Abstract:Objective To investigate the relationship between serum fetuin A,fatty acid binding protein 4(FABP4)and microRNA-31(miR-31)with gestational diabetes mellitus(GDM)and their predictive value for pregnancy outcome.Methods A total of 120 GDM patients admitted to Xinjiang Uygur Autonomous Region People's Hospital from January 2022 to March 2023 were selected as the observation group,and 120 healthy pregnant women were selected as the control group.The serum levels of fetuin A,FABP4 and miR-31 in the two groups were detected,and the correlation between the levels of fetuin A,FABP4 and miR-31 and insulin resistance index(HOMA-IR)in patients with different clinical characteristics was analyzed,and the value of predicting adverse pregnancy outcomes was analyzed.Results The levels of serum fetuin A,FABP4 and miR-31 in the observation group were higher than those in the control group[(40±10)μg/L vs(30±7)μg/L,(27.1±3.6)mg/L vs(15.6±2.9)mg/L,(2.03±0.41)vs(1.00±0.26)](all P＜0.001).In the observation group,the levels of fetuin A,FABP4 and miR-31 in patients with HOMA-IR ≥5 and adverse pregnancy outcomes were higher than those in patients with HOMA-IR＜5 and without adverse pregnancy outcomes(all P＜0.05).Serum fetuin A,FABP4 and miR-31 were positively correlated with HOMA-IR in the observation group(all P＜0.001).The areas under the receiver operating characteristic curve of serum fetuin A,FABP4 and miR-31 for predicting adverse pregnancy outcomes were 0.733,0.831,and 0.824,respectively.Conclusion Serum fetuin A,FABP4 and miR-31 levels are increased in patients with gestational diabetes mellitus,which are positively correlated with HOMA-IR,and have certain application value in predicting adverse pregnancy outcomes.

Abstract:Objective To explore the relationship between intensive care unit memory and post-traumatic stress disorder(PTSD)in elderly patients with sepsis transferred from intensive care unit(ICU),and to explore the mediating effect of rumination thinking between ICU memory and PTSD.Methods From January 2020 to December 2023,240 elderly patients with sepsis transferred from ICU in the 305th Hospital of the Chinese People's Liberation Army and the Eighth Medical Center,Chinese PLA General Hospital were selected as the research objects.The general status questionnaire,post-traumatic stress disorder symptom checklist-Chinese version(PCLC),the intensive care unit memory assessment tool(ICUMT)and multidimensional rumination response scale(MRIS)were used to conduct a cross-sectional survey.The effects of patients'general data on rumination thinking,ICU memory and PTSD scores were analyzed.Pearson method was used to analyze the correlation of the three scores,and structural equation model was used to analyze the mediating effect of rumination thinking between ICU memory and PTSD of patients.Results The scores of those with sleep disorders,ventilator assisted ventila-tion,analgesics,and sedatives were higher than those of the other group(all P＜0.05).There was a positive correlation between ICUMT score and MRIS score and PCLC score in elderly patients with sepsis(r=0.550,P＜0.001;r=0.650,P＜0.001),and there was also a positive correlation between MRIS score and PCLC score(r=0.781,P＜0.001).ICU memory had a positive effect on PTSD,and the direct effect value was 0.840.The positive effect of rumination thinking on PTSD was also confirmed,and the direct effect value was 0.100.ICU memory also had an indirect effect on PTSD by affecting rumination thinking,and the effect value was 0.329.Conclusion ICU memory in elderly patients with sepsis has a direct effect on PTSD,and also an indirect effect through rumination thinking.

Abstract:Objective To investigate the efficacy and safety of high-flow nasal cannula oxygen therapy(HFNCO)in emergency patients with acute exacerbation of chronic heart failure.Methods A total of 63 patients with acute exacerbation of chronic heart failure admitted to the Department of Emergency,the 980th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from January 1,2020 to December 31,2021 were selected and divided into HFNCO group and non-invasive ventilation(NIV)group according to the random number table method.The general condition,oxygenation index and cardiac function related index were observed and compared between the two groups when they entered and left the emergency department.Results Arterial partial pressure of carbon dioxide was significantly lower in the HFNCO group than in the NIV group at discharge from the emergency department[(38±4)mmHg vs(41±5)mmHg](P=0.015).Compared with those at the time of admission to the emergency department,the arterial oxygen partial pressure of patients in the HFNCO group and the NIV group was significantly improved at the time of leaving the emergency department[(74±8)mmHg vs(68±9)mmHg,(75±7)mmHg vs(69±12)mmHg](both P＜0.05).Cardiac index,stroke volume,and stroke volume index were significantly lower in the HFNCO group than in the NIV group at discharge from the emergency department(all P＜0.05).Cardiac output,cardiac index,stroke volume,and stroke volume index were significantly increased at the time of leaving the emergency department in both HFNCO and NIV groups compared with those at the time of admission(all P＜0.05).There were no statistically significant differences in the success rate of ventilation and emergency room stay time between the two groups(both P＞0.05).Conclusion HFNCO can improve oxygenation index and cardiac function in emergency patients with acute exacerbation of chronic heart failure.

Abstract:Objective To investigate the efficacy and safety of anticoagulation therapy with bivalirudin and heparin in adult patients receiving extracorporeal membrane oxygenation(ECMO)support after cardiac surgery.Methods The clinical data of 56 patients receiving ECMO support after adult cardiac surgery at the Department of Critical Care Medicine Center,the First Affiliated Hospital of Xinjiang Medical University from March 2018 to June 2024 were retrospectively analyzed.According to the application of anticoagulant drugs during ECMO support,patients were divided into heparin group(25 cases)and bivalirudin group(31 cases).The baseline data and outcome indicators of the two groups were collected,and the ECMO support time,platelet count,coagulation indicators,the rate of successful ECMO withdrawal,in-hospital mortality and survival at 90 d of follow-up were compared between the two groups.Results There were no significant differences in age,gender,body mass index,ECMO mode,platelet count,activated partial thromboplastin time(APTT)before ECMO,and acute physiology and chronic health evaluation Ⅱ score before ECMO between the two groups(all P＞0.05).In terms of outcome measures,there were no significant differences in the duration of ECMO support,mean hemoglobin value,APTT during ECMO support,coagulation time of activated whole blood during ECMO support,plasma transfusion volume,and the incidence of thrombosis,minor bleeding,and severe bleeding complications between the two groups(all P＞0.05).The lowest platelet count,platelet count,the lowest hemoglobin,and the rate of successful ECMO withdrawal in the bivalirudin group were higher than those in the heparin group,and the amount of red blood cell transfusion,platelet transfusion and in-hospital mortality in the heparin group were less than/lower than those in the heparin group(all P＜0.05).The results of cross-effect analysis showed that there was no interaction between group and before and after treatment,that is,the treatment effect of the two groups had the same trend on the effect of ACT(Fcross=0.509,P=0.799).A total of 25 patients(80.6％)in the bivalirudin group and 13 patients(52.0％)in the heparin group were alive at day 90,with a higher overall survival rate in the bivalirudin group than in the heparin group(Log-rank x2=6.174,P=0.013).Conclusion In adult patients receiving ECMO support after cardiac surgery,bivalirudin has the same anticoagulant effect as heparin,and can reduce blood product transfusion volume and in-hospital mortality,increase the probability of successful ECMO withdrawal,and improve the safety of anticoagulation therapy.

Abstract:Objective To investigate the pregnancy outcomes of pregnant women with arrhythmia without structural heart disease,and to analyze the corr-elation between adverse pregnancy outcomes and arrhythmia types.Methods A total of 283 pregnant women with arrhythmia without structural heart disease admitted to the Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University from June 2013 to June 2020 were collected.The patients were divided into the adverse pregnancy outcome group and the normal pregnancy outcome group according to the pregnancy outcome.The types of arrhythmia and their correlation with adverse pregnancy outcomes were analyzed.Results Among the 283 pregnant women with arrhythmia without structural heart disease,124(43.8％)had adverse pregnancy outcomes and 159(56.2％)had normal pregnancy outcomes.Among the 124 cases with adverse pregnancy outcomes,9 cases(7.3％)had abortion,22 cases(17.7％)had preterm birth,11 cases(8.9％)had small for gestational age,12 cases(9.7％)had macrosomia,27 cases(21.8％)had fetal distress,2 cases(1.6％)had stillbirth,32 cases(25.8％)had gestational diabetes mellitus,17 cases(13.7％)had gestational hypertension and 23 cases(18.5％)had postpartum hemorrhage.The proportions of premature atrial contraction and right bundle branch block in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group(both P＜0.05).Conclusion There is a considerable proportion of the population of pregnant women with arrhythmia without structural heart disease may have adverse pregnancy outcomes such as gestational diabetes mellitus and fetal intrauterine distress.Premature atrial contraction and right bundle branch block are related to the occurrence of adverse pregnancy outcomes,which need to be paid attention to in clinical practice.

Abstract:Objective To investigate the median effective dose(ED50)of dezocine to inhibit the response to modified nasopharyngeal airway insertion during hysteroscopic surgery in elderly female patients when combined with remimazolam.Methods Twenty-eight patients,aged 60-75 years,American Society of Anesthesiologists grade Ⅱ-Ⅲ,scheduled for elective hysteroscopic surgery in Beijing Tongren Hospital,Capital Medical University from February to April 2024,were selected.Dezocine 0.15 mg/kg was injected,and 10 minutes later atropine 0.3 mg,dexamethasone 5 mg and remimazolam 0.3 mg/kg were injected intravenously.When the eyelash reflex disappeared and the patient's state index was less than 50,a fully lubricated modified nasopharyngeal airway was inserted through the nasal cavity.The dose of dezocine in the next patient was determined by sequential method.If there was a positive reaction when the nasopharyngeal airway was inserted,the dose of dezocine in the next patient was increased by 0.01 mg/kg,otherwise the dose of dezocine was decreased by 0.01 mg/kg.The first patient with a positive nasopharyngeal airway reaction was considered the first patient to enter the trial,and this process was repeated until seven turning points had been reached.The ED50 and 95％confidence interval of dezocine inhibiting response to modified nasopharyngeal airway insertion in elderly patients were calculated when combined with remimazolam.The occurrence of adverse reactions during induction was recorded.Results One patient was excluded from this study because of poor ventilation after insertion of the nasopharyngeal airway,which was changed to laryngeal mask airway during the operation.The remaining 27 patients completed the trial,and the ED50(95％confidence interval)of dezocine inhibiting response to modified nasopharyngeal airway insertion was 0.105(0.087-0.114)mg/kg when combined with remimazolam.No adverse reactions such as nasopharyngeal pain,hypoxemia,drowsiness,nausea and vomiting,and respiratory depression occurred in the enrolled patients.One patient had transient dizziness after extubation and recovered after full recovery in the recovery room.Conclusion When combined with 0.3 mg/kg remimazolam,the ED50(95％confidence interval)of dezocine inhibiting the modified nasopharyngeal airway insertion response is 0.105(0.087-0.114)mg/kg in elderly female patients during hysteroscopic surgery.

Abstract:Objective To evaluate the effects of different cerebral perfusion methods on neurological complications during cardiopulmonary bypass in aortic arch surgery.Methods The clinical data of 241 patients who underwent aortic arch surgery in Beijing Anzhen Hospital,Capital Medical University from July 2019 to May 2022 were retrospectively analyzed.According to different cerebral perfusion methods,they were divided into bilateral cerebral perfusion group and unilateral cerebral perfusion group.The operation conditions,30-day in-hospital mortality and incidence of neurological complications were compared between the two groups.Results A total of 119 patients with mild hypothermic circulatory arrest combined with bilateral antegrade cerebral perfusion(bilateral cerebral perfusion group)and 122 patients with moderate hypothermic circulatory arrest combined with unilateral antegrade cerebral perfusion(unilateral cerebral perfusion group)were enrolled in this study.The duration of cardiopulmonary bypass was longer in the unilateral cerebral perfusion group than that in the bilateral cerebral perfusion group[187(155,207)min vs 176(143,198)min],and cerebral perfusion flow,minimum intraoperative temperature,and perioperative plasma consumption were lower in the bilateral cerebral perfusion group[6(5,7)ml/(kg·min)vs 8(7,10)ml/(kg·min),25(24,25)℃ vs 28(27,30)℃,0(0,400)ml vs 0(0,400)ml](all P＜0.05).There was no significant difference in 30-day in-hospital mortality between the two groups(P=0.168).There was no significant difference in the incidence of permanent neurological complications and temporary neurological compli-cations between the two groups(P=0.951,0.843).Conclusion In aortic arch surgery,unilateral cerebral perfusion and bilateral cerebral perfusion have no effect on the incidence of neurological complications,but bilateral cerebral perfusion can tolerate higher temperature and reduce cardiopulmonary bypass time.

Abstract:Objective To investigate the clinical effect of oxycodone hydrochloride sustained-release tablets on neuropathic pain in patients with primary lung cancer during radiotherapy and chemotherapy.Methods From June 2019 to June 2022,108 patients with neuropathic pain who were treated in 3201 Hospital were collected for prospective study,and they were divided into control group(54 cases),12 h titration group(26 cases)and 24 h titration group(28 cases)according to random number table method.The control group was given oral morphine hydrochloride tablets,12 h titration group and 24 h titration group were given oral oxycodone hydrochloride sustained-release tablets.General data,pain relief rate and number of breakthrough pain at different time points after treatment,quality of sleep and quality of life before and after treatment,and incidence of adverse reactions were compared among the three groups.Results There were all no statistically significant differences in gender,age,TNM stage and numerical rating scale score among the three groups(all P＞0.05).The pain relief rates in the 12 h titration group and the 24 h titration group 1 d after treatment were both higher than that in the control group(both P＜0.05).There were statistically significant differences in the numbers of breakthrough pain 1,2 and 3 d after treatment among the three groups(all P＜0.05),the numbers of breakthrough pain 2,3 and 7 d after treatment were all less than that 1 d after treatment(all P＜0.05).The numbers of breakthrough pain in 12 h titration group and 24 h titration group were both less than those in control group 1,2 and 3 d after treatment,and that in the 12 h titration group was less than that in the 24 h titration group(all P＜0.05).There were no statistically significant differences in comparison of Pittsburgh sleep quality index(PSQI)and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative(EORTC QLQ-C15-PAL)scores among the three groups before treatment(both P＞0.05),but there were statistically significant differences in comparison of PSQI and EORTC QLQ-C15-PAL scores 7 d after treatment(both P＜0.05).There were no significant differences in the incidences of adverse reactions among the three groups(P＞0.05).Conclusion Oxycodone hydrochloride sustained-release tablets for neuropathic pain during radiotherapy and chemotherapy in patients with primary lung cancer,especially 12 h as titration dose adjustment treatment,can achieve good pain relief rate,reduce the number of breakthrough pain,and do not increase the incidence of adverse reactions,with high safety.

Abstract:Objective To investigate the analgesic effects of hydromorphone and dezocine in patients with non-mechanical ventilation in intensive care unit(ICU).Methods A total of 94 ICU patients with non-mechanical ventilation admitted to the Second Affiliated Hospital of Guizhou Medical University from October 2021 to April 2024 were selected as the research objects.The patients were divided into control group and observation group by single-blind test method,with 47 cases in each group.The control group was treated with dezocine injection,and the observation group was treated with hydromorphone hydrochloride injection.The analgesic effect,sedative effect,comfort,pain factor levels,incidence of adverse events,and treatment safety were compared between the two groups.Results After treatment,the visual analogue scale score and Ricmond agitation sedation score at 12,24,48 and 72 h in the observation group were lower than those in the control group(all P＜0.05).After treat-ment,the physiological comfort,psychological comfort,environmental comfort,social and cultural comfort scores of the observation group were higher than those of the control group(all P＜0.05).After treatment,the levels of cyclooxygenase-2,bradykinin and prostaglandin E2 in the observation group were lower than those in the control group(all P＜0.001).The total incidence of adverse events in the observation group was lower than that in the control group[6.4％(3/47)vs 21.3％(10/47)](x2=4.376,P=0.034).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.726).Conclusion Compared with dezocine,hydromorphone has better analgesic and sedative effect for ICU patients without mechanical ventilation,which can improve the comfort of patients,reduce the level of pain factors,reduce the incidence of adverse events,and has good safety.

Abstract:Artificial intelligence is used to calculate the fractional flow reserve(CT-FFR)of coronary artery by coronary CT angiography(CCTA)data.This ability can be used to automatically detect and assess coronary stenosis,identify plaque components,and predict disease progression.It can also significantly improve the accuracy and efficiency of diagnosis.The application of artificial intelligence in CCTA also faces some challenges and problems,including the generalization ability of the algorithm,data standardization,and privacy protection.In order to further improve the practicability and efficiency of CT-FFR technology in clinical practice,in-depth research on these challenges and the development of more optimized solutions are needed.

Abstract:Lipids play a crucial role in the growth and metabolism of Mycobacterium tuberculosis(Mtb).During Mtb infection,foamy macrophages accumulate lipids in granulomas,such as triglycerides and cholesterol,which can promote the formation of drug-resistant Mtb,thereby reducing the effectiveness of anti-tuberculosis treatment.Therefore,it is critical to understand the changes in lipid metabolites in the host and Mtb.The slow growth and drug resistance of Mtb results in prolonged treatment with associated risks of side effects and drug resistance.In order to improve the efficacy of anti-tuberculosis drugs,it is necessary to understand the mechanism of action of anti-tuberculosis drugs on lipid metabolism of Mtb.This paper mainly discusses the impact of lipids reprogramming by host and Mtb during infection on the anti-tuberculosis response,and analyzes the interactions between lipids,antibiotics,and lipid metabolites.In addition,this paper discusses the influence of lipids on drug efficacy,in order to provide reference for effective control of Mtb infection.

Abstract:This article reviews the application of bone organoids in osteoarthritis diseases,and prospects the future development trend.Firstly,the definition,treatment status and challenges of osteoarthritis are sorted out to fully understand the background and importance of this disease.Then,the definition,concept and characteristics of bone organoids are described,and the research progress of bone organoids in the field of osteoarthritis was intro-duced in detail.Finally,the potential value and future development trend of bone organoids in the treatment of osteoarthritis are analyzed,in order to provide reference for related research and practice.

Abstract:Objective To evaluate the efficacy,safety and economy of porcine fibrin sealant in coronary artery bypass grafting(CABG).Methods The clinical data of 143 patients who underwent off-pump CABG in the Coronary Surgery Center,Beijing Anzhen Hospital,Capital Medical University from March to October 2023 were retrospectively analyzed.Among them,67 patients were treated with porcine fibrin adhesive during the operation(observation group),and 76 patients were not treated(control group).The intensive care unit(ICU)stay time,postoperative drainage volume,drainage tube indwelling time,postoperative hospital stay,postoperative blood product usage rate,coagulation function and drug allergy were analyzed.Results There was no significant differ-ence in ICU stay time,postoperative drainage volume and postoperative blood product usage between the two groups(all P＞0.05).The postoperative drainage tube indwelling time and hospitalization time of the observation group were shorter than those of the control group[44(38,49)hvs46(41,65)h,5(4,6)dvs5(5,6)d](both P＜0.05).There was no significant difference in prothrombin activity,activated partial thromboplastin time and fibrinogen level between the two groups before operation and on the first day after operation(all P＞0.05).On the first day after operation,the level of fibrin degradation products in the observation group was higher than that in the control group(P＜0.05).There was no drug-related allergic reaction in the two groups,and there was no significant difference in hospitalization costs between the two groups(P＜0.05).Conclusion The use of porcine fibrin adhesive during CABG has good biocompatibility,which can shorten the postoperative drainage tube indwelling time and postoperative hospital stay,but does not reduce the postoperative drainage volume and blood transfusion rate,and has no significant effect on the hospitalization cost of patients.

Abstract:Objective To analyze and summarize the clinical data of patients with pulmonary Tropheryma whipplei(TW)infection,and further improve the understanding of pulmonary TW infection.Methods The clinical data(including basic information,test results,chest CT,treatment and outcome)of 7 patients with pulmonary TW infection admitted to the Department of Respiratory Medicine,Civil Aviation General Hospital from September 1,2021 to January 31,2023 were collected and retrospectively analyzed.Results Among the 7 patients with pulmonary TW infection,there were 3 males and 4 females,with age of 67(45,73)years.All patients had at least one underlying disease in their past medical history that may lead to abnormal immune function,the most common being coronary atherosclerotic heart disease.The white blood cell counts of all patients were in the normal range,but the percentage of neutrophils in 2 patients with mixed infection was significantly increased,which reached 86.9％and 95.9％,respectively.Chest CT showed ground glass density shadow,diffuse small nodular shadow or patchy shadow.All the 7 patients were diagnosed by pathogen targeted next-generation sequencing of bronchoalveolar lavage fluid,and TW was the only pathogen in 2 patients.All the 7 patients received antimicrobial therapy,of which 6 patients had significant improvement in clinical symptoms and imaging after treatment,and 1 patient was lost to follow-up.Conclusion Patients with pulmonary TW infection are often accompanied by diseases with abnormal immune function,and it is difficult to be diagnosed by routine laboratory tests,and most of them are diagnosed by next-generation sequencing.Chest CT can show a variety of non-specific changes.Antimicrobial therapy can significantly improve the condition.

Abstract:Objective To investigate the predictive value of plasma eicosanoids in predicting adverse cardiovascular events in patients with acute coronary syndromes(ACS).Methods Totally 309 hospitalized patients with ACS were retrospective analyzed,admitted to Beijing Anzhen Hospital,Capital Medical University for revascularization treatment from June to December 2019,with a median follow-up time of 3.8(3.6,3.9)years.Patients were divided into event group(33 cases)and non-event group(276 cases)based on the occurrence of adverse cardiovascular events.High performance liquid chromatography tandem mass spectrometry was used to determine 74 types of patient's plasma eicosanoids levels,and patient's global registry of acute coronary events risk(GRACE)score was performed.Differential eicosanoids were screened out in the two groups,patients were divided into different groups according to the cut-off of plasma eicosanoids from receiver operating characteristic(ROC)curve analysis.The effects of eicosanoids on the prognosis of ACS patients were evaluated by multivariate Cox regression analysis and Kaplan-Meier plots,and the value of eicosanoids and GRACE score in predicting adverse cardiovascular events was analyzed by ROC curve.Results The plasma 15-hydroxyeicosatetraenoic acid(15-HETE),15-oxoeicosatetraenoic acid(15-oxo-ETE)and 14,15-dihydroxyeicosatrienoic acid(14,15-DHET)of patients in the event group were significantly higher than those in the non-event group(all P＜0.05).Cox regression analysis showed that after adjusting for multivariate factors,15-HETE≥0.84 μg/L and 14,15-DHET≥0.20 μg/L were independent risk factors for adverse cardiovascular events in ACS patients after revascularization(both P＜0.05).A Kaplan-Meier curve showed patients in 15-HETE≥0.84 μg/L and 14,15-DHET ≥0.20 μg/L,were more likely to experience adverse events(both Log-rank P＜0.01).The ROC curve analysis showed that the area under the curve predicted by GRACE score alone and 15-HETE,14,15-DHET and GRACE scores in combi-nation for adverse cardiovascular events in ACS patients after revascularization were 0.699 and 0.712 respectively.The area under the curve predicted by GRACE score combined with 15-HETE and 14,15-DHET was larger than that predicted by GRACE score alone(P＜0.05).Conclusions High levels of plasma 15-HETE and 14,15-DHET are independent risk factors for the risk of adverse cardiovascular events in patients with ACS after revascularization,and have certain predictive value for adverse cardiovascular events.

Abstract:Objective To observe the clinical effect of standardized intravenous nutrition formula in premature infants.Methods A total of 162 premature infants who needed parenteral nutrition and were hospitalized in Beijing Shijitan Hospital,Capital Medical University from July 2015 to March 2020 were enrolled in this study.According to the random number table method,they were divided into conventional solution group(80 cases)and standard solution group(82 cases).They were treated with individualized intravenous nutrition formula and standard intravenous nutrition formula with added L-carnitine,respectively.The two groups were compared in terms of general data,clinical conditions at 6 weeks after birth,and the incidence of such as cholestasis,bronchopulmonary dysplasia,intracranial hemorrhage,and retinopathy of prematurity.Results After 2 weeks of treatment,the weight gain of the standard solution group was greater than that of the conventional solution group[(151±92)gvs(110±78)g](P=0.003).At 6 weeks after birth,the levels of direct bilirubin and bile acid in the standard solution group were lower than those in the conventional solution group[(18±10)μmol/L vs(26±15)μmol/L,(53±27)μmol/L vs(77±24)μmol/L](both P＜0.001).At 36 weeks of gestation,the incidence of bronchop-ulmonary dysplasia was lower in the standard solution group than in the conventional solution group[12.2％(10/82)vs 27.5％(22/80)](P＜0.05).There was no significant difference in the incidence of intracranial hemorrhage and retinopathy of prematurity between the two groups(both P＞0.05).Conclusion Compared with individualized intravenous nutrition prescription,the weight gain of premature infants receiving standardized intravenous nutrition formula is better after 2 weeks.The use of standardized intravenous nutrition formula with L-carnitine is beneficial to reduce the degree of cholestasis in premature infants.The use of standardized intravenous nutrition is beneficial to reduce the incidence of bronchopulmonary dysplasia in preterm infants.There is no significant difference in the incidence of intracranial hemorrhage and retinopathy of prematurity between the two groups.

Abstract:Objective To investigate the effect of echinoside on the proliferation,migration,invasion and angiogenesis of ovarian cancer cells and its possible mechanism.Methods Ovarian serous cancer cell line SKOV3 was used as the research subjects.Cell counting kit-8 was used to detect the effect of different concentrations of echinoside(0,6.25,12.5,25,50,100,200,400 μmol/L)on cell viability.SKOV3 cells were randomly divided into control group,low-dose echinacoside group(25 μmol/L),middle-dose echinacoside group(50 μmol/L),high-dose echinacoside group(100 μmol/L)and echinacoside high-dose+740Y-P(PI3K agonist,100 μmol/L)group.Colony formation assay,TUNEL staining and Transwell assay were used to detect cell proliferation,apoptosis,migration and invasion.Angiogenesis was detected by tube formation assay.Western blotting was used to detect the expressions of proliferation,apoptosis,invasion,angiogenesis and phosphatidylinositol-3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)pathway related proteins.Results The results of cell counting kit-8 showed that with the increase of echinoside concentration,the survival rate of SKOV3 cells decreased gradually,which were(100.0±5.5)％,(98.3±3.3)％,(93.3±3.4)％,(58.3±3.8)％,(42.4±4.6)％,(28.8±2.2)％,(19.4±3.4)％,(6.4±1.5)％,respectively,in a concentration dependent manner(P＜0.05).Compared with the control group,the number of SKOV3 cell colonies,migration,and invasive cells,the relative circular tubular structure formation ratio,the expression of cell proliferation antigen Ki-67,B-cell lymphoma 2(Bcl-2),N-cadherin,and vascular endothelial growth factor A(VEGFA),the phosphorylated(p)-PI3K/PI3K,p-AKT(S473)/AKT,p-AKT(T308)/AKT,and p-mTOR/mTOR ratios all gradually decreased in the low,medium,and high-dose echinacoside groups,while the apoptosis rate and expression of activate cysteine protease 3(Cleaved caspase 3),Bcl-2 related X protein(Bax),and E-cadherin gradually increased,showing a concentration-dependent effect,with statistically significant differences(all P＜0.05).Compared with the high-dose echinacoside group,the number of SKOV3 cell colonies,migration,and invasive cells,the relative circular tubular structure formation ratio,the expression of Ki-67,Bcl-2,N-cadherin,and VEGFA,the p-PI3K/PI3K,p-AKT(S473)/AKT,p-AKT(T308)/AKT,and p-mTOR/mTOR ratios all increased/rised in the echina-coside high-dose+740Y-P group,while the apoptosis rate and expression of Cleaved caspase 3,Bax,and E-cadherin all decreased,showing a statistically significant difference(all P＜0.05).Conclusion Echinoside can inhibit the proliferation,migration,invasion and angiogenesis of ovarian cancer cells,and its mechanism may be related to the inhibition of PI3K/AKT/mTOR signaling pathway.

Abstract:Objective To investigate the effect of Jinwugutong capsule in the treatment of primary osteo-porosis and evaluate the drug economy.Methods A total of 200 patients with primary osteoporosis in Zhengzhou Orthopaedic Hospital,Henan Province from June 2022 to June 2023 were selected.According to the random number table method,they were divided into the control group and the observation group,with 100 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Jinwugutong capsule on the basis of the control group.The two groups were evaluated and compared after 24 weeks of treatment.The traditional Chinese medicine syndrome score,low back pain and leg pain,activity of daily living scale(ADL)score,bone mineral density and bone metabolism indexes were compared between the two groups before and after treatment.The incidence of adverse reactions was compared between the two groups,and the differences in clinical efficacy between the two groups were analyzed.The short-term drug economy of the two groups was evaluated.Results At 4,12 and 24 weeks after treatment,the traditional Chinese medicine syndrome scores of the observation group were lower than those of the control group(all P＜0.05).After treatment,the pain scores and ADL scores of the two groups were lower than those before treatment,and the bone mineral density was higher than that before treatment.The pain scores and ADL scores of the observation group were lower than those of the control group,and the bone mineral density was higher than that of the control group(all P＜0.05).After treatment,the levels of serum calcium,osteocalcin and total N-terminal propeptide of type Ⅰ collagen in the two groups were higher than those before treatment,and the serum phosphorus level was lower than that before treatment.The levels of serum calcium,osteocalcin and total N-terminal propeptide of type Ⅰ collagen in the observation group were higher than those in the control group,and the serum phosphorus level was lower than that in the control group(all P＜0.05).The incidence of adverse reactions in the observation group was lower than that in the control group[2.0％(2/100)vs 14.0％(14/100)](P=0.002).The total effective rate of the observation group was higher than that of the control group[82.0％(82/100)vs 73.0％(73/100)](P=0.004).The cost-effectiveness ratio of the control group was 132.65,the effectiveness ratio of the observation group was 128.04,and the incremental cost-effectiveness ratio was 90.72.The treatment regimen in the observation group was more economical than that in the control group.Conclusion Jinwugutong capsule is effective in the treatment of primary osteoporosis,which can improve the traditional Chinese medicine syndrome score,relieve pain,improve bone metabolism,and is safe,reliable and more economical.

Abstract:The treatment of intracranial infection secondary to systemic lupus erythematosus is difficult and the mortality rate is high.The clinical data of 4 cases of secondary intracranial infection in patients with systemic lupus erythematosus are retrospectively analyzed and the related literature is reviewed.All the 4 patients were female,aged from 16 to 36 years.All patients were diagnosed with systemic lupus erythematosus and had secondary intracranial infection and cerebrospinal fluid circulation dysfunction,including 3 cases of hydrocephalus and 1 case of refractory intracranial hypertension.It is concluded that long-term cerebrospinal fluid drainage combined with anti-infection comprehensive treatment can greatly improve the prognosis and quality of life of patients with intracranial infection secondary to systemic lupus erythematosus.In order to provide experience and reference for clinical practice.

Abstract:Objective To explore the effect and adverse events of zanubrutinib first line treatment of elderly patients with previously untreated mantle cell lymphoma(MCL).Methods The clinical data of 13 elderly patients with previously untreated MCL treated with zanubrutinib from August 2020 to July 2022 in Gansu Provincial Cancer Hospital were retrospectively reviewed.Patients were given zanubrutinib for more than 4 cycles(1 month as a cycle),and the initial dose was 160 mg twice daily.The objective response rate(ORR),progression free survival(PFS),overall survival(OS),6-month and 12-month PFS rate and OS rate were recorded,and the effects of different factors on PFS and OS were analyzed.Results Follow-up until November 1,2022,among the 13 patients,7 cases achieved completely response(53.8％),2 cases achieved partially response(15.4％)and 4 cases achieved progressive disease(30.8％).The ORR was 69.2％(9/13).The median PFS was 8(4-28)months,and the median OS was 10(5-28)months.The 6-month PFS rate and the OS rate were 68.0％and 92.0％.The 12 month PFS rate and the OS rate were 23.0％and 31.0％.Univariate analysis showed that the Eastern Cooperative Oncology Group score,Ki-67 index and lactic dehydrogenase(LDH)were the probable effect factors for PFS,the age,Ki-67 index and LDH were the probable effect factors for OS(all P＜0.05).However,no statistically significant factors affecting PFS and OS were observed in the multivariate Cox regression analysis results(all P＞0.05).Among the 13 patients,one patient with hematological toxicity was mild,while four patients with non hematological toxicity included infection,secondary malignant tumors,joint pain,and nausea.All adverse reactions were safe and controllable after reduction,discontinuation of zanubrutinib,and symptomatic treatment,with no treatment-related deaths.Conclusions Zanubrutinib first line monotherapy had higher ORR,completely response rates and better tolerance in elderly patients with previously untreated MCL.Especially for patients with poor physical status can not tolerate chemotherapy and personal willingness to refuse chemotherapy.