Objective To analyze the predictive value of inferior vena cava related indicators and their variability for the effectiveness of fluid resuscitation in septic shock. Methods A total of 109 patients with septic shock admitted to the ICU Ward of Xinjiang Production and Construction Corps Hospital from January 2021 to March 2022 were selected, all of whom received standardized treatment such as fluid replacement and anti-infection. According to whether the patients died within 28 days, they were divided into a survival group of 69 cases and a death group of 40 cases. The clinical data of the two groups of patients were compared, including average arterial pressure(MAP), central venous pressure(CVP), inferior vena cava(IVC) diameter before and 6 hours after resuscitation The variability of IVC dilation index and related indicators was analyzed using a multivariate Cox regression model to analyze the influencing factors of prognosis in septic shock patients, and the diagnostic value of the influencing factors of prognosis in septic shock patients was evaluated by drawing a receiver operating characteristic curve(ROC). Results The APACHE II score of patients in the death group was higher than that in the survival group(t/P=3.714/0.002). Before treatment, the MAP, CVP, and IVC diameter of the death group were lower than those of the survival group, while the IVC dilation index was higher than that of the survival group(t/P=6.505/<0.001, 2.062/0.042, 2.943/0.004, 6.383/<0.001); After 6 hours of treatment, the MAP, CVP, and IVC diameter of both groups of patients increased, while the IVC dilation index decreased. The MAP of the death group was lower than that of the survival group, and the IVC dilation index was higher than that of the survival group(t/P=12.196/<0.001, 14.478/<0.001); The MAP variability and CVP variability of patients in the death group were higher than those in the survival group(t/P=8.873/<0.001, 7.355/<0.001); Multivariate Cox regression analysis showed that high MAP variability, high CVP variability, high ICV dilation index before treatment, and high ICV dilation index after 6 hours of treatment were independent risk factors affecting patient prognosis [HR(95%CI)=1.465(1.179-1.819), 1.133(1.034-1.240), 1.142(1.007-1.295), 1.278(1.025-1.593)]; The ROC curve results showed that the area under the curve(AUC) of MAP variability, CVP variability, IVC dilation index before treatment, IVC dilation index after 6 hours of treatment, and the combination of the four predicted the recovery effect of septic shock patients were 0.929, 0.862, 0.790, 0.862, and 0.985, respectively. The combination of the four was superior to their individual predictive efficacy(Z/P=2.334/0.020, 3.579/<0.001, 4.602/<0.001, 2.970/0.003). Conclusion The combination of IVC dilation index before and after treatment has high specificity and sensitivity in predicting the prognosis of septic shock patients, and can be used as a clinical observation indicator to monitor patient condition changes and prognosis.

Objective To explore the effects of Angong Niuhuang Wan combined with continuous kidney replacement therapy on vital signs, cardiac and renal function, and serum angiopoietin-2(Ang-2) levels in patients with heat stroke. Methods Sixty patients with heat stroke who were admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province from July 2019 to September 2021 were selected as the study subjects. They were randomly divided into a control group and an observation group with 30 cases each. The control group received continuous kidney replacement therapy, while the observation group received continuous kidney replacement therapy combined with Angong Niuhuang Wan. Compare the clinical efficacy, vital signs(respiratory rate, heart rate, urine volume, blood pressure), cardiac function [left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVEDD), N-terminal pro brain natriuretic peptide(NT proBNP)], renal function [urine nitrogen(BUN), blood creatinine(SCR), cystatin C(Cys-C)], serum Ang-2 level, body temperature change Changes in consciousness recovery time and acute physiology and chronic health status scoring system II(APACHE II). Results The total effective rate of the observation group was significantly higher than that of the control group(93.33% vs. 73.33%,χ2/P=4.320/0.038);Compared with that before treatment, after treatment, the respiratory rate and heart rate of the two groups were significantly reduced, and the urine volume and blood pressure were significantly increased, and the decrease/increase in the observation group was better than that in the control group(t=5.988, 3.871, 36.974, 3.293,P<0.001); After treatment, LVEF levels significantly increased in both groups, while LVEDD and NT-proBNP levels significantly decreased. The increase/decrease in the observation group was better than that in the control group(t=3.638, 4.778, 13.297,P<0.001); After treatment, the levels of BUN, SCr, and Cys-C in the two groups were significantly reduced, and the observation group was lower than the control group(t=7.689, 7.397, 5.865,P<0.001); After treatment, the serum Ang-2 levels in the two groups significantly decreased, and the observation group was significantly lower than the control group(t=17.867,P<0.001); After treatment, the APACHE-II scores of the two groups significantly decreased, and the observation group was lower than the control group(t=17.045,P<0.001); After treatment, the body temperature of the two groups significantly decreased at 2 hours, 3 days, and 7 days, and the observation group was lower than the control group(t/P=2.446/0.018, 5.794/<0.001, 8.329/<0.001); The recovery time of consciousness in the observation group was significantly shorter than that in the control group(t=30.059,P<0.001). Conclusion The combination of Angong Niuhuang Wan and continuous kidney replacement therapy for heat stroke can effectively improve the patient's vital signs, cardiac function, and renal function, effectively alleviate the patient's high fever phenomenon, significantly shorten the time for consciousness recovery, and reduce serum Ang-2 levels. The therapeutic effect is significant.

Objective To investigate the differences in clinical characteristics, myositis antibody spectrum, and electromyography among different subtypes of idiopathic inflammatory myopathy(IIM) patients.Methods One hundred and seventy-nine IIM patients admitted to the Rheumatology and Immunology Department of the First Affiliated Hospital of the University of Science and Technology of China from February 2017 to February 2021 were selected for clinical data. They were divided into a dermatomyositis(DM) group of 135 cases, a polymyositis(PM) group of 26 cases, and a non-myositis dermatomyositis(CADM) group of 18 cases based on different types. The serum levels of myositis specific antibodies(MSAs) and electromyography of the patients were measured, and the clinical characteristics, myositis antibody spectrum, and electromyographic results of the three groups of IIM patients were compared.Results Among 179 IIM patients, DM, PM, and CADM all showed muscle pain, but CADM patients did not show muscle weakness; Almost all patients with DM and CADM have classic skin manifestations(periorbital edema, shawl sign, V-zone rash, high snow sign), while PM patients have no skin manifestations; In DM and CADM patients, the frequency of periorbital edema, shawl sign, and V-zone rash is similar, while the frequency of high snow sign in the CADM group is higher than that in the DM group(P<0.05). 12="" among="" the="" types="" of="" anti="" mda5="" are="" most="" followed="" by="" ars="" with="" highest="" positive="" rate="" jo-1="" and="" tif1="" mi2="" comparison="" rates="" anti-mda5="" antibodies="" in="" cadm="" group="">DM group>PM group(χ2=19.220,P<0.001);The CADM group had no anti Jo-1 or anti SRP antibodies, while the positive rates of anti Jo-1 and anti SRP antibodies in the PM group were higher than those in the DM group(P<0.05). The positive rates of anti OJ antibodies in the CADM group were higher than those in the PM and DM groups(P<0.05); there="" was="" no="" statistically="" significant="" difference="" in="" the="" expression="" of="" residual="" antibodies="" among="" three="" groups="" p="">0.05). Out of 179 patients, 112 cases were sent for electromyography examination, and 105 cases(93.8%) had electromyographic results indicating abnormalities. A total of 88 cases(78.6%) had myogenic damage, and 54 cases(48.2%) had neurogenic damage. There was no statistically significant difference in the abnormal rate of electromyography, myogenic damage, and abnormal nerve conduction velocity among the DM, PM, and CADM groups(P>0.05).Conclusion IIM patients with three subtypes of DM, PM, and CADM may experience varying degrees of muscle pain, while CADM patients are mainly characterized by skin lesions without any signs of muscle weakness. Anti MDA5 antibodies are the most common MSAs, followed by anti ARS antibodies. The electromyography(EMG) of patients with different types of myositis shows myogenic damage, and some damaged muscles may exhibit neurogenic damage. EMG plays an important role in the clinical diagnosis and application of IIMs.

Objective To analyze the relationship between the expression of selenium binding protein 1(SBP1) and interleukin-17(IL-17) in perianal abscess tissue and the clinical pathological characteristics and prognosis of patients. Methods One hundred and twenty patients with perianal abscess who underwent surgical treatment in the daytime ward of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to December 2021 were selected as the perianal abscess group. Based on the prognosis after 6 months, they were divided into a subgroup of 75 patients with good prognosis and a subgroup of 45 patients with poor prognosis. Another 120 non-infected mixed hemorrhoid patients admitted at the same time were selected as the control group. Two groups of pathological tissue samples were collected, and the relative expression levels of SBP1 and IL-17 mRNA and protein positive expression rates in the local pathological tissues of the two groups of patients were detected and compared. The relationship between the positive expression rates of SBP1 and IL-17 protein, relative expression levels of mRNA and clinical pathological characteristics in the local tissues of patients with perianal abscess was analyzed; Logistic multiple factor regression analysis is used to identify the risk factors that affect the prognosis of patients with perianal abscess; The predictive value of relative expression levels of SBP1 and IL-17 mRNA on the prognosis of patients with perianal abscess was analyzed using the receiver operating characteristic curve(ROC). Results The relative expression level and protein positive rate of SBP1 mRNA in the perianal abscess group were lower than those in the control group [t(χ2)/P=30.059/<0.001, 33.189/<0.001], the relative expression level of IL-17 mRNA and protein positivity rate were higher than those in the control group [t(χ2)/P=29.003/<0.001,126.159/<0.001];The relative expression level and protein positivity rate of SBP1 mRNA in local tissues of patients with poor prognosis subgroup were lower than those of patients with good prognosis subgroup(χ2/P=10.051/<0.001, 6.012/0.014), while the relative expression level of IL-17 mRNA and protein positivity rate were higher than those in the subgroup with good prognosis [t(χ2)/P=5.597/0.018,4.474/<0.001]. There was no statistically significant difference in the expression of SBP1 and IL-17 in the local tissues around the anus among different patients' gender, age, abscess location, infection type, and disease course(P>0.05); Compared with abscesses<5 cm, patients with abscesses ≥ 5 cm showed a decrease in the relative expression of SBP1 mRNA and protein positivity rate [t(χ2)/P=3.630/<0.001, 4.472/0.034],the relative expression level of IL-17 mRNA and protein positivity rate increased [t(χ2)/P=4.387/<0.001,7.721/0.005];Compared with postoperative healing time<4 weeks, patients with postoperative healing time ≥ 4 weeks showed a decrease in the relative expression of SBP1 mRNA and protein positivity rate [t(χ2)/P=3.070/0.003, 4.577/0.032], the relative expression level of IL-17 mRNA and protein positivity rate increased [t(χ2)/P=5.768/<0.001,5.006/0.025].Logistic multivariate regression analysis showed that a decrease in SBP1 expression and an increase in IL-17 expression were independent risk factors affecting the prognosis of patients with perianal abscess after a healing time of ≥ 4 weeks after surgery [OR(95%CI)=1.373(0.623-3.056), 4.237(1.924-10.683), 4.521(4.125-11.878)]; The AUC of SBP1, IL-17 mRNA, and their combination in predicting perianal abscess were 0.888, 0.890, and 0.933, respectively. The combination of the two was superior to their respective predictive efficacy alone(Z/P=3.583/<0.001, 4.252/<0.001). Conclusion The abnormal expression of SBP1 and IL-17 in local tissues of perianal abscess is related to the size, healing time, and patient prognosis of the abscess. Detecting the relative expression levels of SBP1 and IL-17 mRNA has certain clinical value in predicting patient prognosis, and the combined prediction is more effective.

Objective To analyze the relationship between the levels of positive pentameric protein 3(PTX3) and neuregulin-4(Nrg4) in gingival crevicular fluid(GCF) and the prognosis of implants in patients with oral bone incremental implant repair. Methods Ninety-two patients with oral bone augmentation implant repair admitted to the Department of Stomatology, Tongji Medical College Affiliated Hospital, Huazhong University of Science and Technology from April 2021 to April 2022 were selected as the research group. Based on the X-ray examination results at the follow-up one month after implantation, they were divided into a subgroup of 56 patients with poor prognosis and a subgroup of 36 patients with good prognosis; During the same period, 92 periodontal health volunteers underwent physical examination in the hospital as a healthy control group. The expression levels of PTX3 and Nrg4 in gingival crevicular fluid were measured using enzyme-linked immunosorbent assay(ELISA). Pearson correlation analysis was used to investigate the correlation between the expression levels of PTX3 and Nrg4 in gingival crevicular fluid of patients with oral bone augmentation implant repair, and logistic regression analysis was used to analyze the factors affecting the prognosis of dental implants in patients with bone augmentation implant repair. Results Compared with the healthy control group, the study group showed CRP, TNF-α, PTX3's expression level in gingival crevicular fluid increased(t/P=30.695/<0.001, 18.994/<0.001, 8.383/<0.001), while the expression level of Nrg4 decreased(t/P=10.988/<0.001). Compared with the subgroup with good prognosis, the subgroup with poor prognosis' PTX3, CRP, TNF-α increased(t/P=4.706/<0.001, 17.480/<0.001, 9.410/<0.001), while the expression level of Nrg4 decreased(t/P=9.033/<0.001). The expression levels of PTX3 and Nrg4 in gingival crevicular fluid of patients with bone augmentation implant repair were negatively correlated(r/P=-0.349/0.001). Logistic regression analysis showed that high PTX3, low Nrg4, and high CRP were risk factors for implant prognosis in patients with incremental bone implant repair [OR(95%CI)=3.542(1.742 to 7.201), 2.524(1.121 to 5.682), 4.767(2.056 to 11.051)].Conclusion PTX3 is highly expressed in the gingival crevicular fluid of patients with oral bone augmentation implant repair, while Nrg4 is low in expression, both of which are related to implant prognosis.