Objective To analyze the relationships of serum microRNA(miR)-15,miR-16,miR-17-5p,and triglyceride-glucose index(TyG)with severity and prognosis of acute ischemic stroke(AIS).Methods A total of 136 AIS patients admitted to the Shijiazhuang Hospital of Traditional Chi-nese Medicine from April 2023 to April 2024 were enrolled.Prognosis and disease severity were as-sessed using modified Rankin Scale(mRS)and National Institutes of Health Stroke Scale(NIHSS),respectively.Based on mRS scores at 3 months post-onset,patients were divided into poor prognosis group(mRS Score＞2,n=42)and good prognosis group(mRS Score ≤ 2,n=94).Serum levels of miR-15,miR-16,miR-17-5p,TyG,and NIHSS scores were compared between two groups.Pearson correlation analysis was used to evaluate associations of these biomarkers with NIHSS scores.Logistic regression was used to identify risk factors for poor prognosis,while receiver operating characteristic(ROC)curves was applied to assess the predictive value of individual and combined biomarkers.Results The poor prognosis group exhibited significantly higher serum miR-15,miR-16,miR-17-5p,TyG,and NIHSS scores than the good prognosis group(t=8.634,13.171,29.018,2.687,26.432;P＜0.05).Positive correlations were observed between these biomarkers and NIHSS scores(r=0.472,0.449,0.492,0.437;P＜0.05).Logistic regression identified miR-15[OR(95％CI):3.526(2.628 to 5.859)],miR-16[1.976(1.226 to 3.017)],miR-17-5p[1.828(1.294 to 3.428)],NIHSS score[1.787(1.105 to 2.896)],TyG[1.886(1.233 to 3.284)],and homo-cysteine[1.906(1.252 to 3.794)]as independent risk factors for poor prognosis(P＜0.05).ROC analysis demonstrated that the combined model(miR-15,miR-16,miR-17-5p,TyG,and NIHSS)achieved superior predictive performance(AUC=0.877;95％CI,0.820 to 0.948)com-pared to individual biomarkers(Z＞2.527,P＜0.05).Conclusion Elevated serum miR-15,miR-16,miR-17-5p,and TyG are closely associated with AIS severity and poor prognosis.The above indicators combined with NIHSS scores can enhance predictive accuracy for unfavorable outcomes.

Objective To explore the risk factors of cognitive dysfunction in patients with sepsis and constructing a predictive model.Methods A total of 102 patients treated in the Department of this hospital from April 2021 to April 2024 were selected as the research subjects.According to the scores of the Mini-Men-tal State Examination(MMSE)three months after discharge,the patients were divided into the cognitive im-pairment group and the non-cognitive impairment group.Demographic data,critical illness-related scores and laboratory indicators of the patients were collected.Univariate analysis and multivariate logistic regression were used to analyze the risk factors for cognitive impairment in patients with sepsis.A nomogram model was constructed and its performance was verified through internal data.Results According to the MMSE scores,there were 60 patients were divided into the cognitive impairment group and 42 patients into the non-cognitive impairment group.The results of logistic regression analysis showed that age,educational level,the time of hospital stay,total hospitalization cost,chronic diseases,APACHEⅡ score,SOFA score,WBC,use of vasoac-tive drugs,indwelling urinary catheter,opening of artificial airway,medical devices,and clinical conditions were influencing factors for the occurrence of cognitive impairment(P＜0.05).The area under the receiver operating characteristic curve of the nomogram model for predicting the occurrence of cognitive dysfunction was 0.883.The predicted probability of the occurrence of cognitive impairment was highly similar to the actu-al situation,indicating that the predictive model had good discrimination and accuracy.Conclusion The nomo-gram risk model can predict the incidence of cognitive impairment in sepsis patients relatively well,which is beneficial to the early identification,early evaluation,early intervention and treatment of high-risk groups.

Purpose To explore the pathological characteristics,diagnosis,and differential diagnosis of pure ery-throid leukemia(PEL).Methods A retrospective analysis was conducted on the clinicopathological data of 12 cases of PEL.Immunohistochemical EnVision method and flow cytometry were used to detect PEL-related immune markers,and heat-treated Giemsa R-banding technique was applied to analyze the chromosomal karyotype.Results Peripheral blood and bone marrow smears revealed that 2 out of 7 cases showed presence of proerythroblast in peripheral blood,and 7 out of 12 cases showed atypical proerythroblast in bone marrow samples.After recounting,the average percentage of proerythroblast in the 12 PEL cases was 36.8％(ranging from 2％to 69.5％),with an average of 53.2％of all er-ythroid cells(ranging from 5％to 88％).Among them,9 cases did not meet the diagnostic criteria for PEL.Bone marrow biopsy:11 cases showed hypercellularity,with tumor cells showing diffuse proliferation in 9 cases,accompa-nied by dysplasia of megakaryocytes in 7 cases,and there was increased proliferation of fibrous tissue in 9 cases.Im-munohistochemistry:12 cases exhibited strong staining intensity for CD71 and E-cadherin.11 cases expressed CD117,while 4 cases expressed CD34,3 cases exhibited slight expression of GPA,and 1 case weakly expressed CD61.Flow cytometry:in 8 cases,there was an increased proportion of early-stage erythroid cells,accounting for 3.1％to 80.31％of nucleated cells,with an average of 31.0％.All cases expressed CD117 and CD71 to varying degrees,with 7 out of 8 cases expressing CD36,5 out of 7 cases expressing CD105,and 3 out of 4 cases expressing GPA.A few ca-ses demonstrated aberrant expression of CD123 and CD7.Chromosomal Karyotyping:7 cases exhibited highly complex karyotypes(7/8),with frequent involvement of chromosomes 5,7,8,17,and 19.One case had a normal karyotype.Conclusion The diagnosis of PEL requires a comprehensive assessment combining various methods including bone marrow smears,bone marrow biopsy,immunohistochemistry,and flow cytometry.

Obstructive sleep apnea(OSA)is a common sleep disorder characterized by repeated episodes of upper airway collapse and obstruction during sleep.Polysomnography is the gold standard for diagnosing OSA,but it is expensive,time-consuming,and can cause discomfort for patients.In recent years,acoustic-based approaches for detecting OSA have emerged as a research focus.This review summarizes recent advances in OSA automatic detection techniques based on snoring and speech signals,and systematically examines their applications in diagnosis,severity assessment,and localization of obstruction sites.Findings indicate that the acoustic features of snoring and speech signals hold significant value for OSA screening,and when combined with machine learning and deep learning models,it can achieve high diagnostic accuracy.Future research should focus on elucidating the relationship between acoustic features and the pathophysiological mechanisms of OSA,integrating multimodal information,and advancing the clinical application of wearable devices,with the aim of promoting intelligent,non-invasive,and cost-effective screening technologies for OSA.

Objective:To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PTLIF) on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods:A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method: 42 cases in the control group were treated with traditional open posterior lumbar interbody fusion (PLIF), and 42 cases in the observation group were treated with midline approach MIS-PTLIF. Perioperative related indicators, Visual Analogue Scale (VAS) scores, creatine phosphokinase (CPK) levels, Oswestry Disability Index (ODI) scores at different time points, and the incidence of postoperative complications were compared between the two groups.Results:The observation group was superior to the control group in operation time, incision length, intraoperative blood loss, time to get out of bed, and hospital stay (all P<0.05). There were no significant differences in preoperative VAS and ODI scores between the two groups (all P>0.05). At 1 week and 3 months after surgery, the VAS and ODI scores of both groups were significantly lower than those before surgery (all P<0.05). The VAS and ODI scores of the observation group at 1 week after surgery were significantly lower than those of the control group (all P<0.05). There was no significant difference in serum CPK level between the two groups 1 day before surgery ( P>0.05). The serum CPK levels of the observation group on the 1st, 3rd, and 5th days after surgery were significantly lower than those of the control group (all P<0.05). The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery ( P>0.05), while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery ( P<0.05). There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups (all P>0.05). Conclusions:MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases, which can effectively relieve postoperative pain, help the recovery of lumbar function, and its safety and fusion rate are comparable to traditional PLIF, which is worthy of clinical promotion.

Obstructive sleep apnea(OSA)is a common sleep disorder characterized by repeated episodes of upper airway collapse and obstruction during sleep.Polysomnography is the gold standard for diagnosing OSA,but it is expensive,time-consuming,and can cause discomfort for patients.In recent years,acoustic-based approaches for detecting OSA have emerged as a research focus.This review summarizes recent advances in OSA automatic detection techniques based on snoring and speech signals,and systematically examines their applications in diagnosis,severity assessment,and localization of obstruction sites.Findings indicate that the acoustic features of snoring and speech signals hold significant value for OSA screening,and when combined with machine learning and deep learning models,it can achieve high diagnostic accuracy.Future research should focus on elucidating the relationship between acoustic features and the pathophysiological mechanisms of OSA,integrating multimodal information,and advancing the clinical application of wearable devices,with the aim of promoting intelligent,non-invasive,and cost-effective screening technologies for OSA.

Purpose To explore the pathological characteristics,diagnosis,and differential diagnosis of pure ery-throid leukemia(PEL).Methods A retrospective analysis was conducted on the clinicopathological data of 12 cases of PEL.Immunohistochemical EnVision method and flow cytometry were used to detect PEL-related immune markers,and heat-treated Giemsa R-banding technique was applied to analyze the chromosomal karyotype.Results Peripheral blood and bone marrow smears revealed that 2 out of 7 cases showed presence of proerythroblast in peripheral blood,and 7 out of 12 cases showed atypical proerythroblast in bone marrow samples.After recounting,the average percentage of proerythroblast in the 12 PEL cases was 36.8％(ranging from 2％to 69.5％),with an average of 53.2％of all er-ythroid cells(ranging from 5％to 88％).Among them,9 cases did not meet the diagnostic criteria for PEL.Bone marrow biopsy:11 cases showed hypercellularity,with tumor cells showing diffuse proliferation in 9 cases,accompa-nied by dysplasia of megakaryocytes in 7 cases,and there was increased proliferation of fibrous tissue in 9 cases.Im-munohistochemistry:12 cases exhibited strong staining intensity for CD71 and E-cadherin.11 cases expressed CD117,while 4 cases expressed CD34,3 cases exhibited slight expression of GPA,and 1 case weakly expressed CD61.Flow cytometry:in 8 cases,there was an increased proportion of early-stage erythroid cells,accounting for 3.1％to 80.31％of nucleated cells,with an average of 31.0％.All cases expressed CD117 and CD71 to varying degrees,with 7 out of 8 cases expressing CD36,5 out of 7 cases expressing CD105,and 3 out of 4 cases expressing GPA.A few ca-ses demonstrated aberrant expression of CD123 and CD7.Chromosomal Karyotyping:7 cases exhibited highly complex karyotypes(7/8),with frequent involvement of chromosomes 5,7,8,17,and 19.One case had a normal karyotype.Conclusion The diagnosis of PEL requires a comprehensive assessment combining various methods including bone marrow smears,bone marrow biopsy,immunohistochemistry,and flow cytometry.

Objective:To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PTLIF) on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods:A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method: 42 cases in the control group were treated with traditional open posterior lumbar interbody fusion (PLIF), and 42 cases in the observation group were treated with midline approach MIS-PTLIF. Perioperative related indicators, Visual Analogue Scale (VAS) scores, creatine phosphokinase (CPK) levels, Oswestry Disability Index (ODI) scores at different time points, and the incidence of postoperative complications were compared between the two groups.Results:The observation group was superior to the control group in operation time, incision length, intraoperative blood loss, time to get out of bed, and hospital stay (all P<0.05). There were no significant differences in preoperative VAS and ODI scores between the two groups (all P>0.05). At 1 week and 3 months after surgery, the VAS and ODI scores of both groups were significantly lower than those before surgery (all P<0.05). The VAS and ODI scores of the observation group at 1 week after surgery were significantly lower than those of the control group (all P<0.05). There was no significant difference in serum CPK level between the two groups 1 day before surgery ( P>0.05). The serum CPK levels of the observation group on the 1st, 3rd, and 5th days after surgery were significantly lower than those of the control group (all P<0.05). The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery ( P>0.05), while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery ( P<0.05). There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups (all P>0.05). Conclusions:MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases, which can effectively relieve postoperative pain, help the recovery of lumbar function, and its safety and fusion rate are comparable to traditional PLIF, which is worthy of clinical promotion.

Purpose To explore the pathological features of angioimmunoblastic T-cell lymphoma(AITL)with bone marrow involvement and to improve awareness of bone marrow infiltration in AITL.Methods The tissue morphology of 32 cases of AITL with bone marrow involvement was retrospectively analyzed.Im-munohistochemistry using the EnVision method and ten-color flow cytometry were conducted to detect AITL-related immune markers.T cell clonality was analyzed through T cell receptor(TCR)gene rearrangement.Results The predominant pat-terns of tumor cell infiltration were nodular(20/32,62.5％)and interstitial or small clusters(10/32,31.3％).The nodules showed a mixture of cellular components.In some cases,the fo-ci contained a mixture of cells with characteristic"granuloma-toid"changes.The tumor cells were mainly small to medium-sized lymphocytes with inconspicuous atypia.Some cases showed plasma cell proliferation.19 cases were subject to immunohisto-chemical staining,which revealed a low count of CD4-positive T cells,with an average of 8.4％.The positive rates of T follic-ular helper cells(TFH)markers were as follows:CD10(7/14,50.0％),BCL6(6/19,31.6％),PD-1(13/19,68.4％),and CXCL13(13/19,68.4％).In most cases,tumor cells showed co-expression of PD-1 and CXCL13,but the number of positive cells was less than 1％.Flow cytometry analysis was performed in 24 cases,among which 22 cases all consistently expressed cytoplasmic CD3(cCD3),CD5,CD4,and CD2,with varying degrees of CD10 expression.In some cases,there was a lack of expression of surface CD3(sCD3)(12/22,54.5％),while there was a lack of expression of CD7(8/22,36.4％).and no abnormal T cells were found in 2 cases.TCR gene rearrangement analysis was performed in 7 cases,with 3 cases showing TCR clonality.Conclusion AITL with bone marrow involvement exhibits a lower proportion of tumor cells and less atypia,making it prone to misdiagnosis.The presence of lymphocytic foci with mixed cellular components in the bone marrow can indicate bone marrow involvement in AITL.Flow cy-tometry detection of abnormal T cells(double positive for CD4 and CD10)strongly suggests bone marrow infiltration in AITL.A comprehensive diagnosis of bone marrow involvement in AITL re-quires consideration of bone marrow biopsy,flow cytometry,and TCR gene rearrangement analysis.

The latest research findings on bidirectional regulation of neuro-immunity through traditional neural circuits shed new light on the theoretical basis of the role of vidian neurectomy (VN). This article aims to provide a comprehensive understanding of VN, including the history of VN, the principle of neuroimmuno-interaction, the applied anatomy of VN as well as the methods of transnasal endoscopic surgery. Additionally, we introduce the concept of the nose-brain axis, which was proposed based on the advancement in the area of neuro-immune interactions.