Objective To investigate the expression levels of serum microRNA-10a(miR-10a) and microRNA-21(miR-21) in end-stage renal disease(ESRD) hemodialysis patients and their predictive value for prognosis. Methods One hundred and fifty ESRD patients who underwent regular haemodialysis treatment at the Blood Purification Centre, Gansu Provincial Hospital from October 2021 to October 2023 were selected as the study group, and 60 patients with chronic kidney disease stages 4-5 who required dialysis treatment for the first time in our hospital were randomly selected as the control group. Total cholesterol(TC), triacylglycerol(TG), blood creatinine(SCr), urea nitrogen(BUN), uric acid(UA), eGFR, haemoglobin, C-reactive protein(CRP), blood calcium, and blood phosphorus were detected, and the expression levels of miR-10a and miR-21 were detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR); the statistics of patients of the study group after 1 year of follow-up Survival and death, the predictive value of serum miR-10a and miR-21 expression levels on the prognosis of ESRD haemodialysis patients was analysed by using subject operating characteristic(ROC) curves, and logistic regression was used to analyse the factors affecting the prognosis of ESRD haemodialysis patients. Results Compared with the control group, the study group had elevated levels of SCr, serum miR-10a, and miR-21 expression(t=18.059, 7.349, 8.391,P<0.001), and decreased levels of eGFR(t=28.867, P<0.001). Compared with the survival subgroup, the death subgroup BUN, miR-10a and miR-21 expression levels were elevated(t/P=5.342/<0.001, 8.703/<0.001, 8.273/<0.001), and haemoglobin, eGFR levels were decreased(t/P=2.324/0.022,2.760/0.007); miR-10a, miR-21 alone predicted and both combination predicted the prognosis of SRD haemodialysis patients with AUCs of 0.872, 0.826 and 0.944, respectively, and the combination of the two was superior to their respective individual predictive efficacy(Z/P=2.635/0.030, 3.294/0.014); low eGFR, serum miR-10a expression level was high, and miR-21 expression level was high were all risk factors for prognostic mortality in ESRD haemodialysis patients[OR(95%CI)=1.409(1.100-1.804), 1.364(1.078-1.726), 1.395(1.164-1.671)].Conclusion The levels of miR-10a and miR-21 in the serum of ESRD hemodialysis patients are obviously upregulated, both of which are risk factors affecting the prognosis and death of ESRD hemodialysis patients. The combined prediction of the two has high predictive value for the prognosis of ESRD patients.

Objective To explore the influencing factors of sarcopenia in elderly people and construct a column chart prediction model based on the influencing factors. Methods Clinical data of 200 hospitalized elderly patients admitted to the Department of Geriatrics of our hospital from January 2021 to July 2024 were collected. According to the occurrence of sarcopenia, they were separated into a sarcopenia group of 60 cases and a non-sarcopenia group of 140 cases. Multivariate logistic regression analysis was applied to screen the influencing factors of sarcopenia in elderly people. The rms package in R software was applied to construct a column chart prediction model for the occurrence of sarcopenia in elderly people. Internal validation of the column chart prediction model was performed using Bootstrap method with 1000 repeated samplings. Calibration curve, ROC curve, and clinical decision curve were applied to verify the consistency, discriminability, and clinical value of the column chart prediction model. Results Compared with the non myopenia group, the myopenia group has a high proportion of people aged ≥ 75 years, a low BMI, a high proportion of osteoporosis, a high proportion of diabetes, low albumin, and high TG/HDL-C, with statistically significant differences(χ2/t=15.629, 7.095, 14.618, 15.126, 7.968, 7.658, P<0.001). Age≥75 years old, osteoporosis, diabetes, high TG/HDL-C are independent risk factors for sarcopenia in the elderly [OR(95%CI)=3.167(1.140-8.799), 2.978(1.088-8.153), 11.759(2.723-50.781), 3.271(1.218-4.584)]. High BMI, high albumin are protective factor for the occurrence of myopenia in the elderly[OR(95%CI)=0.691(0.570-0.838), 0.737(0.642-0.845)]. The H-L goodness of fit test results of the column chart prediction model showed that χ2=7.039, P=0.532, the slope of the calibration curve approached 1, and the AUC in the ROC curve was 0.947(95%CI=0.919-0.975), indicating good consistency and discriminability of the predictive model in this column chart. There was a high net profit within the high-risk threshold range of 0.05-0.95, and the decision curve was above the All and None lines, and this column chart prediction model had high clinical practicality. Conclusion The age≥75 years old, osteoporosis, diabetes, high level of TG/HDL-C, low level of BMI, and low level of albumin are the influencing factors for the occurrence of sarcopenia in the elderly. The column chart model constructed by this method can effectively predict the occurrence of sarcopenia.

Objective To investigate the influencing factors of peripheral perineural or lymphovascular invasion(PNI/LVI) in patients with colorectal cancer(CRC) and construct a corresponding prediction model. Methods Three hundred patients admitted to the Department of Anus and Intestines of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine with confirmed diagnosis of CRC and undergoing radical surgery from January 2020 to January 2024 were selected for the study, and were randomly split into the training set(n=210) and the validation set(n=90) according to the ratio of 7:3. Patients in the training set were included in the positive(n=80) and negative(n=130) groups according to the presence of PNI/LVI. The clinical data of the training set, validation set, and positive and negative groups were compared. Multifactorial Logistic regression was used to analyze the influencing factors of PNI/LVI in patients with CRC and to construct a column-line diagram prediction model. The validation set data were used to perform an internal test of the column-line diagram model, and the efficacy of the model was assessed using the subject's work characteristics(ROC) curves, calibration curves, and decision curves. Results There was no statistically significant difference in the comparison of clinical data between the training set and validation set(P>0.05). The proportions of T stage T3-T4, N stage N1-N2, ulcerative type, low differentiation degree, lymph node metastasis, and cancer nodules in the positive group were higher than those in the negative group(χ2/P=17.037/<0.001, 33.094/<0.001,-/0.006, 18.674/<0.001, 51.822/<0.001, 47.223/<0.001). Multifactorial Logistic regression analysis showed that T stage T3 to T4, lymph node metastasis, and cancerous nodules were independent risk factors for PNI/LVI in CRC patients[OR(95%CI)=7.158(1.474-34.756),8.464(2.657-26.963),4.617(2.042-10.440)].A column-line graph model was constructed, and the area under the ROC curve(AUC) of the model was 0.832(95%CI= 0.800-0.885) in the training set and 0.653(95%CI=0.535-0.771) in the validation set. The calibration curve of the model suggests that the model has good agreement between the ideal and actual values in the training set(P=0.748) and validation set(P=0.132). The decision curve suggests that the model leads to greater clinical benefits for patients in both the training and validation sets. Conclusion Staging T3-T4, lymph node metastasis, and cancer nodules are independent risk factors for PNI/LVI infiltration in CRC patients, and the column-line diagram model developed based on the above risk factors has good predictive value and practicality.

Objective To investigate the effects of calcitonin gene-related peptide(CGRP) on sevoflurane-induced neurotoxicity and phosphatidylinositol 3-kinase(PI3k)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR) signaling pathway in neonatal rats. Methods Conducted the experiment in the Anesthesia Research Laboratory of the Second Hospital of Shanxi Medical University from January 2023 to June 2024.The neonatal rat model induced by sevoflurane was constructed, the model rats were randomly divided into model group(Model group),CGRP group and CGRP+LY294002 group, with 12 rats in each group, another 12 normal rats were taken as control group(Control group). The cognitive function of rats in each group were detected by Morris water maze. The level of oxidative stress was detected by enzyme-linked immunosorbent assay(ELISA). The pathological damage of brain tissue was detected by hematoxylin-eosin(HE) staining. Neuronal apoptosis was detected by terminal deoxynucleotidyl transferase mediated nick end labeling(TUNEL) staining. Through the use of immunohistochemistry, the expression of proteins associated to autophagy was found. The PI3k/Akt/mTOR signaling pathway and apoptosis-related proteins were detected by Western blot. Results The brain tissue structure of the Model group was destroyed compared with Control group, the arrangement of neurons was disordered, the number of neurons was reduced, the nuclear pyknosis was deeply stained, the escape latency of rats was prolonged, the residence time in the target quadrant was shortened, the malondialdehyde(MDA) level and neuronal apoptosis rate, the expression of B-cell lymphoma-2(Bcl-2)-related X protein(Bax) and recombinant human autophagy effector protein(Beclin1) were increased, the levels of superoxide dismutase(SOD), glutathione peroxidase(GSH-px) and the expression of Bcl-2, p62, Phosphorylated(p)-Akt/PI3k, p-Akt/Akt, p-mTOR/mTOR were decreased(P<0.05). The brain tissue structure of CGRP group was relatively normal compared with Model group, the neurons were arranged relatively neatly, a small amount of neurons were apoptotic, the phenomenon of nuclear pyknosis was significantly reduced, the escape latency of the rats was shortened, the target quadrant residence time was prolonged, the MDA level and neuronal apoptosis rate, Bax, Beclin1 expression decreased, SOD, GSH-px levels and Bcl-2, p62, p-PI3k/PI3k, p-Akt/Akt, p-mTOR/mTOR expression increased(P<0.05).The brain tissue of CGRP+LY294002 group was more severely damaged than that of CGRP group, the pathological damage of neurons was aggravated, the escape latency was prolonged, the target quadrant residence time was shortened, the MDA level and neuronal apoptosis rate, Bax, Beclin1 expression were increased, SOD, GSH-px levels and Bcl-2, p62, p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR expression were decreased(P<0.05). Conclusion CGRP can reduce sevoflurane-induced neurotoxicity in neonatal rats, and its mechanism is related to the activation of PI3K/AKT/mTOR signaling pathway.

This article presents the clinical data of a case of relapsing polychondritis with airway involvement and provides a literature review.