Objective To OxplorO thO OffOct of N-tOrminal pro-brain natriurOtic pOptidO( NT-proBNP) combinOd with nOutrophil to lymphocytO ratio ( NLR) on short -tOrm prognosis in patiOnts with acutO ST sOgmOnt OlOvation myocardial infarction ( STEMI ) undOrgoing primary pOrcutanOous coronary intOrvOntion ( PCI ). Methods From January 2015 to DOcOmbOr 2016, 243 patiOnts with acutO STEMI who undOrwOnt primary PCI in Harrision IntOrnational POacO Hospital wOrO OnrollOd in thO study. ThO lOvOls of NT-proBNP and NLR wOrO mOasurOd at admission. ThO occurrOncO of major advOrsO cardiac and cOrObrovascular OvOnts(MACCE) was followOd up during 1 yOar aftOr PCI. ROcOivOr opOrating charactOristic( ROC) curvOs wOrO usOd to sOt cut-off valuOs of NT-proBNP and NLR for prOdicting MACCE. All patiOnts wOrO dividOd into 4 groups basOd on thO optimal cut-off point: low NT-proBNP/low NLR group, low NT - proBNP/high NLR group, high NT - proBNP/low NLR group, high NT-proBNP/high NLR group. Various indicators wOrO comparOd among thO four groups. Survival curvOs of thO 4 groups at 12 months wOrO constructOd by Kaplan -MOiOr analysis and comparOd using thO log -rank tOst. ThO prOdictivO valuO of NT-proBNP and NLR alonO or in combination for MACCE aftOr PCI was OvaluatOd by thO Cox proportional hazard modOl. Results ThOrO wOrO statistically significant diffOrOncOs in TC,LDL-C, blood glucosO, glycosylatOd hOmoglobin, FMC to Ballon timO, NT-proBNP, NRL among thO high NT-proBNP/high NLR group and thO othOr thrOO groups(F =40.684,65.429,398.62,41.330,217.218,331.5,393.02,all P <0.05). ROC analysis indicatOd thO optimal cut-off point of NT-proBNP, NLR for prOdicting MACCE wOrO 1 600 ng/L(thO arOa undOr thO ROC curvO 0.779,sOnsitivity 81.4% ,spOcificity 83.5% ) and 6.5(thO arOa undOr thO ROC curvO 0.742, sOnsitivity 78.6% ,spOcificity 80.8% ),rOspOctivOly.ThO patiOnts in thO high NT-proBNP(>1 600ng/L) and high NLR(>6.5) group had significantly highOr risk of cardiovascular dOath(23.5% ),hOart failurO(47.1% ),rOcurrOnt MI(17.6% ),and cOrObral strokO(11.7% ),but no significantly incrOasO in thO risk of non-plan rOpOat rOvascular-ization, stOnt thrombosis.ThO survival ratO in high NT -proBNP and high NLR group(76.5% ) was significantly lowOr than thO othOr thrOO groups(98.1% ,97.9% ,95.0% ,χ2 =20.626,P<0.05).MultivariatO analysis of COX proportional hazards modOl showOd that TC, LDL - C, blood glucosO, glycosylatOd hOmoglobin, thO onsOt timO, NT-proBNP, NRL could bO usOd as thO prognostic factors for cardiac and cOrObrovascular OvOnts. ThO prOdictivO powOr of NT-proBNP combinOd with NLR was highOr than OithOr NT-proBNP or NLR alonO.Conclusion IncrOasOd lOvOls of NT -proBNP and NLR at admission could prOdict cardiovascular dOath, hOart failurO, rOcurrOnt MI and cOrObral strokO in patiOnts with STEMI aftOr primary PCI. ThO prognostic capability of intOrgratOd application of NT-proBNP and NLR is bOttOr than OithOr NT-proBNP or NLR alonO.

Objective To explore the feasibility,safety and efficacy of customized porous tantalum acetabular patch made by three-dimensional (3D) printing technique in treating adult developmental dysplasia of the hip (DDH).Methods Eight adult patients with Crowe Ⅰ type DDH (2 men and 6 women,with a mean age of 43.75±7.81 years,range 33-58 years) who were treated with 3D printed customized porous tantalum acetabular patch hip reconstruction from January 2017 to September 2017 were included.The 3D printing technique was used for reconstructing and designing the optimal acetabular patch for the personalized hip joint of each patient.The acetabular patch was subjected to porous processing and finite element analysis until the biomechanical requirements were met.The 3D printing of porous tantalum acetabular patch and post-processing was subsequently performed.The acetabular patch was implanted through the anterior approach of the hip joint.The operative duration,intraoperative blood loss and complications were recorded.All the included patients were followed up at 1.5,3 and 6 months postoperatively.Pain was assessed using the visual analog scale (VAS),and the hip joint function was evaluated using the Harris score and gait analysis.The patients underwent anterior-posterior radiography and 3D computed tomography of the hip joint aiming to observe the position of the acetabular patch and osteoarthritis progression.Results The mean operative duration was 1.13±0.23 h,and the mean blood loss was 114.17±41.22 ml.All patients were followed up for 6 to 12 months,with an average of 8.2 months.The mean lateral central-edge angle and anterior central-edge angle ranged from 9.83°±5.34° preoperatively to 32.67°±2.53° postoperatively and from 3.83°± 2.79° preoperatively to 21.67°± 1.87° postoperatively,respectively.The rate of acetabular coverage increased from 57.33％±7.97％ preoperatively to 87.33％±4.56％ postoperatively.The VAS and Harris scores ranged from 2.92± 0.79 preoperatively to 0.83±0.72 postoperatively and from 69.67±4.62 preoperatively to 84.25±4.14 postoperatively with statistically significant difference,respectively.The results of gait analysis showed that the step speed,stride,the range of motion of hip and knee were better than that preoperatively.The images suggested a close contact between the tantalum acetabular patch and the iliac bone without loosening and progress of osteoarthritis in hip joint.Conclusion 3D printed customized porous tantalum acetabular patch could reconstruct the defect of acetabular,increase the coverage,and delay the progress of osteoarthritis of the hip joint.This method could reduce the difficulty of hip reconstruction,and the patients could obtain better joint function at the early stage.

OBJECTIVE To investigate the clinical effect of Budigafol combined with Staphylococcus and neisseria tablets in maintenance treatment of patients with stable moderate to severe chronic obstructive pulmonary disease （COPD）. METHODS A total of 122 patients with stable moderate to severe COPD who were admitted to the infections diseases ward of the department of respiratory and critical care medicine in our hospital from October 1， 2021 to January 31， 2023 were divided into control group （n＝61） and observation group （n＝61） according to the random number table method. Patients in the control group were treated with Budigafol inhalation aerosol alone （2 presses each time， twice a day）， and patients in the observation group were treated with Staphylococcus and neisseria tablets （1.2 mg each time， 3 times a day） on the basis of the control group. The treatment course of both groups was 3 months. The quality of life， exercise tolerance， lung function， inflammatory indexes， immune function， as well as the number of acute attacks of COPD and the occurrence of adverse reactions were compared between the two groups before and after treatment. RESULTS Control group and observation group shed 12 and 9 patients， respectively. After treatment， the 6 minute walking distance of the two groups of patients was significantly prolonged compared with that before treatment （P＜0.05）. The COPD assessment test questionnaire score， St George’s respiratory questionnaire score， the ratio of residual volume to total lung capacity， the fractional exhaled nitric oxide， the serum levels of C-reactive protein and interleukin-6 were significantly E-mail：13956685295@163.com decreased compared with those before treatment （P＜0.05）. The forced expiratory volume in one second （FEV1）， the ratio E-mail：13966580920@163.com of FEV1 to forced vital capacity， the percentage of the measured value of carbon monoxide diffusion capacity to the predicted value， and the percentage of the measured value of FEV1 to the predicted value were significantly increased compared with those before treatment （P＜0.05）. The improvement of the above indicators in the observation group was significantly better than that in the control group （P＜0.05）. Compared with before treatment， there was no statistical significance in the immune function indexes of the control group or the serum levels of immunoglobulin A （IgA） and IgM in the observation group after treatment （P＞0.05）. The percentages of CD3+ ， CD4+ ， B lymphocytes and natural killer cells， the levels of CD4+/CD8+ and IgG were significantly increased in the observation group （P＜ 0.05）， the percentage of CD8+ cells was significantly decreased （P＜0.05）， and the improvement degree of the observation group was significantly better than that of the control group （P＜0.05）. There was no significant difference in the number of acute exacerbations of COPD during the follow-up period and the incidence of adverse events during treatment between the two groups （P＞0.05）. CONCLUSIONS Budigafol combined with Staphylococcus and neisseria tablets can effectively improve the immune function of patients with stable moderate to severe COPD， further reduce the level of inflammation， and improve their exercise tolerance and their quality of life with good safety.