Objective To investigate the relationship between serum amyloid A(SAA),interleukin-10(IL-10),interleukin-21(IL-21)levels and the first acute exacerbation in patients with chronic obstructive pulmo-nary disease(COPD)with pneumothorax.Methods A total of 102 patients with stable COPD complicated with pneumothorax admitted to the hospital from January 2020 to January 2023 were selected.They were treated with closed thoracic drainage,anti-inflammatory,antiasthmatic,expectorant,and high-flow nasal hu-midification oxygen therapy(HFNC).The patients were divided into two groups according to whether they had the first acute exacerbation within 1 year after treatment,the first acute exacerbation group(32 patients had the first acute exacerbation within 1 year of follow-up)and the non-first acute exacerbation group(70 pa-tients had no first acute exacerbation within 1 year of follow-up).Serum SAA,IL-10 and IL-21 levels and blood gas indexes were compared between the two groups after treatment.Multivariate Logistic regression a-nalysis was used to analyze the influencing factors of the first acute exacerbation after HFNC treatment.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum SAA,IL-10 and IL-21 levels after treatment for the first acute exacerbation of COPD patients with pneumothorax.Results There were significant differences in hypoproteinemia,smoking,underlying diseases,forced vital ca-pacity(FVC),forced expiratory volume in one second(FEV1)as a percentage of predicted value(FEV1%),FEV1 to FVC ratio(FEV1/FVC),arterial partial pressure of oxygen(PaO2),arterial partial pressure of car-bon dioxide(PaCO2),SAA,IL-10,IL-21 between the two groups(P<0.05).Multivariate Logistic regression analysis showed that hypoproteinemia,smoking,underlying diseases,PaCO2,SAA,IL-10 and IL-21 were the risk factors for the first acute exacerbation after HFNC treatment(P<0.05).FVC,FEV1%,FEV1/FVC and PaO2 were protective factors for the first acute exacerbation after treatment(P<0.05).ROC curve results showed that the area under the curve(AUC)of SAA,IL-10 and IL-21 levels after treatment to predict the first acute exacerbation of COPD patients with pneumothorax was 0.755,0.726 and 0.674,respectively.When the cut-off values of SAA,IL-10 and IL-21 were 171.06 g/L,26.46 pg/mL and 244.79 pg/mL,the sen-sitivity was 76.51%,60.84%and 56.90%,and the specificity was 66.73%,74.49%and 74.52%,respective-ly.The AUC of combined prediction was 0.860,the sensitivity was 80.44%,and the specificity was 76.51%.Conclusion The serum SAA,IL-10 and IL-21 levels in COPD patients with pneumothorax have certain pre-dictive value for the first acute exacerbation of COPD patients with pneumothorax.

Objective To investigate the influence of platelet-albumin-bilirubin(PALBI)score on the textbook outcome(TO)of patients with hepatocellular carcinoma(HCC)after hepatectomy,as well as the association of different PALBI scores before surgery with the achievement of TO after hepatectomy in HCC patients.Methods A retrospective analysis was performed for the data of HCC patients who underwent hepatectomy in West China Hospital of Sichuan University and Ziyang Central Hospital from January 2013 to January 2022.TO was defined as no serious complication within 30 days after surgery,no death within 90 days,no rehospitalization within 30 days after discharge,no blood transfusion in the perioperative period,RO resection,and no prolongation of hospital stay.The chi-square test was used for comparison of categorical data between two groups.The univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for the achievement of TO after hepatectomy in HCC patients.The Kaplan-Meier method was used to plot the survival curves of HCC patients,and the Log-rank test was used for comparison.Results A total of 3 599 patients were included in this study,among whom 2 369(65.8%)achieved TO.The multivariate Logistic regression analysis showed that PALBI grade(PALBI grade 2:odds ratio[OR]=1.562,95%confidence interval[CI]:1.308-1.864,P<0.001;PALBI grade 3:OR=2.216,95%CI:1.463-3.359,P<0.001)was an independent risk factor for achievement of TO after surgery in HCC patients.The proportion of patients achieving TO decreased with the increase in PALBI grade.Among the patients with PALBI grade 1,2 or 3,the patients achieving TO accounted for 70.2%,54.2%,and 38.4%,respectively(χ2=106.295,P<0.001).The incidence rate of serious complications within 30 days,the mortality rate of patients within 90 days after hepatectomy,readmission rate within 30 days after discharge,perioperative blood transfusion rate,and the rate of prolonged hospital stay all increased with the increase in PALBI grade(all P<0.05).For the patients achieving TO,the 1-,3-,and 5-year relapse-free survival rates were 79.5%,60.6%,and 51.5%,respectively,and the overall survival rates were 92.1%,80.0%,and 71.1%,respectively;for those who did not achieve TO,the 1-,3-,and 5-year relapse-free survival rates were 68.5%,52.7%,and 46.2%,respectively,and the overall survival rates were 83.3%,66.0%,and 57.1%,respectively.The patients who achieved TO had significantly better relapse-free survival rate and overall survival rate than those who did not achieve TO(χ2=18.936 and 79.371,both P<0.001).Conclusion Preoperative PALBI grade can affect the achievement of TO after hepatectomy in HCC patients,and it is more difficult for patients with a higher PALBI grade to achieve TO.Preoperative PALBI score can be used to early identify the patients with a high risk of postoperative complications,provide early intervention,and enhance perioperative management,thereby improving the perioperative safety and long-term prognosis of HCC patients after hepatectomy.

ObjectiveTo investigate the influence of platelet-albumin-bilirubin （PALBI） score on the textbook outcome （TO） of patients with hepatocellular carcinoma （HCC） after hepatectomy， as well as the association of different PALBI scores before surgery with the achievement of TO after hepatectomy in HCC patients. MethodsA retrospective analysis was performed for the data of HCC patients who underwent hepatectomy in West China Hospital of Sichuan University and Ziyang Central Hospital from January 2013 to January 2022. TO was defined as no serious complication within 30 days after surgery， no death within 90 days， no rehospitalization within 30 days after discharge， no blood transfusion in the perioperative period， RO resection， and no prolongation of hospital stay. The chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for the achievement of TO after hepatectomy in HCC patients. The Kaplan-Meier method was used to plot the survival curves of HCC patients， and the Log-rank test was used for comparison. ResultsA total of 3 599 patients were included in this study， among whom 2 369 （65.8%） achieved TO. The multivariate Logistic regression analysis showed that PALBI grade （PALBI grade 2： odds ratio ［OR］=1.562， 95% confidence interval ［CI］： 1.308‍ ‍—‍ ‍1.864， P<0.001； PALBI grade 3： OR=2.216， 95%CI： 1.463‍ ‍—‍ ‍3.359， P<0.001） was an independent risk factor for achievement of TO after surgery in HCC patients. The proportion of patients achieving TO decreased with the increase in PALBI grade. Among the patients with PALBI grade 1， 2 or 3， the patients achieving TO accounted for 70.2%， 54.2%， and 38.4%， respectively （χ²=106.295， P<0.001）. The incidence rate of serious complications within 30 days， the mortality rate of patients within 90 days after hepatectomy， readmission rate within 30 days after discharge， perioperative blood transfusion rate， and the rate of prolonged hospital stay all increased with the increase in PALBI grade （all P<0.05）. For the patients achieving TO， the 1-， 3-， and 5-year relapse-free survival rates were 79.5%， 60.6%， and 51.5%， respectively， and the overall survival rates were 92.1%， 80.0%， and 71.1%， respectively； for those who did not achieve TO， the 1-， 3-， and 5-year relapse-free survival rates were 68.5%， 52.7%， and 46.2%， respectively， and the overall survival rates were 83.3%， 66.0%， and 57.1%， respectively. The patients who achieved TO had significantly better relapse-free survival rate and overall survival rate than those who did not achieve TO （χ²=18.936 and 79.371， both P<0.001）. ConclusionPreoperative PALBI grade can affect the achievement of TO after hepatectomy in HCC patients， and it is more difficult for patients with a higher PALBI grade to achieve TO. Preoperative PALBI score can be used to early identify the patients with a high risk of postoperative complications， provide early intervention， and enhance perioperative management， thereby improving the perioperative safety and long-term prognosis of HCC patients after hepatectomy.

ObjectiveTo observe the clinical efficacy of Gandou Fumu Granules （GDFMG） combined with sodium dimercaptosulphonate （DMPS） on liver fibrosis in Wilson disease （WD） patients with the syndrome of phlegm and blood stasis， evaluate its effect on cuproptosis-related indicators， and explore the possible mechanisms of cuproptosis in WD-related liver fibrosis. MethodsSixty WD patients diagnosed with the syndrome of phlegm and blood stasis between January 2023 and December 2023 were randomly divided into a control group and an observation group， with 30 patients in each group. The control group received the copper chelator DMPS for the first 6 days， followed by calcium gluconate injection for the next 2 days， completing an 8-day treatment cycle. The observation group received GDFMG in addition to the treatment regimen of the control group， with both groups treated for 21 cycles. A Beckman fully automated biochemical analyzer was used to detect levels of type Ⅳ collagen （CⅣ）， hyaluronic acid （HA）， laminin （LN）， N-terminal propeptide of type Ⅲ procollagen （PⅢ-NP）， and serum copper （SCu） before and after treatment in both groups. Enzyme-linked immunosorbent assay （ELISA） was used to measure levels of ferredoxin 1 （FDX1）， lipoic acid synthetase （LIAS）， and dihydrolipoamide S-acetyltransferase （DLAT）. Atomic absorption spectroscopy measured 24-hour urine copper levels before treatment and after the 7， 14， and 21 treatment cycles in both groups. An Fibro Touch （FT） non-invasive liver fibrosis diagnostic device was used to measure liver stiffness （LSM） in both groups before and after treatment. Traditional Chinese medicine syndrome score （TCMSS） was evaluated at the same intervals. Clinical efficacy， adverse events， and safety indicators were also compared. ResultsAfter treatment， levels of CⅣ， HA， LN， and PⅢNP significantly decreased in both groups compared to pre-treatment levels （P<0.01）. The observation group showed a more pronounced reduction compared to the control group （P<0.05）. There were no statistically significant differences in SCu levels in both groups before and after treatment. After treatment， levels of FDX1，LIAS and DLAT significantly increased in both groups（P<0.01）. The observation group showed more notable improvements in these indicators than the control group （P<0.05）. After the 7， 14， 21 treatment cycles， 24-hour urine copper levels significantly increased in both groups compared to pre-treatment levels （P<0.01）. The observation group had a greater increase in 24-hour urine copper levels than the control group after treatment （P<0.05，P<0.01）， and although 24-hour urine copper levels increased after 7 cycles， a gradual decline was observed in subsequent cycles. After treatment， LSM levels significantly decreased in both groups compared to pre-treatment levels （P<0.01）， with the observation group showing a greater reduction than the control group （P<0.05）. Clinical efficacy was significantly better in the observation group than the control group （P<0.05）. No significant differences in the incidence of adverse events or safety indicators were observed between the two groups after treatment. ConclusionGDFMG combined with DMPS can reduce LSM in WD patients with liver fibrosis and the syndrome of phlegm and blood stasis， inhibit cuproptosis， and improve clinical efficacy.

Objective To explore the effects of behavior change intervention based on the multi-ple-theory model on patients with dyslipidemic ischemic stroke.Methods A total of 93 patients with dyslipidemic ischemic stroke who were hospitalized in the vascular neurology ward of Beijing Tiantan Hospital,Capital Medical University from January to August 2024 were selected as the study subjects using the convenience sampling method.They were randomly divided into control group(n=49)and intervention group(n=44)using the envelope-drawing method.Patients in the control group re-ceived routine stroke health education,while those in the intervention group underwent a 3-month be-havior change program guided by the multiple-theory model.The levels of healthy behaviors,body mass index(BMI),total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL-C),and low-density lipoprotein(LDL-C)were compared between the two groups.Results There were no statistically significant differences in general information and disease-related data between the two groups(P＞0.05).At 1-,3-,and 6-month after the intervention,the level of healthy behaviors in the intervention group was higher than that in the control group,with statistically significant differ-ences(P＜0.05).There was a statistically significant difference in BMI between the two groups at 6 months after the intervention(P＜0.05).The TC levels in the intervention group at 3 and 6 months after the intervention were lower than those in the control group,with statistically significant differences(P＜0.05).The HDL-C level in the intervention group at 6 months after the intervention was high-er than that in the control group,with a statistically significant difference(P＜0.05).The LDL-C levels in the intervention group at 1-,3-,and 6-month after the intervention were lower than those in the control group,with statistically significant differences(P＜0.05).There were no statistically significant differences in TG levels between the intervention group and the control group at different time points after the intervention(P＞0.05).Conclusion The behavior change intervention pro-gram based on the multiple-theory model can effectively improve and maintain healthy behaviors and improve blood lipid levels in patients with dyslipidemic ischemic stroke.

OBJECTIVE To investigate the role and mechanism of paeonol in inhibiting the migration of bladder cancer T24 cells by regulating nuclear factor κB(NF-κB)/hypoxia-inducible factor-1α(HIF-1α)-mediated aerobic glycolysis.METHODS T24 cells were divided into control group,cisplatin group(positive control,3.001 μg/mL),and paeonol low-,medium-and high-dose groups(100,200,400 μg/mL),respectively.After 24 h of administration intervention,the effect of paeonol on the migration ability of T24 cells was detected(expressed by the cell scratch wound healing rate).The effect of paeonol on the mitochondrial membrane potential of T24 cells was detected(expressed by the ratio of red/green fluorescence intensity).Cellular adenosine triphosphate(ATP)levels and lactate content in T24 cells were measured.The levels of NF-κB/HIF-1α signaling pathway,the expression of migration-related proteins,and key enzymes involved in aerobic glycolysis in the cells were all determined.RESULTS Compared with the control group,the cell scratch wound healing rates in the paeonol medium-and high-dose groups and the cisplatin group were decreased significantly(P＜0.01);in the paeonol groups,the expression levels of NF-κB/HIF-1α signaling pathway-related proteins such as NF-κB and HIF-1α,migration-related proteins such as matrix metalloproteinase 2(MMP2),MMP9,and vascular endothelial growth factor,as well as key enzymes involved in aerobic glycolysis such as glucose transporter 1,hexokinase 2 and pyruvate kinase isozyme type M2,were all reduced to varying degrees in the cells,most of these reductions showed statistically significant differences(P＜0.05 or P＜0.01);the ratio of red/green fluorescence intensity in mitochondria of cells in the medium-and high-dose paeonol groups were significantly decreased(P＜0.01);the ATP concentration in cells of the paeonol high-dose group,and the lactate content in cells across all paeonol groups were significantly decreased(P＜0.05 or P＜0.01).CONCLUSIONS Paeonol significantly inhibits the migration of bladder cancer T24 cells,and its mechanism of action may be related to the inhibition of the NF-κB/HIF-1α signaling pathway,and the down-regulation of key enzyme activities involved in aerobic glycolysis.

Objective:To systematically evaluate the perioperative risk factors for deep vein thrombosis (DVT) in aged patients with hip fractures.Methods:A comprehensive search was conducted in CNKI, VIP, Wanfang, PubMed, Web of Science, Cochrane Library, and Embase for studies on DVT risk factors in aged patients with hip fractures. The search timeframe was from January 1, 2000, to January 31, 2023.Results:A total of 55 studies were included, comprising 41 case-control studies and 14 cohort studies. Meta-analysis results showed that age, female, body mass index, hypertension, hyperlipidemia, diabetes, pulmonary disease, cerebrovascular disease, smoking history, thrombosis history, combined anesthesia, intraoperative bleeding, intraoperative blood transfusion, hemoglobin, albumin, activated partial thromboplastin time, D-dimer, fibrinogen, intertrochanteric fractures, high-energy injury, prolonged bed rest, time from injury to admission, and time from injury to surgery were risk factors for DVT in aged hip fracture patients ( P<0.05) ; the use of anticoagulants was found to be a protective factor ( P<0.05) . Conclusions:The occurrence of DVT in aged hip fracture patients is influenced by multiple factors. Nursing staff should enhance the assessment and screening for DVT and take measures to minimize its incidence in this patient population.

Objective:To retrieve, evaluate, and integrate evidence related to balance function management in stroke patients with hemiplegia.Methods:A systematic search was conducted on BMJ Best Practice, UpToDate, National Institute for Health and Care Excellence, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Australia Joanna Briggs Institute Evidence-Based Practice Center, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, Web of Science, Medlive, and other websites or data platforms for relevant guidelines, best practices, evidence summaries, systematic reviews, and Meta-analyses on balance function management in stroke patients with hemiplegia, with a retrieval period from March 2014 to March 2024. Two researchers trained in evidence-based practices evaluated the methodological quality of the literature and extracted and summarized the relevant evidence.Results:Based on the inclusion and exclusion criteria, a total of eight guidelines and seven systematic reviews were included, yielding 29 pieces of best evidence across nine aspects: the importance of balance function training, organizational management, assessment tools, assessment timing, assessment content, assessment frequency, balance exercise programs, exercise duration, and health education.Conclusions:This study summarizes the best evidence for balance function management in stroke patients with hemiplegia, providing accurate evidence-based support for clinical practice among medical professionals. It is recommended that healthcare providers appropriately apply this evidence based on clinical scenarios to improve measures related to balance function management in stroke patients with hemiplegia.

Objective To assess the sweat secretion of Yin-deficient ovariectomized rats and investigate the changes in biochemical indexes.Methods Eighteen SD female rats were randomly divided into a sham operation group,model group,and positive control group of six rats each.The rats in the sham operation group underwent a sham operation,and those in the model group and positive control group underwent bilateral ovariectomy.L-Thyroxine(92 mg/kg)was given once a day for 7 consecutive days starting on the 7th postoperative day to establish a Yin-deficient ovariectomized model.The rats in the positive control group were orally administered Qinggu San Tang(7.3 g/kg)once a day,while those in the sham operation group and model group were orally administered an equal amount of distilled water once a day for a total of 14 days.Sweat secretion from the plantar region of the foot was measured using the Wada-Takagaki reagent coloring method.At the end of the experiment,blood was taken from the abdominal aorta and the tissue of the paw pads was separated.The serum levels cyclic adenosine monophosphate(cAMP),cyclic guanosine monophosphate(cGMP),luteinizing hormone(LH),gonadotropin-releasing hormone(GnRH),and estradiol(E2)were measured by enzyme-linked immunosorbent assay.Western Blot was used to determine the expression levels of M3 R,β2 AR,and aquaporin-5(AQP5)in the paw pad.Results The three main findings of this study were as follows.(1)Compared with the rats in the sham operation group,those in the model group were more irritable and aggressive,and their body weights decreased while their average temperature and sweat secretion significantly increased.(2)Serum cAMP level and cAMP/cGMP ratio increased,the LH and GnRH levels significantly increased,and the E2 level decreased.(3)M3 R expression was down-regulated and β2 AR and AQP5 expression was up-regulated in the paw pads of the rats.After 2 weeks of positive control treatment,the serum cAMP level and cAMP/cGMP ratio significantly decreased and the LH and GnRH levels decreased;however,no statistically significant difference was observed in the serum E2 level.The expression levels of M3 R were increased-regulated in paw pads of the rats,and reduced expression of β2 AR and AQP5.Conclusions Sweat secretion significantly increased in this"combined disease and evidence"model of perimenopausal syndrome kidney yin deficiency established by desiccation combined with thyroxine.The underlying mechanism may be related to the changes in cGMP,cAMP,and key proteins M3 R,β2 AR,and AQP5 in sweat glands that regulate sweat secretion.

As an important non-drug treatment for chronic obstructive pulmonary disease(COPD),pulmonary rehabilitation helps to improve dyspnea and negative emotions.This article mainly elaborates on pulmonary rehabilitation contents such as smoking cessation,breathing training,exercise training,traditional Chinese medicine rehabilitation,and psychological rehabilitation,and discusses the application of telemedicine and virtual reality technology in COPD pulmonary rehabilitation.The COVID-19 has a certain impact on the traditional pulmonary rehabilitation model.This article explores the relationship between COVID-19 and COPD and the implementation methods of pulmonary rehabilitation for COPD patients with COVID-19,so as to provide evidence-based basis for the implementation of pulmonary rehabilitation in the context of COVID-19,and provide new ideas and methods for improving the clinical treatment effect of COPD.