Objective To investigate the impact of phase Ⅱ cardiac rehabilitation on the rehabilitation needs and physical activity status of patients after coronary heart disease intervention.Methods A total of 90 patients with coronary heart disease who underwent percutaneous coronary intervention(PCI)in the Coronary Heart Disease Center of the hospital from August 2023 to August 2024 were selected as the research subjects.They were subjected to a 12-week standardized phase Ⅱ cardiac rehabilitation training.General data survey forms,cardiac rehabilitation scales,and the International Physical Activity Questionnaire were used for scale surveys to understand the patients' needs before and after rehabilitation and their weekly physical activity en-ergy expenditure.The cardiopulmonary exercise test gold standard,which reflects exercise capacity through three indicators-maximum oxygen uptake(VO2 max),anaerobic threshold(AT),and metabolic equivalents(MET),were used to compare the physical activity status before and after cardiac rehabilitation.Results Compared with before the implementation,after the implementation of cardiac rehabilitation,the autonomy score in-creased(21.36±1.85 vs.16.73±3.28),the process anxiety(12.60±3.87 vs.14.27±2.12)and outcome anxiety scores(2.31±1.76 vs.4.56±3.56)decreased,the level of low-intensity physical activity decreased[(2 711.62±1 487.09)min/week vs.(3 845.97±2 083.71)min/week],the levels of moderate-intensity[(1 314.67±783.54)min/week vs.(686.22±126.79)min/week],high-intensity[(1 861.33±798.27)min/week vs.(112.00±40.77)min/week],and total physical activity increased[(5 887.62±2 843.54)min/week vs.(4 644.19±2 287.16)min/week].The levels of VO2 max[(28.11±14.28)mL·min-1·kg-1 vs.(23.82±12.34)mL·min-1·kg-1],AT[(16.06±5.41)mL·min-1·kg-1 vs.(13.53±4.56)mL·min-1·kg-1],and MET[(6.89±1.59)mL·min-1·kg-1 vs.(5.78±1.21)mL·min-1·kg-1]all in-creased,with statistically significant differences(P＜0.05).Conclusion Phase Ⅱ rehabilitation after PCI can effectively improve patients' physical activity levels.

Objective To investigate the effect of baseline atherogenic index of plasma(AIP)on the long-term prognosis of patients with acute myocardial infarction(AMI).Methods A total of 712 AMI patients admitted to the hospital from January 2018 to December 2019 were continuously included as subjects and divided into a low-value group(AIP<0.280,n=237),a median-value group(AIP 0.280～0.852,n=238)and a high-value group(AIP>0.852,n=237)according to the baseline AIP tertiles.The primary endpoint was defined as the occurrence of major cardiovascular adverse events(MACEs).Multivariate Cox regression was used to analyze the independent influencing factors of MACEs.The nonlinear relationship between AIP and the risk of MACEs was analyzed with restricted cubic spline plots.Kaplan-Meier curve was used to analyze survival differences between groups.Subgroup analysis assesses the consistency of AIP's predictive value to MACEs.Results With the increase of AIP tertile groups,the proportion of dyslipidemia and MACEs increased,white blood cell count,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein and AIP increased,and high-density lipoprotein decreased,with statistical significance(P<0.05).Multivariate Cox regression analysis showed that AIP was an independent risk factor for MACEs(HR=2.024,95%CI:1.211～3.381,P=0.007).The results of restricted cubic spline analysis show that there is an L-shaped nonlinear effect relationship between AIP and the risk of MACEs(P-nonlinear=0.008).When AIP>0.613,the risk of MACEs in AMI patients increases with the increase of AIP.Kaplan-Meier survival curve analysis results show:With the increase of AIP,the cumulative incidence of MACEs in AMI patients increased significantly(Log-rank test,P=0.032).Compared with the low-value group,the risk of MACEs in the high-value group increased by 131%(HR=2.311,95%CI:1.261～4.234,P=0.007).The results of subgroup analysis showed that the P value of interaction within each subgroup was not significant,and the ability of AIP to predict MACEs was applicable to all subgroups.Conclusion Increased AIP at baseline is an independent predictor of poor long-term prognosis in patients with AMI.

Objective:To investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and the long-term prognosis in patients with acute myocardial infarction (AMI).Methods:It was a retrospective cohort study. A total of 712 patients diagnosed with AMI who were admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019 were continuously included as subjects. The fatty liver index (FLI) was used to evaluate the degree of hepatic steatosis. Subjects were divided into No NAFLD group (FLI?30), grade 1 NAFLD group (30≤FLI?60), and grade 2 NAFLD group (FLI≥60). The endpoint event was defined as the occurrence of major cardiovascular adverse events (MACEs). The Cox proportional risk model was used to assess the risk of MACEs. The Kaplan-Meier curve was used to analyze the survival differences between the groups, and subgroup analysis was performed for age, gender, and complicity with hypertension, diabetes, dyslipidemia, and abdominal obesity.Results:During the follow-up period, the incidence of MACEs was 10.92% (26/238) in the No NAFLD group, it was 18.01% (47/261) in the grade 1 NAFLD group, and 24.41% (52/213) in the grade 2 NAFLD group, there was significant difference in the incidence of adverse events among the groups ( χ2=9.136, P?0.05). After adjusting for confounding factors, compared with the No NAFLD group, the risk of MACEs in grade 1 NAFLD group was increased by 69.0%( HR=1.690, 95% CI: 1.026-2.783, P=0.039) and 131.2%( HR=2.312, 95% CI: 1.415-3.773, P=0.001), respectively. Kaplan-Meier curve analysis indicated that the cumulative incidence of MACEs was significantly increased and the prognosis was worse in grade 2 NAFLD group (Log-rank test χ2=13.500, P=0.001). The results of subgroup analysis suggested that grade 2 NAFLD could significantly increase the risk of MACEs in all age groups, women, dyslipidemia, normal body type, and people with or without hypertension or diabetes. In particular, it had higher predictive value in women and normal-size people (interaction P?0.05). Conclusion:The degree of NAFLD is closely related to the long-term prognosis of AMI patients, the more severe the NAFLD, the higher the risk of adverse events in AMI patients.

Objective:To investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and the long-term prognosis in patients with acute myocardial infarction (AMI).Methods:It was a retrospective cohort study. A total of 712 patients diagnosed with AMI who were admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019 were continuously included as subjects. The fatty liver index (FLI) was used to evaluate the degree of hepatic steatosis. Subjects were divided into No NAFLD group (FLI?30), grade 1 NAFLD group (30≤FLI?60), and grade 2 NAFLD group (FLI≥60). The endpoint event was defined as the occurrence of major cardiovascular adverse events (MACEs). The Cox proportional risk model was used to assess the risk of MACEs. The Kaplan-Meier curve was used to analyze the survival differences between the groups, and subgroup analysis was performed for age, gender, and complicity with hypertension, diabetes, dyslipidemia, and abdominal obesity.Results:During the follow-up period, the incidence of MACEs was 10.92% (26/238) in the No NAFLD group, it was 18.01% (47/261) in the grade 1 NAFLD group, and 24.41% (52/213) in the grade 2 NAFLD group, there was significant difference in the incidence of adverse events among the groups ( χ2=9.136, P?0.05). After adjusting for confounding factors, compared with the No NAFLD group, the risk of MACEs in grade 1 NAFLD group was increased by 69.0%( HR=1.690, 95% CI: 1.026-2.783, P=0.039) and 131.2%( HR=2.312, 95% CI: 1.415-3.773, P=0.001), respectively. Kaplan-Meier curve analysis indicated that the cumulative incidence of MACEs was significantly increased and the prognosis was worse in grade 2 NAFLD group (Log-rank test χ2=13.500, P=0.001). The results of subgroup analysis suggested that grade 2 NAFLD could significantly increase the risk of MACEs in all age groups, women, dyslipidemia, normal body type, and people with or without hypertension or diabetes. In particular, it had higher predictive value in women and normal-size people (interaction P?0.05). Conclusion:The degree of NAFLD is closely related to the long-term prognosis of AMI patients, the more severe the NAFLD, the higher the risk of adverse events in AMI patients.

Objective To investigate the effect of baseline atherogenic index of plasma(AIP)on the long-term prognosis of patients with acute myocardial infarction(AMI).Methods A total of 712 AMI patients admitted to the hospital from January 2018 to December 2019 were continuously included as subjects and divided into a low-value group(AIP<0.280,n=237),a median-value group(AIP 0.280～0.852,n=238)and a high-value group(AIP>0.852,n=237)according to the baseline AIP tertiles.The primary endpoint was defined as the occurrence of major cardiovascular adverse events(MACEs).Multivariate Cox regression was used to analyze the independent influencing factors of MACEs.The nonlinear relationship between AIP and the risk of MACEs was analyzed with restricted cubic spline plots.Kaplan-Meier curve was used to analyze survival differences between groups.Subgroup analysis assesses the consistency of AIP's predictive value to MACEs.Results With the increase of AIP tertile groups,the proportion of dyslipidemia and MACEs increased,white blood cell count,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein and AIP increased,and high-density lipoprotein decreased,with statistical significance(P<0.05).Multivariate Cox regression analysis showed that AIP was an independent risk factor for MACEs(HR=2.024,95%CI:1.211～3.381,P=0.007).The results of restricted cubic spline analysis show that there is an L-shaped nonlinear effect relationship between AIP and the risk of MACEs(P-nonlinear=0.008).When AIP>0.613,the risk of MACEs in AMI patients increases with the increase of AIP.Kaplan-Meier survival curve analysis results show:With the increase of AIP,the cumulative incidence of MACEs in AMI patients increased significantly(Log-rank test,P=0.032).Compared with the low-value group,the risk of MACEs in the high-value group increased by 131%(HR=2.311,95%CI:1.261～4.234,P=0.007).The results of subgroup analysis showed that the P value of interaction within each subgroup was not significant,and the ability of AIP to predict MACEs was applicable to all subgroups.Conclusion Increased AIP at baseline is an independent predictor of poor long-term prognosis in patients with AMI.

Objective To explore the predictive value of novel anthropometric indicators for the long-term prognosis in patients with acute myocardial infarction(AMI).Methods A total of 712 patients diagnosed with AMI in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019 were selected as research subjects,and divided into an event group and a non-event group according to whether major cardiovascular adverse events(MACEs)occurred during the period of follow-up.Gensini score was used to quanti-tatively assess the degree of coronary artery stenosis.Spearman correlation analysis was used to explore the correla-tion between the new anthropometric indicators and Gensini score.Receiver operating characteristic(ROC)curve was used to evaluate the ability of new anthropometric indicators to predict MACEs,and the patients were grouped according to the optimal cut-off value.Kaplan-Meier curve was used to analyze the survival difference between the groups.Multivariate Cox regression was used to analyze the independent risk factors of MACEs.Results During a median follow-up of 27(20,39)months,a total of 125 patients developed MACEs.As compared with those in the non-event group,the patients in the event group had a higher proportion of hypertension,diabetes and abdominal obesity,higher HbA1c and FBG levels,and longer body weight and waist circumference.The LAP index,CMI index,BRI index and Gensini score were significantly increased,and the differences were statistically significant(P＜0.05).Spearman correlation analysis showed that LAP index,CMI index and BRI index were positively corre-lated with Gensini score(r=0.233,0.126,0.272,P<0.001).ROC curve analysis showed that the AUC of LAP index,CMI index,VAI index,BRI index and ABSI index were 0.745,0.640,0.490,0.874 and 0.506 respec-tively;Kaplan-Meier curve analysis showed that the cumulative incidence of MACEs in LAP index,CMI index and BRI index was significantly increased in the high-value group(Log-rank test,P＜0.05).The results of multivariate Cox regression analysis after adjusting confounding showed that CMI index(HR=1.430,95%CI:1.049～1.952,P=0.024)and BRI index(HR=1.332,95%CI:1.234～1.439,P＜0.001)were independent risk factors for MACEs.Conclusions CMI index and BRI index of new anthropometric indicators are independent risk factors for long-term prognosis in patients with AMI.

OBJECTIVE To investigate the effect of Huangqi-Ezhu-Chonglou combination on macrophage polarization and its mechanism of inhibiting colorectal cancer(CRC)cells proliferation and migration.METHODS THP-1 cells were stimulated with phorbol 12-myristate 13-acetate(PMA)and interleukin-4(IL-4)to establish M2 macrophage polarization model.The experiment was divided into M0 group(PMA treatment),M2 group(PMA+IL-4 treatment),and M2+ Huangqi-Ezhu-Chonglou combination group(PMA+IL-4+Huangqi-Ezhu-Chonglou combination treatment).The effect of Huangqi-Ezhu-Chonglou combination freeze-dried powder on the viability of macrophage was detected by CCK-8 method.The expression of macrophage polarization markers,glu-taminase(GLS)mRNA and protein was detected by qPCR and Western blot.The levels of interleukin-10(IL-10),transforming growth factor-β(TGF-β)and tumor necrosis factor-α(TNF-α)in cell supernatant were detected by ELISA.CCK-8 method and Tr-answell assays were used to detect the proliferation and migration of HCT116 cells intervened by the supernatant of macrophage culture treated with Huangqi-Ezhu-Chonglou combination,namely conditioned medium(CM).RESULTS Compared with the M0 group,the expression levels of IL-10,mannose receptor(CD206),arginase 1(ARG1),and GLS mRNA and protein in the M2 group were significantly increased(P<0.01,P<0.001),the levels of IL-10 and TGF-β secreted by macrophages were significantly increased(P<0.01,P<0.001);compared with the M2 group,the M2+ Huangqi-Ezhu-Chonglou combination group had significantly reduced IL-10,CD206,ARG1,and GLS mRNA and protein expression(P<0.05,P<0.01),the mRNA and protein levels of TNF-α and in-ducible nitric oxide synthase(iNOS)were significantly increased(P<0.05,P<0.01,P<0.001),the interleukin-1β(Interleukin-1β,IL-1β)mRNA expression significantly increased(P<0.01),and the contents of IL-10 and TGF-β in the cell supernatant sig-nificantly decreased(P<0.05,P<0.01),while TNF-α content significantly increased(P<0.01).CCK-8 and Transwell results showed that compared with the M0-CM group,the M2-CM promoted the proliferation and migration of HCT116 cells(P<0.01,P<0.001),the M2+ Huangqi-Ezhu-Chonglou-CM group significantly inhibited HCT116 cell proliferation and reduced cell migration compared to the M2-CM group(P<0.01,P<0.001).CONCLUSION Huangqi-Ezhu-Chonglou combination can inhibit colorectal cancer cells proliferation and migration by regulating macrophage polarization,and its mechanism may be related to the changes in the expression of GLS,a key enzyme in glutamine metabolism.

BACKGROUND:Previous studies have confirmed that the new compound cottonrose hibiscus leaf gel plaster has a good effect in the treatment of acute soft tissue swelling. OBJECTIVE:To observe the clinical efficacy of compound cottonrose hibiscus leaf gel plaster in the treatment of synovitis of the knee joint. METHODS:Seventy-two patients with knee synovitis were selected from Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2019 to May 2021.These patients were randomly divided into a trial group and a control group,with 36 cases in each group.The trial group was treated with compound cottonrose hibiscus leaf gel plaster,once a day,12 hours each time,while the control group was treated with Diclofenac Diethylamine Emulgel,twice a day.After 28 days of treatment,visual analog scale score,WOMAC Osteoarthritis Index score,quality of life score(SF-36),thickness of knee synovium and comprehensive curative effect were compared between the two groups. RESULTS AND CONCLUSION:(1)Visual analog scale scores after treatment were lower than those before treatment(P<0.05).Visual analog scale scores in the trial group after 7,14 and 28 days of treatment were lower than those in the control group(P<0.05).The WOMAC Osteoarthritis Index scores of the two groups after treatment were lower than those before treatment(P<0.05),and the WOMAC Osteoarthritis Index scores in the trial group after 7,14 and 28 days of treatment were lower than those in the control group(P<0.05).(3)The SF-36 quality of life score in the two groups after 28 days of treatment was higher than that before treatment(P<0.05).SF-36 quality of life score in the trial group after 28 days of treatment was higher than that in the control group(P<0.05).(4)After 28 days of treatment,the thickness of knee synovium in the trial group was less than that in the control group(P<0.05),and the effective rate in the trial group was higher than that in the control group(P<0.05).(5)These findings indicate that compared with Diclofenac Diethylamine Emulgel,the compound cottonrose hibiscus leaf gel plaster can better relieve knee pain,enhance knee joint function,reduce synovial hyperplasia,and elevate the overall quality of life of patients.

Objective To analyze the efficacy of different intracavitary operations for calyceal diverticulum calculi,so as to provide reference for the diagnosis and treatment of such disease.Methods A retrospective analysis of the data of 21 patients with calyceal diverticulum calculi was conducted during Jan.2015 and Dec.2021.The patients were divided into the retrograde intrarenal surgery(RIRS,n=14)group and percutaneous nephrolithotomy(PCNL,n=7)group.The perioperative data were compared.Results There was no significant difference in stone load between the RIRS group and PCNL group[(11.56±4.79)mm vs.(13.06±6.27)mm,P=0.609].There were significant differences in the thickness of renal parenchyma at the top of the diverticulum[(10.08±4.81)mm vs.(5.24±2.23)mm,P=0.005],operation time[(58.57±19.23)min vs.(88.29±25.28)min,P=0.007],hospitalization time[3(1,5)vs.12(5,7),P=0.023]days.After operation,there were no significant differences in stone-clearance rate,decrease of hemoglobin,and postoperative complications between the two groups(P＞0.05).Conclusion Both RIRS and PCNL are viable options for treating renal calyceal diverticulum calculi.RIRS has advantages of shorter operation time and hospital stay.PCNL can be an alternative treatment when RIRS is unsuccessful.

Objective:To understand the infection status, epidemiological characteristics and drug resistance of Diarrheagenic Escherichia coli (DEC) in Shanghai and provide evidence for the disease surveillance. Methods:The epidemiological data of diarrhea cases in Shanghai from 2016 to 2022 were collected from Shanghai Diarrhea Comprehensive Surveillance System, and stool samples were collected from the cases for DEC detection. The drug resistance data was obtained from Chinese Pathogen Identification Network. Statistical analysis was conducted by using χ2 and fisher test. Results:In 24 883 diarrhea cases detected during 2016-2022, the DEC positive rate was 9.13% (2 271/24 883), the single DEC positive rate was 8.83% (2 197/24 883) and the mixed DEC positive rate was 0.30% (74/24 883). The main type of DEC was Enterotoxigenic Escherichia coli (ETEC) [4.33% (1 077/24 883)]. The DEC positive rate was highest in people aged ≤5 years 18.48% (22/119). The annual peak of DEC positive rate was observed during July - September [5.91% (1 470/24 883)]. The DEC positive rate were 9.47% (554/5 847) and 9.02% (1 717/19 036) in urban area and in suburbs, respectively, Enteroaggregative Escherichia coli (EAEC) [3.98% (233/5 847)] and ETEC [4.56% (868/19 036)] were mainly detected. From 2016 to 2019, the DEC positive rate was 9.42% (1 821/19 330), while it was 8.10% (450/5 553) from 2020 to 2022, the main DEC types were ETEC (4.87%, 941/19 330) and EAEC (4.70%, 261/5 553). The multi-drug resistance rate was 40.21% (618/1 537). The top three antibiotics with high drug resistance rates were ampicillin [64.74% (995/1 537)], nalidixic acid [58.49% (899/1 537)] and tetracycline [45.09% (693/1 537)]. Conclusions:Compared with 2016- 2019, a decrease in DEC detection rate was observed during 2020-2022, and the main type of DEC detected shifted from ETEC to EAEC. The prevalence of multi-drug resistance was severe. Therefore, it is necessary to further strengthen the surveillance for DEC drug resistance and standardize the use of clinical antibiotics.