OBJECTIVE To observe the clinical efficacy of evolocumab combined with atorvastatin in the treatment of patients with borderline coronary heart disease （CHD）. METHODS In this retrospective cohort study， 342 hospitalized patients diagnosed with borderline CHD were enrolled in the First Affiliated Hospital of Nanyang Medical College from August 2021 to June 2024， and divided into control group （treated with atorvastatin， 190 cases） and trial group （treated with evolocumab combined with atorvastatin， 152 cases） according to therapeutic regimen. Blood lipid indexes， high-sensitivity C-reactive protein （hs-CRP） and intravascular ultrasound of the coronary artery at baseline and after 1 year of treatment， and incidence of cardiovascular adverse events were compared after propensity score matching. RESULTS A total of 295 patients （158 in control group and 137 in trial group） were finally included in the analysis. One year after the treatment， compared with control group， total cholesterol， triglycerides， low-density lipoprotein cholesterol and hs-CRP levels were decreased significantly in trial group （ P ＜0.05）， whereas high-density lipoprotein cholesterol level was increased significantly （ P ＜0.05）. The lumen diameter， lumen area， and the minimum lumen area were significantly increased （ P ＜0.05）， while plaque area and plaque burden were significantly decreased （ P ＜0.05）. Overall incidence of adverse events in trial group was significantly lower than that in control group （ P ＜0.05）. CONCLUSIONS Evolocumab combined with atorvastatin can significantly improve coronary luminal narrowing and reduce plaque burden， as well as reduce the incidence of cardiovascular adverse events in patients with borderline CHD.

Objective To compare the long-term survival outcomes of patients with T_1-2N₀M₀ duodenal neuroendocrine tumor (DNET) after endoscopic resection (ER) or surgical resection (SR). Methods Patients diagnosed with T_1-2N₀M₀ DNET between January 1, 2004, and December 31, 2015, were extracted from the SEER database. Kaplan-Meier survival curve and log-rank test were used to compare overall survival (OS) rate and cancer-specific survival (CSS) rate between patients undergoing ER or SR. Propensity score matching (PSM) was used to reduce grouping differences, and multivariate Cox regression was used to analyze factors affecting OS and CSS before and after PSM. Results A total of 656 patients were included, with 457 in ER group and 199 in SR group. Before PSM, there was no significant difference in the 5-year OS rate between the ER and SR groups (88.9% vs 89.6%), but there was a significant difference in the 5-year CSS rate (99.3% vs 96.9%, P＝0.017). Before PSM, multivariate Cox regression analysis showed advanced age was an independent risk factor for decreased OS (P＜0.001). After PSM, there was no significant difference between the ER group (n＝187) and SR group (n＝187) in 5-year OS rate (90.2% vs 88.9%) or CSS rate (98.9% vs 96.7%). After PSM, multivariate Cox regression also showed advanced age was an independent risk factor for decreased OS, while resection method was not an independent factor for OS or CSS. Conclusions There is no significant difference in OS or CSS after endoscopic treatment and surgical treatments for patients with T_1-2N₀M₀ DNET, and advanced age is an independent factor for OS.

Objective:To investigate the effect of innovative perioperative pain management on prostate cancer patients with he-maturia undergoing prostatic artery embolization(PAE).Methods:A total of 60 patients undergoing PAE in the Interventional Ther-apy Department of General Hospital of Eastern Theater Command from May 2024 to January 2025 were selected by convenience sam-pling method and randomly divided into the intervention group and the control group,with 30 patients in each group.The control group received traditional pain management of nursing.An innovative perioperative pain management was performed in intervention group in-cluding preoperative"body-mind-pain"holistic assessment and preparation,intraoperative humanistic care and real-time support,post-operative multimodal analgesia and rehabilitation,dynamic monitoring and closed-loop feedback.The pain degree after 6 hours,1 day,3 days and 1 week of the operation,and the quality of life after 1 week of operation,as well as nursing satisfaction at discharge were compared between the two groups.Results:The VAS scores of the intervention group were significantly lower than those of the con-trol group after 6 hours,1 day,3 days and 1 week of operation(P＜0.05).One week after the operation,the quality of life in the ob-servation group was higher than that of the control group significantly(P＜0.05).The nursing satisfaction of the observation group was significantly higher than that of the control group at discharge(P＜0.05).Conclusion:The application of innovative perioperative pain management can alleviate pain of patients with PAE,which improves the quality of life and nursing satisfaction of patients,and is conducive to the rehabilitation of patients.

Objective:To explore the effect of Chaibei Zhixian Decoction on intestinal flora and T helper 17/regulatory T cell(Th17/Treg)immune balance in epileptic rats by regulating mammalian target of rapamycin/hypoxia-inducible factor-1α(mTOR/HIF-1α)pathway.Methods:Sixty rats were randomly divided into Sham group,Model group,low-dose Chaibei Zhixian Decoction group(CBZXD-Low)and high-dose Chaibei Zhixian Decoction group(CBZXD-High),with 15 rats in each group.Lateral ventricular injec-tion 1 μl kainic acid(1.5 μg/μl)was used to prepare epileptic rat model,Sham group was injected with an equal amount of physiological saline.CBZXD-Low group and CBZXD-High group were given Chaibei Zhixian Decoction by gavage daily(8.48 g/kg,16.96 g/kg),while Sham group and model group were given an equal amount of physiological saline by gavage.After continuous gavage for 4 weeks,HE staining and Nissl staining were used to detect pathological damage in hippocampal tissue;RT-qPCR was used to detect Th17/Treg related marker mRNA levels in spleen tissue and mTOR,HIF-1α mRNA levels in hippocampus tissue;flow cytometry was used to de-tect Th17/Treg cell ratio in spleen tissue;16S rRNA sequencing of feces in colon segment was performed;Western blot was used to de-tect mTOR and HIF-1α protein levels in hippocampal tissue.Results:Compared with Sham group,Model group rats suffered from spontaneous epilepsy,the arrangement of hippocampal neurons was disordered and severely lacking,intracellular Nissl bodies was de-creased,RORγt,IL-17A mRNA levels in spleen tissue were increased,Foxp3,CTLA-4 and GITR mRNA levels were decreased,the proportion of Th17 cells and Th17/Treg were increased,the proportion of Treg cell was decreased,intestinal flora α/β diversity were decreased,the proportion of harmful bacteria such as Cronobacter and Heliobacillus were increased,the proportion of beneficial bacte-ria such as Bacteroides,Lactobacillus,Prevotella and Akkermansia were decreased;mTOR and HIF-1α mRNA levels,p-mTOR/mTOR,HIF-1α protein levelsin hippocampal tissue were increased(P<0.05);compared with Model group,the seizures of rats in CBZXD-Low group and CBZXD-High group were significantly reduced,and the damage to hippocampal neurons was alleviated,RORγt,IL-17A mRNA levels in spleen tissue were decreased,Foxp3,CTLA-4 and GITR mRNA levels were increased,the propor-tion of Th17 cells and Th17/Treg were decreased,the proportion of Treg cell was increased,intestinal flora α/β diversity were in-creased,the proportion of harmful bacteria such as Cronobacter and Heliobacillus were decreased,the proportion of beneficial bacte-ria,such as Bacteroides,Lactobacillus,Prevotella,and Akkermansia were increased;mTOR and HIF-1α mRNA levels,p-mTOR/mTOR,HIF-1α protein levels in hippocampal tissue were decreased(P<0.05);and it showed a dose-dependent effect of Chaibei Zhixian Decoction(P<0.05).Conclusion:Chaibei Zhixian Decoction can restore intestinal flora and Th17/Treg cell immune balance in epileptic rats,it possibly plays a role by regulating mTOR/HIF-1α pathway.

Objective:To investigate the current status of psychosocial adaptation in young and middle-aged patients after colorectal cancer surgery and to explore its influencing factors, providing a basis for the development of targeted interventions.Methods:A total of 200 postoperative young and middle-aged colorectal cancer patients undergoing follow-up at the outpatient department of Shanxi Cancer Hospital from June 2023 to March 2024 were selected by convenience sampling. Data were collected using a general demographic questionnaire, the Self-Report Psychosocial Adjustment to Illness Scale (PAIS-SR), the Family APGAR Index Questionnaire, and the Simplified Ways of Coping Questionnaire (SWCQ). Multiple linear regression analysis was performed to identify factors influencing psychosocial adaptation.Results:A total of 200 questionnaires were distributed, and 191 valid responses were collected, yielding a valid response rate of 95.5%. The total PAIS-SR score of participants was (57.91±23.45). Multiple linear regression analysis revealed that education level, self-perceived economic status, employment status, presence of a stoma, time since surgery, family care, and positive coping style were statistically significant influencing factors ( P<0.05), explaining 46.4% of the variance in psychosocial adaptation. Conclusions:Healthcare providers should pay particular attention to patients with lower educational levels, poor self-perceived economic conditions, unemployment, a stoma, and shorter postoperative duration. Enhancing family care—starting with patient caregivers—and encouraging the use of positive psychological interventions to foster active coping strategies may help improve psychosocial adaptation in young and middle-aged colorectal cancer patients.

Objective:To establish a Zika virus-infected suckling SD rat model with type Ⅰ interferon receptor deficiency（SD-Ifnar1 -/-［cc］）and provide a novel animal model for investigating Zika virus pathogenesis and developing therapeutic strategies. Methods:Seventeen-day-old male SD-Ifnar1 -/-［cc］rat pups were randomly divided into experimental and control groups（ n=6）. The experimental group received an intraperitoneal injection of Zika virus strain SZ-wiv01（5×10 4 PFU/rat，200 μl），while the control group received an equal volume of phosphate-buffered saline（PBS）. Animals were euthanized via CO 2 asphyxiation on days 12 and 15 post-infection（dpi），and brain，spleen，liver，and testis tissues were harvested. Viral loads and cytokine expression levels were quantified using quantitative real-time PCR qRT-PCR），and histopathological evaluation was performed via HE staining. Results:qRT-PCR analysis revealed no detectable Zika virus RNA（Ct >35）in control tissues. In the experimental group，viral RNA（Ct <35）was detected in the brain，spleen，liver，and testis by day 12，with stable viral loads across tissues by day 15（ P>0.05）. Cytokine profiling demonstrated significant upregulation in the brain at day 12：IFN-β（5.58-fold， P<0.01），IL-6（7.11-fold， P<0.01），and CCL5（3.79-fold， P<0.01）. By day 15，these levels remained elevated（IFN-β：3.07-fold；IL-6：4.04-fold；CCL5：5.22-fold；all P<0.01）. In the liver，IFN-β mRNA decreased to 20% of the control level by day 15（ P<0.05），while IL-6 declined to 24% and CCL5 mRNA dropped to 38% by day 12. No significant cytokine changes were observed in the spleen（ P>0.05）. Testicular tissues exhibited reduced IFN-β mRNA levels（43% of control at day 12，31% at day 15； P<0.05）. Histopathological analysis revealed marked splenomegaly with disrupted splenic corpuscle architecture and lymphocyte depletion，significant inflammatory cell infiltration in hepatic portal areas，and testicular structural disorganization with inflammatory infiltration in Zika-infected rats. Conclusions:The SD-Ifnar1 -/-［cc］suckling rat model is successfully established and validated. This model recapitulates systemic Zika virus infection，tissue-specific pathology，and immune response dynamics，providing a robust platform for elucidating viral pathogenesis and advancing antiviral drug development.

Objective:To investigate the current status of psychosocial adaptation in young and middle-aged patients after colorectal cancer surgery and to explore its influencing factors, providing a basis for the development of targeted interventions.Methods:A total of 200 postoperative young and middle-aged colorectal cancer patients undergoing follow-up at the outpatient department of Shanxi Cancer Hospital from June 2023 to March 2024 were selected by convenience sampling. Data were collected using a general demographic questionnaire, the Self-Report Psychosocial Adjustment to Illness Scale (PAIS-SR), the Family APGAR Index Questionnaire, and the Simplified Ways of Coping Questionnaire (SWCQ). Multiple linear regression analysis was performed to identify factors influencing psychosocial adaptation.Results:A total of 200 questionnaires were distributed, and 191 valid responses were collected, yielding a valid response rate of 95.5%. The total PAIS-SR score of participants was (57.91±23.45). Multiple linear regression analysis revealed that education level, self-perceived economic status, employment status, presence of a stoma, time since surgery, family care, and positive coping style were statistically significant influencing factors ( P<0.05), explaining 46.4% of the variance in psychosocial adaptation. Conclusions:Healthcare providers should pay particular attention to patients with lower educational levels, poor self-perceived economic conditions, unemployment, a stoma, and shorter postoperative duration. Enhancing family care—starting with patient caregivers—and encouraging the use of positive psychological interventions to foster active coping strategies may help improve psychosocial adaptation in young and middle-aged colorectal cancer patients.

Objective:To investigate the application of time series models in forecasting pre-hospital emergency ambulance trips in Handan City and develop the LPro ensemble model for improved prediction accuracy to support emergency resource allocation.Methods:Pre-hospital emergency data from Handan Emergency Medical Command Center (2019-2023) were retrospectively analyzed. From 324 799 original records, 289 949 valid records were included after cleaning. The training set (2019-2022: 215 918 records) included 35 527 records in 2019, 52 015 in 2020, 61 836 in 2021, and 66 540 in 2022. The validation set (2023) contained 74 031 records. ARIMA, linear trend seasonal, exponential smoothing, and Prophet models were fitted to the training set. The LPro ensemble model was constructed using MAPE-based weighting (linear trend seasonal model: 0.38, Prophet: 0.62). Performance metrics included MAPE, RMSE, MAE, and R 2. Results:Data showed annual growth (compound annual growth rate 23.27%) and seasonal patterns (October peaks, February troughs). Ambulance dispatches increased annually with monthly cyclical patterns. For 2023 validation predictions: ARIMA (MAPE 8.76%, RMSE 619, MAE 491, R 2 0.4563), linear trend seasonal (MAPE 9.83%, RMSE 671, MAE 545, R 2 0.3608), Prophet (MAPE 8.43%, RMSE 562, MAE 503, R 2 0.5513), exponential smoothing (MAPE 8.08%, RMSE 643, MAE 410, R 2 0.4124). LPro model showed superior performance (MAPE 7.05%, RMSE 491, MAE 393, R 2 0.6570), with 16.37% lower MAPE, 12.63% lower RMSE, 21.87% lower MAE, and 19.17% higher R 2 versus Prophet. Conclusion:The LPro ensemble model substantially enhances prediction accuracy and reliability, offering scientific support for emergency resource optimization and dispatch scheduling in Handan City.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Asarum forbesii is a perennial herb born in a shaded and humid environment, which is warm in nature. With the efficacy of warming lung, resolving fluid retention, and relieving coughs, it can be used to treat the syndrome of cold fluid accumulating in lung. To investigate the effects of different shading conditions on the composition and efficacy of A. forbesii, this study planted A. forbesii under 20% natural light(NL20), 40% natural light(NL40), 60% natural light(NL60), and 80% natural light(NL80) and utilized ultra performance liquid chromatography(UPLC) and micro broth 2-fold dilution method to detect the volatile chemical compounds and the minimum inhibitory concentration. At the same time, the study investigated the effects of A. forbesii grown under different shading conditions on the signs, pathological changes of lung tissues, serum cytokine levels, activities of mitochondrial respiratory chain complexes Ⅰ-Ⅴ in lung tissues, and relative expression of related genes of mice with syndrome of cold fluid accumulating in lung. The results indicated that with the increase of shading, the content of kakuol, methyl eugenol, and asarinin in A. forbesii and the antibacterial effect showed a tendency of increasing first and then decreasing, and the NL40 group was significantly better than the other groups. Under the conditions of NL20 and NL40, A. forbesii significantly alleviated the pathological damage to lung tissues, restored the homeostasis of the lung, and enhanced the energy metabolism level of mice with syndrome of cold fluid accumulating in lung. In addition, A. forbesii planted under the two conditions reduced the content of interleukin-8(IL-8), interleukin-13(IL-13), tumor necrosis factor-α(TNF-α), and mucin 5AC(MUC5AC), increased the levels of interleukin-10(IL-10) and aquaporin 1(AQP1), lowered the expression of MMP9, VEGF, TGF-β, and MAPK3. In conclusion, the therapeutic effect of A. forbesii on the syndrome of cold fluid accumulating in lung was positively correlated with the degree of shading, and the chemical composition and efficacy of warming lung and resolving fluid retention were optimal under the conditions of NL20-NL40. This study can provide reference for the pharmacological research and cultivation of A. forbesii.
Animals ; Mice ; Lung/pathology* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Light ; Cytokines/genetics* ; Humans