ObjectiveTo develop a full-process data platform of renal rehabilitation, diagnosis and quality control information. MethodsA hierarchical architectural design was proposed, adhering to clinical pathway models and standardized data protocols. The platform comprehensively covered assessment, intervention, follow-up and quality control for maintenance hemodialysis (MHD) patients. By integrating multidisciplinary resources and standardizing rehabilitation workflows, it delivered standardized and intelligent rehabilitation services. ResultsThe platform achieved standardized and intelligent management of rehabilitation services, effectively improved the physiological function, psychological state and quality of life convenience for MHD patients, while significantly reduced the economic and care burden on patients' families and society. ConclusionThe rehabilitation service model based on a full-process data platform may provide scientific and systematic support for MHD patients.

OBJECTIVE To study the improvement effect and mechanism of Shengmai powder on heart failure （HF） mice with qi-yin deficiency. METHODS The mice were randomly divided into blank group （water）， model group （water）， Shengmai powder low-， medium-， and high-dose groups [2.61， 5.22 and 10.44 g/kg （based on crude drug dosage）] and positive control group （metoprolol， 30 mg/kg）， with 10 mice in each group. Except for the blank group， all other groups were subcutaneously injected with D-galactose， and a qi-yin deficiency HF mice model was established by continuous food restriction and weight-bearing swimming. At the same time of modeling， the corresponding medicine/water was gavaged once a day for five weeks. The general state of mice was recorded and the traditional Chinese medicine （TCM） syndrome score was evaluated. Behavioral experiments were conducted to investigate the total distance of open field action， the percentage of immobility time， and the swimming exhaustion time of mice. The contents of aspartate transaminase （AST）， creatine kinase （CK） and lactate dehydrogenase （LDH） in the serum of mice were detected； cardiac function indexes [heart rate， left ventricular ejection fraction （LVEF）， left ventricular end systolic diameter （LVESD）， left ventricular end diastolic diameter （LVEDD）， left ventricular mass index and whole heart mass index] were all detected； the histopathological morphology of mice myocardium was observed； the level of cardiomyocyte apoptosis in mice was detected； mRNA expression levels of B-cell lymphoma 2 （Bcl-2）， Bcl-2 associated X protein （Bax）， and Cleaved-caspase-3 in myocardial tissue of mice were detected； the phosphorylation levels of sarcoplasmic reticulum calcium regulatory related proteins [ryanodine receptor 2 （RyR2） and phospholamban （PLB）] in myocardial tissue of mice were detected. RESULTS Compared with the blank group， the body weight， total distance of open field action， swimming exhaustion time， LVEF， LVEDD， Bcl-2 mRNA expression level in myocardial tissue and PLB protein phosphorylation level in the model group were significantly reduced/shortened （P＜0.05）； TCM syndrome score， the percentage of immobility time， heart rate， LVESD， left ventricular mass index， whole heart mass index， cardiomyocyte apoptosis rate， the contents of CK， LDH and AST in serum， mRNA expression levels of Cleaved-caspase-3 and Bax and the phosphorylation level of RyR2 protein in myocardial tissue were significantly increased （P＜0.05）； there were inflammatory cell infiltration， disordered cell arrangement and obvious myocardial interstitial fibrosis in myocardial tissue. After the intervention of Shengmai powder， most of the above quantitative indexes in mice were significantly reversed （P＜0.05）， the inflammatory cell infiltration in myocardial tissue was reduced， and the degree of fibrosis was significantly reduced. CONCLUSIONS Shengmai powder can improve cardiac function， reduce the level of cardiomyocyte apoptosis and myocardial fibrosis in HF mice with qi-yin deficiency. Its mechanism may be related to the regulation of the expression of sarcoplasmic reticulum calcium regulation related proteins.

Objective To analyze the types and distribution of microbiome in intestinal and lung tissues of children with asthma, and to explore the correlation between microbiota changes and asthma. Methods From 2021 to 2023, a total of 28,939 children with asthma who visited Ezhou Central Hospital, Maternal and Child Health Hospital or Ezhou Egang Hospital were selected as the study subjects, and 2,000 healthy children who underwent outpatient physical examinations at these three hospitals during the same period were selected as the control group. The distribution and characteristics of intestinal and pulmonary microbiome in the two groups were analyzed by 16SrDNA sequencing. Logistic regression analysis model was used to analyze the correlation between microbiota distribution and asthma occurrence. Results In the intestinal tissues of children with asthma compared to healthy children, the abundance of Bacteroidetes at the phylum level decreased, while the abundance of Firmicutes and Proteobacteria increased significantly (P<0.05), and the abundance of Prevotalle and Clostridium at the genus level increased significantly. In lung tissues of asthmatic children compared to health children, the abundance of Firmicutes at the phylum level decreased while the abundance of Proteobacteria increased significantly (P<0.05), and the abundance of Neisseria, Prevotella and Actinomyces at the genus level increased significantly. Binary logistic regression results showed that the abundances of Lactobacillus (OR=0.842, 95% CI: 0.533-0.947), Bacteroides fragilis (OR=0.649, 95%CI: 0.377-0.890), Bifidobacterium (OR=0.901, 95% CI: 0.633-0.994), and Parabacteroides distasonis (OR=0.547, 95% CI: 0.192-0.708) in the intestinal tissues were all protective factors for the asthma in children. In the lung tissue, the abundance of Neisseria (OR=2.140, 95% CI: 1.749-3.305) was a risk factor for the asthma in children, and Prevotella (OR=0.691, 95% CI: 0.491-0.926) was a protective factor for the asthma in children (P<0.05). Conclusion The dysbiosis of intestinal and pulmonary microbiome is closely related to the occurrence of asthma in children, and the detection of microbiota is of great significance for the diagnosis of childhood asthma.

Thyroid nodules are a common endocrine disorder with complex pathogenesis that remains incompletely understood. In recent years, studies have revealed that the gut microbiota may play a critical role in the occurrence and progression of thyroid nodules. This review systematically summarizes the current research progress on the association between gut microbiota and thyroid nodules, with a particular focus on potential mechanisms through which gut dysbiosis influences nodule formation via immune regulation, metabolic pathways, and gut barrier function. Evidence suggests that reduced gut microbial diversity, decreased abundance of specific beneficial bacteria, and an increased proportion of pro-inflammatory bacteria may contribute to a pro-inflammatory environment and metabolic disturbances associated with thyroid nodules. Furthermore, this review explores the potential of interventions such as probiotics, prebiotics, dietary modifications, and fecal microbiota transplantation in modulating gut microbiota and improving thyroid nodule outcomes. Although direct clinical evidence is currently lacking, the regulation of gut microbiota has emerged as a promising direction for the diagnosis and treatment of thyroid nodules, demonstrating significant clinical potential. Future efforts should focus on advancing basic and clinical research strategies to facilitate the translational application of findings in this field.

Objective To investigate the early predictive value of combined detection of serum sodium,heparin-binding protein-to-albumin ratio(HBP/ALB)and interleukin-10(IL-10)in Ka-wasaki disease shock syndrome(KDSS)caused by Kawasaki disease in children.Methods A total of 105 children with KDSS caused by Kawasaki disease(KDSS group)and 105 children with Kawasa-ki disease(control group)were selected as study subjects.Clinical data,serum sodium levels,HBP/ALB and IL-10 levels were compared between the two groups.Multivariate logistic regression a-nalysis was used to screen the influencing factors of KDSS caused by Kawasaki disease in children a-mong serum sodium,HBP/ALB and IL-10.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of traditional prediction schemes(coronary artery dam-age and IVIG resistance)and new prediction schemes(serum sodium and HBP/ALB,IL-10)for KDSS caused by Kawasaki disease in children.Results The proportion of patients with coronary ar-tery damage and IVIG resistance was significantly higher in the KDSS group than those in the control group(P＜0.05).Serum sodium levels were lower,while HBP/ALB and IL-10 levels were higher in the KDSS group compared to the control group(P＜0.05).Multivariate logistic regression analysis showed that serum sodium,BP/ALB and IL-10 were influencing factors of KDSS caused by Kawasaki diseasein children(P＜0.05).For traditional prediction schemes,the areas under the curves(AUCs)for coronary artery damage,IVIG resistance and their combination in predicting KDSS caused by Kawasaki disease were 0.795,0.676 and 0.873,respectively(P＜0.05);for new prediction schemes,the AUCs for serum sodium,HBP/ALB,IL-10 and their combination in predicting KDSS were 0.767,0.824,0.760 and 0.945,respectively(P＜0.05).The AUC for the combination of serum sodium,HBP/ALB and IL-10 was greater than that for the combination of coronary artery dam-age and IVIG resistance(P＜0.05).Conclusion Decreased serum sodium,elevated HBP/ALB and elevated IL-10 are associated with KDSS caused by Kawasaki disease in children.Combined prediction using serum sodium,HBP/ALB and IL-10 has a high predictive value for KDSS caused by Kawasaki disease in children.

Objective:To investigate the application value of sevoflurane combined with remifentanil in interventional thrombectomy of ischemic stroke patients and its influence on neurological and cognitive function.Methods:The clinical data of 84 patients with ischemic stroke treatment in the Xining Third People′s Hospital from September 2020 to September 2022 were selected retrospectively, and they were divided into the conventional group (42 cases) and experimental group (42 cases) according the treatment methods. Interventional thrombectomy was performed in both groups. Propofol combined with remifentanil was used in the conventional group, and sevoflurane combined with remifentanil was used in the experimental group. The excellent and good rate of anesthesia was compared between the two groups; the hemodynamic indexes before anesthesia induction (T 1), at the beginning of surgery (T 2), after thrombectomy and extubation (T 3) and at the end of surgery (T 4) were compared between the two groups; the brain injury indexes were compared before and 12, 24 and 48 h after surgery were compared between the two groups; the National Institutes of Health Stroke Scale (NIHSS) score, Simple Mental State Examination Scale (MMSE) score, postoperative cognitive dysfunction (POCD) and anesthesiation-related adverse reactions were compared between the two groups. Results:The excellent and good rate of anesthesia in the experimental group was higher than that in the conventional group:100.00% (42/42) vs. 83.33% (35/42), there was statistical difference ( χ2 = 5.61, P<0.05). The mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO 2) in the two groups at T 2, T 3 and T 4 were higher than those at T 1 ( P<0.05); the MAP, HR and SpO 2 in the experimental group at T 2, T 3 and T 4 were lower than those in the conventional group ( P<0.05). The serum neuron-specific enolase (NSE) and S100β protein were significantly increased at 12 and 24 h after surgery in both groups ( P<0.05); serum NSE and S100β proteins in the experimental group at 12, 24 and 48 h were lower than those in the conventional group: (30.12 ± 4.26) μg/L vs. (35.64 ± 5.70) μg/L, (22.69 ± 4.01) μg/L vs. (26.81 ± 5.53) μg/L, (18.71 ± 2.92)μg/L vs. (21.34 ± 4.02) μg/L, (1.19 ± 0.20) μg/L vs. (1.37 ± 0.24) μg/L, (0.96 ± 0.13) μg/L vs. (1.13 ± 0.16) μg/L, (0.80 ± 0.11) μg/L vs. (0.94 ± 0.15) μg/L, there were statistical differences ( P<0.05). The NIHSS score was significantly higher and the MMSE score was significantly lower in both groups at 12 and 24 h after surgery ( P<0.05); the NIHSS score and MMSE score in both groups recovered to preoperative level at 48 h after the operation ( P>0.05). The NIHSS score in the experimental group at 12 and 24 h after surgery was lower than that in the conventional group, and the MMSE score was higher than that in the conventional group ( P<0.05). The incidence of anesthesia-related adverse reactions in the experimental groups was lower than that in the control group: 4.76%(2/42) vs. 21.43%(9/42); and the incidence of POCD was lower than that in the conventional group: 19.05%(8/42) vs. 2.38%(1/42), there were statistical differences ( χ2 = 5.13, 4.48, P<0.05). Conclusions:Sevoflurane combined with remifentanil has a significant anesthetic effect in interventional thrombectomy of ischemic stroke patients, which can stabilize hemodynamics, reduce the degree of brain injury, promote cognitive function recovery, and reduce POCD and adverse reactions.

Thyroid nodules are a common endocrine disorder with complex pathogenesis that remains incompletely understood. In recent years, studies have revealed that the gut microbiota may play a critical role in the occurrence and progression of thyroid nodules. This review systematically summarizes the current research progress on the association between gut microbiota and thyroid nodules, with a particular focus on potential mechanisms through which gut dysbiosis influences nodule formation via immune regulation, metabolic pathways, and gut barrier function. Evidence suggests that reduced gut microbial diversity, decreased abundance of specific beneficial bacteria, and an increased proportion of pro-inflammatory bacteria may contribute to a pro-inflammatory environment and metabolic disturbances associated with thyroid nodules. Furthermore, this review explores the potential of interventions such as probiotics, prebiotics, dietary modifications, and fecal microbiota transplantation in modulating gut microbiota and improving thyroid nodule outcomes. Although direct clinical evidence is currently lacking, the regulation of gut microbiota has emerged as a promising direction for the diagnosis and treatment of thyroid nodules, demonstrating significant clinical potential. Future efforts should focus on advancing basic and clinical research strategies to facilitate the translational application of findings in this field.

Objective:To investigate the application value of sevoflurane combined with remifentanil in interventional thrombectomy of ischemic stroke patients and its influence on neurological and cognitive function.Methods:The clinical data of 84 patients with ischemic stroke treatment in the Xining Third People′s Hospital from September 2020 to September 2022 were selected retrospectively, and they were divided into the conventional group (42 cases) and experimental group (42 cases) according the treatment methods. Interventional thrombectomy was performed in both groups. Propofol combined with remifentanil was used in the conventional group, and sevoflurane combined with remifentanil was used in the experimental group. The excellent and good rate of anesthesia was compared between the two groups; the hemodynamic indexes before anesthesia induction (T 1), at the beginning of surgery (T 2), after thrombectomy and extubation (T 3) and at the end of surgery (T 4) were compared between the two groups; the brain injury indexes were compared before and 12, 24 and 48 h after surgery were compared between the two groups; the National Institutes of Health Stroke Scale (NIHSS) score, Simple Mental State Examination Scale (MMSE) score, postoperative cognitive dysfunction (POCD) and anesthesiation-related adverse reactions were compared between the two groups. Results:The excellent and good rate of anesthesia in the experimental group was higher than that in the conventional group:100.00% (42/42) vs. 83.33% (35/42), there was statistical difference ( χ2 = 5.61, P<0.05). The mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO 2) in the two groups at T 2, T 3 and T 4 were higher than those at T 1 ( P<0.05); the MAP, HR and SpO 2 in the experimental group at T 2, T 3 and T 4 were lower than those in the conventional group ( P<0.05). The serum neuron-specific enolase (NSE) and S100β protein were significantly increased at 12 and 24 h after surgery in both groups ( P<0.05); serum NSE and S100β proteins in the experimental group at 12, 24 and 48 h were lower than those in the conventional group: (30.12 ± 4.26) μg/L vs. (35.64 ± 5.70) μg/L, (22.69 ± 4.01) μg/L vs. (26.81 ± 5.53) μg/L, (18.71 ± 2.92)μg/L vs. (21.34 ± 4.02) μg/L, (1.19 ± 0.20) μg/L vs. (1.37 ± 0.24) μg/L, (0.96 ± 0.13) μg/L vs. (1.13 ± 0.16) μg/L, (0.80 ± 0.11) μg/L vs. (0.94 ± 0.15) μg/L, there were statistical differences ( P<0.05). The NIHSS score was significantly higher and the MMSE score was significantly lower in both groups at 12 and 24 h after surgery ( P<0.05); the NIHSS score and MMSE score in both groups recovered to preoperative level at 48 h after the operation ( P>0.05). The NIHSS score in the experimental group at 12 and 24 h after surgery was lower than that in the conventional group, and the MMSE score was higher than that in the conventional group ( P<0.05). The incidence of anesthesia-related adverse reactions in the experimental groups was lower than that in the control group: 4.76%(2/42) vs. 21.43%(9/42); and the incidence of POCD was lower than that in the conventional group: 19.05%(8/42) vs. 2.38%(1/42), there were statistical differences ( χ2 = 5.13, 4.48, P<0.05). Conclusions:Sevoflurane combined with remifentanil has a significant anesthetic effect in interventional thrombectomy of ischemic stroke patients, which can stabilize hemodynamics, reduce the degree of brain injury, promote cognitive function recovery, and reduce POCD and adverse reactions.

Objective:To investigate the CLEC3B protein of differentially expressed proteins(DEPs)in serum of normal persons and patients with sepsis,and explore the possibility that target C-type lectin domain family 3 member B(CLEC3B)protein was used as molecular markers of sepsis.Methods:Peripheral bloods of 10 healthy persons and 18 patients with sepsis were collected,and the data of peripheral serum proteins were collected by data independent acquisition(DIA)method.The data were uploaded to iDEP online platform to analyze the DEPs in peripheral blood of patients with sepsis.Bioinformatics analysis of these DEPs was conducted to screen out the key proteins of sepsis.Enzyme linked immunosorbent assay(ELISA)was used to verify and plot the receiver operating characteristic(ROC)curves of key proteins.Results:A total of 138 differentially expressed proteins(DEPs)were screened out by using proteomics analysis,of which 34 kinds of proteins were significantly down-regulated and 104 kinds of proteins were significantly up-regulated.DEPs mostly concentrated in cellular processes,biological regulation,biological process regulation,participating binding,catalytic activation,molecular function regulation,immune system,signal transduction and so on.A protein-protein interaction network was constructed by DEPs,which screened out the key protein CLEC3B.ELISA results showed that the CLEC3B protein concentration[(297.73±22.00)ng/mL]of patients in the sepsis group was significantly lower than that[(452.42±191.72)ng/mL]in the healthy group,and the difference was statistically significant(t=13.13,P=0.000).The area under curve(AUC)value of ROC curve,sensitivity and specificity of CLEC38 protein were respectively 0.998,97.73%and 100.0%.Conclusion:CLEC3B is significantly decreased in sepsis group,which sensitivity and specificity are high.It can be used as a potentially biological diagnostic biomarker of sepsis.

Objective To compare the effectiveness of Defocus Incorporated Multiple Segments (DIMS) and High Aspheric Lenslet (HAL) defocus lenses in controlling myopia. Methods A total of 214 children and adolescents who were fitted with defocus lenses (DIMS or HAL) in our hospital from January to June 2023 were selected, including 100 cases in DIMS group and 114 cases in the HAL group. Changes in parameters such as spherical lens power, cylindrical lens power, spherical equivalent (SE), corneal curvature (K), axial length (AL), binocular accommodative response (BCC), positive/negative relative accommodation (PRA/NRA), distance/near latent phoria (DLP/NLP), and accommodative convergence to accommodation ratio (AC/A) were compared between the two groups before wearing and after wearing the lenses for 6 months, and the effectiveness of myopia control between DIMS and HAL was further compared. Results After wearing the lenses (DIMS or HAL) for 6 months, the average increase in axial length was (0.09±0.14) mm, the average increase in spherical lens power was (-0.11±0.23) D, the average increase in astigmatism was (-0.07±0.16) DC, and the average increase in spherical equivalent was (-0.15±0.24) D, with statistically significant differences observed for all these changes (t=9.24, -7.27, -6.60, -9.03, respectively, P < 0.001). Compared with parameters before wearing the lenses, statistically significant differences were noted after wearing for 6 months in spherical lens power, cylindrical lens power, SE, BCC, PRA, DLP, average K, and AL (P≤0.001), except for NRA (t=-0.12, P>0.05), NLP (t=-0.28, P>0.05), and AC/A (t=0.33, P>0.05). The differences in parameters between the two groups after wearing the lenses for 6 months showed a statistically significant difference only in the AL difference (t=4.38, P≤0.001), with no statistically significant differences observed for other parameter differences (P>0.05). Conclusion Wearing defocus lenses has a positive effect on controlling myopia, delaying axial length elongation, and maintaining binocular visual function balance.