Day surgery has the advantages of fast turnover of beds， high patient satisfaction， low medical cost and low nosocomial infection rate， which is a kind of surgical mode vigorously explored and developed at home and abroad. Safety is the bottom line of day surgery， comfort is the core pursuit of day surgery， both of which cannot be guaranteed without high?quality perioperative anesthesia management. Therefore， under the fast?turnover day surgery mode， this paper focus on how to implement standardized anesthesia management strategies from the aspects of the formulation of clinical anesthesia pathways， facilities and personnel allocation， pre?anesthesia evaluation and preoperative preparation， anesthesia type selection， perioperative pain management， postoperative nausea and vomiting management， post?anesthesia monitoring and treatment， and postoperative follow?up.

Hepatic encephalopathy is a clinical syndrome of central nervous system dysfunction caused by liver insufficiency. It severely affects the quality of life of patients and may lead to death. Accurate prediction of the risk of developing hepatic encephalopathy is crucial for early intervention and treatment. In order to identify the risk of hepatic encephalopathy in patients in advance， many studies have been devoted to efforts to develop tools and methods to identify the risk of hepatic encephalopathy as early as possible， so as to develop preventive and early management strategies. Most conventional hepatic encephalopathy risk prediction models currently assess the probability of a patient developing hepatic encephalopathy by analysing factors such as clinical data and biochemical indicators， however， their accuracy， sensitivity and positive predictive value are not high. The application of artificial intelligence to clinical predictive modelling is a very hot and promising area， which can use large amounts of data and complex algorithms to improve the accuracy and efficiency of diagnosis and prognosis. To date， there have been few studies using AI techniques to predict hepatic encephalopathy. Therefore， this paper reviews the research progress of hepatic encephalopathy risk prediction models， and also discusses the prospect of AI application in hepatic encephalopathy risk prediction models. It also points out the challenges and future research directions of AI in HE risk prediction model research in order to promote the development and clinical application of hepatic encephalopathy risk prediction models.

Objective To explore the roles of iron overload in pro?atherogenic activation of foam cells. Methods RAW264.7 and MOVAS cells were stimulated by oxLDL， ferrimine citrate and deferoxamine respectively. Prussian Blue and Oil Red O staining were used to detect iron deposition and foam cell. CCK?8 test， DHE probe， ELISA， RT?qPCR were performed to detect the cell death rate， reactive oxygen species （ROS） generation， lipid peroxidation molecules ［glutathione peroxidase （GSH）， glutathione peroxidase 4 （GPX4）， malondialdehyde （MDA） content］ and the mRNA level of ATP binding cassette transporter A1 （ABCA1）， ATP binding cassette transporter G1 （ABCG1）， inductible nitris oxide synthase （iNOS）， arginase?1 （Arg?1）， α?smooth muscle actin （α?SMA），smooth muscle 22 alpha （SM22a）， osteopontin （OPN）， Interleukin?1β （IL?1β）， tumor necrosis factor?α （TNF?α）. Results Iron overload could reduced reverse cholesterol transporters （ABCA1 and ABCG1）， promote foam cells generation， increased cell death rate， induced the expression of lipid peroxidation molecules （GSH， GPX4， MDA）， and promoted pro?inflammatory M1 marker of macrophage and synthetic marker expression of vascular smooth muscle cell （VSMC） and inflammatory cytokines （IL?1β，TNF?α）. Conclusion Iron overload promotes the generation of foam cells derived from macrophages and smooth muscle cells and transform them into pro?atherosclerotic phenotype， aggravates cell lipid peroxidation and inflammatory reaction， which contributes to the progress of atherosclerosis.

Objective To investigate the expression of lncRNA SENCR in aortic dissection （AD） tissues of AD patients and its effect on and mechanism in the proliferation apoptosis of human vascular smooth muscle cells （HVSMCs）. Methods HE staining was done to detect the pathological changes of AD tissues. Fluorescence in situ hybridization （FISH） and RT-qPCR were used to determine the expression of SENCR in the AD tissue and HVSMCs and the expression of SENCR and miR?206 in the tissues， respectively. HVSMCs were cultured and transfected with pcDNA3.1-SENCR overexpression plasmids， or pcDNA3.1 blank plasmid. Then cell proliferation and apoptosis were detected by CCK-8 method and Annexin V/PI double staining flow cytometry assay， respectively. Double luciferase report verified the targeting relationship between SENCR and miR-206. Results SENCR was mainly located in the cytoplasm and nucleus of HVSMCs. Compared with the normal tissue， the expression of SENCR in the AD tissues was down?regulated （P < 0.01）， but the expression of miR-206 was up?regulated （P < 0.01）. Overexpressed SENCR decreased the cell proliferation of HVSMCs （P < 0.01）， but significantly increased the cell apoptosis of HVSMCs （P < 0.01）. SENCR could target and negatively regulate miR-206. Conclusion The expression of SENCR is down-regulated in AD tissues， and overexpressed SENCR may inhibit the proliferation and promote the apoptosis of HVSMCs by targeting down?regulated miR?206.

Objective The preventive effect of epigallocatechin gallate （EGCG） on hyperglycemia?induced hemorrhagic transformation （HT） was analyzed， and the underlying mechanisms were further explored. Methods Male SD rats were randomly divided into sham operation group （Sham， n = 20）， model group （n = 27）， hyperglycemia model group （HG， n = 43）， and EGCG group （n = 43）. In the model group， only the electrocoagulation cerebral ischemia model was established， and the HG group and the EGCG group were used to establish the HT model with acute hyperglycemia combined with electrocoagulation cerebral ischemia model. In addition， EGCG was administered by gavage for 5 days before cerebral ischemia at a dose of 50 mg/kg/d. Further studies confirmed the relevant targets by using network pharmacology to predict the potential targets and pathways of EGCG in the occurrence of HT. Results Compared with the model group， the mortality rate of the rats in the HG group was significantly increased ［21.2% （6/27） vs. 51.2% （22/43）， P < 0.05］. The mortality of rats in the EGCG group was significantly lower than that in the HG group ［30.20% （13/43） vs. 51.2% （22/43）， P < 0.05］. Second， mNSS， Longa score and infarct volume in the EGCG group were significantly lower than those in the HG group （P < 0.05）. The incidence of HT in the HG group was higher than that in the model group （59.3% vs. 90.7%）. EGCG significantly reduced the incidence of hyperglycemia?induced HT to 69.8%. Compared with the HG group， EGCG decreased the hemoglobin content from （53.42 ±?5.11） mg/dL to （37.04?±?2.39）?mg/dL respectively （P < 0.05）. Network pharmacology revealed that Nrf2?Keap1?mediated neuroinflammation may be associated with hyperglycemia?induced HT. The expression of Nrf2 and Keap1 was significantly decreased and the expression of TLR4 and phosphorylation of NF?κB was significantly increased in the HG group， but EGCG reversed this process. Conclusion EGCG pretreatment prevents the occurrence of HT， which may be related to the neuroprotection mediated by activation of the Nrf2?Keap1 signaling pathway.

Objective To investigate the regulatory effects of wedelobata on apoptosis and secretion of inflammatory factors in the alveolar epithelial cells infected by Streptococcus pneumoniae. Methods Alveolar epithelial cells A549 were divided into infection group （1 × 10⁸ /CFU/mL cultured cells of Streptococcus pneumoniae）， control group （no treatment）， infection+wedelolactone low-dose group， middle-dose group and high-dose group （pretreated with wedelolactone at 10， 20 and 40 μmol/L and then cultured cells of Streptococcus pneumoniae at 1 × 10⁸ /CFU/mL）. Alveolar epithelial cells A549 were divided into infection group （1 × 10⁸ /CFU/mL cultured cells of Streptococcus pneumoniae）， control group （no treatment）， infection+wedelolactone low-dose group， middle-dose group and high-dose group （pretreated with wedelolactone at 10， 20 and 40 μmol/L and then cultured cells of Streptococcus pneumoniae at 1 × 10⁸ /CFU/mL）. Results Compared with control group， the apoptosis rate， the relative expression levels of Bax， Caspase-3 protein， IL-6， IL-1β and TNF-α mRNA were higher in infection group， infection + wedelolide low dose group， medium dose group and high dose group， while the expression level of Bcl-2 protein was lower （P < 0.05）. Compared with the infected group， the apoptosis rate， the relative expression levels of Bax， Caspase-3 protein， IL-6， IL-1β and TNF-α mRNA and the expression levels of Bcl-2 protein were lower in the infected + wedelolide low dose， medium dose and high dose groups. Moreover， the apoptosis rate， the expression levels of Bax， Caspase-3 protein， IL-6， IL-1β and TNF-α mRNA were the highest in the infected + wedelactone high-dose group， and the expression levels of Bcl-2 protein were the lowest （P < 0.05）. Conclusion The apoptosis rate of alveolar epithelial cells infected by Streptococcus pneumoniae decreased and the secretion of inflammatory factors decreased after the intervention of wedelia lactone.

Objective To investigate the expression of HOXB4 gene in patients with myelodysplastic syndromes （MDS） and its clinical significance in disease progression. Methods mRNA expression of HOXB4 gene in bone marrow mononuclear cells was detected by real?time fluorescence quantitative PCR （RT?qPCR）， and the difference in HOXB4 expression was compared between 49 patients with MDS （MDS group） and 35 patients without MDS （group C）. The relationship of mRNA expression of HOXB4 with disease characteristics and clinical prognosis was explored in MDS patients. Results mRNA expression level of HOXB4 gene was higher in MDS group than that in group C （P < 0.05）. The patients were divided into a high? and a low?expression group according to the median expression level of HOXB4. Leukocyte count was lower in the high?expression group in the low?expression group at the time of initial diagnosis. The proportion of patients with subtypes of primitive cellular hyperplasia， poor prognostic staging and leukemic transformation was higher in the high?expression group than in the low?expression group. Conclusions mRNA expression level of HOXB4 gene has certain relation with AML transformation in MDS patients.

Objective To explore the correlation of glucose and lipid metabolism indicators combined with antiphospholipid antibodies with the prognosis of patients with atherosclerosis. Methods A total of 128 patients with atherosclerosis treated in our hospital from April 2021 to March 2023 were selected as study group， and 48 healthy individuals as control group. Glycolipid metabolism indexes and antiphospholipid antibody level of the two groups were compared， and the predictive value of glycolipid metabolism indexes， antiphospholipid antibodies and combined detection for the prognosis of patients with atherosclerosis were analyzed by ROC. Results TC， TG， ACL， and anti-β2-GP1 in the study group was higher than that in the control group （P < 0.05）. The study group was divided into two sub-groups according to the prognosis. The expression level of TC， TG， ACL， and anti-β 2-GP1 in poor prognosis group was higher than that in good prognosis group （P < 0.05）. TC， TG， ACL， and anti-β 2-GP1 was positively correlated with the poor prognosis of patients with atherosclerosis （P < 0.05）. ROC curve showed that the predictive value of six combined tests for the prognosis of patients with atherosclerosis was higher than that of single test of TC， TG， ACL， and anti-β2-GP1 （P < 0.05）. Conclusion The combined detection of TC， TG， ACL， and anti-β2-GP1 has high predictive value for the prognosis of patients with atherosclerosis.

Objective To analyze the frailty of patients with long-term maintenance dialysis （MD） and its influencing factors， and to explore the correlation of different dialysis modalities with the re-infection of novel coronavirus infection （COVID-19） and frailty syndrome. Methods Patients with regular dialysis in Nephrology Department of the Second Affiliated Hospital of Kunming Medical University from February to June 2023 were selected. A cross-sectional survey was conducted to collect clinical data of the patients， including dialysis modality（i.e. maintenance hemodialysis， abbreviated as hemodialysis， and continuous ambulatory peritoneal dialysis， abbreviated as peritoneal dialysis），and whether with re-infection of COVID-19. Patients were divided into 3 groups using Fried′s frailty phenotype （FP）： non-frailty group， pre-or-intermediate frailty group， and frailty syndrome group. The clinical characteristics of the FP were compared among the three groups. The correlation of frailty with clinical data， dialysis modality， re-infection of COVID-19 in each group was compared. Multifactorial logistic regression was used to analyze the factors influencing the development of frailty syndrome in patients. Results A total of 246 dialysis patients were included in this study， with 77 （31.3%） in the non-frailty group， 83 （33.7%） in the pre-frailty group and 86 （35.0%） in the frailty syndrome group. The frailty syndrome group showed characteristics of advanced age， high pre-dialysis creatinine level， low serum albumin level and combined pleural effusion （all P < 0.05）.There was no statistically significant difference in the comparison of frailty between the hemodialysis and peritoneal dialysis group（P = 0.960）.COVID-19 re-positive patients had higher frailty score than non-re-positive patients. Multifactor logistic regression showed that age， COVID-19 re-infection of COVID-19， serum albumin， pre-dialysis creatinine， and pleural effusion were factors influencing the development of frailty syndrome in dialysis patients（P < 0.05）. Conclusion There is high incidence of frailty syndrome in dialysis patients， and there is no correlation of frailty with dialysis modality. High serum albumin level is a protective factor for the development of frailty syndrome in patients， whereas re-infection of COVID-19， advanced age， high pre-dialysis blood creatinine level and pleural effusion are risk factors for the development of frailty syndrome.

Objective To compare the value of the 2018 Chinese guideline prognostic score with that of the 2019 European Society of Cardiology （ESC） in the predicting efficiency for acute pulmonary embolism （APE） in 30?day all?cause mortality. Methods The data of the hospitalized patients with confirmed APE from January 2015 to December 2019 were retrospectively collected. According to death within 30 days， the patients were divided into a death group and a survival group. Subgroup analysis was performed according to gender， oxygen saturation and infection. The SPSS software was used to establish the receiver operating characteristic curve （ROC） for the two scores and calculated the area under the curve （AUC）. The Delong′s test was applied to compare the AUC differences. The net reclassification index （NRI） and integrated discrimination improvement （IDI） were calculated using the R software packages of survival， survIDINRI， and PredictABEL. Results 626 APE patients were enrolled， and 30?day death was predicted in those patients using two scores. In terms of overall discrimination， the 2018 Chinese guideline prognostic score was better than the 2019 ESC guideline prognostic score， with an AUC of 0.782 and 0.749， respectively； but there were no statistical differences between the two AUC （P > 0.05）. In terms of prediction accuracy， the NRI of the 2019 ESC guideline prognostic score was 44.4% （95%CI：0.091 ~ 0.753）， higher than that of the 2018 Chinese guidelines prognostic score， which increased by 58.6% （95%CI：0.161 ~ 0.917） in the correct reclassification to death group， while decreased by 14.2% （95% CI：?0.249 ~ 0.08） in the correct reclassification to survival group. IDI increased by 3.38% （P < 0.05）. Subgroup analysis showed the prognostic scores of the 2018 Chinese guidelines and the 2019 ESC guidelines prognostic scores had predictive ability for patients with different gender and different oxygen saturation （P < 0.05）， and the prognostic scores for co?infected population （AUC： 0.749， 0.772） （P > 0.05）， non?coinfected population （AUC： 0.652， 0.833）. Conclusions Both the 2018 Chinese guideline prognostic score and the 2019 ESC guideline prognostic score can predict 30?day mortality in APE patients， and have a better predictive ability for the co?infected population. However， the predictive accuracy of the former is higher than that of the latter in the survival group， and the score is more rapid and convenient for clinical application， while the latter has improved the prediction ability in the death group。

Objective To explore the relationship between serum miRNA-21 and miR-27b levels and prognosis of patients with renal clear cell carcinoma. Methods A total of 118 patients with renal clear cell carcinoma admitted to the Qinghai University Hospital from February 2019 to April 2021 were selected as the study subjects， and another 118 healthy patients in the same period as the control group. Real time fluorescence quantitative polymerase chain reaction （PCR） was used to detect the expression of miR-21 and miR-27b in the serum of all subjects. The relative expression levels of serum miR-21 and miR-27b between the patients with renal clear cell carcinoma and healthy control patients were compared. The expression and correlation of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma of different pathological stages and Fuhrman grading were analyzed. The relationship between the expression of serum miR-21 and miR-27b and the survival and prognosis of the patients was explored as well. Results The expression levels of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma were higher than those in the healthy control group （P < 0.05）. The serum miR-21 expression level in stage Ⅲ patients was higher than in stageⅠ（P < 0.05）， while the serum miR-21 expression level in the stage Ⅳ patients was higher than that in stagesⅠ，Ⅱ， and Ⅲ（P < 0.05）. The expression level of miR-27b in the serum of patients gradually increased across the four stages， with a significant difference （P < 0.05）. The pathological staging was positively correlated with the expression of miR-21 and miR-27b （P < 0.001）. The expression levels of miR-21 and miR-27b in serum of patients gradually increased across grades Ⅰ， Ⅱ and Ⅲ by Fuhrman grading， with significant difference （P < 0.05）. Fuhrman grading was positively correlated with the serum miR-21 and miR-27b expression （P < 0.001）. There was a statistically significant difference in the survival curve between the miR-21 high expression group and the low expression group （P < 0.05）. There was a statistically significant difference in the survival curve between the high expression group and the low expression group of miR-27b （P < 0.05）. Conclusion The expression levels of serum miR-21 and miR-27b in patients with renal clear cell carcinoma is indicative of the progression and prognosis of the patient's condition.

Objective To explore the effect of low replacement plasma exchange （LPE） combined with double plasma molecular adsorption （DPMAS） in the treatment of patients with chronic acute liver failure （ACLF） and its influence on liver function， inflammatory cytokines and short-term prognosis. Methods One hundred patients with ACLF were randomly divided into the observation group and the control group by envelope method， with 50 cases in each group. On basis of routine symptomatic treatments （liver protection， removing jaundice， reducing enzymes， anti-viruses， bleeding prevention）， the control group and the observation group were treated with plasma exchange （PE） and LPE plus DPMAS， respectively. The liver function， coagulation function， the levels of inflammatory cytokines， incidence of adverse reactions， and 90-day survival rate were compared between the two groups after treatment. Results After treatment， the liver function and coagulation function in the observation group were significantly improved （P < 0.05） and the levels of inflammatory cytokines were significantly lowered than those in the control group （P < 0.05）. There was no statistically significant difference in the 90-day survival rate and the total incidence of adverse reactions between the groups （P > 0.05）. Conclusion LPE combined with DPMAS can effectively improve liver function and coagulation function， and reduce levels of inflammatory cytokines in ACLF patients， with high safety.

Objective To provide reference for the subsequent clinical application of WBV， based on the impacts of whole body vibration （WBV） with different frequencies on gross motor function and walking function in children with dyskinetic cerebral palsy. Methods 60 children aged 6 ~ 12 with dyskinetic cerebral palsy， who had been treated at the department of rehabilitation medicine in the Affiliated Southwest Medical University from October 2021 to November 2022， were selected. They were randomly divided into a control group （n = 20）， （25 ± 5） Hz group （n = 20）， and （35 ± 5） Hz group （n = 20）. All the three groups received conventional rehabilitation， while the （25 ± 5） Hz group received additional WBV with （25 ± 5） Hz and the （35 ± 5） Hz group received WBV with （35 ± 5） Hz. They were treated for eight weeks. The scores on D and E domains of GMFM-88， TUGT， the score on Berg Balance Scale， and footprint analysis were used for assessment of the efficacy after treatment. Results As compared with the baselines， the scores were improved in the three groups after treatment （P < 0.001）. BBS （F = 12.502）， TUGT （F = 8.211）， scores on D and E domains of GMFM-88 （F = 12.802 and 8.505）， stride length （F = 12.279）， 1MWT distance （F = 12.619）， and step width （F = 13.582） were better in the （35 ± 5） Hz group than in the （25 ± 5） Hz group and the control group （P < 0.05 and P < 0.01）； and the efficacy was better in the （25 ± 5） Hz group than in the control group， the difference was statistically significant （P < 0.05 and P < 0.01）. Conclusion WBV can improve trunk control， lower limb gross motor function， and walking function in children with involuntary motor type cerebral palsy. （35 ± 5） Hz is better than （25 ± 5） Hz for the efficacy of WBV.

Objective To explore the effect of protective ventilation strategies based on individualized positive end expiratory pressure （PEEP） regulated by driving pressure （P_d） in infants under OLV. Methods Sixty infants undergoing elective thoracoscopic surgery were randomly divided into the control group and driving pressure group， with 30 cases in each group. The two groups were compared in terms of MAP， HR， tidal volume （Vt）， PEEP， P_d， airway peak pressure （P_peak）， and static lung compliance （Cs）， and arterial blood gas during OLV before the artificial pneumothorax （T₀）， 10 min （T₁）， 30 min （T₂）， and 60 min （T₃） after the artificial pneumothorax， and right at the end of the artificial pneumothorax （T₄）. Results There were no significant differences in MAP， HR， and Vt between the two groups at all the time points （P > 0.05）. Both groups showed the increase in P_d and P_peak and decresase in Cs at T₁， T₂， and T₃ （all P < 0.05）. PaO₂ and OI in both group were decreased and PaCO₂ was increased at T₂ （all P < 0.05）. Compared with the control group， the driving pressure group presented lower P_d and P_peak， higher PEEP and Cs at T₁， T₂， and T₃ （P < 0.05）， and higher PaO₂ and OI （P < 0.05） and no significant differences in PaCO₂ and FiO₂ at T₂ （P < 0.05）. The rate of rescue ventilation during OLV was lower in the driving pressure group （2 cases） than in the control group （9 cases） （6.9% versus 32.4%， P < 0.05）. There was no significant difference in the incidence of postoperative complications between the two groups （P < 0.05）. Conclusion The individualized positive end expiratory pressure （PEEP） regulated by Pd can optimize the PEEP settings upon infant individuals under OLV and improve the compliance and oxygenation of ventilated lung.

Objective To investigate the expression of centromeric protein F （CENPF） and microribonucleic acid 1?3p （miR?1?3p） in the serum of patients with advanced gastric cancer and their correlation with prognosis. Methods Sixty patients with advanced gastric cancer admitted to our hospital from March 2019 to March 2020 were collected as the study group， while 60 healthy volunteers who underwent physical examinations at our hospital's physical examination center during the same period were collected as the control group. Real?time fluorescence quantitative PCR （qRT?PCR） method was applied to detect the expression levels of serum CENPF and miR?1?3p in each group； Pearson method was applied to analyze the correlation between serum levels of CENPF and miR?1?3p； Kaplan?Meier method was applied to analyze the relationship between the expression of CENPF， miR?1?3p， and prognosis in patients with advanced gastric cancer； and COX regression was applied to analyze risk factors affecting the prognosis of patients with advanced gastric cancer. Results Compared with the control group， the CENPF level in the study group was obviously increased， while the miR?1?3p level was obviously reduced （P < 0.05）. The correlation analysis results showed that there was a negative correlation between serum CENPF and miR?1?3p levels in patients with advanced gastric cancer （r = -0.650，P < 0.001）. There were obvious differences in CENPF and miR?1?3p levels among different TNM stages and lymph node metastasis status （P < 0.05）. The 3?year survival rate of patients in the high expression group of CENPF was 19/30 （63.33%）， which was obviously lower than that in the low expression group， 28/30 （93.33%） （χ² = 7.954， P < 0.001）； the 3?year survival rate of patients in high expression group of miR?1?3p was 29/30 （96.67%）， which was obviously higher than that in the low expression group， 18/30 （60.00%） （χ² = 11.882， P = 0.001）. Multivariate COX regression analysis showed that TNM staging， lymph node metastasis， CENPF， and miR?1?3p expression were risk factors affecting the prognosis of patients with advanced gastric cancer（P < 0.05）. Conclusion The serum CENPF level in patients with advanced gastric cancer obviously increase， while miR?1?3p level obviously decrease， both of which are related to prognosis.

Objective The objective of this study is to investigate whether there is a correlation between a high TyG index （serum triglyceride glucose index） and higher mortality rates among patients undergoing peritoneal dialysis （PD）. Methods This study utilized a single-center retrospective cohort as the basis for its methods.. From January 1，2007 to December 31，2015，a total of 519 PD patients kept under observation until December 31，2018. There searchers employed the Kaplan-Meier method and Cox proportional hazards modelsto examine the correlation between TyG index levels and mortality. Results Over a period of 40.5 months， 104 （20.0%） individuals with Parkinson's disease passed away， with 55 （52.9%） of these deaths attributed to cardiovascular disease （CVD）. The serum median TyG index at baseline was 8.44 （6.48， 11.94）. Through Cox regression analysis subject to the adjustments of such parameters as gender， age， body mass index（BMI）， presence of cardiovascular disease， hypertension， diabetes mellitus， hemoglobin， serum albumin， serum Ferritin， total cholesterol， renal residual function（RRF）， An increased risk of all-cause mortality （HR = 2.22，95%CI： 1.43 ~ 3.44，P < 0.001） and CVD mortality （HR = 2.50，95%CI： 1.34 ~ 4.65，P = 0.004） was observed with a higher baseline TyG index （8.44）. A comparable impact was observed in the correlation between the average TyG index over time（TA-TyG index）and both all-cause mortality and CVD mortality. （HR = 1.90， 95％CI： 1.25 ~ 2.90， P = 0.003； HR = 2.05， 95％CI： 1.14 ~ 3.70， P = 0.017，respectively）. Conclusion PD patients with a higher serum TyG index have a greater risk of all-cause mortality and mortality related to cardiovascular disease.

Objective To investigate the clinical characteristics， treatment and prognosis of tuberculosis in patients with autoimmune diseases after tumor necrosis factor?αinhibitors. Methods Clinical data of 33 patients with TB after biologics （tumor necrosis factor?α inhibitors） treated in Guangzhou Chest Hospital from January 2019 to March 2023 were collected， including 25 males and 8 females， with a median age of 32 years. The clinical symptoms， laboratory results， imaging and tracheoscopic features， pathological features， treatment and outcome were analyzed retrospectively. Results The common clinical manifestations were cough （26/33）， sputum （23/33） and fever （17/33）. The most common cases were pulmonary tuberculosis （32/33）， bronchial tuberculosis （15/33）， mediastinum and hilar lymph node tuberculosis （11/33）. Bilateral lung spread of tuberculosis （21/33）， intrapulmonary spread of tuberculosis （bronchus， mediastinal hilar lymph nodes， pleura） （19/33）， extrapulmonary tuberculosis （18/33）， pulmonary tuberculosis with intrapulmonary or extrapulmonary tuberculosis （26/33）. Blood CD4⁺T lymphocyte test was normal （23/33）， and blood IGRA test was positive （27/33）. Pulmonary imaging miliary nodules （8/33）. The histopathology of the lymph nodes showed atypical granulomatous nodules. The duration of anti?tuberculosis treatment is 8 - 32 months. 1 case of death. Conclusion Patients with autoimmune diseases complicated with tuberculosis after the application of tumor necrosis fact?α inhibitor are more likely to have double lung lesions， which are easy to spread to lung tissues and multiple organs of the body， and have decreased immune function. Most of them need to extend the treatment course， and the prognosis is generally good after comprehensive treatment.

Objective To compare endoscopic thyroidectomy via transoral submental approach with open surgery for treating thyroid tumors in terms of the clinical effectiveness. Methods We retrospectively reviewed and analyzed the clinical data and follow?up records of 154 patients in the study， who were hospitalized for thyroidectomy in our hospital from January 2021 to June 2022. Among them， 74 cases undergoing endoscopic thyroidectomy via transoral submental approach were assigned to the endoscopic group and 80 cases undergoing traditional open thyroid surgery to the open surgery group. Results All operations were completed successfully and safely in both groups， with no intermediate openings in the endoscopic group. Compared with the open surgery group， the endoscopic group had significantly fewer intraoperative blood losses ［（19.46 ± 10.24）mL vs. （32.05 ± 15.87）mL］， significantly less incision length ［（1.95 ± 0.30）cm vs. （7.05 ± 0.60）cm］， significant shorter operative time ［（136.66 ± 22.44）min vs. （82.75 ± 15.20）min］， and significantly less total postoperative drainage ［（111.35 ± 38.92）mL vs. （95.45 ± 36.73）mL］ （all P < 0.05）. Endoscopic patients had superior postoperative pain and cosmetic satisfaction compared to open patients， and the difference was statistically significant （P < 0.05）. The two groups had no significant differences in the number of lymph node dissections， parathyroid hormone， and postoperative morbidity between the two groups （P > 0.05）. Conclusion The endoscopic thyroidectomy via transoral submental approach can achieve the same clinical effectiveness as the traditional open surgery. However， it is advantageous in reducing intra?operative blood loss， relieving post?operative pain， and achieving a better cosmetic effects of neck incision， thus deserving clinical promotion and application.

Objective To investigate the effect of diosmine on semen quality and sex hormone concentration in patients with spermatovenous ligation. Methods Clinical data were retrospectively collected from January 2019 to January 2022 on patients with varicocele admitted to Department of Urology， General Hospital of Southern Theater Command， divided into a control group and a study group based on whether they had a history of Diosmine use after surgery. Clinical data from both groups were matched using propensity score matching. Sperm quality and sex hormone tests were then compared before surgery， three months after surgery and six months after surgery. Results There were 73 in the control group and 73 in the study group. Both groups were balanced in terms of age， BMI， seminal fluid volume and testosterone （P > 0.05）. Sperm motility， forward motility and testosterone were all increased 3 and 6 months after surgery， and sperm malformations， sperm DNA fragment index， follicle stimulating hormone and luteinizing hormone were all reduced significantly （P < 0.05）. The results were also better than those in the control group for total sperm motility， forward motility， testosterone， sperm DNA fragment index， follicle stimulating hormone and luteinizing hormone （P < 0.05）. Conclusions Diosmine can help to restore semen quality and improve sex hormone concentration in patients with varicocele after Laparoscopic varicocelectomy.

Objective To investigate the enhanced CT and MRI imaging features of nasal sinus squamous cell carcinoma （SCC） and lymphoma （NHL）， and to analyze the efficacy of different imaging features in differentiating nasal sinus SCC from NHL. Methods The imaging， clinical and pathological data of 67 patients with sinus SCC and NHL who underwent sinus CT and MRI with contrast CT and MRI in our hospital and confirmed by surgical pathology were retrospectively analyzed， and the tumor origin， maximum diameter， CT density， MRI signal intensity， enhancement degree， tumor internal necrosis， adjacent bone destruction， invasion of surrounding tissues， and The imaging features such as cervical lymph node metastasis within the scanning range were analyzed， and the receiver operating characteristic （ROC） curve and area under the curve （AUC） were used to analyze the efficacy of different imaging features to distinguish nasal sinus SCC and NHL. Results There were statistically significant differences between the five imaging features of nasal sinus SCC and NHL， including tumor origin， maximum diameter， internal tumor necrosis， surrounding bone destruction and peripheral tissue invasion （P < 0.05）， and the AUC of differentiating SCC and NHL were 0.708， 0.694， 0.785， 0.850 and 0.629， respectively. The AUC of SCC and NHL was 0.969， and the sensitivity and specificity were 83.9% and 97.2%， respectively. Conclusion On contrast?enhanced CT and MRI， the imaging signs of tumor origin， maximum diameter， tumor internal necrosis， bone destruction and surrounding tissue invasion are helpful to distinguish nasal sinus SCC from NHL， especially if the tumor originates in the nasal cavity， necrosis is rare， bone destruction is mild， and the possibility of nasal sinus NHL should be given priority. Contrast?enhanced CT and MRI can help differentiate nasal sinus SCC from NHL， and the combination can help improve differential diagnostic performance.

Objective To construct a risk prediction model of pulmonary involvement based on chest CT and clinical feature in patients with primary Sjogren′s syndrome （pSS）， and to explore the risk prediction value of the model. Methods A total of 360 pSS patients who had been treated at Handan Hospital of Traditional Chinese Medicine from October 2020 to August 2023 were retrospectively selected as study objects， and were then divided into a modeling group （252 patients） and a verification group （108 patients） according to a ratio of 7∶3. The patients in the modeling group were divided into a control group （201 patients） and an involvement group （51 patients） based on presence or absence of lung involvement. The data on clinical characteristics and features of chest high?resolution CT （HRCT） in the modeling group was collected. Univariate analysis was performed among the groups to determine the relevant factors affecting lung involvement in pSS patients. Binary logistic regression analysis was performed on related factors to screen independent risk factors. A prediction model was established based on the independent risk factors. A verification and value analysis of the column?line prediction model were completed through data collection of the verification group. Results Age， disease course， cough， Raynaud′s phenomenon， C?reactive protein （CRP）， anti?SSA antibody， and HRCT were the relevant factors affecting lung involvement in pSS patients （all P < 0.05）. Further binary logistic regression analysis showed that old age， prolonged disease course， cough and abnormal HRCT imaging were independent risk factors for lung involvement in SS patients （all P < 0.05）. A nomogram risk prediction model was constructed based on independent factors. The model verification results indicated that the calibration chart showed better performance in the prediction model. The AUC of the area under the receiver operating characteristic （ROC） curve was 0.993 the modeling group and 0.995 in the validation group. Conclusions The clinical characteristics and the results of chest CT are closely related with lung involvement in patients with pSS. Old age， prolonged disease course， cough， and abnormal HRCT imaging are independent risk factors affecting lung involvement in patients with pSS. The prediction model established on this basis has a higher predictive value for the occurrence of lung involvement in patients receiving after?loading radiotherapy.

Objective To observe the clinical effect of Yangming meridian acupuncture combined with acupuncture push based on the theory of "treating flaccence and taking Yangming" in the treatment of Guillain-Barre syndrome. Methods 52 cases of patients with conventional rehabilitation combined with Yangming meridian acupuncture combined with acupuncture based on the theory of "treating potence and taking Yangming alone" were taken as the study group and 52 cases of patients with conventional rehabilitation alone as the control group. Limb muscle strength score， clinical efficacy， limb sensory function， limb motor function， upper limb median nerve electrophysiology and daily living ability were compared between the two groups. Results After treatment， muscle strength scores of proximal lower extremity， distal lower extremity， proximal upper extremity， distal upper extremity， median sensory nerve action potential （SNAP）， motor conduction velocity （MCV）， sensory conduction velocity （SCV） and modified Barthel index （MBI） were increased in 2 groups （P < 0.05）. The study group was more obvious （P < 0.05）. The total effective rate of the study group （86.54%） was higher than control group （69.23%） （P < 0.05）. After treatment， the sensory function and motor function of limbs in 2 groups were better than before treatment （P < 0.05）， especially in the study group （P < 0.05）. After treatment， the distal motor latency （DML） of upper limb median nerve was decreased in 2 groups （P < 0.05）， and more significantly in the study group （P < 0.05）. Conclusion Yangming meridian acupuncture combined with acupuncture pushing based on the theory of "treating impotence and taking Yangming" is effective in the treatment of Guillain-Barre syndrome， which can improve the muscle strength， sensation and motor function of limbs， and regulate nerve electrophysiology.

Objective To explore the clinical effects of Tiaojing Zhuyun mixture combined with regulating menstration and promoting pregnancy by thirteen acupuncture in the treatment of Declining Ovarian Function （DOR） combined with follicular dysplasia infertility. Methods From January 1， 2022 to January 1， 2023， 60 cases of infertility patients with DOR follicular dysplasia were treated in our hospital， and the above cases were randomly divided into experimental group： Tiaojing Zhuyun mixture+ regulating menstration and promoting pregnancy by thirteen acupuncture + Clomiphene group； Control group： Clomiphene group， 30 cases each. The improvement of FSH， maximum follicle size and ovulation， uterine artery blood flow index， endometrial thickness and pregnancy were observed after treatment. Results The improvement of follicle stimulating hormone， maximum follicle size， endometrial thickness and uterine artery blood flow indexes in Tiaojing Zhuyun mixture+ regulating menstration and promoting pregnancy by thirteen acupuncture + Clomiphene group were better than clomiphene group. The difference between groups was statistically significant （P < 0.05）. The ovulation rate was 66.7% and the pregnancy rate was 40%. The ovulation rate was 40% higher than the control group， and the pregnancy rate was 20%. The difference between groups was statistically significant （P < 0.05）. Conclusion In the patients with DOR follicular dysplasia infertility， Tiaojing Zhuyun mixture combined with regulating menstration and promoting pregnancy by thirteen acupuncture can improve the level of follicle stimulating hormone， promote follicular maturation and ovulation， reduce the resistance of uterine artery blood flow， increase the thickness of endometrial， promote pregnancy， and have fewer adverse reactions.

Diabetes mellitus （DM） is a common metabolic disease， and its hyperglycemia can induce many complications and even threaten human health and life. Ferritinophagy， currently a research focus， has been proven to be related to the occurrence and development of DM and its complications. Ferritinophagy， which is cell-selective， is mediated by nuclear receptor coactivator 4 （NCOA4）， which degrades ferritin in autophagosomes and releases excessive iron ions so that irons are overloaded and ROS are accumulated. This process contributes to the upstream ferroptosis. This article reviews the mechanism of ferritinophagy and its pathogenesis in DM and its complications， and further analyzes the effects of regulated ferritinophagy on DM and its complications， providing new insight into the prevention and treatment of DM and its complications.

Neurodegenerative diseases are irreversible neurological disorders caused by the loss or progression lesion of specific neuronal cell populations in the brain or spinal cord. Neuroinflammation， oxidative stress， mitochondrial dysfunction， excitotoxicity， and protein may aggregation contribute to neurodegenerative processes. FoxO3a， an important member of the FoxO subfamily of Forkhead transcription factors， plays a crucial role in cell proliferation， apoptosis， autophagy and ROS detoxification through phosphorylation， ubiquitination mediated degradation， microsignal transduction and related protein pathways， which is closely related to the occurrence and development of neurodegenerative diseases. This article focuses on the mechanism of FoxO3a in neurodegenerative diseases and the targeting of related pathways in recent years were described， indicating that FoxO3a plays a key role in the occurrence and development of the disease， aiming to provide new research ideas for the prevention and treatment of this disease.

Glioma is the most common primary central nervous system tumor， mainly derived from glial cells， with strong invasiveness， easy recurrence， and poor prognosis. Glioblastoma is a high-grade glioma with the highest degree of malignancy. The clinical treatment method is mainly surgical resection， supplemented by comprehensive treatment such as radiotherapy， chemotherapy， and electric field therapy， but the treatment effect is not satisfactory. In recent years， with the rapid development of the field of tumor immunotherapy， CD73 is a novel immune checkpoint related to adenosine metabolism， which can promote tumor progression by inhibiting anti?tumor immune responses and promoting angiogenesis. This article systematically reviews the mechanism of action of CD73 and discusses its biological role and application in glioma， aiming to provide potential treatment options for glioma patients.

China is a country with a high incidence of esophageal cancer. The pathological type is mainly squamous cell carcinoma. Squamous intraepithelial neoplasia is the most recognized precancerous lesion of esophageal squamous cell carcinoma， and its monitoring and intervention is an effective method to reduce the incidence of esophageal squamous cell carcinoma and improve the quality of life of patients. Understanding the etiology， clinical features， diagnosis and treatment of esophageal squamous cell carcinoma plays a crucial role in the prevention and early diagnosis and treatment of esophageal squamous cell carcinoma. At present， the clinical research related to esophageal squamous intraepithelial neoplasia is still insufficient， and there are some differences in clinical treatment. This review summarizes the risk factors， clinical features， diagnosis， prognosis and treatment of esophageal squamous intraepithelial neoplasia， hoping to provide ideas for the clinical management of esophageal squamous intraepithelial neoplasia.