Sarcopenia is a progressive and systemic skeletal muscle disease and an important extrapulmonary complication of chronic obstructive pulmonary disease （COPD）. Multiple studies have confirmed that COPD patients with sarcopenia have more severe airflow obstruction and emphysema， higher dyspnea index scores， reduced quality of life and exercise capacity， frequent acute exacerbations， and increased mortality. Although sarcopenia has been mentioned as a complication of COPD for many years， current clinical practice has received insufficient attention and insufficient intervention. The main reason is that its pathogenesis is unknown and drug treatment regimens are ineffective. As more and more research has been done on COPD combined with sarcopenia in recent years， this article reviews the current research progress to pay attention to further research and early intervention， including new mechanisms， diagnostic criteria， and drug treatment progress.

Since COVID?19 infection， many infected patients have developed multiple systemic symptoms that persist long after 3 months of infection， which is called Long COVID. Numerous studies have shown that fatigue is the most common symptom among the many symptoms of Long COVID that has severely impacted the quality of their life. Therefore， it is particularly important to understand the mechanisms by which Long COVID causes fatigue symptoms. This article summarizes the possible mechanisms of Long COVID fatigue， including immune response， oxidative stress， and affecting the central nervous system， by combing through the relevant literature， aiming to increase clinical awareness of fatigue induced by Long COVID and to provide certain ideas for its treatment.

Objective To Investigate the effect of copper ions on the radiosensitivity of nasopharyngeal carcinoma （NPC） and identify potential targets to improve the efficacy of NPC radiation therapy. Methods The content of copper ions in normal nasopharyngeal epithelial cell line NP69 and a variety of NPC cell lines was detected by a copper microplate assay. After adding 0， 5， 10， 20， 50， 100， 200 μmol/L copper ion solution and 0， 0.05， 0.1， 0.2， 0.5， 1.0， 2.0 mmol/L TEPA solution， CCK?8 assay was used to determine the effect of intracellular copper ion content on the survival rate of NPC cells before and after irradiation. And determine the drug concentration to be used in subsequent experiments. CCK?8 assay was used to determine the effect of intracellular copper ion content on the survival rate of NPC cells before and after irradiation， and to determine the drug concentration used in the copper ion group and TEPA group in the subsequent experiments. CCK?8 assay and clone formation assay were used to detect the changes in radiosensitivity of NPC cells after drug treatment. The DNA damage and MAPK-ERK signaling pathway-related protein expression of NPC cells in each group before and after irradiation were detected by Western blot. Results The content of copper ions in NPC cells was significantly higher than that in normal nasopharyngeal epithelial cells （P < 0.05）. When the concentration of copper ion solution was lower than 50 μmol/L， the radiation resistance of CNE1 cells was improved， and the radiation sensitivity of SUNE1 cells was increased by 0.1 ~ 0.2 mmol/L TEPA （P < 0.05）. Compared with the control group， the NPC cell radiotherapy resistance of copper ion group was enhanced， and the NPC cell radiotherapy sensitivity of copper ion group was enhanced （P < 0.05）. Compared with the control group， the activation degree of MAPK-ERK pathway in copper ion group was up-regulated （P < 0.05）. MAPK-ERK pathway inhibitor SCH772984 effectively reversed copper-mediated NPC radiotherapy resistance （P < 0.05）. Conclusion The increased copper ion content in NPC cells promoted the radiotherapy resistance of NPC cells by activating the MAPK-ERK signaling pathway.

Objective To study the influence of ANGPTL8 in lipopolysaccharide （LPS）?induced hepatic lipid deposition. Methods Male wild?type（WT） and ANGPTL8 knockout mice at 6-8 weeks were used to induce sepsis models by intrabitoneal injection of LPS （10 mg/kg）. qPCR and immunofluorescence were used to detected the mRNA and protein expression of ANGPTL8 in liver tissue and HepG2 cells respectively； The contents of alanine aminotransferase （ALT）， aspartate aminotransferase （AST） in serum and the triglyceride （TG） and malondialdehyde （MDA） in liver homogenate were detected by kits； the histopathological changes of liver tissue were analyzed through HE staining. Lipids accumulation in liver were detected by oil red O staining. The apoptosis of liver was determinated by TUNEL staining. RNA?seq was used to analyzing the differentially expressed genes in the liver tissue of WT and ANGPTL8 KO mice， and the qPCR and Western Blot were used to verify the differential expressed genes. Results The expression of ANGPTL8 in the liver was significantly upregulated at 48 hours after LPS stimulation. Compared with WT mice， the hepatic lipid deposition， steatosis， and apoptosis were significantly alleviated in liver of ANGPTL8 KO mice， the ALT and AST levels in serum and the TG and MDA content in liver homogenate of ANGPTL8 KO mice were also reduced significantly. The expression of caveolin?1（CAV1） in liver of ANGPTL8 KO mice was significantly higher than that of WT mice. Conclusions LPS promoted the expression and secretion of ANGPTL8 in liver tissue， and ANGPTL8 increased hepatic lipid deposition and peroxidation by inhibiting the expression of CAV1.

Objective The present study aimed to explore the effects of CC?chemokine receptor 5 antagonism on tumor growth and immune microenvironment. Methods Cell Counting Kit?8 was used to detect in vitro anti?proliferation activity of maraviroc， a selective CC?chemokine receptor 5 inhibitor， on Lewis cells， a mouse lung adenocarcinoma cell strain. Flow cytometry and real?time quantitative PCR were respectively used to detect cell apoptosis and Caspase 8 gene expression. In a congenic mouse lung cancer model， the mice were intraperitoneally administered with maraviroc or vehicle. Tumor sizes were measured and tumor infiltrating CD4⁺， CD8⁺ and Foxp3⁺ cells were determined by immunofluorescent staining. Results Our results showed that maraviroc could inhibit the growth of Lewis cancer cells not only in vitro but also in vivo. This in?vitro inhibition was presumably attributable to apoptosis induction by the enhancement of Caspase 8 gene expression after maraviroc blockade. Additionally， more CD4⁺ and CD8⁺ cells but less Foxp3⁺ cells were detected in tumor mass from the mice administered with maraviroc. Conclusions Taken together， it can be speculated that CCR5 blockade may inhibit the growth of Lewis cells by inducing cell apoptosis and impairing the immunosuppressive tumor microenvironment. It is worthy of further investigation as a candidate for cancer therapy

Objective To investigate the effect of human pulp stem cells （hDPSC） -derived exosomes （Exo） modified by circRNA （circRNA） signal-induced proliferation-associated protein-like 1 （SIPA1L1） on the angiogenesis of human umbilical vein endothelial cells （HUVEC）. Methods hDPSC was isolated and cultured from pulp tissue， the circSIPA1L1 overexpression plasmid was transfected into hDPSC， and Exo was isolated and identified. HUVEC was divided into control group， hDPSC Exo group and circSIPA1L1-hDPSC Exo group. After culture for 48 h， the vasculoformation ability was detected by Matrigel matrix gel vasculoformation test， the expression levels of vascular endothelial growth factor （VEGF）， vascular endothelial growth factor receptor 2 （VEGFR2） and placental growth factor （PGF） were determined by qRT-PCR and Western blot. Results The Exo was successfully isolated from the untransfected hDPSC and the hDPSC transfected with circSIPA1L1， and compared with the HDPSC-derived Exo， the relative expression of circSIPA1L1 in the hDPSC Exo transfected with circSIPA1L1 was significantly up-regulated （P < 0.05）. Compared with hDPSC Exo group， the number of HUVEC tubular structures in circSIPA1L1-hDPSC Exo group was significantly increased （P < 0.05）， and the mRNA and protein relative expressions of VEGF， VEGFR2 and PGF were also significantly up-regulated （P < 0.05）. Conclusions Modification of hDPSC-derived Exo by circRNA SIPA1L1 can promote angiogenesis， and the mechanism may be related to up-regulation of VEGF， VEGFR2 and PGF expression levels.

Objective We systematically analyze the changes in the count and function of platelet at the early sepsis based on clinical study and single cell sequencing. Methods Clinical data of sepsis patients at the early stage were collected and had been compared between different prognostic groups in the prospective case?control study. The independent risk factors of death were analyzed by logistic regression， and the predictive efficacy of clinical indicators was evaluated by receiver operating characteristic （ROC） curve. The healthy volunteers and sepsis patients were recruited. Clinical researchers collected peripheral venous blood samples for sorting cell samples to carry out single?cell RNA sequencing （sc?RNA seq）. Through bioinformatics techniques， we analyzed the changes in platelet count， the significantly differential?expressed genes and its enriched functional signaling pathways in the early stages of sepsis. Results （1） A total of 224 patients were enrolled， with a 90 day survival rate of 70.5%. Compared with the survival group， the count of platelet and MAP in the death group at the early stage of sepsis were significantly lower， but the plasma lactate content and SOFA score were significantly higher. （2） Based on single cell sequencing technology， cells are annotated as six groups. The proportion of innate immune cells （neutrophils， monocytes， and dendritic cells） was significantly increased in the early stage of sepsis compared to the healthy volunteers （2.15∶1）， while platelets significantly decreased （0.31∶1）. （3） Through bioinformatics technology， CD41/CD42a/CD61 was identified as platelet specific molecules， with significantly increased expression levels in sepsis. Three molecules can distinguish platelets together. （4） 771 genes were significantly upregulated and 1101 genes were significantly downregulated in platelets of patients with sepsis， including core molecules involved in physiological functions such as cell adhesion， chemotaxis， and immune response. Functional analysis suggests that differentially expressed genes are enriched in coagulation， immune functions and cell death， participating in oxidative phosphorylation， leukocyte chemotaxis， iron death， and NOD like receptor signaling pathways. Conclusion Reduced platelet count is associated with poor prognosis in the early stage of sepsis. The specific high expression molecules CD41/CD42a/CD61 that are significantly upregulated in platelets can serve as biomarkers for platelets. Platelets not only mediate cell adhesion and coagulation cascade， but also participate in functional changes such as immune cell chemotaxis， inflammatory response， and the pathological death of inflammatory cells.

Objective Exploring the use of thromboelastography（TEG） to assess the risk of bleeding in patients with acute leukemia（AL）undergoing platelet transfusion refractoriness（PTR）. Methods To investigate the differences in TEG parameters between the PTR group and the non?PTR group in adult AL patients， and compare the differences in PLT and TEG parameters between the bleeding group and the non?bleeding group in the PTR group. Results A total of 58 AL patients were positive for platelet?related antibodies， and the proportion of PTR was 48.28%. A total of 20 patients with PTR were transfused with large?dose immunoglobulin， the effective rate was 40%， and 26 patients with PTR were transfused with matching platelets， the effective rate was 42.62%。 This study observed the difference of TEG parameters between the PTR group and the non?PTR group， and the results showed that there were no significant differences in PLT， R value， K value， α Angle and MA value before and after platelet transfusion in the PTR group. The PLT and MA values of the non?PTR group were significantly different before and after transfusion（P < 0.05）， while the R value， K value and α Angle were not significantly different. The PLT and MA values of the non?PTR group were significantly higher than those in PTR group after transfusion（P < 0.05）. Analysis and comparison of PLT and TEG parameters between the bleeding group and the non?bleeding group in patients with PTR showed that there was no significant difference in PLT value， R value， K value and α Angle of TEG， while MA value in the non?bleeding group was higher than that in the bleeding group， with significant difference（P < 0.05）. Conclusions Platelet count alone cannot accurately reflect the risk of bleeding in AL patients with PTR. TEG can effectively predict and evaluate the bleeding risk in AL patients， among which the maximum amplitude index has the most significant clinical significance， which is of great significance for disease evaluation and treatment guidance.

Objective This study aims to develop a prognostic risk prediction model for gastric cancer based on m1A/m5C/m6A/m7G regulated genes and to investigate the relationship between this model and immunology. Methods The Cancer Genome Atlas （TCGA） gastric cancer dataset was utilized to identify m1A/m5C/m6A/m7G regulated genes with significant expression differences. A prognostic risk score （RS） model was constructed using univariate Cox regression analysis and the LASSO algorithm. The RS model was validated using the Kaplan?Meier （K?M） statistic and cell lines for RT?qPCR biological validation. A nomogram model was created using univariate and multivariate Cox regression analyses. The CIBERSORT algorithm and ESTIMATE package were employed to conduct immune correlation analysis. Results A prognostic RS model based on eight methylation regulated genes was developed to classify patients with gastric cancer as high?risk or low?risk. These eight genes showed significant expression in gastric cancer cell lines （P < 0.05）. The TCGA?gastric cancer training set and GSE62254?validation set showed a substantial connection （P < 0.001） between overall survival rate （OS） and grouping status. The nomogram survival models accurately predicted 1?year （C?index = 0.703）， 3?year （C?index = 0.729）， and 5?year （C?index = 0.734） survival rates. Immune correlation analysis showed that compared to the low?risk group， the high?risk group had higher immune scores and higher expression of immune checkpoint?related genes （P < 0.05）. Conclusion We created a reliable prognostic RS model based on m1A/m5C/m6A/m7G regulated genes that can predict gastric cancer prognosis and guide individualized immunotherapy decisions.

Objective To explore the effect of the physician-nurse-social worker linkage rehabilitation model on the psychological status in patients receiving methadone maintenance treatment （MMT）. Methods Ninety-four patients who received MMT were enrolled and randomly divided into experimental group （n = 48） and control group （n = 46）. The experimental group received physician-nurse-social worker linkage rehabilitation model intervention， while the control group received conventional methadone treatment service. The anxiety， depression and quality of life of the two groups were evaluated before the intervention， 3 months and 6 months after the intervention. Results After 6 months of physician-nurse-social worker linkage rehabilitation mode intervention， the depression status and the anxiety status of the experimental group subjects were significantly improved compared with those before intervention， and both BDI and BAI scores were significantly lower than those of the control group subjects （P < 0.05）. Moreover， the proportion of "had depression" and "had anxiety" in the experimental group were significantly lower than those in the control group （P < 0.05）. After 6 months of intervention， the QOL-DA score of the experimental group subjects （183.77 ± 8.90） was significantly higher than that of the control group subjects （174.76 ± 11.14） （P < 0.01）. Conclusion The physician-nurse-social worker linkage rehabilitation model had certain advantages in improving the psychological state of MMT patients， which is worthy of promotion.

Objective To study and compare the oral microbiota and metabolites of children with Henoch Schonlein purpura（HSP） to identify specific microbiota and metabolites related to this disease and elucidate the pathogenesis of HSP. Methods Three groups of qualified subjects were included， including 20 in the HSP group， 20 in the HSP nephritis （HSPN） group， and 20 in the control group. Perform high?throughput 16S rRNA sequencing and metabolic profiling of saliva from each group to analyze the correlation between differential microbiota and differential metabolites. Results （1） Compared with the control group， there was a significant difference in richness and diversity in the HSPN group （P < 0.05）. At the same time， there was no significant difference in richness and diversity in the HSP group （P > 0.05）. Compared with the HSP group， the abundance， and diversity of the HSPN group were significantly increased （P < 0.05）. At the genus level， the proportion of Streptococcus in each group is the highest. Compared with the control group， there was no significant correlation between the HSP group and the genus of bacteria. In contrast， the HSPN group showed a significant increase in the genera of Pseudomonas and Parabacteroides （P < 0.05）. Compared with the HSP group， the abundance of Pseudomonas and Parabacteroides in the HSPN group was significantly increased （P < 0.05）. （2） Compared with the control group， the HSPN group had 12 differential metabolites involving nine metabolic pathways， such as phenylalanine metabolism； There was no significant difference in metabolites and no metabolic pathway in the HSP group. Compared with the HSP group， the HSPN group has 15 differential metabolites involving nine metabolic pathways， such as phenylalanine metabolism. （3） In the HSPN and control groups， Pseudomonas and Parabacteroides negatively correlated with Phenylalanine metabolic pathway products. In the HSPN and HSP groups， Pseudomonas， Parabacteroides， and Phenylalanine metabolic pathway products were negatively correlated. The metabolites involved in phenylalanine metabolism in the oral cavity are 2?hydroxycinnamic acid， Phenylpyruvic acid， and N?acetyl?L?phenylalanine. Conclusion There is a significant difference between HSPN and HSP children and healthy children. Streptococcus， Pseudomonas， and Parabacteroides may be one of the trigger factors of HSPN， and Phenylalanine metabolism may be one of the pathways in the pathogenesis of HSPN. Children with HSPN have a more pronounced imbalance in oral microbiota and greater differences in metabolic products than children with HSP.

Objective To compare the effect of posterior cruciate ligament retaining （CR） and posterior cruciate substituting （PS） prosthesis in knee arthroplasty. Methods 64 patients with knee osteoarthritis were admitted to our department from June 2021 to June 2022 and whom met the selection criteria were randomly selected and divided into observation group and control group （n = 32）. CR prosthesis was used in the observation group， and PS prosthesis was used in the control group. Operation time， postoperative drainage volume， difference of hemoglobin （HGB） before and after operation， postoperative hospital stay， postoperative range of motion at 7 d， 14 d， 45 d， 3 months and 1 year were recorded. ROM， visual analog pain Scale （VAS）， Hospital for special surgery （HSS） score， and maximum forward and backward displacement of knee joint and the regular radiographs were also recorded， too. Results The two groups were similar in terms of operation time， postoperative hospital stay， postoperative VAS score and maximum anterior and posterior displacement of knee joint， with P values greater than 0.05， which had no statistical significance. The postoperative drainage volume in the observation group was significantly less than that in the control group， with statistical significance （P < 0.05）. The HGB difference of observation group was significantly lower than that of control group， with statistical significance （P < 0.05）. There was no statistically significant difference in ROM and HSS scores between the two groups before surgery； the ROM and HSS scores of the control group at 7， 14 and 45 days after surgery was better than that of the observation group， with statistical significance （P < 0.05）； the ROM and HSS scores of the two groups at 3 months after surgery was not statistically significant. The ROM and HSS scores in the observation group was better than that in the control group at 6 months and 1 year after operation， and the difference was statistically significant （P < 0.05）. Conclusions CR prosthesis is superior to PS prosthesis in terms of intraoperative blood loss and post?operative drainage volume， which can reduce surgical risk. Both kinds of prosthesis can achieve good knee stability after surgery， while PS prosthesis has better early clinical effect， while CR prosthesis has better long?term clinical effect.

Objective To investigate the radiographic anatomical relationship between tibial plateau and distal femur and evaluate the impact of reset tibial plateau of various widths after reduction of the Schatzker IV-C tibial plateau fractures on postoperative outcomes. Methods We collected and reviewed the X-ray images of the normal knees of 207 standard neutrally-positioned adults （non-fracture group） and pre-and post-operative immediate anterior-posterior X-ray images of the knees of 60 patients with Schatzker IV-C fractures （fracture group） in our hospital from August 2012 to August 2022. We measured the proximal tibial joint width （TAW）， distal femoral width （DFW）， and distal femoral joint width （FAW） in both groups and calculated the TAW/DFW and TAW/FAW ratios. In the fracture group， the cases with TAW between FAW and DFW were assigned to the well-reduced group， while those with TAW outside this range between FAW and DFW to the poorly-reduced group. Both groups were assessed using the Hospital for Special Surgery knee score （HSS） one year after operation. Results In the non-fracture group， there were no significant differences in gender or affected side in terms of TAW/DFW and TAW/FAW ratios （P > 0.05）， while in the fracture group， there were statistically significant differences in the TAW/DFW and TAW/FAW ratios compared to the non-fracture group （P < 0.05）. There was a statistically significant difference in the one-year postoperative HSS scores between the well-reduced and poorly-reduced groups in the fracture group （P < 0.05）. Conclusion The radiographic anatomical relationship between the tibial plateau and distal femur in normal adults is relatively constant， providing a radiological reference for resetting the tibial plateau to a satisfactory width during reduction of Schatzker IV-C fractures. TAW/DFW > 1 or TAW/FAW < 1 indicates a poor reduction of the fracture and predicts poor postoperative recovery of knee joint function.

Objective To investigate the expression of zinc finger E-box-binding protein 2（ZEB2） and CC chemokine ligand 20 （CCL20） in glioma tissue and their relationship with prognosis. Methods The tumor tissues of 156 patients with glioma were collected as tumor group and 52 normal brain tissues of the same period were collected as normal group. The expression of ZEB2 and CCL20 in tissues were detected by immunohistochemistry， and the relationship between the expression and survival was analyzed by Kaplan-Meier survival curve. Patients in the tumor group were followed up for three years and grouped into a poor prognosis group and a good prognosis group based on their survival status， and the prognostic factors were analyzed by COX regression. Results The positive expression rate of ZEB2 and CCL20 in the tumor group were higher than those in the normal group （P < 0.05）. The 3-year survival rate of 156 glioma patients was 69.87%. The survival rate of patients with positive ZEB2 and CCL20 expression was lower than that of patients with negative expression （P < 0.001）. Age， maximum tumor diameter， tumor pathological grade， and positive expression of ZEB2 and CCL20 were all risk factors for poor prognosis of patients with glioma （P < 0.05）， and preoperative KPS， postoperative radiotherapy， and course of temozolomide treatment were all protective factors （P < 0.05）. Conclusion The expression level of ZEB2 and CCL20 in tumor tissues of glioma patients is up-regulated， and related to the prognosis of patients.

Objective To compare and analyze the clinical efficacy， recurrence rate， and breast appearance evaluation of simple surgery and surgery combined with glucocorticoids in the treatment of mass type granulomatous mastitis. Methods This study retrospectively analyzed 106 patients with nodular granulomatous mastitis who visited the Department of Breast Surgery at Yichang Central People's Hospital from January 2017 to January 2022 as the study subjects. According to the different treatment methods during the visit， patients were divided into Group A with simple surgical treatment （n = 67） and Group B with surgery combined with glucocorticoid treatment （n = 39）. The general information and clinical indicators of the two groups of patients were observed and compared. Obtain patient clinical efficacy， time to clinical cure （TTCR）， recurrence rate within one year， and breast appearance evaluation through follow?up. Results The prognosis of the follow?up patients after treatment showed that Group B patients had better clinical cure rate and one?year recurrence rate than the simple surgery group （P < 0.05）. Moreover， the difference in breast appearance evaluation between the two groups was statistically significant， with Group B patients having a significantly higher rate of excellent appearance （88.06%） than Group A （92.31%）. According to statistics， only 5.13% of patients in Group B experienced gastrointestinal reactions within one year after taking hormone therapy. Conclusions The combination of surgery and glucocorticoids in the treatment of mass type GM can effectively improve the overall clinical treatment effect of patients， reduce the short?term recurrence rate， and have a significant effect on ensuring the integrity of breast appearance. At the same time， low?dose oral steroid drugs have fewer adverse reactions and high safety.

Objective Investigate the expression level and clinical significance of microRNA?223?3p （miR?223?3p） in the serum of pregnant women with preterm premature rupture of membranes （PPROM）. Methods A total of 91 pregnant women who underwent cesarean delivery at the Xuzhou Maternal and Child Health Hospital affiliated with Xuzhou Medical University between April and September 2023 were selected for the study. This included 60 cases of PPROM and 31 cases of term normal pregnant women as the research subjects. The study group was divided based on the pathological results of the membranes into： PPROM group without histological chorioamnionitis （HCA） （PPROM group， n = 37）， and PPROM group with HCA （PPROM+HCA group， n = 23）. Serum samples from pregnant women were collected before hospital treatment， and the expression level of miR?223?3p in the serum was detected by quantitative real?time PCR （qRT?PCR）. The levels of inflammatory factors such as IL?1β， IL?6， IL?8， and TNF?α in the serum were measured by enzyme?linked immunosorbent assay （ELISA）. Results The expression level of miR?223?3p in the serum of the PPROM+HCA group was significantly higher than that of the PPROM group and the normal group （P < 0.05）. The expression levels of IL?1β， IL?6， IL?8， and TNF?α in the serum of the PPROM+HCA group were also significantly higher than those of the PPROM group and the normal group （P < 0.05）. There was a positive correlation between the expression level of miR?223?3p in the serum of the PPROM+HCA group and the expression levels of IL?1β， IL?6， IL?8， and TNF?α （r = 0.553， 0.505， 0438， 0.656， P < 0.05）. Conclusion The upregulation of miR?223?3p in the serum of pregnant women with PPROM+HCA is associated with the severity of inflammation in PPROM.

Objective To investigate the effect of core decompression combined with bone-morphogenetic proteins （BMP） activity inducing rod implantation in the treatment of early-stage femoral head necrosis. Methods Retrospective analysis of 116 patients with early-stage femoral head necrosis from June 2018 to June 2022 were divided into core decompression combined with BMP activity inducing rod group （BMP group） and allograft bone group. Sixty cases in the BMP group were treated with core decompression combined with implantation of BMP-activated induced rods， and 56 cases in the allograft group were treated with core decompression combined with bone grafting of the allograft bone by punching and compression.The differences in hip Harris scores and visual analogue scores （VAS） of pain between the two groups at preoperative， 6 months postoperative and 1 year postoperative， and the patient treatment response and femoral head survival rate at 1 year postoperative were compared. Results All patients were followed-up， and the difference between the preoperative VAS score and Harris score of the two groups was not statistically significant （P > 0.05）， and the VAS score and Harris score of the two groups were significantly improved at 6 months and 1 year after operation， and the BMP group was better than the allograft bone group， with significant difference（P < 0.05）. At 1 year after surgery， the Harris hip score excellence rate of the BMP group was higher than that of the allograft bone group， and the difference was statistically significant （P < 0.05）； the femoral head survival rate of the BMP group was higher than that of the allograft bone group， and the difference was statistically significant （P < 0.05）. Conclusions Core decompression combined with BMP activity induced rod implantation was effective in the treatment of early femoral head necrosis， which accelerated the induction of new bone formation， improved the quality of new bone， provided biomechanical support for the femoral head， and effectively avoided femoral head collapse. Moreover， it has good biocompatibility and couldbe degraded and absorbed in the body， which is worthy of clinical promotion.

Objective To analyze the joint efficacy of butylphthalide （NBP） and limb ischemic postconditioning （LIPost C） in the treatment of elderly patients with atherosclerotic cerebral infarction. Methods A total of 160 patients with large atherosclerotic cerebral infarction hospitalized in Bijie Hospital from October 2020 to October 2022 were divided into four groups： NBP， LIPost C， NBP + sham LIPost C， and NBP + LIPost C by the random number table method， with 40 cases in each group. Before and after one-month treatment， the four groups were compared in terms of collateral circulation evaluated by the leptomeningeal scoring （rLMC）， neurological function evaluated by the National Institutes of Health Stroke Scale （NIHSS）， limb function disability evaluated by the Modified Rankin Scale （MRS）， cognitive function evaluated by the Mini Mental State Scale （MMSE）， daily living ability evaluated by the Barthel Index， as well as the occurrence of bleeding adverse events. Results After one-month treatment， the four groups all showed an increase in the rLMC score， with the NBP + LIPost C group significantly higher than the other three groups （P < 0.05）， and a decrease in the scores of NIHSS and MRS at each time point， with the NBP + LIPost C group significantly lower than the other three groups （P < 0.05）. Additionally， the four groups demonstrated an increase in the MMSE score and Barthel index at each time point （P < 0.05）， with the NBP + LIPost C group higher than the other three groups （P < 0.05）. Moreover， all the four groups showed no statistically significant difference in the incidence of bleeding adverse events （P > 0.05）. Conclusion NBP combined with LIPost C can effectively promote the establishment of collateral circulation and the recovery of neurological function in elderly patients with atherosclerotic cerebral infarction. Meanwhile， it can improve their motor function， daily living ability， and cognitive function. Moreover， it has high safety.

Objective To observe the efficacy and safety of radiotherapy combined with programmed death receptor?1 （PD?1） inhibitors and tyrosine kinase inhibitors （TKIs） for the treatment of microsatellite?stabilized （MSS）?type or mismatch?matched repair?normal （pMMR）?type colorectal cancer with liver metastases （CCLM）. Methods Case data of 25 patients with MSS?type CCLM admitted to Jiangsu Provincial Cancer Hospital from April 2021 to August 2023 were retrospectively analyzed. They were divided into observation group （n = 12） and control group （n = 13）. The observation group was given radiotherapy combined with PD?1 inhibitor and TKI treatment， and the control group was given TKI monotherapy. The baseline data， treatment effect， progression?free survival， and treatment?related adverse reactions of patients in the two groups were compared. Results The difference in baseline data between the two groups was not statistically significant （P > 0.05）， the disease control rate （DCR） of the observation group was higher than that of the control group （P < 0.05）， the progression?free survival （PFS） of the patients in the observation group was longer than that of the control group， but the difference was not statistically significant （P > 0.05）， and the difference in the incidence of treatment?related adverse events （TRAE） between the two groups was not statistically significant （P > 0.05）. Conclusion The treatment regimen of radiotherapy combined with PD?1 inhibitors and TKI drugs improved clinical efficacy and did not increase the incidence of adverse events when compared with TKI alone， which is a treatment regimen worthy of further validation.

Objective To explore the clinical efficacy of alirocumab combined with ybutimibe in acute ST segment elevation myocardial infarction （STEMI）. Methods A total of 112 cases of STEMI patients were randomly divided into control group and study group， with 56 cases in each. All patients underwent PCI treatment after admission. The control group received oral administration of atorvastatin after the surgery， while the study group received combined treatment of atorvastatin with alirocumab. After 6 months of maintenance treatment， the low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， triglycerides， total cholesterol， left ventricular ejection fraction （LVEF）， early and late diastolic peak flow velocity ratio （E/A） of the mitral valve orifice， left ventricular end-systolic diameter （LVESD）， N-terminal pro-brain natriuretic peptide （NT-proBNP）， cardiac troponin I （cTnI）， lipoprotein-associated phospholipase A2 （Lp-PLA2）， matrix metalloproteinase-9 （MMP-9）， interleukin-6 （IL-6）， thrombolysis in myocardial infarction （TIMI） flow grade， drug toxicity， and postoperative cardiovascular adverse events were compared between the two groups. Results After treatment， the level of LDL-C， triglycerides， and total cholesterol in both groups decreased， and more significant results were found inthe study group （P < 0.05）. There was no significant difference in HDL-C between the two groups before and after treatment （P > 0.05）. After treatment， LVEF and E/A in both groups increased， with more significantresults in the study group （P < 0.05）. LVESD， NT-proBNP， cTnI， Lp-PLA2， MMP-9， and IL-6 in both groups decreased after treatment， with more significant resultsin the study group （P < 0.05）. The proportion of TIMI III grade in the study group was higher than that in the control group （P < 0.05）， and there was no significant difference in the incidence of drug adverse reactions and postoperative cardiovascular adverse events between the two groups6 months after surgery（P > 0.05）. Conclusion The combination of alirocumab and ybutimibe in the treatment of STEMI PCI patients is more helpful in reducing blood lipid levels， promoting blood flow perfusion and improving myocardial function， and has good safety.

Objective To compare different therapeutic regimens for treatment of Helicobacter pylori （Hp） infection combined with small intestinal bacterial overgrowth （SIBO）. Methods This study was a single?center， single?blind， 16?week randomized controlled trial to evaluate the efficacy of different therapeutic regimens for patients with Hp infection combined with SIBO. Patients who were co?positive for Hp and SIBO attending the outpatient and inpatient departments of the Department of Gastroenterology of the Sixth Medical Center of the PLA General Hospital from April 2022 to July 2023 were enrolled. The enrolled patients were randomly divided into 3 groups， A， B， and C. Different treatment regimens were applied to the three groups. The 13C?urea breath test and methane hydrogen breath test were reviewed respectively after 4 ~ 6 weeks of drug discontinuation， to compare the rate of co?conversion of Hp and SIBO， the degree of improvement of abdominal symptom scores， and the incidence of adverse reactions， such as diarrhea， constipation， and nausea in the three groups. Results There was no statistically significant difference in the Hp conversion rate among the three groups（P > 0.05）， and the SIBO conversion rate and co?conversion rate of group B were higher than that of group A（P < 0.05）， and the difference was not statistically significant compared with that of group C（P > 0.05）. The degree of improvement in GSRS score after treatment was higher in group B than in groups A and C （P = 0.015，P = 0.014）， and the overall adverse reactions in group B were lower than those in group A （P < 0.001）. The difference in overall adverse reactions between groups B and C was not statistically significant（P > 0.05）. The rate of SIBO conversion， the rate of co?conversion， and the degree of improvement in GSRS score after treatment were not statistically significant between group A and C（P > 0.05）， and the adverse reaction incidence was higher than that of group C （P = 0.004）. Conclusion Most patients with Hp infection combined with SIBO are accompanied by gastrointestinal discomforts such as acid reflux， heartburn， abdominal distension， constipation， and diarrhea， etc. HP treatment after removal of small intestinal bacteria can improve the rate of Hp and SIBO co?conversion， and effectively alleviate the abdominal symptoms and reduce the incidence of adverse reactions.

Objective To explore the effect of MSCT 3D scanning and reconstruction on developmental dysplasia of the hip（DDH）in adult patients with total hip arthroplasty， The predictive value of acetabular prosthesis selection and osteotomy accuracy in THA. Methods Selection in our hospital between February 2021 and February 2023 were 60 adult DDH patients underwent total hip replacement， which USES routine preoperative planning as a control group of 30 patients，and using MSCT + reconstruction of 3 d scanning technology as observation group of 30 patients，planning after the completion of the planning of the surgical operation and implant placement， Relevant information was collected before and after the operation of the two groups. Operation time，intraoperative blood loss，intraoperative fluoroscopy time， acetabular prosthesis selection and matching rate， femur split fracture rate， pelvis and acetabular reduction quality， Majeed score and Harris hip function score were compared between the two groups. The osteotomy distance and sharp shoulder distance of the two groups were compared before planning and in actual conditions，and the correlation between MSCT 3D scanning and reconstruction technology and the accuracy of acetabular prosthesis selection was evaluated. Results Results analysis showed that MSCT 3D scanning+reconstruction technology used in preoperative evaluation of patients in the observation group was correlated with the accuracy of acetabular prosthesis selection（P < 0.05）， and the absolute errors of osteotomy distance and sharp shoulder distance of patients in the observation group were smaller than the actual situation before planning（P < 0.05）. In addition，compared with the control group， the operative time，intraoperative blood loss， intraoperative fluoroscopy time and incidence of femoral split fracture in the observation group were significantly lower，and the matching rate of acetabular prosthesis selection，the Majeed scores and Harris scores were significantly higher in the following 3 months were significantly higher（P < 0.05）. The reduction quality of pelvis and acetabulum was not statistically significant between the two groups（P > 0.05）. Conclusion Msct?based 3D scanning + reconstruction has a high predictive value for the selection of acetabular prosthesis and the accuracy of osteotomy in adult DDH total hip replacement， and the use of this technology for preoperative planning has a significant optimization effect on the actual treatment effect and patient recovery.

Immune checkpoint inhibitors （ICIs）， including cytotoxic T?lymphocyte?associated protein 4 （CTLA?4） inhibitors and programmed cell death receptor 1 （PD?1） inhibitors and their ligand 1 （PD?L1） inhibitors， have transformed the clinical outcomes of many patients with malignancies. programmed cell death receptor 1 （PD?1） inhibitors and their ligand 1 （PD?L1） inhibitors have changed the clinical outcomes of many patients with malignancies and have become the most important anti?tumor tools available. With the widespread use of immunotherapy， immune?related adverse events （irAEs） induced by ICIs have gradually attracted clinical attention， among which ICI?related colitis has become the most common adverse event in the gastrointestinal system. In this paper， we describe the epidemiology， pathogenesis and clinical management of ICI?related colitis， with the aim of providing reference for clinicians to identify and treat ICI?related colitis in a timely manner.

The incidence of perioperative arrhythmias is 4%~20% in noncardiac surgery and 10% ~ 30% in cardiothoracic surgery， with the incidence of perioperative arrhythmias in cardiac surgery patients as high as 90%. Perioperative arrhythmias can prolong hospitalization and increase morbidity and mortality during hospitalization. Studies have shown that aberrantly expressed microRNAs in cardiovascular diseases can participate in cardiac automaticity， excitability and conductivity by regulating ion channels， gap junction proteins， and intracellular Ca²⁺ handling proteins， thereby regulating cardiac electrophysiological homeostasis and arrhythmias. In this article， we will review the research progress of microRNAs and arrhythmias mainly from the perspective of cardiac electrophysiological imbalance.

Ischemic stroke is feature by high incidence， high disability and high mortality. Inflammation plays an important role in the occurrence and development of ischemic stroke. Activated microglia exhibit two different phenotypes of proinflammatory （M1） and anti-inflammatory （M2）， and regulating the transformation of microglia from M1 to M2 is the key to clinical benefit. Recent studies have shown that autophagy plays a key role in regulating phenotypic transformation of microglia. How to exert the regulatory role of autophagy and promote the transformation of microglia into M2 type has become a hotspot of clinical research in reducing secondary brain injury after stroke. This paper reviews the research progress of autophagy regulation of microglia polarization in ischemic stroke， aiming to provide a reference for further clinical and basic research in this field.