Abstract:Objective: To explore the mechanism of action of vitamin D in regulating autophagy activity and improving type 2 diabetes in rats through the FXR/FGF15 signaling pathway.Methods: 40 SPF-grade SD rats were selected. Among them, 10 rats were set as the control group, and 30 were used to establish the type 2 diabetes model. The 27 successfully modeled rats were divided into a model group, a vitamin D group, and a vitamin D + FXR inhibitor group, with 9 rats in each group. The histopathological changes in renal tissue, fasting blood glucose, insulin, body weight, renal function, inflammatory factor levels, autophagy-related proteins, and mRNA and protein expression levels of the FXR/FGF15 pathway in rats from each group were compared.Results: The renal tissue structure of rats in the control group was normal. In the model group, the rats exhibited glomerular hypertrophy, mesangial cell proliferation, and swelling, degeneration, and partial atrophy of renal tubular epithelial cells. The renal pathological damage in the vitamin D group was alleviated, while the damage in the vitamin D + FXR inhibitor group was more severe than that in the vitamin D group, with a degree between that of the model group and the vitamin D group. Compared with the control group, the model group rats exhibited elevated fasting blood glucose, creatinine (Scr), blood urea nitrogen (BUN), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and P62 protein expression. The mRNA and protein expression levels of insulin, body mass, lysosomal-associated membrane protein 1 (LAMP1), LC3-II/I protein, farnesoid X receptor (FXR), and fibroblast growth factor 15 (FGF15) decreased, with statistically significant differences (P < 0.05). Compared with the model group, the vitamin D group exhibited reduced fasting blood glucose, Scr, BUN, MCP-1, IL-6, IL-1β, TNF-α, and P62 protein expression, while insulin, body weight, LAMP1, LC3-II/I protein, FXR, FGF15 mRNA, and protein expression levels were increased (P < 0.05). Compared with the vitamin D group, the rats in the vitamin D + FXR inhibitor group exhibited increased fasting blood glucose, Scr, BUN, MCP-1, IL-6, IL-1β, TNF-α, and P62 protein expression, and decreased insulin, body weight, LAMP1, LC3-II/I protein, FXR, FGF15 mRNA, and protein expression levels, with statistically significant differences (P < 0.05). Conclusion: Vitamin D can improve renal function, and its mechanism of action may be related to regulating autophagy activity and the FXR/FGF15 pathway.

Abstract:Objective: To investigate the feasibility of establishing an early-stage age-related macular degeneration (AMD) model in C57BL/6J mice using low-dose sodium iodate (NaIO?).Methods: 24 nine-week-old specific pathogen-free (SPF) male C57BL/6J mice were randomly assigned to four groups (n=6/group): control, 10 mg/kg NaIO?, 15 mg/kg NaIO?, and 20 mg/kg NaIO?. Injury groups received a single intraperitoneal injection of NaIO?, while controls received sterile phosphate-buffered saline (PBS). At 1, 2, and 4 weeks post-injection, two mice per group were euthanized for bilateral eyeball enucleation. Retinal morphology was assessed using hematoxylin-eosin (H&E) staining of paraffin-embedded sections.Results: With the increase of sodium iodate concentration and the prolongation of treatment time, the structure of mouse retinal tissue gradually loosened, the nerve fiber layer (NFL) gradually shrank and became thinner (P < 0.05), and ganglion cell layer (GCL) cells and retinal pigment epithelium (RPE) cells gradually decreased (P < 0.05). As the concentration of sodium iodate gradually increased to 20 mg/kg and the treatment time was extended to 2 weeks, irregular deposits were observed beneath the mouse RPE layer.Conclusion: Low-dose NaIO? effectively induces early AMD-like pathology in mice, supporting its utility for mechanistic studies.

Abstract:Objective: To mine key genes and pathways of osteoarthritis (OA) based on bioinformatics and validate them using an in vitro chondrocyte model.Methods: This study was based on the GSE269735 dataset from the GEO database, using Weighted Gene Co-expression Network Analysis (WGCNA) to identify key gene modules, combined with differential expression gene (DEG) analysis to screen candidate genes. GO and KEGG pathway analyses were performed on the common genes between DEGs and WGCNA key gene modules, with the STRING database and Cytoscape software used to identify key genes among the DEGs. To validate the robustness of the screening results, the GSE2204879 dataset was used for cross-validation, and a plasmid was constructed with CSF-1 as the candidate gene for transfection interference experiments in OA chondrocytes. Finally, the expression changes of CSF-1 at the cellular level were detected by Western blot, and its effects on cellular function were evaluated to verify its potential role in OA.Results: WGCNA analysis identified multiple modules closely related to OA phenotypes, and key genes were co-screened with DEGs. GO and KEGG analysis showed that the main biological processes involved cytokine activity, chemokine activity, collagen binding, etc. Key genes included CCL20, CSF-1, CXCL11, CXCL3, CXCL5, and CXCR4. In the GSE2204879 dataset, CSF-1 and CXCR4 still showed a consistent expression trend. At the cellular level, CSF-1 and CXCR4 were upregulated in OA model cells. Furthermore, a CSF-1 knockdown plasmid was constructed and transfected into OA chondrocytes; the results showed that CSF-1 knockdown suppressed CXCR4 expression, reduced the expression levels of MMP3 and MMP13 in the cells, and increased the protein expression level of Col2a1, suggesting that CSF-1 may participate in the OA inflammatory response and matrix degradation process by regulating CXCR4. Conclusion: This study, combining bioinformatics and cellular experiments, has screened out multiple key genes closely related to OA. Among them, CSF-1 and CXCR4 show high expression in OA. The experiments indicate that CSF-1 may participate in the OA inflammatory response and matrix degradation process by regulating CXCR4 expression. In summary, CSF-1 may be a key pathogenic factor and potential therapeutic target for OA.

Abstract:Objective: To observe the expression of CD163 and CD105 in colorectal cancer tissues and explore their clinical significance.Methods: 82 pathological specimens of colon cancer and corresponding normal tissues adjacent to the cancer were collected from our hospital following surgical resection. Immunohistochemistry (IHC) was used to detect the expression of CD163 and CD105 in the two tissue types, and the difference in positive high expression rates of CD163 and CD105 was compared. The differences between the different expression patterns of CD163 and CD105 and clinical parameters of patients, as well as the correlation between CD163 and CD105 expression in colorectal cancer tissues, were analyzed.Results: The positive high expression rates of CD163 and CD105 in colorectal cancer tissues were 68.3% and 53.7%, respectively, while those in normal tissues adjacent to the cancer were 51.2% and 0%, respectively, with statistical significance (P0.05). Immunohistochemical quantitative detection confirmed a positive correlation between the expression levels of CD163 and CD105 in colorectal cancer tissues (P<0.05).Conclusion: The high expression of CD163 and CD105 is associated with tumor TNM staging and lymph node metastasis, and their expression in colorectal cancer tissues is positively correlated. This suggests that the combined high expression pattern of CD163 and CD105 is related to the progression of colorectal cancer, and its related molecular mechanisms can be further studied.

Abstract:Objective: To explore the effects of Niuhuang Qingxin Pill on serum inflammatory factors and neurotransmitters in elderly patients with hypertension-induced vertigo accompanied by anxiety and depression.Methods: 122 elderly patients with hypertensive vertigo with anxiety and depression were divided into an observation group (n=61) and a control group (n=61). The control group was given conventional Western medicine treatment, while the observation group was given Niuhuang Qingxin Pill on top of that. All were treated for 7 days. The changes in TCM syndrome scores, Self-Rating Anxiety Scale (SAS) scores, Self-Rating Depression Scale (SDS) scores, ECG function [Standard deviation of all NN intervals (SDNN), root mean square of successive RR interval differences (rMSSD), percentage of all successive RR interval differences greater than 50ms (pNN50), very low frequency power (VLF)], blood pressure, inflammatory factors [interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], and neurotransmitters [5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA)] levels were observed in both groups before and after treatment. The clinical efficacy and adverse reactions of the two groups of patients were compared.Results: After 7 days of treatment, the total effective rate of the observation group was 91.80%, while that of the control group was 75.41%; the clinical efficacy of the observation group was higher than that of the control group (P0.05). After 3 months of follow-up, there were no delayed adverse reactions in the two groups; the incidence of recurrent hypertension vertigo, anxiety progression, and depression progression in the observation group was lower than that in the control group (P<0.05).Conclusion: Niuhuang Qingxin Pills can effectively inhibit the level of inflammatory factors, up-regulate the level of neurotransmitters, control blood pressure, improve neurological function, relieve vertigo, anxiety, depression, and other clinical symptoms in the treatment of elderly patients with hypertensive vertigo with anxiety and depression. The curative effect is remarkable, it can maintain the medium and long-term curative effect, and the safety is reliable.

Abstract:Objective: To investigate the differences in gastric motility function among populations with different body mass index (BMI) levels using gastric filling ultrasound, clarify the independent impact of BMI on gastric motility, and provide a basis for the research on the mechanism of obesity-related gastric motility disorders.Methods: A total of 100 subjects with BMI ≥ 25.0 kg/m2 were enrolled and divided into Group A (overweight group: 25.0 kg/m2 ≤ BMI 0.05). Within 3~5 minutes after drinking contrast agent, compared with the control group, Group A and Group B showed significant decreases in gastric peristaltic wave peak intensity (1.02±0.29 vs. 0.71±0.30 vs. 1.34±0.38) cm, gastric peristaltic velocity (0.28±0.08 vs. 0.24±0.07 vs. 0.31±0.07) cm/s, MI (0.35±0.11 vs. 0.28±0.10 vs. 0.45±0.23) cm2/s, and number of gastric peristalsis (6.15±1.28 vs. 5.61±1.32 vs. 6.72±1.29) times/2 minutes. Moreover, these indicators in Group B were lower than those in Group A, with statistically significant differences (P Group A > Group B”, with statistically significant differences (P0.05).Conclusion: After excluding confounding factors, BMI is negatively correlated with gastric motility function. The higher the BMI, the weaker the gastric peristaltic capacity and gastric emptying efficiency. Gastric filling contrast-enhanced ultrasound is a potential preferred examination method for evaluating gastric motility function in populations with different BMI levels due to its real-time, non-invasive, highly operable, and reproducible characteristics.

Abstract:Objective: To investigate detection strategies for autoantibodies coexisting with alloantibodies and alloantibody-like specific antibodies in patients with autoimmune hemolytic anemia (AIHA), providing a theoretical basis for formulating safe and effective transfusion protocols in complex crossmatching scenarios.Methods: Serum autoantibodies and combined antibodies were detected using a combination of saline method, classic anti-human globulin test (Coombs test), and microcolumn gel assay. Antibody specificity and titer were determined through panel cell reaction pattern analysis, absorption/elution tests, and antibody titration.Results: Serum analysis revealed the presence of autoantibodies, anti-E alloantibody (titer: 1), anti-Wra alloantibody, and an antibody mimicking anti-Ce specificity (titer: 4). Crossmatch tests showed that the strong agglutination (2+) in the major crossmatch with group A, CCDee washed red blood cells (RBCs), weak agglutination (±) in the major crossmatch with group A, ccDEE washed RBCs. Consequently, 2 units of group A, ccDEE washed RBCs were transfused. The patient exhibited a satisfactory increase in hemoglobin post-transfusion, confirming transfusion efficacy without adverse reactions.Conclusion: In patients with multiple coexisting antibodies, priority must be given to excluding autoantibody interference before selecting the most compatible RBCs for transfusion based on antibody affinity and clinical urgency. The combined application of serological techniques and individualized transfusion strategies enhances transfusion safety in patients with complex serology.

Abstract:Objective: To explore the clinical efficacy of concentrated growth factor (CGF) filling combined with carbon dioxide (CO2) fractional laser treatment for atrophic scars following subcutaneous separation surgery.Methods: A total of 82 patients with depressed scars were enrolled as study subjects. They were grouped according to treatment modality into a control group (CO2 fractional laser therapy) and an observation group (CO2 fractional laser therapy combined with subcutaneous separation followed by CGF filling), with 41 cases in each group. The efficacy assessed by the Goodman & Baron Scar Grading Scale, Visual Analogue Scale (VAS), treatment satisfaction, Global Aesthetic Improvement Scale (GAIS), Self-Rating Anxiety Scale (SAS), duration of erythema and edema, healing time, incidence of hyperpigmentation, time off work, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interferon-γ (INF-γ), and adverse reactions were recorded and compared between the two groups.Results: At 2 months post-treatment, the observation group exhibited lower Goodman & Baron scar grade scores, pre- and post-treatment difference scores, IL-6, TNF-α, and INF-γ levels compared to the control group (P0.05).Conclusion: Subcutaneous separation followed by CGF filling combined with CO2 fractional laser treatment demonstrates significant efficacy in treating atrophic scars, reducing long-term inflammatory responses and anxiety levels while enhancing patient satisfaction with treatment outcomes.

Abstract:Objective: To evaluate the predictive value of a predictive model for the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer by multimodal ultrasound assessment of tumor biological behavior combined with systemic immune inflammation index.Methods: 98 patients with breast cancer were selected as prospective cohort study subjects. According to the NAC Miller-Payne grading system, it was divided into an effective group (MP4-5 grade, n=62) and ineffective group (MP1-3 level, n=36). All patients underwent multimodal ultrasound examination (including two-dimensional color Doppler, elastography, and contrast-enhanced ultrasound) before NAC to evaluate tumor blood flow (Adler grade), stiffness strain ratio (SR), perfusion peak intensity (PI) and time to peak (TTP). Using a fully automated blood cell analyzer to detect and calculate the Systemic Inflammatory Index (SII) based on the absolute value parameters in the blood routine report, and performing Miller-Payne grading of surgical pathology after NAC. Establish a joint prediction model using multiple logistic regression (Forward LR method), ROC curve analysis, calculate AUC, sensitivity, and specificity, Delong test compared the differences in curves.Results: The Adler blood flow grading, strain rate ratio, and peak intensity of the effective group were significantly lower than those of the ineffective group (P<0.001). On the contrary, the peak time of the effective group was significantly higher than that of the ineffective group (P<0.001). The SII, neutrophil count, and platelet count of the effective group were significantly lower than those of the ineffective group (P<0.05). On the contrary, the lymphocyte count in the effective group was significantly higher than that in the ineffective group (P<0.001). Multivariate Logistic regression analysis showed that tumor diameter, Adler blood flow grading, SR, PI, TTP, and SII were independent predictors of treatment efficacy (P<0.05). After multivariable adjustment, SR, PI, and SII remained independent predictors of treatment efficacy (P<0.05). ROC curve analysis showed that SR, PI, and SII all had good predictive value for efficacy failure, and the combined model significantly improved predictive performance.Conclusion: Multimodal ultrasound is used to evaluate the biological characteristics of tumor and SII to reflect the immune and inflammatory state of the body. The combination of the two can better indicate the development trend of the disease and the chemosensitivity of breast cancer patients when judging their condition.

Abstract:Objective: To explore the application effect of double fixed laparoscopic jejunostomy in total endoscopic Ivor-Lewis operation for esophageal cancer. Methods: A retrospective analysis was conducted on 106 patients who underwent totally laparoscopic Ivor-Lewis esophagectomy performed by the same surgical team. Patients were divided into an observation group and a control group based on the jejunostomy technique used, with 53 cases in each group. The control group underwent traditional sutured laparoscopic jejunostomy, while the observation group underwent double-fixation laparoscopic jejunostomy. The postoperative jejunostomy tube removal time and time to first flatus were compared between the two groups. The inflammatory stress indicators [norepinephrine (NE), cortisol (COR), C-reactive protein (CRP)] before and 4 weeks after surgery were detected and compared. The levels of nutritional markers [serum albumin (ALB), globulin (GLB), hemoglobin (Hb)] were measured and compared before, 4 and 12 weeks after operation. The incidence of complications was also recorded for each group. Results: The observation group had shorter times to stoma tube removal and first anal exhaust compared to the control group (P0.05). Conclusion: Double-fixed laparoscopic jejunostomy combined with Ivor-Lewis operation can effectively reduce the incidence of postoperative intestinal obstruction, relieve inflammatory stress, and improve the nutritional status of patients, which is worth popularizing.

Abstract:Objective: To explore the clinical outcomes of using modified Buyang Huanwu Decoction alongside acupuncture in treating post-stroke Qi deficiency and blood stasis syndrome in cerebral infarction patients. Methods: A retrospective analysis was conducted on 102 patients with Qi deficiency and blood stasis syndrome after cerebral infarction. The patients were divided into two groups based on treatment methods: the control group (receiving conventional treatment + acupuncture, n=51) and the observation group (receiving Buyang Huanwu Decoction with modifications in addition to the treatment in the control group, n=51). Both groups were treated for 4 weeks. The clinical efficacy, Traditional Chinese Medicine (TCM) syndrome scores before and after treatment, Barthel Index, muscle strength grading, Water Swallowing Test (WST) grading, coagulation function, and safety were compared between the two groups. Results: The observation group achieved a higher overall effectiveness rate than the control group (P0.05). Conclusion: Modified Buyang Huanwu Decoction combined with acupuncture can improve clinical symptoms, muscle strength, swallowing ability, daily living capacity, and coagulation function in patients with post-stroke Qi deficiency and blood stasis syndrome, without increasing the incidence of adverse reactions.

Abstract:Objective: To analyze the correlation between the intensity of spontaneous nystagmus (SN) and vestibular function in patients with acute vestibular neuritis (VN), and to clarify the quantitative relationship between the degree of semicircular canal dysfunction and the characteristics of SN. Methods: A total of 251 inpatients diagnosed with acute VN were enrolled in this study. All participants underwent comprehensive assessments including electronystagmography, rotational chair stop test, video head impulse test (v-HIT), and Dizziness Handicap Inventory (DHI) evaluation. Based on the intensity of SN, patients were stratified into three groups: 0~5°, 5~15°, and >15°. Statistical analyses were conducted to: compare DHI scores and rotational chair stop test Canal Paresis (CP) values among the three SN-intensity groups, evaluate the prevalence of abnormal v-HIT gain values in semicircular canals and compare horizontal, anterior, and posterior semicircular canal v-HIT gain values across the three SN-intensity subgroups. Results: A total of 251 acute VN patients were stratified into three groups by SN intensity: 0~5° (n=51, 20.32%), 5~15° (n=132, 52.59%), and >15° (n=68, 27.09%). Both DHI scores and CP values increased with SN intensity, and the differences between the three groups were statistically significant (P0.05). No significant between-group differences were observed in affected-to-healthy side v-HIT gain ratios across all three semicircular canals (P >0.05). Conclusion: In acute VN, SN intensity serves as a composite indicator of overall vestibular system involvement (encompassing peripheral lesion extent and central compensation status), likely reflecting widespread vestibular nerve involvement or abnormal central regulatory mechanisms rather than mere semicircular canal anatomical damage.

Abstract:Objective: To explore the influence of ultrasound-guided axillary brachial plexus block anesthesia on block analgesia status in children with distal ulna and radius fractures in emergency room. Methods: A total of 106 children with distal ulna and radius fractures were selected as research subjects. According to different reduction methods of fractures, the children were divided into control group (n=36, routine manipulation reduction) and painless treatment group (n=70, ultrasound-guided axillary brachial plexus block anesthesia manipulation reduction). The children in painless treatment group were further divided into group A (n=35, 1.0% lidocaine) and group B (n=35, 0.8% lidocaine) according to the different concentrations of lidocaine used. The block onset time, duration of analgesia and success rate of block were compared between group A and group B. The scores of Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) before reduction (T0), during reduction (T1) and at 1 h after reduction (T2), the excellent and good rate of manipulation reduction, satisfaction of medical staff, satisfaction of parents and occurrence of adverse reactions were compared among the three groups. Results: The onset time of block in group A was shorter than that in group B (P0.05). At T1 and T2 the CHEOPS score in group A and group B was lower than that in control group (P 0.05). There was no statistically significant difference in the incidence of adverse reactions among group A, group B, and the control group (P>0.05). Conclusion: In emergency room environment, the application of ultrasound-guided brachial plexus block in children with distal radius and ulna fractures is an efficient and safe analgesic strategy, which can improve the quality of reduction and the satisfaction of both doctors and patients. 0.8% lidocaine is sufficient to meet the analgesic needs of manipulation reduction.

Abstract:Objective: To explore the evaluated value of ultrasound evaluation of renal resistance index (RRI) combined with serum cystatin C (CysC) level on acute kidney injury (AKI). Methods: The clinical data of 86 patients with AKI were retrospectively analyzed. According to the Kidney Disease Improving Global Outcomes (KDIGO) staging, they were divided into mild group (n=50) and severe group (n=36). The AKI staging was recorded, and the general data, RRI and CysC were compared between groups. ROC curve was drawn to evaluate the predictive value of CysC, RRI and their combination on patients with severe AKI. Spearman correlation analysis was used to analyze the correlation between RRI and CysC levels and AKI staging. Results: There were no statistical differences in gender and age between the two groups of patients (P>0.05). Statistically significant differences were observed in concurrent hypertension, concurrent diabetes mellitus and etiology in severe group compared with those in mild group (P<0.05). The RRI and CysC in severe group were higher than those in mild group, with statistical differences (P<0.05). ROC curve analysis showed that the AUCs of CysC, RRI and combined prediction in predicting severe AKI were 0.807, 0.773 and 0.903. The optimal cut-off value of CysC was 1.96 μmol/L, with a sensitivity of 68.00% and a specificity of 86.11%. The optimal cut-off value of RRI was 0.68, and the sensitivity and specificity were 58.00% and 86.11%. The sensitivity and specificity of combined prediction were 100.00% and 74.00%, respectively. Spearman correlation analysis showed that RRI and CysC were positively correlated with AKI staging (P<0.05). Conclusion: Most patients with AKI are in the early stage, and hypertension and diabetes mellitus are related to the disease severity. Ultrasound evaluation of RRI combined with serum CysC alone and in combination in predicting severe AKI has value. Combined prediction can enhance the predictive sensitivity, and the levels of the two are positively correlated with AKI staging.

Abstract:Objective: To investigate the clinical efficacy of supplementing vitamins A and D in the treatment of preeclampsia (PE) patients with gestational hypertension. Methods: 86 patients with gestational hypertension and PE were enrolled and divided into a control group (n=43, 50.0%) and a study group (n=43, 50.0%) based on different treatment regimens. The control group received magnesium sulfate + nifedipine for blood pressure control and seizure prophylaxis, while the study group received additional vitamin A and D as adjunctive therapy alongside magnesium sulfate and nifedipine. Changes in blood pressure, catecholamine levels, and inflammatory/endothelial factors were compared between the two groups before and after treatment. Results: After treatment, both groups of PE patients showed a decrease in systolic blood pressure (SBP) and diastolic blood pressure (DBP) compared to before treatment (P<0.05). The post-treatment systolic blood pressure (142.52±9.41) mmHg and diastolic blood pressure (90.40±8.11) mmHg in the study group were significantly lower than those in the control group (158.01±10.32) mmHg and (98.31±9.22) mmHg, respectively (P<0.05). After treatment, dopamine, norepinephrine, and epinephrine levels decreased significantly in both groups of PE patients compared to before treatment (P<0.05), with the study group was lower than the control group (P <0.05). After treatment, tumor necrosis factor-α (TNF-α), endothelin-1 (ET-1), and C-reactive protein (CRP) levels decreased significantly in both groups of PE patients compared to before treatment (P<0.05), with the study group was lower than the control group (P<0.05). Vascular endothelial growth factor (VEGF) and placental growth factor (PLGF) levels increased significantly in both groups after treatment compared to before treatment (P<0.05), with the study group was higher than the control group (P<0.05). Conclusion: Supplementation with vitamins A and D, in addition to conventional anticonvulsant and antihypertensive therapy, significantly reduces blood pressure and catecholamine levels, and improves inflammatory and endothelial factor levels in patients with gestational hypertension and PE.

Abstract:Objective: To assess the feasibility and safety of the full-endoscopic trans-lumbosacral triangle approach for treating L5/S1 far-lateral lumbar disc herniation (FLLDH) and to evaluate its mid-to long-term clinical outcomes. Methods: A single-center retrospective observational study was conducted on 44 patients with L5/S1 far-lateral lumbar disc herniation. All patients underwent full-endoscopic trans-lumbosacral triangle approach surgery. Outcomes were assessed using the Visual Analog Scale (VAS) for low back and lower limb pain, the Oswestry Disability Index (ODI) for lumbar function, and the modified MacNab criteria for excellent/good rates. Radiographic follow-up included dynamic lumbar radiographs, thin-slice lumbar CT, and lumbar MRI. Results: The operative time for the 44 patients ranged from 45 to 73 minutes, with a mean of 58.0 ± 7.71 min. The follow-up period ranged from 35 to 46 months, with a median of 40 months. The low back pain VAS score significantly decreased from 5.41 ± 1.06 preoperatively to 1.57 ± 0.82 at 1-month postoperatively and further reduced to 0.93 ± 0.73 at the final follow-up. The leg pain VAS score decreased from 6.80 ± 1.00 preoperatively to 1.43 ± 0.50 at 1-month postoperatively and 0.84 ± 0.53 at the final follow-up. The ODI improved from 62.93 ± 14.22% preoperatively to 20.58 ± 12.56% at 1-month postoperatively and 6.99 ± 5.47% at the final follow-up. The differences in VAS and ODI scores at both 1-month and final follow-up were statistically significant compared to preoperative values (P < 0.05), and this difference remained statistically significant when compared the final follow-up to the 1-month postoperative assessment (P < 0.05). According to the modified MacNab criteria at the final follow-up, yielding an excellent/good rate of 93.2%. Postoperative thin-slice lumbar CT and MRI confirmed complete removal of the herniated nucleus pulposus, and dynamic lumbar radiographs showed no instability. Conclusion: The full-endoscopic trans-lumbosacral triangle approach demonstrates favorable mid-to long-term clinical outcomes in the treatment of L5/S1 far-lateral lumbar disc herniation.

Abstract:Objective: To investigate the effect ofBifidobacterium triple viable capsules on treatment efficacy and carotid atherosclerosis risk in patients with chronic hepatitis B (CHB) complicated by non-alcoholic fatty liver disease (NAFLD), based on the gut-liver axis and immunomodulation mechanisms.Methods: A total of 130 CHB patients with NAFLD were divided into an observation group and a control group according to different treatment methods, with 65 cases in each group. The control group received conventional comprehensive treatment, while the observation group receivedBifidobacterium triple viable capsules in addition to the control group's regimen. After 6 months of continuous intervention, the following indicators were compared between the two groups:Virological response: HBV DNA levels.Liver function: Alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), and total bilirubin (TBIL).Liver steatosis and fibrosis: Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM).Intestinal flora indices: Relative abundance ofBifidobacterium andEnterobacteriaceae, and flora α-diversity (Shannon index).Intestinal mucosal barrier indices: Endotoxin (LPS), diamine oxidase (DAO), and intestinal fatty acid-binding protein (I-FABP).Inflammation and immune indices: High-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), CD4+/CD8+ ratio, and regulatory T cell (Treg) proportion.Carotid atherosclerosis risk indices: Carotid intima-media thickness (CIMT), carotid plaque detection rate, maximum area of carotid plaque, and carotid hemodynamic parameters [peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI)].Results:Virological & Liver Function: The HBV DNA level in the observation group after treatment was significantly lower than in the control group (P0.05).Gut Microbiota & Barrier: The abundance ofBifidobacterium and the Shannon index were higher in the observation group, while the abundance ofEnterobacteriaceae was lower compared to the control group (P0.05).Conclusion: The addition ofBifidobacterium triple viable capsules to standard antiviral therapy can regulate intestinal flora balance, repair the intestinal mucosal barrier, inhibit systemic inflammatory responses, and improve immune disorders. Consequently, this adjunctive therapy enhances virological response in CHB-NAFLD patients, improves liver function, reduces liver steatosis and fibrosis, and helps delay the early progression of carotid atherosclerosis.

Abstract:Objective: To explore the application of cone-beam computed tomography (CBCT) combined with microscopic root canal technique in the detection of root canals and the evaluation of therapeutic efficacy in elderly patients with maxillary second molars.Methods: A total of 108 elderly patients requiring root canal therapy for maxillary second molars were divided into a control group and an observation group based on different intervention methods, with 54 cases in each group. The control group received panoramic radiography (PAN) combined with conventional root canal therapy, while the observation group was treated with CBCT combined with microscopic root canal therapy. Preoperative diagnosis results, postoperative evaluation results of PAN and CBCT, and therapeutic effects of the two groups were compared.Results: In the observation group, the detection rate of the second mesial canal on the buccal side (MB2) by CBCT was significantly higher than that by PAN (P<0.05). There was a statistically significant difference between the two methods in judging root filling quality (P<0.05), as well as in evaluating periapical healing (P<0.05). The total incidence rate of intraoperative complications and the postoperative pain visual analog scale (VAS) scores in the observation group were lower than those in the control group (P<0.05), and the clinical success rate was higher than that in the control group (P<0.05).Conclusion: The combination of CBCT and microscopic root canal technique can enhance the detection of root canals and the treatment success rate for elderly maxillary second molars, while providing an objective evaluation of therapeutic efficacy.

Abstract:Objective: To investigate the efficacy of a combination ofStaphylococcus andNeisseria tablets with Budesonide, glycopyrronium bromide, and formoterol fumarate inhalation aerosol in the treatment of childhood bronchial asthma, as well as its effects on intercellular adhesion molecule-1 (ICAM-1), peripheral blood eosinophils (EOS), and lung function.Methods: A total of 80 pediatric patients with bronchial asthma were enrolled and divided into a control group and a combination group according to different treatment methods, with 40 patients in each group. The control group was treated with Budesonide, glycopyrronium bromide, and formoterol fumarate inhalation aerosol, while the combination group received treatment withStaphylococcus andNeisseria tablets in addition to the control group's regimen. Both groups were treated for 3 months. Treatment efficacy, inflammatory indicators [ICAM-1, interleukin-6 (IL-6) levels], immune function indicators [total immunoglobulin E (IgE) and EOS levels], lung function indicators [maximum voluntary ventilation (MVV), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1)], symptom improvement status [Medical Research Council (MRC) dyspnea scale and Asthma Control Test (ACT) scores], and the incidence of adverse reactions were compared between the two groups.Results: The effective rate of the combination group was higher than that of the control group (P0.05).Conclusion: The combination ofStaphylococcus andNeisseria tablets with Budesonide, glycopyrronium bromide, and formoterol fumarate inhalation aerosol demonstrates significant efficacy in treating bronchial asthma. It effectively reduces the severity of airway inflammatory responses, promotes the recovery of immune function, and improves lung function.

Abstract:Objective: To investigate the effects of growth hormone combined with letrozole treatment on serum sex hormone-binding globulin (SHBG), Th1/Th2 cytokines, and C1q tumor necrosis factor-related protein 9 (CTRP9) in patients with polycystic ovary syndrome (PCOS).Methods: A total of 192 patients with PCOS were included in the study and divided into a control group and a combined group according to different treatment schemes, with 96 cases in each group. The control group was treated with letrozole, while the combined group received growth hormone in addition to letrozole. The maximum follicle diameter, endometrial thickness, ovarian volume, interleukin-4 (IL-4), interferon-gamma (IFN-γ), Th1/Th2 cytokine ratios, SHBG, CTRP9, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), pregnancy outcomes, and the incidence of adverse reactions were recorded and compared between the two groups.Results: After treatment, the combined group showed significantly higher levels of maximum follicle diameter and endometrial thickness compared to the control group (P0.05).Conclusion: The use of growth hormone combined with letrozole in the treatment of polycystic ovary syndrome can regulate immune imbalance by shifting cytokine status, enhance ovarian reserve function, and improve levels of SHBG, CTRP9, and sex hormones. This combination therapy helps improve ovulation and pregnancy rates in patients and demonstrates a good safety profile.

Abstract:Objective: To analyze the differential diagnosis efficiency of intravoxel incoherent motion (IVIM) model histogram parameters for prostate cancer (PCa) and benign prostatic hyperplasia (BPH). Methods: The clinical data of 90 patients with clinically suspected PCa but without hormone therapy or radiotherapy who underwent multiparametric MRI (mpMRI) examination were retrospectively analyzed. The enrolled patients were classified into the PCa group and the BPH group based on pathological results. Histogram parameters such as the pseudo-diffusion coefficient (), quantitative diffusion coefficient (D), apparent diffusion coefficient (ADC), and perfusion fraction (f) were obtained, and differences in these parameters were compared. The diagnostic efficiency of each parameter in differentiating PCa from BPH was analyzed by drawing receiver operating characteristic (ROC) curves. Results: The mean value, 75th percentile, 90th percentile, and maximum value of D in the PCa group were lower than those in the BPH group (P<0.05), and the minimum value and 10th percentile of D were also lower (P<0.05). The mean value, main percentiles, and kurtosis of f were lower in the PCa group than in the BPH group (P<0.05). The minimum value, main percentiles, and maximum value of ADC in the PCa group were lower, while kurtosis was higher compared to the BPH group (P<0.05). The areas under the curve (AUCs) of the mean value of D, minimum value of D*, mean value of f, and 50th percentile of ADC were significantly higher (P<0.05). Conclusion: IVIM model histogram parameters have significant advantages in identifying PCa and BPH, providing a valuable reference basis for clinical diagnosis.

Abstract:Objective: To explore the efficiency of transcranial Doppler ultrasound flow imaging (TCD-FI) combined with amplitude-integrated electroencephalogram (aEEG) parameters in predicting the prognosis of acute stroke. Methods: The data of 121 patients with acute stroke were retrospectively analyzed. Prognosis was evaluated by the modified Rankin Scale (mRS). Patients with an mRS score of less than 2 points were incorporated into the good prognosis group (n=87), and patients with an mRS score ≥ 2 points were enrolled in the poor prognosis group (n=34). General data, TCD-FI cerebral hemodynamic parameters [peak systolic blood flow velocity (Vs), end-diastolic blood flow velocity (Vd), resistance index (RI)], and aEEG brain electrical activity (upper and lower boundary voltages) were compared between the two groups. A receiver operating characteristic (ROC) curve was utilized to analyze the predictive efficiency of TCD-FI combined with aEEG parameters on the prognosis of acute stroke. Pearson correlation analysis was used to analyze the correlation between each parameter and the mRS score. Results: Statistical differences were found in age, infarction size, and degree of vascular stenosis between the two groups (P<0.05). The Vs, Vd, upper boundary voltage, and lower boundary voltage in the poor prognosis group were lower than those in the good prognosis group, while the RI was higher compared to the good prognosis group (P<0.05). ROC curve analysis revealed that the area under the curve (AUC), sensitivity, and specificity of TCD-FI combined with aEEG parameters were 0.873, 52.94%, and 100%, respectively. Correlation analysis showed that Vs, Vd, upper boundary voltage, and lower boundary voltage all exhibited negative correlations with the mRS score (P<0.05), and RI showed a positive correlation with the mRS score (P<0.05). Conclusion: TCD-FI combined with aEEG parameters has high predictive efficiency for the prognosis of acute stroke and can provide a reference for clinical treatment.

Abstract:Objective: To investigate the correlation between ATP binding cassette transporter G1 (ABCG1) polymorphisms and lower extremity atherosclerosis disease (LEAD) in individuals aged over 60. Methods: 200 hospitalized patients with LEAD confirmed by vascular ultrasound (case group) and 66 age-matched healthy controls (control group) were enrolled. ABCG1-rs1378577, rs225374, and rs57137919 polymorphisms were analyzed via TaqMan probe assay. The correlation between ABCG1 polymorphism and LEAD in elderly individuals was analyzed. Logistic regression was used to analyze the risk factors of LEAD in elderly patients. Results: For the ABCG1-rs1378577 locus: Genotype distribution in cases was GG > GT > TT, showing statistical significance (P GG > CC, without statistical significance (P>0.05). For the ABCG1-rs57137919 locus: genotype distribution in the case group ranked GG > AG > AA, showing statistical significance (P<0.05). The AA genotype exhibited a negative correlation with disease incidence (r=-0.172, P<0.05), while Logistic regression identified that the GG genotype increases the risk of disease (OR=4.168, P<0.05). Conclusion: ABCG1-rs1378577 and rs57137919 are correlated with LEAD in the elderly, while ABCG1-rs225374 shows no significant correlation.

Abstract:Objective: To investigate the changes and clinical significance of T lymphocyte subsets and mitochondrial damage in patients with bipolar disorder (BD). Methods: 102 BD patients were retrospectively selected as the observation group. According to the evaluation results of the Clinical Global Impressions-Severity scale at admission, the patients were classified into a mild group (n=41), moderate group (n=35), and severe group (n=26). All patients received standardized treatment with quetiapine fumarate tablets combined with amitriptyline hydrochloride tablets for 8 weeks after admission, and were categorized into an effective treatment group (n=81) and an ineffective treatment group (n=21) based on treatment response results. 90 healthy subjects undergoing physical examination were included in the control group. T lymphocyte subsets (percentage of CD45+ lymphocytes, percentage of CD3+ T cells) and mitochondrial damage indexes of helper T lymphocytes (Th) and cytotoxic T lymphocytes (Ts) were detected and compared. A receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of related indicators. Results: Compared with the control group, the percentages of CD45+ lymphocytes and CD3+ T cells in the observation group were lower, while the positive rates of Th and Ts mitochondrial damage indexes were higher (P<0.05). Compared with the mild group, the percentage of CD45+ lymphocytes and percentage of CD3+ T cells in the moderate group and the severe group were lower in turn, while the positive rate of Th cell mitochondrial damage index and positive rate of Ts cell mitochondrial damage index were higher in turn (P<0.05). ROC curve analysis revealed that the areas under the curves (95% CI) of the above indicators for predicting severe BD were 0.672 (0.536~0.807), 0.628 (0.492~0.763), 0.706 (0.595~0.818), and 0.700 (0.586~0.815) respectively, and the area under the curve (95% CI) of the combined prediction of the four indicators was higher at 0.846 (0.761~0.931). The percentage of CD45+ lymphocytes and percentage of CD3+ T cells in the ineffective treatment group were lower compared with those in the effective treatment group, while the positive rates of Th and Ts cell mitochondrial damage indexes were higher (P<0.05). ROC curve analysis showed that the areas under the curves (95% CI) of the above indicators for predicting BD treatment ineffectiveness were 0.892 (0.803~0.982), 0.858 (0.759~0.956), 0.785 (0.691~0.879), and 0.773 (0.672~0.875), respectively, and the combined prediction value of the four indicators was higher, with an area under the curve (95% CI) of 0.981 (0.727~0.989). Conclusion: BD patients have immune dysfunction. T lymphocyte subsets and mitochondrial damage indexes can be used as effective indicators to evaluate the disease condition and treatment response.

Abstract:Objective: To explore the relationship between serum cystatin C (Cys-C), retinol-binding protein (RBP), urine microalbumin-to-creatinine ratio (ACR), and disease severity in patients with type 2 diabetic nephropathy (T2DN). Methods: A total of 103 patients with T2DN were enrolled as the T2DN group. According to the excretion rate of urinary albumin, they were divided into the early stage group (n=36), clinical stage group (n=55), and uremia group (n=12). A total of 105 patients with type 2 diabetes mellitus (T2DM) during the same period were enrolled as the T2DM group. The levels of serum Cys-C, RBP, and ACR in the T2DN group and T2DM group were detected and compared, and their relationship with disease severity was analyzed. The diagnostic efficiency of Cys-C, RBP, ACR, and combined detection for the severity of T2DN was analyzed by ROC curves. Results: The levels of serum Cys-C, RBP, and ACR in the T2DN group were higher than those in the T2DM group (P<0.05). The levels of Cys-C, RBP, and ACR in the clinical stage group and uremia group were higher than those in the early stage group (P<0.05). Serum Cys-C, RBP, and ACR were positively correlated with disease severity (P<0.05). The AUC of Cys-C combined with RBP and ACR in the diagnosis of T2DN in the clinical stage and uremia stage was 0.934, greater than that of a single index (P<0.05). Conclusion: The changes of Cys-C, RBP, and ACR are positively correlated with the severity of T2DN, and combined detection of the three indexes has higher diagnostic efficiency.

Abstract:Objective: To investigate the effect of Teach-back health education combined with graded exposure therapy on postoperative kinesiophobia, psychological resilience, and post-traumatic growth in patients with lung cancer. Methods: A total of 102 patients who underwent lung cancer surgery were selected and divided into an intervention group (n=51) and a control group (n=51) according to the different intervention methods. The control group received routine care, while the intervention group received additional Teach-back health education and graded exposure therapy. The intervention lasted for 4 weeks, after 4 weeks the levels of kinesiophobia (Tampa Scale of Kinesiophobia, TSK), psychological resilience (Connor-Davidson Resilience Scale, CD-RISC), and post-traumatic growth (Chinese-Posttraumatic Growth Inventory, C-PTGI) were evaluated in both groups. Results: After the intervention, the intervention group showed lower scores in all dimensions of the TSK—including kinesiophobia, functional disorder, activity avoidance, and risk perception—as well as in the total score compared to the control group (P<0.05). The intervention group demonstrated higher scores in all dimensions of the CD-RISC—including strength, tenacity, and optimism—compared to the control group (P<0.05). The intervention group exhibited higher scores in all dimensions of the C-PTGI—such as relationship with others, personal strength, spiritual change, appreciation of life, and new possibilities—as well as in the total score compared to the control group (P<0.05). Conclusion: The combined intervention of Teach-back health education and graded exposure therapy has positive clinical value in reducing postoperative kinesiophobia, enhancing psychological resilience, and promoting post-traumatic growth in patients with lung cancer.