Objective: To investigate the protective effect of oridonin on type 2 diabetic osteoporosis (DOP) in rats by modulating Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway. Methods: Nine rats were randomly labeled as control group from 36 rats, while the rest were induced to establish rat DOP models through a high-glucose and high-fat diet combined with STZ induction before they were assigned into DOP group, Oridonin group, and Oridonin+activator (Coumermycin A1) group, with 9 rats in each group and 10-week drug administration. After administration, enzyme-linked immunosorbent assay (ELISA) was used to detect serum bone turnover markers osteocalcin (OCN) and procollagen type I amino-terminal propeptide (PINP). Microscopic computed tomography was performed to detect femur related parameters. Biomechanics was performed to test the maximum load of the femur. HE staining was used to observe femoral tissue. RT-qPCR was used to detect the expression of JAK2 and STAT3 mRNA in femurs. Western blot was performed to detect the expression of JAK2 and STAT3 proteins in femurs. Results: Compared with control group, the bone turnover markers PINP and OCN reduced in DOP group, the bone mineral density (BMD), number of bone trabeculae (Tb.N), thickness of bone trabeculae (Tb.Th), bone volume/tissue volume (BV/TV), and maximum load of femur reduced, the JAK2, STAT3 mRNA and protein expression increased (P<0.05), and the femur structure was disordered, with thinning and reduced number of bone trabeculae. Compared with DOP group, the PINP and OCN increased in Oridonin group, the femoral BMD, Tb.N. Tb.Th, BV/TV, and maximum load increased, the JAK2, STAT3 mRNA and protein expression decreased (P<0.05), and the symptoms of osteoporosis were alleviated. In addition, JAK2 activator reversed the effect of Oridonin on DOP rats (P<0.05). Conclusion: Oridonin may have a protective effect on DOP rats by inhibiting JAK2/STAT3 signaling pathway.

Objective: To investigate the effect and underlying mechanism of Danshen injection on endothelial angiogenesis in diabetic cardiomyopathy (DCM) rats via modulation of the vascular endothelial growth factor (VEGF)/VEGF receptor 2 (VEGFR2) and phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT) signaling pathway. Methods: A DCM rat model was established and the rats were randomly divided into model group, valsartan (40mg/kg, ig) group, and Danshen(Salvia miltiorrhiza) (2mL/kg, ip) group; with normal rats serving as the control group (n = 12 each group). After 4-week intervention, echocardiography and biochemical assays were used to measure left-ventricular ejection fraction (LVEF), left-ventricular fractional shortening (LVFS), mitral E/A ratio (Em/Am), fasting blood glucose (FBG), fasting insulin (FINS), creatine kinase-MB (CK-MB), and cardiac troponin I (cTnI). Myocardial histopathology and fibrosis were evaluated by HE and Masson staining; microvessel density (MVD) was determined by immunofluorescence; and myocardial protein expression of VEGF, VEGFR2, phosphorylated PI3K (p-PI3K), total PI3K, phosphorylated AKT (p-AKT), and total AKT was detected by Western blot. Results: Compared with the control group, the model group exhibited decreased LVEF, LVFS, and Em/Am, and increased FBG, FINS, CK-MB, and cTnI (P<0.05); disordered myocardial architecture, enlarged inter-fiber gaps, hypertrophied cardiomyocytes with inflammatory infiltration, and elevated collagen fraction (P<0.05); and reduced myocardial expression levels of VEGF, VEGFR2, p-PI3K/PI3K, and p-AKT/AKT (P<0.05). Relative to the model group, both valsartan and Danshen(Salvia miltiorrhiza) group exhibited increased levels of LVEF, LVFS, and Em/Am, and decreased levels of FBG, FINS, CK-MB, and cTnI (P<0.05); ameliorated myocardial structure, attenuated fiber rupture and collagen deposition, and lessened inflammatory infiltration (P<0.05); and up-regulated expression levels of VEGF, VEGFR2, p-PI3K/PI3K, and p-AKT/AKT(P<0.05). No significant differences in the above indices were observed between the valsartan and Danshen(Salvia miltiorrhiza) group (P>0.05). Conclusion: Danshen may attenuate myocardial injury in DCM rats by promoting endothelial angiogenesis via activation of the VEGF/VEGFR2 and PI3K/AKT signaling pathway.

Objective: To investigate the effect of lysine-specific demethylase 5 (KDM5A)-mediated trimethylation (H3K4me3) of lysine 4 of histone subunit III on the growth and metastasis of human oral squamous cell carcinoma (OSCC) cells and its mechanism. Methods: Human OSCC cell lines and human oral mucosal epithelial cells (HOMEC) were cultured, and the expression of KDM5A in the two cells was compared by RT-qPCR and Western blot. In the KDM5A knockdown assay, three groups, namely the control group, sh-NC group, and sh-KDM5A group, were established using the human OSCC cell line CAL27. Separately, in the KDM5A overexpression assay, another three groups, including the control group, oe-NC group, and oe-KDM5A group, were constructed with the same cell line. Lentiviral transfection was performed to achieve KDM5A knockdown or overexpression in CAL27 cells. The transfection efficiency was verified via reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blot assays. Cell Counting Kit-8 (CCK-8) assay and colony formation assay were conducted to evaluate the proliferative capacity of CAL27 cells, while the Transwell assay was employed to detect cell migration and invasion abilities. Western blot assay was used to determine the expression levels of E-cadherin and Vimentin in CAL27 cells. Additionally, Western blot assay was applied to measure the expression of p53 protein in KDM5A-knockdown CAL27 cells, and chromatin immunoprecipitation (ChIP)-qPCR was carried out to detect the enrichment levels of KDM5A and H3K4me2 in the p53 promoter region of CAL27 cells. Results: Compared with HOMEC, the relative expression levels of KDM5A mRNA and protein in human OSCC cell lines CAL27, HN30, HSC3 and SCC9 were upregulated (P<0.05). Compared with untransfected CAL27 cells and CAL27 cells transfected with sh-NC, the relative expression levels of KDM5A mRNA and protein in CAL27 cells transfected with sh-KDM5A were downregulated, the cell proliferation activity was decreased, the number of clones formed, the number of migration and the number of invasion were reduced, the relative expression level of E-cadherin protein was upregulated, and the relative expression level of Vimentin protein was downregulated (P<0.05). Compared with untransfected CAL27 cells and CAL27 cells transfected with oe-NC, the relative expression levels of KDM5A mRNA and protein in CAL27 cells transfected with oe-KDM5A was upregulated, the relative expression of mRNA and protein was upregulated, the cell proliferation activity was increased, the number of clones, migration and invasion were increased, the relative expression of E-cadherin protein was downregulated, and the relative expression of Vimentin protein was upregulated (P<0.05); in addition, the relative expression of p53 protein was upregulated in CAL27 cells transfected with sh-KDM5A, and the enrichment level of H3K4me3 in the p53 promoter region was increased (P<0.05). Conclusion: KDM5A promotes the growth and metastasis of human OSCC cells in vitro, and this mechanism may be related to its role in promoting H3K4me3 demethylation and subsequently inhibiting p53 expression.

Objective: To investigate the effects and molecular mechanisms of Xiangpi Shengji Ointment (XPSJO) on wound healing of postoperative anal fistula in rats by modulating the caveolin-1 (CAV1)/transforming growth factor-β1 (TGF-β1)/hypoxia-inducible factor-1α (HIF-1α) signaling pathway. Methods: A rat model of postoperative anal fistula was established by infecting the wound with Escherichia coli suspension. The rats were randomly divided into three groups (n=10 each): model group, Kangfuxin Liquid (KFXL) group, and XPSJO group. Each group received corresponding interventions once daily for 14 consecutive days. Wound healing rates were calculated on days 7 and 14 respectively. Twenty-four hours after the last intervention, serum levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α were measured by ELISA. Histopathological changes and collagen deposition in wound tissues were assessed by HE and Masson staining. Microvessel density (MVD) was evaluated by immunofluorescence. Protein expression of CAV1, TGF-β1, and HIF-1α in wound tissues were detected by immunohistochemistry and Western blot. Results: Compared with the model group, both KFXL and XPSJO group exhibited significantly increased wound healing rate on days 7 and 14 (P<0.05), reduced serum levels of IL-1β, IL-6, and TNF-α (P<0.05), alleviated inflammatory cell infiltration and edema, and meanwhile exhibited increased collagen deposition rate, MVD, and protein expression levels of CAV1, TGF-β1, and HIF-1α (P<0.05). Notably, the therapeutic effects of XPSJO were more pronounced than those of KFXL (P<0.05). Conclusion: Xiangpi Shengji Ointment can promote wound healing in rats after anal fistula surgery by enhancing collagen deposition and angiogenesis, and reducing inflammatory responses. The underlying molecular mechanism may be associated with the activation of the CAV1/TGF-β1/HIF-1α signaling pathway.

Objective: To discuss the effects of the Bushen Jianpi Huatan Formula on sex hormone and insulin resistance in polycystic ovary syndrome (PCOS) rats by regulating the Kelch-like epichlorohydrin-associated protein 1 (Keap1)/nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1)signaling pathway. Methods: A PCOS rat model was established via letrozole combined with a high-fat diet, then the model rats were assigned to a model group, a metformin group, a Bushen Jianpi Huatan Formula group, and a Bushen Jianpi Huatan Formula+Nrf2 inhibitor group, each with 10 rats. Another 10 rats fed with regular feed were served as the normal group. The gavage dose for the metformin group was 0.3g/kg,16g/kg for the Bushen Jianpi Huatan Formula group, and for the Bushen Jianpi Huatan Formula +Nrf2 inhibitor group, 16g/kg of the Bushen Jianpi Huatan Formula was gavage along with an intraperitoneal injection of Nrf2 inhibitor 10mg/kg, all regiments were given once a day for 4 weeks. Hematoxylin eosin (HE) staining was used to detect the estrous cycle and ovarian tissue lesions. The blood glucose meter was used to detect fasting blood glucose (FBG) in rat serum. Enzyme-linked immunosorbent assay (ELISA) was used to detect changes in serum fasting insulin (FINS), sex hormones [testosterone (T), estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH)], blood lipid indicators [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)], inflammatory factors [tumor necrosis factor -α (TNF-α), interleukin-18 (IL-18)], as well as the levels of oxidative stress indicators [total superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA)] in ovarian tissues, and the homeostatic model assessment of insulin resistance index (HOMA-IR) was calculated. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression levels of Keap1, Nrf2, and HO-1 mRNAs in ovarian tissue. While Western blot was used to detect the protein levels of Keap1, Nrf2, and HO-1 in ovarian tissue. Results: Compared with the normal group,Rats in the model group showed dysregulation of the estrous cycle, cystic expansion of follicles, increased levels of T, LH, LH/FSH, TG, TC, LDL-C, FINS, FBG, HOMA-IR, TNF-α, IL-18, MDA,and the Keap1 mRNA and protein, and meanwhile showed the decreased levels of E2, HDL-C, SOD, GSH-Px, the Nrf2 and the HO-1 mRNAs and protein(P<0.05). Compared with the model group, The Bushen Jianpi Huatan Formula group showed a decreased follicular cystic expansion, decreased levels of T, LH, LH/FSH, TG, TC, LDL-C, FINS, FBG, HOMA-IR, TNF-α, IL-18, MDA, the Keap1 mRNA and protein, and meanwhile showed increased levels of E2, HDL-C, SOD, GSH-Px, the Nrf2, HO-1 mRNAs and protein(P<0.05). The Bushen Jianpi Huatan Formula and Nrf2 inhibitor group showed an increased follicular cystic expansion, and the changes in various indicators in serum and ovaries were opposite to those in the Bushen Jianpi Huatan Formula group (P<0.05). Conclusion: Bushen Jianpi Huatan Formula may alleviate sex hormone disorders and insulin resistance in PCOS rats by regulating Keap1/Nrf2/HO-1 signaling pathway.

Objective: To investigate whether electroacupuncture treatment can regulate the PI3K/AKT signaling pathway to improve the neurological function of neonatal rats with cerebral palsy (CP). Methods: Neonatal rats were randomly divided into the Sham group, CP group, electroacupuncture group, and electroacupuncture+Ly294002 (PI3K inhibitor) group. The neurological function of the neonatal rats was evaluated. The morphology of hippocampal tissue was observed by HE staining. The neuron apoptosis rate was detected by TUNEL assay. The level of myelin basic protein (MBP) in the hippocampal tissues was detected by immunohistochemistry. The levels of inflammatory factors and oxidative stress indices in the hippocampal tissues were detected. The expressions of BDNF, cleaved-caspase-3, NGF and proteins related to the PI3K/AKT signaling pathway were detected by Western blot. Results: Compared with the Sham group, in the CP group, there was obvious damage to the hippocampal cells of neonatal rats. The number of correct responses in the Y-maze test, the suspension score, the integrated optical density (IOD) level of proliferative MBP in the hippocampus, the activities of superoxide dismutase (SOD) and catalase (CAT), and the expression levels of BDNF, NGF, p-PI3K/PI3K, and p-AKT/AKT proteins were decreased. While the neuron apoptosis rate, the levels of tumor necrosis factor-α (TNF-α), interleukin-18 (IL-18) and interleukin-6 (IL-6), the content of malondialdehyde (MDA), and the expression level of cleaved-caspase-3 protein were increased (P<0.05 ). Compared with the CP group, in the electroacupuncture group, the morphological changes of hippocampal cells in neonatal rats were significantly improved. The number of correct responses in the Y-maze test, the suspension scores, the IOD level of proliferative MBP in the hippocampus, the activities of SOD and CAT, and the expression levels of BDNF, NGF, p-PI3K/PI3K, and p-AKT/AKT proteins were increased. Whereas the neuron apoptosis rate, the levels of TNF-α, IL-18 and IL-6, the content of MDA, and the expression level of cleaved-caspase-3 protein were decreased (P<0.05 ). Ly294002 could reduce the effect of electroacupuncture on the improvement of neurological function in neonatal rats with CP (P<0.05 ). Conclusion: Electroacupuncture treatment may activate the PI3K/AKT signaling pathway to alleviate hippocampal damage and improve neurological function in neonatal rats with CP.

Objective: To investigate the mechanism of tetrahydropalmatine in modulating Treg cell function to alleviate chronic pain in the spinal dorsal horn. Methods: A chronic constriction injury (CCI) model of the sciatic nerve was established. Rats were divided into a model group, a tetrahydropalmatine (64 mg/kg) group, and a positive drug (pregabalin, 30mg/kg) group, with normal rats serving as a sham-operated group (n=10 per group). Rat behavioral changes were assessed. ELISA was used to detect the serum levels of interleukin (IL)-1β and IL-6, as well as the levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in the spinal dorsal horn. Fluorescent staining was used to measure the level of reactive oxygen species (ROS) in the spinal dorsal horn. Immunohistochemical staining was performed to detect the expression of glial fibrillary acidic protein (GFAP) in the spinal dorsal horn. Flow cytometry was used to analyze the proportion of Treg cells in the rat spleen. Western blot was used to detect the protein expression of TNFR2 in the spinal dorsal horn. Results: Compared with the sham-operated group, the model group showed decreased mechanical withdrawal threshold and a reduced proportion of Treg cells among CD4⁺ T cells (P<0.05), indicating exacerbated pain. The serum levels of IL-1β and IL-6, as well as the expression levels of MDA, ROS, and GFAP protein in the spinal dorsal horn, were all increased, while the expression levels of SOD and TNFR2 protein were decreased (P<0.05). Compared with the model group, the tetrahydropalmatine group and the positive drug group showed increased mechanical withdrawal threshold and an increased proportion of Treg cells among CD4⁺ T cells (P<0.05), indicating pain relief. The serum levels of IL-1β and IL-6, as well as the expression levels of MDA, ROS, and GFAP protein in the spinal dorsal horn, were all decreased, while the expression levels of SOD and TNFR2 protein were increased (P<0.05). Conclusion: Tetrahydropalmatine may exert its analgesic effects by regulating Treg cell function, inhibiting the inflammatory response and oxidative stress in the spinal dorsal horn of CCI rats, and upregulating the expression of TNFR2 protein.

Objective: To discuss the effects of lncRNA NNT-AS1 on the proliferation of bladder cancer cells and the stemness of tumor stem cells by regulating the miR-130a-5p/cyclin T2 (CCNT2) signal axis. Methods: The expression of lncRNAs NNT-AS1, miR-130a-5p and CCNT2 in normal bladder epithelial cells SV-HUC-1 and human bladder cancer cell lines BIU-87, HT-1376 and T24 were detected by RT-qPCR. T24 cells and bladder cancer stem cells were randomly assigned into normal group, pcDNA group, pcDNA-NNT-AS1 group, si-NC group and si-NNT-AS1 group. After grouping and 48 hours of transfection, RT-qPCR was used to detect the regulatory effect of lncRNA NNT-AS1d on the miR-130a-5p/CNT2 axis, and dual-luciferase reporter gene experiments were used to verify their targeting relationship. CCK-8 method was used to detect cell proliferation in each group. Cell spherulation test was used to detect the stemness of bladder cancer stem cells in each group. Western blot was used to detect the stemness marker protein of bladder cancer stem cells in each group. Reply experiment: T24 cells and bladder cancer stem cells were randomly assigned into si-NNT-AS1 group, si-NNT-AS1+NC-miR-130a-5p group, si-NNT-AS1+anti-miR-130a-5p group, si-NNT-AS1+pcDNA group and si-NNT-AS1+pcDNA-CCNT2 group. After grouping and transfection, the stemness of T24 cells and bladder cancer stem cells in each group was detected by the same method. T24 cells and bladder cancer stem cells were randomly grouped into normal group, miR-130a-5p mimic group and miR-130a-5p mimic+pcDNA-CCNT2 group. After grouping and transfection, the stemness of T24 cells and bladder cancer stem cells in each group were detected by the same method. Results: The lncRNA NNT-AS1 and CCNT2 in human bladder cancer cell line increased (P<0.05), and miR-130a-5p decreased (P<0.05). LncRNA NNT-AS1 could target and regulate the miR-130a-5p/CNT2 signaling axis. Compared with the normal group,in the si-NNT-AS1 group,the T24 cell activity,bladder cancer stem cell spherulation,and the relative expression of cluster of differentiation 44 (CD44), octamer binding transcription factor 4 (Oct4), aldehyde dehydrogenase 1A1 (ALDH1A1) and Nanog proteins decreased at 24, 48 and 72 hours (P<0.05); while the T24 cell activity, bladder cancer stem cell spherulation, and the relative expression of CD44, Oct4, ALDH1A1 and Nanog proteins in the pcDNA-NNT-AS1 group increased at 24, 48 and 72 hours(P<0.05); in addition, there was no conspicuous difference in the above cellular indicators in the si-NC group and the pcDNA group (P>0.05).Both downregulation of miR-130a-5p and overexpression of CCNT2 could reverse the inhibitory effects of lncRNA NNT-AS1 knockdown on the stemness of T24 cells and bladder cancer stem cells. Overexpression of CCNT2 could reverse the inhibitory effect of miR-130a-5p on the proliferation of T24 cells and the stemness of bladder cancer stem cells. Conclusion: LncRNA NNT-AS1 can promote the proliferation of bladder cancer cells and enhance the stemness of bladder cancer stem cells by targeting the miR-130a-5p/CCNT2 signal axis. Knocking down lncRNA NNT-AS1 can inhibit the proliferation of bladder cancer cells and the stemness of bladder cancer stem cells.

Objective: To investigate the influencing factors of postoperative complications after pterygium excision and to analyze their predictive value. Methods: A total of 112 patients who underwent pterygium excision in our hospital from January 2023 to December 2024 were selected as the study subjects and divided into two groups based on occurrence of postoperative complications: the non-complication group (n=70) and the complication group (n=42).Clinical data of the patients were collected and analyzed. Spearman correlation analysis was used to assess the correlation between relevant factors and the occurrence of postoperative complications after pterygium excision. Multivariate binary Logistic regression analysis was conducted to identify independent influencing factors for postoperative complications. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of relevant indicators. Results: The tear film break-up time (TBUT) in the non-complication group was significantly longer than that in the complication group (P<0.05). The proportion of patients with corneal suture loosening and irrational use of hormonal drugs was significantly lower in the non-complication group than that in the complication group (P<0.05). TBUT, corneal suture loosening and irrational use of hormonal drugs were identified as independent risk factors for postoperative complications (P<0.05). Among the predictors, the tear-film break-up time yielded an AUC of 0.660 for complication occurrence, indicating poor predictive value.The sensitivity, specificity, Youden index and Kappa coefficient of corneal suture loosening for predicting complications were 0.190, 0.957, 0.147 and 0.600, respectively. And those of irrational corticosteroid use were 0.310, 0.871,0.181 and 0.576, respectively. Conclusion: Short TBUT, corneal suture loosening and irrational use of hormonal drugs can increase the risk of postoperative complications in patients undergoing pterygium excision, but their predictive values are poor.

Objective: To explore the effect of taxifolin (TAX) on hypoxia/reoxygenation (H/R)-induced myocardial cell injury based on the RhoA/ROCK1 pathway. Methods: CCK-8 was used to screen for the optimal concentration of TAX treatment for H/R induced H9C2. H9C2 cells were separated into normal group, H/R group, H/R+TAX group, H/R+ROCK inhibitor (Y-27632) group, and H/R+TAX+RhoA activator lysophosphatidic acid (LPA) group. Trypan blue staining was performed to detect the survival rate of H9C2 cells. The reagent kit was used to detect the LDH release rate of H9C2 cells. Flow cytometry and TUNEL staining were performed to detect the apoptosis rate of H9C2 cells in each group. DCFH-DA method and ELISA were performed to detect oxidative stress and inflammatory response in H9C2 cells. Western blot was used to detect the expression of RhoA/ROCK1 pathway related proteins in H9C2 cells of each group. Results: Compared with the control group, the survival rate of H9C2 cells in the H/R group was prominently lower (P<0.05). Compared with the H/R group, the survival rate of H9C2 cells was prominently higher in the H/R+TAX 20μmol/L group and the H/R+TAX 40μmol/L group (P<0.05). Compared with the H/R+TAX 40μmol/L group, the H/R+TAX 80μmol/L group showed a prominent decrease in H9C2 cell survival rate (P<0.05). Compared with the control group, the H/R group showed downregulation of H9C2 cell survival rate and GSH-Px, and upregulation of LDH release rate, apoptosis rate, TUNEL positive cell number, ROS fluorescence intensity, MDA, NOX4, IL-6, TNF-α, NLRP3, ICAM-1, RhoA, ROCK1, and p-MLC2/MLC2 (P<0.05). Compared with the H/R group, the H/R+TAX group and H/R+Y-27632 group showed upregulation of H9C2 cell survival rate and GSH-Px, and downregulation of LDH release rate, apoptosis rate, TUNEL positive cell number, ROS fluorescence intensity, MDA, NOX4, IL-6, TNF-α, NLRP3, ICAM-1, ROCK1, and p-MLC2/MLC2 (P<0.05). Compared with the H/R+TAX group, the H/R+TAX+LPA group showed downregulation of H9C2 cell survival rate and GSH-Px, and upregulation of LDH release rate, apoptosis rate, TUNEL positive cell number, ROS fluorescence intensity, MDA, NOX4, IL-6, TNF-α, NLRP3, ICAM-1, RhoA, ROCK1, and p-MLC2/MLC2 (P<0.05). Conclusion: TAX alleviates H/R-induced myocardial cell injury by inhibiting the RhoA/ROCK1 pathway to regulate oxidative stress, inflammatory response, and cell apoptosis.

Objective: To explore the value of preoperative systemic immune-inflammation index (SII) and intraoperative signs of infection in predicting urinary tract infection after ureteroscopic retrograde intracavitary lithotripsy. Methods: From January 2022 to December 2024, 210 patients with ureteroscopic retrograde intracavitary lithotripsy were selected as the research subjects. They were divided into an infected group and an uninfected group based on whether they had urinary infection after surgery. Their data, preoperative SII, and intraoperative infection signs of infection were statistically analyzed. The factors influencing postoperative urinary infection were identified through multivariate logistic regression. The receiver operating characteristic (ROC) curves were plotted to analyze the predictive efficacy of preoperative SII, and the sensitivity and specificity of preoperative SII and intraoperative infection signs were calculated and compared. Results: Preoperative SII of the infected group was higher than that of the uninfected group, and there were more patients with intraoperative signs of infection in the infected group than in the uninfected group before surgery (P<0.05). Hemoglobin level in the infected group was lower than that in the uninfected group, while blood urea nitrogen, serum creatinine and White blood cell(WBC) levels were higher than those in the uninfected group (P<0.05). Multivariate logistic regression analysis results showed that preoperative SII, intraoperative sign of infection, and WBC were influencing factors of urinary infection after ureteroscopic retrograde intracavitary lithotripsy (P<0.05). ROC curve analysis results showed that with 609×10⁹L^-1 as the cut-off value, the area under the curve (AUC) of preoperative SII in predicting postoperative urinary infection was 0.982, the sensitivity and specificity were 94.44% and 93.10%, respectively. The sensitivity and specificity of intraoperative infection signs in predicting postoperative urinary infection were 52.78% and 90.23%, respectively. The sensitivity of preoperative SII was significantly higher than that of intraoperative infection signs, and the difference was statistically significant (P<0.05). There was no statistically significant difference in specificity between the two indicators (P>0.05). Conclusion: The influencing factors of postoperative urinary infection after ureteroscopic retrograde intracavitary lithotripsy include preoperative SII, intraoperative sign of infection, and WBC level. Preoperative SII and intraoperative sign of infection both demonstrate high predictive efficacy for postoperative urinary infection, especially preoperative SII.

Objective: To investigate the influencing factors and predictive value of recurrence after radiotherapy in patients with esophageal cancer (EC). Methods: A total of 106 patients with EC who underwent radiotherapy in our hospital from January 2020 to February 2023 were selected and followed up for 2 years. They were divided into the recurrence group and the non-recurrence group according to the recurrence of EC or not. The correlation between the influencing factors and the recurrence of EC after radiotherapy was analyzed by binary Logistic regression, and ROC curve was used to evaluate its predictive performance. Results: TNM stage, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), systemic immune inflammation index (SII), and prognostic nutritional index (PNI) were the influencing factors of recurrence in patients with EC after radiotherapy (P<0.05). ROC curve analysis showed that the detection efficiency of CEA, CA125, SII, and PNI was higher, and the combined detection was higher than that of single detection. Conclusion: The recurrence of EC following radiation is closely associated with TNM stage, CEA, CA125, SII, and PNI, and the prediction effectiveness is excellent.

Objective: To explore the relationship between the expression of Prospero-related homeobox protein 1 (PROX1) and Krüppel-like factor 4 (KLF4) in breast cancer patients and their relation with disease progression and prognosis. Methods: A total of 257 patients with breast cancer admitted to our hospital from May 2019 to April 2022 were selected as the breast cancer group, and another 257 patients with benign breast lesions were selected as the benign breast lesion group. The levels of serum PROX1 and KLF4 were measured using enzyme-linked immunosorbent assay (ELISA). The levels of serum PROX1 and KLF4 were compared between the two groups, as well as among patients with different pathological characteristics of breast cancer. The relationship between the levels of serum PROX1 and KLF4 and the prognostic survival of breast cancer patients was analyzed. COX regression analysis was used to investigate the factors affecting the prognostic survival of breast cancer patients and the relationship between the levels of serum PROX1 and KLF4 and the prognostic survival of various subgroups. The restricted cubic spline (RCS) model was used to analyze the nonlinear relationship between the levels of serum PROX1 and KLF4 and the prognostic survival of breast cancer patients. Results: The serum PROX1 level in breast cancer patients was higher than that in patients with benign breast lesions, while the KLF4 level was lower than that in patients with benign breast lesions (P<0.05). The serum PROX1 and KLF4 levels in breast cancer patients showed significant differences in the differentiation degree, clinical stage, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (Her-2), molecular typing, and lymph node metastasis (P<0.05). Among 257 breast cancer patients followed up for 24 months, seven were lost to follow-up, yielding a survival rate of 77.20% (193/250). The survival rate of patients with high PROX1 levels at 24 months was 65.93%, significantly lower than that of patients with low PROX1 levels at 90.43%. The survival rate of patients with high KLF4 levels at 24 months was 87.80%, significantly higher than that of patients with low KLF4 levels at 66.93% (P<0.05). Multivariate COX regression analysis showed that differentiation degree, clinical stage, lymph node metastasis, and serum PROX1 and KLF4 levels were independent factors affecting the prognosis and survival of breast cancer patients (P<0.05). Subgroup analysis indicated a significant interaction between serum PROX1 and KLF4 levels and clinical stage and lymph node metastasis in terms of prognosis and survival in breast cancer patients. In the RCS model, the serum PROX1 and KLF4 levels in breast cancer patients showed a linear relationship with the risk of death (P<0.05). Conclusion: Patients with breast cancer have elevated serum levels of PROX1 and decreased levels of KLF4, which is closely related to the progression and prognosis of breast cancer. Monitoring the levels of serum PROX1 and KLF4 in breast cancer patients may help to identify the risk of breast cancer and death in the early stage and improve the prognosis of patients.

Objective: To analyze the value of serum serine protease inhibitor factor Kazal1 (SPTINK1) and suppressors of cytokine signaling 3 (SOCS3) in predicting the prognosis of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods: A total of 210 HCC patients were selected who underwent TACE treatment in Nanping First Hospital Affiliated to Fujian Medical University from January 2021 to January 2023. They were followed up for 2 years after TACE treatment. According to the prognosis, they were divided into a poor prognosis group and a good prognosis group. The general data of the two groups and the levels of serum SPTINK1 and SOCS3 before and after TACE treatment were compared. The changes in serum SPTINK1 and SOCS3 levels before and after treatment were calculated. The influencing factors of poor prognosis in HCC patients after TACE treatment were analyzed. The dose-response relationship between △SPTINK1, △SOCS3 and poor prognosis was analyzed. The mean values of △SPTINK1 and △SOCS3 were used as the boundary to compare the poor prognosis of patients with different △SPTINK1 and △SOCS3. The value of △SPTINK1 and △SOCS3 in predicting poor prognosis was analyzed. Results: The proportion of patients with Child-Pugh grade B, Barcelona clinical liver cancer stage (BCLC) B-C, tumor maximum diameter > 7 cm, tumor number ≥ 2, vascular invasion, control of nutritional status (CONUT) score > 4 scores, serum alpha-fetoprotein (AFP) ≥ 400ng/mL, stable disease (SD)/progressive disease (PD) in TACE treatment response in the poor prognosis group was higher than that in the good prognosis group (P<0.05). The levels of serum SPTINK1 in the poor prognosis group before and after treatment were higher than those in the good prognosis group, and the levels of serum SOCS3, △SPTINK1, and △SOCS3 before and after treatment were lower than those in the good prognosis group (P<0.05). Child-Pugh grade B, BCLC stage B-C, tumor maximum diameter > 7 cm, CONUT score > 4 points, serum AFP ≥ 400ng/mL, TACE treatment response SD/PD were all independent risk factors for poor prognosis of HCC patients after TACE treatment, △SPTINK1 and △SOCS3 were independent protective factors (P<0.05). There was a negative dose-response relationship between △SPTINK1, △SOCS3, and poor prognosis (P<0.05). The poor prognosis rate of TACE in HCC patients with △SPTINK1 < 26.36% and △SOCS3 < 19.38% was higher than that in patients with △SPTINK1 ≥ 26.36% and △SOCS3 ≥ 19.38% (P<0.05). The area under the curve (AUC) of △SPTINK1 and △SOCS3 alone in predicting the poor prognosis of TACE in HCC patients was 0.742 and 0.732, respectively, and the AUC of combined prediction was 0.868. The AUC of △SPTINK1 and △SOCS3 combined prediction was significantly greater than that of the two alone (P<0.05). Conclusion: There is a negative dose-response relationship between the change rate of serum SPTINK1 and SOCS3 levels and poor prognosis in HCC patients before and after TACE treatment, and it has the efficacy of predicting the risk of poor prognosis. The combination of △SPTINK1 and △SOCS3 can significantly improve the predictive value.

Objective: To analyze the value of carotid magnetic resonance angiography (MRA) in predicting short-term acute cerebral infarction in patients with transient ischemic attack (TIA). Methods: A total of 150 TIA patients admitted to our hospital from January 2021 to June 2022 were selected and divided into a concurrent group (n=32) and a non-concurrent group (n=118) based on the incidence of acute cerebral infarction. The results of carotid MRA examinations were observed, the independent predictive indicators for concurrent ACI were screened through multivariate logistic regression analysis, and their individual and combined predictive value was assessed. Results: The proportion of severe stenosis, plaque hemorrhage, necrotic fat nuclei, fibrous cap rupture and other values in patients with atherosclerosis was higher than that in non-concurrent patients (P<0.05), the minimum lumen area was smaller than that in non-concurrent patients (P<0.05), and the maximum wall thickness was larger than that in non-concurrent patients (P<0.05). Multivariate analysis showed that plaque bleeding (OR=8.72, 95% CI: 2.34~32.48), fibrous cap rupture (OR=6.95, 95% CI: 1.89~25.61), and maximum wall thickness (OR=1.42, 95% CI: 1.05~1.92) were independent predictive factors for concurrent ACI. The sensitivity of the joint prediction model is 90.6%, and the specificity is 88.1%, higher than that of single indicator detection. Conclusion: In the detection of carotid MRA, plaque bleeding, fibrous cap rupture, and maximum wall thickness are independent predictive indicators for TIA complicated with ACI. The combined application can significantly improve the predictive efficiency and has important clinical significance.

Objective: To analyze the application of multimodal cranial magnetic resonance imaging in refractory epilepsy. Methods: A total of 78 patients with refractory epilepsy diagnosed by postoperative pathological results in our hospital from March 2021 to May 2023 were selected as the observation objects of this study. All patients underwent head MRI and multimodal MRI examination. The detection rate of epileptogenic zone, the consistency with postoperative pathological results, the relationship with neurological deficits, the total effective rate of postoperative prognosis and the contribution weight of different sequences to epileptogenic zone were compared. Results: Using postoperative pathological findings as the gold standard, 34 cases of medial temporal lobe sclerosis, 20 cases of focal cortical dysplasia, and 24 cases of other aetiologies were detected. Multimodal MRI detected 32, 18, and 21 cases of these types respectively, 71 cases in sum, with a detection rate of 91.03%. Head MRI detected 26, 12, and 19 cases, respectively, 57 cases in sum, with a detection rate of 73.08%. The detection rate of multimodal MRI was significantly higher than that of head MRI (P<0.05). The sensitivity and positive predictive value of multimodal MRI were higher than those of head MRI, and the consistency between multimodal MRI and postoperative pathological results was better than that of head MRI. Compared with the normal side, the DTI-FA and MRS-NAA/Cr in the epileptogenic zone were increased, and the fMRI activation volume was decreased. The fMRI activation volume was negatively correlated with the neurological deficit score, and DTI-FA and MRS-NAA/Cr were positively correlated with the neurological deficit score (P<0.05). In the Engel classification, the total effective rate of patients with refractory epilepsy was 71 cases (91.03%). Multivariate regression analysis showed that the standardized β values of DTI-FA, MRS-NAA/Cr, fMRI activation volume, and conventional MRI positivity were -0.42, 0.38, 0.28, and 0.19, respectively, indicating that there were differences in the contribution weights of different sequences in the epileptogenic zone (P<0.05). Conclusion: The detection rate and consistency of multimodal MRI imaging technology are higher than those of head MRI, and the multimodal MRI-guided strategy can improve the prognosis of refractory epilepsy and the total effective rate. The contribution weights of different sequences are different, which provides a reference for the clinical diagnosis of refractory epilepsy.

Objective: To explore the curative effect of ligation of intersphincteric fistula tract (LIFT) and incision-thread-drawing therapy for complex anal fistula and their influences on anal function and postoperative recurrence. Methods: A total of 90 patients with complex anal fistula admitted to the Anqing Municipal Hospital between January 2021 and August 2024 were retrospectively enrolled as the research subjects. According to the different surgical methods, they were divided into an incision-thread-drawing group (41 cases, incision-thread-drawing therapy) and a LIFT group (49 cases, LIFT). After treatment, clinical curative effect, perioperative indexes and anal function at 3 month after surgery in the two groups were observed, with the complications and recurrence recorded. Results: There was no significant difference in response rate of treatment between groups (all 100.00%, P>0.05). The wound healing time and length of hospital stay in LIFT group were shorter, intraoperative blood loss was less, scores of visual analogue scale (VAS) was lower, and the wound was smaller than those in incision-thread-drawing group at 7d after surgery (P<0.05). At 3 months after surgery, scores of wexner incontinence, anal canal rest pressure and anal maximal contraction pressure were decreased in both groups. Moreover, the difference value in wexner incontinence score before and after surgery in LIFT group was greater, while difference values in anal canal rest pressure and anal maximal contraction pressure before and after surgery were lower than those in incision-thread-drawing group, the differences were all statistically significant. (P<0.05). The incidence of complications in LIFT group was lower than that in incision-thread-drawing group (6.12% vs 21.95%, P<0.05). At 6 months after surgery, recurrence rate in LIFT group was lower than that in incision-thread-drawing group (0.00% vs 9.76%, P<0.05). Conclusion: The curative effect of LIFT and incision-thread-drawing therapy is similar in patients with complex anal fistula. However, LIFT is more advantageous in terms of controlling incision area, postoperative pain, healing and complications, which has fewer effects on anal function and lower recurrence rate at 6 months after surgery.

Objective: To explore the correlation between B lymphocyte-related cytokines levels and early renal injury as well as disease activity in patients with systemic lupus erythematosus (SLE), and to screen potential predictive markers for early renal injury with clinical application value. Methods: A total of 117 SLE patients from February 2022 to August 2024 were enrolled in this retrospective study. Patients were categorized into two groups based on the presence of early renal injury, and the early renal injury subgroups were further stratified according to SLE Disease Activity Index (SLEDAI) scores. Univariate analysis, multivariate Logistic regression, and ROC curve analysis were employed to assess the correlation between cytokines and early renal injury, as well as the predictive value of these cytokines for early renal injury. Results: The SLEDAI score, complement C3 and C4 levels, positive rate of anti-double-stranded DNA antibody, and levels of B lymphocyte-related cytokines (BAFF, APRIL, IL-10, IL-21, IL-6, TNF-α, IL-17) in the early renal injury group were significantly higher than those in the non-early renal injury group (all P<0.05). In the early renal injury group, the levels of BAFF, APRIL, IL-10, IL-6, TNF-α, IL-17 and other cytokines showed an upward trend with the increase of SLE disease activity (all P<0.05). Ordinal Logistic regression analysis showed that BAFF, APRIL, and IL-10 were independent predictors of increased SLE disease activity (all P<0.05). Binary Logistic regression analysis demonstrated that APRIL, TNF-α, and IL-17 served as independent risk factors for early renal injury in SLE patients, whereas IL-10 acted as a protective factor (all P<0.05). ROC curve analysis indicated that the combined detection of APRIL, IL-10, TNF-α, and IL-17 exhibited superior predictive performance compared to individual markers, with the area under the ROC curve (AUC) achieving 0.925. Conclusion: This study reveals the important role of B lymphocyte-related cytokines in early renal injury and disease activity of SLE, offering novel evidence for the early identification of high-risk patients and the guidance of precision treatment.

Objective: To explore the diagnostic value of combined detection of serum Src homology domain 2 protein B1 (SH2B1), Nedd4 family interacting protein 1 (NDFP1), and α-hydroxybutyrate dehydrogenase (α-HBDH) in differentiating benign and malignant solitary pulmonary nodules (SPN). Methods: Totally 260 SPN patients in our hospital were designated as the SPN group, and were classified into a benign group (112 cases) and a malignant group (148 cases) based on pathological examination results. Meanwhile, 200 healthy individuals were made the control group. The ELISA method was used to detect serum SH2B1, NDFIP1, and α-HBDH. Multivariate logistic regression was used to explore the risk factors affecting SPN malignancy. Relative risk analysis of serum SH2B1, NDFIP1, and α-HBDH levels on malignant transformation of SPN. ROC curve was plotted to evaluate the differential diagnostic value of serum SH2B1, NDFIP1, and α-HBDH for benign and malignant SPN. Results: Compared with the control group, the SPN group had higher serum SH2B1 and α-HBDH (t=46.344, 28.857, P<0.05), and lower NDFIP1 (t=26.385, P<0.05). The malignant group had higher serum SH2B1 and α-HBDH than the benign group (t=6.877, 6.705, P<0.05), and lower NDFIP1 than the benign group (t=6.959, P<0.05). Multivariate logistic regression analysis revealed that spiny nodule morphology (OR=3.613, 95%CI: 1.182~7.203), solid nodules (OR=4.079, 95%CI: 1.410~11.801), elevated SH2B1 levels (OR=2.440, 95%CI: 1.290~4.614), and high α-HBDH expression (OR=2.228, 95%CI: 1.346~3.687) were independent risk factors for SPN malignancy, whereas high NDFIP1 expression (OR=0.724, 95%CI: 0.559~0.938) was a protective factor (P<0.05). Relative risk analysis further indicates that patients with high levels of SH2B1 and high levels of α-HBDH have a 2.498-fold and 2.424-fold increased risk of developing malignant SPN, respectively, compared to those with low levels; whereas patients with high levels of NDFIP1 had a risk that was 0.492 times lower than that of patients with low levels. The AUC for the combined diagnosis of malignant SPN using serum SH2B1, NDFIP1, and α-HBDH was 0.919, which was superior to the combined diagnosis using nodule morphology and nodule characteristics (Zcombined-nodule morphology + nodule characteristics=4.611, P<0.001). Conclusion: The changes in serum SH2B1, NDFIP1, and α-HBDH are closely related to the benign and malignant natures of SPN. All three have certain differential diagnostic value for benign and malignant SPN, and combined detection has high differential diagnostic efficacy.

Objective: To investigate the difference of survival rate between video-assisted thoracoscopic wedge resection versus lobectomy in patients with Stage T₁ lung cancer. Methods: A total of 253 patients with stage T₁ lung cancer, admitted from March 2022 to March 2023, were selected. Among them, 76 patients underwent wedge resection, and 177 patients underwent lobectomy. Clinical data were collected and compared. The Kaplan-Meier curves and Log-rank test were used to compare the prognosis of patients with stage T₁ lung cancer treated with different surgical methods. While the Cox proportional hazards regression model was used to analyze the factors affecting the prognosis of lung cancer patients. Results: The surgery duration and intraoperative blood loss were longer and greater respectively in the lobectomy group than in the wedge resection group (P<0.05). The 2-year survival rates for the wedge resection and lobectomy groups were 71.0% and 81.3%, respectively (χ²=3.169, P=0.075), with no statistically significant difference (P>0.05). The results of Cox multivariate regression analysis showed that age ≥70 years, N₁, and N₂ were risk factors for the prognosis of lung cancer patients (HR=2.479, 3.881, 6.135), while moderate to high differentiation was a protective factor for prognosis (HR=0.319)(all P<0.05). Conclusion: There is no significant difference in overall survival between thoracoscopic wedge resection and lobectomy. Age, tumor differentiation and N stage are independent prognostic factors for lung cancer patients.

Objective: To investigate the correlation between clinical features combined with immune markers and adenomyosis, and analyze their diagnostic value. Methods: A total of 113 patients with adenomyosis who were diagnosed and treated at our hospital from March 2022 to March 2025 were selected as the study group, while 109 patients diagnosed with uterine fibroids during the same period were chosen as the control group. The clinical data of the patients were collected and analyzed. Multivariate binary Logistic regression analysis was performed to identify independent influencing factors for the occurrence of adenomyosis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of relevant indicators. Results: The proportion of patients with ≥3 miscarriages, E2 levels, NLR, and IL-10 levels were higher in the adenomyosis group than those in the control group (P<0.05), all of which were positively correlated with the occurrence of adenomyosis except for E2 (P<0.05). In contrast, IL-6 and CXCL1 levels were lower in the adenomyosis group than those in the control group (P<0.05), both of which were negatively correlated with the occurrence of adenomyosis (P<0.05). Only NLR, IL-6, and CXCL1 levels were identified as independent influencing factors for adenomyosis, and their combination had the best diagnostic value (AUC=0.948). Conclusion: NLR, IL-6, and CXCL1 levels are independent influencing factors for the occurrence of adenomyosis. Their combination, as well as NLR and CXCL1 levels, show satisfactory diagnostic value and the potential to serve as non-invasive biomarkers for the auxiliary diagnosis of adenomyosis, which can provide new insights for early clinical diagnosis.

Objective: To analyse the correlation between early pregnancy nuchal translucency (NT) thickness and pregnancy outcomes. Methods: A total of 77 cases with increased NT thickness were selected from pregnant women undergoing early pregnancy (11⁺⁰ to 13⁺⁶ weeks) NT ultrasound examinations from January to December 2022 at our hospital to form the study group. An age-matched control group of 80 cases with normal NT was established. Fetal structural abnormalities were assessed, and cases with increased NT underwent amniocentesis with G-banding karyotyping and/or chromosomal microarray analysis (CMA), with continuous follow-up until pregnancy completion. Results: The adverse pregnancy outcome rate in the increased NT group was 29.9%, significantly higher than the 2.5% in the normal NT group (P<0.05). An increased incidence of adverse pregnancy outcomes, foetal structural abnormalities, and chromosomal abnormalities was observed with NT thickening. This trend was particularly pronounced when NT≥4.0mm, showing statistically significant differences compared to groups with NT<4.0mm (P<0.001). Conclusion: First-trimester NT ultrasound screening serves as an effective method for early diagnosis of foetal abnormalities. Changes in NT thickness correlate closely with foetal chromosomal abnormalities. Increased NT thickness elevates the risk of foetal chromosomal and structural abnormalities, as well as the probability of adverse pregnancy outcomes.

Objective: To explore the clinical efficacy of rigid bronchoscopy combined with electronic bronchoscopy in the interventional treatment of malignant central airway tumors, and to provide a basis for optimizing clinical treatment regimens. Methods: The clinical data of patients with malignant central airway tumors who received bronchoscopic interventional treatment in Anqing Municipal Hospital from February 2020 to February 2025 were retrospectively analyzed. According to the treatment methods, the patients were divided into the combined group (treated with rigid bronchoscopy combined with electronic bronchoscopy) and the single-scope group (treated with electronic bronchoscopy alone). After 1:1 matching using propensity score matching (PSM), 51 patients were finally included in each group. The tumor resection degree, ventilation function improvement indicators [airway stenosis degree, dyspnea index, modified Medical Research Council (mMRC) dyspnea scale, blood gas indicators and pulmonary function indicators], perioperative indicators (operation time, blood loss, length of hospital stay, intraoperative stent implantation rate, complication rate, ICU admission rate and 7-day postoperative reintervention rate), and overall efficacy were compared between the two groups. Results: After PSM, the baseline data of the two groups were balanced and comparable (P>0.05). The complete tumor resection rate in the combined group (78.43%) was higher than that in the single-scope group (50.98%) (P<0.05). At 7 days after operation, the indicators in the combined group, such as airway stenosis degree, dyspnea index, mMRC score, arterial oxygen saturation (SaO₂), arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV), were better than those in the single-scope group (P<0.05). The operation time and blood loss in the combined group were higher than those in the single-scope group (P<0.05), but the length of hospital stay and 7-day postoperative reintervention rate were lower than those in the single-scope group (P<0.05). The number of people (31/51) who achieved remarkable results in the combined group was higher than that in the single-scope group (16/51). (P<0.05). Conclusion: Rigid bronchoscopy combined with electronic bronchoscopy in the interventional treatment of malignant central airway tumors is superior to electronic bronchoscopy alone in terms of tumor resection effect, ventilation function improvement and perioperative safety. It is an effective treatment strategy and worthy of clinical promotion and application.

Objective: To analyze factors affecting acromiohumeral distance (AHD) changes in patients with full-thickness rotator cuff tears (RCT) and investigate the correlation between AHD and clinical outcomes after rotator cuff repair. Methods: A retrospective analysis was conducted on 64 patients with medium-to-large full-thickness RCTs treated between June 2019 and September 2020. Preoperative and postoperative AHD measurements were obtained using MRI for detailed assessment and X-ray for the evaluation of the subacromial space. Fat infiltration (Goutallier classification), supraspinatus atrophy (Thomazeau classification), and tendon retraction (Patte classification) were assessed using MRI. Tear size was measured intraoperatively. Spearman/Pearson correlation analyses were used to evaluate the relationships between AHD and variables. All patients underwent arthroscopic double-row suture bridge repair, with postoperative Constant-Murley scores analyzed for correlation with AHD. Results: Preoperative X-ray-measured AHD (7.7±2.3 mm) was significantly larger than MRI measurements (5.8±2.1 mm; t=-4.861, P<0.001). Preoperative MRI AHD showed strong negative correlations with tear size (r=-0.836, P<0.001), symptom duration (r=-0.715, P<0.001), fat infiltration (r=-0.623, P<0.001), and tendon retraction (r=-0.572, P<0.001). The study found no significant correlation between supraspinatus atrophy and rotator cuff tears (r=0.082, P=0.518), nor between age and the incidence of such tears (r=0.129, P=0.308). Additionally, no significant difference was observed in the prevalence of rotator cuff tears between genders (r=-0.052, P=0.683). These findings are consistent with broader research indicating that while age is a risk factor for rotator cuff injuries, the correlation with gender is not as pronounced. Immediate postoperative MRI AHD (8.6±1.8 mm) increased significantly compared to preoperative values (t=-30.399, P<0.001). Postoperative clinical outcomes (Constant-Murley scores) showed no significant correlation with changes in AHD (r=-0.156, P=0.219) but were strongly positively correlated with preoperative AHD (r=0.846, P<0.001). Conclusion: X-ray measurements overestimate AHD compared to MRI. The acromiohumeral distance (AHD) is affected by the extent of the tear, the duration of symptoms, fatty infiltration, and tendon retraction, offering insights into the mechanisms of humeral head migration. Preoperative AHD measurements, as opposed to postoperative changes, are crucial in predicting the outcomes of shoulder surgeries, as evidenced by studies indicating that preoperative AHD can serve as a significant indicator for postoperative shoulder function. a reliable predictor of clinical outcomes after rotator cuff repair.Preoperative radiographic measurement of AHD (7.7±2.3mm) was greater than the MRI measurement (5.8±2.1mm), with a statistically significant difference (t=-4.861, P<0.001). Preoperative MRI-measured AHD correlated negatively with tear size (r=-0.836, P<0.001), duration of symptoms (r=-0.715, P<0.001), degree of fatty infiltration (r=-0.623, P<0.001), and tendon stump contracture (r=-0.572, P<0.001); while showing no statistically significant correlation with supraspinatus muscle atrophy (r=0.082, P=0.518), age (r=0.129, P=0.308), or gender (r=-0.052, P=0.683). Immediate postoperative MRI-measured AHD (8.6±1.8mm) increased compared to preoperative values (t=-30.399, P<0.001), consistent with findings from studies examining changes in acromioclavicular distance following arthroscopic repair of traumatic rotator cuff tears. Postoperative clinical efficacy (Constant-Murley score) showed no statistically significant correlation with postoperative AHD changes (r=-0.156, P=0.219), but exhibited a positive correlation with preoperative AHD (r=0.846, P<0.001).

Objective: To evaluate the antibacterial activity of amtraxam (ATM) combined with Ceftazidime/avibactam (CZA) against carbapenem resistant enterobacter cloacae complex group in vitro, and to analyze the production and genotype distribution of carbapenase in CRECC. Methods: A total of 46 CRECC strains were collected from 2021 to 2023. The combined antibacterial effect of ATM and CZA was evaluated by microbroth dilution checkerboard method, and the type of action was determined according to fractional inhibitory concentration (FIC). The modified carbapenem inactivation method (mCIM) and EDTA modified carbapenem inactivation method (eCIM) were used to confirm whether the strain produced carbapenase and preliminatively distinguish class A and Class B carbapenase, and the carbapenase genotypes were further confirmed by immunochromatography. Results: In 46 strains of CRECC, ATM combined with CZA showed synergistic effect (FIC≤0.5) in 39 strains, additive effect (0.5<FIC≤1) in 7 strains, no unrelated or antagonistic effect was found. The minimum inhibitory concentration (MIC) of ATM decreased significantly from 256 mg/L to 0.008 mg/L, which was reduced by 32,000 times. The MIC of CZA was reduced from 64 mg/L to 0.015 mg/L, a 4,267-fold decrease. Carbapenase genotype analysis confirmed that 38 of 46 CRECC strains produced carbapenase NDM (82.61%), and 8 strains did not produce carbapenase (17.39%). The combination of ATM and CZA showed synergistic effect (31 strains, 81.58%) or additive effect (7 strains, 18.42%) in 38 enzyme-producing strains, and synergistic effect in 8 strains without enzyme-producing CRECC strains. Conclusion: The popular CRECC in this region mainly produces NDM carbapenemase. ATM combined with CZA showed significant antibacterial activity against CRECC in vitro. The combination regimen has shown promising potential in combating CRECC and is expected to be an effective regimen for the treatment of such infections. In the future, it is necessary to further study the clinical application effect and safety to optimize the treatment strategy.

Objective: To evaluate the effects of Cadonilimab on immune function and cell proliferation/apoptosis-related proteins in patients with recurrent/advanced cervical cancer. Methods: A total of 48 patients with recurrent/advanced cervical cancer treated in our hospital from October 2022 to May 2024 were selected. All patients received Cadonilimab treatment. Patient efficacy, adverse reactions, and survival rates were statistically analyzed during the follow-up period. Changes in cellular immune function, serum tumor markers [squamous cell carcinoma antigen (SCCA), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin 19 fragment (CYFRA21-1)], expression levels of cell proliferation/apoptosis-related proteins [tumor protein P53 (P53), Bcl-2-associated X protein (Bax), programmed cell death factor 5 (PDCD5), epidermal growth factor receptor (EGFR), cytosolic thymidine kinase 1 (TK1)], and quality of life [Functional Assessment of Cancer Therapy-Cervical cancer (FACT-Cx) scores] were observed before and after treatment. Results: The objective response rate (ORR) and the disease control rate (DCR) were 68.75% (33/48) and 81.25% (39/48) respectively in the 48 patients with recurrent/advanced cervical cancer. After treatment, the levels of CD3⁺, CD4⁺ T lymphocytes, and CD4⁺/CD8⁺ ratios were higher than before treatment (P<0.05). The serum levels of SCCA, CEA, CA125, and CYFRA21-1 were lower after treatment compared with before treatment (P<0.05). The serum expression levels of P53, Bax, and PDCD5 were higher after treatment, while expression levels of EGFR and TK1 were lower than before treatment (P<0.05). The scores across all 5 dimensions of the FACT-Cx scale were higher after treatment (P<0.05). With a median follow-up time of 11.354 months (95% CI: 10.920-11.788), the 1-year overall survival (OS) rate was 81.25% (39/48). The incidence of grade 3-4 adverse reactions was 58.33% (28/48); grade 1-2 adverse reactions were gradually resolved after appropriate management. Conclusion: Cadonilimab-based regimens can improve cellular immune function, reduce serum tumor marker levels, and modulate the expression of cell proliferation/apoptosis-related proteins in patients with recurrent/advanced cervical cancer, which is associated with higher survival rates and a manageable safety profile.

Objective: To investigate the clinical efficacy of sacubitril valsartan in patients with type II cardiorenal syndrome and its effect on vascular endothelial growth factor. Methods: A total of 144 patients with crs-2 admitted from April 2024 to February 2025 were selected and randomly divided into a control group and an experimental group, with 72 cases in each group. The control group received standard treatment, and the experimental group was treated with sacubitril valsartan on the basis of standard treatment. The indexes of cardiac function, Holter heart rate, renal function, vascular endothelial function, and brachial artery flow mediated vasodilation (FMD) were compared between the two groups before and after treatment. Results: Compared with the control group, the experimental group showed significantly higher differences in SDNN, SDANN, rMSSD, and PNN50 before and after treatment (P<0.05). The experimental group also exhibited significantly higher differences in LVFS, LVEF, and E/A ratio before and after treatment (P<0.05). The experimental group demonstrated significantly higher differences in eGFR before and after treatment, while showing significantly lower differences in BUN and Scr (P<0.05). The experimental group showed significantly higher differences in EDD function and D1 before and after treatment (P<0.05), but no significant differences in D0 values between the two groups (P>0.05). Compared with the control group, the experimental group showed significantly higher differences in CGRP and NO before and after treatment, while the experimental group showed significantly lower differences in ET (P<0.05). Conclusion: Sacubitril valsartan tablets can significantly improve cardiac function, renal function and vascular endothelial function in patients with crs-2, which is worthy of clinical application.