Polyglutamine （PolyQ） expansion， encoded by repetitive cytosine-adenine-guanine （CAG） sequences， is a key pathogenic mechanism in various neurodegenerative diseases. Abnormal PolyQ expansion leads to protein misfolding and aggregation， resulting in disruptions of the protein degradation system， mitochondrial dysfunction， and endoplasmic reticulum stress， ultimately causing neuronal damage and death. This review examines the impact of PolyQ expansion on protein structure， function， and gene expression， with a focus on its role in the pathogenesis of neurodegenerative diseases. Furthermore， it summarizes current therapeutic research progress in these diseases， including emerging approaches such as gene therapy， antisense oligonucleotide therapy， and stem cell therapy. Additionally， it explores the future potential of precision medicine and gene editing technologies in treatment applications.

Objective To investigate the effects of bis（acetylacetonato）oxovanadium（IV） ［VO（acac）?］ on human adrenocortical carcinoma cell lines SW?13 and NCI?H295R in vitro， aiming to determine whether VO（acac）? promotes or inhibits the proliferation， migration， and invasion of these cells. Methods SW?13 and NCI?H295R cells in logarithmic growth phase were exposed to VO（acac）? at concentrations of 6.25， 12.5， 25， 50， 75， 100， and 200 μmol/L for 24 and 48 hours， respectively. Mitotane served as the positive control. Cell viability was assessed using the CCK?8 assay to evaluate the effects of VO（acac）? on SW?13 and NCI?H295R cells. Subsequently， cells were treated with VO（acac）? at concentrations of 0， 6.25， 12.5， and 25 μmol/L for 48 hours， and flow cytometry was employed to investigate the impact of VO（acac）? on apoptosis. The migratory ability of the cells was evaluated using a wound healing assay， while their invasive capacity was assessed via a Transwell assay. Additionally， the clonogenic assay was used to determine the proliferative potential of SW?13 and NCI?H295R cells following VO（acac）? treatment. Results The CCK?8 results demonstrated that VO（acac）₂ inhibited the viability of SW?13 and NCI?H295R cells in a time? and concentration?dependent manner. Specifically， the half?maximal inhibitory concentrations （IC50） for VO（acac）₂ against SW?13 cells were 62.98 ± 6.67 μmol/L after 24 hours and （14.61 ± 1.66） μmol/L after 48 hours of treatment， while the corresponding IC50 values for NCI?H295R cells were 46.78 ± 7.89 μmol/L and 12.61 ± 2.98 μmol/L， respectively. Flow cytometry analysis revealed that VO（acac）₂ induced apoptosis in both SW?13 and NCI?H295R cells in a concentration?dependent manner （P < 0.05）. The wound healing assay indicated a significant reduction in the migratory rate of SW?13 and NCI?H295R cells with increasing concentrations of VO（acac）₂ （P < 0.05）. Transwell assay results showed that VO（acac）₂ significantly inhibited the invasive ability of SW?13 and NCI?H295R cells in a concentration?dependent fashion. Finally， the clonogenic assay confirmed that VO（acac）₂ suppressed the proliferative capacity of SW?13 and NCI?H295R cells in a concentration?dependent manner. Conclusion VO（acac）₂ inhibits the proliferation， migration， and invasion of human adrenocortical carcinoma cells （SW?13 and NCI?H295R）， while inducing apoptosis in these cell lines.

Objective This study aims to investigate the pathological role and molecular mechanisms of pericyte depletion in neuropsychiatric lupus （NPSLE） and to assess the potential of the PDGFR-β signaling pathway as a novel therapeutic target for NPSLE. Methods NPSLE models were established using 8-week-old female MRL/lpr mice， from which those exhibiting abnormal behaviors were selected for further analysis. The PDGFR-β signaling pathway was modulated using an agonist to promote pericyte proliferation or an inhibitor to suppress pericyte apoptosis. The effects of these treatments on blood-brain barrier （BBB） integrity， eye-signs in blood stasis syndrome， neuronal integrity， and tight junction protein expression were evaluated. Evans blue staining， H&E staining， Nissl staining， and immunofluorescence staining were employed to assess the expression of tight junction proteins （Cadherin， ZO-1）， endothelial cell markers （CD31）， and pericyte markers （NG2）. Results Mice in the NPSLE group exhibited significant anxiety， depression， and cognitive impairment. In the PDGFR-β inhibition group， eye-signs in blood stasis syndrome scores were significantly elevated （P < 0.01）， BBB permeability was markedly increased （P < 0.001）， neuronal numbers were significantly reduced， tight junction protein expression was diminished， and pericyte depletion was aggravated. Conversely， the PDGFR-β agonist group showed a significant reduction in eye-signs in blood stasis syndrome scores （P < 0.01）， improved pericyte survival， enhanced expression of tight junction proteins， reduced neuronal damage， and restoration of BBB function （P < 0.001）. Immunofluorescence staining further confirmed that PDGFR-β activation significantly protected pericytes. Conclusions Pericyte depletion is closely associated with increased BBB permeability and exacerbation of eye-signs in blood stasis syndrome. Modulation of the PDGFR-β signaling pathway may provide a promising therapeutic strategy for NPSLE.

Objective The pathogenesis of EAP in rats based on the TLR4/NF-κB?NLRP3 inflammasome signaling pathway was explored. Methods Randomly divide 12 male SD rats into 4 groups using the number table， namely normal group （N）， model group （M）， Caspase-1 inhibitor group （Caspase-1）， and NLRP3 inhibitor MCC950 group （NLRP3）， with 3 rats in each group. After drug intervention， relevant indicators were observed by using HE staining， ELISA， WB methods. Results Compared with the N group， the M group rats had showed significant damage in prostate gland structure and infiltration of inflammatory cells. Compared with group N， the expression of TLR4， P?NF-κB P65， NLRP3， ASC， Cleaced?Caspase-1， Cleaced?IL?1β， and IL?18 proteins in the prostate tissue of group M rats had increased（P < 0.01）. Compared with group M， the expression of TLR4， P?NF-κB P65， NLRP3， ASC， Cleaced?Caspase-1， Cleaced?IL?1β， and IL?18 proteins in the NLRP3 and Caspase?1 groups had significantly reduced（P < 0.01）. The serum levels of IL?1 β， IL?6， IL?8， IL?17A， IL?18， IFN?γ， and TNF?α in group M rats had been significantly higher than those in group N（P < 0.01）. But the serum levels of IL?10 had been slightly lower and no statistical significance. The serum levels of IL?1β， IL?6， IL?8， IL?17A， IL?18， IFN?γ， and TNF?α in group M rats had been lower than those in group N（P < 0.01 or P < 0.05）， the serum IL?10 level had increased（P < 0.01）. Conclusion The activation of TLR4/NF-κB-NLRP3 inflammasome signaling pathway promotes the occurrence and development of prostatitis in EAP rats.

Objective To explore the clinical significance of pulse pressure variability （PPV） in early prevention and diagnosis of prostate resection syndrome by observing the changes in PPV during transurethral resection of the prostate. Methods Eighty patients undergoing transurethral resection of the prostate （TURP） under general anesthesia from March to April 2023 were randomly divided into a control group and an observation group， with 40 patients in each group. The control group underwent routine monitoring of invasive blood pressure， while the observation group continued to monitor PPV in addition to invasive blood pressure monitoring. Observe and record the hemodynamic parameters， electrolyte Na⁺， K⁺，CL ^-， Changes in hemoglobin （Hb） and hematocrit （Hct）， recording surgical time， intraoperative lavage fluid dosage， and occurrence of dilutive hyponatremia （TURS）. Results One patient in the observation group experienced two unexplained drops in blood pressure and heart rate during surgery， and was diagnosed with TURS based on blood gas analysis. Among them， the observation group showed a decreasing trend in PPV with the prolongation of surgery time. PPV gradually decreased at 45 ~ 60 minutes after surgery， and at 90 minutes after surgery， PPV decreased significantly compared to preoperative levels. Among them， 6 patients had a 50% decrease in PPV compared to preoperative levels. For patients with significantly reduced PPV， immediate treatment was given 10 ~ 20 mg of furosemide and 10 mg of dexamethasone. By the end of surgery， PPV had basically recovered to preoperative levels. Both groups of patients showed varying degrees of decrease in Na⁺， K⁺， Hct， and Hb levels. Conclusions PPV can reflect the volume status of patients. When PPV decreases by more than 50% compared to preoperative levels and there are unexplained hemodynamic changes and abnormal clinical manifestations during surgery， it is necessary to be vigilant and handle them promptly to reduce and prevent the occurrence of TURS.

Objective This study aims to compare the efficacy of video stylets and video laryngoscopes in facilitating nasotracheal intubation during oral surgery. Methods A total of 80 patients， aged between 18 and 70 years old， with ASA grade Ⅰ or Ⅱ， scheduled for elective oral surgery under general anesthesia， were randomly assigned to either the video stylet group （Group N） or the video laryngoscope group （Group C）， with 40 patients in each group. In Group N， a video stylet was used to shape the tracheal tube at a 90-degree angle， with the shaping position being the vertical distance from the Adam's apple to the nostril. The tube was inserted from the nasal cavity into the throat under direct visualization， and positioned behind the glottis. In Group C， the tube was initially blindly inserted into the nasal cavity without a core. Upon reaching the throat， a video laryngoscope was employed to lift the epiglottis and expose the glottis from the mouth. The tube was then inserted with the aid of intubation forceps or cuff inflation. The primary outcome measure was the intubation time. Additional measures included the time taken for nasal passage， glottis exposure， and the number of intubation attempts and assistant interventions required. Vital signs， including MAP and HR， were recorded at five minutes of quiet rest upon entering the room （T₀）， during glottis exposure （T₁）， upon passage of the tube through the glottis （T₂）， and one minute after the tube entered the trachea （T₃）. Complications such as epistaxis， oral mucosal bleeding， loose incisors， and postoperative sore throat were also documented. Results The intubation time and nasal passage time in Group N were significantly shorter than those in Group C （P < 0.05）. The number of cuff inflations and intubation forceps assisted cases in Group N was significantly lower than in Group C （P < 0.05）. There were no significant differences between the two groups in terms of glottis exposure time， first successful intubation times， C-L glottis classification， and mandibular lift-assisted intubation （P > 0.05）. The increase in MAP and HR in Group N at T₁ and T₂ was significantly less than in Group C （P < 0.05）. The number of cases with mild epistaxis in Group N was significantly lower than in Group C （P < 0.05）. Similarly， the number of cases with loose incisors and oral mucosal bleeding in Group N was significantly less than in Group C （P < 0.05）. Conclusion Compared to the video laryngoscope， the video stylet-guided nasotracheal intubation results in a shorter intubation time， less damage to the oronasopharynx， eliminates the need for intubation forceps， and reduces the patient's stress and vascular stress response during intubation.

Objective To investigate whether the geometric triangular relationship between the Blumensaat line and the tibial plateau can serve as an auxiliary diagnostic index for identifying and evaluating anterior cruciate ligament （ACL） injuries， thereby enhancing diagnostic accuracy. Methods A retrospective self?controlled study was conducted involving 64 patients diagnosed with unilateral ACL injury via arthroscopy and treated with ACL reconstruction at Qingdao Municipal Hospital from January to August 2023. Ultimately， 40 cases were included in the analysis. Preoperative MRI images of the affected knees and contralateral healthy knees were collected as the ACL injury group and control group， respectively. In the MRI images， point C， point D， and point E were defined as the anterior end， posterior end， and midpoint of the Blumensaat line， respectively； point A and point B were defined as the turning points of the anterior and posterior edges of the tibial plateau， respectively； and point C' was defined as the intersection of the extension line of DC and line AB. Based on these anatomical landmarks， angles ∠DAB， ∠CEB， ∠DC'B， and ∠CDB were established. The intra?class correlation coefficient （ICC） was calculated to assess measurement consistency and reproducibility. Differences between the aforementioned angles were compared， and the area under the receiver operating characteristic （ROC） curve was computed to evaluate diagnostic performance. Results For ∠CDB， ∠DC'B， ∠CEB， and ∠DAB， the intra?group and inter?group correlation coefficients all exceeded 0.80， indicating excellent consistency and reproducibility. Compared to the control group， the angles ∠CDB， ∠CEB， and ∠DAB in the ACL injury group were significantly reduced （P < 0.001）. Among these， ∠DAB appears to be the most reliable index for diagnosing and evaluating ACL injuries， with an area under the receiver operating characteristic curve （AUC） of 0.829， a cut?off value of 42.2°， a sensitivity of 82.5%， and a specificity of 80.0%. Conclusion The geometric triangular relationship between the Blumensaat line and the tibial plateau in MRI images， particularly the angle ∠DAB， can serve as an auxiliary indicator for diagnosing and evaluating ACL injuries， thereby enhancing diagnostic accuracy.

Objective To analyze the clinical characteristics associated with prenatal diagnosis of FBN 1 gene mutations in a family. This study explores the correlation between gene mutations and their corresponding clinical phenotypes， emphasizing the significance of prenatal diagnosis in providing a foundation for subsequent follow?up and intervention. Methods Genomic DNA was extracted from the amniotic fluid of the fetus and the peripheral blood of the parents for trio?whole exome sequencing. The candidate variant identified was subsequently validated using Sanger sequencing. Results The pedigree comprised four generations and nine family members， with four individuals exhibiting slender limbs and toes. Among these， three showed congenital lens dislocation or subluxation. No abnormalities in the cardiovascular system were observed. Genetic testing of symptomatic individuals revealed a heterozygous mutation （c.6158G > T） in the FBN 1 gene. Conclusions The FBN 1 c.6158G > T （p.C2053F） mutation was identified as the pathogenic variant responsible for the condition in this family， exhibiting autosomal dominant inheritance. To our knowledge， this is the first reported case of the FBN 1 c.6158G > T （p.C2053F） mutation in China. Prenatal diagnosis can facilitate early confirmation of the condition and provide a foundation for subsequent interventions and follow?up care.

Objective To evaluate the clinical efficacy of hip?knee?ankle active and passive exercise therapy in patients with early? to mid?stage knee osteoarthritis （KOA）. Methods A total of 180 patients with early to mid?stage knee osteoarthritis （KOA） were recruited from the First Affiliated Hospital of Hebei University of Traditional Chinese Medicine between March 2023 and March 2024. Patients were randomly assigned to one of four groups： active movement group， passive movement group， combined movement group， and control group， with 45 patients in each group. The active movement group received hip?knee?ankle active movement therapy daily until the end of follow?up. The passive movement group underwent hip?knee?ankle passive movement therapy three times per week for two weeks. The combined movement group received both active and passive therapies. The control group was administered oral celecoxib capsules （200 mg once daily for two weeks）. Joint function was assessed in all four groups before treatment， at two weeks post?treatment， and at 14 weeks post?treatment. The primary outcome measure was the WOMAC joint function score， while secondary outcomes included the WOMAC pain score， stiffness score， and quality of life score （SF?12）. Results A total of 160 patients completed the trial， with 39 in the active group， 42 in the passive group， 40 in the combined group， and 39 in the control group. There were no significant differences in baseline characteristics among the groups （P > 0.05）. Compared to baseline， the WOMAC scores for function， pain， and stiffness in the passive， combined， and control groups decreased significantly at both 2 and 14 weeks post?treatment （P < 0.05）， while the SF?12 scores increased significantly （P < 0.05）. Between 2 and 14 weeks post?treatment， the active and combined groups showed further significant decreases in WOMAC function， pain， and stiffness scores （P < 0.05） and increases in SF?12 scores （P < 0.05）. At 2 weeks post?treatment， compared to the control group， the passive and combined groups exhibited significantly lower WOMAC function scores （P < 0.05）， with no significant difference between the passive and combined groups （P > 0.05）. By 14 weeks post?treatment， the active and combined groups demonstrated significantly lower WOMAC function scores （P < 0.05）， with the combined group showing a significantly lower score than the active group （P < 0.05）. Conclusion The four therapeutic approaches demonstrate a certain degree of efficacy in improving joint function for patients with early and mid?stage KOA. The passive therapy group exhibits superior short?term outcomes， while the active therapy group shows better long?term benefits. The combined therapy group presents notable advantages in both short?term and long?term efficacy， although its short?term effectiveness does not surpass that of the passive therapy group. It is recommended for patients with early and mid?stage KOA who have underlying gastrointestinal and cardiovascular conditions.

Objective To identify risk factors for colorectal adenomatous polyps using logistic regression analysis， construct a prediction model based on these identified factors， and subsequently evaluate the performance of the model. Methods Encompassed 1，023 patients who underwent large intestine polyp resection at the First Hospital of Handan between January 2017 and January 2022. Among these patients， 676 had adenomatous polyps （adenomatous polyp group） and 347 had non-adenomatous polyps （non-adenomatous polyp group）. We collected data on basic information， medical history， colonoscopy results， and polyp pathology. By comparing the two groups， we identified significant differences in various indicators， which were selected as candidate factors for model construction. Patients were randomly divided into a training set and a validation set at an 8∶2 ratio. Using the training set data， we constructed a risk prediction model and developed a nomogram using R Studio software to visually present the model. Finally， we internally validated the model using the validation set. The model's discrimination ability was evaluated using the ROC curve， its accuracy was assessed via the calibration curve， and its clinical utility was evaluated through decision curve analysis （DCA）. Results Significant differences were observed between the two groups in terms of age， drinking habits， family history of colorectal cancer， hyperlipidemia， history of cholecystectomy， HP infection， and history of appendectomy （P < 0.05）. These variables were included in the model construction. A total of 818 participants were randomly assigned to the training set， while 205 were allocated to the validation set. Multivariate logistic regression analysis on the training set confirmed that age （OR = 1.021， 95%CI： 1.006 ~ 1.036， P = 0.006）， alcohol consumption （OR = 3.440， 95%CI： 2.251 ~ 5.257， P < 0.001）， first-degree relatives with colorectal cancer （OR = 3.775， 95%CI： 1.881 ~ 7.577， P < 0.001）， hyperlipidemia （OR = 3.428， 95%CI： 2.443 ~ 4.808， P < 0.001）， history of cholecystectomy （OR = 3.916， 95%CI： 1.756 ~ 8.735， P < 0.001）， Helicobacter pylori （HP） infection （OR = 3.292， 95%CI： 2.309 ~ 4.693， P < 0.001）， and history of appendectomy （OR = 3.819， 95%CI： 2.002 ~ 7.286， P < 0.001） were independent risk factors for adenomatous polyps. Consequently， a prediction model for large intestine adenomatous polyps was developed using the formula P = 1/（1+e^-Y）， where Y = 0.020 × age + 1.328 × first-degree relatives with colorectal cancer + 1.235 × alcohol consumption + 1.232 × hyperlipidemia + 1.365 × cholecystectomy + 1.192 × HP infection + 1.340 × appendectomy - 1.995. The model demonstrated good performance with AUC values of 0.763 （95%CI： 0.729 ~ 0.797） for the training set and 0.769 （95%CI： 0.644 ~ 0.787） for the validation set. The calibration curve indicated a good fit， and decision curve analysis showed that the model could achieve positive net benefit across a wide range of threshold probabilities， confirming its clinical utility. Conclusions Age， alcohol consumption， a family history of colorectal cancer in first-degree relatives， hyperlipidemia， cholecystectomy， HP infection， and appendectomy were identified as independent risk factors for adenomatous polyps. A prediction model incorporating these risk factors holds significant practical value for predicting the occurrence of colorectal adenomatous polyps.

Objective To examine the correlation between ferroptosis-related gene expression levels and myocardial dysfunction as well as prognosis in sepsis patients. Methods Eighty-five sepsis patients admitted to our hospital from May 2023 to August 2024 were categorized into two groups based on the presence of myocardial dysfunction： the impaired group （n = 39） and the non-impaired group （n = 46）. The mRNA expression levels of cytochrome P450 oxidoreductase （POR）， solute carrier family 7 member 5 （SLC7A5）， and signal transducer and activator of transcription 3 （STAT3） were measured. Multivariate logistic regression analysis was conducted to examine the correlation between the expression levels of iron death-related genes and sepsis-induced myocardial dysfunction （SIMD）. Kaplan-Meier survival curves were plotted to evaluate the relationship between the expression levels of iron death-related genes and the prognosis of sepsis patients. Results In patients with sepsis， the disorder group exhibited higher male proportions， age， and expression levels of POR， SLC7A5， and STAT3 compared to the non-disorder group （P < 0.05）. After adjusting for potential confounders such as gender and age， the expression levels of POR， SLC7A5， and STAT3 remained independent predictors of SIMD （P < 0.05）. The ROC curve analysis revealed that the AUC for POR expression in predicting SIMD was 0.677 （95%CI： 0.561 ~ 0.792）， with a sensitivity of 87.20% and specificity of 54.30%. For SLC7A5， the AUC was 0.844 （95%CI： 0.749 ~ 0.939）， with a sensitivity of 74.40% and specificity of 93.50%. STAT3 had an AUC of 0.690 （95%CI： 0.570 ~ 0.809）， with a sensitivity of 69.20% and specificity of 71.70%. During the follow-up period， 69 patients （81.18%） survived， while 16 （18.82%） did not. Kaplan-Meier survival analysis indicated that POR and SLC7A5 expression levels were significantly associated with the 28-day survival rate of septic patients （χ2 = 6.048/10.143， P < 0.05）， whereas STAT3 expression showed no significant correlation （χ2 = 2.149， P > 0.05）. Conclusion The expression levels of POR， SLC7A5 and STAT3 are closely related to SIMD， and the expression levels of POR and SLC7A5 are significantly related to the prognosis of sepsis patients.

Objective To investigate the efficacy of continuous suture and parachute continuous suture in forearm autologous arteriovenous endovascular fistula surgery， and to analyse their effects on postoperative fistula patency rate and complications. Methods 209 patients with end-stage renal disease （ESRD） admitted to our hospital from January， 2020 to January， 2024 were selected as observation objects， and they were divided into group A （simple intermittent suture， n = 50）， group B ［simple continuous （two-point） suture， n=63］ and group C （parachute continuous suture， n = 96） The postoperative vascular anastomosis time， operation time， blood flow， vascular patency rate， thrombosis rate， complication rate and quality of life score of each group were compared. Results In group C， the vascular anastomosis time and overall operation time were the shortest， and the blood flow was less （P < 0.05）， but there was no significant difference in vascular patency rate， thrombosis rate and complication rate （P > 0.05）. In group C， the level of serum inflammatory factors decreased the most and the quality of life improved the most significantly （P < 0.05）. Conclusions Continuous suture and parachute suture can shorten the operation time， reduce the level of serum factors and improve the quality of life. The best scheme should be selected according to the individual differences of patients.

Objective To explore the clinical efficacy of transcranial combined peripheral magnetic stimulation on bladder and voiding ability in patients with NB after spinal cord injury. Methods From September 2023 to October 2024， 60 patients with NB after spinal cord injury were chosen from the Department of Rehabilitation Medicine of the First Affiliated Hospital of Bengbu Medical University， and were separated into the regular group （n = 15）， M1 area stimulation group （n = 15）， sacral nerve root stimulation group （n = 15）， and combined stimulation group （n = 15）. The control group underwent conventional rehabilitation treatment， the M1 area stimulation group added repetitive transcranial magnetic stimulation （rTMS） of the M1 area of the motor cortex， the sacral nerve root stimulation group added repetitive peripheral magnetic stimulation （rPMS） of the sacral 3 nerve roots， and the co-stimulation group added rTMS of the M1 area and rPMS of the sacral 3 nerve roots， and the treatment was carried out for 4 weeks in total. Urodynamic indices， voiding diaries， and neurogenic bladder symptom scores （NBSS） were assessed before and after therapy in the four groups. Results Before therapy， the differences in maximum bladder capacity， bladder capacity at the time of the first urge to urinate， maximum urine flow rate， residual urine volume， average number of urination per day， average daily urinary output， and NBSS scores of the four groups were not statistically significant when compared with those of the pre-treatment group （P < 0.05）； after treatment， the maximum bladder capacity， bladder capacity at the time of the first urge to urinate， maximum urine flow rate， residual urine volume， average number of urination per day， average daily urinary output， and NBSS scores were all improved compared with those before treatment （P < 0.05）； in comparison between the groups， after treatment， the Urodynamic indices， voiding diaries， and NBSS scores of the combined group were better than those of the other three groups （P < 0.05）. Conclusion Transcranial combined peripheral bidirectional feedback magnetic stimulation therapy can improve urodynamic and voiding symptoms and promote the recovery of bladder and voiding function in patients with NB after spinal cord injury

Objective To evaluate the application of carbapenem antibiotics in conjunction with hemofiltration for patients with septic shock and to analyze the impact on serum levels of lncRNA XIST and miRNA-130a. Methods A prospective study was conducted on 80 patients with septic shock treated at our hospital from August 2022 to January 2024. These patients were randomly divided into a control group and an experimental group， each comprising 40 cases. The control group received carbapenem antibiotics， while the experimental group received carbapenem antibiotics in combination with hemofiltration. The clinical outcomes of both groups were evaluated， and comparisons were made regarding their hemodynamic indices ［including cardiac output （CO）， central venous pressure （CVP）， and mean arterial pressure （MAP）］， immune function indices ［including interleukin-6 （IL-6）， C-reactive protein （CRP）， and tumor necrosis factor-alpha （TNF-α）］， oxygen metabolism indices ［including blood oxygen saturation （SaO₂）， blood lactate （LAC）， and oxygenation index （PaO₂/FiO₂）］， as well as serum levels of lncRNA XIST and miRNA-130a expression. Results Following treatment， the levels of CO， CVP， MAP， SaO₂， PaO₂/FiO₂， and miRNA-130a were significantly increased， whereas the levels of IL-6， CRP， TNF-α， LAC， and lncRNA XIST were significantly decreased compared to pre-treatment levels （all P < 0.05）. In comparison with the control group， the experimental group exhibited significantly higher levels of CO， CVP， MAP， and miRNA-130a， as well as significantly lower levels of IL-6， CRP， TNF-α， and lncRNA XIST （all P < 0.05）. The overall effective rate in the experimental group was significantly higher than that in the control group （χ ² = 4.501， P < 0.05）， while no significant difference was observed in the incidence of adverse reactions between the two groups （χ ² = 0.180， P > 0.05）. Conclusion Carbapenem antibiotics and hemofiltration therapy can alleviate the symptoms of septic shock patients by downregulating lncRNA XIST expression， upregulating miRNA-130a expression， modulating inflammatory factors， enhancing oxygen metabolism indices， and maintaining hemodynamic stability.

Objective To evaluate the efficacy of combining surgical treatment with biological agents for perianal fistulizing Crohn′s disease （pfCD）. Methods Sixty patients with perianal fistulizing Crohn′s disease （pfCD） admitted to our hospital from May 2021 to December 2023 were randomly allocated into two groups： Treatment Group A （n = 30） and Treatment Group B （n = 30）. Treatment Group A received pfCD surgery combined with infliximab （IFX） and azathioprine （AZA）， while Treatment Group B underwent pfCD surgery along with ustekinumab （UST） and AZA. The CDAI score， PDAI score， and Assche score were monitored for both groups， and postoperative MRI examinations were conducted to evaluate the healing of pfCD. Results There were statistically significant differences in CDAI， PDAI， and Assche scores between pre?treatment and post?treatment comparisons within treatment groups A and B （P < 0.05）， as well as in the magnitude of change at each time point. Comparisons of CDAI， PDAI， and Assche scores at 8， 16， 24， and 32 weeks， and PDAI scores at 40 weeks between groups A and B using independent samples t?tests did not yield statistically significant results （P > 0.05）. However， significant differences were observed for CDAI and Assche scores at 40 weeks （P < 0.05）. Significant changes in CDAI， PDAI， and Assche scores were noted at 8， 16， 24， 32， and 40 weeks post?treatment within both groups A and B （P < 0.05）. Multiple comparisons using the LSD method revealed that the changes in these scores at each time point were statistically significant （P < 0.05）. The data indicate a temporal trend in the changes of CDAI， PDAI， and Assche scores， with group B showing a more rapid decline compared to group A. In terms of fistula response rates， both groups A and B achieved 100% （30/30）. However， the clinical healing rate of fistulas was higher in group B at 86.7% （26/30） compared to 76.7% （23/30） in group A. Conclusion The combination of surgical treatment with IFX/UST plus AZA is safe and effective for treating pfCD. However， the long?term efficacy of combining surgical treatment with UST appears to be superior.

Objective To assess the utility of real?time shear wave elastography （SWE） in diagnosing vascular erectile dysfunction （ED） and to predict the optimal timing for color Doppler flow imaging （CDFI） examination. Methods Patients diagnosed with ED who received intracavernosal injection （ICI） of vasoactive drugs were recruited and categorized based on CDFI findings into three groups： arterial ED （n = 17）， venous ED （n = 33）， and non?vascular ED （n = 29）. SWE technology was utilized to measure the average Young's modulus （E value） of the corpus cavernosum in these patients， both in the flaccid state prior to ICI and at four time points following ICI?induced erection. Subsequently， the differences in E values among the three groups were analyzed. Results There was no significant difference in the E value of the corpus cavernosum in the flaccid state among the arterial， venous， and non?vascular ED groups before ICI （P > 0.05）. However， the E value in the flaccid state for each group was significantly higher than the mean E values observed at the four time points after ICI?induced erection （P < 0.01）. Additionally， the mean E values at these four time points post?ICI were also statistically significant （P < 0.01）. ROC curve analysis revealed that the AUC for diagnosing arterial， venous， and non?vascular ED using the E value after ICI were 0.814， 0.770， and 0.711， respectively， with corresponding cutoff values of 9.98， 8.16 and 7.06 kPa. The combined use of CDFI and SWE cutoff values following ICI?induced erection significantly shortened the detection time for both arterial and venous ED groups （P < 0.01）. Conclusions SWE can accurately measure the E value of the corpus cavernosum following erection induced by the vasoactive drug ICI， thereby facilitating the differentiation of various types of ED. Additionally， when combined with CDFI， this technique can reduce the time required for examination.

Objective To examine the correlation between fetal rectal ampulla diameter and gestational age， and to establish reference value ranges for low-risk fetuses between 18 and 40 weeks of gestation in Yibin region. Methods A total of 1，103 low-risk singleton pregnant women between 18 and 40 weeks of gestation were recruited from five hospitals in Yibin City （the Second People′s Hospital， the First People′s Hospital， the Fifth People′s Hospital， the Maternal and Child Health Hospital of Yibin City， and the Maternal and Child Health Hospital of Cuiping District） for routine level Ⅰ， Ⅱ， and Ⅲ prenatal ultrasound screening from October 2022 to March 2024. Fetal rectal ampulla diameters， including anteroposterior diameter， transverse diameter， and area， were measured using prenatal ultrasound. The normality of these measurements was assessed using the Shapiro-Wilk test. Scatter plots depicting the relationship between fetal rectal ampulla diameter parameters and gestational age were generated using the "Overlap Scatter Plot" function in SPSS. Percentiles were calculated using the "Explore" function in SPSS， with reference value ranges described by P5， P10， P50， P90， and P95. Results The visualization rate of the fetal rectal ampulla diameter was 55% at 18 ~ 20 weeks of gestation， 100% at 21 ~ 37 weeks， and 96% at greater than 37 weeks. The fetal rectal ampulla diameter exhibited a significant positive correlation with gestational age （r = 0.925 ~ 0.949， P < 0.01）. Conclusions Prenatal ultrasound measurement of fetal rectal ampulla diameter demonstrates a robust correlation with gestational age. The reference intervals for the rectal ampulla diameter of low-risk fetuses between 18 and 40 weeks of gestation， established in this study， may offer valuable theoretical guidance for prenatal diagnosis of fetal rectal and anal abnormalities in Yibin region.

Objective To investigate the feasibility and accuracy of an ultrasound-based transfer learning artificial intelligence model in predicting the malignancy probability of partially cystic thyroid nodules （PCTN）. Methods A retrospective analysis was conducted on 246 patients with PCTN who had definitive pathological results and were admitted to Weihai Municipal Hospital， Cheeloo College of Medicine， Shandong University from January 2021 to December 2023. Patients were randomly divided into training and test cohorts at a ratio of 7：3. Ultrasonic image features of PCTN were evaluated， and independent risk factors were identified using multivariate logistic regression analysis， with the area under the curve （AUC） subsequently calculated. Additionally， five different pre-trained models?Inception_v3， EfficientNet， VGG19， ResNet50， and DenseNet121?were selected for transfer learning after data preprocessing using the PyTorch framework in Python. The AUC values of these models were calculated and compared. Results Solid portion greater than 50%， eccentric acute angle， ill-defined margin， spiculated or microlobulated margin， rim calcification， and microcalcification exhibited statistically significant differences（P < 0.05） in distinguishing between benign and malignant PCTN. The AUC value derived from these independent risk factors was 0.843. Furthermore， among the five transfer learning models evaluated， the ResNet50 model demonstrated the highest diagnostic efficiency， achieving an AUC value of 0.903 2. Conclusion The ultrasound-based transfer learning artificial intelligence model demonstrated superior performance compared to traditional ultrasound image evaluation methods， enabling accurate prediction of the nature of PCTN and thereby reducing unnecessary ultrasound-guided fine needle biopsies.

Objective To evaluate the association between cervical insufficiency （CI） and spontaneous preterm birth （SPB）， and to investigate the predictive value of shear wave elastography （SWE）， cervical length （CL）， and anterior cervical angle （ACA） in identifying SPB resulting from CI. Methods This study recruited 786 pregnant women who attended prenatal outpatient clinics or were hospitalized for treatment at the Affiliated Hospital of Nantong University and the Maternity Hospital affiliated with Jiangnan University from June 2023 to January 2024. Among these participants， 723 were full-term pregnancies and 63 were preterm pregnancies. Cervical SWEI， CL， and cervical ACA were measured using a Mindray Resona R9 Pro/Eagus R9s ultrasound device equipped with shear wave elasticity imaging software. Additionally， the participants were categorized into four gestational age groups： 19-23⁺⁶ weeks， 24-27⁺⁶ weeks， 28-33⁺⁶ weeks， and 34-36⁺⁶ weeks， to evaluate the relationship between gestational age and ultrasound parameters. Results The mean CL in the preterm group was 25.4 mm， significantly shorter than the 29.7 mm observed in the full-term group （P < 0.001）. The ACA in the preterm group was 121°， which was significantly higher than the 99° in the full-term group （P < 0.001）. Additionally， SWE values were significantly lower in the preterm group compared to the full-term group at all measured cervical sites： anterior external os （AE） 6.47 kPa versus 9.91 kPa （P < 0.001）， anterior internal os （AI） 10.98 kPa versus 18.62 kPa （P < 0.001）， posterior internal os （PI） 11.32 kPa versus 21.09 kPa （P < 0.001）， and posterior external os （PE） 8.16 kPa versus 13.24 kPa （P < 0.001）. A significant negative correlation was found between CL and gestational age （r = -0.278， P = 0.001）. The combined predictive indicators demonstrated high accuracy and specificity for predicting preterm birth， with an area under the curve （AUC） of 0.952， sensitivity of 95%， and specificity of 86%. Conclusions The integration of cervical SWE， CL measurement， and assessment of the angle of ACA can substantially enhance the predictive accuracy for SPB due to CI. This multimodal approach offers clinicians a more robust and precise tool for identifying high-risk pregnancies， enabling timely interventions that can reduce the incidence of preterm birth and improve maternal and neonatal outcomes.

Objective To investigate the incidence of placental abruption in the third trimester of pregnancy in Hebei Province， identify its associated risk factors， and develop a corresponding nomogram prediction model. Methods Data from pregnant women at 22 monitored hospitals in Hebei Province， collected between 2013 and 2023， were analyzed to assess the incidence， trends， and associated risk factors of placental abruption. A prediction model was developed and visualized using R programming to generate the receiver operating characteristic （ROC） curve. The model's predictive performance was evaluated using the area under the curve （AUC） and calibration curve parameters. Results A total of 480 690 pregnant women were included in this study over the specified period. The incidence of placental abruption was 0.29% （1 395 out of 480 690）， with an average annual percentage change of 2.73%， indicating a stable trend （P = 0.34）. Multivariate logistic regression analysis revealed that pregnancy-related anemia， preeclampsia， placenta previa， vaginal bleeding before 28 weeks' gestation， and between 28 and 31⁺⁶ weeks' gestation were significant risk factors for placental abruption （all P < 0.05）. In contrast， regular prenatal examinations （7 ~ 11 visits） and multiple pregnancies were identified as protective factors against placental abruption （both P < 0.05）. The area under the curve （AUC） for the nomogram model constructed based on independent risk factors for placental abruption was 0.79， and the calibration curve demonstrated that the predicted values closely aligned with the observed values. Conclusions Prenatal examinations should be prioritized， especially for women with preeclampsia， placenta previa， or a history of vaginal bleeding before 28 weeks of gestation. Management of pregnancies between 28 and 31⁺⁶ weeks is also crucial to reduce the incidence of placental abruption and mitigate adverse maternal and neonatal outcomes. The nomogram model constructed based on these factors exhibits excellent predictive performance， providing a solid theoretical foundation for the prevention and clinical management of placental abruption.

Cardiac arrest is a major health event that poses a major threat to human life and health. Post-cardiac arrest brain injury is the main adverse prognostic factor and cause of death in patients who experience cardiac arrest. Currently， the therapeutic methods and effects are limited. In recent years， with the in-depth research on microbiota-gut-brain communication， it has been found that intestinal microbiota and their metabolites may play a role in the regulation of neuroinflammation in post-cardiac arrest brain injury. Short-chain fatty acids are the key substances in microbiota-gut-brain communication， and the mechanism involves immune， endocrine and neuroregulatory pathways. Supplementation of short-chain fatty acid-producing bacteria or short-chain fatty acids can improve intestinal flora disorder and reduce neuroinflammation after cardiopulmonary resuscitation. As a key mediator in microbial-gut-brain communication， short-chain fatty acids have great potential for the treatment of brain injury after cardiac arrest. This review explores the role and regulatory mechanism of microbiota-gut-brain communication in the neuroinflammation of brain injury after cardiopulmonary resuscitation through immune， endocrine and neuroregulatory pathways， providing a new idea for the treatment of post-cardiac arrest brain injury.

The incidence rate of coronary atherosclerotic heart disease （commonly referred to as coronary heart disease） remains high in China. In clinical practice， drug therapy， percutaneous coronary intervention （PCI）， and coronary artery bypass grafting （CABG） are commonly employed. For patients with multi?vessel coronary artery stenosis， minimally invasive interventional therapy is often the preferred option. However， for those with multi?vessel disease complicated by comorbidities， CABG is generally recommended. Despite its advantages， PCI carries risks such as vascular restenosis， thrombosis， and other adverse events. Consequently， hybrid coronary revascularization （HCR） has emerged as an alternative approach. This paper provides an overview of coronary heart disease and reviews the advantages， applications， and patient selection criteria for HCR.

Deep learning （DL） is a machine learning technique that emulates the human brain's functionality through multi?layered neural network models， enabling it to learn and extract features from data， thereby facilitating the automatic processing and learning of complex tasks. DL has achieved numerous significant breakthroughs in areas such as image recognition， speech recognition， and natural language processing， becoming one of the most prominent technologies in the field of artificial intelligence. With the rapid advancement of DL technology， its application in the medical field has yielded remarkable outcomes， offering new possibilities for the diagnosis and treatment of lumbar diseases. This review aims to elucidate the application and research progress of DL in diagnosing， planning surgeries， and predicting postoperative efficacy for lumbar spine diseases.