Objective To explore the effects of different serum potassium levels on the 28-day prognosis of elderly patients with sepsis. Methods A retrospective analysis was conducted on the clinical data and laboratory indicators within 24 hours after the diagnosis in 204 elderly patients with sepsis admitted to the Department of Critical Care Medicine, Zhongshan Hospital, Fudan University from January 2018 to January 2022. According to the potassium concentrations in the blood of the patients within 24 hours after admission to intensive care unit (ICU), the patients were divided into the hyperkalemia group (K^＋≥5.3 mmol/L), normokalemia group (K^＋ 3.5–＜5.3 mmol/L), and hypokalemia group (K^＋＜3.5 mmol/L). According to 28-day outcomes, the patients were divided into the death group and survival group. The acute physiological and chronic health evaluation (APACHE) Ⅱ score, sequential organ failure assessment (SOFA) score and laboratory indicators were analyzed. Multivariate logistic regression analysis was used to analyze the risk factors for 28-day mortality in elderly patients with sepsis. Results Compared with the normokalemia group (n＝99), patients in both the hyperkalemia (n＝61) and hypokalemia (n＝44) groups had significantly higher levels of C-reactive protein (CRP) and procalcitonin (PCT), longer duration of mechanical ventilation, longer length of hospital stay and ICU stay, and higher mortality (P ＜ 0.05). The death group (n＝49) had significantly higher APACHE Ⅱ score, SOFA score, white blood cell (WBC) counts, CRP level, and PCT level than the survival group (n＝155, P＜0.05). Multivariate logistic regression analysis showed that increased or decreased serum potassium level, higher SOFA score, and increased WBC counts were independent risk factors for 28-day mortality in elderly patients with sepsis (P＜0.05). Quadratic fitted curve showed a U-shaped association between serum potassium levels and 28-day mortality risk in elderly patients with sepsis, with the lowest mortality risk observed within the intermediate (normal) range, and both hypokalemia and hyperkalemia were associated with an increased mortality risk (P＝0.182). Conclusion Both increased and decreased serum potassium levels are independent risk factors for 28-day mortality in elderly patients with sepsis, which should be given particular attention in clinical management.

OBJECTIVE To investigate α1-adrenergic receptors(α1-AR)distribution in mouse tissues and its function on dexmetomidine(DMED)induced toxic effects.METHODS ① Real-time fluorescence quantita-tive PCR was used to detect the relative expression of α1A-AR,α1B-AR,α1D-AR,α2A-AR,α2B-AR and α2C-AR mRNAs in the heart,apical potion of heart,lungs,apical potion of lung,liver,kidneys,abdominal aorta,prefrontal cortex,hippocampus,striatum,brainstem,thalamus,olfactory bulb,and the rest of the brain tissues of the mouse.The relative expression of mRNA were analyzed.② C57BL/6J mice were pretreated with α2 adrenergic receptor antagonist atipamezole ATI(0.005,0.010,0.020,0.025,0.040,0.050 mg·kg-1,im),orα1-adrenoceptor antagonist prazosin(1 mg·kg-1,im)for 15 min,and then DMED(0.20 mg·kg-1,iv)was given to observe the rate of the loss of righting reflex and the immobilization time in mice.③ C57BL/6J mice were treated with DMED(16.38,20.48,25.60,32.00,40.00,and 50.00 mg·kg-1,iv)to observe the lethality of the mice in 24 h.The dose-effect relationship curves of the lethality rate and the half lethal-dose(LD50)were detected.ATI(1,2,4,and 8 mg·kg-1,im)or prazosin(1 mg·kg-1,im)were pretreated 15 min followed by the administration of DMED(25.60 mg·kg-1,iv).The lethality of the mice were recorded for 24 h.HE staining to observe the lung tissue damage in the mice.RESULTS ① The mRNA expression levels of three α1-AR subtype were higher than those of α2-AR subtype.α2A-AR and α2C-AR were highly expressed in the central nervous system.α2B-AR was highly expressed in the brainstem and peripheral tissues.The mRNA expres-sion levels of α1-AR subtypes were higher than those of α2-AR subtypes in heart,apical potion of heart or lung(P＜0.05).② ATI(0.005 to 0.05 mg·kg-1,im)dose dependently antagonized the loss of righting reflex and decreased the immobilization time induced by DMED(0.20 mg·kg-1,iv).In contrast,prazosin(1 mg·kg-1,im)had no effect on the loss of righting reflex induced by DMED(0.20 mg·kg-1,iv).③ The LD50 of DMED in mice was 26.734 mg·kg-1(iv)with a 95％Cl of 23.606-30.000 mg·kg-1.DMED(25.6 mg·kg-1)was selected for subsequent toxicity.ATI(1,2,4,and 8 mg·kg-1,im)did not antagonize the lethality induced by DMED(25.6 mg·kg-1,iv).The high dose of ATI resulted in elevated death rate and accelerated mortality induced by DMED(25.6 mg·kg-1,iv)in the mice.However,prazosin(1 mg·kg-1,im)reduced the lethality of DMED(25.6 mg·kg-1,iv)(P＜0.01).After administration of DMED(25.6 mg·kg-1),the mice lungs showed significant congestion.HE staining of lung tissues revealed obvious vascular hemorrhage,alveolar rupture,and erythrocyte spillage.Prazosin(1 mg·kg-1,im)effectively attenuated the tissue damage in the lungs,but ATI(1 mg·kg-1,im)aggravated the pulmonary hemorrhage.CONCLU-SIONS In cardiopulmonary tissues,the high expression levels of α1 adrenoceptor overactivation,might related with the lethality induced by DMED.

Objective:To investigate the features of peripheral blood lymphocyte subsets in children with sepsis and evaluate the value of these cells in combination with multiple indicators in the diagnosis of pediatric sepsis.Methods:A retrospective study was conducted on 86 sepsis children and 83 children with local infection admitted to Hebei Children′s Hospital from October 2022 to October 2024. Baseline clinical data, peripheral blood lymphocyte subsets, and other laboratory indicators were compared between the two groups. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to evaluate the independent risk factors correlated with the initiation of sepsis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of each independent risk factor for diagnosing sepsis.Results:The thrombin time, the absolute counts of NK, CD3 + T, CD4 + T, and CD8 + T cells, the levels of IgG and IgM, and the counts of lymphocytes and platelets were lower in the sepsis children than in the children with local infection. However, the prothrombin time (PT), activated partial thromboplastin time, the levels of fibrinogen, direct bilirubin, and C-reactive protein (CRP) were higher in the sepsis group (all P<0.05). The variables screened by LASSO regression were analyzed by the multivariate logistic regression, and the results showed that PT, absolute CD4 + T cell count, and the levels of IgM and CRP were independent risk factors for sepsis. The ROC analysis indicated that the area under the ROC curve (AUC) for PT, absolute CD4 + T cell count, and IgM and CRP levels when used individually in diagnosing sepsis was 0.729, 0.593, 0.605, and 0.795, respectively. The AUC for the four indexes when used in combination for diagnosing sepsis reached 0.822, showing greater superiority over that of the single index. Conclusions:The combined measurement of PT, absolute CD4 + T cell count, and the levels of IgM and CRP can improve the diagnostic efficacy for sepsis in children. Early monitoring of these indexes facilitates the assessment of the condition in children suffering from sepsis.

Objective To investigate the impacts of intervertebral foramen endoscopic surgery combined with silver needle hyperthermia therapy on lumbar spine function and local tenderness in patients with lumbar disc herniation(LDH).Methods From April 2020 to March 2023,100 LDH patients were randomly devided into a control group(50 cases)and an observation group(50 cases)through random number table method.The control group was treated with intervertebral foramen endoscopic surgery combined with conventional lumbar and dorsal muscle training,while observed group was treated with intervertebral foramen endoscopic surgery combined with silver needle warm therapy.The lumbar function,local tenderness,laboratory indicators,and adverse reactions were compared.Results The Japanese Orthopaedic Association(JOA)score increased in both groups after treatment,and observed group had obviously higher scores,the differences were statistically significant(P<0.05);After treatment,both groups showed a decrease in pain visual analogue scale(VAS)score,and observed group had obviously lower scores,the differences were statistically significant(P<0.05);The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE2),and 5-hydroxytryptamine(5-HT)in both groups decreased after treatment,and the observed group showed a more obvious decrease in all indicators,the differences were statistically significant(P<0.05);The incidence of adverse reactions was 4.00%(2/50)in observed group and 20.00%(10/50)in the control group,adverse reactions in observed group were obviously fewer,the difference was statistically significant(P<0.05).Conclusion The combination of intervertebral foramen endoscopic surgery and silver needle hyperthermia therapy can effectively improve lumbar spine function and alleviate local tenderness symptoms in patients with LDH.It is worthy clinical application.

OBJECTIVE To evaluate the clinical efficacy and safety of Xiaoyin capsules combined with secukinumab in the treatment of moderate to severe plaque psoriasis. METHODS A retrospective study was conducted on 105 patients with moderate to severe plaque psoriasis who received treatment in the Dept. of Dermatology of Xinxiang Central Hospital from January 2021 to June 2024. According to the treatment plan， they were divided into conventional group（n＝32）， monoclonal antibody group（n＝45）， and combination group（n＝28）. The conventional group was given Calcipotriol ointment+Fluticasone propionate cream+Acitretin capsules； the monoclonal antibody group was treated with secukinumab injection in addition to the treatment of the conventional group； the combination group received oral administration of Xiaoyin capsules in addition to the treatment of the monoclonal antibody group. All patients received at least 12 weeks of treatment. The psoriasis area and severity index（PASI） score， PASI improvement rate， dermatology life quality index（DLQI） score， physician’s global assessment（PGA） score， patient’s global assessment（PtGA） score before and after treatment， and the incidence of adverse reactions during treatment were compared among the three groups. RESULTS Before treatment， there was no statistically significant difference in the above scores among the three groups（P＞0.05）. After treatment， the scores of all three groups of patients significantly decreased compared to before treatment （P＜0.05）； the total PASI score and erythema， scales， affected body surface area score， the total DLQI score and symptom perception， daily activity， social score， the PGA and PtGA scores of the combination group were significantly lower than the other two groups（P＜0.05）； PASI 50（the proportion of patients whose PASI score decreased by ≥50% from baseline， and so on）， PASI 75， and PASI 90 were significantly higher than the other two groups（P＜0.05）； the total PASI score， erythema， and affected body surface area score of patients in the monoclonal antibody group were significantly lower than the conventional group（P＜0.05）， and PASI 75 was significantly higher than the conventional group（P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions among the 3 groups（P＝0.637）. CONCLUSIONS The combination of Xiaoyin capsules and secukinumab can significantly improve the skin lesions and quality of life in patients with moderate to severe plaque psoriasis， with good tolerability in the short term and no significant increasein the risk of serious adverse reactions.

OBJECTIVE: To assess the association of single nucleotide polymorphisms (SNPs) of interleukin-23 receptor (IL-23R) gene with susceptibility to psoriasis. METHODS: Two hundred and ten psoriasis patients admitted to Xinxiang Central Hospital from January 2019 to December 2024 were selected as the study group, and 210 healthy individuals undergoing physical examination during the same period were selected as the control group. 3 mL of peripheral venous blood sample was collected from each individual from the two groups, and PCR-Restriction fragment length polymorphism (PCR-RFLP) assay was used to determine the polymorphisms of the IL-23R gene at rs2201841, rs1004819, rs10889677, rs1343151 and rs1495965 loci. Genotypic and allelic distribution of each SNP locus was calculated to assess the association between SNPs of the IL-23R gene with the onset of psoriasis, and the difference in serum IL-23 levels among patients with different genotypes at each locus was compared. This study was approved by the Medical Ethics Committee of Xinxiang Central Hospital (Ethic No. 2024-749). RESULTS: The results showed that the frequency of CC genotype at rs1004819 locus of the study group was significantly higher than that of the control group (26.19% vs. 18.10%, P < 0.05), and the frequency of C allele was also significantly higher than that of the control group (54.05% vs. 42.62%, P < 0.05). There was no significant difference in allelic and genotypic frequencies between the two groups at rs2201841, rs10889677, rs1343151, and rs1495965 loci (P > 0.05). The dominant and recessive inheritance patterns at the rs1004819 locus are associated with susceptibility to psoriasis (P < 0.05), while the different inheritance patterns at rs2201841, rs10889677, rs1343151, and rs1495965 loci are not associated with psoriasis (P > 0.05). The serum IL-23 levels of patients with CC genotype at the rs1004819 locus were higher than those with the CT and TT genotypes (P < 0.05). No significant difference was detected in the serum levels of IL-23 between patients with different genotypes for the rs2201841, rs10889677, rs1343151, and rs1495965 loci (P > 0.05). CONCLUSION The polymorphism at the rs1004819 locus of the IL-23R gene is associated with susceptibility to psoriasis, and individuals carrying the CC genotype and C allele have a higher risk of developing the disease.
Humans ; Psoriasis/genetics* ; Polymorphism, Single Nucleotide ; Receptors, Interleukin/genetics* ; Genetic Predisposition to Disease ; Male ; Female ; Adult ; Middle Aged ; Genotype ; Alleles ; Gene Frequency ; Case-Control Studies ; Interleukin-23/blood*

Objective:To assess the association of single nucleotide polymorphisms (SNPs) of interleukin-23 receptor ( IL-23R) gene with susceptibility to psoriasis. Methods:Two hundred and ten psoriasis patients admitted to Xinxiang Central Hospital from January 2019 to December 2024 were selected as the study group, and 210 healthy individuals undergoing physical examination during the same period were selected as the control group. 3 mL of peripheral venous blood sample was collected from each individual from the two groups, and PCR - Restriction fragment length polymorphism (PCR-RFLP) assay was used to determine the polymorphisms of the IL-23R gene at rs2201841, rs1004819, rs10889677, rs1343151 and rs1495965 loci. Genotypic and allelic distribution of each SNP locus was calculated to assess the association between SNPs of the IL-23R gene with the onset of psoriasis, and the difference in serum IL-23 levels among patients with different genotypes at each locus was compared. This study was approved by the Medical Ethics Committee of Xinxiang Central Hospital (Ethic No. 2024-749). Results:The results showed that the frequency of CC genotype at rs1004819 locus of the study group was significantly higher than that of the control group (26.19% vs. 18.10%, P<0.05), and the frequency of C allele was also significantly higher than that of the control group (54.05% vs. 42.62%, P<0.05). There was no significant difference in allelic and genotypic frequencies between the two groups at rs2201841, rs10889677, rs1343151, and rs1495965 loci ( P>0.05). The dominant and recessive inheritance patterns at the rs1004819 locus are associated with susceptibility to psoriasis ( P<0.05), while the different inheritance patterns at rs2201841, rs10889677, rs1343151, and rs1495965 loci are not associated with psoriasis ( P>0.05). The serum IL-23 levels of patients with CC genotype at the rs1004819 locus were higher than those with CT and TT genotypes ( P<0.05). No significant difference was detected in the serum levels of IL-23 between patients with different genotypes for the rs2201841, rs10889677, rs1343151, and rs1495965 loci ( P>0.05). Conclusion:The polymorphism at the rs1004819 locus of the IL-23R gene is associated with susceptibility to psoriasis, and individuals carrying the CC genotype and C allele have a higher risk of developing the disease.

OBJECTIVE To investigate α1-adrenergic receptors(α1-AR)distribution in mouse tissues and its function on dexmetomidine(DMED)induced toxic effects.METHODS ① Real-time fluorescence quantita-tive PCR was used to detect the relative expression of α1A-AR,α1B-AR,α1D-AR,α2A-AR,α2B-AR and α2C-AR mRNAs in the heart,apical potion of heart,lungs,apical potion of lung,liver,kidneys,abdominal aorta,prefrontal cortex,hippocampus,striatum,brainstem,thalamus,olfactory bulb,and the rest of the brain tissues of the mouse.The relative expression of mRNA were analyzed.② C57BL/6J mice were pretreated with α2 adrenergic receptor antagonist atipamezole ATI(0.005,0.010,0.020,0.025,0.040,0.050 mg·kg-1,im),orα1-adrenoceptor antagonist prazosin(1 mg·kg-1,im)for 15 min,and then DMED(0.20 mg·kg-1,iv)was given to observe the rate of the loss of righting reflex and the immobilization time in mice.③ C57BL/6J mice were treated with DMED(16.38,20.48,25.60,32.00,40.00,and 50.00 mg·kg-1,iv)to observe the lethality of the mice in 24 h.The dose-effect relationship curves of the lethality rate and the half lethal-dose(LD50)were detected.ATI(1,2,4,and 8 mg·kg-1,im)or prazosin(1 mg·kg-1,im)were pretreated 15 min followed by the administration of DMED(25.60 mg·kg-1,iv).The lethality of the mice were recorded for 24 h.HE staining to observe the lung tissue damage in the mice.RESULTS ① The mRNA expression levels of three α1-AR subtype were higher than those of α2-AR subtype.α2A-AR and α2C-AR were highly expressed in the central nervous system.α2B-AR was highly expressed in the brainstem and peripheral tissues.The mRNA expres-sion levels of α1-AR subtypes were higher than those of α2-AR subtypes in heart,apical potion of heart or lung(P＜0.05).② ATI(0.005 to 0.05 mg·kg-1,im)dose dependently antagonized the loss of righting reflex and decreased the immobilization time induced by DMED(0.20 mg·kg-1,iv).In contrast,prazosin(1 mg·kg-1,im)had no effect on the loss of righting reflex induced by DMED(0.20 mg·kg-1,iv).③ The LD50 of DMED in mice was 26.734 mg·kg-1(iv)with a 95％Cl of 23.606-30.000 mg·kg-1.DMED(25.6 mg·kg-1)was selected for subsequent toxicity.ATI(1,2,4,and 8 mg·kg-1,im)did not antagonize the lethality induced by DMED(25.6 mg·kg-1,iv).The high dose of ATI resulted in elevated death rate and accelerated mortality induced by DMED(25.6 mg·kg-1,iv)in the mice.However,prazosin(1 mg·kg-1,im)reduced the lethality of DMED(25.6 mg·kg-1,iv)(P＜0.01).After administration of DMED(25.6 mg·kg-1),the mice lungs showed significant congestion.HE staining of lung tissues revealed obvious vascular hemorrhage,alveolar rupture,and erythrocyte spillage.Prazosin(1 mg·kg-1,im)effectively attenuated the tissue damage in the lungs,but ATI(1 mg·kg-1,im)aggravated the pulmonary hemorrhage.CONCLU-SIONS In cardiopulmonary tissues,the high expression levels of α1 adrenoceptor overactivation,might related with the lethality induced by DMED.

Objective To investigate the impacts of intervertebral foramen endoscopic surgery combined with silver needle hyperthermia therapy on lumbar spine function and local tenderness in patients with lumbar disc herniation(LDH).Methods From April 2020 to March 2023,100 LDH patients were randomly devided into a control group(50 cases)and an observation group(50 cases)through random number table method.The control group was treated with intervertebral foramen endoscopic surgery combined with conventional lumbar and dorsal muscle training,while observed group was treated with intervertebral foramen endoscopic surgery combined with silver needle warm therapy.The lumbar function,local tenderness,laboratory indicators,and adverse reactions were compared.Results The Japanese Orthopaedic Association(JOA)score increased in both groups after treatment,and observed group had obviously higher scores,the differences were statistically significant(P<0.05);After treatment,both groups showed a decrease in pain visual analogue scale(VAS)score,and observed group had obviously lower scores,the differences were statistically significant(P<0.05);The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE2),and 5-hydroxytryptamine(5-HT)in both groups decreased after treatment,and the observed group showed a more obvious decrease in all indicators,the differences were statistically significant(P<0.05);The incidence of adverse reactions was 4.00%(2/50)in observed group and 20.00%(10/50)in the control group,adverse reactions in observed group were obviously fewer,the difference was statistically significant(P<0.05).Conclusion The combination of intervertebral foramen endoscopic surgery and silver needle hyperthermia therapy can effectively improve lumbar spine function and alleviate local tenderness symptoms in patients with LDH.It is worthy clinical application.

Objective:To investigate the features of peripheral blood lymphocyte subsets in children with sepsis and evaluate the value of these cells in combination with multiple indicators in the diagnosis of pediatric sepsis.Methods:A retrospective study was conducted on 86 sepsis children and 83 children with local infection admitted to Hebei Children′s Hospital from October 2022 to October 2024. Baseline clinical data, peripheral blood lymphocyte subsets, and other laboratory indicators were compared between the two groups. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to evaluate the independent risk factors correlated with the initiation of sepsis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of each independent risk factor for diagnosing sepsis.Results:The thrombin time, the absolute counts of NK, CD3 + T, CD4 + T, and CD8 + T cells, the levels of IgG and IgM, and the counts of lymphocytes and platelets were lower in the sepsis children than in the children with local infection. However, the prothrombin time (PT), activated partial thromboplastin time, the levels of fibrinogen, direct bilirubin, and C-reactive protein (CRP) were higher in the sepsis group (all P<0.05). The variables screened by LASSO regression were analyzed by the multivariate logistic regression, and the results showed that PT, absolute CD4 + T cell count, and the levels of IgM and CRP were independent risk factors for sepsis. The ROC analysis indicated that the area under the ROC curve (AUC) for PT, absolute CD4 + T cell count, and IgM and CRP levels when used individually in diagnosing sepsis was 0.729, 0.593, 0.605, and 0.795, respectively. The AUC for the four indexes when used in combination for diagnosing sepsis reached 0.822, showing greater superiority over that of the single index. Conclusions:The combined measurement of PT, absolute CD4 + T cell count, and the levels of IgM and CRP can improve the diagnostic efficacy for sepsis in children. Early monitoring of these indexes facilitates the assessment of the condition in children suffering from sepsis.