OBJECTIVE To investigate the clinical characteristics and risk factors for batroxobin-related severe hypofibrinogenemia （HFIB） and construct a risk prediction model. METHODS A retrospective analysis was conducted on inpatients treated with batroxobin in the First Medical Center of a tertiary hospital from January 1， 2020， to December 31， 2024. Patients were categorized into non-severe HFIB group and severe HFIB group based on the severity of HFIB. Univariate and multivariate Logistic regression analyses were performed to identify the independent influencing factors for batroxobin-related severe HFIB. A nomogram was developed using the “rms” package in R 4.5 software. The predictive performance of the model was evaluated using the receiver operating characteristic curve. Calibration was assessed via the Bootstrap resampling method， and goodness-of-fit was evaluated with the Hosmer-Lemeshow test. RESULTS A total of 1 472 patients were included in this study. Of these， 1 445 developed HFIB， yi elding an incidence of 98.17%. Furthermore， 895 were classified as severe HFIB， accounting for 60.80% of the cohort. Multivariate Logistic regression analysis showed that increased age， high initial dose per 10 kg body weight， use of maintenance dose， and concomitant glucocorticoid use were independent risk factors for batroxobin-related severe HFIB， while high baseline fibrinogen （FIB） level was identified as a protective factor. The model demonstrated an area under the curve of 0.760 （95% CI： 0.735-0.785）. The mean absolute error of the calibration curve was 0.006. The P value of the Hosmer-Lemeshow test was 0.609. CONCLUSIONS Batroxobin can rapidly and significantly reduce FIB levels and carries a risk of inducing severe HFIB. Patients with advanced age， high initial dose per 10 kg body weight， use of maintenance dose and concomitant glucocorticoid use had a higher risk of batroxobin-related severe HFIB， while high baseline FIB level had a lower risk of batroxobin-related severe HFIB. The risk prediction model developed based on these factors can be used to predict the likelihood of batroxobin-related severe HFIB.

With the aging population and the widespread implementation of lung cancer screening programs, an increasing number of elderly patients are undergoing curative lung resection. Due to diminished physiological reserve and complex comorbidities, this demographic exhibits a significantly higher incidence of severe perioperative complications (defined as Clavien-Dindo grade≥Ⅲ), which adversely affects both perioperative safety and long-term prognosis. In recent years, the research paradigm has shifted from univariate analysis toward multidimensional risk integration and the development of predictive models. This article systematically reviews the key risk factors for severe perioperative complications in elderly lung cancer patients, encompassing biological aging processes, frailty and sarcopenia, cardiopulmonary and renal functional reserves, inflammatory-immune and coagulation status, and perioperative interventions. Furthermore, it traces the evolution of risk assessment tools from traditional regression models to machine learning models that integrate multimodal data. The review also discusses common challenges in this field, including the standardization of outcome definitions, external validation, calibration assessment, and clinical translation. Future efforts should prioritize the deep integration of predictive tools with clinical decision support systems to establish a closed-loop care pathway from risk identification to stratified intervention, thereby effectively reducing complication rates and enhancing surgical outcomes for elderly lung cancer patients.

Intra-aortic balloon pump(IABP),as the most commonly used percutaneous mechanical circulatory assist device,is routinely implanted through the femoral artery pathway.However,when implantation through the femoral artery pathway is difficult or contraindicated,other pathways including the brachial artery pathway,axillary artery pathway,etc.can be considered.IABP assisted interventional treatment for complex high-risk and indicated patients(CHIP)can reduce the risk of intraoperative complications,stabilize hemodynamics,increase the complete revascularization rate of CHIP,and improve long-term prognosis.The reverse guidewire technique can improve the success rate of percutaneous coronary intervention(PCI)for chronic total occlusion(CTO)of coronary arteries.In clinical practice,the reverse pathway is often chosen in addition to the forward pathway,such as the contralateral radial and brachial artery pathway,femoral artery pathway,etc.This article reports a case of bilateral femoral artery occlusion,in which IABP was implanted through the left brachial artery pathway,and then with the assistance of IABP,the right coronary artery CTO lesion was successfully opened through the right radial artery in the forward direction and the right brachial artery in the reverse direction,with the aim of providing reference for clinical PCI treatment for such special cases.

Objective:To investigate the role and potential regulation mechanism of miR-22-3p in lipotoxic hepatocyte inflam-matory injury and apoptosis caused by palmitic acid(PA).Methods:Human normal immortalized hepatocytes(LO2 cells)were treated with different concentrations of PA for 24 h.CCK-8 and qRT-PCR were used to detect cell proliferation and miR-22-3p expression.miR-22-3p mimics or inhibitors were transfected into LO2 cells and then treated with 0.32 mmol/L PA for 24 h,the expression level of miR-22-3p was determined by qRT-PCR;cell viability was determined by CCK-8;biochemical kits to determine the ALT and AST contents;the mRNA and protein expression levels of inflammatory cytokines TNF-α,IL-1β and IL-6 in intracellular and culture super-natants were determined by qRT-PCR and ELISA;the cell apoptosis rate in each group was determined by flow cytometry;the expres-sion levels of NF-κB signaling pathway-related proteins were detected by Western blot and immunofluorescence.Results:With the increaseing of PA concentration,the cell survival rate and the expression of miR-22-3p decreased in a dose-dependent manner.After PA treatment,the cell proliferation activity decreased significantly,the activities of ALT and AST enzymes were increased,the expressions of inflammatory cytokines TNF-α,IL-1β and IL-6 were increased,cell apoptosis was increased,and NF-κB signaling pathway was activated.Transfection of miR-22-3p mimics significantly increased the proliferation activity of LO2 cells,and decreased the levels of ATL,AST,TNF-α,IL-1β,IL-6 and apoptosis,and inhibited the activation of NF-κB signaling pathway.Transfection of miR-22-3p inhibitor further activated NF-κB signaling pathway,and promoted cell inflammatory injury and apoptosis(all P<0.05).Conclusion:Overexpression of miR-22-3p can alleviate PA-induced apoptosis and inflammation,and the mechanism is related to inhibit the activation of NF-κB signaling pathway.

Objective:To investigate the expression of family with sequence similarity 110 member B (FAM110B) and analyze its associations with clinical prognosis, tumor heterogeneity, and immune-related gene expression through a pan-cancer analysis.Methods:TCGA and GTEx databases were used to evaluate the differential expression of FAM110B at mRNA level in pan-cancer and normal tissues. SangerBox platform and TISIDB database were used to analyze the associations of the expression level of FAM110B mRNA with clinical stages, histological grades, and overall survival of patients. The cBioPortal database and the GSCALite platform were used to analyze the genetic variations in the FAM110B gene, and the associations of FAM110B expression with immune regulatory genes, immune checkpoints, tumor mutation burden, microsatellite instability, and anti-cancer drug sensitivity. qRT-qPCR and Western blot were used to detect the expression of FAM110B at mRNA and protein levels in pancreatic cancer, respectively. Independent samples t-test was employed to assess the significance of differences between two groups; Spearman correlation coefficient was used to evaluate the associations between variables; Log-rank test was used for survival analysis. Results:FAM110B was abnormally expressed in a variety of tumors and associated with the overall survival of patients ( P<0.05), with the most significant difference observed in pancreatic cancer ( P<0.001). In vitro experiments verified that FAM110B was highly expressed in PANC-1 cells ( P<0.01), a pancreatic cancer cell line, and its expression level was related to pathological staging and histological grading ( P<0.001). In addition, the expression level of FAM110B mRNA was related to the expression levels of multiple immunomodulatory genes and correlated with tumor mutational burden and microsatellite instability in various tumors ( P<0.05). Conclusions:FAM110B is related to the prognosis, immune regulation, and tumor heterogeneity across multiple cancers, demonstrating promising potential in both basic research and clinical treatment of various cancers.

Aim To evaluate the role of the glucose transporter protein 1(GLUT1)-dependent glycolytic in the attenuation of oxygen-glucose deprivation-reoxygen-ation(OGD/R)injury in HK-2 cells by dexmedetomi-dine(Dex).Methods C57/BL6 mice were random-ly divided into three groups(n=6),namely,sham operation group(Sham group),renal ischemia reper-fusion group(I/R group)and Dex group(I/R+Dex group).Serum creatinine(Cr)and urea nitrogen(BUN)were measured,while the levels of key glyco-lytic enzymes HK2,PFKFB3 and GLUT1 were meas-ured.HK-2 cells were cultured and randomised into seven groups(n=6),which was treated with OGD/R,overexpression or interference with GLUT1,Dex and glycolysis inhibitor 2-DG.CCK-8 and LDH activi-ty were used to detect cellular damage.Glycolysis lev-els were detected by lactate and ECAR.The inflamma-tory level was reflected by qRT-PCR for IL-6 and TNF-α.qRT-PCR and Western blot were performed to de-tect the levels of GLUT1,HK2,and PFKFB3.Results Dex significantly ameliorated kidney injury and HK-2 cell injury(P＜0.05).Dex inhibited the OGD/R-induced rise in lactate and extracellular acidification rate(ECAR),as evidenced by suppression of the ex-pression of GLUT1,HK2 and PFKFB3(P＜0.05).In vitro experiments showed that GLUT1 knockdown sig-nificantly improved OGD/R-induced cellular damage.Lactate,ECAR,glycolysis-related mRNAs and pro-teins were inhibited by GLUT1 knockdown(P＜0.05).Significantly,there were no significant differ-ences in above indexes after Dex treatment based on GLUT1 knockdown.Overexpression of GLUT1 abroga-ted the protective effects of Dex,while reversing the inhibitory effects of Dex on the expression of GLUT1,HK2,and PFKFB3(P＜0.05).Conclusions Dexmedetomidine attenuates OGD/R induced injury in HK-2 cells by inhibiting GLUT1-dependent glycolysis.

Objective To analyze the serum metabolomic changes of preterm infants with bronchopulmonary dysplasia(BPD)at postmenstrual age(PMA)36 weeks,screen potential biomarkers and associated metabolic pathways,and assess their relationship with short-term respiratory outcomes.Methods A retrospective case-control study was conducted.Infants with gestational age 28-32 weeks admitted to the Children's Hospital Affiliated to Zhengzhou University from January to December 2024 were included.Twenty infants with BPD and 20 gestational age-,birth weight-,and sex-matched non-BPD preterm infants were included.Serum collected at PMA 36 weeks was subjected to untargeted metabolomics analysis,and associations with short-term respiratory outcomes were analyzed.Results Thirteen potential biomarkers distinguishing BPD were identified(area under the curve>0.75,P<0.05).Eight biomarkers—including terephthalic acid,phosphatidylinositol,fumarate,and lysophosphatidic acid—were significantly upregulated(FC≥1.5),while five biomarkers,such as 7α-hydroxy-3-oxo-4-cholestenoate ester and phosphatidylcholine,were significantly downregulated(FC≤1/1.5).Pathway analysis indicated five pathways associated with BPD,including glycerophospholipid metabolism and phenylalanine metabolism.Dysregulation of glycerophospholipid and bile acid metabolism may affect adverse short-term respiratory outcomes in infants with BPD.Conclusions The 13 significantly different metabolites may serve as biomarkers for the diagnosis of BPD.Glycerophospholipid metabolism is associated with the occurrence of BPD and with adverse short-term respiratory outcomes.

Intra-aortic balloon pump(IABP),as the most commonly used percutaneous mechanical circulatory assist device,is routinely implanted through the femoral artery pathway.However,when implantation through the femoral artery pathway is difficult or contraindicated,other pathways including the brachial artery pathway,axillary artery pathway,etc.can be considered.IABP assisted interventional treatment for complex high-risk and indicated patients(CHIP)can reduce the risk of intraoperative complications,stabilize hemodynamics,increase the complete revascularization rate of CHIP,and improve long-term prognosis.The reverse guidewire technique can improve the success rate of percutaneous coronary intervention(PCI)for chronic total occlusion(CTO)of coronary arteries.In clinical practice,the reverse pathway is often chosen in addition to the forward pathway,such as the contralateral radial and brachial artery pathway,femoral artery pathway,etc.This article reports a case of bilateral femoral artery occlusion,in which IABP was implanted through the left brachial artery pathway,and then with the assistance of IABP,the right coronary artery CTO lesion was successfully opened through the right radial artery in the forward direction and the right brachial artery in the reverse direction,with the aim of providing reference for clinical PCI treatment for such special cases.

Objective To investigate the clinical characteristics,antimicrobial susceptibility of pathogens,and laboratory test results of patients with Vibrio vulnificus infection.Methods The clinical and etiological data,as well as laboratory tests were reviewed retrospectively for 14 patients with V.vulnificus infection,who were admitted to the 909th Hospital from May 2022 to November 2023.Results Overall,9 of the 14 patients(64.3％)had a history of exposure to seafood or seawater.Six patients(42.9％)had underlying diseases,such as hepatitis,coronary heart disease and diabetes mellitus.Eleven patients(78.6％)had a good outcome,while 3 patients(21.4％)had a poor outcome.A total of 18 strains of V.vulnificus were isolated,including 11(61.1％)strains from wound pus,and 7 strains(38.9％)from blood.V.vulnificus isolates were susceptible to ampicillin-sulbactam,piperacillin-tazobactam,imipenem,meropenem,tetracycline,ciprofloxacin,levofloxacin,trimethoprim-sulfamethoxazole,and chloramphenicol,but only 50.0％,55.6％,and 61.1％of the strains were susceptible to cefazolin,ampicillin,and amikacin,respectively.White blood cell count,neutrophil,C-reactive protein,prothrombin time,fibrinogen,activated partial thromboplastin time,D-Dimer,urea nitrogen,creatinine,uric acid,glutamic-pyruvic transaminase,glutamic oxaloacetic transaminase,lactate dehydrogenase,alkaline phosphatase,creatine kinase,creatine kinase isoenzyme MB,hypersensitive troponin I,myoglobin,procalcitonin,and N-terminal pro-brain natriuretic peptide were significantly increased in patients with V.vulnificus infection.Conclusions Wound pus and blood samples collected simultaneously for microbial culture can improve the detection of V.vulnificus.Early debridement and antibiotic combination therapy are vital for improving patient survival rate.

Objective:To investigate the role and potential regulation mechanism of miR-22-3p in lipotoxic hepatocyte inflam-matory injury and apoptosis caused by palmitic acid(PA).Methods:Human normal immortalized hepatocytes(LO2 cells)were treated with different concentrations of PA for 24 h.CCK-8 and qRT-PCR were used to detect cell proliferation and miR-22-3p expression.miR-22-3p mimics or inhibitors were transfected into LO2 cells and then treated with 0.32 mmol/L PA for 24 h,the expression level of miR-22-3p was determined by qRT-PCR;cell viability was determined by CCK-8;biochemical kits to determine the ALT and AST contents;the mRNA and protein expression levels of inflammatory cytokines TNF-α,IL-1β and IL-6 in intracellular and culture super-natants were determined by qRT-PCR and ELISA;the cell apoptosis rate in each group was determined by flow cytometry;the expres-sion levels of NF-κB signaling pathway-related proteins were detected by Western blot and immunofluorescence.Results:With the increaseing of PA concentration,the cell survival rate and the expression of miR-22-3p decreased in a dose-dependent manner.After PA treatment,the cell proliferation activity decreased significantly,the activities of ALT and AST enzymes were increased,the expressions of inflammatory cytokines TNF-α,IL-1β and IL-6 were increased,cell apoptosis was increased,and NF-κB signaling pathway was activated.Transfection of miR-22-3p mimics significantly increased the proliferation activity of LO2 cells,and decreased the levels of ATL,AST,TNF-α,IL-1β,IL-6 and apoptosis,and inhibited the activation of NF-κB signaling pathway.Transfection of miR-22-3p inhibitor further activated NF-κB signaling pathway,and promoted cell inflammatory injury and apoptosis(all P<0.05).Conclusion:Overexpression of miR-22-3p can alleviate PA-induced apoptosis and inflammation,and the mechanism is related to inhibit the activation of NF-κB signaling pathway.