for ECG vs.the three-index combination=5.075,P＜0.001;AUC of IL-33=0.837,Z value for IL-33 vs.the three-index combination=3.424,P=0.001;AUC of ANGPTL3=0.816,Z value for ANGPTL3 vs.the three-index combination=3.640,P＜0.001).The accuracy rate of T-wave inversion in predicting MACE in AMI patients 6 months after PCI was 68.18％,that of elevated serum IL-33 level was 80.00％,that of elevated serum ANGPTL3 level was 82.73％,and that of the combination of the three indicators was 91.82％,significantly higher than the single prediction of the three indicators(x2/P=19.205/＜0.001,6.346/0.012,4.092/0.043).Conclusion ECG T-wave inversion and elevated serum levels of IL-33 and ANGPTL3 are independent risk factors for MACE in AMI patients after PCI,and the combination of these three indicators has higher predictive value for MACE occurrence.

Abstract:Objective To explore the value of serum synaptic vesicle protein 2A(SV2A)level in the diagnosis and condition assessment of Alzheimer's disease(AD).Methods A total of 130 AD patients(60 cases of mild,40 cases of mod-erate and 30 cases of severe)who visited the Department of Neurology of the 904th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China from January 2021 to December 2023 and 20 healthy controls were included.The levels of serum SV2A,Aβ42,Tau protein and p-Tau181 were detected by enzyme-linked immunosorbent assay(ELISA).The correlations were analyzed in combination with cognitive function scales(MMSE,MoCA),disease severity scales(CDR,ADL,NPI)and hippocampal volume.The diagnostic efficacy of SV2A was evaluated by ROC curve.Multiple linear regres-sion is used to screen for independent influencing factors.Results Compared with the healthy control group,the levels of se-rum SV2A and A β4 2 in the AD group decreased,but the levels of Tau protein and p-Tau181 increased in the AD group(t/P=12.682/＜0.001,10.875/＜0.001,15.923/＜0.001,20.341/＜0.001).In the AD group,the levels of serum SV2A and Aβ42 in patients with mild,moderate and severe AD decreased successively,but the levels of Tau protein and p-Tau181 increased successively(F/P=56.789/＜0.001,32.145/＜0.001,45.670/＜0.001,68.912/＜0.001).The serum SV2A level showed a decreasing trend with the aggravation of AD severity(150.45±15.87 ng/mL in the healthy control group vs 80.78±13.45 ng/mL in the severe AD group,P＜0.001),which was significantly positively correlated with MMSE and MoCA scores(r=0.652,0.625,both P＜0.001),and negatively correlated with CDR,ADL,NPI scores and disease course(r=-0.721 to-0.552,all P＜0.001),and was positively correlated with hippocampal volume(r=0.502,P＜0.001).Serum SV2A level(OR=0.821,95％CI.0.756-0.889,P＜0.001),age(OR=1.123,95％CI:1.087-1.160,P＜0.001),MMSE score(OR=0.895,95％CI:0.856-0.934,P＜0.001),ADL score(OR=1.056,95％CI:1.023-1.089,P＜0.001),and hippocampal volume(OR=0.912,95％CI:0.876-0.948,P＜0.001)were independ-ent risk factors for the progression of AD.The ROC curve further demonstrated that the AUC for predicting the prevalence of AD by combining serum SV2A level,age,MMSE score,ADL score and hippocampal volume increased to 0.905(95％CI:0.856-0.954,P＜0.001),which was significantly higher than that of a single indicator(P＜0.001).Conclusion The level of se-rum SV2A is closely related to the severity of AD and cognitive function,and has high efficacy in the diagnosis of AD.It can be used as a potential biomarker for auxiliary diagnosis and disease assessment.

Abstract:Femtosecond laser small incision corneal stromal lenticule extraction(SMILE)is a representative of the new generation of refractive surgeries,which is a minimally invasive and flapless refractive correction procedure based on femtosecond laser technology.This surgical method,with its outstanding corneal biomechanical stability and relatively minor damage to the nerve plexus of the stromal layer,has established a dominant position in the field of myopia and astigmatism correction.However,current clinical studies have shown that although SMILE surgery demonstrates good safety and effective-ness in myopia and astigmatism correction,postoperative refractive undercorrection and regression phenomena still cannot be ignored,and this phenomenon is particularly prominent in patients with high astigmatism.This review systematically analyzed the multiple factors that affect the refractive correction effect of SMILE surgery,aiming to provide theoretical basis and deci-sion-making references for clinical practice.

Abstract:Objective To investigate the expression and clinical significance of plasma peptidyl arginine deiminase 4(PAD4)and C-C motif chemokine ligand 19(CCL19)in patients with severe pneumonia(SP)complicated by acute respiratory distress syndrome(ARDS).Methods A total of 100 patients with SP complicated by ARDS(SP+ARDS group)and 100 pa-tients with SP alone(SP group)admitted to the Department of Respiratory and Critical Care Medicine of Affiliated Hospital of Inner Mongolia Medical University from January 2020 to December 2024 were prospectively enrolled in a 1∶1 ratio.Plasma PAD4 and CCL19 levels were measured by enzyme-linked immunosorbent assay.Based on oxygenation index,SP+ARDS pa-tients were further divided into mild(n=30),moderate(n=36),and severe(n=34)ARDS subgroups.Spearman correlation analysis was used to evaluate the association between PAD4,CCL19 levels and oxygenation index.Patients were also classi-fied into survival and death groups based on 28-day outcomes.Multivariate Logistic regression was performed to analyze fac-tors affecting prognosis.Receiver operating characteristic(ROC)curves were used to assess the predictive value of plasma PAD4 and CCL19 levels for prognosis.Results Compared with the SP group,plasma PAD4 and CCL19 levels were significantly higher in the SP+ARDS group(t/P=14.368/＜0.001,17.701/＜0.001).In SP patients with ARDS,plasma PAD4 and CCL19 lev-els increased progressively from mild to moderate to severe subgroups(F/P=146.875/＜0.001,166.125/＜0.001).Plasma PAD4 and CCL19 levels were negatively correlated with oxygenation index(rs/P=-0.752/＜0.001,-0.744/＜0.001).The 28-day mor-tality rate in SP patients with ARDS was 41.00％(41/100).Increased oxygenation index was an independent protective factor for poor prognosis,while elevated PAD4 and CCL19 levels were independent risk factors[OR(95％CI)=0.977(0.964-0.991),2.710(1.567-4.684),4.010(1.759-9.144)].The AUCs for plasma PAD4,CCL19,and their combination in predicting poor prognosis were 0.814,0.795,and 0.909,respectively;the combined model outperformed either biomarker alone(Z/P=2.865/0.004,2.819/0.005).Conclusion Elevated plasma PAD4 and CCL19 levels in SP patients with ARDS are closely associated with greater disease severity and higher mortality.The combination of plasma PAD4 and CCL19 levels provides superior pre-dictive value for prognosis compared with either marker alone.

Abstract:Objective To analyze the predictive value of serum Parkinson's disease protein 7(DJ-1),kallikrein in-hibitor(Kallistatin)and tumor protein P53(TP53)for major adverse cardiovascular events(MACE)after percutaneous coro-nary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods From January 2024 to October 2024,102 patients with AMI admitted to the Department of Cardiovascular Medicine of Inner Mongolia Baogang Hospital were se-lected as the AMI group,and 100 healthy volunteers who underwent physical examination in the hospital during the same pe-riod were selected as the healthy control group.Serum levels of DJ-1,Kallistatin and TP53 were detected by ELISA.The AMI patients were followed up for 6 months,and the occurrence of recurrent MACE was recorded.Patients with recurrent MACE were assigned to the poor prognosis subgroup,while the rest were classified into the good prognosis subgroup.The Pearson method was used to analyze the correlation between serum DJ-1,Kallistatin and TP53.Logistic regression was performed to identify risk factors for poor prognosis in AMI patients,and ROC curve analysis was used to evaluate the predictive efficacy for poor prognosis.Results The serum levels of DJ-1(t=7.397,P＜0.001)and Kallistatin(t=7.632,P＜0.001)in the AMI group were lower than those in the healthy control group,while the level of TP53 was higher(t=7.978,P＜0.001).The serum levels of DJ-1(t=8.534,P＜0.001)and Kallistatin(t=7.737,P＜0.001)in the poor prognosis subgroup were lower than those in the good prognosis subgroup,while the level of TP53 was higher(t=7.382,P＜0.001).Serum DJ-1 was positively correlated with Kallistatin levels,and serum TP53 was negatively correlated with DJ-1 and Kallistatin levels(r=0.513,-0.467,-0.451,all P＜0.001).Low serum DJ-1[OR(95％CI)=0.714(0.577-0.884)],low Kallistatin[OR(95％CI)=0.692(0.553-0.865)],and high TP53[OR(95％CI)=2.315(1.296-4.135)]were risk factors for poor prognosis in AMI patients.The AUC values of serum DJ-1,Kallistatin,TP53 alone and their combination for predicting recurrent MACE in AMI patients were 0.795,0.796,0.807 and 0.917,respectively.The AUC of the combined three biomarkers was larger than that of each individual bio-marker(Z=2.931,2.900,2.640,P=0.003,P=0.004,P=0.008).Conclusion In AMI patients with recurrent MACE after PCI,serum DJ-1 and Kallistatin levels are lower and TP53 levels are higher compared to those without recurrent MACE.The com-bined detection of these three biomarkers can effectively predict the risk of recurrent MACE in AMI patients after PCI.

Abstract:Objective To explore the clinical efficacy of dapagliflozin in the treatment of non-diabetic AMI and its impact on the TLR4/NF-κB signaling pathway.Methods From January 2023 to June 2024,86 non-diabetic AMI patients admitted to Jinhua Municipal People's Hospital were randomly divided into a control group and an observation group,each consisting of 43 cases.The control group received conventional drug therapy,while the observation group was treated with dapagliflozin in addition to the standard treatment,both for six months.Post-treatment cardiac function indicators(LVEF,LVEDD,NT-proBNP),inflammatory factor indicators(TNF-α,IL-6,IL-8),and TLR4/NF-κB signaling pathway-related indicators(TLR4,MyD88,NF-κB mRNA)were analyzed.Additionally,the incidence of adverse drug reactions and major adverse cardiovascular events during treatment was observed.Results After six months of treatment,the observation group had a higher LVEF than the control group(t/P=13.725/＜0.001).The LVEDD,NT-proBNP,TNF-α,IL-6,IL-8,TLR4 mRNA,MyD88 mRNA,and NF-κB mRNA levels were lower in the observation group compared to the control group(t/P=12.732/＜0.001,7.369/0.003,4.659/0.005,5.930/＜0.001,4.169/0.009,11.949/＜0.001,6.594/0.002,8.556/＜0.001),with all differences being statistically significant.During follow-up,the incidence of major adverse cardiovascular events(13.95％,20.93％)and drug adverse reactions(13.95％,18.60％)between the observation group and the control group did not show statistical significance(P＞0.05).Conclusion Dapagliflozin can improve cardiac function in non-diabetic AMI patients,inhibit inflammatory responses,and has good safety.Its mechanism of action may be related to the inhibition of TLR4/NF-κB signaling pathway expression.

Abstract:Objective To discuss the impacts of percutaneous coronary intervention(PCI)through the distal transra-dial artery access(dTRA)in the anatomical snuffbox area on puncture-related conditions and complications in elderly patients.Methods From January 2023 to January 2025,126 elderly patients requiring PCI were admitted to the First Department of Cardiology of the 901st Hospital of the Joint Logistic Support Force of the People's Liberation Army of China.They were randomly divided into Group A and Group B,with 63 cases in each group.Group A received dTRA,and Group B received the conventional radial artery approach(cTRA).The puncture situation,surgical condition,vascular ultrasound examination re-sults,complications,and prognosis were compared.Results There were no statistically significant differences between the two groups of patients in terms of the number of punctures,the success rate of the first puncture,the success rate of catheter-ization,the angiography time,the operation time of percutaneous coronary intervention(PCI),the dosage of contrast agent,the total radiation dose,the diameter of the right radial artery,and the occurrence of complications(P＞0.05).Compared with group B,the puncture time of patients in group A was prolonged(t/P=2.713/0.008).The postoperative radial artery compression time was shortened(t/P=10.350/＜0.001),and the diameter of the right distal radial artery(t/P=2.175/0.032),VAS score(t/P=9.700/＜0.001),and the incidence of postoperative radial artery occlusion were all decreased(x2/P=4.308/0.038).Conclusion Performing PCI through dTRA in the anatomical snuffbox area can optimize the puncture situation in elderly patients and re-duce complications.

Abstract:To report a case of acute inflammatory demyelinating polyradiculoneuropathy(AIDP)with treatment-related fluctuation(TRF),presenting with elevated intracranial pressure and positivity for anti-sulfatide antibody in cerebrospi-nal fluid and anti-GM3 antibody in serum,along with a literature review.

Abstract:Intestinal flora,as the largest bacterial reservoir in the human body,serves as a critical microbial barrier and plays a vital role in maintaining internal homeostasis and host health.The living environment significantly influences the structural composition of the intestinal flora.When the body is exposed to the hypobaric hypoxic(HH)environments in the plateau region,the intestinal flora may become imbalanced due to high-altitude-related damage,while the body's adaptation can also drive convergent evolution of the microbiota.Specific interventions such as probiotics,prebiotics,or fecal microbiota transplantation can modulate the intestinal flora to some extent,thereby enhancing the body's adaptation to high-altitude envi-ronments and mitigating HH-induced tissue damage.This review summarizes domestic and international literature on the chan-ges in intestinal flora under plateau environments and their association with the body's damage and adaptation,aiming to provide new insights and strategies for the prevention and treatment of plateau injury and the regulation of physiological adaptation.

Abstract:Objective To investigate the predictive value of serum granulocyte colony-stimulating factor(G-CSF)and interferon gamma-induced protein-10(IP-10)for autoimmune encephalitis(AE)in patients with herpes simplex virus(HSV)infection.Methods A total of 183 patients with HSV infection admitted to the Second People's Hospital of Hunan Province(Hunan Provincial Brain Hospital)from January 2020 to December 2024 were selected as the HSV group.Based on AE development,HSV-infected patients were divided into AE subgroup(n=32)and non-AE subgroup(n=151).Additionally,200 healthy individuals undergoing physical examinations during the same period were selected as the healthy control group.Serum G-CSF and IP-10 levels were measured using enzyme-linked immunosorbent assay(ELISA).Multivariate logistic re-gression was used to analyze the influence of serum G-CSF and IP-10 levels on AE development in HSV-infected patients.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of serum G-CSF,IP-10,and their combination for AE development in HSV-infected patients.Results Serum G-CSF and IP-10 levels in the HSV group were significantly higher than those in the healthy control group(t=5.873,6.416;both P＜0.001).The AE subgroup showed significantly higher serum G-CSF and IP-10 levels compared to the non-AE subgroup(t=5.594,5.431;both P＜0.001).Multivariate logistic regression analysis indicated that elevated serum G-CSF and IP-10 levels were independent risk factors for secondary AE in HSV-infected patients[OR(95％CI)=4.245(1.892-9.524),3.492(1.635-7.459)].ROC curve analysis demonstrated that the areas under the curve(AUC)for predicting secondary AE using G-CSF,IP-10,and their combi-nation were 0.776,0.783,and 0.868,respectively.The combined prediction was superior to individual predictions(Z/P=2.224/0.026,2.388/0.017).Conclusion Serum G-CSF and IP-10 levels are significantly elevated in HSV-infected patients who de-velop secondary AE.Combined detection of these two biomarkers shows high predictive value for secondary AE in HSV-in-fected patients.

Abstract:Objective To analyze the risk factors of myocardial injury in patients with acute coronary syndrome(ACS)after direct percutaneous coronary intervention(PCI),and to construct a risk prediction model based on these risk fac-tors.Methods The clinical data of 126 patients with ACS who underwent direct PCI treatment in the Department of Cardio-vascular Medicine of the Sixth Affiliated Hospital of Xinjiang Medical University from March 2019 to April 2023 were retro-spectively selected.Patients were divided into myocardial injury group(n=44)and non-myocardial injury group(n=82)based on the occurrence of myocardial injury.Multivariate Logistic regression was used to analyze the influencing factors of myocar-dial injury in patients with ACS,and the nomogram risk prediction model was drawn using R software and rms package.The correction curve was drawn by the Bootstrap method using the caret package for internal verification,and the receiver operat-ing characteristic(ROC)curve and decision curve(DCA)were used to evaluate the prediction model.Results The proportion of patients aged over 60 years old in the myocardial injury group showed higher levels of high-sensitivity C-reac-tive protein(hs-CRP),lipoprotein-associated phospholipase A2(Lp-PLA2),galectin-3(GAL3),heart-type fatty acid binding protein(H-FABP),and tissue protease S(CTSS)compared to the non-myocardial injury group(t/P=8.287/0.004,5.137/＜0.001,7.939/＜0.001,5.243/＜0.001,6.913/＜0.001,4.999/＜0.001).Multivariate Logistic regression analysis showed that age＞60 years,high Lp-PLA2,high GAL3,high H-FABP,and high CTSS were independent risk factors for myocardial injury in ACS patients after direct PCI[OR(95％CI)=5.916(1.298-26.967),1.035(0.743-6.637),2.270(1.015-1.054),1.392(1.092-1.774),1.489(1.044-2.125)].Based on the risk factors,a risk prediction model was constructed:the column-line diagram model showed that C-index was 0.961,and the internal correction curve and the ideal curve fit well and were highly coinci-dent.ROC curve showed that AUC predicted by the model was 0.961,sensitivity and specificity were 0.846 and 0.939,respec-tively.The decision curve showed that the clinical net benefit of the model was ideal.Conclusion Age over 60 years old and high levels of Lp-PLA2,GAL3,H-FABP,and CTSS are all risk factors for myocardial injury in ACS patients after direct PCI.Based on these factors,a risk prediction model can be constructed to visualize the risk and have ideal predictive value.

Abstract:Objective To explore the predictive value of pan-immune inflammation value(PIIV)combined with albumin-to-globulin ratio(AGR)for infection during chemotherapy in elderly patients with multiple myeloma.Methods A total of 118 elderly patients with multiple myeloma admitted to the Department of Hematology of Xinjiang Uygur Autonomous Region People's Hospital from February 2022 to March 2024 were selected.The patients were divided into the infection group(30 cases)and the non-infection group(88 cases)based on whether infection occurred during chemotherapy.Multivariate logistic regression analysis was used to identify influencing factors of infection during chemotherapy in elderly patients with multiple myeloma.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of PIIV and AGR for infection during chemotherapy in elderly patients with multiple myeloma.Results The PIIV in the infection group was higher than that in the non-infection group,and the AGR was lower than that in the non-infection group(t/P=21.943/＜0.001,6.854/＜0.001).Multivariate logistic regression analysis showed that CRP ≥ 10 mg/L,high NEUT,high MONO,and high PIIV were independent risk factors for infection during chemotherapy in elderly patients with multiple myeloma[OR(95％CI)=3.052(1.298-7.176),2.190(1.463-3.277),3.081(2.175-8.726),1.035(1.011-1.579)],while ECOG score≤2 points,high LYM,and high AGR were protective factors[OR(95％CI)=0.416(0.179-0.967),0.055(0.015-0.193),0.233(0.227-0.923)].The AUC of PIIV,AGR and their combination in predicting infection during chemotherapy in elderly patients with multiple myeloma was 0.850,0.824 and 0.933,respectively.The combination of the two was superior to the individual predictive value of each(Z/P=2.951/0.003,3.562/＜0.001).Conclusion PIIV combined with AGR has good predictive value for infection during chemotherapy in patients with multiple myeloma,and can effectively identify patients with high-risk infection.

Abstract:Objective To evaluate the predictive value of serum tissue inhibitor of metalloproteinase-2(TIMP-2),histone deacetylase 4(HDAC4),and uric acid(UA)/albumin(ALB)ratio(UAR)for acute kidney injury(AKI)in patients with acute Stanford type A aortic dissection(ATAAD)after surgery.Methods From December 2021 to December 2024,133 ATA AD patients who underwent Sun's surgery and 133 heart healthy examinees in our hospital were selected as the study subjects and included in the ATAAD group and heart healthy group,respectively.Among them,55 patients in the ATAAD group developed AKI after surgery and were included in the postoperative AKI group,while the remaining 78 patients were included in the postoperative normal group.The serum TIMP-2,HDAC4,and UAR were compared.Multivariate logistic re-gression was performed to analyze the influencing factors of AKI in ATAAD patients after Sun's surgery.The relative risk was performed to discuss the risk of AKI in high expression of TIMP-2,HDAC4,and UAR compared to low expression.ROC curve was used to analyze the value of TIMP-2,HDAC4,and UAR in predicting AKI in ATAAD patients after surgery.Results The ATAAD group had higher serum TIMP-2,HDAC4,and UAR than the heart healthy group(t/P=11.469/＜0.001,10.311/＜0.001,12.235/＜0.001).The postoperative AKI group had higher proportion of cases involving renal artery dissection,TIMP-2,HDAC4,UAR,and longer total extracorporeal circulation time than the postoperative normal group,and all of them were risk factors for AKI[OR(95％CI)=3.125(1.795-5.442),2.674(1.651-4.330),2.831(1.691-4.740),3.335(1.824-6.099),2.749(1.661-4.549)].Relative risk analysis showed that the risk of developing AKI after surgery in patients with high TIMP-2,HDAC4,and UAR was 2.343 times,2.269 times,and 3.457 times higher than that in patients with low levels.The AUCs of TIMP-2,HDAC4,UAR and the combination of the three for predicting AKI after Sun's surgery in patients with ATAAD were 0.833,0.847,0.832 and 0.963,respectively.The combination of the three was superior to the AUCs of TIMP-2,HDAC4 and UAR alone(Z=3.366,3.236,3.391,P=0.001,0.001,0.001).Conclusion Serum TIMP-2,HDAC4,and UAR are elevated,and their union has high value in predicting postoperative AKI in ATAAD patients.

Abstract:Objective To compare the clinical effects of unicompartmental knee arthroplasty(UKA),total knee ar-throplasty(TKA),and high tibial osteotomy(HTO)in patients with medial compartment knee osteoarthritis.Methods A ret-rospective analysis was performed on 292 patients with medial compartment knee osteoarthritis treated surgically in our hospi-tal from May 2020 to May 2023.According to the surgical method,patients were divided into the UKA group(n=97),TKA group(n=97),and HTO group(n=98).Perioperative status,knee function before and after surgery,early joint forgetfulness,femorotibial angle,knee motion,and complication rates were compared among the three groups.Results The operation time in the UKA group(103.6±13.0 min)was shorter than that in the HTO group(136.2±18.4 min)and TKA group(131.8±17.5 min)(F=29.664,P＜0.05).Postoperative decreases in hemoglobin(9.63±2.00 g/L)and hematocrit(4.11±0.96％),as well as surgical blood loss(336.8±55.9 mL),were lower in the UKA group than in the HTO and TKA groups(F=37.055,27.468,37.464;all P＜0.05).At 3 and 6 months postoperatively,WOMAC scores in the UKA and TKA groups[(14.0±4.3),(12.1±5.7)and(10.2±3.4),(8.8±4.0),respectively]were lower than those in the HTO group[(20.0±5.9),(13.4±6.1)](F=39.48,16.334;all P＜0.05).HSS scores in the UKA and TKA groups at 3 and 6 months[(78.6±8.6),(80.0±8.0)and(86.3±9.0),(88.5±6.7),respectively]were higher than those in the HTO group[(74.1±8.4),(82.0±9.2)](F=37.664,17.485;both P＜0.05).FJS-12 scores in the UKA group at 1,3,and 6 months postoperatively[(33.8±6.0),(54.1±7.6),(69.8±11.0)]were sig-nificantly higher than those in the HTO group[(28.0±5.8),(43.0±8.1),(51.4±9.7)]and TKA group[(29.5±6.7),(42.1±7.8),(53.0±10.8)](F=14.776,48.209,41.774;all P＜0.05).Conclusion UKA,TKA,and HTO all achieve favorable clinical out-comes in the treatment of medial compartment knee osteoarthritis.However,UKA offers advantages including shorter operative time,better early joint forgetfulness,and superior knee function recovery compared to TKA and HTO.Therefore,UKA may be the preferred option for eligible patients.

Abstract:This article systematically elaborates the theoretical and clinical value of establishing a system for syndrome differentiation and treatment of pulmonary collateral diseases.Based on the historical coordinates and the intersection of the times of the theory of collateral disease,the theory of visceral outward manifestation,and the development of the syndrome differentiation of the viscera,this article clarifies the historical mission of constructing syndrome differentia-tion and treatment of pulmonary collateral diseases.This article clearly defines the core concepts and physiological functions of the pulmonary collateral and the pulmonary airways.It briefly elaborates on the causes,the basic pathogenesis,the main clini-cal manifestations,the therapeutic principles and methods,the treatment formulas,as well as the syndrome differentiation and treatment of pulmonary collateral diseases.This article presents some examples of representative research achievements in pre-vention and treatment of major chronic diseases such as respiratory communicable or infectious diseases and COPD,which are acquired under the guidance of syndrome differentiation and treatment of pulmonary collateral diseases.Thus,the significant theoretical and clinical value of the syndrome differentiation and treatment system of pulmonary collateral diseases are demon-strated.

Abstract:Objective To investigate the expression of serum homer scaffold protein 1(Homer1)and Dickkopf-3(DKK3)levels in patients with acute ischemic stroke(AIS)and their relationship with neurological outcomes.Methods Ac-cording to the ratio of 2∶1,108 AIS patients(AIS group)and 54 healthy volunteers(healthy control group)were selected from the Department of Neurology,Xianyang Hospital of Yan'an University from January 2022 to October 2024.The AIS group was divided into mild,moderate and severe subgroups according to the National Institutes of Health Stroke Scale(NIHSS)score,and divided into poor subgroup and good subgroup according to the 3-month neurological outcome.The levels of serum Homer1 and DKK3 were detected by enzyme-linked immunosorbent assay,and the correlation between them and NIHSS score was analyzed by Spearman rank correlation.Multivariate logistic regression and receiver operating characteristic analysis were used to analyze the relationship between serum Homer1 and DKK3 levels and neurological outcome in AIS patients and their predictive efficacy.Results Compared with the healthy control group,the serum Homer1 level in the AIS group in-creased and the DKK3 level decreased(t/P=22.391/＜0.001,16.202/＜0.001);Among the 108 AIS patients,31 were mild,42 were moderate,and 35 were severe.The serum Homer1 level in the mild,moderate,and severe subgroups gradually increased,and the DKK3 level gradually decreased(F/P=121.399/＜0.001,174.103/＜0.001);Serum Homerl level was positively correlated with NIHSS score in AIS patients,and DKK3 level was negatively correlated with NIHSS score(rs/P=0.706/＜0.001,-0.745/＜0.001);Compared with the good subgroup,the poor subgroup had higher NIHSS score,larger infarct volume,higher Homer1 and lower DKK3(t/Z/P=4.573/＜0.001,4.520/＜0.001,5.993/＜0.001,6.583/＜0.001);High NIHSS score,large in-farct volume,and high Homer1 were independent risk factors for poor neurological outcomes in AIS patients,and high DKK3 was an independent protective factor[OR(95％CI)=1.088(1.025-1.155),1.392(1.144-1.694),1.307(1.117-1.528),0.892(0.842-0.946)];The areas under the curve of Homer1,DKK3 and their combination in predicting poor neurological outcome in AIS patients were 0.808,0.814 and 0.897,respectively.The combination of the two was superior to their respective predic-tive efficacy(Z/P=2.653/0.008,2.666/0.008).Conclusion The increase of serum Homer1 level and the decrease of DKK3 level in AIS patients are related to the aggravation of the disease and the poor outcome of neurological function.The combina-tion of Homer1 and DKK3 has a higher efficacy in predicting the outcome of neurological function.