Objective To analyze the incidence of cardiovascular events among patients with comorbid chronic obstructive pulmonary disease(COPD)and hypertension(HTN),as well as to identify the associated influ-encing factors.Methods A retrospective analysis was conducted on patients diagnosed with primary hypertension(HTN group,n=64),chronic obstructive pulmonary disease(COPD group,n=64),and concomitant primary hypertension and COPD(combined group,n=64)at our hospital between December 2021 and January 2025.Cardiovascular event incidence,pulmonary function parameters-including forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),and percent predicted FEV1(FEV1%pred)-and blood pressure levels(systolic blood pressure[SBP],diastolic blood pressure[DBP])were compared across the three groups.Kaplan-Meier curves were constructed to illustrate and compare the cumulative incidence of cardiovas-cular events.Covariance analysis was performed to assess the impact of hypertension on pulmonary function,and Cox proportional hazards regression was employed to identify factors associated with cardiovascular outcomes.Results The total incidence rate of cardiovascular events in the HTN group was 14.06%,which was significantly lower than that in the COPD group(29.69%)and the combined HTN-COPD group(48.44%)(P<0.05).A highly significant difference was observed in the cumulative incidence rates across the three groups(P<0.05).Specifically,the COPD group exhibited a higher cumulative incidence than the HTN group(P<0.05),while the combined group showed the highest incidence,exceeding both the COPD and HTN groups(P<0.05).Pulmonary function parameters-including FVC,FEV1,PEF,and FEV1%pred-were significantly higher in the HTN group compared to both the COPD and combined groups(P<0.05).Moreover,these indices were also higher in the COPD group than in the combined group(P<0.05).Systolic and diastolic blood pressure(SBP and DBP)levels in the combined group were significantly elevated compared to both the HTN and COPD groups(P<0.05),and SBP and DBP in the HTN group were higher than those in the COPD group(P<0.05).After adjusting for potential confounders,the intergroup dif-ference in FVC remained statistically significant(P<0.05),and the effect of group on FEV1%pred was particularly robust(partial η2=0.754,P<0.05).Compared with patients without cardiovascular events,those who experienced events differed significantly by disease type(P<0.05).The proportions of patients with HTN alone and HTN com-bined with COPD were higher in the event group than in the non-event group(P<0.05).Additionally,FVC and FEV1%pred were lower in the event group,whereas SBP and DBP were higher(all P<0.05).Multivariate analysis identified disease type,FEV1%pred,and SBP as independent predictors of cardiovascular events(P<0.05).Deci-sion tree analysis further highlighted that the coexistence of HTN and COPD constitutes a critical determinant in cardiovascular risk stratification.Conclusions The incidence of cardiovascular events in patients with COPD com-bined with HTN was significantly higher than in those with either condition alone.Furthermore,the coexistence of these diseases,along with impaired lung function(as indicated by reduced FEV1%predicted)and increased SBP,were independent risk factors for cardiovascular events.

Objective To analyze the incidence of cardiovascular events among patients with comorbid chronic obstructive pulmonary disease(COPD)and hypertension(HTN),as well as to identify the associated influ-encing factors.Methods A retrospective analysis was conducted on patients diagnosed with primary hypertension(HTN group,n=64),chronic obstructive pulmonary disease(COPD group,n=64),and concomitant primary hypertension and COPD(combined group,n=64)at our hospital between December 2021 and January 2025.Cardiovascular event incidence,pulmonary function parameters-including forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),and percent predicted FEV1(FEV1%pred)-and blood pressure levels(systolic blood pressure[SBP],diastolic blood pressure[DBP])were compared across the three groups.Kaplan-Meier curves were constructed to illustrate and compare the cumulative incidence of cardiovas-cular events.Covariance analysis was performed to assess the impact of hypertension on pulmonary function,and Cox proportional hazards regression was employed to identify factors associated with cardiovascular outcomes.Results The total incidence rate of cardiovascular events in the HTN group was 14.06%,which was significantly lower than that in the COPD group(29.69%)and the combined HTN-COPD group(48.44%)(P<0.05).A highly significant difference was observed in the cumulative incidence rates across the three groups(P<0.05).Specifically,the COPD group exhibited a higher cumulative incidence than the HTN group(P<0.05),while the combined group showed the highest incidence,exceeding both the COPD and HTN groups(P<0.05).Pulmonary function parameters-including FVC,FEV1,PEF,and FEV1%pred-were significantly higher in the HTN group compared to both the COPD and combined groups(P<0.05).Moreover,these indices were also higher in the COPD group than in the combined group(P<0.05).Systolic and diastolic blood pressure(SBP and DBP)levels in the combined group were significantly elevated compared to both the HTN and COPD groups(P<0.05),and SBP and DBP in the HTN group were higher than those in the COPD group(P<0.05).After adjusting for potential confounders,the intergroup dif-ference in FVC remained statistically significant(P<0.05),and the effect of group on FEV1%pred was particularly robust(partial η2=0.754,P<0.05).Compared with patients without cardiovascular events,those who experienced events differed significantly by disease type(P<0.05).The proportions of patients with HTN alone and HTN com-bined with COPD were higher in the event group than in the non-event group(P<0.05).Additionally,FVC and FEV1%pred were lower in the event group,whereas SBP and DBP were higher(all P<0.05).Multivariate analysis identified disease type,FEV1%pred,and SBP as independent predictors of cardiovascular events(P<0.05).Deci-sion tree analysis further highlighted that the coexistence of HTN and COPD constitutes a critical determinant in cardiovascular risk stratification.Conclusions The incidence of cardiovascular events in patients with COPD com-bined with HTN was significantly higher than in those with either condition alone.Furthermore,the coexistence of these diseases,along with impaired lung function(as indicated by reduced FEV1%predicted)and increased SBP,were independent risk factors for cardiovascular events.

Objective:To correlate homocysteine (Hcy) and blood lipid levels with neurological function in patients with progressive ischemic stroke.Methods:A total of 400 patients with ischemic stroke who received treatment between June 2018 and June 2020 in Linhai Second People's Hospital were included in this study. Progressive ischemic stroke ( n = 126) and non-progressive ischemic stroke ( n = 274) groups were designated. Hcy level was determined by enzyme-linked immunosorbent assay. High-density lipoprotein cholesterol, triacylglycerol, low-density lipoprotein cholesterol and cholesterol levels were measured using a biochemical analyzer. Hcy and blood lipid levels as well as National Institute Health of Stroke Scale (NIHSS) score were determined in each group. Hcy and blood lipid levels were correlated with NIHSS score. Results:Hcy level in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(28.39 ± 4.36) μmol/L vs. (20.17 ± 3.24) μmol/L, t = 18.894, P < 0.05]. Low-density lipoprotein cholesterol , triacylglycerol and TC levels in the progressive ischemic stroke group were (3.29 ± 0.45) mmol/L, (2.08 ± 0.34) mmol/L and (4.82 ± 0.79) mmol/L, respectively, which were significantly higher than those in the non-progressive ischemic stroke group [(2.48 ± 0.37) mmol/L, (1.56 ± 0.29) mmol/L and (4.08 ± 0.43) mmol/L, t = 17.644, 14.859, 9.860, P < 0.05]. High-density lipoprotein cholesterol level in the progressive ischemic stroke group was significantly lower than that in the non-progressive ischemic stroke group [(1.03 ± 0.13) mmol/L vs. (1.19 ± 0.14) mmol/L, t =11.158, P < 0.05]. NIHSS score in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(21.72 ± 4.35) points vs. (15.52 ± 2.89) points, t = 14.582, P < 0.05]. Hcy, low-density lipoprotein cholesterol, cholesterol and triacylglycerol levels were linearly and positively correlated with NIHSS score ( r = 0.846, 0.724, 0.718, 0.765, all P < 0.05), while igh-density lipoprotein cholesterol level was linearly and negatively correlated with NIHSS score ( r = -0.710, P < 0.05). Conclusion:In patients with progressive ischemic stroke, Hcy level is increased and blood lipid level is obviously abnormal. Hcy and blood lipid levels are greatly correlated with neurological function.

Metabolic syndrome is closely related to target organ injury such as heart, brain, and kidney. And bilirubin is an effective antioxidant. At present, there is a lack of research data on metabolic syndrome and serum total bilirubin in longevity elderly people. This study aimed to study the prevalence of the metabolic syndrome and its correlation with serum total bilirubin level in nonagenarians and centenarians living in Hubei Zhongxiang Province. According to the demographic information provided by Zhongxiang Civil Affairs Bureau, 128 elderly people were interviewed and 11 of them were excluded. A total of 117 population were included in the study. Questionnaires, physical examination, and blood test were made. 117 subjects aged 90-113 years with an average age of (98.6±4.8) years old were analysed. The prevalence of metabolic syndrome and its diagnostic components were obesity 19.7%, hyperglycemia 29.9%, hypertension 94.0%, hypertriglyceridemia 33.3%, low high density lipoprotein-cholesterol (HDL-C) levels 17.1%, and metabolic syndrome 23.9%. Logistic regression analysis found that the total bilirubin level was negatively correlated with metabolic syndrome and triglyceride levels(P<0.05), but not with obesity, hyperglycemia, hypertension, and total cholesterol (P>0.05). The nonagenarians and centenarians have a low prevalence of metabolic syndrome in Zhongxiang, Hubei Province, total bilirubin was negatively correlated with metabolic syndrome and triglyceride.

Objective To investigate the associations of cognitive function with apolipoprotein E (APOE) gene polymorphism and chronic diseases among long-lived people in Zhongxiang City of Hubei Province.Methods A total of 110 long-lived elderly residents aged 90 years and over were collected.Their cognitive function was determined face-to-face using questionnaires by trained interviewers.According to mini-mental state examination(MMSE) scores,subjects were divided into a no dementia risk group and a high dementia risk group.General demographic characteristics,activities of daily living,depression state and nutrition status were compared between the two groups.Correlations of dementia with APOE gene polymorphism and chronic diseases were analyzed.Results The average MMSE score was 22.3±4.8.Among the 110 long-lived people,18 cases had a high risk for dementia,accounting for 16.4％,and 92 cases had no risk of dementia,accounting for 83.6％.The risk of dementia in long-lived elderly people was correlated with activities of daily living,mental state,nutritional status and falls(all P＜0.05).There were 8 cases with the APOE gene ε4/ε3 genotype in the high dementia risk group and 16 cases with the APOE gene ε4/e3 genotype in the no dementia risk group,with the former group showing a higher frequency of the APOE ε4/ε3 genotype (44.4％ vs.17.4％,x2 =6.46,P＜0.05).The former group also seemed to have a higher APOE ε4 frequency,but the difference was not statistically significant(22.2 ％ vs.10.3 ％,x2 =3.96,P =0.055)Chronic diseases prevalent in the long-lived people were hypertension(86 cases,78.2 ％),hearing loss (72 cases,65.5％),hyperlipidemia(56 cases,50.9％),anemia(43 cases,39.1％),impaired vision(39 cases,35.5 ％),chronic kidney diseases(25 cases,22.7 ％),chronic heart diseases (18 cases,16.4 ％) and osteoarthritis(18 cases,16.4％).No correlation was found between the risk of dementia and chronic diseases(P＞0.05).Conclusions Cognitive function is highly correlated with activities of daily living,mental state and nutritional status among long-lived elderly people in Zhongxiang City.The risk of dementia has a correlation with the APOE gene e4/e3 genotype but not with chronic diseases in long-lived people.

Objective To investigate the calcium dobesilate tablets combined with mecobalamin injection in treatment of diabetic peripheral neuropathy and effects on oxidative stress and neurotrophic factor.Methods 82 cases of diabetic peripheral neuropathy(DPN) patients from February 2015 to October 2016 in our hospital were selected and randomly divided into observation group and control group with 41 cases in each group.The control group was treated with mecobalamin injection, the observation group were treated with calcium dobesilate tablets.The course of treatment was two weeks in two groups.Results The total efficiency of the observation group (90.24%) was higher than the control group (68.29%) , the difference was statistically significant ( P<0.05 ) , patients in the observation group after the treatment of common peroneal nerve and median nerve SCV and MCV higher than the control group, the difference was statistically significant (P <0.05), the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control group and the level of superoxide dismutase ( SOD) in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05), the levels of serum NGF and BDNF in the observation group were higher than those in the control group, the difference was statistically significant (P<0.05), the two groups were no obvious adverse reactions.Conclusion Calcium dobesilate tablets and mecobalamin injection curative effect in the treatment of diabetic peripheral neuropathy , and patients could improve oxidative stress and neurotrophic factors, and the safety is good, has the important research significance.

Objective To evaluate the safety and drug adherence of tocilizumab(TCZ)in patients with moderate to severe rheumatoid arthritis(RA)in routine clinical practice. Methods This 24 week single center observational study recruited patients with moderate to severe RA. Therapy adherence rate was calculated by actual dosing/expected dosing×100%. Efficacy end points included physician global assessment of disease activity(PGA),patient global assessment of disease activity(PtGA),28-joint disease activity score(DAS28)and so on. Safety was evaluated by recorded adverse events (AEs). Results Sixty patients were enrolled with a mean (SD) treatment adherence of (67±27)%. PGA, PtGA, pain assessment (VAS), TJC and SJC all decreased during this study. At the 12th week, 25%(6/24) and 29%(7/24) of the patients achieved DAS28 remission and EULAR good response,respectively.Eighteen AEs were recorded,of which only 2 were severe AEs(SAEs)and neither was related to TCZ. Conclusion TCZ is a highly safe treatment for decreasing disease activity in patients with moderate to severe RA in China.However,drug adherence still need to be improved.

Objective Ultrasonongraphy and mammography were employed to estimate the pathological response of patients with breast cancer ,who had been accepted neoadjuvant chemotherapy .According to the pres-ent study ,we can provide additional evidence on therapeutic effect on evaluation of neoadjuvant chemotherapy and better selection of regime for breast cancer .Methods One hundred Thirty-six patients who were previously dia-gosed diagnosed with primary breast cancer were included in this study .All subjects were female with clearly pathological detection and accepted neoadjuvant chemotherapy about 4 to 6 cycles regardless of regime .The resid-ual tumor size was evaluated by mammography and /or ultrasonography before operation .Tumor size measured by image were compared with pathological size to predicting the accuracy of two types of imaging .Results Forty one of 116 records were undetectable imaging by mammogram and 19 of 106 records were undetectable by ultrasound which were considered a pathologic complete response .Sixty one(62.24%)of 98 patients who were accepted de-tection of mammogram and ultrasound would be predicted the tumor size by mammogram .Eighty three(84.69%) of 98 patients would be predicted the residual tumor by ultrasound .31 and 59 were accurately evaluated by mam-mogram and ultrasound , respectively .The result indicated that ultrasound was more accurate than mammogram (60.20%vs.31.63%,χ2 =16.11,P<0.001).The correctly rate was 92.85%(91/98)for ultrasound and 68. 37%(67/98) for mammogram.The diagnosis efficiency of ultrasound was more higher than mammogram ,even though there was no different significance between the two methods (χ2 =2.028,P=0.164).Conclusion Ultra-sonongraphy in estimating the residual tumor size after neoadjuvant chemotherapy of patients with breast cancer displays more accurately than mammography .

OBJECTIVE To explore the curative effect of budesonide on acute epiglottitis. METHODS Seventy-eight patients with acute epiglottitis were devided into 2 groups randomly. Budesonide and dexamethasone were breathed in respectively with other treatments being the same. The results were processed statistically. RESULTS The effective and apparent effective rate were 98 % and 95 % in the experimental group,81 % and 72 % in control group. The effective rate was significantly different between the 2 groups,the apparent effective rate was very significantly different between the 2 groups. CONCLUSION The budesonide is more powerful than dexamethasone in the treatment of acute epiglottitis. It can decrease the epiglottis edema more quickly and reduce the opportunity of tracheotomy.

Ovbective To evaluate whether the deleterious effect of cardiopulmonary bypass (CPB) mediated by oxygen free radicals could be prevented by controlling PaO 2 in cyanotic children. Methods Cyanotic pediatric patients undergoing cardiac surgery (n=38) were randomly allocated into 2 groups. The groups matched in respect to sex,age,body surface area and preoperative ventricular function. Group H (n=18) had CPB initiated at a FiO 2 of 0.8,group L (n=18) had CPB initiated at a FiO 2 of 0.4. SOD and MDA were determined in arterial blood sample before CPB,30 minutes after initiation of CPB and 30 minutes post CPB. Various pulmonary parameters were determined 10 minutes after intubation,30 minutes after CPB,the 2nd hours and the 6th hours in the intensive care units. Results At the 6th hours in ICU,the mean postoperative increase in peak airway pressure and P(A-a)O 2/PaO 2 in group H was significant higher than that in group L(P