The electrocardiogram (ECG) examination, as a commonly used diagnostic tool for cardiovascular diseases, holds significant importance in clinical application. However, its interpretation relies heavily on the expertise of cardiologists. In recent years, remote ECG technology has flourished under the dual impetus of policy and technology, demonstrating immense potential in aspects such as promoting the reallocation of high-quality medical resources to grassroots areas, executing the graded diagnosis and treatment system, and enhancing both pre-hospital emergency response and out-of-hospital monitoring frameworks. Particularly, breakthroughs in artificial intelligence and the widespread adoption of wearable devices have significantly energized the application of telemetry ECG. This paper provides a systematic overview of the present state and future prospects of telemetry ECG, focusing on its clinical value and technological advancements.

Magnetocardiography ( MCG), a technique that measures the weak magnetic field generated by human electrophysiological activities, provides non-invasive, ionizing-radiation-free functional information.Compared with traditional structural imaging techniques, MCG can capture functional changes in the early stages of diseases, making it particularly suitable for early screening and disease progression assessment. In recent years,rapid advancements in quantum magnetic sensors, magnetic shielding, and active compensation technologies have enabled MCG to overcome the limitations of low-temperature superconductivity and magnetically shielded rooms gradually, developing in the direction of greater convenience and lower cost. However, despite its significant potential in clinical applications such as chest pain triage, coronary heart disease screening, and myocardial ischemia assessment, the clinical translation of MCG still faces challenges including insufficient specificity and lack of standardization. Furthermore, variations in equipment and signal processing methods lead to low comparability among research findings. This article reviews the development history and current application status of MCG technology, synthesizes the research progress of our team over the past three years, discusses the bottlenecks in applying MCG across different clinical settings, and proposes that future research should focus on areas such as physical mechanisms, feature interpretability, establishing quantitative relationships between diseases, and improving clinical diagnostic specificity. These efforts aim to promote the standardization of MCG, and advance its research and application in the fields of cardiology, neurology, oncology, and traditional Chinese medicine.

Objective To investigate the application value of transesophageal echocardiography ( TEE) in diagnosing left atrial appendage thrombus (LAAT) among patients with atrial fibrillation (AF), and to analyze the impact of echocardiographic parameters and clinical factors on the diagnosis of LAAT by TEE. Methods Clinical data of 326 AF patients who had undergone TEE examination were retrospectively analyzed. Patients were divided into LAAT positive group ( n = 52) and negative group ( n = 274) according to TEE results. Patients' general information, AF type and duration, echocardiographic parameters, and TEE findings were recorded. Univariate analysis was performed. ROC curves were used to evaluate the predictive efficacy of left atrial appendage peak flow velocity (LAAV) and left atrial appendage area (LAAA) for LAAT. Independent influencing factors for LAAT in AF patients were identified via Logistic regression analysis. The Hosmer-Lemeshow test and decision curve analysis were employed to assess the goodness-of-fit and clinical utility of the predictive model. Results TEE detected LAAT in 52 (16. 0%) AF patients. Compared with the LAAT negative group, patients in the LAAT positive group were older, had longer AF duration, higher CHA2DS2-VASc scores, larger left atrial diameter (LAD) and LAAA,lower LAAV, and a higher proportion of persistent or permanent AF (all P<0. 05). For predicting thrombus, the area under the curve (AUC) was 0. 893 for LAAV, with an optimal cutoff value of 25. 6 cm / s, sensitivity of 82. 7%, and specificity of 84. 3%. The AUC value for LAAA was 0. 812, with an optimal cutoff value of 5. 2 cm2,sensitivity of 76. 9%, and specificity of 75. 5%. The combined prediction of LAAV and LAAA increased the AUC value to 0. 921, which was significantly higher than the predictive efficacy of LAAV or LAAA used alone (both P<0. 05). Logistic regression analysis identified longer AF duration (OR = 1. 089), decreased LAAV (OR = 0. 876),and larger LAAA (OR = 1. 626) as independent risk factors for LAAT (all P<0. 05). The Hosmer-Lemeshow test indicated good model fit ( P = 0. 587 ), and decision curve analysis confirmed its good clinical utility.Conclusion TEE is an effective tool for diagnosing LAAT in AF patients. Longer AF duration, decreased LAAV,and larger LAAA are independent risk factors for LAAT formation. The combined application of LAAV and LAAA could significantly enhance the predictive value for LAAT, and may serve as an important screening indicator inTEE examinations.

Objective  To investigate the predictive value of electrocardiogram morphology-voltage-P-wave duration (MVP) score in hypertension complicated by atrial fibrillation (AF). Methods  A total of 198 hospitalized patients with hypertension were enrolled, and divided into an AF group (n=99) and a hypertension-only group (n=99) based on the presence of paroxysmal AF. Indicators such as left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), LVEF, P-wave duration, P-wave voltage in lead Ⅰ, MVP score, PtfV1, RV5, and RV5+SV1 were compared between the two groups. The predictive efficacy of MVP score was analyzed using ROC curve analysis. Results  The LAD in the AF group was significantly larger than that in the hypertension-only group (P<0.001), while there were no statistically significant differences in LVEDD or LVEF between the two groups (both P>0.05). P-wave duration, positive rate of PtfV1, RV5, RV5+SV1, and MVP score were all significantly higher in the AF group, whereas the P-wave voltage in lead Ⅰ was significantly lower compared with the hypertension-only group (P<0.05). The area under the ROC curve for an MVP score≥4 points in predicting AF was 0.818, with a sensitivity of 0.838 and a specificity of 0.798. Conclusion  The MVP score is an independent predictor of AF in patients with hypertension.

Objective  To investigate the predictors of severe arrhythmia in patients with acute inferior wall myocardial infarction (IWMI) during hospitalization. Methods  A total of 82 patients with acute IWMI were enrolled, and divided into an arrhythmia group (n=28) and a non-arrhythmia group (n=54) based on the occurrence of severe arrhythmia during hospitalization. Baseline characteristics, laboratory results, electrocardiogram (ECG), and coronary angiography indexes were collected from both groups. These data included sex, age, diabetes, hypertension, smoking history, Killip classification, time from symptom onset to hospital admission, systolic blood pressure and heart rate on admission, as well as serum potassium, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL-C), neutrophil-to-lymphocyte ratio (NLR), troponin I, left ventricular ejection fraction (LVEF), Gensini score, presence of pathological Q waves, ST-segment elevation amplitude, QTc dispersion, right dominant coronary artery supply, and pre-procedural TIMI flow grade. The relationship between the above parameters and the occurrence of arrhythmia was analyzed. Results  Univariate analysis revealed no statistically significant differences between the two groups in terms of sex, age, comorbidities (diabetes and hypertension), smoking history, time from symptom onset to hospital admission, heart rate on admission, LDL-C level, Gensini score, pathological Q waves, ST-segment elevation amplitude, or pre-procedural TIMI flow grade (all P>0.05). However, statistically significant differences were observed in Killip classification, systolic blood pressure on admission, serum potassium, FBG, NLR, troponin I, LVEF, QTc dispersion, and right dominant coronary artery supply (all P<0.05). Multivariate Logistic regression analysis identified Killip class (Ⅲ-Ⅳ), NLR≥5.0, QTc dispersion≥80 ms, and right dominant coronary artery supply as independent risk factors for severe arrhythmia (all P<0.05), while serum potassium ≥3.8 mmol/L was an independent protective factor (P<0.05). Conclusion  High Killip classification, elevated NLR, increased QTc dispersion, right dominant coronary artery supply, and low serum potassium level (<3.8 mmol/L) are strong independent predictors of severe arrhythmia in patients with acute IWMI. These factors facilitate early identification of high-risk patients and guide clinical intervention.

Objective  To explore the bidirectional causal relationship between gastroesophageal reflux disease (GERD) and gallstone disease using Mendelian randomization (MR) approach. Methods  Instrumental variables—single nucleotide polymorphisms (SNPs)—were obtained from public Genome-Wide Association Study (GWAS) databases, and two-sample bidirectional MR analyses were performed mainly by the inverse variance weighted (IVW) method. MR-PRESSO test, Cochran's Q test, MR-Egger regression intercept test, and leave-one-out analysis were used for sensitivity analysis to assess the reliability and stability of the study results. Subsequently, MR analysis was repeated after adjusting for the effects of different confounding factors to validate the results. The GERD data were sourced from the IEU OpenGWAS project, comprising a total of 602 604 samples (129 080 cases and 473 524 controls). The gallstone disease data were obtained from the FinnGen Biobank, comprising a total of 214 167 samples (19 023 cases and 195 144 controls). ResultsThe results by using the IVW method indicated a causal effect of GERD on gallstone disease (OR=1.472, 95%CI: 1.326-1.634, P=3.688×10－13), and also a causal effect of gallstone disease on GERD (OR=1.048, 95%CI: 1.027-1.069, P=5.791×10－6). After adjusting for confounding factors, the results by IVW method showed that the positive association risk of GERD on gallstone disease still remained (OR=1.407, 95%CI: 1.211-1.635, P=7.948×10－6), and the positive association risk of gallstone disease on GERD also remained (OR=1.052, 95%CI: 1.029-1.075, P=3.316×10－6). The analysis results using MR-Egger regression intercept test results indicated no evidence of horizontal pleiotropy among the included instrumental variables. The results by leave-one-out analysis suggested that no single SNP that could significantly affect the results. Conclusion  MR analysis supports a bidirectional causal relationship between GERD and gallstone disease.

Objective  To review the research status and hotspots in the artificial intelligence (AI) application of the hypertension field over the past decade using bibliometric methods, and to provide references for future related research in the future. Methods  The Web of Science Core Collection database was used as the data source to retrieve literature published between January 1, 2015 and December 31, 2024, on the application of AI in the field of hypertension. CiteSpace 6.3.R1 software was employed to conduct visual mapping analysis of annual publication volume, countries/regions, research institutions, authors, co-citation networks, and key words. Results  A total of 654 articles were included. Between 2015 and 2024, although there were fluctuations in parts of these years, the annual publication volume in the field of AI applied to hypertension showed a general upward trend, with particularly notable growth after 2020. China had the highest volume of publications, while the United States showed the highest centrality index. The Chinese Academy of Sciences was the institution with the highest publication volume. Acharya UR, Mulatero P, and Li Y were the authors with the highest publication outputs. The top three authors ranked by co-citation frequency, Kachuee M, O Brien E, and Whelton PK, made significant contribution to this field. The most frequently co-cited literature was “Cuffless blood pressure estimation algorithms for continuous health-care monitoring”. Hypertension, J Hypertens, and Circulation were the top three journals in terms of influence. Research hotspots primarily focused on the prediction and early identification of hypertension, non-invasive continuous blood pressure monitoring, diagnosis, risk assessment, and intelligent clinical decision support. Conclusion  The application of AI in the field of hypertension shows broad prospects. Future research could focus on multimodal data fusion, optimization of non-invasive continuous blood pressure monitoring technology, improvement of AI-assisted clinical decision support systems, integrated application of digital health technologies, and in-depth studies on specific hypertensive populations.

Objective  To explore the value of ABC-X model-based nursing intervention applied in patients with mild cognitive impairment (MCI). Methods  A total of 100 MCI patients were selected, and randomly divided into an observation group and a control group using a random number table method, with 50 cases in each group. The observation group received the ABC-X model-based nursing intervention, while the control group received conventional nursing care. The self-rating anxiety scale (SAS), self-rating depression scale (SDS), Montreal cognitive assessment (MoCA) scale, and 36-item short form health survey (SF-36) scores were compared between the two groups before the intervention and after 4 weeks of intervention. Results  Before the nursing intervention, there were no statistically significant differences in SAS score, SDS score, total MoCA scale score, or the average SF-36 score between the two groups (all P>0.05). After 4 weeks of intervention, the SAS and SDS scores in the observation group were both significantly lower than those in the control group (all P<0.01), while the total MoCA scale score and the average SF-36 score were both significantly higher in the observation group than those in the control group (both P<0.01). Conclusion  The application of the ABC-X model-based nursing intervention in MCI patients could effectively alleviate negative emotions, improve cognitive function, and further enhance their quality of life, thereby making it highly recommended for widespread use.

Objective  To investigate the correlation between ambulatory arterial stiffness index (AASI) and pulse pressure or blood pressure variability (BPV) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods  A total of 205 patients specifically diagnosed with OSAHS were enrolled as research objects. They completed general data collection, and polysomnography and ambulatory blood pressure monitoring. Based on the classification of circadian blood pressure rhythm, the study population was divided into a dipper blood pressure group (n=92) and a nondipper blood pressure group (n=113). We compared the general clinical characteristics between the two groups as well as the correlation between AASI and ambulatory blood pressure parameters by using Pearson correlation analysis. Multiple linear regression analysis was applied to explore the relationship between AASI and pulse pressure or BPV. Results   The AASI of the non-dipper blood pressure group was significantly higher than that of the dipper blood pressure group (P<0.01). AASI was positively correlated with age, 24-hour mean systolic blood pressure and pulse pressure, while it was negatively correlated with 24-hour mean diastolic blood pressure, and the decline ratio of nocturnal systolic and diastolic blood pressure (all P<0.05). Pulse pressure was associated with AASI if BPV remained constant (P＜0.05). Conclusion  The AASI of OSAHS patients demonstrates an association with pulse pressure and age. AASI may serve as a promising indicator reflecting arterial stiffness.

Objective  To develop a transfer learning-based classification model for sleep apnea syndrome using electrocardiogram (ECG) data, increasing its classification accuracy and clinical applicability. Methods  Based on the Apnea-ECG and MIT-BIH polysomnographic databases, with respiratory signals as input, we applied a Butterworth low-pass filter for denoising, and constructed an original data set. To address the problem of insufficient respiratory signal data, a model training method based on a transfer learning approach was proposed: first, ECG signals with a large sample size were used for model pre-training, and then they were fine-tuning for respiratory signals, finally fulfilling binary classification or multi-class classification tasks. A cascade model combining residual network and bidirectional long short-term memory network was proposed, which performed better in capturing the timing features of signals and improving classification performance. Additionally, the performance of this model was made comparative analysis with those of various classic convolutional neural networks. Results  Through comparative experiments, it was found that employing transfer learning approach could accelerate model convergence and improve the model's overall performance. Validated on the test set, the proposed cascade model demonstrated a favorable performance in both binary classification and multi-class classification tasks, achieving an accuracy of 95.43% on the binary classification task and 91.26% on the multi-class classification task. Conclusion  This study offers novel insights into the design of disease classification models under small-sample conditions, and validates the effectiveness of transfer learning in sleep apnea syndrome classification, thereby demonstrating its potential clinical utility.

Objective  To explore the association between obstructive sleep apnea syndrome (OSAS) and heart rate variability (HRV) or circadian rhythm of blood pressure in hypertensives. Methods  A total of 102 inpatients and outpatients with hypertension were selected in our study, and they were divided into hypertension with OSAS group (55 cases) and primary hypertension group (47 cases). This study enrolled 50 concurrent healthy subjects (all with organic diseases excluded, and without comorbidities of hypertension or OSAS) as a control group. We compared and analyzed the HRV time-domain indexes of SDANN and rMSSD, and HRV frequency-domain indexes of LF and HF, as well as apnea hypopnea index (AHI), nocturnal mean oxygen saturation level, daytime and nocturnal blood pressure levels, and changes of circadian blood pressure rhythm. Results  The nocturnal minimum saturation of arterial oxygen (SaO2) and nocturnal mean SaO2 of patients in the hypertension with OSAS group were both lower than those of patients in the primary hypertension group, while AHI was higher (all P＜0.05). There were no statistically significant differences in the above sleep respiratory parameters between the primary hypertension group and the control group (all P＞0.05). There were no statistically significant differences in the daytime and nocturnal blood pressure levels, and the incidence of non-dipper pattern between the primary hypertension group and the control group (all P＞0.05). Comparisons of the aforementioned parameters between the hypertension with OSAS group and the control group all demonstrated statistically significant differences (all P＜0.01). The hypertension with OSAS group exhibited a significantly higher prevalence of non-dipper circadian blood pressure rhythm compared to the other two groups (all P＜0.05). Compared to the other two groups, the values of SDANN and LF of patients in the hypertension with OSAS group were higher, while the values of rMSSD and HF were lower (all P＜0.05). There were no statistically significant differences in the LF, HF, SDANN and rMSSD values between the primary hypertension group and the control group (all P＞0.05). Conclusion  Patients with OSAS demonstrate increased nocturnal blood pressure level, enhanced sympathetic nerve tension and decreased vagus nerve tension, as well as increased risk of cardiovascular and cerebrovascular diseases.

Objective  To investigate the association between homocysteine (Hcy) and the C677T gene polymorphism in its key metabolic enzyme, methylenetetrahydrofolate reductase (MTHFR), and the complications of hypertension, type 2 diabetes mellitus and atherosclerosis in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods  A total of 85 OSAHS patients and 77 non-OSAHS patients were enrolled. The genotypes, and levels of serum Hcy, fasting blood glucose and hemoglobin Alc of all subjects were detected, while cervical vascular ultrasound was performed simultaneously. Hcy≥10 μmol/L was defined as hyperhomocysteinemia (HHcy). The serum Hcy levels were compared among patients with different genotypes. The Hcy levels, MTHFR C677T gene polymorphism, and C/T allele frequencies were compared among an OSAHS with complications group, a pure OSAHS group, and a control group (without OSAHS or complications). Then, multivariate binary Logistic regression analysis was performed to identify independent risk factors for complications in OSAHS patients with confounding factors adjusted. Results  The Hcy levels in the patients with CC, CT and TT genotypes were 10.11 (9.15, 11.07), 10.86 (9.58, 11.10) and 15.81 (11.43, 50.76) μmol/L, respectively. Hcy level in the patients with TT genotype was significantly higher than that in the cases with CT or CC genotypes (both P＜0.05). The Hcy levels of the OSAHS with complications group, the pure OSAHS group, and the control group were 11.16 (10.05, 13.80), 9.88 (9.31, 11.41), and 10.38 (9.29, 11.34) μmol/L, respectively. The Hcy level of the OSAHS with complications group was significantly higher than that of the pure OSAHS group (P<0.05). There were no statistically significant differences in gene polymorphism or C/T allele frequency among the three groups. After adjusting for confounding factors, it revealed that HHcy was an independent risk factor for concurrent complications in OSAHS patients, and the odds ratio (95% confidence interval) was 4.682 (1.261-17.380). Conclusion  The MTHFR C677T gene polymorphism affects serum Hcy level. HHcy is an independent risk factor for concurrent complications in OSAHS patients, however, neither the MTHFR C677T gene polymorphism nor the C/T allele frequency were associated with complications in OSAHS patients.

Objective  To explore the influence of colonization factor (CF) on the adhesion of Jiulian probiotics to intestinal mucosal epithelial cells, and the efficacy of Jiulian probiotics combined with CF in treating intestinal dysfunction. Methods  Twenty patients with intestinal dysfunction were selected. Based on whether the Jiulian probiotics were co-cultured with intestinal mucosal epithelial cells in combination with CF, they were divided into an experimental group (the Jiulian probiotic suspension was co-cultured with intestinal mucosal epithelial cells in combination with CF) and a control group (only the Jiulian probiotic suspension was co-cultured with intestinal mucosal epithelial cells). Observation was conducted using a self-controlled approach. The Jiulian probiotics that adhered to the intestinal mucosal epithelial cells were extracted separately 4 and 12 hours after co-cultivation; the number of formed colonies was counted, and the effect of CF on promoting the adhesion of the probiotics to the intestinal mucosal epithelial cells was analyzed. According to the gastrointestinal symptom rating scale (GSRS) scores, the curative effect was assessed between the two groups. Results  The Jiulian probiotics adherent to cells, harvested from the experimental group after 4 hours of co-cultivation, formed significantly more colonies than those harvested from the control group after 24-hour of cultivation (P<0.05), while the formed colonies after 12 hours of cocultivation were significantly more than those harvested from the control group (P<0.01). After the combination treatment, the GSRS score of the patients was significantly lower than that before the treatment (P<0.01), while symptoms such as abdominal pain and diarrhea were significantly improved. Conclusion  CF could promote the adhesion of Jiulian probiotics to intestinal mucosal epithelial cells. Probiotics combined with CF may become one of effective methods for treating intestinal dysfunction.

Objective  To investigate autonomic function changes in patients with neurally mediated syncope. Methods  We collected the clinical data of patients presenting with syncope or presyncope. According to the results of head-up tilt test (HUTT), they were divided into an HUTT positive (mixed type) group and an HUTT negative group, each with 53 cases. Each heart rate variability (HRV) index of the two groups were comparatively analyzed before HUTT and during the testing. Results  Before the testing, there were no statistically significant differences in the HRV time-domain indexes of SDNN, SDANN, SDNN index, rMSSD, pNN50, and TINN between the two groups (all P>005); there were also no statistically significant differences in the HRV frequency-domain indexes of LF, HF and LF/HF between the two groups (all P>0.05). During the process of HUTT, if the during-HUTT indexes were compared between the two groups, it revealed that rMSSD value of the HUTT positive (mixed type) group was significantly higher than that of the HUTT negative group (P<0.05). Conclusion  Compared to pre-HUTT HRV indexes, during-HUTT HRV indexes demonstrate greater clinical significance. The presence of vagal overactivity immediately at the onset of syncope in patients with neurally mediated syncope.

Objective  To investigate the efficacy of sugemalimab combined with cisplatin plus paclitaxel regimen in patients with advanced nonsmall cell lung cancer (NSCLC). Methods  Seventy patients with advanced NSCLC were selected as study objects; by using a randomized single-blind method, they were assigned into a control group and a sugemalimab group, with 35 cases in each group. The control group received cisplatin plus paclitaxel therapy, while the sugemalimab group adopted sugemalimab in addition to the control group's regimen. The short-term efficacy, occurrence of adverse reactions, prognosis, levels of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen, squamous cell carcinoma antigen (SCC-Ag), carbohydrate antigen 125 (CA125) and carbohydrate antigen 50 (CA50), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTCQLQ-C30) scores were compared between the two groups before and after treatment. Results   After three treatment cycles, the sugemalimab group showed a significantly higher disease control rate compared to the control group ［80.00% (28/35) vs. 57.14% (20/35), P<0.05］; the levels of CYFRA21-1, carcinoembryonic antigen, SCC-Ag, CA125, and CA50 were all significantly lower in the sugemalimab group than those in the control group (all P<0.01). The sugemalimab group also exhibited significantly lower EORTCQLQ-C30 symptom scores compared to the control group, with significantly higher functional and overall quality of life scores (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). After one year of follow-up, the survival rate was significantly higher in the sugemalimab group than that in the control group ［73.53% (25/34) vs. 51.52% (17/33), P<0.05］. Conclusion  Combining sugemalimab with the cisplatin plus paclitaxel regimen improves treatment efficacy in patients with advanced NSCLC, further reduces tumor marker levels, increases quality of life and survival rates, and demonstrates a favorable safety.

ObjectiveTo investigate the anesthesia effect of dexmedetomidine combined with esketamine in elderly patients with orthopedic lower extremity surgery. MethodsEighty elderly patients undergoing orthopedic lower extremity surgery were randomly divided into two groups, with 40 cases in each group. The control group was given esketamine for anesthesia, while the drug combination group was given dexmedetomidine combined with esketamine for anesthesia. The anesthesia indexes between the two groups of patients were compared, as well as the vital signs, sedation degree, pain degree, and cognitive status before operation (T0), 6 hours after operation (T1), 12 hours after operation (T2) and 48 hours after operation (T3). The occurrence of adverse reactions was also compared between the two groups. ResultsThe recovery time of spontaneous respiration, anesthesia recovery time, orientation recovery time and extubation time in the drug combination group were all significantly shorter than those in the control group (P＜0.05). There were statistically significant differences in heart rate and mean arterial pressure (MAP) at different times in the control group (P<0.01), but there was no statistically significant difference in blood oxygen saturation (SpO2) at different times in the control group (P>0.05). There were no statistically significant differences in heart rate, MAP and SpO2 at different times in the drug combination group (P>0.05). At T1, T2 and T3, heart rate and MAP of the drug combination group were both lower than those of the control group (all P<0.01). There were statistically significant differences in sedation scores at different times in the control group (P<0.01), while there were no statistically significant differences in sedation scores at different times in the drug combination group (all P>0.05). At different times, the sedation scores of the drug combination group were all significantly higher than those of the control group (all P<0.01). There were statistically significant differences in pain scores at different times between the two groups (P<0.01). At T1, T2 and T3, the pain scores of the drug combination group were all significantly lower than those of the control group (all P<0.01). There were statistically significant differences in mini-mental state examination (MMSE) scores between the two groups at different times (all P<0.01). At 24 hours after the operation, MMSE score of the drug combination group was significantly higher than that of the control group (P<0.01); there was no statistically significant difference in MMSE score between the two groups at 72 h, 1 week and 1 month after the operation (all P>0.05). The total incidence of adverse reactions in the drug combination group was 5.00%, significantly lower than 22.50% in the control group (P<0.05). Conclusion  Compared to anesthesia using esketamine alone, dexmedetomidine combined with esketamine is safe and effective for elderly patients with orthopedic lower extremity surgery. It could significantly shorten the recovery time of anesthesia, stabilize perioperative hemodynamics, improve the effect of sedation and analgesia, and reduce the risk of cognitive dysfunction 24 hours after surgery with lower incidence rates of adverse reactions.

Systemic lupus erythematosus (SLE) is an autoimmune disease that produces a large number of pathogenic autoantibodies and immune complexes, damaging multiple tissues and organs. With the update of the classification criteria proposed by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) in 2019, as well as the guidelines for the diagnosis and treatment of SLE, our understandings of SLE, and the level of its diagnosis and treatment have been significantly improved. However, due to the incompletely elucidated pathogenesis of the disease, there is still a lack of targeted intervention measures at present, and the prognosis is not optimistic. In the study of the pathogenesis of SLE, the imbalance of Th17/Treg cells has drawn significant attention. Probing into the key molecules related to their equilibrium is expected to open up a new path for the precise treatment of SLE.

Continuous renal replacement therapy (CRRT) is an extracorporeal blood purification method used for critically ill patients with conditions such as acute kidney injury. The therapeutic effect of CRRT is influenced by the blood flow rate in the extracorporeal circuit. Low blood flow rate is significantly associated with circuit clotting and treatment interruption, while excessively high blood flow rate may lead to elevated circuit pressure, similarly impair therapeutic outcomes. At present, the optimal extracorporeal blood flow rate for CRRT remains unclear. Additionally, the special needs of different populations should be considered during the treatment, and how to set blood flow rate in various treatment scenarios is still an unresolved issue. This article provides a review of the current research status and future prospect of blood flow rate in CRRT, aiming to offer references for clinical practice and further research in this area.