Objective To explore the correlation between the expression level of secreted curl associated protein 5(SFRP5)and the condition and prognosis of patients with severe pneumonia.Methods A total of 168 patients with pneumonia admitted to the Department of Respiratory and Critical Care Medicine of this hospital from June 2022 to June 2024 were selected as the research subjects,and 78 healthy individuals who underwent physical examinations in this hospital during the same period were selected as the control group.According to the acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,the patients were di-vided into the common pneumonia group(APACHE Ⅱ score＜15,n=82)and the severe pneumonia group(APACHE Ⅱ score≥ 15,n=86).Peripheral venous blood was collected from the three groups after fasting for 8 to 12 hours and peripheral blood mononuclear cells were extracted by centrifuging.Real-time fluores-cence quantitative PCR was used to detect the expression level of SFRP5 mRNA in peripheral blood mononu-clear cells,which was Used to determine the expression level of SFRP5.Pearson analysis was used to analyze the correlations between the expression level of SFRP5 and the levels of inflammatory factors,pulmonary function indices and the condition in patients with severe pneumonia.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of the expression level of SFRP5 for the prognosis of patients with severe pneumonia.Results There were also significant differences in the levels of WBC,C re-active protein(CRP),procalcitonin(PCT),interleukin(IL)-6,and IL-8 among the three groups(P＜0.05),with the highest levels observed in the severe pneumonia group and the lowest in the control group.There were significant differences in the levels of forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),and FEV1/FVC among the three groups(P＜0.05),with the highest levels observed in the severe pneumonia group and the lowest in the control group.The expression level of SFRP5 in the severe pneumonia group was the lowest(0.46±0.13),followed by the common pneumonia group(0.78±0.15),and the control group was the highest level(1.23±0.22),with statistically significant differences(P＜0.05).The results of Pearson correlation analysis showed that the expression level of SFRP5 in patients with severe pneu-monia was negatively correlated with the levels of WBC,CRP,PCT,IL-6,IL-8,and the APACHE Ⅱ score(P＜0.05),and positively correlated with the levels of FEV1,FVC,and FEV1/FVC(P＜0.05).The area un-der the curve(AUC)of the expression level of SFRP5 for predicting poor prognosis in patients with severe pneumonia was 0.843(95％CI:0.748-0.912),with a sensitivity of 68.18％and a specificity of 89.06％.Conclusion The expression level of SFRP5 is related to the condition of patients with severe pneumonia,and SFRP5 can predict the prognosis of patients with severe pneumonia.

Objective To observe the role of dried tangerine peel in Yigong Powder improves iron metabolism and promotes red blood cell generation in anemia of chronic disease (ACD).Methods With a two-by-two factorial design,the Yigong Powder was divided into dried tangerine peel and Chenpi absent Decoction. According to the random number table method,32 zymosan-induced generalized inflammation (ZIGI) mice were randomly divided into the model group,the dried tangerine peel group,the Chenpi absent Decoction group,and the Yigong Powder group. The dried tangerine peel group,Chenpi absent Decoction group and the Yigong Powder group were given dried tangerine peel(3.083 g/kg),Chenpi absent Decoction(12.33g/kg),and Yigong Powder(15.413g/kg)by gavage to the corresponding group of mice. The model group was given an equal amount of physiological saline by gavage,and treated continuously for 7 days. After the completion of administration,the body weight of each group of mice was recorded. The hemoglobin content of each group of mice was detected using a fully automatic cell counter,the serum iron content was detected using colorimetry,the serum ferritin content was detected using enzyme-linked immunosorbent assay (ELISA),and the spleen index was calculated. The liver tissue inflammatory factors interleukin-1β (IL-1β),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),interferon-γ (IFN-γ),interleukin-4 (IL-4),and interleukin-10 (IL-10) levels were detected using Luminex method. The mRNA expressions of liver tissue hepcidin gene (HAMP) and membrane iron transporter ( Fpn) were detected using real-time fluorescence PCR method. Results Dried tangerine peel and Chenpi absent Decoction both showed interactive effects in regulating hemoglobin,serum iron,serum ferritin content,improving spleen index,and regulating the mRNA expressions of HAMP,Fpn,as well as IL-1β and IFN-γ (P<0.05). Compared with the model group,dried tangerine peel significantly increased hemoglobin,serum iron content,and Fpn mRNA expression in ZIGI model mice,while decreasing ferritin content,spleen index,HAMP mRNA expression,and the levels of IL-1β,IL-6,TNF-α,and IFN-γ (P<0.05). Chenpi absent Decoction significantly increased serum iron content and Fpn mRNA expression in ZIGI model mice,while reducing spleen index,ferritin content,HAMP mRNA expression,and the levels of IL-1β and IFN-γ、IL-4 (P<0.05). Conclusion The effects of dried tangerine peel on inflammatory factors (IL-6 and TNF-α) and Fpn may play a key role in the improvement effects of Yigong Powder on ACD and iron metabolism.

Ferroptosis is a nonapoptotic form of cell death and differs considerably from the well-known forms of cell death in terms of cell morphology,genetics,and biochemistry.The three primary pathways for cell ferroptosis are system Xc-/glutathione peroxidase 4(GPX4),lipid metabolism,and ferric metabolism.Since the discovery of ferroptosis,mounting evidence has revealed its critical regulatory role in several diseases,especially as a novel potential target for cancer therapy,thereby attracting increasing attention in the fields of tumor biology and anti-tumor therapy.Accordingly,broad prospects exist for identifying ferroptosis as a potential therapeutic target.In this review,we aimed to systematically summarize the activation and defense mechanisms of ferroptosis,highlight the therapeutic targets,and discuss the design of nanomedicines for ferroptosis regulation.In addition,we opted to present the advantages and disadvantages of current ferroptosis research and provide an optimistic vision of future directions in related fields.Overall,we aim to provide new ideas for further ferroptosis research and inspire new strategies for disease diagnosis and treatment.

【Objective】 To retrospectively analyze the guiding significance and effect of thromboelogram (TEG) in the clinical use of cryoprecipitation. 【Methods】 A total of 289 patients with fibrinogen reduction, admitted to our hospital between January 2018 and December 2021, were collected. They was divided into control group (using coagulation examination and clinical feature as the transfusion criteria) and observation group (above parameters plus TEG). The TEG index in the observation group before and after transfusion and Fg, APTT, PT, and TT in 2 groups of patients before and after transfusion were monitored. The efficacy and prognosis of different blood products and cryoprecipitate were compared between 2 groups of patients.) 【Results】 The efficacy of choprecipitate transfusion was better in the observation group than the control[Fg index after transfusion (g / L) 1.92±0.92 vs 1.80±1.00, P<0.05]. And less blood products were used in observation group as compared with the control[ RBC(U) 1.93±2.69 vs 2.81±3.25 (P<0.05); FFP(mL) 667±378 vs 879±455(P<0.05)]. No differences were noticed by hospital stay between the two groups, but the prognosis in the observed group was significantly better than that in the control. 【Conclusion】 It’s scientific and reasonable to apply TEG to guide the clinical transfusion of cryoprecipitate, so as to save blood resources and improve the prognosis.

Objective:To investigate the current situation of activity of daily living (ADL) among the community elders in Mianyang City in Sichuan Province and analyze its influencing factors, so as to provide reference for improving the ADL of the community elders.Methods:Using the convenient sampling method, from April 2020 to December 2021, a total of 17 259 community elders (≥65 years old) in 3 counties/districts in Mianyang City in Sichuan Province were selected as the research objects, and The Elderly Ability Assessment Standard Table was used to investigate them. A total of 17 259 questionnaires were sent out in this study and 16 482 were effectively received, with the effective recovery of 95.50%.Results:Among the 16 482 community elderly, a total of 20.59% (3 394/16 482) had ADL impairment, including 2 557 (75.34%) with mild ADL impairment, 517 (15.23%) with moderate ADL impairment and 320 (9.43%) with severe ADL impairment. The results of binomial Logistic regression analysis showed that age, educational level, marital status, children's status, mental state and social participation ability, perception and communication ability were the influencing factors of ADL among the elderly in community ( P<0.05) . Conclusions:The ADL impairment rate of the elderly in the community in Mianyang City is relatively high. Community medical staff should focus on the elderly. For those with low educational level, no spouse, children, impaired mental state and social participation ability and impaired perception and communication ability, the community medical staff give targeted interventions as soon as possible to improve the abilities of daily living of the elderly in the community.

The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.

The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.

Objective Toexploretheimagingfeaturesofextramedullarydisease(EMD)in multiplemyeloma(MM).Methods Theclinicalandimagingdataof17patientswithpathologicallydiagnosedMMcombinedwithEMDwereanalyzedretrospectively.Results EMDhadcertainpredilectionsites,Centralnervoussysteminvasion (6):meningealinvasion (3:1 multiple,2focal),spinalcanal invasion (1focal),thelefttemporalpoleinvasion(1focal),theleftsideforeheadinvasion(1focal);Headandneckinvasion(3:allfocal);Thoraxinvasion(8):pleuralinvasion(6:5 multiple,1focal),intrapulmonaryinvasion(1focal),anteriormediastinalinvasion(1focal);Subcutaneoussofttissueinvasion(5:allmultiple);Muscleinvasion(2focal);Lymphnodeinvasion (1 multiple).BothCTand MRI showedsofttissuenodulesormasses.ThevaluesofCTwereabout30~70HU,especiallyin30~45HU,whileMRIpresentedequal orslightlylowsignalonT1WI,equalorslightlyhighsignalonT2WI,andhighsignalinthesequenceofDWIcombinedwithmoderate toobviousenhancement,Generally,theboundaryofEMDwereclearandtheshapeoftheselesionswereregular,However,theinvasion tomuscleinsomelesionsshowedthepatternofinvasivegrowth.Conclusion EMDofmultiplemyelomamayhappenanywhere,and thepleural,meningesandsubcutaneoussofttissuesarethemostcommonlocation.CTandMRIcanshowtheEMDverywell.Thelocation, size,shapeandrelationshipwithsurroundingtissuesoftheselesionshavecertainreferencevaluesforthediagnosisanddifferential diagnosisofEMD.

Due to the particularity of oncology,which is not included in undergraduate coume,most of the physicians gain the oncology knowledge in a fragmented way.The process of diagnosis and treatment of cancer needs to be concluded and systematization.According to characteristics of standardized training in the Department of Oncology,combined with the characteristics of internal medicine and oncology,we should increase the training of strengthening concept of multidisciplinary team cooperation for students,clinical thinking of cancer subjects,the training of transitional medical ideas and humanistic care knowledge with tumor characteristic,on the basis of strengthening skill training on Oncology.We should also encourage the general physicians of non cancer majors to participate in the standardized training of cancer specialties and explore more teaching methods and forms,as well as the positive significance of cross professional training.

Objective To investigate the clinical manifestations,laboratory tests,and image modalities on rheumatoid arthritis (RA) accompanied with atlanto-axial joint involvement.Methods Sixty-four cases of RA accompanied with cervical vertebra involvement were divided into 2groups by lesion location.Twenty-two cases were RA accompanied with atlanto-axial joint involvement,while 42 cases were RA with cervical vertebra other than atlanto-axial joint involvement.The age,course,clinical manifestations and the lab results were compared between the two groups by t test,Chi-square test and Fisher's exact probability.The X-ray,CT and magnetic resonance imaging (MRI) for cervical vertebra were analyzed in RA with atlanto-axial joint involvement.Results Compared with non-atlantoaxial cervical group,the disease course [(15±10) years vs (8±9) years,t=3.030,P=0.004],upper cervical vertebra pain (73％ vs 7％,x2=29.75,P＜0.01),lower cervical vertebra pain (9％ vs 40％,x2=6.813,P=0.009),cervical activity limitation (68％ vs 14％,x2=19.023,P＜0.01),upper cervical vertebra pressing pain (100％ vs 7％,22=52.297,P＜0.01),lower cervical vertebra pressing pain (9％ vs 60％,x 2=15.056,P＜0.01) and erythrocyte sedimentation rate (ESR) [(73±34) mm/1 h vs (53±37) am/1 h,t=2.039,P=0.046)] were significantly different in atlantoaxial joint lesions group.CT combined with MRI exams had high diagnostic..value in RA with atlanto-axial joint involvement.CT scan had the conformed diagnostic value.Sixteen cases were positive (73％) by MRI scan,while 3 cases (14％) by X-ray.Conclusion Timely CT scan and/or MRI scan for RA patients with neck pain in upper cervical vertebra,long disease course,cervical activity limitation and high ESR are helpful for early diagnosis of atlanto-axial joint involvement.