Patients with Takayasu arteritis combined with aortic valve disease often have a poor prognosis following surgical valve replacement, frequently encountering complications such as perivalvular leakage, valve detachment, and anastomotic aneurysm. This article presents a high-risk case wherein severe aortic valve insufficiency associated with Takayasu arteritis was successfully managed through transcatheter aortic valve implantation via the transapical approach. The patient had satisfactory valve function with no complications observed during the six-month postoperative follow-up. This case provides a minimally invasive and feasible alternative for the clinical management of such high-risk patients.

OBJECTIVE To retrospectively analyze the clinical efficacy of Qingchi San in the treatment of mild-to-moderate ul-cerative colitis.METHODS A retrospective analysis was conducted on 221 ulcerative colitis patients treated at the Gastroenterology Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2014 to February 2024.Participants were divided into an observation group(n=121)and a control group(n=100).The control group received oral me-salazine,while the observation group received Qingchi San enema in addition to the control group's treatment.Both groups received a 4-week course of treatment.The two groups were compared in terms of clinical efficacy,clinical remission rate,TCM syndrome score,time to intestinal bleeding remission,and changes in inflammatory markers(C-reactive protein,erythrocyte sedimentation rate,and white blood cells)and coagulation markers(platelets and D-dimer).RESULTS After treatment,the total effective rate and clinical remission rate in the observation group were significantly higher than those in the control group(P<0.05,P<0.01).The TCM syn-drome scores for each item(diarrhea,abdominal pain,bloody stools with mucus,and tenesmus)in the observation group were signifi-cantly improved compared with those in the control group(P<0.01).The time to intestinal bleeding remission in the observation group was significantly shorter than that in the control group(P<0.01).C-reactive protein,erythrocyte sedimentation rate,and white blood cell count in the observation group were significantly decreased compared with those in the control group(P<0.05,P<0.01).There was no statistically significant difference in coagulation markers(platelets and D-dimer)between the two groups(P>0.05).No signif-icant treatment-related adverse reactions,such as liver and kidney damage,were observed during treatment.CONCLUSION Qing-chi San enema can improve the clinical efficacy of patients with mild-to-moderate ulcerative colitis,improve clinical symptoms,short-en bleeding time,and reduce inflammatory markers.

Fluorine, as one of the important trace elements, has multiple physiological functions and participates in body metabolism. Moderate intake of fluoride is beneficial for human health, while excessive fluoride can lead to dental fluorosis, skeletal fluorosis, and multi-organ damage. Typical symptoms of skeletal fluorosis include bone sclerosis, osteomalacia, osteoporosis, and degenerative changes in articular cartilage. The pathological basis for skeletal changes in fluorosis involves enhanced osteogenesis and accelerated bone turnover, which are comprehensively regulated by multiple signaling pathways. Although the etiology of skeletal fluorosis has been determined, its pathogenic mechanisms remain inconclusive. In recent years, researchers have extensively investigated the signaling pathways involved in skeletal fluorosis development, including Notch, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR), Wnt/β-catenin, Hedgehog, nuclear factor κB (NF-κB), parathyroid hormone (PTH), and insulin signaling pathways, as well as their interactive networks. This article summarizes and reviews the recent research findings, aiming to provide a theoretical foundation for comprehensively understanding the pathogenic mechanisms of skeletal fluorosis and offer insights for scientific prevention of skeletal fluorosis.

Objective To explore the correlation between the expression of serum human leukocyte antigen B27(HLA-B27) and serum amyloid A(SAA) in patients with pulmonary tuberculosis and the severity of the disease and the infection of other pulmonary pathogens. Methods From September 2021 to September 2023,120 patients with pulmonary tuberculosis complicated with pulmonary infection in Beijing Ditan Hospital Affiliated to Capital Medical University were selected as the research group,and another 120 patients with pulmonary tuberculosis were selected as the control group. According to the pneumonia severity index (PSI),the study group patients were divided into low-risk group (n=47),medium risk group (n=42) and high-risk group (n=31). Collected patient sputum for pathogen detection. Enzyme-linked immunosorbent assay (ELISA) was applied to measure the expression levels of HLA-B27 and SAA in serum. Multivariate Logistic regression was applied to analyze the factors that affected the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic efficacy of serum HLA-B27 and SAA for the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Results Compared with the control group,the positive rate of serum HLA-B27(72.50％ vs 19.17％)in the study group,expression level of SAA (9.32±2.32 ng/ml vs 4.64±1.04 ng/ml)were significantly increased,and the differences were statistically significant(x2=68.744,t=20.164,all P<0.05). A total of 84 strains of pathogenic bacteria were isolated by the research group,including 46 Gram negative bacteria,34 Gram positive bacteria,and 4 fungi,with Klebsiella pneumoniae accounting for the highest proportion (15.48％). Compared with the low-risk group,the positive rate of HLA-B27(76.19％,93.55％ vs 55.32％),the expression level of SAA(9.35±2.35ng/ml,10.94±2.42ng/ml vs 8.23±2.23ng/ml)and the PSI score(108.63±12.47score,145.93±12.44 score vs 54.48±17.31 score) in the middle-risk group and the severe-risk group were significantly higher,and the differences were statistically significant (x2=4.256,13.130,t=2.306,5.077;15.021,25.384,all P<0.05). Serum HLA-B27 and SAA levels in patients with pulmonary tuberculosis complicated with pulmonary infection were positively correlated with PSI score (r=0.385,0.522,all P<0.05). The results of multivariate Logistic regression analysis showed that HLA-B27 positivity and SAA were risk factors affecting the severity of pulmonary tuberculosis combined with pulmonary infection in patients (P<0.05). The combined diagnosis of serum HLA-B27 and SAA had the highest area under the curve (AUC) for the severity of pulmonary infection in patients,which was superior to the individual diagnosis of serum HLA-B27 and elevated SAA expression levels (Z=3.132,2.131,P=0.002,0.033). Conclusion The pathogenic bacteria in patients with pulmonary tuberculosis and pulmonary infection are mainly Gram negative bacteria. The increases in serum HLA-B27 positive rate and SAA expression level are closely related to the disease progression in patients with pulmonary tuberculosis and pulmonary infection. The combination of the two can better diagnose the severity of the disease in patients with pulmonary infection.

OBJECTIVE To retrospectively analyze the clinical efficacy of Qingchi San in the treatment of mild-to-moderate ul-cerative colitis.METHODS A retrospective analysis was conducted on 221 ulcerative colitis patients treated at the Gastroenterology Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2014 to February 2024.Participants were divided into an observation group(n=121)and a control group(n=100).The control group received oral me-salazine,while the observation group received Qingchi San enema in addition to the control group's treatment.Both groups received a 4-week course of treatment.The two groups were compared in terms of clinical efficacy,clinical remission rate,TCM syndrome score,time to intestinal bleeding remission,and changes in inflammatory markers(C-reactive protein,erythrocyte sedimentation rate,and white blood cells)and coagulation markers(platelets and D-dimer).RESULTS After treatment,the total effective rate and clinical remission rate in the observation group were significantly higher than those in the control group(P<0.05,P<0.01).The TCM syn-drome scores for each item(diarrhea,abdominal pain,bloody stools with mucus,and tenesmus)in the observation group were signifi-cantly improved compared with those in the control group(P<0.01).The time to intestinal bleeding remission in the observation group was significantly shorter than that in the control group(P<0.01).C-reactive protein,erythrocyte sedimentation rate,and white blood cell count in the observation group were significantly decreased compared with those in the control group(P<0.05,P<0.01).There was no statistically significant difference in coagulation markers(platelets and D-dimer)between the two groups(P>0.05).No signif-icant treatment-related adverse reactions,such as liver and kidney damage,were observed during treatment.CONCLUSION Qing-chi San enema can improve the clinical efficacy of patients with mild-to-moderate ulcerative colitis,improve clinical symptoms,short-en bleeding time,and reduce inflammatory markers.

Fluorine, as one of the important trace elements, has multiple physiological functions and participates in body metabolism. Moderate intake of fluoride is beneficial for human health, while excessive fluoride can lead to dental fluorosis, skeletal fluorosis, and multi-organ damage. Typical symptoms of skeletal fluorosis include bone sclerosis, osteomalacia, osteoporosis, and degenerative changes in articular cartilage. The pathological basis for skeletal changes in fluorosis involves enhanced osteogenesis and accelerated bone turnover, which are comprehensively regulated by multiple signaling pathways. Although the etiology of skeletal fluorosis has been determined, its pathogenic mechanisms remain inconclusive. In recent years, researchers have extensively investigated the signaling pathways involved in skeletal fluorosis development, including Notch, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR), Wnt/β-catenin, Hedgehog, nuclear factor κB (NF-κB), parathyroid hormone (PTH), and insulin signaling pathways, as well as their interactive networks. This article summarizes and reviews the recent research findings, aiming to provide a theoretical foundation for comprehensively understanding the pathogenic mechanisms of skeletal fluorosis and offer insights for scientific prevention of skeletal fluorosis.

[Objective] To analyze the loss rate of platelet donors and evaluate the strategies for establishing a platelet donor bank. [Methods] A total of 1 443 donors who joined the HLA and HPA gene donor bank for platelets in Henan Province from 2018 to 2020 were included in this study. Data on the total number of apheresis platelet donations, annual donation frequency, age at enrollment, donation habits (including the number of platelets donated per session and whether they had previously donated whole blood), and enrollment location were collected from the platelet donor information management system. Donor loss was determined based on the date of their last donation. The loss rates of different groups under various conditions were compared to assess the enrollment strategies. [Results] By the time the platelet bank was officially operational in 2022, 421 donors had been lost, resulting in an loss rate of 29% (421/1 443). By the end of 2023, the overall cumulative loss rate reached 52% (746/1 443). The loss rate was lower than the overall level in groups meeting any of the following conditions: total apheresis platelet donations exceeding 50, annual donation frequency of 10 or more, age at enrollment of 40 years or older, donation of more than a single therapeutic dose per session, or a history of whole blood donation two or more times. Additionally, loss rates varied across different enrollment locations, with higher enrollment numbers generally associated with higher loss rates. [Conclusion] Through a comprehensive analysis of donor loss, our center has adjusted its strategies for establishing the donor pool. These findings also provide valuable insights for other blood collection and supply institutions in building platelet donor banks.

ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

OBJECTIVE To investigate the efficacy and safety of tirofiban for early neurological deterioration in patients with acute ischemic stroke. METHODS A total of 126 patients with early neurological deterioration of acute ischemic stroke who were admitted to the Department of Neurology， Heji Hospital Affiliated to Changzhi Medical College from January 2022 to December 2023 were selected and divided into observation group and control group according to random number table method， with 63 cases in each group. All patients received standardized treatment such as lipid-lowering and blood pressure-lowering therapy. Based on the standard treatment， patients in the control group additionally took Aspirin enteric-coated tablets 100 mg+Clopidogrel bisulfate tablets 75 mg orally （once a day， for 14 consecutive days）. The patients in the observation group received Tirofiban hydrochloride and sodium chloride injection based on the standardized treatment [first intravenous infusion of 0.40 μg/（kg·min） for 30 min， and then continuous intravenous infusion of 0.10 μg/（kg·min） for 47.5 h]； subsequently， patients were given Aspirin enteric-coated tablets （100 mg） and Clopidogrel bisulfate tablets （75 mg） once a day for 14 consecutive days. The clinical efficacy， the National Institutes of Health Stroke Scale （NIHSS） score， modified Rankin Scale （mRS） score， and hemorheological indexes before and after treatment were compared between the two groups， and the adverse reactions were recorded. RESULTS The total effective rate （87.30%） of the observation group was significantly higher than that of the control group （71.43%） （P＜0.05）. NIHSS scores of the two groups at 1st， 7th and 14th day after treatment， the mRS score at 90th day after treatment， and the platelet aggregation rate， whole blood viscosity， plasma viscosity and fibrinogen at 14th day after treatment were significantly lower than those before treatment in the same group， and the observation group was significantly lower than the control group at the same period （P＜0.05）. The total incidences of adverse reactions such as nausea， headache， fever， gastrointestinal bleeding， oral and nasal mucosal bleeding and thrombocytopenia in both groups of patients were 28.57% respectively， with no statistically significant difference （P＞0.05）. CONCLUSIONS For patients with early neurological deterioration in acute ischemic stroke， the addition of tirofiban can accelerate the recovery of neurological function， improve blood hyperviscosity and platelet aggregation， and improve the prognosis of patients with good safety.

Objective To explore the correlation between the expression of serum human leukocyte antigen B27(HLA-B27) and serum amyloid A(SAA) in patients with pulmonary tuberculosis and the severity of the disease and the infection of other pulmonary pathogens. Methods From September 2021 to September 2023,120 patients with pulmonary tuberculosis complicated with pulmonary infection in Beijing Ditan Hospital Affiliated to Capital Medical University were selected as the research group,and another 120 patients with pulmonary tuberculosis were selected as the control group. According to the pneumonia severity index (PSI),the study group patients were divided into low-risk group (n=47),medium risk group (n=42) and high-risk group (n=31). Collected patient sputum for pathogen detection. Enzyme-linked immunosorbent assay (ELISA) was applied to measure the expression levels of HLA-B27 and SAA in serum. Multivariate Logistic regression was applied to analyze the factors that affected the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic efficacy of serum HLA-B27 and SAA for the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Results Compared with the control group,the positive rate of serum HLA-B27(72.50％ vs 19.17％)in the study group,expression level of SAA (9.32±2.32 ng/ml vs 4.64±1.04 ng/ml)were significantly increased,and the differences were statistically significant(x2=68.744,t=20.164,all P<0.05). A total of 84 strains of pathogenic bacteria were isolated by the research group,including 46 Gram negative bacteria,34 Gram positive bacteria,and 4 fungi,with Klebsiella pneumoniae accounting for the highest proportion (15.48％). Compared with the low-risk group,the positive rate of HLA-B27(76.19％,93.55％ vs 55.32％),the expression level of SAA(9.35±2.35ng/ml,10.94±2.42ng/ml vs 8.23±2.23ng/ml)and the PSI score(108.63±12.47score,145.93±12.44 score vs 54.48±17.31 score) in the middle-risk group and the severe-risk group were significantly higher,and the differences were statistically significant (x2=4.256,13.130,t=2.306,5.077;15.021,25.384,all P<0.05). Serum HLA-B27 and SAA levels in patients with pulmonary tuberculosis complicated with pulmonary infection were positively correlated with PSI score (r=0.385,0.522,all P<0.05). The results of multivariate Logistic regression analysis showed that HLA-B27 positivity and SAA were risk factors affecting the severity of pulmonary tuberculosis combined with pulmonary infection in patients (P<0.05). The combined diagnosis of serum HLA-B27 and SAA had the highest area under the curve (AUC) for the severity of pulmonary infection in patients,which was superior to the individual diagnosis of serum HLA-B27 and elevated SAA expression levels (Z=3.132,2.131,P=0.002,0.033). Conclusion The pathogenic bacteria in patients with pulmonary tuberculosis and pulmonary infection are mainly Gram negative bacteria. The increases in serum HLA-B27 positive rate and SAA expression level are closely related to the disease progression in patients with pulmonary tuberculosis and pulmonary infection. The combination of the two can better diagnose the severity of the disease in patients with pulmonary infection.