miR-101-3p is an evolutionarily conserved non-coding RNA that has shown aberrant expression and regulatory functios in various cardiovascular diseases(CVDs)in recent years.It participates in key pathological processes including post-infarction myocardial remodeling,myocardial fibrosis in heart failure and the development of atherosclerosis by modulating pathways such as apoptosis,autophagy and metabolism.In addition,it exhibits immunoregulatory potential in myocardium injury related to systemic diseases.This review summarizes the recent advances in understanding the role of miR-101-3p in CVDs,focusing on its expression dynamics and regulatory mechanisms in different disease models.It further elaborates on the biological effects of miR-101-3p in cardiovascular pathology and explores its potential as a diagnostic biomarker and therapeutic target.miR-101-3p is expected to provide novel insights for early detection and targeted intervention of cardiovascular diseases.

Objective With the comprehensive implementation of Diagnosis-Related Groups(DRG)and Diagnosis-In-tervention Packet(DIP)payment reforms,ambulatory surgery has been widely adopted in clinical practice due to its efficiency and cost-effectiveness.However,medical insurance compliance issues have become increasingly prominent during management processes.Standardizing ambulatory surgery management and ensuring the security of medical insurance funds have grown in im-portance.Methods Based on the current status of ambulatory surgery medical insurance policies in Tianjin,this study analyzes common compliance issues under DRG/DIP payment systems,explores their causes,and proposes targeted management strate-gies.Results Tianjin currently has 786 ambulatory surgery procedures,with orthopedics being the most common specialty,fol-lowed by ophthalmology,urology,and general surgery.From 2020 to 2024,the sample hospital completed 12,705 ambulatory surgery cases,with a significant increase in 2024.In 2020,the most frequent procedure was circumcision,while in 2024,it was colonoscopic polypectomy.Under DRG/DIP payment systems,common medical insurance compliance issues include upeoding,split hospitalization,excessive treatment,cost shifting,and undertreatment.Conclusion Healthcare and medical insurance sys-tems should collaborate to implement targeted management strategies.These include strengthening hospital medical record and coding management,improving medical quality control,refining medical insurance supervision mechanisms and payment stand-ards,and establishing a multi-stakeholder collaborative oversight system.These measures aim to standardize ambulatory surgery management,safeguard medical insurance funds,and promote the healthy development of the healthcare industry.

There is a notable trend of "conceptual alienation" in the current "minimally invasive" treatment of thyroid cancer, where "minimally invasive" is simplistically equated with small incisions or overemphasis on cosmetic outcomes, while neglecting its core essence: minimizing overall trauma while ensuring radical treatment. Endoscopic/robotic surgeries, though capable of hiding scars, may involve greater trauma from creating operational spaces and are suitable for strictly selected patients rather than being universally applicable. Thermal ablation techniques, while less traumatic for treating microcarcinomas, carry the risk of expanded indications beyond recommended guidelines. We emphasize that all treatments must adhere to the principle of "radical cure first, function intact second, and cosmetic result third " avoiding technological misuse, and advocating a return to radical cure-focused, individualized rational treatment based on long-term follow-up data.

Objective To evaluate the clinical value of the combination of routine pleural effusion and serum assay in differentiating tuberculous pleural effusion from malignant pleural effusion.Methods A total of 160 patients with tuberculous pleural effusion and 267 patients with malignant pleural effusion were selected as the study group.Pleural effusion and serum levels of lactate dehydrogenase(LDH),adenosine deaminase(ADA)and carcinoembryonic antigen(CEA)were collected.Receiver operating characteristic(ROC)curve was used to determine the diagnostic value of pleural effusion ADA,serum LDH/pleural effusion ADA and pleural effusion CEA/serum CEA in tuberculous pleural effusion,and to determine the optimal cut-off value.The initial diagnosis procedure was designed as follows:the group 1 was defined as meeting the three conditions of pleural effusion ADA≥29.700 U/L,serum LDH/pleural effusion ADA＜8.523 and pleural effusion CEA/serum CEA＜1.096(considering tuberculous pleural effusion),patients meeting the three conditions of pleural effusion ADA＜29.700 U/L,serum LDH/pleural effusion ADA≥8.523 and pleural effusion CEA/serum CEA≥1.096 were defined as the group 2(malignant pleural effusion considered),and the remaining ones that did not meet all of the above conditions were defined as the group 3.For patients in the group 3,if multinucleated cells≥50%in cell classification of pleural effusion,malignant pleural effusion was considered.For patients with monocytes>50%in cell classification of pleural effusion,the optimal critical value of ADA in pleural effusion was determined as 34.450 U/L by ROC curve.If ADA≥34.450 U/L,tuberculous effusion was considered.If ADA＜34.450 U/L,malignant pleural effusion was considered.According to the initial diagnosis process,151 patients with exudative pleural effusion were selected as the verification group.Results Through the initial diagnosis process,5 patients in the study group did not meet the final diagnostic criteria,including 3 patients with tuberculous pleural effusion(the pleural effusion disappeared after standard anti-tuberculosis treatment),1 patient was found to have lung cancer 3 years later,1 patient was found to have colon cancer 2 years later,and 1 patient was complicated with ulcerative colitis.There were 2 patients with malignant pleural effusion,among whom 1 was pleural mesothelioma and the other was lung adenocarcinoma.The sensitivity and specificity of the study group diagnosed by this initial diagnostic procedure for tuberculous pleural effusion were 98.13%and 99.25%,respectively,which were higher than those using ADA alone for pleural effusion.After excluding 49 patients who did not meet the criteria of this study,102 patients were finally included in the verification group,including 20 cases of tuberculous pleural effusion and 82 cases of malignant pleural effusion.Through the initial diagnosis process,only 2 patients with tuberculous pleural effusion were preliminarily diagnosed and did not meet the final diagnostic criteria,including 1 case of leukemia and 1 case of lymphoma.Conclusion The initial diagnosis process designed by combining conventional pleural effusion and serum tests has improved the accuracy of differentiating tuberculous and malignant pleural effusion.

Submucosal angiomyolipoma(AML)of rectum is clinically rare.This article reports the endoscopic diagnosis and treatment process of a case of rectal AML.By reviewing the clinical data of this patient and combining with literature review,we aim to deepen the current understanding of AML in the digestive tract and avoid misdiagnosis and mistreatment in clinical practice.

Objective To explore the effects of apolipoprotein E gene(ApoE)polymorphism on cerebral oxygen metabolism and postoperative cognitive function in patients undergoing laparoscopic general anesthesia surgery.Methods In this study,210 patients who underwent laparoscopic cholecystectomy in our hospital from January 2020 to January 2024 were selected and di-vided into ApoE ε2 group(45 cases,ε2/ε2,ε2/ε3),ApoE ε3 group(98 cases,ε3/ε3),and ApoE ε4 group(67 cases,ε3/ε4,ε4/ε4)based on their ApoE genotype.The general information,blood lipid levels,and cerebral oxygen metabolism index levels of each group were compared.Multiple linear regression analysis was conducted to investigate the relationship between ApoE gene poly-morphism,blood lipid levels,and cerebral oxygen metabolism indicators,and to analyze the correlation between blood lipid levels and oxygen metabolism indicators under different genotypes.Patients were divided into cognitive impairment group(n=54)and non-cognitive impairment group(n=156)based on whether they experienced cognitive impairment after surgery.General infor-mation,blood lipid levels,and cerebral oxygen metabolism indicators were compared between the two groups.Multivariate logis-tic regression analysis was conducted to identify the influencing factors of cognitive dysfunction.Restrictive cubic spline method was used to analyze the dose-response relationship between blood lipid levels,cerebral oxygen metabolism indicators,and cogni-tive impairment.The adjusted odds ratio(OR)and 95％confidence interval(CI)of ApoE gene polymorphism and cerebral oxygen metabolism indicators to the risk of cognitive impairment were estimated,and the interaction between ApoE gene polymorphism and cerebral oxygen metabolism indicators on cognitive impairment was analyzed.Results Among 210 patients undergoing lap-aroscopic general anesthesia surgery,the frequency of the ε3 allele was the highest,accounting for 71.67％,while the ε2 and ε4 alleles accounted for 11.90％and 16.43％,respectively.The highest proportion of the ε3/ε3 genotype was 46.67％(98/210),while the others were ε3/ε4(65/210),ε2/ε3(40/210),ε2/ε2(5/210),and ε4/ε4(2/210)in descending order.The total cholester-ol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)of ApoE ε4 group patients were higher than those of ApoE ε2 group and ApoE ε3 group patients,while high-density lipoprotein cholesterol(HDL-C)was lower than that of ApoE ε2 group and ApoE ε3 group patients,and the differences were statistically significant(all P＜0.05).The difference in radial artery and internal jugular vein bulb oxygen content(DajvO2)in ApoE ε4 group patients was higher than that in ApoE ε2 group and ApoE ε3 group.The cerebral oxygen uptake rate(COER),internal jugular vein bulb oxygen content(CjvO2),and internal jugu-lar vein bulb oxygen saturation(SjvO2)were lower than those in ApoE ε2 group and ApoE ε3 group patients,and the differences were statistically significant(all P＜0.05).The TC,TG,LDL-C,HDL-C,COER,DajvO2,CjvO2,and SjvO2 levels were not cor-related with ApoE ε2 and ApoE ε3 types,but were correlated with ApoE ε4 type.The TC,TG,LDL-C,DajvO2 levels were posi-tively correlated with ApoE ε4 type,while HDL-C,COER,CjvO2,SjvO2 were negatively correlated with ApoE ε4 type(all P＜0.05).Under different genotypes,TC,TG,LDL-C were positively correlated with COER,CjvO2,and SjvO2(all P＜0.05),and negatively correlated with DajvO2(P＜0.05).HDL-C was negatively correlated with COER,CjvO2,and SjvO2(all P＜0.05),and positively correlated with DajvO2(P＜0.05).The differences in ApoE gene polymorphism,TC,TG,LDL-C,HDL,COER,DajvO2,CjvO2,and SjvO2 between patients with cognitive impairment and those without cognitive impairment were statistically significant(all P＜0.05).Multivariate logistic regression analysis showed that high TC,high TG,and ApoE ε4 genotypes were independent risk factors for cognitive dysfunction(all P＜0.05),while high COER and high SjvO2 were independent protective factors for cognitive dysfunction.The association intensity between TC,TG,LDL-C,HDL,COER,DajvO2,CjvO2,and SjvO2 and cognitive impairment showed a nonlinear dose-response relationship(P＜0.05).TC,TG,LDL-C,DajvO2 were positively correlated with the risk of cognitive impairment,while HDL-C,COER,CjvO2,and SjvO2 were negatively correlated with the risk of cognitive impairment.The interaction analysis of the generalized multifactor dimensionality reduction model showed that ApoE ε4 had interactions with COER,DajvO2,CjvO2,and SjvO2.Conclusion The polymorphism of ApoE gene is associated with cerebral oxygen metabolism in patients undergoing laparoscopic general anesthesia surgery.Among them,patients with ApoE ε4 genotype have a higher risk of cognitive dysfunction after surgery than those with ApoE ε2 and ApoE ε3 genotypes.Clinically,patients with ApoE ε4 genotype should strengthen intraoperative cerebral oxygen monitoring and achieve more accurate individualized anesthesia management based on their genotype.

Medical equipment is one of the important factors influencing medical services,and ensuring the integrity of medical equipment is an important part of hospital management,and the introduction of reliable medical equipment maintenance services can improve the quality of hospital medical management as a whole.Taking a tertiary hospital in Tianjin as an example,the study explores the subjective and objective evaluation indexes of clinical satisfaction after the introduction of maintenance serv-ices,builds a refined management system for medical equipment,and constantly adjusts the evaluation program of medical equip-ment maintenance services through the feedback mechanism,aiming to enhance the safety of the use of medical equipment,re-duce the cost of maintenance of medical equipment,and contribute to the high-quality development of the hospital.

Objective To compare the macular retinal thickness characteristics of diabetic kidney disease(DKD)patients with different blood pressure levels and explore the relationship between blood pressure and macular retinal damage in DKD patients.Methods A total of 435 DKD patients were selected and divided into four groups based on medical history and blood pressure:the non-hypertensive group(NH group,n=100),the well-controlled blood pressure group(G0 group,n=176),the grade 1 hypertension group(G1 group,n=118)and the grade 2 hypertension group(G2 group,n=41).General information,routine laboratory test results as well as the average thickness of the macular retinal nerve fiber layer(RNFL),ganglion cell layer(GCL),ganglion cell complex(GCC),choroidal layer(CL)and central macular retinal thickness(CMT)were compared between the four groups.The correlation between macular retinal thickness in both eyes and clinical data was analyzed.Results Compared with the G1 group and the G2 group,the G0 group had a longer duration of hypertension.Compared to the NH group,the G2 group had higher fasting plasma glucose(FPG).Compared to the G0 group,the G1 group and the G2 group had higher FPG,and the G2 group had higher glycated hemoglobin(HbA1c)and lower estimated glomerular filtration rate(eGFR).Compared to the NH group,the G0 group had decreased thickness in the GCL and GCC(P<0.05).The macular retinal thickness of the GCL and GCC in both eyes was negatively correlated with diastolic blood pressure(r=-0.158 and-0.195,respectively,P<0.05).Conclusion Macular retinal thickness is helpful in assessing the long-term effects of hypertension on optic nerve and microvascular damage in DKD patients.

Objective To explore the correlation between psoas major index(PMI)in patients with diffuse large B-cell lymphoma(DLBCL)and prognosis after rituximab,cyclophosphamide,doxorubicin,vincristine,prednisone(R-CHOP)chemotherapy.Methods Totally 148 DLBCL patients who received R-CHOP chemotherapy were retrospectively enrolled.Based on axis CT image at L3 vertebral transverse process,bilateral psoas muscles were delineated,and PMI was calculated.Then the patients were divided into muscle reduction group(≤lower quartile,n=37)and control group(＞lower quartile,n=111)according to the lower quartile of PMI.Clinical and imaging data were compared between groups,and the correlations of PMI with the above indexes were analyzed.The impact factors of prognosis of DLBCL were observed.Results Significant differences of body mass index(BMI),Eastern Cooperative Oncology Group(ECOG)score,international prognostic index(IPI),the proportion of B symptoms,mortality rate,3-year survival rate,β2-microglobulin,hemoglobin,albumin and PMI were found between groups(all P＜0.05).PMI of DLBCL patient was negatively correlated with age,ECOG score,IPI,β2-microglobulin and lactate dehydrogenase(LDH)(r=—0.126,-0.225,—0.262,—0.232,—0.229,all P＜0.05),but positively correlated with BMI and hemoglobin(r=0.282,0.376,both P＜0.05).The age,ECOG score,IPI and PMI were all independent impact factors of overall survival in DLBCL patients(all P＜0.05).Conclusion PMI was an independent impact factor of prognosis of DLBCL after R-CHOP chemotherapy.

Oral cancer is a common inflammation-associated malignant tumor of the head and neck.In recent years,the role of the tumor microenvironment in the progression of oral cancer has received increasing attention.In the microenvironment of solid tumors,including or-al cancer,tumor-associated macrophages(TAMs)are among the most common type of immune cell and are closely associated with the poor prognosis of more than 80%of human malignant tumors.An increasing body of evidence indicates that TAMs play important roles in the oc-currence and progression of oral cancer.On the basis of the most recent research progress,both domestic and international,we systematic-ally reviewed the phenotypic characteristics,clinicopathological correlations,and molecular regulatory mechanisms of TAMs in the microen-vironment of oral squamous cell carcinoma(OSCC).In particular,we focus on the key signaling pathways promoting tumorigenesis and de-velopment and immune escape mechanisms,with the aim of constructing a systematic theoretical framework for developing therapeutic strategies targeting TAMs and providing a scientific basis for clinical translational research.