Abstract:Objective To investigate the application of oliceridine fumarate for postoperative analgesia in elderly patients underwent thyroid tumors resection.Methods A total of 100 elderly patients admitted to Beijing Nanjiao Cancer Hospital from June 2023 to January 2024 who underwent thyroid tumor resection were selected.The study subjects were randomly divided into the control group and study group using a random number table,with 50 cases per group.Patient-controlled analgesia(PCA)using 100mL of mixture containing,including 1μg/kg dexmedetomidine,0.5mg/kg diazoxide,5mg tropisetron and 0.9％sodium chloride injection was given to patients of the control group.PCA using oliceridine fumarate at an initiating dose of 1.5mg,0.35mg at a 6-min lock-out,and 0.75mg after 1-h initiating dosage,for an interval of 1 hour and a total of 24h,was performed in the study group.The degree of pain at 2,6,12,and 24h after recovery of postoperative orienting force,the scores on the degree of comfort and sedation at 24 h postoperatively,and the incidence of postoperative adverse events were compared.Results The Visual Analogue Scale(VAS)scores at different postoperative time points in the study group were significantly lower than the control group(P＜0.05).The Bruggrmann Comfort Scale(BCS)scores at 24h postoperatively were significantly higher in the study group than the control group,while the Ramsay sedation scores were significantly lower(P＜0.05).C-reactive protein(CRP)and interleukin-6(IL-6)levels at 12h and 24h postoperatively in the study group were significantly lower than the control group(P＜0.05).The incidence of adverse events of the study group was significantly lower than the control group(P＜0.05).Conclusion Oliceridine fumarate used in postoperative analgesia for elderly patients underwent thyroid tumors resection can significantly reduce the VAS score,improve the level of patient comfort and inflammatory factors,and reduce the incidence of adverse reactions.

Abstract:Objective To explore the differences in exposure factors and exposure levels in patients with coronary artery severe stenosis versus cerebral artery severe stenosis,and to analyze the relevant risk factors,thus providing a theoretical basis for the early prevention of cardiovascular and cerebrovascular diseases.Methods Totally 120 patients with severe stenosis of the coronary and/or cerebral arteries from July 2021 to July 2023 were included.They were divided into the cerebral artery stenosis group,coronary artery stenosis group,and cerebrocardiac artery stenosis group based on the location of the affected arteries.Clinical data and laboratory indicators of the three groups were collected.Independent risk factors for severe arterial stenosis were identified using a logistic regression model.Results There was a significant difference in the correlation between gender composition and distribution of severe arterial stenosis among the three groups(x2=10.015,P＜0.01).The levels of apolipoprotein A1(ApoA1),high-density lipoprotein cholesterol(HDL-C),and glycosylated hemoglobin(HbA1c)in the cerebral artery stenosis group were significantly higher than the cerebrocardiac artery stenosis group(P＜0.05).The levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and apolipoprotein B(ApoB)in the cerebral artery stenosis group were significantly higher than the coronary artery stenosis group(P＜0.05).A multivariate logistic regression analysis was conducted with the coronary artery stenosis group as the control group.The results showed that body mass index(BMI)had a significant impact on cerebral artery stenosis(OR=0.825,P=0.035).The number of patients with both intracranial and extracranial artery stenosis in the cerebrocardiac artery stenosis group was significantly higher than the cerebral artery stenosis group(x2=7.132,P＜0.05).Conclusion Male are more prone to severe stenosis of only coronary artery,and both coronary and cerebral arteries.Individuals with high BMI are more prone to severe stenosis of only coronary artery.Individuals with higher levels of ApoA1,HDL-C,and HbA1c are more prone to severe stenosis of only cerebral artery.Individuals with higher levels of TC,LDL-C,and ApoB are more prone to developing only cerebral artery stenosis.Among patients with severe stenosis of both coronary and cerebral arteries,those with stenosis of both intracranial and extracranial arteries are significantly higher than the stenosis of only cerebral artery.

Abstract:Objective To investigate the effects of semaglutide on blood glucose,blood lipids and mental status in type 2 diabetes mellitus(T2DM)patients with ischemic stroke and depression.Methods A total of 100 T2DM patients with ischemic stroke and depression admitted to the Department of Endocrinology in Kailuan General Hospital from January 2022 to December 2023 were selected and randomly divided into the observation group(n=50)and control group(n=50)by the random number method.Patients in the observation group were treated with metformin plus semiglutide,and those in the control group were treated with metformin plus insulin glargine injection.The dosage was adjusted according to the patient's blood sugar level.Gender,age,course of disease,fasting blood glucose(FBG),hemoglobin A1c(HbA1c),total cholesterol(TC),triglyceride(TG)level,low-density lipoprotein cholesterol(LDL-C),the Hamilton Depression Rating Scale(HAMD)score,body mass index(BMI)and insulin resistance index(HOMA-IR)were recorded before treatment and 3 and 6 months after treatment.Results After 3 months of treatment,FBG,HOMA-IR,HbA1c and HAMD scores in both groups were significantly reduced than pre-treatment values(P＜0.05).The HAMD scores of the patients treated with semaglutide were significantly lower than those treated with insulin glargine.The levels of BMI,TC,TG and LDL-C were also significantly reduced in patients treated with semaglutide(P＜0.05),which were not significantly changed in patients treated with insulin glargine.After 6 months of treatment,HbA1c and HAMD scores were significantly lower in patients treated with semaglutide than those treated with insulin glargine(P＜0.05).Conclusion For T2DM patients with ischemic stroke and depression,both semaglutide and insulin glargine can reduce the blood sugar of patients.Semaglutide,however,can better reduce the body weight and lipid levels,and also have a significant improvement in mental state.

Abstract:Bone morphogenetic protein(BMP)is involved in biological processes of bone formation,neuronal differentiation,neurulation and cell apoptosis.BMPs play an important role in the development of central nervous system diseases.BMPs/BMPR/Smads signaling pathway can regulate neuronal differentiation and act on different nervous system diseases.To study the mechanism of BMPs and BMPs/Smads signaling pathway in central nervous system diseases is of great significant for diagnosis,treatment and prognosis evaluation.This article reviews the role of BMPs and BMPs/Smads signaling pathway in central nervous system diseases.

Abstract:Objective To investigate the relationship between the hemodynamics in the lesions examined by color Doppler ultrasonography and prognosis of subacute thyroiditis,thus providing references for early targeted treatment.Methods From January 2023 to September,a total of 105 subacute thyroiditis patients were selected.All patients were followed up for 1 year.They were divided into the normal thyroid function group(86 cases)and hypothyroidism group(19 cases)according to the presence or absence of the thyroid dysfunction,and they were also assigned to rehabilitation group(94 cases)and recurrence group(11 cases)according to the presence or absence of the recurrence.The clinical data,resistance index(RI),pulsatility index(PI)were compared,Logistic regression analyzed the influencing factors for the prognosis of subacute thyroiditis.Results There were significant differences in respiratory symptoms,fatigue,thyroglobulin antibody(TG-Ab),thyroid peroxidase antibody(TPO-Ab),white blood cell count(WBC),RI,PI between the normal thyroid function group and the hypothyroidism group(P＜0.05).Significant differences in age,fatigue,TG-Ab,TPO-Ab,RI,and PI were found between the rehabilitation group and recurrence group(P＜0.05).Multivariate logistic regression analysis showed that elevated TG-Ab(OR:1.046,95％CI:1.006-1.099,P=0.042),decreased RI(OR:0.043,95％CI:0.017-0.881,P=0.031),and decreased PI(OR:0.054,95％CI:0.030-0.974,P=0.034)were risk factors for hypothyroidism.Symptoms of fatigue(OR:0.043,95％CI:0.017-0.881,P=0.031),decreased RI(OR:0.034,95％CI:0.018-0.058,P=0.011),and decreased PI(OR:0.276,95％CI:0.028-0.723,P=0.033)were risk factors for recurrence of subacute thyroiditis.Conclusion The hemodynamic parameters RI and PI within the lesions of subacute thyroiditis are related to the recurrence of subacute thyroiditis and hypothyroidism,and can be used as the indicators to evaluate the prognosis.

Abstract:Objective To explore the application of a clinical pathway based on evidence-based intervention strategy to the perioperative management of transfemoral puncture in patients with interventional angiography.Methods A total of 120 patients with cerebrovascular disease for interventional angiography from January 2024 to May 2024 were included in the study.They were randomly divided into the observation group and control group by random number table method,with 60 cases per group.Patients in both groups were treated with perioperative routine nursing,and those in the observation group were additionally treated with clinical pathway nursing mode based on evidence-based intervention strategy.The Modified Rankin Scale(mRS),the Function Independent Measure(FIM),the Hamilton Depression Rating Scale(HAMD),the Hamilton Anxiety Rating Scale(HAMA),nursing satisfaction,and complications were compared.Results The mRS score on admission was comparable between groups(t=0.504,P＞0.05),but significantly higher in the observation group than the control group at discharge(t=2.221,P＜0.05).The FIM score on admission was comparable between groups(t=0.103,P＞0.05),but significantly higher in the observation group than the control group at discharge(t=8.169,P＜0.05).The HAMD score on admission was comparable between groups(t=0.123,P＞0.05),but significantly lower in the observation group than the control group at discharge(t=22.625,P＜0.05).The HAMA score on admission was comparable between groups(t=0.312,P＞0.05),but significantly lower in the observation group than the control group at discharge(t=18.519,P＜0.05).The overall satisfaction rate was significantly lower in the control group than the observation group(85.00％vs 98.33％,x2=6.982,P＜0.05).In the control group,there were 2 cases of urinary retention,1 case of low back pain,and 5 cases of subcutaneous hematoma.In the observation group,there was one case of subcutaneous hematoma.The total incidence of adverse events was significantly lower in the observation group than the control group(13.33％vs 1.67％,x2=5.886,P＜0.05).Conclusion In the perioperative management of patients undergoing femoral artery puncture with interventional angiography,the clinical nursing pathway based on evidence-based nursing strategy can improve the function,quality of life,and satisfaction,effectively relieve the psychological pressure,and significantly reduce the incidence of complications.Its effect is significantly better than that of traditional nursing mode.

Abstract:Objective To investigate the effect of azathioprine(AZA)combined with infliximab(IFX)on the efficacy and inflammatory factors in patients with Crohn's disease(CD).Methods Seventy-four CD patients admitted from August 2022 to July 2024 were included as study objects,and they were divided into the observation group(n=37)and the control group(n=37)according to the random ball touching method.AZA was used in the control group,while AZA+IFX combined method was used in the observation group.The outcome measures included clinical efficacy,symptom remission time,coagulation function index level,inflammatory mediator level,oxidative stress index,and intestinal mucosal barrier function and adverse reactions.Results Compared with the control group,the observation group had significantly higher total effective rate 94.59％(P＜0.05).Compared with the control group,the relief time of abdominal distension(8.19±1.31 d)and the relief time of abdominal pain(6.28±1.21 d)in the observation group were significantly shorter(P＜0.05).Compared with the control group,the D-dimer(D-D)level(241.47±51.31 μg/L)and fibrinogen(FIB)level(2.25±0.41 g/L)were significantly lower in the observation group after treatment(P＜0.05).Compared with the control group,the level of tumor necrosis factor-α(TNF-α)(12.44±2.49 ng/L)and the level of interleukin-12(IL-12)(70.59±8.97 ng/L)were significantly decreased in the observation group after treatment,and IL-10 level(100.82±7.74 ng/L)was significantly higher(P＜0.05).Compared with the control group,after treatment,malondialdehyde(MDA)level(5.72±0.31 nmol/L)in the observation group was significantly lower,and superoxide dismutase(SOD)level(1.89±0.12 U/ml)was significantly higher(P＜0.05).Compared with the control group,the level of diamine oxidase(DAO)(5.33±0.34 U/L)and the level of lactic acid(4.09±0.32 mmol/L)in the observation group were significantly lower after treatment(P＜0.05).The incidence of adverse reactions in the observation group was 10.81％,which was no significant difference compared with 8.11％in the control group(P＞0.05).Conclusion The AZA+IFX combined method for the treatment of patients with CD can improve the clinical efficacy,shorten the relief time of abdominal distension and abdominal pain,reduce the levels of coagulation function index and inflammatory factors,improve the level of oxidative stress and intestinal barrier function indexes of patients,with better effect and good safety,which is worthy of clinical reference.

Abstract:Objective To study the expressions of myosin light chain kinase(MLCK)and proliferating cell nuclear antigen(PCNA)in colon cancer tissues and their correlation with metastasis and prognosis.Methods A total of 100 patients with colon cancer who underwent surgical resection in our hospital from January 2019 to January 2023 were included.Colon cancer tissue and corresponding adjacent tissue(＞5 cm from the tumor edge)of all patients were collected.The expressions of MLCK and PCNA in colon cancer and adjacent normal tissues were detected.Results Among the 100 colon cancer tissues,83 patients had positive expression of MLCK,with the positive expression rate of 83.00％;while in the adjacent tissues,47 patients had MLCK positive expression,with the positive expression rate of 47.00％.The positive expression rate of MLCK in cancer tissues was significantly higher than that of adjacent tissues(P＜0.05).In colon cancer tissue,there were 89 cases of PCNA-positive tissue,with the positive expression rate of 89.00％;there were 17 cases of PCNA-positive adjacent normal tissue,with a positive expression rate of 17.00％.The positive expression rate of PCNA in cancer tissue was significantly higher than that of adjacent tissues(P＜0.05).The positive expression rate of MLCK in colon cancer patients with distant metastasis was significantly higher than that in patients without distant metastasis(P＜0.05).The positive expression rate of MLCK in colon cancer patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis(P＜0.05).The positive expression rate of MLCK in patients with stage Ⅲ-Ⅳ was significantly higher than that in patients with stage Ⅰ-Ⅱ(P＜0.05).The positive expression rate of PCNA in colon cancer patients with distant metastasis was significantly higher than that in patients without distant metastasis(P＜0.05).The positive expression rate of PCNA in colon cancer patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis(P＜0.05).The positive expression rate of PCNA in patients with stage Ⅲ-Ⅳ was significantly higher than that in patients with stageⅠ-Ⅱ(P＜0.05).The survival time of patients with positive expression of MLCK was significantly shorter than that of patients with negative expression of MLCK(P＜0.05),and the survival time of patients with positive expression of PCNA was significantly shorter than that of patients with negative expression of PCNA(P＜0.05).Univariate analysis showed that the protein expression of MLCK,the protein expression of PCNA,the degree of tumor differentiation,angiolymphatic infiltration,lymph node metastasis and tumor,node,metastasis(TNM)staging were significantly associated with the prognosis of colon cancer(P＜0.05).Multivariate analysis further showed that he protein expression of MLCK,the protein expression of PCNA,tumor differentiation,angiolymphatic invasion,lymph node metastasis,and TNM staging were independent risk factors for the prognosis of colon cancer patients(P＜0.05).Conclusion The protein expressions of MLCK and PCNA are upregulated in colon cancer tissue,and the positive expression rates of MLCK and PCNA are higher in colon cancer patients with distant metastasis.Their expression levels are related to the prognosis of colon cancer.This study provides a research basis for finding new therapeutic drugs and targets for distant metastasis and prognosis of colon cancer.

Abstract:Objective To examine the relationship between maternal glucose-lipid metabolic parameters and neonatal birth weight.Methods Totally 642 pregnant women with single fetus attending routine antenatal check-ups at Qinhuangdao Maternal and Child Health Hospital from December 2017 to December 2018 were categorized into normal birth weight,macrosomia,and low birth weight groups according to neonatal birth weight.Baseline characteristics and maternal metabolic indices during pregnancy were compared.Correlations between maternal metabolic indices and birth weight were assessed.Multiple linear regression was used to identify independent determinants of birth weight.Results Maternal height,pre-pregnancy weight and body mass index(BMI),as well as fasting blood glucose(FBG),triacylglycerol(TG),and glycated hemoglobin(HbA1c)in early pregnancy were each positively correlated with neonatal birth weight(all P＜0.05).In regression analysis,pre-pregnancy BMI as well as FBG and TG in early pregnancy remained significant independent predictors of birth weight(all P＜0.05).Conclusion Pre-pregnancy BMI,as well as FBG,HbA1c,and TG in early pregnancy,are independent risk factors for neonatal birth weight.

Abstract:Objective To investigate the effect of integrative theory of health behavior change on blood pressure control and pregnancy outcome in pregnant women with gestational hypertension.Methods A total of 84 pregnant women with gestational hypertension in the Department of Obstetrics and Gynecology of Daqing Longnan Hospital from January 2022 to January 2024 were selected.They were randomly divided into the control group and observation group using the random number table,with 42 cases per group.Routine nursing care was performed in both groups,and integrative theory of health behavior change was additionally given to patients of the observation group.Psychological state,self-management ability,blood pressure control effect and pregnancy outcome of the two groups were compared.Results After nursing,patients in the observation group had significantly lower Pregnancy Stress Scale(PPS)score,but higher General Self-Efficacy Scale(GSES)score than the control group(P＜0.05).After nursing,patients in the observation group had significantly higher self-management behavior score of pregnancy hypertension than the control group(P＜0.05).Diastolic blood pressure(DBP)and systolic blood pressure(SBP)after nursing were significantly lower in the observation group than the control group(P＜0.05).The incidence of poor pregnancy outcome was significantly lower in the observation group than the control group(7.14％vs 23.81％,P＜0.05).Conclusion In pregnant women with gestational hypertension,the application of integrative theory of health behavior change can promote the further improvement of their mental state and self-management ability,as well as enhance the effect of blood pressure control,so as to improve the pregnancy outcome.

Abstract:Objective To investigate the function and possible molecular mechanism of plant homologous domain finger protein 14(PHF14)in cardiac myocyte hypertrophy.Methods Myocardial tissues and control tissues were collected from patients with myocardial hypertrophy,and the mRNA and protein levels of PHF14 were detected by real-time fluorescence quantitative polymerase chain reaction(RT-PCR)and Western blot,respectively.A mouse myocardial hypertrophy model was created by angiotensin Ⅱ induction.RT-PCR and Western blot were used to detect the expression of myocardial hypertrophy marker genes and PHF14.Rat cardiomyocytes were isolated and treated with angiotensin Ⅱ for inducing myocardial hypertrophy.Cells were then transfected with shPHF14 to interfere with the expression of PHF14.RT-PCR and Western blot were used to detect the expression of myocardial hypertrophy marker genes and downstream signaling pathways.Results Compared with normal myocardial tissues,the mRNA and protein levels of PHF14 were significantly higher in myocardial tissues of patients with myocardial hypertrophy(P＜0.05).In the mouse cardiac hypertrophy model,the expressions of three marker genes,including atrial natriuretic peptide(ANP),B-type natriuretic peptide(BNP)and Myosin heavy chain 7(MYH7),significantly increased(P＜0.05).In addition,the expression level of PHF14 significantly increased(P＜0.05).In the in vitro model of rat cardiomyocytes,shPHF14 transfection significantly reduced the expressions of PHF14,ANP,BNP and MYH7 induced by angiotensin Ⅱ.In addition,knockdown of PHF14 significantly promoted the activation of the phosphatidylinositol 3-kinase(PI3K)-protein kinase B(Akt)signaling pathway inhibited by angiotensinⅡ.Conclusion PHF14 is highly expressed in myocardial hypertrophy,and inhibiting PHF14 can alleviate the degree of myocardial hypertrophy,possibly by inhibiting the PI3K-AKT signaling pathway.It indicated that PHF14 can be a potential target for treating myocardial hypertrophy.

Abstract:Objective To construct a quality control intervention scheme for patients undergoing bladder cancer surgery based on the failure mode and effects analysis(FMEA)model,and to analyze its application effect.Methods A total of 114 surgically treated bladder cancer patients admitted from May 2022 to December 2023 were selected and divided into the intervention group(n=58)and control group(n=56)by convenient lottery method.Conventional interventions were given to patients of the control group,and a quality control scheme based on the FMEA model was applied to patients in the intervention group.Psychological stress reaction,negative emotion,the quality of life score,postoperative complications and the degree of quality control intervention were compared.Results After the intervention,the Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)scores significantly decreased,and the score of quality of life significantly increased in both groups(P＜0.05).Compared with the control group,the preoperative immediate diastolic blood pressure,incidence of shivering,respiratory rate,immediate heart rate before surgery,total incidence of postoperative complications,SDS and SAS scores were significantly lower in the intervention group,and the quality of life scores and satisfaction with quality control intervention were significantly higher than the control group(P＜0.05).Conclusion The quality control intervention scheme based on the FMEA model for surgically treated bladder cancer patients can effectively enhance the therapeutic effect and prognostic effect,showing positive significance in reducing the psychological stress response,negative emotions,postoperative complications and improving the quality of life.

Abstract:Parkinson's disease(PD)is a chronic and progressive neurological disorder,mainly characterized by the loss of dopaminergic neurons and the abnormal alpha-Synuclein?(alpha-Syn)?aggregation.Recently,it has been shown that the nuclear factor erythroid 2 related factor 2(NRF2)signaling pathway plays an important role in the pathogenesis of PD.NRF2 is a transcription factor whose main function is to regulate the antioxidative stress response and cellular autophagy processes.In PD,activation of NRF2 signaling can reduce oxidative stress,suppresses inflammatory responses and neuronal damage,thereby protecting dopaminergic neurons from the toxic effects of alpha-Syn aggregation.Furthermore,several drugs and natural compounds have been found to treat PD by activating the NRF2 signaling pathway.In conclusion,the role of NRF2 signaling in PD is mainly reflected in terms of anti-oxidation,anti-inflammatory and neuroprotective,therefore,further studies of the regulatory mechanism of NRF2 signaling may provide new ideas and targets for the treatment of PD.

Abstract:Objective To explore the effect of stepwise synergistic nutritional management combined with Xingnaojing Injection on neurological function recovery of patients with cerebral hemorrhage.Methods A total of 112 patients with cerebral hemorrhage treated between March 2022 and December 2023 were retrospectively studied as research subjects.They were divided into the experimental group and the control group according to the different treatment methods.Patients in the control group(n=56)were given the internal medicine conservative treatment and routine nutritional intervention,and the intracranial hypertension was treated with mannitol to lower the intracranial pressure.Those in the experimental group(n=56)were treated with stepwise synergistic nutritional management combined with Xingnaojing Injection on the basis of the treatment program of the control group.The nutritional status,neurological function and neurological function influencing factors,as well as stress indicators and clinical efficacy of the two groups were compared.Results Transferrin(TF),albumin(ALB),and prealbumin(PA)before treatment were comparable between groups(P＞0.05),which were elevated at varying degrees in both groups after treatment,and significantly pronounced in the experimental group than the control group(P＜0.05).The National Institutes of Health Stroke Scale(NIHSS)and Glasgow Coma Scale(GCS)scores before treatment were comparable between groups(P＞0.05).NIHSS score significantly decreased,while the GCS score significantly increased after treatment,which were significantly pronounced in the experimental group than the control group(P＜0.05).The neuron-specific enolase(NSE),plasma S100,matrix metalloproteinase 9(MMP-9)and myelin basic protein(MBP)were comparable between groups(P＞0.05),which were significantly improved in both groups after treatment,and significantly pronounced in the experimental group than the control group(P＜0.05).Oxidative stress before treatment was comparable between groups(P＞0.05).The superoxide dismutase(SOD)and AngⅡ were significantly elevated,and malondialdehyde(MDA)was significantly reduced in both groups after treatment,which were significantly pronounced in the experimental group than the control group(P＜0.05).The total effective rate was significantly higher in the experimental group than the control group(85.7％vs 66.1％,P＜0.05).Conclusion Stepwise synergistic nutritional management combined with Xingnaojing Injection effectively improves the nutritional status,alleviates neurological damage,adjusts stress responses,and enhance clinical therapeutic effects on cerebral hemorrhage.

Abstract:Objective To compare the efficacy of flexible ureteroscopic holmium laser lithotripsy versus posterior laparoscopic ureterotomy in removing renal stones.Methods A total of 52 patients with kidney stones admitted from August 2022 to August 2023 were selected and divided into laparoscopic group(n=6)and ureteral group(n=52)according to the surgical method.Flexible ureteroscopic holmium laser lithotripsy and posterior laparoscopic ureterotomy were performed in the ureteral group and laparoscopic group,respectively.Disappearance time of blood in the urine,renal function,the Visual Analogue Scale(VAS)score,and immune function were compared between groups.The incidence of complications and clinical efficacy were compared.Results Compared with the laparoscopic group,disappearance time of blood in the urine and pain was significantly shorter in the ureteral group(P＜0.05).Preoperative renal function was comparable between groups(P＞0.05).Postoperative renal function was significantly better in both groups(P＜0.05).Postoperative serum creatinine(SCr)and blood urea nitrogen(BUN)were significantly higher in the ureteral group than the laparoscopic group(P＜0.05).Preoperative immune function was comparable between groups(P＞0.05).Postoperative immune function in both groups was significantly lower than the preoperative value(P＜0.05).Postoperative ICR and TER were significantly lower in the ureteral group than the laparoscopic group(P＜0.05).The incidence of complications was significantly lower in the ureteral group than the laparoscopic group(1.92％vs 50.00％,P＜0.05).The overall efficacy was significantly higher in the ureteral group than the laparoscopic group(98.07％vs 50.00％,P＜0.05).Conclusion Flexible ureteroscopic holmium laser lithotripsy is better than posterior laparoscopic ureterotomy,which can effectively reduce the occurrence of complications and promote rapid postoperative recovery.

Abstract:Objective To explore the changes in pathogen spectrum of children with respiratory tract infection in Handan City before and after COVID-19.Methods A total of 46,613 children aged 29 days to 14 years with respiratory tract infection from January 2018 to December 2023 were retrospectively analyzed.Nine respiratory pathogens,including respiratory syncytial virus,adenovirus,influenza B virus,influenza A virus,parainfluenza virus,mycoplasma pneunoniae,chlamydia pneumoniae,coxiella burnetii and Legionella pneumophila were examined.Three time periods were set:from January 2018 to December 2019(before COVID-19),from January 2020 to December 2022(during COVID-19),and from January 2023 to December 2023(COVID-19 as a Class B infectious disease managed by Class B interventions).The changes in pathogen spectrum were analyzed.Results At least one pathogen was detected in 24,661 out of the 46,613 children,with a positive rate of 52.91％.The top three pathogens were mycoplasma pneumoniae,influenza A virus and respiratory syncytial virus,with the detection rate of 21.97％,13.47％and 6.26％,respectively.The pathogen detection rate was 53.82％(14,056/26,117)in male children,and 53.16％(10,736/20,196)in female children,without a significant difference(P=0.158).The pathogen detection rate of inpatients was significantly higher than that in outpatients(54.53％[19,299/35,391]vs 48.95％[5,493/11,222],P＜0.001).The detection rates of pathogens were different in different seasons.Respiratory syncytial virus,influenza A virus and influenza B virus were the main pathogens in winter.The detection rate of Legionella pneumophila was the highest in summer and autumn,adenovirus was the highest in spring and summer,and that of mycoplasma pneunoniae and chlamydia pneumoniae was the lowest in summer.The detection rate of pathogens before COVID-19,during COVID-19 and after COVID-19 was considered as a Class B infectious disease and managed by Class B interventions was 55.67％,45.77％and 60.39％,respectively.Conclusion The detection rate of pathogens during COVID-19 is significantly lower than that before COVID-19,and the detection rate of pathogens after it has been considered as a Class B infectious disease and managed by Class B interventions is significantly higher than that before and during COVID-19,and the detection rate of pathogen spectrum differs in different seasons.We should fully understand the physical detection of pathogens in the current region,which is conducive to targeted preventive measures and treatment for children.

Abstract:Objective To evaluate the efficacy and safety of anlotinib combined with programmed death 1(PD-1)inhibitors in treating advanced non-small cell lung cancer(NSCLC)with sensitive mutations in the epidermal growth factor receptor(EGFR)gene.Methods A total of 278 advanced NSCLC patients who were treated with the combination of anlotinib with PD-1 inhibitors from January 2020 to December 2023 were retrospectively included.Among them,44 patients with EGFR sensitive mutations were enrolled as subjects.Efficacy and safety were analyzed.The correlation between clinical pathological features and progression-free survival(PFS)was identified.PFS curves were constructed using the Kaplan-Meier method.Results Among the 44 patients,the objective response rate(ORR)was 31.8％,and the disease control rate(DCR)achieved 86.3％.Follow-ups were conducted until February 29,2024,showing a median PFS of 7.1 months,and a median overall survival(OS)of 11.7 months.The PFS was significantly correlated with the expression of programmed death ligand 1(PD-L1),type of EGFR mutation,T790M status,history of chemotherapy,and prior use of bevacizumab(P＜0.05).Multivariate analysis indicated that EGFR L858R mutation(odds ratio[OR]=2.604,P=0.012),non-use of bevacizumab(OR=2.594,P=0.004),and T790M-negative status(OR=2.575,P=0.010)were significantly correlated with the prolonged median PFS.A total of 6 patients experienced grade 3 or higher adverse events.Conclusion The combination of anlotinib and PD-1 inhibitors demonstrates promising therapeutic efficacy in advanced NSCLC patients carrying EGFR-sensitive mutations who are resistant to EGFR-tyrosine kinase inhibitor(TKI)therapy,with particularly favorable outcomes observed in patients harboring the EGFR L858R mutation,those who have not received bevacizumab,and those with a T790M-negative status.

Abstract:Objective To explore the application effect of the visiting mode based on the patient and family-centered care(PFCC)in patients with cerebral infarction in the acute phase.Methods From January 2019 to December 2023,100 patients with cerebral infarction in the acute phase were selected.They were randomly divided into two groups according to the method of randomized numerical table,with 50 cases in the reference group(conventional visiting mode),and 50 cases in the study group(PFCC-based visiting mode).The family members of the two groups were observed for their sense of uncertainty about the disease,the incidence of intensive care unit(ICU)syndromes,short-term prognosis and family members' satisfaction.Results The scores of each dimension of the Chinese version of the Mishel Uncertainty in Illness Scale-Family Member(MUIS-FM)were significantly reduced in both groups,and significantly lower in the study group than the reference group(P＜0.05).The incidence of ICU syndromes in the study group was significantly lower than the reference group(4.00％vs 16.00％,P＜0.05).Significantly shorter ICU stay,and lower incidence of acquired infection and delirium in the ICU were detected in the study group than the reference group(P＜0.05).The incidence of delirium-related adverse events was comparable between groups(P＞0.05).The Critical Care Family Satisfaction Survey(CCFSS)score after interventions were significantly elevated in both groups,and significantly higher in the study group than the reference group(P＜0.05).Conclusion The PFCC-based visiting mode can reduce the sense of uncertainty about the disease among the families of patients with cerebral infarction in the acute phase,reduce the incidence of ICU syndromes,improve the short-term prognosis,and promote the improvement of the satisfaction of patients' families.

Abstract:Objective To investigate the impacts of andrographolide on wound healing in diabetes rats by regulating the Wnt/β-catenin signaling pathway.Methods A total of 60 Sprague-Dawley(SD)rats were randomly separated into diabetes foot group,normal group,andrographolide group,Wnt/β-catenin pathway inhibitor(DKK-1)group,and andrographolide+DKK-1 group,with 12 rats in each group.In addition to the normal group,rats in other groups were fed with high-glucose and high-fat diet,injected with streptozotocin and punched with a hole maker to create a foot wound to create the diabetes foot model.After successful modeling,once daily administration was given for 4 weeks.The changes in wound healing rate,fasting insulin,and fasting blood glucose in rats were detected.The hematoxylin and eosin(H&E)staining was applied to detect pathological changes in wound tissue.The enzyme-linked immunosorbent assay(ELISA)was applied to detect levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-10 in wound tissue.Immunohistochemistry was applied to detect the average optical density values of vascular endothelial growth factor(VEGF)and platelet endothelial cell adhesion molecule(CD31)in wound tissue.Western blot was applied to detect protein levels of Wnt3a and β-catenin in wound tissue.Results Compared with those in the normal group,rats in the diabetes foot group had significantly thickened epithelium of the wound,massive inflammatory cell infiltration,lower wound healing rate,relative level of IL-10 in wound tissue,average optical densities of VEGF and CD31,and protein levels of Wnt3a and β-catenin,but higher fasting insulin,fasting blood glucose and relative levels of TNF-α and IL-6 in wound tissue(P＜0.05).Compared with the diabetes foot group,rats in the andrographolide group had significantly thickened epithelium of the wound,reduced inflammatory cell infiltration,higher wound healing rate,relative level of IL-10 in wound tissue,average optical densities of VEGF and CD31,and protein levels of Wnt3a and β-catenin,but lower fasting insulin,fasting blood glucose and relative levels of TNF-α and IL-6 in wound tissue(P＜0.05).Opposite findings were detected in the DKK-1 group(P＜0.05).DKK-1 weakened the effect of andrographolide on promoting wound healing in rats with diabetes foot.Conclusion Andrographolide promotes wound healing in rats with diabetes foot by activating the Wnt/β-catenin pathway.

Abstract:Objective To explore the role of positive coping style and sense of disease in the self-disclosure and psychological distress in patients with early digestive tract carcinomas,thus providing theoretical basis for targeted psychological distress intervention in clinical practice.Methods From May to November 2022,272 cases of early digestive tract carcinomas in Jinan City of Shandong Province were selected as the study object.They were surveyed using the distress disclosure index scale,simplified coping style scale,benefit finding scale,Kessler psychological distress scale and a general data questionnaire.The mediating regulatory mechanism was tested.Results Self-disclosure,positive coping style and disease benefit sense all had a significant negative relationship with psychological distress(r=-0.341,-0.289,-0.308,all P＜0.01),and the proportion of its intermediary effect was 13.99％and 14.58％,respectively.Conclusion Positive coping style and disease benefit sense are the mediators that influence the self-disclosure and psychological distress of early digestive tract carcinomas.It is recommended that clinical doctors take appropriate intervention measures to reduce psychological distress and increase their physical health development.