Objective To investigate the expression and clinical significance of serum microRNA-144-3p(miR-144-3p)and microRNA-126-3p(miR-126-3p)in patients with intracerebral hemorrhage(ICH).Methods From February 2022 to April 2023,120 ICH patients who underwent treatment at our hospital were recruited as the ICH group.They were separated into a good prognosis group and a poor prognosis group based on the modified Rankin Scale(mRS)score After 6 months treatment Additionally,110 healthy individuals who underwent physical examination at our hospital were included as the control group.Clinical data of patients were collected and analyzed.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of tumor necrosis factor-α(TNF-α)and vascular endothelial growth factor(VEGF)indicators.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was applied to detect the expression levels of serum miR-144-3p and miR-126-3p.Pearson method was applied to analyze the correlation between serum miR-144-3p,miR-126-3p,TNF-α,and VEGF levels in ICH patients.Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of ICH patients.ROC curve was applied to analyze the predictive value of serum miR-144-3p and miR-126-3p for the prognosis of ICH patients.Results In the control group,the serum miR-144-3p was 1.02±0.02,the TNF-α was(19.15±6.79)pg/ml,the VEGF level was(1.05±0.18)ng/ml,and the serum miR-126-3p level was 1.04±0.05.The values in the ICH group were 2.12±0.23,(48.32±8.43)pg/ml,(6.56±1.49)ng/ml,and(0.53±0.12),respectively.There was a statistically significant difference between the two groups(P＜0.05).Pearson analysis results showed that serum miR-144-3p was positively correlated with TNF-α and VEGF levels in ICH patients(r=0.496,0.542,P＜0.05),while serum miR-126-3p was negatively correlated with TNF-α and VEGF levels(r=-0.493,-0.526,P＜0.05).There were significant differences in the serum levels of miR-144-3p,miR-126-3p,TNF-α,VEGF,and NIHSS score between different prognostic groups(P＜0.05).Multivariate logistic analysis revealed that serum miR-144-3p,miR-126-3p,TNF-α,and VEGF were all factors affecting the poor prognosis of ICH patients(P＜0.05).The area under the curve(AUC)of serum miR-144-3p,miR-126-3p,and combined prediction of prognosis in ICH patients was 0.851,0.886,and 0.952,respectively,the combined prediction of the two was more valuable(Zcombination-miR-144-3p=3.371,Zcombination-miR-126-3p=2.791,P＜0.05).Conclusion The expression of miR-144-3p in the serum of ICH patients increases,while the expression of miR-126-3p decreases.The two may serve as biological markers for predicting the prognosis of ICH patients,and the combination of the two is more valuable in predicting the prognosis of ICH patients.

This article systematically explores the synergistic value of endoscopic evaluation and local resection techniques in diagnosing clinical complete response (cCR) after neoadjuvant therapy for rectal cancer. Endoscopic techniques, including high-definition narrow-band imaging, endoscopic ultrasound, and confocal laser endomicroscopy, significantly improve the detection rate of microscopic residual lesions and provide objective evidence for clinical decision-making through standardized scoring systems. Local resection techniques, serving as both pathological verification and minimally invasive treatment, offer organ preservation opportunities for patients with cCR. The integrated three-step diagnostic pathway of "endoscopic screening-radiological reassessment-local resection confirmation" enhances the specificity of cCR diagnosis while reducing unnecessary radical surgeries. However, standardizing technical implementation, deepening multidisciplinary collaboration, and integrating molecular diagnostics remain critical directions for future development.

Objective To explore the risk factors of clopidogrel resistance in elderly patients with acute myocardial infarction(AMI)in order to provide personalized medication plans.Methods A prospective trial was conducted on 472 elderly AMI patients undergoing coronary stent placement in No.901 Hospital of Joint Logistics Support Force of PLA and Hangzhou Special Service Conva-lescent Center of Air Force from January 2018 to December 2022.All patients received clopidogrel for antiplatelet postoperatively,and after 7 consecutive days of administration,peripheral venous blood samples were collected to observe whether the patient had resistance to clopidogrel and to measure the concentration of active metabolites of clopidogrel and the maximum platelet aggrega-tion ratio(MARAA)of arachidonic acid induced platelets.According to MARAA,they were divid-ed into a clopidogrel resistant group(MARAA≥55％,142 cases)and a clopidogrel sensitive group of(＜55％,330 cases).The clinical characteristics were compared between the two groups,and multivariate logistic regression analysis was used to identify the risk factors for clopidogrel resistance.The impact of clopidogrel resistance on major adverse cardiovascular events was ana-lyzed.Results The clopidogrel resistant group had significantly higher MARAA level,decrease in the concentration of clopidogrel active metabolites,higher BMI,and larger ratios of obesity,CYP2C19*2 mutation,diabetes,hyperlipidemia and administration of hypoglycemic drugs when compared with the clopidogrel sensitive group(P＜0.01).Obesity,diabetes,hyperlipidemia and CYP2C19*2 mutation were risk factors for clopidogrel resistance in elderly AMI patients(OR=2.036,95％CI:1.282-3.235;OR=2.795,95％CI:1.803-4.334;OR=2.125,95％CI:1.355-3.331;OR=4.881,95％CI:2.807-8.486).The incidence of major adverse cardiovascular events was notably higher in the clopidogrel resistant group than the sensitive group(11.27％vs 4.55％,P＜0.01).After a prediction model was constructed with R4.0.3 statistical software,330 cases randomly selected from the dataset were assigned into a training set,and the remaining 142 cases into a validation set.The AUC value of the training set and the validation set was 0.750 and 0.780,respectively.Hosmer-Lemeshow Goodness of Fit test indicated that the model had good re-liability and predictive value(Chi-square=18.907,P=0.215).Conclusion Obesity,diabetes,hy-perlipidemia and CYP2C19*2 mutation are risk factors of clopidogrel resistance in elderly AMI patients,and clopidogrel resistance may lead to poor prognosis.

Objective To explore the risk factors of clopidogrel resistance in elderly patients with acute myocardial infarction(AMI)in order to provide personalized medication plans.Methods A prospective trial was conducted on 472 elderly AMI patients undergoing coronary stent placement in No.901 Hospital of Joint Logistics Support Force of PLA and Hangzhou Special Service Conva-lescent Center of Air Force from January 2018 to December 2022.All patients received clopidogrel for antiplatelet postoperatively,and after 7 consecutive days of administration,peripheral venous blood samples were collected to observe whether the patient had resistance to clopidogrel and to measure the concentration of active metabolites of clopidogrel and the maximum platelet aggrega-tion ratio(MARAA)of arachidonic acid induced platelets.According to MARAA,they were divid-ed into a clopidogrel resistant group(MARAA≥55％,142 cases)and a clopidogrel sensitive group of(＜55％,330 cases).The clinical characteristics were compared between the two groups,and multivariate logistic regression analysis was used to identify the risk factors for clopidogrel resistance.The impact of clopidogrel resistance on major adverse cardiovascular events was ana-lyzed.Results The clopidogrel resistant group had significantly higher MARAA level,decrease in the concentration of clopidogrel active metabolites,higher BMI,and larger ratios of obesity,CYP2C19*2 mutation,diabetes,hyperlipidemia and administration of hypoglycemic drugs when compared with the clopidogrel sensitive group(P＜0.01).Obesity,diabetes,hyperlipidemia and CYP2C19*2 mutation were risk factors for clopidogrel resistance in elderly AMI patients(OR=2.036,95％CI:1.282-3.235;OR=2.795,95％CI:1.803-4.334;OR=2.125,95％CI:1.355-3.331;OR=4.881,95％CI:2.807-8.486).The incidence of major adverse cardiovascular events was notably higher in the clopidogrel resistant group than the sensitive group(11.27％vs 4.55％,P＜0.01).After a prediction model was constructed with R4.0.3 statistical software,330 cases randomly selected from the dataset were assigned into a training set,and the remaining 142 cases into a validation set.The AUC value of the training set and the validation set was 0.750 and 0.780,respectively.Hosmer-Lemeshow Goodness of Fit test indicated that the model had good re-liability and predictive value(Chi-square=18.907,P=0.215).Conclusion Obesity,diabetes,hy-perlipidemia and CYP2C19*2 mutation are risk factors of clopidogrel resistance in elderly AMI patients,and clopidogrel resistance may lead to poor prognosis.

Objective To investigate the expression and clinical significance of serum microRNA-144-3p(miR-144-3p)and microRNA-126-3p(miR-126-3p)in patients with intracerebral hemorrhage(ICH).Methods From February 2022 to April 2023,120 ICH patients who underwent treatment at our hospital were recruited as the ICH group.They were separated into a good prognosis group and a poor prognosis group based on the modified Rankin Scale(mRS)score After 6 months treatment Additionally,110 healthy individuals who underwent physical examination at our hospital were included as the control group.Clinical data of patients were collected and analyzed.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of tumor necrosis factor-α(TNF-α)and vascular endothelial growth factor(VEGF)indicators.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was applied to detect the expression levels of serum miR-144-3p and miR-126-3p.Pearson method was applied to analyze the correlation between serum miR-144-3p,miR-126-3p,TNF-α,and VEGF levels in ICH patients.Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of ICH patients.ROC curve was applied to analyze the predictive value of serum miR-144-3p and miR-126-3p for the prognosis of ICH patients.Results In the control group,the serum miR-144-3p was 1.02±0.02,the TNF-α was(19.15±6.79)pg/ml,the VEGF level was(1.05±0.18)ng/ml,and the serum miR-126-3p level was 1.04±0.05.The values in the ICH group were 2.12±0.23,(48.32±8.43)pg/ml,(6.56±1.49)ng/ml,and(0.53±0.12),respectively.There was a statistically significant difference between the two groups(P＜0.05).Pearson analysis results showed that serum miR-144-3p was positively correlated with TNF-α and VEGF levels in ICH patients(r=0.496,0.542,P＜0.05),while serum miR-126-3p was negatively correlated with TNF-α and VEGF levels(r=-0.493,-0.526,P＜0.05).There were significant differences in the serum levels of miR-144-3p,miR-126-3p,TNF-α,VEGF,and NIHSS score between different prognostic groups(P＜0.05).Multivariate logistic analysis revealed that serum miR-144-3p,miR-126-3p,TNF-α,and VEGF were all factors affecting the poor prognosis of ICH patients(P＜0.05).The area under the curve(AUC)of serum miR-144-3p,miR-126-3p,and combined prediction of prognosis in ICH patients was 0.851,0.886,and 0.952,respectively,the combined prediction of the two was more valuable(Zcombination-miR-144-3p=3.371,Zcombination-miR-126-3p=2.791,P＜0.05).Conclusion The expression of miR-144-3p in the serum of ICH patients increases,while the expression of miR-126-3p decreases.The two may serve as biological markers for predicting the prognosis of ICH patients,and the combination of the two is more valuable in predicting the prognosis of ICH patients.

Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

This article systematically explores the synergistic value of endoscopic evaluation and local resection techniques in diagnosing clinical complete response (cCR) after neoadjuvant therapy for rectal cancer. Endoscopic techniques, including high-definition narrow-band imaging, endoscopic ultrasound, and confocal laser endomicroscopy, significantly improve the detection rate of microscopic residual lesions and provide objective evidence for clinical decision-making through standardized scoring systems. Local resection techniques, serving as both pathological verification and minimally invasive treatment, offer organ preservation opportunities for patients with cCR. The integrated three-step diagnostic pathway of "endoscopic screening-radiological reassessment-local resection confirmation" enhances the specificity of cCR diagnosis while reducing unnecessary radical surgeries. However, standardizing technical implementation, deepening multidisciplinary collaboration, and integrating molecular diagnostics remain critical directions for future development.

Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

Objective: To understand the current situation and regulatory effectiveness of daylighting and artificial lighting in primary and secondary school classrooms in Shanghai, so as to provide a basis for enhancing the visual environment of school classrooms. Methods: From April 2021 to December 2023, the daylighting and artificial lighting conditions of classrooms in 1 735 regular primary and secondary schools currently in operation in Shanghai were monitored, and the qualified rate of each indicator was calculated. The Chisquare test or Fisher exact probability method were used to compare the differences in qualification rates across different educational stages, regions, school type, both before and after the implementation of regulatory measures. The regulatory measures included convene interview, propaganda and education, supervision order, supervisory opinion paper, rectification requests and offenses and punishment. Results: The qualified rate of daylighting and artificial lighting in primary and secondary school classrooms was 30.1%, with a qualified daylighting rate of 85.6% and a qualified artificial lighting rate of 32.9%. There was no statistically significant differences in the qualified rate of daylighting and artificial lighting in primary and secondary schools (32.4%，28.1%；χ2=3.76，P＞0.05). However, statistically significant differences were found in the qualified rate of daylighting and artificial lighting in urban and rural school classrooms (32.6%，26.7%), as well as in public and private schools (31.4%, 20.6%) (χ2=6.99，9.92，P＜0.05). Following the implementation of regulatory measures, the qualified rate of classroom daylighting and artificial lighting improved from 30.1% to 83.2%, while the respective qualified rates of daylighting and artificial lighting increased from 85.6% to 91.1% and 32.9% to 90.5%. Compared to the preimplementation period, the qualified rate of classroom daylighting and artificial lighting, as well as the respective rates of daylighting and artificial lighting, all showed statistically significant differences after the implementation of regulatory measures (χ2=995.29，25.34，1 219.87，P<0.01). Conclusions Effective regulatory measures can promote enhanced classroom daylighting and artificial lighting. Attention should be paid to improving classroom artificial lighting, in order to provide students with enhanced visual environment.

Objective To explore the effect of targeted inhibition of miR-628-5p by long non-coding RNA(lncRNA)KCNQ1 overlapping transcript 1(KCNQ1OT1)on high glucose(HG)-induced retinal pigment epithelial cell injury.Meth-ods The real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was performed to detect KCNQ1OT1 expression in serum and aqueous humor of patients with diabetic retinopathy(DR),type 2 diabetes mellitus(T2DM)and uveitis.Human retinal pigment epithelial cells(ARPE-19)were treated with different concentrations of glucose,and their KCNQ1OT1 expression was detected to determine the optimal glucose concentration.ARPE-19 cells were divided into the control(CON)group,HG group,HG+si-NC group,HG+si-KCNQ1OT1 group,HG+miR-NC group,HG+miR-628-5p group,HG+si-KCNQ1OT1+anti-miR-NC group,and HG+si-KCNQ1OT1+anti-miR-628-5p group.The expression levels of KCNQ1OT1 and miR-628-5p in cells were measured by RT-qPCR.The cell apoptosis was detected by flow cytometry.The malondialdehyde(MDA)level and superoxide dismutase(SOD)activity were detected by enzyme-linked immunosorbent assay.The expression level of cleaved Caspase-3 protein was measured by Western blot.The targeting relationship between KCNQ1OT1 and miR-628-5p was detected by dual-luciferase reporter assay.Results The expression levels of KCNQ1OT1 in serum and aqueous humor of DR patients were higher than those of T2DM patients and uveitis patients,and those of uve-itis patients were the lowest(all P＜0.05).Compared with the 0 mmol·L-1 glucose group,the expression levels of KC-NQ1OT1 in ARPE-19 cells in the 5 mmol·L-1 glucose group,15 mmol·L-1 glucose group,and 30 mmol·L-1 glucose group significantly increased,and those in the 30 mmol·L-1 glucose group were the highest(all P＜0.05);thus,30 mmol·L-1 glucose was selected for subsequent experiments.Compared with the CON group,the KCNQ1OT1 expres-sion,apoptosis rate,cleaved Caspase-3 protein expression,and MDA level in the HG group significantly increased,while the SOD activity and miR-628-5p significantly decreased(all P＜0.05).Compared with the HG+si-NC group,the KC-NQ1OT1 expression,apoptosis rate,cleaved Caspase-3 protein expression,and MDA level in the HG+si-KCNQ1OTl group significantly decreased,while the SOD activity significantly increased(all P＜0.05).Compared with the HG+miR-NC group,miR-628-5p and SOD activity in the HG+miR-628-5p group significantly increased,while the apoptosis rate,cleaved Caspase-3 protein expression,and MDA level significantly decreased(all P＜0.05).Compared with the HG+si-KCNQ1OT1+anti-miR-NC group,miR-628-5p and SOD activity in the HG+si-KCNQ1OT1+anti-miR-628-5p group significantly decreased,while the apoptosis rate,cleaved Caspase-3 protein expression,and MDA level significantly increased(all P＜0.05).Conclusion lncRNA KCNQ1OT1 can reduce the HG-induced apoptosis and oxidative damage of ARPE-19 cells by targeted inhibition of miR-628-5p.