Objective To investigate the correlation between serum homocysteine(Hcy),hemoglobin(HGB)and hematocrit(HCT)levels and the severity of condition and inflammatory factor levels in patients with chronic atrophic gastritis.Methods A total of 122 patients with chronic atrophic gastritis admitted to a hospital from January 2022 to December 2023 were selected as the disease group,and the disease group was di-vided into mild group(n=63)and severe group(n=59)according to pathological grades,and 106 healthy volunteers who underwent physical examination in a hospital during the same period were selected as the con-trol group.Clinical data of patients were collected and binary Logistic regression analysis was performed to an-alyze the factors affecting the severity of patients'condition,and Pearson correlation analysis was used to ana-lyze the correlation between Hcy,HGB,HCT and the levels of inflammatory factors.Receiver operating char-acteristic(ROC)curve was drawn to analyze the diagnostic value of Hcy,HGB and HCT on the severity of patients'condition.Results Compared with the control group,the serum Hcy level in the diseased group was increased,the serum HGB and HCT levels were decreased,the difference was statistically significant(P<0.05).Compared with the mild group,the serum Hcy level in the severe group was increased,the HGB and HCT levels were decreased,and the difference was statistically significant(P<0.05).Compared with mild group,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin(IL)-6 in se-vere group were increased,and the levels of IL-10 were decreased,with statistical significance(P<0.05).Bi-nary Logistic regression analysis showed that Hcy and CRP were the risk factors affecting the severity of pa-tients'condition(P<0.05),and HCT,HGB and IL-10 were the protective factors affecting the severity of pa-tients'condition(P<0.05).Hcy was positively correlated with CRP,TNF-α and IL-6,and negatively correla-ted with IL-10(P<0.05).HGB and HCT were negatively correlated with CRP,TNF-α and IL-6,and posi-tively correlated with IL-10(P<0.05).ROC curve analysis showed that the area under the curve of serum Hcy,HGB,HCT and the combined diagnosis of the severity of patients'condition were 0.834,0.814,0.822 and 0.923,respectively,and the combined diagnosis value of the three was significantly better than that of Hcy(Z=2.519,P=0.012),HGB(Z=2.660,P=0.008)and HCT(Z=2.596,P=0.009)alone.Conclusion The increase of serum Hcy and the decrease of serum HGB and HCT in patients with chronic atrophic gastritis are correlated with the severity of the patient's condition and the level of inflammatory factors.The combined de-tection of the three can be used for the diagnosis of the severity of chronic atrophic gastritis.

Objective:To investigate the efficacy of a domestically developed small esophageal cooling device in implementing targeted temperature management (TTM) after resuscitation and its impact on organ injury using a porcine model of cardiac arrest and resuscitation.Methods:Thirty healthy male domestic white pigs were randomly divided into four groups using a random number table: sham (S group, n=6), normothermia (NT group, n=8), surface cooling (SC group, n=8), and esophageal cooling (EC group, n=8). The S group underwent only surgical preparation, while the other groups were subjected to 12 minutes of ventricular fibrillation followed by 6 minutes of cardiopulmonary resuscitation to establish cardiac arrest. The S and NT groups maintained a core temperature of (37.5±0.5)°C using a surface blanket. In the SC and EC groups, therapeutic hypothermia was induced post-resuscitation via surface blanket or esophageal cooling catheter to achieve a target temperature of 34°C, maintained the target temperature (34±0.5)°C for 6 hours, followed by controlled rewarming at 0.5°C/h to 37°C. Core temperature was continuously monitored for 12 hours post-resuscitation. Hemodynamic parameters, including stroke volume (SV), global ejection fraction (GEF), extravascular lung water index (ELWI), and pulmonary vascular permeability index (PVPI), were assessed using pulse indicator continuous cardiac output (PiCCO) monitoring. Serum levels of cardiac troponin I (cTnI), neuron-specific enolase (NSE), creatinine (Cr), and intestinal fatty acid-binding protein (IFABP) were measured via ELISA at 2, 6, 12, and 24 hours post-resuscitation. Neurological outcomes were evaluated at 24 hours using the neurological deficit score (NDS) and cerebral performance category (CPC). Continuous variables were analyzed using one-way ANOVA. Results:During TTM, the EC group exhibited a faster cooling rate [(1.52±0.18)°C/h vs. (0.94±0.32)°C/h, P<0.05] and shorter time to target temperature [(2.32±0.43) h vs. (3.78±0.82) h, P<0.05] compared to the SC group, with comparable maintenance and rewarming ( P>0.05). Compared to the S group, the NT, SC, and EC groups demonstrated significant post-resuscitation multi-organ injury, characterized by reduced SV and GEF, elevated ELWI and PVPI, and increased serum cTnI, NSE, Cr, IFABP, NDS, and CPC scores (all P<0.05). Relative to the NT group, the SC and EC groups showed improved SV (at 1 h post-resuscitation), GEF (at 1, 2, 4, and 6 h), ELWI (at 12 h), and reduced cTnI and NSE (at 6 h), Cr and IFABP (at 2 h), and NDS and CPC (at 24 h) (all P<0.05). Compared to the SC group, the EC group exhibited lower PVPI (at 12 h), reduced cTnI, Cr, and IFABP (at 2 h), decreased NSE (at 2, 12, and 24 h), and improved NDS (at 24 h) (all P<0.05). Conclusions:In a porcine model of cardiac arrest and resuscitation, the domestic esophageal cooling device facilitated rapid induction, stable maintenance, and controlled rewarming during TTM, outperforming traditional surface cooling. This approach demonstrated superior organ protection, warranting further investigation.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective:To investigate the effect of citric acid-induced cough on swallowing function and serum substance P in stroke patients with early tracheotomy.Methods:Forty-nine post-stroke tracheotomy patients admitted to the Department of Neurosurgery at the First Affiliated Hospital of Soochow University from January 2018 to July 2019 were selected as study subjects. They were divided into intervention group ( n=24) and control group ( n=25) using the random digit table. The control group was subjected to routine nursing, while the intervention group was given citric acid to induce cough based on routine care. The intervention time was 1 week. The swallowing function and serum substance P levels were compared between the two groups before and after the intervention. Results:After the intervention, 45.8% (11/24) of the patients in the intervention group were assessed as having "strong" swallowing function, compared to 28.0% (7/25) in the control group, with a statistically significant difference in swallowing function between the two groups ( Z= -2.22, P<0.05), and the level of substance P in the intervention group was (283.40 ± 134.82) ng/L, significantly higher than that of the control group (203.59 ± 126.16) ng/L ( t=2.14, P<0.05). Conclusions:Citric acid-induced cough helped stroke patients with early tracheotomy to produce effective swallowing action and up-regulate substance P in serum to promote recovery of swallowing function.

Objective:To investigate the clinical efficacy of low-energy laser in the treatment of erosive oral lichen planus (OLP) and its effect on patients' pain.Methods:Eighty-six patients with erosive OLP who were treated in Shanxian Central Hospital from February 2018 to January 2020 were included in this study. They were randomly divided into control and observation groups ( n = 43/group). The control group was treated by local injection of dexamethasone, and the observation group was treated with semiconductor low-energy laser irradiation. All patients were treated for 8 weeks. Pain scores and physical sign score before and after treatment were evaluated in each group. Therapeutic effects were compared between the two groups. Area of lesion was measured in each group. Recurrence of erosive OLP was calculated at 3 and 6 months after surgery. Results:Before treatment, there were no significant differences in visual analogue scale (VAS) score and physical sign score between the two groups (both P > 0.05). At 7, 14, 28 and 56 days after treatment, VAS score and physical sign score were significantly decreased in each group compared with those before treatment, and VAS score and physical sign score in the observation group were significantly lower than those in the control group (all P < 0.05). Total response rate in the observation group was significantly higher than that in the control group [93.02% (40/43) vs. 83.72% (36/43), χ2 = 1.81, P > 0.05). Before and 1 month after treatment, there was no significant difference in area of lesion between control and observation groups (both P > 0.05). At 3 and 6 months after surgery, area of lesion in the observation group was (0.31 ± 0.14) cm 2 and (0.32 ± 0.12) cm 2, respectively, which were significantly smaller than those in the control group [(0.42 ± 0.18) cm 2, (0.48 ± 0.19) cm 2, t = 3.16, 4.67, both P < 0.05). At 3 and 6 months after treatment, recurrence of erosive OLP in the observation group was 2.33% (1/43) and 13.95% (6/43), respectively, which were significantly lower than those in the control group [13.95% (6/43), 37.21% (16/43), χ2 = 3.89, 6.11, both P < 0.05]. Conclusion:There is no significant difference in the short-term efficacy of low-energy laser versus conventional corticosteroids in the treatment of erosive OLP. However, low-energy laser has a more obvious short-term pain relief effect than conventional corticosteroids. It can accelerate the healing of injured tissue and decrease the recurrence rate of erosive OLP.

Objective:To explore the effect of health education model based on intelligent medical in patients who undergoing surgery with lumbar degenerative changes.Methods:A total of 80 patients with lumbar degenerative changes, who met the inclusion criteria, in the Orthopedics Department of Zhuhai People's Hospital from January 2019 to December 2020 were recruited as the research subjects by convenient sampling method. According to the order of admission, they were divided into control group and intervention group, with 40 cases in each group. The control group was given routine health education. A health education model relying on intelligence medical treatment was constructed and implemented in the intervention group, by making full use of their respective functional modules with the help of three intelligent medical tools: intelligent pad in the nurse station, electronic display screen and hand-held electronic devices. The pain, lumbar function, functional exercise compliance, satisfaction, anxiety and sleep quality and constipation of the two groups were compared by Visual Analog Score (VAS) , Japanese Orthopaedic Association (JOA) score, functional exercise compliance evaluation form for patients undergoing surgery for lumbar degenerative diseases, patient satisfaction questionnaire, Hamilton Anxiety Scale (HAMA) and Pittsburgh Sleep Quality Index (PSQI) .Results:The pain score and lumbar function score on the 7th day after surgery in the intervention group were (2.57±0.73) and (15.00±1.89) respectively, and those scores in the control group were (3.10±0.61) and (12.80±1.75) respectively. The differences were statistically significant ( P<0.05) . The compliance of functional exercise in the intervention group was better than that in the control group, and the satisfaction was higher than that in the control group, with statistical significance ( P<0.05) . The postoperative anxiety of patients in the intervention group was lighter than that in the control group, and the sleep quality and defecation were better than those in the control group, with statistical significance ( P<0.05) . Conclusions:Health education based on intelligent medical treatment can reduce the pain in patients who undergoing surgery with lumbar degenerative changes, at the same time improve the compliance of exercise and satisfaction, reduce anxiety, sleep disorder and constipation, which is worthy of clinical application.

Objective:To investigate the clinical significance of the serum platelet-derived growth factor BB (PDGF-BB) level in the diagnosis and treatment monitoring of non-small cell lung cancer (NSCLC) patients.Methods:Serum samples of 111 NSCLC patients in Xuzhou Cancer Hospital of Jiangsu Province and 105 healthy controls from Outpatients Department of Nanjing Yian Medical Examination Center between October 2014 and December 2017 were collected. Luminex assay was used to determine PDGF-BB level in serum samples of NSCLC patients and the healthy controls as well as patients after platinum chemotherapy. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of serum PDGF-BB level in patients with NSCLC, and the relationship of serum PDGF-BB level with clinicopathological features of NSCLC patients and platinum chemotherapy and effect was analyzed.Results:Compared to the healthy controls, serum PDGF-BB level was decreased in NSCLC patients [(54±24) ng/ml vs. (125±61) ng/ml, t = 11.09, P < 0.01], and the area under the ROC of serum PDGF-BB level on the diagnosis of NSCLC was 0.890. There were no significant differences in serum PDGF-BB level among NSCLC patients with different gender, age or lymph node metastasis (all P > 0.05); the serum PDGF-BB level in patients with high TNM stage was lower than that in patients with low TNM stage, and the serum PDGF-BB level in patients with low differentiation degree was lower than that in patients with high differentiation degree (all P < 0.05). Serum PDGF-BB level was continued to decrease in NSCLC patients after treatment with platinum-based chemotherapy. Conclusion:Serum PDGF-BB level of NSCLC patients is decreased, and it has a certain clinical significance in the early diagnosis of NSCLC.

Objective: To evaluate the efficacy and safety of apatinib combined with chemotherapy in the first-line treatment of advanced non-small cell lung cancer (NSCLC) with negative driving genes. Methods: From January 2016 to March 2018, 62 advanced NSCLC patients with negative driving genes diagnosed at Xuzhou Cancer Hospital were randomly divided into study group (30 cases) and control group (32 cases), respectively. The patients in the study group were treated with standard first-line chemotherapy combined with apatinib, while those in control group were treated with chemotherapy alone. Results: The disease control rate (DCR) and objective remission rate (ORR) in the study group were 60.0% and 16.7%, respectively, higher than 46.9% and 9.3% in the control group, but without statistical difference (P>0.05). The median progression-free survival (PFS) of study group and control group were 6.4 months and 4.9 months, respectively (P=0.004), and the median overall survival (OS) were 11.3 months and 9.2 months, respectively (P=0.006). Multivariate survival analysis indicated that treatment regimen (P=0.001) was the independent prognostic factor of PFS, and PS score (P=0.002), clinical stage (P=0.02) and treatment regimen (P<0.001) were the independent prognostic factors of OS. After treatment, the incidence of hypertension and hand-foot syndrome in the study group were 46.7% and 53.3%, respectively, significantly higher than 3.3% and 0 in the control group, respectively (P<0.05). The incidence of grade 3-4 adverse drug reactions (ADRs) in the study group was 26.7% (8/30), mainly including hypertension, hand-foot syndrome and bone marrow suppression. The incidence of grade 3-4 ADRs in the control group was 15.6% (5/32), all of which were bone marrow suppression, without significant difference (P=0.286). There was no difference in serum levels of VEGF and CEA between the two groups before treatment. After treatment, the serum level of VEGF in the study group was (169.3±10.1) pg/ml, lower than (211.8±16.7) pg/ml of the control group (P<0.05). Conclusion Apatinib combined with first-line chemotherapy for advanced NSCLC patients with negative driving genes is safe and beneficial for survival. This therapeutic strategy can significantly prolong the PFS and OS, and further improvement and application can be considered as a choice in the clinical treatment.

Objective To investigate the diagnosis and treatment status of neonatal respiratory dis-tress syndrome (NRDS) in Inner Mongolia and explore the problems and countermeasures for NRDS diagno-sis and treatment. Methods Data of infants with NRDS in 4 hospitals(3 hospitals were in the west,which were the Affiliated Hospital of Inner Mongolia Medical University,Baotou Steel Three Hospital and Ordos Central Hospital,1 hospital was in the east,which was the Affiliated Hospital of Chifeng Institute) participat-ing in the study during the period from 1th January,2016 to 30th June,2018 were investigated retrospectively with descriptive epidemiological survey,including basic situation,perinatal period, clinical manifestations, treatment,complications and prognosis. Results Among 11406 newborns admitted in 4 hospitals during the study period,748 infants were diagnosed with NRDS,accounting for 6. 56％ . In the eastern region,279 infants were diagnosed with NRDS,the rate was 9. 30％ ,and in the western region were 469(5. 58％ ). The average hospitalization time in the eastern region was longer than that in the western region,and the age of motherswas higher than that in the western region. There were significant differences between the two groups(P <0. 05). The antenatal hormone use,cesarean delivery,multiple gestation,low Apgar score,premature rupture of membrane in the western region were higher than those in the eastern region(P < 0. 05). The proportion of NRDS grade Ⅰ and gradeⅢ,pulmonary surfactant(PS) utilization ratio and INSURE technology usage in the eastern region were higher than those in the western region. The ratio of NRDS(grade Ⅱ) and the first dose of PS in the western region were higher than those in the eastern region(P < 0. 05). The total mortality of neonates with NRDS was 6. 15％ (46 / 748). The incidence rates of patent ductus arteriosus,bronchopulmo-nary dysplasia,necrotizing enterocolitis,ventilator-associated pneumonia in the western region were higher than those in the eastern region(P < 0. 05). Conclusion The level of diagnosis and treatment of NRDS in four hospitals in two districts of Inner Mongolia varies widely. But overall compared with other areas,the treatment of NRDS in Inner Mongolia has the problems of low antenatal hormone use,insufficient use of PS and INSURE technology,and late use of PS. The treatment of NRDS should continue to standardize antenatal hormone use,early and sufficient use of PS,the promotion of the use of INSURE technology.

Objective To evaluate the efficacy and safety of apatinib combined with chemotherapy in the first?line treatment of advanced non?small cell lung cancer ( NSCLC) with negative driving genes. Methods From January 2016 to March 2018, 62 advanced NSCLC patients with negative driving genes diagnosed at Xuzhou Cancer Hospital were randomly divided into study group (30 cases) and control group (32 cases), respectively. The patients in the study group were treated with standard first?line chemotherapy combined with apatinib, while those in control group were treated with chemotherapy alone. Results The disease control rate (DCR) and objective remission rate (ORR) in the study group were 60.0% and 16.7%, respectively, higher than 46.9% and 9.3% in the control group, but without statistical difference (P＞0.05). The median progression?free survival ( PFS) of study group and control group were 6.4 months and 4.9 months, respectively (P＝0.004), and the median overall survival (OS) were 11.3 months and 9.2 months, respectively (P＝0.006).Multivariate survival analysis indicated that treatment regimen (P＝0.001) was the independent prognostic factor of PFS,and PS score (P＝0.002), clinical stage ( P＝0.02) and treatment regimen ( P＜0.001) were the independent prognostic factors of OS. After treatment, the incidence of hypertension and hand?foot syndrome in the study group were 46.7% and 53.3%, respectively, significantly higher than 3.3% and 0 in the control group, respectively ( P＜0.05). The incidence of grade 3?4 adverse drug reactions (ADRs) in the study group was 26.7%(8／30), mainly including hypertension, hand?foot syndrome and bone marrow suppression. The incidence of grade 3?4 ADRs in the control group was 15.6%(5／32), all of which were bone marrow suppression, without significant difference (P＝0.286). There was no difference in serum levels of VEGF and CEA between the two groups before treatment. After treatment, the serum level of VEGF in the study group was (169.3±10.1) pg／ml, lower than (211.8±16.7) pg／ml of the control group ( P＜0.05). Conclusion Apatinib combined with first?line chemotherapy for advanced NSCLC patients with negative driving genes is safe and beneficial for survival. This therapeutic strategy can significantly prolong the PFS and OS, and further improvement and application can be considered as a choice in the clinical treatment.