OBJECTIVE: To analyze the risk factors of acute spinal cord injury complicated with respiratory dysfunction, and to construct the clinical prediction model of acute spinal cord injury complicated with respiratory dysfunction. METHODS: Continuous 170 cases of acute spinal cord injury treated from April 2019 to October 2022 were retrospectively collected, and clinical data were uniformly collected. Patients were divided into respiratory dysfunction group 30 cases and non-respiratory dysfunction group 140 cases according to whether they had respiratory dysfunction during treatment. The predictive factors of acute spinal cord injury complicated with respiratory dysfunction were screened by Lasso analysis, and the risk factors of acute spinal cord injury complicated with respiratory dysfunction were screened by multivariate Logistic regression analysis. R(R4.2.1) software was used to establish a nomogram risk warning model for predicting acute spinal cord injury complicated with respiratory dysfunction, and Hosmer-Lemeshow test was used to evaluate the model fit. Finally, area under receiver operating characteristic(ROC) curve (AUC), calibration curve, and decision curve analysis(DCA) were used to evaluate the differentiation, calibration and clinical impact of the model. RESULTS: The incidence of respiratory dysfunction in 170 patients was 17.65%. Lasso regression analysis selected age, residence, marital status, smoking, hypertension, degree of paralysis, spinal cord injury plane, multiple injuries, spinal cord fracture and dislocation, and ASIA grade as the influencing factors. Multivariate Logistic regression analysis showed that age, smoking, degree of paralysis, level of spinal cord injury, spinal cord injury of fracture and dislocation, and ASIA grade were risk factors for acute spinal cord injury complicated with respiratory dysfunction. The prediction model of acute spinal cord injury complicated with respiratory dysfunction was established by Hosmer-Lemeshow test, χ²=5.830, P=0.67. The AUC value of the model was 0.912. DCA analysis showed that the net benefit value of nomogram prediction of acute spinal cord injury complicated with respiratory dysfunction was higher when threshold probability ranged from 1% to 100%. CONCLUSION This column chart can help identify the risk of acute spinal cord injury complicated with respiratory dysfunction in early clinical stage, facilitate early clinical decision-making and intervention, and has important guiding significance for optimizing clinical efficacy and improving prognosis of patients. It is expected to improve and verify this model with larger samples and multi-center in the future.
Humans ; Spinal Cord Injuries/complications* ; Nomograms ; Male ; Female ; Middle Aged ; Adult ; Retrospective Studies ; Risk Factors ; Aged ; Respiration Disorders/etiology* ; Adolescent ; Logistic Models

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

A total of 300 1-day-old broilers were randomly divided into 5 groups with 5 replicates per group and 12 broilers per replicate.The control group was given free drinking water(CG),the astragalus polysaccharide control group(HPS)received 0.8 mL/L of astragalus polysaccharide o-ral liquid in drinking water,and the experimental groups(SBL,SBM,SBH)received 1.5,3.0,4.5 mL/,of Shenling Baizhu Oral Liquid in drinking water.The results showed as follows:com-pared to the CG group,SIgA content in HPS group,group SBM and group SBH was significantly increased(P＜0.05),IL-6 and IL-1β contents were significantly decreased(P＜0.05),Occludin,Mucin-2 and Bcl-2 contents were significantly increased(P＜0.05).The results of 16S rRNA test showed that the specific OUT number in groups HPS and SBM was significantly higher than that in group CG(P＜0.05),α diversity analysis showed that compared with group CG,Chao1 index and Simpson index of group HPS,group SBM and group SBH were significantly increased,and βdiversity analysis showed that there were significant differences in species composition between test group and blank control group(P＜0.05).The relative abundance analysis at the phylum level showed that the relative abundance of Firmicutes and Bacteroides in groups SBM and SBH was significantly higher than that in group CG(P＜0.05).The above results showed that Shenling Baizhu Oral Liquid could improve the intestinal health and enhance the resistance of broilers.

Objective To explore strategies for further subdivision of DRG in gastrointestinal surgery cases,providing references to enhance the differentiation of DRG subgroups.Methods A total of 5 108 gastrointestinal surgery cases were selected from a tertiary grade A hospital and a tertiary hospital in Hubei Province,spanning from January 2019 to June 30,2023,and another secondary hospital's data from 2020 and 2021.It employs single factor analysis and multiple linear regression analysis to identify factors influencing case costs.Additionally,the opinions of nine clinicans were gathered regarding factors affecting resource consumption in gastrointestinal surgery cases.The four selected case groups were further subdivided considers the peak characteristics of disease costs.It compares subdivided groups with the DRG Payment Subgroups Scheme(Version 2.0).Results Groups GB1,GB2,GC1,and GC2 were subdivided into 7,4,7,and 6 DRG groups,respectively.The coefficient of variation of each subdivided DRG were reduced,homogeneity was increased,and inter-group differentiation was increased.The results were consistent with the DRG Payment Subgroups Scheme(Version 2.0).Conclusion Based on DRG grouping,the DRG groups can be further subdivided according to the peak characteristics presented by case costs.This subdivision strategy is helpful to provide new ideas for case grouping of Medicare payment.

Objective:To evaluate the clinical characteristics of primary thyroid lymphoma (PTL) and the prognoses.Methods:A retrospective analysis was performed on the clinical data, prognosis and influencing factors of 18 PTL patients at the First Affiliated Hospital of Xiamen University from Oct 2012 to Aug 2021.Results:There were 12 females and 6 males, average age of (60±11.5)years. Fifteen patients were complicated with hashimoto's thyroiditis (HT). Seventeen patients received treatments including surgery, chemotherapy, radiotherapy, and targeted therapy. Median follow-up time was 35.8 months. Four cases suffered from recurrence and progression, and 3 cases died. The 3-year overall survival rate(OS) was 94%, and the 5-year OS rate was 83%. The 3-year progression-free survival(PFS)rate was 89%, and the 5-year PFS rate was 79%. The OS rate and PFS rate of patients with HT were higher than those of patients without ( P<0.05). The 5-year OS rates were 100% vs.33% ( χ2=7.681, P=0.006), and the 3-year PFS rates were 93% vs. 67% respectively( χ2=5.368, P=0.021). The OS and PFS of patients who had undergone surgical treatment were higher than those of patients without ( P<0.01). The 5-year OS rates were 100% vs.40% ( χ2=8.579, P=0.003), and the 5-year PFS rates were 100% vs.30% ( χ2=12.267, P<0.001).The PFS rate of patients aged ≤60 years was higher than that of patients aged >60 years, and the difference was statistically significant ( P<0.05). The 5-year PFS rates were 100% vs. 56% ( χ2=4.906, P=0.027). Conclusions:PTL shows a female predominance and tends to occur at a relatively advanced age. The overall prognosis of PTL patients is favorable after multidisciplinary treatment.Patients with HT or who have undergone surgical treatment tend to have relatively longer survival periods.

Objective:To explore the effect of Sugammadex sodium on muscle relaxant recovery and coagulation function after modified radical mastectomy for breast cancer.Methods:A total of 110 patients who underwent modified radical mastectomy in Shanxi Cancer Hospital from May. 2022 to May. 2024 were chosen and separated into two groups according to random number table method, with 55 cases in each group, receiving the same anesthesia scheme. Muscle relaxant was monitored by train-of-four stimulation (TOF) . After surgery, when the TOF count was ≥2, the study group was given Sugammadex sodium, and the control group was given neostigmine + atropine. Operation-related indexes and adverse reactions were recorded; The muscle relaxant residue was analyzed at 5, 15 and 30min after injection of muscle relaxant antagonists; Blood clot formation time (K value) , blood clot formation rate (Angle) , maximum blood clot intensity (MA value) and blood clot reaction time (R value) of the two groups were compared before (T1) and 5min (T2) , 15min (T3) and 30min (T4) after injection.Results:The extubation time and the first extubation time in the study group were shorter [ (4.10±1.05) min, (22.95±2.24) h vs. (13.28±2.96) min, (29.83±3.06) h] ( t=21.68, 13.46, all P < 0.05) . The muscle relaxation residual rates in the study group at 5min and 15min were lower [12.73% (7/55) , 0.00% (0/55) vs. 100.00% (55/55) , 63.64% (35/55) ] ( χ2=85.16, 51.33, P < 0.05) . There were no differences in K value, Angle value, MA value and R value between the two groups at T1, T2, T3 and T4 ( t K=0.17, 0.44, 0.14, 0.13, t Angle=0.93, 1.29, 1.04, 1.00, t MA=1.17, 1.72, 0.87, 1.03, t R=0.36, 0.08, 0.09, 0.37, all P > 0.05) . The incidence rates of postoperative nausea, vomiting and respiratory depression in the study group were lower [5.45% (3/55) , 7.27% (4/55) , 0.00% (0/55) vs. 18.18% (10/55) , 21.82% (12/55) , 10.91% (6/55) ] ( χ2/ Fisher=4.27, 4.68, -, all P < 0.05) . Conclusion:Sugammadex sodium can promote the recovery of muscle relaxant in patients after modified radical mastectomy for breast cancer, and has little effect on coagulation function, which can reduce the occurrence of postoperative adverse reactions.

This experiment was conducted to study the effects of replacing feed protein by Herme-tia illucens larvae meal on immune function,intestinal morphology and microflora of Sichuan white geese.A total of 64 healthy 1-day-old Sichuan white geese were randomly allocated into 4 groups with 4 replicates in each group and 4 geese in each replicate,namely the control group,the 2％HILM,4％HILM and 8％HILM groups fed diets contained 0％,2％,4％and 8％of HILM,re-spectively.The experimental period was 40 days.The results showed that compared with the con-trol group,8％HILM increased the levels of serum IgG1,IgG2a and complement C3,and the difference was statistically significant(P＜0.01).4％HILM significantly increased the expression level of CD4(P＜0.05),and 8％HILM significantly increased the expression level of IL-10(P＜0.05).The ratio of villus length to crypt depth(VH/CD)in the jejunum and ileum in 4％HILM group was significantly increased(P＜0.05).The SIgA level of jejunum was significantly increased in all HILM replacement groups(P＞0.05).The abundance of Bacteroides in 4％HILM group were extremely significantly increased(P＜0.01),and the abundance of Bilophila and Bilophila wadsworthia were significantly decreased in all HILM replacement groups(P＜0.05).In conclu-sion,HILM can enhance the immune function of Sichuan white geese,improve the intestinal mor-phology of jejunum and ileum,enhance the local mucosal immunity of jejunum,increase the abun-dance of beneficial bacteria in cecum and decrease the abundance of harmful bacteria in cecum,and protect intestinal health.

Danggui Buxue decoction(DBD)is a classic prescription with immunomodulatory and hematopoietic effects.Previous studies have shown the DBD has potential to be used as an oral im-mune booster.However,its immunomodulatory effects and mechanism of action have not been thoroughly studied,especially the protective mechanism of immunomodulatory regulation in the state of immunosuppressive is still unclear.The aim of this study was to explore the protective mechanism of DBD in the immunosuppressive state using network pharmacology combined with animal experiments verification.The active components,core targets and signaling pathways of DBD in treating immunosuppression were obtained using network pharmacology tools.On this ba-sis,the active components of DBD were identified using HPLC-MS,and in vivo studies were con-ducted at the same time.The key active components of DBD obtained using network pharmacology included quercetin,kaempferol and formononetin.The core targets included TP53,RELA,TNF,AKT1,and IL-6.KEGG pathway enrichment analysis showed that phosphoinositide 3-kinase(PI3K)-protein kinase B(AKT)may play an important role in the treatment of immunosuppres-sive diseases using DBD.Molecular docking confirmed that each core target had good binding activ-ity with its corresponding compounds.Animal experiments showed that after DBD intervention,the mRNA gene and protein expression of RELA,TNF,and IL-6 in the serum was significantly down-regulated.The mRNA expression of PI3K and AKT in the ileum and PI3K protein expression were also downregulated.In conclusion,DBD exerts its role in treating immunosuppressive diseases by regulating the PI3K-AKT signaling pathway.

Objective:To explore the effect of Sugammadex sodium on muscle relaxant recovery and coagulation function after modified radical mastectomy for breast cancer.Methods:A total of 110 patients who underwent modified radical mastectomy in Shanxi Cancer Hospital from May. 2022 to May. 2024 were chosen and separated into two groups according to random number table method, with 55 cases in each group, receiving the same anesthesia scheme. Muscle relaxant was monitored by train-of-four stimulation (TOF) . After surgery, when the TOF count was ≥2, the study group was given Sugammadex sodium, and the control group was given neostigmine + atropine. Operation-related indexes and adverse reactions were recorded; The muscle relaxant residue was analyzed at 5, 15 and 30min after injection of muscle relaxant antagonists; Blood clot formation time (K value) , blood clot formation rate (Angle) , maximum blood clot intensity (MA value) and blood clot reaction time (R value) of the two groups were compared before (T1) and 5min (T2) , 15min (T3) and 30min (T4) after injection.Results:The extubation time and the first extubation time in the study group were shorter [ (4.10±1.05) min, (22.95±2.24) h vs. (13.28±2.96) min, (29.83±3.06) h] ( t=21.68, 13.46, all P < 0.05) . The muscle relaxation residual rates in the study group at 5min and 15min were lower [12.73% (7/55) , 0.00% (0/55) vs. 100.00% (55/55) , 63.64% (35/55) ] ( χ2=85.16, 51.33, P < 0.05) . There were no differences in K value, Angle value, MA value and R value between the two groups at T1, T2, T3 and T4 ( t K=0.17, 0.44, 0.14, 0.13, t Angle=0.93, 1.29, 1.04, 1.00, t MA=1.17, 1.72, 0.87, 1.03, t R=0.36, 0.08, 0.09, 0.37, all P > 0.05) . The incidence rates of postoperative nausea, vomiting and respiratory depression in the study group were lower [5.45% (3/55) , 7.27% (4/55) , 0.00% (0/55) vs. 18.18% (10/55) , 21.82% (12/55) , 10.91% (6/55) ] ( χ2/ Fisher=4.27, 4.68, -, all P < 0.05) . Conclusion:Sugammadex sodium can promote the recovery of muscle relaxant in patients after modified radical mastectomy for breast cancer, and has little effect on coagulation function, which can reduce the occurrence of postoperative adverse reactions.