Objective To explore the effect of PCSK9 inhibitor combined with atorvastatin on carotid atherosclerosis and its anti-inflammatory effect in patients with hypertension complicated with type 2 diabetes mellitus.Methods A total of 100 patients with hypertension complicated with type 2 diabetes mellitus who were treated in Nanchang Third Hospital from October 2022 to August 2023 were selected as the research subjects.They were divided into the control group and the study group by the random number table method,with 50 cases in each group.Both groups of patients received conventional antihypertensive,hypoglycemic,and antiplatelet therapy.The control group took 20 mg of atorvastatin calcium tablets orally,once a night.On the basis of the control group,the study group was additionally given 150 mg of evolocumab injection(a PCSK9 inhibitor)by subcutaneous injection,once every two weeks.Both groups of patients were followed up for 24 weeks.The levels of blood lipids,blood glucose,inflammatory cytokines,carotid intima-media thickness(IMT),atherosclerotic plaque score and adverse reactions of the patients in the two groups before and after treatment were detected and compared.Results The levels of TC,TG and LDL-C in the study group after treatment were lower than those before treatment and those in the control group at the same period,and the differences were statistically significant(P＜0.05).The levels of IL-1,IL-6,TNF-α,hs-CRP,as well as the ca-rotid IMT and atherosclerotic plaque score in the study group after treatment were lower than those before treatment and those in the control group at the same period,and the differences were statistically significant(P＜O.05).During the treatment period,there was no significant difference in the occurrence of adverse reac-tions between the two groups(P＞0.05).Conclusion The combination of PCSK9 inhibitor and atorvastatin can effectively regulate the blood lipid levels of patients with hypertension complicated and type 2 diabetes mellitus,alleviate the inflammatory response,and improve the degree of carotid atherosclerosis in these pa-tients.

OBJECTIVE To explore the epidemiological characteristics of tuberculosis complicated with human im-munodeficiency virus(HIV)infection and their relationships with T helper lymphocyte(Th)1/Th2 related fac-tors.METHODS From May 2022 to Feb.2024,118 patients with tuberculosis combined with HIV infection admit-ted to Guiyang Public Health Rescue Center were selected as the study group.The patients were divided into group A(＞1.0E3 cp/ml＜1.0E4 cp/ml)with 31 cases,group B(≥1.0E4 cp/ml＜1.0E5 cp/ml)with 36 cases,group C(≥1.0E5 cp/ml)with 51 cases according to viral load.Another 120 patients with simple pulmonary tu-berculosis were selected as control group.The characteristics of epidemic cases,imaging CT features and levels of Th1/Th2 related cytokines[including interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interferon γ(IFN-γ),IL-4,IL-6 and IL-10]were compared between the study group and the control group,and the relationship be-tween viral load and atypical CT manifestations of tuberculosis were analyzed.RESULTS There were significant differences in educational level,occupational status,intravenous drug use history and baseline CD4 values between the two groups(P＜0.05).The study group showed higher rates of CT manifestations such as multiple pulmona-ry fields and segments exudation,extrapulmonary tuberculosis,multiple cavities,intrathoracic lymph node en-largement,multiple nodules,and diffuse miliary shadow than the control group,conversely,the frequencies of single cavity,calcification and speckle shadow in the study group were lower than those in the control group(P＜0.05).Compared with the control group,the levels of IL-2,TNF-α and IFN-γ in the study group were low,while the levels of IL-4,IL-6 and IL-10 were high(P＜0.05).With the increase of viral load,the rates of atypical CT tuberculosis were also increased(P＜0.05).CONCLUSION The CT imaging findings in patients with tuberculosis combined with HIV infection are atypical and Th1/Th2 related cytokines are abnormal,and the chest CT manifes-tations are associated with high viral load.

OBJECTIVE To explore the epidemiological characteristics of tuberculosis complicated with human im-munodeficiency virus(HIV)infection and their relationships with T helper lymphocyte(Th)1/Th2 related fac-tors.METHODS From May 2022 to Feb.2024,118 patients with tuberculosis combined with HIV infection admit-ted to Guiyang Public Health Rescue Center were selected as the study group.The patients were divided into group A(＞1.0E3 cp/ml＜1.0E4 cp/ml)with 31 cases,group B(≥1.0E4 cp/ml＜1.0E5 cp/ml)with 36 cases,group C(≥1.0E5 cp/ml)with 51 cases according to viral load.Another 120 patients with simple pulmonary tu-berculosis were selected as control group.The characteristics of epidemic cases,imaging CT features and levels of Th1/Th2 related cytokines[including interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interferon γ(IFN-γ),IL-4,IL-6 and IL-10]were compared between the study group and the control group,and the relationship be-tween viral load and atypical CT manifestations of tuberculosis were analyzed.RESULTS There were significant differences in educational level,occupational status,intravenous drug use history and baseline CD4 values between the two groups(P＜0.05).The study group showed higher rates of CT manifestations such as multiple pulmona-ry fields and segments exudation,extrapulmonary tuberculosis,multiple cavities,intrathoracic lymph node en-largement,multiple nodules,and diffuse miliary shadow than the control group,conversely,the frequencies of single cavity,calcification and speckle shadow in the study group were lower than those in the control group(P＜0.05).Compared with the control group,the levels of IL-2,TNF-α and IFN-γ in the study group were low,while the levels of IL-4,IL-6 and IL-10 were high(P＜0.05).With the increase of viral load,the rates of atypical CT tuberculosis were also increased(P＜0.05).CONCLUSION The CT imaging findings in patients with tuberculosis combined with HIV infection are atypical and Th1/Th2 related cytokines are abnormal,and the chest CT manifes-tations are associated with high viral load.

Objective:To determine whether postoperative concurrent chemoradiotherapy (CCRT) improves the survival outcomes of cervical cancer patients with pelvic and/or para-aortic lymph node metastasis after radical surgery.Methods:Clinical data of 188 cervical cancer patients presenting with pelvic and/or para-aortic lymph node metastasis after radical surgery between February 2008 and November 2011 were retrospectively analyzed. The incidence of pelvic and/or para-aortic lymph node metastasis was confirmed by postoperative pathology. The clinical efficacy of CCRT was evaluated.Results:Recurrence/metastasis occurred in 46 patients. In the radiotherapy alone group, 4(57.1%) patients had recurrence/metastasis in the posterior peritoneum subgroup, 5(55.6%) in the iliac subgroup and 11(28.2%) in the pelvic non-iliac subgroup, respectively. In the CCRT group, there were 5(62.5%) cases of recurrence/metastasis in the posterior peritoneum subgroup, 5(25%) in the iliac subgroup and 16(15.2%) in the pelvic non-iliac subgroup, respectively. Compared with the radiotherapy alone, CCRT could significantly improve the 5-year overall survival (OS) rate of patients with pelvic without iliac lymph node metastasis or iliac lymph node metastasis (pelvic without iliac: 88.6% vs.76.9%, P=0.003; iliac: 80.0% vs.44.4%, P=0.041), whereas failed to improve the 5-year OS of patients with para-aortic lymph node metastasis (50.0% vs.42.9%, P=0.973). The location of lymph node metastasis and CCRT were the independent prognostic factors for OS (para-aortic vs. pelvic without iliac: hazard ratio[HR]=4.259, 95% CI=1.700-10.671, P=0.002; iliac vs. pelvic without iliac: HR=2.985, 95% CI=1.290-6.907, P=0.011; concurrent chemotherapy vs. radiotherapy alone: HR=0.439, 95% CI=0.218-0.885, P=0.021). Conclusions:CCRT can improve the survival of patients with pelvic lymph node metastasis, but it fails to enhance the survival rate of patients with para-aortic lymph node metastasis.

Objective To investigate whether mild hypothermia can promote neurogenesis in the dentate gyrus of hippocampus and cognitive function recovery after traumatic brain injury ( TBI) through inhibiting apoptosis of hippocampal neurons. Methods A total of 66 healthy adult Sprague-Dawley rats were randomly divided into sham group, TBI group and TBI+hypothermia group, with 22 rats in each group. The rat TBI model was established using the fluid percussion device. The rats in TBI +hypothermia group received 4-hour hypothermia therapy immediately after injury, with the target temperature of 33. 5℃. Bromodeoxyuridine (BrdU) was injected into the rats' abdominal cavity to label the mitotic cells. The test of Morris water maze was used to evaluate the rats' spatial learning and memory capabilities. Immunofluorescence staining was used to observe the expression levels of BrdU, doublecortin (DCX), neuron specific nuclear protein (NeuN), cysteinyl aspartate specific proteinase 3 (caspase-3) and cleaved caspase-3 expressions in dentate gyrus of hippocampus at 7 days and 28 days after injury. Expressions apoptosis-related proteins including the factor associated suicide ( FAS )/factor associated suicide ligand (FASL), B-cell lymphoma-2 (Bcl-2), caspase-3 and cleaved caspase-3 expressions were detected by Western blot assay. Results The water maze tests at 28 days after injury showed that compared with TBI group, the escape latency in TBI+hypothermia group was significantly shorter [(24. 2 ± 5. 9)s:(18 ± 4. 1)s], and both the time in the target quadrant and the number of platform crossing were increasedsignificantly[(24.9±6.5)s:(31.7±5.2)s; (1.9±0.8) times:(3.5±1.2)times](P<0. 05). Compared with the sham group, in TBI group and TBI+hypothermia group, the BrdU+ new-born cells in the dentate gyrus of hippocampus were significantly increased at 7 days after injury [(9. 4 ± 4. 1):(33. 4 ± 3. 8);(9. 4 ± 4. 1):(45. 8 ± 5. 6)], the BrdU+ /DCX+ new-born neurons were increased at 7 days after injury [(2. 0 ± 0. 6):(9. 6 ± 1. 6);(2. 0 ± 0. 6):(19. 2 ± 3. 7)], and the BrdU+ /NeuN+mature neurons were increased at 28 days after injury [(2. 6 ± 1. 0) :(17. 2 ± 3. 9); (2. 6 ± 1. 0) :(33. 6 ± 9. 1)] (P<0. 01). TBI group showed more obvious increase than the TBI+hypothermia group (P<0. 01). Moreover, compared with 7 days after injury, the number of BrdU+ cells at 28 days after injury was further increased in TBI +hypothermia group but decreased in TBI group [(45. 8 ± 5. 6) :(58. 8 ± 9. 2);(33. 4 ± 3. 8):(22. 0 ± 3. 5)](P<0. 05 or <0. 01). Compared with the sham group, the caspase-3 +NeuN+ and caspase-3 +NeuN+ apoptotic neurons were significantly increased at 7 days after injury in TBI group [(2. 0 ± 0. 9):(11. 6 ± 2. 6); (2. 6 ± 1. 0):(10. 2 ± 2. 9)] (P<0. 05). Compared with the TBI group, the cleaved caspase-3 +NeuN+ apoptotic neurons were decreased in TBI+hypothermia group [(6. 6 ± 2. 0):(11. 6 ± 2. 6)](P<0. 05). Furthermore, compared with the TBI group, mild hypothermia might down-regulate the expression of FAS, FASL, cleaved caspase-3 and caspase-3 and up-regulate the expression of Bcl-2 in the hippocampus [(1. 54 ± 0. 15) :(1. 14 ± 0. 12);(1. 06 ± 0. 04):(0. 80 ± 0. 09); (0. 84 ± 0. 03):(0. 62 ± 0. 08); (0. 93 ± 0. 06):(0. 86 ± 0. 09);(0. 71 ± 0. 01):(1. 58 ± 0. 18)](P<0. 05). Conclusions Mild hypothermia might inhibit apoptosis of hippocampal neurons through cleaved caspase-3, FAS/FASL and Bcl-2 pathways, thus improving the neurogenesis and maturation of neurons in the dentate gyrus of hippocampus and facilitating cognitive function recovery in rats. It indicates that the function of hypothermia in anti-apoptosis and neurogenesis and maturity of hippocampal neurons may have a potential role in predicting the prognosis of TBI patients.

Objective To compare the diagnostic accuracy between neutrophil CD64 and C-reactive protein (CRP) as a single test for the early detection of neonatal sepsis. Methods A total of 36 patients who were hospitalized in neonatal intensive care unit (NICU) in our hospital were divided into documented sepsis group(n=10), clinical sepsis group (n=14) and control newborns (n=12). CRP, neutrophil CD64, complete blood counts and blood culture were detected at the time of the suspected sepsis for the documented or clinical group. CD64 was measured by automatic flow cytometry. The di-agnostic value of CRP and CD64 was assessed by receiver operating characteristic (ROC) curve analysis. Results CD64 was significantly elevated in the groups with documented or clinical sepsis, whereas CRP was not significantly increased compared with controls. For documented sepsis group, CD64 and CRP had a sensitivity of 92% and11%, a specificity of 83% and 80%, a positive predictive value of 83% and 34% and a negative predictive value of 91% and 50%, respectively, with a cutoff value of 3.2 mg/dL for CD64 and 1.1 mg/dL for CRP. Conclusion The diagnostic ac-curacy of CD64 is superior to CRP when measured at the time of suspected sepsis, which implies that CD64 is a more reliable marker for the early identification of neonatal sepsis as a single determination compared with CRP.