Objective To analyze the effects of agatroban combined with mitochondrial transplantation on endothelial function and hemorheology in mice with cerebral ischemia?reperfusion injury. Methods 50 SPF grade Kunming mice， with 10 as the normal group，38 mices were successfully modeled and divided into a model group of 9， a mitochondrial transplantation group of 9， an Agatroban group of 10， and a combination group of 10. The mitochondrial transplantation group was given exogenous mitochondrial extract， the agatroban group was given agatroban， the combined group was given agatroban combined with mitochondrial transplantation， and the blank group and model group were injected with normal saline. Observation of changes in cerebral infarction volume， pathological morphology of brain tissue， endothelial function， hemorheology， and relative expression of apoptosis related proteins in mice after 7 days of intervention. Results Compared with normal group， cerebral infarction volume ratio， ET?1， whole blood viscosity， plasma viscosity， Caspase-3 and Bax protein expression levels were increased in model group， mitochondrial transplantation group， agatroban group and combined group， while NO level and Bcl-2 protein expression levels were decreased （P < 0.05）. Compared with the model group， the cerebral infarction volume ratio， ET-1， whole blood viscosity， plasma viscosity， Caspase-3 and Bax protein expressions in the mitochondrial transplantation group， agatroban group and combined group were decreased， and the combined group was lower than the mitochondrial transplantation group and agatroban group， and the NO level and Bcl-2 protein expression were increased. The combined group was higher than that of mitochondrial transplantation group and agatriban group （P < 0.05）. Conclusion In mice with cerebral ischemia-reperfusion injury， endothelial function injury was improved， hemorheology was regulated， and brain injury was alleviated after agatroban combined with mitochondrial transplantation.

Objective To investigate the impact of Atractylodin on lung tissue damage in young asthmatic rats by regulating the CXC chemokine ligand 12 （CXCL12）/CXC chemokine receptor 4 （CXCR4） signaling pathway. Methods Twelve young SD rats were randomly selected from 60 rats as the control group （CON group）， while the remaining 48 rats were used to construct asthma models using ovalbumin （OVA）. Successfully modeled asthma rats were randomly separated into Model group， Atractylodin group （50 mg/kg Atractylodin）， and CXCL-12 group （5 μg/kg recombinant CXCL-12 protein） and Atractylodin+CXCL-12 group （50 mg/kg Atractylodin+5 μg/kg recombinant CXCL-12 protein）， with 12 in each group， continuously administered for 14 days. The CON and Model groups were given equal amounts of physiological saline. The percentages of neutrophils and eosinophils in bronchoalveolar lavage fluid （BALF） were detected. ELISA method was applied to detect cytokine levels in serum and BALF fluid； HE staining was applied to detect pathological changes in lung tissue； Western blot was applied to detect the levels of CXCL12/CXCR4 pathway related proteins. Results Compared with the CON group， the pathological score of lung tissue， percentage of neutrophils， percentage of eosinophils， the levels of IL-17， IL-4， IL-5， IL-13， IgE， OVA sIgE， and the protein levels of CXCL12 and CXCR4 in Model group were obviously increased （P < 0.05）； compared with the Model group， the pathological score of lung tissue， percentage of neutrophils， percentage of eosinophils， the levels of IL-17， IL-4， IL-5， IL-13， IgE， OVA sIgE， and the protein levels of CXCL12 and CXCR4 in the Atractylodin group were obviously reduced （P < 0.05）， the results in the CXCL-12 group were opposite to those in the Atractylodes group； CXCL-12 eliminated the improvement effect of atractylodes on asthma rats. Conclusion Atractylodin may improve lung tissue damage in asthmatic rats by down-regulating the CXCL12/CXCR4 signaling pathway.

Objective To compare the effects of two exercise intensities on metabolic syndrome （MS）. Methods Forty-nine MS patients hospitalized in Taiyuan Central Hospital from December， 2022 to January 2024 were selected and randomly divided into two groups： a standard group（n = 24） and individual group（n = 25）. All patients underwent cardiopulmonary exercise test （CPET） before and after treatment， collecting major indexes including body parameter， body component， and metabolic indicator for prescribing exercise programs. The standard group was trained with exercise intensity prescribed on heart rate reserve， while the individual group received the exercise with intensity prescribed on ventilatory threshold. Both groups received equal energy consumption exercise intervention with the same exercise frequency for 12 weeks. Results The two groups demonstrated significant improvements in waist circumference （WC）， body mass index （BMI）， body fat related indexes， and systolic blood pressure after intervention （P < 0.05）. The individual group showed significant improvements inWC， BMI and body fat related indexes as compared to the standard group （P < 0.05）. Both groups showed significant improvements in peak oxygen uptake， （PeakVO₂）， peak load power （Peak WR）， peak metabolic equivalent （PeakMets）， and peak respiratory exchange ratio （Peak RER） after intervention （P < 0.05）. The individual group presented significant improvements in peak heart rate （HRpeak）， peak oxygen pulse （Peak VO₂/HR）， and maximum voluntary ventilation （MVV） （P < 0.05） after intervention. Before intervention， the standard group demonstrated significantly higher levels in PeakVO₂ and Peak MET compared to the individual group （P < 0.05）， but after intervention the two groups showed no significant differences in the two indexes. After the intervention， the individual group demonstrated insignificant improvements in all indexes compared to the standard group （P > 0.05）. Conclusions Both exercise prescriptions based on CPET can effectively improve the health-related indicators of MS patients on condition of moderate exercise intensity. However， the program prescribed based on individualized ventilatory threshold shows superiority to the program prescribed based on maximum physiological value in improving these indicators.

Objective To investigate the impact of statistical uncertainty per control point （SUpCP） on dose calculation on volumetric modulated arc therapy（VMAT） for rectum cancer， and to analyze the accuracy and efficiency of calculation. Methods 19 patients with rectum cancer undergoing radiotherapy were selected. The initial VMAT plans were generated on Monaco TPS using SUpCP = 3， then changed SUpCP in the dose calculation process as follow： 10 SUpCPs （1 ~ 10） for each patient， and totally190 VMAT dose distributions were obtained. For plan evaluation， D_max， D_mean， D_95%， V₅₀， homogeneity index（HI）， conformity index（CI） of the planning target volume（PTV）， dissymmetric variations of bladder， small intestine and femoral head， and time calculation（Time）were analyzed. Patient specific quality assurance（PSQA）， dose deviation of isocenter （ΔD_ISO）and passing rate of three-dimensional dose distribution（γ₃₃， γ₃₂， γ₂₂） between calculated and delivered radiation doses were measured. Results AsSUpC increased， D_max and HI of PTV， D_max of bladder were increased， but D_95% and V₅₀ of PTV， Time， γ₃₂ and γ₂₂ were decreased（P < 0.05）. D_max and CI of PTV， Dmean of bladder， Dmax and Dmean of small intestine and femoral head， ΔD_ISO and γ₃₃ showed no statistical significance （P > 0.05）. When ΔD_ISO < 1%， gamma passing rate > 90% for all VMAT plan. When SUpCP < 6， Dmax of PTV < 110% of the prescribed dose was obtained； while SUpCP > 2， time for dose calculation was less than 5 min. Conclusion For VMAT plan of rectum cancer on Monaco TPS using XVMC algorithm， 3% ~ 5% of statistical uncertainty per control point for dose calculation， and 3% 2 mm or 2% 2 mm gamma criteria for three-dimensional dose verification is recommended. This study provides clinical application basis for precise dose calculation of VMAT plan of rectum cancer.

Objective To investigate the determinants of linezolid-associated neurological adverse reactions in patients with multidrug-resistant tuberculosis and develop a risk prediction model for such adverse events. Methods A prospective cohort study design was employed to select 120 patients with drug-resistant pulmonary tuberculosis who received a chemotherapy regimen containing linezolid at Guangzhou Chest Hospital from April 2023 to January 2024 as the study population. Clinical data， adverse reactions， and plasma concentration of linezolid were collected during fasting and at 2 hours post-medication. Univariate analysis and multivariate logistic regression were conducted to identify factors influencing linezolid-related neurological adverse reactions. Furthermore， a prediction model for such adverse reactions was developed， and its predictive efficacy and calibration ability were evaluated using ROC analysis. Results Re-treatment（OR = 2.540，P =0.028）， coexistence of cavities （OR = 4.092，P =0.021）， anemia （OR = 10.921，P = 0.005）， and C_min ≥ 0.7665 mg/L （OR = 6.813，P < 0.001） are independent risk factors for the occurrence of linezolid-related neurological adverse reactions. The prediction model， based on these four factors， exhibits an AUC of 0.851 （95% CI：0.774 ~ 0.929）， accompanied by a Youden index of 0.590， a sensitivity of 66.7%， and a specificity of 92.3%. Moreover， the prediction model demonstrates excellent calibration ability. （Hosmer-lemeshow χ² = 8.719， P = 0.273）. Conclusion In MDR/RR-TB patients， the presence of cavitation， retreatment， and anemia may confer a heightened risk of linezolid-related neurological adverse reactions. A risk prediction model incorporating these four indicators demonstrates significant predictive value for the occurrence of such adverse events.

Objective To investigate the efficacy of biportal endoscopic transforaminal lumbar interbody fusion （BE-LIF） in the treatment of lumbar spondylolisthesis complicated with osteoporosis. Methods From June 2021 to June 2022， 36 cases of lumbar spondylolisthesis complicated with osteoporosis were treated with BE-LIF， including 9 males and 27 females， aged （65.94 ± 6.83） years （range： 51 ~ 76 years）. All were single segment， and the responsible segment was L_3/4 in 4 cases， L_4/5 in 26 cases， and L₅/S₁ in 6 cases. Imagingexamination showed 1 and 2 degree of spondylolisthesis in 28 and 8 cases， and degenerative and ischemic spondylolisthesis in 24 and 12 cases respectively. Preoperative average bone mineral density T value of the lumbar spine was （-3.19 ± 0.82） SD， and T value of the femur （-2.26 ± 0.86） SD. Oswestry disability index （ODI） was used to evaluate lumbar spine function； visual analogue scale （VAS） to evaluate low back pain and leg pain. ODI， VAS of low back and leg pain were recorded respectively before the operation， at discharge and at the last follow-up. MacNab criteria were used to evaluate the surgical efficacy at the last follow-up. The anterior and posterior disc height， segmental lordotic angle and percentage of slip were measured on the lateral lumbar X-ray films before and after the operation. All patients received standard anti-osteoporosis treatment after surgery. Results All patients completed the operation in one stage. The average operation time was （160.97 ± 35.01） min （range： 105~245 min）， and the average intraoperative blood loss was （72.50 ± 47.53） ml （range： 20 ~ 150 mL）. The mean follow-up time was （15.17 ± 6.53） months （range： 6 ~ 26 months）. There were statistically significant differences in both VAS score of back and leg and ODI score at discharge and last follow-up when compared with those before the surgery （F = 107.48， 103.66， 55.52， P < 0.001）. Macnab criteria of the last follow-up showed excellent in 21 cases， good in 12 cases， fair in 3 cases， and the excellent and good rate was 91.7%. Radiographic results showed that the height of the anterior and posterior disc height， segmental lordotic angle and percentage of slip were all improved immediately after surgery and at the last follow-up when compared with those before operation， but the anterior and posterior disc height， segmental lordotic angle at the last follow-up were decreased comparing with those immediate after the operation； the difference was statistically significant （P < 0.001）. The fusion rate at the last follow-up was 91.7% （33/36）. The complication rate was 13.8% （5/36）， including 1 case of intraoperative endplate injury， 1 case of nerve root cuff tear， 1 case of delayed postoperative wound infection， and 2 cases of posterior cage migration. Conclusion BE-LIF for the treatment of lumbar spondylolisthesis complicated with osteoporosis can achieve better immediate reduction effect， good clinical outcomes and high fusion rate in short-term follow-up， but the anterior and posterior disc height， segmental lordotic angle are partially lost at the last follow-up. There are still complications， and beginners should be cautious when performing the operation. Postoperative standardized anti-osteoporosis treatment is still an important measure to ensure the curative effect of surgery.

Objective To investigate the predictive value of thromboelastography （TEG） parameters in conjunction with platelet count （PLT） for guiding platelet transfusion in critically ill patients with fever associated with thrombocytopenia syndrome （SFTS）. Methods Sixty-two critically ill patients with fever and thrombocytopenia syndrome were selected from the infection department of a hospital. They were divided into two groups： the bleeding group （n = 30） and non-bleeding group （n = 32）. Changes in relevant indices， such as PLT and TEG， were compared between the two groups using t-test， chi-square test or non-parametric test. Binary logistic regression was employed to analyze factors predicting bleeding in critically ill patients. The efficacy of these indices in predicting bleeding was assessed by calculating the area under the receiver operating characteristic curve， determining optimal cut-off values， and comparing PLT levels with mortality rates using chi-square test after grouping based on MA cut-off value. Results First of all，the MA value and PLT were significantly lower in bleeding patients compared to non-bleeding patients （P < 0.05）， while the K value and PT were significantly higher in bleeding patients （P < 0.05）. Second of all，logistic regression analysis revealed that both MA value and PLT were significant influencing factors for hemorrhage in patients （P < 0.05）. Third of all， ROC analysis demonstrated that the area under the curve for PLT was 0.884， while for MA it was 0.890（P < 0.05）. Among these， PLT exhibited the highest specificity and MA value had the highest sensitivity， with a best cut-off value of 48.85 mm for MA. The combined index of K， MA， and PLT yielded an area under the curve of 0.941 and a Youden index of 0.77， which were higher than those obtained from individual indices. Finally， Rank sum test and Fisher exact test indicated that individuals with an MA value < 48.85 mm had lower PLT levels and higher mortality rates （P < 0.05）. Conclusion The integration of TEG and PLT demonstrates significant potential in predicting bleeding events among critically ill patients with SFTS， thereby offering valuable clinical implications for guiding prophylactic platelet transfusion in this patient population.

Objective To analyze the relationship of miRNA-146a gene polymorphisms and ischemic post-stroke depression （PSD）. Methods The SNP rs2910164 in the miRNA-146a gene in 200 ischemic PSD patients （case group） and 200 ischemic non-PSD patients （control group） was analyzed using the SNaPshot technique. The relative expression levels of miRNA-146a in the peripheral blood of two groups were determined. Results The case group showed significantly different allele and genotype frequencies of the SNP rs2910164 as compared with the control group （G vs. C： P = 0.003； GG + CG vs. CC： P = 0.012）. Meanwhile， the case group presented a significantly lower level of miRNA-146a relative expression （P < 0.05）. Within the control group， additionally， the subgroup of GG + CG genotypes demonstrated a significantly lower level of miRNA-146a relative expression compared with the subgroup of CC genotypes （P < 0.05）. Conclusion SNP rs2910164 in the miRNA-146ais associated with the susceptibility to ischemic PSD， and G allele may play a role in the ischemic PSD.

Objective By comparing with arthroscopic rotator cuff repair alone， to explore the efficacy and difference of leukocyte poor platelet?rich plasma （LP-PRP） and leukocyte rich platelet-rich plasma （LR-PRP） in arthroscopic rotator cuff repair. Methods Sixty patients with total rotator cuff tear accompanied by arthroscopic rotator cuff repair admitted to the Affiliated Hospital of North China University of Science and Technology from October 2021 to September 2022 were included and randomly divided into control group （n = 20）， LP-PRP group （n = 20） and LR-PRP group （n = 20）. The control group only received arthroscopic rotator cuff repair. The LP-PRP group was injected with leukocyte poor platelet-rich plasma （LP-PRP） into the sutured torn tendon after the same operation， and the LR-PRP group was injected with leukocyte rich platelet-rich plasma （LR-PRP） into the sutured torn tendon after the same operation. The postoperative rehabilitation training plan of the three groups was the same， and the postoperative follow-up and evaluation were conducted for 1 year. It included pain score （VAS score）， shoulder joint function score （CMS， UCLA， ASES score）， retear rate and related complications. Results All patients were followed up. （1）VAS score： Compared with the LR-PRP group and the control group， the results were statistically significant only at 1， 3 and 6 weeks after surgery （P < 0.05）； There was no statistical significance between the LR-PRP group and the control group at 1 week， 3 weeks， 6 weeks， 3 months， 6 months and 12 months after surgery（P > 0.05）. （2）CMS， UCLA and ASES scores： There were no significant differences between the LP-PRP group and the LR-PRP group at 3 months， 6 months and 12 months after surgery（P > 0.05）； Compared with LP-PRP group and LR-PRP group， there were significant differences in each follow-up time point of control group （P < 0.05）. （3）Retear rate： In the LP-PRP group， there was 1 retear in the LR-PRP group （tear rate 5%）， and 3 in the control group （tear rate 15%）. There was no statistically significant difference between the three groups（P > 0.05）. （4）There were no postoperative complications in 60 patients. Conclusions Compared with arthroscopic rotator cuff repair alone， although the application of LP-PRP and LR-PRP could not reduce the rate of retear， it could significantly improve the shoulder joint function of patients， and LP-PRP could significantly reduce the pain of patients with rotator cuff injury in the early postoperative period （within 6 weeks）， with no postoperative complications， and the short-term clinical results of patients were satisfactory.

Objective To investigate the safety and clinical effect of prophylactic ileostomy using right lower abdominal specimen extraction incision in laparoscopic rectal low anterior resection and its impact on ileostomy closure. Methods A retrospective analysis was conducted on 127 patients who underwent laparoscopic low anterior resection of rectal cancer combined with prophylactic ileostomy in Department of General Surgery in our hospital from January 2020 to December 2023. Patients were divided into observation group （n = 60） and control group （n = 67） based on whether with prophylactic ileostomy using the right lower abdominal specimen extraction incision or not. Relevant data and clinical data of ileostomy closure were compared between the two groups. Results （1）There was no significant difference in baseline clinical data between the two groups （P > 0.05）. （2）In terms of operation time， pain score within three days after surgery and postoperative first exhaust time， the observation group was better than the control group， showing statistical difference （P < 0.05）. In the observation group， the average length of the incision was longer than that in the control group， and it was significantly different between the two groups （P < 0.05）. There was no significant difference between the two groups in terms of blood loss， postoperative feeding time and postoperative hospital stay （P > 0.05）. （3） There was no significant difference between the two groups in postoperative and ostomy-related complication S （P > 0.05）. （4） The observation group was better than the control group in terms of postoperative pain score and postoperative first exhaust time， indicating statistical significance （P < 0.05）. There were no significant differences in surgical time， abdominal adhesion， blood loss， postoperative hospital stay and postoperative complications between the two groups （P > 0.05）. Conclusion The patients undergoing laparoscopic rectal low anterior resection who needs prophylactic ileostomy using right lower abdominal specimen extraction incision can improve the appearance of the incision， shorten operation time， reduce postoperative pain of the patients but does not increase postoperative complications and the difficulty of ileostomy closure. It is safe and feasible， which worthy for clinical promotion.

Objective To evaluate the methylation levels of DNA at six specific CpG sites located in the mRNA region of histone cluster 4 subfamily F member 6 （HIST1H4F） gene and determine their diagnostic significance about lung cancer. Methods The DNA methylation levels of 15 cases of lung cancer and adjacent paired normal lung tissue were detected using pyrophosphate sequencing. Based on preliminary evaluation， a methylation-sensitive restriction enzyme-fluorescence quantitative PCR （MSRE-qPCR） method was developed to detect DNA methylation levels in the test group （60 cases of lung adenocarcinoma， 38 cases of squamous cell carcinoma， 30 cases of benign diseases， and 26 cases of normal lung tissue） and the validation group （36 cases of lung adenocarcinoma， 16 cases of squamous cell carcinoma， 21 cases of benign diseases， and 23 cases of normal lung tissue）. The diagnostic value was evaluated using ROC curves. Results The results of pyrophosphate sequencing showed that the methylation levels of lung cancer were significantly higher than that of paired normal lung tissue （P < 0.005）. The detection results of MSRE-qPCR showed that the areas under the ROC curve for diagnosing lung cancer in the test group and validation group were 0.894 and 0.888， with sensitivity of 76.5% and 73.1%， and specificity of 92.9% and 97.7%， respectively. The methylation levels were significantly positively correlated with smoking in lung cancer patients （r = 0.273， P < 0.01）. Conclusion The six CpG sites in the mRNA region of the HIST1H4F gene can serve as biomarkers for diagnosing lung cancer， providinga new molecular target for clinical lung cancer diagnosis.

Objective To investigate the effects of citicoline sodium and Ureicrin on the expression of miR-17-5p and miR-29b in patients with ischemic stroke. Methods A total of 100 patients with ischemic stroke treated in the hospital were divided into control group and combination group by random table method. From February 2023 to February 2024， they were respectively given Eurecrine monotherapy and citicoline sodium and eurecrine combination therapy. Cerebral blood perfusion indexes， inflammatory factors， oxidative stress， miR-17-5p， miR-29b levels and clinical efficacy were detected in the two groups， and adverse reactions were statistically recorded. Results There was no significant difference in CBF， CBV， hs-CRP， miR-29b， IL-6， TNF-α and miR-17-5p between the two groups before treatment （P > 0.05）. After treatment， the levels of CBF， CBV， miR-29b， SOD and GSH-Px increased， while the levels of hs-CRP， IL-6， TNF-α， miR-17-5p and MDA decreased， and the levels of CBF， CBV， miR-29b， SOD and GSH-Px in the combined group were higher than those in the control group. The levels of hs-CRP， TNF-α， IL-6， miR-17-5p and MDA were significantly different from those of the control group （P < 0.05）. The incidence of adverse reactions and the total effective rate of treatment in combination group were higher than those in control group （P < 0.05）， and the adverse reactions were mild and tolerable. Conclusion The combination of citicoline sodium and Ureicrin can improve the clinical efficacy and prognosis of patients.

Objective To establish a rapid detection method for invasive candidiasis based on droplet digital polymerase chain reaction （ddPCR）. Methods We developed an assay system using a microtitre-based digital PCR platform and designed primer probes specific for four Candida species， namely Candida albicans， Candida smoothii， Candida near-smoothii， and Candida tropicalis. （1） The Limit of Blank （LOB） range and positive judgment value were determined by analyzing No Template Control （NTC） samples. （2） The Limit of Detection （LOD） range was determined by diluting positive samples with 10 replicate extractions at each concentration gradient. （3） The Linear Limit of Quantitation （LOQ） range was determined by repetitive testing of diluted samples. （4） The linear range limit was determined through gradient dilution of the positive samples. （5） The coefficient of variation （CV）， calculated from the logarithmic values of the resultant concentrations， was assessed by extracting and testing positive samples in 12 repetitions at both high and low concentrations. （6） Method reliability was evaluated by calculating the CV from the logarithmic values of the resultant concentrations obtained from clinical samples with fungal culture results. Results The ddPCR assay detected Candida LOB at a range of 0 ~ 81 copies/mL， with a positive threshold set at ≥ 3 positive microdroplets. The LOD and LOQ were determined to be 3 × 10² copies/mL. The linear range for detecting different concentration gradients was found to be between 3 × 10² and 3 × 10⁷ copies/mL， with high correlation coefficients observed for Candida albicans （R² = 0.999 5）， Candida smoothii （R² = 0.998 9）， Candida near-smoothii （R² = 0.999 4）， and Candida tropicalis （R² = 0.999）. Additionally， the coefficient of variation for the resultant concentration logarithmic values was less than 5%， meeting precision requirements. Furthermore， preliminary validation using clinical specimens demonstrated consistent results compared to clinical culture findings. Conclusion ddPCR exhibits rapidity， high sensitivity， good repeatability， and high specificity in detecting invasive candidiasis in critically ill patients. This study highlights the potential value of droplet digital PCR as a diagnostic tool for invasive candidiasis.

Objective To develop deep learning-based auxiliary diagnostic models for diverse pulmonary diffuse cystic diseases， and subsequently evaluate their classification performance to identify the optimal model for clinical diagnosis. Methods A total of 288 patients diagnosed with idiopathic pulmonary fibrosis （IPF）， pulmonary lymphangioleiomyomatosis （PLAM）， and pulmonary Langerhans cell histiocytosis （PLCH） were prospectively enrolled from the First Affiliated Hospital of Guangzhou Medical University between January 2010 and October 2022， comprising 76 cases of IPF， 179 cases of PLAM， and 33 cases of PLCH.A total of 877 CT cases were collected， comprising 232 cases of IPF， 557 cases of PLAM， and 88 cases of pulmonary PLCH. Based on the cutoff date of December 31， 2019， the CT scans were divided into two datasets： dataset A consisted of 500 CT scans including 185 IPF cases， 265 PLAM cases， and 50 PLCH cases； while dataset B comprised 377 CT scans with a distribution of 47 IPFcases， 292 PLAMcases， and 38 PLCH cases. The Dataset A was randomly partitioned into training set， validation set， and test set in a ratio of 7∶1∶2. Subsequently， six distinct deep learning neural networks were employed for training after preprocessing and data augmentation. Receiver operating characteristic curves were generated to assess the model performance using metrics such as area under the curve （AUC）， accuracy， sensitivity， specificity， and F1 score in order to identify the optimal model. Furthermore， a test set B comprising 30 randomly selected cases from dataset B for each disease type was utilized to evaluate the trained optimal model by employing the same aforementioned metrics. Results In test A， six well-established diagnostic models demonstrated superior classification performance for IPF and LAM， with an AUC greater than 0.9. For LCH， EfficientNet exhibited low classification efficiency with an AUC between 0.6 and 0.7， while Vgg11 showed an AUC between 0.8 and 0.9； the other four models displayed excellent classification efficiency with an AUC greater than 0.9. Except for Inception V3， the remaining five diagnostic models performed poorly in identifying and classifying LCH lesions. Considering multiple indicators， the InceptionV3 model showcased optimal comprehensive performance among the six models， achieving high evaluation parameters such as overall accuracy （94.90%）， precision （93.49%）， recall （90.84%）， and specificity （96.91%）. TestB was conducted using the trained InceptionV3 model resulting in an accuracy of 81%， precision of 82%， recall of 81%， and specificity of 90%. Conclusions Six recognition and classification models， developed using deep learning technology in conjunction with pulmonary CT images， demonstrate effective discrimination between LAM， LCH， and IPF. Notably， the model constructed utilizing the InceptionV3 neural network exhibits superior efficiency in accurately recognizing and classifying IPF and LAM.

Objective The purpose of this study was to investigate the application value of Chromosomal microarray analysis （CMA） in prenatal diagnosis of nuchal translucency （NT） thickening and nasal bone dyscalcification. Methods The fetuses diagnosed with NT thickening and nasal bone dyscalcification at the Prenatal Diagnosis Center of Meizhou People's Hospital from September 2022 to April 2024， who underwent CMA and karyotype analysis were collected to analyze the relationship between NT thickening and nasal bone dyscalcification and chromosome abnormalities. The detection of chromosomal abnormalities in fetuses with NT thickening， nasal bone dyscalcification and the value of ultrasound combined with CMA in prenatal diagnosis were analyzed. Results In 75 fetuses with NT thickening and/or nasal bone dyscalcification， 11 cases of chromosome aneuploidy were detected by karyotype analysis， and 5 cases of pathogenic copy number variations （CNV） were detected by CMA， with an additional detection rate of 6.7%. The additional diagnosis rates of CMA were 6.0% and 5.0% in fetuses with simple NT thickening and nasal bone dyscalcification， respectively. Conclusion CMA technique is of high value in prenatal diagnosis of fetuses with NT thickening and nasal bone dyscalcification， it can improve the detection rate of fetal chromosomal abnormalities， and the combined application of multiple techniques can provide a more comprehensive evaluation of the fetuses.

Objective Discuss the application methods and effects of closed femoro?femoral partial bypass （C-FPB） in thoracoabdominal aortic replacement（TAAAR） surgery. Methods A retrospective analysis of the clinical data of 70 cases of TAAAR assisted by C-FPB from April 2021 to May 2023， some of which combined with abdominal organ perfusion. The main evaluation indicators were in-hospital mortality， postoperative stroke， postoperative spinal cord injury， and the incidence of hemodialysis. Based on an open-type conventional Cardiopulmonary bypass（CPB）circuit， the venous tubing was split with a 10 × 10 × 10 mm "Y" connector directly connected to the inlet of the centrifugal pump， and the tubing after the roller pump was connected to the outlet of the centrifugal pump， while the front of the membrane oxygenator with another 10 × 10 × 10 mm "Y" connector to establish a closed femoro-femoral bypass. During bypass， the lower body is perfused by the centrifugal pump， while the upper body is perfused by the roller pump. Results No system failures happen in all cases. The average bypass time was （101.0 ± 22.2） minutes， the average time for intercostal artery reconstruction was （18.6 ± 5.4） minutes， with an average of （4.7 ± 1.8） pairs. The average length of stay in the ICU was （5.1 ± 1.5） days， and the average length of hospital stay was （34.4 ± 12.5） days. 2 cases （2.9%） experienced postoperative stroke， 1 case （1.4%） resulted in in-hospital mortality， 2 cases （2.9%） experienced postoperative paraplegia， 7 cases （10.0%） underwent postoperative hemodialysis， and 3 cases （4.3%） experienced prolonged mechanical ventilation. Conclusion The Closed-type femoro-femoral partial bypass takes the whole surgical process into account， reduces the management difficulty for perfusionist， and provides a unique advantage for distal perfusion during thoracoabdominal aortic replacement surgery.

Objective To investigate the application value of Yishen Huayu Xugu prescriptionin the management of osteoporotic lumbar compression fracture among elderly patients. Methods From March 2022 to August 2023， all elderly patients with osteoporotic lumbar compression fractures were enrolled in our hospital and randomly assigned into two groups. The patients were diagnosed with kidney deficiency and blood stasis syndrome through physical identification. After admission， both groups （85 cases each） underwent percutaneous kyphoplasty. The control group received conventional Western medicine treatment post-surgery， while the observation group was administered Yishen Huayu Xugu prescription. This herbal formula was prepared by decocting 300 mL of juice in water， divided into two doses， and taken warmly after breakfast and dinner for a duration of 12 weeks. Therapeutic effects were compared after completion of the 12-week treatment period. Results After treatment， the serum levels of D-dimer （D-dimer， D-D） were （5.02 ± 0.63）， interleukin-17 （IL-17） was （53.68 ± 5.47）， β-collagen special sequence （β-CTX） was （0.37 ± 0.06， interleukin-6 （IL-6） was （69.38 ± 8.27） compared to the control group； bone morphogenetic protein-2 （BMP-2） was （2.69 ± 0.31）， 25-hydroxyvitamin D was （58.93 ± 7.17）， and vascular endothelial growth factor （VEGF） was （309.81 ± 51.49） which were higher than those in the control group with more significant improvement observed in the intervention group （P < 0.05）. Bone mineral density （BMD） increased at both week 6 and week12 after treatment with a more pronounced improvement seen in the intervention group（P < 0.05）. After treatment， the observation group exhibited a more significant reduction in the total Traditional Chinese Medicine （TCM） symptom score， Cobb Angle， and ODI， compared to the control group （P < 0.05）. Furthermore， the observation group demonstrated a higher total effective rate of 95.29% （81/85） compared to 85.88% （73/85） in the control group after treatment， with a statistically significant difference between the two groups （P < 0.05）. Conclusion The Yishen Huayu Xugu prescription holds significant positive implications for this particular medication， as it exhibits enhanced efficacy in reducing inflammation， regulating bone metabolism， improving lumbar function， promoting disease amelioration， and enhancing clinical outcomes.

Objective To investigate the clinical， psychological， and economic impacts of the initial dressing change timing following peripherally inserted central catheter （PICC） placement in postoperative breast cancer patients. Methods We enrolled a total of 120 patients who underwent PICC placement following breast cancer surgery at a tertiary hospital in Guangzhou between April and October 2023 for this study. Based on predefined inclusion and exclusion criteria， the patients were divided into an observation group and a control group， with each group comprising 60 patients. In the observation group， the first dressing change was performed 48 hours after PICC placement， whereas in the control group it was done within 24 hours post-placement. The primary outcomes assessed included pain intensity at the puncture site during the initial dressing change， occurrence of bleeding at the puncture site within one week， psychological state evaluated using validated scales such as PHQ-9 depression scale and GAD-7 anxiety scale， as well as maintenance frequency and associated costs over a three-week period. Results There were no significant differences in baseline characteristics between the two groups. The observation group exhibited significantly lower pain levels at the puncture site during the initial dressing change， reduced bleeding at the puncture site within one week， and a shorter duration of bleeding compared to the control group （P < 0.001）. Moreover， the observation group demonstrated statistically significant decreases in depression and anxiety scores， as well as maintenance frequency and costs within three weeks post-placement when compared to the control group（P < 0.001）. Conclusions The implementation of an early dressing change within 48 hours after PICC catheterization in breast cancer patients undergoing surgery has been demonstrated to effectively ameliorate hemorrhage and discomfort at the puncture site， consequently mitigating patient distress and anxiety. Moreover， this intervention facilitates a decrease in dressing change frequency while reducing financial burdens on patients.

Objective To explore the effect of Internet+cardiac rehabilitation on hypertension patients with coronary heart disease. Methods 80 patients with hypertension and coronary heart disease admitted to our hospital from January 2022 to April 2023 were randomly divided into the combined group （n = 40） and the conventional group （n = 40）. Both groups were given routine cardiac rehabilitation interventions. The combined group combined adoptionof the Internet for continuous interventionson the basis of routine cardiac rehabilitation interventions. Compare the oxygen uptake， blood pressure， compliance， and self-management scores between two groups before intervention and three months after discharge. Results The AT Mets， AT VO₂， peak VO₂， and expected value compliance ratio in the combined group were all higher than those in the conventional group （P < 0.05）； The systolic and diastolic blood pressure in the combination group were lower than those in the control group， and the proportion of complete compliance was significantly higher than that in the control group （P < 0.05）； The self-management scores of the joint group were higher than those of the conventional group （P < 0.05）. Conclusion The continuous interventions of Internet plus cardiac rehabilitation can control the blood pressure of patients with hypertension and coronary heart disease， and patients' compliance behavior is significantly improved， andthus improving patients' self-management ability， which can be used for reference and promotion in clinical practice.

Sepsis is a heterogeneous syndrome. It is caused by infections， attributing to immune dysfunction pathologically. The disease is characterized by macrophage-mediated inflammation and immune response throughout its development. During septic development， macrophages metabolize crucially with glycolysis remarkably enhanced. The glycolystic enhancement facilitates septic development by promoting the inflammatory response of macrophages and altering their phenotype. Therefore， direct or indirect inhibition of macrophagic glycolysis can alleviate sepsis and neutralize damages to organs functionally， promoting the polarization of anti-inflammatory phenotype. In this review， we aim to investigate the relationship between macrophagic glycolysis and sepsis， focusing on researching into relevant molecular mechanisms by which glycolysis is regulated for treating sepsis. It is concluded that interfering with macrophagic glycolysis may serve as a novel therapeutic strategy for treating sepsis.

Maxillary sinus floor lifting surgery is a commonly used surgical method in the field of oral implantology to solve the problem of insufficient vertical bone in the posterior maxillary area. It includes internal and external maxillary sinus lifting. Platelet-rich fibrin （PRF）， as a second-generation platelet concentrate， has certain osteoinductive properties and can promote the osteogenic differentiation of mesenchymal stem cells. In maxillary sinus floor lifting surgery， PRF is often mixed with bone grafting materials or used alone， which has great application prospects. Based on current research， the molecular mechanism of PRF promoting osteogenic differentiation of maxillary sinus mucoperiosteal has not been reported in detail， and the application of PRF in maxillary sinus floor lifting surgery is still controversial.This article reviewed the mechanism of PRF in promoting osteogenic differentiation of maxillary sinus mucoperiosteal after maxillary sinus floor lifting surgery， as well as the different application methods of PRF in maxillary sinus floor lifting surgery based on relevant literature， in order to provide a reference for clinicians to rationally use PRF in maxillary sinus floor lifting surgery and furtherly promote the clinical application of PRF.

Chronic obstructive pulmonary disease is characterized by progressive and partially reversible airflow restriction， and is a preventable and treatable respiratory disease. More and more attention has been paid to its complications， including osteoporosis， cardiovascular and cerebrovascular diseases， metabolic syndrome， diabetes， anxiety， depression， etc.Osteoporosis， as the main extrapulmonary complication of chronic obstructive pulmonary disease， seriously threatens the physical and mental health of patients.There are many causes of secondary osteoporosis in chronic obstructive pulmonary disease， including hypoxia， malnutrition， decreased weight and exercise ability， glucocorticoids use， smoking， etc.This article reviews the causes and treatment methods of secondary osteoporosis in chronic obstructive pulmonary disease， aiming to provide theoretical basis for the prevention and treatment of secondary osteoporosis in chronic obstructive pulmonary disease.

The idiopathic inflammatory myopathies encompass a diverse array of autoimmune diseases， characterized by muscular inflammation and various extramuscular manifestations. These conditions have the potential to impact multiple organs， including the lungs， skin， joints， gastrointestinal tract， and heart. The defining features of these conditions are muscle weakness and myalgia. Although cardiac involvement is infrequent， its clinical manifestations are subtle and easily overlooked. Cardiac damage represents a significant contributor to mortality and morbidity in patients with idiopathic inflammatory myopathy. Early and accurate identification of cardiac involvement may facilitate improved patient outcomes. This article provides an overview of the potential etiology， clinical presentations， risk factors， biomarkers， and imaging studies for early diagnosis of cardiac involvement in idiopathic inflammatory myopathy. This review aims to enhance clinicians' understanding and diagnostic capabilities regarding cardiac involvement in idiopathic inflammatory myopathy while promoting early intervention strategies for lifelong management and improved prognosis.

Helicobacter pylori infection is an important causative factor in a variety of gastrointestinal diseases， such as atrophic gastritis， peptic ulcer disease， and gastric cancer. Timely eradication treatment is conducive to maintaining the health of patients. With the increase of drug resistance in Helicobacter pylori， dual therapy with proton pump inhibitors combined with high?dose amoxicillin has gradually gained attention. Potassium?competitive acid blockers are new types of antacids that have a faster onset of action and a longer lasting acid suppression effect than traditional proton pump inhibitors， making it more suitable for dual therapy. In recent years， scholars have carried out a lot of exploration， improvement and verification of potassium?competitive acid blockers dual therapy， and this article reviews its research progress.