Objective To study the predictive value of umbilical artery blood gas analysis combined with early postnatal myocardial enzyme spectrum for neonatal respiratory distress syndrome(RDS)and its severity in premature infants.Methods From January 2018 to December 2024,85 newborns with the gestation age of 30-36+6 weeks who were diagnosed as RDS after birth form Hangzhou Women's Hospital were selected as study group.85 newborns without diagnosed as RDS during the same period were included as control group in a 1:1 ratio.All of them born by cesarean section.The umbilical arterial blood gas analysis was performed and blood samples were collected for blood biochemical tests.The umbilical artery blood pH,base excess,lactate,and myocardial enzyme spectrum such as aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase isoenzymes(CK-MB)were compared between two groups.Binary Logistic regression was used to analyze the correlation between umbilical artery blood gas analysis and venous blood myocardial enzyme spectrum and RDS.Receiver operating characteristic curve of umbilical artery blood pH value and creatine kinase isoenzyme alone and their combined detection for predicting RDS was detected,and area under the curve(AUC),sensitivity and specificity of the single detection and combined detection were compared.The study group was further divided into subgroup A(mild)and subgroup B(severe)and the differences of the above indicators between two subgroups were compared.Results Compared with control group,tstudy group had lower pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were higher than those in control group with statistically significant differences(P＜0.05).pH and CK-MB were correlated with RDS(P＜0.05).The AUC of umbilical artery blood pH in predicting RDS was 0.728,the sensitivity was 0.588 and the specificity was 0.812.Combined with CK-MB,the AUC of predicting RDS was 0.813,the sensitivity was 0.729,and the specificity was 0.824.In the study group,subgroup A had higher pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were lower than those in subgroup B with statistically significant differences(P＜0.05).CK-MB was correlated with disease severity in newborns with RDS(P＜0.01).Conclusion Compared with simple application of pH,the combined use of CK-MB can more accurately predict RDS in premature infants,and also has a certain significance for the severity of RDS in premature infants.

Objective To comparatively analyze the differences in clinical efficacy and safety between rheolytic and large-lumen catheter thrombectomy systems in the treatment of early-stage lower extremity deep venous thrombosis(LEDVT).Methods A retrospective analysis was conducted on 88 patients with LEDVT who underwent mechanical thrombectomy at Ningbo Medical Center Lihuili Hospital from January 2020 to October 2024.Patients were divided into group A(rheolytic thrombectomy system)and group B(large lumen catheter thrombectomy system).Perioperative parameters(operative duration,hospitalization duration),thrombus clearance rates were compared between two groups.Results The surgical success rate was 100％in both groups.No statistically significant differences were observed in hospitalization duration,operation duration,or thrombus clearance rate(P＞0.05).Regarding complications,the incidence of hematuria was significantly higher in group A than in group B.Three patients in group B experienced puncture site bleeding.Conclusion Both thrombectomy systems demonstrated favorable therapeutic effects in the early treatment of LEDVT.The rheolytic thrombectomy system warrants vigilance for the risk of hemolysis-related renal injury,and it is recommended to enhance perioperative renal function monitoring and renal protective measures.The large lumen catheter thrombectomy system has drawbacks,including puncture site bleeding,cumbersome operation,and potential damage to venous valves.Two different intracavitary thrombus clearing systems still need continuous improvement and innovation.

Objective To investigate the potential mechanism of Erchen Pingwei formula in treating obesity with insulin resistance(IR)by using network pharmacology and molecular docking technology.Methods The main active ingredients and their potential target proteins were obtained from Traditional Chinese Medicine System Pharmacology database and analysis platform and Swiss Target Prediction databases,therapeutic target database,online Mendelian inheritance in man database and genecards databases were used to screen the disease targets related to IR and obesity,and Venny mapping tool was used to screen the intersection of herbal formula and disease targets,and Cytoscape 3.10.0 software was used to construct protein-protein interaction(PPI)network diagrams.Gene Ontology(GO)enrichment,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis on the intersection targets were conducted by using DAVID database,molecular docking and visualization analysis were carried out by Autodock and Pymol.Results 136 active ingredients and 236 active targets of Erchen Pingwei formula were retrieved,with 2527 IR active targets,1598 obesity active targets,and 91 drug-disease intersecting targets.GO and KEGG enrichment analyses showed that quercetin,kaempferol,and naringenin were the main active ingredients of Erchen Pingwei formula,through the regulation of protein kinase B,interleukin-6,tumor protein p53,peroxisome proliferator activated receptor,estrogen receptor α and other core targets,affecting lipid and atherosclerosis,insulin resistance,advanced glycation end product-receptor signaling pathway,and playing a therapeutic role in obesity.Conclusion Erchen Pingwei formula treats obesity with IR via a multi-component,multi-target,and multi-pathway mechanism.

Objective To explore the intention of chronic disease patients to use internet hospitals and its influencing factors based on the theory of planned behavior.Methods A convenience sampling survey was conducted using a questionnaire based on theory of planned behavior from July to October 2024.Structural equation modeling was employed to analyze the determinants of behavioral intention.Results The mean behavioral intention score was(96.25±11.62),indicating a moderate-to-high level.Structural equation modeling revealed significantly positive effects of subjective norms(β=0.696,P＜0.05)and perceived behavioral control(β=0.175,P＜0.05)on behavioral intention,while significant negative effects were observed for information risk perception(β=-0.286,P＜0.05)and medical risk perception(β=-0.221,P＜0.05).Conclusion Chronic disease patients demonstrate moderate-to-high intention to use internet hospitals.Key determinants of behavioral intention include subjective norms,perceived behavioral control,information risk perception,and medical risk perception.

Objective To explore the application effect of traditional Chinese medicine elastic stockings in preventing deep venous thrombosis(DVT)after laparoscopic gastric cancer surgery.Methods A total of 96 patients who underwent gastric cancer surgery at Jiaxing Hospital of Traditional Chinese Medicine from January 2022 to June 2024 and were assessed as medium-to-high risk for Caprini thrombosis were selected and divided into control group and treatment group,with 48 cases in each group.The patients of control group received the conventional DVT prevention protocol,while the patients of treatment group applied self-made traditional Chinese medicine elastic stockings on the basis of control group.The prothrombin time(PT),activated partial thromboplastin(APTT),D-dimer(DD),plasma viscosity,erythrocyte aggregation index,thigh circumference difference,comfort status scale and color Doppler ultrasound manifestations of two groups of patients before and after the operation were compared.Results On the 3rd and 7th days after the operation,the PT and APTT of patients in treatment group were significantly longer than those in control group,the DD,plasma viscosity,erythrocyte aggregation index and thigh circumference difference were significantly lower than those in control group,and the score of comfort status scale was significantly higher than that in control group(P＜0.05).On the 3rd days after the operation,the various ultrasound manifestations of patients in treatment group were significantly better than those in control group(P＜0.05).During hospitalization,the incidence of DVT in treatment group was significantly lower than that in control group(P＜0.05).Conclusion Traditional Chinese medicine elastic stockings can improve the coagulation function,hemorheology and lower extremity swelling of patients after laparoscopic gastric cancer surgery,enhance comfort and reduce the incidence of DVT.

Objective To explore the clinical and pathological characteristics of medullary thyroid carcinoma(MTC)combined with papillary thyroid carcinoma(PTC),and to improve the detection rate of mixed thyroid tumors.Methods A retrospective analysis was conducted on the clinicopathological data of 11 cases of MTC combined with PTC diagnosed in the Department of Pathology,Jiangsu Province Hospital on Integration of Chinese and Western Medicine from April 2010 to April 2025,and analysis.Results Among the 11 patients,there were 4 males and 7 females with a median age of 57 years.The preoperative puncture pathology of 11 cases was not diagnosed as MTC combined with PTC.All patients underwent intraoperative rapid pathological diagnosis.Among them,5 cases were MTC combined with PTC,3 cases were PTC combined with thyroid follicular neoplasm,and the rest were diagnosed with single tumor(PTC or MTC).Conventional pathology diagnosed that all 11 patients had MTC combined with PTC,among which 2 cases were mixed MTC-PTC,and 6 cases were combined with multinodular goiter,and 3 cases combined with chronic lymphocytic thyroiditis.The histological morphology of MTC and PTC was diverse,presenting in arrangements such as papillary,island,follicular or solid.MTC cells are round,oval,spindle-shaped or plasma cell-like,with indistinct boundaries.The cytoplasm is eosinophilic,bicolotropic or transparent.The nucleus is round,irregular or spindle-shaped,with rough chromatin that does not have the characteristics of PTC cell nuclei.Amyloid deposits are seen in the interstitium.Immunohistochemistry expresses calcitonin(CT)and carcinoembryonic antigen(CEA),but does not express thyroglobulin(Tg).Special staining shows Congo red as brick red,and under a polarizing microscope,it appears as a refractive apple green.The nuclei of PTC cells are round or oval,and the cytoplasm is eosinophilic or bicolotropic.The nuclei are enlarged and arranged in a crowded manner.Nuclear grooves and pseudo-inclusions within the nucleus can be seen.Immunohistochemistry expressed thyroid transcription factor-1,paired box gene 8,and mesothelial cell membrane protein protenin mesothelial cell membrane protenin-1,Tg,galectin-3,cytokeratin are not expressed.CT and CEA are not expressed.Special staining is negative for Congo red.Conclusion MTC combined with PTC is relatively rare.There are no special manifestations in clinical features and imaging examinations.Preoperative puncture pathology and intraoperative rapid pathology are difficult to make a clear diagnosis.Clinicians and pathologists should avoid missed diagnoses or misdiagnoses.

Objective To construct a health management information service platform for glaucoma patients to achieve continuous care.Methods The architecture of the health management information service platform for glaucoma patients was designed,and the platform was developed and implemented.Results A WeChat mini program-based health management information service platform was developed,consisting of a medical staff interface,a patient interface,and a backend management center.The platform integrates functions such as whole-process disease tracking,surgical management,medication and follow-up record-keeping with reminders,communication for follow-ups,and health education.From March 2021 to March 2024,the platform registered 2764 patients and 45 medical staff,with a total of 10 947 platform interactions.An overall assessment with the post-study system usability questionnaire yielded a mean score of 28.2,indicating good user experience.Conclusion This platform realizes closed-loop management for continuous care of glaucoma patients and provides a practical reference for the development and exploration of health management information service platforms.

Objective To explore the value of combining quantitative indicators of rectus femoris muscle obtained through ultrasound technology with clinical data in identifying protein energy wasting(PEW)in patients with chronic kidney disease(CKD)undergoing maintenance hemodialysis.Methods 90 CKD patients undergoing regular hemodialysis treatment in Guangzhou Red Cross Hospital from November 2023 to August 2024 were selected and divided into experimental group(30 cases with PEW)and control group(60 cases without PEW)according to PEW diagnostic criteria.Clinical indicators and quadriceps ultrasound quantitative data were measured and compared between two groups.Independent predictors of PEW were screened through multivariate Logistic regression analysis.A prediction model was constructed and receiver operating characteristic curve were drawn to evaluate its diagnostic performance.Results Significant differences were observed between experimental group and control group in body mass index(BMI),serum albumin,age,gender,rectus femoris thickness,and cross-sectional area(P＜0.05).Multivariate Logistic regression analysis showed that BMI and rectus femoris thickness were independent factors affecting PEW in CKD patients.A diagnostic model based on these two indicators,Logit(P)=1/[1+e-(10.292-0.378×BMI-2.992×rectus femoris thickness)],demonstrated good diagnostic performance(area under the curve=0.853,95％CI:0.764-0.943,P＜0.05).Conclusion Ultrasound assessment of rectus femoris thickness can objectively reflect the degree of skeletal muscle atrophy in CKD patients,and the prediction model constructed in combination with BMI helps in early identification of PEW and clinical intervention decision-making.

Objective To investigate the changes in the levels of D-dimer(D-D),fibrin degradation product(FDP),thrombomodulin(TM),thrombin-antithrombin complex(TAT),tissue plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC),and plasmin-alpha 2 plasmin inhibitor complex(PIC)during the treatment of patients with acute myeloid leukemia(AML)and their predictive value for efficacy and prognosis.Methods Thirty-one AML patients initially diagnosed at Guidong People's Hospital of Guangxi Zhuang Autonomous Region from January 2022 to December 2024 were collected as observation group,and 34 healthy medical checkupers were selected as control group.The changes in the levels of the indicators between two groups as well as before,during and after the treatment of observation group were compared,and observation group was divided into remission group and non-remission group according to the efficacy criteria,and the levels of the indicators between two groups were further compared.Risk factors for the efficacy and prognosis of AML patients were analyzed by using Logistic regression analysis.Results Before treatment,the levels of prothrombin time(PT),activated partial thromboplastin time(APTT),D-D,FDP,t-PAIC,PIC,TM and TAT in observation group were significantly higher than those in control group(P＜0.05),whereas there was no significant difference in fibrinogen(Fib)compared with control group(P＞0.05).During the treatment,the levels of t-PAIC and TM in observation group were higher than those before treatment(P＜0.05);After treatment,the levels of PT,D-D,FDP,PIC and TAT in observation group were significantly lower than those before treatment(P＜0.05).After treatment,the levels of PT,D-D,FDP,t-PAIC,PIC,TM and TAT were all lower than those during treatment(P＜0.05).The D-D,FDP,t-PAIC,PIC,TAT and TM levels in non-remission group were all higher than those in remission group,with the t-PAIC and TM levels showing statistical significance(P＜0.05).Binary Logistic regression analysis showed that t-PAIC was an independent risk factor affecting the efficacy and prognosis of AML patients(P＜0.05,OR=1.205,95％CI:1.015-1.430).Conclusion Regular testing of D-D,FDP,TM,TAT,t-PAIC and PIC levels can help to assess the disease changes and efficacy prognosis of AML patients,and provide an important reference for clinical decision-making.

Objective To explore the efficacy of Wuling capsule and zolpidem tartrate tablets in the treatment of insomnia patients,and to compare and analyze the clinical benefits of the combined medication scheme and single sedative-hypnotic drugs intervention.Methods To collect the clinical data of insomnia patients with heart kidney disharmony in the 900th Hospital of Joint Logistic Support Force of the People's Liberation Army of China outpatient department from December 2024 to March 2025 as research materials.According to the different treatment method,patients were divided into observation group and control group,with 30 cases in each group.Patients in observation group were treated with Wuling capsule combined with zolpidem tartrate tablets,and patients in control group were treated with zolpidem tartrate tablets alone.The observation indexes of sleep quality evaluation index[Pittsburgh sleep quality index(PSQI)],insomnia severity index(ISI)and mental health evaluation dimension[self rating anxiety scale(SAS)and self rating depression scale(SDS)],traditional Chinese medicine syndrome score and therapeutic efficacy of two groups before and after treatment were compared.Results After 2 weeks of clinical intervention,the PSQI,ISI,SAS,SDS scores,traditional Chinese medicine symptom scores,and therapeutic efficacy of observation group patients were all better than those of control group(P＜0.05).Conclusion Compared with zolpidem tartrate tablets alone,Wuling capsule combined with zolpidem tartrate tablets has better curative effect in the treatment of insomnia patients with"heart kidney disharmony",lower PSQI score and more obvious emotional improvement,alleviated symptoms accompanying insomnia.