Objective To analyze the impact factors on the occurrence of in-hospital adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD),and to construct a prediction model in the form of a column-line diagram and to evaluate the effectiveness of the model.Methods The clinical data of 304 elderly coronary heart disease patients who underwent PCI from February 2021 to March 2024 in our hospital were collected.Patients were divided into MACE group(n=81)and non-MACE group(n=223)based on the occurrence of in-hospital MACE.The optimal cutoff values of each fac-tor were obtained by receiver operating characteristic(ROC)curve analysis.Logistic multiple regression modeling was used to investigate the risk factors of in-hospital MACE after PCI in elderly patients with CHD and a predictive model with columnar graphs was constructed.The correction curve was used for the internal validation of the column chart model and the decision curve was used for evaluating the pre-diction efficacy of the column chart model.Results The proportion of angina pectoris,Gensini score,the proportion of the implanted stent number＞2,and the levels of PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were higher in the MACE group than in the non MACE group,and the difference was statistically significant(P＜0.05).The results of ROC curve analysis showed that the optimal cut-off val-ues for Gensini integral,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were 21 points,38.64％,96.92μmol/L,8.56mg/L,247.67μg/L and 475.14mg/L,respectively.The results of Logistic multiple regression modeling showed that the number of implanted stents,Gensi-ni score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were risk factors for the occurrence of in-hospital MACE after PCI in elderly pa-tients with CHD.Internal validation shows that the C-index of the column-line graph model constructed in this study was 0.991(0.982-0.999).The observed values aligned well with the predicted values.The column-line diagram model with a threshold＞0.08 provided net clinical benefits above the number of implanted stent,Gensini score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a).Conclu-sion In this study,the column-line graph prediction model constructed based on the number of implantated stent,Gensini score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)had good predictive value for the occurrence of in-hospital MACE after PCI in elderly patients with CHD,which may provide a basis for targeted clinical interventions to reduce the occurrence of in-hospital MACE.

Objective To explore the efficacy and safety of TACE and apatinib combined with camrelizumab for treating giant hepatocellular carcinoma(HCC).Methods Totally 78 patients with giant HCC were retrospectively collected,including 22 cases received TACE and apatinib combined with camrelizumab(TACE+AC group)and 56 cases received TACE and apatinib(TACE+A group).Propensity score matching analysis was used to select 44 cases(TACE+A'group)from TACE+A group who were matched to those in TACE+AC group at 1:2 ratio.The overall survival(OS),progression-free survival(PFS)and the adverse events were recorded and compared among groups.Results Patients in TACE+AC group had a median OS of 17.8(95％CI:17.5-18.1)months and a median PFS of 8.8(95％CI:5.4-12.3)months,which in TACE+A'group was 9.8(95％CI:7.6-12.1)months and 5.5(95％CI:2.7-8.3)months,respectively.The overall OS rate and PFS rate in TACE+AC group were significantly higher than those in TACE+A' group(both P<0.05).The incidences of thyroid dysfunction,immune pneumonia and reactive cutaneous capillary endothelial proliferation in TACE+AC group were significantly higher than those in TACE+A' group(all P<0.05).No death associated with adverse events occurred.Conclusion Compared with TACE and apatinib,further combining with camrelizumab could get better survival benefit for giant HCC patients with acceptable adverse events.

Patients with diabetes mellitus are at a significantly elevated risk of developing cognitive impairment,which adversely impacts their quality of life and imposes a substantial burden on the healthcare system.Novel antidiabetic agents,including sodium-glucose cotransporter 2 inhibitors(SGLT-2i),dipeptidyl peptidase-4 inhibitors(DPP-4i),glucagon-like peptide-1 receptor agonists(GLP-1RAs),and dual glucagon-like peptide-1 receptor/glucose-dependent insulinotropic polypeptide receptor agonists(e.g.,Tirzepatide),have been shown to not only effectively regulate glycemic control but also mitigate cognitive decline by inhibiting inflammation,reducing oxidative stress,preventing apoptosis,attenuating amyloid β-protein(Aβ)deposition,and suppressing tau protein phosphorylation.

Objective To investigate the clinical effect and safety of bronchial arterial chemoembolization(BACE)combined with micro wave ablation(MW A)and immunotherapy in treating patients with advanced lung squamous cell carcinoma.Methods The clinical data of 68 patients with advanced lung squamous cell carcinoma,who were admitted to the North Jiangsu People's Hospital of China from June 2020 to June 2022 to receive treatment,were retrospectively analyzed.According to the therapeutic method,the patients were divided into control group(n=30,receiving BACE combined with immunotherapy)and observation group(n=38,receiving BACE followed by MW A,which was performed with CT-guided localization of the lung lesion,and immunotherapy in 3-5 days after BACE).Results The surgical success rate in both the 30 patients of the observation group and the 38 patients of the control group was 100％.After treatment,no surgery-related or chemoembolization-related serious complications occurred in both groups.In the control group and the observation group,the mean progression-free survival(PFS)was(5.70±1.61)months and(12.10±0.72)months respectively,the mean overall survival(OS)was(11.80±1.10)months and(13.00±1.13)months respectively.The PFS of the observation group was obviously longer than that of the control group(P＜0.05),and no statistically significant difference in OS existed between the two groups(P=0.255).Conclusion BACE combined with MW A and immunotherapy can effectively control the advanced lung squamous cell carcinoma,it has reliable short-term efficacy when compared with BACE plus immunotherapy,and it can inhibit tumor growth and prolong the PFS of patients,with a trend of extending OS and a satisfactory clinical safety.

Objective To discuss the clinical efficacy of microwave ablation(MWA)combined with percutaneous vertebroplasty(PVP),radiofrequency ablation(RFA)combined with PVP,and simple PVP in the treatment of vertebral metastatic tumors.Methods A total of 65 patients with vertebral metastatic tumors,who were admitted to the Northern Jiangsu People's Hospital of China to receive treatment from January 2019 to June 2023,were enrolled in this study.The patients were divided into MWA plus PVP group(M+P group,n=25,27 diseased vertebral bodies in total),RFA plus PVP group(R+P group,n=20,23 diseased vertebral bodies in total),and simple PVP group(P group,n=20,24 diseased vertebral bodies in total).Visual analog scale(VAS)score was used to assess the preoperative pain degree and the postoperative relief degree.Bone cement distribution and leakage at one week after surgery were evaluated.Results Successful operation was accomplished in all of the patients.No serious procedure-related complications occurred in all the patients of three groups.In R+P group,P group and M+P group,the preoperative mean VAS scores were(8.48±0.80)points,(8.57±0.98)points and(8.20±1.00)points respectively;the differences among the three groups were not statistically significant(P＞0.05).One week after operation,the pain was significantly relieved in all the patients of three groups;the mean VAS scores in R+P group,P group and M+P group were(4.10±0.85)points,(3.17±0.93)points and(2.44±1.23)points respectively,and the reduction in VAS score was most pronounced in M+P group(P＜0.05).Six months after operation;the mean VAS scores in R+P group,P group and M+P group were(1.87±0.84)points,(4.60±1.09)points and(1.48±0.71)points respectively;and the reduction in VAS score was most pronounced in the M+P group(P＜0.05).The used amount of bone cement in M+P group,R+P group and P group was(7.54±1.44)mL,(5.48±1.12)mL and(4.59±1.56)mL respectively,the difference among the three groups was statistically significant(P＜0.05).The vascular leakage rate(34.8％)and non-vascular leakage rate(52.2％)in P group were remarkably higher than those in R+P group and in M+P group(P＜0.05).No statistically significant difference in the rate of cement leakage existed between R+P group and M+P group(P＞0.05).Conclusion For the treatment of vertebral metastases,MW A plus PVP is superior to RFA plus PVP in pain relief rate.

Objective To explore the efficacy and safety of TACE and apatinib combined with camrelizumab for treating giant hepatocellular carcinoma(HCC).Methods Totally 78 patients with giant HCC were retrospectively collected,including 22 cases received TACE and apatinib combined with camrelizumab(TACE+AC group)and 56 cases received TACE and apatinib(TACE+A group).Propensity score matching analysis was used to select 44 cases(TACE+A'group)from TACE+A group who were matched to those in TACE+AC group at 1:2 ratio.The overall survival(OS),progression-free survival(PFS)and the adverse events were recorded and compared among groups.Results Patients in TACE+AC group had a median OS of 17.8(95％CI:17.5-18.1)months and a median PFS of 8.8(95％CI:5.4-12.3)months,which in TACE+A'group was 9.8(95％CI:7.6-12.1)months and 5.5(95％CI:2.7-8.3)months,respectively.The overall OS rate and PFS rate in TACE+AC group were significantly higher than those in TACE+A' group(both P<0.05).The incidences of thyroid dysfunction,immune pneumonia and reactive cutaneous capillary endothelial proliferation in TACE+AC group were significantly higher than those in TACE+A' group(all P<0.05).No death associated with adverse events occurred.Conclusion Compared with TACE and apatinib,further combining with camrelizumab could get better survival benefit for giant HCC patients with acceptable adverse events.

Patients with diabetes mellitus are at a significantly elevated risk of developing cognitive impairment,which adversely impacts their quality of life and imposes a substantial burden on the healthcare system.Novel antidiabetic agents,including sodium-glucose cotransporter 2 inhibitors(SGLT-2i),dipeptidyl peptidase-4 inhibitors(DPP-4i),glucagon-like peptide-1 receptor agonists(GLP-1RAs),and dual glucagon-like peptide-1 receptor/glucose-dependent insulinotropic polypeptide receptor agonists(e.g.,Tirzepatide),have been shown to not only effectively regulate glycemic control but also mitigate cognitive decline by inhibiting inflammation,reducing oxidative stress,preventing apoptosis,attenuating amyloid β-protein(Aβ)deposition,and suppressing tau protein phosphorylation.

Objective To analyze the impact factors on the occurrence of in-hospital adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD),and to construct a prediction model in the form of a column-line diagram and to evaluate the effectiveness of the model.Methods The clinical data of 304 elderly coronary heart disease patients who underwent PCI from February 2021 to March 2024 in our hospital were collected.Patients were divided into MACE group(n=81)and non-MACE group(n=223)based on the occurrence of in-hospital MACE.The optimal cutoff values of each fac-tor were obtained by receiver operating characteristic(ROC)curve analysis.Logistic multiple regression modeling was used to investigate the risk factors of in-hospital MACE after PCI in elderly patients with CHD and a predictive model with columnar graphs was constructed.The correction curve was used for the internal validation of the column chart model and the decision curve was used for evaluating the pre-diction efficacy of the column chart model.Results The proportion of angina pectoris,Gensini score,the proportion of the implanted stent number＞2,and the levels of PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were higher in the MACE group than in the non MACE group,and the difference was statistically significant(P＜0.05).The results of ROC curve analysis showed that the optimal cut-off val-ues for Gensini integral,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were 21 points,38.64％,96.92μmol/L,8.56mg/L,247.67μg/L and 475.14mg/L,respectively.The results of Logistic multiple regression modeling showed that the number of implanted stents,Gensi-ni score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)were risk factors for the occurrence of in-hospital MACE after PCI in elderly pa-tients with CHD.Internal validation shows that the C-index of the column-line graph model constructed in this study was 0.991(0.982-0.999).The observed values aligned well with the predicted values.The column-line diagram model with a threshold＞0.08 provided net clinical benefits above the number of implanted stent,Gensini score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a).Conclu-sion In this study,the column-line graph prediction model constructed based on the number of implantated stent,Gensini score,PAG,Scr,hs-CRP,Lp-PLA2 and Lp(a)had good predictive value for the occurrence of in-hospital MACE after PCI in elderly patients with CHD,which may provide a basis for targeted clinical interventions to reduce the occurrence of in-hospital MACE.

Objective To comparatively observe the value of TIPS combined with catheter-directed thrombolysis and percutaneous transhepatic portal vein catheterization thrombolysis for acute non-cirrhotic non-neoplastic portal vein thrombosis(PVT).Methods Twenty-five patients with acute non-cirrhotic non-neoplastic PVT were retrospectively enrolled and clustered into TIPS group(n=17,underwent TIPS combined with catheter-directed thrombolysis)and liver puncture group(n=8,underwent percutaneous transhepatic portal vein catheterization thrombolysis)according to the access of thrombolysis.The technical success rate,duration of catheter-directed thrombolysis,complications within 7 days,as well as portal vein patency 3 months after treatment,Child-Pugh grading of liver function and occurrence of hepatic encephalopathy(HE)were recorded and compared between groups.Results The technical success rates were both 100%in 2 groups.There was no significant difference of the duration of catheter-directed thrombolysis between groups(P＞0.05).The thrombolytic effect in TIPS group was better than that in liver puncture group(P＜0.05).No significant difference of the occurrence of bleeding within 7 days was found between groups(P＞0.05).After 3 months'follow-up,the degree of portal vein patency in TIPS group was higher than that in liver puncture group(P＜0.05).No significant difference of Child-Pugh grading of liver function nor occurrence of HE was found between groups(both P＞0.05).Conclusion Both TIPS combined with catheter-directed thrombolysis and percutaneous transhepatic portal vein catheterization thrombolysis were effective for treating acute non-cirrhotic non-neoplastic PVT,and the thrombolytic effect of the former was better than the latter.

Stroke is a prevalent acute cerebrovascular disease associated with significant morbidity and mortality,which highly demand effective prevention and treatment strategies.Glucagon-like peptide-1 receptor agonists(GLP-1RA)is a novel type of antidiabetic drug that exerts hypoglycemic and weight loss effects on GLP-1 receptors.Additionally,GLP-1RA possess the potential to reduce infarction size and promote nerve recovery by inhibiting inflammation,oxidative stress,apoptosis,and improving blood-brain barrier permeability and other pathologies.This paper provides a comprehensive summary of the role of GLP-1 in stroke occurrence while also explores the underlying mechanisms by which GLP-1RA influences stroke pathogenesis.Furthermore,it briefly reviews the therapeutic efficacy of GLP-RA in managing stroke.