Objective To investigate the relationship between serum alpha-1 antitrypsin ( AAT) ，regulated upon activation normal T cell expressed and secreted ( ＲANTES) ，and Ｒesistin levels and the condition and prognosis of patients with large artery atherosclerosis ( LAA) -type acute ischemic stroke ( AIS) ． Methods One hundred and fifty-nine patients with LAA-type AIS were admitted to the Department of Neurology，Xianyang Hospital，Yan＇an University，from January 2022 to January 2023，and included them in the AIS group． 31 patients were divided into mild subgroups，72 cases of moderate subgroups，and 56 cases of severe subgroups according to the score of the National Institutes of Health Stroke Scale ( NIHSS) at the time of hospitalization． In addition，84 cases of healthy volunteers who underwent physical examination in the hospital during the same period were selected to be included in the healthy control group． After 90 d of follow-up，patients with LAA-type AIS were categorized into 61 cases of poor prognosis subgroup and 98 cases of good prognosis subgroup according to the modi-fied Rankin Scale score． Multifactorial Logistic regression was used to analyze the factors affecting the prognosis of LAA-type AIS patients，and receiver operating characteristics ( ＲOC) curves were analyzed to predict the prognostic value of serum AAT，ＲANTES，and Ｒesistin levels in LAA-type AIS patients． Ｒesults Compared with the healthy control group，and the serum AAT，ＲANTES，and Ｒesistin levels were elevated in the AIS group ( t /P = 16． 897 / ＜ 0． 001，20． 334 / ＜ 0． 001，and 17． 775 / ＜ 0． 001) ． AAT，ＲANTES，and Ｒesistin levels were elevated in mild，moderate，and severe subgroups in that order ( F/P = 146． 195 / ＜ 0． 001，192． 910 / ＜ 0． 001，194． 396 / ＜ 0． 001) ． At 90 d of follow-up，the incidence of poor prognosis in 159 patients with LAA-type AIS was 38． 36% ． Independent risk factors affecting the prognosis of patients with LAA type AIS were increased age，diabetes mellitus，increased NIHSS score on admission，elevated AAT，elevated ＲANTES，and elevated Ｒesistin ［OＲ( 95% CI) = 1． 078 ( 1． 019 － 1． 141) ，2． 774 ( 1． 010 － 7． 622) ，1． 106 ( 1． 054 － 1． 160) ，1． 597 ( 1． 057 － 2． 414) ，1． 136 ( 1． 059 － 1． 219) ，1． 097 ( 1． 035 － 1． 163) ］; serum AAT，ＲANTES，Ｒesistin levels and the areaunder the curve of the combination of the three predicted poor prognosis in patients with LAA-type AIS were 0． 769，0． 771，0． 766，and 0． 897，respectively，and the area under the curve of the combination of the three was greater than that predicted alone ( Z/P = 3． 484 /0． 001，3． 416 / 0． 001，3． 230 /0． 001) ． Conclusion Elevated serum AAT，ＲANTES，and Ｒesistin levels in LAA-type AIS patients are closely associated with exacerbation and poor prognosis，and the combination of serum AAT，ＲANTES，and Ｒesistin levels is of high value in predicting the poor prognosis of LAA-type AIS patients．

Objective To analyze the correlation between the expression of serum silence-information regulatory factor ( SIＲT1) ，transforming growth factor β1 protein ( TGF-β1 ) and dysfunction index and pain score in patients with degenerative lumbar spinal stenosis ( DLSS) ． Methods A total of 86 DLSS patients admitted to the Trauma and Spinal Department of Fenyang Hospital in Shanxi Province from October 2020 to October 2023 were selected as the DLSS group． According to the Oswestry Low Back Pain Dysfunction Index ( ODI) ，patients were divided into mild to moderate dysfunction subgroup ( n = 50) and severe dysfunction subgroup ( n = 36) ． In the same period，85 healthy subjects in hospital were used as healthy control group． The clinical data of 2 groups were collected，and the total adipose multifidus cross-sectional area ( TFCSA) and total multifidus cross-sectional area ( TCSA) of all subjects were measured，and the ratio of TFCSA/TCSA was calculated． Serum levels of SIＲT1，TGF-β1，cortisol and adrenocorticotropin ( ACTH) were detected by enzyme-linked immunosorbent assay ·446( ELISA) ． Low back pain dysfunction was assessed by ODI． Visual analogue pain scale ( VAS) was used to evaluate the pain degree of the subjects． Spearman method was used to analyze the correlation between serum SIＲT1，TGF-β1 level and ODI index and VAS score． The influencing factors of DLSS were analyzed by Logistic regression． Ｒesults The levels of TFCSA， TFCSA/TCSA and serum SIＲT1，TGF-β1 in DLSS group were lower than those in healthy control group ( t /P = 8． 696 / ＜ 0． 001，6． 669 / ＜ 0． 001，38． 323 / ＜ 0． 001，22． 313 / ＜ 0． 001) ． Cortisol，ACTH，ODI index and VAS scores were higher than those of healthy control group ( t /P = 57． 280 / ＜ 0． 001，58． 495 / ＜ 0． 001，48． 583 / ＜ 0． 001，53． 355 / ＜ 0． 001) ． Serum levels of SIＲT1，TGF-β1，TFCSA and TFCSA/TCSA were decreased in the severe dysfunction subgroup compared with the mild to moderate dysfunction subgroup ( t /P = 13． 834 / ＜ 0． 001，4． 684 / ＜ 0． 001，3． 520 /0． 001，5． 418 / ＜ 0． 001) ． Cortisol，ACTH，ODI and VAS scores were increased ( t /P = 6． 168 / ＜ 0． 001，2． 355 /0． 021，15． 784 / ＜ 0． 001，11． 004 / ＜ 0． 001) ． Correlation analysis showed that serum SIＲT1 and TGF-β1 levels were negatively correlated with ODI index and VAS score ( r = － 0． 534，－ 0． 577，－ 0． 602，－ 0． 556，all P ＜ 0． 001) ． High levels of serum SIＲT1 and TGF-β1 were protective factors for DLSS［OＲ( 95% CI) = 0． 687 ( 0． 491 － 0． 961) ，0． 547 ( 0． 401 － 0． 746) ］． High cortisol，high ACTH，high ODI and high VAS score were the risk factors for DLSS ［OＲ( 95% CI) = 2． 468 ( 1． 200 － 5． 077) ，2． 673 ( 1． 162 － 6． 148) ，3． 345 ( 1． 165 － 9． 602) ，3． 123 ( 1． 457 － 6． 694) ］． Conclusion Serum SIＲT1 and TGF-β1 levels decrease in DLSS patients， which are negatively correlated with ODI index and VAS score，and are influencing factors for DLSS．

Objective To explore the value of the nomogram model based on brain natriuretic peptide ( BNP) and interleukin-6 ( IL-6) in the individualized prediction of the risk of postoperative major adverse cardiovascular events ( MACE) in elderly hip fracture patients． Methods Two hundred and thirty-four elderly hip fracture patients admitted to author’s hospital from January 2016 to December 2022 were included as the modeling set，while 253 elderly hip fracture patients admitted to orthopedics department of the Sixth Affiliated Hospital of Xinjiang Medical University were included as the validation set． Elderly hip fracture patients in the validation set who experienced MACE within 30 days after surgery were divided into the MACE group of 37 cases ( 15． 8% ) and the N-MACE group of 197 cases ( 84． 2% ) ． The general clinical data，laboratory indicators， left ventricular ejection fraction and surgery related indicators of patients between the two groups in the modeling set were compared，the statistically significant variables in the single factor analysis were included in the multivariate Logistic regression analysis to obtain the independent predictors of MACE in elderly hip fracture patients after surgery，the analysis was focused on the predictive value of BNP and IL-6，and a nomogram model was constructed，calibration curve and ＲOC curve were drawn to further analyze the predictive performance and accuracy of the nomogram model． Ｒesults Multivariate Logistic regression analysis adjusted for confounding factors，ASA grade，age，BNP and IL-6 were still independent predictors of postoperative MACE in elderly hip fracture patients［OＲ( 95% ) CI = 2． 576 ( 1． 243 － 4． 567) ，2． 317 ( 1． 237 － 4． 347) ，2． 467 ( 1． 214 － 3． 598) ，2． 389 ( 1． 208 － 3． 672) ，P ＜ 0． 05］; A nomograph model was constructed to predict the risk of postoperative MACE in elderly hip fracture patients based on four independent predictors: ASA grade，age，BNP and IL-6; The calibration curve showed that the predicted value of postoperative MACE risk of elderly hip fracture patients in the modeling set and the validation set were in good agreement with the actual observation value ( P ＞ 0． 05) ． The ＲOC analysis results showed that the area under the curve ( AUC) of jointly prediction in the modeling set was 0． 923 ( 95% CI 0． 882 － 0． 967) ，and the AUC of jointly prediction in the validation set was 0． 903 ( 95% CI 0． 876 － 0． 958) ． Conclusion The nomograph model based on BNP and IL-6 can be used to accurately predict the risk of postoperative MACE in elderly hip fracture patients．

Objective To investigate the predictive value of posterior convexity Cobb＇s angle，bone mineral density ( BMD) ，and pre-collagen type I amino-terminal pre-peptide ( P Ⅰ NP) on the risk of recurrent fracture in osteoporotic vertebral compression fracture ( OVCF) patients following balloon dilatation vertebral kyphoplasty ( PKP) ． Methods One hundred and ten OVCF patients who underwent PKP admitted to the Department of Orthopedics of Shijiazhuang People＇s Hospital from December 2018 to June 2020 were selected as study subjects for 2-year follow-up，and were categorized into 28 cases in the recurrent fracture group and 82 cases in the non-recurrent fracture group according to whether new fractures appeared in the follow-up process． Comparing the general data and postoperative indexes of patients in the 2 groups，Cox analyzed the risk factors affecting the recurrent fracture after PKP，and drew ＲOC curve to analyze the predictive value of posterior convex Cobb＇s angle，BMD，and P1NP on the recurrent fracture after PKP in patients with OVCF． Ｒesults There were 28 cases of new fractures during the follow-up period，and the fracture recurrence rate was 25． 45% ( 28 /110) ． The Cobb＇s angle of posterior convexity and P1NP of the recurrent fracture group were higher than that of the non-recurrent fracture group，and the BMD was lower than that of the non-recurrent fracture group，and the differences were statistically significant ( t /P = 4． 678 / ＜ 0． 001， 4． 591 / ＜ 0． 001，4． 784 / ＜ 0． 001) ; Cox analysis showed that increased posterior convex Cobb＇s angle，decreased BMD，and levated P1NP were all risk factors for recurrent fracture after PKP［OＲ( 95% CI) = 1． 394 ( 1． 135 － 1． 712) ，1． 910 ( 1． 127 － 3． 236) ，2． 140 ( 1． 084 － 4． 225) ，P ＜ 0． 05］; ＲOC curve analysis showed that posterior convex Cobb＇s angle ≥5． 87°， BMD value ≤ － 3． 38 SD，and P ⅠNP ≤50． 67 μg /L were the cut-offs，and the posterior convex Cobb＇s angle，BMD，PⅠ NP predicted the AUC of 0． 725，0． 846，and 0． 836 for postoperative recurrent fractures after PKP in patients with OVCF，respectively，and the combined AUC of the 3 items was 0． 899，which was higher than that of the single test ( Z/P = 8． 129 / ＜ 0． 001，7． 195 / ＜ 0． 001，and 7． 695 / ＜ 0． 001) ． Conclusion Ｒegular monitoring of posterior convex Cobb＇s angle，BMD， and P1NP levels can predict the risk of recurrent fracture after PKP in patients with OVCF at an early stage so that timely intervention can be given．

Objective To analyze the feasibility of laparoscopic high position hysterosacral ligament suspension and transvaginal sacrospinal ligament fixation as treatment options for patients with severe pelvic organ prolapse，and to observe the impact of the above two surgical methods on clinical related indicators of patients． Methods From May 2021 to May 2022，73 patients with severe pelvic organ prolapse were treated in the Gynecology Department of Hubei Maternal and Child Health Hospital，there clinical data were collected and analyzed retrospectively． They were divided into an observation group of 37 cases and a control group of 36 cases according to different treatment methods． The observation group underwent laparoscopic high sacral ligament suspension surgery，while the control group underwent transvaginal sacral spine ligament fixation surgery． Compare perioperative indicators and prognosis between two groups，as well as organ prolapse，quality of life，and changes in urodynamics at different stages． Ｒesults The observation group had longer surgical time than the control group，less intraoperative bleeding，shorter removal time of the urinary catheter，and shorter postoperative hospital stay than the control group ( t / P = 21． 641 / ＜ 0． 001，6． 195 / ＜ 0． 001，15． 199 / ＜ 0． 001，17． 575 /0． 001) ． The observation group showed lower values in PFIQ-7 scores，and PFDI-20 scores at 6 months after surgery compared to the control group，including various POP-Q indicator points，I-QOL scores，maximum bladder volume，and maximum urinary flow rate The average urine flow rate showed higher values compared to the control group ( t /P = 5． 189 / ＜ 0． 001，22． 447 / ＜ 0． 001，11． 051 / ＜ 0． 001，16． 916 / ＜ 0． 001，31． 005 / ＜ 0． 001，3． 477 / ＜ 0． 001，11． 211 / ＜ 0． 001，3． 503 / ＜ 0． 001，5． 728 / ＜ 0． 001，10． 010 / ＜ 0． 001) ; The incidence of newly diagnosed stress urinary incontinence，reoperation rate，and incidence of complications in the observation group were lower than those in the control group at 6 months after surgery ［χ 2 ( t) /P = 5． 471 /0． 019，4． 103 /0． 042，4． 364 /0． 036］． Conclusion Laparoscopic high sacral ligament suspension surgery and transvaginal sacral spine ligament fixation surgery can both be effective treatment options for patients with severe postpartum pelvic prolapse． Although the former method takes slightly longer than the latter，it shows better results in improving postoperative pelvic floor function and urodynamics