Objective:To analyze the anatomical characteristics and surgical management measures of acute Stanford type A aortic dissection (AAD) involving coronary arteries, and to preliminarily explore the clinical efficacy of different coronary artery treatment techniques.Methods:A retrospective analysis was conducted on the clinical data of 42 patients who underwent surgery for AAD involving coronary arteries in Hunan Provincial People′s Hospital from January 2022 to May 2025. They were divided into the MI group (14 cases) and the nMI group (28 cases) according to whether they had acute myocardial infarction before surgery. The clinical data such as the actual surgical methods and mortality in the two groups were summarized.Results:Among 294 surgeries, 42 cases (14.3%) had definite coronary artery involvement, including 14 cases in the MI group and 28 cases in the nMI group; 1 case had bilateral coronary artery involvement and 41 cases had right coronary artery involvement. Regarding injury types: 16 cases were of the coronary trunk compression type, 12 cases were of the sinus intimal tear neal to ostium type, and 14 cases were of the coronary trunk intimal type. There was no statistically significant difference in the types of coronary artery involvement between the two groups ( P>0.05). There were 18 cases of Sun′s procedure with preserved aortic sinus and aortic valve, 7 cases of Bentall procedure without bypass, and 17 cases of Bentall procedure plus bypass. There was no statistically significant difference in the surgical plans between the two groups ( P>0.05). There were 4 deaths within 30 days (2 cases in each group). Conclusions:AAD involving coronary arteries is a critical condition, and accurate diagnosis is somewhat difficult. Myocardial ischemia is not significantly associated with the type of coronary artery involvement. The surgical plan depends on the type of coronary artery involvement. The classification method in this study is conducive to selecting appropriate surgical methods and improving surgical prognosis.

Objective To explore the predictive value of transforming growth factor beta 1(TGF-β1),chromobox homolog 7(CBX7),and soluble urokinase type plasminogen activator receptor(suPAR)for post-operative recurrence of cervical intraepithelial neoplasia after cervical conization.Methods A total of 200 pa-tients with cervical intraepithelial neoplasia admitted to the hospital from April 2020 to June 2023 were select-ed as the research subjects.All patients were treated with cervical conization.All patients were followed up for one year.According to the postoperative recurrence of cervical intraepithelial neoplasia patients after cervical conization,they were divided into the recurrence group and the non-recurrence group.Univariate and multiva-riate Logistic regression analyses were conducted to analyze the risk factors influencing the postoperative re-currence of cervical intraepithelial neoplasia after cervical conization.The receiver operating characteristic(ROC)curve was drawn to analyze the value of TGF-β1,CBX7 and suPAR in predicting the postoperative re-currence of cervical intraepithelial neoplasia after cervical conization.A nomogram model for predicting the postoperative recurrence of cervical intraepithelial neoplasia after cervical conization was established using R software and verified both internally and externally.The calibration curve and decision curve were used to ana-lyze the calibration ability and application value of the nomogram.Results The levels of TGF-β1,CBX7 and suPAR in the recurrence group were all higher than those in the non-recurrence group,and the difference was statistically significant(P<0.05).The results of multivariate Logistic analysis showed that TGF-β1,CBX7,and suPAR were all risk factors for postoperative recurrence of cervical intraepithelial neoplasia after cervical conization(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of the combined prediction of TGF-β1,CBX7,and suPAR for the postoperative recurrence of cervical intraepithelial neoplasia after cervical conization was higher than AUC of the individual detection of each index(Z=3.554,2.311,2.520,P<0.05).The correction curve of the nomogram model for predicting the postoperative recur-rence of cervical intraepithelial neoplasia after cervical conization approached the ideal curve(P=0.298,0.687).Conclusion The combination of TGF-β1,CBX7 and suPAR has certain value in predicting the postoperative recurrence of cervical intraepithelial neoplasia after cervical conization.

Objective To analyze the disease burden of hip osteoarthritis(HOA)and its changing trends in China from 1990 to 2021.Methods Utilizing the Global Burden of Disease(GBD)2021 database,age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized disability adjusted life years(DALY)rate(ASDR)of HOA were compared and analyzed in China,globally,and in regions with high sociodemographic index(SDI)from 1990 to 2021.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age and gender were combined to deeply analyze the disease burden of HOA in China.Meanwhile,the age-period-cohort model was used to analyze the influencing factors and the Bayesian age-period-cohort model to predict the trend of China's HOA disease burden in the next 10 years.Results The ASIR,ASPR,and ASDR of HOA in China showed an increasing trend from 1990 to 2021[average annual percentage change(AAPC)were 0.87％,0.82％,and 0.81％,respectively,P＜0.001],and their AAPCs were higher than those of the global and high SDI regions,but in 2021,the ASIR,ASPR,and ASDR of China were lower than those of the global and high SDI regions.Crude incidence,crude prevalence,and crude DALY rate in Chinese HOA increased with age,with the highest number of incidence in the 55-59 age group and the highest number of prevalence,DALY,in the 65-69 age group.In 2021,the ASIR,ASPR and ASDR of HOA in Chinese males were 1.25,1.24 and 1.25 times higher than those in females.Changes in the incidence of HOA in China from 1990 to 2021 were influenced by age,period,and birth cohort.Compared with 2021,new cases of HOA are expected to increase by 37.78％by 2035,and the number of incidence cases in people aged 60 years and above will increase significantly.Conclusion The disease burden of HOA in China continued to rise from 1990 to 2021,and prevention and control need to be strengthened,with a focus on men,high BMI,and middle-aged and older populations.

Objective:To explore the effects of radical resection of pelvic autonomic nerve sparing cervical cancer on urodynamics, sexual function and prognosis of patients with cervical cancer.Methods:A total of 76 patients with cervical cancer admitted to Dingzhou People’s Hospital from Jan. 2021 to Jan. 2023 were selected as research objects, and all patients were divided into control group and study group by random number table method, with 38 cases in each group. The control group was treated with traditional laparoscopic radical cervicectomy, and the study group was treated with laparoscopic radical cervicectomy preserving pelvic autonomic nerve. Perioperative indexes, preoperative and postoperative urodynamics, tumor markers, sexual function and postoperative adverse reactions were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group ( P<0.05). The exhaust time and defecation time of the observation group were lower in the observation group than in the control group ( P<0.05). There was no significant difference in the amount of blood loss or lymph node dissection between the two groups ( P>0.05). There was no significant difference in urodynamic indexes between the two groups before surgery ( P>0.05). In the observation group after surgery, the bladder compliance, maximum urine flow rate and maximum detrusor systolic blood pressure were (81.55±13.18 mL/cm H 20, 20.46±4.65 L/s, 35.09±7.41 cm H 20), while they were (60.14±10.27) mL/cm H 20, (14.48±3.92) L/s, (28.15±6.94) cm H 20 in the control group. The observation group were higher than the control group ( P<0.05). There was no significant difference in maximum bladder volume between the two groups ( P>0.05). There was no significant difference in sexual function scores between the two groups before surgery ( P>0.05). The scores of sexual desire, vaginal wetness and pain, sexual arousal and orgasm, and sexual satisfaction in the observation group were higher than those in the control group ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05) . Conclusion:Radical resection of pelvic autonomic nerve preserving cervical cancer can improve urodynamic indexes and sexual function of patients with cervical cancer, and has the same efficacy as conventional laparoscopic radical resection of cervical cancer without increasing adverse reactions, and has a good effect and safety.

Objective:To study the diagnostic value and correlation of contrast-enhanced ultrasound time-intensity curve in the main pathological features of cervical cancer.Methods:From August 2021 to August 2023, 100 patients with cervical cancer and 100 patients with benign cervical tumors examined in Dingzhou People’s Hospital were selected for study. Patients with benign cervical tumors were included in the control group, and patients with cervical cancer were included in the observation group.The two groups of patients were examined by PHILIPS EPIQ7 C color Doppler ultrasound diagnostic instrument and PHILIPS EPIQ5 color Doppler ultrasound diagnostic instrument to obtain the quantitative parameters of the time-intensity curve of the two groups. The bivariate Spearman correlation test was used to analyze the main pathological features of cervical cancer patients (lesion diameter, pathological type, vascular invasion, lymph node metastasis, differentiation degree, clinical stage) and the correlation between radiotherapy and chemotherapy and the acquisition of time-intensity curve. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of the time-intensity curve.Results:The time to peak (TTP) value of the cervical cancer group was lower than that of the control group, and the peak intensity (PI) and maximum peak intensity ratio (PI/PIc) values were higher than those of the control group, the differences were statistically significant ( P<0.05). Compared with patients with non-squamous cell carcinoma, vascular invasion < 1/2, no lymph node metastasis, moderate to high differentiation, stage I-II, and after radiotherapy and chemotherapy, patients with squamous cell carcinoma, vascular invasion ≥ 1/2, lymph node metastasis, low differentiation, stage III-IV, and before radiotherapy and chemotherapy had lower TTP values, higher PI and PI/PIc values, and the differences were statistically significant ( P<0.05). Pathological type, vascular invasion, lymph node metastasis, differentiation degree and clinical stage were negatively correlated with TTP, and positively correlated with PI and PI/PIc ( P<0.05) .Chemoradiotherapy was positively correlated with TTP, and negatively correlated with PI and PI/PIc ( P<0.05). The sensitivity and specificity of combined detection of time intensity curve were higher than those of TTP, PI, PI/Ic, area under curve (AUCTC) and mean transit time (MTT), and the differences were statistically significant ( P<0.05). The AUC values of combined detection of TTP, PI, PI/PIc and time intensity curve were all > 0.85, and the diagnostic value was high. Conclusions:The time-intensity curve of contrast-enhanced ultrasound is closely related to the main pathological features of cervical cancer, such as pathological type, lymph node metastasis and staging. According to the changes, the effect of radiotherapy and chemotherapy can be judged, which can provide a good reference for the diagnosis and treatment of cervical cancer.

Objective:To explore the effects of radical resection of pelvic autonomic nerve sparing cervical cancer on urodynamics, sexual function and prognosis of patients with cervical cancer.Methods:A total of 76 patients with cervical cancer admitted to Dingzhou People’s Hospital from Jan. 2021 to Jan. 2023 were selected as research objects, and all patients were divided into control group and study group by random number table method, with 38 cases in each group. The control group was treated with traditional laparoscopic radical cervicectomy, and the study group was treated with laparoscopic radical cervicectomy preserving pelvic autonomic nerve. Perioperative indexes, preoperative and postoperative urodynamics, tumor markers, sexual function and postoperative adverse reactions were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group ( P<0.05). The exhaust time and defecation time of the observation group were lower in the observation group than in the control group ( P<0.05). There was no significant difference in the amount of blood loss or lymph node dissection between the two groups ( P>0.05). There was no significant difference in urodynamic indexes between the two groups before surgery ( P>0.05). In the observation group after surgery, the bladder compliance, maximum urine flow rate and maximum detrusor systolic blood pressure were (81.55±13.18 mL/cm H 20, 20.46±4.65 L/s, 35.09±7.41 cm H 20), while they were (60.14±10.27) mL/cm H 20, (14.48±3.92) L/s, (28.15±6.94) cm H 20 in the control group. The observation group were higher than the control group ( P<0.05). There was no significant difference in maximum bladder volume between the two groups ( P>0.05). There was no significant difference in sexual function scores between the two groups before surgery ( P>0.05). The scores of sexual desire, vaginal wetness and pain, sexual arousal and orgasm, and sexual satisfaction in the observation group were higher than those in the control group ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05) . Conclusion:Radical resection of pelvic autonomic nerve preserving cervical cancer can improve urodynamic indexes and sexual function of patients with cervical cancer, and has the same efficacy as conventional laparoscopic radical resection of cervical cancer without increasing adverse reactions, and has a good effect and safety.

Objective:To study the diagnostic value and correlation of contrast-enhanced ultrasound time-intensity curve in the main pathological features of cervical cancer.Methods:From August 2021 to August 2023, 100 patients with cervical cancer and 100 patients with benign cervical tumors examined in Dingzhou People’s Hospital were selected for study. Patients with benign cervical tumors were included in the control group, and patients with cervical cancer were included in the observation group.The two groups of patients were examined by PHILIPS EPIQ7 C color Doppler ultrasound diagnostic instrument and PHILIPS EPIQ5 color Doppler ultrasound diagnostic instrument to obtain the quantitative parameters of the time-intensity curve of the two groups. The bivariate Spearman correlation test was used to analyze the main pathological features of cervical cancer patients (lesion diameter, pathological type, vascular invasion, lymph node metastasis, differentiation degree, clinical stage) and the correlation between radiotherapy and chemotherapy and the acquisition of time-intensity curve. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of the time-intensity curve.Results:The time to peak (TTP) value of the cervical cancer group was lower than that of the control group, and the peak intensity (PI) and maximum peak intensity ratio (PI/PIc) values were higher than those of the control group, the differences were statistically significant ( P<0.05). Compared with patients with non-squamous cell carcinoma, vascular invasion < 1/2, no lymph node metastasis, moderate to high differentiation, stage I-II, and after radiotherapy and chemotherapy, patients with squamous cell carcinoma, vascular invasion ≥ 1/2, lymph node metastasis, low differentiation, stage III-IV, and before radiotherapy and chemotherapy had lower TTP values, higher PI and PI/PIc values, and the differences were statistically significant ( P<0.05). Pathological type, vascular invasion, lymph node metastasis, differentiation degree and clinical stage were negatively correlated with TTP, and positively correlated with PI and PI/PIc ( P<0.05) .Chemoradiotherapy was positively correlated with TTP, and negatively correlated with PI and PI/PIc ( P<0.05). The sensitivity and specificity of combined detection of time intensity curve were higher than those of TTP, PI, PI/Ic, area under curve (AUCTC) and mean transit time (MTT), and the differences were statistically significant ( P<0.05). The AUC values of combined detection of TTP, PI, PI/PIc and time intensity curve were all > 0.85, and the diagnostic value was high. Conclusions:The time-intensity curve of contrast-enhanced ultrasound is closely related to the main pathological features of cervical cancer, such as pathological type, lymph node metastasis and staging. According to the changes, the effect of radiotherapy and chemotherapy can be judged, which can provide a good reference for the diagnosis and treatment of cervical cancer.

Objective To analyze the disease burden of hip osteoarthritis(HOA)and its changing trends in China from 1990 to 2021.Methods Utilizing the Global Burden of Disease(GBD)2021 database,age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized disability adjusted life years(DALY)rate(ASDR)of HOA were compared and analyzed in China,globally,and in regions with high sociodemographic index(SDI)from 1990 to 2021.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age and gender were combined to deeply analyze the disease burden of HOA in China.Meanwhile,the age-period-cohort model was used to analyze the influencing factors and the Bayesian age-period-cohort model to predict the trend of China's HOA disease burden in the next 10 years.Results The ASIR,ASPR,and ASDR of HOA in China showed an increasing trend from 1990 to 2021[average annual percentage change(AAPC)were 0.87％,0.82％,and 0.81％,respectively,P＜0.001],and their AAPCs were higher than those of the global and high SDI regions,but in 2021,the ASIR,ASPR,and ASDR of China were lower than those of the global and high SDI regions.Crude incidence,crude prevalence,and crude DALY rate in Chinese HOA increased with age,with the highest number of incidence in the 55-59 age group and the highest number of prevalence,DALY,in the 65-69 age group.In 2021,the ASIR,ASPR and ASDR of HOA in Chinese males were 1.25,1.24 and 1.25 times higher than those in females.Changes in the incidence of HOA in China from 1990 to 2021 were influenced by age,period,and birth cohort.Compared with 2021,new cases of HOA are expected to increase by 37.78％by 2035,and the number of incidence cases in people aged 60 years and above will increase significantly.Conclusion The disease burden of HOA in China continued to rise from 1990 to 2021,and prevention and control need to be strengthened,with a focus on men,high BMI,and middle-aged and older populations.

Objective:To analyze the anatomical characteristics and surgical management measures of acute Stanford type A aortic dissection (AAD) involving coronary arteries, and to preliminarily explore the clinical efficacy of different coronary artery treatment techniques.Methods:A retrospective analysis was conducted on the clinical data of 42 patients who underwent surgery for AAD involving coronary arteries in Hunan Provincial People′s Hospital from January 2022 to May 2025. They were divided into the MI group (14 cases) and the nMI group (28 cases) according to whether they had acute myocardial infarction before surgery. The clinical data such as the actual surgical methods and mortality in the two groups were summarized.Results:Among 294 surgeries, 42 cases (14.3%) had definite coronary artery involvement, including 14 cases in the MI group and 28 cases in the nMI group; 1 case had bilateral coronary artery involvement and 41 cases had right coronary artery involvement. Regarding injury types: 16 cases were of the coronary trunk compression type, 12 cases were of the sinus intimal tear neal to ostium type, and 14 cases were of the coronary trunk intimal type. There was no statistically significant difference in the types of coronary artery involvement between the two groups ( P>0.05). There were 18 cases of Sun′s procedure with preserved aortic sinus and aortic valve, 7 cases of Bentall procedure without bypass, and 17 cases of Bentall procedure plus bypass. There was no statistically significant difference in the surgical plans between the two groups ( P>0.05). There were 4 deaths within 30 days (2 cases in each group). Conclusions:AAD involving coronary arteries is a critical condition, and accurate diagnosis is somewhat difficult. Myocardial ischemia is not significantly associated with the type of coronary artery involvement. The surgical plan depends on the type of coronary artery involvement. The classification method in this study is conducive to selecting appropriate surgical methods and improving surgical prognosis.

Objective To observe the effect of Bushen Gutai mixture on uterine blood supply of rat model of abortion induced by hydroxyurea tablets combined with mifepristone through PKA-CREB signal pathway and its mechanism of calming fetus.Methods 60 pregnant rats of SPF grade SD rats were prepared by closing cages at 2∶1.According to the order of pregnancy,60 pregnant rats were randomly divided into 6 groups with 10 rats in each group:Bushen Gutai mixture group(low,middle and high dose),normal pregnancy group,model group and Di qu progesterone group.On the 1st to 9th day of pregnancy,except the normal group,the pregnant rats in each group were gavaged with hydroxyurea tablets at 5∶00 pm every day(450 mg·kg-1),and at 10∶00 am on the 10th day of pregnancy.Mifepristone tablets were given by intragastric administration(4.0 mg·kg-1).At 9∶00 am every day from the 1st to 9th day of pregnancy,Bushen Gutai mixture was given to the low,middle and high dose groups(0.5,1.0,2.0 g·kg-1),didrone group(3.02 mg·kg-1),model group and normal pregnancy group with 0.9%normal saline.24 hours after the last administration of pentobarbital sodium(50 mg kg-1),all pregnant rats were killed by intraperitoneal injection of pentobarbital sodium,and the uterine decidual tissue of pregnant rats was bluntly isolated in sterile environment.Hematoxylin-eosin(HE)staining was used to observe the lumen diameter and wall thickness of spiral artery in uterine decidual tissue.Immunohistochemical staining(IHC)was used to detect the expression of vascular endothelial growth factor(VEGF)in decidual tissues.Western blot was used to detect the protein expression of phosphorylated protein kinase A,protein kinase A,phosphorylated cyclic adenosine monophosphate response element binding protein,Cyclic Adenosine monophosphate response element binding protein and aquaporin 5 in the decidua of pregnant rats.The apoptosis of decidual cells was detected by in situ end labeling(TUNEL)of DNA fragmentation.Results Compared with the model group,the wall thickness of spiral artery was higher than that in other groups(P<0.05),the lumen diameter was lower than that in other groups(P<0.05)and the expression of VEGF protein was lower than that of other groups(P<0.01).Compared with the model group,the apoptosis level of decidual cells in uterine decidua of abortive rats in high,middle and low dose groups of Bushen Gutai mixture and diqu progesterone group decreased in varying degrees.Bushen Gutai mixture can up-regulate the levels of p-PKA/PKA and p-CREB/CREB in uterine decidua(P<0.01)and promote the expression of AQP5 protein in uterine decidua of abortion rats(P<0.01).Conclusion Bushen Gutai mixture can improve uterine blood supply of aborted rats by activating PKA and CREB phosphorylation,up-regulating AQP5 expression,promoting physiological recasting of spiral artery and high expression of Vascular endothelial growth factor.