ObjectiveTo explore the application value of modified Wendantang in the treatment of perimenopausal insomnia of phlegm heat type and observe its effects on neurotransmitters and body fat. MethodsA total of 162 patients with perimenopausal insomnia of phlegm heat type who were treated in the Traditional Chinese Medicine Department of The First Affiliated Hospital with Nanjing Medical University from May 2021 to November 2023 were randomly divided into two groups before inclusion in the study. The control group of 81 cases received conventional Western medicine treatment， while the observation group of 81 cases received combined treatment with modified Wendantang， and the treatment lasted for 4 weeks. ResultsInterleukin-β （IL-1β）， and tumor necrosis factor alpha （TNF-α） decreased， while serum dopamine （DA）， melatonin （MT） and serotonin （5-HT） increased in both groups after treatment compared with before treatment （P<0.05）. After treatment， compared with the control group， the observation group showed better improvement in the above indicators （P<0.05）. The levels of follicle stimulating hormone （FSH） and luteinizing hormone （LH） decreased， while the level of estradiol （E₂） increased in both groups after treatment compared with before treatment （P<0.05）. Compared with the control group， the observation group showed better improvement in the above sex hormone indicators after treatment （P<0.05）. The rapid eye movement sleep period （REM） and total sleep time （TST） were prolonged， and the sleep latency （SL） was shortened in the two groups after treatment compared with before treatment （P<0.05）. Compared with the control group， the observation group showed better improvement in sleep conditions after treatment （P<0.05）. The Pittsburgh sleep quality index （PSQI） and Traditional Chinese Medicine （TCM） total symptom score decreased significantly in both groups after treatment compared with before treatment （P<0.05）. Compared with the control group， the observation group showed better improvement in PSQI and TCM total symptom score after treatment （P<0.05）. The total effective rate of the observation group was 93.83% （76/81）， while that of the control group was 82.72% （67/81）， and the two had a statistically significant difference （χ²=9.135， P<0.05）. ConclusionFor patients with perimenopausal insomnia of phlegm heat type， the application of modified Wendantang can help regulate neurotransmitters and inflammatory factor levels， improve sex hormone levels， enhance sleep quality， and improve therapeutic effects.

ObjectiveTo investigate the expression of serum Aldo-keto reductase family 1 member B10 （AKR1B10） in patients with hepatocellular carcinoma （HCC） in northern China， and to provide a new and valuable biomarker for the clinical diagnosis of HCC. MethodsThis study was conducted among 102 patients with HCC， 119 patients with benign liver disease， and 132 patients with other malignant tumors who attended The Affiliated Hospital of Chengde Medical University and 148 healthy individuals who underwent physical examination from May 2020 to May 2024. ELISA and chemiluminescence were used to measure the serum levels of AKR1B10 and alpha-fetoprotein （AFP）. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between three groups and further comparison between two groups； the chi-square test was used for comparison of categorical data between groups. The area under the ROC curve （AUC） was used to assess diagnostic efficiency. ResultsThe expression level of AKR1B10 was 3 053.79 （1 475.67‍ ‍—‍ ‍4 605.86） pg/mL in the HCC group， 1 324.42 （659.68‍ ‍—‍ ‍2 023.88） pg/mL in the benign liver disease group， 660.68 （377.56‍ ‍—‍ ‍2 087.77） pg/mL in the other malignant tumor group， and 318.30 （82.73‍ ‍—‍ ‍478.82） pg/mL in the healthy group， with a significant difference between the four groups （H=240.86， P<0.001）， and further comparison between two groups showed that the HCC group had a significantly higher level than the other three groups （all P<0.001）. The ROC curve analysis of the HCC group and the other three groups showed that serum AKR1B10 had an optimal cut-off value of 1 584.97 pg/mL in the diagnosis of HCC， with an AUC of 0.86 （95% confidence interval ［CI］： 0.82‍ ‍—‍ ‍0.90）， a sensitivity of 74.3%， and a specificity of 85.2%. Compared with each indicator alone， a combination of AKR1B10 and AFP could improve the sensitivity （81.8%） and specificity （91.4%） of HCC diagnosis. AKR1B10 had an AUC of 0.84 （95%CI： 0.78‍ ‍—‍ ‍0.90） in the diagnosis of patients with early- or middle-stage HCC， with a sensitivity of 76.2% and a specificity of 81.2%. AKR1B10 had an AUC of 0.85 （95%CI： 0.77‍ ‍—‍ ‍0.92） in the diagnosis of patients with AFP-negative HCC， with a sensitivity of 81.6% and a specificity of 79.9%. ConclusionAKR1B10 is a promising serological marker for the diagnosis of HCC， and a combination of AKR1B10 and AFP can improve the detection rate of HCC patients in northern China， especially those with early- or middle-stage HCC and AFP-negative HCC.

Objective To explore the relationship between the levels of serum death-associated protein kinase 1(DAPK1)and total tau(T-tau)protein and cognitive dysfunction in patients with type 2 diabetes mellitus(T2DM).Methods A total of 178 patients with T2DM who were diagnosed and treated at the Affiliated Hospital of Xuzhou Medical University from May 2024 to January 2025 were selected.According to whether the patients had cognitive dysfunction,they were divided into cognitive dysfunction group(88 cases)and control group(90 cases).Based on Montreal cognitive assessment(MoCA)score,patients with cognitive dysfunction were further divided into severe group(MoCA score＜10 points,24 cases);moderate group(10 points ≤MoCA score ≤17 points,31 cases),and mild group(18 points ≤MoCA score＜26 points,33 cases).The levels of serum DAPK1 and T-tau proteins were detected by enzyme-linked immunosorbent assay,and the risk factors were analyzed by Logistic regression.Spearman correlation analysis was used to evaluate the correlation between T-tau protein,DAPK1 and the severity of cognitive dysfunction.Results The age,duration of diabetes mellitus,proportion of hyperlipidemia,fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,T-tau protein,and DAPK1 of patients in cognitive dysfunction group were significantly higher than those in control group,while the educational level was significantly lower than that in control group(P＜0.05).Logistic regression analysis showed that the duration of diabetes mellitus,T-tau protein,DAPK1,and glycated hemoglobin were all independent risk factors for cognitive dysfunction in patients with T2DM(P＜0.05).The T-tau protein and DAPK1 of patients in severe group were significantly higher than those in mild group and moderate group(P＜0.001).Spearman correlation analysis showed that DAPK1 and T-tau proteins were positively correlated with severity of cognitive dysfunction(P＜0.05).Conclusion The duration of diabetes mellitus,glycated hemoglobin,DAPK1 and T-tau protein are all independent risk factors for cognitive dysfunction in patients with T2DM.The levels of DAPK1 and T-tau protein are related to the severity of cognitive dysfunction and can be used as potential markers for risk assessment.

Objective To construct and validate the efficacy of a risk prediction model for pneumothorax after CT-guided percutaneous pulmonary puncture biopsy(CT-PCNB)based on nomograms.Methods A total of 246 patients who underwent CT-PCNB examination in the hospital from October 2020 to October 2023 were selected and divided into training set(n=144)and validation set(n=102)using a random sampling method.In the training set,univariate and multivariate logistic regression analyses were performed to identify risk factors for pneumothorax after CT-PCNB.A nomogram model was constructed based on the identified risk factors,and its accuracy was validated using the validation set.Results Multifactorial logistic regression analysis showed that age≥60 years,concomitant underlying lung disease,lesion diameter<2 cm,distance from lesion to pleura≥10 mm,puncture through interlobular pleura,and≥2 pleural punctures were the risk factors for pneumothorax after CT-PCNB in the training set(P<0.05).A nomogram model was constructed based on these six factors.The ROC curve results for the training set showed an AUC of 0.852,sensitivity of 84.50%,and specificity of 67.50%.The nomogram model was validated using the validation set,with ROC curve results showing an AUC of 0.845,sensitivity of 83.00%,and specificity of 69.50%.There was no statistically significant difference between the predicted and actual values in both the training and validation sets(χ2=1.803,1.225;P>0.05),indicating clinical validity.Conclusion The nomogram model constructed based on the risk factors for pneumothorax after CT-PCNB has high predictive efficacy and is clinically meaningful.

OBJECTIVE To explore the clinical efficacy of dapagliflozin for stable coronary heart disease combined with heart failure （HF）. METHODS A prospective study method was employed. A total of 158 patients with stable coronary heart disease and HF admitted to our hospital from January 1， 2023， to January 1， 2024， were enrolled. Using a random number table method， they were divided into dapagliflozin group （n＝76） and conventional treatment group （n＝82）. All patients received conventional treatment， including diuretic， aspirin， losartan， metoprolol and statins. Patients in the dapagliflozin group were additionally administered Dapagliflozin tablets at a dose of 10 mg once daily on top of the conventional treatment. The treatment duration was six months. The changes in left ventricular ejection fraction （LVEF）， left ventricular end-systolic diameter （LVESD）， left ventricular end-diastolic diameter （LVEDD）， fasting blood glucose， N-terminal pro-brain natriuretic peptide （NT-proBNP）， the number of angina attacks， the duration of angina attacks， and lipoprotein-associated phospholipase A2 before and after treatment were compared between the two groups. The occurrence of adverse reactions such as renal dysfunction， liver dysfunction， urinary system infections， new-onset dialysis， hypotension and hypoglycemia was evaluated in the two groups during treatment. RESULTS During the study， 16 patients were lost to follow-up. Ultimately， 70 patients in the dapagliflozin group and 72 patients in the conventional treatment group completed the study. Before treatment， there were no statistically significant differences in the aforementioned indicators between the two groups （P＞0.05）. Compared with before treatment， after treatment， both groups showed significant shortening in LVESD and LVEDD， significant increases in LVEF， significant reductions in NT-proBNP and lipoprotein-associated phospholipase A2 levels， and significant reductions in the number of angina attacks and the duration of angina attacks （P＜0.05）； the improvements in the dapagliflozin group were more significant than those in the conventional treatment group （P＜0.05）. There was no statistically significant difference between the two groups in fasting blood glucose levels and the incidence of the aforementioned adverse reactions （P＞0.05）. CONCLUSIONS Adding dapagliflozin to conventional treatment can shorten LVESD and LVEDD， increase LVEF levels， reduce NT-proBNP and lipoprotein-associated phospholipase A2 levels， and decrease the number and duration of angina attacks in patients with stable coronary heart disease combined with HF， thereby improving their cardiac function， and demonstrates good safety.

Objective:To investigate the expression of Cullin associated NEDD8 dissociated protein 1 in colorectal cancer and its effect on the biological behavior of colorectal cancer.Method:A total of 70 pairs of colorectal cancer and paired normal tissue specimens were collected from Jun to Dec 2017 at the Department of Gastrointestinal Surgery at Peking University People's Hospital. Immunohistochemistry was used to detect the expression of Cullin associated NEDD8 dissociated protein 1 and analyze its relationship with clinical pathological indicators and prognosis. CCK8, colony formation assay, transwell assay, and wound healing assay were used to evaluate the effects of Cullin associated NEDD8 dissociated protein 1 on the proliferation, migration, and invasion ability of colon cancer cells.Result:Compared with normal tissues, Cullin associated NEDD8 dissociated protein 1 was highly expressed in colorectal cancer (Immunohistochemistry score: 3.685±1.257 vs. 2.000±0.851, Z=6.536, P<0.001). The expression level of Cullin associated NEDD8 dissociated protein 1 was significantly correlated with T stage ( χ2=5.67, P=0.017), N stage ( χ2=7.20, P=0.007), and pathology stage ( χ2=4.66, P=0.031). Patients with high expression of Cullin associated NEDD8 dissociated protein 1 had a worse prognosis than those with low expression ( χ2=4.80, P=0.037). Knocking down Cullin associated NEDD8 dissociated protein 1 significantly reduced the proliferation, colony formation, and invasive migration ability of DLD1 cells (all P<0.05). Conclusion:Cullin associated NEDD8 dissociated protein 1 is significantly overexpressed in colorectal cancer and has a promoting effect on the occurrence and development of colorectal cancer.

The corona virus disease 2019(COVID-19)infection has assumed global pandemic status in a short period of time since its outbreak.This public health crisis has inflicted unprecedented damage and challenges to more than 200 countries and regions around the word.As the peak of the epidemic gradually subsides,an increasing amount of attention has been shifted to the issue of long-term sequelae in COVID-19 patients.These sequelae are manifested as the continuous dysfunction of multiple organ systems and are known as Long COVID.In response to this new issue,clinical pathological research has continuously made new progress,posing new requirements and challenges for the pre-vention and treatment of Long COVID.This article aims to review the progress of clinical pathological research on Long COVID in recent years,with the expectation of providing new ideas and methods for the prevention and treatment of this disease.

Objective To construct and validate the efficacy of a risk prediction model for pneumothorax after CT-guided percutaneous pulmonary puncture biopsy(CT-PCNB)based on nomograms.Methods A total of 246 patients who underwent CT-PCNB examination in the hospital from October 2020 to October 2023 were selected and divided into training set(n=144)and validation set(n=102)using a random sampling method.In the training set,univariate and multivariate logistic regression analyses were performed to identify risk factors for pneumothorax after CT-PCNB.A nomogram model was constructed based on the identified risk factors,and its accuracy was validated using the validation set.Results Multifactorial logistic regression analysis showed that age≥60 years,concomitant underlying lung disease,lesion diameter<2 cm,distance from lesion to pleura≥10 mm,puncture through interlobular pleura,and≥2 pleural punctures were the risk factors for pneumothorax after CT-PCNB in the training set(P<0.05).A nomogram model was constructed based on these six factors.The ROC curve results for the training set showed an AUC of 0.852,sensitivity of 84.50%,and specificity of 67.50%.The nomogram model was validated using the validation set,with ROC curve results showing an AUC of 0.845,sensitivity of 83.00%,and specificity of 69.50%.There was no statistically significant difference between the predicted and actual values in both the training and validation sets(χ2=1.803,1.225;P>0.05),indicating clinical validity.Conclusion The nomogram model constructed based on the risk factors for pneumothorax after CT-PCNB has high predictive efficacy and is clinically meaningful.

The corona virus disease 2019(COVID-19)infection has assumed global pandemic status in a short period of time since its outbreak.This public health crisis has inflicted unprecedented damage and challenges to more than 200 countries and regions around the word.As the peak of the epidemic gradually subsides,an increasing amount of attention has been shifted to the issue of long-term sequelae in COVID-19 patients.These sequelae are manifested as the continuous dysfunction of multiple organ systems and are known as Long COVID.In response to this new issue,clinical pathological research has continuously made new progress,posing new requirements and challenges for the pre-vention and treatment of Long COVID.This article aims to review the progress of clinical pathological research on Long COVID in recent years,with the expectation of providing new ideas and methods for the prevention and treatment of this disease.

Objective To explore the relationship between the levels of serum death-associated protein kinase 1(DAPK1)and total tau(T-tau)protein and cognitive dysfunction in patients with type 2 diabetes mellitus(T2DM).Methods A total of 178 patients with T2DM who were diagnosed and treated at the Affiliated Hospital of Xuzhou Medical University from May 2024 to January 2025 were selected.According to whether the patients had cognitive dysfunction,they were divided into cognitive dysfunction group(88 cases)and control group(90 cases).Based on Montreal cognitive assessment(MoCA)score,patients with cognitive dysfunction were further divided into severe group(MoCA score＜10 points,24 cases);moderate group(10 points ≤MoCA score ≤17 points,31 cases),and mild group(18 points ≤MoCA score＜26 points,33 cases).The levels of serum DAPK1 and T-tau proteins were detected by enzyme-linked immunosorbent assay,and the risk factors were analyzed by Logistic regression.Spearman correlation analysis was used to evaluate the correlation between T-tau protein,DAPK1 and the severity of cognitive dysfunction.Results The age,duration of diabetes mellitus,proportion of hyperlipidemia,fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,T-tau protein,and DAPK1 of patients in cognitive dysfunction group were significantly higher than those in control group,while the educational level was significantly lower than that in control group(P＜0.05).Logistic regression analysis showed that the duration of diabetes mellitus,T-tau protein,DAPK1,and glycated hemoglobin were all independent risk factors for cognitive dysfunction in patients with T2DM(P＜0.05).The T-tau protein and DAPK1 of patients in severe group were significantly higher than those in mild group and moderate group(P＜0.001).Spearman correlation analysis showed that DAPK1 and T-tau proteins were positively correlated with severity of cognitive dysfunction(P＜0.05).Conclusion The duration of diabetes mellitus,glycated hemoglobin,DAPK1 and T-tau protein are all independent risk factors for cognitive dysfunction in patients with T2DM.The levels of DAPK1 and T-tau protein are related to the severity of cognitive dysfunction and can be used as potential markers for risk assessment.