Objective To compare the effects of the left and right stellate ganglion resection on myocardial injury in rats with acute myocardial infarction(AMI).Methods According to the random number table method,30 healthy male Sprague Dawley rats were divided into the AMI group,left stellate ganglionectomy group,and right stellate ganglionectomy group,with 10 rats in each group.AMI models were prepared by ligation of the left anterior descending branch of the coronary artery in all the three groups.In the AMI group,the stellate ganglion was isolated(randomly left or right)without excision.The rats in the left and right stellate ganglionectomy groups underwent the left and right stellate ganglionectomy,respectively.At 24 hours after modeling,2 mL of subclavian venous blood was extracted from the three groups of rats.The serum levels of cardiac troponin Ⅰ(cTnⅠ),noradrenaline(NE),interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),and superoxide dismutase(SOD)were detected by enzyme-linked immunosorbent assay.The left ventricular fractional shortening(LVFS),left ventricular ejection fraction(LVEF)and cardiac output(CO)of rats in the three groups were measured by echocardiography one week after modeling.Results The serum levels of NE,cTnⅠ and MDA in the left and right stellate ganglionectomy groups were significantly lower than those in the AMI group,and SOD level was significantly higher than that in the AMI group(P＜0.05);the serum levels of NE,cTnⅠ and MDA in the right stellate ganglionectomy group were significantly lower than those in the left stellate ganglionectomy group,and SOD level was significantly higher than that in the left stellate ganglionectomy group(P＜0.05).The levels of serum IL-1β,IL-6 and TNF-α in the left and right stellate ganglionectomy groups were significantly lower than those in the AMI group(P＜0.05);the levels of serum IL-1β,IL-6 and TNF-αin the right stellate ganglionectomy group were significantly lower than those in the left stellate ganglionectomy group(P＜0.05).LVEF,LVFS and CO in the left and right stellate ganglionectomy groups were significantly higher than those in the AMI group,and LVEF and LVFS in the right stellate ganglionectomy group were significantly higher than those in the left stellate ganglionectomy group(P＜0.05);there was no significant difference in CO between the left and right stellate ganglionectomy groups(P＞0.05).Conclusion Stellate ganglionectomy has a protective effect on AMI induced by ligation of the left anterior descending branch of the coronary artery,which may be related to reducing inflammatory reaction and oxidative stress damage.The right stellate ganglion resection has more protective effects on cardiac function than the left stellate ganglion resection.

Objective To explore the effect and the possible mechanism of knockdown acetyl CoA carboxylase 1(ACC1)on the migration of KYSE450 cells.Methods KYSE450 cells during the logarithmic phase were randomly divided into the shNC group,shACC1 group,shNC+AEB071 group,and shACC1+AEB071 group.The KYSE450 cells in the shNC group were transfected with empty plasmid;the KYSE450 cells in the shACC1 group were transfected with lentiviral plasmid;the KYSE450 cells in the shNC+AEB071 group were transfected with empty plasmid and then added with 5 μL of 2 mmoL·L-1 protein kinase C(PKC)inhibitor AEB071(final concentration 5 μmoL·L-1);The KYSE450 cells in the shACC1+AEB071 group were transfected with lentiviral plasmid and then added with 5 μL of 2 mmoL·L-1 PKC inhibitor AEB071(final concentration 5 μmoL·L-1).The migration of KYSE450 cells was detected by Transwell assay.The morpho-logical changes of KYSE450 cells were observed under the microscope.The expression levels of ACC1,histone H3(H3),histone H3 lysine 9 acetylation(H3K9Ac),and epithelial-mesenchymal transition(EMT)markers such as β-catenin,Vimentin and Snail were measured by Western blot.Results The migration of KYSE450 cells in the shACC1 group was significantly higher than that in the shNC group(P＜0.05);there was no significant difference in the migration ability of KYSE450 cells between the shNC+AEB071 group and the shNC group(P＞0.05);the migration of KYSE450 cells in the shACC1+AEB071 group was significantly lower than that in the shACC1 group(P＜0.05).The KYSE450 cells in the shNC group revealed an elliptical epithelial-like cell morphology;the KYSE450 cells in the shACC1 group exhibited a spindle-like interstitialcell morphology;the KYSE450 cells in the shNC+AEB071 and shACC1+AEB071 groups showed an elliptical epithelial-like cell morphology.The relative expression level of ACC1 in KYSE450 cells in the shACC1 group was significantly lower than that in the shNC group(P＜0.05),while the relative expression levels of β-catenin,Vimentin and Snail as well as the ratio of H3K9Ac/H3 were significantly higher than those in the shNC group(P＜0.05);the relative expression levels of ACC1,β-catenin,Vimentin and Snail as well as the ratio of H3K9Ac/H3 showed no significant difference between the shNC+AEB071 group and the shNC group(P＞0.05);the relative expression levels of β-catenin,Vimentin and Snail as well as the ratio of H3K9Ac/H3 in the shACC1+AEB071 group were significantly lower than those in the shACC1 group(P＜0.05);there was no significant difference in the relative expression level of ACC1 in KYSE450 cells between the shACC1+AEB071 group and the shACC1 group(P＞0.05).Conclusion Knockdown of ACC1 promotes migration of KYSE450 cells and thus aggravates the tumor,which may be mediated by PKC-related signaling pathways.

Objective To investigate the effect and molecular mechanism of safflower yellow(SY)on wound healing of diabetic foot ulcer(DFU)in mice.Methods Forty-five C57BL/6 mice were injected intraperitoneally with streptozotocin to establish diabetic models.The diabetic mice were randomly divided into the sham operation group,model group,low-dose SY intervention group,high-dose SY intervention group,and high-dose SY combined with insulin-like growth factor-1(IGF-1)group,with 9 mice in each group.Before modelling,mice in the model group were not given any intervention,mice in the low-dose SY intervention group and high-dose SY intervention group were injected intraperitoneally with 5 and 20 mg·kg-1 SY,respectively,and mice in the high-dose SY combined with IGF-1 group were injected intraperitoneally with 20 mg·kg-1 SY and 0.03 mg·kg-1 IGF-1.Except for the sham operation group,the DFU model was established by incising the dorsal skin of the foot in the remaining four groups of mice.No wound on the dorsal skin of the foot was made in the sham operation group,and the remaining surgical steps were the same as those in the model group.The body mass of mice in each group was measured on day 14 after modelling using an electronic scale,tail vein blood was collected for fasting blood glucose measurement,and the wound width was measured using a small vernier caliper.Then,the mice were executed to collect the wound tissues.Hematoxylin-eosin staining was used to detect the histopathological changes in the wound tissues of mice in each group.Reverse transcription-quantitative real-time polymerase chain reaction was used to measure the relative expression levels of platelet-derived growth factor(PDGF),vascular endothelial growth factor(VEGF),alpha-smooth muscle actin(α-SMA),type Ⅰ collagen(collagen Ⅰ),protein tyrosine phosphatase 1B(PTP1B)and advanced glycation end products(AGEs)mRNA in the wound tissues of mice in each group.Western blot was used to detect the relative expression levels of proliferation marker Ki-67,proliferating cell nuclear antigen(PCNA),apoptosis-associated proteins(caspase-3,caspase-6,and caspase-7),p85 phosphatidylinositol-3-kinase(PI3K)and phosphorylated protein kinase B(p-AKT)protein in the wound tissues of mice in each group.Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,and IL-6 in the wound tissues of mice in each group.Results The differences in blood glucose and body mass of mice among the sham operation group,model group,low-dose SY intervention group,high-dose SY intervention group,and high-dose SY combined with IGF-1 group were not statistically significant(P＞0.05).The healing rate of wound tissues in the high-dose SY intervention group was significantly greater than that in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01).There was no statistically significant difference in the healing rate of wound tissues among the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＞0.05).In the high-dose SY intervention group,a large number of collagen fibers were densely and orderly arranged in the wound tissues,accompanied by a large number of neovessels;in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group,the wound tissues were sparsely populated with collagen fibers,accompanied by a small number of neovessels.The relative expression levels of PDGF,VEGF,α-SMA and collagen Ⅰ mRNA in the wound tissues of mice in the high-dose SY intervention group were significantly higher than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01);the relative expression levels of PTP1B and AGEs mRNA in the wound tissues of mice in the high-dose SY intervention group were significantly lower than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01).The relative expression levels of PDGF,VEGF,α-SMA,collagen Ⅰ,PTP1B and AGEs mRNA showed no statistically significant difference among the model,low-dose SY intervention,and high-dose SY combined with IGF-1 groups(P＞0.05).The relative expression levels of Ki-67 and PCNA protein in the wound tissues of mice in the high-dose SY intervention group were significantly higher than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01);the relative expre-ssion levels of caspase-3,caspase-6,caspase-7,p85 PI3K,and p-AKT protein were significantly lower than those in the model group,low-dose SY intervention group,and high-dose SY combined with IGF-1 group(P＜0.01).There was no statistically significant difference in the relative expression levels of Ki-67,PCNA,caspase-3,caspase-6,caspase-7,p85 PI3K and p-AKT protein among the model,low-dose SY intervention,and high-dose SY combined with IGF-1 groups(P＞0.05).The levels of TNF-α,IL-1β and IL-6 in the wound tissues of mice in the high-dose SY intervention group were significantly lower than those in the model,low-dose SY intervention,and high-dose SY combined with IGF-1 groups(P＜0.01).There was no statistically significant difference in the levels of TNF-α,IL-1β and IL-6 in the wound tissues of mice in the model,low-dose SY intervention and high-dose SY combined with IGF-1 groups(P＞0.05).Conclusion High-dose SY intervention promotes DFU wound healing in mice by increasing angiogenesis,collagen formation and cell proliferation and reducing insulin resistance,inflammatory response and cell apoptosis,which may be related to the inhibition of the PI3K/AKT pathway.

Objective To analyze the risk factors for hyperuricemia in patients with primary IgA nephropathy(IgAN).Methods A total of 186 patients with primary IgAN admitted to the Department of Nephrology of the First Affiliated Hospital of Xinjiang Medical University from March 2018 to February 2021 were selected as the research subjects.The patients were divided into the IgAN group(n=104)and IgAN with hyperuricemia group(n=82)according to the blood uric acid(UA)level.The clinical data of patients in the two groups were compared.Univariate and multivariate logistic regression were used to analyze the risk factors of IgAN with hyperuricemia,and Pearson correlation was used to analyze the relationship between blood UA levels and clinical indicators in patients with primary IgAN.Results The results of univariate analysis showed that there was no significant difference in gender,age,body mass index(BMI),blood albumin,plasma total protein,high-density lipoprotein,serum IgA,serum complement C3,and serum complement C4 between the two groups(P＞0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),low-density lipoprotein,serum creatinine,total cholesterol,triglycerides,blood urea nitrogen,24-hour urine protein quantification,and blood UA level of patients in the IgAN with hyperuricemia group were significantly higher than those in the IgAN group,while hemoglobin and estimated glomerular filtration rate(eGFR)were significantly lower than those in the IgAN group(P＜0.05).Pearson correlation analysis showed that there was no significant association between primary IgAN with hyperuricemia and age,BMI,blood albumin,plasma total protein,high-density lipoprotein,serum IgA,and serum complement C3(r=-0.020,-0.067,-0.064,-0.037,-0.103,0.008,0.042,P＞0.05);primary IgAN with hyperuricemia was positively correlated with SBP,low-density lipoprotein,DBP,serum creatinine,total cholesterol,triglycerides,blood urea nitrogen,and 24-hour urine protein quantification(r=0.392,0.296,0.552,0.713,0.452,0.787,0.599,0.655,P＜0.05),and was negatively correlated with hemoglobin level,serum complement C4 level,and eGFR(r=-0228,-0663,-0516,P＜0.05).Multivariate logistic regression analysis showed that high SBP,DBP,triglyceride level,and blood UA level were independent risk factors for hyperuricemia in IgAN patients(P＜0.05).Conclusion High SBP,DBP,triglyceride level,and blood UA level are independent risk factors for hyperuricemia in patients with primary IgAN.

Objective To investigate the influencing factors of low cardiac output syndrome(LCOS)after coronary artery bypass grafting(CABG)and construct a nomogram model to predict the risk of LCOS occurrence.Methods A total of 231 patients with coronary atherosclerotic heart disease who underwent CABG surgery in the Heart Center of Henan Provincial People's Hospital from October 2019 to May 2022 were selected for the study.The patients were randomly divided into a training set(n=162)and a validation set(n=69)at a ratio of 7∶3.The comparability between the parameters of the patients in the training and validation sets was assessed.Based on the occurrence of LCOS after CABG,patients in the training set were divided into LCOS group(n=33)and non-LCOS group(n=129).Univariate and multivariate logistic regression analysis were conducted on the sample parameters in the training set to identify independent risk factors for LCOS after CABG.A nomogram prediction model for the risk of LCOS after CABG was constructed,and its discrimination,calibration,and clinical applicability were evaluated by using the receiver operating characteristic curve,calibration curve,and decision curve analysis.Results The incidence of LCOS in patients of the training and validation sets was 20.37％(33/162)and 18.84％(13/69),respectively.There were no statistically significant differences in various parameters between the training and validation sets(P＞0.05).In the training set,there were statistically significant differences in the following parameters between the non-LCOS group and the LCOS group patients,including age,heart rate,blood urea nitrogen,serum creatinine,estimated glomerular filtration rate(eGFR),serum N-terminal pro B-type natriuretic peptide(NT-proBNP),serum troponin T,left ventricular ejection fraction(LVEF),mitral regurgitation area,history of myocardial infarction,proportion of NYHA class Ⅲ-Ⅳ,proportion of patients requiring cardiopulmonary bypass,surgical duration,intraoperative bleeding volume,and postoperative hemodynamic indicators such as central venous pressure,pulmonary arterial diastolic pressure and pulmonary artery pulse index(PAPI)(P＜0.05).Multivariate logistic regression analysis showed that preoperative LVEF decrease[odds ratio(OR)=0.891,95％confidence interval(CI):0.832-0.954,P=0.001)],preoperative eGFR decrease(OR=0.963,95％CI:0.934-0.994,P=0.018),preoperative NT-proBNP increase(OR=1.001,95％CI:1.000-1.001,P=0.006),increased operation time(OR=1.013,95％CI:1.003-1.022,P=0.008),and postoperative PAPI reduction(OR=0.094,95％CI:0.028-0.319,P=0.000)were independent risk factors for LCOS after CABG.A nomogram prediction model was built based on these indicators.In the training set,the nomogram prediction model had an area under the curve(AUC)of 0.931(95％CI:0.890-0.972)for predicting the LCOS occurrence,with a sensitivity of 82.20％and a specificity of 90.90％.In the validation set,the AUC for predicting the LCOS occurrence was 0.907(95％CI:0.813-1.000),with a sensitivity of 96.40％and a specificity of 84.60％.This indicated that the model had high discrimination.The calibration curve showed good consistency between the predicted probability and the actual probability of LCOS occurrence in both the training and validation sets(average absolute error:0.038 and 0.026,respectively).The Hosmer-Lemeshow goodness-of-fit test demonstrated that the model's prediction deviation for the LCOS occurrence was not statistically significant compared to the actual occurrence(x2=6.381,6.907,P＞0.05),indicating good calibration of the model.Conclusion Decreased LVEF and eGFR and elevated NT-proBNP preoperatively,prolonged surgical duration,and decreased PAPI postoperatively are independent risk factors for LCOS after CABG.The nomogram prediction model established based on these factors has high discrimination,calibration,and clinical applicability,and can effectively predict the occurrence of LCOS after CABG.

Objective To explore the trends and patterns of changes in airway inflammation,mitochondrial function,and arginine levels in patients with different degrees of asthma.Methods A total of 122 patients with acute asthma admitted to the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from November 2016 to May 2017 were selected as the research subjects.According to the severity grading criteria,the patients were divided into the intermittent state group(n=45),mild asthma group(n=23),moderate asthma group(n=30),and severe asthma group(n=24).Another 44 healthy individuals who underwent physical examinations at the Medical Examination Center of the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from November 2016 to May 2017 were selected as the healthy control group.About 18-20 mL of venous blood was extracted from each group of subjects.The levels of L-arginine(L-Arg)and asymmetric dimethylarginine(ADMA)were detected by high-performance liquid chromatography-tandem mass spectrometry,and the levels of type 1 protein arginine methyltransferase(PRMT1),dimethylarginine dimethylaminohydrolase 1(DDAH1),reactive oxygen species(ROS),thiobarbituric acid reactive substances(TBARS),8-isoprostaglandin(8-iso),lipid peroxide(LPO),and malondialdehyde(MDA)were detected by enzyme-linked immunosorbent assay.Platelets and mitochondria were extracted from each group of subjects.The platelet mitochondrial membrane potential(MMP)was measured using JC-1 flow cytometry,and the mitochondrial adenosine triphosphate(ATP)and cytochrome C oxidase(COX)activity were detected.Results The level of 8-iso in plasma of patients in the intermittent state group,mild asthma group,moderate asthma group,and severe asthma group were significantly higher than that in the healthy control group(P＜0.05);the level of 8-iso in plasma of patients in the severe asthma group was significantly higher than that in the intermittent state group,mild asthma group,and moderate asthma group(P＜0.05);the level of 8-iso in plasma of patients in the intermittent state group,mild asthma group,and moderate asthma group showed an increasing trend,but there was no statistically significant difference(P＞0.05).There was no statistically significant difference in the TBARS level in the plasma of subjects in the five groups(P＞0.05).The levels of ROS and MDA in plasma of patients in the intermittent state group,mild asthma group,moderate asthma group,and severe asthma group were significantly higher than those in the healthy control group(P＜0.05);the levels of ROS and MDA in plasma of patients in the moderate asthma group and severe asthma group were significantly higher than those in the intermittent state group and mild asthma group(P＜0.05);there was no statistically significant difference in plasma ROS and MDA levels between the intermittent state group and the mild asthma group(P＞0.05),and there was no statistically significant difference in plasma ROS and MDA levels between the moderate asthma group and the severe asthma group(P＞0.05).The plasma LPO level of patients in the intermittent state group,mild asthma group,moderate asthma group,and severe asthma group was significantly higher than that in the healthy control group(P＜0.05);the plasma LPO level of patients in the moderate asthma group and severe asthma group was significantly higher than that in the intermittent state group(P＜0.05);there was no statistically significant difference in plasma LPO level of patients in the mild asthma group,moderate asthma group,and severe asthma group(P＞0.05).The mitochondrial MMP,ATP,and COX activity in the intermittent state group,mild asthma group,moderate asthma group,and severe asthma group were significantly lower than those in the healthy control group(P＜0.05);there was no statistically significant difference in mitochondrial MMP,ATP,and COX activity of patients in the intermittent state group,mild asthma group,moderate asthma group,and severe asthma group(P＞0.05).The levels of plasma L-Arg,the ratio of L-Arg/ADMA,and DDAH1 in the intermittent state group,mild asthma group,moderate asthma group,and severe asthma group were significantly lower than those in the healthy control group(P＜0.05);there was no statistically significant difference in plasma L-Arg,the ratio of L-Arg/ADMA,and DDAH1 levels of patients in the intermittent state group,mild asthma group,moderate asthma group,and severe asthma group(P＞0.05).The plasma ADMA and PRMT1 levels showed no statistically significant difference among the five groups of patients(P＞0.05).Conclusion Asthma patients exhibit mitochondrial dysfunction and abnormal arginine metabolism at any stage of the disease.Although there is no statistically significant difference in the change trend at the cellular micro level among patients with different stages of asthma,the trend of changes in oxidative damage in the body is consistent with the aggravation of the disease.

Objective To investigate the influence of sodium bicarbonate Ringer's solution and compound Ringer's solution on patients'acid-base balance and liver and kidney function during controlled low central venous pressure(CLCVP)hepatectomy.Methods A total of 60 patients with primary liver cancer who underwent CLCVP hepatectomy in the Affiliated Cancer Hospital of Zhengzhou University from June 2020 to June 2022 were selected and randomly divided into the sodium bicarbonate Ringer's solution group and compound Ringer's solution group,with 30 patients in each group.Patients in the sodium bicarbonate Ringer's solution group were infused with sodium bicarbonate Ringer's solution,while patients in the compound Ringer's solution group were infused with compound Ringer's solution after anesthesia induction and before liver parenchymal disconnection.The pH value,base excess(BE)and blood lactic acid(Lac)levels were detected using the blood gas analyzer in the two groups before anesthesia induction(T,),at the beginning of surgery(T2),2 h during surgery(T3),4 h during surgery(T4),and at the end of surgery(T5),respectively.The levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),and serum creatinine(Scr)were detected using the automatic biochemical analyzer 24 h before and 24 h after surgery,respectively.The body mass,surgical time,intraoperative infusion volume,urine volume,changes in body acid-base balance during surgery,and changes in liver and kidney function before and after surgery between the two groups were compared.Results There was no statistically significant difference in body mass,surgical time,intraoperative infusion volume,and urine volume between the two groups of patients(P＞0.05).At T,,there was no statistically significant difference in pH value,BE and Lac levels between the two groups of patients(P＞0.05).Compared to T,,the pH value in the compound Ringer's solution group increased at T2 and decreased at T3,T4 and T5,while BE and Lac levels from T2 to T5 showed an increasing trend(P＜0.05);compared to T,,the pH value in the sodium bicarbonate Ringer's solution group increased at T2 and decreased at T3,BE and Lac levels increased at T2 and T3(P＜0.05),and there was no statistically significant difference in pH value,BE and Lac levels at T4 and T5 compared to T1(P＞0.05).At T5,the pH value in the sodium bicarbonate Ringer's solution group was significantly higher than that in the compound Ringer's solution group,while the BE and Lac levels were significantly lower than those in the compound Ringer's solution group(P＜0.05).There was no statisti-cally significant difference in the levels of ALT,AST,BUN and Scr 24 hours before surgery between the two groups of patients(P＞0.05);compared to 24 hours before surgery,there was no significant change in the levels of ALT,AST,BUN and Scr 24 hours after surgery(P＞0.05);there was no statistically significant difference in the levels of ALT,AST,BUN and Scr 24 hours after surgery between the two groups(P＞0.05).Conclusion Compared to compound Ringer's solution,sodium bicarbonate Ringer's solution has a smaller impact on the internal environment of the body during the CLCVP hepatectomy and can effectively maintain the stability of the body's acid-base balance.Both the two solutions have no significant impact on the patient's liver and kidney function.

Objective To explore the efficacy of semaglutide in the treatment of type 2 diabetes mellitus(T2DM)com-bined with non-alcoholic fatty liver disease(NAFLD)and its effect on oxidative stress and inflammatory factors.Methods Totally 80 patients with T2DM accompanied by NAFLD admitted to the First Affiliated Hospital of Xinxiang Medical University from July 2021 to December 2022 were selected and randomly assigned to the observation group and the control group,with 40 patients in each group.Patients in the control group were treated with pioglitazone metformin and dapagliflozin,while patients in the observation group were treated with pioglitazone metformin,dapagliflozin,and semaglutide.The levels of glycated hemoglobin(HbA1c),fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG),body mass,body mass index(BMI),waist circumference,alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT),controlled attenuation parameter(CAP),liver stiffness measurement(LSM),malondialdehyde(MDA),glutathione peroxidase(GSH-PX),lipid peroxide(LPO),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-10(IL-10)before and after the treatment were compared.Results After 24 weeks of treatment,the overall response rate(ORR)in the observation group and control group was 92.5％(37/40)and 72.5％(29/40),respectively;and the ORR in the observation group was significantly higher than that in the control group(x2=5.541,P＜0.05).Before treatment,there was no statistically significant difference in the body mass,BMI,waist circumference,HbA1c,FBG,2hPG,ALT,AST,GGT,CAP,LSM,MDA,GSH-PX,LPO,TNF-α,IL-6,and IL-10 of patients between the 2 groups(P＞0.05);after 24 weeks of treatment,the body mass,BMI,waist circumference,HbA1c,FBG,2hPG,ALT,AST,GGT,CAP,LSM,MDA,LPO,TNF-α,IL-6,and IL-10 were significantly lower than before treatment,while GSH-PX was significantly higher than before treatment(P＜0.05);after 24 weeks of treatment,the body mass,BMI,waist circumference,HbA1c,FBG,2hPG,ALT,AST,GGT,CAP,LSM,MDA,LPO,TNF-α,IL-6,and IL-10 of patients in the observation group were significantly lower than those in the control group,and GSH-PX was significantly higher than that in the control group(P＜0.05).The incidence of adverse reactions in the observation group and the control group during the treatment period was 17.5％(7/40)and 12.5％(5/40),respectively;and the difference in the incidence of adverse reactions between the two groups was not statistically significant(P＞0.05).Conclusion Semaglutide significantly downregulates the levels of FBG,2hPG and HbA1c in patients with T2DM combined with NAFLD and reduces the body mass,waist circumference,liver enzyme level,hepatic fat content,hepatic fibrosis,oxidative stress,and inflammatory indicators.

Objective To investigate the effect of combined lactobacillus complex capsules and nutritional support on nutritional biochemical indices and intestinal microecology in patients with severe pneumonia.Methods A total of 117 patients with severe pneumonia treated in Zhengzhou Central Hospital from October 2017 to November 2019 were selected as the research subjects.The patients were divided into the control group(n=58)and observation group(n=59)based on their treatment plans.Both groups received basic symptomatic treatment,and on this basis,the control group was given enteral nutritional support,while the observation group was given both enteral nutritional support and lactobacillus complex capsules for two weeks.The duration of mechanical ventilation,hospital stay,length of stay in the intensive care unit,duration of antibiotic use,and incidence of adverse events were recorded and compared between the two groups.The serum albumin(ALB),pre-albumin(PA),and total lymphocyte count(TLC)of patients in the two groups were detected using the fully automatic biochemical analyzer;the proportion of helper T cell(Th)1 and Th2 was detected by flow cytometer,and the Th1/Th2 ratio was calculated;the partial pressure of carbon dioxide(PaCO2),oxygenation index(PaO2/FiO2),and blood oxygen saturation(SaO2)were measured using the blood gas analyzer.Before treatment and after two weeks of treatment,the severity of the disease was evaluated using the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,and intestinal microecological indicators(the counts of Lactobacillus,Enterococcus,and Bifidobacterium)were measured.Results The observation group had shorter durations of mechanical ventilation,hospital stay,intensive care unit stay,and antibiotic use compared to the control group(P＜0.05).There were no significant differences in the levels of PA,TLC,and ALB between the two groups before treatment(P＞0.05).After two weeks of treatment,the levels of PA,TLC,and ALB in both groups increased compared to before treatment(P＜0.05),and the observation group had higher levels of PA,TLC,and ALB than the control group(P＜0.05).Before treatment,there were no significant differences in PaO2/FiO2,PaCO2,SaO2,and APACHE Ⅱ score between the two groups(P＞0.05).After two weeks of treatment,both groups had higher PaO2/FiO2 and SaO2,and lower PaCO2 and APACHE Ⅱ score compared to before treatment(P＜0.05).After two weeks of treatment,the observation group had higher PaO2/FiO2 and SaO2,and lower PaCO2 and APACHE Ⅱ score than the control group(P＜0.05).Before treatment,there were no significant differences in Th1 and Th2 proportions and Th1/Th2 ratio between the two groups(P＞0.05).After two weeks of treatment,both groups had higher Th1 proportion and Th1/Th2 ratio and lower Th2 proportion compared to before treatment(P＜0.05).After two weeks of treatment,the observation group had higher Th1 proportion and Th1/Th2 ratio and lower Th2 proportion than the control group(P＜0.05).Before treatment and after two weeks of treatment,there was no significant differences in the counts of Lactobacillus,Enterococcus,and Bifidobacterium between the two groups(P＞0.05);there was no significant differences in the counts of Lactobacillus,Enterococcus,and Bifidobacterium before and after treatment within each group(P＞0.05).The incidences of ventilator-associated pneumonia(VAP),respiratory failure,diarrhea,and 28-day mortality in the control group were 18.97％(11/58),17.24％(10/58),20.70％(12/58),and 5.17％(3/58),respectively;and in the observation group,they were 5.08％(3/59),3.40％(2/59),3.40％(2/59),and 1.70％(1/59),respectively.The incidences of VAP,respiratory failure and diarrhea in the observation group were significantly lower than those in the control group(P＜0.05),and there was no significant difference in the 28-day mortality rate between the two groups(P＞0.05).Conclusion The combination of lactobacillus complex capsules with nutritional support improves the nutritional biochemical indicators and blood gas indicators of patients with severe pneumonia,reduces APACHE Ⅱ scores,and decreases the occurrence of adverse events.

Objective To investigate the predictive value of systemic immune inflammation index(SII),myoglobin(Mb),and their combination for acute kidney injury(AKI)after acute Stanford type A aortic dissection(ATAAD)surgery.Methods A total of 102 patients with ATAAD who underwent surgical treatment in Henan Chest Hospital from February 2021 to December 2022 were selected as the research subjects.The patients were divided into the AKI group and the non-AKI group according to the occurrence of AKI or not after operation.The age,gender,smoking history,body mass index(BMI),hyperten-sion history,diabetes history,and hemoglobin,serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA),myoglobin(Mb),SII and estimated glomerular filtration rate(eGFR)before operation,as well as operation time,cardiopulmonary bypass(CPB)time,aortic occlusion(ACC)time,intraoperative bleeding volume,and intraoperative urine volume were compared between the two groups.Univariate and multivariate logistic regression models were used to analyze the risk factors for AKI after ATAAD surgery,and receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of SII,Mb and their combination for AKI after ATAAD surgery.Results The overall incidence of AKI among 102 patients was 46.08％(47/102).There was no significant difference between the two groups in age,diabetes history,preoperative hemoglobin and BUN levels,ACC time,and intraoperative bleeding volume(P＞0.05),while gender,smoking history,BMI,hypertension history,preoperative SII,Mb,Scr,UA and eGFR,operation time,CPB time,and intraoperative urine volume had statistically significant differences between the two groups(P＜0.05).Multivariate logistic regression analysis showed that a history of hypertension,high BMI,preoperative high SII and Mb,and long CPB time were independent risk factors for AKI after ATAAD surgery(P＜0.05).ROC curve analysis showed that the cutoff values for predicting postoperative AKI in AT A AD patients with preoperative SII and Mb were 2 038.825 × 109 L-1 and 27.000 μg·L-1,respectively.The area under the curve(AUC)was 0.785 and 0.769,with a sensitivity of 0.745 and 0.766 and a specificity of 0.727 and 0.745,respectively.The ROC of combined preoperative SII and Mb for prediction of postoperative AKI in ATAAD patients was 0.800,sensitivity was 0.723,and specificity was 0.782.Conclusion A history of hypertension,high BMI,preoperative high SII and Mb levels,and long CPB time are independent risk factors for AKI after ATAAD surgery.Preoperative SII and Mb have certain values in predicting the occurrence of AKI after ATAAD surgery,and the predictive power of the combination is higher than that of a single indicator.