Objective To analyze the clinical manifestations and influencing factors of Tourette syndrome (TS) in children. Methods 50 children with TS in the hospital from February 2019 to February 2024 were selected as study group, and 105 healthy children who came to the hospital for physical examination during the same period were included in control group. The clinical manifestations of children with TS were recorded. The general data[gender, age, family history of tic disorder, bad eating habits, recurrent respiratory tract infection within 1 year, education level of guardians, history of perinatal abnormal diseases, family education mode]and laboratory indicators[blood lead (Pb), blood zinc (Zn), blood selenium (Se), 25-hydroxyvitamin D]were collected and compared between groups. The family relationship was evaluated by the three dimensions of intimacy, emotional expression and contradiction of Family Environment Scale - Chinese Version (FES-CV). Variables with P<0.05 in univariate analysis were included in a binary logistic regression model with sex and age forced as control variables to identify factors independently associated with TS. Results The clinical manifestations of 50 children with TS were complicated, including frowning and blinking (84.00%), followed by throat noise (68.00%), head shaking and shoulder shrug (58.00%), mouth opening and grin (46.00%), sniffing (36.00%), shoulder twisting (30.00%) and abdominal muscle twitching (6.00%). There were no statistical differences in gender, age, bad eating habits, education level of guardians, per capita monthly family income, domicile, residence, Pb, Zn, Se and 25-hydroxyvitamin D levels between the two groups (P>0.05). The proportions of family history of tic disorder, recurrent respiratory tract infection within 1 year, history of perinatal abnormal diseases and strict family education mode in study group were higher than those in control group (P<0.05), and the scores of intimacy and emotion expression of family relationship were lower (P<0.05) while the score of contradiction was higher compared with the control group (P<0.05). Regression analysis results showed that family history of tic disorder (OR=3.431, 95%CI: 1.642-7.170), recurrent respiratory tract infection within 1 year (OR=2.903, 95%CI: 1.488-5.665), history of perinatal abnormal diseases (OR=2.601, 95%CI: 1.346-5.026), strict family education mode (OR=3.656, 95%CI: 1.801-7.415), low intimacy score (OR=2.581, 95%CI: 1.336-4.986), low emotional expression score (OR=2.927, 95%CI: 1.477-5.801) and high contradiction score (OR=2.646, 95%CI: 1.353-5.172) were independent risk factors for TS occurrence (P<0.05). Conclusion The clinical manifestations of children with TS are complex and diverse, including frowning and blinking, throat noise, head shaking and shoulder shrug, mouth opening and grin, sniffing, shoulder twisting and abdominal muscle twitching. Children with family history of tic disorder, recurrent respiratory tract infection within 1 year, history of abnormal perinatal diseases, strict family education mode, and discordant family relationship show higher detection rates of TS, and these factors may serve as references for high-risk screening. Clinical interventions should focus on modifiable family environmental factors, with family history used as a risk marker to strengthen early identification however, the causal direction and intervention efficacy require further validation through prospective studies.

Objective To investigate the clinical effect of press needle combined with eptazocine on acute pain after hepatectomy for liver cancer based on neuroimmune regulation mechanism. Methods Eighty patients undergoing hepatectomy for liver cancer were randomly divided into observation group (press needle + eptazocine) and control group (eptazocine), with 40 cases in each group, treated continuously for 3 days. Serum levels of β-endorphin, substance P, IFN-γ, IL-10, and inflammatory factors (IL-4, IL-6, TNF-α) were measured in both groups. Visual Analogue Scale (VAS) score, Karnofsky Performance Status (KPS) score, cumulative eptazocine consumption, adverse reactions, and total effective rate of analgesia were evaluated within 72 hours postoperatively. Results The levels of β-endorphin in the observation group were higher than those in the control group at 48 h and 72 h postoperatively (P<0.05). At each time point, the levels of substance P, IFN-γ, IL-6, TNF-α and VAS scores in the observation group were lower than those in the control group, while the levels of IL-10, IL-4 and KPS scores were higher than those in the control group (P<0.05). The cumulative eptazocine consumption and incidence of adverse reactions in the observation group were lower than those in the control group, and the total effective rate of analgesia in the observation group (100%) was higher than that in the control group (85%) (P<0.05). Conclusion Press needle combined with eptazocine can enhance the analgesic effect after hepatectomy and reduce the dosage of eptazocine and adverse reactions. The mechanism may be related to the regulation of neuroimmune axis and inhibition of inflammation.

Objective To compare the prognostic value of four scoring systems, including the original intracerebral hemorrhage score (OICH), modified intracerebral hemorrhage scale A (mICH-A), modified intracerebral hemorrhage scale B (mICH-B) and intracerebral hemorrhage grading scale (ICH-GS), for 30-day in-hospital prognosis in patients with spontaneous intracerebral hemorrhage (SICH). Methods A total of 218 patients with SICH were enrolled in this study. Clinical data of all patients were collected, and the scores of OICH, mICH-A, mICH-B and ICH-GS were calculated respectively. The 30-day in-hospital prognosis (death/survival) was regarded as the primary outcome indicator. Binary logistic regression analysis was performed to screen independent risk factors, and receiver operating characteristic (ROC) curve was adopted to compare the predictive efficacy of each single scale and their combined application. Results Binary logistic regression analysis showed that age (OR=1.055, 95%CI: 1.008-1.105, P=0.022), level of consciousness (OR=2.074, 95%CI: 1.101-3.908, P=0.024), intraventricular hemorrhage (OR=4.644, 95%CI: 1.256-17.194, P=0.021), OICH (OR=2.123, 95%CI: 1.006-4.481, P=0.048), mICH-A (OR=1.321, 95%CI: 1.014-1.721, P=0.039), mICH-B (OR=1.411, 95%CI: 1.042-1.912, P=0.026) and ICH-GS (OR=1.847, 95%CI: 1.237-2.761, P=0.003) were independent risk factors for poor 30-day in-hospital prognosis in SICH patients. ROC curve analysis indicated that the area under the curve (AUC) of mICH-B was higher than that of the other three single scales. The combined prediction model of four scales achieved the highest AUC (0.928, 95%CI: 0.886-0.959, P<0.001), with a sensitivity of 80.77% and a specificity of 96.35%. Conclusion mICH-B can be used as a clinical prognostic prediction tool for SICH patients. The combined application of the four scales can further improve the accuracy of 30-day prognosis prediction, so as to provide evidence for the optimization of clinical treatment strategies.

Objective To identify risk factors influencing ICU transfer after orthopedic surgery in patients with multiple trauma and to develop a corresponding predictive model. Methods A total of 300 patients with orthopedic multiple trauma admitted to our hospital from January 2020 to January 2025 were retrospectively selected as the research subjects. They were divided into a modeling set (n=210) and a validation set (n=90) using simple random grouping in a 7∶3 ratio. Patients were classified into the transfer group and the non-transfer group based on whether they were transferred to the ICU after surgery. Risk factors for postoperative ICU transfer were screened, and a prediction model was constructed. Results Among the 210 patients in the modeling set, 61(29.05%) were transferred to the ICU, while 26 (28.89%) of the 90 patients in the validation set were transferred to the ICU. Multivariate Logistic regression analysis showed that age, ASA grade, ISS score, emergency surgery, intraoperative blood loss, intraoperative hypotension or hypoxemia, postoperative GCS score, urine output at 6 h postoperatively, and Hb, D-dimer, SpO₂, Lac, PT, ALB, and Cr levels within 6 h postoperatively were independent factors associated with postoperative ICU transfer (all P<0.05). No significant multicollinearity was observed among these factors. LASSO regression further identified six core predictors, including ASA grade, ISS score, emergency surgery, intraoperative blood loss, SpO₂ within 6 h postoperatively, and Lac, which were used to construct the nomogram. The AUC was 0.783 (95%CI: 0.677-0.889) in the modeling set and 0.771 (95%CI: 0.554-0.823) in the validation set. The model showed good calibration and clinical net benefit. Conclusions The ICU-transfer risk nomogram, based on ASA class, ISS score, emergency surgery, intra-operative blood loss, postoperative 6 h SpO₂, and lactate level, exhibits good discriminative performance and calibration. It can serve as a practical tool to support clinical decision-making in orthopedic patients with multiple trauma.

Objective To observe the efficacy of ultrasound-guided external oblique intercostal plane block (EOIPB) in patients undergoing laparoscopic gastrectomy. Methods 80 patients undergoing elective laparoscopic gastrectomy were randomly divided into two groups, an EOIPB group and a control group. In the EOIPB group, the patients received ultrasound-guided bilateral EOIPB 20 mL of 0.5% ropivacaine administered on each side before anesthesia induction. In the control group, the patients received no intervention before anesthesia induction. The primary outcomes were visual analog scale (VAS) scores within 24 h postoperatively and the number of patient-controlled analgesia (PCA) uses 24 h postoperatively. The secondary outcomes were dermatomal coverage of EOIPB, intraoperative vital signs, the intraoperative dose of remifentanil, and the 24-h postoperative quality of recovery-40(QoR-40) score of the two groups. Results In the EOIPB group, the intraoperative remifentanil dose was significantly reduced (1.74±0.25 mg) compared to the C group (1.93±0.13mg, P<0.05). The number of PCA uses within 24 h was significantly lower in the EOIPB group (1.55±1.00) compared to C group (5.18±1.33, P<0.05). Dermatomal coverage in the EOIPB group achieved 100% T6-T10 at the anterior median and midclavicular line, 87.5% T6-T10 at the anterior axillary line, and 95% T7-T8 at the posterior axillary line. VAS scores at rest and movement were significantly lower in the EOIPB group than in the control group at 30min, 6h, and 12h postoperation (P<0.05), with no significant difference at 24 h (P>0.05). Mean arterial pressure (MAP) was significantly lower in the EOIPB group at skin incision (T2), 10 min postoperative (T3), and 30 min after extubation (T5) (P<0.05), and heart rate (HR) was significantly lower at T2(P<0.05). The EOIPB group had a shorter bedridden time (24.50±2.46 h vs 27.33±2.95 h, P<0.05) and a higher QoR-40 score (170.15±4.89 vs.165.40±6.41, P<0.05), indicating improved recovery. The incidence of adverse reactions in the EOIPB group (15.0%) was significantly reduced compared to the C group (37.5%, P<0.05). Conclusion EOIPB in laparoscopic gastrectomy can reduce the use of analgesic drugs during and after surgery. EOIPB also steadied the intraoperative vital signs, reduced pain sensations, and improved the quality of recovery. EOIPB can be safely and effectively used in laparoscopic gastrectomy.

Objective To investigate the effects of acupuncture at Shenshu (BL23), Dachangshu (BL25), and Jiaji (EX-B2) points combined with prone position traction-oblique pulling manipulation on pain degree, lumbar function, and sleep quality in patients with lumbar disc herniation (LDH). Methods A total of 104 LDH patients admitted between November 2023 and November 2025 were selected as study subjects. They were randomly divided into a control group and an observation group using a random number table, with 52 cases in each group. The control group was treated with prone position traction-oblique pulling manipulation alone, while the observation group received additional acupuncture at Shenshu, Dachangshu, and Jiaji points on the basis of the control group's treatment. Both groups underwent 2 treatment courses. Clinical efficacy was evaluated. Pain degree [Numerical Rating Scale (NRS)],lumbar function [Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were assessed before and after treatment. In addition, the improvement in lumbar spine function (straight leg raising test angle, sensory disturbance score, muscle strength score) was observed in both groups. Results A total of 49 cases in the observation group and 47 cases in the control group completed the study. The total effective rate was 89.80% (44/49) in the observation group, which was significantly higher than that in the control group (76.60%, 36/47) (P<0.05). After 2 treatment courses, NRS pain score, ODI score, PSQI total score, and sensory disturbance score decreased in both groups compared with before treatment (P<0.05), and all these indicators were lower in the observation group than in the control group: NRS score (2.34±0.73) vs. (3.52±1.21), ODI score (24.22±4.18) vs. (32.51±4.62), PSQI total score (8.12±2.04) vs. (11.78±2.65), sensory disturbance score (2.6±0.8) vs. (4.1±1.0) (P<0.05) . JOA score, straight leg raising angle, and muscle strength score increased in both groups compared with before treatment (P<0.05), and all these indicators were higher in the observation group than in the control group：JOA score (21.12±3.08) vs. (18.53±2.91), straight leg raising angle (60.1±5.0)°vs. (50.5±6.1)°, muscle strength score (4.5±0.4) vs. (4.0±0.5) (P<0.05) . Conclusion Acupuncture at Shenshu, Dachangshu, and Jiaji points combined with prone position traction-oblique pulling manipulation can effectively alleviate pain, improve lumbar function and sleep quality, and aid in the recovery of lower limb sensation and muscle strength in LDH patients.

Objective To investigate the differences in efficacy and safety between tirofiban and aspirin in patients with acute ischemic stroke (AIS) and varying degrees of intracranial artery stenosis. Methods A total of 201 AIS patients were retrospectively enrolled and divided into a control group (oral aspirin enteric-coated tablets + clopidogrel bisulfate tablets, n=97) and an observation group (intravenous infusion of tirofiban injection, followed by oral aspirin enteric-coated tablets + clopidogrel bisulfate tablets, n=104) according to the actual treatment received. Patients in both groups were further stratified into three subgroups according to the severity of the culprit vessel stenosis: no stenosis, mild to moderate stenosis, and severe stenosis or arterial occlusion. Baseline characteristics, NIHSS scores before and after treatment, incidence of END, 90-day favorable prognosis rate, changes in platelet aggregation rate, and the occurrence of bleeding and death events were compared. Results Baseline characteristics were comparable between the two groups within each stenosis subgroup. After treatment, NIHSS scores and platelet aggregation rates significantly decreased in all subgroups compared to pre-treatment levels (P<0.05), and the scores in the observation group were significantly lower than those in the control group (P<0.05). In patients with severe stenosis or occlusion, the incidence of END was significantly lower and the 90-day favorable prognosis rate was significantly higher in the observation group compared to the control group (P<0.05). In contrast, no statistically significant differences were found in END incidence or favorable prognosis rate between the two groups for patients with no stenosis or mild to moderate stenosis. Regarding safety, there were no statistically significant differences in the incidence of systemic bleeding events or mortality between the two groups within any stenosis subgroup, and no symptomatic intracranial hemorrhage occurred in any group. Conclusion Tirofiban has significant efficacy and safety advantages in AIS patients with severe intracranial artery stenosis or occlusion, while its effects are comparable to aspirin in patients with non-severe stenosis.

Objective To explore the effects of acupoint massage nursing based on action research method on recovery of intestinal function, self-efficacy and adverse events in patients after laparoscopic cholecystectomy. Methods A total of 134 patients with gallstones and cholecystitis who underwent laparoscopic cholecystectomy in the hospital were enrolled between August 2024 and June 2025, and they were randomly divided into study group (67 cases, acupoint massage nursing based on action research method) and routine group (67 cases, routine intervention). The postoperative intestinal function, pain[Visual Analogue Scale (VAS) ]under rest and motion states at 1 d, 2 d and 3 d after surgery, mood state[Profile of Mood States (POMS) ], comfort[General Comfort Questionnaire (GCQ) ], self-efficacy[General Self-Efficacy Scale (GSES), Exercise of Self-Care Agency Scale (ESCA) ]before and after intervention, and the incidence of postoperative adverse events were compared between the two groups. Results The postoperative exhaust time, defecation time, recovery time of bowel sound and eating time in study group were all shorter than those in routine group (P<0.05). At 1 d and 3 d after surgery, VAS scores under rest and motion states in study group were lower than those in routine group (P<0.05). The scores of POMS in positive mood dimension and GCQ in study group were higher than those in routine group, and score in negative mood dimension was lower than that in routine group (P<0.05). After intervention, scores of GSES and ESCA in study group were higher than those in routine group (P<0.05). The incidence of postoperative adverse events in study group was lower than that in routine group (P<0.05). Conclusion The acupoint massage nursing based on action research method can effectively promote recovery of intestinal function, relieve pain, improve mood, self-efficacy and comfort, reduce incidence of adverse events and accelerate rehabilitation in patients after laparoscopic cholecystectomy.

Objective To explore the effect of multidisciplinary standardized evidence-based intervention on patients with brain contusion and laceration complicated by pneumonia. Methods From August 2023 to August 2024, 110 patients with brain contusion complicated by pneumonia and laceration hospitalized in the neurosurgery department of a tertiary grade A hospital were enrolled in this study. They were divided into a control group and an observation group according to random number table method. Patients in the control group received routine intervention measures, while those in the observation group received multidisciplinary standardized evidence-based intervention. The two groups were compared in terms of lung function[forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) ], the 36-Item Short Form Health Survey (SF-36) scores, Mini-Mental State Examination (MMSE) scores, Prognostic Nutritional Index (PNI) scores and Clinical Pulmonary Infection Score (CPIS) before and after intervention, duration of mechanical ventilation, length of ICU stay, and incidence of adverse events during intervention. The duration of mechanical ventilation and length of ICU stay were taken as primary study endpoints. Results After intervention, the observation group showed higher FEV1, FVC, and FEV1/FVC ratio than the control group (P<0.05). After intervention, scores for all domains of the SF-36 in the observation group were higher than those in the control group (P<0.05). After intervention, the observation group had higher MMSE and PNI scores, and lower CPIS scores than the control group (P<0.05). The duration of mechanical ventilation and length of ICU stay were shorter in the observation group than in the control group (P<0.05). No statistically significant difference was found in adverse events between the two groups during intervention (P>0.05). Conclusion Multidisciplinary standardized evidence-based intervention can effectively improve lung function, cognitive function, and nutritional status in patients with cerebral contusion and laceration complicated by pneumonia. It also can reduce the severity of pulmonary infection, enhance quality of life, and shorten the duration of mechanical ventilation and ICU stay. It is worthy of clinical application.

Objective To investigate the effects of acupuncture combined with Yiqi Tongluo Granules on Montreal Cognitive Assessment (MoCA) scores and the structure of gut microbiota in patients with post-stroke cognitive impairment (PSCI). Methods A total of 80 patients with PSCI admitted to the Department of Neurology of Cangzhou People's Hospital between January 2023 and December 2024 were selected and randomly assigned using a random number table method into an observation group and a control group, with 40 patients in each group. The control group received acupuncture treatment, while the observation group was administered oral Yiqi Tongluo Granules as an add-on therapy to the control regimen for a 12-week continuous treatment period. MoCA scores were compared between the two groups before and after treatment. Gut microbiota diversity and the abundance of key microbial taxa were detected before and after the intervention, and the incidence of adverse reactions was recorded. Results Following the treatment, MoCA scores were significantly increased compared to those before treatment in both groups (P<0.05), with the observation group demonstrating higher scores than the control group (P<0.05). After treatment, no statistically significant difference in the Chao1 index was observed between the two groups. However, the Shannon index was significantly increased compared to pre-treatment levels, and was higher in the observation group than in the control group (P<0.05). Spearman correlation analysis showed that the Shannon index was positively correlated with cognitive function (P<0.05). Post-intervention, the abundances of Bifidobacterium and Lactobacillus were significantly increased (P<0.05), while the abundance of Escherichia coli was significantly decreased (P<0.05) in both groups compared to baseline. The improvement in these key gut microbiota was more pronounced in the observation group than in the control group (P<0.05). During the treatment period, no statistically significant difference was found in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Acupuncture combined with Yiqi Tongluo Granules was found to significantly improve cognitive function and modulate the balance of gut microbiota in patients with PSCI, with a favorable safety profile.

Objective To investigate the influence of ultrasound-guided different approaches of fascia iliaca compartment block (FICB) on postoperative delirium and early rehabilitation quality in elderly patients undergoing hip replacement. Methods The clinical data of 120 elderly patients with femoral neck fractures who underwent total hip replacement in the hospital from May 2024 to May 2025 were retrospectively analyzed. All patients underwent ultrasound-guided FICB. According to the different approaches, they were divided into group A (56 cases, subinguinal approach) and group B (64 cases, suprainguinal approach). The nerve block related conditions, pain status[visual analogue scale (VAS) ], occurrence of postoperative delirium, early rehabilitation quality[40-item quality of recovery scale (QoR-40) ]and occurrence of complications were compared between the two groups. Results There were no statistical differences in the operation time of nerve block and onset time of femoral nerve block between the two groups (P>0.05). The onset time of lateral femoral cutaneous nerve block in group B was shorter than that in group A (P<0.05). Compared with admission, the VAS scores in the two groups at 12 h and 24 h after surgery were decreased (P<0.05). Compared with 12 h after surgery, the VAS scores in the two groups at 24 h after surgery were increased, but the VAS scores in group B at 12 h and 24 h after surgery were lower than those in group A (P<0.05). The total incidence rate of postoperative delirium in group B was lower than that in group A (P<0.05). Compared with 1 d after surgery, the QoR-40 scores in the two groups at 2 d after surgery were increased, and the QoR-40 scores in group B at 1 d and 2 d after surgery were higher than those in group A (P<0.05). The postoperative first ambulation time in group B was shorter than that in group A (P<0.05). There were no statistical differences in the complications between the two groups (P>0.05). Conclusion Compared with the subinguinal approach, ultrasound-guided suprainguinal FICB in elderly patients undergoing total hip arthroplasty achieved faster onset of lateral femoral cutaneous nerve blockade, improved postoperative analgesia, reduced the incidence of postoperative delirium, and facilitated early rehabilitation, without increasing the risk of complications.

Objective To explore the clinical effect of Qidongyixin Granule combined with auricular point sticking in the treatment of elderly cardiac neurosis. Methods A total of 80 elderly patients with cardiac neurosis were recruited at our hospital between July 2024 and July 2025. Participants were randomly assigned to either the auricular point group (n=40) or the combined group (n=40) using the random number method. The auricular point group received auricular point sticking treatment, while the combined group underwent treatment with Qidong Yixin granules in conjunction with auricular point sticking therapy. The Hamilton Depression Scale (HAMD) score, Hamilton Anxiety Scale (HAMA) score, Traditional Chinese Medicine (TCM) syndrome quantification score, clinical efficacy, routine electrocardiogram, and liver and kidney function safety were assessed for both groups prior to treatment and at 1 and 2 months post-treatment. Results The total effective rate in the combined group was significantly higher than that in the auricular point group (P<0.05). Compared with pre-treatment levels, the HAMD and HAMA scores of elderly patients in both groups decreased at the 1st and 2nd months post-treatment (P<0.05), with the combined group showing lower scores than the auricular point group (P<0.05). Similarly, compared with pre-treatment levels, the scores for TCM syndromes such as palpitation, chest tightness or pain, depression, shortness of breath, fatigue, insomnia, and the total score all decreased after treatment in both groups (P<0.05), and the scores in the combined group were lower than those in the auricular point group (P<0.05). The total effective rate of electrocardiogram improvement in the combined group was significantly higher than that in the auricular point group after treatment (P<0.05). No significant differences were observed in creatine kinase (CK), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels between the two groups before and after treatment (P>0.05). Compared with before treatment, the levels of creatine kinase isoenzyme (CK-MB), serum creatinine (Scr), and blood urea nitrogen (BUN) in both groups were decreased (P<0.05) after treatment, and the decreases in Scr and BOW levels were more significant in the combination group (P<0.05). Conclusion Qidongyixin Granule combined with auricular point sticking has better clinical efficacy in the treatment of elderly cardiac neurosis, which can reduce HAMD and HAMA scores, TCM syndrome scores, liver and kidney function related indexes of elderly patients, increase the total effective rate of electrocardiogram, improve the overall treatment effect, and provide a more optimized plan for clinical use, which is worth promoting.

Objective To analyze the cartilage repair effect of Ruanshang Lotion on patients with knee osteoarthritis (KOA). Methods A total of 152 KOA patients admitted to our hospital from May 2020 to March 2025 were randomly divided into two groups (76 cases each) using a random number table. The control group received conventional KOA treatment, while the observation group received Ruanshang Lotion in addition to the conventional treatment. The clinical efficacy, TCM syndrome scores, levels of inflammatory factors, knee joint recovery, deep cartilage repair, and cartilage tissue indicators were compared between the two groups. Results After treatment, 74 cases were included in the observation group and 72 in the control group. The total effective rate in the observation group (89.19%) was higher than that in the control group (76.39%) (P<0.05). The TCM syndrome scores in both groups decreased compared with those before treatment, and were lower in the observation group than in the control group (P<0.05). After 4 weeks of treatment and at the end of treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in both groups decreased compared with those before treatment (P<0.05), and were lower in the observation group than in the control group (P<0.05). After 4 weeks of treatment and at the end of treatment, the index of severity for osteoarthritis (ISOA), visual analog scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in both groups decreased compared with those before treatment, and were lower in the observation group than in the control group (P<0.05). Before treatment, there were no statistically significant differences between the two groups in the levels of C-telopeptide of type Ⅱ collagen (CTX-Ⅱ), cartilage oligomeric matrix protein (COMP), matrix metalloproteinase-13 (MMP-13), or a disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS4) (P>0.05). After 4 weeks of treatment and after 8 weeks of treatment, the levels of CTX-Ⅱ, COMP, MMP-13, and ADAMTS4 in both groups decreased compared with those before treatment; however, there were no statistically significant differences between the two groups in CTX-Ⅱ, COMP, or MMP-13 (P>0.05), while ADAMTS4 in the observation group was lower than that in the control group (P<0.05). After 8 weeks of treatment, the levels of CTX-Ⅱ, COMP, MMP-13, and ADAMTS4 in the observation group were lower than those in the control group (P<0.05). During the treatment period, there was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The application of Ruanshang Lotion in the treatment of patients with knee osteoarthritis can reduce the body's inflammatory response, alleviate cartilage damage, relieve clinical symptoms, improve clinical efficacy, and does not increase the incidence of adverse reactions.

Objective To investigate the relationship between NLR, PLR and post-hospital mortality in ischemic stroke patients with pulmonary infection, aiming to provide a basis for clinical treatment strategies. Methods We retrospectively collected data from the MIMIC-Ⅳ 3.0 database of patients with ischemic stroke complicated by pulmonary infection who met the study criteria. Using a tertile method, NLR and PLR were each divided into three groups. NLR and PLR were assessed in relation to patient survival and mortality risk using Kaplan-Meier (K-M) survival curves and Cox risk models. Subgroup analyses were also performed to explore differences between different subgroups. Results A total of 2249 patients with ischemic stroke complicated by pulmonary infection were included. K-M survival curves indicated that patients with NLR of 4.49~39.10 and PLR>810.12 had lower post-hospital mortality rates. Cox model showed that patients with an NLR>39.10 and a PLR between 0.54~138.85 had an increased risk of post-hospital mortality. Subgroup analysis revealed a significant association between NLR and post-hospital mortality in patients with ischemic stroke complicated by pulmonary infection and malignant tumors, and between PLR and post-hospital mortality in patients with ischemic stroke complicated by pulmonary infection and malignant tumors or metastatic solid tumors. Conclusion Combined assessment of the NLR and PLR has a certain predictive value for the risk of mortality in patients with ischemic stroke with pulmonary infection, providing a reference for the diagnosis and treatment of this disease.

Objective To study the changes of total progressive motile sperm count (TPMSC) after semen optimization treatment and its influence on the clinical pregnancy outcome of artificial insemination with husband's sperm. Methods A retrospective analysis was conducted on the clinical data of 169 couples who received artificial insemination with husband's sperm by intrauterine insemination (AIH-IUI) for a total of 314 cycles in our hospital from February 2019 to December 2024. Compare the changes of TPMSC after semen optimization treatment; According to whether clinical pregnancy outcome of AIH-IUI was clinical pregnancy, the patients were divided into the pregnancy group (n=69) and the non-pregnancy group (n=100). The ages of both spouses, the duration of infertility, the number of inseminations, the incubation temperature of the inseminated semen, and the TPMSC after semen optimization treatment were compared between the two groups. According to the TPMSC values after semen optimization treatment, the patients were divided into three groups: Group A with TPMSC values of (0-9) ×10⁶, Group B with (10-50) ×10⁶ and Group C with>50×10⁶. The clinical pregnancy rates of AIH-IUI among the groups were compared. Logistic multivariate regression analysis was conducted on the age of the female, the incubation time of the optimized sperm, and the clinical pregnancy results of TPMSC and AIH-IUI after optimized treatment. Results (1) The TPMSC value of semen after optimized processing was significantly lower than that before processing (P<0.05), and sperm viability and progressive motility ratio were generally improved after treatment; (2) There was no statistically significant difference in the age of the male partner, the duration of infertility, the frequency of insemination and the incubation temperature of the inseminated semen between the pregnant group and the non-pregnant group (P>0.05). However, the female age of the two groups, the incubation time of the optimized sperm and the TPMSC after semen optimization treatment were statistically significant (P<0.05). (3) After semen optimization treatment, the clinical pregnancy rate of group A was 14.29%, that of group B was 40.00%, and that of group C was 13.04%. The rate of group B was significantly higher than that of groups A and C (P<0.05). (4) Logistic regression analysis showed that the age of the female would affect the clinical pregnancy rate, and the pregnancy rate decreased with the increase of the female's age (OR=0.81, 95% CI: 0.78-0.91, P<0.05), while the optimized sperm incubation time was 18-40 minutes (OR=2.19, 95% CI: 1.83-3.24, P<0.05) and treated TPMSC (10-50) ×10⁶[OR=2.23, 95% CI: 1.87-3.16, P<0.05) could significantly increase the clinical pregnancy rate. Conclusion TPMSC decreases after semen optimization treatment, and TPMSC after semen optimization treatment has a certain impact on the clinical pregnancy outcome of AIH-IUI.

Objective To investigate the correlation between serum biomarker levels and the severity of patients with acute pancreatitis and its predictive value. Methods A total of 209 patients with acute pancreatitis (AP) who were treated in the Third People's Hospital of Chengdu from January 2019 to June 2025 were selected and categorized into mild AP (MAP) group, moderately severe AP (MSAP) group and severe AP (SAP) group according to the severity of the disease. The general data and serum biomarker levels of the three groups were compared and analyzed. Multivariate logistic regression analysis was used to analyze the correlation between each index and the severity of AP patients, and the receiver operating characteristic (ROC) curve was used to verify its predictive performance. Results There were statistically significant differences in neutrophil/lymphocyte ratio (NLR), red blood cell distribution width (RDW), fibrinogen (FIB), D-dimer (D-D), triglyceride (TG), blood calcium (Ca²⁺), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels among the three groups (P<0.05). The levels of NLR, FIB, D-D, TG, AST, LDH and CRP in the SAP group were higher than those in the MAP and MSAP groups, and the levels of Ca²⁺ were lower than those in the MAP and MSAP groups (P<0.05). The levels of NLR, RDW, FIB, D-D, TG and LDH in the MSAP group were higher than those in the MAP group (P<0.05). NLR (OR=1.451), RDW (OR=1.632), TG (OR=1.355) and AST (OR=1.043) were independent influencing factors for the progression of AP to SAP (P<0.05). The area under the curve of single and combined detection of NLR, RDW, TG and AST in the diagnosis of SAP were 0.787, 0.784, 0.743, 0.778 and 0.941, respectively. Conclusion NLR, RDW, TG and AST are closely related to the severity of AP patients, and the combined prediction efficacy is favorable.

Objective To construct a prediction model for the therapeutic effect of electronic bronchoscopy in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation based on multidimensional clinical indicators, and to validate the model's efficacy clinically. Methods A total of 168 pediatric patients with Mycoplasma pneumoniae pneumonia and pulmonary consolidation who underwent electronic bronchoscopy treatment at our hospital from January 2022 to December 2024 were selected as the study subjects. According to the treatment outcome, they were divided into an effective group (125 cases) and an ineffective group (43 cases). Univariate analysis was conducted on multimodal data from the two groups, including medical imaging, clinical laboratory indicators, symptoms, and signs. Binary logistic regression was used to analyze the risk factors affecting the efficacy of electronic bronchoscopy treatment in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation. The predictive performance of the identified risk factors and a nomogram for the treatment outcome was evaluated using the receiver operating characteristic (ROC) curve. Results Significant differences were observed between the ineffective and effective groups in the extent of pulmonary consolidation, presence of atelectasis, NLR, CRP, and serum mycoplasma antibody titers (P<0.05). Large consolidation area, presence of atelectasis, elevated NLR, elevated CRP, and antibody titers ≥1∶320 were risk factors for poor treatment outcomes (P<0.05). The AUC values for the extent of consolidation, atelectasis, NLR, CRP, antibody titers, and the combined prediction were 0.729, 0.637, 0.898, 0.754, 0.709, and 0.972, respectively. The combined prediction achieved the highest AUC, along with the highest sensitivity (95.3%) and specificity (90.4%). Conclusion A prediction model based on multidimensional clinical indicators—including imaging findings (extent of consolidation, atelectasis) and laboratory markers (NLR, CRP, serum antibody titers) —demonstrates strong efficacy in predicting the therapeutic outcomes of electronic bronchoscopy in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation, with good sensitivity and specificity.

Objective To explore the potential value of stromal cell proteins thrombospondin 1(TSP1) and osteocalcin (OCN) in evaluating hormonal exposure in patients with hypopituitarism (HP) receiving glucocorticoid (GC) replacement therapy at different doses, and to investigate whether the TSP1, OCN and their ratio can serve as a reference indicator for adequate exogenous glucocorticoid replacement. Methods From August 2022 to December 2024, 82 patients with HP who had received continuous GC replacement therapy for ≥6 months and were in a stable condition were enrolled as observation subjects at Xiangdong Hospital Affiliated to Hunan Normal University. Based on the GC dosage administered, the patients were divided into three groups: Group A (low physiological dose, n=19), Group B (physiological dose, n=36), and Group C (supraphysiological dose, n=27). Baseline (at enrollment) levels of TSP1 and OCN were measured, and their ratio was calculated. Furthermore, 19 patients from the above three groups were subdivided into three subgroups: Subgroup A1(n=7), Subgroup B1(n=6), and Subgroup C1(n=6). After 12 weeks of continued treatment, serum levels of bone-specific alkaline phosphatase (β-ALP), propeptide of type I procollagen (PINP), cross-linked C-telopeptide of type I collagen (CTX-I), TSP1, and OCN, as well as their respective ratios, were measured at baseline and after 12 weeks of treatment for comparison. In addition, the above parameters were compared between the 19 HP patients and 10 healthy controls at baseline. Results 1) Baseline comparisons revealed that OCN levels in the three groups gradually decreased with increasing GC dosage, and the differences were statistically significant (P<0.05).2) Intergroup comparisons among the three subgroups demonstrated that OCN and CTX-I levels decreased with increasing GC replacement doses (P<0.05). Compared with the respective baseline values, the A1 subgroup showed a decrease in PINP levels after 12 weeks of treatment, the B1 subgroup exhibited an increase in TSP1 levels, and the C1 subgroup showed a decrease in OCN levels along with an increase in the TSP1∶OCN ratio after treatment, all with statistically significant differences (all P<0.05).3) Compared with healthy controls, HP patients exhibited significantly lower levels of PINP, β-ALP, TSP1, and OCN (P<0.05). Conclusion 1) GC replacement therapy results in exogenous hormone exposure in patients with HP. Higher replacement doses are associated with lower OCN levels and an increased risk of osteoporosis. It is therefore postulated that OCN may serve as a potential biomarker for assessing the risk of exogenous glucocorticoid exposure. However, current evidence does not support the use of TSP1 or the TSP1∶OCN ratio as reference indicators for evaluating such risk. 2) Compared with healthy controls, patients with HP exhibit reduced levels of PINP, β-ALP, TSP1, and OCN, suggesting that glucocorticoids suppress bone formation. In contrast, no significant modulatory effect on bone resorption was observed.

Objective To investigate the current status of caregiver burden, social support, and quality of life among family caregivers of patients with recurrent schizophrenia, analyze the correlations among these three factors, and identify the influencing factors of quality of life. Methods Using systematic sampling, 250 core family caregivers of patients with recurrent schizophrenia were selected from the psychiatric department of a tertiary hospital in Hunan Province between July 2025 and January 2026. The Family Burden Interview Schedule (FBIS), World Health Organization Quality of Life - Brief Version (WHOQOL-BREF), and the Social Support Rating Scale were employed for investigation. Data were analyzed using Pearson correlation and multivariate logistic regression analyses. Results The average FBIS score among family caregivers was 22.80±9.97. Univariate analysis showed significant differences in caregiver burden among caregivers of education levels, duration of caregiving (months), daily caregiving hours, and monthly family income (P<0.05). The average social support score was 40.17±6.76, with significant differences related to age, religious belief, caregiving duration, and number of co-caregivers (P<0.05). The average WHOQOL-BREF score was 59.08±9.15, with significant differences found according to education level, occupation, residence, relationship to patient, daily caregiving time, family monthly income, and presence or absence of mental illness (P<0.05). Caregiver burden and social support were correlated with their quality of life. Relationship to patient, daily caregiving time, family monthly income and caregiver burden were influencing factors of caregivers' quality of life. Conclusion Family caregivers of patients with recurrent schizophrenia bear a heavy caregiver burden, which significantly affects their quality of life. Clinical and social interventions should consider factors such as caregiving duration to develop targeted strategies to alleviate caregiver burden and improve quality of life.

Objective To investigate the relationship between body mass index (BMI), waist circumference (WC), body roundness index (BRI), weight-adjusted waist index (WWI) and dyslipidemia in high-risk populations for atherosclerotic cardiovascular disease (ASCVD), providing guidance for lipid health management programs conducted in community hospitals. Methods A total of 389 subjects from a certain community in Changsha City who met the high-risk criteria for atherosclerotic cardiovascular disease (ASCVD) were included. Baseline data and lipid levels were collected. BMI, BRI, and WWI were calculated. Pearson or Spearman partial correlation analysis was used to examine the correlation between each index and lipid component levels. Logistic regression analysis was employed to explore the association between each index and dyslipidemia. The predictive ability of each index and combined indices for dyslipidemia was analyzed using receiver operating characteristic (ROC) curves. Results In high-risk populations for atherosclerotic cardiovascular disease (ASCVD), BMI, WC, BRI, and WWI were all positively correlated with total cholesterol, triglycerides, and low-density lipoprotein cholesterol (P<0.05), and negatively correlated with high-density lipoprotein cholesterol (P<0.05). Multivariate logistic regression analysis showed that each morphological index was associated with the risk of dyslipidemia (P<0.05). ROC curve analysis indicated that each morphological index could predict the risk of dyslipidemia (P<0.05). From the perspective of individual morphological indices, the AUC of BMI and BRI was slightly higher than that of WC, but there was no significant statistical difference (P>0.05); compared with BMI and BRI, WWI did not show a better predictive ability (P<0.05). Compared with WC and WWI as independent predictors, BMI+BRI and BMI+WWI both exhibited better predictive power (P<0.05). Conclusions BMI, WC, BRI, and WWI are all associated with the prevalence of dyslipidemia. Compared with WC and WWI as independent predictors, combined indicators (BMI+BRI, BMI+WWI) have a better predictive effect on dyslipidemia.

Objective To explore the application effect of multimodal temperature management combined with sensory stimulation under the enhanced recovery after surgery pathway in patients undergoing general anesthesia for thoracolumbar fractures, as well as its impact on the perioperative body temperature and anesthesia awakening quality of the patients. Methods A total of 154 patients with thoracolumbar fractures undergoing general anesthesia surgery in the hospital from August 2022 to August 2025 were selected as research subjects. According to the random number table method, the selected patients were categorized into two groups, with 77 cases in each group. The control group was given routine heat preservation regimen and wake-up service, whereas the study group received multimodal body temperature management under fast track surgery pathway combined with sensory stimulation. Perioperative indicators, coagulation indicators before and after intervention, quality of anesthesia recovery and incidence rates of postoperative adverse reactions were compared between both groups of patients. Results After surgery, the body temperature in the study group was higher than that in the control group. The number of blood transfusion cases was less than that of the control group (P<0.05). After surgery, the thrombin time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) in the control group were prolonged, and the level of fibrinogen (Fbg) was decreased (P<0.05), and no significant differences were observed in the study group compared with preoperative values (P>0.05). TT, PT and APTT in the study group were shorter than those in the control group, and Fbg was higher (P<0.05). The recovery time of consciousness, the recovery time of spontaneous breathing, and the length of stay in the anesthesia recovery room for the patients in the study group were all shorter than those in the control group (P<0.05). The total incidence rate of postoperative adverse reactions in the study group (7.79%) was lower compared to the control group (19.48%) (P<0.05). Conclusion For patients undergoing general anesthesia surgery for thoracolumbar fractures, the application of the enhanced recovery after surgery (ERAS) pathway combined with multimodal temperature management and sensory stimulation is beneficial for maintaining the patient's body temperature, ensuring normal coagulation function, improving the quality of anesthesia recovery, and reducing postoperative adverse reactions.

Objective Using the CLSI EP09c guideline as the standard, this study evaluated the comparability and bias of measurement procedures for detecting fibrin/fibrinogen degradation products (FDP) and D-dimers (DD) in plasma using chemiluminescence and latex immunoturbidimetry methods, providing a reference basis for mutual recognition of FDP and DD results obtained using different methods. Methods Latex immunoturbidimetry was used as the reference method (X) and chemiluminescence immunoassay as the test method (Y). Passing-Bablok regression was used to perform linear fitting of the results, and the bias at the selected concentration levels was calculated separately. Using 1/2 TEa (the total allowable error permitted by the National Health Commission Clinical Laboratory Center's interlaboratory quality assessment) as the evaluation criterion, the test results were subjected to methodological comparison and bias assessment, and the correlation, consistency, and superiority of the two measurement procedures were assessed. Results The bias of chemiluminescence method was -9.59% (<17.5%) for FDP at 5.0 mg/L and 14.29% (<25.0%) for DD at 0.5 mg/L, both within acceptable ranges. The chi-square test results of DD and FDP showed that the two methods had a good correlation (P<0.001), The Kappa test results of FDP were k=0.66(P<0.001) and the Kappa test of DD was k=0.85(P<0.001), both indicating good agreement, and the McNemar test showed no significant difference between the two methodologies (P>0.05), and the two measurement procedures were comparable. Conclusion The measurement procedures for FDP and DD using the two methods show good consistency and correlation. The bias at the upper limit of the clinical reference range is within an acceptable range, meeting clinical testing requirements, and mutual recognition is possible within a certain range.

Objective To investigate the distribution characteristics of voriconazole trough concentrations and the factors influencing their variability, and to provide a basis for individualized therapy. Methods A retrospective study was conducted in patients receiving voriconazole therapy with therapeutic drug monitoring. Clinical data were collected and voriconazole plasma concentrations were determined using high-performance liquid chromatography. Differences in trough concentrations across clinical characteristics and concomitant medications were analyzed. The dose-normalized trough concentration (Cmin/Dose) was calculated as the trough concentration divided by the corresponding daily dose. Univariate and multivariate linear regression analyses were performed to identify independent factors affecting drug exposure. Results A total of 267 patients were included. The daily dose of voriconazole ranged from 50 to 640 mg. Among them, 11.6% of patients had trough concentrations below the effective lower limit (<1.0 μg/mL), and 13.48% exceeded the safety upper limit (>5.5 μg/mL). Trough concentrations were significantly associated with age and loading dose. Multivariate analysis identified total bilirubin as an independent factor influencing dose-normalized trough concentrations (P<0.001). Conclusion Voriconazole trough concentrations exhibit substantial interindividual variability. Total bilirubin may serve as an important predictor of concentration changes and has clinical value for individualized dosing under therapeutic drug monitoring.

Objective To investigate the survival, complications, growth and development of extremely preterm infants (EPI). Methods This study collected clinical data of EPI (<28 gestational weeks) admitted to our neonatal intensive care unit (NICU) from January 2020 to December 2023. The infants were categorized by outcome into death group, treatment withdrawal group, and survival group; by gestational age into<26 weeks group and ≥26 weeks group; and by birth weight into ≤750 g group and>750 g group. We analyzed the clinical characteristics, developmental outcomes of survivors, and identified prognostic risk factors through multivariate unconditional logistic regression analysis. Results A total of 64 extremely preterm infants were included. Among them, 3 cases were in the treatment withdrawal group(not included in the denominator for survival rate calculation), 46(75.41%) in the survival group, and 15(24.59%) in the death group. The proportion with a birth weight>750g in the survival group was significantly higher than that in the death group (P<0.05). Both gestational age and birth weight in the survival group were significantly greater than those in the death group (P<0.05). The top five complications among the 64 extremely preterm infants were neonatal respiratory distress syndrome (NRDS), early postnatal hyperglycemia, bronchopulmonary dysplasia (BPD), neonatal sepsis, and pulmonary infection. The survival group had significantly lower proportions of the following compared to the death group (P<0.05): mechanical ventilation, ≥2 doses of pulmonary surfactant (PS), NRDS grade Ⅲ-Ⅳ, pulmonary hemorrhage, discharge weight>10th percentile (P10) for corrected gestational age and sex, patent ductus arteriosus (PDA) size-to-weight ratio. Conversely, the survival group had significantly higher values than the death group (P<0.05) in: duration of proportion receiving PDA treatment, rate of ductus arteriosus closure, proportion requiring red blood cell transfusions, incidence of retinopathy of prematurity (ROP), length of hospital stay, hospitalization costs. Multivariate unconditional logistic regression analysis identified shock and PDA as independent risk factors affecting EPI (P<0.05). The ≥26 weeks group had significantly larger head circumference at 1 month of corrected gestational age compared to the<26 weeks group (P<0.05). Conclusion The survival rate of EPI is approximately 75%, which is positively correlated with gestational age and birth weight. Shock and PDA are independent risk factors affecting mortality outcomes in extremely preterm infants. There were no significant differences in long-term development among EPI of different gestational ages at birth, and no significant developmental differences were observed among EPI with different birth weights.

Objective To explore the prevalence status of respiratory syncytial virus (RSV) pneumonia in preschool children and analyze its influencing factors. Methods The data of 286 children who were treated in the hospital from October 2022 to October 2025 were retrospectively analyzed. The prevalence status of pneumonia in children was counted. According to the severity of pneumonia, the children were divided into mild group (n=210) and severe group (n=76). The clinical data were compared between both groups, and the risk factors that influence the progression of RSV induced pneumonia to severe cases were analyzed. Results The proportion of age≤2 years old, high fever, fever duration, hospitalization time, proportions of asthma, medium-coarse rales, mixed infection, pulmonary parenchymal lesions and viral load≥10⁶ copies/mL, WBC, NEUT, serum CRP, ALT and CK-MB levels in severe group were significantly higher than those in mild group (P<0.05) while LY was significantly lower than that in mild group (P<0.05). There were no statistical differences in gender, contact history, wheezing due to phlegm in the throat and extrapulmonary symptom between the two groups (P>0.05). Binary Logistic regression analysis showed that age≤2 years old, high fever, prolonged fever duration, asthma, mixed infection, viral load≥10⁶ copies/mL and elevated WBC were risk factors of severe pneumonia in children with RSV infection (P<0.05). Conclusion The rate of severe lung disease is high in preschool children with RSV pneumonia. Age, high fever, fever duration, asthma, mixed infection, viral load and WBC level can affect the disease conditions of children. It is necessary to perform early detection and early treatment of children with RSV pneumonia to avoid progression to severe condition.

Objective To explore mediation effects of social status and lifestyle on the associations of diabetes and its traits with sarcopenia traits. Methods Mediation analysis was conducted to explore the potential social and lifestyle mediators of diabetes and its traits on sarcopenia traits [appendicular lean mass (ALM), hand grip strength (HGS), and walking pace (WP) ] in the National Health and Nutrition Examination Survey (NHANES). Mendelian randomization was performed to examine the causal associations based on summary-level data of the exposures, mediators, and outcomes derived from the public genome-wide studies. Results Based on NHANES data, diabetes was negatively associated with WP and HGS [β=-0.466, 95%CI (-0.562, -0.370), P=2.92×10^-10], [β=-2.664, 95%CI (-3.645, -1.684), P=8.48×10^-6], whereas no significant association was observed between diabetes and ALM (P>0.05), partly through factors like education, income, heavy physical activities and intakes of energy, carbohydrate, vitamin E and alcohol (indirect effect ranging from 2.96% to 73.11%). According to the Mendelian randomization analyses, diabetes was negatively associated with HGS [β=-0.275, 95%CI (-0.419, -0.130), P=2.04×10^-4]. Additionally, diabetes related traits like paternal diabetes was negatively associated with HGS [β=-0.221, 95%CI (-0.377, -0.066), P=5.33×10^-3], whereas sibling diabetes was negatively associated with HGS[β=-0.224, 95%CI (-0.377, -0.071), P=4.18×10^-3 for right, [β=-0.293, 95%CI (-0.435, -0.151), P=5.21×10^-5 for left], and WP[β=-0.275, 95%CI (-0.387, -0.164), P=1.33×10^-6]. Income, light physical activities (PAs), intake frequency of dried fruit, salad and raw vegetable, intakes of red wine and spirits, played crucial roles as mediating factors in these associations (indirect effect ranging from 5.36% to 36.63%). Conclusion Income, PAs, alcohol consumption, and vegetable and fruit intakes play mediating roles in the relationships of diabetes and its traits with muscle health.

Objective To systematically evaluate the distribution characteristics of human papillomavirus (HPV) infection among in high-risk female populations for sexually transmitted disease. Methods Studies on HPV infection in high-risk female populations for sexually transmitted disease were retrieved from 7 databases (from the establishment of the database to May 2025). The quality of the articles that met the requirements was evaluated. Stata 18.0 and Review Manager 5.4 software were used for Meta-analysis. Results A total of 12 studies were included. Meta-analysis showed that the pooled prevalence of HPV infection among high-risk female populations for sexually transmitted disease was 41.3% (95% CI: 28.1%-54.5%). Low educational level was a significant risk factor for infection (OR=26.28, 95% CI: 7.41-93.62); smoking (OR=0.35, 95% CI: 0.12-0.98), history of other sexually transmitted infections (STI) (OR=0.11, 95% CI: 0.02-0.78), and younger age at first sexual intercourse (OR=0.07, 95% CI: 0.03-0.18) were associated with a risk of infection. No publication bias was detected in the analyses of the infection rate or the above factors. Conclusion The HPV infection rate among high-risk female populations for sexually transmitted disease is relatively high, and it is significantly associated with low educational level, smoking, a history of concurrent STI, and a young age at first sexual intercourse. This group is a key target for cervical cancer prevention and control, and comprehensive intervention measures need to be taken.

Objective To analyze the relationship of disease perception and negative emotions with quality of life in patients with erectile dysfunction. Methods A total of 132 patients with erectile dysfunction admitted to the hospital between August 2024 and August 2025 were selected as research subjects. Brief illness perception questionnaire (BIPQ) was applied for disease perception evaluation, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were utilized to evaluate the negative emotions of patients.36-item short form health survey (SF-36) was used for assessment of quality of life of patients. Pearson correlation analysis was performed to analyze the correlation between BIPQ score, SAS score, SDS score and SF-36 scores. Multivariate linear regression analysis was performed by taking SF-36 total score as the dependent variable and BIPQ score, SAS score, SDS score and important baseline data as independent variables. Results The BIPQ score of 132 patients with erectile dysfunction was (42.35±6.25) points, indicating a moderate negative perception state. The SAS score and SDS score were (62.25±5.24) points and (64.86±3.08) points, reflecting moderate levels of anxiety and depression. Pearson correlation analysis suggested that the BIPQ score was negatively associated with total score of SF-36 and scores of dimensions of vitality, social function, emotional function and mental health (r=-0.324, -0.302, -0.403, -0.428, -0.507, P<0.05). The SAS score was negatively correlated with the total score of SF-36 and the scores of vitality, social function, emotional function, and mental health dimensions (r=-0.347, -0.426, -0.501, -0.413, -0.558, P<0.05). The SDS score was negatively associated with the total score of SF-36 and the scores of dimensions of overall health, vitality, emotional function and mental health (r=-0.387, -0.287, -0.447, -0.469, -0.510, P<0.05). Multivariate linear regression analysis indicated that BIPQ score, SAS score and SDS score showed associations with SF-36 total score (P<0.05). Conclusion The disease perception and negative emotions in patients with erectile dysfunction exhibit negative associations with the quality of life, and negative disease perception and negative emotions may lead to a decline in quality of life.

Objective To explore the complex network of relationships between treatment burden and coping styles among older adults with multimorbidity, identify key nodes, and provide references for effectively reducing their treatment burden. Methods A total of 505 older adults with chronic multimorbidity were selected and surveyed using the Treatment Burden Questionnaire and the Medical Coping Modes Questionnaire. The R software (version 4.5.2) was used to assess the network structure, node centrality, and the stability of the results. Results The average treatment burden score for the older adults with multimorbidity was 99.22±22.42, and the average coping style score was 44.99±4.94. Network analysis revealed the strongest edge between resignation coping showed the strongest correlation with medication burden (r=0.21). Healthcare-related Lifestyle Burden had the highest centrality indices: strength (Str=1.277), betweenness (Bet=6), and closeness (Clo=0.032). Conclusion Network analysis reveals that Healthcare-related Lifestyle Burden is the central node within the treatment burden network, while Resignation Coping acts as a key bridge connecting treatment burden to coping styles. Clinical interventions should prioritize alleviating patients' lifestyle-related burdens and guide them towards reducing resigned coping and increasing confrontative coping to effectively mitigate the overall treatment burden.

Objective To observe the application effect of whole-course precision health education in patients undergoing cataract surgery. Methods According to random number table method, 82 patients with cataract treated in the hospital were divided into control group (n=41) and experimental group (n=41) between January and October 2024. The control group was given routine health education, while experimental group was additionally given whole-course precision health education. The psychological stress response[self-rated anxiety scale (SAS), self-rating depression scale (SDS) ], mastery of disease knowledge, self-care ability[exercise of self-care agency scale (ESCA) ]and quality of life[cataract-related visual quality of life (CLVQOL) ]before and after intervention, visual acuity at discharge and nursing satisfaction in the two groups were observed. Results After intervention, scores of SAS and SDS were lower in experimental group than control group (P<0.001). After intervention, mastery of disease knowledge was better in experimental group than control group (P=0.014). After intervention, ESCA score was higher in experimental group than control group (P<0.05), and CLVQOL score (the higher the score, the worse the vision-related quality of life) was lower in experimental group (P<0.05), indicating that quality of life was better in experimental group than control group. On the day of discharge, there was no significant difference in uncorrected visual acuity or best corrected visual acuity between the two groups (P>0.05). The nursing satisfaction was higher in experimental group than control group (95.12% vs 80.49%, P=0.043). Conclusion Whole-course precision health education can effectively improve psychological state, improve disease cognition and self-care ability, optimize vision-related quality of life and improve nursing satisfaction in patients undergoing cataract surgery.

Objective To analyze the clinical efficacy of Orem's Self-Care Deficit Nursing Theory combined with the Transtheoretical Model (TTM) of behavior change in bone tumor patients. Methods Clinical data of 95 bone tumor patients admitted to the First Affiliated Hospital of Air Force Medical University, PLA, from January 2022 to August 2024 were retrospectively collected. After screening by inclusion and exclusion criteria, 80 patients were finally included. Patients were naturally grouped according to admission time: the control group (n=38, admitted from January 2022 to April 2023) received routine nursing, while the study group (n=42, admitted from May 2023 to August 2024) received Orem theory combined with TTM nursing. Pain status[Numerical Rating Scale (NRS), pain relief duration], psychological status [Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), General Self-Efficacy Scale (GSES)], self-care capacity [Barthel Index (BI)], and quality of life [Functional Assessment of Cancer Therapy-General (FACT-G)] were compared before intervention and 2 months post-intervention. Nursing satisfaction was also evaluated. Results Post-intervention, both groups showed decreased NRS, HAMA, and HAMD scores, and increased GSES, BI, and FACT-G scores. The intervention group demonstrated significantly greater improvements in all parameters and shorter pain relief duration (P<0.05). Nursing satisfaction was higher in the intervention group (92.86% vs 76.32%, P<0.05). Conclusion The integrated Orem-TTM nursing model effectively alleviates negative emotions, enhances self-efficacy, improves pain management, and promotes self-care capacity and quality of life in bone tumor patients.

Objective To explore the swallowing rehabilitation training behavior experience of patients after oral cancer surgery, and to provide a reference basis for formulating scientific and effective swallowing rehabilitation training intervention strategies. Methods This study adopted a descriptive qualitative research design. An interview guide was developed based on the Information-Motivation-Behavioral Skills (IMB) theoretical model. Using purposive sampling, 16 patients who underwent oral cancer surgery between November 2024 and January 2025 at a Grade A tertiary cancer hospital in Hunan Province were recruited for semi-structured interviews. Data were analyzed using directed content analysis. Results A total of 3 themes and 10 sub-themes were extracted: Information deficiency and acquisition difficulties (insufficient understanding of swallowing rehabilitation concepts, obstacles in information discrimination and comprehension), The assistance and test of internal and external motivation (driving force oriented towards health goals, perceived benefits enhancing training compliance, shame leading to rehabilitation withdrawal, postoperative discomfort hindering rehabilitation progress, the double-edged sword effect of social support), and the need for behavioral skills optimization (differences in self-efficacy, demand for professional guidance and support, application of self-management strategies). Conclusion The swallowing rehabilitation behavior of patients after oral cancer surgery is influenced by multiple factors. Interventions should be based on individualized patient needs, leveraging modern internet platform resources to bridge cognitive gaps, stimulate internal rehabilitation motivation, and strengthen diversified external social support. The swallowing rehabilitation training teaching model should be optimized to enhance self-efficacy and self-management abilities, thereby promoting patient swallowing rehabilitation.

Objective To explore the improvement effect of multimodal analgesia management combined with health belief model intervention on pain control and compliance of health behaviors in cancer patients, and to provide practical basis for optimizing the comprehensive management of cancer pain. Methods A randomized controlled trial was conducted. 126 hospitalized patients with tumors from February 2023 to February 2025 were selected and randomly divided into the observation group (n=63) and the control group (n=63). The observation group implemented multimodal analgesia management (step-based drug therapy combined with non-drug intervention) combined with health belief model education (disease cognition remodeling, self-efficacy training), while the control group received multimodal analgesia management exclusively. The degree of pain was evaluated by the Numerical Rating Scale for Pain (NRS), negative emotions were evaluated by the Hamilton Depression Scale (HAMD), the quality of life was evaluated by the EORTC QLQ-C30, and the nursing satisfaction was evaluated by the self-made satisfaction questionnaire. Results After 4 weeks of intervention, the degree of pain and negative emotions in the observation group were lower than those in the control group (P<0.05), and the dimensions such as physical function, emotional function, fatigue, and pain in the quality of life score were all improved (P<0.05). Furthermore, the proportion of nursing satisfaction in the observation group (95.24% vs 66.67%) was higher than that in the control group (χ²=32.175, P<0.001). Conclusion Multimodal analgesia management combined with the health belief model can effectively relieve the pain and depressive mood of cancer patients, improve the quality of life and increase the satisfaction of nursing. It is an effective comprehensive intervention plan for symptom management of cancer patients.

Objective To observe the effect of need-satisfaction intervention based on the Problem-Goal-Intervention-Outcome (PGIO) nursing model on pain degree, sleep quality, and self-care ability in patients after anal fistula surgery. Methods From August 2023 to August 2025, 82 patients who underwent anal fistula surgery at the hospital were selected and divided into two groups by random number table method, with 41 cases in each group. The control group received routine nursing intervention, while the observation group received PGIO-based need satisfaction intervention in addition to routine nursing. The two groups were compared in terms of postoperative Visual Analog Scale (VAS) score for pain, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) and Exercise of Self-Care Agency (ESCA) scores before and after intervention, length of hospital stay, and complications. Results The two groups had similar VAS scores for pain at 24 h postoperatively (P>0.05). At 48 h and 72 h postoperatively, VAS scores of the observation group were significantly lower than those of the control group at 10 min after dressing change (P<0.05). After intervention, the observation group got significantly lower SAS, SDS and PSQI scores but significantly higher ESCA scores of all dimensions and total score compared to the control group (P<0.05). The total complication rate was significantly lower and hospital stay was significantly shorter in the observation group (P<0.05). Conclusion PGIO-based need satisfaction can effectively reduce postoperative pain, improve psychological state, enhance sleep quality and self-care ability, and promote recovery in patients with anal fistula.