Objective To investigate the correlation between levels of intercellular adhesion molecule-1 (ICAM-1), platelet surface P-selectin (CD62P), and inflammatory factors and cerebral artery stenosis in patients with acute cerebral infarction (ACI). Methods A total of 305 patients with ACI complicated with cerebral artery stenosis admitted to Zhongwu Hospital of Suqian City and Xinyi People's Hospital from January 2021 to December 2023 were selected as the research subjects. According to the degree of cerebral artery stenosis, they were divided into grade I group (stenosis degree<50%, n=85), grade II group (stenosis degree of 50%-75%, n=128), and grade III group (stenosis degree>75%, n=92). Sixty-eight ACI patients without cerebral artery stenosis during the same period were included in the reference group. The levels of serum inflammatory factors [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8)], ICAM-1 and CD62P were compared among the four groups. Spearman analysis was used to analyze the correlation between each factor and degree of cerebral artery stenosis. Results The levels of CRP, TNF-α, IL-6, IL-8, ICAM-1 and CD62P in the grade I, II and III groups were higher than those in the reference group. The levels of these factors were higher in the grade II and III groups than those in the grade I group, while the levels of various factors were higher in the grade III group than those in the grade II group (P<0.05). Spearman analysis showed that CRP, TNF-α, IL-6, IL-8, ICAM-1, and CD62P were positively correlated with the degree of cerebral artery stenosis in patients with ACI complicated with cerebral artery stenosis (P<0.05). Conclusion The levels of serum inflammatory factors, ICAM-1 and CD62P are significantly correlated with cerebral artery stenosis degree in patients with ACI.

Cervical metastatic carcinoma from unknown primary lesion(CMCUP) usually refers to a malignant tumor confirmed by histological and pathological examination as cervical lymph node metastasis. However, after systematic medical history collection, physical examination, endoscopy, and imaging examinations, it is still unclear whether the primary lesion is cervical metastatic malignant tumor. Although with the development of examination techniques such as endoscopy and imaging, the detection of unknown primary lesions has been increasing year by year in recent years, there are still some cases where the primary lesion cannot be diagnosed through known examination methods. For the diagnosis and treatment of patients with unknown primary metastatic cancer in the neck, it is necessary to correctly identify clinical manifestations and use the least invasive approach to achieve diagnosis and treatment, avoiding inappropriate diagnostic methods. The current situation of standardized treatment is not optimistic, and there is an urgent need to pay attention to the standardized diagnosis and treatment of cervical metastatic cancer from unknown primary lesions. This article will focus on the key diagnostic and treatment issues and the latest progress of CMCUP clinical attention, providing reference for the standardized clinical diagnosis and treatment of cervical metastatic cancer from unknown primary lesions.

Objective To investigate the relationship between interlukin-10(IL-10)gene polymorphisms and acute kidney injury(AKI)and its related mechanisms.Methods A prospective study was conducted on 100 patients with AKI admitted to our hospital from March 2021 to March 2023,who were selected as the study group.Following the 1∶1 pairing principle,100 healthy individuals who underwent physical examinations during the same period were included as the control group.General data,IL-10 genotypes,and gene frequency distributions of the two groups were compared.The factors influencing AKI were assessed using a logistic regression analysis,and the interaction between IL-10gene polymorphisms and conventional risk factors was analyzed using multifactor dimension reduction(MDR).Results The quantitative values of serum creatinine(sCr),blood urea nitrogen(BUN),and urine protein in the study group were higher than those in the control group.The proportion of the GG genotype at IL-10-1082 was lower than that in the control group,and the proportions of the AA genotype and A allele were higher than those in the control group(P<0.05).Logistic regression analysis showed that BUN(OR=4.487),urinary protein quantitation(OR=5.905),sCr(OR=3.573),AA genotype at position 1082(OR=4.823),and the A allele(OR=4.479)were risk factors for AKI(P<0.05).Interaction display,IL-10-1082 polymorphism×sCr,IL-10-1082 polymor-phism×BUN,IL-10-1082 polymorphism×urinary protein quantification,and IL-10-1082 polymorphism×sCr×BUN×urinary protein quantification models exhibited good accuracy and cross-consistency(P<0.05).Conclusion IL-10gene polymorphisms are strongly associated with the development of AKI.

BACKGROUND:The clinical application of Mongolian Medicine Erdun-uril in the treatment of osteoarthritis is effective,but its therapeutic effect and related mechanism are still unclear. OBJECTIVE:To observe the repairing process of osteoarthritis in rats by Mongolian Medicine Erdun-uril and analyze its mechanism. METHODS:Thirty male Sprague-Dawley rats(8 weeks of age)were selected to establsih an osteoarthritis model using intraarticular injection of sodium iodoacetate solution into the unilateral knee joint.Two weeks after modeling,the model rats were randomly divided into three groups:control group(n=6)was given normal saline by gavage,and low and high dose groups(n=12 per group)were given Erdun-uril 1.4 and 2 g,respectively,3 times per day.After 2 and 4 weeks of continuous administration,blood samples,articular cartilage and periarticular bone tissue were taken from rats to detect changes in cartilage metabolic markers(cartilage oligomeric matrix protein,proteoglycan),bone metabolic markers(bone alkaline phosphatase,keratan sulfate),inflammatory markers(interleukin 6,tumor necrosis factor α),lipid metabolic markers(total cholesterol,triacylglycerol).Histopathological changes were also observed. RESULTS AND CONCLUSION:qRT-PCR results showed that after 2 and 4 weeks of administration,the mRNA expression of cartilage oligomeric matrix protein,proteoglycan and bone alkaline phosphatase and keratan sulfate in knee cartilage of rats were significantly reduced in the low and high dose groups compared with the control group(P<0.05,P<0.01,P<0.001),with the reduction being more significant in the high dose group.After 2 and 4 weeks of administration,compared with the control group,serum tumor necrosis factor α and interleukin 6 levels were decreased(P<0.01,P<0.001)and total cholesterol and triacylglycerol levels were increased(P<0.05,P<0.01,P<0.001)in the low and high dose groups,with the improvement being more significant in the high dose group.Hematoxylin-eosin staining results showed that in the control group,there were large defective areas on the surface of the knee cartilage with unknown structure and severe inflammatory cell infiltration;in the low dose group,the surface of the knee cartilage was rough with disordered cell arrangement and the cartilage structure did not improve significantly after 2 weeks of administration,while the number of inflammatory cells in the knee cartilage was reduced and the cartilage structure was restored to some extent after 4 weeks of administration;in the high dose group,the structure of the knee cartilage become clear after 2 weeks of administration and even clearer after 4 weeks of administration,and the inflammation was significantly reduced after 2 weeks of administration.To conclude,Mongolian Medicine Erdun-uril with better anti-inflammatory properties can improve cartilage metabolism and obviously alleviate osteoarthritis in rats.

Objective:To explore the prevalence, clinical features, genetic characteristics and prognosis of Citrin deficiency in Henan province of China.Methods:A total of 986 565 neonates screened by tandem mass spectrometry at the Third Affiliated Hospital of Zhengzhou University from January 2013 to December 2021 were retrospectively analyzed. Analysis of SLC25A13 gene variants and parental verification were carried out for neonates suspected for Citrin deficiency by next-generation sequencing. The clinical, biochemical and genetic characteristics of Citrin deficiency patients were integrated to guide the diet treatment and follow up the growth and development. Paired- t test was used to compare the amino acid levels in the peripheral blood samples before and after the treatment. Results:Nine cases of Citrin deficiency were diagnosed among the 986 565 neonates. Specific elevation of citrulline was observed in all of the 9 cases. Six variants were detected by genetic sequencing, among which c. 852_855delTATG, c. 615+ 5G>A, c. 550C>T and IVS16ins3kb were known pathogenic variants, whilst c. 1111_1112delAT and c. 837T>A were unreported previously. The detection rate for c. 852_855delTATG was the highest (61.6%, 11/18), followed by IVS16ins3kb (16.7%, 3/18). The clinical symptoms of all patients were relieved after the treatment, and the blood amino acid profile and biochemical parameters were significantly improved by gradually falling within the normal range. By June 2022, all patients had shown a good prognosis.Conclusion:The prevalence of Citrin deficiency among neonates from Henan Province by tandem mass spectrometry is 1/109 618, and the carrier rate for the pathogenic variants of the SLC25A13 gene was 1/166. The c. 852_855delTATG may be a hot spot variant among the patients. Discovery of the novel variants has enriched the mutational spectrum of the SLC25A13 gene. Above results have provided a basis for the early diagnosis, treatment, prognosis and genetic counseling for the affected families.

Objective To evaluate the efficacy of endovascular treatment for ruptured descending thoracic aortic aneurysm(rDTAA),and to summarize the treatment experience.Methods The clinical data of 8 patients with rDTAA,who were admitted to the Department of Vascular Interventional Surgery,Zhangjiajie Municipal People's Hospital of China to receive treatment between January 2016 and June 2023,were retrospectively analyzed.The patients included 4 males and 4 females,with a median age of 70.5 years(61-78 years).Preoperative computed tomography angiography(CTA)was performed in all the 8 patients,and the diagnosis of rDTAA complicated by hematoma in the thoracic cavity and/or mediastinum was confirmed.Emergency thoracic endovascular aortic repair(TEVAR)was carried out in all the 8 patients.Results Complete isolation of the thoracic descending aortic aneurysm was achieved in 6 patients,and 2 of them received reconstruction of left subclavian artery by using chimney stent technique.The remaining two patients had a small amount of type Ⅰa endoleak,which disappeared after implantation of a cuff stent at the proximal site.During hospitalization,one patient died of septic shock caused by thoracic aortic-esophageal fistula,and 3 patients developed respiratory failure after operation,which was recovered after thoracic drainage,anti-infection medication and ventilator-assisted breathing therapy.Two patients developed postoperative ischemic stroke,one of them presented as grade Ⅲ motor muscle weakness on the affected side accompanied by speech impairment,and the another patient presented as grade Ⅳ motor muscle weakness on the affected side accompanied by speech impairment.During the follow-up period,one patient died of sudden chest pain 7 months after surgery,and another patient who had not received chimney stent implantation developed type Ⅰa endoleak 18 months after operation,which disappeared after implantation of a cuff stent at the proximal site.The remaining 5 patients showed good clinical condition during the follow-up period.Conclusion For the treatment of rDTAA,TEVAR is clinically safe and effective.

ObjectiveTo present the health status of traditional Chinese medicine （TCM） constitutions more intuitively and comprehensively based on improved radar chart. MethodsParticipants who completed a 26-week comprehensive intervention based on TCM constitution from February 2013 to January 2014 in Zhuhai branch of Guangdong Provincial Hospital of Chinese Medicine were included in the study. They were divided into groups according to gender and age， i.e. young， middle-aged， and elderly male and female groups. TCM constitution scale and health survey short form （SF-36） were used to evaluate the 9 basic TCM constitution types and quality of life at three time points， including pre-intervention （T1）， at 13-week intervention （T2）， and at 26-week intervention （T3）. The improved radar charts were drawn to visually present the comprehensive evaluation results on the health status of 9 TCM constitutions， and graphic features （area S value， perimeter L value） were extracted to construct a comprehensive health index for TCM constitutions （H value）. Spearman correlation analysis was used to analyze the correlation between H value and SF-36 total score. ResultsAmong the included 509 participants， there were 45 elderly male， 76 elderly female， 60 middle-aged male， 140 middle-aged female， 53 young male and 135 young female. The radar charts for comprehensive evaluation of TCM constitution health status showed that the total areas for all groups increased at T3 compared to T1， with the most significant increase in the young population. In the middle-aged population， the fan-shaped areas of certain constitutions decreased at T2 than T1. At T3， the radar chart shapes for females were more balanced than males in the same age group. By calculating the features of function graphs， it was found that the S， L， and H values for the elderly population were relatively higher than those for the middle-aged and young population with the same gender， and the young population increased by highest ratio. The values measured at T3 compared to T1 showed average increase of 26% for S value （11% for the middle-aged and 14% for the elderly）， 22% for L value （10% for the middle-aged and the elderly each）， and 22% for H value （10% for the middle-aged and 9% for the elderly）. The female had lower S and L values， as well as higher H value than the male of the same age group measured at T3. The correlation coefficient between the H value of all participants and the total SF-36 score was 0.662 （P＜0.01）. ConclusionThe comprehensive evaluation model for the health status of TCM constitution based on the improved radar chart constructed in this study can present the health status of TCM constitutions and intervention effectiveness more comprehensively and intuitively. It is suggested to regulate the constitution in pursuit of the dynamic balance of the constitution health status， as well as consider the parts from the whole， and put focus on the balance of nine TCM constitutions.

Objective:To evaluate the efficacy and safety of noninvasive high-frequency oscillatory ventilation (nHFOV) as the initial ventilation mode for respiratory distress syndrome (RDS) in premature infants.Methods:From the establishment of the databases [(PubMed, Embase, Cochrane Library, CNKI, Wanfang database, CQVIP and CBM (SinoMed)] to March 1, 2022, literature on randomized controlled trials (RCTs) using nHFOV and nasal continuous positive airway pressure(NCPAP) as the initial ventilation modes for RDS in premature infants were searched. The qualities of the included literature were evaluated according to Cochrane Evaluation Manual. RevMan 5.4 software was used for Meta-analysis.Results:Seven RCTs involving 786 children were included for the final Meta-analysis, with 395 cases in the nHFOV group and 391 cases in the NCPAP group. The results showed that the nHFOV group had lower intubation rates than the NCPAP group ( OR=0.34, 95% CI 0.22~0.51, P<0.001). No significant differences existed in mortality rates and complication rates between the two groups ( P>0.05). Conclusions:nHFOV as the initial treatment for RDS in premature infants may reduce the incidence of early treatment failure without increasing complications.

With the development of medical technology, the survival rate of cancer patients continues to improve, and the number of stoma patients is increasing day by day. Self-management refers to patients monitoring and managing their own diseases to maintain and improve physical health. Good self-management ability can enhance patient treatment compliance, reduce the incidence of stoma and surrounding complications, improve health outcomes, and raise patient quality of life. This article reviews the research progress on self-management of stoma patients, with the aim of providing reference for research on self-management of stoma patients.

Objective:To analyze the changes in serum IL-1β, IFN-γ and IL-4 levels in children with sepsis and analyze their values in the differential diagnosis of Gram-positive (G + )/Gram-negative (G -) bacterial infection. Methods:Clinical data of 195 children with sepsis admitted to Xuzhou Central Hospital from February 2020 to February 2023 were retrospectively analyzed. They were all confirmed to have G + /G - bacterial infection based on pathogen culturing and identification and enrolled as disease group. Another 180 healthy children taking physical examination in the same hospital during the same period were recruited as control group. The distribution of G + /G - bacterial infection in the disease group was analyzed after pathogen culturing. ELISA was used to detect serum IL-1β, IFN-γ and IL-4 levels in both groups. Differences in the levels of serum IL-1β, IFN-γ and IL-4 were compared between the disease group and the control group as well as between the patients with G + /G - bacterial infection. Receiver operating characteristic (ROC) curve was drawn to evaluate the values of serum IL-1β, IFN-γ and IL-4 levels used alone or in combination in the differential diagnosis of G + /G - bacterial infection. Results:A total of 211 strains were isolated from 195 blood culture samples in the disease group, including 181 strains (85.78%) of G + bacteria and 30 strains (14.22%) of G - bacteria. Coagulase-negative Staphylococcus and Salmonella were the predominant bacteria causing G + /G - bacterial infection, respectively. The levels of serum IL-1β and IFN-γ in the disease group were higher than those in the control group ( P<0.05), while the levels of serum IL-4 were similar in the two groups ( P>0.05). The levels of serum IL-1β, IFN-γ and IL-4 in the patients with G - bacterial infection were higher than those in the patients with G + bacterial infection ( P<0.05). The sensitivity and the area under the ROC curve of serum IL-1β, IFN-γ and IL-4 levels used in combination in the differential diagnosis of G + /G - bacterial infection were respectively 91.62% and 0.960, which were higher than those of each parameter used alone ( P<0.01, P<0.05). However, there was no significant difference in the specificity ( P>0.05). Conclusions:The levels of serum IL-1β and IFN-γ increased in children with sepsis, while the serum IL-4 level was basically normal in them. Children with G - bacterial infection tended to have higher serum IL-1β, IFN-γ and IL-4 levels. The combination use of all three parameters showed higher value in the differential diagnosis of G + /G - bacterial infection.