Abstract:Objective To discuss the relationship between serum leukotriene B4(LTB4),human cartilage glycoprotein(YKL-40),matrix metalloproteinase-3(MMP-3)and postoperative cerebrovascular spasm(CVS)in patients with intracranial aneurysms(IAs)undergoing interventional embolization.Methods A total of 122 patients diagnosed with IAs were admitted to the Department of Neurology of the 920th Hospital of the Joint Logistics Support Force of the Chinese Peo-ple's Liberation Army from January 2023 to March 2025 and were included in the IAs group.Based on whether CVS oc-curred,they were divided into CVS subgroups and non-CVS subgroups.A total of 100 healthy individuals who underwent physical examinations at the hospital during the same period were included in the healthy control group.ELISA assay for ser-um LTB4,YKL-40,and MMP-3 levels.Compare serum LTB4,YKL-40,and MMP-3 levels between subjects;Record the inci-dence of CVS in IA patients after surgery;Multifactorial logistic regression analysis of factors influencing the occurrence of CVS after surgery in patients with IAs;ROC curve analysis of the predictive value of serum LTB4,YKL-40,and MMP-3 lev-els for the occurrence of CVS after surgery in patients with IAs;Relative risk analysis of the effects of different LTB4,YKL-40,and MMP-3 levels on the occurrence of postoperative CVS in IAs patients.Results The serum levels of LTB4,YKL-40,and MMP-3 in the IAs group were higher than those in the healthy control group(t/P=27.101,32.638,12.340,respec-tively;all P＜0.001).The serum levels of LTB4,YKL-40,and MMP-3 were significantly higher in the CVS subgroup than in the non-CVS subgroup(t/P=5.078,5.847,5.030,respectively;all P＜0.001).The incidence of CVS in IAs patients after surgery was 32.79％.Elevated serum levels of LTB4,YKL-40,and MMP-3 are all risk factors for the occurrence of CVS after surgery in IAs patients[OR(95％CI)=6.781(3.388-13.571),7.332(3.315-16.217),7.662(3.754-15.638)].The AUC values for predicting the occurrence of CVS in IAs patients postoperatively were 0.732,0.786,0.816,and 0.904 for serum LTB4,YKL-40,MMP-3 levels,and the combination of the three,respectively.The combined prediction was superior to the individual predictions(Z=3.492,2.903,2.312;P=0.001,0.004,0.021).Patients with high levels of serum LTB4,YKL-40,and MMP-3 had a risk of CVS that was 4.272 times,3.141 times,and 2.478 times higher than patients with low levels,respectively.Conclusion Serum LTB4,YKL-40,and MMP-3 are elevated in patients with CVS after IAs surgery.The combination of serum LTB4,YKL-40,and MMP-3 has high value in predicting postoperative CVS in patients with IAs.

Abstract:Objective To investigate the relationship between the expression of serum microRNA-744-5p(miR-744-5p),microRNA-342-3p(miR-342-3p),and microRNA-769-5p(miR-769-5p)with clinicopathological features and prognosis in prostate cancer patients.Methods A total of 96 patients diagnosed with prostate cancer by pathological examination and ad-mitted to the First Ward of Urology,Xi'an International Medical Center Hospital from March 2019 to March 2021 were se-lected as the cancer group.The prostate cancer patients were followed up for 3 years and divided into a poor prognosis sub-group(25 cases)and a good prognosis subgroup(71 cases)based on outcomes.Additionally,96 patients with benign prostatic hyperplasia during the same period were selected as the benign group,and 96 healthy volunteers as the healthy control group.QRT-PCR was used to detect the relative expression levels of miR-744-5p,miR-342-3p,and miR-769-5p.The Kaplan-Meier method was applied to analyze the relationship between serum levels of these miRNAs and prognosis.ROC curve analysis was used to evaluate the predictive value of serum miR-744-5p,miR-342-3p,and miR-769-5p for poor prognosis in prostate cancer patients.Results Compared with the control group,the levels of miR-744-5p,miR-342-3p,and miR-769-5p in the se-rum of the benign and cancer groups were sequentially decreased(F/P=126.382/＜0.001,76.464/＜0.001,87.597/＜0.001).There were no significant differences in serum levels of miR-744-5p,miR-342-3p,and miR-769-5p across lymph node metastasis,vascular invasion,clinical stages,or differentiation degrees.Compared with the good prognosis group,serum levels of miR-744-5p,miR-342-3p,and miR-769-5p in the poor prognosis group were significantly reduced(t/P=7.133/＜0.001,6.312/＜0.001,6.372/＜0.001).The 3-year survival rate in the miR-744-5p high expression group[45/48(93.75％)]was higher than that in the low expression group[26/48(54.17％)](Log-rank x2=376.516,P＜0.001);the 3-year survival rate in the miR-342-3p high expression group[46/48(95.83％)]was higher than that in the low expression group[25/48(52.08％)](Log-rank x2=24.986,P＜0.001);the 3-year survival rate in the miR-769-5p high expression group[44/47(93.62％)]was higher than that in the low expression group[27/49(55.10％)](Log-rank x2=19.295,P＜0.001).Compared with individual detection of serum miR-744-5p,miR-342-3p,and miR-769-5p,the combined detection of all three significantly increased the AUC for predicting prognosis in prostate cancer patients(Z=2.705,P=0.007;Z=3.424,P=0.001;Z=3.053,P=0.002).Con-clusion The levels of miR-744-5p,miR-342-3p,and miR-769-5p in the serum of prostate cancer patients are significantly re-duced,and their combined detection can improve the predictive value for prognosis in prostate cancer patients.

Abstract:Lumbar disc herniation(LDH)is a common disease in orthopedics,and its pathological mechanism in-volves disc degeneration,inflammatory response and cell apoptosis.In recent years,the treatment methods of traditional Chi-nese medicine based on Qi-blood theory have shown potential in promoting the reabsorption of protrusion,and Fas/FasL sig-naling pathway,as a key pathway to regulate cell apoptosis,may be related to the biological effects of Qi-blood theory.In this paper,by integrating the Qi-blood theory and modem molecular biology mechanism,we explore the role of Fas/FasL signaling pathway in the resorption of lumbar disc herniation,and provide experimental and theoretical basis for the prevention and treatment of LDH.

Abstract:Romiplostim,as a thrombopoietin receptor agonist,is approved for use in patients with immune thrombo-cytopenia(ITP)in the United States,Australia,and several countries in European,Africa and Asia,and in patients with refrac-tory aplastic anemia(AA)in Japan and South Korea.Romiplostim binds to and activates TPO receptors on megakaryocyte precursors,promoting cell proliferation and viability,leading to increased platelet production.Through this mechanism,Romip-lostim reduces the reliance for other treatments and reduces bleeding events in patients with thrombocytopenia.This article re-views the mechanism of action,pharmacodynamics,pharmacokinetics and clinical application research progress of romiplostim.

Abstract:This article reported a rare case of a patient with cardiac sarcoidosis combined with atrial septal defect,and conducted a literature review.

Abstract:Objective To investigate the effects of complement component 1q subcomponent B(C1QB)on neural repair and the phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT)signaling pathway in rats with spinal cord injury(SCI).Methods From March 2024 to October 2024,experiments were conducted in the laboratory of Xuzhou Medical Uni-versity.An SCI rat model was established,and successfully modeled rats were randomly assigned to the model group(SCI group),si-NC group,si-C1QB group,and si-C1QB+PI3K/AKT signaling pathway inhibitor group(si-C1QB+LY294002 group),with 12 rats in each group.Additionally,12 normal healthy SD rats were used as the blank control group(Control group).At the end of the treatment,the BBB score was assessed.Enzyme-linked immunosorbent assay(ELISA)was used to detect inflammatory factors in spinal cord tissue.Hematoxylin-eosin(HE)staining was used to observe pathological damage in spinal cord tissue.Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)staining was used to de-tect apoptosis of spinal cord neurons.Immunohistochemistry was used to detect the expression of ionized calcium-binding adapter molecule 1(IBA-1)and glial fibrillary acidic protein(GFAP).Western blot was used to detect the expression of pro-teins related to the PI3K/AKT signaling pathway.Results Compared with the Control group,the spinal cord tissue structure in the SCI group was more disordered,with extensive cavitation due to loss of integrity,severe neuronal damage,disorganized nerve fiber arrangement,and prominent inflammatory cell infiltration.The BBB score,IL-10 level,and p-PI3K/PI3K and p-AKT/AKT expression were decreased(t/P=23.859/＜0.001,13.739/＜0.001,13.418/＜0.001,13.191/＜0.001),while TNF-α and IL-6 levels,neuronal apoptosis rate,and expression of C-caspase-3,C-caspase-9,IBA-1,and GFAP were increased(t/P=14.325/＜0.001,14.820/＜0.001,18.653/＜0.001,13.191/＜0.001,12.269/＜0.001,13.168/＜0.001,14.795/＜0.001).Compared with the si-NC group,the si-C1QB group showed better structural and morphological repair of spinal cord tissue,with noticeable reduction in cavitation,relatively clear gray and white matter boundaries,orderly nerve fiber arrangement,and reduced inflam-matory cell infiltration.The BBB score,IL-10 level,and p-PI3K/PI3K and p-AKT/AKT expression were increased(t/P=21.430/＜0.001,11.692/＜0.001,11.393/＜0.001,13.182/＜0.001),while TNF-α and IL-6 levels,neuronal apoptosis rate,and ex-pression of C-caspase-3,C-caspase-9,IBA-1,and GFAP were decreased(t/P=11.889/＜0.001,12.385/＜0.001,3.846/0.003,12.187/＜0.001,9.242/＜0.001,12.050/＜0.001,11.900/＜0.001).Compared with the si-C1QB group,the si-C1QB+LY294002 group showed more severe spinal cord tissue damage.The BBB score,IL-10 level,and p-PI3K/PI3K and p-AKT/AKT expres-sion were decreased(t/P=14.543/＜0.001,9.647/＜0.001,10.735/＜0.001,12.187/＜0.001),while TNF-α and IL-6 levels,neuronal apoptosis rate,and expression of C-caspase-3,C-caspase-9,IBA-1,and GFAP were increased(t/P=10.708/＜0.001,10.678/＜0.001,3.149/0.010,10.694/＜0.001,8.832/＜0.001,10.681/＜0.001,10.614/＜0.001).Conclusion Silencing C1QB can promote neural repair in rats with spinal cord injury,which is associated with activation of the PI3K/AKT signaling pathway.

Abstract:Objective To explore the effects of three-dimensional digital subtraction angiography(3D-DSA)-guided neurointerventional thrombectomy on brachial-ankle pulse wave velocity(ba-PWV)and serum Netrin-1 in patients with ische-mic stroke(IS).Methods From September 2021 to November 2024,totally 180 patients with IS who received treatment in Department of Neurology,Jiangsu Province Hospital/The First Affiliated Hospital with Nanjing Medical University were served as the research subjects and assigned into two groups through the random number table method:thrombolysis group(intravenous thrombolysis)and thrombectomy group(intravenous thrombolysis+3D-DSA-guided neurointerventional throm-bectomy).The vascular recanalization rate,ba-PWV,neurological function,cerebral hemodynamics,serum indicators[neuron specific enolase(NSE),Netrin-1],and adverse reactions were compared.Results The vascular recanalization rate in the thrombectomy group was 94.44％,which was higher than the 83.33％in the thrombolysis group(x2/P=5.625/0.018).After treatment,the thrombectomy group had lower ba-PWV,neurological function score,peripheral resistance(Rv),and NSE(t/P=7.327/＜0.001,16.857/＜0.001,6.630/＜0.001,8.480/＜0.001),and higher Netrin-1 and mean cerebral blood flow(Qm)than the thrombolysis group(t/P=4.905/＜0.001,4.598/＜0.001).There was no prominent difference in adverse reactions between two groups(x2/P=0.669/0.414).Conclusion The 3D-DSA-guided neurointerventional thrombectomy can improve vascular reca-nalization rate,cerebral hemodynamics,reduce the risk of IS recurrence,upregulate Netrin-1 level,inhibit NSE expression,re-duce brain injury,and improve neurological function in patients with IS.

Abstract:Osteoporosis(OP)is a systemic bone disease characterized by decreased bonemineral density(BMD)and destruction of bone microarchitecture,which is prone to fracture and seriously affects patients' quality of life.Insulin-like growth factor-1(IGF-1)is a core factor in the regulation of bone metabolism,and its level is regulated by estrogen,growth hormone and other multifactors,which is closely related to the occurrence of primary(POP)and secondary osteoporosis(Sec-OP).Serum uric acid(UA),an endogenous antioxidant,protects BMD by inhibiting oxidative stress,but hyperuricemia may exacerbate bone loss through an inflammatory response.Currently,the relationship between UA and BMD remains controver-sial,and the mechanism of interaction between IGF-1 and UA has not been fully elucidated.This article reviews the association between IGF-1,UA and OP with a view to providing a theoretical basis for early diagnosis and targeted therapy.

Abstract:Objective To investigate the correlation of serum laminin(LN)and high molecular weight fibroblast growth factor-2(Hi-FGF-2)levels with the severity and prognosis of patients with chronic heart failure complicated with atrial fibrillation(CHF-AF).Methods A total of 235 patients with CHF-AF admitted to the Department of Cardiology of Inner Mongolia People's Hospital from January 2022 to June 2024 were prospectively enrolled as the CHF-AF group.According to NYHA cardiac function classification,patients were divided into class Ⅰ(n=43),class Ⅱ(n=57),class Ⅲ(n=61),and classⅣ(n=74).Based on 6-month prognosis,patients were categorized into poor prognosis subgroup(n=62)and good prognosis subgroup(n=173).Meanwhile,58 healthy volunteers undergoing physical examination during the same period were included as the control group.Serum LN and Hi-FGF-2 levels were measured by enzyme-linked immunosorbent assay.Spearman cor-relation analysis was used to evaluate the relationship between serum LN,Hi-FGF-2 levels and NYHA classification.Multiva-riate logistic regression was performed to identify risk factors for poor prognosis in CHF-AF patients.Receiver operating char-acteristic(ROC)curve analysis was conducted to assess the predictive value of serum LN and Hi-FGF-2 for poor prognosis.Results Serum LN and Hi-FGF-2 levels were significantly higher in the CHF-AF group than in the control group(t/P=26.273/＜0.001,17.252/＜0.001).Both LN and Hi-FGF-2 levels increased progressively with NYHA class(F/P=42.349/＜0.001,80.620/＜0.001)and were positively correlated with NYHA classification(rs/P=0.670/＜0.001,0.682/＜0.001).The 6-month poor prognosis rate in CHF-AF patients was 26.38％(62/235).The poor prognosis subgroup had higher serum LN and Hi-FGF-2 levels than the good prognosis subgroup(t/P=8.885/＜0.001,6.645/＜0.001).Multivariate logistic regression showed that NYHA class Ⅲ-Ⅳ,elevated NT-proBNP,higher LN,and higher Hi-FGF-2 were independent risk factors for poor prognosis[OR(95％CI)=2.173(1.034-4.568),1.001(1.000-1.001),1.038(1.024-1.053),1.049(1.031-1.067)].The AUCs of LN,Hi-FGF-2,and their combination in predicting poor prognosis were 0.809,0.801,and 0.911,respectively,with the combined model out-performing either marker alone(Z/P=3.803/＜0.001,4.300/＜0.001).Conclusion The levels of serum LN and Hi-FGF-2 in pa-tients with CHF-AF are increased,which are related to the aggravation of the disease and poor prognosis.The combination of the two has a higher predictive efficiency for prognosis.

Abstract:Objective To investigate the expression of protein S gene(PROS1)and proteasome 20S subunit alpha 2(PSMA2)in glioma tissues and their correlation with epithelial-mesenchymal transition(EMT)and prognostic significance.Methods A total of 102 patients with glioma diagnosed and treated in the Department of Neurosurgery,Xingtai Central Hos-pital from February 2020 to February 2022 were selected.Real-time quantitative PCR was used to detect the expression of PROS1 mRNA,PSMA2 mRNA,and EMT markers[Snail,epithelial cadherin(E-cad),neuronal cadherin(N-cad)]mRNA.Immunohistochemistry was performed to detect PROS1 and PSMA2 protein expression in tissues.Pearson correlation analysis was used to analyze the correlation between PROS1 mRNA,PSMA2 mRNA and EMT markers.The effects of PROS1 and PSMA2 on glioma prognosis were evaluated.Results Compared with adjacent tissues,glioma tissues showed higher expres-sion of PROS1 mRNA,PSMA2 mRNA,Snail mRNA,and N-cad mRNA,and lower expression of E-cad mRNA(t/P=31.199/＜0.001,31.146/＜0.001,24.632/＜0.001,31.892/＜0.001,19.886/＜0.001).PROS1 mRNA and PSMA2 mRNA in glioma tissues were positively correlated with Snail mRNA and N-cad mRNA,and negatively correlated with E-cad mRNA(r=0.665,0.702,0.714,-0.687,-0.734,all P＜0.001).The positive rates of PROS1 protein and PSMA2 protein in glioma tissues were 70.59％(72/102)and 68.63％(70/102),respectively,which were higher than those in adjacent tissues[4.90％(5/102)and 6.86％(7/102)](x2=93.645,82.797,P＜0.001).The positive rates of PROS1 and PSMA2 proteins were higher in gliomas with tumor diameter ≥3 cm and WHO grade Ⅲ-Ⅳ than in those with tumor diameter＜3 cm and WHO grade Ⅰ-Ⅱ(x2/P=13.512/＜0.001,8.525/0.004,7.913/0.005,8.824/0.003).The 3-year overall survival rates of PROS 1-positive and PSMA2-positive pa-tients[36.11％(26/72)and 34.29％(24/70)]were lower than those of PROS 1-negative and PSMA2-negative patients[66.67％(20/30)and 68.75％(22/32)],with statistically significant differences(Log-rank x2=8.530,11.670;P=0.004,0.001).PROS1 positivity,PSMA2 positivity,and WHO grade Ⅲ-Ⅳ were risk factors affecting the prognosis of glioma pa-tients[HR(95％CI)=1.605(1.157-2.226),1.454(1.077-1.962),1.789(1.184-2.706)].Conclusion The expression of PROS1 and PSMA2 is elevated in gliomas and correlated with EMT markers.Both molecules may serve as novel indicators for evaluating the prognosis of glioma patients.

Abstract:Objective To analyze the expression of ATPase family AAA domain containing 3A(ATAD3A)and OTU deubiquitinase 1(OTUD1)in cervical cancer tissues and their clinical prognostic value.Methods A total of 162 pa-tients with cervical cancer admitted to the Affiliated Hospital of Xuzhou Medical University from April 2020 to April 2021 were selected.The expression levels of ATAD3A mRNA and OTUD1 mRNA in cervical cancer tissues and adjacent normal tissues were analyzed using the TCGA database.ATAD3A and OTUD1 expression were detected by qPCR and immunohisto-chemistry.The chi-square test was used to compare the protein expression of ATAD3A and OTUD1 in cervical cancer patients with different clinical parameters.Kaplan-Meier curve and Cox regression analysis were used to analyze the prognosis of cer-vical cancer.Results Analysis of the TCGA database showed that the expression levels of ATAD3A mRNA(5.44±0.76 vs 4.16±0.27)and OTUD1 mRNA(5.81±0.57 vs 4.61±0.85)in cancer tissues were significantly higher than in normal tissues(t=27.762,20.511,all P＜0.001).The mRNA and protein expression levels of both ATAD3A and OTUD1 were significantly elevated in cervical cancer tissues(t/x2=24.739,152.254,all P＜0.001).The positive rates of ATAD3A and OTUD1 were high-er in cervical cancer tissues with FIGO stage ⅠB2-ⅡB and lymph node metastasis(x2=4.000,6.359,all P＜0.05).The 3-year progression-free survival rates in the ATAD3A-positive and OTUD1-positive groups were 67.39％(99/120)and 70.19％(105/126),respectively,which were significantly lower than the 89.29％(39/42)and 88.64％(33/36)in the negative groups(Log-rank x2=4.432,4.608,P=0.035,0.027).FIGO stage,lymph node metastasis,ATAD3A,and OTUD1 were identi-fied as independent prognostic factors for cervical cancer[HR(95％CI)=1.550(1.213-1.980),1.415(1.168-1.714),1.374(1.108-1.705),1.279(1.046-1.560)].Conclusion The expressions of ATAD3A and OTUD1 are increased in cervical cancer,which are associated with tumor progression and serve as prognostic factors for cervical cancer.

Abstract:Objective To investigate the relationship between human papillomavirus(HPV)16 E6/E7-mediated cir-cular RNA(circRNA)and the clinicopathological features of cervical cancer(CC).Methods Normal cervical HcerEpic cells were cultured and divided into a transfection group and a blank control group.HPV16 E6/E7 was introduced into the transfec-tion group,and RNA transcriptome sequencing combined with bioinformatics analysis was performed to identify differentially expressed circRNAs after confirming HPV16 E6/E7 overexpression.A total of 37 patients with cervical cancer who visited the People's Hospital of Xinjiang Uygur Autonomous Region from June 2021 to June 2024 were selected.The lesions and para-cancerous tissues of all patients were collected.RT-PCR was used to detect the levels of differential circRNAs,and their corre-lations with clinical and pathological data were analyzed.Results Based on protein-coding gene and transcript annotation in-formation from databases,5,584 circRNAs were identified in HcerEpic cells through positional alignment.After transfection with HPV16 E6/E7-overexpressing lentivirus,445 differentially expressed circRNAs were screened(296 upregulated and 149 downregulated,P＜0.05).GO functional analysis revealed that these circRNAs were significantly enriched in nucleocytoplasmic transport,protein localization to the nucleus,endoplasmic reticulum membrane,and proteasome processes.Pathway analysis identified 7 significantly enriched signaling pathways(P＜0.05).Three candidate circRNAs were ultimately selected:two upreg-ulated(hsa_circ_0052602 and hsa_circ_0051620)and one downregulated(hsa_circ_0038475).The expression levels of hsa_circ_0052602 and hsa_circ_0051620 in the HPV-16 positive cervical cancer group were significantly higher than those in pa-racancerous tissues.The expression level of hsa_circ_0038475 was significantly lower than that in paracancerous tissues(t/P=11.629/＜0.001,11.776/＜0.001,-8.709/＜0.001).Patients with FIGO stage Ⅲ,poorly differentiated tumors,or lymph node me-tastasis had significantly higher expression levels of hsa_circ_0052602 and hsa_circ_0051620 than those with FIGO stageⅠ-Ⅱ,moderately/well-differentiated tumors,or no lymph node metastasis(hsa_circ_0052602:t/P=-5.408/＜0.001,3.076/＜0.001,5.884/＜0.001;hsa_circ_0051620:t/P=-5.603/＜0.001,3.320/0.002,5.558/＜0.001).Conversely,the expression level of hsa_circ_0038475 was significantly lower in patients with FIGO stage Ⅲ,poorly differentiated tumors,or lymph node metas-tasis than in those with FIGO stage Ⅰ-Ⅱ,moderately/well-differentiated tumors,or no lymph node metastasis(t/P=2.792/0.008,-2.372/0.031,-2.895/0.006).hsa_circ_0052602 and hsa_circ_0051620 are independent risk factors for high FIGO stage[OR(95％CI)=3.636(1.296-10.201)、2.545(1.127-5.745)],poorly differentiated CC[OR(95％CI)=25.954(2.307-291.997)、8.271(1.583-43.221)]and lymph node metastasis[OR(95％CI)=12.159(2.413-61.275)、2.405(1.033-5.589)].Conversely,high expression of hsa_circ_0038475 was an independent protective factor against higher FIGO stage,poorly differentiated cervical cancer,and lymph node metastasis[OR(95％CI)=0.344(0.132-0.902)、0.063(0.005-0.739)、0.162(0.031-0.865)].Conclusion HPV16 E6/E7-mediated circRNAs(hsa_circ_0052602,hsa_circ_0051620,and hsa_circ_0038475)are significantly correlated with advanced FIGO stage and lymph node metastasis in CC patients.

Abstract:Objective To compare the diagnostic value of metagenomics next-generation sequencing(mNGS)in etio-logical detection of diabetes mellitus complicated with community-acquired pneumonia(CAP).Methods The clinical data of 134 patients with diabetes mellitus complicated with community-acquired pneumonia who treated at the Respiratory Center of the First Affiliated Hospital of Xinjiang Medical University from July 2021 to December 2024 were selected.All enrolled pa-tients received The conventional microbiological tests(CMTs)and mNGS,and the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV),pathogen distribution and the consistency of detection results of the two methods were compared.The diagnostic efficiency of the two methods for diabetes mellitus complicated with community-ac-quired pneumonia was compared.Results Among 134 patients with DM complicated with CAP,the detection sensitivity of mNGS examination for infectious pathogens(94.3％)was higher than that of CMTs(78.3％),and the difference was statisti-cally significant(x2=9.481,P=0.002).However,in terms of detection efficacy(0.775),specificity(60.7％),PPV(90.09％),and NPV(73.91％),there was no statistically significant difference compared with mNGS(P＞0.05).In terms of pathogen de-tection,the bacteria most frequently detected by mNGS were mycobacterium tuberculosis(19 cases).In terms of virus detec-tion,the most frequently detected virus was human herpes virus(66 cases).The incidence of mixed infection detected by mNGS in diabetes mellitus patients with community-acquired pneumonia was 51.49％(69/134),and the most common type of mixed infection was bacteria-virus infection.Conclusion NGS can improve the pathogen detection rate of diabetes melli-tus complicated with community-acquired pneumonia,effectively increase the detection efficiency of rare and special patho-gens,and provide reasonable suggestions for the formulation of anti-infection treatment.

Abstract:This article reports a clinical case of primary bilateral adrenal diffuse large B-cell lymphoma and provides a comprehensive literature review.

Abstract:Objective To investigate whether long non-coding RNA(LncRNA)mitochondrial RNA processing RNA endonuclease RNA component(RMRP)can inhibit lipopolysaccharide(LPS)-induced renal tubular epithelial cell injury by tar-geting the microRNA(miR)-580-3p/Ras homologous gene family member A(RhoA)axis.Methods The experiment was conducted in the Central Laboratory of Jiaozhou Central Hospital of Qingdao from May to October 2024.Normally cultured human renal tubular epithelial cells HK-2 were designated as the Control group.A cell injury model was established using LPS,and the cells were divided into the Model group,sh-NC group,sh-RMRP group,sh-RMRP+anti-NC group,and sh-RMRP+anti-miR-580-3p group according to different treatments.The expression levels of LncRNA RMRP,miR-580-3p,and RhoA mRNA were detected by quantitative real-time PCR(qRT-PCR).The regulatory relationships between LncRNA RMRP and miR-580-3p,and between miR-580-3p and RhoA were examined by dual-luciferase assay.Cell proliferation was assessed by Cell Counting Kit-8(CCK-8)assay.The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay(ELISA).Apoptosis was analyzed by flow cytometry.The protein expressions of RhoA,proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2),and Bcl-2 associated X protein(Bax)were detected by Western blot.Results Compared with the Control group,the Model group showed increased expression of LncRNA RMRP,RhoA mRNA and protein,apoptosis rate,IL-1β,IL-6,TNF-α,and Bax protein expression,while miR-580-3p expression,HK-2 cell survival rate,and PCNA and Bcl-2 protein expression decreased(P＜0.01).Compared with the Model group and sh-NC group,the sh-RMRP group exhibited decreased expression of LncRNA RMRP,RhoA mRNA and protein,apoptosis rate,IL-1β,IL-6,TNF-α,and Bax protein expression,while miR-580-3p expression,HK-2 cell survival rate,and PCNA and Bcl-2 protein expression increased(P＜0.01).Compared with the sh-RMRP group and sh-RMRP+anti-NC group,the sh-RMRP+anti-miR-580-3p group showed increased expression of LncRNA RMRP,RhoA mRNA and protein,apoptosis rate,IL-1β,IL-6,TNF-α,and Bax protein expression,while miR-580-3p expression,HK-2 cell survival rate,and PCNA and Bcl-2 protein expression decreased(P＜0.01).The dual-luciferase assay showed that,compared with the mimic-NC group,the luciferase activity in the miR-580-3p mimic group was decreased(P＜0.01).Conclusion Knockdown of LncRNA RMRP inhibits the LPS-induced inflammatory response and apoptosis in HK-2 cells by targeting the miR-580-3p/RhoA axis,thereby exerting a protective effect against renal tubular epithelial cell injury.

Abstract:Objective To investigate the expression of phosphoglycerate mutase 1(PGAM1)and arginine succinate synthase 1(ASS1)in hepatocellular carcinoma(HCC)tissues and explore their prognostic significance.Methods Tissue spec-imens and clinical data of 124 HCC patients treated in the Department of Hepatobiliary Pancreatic Hernia Surgery,Affiliated Hospital of Xuzhou Medical University from January 2020 to January 2022 were collected.The expression of PGAM1 and ASS1 proteins in HCC was detected by immunohistochemistry.The differential expression of PGAM1 and ASS1 proteins in cancer tissues of HCC patients with different clinical features was compared.Kaplan-Meier curve and Cox regression analysis were used to investigate the prognostic factors of HCC.Results The positivity rate of PGAM1 in HCC cancer tissues was higher than that in adjacent tissues(66.13％vs.8.06％),while the positivity rate of ASS1 was lower than that in adjacent tis-sues(33.06％vs.87.10％),with statistical significance(x2=89.579,75.471,P＜0.00l).The expression of PGAM1 and ASS1 proteins in HCC cancer tissues was negatively correlated(rs=-0.795,P＜0.001).The positivity rate of PGAM1 protein in cancer tissues was higher in CNLC stages Ⅱ-Ⅲ than in stage Ⅰ,and the positivity rate of ASS1 protein in cancer tissues with CNLC stages Ⅱ-Ⅲ was lower than in stage Ⅰ(x2/P=22.689/＜0.001,6.933/0.008).The overall 3-year survival rates of PGAM1 positive and negative groups were 43.90％(36/82)and 76.19％(32/42),respectively,with a statistically significant difference between the curves(Log-rank x2=13.440,P＜0.001).The overall 3-year survival rates of ASS1 positive and negative groups were 82.93％(34/41)and 41.98％(34/81),respectively,with statistically significant differences between the curves(Log-rank x2=19.280,P＜0.001).CNLC stage Ⅱ-Ⅲ and PGAM1 positivity were risk factors affecting the prognosis of HCC,while ASS1 positivity was a protective factor[HR(95％CI)=1.602(1.175-2.183),1.684(1.228-2.308),0.635(0.484-0.834)].Conclusion The upregulation of PGAM1 expression and downregulation of ASS1 expression in HCC are associated with CNLC staging and are potential tumor markers for evaluating the prognosis of HCC patients.

Abstract:Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine injection combined with conventional Western medicine for the treatment of prostate cancer patients and to provide evidence-based sup-port for clinical practice.Methods Chinese and English databases including CNKI,Wanfang,VIP,CBM,PubMed,and Co-chrane Library were searched electronically from inception to 2024.Randomized controlled trials(RCTs)and retrospective studies comparing TCM injection combined with Western medicine versus Western medicine alone were included.The Co-chrane Handbook 5.1.0 was used to assess the quality of the literature,and meta-analysis was performed using RevMan 5.4 software.Heterogeneity was evaluated using I2 statistics,with a fixed-effects model applied for low heterogeneity(I2≤50％)and a random-effects model for high heterogeneity(I2＞50％).Publication bias was assessed using funnel plots and Begg's test.Results A total of 20 RCTs and retrospective studies were included,comprising 1972 patients.Meta-analysis showed that:① The total response rate in the experimental group was significantly higher than that in the control group(MD=2.70,95％CI:2.06-3.54,P＜0.00 1);② KPS score:After treatment,the experimental group showed better improvement than the con-trol group(MD=2.21,95％CI:0.83-3.58,P=0.05),with no significant difference before treatment;③ PSA level:After treat-ment,the experimental group had significantly lower PSA levels than the control group(MD=-2.61,95％CI:-3.35--1.88,P＜0.001),with no significant difference before treatment;④ VAS score:Pain improvement in the experimental group was superi-or to that in the control group after treatment(MD=-1.02,95％CI:-1.65--0.39,P=0.001);⑤ Prostate volume:No significant difference was observed between the two groups.The overall incidence of adverse reactions in the experimental group was lower than that in the control group,though heterogeneity among studies was high(e.g.,hematuria,anemia,hot fla-shes).Conclusion Traditional Chinese medicine injection combined with conventional Western medicine can improve the total effective rate,quality of life,and PSA levels in prostate cancer patients,with favorable safety.However,due to study het-erogeneity and methodological limitations,more high-quality RCTs are needed to verify its long-term efficacy and mecha-nisms.

Abstract:Objective To investigate the clinical efficacy of preoperative short-course radiotherapy(SCRT)combined with anti-programmed death receptor-1(PD-1)monoclonal antibody in elderly patients with locally advanced rectal cancer.Methods A retrospective study was conducted on rectal cancer patients admitted to Minda Hospital Affiliated to Hubei Min-zu University from June 2021 to June 2024.After screening,80 patients were enrolled and divided into an observation group(n=40)and a control group(n=40).The observation group received SCRT(25 Gy/5 fractions over 5 days)combined with tirelizumab(200 mg intravenous infusion on day 1,repeated every 3 weeks for 2 cycles)followed by radical surgery.The con-trol group underwent radical surgery 8 to 12 weeks after SCRT alone.Perioperative indicators,disease remission rates,and postoperative complications were compared between the two groups.Results The positive rate of serum SDC2 decreased sig-nificantly after surgery in both groups compared to preoperative levels(P＜0.05).The observation group showed a significantly greater reduction in SDC2 expression than the control group(x2=5.59,P=0.018).Postoperative levels of CD3+,CD4+,and CD4+/CD8+decreased significantly in both groups(all P＜0.05),but these levels were significantly higher in the observation group than in the control group(P＜0.05).No significant differences were observed in operative duration,intraoperative blood loss,time to first flatus,time to first bowel movement,duration of abdominal drainage,or length of hospital stay(all P＞0.05).The objective response rate did not differ significantly between the observation and control groups(75.00％vs.62.50％,x2=1.455,P=0.228),but the disease control rate was significantly higher in the observation group(95.00％vs.77.50％,x2=5.165,P=0.023).Postoperative complication rates were comparable between the two groups(15.00％vs.17.50％,x2=0.092,P=0.762).Conclusion Preoperative SCRT combined with PD-1 monoclonal antibody can effectively improve disease control rates,reduce serum SDC2 positivity,and enhance immune function without compromising surgical safety in elderly patients with locally advanced rectal cancer.

Abstract:Objective To construct and validate a risk prediction model for disseminated intravascular coagulation(DIC)in sepsis patients based on neutrophil-to-platelet ratio(NPR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII).Methods A retrospective study was conducted on 353 sepsis patients admitted to the Infectious Disease and Liver Disease Center of the First Affiliated Hospital of Xinjiang Medical University from December 2022 to De-cember 2024.According to DIC occurrence,patients were divided into DIC group(n=58)and non-DIC group(n=295).Mult-ivariate logistic regression analysis was used to identify independent risk factors for DIC in sepsis patients,and a nomogram prediction model was constructed based on NPR,PLR,SII,and other significant factors.The model's predictive performance was evaluated using receiver operating characteristic(ROC)curve and area under the curve(AUC),while the calibration curve assessed model fit.Results Among 353 sepsis patients,58 developed DIC,with an incidence of 16.4％.Compared with the non-DIC group,the DIC group showed significantly higher values in:mean age,proportion with diabetes history,pulmonary infections,bloodstream infections,SOFA score,APACHE Ⅱ score,shock incidence,vasoactive drug use,mechanical ventila-tion rate,renal replacement therapy rate,NPR,SII,prothrombin time(PT),activated partial thromboplastin time(APTT),and D-dimer(D-D).Conversely,PLR and fibrinogen(FIB)were significantly lower in the DIC group(x2/t/P=2.367/0.018,4.173/0.041,4.062/0.044,4.053/0.044,2.412/0.016,2.757/0.006,4.109/0.043,4.538/0.033,4.04/0.044,4.304/0.038,4.735/＜0.001,-4.158/＜0.001,3.812/＜0.001,2.622/0.009,2.662/0.008,-3.696/＜0.001,3.221/0.001).Multivariate analysis identified older age,higher SOFA score,higher APACHE Ⅱ score,elevated NPR,elevated SII,and prolonged PT as independent risk factors for DIC,while higher PLR and FIB were protective factors[OR(95％CI)=1.091(1.013-1.175),3.807(1.616-8.967),1.183(1.050-1.333),4.680(2.080-6.092),0.980(0.969-0.991),1.001(1.000-1.003),1.050(1.008-1.094),0.501(0.301-0.833)].The ROC analysis showed an AUC of 0.821(95％CI:0.715-0.868)for DIC prediction.The calibration curve indica-ted good model fit(Hosmer-Lemeshow x2=6.400,P=0.603).Conclusion The age,SOFA score,APACHE Ⅱ score,NPR,PLR,SII,PT,and fibrinogen are associated with DIC in sepsis patients.The nomogram model incorporating NPR,PLR,SII,and other relevant indicators demonstrates high predictive value for DIC risk in sepsis patients.

Abstract:Objective To investigate the expression levels of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and dipeptidyl peptidase Ⅲ(DPP3)in patients with acute coronary syndrome(ACS)complicated with car-diogenic shock(CS)and their relationship with prognosis.Methods A total of 137 patients with ACS complicated with CS admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2021 to December 2024 were selected as the ACS-CS group.According to 28-day survival after admission,patients were divided into a survival subgroup(n=86)and a death subgroup(n=51).Additionally,137 patients with uncomplicated ACS during the same period were selected as the ACS group,and 137 healthy subjects were enrolled as the healthy control group.Serum sTREM-1 and DPP3 levels were measured by enzyme-linked immunosorbent assay.Spearman rank correlation was used to analyze the corre-lation between serum sTREM-1,DPP3 levels and CS severity.Cox proportional hazards regression was used to analyze factors influencing prognosis and death in ACS patients with CS.The receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum sTREM-1 and DPP3 levels for the risk of death in ACS patients with CS.Results Ser-um sTREM-1 and DPP3 levels in the ACS-CS group and ACS group were higher than those in the healthy control group,and levels in the ACS-CS group were higher than those in the ACS group(P＜0.05).Serum sTREM-1 and DPP3 levels in the typi-cal phase,deterioration phase,and end-stage phase were higher than those in the risk phase and initial phase,and levels in the deterioration and end-stage phases were higher than those in the typical phase(P＜0.05).Serum sTREM-1 and DPP3 were pos-itively correlated with disease severity(rs/P=0.516/0.001,0.559/0.001).Compared with the risk phase,the risk of death in-creased in patients in the typical phase,deterioration phase,and end-stage phase(HR=1.445,2.670,6.633,P＜0.05).Elevated LVEF was a protective factor against death(HR=0.875,P＜0.05),while elevated sTREM-1 and elevated DPP3 were independ-ent risk factors(HR=1.626,1.714,P＜0.05).The AUC values of serum sTREM-1,DPP3,and their combination in predicting the risk of death were 0.866,0.859,and 0.935,respectively.The combined predictive value was greater than that of either sin-gle indicator(Z/P=2.089/0.036,2.192/0.028).Conclusion Serum sTREM-1 and DPP3 expression is upregulated in patients with ACS complicated with CS and is closely related to CS severity and prognosis.Early combined detection may serve as a potential biomarker for assessing disease status and predicting prognosis.