OBJECTIVE To compare the efficacy and safety of evolocumab and probucol in patients with ultra-high-risk atherosclerotic cardiovascular disease （ASCVD） following percutaneous coronary intervention （PCI）. METHODS A retrospective analysis was conducted on 156 ultra-high-risk ASCVD patients who underwent PCI in our institution between January 1， 2023 and December 31， 2024. According to the lipid-lowering regimen， the patients were categorized into evolocumab group （ n ＝86） and probucol group （ n ＝70）. Changes in lipid parameters [total cholesterol （TC）， low-density lipoprot ein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， triglycerides， lipoprotein （a）， and lipid goal achievement rate ] ， inflammatory markers [interleukin-6 （IL-6） and C-reactive protein （CRP） ] ， and cardiac function indices （left ventricular ejection fraction， left ventricular end-systolic diameter， left ventricular end-diastolic diameter， and N-terminal pro-B-type natriuretic peptide） were compared between two groups at baseline and after 6 months of treatment. The incidence of adverse clinical events during treatment， including acute myocardial infarction， in-stent restenosis， acute heart failure， cerebral hemorrhage， and stroke， was also evaluated. RESULTS No statistically significant differences were observed between the two groups at baseline （ P ＞0.05）. After 6 months of treatment， both groups demonstrated significant improvements in lipid profiles （except HDL-C） and inflammatory markers compared to those at baseline （ P ＜0.05）. The evolocumab group exhibited greater reductions in TC， LDL-C， IL-6， and CRP， along with a higher lipid target achievement rate， compared with the probucol group （ P ＜0.05）. There were no statistically significant differences in the cardiac function-related indicators before and after treatment between the two groups， nor in the incidence of adverse events during the treatment （ P ＞0.05）. CONCLUSIONS For ultra-high-risk ASCVD patients after PCI， both of the above treatment options are associated with improvements in blood lipid and inflammatory response， with good safety during short-term follow-up. Evolocumab shows superior efficacy in TC， LDL-C and inflammatory markers reduction and lipid target achievement， compared to probucol.

The aim of the experiment was to study the effects of Echinacea purpurea extract on the digestive ability,immune function and intestinal barrier of the Bamei ternary pigs.Forty-eight healthy pigs of 50 days old were randomly divided into four groups,each with three replicates and four pigs in each replicate.The control group(CON)was fed a basal diet,and the experimental group was divided into 5 g/kg(T1),10 g/kg(T2)and 15 g/kg(T3)of Echinacea extract in the basal diet.The pre-test period was 5 days and the main test period was 35 days with free feeding and drinking during the test period.The results showed that:There was no significant effect on the apparent digestibility of nutrients and jejunum morphology in the test group compared to the CON group(P＞0.05).Amylase and trypsin activities were significantly higher in the experimental group and lipase activities were significantly higher in T2 and T3 groups compared to CON group(P＜0.05).GSH,CAT and T-AOC activities were significantly higher in the experimental group compared to CON group(P＜0.05).In comparison with CON group,the levels of IL-1 and IL-6 were significantly lower in the experimental group(P＜0.05),and the levels of TNF-α were significantly lower in the T2 and T3 groups(P＜0.05);and the levels of IL-10 were signifi-cantly higher in the T3 group(P＜0.05).The mRNA and protein expression levels of TLR4,MyD88,TRAF6,and NF-κB were significantly lower in the experimental group(P＜0.05).The mRNA and protein expression levels of CLDN-1,OCLN and ZO-1 were significantly increased in the test group(P＜0.05).The results between the test groups showed that the protein expression levels of CLDN-1 and OCLN were significantly increased in the T3 group compared with the T1 group(P＜0.05).In conclusion,the addition of Echinacea extract to the ration can,to a certain ex-tent,improve the digestive ability,balance the immune ability,and improve the intestinal barrier function of the Bamei ternary pigs,thus promoting the intestinal health of pigs.

Objective To construct the prevention strategy of emergance agitation in orthopedic surgery patients under general anesthesia,it provides reference for clinical nursing practice.Methods Through literature review and expert correspondence,strategy to prevent agitation during the awakening period in patients undergoing orthopedic general anesthesia surgery was developed.Results Two rounds of expert correspondence were conducted.The effective recovery rates of the questionnaires were 91.3％and 95.2％respectively.Expert authority coefficients were 0.940 and 0.919 respectively.Kendall harmony coefficients were 0.153 and 0.163.In the second round of expert correspondence,the average importance of indicators at all levels ranged from 4.000 to 4.944,and coefficient of variation ranged from 0.046 to 0.213.Finally,3 first-level indicators,15 second-level indicators,and 42 third-level indicators were determined.Conclusion The preventive strategy constructed in this study covers the entire perioperative process and has good scientific validity,reliability.

Objective:To evaluate value of CT perfusion in evaluating the efficacy of different vascular reconstruction methods in the treatment of adult ischemic moyamoya disease.Methods:The clinical data of 80 adult patients with moyamoya disease with ischemic blood type who received revascularization in the Affiliated Hospital of Jining Medical University from February 2019 to February 2023 were retrospectively analyzed, including 43 patients who received superficial temporal arterio-middle cerebral artery anastomosis (direct group) and 37 patients who received brain-dural arterio-artery vascularization (indirect group). The improvement of clinical symptoms, Modified Rankin Scale (mRS) Score, collateral vessels and CTP parameters were compared between the two groups.Results:The improvement of clinical symptoms in the direct group was better than that in the indirect group ( P<0.05), and the significant remission rate was significantly higher than that in the indirect group [86.0%(37/43) vs 59.5%(22/37), χ 2=7.262, P=0.007]. The postoperative mRS score in the direct group was significantly lower than that before surgery [0(0, 1) vs 1(1, 2), Z=5.550, P<0.001]. The score of mRS After surgery in the indirect group was significantly lower than that before surgery [0(0, 1) vs 1(1, 2), Z=4.281, P<0.001], but there was no statistically significant difference between the two groups ( P>0.05). There was no significant difference in digital subtraction angiography (DSA) collateral vessel formation between the two groups ( P>0.05). The CTP parameters of the two groups before and after surgery were consistent between observers and within observers [intraclass correlation coefficient (ICC) range 0.88-0.94]. In the operation area, the relative cerebral blood flow (rCBF) after surgery was significantly increased, and the relative time to peak (rTTP) and relative mean transit time (rMTT) were significantly decreased in both groups, with statistical significance ( P<0.05). In the ipsilateral basal ganglia and frontal lobe, rCBF in the direct group was significantly increased, rTTP and rMTT were significantly decreased, and the differences were statistically significant (all P<0.05), while there were no statistically significant differences in parameters in the indirect group (all P>0.05). The changes of rCBF, rTTP and rMTT in the operative area in the direct group were better than those in the indirect group, and the changes of rCBF, rTTP and rCBF in the basal ganglia and frontal lobe were better than those in the indirect group, with statistical significance (all P<0.05), while there were no statistically significant differences in the remaining parameters (all P>0.05). Conclusions:CT perfusion is of great value in evaluating the difference of clinical symptom improvement in the treatment of adult ischemic moyamoya disease with different vascular reconstruction methods.

Objective:To explore the potential lesional range of keloids by analyzing the transcriptomic characteristics, and to provide a molecular basis for understanding the recurrence of keloids following surgical excision.Methods:From July to December in 2022, 3 patients clinically diagnosed with keloids and treated with surgical excision at the Department of Dermatology and Venereology, Peking University First Hospital were included in the study. Samples of keloids and keloid-adjacent dermis were collected from these 3 patients, and normal dermal tissues adjacent to benign skin tumors were collected from 4 patients and served as controls. Dermal fibroblasts were obtained by primary cell culture and purification, which were then subsequently passaged to the second generation for transcriptome sequencing. Differential gene expression analysis, gene ontology (GO) -based functional analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed. While analyzing differential expression genes, those with a fold change (FC) > 2 and a P value < 0.05 were defined as upregulated genes, whereas those with a FC < 0.5 and a P value < 0.05 were considered downregulated genes. The accuracy of the results was further validated by comparing them with published single-cell sequencing data on keloid and keloid-adjacent tissues (HRA000425 in GSA database) and single-cell sequencing data on the normal dermis (GSE130973 in GEO database). Key genes in keloid-adjacent dermal fibroblasts were validated in tissue samples from this study and the literature. Results:Compared with keloid-derived fibroblasts, keloid-adjacent and control dermal fibroblasts shared 63 upregulated genes enriched in biological processes including lipid transport ( P = 0.038) and ion transport ( P = 0.040) ; compared with control dermal fibroblasts, keloid-adjacent and keloid-derived fibroblasts shared 56 upregulated genes enriched in the transforming growth factor β signaling pathway ( P < 0.001), etc. When comparing keloid-derived fibroblasts and keloid-adjacent fibroblasts with control dermal fibroblasts, 79 genes were uniquely upregulated only in keloid-adjacent fibroblasts; after filtering based on gene expression thresholds and consistency, 13 candidate genes (average expression level > 1 000 and variance of expression level within groups < 30 000) closely related to the transcriptomic characteristics of keloid-derived fibroblasts were identified, including genes inhibiting keloid formation such as SMAD6 and SMAD7, as well as those promoting keloid formation such as MSX1, SNAI1, and EDN1, which were enriched in the biological processes such as cell growth, ossification and cartilage development (all P < 0.01). The enrichment analysis of the above-mentioned 13 genes on the ChEA3 website identified some enriched transcription factors, such as myogenic differentiation protein 1 (MYOD1) and myogenin (MYOG) (both P < 0.05) . Conclusions:Compared with keloid-derived fibroblasts and control dermal fibroblasts, the transcriptomics of keloid-adjacent fibroblasts were characterized by high-level coexpression of genes involved in both the inhibition and promotion of keloid formation, which may provide a molecular explanation for the similarity in morphology between keloid-adjacent tissues and normal skin tissues as well as for the potential mechanisms underlying the high recurrence rate of keloids.

Objective:To investigate the current practice of nasogastric tube care and the training needs among nurses in the emergency departments of tertiary hospitals in Beijing, to provide a basis for further standardizing nasogastric tube care practices.Methods:A convenience sampling method was used to select head nurses and nurses from the emergency departments of 47 tertiary hospitals in Beijing in June 2024. A self-designed questionnaire on the current practice of nasogastric tube care and training needs was administered to the participants.Results:A total of 47 emergency departments from tertiary hospitals in Beijing were surveyed, of which only 25 departments implemented nasogastric tube techniques. In the key practices of nasogastric tube care, nine hospitals met the overall implementation standards, while 16 hospitals had substandard implementation. The key practices with poor standardization included the frequency of changing the nasogastric tube dressing, blind insertion (spiral nasogastric tube) through the pylorus, the recommended temperature for enteral nutrition liquids, and the timing for flushing the nasogastric tube. There were statistically significant differences ( P<0.05) in the presence of specialized nasogastric tube care teams and the use of case discussions or workshops for department training between hospitals with good and poor implementation. Moreover, 89.5% (496/554) of the nurses indicated a need for training related to nasogastric tube maintenance, and 91.9% (509/554) expressed willingness to participate in technical training or seminars. Statistically significant differences ( P<0.05) were found between emergency specialized nurses and non-specialized nurses in terms of preferred training frequency, duration, format, and content (sharing of the latest research and advancements) . Conclusions:Nasogastric tube techniques have not been widely implemented in the emergency departments of tertiary hospitals in Beijing. The standardization of nasogastric tube care needs further improvement, and there is a significant demand for training among emergency nurses, indicating an urgent need for specialized nasogastric tube training programs.

The aim of the experiment was to study the effects of Echinacea purpurea extract on the digestive ability,immune function and intestinal barrier of the Bamei ternary pigs.Forty-eight healthy pigs of 50 days old were randomly divided into four groups,each with three replicates and four pigs in each replicate.The control group(CON)was fed a basal diet,and the experimental group was divided into 5 g/kg(T1),10 g/kg(T2)and 15 g/kg(T3)of Echinacea extract in the basal diet.The pre-test period was 5 days and the main test period was 35 days with free feeding and drinking during the test period.The results showed that:There was no significant effect on the apparent digestibility of nutrients and jejunum morphology in the test group compared to the CON group(P＞0.05).Amylase and trypsin activities were significantly higher in the experimental group and lipase activities were significantly higher in T2 and T3 groups compared to CON group(P＜0.05).GSH,CAT and T-AOC activities were significantly higher in the experimental group compared to CON group(P＜0.05).In comparison with CON group,the levels of IL-1 and IL-6 were significantly lower in the experimental group(P＜0.05),and the levels of TNF-α were significantly lower in the T2 and T3 groups(P＜0.05);and the levels of IL-10 were signifi-cantly higher in the T3 group(P＜0.05).The mRNA and protein expression levels of TLR4,MyD88,TRAF6,and NF-κB were significantly lower in the experimental group(P＜0.05).The mRNA and protein expression levels of CLDN-1,OCLN and ZO-1 were significantly increased in the test group(P＜0.05).The results between the test groups showed that the protein expression levels of CLDN-1 and OCLN were significantly increased in the T3 group compared with the T1 group(P＜0.05).In conclusion,the addition of Echinacea extract to the ration can,to a certain ex-tent,improve the digestive ability,balance the immune ability,and improve the intestinal barrier function of the Bamei ternary pigs,thus promoting the intestinal health of pigs.

Objective Exploring the performance of a sensitivity recognition model for neoadjuvant therapy based on ensemble learning algorithms for predicting neoadjuvant therapy sensitive patients.Methods In this study,255 rectal cancer patients who underwent standard neoadjuvant therapy and surgery at the Affiliated Cancer Hospital of Harbin Medical University were collected,of which 139 patients were sensitive to neoadjuvant therapy and 116 patients were not.The recursive feature elimination method was used to screen deep learning features and imaging histology features to construct an integrated learning model.The generalization performance of the model was verified using the leave-out method,and the sensitivity,specificity,positive predictive value,negative predictive value,accuracy,G-mean,F-measure,Mathews correlation coefficient(MCC),and area under the receiver operating charactpristic curve(AUC)were used to evaluate and compare the model performance.Results The performance of the integrated model on the external validation set was:an AUC value of 0.916(95％CI:0.899 to 0.935),a sensitivity of 1.000,a specificity of 0.833,a positive predictive value of 0.875,a negative predictive value of 1.000,an accuracy of 0.923,a G-mean of 0.913,an F-measure of 0.933,a MCC was 0.854.Conclusion The integration model of depth features and imaging omics features is superior to the individual depth feature model and imaging omics feature model,and has good practicality and reliability in identifying sensitive patients with neoadjuvant therapy,which can be used as a reference for clinical practice.

Objective To analyze the status of persistent human papillomavirus (HPV) infection and the distribution of viral subtypes in the Zhengzhou region. Methods Clinical data of 55239 patients who underwent HPV-DNA genotyping tests from 2018 to 2024 were collected. On the basis of HPV follow-up results, patients were divided into three groups: 849 cases of infection with the same HPV type, 255 cases of persistent infection with different HPV types, and 857 cases of transient HPV infection. Results Among the 9232 initially-screened patients who were positive with HPV, the high-risk HPV (HR-HPV) positive rate was 84.6% (7813/9232), and predominant subtypes were HPV-16 (20.8%), HPV-52 (17.2%), and HPV-53 (9.6%). The low-risk HPV (LR-HPV) positive rate was 15.4% (1419/9232), mainly HPV-81 (28.1%) and HPV-42 (27.0%). Among the 1961 follow-up cases, the rates of persistent and non-persistent infections with the same HPV type were 35.7% (701/1961) and 7.5% (148/1961), respectively. The rates of persistent and non-persistent infections with different HPV types were 10.9% (214/1961) and 2.1% (41/1961), respectively. Meanwhile, 43.7% (857/1961) tested negative upon follow-up. Among the 701 cases of persistent infection with the same HPV type, HR-HPV accounted for 85.7% (601/701), and LR-HPV accounted for 14.3% (100/701). Among the 214 cases of persistent infection with different HPV types, 89.7% (192/214) were high-risk transitions, and 10.3% (22/214) were low-risk transitions. Regardless of HPV types, HR-HPV was more likely to cause persistent infection than LR-HPV. In addition, over 60% of HR-HPV persistent infections resolved within 18 months, 30% developed into persistent infections, and only 15% of patients had persistent infections that last more than 24 months. Conclusion Persistent HPV infections are predominantly high-risk types. Most patients clear the infection within 18 months, approximately 30% develop persistent infections, and about 15% of patients have persistent infections that last more than 24 months. However, the HR-HPV persistent infection rates across different age groups slightly differ.

Objective It aims to develop a digital maturity evaluation framework tailored for public hospitals in China to advance digital transformation and achieve high-quality development.Methods Through literature review,policy analysis,key informant interviews,and expert consultations,a preliminary conceptual framework for digital maturity in public hospitals was proposed.The framework's dimensions and key indicators were further refined and finalized through multiple rounds of consultation and validation with 30 experts.Results The findings indicate that the digital ma-turity of public hospitals in China encompasses three core dimensions:digital readiness,digital technology applica-tion,and data management capacity,along with 11 primary indicators.The evaluation framework has gained broad recognition from experts and scholars,demonstrating its effectiveness in identifying gaps in the digitalization process and enhancing hospitals'capacities in infrastructure,technological application,and data governance.Conclusion The study recommends that government authorities optimize resource allocation based on the framework,while public hospitals should strengthen digital planning and implementation.This framework provides practical guidance for ad-vancing the digital transformation of public hospitals in China.