Abstract:Objective: To explore the effect of propofol on cognitive dysfunction and cGAS/STING signaling pathway in rats with tibial fractures undergoing open reduction. Methods: 90 rats were randomly divided into control group, model group, 2'3'-cGAMP group, propofol group, and propofol + 2'3'-cGAMP group, with 18 rats in each group. Except for the control group, all other groups underwent open reduction and internal fixation surgery for tibial fractures during anaesthesia. At 7 d postoperatively, the recognition and memory function were evaluated through the Y Maze and new object recognition tests, the neuronal damage in CA1 region of hippocampus was evaluated through the Nissl staining, the IL-18, TNF-α and IL-1β levels in the hippocampal tissue were detected through the ELISA method, the choline acetyltransferase (ChAT) and γ-aminobutyric acid receptor Aα1 (GABAARα1) mRNA level in hippocampal tissue were detected through the RT-qPCR method, the cGAS (cyclic GMP-AMP synthetase), IRF (interferon regulatory factor) 3, p-IRF3, STING (stimulator of interferon genes), nuclear factor-κB (NF-κB) p65 and p-NF-κB p65 protein level in hippocampal tissue were detected through the Western blot method. Results: Compared with the control group, the model group rats exhibited decreased cognitive and memory abilities, along with a marked reduction in the number of neurons in the CA1 region of the hippocampal tissue, as well as decreased relative expression levels of ChAT and GABAARα1 mRNA. Additionally, there were increased levels of IL-18, IL-1β, TNF-α, and 2'3'-cGAMP, the relative expression levels of cGAS and STING proteins, and the ratios of p-IRF3/IRF3 and p-NF-κB p65/NF-κB p65 (P < 0.05). Compared with the model group, the 2'3'-cGAMP group rats also displayed decreased cognitive and memory abilities, a marked reduction in the number of neurons in the CA1 region of the hippocampal tissue, and decreased relative expression levels of ChAT and GABAARα1 mRNA. Furthermore, there were increased levels of IL-18, IL-1β, TNF-α, and 2'3'-cGAMP, the relative expression levels of cGAS and STING proteins, and the ratios of p-IRF3/IRF3 and p-NF-κB p65/NF-κB p65 (P < 0.05). The above-mentioned indicators showed improvement in the propofol group, while 2'3'-cGAMP partially reversed the ameliorative effects of propofol. Conclusion: In rats after tibial fracture open reduction, propofol can improve cognitive function by inhibiting the activation of cGAS/STING signaling pathway for anti-inflammatory and nerve protection. 如需进一步润色、翻译或格式化为学术论文段落，也可以告诉我！

Abstract:Objective: To investigate the expression and clinical significance of telomere repeat binding factor 2 (TRF2) in gastric cancer. Methods: UALCAN was used to analyze the expression of TRF2 in gastric cancer patients. Clinical patient samples were used to verify their protein expression levels by immunohistochemistry. Kaplan-Meier methods were used to analyze the relationship between overall survival rate and clinical features of GC patients. TIMER was used to analyze immune infiltration in gastric cancer patients. Various online analysis tools were used to explore the potential relationship between TRF2 and gastric cancer, and CTD and SymMap databases were used to screen candidates for drugs targeting TRF2 gene. Results: The expression level of TRF2 in GC patients was higher than that in normal subjects (P < 0.05). Patients with high TRF2 expression in gastric cancer had a poorer prognosis (P < 0.05). TRF2 expression was correlated with methylation, gene mutations, immune cell abundance, and expression of immune markers in gastric cancer (P < 0.05). The expression level of TRF2 was positively correlated with the patient’s age, gender, race, tumor stage, tissue typing, and body weight (P < 0.05). TRF2-related gene enrichment analysis showed that these genes were mainly concentrated in focal adhesion, calcium signaling pathway, purine metabolism, thyroid hormone signaling pathway, FoxO signaling pathway, and so on. Small molecule drugs such as aristolochic acid I, arsenic, and β-methylcholine, and traditional Chinese medicines such as Szechwan Chiberry Fruit and root of Common Monkshood may have potential value in the treatment of gastric cancer. Conclusion: TRF2 is highly expressed in gastric cancer and is associated with poor prognosis, and participates in the regulation of a variety of biological functions of gastric cancer. Small molecule drugs represented by aristolochic acid I and arsenic, and traditional Chinese medicine represented by Szechwan Chiberry Fruit and root of Common Monkshood may be potential targeted drugs for the treatment of gastric cancer.

Abstract:Objective: To investigate the association between ARID1A protein loss and histological differentiation as well as lymph node metastasis in gastric adenocarcinoma, and to further analyze its potential clinicopathological significance.Methods: A retrospective analysis was conducted on 96 patients with gastric adenocarcinoma who underwent radical gastrectomy. All cases had preserved formalin-fixed paraffin-embedded (FFPE) tissue specimens and complete clinicopathological data. Hematoxylin-eosin (HE) staining was performed to evaluate histological differentiation, Lauren classification, lymph node metastasis, lymphovascular invasion (LVI), perineural invasion (PNI), and depth of invasion (pT stage). Immunohistochemistry (IHC) was used to assess ARID1A protein expression, with complete nuclear absence of staining defined as “loss of expression.” Clinicopathological parameters including age, sex, tumor location, Epstein-Barr virus (EBV) status, and microsatellite instability (MSI) status were also collected. The relationships between ARID1A loss and clinicopathological characteristics were analyzed, and multivariate logistic regression was applied to determine independent risk factors for lymph node metastasis.Results: Among the 96 patients, the rate of ARID1A protein loss was 35.4% (34/96). Univariate analysis showed that ARID1A deficiency was correlated with histological differentiation, Lauren classification, lymph node metastasis, pT stage, and EBV status (P < 0.05), but not with sex, age, LVI, PNI, or MSI status (P > 0.05). Multivariate logistic regression analysis demonstrated that pT stage (HR = 2.631, 95% CI: 1.122–6.169, P = 0.026) was an independent risk factor for lymph node metastasis, whereas ARID1A loss did not emerge as an independent factor.Conclusion: Loss of ARID1A expression is correlated with adverse pathological features of gastric adenocarcinoma, including poor differentiation, diffuse Lauren type, and lymph node metastasis, but is not confirmed as an independent risk factor for nodal metastasis. These findings suggest that ARID1A may indirectly contribute to tumor dissemination through its impact on differentiation and invasion depth. ARID1A loss may serve as a potential biomarker for molecular stratification and prognostic evaluation in gastric adenocarcinoma.

Abstract:Objective: To explore Professor Ma Junrong??s medication rules and mechanism in the treatment of children with tic disorder based on data mining and network pharmacology. Methods: Collected the case data of Professor Ma Junrong??s treatment of children with tic disorder in the pediatric outpatient department of the Southwest Medical University Affiliated Traditional Chinese Medicine Hospital from January 2018 to December 2022, and use software such as Microsoft Office Excel 2021, SPSS Modeler 18.0, SPSS Statistics 29.0 to perform frequency analysis of traditional Chinese medicine, analysis of traditional Chinese medicine attributes, association rule analysis, clustering analysis, and data visualization. According to the results, network pharmacological analysis was conducted, and the core TCM active ingredients and disease-related targets were screened using databases such as TCMSP, Batman-TCM, GeneCards, OMIM, and TTD. The network diagram of TCM-Active ingredient-Core target and protein interaction was constructed by using STRING database and Cytoscape 3.9.1 software. Perform GO function and KEGG pathway enrichment analysis on intersection targets using the Metascape database. AutoDock Vina 1.1.2 software was used for molecular docking of the main active ingredients and core targets, and finally PyMOL 2.4 software was used for visualization processing. Results: A total of 1,095 traditional Chinese medicine prescriptions were collected, involving 161 types of traditional Chinese medicine. The drug properties were primarily warm, with flavors often seen as spicy, bitter, and sweet. The channels of entry were mainly the Ganjing and Pijing. The efficacy categories were primarily composed of Pingganxifengyao, Buxuyao, Jiebiaoyao. 216 pairs of drug combinations were obtained through association rule analysis, and 4 core drug combinations were obtained through cluster analysis. The main effects were Bupirougan, Pingganxifen, Shuganqingre, Ziyinhuoxue. The top 8 traditional Chinese medicines with the highest frequency of use were Zhigancao, Quanxie, Chaihu, Wugong, Yujin, Shenjincao, Gouteng, Baishao. A total of 148 core active ingredients and 1,539 targets were selected, with 2,472 disease targets and 396 intersection targets. GO functional enrichment analysis revealed 1,199 biological processes, 171 cellular compositions, 237 molecular functions, and 170 KEGG pathways. The main active components of core drugs, such as Nootkatone, Carvone and Pulegone, may regulate several signaling pathways such as Neuroactive ligand-receptor interaction, cAMP and Dopaminergic synapse by acting on core targets such as BDNF, AKT1 and ALB, and play a role in the treatment of tic disorders in children. The results of molecular docking showed that the main active ingredients had strong binding activity with the core target. Conclusion: Professor Ma Junrong believes that children??s tic disorders belong to the original deficiency (spleen deficiency) and the standard (liver prosperity), which should be “treated from the spleen”, guided by the “spleen and liver leveling method”, treating both the symptoms and the root causes, and using the essence of medicine, so as to provide valuable experience and ideas for the medical staff in southern Sichuan to treat children??s tic disorders.

Abstract:Objective: To investigate the effects of lacrimal duct recanalization tube implantation in combination with triamcinolone acetonide injection on the local stress response and both short-term and long-term prognosis in patients with refractory lacrimal duct obstruction. Methods: A total of 120 patients with refractory lacrimal duct obstruction were recruited and divided into two groups according to different treatment methods: the control group, which received conventional lacrimal duct recanalization tube implantation, and the study group, which underwent lacrimal duct recanalization tube implantation combined with triamcinolone acetonide injection, with 60 cases in each group. The total therapeutic effect, efficacy-related indicators, local stress response, incidence of complications, as well as short-term and long-term prognoses were compared between the two groups. Results: The total therapeutic efficacy rate of the study group was 96.67%, which was higher than the 83.33% of the control group (P < 0.05). Patients in the study group exhibited lower Visual Analogue Scale (VAS) scores at 24 hours postoperatively, reduced incidence of local edema, shorter duration of pain, and earlier discharge time than the control group (P < 0.05). Additionally, tear secretion test results were higher in the study group (P < 0.05). At 1 week post-surgery, tear levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and substance P were reduced compared to preoperative levels in both groups (P < 0.05), and the study group was lower than the control group (P < 0.05). Within 30 days postoperatively, the complication rate in the study group was lower than that in the control group (6.67% vs. 21.67%, P < 0.05). 6 months post-operation, the incidence and recurrence rate of related adverse events in the study group were 5.00% and 3.33%, respectively, which did not differ significantly from the control group values of 16.67% and 10.00% (P > 0.05). At 12 months post-operation, the incidence of related adverse events and the recurrence rate in the study group were 11.67% and 8.33%, respectively, both of which were lower than 30.00% and 25.00% in the control group (P < 0.05). Conclusion: The combination of lacrimal duct recanalization tube implantation with triamcinolone acetonide injection demonstrates significant efficacy in alleviating local stress responses, minimizing postoperative complications, and reducing the long-term recurrence risk. This approach represents a safe and efficient therapeutic option for patients suffering from refractory lacrimal duct obstruction.

Abstract:Objective: To explore the value of gastric filling ultrasound in the quantitative assessment of gastric motility in perimenopausal women, and to identify potential factors affecting gastric emptying function during this stage. Methods: A total of 82 healthy women aged 45～55 were enrolled and divided into three groups based on the modified Kupperman score: normal group (n=14), mild symptom group (n=46), and moderate symptom group (n=22). Gastric motility and emptying parameters were measured and compared among the three groups. Correlations between various symptoms and gastric function parameters were analyzed, and factors influencing gastric emptying function were evaluated. Results: There were statistically significant differences among the three groups in terms of gastric wall thickening rate and gastric emptying rate at various time points (P<0.05). Correlation analysis showed that sensory disturbances, insomnia, dizziness, headache, and palpitations were negatively correlated with the gastric wall thickening rate (P<0.05). Depression, insomnia, anxiety, osteoarticular pain, and headache were negatively correlated with the gastric emptying rate (P<0.05). Multiple linear regression analysis revealed that depression and insomnia were factors affecting gastric emptying function in perimenopausal women, with depression being the primary factor. Conclusion: Women with more pronounced perimenopausal symptoms exhibit significantly reduced gastric emptying function, with depression being the main influencing factor. gastric filling ultrasound is a real-time, non-invasive, and quantitative method for assessing gastric motility in perimenopausal women. For women in this stage, timely psychological counseling and improvements in sleep quality should be key measures to improve gastrointestinal function.

Abstract:Objective: To explore the diagnostic value of metagenomic next-generation sequencing (mNGS) on patients with suspected pulmonary tuberculosis accompanied by atypical imaging manifestations and the value in identifying mixed infection. Methods: The data of 200 patients with atypical CT features and negative sputum smear in the hospital from July 2024 to June 2025 were selected for retrospective analysis. According to the final diagnosis, the patients were categorized into pulmonary tuberculosis group (n=124) and non-pulmonary tuberculosis group (n=76). The diagnostic efficiency of bronchoalveolar lavage fluid mNGS, sputum culture and CT features on pulmonary tuberculosis was compared, and the detection rates of pulmonary tuberculosis mixed infection and non-tuberculosis pathogens by mNGS were analyzed. Results: There were no significant differences in hemoptysis/blood sputum, cough, fever, night sweats and weight loss between the pulmonary tuberculosis group and the non-pulmonary tuberculosis group (P>0.05). The incidence rate of localized lesions in the basal segment of the middle and lower lobes, simple miliary nodules and thin-walled cavity in the pulmonary tuberculosis group were higher than those in the non-pulmonary tuberculosis group (P<0.05) while the incidence rates of unilateral pleural effusion with pleural thickening and ground-glass opacity with air bronchogram were lower (P<0.05). The sensitivity, specificity and accuracy rate of mNGS in the diagnosis of pulmonary tuberculosis were 71.77%, 94.74% and 80.50%, respectively, and the consistency Kappa value with the final diagnosis was 0.616. In the pulmonary tuberculosis group, 31 cases of mixed infection were detected, with a detection rate of 25.00%. In the non-pulmonary tuberculosis group, mNGS identified pathogens in 50 cases, with a detection rate of 65.79%. Conclusion: Bronchoalveolar lavage fluid mNGS can improve the diagnostic specificity of atypical pulmonary tuberculosis, and efficiently identify mixed infection and pathogens such as non-tuberculous mycobacteria, providing a basis for accurate anti-infection.

Abstract:Objective: To explore the diagnostic effectiveness and significance of the pediatric early warning score (PEWS), in conjunction with immunoglobulin levels (IgA, IgG, IgM), in critically ill pediatric patients diagnosed with hand-foot-and-mouth disease (HFMD). Methods: A retrospective analysis was conducted on 61 children with confirmed HFMD, and they were divided into two groups: a mild case group (n=31) and a critically ill case group (n=30), based on disease severity. PEWS scores were assigned, and serum levels of IgG, IgA, and IgM were measured for all participants. The difference of immunoglobulin levels between mild and critical children were compared, and the efficacy of separate and combined tests of PEWS and immunoglobulin levels in the diagnosis of HFMD children were analyzed by ROC curve. Results: At the time of enrollment, the consciousness, cardiovascular system, respiratory system and the total score of PEWS in the critical ill case group were higher than those in the mild case group (P<0.05). The levels of serum IgG and IgA in critical ill case group were lower than those in mild case group (P<0.05), and the level of serum IgM was higher than that in mild case group (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of PEWS score, IgG, IgA, IgM, and their combined diagnosis in HFMD children were 0.735, 0.684, 0.647, 0.908, and 0.927, respectively, with the highest AUC observed in the combined detection (P<0.05). Conclusion: The PEWS score and immunoglobulin IgG, IgA and IgM levels in HFMD children changed significantly, which are closely related to the severity of the disease. Joint monitoring of PEWS score and immunoglobulin level is helpful to predict the severity of HFMD children.

Abstract:Objective: To explore the curative effect of negative pressure ureteral access sheath (NPUAS) in patients with different compositions of upper urinary tract calculi. Methods: A total of 124 patients with upper urinary tract calculi who underwent NPUAS + flexible ureteral lithotripsy (FURL) were retrospectively enrolled. According to the different stone compositions, they were divided into calcium oxalate stone group (COS group, n=53), uric acid stone group (UAS group, n=32) and calcium phosphate stone group (CPS group, n=39). The perioperative indexes, postoperative pain, laboratory indexes and safety were compared among the three groups. Results: The primary clearance rate of stones, levels of hemoglobin (Hb) and creatinine (SCr) in UAS group were higher than those in COS group and CPS group (P<0.05), the total intraoperative laser energy, peak of negative pressure suction, peak pressure of renal pelvis, use rate of lithotomy basket, operation time, length of hospital stay, score of visual analogue scale (VAS), levels of white blood cell (WBC), C-reactive protein (CRP) and urine leukocyte (LEU) were lower than those in COS group and CPS group (P<0.05). There was no significant difference in secondary operation rate or incidence of complications among the three groups (P>0.05). Conclusion: The curative effect and safety of NPUAS + FURL are good in patients with different compositions of upper urinary tract calculi. However, the effect is better in those with relatively softer uric acid calculi.

Abstract:Objective: To explore the efficacy and safety on upper gastrointestinal submucosal tumors treated by endoscopic submucosal excavation (ESE), endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Methods: A retrospective analysis was conducted on 307 patients with upper gastrointestinal submucosal tumors. Patients treated with ESE, EMR, and ESD were included in ESE group (n=98), EMR group (n=105) and ESD group (n=104) respectively. Perioperative indicators, efficacy, gastric function and postoperative complications were compared among the three groups. Results: The surgical time in EMR group was shorter than that in ESE and ESD groups (P<0.05), and the surgical time was shorter in ESE group than that in ESD group (P<0.05), and the hospitalization time was shorter in ESE and EMR groups (P<0.05). The tumor complete resection rate, first exhaust time, first defecation time, pepsinogen I, pepsinogen II, and gastrin-17 revealed no statistical differences among the three groups (P>0.05). The recurrence rate in ESE group was lower compared to EMR group (P<0.05). The incidence rates of postoperative complications in EMR group were lower than those in ESE group and ESD group (P<0.05). Conclusion: ESE, EMR and ESD are effective in the treatment of upper gastrointestinal submucosal tumors. EMR has faster postoperative recovery, fewer complications but higher recurrence rate, and it is recommended for submucosal tumors. ESE achieves complete resection and safety, and is suitable for tumors involving the deep or shallow muscular layer of the submucosa. ESD can reduce the risks of residual and recurrence of deep muscle layer or muscularis propria tumors.

Abstract:Objective: To investigate the effect of early plasma exchange (PE) combined with continuous veno-venous hemofiltration (CVVH) on vasoactive-inotropic score and inflammatory markers in children with septic shock. Methods: A retrospective analysis was conducted on the clinical data of 229 children with septic shock. Based on the treatment methods, and on the basis of standard septic shock treatment, 112 children treated with CVVH were included in the control group, and 117 children treated with early PE combined with CVVH were included in the combined group. The shock correction time, hemodynamic indicators [mean arterial pressure (MAP), capillary refill time (CRT)], vasoactive-inotropic score, lactate clearance rate, pediatric Sequential Organ Failure Assessment (pSOFA) score, inflammatory factors [serum C-reactive protein (CRP), procalcitonin (PCT)], incidence of adverse events, and hospitalization and prognosis indicators were compared between the two groups. Results: The shock correction time in the combined group was shorter than that in the control group (P<0.05), the MAP level after 72 h of treatment in the combined group was higher than that in the control group, and the improvement in CRT was better than that in the control group (P<0.05). The vasoactive-inotropic score at 6, 12, 24, 48, 72 h, and 7 d after treatment in the combined group was lower than that in the control group (P<0.05), the lactate clearance rate at 6, 24, and 72 h after treatment in the combined group was higher than that in the control group (P<0.05), the pSOFA score at 24, 48, 72 h, and 7 d after treatment in the combined group was lower than that in the control group (P<0.05), the serum inflammatory indicators PCT and CRP levels after 72 h of treatment in the combined group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse events and 28-day mortality between the two groups during treatment (P>0.05). The PICU hospitalization time and total hospitalization time in the combined group were shorter than those in the control group (P<0.05). Conclusion: Early PE combined with CVVH in the treatment of children with septic shock can shorten the shock correction time, improve hemodynamic status, reduce vasoactive drug dependence, reduce the body’s inflammatory response, and shorten the length of hospital stay without increasing the risk of adverse events.

Abstract:Objective: To analyze the clinical efficacy of ultrasound-guided acupotomy and injection therapy in the treatment of adult carpal tunnel syndrome (CTS). Methods: 210 patients with CTS were divided into T1 group (short-axis out-of-plane guidance group), T2 group (long-axis in-plane guidance group) and D group (injection therapy group) according to different treatment regimens, with 70 cases in each group. T1 group was treated with short-axis ultrasound-guided out-of-plane guided acupotomy, and T2 group was given long-axis ultrasound-guided in-plane guided acupotomy, and D group received ultrasound-guided injection therapy. The VAS score of finger movement before treatment, immediately after treatment and at 1 week, 1 month and 3 months after treatment, wrist function [Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS), Boston Carpal Tunnel Questionnaire Functional Status Scale (BCTQ-FSS)] before treatment and at 1 week, 1 month and 3 months after treatment and median nerve sensory conduction parameters were recorded in the three groups. The clinical efficacy was compared among the three groups of CTS patients. Results: The VAS score in the three groups of CTS patients immediately after treatment and at 1 week, 1 month and 3 months after treatment was lower than that before treatment (P<0.05), and the score in T2 group was lower than that in T1 group and D group (P<0.05), and was lower in T1 group than that in D group (P<0.05). The BCTQ-SSS score and BCTQ-FSS score in the three groups of CTS patients were lower at 1 week, 1 month and 3 months after treatment than those before treatment (P<0.05), and the scores in T2 group were lower than those in T1 group and D group (P<0.05), and the scores in T1 group were lower than those in D group (P<0.05). The cross-sectional areas of the median nerve at both the outlet and entrance of the carpal tunnel, as well as the thickness of the transverse carpal ligament at these respective locations, along with the flat rate of the hamate bone hook plane in all three groups were observed to be lower at 3 months post-treatment compared to their measurements prior to treatment (P<0.05), and the above indicators in T2 group were lower than those in T1 group and D group (P<0.05), and were lower in T1 group than those in D group (P<0.05). Compared to D group, both T1 and T2 groups showed a significantly greater percentage of excellent and good results (P<0.05). Nevertheless, the difference between T1 group and T2 group revealed no statistical significance (P>0.05). Conclusion: Compared with ultrasound-guided injection therapy, ultrasound-guided acupotomy for adult CTS can more effectively alleviate the pain, improve the wrist function, and relieve the median nerve compression. The effect of long-axis ultrasound-guided in-plane guided acupotomy therapy is better than that of short-axis ultrasound-guided out-of-plane guided acupotomy therapy.

Abstract:Objective: To investigate the relationship between serum Serine protease inhibitor A3 (Serpina3) levels, Intravenous immunoglobulin (IVIG) responsiveness, and oxidative stress in children with Kawasaki disease (KD). Methods: This study enrolled 181 KD patients treated between January 2023 and December 2024. According to the IVIG treatment response, they were divided into a IVIG-responsive group (n=154) and an IVIG-resistant group (n=27). Generalized linear mixed models (GLMMs) were used to analyze associations between Serpina3, oxidative stress markers, and IVIG resistance. Receiver operating characteristic (ROC) curves evaluated predictive value, restricted cubic spline (RCS) analysis assessed dose-response relationships, and Bootstrap mediation analysis examined oxidative stress’s mediating role. Results: The IVIG-responsive group showed significantly higher SOD and GSH-Px levels but lower Serpina3 and MDA levels compared to the resistant group (P<0.05). GLMMs revealed that elevated Serpina3 and MDA levels, as well as reduced SOD and GSH-Px levels, increased IVIG resistance risk (P<0.05). RCS analysis demonstrated nonlinear dose-response relationships between these markers and IVIG resistance. Mediation analysis indicated that Serpina3 directly predicted IVIG resistance while exerting an indirect effect through oxidative stress. Conclusion: Serum Serpina3 may serve as a potential biomarker for predicting IVIG treatment response and influence therapeutic sensitivity by modulating oxidative stress pathways, offering novel insights for clinical intervention strategies.

Abstract:Objective: To explore the relationship between mechanical parameters of meniscus protrusion, inflammatory factors in knee joint effusion and knee cartilage degeneration. Methods: A total of 60 patients with meniscus protrusion and cartilage degeneration (degeneration group) and 60 patients only with meniscus protrusion (control group) in the hospital were enrolled. The displacement of meniscus protrusion and width of joint space were quantified by MRI. The levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-3 (MMP-3) in knee joint effusion were detected by enzyme-linked immunosorbent assay. The influencing factors of cartilage degeneration were analyzed by Logistic regression analysis, and their predictive value in cartilage degeneration was evaluated by receiver operating characteristic (ROC) curves. Results: The average length of meniscus protrusion, width of joint space, levels of IL-1β, TNF-α and MMP-3 in knee joint effusion in degeneration group were higher than those in control group (P<0.05). Logistic regression analysis showed that the increased protrusion displacement and IL-1β were independent predictors of cartilage degeneration (P<0.05). ROC curves analysis showed that area under the curve (AUC) and sensitivity of increased displacement of meniscus protrusion and IL-1β for predicting cartilage degeneration respectively were (0.869, 0.821) and (88.33%, 83.33%), respectively. The AUC for predicting cartilage degeneration with the combination of the two was 0.909, with a sensitivity of 90.00%, indicating good predictive performance (P<0.05). Conclusion: The increased displacement of meniscus protrusion and IL-1β in knee joint effusion are important early warning indexes of knee cartilage degeneration. The combined detection is of significant clinical value for the early identification of high-risk patients.

Abstract:Objective: To compare the differences in gestational complications, adverse pregnancy outcomes, and soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PLGF) levels between singleton pregnancies conceived via assisted reproductive technology (ART) and natural conception. Methods: This prospective study enrolled 547 pregnant women with clinical singleton pregnancies achieved through ART as the ART group (n=547). Based on baseline balance principles, 1,094 naturally conceived singleton pregnant women registered at our hospital’s obstetrics department during the same period were matched at a 1∶2 ratio as the control group (n=1,094). The gestational complications, pregnancy outcomes, and the sFlt-1/PLGF ratio were compared between the two groups. Results: The incidence of gestational diabetes mellitus, gestational hypertension, preeclampsia, postpartum hemorrhage, and fetal distress in the ART group were higher than those in the control group (P<0.05). The rates of cesarean section, fetal growth restriction, preterm birth, and low birth weight were higher in the ART group (P<0.05). Serum PLGF levels were lower, while sFlt-1 levels and the sFlt-1/PLGF ratio were higher in the ART group compared to the control group (P<0.05). Conclusion: Singleton pregnancies conceived through ART demonstrate higher risks of gestational complications and adverse outcomes compared to naturally conceived pregnancies, necessitating tailored management spanning pre-conception, prenatal, and postnatal stages to optimize maternal and neonatal outcomes.

Abstract:Objective: To investigate the effect of nutritional status grading intervention combined with multimodal supervised exercise training in elderly patients with ischemic stroke and frailty. Methods: 92 elderly patients with ischemic stroke and frailty were enrolled and divided into a control group and a combination group according to different intervention methods, with 46 patients in each group. The control group received routine nursing intervention, while the combination group received nutritional status grading intervention combined with multimodal supervised exercise training. The intervention lasted for 8 weeks. Frailty degree, nutritional status, kinesiophobia, and motor function were compared between the two groups of patients. Results: After 8 weeks of intervention, the physical, psychological, social dimension scores, and the total score of the Tilburg Frailty Indicator (TFI) in the combination group were lower than those in the control group (P<0.05). The levels of serum albumin (Alb), prealbumin (PA), hemoglobin (Hb), and transferrin (TF) in the combination group were higher than those in the control group (P<0.05). The scores for the kinesiophobia, activity avoidance, functional disorder, and risk perception dimensions of the Chinese version of the Tampa Scale for Kinesiophobia (TSK) in the combination group were lower than those in the control group (P<0.05). The Berg Balance Scale (BBS) score and the number of 30-second sit-to-stand test (CST) repetitions of both groups of patients were higher than before intervention (P<0.05), and the combination group was higher than the control group (P<0.05). The Timed Up and Go Test (TUGT) completion time was shorter than before intervention (P<0.05), and the combination group was shorter than the control group (P<0.05). Conclusion: Nutritional status grading intervention combined with multimodal supervised exercise training is beneficial for improving frailty and nutritional status in elderly patients with ischemic stroke and frailty, while also effectively alleviating their kinesiophobia and enhancing motor function.

Abstract:Objective: To evaluate the effects of the method of transporting spleen and resolving dampness based on the syndrome differentiation of liver depression and spleen deficiency combined with traditional Chinese medicine emotional regulation on symptoms, sleep and quality of life in patients with cancer-related depression (CRD). Methods: A total of 108 patients with CRD were selected as the research subjects and divided into two groups according to the treatment methods. 54 patients in the control group were given the treatment of regulating emotions with traditional Chinese medicine five-element music, while 54 patients in the study group were treated with the method of transporting the spleen and eliminating turbidity based on the differentiation and treatment of liver depression and spleen deficiency syndrome on the basis of the treatment in the control group. Both groups were treated for 8 weeks. The depressive symptoms [Hamilton Depression Rating Scale (HAMD) score and reduction rate, remission rate, and effective rate], sleep status (falling asleep time, sleep time, sleep efficiency, sleep disorders, daytime function, hypnotic drugs, and sleep quality), and quality of life (EORTC QLQ-C30 score) before and after treatment were compared between the two groups. Results: The HAMD score of the study group was lower than that of the control group after 8 weeks of treatment. The score reduction rate, remission rate and effective rate were higher than those of the control group (P<0.05). The sleep onset time, sleep duration, sleep efficiency, sleep disorders, daytime function, hypnotic drugs, sleep quality score and the difference were all lower than those of the control group (P<0.05). The scores of physical function, role function, cognitive function, emotional function and social function in EORTC QLQ-C30 were higher than those of the control group (P<0.05). Conclusion: The method of transporting spleen and resolving dampness based on the syndrome differentiation of liver depression and spleen deficiency combined with traditional Chinese medicine emotional regulation can improve the symptoms and sleep quality of CRD patients and improve their quality of life.

Abstract:Objective: To investigate the therapeutic effect of probiotic-assisted basic periodontal therapy in patients with cirrhosis complicated by periodontitis and its regulatory effect on dysregulation of the oral microbiota-gut-liver axis. Methods: 102 patients with liver cirrhosis and periodontitis were enrolled and divided into an observation group and a control group according to different treatment regimens, with 51 patients in each group. Both groups received basic treatment for liver cirrhosis. On this basis, the control group received periodontal treatment, and the observation group received probiotic-assisted basic periodontal treatment. Periodontal status indicators [Plaque Index (PI), Gingival Bleeding Index (GBI), Probing Depth (PD), Clinical Attachment Loss (CAL)], oral flora, intestinal flora, gingival crevicular fluid indicators [Interleukin-6 (IL-6), Interleukin-1β (IL-1β), Tumor Necrosis Factor-α (TNF-α), Matrix Metalloproteinase-9 (MMP-9)], liver function indicators [Total Bilirubin (TBIL), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST)], liver fibrosis indicators [Hyaluronic Acid (HA), Procollagen III (PCⅢ), Collagen IV (Ⅳ-C)], and the occurrence of adverse reactions were compared between the two groups. Results: After treatment, the levels of PI, GBI, PD, and CAL in the observation group were lower than those in the control group (P<0.05). The quantities of Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans in the oral cavity of the observation group after treatment were lower than those in the control group (P<0.05). The quantities of Enterobacter, Enterococcus, Lactobacillus, and Bifidobacterium in the intestinal flora of the observation group after treatment were higher than those in the control group, and the quantity of Candida albicans was lower than that in the control group (P<0.05). The levels of IL-6, IL-1β, TNF-α, and MMP-9 in the gingival crevicular fluid of the observation group after treatment were lower than those in the control group (P<0.05). The levels of serum liver function indicators TBIL, ALT, and AST in the observation group after treatment were lower than those in the control group (P<0.05). There were no statistically significant differences in the serum liver fibrosis indicators HA, PCⅢ, and Ⅳ-C between the two groups after treatment (P>0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Probiotics as an adjunct to basic periodontal therapy can improve the periodontal condition of patients with cirrhosis and periodontitis, regulate the balance of oral and intestinal flora, reduce the level of inflammatory factors in the gingival crevicular fluid, improve liver function, and exhibit good safety.

Abstract:Objective: To investigate the efficacy of transcutaneous electrical nerve stimulation (TENS) combined with drug therapy for endometriosis (EM)-related chronic pelvic pain (CPP) and its influence on the TGF-β/Smads signaling pathway. Methods: 78 patients with endometriosis-associated CPP were enrolled and divided into two groups according to different treatment regimens. The control group (n=39) received routine drug intervention, while the observation group (n=39) received TENS treatment in addition to the treatment of the control group. The treatment course for both groups was 2 months. Clinical efficacy, quality of life [Endometriosis Health Profile-5 (EHP-5)], anal sphincter muscle ultrasound indicators [levator hiatus (LH) anteroposterior diameter (AP), area (A), left-right diameter (LR)], levels of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1)], stress hormones [norepinephrine (NE), cortisol (Cor)], pain mediators [substance P (SP), β-endorphin (β-EP), 5-hydroxytryptamine (5-HT), prostaglandin E2 (PGE2)], TGF-β/Smads signaling pathway expression levels, and the incidence of adverse reactions during treatment were compared between the two groups. Results: The treatment efficacy rate in the observation group was higher than that in the control group (P<0.05). After treatment, the EHP-5 scores in the observation group were lower than those in the control group (P<0.05). The increases in LH AP, LH LR, and LH A indices in the observation group were greater than those in the control group (P<0.05), and the serum levels of IL-6, TNF-α, MCP-1, Cor, and NE were decreased (P<0.05). The levels of SP, PGE2, and 5-HT in the observation group were lower than those in the control group (P<0.05), while the concentration of β-EP was higher than that in the control group (P<0.05). The expression of TGF-β1 mRNA and Smad3 mRNA in peripheral blood mononuclear cells of the observation group were lower than those in the control group (P<0.05), while Smad7 mRNA was higher (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: TENS combined with drug therapy for EM-related CPP can effectively alleviate pain symptoms, improve the quality of life, promote the recovery of pelvic floor function, regulate inflammation and stress responses, and modulate TGF-β/Smads signaling pathway expression.

Abstract:Objective: To investigate the efficacy of a propensity score matching-based intragingival groove cut pocket-shaped flap procedure in mandibular low retaining tooth extraction. Methods: 360 patients with mesioangular and low-to-moderate impacted mandibular third molars were enrolled and divided into an observation group (sulcular envelope flap, n=180) and a control group (conventional triangular flap, n=180) based on different treatment methods. The clinical data of the patients were collected retrospectively, and the basic data of the two groups were matched 1∶1 using the propensity score matching method to compare the operation time, bleeding, postoperative swelling, probing depth, degree of restriction of the opening, pain, quality of life, and the occurrence of complications between the two groups. Results: The levels of bleeding and postoperative swelling were lower in the observation group than in the control group (P<0.05). At 3 months postoperatively, the depth levels of buccal distal-medial, central, and proximal-medial and lingual distal-medial, central, and proximal-medial probing in the observation group were lower than those in the control group (P<0.05). At 7 d postoperatively, the degree of opening restriction and the level of visual pain analog score (VAS) were lower in the observation group than in the control group (P<0.05). At 3 d postoperatively, the level of the Comprehensive Quality of Life Assessment Questionnaire (GQOLI-74) score was higher in the observation group than in the control group (P<0.05). The complication rate was lower in the observation group than in the control group (P<0.05). Conclusion: The use of the pocket-shaped flap technique for mandibular low retaining teeth extraction in the gingival sulcus effectively reduces surgical bleeding and postoperative swelling, improves the patient’s quality of life, and reduces pain, as well as reduces the incidence of restricted opening and related complications, which is of value for promotion.

Abstract:Objective: To compare the effect of ropivacaine or lidocaine for stellate ganglion block (SGB) on early postoperative intestinal function in patients undergoing laparoscopic intestinal surgery. Methods: A total of 125 patients scheduled for laparoscopic gastrointestinal surgery were divided into ropivacaine group (group R, n=62) or lidocaine group (group L, n=63) according to different preoperative SGB medications, who received 0.2% ropivacaine 4 mL or 1% lidocaine 4 mL for ultrasound-guided SGB before surgery, correspondingly. The time to first flatus and the recovery rate of bowel sounds at 12, 24, 36, 48, 60 and 72 h after surgery and the I-FEED scoring system were compared between the two groups to evaluate the impairment of gastrointestinal function. The quality of recovery score (QoR-15), including preoperative and postoperative days 1, 3, and 7, the postoperative pain score (NRS), and rescue analgesia utilization rate were compared between the two groups. Results: Compared with group L, the first flatus after surgery was shorter in group R (P<0.05), and the recovery rate of bowel sounds was higher in group R at 36, 48 and 60 h after surgery (P<0.05). There was no significant difference in the outcomes of the gastrointestinal impairment rate, QoR-15 score, resting NRS score, and rescue analgesia rate between the two groups (P>0.05). Conclusion: When performing SGB before surgery, 0.2% ropivacaine is more beneficial than 1% lidocaine for postoperative bowel function recovery, shorter anal exhaust time, and faster recovery of bowel sounds in patients undergoing laparoscopic gastrointestinal surgery.

Abstract:Objective: To integrate conventional imaging features on abdominal magnetic resonance imaging (MRI) with clinical characteristics to construct a machine learning predictive model, and to evaluate the predictive value of tumor necrosis of pancreatic ductal adenocarcinoma (PDAC) in the prognosis. Methods: This study enrolled a total of 139 patients with pathologically confirmed pancreatic ductal adenocarcinoma (PDAC). On conventional MRI images, the presence or absence of tumor necrosis was determined. Conventional MRI features and clinical characteristics associated with survival were screened, and both a Cox proportional hazards model and a random forest survival model were established to analyze the predictive value of necrosis for the prognosis of PDAC patients. The performance of the models was evaluated using the C-index, time-dependent receiver operating characteristic (ROC) curves, calibration curves, and Kaplan-Meier curves. Results: There were statistically significant differences in gender and survival time between the necrosis group and the non-necrosis group of patients as determined on conventional MRI images (P<0.05). Multivariate analysis revealed that age, tumor size, necrosis proportion, and whether surgery was performed were independent risk factors for overall survival (OS). The random forest model demonstrated superior performance in predicting the overall survival rate of PDAC patients, with a C-index of 0.758 (training group) and 0.712 (testing group). The area under the curve (AUC) values for 1-, 2-, and 3-year overall survival rates were 0.739, 0.716, and 0.693 in the training group, and 0.704, 0.679, and 0.647 in the testing group, respectively. The results indicated that machine learning models exhibit better predictive capabilities compared to conventional models. Conclusion: Tumor necrosis determined on abdominal MRI images has predictive value for patient prognosis. The random forest model can more effectively distinguish between high-risk and low-risk patient groups.

Abstract:Objective: To compare the efficacy and safety of totally laparoscopic distal gastrectomy (TLDG) and laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer. Methods: 104 patients with gastric cancer who underwent laparoscopic surgery were divided into TLDG group (n=48, TLDG) and LADG group (n=56, LADG) according to different surgical methods. The operation, postoperative general condition and postoperative complications were compared between the two groups, and the serum gastrointestinal hormones [gastrin (GAS), vasoactive intestinal peptide (VIP), motilin (MTL)] and inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6)] were compared between the two groups before and after operation. Results: Compared with LADG group, TLDG group had less intraoperative blood loss (P<0.05), shorter main incision length (P<0.05), shorter first flatus time, ambulation time, first liquid diet time, drainage tube removal time and hospitalization time (P<0.05). There was no significant difference in the operation time and the number of lymph node dissection between the two groups (P>0.05). At 3 days after operation, the levels of serum GAS, VIP and MTL in TLDG group were higher than those in LADG group (P<0.05), and the levels of CRP and IL-6 were lower than those in LADG group (P<0.05). Conclusion: Compared with LADG, TLDG has more minimally invasive advantages in the treatment of gastric cancer, with small incision, less inflammatory stress, less impact on gastrointestinal hormones, faster postoperative recovery, and no increase in complications.

Abstract:< positive >1 Medical Record Case 1: The patient is a 16-year-old female who presented with decreased vision in her right eye accompanied by photopsia for 3 days. Past medical history: none. Ophthalmic examination: corrected visual acuity of 0.4 in her right eye and 1.0 in her left eye. No significant abnormalities were observed in the anterior segments of both eyes. Fundus photography revealed scattered yellowish-white spots in the macular and peripapillary regions. Optical coherence tomography (OCT) showed unclear and discontinuous ellipsoidal structures in the macular fovea. Fundus autofluorescence (FAF) imaging of the right eye demonstrated irregular strong fluorescence in the macular region and around the optic disc. Fundus fluorescence angiography (FFA) revealed scattered irregular slightly strong fluorescence in the posterior pole.

Abstract:< positive > 1 Case Information The patient, a 63-year-old male, was admitted to the hospital due to episodic vertigo, left tinnitus, and decreased hearing in the left ear for 3 months. Three months before admission (February 2022), the patient suddenly experienced vertigo accompanied by left tinnitus, ear congestion, and decreased hearing in the left ear. The rotational vertigo was episodic, lasting about 2 hours per episode. The patient felt that the vertigo worsened when changing positions and opening the eyes, and improved slightly after lying in bed. He was treated at a local hospital. Middle ear CT revealed: 1. No abnormalities in bilateral middle ear mastoids; 2. Deviated nasal septum, inflammatory changes in bilateral maxillary and ethmoid sinuses; cranial and cervical MRI revealed: 1. A few ischemic lesions under the bilateral frontal cortex; 2. Cervical osteophytosis; 3. Degeneration of C2-T3 intervertebral discs; mild posterior protrusion of C3-7 intervertebral discs.

Abstract:Objective: To investigate the effect of low-intensity ultrasound combined with breast massage on postpartum lactation, breastfeeding and uterine involution. Methods: A cohort of 148 postpartum women was allocated into two equal groups: a control group and an experimental group according to the different ways of intervention, each comprising 74 participants. The control group received manual breast therapy following delivery, and the observation group was given low-intensity ultrasound combined with breast massage intervention. The two groups were intervened continuously for 3 days and followed up for 42 days. The initial time of postpartum lactation, the amount of lactation 48 h after delivery and the degree of breast distending pain 48 h after delivery were recorded in the two groups. Serum prolactin levels were measured at 48 and 72 h after delivery. The breastfeeding rate and uterine involution were compared between the two groups. Results: Compared with the control group, the lactation initiation time of the observation group was earlier (P<0.05), and there was a higher breast milk volume at 48 h postpartum (P<0.05). Compared with the control group, the observation group’s breast distending pain degree was lighter at 42 h after delivery (P<0.05). Compared with the control group, at 48 and 72 h after delivery, the observation group’s serum prolactin levels were increased (P<0.05). At 42 days after delivery, the observation group’s breastfeeding rate was higher compared with the control group (P<0.05). Compared with the control group, the uterine fundus of the observation group decreased at 3 days after delivery (P<0.05), and the rate of uterine involution at 42 days after delivery decreased (P<0.05). Conclusion: The synergistic intervention of low-intensity ultrasound combined with breast massage can effectively promote postpartum lactation function, relieve breast congestion and swelling pain, improve the success rate of breastfeeding, and promote uterine involution.

Abstract:Objective: To explore the impact of health importance and barriers to independent medical care on aging anxiety based on the empirical analysis of CGSS 2021. Methods: Collected comprehensive social survey data from 1,190 elderly people in China and the univariate analysis was used to investigate the differences in aging anxiety among different demographic characteristics. The correlation between the importance of health, barriers to independent medical care, and aging anxiety was analyzed by Pearson’s correlation analysis, and the influencing factors of aging anxiety was analyzed by multivariate linear regression method. Results: Measurement of the Aging Anxiety Scale showed that the mean value of the anxiety level of the elderly in China was (3.35?±?1.02) points, and the anxiety level was at a moderately high level. Univariate analysis showed that there was a statistically significant difference in the level of aging anxiety among elderly people of different genders, educational levels, self-rated health status, and whether they had chronic diseases or long-term health problems (P<0.05). Among them, women, those with lower educational levels, poorer self-rated health status, and chronic diseases or long-term health problems were more likely to experience aging anxiety (P<0.05). The results of multiple linear regression analysis showed that self-assessment of health status, presence of chronic diseases or long-term health problems, health importance, and barriers to seeking medical treatment alone had an impact on aging anxiety (P<0.05). Among them, the better the self-assessment of health status, the lower the aging anxiety of the elderly (P<0.05); suffering from chronic diseases or long-term health problems could exacerbate aging anxiety (P<0.05); the deeper the understanding of the importance of health, the higher the aging anxiety (P<0.05); the greater the obstacle of seeking medical treatment alone, the higher the anxiety of aging (P<0.05). Correlation analysis showed that aging anxiety was positively correlated with the importance of health and the difficulty of seeking medical treatment alone (P<0.05); the importance of health was negatively correlated with the difficulty of seeking medical treatment alone (P<0.05). Conclusion: The importance of health, obstacles to seeking medical treatment alone, and anxiety related to aging in the elderly are closely related. Relevant departments should construct a perfect health service system, optimize age-appropriate medical support, and carry out accurate health education to alleviate aging anxiety in the elderly.