ObjectiveThis paper aims to investigate the effect of Huangqi Guizhi Wuwu Tang combined with low-molecular-weight heparin sodium on preventing deep vein thrombosis of the lower extremities in parturients undergoing cesarean section. MethodsA total of 781 parturients who underwent cesarean section （from June 2022 to October 2025） were included in the study and randomly divided into a control group and an observation group using a random number table method. Two cases were lost to follow-up in this study. The parturients undergoing cesarean section in the control group （389 cases） received low-molecular-weight heparin sodium and a traditional Chinese medicine placebo （similar in color to the traditional Chinese medicine in the observation group）. The parturients in the observation group （390 cases） were treated with Huangqi Guizhi Wuwu Tang in addition to the intervention of the control group. The incidence of deep vein thrombosis of the lower extremities in parturients from both groups undergoing cesarean section， the numerical rating scale （NRS） pain scores on the first day， third day， and seventh day after cesarean section， the venous blood flow velocity in the lower extremities of parturients before and after treatment （popliteal vein， femoral vein）， the venous clinical severity score （VCSS） of parturients in the two groups after treatment， the coagulation function indicators before and after treatment ［prothrombin time（PT），activated partial thromboplastin time （APTT），fibrinogen（FIB），D-Dimer］， hemorheological indicators ［high shear viscosity（HSV），low shear viscosity（LSV），erythrocyte sedimentation rate（ESR）］， and the incidence of adverse reactions were compared. ResultsThe incidence of deep venous thrombosis in the lower extremities of parturients after cesarean section in the observation group （0.77%） was lower than that in the control group （2.83%） （χ²=4.862， P=0.031）. On the first， third， and seventh days after cesarean section， the NRS scores of the parturients in the observation group were lower than those of the control group （t=69.509， 23.266， 90.979； P<0.05 for all）. Before treatment， the venous blood flow velocities （popliteal vein， femoral vein） of the lower extremities in the parturients from the two groups were compared， and no statistical difference was found. After treatment， the venous blood flow velocities （popliteal vein， femoral vein） of the lower extremities in the parturients from these two groups increased， with higher indicator levels among the parturients in the observation group than those in the control group （t=40.492， 21.587； P<0.05 for all）. After treatment， the scores of each item in the VCSS of parturients were lower in the observation group than those in the control group （t=46.234， 37.786， 69.016， 39.464； P<0.05 for all）. Before treatment， coagulation function indicators （PT， APTT， FIB， and D-Dimer） of the parturients from the two groups were compared， and there was no statistical significance in the differences . After treatment， PT and APTT increased（P<0.05）， while FIB and D-Dimer decreased in the parturients from both groups（P<0.05）. The degrees of increase and decrease of all indicators were greater among parturients in the observation group than those in the control group （t=18.916， 12.522， 24.787， 27.635； P<0.05 for all）. Before treatment， the hemorheology indicators （HSV， LSV， ESR） in the parturients from both groups were compared， and there was no statistical significance in the differences. After treatment， these indicators in the parturients from both groups decreased， with lower indicator levels in the observation group than those in the control group （t=85.734， 26.280， 56.792； P<0.05 for all）. The incidence of adverse reactions of parturients after cesarean section in the observation group （3.85%） compared with that in the control group （3.34%）， and there was no statistically significant difference （χ²=0.143， P=0.705）. ConclusionHuangqi Guizhi Wuwu Tang combined with low-molecular-weight heparin sodium demonstrates a favorable preventive effect on deep vein thrombosis of the lower extremities in parturients undergoing cesarean section. This combined regimen improves lower extremity function， alleviates postoperative pain after cesarean section， and enhances lower-extremity blood perfusion in parturients， with safety and reliability.

Objective:To investigate the value of fibrinogen to albumin ratio (FAR), creatinine to albumin ratio (CAR) and platelet to lymphocyte ratio (PLR) in predicting the poor prognosis of hyperlipidemic acute pancreatitis (HLAP).Methods:Clinical data of HLAP patients admitted to the hospital from January 2021 to January and December 2023 were retrospectively collected. According to the prognosis, the patients were divided into two groups: good prognosis group and poor prognosis group.The independent risk factors of HLAP in different prognostic groups were obtained by multivariate Logistic regression analysis. Receiver operating characteristic (ROC) curves were plotted to evaluate the prognostic value of FAR, CAR and PLR alone and in combination.Results:A total of 118 patients with HLAP were included, including 69 patients with good prognosis and 49 patients with poor prognosis.The difference of heart rate, lymphocyte, triglyceride, albumin, creatinine, urea nitrogen, blood calcium, blood glucose, C-reactive protein, procalcitonin, fibrinogen, FAR, CAR, PLR, Bedside indicator of acute pancreatitis Severity score, Acute Physiology and Chronic Health status score, hospitalization time assessment between the two groups was statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that FAR (odds ratio ( OR) = 25.949, 95% confidence interval (95% CI):3.190 ~ 211.080, P = 0.002), CAR ( OR = 1.453, 95% CI:1.095 ~ 1.928, P = 0.010) and PLR ( OR = 1.005, 95% CI: 1.001 ~ 1.009, P = 0.020) were independent risk factors for poor prognosis in HLAP patients. ROC curve analysis showed that the area under the ROC curve (AUC) of FAR, CAR and PLR to predict poor prognosis of HLAP patients were 0.823, 0.781 and 0.652, respectively.The AUC of FAR combined with CAR, FAR combined with PLR and CAR combined with PLR were 0.840, 0.845 and 0.849, respectively.The combined ability of FAR, CAR and PLR to predict poor prognosis in HLAP patients was (AUC=0.875,95% CI:0.814 ~ 0.937). When the cut-off value was 0.387, the sensitivity was 83.7%, and the specificity was 79.7%. Conclusions:The prognostic value of FAR, CAR and PLR in HLAP patients is better than that of single or pairwise combination.

Objective:To analyze the prognostic risk factors of patients with traumatic pancreatitis (TP) and establish an early combined prediction of multiple indicators model for TP.Methods:Patients admitted to the ICU of the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2022 were collected retrospectively. Based on their prognosis, the patients were divided into two groups: the good prognosis group and the poor prognosis group. The general data such as sex, age, underlying diseases, Glasgow Coma Scale (GCS), acute physiology and chronic health evaluationⅡ (APACHEⅡ), injury severity score (ISS), bedside index for severity in acute pancreatitis (BISAP), and clinical test indices such as blood routine, blood coagulation, blood gas analysis, and liver and kidney function at admission were compared between the two groups. Univariate analysis and multivariate logistic regression analysis were used to screen the early independent predictors of poor prognosis of TP, and the prediction model of TP was established by combining all of the independent indicators. The receiver operating characteristic (ROC) curve of each independent predictor and prediction model was drawn, and the area under the curve (AUC), sensitivity, specificity, and optimal cut-off value were calculated to examine the diagnostic impact of each independent predictor and the combined prediction model.Results:There were statistically significant differences in the complication rate of mental disorders, GCS, APACHE II, combined craniocerebral injury, combined chest injury, activated partial thromboplastin time, fibrin(pro)degradation products, lactate, aspartate aminotransferase, glomerular filtration rate, amylase, lipase, NT-proBNP, myoglobin, procalcitonin, ISS, and BISAP between the good and poor prognosis groups (all P<0.05). Multivariate logistic regression analysis showed that lactate ( OR=1.636, 95% CI: 1.046-2.559), lipase ( OR=1.005, 95% CI: 1.001-1.008), and ISS ( OR=1.161, 95% CI: 1.064-1.266) were independent risk factors influencing the prognosis of patients with TP. Based on the risk factors listed above, a prediction model was created: Logit P=-9.260+0.492×lactate+0.005×lipase+0.149×ISS, and the ROC curve was plotted. The AUC curve of the prediction model was 0.96 (95% CI: 0.91-1.00). Conclusions:Lactate, lipase, and ISS are early independent risk factors associated with the prognosis of TP. Their combined multi-indicator prediction model has an excellent clinical prediction effect, which can provide a clinical reference for early prediction and treatment of TP.

Objective:To explore the efficacy and safety of camrelizumab combined with apatinib as the second-line treatment for patients with advanced gastric cancer.Methods:The clinical data of 19 patients with advanced gastric cancer in Hebei General Hospital from August 2019 to March 2022 were retrospectively analyzed. All patients received camrelizumab combined with apatinib as the second-line treatment. The treatment efficacy and adverse reactions were evaluated; the survival analysis was performed using Kaplan-Meier method; Cox proportional hazards model was used to analyze the influencing factors for overall survival (OS) of patients.Results:Among 19 patients, no one achieved complete remission, 4 patients (21.1%) achieved partial remission, 9 patients (47.4%) had stable disease. The objective response rate (ORR) and disease control rate (DCR) were 21.1% (4/19) and 68.4% (13/19), respectively. The ORR of patients with deficient mismatch repair (dMMR) was higher than that of patients with proficient mismatch repair (pMMR) [100.0% (2/2) vs. 11.8% (2/17), P < 0.05], and patients with programmed death receptor ligand 1 (PD-L1) combined positive score (CPS) ≥1 had a higher DCR than patients with PD-L1 CPS < 1 [100.0% (5/5) vs. 25.0% (1/4), P < 0.05]. The median follow-up time of 19 patients was 14.7 months (12.0-17.4 months), the median progression-free survival time and OS time were 2.8 months and 5.7 months (95% CI 2.4-8.9 months). Increased lactate dehydrogenase (LDH) was negatively correlated with OS ( χ2 = 10.262, P = 0.001). Multivariate Cox regression analysis showed that LDH was an independent influencing factor for the OS of patients (<250 U/L vs. ≥250 U/L: HR = 0.149, 95% CI 0.039-0.657, P = 0.005). The most common treatment-related adverse reactions were fatigue (52.6%, 10 cases), anemia (47.4%, 9 cases), thrombocytopenia (36.8%, 7 cases), rash (36.8%, 7 cases), and reactive capillary hemangioma (36.8%, 7 cases). Conclusions:Camrelizumab combined with apatinib as the second-line treatment for advanced gastric cancer have good efficacy and safety.

Gene editing technology is a genetic operation technology that can modify the DNA sequence at the genomic level. The precision gene editing technology based on CRISPR/Cas9 system is a gene editing technology that is easy to operate and widely used. Unlike the traditional CRISPR/Cas9 system, the precision gene editing technology can perform site-directed mutation of genes without DNA template. This review summarizes the recent development of precision gene editing technology based on CRISPR/Cas9, and prospects the challenges and opportunities of this technology.
Gene Editing ; CRISPR-Cas Systems/genetics* ; Mutation ; Genome

Objective:To investigate the application value of paradoxical intention therapy in patients undergoing PCI.Methods:A total of 116 patients who undergoing PCI in Fuwai Center China Cardiovascular Hospital from January 2018 to December 2019 were enrolled in the present study. They were divided into experimental group and control group with 58 cases in each group. The control group received routine therapy and nursing care, while the experimental group carried out paradoxical intention therapy based on the control group. The effects were evaluated by physiological stress index (blood pressure, heart rate), Symptom Checklist-90 (SCL-90) and General Comfort Questionnaire (GCQ) respectively.Results:At 1 day before surgery, once on the operative day and 1 day after surgery, the systolic pressure were (129.58 ± 13.89), (132.08 ± 12.28), (125.58 ± 12.28) mmHg(1 mmHg=0.133 kPa) in the experimental group, significantly lower than those in the control group (137.22 ± 11.18), (138.35 ± 14.94), (132.35 ± 14.89) mmHg, the differences were statistically significant ( t=3.14, 2.38, 2.59, all P<0.05). At 1 day before surgery and once on the operative day, the heart rate were (74.17 ± 4.18), (76.39 ± 5.14) times/minutes in the experimental group, significantly lower than those in the control group (76.62 ± 5.19), (78.78 ± 6.22) times/minutes, the differences were statistically significant ( t=2.69, 2.17, both P<0.05). After 4 weeks of intervention, the scores of somatization, compulsion, anxiety, depression and total SCL-90 were (1.25 ± 0.19), (1.42 ± 0.23), (1.19 ± 0.28), (1.20 ± 0.16), (121.66 ± 9.66) points in the experimental group, significantly lower than those in the control group (1.84 ± 0.25), (1.68 ± 0.37), (1.84 ± 0.39), (1.73 ± 0.33), (146.47 ± 8.64) points, the differences were statistically significant ( t values were 4.45-14.08, all P<0.05). The scores of physiological dimension, psychological dimension and total GCQ were (10.89 ± 2.22), (24.49 ± 4.92), (77.91 ± 6.20) points in the experimental group, significantly higher than those in the control group (8.51 ± 2.27), (21.84 ± 4.61), (72.09 ± 6.66) points, the differences were statistically significant ( t=5.50, 2.89, 4.69, all P<0.05). Conclusions:Paradoxical intention therapy can effectively alleviate physiological and psychological stress and decrease postoperative discomfort of patients undergoing PCI.

Objective:To provide experimental evidence for genetic counseling and prenatal diagnosis by analyzing the clinical characteristics, screening and identification of the function of suspicious variants in a X-1inked spondyloepiphyseal dysplasia tarda (SEDT) family.Methods:The family members' medical history, general physical examination, femur, spine X-ray examination were collected. Peripheral blood samples of the family members were collected and DNA was extracted from these samples. Sequencing clinical whole exons of proband DNA by targeted gene high-throughput sequencing method, then analysis sequencing data. The suspicious mutation was confirmed in pedigree members by PCR and Sanger sequencing. Reverse transcription polymerase chain reaction (RT-PCR) experiments of total RNA from blood lymphocytes were performed. The amplification of exons 3 and 4 of the pathogenic gene were amplified and identified by agarose gel. The expression of the pathogenic gene was also detected.Results:Three affected males of the family were diagnosed with SEDT according to their clinical and radiological features. A nonsense mutation in the transport protein particle complex subunit 2 ( TRAPPC2) gene NM_001011658: c.91A>T (p.K31*) was found in the proband using whole exome sequencing. This variation was also detected in his cousin, but not in non-phenotypic members of the family. The RT-PCR result for amplification of exon 3 and 4 of peripheral blood lymphocytes was the same as those of normal controls, indicating that the mutation did not affect the splicing of transcripts. qPCR results showed that the transcriptional expression of TRAPPC2 in patients was significantly lower than that in family normal controls and normal people controls. Conclusion:Identification of the novel nonsense mutation (c.91A>T) in the SEDT family enables early patients screening, carrier detection, genetic counseling, prenatal diagnosis, and clinical prevention and treatment. The detailed genotype/phenotype descriptions contribute to the SEDT mutation spectrum. The study of the function of TRAPPC2 mutation will help to further elucidate the role of sedlin in cartilage.

Objective:To investigate the role of macrophage migration inhibitory factor (MIF) in severe acute pancreatitis (SAP) associated lung injury in mice.Methods:Totally 32 mice were randomly divided into 4 groups ( n=8/per group): wild type control group (WT+CON group), wild type SAP group (WT+SAP group), MIF gene knockout control group (KO+CON group), and MIF gene knockout SAP group (KO+SAP group). SAP model was established by intraperitoneal injection of L-arginine (4 mg/g). The expression of serum amylase, IL-6, TNF-α and MIF were detected by ELISA. The pathological changes of pancreatic and lung tissues were observed by HE staining. The expression of IL-6 and TNF-α in lung tissue was detected by immunohistochemistry. The expression of NF-κB in lung tissue was detected by Western blot. For measurement data, t test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:Compared with the WT+CON group, pathological score of pancreatic and lung injury, serum amylase, TNF-α and IL-6 expression in serum and lung tissues were significantly increased in the WT+SAP group ( P<0.05), while the above indexes were significantly decreased in the KO+SAP group ( P<0.05). In addition, the expression of NF-κB protein in KO+SAP group was significantly lower than that in the WT+SAP group ( P<0.05). Conclusions:MIF gene knockout can alleviate severe acute pancreatitis associated acute lung injury in mice, and its mechanism may be related to NF-κB.

Objective:To investigate the predictive value of dynamic platelet and hemagglutination-related parameters in patients with acute pancreatitis (AP).Methods:The patients admitted to the Department of Emergency Surgery in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2020 were analyzed. According to the inclusion criteria and exclusion criteria, patients with AP were retrospectively enrolled. According to the Chinese Guidelines for the Diagnosis and Treatment of Acute Pancreatitis (Shenyang, 2019), the patients were divided into two groups: severe acute pancreatitis (SAP group) and non-severe acute pancreatitis (non-SAP group) [including mild acute pancreatitis (MAP) and moderate severe acute pancreatitis (MSAP)]. A normal distribution of the maximum and mean aggregation rates of dynamic platelets (arachiidonic acid), plateletcrit (PCT) and bedside index for severity in acute pancreatitis (BISAP) scores and other measurement data were tested by t test, while measurement data of prothrombin time (PT), fibrinogen (FIB) and D-dimer that did not conform to normal distribution were tested by Mann-Whitney U test. χ 2 test was used for the counting data such as sex, age and etiology of patients in the two groups. The prognostic value of statistically significant indicators for non-SAP group and SAP group was further analyzed by receiver operating characteristic (ROC) curve. Results:A total of 146 patients with AP were enrolled, including 50 patients in SAP group and 96 in non-SAP group. The maximum and average aggregation rates of dynamic platelet (aracidonic acid) in the SAP group were (71.76±17.62) % and (67.91±18.10) %, PT (12.02±1.33) s, FIB (4.76±2.08) g/L, D-dimer (3.75±6.04) μg/L, PCT (0.23±0.08) %, and BISAP scores (1.42±1.18), which were all significantly higher than those in the non-SAP group [the maximum and average aggregation rates of dynamic platelet (arachiidonic acid) (46.65±20.11) % and (42.50±20.71) %, PT (11.50±1.51) s and FIB (3.91±1.48) g/L, D-dimer (1.00±1.37) μg/L, PCT (0.19±0.06) %, BISAP scores (0.45±0.66)] (all P<0.05). According to area under the ROC curve, the maximum and average aggregation rates of dynamic platelets (arachiidonic acid) in serum of patients with SAP were 0.83 and 0.82, respectively, and the sensitivities were 0.56 and 0.68, respectively. The specificity was 0.99 and 0.81, respectively, which was better than PT, FIB, D-dimer, PCT and BISAP scores in predicting the severity of AP. Conclusions:The maximum and average aggregation rates of dynamic platelets (arachidonic acid), PT, FIB, D-dimer, PCT and BISAP scores can be used as predictors of the severity of acute pancreatitis. The maximum and average aggregation rates of dynamic platelets (arachiidonic acid) were the best in predicting the severity of AP.

In 2014, the training of clinical medical genetics was included in the training sequence of resident standardized training in China. The standardized training of clinical geneticist in China started relatively late. As a whole, the training and qualification system of clinical hereditary physicians are still in the process of development and perfection. Based on "Rules for the training of department of medical genetics", basic medical genetics resident training system was established in Henan Provincial People's Hospital. Additionally, we took advantage of interactive online education platform, multiple disciplinary team, the analysis of positive case report, literature report and other teaching practices combined with the tutor system. After 4 years of exploration and practice, the program can quickly improve the residents' comprehensive ability, such as theoretical knowledge, professional literacy, clinical practice skills, and scientific research ability.