ObjectiveTo investigate the value of albumin-bilirubin （ALBI）， easy albumin-bilirubin （EZ-ALBI）， and platelet-albumin-bilirubin （PALBI） scores in predicting 2-year survival in patients with HCV-associated hepatocellular carcinoma （HCV-HCC）. MethodsA retrospective analysis was performed for the clinical data of 174 patients with HCV-HCC who were admitted to The Third People’s Hospital of Kunming from January 2020 to January 2022， and the patients were followed up till 2 years after admission. According to the follow-up results， the patients were divided into survival group with 95 patients and death group with 79 patients. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the influencing factors for the survival of HCV-HCC patients. The Kaplan-Meier method was used to plot survival curves and analyze the 2-year survival rate of HCV-HCC patients with different EZ-ALBI grades， and the log-rank test was used for comparison between groups. ResultsThere were significant differences between the survival group and the death group in platelet count， aspartate aminotransferase （AST）， total bilirubin， albumin （Alb）， alpha-fetoprotein （AFP）， prealbumin， prothrombin time， international normalized ratio， PALBI score， ALBI score， EZ-ALBI score， Model for End-Stage Liver Disease （MELD） score， HCV genotype， peritoneal effusion， and vascular invasion （all P<0.05）. The univariate Cox regression analysis showed that AST， Alb， AFP， ALBI score， EZ-ALBI score， PALBI score， MELD score， Barcelona Clinic Liver Cancer Staging， and peritoneal effusion were influencing factors for the survival of patients （all P<0.05）， and the multivariate Cox regression analysis showed that EZ-ALBI score （hazard ratio ［HR］=1.850， 95% confidence interval ［CI］： 1.054 — 3.247， P=0.032） and peritoneal effusion （HR=1.993， 95%CI： 1.030 — 3.858， P=0.041） were independent risk factors for the survival of HCV-HCC patients. The survival curve analysis showed that the patients with EZ-ALBI grade 1/2/3 had a 2-year survival rate of 90.9%， 60.2%， and 32.2%， respectively， and there was a significant difference in cumulative survival rate between the patients with different EZ-ALBI grades （χ²=26.294， P<0.001）. ConclusionEZ-ALBI score and the presence or absence of peritoneal effusion can be used as predictors of the survival of HCV-HCC patients.

ObjectiveTo investigate the therapeutic efficacy， influencing factors， and safety of a treatment regimen based on coblopasvir hydrochloride capsules/sofosbuvir tablets in patients with chronic hepatitis C virus （HCV） infection in a real-world setting. MethodsA total of 253 patients who attended The Third People’s Hospital of Kunming from September 1， 2021 to May 31， 2024 were enrolled， among whom there were 86 patients with compensated liver cirrhosis （CLC group） and 167 patients with chronic hepatitis C （CHC group）. The patients were treated with coblopasvir hydrochloride capsules （60 mg）/sofosbuvir tablets （400 mg） with or without ribavirin tablets for 12 weeks， and they were followed up for 12 weeks after drug withdrawal. The primary outcome measures were the rate of sustained virologic response at week 12 after treatment （SVR12） and safety， and the secondary outcome measures were the changes in liver function， renal function， blood routine， and liver stiffness measurements （LSM） after 4 weeks of treatment， after 12 weeks of treatment， and at 12 weeks after drug withdrawal. The independent-samples t test and the Mann-Whitney U test were used for comparison of continuous data between two groups， and the Friedman test was used for comparison between multiple groups， while the Bonferroni method was used for paired comparison within each group； the chi-square test was used for comparison of categorical data between two groups. The Logistic analysis was used to investigate related influencing factors. ResultsThe 253 patients with chronic HCV infection had a mean age of 49.38±8.65 years， and there were 151 male patients （59.7%）. Of all patients， 33.99% （86/253） had liver cirrhosis， 25.69% （65/253） had hypertension， 10.67% （27/253） had HIV infection， 8.70% （22/253） had diabetes， 3.95% （10/253） had liver cancer， 1.98% （5/253） had chronic hepatitis B， and 7.91% （20/253） were treatment-experienced patients. As for genotype distribution， 2.77% （7/253） had genotype 1， 12.65% （32/253） had genotype 2， 66.01% （167/253） had genotype 3， 16.60% （42/253） had genotype 6， and 1.98% （5/253） had unknown genotype. The patients had an overall SVR12 rate of 92.09%， with an SVR12 rate of 93.02% in the CLC group and 91.02% in the CHC group. The multivariate logistic regression analysis showed that age （odds ratio ［OR］=1.086， 95% confidence interval ［CI］： 1.007 — 1.170， P=0.032） and HCC （OR=9.178， 95%CI： 1.722 — 48.912， P=0.009） were independent influencing factors for sustained virologic response. Compared with baseline data， the CLC group had significant reductions in alanine aminotransferase （ALT） （χ²=107.103， P0.05）， aspartate aminotransferase （AST） （χ²=90.602， P0.05）， and LSM （χ²=42.235， P0.05） after 12 weeks of treatment， while the CHC group had significant reductions in total bilirubin （χ²=15.113， P0.05）， ALT （χ²=202.237， P0.05）， AST （χ²=161.193， P0.05）， and LSM （χ²=37.606， P0.05）. The incidence rate of serious adverse events was 1.58%， and none of the patients withdrew from drug therapy； the patients with such events were relieved after active symptomatic treatment. The incidence rate of all adverse events was 23.72%， among which fatigue （17.39%） and nausea （2.37%） were the most common adverse events， and these events often disappeared within 2 weeks or were gradually relieved after symptomatic treatment. ConclusionCoblopasvir hydrochloride capsules/sofosbuvir tablets with or without ribavirin tablets has good efficacy and safety in the treatment of chronic HCV infection.

ObjectiveThree methods were applied to conduct occupational health risk assessment for the working positions exposed to silicon dusts in a sanitary ceramic manufacturing factory， and the evaluation results were compared to explore the applicability of different occupational health risk assessment methods. MethodsOne large sanitary ceramic product manufacturing enterprise in Songjiang District， Shanghai was selected to conduct occupational health risk assessment for the working positions exposed to silicon dusts， using occupational hazard risk index evaluation method， exposure ratio evaluation method， and International Council on Mining and Metals （ICMM） quantitative occupational health risk assessment method . The consistency of the evaluation results of the three methods was tested using weighted Kappa method. ResultsFourteen working positions exposed to silicon dusts were identified， and three positions had excessive dust concentration： composite forming position of phase 2 workshop （0.80 mg·m^-3）， addition forming position of phase 2 workshop （1.00 mg·m^-3）， and glazing position of 1F in phase 2 workshop （1.50 mg·m^-3）， with an excessive rate of 21.42%. The occupational hazard risk index evaluation method assessed 6 positions with no harm， 6 positions with mild harm， and 2 positions with moderate harm. The ICMM quantitative occupational health risk assessment method assessed 6 positions with potential risks， 2 positions with tolerable risks， and 6 positions with intolerable risks. The exposure ratio evaluation method assessed 8 positions with medium risk， 5 positions with high risk， and 1 position with extremely high risk. The consistency test results of the three evaluation methods were poor. The Kappa coefficient between the occupational hazard risk index evaluation method and the ICMM quantitative occupational health risk assessment method was 0.15. The Kappa coefficient between the occupational hazard risk index evaluation method and the exposure ratio evaluation method was -0.09. The Kappa coefficient between the ICMM quantitative occupational health risk assessment method and the exposure ratio evaluation method was 0.04. The RR values obtained by the three evaluation methods were significantly correlated： the correlation coefficients between RR_{ICMM quantitative assessment method} and RR_{exposure ratio evaluation method}， RR_{Occupational hazard risk index evaluation method} and RR_{ICMM quantitative assessment method}， RR_{Occupational hazard risk index evaluation method} and RR_{exposure ratio evaluation method} were 0.915， 0.604， and 0.594， respectively. The correlation between the assessment result level and C_TWA was strong. ConclusionThe occupational hazard risk index evaluation method is suitable for the working positions with low silicon dust exposure concentration， the ICMM quantitative occupational health risk assessment method and the exposure ratio evaluation method are suitable for the positions with high silicon dust exposure concentration， but all these three evaluation methods have limitations. It is more reasonable to use multiple methods at the same time in actual evaluation work.

Objective To compare the difference in the efficacies of arthroscopic microfracture operation for talar osteochondral injuries with hyperuricemia and non-hyperuricemia,and to explore the correlation be-tween blood urate level and efficacy.Methods Fifty-three patients with talar osteochondral lesions meeting the inclusion and exclusion criteria from February 2015 to August 2021 were selected as the research subjects and divided into the hyperuricemia group (22 cases) and non-hyperuricemia group (31 cases) according to whether or not the preoperative blood uric acid level exceeding 420 μmol/L.The joint range of motion (ROM),visual analog scale (VAS) score,American Foot and Ankle Surgery Society (AOFAS) score,mag-netic resonance score of cartilage repair tissue (MOCART) score and postoperative satisfaction before and af-ter surgery were compared between the two groups.Results The preoperative blood uric acid level in the hy-peruricemia group was higher than that in non-hyperuricemia group,and the difference was statistically signif-icant[(504.35±86.40)μmol/L vs.(332.56±45.80)μmol/L,P<0.05].The ROM score,VAS score and AOFAS score in postoperative 1 year follow up and last follow up in the two groups were significantly im-proved compared with before operation (P<0.001).The AOFAS scores before operation,in postoperative 1 year and postoperative last follow up in the hyperuricemia group were lower than those in the non-hyperurice-mia group (P<0.05).The VAS scores before operation and postoperative last follow up in the hyperuricemia group were higher than those in the non-hyperuricemia group (P<0.05).The uric acid level was negatively correlated with the postoperative AOFAS score (r2=0.076,P=0.041).The MOCART score in postopera-tive last follow up in the hyperuricemia group was lower than that in the non-hyperuricemia group,and the difference was statistically significant (P<0.05).The cartilage defect repair and filling degree and the fusion of repaired tissue with adjacent cartilage had statistical differences between the hyperuricemia group and non-hyperuricemia group (P<0.05).Conclusion Arthroscopic microfracture operation in treating talar osteo-chondral injuries has good clinical effect,the postoperative clinical effect in the patients with complicating hy-peruricemia is lower than that in the patients with non-hyperuricemia and the blood uric acid level is negative-ly correlated with the AOFAS score after microfracture surgery.

Objective To investigate the relationship between sleep fragmentation(SF)parameters and left ventricular structure in a community-based elderly population using data collected from the Multi-Ethnic Study of Atherosclerosis(MESA)cohort.Methods A total of 1 404 participants from the MESA cohort who underwent polysomnography(PSG)and cardiac magnetic resonance(CMR)were included.PSG was used to assess SF parameters,including wake after sleep onset(WASO),arousal index-total(ArI-total),arousal index-rapid eye movement(ArI-REM),and arousal index-non-rapid eye movement(ArI-NREM).Left ventricular end-diastolic mass(LVEDM)was measured via CMR.Linear regression was employed to analyze the relationship between SF parameters and left ventricular mass to height ratio(LVHi).Results Univariate linear regression analysis showed that WASO[β 0.134;95％confi-dence interval(CI)0.023-0.052;P＜0.001],ArI-total(β 0.184;95％CI 0.203-0.362;P＜0.001),ArI-REM(β 0.116;95％CI 0.100-0.260;P＜0.001)and ArI-NREM(β 0.175;9 5％CI 0.176-0.323;P＜0.001)were positively correlated with LVHi.After adjust-ment for confounding factors in multivariate linear regression analysis,WASO(β 0.045;95％CI 0.001-0.024;P=0.033)was positively correlated with LVHi.WASO(β 0.089;95％CI 0.006-0.034;P=0.006)was significantly associated with increased LVHi in the female group but not in the male group.Conclusion In an ethnically diverse cohort,WASO is significantly associated with increased LVHi after adjustment for potential confounders,especially in the female elderly population.

Purpose: Non-coding RNA activated by DNA damage (NORAD) has been reported to be a cancer-related long non-coding RNA (lncRNA) implicated in the progression of several cancers; however, its role in breast cancer (BC) has not yet been clarified. Methods: Quantitative real-time polymerase chain reaction was used to examine NORAD, microRNA (miR)-155-5p, and suppressor of cytokine signaling 1 (SOCS1) mRNA expression levels. Western blotting was used to analyze SOCS1 protein expression. The malignancy of BC cells was assessed using the cell counting kit-8 (CCK-8), BrdU, and Transwell assays.Bioinformatics analysis, RNA immunoprecipitation assay, and dual-luciferase reporter gene assays were used to verify the targeted relationship between NORAD and miR-155-5p.Additionally, the regulatory effects of NORAD and miR-155-5p on SOCS1 expression were determined by western blotting. Results: NORAD expression was significantly reduced in BC cell lines and tissues, and its low expression was associated with poor tumor tissue differentiation. NORAD overexpression repressed BC cell proliferation, migration, and invasion, whereas its knockdown produced the opposite effects. Additionally, miR-155-5p was found to be a target of NORAD, and the biological functions of miR-155-5p and NORAD were counteractive. MiR-155-5p was confirmed to target SOCS1, and SOCS1 was found to be positively regulated by NORAD. Conclusion NORAD suppresses miR-155-5p to upregulate SOCS1, thereby repressing the proliferation, migration, and invasion of BC cells.

Purpose: Non-coding RNA activated by DNA damage (NORAD) has been reported to be a cancer-related long non-coding RNA (lncRNA) implicated in the progression of several cancers; however, its role in breast cancer (BC) has not yet been clarified. Methods: Quantitative real-time polymerase chain reaction was used to examine NORAD, microRNA (miR)-155-5p, and suppressor of cytokine signaling 1 (SOCS1) mRNA expression levels. Western blotting was used to analyze SOCS1 protein expression. The malignancy of BC cells was assessed using the cell counting kit-8 (CCK-8), BrdU, and Transwell assays.Bioinformatics analysis, RNA immunoprecipitation assay, and dual-luciferase reporter gene assays were used to verify the targeted relationship between NORAD and miR-155-5p.Additionally, the regulatory effects of NORAD and miR-155-5p on SOCS1 expression were determined by western blotting. Results: NORAD expression was significantly reduced in BC cell lines and tissues, and its low expression was associated with poor tumor tissue differentiation. NORAD overexpression repressed BC cell proliferation, migration, and invasion, whereas its knockdown produced the opposite effects. Additionally, miR-155-5p was found to be a target of NORAD, and the biological functions of miR-155-5p and NORAD were counteractive. MiR-155-5p was confirmed to target SOCS1, and SOCS1 was found to be positively regulated by NORAD. Conclusion NORAD suppresses miR-155-5p to upregulate SOCS1, thereby repressing the proliferation, migration, and invasion of BC cells.

At present, total hip arthroplasty (THA) is the primary treatment for hip diseases such as femoral head necrosis and developmental dysplasia of the hip. It has good effects in reducing pain and improving joint function. The appearance of modular hip prosthesis facilitates adjustment of limb length and femoral offset. However, the wear between the interface of hip prosthesis can lead to inflammatory pseudotumor, osteolysis and other adverse reactions. To explore the risk factors of wear between hip prosthesis interface is helpful to improve the design and manufacturing concept of the product, improve the product performance, help surgeons optimize the operation technology and reduce the impact of human factors on the wear of the prosthesis. Many literatures have reported the mechanism of wear between the head-acetabula interface of prosthesis. The mechanism of wear between the interfaces has been described relatively clearly. In addition to the head-acetabula interface, the wear between the head-neck interface is another major cause of unexplained pain around the joint and prosthesis loosening after hip replacement. Many factors affect head-neck wear. The design of prosthesis (such as prosthesis material and prosthesis taper), surgical technology (such as impact strength and prosthesis mismatch) and patient factors (such as age, gender and activity) have important impact on head-neck wear. Adverse reactions caused by head-neck wear have also been widely concerned. However, there is no considerable solution for wear prevention. Thus, we should optimize the design of prosthesis, improve the surgical technology, and guide the rehabilitation of patients to prevent wear. In order to improve the attention of joint surgeons, the present paper reviews the literatures and analyzes the risk factors of head-neck interface wear and the clinical manifestations caused by head-neck wear.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. In recent years, immunotherapy has developed rapidly. Immune checkpoint inhibitors, especially programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors have made a breakthrough in the treatment of NSCLC and changed the treatment pattern for NSCLC. Immunological checkpoint inhibitors targeting PD-1/PD-L1 are beneficial to patients, both in the first-line and second-line treatment of advanced NSCLC, in the adjuvant treatment of locally-advanced NSCLC, and in the neoadjuvant therapy of early NSCLC, which show an important role in the comprehensive treatment of NSCLC. This article reviews the clinical research progress of immunological checkpoint inhibitors targeting PD-1/PD-L1 in NSCLC.
.

Objective To investigate the clinical efficacy of sequential nasal flow ventilation after extubation in patients with acute respiratory failure (referred to as respiratory failure).First of all,before and after extubation in HFNCO group,the respiratory parameters (PaO2,PaCO2,pH,lactic acid value,oxygenation index,HR,RR and LVEF) were compared with each other.The circulatory parameters (PaO2,PaCO2,pH,lactate,oxygenation index,HR,RR),clinical outcomes at the end of treatment / comorbidities (delirium,diarrhea,reintubation,ICU stay after extubation).Methods PaO2,PaCO2,pH value,lactate value at 1 h,6 h,12 h and 24 h after extubation in HFNCO group were not significantly different from those before extubation (all P＞ 0.05) (P ＜0.05).The LVEF of patients after extubation was slightly higher than that before extubation (0.59 ± 0.09 vs.0.60 ± 0.09),and the difference was not statistically significant Significance (P＞ 0.05).PaO2,PaCO2,pH and lactate value in HFNCO group and NIV group at 1 h,6 h,12 h and 24 h after extubation showed no significant difference (all P＞ 0.05).The effect of HFNCO on improving the oxygenation index after extubation was better than that of NPV group (P ＜0.05).HR and RR before extubation were higher or higher in HFNCO group than those in NPV group lower HR,RR better (P ＜0.05).The incidence of diarrhea (33.33％ vs.38.89％) and reintubation rate (6.1％ vs 13.9％) in HFNCO group were lower than those in NIV group (38.89％),but the difference was not statistically significant (all P＞ 0.05).The incidence of delirium in HFNCO group (18.18％ vs.41.67％) and ICU stay time after extubation (2.00 to 3.50) were statistically significant (all P ＜0.05).Results There were no significant differences in the arterial blood gas analysis (PaO2,PaCO2,pH,lactate value),PaO2,PaCO2,pH value,lactate value and LVEF at 1 h,6 h,12 h and 24 h before and after extubation in HFNCO group (all P＞ 0.05) Slightly higher than before extubation (0.59 ± 0.09 vs.0.60 ± 0.09),the difference was not statistically significant (P＞ 0.05).PaO2,PaCO2,pH and lactate value in HFNCO group and NIV group at 1 h,6 h,12 h and 24 h after extubation showed no significant difference (all P＞ 0.05).The incidence of diarrhea (33.33％ vs.38.89％) and reintubation rate (6.1％ vs.13.9％) in HFNCO group were lower than those in NIV group (38.89％),but the difference was not statistically significant (all P＞ 0.05).The incidence of delirium (18.18％ vs.41.67％),and ICU stay time (2.00 to 3.50) in HFNCO group were significantly lower than those in NIV group (all P＜0.05).Conclusions For acute respiratory failure patients after mechanical ventilation extubation,sequential administration of HFNCO and NIV can provide stable and effective oxygen therapy support;relative to the NIV,HFNCO can effectively improve patients oxygenation index,improve patient comfort and reduce the incidence of delirium And ICU stay time.