Ultrasound-guided peripheral nerve block is widely used in perioperative pain management of hip fracture patients,which not only provides better analgesia,but also reduces the use of opioids,while tradi-tional techniques such as femoral nerve block and iliofascial space block often result in motor block,which is not conducive to the early rehabilitation of patients.The newly proposed pericapsular nerve block and iliopsoas plane block of the hip can preserve motor function while providing satisfactory analgesia,further in-depth re-search has found that it has great significance in the diagnosis and treatment process of patients with hip frac-tures.This article reviews the innervation of the hip joint,the methods of operation and clinical application of ultrasound-guided pericapsular nerve block and iliopsoas plane block of the hip joint,in order to provide refer-ence for clinical practice.

Objective To investigate the prevalence and the risk factors of heart disease(HD)in adults aged ≥80 years old in China based on the data from the 8th round of the Chinese Longitudinal Healthy Longevity Survey(CLHLS).Methods A total of 7 675 adults aged ≥80 years old were enrolled from the 8th round of CLHLS dataset.Chi-square tests were employed to examine associations between cardiovascular disease and demographic characteristics,socioeconomic status,social support,lifestyle factors,and health indicators.Logistic regression models were developed to analyze significant predictors of heart disease in the elderly.Results The prevalence of heart disease was 16％(n=1 228)in 7 675 elderly people.Aged 90-99 years old(odds ratio[OR]=0.816),≥100 years old(OR=0.641),female(OR=0.833),and low body mass index(BMI)(＜18.5 kg/m2,OR=0.778)were the protective factors for cardiovascular disease in the elderly;and high BMI(24.0 to 27.9 kg/m2,OR=1.209),rural residence(OR=2.384),health examination(OR=1.164),dysfunction of daily living activities(OR=1.401),hypertension(OR=2.143),diabetes mellitus(OR=1.719),and history of cerebrovascular accident(OR=2.080)were risk factors.Conclusion Male,overweight,rural residence,health examination,dysfunction of daily living activities,hypertension,diabetes mellitus,and a history of cerebrovascular accident are the risk factors for heart disease in the elderly.

Objective To assess stromal fibrosis in epidermal growth factor receptor(EGFR)mutant lung adenocarcinoma and its association with resistance to targeted therapy and patient prognosis.Methods Medical records of 207 patients diagnosed with EGFR-mutant advanced lung adenocarcinoma who received treatment at a hospital between January 2021 and December 2022 were reviewed.A total of 86 patients were ultimately included based on their prognosis and survival duration.These patients were categorized into a resistance group(32 cases)and a non-resistance group(54 cases),depending on whether they developed resistance to targeted therapy within one year.Additionally,patients were classified into mild,moderate,and severe fibrosis groups according to the extent of fibrosis observed.Clinical and pathological characteristics,as well as fibrosis levels,were compared between the two groups.Factors influencing the development of resistance to targeted therapy in patients with EGFR-mutant lung adenocarcinoma were analyzed,and the survival outcomes of patients with varying degrees of fibrosis were evaluated during follow-up.Results In the resistance group,the prevalence of EGFR exon 20 insertion mutations,elevated CA125 levels,and the presence of moderate-to-severe fibrosis were significantly higher compared to the non-resistance group(P<0.05).Multivariate logistic regression analysis revealed that EGFR exon 20 inser-tion mutation(OR=3.691,95%CI:1.043～13.057),elevated CA125 levels(OR=4.104,95%CI:1.160～14.517),and moderate-to-severe fibrosis(OR=3.959,95%CI:1.410～11.115)were independent risk factors associated with resistance to targeted therapy among patients with EGFR-mutant lung adenocarcinoma(P<0.05).The Cox proportional hazards model demonstrated a C-index of 0.72(95%CI:0.65～0.79),with area under the curve(AUC)values for 1-year and 2-year survival predictions of 0.781 and 0.734,respectively.EGFR exon 20 insertion mutation(HR=3.691),moderate-to-severe fibrosis(HR=3.959),and elevated CA125 levels(HR=4.104)were identified as independent prognostic factors for overall survival in these patients following targeted therapy.The median progression-free survival(PFS)for patients with mild,moderate,and severe fibrosis was 10.5 months,7.2 months,and 3.9 months,respectively,while the median overall survival(OS)was 21.4 months,16.1 months,and 11.5 months,respectively.Statistically significant differences in both PFS and OS were observed across the three fibrosis severity groups.(P<0.05).Conclusion The extent of stromal fibrosis in EGFR-mutant lung adenocarcinoma influences resistance to targeted therapy,and the progression of fibrosis is correlated with an unfavorable prognosis.

Objective To analyze the main epidemiological characteristics of fungal infection in this hospital in the past 7 years,and to provide reference for clinical treatment and prevention and control strategies of fun-gal infection.Methods The fungal data and clinical data of related patients isolated from clinical samples in Peking Union Medical College Hospital from early January 2018 to the end of May 2024 were selected,and the main epidemiological characteristics of fungal infection in this hospital were identified and described through multi-angle statistical analysis.Results A total of 4 479 patients with filamentous fungal infection were en-rolled.The proportion of male patients[57.5％(2 576/4 479)]was higher than that of female patients[42.5％(1 903/4 143)],mainly distributed in internal medicine,Intensive Care Unit(ICU)and emergency de-partment,among which internal medicine accounted for the highest proportion[50.0％(2 241/4 479)].About 90.0％of the specimens were from the lower respiratory tract,in addition to specimens from skin and soft tis-sue,tissue,ear and blood culture.In terms of seasonal distribution,there are more patients in winter.The fun-gi were mainly composed of Aspergillus,Mucor,Cerdosporium,Fusarium and Penicillium,among which As-pergillus was the most abundant,accounting for 74.6％of the total.Aspergillus fumigatus was the most a-bundant Aspergillus,accounting for 42.5％of the total Aspergillus(1 418/3 340).Among the related infec-tions caused by mold,Aspergillus was the most common in the lower respiratory tract,accounting for 76.8％.Among them,Aspergillus fumigatus accounted for the highest proportion(33.6％).98.6％of the molds infected the ear were Aspergillus,of which Aspergillus niger and Aspergillus terreus were the most common.Skin infections are mainly caused by Sporothrix schenckii,Trichophyton rubrum,Microsporum ca-nis.The results of in vitro drug sensitivity test showed that the four common Aspergillus isolated in this hos-pital were sensitive to voriconazole,and amphotericin B had better antifungal activity against Mucorales in vitro.Conclusion Based on the main epidemiological characteristics of fungal infections in this hospital,it is recommended that special attention be paid to the admission of patients in the respiratory department during the peak infection period in autumn and winter.In the treatment of fungal infections in different regions and on different body parts,attention should be paid to the differences in the distribution of bacterial species.

Objective To assess stromal fibrosis in epidermal growth factor receptor(EGFR)mutant lung adenocarcinoma and its association with resistance to targeted therapy and patient prognosis.Methods Medical records of 207 patients diagnosed with EGFR-mutant advanced lung adenocarcinoma who received treatment at a hospital between January 2021 and December 2022 were reviewed.A total of 86 patients were ultimately included based on their prognosis and survival duration.These patients were categorized into a resistance group(32 cases)and a non-resistance group(54 cases),depending on whether they developed resistance to targeted therapy within one year.Additionally,patients were classified into mild,moderate,and severe fibrosis groups according to the extent of fibrosis observed.Clinical and pathological characteristics,as well as fibrosis levels,were compared between the two groups.Factors influencing the development of resistance to targeted therapy in patients with EGFR-mutant lung adenocarcinoma were analyzed,and the survival outcomes of patients with varying degrees of fibrosis were evaluated during follow-up.Results In the resistance group,the prevalence of EGFR exon 20 insertion mutations,elevated CA125 levels,and the presence of moderate-to-severe fibrosis were significantly higher compared to the non-resistance group(P<0.05).Multivariate logistic regression analysis revealed that EGFR exon 20 inser-tion mutation(OR=3.691,95%CI:1.043～13.057),elevated CA125 levels(OR=4.104,95%CI:1.160～14.517),and moderate-to-severe fibrosis(OR=3.959,95%CI:1.410～11.115)were independent risk factors associated with resistance to targeted therapy among patients with EGFR-mutant lung adenocarcinoma(P<0.05).The Cox proportional hazards model demonstrated a C-index of 0.72(95%CI:0.65～0.79),with area under the curve(AUC)values for 1-year and 2-year survival predictions of 0.781 and 0.734,respectively.EGFR exon 20 insertion mutation(HR=3.691),moderate-to-severe fibrosis(HR=3.959),and elevated CA125 levels(HR=4.104)were identified as independent prognostic factors for overall survival in these patients following targeted therapy.The median progression-free survival(PFS)for patients with mild,moderate,and severe fibrosis was 10.5 months,7.2 months,and 3.9 months,respectively,while the median overall survival(OS)was 21.4 months,16.1 months,and 11.5 months,respectively.Statistically significant differences in both PFS and OS were observed across the three fibrosis severity groups.(P<0.05).Conclusion The extent of stromal fibrosis in EGFR-mutant lung adenocarcinoma influences resistance to targeted therapy,and the progression of fibrosis is correlated with an unfavorable prognosis.

To evaluate the efficacy and safety of eravacycline in the treatment of pulmonary infections based on real-world data.

Objective:To compare the dosimetric characteristics of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) after left breast conserving surgery.Methods:Twenty-four patients with left breast cancer after breast-conserving surgery who were admitted to the Department of Radiation Oncology of Tumor Hospital of Yunnan Province from May 2016 to May 2019 were selected. The HT plan and the VMAT plan were designed for the same patient. The target dose and the dose volume parameters of organs at risk were compared and analyzed in the two radiotherapy plans.Results:There were significant differences in the D 2% [(59.68±0.46) Gy vs. (60.06±0.20) Gy, t=-4.229, P<0.001], D 98% [(57.46±0.44) Gy vs. (57.20±0.07) Gy, t=2.912, P<0.001], conformity index (CI) (0.80±0.05 vs. 0.76±0.04, t=4.079, P<0.001) and homogeneity index (HI) (0.04±0.01 vs. 0.05±0.00, t=-5.505, P<0.001) of the planning gross tumor volume (PGTV) between the HT and VMAT plans. However, there was no significant difference in the D 50% [(58.77±0.46) Gy vs. (58.75±0.11) Gy, t=0.179, P=0.859]. There were significant differences in the D 50% [(51.99±0.39) Gy vs. (52.39±0.36) Gy, t=-5.278, P<0.001], D 98% [(49.46±0.29) Gy vs. (48.35±0.46) Gy, t=9.538, P<0.001] and HI (0.19±0.01 vs. 0.21±0.01, t=-7.538, P<0.001) of the planned target volume (PTV) between the two plans. However, there were no significant differences in the D 2% [(59.13±0.64) Gy vs. (59.09±0.46) Gy, t=0.511, P=0.614] and CI (0.83±0.04 vs. 0.82±0.04, t=1.637, P=0.115). In terms of organs at risk, there were significant differences in the V 5 [(57.90±1.42)% vs. (52.40±5.74)%, t=4.812, P<0.001], V 20 [(22.40±2.17)% vs. (18.40±3.16)%, t=5.573, P<0.001] and D mean [(12.71±0.55) Gy vs. (11.46±1.26) Gy, t=4.963, P<0.001] of left lung, D mean of right lung [(3.42±0.27) Gy vs. (2.49±0.24) Gy, t=13.310, P<0.001], D mean of right breast [(4.41±0.50) Gy vs. (3.12±0.65) Gy, t=10.326, P<0.001], V 30 [(0.55±0.37)% vs. (1.24±1.11)%, t=-4.020, P=0.001] and D mean of heart [(4.68±0.62) Gy vs. (3.83±0.88) Gy, t=7.335, P<0.001], D mean of left atrium [(2.53±0.31) Gy vs. (2.16±0.28) Gy, t=5.488, P<0.001], D mean of right atrium [(2.77±0.43) Gy vs. (2.20±0.30) Gy, t=7.103, P<0.001], D mean of right ventricle [(5.10±0.72) Gy vs. (3.72±0.94) Gy, t=9.802, P<0.001] and D 2% of spinal cord [(14.79±2.73) Gy vs. (5.42±2.23) Gy, t=14.788, P<0.001] between HT and VMAT plans. There was no significant difference in the D mean of left ventricle [(5.10±1.19) Gy vs. (4.80±1.54) Gy, t=1.250, P=0.224]. Conclusion:Both the HT plan and the VMAT plan can meet the treatment requirements. The HT plan can provide better target area conformity and dose uniformity. The VMAT plan has more advantages in terms of organs at risk. The HT plan shows an advantage only in exposure to high-dose area.

Thoracentesis is common in daily medical practice. During the operation, it is easy to cause complications such as re-expansion pulmonary edema, pulmonary hypotension, liver and spleen injury, pleural reaction, intercostal artery injury, pneumothorax, and so on. If the operator does not master procedures properly, it is easy to damage the thoracic organs. Therefore, the department of the general practice of the First Hospital of Jiaxing improved the puncture needle device based on thoracic puncture cannula, developed a new type of disposable thoracic puncture cannula, and obtained the National Utility Model Patent of China (patent number: ZL 2019 2 2112955.7). New type of disposable thoracic puncture cannula comprises a flexible puncture cannula, a steel needle, a limit structure, and a second bolt. In the process of puncture, the length of the puncture is limited by the limit structure. If the puncture force is too strong, the limit structure will prevent further penetration of the needle. The device is easy to use, flexible to operate, easy to master, and can reduce the risk of thoracentesis, which is worth of clinical promotion.

Objective To analyze the serum gastric function and Helicobacter pylori ( HP ) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps.Methods From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies ( UreA, UreB, VacA, CagA antibodies ) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen?I ( PG?I),pepsinogen?Ⅱ( PG?Ⅱ),gastrin were detected by enzyme?linked immunosorbent assay (ELISA).Gastrin?17( G?17) and calculate PGⅠ and PGⅡ ratio( PGR).Results The levels of serum PGⅡ(13.13(8.15,20.30) μg ／L) and G17 (8.44(3.72,27.17) pmol／L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56,15.14) μg／L and 1.83(0.87,5.95) pmol／L) ( P＜0.05),and the PGR level was lower than the control group ( P＜0.05);serum PGI ( 120.12 ( 86.72,174.70) μg／L), PGII ( 11.92 ( 7.27,22.26) μg／L),G17 ( 5.68 ( 1.79, 14.65) pmol／L) in the gastric fundic gland polyp group was higher than the control group (( 101.32 (79.17,131.33) μg ／L,9.16 ( 5.56,15.14) μg ／L,1.83 ( 0.87,5.95) pmol／L) ( P 均＜0.05)) ( P＜0.05); serum G17 (8.44(3.72,27.17) pmol／L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79,14.65) pmol／L) ( P＜0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42／68)was higher than that in the gastric fundic gland polyp group40.30%(27／67) (P＜0.05),and type I Hp was the main one (P＜0.05).The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative ( all P＜0.05).There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP?positive and negative?positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type ( all P＜0.05).There was no significant difference in the levels of serum PGⅠ,PGⅡ,G17,and PGR between the gastric fundic gland polyps group and the type Ⅱ.Conclusion Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps.