Based on the accelerating global aging process and the increasing prevalence of common and prevalent orthopedic disorders,artificial intelligence(Al),as a core technology in computer science,has penetrated into all processes of orthopedic medical care.AI's use in orthopedics will also to lead a new round of technological revolution and achieve breakthrough developments.This study comprehensively summarizes the innovative achievements and technological breakthroughs of AI technology from five perspectives-disease prevention,diagnosis,surgery,rehabilitation,and pharmaceutical development in orthopedic diseases,elaborating on the current application status and limitations of the technology.Special emphasis is placed on issues such as data security,algorithm credibility,and clinical translation,and corresponding solutions to these three core problems are proposed respectively.Combined with specific clinical transformation paths and research trajectory,the development prospects of multimodal fusion and cross-disciplinary collaboration are prospected.In the fields of precision diagnosis and treatment of fractures,robot-assisted surgery,and personalized rehabilitation,AI outperforms conventional clinical approaches.However,factors such as the lack of comprehensive database retrieval,large-scale clinical validation,and immature technology have hindered the large-scale application and implementation of AI.This article provides a systematic summary for the technological transformation and academic development of AI in orthopedics,and also looks ahead to new directions and prospects.
Diabetic kidney disease(DKD),one of the most severe microvascular complications of diabetes,has become the leading cause of chronic kidney disease and end-stage kidney disease in China. Branched-chain amino acid(BCAA),essential amino acid in humans,constitutes an important part of amino acid metabolism. Accumulating evidence indicates that abnormal BCAA metabolism plays a critical role in the initiation and progression of DKD and is closely related to the injury of glomerular podocytes and renal tubular epithelial cells,whereas the relevant pathogenic mechanisms have not been systematically summarized. This review elaborates on BCAA metabolic pathways and the mechanisms by which disturbed BCAA metabolism induces renal damage in DKD,and discusses the therapeutic potential of BCAA and their key metabolic enzymes as intervention targets,so as to provide novel ideas for clinical treatment of DKD.
Objective To explore the efficacy and safety of Lingjiao Gouteng Decoction combined with pidotimod in the treatment of children with hand,foot,and mouth disease and to provide a reference for clinical treatment.Methods A total of 80 children with hand,foot,and mouth disease admitted to Wuhan Eighth Hospital from June 2019 to June 2022 were selected as the research subjects,and were randomly divided into two groups using a random number table method.The control group(n=40)was treated with pidotimod for one week continuously,and the study group(n=40)was treated with Lingjiao Gouteng Decoction for the first three days on the basis of pidotimod treatment in the control group.The clinical efficacy,T lymphocyte subsets,serum levels of neuron-specific enolase(NSE)and astrocyte derived protein(S100B),time to clinical symptom resolution,and medication safety were compared between two groups.Results After a week of treatment,the total effective rate in the study group was higher than that in the control group(95.00％vs 75.00％,x2=6.275,P=0.012).After treatment,CD8+in two groups was lower than that before treatment,while CD3+,CD4+,and CD4+/CD8+were higher than those before treatment(P＜0.05).CD3+,CD4+,and CD4+/CD8+in the study group were higher than those in the control group after treatment,and CD8+was lower than that in the control group after treatment(P＜0.05).After treatment,the levels of serum NSE and S100B in two groups were lower than before treatment(P＜0.05),and the levels in the study group were lower than in the control group(P＜0.05).Compared to those on pidotimod alone,the time to rash dissipation,ulcer healing and fever reduction in the study group were significantly reduced(P＜0.05).None of the subjects had serious adverse reactions.Conclusion The Lingjiao Gouteng Decoction combined with pidotimod is effective in treating children with hand,foot,and mouth disease.It can improve the immune function,protect brain nerves,quickly dissipate herpes,eliminate ulcers,reduce fever,and has no obvious adverse reactions.
Colon cancer is one of the top three malignant tumors worldwide. The most common site of distant metastasis is the liver.Early detection of metachronous liver metastasis after surgery and the adoption of reasonable treatment strategies are particularly important. The clinical management of metachronous liver metastasis from colon cancer has gradually evolved from a single lesion-oriented treatment to an integrated diagnosis and treatment model that integrates multidisciplinary and multi-omics information. The established diagnosis and treatment system still faces core challenges in advancing towards"precision medicine",including incomplete guideline details and difficulty in standardizing individualized treatment plans. This article systematically reviews the definition,diagnosis,treatment and risk factors of metachronous liver metastasis from colon cancer,aiming to provide a reference for early prediction and comprehensive management in clinical practice.
Objective To evaluate the accuracy of acetabular anterior column screw placement under robotic navigation,so as to provide a reference for clinical treatment.Methods A total of 78 patients who underwent anterior column screw placement with robotic navigation at Gansu Provincial Hospital from January 2022 to January 2024 were retrospectively collected.The patients were divided into observation group(44 cases)and control group(34 cases)according to different surgical methods.Screws were placed under robotic navigation in the observation group,while screws were inserted freehand under fluoroscopic guidance in the control group.Postoperative examinations were completed.Excellent placement was defined as accurate screw position according to the accuracy evaluation criteria.The numbers of accurately placed anterograde anterior column screws,retrograde anterior column screws and total screws were counted,and the screw placement accuracy rates were compared between the two groups.Results Compared with the control group,the observation group showed slightly higher accuracy placement rates of anterograde anterior column screws(92.0％vs 80.0％,x2=0.54,P=0.462),retrograde anterior column screws(94.7％vs 85.7％,P=0.561),and overall screws(93.2％vs 82.4％,x2=1.27,P=0.260),but none of these differences were statistically significant.Conclusion Compared with freehand percutaneous screw insertion under fluoroscopy,the accuracy of percutaneous screw placement assisted by robotic navigation is somewhat higher,but the difference is not statistically significant.
Objective To explore the effects of myofascial release therapy combined with extracorporeal shockwave therapy on pain severity and lumbar spine function in patients with chronic nonspecific lower back pain(CNLBP).Methods From August 2023 to August 2025,196 patients with CNLBP admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University were assigned to either the control group or the observation group,with 98 individuals in each cohort using a random number table.The control group was treated with extracorporeal shockwave,while the observation group received myofascial release therapy on the basis of the control group.The clinical efficacy,inflammatory factors,pain levels,lumbar function,and daily living ability were compared between the two groups before and after treatment.Results A significantly superior total treatment efficacy was achieved in the observation group compared with the control group(93.88％vs 84.69％,x2=4.320,P=0.038).After 4 weeks of treatment,compared to the control group,the observation group showed lower tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,and IL-6 levels,lower Oswestry Disability Index(ODI)score,higher Japanese Orthopaedic Association(JOA)score and Barthel index(P＜0.05).Additionally,at 2 and 4 weeks post-treatment,the Visual Analogue Scale(VAS)score in the observation group was significantly lower than that in the control group(P＜0.05).Conclusion Myofascial release therapy combined with extracorporeal shockwave can effectively reduce levels of serum inflammatory factors,relieve pain,improve lumbar function,and activities of daily living,and enhance clinical curative effect in CNLBP patients.
Objective To investigate the ultrasound features and serological changes in patients with Hashimoto's thyroiditis(HT)during the antibody-positive stage and after progression to subclinical hypothyroidism,to analyze the correlation and trend between antibody titers and thyroid ultrasound characteristics,and to evaluate the diagnostic value of ultrasound indicators at different disease stages.Methods Study subjects were retrospectively enrolled from patients who visited Liaoning Provincial People's Hospital and completed relevant examinations between 2023 and 2024.General data,thyroid serological indices[thyroid-stimulating hormone,free triiodothyronine,free thyroxine,thyroid peroxidase antibody(TPOAb),and anti-thyroglobulin antibody(TgAb)],and thyroid ultrasound findings(including five features:hypo-echogenicity,irregular margins,heterogeneous echotexture,increased blood flow signal,and mesh-like hyper-echogenicity)were collected.Based on thyroid serology,participants were divided into three groups:antibody-positive only group(n=101),subclinical hypothyroidism group(n=74),and control group(n=51).Spearman correlation analysis was used to assess the correlation between antibody titers and ultrasound features.Multivariate logistic regression was performed to identify independent factors for subclinical hypothyroidism.A predictive model was established based on the logistic regression results,and the diagnostic performance of ultrasound features was evaluated using receiver operating characteristic(ROC)curves.Results Significant differences were observed among the three groups in all five ultrasound features:hypo-echogenicity,heterogeneous echotexture,increased blood flow signal,irregular margins,and mesh-like hyper-echogenicity(P＜0.05).TPOAb and TgAb titers were positively correlated with these five ultrasound features(P＜0.05).Multivariate logistic regression showed that the factors influencing the development of subclinical hypothyroidism were hypo-echogenicity(OR=0.043,95％CI:0.014-0.132,P＜0.01)and mesh-like hyper-echogenicity(OR=5.824,95％CI:2.101-16.140,P＜0.01).The combination of ultrasound indicators yielded an AUC of 0.843 for predicting subclinical hypothyroidism,with a sensitivity of 0.797 and a specificity of 0.762.Conclusion The ultrasound features of hypo-echogenicity and mesh-like hyper-echogenicity have good value for early identification of progression from Hashimoto's thyroiditis to subclinical hypothyroidism.
Objective To compare the surgical outcomes of percutaneous endoscopic visualized modified transforaminal lumbar interbody fusion(PEV-MTLIF)versus conventional open transforaminal lumbar interbody fusion(TLIF)in the treatment of grade Ⅰ degenerative lumbar spondylolisthesis(DLS).Methods A retrospective analysis was performed on the clinical data of patients with single-level grade Ⅰ DLS who were treated in the Department of Spine Surgery,Xuzhou Central Hospital from June 2020 to December 2022.The patients were divided into a PEV-MTLIF group and an open TLIF group according to the surgical procedure.All patients were followed up for at least 1 year.Perioperative situation were evaluated by operative time,intraoperative blood loss,postoperative drainage,time to first ambulation,postoperative hospital stay,and incidence of surgical complications.Radiological outcomes were assessed by intervertebral disc height,lumbar spondylolisthesis percentage,slip angle,lumbar lordotic angle,and fusion rate.Clinical outcomes were evaluated using the Visual Analog Scale(VAS)scores for lumbocrural pain and the Oswestry Disability Index(ODI).Results A total of 47 patients were included,with 22 in the PEV-MTLIF group and 25 in the open TLIF group.The PEV-MTLIF group had significantly less intraoperative blood loss,shorter time to first ambulation postoperatively,and shorter postoperative hospital stay compared with the open TLIF group,with statistically significant differences(P＜0.05).There was no significant difference in the incidence of perioperative complications between the PEV-MTLIF group and the TLIF group(13.64％vs 8.00％,x2=0.023,P=0.880).Routine drainage was not placed in the PEV-MTLIF group;the postoperative drainage volume in the TLIF group was(259.60±67.85)mL.The VAS scores and ODI showed significant inter-group,inter-time,and interaction effects(P＜0.01).At 1 month postoperatively,the PEV-MTLIF group had better VAS scores and ODI than the open TLIF group(P＜0.05).At 1 year postoperatively,there were no significant differences in VAS scores and ODI between the two groups(P＞0.05);both groups showed significant improvements in intervertebral disc height,lumbar spondylolisthesis percentage,slip angle,and lumbar lordotic angle compared with preoperative values(P＜0.01),but no significant differences were found between the two groups for these parameters(P＞0.05).The fusion rate was 95.45％(21/22)in the PEV-MTLIF group and 96.00％(24/25)in the open TLIF group,with no significant difference between two groups(P=1.000).Conclusion PEV-MTLIF is safe and effective for the treatment of grade Ⅰ DLS,and it is superior to conventional open TLIF in terms of perioperative clinical indicators and early rehabilitation.
Objective To investigate the predictive value of human neutrophil lipocalin(HNL),procalcitonin(PCT),and C-reactive protein(CRP)for peripancreatic infection in patients with severe acute pancreatitis(SAP),and to provide evidence-based reference for early anti-infective treatment of SAP complicated with peripancreatic infection.Methods A total of 76 SAP patients admitted to Jilin Province FAW General Hospital from October 2020 to February 2024 were enrolled,and divided into a peripancreatic infection group(n=28)and a non-peripancreatic infection group(n=48).Serum HNL was measured by enzyme-linked immunosorbent assay,PCT by chemiluminescence,and CRP by latex immunoturbidimetry,and the differences of the three indicators between the two groups were compared.Logistic regression models were used to explore the association between serum biomarkers(HNL,PCT,CRP)and peripancreatic infection.Receiver operating characteristic(ROC)curve was used to evaluate diagnostic efficacy.Results Median levels of HNL,PCT,and CRP in the peripancreatic infection group were significantly higher than those in the non-peripancreatic infection group(P＜0.01).Multivariate logistic regression analysis revealed that high HNL level(OR=1.031,95％CI:1.013-1.049)and high PCT level(OR=1.451,95％CI:1.040-2.022)were independent risk factors for peripancreatic infection in SAP(P＜0.05).The ROC results indicated that the area under the curve(AUC)values for predicting SAP with peripancreatic infection using HNL,PCT,and the combination of both indicators were 0.893,0.872,and 0.935,respectively.The sensitivity,specificity,positive predictive value,and negative predictive value of the combined prediction were 82.14％,95.83％,92.00％,and 90.20％,respectively.Conclusion The construction of a combined diagnostic model of HNL and PCT is helpful for the early prediction of SAP combined with peripancreatic infection,providing a key time window for clinical intervention.
Objective To investigate the predictive value of biochemical indicators of intestinal barrier function,such as diamine oxidase,D-lactate and bacterial endotoxin for the severity of acute pancreatitis.Methods A total of 139 patients with acute pancreatitis admitted to Nanjing Jiangbei Hospital from December 2021 to January 2023 were retrospectively enrolled.The patients were divided into mild group(mild acute pancreatitis,n=39)and non-mild group(moderately severe acute pancreatitis and severe acute pancreatitis,n=100).The serum levels of diamine oxidase,D-lactate,and bacterial endotoxin,as well as Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,Bedside Index of Severity in Acute Pancreatitis(BISAP)score and Modified Computed Tomography Severity Index(MCTSI)score were collected and compared between the two groups.Spearman correlation analysis was used to analyze the correlation among the above indicators,and receiver operating characteristic(ROC)curve was adopted to evaluate the predictive value of each indicator for non-mild acute pancreatitis.Results Compared with mild group,the levels of diamine oxidase,D-lactate,bacterial endotoxin,APACHE Ⅱ score,BISAP score and MCTSI score in the non-mild group were significantly higher,while the blood calcium level was lower(P＜0.05).In both groups,spearman correlation analysis showed that the levels of diamine oxidase,D-lactate and bacterial endotoxin were positively correlated with APACHE Ⅱ,BISAP and MCTSI scores,respectively(P＜0.05).ROC curve analysis revealed that the area under the curve(AUC)of diamine oxidase,D-lactate and bacterial endotoxin for predicting non-mild acute pancreatitis was 0.690,0.749 and 0.718,respectively,and the combination of D-lactate and the BISAP score presented the largest AUC of 0.852.Conclusion Biochemical indicators of intestinal barrier function have certain predictive value for evaluating the severity of acute pancreatitis,and their combination with scoring systems can achieve higher predictive efficacy.
Objective To preliminarily investigate the composition of immune cells in the upper respiratory tract(URT)of domestic adults and their relationship with age and health status through nasal and nasopharyngeal swab sampling detection.Methods From November 28,2024,to December 10,2024,49 outpatients from Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School were selected for the survey.They were divided into three groups based on age:young group(＜40 years,21 cases),middle-aged group(40-60 years,12 cases),and elderly group(＞60 years,16 cases).According to their clinical manifestations and findings under electronic laryngoscopy,they were further divided into healthy group and diseased group.Swab samples were collected from the midpoint of the inferior nasal turbinate(MT)and nasopharynx.Flow cytometry was performed to detect the proportions of B cells,T cells and their subsets.Differences in immune cell distribution between the two anatomical sites and among different age groups were analyzed.Results(1)Overall distribution of B cells and T cells:the proportion of B cells in the nasopharynx site was significantly higher than that in the MT site(t=11.320,P＜0.01),while the proportion of T cells was significantly lower than that in the MT site(t=5.784,P＜0.01).(2)Distribution of T cell subsets and specific immune cells:compared with MT site,the nasopharynx site had a higher CD4+/CD8+ratio,higher proportions of CD4+T cells,germinal center(GC)B cells,follicular helper T cells,and plasma cells(P＜0.01),while the proportion of CD8+T cells was lower(P＜0.01).(3)Age-stratified analysis:in nasopharynx swabs,the proportion of CD8+T cells was increased in the young and middle-aged diseased groups compared with the healthy group(P＜0.05);in the elderly patients,changes in immune cell proportions showed a disordered trend,with the proportion of memory B cells being higher in diseased group than that in healthy group(P＜0.05).Conclusion The distribution of adult URT immune cells in this region exhibits specificity of anatomical site and age.Although adenoid tissue atrophies with age,the nasopharynx site still has a more active humoral immune microenvironment.
Objective To investigate the clinical imaging characteristics of benign and malignant breast calcifications and explore their underlying molecular mechanisms at the transcriptomic level.Methods A retrospective analysis was conducted on the clinical and pathological data of 1 051 breast cancer patients admitted to Nanjing Women and Children's Healthcare Hospital between January 2016 and February 2024.Patients were divided into a calcification group(n=534)and a non-calcification group(n=517)based on mammography findings.Concurrently,3 pairs of benign and malignant breast calcification tissues were collected for high-throughput RNA sequencing(RNA-seq).Differentially expressed genes(DEGs)were identified using DESeq2,followed by Gene Ontology(GO)annotation and Gene Set Enrichment Analysis(GSEA)to uncover key hallmark pathways driving malignant calcification.Results Clinically,the proportions of ductal carcinoma in situ and microinvasive carcinoma were significantly higher in the calcification group(P＜0.05).Molecularly,compared with the non-calcification group,the calcification group had a higher proportion of estrogen receptor(ER)and progesterone receptor(PR)negativity,a higher proportion of human epidermal growth factor receptor 2(HER2)strong positivity,and a higher proportion of intermediate Ki-67 proliferation(P＜0.05).RNA-seq identified 1 686 DEGs,which were significantly enriched in biological processes such as calcium ion binding,angiogenesis,and extracellular matrix organization by GO analysis.GSEA further revealed the robust activation of classical oncogenic pathways-including mTORC1 signaling pathway,E2F target gene,G2/M checkpoint,and MYC target gene—which are closely associated with metabolic reprogramming and cell cycle dysregulation in malignant calcification tissues(false discovery rate q＜0.01).Conclusion Malignant breast calcification is not merely a macroscopic imaging sign of high tumor proliferation,but a consequential by product of extreme tumor cell proliferation and metabolic remodeling driven by pathways such as mTORC1 and MYC in the microenvironment.Integrating macroscopic imaging with microscopic transcriptomic features will facilitate early accurate warning and targeted intervention for breast cancer.
Objective To compare the efficacy,postoperative complications,quality of life,and subjective satisfaction between percutaneous endoscopic interlaminar discectomy(PEID)and the intervertebral foramen endoscopic broad,easy,and immediate surgery(BEIS)technique in the treatment of lumbar disc herniation(LDH).Methods A prospective study was conducted on 100 LDH patients admitted to Huairou Hospital,Beijing Hospital of Traditional Chinese Medicine from January 2020 to January 2025.The patients were randomly divided into a PEID group(n=50)and a BEIS group(n=50).Clinical efficacy,surgical parameters,pain intensity[Visual Analogue Scale(VAS)],lumbar function[Oswestry Disability Index(ODI)and Japanese Orthopaedic Association(JOA)score],quality of life[measured by Roland-Morris Disability Questionnaire(RMDQ)],and postoperative complications were compared between the two groups.Results The overall response rate in the BEIS group was higher than that in the PEID group(94.00％vs 80.00％,x2=4.332,P=0.037).Operative time and blood loss were significantly lower in the BEIS group than those in the PEID group(P＜0.05).Postoperatively,VAS and ODI score were lower,and JOA score was higher in the BEIS group compared to the PEID group(P＜0.05).There was no statistically significant difference in the total incidence of postoperative complications between the two groups(8.00％vs 12.00％,x2=0.444,P=0.505).At 1 week,3 months,and 6 months postoperatively,RMDQ scores were lower in the BEIS group compared to the PEID group(P＜0.05).After surgery,subjective satisfaction was significantly higher in the BEIS group compared to the PEID group(92.00％vs 74.00％,x2=4.536,P=0.033).Conclusion The intervertebral foramen endoscopic BEIS technique achieves better clinical efficacy than PEID in the treatment of LDH,with superior improvement in surgical parameters,lumbar function,and pain relief.
Objective To analyze the value of cerebrospinal fluid(CSF)levels of adenosine deaminase(ADA),matrix metalloproteinase-9(MMP-9),and alpha-2-macroglobulin(A2M)combined with MRI features in evaluating the prognosis of neonatal purulent meningitis(PM).Methods A retrospective study was conducted on neonates with PM admitted to Xuzhou Central Hospital from May 2022 to March 2025.General data,CSF biomarker levels,and MRI findings were collected.Logistic regression was used to analyze the relationship between prognosis and CSF biomarkers as well as MRI features.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value for prognosis.Results A total of 89 neonates with PM were included and divided into a good prognosis group(n=64)and a poor prognosis group(n=25)based on Glasgow Outcome Scale(GOS)score(≥5 or＜5).The poor prognosis group had significantly higher CSF levels of A2M,MMP-9,and ADA than the good prognosis group(P＜0.05).The proportions of subdural empyema,periventricular white matter reduction,intraventricular hemorrhage,and ependymal thickening were significantly higher in the poor prognosis group than those in the good prognosis group(P＜0.05).Multivariate logistic regression showed that high A2M(OR=1.399,95％CI:1.162-1.684),high MMP-9(OR=1.034,95％CI:1.004-1.065),high ADA(OR=2.010,95％CI:1.227-3.294),subdural empyema(OR=3.976,95％CI:1.053-15.016),periventricular white matter reduction(OR=5.480,95％CI:1.350-22.244),intraventricular hemorrhage(OR=8.702,95％CI:2.300-32.929),and ependymal thickening(OR=7.369,95％CI:2.077-26.143)were independent risk factors for poor prognosis in children with PM(P＜0.05).ROC analysis showed that the combination of these indicators had the highest predictive value for prognosis,with an area under the curve(AUC)of 0.934,sensitivity of 88.00％,and specificity of 95.30％.Conclusion The combination of CSF A2M,MMP-9,and ADA with MRI imaging features has high predictive efficacy for the prognosis of neonatal PM,and can provide guidance for clinical diagnosis and treatment.
Objective To explore influencing factors and disease spectrum features of mold allergy among 3 028 patients in Jiangbei area of Nanjing,so as to provide a scientific basis for prevention and diagnosis of mold allergic diseases.Methods A total of 3 028 patients with positive allergen test results for Aspergillus fumigatus and mixed molds(including Penicillium chrysogenum,Cladosporium herbarum,Aspergillus fumigatus,Candida albicans,Alternaria,Helminthosporium)at Fourth Affiliated Hospital of Nanjing Medical University from December 2021 to December 2024,were retrospectively enrolled.Statistical analysis was performed on their serum specific immunoglobulin E(sIgE)test results with reference to age,season,gender,clinical diagnosis.Results The serum sIgE positive rates of 3 028 cases with positivity for Aspergillus fumigatus and mixed molds were 8.62％and 23.18％,respectively.There were statistically significant differences in the positive rates of sIgE for patients with positive Aspergillus fumigatus and mixed molds among the four age(0-3 years,4-6 years,7-14 years,≥15 years)(x2=37.311,272.222,P＜0.01).The sIgE positive rates of the 4-6 years and 7-14 years were higher than those of the 0-3 years and ≥15 years for patients with positive Aspergillus fumigatus(10.1％,14.0％)and mixed molds(36.1％,35.3％),respectively(P＜0.008).There was a statistically significant seasonal difference in the sIgE positive rate among patients with positive mixed molds(x2=24.991,P＜0.01).The sIgE positive rate of patients with positive mixed molds in summer(29.0％)was significantly higher than that in spring and winter(20.6％and 17.9％,P＜0.008),respectively.The sIgE positive rates for Aspergillus fumigatus and mixed molds positivity in males(11.5％and 29.7％)were higher than those in females(5.4％and 16.0％)(x2=35.893,78.994,P＜0.01).The intensity of mold sensitization varied significantly by age and season(P＜0.01).Mold allergic diseases were mainly respiratory illnesses such as asthma and pneumonia.Conclusion Age,season and gender are important factors affecting mold allergic reactions.Detection of serum sIgE against Aspergillus fumigatus and mixed molds helps provide scientific evidence for the prevention and diagnosis of mold allergic diseases.
Objective To investigate the effects of intensive statin intervention on lipid profile improvement and plaque stability in patients with cerebral atherosclerosis(CAS),and to provide references for clinical treatment.Methods A total of 103 patients with CAS treated at Xinyang People's Hospital from January 2023 to May 2024 were selected and randomly divided into a study group(n=52)and a basic group(n=51)using a random number table method.After basic treatment,the basic group received low-dose atorvastatin calcium(10 mg/d),while the study group received high-dose atorvastatin calcium(40 mg/d for 14 days followed by 20 mg/d thereafter),all of which continued for 6 months.The two groups were compared before and after treatment in terms of lipid levels[total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],plaque parameters[carotid intima-media thickness(IMT),carotid plaque area],hemodynamic parameters[resistance index(RI),pulsatility index(PI),systolic flow velocity(Vs),diastolic flow velocity(Vd)],and inflammatory factor levels[tumornecrosis factor-alpha(TNF-α),high-sensitivity C-reactive protein(hs-CRP),interleukin-1(IL-1)].Results After treatment,TC,TG,HDL-C,LDL-C,RI,PI,Vs,Vd,TNF-α,hs-CRP,andIL-1 improved in both groups compared with before treatment,and the magnitude of change was greater in the study group than in the basic group(P＜0.05).After treatment,the carotid plaque area in both groups decreased slightly compared to before treatment,with no statistically significant differences(P＞0.05).The study group showed lower post-treatment IMT than pre-treatment(t=5.294,P＜0.001)and the basic group(t=2.521,P=0.013).Conclusion High-dose atorvastatin calcium treatment for CAS can not only improve lipid profiles,reduce the IMT,but also regulate hemodynamic parameters and reduce inflammatory responses.The adverse reactions to intensive doses need further observation.
Metabolic dysfunction-associated steatotic liver disease(MASLD)is a prevalent liver condition among elderly individuals,which is closely linked to cardiovascular and renal diseases,metabolic abnormalities,and a range of hepatic complications. Given the global trend towards an aging population,the prevalence of MASLD in elderly cohorts has markedly increased. Although the direct impact of MASLD on all-cause mortality is relatively limited,its negative effects on specific disease-related mortality and patient quality of life cannot be disregarded. The therapeutic measures for elderly patients with MASLD encompass active lifestyle modifications,pharmacotherapy,and necessary surgical procedures. Early-stage screening and individualized precise treatment plans are of vital importance for enhancing the prognosis of patients. Future relevant research will aim to refine diagnostic and therapeutic protocols for MASLD in elderly populations,with a focus on developing novel pharmacotherapies,and endeavoring to bring more benefits to patients.
Inherited arrhythmias(IA)are a group of genetic disorders involving ion channels,calcium handling proteins,and cardiomyopathic substrates,which is typically characterized by familial aggregation and a high risk of sudden death,severely disrupting the generation and conduction of cardiac electrical activity. MicroRNA(miRNA),as an endogenous short-stranded non-coding RNA,negatively regulates gene expression post - transcriptionally and plays a key role in maintaining cardiac electrophysiological homeostasis and structural integrity. miRNA expression dysregulation is closely related to the pathogenesis of IA,and once miRNA function is disrupted,it directly impairs cardiac rhythm and contractile function,thereby inducing arrhythmia.Therefore,in - depth investigation of the expression patterns and regulatory mechanisms of cardiac - specific miRNAs is of great significance for revealing the pathological mechanisms of IA and developing novel therapeutic strategies.
Objective To compare the application of different doses of esketamine combined with remimazolam in hysteroscopic endometrial resection,to provide a basis for optimizing the anesthesia management strategy of hysteroscopic surgery.Methods From December 2024 to May 2025,108 patients scheduled for hysteroscopic endometrial resection at the First People's Hospital of Wuhu were selected and randomly divided into group A,group B,and group C using a random number table,with 36 patients in each group.Esketamine was administered at doses of 0.2,0.5,and 0.8 mg/kg,combined with remimazolam,respectively,for anesthesia induction.Anesthesia recovery time,perioperative hemodynamic parameters[after entering the operating room(T0),2 minutes after anesthesia induction(T1),cervical dilation(T2),and at the end of surgery(T3)],postoperative pain scores,cognitive function preoperatively and at 2,6,and 24 hours postoperatively,and the incidence of adverse events were compared among three groups.Results Patients in group C exhibited significantly longer times to spontaneous breathing recovery,extubation,eye opening,and orientation recovery compared with group A and group B(P＜0.05).The MAP and heart rate in group A and group C fluctuated quite a bit,and there were significant differences at T1,T2 compared to the levels at T0(P＜0.05).In group B,however,the fluctuations in MAP and heart rate were small,with only a slight drop at T1,and the decrease was smaller than in group A and group C(P＜0.05),while the rest remained similar to the levels at T0(P＞0.05).At T3,MAP and heart rate in group A and group B returned to T0 levels(P＞0.05),while those in group C remained significantly higher than T0 levels(P＜0.05).Postoperative VAS scores at 2,6,and 12 hours decreased sequentially in groups A,B,and C(P＜0.05).At 2 and 6 hours post-surgery,Mini-Mental State Examination(MMSE)scores were significantly lower in group C compared with group A and group B(P＜0.05).Group C had a higher overall incidence of adverse events compared to group A and group B(22.22％,2.78％,2.78％,x2=10.800,P=0.004).Conclusion The application of 0.5 mg/kg esketamine combined with remimazolam in patients undergoing hysteroscopic endometrial resection provides stable hemodynamics,short anesthesia recovery time,good analgesic effects,minimal impact on postoperative cognitive function,and high safety.Although 0.8 mg/kg of esketamine has the strongest pain relief effect,it falls short in other aspects compared to 0.5 mg/kg.
Objective To investigate the influence of ropivacaine combined with different doses of esketamine for serratus anterior plane block(SAPB)on postoperative negative emotions and analgesic effect in perimenopausal patients undergoing breast surgery.Methods Ninety-six patients scheduled for breast surgery at the Affiliated Hospital of Jiangnan University between September and November 2025 were enrolled.Patients were aged 45-55 years,with an ASA physical status of Ⅰ-Ⅱ and a BMI of 18-30 kg/m2.Under ultrasound guidance,SAPB was performed after general anesthesia induction.Patients were randomly divided into three groups(n=32 each):Group R(ropivacaine alone,0.375％ropivacaine 20 mL),Group ESK1(0.25 mg/kg esketamine combined with 0.375％ropivacaine 20 mL),and Group ESK2(0.50 mg/kg esketamine combined with 0.375％ropivacaine 20 mL).Positive Affect and Negative Affect Schedule(PANAS)scores were recorded one day preoperatively and on postoperative day(POD)1 and POD3.Visual Analog Scale(VAS)scores on motion were recorded at 2 h,8 h,24 h,and 48 h postoperatively.The incidence of adverse reactions(nause and vomiting,delirium,respiratory depression)were monitored.Results All 96 patients achieved effective nerve block.There were no statistically significant differences in surgical type,age,BMI,or ASA classification among the three groups(P＞0.05).Generalized estimating equation(GEE)analysis revealed significant inter-time effect,inter-group effect,and interaction effect for positive and negative emotion scores across the three groups(P＜0.01).The improvement rates of negative emotions on POD1 were 68.75％,43.75％,and 25.00％in the Group ESK2,Group ESK1,and Group R,respectively;the corresponding rates on POD3 were 81.25％,59.38％,and 34.38％,respectively.The Group ESK2 exhibited the highest improvement rate at both time points,with statistically significant differences among the three groups(x2=12.420,P＜0.01;x2=14.486,P＜0.01).The Group ESK2 had significantly lower VAS scores on motion at 2 h,8 h,and 24 h postoperatively compared with the Group R and Group ESK1(P＜0.05).No statistically significant difference was observed in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion The combination of 0.5 mg/kg esketamine and ropivacaine for SAPB provides superior analgesia,does not increase adverse reactions,and significantly improves negative emotions.This regimen represents an optimal dose for synergistic postoperative pain and depression management in perimenopausal patients undergoing breast surgery.
