Objective:To explore the effect of ezetimibe combined with atorvastatin on the efficacy,blood lipids,ca-rotid ultrasound indicators in patients with coronary heart disease(CHD)and its safety.Methods:This randomized controlled study enrolled 98 CHD patients admitted to 945th Hospital of the PLA Joint Logistic Support Force be-tween June 2021 and June 2023.Patients were divided into intervention group and control group with 49 cases in each group.Patients in the control group was treated with atorvastatin-bascd routine medication comparing to those in intervention group receiving additional ezetimibe,both groups were treated for 90 d.Clinical efficacy,blood lipids,carotid ultrasound indicators,endothelial function indicators,and incidence of adverse reactions were compared between two groups.Results:Compared with patients in the control group,those in the intervention group had significant higher total effective rate(91.83％vs.73.47％,P=0.016).Compared with patients in the control group after treatment,those in intervention group had significant lower levels of low density lipoprotein cho-lesterol(LDL-C)[(2.74±0.61)mmol/L vs.(3.42±0.66)mmol/L],total cholesterol(TC)[(3.80±0.89)mmol/L vs.(4.69±1.02)mmol/L],triglyceride(TG)[(1.79±0.53)mmol/L vs.(2.35±0.62)mmol/L],re-sistance index(RI)[(52.02±6.32)％vs.(57.95±6.02)％],carotid intima-media thickness(IMT)[(0.91±0.17)mm vs.(1.08±0.24)mm],von Willebrand factor(vWF)[(19.03±3.76)mg/L vs.(23.41±4.42)mg/L],angiotensin Ⅱ(Ang Ⅱ)[(45.83±5.87)ng/L vs.(52.87±6.01)ng/L](P＜0.001 all);and significant high-er high density lipoprotein cholesterol(HDL-C)[(1.63±0.32)mmol/L vs.(1.35±0.27)mmol/L],peak systol-ic velocity(PSV)[(47.93±5.26)cm/s vs.(41.32±4.98)cm/s],end-diastolic velocity(EDV)[(36.14±5.10)cm/s vs.(30.73±4.48)cm/s],pulse index(PI)[(85.98±9.03)％vs.(78.42±8.82)％],vascular endothelial growth factor receptor 1(VEGFR1)[(289.14±32.98)ng/L vs.(258.34±29.32)ng/L](P＜0.001 all).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.538).Conclusion:Ezetimibe combined with atorvastatin possesses significant therapeutic effect on CHD patients,which could signifi-cantly reduce blood lipids,improve the carotid blood flow velocity and vascular endothelial function with good safety.

Objective:To explore the clinical characteristics and identification of the independent risk factors for disease progression in patients with anti-gp210 antibody-positive primary biliary cholangitis (PBC).Methods:A retrospective cohort study was performed. A total of 323 cases with PBC diagnosed in Tianjin Medical University General Hospital from January 2013 to June 2023 (125 patients with anti-gp210 antibody-positive and 198 patients with anti-gp210 antibody-negative) were included. Baseline and follow-up data were collected. The independent sample t-test and Mann-Whitney U rank sum test were used for comparison between groups of continuous data. The χ2 test was used to compare the data between groups for the count data. The Pearson test was used for correlation analysis between continuous variables. The Kaplan-Meier method was used to analyze the disease progression-free survival rate. The Cox regression model was used to analyze the risk factors for disease progression. Results:The male proportion (11.2% vs. 5.1%, P=0.040) and IgM level [3.29(1.88, 4.80) g/L vs. 2.56(1.44, 3.87) g/L, P=0.019] were significantly higher in patients with PBC with positive anti-gp210 antibodies than those of the negative group. Histopathological analysis showed that the Scheuer score [1(0,3) vs. 0(0,2)], bile duct inflammation [(2(1,3) vs. 1(1,2)] and bile duct reaction score [(2(1,3) vs. 1(1,2)] were higher in the positive group than those of the negative group ( P<0.05), and the maturity of the tertiary lymphoid structure was higher ( P=0.011). Kaplan-Meier analysis showed that the 5-year disease-free survival rate was significantly lower in patients with positive anti-gp210 antibodies than that of the negative group (55.8% vs. 79.7%, P=0.006) at a median follow-up of 3(2,6) years. Multivariate Cox regression analysis showed that γ-glutamyl transferase [ HR=1.002 (95% CI: 1.000～1.003)] and platelet count [ HR=0.993 (95% CI: 0.988～0.999)] were the independent influencing factors for disease progression in patients with anti-gp210 antibody-positive PBC ( P=0.002, 0.017). Conclusion:Patients with anti-gp210 antibody-positive PBC have more severe clinical pathological manifestations and a higher risk of disease progression. Higher levels of γ-glutamyl transferase and lower platelet counts during the first visit are independent risk factors for disease progression in patients with anti-gp210 antibody-positive PBC, which can be used as dynamic monitoring indicators for this population, suggesting the need for early intensive intervention.

Objective:To explore the perioperative safety and postoperative efficacy of prophylactic jejunal nutrition tube placement during early gastric body cancer pylorus-preserving gastrectomy (PPG).Methods:The clinical data of 29 gastric cancer patients treated by Beijing Friendship Hospital, Capital Medical University from January 2018 to December 2024 were retrospectively analyzed. There were 17 males (58.6%) and 12 females (41.4%), aged from 43 to 74 years, with an average age of (58.9 ± 8.3) years, and an average body mass index (BMI) of (24.3 ± 3.0) kg/m 2. According to the type of catheterization, all cases were divided into jejunal nutrition tube group ( n=12) and gastric tube group( n=17). The main outcome was the incidence of delayed gastric emptying within one month after surgery in both groups. Statistical analysis was conducted using SPSS26.0 software. Results:Patients in the jejunal feeding tube group resumed oral liquid intake, soft diet and regular diet significantly earlier postoperatively compared to those in the gastric tube group, with statistically significant differences ( P<0.05). Conversely, the time to removal of the tube was significantly earlier in the gastric tube group than in the jejunal feeding tube group ( P<0.05). However, the proportion of patients requiring reinsertion of a gastric or jejunal feeding tube postoperatively was significantly higher in the gastric tube group (7 cases) compared to the jejunal feeding tube group (0 case) ( P<0.05). In the jejunal feeding tube group, there were 4 cases occurred DGE, in the gastric tube group, there were 8 cases occurred DGE. There were no statistically significant differences between the two groups in either the overall incidence of DGE or the distribution of DGE severity grades. On postoperative 7th day , the Gastric Outlet Obstruction Scoring System (GOOSS) grade was significantly better in the jejunal feeding tube group than in the gastric tube group ( P<0.05), and all patients in the jejunal feeding tube group had resumed liquid intake, compared to only 58.8% in the gastric tube group. Conclusions:Compared with gastric tube placement, intraoperative prophylactic jejunal feeding tube placement for PPG has significant advantages in perioperative safety and postoperative recovery, but large-sample prospective studies are still needed for further verification.

Objective:To explore the effect of ezetimibe combined with atorvastatin on the efficacy,blood lipids,ca-rotid ultrasound indicators in patients with coronary heart disease(CHD)and its safety.Methods:This randomized controlled study enrolled 98 CHD patients admitted to 945th Hospital of the PLA Joint Logistic Support Force be-tween June 2021 and June 2023.Patients were divided into intervention group and control group with 49 cases in each group.Patients in the control group was treated with atorvastatin-bascd routine medication comparing to those in intervention group receiving additional ezetimibe,both groups were treated for 90 d.Clinical efficacy,blood lipids,carotid ultrasound indicators,endothelial function indicators,and incidence of adverse reactions were compared between two groups.Results:Compared with patients in the control group,those in the intervention group had significant higher total effective rate(91.83％vs.73.47％,P=0.016).Compared with patients in the control group after treatment,those in intervention group had significant lower levels of low density lipoprotein cho-lesterol(LDL-C)[(2.74±0.61)mmol/L vs.(3.42±0.66)mmol/L],total cholesterol(TC)[(3.80±0.89)mmol/L vs.(4.69±1.02)mmol/L],triglyceride(TG)[(1.79±0.53)mmol/L vs.(2.35±0.62)mmol/L],re-sistance index(RI)[(52.02±6.32)％vs.(57.95±6.02)％],carotid intima-media thickness(IMT)[(0.91±0.17)mm vs.(1.08±0.24)mm],von Willebrand factor(vWF)[(19.03±3.76)mg/L vs.(23.41±4.42)mg/L],angiotensin Ⅱ(Ang Ⅱ)[(45.83±5.87)ng/L vs.(52.87±6.01)ng/L](P＜0.001 all);and significant high-er high density lipoprotein cholesterol(HDL-C)[(1.63±0.32)mmol/L vs.(1.35±0.27)mmol/L],peak systol-ic velocity(PSV)[(47.93±5.26)cm/s vs.(41.32±4.98)cm/s],end-diastolic velocity(EDV)[(36.14±5.10)cm/s vs.(30.73±4.48)cm/s],pulse index(PI)[(85.98±9.03)％vs.(78.42±8.82)％],vascular endothelial growth factor receptor 1(VEGFR1)[(289.14±32.98)ng/L vs.(258.34±29.32)ng/L](P＜0.001 all).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.538).Conclusion:Ezetimibe combined with atorvastatin possesses significant therapeutic effect on CHD patients,which could signifi-cantly reduce blood lipids,improve the carotid blood flow velocity and vascular endothelial function with good safety.

Objective:To explore the clinical characteristics and identification of the independent risk factors for disease progression in patients with anti-gp210 antibody-positive primary biliary cholangitis (PBC).Methods:A retrospective cohort study was performed. A total of 323 cases with PBC diagnosed in Tianjin Medical University General Hospital from January 2013 to June 2023 (125 patients with anti-gp210 antibody-positive and 198 patients with anti-gp210 antibody-negative) were included. Baseline and follow-up data were collected. The independent sample t-test and Mann-Whitney U rank sum test were used for comparison between groups of continuous data. The χ2 test was used to compare the data between groups for the count data. The Pearson test was used for correlation analysis between continuous variables. The Kaplan-Meier method was used to analyze the disease progression-free survival rate. The Cox regression model was used to analyze the risk factors for disease progression. Results:The male proportion (11.2% vs. 5.1%, P=0.040) and IgM level [3.29(1.88, 4.80) g/L vs. 2.56(1.44, 3.87) g/L, P=0.019] were significantly higher in patients with PBC with positive anti-gp210 antibodies than those of the negative group. Histopathological analysis showed that the Scheuer score [1(0,3) vs. 0(0,2)], bile duct inflammation [(2(1,3) vs. 1(1,2)] and bile duct reaction score [(2(1,3) vs. 1(1,2)] were higher in the positive group than those of the negative group ( P<0.05), and the maturity of the tertiary lymphoid structure was higher ( P=0.011). Kaplan-Meier analysis showed that the 5-year disease-free survival rate was significantly lower in patients with positive anti-gp210 antibodies than that of the negative group (55.8% vs. 79.7%, P=0.006) at a median follow-up of 3(2,6) years. Multivariate Cox regression analysis showed that γ-glutamyl transferase [ HR=1.002 (95% CI: 1.000～1.003)] and platelet count [ HR=0.993 (95% CI: 0.988～0.999)] were the independent influencing factors for disease progression in patients with anti-gp210 antibody-positive PBC ( P=0.002, 0.017). Conclusion:Patients with anti-gp210 antibody-positive PBC have more severe clinical pathological manifestations and a higher risk of disease progression. Higher levels of γ-glutamyl transferase and lower platelet counts during the first visit are independent risk factors for disease progression in patients with anti-gp210 antibody-positive PBC, which can be used as dynamic monitoring indicators for this population, suggesting the need for early intensive intervention.

Objective:To investigate the impact of early removal of nasogastric tubes on functional recovery after total gastrectomy for gastric cancer patients, to provide scientific evidence for enhanced recovery after surgery strategies in gastric cancer.Methods:A retrospective cohort study was conducted on 102 gastric cancer patients who underwent total gastrectomy at Beijing Friendship Hospital affiliated with the Capital Medical University from March 2018 to July 2022. Patients were divided into two groups based on whether the gastric tube was removed within 24 hours post-operation: the early removal group (within 24 hours, 55 patients) and the non-early removal group (beyond 24 hours, 47 patients). The recovery outcomes, including time to first flatus, time to fluid intake, length of hospital stay, and the incidence of postoperative complications, were compared between the two groups. Non-normally distributed data were expressed as M( Q1, Q3) and compared using the Wilcoxon rank-sum test. Categorical data were expressed as frequencies or percentages and compared using the chi-square test or Fisher′s exact test. To minimize the impact of potential confounders, multivariable linear regression and logistic regression analyses adjusted for propensity scores were further employed to compare quantitative and qualitative data between the groups. Statistical analyses were performed using R software. Results:The exhaust time, water intake time, and hospital stay in the early removal group were 3.0(2.0, 3.5) days, 4.0(3.0, 5.0) days, and 7.0(7.0, 8.0) days, respectively, while those in the non-early removal group were 4.0(3.0, 5.0) days, 6.0(5.0, 7.0) days, and 8.0(7.5, 11.0) days, respectively. Statistically significant differences were observed between the two groups ( P<0.05). However, there was no significant difference in the incidence of postoperative complications between the two groups (5.45% vs 17.02%, P=0.060). Propensity score-adjusted regression analysis suggested that early tube removal might reduce the risk of postoperative complications ( P=0.042). Conclusion:Early removal of nasogastric tubes can significantly accelerate functional recovery after total gastrectomy for gastric cancer patients and may reduce the risk of postoperative complications, providing important clinical guidance for enhanced recovery after surgery management in gastric cancer.

Objective To evaluate the methodological and reporting quality of published guidelines/consensus for childhood autism(CA),providing a basis for formulating domestic CA guidelines.Methods We searched databases including CNKI,Wanfang Data,SinoMed,Medlive,PubMed,national institute of health and clinical excellence(NICE),national guideline clearinghouse(NGC),and Scottish intercollegiate guidelines network(SIGN)for Chinese and foreign guideline/consensus on childhood autism published before February 1,2024.Two researchers independently evaluated the methodology and reporting quality of the guideline/consensus using the Appraisal of Guidelines Research and Evaluation Ⅱ(AGREE Ⅱ)and Reporting Items for Practice Guidelines in Healthcare(RIGHT)tools.Results After literature screening,19 CA guidelines/consensus were included,comprising 11 guidelines,7 consensus,and 1 expert recommendation,with 9 domestic and 10 foreign articles.The AGREE Ⅱ evaluation scores for the six domains were as follows:scope and purpose(91.1％±4.5％),stakeholder involvement(86.8％±6.7％),rigour of development(83.0％±10.2％),clarity of presentation(84.3％±6.2％),applicability(82.7％±13.3％),and editorial independence(65.4％±21.8％).The RIGHT checklist reported rates for the seven domains were:basic information(87.6％±11.0％),background(87.6％±13.8％),evidence(81.1％±22.6％),recommendation(71.1％±38.4％),review and quality assurance(83.5％±16.7％),funding and declaration and management of interests(48.7％±29.4％),and other information(64.4％±11.8％).The domain with the lowest score for methodological quality was"editorial independence"and for reporting quality,it was"funding and declaration and management of interests".The reporting rate of domestic articles(26.2％±1.5％)was significantly lower than that of foreign articles(52.6％±2.2％),with a statistically significant difference(P<0.05).Conclusion The overall quality of current childhood autism guidelines/consensus requires improvement.During the formulation and reporting of guidelines/consensus,strictly adhering to AGREE Ⅱ and RIGHT is imperative,and it is essential to clearly report funding sources and conflicts of interest.

Objective To investigate the mechanism of Esculetin inhibiting the malignant biological behavior of cervical cancer cells by targeting small ubiquitin-like modifier activating enzyme subunit 1(SAE1)via microRNA-617(miR-617).Methods SiHa cells were divided into SiHa group(normal culture),Esculetin group(4 mmol·L-1Esculetin treatment),Esculetin+NC inhibitor+sh-NC group(4 mmol·L-1 Esculetin+miR-617 inhibition negative control+SAE1 inhibition negative control),Esculetin+miR-617 inhibitor+sh-NC group(4 mmol·L-1 Esculetin+miR-617 inhibition+SAE1 inhibition negative control)and Esculetin+miR-617 inhibitor+sh-SAE1 group(4 mmol·L-1 Esculetin+miR-617 inhibition+SAE1 inhibition).The expression of miR-617 and SAE1 mRNA was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR).Cell invasion and apoptosis were detected by Transwell and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL).Results The relative expression levels of miR-617 in SiHa group,Esculetin group,Esculetin+NC inhibitor+sh-NC group,Esculetin+miR-617 inhibitor+sh-NC group and Esculetin+miR-617 inhibitor+sh-SAE1 group were 1.00±0.16,1.93±0.26,2.29±0.31,1.18±0.16 and 1.59±0.23,respectively;the relative expression levels of SAE1 mRNA were 1.00±0.13,0.67±0.08,0.37±0.06,0.74±0.14 and 0.41±0.08,respectively;the number of invasive cells in SiHa group,Esculetin+NC inhibitor+sh-NC group,Esculetin+miR-617 inhibitor+sh-NC group and Esculetin+miR-617 inhibitor+sh-SAE1 group were 102.79±12.37,37.16±5.84,106.36±14.20 and 61.25±11.06,respectively;the apoptosis rates were(11.50±2.23)％,(43.66±6.82)％,(15.35±3.92)％and(38.16±4.67)％,respectively;the above indicators in Esculetin group were statistically significant when compared with SiHa group(all P＜0.05);the above indicators in Esculetin+NC inhibitor+sh-NC group were statistically significant when compared with Esculetin group(all P＜0.001);the above indicators in Esculetin+miR-617 inhibitor+sh-NC group the above indicators were statistically significant when compared with Esculetin+NC inhibitor+sh-NC group(all P＜0.001);Esculetin+miR-617 inhibitor+sh-SAE1 group the above indicators were statistically significant when compared with Esculetin+miR-617 inhibitor+sh-NC group(all P＜0.01).Conclusion Esculetin can inhibit the invasion of cervical cancer cells and promote apoptosis by regulating the miR-6177/SAE1 axis.

Objective To investigate the mechanism of Esculetin inhibiting the malignant biological behavior of cervical cancer cells by targeting small ubiquitin-like modifier activating enzyme subunit 1(SAE1)via microRNA-617(miR-617).Methods SiHa cells were divided into SiHa group(normal culture),Esculetin group(4 mmol·L-1Esculetin treatment),Esculetin+NC inhibitor+sh-NC group(4 mmol·L-1 Esculetin+miR-617 inhibition negative control+SAE1 inhibition negative control),Esculetin+miR-617 inhibitor+sh-NC group(4 mmol·L-1 Esculetin+miR-617 inhibition+SAE1 inhibition negative control)and Esculetin+miR-617 inhibitor+sh-SAE1 group(4 mmol·L-1 Esculetin+miR-617 inhibition+SAE1 inhibition).The expression of miR-617 and SAE1 mRNA was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR).Cell invasion and apoptosis were detected by Transwell and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL).Results The relative expression levels of miR-617 in SiHa group,Esculetin group,Esculetin+NC inhibitor+sh-NC group,Esculetin+miR-617 inhibitor+sh-NC group and Esculetin+miR-617 inhibitor+sh-SAE1 group were 1.00±0.16,1.93±0.26,2.29±0.31,1.18±0.16 and 1.59±0.23,respectively;the relative expression levels of SAE1 mRNA were 1.00±0.13,0.67±0.08,0.37±0.06,0.74±0.14 and 0.41±0.08,respectively;the number of invasive cells in SiHa group,Esculetin+NC inhibitor+sh-NC group,Esculetin+miR-617 inhibitor+sh-NC group and Esculetin+miR-617 inhibitor+sh-SAE1 group were 102.79±12.37,37.16±5.84,106.36±14.20 and 61.25±11.06,respectively;the apoptosis rates were(11.50±2.23)％,(43.66±6.82)％,(15.35±3.92)％and(38.16±4.67)％,respectively;the above indicators in Esculetin group were statistically significant when compared with SiHa group(all P＜0.05);the above indicators in Esculetin+NC inhibitor+sh-NC group were statistically significant when compared with Esculetin group(all P＜0.001);the above indicators in Esculetin+miR-617 inhibitor+sh-NC group the above indicators were statistically significant when compared with Esculetin+NC inhibitor+sh-NC group(all P＜0.001);Esculetin+miR-617 inhibitor+sh-SAE1 group the above indicators were statistically significant when compared with Esculetin+miR-617 inhibitor+sh-NC group(all P＜0.01).Conclusion Esculetin can inhibit the invasion of cervical cancer cells and promote apoptosis by regulating the miR-6177/SAE1 axis.