Objective To investigate the effects of traditional Chinese medicine's five­tone therapy combined with medication on depressive mood and heart rate variability (HRV) indicators in patients with major depressive disorder (MDD). Methods A total of 64 male MDD patients treated at a military hospital between July and October 2024 were were selected and randomly divided into a control group (n=32) and an experimental group (n=32) at a ratio of 1:1. The control group received standard antidepressant pharmacotherapy, including SSRIs, SNRIs, and benzodiazepine drugs, once a day for 4 weeks, while the experimental group received traditional Chinese medicine's five­tone therapy in addition to the standard pharmacotherapy (30-40 min /session,5 sessions/week for 4 weeks). Both groups were assessed using the Hamilton Depression Rating Scale (HAMD) and Patient After treatment, the HAMD scores and PHQ­9 scores of both groups were better than those before treatment, with statistically significant differences (P<0.05).The experimental group demonstrated significantly lower HAMD scores (6.29 ± 4.13 vs. 9.77 ± 7.31; P<0.05) and PHQ­9 scores (3.32 ± 2.51 vs. 5.87 ± 5.32; P<0.05) compared to the control group , with statistically significant differences (P<0.05). The time­domain indicators of HRV in the experimental group were better than those of the control group [SDNN (81.32 ± 31.64 vs. 66.72 ± 28.58), RMSSD (104.14 ± 68.19 vs. 57.63 ± 34.26), PNN50 (25.48 ± 18.02 vs. 16.64 ± 12.7）], and the frequency­domain indicators were also better than those of the control group [TP (361.24 ± 201.85 vs. 684.81 ± 404.84), HF (91.85± 111.52 vs. 145.60 ± 125.79), LF (291.75 ± 129.65 vs. 194.87 ± 90.65), LF/HF ratio (3.25 ± 2.33 vs.7.97 ± 6.41）], with statistically significant differences (P<0.05). Conclusions Traditional Chinese medicine's five­tone therapy combined with antidepressant pharmacotherapy can effectively alleviates depressive mood and improve HRV indicators, and it is relatively safe.

作为现代口腔医学的关键技术,显微根尖手术为治疗根尖周疾病提供了新的视角和解决方案。本文通过系统性综述,对比了显微根尖手术与传统根尖手术技术,并探讨了骨移植技术在显微根尖手术中的应用。显微根尖手术利用显微镜提供的高精度放大和照明,实现了精确的手术操作,有效控制了感染,促进了组织修复,并提高了治疗成功率,与传统手术相比,优势明显。骨移植技术在修复骨缺损、加速组织愈合以及改善长期手术效果方面发挥着重要作用,选择合适的骨移植材料对于手术成功至关重要。此外,患者的牙周状况、回填材料的选择以及手术细节等也是影响手术结果的因素。未来,显微根尖手术将扩大治疗适应证范围,优化治疗方案,深化对预后因素的研究,为根尖周疾病治疗提供新的思路和方法。

Objective To analyze the influencing factors of acute mountain sickness（AMS） in young male athletes who had moved to high-altitude areas and then trained at even higher altitudes. Methods A total of 245 245 young male athletes who had moved to an altitude of 3200 meters were analyzed. The incidence of AMS was observed after one week of training at an altitude of 4200 meters. The difference in various indicators between the AMS group and the non -AMS group were compared, and the influencing factors of AMS were explored. Results Among the 245 young male athletes, 26 experienced AMS symptom score ≥5 points, accounting for 10. 6%. There was no statistical difference in age, smoking history, or body mass index （BMI）between the two groups. The exposure time of high altitude and the arterial oxygen saturation in AMS group was significantly lower. The Self-Rating Depression Scale (SDS) score and Self-Rating Anxiety Scale (SAS) score were significantly higher in the AMS group than those in the non-AMS group. The score of the Connor-Davidson Resilience Scale (CD-RISC) in the AMS group was significantly lower than that in the non-AMS group, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that the occurrence of AMS symptoms was related to high-altitude residence time, blood oxygen saturation, SDS score, and SAS score. Conclusions The incidence of AMS in young male athletes who have moved to an altitude of 3200 m and then trained at an altitude of 4200 m is relatively low. The occurrence of AMS symptoms is related to high-altitude residence time, blood oxygen saturation, SDS score and SAS score.

Objective To evaluate the efficacy and safety of iron isomaltoside in the treatment of iron deficiency anemia in patients undergoing maintenance hemodialysis(MHD). Methods A retrospective analysis was conducted on 23 MHD patients with iron deficiency anemia. who received intravenous infusion of iron isomaltoside (500 mg per dose, twice in total, with an interval of 1 week), and then were followed up for 6 months. Changes in hemoglobin (Hb), transferrin saturation (TSAT), ferritin (Fer), adverse reactions,and changes in the dosage of anemia treatment drugs were observed. Results After treatment, Hb significantly increased. At 1 month, the median Hb rose from the baseline of 98.5 g/L to 113.0 g/L, the difference was statistically significant (P＜0.05),the median Hb during the peak period (2-5 months) remained at 115.0-117.5 g/L, and was maintained at 115.0g/L at 6 months (P=0.016). TSAT and Fer increased from the baseline of 14.3% and 55.9 μg/L to the peak values of 32.3% (P=0.010) and 436.0 μg/L (P=0.016) (3 months), respectively, it dropped back to 22.3% (P=0.047) and 99.0 μg/L (P=0.031) at 6 months, but was still significantly higher than the baseline, the difference was statistically significant. Only one patient (2%) exhibited a mild allergic reaction. The dosage of ESAs decreased significantly (P=0.012).The overall response Hb rate (Hb≥110g/L) increased from 17.4%(4/23) at baseline to 65.2%(15/23) at 6 months (P＜0.05). Conclusions Iron isomaltoside can effectively improve iron metabolism and anemia in MHD patients, with favorable safety, which holds clinical promotion value.

Objective To explore the therapeutic effect of Vericiguat on patients with heart failure with reduced ejection fraction (HFmrEF). Methods A total of 80 HFmrEF patients admitted to Xinjiang Uygur Autonomous Regional Corps Hospital of Chinese People's Armed Police Force from March 2023 to June 2024 were selected and randomly divided into a control group and an observation group,with 40 cases in each group. The control group received standard treatment, while the observation group was treated with Vericiguat tablets on the basis of the control group,and both groups were followed up for 6 months. NT-proBNP, LVEF, LAD, LVESD, LVEDD, 6MWD and Minnesota Heart Failure Quality of Life Questionnaire (MLHFQ) scores were compared. The levels of hypersensitive C-rective protein （hs-CRP） and Interleukin 6 （IL-6） were compared between the two groups,and the incidence of heart failure aggravated readmission was observed. Results After treatment,compared with the control group, the levesl of NT-proBNP, hs-CRP and IL-6 in the observation group were significantly lower (P<0.05), and both groups showed a decrease in LVESD and LVEDD, an increase in LVEF, a decrease in MLHFQ score, and a significant extension of 6MWD (P<0.05). The quality of life of patients improved, and the effective rate of cardiac function improvement in the observation group was higher than that of the control group （95.0% vs.77.5%,P<0.05）. The difference in adverse reactions between the two groups （12.5% vs.5%, P=0.235） was not statistically significant. Conclusions Vericiguat treatment for HFmrEF patients can reduce inflammation, improve NT-proBNP, LVESD, LVEDD, LVEF,and 6MWD, and effectively alleviate clinical symptoms.

Objective To explore the pathological features and incidence patterns of gastric precancerous lesions, and benign and malignant tumors in the stomach region of a certain region of Tianjin. Methods The pathological diagnosis results of 28110 cases of gastroscopy from a tertiary general hospital in Tianjin from July 2014 to August 2024 were extracted. The features of the disease spectrum, as well as the lesion sites, pathological type, differentiation degrees, gender, age, etc. of precancerous lesions and gastric cancer were analyzed. Results The main types of diseases diagnosed by gastroscopy included inflammatory diseases (68.25%), benign tumors and malignant tumors. There were 19186 cases of gastric inflammatory diseases, among which chronic atrophic gastritis accounted for 35.72% (6 854/19 186) and chronic non-atrophic gastritis for 63.46% (12 176/19 186), all of which were more common in the gastric antrum. Among the 7 587 cases of benign tumors, polyps accounted for 93.73% (7 111/7 587). Among the 716 cases of malignant tumors, adenocarcinoma accounted for 72.07% (516/716) and gastrointestinal stromal tumors accounted for 22.77% (163/716). The average age of patients with low and low-to-moderately differentiated adenocarcinoma was 64.00 (56.00, 71.00) years, while that of patients with moderately and moderately-to-highly differentiated adenocarcinoma was 70.04±9.38 years.The age difference between the two groups was statistically significant (P＜0.05). The detection rate of gastric cancer in males was higher than that in females, and the detection rate of low and low-to-moderately differentiated adenocarcinoma was higher than that of moderately and moderately-to-highly differentiated adenocarcinoma before the age of 60. Gastric dysplasia was detected in 3,720 cases, with a detection rate of 13.23% (3,720/28,110). The average age of high-grade dysplasia (HGD) was 63.35±10.31, and that of low-grade dysplasia (LGD) was 59.00 (51.00, 66.00) years. The age difference between the two groups was statistically significant (P＜0.05). Intestinal metaplasia was detected in 9,922 cases, with a detection rate of 35.30% (9,922/28,110), and the average age was 59.00 (51.00, 65.00) years. Conclusions Gastric malignant tumors in the area of Tianjin are mainly adenocarcinoma and stromal tumors. It is recommended that people in this region, especially males (over 40 years old or earlier), should regularly undergo gastroscopy for early detection and intervention to reduce the incidence.

Objective To compare the anesthetic effects of remimazolam and propofol in painless gastroscopy for patients with gastroesophageal varices (GEV). Methods The clinical data of 98 patients with GEV who underwent precision treatment under painless gastroscopy in Affiliated Hospital of Qingdao University between February 2022 and February 2024 were retrospectively analyzed. There were 65 males and 33 females aged 18-75 years. The patients were divided into a remimazolam group and a propofol group according to different anesthesia methods, with 49 cases in each group. After 3 minutes of intravenous anesthesia induction, the patients received either 0.2 mg/kg remimazolam or 2 mg/kg propofol accordingly. Precision gastroscopy treatment began when eyelash reflex disappeared, with intraoperative top-ups of 0.05 mg/kg remimazolam or 0.5 mg/kg propofol administered as required. Data were recorded at four time points: pre-induction baseline (T₀), gastroscope passage through the pharynx (T₁), 5 minutes after procedure initiation (T₂), and immediately post-procedure (T₃). Measured outcomes included sedation onset time, recovery time, discharge readiness time, and adverse reactions (including hiccups, dizziness, and nausea/vomiting). Results Compared with the propofol group, the remimazolam group exhibited significantly higher heart rate (HR) and mean arterial pressure (MAP) at T₁, T₂ and T₃, and the pulse SpO₂ and bispectral index (BIS) were also significantly higher at T₁ and T₂, with statistically significant differences (P<0.05). Compared with the propofol group, the remimazolam group showed significantly shorter recovery time[(5.39±1.12)min vs. (6.64±0.97)min] and discharge time[(19.53±3.24) min vs. (24.32± 3.76)min; P<0.05], but there was no significant difference in the onset time of sedation between the two groups. The incidence of adverse reactions in the remimazolam group was significantly lower than that in the propofol group, with statistically significant differences in the incidence of coughing and hiccups[8(16.33%) vs. 1(2.04%); 13(26.53%) vs. 1(2.04%)](P<0.05), but there was no significant difference in the incidence of bradycardia and body movement. Conclusions The application of remimazolam in the precision treatment of GEV patients under painless gastroscopy is significantly effective, with less impact on hemodynamics than propofol, and the postoperative recovery is faster.

Objective To explore the influencing factors of acute exacerbation in elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 102 elderly patients with acute exacerbation of COPD (AECOPD) treated at Beijing Municipal Corps Hospital of Chinese People’s Armed Police Force from January 2017 to December 2024 were retrospectively selected as the AECOPD group. Meanwhile, 100 patients without AECOPD were randomly selected as the COPD stable group. General data, blood routine test indicators, infection indicators [serum procalcitonin (PCT), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), white blood cell count, lymphocyte count, neutrophil/lymphocyte ratio (NLR), eosinophil count (EOS) levels], blood biochemical indicators [fasting blood glucose (FPG), HDL-C, LDL-C, TG, TC, Lac)] D-dimer (D-D), heart failure indicator serum N-terminal pro brain natriuretic peptide (NT proBNP), and blood gas analysis indicators (pH value, Lac) were compared between the two groups., and multivariate binary logistic regression analysis were used to explore the related factors of AECOPD occurrence. Results The proportion of community-acquired pneumonia, NT proBNP, hs-CRP, TNF-α, D-D, NLR, EOS, Lac, PCT, and IL-6 in the AECOPD group were higher than those in the COPD stable group (P＜0.05). The results of multivariate logistic regression analysis indicated that NT proBNP, hs-CRP, TNF-α, D-D were associated with the occurrence of AECOPD (P＜0.05), and hs CRP and TNF-α were independent influencing factors of AECOPD (P＜0.05). Conclusions The proportion of community-acquired pneumonia, NT proBNP, hs-CRP, TNF-α, D-dimer, NLR, EOS, Lac, PCT, IL-6 in AECOPD patients are significantly elevated, and NT proBNP, hs-CRP, TN-α and D-D are independently correlated with the occurrence of AECOPD, providing a reference basis for the prevention and treatment of COPD progression and improvement of prognosis.

阻塞性睡眠呼吸暂停(OSA)是一种以睡眠期间反复上气道塌陷、间歇性缺氧及睡眠结构紊乱为特征的现象。作为OSA的核心病理特征,慢性间歇性缺氧(CIH)促进动脉粥样硬化(AS)发生发展的机制研究备受关注。众多研究指出,OSA通过炎症反应、氧化应激、交感神经系统激活、血管内皮功能障碍等直接因素和血脂异常、胰岛素抵抗和血压增高等间接因素影响AS的发生发展。但具体影响机制尚未彻底揭示,仍需要进一步深入研究。本文就其可能的机制进行综述,以期为临床诊疗和预防心脑血管疾病提供参考。

Objective To explore the correlation between proactive personality and life satisfaction among a certain group of young people and to examine the chain mediating mechanism of personal growth initiative and self-efficacy in this relationship. Methods A total of 826 young people from a certain unit were surveyed using the Personal Growth Initiative Scale, Life Satisfaction Scale, Proactive Personality Scale, and Self-Efficacy Scale. A total of 759 valid questionnaires were collected, with an effective response rate of 91.88%. Pearson correlation was used to verify the correlations between variables, and multiple step-wise regression analysis was employed to evaluate the predictive effect of proactive personality, self-efficacy, and personal growth initiative on life satisfaction, and to explore the mediating role of personal growth initiative and self-efficacy between proactive personality and life satisfaction. Results There were significant positive correlations among proactive personality, personal growth initiative, self-efficacy, and life satisfaction (all P<0.01). Proactive personality, personal growth initiative and self-efficacy could significantly and positively predict individual life satisfaction. Personal growth initiative and self-efficacy played a chain mediating role between proactive personality and life satisfaction. Conclusions Proactive personality directly affects life satisfaction through two pathways. Firstly, it enhances life satisfaction by promoting personal growth initiative. Secondly, it enhances self-efficacy by improving personal growth initiative, ultimately leading to an improvement in life satisfaction.

Objective To explore the predictive value of bone age, luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio combined with serum 25-hydroxyvitamin D[25-(OH)D] level for rapidly progressive central precocious puberty (RP-CPP). Methods A retrospective study was conducted on 116 girls with central precocious puberty (CPP) admitted to Jiangxi Provincial Corps Hospital of Chinese People’s Armed Police Force and Nanchang People’s Hospital from January 2021 to July 2023. These girls were divided into RP-CPP group (n=42) and the slowly progressive central precocious puberty (SP-CPP) group (n=74) based on their pubertal development process and other indicators. Another 50 girls with CPP were selected from the same hospitals from August 2023 to June 2024 at a ratio of 7∶3 as the validation group, which was further divided into the RP-CPP group (n=16) and the SP-CPP group (n=34). The constructed prediction model was externally validated. The data of the girls in the modeling group were analyzed using univariate analysis, and binary logistic regression analysis was used to select independent influencing factors, and a nomogram model was constructed. The prediction model was validated by combining the existing validation group data. Results Univariate and multivariate logistic regression analyses indicated that bone age difference, LH baseline value, LH peak/FSH peak, and 25-(OH)D level were independent influencing factors for the occurrence of RP-CPP in girls (all P＜0.05). The established nomogram model was validated, and the calibration plot showed good performance of the prediction model. The area under the receiver operating characteristic (ROC) curve for the modeling group was 0.654, and for the validation group, it was 0.687, with good fit of the calibration curve (all P＜0.05). Conclusions Bone age difference, LH baseline value, LH peak/FSH peak, and 25-(OH)D level are independent influencing factors for the occurrence of RP-CPP in girls.

Objective To explore the mechanism of action of Bailing tablets(BLT) in the treatment of vitiligo with nework pharmacology methods. Methods The effective active compounds and target genes of BLT were retrieved, collected, and screened using the TCMSP (Traditional Chinese Medicine System Pharmacology Database and Analysis Platform) and UniProt database platform. The related pathogenic genes of vitiligo were queried through the DisGeNET, OMIM, and GeneCards databases, and the potential common targets for the treatment of vitiligo by BLT were further explored. The data of the active components and action target of BLT were collected and sorted, and then imported into Cytoscape 3.10.2 software to construct an “interaction network of Bailing tablet-active compounds-target genes”. The “protein-protein interaction (PPI) core network visualization analysis of Bailing tablet-key targets of vitiligo” was constructed using the STRING database and Cytoscape software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed on the potential targets of BLT in the treatment of vitiligo using the DAVID database. Results A total of 27 active compounds of main components of BLT, 220 drug targets, 1,500 disease targets, and 74 overlapping targets were screened out. The network diagram of “Chinese medicine-active compounds-target” showed that the core active compounds of the main components of BLT might be quercetin, kaempferol, 7-O-methylisomucronulatol, formononetin, and β-sitosterol. The PPI network was constructed for the key targets of Bailing tablet-vitiligo, and it was found that the key target genes for BLT to treat vitiligo included protein kinase B (AKT1), tumor necrosis factor (TNF), interleukin 6 (IL6), tumor protein p53 (TP53), interleukin-1β (IL1B), caspase 3 (CASP3), B lymphocyte tumor-2 protein (BCL2), human estrogen receptor (ESR1), prostaglandin oxygenase 2 (PTGS2), peroxisome proliferator-activated receptor γ (PPARG), etc. The GO functional enrichment analysis yielded 602 terms, including 495 biological processes, 38 cellular components, and 69 molecular functions. The KEGG pathway enrichment analysis yielded 155 signaling pathways, mainly involving cancer-related pathways, lipid and atherosclerosis, fluid shear stress and atherosclerosis, the AGE-RAGE signaling pathway in diabetes complications, cell aging, human T-cell leukemia virus type 1 infection, the IL-17 signaling pathway, etc. Conclusions BLT may treat vitiligo through multiple components, multiple targets, and multiple pathways.

Objective To evaluate the efficacy and safety of intense pulsed light(IPL) therapy for dry eye associated with meibomian gland dysfunction(MGD). Methods A computerized search was conducted in the Cochrane Library, Pubmed, Embase, CNKI, CBM, and VIP database to collect clinical randomized controlled trails (RCTs) investigating IPL for MGD-associated dry eye.The quality of the included studies was assessed, and meta-analysis was conducted using RevMan 5.4 software. Results A total of 11 RCTs were included. During the 3-month follow-up, compared with the meibomian gland expression(MGX) group, the IPL combined with MGX group significantly increased schirmer and reduced the ocular surface disease index scores, althought no statistical differences were observed in corneal fluorescein staining and tear meniscus height. Compared with the sham treatment group, IPL significantly improved meibomian gland expressibility and meiboscore and meibomian gland quality, but no statistical difference was noted in corneal fluorescein staining. During the 6-month follow-up, compared with the MGX group, the IPL combined with MGX group showed significant improvement in meibomian gland yielding secretion score, but no statistical difference was found in schirmer. Compared with the sham treatment group, IPL significantly prolonged tear break-up time and reduced the ocular surface disease index scores. During the 8-month follow-up, the IPL combined with MGX group significantly increased the tear break-up time and improved corneal fiuorescein staining, althought no significant difference was found in meiboscore and schirmer. At 9-month follow-up, there were no statistically significant differences in tear break-up time, corneal fiuorescein staining, meibomian gland yielding secretion score in the combined treatment group. The standard patient evaluation of eye dryness questionnaire scores showed instability during this period. No serious adverse events were reported in the available data. Conclusions IPL combined with MGX or IPL alone can effectively improve most signs and symptoms of MGD-associated dry eye over a longer period,but the therapeutic effect gradually decreases after 9 months.

Objective To evaluate the efficacy of extracorporeal shock wave therapy (ESWT) in the rehabilitation after anterior cruciate ligament reconstruction (ACLR). Methods Systematic searches were conducted in English databases such as PubMed, Embase, Web of Science, and Cochrane Library, as well as Chinese databases such as CNKI, WanFang, and VIP (up to January 2025). Randomized controlled trials (RCTs) on the application of ESWT in the rehabilitation after ACLR were included. The differences in Lysholm scores and IKDC scores between the ESWT group and the control group were compared. Results A total of 9 studies were included, involving 486 subjects, with 248 cases in the ESWT group and 238 cases in the control group. According to the number of interventions, they were divided into short-term intervention (≤3 times) and long-term intervention (＞3 times). Meta-analysis results showed that short-term ESWT could significantly improve the Lysholm scores (MD=8.06, 95% CI: 5.29-10.84) and IKDC scores (MD=6.46, 95% CI: 3.66-9.26), with the number of interventions being a significant positive moderator of Lysholm scores. Long-term ESWT showed limited improvement on the Lysholm scores (MD=4.58, 95% CI: -0.16-9.33) and had modest improvements on the IKDC scores (MD=1.91, 95% CI: 0.84-2.98). In addition, the effect sizes of long-term Lysholm scores and short-term intervention on the IKDC scores were not stable, and the quality grades of the outcome indicators was mostly medium and low. Conclusions ESWT is a non-invasive and cost-effective treatment method that can promote the rehabilitation after ACLR, especially with significant effects in short-term application.

Objective To compare the clinical effects of transabdominal preperitoneal(TAPP) laparoscopic inguinal hernia repair and tension-free inguinal hernia repair in the treatment of inguinal hernia. Methods A total of 53 patients with inguinal hernia admitted to Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2021 to September 2024 were enrolled and divided into an observation group (25 cases, undergoing TAPP) and a control group (28 cases, undergoing tension-free inguinal hernia repair). General conditions, complications, recurrence of contralateral hernia, and postoperative recovery of the two groups were compared. Results There were no statistically significant differences in age, hernia location, or operation time between the two groups. However, the observation group experienced significantly less intraoperative blood loss[(5.60±2.78) ml vs. (10.36±3.83) ml, P＜0.05], shorter hospital stay (10.38±1.33)d vs. (13.56±2.94)d, P＜0.05), and earlier postoperative ambulation [(18.23±3.90)h vs. (22.17±4.72) h,P＜0.05]. The visual analogue scale(VAS) score of 6 hours postoperatively was significantly lower in the observation group (3.85±0.80) than in the control group (4.72±0.57),P＜0.05. VAS scores of 12, 24, and 72 hours postoperatively were not significantly different between the groups. The incidence of postoperative complications was significantly lower in the observation group compared to the control group (4% vs. 25%), and the difference was statistically significant (P＜0.05). The observation group had a higher recurrence rate of contralateral hernia, , but the difference was not statistically significant . The incidence of local foreign body sensation at 1 month and 3 months postoperatively was significantly lower in the observation group (8% vs. 39.29% at 1 month; 0% vs. 17.86% at 3 months, P＜0.05 for both). By 6 months, the difference was not statistically significant. The incidence of inability to tolerate light physical activity at 1 month and 3 months after surgery was lower than that in the control group (8% vs. 32.14%, 4% vs. 10.17%), and the differences were statistically significant (P<0.05). The incidence of inability to tolerate heavy physical activity in the observation group at 1 month and 3 months after surgery was lower than that in the control group (4% vs. 21.43%, 0 vs. 7.14%), but the differences were not statistically significant. At 6 months after surgery, both groups were able to tolerate light physical activity; the observation group had no heavy physical activity at 1 month after surgery, and the incidence of inability to tolerate heavy physical activity at 3 and 6 months after surgery was lower than that in the control group (4% vs. 21.43%, 0 vs. 7.14%), but the differences were not statistically significant. Conclusions Tension-free inguinal hernia repair and TAPP repair both demonstrate good therapeutic effects in the treatment of inguinal hernia. However, TAPP causes less damage, less blood loss, less pain, fewer complications, and a more rapid recovery.

炎症性肠病(IBD)是一种复杂的慢性肠道炎症性疾病,受环境、遗传易感性及免疫失调等多种因素影响。高原缺氧环境通过加重肠黏膜屏障损伤、氧化应激及免疫紊乱等方式,加速IBD进展。HIF-1α和Nrf2是细胞应对缺氧的关键调控因子,二者通过协同与拮抗的双重作用影响肠道稳态。本文综述高原缺氧环境下,HIF-1α与Nrf2对IBD的病理生理影响的分子机制,为高原地区IBD的精准干预提供理论依据。

Objective To investigate the effect of local perfusion of budesonide combined with acetylcysteine in the treatment of severe pneumonia in children after electronic bronchoscopic alveolar lavage (BAL). Methods A total of 74 children with severe pneumonia admitted to the Pediatric Department of Characteristics Medical Center of Chinese People's Armed Police Force from September 2023 to August 2024 were selected and divided into an observation group (n=37) and a control group (n=37). On the basis of conventional treatment, the control group was treated with 0.9% NaCl alveolar lavage using electronic bronchoscopy, while the observation group was treated with local infusion of budesonide combined with acetylcysteine in addition to the control group. The clinical efficacy, cough disappearance time, body temperature recovery time, inflammatory indicators, hospitalization time, and incidence of adverse reactions were observed respectively in the two groups. Results The clinical efficacy, inflammatory indicators, and hospitalization stay of the observation group were significantly better than those of the control group, with statistically significant difference (P<0.05). There was no statistically significant difference in the recovery time of body temperature, disappearance time of cough, and incidence of adverse reactions between the two groups. Conclusions Local infusion of budesonide combined with acetylcysteine after alveolar lavage is characterized by significant clinical effect in the treatment of children with severe pneumonia, which can accelerate the absorption of pulmonary inflammatory lesions, shorten the length of hospital stay and reduce inflammatory indicators.

Objective To compare the application effects of antegrade catheterization through sinus tract and antegrade guidewire through catheter in nephrostomy tube exchange. Methods The clinical data of patients who underwent nephrostomy tube exchange in the First Medical Center of PLA General Hospital from January 2014 to March 2025 were retrospectively analyzed. The clinical effects of ultrasound-guided antegrade catheterization through sinus tract and antegrade guidewire through catheter in nephrostomy tube exchange were compared. Results A total of 529 cases of nephrostomy tube exchange treatment were performed on 204 patients. Among them, 319 cases were conducted via antegrade catheterization through sinus tract, with 2 cases of mild bleeding, 3 cases of chills and fever, and 6 cases of exchange failure, achieving a success rate of 98.12%; a total of 210 exchanges were performed via antegrade guidewire through catheter, with 2 cases of postoperative bleeding, 1 case of chills and fever, and 21 cases of exchange failure, achieving a success rate of 90.00%. Conclusions Compared with antegrade guidewire through catheter, antegrade catheterization through sinus tract is characterized by shorter operation time, less pain and higher success rate. When the sinus tract has already been formed, it can be used as the preferred method for clinical nephrostomy tube exchange.

Objective To analyze the current situation of blood pressure control and its influencing factors among community hypertension patients in Hedong district of Tianjin, and provide reference for the subsequent formulation of community hypertension management strategies. Methods A total of 4093 hypertension patients selected from four communities in Hedong district of Tianjin by cluster random sampling method were divided them into two groups based on their blood pressure levels: blood pressure control group (blood pressure＜140/90 mmHg) and blood pressure non-control group (blood pressure≥140/90 mmHg). Demographic characteristics, physical examination data and past medical history of the two groups were collected. Blood pressure control rate and influencing factors of the two groups were analyzed. Results A total of 3962 eligible community hypertension patients were included in the study, including 2314 patients (58.4%) in the blood pressure control group. Compared with the blood pressure non-control group, the blood pressure control group had statistically significant differences in gender, education level, income level, smoking, body mass index (BMI), social insurance, diabetes, and hyperlipidemia (P<0.05). Logistic multivariate regression analysis showed that income level (OR=1.119, 95%CI:1.005~1.246, P=0.04), smoking (OR=0.852, 95%CI:0.784~0.927, P<0.001), BMI (OR=0.868, 95%CI: 0.758~0.994, P=0.041), and hyperlipidemia (OR=0.736, 95%CI:0.639~0.850, P<0.001) were independently associated with the blood pressure control rate of hypertension patients. Conclusions The control rate of hypertension patients in Hedong district of Tianjin is low, so it is necessary to strengthen the management of hypertension patients in the community and effectively control the related risk factors to further reduce the incidence of cardiovascular diseases.

慢性肾脏病（CKD）是全球性健康问题,其发病率逐年上升,严重影响患者的生活质量和预后。CKD的病理机制复杂,涉及多种生物标志物和代谢途径。近期研究表明,维生素D缺乏、尿酸升高及微炎症之间的相互作用可能形成恶性循环,进一步加剧CKD的进展。维生素D在肾脏功能、免疫调节和炎症反应中发挥重要作用,其缺乏可能导致尿酸代谢异常和微炎症状态,而尿酸的升高又会促进微炎症反应,形成互为因果的关系。然而,目前对这一复合机制的研究仍显不足,临床干预措施也急需进一步探索。本文旨在探讨维生素D、尿酸及微炎症在CKD发展中的作用,分析其潜在的病理机制,并评估现有的临床干预策略,以期为临床实践提供新的视角和治疗思路,改善CKD患者的管理和预后。

Objective To explore the effect of rehabilitation function training on the motor function of patients after knee joint replacement surgery. Methods A total of 100 patients with knee joint replacement who received intervention treatment at the First Hospital Affiliated to Medical University of PLA Air Force from January 2022 to January 2023 were included in the study, and were divided into an observation group and a control group according to different intervention methods, with 50 cases in each group. The control group received conventional rehabilitation training intervention, while the observation group received rehabilitation function training intervention. The hospital stay, postoperative ambulation time, postoperative extubation time, visual analogue scale (VAS) score, knee flexion, knee joint function (HSS) score, exercise compliance and complications of the two groups were compared and analyzed. Results Before treatment, there was no statistical difference in VAS scores, knee flexion degree or HSS scores between the two groups. The observation group showed shorter hospital stay (14.77±2.75)d, postoperative ambulation time (20.59±1.73)h, and postoperative extubation time (28.53±2.46)h compared to the control group [(18.81±2.72)d; (26.68±1.71)h; (34.49±2.57)h], with statistically significant differences (P<0.05). After intervention, the VAS score of the control group (2.49±0.23) was higher than that of the observation group (2.07±0.18), and the observation group demonstrated greater knee flexion degree (106.46±5.75) ° and HSS scores (84.18±6.23) were higher than those of the control group[ (96.45±5.49)°; (75.35±6.42)] with statistically significant difference (P<0.05). The functional exercise compliance rate of the control group (84.00%) was lower than that of the observation group (98.00%), with statistically significant difference (χ²=5.983, P<0.05). The control group exhibited a higher total complication rate, but there was no statistically significant difference between the two groups (12.00% vs. 2.00%; χ²=2.458; P＞0.05). Conclusions Rehabilitation function training can improve the motor function of patients after knee joint replacement and enhance the compliance of functional exercise.

Objective To evaluate the efficacy and safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with type 2 diabetes mellitus (T2DM) and hypertension(HBP). Methods Randomized controlled trials(RCTs) of SGLT-2 inhibitors in the treatment of patients with type 2 diabetes mellitus complicated with hypertension published up to April 30, 2025 were searched through PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases. Document screening, information extraction and literature quality evaluation were respectively done by two researchers through inclusion and exclusion criteria, and RevMan 5.3 software for data analysis. The primary outcome indicators were 24-hour ambulatory systolic blood pressure(SBP), 24-hour ambulatory diastolic blood pressure(DBP), office-seated SBP, office-seated DBP, and adverse reactions such as hypoglycaemia, urinary tract infection, genital infection, and hypovolaemia. Results A total of 10 RCTs were included. The results showed that compared with placebo group,the SGLT2i group significantly reduced 24-hour ambulatory systolic blood pressure (WMD=-4.78,95% CI:-6.31~-3.25,P＜0.000 01) and 24-hour ambulatory diastolic blood pressure (WMD=-2.57,95% CI:-3.85~-1.29,P＜0.000 01). However, high levels of heterogeneity were observed in both analyses (SBP, I²=85%; DBP, I²=94%). Sensitivity analyses after excluding specific studies reduced heterogeneity, but still had a statistically significant reduction in blood pressure(P＜0.000 01). At the same time, office-seated SBP levels in patients with T2DM and hypertension were significantly reduced in the SGLT2i group compared with placebo group(WMD=-4.98,95% CI:-6.64~-3.32,P＜0.000 01). In addition, SGLT-2 inhibitors in combination with conventional antihypertensive regimens were associated with an increased risk of hypoglycaemia (RR=1.85,95%CI:1.09~3.13,P＜0.05) and genital infections (RR=2.48,95%CI:1.26~4.87,P＜0.05); there was no statistically significant difference in the incidence of hypovolaemia (RR=1.85,95%CI:1.09~3.13,P＜0.05) and urinary tract infection (RR=1.74,95%CI:0.9~3.39,P＞0.05) compared with conventional antihypertensive combined with placebo. Conclusions SGLT2i can reduce 24-hour ambulatory blood pressure and more significant systolic blood pressure in patients with T2DM and HBP, with more significant reduction in systolic blood pressure, but it is necessary to pay attention to the risk of hypoglycaemia and genital infection. For patients with hypertension and type 2 diabetes, SGLT2i can be an effective antihypertensive treatment option in addition to standard therapy.

Objective To explore the clinical efficacy of combined intervention of exercise and cognition in patients with mild cognitive impairment (MCI). Methods A total of 63 patients with MCI were randomly divided into a study group (n=31) and a control group (n=32). Both groups received general treatment, and the study group received combined training of exercise and cognition for 12 weeks. The Montreal Cognitive Assessment Scale (MoCA) was assessed before and after the training and 12 weeks after the training was stopped. Results There was no statistical difference in MoCA scores between the two groups before treatment. After the end of combined cognitive motor training and 12 weeks after stopping training, the MoCA scores of the study group were higher than those of the control group, with statistical significance (P<0.05). The improvement of cognitive function in the study group was mainly manifested in visuospatial/executive function, attention, language and memory. Conclusions Combined intervention of exercise and cognition can improve the cognitive function of patients with MCI, and has a certain lasting effect.

Objective To explore the influencing factors for poor prognosis in patients after perianal abscess surgery, and construct a quantitative risk evaluation model. Methods A total of 145 patients with perianal abscess who underwent surgical treatment in the 960th Hospital of PLA Joint Logistics Support Force from July 2022 to March 2024 were retrospectively selected and followed up for 6 months. The patients were divided into a good prognosis group (n=93) and a poor prognosis group (n=52). The clinical data of the two groups were compared, and the influencing factors for poor prognosis in patients after perianal abscess surgery was screened using multiple logistic regression analysis. Based on the results of multiple regression analysis, a Nomogram evaluation model was constructed using R software and rms package. Bootstrap method was used for internal validation, and calibration curves and receiver operating characteristic (ROC) curves were drawn to evaluate the predictive efficiency of the model. Results Multivariate Logistic analysis showed that body mass index (BMI) ≥ 28 kg/m², diabetes, deep abscess, horseshoe abscess and simple incision and drainage surgery were risk factors for the poor prognosis (P<0.05). Based on the results of multifactor analysis, a Nomogram evaluation model was constructed to evaluate the risk of poor prognosis in patients with perianal abscess surgery. After verification, its internal consistency index (C-index) was 0.884 (95% CI: 0.836~0.931), the calibration curve showed that calibration curve had good consistency with the ideal curve, and the ROC curve showed that the sensitivity, specificity and area under the curve of the model for predicting poor prognosis were 88.46%, 89.25% and 0.905 (95% CI: 0.851~0.959) respectively. Conclusions BMI ≥ 28 kg/m², diabetes, deep abscess, horseshoe abscess, and simple incision and drainage are all risk factors for poor prognosis in patients with perianal abscess, and the quantitative risk Nomogram evaluation model based on this analysis can effectively guide the early screening of high-risk patients with poor prognosis and timely formulate corresponding intervention strategies to improve prognosis.

Objective To investigate the variances in the effects of photobiomodulation therapy (PBM) with different wavelength lasers on chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Methods The second-generation BMSCs were used in the experiment, and laser irradiation treatment was initiated on the first day after passage at a close distance of 7 cm. The experiment was divided into four groups:a control group,a 660 nm group,an 810 nm group, and a 1064 nm group. The control group did not undergo photobiomodulation therapy. The single energy density of laser induction for each group was 4 J/cm2, and the irradiation duration was 15 minutes. After chondrogenic induction culture,the irradiation was repeated every 3 days for 21 days. Cell proliferation activity was evaluated by the CCK-8 method, and glycosaminoglycan (GAG) deposition was detected through toluidine blue staining. The transcription and protein expression levels of chondrogenic marker genes (Aggrecan, Col2A1, GAG) were analyzed by qRT-PCR and Western Blot,respectively. The cell proliferation activity, glycosaminoglycan (GAG) deposition, and the transcription and protein expression levels of chondrogenic marker genes (Aggrecan, Col2A1, GAG)in the three groups under the different wavelengths were compared. Results The CCK-8 results showed that compared with the control group,the proliferation rate of BMSCs under the three wavelengths of laser treatment significantly increased, among which the proliferation-promoting effect of the 1064 nm group was notably superior to that of the 660 nm and 810 nm groups (P＜0.05). The toluidine blue staining revealed that after photobiomodulation therapy,the extracellular matrix metachromatic area of BMSCs was significantly expanded compared to the control group,and the secretion of GAG in each group significantly increased. Compared with the control group, the protein expression levels of Aggrecan and Col2A1 in the photobiomodulation therapy groups were significantly elevated (P＜0.05), and the mRNA expression levels of Aggrecan, Col2A1, and GAG were significantly enhanced (P＜0.05), with the 1064 nm group demonstrating the most significant effect. Conclusions Specific wavelengths (especially 1064 nm) of PBM can significantly optimize the chondrogenic differentiation efficacy of BMSC,providing experimental basis for the optimization of cartilage regeneration strategies in tissue engineering.

Objective To explore the effects of physical exercise on serum uric acid metabolism and body composition of young adult males with hyperuricemia (HUA). Methods The physical examination data of 48 young adult males with HUA who underwent unified exercise in the spring of 2024 were sorted and analyzed. A retrospective analysis was conducted on monthly follow-up data, including serum uric acid levels, height, weight, waist circumference and hip circumference. Changes in uric acid, body mass index (BMI), and waist-to-hip ratio (WHR) during the 4-month period of physical exercise were compared, and the correlation analysis was performed between uric acid changes and changes in BMI and WHR. Results During the physical exercise period, serum uric acid levels significantly decreased compared to the baseline from the first month. (P＜0.05), with the most pronounced reduction at the 4-month mark. After 4 months, 29.17% of recruits achieved serum uric acid levels below 420 μmol/L, and 93.75% fell below 540 μmol/L. Both BMI and WHR showed significant reductions (P＜0.05). The reduction in uric acid levels was positively correlated with the decrease in WHR beginning at 2 months of exercise (P＜0.05), and began to be positively correlated with the decrease in BMI at 3 months of exercise (P＜0.05). Conclusions Physical exercise significantly improves serum uric acid levels, BMI, and WHR in young adult males with HUA, with a positive correlation observed between uric acid reduction and decreases in both BMI and WHR. Combining physical exercise with body fat and weight management can provide an effective health management strategy for the reduction of uric acid levels in young adult males with HUA.

Objective To explore the current status and the influencing factors of core competence of nurses in the context of outpatient medical institutions dispatched by military hospitals. Methods A survey was conducted on 140 nurses from 8 dispatched outpatient medical institutions in Beijing using a demographic data questionnaire, the Core Competence Scale for Chinese Registered Nurse and the General Self-Efficacy Scale. Results The total score of core competence of nurses was (152.66±42.86), with the average scores of the ethical and legal practice items being the highest, and the average scores of critical thinking and research items being the lowest. The total score of self-efficacy was (23.32±5.21), which was lower than the average level. Correlation analysis indicated that the highest educational level, professional title, family support, and passion level were positively correlated with nurses’ core competency scores(P＜0.05), while self-efficacy was negatively correlated with the scores (P＜0.05).Multiple linear regression analysis showed that the highest educational level (β=0.23),family support(β=0.34), passion level(β=0.22)and self-efficacy(β=-0.15) were important factors affecting core competence(P<0.05). Conclusions The core competence of nurses from the dispatched outpatient medical institutions is at a medium level and further improvement is needed, especially in the aspects of critical thinking, scientific research and clinical nursing. Management departments should establish standardized training and incentive mechanisms, improve the family support system, enhance the educational level of nurses and cultivate their passion for the nursing profession to improve the core competence.

Objective To explore the effect of infrared polarized light combined with corticosteroid injections on plantar fasciitis (PF). Methods The data of 110 patients with PF admitted to the Pain Management Department of Hainan Hospital of PLA General Hospital from October 2022 to October 2024 were retrospectively analyzed, and the patients were divided into two groups according to the treatment methods: the corticosteroid injection group (Group A) with 56 cases and the infrared polarization light irradiation combined with corticosteroid injection group (Group B) with 54 cases. The visual analogue scale (VAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS) of ankle-hindfoot function before treatment,1 month and 3 months after treatment were observed. Based on the AOFAS score at 3rd month after treatment, a regression model was established to analyze the influencing factors of the therapeutic effect. Results The two groups did not differ significantly in terms of age, gender, affected side unilateral or bilateral, disease duration, occurrence of heel spurs, pre-treatment VAS scores, or pre-treatment AOFAS ankle-hindfoot function scores (P>0.05). The VAS scores and AOFAS scores were significantly improved in both groups after treatment compared with those before treatment (P＜0.01). The VAS scores of Group B at 1st and 3rd month after treatment were noticeably lower than those of Group A (P=0.019, P＜0.01); the AOFAS scores of Group B at 1st month and 3rd month after treatment were noticeably higher than those of Group A (P=0.036,P=0.014). Regression analysis showed that the unilateral or bilateral of the affected foot (P=0.038), the presence or absence of bone spurs (P＜0.001), the pre-treatment VAS score(P=0.008), and the treatment method (P=0.01) might be the influencing factors of the therapeutic effect. Conclusions Compared with simple corticosteroid injection, infrared polarized light irradiation combined with corticosteroid injection has a more significant effect on PF, which can alleviate patients’ pain and has a significant effect on improving foot and ankle function.

Objective To explore the application and evaluation of HFMEA (healthcare failure mode and effect analysis) and decision tree model in the management of multidrug-resistant organism (MDRO) infection in medical institutions. Methods The HFMEA risk assessment method and decision tree analysis were used to screen out high-risk factors of MDRO infections in the Third People’s Hospital of Yancheng City of Jiangsu Province from June 2023 to December 2023. Targeted improvement intervention measures were adopted and rectification was implemented from January to June 2024, with a comparative analysis conducted to assess the effects before and after the interventions. Results Among the 48 failure modes, 7 high-risk modes that need improvement were selected for intervention. By comparing the MDRO management indicators before and after intervention, it was found that the comprehensive target assessment compliance rates of nosocomial infection before and after intervention were 81.6% and 92.1% respectively, with no statistically significant difference. After the intervention, the other 6 indicators: the awareness rate of the MDRO infection risk assessment system in the department, the execution rate of the MDRO risk assessment in the department, the effective isolation rate of MDRO-infected patients, the qualified rate of the training and examination of clinical physicians on antimicrobial drugs, the qualified rate of the review of antimicrobial drug prescriptions, and the deduction rate of the department for not implementing MDRO prevention and control measures were compared with those before the intervention, and the differences were statistically significant (P<0.05). Conclusions HFMEA and decision tree model as management tools are effective in evaluating the risk of MDRO infection in medical institutions, which can optimize the management process of MDRO, promote the improvement of management measures in departments such as medical care, nursing, and pharmacy, and effectively prevent the spread and outbreak of MDRO within hospitals.

Objective To investigate the current application status of nursing quality indicators in military hospitals, and provide references for the formulation of nursing quality indicators in military hospitals. Methods By using the judgment sampling method, 28 military hospitals from different regions and with various functional tasks were selected. The “Questionnaire on the Application Status of Nursing Quality Indicators in Military Hospitals” was distributed to collect data on nursing quality indicators. The form included general information about the hospital, the names, types, collection methods, and collection standards of the indicators. Results A total of 28 questionnaires were returned, and 509 indicators were collected. The correct reporting rate of structural indicators was 92.86%, for process indicators it was 99.62%, and for outcome indicators it was 89.57%. There were 146 nursing quality indicators, including 11 structural indicators (7.53%), 92 process indicators (63.02%), and 43 outcome indicators (29.45%). There were 3 indicators reflecting the characteristics of military nursing. The names, quantity and collection standards of the indicators applied by each military hospital varied greatly, lacking unified norms, military characteristics and information-based methods for collecting indicator data. Conclusions A standardized and unified nursing quality indicator system for military hospitals should be established, the connotation construction of the indictors should be deepened, and their military characteristics and the informatization construction of the indicator data collection should be strengthened.

Objective To investigate the characteristics of gastric emptying during the entire water drinking process for bowel preparation for colonoscopy in elderly patients. Methods A total of 108 elderly patients who underwent colonoscopy in two grade A hospitals in Beijing from April to September 2024 were selected. Gastric antral cross-sectional area (CSA) was measured via single-plane ultrasonography at fasting and after five water drinking intervals. Gastric emptying rate (GER) was calculated using a standardized formula. Results Ninety-nine elderly patients completed gastric antral ultrasonography monitoring. The first defecation occurred between the 1st and 4th water drinking intervals. The gastric antral CSA reached its peak (mean: 32.94 cm²-38.64 cm², equivalent to 500 ml-600 ml) immediately after the 3rd water intake. Post-defecation gastric emptying rates were significantly higher than pre-defecation rates (47.54%-55.09%, P< 0.05). Conclusions Gastric emptying is delayed during the early phase of water intake for bowel preparation in elderly patients but accelerates after the first defecation. Tailoring hydration strategies based on these gastric emptying characteristics may improve comfort and safety during bowel preparation.

Objective To explore the correlation between immune function, coagulation function indicators and spinal mobility in patients with ankylosing spondylitis (AS). Methods A total of 150 AS patients who visited Characteristics Medical Center of Chinese People’s Armed Police Force from November 2019 to November 2024 were selected and divided into an active stage group and a stable stage group according to Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The levels of indicators related with coagulation and fibrinolytic activity, platelet count (PLT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), factors related with thrombosis, Th17/Treg and related factors, and oxidative stress indicators were compared between the two groups. The correlations between BASDAI, Bath Ankylosing spondylitis Functional Index (BASFI) and the above indicators was analyzed. Results Compared with the stable stage group, the levels of fibrinogen (FIB), D-dimer, PLT, fibrin degradation products (FDP), thrombin A2 (TXA2), plasminogen activator inhibitor (PAI), ESR, CRP, Th17, Th17/Treg, interleukin (IL)-17, IL-23 and malondialdehyde (MDA)were higher in the active stage group, while the levels of activated partial thromboplastin time (APTT), prostacyclin (PGI2), Treg, IL-10, transforming growth factor -β (TGF-β), superoxide dismutase (SOD), and catalase (CAT) were lower (P<0.05); Correlation analysis showed that BASDAI and BASFI in AS patients were positively correlated with D-dimer, PLT, FDP, TXA₂, PAI, ESR, CRP, Th17, Th17/Treg, IL-17, IL-23, and MDA, and negatively correlated with APTT, PGI₂, Treg, IL-10, TGF-β, SOD and CAT (P<0.05). Conclusions The coagulation function, immune function and oxidative stress indicators in AS patients are closely related with the disease activity and spinal mobility.

Objective To evaluate the effect and predictive value of different insulin resistance replacement indices on the risk of gallbladder stones in healthy physical examination population. Methods A total of 8,833 individuals who underwent physical examination at the Physical Examination Center of Xiyuan Hospital of the China Academy of Traditional Chinese Medicine from January 2018 to December 2023 were selected as the research subjects, and a multivariate logistic regression model was used to explore the relationship between different insulin resistance replacement indices and the risk of gallbladder stone. A generalized additive model was used to test for the presence of nonlinear associations. The two-stage linear regression model was constructed and the turning points were calculated using the recursive algorithm, and subgroup analyses and interaction tests were also performed. In addition, the predictive value of different insulin resistance replacement indices for gallbladder stones was assessed using the receiver operating characteristic (ROC) curve. Results In the regression model adjusted for all confounding variables, the OR (95% CI) of the associations between riglyceride-glucose index (TyG), triglyceride-glucose-weight index (TyG-BMI) and insulin resistance metabolic score (METS-IR)(METS-IR) and gallbladder stones were 1.40 (1.18, 1.66), 1.01 (1.00, 1.01) and 1.04 (1.02, 1.05), respectively. There was nonlinear associations between TyG, TyG-BMI and METS-IR and gallbladder stones, with the turning points of TyG-BMI and METS-IR being 162.12 and 26.63, respectively. The associations between TyG, TyG-BMI and METS-IR and gallbladder stones were all interactive with age. The areas under the ROC curves were 0.60, 0.61, and 0.59, respectively. Conclusions The risk of gallbladder stones in adults increases with the increase of TyG, TyG-BMI and METS-IR indices, and TyG, TyG-BMI and METS-IR indices may have important predictive value for the risk of gallbladder stones.

无盂唇损伤冈盂切迹囊肿16例患者经关节镜下治疗,经盂唇裂口及肩胛冈入路(冈上肌和冈下肌间隙)完全切除囊肿,术后随访,MRI明确囊肿是否复发,使用肩关节功能评价量表评价恢复情况。结果表明,对于无盂唇损伤的冈盂切迹囊肿患者关节镜下切除可完全切除囊肿,创伤小、恢复快,可作为冈盂切迹囊肿的首选治疗方法。

Objective To investigate the correlation between hepatic extracellular volume fraction (fECV) derived from dual-layer detector spectral CT (DLCT) and the liver fat content (Fat%) measured by quantitative CT (QCT), and to verify the feasibility of using fECV to assess the stages of non-alcoholic fatty liver disease (NAFLD). Methods A total of 165 NAFLD patients (87 males and 78 females) in Hainan Hospital of PLA General Hospital from January 2022 to December 2024 were included and categorized into mild (<14% Fat%, 115 ROIs), moderate (14%-28% Fat%, 528 ROIs), and severe (≥28% Fat%, 347 ROIs) groups based on QCT measurement. fECV was obtained using DLCT (Philips IQon Spectral CT), and its diagnostic efficacy was evaluated via one-way ANOVA, Pearson correlation, and ROC curve. Results Significant negative correlations were observed between fECV and Fat% across all groups, with Fat% (0.10±0.04) and fECV(0.29±0.04) in the mild group, Fat%(0.21±0.08) and fECV(0.24±0.05) in the moderate group, Fat%(0.37±0.06) and fECV(0.14±0.06) in the severe group. The differences were statistically significant. Linear regression equation was Fat%=0.36-0.58×fECV (R²=0.668), indicating that for every 0.1 decrease in fECV, Fat% increased by 5.8%. ROC analysis showed that fECV had excellent diagnostic efficacy for moderate and above (AUC=0.873) and severe fatty liver (AUC=0.918), with a sensitivity>78% and specificity>81%. Conclusions The fECV derived from DLCT can be used as a reliable quantitative indicator for noninvasive staging of NAFLD, providing a new imaging strategy for clinical precision management.

Objective To analyze the clinical features of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and AECOPD complicated with bronchiectasis (BE) and to explore the value of platelet count in predicting AECOPD combined with BE (AECOPD-BE). Methods A retrospective analysis was conducted to collect the clinical data of AECOPD patients who visited Chongqing Municipal Corps Hospital of Chinese People’s Armed Police Force from 2021 to 2023. The patients with AECOPD were assigned to the control group (AECOPD group), while those with AECOPD-BE were assigned to the case group (AECOPD-BE group). The basic conditions and clinical indicators were compared between the two groups and the influencing factors of AECOPD combined with BE were analyzed. Results A total of 470 AECOPD patients were included and 59 patients (12.55%) had BE. The average platelet count of the AECOPD-BE group 228.00 (182.00, 279.00)]×10⁹/L] was significantly higher than that of the AECOPD group [197.00 (154.00, 237.75)×10⁹/L], and the difference was statistically significant (Z=-3.731, P<0.001). Multivariate logistic regression analysis revealed that elevated platelet count (OR=1.003, 95% CI: 1.001-1.006) was a risk factor for AECOPD-BE, with an area under the curve of 0.651 (P<0.05). Conclusions Elevated platelet count is a risk factor for AECOPD combined with BE, which has certain predictive value in AECOPD-BE patients.

Objective To analyze the endoscopic features of colorectal submucosal tumors(SMTs) and to explore the treatment strategies. Methods A total of 50 patients with SMTs who underwent endoscopic resection and were diagnosed by pathology and immunohistochemistry at Guangdong Provincial Corps Hospital of Chinese People’s Armed Police Forces from January 2018 to December 2022 were selected. All the patients were followed up and reexamined by colonoscopy three, six and twelve months after operation. Clinical symptoms, distribution of submucosal lesions in the colorectum, and endoscopic features of the patients were analyzed one by one, and the pathological results were summarized. Results Among the 50 cases, there were 22 cases of lipoma,8 cases of neuroendocrine tumors, and 20 cases of stromal tumors . Lipomas and stromal tumors were more commonly distributed in the colon, while neuroendocrine tumors were more common in the rectum and had the highest incidence of diarrhea. Forty cases of colorectal tumors were resected by endoscopic submucosal dissection (ESD), and 10 cases were resected by endoscopic mucosal resection (EMR). None of the patients had infection, delayed bleeding, or intestinal perforation after the operation. During the postoperative follow-up period of 6 to 20 months, there was no recurrence or metastasis in the patients. Conclusions SMTs present different features under endoscopic ultrasonography (EUS). EUS has an important guiding role on the differential diagnosis of SMTs and provides a safe and efficient strategy for endoscopic minimally invasive surgery.

Objective To explore the mechanism of Shaoma Zhijing granules (SMZJG) in treating tourette syndrome (TS) by using bioinformatics analysis methods. Methods Bioinformatics and molecular docking techniques were integrated to screen the active compounds and candidate targets, and the pathway enrichment analysis was performed to explain the mechanism of SMZJG against TS. Results A total of 92 pivotal targets were screened by bioinformatics analysis, suggesting their potential role in SMZJG’s therapeutic effect on TS. GO function analysis revealed that the therapeutic effect of SMZJG on TS was possibly associated with synaptic transmission and regulation of neuronal synaptic plasticity. KEGG analysis obtained multiple signaling pathways such as neuroactive ligand-receptor interaction, cAMP signaling pathway, and calcium signaling pathway. Molecular docking was carried out with 8 main active ingredients with corresponding TS-related targets. It was found that several ingredients, such as gastrodin, paeoniflorin and rhynchophylline, showed good affinity, suggesting a direct-action relationship with the known targets of TS. Conclusions Based on its pharmacological characteristics, SMZJG can exert a therapeutic effect on TS through the synergistic effect of multiple components and a complex network of interaction mechanisms among multi-targets and pathways.

Objective To explore the clinical efficacy of Er, Cr:YSGG laser combined with concentrated growth factor membrane in the treatment of peri-implantitis. Methods A total of 60 patients with peri-implantitis from the Department of Stomatology of Affiliated Hospital of Weifang Medical College between February 2021 and February 2024 were included in the study and randomly divided into an experimental group (n=30)and a control group (n=30). The control group received GBR surgery + Er,Cr:YSGG laser irradiation + collagen membrane, while the experimental group received GBR surgery+ Er,Cr:YSGG laser irradiation + CGF membrane. The total effective rate, PLI, SBI, PD, CAL, and changes in inflammatory factors IL-1β, IL-6, and MMP-8 in gingival crevicular fluid were compared between the two groups; the aesthetic indicators, implant stability, patient quality of life, and pain conditions of the dental area before and 3 months after treatment were compared between the two groups. Results After three months of treatment, the total effective rate of the experimental group (96.7%) was higher than that of the control group (80.0%) (P=0.04). Compared with baseline measurements, PLI, SBI, PD, CAL, and inflammatory factors in GCF decreased in both groups after treatment, with the experimental group showing a more pronounced reduction (P<0.05). Additionally, the aesthetic indicators, implant stability, quality of life, and pain scores improved in both groups compared to pre-treatment levels, with the experimental group demonstrating significantly greater improvements than the control group (P<0.05). Conclusions Er,Cr:YSGG laser combined with CGF membrane has better clinical efficacy for peri-implantitis, which can reduce inflammation and pain, and improve aesthetic effects.

Objective To analyze the efficiency and accuracy of tooth root movement during invisible bracketless orthodontic treatment for adults using three-dimensional (3d) digital technique. Methods A total of 86 patients who received orthodontic treatment at Characteristics Medical Center Affiliated to Military Medical University of PLA Air Force from February 2023 to February 2025 were selected and randomly divided into a control group and an experimental group, with 43 patients in each group. The control group received traditional invisible bracketless orthodontic treatment, while the experimental group received the traditional treatment combined with 3d digital technique. Before and after the treatment, periodontal indicators (GI, SBI, PLI, SPD), occlusal function indicators [bite force, chewing function score], inflammatory factors in gingival crevicular fluid (IL-1β, IL-6, TNF-α), oxidative stress indicators (SOD, MDA, ROS), and root movement rate and accuracy were recorded. Results Periodontal indicators of the experimental group: GI (0.66±0.31) vs. (0.90±0.21), SBI (0.15±0.07) vs. (0.46±0.25), PLI (1.09±0.69) vs. (2.12±0.85) were all lower than those of the control group, and SPD (3.18±1.22) mm vs. (2.59±1.13) mm was higher than that of the control group. Inflammatory and Oxidative Stress Levels: IL-1β,IL-6,TNF-α,MDA, and ROS were all lower than those of the control group, and the differences were statistically significant (P<0.05). Three-dimensional accuracy: deviations at crown top, root tip, and root depth decreased by 19.2%, 18.6%, and 20.0%, respectively, with angular deviation reduced by 19.6%.Functional recovery: bite force increased by 22.9%, and chewing function score improved by 29.1%. Antioxidant capacity: SOD activity rose by 25.8%. There was a significant directional difference in tooth root movement efficiency: mesiodistal(46.4%), buccal (50.0%), depressional (40.3%), lingual (38.8%), buccolingual (37.5%), and elongational (27.7%). mesiodistal (46.4%), buccal (50.0%), depressional (40.3%), lingual (38.8%), buccolingual (37.5%), and elongational (27.7%). Conclusions Three-dimensional digital technique can effectively improve the efficiency and accuracy of tooth root movement in the process of adult orthodontic invisible bracketless orthodontic treatment, and has clinical application value.