Objective  To investigate the long-term prognosis of renal dysfunction patients with fragmented QRS complex (fQRS). Methods  A total of 181 inpatients specifically diagnosed with renal dysfunction were selected as research objects. We collected their general information, laboratory test results, routine ECGs, readmissions, and mortality. They were divided into positive fQRS group (n=96) and negative fQRS group (n=85) based on the presence or absence of fQRS in the ECG. The cohort study method was used to compare the occurrence of readmission and death events between the two groups. ResultsThe readmission time of patients in the positive fQRS group was earlier than that in the negative fQRS group, and the difference was statistically significant (HR=2.486, P<0.01). The index of fQRS was an independent predictor of readmission in patients with renal dysfunction. There was no statistically significant difference in the time to death between the two groups (P=0.312). The estimated glomerular filtration rate and NT-proBNP were associated with the time to death (P=0.025 and 0.020, respectively). Conclusion  Renal dysfunction patients with fQRS are more likely to be readmitted. Patients with poorer renal function and elevated NT-proBNP levels demonstrate both higher mortality rates and accelerated time to death. Early screening of fQRS and related risk factors help to assess the prognosis of these patients.

Objective  To observe the changes in vertebral artery hemodynamic parameters by ultrasonic examination and serum calcitonin gene-related peptide (CGRP) level in patients with cervical vertigo, and to explore their assessment value for the therapeutic effect on cervical vertigo. Methods  A retrospective analysis was conducted on 108 patients with cervical vertigo (designated as a study group), while 36 healthy volunteers were selected during the same period as a control group. The vertebral artery hemodynamic parameters ［systolic maximum blood flow velocity (Vmax) of the left vertebral artery (LVA), right vertebral artery (RVA), and basilar artery (BA)］, and serum CGRP level were compared between the two groups. The LVA-Vmax, RVA-Vmax, BA-Vmax, and serum CGRP level in patients with different severities of vertigo were compared in the study group. The study group received routine treatment, and was divided into an effective subgroup with 74 cases and an ineffective subgroup with 34 cases based on the therapeutic effect after one month of treatment. The clinical data, and LVA-Vmax, RVA-Vmax, BA-Vmax and serum CGRP level before and after treatment were compared between the two subgroups. The influencing factors of efficacy were analyzed; the values of LVA-Vmax, RVA -Vmax, BA-Vmax and serum CGRP level in assessing the treatment efficacy were explored. ResultsThe LVA-Vmax, RVA-Vmax, BA-Vmax, and serum CGRP level in the study group were all lower than those in the control group (all P<0.01). The levels of LVA-Vmax, RVA-Vmax, BA-Vmax, and serum CGRP in the study group were ranked in ascending order as follows: patients with severe vertigo < those with moderate vertigo < those with mild vertigo (all P＜0.05). After one month of treatment, the LVA-Vmax, RVA-Vmax, BA-Vmax, and serum CGRP level in the ineffective subgroup were all lower than those in the effective subgroup (all P<0.01). Multivariate Logistic regression analysis showed that age and disease duration were risk factors for treatment efficacy, while LVA-Vmax, RVA-Vmax, BA-Vmax, and serum CGRP level were protective factors for treatment efficacy (all P<0.05). After one month of treatment, the AUC value of the combined LVA-Vmax, RVA-Vmax, BA-Vmax, and serum CGRP level for assessing treatment efficacy was greater than that of any individual indicator (all P<0.01). Conclusion  Patients with cervical vertigo exhibit reduced ultrasonic examination parameters including LVA-Vmax, RVA-Vmax and BA-Vmax, and serum CGRP level, which are associated with the severity of vertigo and treatment efficacy. Combined detection of these parameter levels offers certain assessment value for treatment efficacy.

Objective  To explore the predictive value of fetal umbilical artery blood flow parameters ［pulsatility index (PI), resistance index (RI) and systolic peak/diastolic peak (S/D)］ for fetal growth restriction (FGR) in patients with gestational hypertension, providing effective references for early clinical diagnosis. Methods  A total of 85 patients with gestational hypertension were enrolled, and they were divided into a group with FGR (25 cases) and a group without FGR (60 cases) based on the presence or absence of FGR. The fetal umbilical artery blood flow parameters were compared between the two groups, and among patients with varying severities of illness. The correlation between these parameters and the severity of illness or FGR was analyzed by Spearman's method, while the predictive value of PI, RI and S/D for FGR was assessed by the ROC curve analysis. The early warning effect of different levels of fetal umbilical artery blood flow parameters on FGR was explored by relative risk (RR) analysis. Results  The PI, RI, and S/D values in the group with FGR were all higher than those in the group without FGR, and the differences were statistically significant (all P<0.01). The PI, RI and S/D values among patients with varying severities of illness were ranked in order as: severe preeclampsia > mild preeclampsia > gestational hypertension, with statistically significant differences (all P<0.05). PI, RI, and S/D were all positively correlated with the severity of illness and FGR (all P<0.01). The AUC value of the combined prediction of fetal umbilical artery blood flow parameters for FGR was 0.885, with a Youden index of 0.770, the optimal prediction sensitivity of 92.00%, and a specificity of 85.00%. The RR of the occurrence of FGR in gestational hypertension patients with high levels of PI, RI, and S/D was 6.115 times, 6.729 times, and 3.857 times of that in patients with low levels, respectively. And these parameters had significant early warning effect on the occurrence of FGR (all P<0.01). Conclusion  The blood flow parameters of the fetal umbilical artery are closely related to the severity of disease and the occurrence of FGR among patients with gestational hypertension. The combined detection of each parameter has certain predictive value for the outcome of FGR in these patients.

Objective  To investigate the correlation of the levels of serum iron regulatory protein 2 (IRP2), cyclin-dependent kinase inhibitor 1A (CDKN1A) and human alveolar type Ⅱ cell surface antigen (KL-6) with the pulmonary function and clinical prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods  A retrospective study was conducted on 136 patients with COPD as a observation group. A total of 136 healthy individuals who had undergone physical examinations during the same period were selected as a control group. The levels of serum IRP2, CDKN1A, and KL-6 were compared between the two groups and among patients with different prognoses. The pulmonary function indicators ［the ratio of forced expiratory volume in the first second (FEV1) to forced vital capacity (FVC), and FEV1 as a percentage of the predicted value (FEV1%pred)］ were compared between the two groups. The correlation of serum IRP2, CDKN1A and KL-6 levels with FEV1%pred, FEV1/FVC and the prognosis was analyzed; the predictive value of combined detection of various serum indicators was analyzed. Results  The levels of serum IRP2, CDKN1A, and KL-6 in the observation group were significantly higher than those in the control group (all P<0.01). The FEV1%pred and FEV1/FVC in the observation group were significantly lower than those in the control group (all P<0.01). The levels of serum IRP2, CDKN1A, and KL-6 in patients with poor prognosis were significantly higher than those in patients with good prognosis (all P<0.01). The levels of serum IRP2, CDKN1A, and KL-6 were negatively correlated with FEV1%pred and FEV1/FVC, while they were positively correlated with patients' prognoses (all P<0.01). The AUC value of the combined prediction of serum IRP2, CDKN1A, and KL-6 levels for poor prognosis in patients with COPD was 0.937, with a Youden index of 0.775, and the sensitivity and specificity were 94.12% and 83.33%, respectively; the differences were statistically significant (all P<0.01). Conclusion  The levels of serum IRP2, CDKN1A, and KL-6 vary with the pulmonary function and clinical prognosis of COPD patients; there is a strong correlation between them. The combined detection of these indicators could provide some references for prognosis prediction in clinical practice.

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.