Objective:To observe the relationship between preoperative controlling nutritional status(CONUT)score and cognitive impairment,as well as short-term prognosis after intravenous thrombolysis(IVT)in patients with acute ischemic stroke(AIS).Methods:187 patients with AIS who were admitted to Shandong Provincial Third Hospital from January 2023 to May 2024 were selected,they were divided into non cognitive impairment group(n=106)and cognitive impairment group(n=81)based on whether cognitive impairment occurred,they were divided into poor prognosis group(n=58 cases)and good prognosis group(n=129 cases)according to the prognosis.Preoperative CONUT scores of patients with AIS for different cognitive impairments and prognoses were compared,correlation was analyzed by Spearman rank correlation,influencing factors were analyzed by multivariate logistic regression model.Results:Preoperative CONUT score in the cognitive impairment group was higher than that in the non cognitive impairment group(P＜0.05).Preoperative CONUT score in the poor prognosis group was higher than that in the good prognosis group(P＜0.05).Spearman rank correlation test results showed that,preoperative CONUT score was positively correlated with cognitive impairment and short-term prognosis after IVT(P＜0.05).Cognitive impairment were associated with age,concomitant hypertension,baseline national institutes of health stroke scale(NIHSS)score,and 25 hydroxyvitamin D3[25-(OH)2D3](P＜0.05).Age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase were risk factors for cognitive impairment in patients with AIS(P＜0.05).Conclusion:Preoperative CONUT score increase is positively correlated with cognitive impairment and short-term prognosis after IVT.Meanwhile,age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase are risk factors for cognitive impairment in patient with AIS.

Objective:To analyze the drug resistance status and related risk factors in elderly patients with pulmonary tuberculosis,and to construct and validate a drug resistance risk prediction model for elderly pulmonary tuberculosis patients,providing evidence for early clinical identification of high-risk populations.Methods:A retrospective study was conducted,consecutively enrolling 315 pulmonary tuberculosis patients aged ≥60 years from January 2019 to December 2021.Based on drug susceptibility test results,patients were divided into drug-resistant group(85 cases)and drug-sensitive group(230 cases).Data on demographic characteristics,clinical manifestations,comorbidities,imaging features,and previous treatment history were collected.Univariate and multivariate logistic regression analyses were performed to identify drug resistance-related factors,and a prediction model was constructed accordingly.The model was internally validated using the concordance index(C-index)and Bootstrap method.Results:Among 315 elderly pulmonary tuberculosis patients,the drug resistance rate was 26.98％,predominantly mono-resistance(48.24％)and multidrug-resistance(28.24％).Multivariate logistic regression analysis showed that previous anti-tuberculosis treatment history[OR=4.537,95％CI(1.962-10.498),P=0.005],diabetes mellitus[OR=3.286,95％CI(1.547-6.979),P=0.002],pulmonary cavitation[OR=4.158,95％CI(1.926-8.973),P＜0.001],pleural effusion[OR=2.563,95％CI(1.218-5.390),P=0.013],and tracheobronchial tuberculosis[OR=2.819,95％CI(1.352-5.876),P=0.006]were independent risk factors for drug resistance in elderly pulmonary tuberculosis.The prediction model constructed based on these factors had a C-index of 0.815(95％CI:0.762-0.868).Conclusion:The drug resistance rate is high among elderly pulmonary tuberculosis patients.Previous anti-tuberculosis treatment history,diabetes mellitus,pulmonary cavitation,pleural effusion,and tracheobronchial tuberculosis are independent risk factors for drug resistance in elderly pulmonary tuberculosis.The prediction model constructed based on these factors has good predictive value for identifying high-risk populations,which is helpful for early clinical intervention and individualized treatment strategy formulation.

Objective:To observe the relationship between preoperative controlling nutritional status(CONUT)score and cognitive impairment,as well as short-term prognosis after intravenous thrombolysis(IVT)in patients with acute ischemic stroke(AIS).Methods:187 patients with AIS who were admitted to Shandong Provincial Third Hospital from January 2023 to May 2024 were selected,they were divided into non cognitive impairment group(n=106)and cognitive impairment group(n=81)based on whether cognitive impairment occurred,they were divided into poor prognosis group(n=58 cases)and good prognosis group(n=129 cases)according to the prognosis.Preoperative CONUT scores of patients with AIS for different cognitive impairments and prognoses were compared,correlation was analyzed by Spearman rank correlation,influencing factors were analyzed by multivariate logistic regression model.Results:Preoperative CONUT score in the cognitive impairment group was higher than that in the non cognitive impairment group(P＜0.05).Preoperative CONUT score in the poor prognosis group was higher than that in the good prognosis group(P＜0.05).Spearman rank correlation test results showed that,preoperative CONUT score was positively correlated with cognitive impairment and short-term prognosis after IVT(P＜0.05).Cognitive impairment were associated with age,concomitant hypertension,baseline national institutes of health stroke scale(NIHSS)score,and 25 hydroxyvitamin D3[25-(OH)2D3](P＜0.05).Age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase were risk factors for cognitive impairment in patients with AIS(P＜0.05).Conclusion:Preoperative CONUT score increase is positively correlated with cognitive impairment and short-term prognosis after IVT.Meanwhile,age increase,concomitant hypertension,baseline NIHSS score increase,25-(OH)2D3 decrease,preoperative CONUT score increase are risk factors for cognitive impairment in patient with AIS.

Aging is comprehensively influenced by multiple fac-tors such as internal genes,cellular metabolism,external envi-ronment,and lifestyle habits.Among them,epigenetic regula-tion plays a core role.Epigenetic modifications,including DNA methylation,histone modification,heterochromatin remodeling,and non-coding RNA regulation,act in concert with the three-di-mensional genome architecture to precisely regulate gene expres-sion.This review elaborates on the factors influencing epigenetic regulation,as well as the mechanisms of how epigenetics affects the occurrence of organismal aging and the corresponding inter-vention strategies,providing relevant insights for uncovering the mechanisms of aging and preventing/treating aging-related disea-ses.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Aim To investigate the protective effects of resveratrol(RSV)on hypoxia/reoxygenation(H/R)-induced apoptosis in H9c2 cardiomyocytes and the un-derlying mechanisms.Methods A model of H/R was established in H9c2 cardiomyocytes.Cell apoptosis was determined by flow cytometry.The expressions of Bax,Bcl-2,cleaved caspase-3 and JAK2/STAT3 signa-ling pathway proteins were detected by Western blot.The inhibitor of JAK2,AG490,was used to assess the effect of RSV on H/R-induced apoptosis in H9c2 car-diomyocytes after inhibiting JAK2/STAT3 signaling pathway.Results RSV could effectively inhibit H/R-provoked cell apoptosis in H9c2 cardiomyocytes and increase the expression of p-JAK2 and p-STAT3.After AG490 intervention,the anti-apoptotic effect of RSV on H9c2 cardiomyocytes caused by H/R was significantly counteracted.Conclusions RSV can inhibit H/R-in-duced apoptosis in H9c2 cardiomyocytes through the activation of JAK2/STAT3 signaling pathway.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Objective To investigate the effect of LINC00839 on the malignant biological behavior of endometrial cancer cells by regulating the miR-625-5p/cytoplasmic polyadenylation element binding protein 4 (CPEB4) axis. Methods The cancer tissues and adjacent tissues of 46 patients with endometrial cancer were obtained,endometrial cancer cells of HEC-1B,Ishikawa and RL95-2 and human endometrial epithelial cells (HEEC) were cultured in vitro,and the expression levels of LINC00839,miR-625-5p and CPEB4 in tissues and cells were detected. HEC-1B cells were divided into the HEC-1B group (conventional culture),sh-Ctrl group (transfected with sh-Ctrl),sh-LINC00839 group (transfected with shRNA-LINC00839),anti-miR-625-5p group (transfected with shRNA-LINC00839 and miR-625-5p inhibitor),and anti-NC group (transfected with shRNA-LINC00839 and inhibitor-NC). The proliferation,apoptosis,migration and invasion abilities of HEC-1B cells in each group were compared,and the expressions of CPEB4 and epithelial-mesenchymal transition (EMT) related proteins were determined. The targeting relationships between LINC00839 and miR-625-5p,and miR-625-5p and CPEB4 were analyzed. Results The mRNA expression of LINC00839 and CPEB4,as well as the positive expression rate of CPEB4 protein in endometrial cancer tissues were higher than those in adjacent tissues,and the expression of miR-625-5p was lower than that in adjacent tissues (P<0.05). Compared with HEEC cells,the expression of LINC00839 and the mRNA and protein expression of CPEB4 in Ishikawa,RL95-2 and HEC-1B cells increased (P<0.05),and the expression of miR-625-5p decreased (P<0.05). Compared with the sh-LINC00839 group and anti-NC group,the protein expression of N-cadherin,Vimentin,and CPEB4,24-hour absorbance,and migration and invasion cell numbers of HEC-1B cells in the HEC-1B group,sh-Ctrl group and anti-miR-625-5p group increased (P<0.05),while the expression of E-cadherin protein and cell apoptosis rate decreased (P<0.05). There were binding sites between LINC00839 and miR-625-5p,miR-625-5p and CPEB4,with targeting regulatory relationships. Conclusion LINC00839 is related to the malignant biological behavior of endometrial cancer cells,interference with LINC00839 expression can inhibit the proliferation,invasion and migration,and promote apoptosis of HEC-1B cells,and its mechanism may be achieved by regulating the miR-625-5p/CPEB4 axis.

Abnormal expression of CMTM4 protein is closely related to tumour occurrence,development and prognosis.Although the important role of CMTM4 in tumours has been gradually manifested,its spe-cific mechanism of action in cervical cancer remains unclear.The aim of this study was to investigate the relationship between CMTM4 expression and clinicopathological features in cervical cancer and study its mechanism.Immunohistochemistry and Western blot were used to detect the expression level of CMTM4 in cancer tissues and paracancerous tissues,and it was found that CMTM4 was significantly under-ex-pressed in cervical cancer tissues(P＜0.001).The chi-square test analysed the relationship between high and low CMTM4 expression and the clinical and pathological characteristics of cervical cancer pa-tients and results found that CMTM4 expression was correlated with the number of births,HPV infection status,pathological type,FIGO stage and lymph node metastasis.Data from Western blot and RT-qPCR found that CMTM4 protein and mRNA levels in HaCaT cells were significantly higher than that of C-33A cells,HeLa cells,U14 cells,and HT-3 cells.Among them,the most significant change in CMTM4 ex-pression was observed in C-33A cells,so the C-33A cell line was selected for subsequent overexpression experiments.CCK-8 analysis found that the proliferation ability of C-33A cervical cancer cells in the pcDNA-CMTM4 group was significantly lower than that in the pcDNA-NC group(P＜0.001).Flow cy-tometry and Western blot results indicated that CMTM4 overexpression promoted apoptosis(P＜0.001),significantly increased Bax(P＜0.001)and cleaved caspase 3(P＜0.05)protein levels,and significant-ly decreased Bcl-2 protein level(P＜0.01).Western blot results further found that CMTM4 overexpres-sion significantly reduced the protein levels of p-PI3K(P＜0.001)and p-AKT(P＜0.01),but did not affect the protein levels of PI3K and AKT(P＞0.05).The above findings indicated that CMTM4 gene expression was down-regulated in cervical cancer,and CMTM4 overexpression inhibited cervical cancer cell proliferation and induced apoptosis by inhibiting the PI3K/AKT pathway.Therefore,CMTM4 may be used as a biological marker for screening cervical cancer.

Objective:To explore the characteristics of peripheral retinal defocus distribution in adult myopia and its relationship with refractive error.Methods:A cross-sectional study was conducted.A total of 270 myopic patients aged 18 to 46 years were enrolled at Tianjin Eye Hospital from January to March 2024.Data from the right eye were included in the analysis.Spherical power and cylindrical power were obtained using an autorefractor and the spherical equivalent (SE) was calculated.Corneal curvature parameters including flap keratometry (K1), steep keratometry (K2), and average keratometry (Km) were measured using the Pentacam anterior segment imaging analyzer.Central corneal thickness (CCT) and axial length (AL) were measured using the IOLMaster optical biometer.Peripheral defocus within a 53° area centered on the fovea was assessed using multispectral refractive topography.Based on the peripheral defocus data, the distribution patterns were classified into four types: hemilateral upturn type, saddle type, crater type, and relatively flat type.Characteristics of different tpes and their correlation with diopter were analyzed.This study followed the Declaration of Helsinki.The study protocol was reviewed and approved by the Medical Ethics Committee of Tianjin Eye Hospital (No.KY-2024020).All participants voluntarily participated and signed the informed consent form.Results:Of the different types of peripheral retinal defocus, 186 eyes (68.63%) were hemilateral upturn type, 45 eyes (16.61%) were crater type, 36 eyes (13.28%) were relatively flat type, and 3 eyes (1.11%) were saddle type.The crater type exhibited the lowest mean SE of (-6.18±1.50)D, while the relatively flat type showed the highest mean SE of (-3.88±0.87)D.There were significant differences in SE and AL among different peripheral defocus types ( F=15.469, 17.928, 3.431; all P<0.05).The hemilateral upturn type had significantly lower SE and spherical diopter than the relatively flat type, and crater type had significantly lower SE and spherical diopter compared to the hemilateral upturn type and relatively flat type significantly, and the hemilateral upturn type had longer AL than the relatively flat type (all P<0.05).There was no statistically significant difference in CCT, K1, K2, or Km among different peripheral defocus types ( F=0.861, 1.761, 2.603, 2.248; all P>0.05).Spherical power was weakly negatively correlated with superior, inferior, and temporal peripheral defocus ( r=-0.269, P<0.001; r=-0.176, P<0.01; r=-0.292, P<0.001).Age was positively correlated with superior and temporal peripheral defocus ( rs=0.213, P<0.001; rs=0.181, P=0.003), and negatively correlated with nasal peripheral defocus ( rs=-0.138, P=0.023). Conclusions:Among adult peripheral defocus patterns, the hemilateral upturn type is predominant.The crater type has the lowest mean spherical equivalent, while the relatively flat type has the highest.There are negative correlations between spherical power and the superior, inferior, and temporal peripheral defocus.