Objective To investigate the relevant factors influencing the prognosis of patients with primary small cell carcinoma of the esophagus (PSCCE), providing valuable insights for clinical treatment decision-making. 
Methods This study collected data from the Surveillance, Epidemiology, and End Results (SEER) database and single-center registries in China. A total of 230 PSCCE patients diagnosed between 2000 and 2020 were included (SEER: 158; China: 72). Kaplan-Meier analysis was used to plot survival curves, Log-Rank test was used for survival comparison, and Cox proportional hazards regression was applied to evaluate prognostic factors. 
Results Both univariate and multivariate Cox regression analyses revealed chemotherapy as an independent prognostic factor for overall survival (OS). In the SEER cohort, the hazard ratio (HR) in the chemotherapy group was 0.395 (95%CI: 0.261-0.597, P＜0.001), and the median survival time (MST) for the chemotherapy group was 12 months, which was significantly longer than 3.5 months in the non-chemotherapy group (P＜0.001). In the Chinese cohort, the HR for chemotherapy was 0.399 (95%CI: 0.177-0.899, P=0.027), with MST of 22.6 months and 9.8 months for the chemotherapy and non-chemotherapy groups respectively (P＜0.001). Subgroup analysis demonstrated the protective effect of chemotherapy in limited-stage patients. For the SEER cohort, the HR for chemotherapy in limited-stage patients was 0.416 (95%CI: 0.236-0.735, P=0.003), with MST of 16 months vs. 5.5 months for the chemotherapy and non-chemotherapy groups respectively (P＜0.001). For the Chinese 〖JP2〗cohort, the HR for chemotherapy in limited-stage patients was 0.345 (95%CI: 0.157-0.760, P=0.008),〖JP〗 with MST of 23.6 months vs. 9.8 months for the chemotherapy and non-chemotherapy groups respectively (P＜0.001). Treatment comparison showed that in the SEER cohort, the MST of the chemoradiotherapy combined with surgery group was significantly longer than that of the chemotherapy-alone group (18 months vs. 10 months, P=0.009). In the Chinese cohort, the MST of the surgery combined with chemotherapy group was significantly longer than that of the surgery-alone group (25.8 months vs. 10 months, P＜0.001).
Conclusion Chemotherapy emerges as the only common prognostic factor shared by PSCCE patients in both China and the United States, establishing itself as a pivotal component within multidisciplinary treatment approaches. For limited-stage patients, it′s also crucial to acknowledge the significance of chemotherapy, emphasizing preference for combination regimens that incorporate chemotherapy. 

Objective To evaluate the potential application value of circulating tumor cells (CTCs) combined with tissue dual template sequencing method in the treatment monitoring and medication guidance of non-small cell lung cancer (NSCLC) patients. 
Methods This study applied a sequential sorting and enrichment system (Ep LMB/Vi LMB) modified with epithelial cell adhesion molecule (EpCAM, Ep) and vimentin (Vi) to achieve efficient capture of CTCs. Based on this technology platform, CTC Deoxyribonucleic acid (DNA) was integrated with tissue DNA for analysis, and a dual template sequencing system was constructed. CTC testing was performed on peripheral blood samples of 26 enrolled patients, with tissue samples additionally obtained from 5 patients and fixed in formalin and embedded in paraffin for next-generation sequencing (NGS). 
Results The CTC count of lung cancer patients was significantly higher than that of the healthy control group ［(34.6±5.2) vs. (3.8±1.4), P＜0.001］. The dual template sequencing technology was used to detect an average of 2.44 tumor specific gene variations per case, which could identify 28.7% more low-frequency mutations than single sample sequencing, and the difference was statistically significant (P＜0.05). Simultaneously, dual template sequencing not only detected all expected variations in tissue sequencing, but also other variations that were not detected in tissue sequencing. 
Conclusion The capture technology based on multi-target LMB can overcome the limitations of traditional EpCAM dependent methods and achieve effective enrichment of CTCs during epithelial mesenchymal transition. The dual source (tissue+CTC) sequencing workflow not only covers all gene variations detected by tissue biopsy, but also identifies clinically significant mutation sites. 

Objective To investigate the effect of circular RNA sirt1 (circ-sirt1) expression on pyroptosis and angiogenesis in gastric cancer cells. 
Methods Pathological tissue samples were collected from 30 gastric cancer patients from Tangshan People′s Hospital and the First Hospital of Hebei Medical University, and the expression levels of circ-sirt1 and pyroptosis-related proteins were detected. Gastric cancer cell lines adenocarcinoma gastric stomach (AGS), human gastric carcinoma-27 (HGC27), Nagoya University-Gastric Cancer-3 (NUGC3), Seoul National University-1 (SNU1), Seoul National University-601 (SNU601) and normal gastric mucosal epithelial cell line-1 (GES-1) were cultured, and the expression levels of circ-sirt1 and pyroptosis-related proteins were detected. Knockdown or overexpression of circ-sirt1 was performed on HGC27 cells, and the changes of cell proliferation activity, angiogenesis ability and pyroptosis-related protein levels were detected. 
Results Compared with para-cancerous tissue and GES-1 cells, the expression levels of circ-sirt1 and pyroptosis-related proteins were decreased in gastric cancer tissue and gastric cancer cells. After knocking down circ-sirt1, the proliferation activity and angiogenesis ability of HGC27 cells were enhanced, while the level of pyroptosis was decreased. After overexpressing circ-sirt1, the proliferation activity and angiogenesis ability of HGC27 cells were weakened, while the level of pyroptosis was increased. 
Conclusion circ-sirt1 is down-regulated in gastric cancer tissue and gastric cancer cell lines, and overexpression of circ-sirt1 can increase the level of pyroptosis in gastric cancer cells and inhibit tumor angiogenesis. 

Objective To investigate the clinical value of magnetic resonance imaging (MRI) texture analysis plus diffusion-weighted imaging (DWI) in predicting the response to radiotherapy and chemotherapy in nasopharyngeal carcinoma (NPC). 
Methods A total of 102 patients with NPC treated by radiotherapy and chemotherapy in the First People′s Hospital of Lianyungang City from July 2020 to August 2023 were selected. MRI texture analysis and DWI scanning were performed before radiotherapy and chemotherapy. They were divided into good response group (n=46) and poor response group (n=56) according to the response to radiotherapy and chemotherapy. Baseline data, MRI texture analysis and DWI scanning results of the two groups were recorded to analyze the correlation of MRI texture analysis and DWI scanning results with the response to radiotherapy and chemotherapy for NPC, and to analyze the impact of MRI texture analysis and DWI scanning results on the response to radiotherapy and chemotherapy and predictive value for NPC. 
Results Before treatment, the poor response group exhibited higher values in cluster significance ［(816.40±220.36) vs. (492.13±163.58)］, Haralick correlation ［(12 834.28±875.54) vs. (10 025.14±783.29)］, and apparent diffusion coefficient (ADC) ［(0.85±0.10)×10-3 mm2/s vs. (0.78±0.09)×10-3 mm2/s］ compared with the good response group (P＜0.05). Cluster significance, Haralick correlation and ADC were negatively correlated with the response to radiotherapy and chemotherapy (r=-0.662, -0.594, -0.597, all P＜0.05). Partial regression analysis showed that cluster significance, Haralick correlation and ADC were correlated with the response to radiotherapy and chemotherapy before treatment (P＜0.05). The area under the curve of cluster significance + Haralick correlation + ADC in combination for predicting poor response to radiotherapy and chemotherapy for NPCwas the largest (0.938), with sensitivity of 82.14% and specificity of 89.13%. 
Conclusion MRI texture parameters and DWI parameters are closely related to the response to radiotherapy and chemotherapy in patients with NPC. The combination of cluster significance, Haralick correlation and ADC has high value in predicting the poor response to radiotherapy and chemotherapy in NPC patients. 

Objective To explore the value of preoperative MRI characteristics combined with the ratio of alkaline phosphatase (ALP) to prealbumin (PA) in predicting microvascular invasion in hepatocellular carcinoma. 
Methods A retrospective analysis was performed on medical records of 152 patients with hepatocellular carcinoma (HCC) who underwent surgical treatment at Suining Hospital of Traditional Chinese Medicine from January 2022 to October 2023. Using postoperative pathology as the gold standard, the subjects were divided into the microvascular invasion group and the non-invasion group. Factors influencing microvascular invasion in HCC were analyzed, and the predictive efficacy of preoperative magnetic resonance imaging (MRI) characteristics and the ratio of ALP to PA for microvascular invasion of HCC was evaluated. 
Results Among the 152 HCC patients, 54 patients were confirmed to have microvascular invasion postoperatively, accounting for 35.53%. The proportion of CNLC stage Ⅱ in the invasion and non-invasion groups was 63.27% and 36.73%, respectively, the proportion of incomplete tumor capsule was 77.78% and 59.18%, respectively, and the proportion of heterogeneous tumor signal on T2WI was 74.07% and 40.82%, respectively; the proportion of peritumoral hypointensity in the hepatobiliary phase was 74.07% and 48.98%, respectively, and the ALP/PA scores were (0.72±0.16) and (0.54±0.13), and the difference was significant (P＜0.05). CNLC staging (OR=6.001, 95%CI: 2.753-13.082), incomplete tumor capsule (OR=4.080, 95%CI: 1.913-8.702), heterogeneous tumor signal on T2WI (OR=4.660, 95%CI: 2.246-9.667), peritumoral hypointensity in the hepatobiliary phase (OR=4.375, 95%CI: 2.069-9.252), and ALP/PA ratio (OR=3.904, 95%CI: 1.830-8.328) were identified as risk factors for microvascular invasion in HCC (P＜0.05). The combined prediction of incomplete tumor capsule, heterogeneous tumor signal on T2WI, peritumoral hypointensity in the hepatobiliary phase, and ALP/PA ratio yielded an area under the curve of 0.842 (95%CI: 0.761-0.922) for predicting microvascular invasion in HCC. 
Conclusion Preoperative MRI characteristics combined with the ALP/PA ratio show good efficacy in predicting microvascular invasion in HCC. 

Objective To initially establish a prediction model for the occurrence of early neurological deterioration (END) in middle-aged and elderly patients with acute ischemic stroke (AIS) based on single-centre clinical data, and to validate its performance. 
Methods The clinical data of 318 AIS patients treated in the First Hospital of Harbin Medical University from January 2020 to December 2023 were retrospectively collected and divided into the END group (n=80, 25.16%) and the non-END group (n=238,74.84%) according to the occurrence of END within 7 d of thrombolysis. The risk factors of END were screened using binary logistic regression, and a prediction model was established based on the results of logistic regression.Finally, the performance of the model in identifying END was evaluated using the receiver operating characteristic (ROC) curve, and the evaluation indexes were AUC, accuracy, sensitivity, and specificity. 
Results Multivariate logistic regression analysis showed that age (OR=1.247, 95%CI: 1.030-1.510), National Institute of Health stroke scale(NIHSS) score (OR=1.872, 95%CI: 1.325-2.645), hypersensitive C-reactive protein(hs-CRP) (OR=1.430, 95%CI: 1.091-1.876), hyperglycaemia (OR=1.372, 95%CI: 1.109-1.697), and fibrinogen to albumin ratio (FAR) (OR=1.537, 95%CI: 1.184-1.996) were the independent risk factors for the development of END in middle-aged and elderly AIS patients. An END prediction model was established based on the five parameters screened by logistic regression analysis, and the are under the curve (AUC) of the model for predicting the occurrence of END in middle-aged and elderly AIS patients was 0.879 (95%CI: 0.831-0.927), with an accuracy of 82.71%, a sensitivity of 78.75%, and a specificity of 84.03%, as validated by the ROC curve. 
Conclusion Age, NIHSS score, hs-CRP, blood glucose, and FAR are independent risk factors for END in middle-aged and elderly patients with AIS, and the model established accordingly has good predictive value for END. 

Objective To investigate the factors influencing cardiac rehabilitation compliance after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) and to construct a nomogram prediction model based on this. 
Methods Two hundred and fifty ACS patients admitted to our hospital from June 2020 to August 2022 who underwent cardiac rehabilitation in the acute phase of rehabilitation after PCI were selected, and the ACS patients were divided into good compliance group (n=154) and poor compliance group (n=96) according to cardiac rehabilitation compliance. The general data of the patients in the two groups were collected and surveyed using the demographic data questionnaire, depression scale, and anxiety scale. The influencing factors of post-PCI cardiac rehabilitation compliance in ACS patients were analyzed using multivariate logistic regression, and the relationship between these influencing factors and compliance was analyzed by the Spearman′s correlation test, and a nomogram was constructed based on the factors influencing the post-PCI cardiac rehabilitation compliance in ACS patients. The predictive ability, accuracy, and clinical utility of the model were evaluated and validated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. 
Results Compared with the good compliance group, the patients in the poor compliance group had significantly higher (P＜0.05) age, percentage of education (junior high school and below), monthly income level, distance traveled to see the doctor, percentage of hypertension, percentage of hyperlipidemia, percentage of (poor) perception of disease, percentage of (poor) social support, as well as percentage of depression, anxiety, and cardiac function class (grade Ⅲ) (P＜0.05), and significantly lower levels of serum high-density lipoprotein cholesterol (HDL-C) and left ventricular ejection fraction (LVEF) levels (P＜0.05); however, the levels of gender, smoking history, alcohol consumption history, body mass index (BMI), ACS type, marital status, diabetes mellitus, renal disease, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C),albumin (ALB), glycated hemoglobin (HbA1c), uric acid (UA), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), type of medication, and postoperative complications (cerebral hemorrhage, thrombosis, and infections) were not statistically significant (P＞0.05). The results of multivariate logistic regression analysis showed that age, distance traveled to see the doctor, and depression were independent risk factors affecting cardiac rehabilitation compliance of patients (P＜0.05), while education level, monthly income level, HDL-C, and LVEF level were independent protective factors for cardiac rehabilitation compliance of patients (P＜0.05).The results of Spearman′s correlation analysis showed that education level and monthly income levels, HDL-C, and LVEF were significantly and positively correlated with patients′ cardiac rehabilitation compliance scores (r=0.655, 0.720, 0.694, 0.826, all P＜0.05), while age and distance traveled to see a doctor were significantly and negatively correlated with patients′ cardiac rehabilitation compliance scores (r=-0.643, -0.812, both P＜0.05), and there was no significant correlation between depression and patients′ cardiac rehabilitation compliance scores (r=-0.322, P＞0.05). In the nomogram prediction model, the ROC curve model had an area under the ROC curve (AUC)=0.970, and the calibration and decision curves showed that the model had good accuracy. 
Conclusion Age, education level, monthly income level, distance traveled to see the doctor, depression, HDL-C, and LVEF are all influencing factors of cardiac rehabilitation compliance after PCI in patients with ACS, and a nomogram prediction model based on this can effectively assess the risk of cardiac rehabilitation compliance in patients. 

Objective To explore the safety and efficacy of drug-eluting stents (DES) and bare-metal stents (BMS) in the treatment of vertebral artery stenosis (VAS), as well as the influencing factors of in-stent restenosis (ISR). 
Methods From June 2022 to October 2023, 129 patients undergoing vertebral artery stent implantation in the Department of Neurosurgery, the First Hospital of Hebei Medical University were selected and randomly divided into the DES group and the BMS group using a randomized controlled method and followed up. The clinical data of the patients were recorded and they were divided into the stenosis group and the non-stenosis group according to occurrence of ISR after surgery. Through Logistic regression analysis, the risk factors affecting ISR were analyzed. 
Results All stents were successfully implanted, and there was no hematoma at puncture site, intracranial hemorrhage, or death events after surgery. The incidence of ISR in the DES group was significantly lower than that in the BMS group (4.84% vs. 28.36%, P＜0.05). Multivariate regression analysis confirmed that the BMS group was an independent risk factor for ISR (OR=0.10, P＜0.001, 95%CI:0.02-0.39). 
Conclusion Vertebral artery stent implantation is a safe and effective method for treating patients with symptomatic VAS who are poorly controlled by drugs, and DES can significantly reduce the incidence of ISR. 

Objective To construct a risk prediction model for gout disease activity in male patients based on tumor markers and renal function indicators. 
Methods Clinical data of 118 male gout patients admitted to Xi′an Fifth Hospital from January 2021 to December 2023 were retrospectively analyzed. They were randomly divided into training set (n=94) and verification set (n=24) according to an 8∶2 ratio, and divided into two groups according to disease activity: acute stage (n=41) and remission stage (n=53). Among them, the training set had acute stage group (n=41) and remission stage group (n=53), and the verification set had acute stage group (n=10) and remission stage group (n=14). Tumor markers ［carbohydrate antigen 125 (CA125), carbohydrate antigen72-4 (CA72-4), prostate specific antigen (PSA), pro-gastrin-releasing peptide (proGRP)］ and renal function indexes［serum creatinine (Scr), cystatin C (Cys-C), blood urea nitrogen (BUN), blood β2 microglobulin (β2-MG), blood uric acid (UA)］ were detected in all patients. The levels of tumor markers, renal function indexes and other clinical data of the two groups were compared, and the independent factors affecting the disease activity of the patients were analyzed. The area under the receiver operating characteristic (ROC)curve (AUC) was used to analyze the predictive efficiency of the prediction model for the disease activity of patients. 
Results 〖JP2〗The levels of CA125 ［(14.25±2.85)kU/L vs. (12.67±2.53)kU/L］〖JP〗, CA72-4［(3.41±0.85)kU/L vs. (2.11±0.42)kU/L］, proGRP［(71.32±17.83)ng/L vs. (42.65±10.66)ng/L］, UA［(566.43±113.28)μmol/L vs. (372.71±74.54)μmol/L］, Cys-C ［(1.21±0.25) mg/L vs. (0.77±0.26）mg/L］, β2-MG［(3.41±1.05)mg/L vs. (1.86±0.62)mg/L］, erythrocyte distribution width (RDW) ［(13.84±1.54)% vs. (12.67±1.41)%］ and platelet-lymphocyte ratio (PLR) ［(165.24±33.05) vs. (148.43±29.69)］ in acute stage were higher than those in remission stage, and the differences were significant (P＜0.05). Multivariate stepwise Logistic regression analysis showed that CA72-4 level (OR=2.989, 95%CI: 1.164-7.673), proGRP level (OR=3.678, 95%CI: 1.571-8.610), Cys-C level (OR=3.162, 95%CI: 1.773-5.637), β2-MG level (OR=5.236, 95%CI: 2.621-10.458) and UA level (OR=4.543, 95%CI: 2.778-7.430) were independent risk factors for disease activity (P＜0.05). The C-index was 0.844 (95%CI: 0.759-0.929) in the nomogram constructed based on the above influencing factors, and the correction curve for predicting disease activity was close to the ideal curve (P＞0.05). ROC of the training set showed that the prediction sensitivity of the model was 87.80%, the specificity was 84.90%, and the AUC was 0.896 (P＜0.05). ROC of the validation set showed that the sensitivity was 85.40%, the specificity was 86.80%, and the AUC was 0.861 (P＜0.05). 
Conclusion The nomogram prediction model based on CA72-4, proGRP, UA, Cys-C and β2-MG levels has a good predictive value for identifying high-risk male gout patients with disease activity. 

Objective To ascertain whether there is a correlation between vaginal microecology, genital tract pathogen infections and endometriosis by exploring the characteristics of vaginal microecology and genital tract pathogens in patients with endometriosis. 
Methods Vaginal microecology and reproductive tract pathogens specimens from patients diagnosed with endometriosis by histopathology (n=58) and women of childbearing age (n=50) who underwent physical examinations in the First Affiliated Hospital of Henan University of Science and Technology (HUST) were selected for data collection and comparative analysis, and multivariate Logistic regression was used to analyze the influencing factors of endometriosis. 
Results The differences of vaginal flora concentration (χ2=5.687, P＜0.05), flora diversity (χ2=6.711, P＜0.05), white blood cell/oil microscopy detection rate (χ2=5.680, P＜0.05), Nugent score (χ2=3.880, P＜0.05), hydrogen peroxide positive rate (χ2=8.810, P＜0.05), pH value (χ2=15.027, P＜0.05) and Ureaplasma urealyticum type 1 positive rate (χ2=3.894, P＜0.05) between the endometriosis group and the healthy control group were statistically significant. Multivariate Logistics regression analysis showed that PH value (OR=6.536, 95%CI: 2.197-19.442, P＜0.05) and white blood cell/oil microscopy (OR=7.885, 95%CI: 1.414-43.962, P＜0.05) were the influencing factors of endometriosis. 
Conclusion The vaginal microecology and genital pathogen infection in EMs patients are more complex than those in healthy people. The imbalance of vaginal microecology and genital pathogen infection may have a potential relationship with the occurrence of EMs, but its causal relationship needs to be further verified. 

Objective To explore the risk factors for failed manual reduction under ultrasonic monitoring in children with testicular torsion. 
Methods A retrospective analysis was conducted on the clinical data of 87 children with testicular torsion admitted to the Department of Urology, Hebei Children′s Hospital from January 2019 to October 2024. All children underwent manual reduction under color Doppler ultrasonic monitoring, and were divided into the success group (n=36) and the failure group (n=51) based on the reduction results. Age, duration of onset, hematological parameters, and ultrasound imaging results were compared between the two groups. Multivariate Logistic regression analysis was performed on the predictive factors with significant differences (P＜0.05) in univariate analysis. 
Results Compared with the failure manual reduction groups under ultrasonic monitoring, there were significant differences in age ［(7.53±3.09) years vs. (5.61±2.47) years］, duration of onset (9.0 h vs. 17.0 h), scrotal wall thickness (3.8 mm vs. 4.8 mm), degree of spermatic cord torsion (360 ° vs. 540 °), and testicular survival rate (80.6% vs. 52.9%) in the success group (P＜0.05). There was no significant difference in the left and right sides, white blood cell count, mean platelet volume, and neutrophil/lymphocyte ratio (P＞0.05).Multivariate Logistic regression analysis showed that younger age (OR=0.178, P=0.043), longer duration of onset (OR=3.957, P=0.019), and higher degree of spermatic cord torsion (OR=1.020, P=0.023) were risk factors for failure in manual reduction under ultrasonic monitoring. 
Conclusion Age, duration of onset, and degree of spermatic cord torsion are all risk factors affecting the outcome of manual reduction under ultrasonic monitoring. Manual reduction under ultrasonic monitoring is an effective treatment strategy. Therefore, it is recommended that patients with testicular torsion undergo manual reduction to maximize the possibility of testicular survival. 

Objective To establish a combined model based on ultrasound radiomics combined with clinical parameters and conventional ultrasound features, and to verify its value in predicting benign and malignant thyroid nodules. 
Methods A total of 209 patients with 237 thyroid nodules confirmed by pathology were retrospectively included and randomly divided into training set (190 thyroid nodules) and validation set (47 thyroid nodules) according to an 8∶2 ratio. Pyradiomics was used to extract radiomics features, least absolute shrinkage and selection operator (LASSO) was used for feature screening, and k-Nearest Neighbor (KNN) machine learning algorithm was used to construct radiomics model. Univariate and multivariate Logistic regression were used to screen clinical parameters and conventional ultrasound features. The risk factors analyzed by multivariate Logistic regression were included in the k-nearest neighbor machine learning algorithm to construct a clinical prediction model. A combined model was constructed using the screened radiomics features and the risk factors analyzed by multivariate Logistic regression. The diagnostic efficacy of each model was compared by receiver operating characteristic (ROC) curve. 
Results Multivariate Logistic regression results showed that microcalcification, vertical position and age were independent risk factors for differentiating benign and malignant thyroid nodules (OR=6.082,13.761,0.938, all P＜0.001). The clinical prediction model was constructed using the above risk factors, and the area under the curve (AUC) of the training set and the validation set was 0.881 and 0.704, respectively. The ultrasound radiomics model was established by using the six key radiomics features screened by LASSO algorithm. The AUC of the training set and the test/validation set was 0.830 and 0.819, respectively. The risk factors analyzed by multivariate Logistic regression and radiomics score were used to construct a combined diagnostic model. The AUC of the training set and the validation set was 0.939 and 0.854, respectively. The diagnostic efficiency was better than that of a single clinical prediction model or ultrasound radiomics model. The decision curve showed that the combined model had good clinical application value. The calibration curve showed good fit between the combined model and the ideal model. 
Conclusion The combined model constructed by radiomics based on contrast-enhanced ultrasound combined with clinical parameters and ultrasound features can effectively identify benign and malignant thyroid nodules. 

Objective To study the value of ultrasound evaluation of blood flow parameters (S wave, D wave, A wave) combined with placenta protein-13 detection in the prediction of late-onset intrauterine growth restriction (FGR). 
Methods A total of 130 pregnant women who gave birth in the Department of Obstetrics and Gynecology of our hospital from December 2022 to December 2023 were selected, including 42 patients with late-onset FGR (observation group) and 88 patients with normal FGR (control group). According to the blood flow characteristics of umbilical artery and uterine artery, the patients with late-onset FGR were divided into group Ⅰ, group Ⅱ, group Ⅲ and group Ⅳ. The blood flow velocity (S wave, D wave, A wave) and serum placenta protein-13 levels of intravenous catheter were compared between the observation group and the control group, and the differences of various indexes in patients with late-onset FGR in different subgroups were analyzed. The predictive value of intravenous catheter blood flow velocity (S wave, D wave, A wave) and serum placenta protein-1 for late-onset FGR was analyzed by receiver operating characteristic (ROC) curve. 
Results The S wave ［(55.84±8.46） cm/s vs. （60.67±7.78） cm/s］, D wave ［(42.89±6.64） cm/s vs. （48.38±7.47） cm/s］, A wave ［(23.35±4.58） cm/s vs. （31.68±4.45） cm/s］ and serum placental protein-13 ［(0.98±0.15） cm/s vs. （1.15±0.18） cm/s］ in the observation group were lower than those in the control group (P＜0.05). There were significant differences in blood flow velocity (S wave, D wave, A wave) and serum placental protein-13 levels in different subtypes of pregnant women, and the levels of S wave, D wave, A wave and serum placental protein-13 showed an increasing trend with the increase of grade (P＜0.05). Logistic regression analysis showed that intravenous catheter blood flow velocity (S wave, D wave, A wave) and serum placenta protein-13 were the influential factors of FGR in late pregnancy (P＜0.05). ROC curve analysis showed that the area under the ROC curve (AUC) of S wave, D wave, A wave and serum placenta protein-13 for predicting FGR was 0.766 (95%CI: 0.672-0.861), 0.765 (95%CI: 0.663-0.862), 0.751 (95%CI: 0.653-0.856) and 0.816 (95%CI: 0.717-0.916), respectively, the AUC of combined prediction for FGR was 0.875 (95%CI: 0.793-0.952), and the AUC of combined prediction for FGR was higher than that of single prediction (P＜0.05). 
Conclusion The intravenous catheter blood flow velocity (S wave, D wave, A wave) and placenta protein-13 are closely related to the occurrence and development of FGR, and the combined detection can improve the prediction efficiency of FGR. 

Objective To explore the predictive value of serum procalcitonin (PCT) to albumin (ALB) ratio and interleukin-23 (IL-23) for the clinical prognosis of sepsis patients. 
Methods Clinical data and follow-up data of 150 patients with sepsis admitted to the hospital from January 2021 to December 2023 were retrospectively collected. They were divided into the death group and the survival group based on the 28-day prognosis. The levels of serum PCT/ALB and IL-23 in patients with different prognosis at admission were compared. COX regression analysis was used to analyze the relationship between clinical prognosis and serum PCT/ALB and IL-23 in patients with sepsis. The interaction of serum PCT/ALB and IL-23 on the prognosis of patients with sepsis was analyzed by interaction analysis. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum PCT/ALB and IL-23 for the prognosis of patients with sepsis. 
Results Among 150 sepsis patients with 28-day prognosis, 49 patients died, with a mortality rate of 32.67%. The serum PCT/ALB and IL-23 levels in the death group were higher than those in the survival group at admission ［(60.82±23.28）% vs. （45.35±8.68）%, （425.19±53.48） ng/L vs. (376.12±46.17) ng/L respectively］ (P＜0.05). COX regression analysis showed that the prognosis of sepsis patients was related to the elevation of serum PCT/ALB and IL-23 at admission. Abnormal overexpression of serum PCT/ALB and IL-23 at admission might be a risk factor for mortality in sepsis patients (P＜0.05). There was a positive interaction between serum PCT/ALB and IL-23 levels and mortality in sepsis patients. When both were highly expressed, the risk of mortality was 18.2 times higher than that when both were lowly expressed, and the synergistic effect was 2.435 times higher than the sum of the effects produced by the two alone (SI=2.435). ROC curve was drawn to obtain the area under the curve (AUC), and the results showed that the AUC of serum PCT/ALB and IL-23 alone in predicting the prognosis risk of sepsis patients was 0.726 and 0.763 respectively, which had certain predictive value, while the AUC of combined prediction was 0.872, which was higher than that of the two alone (P＜0.05). Decision curve was drawn, and the results showed that when the threshold was between 0.1 and 0.68, the predictive model combining serum PCT/ALB and IL-23 predicted a better net benefit rate for mortality in sepsis patients than using serum PCT/ALB or IL-23 alone, with a maximum net benefit rate of 0.314 for the combination of the two. 
Conclusion Elevated serum PCT/ALB and IL-23 levels in sepsis patients at admission are risk factors for mortality, and their combined detection has high predictive value for the prognosis of sepsis. 

Objective Respiratory diseases are one of the major threats to the health of Chinese residents, and allergies are one of the important pathogenic factors of respiratory diseases. The correlation between respiratory diseases and allergen spectrum in Shanghai area was analyzed to provide basis for the prevention and treatment of respiratory allergic diseases in Shanghai area. 
Methods In this study, we collected 5 183 serum samples from patients in Department of Respiratory Disease, Hongkou and Songjiang Branches of Shanghai General Hospital from January 2019 to August 2022. Quantitative total immunoglobulin E (IgE) and allergen-specific IgE (sIgE) detections, including 17 types (groups) of allergens, were performed on samples using Thermo Phadia 250, to analyze the distribution of allergen positive rate in ages, sexes, months and years. 
Results The results showed that the inhalant allergen (30.53%) was superior to the ingestion allergen (15.68%) in the patients with respiratory diseases in Shanghai area. Dermatophagoides farinae (34.94%), dermatophagoides pteronyssinus (33.91%), shrimps (11.89%), Blattella germanica (11.82%), mixed fungi (Aspergillus flavus, Fusarium oxysporum, Candida albicans, Alternaria alternata, and Aspergillus nidulans) (8.77%) and cat dander (8.08%) were the main allergens of respiratory diseases. Among them, dust mites and animal dander had seasonal changes, which reached the peak in winter, and the allergic rate of dust mites increased year by year The positive rate of most allergens in children was the highest in all age groups, and the difference of allergen spectrum among the age groups might be related to the immune status and living level. The positive rate of allergen in males was higher than that in females, which might be related to occupational exposure, residence time and hormone level. The main allergens in the respiratory disease groups were a mixture of dust mite combinations. 
Conclusion The overall prevalence of allergic respiratory diseases in China is rising, and there are regional, seasonal, age and sex differences. It is important to prevent and control allergic respiratory diseases according to regional allergic conditions. This research investigates the allergen spectrum of respiratory disease patients in Shanghai area, providing the clinical basis and reference for the identification, prevention, and control of allergens in Shanghai area.