Objective To explore the effect of continuous blood purification(CBP) on the expressions of serum troponin(Tn), fibrinogen(Fib), interleukin 6(IL-6) and tumor necrosis factor α(TNF-α) in children with sepsis. Methods From August 2014 to August 2019, 260 children with sepsis diagnosed and treated by the Department of Pediatric Intensive Medicine of Hubei Maternal and Child Health Hospital were selected and divided into the observation group and the control group with 130 cases in each group by random number table method. The control group was given routine treatment, and the observation group was given CBP treatment on the basis of the treatment of the control group. After 3 days of treatment, the serum cardiac troponin I(cTnI), cTnT, Fib, activated whole blood coagulation time(ACT), activated partial thromboplastin time(APTT) and prothrombin time(PT), inflammatory factors [IL-6, TNF-α, C-reactive protein(CRP)], cellular immune function(CD3+, CD4+, CD8+), renal function [Burea nitrogen(BUN), creatinine(SCr), potassium ion(K+)] changes were compared between the two groups before and after treatment. Results After treatment, the levels of cTnI, cTnT, Fib, IL-6, TNF-α, CRP, BUN, SCr and K+ in the two groups were lower than those before treatment, and the observation group was significantly lower than the control group(t/P=7.467/<0.001,58.394/<0.001,13.064/<0.001,6.129/<0.001,2.954/0.003,4.834/<0.001,11.732/<0.001,2.510/0.013,4.823/<0.001).The percentages of CD3+, CD4+, CD8+ T cell subsets were higher than those before treatment, and the observation group was significantly higher than the control group(t/P=5.713/<0.001, 5.832/<0.001, 3.880/<0.001); There was no statistically significant difference in PT(P>0.05). Conclusion CBP treatment can significantly reduce the levels of serum cTnI, cTnT, Fib and inflammatory factors in children with sepsis, improve cellular immune function and renal function, and has good clinical application value.

Objective To investigate the relationship between serum interleukin-1β(IL-1β), von Willebrand factor(vWF), high mobility group box protein B1(HMGB1) and the condition and prognosis of neonatal persistent pulmonary hypertension(PPHN).Methods From December 2016 to November 2021, 121 children with PPHN who were admitted to the First Department of Pediatrics, Langfang City People's Hospital, Hebei Province were selected as the PPHN group. According to the prognosis, they were divided into a poor prognosis subgroup of 33 cases and a good prognosis subgroup of 88 cases, and 44 healthy neonates during the same period were selected as the healthy control group. Serum IL-1β, vWF and HMGB1 levels were detected by enzyme-linked immunosorbent assay. Spearman correlation was used to analyze the correlation between serum IL-1β, vWF, HMGB1 levels and pulmonary artery systolic blood pressure/systolic blood pressure(SPAP/SBP) in children with PPHN, and multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in children with PPHN. Characteristic curve(ROC) analysis of the predictive value of serum IL-1β, vWF and HMGB1 levels for poor prognosis in children with PPHN.Results Compared with the healthy control group, the serum levels of IL-1β, vWF and HMGB1 in the PPHN group were increased [t(U)=12.456, 32.373, 9.809, all P<0.001]. The serum levels of IL-1β, vWF, and HMGB1 in children with mild, moderate, and severe cases increased in sequence(F=110.958, 108.337, 80.870, all P<0.001). The proportion of intrauterine distress, mechanical ventilation time, NO inhalation time, SPAP/SBP, IL-1β, vWF, and HMGB1 levels in the poor prognosis subgroup were higher than those in the good prognosis subgroup(P<0.05), and the proportion of high-frequency oscillatory ventilation and oxygenation index were lower. in the subgroup with good prognosis(P<0.05). Spearman correlation analysis showed that serum IL-1β, vWF and HMGB1 levels in children with PPHN were positively correlated with SPAP/SBP(rs=0.644, 0.673, 0.616, all P<0.001). Multivariate Logistic regression analysis showed that high-frequency oscillatory ventilation and high oxygenation index were independent protective factors for poor prognosis in children with PPHN [OR(95%CI)=0.823(0.741-0.914), 0.862(0.808-0.918)], mechanical Ventilation time, NO inhalation time, SPAP/SBP, IL-1β, vWF, HMGB1 increased as independent risk factors [OR(95%CI)=2.559(1.458-4.490), 1.285(1.084-1.523), 2.643(1.051-4.490) 6.645), 1.246(1.019-1.524), 1.085(1.006-1.171), 1.340(1.064-1.686)]. ROC curve analysis showed that the AUC of serum IL-1β, vWF, and HMGB1 levels alone and in combination predicting poor prognosis in children with PPHN were 0.764, 0.763, 0.782, and 0.907, respectively(3.938/<0.001, 3.535/<0.001, 3.093/0.002). Conclusion Serum levels of IL-1β, vWF, and HMGB1 in children with PPHN are elevated, which are closely related to the severity and prognosis of PPHN.

Objective To study the effect of self-made Jieduliyan decoction combined with intensity-modulated radiation therapy for advanced nasopharyngeal carcinoma and its effect on serum carcinoembryonic antigen(CEA) and squamous cell carcinoma antigen(SCCAg).Methods A total of 121 patients with advanced nasopharyngeal carcinoma who were admitted to Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to May 2021 were selected and divided into a control group of 60 cases and an observation group of 61 cases according to the random number table method. The control group was treated with intensity-modulated conformal radiotherapy, while the observation group was treated with Self-made Jieduliyan decoction on the basis of radiotherapy. The therapeutic effect and adverse reactions of the two groups were observed, serum CEA, SCCAg, CD4+, CD8+, CD4+/CD8+, vascular endothelial growth factor(VEGF), thrombospondin-1(TSP-1), vascular endothelial growth factor receptor-2(VEGFR-2), transforming growth factor β1(TGF-β1), interleukin-6(IL-6) levels.Results After 6 weeks of treatment, the total effective rate in the observation group was higher than that in the control group(86.89% vs. 71.67%, χ2=5.944,P=0.014). After 6 weeks of treatment, the serum levels of CEA and SCCAg in the two groups decreased, and the observation group was lower than the control group(t/P=56.880/<0.001, 51.320/<0.001); the serum CD4+, CD4+/CD8+ levels in the two groups increased, and the CD8+ levels decreased, and the improvement in the observation group was better than that in the control group(t/P=6.351/<0.001, 8.422/<0.001, 10.680/<0.001); the serum levels of VEGF and VEGFR-2 in the two groups were decreased, and the TSP level was increased, and the observation group improved better than the control group(t/P=28.250/<0.001, 19.900/<0.001, 13.860/<0.001); the serum levels of TGF-β1 and IL-6 in the two groups were decreased, and the observation group was lower than the control group(t/P=35.010/<0.001, 55.470/<0.001). The overall adverse reaction rate in the observation group was lower than that in the control group(9.84%vs.25.00%,χ2=5.170,P=0.022).Conclusion Self-made Jieduliyan decoction combined with intensity-modulated conformal radiotherapy in the treatment of advanced nasopharyngeal carcinoma patients can reduce the levels of serum CEA and SCCAg, and the therapeutic effect is better.

Objective To analyze and construct a risk model of polygene expression and pathological characteristics of colon cancer patients on prognosis.Methods A total of 299 patients with colorectal cancer who underwent surgical treatment in the Department of Gastroenterology and Surgery of Tangshan Central Hospital from January 2019 to January 2021 were selected and included in the study. According to the prognosis of the patients, they were divided into a good prognosis group and a poor prognosis group. Data and expression levels of Cdc2-like kinase 1(CLK1), solute carrier family 2 member 3(SLC2 A3), granzyme B(GZMB), chemokine ligand 11(CXCL11) and other genes, using Cox regression model to determine colorectal cancer Predictors of patient prognosis and established a nomogram risk prediction model, the receiver operating characteristic curve(ROC) was used to evaluate the predictive ability of the nomogram prediction model.Results The poor prognosis group had significantly higher TNM stage IV, poorly differentiated ratio and CLK1 and SLC2 A3 mRNA expression levels than the good prognosis group, while GZMB and CXCL11 mRNA expression levels were significantly lower than those in the good prognosis group [χ2(t)/P=11.583/0.009, 16.103/<0.001, 4.161/<0.001, 4.949/<0.001, 4.877/<0.001, 5.267/<0.001]; multivariate COX regression analysis showed that high expression of CLK1 and SLC2 A3 mRNA was an independent risk factor for the prognosis of colorectal cancer patients, while the high expression of GZMB and CXCL11 mRNA is its protective factor [HR(95%CI)=7.344(3.302-16.334), 7.594(3.043-18.952), 0.001(0.000-0.019), 0.005(0.001-0.043)]; The ROC curve showed that area under the curve(AUC) of CLK1, SLC2 A3, GZMB, CXCL11 and combination of four gene was 0.570,0.635, 0.679, 0.582 and 0.758, respectively, there was significant difference between the combination and sigle gene(Z=4.751, 4.129, 4.483, 5.003, all P<0.001). Conclusion The polygene expression risk model can effectively predict the prognosis of colorectal cancer patients undergoing surgical treatment.

Objective To investigate the efficacy and safety of laparoscopic common bile duct exploration(LCBDE) in the treatment of choledocholithiasis in patients with previous upper abdominal surgery.Methods A retrospective analysis was performed on 60 patients with choledocholithiasis who underwent LCBDE in the Department of Hepatobiliary Surgery of Hebei Provincial People's Hospital from January 2019 to March 2022. According to the previous history of upper abdominal surgery, 25 patients with upper abdominal surgery history(group A) and 35 patients without upper abdominal surgery history(group B) were divided into two groups. The related clinical indicators were compared. Results The age of patients in group A was higher than that in group B(t=3.820,P<0.001), and the proportion of patients with preoperative cholecystolithiasis was lower than that in group B(χ2=35.109,P<0.001). There were no residual stones, intraoperative adjacent organ damage and hospital death in both groups. The operation time and intraoperative blood loss of group A were higher than those of group B, and the difference was statistically significant(t/Z=3.026, 2.537,P=0.004, 0.011). Compared with preoperative, the total bilirubin(TBil), direct bilirubin(DBil), alanine aminotransferase(ALT), aspartate aminotransferase(AST), glutamyl There was no significant difference in transpeptidase(GGT)(P>0.05), and there was no significant difference in the levels of TBil and DBil in group B at 3 days after operation(P>0.05), but the levels of ALT, AST and GGT at 3 days after operation were not statistically significant(P>0.05). Both decreased(Z/P=3.447/0.001, 3.865/<0.001, 3.248/0.001). There was no significant difference in the levels of TBil, DBil, ALT, AST and GGT between the two groups at 3 days after operation(P>0.05). The levels of WBC, C-reactive protein(CRP) and procalcitonin(PCT) in both groups were higher than those before operation at 3 days after operation, and group A was higher than group B(t/P=2.229/0.030, 7.841/<0.001), 2.765/0.010). There were no serious complications such as pancreatitis and abdominal infection in the two groups after operation, and there was no significant difference in the total incidence of postoperative complications(P>0.05). During the follow-up period, there was 1 case of stone recurrence in group B. Conclusion LCBDE is safe and effective in the treatment of common bile duct stones after upper abdominal surgery.