Tuberculosis in kidney transplant（KT） recipients is a common opportunistic infection with higher incidence and prevalence than in the general population. Tuberculosis infection after kidney transplantation included latent tuberculosis infection， inactive tuberculosis infection and active tuberculosis infection. The following factors should be considered in the diagnosis of tuberculosis infection in KT recipients： atypical clinical presentation， association with co-infections， decreased predictive values of screening tests， diverse imaging findings and particular diagnostic methods. Regarding treatment challenges in KT recipients with tuberculosis， course of treatment， drug interaction， drug toxicity and therapeutically adherence should be considered.

Objective This study aimed to investigate the effect and mechanism of Liraglutide on high glucose-induced vascular endothelial cell injury. Methods Human umbilical vein endothelial cells （HUVECs） were cultured and divided into 4 groups： control， high glucose stimulation （HG）， Liraglutide， and Liraglutide + HG group. ELISA was used to detect the secretion of inflammatory cytokines in each group， kits the levels of intracellular reactive oxygen species （ROS）， the activity of SOD2 and Gpx4，and the level of MDA， and Western blot and immun of luorescence method nuclear translocation of Nrf2. Results The HG groupexhibited a significantly higher levels of tumor necrosis factor （TNF?α）， interleukin （IL-1）， IL-6， as well as the levels of intracellular ROS and MDA， but less activity of SOD2 and Gpx4， less contents of NO， and less nuclear translocation of Nrf2， as compared with the control group. Compared with the HG group， the Liraglutide + HG grouppresented significantly higher levels of TNF?α， IL-1， and IL-6， but lower levels of intracellular ROS and MDA， less activities of SOD2 and Gpx4， less contents of NO and less nuclear translocation of Nrf2. Conclusion Liraglutide suppresses high glucose-induced endothelial cell injury by increasing the nuclear translocation of Nrf2.

Objective To study the effect of miR-143-3p on pyroptosis of HCT-116 cells induced by LPS + ATP. Methods The targeting relationship between miR-143-3 p and TLR2 gene was detected by dual luciferase. The pyroptosis model was established after transfection of miR-143-3p mimic. Cell apoptosis was detected by flow cytometry， and the activity of Caspase-1 and LDH was detected by biochemical method. The levels of IL-1β and IL-18 were detected by ELISA. The mRNA levels of NF-κB， TLR2， NLRP3 and GSDMD were detected by q-PCR. The expression of NLRP3 and ASC was detected by immunofluorescence. The protein expressions of TLR2， GSDMD， p-NF-κB p65 and cleave Caspase-1 were detected by Western blot. Results Dual luciferase assay showed that miR-143-3p targeted TLR2 expression. The expressions of NF-κB， TLR2， NLRP3， GSDMD mRNA and TLR2， GSDMD， p-NF-κB p65， cleave Caspase-1， ASC， NLRP3 protein in miR-143-3p mimic group and si TLR2 group were lower than those in model group. The activity of Caspase-1 and the content of LDH， IL-1β and IL-18 decreased. Conclusion miR-143-3p regulates pyroptosis of ulcerative colitis cells by targeting TLR2 gene and regulating NF-κB/NLRP3/Caspase-1 signaling pathway.

Objective To study the protective effect and possible mechanism of dexmedetomidine on sevoflurane-induced cognitive impairment. Methods 40 rats were randomly divided into a blank group， model group， dexmedetomidine group， and combination group， 10 for each group. A rat model of sevoflurane-induced cognitive impairment was established in the model group， dexmedetomidine group， and combination group. The dexmedetomidine group and combination group were intraperitoneally injected with dexmedetomidine of 50 μg/kg 30 min before modeling， so was the combination group injected with sulindac of 5 mg/kg. The blank group and model group were intravenously injected with equal amount of saline. Morris water maze test was used to detect cognitive function. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of homocysteine （Hcy） and monocyte chemoattractant protein-1 （MCP-1）； high-performance liquid chromatography was used to detect hippocampal glutamate （Glu） and γ-aminobutyric acid （GABA） contents. Immunoblotting was used to detect hippocampal glycogen synthase kinase 3β （GSK-3β） and β-catenin protein expression levels. Results The escape latency in the dexmedetomidine group rats was shorter than that in the model group （P < 0.05）， the number of crossing the original platform was greater than that in the model group （P < 0.05）， and duration staying in the original platform quadrant was longer than that in the model group （P < 0.05）. The escape latency in the combination group was longer than that in the dexmedetomidine group （P < 0.05）， the number of crossing the original platform was smaller than that in the dexmedetomidine group （P < 0.05）， and duration staying in the original platform quadrant was shorter than that in the dexmedetomidine group （P < 0.05）. Serum levels of Hcy and MCP-1 were higher in the model group than in the blank group （P < 0.05）， lower in the dexmedetomidine group than in the model group （P < 0.05）， and higher in the combination group than in the dexmedetomidine group （P < 0.05）. Hippocampal Glu content was higher in the model group than in the blank group （P < 0.05）， while GABA content was lower （P < 0.05）. Hippocampal Glu content was lower in the dexmedetomidine group than in the model group （P < 0.05）， whereas GABA content was higher group （P < 0.05）. Hippocampal Glu content was higher in the combination group than in the dexmedetomidine group （P < 0.05）， and GABA content was lower （P < 0.05）. Hippocampal GSK-3β protein expression level was higher in the model group than in the blank group （P < 0.05）， but the β-catenin protein expression level was lower （P < 0.05）. Hippocampal GSK-3β protein expression level was lower in the dexmedetomidine group than in the model group （P < 0.05）， while β-catenin protein expression level was higher （P < 0.05）. Hippocampal GSK-3β protein expression level was higher in the combination group than in the dexmedetomidine group （P < 0.05）， whereas β-catenin protein expression level was lower （P < 0.05）. Conclusions Dexmedetomidine may improve cognitive function in rats with sevoflurane-induced cognitive impairment by activating the Wnt/β-catenin signaling pathway， reducing inflammation， and enhancing neurotransmitter activity.

Objective To analyze the effects of GATA binding protein 3 （GATA3） mediated mini RNA-21 （miR-21）/phosphatase and tensin homologue （PTEN） axis missing from human chromosome Chromosome 10 on the proliferation and invasion of endometrial cancer cells. Methods HEC-1-A cells were transfected and divided into control group， GATA3 empty plasmid group， GATA3 overexpression plasmid group， GATA3 siRNA negative control group， and GATA3 siRNA group. Detect the expression levels of GATA3， miR-21， PTEN， proliferation， apoptosis rate， migration， and invasion in each group of cells. Results Compared with the hEEC group， the expression levels of GATA3 and miR-21 in cells of the HEC-1-A group， HEC-1-B group， and Ishikawa group increased， while the expression levels of PTEN decreased （P < 0.05）. Compared with the GATA3 empty plasmid group， the GATA3 overexpression plasmid group showed an increase in GATA3， miR-21 mRNA expression， proliferation rate， migration distance， number of invading cells， and Vimentin levels， while the PTEN mRNA expression， apoptosis rate， Caspase-9， Bax， and E-cadherin levels decreased （P < 0.05）； Compared with the GATA3 siRNA negative control group， the GATA3， miR-21 mRNA expression， proliferation rate， migration distance， number of invading cells， and Vimentin level decreased， while the PTEN mRNA expression， apoptosis rate， Caspase-9， Bax， and E-cadherin levels increased （P < 0.05）. Conclusion Downregulation of GATA3 expression can regulate the miR-21/PTEN axis， slow down the proliferation of HEC-1-A cells， and promote apoptosis of HEC-1-A cells.

Objective To explore the underlying mechanisms of ulcerative colitis （UC） pathogenesis using single-cell transcriptomic bioinformatics approaches. Methods Single-cell transcriptome dataset GSE125527， consisting of UC samples， was downloaded from a high-throughput Gene Expression Omnibus for this study. Data filtering and normalization were conducted using the Seurat package in R. Cells with similar gene expression profiles were clustered and annotated. Cell subgroups associated with UC pathogenesis were identified， and differentially expressed genes （DEGs） were extracted. Enrichment analysis of these DEGs was performed to uncover potential signaling pathways involved in UC. High-dimensional weighted gene co-expression network analysis （hdWGCNA） was applied to the cell subgroup with the greatest differences to select UC-related gene modules. Additional datasets， GSE36807， GSE42911， GSE65114， and GSE6731， were downloaded for DEG screening. By integrating single-cell DEGs with UC-related gene modules， core genes involved in UC pathogenesis were identified. Receiver operating characteristic （ROC） curves were plotted to evaluate the predictive value of these core genes for UC pathogenesis. The expression of core genes was validated in a UC rat model. Results After filtering， 18 642 cells from UC samples and 4 298 cells from normal colonic tissue were obtained and clustered into ten subgroups， with a high proportion of B cells in UC samples. Eighty-one upregulated and twenty-one downregulated DEGs related to mononuclear cells were identified. Significant enrichment of DEGs was observed in pathways related to tumor necrosis factor-alpha， nuclear factor Kappa B， interleukin-2， signal transducer and activator of transcription 5， and interferon-alpha. Two UC-related gene modules were identified through hdWGCNA. After screening and validation， LAPTM5 was confirmed as a core gene in UC pathogenesis. Compared to control rats， LAPTM5 expression was significantly higher in the colonic tissues of UC model rats. Conclusions There are significant differences in cell distribution between UC and normal colonic tissues， with B cells closely related to UC pathogenesis， serving as potential targets for prevention and treatment. LAPTM5 is identified as a potential core gene in UC pathogenesis.

Objective To explore the prevention and treatment strategies for pancreatic fistula and pancreatic fistula combined with hemorrhage after pancreaticoduodenectomy. Methods We retrospectively reviewed 90 cases of pancreaticoduodenectomy at Guangdong Provincial People's Hospital from August 2019 to December 2022. According to whether postoperative pancreatic fistula occurred， the 90 patients were divided into a postoperative pancreatic fistula group （n = 35） and a postoperative non-pancreatic fistula group （n = 55）. Among the 35 patients with postoperative pancreatic fistula， they were further categorized into two subgroups based on the presence of hemorrhage： the pancreatic fistula with hemorrhage group （n = 10） and the pancreatic fistula without hemorrhage group （n = 25）. Chi-square test or Fisher's exact test was used for univariate analysis. Variables with statistical differences were selected for stepwise regression variable screening. Multivariate Logistic regression analysis was used to determine the independent risk factors for the occurrence of pancreatic fistula and postoperative pancreatic fistula with hemorrhage. Results All 90 patients successfully completed the pancreaticoduodenectomy. The incidence of postoperative pancreatic fistula was 38.9% （35/90）. Significant differences were observed in pancreatic duct diameter （P = 0.013）， intraoperative blood loss （P = 0.045）， anastomosis type （P = 0.045）， and residual pancreatic texture （P = 0.10） between the two groups （P < 0.05）. Multivariate logistic regression analysis revealed that soft pancreas texture， pancreatic duct diameter < 3 mm， intraoperative blood loss ≥ 300 mL， and pancreaticojejunostomy were independent risk factors for postoperative pancreatic fistula. Among patients with postoperative pancreatic fistula， multivariate logistic regression analysis identified pancreatic fistula volume > 100 mL and duration of postoperative pancreatic fistula > 7 days as independent risk factors for hemorrhage. Conclusions The risk of pancreatic fistula after pancreatoduodenectomy is relatively high. Attention to preoperative pancreatic duct diameter and standardized evaluation of pancreatic texture can help identify postoperative pancreatic fistula. Careful hemostasis during operation and avoidance of early postoperative hemorrhage can reduce the incidence of grade B and C pancreatic fistulas. Patients with pancreatic fistula should be warned of the occurrence of combined hemorrhage when the fistula volume is greater than 100ml and the duration of postoperative pancreatic fistula is greater than 7 days.

Objective To investigate the effects and complications of mitral valve membrane replacement surgery with preservation of mitral valve subvalvular structure on cardiac and valve function. Methods A total of 84 patients receiving mitral valve membrane replacement surgery with preserved mitral valve subvalvular structure in the First Affiliated Hospital of Soochow University from August 2019 to July 2022 were selected as the observation group， and 68 patients receiving mitral valve membrane replacement surgery without preservingmitral valve subvalvular structure were selected as the control group. The surgical indicators， comorbidities， preoperative and postoperative cardiac function，and mitral valve hemodynamic parameters were compared between the two groups. Results There was no statistically significant difference between the observation group and the control group in terms of surgical history， extracorporeal circulation time， aortic occlusion time， postoperative mechanical ventilation time， ICU retention time， and postoperative hospitalization time （P > 0.05）. At 1， 3， and 6 months after surgery， the left ventricular end systolic diameter （LVESD） and left ventricular end diastolic diameter （LVEDD） in the observation group were significantly lower than those in the control group （P < 0.05）， while the left ventricular short axis shortening rate （LVFS） was significantly higher than that in the control group （P < 0.05）. There was no statistically significant difference in left ventricular ejection fraction （LVEF） between the observation group and the control group at 1， 3， and 6 months after surgery （P > 0.05）. There was no statistically significant difference （P > 0.05） in the peak mitral valve velocity （Vmax）， maximum pressure gradient difference （PGmax）， and mean pressure gradient difference （PGmean） between the observation group and the control group at 1， 3， and 6 months after surgery. There was no statistically significant difference in creatine kinase isoenzyme （CK-MB） and N-terminal precursor brain natriuretic peptide （NT-proBNP） between the observation group and the control group at 1， 3， and 6 months after surgery （P > 0.05）. There was no statistically significant difference in the incidence of postoperative complications between the observation group and the control group （P > 0.05）. Conclusion The preservation of the mitral valve subvalvular structure and mitral membrane replacement surgery improved patient cardiac function， while there was no significant difference in mitral valve orifice blood flow parameters and complications compared with surgery without preservation of the mitral valve subvalvular structure.

Objective To clarify the changes in CXCL5 in serum and gastric tissues of patients with chronic atrophic gastritis （CAG） and precancerous lesions of gastric cancer （PLGC） and to investigate the predictive value of CXCL5 for the diagnosis of CAG and PLGC. Methods This study enrolled 72 participants of CAG admitted to the Department of Splenology and Gastroenterology of the Second Affiliated Hospital of Anhui University of Chinese Medicine from June 2022 to June 2023， with gastroscopy and pathologically confirmed diagnosis， as well as 68 healthy participants who underwent gastroscopy in the same period at our department.We collected clinical information and laboratory results from all participants. The logistic regression analysis methods were used to identify the diagnostic value of serum CXCL5. Furthermore， in order to clarify the role of CXCL5 in the developent of CAG， a total of 15 patients each with CAG， intestinal metaplasia， and dysplasia treated at our hospital from June 2023 to December 2023， and 15 healthy participants were selected. The relationship between the expression of CXCL5 and the degree of clinicopathology was analysed in each group using ELISA， PCR， and immunohistochemistry staining to validate and assess the diagnostic efficacy of CXCL5. Results The study found that several factors were associated with CAG， including family history of tumours， smoking and alcohol consumption history， dietary regularity， Helicobacter pylori infection， the number of lesions， gastric function scores and CXCL5 （P < 0.05）. The ROC curve had an AUC of 1.00 and a Youden index of 0.986， indicating excellent predictive ability. The ELISA results indicated a significantly higher serum CXCL5 expression level in the CAG， intestinal metaplasia， and dysplasia groups compared to the normal group. There was a positive correlation between the serum CXCL5 expression level and the degree of pathology. The PCR and immunohistochemistry staining results indicate that the mRNA and protein expression levels of CXCL5 in gastric tissues of patient groups were significantly higher compared to the normal group. Furthermore， the mRNA and protein expression levels of CXCL5 in gastric tissues were positively correlated with the degree of pathology. Conclusions The results indicate that CXCL5 is highly expressed in the serum and gastric tissues of patients with CAG and PLGC， and its expression level is positively correlated with the degree of pathology. Therefore， CXCL5 could serve as a predictive indicator and a potential therapeutic target for the diagnosis of CAG and PLGC.

Objective To investigate the expression and clinical significance of miR-34c and miR-29b in peripheral blood of patients with sensorineural hearing loss. Methods 140 patients with neurological deafness admitted to our hospital from June 2020 to June 2023 were included in the study group， and 40 healthy subjects were included in the control group during the same period. SNHL patients were categorized into 63 cases in the mildly deaf group， 42 cases in the moderately deaf group， and 35 cases in the severely deaf group according to their hearing impairment. The expressions of miR-34c and miR-29b were detected by qRT-PCR， and VEGF， oxidative stress （TAC， SOD， MDA）， NO and Cx26 were detected. Correlation analysis was performed by Pearson test， independent risk factors for SNHL severity were calculated by logistics regression algorithm， and the predictive value of miR-34c and miR-29b on the severity of SNHL patients was evaluated by ROC curve. Results Comparing the levels of NO， TAC， SOD， and Cx26 among the four groups， severe deafness group < moderate deafness group < mild deafness group < control group （P < 0.05）； comparing the levels of VEGF and MDA， severe deafness group > moderate deafness group > mild deafness group > control group （P < 0.05）. Comparison of miR-34c mRNA and miR-29b mRNA expression levels among the four groups， severe deafness group > moderate deafness group > mild deafness group > control group （P < 0.05）. Pearson's test showed that SNHL patients' peripheral blood miR-34c and miR-29b were positively correlated with VEGF and MDA， and were negatively correlated with NO， TAC， SOD and Cx26 （P < 0.05）. negative correlation （P < 0.05）. Multifactorial logistic regression analysis showed that VEGF， MDA， NO， Cx26， TAC， SOD， miR-34c， miR-29b were independent factors affecting the severity of SNHL. Conclusion miR-34c and miR-29b are overexpressed in SNHL patients and can be used as serum markers for predictive assessment of disease severity in SNHL patients.

Objective To explore the value of peripheral blood circulating DNA in predicting the efficacy and prognosis of immunotherapy for advanced non-small cell lung cancer. Method A retrospective study was conducted on 78 NSCLC patients who were admitted to the Respiratory and Critical Care Medicine Department of the First Affiliated Hospital of Hebei North University and were treated with tirelizumab for advanced driver gene negativity from January 2021 to December 2021. After 2 cycles of immunotherapy， the efficacy was evaluated according to the Solid Tumor Efficacy Evaluation Criteria （RECIST 1.1）， including complete remission， partial remission， disease stability， and disease progression. CR and PR patients were defined as the experimental group （n = 48） Other patients were defined as the control group （n = 30）， and the ctDNA levels in peripheral blood were measured before and after treatment in both groups. ROC curves were used to analyze the predictive value of peripheral blood ctDNA levels for achieving objective remission after immunotherapy.All patients were followed up and their progression free survival were calcutated.Using univariate and multivariate regression analysis identified the factors affecting the prognosis of patients after immunotherapy. Using Spearman correlation coefficient analyzed the correlation between ctDNA levels and PFS. Kalplan Meier survival curve were used for survival analysis. Result The peripheral blood ctDNA levels before and after treatment in the experimental group were （4.47 ± 1.21）ng/μL and （2.65 ± 1.14） ng/μL， respectively （t = 7.559，P < 0.001）， while those in the control group were （4.54 ± 1.15）ng/mL and （4.29 ± 1.57） ng/μL， respectively （t = 0.699，P = 0.487）. There was no statistically significant difference in peripheral blood ctDNA levels between the two groups before treatment （t = -0.25，P = 0.801）. The peripheral blood ctDNA levels in the experimental group decreased compared to the control group after treatment （t = -5.35，P < 0.001）. The ROC curve analysis showed that the area under the curve for predicting objective remission after immunotherapy based on peripheral blood ctDNA levels was 0.819， with a sensitivity of 81.3% and specificity of 80%. Peripheral blood ctDNA levels were negatively correlated with progression free survival （r = -0.784，P = 0.000）. Single factor COX regression was used to analyze the clinical and pathological characteristics and ctDNA levels of enrolled patients， and the results showed that the maximum tumor diameter was greater than 5 cm （HR = 0.501， 95% CI： 6.731 ~ 35.567） Tumor stage IV （HR = 0.392，95% CI： 0.227 ~ 0.677）， treatment approach （HR = 15.473，95% CI： 6.731 ~ 35.567）， and ctDNA levels （HR = 4.657，95% CI： 3.182 ~ 6.555） are all influencing factors for PFS in advanced NSCLC patients after immunotherapy. Multiple factor analysis was conducted on the appeal indicators with statistical differences， and the results showed that treatment approach （HR = 2.981，95% CI：1.019 ~ 8.722） and peripheral blood ctDNA levels （HR = 3.918，95% CI： 2.619 ~ 5.861） It is an independent influencing factor of PFS in advanced NSCLC patients. The Kalplan Meier survival curve was used for analysis， and the results showed that the median PFS of the treatment effective group was 8.4 months， while the median PFS of the control group was 5.4 months. （χ ² = 49.277， P = 0.000）. Conclusion Immunotherapy combined with chemotherapy can enhance the ability to kill tumor cells， and peripheral blood ctDNA levels can evaluate the efficacy and prognosis of immunotherapy， which can be used to guide immunotherapy in advanced NSCLC patients.

Objective To observe the expression changes of micro RNA-23a（miR?23a） and apoptotic protease-activating factor-1 （APAF-1） in endometrial carcinoma tissues and analyze its clinical significance. Methods 123 specimens of endometrial carcinoma in our hospital from May 2018 to May 2020 were selected as endometrial carcinoma group， and the para cancerous tissue was selected as the normal group. Expression of miR-23a and APAF-1 were examined in endometrial tissues； the relationship between miR-23a and APAF-1 and the clinicopathology of patients and the correlation between the two were analyzed； Kaplan-Meier method was used to analyze the survival of patients with endometrial cancer. Results Compared with the normal group， the expression level of miR-23a in endometrial carcinoma group was significantly increased， the expressions of APAF-1 mRNA and protein decreased significantly （P < 0.05）； miR-23a and APAF-1 were significantly correlated with clinical stage， histological differentiation and myometrial invasion （P < 0.05）； Pearson analysis showed that miR-23a was negatively correlated with APAF-1 （P < 0.05）； Kaplan-Meier curves showed that PFS and OS were significantly higher in the miR-23a low-expression group as well as the APAF-1-positive expression group than in the miR-23a high-expression group and the APAF-1-negative expression group（P < 0.05）. Conclusion The expression level of miR-23a is increased and APAF-1 expression is decreased in endometrial carcinoma， both of which correlate with endometrial cancer progression and patient prognosis， are expected to be biomarkers for clinical assessment of disease progression and prognosis in early-stage patients.

Objective Exploring the predictive value of blood lipid variability for adverse cardiovascular events in patients with acute ST segment elevation myocardial infarction （STEMI） after emergency percutaneous coronary intervention （PCI）. Methods A total of 235 STEMI patients who underwent emergency PCI in our hospital from October 2020 to October 2022 were selected as the research objects. According to whether target lesion failure （TLF） occurred， the patients were divided into TLF group and control group Lipid variability ［standard deviation （SD）， coefficient of variation （CV） and mean-independent coefficient of variation （VIM）］ of the two groups were compared. Multivariate Cox regression analysis was used to explore the related factors of TLF in STEMI patients after emergency PCI， and receiver operating characteristic curve （ROC） was used to analyze the predictive value. Results Variability indexes of low-density lipoprotein （LDL）， high-density lipoprotein （HDL） and lipoprotein a［LP（a）］ in TLF group： LDL （SD）， LDL （CV）， LDL （VIM）， HDL （SD）， HDL （CV）， HDL （VIM）， LP（a） （SD）， LP（a） （CV）， LP（a） （CV） a） （VIM） were higher than those in control group， and the differences were statistically significant （P < 0.05）. The results of multivariate Cox regression analysis showed that LDL （SD）， LDL （CV）， LDL （VIM）， HDL （SD）， HDL （CV）， HDL （VIM）， LP（a） （SD）， LP（a） （CV）， LP（a） （VIM） were all risk factors for TLF in STEMI patients after emergency PCI （P < 0.05）. ROC curve analysis results showed that， LDL （SD）， LDL （CV）， LDL （VIM）， HDL （SD）， HDL （CV）， HDL （VIM）， LP（a） （SD）， LP（a） （CV）， LP（a） （VIM） have certain predictive value for TLF in STEMI patients after emergency PCI（AUC： 0.790， 0.805， 0.833， 0.766， 0.795， 0.816， 0.773， 0.782， 0.798）. Conclusion Lipid variability is associated with adverse cardiovascular events in STEMI patients after emergency PCI， and is an independent risk factor for TLF in STEMI patients after emergency PCI.

Objective To investigate the clinical characteristics and risk factors of the occurrence of hypoxic hepatitis （HH） in children with shock. Methods Clinical data （general situation， clinical situation and prognosis） of 234 children with different types of shock admitted to the pediatrics department of Hainan Women and Children's Medical Center from January 2016 to December 2023 were collected. Serum biochemical indexes on day 1 （d1）， day 2 （d2）， day 3 （d3）， day 5 （d5）， day 7 （d7） of children with shock were collected， including serum alanine aminotransferase （ALT）， glutamate aminotransferase （AST）， lactate dehydrogenase （LDH）， alkaline phosphatase （ALP）， albumin （ALB）， total bilirubin （TBIL）， urea nitrogen （BUN）， C reactive protein （CRP）， international standardized time （INR） and lactate. And the clinical characteristics and risk factors of the occurrence of HH in children with shock were analyzed. Results A total of 234 cases （150 cases of males）of different types of shock in children were enrolled， ages ranged from 1 month to 16 years old. According to whether developed HH， the children with shock were divided into HH group （32 cases） and non-HH group （202 cases）. The total incidence of HH was 13.7% （32/234）. Septic shock was the main disease of the occurrence of HH in children with shock， accounting for 65.63% （21/32）. According to the prognosis， children with shock combined HH were divided into survival group （17 cases） and death group （15 cases）. The case fatality rate of children with shock combined HH was 46.9%. The ALT and AST values in children with shock combined HH were more than 20 times of the upper limits of normal ranges. The peak values of enzymatic indexes in the survival group appeared at the onset time d 1 to d 2， they were close to the normal ranges at the onset time d7， while the enzymatic indexes in the death group were higher than the normal ranges during the whole disease stage. Compared with the survival group， the peak values of ALT， AST， ALP， TBIL， CRP， BUN， and INR in the death group were obviously higher （P < 0.05， both）. The lowest value of ALB in the death group was lower than that in the survival group （P < 0.05）. The results of multivariate Logistic regression analysis showed that pediatric critical illness score（PCIS）， lactate， multiple organ dysfunction syndrome （MODS）， decompensated shock and cardiogenic shock were the risk factors for the occurrence of HH in children with shock（P < 0.05 or 0.01）， and left ventricular ejection fraction（LVEF） and mean arterial pressure （MAP） were the risk factors of the death of HH in children with shock （P < 0.01）. Conclusions Children with shock who have the risk factors as decreased PCIS， increased lactate level， MODS， decompensated shock and cardiogenic shock are apt to suffer from HH. Poor prognosis in the children with shock combined HH is associated with worse condition and lower LVEF. There is a high fatality rate of shock combined HH in children， so that liver function indicators should be closely monitored to early detect HH， and reasonable treatment should be given.

Objective Exploring the relationship between pain recurrence after percutaneous radiofrequency thermocoagulation and the degree of trigeminal nerve atrophy and pontine angle in patients with primary trigeminal neuralgia （INT）. Methods A retrospective analysis was conducted on 297 patients with INT admitted to Qingdao Haici Hospital Affiliated to Qingdao University （Qingdao Traditional Chinese Medicine Hospital） from January 2020 to December 2021. All patients received percutaneous radiofrequency thermocoagulation surgery in our hospital. They were followed up for 24 months， during which 56 patients experienced pain recurrence after surgery （recurrence group）， while 241 patients did not experience postoperative pain recurrence （non-recurrence group）. Results The length of the trigeminal nerve root， degree of trigeminal nerve atrophy， and the combined application of the two were used to draw ROC curves. The AUC values predicted for pain recurrence in INT patients after percutaneous radiofrequency thermocoagulation were 0.553， 0.750， and 0.861， respectively. The results of the logistic regression model showed that shortened trigeminal nerve root length （OR = 0.624， P = 0.038）， increased degree of trigeminal nerve atrophy （OR = 2.257， P = 0.000）， multi vessel compression （OR = 1.842， P = 0.019）， and severe baseline pain （OR = 1.714， P = 0.000） were independent risk factors for pain recurrence in INT patients after percutaneous radiofrequency thermocoagulation （P < 0.05）. Conclusions INT patients undergo thin-layer MRI scans before surgery， and the degree of trigeminal nerve atrophy has a higher predictive value for pain recurrence after radiofrequency thermocoagulation. The length of trigeminal nerve roots and degree of trigeminal nerve atrophy are correlated with postoperative pain recurrence in patients.

Objective To explore the impact of HR-HPV infection on pregnancy outcomes and vaginal microbiota. Methods 128 pregnant women who underwent prenatal examinations at Mingshan Branch of the First Affiliated Hospital of Chengdu Medical College were selected as the research subjects. Both vaginal microbiota and HR-HPV testing were conducted， and single factor analysis and multiple linear regression analysis were used to identify the relevant factors of HR-HPV infection in pregnant women. The impact of HR-HPV infection on pregnancy outcomes and vaginal microbiota was studied. Results Among the 49 cases in the infection group， 30 cases contracted with type 16 HPV， accounting for 61.22%， 13 type 18 HPV， accounting for 26.53%， and 1 type 31， 33， 51， 52， 53， and 58， respectively. Univariate analysis showed that HR-HPV infections were significantly correlated with age of first sexual activity， condom use， number of sexual partners， reproductive tract inflammation， and smoking history （P < 0.05）. Multivariate analysis showed that age of first sexual activity ≤ 20 years， concurrent reproductive tract inflammation， multiple sexual partners， and smoking history were independent risk factors for HR-HPV infection， while condom use was an independent protective factor for HR-HPV infection. There were significant differences in the number of lactobacilli， candida infections， and vaginal cleanliness between the two groups （P < 0.05）. The incidence of spontaneous abortion and fetal growth restriction in the HR-HPV-infected group was significantly higher than that in the HR-HPV-uninfected group （P < 0.05）. Conclusions Pregnant women with HR-HPV infections are closely related to factors such as premature sexual conduct， number of sexual partners， reproductive tract inflammation， and smoking. Infections with HR-HPV during pregnancy can cause changes in the vaginal microenvironment and lead to adverse pregnancy outcomes.

Objective To investigate the effect of PCSK9 inhibitors on the level of inflammation and ventricular remodeling after PCI in ST-elevation acute myocardial infarction. Methods A total of 220 patients with acute ST-segment elevation myocardial infarction who received percutaneous coronary artery intervention in the Emergency Center of Qingdao Central Hospital from April 2021 to July 2023 were randomly divided into two groups， 110 patients in the control group were treated with conventional treatment， and 110 patients in the PCSK9i group were treated with PCSK9 inhibitors on the basis of conventional treatment. Compared before and after treatment left ventricular endsystolic diameter （LVESD） and left ventricular ejection fraction （LVEF） and triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， total cholesterol （TC）. C-reactive protein （CRP）， interleukin 6 （IL-6）， tumor necrosis factor α （TNF-α）. The incidence of major adverse cardiovascular events （MACE） （including myocardial infarction， recurrence of heart failure， malignant arrhythmia， and cardiovascular death） was compared. Results After 6 months of treatment and follow-up， LVEDD（mm）， LVESD（mm）， TG（mmol/L）， TC（mmol/L）， LDL-C（mmol/L）， CRP（mg/L）， TNF-α（pg/mL） and JL-6（ng/mL） after PCSK9i treatment were significantly lower than those in the control group， and the difference was statistically significant ［（51.32 ± 5.84） vs. （54.43 ± 2.91）；（34.88 ± 2.69） vs. （36.96 ± 3.19）；（1.41 ± 0.61） vs. （2.13 ± 1.26）；（3.53 ± 1.06） vs. （3.98 ± 0.93）；（0.95 ± 0.36） vs. （1.79 ± 0.27）；（5.18 ± 1.92） vs. （7.69 ± 2.61）；（36.43 ± 9.41） vs. （57.79 ± 14.43）；（17.4 ± 0.68） vs. （28.55 ± 8.92），All P < 0.01］， and the LVEF（%）and HDL-C（mmol/L）in the PCSK9i group were higher than patients in the control group， and the difference was statistically significant ［（46.69 ± 3.63） vs. （41.34 ± 3.42），P < 0.05，（1.35 ± 0.29） vs. （1.29 ± 0.27），P < 0.01］. The incidence of MACE events in the PCSK9i group was obviously lower than patients in the control group （5.2% vs. 13.6%， P < 0.05）. Conclusion The application of PCSK9 inhibitors after PCI in patients with ST-segment elevation acute myocardial infarction can better reduce blood lipids， stabilize coronary plaque， reduce local and circulatory inflammatory responses after myocardial infarction， improve ventricular adverse remodeling after myocardial infarction， inhibit ventricular remodeling， and reduce the total incidence of MACE， worthing promoting use.

Objective To investigate the value of magnetic resonance image-diffusion weighted imaging （MRI-DMI） combined with attenuation imaging （ATI） in the diagnosis of focal nodular lesions < 2 cm in the background of fatty liver. Methods The clinical data of 68 patients with fatty liver complicated with focal nodular lesions < 2 cm were retrospectively analyzed from June 2022 to June 2023 in Huaihe Hospital of Henan University. All patients underwent MRI， pathology and ATI examination. According to the degree of fatty liver disease， 68 patients were divided into severe group （n = 24）， moderate group （n = 27） and mild group （n = 17）. The apparent diffusion coefficient （ADC） and acoustic attenuation coefficient （AC） values of patients with different focal lesions were compared with clinical data， and the ADC values and AC values of patients with different fatty liver lesions were compared with clinical data， and the correlation was analyzed by Pearson. To analyze the value of MRI-DWI combined with AC value in the diagnosis of malignant fatty liver disease with focal nodular disease < 2 cm. Results Pathological diagnosis showed that 41 of the 68 patients were benign and 27 were malignant. There were no significant differences in low density lipoprotein cholesterol （LDL-C）， age， triglyceride （TG）， sex， total cholesterol （TC） and high density lipoprotein cholesterol （HDL-C） between benign nodule group and malignant nodule group （P > 0.05）. There was no difference in TG， age， HDL-C， sex， TC and LDL-C among mild， moderate and severe groups （P > 0.05）. The ADC value of malignant nodule group was lower than benign nodule group under different b values （P < 0.05）， and the AC value of malignant nodule group was higher than that of benign nodule group （P < 0.05）. ADC value under different b values in the severe group was lower than mild and moderate groups （P < 0.05）， ADC value under different b values in the moderate group was lower than mild group （P < 0.05）， AC value in the severe group was higher than mild and moderate groups （P < 0.05）， and AC value in the moderate group was higher than mild group （P < 0.05）. ADC values at different b values were negatively correlated with the degree of fatty liver disease （P < 0.05）， but not with TG， HDL-C， TC and LDL-C （P > 0.05）. AC was positively correlated with the degree of fatty liver disease （P < 0.05）， negatively correlated with HDL-C （P < 0.05）， but not with TG， TC and LDL-C （P > 0.05）. The area under the curve （AUC） values of MRI-DWI， AC and their combination in the diagnosis of fatty liver complicated with focal nodule disease < 2 cm into malignancy were 0.775， 0.773 and 0.909， respectively （P < 0.05）， and the AUC value of the combination was higher （P < 0.05）. Conclusion MRI-DWI and ATI have important value in the differential diagnosis of benign and malignant lesions of focal nodular lesions < 2 cm in the background of fatty liver， and the combination of MRI-DWI and ATI has higher diagnostic value.

Objective To analyze the risks and related influencing factors of early screening for lung cancer， and to study prognostic factors based on survival conditions， in order to ultimately provide baseline data for the prevention and treatment of lung cancer. Methods A cluster sampling method was used to select 40 to 75 year old registered residence residents in 10 districts and 6 counties of Zhengzhou City in 2020 as screening objects. Through voluntary participation and filling in evaluation questionnaires， high-risk groups of lung cancer were evaluated， and then three screening tests （tumor markers， low-dose spiral CT and lung function） were performed on high-risk groups. Finally， we will adopt an active and passive follow-up approach to collect information on diagnosed lung cancer patients. Statistically describe the screening data and describe the epidemiological results of different characteristic populations； Using multivariate logistic regression method for statistical analysis， compare the differences in various results of different factors. Results 50 128 cases of early screening for lung cancer in Zhengzhou City were evaluated in 2020， with a completion rate of 100.26%. The average age of the survey was （59.86 ± 17.67） years old， and the gender ratio was 0.81∶1. The high-risk detection rate is 30.15%. Multivariate logistic regression analysis showed that males （smoking） （OR = 5.43， 95% CI： 5.20 ~ 5.67）， individuals with a history of tobacco exposure （OR = 3.82， 95% CI： 3.67 ~ 3.98）， first-degree relatives who had previously suffered from lung cancer （OR = 12.06， 95% CI： 11.02 ~ 13.20）， and other populations were more susceptible to lung cancer （all P < 0.05）. Conclusion Male （smoking）， exposure to secondhand smoke， cancer in first-degree relatives， previous diagnosis of other tumors， symptoms of lung infection， “chest tightness， shortness of breath， and difficulty breathing in daily life”， and “significant psychological trauma in the past 3 years” are independent risk factors for lung cancer， which should be given special attention and effective intervention measures should be taken.

Objective To explore the clinical efficacy of arc-edge needle therapy based on Zaodian theory in the treatment of refractory tennis elbow. Methods 64 patients with refractory tennis elbow were collected and randomly divided into a control group and an observation group using a random number table method. Among them， 32 cases in the control group were treated with local pain point injection. 32 patients in the observation group were treated with arc-edge needle therapy once a week， with two treatments per group. The Number rating scale （NRS） Mayo， elbow joint performance score （MEPS） and Disabilities of the arm， shoulder and hand （DASH） score were recorded and compared between the two groups before treatment and at 1， 2， 4 and 24 weeks of follow-up after treatment， disease efficacy score （WDES） at 24 weeks of follow-up. Results During the treatment process，neither group of patients experienced serious adverse reactions.At each stage after treatment， two groups of NRS MEPS， DASH， and WDES at 24 weeks of follow-up all improved compared to before treatment. After one week of treatment， there was no statistically significant difference in NRS scores between the two groups （P > 0.05）. At follow-up visits at weeks 2， 4， and 24， the NRS scores in the observation group were lower than those in the control group.After 1， 2， 4， and 24 weeks of follow-up after treatment， the DASH score was lower in the observation group than in the control group， and the MEPS score was higher in the observation group than in the control group， with statistically significant differences （P < 0.05）. After 24 weeks of treatment， the WDES of the observation group was better than that of the control group， and the difference was statistically significant （P < 0.05）. Conclusion Local pain point injection and arc-edge Zaodian release can alleviate pain and improve elbow joint function in the early stage of refractory tennis elbow. However， the long-term effect of local pain point injection treatment is not good， and the treatment effect of the observation group gradually improves.

Lung cancer is the most fatal malignant tumor worldwide， with non-small cell lung cancer （NSCLC） being the predominant pathological subtype. The development of NSCLC is driven by mutations in the epidermal growth factor receptor （EGFR）， and EGFR tyrosine kinase inhibitors （EGFR-TKIs） are employed as targeted therapies for first-line treatment of advanced NSCLC patients harboring EGFR mutations. However， variations in molecular structures， concurrent mutations， and mechanisms of therapeutic resistance contribute to prognostic disparities among different EGFR subgroups. This review primarily summarizes the molecular structural basis and differential treatment responses associated with distinct types of EGFR mutations in NSCLC.

Myocardial ischemia reperfusion injury （MIRI） is a common cardiovascular complications， which is a major problem for many clinical scholars. To improve the prognosis of MIRI， many scholars have devoted to the research of its mechanism， and founded that mitochondria are closely related to the occurrence of MIRI， where the function of mitochondrial respiratory chain enzyme complex is impaired， and energy metabolism disorders play a key role in the process of MIRI. The aim of this review is to describe the changes of mitochondrial respiratory chain enzyme complex in MIRI and its effect on MIRI， and to provide a basis for finding new and effective therapeutic targets for MIRI.

Diarrhea-predominant irritable bowel syndrome （IBS-D） is a clinically common functional gastrointestinal disease， the "SCFAs-intestinal barrier" pathway plays an important role in the pathogenesis of IBS-D. Traditional Chinese medicine monomers/compounds or Chinese medicine compound can treat IBS-D by regulating the "SCFAs-intestinal barrier" through multiple pathways and multiple targets. This article takes the relationship between SCFAs and the four major intestinal barriers， as well as the mediating effect of IBS-D，as the starting point to systematically review and sort out the relevant literature on the targeted regulation of "SCFAs-intestinal barrier" in the treatment of IBS-D by Traditional Chinese medicine monomers/compounds and Chinese medicine compound； explores the theoretical basis of IBS-D caused by "SCFAs-intestinal barrier" from the perspective of "Large intestine dominating fluid"， in order to provid ideas for Traditional Chinese medicine to establish a precision treatment system with Chinese medicine characteristics.

Obturator nerve injury （ONI） is a rare complication of pelvic lymph node dissection （PLND）. Once ONI occurs， ipsilateral lower limb sensory and motor dysfunction occurs， even affecting daily life. During PLND operation， different types of obturator nerve injuries occur due to various injury mechanisms， and different repair strategies are available according to different injury types. The fundamental repair strategy is to restore the anatomical structure of obturator nerve. Timely intraoperative surgical repair， postoperative adjuvant drug or physical therapy， and the prognosis is good. The purpose of this article is to summarize the treatment and prevention of different types of ONI during PLND for prostate cancer and bladder cancer， which has guiding significance for urologists to avoid and treat ONI during PLND.

Alcoholic liver disease is liver disease caused by heavy and/or chronic alcohol consumption. Bile acids are synthesized in the liver and regulate the body through liver-intestinal circulation. Many studies have shown that bile acid is closely related to alcoholic liver disease. Alcohol intake can cause liver damage by affecting bile acid synthesis， hepato-enteric circulation and intestinal flora. This article summarizes the mechanism of action of bile acids in alcoholic liver disease and the current research status of improving alcoholic liver disease based on bile acid regulation， in order to provide new ideas for future research on the prevention and treatment of alcoholic liver disease.

Carrying the pan-mast cell markers IgE immunoglobulin high-affinity receptor （FcεRI） and SCF receptor c-kit， mast cell-derived exosomes are rich in sphingomyelin， lipid-associated proteins， and loaded with MHC-II molecules and transfer functional mRNAs and miRNAs to the receptor of CD34⁺ progenitor cells and mast cells. Activated mast cell-derived exosomes contain a large number of functional mast cell-specific mediators and may vary in size， protein， lipid， RNA and DNA contents. Mast cell exosomes can recruit B cells and T cells to the lungs， regulating immune and inducing the activation of other asthma-related cells. Also， mast cell-derived exosomes interact with airway smooth muscle cells and induce the release of pro-inflammatory cytokines， allowing asthma symptoms to persist. Immune complexes （IgE and antigens） present on mast cell-derived exosomes exacerbate local allergic reactions by a self-amplification mechanism meanwhile deliver antigens to other immune cells. Mast cell-derived exosomes may be potential targets for the treatment of bronchial asthma， and their purification and optimization be needed further to research. This article will review the mechanism of mast cell-derived exosomes in bronchial asthma， so as to provide new ideas for the prevention and treatment of bronchial asthma.