Objective To analyze the relationship between the levels of serum CX3C chemokine receptor 1(CX3CR1), CC chemokine receptor 2(CCR2) and postherpetic neuralgia(PHN) in patients with herpes zoster(HZ). Methods From July 2020 to February 2022, 93 patients with HZ diagnosed and treated by the Department of Endocrinology and the Department of Pain of Xingtai People's Hospital were selected as the HZ group. After treatment, they were followed up for 3 months. The patients were divided into PHN subgroups(n=32) and non-PHN subgroups(n=61) according to whether PHN occurred. At the same time, 40 health examinees were selected as the healthy control group. The clinical data, visual analogue score(VAS) and serum CX3CR1 and CCR2 levels were compared. Pearson method was used to analyze the correlation between serum CX3CR1 and CCR2 in HZ patients. The clinical value of serum CX3CR1 and CCR2 in predicting PHN in patients with HZ was evaluated by the receiver operating characteristic curve(ROC). Logistic regression analysis was used to analyze the independent risk factors of PHN in HZ patients. Results The proportion of patients with age ≥ 50 years, course of disease, fever, HZ type bleeding type or gangrene type in PHN subgroup was higher than that in non PHN subgroup, and the proportion of patients treated with glucocorticoid was lower than that in non PHN subgroup [χ2(t)/P=6.077/0.014, 14.888/<0.001, 6.129/0.013, 13.391/0.001, 12.560/<0.001]. The VAS score of PHN subgroup was higher than that of non-PHN subgroup(t/P=6.001/<0.001). Serum CX3CR1 and CCR2 levels in HZ group were higher than those in healthy control group(t/P=20.566/<0.001, 18.263/<0.001). Serum CX3CR1 and CCR2 levels in PHN subgroups were higher than those in non-PHN subgroups(t/P=11.624/<0.001, 13.519/<0.001). There was a positive correlation between serum CX3CR1 and CCR2 in HZ patients(r/P=0.442/<0.001). ROC curve results showed that the area under the curve(AUC) of serum CX3CR1, CCR2 and their combined prediction of PHN in HZ patients were 0.859, 0.863 and 0.908, respectively, but there was no significant difference between their combined prediction and single prediction of AUC(Z/P=1.117/0.264, 0.974/0.330). Logistic regression analysis showed that high VAS score, high serum CX3CR1 level and high CCR2 level were independent risk factors for PHN in HZ patients [OR(95%CI)=4.301(1.540-12.012), 5.316(2.284-12.373), 7.245(2.175-24.137)].Conclusion The serum CX3CR1 and CCR2 in HZ patients were abnormally elevated, and had a certain predictive effect on the occurrence of PHN in patients.

Objective To study the distribution of intestinal flora in patients with rheumatoid arthritis and its correlation with serum inflammatory and immune indexes. Methods Eighty-six patients with rheumatoid arthritis admitted to Taihe Hospital/Affiliated Hospital of Hubei Medical College from February 2019 to May 2022 in the Department of Integrated Traditional and Western Medicine in Shiyan City, Hubei Province were selected as the observation group, and 78 healthy people with normal intestinal function in the same period were selected as the healthy control group. 16 s rDNA sequencing and comparison of intestinal flora diversity(Chao1 index, ACE index, Shannon index, Simpson index) were conducted for the intestinal flora of all subjects. The number of intestinal flora was cultured in selective medium and detected. The levels of interleukin-6(IL-6) and interleukin-8 were detected by enzyme-linked immunosorbent assay(ELISA), and C-reactive protein(CRP), immunoglobulin A(IgA), IgE, IgM, and IgG were detected by chemiluminescence. Erythrocyte sedimentation rate(ESR) was detected by infrared barrier method. Pearson correlation analysis was used to analyze the correlation between intestinal flora, inflammatory indicators and immune indicators in patients with rheumatoid arthritis. Results The Chao1 index, ACE index, Shannon index, Simpson index, the number of lactobacilli and bifidobacteria in the observation group were lower than those in the healthy control group(t/P=5.498/< 0.001, 2.551/0.012, 3.312/0.001, 3.611/< 0.001, 8.949/< 0.001, 16.558/< 0.001), and the number of enterococci and true bacilli were higher than those in the healthy control group(t/P=19.353/<0.001, 13.887/< 0.001). The levels of serum CRP, ESR, IL-6, IL-8, IgA, IgE, IgM and IgG in the observation group were higher than those in the healthy control group(t/P=34.883/<0.001, 31.579/<0.001, 48.417/<0.001, 47.260/<0.001, 23.365/<0.001, 5.786/<0.001, 9.176/<0.001, 8.855/<0.001). Lactobacillus and bifidobacteria in rheumatoid arthritis patients were negatively correlated with the inflammatory indicators CRP, ESR, IL-6, IL-8 and immune indicators IgA, IgE, IgM, IgG(Lactobacillus: r=-0.492,-0.504,-0.489,-0.482,-0.497,-0.510,-0.509,-0.479,P<0.001; Bifidobacterium: r=-0.487,-0.485,-0.493,-0.503,-0.501,-0.510,-0.498,-0.482, P<0.001), enterococcus Eubacteria were positively correlated with the above indicators(Enterococcus: r=0.484, 0.495, 0.506, 0.508, 0.487, 0.493, 0.496, 0.504, P<0.001; Eubacteria: r=0.490, 0.492, 0.479, 0.485, 0.491, 0.501, 0.514, 0.487, P<0.001). Conclusion The intestinal flora of patients with rheumatoid arthritis is significantly correlated with the levels of serum inflammatory indicators CRP, ESR, IL-6, IL-8 and immune indicators IgA, IgE, IgM, IgG, which can be used as a basis for treatment of patients with rheumatoid arthritis.

Objective To observe the clinical effect of aerosol inhalation of lidocaine combined with topical anesthesia and dacronin glue applied to the lower end of endotracheal intubation in patients undergoing endoscopic sinus surgery.Methods One hundred patients who underwent endoscopic sinus surgery in Qinhuangdao First Hospital from December 2018 to November 2020 were randomly divided into two groups with 50 cases in each group. Both patients were treated with low-dose midazolam, fentanyl and dexmedetomidine sedation and analgesia(MAC) to complete transoral endotracheal intubation guided by fiberoptic bronchoscope. Group A was treated with lidocaine atomization inhalation combined with dacronin glue to smear the lower end of endotracheal intubation, and group B was treated with lidocaine laryngeal spray combined with cricothyroid membrane puncture. The intubation was immediately(T1) 1 minute after the patient entered the room(T0), 5 min after intubation(T2), immediately after extubation(T3), and 5 min after extubation(T4), record the mean arterial pressure(MAP), pulse oxygen saturation(SpO2) and heart rate(HR). Record the intubation time, record whether there was choking cough and laryngeal spasm during intubation, and follow up the patients for hoarseness, throat pain and intraoperative awareness 2 hours after operation. Record and sort out the data, statistically analyze the research results, and compare the anesthetic effects of the two groups.Results Compared with group B, MAP and HR in group A were significantly lower than those in group B at T3 and T4, and the difference was statistically significant(T3:t/P=8.403/<0.001,19.981/<0.001;T4:10.668/<0.001,17.678/<0.001).The SpO2 in group A was significantly higher than that in group B at T1(t/P=40.018/<0.001). The proportion of choking cough and laryngeal spasm in group A was significantly lower than that in group B(χ2/P=5.263/0.022,6.383/0.012); the restlessness score and postoperative vas during extubation were significantly lower than those in group B(t/P=41.110/<0.001,14.709/<0.001).Conclusion Both groups of surface anesthesia can be used for endotracheal intubation guided by fiberoptic bronchoscope under Mac, and the anesthetic effect of group A is better than that of group B. Under Mac, lidocaine atomization inhalation combined with dacronin glue is applied to the lower end of endotracheal intubation, which has no trauma to patients, sufficient oxygen supply during intubation, more stable perioperative hemodynamics, more perfect analgesia, comfortable feeling and higher overall satisfaction.

The clinical characteristics and treatment of Crohn's disease(CD) patients with aplastic anemia(AA) who were admitted to the Department of Gastroenterology, the First Affiliated Hospital, Air Force Military Medical University from January 2008 to May 2022 were analyzed retrospectively. Among 775 CD patients, 8 patients(1.03%) were associated with AA, 7 patients were primary AA, and 1 patient was secondary AA. There were 7 males, the median age of diagnosis was 34(25-74) years. The most common clinical symptoms were abdominal pain in 7 cases, fever in 5 cases, hematochezia in 3 cases, and diarrhea in 2 cases. All patients with CD were in active stage, while all patients with AA were non severe. Four patients with CD underwent elective or emergency surgery. The treatment drugs mainly included 7 cases of mesalazine, 6 cases of glucocorticoid, 5 cases of cyclosporine, 3 cases of stanzolol, 2 cases of infliximab and 1 case of ulinumab. As of the follow-up period, 4 patients died and the median survival time was 86 months. CD combined with AA is rare in clinical practice. Traditional treatment drugs have poor effect and poor prognosis. Hematopoietic stem cell transplantation may be a potentially effective treatment.

Objective To systematically evaluate the correlation between serum microRNA-133 and the degree of horizontal coronary artery disease. Methods Computer searches were conducted on CNKI, Wanfang Medical Network, Vip, China Biomedical Database, Cochrane Library, PubMed, Embase, and GEO databases to collect research on the correlation between serum microRNA-133 level and coronary artery disease degree. The retrieval time is limited to August 2022. According to the inclusion criteria, the literature included in the study was screened, and the Newcastle Ottawa Scale(NOS) was used to evaluate the literature included in the study, and the main data of the literature was extracted. RevMan 5.4.1 software was used for Meta analysis, and STATA 15.1 software was used for Egger's test to evaluate the publication bias of included literature. Results Finally, 11 articles were included, and 1605 subjects participated in the project, with high literature quality. Meta analysis results showed that the combined effect amount Summary Fisher's Z=0.60, 95%CI 0.41-0.79, P<0.00001, and the converted summary r=0.537. The correlation coefficient obtained from the study with small sample size is lower than that of the study with large sample size(n≤100 group Summary r=0.300; 100

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