Objective To investigate the risk factors associated with helicobacter pylori (HP) eradication failure among active-duty military personnel and to construct a risk prediction model for HP eradication failure. Methods A prospective cohort study was conducted on 240 active-duty military personnel who were diagnosed with HP-related peptic ulcer and received standard bismuth-containing quadruple therapy at the Endoscopy Center of Hunan Provincial Corps Hospital of Chinese People’s Armed Police Force from June 2021 to June 2025, and the eradication effect was assessed at least 4 weeks after completion of therapy using the ¹³C/¹⁴C urea breath test. Demographic, clinical, lifestyle, and psychological behavior data were collected using structured questionnaires. Firth logistic regression analysis was used for univariate and multivariate analysis to screen independent risk factors for HP eradication failure and to construct a risk prediction model. Model discrimination was evaluated using the area under the receiver operating characteristic curve, and risk stratification was performed according to the tertiles of the risk scores. Results Of the 240 patients, 210 achieved HP eradication and 30 failed, with an overall eradication rate of 87.5%. Univariate Firth logistic regression analysis showed that age, body mass index, ulcer size, previous HP treatment history, medication adherence, alcohol consumption, training intensity, psychological stress, regularity of meals, and high-salt diet were significantly associated with the risk of HP eradication failure (P<0.05). Multivariate Firth logistic regression analysis identified previous HP treatment history (OR=4.99,95%CI:1.04-24.58,P=0.045), poor medication adherence (OR=6.69,95%CI:1.72~27.52,P=0.006),increased training intensity (OR=4.25, 95%CI:2.26~9.19,P<0.001),and elevated psychological stress scores (OR=7.65,95%CI:3.66~20.19,P<0.001) as independent risk factors for HP eradication failure. The risk prediction model based on the above factors achieved an AUC of 0.964, indicating its strong discriminative ability. After stratification based on tertiles of the risk scores, no eradication failure was observed in the low-risk group, while the failure rates were 4.4% in the medium-risk group and 36.4% in the high-risk group. Conclusions Previous HP treatment history, poor medication adherence, increased training intensity, and elevated psychological stress scores are independent risk factors for HP eradication failure among active-duty military personnel. The risk prediction model based on these factors demonstrates good discriminative ability and potential for risk stratification, which can provide reference for the early identification and individualized intervention of high-risk individuals.

Objective To observe the implementation of low-protein diet (LPD) in elderly male patients with chronic kidney disease (CKD) and to explore the influence of LPD compliance on their nutritional status and the progression of renal function. Methods A retrospective observation which was 15 months was conducted on the dietary protein control in 139 elderly male patients with CKD stage 3. To evaluate the compliance of patients with LPD, the daily protein intake (eDPI) was estimated based on 24-hour urine urea nitrogen (UUN), and the subjects were categorized into four groups based on eDPI and supplementation with or without α-ketoacids (KA): LPD group, non-protein-restriction group, LPD + KA group, and non-protein-restriction+KA group. The changes in the nutritional status, calcium-phosphate metabolism, and renal function progression were compared at the end of follow-up. Results A total of 126 subjects were included in the final analysis, and 46.8% (59/126) of them effectively adhered to LPD. After the follow-up, the serum albumin level in the LPD group was significantly lower than the baseline (P＜0.05), whereas the serum prealbumin and serum calcium levels in the two KA-supplemented groups were significantly higher than those in the two non-KA groups (P＜0.05). Notably, the LPD+KA group showed a slower decline in estimated glomerular filtration rate than the other three groups (P<0.05). Conclusions The compliance of the elderly male CKD patients with LPD is not high. LPD treatment alone may increase the risk of malnutrition in the elderly male patients, whereas supplementation with KA can maintain or even improve the nutritional status and blood calcium levels of CKD patients, and effectively delay CKD progression in this population.

Objective To investigate the relationship between the dual-modal imaging classification of chest X-ray and CT in children with mycoplasma pneumoniae(MPP) and their clinical features and prognosis. Methods A retrospective analysis was performed on 143 children with MPP who were admitted to Characteristics Medical Center of Chinese People’s Armed Police Force from January 1, 2023 to December 31, 2024. According to X-ray findings, the children were divided into bronchopneumonia type and consolidation/atelectasis type. Based on CT findings, they were classified into bronchopneumonia type, consolidation/atelectasis type, and bronchiolitis type. Clinical features, inflammatory indicators, and prognosis (including refractory MPP, necrotizing pneumonia, obliterative bronchiolitis, etc.) were compared among children with different imaging classifications. Results Among the 143 children, X-ray classification revealed 84 cases of bronchopneumonia type and 59 cases of consolidation/atelectasis type. CT classification identified 104 cases of consolidation/atelectasis type, 22 cases of bronchopneumonia type, and 17 cases of bronchiolitis type. In the X-ray imaging classification, compared with the bronchopneumonia type, children with consolidation/atelectasis type were older, had significantly higher levels of C-reactive protein, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, and D-dimer (all P<0.05), as well as higher incidence of refractory MPP, necrotizing pneumonia, and ICU admission, and longer hospital stay. Children with CT-defined bronchiolitis type had the highest prevalence of allergic disease history (29.41%) and rales (88.24%) among the three groups (all P<0.05), and this type was identified as a potential high-risk factor for obliterative bronchiolitis. Conclusions X-ray and CT imaging classifications of MPP are closely related to clinical features and prognosis. X-ray can serve as an initial screening tool to preliminarily predict disease severity, while CT can more accurately identify subtle lesions such as bronchiolitis, providing a more reliable basis for early intervention and early warning of long-term complications.

Objective To compare the clinical efficacy of fluticasone/umeclidinium/vilanterol(FF/UMEC/VI) inhalation powder and budesonide/glycopyrrolate/formoterol (BUD/GLY/FOR) inhalation aerosol in the treatment of severe chronic obstructive pulmonary disease (COPD) based on symptom scores and health status. Methods A total of 66 patients with severe COPD were retrospectively selected and divided into a FF/UMEC/VI group and a BUD/GLY/FOR group. The health status and symptom scores of the two groups were compared at 1 month of single inhaler triple therapy (SITT) drug use, and the short-term and long-term symptom changes of the FF/UMEC/VI group were retrospectively analyzed. Results The FF/UMEC/VI group had 35 patients, and the BUD/GLY/FOR group had 31 patients. Compared with before treatment, there was significant improvement in COPD assessment test (CAT) score, mMRC score, and 6MWT at 1 month of treatment in both groups, and the differences were statistically significant (P<0.05). Compared with the BUD/GLY/FOR group, the mMRC score (U=-2.277, P<0.05)and 6MWT (U=-3.993,P<0.05) of the FF/UMEC/VI group improved at 1 month of treatment, with statistically significant differences. In the FF/UMEC/VI group, the symptom score and health status improved more at 8 months of maintenance treatment than at 3 months, but the difference was not statistically significant. Conclusions At 1 month of treatment, FF/UMEC/VI inhalation powder is superior to BUD/GLY/FOR inhalation aerosol in improving the symptom scores and health status of the patients with severe COPD.

Objective To analyze the clinical features and risk factors of early postoperative infection in living kidney transplant recipients, and to provide basis for the prevention and control of perioperative infection. Methods A retrospective study was conducted on the baseline information and clinical data of the patients who underwent living kidney transplantation in Beijing Friendship Hospital Affiliated to Capital Medical University from January 2019 to October 2024. Univariate analysis and exploratory multivariate logistic regression analysis were used to identify risk factors of early postoperative infection. Results A total of 119 living kidney transplant recipients were included, among whom 22 received preoperative treatment with plasma exchange, rituximab, and/or eculizumab. Early postoperative infection occurred in 24 cases(20.17%), with urinary tract infection being the most common type(18/24, 75.00%). The predominant pathogens identified were enterococcus and enterobacter. Univariate analysis showed that the operation time was an influencing factor for early postoperative infection (OR=1.010, 95% CI: 1.002-1.018,P<0.05). Exploratory multivariate logistic regression analysis revealed that the operation time (OR=1.013, 95% CI: 1.003-1.023,P<0.05), diabetes mellitus (OR=19.040, 95% CI: 1.640-221.010,P<0.05), and methylprednisolone dose during induction immunotherapy (OR=1.172, 95% CI: 1.023-1.342,P<0.05) were related to early postoperative infection. Conclusions There is an infection risk after living kidney transplantation. Longer operation time, pre-existing diabetes mellitus, and a higher methylprednisolone dose during induction immunotherapy are associated with an increased risk of early postoperative infection.

Objective To systematically evaluate the effect of continuous intravenous application of lidocaine on the incidence of postoperative delirium. Methods Computerized searches were conducted in CNKI, Wanfang Data, PubMed, Embase, Cochrane Library, and the Chinese Medical Association Database, and the search period ended in December 2025. English search terms included “Lidocaine”, “Lidocaine Hydrocarbonate”, or “Xyloneural”, combined with “Postoperative delirium”, “delirium after surgery”, “delirium after surgical intervention”, or “delirium after surgical repair”, etc. A combination of subject terms and free-text words was used, supplemented by manual screening of the reference lists of included studies. Two researchers independently performed the literature screening, data extraction, and quality assessment. Statistical analysis was conducted using Review Manager 5.3 and Stata 16.0. Results A total of 6 randomized controlled trials were included, involving 530 patients. Meta-analysis showed that compared with the control group, the lidocaine group had a significantly lower incidence of postoperative delirium (RR=0.35, 95%CI: 0.24-0.52, P<0.001). Serum levels of IL-6 (MD=-13.94, 95%CI:-15.86 to -12.02, P<0.001) and TNF-α (MD=-11.00, 95%CI: -16.24 to -5.75, P<0.001) on postoperative day 1 were also significantly reduced. Conclusions Continuous perioperative intravenous administration of lidocaine can reduce the risk of postoperative delirium and decrease serum concentrations of IL-6 and TNF-α on postoperative day.

Objective To explore the differences in the prevalence of hypertension (HTN) between Tajik and Kyrgyz residents in Tashkurgan Tajik Autonomous County, Xinjiang, analyze the associated factors for HTN in the two ethnic groups in this area, and provide a scientific basis for formulating targeted HTN prevention and control strategies in border ethnic areas. Methods A total of 19785 Tajik and 605 Kyrgyz permanent residents who completed the annual physical examination in Tashkurgan County in 2024 were included as study participants. Baseline data, including demographic characteristics, lifestyle, past medical history and physical examination findings were collected. The differences in the prevalence of HTN and baseline data between the two ethnic groups were compared, and the independent risk factors for HTN were analyzed using a multivariable logistic regression model. Results The prevalence of HTN in the Tajik ethnic group was 22.4%, which was significantly higher than 17.4% in the Kyrgyz ethnic group (P=0.003). There were statistically significant differences between the two ethnic groups in age structure, occupational distribution, family history of HTN, smoking status, physical exercise participation rate and body mass index (BMI) classification (P<0.05). Multivariable logistic regression analysis showed that increased age (45-59 years and ≥60 years), engaging in agriculture, forestry, animal husbandry and fishery, having a family history of HTN, overweight and obesity by BMI, non-smoking, and Tajik ethnicity were independent risk factors for HTN in residents of this area (P<0.05). The negative correlation between smoking and HTN was caused by population selection bias under the special plateau environment, and it did not mean that smoking had a protective effect. Conclusion The risk of HTN in the Tajik ethnic group in Tashkurgan County is significantly higher than that in the Kyrgyz ethnic group. The occurrence of HTN is the result of the combined action of genetic factors and environmental factors such as the plateau environment, lifestyle and occupational characteristics. Targeting high-risk groups such as older adults and farmers and herdsmen, intervening in weight and improving lifestyle in combination with ethnic characteristics, and continuously promoting tobacco-control education are the key measures to reduce the risk of HTN in ethnic populations in this area.

Objective To investigate the diagnostic value of combined detection of monoclonal gastric cancer 7 antigen (MG7-Ag), gastrin-17 (G-17) and carbohydrate antigen 19-9 (CA19-9) for gastric cancer. Methods A retrospective analysis was conducted on 262 patients with gastric diseases admitted to Shuyang Hospital of traditional Chinese Medicine Affiliated to Medical College of Yangzhou University from January 1,2022 to January 1,2024, including 74 cases of chronic non-atrophic gastritis(28.25%), 62 cases of chronic atrophic gastritis(23.66%), 42 cases of gastric ulcer(16.03%), 43 cases of gastric intraepithelial neoplasia (16.41%), and 41 cases of gastric cancer(15.65%). Forty-one patients were randomly selected from each of the chronic non-atrophic gastritis, chronic atrophic gastritis, gastric intraepithelial neoplasia, and gastric cancer groups for further analysis. The differences in serum levels of MG7-Ag, G-17, and CA19-9 were illustrated. For different stages of disease progression, a binary logistic regression model was constructed for the combined diagnosis of the three indicators, and the predicted probability output by the model was used as the combined detection indicator. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of individual and combined detection. Results The levels of MG7-Ag, G-17, and CA19-9 were significantly higher in the gastric cancer group than those in the precancerous lesion group, and the differences were statistically significant (P<0.05). In gastric cancer diagnosis, the combined test achieved an AUC of 0.970, significantly higher than the single test of MG7-Ag (0.909), G-17 (0.680), and CA19-9 (0.852) (P<0.05), with optimal sensitivity (97.6%) and specificity (87.8%). In precancerous lesion stages (chronic atrophic gastritis and intraepithelial neoplasia), although combined detection did not significantly increase the AUC value, it improved the overall performance of sensitivity and specificity. Conclusions The combined detection of MG7-Ag, G-17, and CA19-9 has high value in the diagnosis of gastric cancer, and its diagnostic efficacy is superior to that of individual indicators.

Objective To explore the clinical efficacy of thoracoscopic-assisted internal fixation for multiple rib fractures and its influence on enhanced recovery. Methods The clinical data of 120 patients with multiple rib fractures admitted to Coast Guard Hospital of Chinese People’s Armed Police Force from January 2020 to December 2024 were retrospectively analyzed. According to different surgical methods, the patients were divided into a thoracoscopic group (n=60) and a traditional thoracotomy group (n=60). The surgical indicators, postoperative recovery, pain score (VAS), complications, and quality of life (SF-36 score) were compared between the two groups. Results The thoracoscopic group showed significantly better outcomes in operation time[(65.2±8.5) min vs. (85.3±10.2 )min], intraoperative blood loss[(95.6±30.1) ml vs. (142.7±45.3 )ml], and incision length[(3.2±0.8 )cm vs. (16.5±2.1 )cm], with statistically significant differences (P<0.05).The postoperative VAS scores, time to ambulation, hospital stay, and recovery time of lung function of the thoracoscopic group were significantly lower or shorter than those of the traditional thoracotomy group, with statistically significant differences (P<0.05). The complication rate of the thoracoscopic group was 6.7%, significantly lower than 22.3% of the traditional thoracotomy group, with statistically significant difference (P<0.05). Conclusions Thoracoscopic-assisted internal fixation surgery is minimally invasive, promotes fast recovery, and significantly improves the prognosis of patients, which conforms to the enhanced recovery concept and is worthy of promotion.