To investigate the relationship between pulmonary function and smoking status in patients with preserved-ratio impaired spirometry (PRISm) and chronic obstructive pulmonary disease (COPD) over 40 years of age in Shijingshan district of Beijing.

Data were obtained from people over 40 years old in Shijingshan district of Beijing who underwent lung function screening from June to December 2019. According to lung function measurements, 477 patients were diagnosed with PRISm and 416 had COPD. They were divided into a non-smoking group, a past smoking group, and a current smoking group according to current smoking status, and the lung function was compared among the three groups.

Among the 416 COPD patients, 62.5% were male and 37.5% were female, while 56.4% of PRISm patients were male and 43.6% were female. Changes in the lung function-related indexes FEV1/FVC and FEV1%pred were closely related to current smoking status, but had no statistically significant association with passive smoking status. The number of patients who had smoking cessation was significantly higher than that of those who were still smoking according to their current smoking status. Correlation analysis showed that the number of years of smoking and the amount of cigarettes smoked in patients with COPD were strongly correlated with lung function decline (P<0.05), and FEV1/FVC was negatively correlated with the number of years of smoking cessation.

Smoking status is closely related to the change in lung function in Chinese people with COPD. Early screening of the population by pulmonary function testing and early intervention and follow-up according to their smoking status are beneficial to reduce the incidence of COPD.

To compare the efficacy of intrathecal injection of pemetrexed via lumbar puncture and Ommaya capsule implantation for leptomeningeal metastasis in patients with non-small cell lung cancer.

The clinical data of 32 patients with non-small cell lung cancer with leptomeningeal metastasis diagnosed at the Affiliated Tumor Hospital of Guangxi Medical University from October 2021 to July 2023 were retrospectively analyzed. The patients were divided into either a treatment group (n=22) or a control group (n=10). Patients in the treatment group were treated with radiotherapy, intrathecal injection of pemetrexed, and oral almonertinib. Among them, 10 patients were given pemetrexed via ommaya capsule injection (ommaya group), and 12 were given pemetrexed via lumbar puncture (lumbar puncture group). Ten patients in the control group were treated with radiotherapy and oral almonertinib. Patients in the ommaya group underwent ommaya capsule implantation, and received radiotherapy + target drug (almonertinib) + intraventricular chemotherapy (injection of pemetrexed) after operation. Patients in the lumbar puncture group were treated with radiotherapy + target drug (almonertinib) + intrathecal chemotherapy (injection of pemetrexed). Whole brain irradiation was given at 3 Gy per time, 5 times per week for 2 weeks. Oral almonertinib 110 mg was given once daily. The chemotherapy regimen was pemetrexed 30 mg, d1 and d8, every 3 weeks, and was continued until intolerance or death.

The survival time, modified Rankin scale scores, and Bathel scores before and after treatment in the two treatment groups were better than those in the control group (P<0.05), but there was no significant difference between the two treatment groups (P>0.05).

Intrathecal administration of pemetrexed, including direct administration through lumbar puncture and ommaya capsule implantation, is superior to oral administration in the treatment of leptomeningeal metastasis of small cell lung cancer, suggesting that these two routes of administration have good application prospects. However, due to the small sample size and other shortcomings, the conclusions of this study need to be confirmed by prospective studies with larger samples in the future.

To analyze the short-term clinical efficacy and safety of 630 nm laser combined with hematoporphyrin derivatives in the treatment of advanced bronchial lung cancer.

A total of 43 patients with pathologically diagnosed bronchial lung cancer who underwent interventional tumor reduction combined with treatment with 630 nm laser and hematoporphyrin derivatives, chemotherapy, and immunotherapy were selected at the Affiliated Hospital of Qingdao University from March 2019 to September 2023. The basic clinical features and adverse reactions after treatment were recorded, and chest CT and bronchoscopy were reviewed 1 month after treatment.

Chest CT showed that the tumor volume in the trachea or bronchus was significantly reduced after treatment, and ventilation was improved. Bronchoscopy showed that the tumor volume decreased or even disappeared after treatment. After 1 month of treatment, 31 patients (72.09%) were re-examined by chest CT and bronchoscopy, and the total effective rate was 70.97%. None of the 43 patients had serious complications, but 3 patients had common complications.

630 nm laser combined with hematoporphyrin derivatives has obvious clinical efficacy in the treatment of advanced bronchial lung cancer, and it can improve airway stenosis and relieve dyspnea, cough, and other symptoms with a favorable safety profile.

To evaluate the diagnostic value of SHOX2 and RASSF1A gene methylation detection combined with liquid-based cytology in bronchoalveolar lavage fluid (BALF) in the diagnosis of lung cancer.

The BALF samples of 106 patients with suspected lung cancer (84 patients with lung cancer and 22 patients with benign lung lesion) were collected. The methylation of SHOX2 and RASSF1A genes in BALF was detected by PCR. Liquid-based cytology was performed using BALF samples. Using pathological results as the gold standard, the diagnostic performance of SHOX2 and RASSF1A methylation detection as well as the liquid-based cytology of BALF was assessed.

The sensitivity and specificity of SHOX2 combined with RASSF1A methylation detection were 52.4% and 100%, respectively. In the subgroup analysis of lung cancer types, the diagnostic accuracy of methylation detection was 66.7%, 72.0%, and 35.9% in small cell lung cancer, squamous cell lung cancer, and lung adenocarcinoma, respectively. The positive rate of combined detection of SHOX2 and RASSF1A gene methylation was 60.0% in advanced lung cancer, higher than that in early lung cancer. The sensitivity and specificity of cytology detection was 44.0% and 95.5%, respectively. The sensitivity of methylation detection combined with cytology detection was 65.5%.

The methylation analysis of SHOX2 and RASSF1A genes in BALF has good sensitivity and specificity in the diagnosis of lung cancer. SHOX2 and RASSF1A methylation analysis combined with cytology can significantly improve the sensitivity of lung cancer diagnosis, and is an effective supplement for pathological diagnosis of lung cancer.

To identify the risk factors for in-stent restenosis (ISR) after peripheral vascular stenting for lower extremity arterial occlusive disease (LEASO), and to analyze the relationship of fibrinogen (FIB) level and ankle-brachial index (ABI) with ISR.

A total of 121 LEASO patients who were treated at the Affiliated Hospital of Hebei University from January 2021 to October 2022 were selected and divided into either an ISR group (n=48) or a non-ISR group (n=73) according to the occurrence of ISR or not after the procedure. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off points for FIB and ABI. Kaplan-Meier survival analysis was perform to analyze the ISR incidence rates between the two groups based on the optimal cut-off points for ABI and FIB, and the log-rank test was used to evaluate the differences between the groups. A multivariable logistic regression model was constructed to assess the independent predictive value of ABI and FIB for ISR by adjusting for confounding factors. The Hosmer-Lemeshow test was conducted to assess the accuracy of the ISR prediction model. The interaction types between ABI and FIB were analyzed using both additive and multiplicative models.

Before and after adjusting for confounding factors, both high levels of FIB and low levels of ABI were independent risk predictors of ISR (P<0.05). ROC curve analysis identified the optimal cut-off points for FIB and ABI, and the incidence rates of ISR were significantly higher in patients with high FIB (38.89%) and low ABI (48.08%), compared to those with low FIB (18.52%) and high ABI (17.31%) (P<0.05). ABI and albumin were identified as protective factors for ISR (P<0.05), while C-reactive protein (CRP), CRP/albumin ratio (CAR), FIB, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were identified as risk factors (P<0.05). The constructed prediction model showed high accuracy and discriminative ability according to the Hosmer-Lemeshow test and ROC curve validation. When the P value threshold was set at 0.65, the prediction consistency reached the highest, which means that when the P value is greater than 0.65, patients are classified as having ISR, while patients with a P value less than or equal to 0.65 are classified as having no ISR. The model showed a consistency rate of 81.82% and a misjudgment rate of 18.18%. FIB showed an additive interaction with ABI, suggesting an increased risk of ISR when ABI<0.69 and FIB≥3.41 (odds ratio=2.413, 95% confidence interval: 1.345-2.890, P<0.05).

ABI and albumin are protective factors for ISR, while CRP, CAR, NLR, PLR and FIB are risk factors. When the P value is greater than 0.65, patients are classified as having ISR, while patients with a P value less than or equal to 0.65 are classified as having no ISR. The model accuracy test results show a consistency rate of 81.82% and a misjudgment rate of 18.18%. There is an additive interaction between FIB and ABI in predicting ISR risk.

To explore the role of Vaspin in the progression of osteoarthritis (OA) by analyzing the serum levels of Vaspin in patients with knee OA of different severity.

All OA patients received a preoperative X-ray examination (antero-posterior and lateral radiographs in weight loading), and the Kellgren-Lawrence (K-L) grade of knee OA was assessed. A total of 30 mild knee OA (MKOA) patients (K/L score≤2) and 70 severe knee OA (SKOA) patients (K/L score≥3) were included in this study, and their blood samples were collected to separate serum. Vaspin levels in serum from all patients were detected using enzyme-linked immunosorbent assay (ELISA). Vaspin levels were compared between patients with different disease severity and between patients with different body mass index (BMI). The relationship of serum Vaspin with disease activity indices, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), was evaluated. Unconditioned Logistic regression analysis was performed to assess which clinical or laboratory index is an independent risk factor for disease severity in OA.

Serum Vaspin concentrations were significantly higher in SKOA patients than in MKOA patients (P=0.011). Serum Vaspin levels were significantly higher in OA patients with a BMI≥28 than in those with a BMI<24 (P=0.027). Serum Vaspin levels were positively correlated with CRP, but not ESR, in OA patients (R=0.36, P<0.01 and R=0.20, P=0.11, respectively). Vaspin level was identified to be an independent risk factor for disease severity in OA.

Abnormal expression of Vaspin may be involved in the development and progression of OA, and Vaspin may be a related molecule between obesity and OA and could be useful for monitoring the activity and progression of OA.

To evaluate the efficacy and safety of sequential therapy with glucocorticoids in preventing esophageal stricture after endoscopic submucosal dissection (ESD) for circumferential superficial esophageal neoplasms, and to investigate the appropriate dosage and course of glucocorticoids.

A retrospective analysis was performed on data of 38 patients who underwent endoscopic submucosal dissection for circumferential superficial esophageal neoplasms from January 2017 to December 2022 in Northern Jiangsu People's Hospital. The patients were divided into an oral prednisone group (n=10), a sequential long-course group (n=11), and a sequential short-course group (n=17). Prednisone 30 mg was administered orally for 3 weeks and then the dose was reduced in 5 mg decrements every 3 weeks since the third day after ESD in the oral prednisone group. Patients in the sequential long-course group received intralesional triamcinolone injection combined with oral prednisone 30 mg/day, and the dosage was reduced in 5 mg decrements every 3 weeks. Patients in the sequential short-course group received prednisone at 30 mg/day, and the dosage was tapered over 8 weeks after intralesional triamcinolone injection. The frequency of esophageal stenosis and refractory stenosis, the number of endoscopic balloon dilatation (EBD) treatments, treatment time for esophageal stenosis, the rate of wound healing at 1 and 3 months after ESD, and adverse events potentially associated with glucocorticoid administration were compared among the three groups.

The frequency of esophageal stenosis and refractory stenosis in the oral prednisone group, sequential long-course group, and sequential short-course group were 80% (8/10), 27.3% (3/11), and 29.4% ( 5/17), and 60% (6/10), 18.2% (2/11), and 17.6% (3/17), respectively, and the difference was statistically significant among the three groups (χ²=8.007, P=0.018 and χ²=6.364, P=0.042, respectively). In pairwise comparisons, the above indicators in the sequential long-course group and sequential short-course group were significantly lower than those of the oral prednisone group (P<0.05), but there were no statistical difference between the sequential long-course group and sequential short-course group (P>0.05). The number of EBD treatments and treatment time for esophageal stenosis of the three groups were 7.5 (range, 0 to 12), 0 (range, 0 to 8) , and 0 (range, 0 to 8), and (133.75±38.61) d, (85.33±20.74 ) d, and (84.8±27.23) d, respectively, and the difference was statistically significant among the three groups (H=9.882, P=0.007 and F=4.38, P=0.035). In pairwise comparisons, the above indicators in the sequential long-course group and sequential short-course group were significantly less than those of the oral prednisone group (P<0.05), but there were no statistical difference between the sequential long-course group and sequential short-course group (P>0.05). The rate of wound healing in the oral prednisone group, sequential long-course group, and sequential short-course group at 1 and 3 months after ESD were 50%, 72.7%, and 76.5%, and 80%, 90.9%, and 94.1%, respectively, with no significant difference among the three groups (χ²=3.225, P=0.199 and χ²=3.429, P=0.180, respectively). Oral herpes virus infection, mycotic esophagitis, and pneumonia were observed in 6 patients in the oral prednisone group and in 7 in the sequential long-course group. Two patients had mycotic esophagitis in the sequential short-course group.

Sequential therapy with glucocorticoids can effectively prevent esophageal stricture after ESD for circumferential superficial esophageal neoplasms. To reduce glucocorticoid-associated adverse events, the total dose of prednisone in sequential therapy can be appropriately reduced.

To investigate the efficacy and side effects of different dosages of colquhounia root in reducing urinary protein.

Patients who had been using angiotensin receptor antagonists for more than 3 months were given colquhounia root at the Taizhou Central Hospital. The changes of urinary protein, hepatic and renal function, and routine blood parameters were compared before and 4~20 weeks after treatment.

After 4, 8, and 20 weeks of treatment with colquhounia root, the random urinary protein/urinary creatinine ratio significantly decreased, with a total effective rate of 33.3%, 75.6%, and 81.5% , and marked effective rate of 0%, 15.4%, and 40.0%, respectively; and microalbuminuria also decreased significantly, with a total effective rate of 35.9%, 75.6%, and 80.0%, and marked effective rate of 0%, 19.2%, and 38.5%, respectively. The marked effective rate and total effective rate at 20 weeks were significantly higher in the high-dose group than in the low-dose group. The incidence of renal function injury was 20.5%, and the incidence of liver enzyme elevation was 15.4%.

Colquhounia root has appreciated curative effect in reducing urine protein with sligh side effects. The dose of colquhounia root is positively correlated with the decrease of urine protein.

To evaluate the clinical efficacy and safety of Huobahuagen tablets combined with Huangkui capsules in treating diabetic kidney disease patients with a high or extremely high risk of disease progression.

Diabetic kidney disease patients with a high or extremely high risk of disease progression admitted to the outpatient ward of Jiangsu Provincial Hospital of Traditional Chinese Medicine from March 2021 to March 2023 were included as the research subjects. They were randomly divided into either a control group or an observation group, with 55 cases in each group. The control group was treated with Huangkui capsules alone, while the observation group was treated with Huobahuagen tablets combined with Huangkui capsules. Both groups were treated for six months. The efficacy with regard to urine microalbumin/creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), blood creatinine, cystatin C, renal function, and urinary protein was compared between the two groups. Adverse reactions were also compared.

After treatment, UACR and blood creatinine decreased significantly, eGFR increased significantly (P<0.05), and cystatin C showed a decreasing trend in the observation group, but there was no statistically significant difference (P>0.05). In contrast, UACR, blood creatinine, and eGFR showed a downward trend in the control group after treatment, though the difference was not statistically significant (P>0.05), and cystatin C increased significantly (P<0.05). The improvement of UACR, eGFR, and cystatin C (ΔUACR, ΔeGFR, and ΔCystatin C) after treatment in the observation group (ΔUACR, ΔeGFR, and ΔCystatin C) were significantly better than those of the control group (P<0.05). In terms of renal function, the observation group had 14 cases of significant improvement, 8 cases of improvement, 18 cases of no significant change, and 12 cases of ineffectiveness after treatment, with a total effective rate of 76.92%. In the control group, 6 cases showed significant improvement, 6 were effective, 11 were stable, and 28 were ineffective, with a total effective rate of 45.1%. The difference in overall effective rate with regard to renal function between the two groups was statistically significant (P<0.05). In terms of urinary protein, in the observation group after treatment, there were 14 cases of short-term remission, 10 cases of significant improvement, 16 cases of effectiveness, and 12 cases of ineffectiveness, with a total effective rate of 76.92%. In the control group, there were eight cases of short-term remission, 6 cases of significant improvement, 19 cases of effectiveness, and 18 cases of ineffectiveness, with a total effective rate of 64.71%. The overall effective rate with regard to proteinuria in the observation group was higher than that of the control group, but the difference was not statistically significant (P>0.05). There was no statistically significant difference in adverse reaction rate between the observation and control groups (7.69% vs 3.92%, P>0.05).

The combination of Huobahuagen tablets and Huangkui capsules has significant clinical efficacy and safety in treating diabetic nephropathy patients with a high or extremely high risk of disease progression. The combination treatment has significant advantages in reducing urinary protein and protecting renal function.

To investigate the correlation between serum Wnt1 induced signaling pathway protein 1 (WISP1) levels and serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM).

A total of 146 T2DM patients were randomly recruited from the department of endocrinology of the authors' hospital. According to the median level of SUA, the patients were divided into either a high uric acid group or a low uric acid group. Height, weight, waist circumference, hip circumference, and visceral fat area were measured. The levels of SUA, hepatorenal function parameters, blood glucose, blood lipid, C-reactive protein (CRP), glycosylated hemoglobin A1c (HbA1c), and fasting C-peptide were detected. ELISA was used to measure the serum levels of WISP1.

The patients in the high uric acid group had higher serum WISP1 levels than those in the low uric acid group (P=0.004). Spearman correlation analysis showed that WISP1 was positively correlated with SUA (r=0.139, P=0.040), CRP (r=0.203, P=0.004), and HbA1c (r=0.185, P=0.006). Multiple stepwise regression analysis demonstrated that WISP1 independently contributed to elevated serum uric acid levels (β=0.220, P<0.001).

Serum WISP1 independently and positively correlates with elevated SUA in type 2 diabetic patients.

To identify factors that affect the prognosis of patients with acute myocardial infarction (AMI) combined with cardiogenic shock (CS), in order to provide reference for predicting prognosis and propose possible measures to improve prognosis in such patients.

A retrospective analysis was performed on the clinical data of patients with AMI and CS who visited the Department of Emergency Medicine of the Second Hospital of Hebei Medical University from December 2018 to December 2021, including gender, age, body mass index (BMI); past history of smoking, coronary heart disease, arrhythmia, diabetes, hypertension, hyperlipidemia, and cerebrovascular disease; APACHE Ⅱ score, highest vasoactive-inotropic score (VIS) within 24 hours of admission, and fastest heart rate within 24 hours of admission; the worst auxiliary examination values within 24 hours after admission: blood lactate, white blood cell count (WBC), cardiac troponin I (cTnI) , alanine aminotransferase (ALT), total bilirubin (TBil), creatinine (Cr), serum potassium, left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction(LVEF); whether to use continuous renal replacement therapy (CRRT), intra-aortic balloon counterpulsation (IABP), or extracorporeal membrane oxygenation (ECMO), etc. The patients were divided into either a survival group or a death group based on the prognosis after 30 days of onset. Univariate analysis was used to compare the differences in the above indicators between the two groups. Logistic regression analysis was used to identify independent risk factors affecting the prognosis of patients with AMI combined with CS, and receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of the identified risk factors on patient prognosis. According to whether ECMO or IABP was used, the patients were divided into a non-ECMO group and an ECMO group, or a non-IABP group and an IABP group, and the differences in APACHE Ⅱ score and VIS were compared between groups.

Among 97 patients, 62 (63.9%) survived for 30 days and 35 (36.1%) died. Compared with the survival group, the APACHE Ⅱ score, VIS, WBC, and blood lactate in the death group were significantly increased, and the proportion of patients using IABP in the death group was significantly increased. Logistic regression analysis showed that WBC and blood lactate were independent risk factors affecting the 30-day prognosis of AMI patients with CS [odds ratio (OR)=1.137, 95% confidence interval (CI): 1.012-1.278, P<0.05; OR=1.166, 95%CI: 1.025-1.326, P<0.05]. ROC curve analysis showed that, using a cutoff value of 15.35×10⁹/L, the AUC of WBC in predicting prognosis was 0.710, with a sensitivity of 60.0% and specificity of 77.4%. When the cutoff value was 6.05 mmol/L, the AUC of blood lactate is 0.756, with a sensitivity of 85.7% and specificity of 67.7%. Compared with the non-ECMO group, the APACHE Ⅱ score and VIS in the ECMO group were significantly increased. Compared with the non-IABP group, the VIS of the IABP group was significantly higher (P<0.05).

WBC and blood lactate are independent risk factors affecting the prognosis of patients with AMI combined with CS. The highest WBC >15.35×10⁹/L and the highest lactate value >6.05 mmol/L within 24 hours of admission indicate a poor prognosis. Due to the fact that AMI patients with CS supported by IABP and ECMO are more critical, these support measures cannot improve their prognosis.

To explore the application of three-dimensional (3D) printing in medical education for lumbar minimally invasive interventional surgery.

Fourteen subjects who learnt lumbar minimally invasive interventional surgery at the Department of Pain, Peking University Third Hospital were enrolled and divided into either a control group or an observation group. Conventional teaching mode was adopted in the control group, while the combination of conventional teaching and 3D printing was adopted in the observation group. The test results, learning experience score, and satisfaction score were compared between the two groups.

The test results, learning experience score, and satisfaction score in the observation group were significantly higher than those of the control group (P<0.05). Better performances were achieved in the observation group, especially in clinical skills, anatomical stereoscopic thinking, and learning interest.

The application of 3D printing technology can significantly improve the teaching effect of lumbar minimally invasive interventional surgery, and it is helpful to the cultivation of anatomical stereoscopic thinking. Learners in the observation group have high interest in learning and high satisfaction with teaching.