Non?occlusive mesenteric ischemia （NOMI） is a series of disorders of digestive tract caused by local blood perfusion damage， which is caused by vasospasm. As an extremely dangerous disease， NOMI is also a common intestinal complication in intensive care unit， especially in patients with hemodynamic instability after cardiac surgery， and the mortality is high. Cardiac surgery aims to improve the prognosis of patients， while the complication of NOMI is easy to be ignored， which hindered the recovery of postoperative patients. Due to the rapid development and lack of specific symptoms and signs， NOMI is easily misdiagnosed as other gastrointestinal complications. Therefore， timely and effective diagnosis of NOMI is the most important factor affecting the prognosis of post cardiac surgery. This review systematically summarized the related research on NOMI after cardiac surgery， and comprehensively concluded the cause， mechanism， treatment as well as prognosis of NOMI. Then we emphasized on the latest progresses of diagnostic methods for NOMI， in order to provide directions on the accurate identification and timely intervention of NOMI in clinical work.

Objective To investigate the repairing effect of ursolic acid extracted from Hippophae rhamnoides L. on sciatic nerve injury in rats. Methods After preparing a sciatic nerve damage model， thirty 2-month old Wistar rats were randomly divided into ursolic acid and control groups， with 15 rats in each group. Ursolic acid group was given Ursolic acid 150 mg/（kg·d） by gavage， while the control group was given the same dose of normal saline for 6 weeks. After 6 weeks， H&E staining was used to observe the pathological changes of rat sciatic nerves， and SFI and MNCV were calculated； The expression of NGF in sciatic nerve was detected by immunohistochemistry， and the expression of GAP-43 in L4-L6 spinal cord was detected by Western blotting. Results After 6 weeks， compared to the control group， the number of regenerated nerve fibers in the ursolic acid group increased， the arrangement was slightly regular， the capillary structure was abundant， and the proliferation of fibroblasts decreased； SFI and MNCV% were significantly increased （P < 0.05）， NGF protein positive expression was significantly increased （P < 0.05）， and the difference was statistically significant （P < 0.05）. GAP-43 protein expression in sciatic nerve tissue was significantly increased （P < 0.05）. Conclusions The intervention of ursolic acid extracted from Hippophae rhamnoides L. can improve the function of rats after sciatic nerve injury， promote the increase of regenerated nerve fibers and the repair of myelin sheath in rats with sciatic nerve injury， which may be related to increased NGF and GAP-43 protein expression in rats.

Objective To investigate the effect of T helper cell 17（Th17）on the progression of B cell?acute lymphoblastic leukemia （B?ALL）and its possible mechanism. Methods We established the B?ALL mouse model and detected the proportion of Th17 cells in peripheral blood， bone marrow， spleen and lymph nodes by flow cytometry. Further， we used cytokine microarray to analyze the expression of cytokine in peripheral blood of B?ALL mice， and used ELISA to verify the IL?17A expression in peripheral blood of B?ALL mice. Th17 cells were co?cultured with leukemia cells， and the apoptosis ratio of Ki?67 positive cells and B?ALL cells was detected by flow cytometry， the recruitment effect of B?All cells on Th17 cells was analyzed. The expression of apoptosis?related proteins was detected by Western blot. The development of B?ALL by secreting IL-17A from Th17 cells was evaluated in vivo in a mouse model of human acute leukemia. Results Th17 cells were increased in peripheral blood（P < 0.000 1）， bone marrow（P < 0.000 1）， spleen （P < 0.000 1） and lymph nodes （P < 0.000 1） of B?ALL mice. The expression of IL?17A was increased in peripheral blood of B?ALL model mice （P < 0.000 1）， and Th17 cells promoted the proliferation of B?All cells and inhibited their apoptosis through IL?17A （P < 0.000 1）. B?All cells recruit Th17 cells through CXCL16（P < 0.000 1）. The animal experiments showed that IL?17A treatment significantly increased the proportion of leukemia cells in peripheral blood， bone marrow and spleen of B?ALL mice， and shortened their survival time. Conclusion The proportion of Th17 cells in B?ALL increases， B?All cells recruit Th17 cells through CXCL16， and Th17 cells secrete IL-17A to promote B?All progression.

Objective To analyze the regulation of gene expression by adenosine deaminase RNA specific 1（ADAR1） in cervical cancer cell line Hela using RNA-seq technology and provide theoretical basis for understanding the role of ADAR1 in the occurrence and progression of cervical cancer. Methods RNA-seq sequencing of normal and ADAR1 knockdown Hela cell lines to identify differentially expressed genes. By conducting enrichment analysis using KEGG Pathway， GO cellular， and GSEA， the study analyzes the relevant signaling pathways and biological processes involving ADAR1 in Hela cell lines. Results Differentially expressed genes are mainly enriched in immune and inflammation-related signaling pathways （such as TNF-α/NF-κB， NIK/NF-κB， Jak/Stat-IL-6）， Hippo signaling pathway， TGF-β signaling pathway， and are involved in interferon response， cellular amino acid metabolism regulation， protein ubiquitination/deubiquitination， viral transcription， and other biological processes. Further analysis of the NF-κB signaling pathway revealed a significant increase in the mRNA expression levels of NF-κB1 and TRAF5 after ADAR1 knockdown. Conclusion ADAR1 may regulate the expression of NF-κB signaling pathway-related factors and thereby regulate the occurrence and development of cervical cancer.

Objective To investigate the potential of ginkgolide B （GB） in mitigating vascular endothelial injury by antagonizing endoplasmic reticulum stress （ERS） and elucidate its underlying molecular mechanism. Methods An injury model of human bone marrow?derived endothelial progenitor cells （EPCs） induced by tunicamycin （TM） was established. Cell proliferation was assessed using MTS assay， while cell viability was determined through Calcein?AM/EthD?I double staining. Transwell assay was employed to evaluate cell migration ability. DCFH?DA staining was utilized to measure intracellular ROS levels， and NADPH activity was quantified via ELISA. JC?1 and DiOC6 staining were performed for qualitative and quantitative assessment of mitochondrial membrane potential respectively. Qrt?pcr analysis was conducted to determine mRNA expression levels， whereas western blot analysis enabled detection of protein expression levels in the cells. Results GB dose?dependently attenuated tunicamycin?induced ERS?mediated endothelial injury in hEPCs， as evidenced by decreased cell viability， impaired cell migration， and angiogenesis inhibition （P < 0.01）. Furthermore， GB treatment significantly reduced ROS production and NADPH levels within the cells （P < 0.01）， while also inhibiting ERS?mediated decline in mitochondrial membrane potential concentration?dependently （P < 0.01）. Additionally， GB inhibited the expression of ERS?related proteins such as GRP78， ATF4， CHOP etc.， regulated apoptosis?related protein Bcl?xl， Bax cleaved caspase?4 cytochrome c； thereby effectively counteracting endoplasmic reticulum stress?induced cellular damage. Conclusions GB exerts a protective effect on vascular endothelium by antagonizing endoplasmic reticulum stress； this mechanism may be attributed to its ability to reduce intracellular reactive oxygen species levels. It also suppresses the expression of ERS?related proteins （CHOP78 and ATF4），and modulates apoptosis?associated proteins （Bcl?xl， Bax， cleaved caspase?4， and cytochrome c）.

Objective To investigate the impacts of tanshinone ⅡA （Tan ⅡA） on lipopolysaccharide （LPS） induced proliferation and apoptosis of dental pulp stem cells by regulating the fatty acid synthase （Fas）/fatty acid synthase ligand （FasL） signaling pathway. Methods Identification of human pulp stem cells （hDPSCs） isolated from the third molar of 18 ~ 20 years old patients requiring orthodontics. Lps-induced hDPSCs were treated with low， medium and high doses of Tan ⅡA， and then human recombinant FasL protein （rh FasL） was used to intervene the LPS-induced hDPSCs after high dose Tan ⅡA. Proliferation and apoptosis of hDPSCs， levels of tumor necrosis factor-α （TNF-α） and interleukin （IL）-6 in hDPSCs supernatant， proliferating cell nuclear antigen （PCNA）， Cleaved aspartate-specific cysteine proteinase-3 （Cleaved Caspase-3） ， Fas， FasL protein expression were detected. Results hDPSCs were successfully isolated. In a dose-dependent manner， Tan IIA promoted LPS-induced proliferation， inhibited apoptosis， up-regulated PCNA protein expression， and inhibited TNF-α， IL-6 level， Cleaved Caspase-3， Fas， and FasL protein expression. The effect of rh FasL on LPS-induced dental pulp stem cells was opposite to the above indexes （P < 0.05）. rh FasL attenuates the effect of high-dose Tan ⅡA on proliferation and apoptosis of LPS-induced dental pulp stem cells. Conclusion Tan ⅡA may promote LPS induced hDPSCs proliferation and inhibit apoptosis by inhibiting the Fas/FasL signaling pathway.

Objective An exploration of the molecular mechanism of microRNA-146a （miR-146） intervention in Sepsis-induced cardiomyopathy（SIC） using P38MAPK/NF-κB. Methods SD rats were divided into four groups by the random number table method： the normal control group， the SIC model group， the miR-146a agonist group， and the miR-146a inhibitor group. Rats in the normal control group and SIC model group were injected intraperitoneally with 0.2 μL/g saline， rats in the miR-146a agonist group were injected intraperitoneally with 0.2 μL/g miR-146a agonist， rats in the miR-146a inhibitor group were injected intraperitoneally with 0.2 μL/g miR-146a inhibitor； 24 h later， rats in the SIC model group， miR-146a agonist group， and miR-146a inhibitor group were injected intraperitoneally with lipopolysaccharide （LPS） to prepare the SIC rat model， and the normal control group was injected with an equal amount of saline.Histopathological morphology was observed by HE staining； apoptosis rate of cardiomyocytes was detected by TUNEL； cardiac troponin I （cTnI） and B-type brain natriuretic peptide （BNP） contents were detected by ELISA； creatine kinase cardiac muscle binding （CK-MB） and myoglobin （Mb） contents were detected by chemiluminescence； p38 mitogen activation in rat myocardial tissue was detected by Western blot protein kinase （p38MAPK）， nuclear factor-kB （NF-κB）， tumor necrosis factor-α （TNF-α） and intercellular adhesion molecule-1 （ICAM-1） by Western-Blot； miR-146a， TNF-α， interleukin-1α （IL-1α） and interleukin-1β （IL-1β） mRNA by reverse transcription quantitative （RT-q） PCR. Results Myocardial cells in the normal control group were uniform in size， neatly arranged， with distinct transverse lines， and had normal structure； myocardial cells in the SIC model group and miR-146a inhibitor group were disordered， with myocardial fibers fragmented and expanded at intervals. Myocardial structural damage was minimized in the miR-146a agonist group compared to the SIC model group. Compared with the normal control group， the apoptosis rate， serum cTnI， BNP， CK-MB， Mb levels， myocardial tissue p-p38 MAPK， p-NF-κB p65， TNF-α， ICAM-1 protein expression levels， TNF-α， IL-1α， miR-146a mRNA levels were significantly higher in the SIC model group， miR-146a agonist group and miR-146a inhibitor group， IL-1β mRNA levels were significantly increased and miR-146a mRNA levels were decreased. Compared with the SIC model group， the apoptosis rate， serum cTnI， BNP， CK-MB， Mb levels， myocardial tissue p-p38 MAPK， p-NF-κB p65， TNF-α， ICAM-1 protein expression in the miR-146a agonist group of rats levels， TNF-α， IL-1α， IL-1β mRNA levels were significantly reduced， and miR-146a mRNA levels were increased. Conclusion miR-146a has the ability to modulate the p38 MAPK/NF-κB signaling axis and the release of inflammatory factors.High miR-146a expression has some negative influence on the inflammatory response， reducing the onset and development of the inflammatory response while improving it. It can offer SIC early intervention therapy with a pre-study mechanism and theoretical support.

Objective To investigate the levels of γδ T cells and their subpopulations in bone marrow（BM）of patients with myelodysplastic syndrome （MDS）， it aims to explore the immune deficiency status of BM microenvironment in MDS patients. Methods BM samples were collected from MDS patients before and after treatment， as well as from normal donors. Multicolor flow cytometry was utilized to detect bone marrow γδ T cells and subpopulation levels. The changes of the T cell subsets after treatment were also analyzed. Results The levels of BM γδ T cells and follicular helper γδ T cells from MDS patients were significantly lower than those of normal donors （P < 0.05）. Among γδ T cells at different stages of differentiation， only the frequencies of na?ve γδ T cells from MDS patients decreased significantly （P = 0.037）， and there was no significant difference observed about central memory， effector memory， and terminally differentiated γδ T cells in MDS patients compared to normal donors （P > 0.05）. Although there was a slight decrease in PD1+γδ T cells and an increase in TIM3+γδ T cells， these differences were not statistically significant （P > 0.05）. In patients who achieved a curative effect， the proportions of γδ T cells and naive γδ T cells increased significantly after treatment， and the effector memory γδ T cells decreased significantly after treatment （P < 0.05）. After treatment， 85.71% （6/7） of MDS patients showed a decrease in γδ+TIM3+ T cell levels to varying degrees. Conclusions The levels of γδ T cells and their subpopulations in the BM microenvironment of patients with MDS exhibit varying degrees of abnormalities. However， in patients who receive effective treatment， these abnormal γδ T cells can recover. By detecting the levels of γδ T cells and subpopulations， we can gain insights into the immune deficiency status of MDS. This information might serve as an indicator to assess treatment efficacy and provide valuable insights for anti?tumor immunotherapy.

Objective To explore the relationship between non-high density lipoprotein cholesterol （non-HDL-C） level and leptomeningeal collateral circulation in patients with acute middle cerebral artery occlusion. Methods A total of 85 patients with first-onset acute cerebral infarction with middle cerebral artery M1 segment occlusion were enrolled. According to the results of DSA， LMC circulation was assessed by American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Circulation Assessment System. All patients were assigned to better LMC circulation group （score 2 ~ 4， n = 30） and worse LMC circulation group （score 0 ~ 1， n = 55）， and the levels of non-HDL-C were compared between the two groups. Results The levels of LDL-C and non-HDL-C in worse LMC circulation group were significantly higher than those of the better LMC circulation group（P = 0.026，P = 0.010）. non-HDL-C was an independent risk factor for the worse LMC circulation （OR = 3.019，95%CI：1.053 ~ 8.658，P = 0.04）. LMC circulatory score of patients was negatively correlated with the levels of non-HDL-C level （r = -0.228，P = 0.036） . The AUC of non-HDL-C predicted for the worse LMC circulation was 0.638（95%CI：0.521 ~ 0.755，P = 0.036） . Conclusions non-HDL-C in patients with acute cerebral infarction was significantly related to worse LMC circulation， and was a risk factor for worse LMC circulation. It is suggested that the higher expression of non-HDL-C could be used to predict worse LMC circulation as a serological indicator.

Objective To determine risk factors of postoperative pulmonary complications within 1 month in patients undergoing thoracic surgery in Day Care Unit. Methods The total of 200 patients routinely scheduled for VATS under centralized management were enrolled in this study. On the postoperative day 1， lung ultrasound （LUS） was conducted by one physician in the ward. The patients received at least once Chest X?ray or CT in outpatient department within 30 days after discharge. The composite of out?of?hospital PPCs， and the value of LUSS in predicting the PPCs was appraised. Furthermore， we identified the perioperative risk factors associated with PPCs in VATS patients. Results Of 200 recruited VATS patients eligible in the Nanjing Drum Tower Hospital， 188 participants received LUS examination and finally completed the 30 days follow?up. Of whom， 68 patients developed the varied types of PPCs. Multivariable Logistic regression analysis indicated that comorbidity of immune system disease（P = 0.021）， lobar resection （P = 0.031） and the postoperative 24 hours LUSS （P = 0.002） were independent risk factors for PPCs within 30 days after VATS. Conclusion Comorbidity of immune system disease，lobar resection and the postoperative 24 h LUSS were independent risk factors for PPCs within 30 days after VATS。

Objective To explore the expression of programmed cell death protein 5 in cervical cancer and its relationship with lymph node metastasis. Methods 98 cases of cervical cancer patients admitted to our hospital were selected as the observation group， and 98 cases of cervical benign lesions were selected as the control group. The expression levels of PDCD5 in serum and lesion tissues of the two groups were compared to analyze the relationship between PDCD5 and pathological features of cervical cancer， and the diagnostic value of PDCD5 in lymph node metastasis of patients with cervical cancer was analyzed by ROC curve. Results The expression levels of PDCD5 in serum and lesion tissue of observation group were lower than those of control group （P < 0.05）. With the increase of clinical stage and pathological grade of cervical cancer， the expression of PDCD5 in serum and lesion tissue was significantly decreased （P < 0.05）. Among the 98 patients with cervical cancer， 32 had lymph node metastasis. The expression levels of PDCD5 in serum and lesion tissue of lymph node metastasis group were lower than those of non-lymph node metastasis group （P < 0.05）. ROC curve results showed that the AUCs of PDCD5 in serum and lesion tissue to predict lymph node metastasis of cervical cancer patients were 0.810 and 0.850， respectively， with no statistical significance （P > 0.05）. Conclusion The Programmed cell death protein 5 is closely related to the pathological features of patients with cervical cancer，and it has a good predictive effect on lymph node metastasis，which is worthy of further study and application.

Objective To analyze the risk factors for lung injury and pulmonary arterial hypertension in patients with chronic obstructive pulmonary disease （COPD）， and the predictive value of serum SDF-1 and sRAGE for lung injury and pulmonary arterial hypertension. Methods A total of 200 patients with COPD admitted to our hospital from January 2021 to January 2023 were selected as research objects， 23 of whom occurred lung injury and the rest 177 had no lung injury， and 31 developed pulmonary hypertension and the remaining 169 had no pulmonary hypertension. The predictive value of serum SDF-1 and sRAGE for pulmonary injury and pulmonary hypertension was analyzed. Results Multi-factor logistic regression analysis showed that D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， pulmonary hypertension， arterial blood oxygen partial pressure， FVC and FEV1 were the main factors affecting lung injury in patients with COPD. D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， arterial partial oxygen pressure， FVC， FEV1 and CT angiographic pulmonary artery volume were the main factors affecting the occurrence of pulmonary hypertension in those patients （P < 0.05）. Serum SDF-1 and sRAGE were positively correlated with lung injury and pulmonary hypertension in patients with COPD （P < 0.05）. The sensitivity and accuracy of SDF-1 and sRAGE for predicting lung injury and pulmonary hypertension in patients with COPD were higher than those of SDF-1 and SRage alone （P < 0.05）. Conclusions Pulmonary injury in patients with COPD is associated with D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， pulmonary hypertension， arterial blood oxygen partial pressure， FVC， FEV1. The occurrence of pulmonary hypertension is related to D-D， PCT， CRP， RDW， MPV， PLT， NLR， SDF-1， sRAGE， arterial partial pressure of oxygen， FVC， FEV1 and CT angiography of pulmonary artery volume. Combined detection of SDF-1 and sRAGE has a higher predictive value for lung injury and pulmonary hypertension.

Objective To analyze the clinical efficacy and safety off emoral head replacement（FHR） assisting by the traction table in direct anterior approach（DAA）for the treatment of femur neck fractures in gerontal patients. Methods A retrospective analysis was conducted on 79 elderly patients who under went FHR for femoral neck fractures from March 2019 to July 2020.A total of 42 patients underwent FHR through DAA by using traction table were assigned to the observation group and 37 patients receiving FHR through the PLA to the control group. The perioperative data， follow-up results and complications were compared between the two groups. Results The observation group was significantly superior to the control group in intraoperative blood loss（P < 0.05）， where as the former was inferior to the latter in preoperative preparation time （P < 0.05）. There was no significant difference in anesthesia time and operation time between the two groups （P > 0.05）. The observation group resumed first postoperative standing time， partial-weight bearing walking time and full-weight bearing walking time significantly earlier than control group （P < 0.05）. Harris score at 1 month after the operation in the observation group were significantly higher than that of the control group（P < 0.05）， whereas which became not statistical significant between the two groups in 6 months and 1 year（P > 0.05）. No significant difference was found between the two groups for the incidence of complications（P > 0.05）. Conclusion DAA-FHR assisting by the traction table for the treatment of femur neck fractures in the elderly was effective and safe， but the preoperative preparation time was longer.

Objective To compare the difference between four-axis positioning 3D printing guide assisted puncture and manual puncture percutaneous vertebroplasty， to clarify the clinical efficacy of 3D printing guide assisted percutaneous vertebroplasty， and to explore its clinical application value. Methods A total of 70 patients who underwent single-segment vertebroplasty for osteoporotic vertebral compression fractures in our hospital were randomly divided into a manual group （control group） and a guide plate group （observation group）. Thirty-five patients in the control group underwent PVP under the traditional manual puncture， and 35 patients in the observation group underwent PVP under the four-axis positioning 3D printing guide assisted puncture. The general data， perioperative data， imaging data， preoperative and postoperative functional scores of the two groups were collected and compared. Results In terms of intraoperative fluoroscopy times， operation time， and postoperative adverse reactions， the observation group was significantly lower than the control group， and the difference was statistically significant（P < 0.05）. However， there was no significant difference between the two groups in intraoperative blood loss， bone cement leakage， and whether bone cement perfusion included fracture sites. In terms of clinical efficacy， the ratio of anterior vertebral height， postoperative VAS score and postoperative JOA score of the two groups were significantly better than those before operation， and the difference was statistically significant（P < 0.05）. At the same time point before and after operation， there was no significant difference in the height ratio of the anterior edge of the injured vertebra， VAS score and JOA score between the two groups （P > 0.05）. Conclusion The clinical efficacy of four-axis positioning 3D printing guide plate-assisted puncture is the same as that of experienced clinicians with free hand puncture for PVP， which can quickly relieve pain and improve dysfunction. However， guide plate assistance can shorten the operation time， reduce the number of fluoroscopy and postoperative adverse reactions， and make vertebroplasty faster and safer.

Objective To analyze the effect of functional magnetic stimulation （FMS） at different frequencies on the recovery of urination function in patients with urinary retention after stroke. Methods A total of 200 patients with urinary retention after stroke admitted to our hospital from January 2020 to January 2022 were recruited as the research objects. They were divided into 5 Hz， 10 Hz， 20 Hz， and control groups by simple random method， with 50 patients in each group. All four groups were treated with conventional medication， rehabilitation therapy， and intermittent catheterization. The 5 Hz group， 10 Hz group， and 20 Hz group were treated with FMS at 5 Hz， 10 Hz， and 20 Hz， respectively， and the control group was treated with sham stimulation at the same site and parameters as the 5 Hz group. Bladder pressure volume index， urination status， recovery time of spontaneous urination， Quality of Life Questionnaire （SQLP） score， and urinary retention efficacy were compared among the four groups. Results There were no significant differences in bladder pressure volume， urination， recovery time of spontaneous urination， and SQLP score among the four groups before treatment （P > 0.05）. After treatment， the bladder volume and pressure of the first four groups were both increased， with those of the 5 Hz group， 10 Hz group， and 20 Hz group significantly higher than those of the control group， while the residual urine volume of the first four groups was significantly lowered， with that of the 5 Hz group， 10 Hz group， and 20 Hz group significantly lower than that of the control group （P < 0.05）， even showing an effect of dose-response； The average daily urination frequency and average single urination volume of the first four groups were all increased， with those of the 5 Hz group， 10 Hz group and 20 Hz group all significantly higher than those of the control group， while the average daily urination frequency was all reduced， with that of the 5 Hz group， 10 Hz group and 20 Hz group significantly less than the control group （P < 0.05）， even showing an effect of dose-response； The SQLP scores of the first four groups were all lowered， with those of the 5 Hz， 10 Hz and 20 Hz groups significantly lower than those of the control group （P < 0.05）， and the recovery time of spontaneous urination in the 5 Hz， 10 Hz， and 20 Hz groups was significantly shorter than that of the control group， showing an effect of dose-response； The total effective rate of urinary retention in the 5 Hz， 10 Hz and 20 Hz groups was significantly higher than that in the control group （P < 0.05）， showing an effect of dose-response. Conclusion FMS at 5 Hz， 10 Hz and 20 Hz can improve the urination function and quality of life of patients with urinary retention after stroke， showing a dose-responsive efficacy. The clinical efficacy by FMS at 20 Hz is better than that at 5 Hz and 10 Hz.

Objective To observe the therapeutic effect of lymphatic plasma therapy （LPE） combined with semi whole blood exchange on patients with moderate to severe anemia caused by severe postoperative infection. Methods Thirty patients who developed severe postoperative infections with moderate to severe anemia and were treated with antibiotics for 48 to 72 hours but failed to meet the criteria were divided into an observation group （LPE combined with semi whole blood replacement surgery and antibiotic treatment， n = 15） and a control group （conventional antibiotic anti infection and blood transfusion treatment， n = 15）. Evaluation indicators of infection and anemia between and within two groups before and after treatment， and the treatment effect were compared， respectively. Results There was no statistically significant difference in the observation indicators of infection and anemia between the two groups before treatment （P > 0.05）； After each treatment， there was a statistically significant difference in the evaluation and observation indicators of infection and anemia between the two groups （P < 0.05）； Observation group： There was a statistically significant difference in the observation and evaluation indicators of infection and anemia before and after treatment within the group （P < 0.05）； Control group： Compared within the group before and after treatment， there was no significant decrease in WBC， NEUT， and NEU observation indicators， and CRP and PCT observation indicators showed an upward trend， while RBC， HBG， and HCT did not show a significant increase. The difference was not statistically significant （P > 0.05）； Conclusions The combination of LPE and semi whole blood replacement surgery is superior to the conventional treatment regimen of antibiotics alone for anti?infection and blood transfusion to improve anemia symptoms in the treatment of postoperative severe anemia.

Objective To compare the anesthetic effects of remazolam and dexmedetomidine assisted sedation in the operation of finger replantation under ultrasound guided brachial plexus block. Methods 60 patients undergoing severed finger replantation were randomly divided into remazolam group （group R） and a dexmedetomidine group （group D） by random number table method， with 30 cases in each group. Both groups received a single brachial plexus block under ultrasound guidance. Group R was injected with remazolam 0.1 mg/kg， followed by 1 mg/（kg·h） pump until 10 min before the end of the operation. In group D， a load dose of 0.5 μg/kg of dexmedetomidine was injected， followed by continuous infusion at a rate of 0.5 μg/（kg·h） until 10 min before the end of surgery. The MAP， HR and SpO₂ values of the two groups were compared when the patients entered the room （T₀）， the wound was cleaned and disinfected （T₁）； the tourniquet was upper （T₂）； the operation began （T₃）； the tourniquet was relaxed （T₄）； and the operation ended （T₅）. MOAA/S scores and BIS values were compared between the two groups at different time. The time from the beginning of medication to the absence of consciousness and the time of consciousness recovery after drug withdrawal were compared between the two groups. Blood lactic acid （Lac） before applying tourniquet and 15 min after relaxing tourniquet were compared between the two groups. The occurrence of intraoperative adverse reactions was recorded in the two groups. Results The MAP of patients in group R had little fluctuation at each time during the operation， and the MAP of patients in group D was significantly increased at T₁， T₂， T₃ and T₀ moments and at the same time as that in group R （P < 0.05）； HR in group R was stable at all times， and HR in group D significantly slowed down at T₁， T₂ and at the same time with group R （P < 0.05）. Patients in both groups achieved ideal sedation during the operation （MOAA/S score ≤ 3 points）， and the MOAA/S score of patients in group R at T₅ minutes after drug withdrawal was higher than that at other moments of the same group and group D （P < 0.05）； the BIS value of group R was higher than that of group D （P < 0.05）. The loss time and recovery time of consciousness in group R were shorter than those in group D （P < 0.05）. The incidence of intraoperative hypertension and bradycardia in group D was significantly higher than that in group R， and the incidence of respiratory depression in group R was higher than that in group D （P < 0.05）. There was no significant change in lactate value between the two groups （P > 0.05）. Conclusion Remazolam and dexmedetomidine can satisfy sedation in brachial plexus nerve block for replantation of severed finger under ultrasound guidanc. Compared with dexmedetomidine， remazolam has better sedation control， stable hemodynamics， low incidence of circulatory adverse events.

Objective To investigate the efficacy and safety of tenofovir alafenamide fumarate （TAF） in the treatment of patients with decompensated hepatitis B cirrhosis. Methods We retrospective analyzed 41 patients with decompensated hepatitis B cirrhosis receiving TAF antiviral therapy for 24 weeks at Wuwei Tumor Hospital in Gansu province from June 2022 to June 2023. Primary endpoint was proportion of patients achieving virologic response （HBV DNA < 20 IU/mL）. Other endpoints included changes in ALT， AST， TBIL， Child-Pugh score （CTP）， and MELD score from baseline to week 24. In terms of safety， changes in Scr， eGFR and adverse events from baseline to week 24 were observed. Results Of 41 patients， 73.2% were male （n = 30）， with mean age of 53.49 years. 24 weeks after treatment with TAF， HBV DNA was undetectable in 90.2% of the patients. The median levels of ALT， AST and total bilirubin （TBIL） were 50.70 U/L， 48.70 U/L and 26.40 μmol/L respectively at baseline， and reduced significantly to 31.50 U/L， 37.8 U/L and 23.8 μmol/L （P < 0.05） respectively after 24-week therapy with TAF. CTP score was improved in 58.6% of the patients （n = 24）， and so was MELD score in 63.4% of the patients （n = 26） at week 24. The median serum creatinine and eGFR were 58.5 μmol/L and 106.15 mL/（min·1.73 m²） respectively at baseline， and creatinine and eGFR were stable during treatment. No drug-related adverse events or severe adverse events occurred during treatment， neither did creatinine and eGFR liver transplantation， HCC or death. Conclusions Our clinical studies demonstrated better effectiveness and safety of TAF for decompensated CHB patients.

Objective To investigate the correlation between serum levels of antiphospholipid antibody （aPL） （ACA-IgG， ACA-IgM， β2-GPI-IgG， β2-GPI-IgM）， LAC， ds-DNA， and ANA and preterm labor with prematurity， and to analyze the prediction of preterm labor with the combination of age， week of gestation， history of delivery， and history of miscarriage， so as to provide references for the prevention and treatment of preterm labor and to promote eugenics. Methods Through a retrospective study design， 43 pregnant women with preterm labor with preeclampsia diagnosed and treated at Guangdong Provincial People's Hospital from June 2018 to December 2020 were collected as a case group， and 47 healthy pregnant women of the same period and similar gestational age were randomly selected as a control group. aPL （ACA-IgG， ACA-IgM， β2-GPI-IgG， β2-GPI-IgM） and ds-DNA were detected by enzyme immunoassay （ELISA） using an enzyme immunoassay instrument， lupus anticoagulant （LAC） in plasma was detected by coagulometer， and ANA was detected by indirect immunofluorescence using an immunofluorescence analyzer， and the application of SPSS 24.0 software was used to statistically analyze the general information and laboratory test data. the age of the patients was combined， gestational week， birth history， miscarriage history and other general information， logistic regression analysis was performed to find the independent influencing factors related to preterm labor； the analysis was performed by using the subjects' work characteristic curve （ROC curve） to determine the area under the ROC curve （AUC）， the best predictive value， sensitivity and specificity， and to analyze the predictive value of preterm labor with preterm labor. Results In this study， the pregnant women in the group of pregnant women with preterm labor with preeclampsia were aged 27 ~ 40 years， with a mean age of （29.93 ± 3.91） years， and the gestational weeks at the time of blood collection were 27-36 weeks， with a mean gestational week of （31.96 ± 2.35） weeks， while the pregnant women in the healthy control group during the same time period were aged 25 ~ 40 years， with a mean age of （30.74 ± 3.44） years， and the gestational weeks at the time of blood collection were 28 ~ 36 weeks， with a mean gestational week of （32.84 ± 2.13） weeks. In the same period， healthy control group pregnant women were aged 25 ~ 40 years， with a mean age of （30.74 ± 3.44） years， and were 28 ~ 36 weeks pregnant at the time of blood collection. The β2-GPI-IgM level of pregnant women in the case group with preterm labor was significantly higher than that of pregnant women in the healthy control group at the same time， with statistically significant differences （P < 0.05）， while the differences in the levels of β2-GPI-IgG， ds-DNA， and LAC between the two groups were not statistically significant （P > 0.05）.The analysis of the ROC curves showed that the AUC of β2-GPI-IgM was 0.642 （P < 0.05）， which was the highest in the preterm group， and the AUC was 0.642 （P < 0.05）. 0.05）， which was an independent influencing factor of preterm labor； age， gestational week， labor history， and miscarriage history could not be used as independent influencing factors of preterm labor. Conclusion β2-GPI-IgM is associated with threatened preterm labor，it can be used as a predictor of threatened preterm labor，and has clinical utility in the monitoring of threatened preterm labor in pregnant women.

Objective To investigate the mutation characteristics and influencing factors of ethambutol （EMB） resistance gene of Mycobacterium tuberculosis in Guangxi Zhuang Autonomous region， and to provide evidence for molecular diagnosis and clinical treatment of tuberculosis. Methods A total of 655 strains of Mycobacterium tuberculosis （52 ethambutol resistant strains and 603 ethambutol sensitive strains） were collected continuously from 30 TB drug resistance monitoring sites in Guangxi in 2018-2019， and the mutation characteristics and influencing factors of ethambutol resistant genes were analyzed by whole genome sequencing. Results Among 655 strains of Mycobacterium tuberculosis， 54 strains had ethambutol drug resistance gene mutation， the mutation rate was 8.24% （54/655）. Among 52 EMB-resistant strains detected by proportional method， 21 had gene mutation， the mutation rate was 40.38% （21/52）， and 33 of 603 EMB-sensitive strains had gene mutation， the mutation rate was 5.47% （33/603）. The gene mutation rate in drug-resistant strains was higher than that in sensitive strains （χ ² =77.133， P = 0.000）. The coincidence rate of EMB drug resistance phenotype and gene mutation was 40.38%（21/52）， and the results of the two tests were not highly consistent （Kappa = 0.343， P < 0.001）. The mutant genes of 54 strains were embA， embB and embC， and there were 20 mutant forms， among which 29 were mutated at unit point， accounting for 53.70% （29/54）， and 25 were mutated at joint site， accounting for 46.30% （25/54）. Among the unit point mutations， embB306（35.19%） had the highest mutation proportion， followed by embB497 （5.56%） and embB406 （3.70%）. Among the joint site mutations， embC270+embB378 had the highest mutation proportion （22.22%），The second was embB306+embA-12 （3.70%）. Gender， anti-tuberculosis treatment history， genotype and MDR might be related to EMB gene mutation （χ ² = 9.388， P = 0.004； χ ² = 27.084， P = 0.000； χ ² = 6.671， P = 0.010； χ ² = 68.826， P = 0.000）. Multivariate logistic regression analysis showed that male （OR = 6.150）， retreatment （OR = 2.636） and multidrug resistance （OR = 7.333） may be risk factors for EMB resistance gene mutation， and Beijing genotype may be a protective factor for EMB resistance gene mutation （OR = 0.511）. Conclusion EMB resistance of Mycobacterium tuberculosis is related to embA， embB and embC gene mutations， and the incidence of EMB resistance phenotype is not high. For male， retreatable， MDR-resistant， and non-Beijing genotype TB patients， attention should be paid to the mutation of the EMB resistance gene.

Objective To understand the characteristics of long-working hours exposure of medical staff， and analyze the impact of long-working hours exposure on mental health problems such as occupational stress， depression， fatigue accumulation， and insomnia. Methods The cluster random sampling method was used to select the medical staff of 12 tertiary general hospitals in Guangdong Province as the research subjects， and the “Core Scale of Occupational Stress Measurement” and other scales were used to evaluate their occupational mental health. Results The average working hours of medical staff per day were（8.99 ± 2.18）h； 2，094 people were exposed during long working hours， accounting for 78.96%. The results of binary logistics regression analysis showed that after excluding the influence of sociodemographic factors such as age， long working hours （weekly working hours greater than 40 h） were the risk factors for occupational stress， depressive symptoms and fatigue accumulation of medical staff （P < 0.01）， and the longer the working week， the higher the risk of occupational stress， depressive symptoms and fatigue accumulation. Weekly working hours greater than 48 hours are risk factors for insomnia （P < 0.01）. Conclusion Long working hours are common among delivery workers on food delivery platforms， and long working hours are a risk factor for occupational tension and fatigue.

Objective To study the feasibility of domestic single-port surgical robot assisted endoscopic system for partial nephrectomy， and analyze its safety in clinical partial nephrectomy based on experimental results Methods Three qualified experimental pigs were selected， two senior urological professors and a senior resident doctor used a domestic single-port surgical robot to perform partial nephrectomy on the left and right kidneys. Recorded the operation duration， hot ischemia duration， suture time， estimated blood loss， volume of renal parenchyma excision and other information. Results There were 8 wedge resection and 4 heminephrectomies. The kidney volume of wedge resection was （7.35 ± 0.81）mL and the blood loss was （8.50 ± 11.09）mL. The total operation time was （41.67 ± 8.50）min， and the time of resection was （5.88 ± 3.27）min and the stitching time was （11.75 ± 2.82）min. The kidney volume of heminephrectomy was （24.30 ± 2.18）mL， and the blood loss was （6.25 ± 4.35）mL. The total operation time of heminephrectomy was （47.00 ± 11.27）min， and the time of resection was （3.25 ± 1.5）min and the stitching time was （10.00 ± 5.25）min. No bleeding was observed on the wound after the Bull dog was released in all operations. There was no significant difference in operation time and blood loss between the heminephrectomy group and the wedge resection group. There was no significant difference in operation time or blood loss between the senior doctor group and the senior resident doctor group. The NASA-TLX scale was used to assess the degree of workload of the operator during surgical operations， and the results showed that none of the three surgeons had a high level of frustration.There were no adverse events related to the single-port surgical robot system during the operation. Conclusion It is safe and feasible for a domestic single-port surgical robot system to perform a partial nephrectomy.

Objective To explore the clinical efficacy of ginseng schisandra decoction in children with lobar pneumonia （lung spleen deficiency syndrome） induced by mycoplasma pneumoniae infection and improvement of inflammatory indicators. Method 84 children with lobar pneumonia （lung spleen deficiency syndrome） caused by mycoplasma infection admitted to the First Clinical Hospital of Jilin Academy of Traditional Chinese Medicine from January 2020 to July 2022 were selected and randomly divided into two groups with 42 cases each. The conventional group was treated according to the traditional treatment plan， while the combined group was treated with ginseng and schisandra decoction in addition to the traditional treatment plan. After 7 days， compare the differences in traditional Chinese medicine syndrome scores， clinical efficacy， inflammatory indicators， and total incidence of adverse reactions between the two groups of children. Result The results showed that the traditional Chinese medicine syndrome score and inflammatory indicators in the combined group were lower than those in the conventional group （P < 0.05）， and the clinical efficacy level distribution was better than that in the conventional group （P < 0.05）. The total effective rate was higher than that in the conventional group （P < 0.05）， and there was no difference in the total incidence of adverse reactions between the two groups （P > 0.05）. Conclusion In the treatment of children with lobar pneumonia （lung spleen deficiency syndrome） caused by Mycoplasma pneumoniae infection， the modified Ginseng Wuweizi decoction has a positive therapeutic effect and good safety， and is worth promoting.

Objective To explore the systematic nursing intervention for patients with artificial anal bowel habit of effect. Methods Our hospital from May 2020 to select-treated 100 cases of artificial anal in May， 2022 patients as the research object， the patients were randomly divided into control group and research group of consent of all the 50 cases， control group adopted routine nursing care， the team take systematic nursing intervention， compare the effect of two groups of patients with bowel movements. Results The team bowel habit each index compared with control group， difference has statistical significance （P < 0.05）. Conclusion Systematic nursing intervention to actively promote the use of clinical nursing work in the future.

3?hydroxybutyrate （3HB）， an anionic small molecule acid metabolite with a hydroxyl group， is a chiral molecule that exists in two enantiomeric forms. It is associated with cell growth， proliferation， and anti?oxidative stress， and demonstrates good biosafety when used within a specific range. In addition to epilepsy treatment， with the popularity of ketogenic diet in recent years， exogenous supplementation of 3HB for human has been gradually found to be associated with a variety of metabolic diseases. This review describes the physiological function， physicochemical characteristics， toxicology and biological safety of 3HB， and its applications as potential drug molecules in epilepsy， weight?loss （or weight control）， systemic inflammation， hemorrhagic shock， cancer， inflammatory bowel disease， atherosclerosis， diabetes， osteoporosis， neurological diseases （e.g.， Parkinson′s disease， Alzheimer′s disease and Huntington′s disease）， muscular dystrophy， COVID?19， anti?aging and many other medical fields. This review also focuses on the discussion and prospect of the new methods and the potential limitations of exogenous 3HB supplementation for clinical transformation.

Acute-on-chronic liver failure （ACLF） is generally accepted as a clinical syndrome characterized by an acute hepatic insult and rapid deterioration of liver function in patients with pre-existing chronic liver disease in combination with multi-organ failure with high short-term mortality. Because of the differences in etiology and inducement， there are different definitions and diagnostic criteria of ACLF in the East and West. Attempting to cover all ACLF diagnosed， WGO defined ACLF into three categories in 2014： patients with CLD but no cirrhosis （type A）， compensated cirrhosis （type B）， and decompensated cirrhosis （type C）. However， different types of ACLF have different pathophysiology， which leads to obvious differences in predisposition， injury， response， organ failure and mortality among different types of ACLF. The concept of PIRO， which is similar to that used in determining outcomes of sepsis， is contribute to comprehensively understand different types of HBV-ACLF， improve management. Therefore， it is of great significance to improve the survival rate of ACLF.