Objective To investigate the value of hemoglobin, albumin, lymphocyte and platelet(HALP) index in predicting the clinical outcome of mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with pulmonary encephalopathy. Methods A total of 102 patients with AECOPD combined with pulmonary encephalopathy were selected as the observation group and 69 patients with AECOPD without pulmonary encephalopathy were selected as the control group from January 2020 to December 2022 in the Department of Serious Medicine, Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University. All patients in the observation group received mechanical ventilation. Hemoglobin, albumin, lymphocyte count and platelet count were measured before treatment, and HALP index was calculated. According to the treatment results, patients were divided into successful subgroup(30 cases) and failed subgroup(72 cases). Multivariate Logistic regression analysis of NPPV treatment failure in patients with AECOPD and pulmonary encephalopathy. The value of receiver operating characteristic(ROC) curve analysis of HALP index in predicting NPPV treatment failure in patients with AECOPD and pulmonary encephalopathy. Results HALP index of observation group was lower than that of control group(t/P=6.286/<0.001). The scores of acute physiology and chronic health evaluationⅡ(APACHEⅡ) in failure subgroup were higher than those in success subgroup(t/P=3.834/<0.001). Baseline Glasgow Coma Scale(GCS) scores and HALP index were lower than those of successful subgroups(t/P=10.765/<0.001, 11.152/<0.001). HALP index was negatively correlated with APACHEⅡ score(r=-0.415,P<0.001), and positively correlated with GCS score(r=0.368, P=0.009). Low baseline GCS score and HALP index were risk factors for NPPV treatment failure in patients with AECOPD and pulmonary encephalopathy[OR(95%CI)=2.782(1.138-6.799), 2.130(1.126-4.027)]. HALP index predicted NPPV failure in AECOPD patients with pulmonary encephalopathy with an area under the curve of 0.811(95%CI:0.722-0.882), critical value of 32.19, sensitivity of 86.67%, specificity of 79.17%, and Jorden index of 0.658.Conclusion The decrease of HALP index in patients with AECOPD combined with pulmonary encephalopathy is associated with NPPV treatment failure, and can predict the risk of NPPV treatment failure.

Objective To analyze the relationship between the changes of inflammatory factors and dietary inflammatory index(DII) in elderly patients with diabetes mellitus complicated with chronic obstructive pulmonary disease(COPD) and the acute attack of COPD. Methods From October 2021 to October 2023, 110 elderly patients with diabetes mellitus and COPD admitted to the First Department of the Cadre Ward of the 980th Hospital of the Joint Logistics Support Force of the Chinese People 's Liberation Army were selected as the research objects. According to whether acute exacerbation of COPD occurred, the patients were divided into acute exacerbation group(48 cases) and stable group(62 cases). The levels of serum inflammatory factors[tumor necrosis factor-α(TNF-α), C-reactive protein( CRP)]were measured by enzyme-linked immunosorbent assay. Pearson correlation analysis was used to analyze the correlation between serum inflammatory factor levels and lung function. Multivariate Logistic regression analysis was used to analyze the influencing factors of acute exacerbation of COPD in elderly diabetic patients with COPD. R software was used to construct a nomogram model for predicting acute exacerbation of COPD in elderly diabetic patients with COPD. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of the nomogram model for acute exacerbation of COPD in elderly diabetic patients with COPD, and the calibration curve was used to evaluate the consistency of the model.Results The levels of serum TNF-α, CRP and DII score in the acute exacerbation group were higher than those in the stable group(t=5.482, 4.603, 4.588, all P<0.01). The levels of FPG, 2 hPG and HbA1cin the acute exacerbation group were higher than those in the stable group, and the levels of FVC and FEV1 were lower than those in the stable group(t=4.481,5.984,4.465,4.710,4.208,all P<0.01). Pearson correlation analysis showed that serum TNF-α and CRP levels were negatively correlated with FVC and FEV1 in diabetic patients with COPD(r=-0.247,-0.260,-0.191,-0.255,P=0.009,0.003,0.045,0.007). Multivariate Logistic regression analysis showed that TNF-α, DII score, 2 hPG and HbA1cwere increased. The decrease of FVC and FEV 1 was an independent risk factor for acute exacerbation of COPD in diabetic patients with COPD[OR(95%CI)=1.459(1.011-2.104),22.687(1.524-337.648),12.500(2.465-63.389),30.593(2.086-448.593),120.662(9.724-1497.195),19.862(4.644-84.950)], and a nomogram prediction model was constructed. ROC curve was used to verify the nomogram model. The area under the curve(AUC) of the nomogram model for predicting acute exacerbation of COPD in diabetic patients with COPD was 0.984(95%CI= 0.966-1.000). Bootstrap was used to verify the nomogram model. The results showed that the C-index value was 0.954, and the calibration curves were in good agreement with the ideal curve fitting. Conclusion The levels of serum TNF-α, CRP and DII score increased with the aggravation of the disease in elderly diabetic patients with COPD. The increase of TNF-α, DII score, 2 hPG and HbA1c, and the decrease of FVC and FEV 1 were independent risk factors for acute exacerbation of COPD in elderly diabetic patients with COPD. The decision tree model based on the above factors had good clinical predictive efficacy.

Objective To investigate the efficacy of carrilizumab combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC) and its effects on serum squamous cell carcinoma antigen(SCC-Ag), tissue inhibitor of matrix metalloproteinase-1(TIMP-1), D-dimer and miR-206.Methods One hundred and ten patients with advanced NSCLC admitted to the Oncology Department of Baoding Second Central Hospital from April 2022 to October 2023 were selected as the research subjects. They were randomly divided into a control group of 55 cases and an observation group of 55 cases using a random number table method. The control group received first-line chemotherapy, while the observation group received additional treatment with Carilizumab on the basis of the control group. The treatment lasted for 21 days as one cycle, for a total of 4-6 cycles. Enzyme linked immunosorbent assay(ELISA) was used to detect the levels of serum SCC Ag, TIMP-1, and D-dimer, and real-time fluorescence quantitative PCR(qPCR) was performed to detect the expression level of miR-206. Compare the clinical efficacy, serum indicators before and after treatment, levels of T lymphocyte subsets, and adverse reactions during treatment between two groups of patients.Results The total clinical effective rate of the observation group was higher than that of the control group(78.18% vs. 60.00%, χ2/P=4.257/0.039);Compared with before treatment, the serum levels of SCC Ag, TIMP-1, and D-dimer in both groups decreased after treatment, while the levels of miR-206 increased. The observation group showed a greater decrease/increase in each indicator than the control group(t/P=38.360, 4.156, 9.567, 4.857/<0.001); Compared with before treatment, CD4+T lymphocytes and CD4+/CD8+increased in both groups after treatment, while CD8+T lymphocytes decreased. Moreover, the observation group showed a greater decrease/increase in various indicators than the control group(t=6.241, 6.879, 5.631, all P<0.001); During the treatment period, the total incidence of adverse reactions in the observation group was lower than that in the control group(5.45% vs. 21.82%, χ2/P=6.253/0.012).Conclusion Carrilizumab combined with chemotherapy is effective in the treatment of advanced NSCLC patients, which can effectively improve immune function, reduce serum SCC-Ag, TIMP-1 and D-dimer levels, and increase miR-206 levels.

Objective To explore the effect of applying hemodialysis filtration combined with hydration therapy to prevent contrast-induced acute kidney injury(CI-AKI) after percutaneous coronary intervention(PCI) in coronary heart disease patients with diabetes mellitus and mild-to-moderate renal insufficiency. Methods Sixty cases of coronary heart disease patients with combined diabetes mellitus and mild-to-moderate chronic renal insufficiency who underwent PCI treatment admitted to the Second Hospital Affiliated to Hebei North College from January 2018 to December 2020 were selected, and divided into 30 cases each in the hydration group and the hydration+blood purification group according to the method of randomized numerical table, and the hydration group was given the intervention of the standard hydration treatment method, and the standard hydration treatment method was given to the hydration group. The hydration + blood purification group was given standard hydration therapy + hemodialysis filtration intervention. The renal function indexes [blood creatinine(SCr), creatinine clearance(CCr), serum cystatin C(Cys-C) and retinol-binding protein(RBP), blood urea nitrogen(BUN), and serum β2-microglobulin(β2-MG)] were measured in the two groups before and 48 and 72 h after PCI, and the estimated glomerular filtration rate(eGFR) was calculated to assess the changes of renal function before and after exposure to the contrast agent. Changes in renal function were evaluated before and after exposure to contrast media. We also determined the levels of related inflammatory factors.Results After the intervention, the levels of SCr, Cys-C, RBP and BUN in the hydration group were higher than those in the preoperative period at 48 and 72 h after PCI, and the difference was statistically significant(P<0.01), while the levels of CCr and eGFR were lower than those in the preoperative period(F/P=59.018/<0.001, 7.028/0.002); β 2-MG levels tended to increase compared with preoperative levels, but the difference was not statistically significant(F/P=1.774/0.176); IL-6, IL-10, TFN-α, and CRP levels decreased compared with preoperative levels(P<0.01), and INF-γ levels increased(F/P=154.350/<0.001). The levels of SCr, RBP, BUN, and β 2-MG were lower in the hydration+blood purification group at 48 and 72 h after PCI compared with the preoperative period(P<0.01) and lower than those in the hydration group at the corresponding time points(P<0.05 or P<0.01); CCr levels were elevated compared to preoperative(F/P=121.038/<0.001) and were higher than those in the hydration group at the corresponding time point(P<0.01); Cys-C levels were not statistically different from preoperative(F/P=0.137/0.872), but were lower than those in the hydration group at the corresponding postoperative time point(P<0.01); eGFR levels were elevated compared with preoperative(F/P=329.348/<0.001), and higher than the corresponding time-point hydration group(P<0.01); IL-6, IL-10, TNF-α, and CRP levels were lower than preoperative(P<0.01) and lower than the corresponding time-point hydration group(P<0.01); INF-γ level was elevated(F/P=704.002/<0.001), and higher than the corresponding time point hydration group(P<0.01).Conclusion The application of hemodialysis filtration combined with hydration therapy to prevent CI-AKI after PCI in coronary artery disease patients with diabetes mellitus with mild to moderate renal insufficiency has good effect, which can effectively reduce the renal injury by contrast agent and has better effect than hydration therapy alone.

Objective To investigate the determinants of relapse among individuals with hyperthyroidism(GD) following their initial iodine-131(~(131) I) treatment. Methods A total of 211 patients diagnosed with GD who underwent131I treatment at the Department of Nuclear Medicine, the First Affiliated Hospital of Xinjiang Medical University, between May 2022 and May 2023 were included in this study. Based on their post-treatment recurrence status, the patients were categorized into two groups: those without recurrence(189 cases) and those with recurrence(22 cases). Various thyroid hormone levels including free triiodothyronine(FT3), free thyroxine(FT4), thyroid-stimulating hormone(TSH), anti-thyroglobulin antibody(TGAb), anti-thyroid peroxidase antibody(TPOAb), and thyroid-stimulating hormone receptor antibody(TRAb) were assessed. The correlation between these markers and the recurrence of GD following131I treatment was examined using Spearman correlation analysis. Additionally, multivariate logistic regression analysis was performed to identify the factors influencing the recurrence of GD post131I treatment. Results The recurrence group exhibited elevated levels of serum FT3, FT4, and TRAb compared to the non-recurrence group, while displaying a lower serum TSH level(t/P=5.726/<0.001, 6.541/<0.001, 6.904/<0.001, 5.898/<0.001). Similarly, the 24-hour uptake rate of131I and the cumulative total dose of131I were higher in the recurrence group than in the non-recurrence group(t/P=4.668/<0.001, 5.724/<0.001). According to Spearman correlation analysis, the recurrence following initial GD treatment with131I was positively associated with disease duration, thyroid Ⅲ degree enlargement, family history of thyroid disease, elevated levels of FT3, FT4, TRAb, 24-hour uptake rate of131I, and cumulative total dose of131I(r/P=0.221/0.001, 0.137/0.046, 0.135/0.05, 0.312/<0.001, 0.322/<0.001, 0.313/<0.001, 0.306/<0.001, 0.333/<0.001), and negatively correlated with TSH levels(r/P=-0.387/<0.001). Additionally, the multivariate logistic regression analysis indicated that elevated FT3, increased FT4, higher TRAb levels, and greater 24-hour uptake rate of131I were independent risk factors for recurrence post initial GD treatment with131I [OR(95%CI)=1.193(1.069-1.636), 1.586(1.121-2.244), 1.944(1.136-3.326), 1.817(1.196-2.760)]. Conclusion It is crucial to consider the pre-treatment levels of thyroid hormones and the sensitivity to131I as significant elements influencing the likelihood of recurrence in patients receiving initial thyroid treatment. Adjusting the treatment dosage promptly and closely monitoring fluctuations in thyroid hormone levels are essential for ensuring the enduring therapeutic efficacy of131I in these patients.