Objective To investigate the prevalence status and influencing factors of metabolic syndrome (MS) in adult patients with hypopituitarism (HP) during hospitalization. Methods The data of adult HP patients who received treatment in the hospital were collected from March 2021 to March 2024. The prevalence status of MS in adult HP patients was counted, and logistic regression analysis was adopted to analyze the influencing factors of MS in adult HP patients. Results Among the 308 adult HP patients in this study, 121 cases developed MS and 187 cases did not develop MS, and they were included in the MS group (n=148) and the non-MS group (n=232). The incidence of MS in adult HP patients was 38.95% (148/380). Compared with the non-MS group, the levels of high-density lipoprotein cholesterol, serum total cholesterol and low-density lipoprotein cholesterol in the MS group were higher, the waist circumference was larger, and the growth hormone was lower (P<0.05). After logistic regression analysis, it was found that high-density lipoprotein cholesterol (OR=1.069, 95%CI: 1.010-1.132, P=0.021), total serum cholesterol (OR=1.065, 95%CI: 1.014-1.119, P=0.012), low-density lipoprotein cholesterol (OR=1.055, 95%CI: 1.005-1.108, P=0.031), waist circumference (OR=1.063, 95%CI: 1.006-1.123, P=0.030) and growth hormone (OR=1.077, 95%CI: 1.019-1.138, P=0.009) could independently affect the occurrence of MS in adult HP patients (P<0.05). Conclusion Adult HP patients during hospitalization are often complicated with MS. High-density lipoprotein cholesterol, serum total cholesterol, low-density lipoprotein cholesterol, waist circumference, and growth hormone are factors affecting the occurrence of MS in adult HP patients.

ObjectivesTo observe the clinical effectiveness， safety， and potential mechanism of Yisui Shengxue Pills （益髓生血丸） as adjuvant treatment for myelosuppression after chemotherapy for malignant tumours with qi and yin deficiency syndrome. MethodsEighty patients of myelosuppression after chemotherapy for malignant tumours with qi and yin deficiency syndrome were randomly divided into trial group and control group， with 40 cases in each group. Both groups received conventional western medicine treatment， while the control group added placebo taken orally， and the trial group received Yisui Shengxue Pills orally， and both groups were treated for 21 consecutive days. Granulocyte colony stimulating factor （G-CSF）， granulocyte-macrophage colony stimulating factor （GM-CSF）， soluble intercellular cell adhesion molecule-1 （sICAM-1）， Jagged 1 （Jagl）， Notch homolog 2 （Notch2）， cell fate determinant membrane associated protein 1 （Numb1）， neutrophils， platelet count， white blood cell count， hemoglobin， cluster of differentiation 4⁺ （CD4⁺）， and cluster of differentiation 8⁺ （CD8⁺） were detected before and after treatment； myelosuppression grade and TCM syndrome scores of the two groups were evaluated before and after treatment， and clinical effectiveness and adverse events of the two groups were compared. ResultsThe difference in myelosuppression grading between the two groups after treatment was statistically significant （P＜0.05）. Compared with this group before treatment， plasma G-CSF， GM-CSF， sICAM-1， Numb1 expression， platelet count， neutrophil count， leukocyte count， haemoglobin， CD4⁺ level decreased， Jagl， Notch2 expression and CD8⁺ level increased， and fatigue， spontaneous sweating， palpitation， night sweating， insomnia， scanty complexion， mouth erosion， vexing heat in chest， palms and soles scores all reduced （P＜0.05）. Compared with the control group after treatment， plasma G-CSF， GM-CSF， sICAM-1， Numb1 expression， platelet count， neutrophil count， leukocyte count， haemoglobin， CD4+ levels increased， Jagl， Notch2 expression and CD8⁺ levels decreased， and fatigue， spontaneous sweating， palpitations， night sweating， insomnia， pale face， mouth erosion， and vexing heat in chest， palms and soles scores decreased in trial group （P＜0.05）. The total effective rate of the trial group was 95.00%， which was significantly higher than that of the control group， which was 80.00% （P＜0.05）. Comparison of the incidence of liver function damage and renal function damage between the two groups showed no statistically significant difference （P＞0.05）， and the incidence of gastrointestinal damage in the trial group was lower than that in the control group （P = 0.02）. ConclusionYisui Shengxue Pills as adjuvant treatment for myelosuppression after chemotherapy for malignant tumours with qi and yin deficiency syndrome can improve the myelosuppression and clinical symptoms， improve the clinical effectiveness， and has a good synergistic and toxicity-reducing effect， and its mechanism of action may be related to the regulation of the Notch signalling pathway and the reduction of immune function impairment.

Objective To investigate the onset situation of sarcopenia in elderly patients with type 2 di-abetes mellitus(T2DM),and to analyze the influence factors of fall risk and the relationship between the com-plicating muscle function reduction and the fall risk.Methods A total of 512 cases of T2DM aged ≥60 years old in this hospital from January 2020 to December 2022 served as the study subjects.The grip strength(HS)was tested by the CAMRY-EH101 grip tester,the walking speed(GS)was measured by the stopwatch and tape measure,the muscle content was analyzed and determined by bioelectrical impedance.The skeletal muscle mass index(SMI)was calculated.Sarcopenia was grouped by the AWGS2019 standard,the Morse fall Risk Prediction Scale was used to evaluate the fall risk,and the influencing factors of fall risk were analyzed by bi-nary logistic regression.Results The detection rate of sarcopenia among the study subjects was 19.92％,and 399 patients(77.93％)had the fall risk.Whether having sarcopenia or the severity of sarcopenia had no influ-ence on the fall risk(P＞0.05).Among the patients without sarcopenia,the fall risk in the HS,GS and SMI decrease group was increased compared with the normal group(P＜0.001).The results of the multi-factor a-nalysis showed that the 7 types of variables such as gender,BMI,blood glucose,IL-6,T2DM retinopathy,T2DM pe-ripheral neuropathy and T2DM vascular disease were the influencing factors of fall risk(P＜0.05).Conclusion Eld-erly patients with T2DM have a higher fall risk,and T2DM combined with decreased muscle function could aggravate the fall risk,but T2DM combined with sarcopenia has no significant effect on the fall risk.

Objective:To predict Chinese materia medica that may prevent and treat coronary microvascular dysfunction (CMD) by identifying disease core targets.Methods:CMD- related targets were obtained through GeneCards and OMIM databases. Subnetworks were extracted by using MCODE plugin in Cytoscape 3.9.1. Core targets of subnetworks were obtained by using cytoNCA plugin. GO function and KEGG pathway enrichment analysis for core targets were performed by using Metascape. Coremine Medical database was used to match targets with Chinese materia medica. Obtained Chinese materia medica was screened, and their properties and tastes, meridians and efficacy categories were under statistics.Results:Totally 3 859 disease-related targets were screened and five subnetworks were obtained. An in-depth study of MCODE1 yielded ten core targets, including IL-1β, IL6, TNF, STAT3, AKT1, ACTB, VEGFA, GAPDH, TP53, and ALB. GO functional enrichment analysis showed that these core targets were mainly involved in biological processes, such as positive regulation of gene expression, positive regulation of transcription, DNA template, and negative regulation of gene expression. KEGG pathway enrichment analysis identified 67 signaling pathways, including the AGEs-RAGE signaling pathway, HIF-1 signaling pathway, adipocytokine signaling pathway, fluid shear stress, and atherosclerosis. The researchers identified 36 kinds of Chinese materia medica associated with the ten core targets, including Salviea Miltiorrhizae Radix et Rhizoma, Chuanxiaong Rhizoma, Carthami Flos, Paeoniae Radix Rubra, Coptidis Rhizoma, Ginseng Radix et Rhizoma, Ophiopogonis Radix, Schisandrae Chinensis Fructus, Cinnamomi Cortex, Nelumbinis Semen, and Valerianae Jatamansi Rhizoma et Radix among 880 herbs.Conclusion:This study predicts 36 kinds of Chinese materia medica that have the effect of preventing and treating CMD, which can provide research ideas for the development of new drugs.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

OBJECTIVE To investigate the effects of erianin （ERI） on the apoptosis of ovarian granulosa cells in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS PCOS rat model was constructed by subcutaneous injection of dehydroepiandrosterone， and the successfully constructed rats were randomly divided into PCOS group， ERI low-dose， medium- dose and high-dose groups （10， 20， 40 mg/kg） and ERI high dose + verteporfin group （40 mg/kg ERI + 10 mg/kg verteporfin）， with 10 rats in each group. Another 10 normal rats were selected as the normal group. Rats in each administration group were given corresponding dose of ERI and/or intraperitoneal injection of vitiporfin， and rats in the PCOS group and normal group were orally administered an equal volume of 1% dimethyl sulfoxide， once a day， for 6 consecutive weeks. After administration， the body weight， fasting blood glucose （FPG）， serum levels of estradiol （E2）， testosterone （T）， follicle stimulating hormone （FSH） and luteinizing hormone （LH） were detected in each group； morphological changes in ovarian tissue were observed， and the apoptosis of ovarian tissue cells was analyzed. Apoptosis-associated proteins [B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， Caspase-3] and Hippo-YAP signaling pathway associated proteins [large tumor suppressor kinase 1 （LATS1）， phosphorylated LATS1 （p-LATS1） and Yes associated protein （YAP）， phosphorylated YAP （p-YAP）， transcriptional co-activator with PDZ binding motif （TAZ）] were detected in ovarian tissue. RESULTS Compared with PCOS group， the ovarian polycystic characteristics of the ERI low-dose， medium-dose，and high-dose groups were reduced， the number of atretic follicles was reduced， and the granulosa cell layer was thickened； the body mass， FPG， T， LH， LH/FSH， the number of cystic follicles， cell apoptosis index， protein expressions of Bax， Caspase-3， p-LATS1 and p-YAP were greatly decreased （P＜0.05）； the number of corpus luteum， protein expressions of E2， Bcl-2， LATS1， YAP and TAZ were greatly increased （P＜0.05）. Compared with ERI high-dose group， the above indexes in ERI high-dose + vitiporfin group were inhibited （P＜0.05）. CONCLUSIONS ERI can promote the proliferation of ovarian granulosa cells and improve the level of sex hormones in PCOS rats， and its mechanism of action may be related to the inhibition of the Hippo-YAP signaling pathway.

OBJECTIVE To investigate the effects of erianin （ERI） on the apoptosis of ovarian granulosa cells in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS PCOS rat model was constructed by subcutaneous injection of dehydroepiandrosterone， and the successfully constructed rats were randomly divided into PCOS group， ERI low-dose， medium- dose and high-dose groups （10， 20， 40 mg/kg） and ERI high dose + verteporfin group （40 mg/kg ERI + 10 mg/kg verteporfin）， with 10 rats in each group. Another 10 normal rats were selected as the normal group. Rats in each administration group were given corresponding dose of ERI and/or intraperitoneal injection of vitiporfin， and rats in the PCOS group and normal group were orally administered an equal volume of 1% dimethyl sulfoxide， once a day， for 6 consecutive weeks. After administration， the body weight， fasting blood glucose （FPG）， serum levels of estradiol （E2）， testosterone （T）， follicle stimulating hormone （FSH） and luteinizing hormone （LH） were detected in each group； morphological changes in ovarian tissue were observed， and the apoptosis of ovarian tissue cells was analyzed. Apoptosis-associated proteins [B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， Caspase-3] and Hippo-YAP signaling pathway associated proteins [large tumor suppressor kinase 1 （LATS1）， phosphorylated LATS1 （p-LATS1） and Yes associated protein （YAP）， phosphorylated YAP （p-YAP）， transcriptional co-activator with PDZ binding motif （TAZ）] were detected in ovarian tissue. RESULTS Compared with PCOS group， the ovarian polycystic characteristics of the ERI low-dose， medium-dose，and high-dose groups were reduced， the number of atretic follicles was reduced， and the granulosa cell layer was thickened； the body mass， FPG， T， LH， LH/FSH， the number of cystic follicles， cell apoptosis index， protein expressions of Bax， Caspase-3， p-LATS1 and p-YAP were greatly decreased （P＜0.05）； the number of corpus luteum， protein expressions of E2， Bcl-2， LATS1， YAP and TAZ were greatly increased （P＜0.05）. Compared with ERI high-dose group， the above indexes in ERI high-dose + vitiporfin group were inhibited （P＜0.05）. CONCLUSIONS ERI can promote the proliferation of ovarian granulosa cells and improve the level of sex hormones in PCOS rats， and its mechanism of action may be related to the inhibition of the Hippo-YAP signaling pathway.

Objective:To investigate the efficacy and safety of atorvastatin combined with indobufen in the treatment of elderly patients with diabetic kidney disease (DKD) complicated with large atheromatous ischemic stroke (LAA-IS) during convalescence.Methods:The clinical data of 102 elderly patients with DKD complicated with LAA-IS during convalescence from September 2018 to April 2022 in Baoding Second Central Hospital were retrospectively analyzed. Among them, 51 patients were treated with atorvastatin combined with indobufen (observation group), 51 patients were treated with atorvastatin combined with aspirin (control group), and both groups were treated continuously for 6 months. The prethrombotic state indexes, neurological function and quality of daily life, carotid artery ultrasound indexes, renal fibrosis indexes before treatment and after treatment were compared between two group. The prethrombotic state indexes included arachidonic acid (AA) and adenosine diphosphate (ADP) induction platelet aggregation rate, fibrinogen (FIB), protein C; the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological function, and the modified Barthel index (MBI) was used to evaluate the quality of daily life; carotid artery ultrasound indexes included carotid artery intima-media thickness (IMT) and maximum plaque area; the renal fibrosis indexes included transforming growth factor-β 1 (TGF-β 1), matrix metalloproteinase-9 (MMP-9), hyaluronic acid and platelet derived growth factor-BB (PDGF-BB). The adverse reactions were recorded. Results:There were no statistical differences in the all indexes before treatment between two groups ( P>0.05). In two groups, compared before treatment, the AA induction platelet aggregation rate, ADP induction platelet aggregation rate, FIB, NIHSS score, IMT and maximum plaque area after treatment were significantly lower, the protein C and MBI score were significantly higher, and there were statistical differences ( P<0.01); but there were no statistical differences after treatment between two groups ( P>0.05). The TGF-β 1, MMP-9, hyaluronic acid and PDGF-BB after treatment in two groups were significantly lower than before treatment, and the indexes in observation group were significantly lower than those in control group: (39.46 ± 6.89) μg/L vs. (45.04 ± 8.20) μg/L, (278.46 ± 49.39) μg/L vs. (327.30 ± 57.28) μg/L, (102.37 ± 20.62) μg/L vs. (116.84 ± 24.97) μg/L vs. (25.26 ± 4.45) μg/L vs. (28.13 ± 5.08) μg/L, with statistically significant differences( P<0.01). The incidence of adverse reactions in observation group was significantly lower than that in control group: 7.84% (4/51) vs. 23.53% (12/51), and there was statistical difference ( P<0.05). Conclusions:Compared with atorvastatin combined with aspirin, atorvastatin combined with indobufen in elderly patients with DKD complicated with LAA-IS during convalescence has the same effect in improving the related indicators of prethrombotic state, reducing neurological function deficit, improving the ability of daily living, and reversing carotid atherosclerosis. However, atorvastatin combined with indobufen can further protect renal function with higher safety.

Objective:To evaluate the value of the ratio of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) in evaluating right ventricular function of patients with hypertrophic cardiomyopathy (HCM) and heart failure with preserved ejection fraction (HFpEF).Methods:A total of 74 patients with HCM and HFpEF and 22 healthy individuals who visited the First Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were included in this study. The HCM patients with HFpEF were divided into three groups based on the tertiles of the TAPSE/PASP (low group: <0.280 0 mm/mmHg; middle group: 0.280 0-0.476 2 mm/mmHg; high group: >0.476 2 mm/mmHg). Conventional echocardiographic parameters were collected, and two-dimensional speckle tracking technology was used to obtain right ventricular strain parameters. The differences in parameters among the groups were compared, and the correlations between TAPSE/PASP and clinical parameters and right ventricular function parameters were analyzed.Results:The results of difference analysis showed that there were significant differences in 6-minute walking test, New York Heart Association grade (NYHA grade), incidence of atrial fibrillation, left atrial area (LAA), left ventricular global longitudinal strain (LVGLS), TAPSE, PASP, right ventricular fractional area change (RVFAC), right ventricular global longitudinal strain (RVGLS), right ventricular free wall strain (RVFWST) and cardiac magnetic resonance right ventricular ejection fraction (CMR-RVEF) among the three groups. The results of correlation analysis and multiple linear regression analysis showed that the TAPSE/PASP was positively correlated with 6-minute walking distance, RVFAC, tricuspid annulus peak systolic velocity (RV s′), and CMR-RVEF ( r=0.449, 0.284, 0.358, 0.577; all P<0.05). It was negatively correlated with N-terminal pro-brain natriuretic peptide (NT-proBNP), NYHA grade, LAA, mitral early diastolic peak velocity / mitral annulus early diastolic peak velocity (LV E/e′), LVGLS, RVGLS, RVFWST and tricuspid early diastolic peak velocity / tricuspid annulus early diastolic peak velocity (RV E/e′) (r/ rs=-0.336, -0.349, -0.468, -0.452, -0.444, -0.339, -0.405, -0.320; all P<0.05). The LAA and CMR-RVEF correlated independently with TAPSE/PASP(all P<0.05). Conclusions:The TAPSE/PASP can provide an early, simple, rapid, and convenient evaluation of right ventricular function in patients with HCM and HFpEF, so as to guide clinical treatment and monitoring disease progression.

The intervention and prevention of perioperative hypothermia is not only reflected in the technical level, but also reveals the important role of humanistic care in the whole intervention work. If perioperative patients have hypothermia, it is likely to cause a series of complications such as postoperative shivering, which seriously threatens the life safety of patients. Prevention and intervention was based on a comprehensive understanding of the causes and hazards of hypothermia, especially the impact on the lives of the elderly. Effective supervision was implemented in the whole process of operation, such as dynamic monitoring of vital signs including body temperature, followed by room temperature regulation, body temperature protection and preoperative and postoperative psychological nursing. At this time, the sense of responsibility, good humanistic care of medical staff are of positive significance to effectively prevent and reduce the probability of perioperative hypothermia and accelerate the postoperative rehabilitation of patients.