Objective To construct vectors that express StayGold green fluorescent protein in both prokaryotic and eukaryotic cells, while simultaneously expressing functional fused antibiotic resistance genes. Method The StayGold coding sequence was inserted at different positions within the antibiotic resistance gene to construct corresponding vectors. The prokaryotic vectors were transformed into E. coli DH10B, while the eukaryotic vectors were transfected into HEK293T cells. Antibiotic selection was used to investigate the expression of the antibiotic resistance gene. Fluorescence microscopy was harnessed to observe the samples and detect the expression of StayGold, with its fluorescence intensity compared to that of EGFP. After storing the bacterial culture samples in a refrigerator at 4℃ for one month, the fluorescence intensity was re-measured to compare the low-temperature stability of the fusion proteins StayGold and EGFP. Results In all prokaryotic vectors, StayGold was expressed normally. Only when StayGold was inserted into the C-terminus of the AmpR gene with or without a peptide linker (32 residues, 32AA), the transformed E. coli DH10B exhibited resistance to ampicillin. Moreover, its fluorescence intensity was comparable to that of the control group EGFP. However, after one month, the fluorescence intensity of the experimental group StayGold was higher than that of EGFP. In all eukaryotic vectors, StayGold was also expressed normally. When StayGold was inserted into the C-terminus of the PuroR or HygroR sequence, and a 32AA linker was added, the transfected HEK293T cells showed tolerance to the corresponding antibiotics. Conclusion Inserting StayGold into the C-terminus of the antibiotic resistance gene encoding protein and adding a linker can achieve functional fusion of fluorescence and resistance in both prokaryotic and eukaryotic cells. In E. coli, StayGold exhibits stronger low-temperature stability compared to EGFP.

Objective Exosomes are vital mediators of intercellular communication. Studies have shown that ovarian cancer cell-derived exosomes can alter the tumor microenvironment, yet their immunomodulatory mechanisms remain unclear. This study aimed to investigate the effects of ovarian cancer cell-derived exosomes on dendritic cells (DCs) and DC-mediated cytotoxic T lymphocyte (CTLs) proliferation and function. Methods Exosomes were isolated from SKOV3 ovarian cancer cells by ultracentrifugation. Western blotting (WB) was used to detect exosomal markers, dynamic light scattering (DLS) to determine particle size distribution, and transmission electron microscopy (TEM) to observe morphology. Peripheral blood mononuclear cells (PBMCs) were treated with phosphate-buffered saline (PBS), tumor necrosis factor-α (TNF-α), or exosomes to obtain immature, mature, and exosome-treated DCs. T cells were co-cultured with different DCs groups to assess proliferation, and activated T cells were incubated with ovarian cancer cells at varying ratios to evaluate cytotoxic activity. Results SKOV3-derived exosomes were successfully isolated and purified. TEM showed round or oval bilayer vesicles with diameters of 50-700 nm. WB confirmed the presence of characteristic exosomal surface markers and tumor-associated antigens. Exosomes significantly enhanced DCs activation and promoted naïve T-cell proliferation. CTLs induced by exosome-treated DCs exhibited markedly stronger cytotoxicity against ovarian cancer cells than controls. Conclusion Ovarian cancer cell-derived exosomes promote dendritic cell activation, enhance T-cell proliferation, and strengthen cytotoxic T lymphocyte activity, suggesting an important role in regulating antitumor immune responses.

Objective A systematic evaluation of the clinical significance of purine metabolism-related genes in glioma, identification of key therapeutic targets, and validation of the antitumor potential of natural small-molecule inhibitors in combination with temozolomide. Methods Based on public databases, differentially expressed purine metabolism-related genes in glioma were identified. A prognostic prediction model was constructed and validated using machine learning algorithms, leading to the identification of key candidate genes. Molecular docking was employed to screen and identify natural inhibitors targeting PAICS. The inhibitory effects of these compounds on PAICS expression and cell proliferation were evaluated through in vitro experiments, and their synergistic efficacy with temozolomide was further assessed. Results Core purine metabolism-related genes were successfully identified, and the constructed prognostic model demonstrated robust discriminative performance in an independent cohort. PAICS was identified as a key gene, with vindoline and triptolide recognized through molecular docking as potential PAICS inhibitors. Cellular experiments revealed that both natural compounds downregulated PAICS expression and significantly suppressed glioma cell proliferation, with enhanced antiproliferative effects observed when combined with temozolomide. Conclusion PAICS serves as a potential prognostic biomarker and therapeutic target in glioma. Vindoline and triptolide enhance the antiproliferative effect of temozolomide by targeting PAICS, providing a novel strategic basis for combination therapy in glioma.

Objective Low-grade glioma (LGG) is a malignant tumor with significant molecular heterogeneity. Lactylation, a lactate-driven post-translational modification, regulates tumor progression by remodeling the tumor microenvironment. This study aims to establish a prognostic prediction model for LGG based on lactylation-related genes (LRGs) and explore their relevant molecular targets. Methods LRGs were retrieved from the MSigDB database. By integrating data from The Cancer Genome Atlas (TCGA) and the Chinese Glioma Genome Atlas (CGGA), LRGs that were differentially expressed and prognosis-related in LGG were screened. Patients were stratified into subtypes using non-negative matrix factorization (NMF) clustering. A Lactylation-Related Risk Score (LRRS) was constructed using differentially expressed genes and multiple machine learning algorithms, and the relationship between LRRS and LGG prognosis was evaluated. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression differences of PDPN (a prognosis-related gene in LGG) in human glioma cells and normal human astrocytes. Small interfering RNA was employed to knock down PDPN expression in the human glioma cell line HS683. Cell Counting Kit-8 assay, wound healing assay, and Transwell assay were respectively used to verify the effects of PDPN knockdown on the proliferation, invasion, and migration abilities of HS683 cells. Results NMF clustering classified LGG into two molecular subtypes with significantly different pathway enrichments. The constructed LRRS model contained 2 key genes associated with LGG prognosis, and patients in the high-risk group exhibited significantly shortened overall survival. Experimental validation demonstrated that PDPN was abnormally highly expressed in glioma cells, and knockdown of PDPN significantly inhibited the proliferation, migration, and invasion abilities of the HS683 cells. Conclusion The constructed lactylation-related prognostic model can effectively predict the survival outcomes of LGG patients. PDPN, a modeling-related gene for LGG, may serve as a candidate worth further in vivo validation.

Objective This study aimed to develop an efficient prognostic model by analyzing the expression of senescence-associated genes (SRGs), combined with transcriptome and single-cell RNA sequencing data, to identify key senescence-related genes with prognostic significance in cervical cancer. Method Genes related to the keyword “senescence” were first obtained from the Genecards database. Using the single-cell RNA sequencing dataset GSE253690 from the Gene Expression Omnibus (GEO) database, senescence-associated scores were calculated for each cell. Based on these scores, differentially expressed genes (DEGs) between the high-score and low-score groups were identified. Subsequently, single-sample gene set enrichment analysis (ssGSEA) and weighted gene co-expression network analysis (WGCNA) were employed to identify senescence-related module genes in cervical cancer patients. The intersection of DEGs and module genes was subjected to univariate Cox analysis, followed by least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox analysis to construct a prognostic model based on senescence-associated genes. The GSE44001 and GSE52903 datasets from GEO were used as external validation sets to verify the model's accuracy. The precision of the model in predicting the prognosis of cervical cancer patients was assessed by constructing a clinical nomogram and performing receiver operating characteristic (ROC) curve analysis. Finally, the expression differences of key genes between normal cervical cells and cervical cancer cells were detected via human protein atlas (HPA) analysis and real-time quantitative polymerase chain reaction (RT-qPCR). Results A prognostic model based on senescence-associated genes was successfully constructed and demonstrated good accuracy and predictive precision. Conclusion The senescence-associated gene-based model we developed can effectively assess the prognosis of cervical cancer, providing a new reference for clinicians in selecting treatment strategies.

Objective Exploring the mechanism of anti VEGF drugs regulating mitochondrial function in an animal model of retinopathy of prematurity (ROP). Methods An oxygen induced retinal disease model was established in 18 newborn SD rats, which were randomly divided into a control group (non retinal disease), a model group, and a treatment group, with 6 rats in each group. After successful modeling, the treatment group of rats was injected with 1 μL of anti VEGF drug (Conbercept) into the vitreous cavity, while the other two groups were injected with an equal amount of physiological saline once a day for 5 days. 24 hours after the last administration, fluorescence angiography was used to observe changes in retinal blood vessels perfusion; Examine the retinal morphology via hematoxylin-eosin (HE) staining; monitor alterations in VEGF expression within the retina using immunohistochemistry; and detect changes in retinal cell apoptosis with Cleaved Caspase-3 immunofluorescence; Western blot analysis of PGC-1 α and 8-OHdG protein expression in the retina. Results The model group exhibited extensive neovascularization and retinal hemorrhaging, whereas the control and treatment groups showed a marked decrease in these occurrences compared to the model group. The inner nuclear layer (INL) and outer nuclear layer (ONL) of the retina in both the control and treatment groups showed a notable increase in thickness when contrasted with the model group; Reduced immune reactivity of VEGF; The fluorescence intensity of Caspase-3 significantly decreased; PGC-1α protein expression significantly rose, concurrently with a marked reduction in 8-OHdG protein expression. Conclusion Anti VEGF drugs can inhibit retinopathy in premature rats, and their mechanism of action is related to regulating mitochondrial function and reducing retinal cell apoptosis.

Objective To explore the potential role of CHAC1 in pan-cancer biology by analyzing its correlation with clinical prognosis and immune characteristics using bioinformatics methods. Methods Data from multiple databases were used to investigate the differential expression of CHAC1 across various cancers, survival analysis, immune cell infiltration, tumor stemness score (DNAss), tumor mutational burden (TMB), and microsatellite instability (MSI) were also evaluated in relation to CHAC1 expression. Western blot analysis was employed to determine CHAC1 expression levels in gastric, lung, and colon cancer cell lines, while immunohistochemistry (IHC) was utilized to evaluate CHAC1 expression in human gastric carcinoma tissues and corresponding adjacent non-tumor tissues. Results CHAC1 was found to be highly expressed in multiple tumor types, with patients exhibiting poorer prognosis. The results of Western blot and IHC demonstrated that CHAC1 is highly expressed in gastric cancer. Immune cell infiltration, including CD8⁺ cells, CD4⁺ cells, neutrophils, dendritic cells, and macrophages, was significantly correlated with CHAC1 expression. Additionally, DNA methylation, DNAss, TMB, and MSI were found to be associated with CHAC1 expression levels. Conclusion CHAC1 may serve as a valuable prognostic biomarker and a potential therapeutic target for multiple cancers. Its role in immune filtration and immune checkpoint inhibitor therapy warrants further investigation.

Objective To investigate the predictive value of the triglyceride glucose-body mass index (TyG-BMI) and blood lipid levels on pregnancy outcomes in advanced-age pregnant women with gestational diabetes mellitus (GDM). Methods A retrospective study was conducted on 300 advanced-age GDM patients who underwent prenatal examination and delivery at our hospital from September 2023 to July 2024, designated as the GDM group. Additionally, 350 healthy advanced-age pregnant women who attended our hospital during the same period were selected as the control group. Based on pregnancy outcomes, the GDM group was further divided into an adverse outcome group (n=109) and a good outcome group (n=191). Basic data, pregnancy outcomes, TyG-BMI index, and blood lipid levels were compared between the GDM group and the control group. Univariate and multivariate analyses were performed to identify factors associated with adverse pregnancy outcomes in advanced-age GDM patients. The predictive value of each indicator was evaluated by drawing receiver operating characteristic (ROC) curves. Results The incidence of adverse pregnancy outcomes was significantly higher in the GDM group than in the control group. Compared to the control group, the GDM group had higher TyG-BMI index, TC, TG, and LDL-C levels, and lower HDL-C levels. Among advanced-age GDM patients, there were no statistically significant differences in age, gestational weeks, or primiparity between the adverse outcome group and the good outcome group. The adverse outcome group had significantly higher HbA1c, FPG, TyG-BMI index, TG, TC, and LDL-C levels, and significantly lower HDL-C levels than the good outcome group. Multivariate logistic regression analysis showed that HbA1c, FPG, TyG-BMI index, and TG were independent risk factors for adverse pregnancy outcomes in advanced-age GDM patients, while HDL-C was a protective factor. The ROC results showed that the AUC of the TyG-BMI index combined with TG and HDL-C was 0.897, with a sensitivity of 90.0% and a specificity of 83.8%, which were all significantly higher than those of the individual indicators. Conclusion The TyG-BMI index combined with blood lipid levels has high predictive value for pregnancy outcomes in advanced-age pregnant women with GDM.

Objective To explore the factors influencing the prognosis of patients with anterior circulation acute cerebral infarction (ACI) after stent thrombectomy and the effects on the levels of visceral adipose tissue-derived serine proteinase inhibitor (Vaspin) and Apelin. Methods 112 patients with anterior circulation acute cerebral infarction who underwent stent thrombectomy in our hospital from March 2022 to March 2025 were selected as the research subjects. The modified Rankin Scale score was used to evaluate the outcome 3 months after the operation. The patients were divided into the good outcome group (73 cases) and the poor outcome group (39 cases) based on the postoperative outcome. Compare the general data of the two groups, analyze the influencing factors of the outcome after anterior circulation ACI stent thrombectomy, compare the serum levels of Vaspin and Apelin in the two groups, and analyze the predictive efficacy on the postoperative outcome of patients. Results There were statistically significant differences between the two groups in terms of age, NIHSS score at admission, ASPECT score at admission, occlusion site, complete postoperative blood flow reperfusion, and postoperative cerebral hemorrhage. Age and the NIHSS score on admission are risk factors for poor outcomes after stent retriever thrombectomy in patients with anterior circulation acute ischemic stroke. The ASPECT score on admission and complete reperfusion of blood flow post-procedure are protective factors against poor outcomes in these patients; The serum levels of Vaspin and Apelin in the poor outcome group were lower than those in the good outcome group. The receiver operating characteristic curve (ROC) evaluated the predictive performance of the aforementioned factors for poor outcomes after stent retriever thrombectomy in patients with anterior circulation acute cerebral infarction, showing that the combined detection of these factors yielded the largest area under the curve (AUC). Conclusion Factors associated with poor post-procedural outcomes after anterior circulation acute ischemic stroke thrombectomy include age and admission NIHSS score, whereas admission ASPECTS score and complete reperfusion post-procedure are protective factors. Combining these factors with serum Vaspin and Apelin levels can enhance the predictive accuracy for poor post-procedural outcomes in patients.

Objective Acute respiratory failure (ARF) is a major adverse event affecting the prognosis of patients with chronic obstructive pulmonary disease (COPD). This study aimed to identify risk factors for ARF in COPD patients using a LASSO-Logistic regression model. Methods This single-center retrospective cohort study included 360 hospitalized COPD patients from January 1, 2019 to December 31, 2021. Based on admission time, patients were divided into a derivation cohort (n=280) and a validation cohort (n=80). Thirty baseline variables—covering demographic features, laboratory tests, arterial blood gas parameters, and pulmonary function indices—were collected. Candidate predictors were first screened by univariate analysis, followed by LASSO-Logistic regression with 10-fold cross-validation, and subsequently incorporated into multivariable logistic regression to construct the final prediction model. Model discrimination and calibration were evaluated using ROC curves, the C-index, and calibration plots, with internal validation performed using 1, 000-time bootstrap resampling. Results Among the 280 patients in the derivation cohort, 89 developed ARF within one year. Baseline characteristics were comparable between the derivation and validation cohorts (all P>0.05). LASSO regression initially identified 10 potential predictors, and multivariable Logistic regression ultimately determined age, GOLD stage, FVC, cTnI, and NT-proBNP as independent predictors. The model yielded a pseudo R² of 0.28(likelihood ratio test P<0.01). The AUC was 0.861 in the derivation cohort and 0.847(95% CI: 0.809-0.905) in the validation cohort, with a sensitivity of 0.704 and specificity of 0.782. The C-index was consistent with the AUC, and calibration curves demonstrated good agreement between predicted and observed outcomes. Bootstrap validation confirmed the stability and robustness of the model. Conclusion The LASSO-Logistic regression model developed in this study can effectively predict the risk of ARF in COPD patients. The model is simple, reproducible, and demonstrates good predictive performance, indicating promising clinical utility for early risk stratification.

Objective To investigate the predictive efficacy of the non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (NHHR) on the thickening of carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 360 patients with T2DM in our hospital from July 2022 to May 2024 were selected as the research subjects. According to whether they developed thickening of CIMT, they were divided into the simple T2DM group (n=208) and the CIMT thickening group (n=152). Compare the general data and NHHR of the two groups, analyze the correlations between each indicator and the thickening of CIMT, analyze the influencing factors of CIMT thickening in patients with T2DM, and analyze the predictive value of NHHR for CIMT thickening in patients with T2DM. Results The CIMT thickening group had higher levels of total cholesterol (TC), duration of T2DM, non-high-density lipoprotein cholesterol (non-HDL-C), hemoglobin A1c (HbA1c), high-density lipoprotein cholesterol (HDL-C), and NHHR compared to the simple T2DM group, the low-density lipoprotein cholesterol (LDL-C) was lower in the CIMT thickening group than in the simple T2DM group. The course of T2DM, non-HDL-C, HbA1c, NHHR, TC, HDL-C are positively correlated with CIMT thickening, while LDL-C is negatively correlated with CIMT thickening; after adjusting for T2DM duration, non-HDL-C, and HbA1c, NHHR remained an influencing factor for the thickening of CIMT in T2DM patients; the areas under the curve for non-HDL-C, HDL-C, and NHHR in predicting the thickening of CIMT in patients were 0.705, 0.846, and 0.895 respectively, and the predictive efficacy of NHHR was significantly higher than that of HDL-C. Conclusion The increase in NHHR in patients with T2DM is associated with the thickening of CIMT. Compared with non-HDL-C and HDL-C alone, NHHR has a higher predictive efficacy in predicting the thickening of CIMT in patients.

Objective The influencing factors of the stability of coronary atherosclerotic plaques were explored through meta-analysis. Methods Seven databases at home and abroad were searched, and the search time limit was from the establishment of the database to August 5, 2025. The research literature on the influencing factors of plaque stability in Chinese patients with coronary atherosclerosis was screened. According to the inclusion and exclusion criteria, the literature was screened, the data was extracted, and the quality was evaluated. Nine influencing factors were collected, including age, smoking, life event stress history, depression, low-density lipoprotein cholesterol (LDL-C) level, total cholesterol (TC), uric acid (UA), C-reactive protein (CRP), cystatin C (CysC). Stata 18.0 and Review Manager 5.4 software were used to conduct Meta-analysis according to the results of heterogeneity test using random effect model or fixed effect model. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated, and sensitivity analysis and subgroup analysis were performed. Results A total of 7 high-quality studies involving 3 523 patients were included. The results of Meta-analysis showed that age (OR=1.04, 95% CI: 1.00-1.07), smoking (OR=3.36, 95% CI: 2.18-5.18), life events stress history (OR=1.03, 95% CI: 1.02-1.04), depression (OR=1.17, 95% CI: 1.11-1.22), LDL-C level (OR=2.74, 95% CI: 2.01-3.72), UA level (OR=3.54, 95% CI: 2.15-5.83), CRP level (OR=1.49, 95% CI: 1.18-1.89) and CysC level (OR=3.18, 95% CI: 2.06-4.90) were risk factors for plaque stability (all P<0.05). However, TC level was not significantly associated with plaque stability (OR=0.90, 95% CI: 0.63-1.29, P=0.568). The analysis results of smoking, LDL-C, UA and CysC showed low heterogeneity and good robustness. Conclusion Smoking, high UA, high LDL-C, high cystatin C, high CRP levels, as well as a history of life event stress, depression and aging are important risk factors for plaque stability in Chinese patients with coronary atherosclerosis.

Objective To explore the diagnostic value of pelvic floor ultrasound parameters combined with diastasis recti abdominis (DRA) for postpartum pelvic organ prolapse (POP). Methods A total of 98 postpartum POP patients admitted to our hospital from January 2023 to December 2024 were selected as the POP group, and 90 postpartum non-POP women during the same period were selected as the control group. Basic data, DRA, and pelvic floor ultrasound parameters under different conditions were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between pelvic floor ultrasound indicators, DRA and the severity of POP. Results The proportion of pregnancy history, delivery history and DRA in the POP group were significantly higher than those in the control group. The anterior-posterior diameter of the levator ani hiatus, the area of the levator ani hiatus and the posterior angle of the bladder urethra in the POP group were significantly higher than those in the control group under resting, anal contraction and maximal Valsalva maneuver conditions. The pelvic floor ultrasound indicators of the POP patients, including the anterior-posterior diameter of the levator ani hiatus, the area of the levator ani hiatus and the posterior angle of the bladder urethra, and DRA were positively correlated with the severity of POP. The results of multivariate Logistic regression analysis showed that pregnancy history, delivery history, DRA and pelvic floor ultrasound indicators were independent risk factors for postpartum POP. The ROC curve showed that the AUC and sensitivity of combined predictive probability in diagnosing postpartum POP were superior to those of individual diagnosis of each index and simple parallel diagnosis. Conclusion The combination of pelvic floor ultrasound and DRA can significantly improve the diagnostic efficiency of postpartum POP, providing a reference basis for the clinical diagnosis and treatment of POP.

Objective To explore the relationship between left ventricular function and cerebral arterial hemodynamics in patients with heart failure with preserved ejection fraction (HFpEF). Methods Fifty patients diagnosed with HFpEF in our hospital (HFpEF group) and fifty healthy volunteers (control group) were enrolled. Conventional echocardiographic parameters of the two groups were collected. Automatic cardiac motion quantification (aCMQ) technology was applied to obtain left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LVGLS) and circumferential strain (LVGCS) of the two groups. Transcranial color-coded duplex sonography (TCCS) was used to obtain the blood flow parameters of the middle cerebral artery: peak systolic velocity (PSV), end-diastolic velocity (EDV), and pulsatility index (PI). The differences in parameters between the two groups were compared. Pearson correlation analysis was used to analyze the correlation between left ventricular function and blood flow parameters of the middle cerebral artery; Logistic regression analysis was used to analyze the influencing factors of HFpEF. Results There were significant differences in the interventricular septal end-diastolic thickness (IVSD), left ventricular posterior wall end-diastolic thickness (LVPWD), early diastolic peak velocity of mitral annulus (e'), the ratio of early diastolic peak velocity of mitral orifice to early diastolic peak velocity of mitral annulus (E/e') and LVGLS between HFpEF group and control group. E/e', IVSD and LVPWD in the HFpEF group were higher than those in the control group, e' and the absolute values of LVGLS were lower than those in the control group. The PI in HFpEF group was higher than that in control group. The PI level of middle cerebral artery in HFpEF group was negatively correlated with the absolute values of LVGLS level (r=-0.327, P<0.05), and positively correlated with E/e^, level (r=0.281, P<0.05). Logistic regression analysis showed that systolic blood pressure, LVGLS and PI were independent risk factors for HFpEF, and e' was an independent protective factor. Conclusion In HFpEF patients, the left ventricular longitudinal systolic function is impaired, the pulsation and stiffness of the middle cerebral artery are increased. There is a correlation between the increased stiffness of the middle cerebral artery and the impaired myocardial function.

Objective To analyze the change characteristics of cross-sectional area (CSA) balance, symmetry and proton density fat fraction (PDFF) of paravertebral muscle in patients with lumbar disc herniation (LDH), and to analyze the effects of gender, age, protruding segments and intervertebral disc reabsorption on the above indexes to provide imaging evidence for curative effect evaluation of non-surgical treatment in LDH. Methods A total of 128 patients with LDH of L4/5 or L5/S1 admitted to Sichuan Province Orthopedic Hospital were enrolled as the research objects between April 2021 and July 2023. All were given a non-surgical treatment regimen and followed up for 1 year. Before and after treatment, all underwent routine T₂WI sequence under sagittal view and IDEAL-IQ sequence under axial view in lumbar magnetic resonance imaging (MRI). The fat fraction (FF), CSA and PDFF of the paravertebral muscles[multifidus (MF), erector spinae (ES), psoas major (PS) ]were measured by Image J software. According to the intervertebral disc reabsorption degree after 1 year of follow-up, patients were divided into reabsorption group (n=82) and non-reabsorption group (n=46). The differences in paravertebral muscle indexes among patients with different genders, age groups (<35 years, 35-49 years, >49 years) and protruding segments (n=70 for group L4/5, n=58 for group L5/S1) were compared. Results FF values of MF on affected and healthy sides of L4/5 and L5/S1 segments in females were significantly higher than those in males. PDFF of MF, ES and PS in non-reabsorption group were significantly higher than those in reabsorption group. During follow-up, CSA on affected and healthy sides of L4/5 and affected side of L5/S1 were significantly increased in reabsorption group compared with those before treatment, but there was no significant change in CSA before and after treatment in non-reabsorption group. Age differences: in the three age groups (<35 years, 35-49 years, >49 years), PDFF of MF, ES and PS in non-reabsorption group were significantly higher than those in reabsorption group, and PDFF of paravertebral muscles was overall higher in patients aged >49 years. Before treatment and during follow-up, PDFF of MF and ES on affected side in L5/S1 segment group were significantly higher than those in L4/5 segment group, while CSA of MF and ES on affected side were significantly lower than those in L4/5 segment group, but there was no significant difference in PDFF and CSA of PS between the two groups. Conclusion In LDH patients, fat infiltration of MF is more severe in females. The fat content is higher in those aged >49 years or L5/S1 segment protruding, and CSA is lower in the latter. The decrease of PDFF and increase of CSA in paravertebral muscles may indicate intervertebral disc resorption, which can be applied as potential imaging indexes to evaluate the curative effect of non-surgical treatment.

Objective To investigate the prevalence of sleep disturbances in patients with Chronic Heart Failure (CHF) and analyze their correlations with biological, social, and psychological multidimensional factors, thereby providing a basis for clinical intervention. Methods A retrospective cross-sectional study was conducted. A total of 396 CHF patients admitted to the Department of Cardiology, Xiangtan Second People's Hospital between March 2023 and March 2025 were enrolled. Sleep quality, somatic perception, anxiety/depression status, social support, and family function were assessed using the Pittsburgh Sleep Quality Index (PSQI), Heart Failure Somatic Perception Scale (HFSPS), Hospital Anxiety and Depression Scale (HADS), Social Support Rating Scale (SSRS), and Family APGAR Index, respectively. Patients were divided into a sleep disturbance group (PSQI≥7) and a non-sleep disturbance group (PSQI<7). General patient data and clinical characteristics were collected. Univariate analysis, multivariate Logistic regression, and mediation effect analysis were performed. Results Among the 396 CHF patients, 282(71.21%) had sleep disturbances. Univariate analysis showed that age, self-rated health, New York Heart Association (NYHA) functional classification, SSRS score, Family APGAR score, and HFSPS score were significantly associated with sleep disturbances. Multivariate analysis further indicated that poor self-rated health (OR=3.485, 95% CI: 2.155-5.788) was an independent risk factor for sleep disturbances, while higher family support (OR=0.869, 95% CI: 0.780-0.965) was a protective factor. Mediation analysis revealed that self-rated health played a complete mediating role in the relationship between NYHA classification and sleep disturbances, indicating a suppression effect. Conclusion The incidence of sleep disturbances is high among CHF patients. Their occurrence is closely related to self-rated health and family support, with self-rated health being a key mediator through which objective cardiac function affects sleep. In clinical nursing practice, emphasis should be placed on assessing and providing psychological guidance regarding patients' subjective health perceptions, as well as strengthening the family support system, to improve patients' sleep quality.

Objective To investigate the association between spinal kyphosis and cognitive function in Chinese older adults, and to analyze the mediating roles of ADL and depression in this relationship. Methods Data from 9, 798 adults aged 65 and older were selected from Chinese longitudinal healthy longevity survey (CLHLS) in 2018. General information, including spinal kyphosis status and cognitive function scores, was collected. Univariate and multivariate analyses were conducted to examine spinal kyphosis in older adults, and a multiple mediation model was used to test the mediating effects of ADL and depression. Results The detection rate of spinal kyphosis among Chinese older adults was 27.93%. Advanced age, female sex, rural residence, hypertension, rheumatoid or rheumatic diseases, presence of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) limitations, depression, and lower cognitive function were identified as risk factors for spinal kyphosis. The mediation effect analysis revealed a significant direct effect of spinal kyphosis on cognitive function. The mediating effects of IADL and depression on cognitive function were significant. The chain mediating effect of IADL and depression was also significant. Conclusion Spinal kyphosis is significantly associated with cognitive decline in Chinese older adults, with limitations in IADL and depression playing important chain-mediating roles in this relationship. Greater attention should be given to functional training and psychological interventions for older adults with spinal kyphosis, adopting multidimensional strategies to delay cognitive decline.

Objective To investigate the influencing factors of flap necrosis in patients with skin and soft tissue defects after free flap transplantation. Methods A total of 180 patients with skin and soft tissue defects of limbs who received free skin flap transplantation in Beijing Jishuitan Hospital from March 2021 to December 2023 were enrolled and analyzed. According to postoperative survival of skin flap, they were divided into survival group (n=158) and necrosis group (n=22). The clinical data and laboratory indexes of patients were compared. Single and multiple Logistic regression were used to analyze the influencing factors of flap necrosis in patients with skin and soft tissue defects of limbs after free flap transplantation. Results Univariate analysis showed that there were significant differences in gender, smoking history, vascular crisis, body mass index (BMI) and operation time between the surviving group and the necrotic group (all P<0.05). Multivariate regression analysis showed that smoking history, vascular crisis and high BMI were independent risk factors for flap necrosis in patients with skin and soft tissue defects of limbs after free flap transplantation (all P<0.05). The area under the curve (AUC) of the combined prediction was 0.773(95%CI 0.671~0.875). The calibration curve shows that there is a good agreement between the predicted value and the actual value, and the average absolute error is 0.033. Hosmer-Lemeshow goodness of fit test showed that the prediction model had a good calibration degree (χ²=794, P=0.531). Conclusion The necrosis of skin flap after free skin flap transplantation in patients with soft tissue defect of extremities may be related to smoking history, vascular crisis, high BMI.

Objective To analyze the clinical characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) carrying the 23S rRNA V region A2063G mutation and to explore predictive factors for macrolide treatment efficacy. Methods A total of 194 hospitalized children with MPP harboring this mutation were enrolled. Based on their response to macrolide treatment, they were divided into a macrolide-unresponsive MPP (MUMPP) group (n=137) and a macrolide-responsive MPP (MRMPP) group (n=57). Clinical data and laboratory findings were compared between the two groups. Results Compared to the MRMPP group, the MUMPP group had significantly longer duration of fever, higher levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), and higher incidences of lobar consolidation and severe bronchoscopic lesions (erosions, plastic bronchitis, mucus plugs). However, the presence of an air bronchogram within lobar consolidation was significantly less frequent in the MUMPP group. Logistic regression analysis identified duration of fever, CRP, and NLR as independent risk factors for MUMPP, while the presence of an air bronchogram was a protective factor. ROC curve analysis showed that the combination of fever duration, CRP, and NLR had an AUC of 0.923 (95% CI: 0.862-0.956, P<0.05) for predicting clinical efficacy. Conclusion The combination of fever duration, CRP, and NLR serves as a valuable predictor of macrolide treatment efficacy in children with A2063G-mutated MPP, facilitating early clinical intervention.

Objective To analyze the traditional Chineses medicine (TCM) syndrome distribution and echocardiographic characteristics of patients with pulmonary hypertension caused by chronic obstructive pulmonary disease (COPD). Methods A retrospective analysis was performed on the case data of 287 patients with COPD admitted to the hospital from July 2024 to June 2025. Patients were grouped according to whether they had pulmonary hypertension.172 patients with pulmonary hypertension caused by COPD were included in group A, and 115 patients with simple COPD were set as group B. The TCM syndrome types of patients in group A were observed, and the related echocardiographic parameters [right ventricular end-diastolic diameter (RV-bDD), right ventricular middle end-diastolic diameter (RV-mDD), right ventricular free end-diastolic thickness (RVDT), right ventricular end-systolic area (RVESA), right ventricular end-diastolic area (RVEDA), tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (FAC), right ventricular myocardial performance index (RIMP) main pulmonary artery diameter (MPA), tricuspid regurgitation peak velocity (TRV), right ventricular systolic pressure (RVSP)] were compared between the two groups of patients. Logistic multivariate analysis was used to analyze the influencing factors of pulmonary hypertension caused by COPD, and receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of echocardiographic indicators in patients with pulmonary hypertension caused by COPD with different TCM syndromes types. Results Among the 172 patients with pulmonary hypertension caused by COPD, there were 54 cases (31.40%) of qi deficiency and blood stasis syndrome, 42 cases (24.42%) of phlegm and blood stasis obstructing lung syndrome, 32 cases (18.60%) of phlegm turbidity obstructing lung syndrome, 21 cases (12.21%) of lung-kidney qi deficiency syndrome, 16 cases (9.30%) of phlegm-heat obstructing lung syndrome and 7 cases (4.07%) of spleen-lung qi deficiency syndrome. Compared with group B, group A had higher MPA, TRV, RVSP, RV-bDD, RV-mDD, RVDT, RVESA, RVEDA and RIMP and lower TAPSE and FAC. Logistic multivariate analysis showed that high levels of echocardiographic indicators such as MPA, TRV, RVSP, RV-bDD, RV-mDD, RVDT, RVESA, RVEDA and RIMP were risk factors of pulmonary hypertension caused by COPD, and high levels of TAPSE and FAC were protective factors of pulmonary hypertension caused by COPD. Among patients with pulmonary hypertension caused by COPD, patients with phlegm and blood stasis obstructing lung syndrome showed significantly lower TRV and RVSP than patients with qi deficiency and blood stasis syndrome. There were no significant differences in TRV and RVSP between patients with other syndromes and patients with qi deficiency and blood stasis syndrome. ROC curve analysis showed that the areas under the ROC curves (AUC) of TRV and RVSP in the diagnosis of qi deficiency and phlegm turbidity obstructing lung syndrome. in patients with pulmonary hypertension caused by COPD were 0.627 and 0.686 respectively. Conclusion Among the patients with pulmonary hypertension caused by COPD, the proportion of qi deficiency and blood stasis syndrome is the highest, and the proportion of spleen-lung qi deficiency syndrome is the lowest, and the right ventricular function of patients is significantly decreased. Echocardiography can noninvasively and accurately evaluate the right ventricular function in patients. The related parameters of echocardiography can indicate the risk of pulmonary hypertension, and have certain diagnostic value for the two TCM syndromes types of qi deficiency and blood stasis syndrome and phlegm turbidity obstructing lung syndrome.

Objective To investigate the effects of Solitaire stent thrombectomy combined with intravenous thrombolysis (IVT) on the prognosis, cerebral hemodynamic status, and neurological function in patients with anterior circulation acute ischemic stroke (CIS). Methods The clinical data of 122 patients with CIS treated in our hospital from June 2019 to June 2024 were retrospectively analyzed. According to different treatment methods, the patients were divided into two groups: 60 patients who received IVT alone were included in the control group, and 62 patients who received Solitaire stent thrombectomy combined with IVT were included in the treatment group. Vascular recanalization status and perioperative complications were compared between the two groups. Cerebral hemodynamic indicators, serum nerve factors, and neurological function scores were compared before and after treatment. Results The vascular recanalization rate in the treatment group was higher than that in the control group, and the recanalization time was shorter than that in the control group. There was no significant difference in mortality and total incidence of complications between the two groups. At 24 hours after surgery, cerebral blood flow (CBF), mean velocity (Vm), and end-diastolic velocity (Vd) in both groups were higher than those before surgery, and those in the treatment group were significantly higher than the control group. At 72 hours after surgery, the levels of neuron-specific enolase (NSE) in both groups were lower than those before surgery, with the treatment group showing lower levels than the control group; the levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were higher than those before surgery, with the treatment group showing higher levels than the control group. At discharge, the National Institutes of Health Stroke Scale (NIHSS) scores in both groups were lower than those before surgery, and the score in the treatment group was lower than that in the control group. At 90 days after surgery, the modified Rankin Scale (mRS) scores in both groups were lower than those before surgery, and the score in the treatment group was lower than that in the control group. Conclusion Solitaire stent thrombectomy combined with IVT can significantly enhance the vascular recanalization rate, and improve the cerebral hemodynamic status, neurocognitive function and cerebral neuroprotective factors levels in patients with CIS, and it has high safety.

Objective To analyze the predictive value of electrocardiogram parameters combined with serum N-terminal pro-brain natriuretic peptide (NT-proBNP) on major adverse cardiac events (MACE) in elderly patients with acute myocardial infarction (AMI). Methods 104 elderly patients with AMI in the hospital were retrospectively selected from June 2021 to February 2024, and they received electrocardiogram examination. Serum NT-proBNP level was detected. The above patients were divided into MACE group (n=46) and non-MACE group (n=58) according to whether MACE occurred within 6 months after discharge. The predictive value of electrocardiogram parameters[QT/QTc interval, P wave dispersion (Pd), QRS wave duration]combined with serum NT-proBNP on MACE occurrence in elderly patients with AMI was analyzed. Results QT interval, QTc interval, Pd, QRS wave duration, NT-proBNP, left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) in MACE group were higher than those in non-MACE group, while left ventricular ejection fraction (LVEF) was lower than that in non-MACE group. Pearson correlation analysis suggested that QT interval, QTc interval, Pd and QRS wave duration were positively correlated with LVESD and LVEDD, and those indicators were negatively correlated with LVEF. Binary logistic regression analysis showed that QT interval, QTc interval, Pd, QRS wave duration, NT-proBNP, LVESD, LVEDD and LVEF were independent influencing factors of the prognosis of elderly patients with AMI. ROC curve indicated that the areas under the ROC curves of QT interval, QTc interval, Pd, QRS wave duration, NT-proBNP and combined detection for predicting the prognosis of elderly patients with AMI were 0.875, 0.753, 0.842, 0.894, 0.840 and 0.985, and combined prediction had high efficiency. Conclusion Electrocardiographic parameters,including the QT/QTc interval,P-wave dispersion（Pd）,and QRS duration,along with serum NT-proBNP levels,are closely associated with cardiac function in elderly patients with acute myocardial infarction（AMI）. Their combined assessment demonstrates good predictive efficacy for the prognosis of these patients,offering high clinical reference value.

Objective To explore the risk factors of poor postoperative recovery of lumbar intervertebral disc protrusion treated by transforaminal endoscopic TESSYS technology, and to construct and validate the relevant prediction model. Methods A retrospective analysis was conducted on patients with lumbar intervertebral disc protrusion who underwent transforaminal endoscopic TESSYS technology treatment in our hospital from January 2019 to December 2021, and all the data of the patients were collected. LASSO regression was used to screen the risk factors for poor recovery after endoscopic TESSYS in patients with lumbar intervertebral disc protrusion. The mediating parameter λ in LASSO regression was verified by the 10-fold cross-validation method. Variables with λ not being 0 were selected and included in the multivariate Logistic regression model. To establish a risk factor prediction model for poor recovery after transforaminal endoscopic TESSYS in patients with lumbar intervertebral disc protrusion. Based on the results of the prediction model, the receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated. The model was internally verified by using Bootstrap for repeated sampling (1000 times), and the consistency index (C-index) could be obtained through calculation. Results According to the inclusion and exclusion criteria, 100 patients were enrolled. Among them, 33 cases had poor postoperative recovery and 67 cases had good recovery. Univariate analysis indicated 8 significantly different indicators. Using LASSO regression dimensionality reduction processing, 7 optimal modeling indicators were indicated, and Logistic regression analysis was conducted on them. Eventually, 3 indicators were obtained: age, combined diabetes, combined osteoporosis, and a risk factor model was constructed: Logi(P)=-1.159+0.681×age+0.291×combined diabetes+0.428×combined osteoporosis. The assessment showed that the C-index of this model was 0.922. The AUC was 0.901(95% CI: 0.863-0.945), and the model had a good predictive ability. Conclusion In this study, a prediction model for poor postoperative recovery of lumbar intervertebral disc protrusion treated by transforaminal endoscopic TESSYS technology was established based on LASSO-Logistic, and it has good predictive ability and good application value in clinical practice.

Objective To investigate the correlation between serum magnesium levels and neonatal bacteria infectious jaundice and its clinical significance in this condition. Methods A total of 136 neonates diagnosed with jaundice at our hospital from May 2022 to May 2025 were enrolled and divided into the non-infectious jaundice group (n=84) and the infectious jaundice group (n=52) based on etiological examinations. Clinical data were collected for univariate analysis, receiver operating characteristic (ROC) curve analysis to evaluate the predictive value of serum magnesium, and Pearson correlation analysis. Results The infectious jaundice group had significantly higher proportions of jaundice resolution time>5 days, liver function injury, moderate and severe disease severity, and levels of serum magnesium, CRP, PCT, and TcB than the non-infectious jaundice group. Serum magnesium showed good predictive value for neonatal bacteria infectious jaundice (AUC=0.801, P<0.05). In neonatal bacteria jaundice, the high-serum-magnesium group had significantly higher proportions of jaundice resolution time>5 days and levels of CRP, PCT, and TcB than the low-serum-magnesium group, and CRP, PCT, and TcB levels were significantly positively correlated with serum magnesium levels. In neonatal infectious jaundice, the high-serum-magnesium group had significantly higher proportions of moderate and severe disease severity and levels of CRP, PCT, and TcB than the low-serum-magnesium group, and only CRP and PCT levels were significantly positively correlated with serum magnesium levels. Conclusion Infants with infectious jaundice have prolonged jaundice resolution time, liver function injury, increased disease severity, and elevated levels of serum magnesium, CRP, PCT, and TcB. Among them, serum magnesium has good predictive value and is positively correlated with CRP and PCT levels in neonatal bacteria infectious jaundice. The results of this study can, to a certain extent, provide a reference for developing early prevention and non-invasive diagnostic tools in clinical practice.

Objective Investigating the correlation between changes in alpha-fetoprotein (AFP) and tumor necrosis factor-α (TNF-α) Levels and the therapeutic efficacy of transarterial chemoembolization (TACE) in Patients with intermediate to advanced primary liver cancer. Methods This study is a retrospective study, with data sourced from the medical records of patients with advanced primary liver cancer who underwent TACE treatment and were admitted to our hospital from March 2022 to April 2023. Patients were categorized into the effective group [complete response (CR) + partial response (PR) + stable disease (SD)] and the ineffective group [progressive disease (PD)] based on treatment efficacy. The relationship between serum AFP, TNF-α expression, and the prognosis of TACE treatment in patients with advanced primary liver cancer was analyzed. Results 82 patients with primary liver cancer were included in TACE treatment and divided into an effective group (CR+PR+SD, 63 cases) and an ineffective group (PD, 19 cases). There was no significant difference in baseline data between groups. The levels of AFP and TNF-α in the effective group were lower than those in the ineffective group. Before treatment, when the clinical stage increases or the tumor boundary is irregular, the serum AFP and TNF-α values increase. ROC analysis showed that the AUC for predicting prognosis by combining AFP and TNF - α was 0.913. Conclusion The changes in serum AFP and TNF-α levels are closely related to the postoperative efficacy of TACE in advanced primary liver cancer and can be used as prognostic indicators.

Objective To explore the application effect of happiness PERMA (positive emotion, engagement, relationships, meaning, and accomplishment) model combined with health education in the control of chronic pain after brachial plexus nerve injury. Methods A total of 88 patients with chronic pain after brachial plexus nerve injury in the hospital were enrolled between June 2021 and June 2025. According to random number table method, they were divided into control group (routine pain management and health education) and study group (happiness PERMA model combined with health education), 44 cases in each group. All patients were intervened for 8 weeks. The scores of numerical rating scale (NRS) before intervention and after 2, 4, 6 and 8 weeks of intervention, scores and total score of exercise of self-care agency scale (ESCA), scores of self-rating anxiety scale (SAS), self-rating depression scale (SDS) and pain catastrophizing scale (PCS), scores and total scores of general well-being schedule (GWB) before intervention and after 8 weeks of intervention were compared between the two groups. Results After 2, 4, 6 and 8 weeks of intervention, NRS scores in study group were significantly lower than those in control group. After intervention, scores and total score of ESCA (health knowledge level, self-care skills, self-care responsibility, self-concept) were higher than those in control group, scores of SAS, SDS and PCS were significantly lower than those in control group, scores and total score of GWB (concern for health, energy, satisfaction and interest in life, depression or pleasure, control of emotions and behaviors, relaxation and tension) were higher than those in control group. Conclusion The happiness PERMA model combined with health education can effectively alleviate chronic pain after brachial plexus nerve injury, improve psychological state and self-management ability, which is worthy of clinical promotion and application.

Objective To explore the high risk factors of complications related to peripherally inserted central catheter (PICC) in neonatal surgery. Methods The clinical data of 550 newborns who underwent PICC catheterization in neonatal surgery in our hospital from January 2023 to December 2024 were retrospectively analyzed. According to whether PICC-related complications occurred during hospitalization, the newborns were divided into complication group (120 cases) and non-complication group (430 cases). The high risk factors of PICC-related complications in neonatal surgery were analyzed by univariate and multivariate Logistic regression analysis, and the regression equation was established. The predictive value of the regression equation for PICC-related complications in neonatal surgery was analyzed by receiver working characteristics (ROC) curve. Results Among the 120 newborns with PICC-related complications, there were 32 cases of ectopic catheter tip, 40 cases of phlebitis, 20 cases of related thrombosis and 28 cases of catheter blockage. Compared with the group without complications, the birth weight in the group with complications was lower, and the proportion of newborns with gestational age<36 weeks, catheter tip not reaching the expected position, flushing frequency of PICC for vasoactive drug infusion ≤2 times a day, amniotic fluid pollution, umbilical cord abnormality, other invasive operations, fasting time>10 d and PICC indwelling time>28 d was higher. Multivariate Logistic regression analysis showed that low birth weight, gestational age<36 weeks, catheter tip not reaching the expected position, PICC indwelling time>28 d and fasting time>10 d are the high risk factors of PICC-related complications in neonatal surgery. The regression equation was established as follows: logit (P) =-6.845+ birth weight ×0.435+ gestational age ×0.874+ whether the catheter tip reaches the expected position ×0.643+PICC indwelling time ×0.231+ fasting time ×1.354. The Logistic regression equation for the diagnosis of PICC-related complications in neonatal surgery was evaluated. The establishment of the regression equation was statistically significant, the coefficient difference of the regression equation was statistically significant. Hosmer-Lemeshow goodness of fit test shows that the fitting effect was good, The ROC curve for predicting PICC-related complications in neonatal surgery was plotted based on the diagnostic probability logit (P), demonstrating a high predictive value of the regression equation. Conclusion Low birth weight, gestational age<36 weeks, catheter tip not reaching the expected position, PICC indwelling time>28 d and fasting time>10 d were the high-risk factors of PICC-related complications in neonatal surgery. The regression equation was effective and had high predictive value, so we could screen high-risk newborns as soon as possible and take targeted interventions to reduce the incidence of PICC-related complications in surgery.

Objective To explore the application value of multidisciplinary team (MDT) collaboration in fiberoptic bronchoscopic lung lavage for pediatric severe pulmonary infection. Methods Using a random number table, 102 children with severe pulmonary infection admitted to the hospital from July 2023 to July 2024 were assigned to the observation group and the control group, with 51 cases in each group. The control group underwent conventional fiberoptic bronchoscopic lung lavage, while the observation group received MDT collaborative intervention on this basis. The success rate of one-time fiber bronchoscope placement, peripheral oxygen saturation (SpO₂), pulmonary function, incidence of adverse events, and family members' satisfaction with nursing were compared between the two groups. Results Compared with the control group, the observation group showed a higher success rate of one-time fiber bronchoscope placement. Compared with the control group, the observation group exhibited higher SpO₂ on postoperative day 3, and higher forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and total lung capacity (TLC) on postoperative day 7. FEV1/FVC was comparable between the two groups. The incidence rates of adverse events in the two groups were close. The scores for visitation and companion system, ward environment and nursing services, and total nursing satisfaction score of the observation group were higher than those of the control group. Conclusion Applying MDT collaborative intervention in fiberoptic bronchoscopic lung lavage for pediatric severe pulmonary infection can effectively increase the success rate of one-time fiber bronchoscope placement, improve postoperative pulmonary function and oxygenation index, and enhance family members' satisfaction with nursing. However, due to the small sample size in this study, no significant difference in the incidence of adverse events is observed between the two groups. Therefore, the impact of this intervention on adverse events requires further study.

Objective To evaluate the application value of low temperature plasma ablation (LTPA) in young and middle-aged patients with sinonasal inverted papilloma (SNIP) based on nasal function and stress response. Methods A retrospective collection of 91 young and middle-aged SNIP patients admitted to Zhangjiagang Hospital of Traditional Chinese Medicine from December 2019 to January 2024 was conducted as the research subjects. They were divided into the control group (45 cases) and the observation group (46 cases) according to different surgical plans. The control group received nasal endoscopic surgery, and the observation group received nasal endoscopic surgery +LTPA. The clinical efficacy, surgical indicators, stress response indicators [epinephrine (E), norepinephrine (NE), cortisol (Cor)], nasal function, sinonasal outcometest-20(SNOT-20) scoring, and the occurrence of postoperative complications and recurrence one year after the operation. Result The total effective rate of the observation group was 95.65%, significantly higher than that of the control group (82.22%). the intraoperative blood loss, postoperative bleeding time and surgical cavity recovery time in the observation group were all lower than those in the control group. On postoperative day 1 and 3, the levels of Cor, E and NE in the observation group were lower than those in the control group. Three months after the operation, the ciliary clearance rate and ciliary clearance speed in the observation group were higher than those in the control group, while the nasal airway resistance, saccharin clearance time and SNOT-20 score were lower than those in the control group. The incidence of complications in the observation group was 6.52%, compared with 13.33% in the control group, and the differences were not statistically significant. The one-year recurrence rate in the observation group was 2.17%, which was lower than that 13.33% in the control group. Conclusion LTPA treatment has a significant effect on young and middle-aged patients with SNIP. It can improve the stress response and nasal function of patients and reduce the recurrence rate one year after the operation.

Objective To evaluate the intervention effect of Xingnao Kaiqiao acupuncture combined with flunarizine hydrochloride on clinical symptoms, cerebral hemodynamics and neural vasoactive substances in patients with migraine. Methods A total of 132 patients with migraine admitted to the hospital were enrolled between January 2022 and June 2025. According to different treatment methods, they were divided into flunarizine group (flunarizine hydrochloride), acupuncture group (Xingnao Kaiqiao acupuncture) and combination group (Xingnao Kaiqiao acupuncture combined with flunarizine hydrochloride), 44 cases in each group. The headache control (duration, onset frequency, severity), scores of TCM symptoms, cerebral hemodynamics[anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), resistance index (RI), pulsatility index (PI) ]and neural vasoactive substances[calcitonin gene-related peptide (CGRP), pituitary adenylate cyclase-activating polypeptide (PACAP), S100B protein, substance P (SP) ]were compared among the three groups, and adverse reactions in the three groups were observed. Results After treatment, onset frequency and severity of headache were decreased in the three groups, which were lower in combination group, and headache duration was shortened, which was shorter in combination group. After treatment, scores of TCM symptoms, ACA, MCA, PCA, RI, PI, CGRP, PACAP, S100B protein and SP were decreased in the three groups, which were lower in combination group. There was no significant difference in the incidence of adverse reactions among the three groups. Conclusion Xingnao Kaiqiao acupuncture combined with flunarizine hydrochloride can effectively improve headache symptoms in migraine patients, optimize local cerebral blood flow and inhibit neural vasoactive substances, which is worthy of clinical application and reference.

Objective To explore the impact and significance of a multidimensional intervention based on the Fogg Behavior Model (FBM) on postoperative self-management behaviors and health outcomes in patients with early invasive breast cancer (EIBC). Methods A retrospective analysis was conducted on 150 patients with EIBC admitted to our hospital from January 2018 to June 2020. Based on the different intervention methods recorded in the medical records system, the subjects were divided into an observation group (n=75) and a control group (n=75). The control group received conventional postoperative care management for breast cancer, while the observation group received an additional FBM-based intervention on top of conventional care. The self-management behaviors, medication adherence, quality of life, anxiety and depression levels, participation rate, and satisfaction were compared between the two groups at 1 month, 3 months, 6 months, and 1 year postoperatively. The 5-year survival rate was also analyzed. Results After the intervention, the SMSCP score of the observation group was significantly higher than that of the control group, and it remained higher even at 1 year post-intervention (65.44±6.99 vs 53.56±8.27). The anxiety and depression scores of the observation group were significantly lower than those of the control group, while medication adherence, FACT score, family participation rate (84.00% vs 40.00%), and overall satisfaction (82.67% vs 68.00%) were significantly higher. The 5-year survival analysis showed no significant difference in overall survival rate between the observation group and the control group (95.12% vs 91.78%). After the intervention, the risk of disease progression or death was reduced by 37% (HR=0.625). Conclusion The systematic intervention based on the FBM theoretical framework, integrating the three core elements of “Motivation-Ability-Trigger”, can effectively enhance the self-management efficacy of patients with early invasive breast cancer, improve their quality of life, and demonstrate strong application potential.

Objective To separate and determine the chemical constituents of the 50% ethanol extract from the dried roots of Polygala fallax Hemsl, intended to find natural active ingredients with good anticancer activities. Methods The air-dried-crushed roots of Polygala fallax Hemsl were soaked in 50% aqueous ethanol for 48h, heating reflux extraction and vacuum concentration to get the concentrated liquid. The concentrated liquid was subjected on a macroporous adsorption resin D101 column and a silica gel column, then edulcorated by Semi-preparative HPLC. The structures of all compounds were identified by modern technologies such as UV, HR-ESI-MS, IR and NMR. MTT assay was used to evaluate the cytotoxicity of xantones on bladder cancer cell UMUC3, human hepatoma cell HepG2, human glioma cell T98G, human gastric cancer cell SGC-7901 and human breast cancer cell MDA-MB-231. Results In this paper, eight xanthones were isolated from the traditional Chinese medicine P. fallax Hemsl. Compound 5 was first isolated from nature and compound 2 was first isolated from P. fallax Hemsl. Compound 4 exhibited moderate cytotoxicity with IC₅₀ of 41.931 μM and 56.544 μM against human gastric carcinoma SGC-7901 cells and human breast cancer MDA-MB-231 cells respectively. Conclusion In this study, eight monomeric compounds were isolated and elucidated from the roots of P. fallax Hemsl, including one new discovered naturalproduct. One compound with good antitumor activity in vitro was selected.

Objective To investigate the application effect of an automatic dispenser in the compounding of commonly used Traditional Chinese Medicine (TCM) injections in PIVAS. Methods From May 22 to June 10, 2025, Compound Kushen Injection, Shenkang Injection, and Kangai Injection compounded at the PIVAS of Shenzhen Hospital of Guangzhou University of Chinese Medicine were enrolled. Samples were categorized into a manual group and an ultra-clean dispensing device group according to the preparation technique. The sample sizes comprised 200 prescriptions each for Kangai and Compound Kushen Injections (split evenly into 100 per group) and 80 prescriptions for Shenkang Injection (40 per group). The efficiency of manual versus automatic dispenser, residual drug volume, compounding stability, microbial detection rates in residual solution/syringes and air cleanliness were compared. Results When compounding three types of Traditional Chinese Medicine injections, the average preparation time per bag in the ultra-clean dispensing device group was significantly shorter than that in the manual group for both compound Kushen Injection and Shenkang Injection [(42.40±3.364) s vs (46.65±4.722) s and (55.18±4.299) s vs (63.90±5.891) s, respectively]. However, no significant difference in preparation time was observed between the two groups for Kangai Injection [(60.05±3.886) s vs (60.96±4.829)]. In the present study most coefficients of variation for compounding time and residual volume were small when using the automatic dispenser. No statistically significant differences were observed in residual drug volume. Under the current research conditions, the introduction of the automatic dispenser has no significant impact on the microbial detection of the inner surface of dispensing syringes, residual medication or air cleanliness. Conclusion Taking Kang'ai Injection, Compound Kushen Injection, and Shenkang Injection as examples, the automatic dispenser significantly reduces the compounding time per bag of finished infusion solution and makes it more stable time. No significant adverse effects were observed on the residual drug volume or microbial test results. This provides a promising option for PIVAS to explore standardized procedures and intelligent compounding.

Objective To investigate the quality control parameters, including volume, Factor Ⅷ (FⅧ) content per bag, and fibrinogen (Fib) content per bag, of cryoprecipitate prepared by two generations of cryoprecipitate preparation instruments. In order to evaluate the advantages of the second-generation device. Methods Fresh frozen plasma (FFP) derived from 400ml whole blood units was randomly divided into two groups. Cryoprecipitate was prepared using the ZBK-LCD-A1(first generation) and ZBK-LCD-A3(second generation) instruments, respectively. The FⅧ content, Fib content, and volume of the cryoprecipitate were measured. Statistical analysis using t-tests and chi-square tests was performed. The preparation time per bag for each generation of instrument was also compared to calculate preparation efficiency. Results The FⅧ content in cryoprecipitate prepared by the second-generation instrument was (145.48±54.32) IU significantly higher than that of the first-generation instrument (88.32±42.89) IU. The FⅧ compliance rate increased. Fib content and the volume increased. But the Fib compliance rate showed no statistically significant difference. The average preparation time per bag for the second-generation instrument showed a statistically significant difference compared to the first-generation instrument. Conclusion The second-generation instrument significantly improves the quality and preparation efficiency of cryoprecipitate by optimizing temperature control, improving the peristaltic pump with tube clamping, and presetting product weight, among other measures.

Objective To assess the current competency status of grassroots mental health prevention personnel in Hunan Province and explore its influencing factors, thereby providing a basis for optimizing human resource strategies. Methods A cross-sectional survey was conducted using cluster random sampling among 2, 276 grassroots mental health workers from 14 prefectures in Hunan. Competency was evaluated using the “Competency Evaluation Index System for Professional Technical Personnel in Mental Health Prevention, “ with data analyzed via t-tests, ANOVA, multiple linear regression, and interaction effect analysis. Results A total of 2 053 valid questionnaires were collected, yielding an effective response rate of 90.2%. The overall mean competency score was 188.37±32.902, with an average item score of 3.69. The personal traits dimension scored the highest (4.02), while the theoretical knowledge dimension scored the lowest (3.53). Multiple regression analysis indicated that gender, professional category, full-time status, and weekly working hours were independent influencing factors of competency (P<0.05). Interaction analysis revealed that increasing weekly working hours could buffer the competency gap associated with part-time roles. Conclusion The overall competency of grassroots mental health workers in Hunan is moderately high, yet a structural imbalance exists with stronger attitudes but weaker theoretical knowledge. It is recommended to strengthen theoretical training, promote full-time positions, and ensure adequate working hours for part-time staff to enhance service capacity.

Objective To investigate the mediating effect of hope level between resilience and anxiety-depression in elderly stroke patients, providing theoretical basis and practical pathways for psychological interventions. Methods A total of 221 elderly stroke patients were selected using convenience sampling from the First Affiliated Hospital of Chengdu Medical College between October 2024 and September 2025. Data were collected using the general information questionnaire, herth hope index (HHI), Connor-Davidson resilience scale-10(CD-RISC-10), and hospital anxiety and depression scale (HADS). Pearson correlation analysis was used to examine correlations among hope level, resilience, and anxiety-depression. The Process mediation model and Bootstrap method were employed to analyze and verify the mediating effects. Results The mean scores for the 221 elderly stroke patients were as follows: total hope level 33.63±3.52, resilience 24.37±6.90, and total anxiety-depression 12.78±7.70. Pearson correlation analysis revealed that hope level was moderately positively correlated with resilience (r=0.700, P<0.01) and moderately negatively correlated with anxiety-depression (r=-0.537, P<0.01). Resilience was also moderately negatively correlated with anxiety-depression (r=-0.661, P<0.01). Mediation effect analysis demonstrated that resilience had a direct effect on anxiety-depression (β=-0.624, 95%CI: -0.779~-0.469) and an indirect effect on anxiety-depression through the partial mediating role of hope level (β=-0.114, 95%CI: -0.205~-0.027), with the mediating effect accounting for 15.45% of the total effect. Conclusion Hope level partially mediates the relationship between resilience and anxiety-depression in elderly stroke patients. Clinical nursing interventions should focus on enhancing patients' resilience and hope levels to alleviate negative emotions and promote psychological rehabilitation.

Objective To understand the current situation of dementia fear in rural elderly people and analyze its influencing factors. Methods A total of 914 elderly people from 18 villages in Hengyang, Chenzhou, Changsha, Yueyang, Shaoyang, and Zhangjiajie under the jurisdiction of Hunan Province were selected by convenient sampling method. They were investigated using the general information questionnaire, Fear of Dementia Scale, Dementia Knowledge Assessment Scale, Lubben Social Network Scale, Geriatric Depression Scale-5, Perceived Ageism Scale, and Subjective Memory Complaints Questionnaire. Results The scores of the 914 rural elderly in fear of dementia were (50.68±8.66), knowledge of dementia (10.19±5.05), social network (11.64±3.25), depression (1.56±0.64), perceived ageism (1.64±1.52) and subjective memory complaints (5.84±2.43). The fear of dementia among rural elderly was negatively correlated with social network, and positively associated with dementia knowledge, depression, perceived ageism, and subjective memory complaint (all P<0.05). Multiple linear stepwise regression results showed that age, sex, sleep status, marital status, family history of dementia, caring dementia, dementia knowledge, social network, perceived ageism, and subjective memory complaint were the influential factors of dementia fear in rural elderly (all P<0.05), which could explain 38.5% of the total variation. Conclusion The fear of dementia of the elderly in rural areas is at a lower middle level. The level of dementia fear is influenced by individual, cognitive, social, and psychological factors. The nursing staff and grassroots managers should pay attention to the rural elderly dementia fear status, improve dementia knowledge, strengthen social support and psychological services, and reduce the level of their dementia fear through targeted intervention measures.

Objective To explore the impact of an innovative nursing model based on the Enhanced Recovery After Surgery (ERAS) concept and empowerment theory on the quality of postoperative recovery in patients undergoing Single-Incision Laparoscopic Cholecystectomy (SILS). Methods A total of 100 SILS patients were randomly divided into an experimental group (innovative nursing model, n=50) and a control group (conventional nursing, n=50) using a random number table. The innovative nursing model included preoperative psychological counseling and education, intraoperative dynamic analgesia, postoperative early staged rehabilitation, and a complication prevention system, with interventions delivered through a “biological-psychological-behavioral” three-dimensional framework. The two groups were compared in terms of postoperative complication rates (incision infection, deep vein thrombosis, bile leakage, postoperative bleeding), related biomarkers [hemoglobin (Hb) , hematocrit (HCT), Procalcitonin, Bilirubin, Albumin, T helper cell 1/T helper cell 2(Th1/Th2)], recovery time (first ambulation time, intestinal recovery time, length of hospital stay), pain scores (Visual Analog Scale, VAS), anxiety scores (self-rating anxiety scale, SAS) and quality of life (36-item short form hHealth survey, SF-36). Results The incidence of postoperative complications in the experimental group was not significantly different from the control group. At 24 hours postoperatively, the levels of Hb, HCT, albumin and the ratio of Th1/Th2 in the experimental group were significantly higher than those in the control group, while the levels of procalcitonin and bilirubin were significantly lower than those in the control group. The average length of hospital stay in the experimental group was significantly shorter than that in the control group. VAS and SAS scores in the experimental group were significantly lower than those in the control group at 24 hours postoperatively. Additionally, SF-36 scores in the experimental group were significantly better than the control group. Conclusion The innovative nursing model can effectively promote physical function recovery, reduce the risk of complications, and improve treatment experience in SILS patients, making it worthy of clinical promotion.

Objective To explore the influence of enhanced recovery after surgery (ERAS) nursing based on aesthetic needs on the appearance and prognosis in breast cancer patients undergoing breast-conserving surgery. Methods 102 patients with breast cancer in the hospital were included from March 2021 to March 2023, and were randomly divided into control group (n=51) and observation group (n=51). The control group received routine nursing care. the observation group received routine nursing combined with ERAS nursing based on aesthetic needs including psychological assessment, environmental beautification, functional exercise, psychological comfort and so on. The excellent and good rates of breast appearance were compared between the two groups after intervention; the quality of life was compared between the two groups before and after intervention; and the postoperative recovery, incidence of postoperative complications, and subjective satisfaction of patients were compared between the two groups. Results After intervention, compared with the control group, the excellent and good rate of breast appearance in the observation group was higher. The quality of life scores in the observation group were higher after intervention compared to the control group. The VAS score in the observation group was lower compared with that in the control group. The first ambulation time in the observation group was shorter than that in the control group, and the hospitalization time was shorter also. Compared with the control group, the total incidence rate of postoperative complications was lower in the observation group. After the intervention, the scores of the observation group in each dimension of subjective satisfaction were significantly higher than those of the control group. Conclusion ERAS nursing based on aesthetic needs can improve the postoperative breast appearance in patients with breast-conserving surgery for breast cancer, so as to enhance the self-confidence and reduce the influence of surgery on quality of life, and it has good postoperative recovery and few complications.

Objective The purpose is to explore the changing trajectory of adverse psychological reactions in postoperative breast cancer patients based on evidence-based nursing, construct a prediction model for adverse psychological reactions, and verify it. Methods A total of 451 patients who underwent breast cancer surgery in a tertiary grade A hospital from December 2021 to December 2024 were selected as the research subjects. The psychological data of the patients were collected at four time points, namely on the day of admission (T1), the first day after surgery (T2), the second day after surgery (T3), and the day of discharge (T4). The latent class growth model was used to identify the adverse psychological trajectory, and logistic regression analysis was used to determine the predictive factors affecting the adverse psychological trajectory, and a risk prediction model was established. And the predictive ability of the model was tested through the receiver operating characteristic curve. Results The research consensus identified three different trajectories of psychological distress. It was determined that educational level, average monthly income per capita, medical treatment method, and disease stage were significant factors affecting psychological distress in postoperative breast cancer patients. The area under the ROC curve (AUC) was 0.821, the optimal cut-off value was 0.136, the sensitivity was 0.862, and the specificity was 0.831. The mean absolute error between the actual value and the predicted value of the prediction model was 0.021, and the Hosmer-Lemeshow goodness-fit test indicated that the model had a good fit. Conclusion Evidence-based nursing can effectively identify the psychological adverse trajectory in postoperative breast cancer patients. Through the predictive model it constructs, high-risk patients with poor psychological status after breast cancer surgery can be screened quickly, providing a reference for medical staff to adopt intervention measures in a timely manner and improve the mental health status of patients.