Chest pain center is a new emergency mode to provide rapid diagnosis and treatment for patients with acute high-risk chest pain represented by acute coronary syndrome, aortic dissection and pulmonary embolism. The development of chest pain center in China originated in 2011. 1. The concept formation and model were established at the beginning of the 21st century,

Ｒadiologically negative axial spondyloarthritis is a type of spinal arthritis． Early diagnosis and treatment are
of great significance for relieving clinical symptoms and reducing disability rate． By interpreting the " Australian consensus
statement on evaluation and treatment of radiologically negative axial spondyloarthritis in 2021"，and comparing it with the "
American Ｒheumatology Society and American Spondylitis Society＇s recommendations on treatment of axial spondyloarthritis
( updated version) " in 2019，and combining the latest research progress of radiologically negative axial spondyloarthritis This
article elaborates and summarizes sports，physical therapy and drug therapy in order to provide scientific reference for Chinese
clinicians．

To explore the changes and correlation analysis of serum Adropin protein and high-sensitivity
C-reactive protein ( hs-CＲP) in patients with coronary aneurysm ectasia ( CAE) ． Methods Three hundred and forty patients
with coronary angiography ( CAG) who were hospitalized in the Department of Cardiology of the Second People＇s Hospital of
Gansu Province from April 2019 to October 2021 due to angina pectoris were selected as the study objects． According to the results of CAG，73 patients without coronary artery abnormalities were selected as the control group ( NCA group) ，98 patients
in the simple coronary aneurysm ectasia ( CAE) group ( group A) ，52 patients in the CAE combined with obstructive coronary
artery disease ( OCAD) group ( group B) ，and 117 patients in the OCAD group ( group C) ． Collect the clinical data，serum
inflammatory index and biochemical index level of all subjects，compare the difference of serum Adropin and hs-CＲP levels among groups，analyze the correlation between serum Adropin and hs-CＲP in patients with CAE using Pearson method，and determine the influencing factors of CAE using logistic regression analysis．Ｒesults Smoking history，proportion of diabetes mellitus，IL-6，TNF-α level in group A，B and C was higher than that of NCA group ( F/P = 7．845 /0．047，8．311 /0．040，64．
304 /＜0．001，56．600 /＜0．001) ; Comparison of serum Adropin level: Group A ＜ Group B ＜ Group C ＜ NCA，comparison of
hs-CＲP level: Group A ＞ Group B ＞ Group C ＞ NCA ( F/P = 217．14 /＜0．001，572．302 /＜0．001) ; Serum Adropin in CAE
patients was negatively correlated with hs-CＲP ( r = －0．522，P＜0．001) ． Logistic regression analysis showed that smoking history，diabetes and the increase of serum IL-6，TNF-α、hs-CＲP level was an independent risk factor for CAE［OＲ ( 95% CI) =
4．676( 2．619－8．348) ，1．917( 1．634－2．253) ，1．634( 1．428－1．869) ，1．523( 1．306－1．775) ，1．839( 1．584－2．136) ］，and the
increase of serum Adropin level was an independent protective factor for CAE ［OＲ( 95%CI) = 0．790( 0．735－0．849) ］．Conclusion Serum Adropin was low expression and hs-CＲP was high expression in patients with CAE，and Adropin was negatively correlated with hs-CＲP，both of which were independent risk factors for CAE

To investigate the effect of cerebral circulation therapeutic apparatus combined with memantine
on Alzheimer＇s disease ( AD) and its influence on cerebral circulation and vascular repair factors． Methods From January
2018 to January 2021，111 patients with AD were selected from the Department of Neurology，Lu＇an Hospital，Peking University Medical College． They were randomly divided into a control group of 55 patients and a study group of 56 patients． The control group was treated with memantine，and the study group was treated with cerebral circulation therapeutic apparatus on the
basis of the control group，both of which were treated for 1 month． The Montreal Cognitive Scale ( MoCA) ，cerebral circulation
indexes ( left vertebral artery，right vertebral artery and basilar artery blood flow velocity) ，vascular repair factors［heme oxygenase-1 ( HO-1) ，matrix metalloproteinase-9 ( MMP-9) ，MMP-2］，neurotransmitter ［S100B protein γ- Aminobutyric acid
( GABA) ，acetylcholine ( Ach) ］，and adverse reactions． Ｒesults After 1 month treatment，the MoCA score of the study
group was higher than that of the control group ( t /P = 6．844 /＜0．001) ． The blood flow velocity of left vertebral artery，right
vertebral artery and basilar artery was higher than that of the control group ( t /P= 6．233 /＜0．001，10．110＜0．001，5．661 /＜0．
001) ． The levels of serum HO-1，GABA and Ach were higher than those in the control group ( t /P= 5．791 /＜ 0．001，5．664 /＜
0．001，4．150 /＜0．001) ，and the levels of MMP-9，MMP-2，S100B protein were lower than those in the control group ( t /P=
3．945 /＜ 0．001，3．640 /＜ 0．001，5．306 /＜0．001) ． There was no significant difference in the incidence of adverse reactions between the two groups ( P＞ 0．05) ． Conclusion The application of cerebral circulation therapeutic apparatus combined with
memantine in AD patients is helpful to improve microcirculation and restore cognitive function． The mechanism may be related
to regulating vascular repair factors and neurotransmitters，with high safety．

To explore the relationship between the expression levels of circular ＲNA DLGAP4 ( circＲNA
DLGAP4) ，circＲNA SAMD4A and the severity of Parkinson＇s disease ( PD) and cognitive impairment． Methods From October 2019 to March 2022，95 patients with PD diagnosed and treated in the Third Department of Neurology of the First Affiliated Hospital of Hebei North University were selected as the PD group． According to the score of Montreal Cognitive Assessment
Scale ( MoCA) ，the PD patients were divided into 54 patients with normal cognition and 41 patients with cognitive impair-
ment; By Hoehn Yahr ( H-Y) staging，patients with PD were divided into three subgroups: 33 patients in stage 1 subgroup，
44 patients in stage 2-3 subgroup，and 18 patients in stage 4-5 subgroup; In addition，95 healthy people in the same period
were selected as the healthy control group． Serum circＲNA DLGAP4，circＲNA SAMD4A expression levels and MoCA scores
were compared in each group． Pearson＇s method was used to analyze the correlation between the expression level of circＲNA
DLGAP4，circＲNA SAMD4A and MoCA score in the serum of PD patients． Logistic regression analysis was used to analyze
the influencing factors of cognitive impairment in PD patients． Subjects＇ work characteristic curve ( ＲOC) was used to analyze
the diagnostic value of serum circＲNA DLGAP4，circＲNA SAMD4A for cognitive impairment in PD patients．Ｒesults Compared with the healthy control group，the expression level of DLGAP4 and MoCA score in serum of patients with PD decreased
( t /P= 47．612 /＜0．001，26．821 /＜0．001) ，and the expression level of SAMD4A in serum increased ( t /P= 23．461 /＜0．001) ．
The age，serum circＲNA SAMD4A expression level of PD patients in cognitive impairment subgroup were higher than those in
cognitive normal subgroup ( t /P= 2．515 /0．014，6．693 /＜0．001) ，and the years of education，serum circＲNA DLGAP4 expression level and MoCA score were lower than those in cognitive normal subgroup ( t /P= 5．162 /＜0．001，8．289 /＜0．001，23．
017 /＜0．001) ; The serum circＲNA DLGAP4 expression level and MoCA score of PD patients in stage 1 subgroup，stage 2-3
subgroup and stage 4-5 subgroup decreased in turn ( F/P = 103．287 /＜ 0．001，230．136 /＜ 0．001) ，and the serum circＲNA
SAMD4A expression level increased in turn ( F/P= 51．949 /＜0．001) ; Pearson analysis showed that the expression level of serum circＲNA DLGAP4 was positively correlated with MoCA score ( r/P = 0．557 /＜0．001) ，and the expression level of serum
circＲNA SAMD4A was negatively correlated with MoCA score ( r/P = －0．598 /＜0．001) ; Logistic regression analysis showed
that long years of education and high serum circＲNA DLGAP4 were protective factors for cognitive impairment in patients with
PD ［OＲ( 95%CI) = 0．698( 0．568－0．857) ，0．580( 0．476－0．707) ］，while age and high serum circＲNA SAMD4A were risk
factors ［OＲ( 95%CI) = 2．462( 1．612－3．760) ，3．836( 2．225－6．615) ］; The area under the curve ( AUC) of serum circＲNA
DLGAP4，circＲNA SAMD4A and their combination in the diagnosis of cognitive impairment in PD patients were 0．791，0．852
and 0．948，respectively． The AUC of their combination was better than that of their individual diagnosis ( Z/P= 2．950 /0．003，
2．081 /0．037) ． Conclusion The expression of circＲNA DLGAP4 is down regulated and the expression of circＲNA SAMD4A
is up regulated in the serum of PD patients． The detection of the levels of circＲNA DLGAP4 and circＲNA SAMD4A in the serum is helpful for clinical evaluation of the severity of PD patients，and the combination of the two is helpful for determining
whether patients have cognitive impairment．