Objectives:To investigate the clinical characteristics and prognosis of patients with pulmonary arterial hypertension(PAH)concomitant with obstructive sleep apnea(OSA).Methods:We analyzed the data of 208 patients diagnosed with PAH in the Pulmonary Vascular Diseases Ward of our hospital from September 2019 to August 2024,who underwent sleep breathing monitoring and echocardiography during hospitalization.Three clusters were identified:Cluster 1(n=121)had no OSA and mildly elevated N-terminal pro-B-type natriuretic peptide(NT-proBNP),Cluster 2(n=71)exhibited mild OSA and mildly elevated NT-proBNP,and Cluster 3(n=16)presented with moderate to severe OSA along with significantly elevated NT-proBNP.Results:The mean age of this patient cohort was(39±12)years,mean body mass index was(21.74±3.67)kg/m2,and 27.9%patients were male.Sixty-five patients(31.3%)had OSA.The echocardiographic indicators reflecting the structural function of the heart chambers and hemodynamic parameters in patients with PAH showed a significant correlation with nocturnal hypoxia.Compared to Cluster 1,patients in Cluster 2 and Cluster 3 had wider pulmonary arteries and inferior vena cava diameters,larger right ventricular diameters,higher pulmonary artery pressure,higher pulmonary vascular resistance,and lower cardiac index(all P<0.05).Cluster 3 patients had a significantly higher risk of death(log-rank P=0.022).Conclusions:Thirty-one percent of PAH patients in this study had concomitant OSA.PAH patients with significantly elevated NT-proBNP and comorbid moderate-to-severe OSA had a significantly higher risk of death compared to those with only mild or without OSA without significantly elevated NT-proBNP.Management strategies that address both PAH and OSA might be effective in improving the outcomes of these patients.

Objective To analyze the risk factors and clinical outcomes of cognitive impairment in elderly patients with heart disease after surgery.Methods A total of 156 patients with heart valve diseases undergoing coronary artery bypass surgery admitted to the First Affiliated Hospital of H ainan Medical University from October 2021 to December 2023 were prospectively recruited.At 7 d postoperatively,Montreal cognitive assessment(MoCA)scale was used to assess their cogni-tive function,and based on MoCA score＜26 or not,they patients were divided into a cognitive impairment group(n=61)and a control group(n=95).The clinical features were compared be-tween the two groups,and the risk factors for cognitive impairment were analyzed.All patients were followed up for 1 year to compare the outcomes of the two groups.Results The cognitive impairment group had significantly advanced age,larger proportions of concomitant chronic respiratory diseases and sarcopenia,increased ratio of undergoing open heart surgery,and elevated incidence of intraoperative hypotension than the control group(P＜0.05,P＜0.01).Multivariate logistic regression analysis indicated that age,chronic respiratory diseases,sarcopenia,open heart surgery,and intraoperative hypotension were independent risk factors for postoperative cognitive impairment in elderly patients with heart diseases(OR=1.081,95％CI:1.007-1.161,P=0.030;OR=2.538,95％CI:1.062-6.066,P=0.036;OR=2.650,95％CI:1.174-5.985,P=0.019;OR=3.104,95％CI:1.391-6.929,P=0.006;OR=3.478,95％CI:1.298-9.322,P=0.0013).There was no statistical difference in preoperative MoCA scores between the two groups(27.90±1.40 vs 28.20±1.40,P=0.195).The MoCA score at 7 d and 6 and 12 months after surgery were obviously lower in the cognitive impairment group than the control group(22.90±1.27 vs 27.73±1.08,P=0.000;24.72±1.66 vs 27.73±1.23,P=0.000;25.48±1.73 vs 27.62±1.22,P=0.000).Age was identified as an independent factor affecting the outcome of cognitive function in the patients(OR=1.168,95％CI:1.035-1.318).Conclusion The incidence of postoperative cog-nitive impairment is relatively high in elderly patients with heart disease.So,relevant risk factors should be addressed to strengthen the prevention and management.

Objectives:To investigate the clinical characteristics and prognosis of patients with pulmonary arterial hypertension(PAH)concomitant with obstructive sleep apnea(OSA).Methods:We analyzed the data of 208 patients diagnosed with PAH in the Pulmonary Vascular Diseases Ward of our hospital from September 2019 to August 2024,who underwent sleep breathing monitoring and echocardiography during hospitalization.Three clusters were identified:Cluster 1(n=121)had no OSA and mildly elevated N-terminal pro-B-type natriuretic peptide(NT-proBNP),Cluster 2(n=71)exhibited mild OSA and mildly elevated NT-proBNP,and Cluster 3(n=16)presented with moderate to severe OSA along with significantly elevated NT-proBNP.Results:The mean age of this patient cohort was(39±12)years,mean body mass index was(21.74±3.67)kg/m2,and 27.9%patients were male.Sixty-five patients(31.3%)had OSA.The echocardiographic indicators reflecting the structural function of the heart chambers and hemodynamic parameters in patients with PAH showed a significant correlation with nocturnal hypoxia.Compared to Cluster 1,patients in Cluster 2 and Cluster 3 had wider pulmonary arteries and inferior vena cava diameters,larger right ventricular diameters,higher pulmonary artery pressure,higher pulmonary vascular resistance,and lower cardiac index(all P<0.05).Cluster 3 patients had a significantly higher risk of death(log-rank P=0.022).Conclusions:Thirty-one percent of PAH patients in this study had concomitant OSA.PAH patients with significantly elevated NT-proBNP and comorbid moderate-to-severe OSA had a significantly higher risk of death compared to those with only mild or without OSA without significantly elevated NT-proBNP.Management strategies that address both PAH and OSA might be effective in improving the outcomes of these patients.

Objective To analyze the risk factors and clinical outcomes of cognitive impairment in elderly patients with heart disease after surgery.Methods A total of 156 patients with heart valve diseases undergoing coronary artery bypass surgery admitted to the First Affiliated Hospital of H ainan Medical University from October 2021 to December 2023 were prospectively recruited.At 7 d postoperatively,Montreal cognitive assessment(MoCA)scale was used to assess their cogni-tive function,and based on MoCA score＜26 or not,they patients were divided into a cognitive impairment group(n=61)and a control group(n=95).The clinical features were compared be-tween the two groups,and the risk factors for cognitive impairment were analyzed.All patients were followed up for 1 year to compare the outcomes of the two groups.Results The cognitive impairment group had significantly advanced age,larger proportions of concomitant chronic respiratory diseases and sarcopenia,increased ratio of undergoing open heart surgery,and elevated incidence of intraoperative hypotension than the control group(P＜0.05,P＜0.01).Multivariate logistic regression analysis indicated that age,chronic respiratory diseases,sarcopenia,open heart surgery,and intraoperative hypotension were independent risk factors for postoperative cognitive impairment in elderly patients with heart diseases(OR=1.081,95％CI:1.007-1.161,P=0.030;OR=2.538,95％CI:1.062-6.066,P=0.036;OR=2.650,95％CI:1.174-5.985,P=0.019;OR=3.104,95％CI:1.391-6.929,P=0.006;OR=3.478,95％CI:1.298-9.322,P=0.0013).There was no statistical difference in preoperative MoCA scores between the two groups(27.90±1.40 vs 28.20±1.40,P=0.195).The MoCA score at 7 d and 6 and 12 months after surgery were obviously lower in the cognitive impairment group than the control group(22.90±1.27 vs 27.73±1.08,P=0.000;24.72±1.66 vs 27.73±1.23,P=0.000;25.48±1.73 vs 27.62±1.22,P=0.000).Age was identified as an independent factor affecting the outcome of cognitive function in the patients(OR=1.168,95％CI:1.035-1.318).Conclusion The incidence of postoperative cog-nitive impairment is relatively high in elderly patients with heart disease.So,relevant risk factors should be addressed to strengthen the prevention and management.

Sofosbuvir has ushered in a new era of hepatitis C treatment with its strong inhibition on the replication of hepatitis C virus, favorable safety profile and less interactions with other drugs. Sofosbuvir-based regimens have been included as the first-line therapies for the treatment of adults with chronic hepatitis C (CHC) in international guidelines. Available clinical trial data show that sofosbuvir with ribavirin and ledipasvir/sofosbuvir are highly efficacious and safe in CHC patients aged 3-17 years old; therefore, they can meet the unmet medical needs of adolescents and children with CHC in China. Furthermore, the pan-genotypic sofosbuvir/velpatasvir is being investigated in adolescents and children with CHC, which is expected to make the treatment in such patients more convenient upon approval.

Objective To explore the relation among the quality of the Paridis polyphylla and different species and growth conditions, and help to provide scientific foundation for introduction and cultivation of Paridis polyphylla.Methods The samples of Paridis polyphylla were collected by different varieties, different growth years, different harvest seasons and different altitude habitats. The content of saponins in Paridis polyphylla was measured by HPLC method according to the Chinese Pharmacopoeia 2015. The chromatographic column was ACQUITY UPLC? HSS T3 (3.0 mm× 100 mm, 1.8μm), the mobile phase was acetonitrile and water (gradient elution), with flow rate of 0.5 ml/min, detection wavelength was 203 nm and column temperature at 35℃.Results Total saponin content ranged from 1.35% to 3.89% among the varieties studied. The content of each components were listed as:Paris polyphylla Smith(PS) >Paris polyphylla Smith var. yunnanensis(Franch.) Hand.-Mazz. (PY) >Paris polyphylla Smith var. chinensis(Franch.) Hara (PC). From 3 to 10 years old of PC, the longer the growth years made the higher the total saponin content. Furthermore, total saponin content of PC increased gradually with the altitudes rising from 400 to 800 meters. The total saponin content of PY harvesting in spring was much higher than that of other seasons.Conclusions The Results showed the importance for introducing and cultivating of Paridis polyphylla.

Objective To compare the clinical efficacy,adverse reactions,and management effect of postoperative intravenous analgesia for patients with postoperative intravenous analgesia with digital information technology and electronic analgesia pump system.Methods Totally 100 patients with postoperative intravenous analgesia (PCIA) were selected from April 2015 to September 2015 with postoperative intravenous analgesia and randomly divided into Wireless analgesic pump system Group (A group) and electronic analgesia pump group (group B),n =50 each group.Pain score (NRS),sedation score (OAA/S),comfort score (BCS),the total number of times and the number of effective press were pressed in patients were observed and compared between two groups after postoperative analgesia 1 hour (T0),4 hour (T1),10 hour (T2),16 hour (T3),and 24 hour (T4).Patients with early adverse reactions,patients and ward medical staff satisfaction,pain pump failure found in the medical staff and effective treatment of adverse events were also observed and compared in two groups.Results There were no significant difference of patients with NRS,OAA/S and BCS in two groups (P ＞ 0.05).Adverse reactions after postoperative analgesia,total number of times and the number of effective press had also no significant difference in two groups (P ＞ 0.05).Two groups of patients with air blockage,incomplete analgesia rate of adverse events was not significantly different (P ＞ 0.05).Medical workers in time [(1.0 ± 0.5) min vs (3.0 ± 2.1) min,P ＜ 0.05],effective processing time [(4.0-± 2.1) min vs (8.0 ± 5.1) min,P ＜ 0.05] in group A was significantly shorter than group B.The patient satisfaction in group A was significantly higher than group B(12.0 ± 4.2 vs 9.0 ± 3.1,P ＜ 0.05).The satisfaction degree of medical staff in group A was also significantly higher than group B(13.0 ±3.1 vs 10.0 ±2.1,P ＜0.05).Conclusions The digital information technology of wireless analgesic pump is applied to postoperative analgesia for medical workers to standardize management,improve the work efficiency,and increase the satisfaction of patients and medical staffs.

Objective To determine vascular endothelial growth factor(VEGF)-460 gene polymorphism in Uyghurs and its relationship to urolithiasis in south Xinjiang. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),gene sequencing and genetic analysis methods were used in 200 urolithiasis patients of Uyghurs, and 200 healthy Uyghurs. Results The distribution of genotype and allele had no significant difference between urolithiasis patients and normal controls (P＞0. 05). The frequencies for the CC,TT and CT genotypes in patients with urolithiasis and normal controls were 1.5 %, 29.0 %, 69.5 % and 0. 5 %, 27.5 %, 72.0 %, respectively. The frequencies for C and T allele were 36.2%,63.7% and 36.9% ,63.1%, respectively. Conclusions The results of VEGF-460 gene polymorphisms indicate no significant relationship between patients with turolithiasis and normal controls in Uyghurs in south Xinjiang,which may not be urolithiasis susceptibility genetic locus.

Objective To explore the differences of intelligence ，ability of social adaptation and behavior problems between patients of benign epilepsy childhood and those of normal controls .Methods Sixty children of benign epilepsy were investigated. Results The intelligence of children showed no significant differences between two groups ( P＞0.05), while the rate of ability of social adaptation among the children of benign epilepsy patients was less than that of nomal controls （P<0.01) . There were no significant differences in the total rate of behavior problems between two groups except that some factors were different . Conclusions We should create methods to enhance the ability of social adaptation in order to avoid the abnormal behavior when the children patients of benign epilepsy are treated by drugs.

Objective To investigate the correlation between gene polymorphisms in IL-10 promoter region and the susceptibility and clinical phenotypes of HCV infection. Methods Two groups of subjects were studied. Group 1 included 85 treatment naive patients with chronic HCV infection, and group 2 included 75 healthy blood donors. Genotyping of IL-10 promoter-592 was performed by PCR-RFLP. Results No significant difference was found in IL-10 promoter-592 genotypes between the healthy individuals and HCV-infected patients. However, IL-10 promoter-592 genetype A/A appeared more frequently in patients with ALT≥80U/L than in those with ALT