Abstract:Objective To investigate the degree of scar pruritus in patients with facial scars,analyze its influencing factors,and provide a basis for formulating targeted clinical intervention strategies.Methods A retrospective analysis was performed on the general data of 203 patients with facial scars admitted to the First Affiliated Hospital of Air Force Military Medical University from November 2022 to June 2025.The degree of scar pruritus was assessed using the pruritus numeric rating scale(NRS).The distribution characteristics of scar pruritus were statistically analyzed.Univariate and multivariate logistic stepwise regression analyses were employed to identify independent risk factors influencing the degree of scar pruritus in these patients.Results The pruritus NRS score for the 203 patients with facial scars was 5.22±1.41.Among them,51 patients(25.12%)had mild pruritus,122(60.10%)had moderate pruritus,and 30(14.78%)had severe pruritus.Based on the degree of pruritus,patients were divided into a mild group(n=51)and a moderate-to-severe group(n=152).Univariate analysis revealed that the proportions of females,patients with a history of smoking,a history of alcohol consumption,a spicy diet,scar area≥30%,and hypertrophic scars were significantly higher in the moderate-to-severe group than in the mild group(P<0.05).Multivariate analysis indicated that female gender(OR=1.919),history of smoking(OR=2.106),history of alcohol consumption(OR=1.385),spicy diet(OR=2.776),scar area≥30%(OR=2.399),and hypertrophic scars(OR=3.404)were independent risk factors for moderate-to-severe pruritus in patients with facial scars(P<0.05).Conclusion The incidence of moderate-to-severe pruritus is relatively high in patients with facial scars and is associated with multiple influencing factors including gender,history of smoking and alcohol consumption,dietary habits,scar area,and scar type.Clinically,high-risk populations can be screened based on these risk factors to develop individualized prevention and intervention strategies,thereby effectively alleviating pruritus symptoms and improving patients'quality of life.

Abstract:Objective To evaluate the effects of eculizumab injection on plasma levels of mannan-binding lectin-associated serine protease 3(MASP-3)and mannan-binding lectin-associated protein 44(MAp44),cardiac function,inflammatory markers,and myocardial injury markers in patients with heart failure,and to explore its therapeutic mechanism and clinical application prospects.Methods A total of 100 patients with heart failure admitted to Zhangjiakou First Hospital between January 2022 and March 2024 were prospectively enrolled and divided into an observation group and a control group,with 50 patients in each group.The control group was administered conventional medication,while the observation group received eculizumab injection on the basis of the same conventional treatment regimen as the control group.Plasma MASP-3 and MAp44 levels were measured before treatment,after 6 weeks of treatment,and after 12 weeks of treatment.Cardiac function(including echocardiographic and electrocardiographic parameters),inflammatory markers[C-reactive protein(CRP),interleukin-6(IL-6)],and myocardial injury markers[cardiac troponin I(cTnI),brain natriuretic peptide(BNP)]were assessed at the same time points.Results After 6 and 12 weeks of treatment,plasma levels of MASP-3 and MAp44 in the observation group were significantly lower than those before treatment(P<0.05).Left ventricular ejection fraction was significantly higher than before treatment(P<0.05),while left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly lower(P<0.05).Levels of CRP,IL-6,cTnI,and BNP were also significantly lower than before treatment(P<0.05).After treatment,all the above indicators in the observation group were significantly better than those in the control group(P<0.05).Conclusion The eculizumab injection can effectively regulate the complement system,reduce plasma MASP-3 and MAp44 levels,improve cardiac function,and alleviate myocardial inflammatory injury.It provides a new approach for the treatment of heart failure.Further studies are needed to investigate its specific molecular mechanisms and long-term efficacy.

Abstract:Objective To investigate the effects of a precision gait training program on walking performance in post-stroke patients with gait disorders.Methods A total of 188 post-stroke patients with gait disorders admitted to the Department of Neurological Rehabilitation,Qingdao Special Servicemen Recuperation Center of PLA Navy,from April 2022 to February 2025 were enrolled by convenience sampling and randomly divided into an observation group and a control group,with 94 cases in each group.The control group received the routine rehabilitation training program for gait disorders,while the observation group received the precision gait training program.Baseline data were compared between the two groups.The 6Minute Walk Test(6MWT)distance,FuglMeyer Assessment of Lower Extremity(FMA-LE)scores,and Berg Balance Scale(BBS)scores were compared between the two groups.Twoway analysis of variance was used to analyze the interaction effect between group and time.Multiple linear regression analysis was performed.Results Before the intervention,there were no statistically significant differences in 6MWT distance,FMALE scores,or BBS scores between the two groups(P>0.05).After the intervention,the 6MWT distance,FMALE scores,and BBS scores of both groups were significantly higher than those before the intervention,and the observation group showed significantly higher values than the control group(P<0.001).For 6MWT distance and BBS scores,the main effects of time,the main effects of group,and the time×group interaction effects were all significant(P<0.001),while FMALE scores as a covariate were not significant(P>0.05).For FMALE scores,the main effects of time and group were both significant(P<0.001),but the time×group interaction effect was not significant(P>0.05).Multiple linear regression analysis showed that after adjusting for multiple confounding factors,6MWT distance,FMALE scores,and BBS scores were independent influencing factors for the observation group(β=30.317,95%CI:18.405-42.230,P<0.001;β=1.904,95%CI:1.691-2.116,P<0.001;β=5.498,95%CI:3.726-7.270,P<0.001).Conclusion Compared with conventional rehabilitation,the precision gait training program shows greater advantages in improving walking endurance,lower limb motor function,and balance capacity.It can also significantly and specifically enhance walking endurance and balance ability in stroke patients over time,providing evidence to support the application of the precision rehabilitation concept in post-stroke rehabilitation.

Abstract:Objective To analyze the risk factors for secondary pulmonary infection in patients with acute myocardial infarction(AMI)and to construct a nomogram model.Methods A total of 204 AMI patients admitted to Dazhou Central Hospital from April 2022 to March 2025 were retrospectively enrolled as subjects.They were divided into an infection group and a non-infection group based on the occurrence of secondary pulmonary infection.Clinical data were compared between the two groups.Multivariate Logistic stepwise regression analysis was used to explore the influencing factors for secondary pulmonary infection in AMI patients.A nomogram model for predicting secondary pulmonary infection in AMI patients was constructed,and a calibration curve was plotted.The goodness-of-fit test was used to evaluate the model's fit,and the receiver operating characteristic curve was used to assess the predictive value of the nomogram model.Results Among the 204 AMI patients,43(21.08%)developed secondary pulmonary infection(infection group)and 161(78.92%)did not(non-infection group).In the infection group,58 pathogenic strains were detected,predominantly Gram-negative bacteria(60.34%).Compared with the non-infection group,the infection group had a higher proportion of males,patients aged≥60 years,patients with diabetes,Killip class Ⅲ-Ⅳ cardiac function,multi-vessel disease,and invasive procedures(all P<0.05).The infection group also had a longer hospital stay,higher levels of C-reactive protein and B-type natriuretic peptide(BNP),and a lower albumin level(all P<0.05).Multivariate Logistic stepwise regression analysis showed that age≥60 years,Killip class Ⅲ-Ⅳ cardiac function,invasive procedures,and high BNP level were risk factors for secondary pulmonary infection in AMI patients(all P<0.05).In the goodness-of-fit test for the nomogram model,χ²=0.752,P=0.513,indicating good model fit.The area under the curve(95%CI)of the nomogram for predicting secondary pulmonary infection was 0.902(0.851-0.953),with a specificity of 68.55%and a sensitivity of 92.13%.Conclusion The influencing factors for secondary pulmonary infection in AMI patients include age,Killip cardiac function classification,invasive procedures,and BNP level.The nomogram model constructed based on these factors shows good predictive performance.

Abstract:Objective To evaluate the value of quantitative assessment of early injury severity in patients with traumatic brain injury(TBI)based on computed tomography perfusion imaging(CTPI)parameters.Methods A total of 220 patients with TBI admitted to the Fourth People's Hospital of Hengshui from January 2019 to December 2022 were retrospectively enrolled.All patients underwent CT and CTPI upon admission,and were divided into a mild-to-moderate group[Glasgow Coma Scale(GCS)score:9-15,n=138]and a severe group(GCS score:≤8,n=82)according to their admission GCS scores.The CTPI parameters of the hemorrhagic core area of the lesion,perilesional hypodense area and contralateral mirror area were compared between the two groups.Multivariate Logistic regression analysis was performed to identify the influencing factors of early injury severity in TBI patients;a predictive model for early injury severity in TBI patients was constructed,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of this model.Results In both groups,the cerebral blood volume(CBV)and cerebral blood flow(CBF)in the hemorrhagic core area were lower than those in the perilesional hypodense area and contralateral mirror area,and the CBV and CBF in the perilesional hypodense area were lower than those in the contralateral mirror area(P<0.05).The mean transit time(MTT)in the hemorrhagic core area was longer than that in the perilesional hypodense area and contralateral mirror area,and the MTT in the perilesional hypodense area was longer than that in the contralateral mirror area(P<0.05).Compared with the mild-to-moderate group,the severe group had lower CBV and CBF and longer MTT in the hemorrhagic core area and perilesional hypodense area(P<0.05).Multivariate Logistic regression analysis showed that higher CBV and CBF in both the hemorrhagic core area and perilesional hypodense area,as well as a higher GCS score,were independent protective factors for early injury severity in TBI patients.In contrast,prolonged MTT in both the hemorrhagic core area and perilesional hypodense area were independent risk factors for early injury severity in TBI patients(OR=0.592,95%CI:0.429-0.783,P=0.008;OR=0.826,95%CI:0.608-0.955,P=0.038;OR=0.616,95%CI:0.427-0.806,P=0.009;OR=0.842,95%CI:0.507-0.895,P=0.041;OR=0.848,95%CI:0.686-0.963,P=0.009;OR=2.007,95%CI:1.615-3.790,P=0.004;OR=1.487,95%CI:1.273-1.890,P=0.038).ROC curve analysis indicated that the area under the curve of the predictive model for evaluating early injury severity in TBI patients was 0.795(95%CI:0.684-0.853),with a sensitivity of 0.753 and a specificity of 0.775.Conclusion The quantitative model based on CTPI parameters has a high value in predicting the severity of early injury in TBI patients.

Abstract:Objective To explore the efficacy,safety and prognostic factors of involved-field radiotherapy combined with camrelizumab immunotherapy versus involved-field radiotherapy alone in elderly patients with esophageal squamous cell carcinoma.Methods A prospective,multicenter,randomized controlled study was designed.From November 2021 to November 2023,80 elderly patients with esophageal squamous cell carcinoma aged over 70 years were enrolled from Heze Hospital of Traditional Chinese Medicine and the Air Force Medical Center,and randomly divided into Group A(involved-field radiotherapy alone+placebo)and Group B(involved-field radiotherapy combined with camrelizumab),with 40 patients in each group.General clinical data,short-term efficacy,long-term efficacy,and toxicities were compared between the two groups.Multivariate Cox regression analysis was used to analyze the prognostic factors in elderly patients with esophageal squamous cell carcinoma.Results The overall response rate of Group B(67.50%)was higher than that of Group A(45.00%),and the difference was statistically significant(P<0.05).All 80 elderly patients with esophageal carcinoma completed follow-up.The last follow-up was until December 2024,with a median follow-up time of 28.50 months.At the last follow-up,the median overall survival(OS)of Group A and Group B was 18.90 months and 26.70 months,respectively.Kaplan-Meier survival curve analysis showed that the 18-month overall survival rate of Group A was 42.50%,which was lower than that of Group B(60.00%)(P<0.05).There were no statistically significant differences in the incidence and severity of radiation injury,radiotherapy-related pulmonary changes,gastrointestinal reactions,hematological toxicity,abnormal liver and renal function,and immune-related adverse events between the two groups(P>0.05).Univariate Cox proportional hazards regression analysis revealed that clinical stage,maximum tumor diameter,ECOG score,PD-1 expression,and PD-L1 expression were risk factors for the prognosis of elderly patients with esophageal squamous cell carcinoma,while treatment modality and short-term therapeutic effect were protective factors(P<0.05).Multivariate Cox proportional hazards regression analysis showed that clinical stage and maximum tumor diameter were independent risk factors for the prognosis of elderly patients with esophageal squamous cell carcinoma,while treatment method and short-term efficacy were independent protective factors(HR=2.440,95%CI:1.275-4.668,P=0.007;HR=2.555,95%CI:1.436-4.546,P=0.001;HR=0.313,95%CI:0.168-0.584,P<0.001;HR=0.338,95%CI:0.182-0.629,P=0.001).Conclusion Compared with involved-field radiotherapy alone,involved-field radiotherapy combined with immunotherapy can improve the short-term overall response rate and overall survival rate in elderly patients with esophageal squamous cell carcinoma without significantly increasing treatment-related adverse reactions.Furthermore,involved-field radiotherapy combined with immunotherapy is an independent protective factor for the prognosis of these patients.

Abstract:Objective To investigate the correlation between the levels of chemokine ligand 22(CCL22)and regulatory T cells(Treg)and postoperative tumor recurrence in cervical cancer patients.Methods Clinical data of 113 cervical cancer patients who underwent surgical treatment at the People's Hospital of Xinjiang Uygur Autonomous Region from August 2019 to December 2022 were retrospectively collected.Based on recurrence status during the 2year postoperative followup,patients were divided into a recurrence group(21 cases)and a nonrecurrence group(92 cases).Preoperative levels of CCL22 and Treg were collected to explore their correlation with postoperative recurrence in cervical cancer patients.Results Among the 113 cervical cancer patients,21(18.58%)experienced recurrence within 2 years after surgery.The tumor diameter in the recurrence group was significantly larger than that in the nonrecurrence group,and the proportions of International Federation of Gynecology and Obstetrics stage ⅡA and poor differentiation were significantly higher in the recurrence group,with statistically significant differences(P<0.05).The preoperative levels of CCL22 and Treg in the recurrence group were significantly higher than those in the nonrecurrence group,with a statistically significant difference(P<0.05).Receiver operating characteristic curve analysis showed that the areas under the curve for predicting postoperative recurrence using preoperative CCL22 level alone,Treg level alone,and their combination were 0.831,0.765,and 0.904,respectively.Logistic multivariate regression analysis indicated that high preoperative levels of CCL22(OR=31.493,95%CI:3.692-268.611)and Treg(OR=5.089,95%CI:1.036-24.995)were independent risk factors for postoperative recurrence in cervical cancer patients(both P<0.05).After adjusting for confounding factors,a positive interaction was observed between preoperative CCL22 and Treg levels regarding postoperative recurrence,with an interaction index of 11.706,indicating that the synergistic effect of the two was 11.706 times the sum of their individual effects.The super hazard ratio was 43.337,indicating that when other factors were controlled,the recurrence risk increased by an additional 43.337 fold when both factors were present simultaneously compared to when each existed independently.The attributable proportion was 89.57%,suggesting that 89.57%of the recurrence risk in patients with high levels of both factors could be attributed to their interaction.Decision curve analysis showed that the decision curve plotted using preoperative CCL22 combined with Treg had a high net benefit rate.When the threshold ranged from 0 to 1.00,the net benefit rate was greater than 0,with a maximum net benefit rate of 0.185.Conclusion High preoperative levels of CCL22 and Treg are independent risk factors for postoperative recurrence in cervical cancer patients.The combination of CCL22 and Treg shows high diagnostic efficacy in predicting postoperative recurrence risk.

Abstract:Objective To investigate the relationship between the triglyceride to high-density lipoprotein cholesterol(TG/HDL-C)ratio and the risk of developing type 2 diabetes mellitus(T2DM),and to determine its optimal cutoff value.Methods This retrospective cohort study included 12,483 adults who underwent health examinations at RICI Healthcare between 2010 and 2016.The dataset has been uploaded to the Dryad repository.Using the downloaded database,the TG/HDL-C ratio was calculated.Participants were divided into groups Q1,Q2,and Q3 according to tertiles of the TG/HDL-C ratio.Cox proportional hazards regression models were used to assess the association between the TG/HDL-C ratio,modeled as both a continuous variable and a categorical variable,and the risk of incident T2DM.Using the median TG/HDL-C ratio(0.8773),the 12 483 participants were divided into a low TG/HDL-C ratio group(n=6 241)and a high TG/HDL-C ratio group(n=6 242).Kaplan Meier curves were plotted to depict changes in T2DM incidence over follow-up time in the two groups,and the log-rank test was used to compare differences between them.Receiver operating characteristic(ROC)curve analysis was employed to determine the optimal cutoff value of the TG/HDL-C ratio for predicting T2DM risk at 3,4,and 5 years.Results After adjusting for other confounding factors,each 1-unit increase in the TG/HDL-C ratio was associated with a 1.19-fold higher risk of T2DM(HR=1.19,95%CI:1.10-1.28,P<0.001).Analysis by tertiles of the TG/HDL-C ratio showed that,after adjustment,the risks of T2DM in both the Q2 and Q3 groups were significantly higher than in the Q1 group.The risk in the Q2 group was 1.24 times that of the Q1 group(HR=1.24,95%CI:0.77-1.99,P=0.380),and the risk in the Q3 group was 1.91 times that of the Q1 group(HR=1.91,95%CI:1.21-2.99,P=0.005).The P-values for trend across the three models were all<0.001.Kaplan Meier curve analysis showed that T2DM incidence gradually increased over follow-up time in both the low and high TG/HDL-C ratio groups.The log-rank test indicated a higher risk of incident T2DM in the high TG/HDL-C ratio group compared to the low ratio group(Log-rank χ²=71.43,P<0.001).At the 3-year follow-up,the area under the ROC curve(AUC),cutoff value,sensitivity,specificity,and Youden index for predicting incident T2DM using the TG/HDL-C ratio were 0.675,0.766,61.08%,67.86%,and 0.289,respectively.At 4 years,the corresponding values were 0.688,0.713,59.92%,70.90%,and 0.308.At 5 years,they were 0.706,0.716,62.68%,72.43%,and 0.351.The AUC values at different time points from 2 to 5.5 years also gradually increased with longer follow-up duration.Conclusion The TG/HDL-C ratio,as a simple and effective biomarker,can be used for the early prediction of T2DM risk and demonstrates relatively high predictive value during long-term follow-up.

Abstract:Objective To identify independent risk factors for multivessel coronary artery disease(MVD)and to develop a nomogram for predicting MVD risk.Methods A total of 311 patients diagnosed with coronary artery disease(CAD)who underwent coronary angiography during hospitalization in the Emergency Department of Xuanwu Hospital,Capital Medical University,from September 2023 to December 2024 were retrospectively enrolled.They were divided into the single-vessel disease group(126 cases)and the multi-vessel disease group(185 cases)according to the number of diseased coronary artery branches.Baseline data were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to identify the influencing factors for coronary multi-vessel disease in CAD patients.All patients were assigned to the training set(186 cases)and the validation set(125 cases)at a ratio of 3:2.A nomogram prediction model was established based on the training set,and the validation set was used for internal validation.The discriminative ability,calibration performance,and clinical application value of the model were comprehensively evaluated by means of receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis.Results The multi-vessel disease group had higher levels of alcohol consumption,diabetes mellitus,white blood cell count,neutrophil count,triglyceride-glucose index,systemic immune-inflammation index,and platelet-to-lymphocyte ratio,but lower prevalence of hypertension,lower age,and lower lymphocyte-albumin-neutrophil ratio compared with the single-vessel disease group(P<0.05).Multivariate logistic regression analysis showed that alcohol consumption,diabetes mellitus,triglyceride-glucose index,and platelet-to-lymphocyte ratio were independent risk factors for coronary multi-vessel disease in patients with coronary artery disease(alcohol consumption:OR=2.231,95%CI:1.992-5.031,P=0.042;diabetes mellitus:OR=13.607,95%CI:6.961-26.596,P<0.001;triglyceride-glucose index:OR=1.113,95%CI:1.053-1.177,P<0.001;platelet-to-lymphocyte ratio:OR=1.013,95%CI:1.006-1.021,P<0.001).ROC curve analysis indicated that the area under the curve was 0.860(95%CI:0.807-0.914)in the training set and 0.888(95%CI:0.832-0.945)in the validation set.The Hosmer-Lemeshow goodness-of-fit test showed good calibration(P=0.798 for the training set,P=0.966 for the validation set).Decision curve analysis demonstrated that the nomogram yielded a higher net benefit for predicting the risk of multi-vessel disease when the threshold probability ranged from 0 to 0.9.Conclusion Alcohol consumption,diabetes mellitus,triglyceride-glucose index,and platelet-to-lymphocyte ratio were identified as independent risk factors for multi-vessel coronary artery disease in patients with coronary heart disease.The nomogram prediction model constructed based on these factors exhibited good discrimination and calibration,which can assist in the early clinical identification of high-risk populations.

Abstract:Objective To explore the efficacy of compound glutamine enteric-coated capsules combined with live combined bifidobacterium and lactobacillus tablets in the treatment of irritable bowel syndrome(IBS)and its effects on intestinal flora and serum indicators related to the brain-gut axis.Methods A total of 86 IBS patients admitted to the People's Hospital of Pidu District,Chengdu from March 2022 to March 2024 were randomly divided into a control group(n=43,compound glutamine enteric-coated capsules)and a study group(n=43,compound glutamine enteric-coated capsules combined with live combined bifidobacterium and lactobacillus tablets).The treatment course for both groups was 4 weeks.Clinical scale scores,intestinal flora,and related laboratory indicators were measured before and after 4 weeks of treatment.The efficacy and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the study group was 93.02%,which was higher than that in the control group(76.74%)(P<0.05).After treatment,the IBS Symptom Severity Scale score and the abundance of Escherichia coli in the study group were lower than those in the control group,while the abundances of Lactobacillus and Bifidobacterium were higher than those in the control group(all P<0.05).After treatment,the serum levels of vasoactive intestinal peptide,calcitonin gene-related peptide,5-hydroxytryptamine and neuropeptide Y in both groups decreased significantly,and those in the study group were all lower than those in the control group(P<0.05).After treatment,serum interleukin(IL)-6 and IL-17A levels significantly decreased in both groups(P<0.05),while IL-10 levels significantly increased(P<0.05).Moreover,after treatment,the study group showed lower serum IL-6 and IL-17A levels and a higher IL-10 level compared with the control group(P<0.05).No obvious adverse reactions,liver or kidney dysfunction,allergic reactions,or other serious adverse events occurred in either group during treatment.Conclusion Compound glutamine enteric-coated capsules combined with live combined bifidobacterium and lactobacillus tablets are safe and effective in treating IBS.This combination can effectively improve intestinal flora and regulate brain-gut axis-inflammation related indicators.

Abstract:Objective To explore the predictive value of serum secreted frizzled-related protein 1(SFRP1)and progranulin(PGRN)for in-hospital outcomes after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 202 AMI patients who underwent PCI in Tangshan Central Hospital from February 2022 to January 2025 were selected.Clinical data and serum levels of SFRP1 and PGRN were collected.According to the in-hospital prognosis after PCI,patients were divided into a good prognosis group(n=162)and a poor prognosis group(n=40).The receiver operating characteristic curve was used to analyze the value of serum SFRP1,PGRN and their combination in predicting in-hospital outcomes after PCI in AMI patients.Multivariate logistic stepwise regression analysis was used to explore independent influencing factors for in-hospital outcomes after PCI in AMI patients.Results Serum SFRP1 level was significantly lower,and the PGRN level was significantly higher in the poor prognosis group than in the good prognosis group(both P<0.05).The areas under the curve(AUC)(95%CI)of serum SFRP1,PGRN and their combination(in series)for predicting in-hospital outcomes were 0.819(0.774-0.869),0.736(0.686-0.786),and 0.904(0.859-0.954),respectively.The AUC of the combined prediction was significantly higher than that of SFRP1 alone(Z=4.043,P<0.001)and PGRN alone(Z=3.102,P<0.001).Levels of low-density lipoprotein cholesterol and cardiac troponin I(cTnI),as well as the proportion of patients with multi-vessel disease,were significantly higher in the poor prognosis group,while left ventricular ejection fraction was significantly lower than in the good prognosis group(P<0.05).Multivariate analysis showed that high cTnI level(OR=2.230,95%CI:1.175-4.233),presence of multi-vessel disease(OR=2.094,95%CI:1.052-4.166),serum SFRP1≤12.60 ng/mL(OR=3.511,95%CI:1.935-6.372),and serum PGRN≥251.46 pg/mL(OR=2.824,95%CI:1.634-4.879)were independent risk factors for in-hospital outcomes after PCI in AMI patients(P<0.05).Conclusion Decreased serum SFRP1 level and increased PGRN level in AMI patients after PCI are closely related to poor in-hospital outcomes.Combined detection has good predictive value for in-hospital outcomes.

Abstract:Objective To investigate the accuracy,safety and early efficacy of the domestic NATON robotic-assisted medial unicompartmental knee arthroplasty.Methods A retrospective analysis was performed on 27 patients with anteromedial osteoarthritis of the knee who underwent domestic NATON robotic-assisted medial unicompartmental knee arthroplasty at the Fourth Medical Center of PLA General Hospital from July to October 2022.There were 6 males and 21 females,aged 50.0-77.0(62.2±4.5)years;body mass index ranged from 18.2 to 27.5(23.2±2.5)kg/m².All surgeries were performed with the assistance of the domestic NATON robot,and the LINK SLED unicompartmental knee prosthesis(LINK GmbH,Germany)was used.Unilateral surgery was performed in all patients.The knee varus angle,tibial and femoral component placement angles,Oxford Knee Score(OKS),and Knee Society Score(KSS)were compared before surgery,after surgery,and at the last follow-up.Results All patients were followed up for 18.0-22.0(20.2±1.0)months.At the last follow-up,the coronal tibial component varus angle ranged from-1.2°-4.4°(1.1°±0.7°);the coronal femoral component varus angle ranged from-4.7°-9.4°(3.5°±2.1°).The OKS of the affected knee decreased from(33.4±2.0)preoperatively to(12.2±4.2)at the last follow-up;the KSS clinical score increased from(45.0±11.0)preoperatively to(88.0±3.0);and the KSS functional score increased from(44.0±12.0)preoperatively to(77.0±10.0).All differences were statistically significant(P<0.01).No severe complications such as fracture,infection,or lower extremity venous thrombosis occurred during the follow-up period.Conclusion The domestic NATON robot can assist in the safe performance of medial unicompartmental knee arthroplasty and achieve accurate prosthesis placement,with no severe complications and satisfactory short-term efficacy.

Abstract:Objective To investigate the predictive value of dynamic electrocardiography parameters combined with the Thrombolysis in Myocardial Infarction(TIMI)risk score for major adverse cardiovascular events(MACE)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods A total of 119 STEMI patients admitted to the First People's Hospital of Lianyungang from July 2021 to June 2024 were enrolled.According to the occurrence of MACE during the 1-year follow-up after PCI,they were divided into the event group(24 cases)and the non-event group(95 cases).General clinical data and dynamic electrocardiography parameters were compared between the two groups.Multivariate logistic regression analysis was used to identify influencing factors for MACE in STEMI patients after PCI.Receiver operating characteristic(ROC)curve analysis was applied to evaluate the predictive value of dynamic electrocardiography parameters[including 24-hour QT interval variability(24-h QTV),standard deviation of normal-to-normal intervals(SDNN),etc.]and the TIMI risk score for MACE in STEMI patients after PCI.Results The age,proportion of Killip cardiac function classification≥Grade Ⅱ,and TIMI risk score in the event group were higher than those in the non-event group(P<0.05).The values of 24-h QTV and SDNN in the event group were lower than those in the non-event group(P<0.001).Multivariate logistic regression analysis showed that age and TIMI risk score were independent risk factors for MACE in STEMI patients after PCI,while 24-h QTV and SDNN were independent protective factors(OR=2.098,95%CI:1.022-4.307,P=0.044;OR=2.869,95%CI:1.267-6.497,P=0.012;OR=0.355,95%CI:0.159-0.795,P=0.012;OR=0.376,95%CI:0.174-0.813,P=0.013).ROC curve analysis showed that the areas under the curve(AUC)for 24-h QTV,SDNN,and TIMI risk score in predicting MACE after PCI were 0.762,0.740,and 0.761,respectively.The AUC for the combined prediction reached 0.930,which was significantly superior to that of any single parameter(P<0.05).Conclusion Dynamic electrocardiography parameters(24-h QTV,SDNN)and the TIMI risk score are independent influencing factors for MACE in STEMI patients after PCI.Their combined use can effectively predict the occurrence of MACE in these patients.

Abstract:Objective To explore the risk factors for vaginal invasion in patients with stage ⅠB-ⅡA cervical cancer,construct a nomogram model,and validate the predictive performance of the model for vaginal invasion.Methods A total of 380 cervical cancer patients admitted to the Affiliated Zhangjiagang Hospital of Soochow University from September 2021 to September 2024 were retrospectively collected.The patients were randomly divided into a modeling cohort(n=266)and an internal validation cohort(n=114)in a 7:3 ratio.Additionally,150 cervical cancer patients admitted to Zhangjiagang Hospital of Traditional Chinese Medicine were retrospectively collected as an external validation cohort.Clinical data of the patients were collected.LASSO regression was used to screen key variables for inclusion in multivariate analysis.A nomogram model was constructed based on the independent factors identified by multivariate analysis.The predictive performance of the model was validated using receiver operating characteristic(ROC)curve and decision curve analysis(DCA).Results The incidence of vaginal invasion in patients with stage ⅠB-ⅡA cervical cancer in this study was 17.37％(66/380).LASSO regression analysis screened 7 key variables.Multivariate analysis showed that older age(OR=1.173,95％CI:1.097-1.254),positive MRI diagnosis of vaginal invasion(OR=3.004,95％CI:1.185-7.616),and a high systemic inflammatory response index(OR=1.327,95％CI:1.002-1.757)were independent risk factors for vaginal invasion in stage ⅠB-ⅡA cervical cancer patients,while a high prognostic nutritional index(OR=0.912,95％CI:0.859-0.968)was an independent protective factor(P<0.05).ROC curve analysis showed that the area under the curve was 0.866(95％CI:0.803-0.930)for the modeling cohort,0.828(95％CI:0.761-0.896)for the internal validation cohort,and 0.834(95％CI:0.774-0.897)for the external validation cohort.DCA results showed that within the high-risk threshold range of 0-0.6,intervening based on the nomogram model provided a higher standardized net benefit compared to intervening in all patients or in none.Conclusion The nomogram model constructed in this study can relatively accurately predict the risk of vaginal invasion in patients with stage ⅠB-ⅡA cervical cancer,providing a reference for tumor staging assessment and treatment planning for such patients.

Abstract:Objective To explore the predictive value of the platelet-to-lymphocyte ratio(PLR)for peripherally inserted central catheter-associated upper extremity venous thrombosis(PICC-UEVT)in lung cancer patients under digital subtraction angiography(DSA)guidance.Methods A total of 160 lung cancer patients treated at the Affiliated Gaochun Hospital of Jiangsu University from January 2022 to February 2025 were selected.According to the occurrence of PICC-UEVT,the patients were divided into a thrombosis group(n=36)and a non-thrombosis group(n=124).The receiver operating characteristic curve was constructed to evaluate the predictive value of PLR for PICC-UEVT in lung cancer patients under DSA guidance.Multivariate logistic regression analysis was used to analyze the influencing factors for PICC-UEVT in these patients.Results The platelet count(PLT)and PLR in the thrombosis group were significantly higher than those in the non-thrombosis group,while the lymphocyte count(LYM)was significantly lower(P<0.05).The area under the curve(95%CI)of PLR for predicting PICC-UEVT was 0.910(0.870-0.953),which was significantly higher than that of PLT alone 0.847(0.796-0.895)and LYM count alone 0.753(0.702-0.804)(Z=8.328,9.741,P<0.001).The age,body mass index,and the proportions of patients with diabetes,pre-catheterization D-dimer≥0.5 mg/L,and activities of daily living(ADL)score<65 were all significantly higher in the thrombosis group than in the non-thrombosis group(P<0.05).Multivariate analysis showed that diabetes(OR=2.392,95%CI:1.417-4.036),pre-catheterization D-dimer≥0.5 mg/L(OR=2.818,95%CI:1.408-5.640),ADL score<65(OR=2.356,95%CI:1.421-3.907),and PLR≥203.82(OR=2.779,95%CI:1.458-5.295)were independent risk factors for PICC-UEVT in lung cancer patients under DSA guidance(P<0.05).Conclusion Elevated PLR is closely related to PICC-UEVT in lung cancer patients under DSA guidance and demonstrates good predictive efficacy.

Abstract:Objective To compare the effects of ropivacaine and bupivacaine combined spinal-epidural anesthesia on the stress response and cognitive function of elderly patients undergoing transurethral resection of the prostate.Methods A total of 150 elderly patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate at Chengdu Wuhou District People's Hospital from June 2023 to June 2025 were prospectively enrolled.Using the random number table method,patients were divided into the ropivacaine group(combined spinal-epidural anesthesia with ropivacaine,n=76)and the bupivacaine group(combined spinal-epidural anesthesia with bupivacaine,n=74).All patients received standard temperature protection measures during surgery.The onset and maintenance times of sensory and motor block,the incidence of adverse reactions,as well as stress response indicators[adrenaline(EPI),cortisol(COR)],cognitive function[Mini-Mental State Examination(MMSE)]and hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP)]at different time points were compared between the two groups.Results The maintenance times of both sensory and motor block in the ropivacaine group were significantly shorter than those in the bupivacaine group,while the onset time of motor block in the ropivacaine group was significantly longer than that in the bupivacaine group(P<0.05).The intergroup main effect,time main effect,and interaction effect on MMSE scores were statistically significant in both groups(P<0.05).The MMSE scores at 24 hours and 7 days after surgery were significantly lower than those before surgery in both groups(P<0.05),and the scores in the ropivacaine group were significantly higher than those in the bupivacaine group at both time points(P<0.05).Compared with preoperative levels,serum EPI and COR levels at 24 hours after surgery were significantly increased in both groups,and the levels in the ropivacaine group were significantly lower than those in the bupivacaine group(P<0.05).The intergroup main effect,time main effect,and interaction effect on HR and MAP were statistically significant in both groups(P<0.05).HR and MAP at 5 minutes(T1)and 10 minutes(T2)after anesthesia induction were significantly lower than those before anesthesia(T0)in both groups(P<0.05),and HR and MAP at T1 and T2 in the ropivacaine group were significantly higher than those in the bupivacaine group(P<0.05).The incidence of postoperative adverse reactions in the ropivacaine group was 10.53%,which showed no statistically significant difference compared with 17.57%in the bupivacaine group(P>0.05).Conclusion Compared with bupivacaine,ropivacaine used for combined spinal-epidural anesthesia in elderly patients undergoing transurethral resection of the prostate can more effectively alleviate the intraoperative stress response,maintain hemodynamic stability more steadily,shorten the maintenance time of sensory and motor block,and help reduce the risk of early postoperative cognitive impairment,with a comparable safety profile.

Abstract:Objective To analyze the status of knowledge,attitude and practice of nutrition in patients undergoing thoracoscopic surgery for lung cancer and analyze the influencing factors.Methods A total of 120 lung cancer patients who underwent thoracoscopic surgery at the Second People's Hospital of Huai'an City from March 2022 to March 2025 were selected as the research subjects by cluster sampling.General information of the patients was investigated.The nutritional knowledge,attitude and practice of the patients were surveyed using the Nutrition Knowledge-Attitude-Practice Questionnaire for Digestive System Tumor Patients,and multiple linear regression analysis was used to analyze the factors influencing the nutritional knowledge,attitude and practice of patients undergoing thoracoscopic surgery for lung cancer.Results The total score of knowledge,attitude and practice(KAP)of nutrition for 120 patients undergoing thoracoscopic surgery for lung cancer was(46.13±5.79)points.The proportion of those who scored at or above the passing level was 43.33%(52/120),while the proportion of those with poor scores was 56.67%(68/120).Univariate analysis showed that there were statistically significant differences in the KAP scores of nutrition among patients with different educational levels,monthly family incomes,places of residence,dietary management,nutritional status and social support(P<0.05).The results of multiple linear regression analysis indicated that educational level,monthly family income,place of residence,dietary management,nutritional status and social support were independent influencing factors of the KAP scores of nutrition for patients undergoing thoracoscopic surgery for lung cancer(P<0.05),which could explain 59.10%of the total variation.Conclusion The level of knowledge,attitude and practice of nutrition among patients undergoing thoracoscopic surgery for lung cancer remains low,and is influenced by educational attainment,monthly family income,place of residence,dietary management,nutritional status and social support.

Abstract:Objective To analyze the effect of butylphthalide combined with edaravone and dexborneol in the treatment of elderly patients with acute cerebral infarction.Methods A total of 146 elderly patients with acute cerebral infarction admitted to Qinhuangdao Workers'Hospital from January 2024 to December 2024 were selected as the research subjects.They were randomly divided into a control group(73 cases)and a study group(73 cases)using a random number table.The control group was treated with edaravone and dexborneol,while the study group was treated with butylphthalide soft capsules in addition to the treatment received by the control group.The clinical efficacy,adverse reactions,National Institutes of Health Stroke Scale(NIHSS)score,Fugl-Meyer Assessment(FMA)score,Activities of Daily Living(ADL)scale score,36-Item Short Form Health Survey(SF-36)score,as well as the levels of blood uric acid,homocysteine(Hcy),low-density lipoprotein cholesterol(LDL-C),hematocrit,plasma viscosity,and whole blood high-shear viscosity were compared between the two groups.Results The total effective rate in the study group was higher than that in the control group(95.89%vs 73.97%)(P<0.05),and the incidence of adverse reactions was lower in the study group than in the control group(4.11%vs 13.70%)(P<0.05).After treatment,the NIHSS scores of both groups decreased(P<0.05),while the FMA,ADL,and SF-36 scores increased(P<0.05).Moreover,the NIHSS score of the study group was lower than that of the control group,and the FMA,ADL,and SF-36 scores of the study group were higher than those of the control group(P<0.05).After treatment,the levels of blood uric acid,Hcy,LDL-C,as well as the whole blood high-shear viscosity,hematocrit,and plasma viscosity in both groups decreased(P<0.05),and all these values in the study group were lower than those in the control group(P<0.05).Conclusion Butylphthalide combined with edaravone and dexborneol in the treatment of elderly patients with acute cerebral infarction can improve clinical efficacy,enhance neurological and limb function,and demonstrates good safety.

Abstract:Objective To investigate the effect of pulmonary surfactant(PS)combined with caffeine citrate injection on blood gas parameters,coagulation function,and the risk of complications in neonates with respiratory distress syndrome(RDS)in high-altitude areas,and to evaluate the clinical application value of this combination regimen.Methods Clinical data of 102 neonates with RDS admitted to Ganzi Tibetan Autonomous Prefecture People's Hospital from July 2022 to June 2025 were retrospectively selected.According to the treatment methods,they were divided into an observation group(51 cases)and a control group(51 cases).The control group received conventional treatment and PS treatment,while the observation group received additional caffeine citrate injection based on the control group's treatment.Clinical indicators,blood gas parameters,coagulation parameters,adverse reactions,and complications were compared between the two groups.Results Compared with the control group,the observation group had fewer episodes of apnea,shorter duration of oxygen use,shorter ventilator use time,and shorter hospital stay(P<0.05).After treatment,the observation group had higher blood oxygen saturation and arterial oxygen partial pressure,but lower arterial carbon dioxide partial pressure than the control group(P<0.05).After treatment,all coagulation parameters in the observation group were significantly lower than those in the control group(P<0.05).The total effective rate of treatment in the observation group was significantly higher than that in the control group(94.12%vs 78.43%,P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(11.76%vs 7.84%,χ2=0.439,P=0.508).The incidence of complications in the observation group was lower than that in the control group(3.92%vs 15.69%,χ2=3.952,P=0.047).Conclusion The combination of PS and caffeine citrate injection for treating neonatal RDS in high-altitude areas can correct abnormal arterial blood gas parameters,improve coagulation disorders,shorten recovery time,significantly enhance clinical efficacy,and reduce the risk of complications with good safety.

Abstract:Objective To explore the influence of preoperative anxiety level on perioperative stress response and postoperative recovery in patients undergoing otorhinolaryngology head and neck surgery.Methods A total of 156 patients undergoing otorhinolaryngology head and neck surgery admitted to the First Affiliated Hospital of Air Force Medical University from June 2023 to June 2025 were selected as research subjects.According to the self-rating anxiety scale scores,patients were categorized into a no or mild anxiety group(≤59 points,71 cases),a moderate anxiety group(60-69 points,46 cases),and a severe anxiety group(>69 points,39 cases).Perioperative stress hormone levels[cortisol(Cor),norepinephrine(NE),angiotensin Ⅱ(AngⅡ),insulin],vital signs[heart rate(HR),systolic blood pressure(SBP)],and postoperative recovery outcomes(postoperative complications,time to ambulation,length of hospital stay,number of postoperative analgesic administrations)were compared among the groups.Results One day before surgery,levels of Cor,NE,AngⅡ,and insulin in the severe anxiety group were higher than those in the no or mild anxiety group and the moderate anxiety group(P<0.05).On the day of surgery,Cor,NE,AngⅡ,and insulin levels in the moderate anxiety group were lower than those in the no or mild anxiety group and the severe anxiety group(P<0.05),and levels in the no or mild anxiety group were lower than those in the severe anxiety group(P<0.05).One day after surgery,insulin level in the no or mild anxiety group was lower than that in the severe anxiety group(P<0.05),and levels of Cor,NE,AngⅡ,and insulin in the moderate anxiety group were lower than those in the no or mild anxiety group and the severe anxiety group(P<0.05).Upon entering the operating room,HR in the severe anxiety group was higher than that in the no or mild anxiety group and the moderate anxiety group(P<0.05).At 0.5 hours after surgery began,HR and SBP in the moderate anxiety group were lower than those in the no or mild anxiety group and the severe anxiety group(P<0.05).At 1 hour after surgery,HR in the moderate anxiety group was lower than that in the no or mild anxiety group and the severe anxiety group(P<0.05),and HR in the no or mild anxiety group was lower than that in the severe anxiety group(P<0.05).Time to ambulation and length of hospital stay in the moderate anxiety group were shorter than those in the no or mild anxiety group and the severe anxiety group;length of hospital stay in the no or mild anxiety group was shorter than that in the severe anxiety group;and the proportion of patients requiring postoperative analgesics less than twice was higher in the moderate anxiety group than in the severe anxiety group(P<0.05).Conclusion Patients with no,mild,or moderate preoperative anxiety exhibited a milder stress response than severe anxiety patients one day before surgery.However,after surgery,patients with moderate anxiety showed the mildest stress response,followed by those with no or mild anxiety,while severe anxiety patients had the most pronounced response.Patients with moderate preoperative anxiety had the shortest time to ambulation and hospital stay,and required the fewest postoperative analgesic administrations.