Abstract:Objective To investigate the correlation between preoperative serum C-X-C motif chemokine ligand 9(CXCL9)and C-X-C motif chemokine receptor 4(CXCR4)levels and postoperative recurrence in patients with brain glioma,and to e-valuate the predictive value of CXCL9 and CXCR4 for postoperative recurrence.Methods This study enrolled 120 patients with brain glioma treated at Xingtai Central Hospital from January 2023 to January 2024.According to recurrence within 1 year after surgery,patients were assigned to a recurrence group(n=75)and a non-recurrence group(n=45).Preoperative serum CXCL9 and CXCR4 levels were measured in all patients.Logistic regression analysis was used to analyze the associa-tion between CXCL9,CXCR4 and postoperative recurrence;receiver operating characteristic(ROC)curves were used to as-sess the performance of CXCL9 and CXCR4 in predicting postoperative recurrence.Results Serum CXCL9 and CXCR4 lev-els in the recurrence group were(1099.21±121.33)pg/mL and(328.45±27.74)ng/L,respectively,both higher than those in the non-recurrence group([966.88±136.92]pg/mL and[313.88±23.83]ng/L,respectively);the differences were statistically significant(P＜0.05).Binary logistic regression analysis showed that elevated serum CXCL9 and CXCR4 levels were risk factors for postoperative recurrence among brain glioma patients(P＜0.05).ROC curve analysis demon-strated that the combined CXCL9 and CXCR4 prediction for postoperative recurrence had an area under the curve(AUC)of 0.823,with a sensitivity of 81.33％and specificity of 71.11％;the combined AUC was significantly higher than that of each marker alone(Z=2.595,3.116,both P＜0.05).Conclusion Elevated preoperative serum CXCL9 and CXCR4 levels are correlated with postoperative recurrence in brain glioma patients.Preoperative measurement of these two markers may provide an early warning of recurrence,and their combined assessment improves predictive performance.

Abstract:Objective To analyze the correlation between peripheral blood C-reactive protein/procalcitonin(CRP/PCT)ratio,monocyte/lymphocyte ratio(MLR),and disease outcome in burn patients with sepsis-associated acute respiratory distress syndrome(ARDS),aiming to provide a reference for clinical decision-making.Methods A total of 202 burn patients with sepsis-associated ARDS admitted to our hospital from January 2020 to December 2024 were included and followed continu-ously for 1 month.According to disease outcome,they were divided into a death group(n=79)and a survival group(n=123).Receiver operating characteristic(ROC)curves were used to assess the predictive value of peripheral blood CRP/PCT ratio and MLR for disease outcome among these participants;multivariate stepwise logistic regression was used to analyze prognostic factors.Results The death group had significantly higher peripheral blood CRP/PCT ratio and MLR than the survival group(P＜0.05).Univariate analysis showed that proportions of patients aged ≥60 years,septic shock,and se-vere ARDS were greater in the death group;the death group had higher admission Sequential Organ Failure Assessment(SOFA)and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,higher CRP,procalcitonin(PCT)and monocyte(MN)levels,longer duration of mechanical ventilation,and lower lymphocyte(LYM)levels than the survival group,with statistically significant differences(P＜0.05).Multivariate logistic regression analysis indicated that higher ad-mission APACHE Ⅱ score(OR=2.020,95％CI:1.433-2.846),longer duration of mechanical ventilation(OR=2.401,95％CI:1.594-3.617),CRP/PCT ratio ≥18.99(OR=3.019,95％CI:1.939-4.702)and MLR ≥0.56(OR=2.524,95％CI:1.669-3.817)were risk factors for death in burn patients with sepsis-associated ARDS(P＜0.05).The AUCs of peripheral blood CRP/PCT ratio and MLR for predicting disease outcome were 0.867 and 0.759,re-spectively,both lower than the AUC of the combined prediction(AUC=0.916)and the AUC of the logistic model com-bined prediction(AUC=0.903).DeLong test showed that the predictive performance of the two combined approaches was significantly superior to single indicators(combined vs.CRP/PCT:Z=2.303,P=0.021;combined vs.MLR:Z=5.927,P＜0.001;logistic model vs.CRP/PCT:Z=2.130,P=0.033;logistic model vs.MLR:Z=5.754,P＜0.001),while there was no significant difference between the two combined approaches(Z=0.138,P=0.891).Conclusion Elevations of peripheral blood CRP/PCT ratio and MLR are associated with increased risk of death in burn patients with sepsis-associat-ed ARDS and can serve as important predictors of disease outcome.

Abstract:Objective To explore the effects of different administration strategies of 50％glucose injection on blood glucose during dialysis with glucose-free dialysate in elderly hemodialysis patients,and to identify an appropriate administration method to prevent intradialytic hypoglycemia in this population.Methods Thirty regularly hemodialyzed patients treated at our center through December 2023 were enrolled.During dialysis,each patient successively received the following three in-terventions(each with 20 g of 50％glucose):oral administration(oral high-glucose group),intravenous injection(Ⅳ high-glucose group),and micro-pump infusion(micro-pump high-glucose group).These were compared with a control condition of ad libitum oral intake during dialysis(control group)in a within-subject before-after design.A mixed-effects model was used to analyze the effects of different 50％glucose administration strategies on the incidence of intradialytic hypoglycemia,incidence of intradialytic hypotension,and blood glucose levels.Results After adjustment for dialysis mode,age,sex,body mass index(BMI),dry weight,primary disease,and dialysis duration,the Ⅳ high-glucose group,oral high-glucose group,and micro-pump high-glucose group all had significantly lower incidence of hypoglycemia compared with the control group(P＜0.05);the micro-pump high-glucose group additionally had a significantly lower incidence of hypotension(P＜0.05).Mixed-effects model analysis showed that,after adjustment for dialysis mode,age,sex,BMI,dry weight,and dialysis dura-tion,patients whose primary disease was diabetic nephropathy had lower blood glucose levels across the observation period.Compared with the control group,the estimated regression coefficients for the effect on blood glucose were 0.289 for the o-ral high-glucose group,0.160 for the Ⅳ high-glucose group,and 0.213 for the micro-pump high-glucose group,with differences being statistically significant(P＜0.05).Conclusion Oral,intravenously injected,and micro-pump infusion of 50％glucose during dialysis with glucose-free dialysate all decrease the incidence of intradialytic hypoglycemia in elderly he-modialysis patients;micro-pump infusion also reduces the incidence of intradialytic hypotension.Over the observation peri-od,oral administration produced the largest effect on blood glucose.

Abstract:Objective To investigate the efficacy of Xueshuan Xinmaining combined with nicorandil in elderly patients with unstable angina pectoris(UAP)and its effect on vascular endothelial function.Methods From February 2023 to March 2025,220 elderly UAP patients admitted to the Affiliated Jianli Hospital of China Three Gorges University were enrolled.Using a random number table,patients were assigned to a control group and an observation group,with 110 cases in each.The control group received nicorandil,and the observation group received Xueshuan Xinmaining in combination with nic-orandil.Both groups were treated for 4 weeks.After 4 weeks of treatment,therapeutic efficacy was compared between the two groups.Vascular endothelial function(nitric oxide[NO],endothelin-1[ET-1],soluble vascular cell adhesion mole-cule-1[sVCAM-1]),cardiac function(left ventricular ejection fraction[LVEF],left ventricular end-diastolic diameter[LVEDD],cardiac output[CO]),and inflammatory markers(C-reactive protein[CRP],interleukin-6[IL-6],tumor nec-rosis factor-α[TNF-α])were measured before and after treatment(after treatment indicates at 4 weeks during treatment).Adverse reactions during treatment were compared.Results The overall response rate in the observation group was signifi-cantly higher than that in the control group(P＜0.05).Before treatment,there was no significant difference between the two groups in NO,ET-1,and sVCAM-1 levels(P＞0.05).After treatment,NO levels in both groups were higher than before treatment,and the observation group was higher than the control group;ET-1 and sVCAM-1 levels in both groups were lower than before treatment,and the observation group was lower than the control group;the differences were statisti-cally significant(P＜0.05).Before treatment,there were no significant differences between the two groups in LVEF,LVEDD,and CO(P＞0.05).After treatment,LVEF and CO in both groups were bigger than before treatment,and the observation group was bigger than the control group;LVEDD in both groups was smaller than before treatment,and the ob-servation group was smaller than the control group;the differences were statistically significant(P＜0.05).Before treat-ment,there were no significant differences between the two groups in serum CRP,IL-6,and TNF-α levels(P＞0.05).Af-ter treatment,serum CRP,IL-6,and TNF-α levels in both groups were lower than before treatment,and the observation group was lower than the control group;the differences were statistically significant(P＜0.05).The incidence of adverse reactions in the two groups showed no significant difference(P＞0.05).Conclusion Xueshuan Xinmaining in combination with nicorandil has good clinical efficacy in treating elderly UAP patients.It can promote vascular endothelial function and cardiac function,and reduce inflammatory responses,with high safety profiles,warranting clinical promotion and applica-tion.

Abstract:Objective To observe the clinical efficacy of video-assisted thoracoscopic-guided open reduction and plate fixation of ribs combined with closed thoracic drainage in the treatment of rib fractures complicated by hemopneumothorax,provi-ding a reference for clinical decision-making.Methods From July 2020 to December 2024,126 patients with rib fractures complicated by hemopneumothorax treated at our hospital were enrolled and randomly assigned by drawing lots to an obser-vation group(n=63;video-assisted thoracoscopic-guided open reduction and plate fixation of ribs combined with closed tho-racic drainage)or a control group(n=63;conventional transthoracic internal fixation).Length of hospital stay,time to in-dependent ambulation,and time to chest pain relief were compared between groups.At 1 month postoperatively,clinical outcomes(fracture alignment rate,lung re-expansion rate,incision healing rate)were compared.Arterial blood gas indices were compared preoperatively and at 8 hours postoperatively.Postoperative complications within 1 month were recorded and compared.Results The observation group had significantly shorter length of hospital stay,earlier time to independent am-bulation,and shorter time to chest pain relief than the control group(P＜0.05).The observation group showed significant-ly higher fracture alignment rate,lung re-expansion rate,and incision healing rate than the control group(P＜0.05).At 8 hours postoperatively,the observation group had higher arterial partial pressure of oxygen(PaO2),arterial oxygen satura-tion(SaO2)and oxygenation index,ratio of PaO2 to fractional inspired oxygen(PaO2/FiO2),and lower arterial partial pressure of carbon dioxide(PaCO2)as compared with the control group;the differences were statistically significant(P＜0.05).At 1 month postoperatively,the overall incidence of complications in the observation group was significantly lower than in the control group(P＜0.05).Conclusion Video-assisted thoracoscopic-guided open reduction and plate fixation of ribs combined with closed thoracic drainage facilitates postoperative recovery in patients with rib fractures complicated by he-mopneumothorax,strengthens arterial blood gas indices,and reduces the risk of complications,with favorable clinical effi-cacy.

Abstract:Objective To develop a nomogram predicting postoperative infection in patients with hypertensive intracerebral hemorrhage(HICH),with the aim of facilitating early identification and targeted intervention for high-risk patients.Methods We retrospectively enrolled 275 HICH patients treated at Wuhan No.1 Hospital from July 2020 to April 2024.Patients were assigned to an infection group(n=47)and a non-infection group(n=228)according to whether postoperative infection occurred.Multivariable logistic regression a-nalysis was used to identify independent risk factors for postoperative infection;a nomogram was then constructed based on these fac-tors.The nomogram's discriminative performance was assessed by the receiver operating characteristic(ROC)curve and its calibration was evaluated with a calibration curve.Results There were no significant differences between the infection and non-infection groups in sex composition,body mass index,comorbid baseline diseases,hemorrhage location,National Institutes of Health Stroke Scale(NIH-SS)score on admission,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score on admission,time from onset to sur-gery,surgical approach,intraoperative blood loss,operation time,type of nutritional support,smoking history,alcohol history,history of anticoagulant or antiplatelet use,intraoperative blood transfusion,prophylactic proton pump inhibitor(PPI)use,nasogastric tube placement,or admission values of White blood cell count(WBC),lactate(Lac),procalcitonin(PCT),albumin(ALB)and platelet-to-lymphocyte ratio(PLR;P＞0.05).Compared with the non-infection group,the infection group had higher age,greater proportion with hypertension duration ≥10 years,higher rate of intraventricular extension,higher proportion with hematoma volume ≥30 mL on admission,higher proportion with Glasgow Coma Scale(GCS)≤8 on admission,higher rates of invasive assisted ventilation and me-chanical ventilation ≥3 days,and higher fasting blood glucose(FBG)on admission and neutrophil-to-lymphocyte ratio(NLR;P＜0.05).Multivariable logistic regression analysis identified hypertension duration ≥10 years(OR=2.790,95％CI:1.227-6.342),intraventricular extension(OR=4.187,95％CI:1.529-11.467),and GCS ≤8 on admission(OR=2.547,95％CI:1.147-5.656)as independent risk factors for postoperative infection in HICH patients(P＜0.05).ROC curve analysis demonstrated that the nomo-gram predicting postoperative infection achieved an area under the curve(AUC)of 0.909(95％CI:0.855-0.963),with a sensitivity of 86.17％and specificity of 83.33％.The Hosmer-Lemeshow goodness-of-fit test indicated good model fit(x2=5.873,P=0.511).Conclusion Hypertension duration ≥10 years,intraventricular extension,and lower GCS score on admission are independent risk fac-tors for postoperative infection in HICH patients.The nomogram based on these factors demonstrates high predictive performance and may help clinicians identify high-risk patients early and implement targeted interventions to improve outcomes.

Abstract:Objective To compare the clinical efficacy of transepithelial photorefractive keratectomy(TPRK)and laser-assis-ted subepithelial keratectomy(LASEK),two surface corneal refractive surgeries,aiming to provide a reference in the treat-ment of myopia.Methods From August 2022 to June 2024,116 myopic patients who underwent surface corneal refractive surgery at the First Affiliated Hospital of Xinjiang Medical University were enrolled.The right eye of each patient was se-lected as the study eye.According to the surgical technique,patients were assigned to a TPRK group(n=58)and a LASEK group(n=58).Pain was assessed by the visual analogue scale(VAS)on postoperative days 1,3,5,and 7.Follow-up vis-its were conducted on day 3,day 14,and at 1,3,and 6 months postoperatively to measure and record uncorrected visual a-cuity(UCVA).Corneal subepithelial haze(Haze)was compared at 1,3 and 6 months postoperatively.Postoperative com-plications within 6 months were recorded and compared between groups.Results VAS scores in both groups decreased pro-gressively on postoperative days 1,3,5,and 7,with the differences being statistically significant(P＜0.05).The LASEK group had significantly higher VAS scores than the TPRK group on postoperative days 1,3,and 5(P＜0.05);there was no significant difference in VAS score on day 7(P＞0.05).UCVA in both groups increased progressively at postoperative day 3,day 14,and at 1 and 3 months,with statistically significant differences compared with earlier time points(P＜0.05).The LASEK group had significantly lower UCVA than the TPRK group at postoperative day 3,day 14,and 1 month(P＜0.05).UCVA at 3 and 6 months postoperatively showed no significant difference between the two groups(P＞0.05).The overall incidence of Haze at 1,3,and 6 months postoperatively did not differ significantly between groups(P＞0.05).The complication rate within 6 months was 13.79％in the LASEK group and 3.44％in the TPRK group,with a statistically significant difference(P＜0.05).Conclusion Compared with LASEK,TPRK for myopia more effectively re-duces postoperative pain,accelerates postoperative visual recovery,and has a higher safety profile.The long-term clinical efficacy of the two procedures is essentially comparable.

Abstract:Objective To investigate the effects of different surgical procedures for non-small cell lung cancer(NSCLC)on patients'pain mediators and circulating tumor cells(CTCs)in peripheral blood,providing a reference for clinical decision-making.Methods Clinical data of NSCLC patients admitted to the Department of Thoracic Surgery of our hospital from January 2018 to January 2020 were retrospectively analyzed.Patients were grouped by surgical procedure into a single-port group(uniportal thoracoscopic surgery)and a two-port group(two-port thoracoscopic surgery).Propensity score matching was used for 1∶1 matching between groups,and 60 pairs of data were successfully matched.Recorded and compared items included surgical indicators(time of operation,intraoperative blood loss,length of hospital stay),pain stress response indi-cators at 48 h and 72 h postoperatively(norepinephrine[NE],substance P[SP],cortisol[Cor]),peripheral blood CTC levels preoperatively and on postoperative day 5,tumor markers(carcinoembryonic antigen[CEA],cytokeratin 19 fragment[CYFRA21-1],neuron-specific enolase[NSE]),and long-term prognosis indicators(mortality,recurrence rate,overall survival[OS]).Results The single-port group had significantly shorter time of operation and length of hospital stay and less intraoperative blood loss than the two-port group(P＜0.05).Serum NE,SP,and Cor at 72 h postoperatively were lower than at 24 h in both groups,and levels in the single-port group were significantly lower than those in the two-port group(P＜0.05).On postoperative day 5,CTC levels in stage Ⅰ patients were(8.15±1.32)CTCs/mL in the single-port group and(8.27±1.21)CTCs/mL in the two-port group,with no significant difference(P=0.663);for stage Ⅱ patients,the values were(9.55±1.27)CTCs/mL in the single-port group and(9.31±1.07)CTCs/mL in the two-port group,with no significant difference(P=0.551).On postoperative day 5,CEA,CYFRA21-1,and NSE levels in both groups were sig-nificantly lower than preoperative levels(P＜0.05);comparisons of postoperative CEA,CYFRA21-1,and NSE between the two groups showed no significant differences(P＞0.05).At 5-year follow-up,mortality,recurrence rate,and OS showed no significant differences between the two groups(P＞0.05).Conclusion Uniportal thoracoscopic surgery has clear advantages in shortening the time of operation and length of hospital stay,reducing intraoperative blood loss and postopera-tive complication risk,and accelerating postoperative recovery.Uniportal and two-port thoracoscopic surgeries are compara-ble in reducing postoperative serum tumor marker levels and CTC levels,and the 5-year follow-up shows no significant difference in long-term prognosis between the two surgical procedures.

Abstract:Preterm neonatal brain injury is one of the common and difficult clinical conditions in neonatology,among which intraventricular hemorrhage(IVH)is the most frequent.IVH not only markedly affects neurological development in affect-ed infants but also increases mortality risk,imposing a heavy burden on families and society.Recently,with continuous im-provements in perinatal medicine,the mortality of preterm infants with IVH has decreased to some extent,yet long-term neurodevelopmental outcomes remain unsatisfactory.The pathogenesis of IVH is complex and involves immature cerebro-vascular development,disturbances in cerebral blood flow(CBF)hemodynamics,coagulation disorders,oxidative stress in-jury,and other factors.Among these,dysregulation of CBF hemodynamics is widely regarded as a key link in the initiation and progression of IVH,and abnormal changes in CBF and regional cerebral oxygen saturation(rSO2)are considered critical early-warning indicators of IVH risk.Clinically,continuous monitoring of CBF and rSO2 enables dynamic assessment of the condition of pediatric patients with IVH,helps early identification of disease progression,and allows timely adjustment of treatment strategies,thereby maximizing protection of infant survival and improving clinical prognosis.Therefore,this arti-cle summarizes the change patterns of CBF and rSO2 changes in preterm infants with IVH and reviews recent applications of CBF and rSO2 monitoring in these patients,with the aim of providing a reference for early identification and clinical diagno-sis and treatment of IVH.

Abstract:Objective To evaluate the preventive effect of a refined non-artificial-airway nursing protocol on stroke-associated pneumonia(SAP),so as to provide evidence for optimizing SAP nursing interventions.Methods From March 2023 to De-cember 2024,158 acute stroke patients admitted to Nanjing Gaochun People's Hospital were enrolled and assigned by a ran-dom number table to a control group and an observation group,with 79 cases each.The control group received routine nurs-ing;the observation group received a refined non-artificial-airway nursing protocol.Outcomes compared included SAP inci-dence,SAP duration,Clinical Pulmonary Infection Score(CPIS),and length of ICU stay.Pulmonary function(forced ex-piratory volume in 1 second[FEV1],maximum voluntary ventilation[MVV],and vital capacity[VC])was recorded be-fore and after intervention.Swallowing function and oral hygiene were assessed before and after intervention using the Standardized Swallowing Assessment(SSA)and a modified Beck oral score(for comatose or uncooperative patients assessed by clinical observation and nursing records).Quality of life was evaluated before and after intervention by the WHO Quality of Life-BREF(WHOQOL-BREF).Results The observation group had significantly lower SAP incidence and CPIS score,and shorter SAP duration and length of ICU stay than the control group(P＜0.05).Before intervention,there were no sig-nificant differences between groups in FEV1,MVV,or VC(P＞0.05).After intervention,FEV1,MVV,and VC in both groups increased compared with before intervention,and values in the observation group were greater than those in the con-trol group,with statistically significant differences(P＜0.05).Before intervention,SSA and modified Beck oral scores did not differ significantly between groups(P＞0.05);after intervention,both scores decreased in both groups versus baseline,and the observation group had lower scores than the control group,with statistically significant differences(P＜0.05).Be-fore intervention,WHOQOL-BREF scores did not differ significantly between groups(P＞0.05);after intervention,WHOQOL-BREF scores increased in both groups and were higher in the observation group than the control group,with sta-tistically significant differences(P＜0.05).Conclusion A refined non-artificial-airway nursing protocol that integrates risk assessment with coordinated management of swallowing,respiratory function,and oral hygiene can significantly reduce the risk of SAP and improve patient outcomes,indicating high clinical promotion value.

Abstract:Cancer-related depression(CRD)may accompany the entire course of cancer and exerts substantial negative effects on patients' psychological state,quality of life,and treatment outcomes.With the continued rise in global cancer incidence and accelerated population aging,the incidence of CRD has also shown a marked upward trend.Summarizing previous stud-ies,the occurrence of CRD is closely related to gender,age,education level,economic capacity,psychological factors,as well as cancer type,tumor staging,treatment modality,complications,and related pathophysiological mechanisms.There-fore,formulation of CRD treatment plans needs to be closely combined with the patient's specific disease characteristics,with a comprehensive assessment of the clinical efficacy and safety of interventions to determine an appropriate treatment regimen.Acupuncture has advantages in treating CRD,including multiple targets,overall regulation,fewer side effects,and absence of addiction.This article reviews the influencing factors of CRD and the research status of acupuncture treat-ment for CRD,with the aim of providing a reference for clinical diagnosis and treatment practice.

Abstract:Objective To evaluate the value of serum procalcitonin(PCT),D-dimer(D-D),and red blood cell distribution width(RDW)measurements in predicting short-term prognosis of patients with sepsis,providing a reference for clinical management.Methods From October 2022 to October 2023,116 patients with sepsis admitted to Heping Hospital Affilia-ted to Changzhi Medical College were enrolled.According to disease severity,they were assigned to sepsis(n=51),severe sepsis(n=36),and septic shock(n=29)groups.General clinical data and serum PCT,D-D,and RDW levels within 1 day of admission were collected.Patients were followed for 30 days and classified into a survival group(n=85)and a death group(n=31).Risk factors for poor prognosis were analyzed and the predictive value of each marker was assessed.Results Serum PCT,D-D,and RDW levels in the severe sepsis and septic shock groups were significantly higher than those in the sepsis group(P＜0.05);these measurement levels in the septic shock group were significantly higher than in the severe sepsis group(P＜0.05).The overall mortality at the 30-day follow-up was 26.72％(31/116):9.80％(5/51)in the sepsis group,25.00％(9/36)in the severe sepsis group,and 58.62％(17/29)in the septic shock group;mortality differed signif-icantly among the three groups(x2=22.578,P＜0.05).Compared with the survival group,the death group had signifi-cantly higher RPR,SCr,Lac,PCT,D-D,and RDW levels and lower ALB and PLT levels(P＜0.05).Multivariate logistic regression analysis showed that elevated PCT,D-D,and RDW were independent risk factors for poor prognosis in patients with sepsis(OR=1.148,1.741,2.033;95％CI=1.025-1.286,1.184-2.559,1.160-3.564;P＜0.05).ROC curve analysis demonstrated that the area under the curve(AUC)for the combined detection of PCT,D-D,and RDW was signifi-cantly higher than that for any single marker(Z=4.060,3.609,3.202;P＜0.05).Conclusion Combined measurement of serum PCT,D-D,and RDW can serve as an effective approach for prognostic assessment in patients with sepsis and has important implications for clinical treatment and improving patient survival.

Abstract:Objective As an important province in central China with a relatively large population of individuals with disabili-ties and prominent rehabilitation needs,Jiangxi province requires an assessment of its rehabilitation service provision.This study aimed to evaluate the implementation effects of rehabilitation services for individuals with disabilities in Jiangxi prov-ince from 2016 to 2023 and to propose corresponding optimization strategies for improving the rehabilitation service system and enhancing the quality of life of this population.Methods We collected data from the Second National Sample Survey on Disability,the Jiangxi Provincial Statistical Bulletins on the Development of Disability Undertakings for 2016-2023,and other official statistics.Descriptive statistics and time-series analysis were employed to assess the construction of Jiangxi province's rehabilitation service system,organizational system,and support system.Results Jiangxi province has achieved notable progress in promoting rehabilitation services for individuals with disabilities,but still faces several challenges.Defi-ciencies remain in the construction of the service,organizational and support systems.In terms of overall supply relative to the population of individuals with disabilities,there are substantial gaps in the availability of rehabilitation institutions,care-and-support institutions,and classes/departments in special education schools.Indicators such as the proportion of individu-als receiving basic rehabilitation services,the proportion receiving institutional care services,employment rate,proportion receiving government insurance/support,proportion of professionals in rehabilitation institutions,and total enrollment in special education schools all show considerable room for improvement.Conclusion Although Jiangxi province has made progress in rehabilitation services for individuals with disabilities,problems remain,including low service coverage,shortage of professional personnel,mismatch between supply and demand for care-and-support services,and imperfect precision of services.Optimization should focus on strengthening policy and funding guarantees,expanding service coverage,accelera-ting talent cultivation,optimizing resource allocation,and promoting service precision,so as to increase service quality and support the sustainable development of the cause for this population.

Abstract:Objective To evaluate the value of the peripheral blood C-reactive protein/lymphocyte count ratio(CLR)for pre-dicting pulmonary infection in elderly patients with chronic heart failure(CHF).Methods From October 2022 to October 2024,186 elderly CHF patients admitted to Baoding No.1 Central Hospital were enrolled.Patients were grouped according to whether pulmonary infection occurred during hospitalization:infection group(n=46)and non-infection group(n=140).Clinical data were collected,including sex,age,body mass index,CLR,left ventricular ejection fraction(LVEF),and oth-ers.Receiver operating characteristic(ROC)curves were used to assess the value of CLR for predicting pulmonary infection in CHF patients;AUC comparisons were performed using the Delong test.Multivariate stepwise logistic regression analysis was used to analyze factors associated with pulmonary infection in CHF patients.Results C-reactive protein(CRP)level and CLR were higher,and lymphocyte count was lower,in the infection group than in the non-infection group,with statisti-cally significant differences(P＜0.05).ROC curve analysis showed that CLR predicted pulmonary infection in elderly CHF patients with an AUC of 0.904,which was significantly higher than CRP alone(AUC=0.852)and lymphocyte count a-lone(AUC=0.763;Z=8.384,9.577,respectively,P＜0.001).Multivariate analysis indicated that history of diabetes(OR=2.779,95％CI:1.519-5.082),invasive procedures(OR=2.801,95％CI:1.405-5.584),elevated procalcito-nin(OR=1.923,95％CI:1.269-2.914),elevated CRP(OR=2.109,95％CI:1.330-3.342),and elevated CLR(OR=2.617,95％CI:1.494-4.584)were independent risk factors for pulmonary infection in elderly CHF patients(P＜0.05).Conclusion Compared with CRP or lymphocyte count alone,CLR more accurately predicts pulmonary infection in CHF patients in the elderly and may serve as an effective clinical indicator for anticipating this adverse event.

Abstract:Objective To investigate factors associated with device-related thrombosis(DRT)after left atrial appendage clo-sure(LAAC)in patients with non-valvular atrial fibrillation(NVAF)and to analyze the relationship between DRT and prognosis.Methods From August 1,2014 to July 31,2024,a consecutive cohort of 1,581 NVAF patients who were hos-pitalized in the Department of Cardiology at the First Affiliated Hospital of Army Medical University and underwent LAAC was enrolled.Patients were assigned according to the presence or absence of postoperative DRT into a DRT group(n=40)and a non-DRT group(n=1,541).Gender,age,combined underlying diseases,laboratory results,transthoracic echocar-diography(TTE),and transesophageal echocardiography(TEE)findings were collected.Patients were followed for ische-mic stroke,bleeding,DRT,heart-failure re-hospitalization,and cardiogenic death;factors associated with DRT after LAAC and the relationship between DRT and clinical outcomes were analyzed.Results Compared with the non-DRT group,pa-tients in the DRT group were older,had higher D-dimer(D-D)levels,and lower left ventricular ejection fraction(LVEF);the differences were statistically significant(P＜0.05).Logistic regression analysis indicated that decreased LVEF was a risk factor for DRT formation(P＜0.05).All patients completed at least 6 months of follow-up.During follow-up,there were 3 strokes(7.50％)and 3 heart-failure re-hospitalizations(7.50％)in the DRT group;there were 15 major bleeding e-vents(0.97％),15 strokes(0.97％),56 heart-failure re-hospitalizations(3.64％),and 21 cardiogenic deaths(1.56％)in the non-DRT group.The incidence of stroke was significantly higher in the DRT group than in the non-DRT group(P=0.009).Kaplan-Meier survival analysis showed that DRT formation was closely associated with stroke occurrence(HR 95％CI:94.44[6.514-1,369.000],P＜0.001).Conclusion Reduced LVEF is a risk factor for DRT after LAAC,and the occurrence of DRT increases the risk of stroke.

Abstract:Objective To analyze factors influencing the success of ultrasound-guided external cephalic version(ECV)per-formed in term pregnant women during the third trimester,in order to provide a reference for clinical treatment.Methods Seventy-one pregnant women who underwent ECV and were followed until delivery at Bengbu First People's Hospital from March 2021 to December 2024 were included.According to whether ECV was successful,patients were allocated to a suc-cess group(n=47)and a failure group(n=24).Clinical data of all mothers and neonates were collected.Multivariable lo-gistic regression analysis was used to analyze factors affecting ECV outcome.Results Among the 71 women who underwent ECV,47 were successful and 24 failed,with a success rate of 66.20％.Overall,there were 43 vaginal deliveries and 28 ce-sarean deliveries,yielding a final vaginal delivery rate of 60.56％.In the success group,43 women(91.49％)delivered va-ginally and 4(8.51％)by cesarean;all women in the failure group underwent cesarean delivery.The complication rate in the success group was significantly lower than that in the failure group(8.51％vs.33.33％;P＜0.05).Compared with the failure group,the success group had higher proportions of multiparas,non-anterior placentation,higher amniotic fluid index(AFI),use of neuraxial anesthesia,and pre-procedure use of tocolytics;differences were all statistically significant(P＜0.05).Multivari-able logistic regression analysis showed that non-anterior placentation(OR=0.119,95％CI:0.025-0.562),use of neuraxial an-esthesia(OR=0.186,95％CI:0.040-0.861),and pre-procedure use of tocolytics(OR=0.148,95％CI:0.033-0.659)were factors influencing ECV outcome(P＜0.05).Conclusion For pregnant women without contraindications to vaginal de-livery,ultrasound-guided ECV can help improve the delivery experience and increase the vaginal delivery rate,and provides theoretical evidence for assessing the safety and effectiveness of ECV for breech or transverse presentations in strengthening pregnancy outcomes.

Abstract:Objective To establish a rational evaluation system for carboplatin injection and provide a reference for evaluating its rational use.Methods Based on the carboplatin injection product insert and relevant guidelines,detailed criteria for eval-uating the rationality of carboplatin injection use were formulated.The Analytic Hierarchy Process(AHP)was used to cal-culate the weight of each evaluation index,and the Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)was applied to analyze the rationality of drug use in medical records involving carboplatin injection at Affiliated Bozhou Hos-pital of Anhui Medical University from October 2023 to October 2024.Results An evaluation system was established with 4 primary indicators and 9 secondary indicators.Among the 235 included medical records,10.21％were fully rational,17.02％were rational,63.83％were basically rational,and 8.94％were irrational drug use.Conclusion The use of carbo-platin injection in our hospital is generally rational,but there are still some irrationalities in the indications for administration and dosage,which merit further improvement.

Abstract:Objective To investigate factors associated with frailty in hematologic malignancy patients undergoing chemother-apy and to construct a nomogram prediction model to provide a reference for clinical care.Methods From June 2023 to May 2025,202 hematologic malignancy patients receiving chemotherapy at the First Affiliated Hospital of Air Force Medical Uni-versity were enrolled.Data were collected by questionnaire;all scale assessments were completed within 24 hours before the start of the current chemotherapy cycle.Scales included a general information questionnaire,the Fried Frailty Phenotype(FP),the Self-Rating Anxiety Scale(SAS),the Self-Rating Depression Scale(SDS),the Barthel Index,and Nutritional Risk Screening 2002(NRS 2002).Multivariable logistic stepwise regression analysis was used to identify influencing factors related to frailty;receiver operating characteristic(ROC)curve analysis was adopted to evaluate the nomogram's predictive performance.Results Among the 202 patients,85 had FP ≥3 points,yielding a frailty prevalence of 42.08％.Univariate analysis showed that,compared with the non-frail group,the frail group had significantly higher proportions of patients aged ≥60 years,living alone,body mass index＜18.5 kg/m2,≥ 2 chronic comorbidities,≥2 prior chemotherapy cycles,anxiety,depression,impaired activities of daily living,and nutritional risk(P＜0.05).Multivariable stepwise logistic re-gression analysis identified age ≥60 years(OR=1.933,95％CI:1.391-2.687),chemotherapy cycles ≥ 2(OR=2.784,95％CI:1.788-4.336),impaired activities of daily living(OR=2.018,95％CI:1.435-2.838),depression(OR=2.255,95％CI:1.548-3.285),and presence of nutritional risk(OR=2.524,95％CI:1.679-3.795)as independent risk factors for frailty in patients with hematologic malignancy(P＜0.05).The nomogram's concordance index(C-index)was 0.815(95％CI:0.763-0.867);the calibration curve slope approached 1.The nomogram's area under the ROC curve(AUC)for predicting frailty was 0.907(95％CI:0.856-0.958),with a specificity of 68.53％and sensitivity of 92.67％.Conclusion Age,number of chemotherapy cycles,impaired activities of daily living,depression,and nutritional risk are as-sociated with frailty in hematologic malignancy patients receiving chemotherapy.The constructed nomogram based on these factors demonstrates good predictive accuracy.

Abstract:Objective To investigate the relationship between serum interleukin-33(IL-33)and chitinase-3-like protein 1(CHI3L1)level changes and the occurrence of post-stroke cognitive impairment(PSCI)and recurrence risk in elderly pa-tients with ischemic stroke(IS).Methods Ninety-eight elderly IS patients treated at the Affiliated Hospital of Inner Mon-golia Medical University from July 2021 to July 2024 were enrolled.Cognitive function was assessed at 3 months after IS on-set.Patients were divided into PSCI group and non-PSCI group according to whether PSCI occurred.At 12 months after IS onset,head CT/MRI was reexamined and patients were classified as recurrent or non-recurrent according to the presence of new ischemic lesions.Serum IL-33 and CHI3L1 levels were measured,and their relationships with PSCI occurrence and IS recurrence risk were analyzed.Results Multivariate logistic regression analysis showed that lesion location in functional are-as,low IL-33 level and high CHI3L1 level were risk factors for PSCI(P＜0.05).Receiver operating characteristic(ROC)curve analysis yielded AUCs of 0.732 and 0.763 for IL-33 and CHI3L1,respectively,in assessing PSCI,while the regres-sion model produced an AUC of 0.866.Multivariate logistic regression analysis indicated that higher National Institutes of Health Stroke Scale(NIHSS)score,low IL-33 level and high CHI3L1 level were risk factors for IS recurrence(P＜0.05).ROC curve analysis for IS recurrence produced AUCs of 0.760 and 0.815 for IL-33 and CHI3L1,respectively,and the re-gression model AUC was 0.899.Conclusion Abnormal changes in IL-33 and CHI3L1 levels in elderly IS patients are asso-ciated with the occurrence of PSCI and with increased risk of IS recurrence;their level changes may be useful as adjunctive assessments in clinical practice.

Abstract:Objective To investigate the mechanism of action by which Qijiao Tiaojing granules treat prolonged menstrual bleeding caused by intrauterine devices(IUDs).Methods Network pharmacology was used to screen the active components and potential targets of Qijiao Tiaojing granules;molecular docking was performed to validate interactions between key com-ponents and core targets(matrix metalloproteinase-9[MMP9]and tumor necrosis factor-α[TNF-α]).The effects of drug-containing serum on cell viability and on TNF-α and MMP9 expression were examined by isolating endometrial stromal cells from IUD patients.Results Network pharmacology analysis indicates that Qijiao Tiaojing granules acted on 10 core targets,including AKT1,TNF,and MMP9,and modulate signaling pathways,such as IL-17,TNF,and p53,to treat IUD-induced prolonged menstrual bleeding.Molecular docking confirmed that active ingredients luteolin and quercetin have high binding affinities to TNF-α and MMP9.Cell experiments showed that 20％Qijiao Tiaojing granules-containing serum significantly upregulated MMP9 expression(P＜0.05)and downregulated TNF-α secretion(P＜0.05),without marked cytotoxicity.Conclusion Qijiao Tiaojing granules exert therapeutic effects by multi-component,multi-target synergistic actions,regula-ting MMP9 and TNF-α expression to promote endometrial repair and relieve inflammation,providing a scientific basis for clinical application.