Objective:To investigate the clinical features and multi-slice spiral computed tomography(CT)imaging features of acute appendicitis in soldiers who have been living in plateau for a long time.Methods:The clinical features and imaging data of 56 cases of acute appendicitis in soldiers who have been living in plateau for a long time confirmed by surgery from February 2022 to August 2024 were retrospectively analyzed.Results:In 56 cases with acute appendicitis in soldiers who have been living in plateau for a long time,the appendectomy position results showed:anterior ileum 4 cases(7.14％),lower ileum 10 cases(17.86％),posterior cecum 16 cases(28.57％),lower cecum 9 cases(16.07％),lateral cecum 2 cases(3.58％),posterior ileum 6 cases(10.71％),high(subhepatic)9 cases(16.07％),and left lower abdominal 0 cases,retroperitoneal appendicitis 0 cases,which was suggested that the anatomical position variation of appendicitis in soldiers with acute appendicitis who have been living at high altitude for a long time was relatively large.The direct manifestations of multi-slice spiral CT showed:appendectomy enlarged diameter＞6 mm in 49 cases(87.50％),appendicular wall thickening＞2 mm in 42 cases(75.00％),ppendiceal dilation lumen and effusion in 29 cases(51.79％),appendix indistinctness in 3 cases(5.36％),lppendix fecalith:27 cases(48.21％),gas in the appendix in 16 cases(28.57％).Indirect findings of multi-slice spiral CT showed that,periappendiceal exudation with shadow in 32 cases(57.14％),appendiceal cellulitis with peripheral abscess in 9 cases(16.07％),peritonitis and ascites in 13 cases(23.21％),ileocecal intestinal wall thickening in 22 cases(39.29％),mesenteric lymph node enlargement in 16 cases(28.57％),reflexive intestinal stasis in ileocecal region was observed in 19 cases(33.93％).Conclusion:In the officers and soldiers with acute appendicitis who lived at high altitude for a long time,multi-slice spiral CT showed the direct manifestations of appendiceal thickening,tube wall thickening,lumen dilatation,fluid accumulation,etc.,and the indirect manifestations were periappendiceal exudation with shadow,appendiceal cellulitis with peripheral abscess,ileocecal intestinal wall thickening,reflexes of small intestine and mesenteric lymph node enlargement.Multi-slice spiral CT has the advantages of clear and intuitive,high safety,high resolution and simple operation in the diagnosis of acute appendicitis.

Objective To investigate the diagnostic value of 4 novel inflammatory markers related to routine blood tests,namely neutrophil-to-lymphocyte ratio(NLR),red blood cell distribution width(RDW),hemoglobin-to-RDW ratio(HRR)and systemic immune-inflammation index(SII),in elderly patients with chronic cardiovascular disease(CVD)complicated with frailty.Methods Retrospectively analyze 110 patients with chronic stable CVD who were hospitalized in the cadre ward of cardiovascular medicine at the Air Force Characteristic Medical Center from January 2022 to June 2023.According to the assessment results of the Fried scale,they were divided into three groups:non-frailty group(Fried score=0,n=30),the pre-frailty group(Fried score 1 or 2,n=40)and frailty group(Fried score≥3,n=40).The differences in general information,the impairment rate of daily living activities,miniature nutritional assessment-short form(MNA-SF)scores,mini-mental state examination(MMSE)scores,and the indicators such as NLR,RDW,HRR,and SII among the three groups were compared.Spearman rank correlation was used to analyze the correlation between NLR,RDW,HRR,SII and frailty scores as well as each frailty indicator.Multivariate logistic regression analysis was performed to identify the independent risk factors for frailty in elderly patients with chronic CVD,and the receiver operating characteristic(ROC)curve was used to assess the clinical diagnostic value of NLR and HRR in elderly patients with chronic CVD complicated with frailty.Results Compared with non-frailty group and pre-frailty group,patients in frailty group were older,with higher impaired rates of daily living activities,NLR,RDW,and SII,and lower MNA-SF scores,MMSE scores,and HRR,and differences were statistically significant(P<0.05).Spearman rank correlation analysis showed that the frailty score was positively correlated with NLR(rs=0.354,P<0.001),and RDW(rs=0.448,P<0.001),negatively correlated with HRR(rs=-0.232,P=0.024),and had no significant correlation with SII(rs=0.144,P=0.167).Further analysis of the correlation between the above novel inflammatory markers and the 5 components of frailty showed that NLR was positively correlated with fatigue(rs=0.228,P=0.017),slowed walking speed(rs=0.299,P<0.001),and low physical function(rs=0.319,P<0.001);RDW was positively correlated with decreased grip strength(rs=0.321,P<0.001),slowed walking speed(rs=0.422,P<0.001),and low physical function(rs=0.246,P=0.001);and HRR was negatively correlated with slowed walking speed(rs=-0.230,P=0.025),and low physical function(rs=-0.299,P=0.003).Multivariate logistic regression analysis showed that MNA-SF score(OR=0.577,95%CI 0.342-0.973)was an independent protective factor for pre-frailty in elderly patients with chronic CVD(P<0.05);NLR(OR=7.866,95%CI 1.101-56.185)was an independent risk factor for frailty,while HRR(OR=0.344,95%CI 0.120-0.983)and MNA-SF score(OR=0.292,95%CI 0.146-0.580)were independent protective factors for frailty in elderly CVD patients(P<0.05).The area under the ROC curve of NLR and HRR for diagnosing frailty in elderly patients with chronic CVD were 0.778 and 0.749,respectively.Conclusion NLR and HRR have high clinical diagnostic value for frailty in elderly patients with chronic CVD,and are expected to become effective inflammatory markers for screening elderly patients with chronic CVD complicated with frailty.

Objective Aedes albopictus is the primary vector of the dengue virus.Screening and the analysis of immune-related genes in DENV2-infected Ae.albopictus provides a scientific basis for further research on blocking the extrinsic incubation period of the dengue virus.Methods Through the approach of literature mining,thirty-three potential immune-related genes were screened from species such as Aedes aegypti and Anopheles gambiae,which have a close genetic relationship with Ae.albopictus.The protein—protein interaction(PPI)analysis is employed to explore the interaction relationship of the proteins encoded by genes.The alterations in mRNA expression levels of the relevant genes in DENV2-infected Ae.albopictus midgut were detected using the qRT-PCR method.Results The PPI results indicates that TLR and Spz of Ae.albopictus;Rel1,Rel2,DefC,Spz,PIWI,Ago2,DOME and HOP of Ae.aegypti;and Rel1,Rel2,CACT,STAT and DOME of An.gambiae exhibit PPI relationships.After Ae.albopictus was infected with DENV2,10 genes showed significant difference in expression.Ago3(7.39,P<0.05),DOMEa(1.63,P<0.01),DOMEb(21.29,P<0.001),and TLRb(1.61,P<0.05)were significantly up-regulated.Rel1(0.62,P<0.001),CACTl(0.65,P<0.001),Rel2a(0.65,P<0.01),Rel2b(0.24,P<0.001),GATAa(0.64,P<0.01)and DefC(0.28,P<0.05)were significantly down-regulated.Conclusions The concordance of Ae.albopictus with Ae.aegypti was higher than that with An.gambiae.DOMEb,Ago3,Rel2b and DefC,can serve as the preferred target genes for subsequent studies on DENV2 immune blockade.

Objectives:To investigate the relationship between serum miR-550a-5p levels and spinal metas-tasis in patients with non-small cell lung cancer(NSCLC).Methods:The clinical data of 175 patients with NSCLC who received treatment in the Affiliated Hospital of Chengde Medical College between May 2021 and May 2023 were retrospectively analyzed.According to the results of whole body bone imaging,70 patients with spinal metastasis were enrolled into the metastasis group,and 104 patients without spinal metastasis were enrolled into the none-metastasis group.There were no statistically significant differences in gender,age,smoking,hypertension,thrombosis,and tumor location between the two groups(P＞0.05).The pathological type,clinical stage,lymph node metastasis,and tumor diameter of the patients were collected and compared between the two groups.qRT-PCR was used to detect the expression level of serum miR-550a-5p,enzyme-linked immunosorbent assay was used to detect the serum tartrate-resistant acid phosphatase-5b(TRACP-5b)and type Ⅰ collagen cross-linked C-terminal peptide(ICTP)levels.The differences in serum levels of TRACP-5b,ICTP,and miR-550a-5p were compared between the two groups.The receiver operating characteristic(ROC)curve was adopted to evaluate the diagnostic value of miR-550a-5p,TRACP-5b,and ICTP alone and in combination for spinal metastasis in NSCLC patients.Results:Compared with the none-metastasis group,serum TRACP-5b,ICTP,and miR-550a-5p levels were significantly higher in patients in the metastasis group(P＜0.05).The miR-550a-5p level was significantly higher in patients with tumor diameter≥5cm,lung adenocarcinoma,stage Ⅲ-Ⅳ,and lymph node metastasis than in patients with tumor diameter＜5cm,squamous carcinoma,stage Ⅰ-Ⅱ,and no lymph node metastasis(P＜0.05).Elevated serum miR-550a-5p,lung adenocarcinoma,stage Ⅲ-Ⅳ,and lymph node metastasis were the independent risk factors for the development of spinal metastasis in NSCLC patients(P＜0.05).The AUC of miR-550a-5p for diagnosing spinal metastasis in NSCLC patients was 0.851,and the sensitivity and specificity were 74.29％and 85.58％,respectively,at the optimal cut-off value of 0.20.The diagnostic efficacy of serum miR-550a-5p for diagnosing spinal metastasis in NSCLC patients was significantly better than that of TRACP-5b(Z=2.309,P=0.023)and ICTP(Z=1.852,P=0.049).The AUC of miR-550a-5p,TRACP-5b,and ICTP combination for the diagnosis of spinal metastasis in NSCLC patients was 0.931,and the sensitivity and specificity were 88.57％and 87.50％,respectively.The diagnostic efficacy of the three-marker combination was significantly better than that of the two-marker combination of TRACP-5b and ICTP(Z=2.205,P=0.027).Conclusions:Elevated level of serum miR-550a-5p is associated with spinal metastasis,which can be used as a molecular marker for predicting spinal metastasis in NSCLC patients,moreover,its combination use with bone metabolism-related tumor markers,the ICTP and TRACP-5b,can improve diagnostic efficacy.

Objective:To explore the effects of 4C management mode on rehabilitation and quality of life in patients with acute heart failure(AHF)in cardiovascular intensive care unit(CCU).Methods:This randomized controlled study enrolled 110 patients with AHF admitted in CCU of Guangdong Provincial Hospital of Traditional Chinese Medicine between February 2021 and February 2023.Patients were randomly divided into intervention group(n=55)and control group(n=55).Patients in the control group received routine intervention,while those in the inter-vention group received additional 4C management mode,both groups were intervened for 3 months.The indexes of cardiac function,self-efficacy,exercise tolerance,blood oxygen saturation(SpO2),mental state and quality of life were compared between the two groups.Results:Compared to those in the control group after intervention,patients in the intervention group had significantly lower interventricular septal thickness(IVST)[(9.20±0.10)mm vs.(10.30±0.17)mm,P＜0.001],left ventricular end-systolic volume index(LVESVI)[(35.21±0.74)ml/m2 vs.(39.70±1.09)ml/m2,P＜0.001],left ventricular end-diastolic volume index(LVED VI)[(45.35±0.71)ml/m2 vs.(56.76±1.48)ml/m2,P＜0.001],scores of self-rating anxiety scale(SAS)[(32.10±1.57)points vs.(45.36±1.94)points,P＜0.001],self-rating depression scale(SDS)[(35.03±1.52)points vs.(47.70±2.12)points,P＜0.001]and Minnesota living with heart failure questionnaire(MLHFQ)[(51.27±2.85)points vs.(56.46±3.53)points,P＜0.001],and significantly higher score of general self-efficacy scale(GSES)[(28.71±3.84)points vs.(20.34±1.56)points,P＜0.001],6 min walking distance(6MWD)[(428.53±5.50)m vs.(362.14±6.18)m,P＜0.001]and SpO2[(99.11±0.87)％vs.(94.23±0.73)％,P＜0.001].Conclusion:4C management mode may improve the cardiac function,self-efficacy,mental state and quality of life in patients with acute heart failure in CCU.

Purpose To achieve intelligent detection of acute pulmonary embolism(APE)in CT pulmonary angiography based on the Res2Net attention mechanism network.Materials and Methods Retrospectively included patients with suspected of APE who underwent CT pulmonary angiography examination and were diagnosed as APE at the First Affiliated Hospital of Henan University of Chinese Medicine from February 2015 to May 2023.The dataset was randomly divided into training,validation and test set in a ratio of 7∶2∶1.The model was trained based on the Res2Net network,combined with atrous spatial pyramid pooling and attention mechanism modules,and was performed five-fold cross internal validation.Using the area under the receiver operator characteristic curve,sensitivity and specificity to assess the diagnostic performance of the model.Dice similarity coefficient,precision and intersection over union(IOU)were used to assess the segmentation performance of thrombus on the test set and plot the corresponding curves.The performance of the Res2Net attention mechanism network was compared with the classic U-Net and CE-Net model.Results A total of 303 patients with APE were included in this study.There were 212,61 and 30 cases in the training set,validation set and test set,respectively.The model's area under the curve was 0.95,sensitivity was 0.90,specificity was 1.00,Dice similarity coefficient was 0.86,precision was 0.90,Pos-IOU was 0.78 and Neg-IOU was 1.00,respectively.The parameter curves and radar chart showed that the Res2Net attention mechanism network performed better than the U-Net and CE-Net models.The visualization results of the segmentation comparison showed that the Res2Net attention mechanism network achieved higher precision in segmenting pulmonary artery thrombus.Conclusion The Res2Net attention mechanism network has good performance for detection of APE.

Objective:To explore the effects of 4C management mode on rehabilitation and quality of life in patients with acute heart failure(AHF)in cardiovascular intensive care unit(CCU).Methods:This randomized controlled study enrolled 110 patients with AHF admitted in CCU of Guangdong Provincial Hospital of Traditional Chinese Medicine between February 2021 and February 2023.Patients were randomly divided into intervention group(n=55)and control group(n=55).Patients in the control group received routine intervention,while those in the inter-vention group received additional 4C management mode,both groups were intervened for 3 months.The indexes of cardiac function,self-efficacy,exercise tolerance,blood oxygen saturation(SpO2),mental state and quality of life were compared between the two groups.Results:Compared to those in the control group after intervention,patients in the intervention group had significantly lower interventricular septal thickness(IVST)[(9.20±0.10)mm vs.(10.30±0.17)mm,P＜0.001],left ventricular end-systolic volume index(LVESVI)[(35.21±0.74)ml/m2 vs.(39.70±1.09)ml/m2,P＜0.001],left ventricular end-diastolic volume index(LVED VI)[(45.35±0.71)ml/m2 vs.(56.76±1.48)ml/m2,P＜0.001],scores of self-rating anxiety scale(SAS)[(32.10±1.57)points vs.(45.36±1.94)points,P＜0.001],self-rating depression scale(SDS)[(35.03±1.52)points vs.(47.70±2.12)points,P＜0.001]and Minnesota living with heart failure questionnaire(MLHFQ)[(51.27±2.85)points vs.(56.46±3.53)points,P＜0.001],and significantly higher score of general self-efficacy scale(GSES)[(28.71±3.84)points vs.(20.34±1.56)points,P＜0.001],6 min walking distance(6MWD)[(428.53±5.50)m vs.(362.14±6.18)m,P＜0.001]and SpO2[(99.11±0.87)％vs.(94.23±0.73)％,P＜0.001].Conclusion:4C management mode may improve the cardiac function,self-efficacy,mental state and quality of life in patients with acute heart failure in CCU.

Objective:To investigate the clinical features and multi-slice spiral computed tomography(CT)imaging features of acute appendicitis in soldiers who have been living in plateau for a long time.Methods:The clinical features and imaging data of 56 cases of acute appendicitis in soldiers who have been living in plateau for a long time confirmed by surgery from February 2022 to August 2024 were retrospectively analyzed.Results:In 56 cases with acute appendicitis in soldiers who have been living in plateau for a long time,the appendectomy position results showed:anterior ileum 4 cases(7.14％),lower ileum 10 cases(17.86％),posterior cecum 16 cases(28.57％),lower cecum 9 cases(16.07％),lateral cecum 2 cases(3.58％),posterior ileum 6 cases(10.71％),high(subhepatic)9 cases(16.07％),and left lower abdominal 0 cases,retroperitoneal appendicitis 0 cases,which was suggested that the anatomical position variation of appendicitis in soldiers with acute appendicitis who have been living at high altitude for a long time was relatively large.The direct manifestations of multi-slice spiral CT showed:appendectomy enlarged diameter＞6 mm in 49 cases(87.50％),appendicular wall thickening＞2 mm in 42 cases(75.00％),ppendiceal dilation lumen and effusion in 29 cases(51.79％),appendix indistinctness in 3 cases(5.36％),lppendix fecalith:27 cases(48.21％),gas in the appendix in 16 cases(28.57％).Indirect findings of multi-slice spiral CT showed that,periappendiceal exudation with shadow in 32 cases(57.14％),appendiceal cellulitis with peripheral abscess in 9 cases(16.07％),peritonitis and ascites in 13 cases(23.21％),ileocecal intestinal wall thickening in 22 cases(39.29％),mesenteric lymph node enlargement in 16 cases(28.57％),reflexive intestinal stasis in ileocecal region was observed in 19 cases(33.93％).Conclusion:In the officers and soldiers with acute appendicitis who lived at high altitude for a long time,multi-slice spiral CT showed the direct manifestations of appendiceal thickening,tube wall thickening,lumen dilatation,fluid accumulation,etc.,and the indirect manifestations were periappendiceal exudation with shadow,appendiceal cellulitis with peripheral abscess,ileocecal intestinal wall thickening,reflexes of small intestine and mesenteric lymph node enlargement.Multi-slice spiral CT has the advantages of clear and intuitive,high safety,high resolution and simple operation in the diagnosis of acute appendicitis.

Objective:To retrospectively analyze the genetic differences of thalassemia gene mutations among ethnic groups in Hechi,Guangxi.Methods:A total of 15 595 whole blood samples of residents of Hechi from January 1,2020 to June 30,2023 were screened for thalassemia,and the Gap-PCR method and RDB-PCR method were used to perform genetic testing on the positive samples.Gene sequencing was performed on the samples with positive screening results but negative genotyping results.Results:Among the 15 595 samples,10 501 cases were screened positively,and 8 506 cases were thalassemia gene carriers among the positive samples,with a positive coincidence rate of 81.00％.Among them,there were 5 374 cases of α-thalassemia,2 531 cases of β-thalassemia,and 601 cases of α+β compound thalassemia.A total of 13 mutant types were detected in α-thalassemia,including--SEA(48.57％),-α3.7(31.31％),αCS(8.57％)and-α4.2(8.07％).A total of 17 mutant types were detected in β-thalassemia,mainly CD17(48.27％)and CD41-42(41.24％).The thalassemia gene carriers were mainly from the Zhuang(6 106 cases),Han(969 cases),Yao(793 cases),Mulam(275 cases),and Maonan(228 cases)ethnic groups.The comparison of constituent ratios within the above five ethnic groups demonstrated that there were differences in the proportions of--SEA,-α3.7,αCS,and-α4.2 among the Zhuang,Han,and Yao ethnic groups(P＜0.005).The proportion of αCS in the Mulam ethnic group was not significantly different from-α3.7 and-α4.2.The proportions of--SEA,-α3.7,and αCS in the Maonan ethnic group were not significantly different.There were no significant differences in the proportion of CD17 and CD41-42 among the Han,Yao,Mulam and Maonan ethnic groups.The proportion of--SEA was the highest in the Mulam ethnic group(56.68％),which was statistically different from 35.92％in the Maonan ethnic group.The proportion of-α3.7 was the highest in the Zhuang ethnic group(33.25％),and the difference was statistically significant compared to the Mulam ethnic group which had the lowest proportion(18.72％).The proportion of αCS was the highest in the Maonan ethnic group(27.46％),and the differences were statistically significant compared with other ethnic groups.The proportions of CD17 in the Zhuang and Maonan ethnic groups(50.79％,55.68％)were higher than those in the Han(39.12％),Yao(39.63％)and Mulam(30.00％),and the differences were statistically significant.There was no significant difference in the proportion of CD41-42 among the above five ethnic groups.Conclusions:The mutation type and distribution differences of genes causing thalassemia among main ethnic groups in the minority inhabited areas of Hechi,Guangxi,show the characteristics of ethnic differentiation.The result is helpful to develop a special prevention and control plan for thalassemia in line with the population distribution characteristics,and provide reference for revealing the genetic background and geographical distribution of thalassemia in this area.

Objectives:To investigate the relationship between serum miR-550a-5p levels and spinal metas-tasis in patients with non-small cell lung cancer(NSCLC).Methods:The clinical data of 175 patients with NSCLC who received treatment in the Affiliated Hospital of Chengde Medical College between May 2021 and May 2023 were retrospectively analyzed.According to the results of whole body bone imaging,70 patients with spinal metastasis were enrolled into the metastasis group,and 104 patients without spinal metastasis were enrolled into the none-metastasis group.There were no statistically significant differences in gender,age,smoking,hypertension,thrombosis,and tumor location between the two groups(P＞0.05).The pathological type,clinical stage,lymph node metastasis,and tumor diameter of the patients were collected and compared between the two groups.qRT-PCR was used to detect the expression level of serum miR-550a-5p,enzyme-linked immunosorbent assay was used to detect the serum tartrate-resistant acid phosphatase-5b(TRACP-5b)and type Ⅰ collagen cross-linked C-terminal peptide(ICTP)levels.The differences in serum levels of TRACP-5b,ICTP,and miR-550a-5p were compared between the two groups.The receiver operating characteristic(ROC)curve was adopted to evaluate the diagnostic value of miR-550a-5p,TRACP-5b,and ICTP alone and in combination for spinal metastasis in NSCLC patients.Results:Compared with the none-metastasis group,serum TRACP-5b,ICTP,and miR-550a-5p levels were significantly higher in patients in the metastasis group(P＜0.05).The miR-550a-5p level was significantly higher in patients with tumor diameter≥5cm,lung adenocarcinoma,stage Ⅲ-Ⅳ,and lymph node metastasis than in patients with tumor diameter＜5cm,squamous carcinoma,stage Ⅰ-Ⅱ,and no lymph node metastasis(P＜0.05).Elevated serum miR-550a-5p,lung adenocarcinoma,stage Ⅲ-Ⅳ,and lymph node metastasis were the independent risk factors for the development of spinal metastasis in NSCLC patients(P＜0.05).The AUC of miR-550a-5p for diagnosing spinal metastasis in NSCLC patients was 0.851,and the sensitivity and specificity were 74.29％and 85.58％,respectively,at the optimal cut-off value of 0.20.The diagnostic efficacy of serum miR-550a-5p for diagnosing spinal metastasis in NSCLC patients was significantly better than that of TRACP-5b(Z=2.309,P=0.023)and ICTP(Z=1.852,P=0.049).The AUC of miR-550a-5p,TRACP-5b,and ICTP combination for the diagnosis of spinal metastasis in NSCLC patients was 0.931,and the sensitivity and specificity were 88.57％and 87.50％,respectively.The diagnostic efficacy of the three-marker combination was significantly better than that of the two-marker combination of TRACP-5b and ICTP(Z=2.205,P=0.027).Conclusions:Elevated level of serum miR-550a-5p is associated with spinal metastasis,which can be used as a molecular marker for predicting spinal metastasis in NSCLC patients,moreover,its combination use with bone metabolism-related tumor markers,the ICTP and TRACP-5b,can improve diagnostic efficacy.