With the increasing prevalence of unhealthy lifestyles among Chinese residents， the growing burden of cardiovascular risk factors， and the accelerating aging of the population， cardiovascular diseases （CVD） remain a major public health challenge that seriously threatens the health of Chinese residents. In 2023， the crude incidence rate of CVD among Chinese residents aged 18 and above was 620.33 per 100 000， with rates of 717.36 per 100 000 for men and 519.64 per 100 000 for women. The incidence rate of CVD increases significantly with age. Despite notable advancements in CVD diagnostic and therapeutic technologies in recent years， both the incidence and mortality rates continue to rise， indicating that the turning point for a reduction in the disease burden has not yet been reached. Drawing upon the latest data from the 《China Cardiovascular Health and Disease Report 2024》， this article provides a systematic review of recent findings on the prevalence trends， risk factors， current status of diagnosis and treatment， research developments， and economic burden associated with CVD in China， with the aim of offering a scientific foundation for the development of effective prevention and control strategies.

This review systematically elucidates recent advances in the therapeutic application of Erianin， a natural compound derived from Dendrobium， a traditional Chinese medicine， in the treatment of breast cancer， with particular emphasis on triple-negative breast cancer （TNBC）. TNBC is characterized by the absence of estrogen receptor （ER）， progesterone receptor （PR）， and human epidermal growth factor receptor 2 （HER2） expression， which presents significant clinical challenges due to limited therapeutic targets and continued reliance on conventional chemotherapy. Erianin exhibits notable anticancer potential through the induction of apoptosis in breast cancer cells. Its primary mechanisms involve sensitizing cancer cells to apoptotic signals via activation of both intrinsic and extrinsic apoptotic pathways， particularly through mitochondrial dysfunction-mediated cytochrome c release and subsequent activation of caspase-dependent pathways. At the molecular level， Erianin effectively modulates key oncogenic signaling pathways， including PI3K/Akt， MAPK， and NFATc1 cascades， thereby suppressing cell proliferation and migration while promoting apoptosis. However， current research priorities center on investigating its synergistic effects with chemotherapeutic agents and assessing its radiosensitization potential to further enhance its clinical utility. Notably， Erianin demonstrates unique advantages in overcoming drug resistance in TNBC by modulating apoptotic regulatory networks， particularly through regulation of the Bax/Bcl-2 protein ratio， positioning it as a promising multi-target therapeutic candidate. Although existing evidence largely stems from in vitro and animal studies， future research should prioritize human clinical trials to validate its efficacy and safety， alongside pharmaceutical optimization strategies such as the development of nanodelivery systems and exploration of structural derivatives. This review systematically clarifies the core mechanism and therapeutic potential of pilanin-induced apoptosis， and provides theoretical basis for developing innovative therapeutic regimens for TNBC.

Objective To investigate the impact of different application methods of tissue compensators （bolus） on the skin dose delivered to the chest wall following radical mastectomy for breast cancer. Methods A retrospective analysis was conducted on 60 female patients who underwent radical mastectomy and required chest wall radiotherapy at the hospital between January 2023 and March 2025. The Pinnacle³ 9.10 radiotherapy planning system （TPS） was utilized to design two VMAT dual semi-arc radiotherapy plans for each patient， with a prescribed target dose of 50 Gy delivered in 2 Gy fractions over 25 sessions. In Plan 1， a Bolus was applied and optimized during the first 15 fractions， and subsequently removed for the remaining 10 fractions without re-optimization. The sub-field configuration and dose weighting from the initial optimization were retained， and only dose recalculations were performed. The final treatment plan combined both the Bolus-included and Bolus-excluded phases. In contrast， Plan 2 involved the application and optimization of Bolus during the first 15 fractions， followed by its removal and re-optimization of the plan for the last 10 fractions. The two optimized plans were then combined for the overall treatment delivery. Data from the two plan groups were analyzed using a paired sample t-test with SPSS 29.0 software. Results There was a statistically significant difference （P < 0.05） in skin D_mean， V_52.5， and V₅₅； heart D_mean， V₅， V₃₀， and V₄₀； affected lung D_mean， V₅， and V₂₀； PRVcord D_mean and D_max； healthy breast D_mean， V₅， and V₁₀； affected humeral head D_mean and V₃₀； as well as PTV D_mean， V₅₀， V₅₅， D_2%， D_98%， CI， and MU. Moreover， the dose distribution on the target layer and the DVH curves showed marked differences. However， no statistically significant difference was observed in PTV HI （P = 0.125）. Conclusion The combination of the two optimized plans， consisting of 15 fractions with bolus and 10 fractions without bolus， more accurately reflects the dose distribution within the planned target area and organs at risk， thereby providing enhanced protection for the patient's chest wall skin.

Objective To develop a multivariate predictive nomogram to identify high-risk cohorts for sentinel lymph node （SLN） metastasis among cT1-2N0 breast cancer patients with preoperatively normal axillary ultrasound （AUS）， thereby providing a reference for personalized axillary management. Methods A retrospective analysis was conducted on the clinicopathological and ultrasonographic data of 427 patients diagnosed with invasive breast cancer who received treatment at Ward 4 （Breast Unit）， Department of General Surgery， Liuzhou Workers' Hospital， between January 2018 and December 2023. Univariate correlation analysis and multivariate logistic regression analysis were employed to identify independent risk factors associated with SLN metastasis. The accuracy and predictive performance of the nomogram were assessed using receiver operating characteristic （ROC） curve analysis. Results Our study enrolled 427 women diagnosed with clinical T1-2N0 breast cancer who underwent preoperative AUS with normal findings. Among these patients， 47 cases （11.0%） exhibited sonographically normal axillary lymph nodes， whereas 380 cases （89.0%） showed non-visualized lymph nodes. SLN metastasis， confirmed by postoperative pathological examination， was identified in 78 patients （18.3%）. Univariate analysis revealed that estrogen receptor （ER） status， maximal tumor diameter， tumor location， lymphovascular invasion （LVI）， and perineural invasion （PNI） were significantly associated with the presence of SLN metastasis （P < 0.05）. Multivariate logistic regression analysis further identified the following independent high-risk factors for SLN metastasis： tumor location in the upper outer quadrant （OR = 4.118， 95% CI = 1.349 ~ 12.571）， tumor size greater than 2 cm （OR = 2.246， 95% CI = 1.252 ~ 4.029）， presence of LVI （OR = 4.477， 95% CI = 2.207 ~ 9.081）， and presence of PNI （OR = 3.013， 95% CI = 1.573 ~ 5.771） （all P < 0.05）. Ultrasonographic features of axillary lymph nodes—including their positivity status， short-axis diameter， and numerical count—did not show a statistically significant association with the SLN metastatic burden （P ≥ 0.05）. However， these features demonstrated a statistically significant correlation with the pathological nodal stage （pN-stage） classification （P < 0.05）. In patients with 1 ~ 2 positive sentinel lymph nodes， sonographic characteristics of axillary lymph nodes （including status， maximum diameter， minimum diameter， and numerical count） did not exhibit a significant association with either axillary lymph node metastatic burden or pN-stage classification （all P ≥ 0.05）. The area under the receiver operating characteristic curve （AUC） for the predictive nomogram was 0.702 （95% CI： 0.651 ~ 0.749， P < 0.0001）， with a sensitivity of 78.21% and specificity of 59.12%. Conclusions Tumor location in the upper outer quadrant， tumor size greater than 2 cm， LVI， and PNI were identified as significant independent risk factors for SLN metastasis among patients with clinical T1-2N0 breast cancer who underwent preoperative AUS with normal findings. Furthermore， from the perspective of pN-stage stratification， omission of axillary lymph node dissection （ALND） appears to be clinically feasible for the majority of cT1-2N0 patients with 1 ~ 2 metastatic SLNs. However， preoperative ultrasonographic characteristics of lymph nodes demonstrate limited predictive value for axillary lymph node （ALN） metastatic burden or pN-stage progression.

Objective To compare the diagnostic performance of three breast MRI measurement methods—RECIST 1.1， the optimal method， and three-dimensional （3D） volumetric assessment—in assessing the efficacy of neoadjuvant chemotherapy （NAC） in breast cancer patients， with the objective of identifying the most clinically practical approach. Methods A total of 110 breast cancer patients who underwent NAC followed by surgical treatment between 2019 and 2023 were included in the study. Breast magnetic resonance imaging （MRI） was conducted within one week before and after the completion of NAC. Tumor response was evaluated using RECIST 1.1 criteria， widely recognized as the optimal method， as well as 3D volume measurement. Pathological response was determined according to the Miller-Payne grading system. Sensitivity， specificity， accuracy， and the area under the receiver operating characteristic curve （AUC） were computed and compared using the DeLong test. Results The AUC values for RECIST 1.1， the optimal method， and 3D volumetric assessment were 0.768， 0.795， and 0.883， respectively. The 3D volumetric assessment exhibited significantly better discriminative performance （P < 0.05）， with the highest sensitivity （98.9%）， specificity （77.8%）， and accuracy （95.5%）. Additionally， the optimal method demonstrated superior performance over RECIST 1.1 across multiple parameters. Conclusions 3D volumetric measurement demonstrates superior performance compared to RECIST 1.1 and the optimal method in evaluating the response to NAC， offering a more accurate and comprehensive assessment tool. Additionally， the optimal method shows advantages over RECIST 1.1 and may serve as a practical alternative in settings where 3D software is not available.

Gastric carcinoma （GC）， a highly prevalent malignant tumor globally， often progresses to advanced stages by the time of diagnosis due to its insidious clinical presentation， thereby significantly reducing therapeutic effectiveness and patient quality of life. Accurate screening and histopathological characterization of early gastric cancer （EGC） are essential for developing individualized treatment approaches. Although endoscopic techniques remain the gold standard for early GC detection， their diagnostic accuracy is largely dependent on the operator′s skill， a challenge that current artificial intelligence （AI）-assisted innovations aim to address by standardizing diagnostic procedures. Deep learning （DL）-based computer vision systems have demonstrated remarkable performance in identifying subtle EGC features， not only improving lesion detection sensitivity but also enabling automated assessment of key pathological indicators. These technological advances offer objective， visualized diagnostic support for clinical decision-making. This review provides a systematic overview of recent developments in DL applications for endoscopic image analysis of EGC and evaluates their potential for clinical integration.

Objective To investigate the role of the ROS/NLRP3/Caspase-1 pyroptosis signaling pathway in mediating the inflammatory response of nerve roots in a rabbit model of lumbar disc herniation （LDH） following acupotomy intervention. Methods Forty New Zealand white rabbits were randomly assigned to four groups： a blank control group （10 rabbits）， a model control group （10 rabbits）， an electroacupuncture intervention group （positive control group， 10 rabbits）， and an acupotomy intervention group （10 rabbits）. The LDH nerve root inflammatory response model was established in the model control group， electroacupuncture intervention group， and acupotomy intervention group using the classical autologous nucleus pulposus transplantation method. Following successful model establishment， corresponding interventions were administered. Dorsal root ganglion tissues were then collected for analysis. Reactive oxygen species levels were assessed using fluorescent probe staining. The expression of NLRP3 inflammasome-related proteins （NLRP3， ASC， GSDMD-N， and Caspase-1） was evaluated by Western blot. Mitochondrial permeability transition pore opening was assessed via Calcein AM staining. Results The comparison of relative fluorescence intensity of reactive oxygen species in dorsal root ganglion tissue among the groups indicated that the model control group exhibited significantly higher levels compared to the blank control group （P < 0.05）. Both the electroacupuncture intervention group and the acupotomy intervention group demonstrated significantly lower levels than the model control group （P < 0.05）. Western blot analysis revealed that the expression levels of NLRP3， ASC， GSDMD-N， and Caspase-1 in the model control group were significantly elevated compared to those in the blank control group （P< 0.05）. Both intervention groups showed markedly reduced expression of these proteins compared to the model control group （P < 0.05）. Additionally， the assessment of mitochondrial permeability transition pore activity based on relative fluorescence intensity showed a significant increase in the model control group compared to the blank control group （P < 0.05）， with both intervention groups exhibiting significantly lower levels than the model control group （P < 0.05）. Conclusions Acupotomy therapy modulates the ROS/NLRP3/Caspase-1 signaling pathway， thereby inhibiting pyroptosis and attenuating the inflammatory response in nerve roots. This elucidates the potential molecular mechanism underlying the therapeutic effects of acupotomy on LDH through the regulation of ROS/NLRP3/Caspase-1-mediated downstream signaling cascades.

Objective To investigate the regulatory effect of lipocalin 2 （LCN2） on epidermal growth factor receptor （EGFR） phosphorylation and its impact on inflammatory damage in human fallopian tube epithelial cells. Methods Human fallopian tube epithelial cells were isolated and a lipopolysaccharide （LPS） intervention was applied to establish an in vitro cell model. The cells were randomly assigned into the following groups： a blank control group （Control）， a model group （Model）， experimental groups （Model + si-LCN2 or Model + oe-LCN2）， and negative control groups （Model + si-NC or Model + oe-NC）. Changes in cell viability， apoptosis rates， inflammatory levels， as well as the expression of EGFR mRNA， LCN2， EGFR， p-EGFR， and the ratio of p-EGFR/EGFR proteins were evaluated. Results Compared to the Model group， the Model + si-LCN2 group exhibited enhanced cell viability， a reduced apoptosis rate， and decreased expression of inflammatory factors （P < 0.05）. Immunoprecipitation analysis confirmed a direct interaction between LCN2 and EGFR. In comparison with the Model group， the Model + oe-LCN2 group demonstrated elevated levels of p-EGFR and the p-EGFR/EGFR ratio （P < 0.05）， while no significant change was observed in total EGFR expression （P > 0.05）. Conclusion Inhibition of LCN2-mediated EGFR phosphorylation enhances cell viability， reduces apoptosis， and mitigates inflammatory responses， thereby ameliorating LPS-induced inflammatory injury in human fallopian tube epithelial cells.

Objective To explore the differences in cerebellar gray matter myelin content and gray matter volume between patients with post-traumatic stress disorder （PTSD） and healthy controls （HC） using the ratio of T1-weighted （T1w） and T2-weighted （T2w） images and voxel-based morphometry （VBM） analysis， and to examine the correlation of these differences with cognitive function. Methods A total of 30 PTSD patients and 30 healthy controls （HC） matched for age， gender， and education level were included in this study. Cognitive function was assessed using the Montreal Cognitive Assessment （MoCA）， and magnetic resonance imaging （MRI） scans were performed for both groups. Two-sample t-tests were used to analyze the group differences in cerebellar gray matter region T1w/T2w ratios and gray matter volume. Spearman partial correlation analysis was used to explore the correlation between the intergroup differences and cognitive function. Results Compared to the HC group， the PTSD group showed a reduced left cerebellar gray matter T1w/T2w ratio （voxel level P < 0.001， cluster level P < 0.05， GRF corrected）. The areas with decreased T1w/T2w ratio in the PTSD group also exhibited reduced gray matter volume （voxel P < 0.005， cluster P < 0.05， GRF corrected）. Correlation analysis revealed a positive correlation between the left cerebellar gray matter T1w/T2w ratio and the severity of cognitive impairment in the PTSD group. Conclusions The PTSD group exhibited reduced myelin content and gray matter volume in the left cerebellar gray matter region， with both myelin reduction and volume loss positively correlating with the severity of cognitive impairment. The T1w/T2w ratio provides a new perspective for studying myelination in PTSD patients.

Objective To evaluate the feasibility and effectiveness of 3D digital holographic imaging combined with intraoperative navigation technology in the context of partial nephrectomy. Methods A total of 46 patients who underwent laparoscopic partial nephrectomy in the Department of Urology at the Second People's Hospital of Hefei City between June 2023 and January 2025 were randomly assigned to either the experimental group or the control group. The experimental group （n = 23） utilized preoperative planning and intraoperative real-time navigation based on 3D digital holographic imaging， whereas the control group （n = 23） relied on preoperative planning using optimized two-dimensional images obtained via contrast-enhanced CT and MRI scans. Preoperative data—including gender， age， body mass index （BMI）， tumor diameter， and RENAL score—were collected. Intraoperative parameters such as total operative time， warm ischemia time， intraoperative blood loss， hemoglobin levels， postoperative hospitalization duration， and time to drain removal were recorded. Renal function changes were assessed by comparing serum creatinine levels and estimated glomerular filtration rates （eGFR） before surgery and one month post-surgery. Additionally， the incidence of intraoperative complications—particularly injury to the renal collecting system—and postoperative complications—including positive surgical margins， bleeding， subcutaneous emphysema， and urinary fistula—was analyzed. Results In this study， holographic images were successfully reconstructed for 23 patients with renal tumors in the experimental group. Each anatomical structure—including the kidney and tumor lesions， collecting system， renal arteries and veins， adrenal glands， and inferior vena cava—was color-coded to enable intuitive visualization. These images were used for preoperative planning and provided real-time spatial orientation to accurately locate and guide resection of the tumor during surgery. In the control group， 23 patients underwent preoperative planning based on contrast-enhanced CT and MRI scans acquired using optimized parameters. All 46 patients underwent laparoscopic partial nephrectomy performed by the same qualified surgeon， and postoperative pathological analysis confirmed renal tumors， including 27 cases of clear cell carcinoma， 7 cases of chromophobe cell carcinoma， 5 cases of papillary cell carcinoma， 2 cases of sarcomatoid carcinoma， and 5 cases of angiomyolipoma. No significant differences were observed in baseline clinical characteristics （including age， body mass index， tumor diameter， and RENAL score） between the two groups （P > 0.05）. The experimental group showed significantly lower values in total operative time， warm ischemia time， intraoperative blood loss， pre- to postoperative hemoglobin changes， and pre-surgical to one-month post-surgical creatinine changes compared to the control group （P < 0.01）. Additionally， the experimental group exhibited smaller changes in hospitalization duration， time to drain removal， and glomerular filtration rate from preoperative to one month post-surgery； however， these differences were not statistically significant （P = 0.175， P = 0.331， and P = 0.273）. There were no intraoperative complications or damage to the collecting system in either the experimental or control groups. Postoperatively， the control group experienced one case of positive surgical margin， one case of hemorrhage， and one case of subcutaneous emphysema. No statistically significant differences were observed between the groups （P > 0.05）. Conclusions 3D digital holographic imaging combined with intraoperative navigation technology， based on the fusion of MRI and CT data， facilitates preoperative planning and precise intraoperative guidance. This approach helps reduce operative time， preserve renal function， and lower perioperative risks while ensuring therapeutic efficacy.

Objective The aim of this study was to explore the potential influence of time sequence （before or after sugery） of thoracic paravertebral nerve block （TPVB） on the body temperature of elderly patients during recovery. Methods Patients in postanesthesia care unit （PACU） between January 2023 and October 2024 in Tongzhou district of Peking University People′s Hospital were retrospectively collected. Inclusion criteria were as follows： （1） patients aged more than 60 years； （2） those preformed thoracoscopic lung surgery under general anesthesia； （3） American Society of Anesthesiologists （ASA） Physical Status of patients was Ⅰ to Ⅲ； （4） those received TPVB for analgesia. All the patients were divided into two groups： preoperative TPVB group （pre-TPVB group） and postoperative TPVB group （post-TPVB group）. The demographic and anesthesia- and surgery-related data of patients were collected. The body temperature， incidence of hypothermia， numerical rating scale （NRS） score， extubation time， the length of stay and the occurrence of hypotension， chill and delayed awakening in PACU were compared between the two groups. Results After excluded 4 patients from 538 patients enrolled， a total of 534 patients were eligible， with 406 cases in pre-TPVB group and 128 cases in post-TPVB group， respectively. The results showed that the body temperature was significantly higher in pre-TPVB group ［36.1（36.0，36.2）℃ vs. 36.0（35.9，36.2）℃， P = 0.022］， and the incidence of hypothermia was lower in pre-TPVB group （18% vs. 29.7%， P = 0.007）. And the pre-TPVB group were higher in NRS scores ［0（0，0） vs. 0（0，0）， mean rank： 248.38 vs. 270.95， P = 0.036］ and shorter in the length of stay in PACU ［44（38，53）min vs. 48（40，55）min， P = 0.039］. Conclusion Preoperative TPVB offers more benefits for body temperature protection and shortening the length of stay in PACU in elderly patients undergoing thoracoscopic lung surgery， but it slightly offset the analgesic efficacy in the PACU.

Objective To investigate the effect of surgical intervention on IVF/ICSI assisted conception outcomes in patients with ovarian endometriosis （OEM）. Methods OEM patients who underwent IVF/ICSI treatment at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between January 1， 2019 and February 1， 2024 were selected， including 228 cases in the non-operated group before assisted conception （Group A） and 426 cases in the operated group before assisted conception （Group B）， and the assisted conception outcomes of the two groups were analysed. Results There were no statistically significant differences in female age， BMI， infertility years， infertility type， and basal FSH level between the two groups （P > 0.05）. AMH level and basal AFC were higher in group A than in group B （P = 0.003）. There was no statistical difference in the application of ovulation induction programme， total number of Gn days and total amount of Gn between the two groups （P > 0.05）， but the amount of Gn initiation in Group A was lower than that in Group B （P = 0.011）. Applying multiple linear regression to adjust for confounding factors， there was a statistical difference in the 2PN fertilization rate between Groups A and B （P = 0.007）， whereas there was no statistical difference in the number of eggs obtained， the rate of available embryos， the rate of high-quality embryos and the rate of blastocyst formation between the two groups （P > 0.05）. After applying binary logistic regression to adjust for the influencing factors related to clinical pregnancy rate and live birth rate， the clinical pregnancy rate （aOR = -0.896， 95%CI： 0.540 ~ 1.488）， live birth rate in the two groups （aOR = 0.976， 95%CI： 0.589 ~ 1.620） remained statistically indistinguishable. Conclusions Surgical intervention may further impair ovarian reserve function in patients with OEM， but does not appear to affect embryo quality or pregnancy outcome. Surgical treatment prior to assisted conception may improve fertilization rates in patients with OEM.

Objective To investigate the clinical efficacy of the "dynamic and static combination" approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus（OLT）， utilizing external ankle shaking， pulling， and poking manipulations in conjunction with ankle brace fixation. Methods A total of 82 patients diagnosed with OLT， who sought treatment at four hospitals between June 2022 and December 2023， were included in the study. Both the experimental and control groups received ankle immobilization using braces throughout the treatment period. The control group was administered Voltaren Emulgel topically twice daily （morning and evening）， with each treatment course lasting 30 days， for a total of one course. The experimental group received additional therapeutic intervention involving shaking， pulling， and poking manipulations， conducted twice weekly， with the same duration and number of treatment courses as the control group. Follow-up assessments were scheduled at 2 weeks， 4 weeks， and 2 months post-treatment. Outcome measures included the pain rating index （PRI）， visual analogue scale （VAS） for pain intensity， current pain intensity （PPI）， American Orthopaedic Foot & Ankle Society （AOFAS） ankle and hindfoot scores， proprioceptive function， and the size of OLT. Results During the longitudinal assessment conducted at 2-week， 4-week， and follow-up intervals， the experimental group exhibited superior clinical outcomes compared to the control group， with statistically significant decreases in PRI， PPI， and AOFAS scores （all P < 0.05）. VAS scores showed progressive improvement over time， with significant intergroup differences observed at both the 4-week and follow-up assessments （P < 0.05）. Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group， as reflected by significantly reduced active-passive error angles （P < 0.05）. Importantly， measurements of OLT area revealed notable therapeutic effects in the experimental group （P < 0.05）， whereas no statistically significant changes were observed in the control group throughout the study period （all P > 0.05）. Conclusions Under the guidance of the "dynamic and static combination" concept， the integration of shaking， pulling， and poking manipulation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain， improving ankle joint function， restoring proprioception， facilitating lesion recovery， and enhancing overall quality of life.

Objective To investigate the effects of two driving pressure-based methods to set positive end-expiratory pressure on pulmonary mechanics and oxygenation in patients undergoing laparoscopic and thoracoscopic esophagectomy. Methods Sixty patients undergoing laparoscopic and thoracoscopic esophagectomy were divided into two groups （n = 30 each）： incremental group （group I） and decremental group （group D）. PEEP titration was performed in both groups during thoracoscopy and laparoscopy. Respiratory mechanics parameters， hemodynamic parameters， and blood gas analysis were collected for analysis before preoxygenation （T₀）， 10 minutes after intubation （T₁）， 20 minutes after PEEP application for one-lung ventilation （T₂）， 20 minutes after PEEP application for two-lung ventilation （T₃）， before extubation （T₄）， and 30 minutes after extubation （T₅）. The postoperative pulmonary complications within 3 days and 7 days after operation， hospitalization duration， and costs were recorded. Results Compared with group I， patients in group D showed higher oxygenation index and pulmonary compliance during surgery （P < 0.05）. In both groups， driving pressure decreased and compliance increased after PEEP titration （P < 0.05）. Conclusion Both driving pressure-guided incremental and decremental titration of individualized PEEP improved intraoperative respiratory mechanics in patients undergoing laparoscopic and thoracoscopic esophagectomy， and decremental titration was more effective in improving intraoperative respiratory mechanics and oxygenation in patients during operation.

Objective To investigate the clinical characteristics of patients with chronic abacterial prostafitis （CAP），the CAP related factors were analyzed， and a risk prediction model for CAP were constructed and validated. Methods The clinical dataes of 252 suspected CAP patients admitted to the hospital from June 2022 to December 2024 were collected， the patients were divided into modeling set （n = 177） and validation set （n = 75） by 7∶3 ratio. Based on the modeling set dataes， the Lasso was used to screen CAP related predictive factors， a logistic multiple factor model was used to analyze the independent influence factors of CAP and a risk prediction model was constructed. The validation set patient dataes were used to plot ROC and DCA and validate the prediction model. Results There were 86 cases of CAP in the modeling set， accounting for 48.59%； 32 cases of CAP in the validation set， accounting for 42.67%. The Logistic multiple regression analysis showed that BMI， waist to hip ratio， abnormal elevation of IL-8， COX-2， and PGE2 in prostate fluid were independent influence factors of CAP （P < 0.05）， a Nomogram column chart based on this was established.The ROC analysis showed that the sensitivity of the model for detecting CAP in the modeling and validation sets were 0.814 and 0.802， respectively， and the specificity were 0.673 and 0.703， respectively. The DCA analysis showed that the net benefit thresholds for modeling and validation sets by column charts are 0.1 ~ 0.9 and 0.2 ~ 1.0， respectively. Conclusions The occurrence of CAP is related to the patient's BMI， waist to hip ratio， the levels of IL-8， COX-2， and PGE2 in prostate fluid. The predictive model established based on this is highly accurate and it can help for CAP screening.

Objective To investigate the clinical efficacy of maxillary protraction combined with customized titanium plates in the treatment of skeletal Class Ⅲ malocclusion during the growth and development stage. Methods A total of 96 patients diagnosed with skeletal Class Ⅲ malocclusion who received treatment at our hospital between May 2021 and May 2023 were included in this study. Participants were randomly divided into two groups using a ball-drawing method： those assigned odd numbers were placed in the control group （n = 48）， while those assigned even numbers were allocated to the experimental group （n = 48）. The control group underwent maxillary protraction therapy alone， whereas the experimental group received maxillary protraction combined with customized titanium plate intervention. The two groups were evaluated and compared based on clinical effectiveness， facial soft tissue parameters （LL-EP， NLA， G-SnPg）， hard tissue parameters ［SNA （sella-nasion-A point angle）， SNB （sella-nasion-B point angle）， ANB （A point-nasion-B point angle）， MP-SN （mandibular plane-SN angle）， MP-FH （mandibular plane-Frankfort horizontal angle）， A-OLP （vertical distance from A point to occlusal line plane）， Pg-OLP （vertical distance from pogonion to OLP）， and Y-axis angle］， hyoid bone position， dental indicators （H-X， H-Y， H-MP， H-FH）， and the incidence of adverse events. Results Following the intervention， the experimental group demonstrated a significantly higher overall efficacy rate compared to the control group （P < 0.05）. The LL-EP value was significantly lower in the experimental group （P < 0.05）； conversely， SNA， ANB， MP-SN， MP-FH， A-OLP， and the Y-axis angle were all significantly increased （P < 0.05）. Additionally， H-X and H-Y distances were notably shorter （P < 0.05）， while U1-NA was greater and overbite depth was reduced in comparison to the control group （P < 0.05）. No statistically significant difference was observed in the incidence of adverse reactions between the two groups （P > 0.05）. Conclusion Maxillary protraction utilizing customized titanium plates can significantly improve clinical outcomes in patients with skeletal Class Ⅲ malocclusion， positively affecting both craniofacial hard and soft tissue structures， hyoid bone positioning， and dental parameters， while maintaining a favorable safety profile.

Objective To investigate the effects of early pulmonary rehabilitation training on lung function recovery， complication rates， and quality of life in patients who undergo thoracoscopic surgery. Methods A randomized controlled trial was conducted involving 132 patients who underwent thoracoscopic surgery between June 2020 and June 2023. Participants were randomly allocated to either an early pulmonary rehabilitation program （n = 72） or a conventional rehabilitation program （n = 60）. The early intervention group commenced a staged rehabilitation protocol—including respiratory training and physical exercise—within 24 to 72 hours following surgery， whereas the conventional group received standard postoperative nursing care only. Outcomes measured included postoperative pulmonary function （FEV₁， FVC）， incidence of postoperative complications， length of hospital stay， and quality of life scores （maximum score： 40）. These outcomes were compared between the two groups. Results On postoperative days 3 and 7， the early group showed significantly higher FEV₁ values compared to the conventional group ［（1.6 ± 0.17） L vs. （1.3 ± 0.21） L； （1.9 ± 0.20） L vs. （1.6 ± 0.11） L， respectively］， as well as improved FVC measurements ［（2.5 ± 0.20） L vs. （2.1 ± 0.14） L； （2.9 ± 0.25） L vs. （2.3 ± 0.23） L （all P < 0.05）］. The early intervention group also demonstrated a significantly lower overall complication rate （14.3% vs. 33.3%， χ2 = 6.79， P = 0.009）， including reduced incidences of atelectasis （6.9% vs. 20.0%， P = 0.031） and pulmonary infection （4.2% vs. 13.3%， P=0.044）. Additionally， patients in the early group had a shorter average hospital stay ［（8.4 ± 1.2） days vs. （10.9 ± 2.3） days， P = 0.018］ and reported higher quality of life scores ［（35.6 ± 3.7） vs. （30.8 ± 4.5）， P = 0.032］. No significant difference was observed between the two groups in terms of the overall incidence of adverse events （23.6% vs. 31.7%， χ2 = 1.07， P = 0.301）. Conclusions Early pulmonary rehabilitation significantly facilitates the recovery of lung function， reduces the incidence of postoperative complications， enhances quality of life， and demonstrates a favorable safety profile among patients undergoing thoracoscopic surgery. Therefore， this intervention should be more broadly implemented in clinical practice to optimize postoperative recovery outcomes.

Objective To investigate the distribution characteristics of model numbers associated with the third-generation Oxford unicompartmental knee arthroplasty （UKA） prostheses， in order to provide evidence-based guidance for the selection of appropriate UKA prostheses in clinical practice. Methods A retrospective analysis was conducted on data from 270 patients who underwent UKA using third-generation Oxford prostheses and fulfilled the inclusion criteria between April 2019 and September 2023. Patient characteristics， including gender， age， height， weight， affected side， and prosthesis model numbers， were collected and recorded. The distribution and matching patterns of femoral and tibial prosthesis model numbers were evaluated. Multiple ordinal logistic regression analyses and receiver operating characteristic （ROC） curves were employed to identify significant predictors influencing the selection of femoral component models. Additionally， a parameter distribution map related to UKA prosthesis model numbers was developed. Results Among the femoral prostheses， the XS size accounted for 21.5%， S for 44.1%， M for 26.3%， and L for 8.1%. Regarding tibial prostheses， AA represented 11.1%， A 23.7%， B 29.3%， C 18.9%， D 10.4%， and E 6.7%. The matching rates between tibial and femoral components were as follows： 93.3% for tibial AA corresponding to femoral XS， 96.0% for tibial A/B corresponding to femoral S， 95.8% for tibial C/D corresponding to femoral M， and 91.7% for tibial E corresponding to femoral L， resulting in an overall matching rate of 95.2%. Height （AUC = 90.63%）， gender （AUC = 81.59%）， and weight （AUC = 84.47%） showed significant correlations with femoral model selection （P < 0.01）， whereas age and side did not demonstrate statistical significance. The S femoral model was predominantly used in female patients （59.6%）， while the M and L models were more commonly utilized in male patients （65.2%）. When female patients' height was ≤160 cm， the combined usage rate of the XS and S models exceeded 90%. For male patients taller than 175 cm， the utilization rate of the L model reached 88.9%. The accuracy rate of preoperative prediction based on height and gender was 70.7%， which improved to 77.0% when incorporating intraoperative tibial model information. Conclusions The distribution of UKA prostheses in the study population differed from that observed in Western populations， as well as from other regions in Asia and China. The distribution map of UKA prostheses and the corresponding matching rules established in this study demonstrate a high level of predictive accuracy， which can effectively support preoperative planning and intraoperative selection of femoral prosthesis model numbers.

Objective To investigate the effect of high， middle and low dose dexmedetomidine combined with sufentanil on perioperative analgesia and sleep quality in patients with oral cancer. Methods A total of 158 patients undergoing oral cancer surgery in the hospital from January 2023 to June 2024 were selected and divided into group A［n = 53，0.6 μg/（kg·h） dexmedetomidine + 2 μg/kg sufentanil］and group B［n = 53，0.4 μg/（kg·h） dexmedetomidine + 2 μg/kg sufentanil］ ， Group C ［n = 52， 0.2 μg/（kg·h） dexmedetomidine + 2 μg/kg sufentanil］by random number table method. Stress response indexes ［brain-derived neurotrophic factor （BDNF）， cortisol （Cor）， interleukin-6 （IL-6）］， bifrequency index and analgcsia nociccption index（BIS， ANI）， pain level， T lymphocyte subsets CD3⁺， CD4⁺， CD8⁺ levels， Richards Campbell Sleep Scale （RCSQ） score and adverse reactions were compared between the two groups. Results Compared with 12 h before surgery， serum levels of BDNF， Cor and IL-6 in 3 groups were decreased 48 h after surgery， group A was lower than group B， group C， group B was lower than group C（P < 0.05）. Compared with T₀， BIS at T₁ ~ T₃ were significantly different between the 3 groups （P < 0.05）， BIS at T₁ ~ T₃ were lower than those at T₀ （P < 0.05）， and there was no significant difference in BIS at the same time between the 3 groups （P>0.05）， from T₁ to T₃， ANI was higher than that at T₀， and ANI in group A was higher than that in group B and group C （P < 0.05）. Compared with the preoperative results， the pain scores of the 3 groups were decreased at 1 h， 6 h， 24 h and 48 h after operation， and the pain scores of group A were lower than those of group B and C， and the pain scores of group B were lower than those of group C （P < 0.05）. After operation， CD3⁺ and CD4⁺ were decreased in all 3 groups， group A was lower than group B and group C， group B was lower than group C （P < 0.05）， and CD8⁺ was increased in all 3 groups， group A was higher than group B and group C， group B was higher than group C （P < 0.05）. Compared with 1 day before the operation， the sleep quality scores of the three groups on the night after the operation and the second night after the operation were all decreased， group A was lower than group B and group C， and group B was lower than group C（P < 0.05）. The incidence of hypotension and sinus bradycardia in group A was higher than that in group B and group C （P < 0.05）. There was no significant difference in the incidence of hypotension and sinus bradycardia between group B and group C （P > 0.05）. There was no significant difference in the incidence of nausea， vomiting and dizziness among the three groups （P > 0.05）. Conclusion The analgesic effect of 0.6 μg/（kg·h） dose dexmedetomidine combined with sufentanil can effectively reduce the body's stress response and immune suppression， improve sleep quality， but with a greater incidence of intraoperative hypotension and bradycardia.

Objective To investigate the changes of diameter of the main trunk of the extracranial segment of the facial nerve， local hemodynamics and facial muscle thickness in patients with peripheral facial palsy （PFP） at acute stage by high frequency ultrasound（HFUS）. Methods Sixty patients with acute PFP were enrolled as the PFP group， and 30 healthy people were selected as the control group.The following facial parameters were scanned and recorded using HFUS： diameter of the main trunk of the extracranial segment of the facial nerve （FN-d）， facial artery diameter （FA-d）， facial artery systolic velocity （FA-Vs）， facial artery diastolic velocity （FA-Vd）， facial artery resistance index （FA-RI）， frontalis muscle thickness （FM-t）， depressor anguli oris muscle thickness （DAO-t）， and depressor labii inferioris muscle thickness （DLI-t）.The feasibility of facial parameters in the diagnosis of acute-phase peripheral facial palsy （PFP） was evaluated， with intra-group and inter-group variability comparisons performed. Pearson correlation analysis was conducted to evaluate the relationship between acute-phase facial parameters and House-Brackmann （H-B） scale scores in PFP patients. Results （1）The H-B score of the PFP group was significantly lower than that of the control group， and the difference was statistically significant （P < 0.05）. （2）The reliability of repeated measurements of facial parameters by different testers is good （ICC > 0.75）. （3）The FN-d and FA-RI values on the affected side of PFP group were higher than those on the healthy side and control group， and FA-Vs， FA-Vd， DAO-t and DLI-t values were lower than those on the healthy side and control group， with statistical significance （P < 0.05）. （4）The FN-d and FA-RI values of the affected side in the PFP group were negatively correlated with the H-S scale score （r = -0.847， P < 0.05； r = -0.863， P < 0.05）； FA Vs， FA Vd， DAO-t， DLI-t are positively correlated with H-S scale scores （r = 0.808， P < 0.05； r = 0.757， P < 0.05； r = 0.836， P < 0.05； r = 0.694， P < 0.05）. Conclusions HFUS can effectively detect the characteristic changes such as the increase in the diameter of the extrcranial facial nerve trunk， local microcirculation disturbance and facial muscle atrophy in patients with PFP in the acute stage， and the increase and decrease of FN-d， FA Vs， FA Vd， FA-RI， DAO-t， and DLI-t can accurately reflect the improvement or progress of PFP， which has important guiding significance for clinical disease monitoring and efficacy evaluation.

Objective To investigate the functional brain characteristics of the frontal and bilateral temporal regions during a verbal fluency task （VFT） in patients with stable schizophrenia using functional near-infrared spectroscopy （fNIRS）， and to evaluate its potential clinical application in assisting the diagnosis of schizophrenia. Methods A total of 45 stable schizophrenia patients and 30 healthy controls were enrolled in the study. fNIRS was employed to assess brain activation patterns in the frontal and bilateral temporal lobes during the VFT. The integral values， centroid values， and slopes of the frontal and bilateral temporal lobes were measured. Differences in demographic characteristics， word count， and fNIRS-derived parameters between the two groups were analyzed. A logistic regression model and receiver operating characteristic （ROC） curve analysis were conducted to evaluate the diagnostic performance of the fNIRS measures in distinguishing schizophrenia patients from healthy controls. Results During VFT， the patient group demonstrated reduced word count and decreased integral values and slopes in the frontal lobe， as well as lower integral values in the bilateral temporal lobes， compared to the healthy control group （all P < 0.05）. However， no statistically significant differences were observed between the two groups in terms of frontal lobe centroid value， temporal lobe centroid value， or bilateral temporal lobe slope （all P > 0.05）. The logistic regression model indicated that the temporal lobe integral value was significantly associated with the diagnosis of schizophrenia （OR = 0.979， P = 0.005）. ROC curve analysis revealed that the frontal lobe integral value， frontal lobe slope， and temporal lobe integral value exhibited acceptable discriminatory power for disease classification， with area under the curve （AUC） values of 0.681， 0.644， and 0.779， respectively （all P < 0.05）. Conclusion In stable schizophrenia， the integral values of the frontal and temporal lobes， as well as the slope of the frontal lobe， decrease during the VFT， suggesting potential clinical utility in differentiating individuals with schizophrenia from healthy controls.

Objective The present study aims to explore the mediating role of rumination and coping styles in social support and post -traumatic stress disorder（PTSD） in young and middle-aged spinal cord injury（SCI）patients. The study will provide a basis for developing targeted interventions. Methods Two hundred and forty young and middle-aged SCI patients hospitalized for treatment were selected by convenience sampling and questionnaires were administered using the General Information Questionnaire， the Perceived Social Support Scale （PSSS）， the Simplified Coping Style Questionnaire （SCSQ）， the Event Related Rumination Inventory （ERRI）， and the Post-traumatic Stress Disorder Self-assessment Scale （PCL-C），Mediation analysis using Model-6 with Process4.1 plugin in SPSS 25.0. Results The mean scores for PTSD， social support， rumination， positive coping， and negative coping in young and middle-aged SCI patients were 29.00 （26.00， 35.75）， 67.00 （62.00， 70.00）， and 37.00 （34.00， 4 1.00）， and 36.00 （33.00，42.00）， respectively. PTSD demonstrated a negative correlation （r = -0.553， r = -0.484， P < 0.001） and a negative correlation with positive coping and rumination （r = 0.499， r = 0.472， P < 0.001）. The mediation modelling test demonstrated that rumination and positive and negative coping mediated significantly between social support and PTSD， with effect values of -0.078 1， -0.097 0 and -0.049 6， accounting for 17.81%， 22.12 % and 11.31% of the total effect， respectively. Furthermore， the chain mediation effects of rumination and positive coping and negative coping were also significant， with effect values of -0.026 3 and -0.026 2， accounting for 5.99% and 5.97% of the total effect， respectively. Conclusions The present study hypothesises that rumination， thinking and coping styles play a simple and chain-mediating role between social support and PTSD in young and middle-aged SCI patients. Medical professionals should focus on the mediating role of rumination and coping styles when developing interventions related to improving and preventing PTSD in patients， which can be done by increasing the level of social support for patients， decreasing the level of rumination， and guiding patients to positively cope with their illness.

Tuberculosis remains a significant global public health threat. Early diagnosis and effective treatment are crucial to combat this disease. Yet， traditional diagnostic methods for tuberculosis face limitations due to their low sensitivity， extended detection periods， and dependence on sputum samples. Molecular diagnostic techniques， while offering higher sensitivity， still primarily rely on sputum samples， thereby impeding significant advancements in tuberculosis diagnosis. In clinical settings， there exists a pressing demand for diagnostic approaches that are not solely reliant on sputum samples. In recent years， extracellular vesicles （EVs）， as emerging biomarkers， have demonstrated substantial potential in various diseases， including tumors and infectious diseases. A multitude of studies indicate that EVs also exhibit potential in the field of tuberculosis. This review provides an in-depth analysis of the biological characteristics of EVs and their role in the pathogenesis of tuberculosis. It systematically summarizes the progress and significance of EV-based biomarkers in tuberculosis diagnosis， treatment monitoring， and disease mechanism exploration， while addressing the challenges and future prospects in this field. The aim is to offer valuable insights and up-to-date research findings to researchers and clinicians engaged in tuberculosis-related studies.