Objective: To investigate the effect of punicalagin (PUN) on autophagy and apoptosis in acute myeloid leukemia (AML) cells by regulating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway.Methods: Human AML cells (HL-60) were cultured in vitro and randomly separated into control group (normal culture), L-PUN, M-PUN, H-PUN groups (20, 40, 60 μg/mL PUN), and 740 Y-P group (60 μg/mL PUN+30 μmol/L PI3K/Akt/mTOR signaling pathway activator 740 Y-P). Methylthiazolyltetrazolium (MTT) method and plate cloning method were applied to detect cell proliferation in each group. MDC staining was applied to detect the occurrence of autophagy of cells in various groups. Flow cytometry was applied to detect cell apoptosis in each group. Protein immunoblotting (WB) was applied to detect the expression of apoptosis related proteins (Bcl-2, Bax), autophagy related proteins (P62, LC3-II/I ratio, BECN1), and PI3K/Akt/mTOR signaling pathway related proteins (p-PI3K, p-Akt, p-mTOR) of cells in each group.Results: Compared with the control group, the survival rate, clone count, p-PI3K, p-Akt, p-mTOR, P62, and Bcl-2 protein expression of HL-60 cells in the L-PUN group, M-PUN group, and H-PUN group decreased, while the apoptosis rate, autophagosome positive rate, LC3-II/I ratio, BECN1, and Bax protein expression increased (P<0.05). Compared with the H-PUN group, the survival rate, clone number, p-PI3K, p-Akt, p-mTOR, P62, and Bcl-2 protein expression of the 740 Y-P group cells increased, while the apoptosis rate, autophagosome positive rate, LC3-II/I ratio, BECN1, and Bax protein expression levels decreased (P<0.05).Conclusion: PUN inhibits the PI3K/Akt/mTOR signaling pathway, inhibits HL-60 cell proliferation, promotes apoptosis and autophagy, and slows down the progression of AML.

Objective: To investigate the effects of Chrysoeriol (Chry) on the growth and metastasis of human gastric cancer in nude mice and the IL-6/JAK2/STAT3 signaling pathway. Methods: Orthotopic transplantation model of human gastric cancer nude mice was established, and successfully modeled nude mice were randomly separated into a model group, low, medium, and high dose Chry groups (Chry-L, Chry-M, Chry-H groups), and high-dose Chry+JAK2 activator Coumermycin A1 group (Chry-H+CA1 group), 12 animals per group. After subcutaneous injection, the nude mice were killed to take transplanted tumors and weigh them, and the tumor inhibition rate was calculated. HE staining was applied to observe the pathological changes of transplanted tumor tissue. TUNEL staining was applied to detect apoptosis in transplanted tumor tissues. Immunohistochemistry was applied to detect the expression of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) proteins related to migration and invasion of transplanted tumors. Immunoblotting was applied to detect apoptosis of transplanted tumor cells and the expression of IL-6/JAK2/STAT3 signaling pathway related proteins.Results: Compared with the model group, the tumor cell density in the Chry-L, Chry-M, and Chry-H groups decreased, with loose and disordered arrangement, a large number of tumor cells ruptured and necrotic, obvious proliferation of connective tissue, with an increase in nuclear pyknosis and deep staining, a decrease in nuclear division, an increase in apoptotic and necrotic cells, and a reduction in the quality of transplanted tumors, the tumor inhibition rate, cell apoptosis index, and Bax expression increased, the tumor metastasis rate and the expression of Bcl-2, MMP-2, MMP-9, IL-6, p-JAK2/JAK2, p-STAT3/STAT3 reduced, the Chry-H group showed the most obvious changes (P<0.05). Compared with the Chry-H group, the Chry-H+CA1 group showed an increase in tumor cells, relatively neat arrangement, reduced nuclear pyknosis and deep staining, increased nuclear division, obvious tumor necrosis, and increased weight of transplanted tumors, the tumor inhibition rate, cell apoptosis index, and Bax expression decreased, the tumor metastasis rate and the expression of Bcl-2, MMP-2, MMP-9, IL-6, p-JAK2/JAK2, and p-STAT3/STAT3 increased (P<0.05). Conclusion: Chrysoeriol can inhibit the growth and metastasis of human gastric cancer transplanted in nude mice, and its mechanism of action is related to the inhibition of the IL-6/JAK2/STAT3 signaling pathway.

Objective: To investigate the effect of Acacetin on gastric mucosal injury in Helicobacter pylori (Hp)-infected mice by regulating NF-κB signaling pathway.Methods: C57BL/6 mice were given 10⁹ CFU/mL Hp (0.3 mL) gavage, and the successfully modeled mice were randomly divided into Hp group, low Acacetin (Acacetin-L, 30 mg/kg), high dose (Acacetin-H, 75 mg/kg) group, positive control [omeprazole (400 μg/kg), clarithromycin (7.15 mg/kg) and amoxicillin (14.25 mg/kg)] group, and Acacetin-H+Prostratin (75 mg/kg Acacetin+ 0.5 mg/kg Prostratin) group, and mice given 0.3 mL of normal saline by gavage were made the control group. Gastrointestinal hormones [motilin (MTL), Ghrelin, 5-tryptamine (5-HT)] in serum were measured. Gastric tissue was isolated and the pathological changes and scores were detected. The levels of interleukin (IL)-1β, IL-10, tumor necrosis factor (TNF)-α, mRNA expression of occludin (Occludin), atresia band protein (ZO-1), apoptosis and the expression of apoptotic proteins Bax, Bcl-2, p-NF-kB p65 and NF-kB p65 were detected.Results: Compared with the control group, the Ghrelin level, IL-10 level, Occludin, ZO-1 mRNA expression and Bcl-2 expression in the Hp group were greatly reduced, the MTL, 5-HT levels, damage score, IL-1β, TNF-α levels, apoptosis rate, Bax, p-NF-kB p65/NF-kB p65 expression were greatly increased (P<0.05). Compared with the Hp group, the Ghrelin level, IL-10 level, Occludin, ZO-1 mRNA expression and Bcl-2 expression in the Acacetin-L, Acacetin-H group, positive control group were greatly increased, the MTL, 5-HT levels, damage score, IL-1β, TNF-α levels, apoptosis rate, Bax, p-NF-kB p65/NF-kB p65 expression were greatly reduced, there were differences among different Acacetin groups (P<0.05). Compared with the Acacetin-H group, the Ghrelin level, IL-10 level, Occludin, ZO-1 mRNA expression and Bcl-2 expression in the Acacetin-H+Prostratin group were greatly decreased, the MTL, 5-HT levels, damage score, IL-1β, TNF-α levels, apoptosis rate, Bax, p-NF-kB p65/NF-kB p65 expression were greatly increased (P<0.05).Conclusion: Acacetin can improve gastric mucosal injury in Hp infected mice through NF-κB signaling pathway.

Objective: To investigate the effect of Lobetyolin on cartilage injury in osteoarthritis (OA) rats by regulating the TXNIP/NLRP3 signaling pathway.Methods: The rats were randomly divided into sham group, model group, Lobetyolin low-dose group, Lobetyolin high-dose group, and Lobetyolin high-dose +HY-N2485 (NLRP3 activator) group, with 10 rats in each group. ELISA was used to measure TNF-α, IL-1β, IL-4, CTX-I, CTX-II levels in rat serum. HE and saffron O-green staining were applied to observe morphological changes in articular cartilage tissue. The Mankin score was used to assess the degree of cartilage degeneration. TUNEL was applied to observe apoptosis of rat chondrocytes. Cartilage tissue NO, MDA, and SOD levels were measured. Western blot was used to detect the protein expression of MMP-3, MMP-13, Cleaved-caspase-3, TXNIP and NLRP3 in rat articular cartilage tissue.Results: Compared with the Sham group, the cartilage tissue structure of the rats in the model group was obviously damaged, the serum IL-1β, TNF-α, CTX-I, CTX-II levels, Mankin score, apoptosis rate, NO and MDA levels in cartilage tissue, MMP-3, MMP-13, Cleaved-caspase-3, TXNIP, NLRP3 protein expression levels increased, the serum IL-4 level and cartilage tissue SOD level decreased (P<0.05). Compared with the model group, the degree of cartilage tissue structure destruction in the Lobetyolin low-dose and high-dose groups was reduced, the serum IL-1β, TNF-α, CTX-I, CTX-II levels, Mankin score, apoptosis rate, NO and MDA levels in cartilage tissue, MMP-3, MMP-13, Cleaved-caspase-3, TXNIP, NLRP3 protein expression levels decreased, the serum IL-4 level and cartilage tissue SOD level increased (P<0.05). HY-N2485 could partially reverse the ameliorating effect of Lobetyolin on cartilage injury in OA rats (P<0.05).Conclusion: Lobetyolin can reduce cartilage inflammation, oxidative stress and apoptosis, and alleviate cartilage tissue damage in OA rats, which may be achieved by inhibiting the TXNIP/NLRP3 signaling pathway.

Objective: To investigate the effect of long non-coding RNA nuclear enriched abundant transcript 1 (LncRNA NEAT1) on the biological function of lung cancer A549 cells by regulating the miR-582-5p/COL5A1 signaling pathway.Methods: Human lung cancer A549 cells were cultured in vitro and randomly grouped into a control group, si-NEAT1 group (transfected with LncRNA NEAT1 siRNA plasmid), miR-582-5p mimics group (transfected with miR-582-5p mimics), si-NC+miR-582-5p-NC group (co transfected with LncRNA NEAT1 siRNA negative control and miR-582-5p negative control), and si-NEAT1+miR-582-5p inhibitor group (co transfected with LncRNA NEAT1 siRNA plasmid and miR-582-5p inhibitor). After grouping and transfection, real-time fluorescence quantitative PCR experiment was applied to detect the expression of LncRNA NEAT1, miR-582-5p, and COL5A1 in cells. Nude mouse transplantation tumor model was constructed, and the mass and volume of the nude mouse transplantation tumor were measured. CCK-8 experiment and clone formation experiment were applied to detect cell proliferation. Immunoblotting experiments were applied to detect the expression of proliferation related proteins (cyclin D1, PCNA) in cells and nude mouse transplanted tumor tissues. Transwell experiment was applied to detect cell migration and invasion. Immunoblotting experiment was applied to detect the expression of epithelial mesenchymal transition (EMT) related proteins (Vimentin, MMP2, E-cadherin) in cells. Dual luciferase reporter gene assay was applied to detect the targeted regulatory effects of LncRNA NEAT1 on miR-582-5p and miR-582-5p on COL5A1 in cells.Results: Compared with the control group, the expression of COL5A1 mRNA, cell viability and clone formation rate, weight and volume of nude mouse transplanted tumors, expression of cyclin D1 and PCNA proteins, numbers of cell migration and invasion, and expression of Vimentin and MMP2 proteins in cells and nude mouse transplanted tumor tissues reduced in the si-NEAT1 group and miR-582-5p mimics group (P<0.05), the expression of miR-582-5p and E-cadherin protein in cells increased (P<0.05); there was no great difference in all indicators in the si-NC+miR-582-5p-NC group (P>0.05). Compared with the si-NEAT1 group, the expression of COL5A1 mRNA, cell viability and clone formation rate, weight and volume of nude mouse transplanted tumors, expression of cyclin D1 and PCNA proteins, numbers of cell migration and invasion, and expression of Vimentin and MMP2 proteins in cells and nude mouse transplanted tumor tissues increased in the si-NEAT1+miR-582-5p inhibitor group (P<0.05), the expression of miR-582-5p and E-cadherin protein in cells decreased (P<0.05). LncRNA NEAT1 was able to target downregulation of miR-582-5p in A549 cells, and miR-582-5p was able to target downregulation of COL5A1 in A549 cells (P<0.05).Conclusion: Knocking down LncRNA NEAT1 can reduce COL5A1 expression by upregulating miR-582-5p expression, thereby inhibiting in vitro and in vivo growths of lung cancer A549 cells and weakening their invasion and migration activities.

Objective: To investigate the effect of baicalin on high glucose (HG) induced apoptosis of myocardial cells by regulating the stromal cell derived factor 1 (SDF-1)/chemokine receptor 4 (CXCR4) signaling pathway.Methods: H9C2 myocardial cells were used as the research object and grouped into control group, HG group, low concentration baicalin group (L-Ba group), medium concentration baicalin group (M-Ba group), high concentration baicalin group (H-Ba group), and baicalin+CXCR4 inhibitor group (Ba+AMD3100 group). CCK-8 method was applied to detect cell viability in each group; flow cytometry was applied to detect the apoptosis rate of cells in each group; qRT-PCR was applied to detect the mRNA expression of Bax and Bcl-2 of cells in each group; microplate method was applied to detect SOD activity and content of MDA of cells in each group; Western blot (WB) was applied to detect the expression levels of SDF-1 and CXCR4 proteins of cells in each group.Results: Compared with the control group, the survival rate, relative expression of Bcl-2 mRNA, SOD activity, and expression levels of SDF-1 and CXCR4 proteins in the HG group decreased, the apoptosis rate of myocardial cells, relative expression of Bax mRNA, and content of MDA increased (P<0.05); compared with the HG group, the survival rate, relative expression of Bcl-2 mRNA, SOD activity, and expression levels of SDF-1 and CXCR4 proteins in the L-Ba group, M-Ba group, H-Ba group increased, the apoptosis rate of myocardial cells, relative expression of Bax mRNA, and content of MDA decreased, and showed gradual upward or downward trend as the concentration of baicalin increased (P<0.05); the survival rate of myocardial cells, relative expression of Bcl-2 mRNA, SOD activity, and protein expression levels of SDF-1 and CXCR4 in the Ba+AMD3100 group were lower than those in the L-Ba, M-Ba, and H-Ba groups, the apoptosis rate of myocardial cells, relative expression of Bax mRNA, and content of MDA were higher in the L-Ba group, M-Ba group, and H-Ba group (P<0.05).Conclusion: Baicalin can alleviate HG-induced apoptosis of myocardial cells by activating the SDF-1/CXCR4 signaling pathway.

Objective: To investigate the effect of sevoflurane (Sevo) on lung tissue damage in pulmonary tuberculosis (PTB) rats by regulating the nuclear factor E2 related factor (Nrf2)/heme oxygenase (HO-1) signaling pathway.Methods: A PTB rat model was established. The rats were separated into control group, model group, high-dose, medium-dose, and low-dose sevoflurane groups (S-H group, S-M group, S-L group), and high-dose sevoflurane+Nrf2 inhibitor group (S-H+ML385 group). The levels of inflammatory factors and oxidative stress in serum were detected, the pathological changes in rat lung tissue were observed and the number of tuberculosis bacteria was calculated, and protein expression was detected.Results: Compared with the control group, the model group showed more severe lung tissue damage, with a large number of tuberculosis nodules and inflammatory cell infiltration, and disordered alveolar structure, the number of tuberculosis bacterial colonies increased, and the levels of IL-6, TNF-α, IL-1β, MDA and ROS increased, the level of SOD decreased, and the expression of Nrf2 and HO-1 was down regulated (P<0.05). Compared with the model group, the lung tissue damage was improved in the S-L, S-M, and S-H groups, the number of tuberculosis bacterial colonies decreased, the levels of IL-6, TNF-α, IL-1β, MDA, and ROS decreased, the level of SOD increased, and the expression of Nrf2 and HO-1 was upregulated (P<0.05). Compared with the S-H group, the lung tissue damage in the S-H+ML385 group worsened, the number of tuberculosis bacterial colonies increased, and the levels of IL-6, TNF-α, IL-1β, MDA, and ROS increased, the level of SOD decreased, and the expression of Nrf2 and HO-1 was down regulated (P<0.05).Conclusion: Sevoflurane can improve lung tissue damage in rats with pulmonary tuberculosis, possibly by activating the Nrf2/HO-1 signaling pathway.

Objective: To investigate the impact of trastuzumab on macrophage-related signaling factors and prognosis in human epidermal growth factor receptor 2 (HER2)-positive breast cancer.Methods: A total of 155 patients with primary, non-metastatic HER2⁺ breast cancer who underwent surgery between January 2013 and December 2020 were enrolled in this study. Immunohistochemistry was used to analyze the expression levels of CD8⁺, CD4⁺, FOXP3⁺ tumor-infiltrating lymphocytes (TILs) and CD68⁺, CD163⁺ tumor-associated macrophages (TAMs) in tumor tissues. Spearman correlation analysis was used to assess the correlation between TILs and TAMs. Univariate and multivariate Cox regression analyses were performed to evaluate prognostic factors in patients who received adjuvant trastuzumab therapy.Results: Thirty-two patients (20.6%) died during the follow-up period. The median follow-up time for all patients was 53.57 months (range, 33.30~72.37). FOXP3⁺ TIL counts were positively correlated with CD4⁺ and CD8⁺ TIL counts (P<0.001). CD4⁺, CD8⁺, and FOXP3⁺ TIL counts were positively correlated with CD163⁺ and CD68⁺ TAM counts (P<0.001). Cox regression analysis showed that lymphovascular invasion (OR=2.631, 95% CI=1.218-5.685), CD68⁺ TAM (OR=1.002, 95% CI=1.001-1.003), CD8⁺ TIL (OR=1.002, 95% CI=1.001-1.004), and Ki-67 proliferation index (OR=0.998, 95% CI=0.997-1.000) were independent prognostic factors for patients receiving adjuvant trastuzumab therapy (P<0.05). ROC analysis showed that when the cutoff value for CD68⁺ TAM was 235.33, the AUC for predicting patient death was 0.933 (95% CI=0.896~0.970), with a sensitivity of 93.8% and a specificity of 83.7%. When the cutoff value for CD8⁺ TIL was 53.67, the AUC for predicting patient death was 0.645 (95% CI=0.536-0.754), with a sensitivity of 56.3% and a specificity of 65.0%.Conclusion: High counts of CD68⁺ TAM and CD8⁺ TIL were associated with poor prognosis in HER2⁺ breast cancer patients receiving trastuzumab therapy, and CD68⁺ TAM counts had a higher predictive value for adverse prognosis.

Objective: To investigate the effect of Yiyaobi Ⅱ on the expression and biological behavior of mouse model of rheumatoid arthritis by mediating KLF2 regulation of PI3K/Akt/mTOR pathway. Methods: A total of 80 Kunming mice were divided into control group, model group, Yiyaobi Ⅱ group, low dose group and high dose group. Except the control group, RA model was established by intradermal injection of Freund's complete adjuvant in the left posterior toe of the other groups. Yiyaobi Ⅱ group, low, and high dose groups were given corresponding doses of drugs by intragastric administration on the first day of successful modeling for 3 months, and control group and model group were given equal volume of normal saline. After the experiment, PEL, joint inflammation score and toe volume were measured. The levels of KLF2, PI3K, Akt and mTOR were determined by RT-PCR, Western blot and immunohistochemistry. Results: The PEL of the model group was lower than that of the control group, while the arthritis inflammation score and paw volume were higher than those of the control group (P<0.05). In the low- and high-dose Yiyaobi Ⅱ groups, the PEL was higher, and the arthritis inflammation score and paw volume were lower compared to the model group (P<0.05). With increasing doses of Yiyaobi Ⅱ, PEL increased, while the arthritis inflammation score and paw volume decreased (P<0.05). The expression of KLF2, PI3K, Akt, and mTOR mRNA and proteins in the ankle cartilage of the model group was higher than in the control group (P<0.05). In the low- and high-dose Yiyaobi Ⅱ groups, the expression of these markers was lower than in the model group (P<0.05), with expression levels decreasing as the dose increased (P<0.05).Conclusion:Yiyaobi Ⅱ has a significant therapeutic effect on rheumatoid arthritis in mice, notably inhibiting synovitis and inflammation in the ankle cartilage. The mechanism is associated with suppressing the activation of the KLF2-PI3K-Akt-mTOR pathway in rheumatoid arthritis.

Objective: To investigate the effect of dulaglutide (Dula) on kidney injury in rats with type 2 diabetic nephropathy (T2DN) and explore the underlying mechanism based on the transforming growth factor-β₁ (TGF-β₁)/Smad signaling pathway.Methods: A total of 10 rats were randomly selected as the Control group, while the remaining rats were used to establish a T2DN model. Successfully modeled rats were divided into five groups: T2DN group, L-Dula group (low-dose Dulaglutide), M-Dula group (medium-dose Dulaglutide), H-Dula group (high-dose Dulaglutide), and Dula+SRI-011381 group, with 10 rats per group. The body weight of each group was measured. Serum levels of albumin (ALB), serum creatinine (Scr), blood urea nitrogen (BUN), triglycerides (TG), and total cholesterol (TC) were detected using an automatic biochemical analyzer. Hematoxylin-eosin (HE) and periodic acid-Schiff (PAS) staining were employed to observe pathological changes in kidney tissues. Western blotting was used to detect the expression of TGF-β₁, Smad2/3, and Smad7 proteins in the kidney tissue of T2DN rats.Results: In the T2DN group, glomerular hypertrophy, thickened basement membranes, shrunken cavities, inflammatory cell infiltration in the interstitial region, and increased glycogen deposition in the glomeruli were observed. Red-stained areas were visible, and the levels of 24-hour urinary protein, Scr, BUN, fasting blood glucose (FBG), TG, TC, TGF-β₁, and Smad2/3 were significantly higher, while body weight and Smad7 expression were lower than in the Control group (P<0.05). The severity of glomerular and tubular lesions decreased progressively from the L-Dula to the H-Dula group, with a reduction in red-stained areas. Levels of 24-hour urinary protein, Scr, BUN, FBG, TG, TC, TGF-β₁, and Smad2/3 were lower in the Dula-treated groups compared to the T2DN group, and body weight and Smad7 expression were higher (P<0.05). In the Dula+SRI-011381 group, glomerular and tubular damage worsened, with larger red-stained areas, higher levels of 24-hour urinary protein, Scr, BUN, FBG, TG, TC, TGF-β₁, and Smad2/3, and lower body weight and Smad7 expression compared to the H-Dula group (P<0.05).Conclusion: Dulaglutide may inhibit kidney injury in T2DN rats by suppressing the TGF-β₁/Smad signaling pathway.

Objective: To investigate the effect of RNPEP on the biological behavior of gastric cancer cells and its possible mechanism.Methods: RNPEP mRNA levels in normal gastric tissues and gastric cancer tissues were detected by RT-qPCR. THP-1 cells were cultured and induced into M0 macrophages, which were divided into control group and RNPEP overexpression group. The expression levels of RNPEP, GSDME, NLRP3, IL-1β and IL-18 in macrophages were detected by Western blotting. Human gastric adenocarcinoma cell MGC-803 was co-cultured with M0 macrophages of the control and RNPEP overexpression groups, and divided into control group and RNPEP overexpression group. MGC-803 cells and M0 macrophages in the over-expressing RNPEP group were co-cultured, and IL-1β IgG1 homologous antibody and IL-1β IgG1 neutralizing antibody were added to the culture medium of the two groups, respectively, and they were divided into the RNPEP over-expression group and the inhibiting IL-1β group. The proliferation ability of MGC-803 gastric cancer cells was detected by EdU kit. The invasive ability of MGC-803 gastric cancer cells was detected by Transwell assay. The migration ability of MGC-803 gastric cancer cells was detected by scratch test.Results: Compared with normal tissues, mRNA level of RNPEP was increased in gastric cancer tissues (P<0.05). Compared with the control group, the expressions of RNPEP, GSDME, NLRP3, IL-1β, and IL-18 in macrophages of the RNPEP over-expression group were increased (P<0.05). Compared with the control group, the proliferation, migration and invasion ability of MGC-803 cells in the RNPEP over-expression group were increased (P<0.05). Compared with the RNPEP over-expression group, the proliferation, migration, and invasion ability of MGC-803 cells in IL-1β inhibition group were decreased (P<0.05).Conclusion:The secreted protein RNPEP can promote the biological behavior of gastric cancer cells by up-regulating pyroptosis of macrophages.

Objective: To investigate the impacts of Oleuropein (Ole) on the malignant biological behavior of cholangiocarcinoma cells by regulating the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway.Methods: HuCCT1 cells in logarithmic growth phase were divided into control group, 100μg/mL Ole group, 200μg/mL Ole group, 400μg/mL Ole group, 800μg/mL Ole group, and Ole+JAK2/STAT3 signaling pathway activator (Colivelin) group. The control group was not treated, and HuCCT1 cells in 100μg/mL Ole group, 200μg/mL Ole group, 400μg/mL Ole group, and 800μg/mL Ole groups were treated with 100, 200, 400, and 800μg/mL Ole, and the Ole+Colivelin group treated HuCCT1 cells with (800μg/mL Ole and 0.5μmoL/L Colivelin respectively). CCK-8 method, plate cloning method, and flow cytometry were applied to determine cell viability, cloning, and apoptosis, respectively. Transwell experiment was applied to detect cell migration and invasion. Western blot was applied to determine the expression of JAK2/STAT3 signaling pathway proteins and apoptotic proteins.Results: The HuCCT1 cell viability and number of cloned cells in the 100, 200, 400, and 800μg/mL Ole groups were lower than those in the control group, and the apoptosis rate was higher than that in the control group, the trend of change was Ole dose-dependent (P<0.05). Compared with the 800μg/mL Ole group, the HuCCT1 cell viability and number of cloned cells in the Ole+Colivelin group increased, while the apoptosis rate decreased (P<0.05). Compared with the control group, the migration and invasion of HuCCT1 cells in the 100, 200, 400, and 800μg/mL Ole groups showed an Ole dose-dependent decrease (P<0.05). Compared with the 800μg/mL Ole group, the migration and invasion of HuCCT1 cells in the Ole+Colivelin group increased (P<0.05). Compared with the control group, the protein expression of p-JAK2/JAK2, p-STAT3/STAT3, and Bcl-2 in HuCCT1 cells in the 100, 200, 400, and 800μg/mL Ole groups showed an Ole dose-dependent decrease, the protein expression of Bax showed an Ole dose-dependent increase (P<0.05). Compared with the 800μg/mL Ole group, the expression of p-JAK2/JAK2, p-STAT3/STAT3, and Bcl-2 proteins in HuCCT1 cells in the Ole+Colivelin group increased, the protein expression of Bax decreased (P<0.05). Conclusion:Ole may inhibit the malignant biological behavior of cholangiocarcinoma cells by inhibiting the activation of the JAK2/STAT3 signaling pathway.

Objective: To analyze the changes of serum interleukin-6 (IL-6), interleukin-17 (IL-17) and interleukin-35 (IL-35) levels in children with acute lymphoblastic leukemia (ALL) with different disease conditions and chemotherapy efficacy.Methods: A total of 95 children with ALL admitted to the hospital from October 2018 to October 2023 were divided into initial stage group (n=45) and advanced stage group (n=50) according to the severity of admission examination. By means of efficacy after 1 cycle of chemotherapy, they were classified into remission group (n=70) and non-remission group (n=25). Serum IL-6, IL-17 and IL-35 levels were measured among the study subjects. Binary Logistic regression analysis was used to construct an evaluation model with serum IL-6, IL-17 and IL-35 levels as variables. Receiver operating characteristic curve (ROC) was applied to analyze the evaluated value of serum IL-6, IL-17 and IL-35 on disease condition of children.Results: The levels of serum IL-6, IL-17 and IL-35 of advanced stage group were higher than initial stage group (P<0.05). Serum IL-6, IL-17 and IL-35 of non-remission group were higher than remission group (P<0.05). Logistic regression analysis indicated that serum IL-6, IL-17 and IL-35 were independent risk factors for disease progression of children with ALL, and the evaluation model was logit(P)=-7.052+0.206×IL-6+0.238×IL-17+0.406×IL-35. ROC analysis suggested the AUC of serum IL-6, IL-17 and IL-35 levels combined to evaluate the severity of childhood acute lymphoblastic leukemia was 0.918, the sensitivity was 80.00%, and the specificity was 95.56%, which was better than that of each index alone (P<0.05).Conclusion: Serum levels of IL-6, IL-17 and IL-35 are significantly different among ALL children with different disease conditions and chemotherapy efficacy. Early detection of serum IL-6, IL-17 and IL-35 can provide certain reference value for the evaluation of leukemia.

Objective: To explore and analyze the association between changes of neutrophil (NE) and coagulation parameters and lower extremity deep venous thrombosis (DVT) in patients after craniocerebral trauma surgery.Methods: A total of 105 patients with craniocerebral trauma in the hospital were enrolled from April 2021 to April 2024. The changes of NE, four coagulation indexes and D-dimer (D-D) were measured after surgery. Logistic regression analysis was used to analyze the related factors affecting the occurrence of lower extremity DVT, and receiver operating characteristic curve (ROC) was drawn to evaluate the predictive efficiency of NE and coagulation parameters on lower extremity DVT.Results: The thrombin time (TT), prothrombin time (PT) and activated partial prothrombin time (APTT) of lower extremity DVT patients after craniocerebral trauma surgery were significantly shorter than those of non-DVT patients (P<0.05), and the levels of NE, fibrinogen (FIB) and D-D were significantly higher (P<0.05). The proportion of tracheotomy in DVT patients was higher than that in non-DVT patients, and the surgical time was longer than that in non-DVT patients (P<0.05). Logistic regression analysis suggested that tracheotomy, surgical time, NE, PT, FIB and D-D were the risk factors affecting postoperative lower extremity DVT (P<0.05). ROC curve indicated that the AUCs of NE, PT, FIB and D-D in evaluating lower extremity DVT were 0.787, 0.769, 0.707 and 0.779 respectively. The AUC of the combination of the four indexes in assessing lower extremity DVT was 0.958, and the sensitivity and specificity under the maximum Youden index were 0.962 and 0.899 respectively.Conclusion: The abnormal changes of coagulation parameters such as NE, PT, FIB and D-D in patients after craniocerebral trauma surgery are related to the risk of lower extremity DVT, and the combination of NE, PT, FIB and D-D has high predictive value on lower extremity DVT.

Objective: To observe the relationship between changes of homocysteine (Hcy), apolipoprotein B (ApoB)/apolipoprotein AⅠ(ApoAⅠ) and ambulatory arterial stiffness index (AASI) and carotid plaque properties in elderly patients with acute cerebral infarction (ACI).Methods: A total of 103 elderly patients with ACI (61 cases of stable plaque and 42 cases of unstable plaque) admitted to hospital from July 2021 to July 2023 were included. The Hcy, ApoB/ApoAⅠand AASI were observed. The relationship between Hcy, ApoB, ApoAⅠ, AASI and carotid plaque properties was analyzed by univariate analysis and multivariate Logistic regression analysis, and receiver operating characteristic curve (ROC) was plotted to analyze the evaluated efficiency of the three indicators on carotid plaque properties.Results: The Hcy, ApoB/ApoAⅠ, AASI and carotid intima-media thickness (IMT) in unstable plaque group were significantly higher than those in stable plaque group (P<0.05). Pearson correlation showed that Hcy, ApoB/ApoAⅠand AASI were positively correlated with IMT, showing statistical significance (r=0.354, 0.372, 0.390, P<0.05). Univariate analysis suggested that hypertension, diabetes mellitus and hyperlipidemia were related to the carotid plaque properties (P<0.05). Multivariate Logistic regression analysis revealed that hypertension, diabetes mellitus, hyperlipidemia, Hcy, ApoB/ApoAⅠ, and AASI were risk factors affecting the carotid plaque properties (P<0.05). ROC analysis showed that the AUCs of Hcy, ApoB/ApoAⅠ and AASI in evaluating the carotid plaque properties were 0.696, 0.711 and 0.764 respectively. The AUC of the combined evaluation of the three indicators was the highest (0.853), and the sensitivity and specificity under the maximum Youden index were 0.952 and 0.607 respectively.Conclusion: The changes of Hcy, ApoB/ApoAⅠ and AASI in elderly patients with ACI are related to the carotid plaque properties, and have certain evaluated value on unstable plaque.

Objective: To analyze the clinicopathological features, immunohistochemical features and prognosis of clear cell renal cell carcinoma (CCRCC) and papillary renal cell carcinoma (PRCC).Methods: The clinical data of 80 patients with renal cell carcinoma in the hospital from April 2021 to April 2023 were retrospectively analyzed. According to the pathological results, the patients were divided into CCRCC group (n=50) and PRCC group (n=30). The basic data, clinicopathological features and immunohistochemical features were compared between the two groups. All patients received surgical treatment and were followed up after discharge. The survival status at 1 year after surgery was counted and compared.Results: The hematuria ratio in CCRCC group was lower than that in PRCC group (P<0.05). There were no statistical differences in tumor diameter, T staging, N staging, M staging, renal envelope invasion and Fuhrman grading between CCRCC group and PRCC group (P>0.05). The positive rate of CD10 in CCRCC group was higher than that in PRCC group (P<0.05) while the positive rate of CK7 was lower than that in PRCC group (P<0.05), but the positive rates of PAX-8, TFE-3 and Vimentin revealed no statistical differences between CCRCC group and PRCC group (P>0.05). There was no statistical significance in survival status at 1 year after surgery in CCRCC group compared to PRCC group (P>0.05).Conclusion: There are differences in hematuria and immunohistochemical CD10 and CK7 positive expressions between CCRCC patients and PRCC patients, and the short-term prognosis is similar.

Objective: To observe the computed tomography (CT) and magnetic resonance imaging (MRI) features of patients with orbital cavernous hemangioma and orbital schwannoma, and value of the two methods in differential diagnosis.Methods: From January 2021 to January 2024, 82 patients with orbital cavernous hemangioma and orbital schwannoma were admited to our hospital, and they were selected as the research subjects. Based on surgical and pathological results, the patients were divided into cavernous hemangioma group (n=44) and schwannoma group (n=38). All patients underwent CT and MRI examinations before surgery. CT and MRI features of the two groups were comparatively analyzed. The value of the two imaging methods in differential diagnosis of orbital cavernous hemangioma and orbital schwannoma was compared.Results: CT examination showed that the density of soft tissues in patients with cavernous hemangioma was uniform, and the proportion of CT values ≥ 50HU was higher than that in patients with schwannoma (P<0.05). MRI examination showed that patients with cavernous hemangioma had flatter eyeball walls, with equal signal intensity on T1WI and T2WI, uniform and progressively enhanced signals on T1WI and T2WI. The proportion of plateau/outflow type TIC was higher than that in patients with schwannoma (P<0.05). The accordance rates of MRI were higher than those of CT for qualitative diagnosis and localization diagnosis of orbital cavernous hemangioma and orbital schwannoma (P<0.05).Conclusion: MRI features of patients with orbital cavernous hemangioma and orbital schwannoma are significantly different. MRI is superior to CT for qualitative diagnosis and localization diagnosis of orbital cavernous hemangioma and orbital schwannoma, and can provide an imaging basis for clinical diagnosis and differentiation.

Objective: To analyze the value of serum creatine kinase isoenzyme (CK-MB) combined with blood lactic acid on the prediction of short-term prognosis in patients with multiple trauma.Methods: Totally 119 patients with multiple trauma in the hospital were collected from January 2020 to December 2023 as the study subjects, and were divided into survival group (n=99) and death group (n=20) by means of 28-day prognosis status. Serum CK-MB and blood lactic acid levels of all subjects were measured after admission. The prediction model with CK-MB and blood lactic acid as variables was constructed by binary Logistic regression analysis. Receiver operating characteristic curve (ROC) was performed to analyze the predictive value of serum CK-MB and blood lactic acid on short-term prognosis of patients.Results: The levels of serum CK-MB and blood lactic acid in the death group were higher than those in the survival group (P<0.05). Logistic regression analysis indicated that CK-MB and blood lactic acid were independent predictors of short-term prognosis in patients with multiple trauma, and the prediction model was logit(P)=-6.789 + 0.188 × CK-MB + 0.234 × blood lactic acid. ROC curve analysis showed that the area under the curve (AUC), sensitivity and specificity of serum CK-MB combined with blood lactic acid in predicting the short-term prognosis were 0.997, 100.00% and 98.99%, which were better than each indicator alone (P<0.05).Conclusion: Serum CK-MB and blood lactic acid are closely related to the short-term prognosis in patients with multiple trauma. Early detection of CK-MB and blood lactic acid levels has certain predictive value on the short-term prognosis of patients with multiple trauma, and the combined prediction of the two indicators is more effective.

Objective: To explore the correlation between streptococcal infections and the various classifications of Henoch-Schönlein Purpura (HSP) in children, focusing on associated clinical and laboratory parameters.Methods: From January 2021 to December 2023, 78 children diagnosed with HSP at Nanjing Gaochun People's Hospital were enrolled. They were divided into ASO positive and ASO negative groups for analysis of incidence rates and laboratory indicators. The children were further classified based on clinical manifestations into simple, joint, abdominal, renal, and mixed types. Additionally, 50 healthy children undergoing routine physical examinations at the same hospital were included as controls. Serum samples from all participants were tested for IgG and IgM antibodies, C4 complement levels, and throat swab cultures were performed to determine the relationship between streptococcal infection and HSP types.Results: The ASO positive group, generally older, showed significantly higher serum albumin levels (26.73±5.22 g/L) than the ASO negative group (23.45±4.88 g/L)(P<0.05), with no marked differences in urea and creatinine levels between the groups (P>0.05). Among immunoglobulin and complement levels, only IgA showed significant differences (P<0.05). IgG levels did not significantly vary among different HSP subtypes compared to controls, while IgM levels displayed significant differences (P<0.05). C4 levels were consistent across subtypes and controls (P>0.05). In terms of streptococcal types, type B hemolytic streptococcus appeared in 2.00% of the control group, and grass green streptococcus in 50.00%. Each HSP subtype had a distinct distribution of these bacteria, with type B hemolytic and grass green streptococci showing variable prevalence among the joint, abdominal, renal, and mixed types.Conclusion: This study substantiates a significant link between streptococcal infections and the subtypes of allergic purpura (HSP) in pediatric patients. The association of ASO titers with specific clinical features and laboratory markers underscores the critical role of streptococcal infection consideration in the diagnostic and treatment strategies for HSP. This underscores the need for vigilant monitoring and management of streptococcal infections to optimize outcomes for children with HSP.

Objective: To explore the influence of 3D printing navigation-assisted neuroendoscopic hematoma evacuation on hematoma clearance rate, postoperative recovery, and prognosis in patients with hypertensive intracerebral hemorrhage (HICH).Methods: The clinical data of HICH patients admitted to our hospital from March 2020 to September 2023 were retrospectively analyzed. Among the patients, 51 who received CT-guided neuroendoscopic hematoma evacuation were included in control group, and another 51 who were given 3D printing navigation-assisted neuroendoscopic hematoma evacuation were enrolled as observation group. The surgical status, postoperative recovery status and occurrence of postoperative complications, hemodynamic indicators, and brain neurological function indicators before surgery and at 1 week after surgery were compared between the two groups, and the prognosis was evaluated.Results: In observation group, except that the hematoma clearance rate was significantly higher than that in control group, the other surgical indicators and postoperative recovery indicators were lower than those in control group (P<0.05). Within 1 week after surgery, there were no statistical differences in the incidence rates of postoperative complications between groups (P>0.05). At 1 week after surgery, the NSE in the two groups was significantly enhanced than that before treatment, and the other hemodynamic indicators and brain nerve function indicators were significantly risen compared with those before treatment, and absolute values of pre- and post-operative differences were higher in the observation group than in the control group (P<0.05). The GOS score in observation group was higher than that in control group (P<0.05).Conclusion: 3D printing navigation-assisted neuroendoscopic hematoma evacuation can contribute to the recovery and prognosis of HICH patients, and has high hematoma clearance rate, and it can significantly improve the hemodynamic indicators and brain neurological function indicators, and has low risk of complications.

Objective: To compare and analyze the postoperative recovery status of 3D laparoscopic regional hepatic blood flow occlusion and intermittent total hepatic blood flow occlusion in patients with PLC treated by LH.Methods: A total of 109 PLC patients (from March 2023 to March 2024) were selected for the study, all of whom received LH surgical treatment. 54 patients using regional hepatic blood flow obstruction were classified as the observation group, and another 55 patients who adopted intermittent total hepatic blood flow obstruction were set as the control group. The perioperative indexes were compared and analyzed, and the changes of liver function indexes and gastrointestinal function indexes [serum gastrin (GAS), plasma motilin (MTL)] before surgery and at 3 days after the surgery were statistically analyzed.Results: Operation and treatment time, bleeding status during surgery, hepatic blood flow occlusion time and overall hospital stay in the observation group were shorter or lower (P<0.05). After 3 months follow-up, the incidence of complications in the observation group (3.70%) was lower than that in the control group (18.18%) (P<0.05). The difference of serum ALT, AST, TBIL, DBIL levels between pre-operation and post-operation in observation group were less than that in control group (P<0.05); the difference of serum GAS content and plasma MTL level between pre-operation and post-operation in observation group were less than in control group (P<0.05).Conclusion: Compared with 3D laparoscopic regional hepatic blood flow occlusion in the treatment of PLC patients, intermittent total hepatic blood flow occlusion has shorter surgical time, less intraoperative blood loss and no blood flow occlusion time, and the latter one can better shorten the hospitalization time, which may be related to the small influence of the surgery on postoperative liver function and gastrointestinal function.

Objective: To study the relationship between serum pro-brain natriuretic peptide (Pro-BNP), electrocardiogram QRS wave duration, and cardiac ultrasound parameters in patients with heart failure (HF).Methods: Totally 104 patients with HF in the hospital were selected from January 2023 to March 2024 as the study subjects, and 30 patients with normal cardiac function during the same period were made the control group. Serum Pro-BNP detection, electrocardiogram examination and echocardiography were performed in both groups. The two groups were compared in terms of serum Pro-BNP level, QRS wave duration and cardiac ultrasound parameters [left ventricular ejection fraction (LVEF), LVEDV and LVESV]. According to the cardiac function evaluation status and prognosis status, patients with HF were divided into grade I-II group, grade III-IV group, good prognosis group, and poor prognosis group. Serum Pro-BNP level, QRS wave duration and cardiac ultrasound parameters were compared between grade I-II group and grade III-IV group and between good prognosis group and poor prognosis group. Pearson correlation analysis was performed on the relationship between these indicators in patients with HF.Results: Serum Pro-BNP level, QRS wave duration, LVEDV and LVESV in the heart failure group were higher (P<0.05) while LVEF was lower than in the control group (P<0.05). Serum Pro-BNP level, QRS wave duration, LVEDV and LVESV in cardiac function grade III-IV group were higher (P<0.05) while LVEF was lower compared to grade I-II group (P<0.05). The level of serum Pro-BNP, QRS wave duration, LVEDV and LVESV in the poor prognosis group were higher than in the good prognosis group (P<0.05) while the LVEF was lower (P<0.05). Serum Pro-BNP level in patients with HF was positively correlated with QRS wave duration, LVEDV and LVESV (P<0.05), and was negatively correlated with LVEF (P<0.05). QRS wave duration was positively associated with LVEDV and LVESV (P<0.05), and inversely related to LVEF (P<0.05).Conclusion: There is a significant correlation between serum Pro-BNP level, electrocardiogram QRS wave duration and cardiac ultrasound parameters in patients with heart failure, and the above indicators are associated with the disease condition and prognosis of patients.

Objective: To compare the influence of laparoscopic choledocholithotomy and ERCP (endoscopic retrograde cholangiopancreatography) on postoperative recovery and long-term follow-up outcome in patients with bile duct stones (BDS) and gallbladder stones (GBS).Methods: Totally 128 BDS patients with GBS in the hospital from May 2019 to May 2022 were divided into laparoscopic group (n=66, laparoscopic choledocholithotomy) and ERCP group (n=62, ERCP) by means of the surgical methods. The success rate of one surgery, surgical time, intraoperative blood loss, Winslow foramen/nasobiliary drainage time, postoperative first exhaust time, ambulation time, hospitalization time and cost and postoperative complications were compared between groups, and the stone recurrence rate in both groups was observed at 2 years after surgery.Results: The success rate of one surgery in the laparoscopic group was higher than that in the ERCP group, and the surgical time and intraoperative blood loss were longer or more than those in the ERCP group while the Winslow foramen/nasobiliary drainage time was shorter (P<0.05). Compared with the ERCP group, the postoperative first exhaust time, ambulation time and postoperative hospitalization time were shortened in the laparoscopic group, and the hospitalization cost was increased (P<0.05). The postoperative complications revealed no obvious differences between groups (P>0.05). The stone recurrence rate in the laparoscopic group within 2 years after surgery was obviously lower than that in the ERCP group (P<0.05).Conclusion: Laparoscopic choledocholithotomy and ERCP can achieve significant results in the treatment of patients with bile duct stones and gallbladder stones. Compared with ERCP, laparoscopic choledocholithotomy has faster postoperative recovery and lower long-term recurrence rate, but has higher surgical cost.

Objective: To explore the clinical effect of three different regimens on patients with breast cancer (BC).Methods: Totally 155 patients with BC in the hospital were selected from February 2019 to February 2022, and were divided into three groups by means of different treatment regimens. Patients in group A (n=50) were treated with endoscopic breast-conserving surgery, patients in group B (n=53) received endoscopic breast-conserving surgery + radiofrequency ablation, and patients in group C (n=52) were given endoscopic breast-conserving surgery + radiotherapy. The tumor residual rate of residual cavity edge, clinical efficacy, incidence of complications, quality of life [functional assessment of cancer therapy-breast (FACT-B)] and long-term prognosis were compared among the three groups.Results: There was no statistical significance in the residual tumor rate among group A, group B and group C (16.00% vs 5.66% vs 7.55%, P>0.05). Compared with group A, the objective response rate in group B was higher (83.02% vs 56.00%, P<0.0167), and the objective response rate was statistically different among group A, group B and group C (56.00% vs 83.02% vs 65.38%, P<0.05). There was no statistical difference in the incidence of postoperative complications among group A, group B and group C (16.00% vs 11.32% vs 17.31%, P>0.05). At 3 months after surgery, FACT-B scores in all three groups were enhanced compared with those before surgery (P<0.05), and compared with groups A and C, the increases in group B were greater (P<0.05). After 2 years of follow-up, compared with group A, the local recurrence rate in group C was lower (1.92% vs 16.00%, P<0.0167), but there was no statistical significance in the local recurrence rate between group B and group C (13.21% vs 1.92%, P>0.05), and no statistical significance was shown in the local recurrence rate between group B and group A (13.21% vs 16.00%, P>0.05). The 2-year survival rate revealed no statistical difference among groups A, B and C (88.00% vs 86.79% vs 86.54%, P>0.05).Conclusion: Endoscopic breast-conserving surgery combined with radiofrequency ablation has better clinical efficacy and quality of life, and endoscopic breast-conserving surgery combined with radiotherapy has lower recurrence rate. Both regimens have similar tumor residual rate of residual cavity edge, complications and 2-year survival rate as simple endoscopic breast-conserving surgery.

Objective: To explore the etiological distribution and high-risk factors of concurrent bacterial infection in hospitalized children with Mycoplasma pneumoniae pneumonia (MPP).Methods: A total of 520 hospitalized children with MPP in the hospital were selected from June 2022 to April 2024 as the research subjects, and they underwent sputum culture pathogen detection. According to the results of automatic microbial identification, the occurrence of concurrent bacterial infection and etiological distribution results of concurrent bacterial infection in these research subjects were recorded. The children with concurrent bacterial infection were set as the infection group, and the other children were set as the non-infection group. Univariate analysis was used to analyze the influencing factors of concurrent bacterial infection in hospitalized children with MPP. Multivariate Logistic regression analysis was adopted to analyze the high-risk factors of concurrent bacterial infection in hospitalized children with MPP.Results: Sputum culture of 520 hospitalized children with MPP showed that 177 cases were positive for bacterial infection and 343 cases were negative, and the incidence of bacterial infection in hospital was 34.04%. 182 strains of pathogenic bacteria were detected in 177 hospitalized MPP children with positive bacterial infection, including 121 strains of Gram-negative bacteria (66.48%) and 61 strains of Gram-positive bacteria (33.52%). Gram-negative bacteria were mainly Klebsiella pneumoniae (33.52%) and Pseudomonas aeruginosa (21.43%), and Gram-negative bacteria were mainly Staphylococcus aureus (25.82%). The proportions of age≤3 years old, malnutrition and fever>1 week, skin rash, C-reactive protein>100 mg/L, respiratory support and hospitalization time>14 days in the infection group were higher compared with those in the non-infection group, and the duration of antibiotic use was longer (P<0.05). Multivariate Logistic regression analysis indicated that age≤3 years old (OR=3.086, 95%CI: 1.497-6.361), duration of antibiotic use (OR=1.104, 95%CI: 1.031-1.182), malnutrition (OR=3.043, 95%CI: 1.697-5.458), fever>1 week (OR=3.068, 95%CI: 1.639-5.774), skin rash (OR=2.735, 95%CI: 1.540-4.856), C-reactive protein>100mg/L (OR=3.105, 95%CI: 1.539-6.263), respiratory support (OR=2.954, 95%CI: 1.726-5.053) and hospitalization time>14 days (OR=2.989, 95%CI: 1.703-5.246) were the high-risk factors leading to concurrent bacterial infection in hospitalized children with MPP (P<0.05).Conclusion: Gram-negative bacteria are the main pathogenic bacteria of concurrent bacterial infection in hospitalized children with MPP, among which Klebsiella pneumoniae and Pseudomonas aeruginosa are at the forefront of infection. There are various high-risk factors for concurrent bacterial infection in hospitalized children with MPP, and targeted measures can be taken to prevent bacterial infection according to these factors.

Objective: To analyze the prognostication value of 6 systemic inflammatory indicators, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), systemic immune inflammatory index (SII), pan-immune inflammatory value (PIV), and systemic inflammatory response index (SIRI), in neonates with intrauterine infectious pneumonia.Methods: A total of 306 high-risk newborns with premature rupture of membranes, prenatal fever of pregnant mothers and gestational diabetes mellitus admitted to our hospital from March 2020 to March 2023 were selected as the study subjects. With etiological examination as the "gold standard", 226 newborns confirmed to be infected with pneumonia were selected as the study group. The control group was 80 non-infectious jaundice neonates. All newborns were given 3mL venous blood immediately after delivery and 6 systemic inflammatory indicators (NLR, PLR, MLR, SII, PIV, SIRI) were detected in time.Results: Compared with the control group, the proportion of premature rupture of membranes, maternal diabetes mellitus and prenatal fever in the study group was higher (P<0.05). Compared with the control group, the levels of NLR, PLR, MLR, SII, PIV and SIRI in the study group were higher (P<0.05). Using the occurrence of intrauterine pneumonia in newborns as the dependent variable (no occurrence=0; occurrence=1), select variables with statistical significance in univariate analysis for multivariate logistics regression analysis, the results showed that premature rupture of membranes, maternal diabetes mellitus, maternal prenatal fever, NLR, PLR, MLR, SII, PIV and SIRI were the influencing factors for the occurrence of intrauterine pneumonia in newborns (P<0.05). ROC curve showed that compared with the single diagnosis of NLR, PLR, MLR, SII, PIV and SIRI, the sensitivity and accuracy of the combined diagnosis of neonatal intrauterine infectious pneumonia were higher (P<0.05).Conclusion: The serum levels of NLR, PLR, MLR, SII, PIV and SIRI of newborns with intrauterine pneumonia were high. The accuracy of the six systemic inflammation indicators in predicting neonatal intrauterine pneumonia was more than 70%, and the combined detection was higher than the single detection in predicting neonatal intrauterine pneumonia.

Objective: To investigate the efficacy and safety of endoscopic thyroidectomy (ETS) through submental vestibular combined approach for the treatment of papillary thyroid carcinoma (PTC) by analyzing perioperative stress response and postoperative complication rate. Methods: A total of 114 patients with PTC from the First Affiliated Hospital of Kunming Medical University from January 2020 to October 2023 were selected and randomly divided into two groups using a random number table method, with 57 cases in each group. The control group underwent ETS through the oral vestibular approach, while the observation group underwent ETS through the submental vestibular combined approach. Surgical-related indicators, postoperative pain levels, perioperative stress indicators, parathyroid hormone (PTH) and blood calcium levels, immune function indicators (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), and postoperative complication rates were compared between the two groups. Results: The intraoperative blood loss, postoperative drainage volume, operation time, drainage tube placement, and hospitalization time in the observation group were (21.53±2.69) ml, (33.52±3.09) ml, (60.54±9.12) min, (2.74±0.89) d, and (4.67±1.25) d, respectively, which were all less than those in the control group (24.59±4.37) ml, (36.14±4.18) ml, (80.96±11.23) min, (3.32±1.04) d, and (6.49±1.37) d, with statistically significant differences (t=4.502, 3.805, 10.657, 3.199, 7.409, all P<0.05). The pain VAS scores of the observation group at 4 h, 12 h, 24 h, and 48 h after surgery were (2.11±0.65), (2.84±0.78), (2.34±0.78), and (1.34±0.40), respectively, which were lower than in the control group (2.63±0.80), (3.31±0.87), (2.89±0.82), and (1.92±0.58), respectively, with statistically significant differences (t=3.809, 3.037, 3.669, 6.215, all P<0.05). The NE levels in the observation group at 24 hours and 72 hours after surgery were (0.64±0.12) mmol/L and (0.41±0.07) mmol/L, respectively, which were lower than in the control group (0.72±0.15) mmol/L and (0.46±0.09) mmol/L, and Cor values of (76.92±12.33) μg/L and (52.12±5.27) μg/L, respectively, which were lower than in the control group (85.46±15.02) μg/L and (58.14±7.12) μg/L, with statistically significant differences (t=3.144, 3.311, 3.318, 5.131, all P<0.05). The PTH levels in the observation group were (4.65±1.08) pmol/L and (5.15±0.70) pmol/L at 24 h and 72 h after surgery, respectively, which were higher than in the control group (4.08±1.24) pmol/L and (4.81±0.82) pmol/L. The blood calcium levels were higher than in the control group (2.15±0.09) mmol/L and (2.22±0.07) mmol/L, which were higher than in the control group (2.04±0.12) mmol/L and (2.17±0.09) mmol/L, respectively. The differences were statistically significant (t=2.617, 2.381, 5.537, 3.311, all P<0.05). At 7 days and 1 month after surgery, the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the observation group were (61.33±4.06)%, (68.74±4.27)%, (32.94±3.02)%, (43.98±2.27)%, (1.14±0.12), and (1.76±0.17), respectively, which were higher than in the control group (59.07±3.85)%, (63.24±3.89)%, (28.89±2.74)%, (36.72±2.05)%, (0.93±0.10), and (1.34±0.15), and the CD8⁺ were (29.01±2.45)%, (25.02±2.13)%, which were lower than in the control group (31.14±3.02)%, (27.46±2.77)%, with significant differences (t=3.050, 7.189, 7.498, 17.920, 4.135, 5.272, 10.150, 13.986, P<0.05). The incidence of postoperative complications in the observation group was 3.51%, which was lower than in the control group (15.79%) (χ²=4.930, P<0.05).Conclusion: The treatment of PTC with submental vestibular ETS can reduce inflammation, relieve pain and promote the recovery of immune function with less trauma, rapid postoperative recovery and fewer complications.

Objective: To investigate the safety and efficacy of remimazolam tosilate combined with low-dose esketamine in transendoscopic retrograde cholangiopancreatography (ERCP) of elderly patients.Methods: One hundred and seventy elderly patients undergoing ERCP were randomly separated into group A (86 patients) and group B (84 patients). Group A was anesthetized with remimazolam tosilate combined with low-dose esketamine intravenously, and group B was anesthetized with propofol combined with low-dose sufentanil intravenously. The vital signs indexes at different time points of anesthesia [admission (T0), the moment of endoscopic entry into the laryngopharynx (T1), at cholangiography (T2), at the moment of lithotripsy (T3), at the end of the procedure (T4), and at the time of awakening (T5)] were compared between the two groups, and the MOAA/S scores and adverse reactions were recorded.Results: The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), partial pressure of arterial oxygen (SPO₂) and levels at each time point from T1 to T4 in both groups were greatly lower than those at T0 (P<0.05), and the levels of MAP, HR, RR, and SPO₂ were higher in group A than in group B from T1 to T4 (P<0.05). The VAS score of group A after anesthesia was (1.73±0.33), lower than that of group B (2.15±0.38), MOAA/S score was (4.03±0.67), higher than that of group B (3.19±0.53) (t=7.700, 9.052, all P<0.05). Anesthesia recovery time and spontaneous respiration recovery time in group A were (7.40±2.12) min and (6.53±1.62) min, which were earlier than (11.57±3.26) min and (8.70±2.18) min in group B (t=9.910, 7.378, all P<0.05). The incidences of hypotension and bradycardia in group A were lower than those in group B (P<0.05).Conclusion: Compared with propofol combined with low-dose sufentanil, the use of remimazolam tosilate combined with low-dose esketamine has a better safety and efficacy in ERCP in elderly patients, improves the quality of awakening, and produces relatively fewer adverse effects.

Objective: To investigate the efficacy of gefitinib targeted therapy combined with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) and to analyze the predictors of progression-free survival (PFS).Methods: The clinical data of 255 patients with advanced NSCLC who were diagnosed and treated in the hospital were retrospectively analyzed from January 2019 to December 2021. The above subjects were divided into control group (n=78) and combined group (n=177) by the treatment methods. The control group was treated with conventional chemotherapy, while the combined group received gefitinib targeted therapy combined with chemotherapy. The short-term efficacy was compared between the control group and the combined group. Kaplan-Meier was used to draw the PFS survival curve of the two groups to evaluate the long-term efficacy. Univariate analysis and multivariate COX regression analysis were used to analyze the predictors of PFS in the combined group.Results: Compared with the control group, the objective response rate (ORR) (68.36% vs 55.13%) and disease control rate (DCR) (97.14% vs 87.18%) in the combined group were higher (P<0.05). The median PFS in the combined group was 14 months and that in the control group was 9 months. Log-rank test revealed that the survival curve in the two groups was different (95%CI: 1.12~2.17, Log-rank test χ²=7.624, P=0.006). Univariate analysis suggested that age, pleural effusion, bone metastasis, epidermal growth factor receptor (EGFR) mutation, tumor staging, tumor diameter, lactate dehydrogenase (LDH) level and short-term efficacy were correlated with PFS (P<0.05). Multivariate COX regression analysis revealed that pleural effusion (95%CI: 1.025~1.166), EGFR mutation (95%CI: 1.018~1.067), tumor stage IV A-IV B (95%CI: 1.021~1.140), tumor diameter≥5cm (95%CI: 1.039~1.159), LDH > 245U/L (95%CI: 1.055~1.150) and optimal efficacy (95%CI: 1.548~4.752) were independent predictors of PFS (P<0.05).Conclusion: Gefitinib targeted therapy combined with chemotherapy has a good short-term effect in the treatment of advanced NSCLC, and can effectively improve the long-term prognosis of patients. Pleural effusion, tumor staging, tumor diameter, LDH level and optimal efficacy are independent predictors of PFS in patients with advanced NSCLC receiving gefitinib targeted therapy combined with chemotherapy.

Objective: To analyze the related factors of clinical outcomes on the 90th day after discharge in patients with stroke treated by alteplase (rt-PA) intravenous thrombolysis within 4.5 hours of onset .Methods: From January 2021 to February 2024, 87 patients with stroke within 4.5 hours of onset who received rt-PA intravenous thrombolysis in the hospital were selected as the research subjects. According to the 90-day modified Rankin scale (mRS) evaluation results, they were divided into poor outcome group (mRS>2 points, n=31) and good outcome group (mRS≤2 points, n=56). Univariate analysis was used to analyze the influencing factor affecting the poor clinical outcomes on the 90th day after discharge. Multivariate Logistic regression analysis was applied to analyze the independent risk factors leading to the poor clinical outcomes.Results: Univariate analysis showed that compared with the good outcome group, the poor outcome group had longer onset to thrombolysis time (ONT) and admission to thrombolysis time (DNT), higher pre-thrombolysis National Institutes of Health Stroke Scale (NIHSS) score, lower early Alberta Stroke Project CT (ASPECTS) score, higher probabilities of hypertension and anterior circulation infarction and higher lipoprotein (a) level (P<0.05). Multivariate Logistic regression analysis found that long ONT (95%CI: 1.030-1.195), long DNT (95%CI: 1.031-1.182) and high NIHSS score before thrombolysis (95%CI: 1.052-1.192) were independent risk factors for poor clinical outcomes on the 90th day after discharge in stroke patients after the treatment of rt-PA intravenous thrombolysis within 4.5 hours of onset (P<0.05).Conclusion: ONT, DNT, and pre-thrombolysis NIHSS score are significantly correlated with the clinical outcomes on the 90th day after discharge in stroke patients within 4.5 hours of onset, and they are all independent risk factors for poor clinical outcomes on the 90th day after discharge.

Objective: To explore the clinical efficacy and adverse reactions of probiotic combination with pyrotinib and capecitabine for the treatment of HER-2 positive advanced breast cancer, with a view to providing a reference for clinical treatment plans.Methods: One hundred and five HER-2 positive breast cancer patients were selected from January 2019 to August 2023 in the Affiliated Tumor Hospital of Guangxi Medical University and were divided into the study group and the control group by randomized numerical table method, and the numbers of cases were 53 and 52, respectively. The study group was treated with probiotics + pyrotinib + capecitabine, and the control group was treated with pyrotinib + capecitabine. The two groups were compared in terms of recent efficacy, the number of major intestinal flora colonies before and after chemotherapy, T-lymphocyte subsets (CD3⁺, CD4⁺, CD4⁺/CD8⁺), inflammatory factors [interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor cell necrosis factor-alpha (TNF-alpha)], and the degree of cancer-caused fatigue [Piper Fatigue Scale (PFS) score], sleep quality [Pittsburgh Sleep Quality Index (PSQI) score], quality of life [European Organization for Research and Treatment of Cancer Quality of Life questionmaire core 30 (EORTC QLQ-C30) score], and adverse effects.Results: The total remission rate of the two groups was not statistically significant (P>0.05), but the rate of discontinuing or lowering the dose of pyrotinib due to adverse reactions was lower in the study group than in the control group (P<0.05); the number of bifidobacteria and Lactobacillus colonization was higher than that of the control group, and the number of Escherichia coli and enterococci colonization was lower than that of the control group after 2 cycles of treatment in the study group, and 4 cycles later (P<0.05); the number of peripheral blood CDs was higher than that of the control group after 2 cycles of treatment in the study group. After 2 cycles of treatment, peripheral blood CD3⁺, CD4⁺, CD4⁺/CD8⁺ levels were higher than those of the control group (P<0.05); serum IL-6, IL-8, TNF-α levels were lower than those of the control group after 2 cycles of treatment and after 4 cycles of treatment in the study group (P<0.05); PFS and PSQI scores were lower than those of the control group after 2 cycles of chemotherapy and after 4 cycles of chemotherapy in the study group, and EORTC QLQ- C30 score was higher than that of the control group (P<0.05); the incidence of diarrhea in the study group was lower than that of the control group (P<0.05), and the difference in the incidence of hand-foot syndrome, leukopenia, neutropenia, and thrombocytopenia was not statistically significant when compared with that of the control group (P>0.05).Conclusion: Probiotic can promote the improvement of immune function in HER-2 positive breast cancer patients after treatment with pyrotinib combined with capecitabine, which can effectively reduce the occurrence of gastrointestinal-related adverse reactions, thus improving the quality of patient survival.