Abstract:Coronary artery spasm is secondary to almost complete or complete occlusion of blood vessels after constriction.This process can cause ischemia,leading to typical variant angina pectoris,atypical angina pectoris,acute myocardial infarction,sudden death,various types of arrhythmia,heart failure and so on.It is fatal if not detected and treated in time.Among them,cardiac arrest caused by coronary artery spasm is rare.This article reports the clinical data of a case of cardiac arrest caused by severe coronary artery spasm successfully rescued by extracorporeal membrane oxygenation,in order to improve the vigilance of clinicians for cardiac arrest caused by coronary artery spasm,and to provide a reference for the treatment of cardiac arrest by extracorporeal membrane oxygenation.

Abstract:Objective To investigate the relationship between antinuclear antibody,antinuclear antibody spectrum(ANAs),antiphospholipid antibodies(aPLs)and adverse pregnancy outcomes,and analyze the medication use.Methods The clinical data of 153 pregnant patients with positive antinuclear antibodies,ANAs or aPLs in the Second Affiliated Hospital of Kunming Medical University from January 2021 to May 2024 were retrospectively collected.The pregnancy outcomes were recorded,and the patients with adverse pregnancy outcomes were included in the observation group(80 cases),and the rest of the patients with good pregnancy outcomes were included in the control group(73 cases).The clinical data,antinuclear antibodies,ANAs,aPLs and medication during pregnancy were compared between the two groups.The binary Logistic regression model was used to analyze the risk factors of adverse pregnancy outcomes.Results There were significant differences in the history of previous pregnancy loss,gestational age,gravidity,proportion of cesarean section and neonatal admission to the neonatal department between the two groups(all P＜0.05).The positive rates of antinuclear antibody,anti-SSA antibody,anticardiolipin antibody,anti-β2 glycoprotein Ⅰ antibody(aβ2GPI)and antinuclear antibody combined with SSA in the observation group were higher than those in the control group(all P＜0.05).The proportion of drugs used during pregnancy in the observation group was lower than that in the control group[75.0％(60/80)vs 90.4％(66/73)](x2=6.238,P=0.013).Binary Logistic regression analysis showed that neonatal admission to the neonatal department,positive antinuclear antibody and positive aβ2GPI were risk factors for adverse pregnancy outcomes,and gestational age was a protective factor(all P＜0.05).Conclusion Abnormal antinuclear antibodies,ANAs and aPLs are found in pregnant patients.Early intervention and timely drug treatment should be used to reduce the occurrence of adverse pregnancy outcomes and ensure the safety of mother and child.

Abstract:Objective To explore the cognition of chronic kidney disease patients on disease prognosis and traditional Chinese medicine treatment from the perspective of"knowledge,belief and action".Methods A total of 21 patients with chronic kidney disease who visited the Department of Nephrology Endocrinology,Dongzhimen Hospital,Beijing University of Chinese Medicine from January to February 2025 were interviewed by semi-structured in-depth interviews.The Colaizzi seven-step method was used to analyze and refine the data,and Maxqda 2022 software was used to assist data sorting and data coding.Results In this study,the data was saturated when the 21st patient was interviewed,including 8 males and 13 females,aged 29 to 76 years,and the course of disease was 3 to 420 months.The patients had insufficient cognition of the development and prognosis of the disease,and the recognition of traditional Chinese medicine treatment was high,and the advantages of traditional Chinese medicine treatment were prominent.They had high expectations and confidence in disease treatment,and traditional Chinese medicine treatment was widely accepted and trusted.Patients' self-management is biased,and their diet and daily life need to be standardized.Conclusion There is a contradiction among the ambiguity of patients' cognition of the disease and prognosis,their high confidence and high expectations in treatment,and the deviation of self-management behaviors.It is necessary to strengthen health education to improve the conflict between insufficient cognition and high expectations.Promoting the treatment of traditional Chinese medicine,giving full play to its characteristic advantages,constructing a collaborative intervention model of"cognition-belief-behavior",and forming a virtuous cycle of"knowledge,belief and action"can provide the wisdom of traditional Chinese medicine for the management of chronic diseases.

Abstract:Multiple myeloma(MM)is a heterogeneous disease of plasma cells.Autophagy is a biological process of eukaryotic cells to maintain the homeostasis of the internal environment.It has a dual role in the occurrence and development of MM,which can promote or inhibit the development of tumor.This article reviews autophagy and its regulatory mechanism,the role of autophagy in MM,and the treatment strategies of autophagy-related MM,in order to provide new ideas for the clinical diagnosis and treatment of MM.

Abstract:Tic disorders are common neuropsychiatric disorders in children and adolescents.They are often accompanied by one or more comorbidities,which increase the difficulty of disease diagnosis and treatment and have become the focus of attention in recent years.Tic disorders comorbid with obsessive-compulsive disorder is a common comorbidity in clinical practice.Studies have shown that there is a complex bidirectional causal relationship between tic disorders and obsessive-compulsive disorder.Comorbid obsessive-compulsive disorder increases the complexity and difficulty of diagnosis and treatment of tic disorders,resulting in reduced clinical treatment effect and prolonged course of disease.It has become a major problem in the clinical treatment of tic disorders and an important cause of refractory tic disorders.It has attracted wide attention in the world,but there is relatively little attention in domestic academic circles.This article reviews the latest global literature on the clinical characteristics,etiology,pathogenesis and clinical treatment of tic disorders comorbid with obsessive-compulsive disorder,aiming to provide a reference for related research on tic disorders comorbid with obsessive-compulsive disorder.

Abstract:Objective To systematically evaluate the incidence of peripherally inserted central catheter(PICC)-related thrombosis in neonates.Methods Medline,Embase,Web of Science,CINAHL,China Biology Medicine Disc,China National Knowledge Infrastructure,VIP Database and Wanfang Database were searched for studies on the incidence of PICC-related thrombosis in neonates by computers.The search time limit was from the establishment of the database to May 17,2022.After screening and quality evaluation by two reviewers,Meta-analysis was performed using Stata 16.0 software.Results A total of 5 studies were included,with a total sample size of 4 573 cases,among which 104 cases of PICC-related thrombosis occurred.Meta-analysis showed that the incidence of PICC-related thrombosis in neonates was 1.7％(95％confidence interval:0.5％-3.6％).The results of subgroup analysis showed that the incidence of PICC-related thrombosis in neonates published from 2017 to 2021 and those with catheterization through the lower extremity vein was higher.Conclusion The incidence of PICC-related thrombosis in neonates is 1.68％.The incidence of thrombosis is higher in neonates with lower extremity venous catheterization.Therefore,for neonates with coagulopathy and high risk of thrombosis,lower extremity venous catheterization should be avoided.

Abstract:Objective To investigate the causes and management measures of lower limb deep venous thrombosis(DVT)in patients undergoing urology surgery.Methods From June 2016 to June 2023,the clinical data of 58 patients with lower limb DVT after surgery at Department of Urology,Beijing Shijitan Hospital,Capital Medical University were retrospectively analyzed.The treatment results and prognosis were summarized.Results Of the 58 patients,50 cases(86.2％)were malignant tumors after resection.Thirty-nine cases(67.2％)were overweight or obese,and 30 cases(51.7％)were smokers.Among them,42 cases had no obvious clinical symptoms and were found during screening for D-dimer,and 16 cases had varying degrees of lower limb pain,swelling,limited mobility,pale skin,and positive gastrocnemius muscle grip test.All 58 patients were given bed rest,with the affected limb elevated by 20°-30°.Low molecular weight heparin calcium was administered subcuta-neously at a dose of 85 IU/kg every 12 h for a treatment period of 10-14 d.Warfarin was also administered orally at a dose of 3 mg/time once a day for the next 3 d.Warfarin was maintained for 3-6 months.All 58 patients were successfully treated with conservative treatment.One patient developed pulmonary embolism 2 d after operation and was treated with inferior vena cava filter implantation,and the thrombus disappeared 6 months later.All patients were followed up for(20±14)months,and no DVT recurrence,cerebral infarction and other serious complica-tions occurred.One patient with ureteral cancer died of cancer recurrence and metastasis 9 months after surgery.Conclusion The incidence of lower limb DVT after urological surgery is not low.The risk factors of lower limb DVT include radical resection of malignant tumors,obesity,smoking and so on.Postoperative detection of D-dimer level is beneficial to the early detection of lower limb DVT.Once lower limb DVT occurs,it should be treated actively.The effect of anticoagulation with low molecular weight heparin after operation is better.

Abstract:Neutrophilic asthma is often resistant to steroids and may progress to severe asthma.The key immune cell in neutrophilic asthma is T helper cell 17,which recruits neutrophils by secreting interleukin-17(IL-7)and promotes the occurrence and development of neutrophilic asthma.The nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome is an immunosensor complex composed of a variety of proteins,which plays a promoting role in the progression of neutrophilic asthma.Studies have shown that blocking NLRP3/IL-1 β/IL-17 signaling pathway has a certain effect on the treatment of this type of asthma.This article discusses the biological characteristics of NLRP3 inflammasome and its pathogenesis in neutrophilic asthma,and summarizes the research progress of targeting NLRP3 inflammasome in the treatment of neutrophilic asthma,aiming to provide a new perspective for the treatment of neutrophilic asthma.

Abstract:The human microecosystem plays an important role in regulating normal physiological functions and maintaining the stability of the internal environment.As an important immune organ of the human body,the liver is chronically exposed to the effects of circulating nutrients and endotoxin from the gut microbiota.The pathogenesis of autoimmune liver disease is not completely clear at present.In addition to autoimmune factors,in recent years,with the emergence of high-throughput sequencing and other technologies,through the continuous in-depth study of human microbiota,it has been found that gut and oral microbiota also play an important role in the occurrence,development and treatment of autoimmune liver disease.This article summarizes the characteristics of gut and oral microbiota in different autoimmune liver diseases and the positive therapeutic effect of regulating microbiota on autoimmune liver diseases.

Abstract:Objective To investigate the prognostic value of blood urea nitrogen to albumin ratio(BAR)in patients with acute myocardial infarction(AMI)complicated with ventricular arrhythmias(VA).Methods A total of 954 patients diagnosed with AMI complicated with VA in Beijing Anzhen Hospital,Capital Medical University from January 2019 to January 2024 were retrospectively selected.They were divided into survival group(696 cases)and death group(258 cases)according to death within 30 d.Logistic regression analysis and subgroup analysis were used to evaluate the correlation between BAR and 30 d mortality of patients,and a nomogram model was constructed.The receiver operating characteristic curve,Kolmogorov-Smirnov curve,calibration curve and learning curve were used for model evaluation.Results The BAR in the death group was higher than that in the survival group[13.8(8.6,20.3)vs 7.3(4.9,11.9)](P＜0.001).Logistic regression analysis showed that BAR＞8.45 was an independent risk factor for death within 30 d in patients with AMI and VA(all P＜0.05).In the training set,multivariate Logistic regression analysis showed that BAR＞8.45,age,systolic blood pressure,lactate dehydrogenase,respiratory rate,body temperature,acute kidney injury and stroke were independent risk factors for death within 30 d in AMI patients with VA(all P＜0.05).A nomogram model was constructed based on the above influencing factors.In the training set,validation set and test set,the area under the curve of the model was 0.81,0.80 and 0.79,respectively.The calibration curve and Kolmogorov-Smirnov curve suggested that the model had good fit and discrimination.Conclusion BAR is an independent risk factor for all-cause death within 30 d in AMI patients with VA.

Abstract:Objective To investigate the effects of lung protective ventilation strategy on perioperative lung compliance and oxygenation function in patients undergoing gynecological open surgery in plateau area.Methods Sixty patients who underwent gynecological open surgery in Qinghai Red Cross Hospital in the plateau region from December 2023 to December 2024 were selected.According to the random number table method,they were divided into conventional ventilation group(group C)and lung protective ventilation group(group L),with 30 cases in each group.In group C,the tidal volume was 10 ml/kg,and there was no positive end-expiratory pressure and lung recruitment maneuverduring the operation.In group L,the tidal volume was 6-8 ml/kg,positive end-expiratory pressure was 5 cmH2O,and lung recruitment maneuvers were performed every 30 minutes.The peak airway pressure,mean airway pressure,lung compliance and vital signs were compared between the two groups at 5 min after anesthesia induction intubation(T1),1 h after mechanical ventilation(T2)and before surgical extubation(T3).Arterial blood samples were collected at each time point for blood gas analysis.Arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),alveolo-arterial partial pressure of oxygen(PA-aDO2),oxygenation index and the ratio of dead space to tidal volume were compared.Results The levels of the end-tidal carbon dioxide partial pressure at T2 and T3 in group L were significantly higher than those in group C(both P＜0.05).The peak airway pressure and mean airway pressure at T2 and T3 in group L were significantly lower than those in group C,and the lung compliance was significantly higher than that in group C[(56±16)L/cmH2O vs(47±9)L/cmH2O,(56±16)L/cmH2O vs(46±9)L/cmH2O](all P＜0.05).Compared with T,,PaO2 and oxygenation index at T2 and T3 were significantly decreased in the two groups,PA-aDO2 and the ratio of ineffective cavity to tidal volume increased significantly,PaCO2 decreased significantly at T2 and T3 in group C,and PaCO2 increased significantly at T2 and T3 in group L(all P＜0.05).PaO2,PaCO2 and oxygenation index at T2 and T3 in group L were significantly higher than those in group C,while PA-aDO2 was significantly lower than that in group C(all P＜0.05).Conclusion Lung protective ventilation strategy can significantly improve perioperative lung compliance and oxygenation function in patients undergoing gynecological open surgery in plateau area,and reduce the incidence of postoperative pulmonary complications.

Abstract:Objective To investigate the application effect and dose-effect relationship of oxycodone in CT-guided micro-coil puncture localization of pulmonary nodules.Methods A total of 125 patients who underwent CT-guided micro-coil puncture localization of pulmonary nodules in Jiangsu Cancer Hospital from December 2023 to June 2024 were selected.The patients were divided into control group and oxycodone 1,2,3 and 4 groups by random number table method,with 25 cases in each group.In the control group,the same volume of 0.9％sodium chloride solution was injected intravenously before the operation,and 1 mg/ml oxycodone hydrochloride injection 0.025 mg/kg,0.05 mg/kg,0.075 mg/kg,and 0.1 mg/kg were injected intravenously in oxycodone 1,2,3,and 4 groups before operation,respectively.The visual analogue scale(VAS)score during the peri-puncture period,the incidence of moderate and severe pain during the peri-puncture period,the basic vital signs at admission,before puncture,during puncture and at the end of puncture,the incidence of irritating symptoms during puncture,the success rate of one-time puncture and the incidence of adverse drug reactions were compared among the five groups.Results One patient in the oxycodone 2 group and one in the oxycodone 4 group were excluded from the study.The VAS scores of the control group and oxycodone 1,2,3,4 groups were(4.7±1.6),(3.9±1.5),(2.9±1.7),(1.6±1.4),and(1.4±1.1),respectively.The incidences of moderate and severe pain were 64.0％(16/25),56.0％(14/25),37.5％(9/24),8.0％(2/25),and 4.2％(1/24),respectively.The VAS scores of oxycodone 3 group and oxycodone 4 group were significantly lower than those of control group,oxycodone 1 group and oxycodone 2 group(all P＜0.05).The incidence of moderate to severe pain in oxycodone 3 group was significantly lower than that in control group and oxycodone 1 group(both P＜0.05).At the time of puncture,the heart rates of the oxycodone 3 groupand oxycodone 4 group were significantly lower than those of the control group and oxycodone 1 group(all P＜0.05).The incidences of respiratory incompliance and body movement in oxycodone 3 group and oxycodone 4 group were significantly lower than those in control group(all P＜0.05).The incidences of dizziness,nausea and vomiting in oxycodone 4 group were significantly higher than those in the other four groups(all P＜0.05).Conclusion Intravenous injection of 0.075 mg/kg and 0.1 mg/kg oxycodone during CT-guided micro-coil puncture positioning of pulmonary nodules can effectively reduce the pain of patients,reduce the incidence of moderate and severe pain during puncture,and significantly improve the cooperation of patients,among which 0.075 mg/kg oxycodone has fewer adverse drug reactions.

Abstract:Objective To investigate the prognostic value of stress hyperglycemia ratio(SHR)in patients with peripartum cardiomyopathy(PPCM).Methods The clinical data of 78 patients diagnosed with PPCM in Beijing Anzhen Hospital,Capital Medical University from January 2007 to March 2023 were collected and retrospectively analyzed.According to the improvement of cardiac function,the patients were divided into non-improvement group(37 cases)and improvement group(41 cases).The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of SHR for poor prognosis of patients,and Logistic regression analysis was used to evaluate the influencing factors of no improvement of cardiac function.Results The age,proportion of multipara,proportion of PPCM history,left ventricular end diastolic diameter,serum creatinine,blood glucose,B-type natriuretic peptide and SHR in the non-improvement group were larger/higher than those in the improvement group,while systolic blood pressure and left ventricular ejection fraction(LVEF)were lower than those in the improvement group(all P＜0.05).The ROC curve analysis results showed that the optimal cut-off value of SHR for predicting poor prognosis in patients with PPCM was 1.079,the sensitivity was 81.1％,the specificity was 90.2％,and the area under the curve was 0.880(95％confidence interval:0.800-0.961)(P=0.041).Multivariate Logistic regression analysis results showed that SHR≥1.079,serum creatinine and LVEF＜35％were independent risk factors for poor prognosis in patients with PPCM(all P＜0.05).Conclusion SHR ≥ 1.079 is a risk factor for poor prognosis in PPCM patients,and the use of SHR can assist in identifying high-risk populations for PPCM.

Abstract:Objective To investigate the efficacy of bare metal stent combined with endovascular aortic repair in the treatment of distal descending aortic dissection.Methods Six patients who underwent bare metal stent combined with endovascular aortic repair in the Department of Cardiovascular and Vascular Surgery,Affiliated Hospital of North Sichuan Medical College from April 2023 to April 2024 were selected.Among them,4 patients were Stanford type B aortic dissection,and 2 patients were Stanford type A aortic dissection treated after operation.All the 6 patients had thoracoabdominal aortic dissection,with obvious collapse of true lumen and malperfusion of distal organs.The clinical data of the patients were retrospectively analyzed.Methods,postoperative complications and vascular remodeling of distal descending aorta before and after bare-metal stent combined with endovascular aortic repair were analyzed.Results The operation was successfully completed in all 6 patients.The operation time was(113±28)min.There was no perioperative death.Three patients with Stanford type B dissection were treated with 1 covered stent and 1 bare metal stent.One patient diagnosed as aortic root aneurysm with type B aortic dissection was implanted with Fabulous stent system.In the 2 patients with Stanford type A aortic dissection,1 bare stent was reattached to the distal end of the stent during the first stage operation,and 1 covered stent and 1 bare metal stent were implanted in the other patient,without endoleak and stent migration.Follow-up CT angiog-raphy showed that the maximum diameter of the descending aorta was significantly decreased after operation,and the ratio of false lumen to true lumen was significantly decreased after operation(both P＜0.05).The true lumen of the distal descending aorta was dilated obviously,the vascular remodeling effect was satisfactory,and the poor perfusion of the distal organs was recovered.Conclusion Bare-metal stent combined with endovascular aortic repair is safe and feasible for the treatment of distal descending aortic dissection.The effect of vascular remodeling of the distal descending aorta is good,and it can effectively improve the distal organ malperfusion and reduce the incidence of postoperative adverse events.The early follow-up results are satisfactory.

Abstract:Objective To analyze the influence of different incision size and suture methods on the healing of calcaneal fracture incision,and to identify the independent factors affecting the healing of calcaneal incision.Methods This study was a contemporaneous parallel controlled clinical study.A total of 120 patients who underwent emergency open reduction and internal fixation of calcaneal fractures in Department of Orthopedics,Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2020 were selected as the research objects.According to the order of admission,they were divided into groups A(traditional lateral incision+intermittent mattress suture),B(traditional lateral incision+subcutaneous suture),C(traditional lateral incision+wound adhesive),D(limited incision+intermittent mattress suture),E(limited incision+subcutaneous suture),F(limited incision+wound adhesive),with 20 cases in each group.The suture time,drainage time,incision healing time,hospital stay and other clinical indicators were compared between the groups.Results The comparison between groups with the same incision method showed that the suture time and drainage time in group C were significantly shorter than those in groups A and B,and the suture time and drainage time in group F were signifi-cantly shorter than those in groups D and E.The drainage time in group E was significantly shorter than that in group D(all P＜0.05).The limited incision group was compared with the traditional incision group,the suture time in group D was significantly shorter than that in group A,and the suture time in group E was significantly shorter than that in group B(both P＜0.05).The comparison between groups with the same suture method showed that the drainage time of groups D,E,and F was shorter than that of groups A,B,and C,respectively.The wound healing time of group F was significantly shorter than that of group C(all P＜0.05).The results of correla-tion analysis showed that the incision size and suture method were correlated with drainage time(r=-0.360,-0.575,both P＜0.001)and wound healing time(r=-0.284,P=0.002;r=-0.203,P=0.026).In addition,the incision size and wound healing time were also correlated with the length of hospital stay(r=0.116,P=0.021;r=0.779,P＜0.001).The results of multiple linear regression analysis showed that the incision size and suture method were both independent factors affecting the drainage time(both P＜0.001),and the incision size was the only independent factor affecting the incision healing time(P=0.002).Conclusions Incision drainage time of calcaneal fractures is affected by incision size and suture method,while incision healing is only affected by incision size.The method of limited incision+wound adhesive has the advantages of shortening the drainage time and wound healing time.

Abstract:Objective To explore the correlation between glucose and lipid metabolism and traditional Chinese medicine(TCM)syndrome elements in obese patients before and after metabolic surgery.Methods The obese patients who underwent metabolic surgery in China-Japan Friendship Hospital from February 2023 to March 2024 and followed-up in outpatient clinic 1 and 3 months after operation were selected.The blood biochemical indexes and TCM syndrome factors were collected before operation,1 and 3 months after operation,and the correlation between them was analyzed.Results A total of 95 obese patients were included,85 patients were reexamined 1 month after operation,and 60 patients were reexamined 3 months after operation.The body mass,body mass index and waist circumference of male and female at 1 and 3 months after operation were lower than those before operation(all P＜0.05).At 1 and 3 months after operation,the percentage of overall body mass reduction was higher in the severely obese group than in the mildly and moderately obese group(all P＜0.001).The levels of fasting blood glucose,glycosylated hemoglobin,fasting insulin and homeostasis model assessment of insulin resistance index(HOMA-IR)in obese patients at 1 and 3 months after operation were lower than those before operation.The levels of fasting insulin and HOMA-IR in the heat syndrome group were higher than those in the non-heat syndrome group in obese patients with diabetes mellitus[37.4(17.0,55.4)mIU/L vs 19.8(14.4,32.6)mIU/L,12.3(11.0,21.8)vs 6.6(5.6,11.2)](all P＜0.05).Heat syndrome factor was positively correlated with fasting insulin and HOMA-IR levels,respectively(Hazard ratio=0.371,P=0.030)and(Hazard ratio=0.415,P=0.026).Conclusions Metabolic surgery can quickly and effectively reduce the body mass of obese patients and improve glucose and lipid metabolism in obese patients.The more obvious the heat syndrome factor before operation,the higher the fasting insulin and HOMA-IR levels in patients with obesity combined with diabetes mellitus.

Abstract:Objective To investigate the effect of Fuyanjing capsules combined with ceftriaxone sodium in the treatment of chronic pelvic inflammatory disease.Methods A total of 90 patients with chronic pelvic inflammatory disease admitted to Bozhou Hospital Affiliated to Anhui Medical University from October 2020 to September 2023 were selected and divided into observation group(45 cases)and control group(45 cases)by random number table method.The control group was treated with ceftriaxone sodium,and the observation group was treated with Fuyanjing capsules on the basis of ceftriaxone sodium.Both groups were treated for 7 d.The clinical efficacy,improvement time of clinical symptoms,hemorheological indexes and serum inflammatory indexes before and after treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[91.1％(41/45)vs 75.6％(34/45)],and the improvement time of leucorrhea,lower abdominal pain and lumbosacral pain were shorter than those of the control group(all P＜0.05).After treatment,the levels of plasma viscosity,whole blood high shear viscosity,erythrocyte sedimentation rate,C-reactive protein,monocyte chemotactic 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 were no obvious adverse reactions in the two groups during treatment.Conclusion Ceftriaxone sodium combined with Fuyanjing capsules in the treatment of chronic pelvic inflammatory disease can achieve good effect,and can effectively improve the state of hemorheology disorders,reduce the inflammation in patients with good safety.

Abstract:Objective To investigate the prognostic value of the product of reverse shock index and Glasgow coma scale(rSIG)index combined with serum D-dimer,fibrinogen and C-reactive protein in multiple trauma patients with multiple organ dysfunction syndrome(MODS).Methods A total of 194 patients with multiple trauma treated in the Emergency Treatment Room,North China University of Science and Technology Affiliated Hospital from January 2020 to January 2022 were selected as the research objects.According to the presence or absence of MODS during treatment,they were divided into non-MODS group(98 cases)and MODS group(96 cases).The MODS group was further divided into survival group(52 cases)and death group(44 cases)according to the survival situation of patients at 28 d after injury.The levels of serum D-dimer,fibrinogen,C-reactive protein and rSIG index were compared among the groups.Multivariate Logistic regression was used to analyze the influencing factors of the prognosis of multiple trauma patients with MODS.Receiver operating characteristic(ROC)curve was used to analyze the value of rSIG index combined with serum D-dimer,fibrinogen and C-reactive protein in predicting the prognosis of multiple trauma patients with MODS.Results The levels of serum D-dimer,fibrinogen and C-reactive protein in MODS group were higher than those in non-MODS group[(14±3)mg/L vs(9±3)mg/L,(4.5±1.0)g/L vs(3.0±1.0)g/L,(32±6)mg/L vs(21±6)mg/L](t=10.352,10.079,12.883;all P＜0.001).The levels of serum D-dimer,fibrinogen,and C-reactive protein in the death group were significantly higher than those in the survival group,and the rSIG index was significantly lower than that in the survival group(all P＜0.001).Multivariate Logistic regression analysis showed that D-dimer,fibrinogen,C-reactive protein and rSIG index were independent prognostic factors for multiple trauma patients with MODS(all P＜0.05).ROC curve analysis showed that the area under the curve of D-dimer,fibrinogen,C-reactive protein,and rSIG index combined detection to predict the prognosis of multiple trauma patients with MODS was 0.964,the sensitivity was 84.09％,and the specificity was 96.15％,which was better than that of each index alone(all P＜0.05).Conclusion The serum D-dimer,fibrinogen,and C-reactive protein of patients in the death group of multiple trauma combined with MODS increased significantly,and the rSIG index decreased significantly.The combination of the above indicators has a good predictive value for the prognosis of patients with multiple trauma combined with MODS.

Abstract:Objective To investigate the clinical effect of Xiongdan Jiuxin pills combined with sacubitril/valsartan in the treatment of chronic heart failure with reduced ejection fraction.Methods A total of 120 patients with chronic heart failure with reduced ejection fraction admitted to Lianyungang Municipal Oriental Hospital Affiliated to Xuzhou Medical University from October 2020 to October 2023 were selected.According to the random number table method,they were divided into the control group and the observation group,with 60 cases in each group.All patients were given conventional treatment,the control group was given sacubitril/valsartan,and the observation group was given Xiongdan Jiuxin pills on the basis of the control group.The 6 min walk test distance,maximum exercise time,cardiac function indexes,serum indexes,and adverse reactions were compared between the two groups.Results After treatment,the 6 min walk test distance and maximum exercise time of the two groups were longer than those before treatment,and those of the observation group were longer than those of the control group(all P＜0.001).After treatment,left ventricular ejection fraction,stroke volume,cardiac output,nitric oxide and nitric oxide synthase in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group;the levels of left ventricular end-diastolic diameter,endothelin-1,laminin,hyaluronic acid and N-terminal procollagen type Ⅲ in the two groups were lower than those before treat-ment,and those in the observation group were lower than those in the control group(all P＜0.05).During the treatment,there was no significant difference in the incidence of adverse reactions between the observation group and the control group[10.0％(6/60)vs 6.7％(4/60)](x2=0.436,P=0.509).Conclusion Xiongdan Jiuxin pills combined with sacubitril/valsartan has a significant effect on chronic heart failure with reduced ejection fraction,which can improve the exercise tolerance,cardiac function and vascular endothelial function of patients,slow down myocardial fibrosis,and has good safety.

Abstract:Currently,transcatheter aortic valve replacement(TAVR)has emerged AS a high-yield treatment option for symptomatic patients with severe aortic stenosis(AS)and moderate-to-high surgical risk.In patients with severe AS and concomitant small aortic annulus(SAA),its unique aortic root anatomical characteristics increase the challenge of surgery,and the choice of treatment strategy has become a hot topic in recent years.Previous studies have shown that such patients show better hemodynamic characteristics and prognosis after TAVR.This article mainly reviews the prevalence and population characteristics of SAA in patients with severe AS,and the application of echocardiography in the evaluation of aortic root condition before TAVR in SAA patients.