Objective To observe the safety and efficacy of levosimendan in the perioperative pe-riod for patients with pulmonary hypertension associated with valvular heart disease undergoing heart valve replacement surgery.Methods A total of 90 patients with pulmonary hypertension associated with valvular heart disease who underwent valve replacement surgery from April 2023 to May 2024 were enrolled.Based on the use of levosimendan,patients were divided into low-dose group,high-dose group,and control group,with 30 patients in each group.The control group received conventional drug therapy;the low-dose group received one dose of levosimendan from 3 days before surgery to 3 days after surgery combined with conventional drug therapy;the high-dose group received two doses of levosimendan from 3 days before surgery to 3 days after surgery combined with conventional drug therapy.Data on brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),creatinine(Cr),mean pulmonary artery pressure(mPAP),PH related to left heart disease(PH-LHD)status,postoperative ICU stay,postoperative hospital stay,and cardiac function classification were collected and recorded at admission and before discharge.Results There were no statistically significant differences in gender,age,and body mass among the control group,low-dose group,and high-dose group(P＞0.05).There was no sta-tistically significant difference in the increase in Cr among the three groups(P＞0.05).There were statistically significant differences in postoperative ICU stay between the control group and the high-dose group,and between the control group and the low-dose group(P=0.017,0.028).However,there was no statistically significant difference in postoperative ICU stay between the low-dose group and the high-dose group(P=0.839).There were statistically significant differences in postopera-tive hospital stay between the control group and the high-dose group,and between the control group and the low-dose group(P=0.001,0.009),but no statistically significant difference was found between the low-dose group and the high-dose group(P=0.463).No serious complications oc-curred in any of three groups,and no patients withdrew from the study.Only one patient in the high-dose group experienced hypotension during the postoperative use of levosimendan,which nor-malized after fluid replacement.There was no statistically significant difference in the decrease in mPAP among the three groups(P＞0.05).There was a statistically significant difference in the de-crease in BNP between the control group and the high-dose group(P=0.025);however,there were no statistically significant differences in the decrease in BNP between the control group and the low-dose group,or between the low-dose group and the high-dose group(P=0.068,0.970).There was a statistically significant difference in the increase in LVEF between the control group and the high-dose group(P=0.019);however,there were no statistically significant differences in the increase in LVEF between the control group and the low-dose group,or between the low-dose group and the high-dose group(P=0.055,0.652).There were statistically significant differences in the decrease in LVEDD between the control group and the low-dose group,and between the control group and the high-dose group(P=0.019,0.033);however,there was no statistically significant difference between the low-dose group and the high-dose group(P=0.829).In the control group,18 patients(60.0％)had clinically effective treatment,22 patients(73.3％)in the low-dose group,and 24 patients(80.0％)in the high-dose group.There was no statistically significant differ-ence in clinical efficacy among the three groups(P=0.220).Conclusion Levosimendan is safe and effective in the perioperative period for patients with pulmonary hypertension associated with valvular heart disease,and high-dose use can more significantly improve LVEF and reduce BNP levels.

Objective To observe the effect of preoperative muscle strength training combined with postoperative BIODEX balance function training in improving the motor function of patients with total hip arthroplasty (THA). Methods A total of 110 patients with THA from January 2021 to December 2022 were selected as research objects, and were divided into observation group and control group by the simple randomization method, with 55 cases in each group. The control group received conventional postoperative rehabilitation training, while the observation group was treated with muscle strength training and BIODEX balance function training. Imaging indicators (acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone, and centering rate of femoral prosthesis) at 5 days after surgery were compared between two groups; the joint motor function (Harris score for hip joint), balance ability [Berg Balance Scale (BBS)] and daily activity ability [Activities of Daily Life Scale (ADL)] before treatment and one month after treatment were compared between the two groups. Results There were no significant differences in acetabular abduction angle, anterior inclination angle, proportion of acetabular cup in safe zone and centering rate of femoral prosthesis between the two groups at 5 days after surgery (P>0.05); after one month of treatment, the Harris score for hip joint, the BBS score and ADL score in both group increased significantly, and the scores in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion Preoperative muscle strength training combined with postoperative BIODEX balance function training shows a significant therapeutic effect, which can effectively improve the hip motor function and enhance the balance control ability in patients with THA.

Objective To explore the pathogenesis of juvenile idiopathic arthritis (JIA) and its potential molecular targets.Methods Gene microarray data about JIA was downloaded from Gene Expression Omnibus (GEO) in NCBI.Different expressed genes were identified through bioconductor packages in R programing.The causal genes from the different expressed genes were optimized and replenished by GLAD4U and ToppGene.Functional annotation information of causal genes was carried out by DAVID.Results List of causal genes was obtained as well as their enriched function.Some potential pathways such as Cytokine-cytokine receptor interaction,Jak-STAT signaling pathway,which may be important in the progression of JIA were screened.Conclusions The pathogenesis of JIA,as well as its potential causal genes,can be captured through bioinformatics methods,so it may be used as time and cost saving method in experimental study and clinical application.