Objective To explore the risk factors for mortality in patients with acute kidney injury(AKI) receiving renal replacement therapy and their predictive value in the prognosis of AKI patients.Methods One hundred and sixteen elderly AKI patients who underwent continuous renal replacement therapy(CRRT) in the intensive care unit of Beijing Rehabilitation Hospital affiliated with Capital Medical University from January 2020 to December 2021 were selected as the study subjects. According to the 28 day prognosis of patients admitted to the intensive care unit, they were divided into survival group and mortality group, and the data of the two groups of patients were compared. Multivariate logistic regression analysis was used to assess the risk factors associated with 28 day mortality in AKI patients, and the predictive value was evaluated using the receiver operating characteristic curve(ROC). Results During the study period, there were a total of 116 AKI patients. According to the exclusion criteria, 80 of them met the inclusion criteria, including 32 in the survival group and 48 in the mortality group, with a mortality rate of 60.0%. Compared with the survival group, AKI patients in the death group were older, with higher acute physiology and chronic health status score Ⅱ(APACHE Ⅱ), sequential organ failure score(SOFA), and central venous pressure(CVP) before CRRT withdrawal, with statistically significant differences(t/P=2.832/0.006, 3.374/0.001, 3.159/0.002, 4.184/<0.001). The results of multivariate Logistic regression analysis showed that older age, higher APACHE Ⅱ score, higher SOFA score, and higher CVP before CRRT withdrawal were independent risk factors for 28 day mortality in AKI patients [OR(95%CI)=1.103(1.005-1.210), 1.117(1.042-1.197), 1.232(0.971-1.562), 2.590(1.379-4.862)].ROC curve analysis showed that all four risk factors leading to death in AKI patients in the intensive care unit were able to predict the patient's 28 day prognosis, with the area under the ROC curve(AUC) of CVP before CRRT withdrawal being the largest(AUC=0.829). When the optimal critical value was 7.5 mmHg, the sensitivity was 0.813, the specificity was 0.719, and the AUC of other major clinical indicators was<0.8. Conclusion The mortality rate of AKI patients receiving CRRT treatment is very high. Elderly age, high CVP before CRRT withdrawal, high APACHE Ⅱ score, and high SOFA score are all risk factors for patient death. All four predictive indicators have certain predictive value for the adverse prognosis of AKI patients.

Objective To investigate the effects of programmed death receptor-1(PD-1) programmed death receptor-1/ligand(PD-L1) inhibitor Navurizumab combined with Taxus capsule therapy on lactate dehydrogenase(LDH), neutrophil/lymphocyte ratio(NLR), and immune function in patients with advanced non-small cell lung cancer(NSCLC).Methods One hundred and two patients with advanced NSCLC admitted to the Hematology and Oncology Department of the Third People's Hospital of Yangquan City, Shanxi Province from January 2020 to February 2021 were selected. They were randomly divided into an observation group and a control group, with 51 cases in each group. The control group was treated with navulizumab, while the observation group was treated with a combination of yew capsule on the basis of the control group, both of which were treated for 8 weeks. Compare the efficacy of two groups after 8 weeks of treatment, and detect serum tumor markers [carcinoembryonic antigen(CEA), carbohydrate antigen-125(CA125), cytokeratin 19 fragment(CYFRA21-1)], immune function indicators(CD3+, CD4+, CD4+/CD8+), serum LDH, NLR levels, Karnofsky functional status score(KPS) before treatment, and after 6 and 8 weeks of treatment. Calculate the incidence of adverse reactions in both groups.Results After 8 weeks of treatment, there was no statistically significant difference in the total effective rate between the two groups in the observation group(P>0. 05), but the disease control rate was significantly higher than that of the control group(70.59% vs. 50.98%, χ2=4.113, P=0.043).After 6 and 8 weeks of treatment, the serum CEA, CA125, and CYFRA21-1 levels in both groups were lower than before treatment, and the observation group was lower than the control group(6 weeks: t/P=10.775/<0.001, 9.874/<0.001, 9.684/<0.001; 8 weeks: t/P=11.634/<0.001, 10.008/<0.001, 9.887/<0.001). After 6 and 8 weeks of treatment, the levels of CD3+, CD4+, and CD4+/CD8+markers in both groups decreased compared to before treatment(P<0.001); After 6 and 8 weeks of treatment, the observation group showed higher levels than the control group(6 weeks: t/P=4.607/<0.001, 7.353/<0.001, 8.333/<0.001; 8 weeks: t/P=7.226/<0.001, 7.660/<0.001, 8.970/<0.001). After 6 and 8 weeks of treatment, the serum LDH and NLR levels in both groups decreased compared to before treatment(P<0.001), and the observation group was significantly lower than the control group(6 weeks: t/P=3.330/<0.001, 2.687/0.008; 8 weeks: t/P=2.174/0.032, 2.725/0.007). After 6 and 8 weeks of treatment, the KPS scores of both groups increased compared to before treatment(P<0.001), and the observation group was higher than the control group(t/P=6.006/<0.001, 4.097/<0.001); The incidence of adverse reactions such as thrombocytopenia, fatigue, nausea and vomiting, and decreased appetite in the observation group was lower than that in the control group(P<0.05).Conclusion The combination of Navulizumab and Taxus capsule can effectively control the progression of non-small cell lung cancer, enhance immune function, improve functional status, and regulate LDH and NLR levels.

Objective To study the effect of applying anterior lateral ligament(ALL) reconstruction in anterior cruciate ligament(ACL) injury reconstruction.Methods One hundred and twenty patients with ACL injury who received treatment at the Orthopedic Department of Friendship Hospital in Urumqi from October 2017 to October 2020 were selected as the research subjects. According to a standard randomized design, the patients were divided into two groups of 60 each. The observation group received reconstruction with hamstring tendon(HT)+ACL combined with allogeneic tendon(AT)+ALL, while the control group received reconstruction with HT+ACL. The patients were followed up for 2 years to compare the clinical efficacy, treatment safety, and effectiveness of the two groups.Results Two sets of International Knee Joint Demonstration Committee(IKDC) scores and Tegner Activity Rating Scale(Tegner score): preoperativepostoperative 6 months > postoperative 1 year > postoperative 2 years. The Lysholm knee joint score scale(Lysholm score): preoperative < postoperative 6 months0.05). Two years after surgery, there was no statistically significant difference in the rate of plant rupture between the two groups(P>0.05). The observation group had a significantly higher rate of pre injury exercise than the control group(86.87% vs. 71.67%,χ2=4.093,P=0.043).Conclusion ALL reconstruction is beneficial for promoting the recovery of knee joint function in patients with ACL injury, improving disease symptoms and reducing pain, and ensuring the safety and effectiveness of clinical treatment.

Objective To analyze the correlation between the expression of miR-142-5p and forkhead transcription protein O subgroup 3(FOXO3) in saliva exosomes and immune function in patients with recurrent aphthous ulcer(RAU). Methods Collect 134 RAU patients admitted to the Stomatology Department of Sanya Central Hospital/Hainan Third People's Hospital from December 2019 to December 2021 as the observation group, and select 134 healthy volunteers from the same period as the healthy control group. Collect saliva from subjects and extract salivary exosomes. Analyze the expression levels of miR-142-5p and FOXO3 mRNA in the samples using qRT PCR. Measure the proportion of CD3+CD4+and CD3+CD8+cells in peripheral blood using flow cytometry, and calculate the CD4+/CD8+ratio; Compare the pain index and ulcer area of RAU patients between high and low expression subgroups of miR-142-5p and FOXO3; Pearson's method was used to analyze the correlation between miR-142-5p and FOXO3 mRNA levels in patients' saliva exosomes, as well as their correlation with CD3+CD4+, CD3+CD8+, and CD4+/CD8+; Draw a receiver operating characteristic curve(ROC) to evaluate the diagnostic value of miR-142-5p and FOXO3 mRNA expression levels in predicting RAU. Results Compared with the healthy control group, the observation group showed an increase in the expression level of miR-142-5p in saliva extracellular vesicles and the proportion of CD3+CD8+cells in peripheral blood(χ2/P=34.580/<0.001, 6.889/<0.001), FOXO3 mRNA and protein expression levels, peripheral blood CD3+CD4+, CD4+/CD8+cell ratio decreased [t(χ2)/P=43.121/<0.001, 37.692/<0.001、10.219/0.001、26.091/<0.001)].Compared with the low expression subgroup of miR-142-5p, the high expression subgroup of miR-142-5p showed an increase in pain index and ulcer area(t/P=3.880/<0.001, 5.027/<0.001); Compared with the high expression subgroup of FOXO3, the low expression subgroup of FOXO3 showed an increase in pain index and ulcer area(t/P=4.711/<0.001, 5.382/<0.001). The observation group showed a negative correlation between miR-142-5p and the proportion of CD3+CD4+, CD4+/CD8+cells in the saliva exosomes(P<0.001), while FOXO3 mRNA was positively correlated with the proportion of CD3+CD4+, CD4+/CD8+cells(P<0.001). There was no correlation between miR-142-5p, FOXO3, and the proportion of CD3+CD8+cells(P>0.05). The results of plotting ROC curves indicate that the area under the curve(AUC) of miR-142-5p, FOXO3 mRNA, and their combination for predicting RAU recurrence are 0.810, 0.809, and 0.947, respectively. The combined detection of the two is superior to their respective individual predictive efficacy(Z=6.528, 8.573,P<0.001). Conclusion In RAU patients, miR-142-5p in the salivary exosomes is highly expressed, while FOXO3 is in a low expression state. Both are involved in the immune regulation of recurrent oral ulcers.

Objective To investigate the effect of tetrandrine(Tet) on regulating the nuclear factor E2 related factor 2(Nrf2)/heme oxygenase 1(HO-1)/Nord like receptor protein 3(NLRP3) signaling pathway on neuronal damage in depression rats. Methods Seventy-two SD rats were selected and randomly divided into 6 groups(12 rats/group) using a number table method: control group, model group, low dose Tet group(10 mg/kg), medium dose Tet group(20 mg/kg), high dose Tet group(40 mg/kg), and inhibitor group(Tet 40 mg/kg+Nrf2/HO-1/NLRP3 pathway inhibitor ML385, 30 mg/kg); Except for the control group, other rats were injected subcutaneously with corticosterone to construct a depression model. After successful modeling, the control group and model group rats were gavaged and intraperitoneally injected with an equal amount of physiological saline, while the other rats were gavaged and intraperitoneally injected with corresponding drugs once a day for 21 days. Evaluate depression in rats using sugar water preference test, forced swimming test, and open field test; Hematoxylin eosin(HE) and Nissl staining were used to evaluate the damage of hippocampal tissue and neurons in each group of rats; Observation of hippocampal synaptic ultrastructure using transmission electron microscopy; Enzyme linked immunosorbent assay(ELISA) for detecting interleukin-6(IL-6) and IL-β in the hippocampus of rats in each group, Tumor Necrosis Factor(TNF)-α Levels and levels of catalase(CAT), malondialdehyde(MDA), and reactive oxygen species(ROS); Western blot was used to detect the expression of Nrf2/HO-1/NLRP3 signaling pathway proteins, apoptosis related spot like proteins(ASC), and cysteine protease-1(Caspase-1) in the hippocampus of rats in each group. Results Compared with the control group, the model group showed significant depressive behavior and severe damage to hippocampal neurons. The body mass, glucose preference rate, autonomous activity score, number of neurons, length of active zone, thickness of dense zone, CAT activity, Nrf2, and HO-1 protein expression levels in the hippocampal tissue of the rats were significantly reduced, while immobility time, synaptic gap, IL-6, and IL-β TNF-α,MDA, ROS, NLRP3, ASC, and Caspase-1 protein expression levels in the hippocampal tissue were significantly increased(P<0.05); Compared with the Model group, low, medium, and high doses of Tet can improve depressive behavior in rats and alleviate hippocampal neuronal damage(P<0.05); Inhibitors can reverse the improvement effect of high-dose Tet on depression in rats(P<0.05). Conclusion Tet may alleviate depression in rats by activating the Nrf2/HO-1/NLRP3 signaling pathway, alleviating inflammatory responses and oxidative stress damage in the hippocampus.