Abstract:Objective To summarize the treatment experience for poor wound healing(skin flap necrosis and incision infection)following modified radical mastectomy for breast cancer.Methods A retrospective analysis was conducted on the clinical data of 9 patients who developed poor wound healing among 46 patients who underwent modified radical mastectomy at the Affiliated Hospital of Yanbian University from October 2023 to March 2024.Different treatment modalities were applied based on the type of wound healing impairment,and healing outcomes were observed.Results Among the 9 patients with poor wound healing,2 patients with complete flap necrosis and 3 patients with superficial flap necrosis achieved delayed healing,while 3 patients with partial flap necrosis and 1 patient with incision infection achieved normal healing.Their mean healing times were 84.00,64.33,42.00,and 32.00 days,respectively.Conclusions Timely identification of poorly healed wounds,combined with the use of topical agents and antibiotics,appropriate adjustment of drain removal timing,wound care location and frequency,and the rational application of debridement and functional exercises,can effectively promote the repair of poorly healing wounds after modified radical mastectomy for breast cancer.

Abstract:Invasive stratified mucin-producing carcinoma(ISMC)of the cervix is a rare pathological type of cervical adenocarcinoma.Due to its recent recognition and low incidence,clinicians have limited knowledge about it,leading to a high risk of missed diagnosis and misdiagnosis.In recent years,case reports on this rare cervical adenocarcinoma have gradually increased,and academic understanding,particularly of its pathological features,has deepened.However,research on its clinical manifestations,diagnosis and treatment remains scarce.This article reviews the research progress regarding the etiology,risk factors,histopathological features,clinical symptoms,diagnosis and differential diagnosis,treatment,prognosis and influencing factors of cervical ISMC,aiming to provide a reference for its clinical diagnosis and treatment.

Abstract:Objective To explore the relationship between serum levels of nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3(NLRP3)and interleukin-1β(IL-1β)and disease severity and prognosis in patients with acute respiratory distress syndrome(ARDS).Methods A total of 102 cases diagnosed with ARDS from January 2024 to February 2025 were prospectively selected(study group)and divided into mild group(n=43),moderate group(n=31),and severe group(n=28).Based on prognosis,they were further divided into a survival group(n=80)and a non-survival group(n=22).Additionally.112 age-matched healthy individuals during the same period were selected as the control group.Serum levels of NLRP3 and IL-1β were compared between the study group and the control group,among ARDS patients with different severity levels,and between the survival and non-survival groups.Spearman correlation analysis was used to assess the relationship between serum NLRP3/IL-1β levels and disease severity in ARDS patients.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic value of serum NLRP3 and IL-1β for poor prognosis in ARDS patients.Univariate analysis and multivariate stepwise logistic regression analysis were employed to identify factors influencing poor prognosis in ARDS patients.Results Serum levels of NLRP3 and IL-1β were significantly higher in the study group than in the control group(t=30.938,54.966,respectively,P<0.001).Both serum NLRP3 and IL-1β levels exhibited a stepwise increase with worsening ARDS severity(F=54.940 and 189.672,respectively,P<0.001).Spearman correlation analysis showed that the levels of serum NLRP3 and IL-1β in patients with ARDS were positively correlated with the disease severity(r=0.423,0.536,P<0.001).Serum levels of NLRP3 and IL-1β were significantly lower in the survival group than in the non-survival group(t=20.733 and 29.276,respectively,P<0.001).The areas under the curve(AUC)for predicting poor prognosis in ARDS patients were 0.863(95%CI:0.816-0.916)for serum NLRP3,0.736(95%CI:0.676-0.798)for IL-1β,and 0.913(95%CI:0.863-0.963)for their combination.Multivariate logistic regression analysis identified NLRP3≥8.71 pg/mL(OR=3.766,95%CI:2.381-5.957),IL-1β≥32.78 pg/mL(OR=3.340,95%CI:2.460-4.535),and APACHE Ⅱ score≥20(OR=2.620,95%CI:1.760-3.900)as risk factors for poor prognosis in ARDS patients(P<0.001).Conclusions Serum levels of NLRP3 and IL-1β are significantly elevated in ARDS patients,correlate positively with disease severity,and the combined detection demonstrates high predictive value for prognosis.

Abstract:Objective To investigate the pathogen spectrum of community-acquired pneumonia(CAP)in children and provide a basis for clinical diagnosis,treatment,and prevention.Methods A total of 1,101 children hospitalized with CAP in the Department of Pediatrics of Tianjin People's Hospital from January to December 2024 were retrospectively selected.They were categorized by age into:<1 year group(n=34),1～<3 years group(n=96),3～<6 years group(n=227),and 6～14 years group(n=744);and by season into:spring group(n=156),summer group(n=269),autumn group(n=323),and winter group(n=353).Nasopharyngeal swabs and sputum samples were collected,and a multiplex nucleic acid detection kit for respiratory pathogens was used to detect 11 common respiratory pathogens.The analysis included the detection rates of respiratory pathogens by gender,age,and season;overall pathogen detection;distribution of detected pathogen strains;detection of different pathogens across age groups;and seasonal detection patterns of various pathogens.Results The overall pathogen positive rate among the 1,101 children was 89.56%(986/1,101).No statistically significant difference in pathogen positive rate was observed between different genders(χ2=3.759,P=0.053).However,significant differences were found across different age groups(χ2=7.927,P=0.048)and seasonal groups(χ2=9.127,P=0.028).The highest positive rates were in the 6-14 years age group(90.86%,676/744)and the winter group(92.92%,328/353).A total of 2,112 pathogenic strains were detected.Single pathogen infections accounted for 13.02%(275/2,112),while co-infections with multiple pathogens accounted for 86.98%(1,837/2,112).The top three detected pathogens were Streptococcus pneumoniae(SP,34.75%,734/2,112),Haemophilus influenzae(Hi,26.09%,551/2,112),and Mycoplasma pneumoniae(MP,22.21%,469/2,112).The distribution of the main pathogens(SP,Hi,MP)differed significantly across age groups(SP:χ2=15.235,P=0.002;Hi:χ2=17.143,P=0.001;MP:χ2=52.176,P<0.001).Significant seasonal variations were also observed for MP(χ2=20.469,P<0.001)and Hi(χ2=12.328,P=0.006),but not for SP(χ2=2.639,P=0.451).Conclusions Among hospitalized children with CAP,bacteria(SP and Hi)are the main pathogens,distributed in all age groups.MP infection is mainly in school-aged children,showing a trend of younger age,with a small peak in winter.Most cases of CAP in children are co-infections.It is recommended to conduct multi-pathogen nucleic acid testing as early as possible,especially in winter.When conducting initial empirical treatment,it is necessary to rationally select medications based on the pathogen spectrum characteristics of children in different age groups and the possible co-infected pathogens.

Abstract:Objective To explore the clinical efficacy and safety of the combined use of Qingfei Pingchuan Decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with phlegm-heat obstructing the lung.Methods Retrospective selection of 50 AECOPD patients admitted to the Department of Pulmonary Disease at Taizhou Traditional Chinese Medicine Hospital from October 2022 to October 2023,who were treated with Qingfei Pingchuan Decoction in addition to conventional Western medicine treatment(combination treatment group).A 1:1 matching design was used to retrospectively screen 50 AECOPD patients who only received conventional Western medicine treatment(control group)based on core disease variables and basic variables.Both groups received continuous treatment for 10 days.The traditional Chinese medicine(TCM)syndrome scores,pulmonary function indexes,inflammatory response indexes,clinical efficacy and incidence of adverse reactions were compared between the two groups before and after treatment.Results After 10 days of treatment,the total TCM syndrome score,cough score,and wheezing score of the combined treatment group were lower than those of the control group,with statistically significant differences[(7.16±4.39)vs.(9.44±5.27),(1.00±1.16)vs.(1.92±1.66),and(0.92±1.16)vs.(1.56±1.42),respectively;t=2.351,3.207,2.474,P<0.05].After 10 days of treatment,the forced expiratory volume in 1 second(FEV1)of the combined treatment group was higher than that of the control group,and the difference was statistically significant[(60.74±8.34)L vs.(55.36±8.26)L;t=-3.240,P<0.05].After 5 days of treatment,the C-reactive protein(CRP)level of the combined treatment group was higher than that of the control group(39.52±15.91)mg/L vs.(32.54±10.57)mg/L;t=-2.584,P<0.05].After 10 days of treatment,the levels of white blood cells(WBC)count and CRP in the combined treatment group[(8.51±2.31)×109/L and(16.56±9.13)mg/L]were higher than those in the control group[(7.26±2.04)×109/L and(13.46±5.56)mg/L;t=-2.860 and-2.051,respectively,P<0.05].The total response rate of the combined treatment group was 98.0%(49/50),which was higher than 84.0%(42/50)in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Integrated therapy with Qingfei Pingchuan Decoction significantly enhances clinical efficacy and improves pulmonary function in patients with AECOPD presenting with the phlegm-heat obstructing the lung pattern,demonstrating a favorable safety profile.

Abstract:Objective To analyze the clinical characteristics and factors influencing short-term prognosis in elderly patients with infective endocarditis(IE)at a tertiary hospital in Zhumadian.Methods A total of 92 patients with IE who were admitted to Zhumadian Central Hospital from January 2020 to August 2024 were retrospectively selected.All patients were followed up for 6 months after completing treatment.Based on the prognosis,they were divided into the poor prognosis group(experiencing death,IE recurrence,recurrent embolism,heart failure,etc.n=32)and the good prognosis group(no adverse events mentioned above,n=60).General clinical data,clinical characteristics,and pathogen distribution were compared between the two groups.Multivariate logistic regression was used to analyze factors influencing short-term prognosis in IE patients.Results Symptoms of the 92 elderly patients with IE was dominated by fever,accounting for 97.83％(90/92),followed by palpitation 40.22％(37/92),chest distress 28.26％(26/92),and fatigue 15.22％(14/92).A total of 55 patients(59.78％)had underlying cardiac comditions,including congenital heart disease(27/92,29.35％),rheumatic heart disease(15/92,16.30％),and history of cardiac surgery or interventional therapy(13/92,14.13％).Blood cultures were positive in 74 patients(82.61％),with Gram-positive bacteria identified in 56 cases(75.68％)and Gram-negative bacteria in 18 cases(24.32％).Compared to the good prognosis group,the poor prognosis group had significantly higher proportions of elevated neutrophil count,elevated white blood cell count,patients with NYHA(New York Heart Association)class Ⅳ heart function,patients with in-hospital complications,patients with serum albumin<30 g/L,and patients with hemoglobin<90 g/L.The proportion of patients who underwent valve replacement or valve repair was significantly lower in the poor prognosis group(P<0.05).Multivariate logistic regression analysis identified NYHA class Ⅳ heart function(OR=3.271,95％CI:1.578-6.781,P=0.002)and high neutrophil count(OR=1.219,95％CI:1.073-1.385,P=0.002)as independent risk factors for short-term prognosis in elderly IE patients.Conversely,receiving valve replacement or valve repair(OR=0.223,95％CI:0.102-0.486,P<0.001)and high hemoglobin levels(OR=0.196,95％CI:0.088-0.436,P<0.001)were identified as independent protective factors.Conclusions Elderly IE patients present with diverse clinical symptoms.Key factors influencing short-term prognosis include NYHA functional class,valve replacement or valve repair,and levels of hemoglobin and neutrophils.Close clinical monitoring of these indicators is recommended.

Abstract:In recent years,negative pressure wound therapy(NPWT)has been widely used for various acute and chronic wounds.However,during treatment,moisture-associated skin damage(MASD)around the wound often causes discomfort to patients and adversely affects wound healing outcomes.Preventing MASD is therefore a key aspect of successful NPWT management.This paper summarizes the main causes of MASD during NPWT,including the therapy mode and instillation treatment,the influence of negative pressure levels on exudate management,and patient-related factors such as obesity and excessive sweating.Furthermore,strategies to prevent MASD are discussed,including protecting the surrounding skin,preventing skin breakdown,providing moisture barriers,and absorbing exudate to avoid skin maceration.These insights aim to provide a reference for clinical practice.

Abstract:The Eagle effect refers to the phenomenon where some bacteria exhibit enhanced proliferation,rather than inhibition,under high concentrations of antibiotics.This finding challenges the traditional linear perception of the relationship between antibiotic dosage and bacteriostatic efficacy,revealing a complex non-linear correlation between antimicrobial concentration and microbial inhibition.The Eagle effect is crucial for a deeper understanding of bacterial resistance mechanisms and their transmission pathways,and it also highlights the diversity of bacterial responses to antibiotics and their regulation by environmental factors.Although this phenomenon has been recognized for decades,relevant research remains relatively limited.This review systematically summarizes the biological basis,clinical implications,and detection technologies associated with the Eagle effect,aiming to provide insights for optimizing antibiotic usage strategies and addressing the increasingly serious challenge of antimicrobial resistance.

Abstract:An iatrogenic sinus tract refers to an abnormal connecting channel formed as a result of medical procedures,which bring serious pain to patients and increase the consumption of medical resources.Its occurrence is closely related to iatrogenic injuries such as surgical trauma,infection,and tissue necrosis.Clinical manifestations primarily include leakage and local infection.High-resolution imaging examinations,including computed tomography(CT)and magnetic resonance imaging(MRI),can clarify the diagnosis.Treatment methods include conservative treatment,surgical intervention,and minimally invasive therapies.The current trend involves using minimally invasive approaches,such as the injection of biomaterials,to promote healing,which achieves a high success rate with minimal trauma.Common complications include infection and poor wound healing.The key to preventing iatrogenic sinus tract is to avoid iatrogenic injury and pay attention to drainage and anti-infection measures after injury.Future research directions include in-depth studies on the pathogenesis,development of novel filler materials,and improving the efficacy of minimally invasive treatments.

Abstract:Objective To explore the predictive value of C-reactive protein-triglyceride-glucose index(CTI)for the pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET)in infertile patients with polycystic ovary syndrome(PCOS).Methods A total of 120 infertile PCOS patients who underwent IVF-ET at Quanzhou Maternal and Child Health Hospital from March 2022 to October 2024 were and divided into pregnancy group(n=58)and non pregnancy group(n=62)according to the pregnancy outcome.The level of C-reactive protein(CRP)was detected by fluorescence immunochromatography.Fasting plasma glucose(FPG)and triglyceride(TG)levels were measured,and triglyceride glucose product(TyG)index and CTI were calculated.The levels of serum CRP,TyG and CTI were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of IVF-ET assisted pregnancy outcomes in PCOS infertility patients.The receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of CTI on pregnancy outcome.Results The serum CRP,TyG index,CTI,body mass index,triglyceride and testosterone levels in the non-pregnancy group were higher than those in the pregnancy group(P<0.05).Multivariate logistic regression analysis showed that testosterone(OR=2.843,95%CI:1.620-4.990,P<0.001),TyG index(OR=2.776,95%CI:1.384-5.567,P=0.004)and CTI(OR=10.216,95%CI:4.433-23.546,P<0.001)were independent risk factors for the outcome of IVF-ET in infertile PCOS patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of CTI in predicting the outcome of IVF-ET was 0.902,which was significantly superior to the AUCs for testosterone alone(0.837)and the TyG index alone(0.792)(Z=8.762 and 9.595,respectively,P<0.001).Conclusions The CTI is closely associated with IVF-ET outcomes in infertile PCOS patients and demonstrates high predictive efficacy,indicating its potential utility as a biomarker for assessing IVF-ET prognosis in this population.

Abstract:Acute pancreatitis is a common disorder of the digestive system,and its diagnosis and treatment still face numerous challenges.The emergence of radiomics signifies the deep integration of medical image processing and data analysis technologies.Leveraging high-throughput feature extraction and big data analysis techniques,radiomics unveils latent biological and pathological information,demonstrating tremendous potential in the diagnosis,staging,prognostic assessment,and therapeutic monitoring of acute pancreatitis.This review summarizes the applications and advances of radiomics in the diagnosis and treatment of pancreatic diseases,encompassing its use for predicting disease severity,complications,recurrence,and extrapancreatic necrosis in acute pancreatitis.

Abstract:Objective To explore the relationship between systemic immune-inflammation index(SII)and post-stroke infection as well as prognosis in patients with acute cerebral infarction(ACI).Methods A total of 150 patients with ACI admitted to Xinyang Central Hospital from July 2023 to October 2024 were retrospectively selected.According to the prognosis,they were divided into a poor prognosis group(n=42)and a good prognosis group(n=108).According to the occurrence of infection,they were further classified into an infection group(n=46)and a non-infection group(n=104).General clinical data and SII levels were compared between the two groups.Univariate analysis and binary logistic regression analysis models were used to screen for prognostic influencing factors.The performance of SII in predicting infection and prognosis was evaluated using receiver operating characteristic(ROC)curve analysis.Results Among the 150 ACI patients,46 developed infections,resulting in an incidence rate of 30.67%.The SII was higher in patients with infection[(703.56±182.14)×109/L]than in those without infection[(395.27±106.91)×109/L;t=12.962,P<0.05].Similarly,the SII was significantly higher in the poor prognosis group[(735.15±196.37)×109/L]compared to the good prognosis group[(394.63±104.16)×109/L;t=13.758,P<0.05].Compared to the good prognosis group,the poor prognosis group had significantly higher age(t=2.835),National Institutes of Health Stroke Scale(NIHSS)scores(t=10.164),and a higher proportion of patients with infection(χ2=9.907,P<0.05).Binary logistic regression analysis indentified NIHSS score(OR=1.408,95%CI:1.102-1.799),infection(OR=9.440,95%CI:2.171-41.059),and SII(OR=1.047,95%CI:1.015-1.080)as independent risk factors for poor prognosis in ACI patients(P<0.001).ROC curve analysis showed that the area under the curve(AUC)for SII in predicting post-ACI infection was 0.895(95%CI:0.934-0.939),with an optimal cutoff value of 538.46×109/L,yielding a sensitivity of 76.09%and a specificity of 91.35%.The AUC for SII in predicting poor prognosis after ACI was 0.980(95%CI:0.942-0.996),with an optimal cutoff value of 554.20×109/L,yielding a sensitivity of 88.10%and a specificity of 97.22%.Conclusions Patients with post-ACI infection or poor prognosis exhibit elevated SII.The SII demonstrates considerable predictive value for both post-stroke infection and prognosis in ACI patients.

Abstract:Objective To analyze the clinical characteristics and medication patterns in patients with terminal-stage cancer cachexia complicated by pulmonary infection.Methods A retrospective study was conducted on 106 patients with terminal-stage cancer cachexia admitted to the First Medical Center of the Chinese People's Liberation Army General Hospital from January 2009 to May 2025.Based on the presence of pulmonary infection,they were divided into an infection group(n=44)and a control group(n=62).Comparative analysis was performed on various clinical parameters,including causative pathogens,antimicrobial agents used,primary tumor site,nutritional risk assessment at admission,serum white blood cell count,neutrophil percentage(NEUT%),and serum C-reactive protein(CRP)levels.Results The top three most frequently identified pathogens in sputum from the infection group were Enterobacter spp.(33.33%,8/24),Acinetobacter spp.(25.00%,6/24),and Pseudomonas spp.(16.67%,4/24).The top three most commonly used antimicrobial agents in this group were cefoperazone-sulbactam(38.64%,17/44),meropenem(27.27%,12/44),and levofloxacin sodium chloride(25.00%,11/44).The proportion of patients with a primary lung tumor site in the infection group(27.27%,12/44)was significantly higher than that in the control group(8.06%,5/62,χ2=7.052,P<0.01).While no statistically significant difference was observed in the proportion of patients with nutritional risk at admission between the two groups(P>0.05),a trend toward a higher prevalence was observed in the infection group.No significant differences were found in white blood cell count,NEUT%,or CRP levels between the two groups(P>0.05).Conclusions Terminal-stage cancer cachexia patients with a primary lung tumor have a significantly higher probability of developing pulmonary infection.There is also a trend suggesting an increased probability of pulmonary infection in those with nutritional risk at admission.However,elevated serum infection indicators alone are not sufficient to confirm a localized pulmonary infection.

Abstract:Objective To explore the relationship between the expression of calcium-activated nucleotidase 1(CANT1)and protamine 1(PRM1)in tumor tissues and the clinicopathological characteristics and prognosis of patients with esophageal carcinoma.Methods A total of 198 patients with esophageal carcinoma admitted to the First Affiliated Hospital of Nanyang Medical College from January 2021 to January 2022 were selected.The expression levels of CANT1 and PRM1 were measured in both cancerous and adjacent tissues.The relationship between expressions of CANT1 and PRM1 in tumor tissues and the clinicopathological parameters of esophageal carcinoma was analyzed.Patients were followed up for 3 years.Based on their prognosis,they were grouped,and differences in CANT1 and PRM1 expression in tumor tissues were compared.The relationship between their expression and patient prognosis was further analyzed.Results The proportions of patients with positive CANT1 and PRM1 expression in esophageal carcinoma tissues[64.14%(127/198)and 93.43%(185/198),respectively]was significantly higher than that in adjacent normal tissues[17.17%(34/198)and 60.61%(120/198),respectively;χ2=90.525 and 60.281,P<0.001].A higher proportions of positive CANT1 and PRM1 expression in tumor tissues was observed in patients with poorly differentiated tumors,clinical stage Ⅲ-Ⅳ disease,lymph node metastasis,tumor length≥5 cm,and T3-T4 invasion depth(CANT1:χ2=67.336,90.349,43.150,10.358,53.098;PRM1:χ2=10.715,7.231,7.785,6.865,7.272;P<0.01).During the 3-year follow-up,4 patients were lost,leaving 194 patients for analysis.Kaplan-Meier survival curve analysis revealed that the median survival time was 25.20 months for the 126 patients with CANT1 positive tumors,compared to 32.40 months for the 68 patients with CANT1-negative tumors.The cumulative survival rate was significantly lower in CANT1-positive patients than in CANT1-negative patients(Log-rank χ2=15.582,P=0.001).For PRM1,the median survival time was 21.60 months for the 181 patients with positive expression and 26.70 months for the 13 patients with negative expression.However,no statistically significant difference in cumulative survival rate was found between PRM1-positive and PRM1-negative patients(Log-rank χ2=2.975,P=0.085).Conclusions Positive expression of CANT1 and PRM1 is relatively common in esophageal carcinoma tissues and is associated with pathological grade,clinical stage,lymph node metastasis,tumor length,and depth of invasion.Furthermore,positive CANT1 expression is linked to a poorer prognosis in these patients.

Abstract:Endoscopic retrograde cholangiopancreatography(ERCP)is one of the most common and effective clinical methods for diagnosing and treating biliary and pancreatic diseases.However,post-ERCP pancreatitis(PEP),one of the most frequent complications of ERCP,has significantly impacted the prognosis of patients.Research on preventing PEP is crucial for enhancing the safety and applicability of ERCP.This article comprehensively reviews current approaches to PEP prevention,including pharmacological,procedural,and combined interventions.Pharmacological strategies include agents such as non-steroidal anti-inflammatory drugs(NSAID),nitroglycerin,protease inhibitors,and pancreatic enzyme secretion inhibitor.Procedural prevention primarily encompasses techniques such as endoscopic nasobiliary drainage(ENBD)and pancreatic duct stenting.The combined application of different preventive methods for multi-target intervention can enhance prophylactic efficacy.Further exploration of optimal prevention strategies for different patient populations is still required in the future.

Abstract:Objective To investigate the prevalence of asymptomatic patellar tendinopathy(APT)and explore its potential influencing factors among young males in a specific population.Methods From June to November 2021,1,330 young males(exercise intensity grade 4-8)underwent ultrasonographic examination of the patellar tendon.The prevalence of asymptomatic patellar tendinopathy was calculated,and comparisons were made between the APT group and the normal control group(those without ultrasonographic evidence of APT).Results The 1,330 participants,aged 18 to 30 years(mean 22.7±0.6),included 157 individuals(11.80%)diagnosed with asymptomatic patellar tendinopathy via ultrasonography.No statistically significant differences were observed between the APT group and the normal control group regarding age or body mass index(χ2=0.00 and 1.17,respectively;P>0.05).However,daily exercise intensity was significantly higher in the APT group[Grade 4:16 cases(10.2%);Grade 6:112 cases(71.3%);Grade 8:29 cases(18.5%)]compared to the normal control group[Grade 4:301 cases(25.7%);Grade 6:827 cases(70.5%);Grade 8:45 cases(3.8%);χ2=21.76,P<0.05].Conclusions The prevalence of asymptomatic patellar tendinopathy is relatively high among young male with moderate to vigorous excercise intensity.Affected individuals typically engage in higher levels of physical activity,underscoring the importance of promoting scientifically-grounded excercise regimens in daily practice.

Abstract:Objective To analyze the positive role of multi-sequence MRI combined with ABCD3 score in evaluating the risk of secondary cerebral infarction within 7 days after transient ischemic attack(TIA).Methods A total of 125 TIA patients admitted to Zhengzhou Hospital of Traditional Chinese Medicine from July 2021 to June 2024 were selected.The incidence of secondary cerebral infarction within 7 days was recorded,and patients were divided into a cerebral infarction group(15 cases)and a non-cerebral infarction group(110 cases).General clinical data,ABCD3 scores,and multi-sequence MRI findings were compared between the two groups.Multivariate logistic regression was used to identify risk factors for secondary cerebral infarction within 7 days post-TIA.The predictive value for cerebral infarction risk was assessed for the ABCD3 score alone and for the ABCD3 score combined with multi-sequence MRI(in series).Results Among the 125 TIA patients,the incidence of secondary cerebral infarction within 7 days was 12.00%(15/125).The cerebral infarction group showed significantly higher values than the non-cerebral infarction group in the following aspects:ABCD3 score(6.89±1.57 vs.4.50±1.03,t=7.859),the proportion of ipsilateral cerebrovascular stenosis(≥50%)[86.67%(13/15)vs.0%(0/110),χ2=107.469],the proportion of any vascular stenosis(≥50%)[86.67%(13/15)vs.3.64%(4/110),χ2=76.507],and the proportion of tortuous+stenotic vascular morphology[86.67%(13/15)vs.9.09%(10/110),χ2=52.907].All these differences were statistically significant(P<0.001).Multivariate logistic regression analysis identified ABCD3 score(OR=1.688,95%CI:1.192-2.387)the degree of ipsilateral cerebrovascular stenosis(OR=3.364,95%CI:1.350-6.105),any vascular stenosis(≥50%)(OR=2.875,95%CI:1.298-6.367),and cerebrovascular morphology(OR=2.573,95%CI:1.230-5.359)as independent risk factors for secondary cerebral infarction within 7 days after TIA(P<0.05).The sensitivity,specificity,accuracy,positive predictive value(PPV),and negative predictive value(NPV)of multi-sequence MRI combined with ABCD3 score for predicting secondary cerebral infarction within 7 days were 86.67%,90.91%,90.40%,56.52%and 98.04%,respectively.In contrast,the corresponding values for the ABCD3 score alone were 66.67%,81.82%,80.00%,33.33%,and 94.97%.The predictive performance of the combined approach was superior to that of the ABCD3 score alone.Conclusions Compared to using the ABCD3 score alone for predicting the risk of cerebral infarction within 7 days after TIA,incorporating multi-sequence MRI into the assessment significantly enhances predictive sensitivity,specificity,and accuracy.This integrated approach provides a more precise risk assessment tool for secondary infarction in TIA patients in clinical practice.

Abstract:Objective To explore the relationship between serum fructosamine(FA)and proprotein convertase subtilisin/kexin type 9(PCSK9)levels in subclinical hypothyroidism(SCH)patients during pregnancy and thyroid function and pregnancy outcomes.Methods From March 2022 to March 2023,65 pregnant women with SCH admitted to Kaifeng People's Hospital were retrospectively collected as the observation group,and 65 healthy pregnant women who underwent pregnancy tests were collected as the control group.Compare the differences in FA and PCSK9 levels between the two groups,analyze the correlation between serum FA and PCSK9 levels and related indicators of thyroid function,blood lipid and blood glucose,and to determine the correlation between FA and PCSK9 levels and different pregnancy outcomes in SCH patients.The differences in FA and PCSK9 levels between the two groups were compared,the correlations between serum FA and PCSK9 levels and thyroid function-related indicators,blood lipids and blood glucose were analyzed,the relationship between FA and PCSK9 levels and different pregnancy outcomes in SCH patients were determined,multivariate Logistic regression analysis was used to analyze whether FA and PCSK9 were independent risk factors with predictive value for the pregnancy outcomes of pregnant SCH patients,and draw the receiver operating characteristic curve to evaluate their predictive value.Pearson correlation analysis was performed to assess the associations of FA and PCSK9 levels with fasting plasma glucose(FPG),lipid profiles,and thyroid-stimulating hormone(TSH).Results Compared with the control group,the serum levels of FA,PCSK9,TSH,FPG,low density lipoprotein cholesterol(LDL-C),triglyceride(TG)and total cholesterol(TC)in the observation group were higher(P<0.001).The proportion of adverse pregnancy outcomes in the observation group was higher(23.08%vs 4.61%;χ2=9.286,P<0.05).The levels of FA and PCSK9 in the poor pregnancy group were higher than those in the good pregnancy group(in SCH patients during pregnancy[FA:C 194.92±21.04)mmol/L vs.(174.38±19.92)mmol/L,t=3.458,P<0.01;PCSK9:(110.96±13.39)μg/L vs.(90.60±12.44)μg/L,t=5.464,P<0.01].Serum FA and PCKS9 levels of SCH patients in the observation group were positively correlated with TSH,FBG,LDL-C,TG and TC,respectively(FA:r=0.514,0.389,0.449,0.612,0.481;PCSK:r=0.437,0.319,0.501,0.571,0.514;P<0.001).Mutivariate Logistic regression analysis showed that high levels of FA and PCSK9 were risk factors for adverse pregnancy outcomes in SCH patients(P<0.001).The ROC curve showed that the area under the curve(AUC)of serum FA and PCSK9 combined in predicting pregnancy outcome of SCH patients during pregnancy was 0.844,with a sensitivity of 93.33%and a specificity of 76.00%,the AUC of the combined prediction of FA and PCSK9 of pregnancy outcome was obviously greater than that of FA and PCSK9 alone(P<0.001).Conclusions Serum FA and PCSK9 levels increase in SCH patients during pregnancy,and are closely related to thyroid function and adverse pregnancy outcomes.

Abstract:Androgenetic alopecia(AGA)is a common hereditary hair loss condition,particularly prevalent among males.Despite the availability of numerous treatment options,the complexity of AGA's etiology makes its treatment challenging.This article reviews various therapeutic approaches for AGA,including surgical methods such as follicular unit transplantation and organoid grafting,as well as non-surgical treatments like pharmacotherapy,injections,laser therapy,and physical therapy.The clinical efficacy,advantages,and disadvantages of these methods are analyzed to identify efficient,cost-effective,and minimally adverse treatment solutions.

Abstract:Objective To observe the levels of peripheral blood monocyte chemoattractant protein-1(MCP-1)and nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3(NLRP3)mRNA in pulmonary tuberculosis(PTB)patients and analyze their relationship with patient prognosis.Methods Seventy-one patients with active pulmonary tuberculosis and 31 patients with inactive pulmonary tuberculosis were selected from Lanzhou Pulmonary Hospital from January 2021 to January 2024.The general clinical data of patients and prognosis status at 2 months after treatment were collected.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect peripheral blood MCP-1 mRNA and NLRP3 mRNA levels.These levels were compared among patients with different disease severities,in active PTB patients before and after treatment,and among patients with different prognoses.The correlation between MCP-1/NLRP3 mRNA levels and PTB severity,as well as their predictive value for PTB prognosis,were analyzed.Results The mRNA expression levels of MCP-1 and NLRP3 in peripheral blood were significantly higher in active PTB patients compared to inactive PTB patients(MCP-1 mRNA:1.90±0.60 vs.1.22±0.15,t=8.932,P<0.001;NLRP3 mRNA:3.01±0.98 vs.1.28±0.21,t=9.706,P<0.001).Levels were significantly higher in severe active PTB patients compared to mild-moderate active PTB patients[MCP-1 mRNA:2.77±0.46 vs.1.69±0.40,t=8.788,P<0.001;NLRP3 mRNA:4.34±1.06 vs.2.99±0.60,t=4.588,P<0.001).and the expression levels of these two indicators were positively correlated with severity of PTB(MCP-1 mRNA:r=0.625,NLRP3:r=0.569,P<0.05).The expression levels of peripheral blood MCP-1 mRNA and NLRP3 mRNA in patients with active PTB were downregulated after treatment compared to before treatment(MCP-1 mRNA:1.52±0.53 vs.1.90±0.60,t=5.667,P<0.001;NLRP3 mRNA:1.55±0.48 vs.3.26±0.89,t=21.034,P<0.001).At 2 months after treatment,47 patients with active PTB had good prognosis and 24 patients had poor prognosis.Compared with patients with good prognosis,the mRNA expression levels of MCP-1 and NLRP3 in peripheral blood of patients with poor prognosis were increased(MCP-1 mRNA:1.66±0.46 vs.2.40±0.54,t=6.096,P<0.001;NLRP3 mRNA:2.74±0.82 vs.3.56±1.06,t=3.599,P<0.001).The areas under the curve(AUC)for predicting PTB prognosis were 0.867 for MCP-1 mRNA and 0.756 for NLRP3 mRNA in peripheral blood.and the AUC of combination of two indicators was 0.876(P<0.001).Conclusions Excluding other pulmonary infections,active PTB patients exhibit elevated levels of MCP-1 and NLRP3 mRNA expression in peripheral blood,which are positively correlated with the severity of the disease.These levels are significantly downregulated after standard treatment,and the combination of both markers enhances the predictive value for the prognosis of PTB patients.