The dialogue between medicine and art， which has evolved throughout the history of human civilization， illustrates the deep interconnection between science and humanities. While medicine preserves life health through rational thought and technological progress， art explores the essence of life through emotional expression. This article examines the common origins of medicine and art， the ways in which art inspires medical innovation， the application of art therapy in clinical settings， the representation of medicine in artistic creation， and the role of art education in medical training. Drawing on historical and contemporary case studies， this article revisits key moments in the integration of medicine and art， highlighting their joint contributions to the understanding of life， emotional healing， ethical reflection and cultivation of medical professionals. It underscores the importance of sustained interdisciplinary dialogue between these fields for advancing both human health and cultural development.

Non-alcoholic fatty liver disease （NAFLD） has become a significant global public health concern， posing substantial challenges to healthcare systems worldwide. The condition is characterized by pathological changes such as hepatic steatosis， fibrosis， and cirrhosis， with the extent of liver fibrosis serving as a key determinant in assessing disease progression. Due to the limitations of liver biopsy in evaluating fibrosis， there has been a growing emphasis on the clinical application of non-invasive biomarkers. This article provides a comprehensive review of four widely used serological fibrosis scoring systems for assessing NAFLD-related liver fibrosis and offers guidance on model selection tailored to specific patient populations. It further explores disease-specific scoring methodologies for patients with comorbidities， population-specific evaluation strategies， combined scoring systems， and criteria for selecting prognostic models. The discussion aims to provide both theoretical insights and practical recommendations for the future implementation of serological fibrosis assessment in NAFLD management.

Objective The effects of carrimycin （CAM） on the biological functions of intrahepatic cholangiocarcinoma HuCCT1 cells were examined through in vitro experiments， and a preliminary investigation was conducted into its mechanism of action. Methods The intrahepatic cholangiocarcinoma cell line HuCCT1 was selected for the study. The effect of CAM on cell viability was assessed using the CCK-8 assay， and the IC₅₀ concentration was determined accordingly. The impact of CAM on cell migration was evaluated through a scratch wound healing assay. In addition， the effect of CAM on clonogenic ability was examined using a colony formation assay. Cell invasion capacity was assessed using a Transwell invasion assay. Flow cytometry was employed to analyze the effect of CAM on cell cycle progression. Furthermore， Western blotting was conducted to evaluate the expression levels of key proteins associated with epithelial-mesenchymal transition and the cell cycle. Finally， the influence of CAM on the AXL/c-Myc/c-Met signaling axis was also investigated. Results Compared with the control group， CAM significantly inhibited the proliferation of HuCCT1 cells in a concentration-dependent manner （P < 0.05）. Plate cloning assays demonstrated that CAM markedly suppressed the colony-forming ability of HuCCT1 cells （P < 0.05）. Scratch wound healing assays confirmed that CAM treatment significantly reduced the migration speed and narrowed the migration area of HuCCT1 cells （P < 0.05）. Flow cytometry analysis revealed that CAM treatment led to a significant increase in the proportion of cells in the G₀/G₁ phase and a decrease in the S phase （P < 0.05）. Western blot analysis further confirmed that the expression levels of key regulatory proteins CCND1 and CDK4， which are involved in the G_1/S phase transition， were down-regulated， while the expression of p21 was up-regulated （P < 0.05）. Transwell invasion assays indicated that CAM inhibited the invasive capacity of HuCCT1 cells. Consistently， Western blot results showed that E-Cadherin expression was increased （P < 0.05）， whereas the expression levels of N-Cadherin and Vimentin were decreased （P < 0.05）. Moreover， Western blot analysis verified that the expression of AXL， c-Met， and c-Myc was up-regulated in HuCCT1 cells treated with AXL recombinant protein （P < 0.05）. However， co-treatment with CAM and AXL recombinant protein significantly attenuated the expression of these proteins （P < 0.05）. Conclusions CAM inhibits the proliferation， migration， and invasion of intrahepatic cholangiocarcinoma HuCCT1 cells， thereby demonstrating antitumor effects， which may be associated with the AXL/c-Met/c-Myc signaling pathway.

Objective To construct a model for predicting ki-67 expression in hepatocellular carcinoma using the intratumoral and peritumoral radiomic features of contrast enhanced magnetic resonance imaging （CEMRI） in the arterial phase as well as clinical imaging features. Methods A total of 120 patients pathologically diagnosed with hepatocellular carcinoma （HCC） from January 2016 to December 2024 in No. 910 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army were retrospectively enrolled and randomly divided into a training set （84 cases） and a test set （36 cases） in a ratio of 7∶3. ITK-SNAP software was used to delineate the global region of interest （ROI） of HCC on the arterial phase MR images. The ROIs of all patients were automatically expanded outward by 2 mm， and then the intratumoral ROI areas were eliminated to obtain the peritumoral ROI. With the help of PyRadiomics software， 1 198 intratumoral and peritumoral radiomic features were extracted. Spearman correlation analysis， maximum relevance-minimum redundancy （mRMR）， and least absolute shrinkage and selection operator （LASSO） regression were used to reduce the data dimension and select the best features. Then， a radiomics model of the logistic regression （LR） machine learning algorithm was constructed. A combined model including clinical imaging features and radiomics features was established. The area under the curve （AUC）， accuracy， sensitivity， specificity， positive predictive value （PPV）， negative predictive value （NPV）， calibration curve and decision curve analysis （DCA） were used to evaluate the efficacy of the intratumoral and peritumoral radiomics features combined with clinical imaging features model in predicting ki-67 expression in hepatocellular carcinoma. Results The intratumor model exhibited an efficacy in predicting the expression of ki-67 in hepatocellular carcinoma with AUC values of 0.817 and 0.787 in the training set and test set， respectively. The peritumoral model showed an efficacy with AUC values of 0.805 and 0.633 in the training set and test set， respectively. The intratumoral and peritumoral model demonstrated AUC values of 0.874 and 0.836 in the training set and test set， respectively. The combined model constructed by integrating the intratumoral and peritumoral model with clinical imaging features yielded AUC values of 0.877 and 0.849 in the training set and test set， respectively， indicating clinical imaging features improved the performance of the model. DCA showed that the combined models all had good clinical benefits， with the intratumoral and peritumoral model performing the best. Conclusion The intratumoral and peritumoral radiomics model based on CEMRI arterial phase combined with clinical imaging data can accurately predict the expression of ki-67 in hepatocellular carcinoma. This combined model yields the best clinical benefit.

Objective To explore the effects of different sealing methods in the treatment of liver failure patients using a dual plasma molecular adsorption system combined with plasma exchange. Methods A total of 120 patients with liver failure admitted between January 2022 and October 2024 were enrolled in the study and randomly divided into an observation group and a control group， each consisting of 60 patients. Both groups received treatment with a dual plasma molecular adsorption system combined with plasma exchange. The control group was administered heparin sodium for catheter sealing， whereas the observation group received protamine prior to heparin sodium catheter sealing. The study compared the two groups in terms of liver function indicators—including aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， and bilirubin—coagulation function indicators such as fibrinogen and international normalized ratio （INR）， hemoglobin （HGB） levels， catheter blockage rates， and the incidence of adverse reactions. Results No statistically significant differences were observed in liver function， coagulation function， or routine blood parameters between the two patient groups following treatment （P > 0.05）. However， the incidence of blockage in the observation group （3.33%） was significantly lower than that in the control group （20.00%）， with the difference being statistically significant （P < 0.05）. Additionally， no significant differences were found in the occurrence of adverse reactions between the two groups （P > 0.05）. Conclusions The treatment of liver failure involves the use of a dual plasma molecular adsorption system combined with plasma exchange. Administering protamine prior to heparin sodium sealing has minimal impact on the patient's liver function， blood parameters， coagulation profile， and incidence of adverse reactions， yet it effectively reduces the risk of circuit clotting.

Objective To investigate programmed death including necroptosis， apoptosis， autophagy， ferroptosis， and pyroptosis in bone marrow megakaryocytes of mice during sepsis and its impact on platelet production capacity and coagulation function in mice. Methods C57BL/6J mice were randomly divided into a sham operation group （sham group） and a sepsis model group （CLP group）. Peripheral blood platelets and coagulation function were measured by abdominal aortic blood sampling at 24 h postoperatively in both sham and CLP groups. After the mice were sacrificed， long bones of both lower limbs were taken， and bone marrow megakaryocytes were extracted using megakaryocyte separation solution and immunomagnetic bead separation. Laser confocal microscopy was used to observe the activation of programmed death-related marker molecules in mouse bone marrow megakaryocytes. Flow cytometry was used to detect programmed death rate， platelet production phenotype， and platelet surface markers （CD41， CD42b， CD61） of megakaryocytes. Western blotting was used to detect the expression of programmed death-related proteins in megakaryocytes. Results Compared with the sham group， the CLP group showed significant decreases in the number of platelets during acute sepsis （24 h） （P < 0.000 1）， significant increases in platelet distribution width （PDW） and mean platelet volume （MPV） （P < 0.01）， significant prolonging of thrombin time （TT）， prothrombin time （PT）， and activated partial thromboplastin time （APTT） （P < 0.000 1， P < 0.001， P < 0.01）， and significant reduction in fibrinogen （Fib） （P < 0.000 1）. Compared with the Con/sham group， the LPS/CLP group exhibited significant increases in the platelet production phenotype of megakaryocyte， the number of PLP in the supernatant， and the expression levels of platelet surface markers （CD41， CD42b， CD61）. The rates of megakaryocyte necroptosis/apoptosis， pyroptosis， and ferroptosis were significantly elevated at 24 h post-CLP surgery. Laser confocal microscopy showed significant activation of LC3， P-MLKL， Caspase-1， and Fe2+ in megakaryocytes of mice after CLP surgery. Western blotting results revealed that the CLP group exhibited a significant increase in the activation rate of necroptosis-related protein P-MLKL （P < 0.001）， a significant increase in the cleavage of pyroptosis-related proteins GSDMD and GSDMD-N （P < 0.01， P < 0.001， respectively）， a significant increase in the expression of ferroptosis-related protein ACSL4 （P < 0.01）， and a significant decrease in the expression of GPX4 （P < 0.01） compared to the sham group. Additionally， the CLP group demonstrated significant increases in the expression of apoptosis-related protein Bax， the cleavage of autophagy-related protein LC3B-Ⅱ， and the expression of P62 （P < 0.05， P < 0.001， P < 0.001， respectively）. Inhibition of apoptosis with programmed cell death inhibitors decreased platelet production function of megakaryocyte， while inhibition of necroptosis and pyroptosis had limited effects on platelet production function of megakaryocyte. Inhibition of ferroptosis and autophagy enhanced platelet production function of megakaryocyte. Conclusion Significant programmed death of megakaryocytes was observed during the acute phase of sepsis （24 h）. Among those megakaryocytes， apoptosis is an important mechanism for the differentiation of platelet production phenotype and increased platelet production capacity of megakaryocyte. Overactive autophagy and ferroptosis in megakaryocytes lead to megakaryocyte dysfunction， which is an important mechanism for coagulation abnormalities in sepsis.

Objective To investigate whether Dauricine （Dau） can ameliorate acute kidney injury induced by renal ischemia-reperfusion （IR） in mice. Methods C57BL/6 mice were randomly assigned to three experimental groups： sham operation， ischemia-reperfusion injury （IRI）， and IRI treated with daunorubicin （IRI+Dau）， with 12 animals in each group. Following oral administration of Dau （15 mg/kg）， renal ischemia-reperfusion was induced， and blood and kidney tissue samples were collected 24 hours post-surgery. Histopathological changes were assessed using hematoxylin and eosin （HE） staining. Renal function was evaluated by measuring serum creatinine and blood urea nitrogen （BUN） levels. Protein expression related to lipid peroxidation was analyzed using western blotting and immunofluorescence. Inflammatory gene expression was determined via quantitative polymerase chain reaction （qPCR）. Nuclear translocation of nuclear factor κB （NF-κB）， a key inflammatory marker， was assessed using immu-nofluorescence. Statistical comparisons between groups were performed using t-tests. Results The administration of Dau significantly ameliorated IR-induced acute kidney injury compared to the Sham group. Serum creatinine （P < 0.001） and urea nitrogen （P < 0.000 1） levels were markedly decreased in Dau-treated mice relative to those in the IRI group. Furthermore， Dau significantly suppressed lipid peroxide production in renal tissues （P < 0.001）， without significantly affecting the expression levels of Gpx4 （P = 0.919） and Acsl4 （P = 0.086）， two key proteins involved in lipid peroxidation. In addition， Dau effectively inhibited IR-induced nuclear translocation of NF-κB （P < 0.001） and reduced apoptosis in kidney cells （P = 0.004）. Conclusion Dau mitigates IR-induced kidney damage by reducing the accumulation of lipid peroxides and inhibiting the nuclear translocation of NF-κB， thereby attenuating inflammation and renal cell apoptosis.

Objective To develop a nomogram-based predictive model for assessing the risk of respiratory distress syndrome （RDS） in premature infants in the high-altitude region of Dali. The predictive performance and clinical applicability of the model will be systematically evaluated to provide evidence-based guidance for the early diagnosis and clinical management of respiratory distress in premature infants. Methods A total of 680 preterm infants admitted to the Dali Maternal and Child Health Hospital between January 2020 and December 2024 were enrolled in the study and randomly divided into a training set （n = 476） and a validation set （n = 204） at a ratio of 7∶3. Independent predictors were identified through univariate logistic regression and multivariate stepwise regression analyses， and a nomogram model was subsequently developed using R software. The performance of the model， including its discrimination， calibration， stability， and clinical applicability， was evaluated using the receiver operating characteristic curve （ROC）， Hosmer-Lemeshow goodness-of-fit test， bootstrap resampling method， and decision curve analysis （DCA）. Results The final model incorporated seven independent variables： gestational age， birth weight， Apgar score， blood oxygen saturation， gestational hyperglycemia， prenatal glucocorticoid therapy， and maternal history of infection. The areas under the curve （AUCs） for the training and validation sets were 0.88 （95%CI： 0.84 ~ 0.92） and 0.83 （95%CI： 0.76 ~ 0.89）， respectively， with all Hosmer-Lemeshow test p-values exceeding 0.05. The bootstrap-corrected AUC was 0.85 （95%CI： 0.81 ~ 0.89）. DCA indicated that the model achieved the highest net benefit at a risk threshold range of 10% to 35%. Conclusions This model integrates multiple risk factors associated with the occurrence of RDS in plateau environments， demonstrating robust predictive performance for RDS in preterm infants residing in high-altitude areas such as Dali. It can serve as a valuable tool for risk stratification and clinical decision-making， and may also provide a reference for future multicenter prospective studies.

Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis （PLNM） in prostate cancer patients prior to surgery. Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil?to?lymphocyte ratio （NLR）， platelet?to?lymphocyte ratio （PLR）， systemic immune?inflammation index （SII）， and monocyte?to?lymphocyte ratio （MLR）—of patients diagnosed with prostate cancer. Univariate and multivariate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM. Based on the results of the multivariate analysis， a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves （ROC） and calibration plots. Results Among the 334 enrolled patients with prostate cancer， 107 were identified with PLNM. Univariate analysis revealed statistically significant differences in free prostate?specific antigen （fPSA）， Gleason score， NLR， PLR， MLR， and SII between the PLNM and non?pelvic lymph node metastasis （NPLNM） groups （P < 0.05）. Multivariate analysis confirmed that fPSA， Gleason score， and SII were independent predictors of PLNM （P < 0.05）. A nomogram incorporating these predictors exhibited strong discriminative ability， with an area under the ROC curve （AUC） of 0.79 （95%CI： 0.73 ~ 0.84）. Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM. Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer. Owing to its user?friendly design and high predictive accuracy， this tool may serve as a valuable complementary method to conventional imaging techniques， thereby supporting personalized treatment decision?making.

Objective To analyze the clinical characteristics and explore the potential mechanisms underlying acute wheezing associated with respiratory syncytial virus （RSV） and human rhinovirus （HRV） infections in infants. Methods A retrospective analysis was conducted on 560 infants who consecutively presented to the emergency department of Qingdao University Affiliated Women and Children's Hospital between January 2022 and December 2024 with acute exacerbation of wheezing caused by RSV and/or HRV infection； these infants constituted the infection group. A control group of 120 healthy infants who underwent routine physical examinations at the same hospital during the same period was also included. Multiplex PCR amplification sequencing technology was employed to detect respiratory pathogens via nucleic acid analysis. The infection group was further classified into the RSV-only group （n = 248）， the HRV-only group （n = 186）， and the co-infection group （HRV + RSV， n = 126）. One-way analysis of variance （ANOVA） was used to compare body mass index （BMI）， peripheral blood white blood cell （WBC） count， neutrophil count， lymphocyte count， C-reactive protein （CRP） levels， and concentrations of interleukin （IL）-1β， IL-6， Toll-like receptor 4 （TLR4）， NOD-like receptor protein 3 （NLRP3） inflammasome， and matrix metalloproteinase-9 （MMP-9） across the groups. Additionally， comparisons were made regarding gender distribution， severity of wheezing， history of wheezing， history of eczema， parental allergic history， oxygen supplementation requirements， and presence of concurrent pulmonary infection among the infected infants. Based on wheezing severity， the infection group was further divided into a severe wheezing group and a mild wheezing group. Clinical characteristics and biological indicators were analyzed and compared between these two groups to identify potential independent risk factors. Pearson correlation analysis was performed to evaluate the association between peripheral blood levels of IL-6， NLRP3， and MMP-9 and the severity of acute wheezing exacerbation in children. Results A one-way ANOVA indicated statistically significant differences in WBC count， neutrophil count， CRP， IL-1β， IL-6， TLR4， NLRP3， and MMP-9 levels across the study groups （all P < 0.001）. Both the RSV and co-infection groups demonstrated significantly higher rates of severe wheezing， oxygen requirement， and prolonged wheezing duration compared to the HRV group （all P < 0.05）. Among these， the co-infection group exhibited the highest oxygen requirement rate， although the duration of wheezing was shorter than that observed in the RSV group （P < 0.05）. The incidence of concurrent pulmonary infection was significantly greater in the RSV group compared to the HRV group （P < 0.05）. Additionally， the proportion of infants with a prior history of wheezing was significantly higher in the RSV group than in both the HRV and co-infection groups （P < 0.05）. Both the RSV and co-infection groups showed a significantly higher prevalence of eczema history among infants compared to the HRV group （P < 0.05）. Moreover， the co-infection group had a significantly higher proportion of parental allergic history compared with both the RSV and HRV groups （P < 0.05）. Clinical data analysis stratified by wheezing severity revealed that RSV was the most commonly detected virus among the enrolled infants， particularly in those presenting with severe wheezing （χ2 = 3.940， P = 0.002）. The severe wheezing group exhibited significantly higher rates of prior wheezing， history of eczema， parental allergy， need for oxygen supplementation， and concurrent pulmonary infections compared to the mild wheezing group （P < 0.001）. Furthermore， the duration of wheezing was significantly prolonged in the severe group relative to the mild group （t = 2.058， P = 0.040）. Levels of IL-6， NLRP3， and MMP-9 were also significantly elevated in the severe wheezing group （P < 0.05）. Multivariate logistic regression analysis revealed that RSV infection， along with elevated levels of IL-6， NLRP3， and MMP-9， were independent risk factors associated with severe wheezing （OR = 3.217， 1.023， 1.022， and 1.056， respectively； all P < 0.05）. In children with RSV/HRV infection， the severity of acute wheezing demonstrated a positive correlation with NLRP3 and MMP-9 levels （P < 0.05）. The Pearson correlation coefficient between NLRP3 and MMP-9 was r = 0.238 （P < 0.001）， indicating a weak yet statistically significant positive relationship. Conclusions RSV may provoke more severe respiratory inflammatory responses and clinical manifestations compared to HRV. Individuals with a genetic predisposition to allergies or a pre-existing history of respiratory conditions may experience heightened severity of wheezing following viral infection. The NLRP3 inflammasome may further intensify airway inflammation and remodeling through the promotion of MMP-9 release. These mechanisms may collectively contribute to the pathogenesis of acute wheezing episodes and subsequently influence the progression of respiratory diseases.

Objective To investigate the association between the TyG index， its modified variants， and the risk of developing colorectal cancer （CRC）. Methods This study included a total of 93，177 participants from the 2006 Kailuan Group health examination cohort. Participants were categorized into four quartiles （Q1-Q4） according to their TyG and modified TyG indices. Follow-up began at the baseline examination， with incident CRC as the primary outcome. Participants were censored at the time of CRC diagnosis， death， or the end of the study， whichever occurred first. The dose-response relationship between TyG and its modified indices and the risk of CRC was evaluated using restricted cubic splines （RCS） in conjunction with Cox proportional hazards regression models， yielding hazard ratios （HRs） and 95% confidence intervals （CIs）. To compare the strength of associations between TyG and its modified versions （TyG-BMI， TyG-WC， TyG-WHR， TyG-WHtR， TyG-WWI） and CRC risk， HRs for CRC per one standard deviation increase in each index were calculated and compared. Results Both the TyG index and its modified variants demonstrated a significant dose-response relationship with the risk of CRC incidence. Specifically， for the TyG index， each 1-standard deviation （SD） increase was associated with a 1.17-fold （95%CI： 1.09 ~ 1.27） higher risk of CRC. Compared with the first quartile （Q1）， the third quartile （Q3） and fourth quartile （Q4） exhibited a 1.25-fold （95%CI： 1.01 ~ 1.55） and 1.26-fold （95%CI： 1.01 ~ 1.57） increased risk， respectively. For TyG-BMI， each 1-SD increase was linked to a 1.20-fold （95%CI： 1.07 ~ 1.35） elevated CRC risk. Compared with Q1， Q3 and Q4 showed a 1.32-fold （95%CI： 1.06 ~ 1.64） and 1.51-fold （95%CI： 1.21 ~ 1.88） increase， respectively. Regarding TyG-WC， each 1-SD increment was associated with a 1.22-fold （95%CI： 1.13 ~ 1.32） higher CRC risk， with Q3 and Q4 showing a 1.35-fold （95%CI： 1.08 ~ 1.70） and 1.56-fold （95%CI： 1.24 ~ 1.96） increased risk compared to Q1. For TyG-WHtR， each 1-SD increase was associated with a 1.24-fold （95%CI： 1.08-1.42） higher CRC risk. Compared with Q1， Q2， Q3， and Q4 demonstrated a 1.31-fold （95%CI： 1.03 ~ 1.66）， 1.55-fold （95%CI： 1.23 ~ 1.95）， and 1.60-fold （95%CI： 1.27 ~ 2.02） increase， respectively. In the case of TyG-WHR， each 1-SD increase was associated with a 1.19-fold （95%CI： 1.10 ~ 1.29） higher CRC risk， with Q4 showing a 1.42-fold （95%CI： 1.14 ~ 1.77） increased risk compared to Q1. Finally， for TyG-WWI， each 1-SD increase was associated with a 1.22-fold （95%CI： 1.13 ~ 1.32） elevated CRC risk， with both Q3 and Q4 showing a 1.58-fold increase （Q3： 95%CI： 1.26 ~ 1.98； Q4： 95%CI： 1.25 ~ 1.99）. Stratified analyses by sex and age consistently revealed significant associations between the TyG index and its modified variants and CRC risk. Furthermore， these indices were independently associated with the incidence of both colon cancer and rectal cancer. Conclusions （1） Elevated levels of the TyG index and its modified variants are independent risk factors for CRC. （2） Both the TyG index and its modified forms demonstrate a significant dose-response association with the incidence of CRC. （3） Among the modified TyG indices， TyG-WWI， TyG-WHtR， TyG-BMI， TyG-WC， and TyG-WHR showed stronger correlations with CRC risk compared to the original TyG index.

Objective To investigate the effects of integrating pelvic floor magnetic stimulation and medium-frequency pulsed electrotherapy with biofeedback on alleviating obstructed defecation symptoms in patients diagnosed with pelvic floor spasm syndrome. Methods A total of 133 patients diagnosed with pelvic floor spasm syndrome at the Gastrointestinal Surgery Outpatient and Inpatient Departments of the Third Hospital of Hebei Medical University between January 2017 and January 2025 were enrolled in this study. All patients underwent two sessions of conventional biofeedback therapy. According to the additional treatments they received， the patients were categorized into four groups： the Control group （received biofeedback therapy only）； the Magnetic Stimulation group （received two additional sessions of pelvic floor magnetic stimulation）； the Electrical Stimulation group （received two additional sessions of medium-frequency pulse electrical therapy）； and the Magnetic-Electric Combined group （received two additional sessions of both pelvic floor magnetic stimulation and medium-frequency pulse electrical therapy）. The improvement in obstructed defecation symptoms was evaluated before treatment， after treatment， and at the 3-month follow-up across all four groups. Results A total of 133 patients diagnosed with pelvic floor spasm syndrome were enrolled in this study. After a 3-month follow-up period， 8 patients were lost to follow-up （6.0%）. Consequently， 125 patients completed the follow-up and were included in the final analysis. These patients were distributed across four groups： the control group （n = 32）， the magnetic stimulation group （n = 30）， the electrical stimulation group （n = 31）， and the combined magneto-electric stimulation group （n = 32）. Compared with biofeedback therapy alone， combination therapy led to a greater reduction in the need for manual assistance during defecation， the sensation of incomplete evacuation， and the requirement for straining during defecation， with the most pronounced improvements observed in the combined magneto-electric stimulation group. Conclusions The integration of biofeedback， pelvic floor magnetic stimulation， and medium-frequency pulse electrotherapy can significantly alleviate symptoms including straining during defecation， the sensation of incomplete bowel evacuation， and reduce the need for manual assistance. Moreover， this combined approach contributes to the stabilization and maintenance of therapeutic effects in the short term.

Objective To assess stromal fibrosis in epidermal growth factor receptor （EGFR） mutant lung adenocarcinoma and its association with resistance to targeted therapy and patient prognosis. Methods Medical records of 207 patients diagnosed with EGFR-mutant advanced lung adenocarcinoma who received treatment at a hospital between January 2021 and December 2022 were reviewed. A total of 86 patients were ultimately included based on their prognosis and survival duration. These patients were categorized into a resistance group （32 cases） and a non-resistance group （54 cases）， depending on whether they developed resistance to targeted therapy within one year. Additionally， patients were classified into mild， moderate， and severe fibrosis groups according to the extent of fibrosis observed. Clinical and pathological characteristics， as well as fibrosis levels， were compared between the two groups. Factors influencing the development of resistance to targeted therapy in patients with EGFR-mutant lung adenocarcinoma were analyzed， and the survival outcomes of patients with varying degrees of fibrosis were evaluated during follow-up. Results In the resistance group， the prevalence of EGFR exon 20 insertion mutations， elevated CA125 levels， and the presence of moderate-to-severe fibrosis were significantly higher compared to the non-resistance group （P < 0.05）. Multivariate logistic regression analysis revealed that EGFR exon 20 insertion mutation （OR = 3.691， 95%CI： 1.043 ~ 13.057）， elevated CA125 levels （OR = 4.104， 95%CI： 1.160 ~ 14.517）， and moderate-to-severe fibrosis （OR = 3.959， 95%CI： 1.410 ~ 11.115） were independent risk factors associated with resistance to targeted therapy among patients with EGFR-mutant lung adenocarcinoma （P < 0.05）. The Cox proportional hazards model demonstrated a C-index of 0.72 （95%CI： 0.65 ~ 0.79）， with area under the curve （AUC） values for 1-year and 2-year survival predictions of 0.781 and 0.734， respectively. EGFR exon 20 insertion mutation （HR = 3.691）， moderate-to-severe fibrosis （HR = 3.959）， and elevated CA125 levels （HR = 4.104） were identified as independent prognostic factors for overall survival in these patients following targeted therapy. The median progression-free survival （PFS） for patients with mild， moderate， and severe fibrosis was 10.5 months， 7.2 months， and 3.9 months， respectively， while the median overall survival （OS） was 21.4 months， 16.1 months， and 11.5 months， respectively. Statistically significant differences in both PFS and OS were observed across the three fibrosis severity groups. （P < 0.05）. Conclusion The extent of stromal fibrosis in EGFR-mutant lung adenocarcinoma influences resistance to targeted therapy， and the progression of fibrosis is correlated with an unfavorable prognosis.

Objective To investigate the clinical efficacy of the median and paramedian approaches in ultrasound-guided combined spinal-epidural anesthesia for patients with hemorrhoidectomy and to evaluate the differences between the two techniques. Methods A retrospective analysis was performed on 90 AIDS patients who underwent hemorrhoidectomy under combined spinal-epidural anesthesia from February 2024 to March 2025. The patients were categorized into two groups based on the ultrasound-guided puncture approach： a midline approach group and a paramedian approach group. In the midline approach group， anatomical landmarks such as the spinous process space， facet joint， and transverse process were identified in the transverse axial plane for accurate localization. The puncture site was determined as the midpoint of the interspinous space along the spinal midline， and an out-of-plane puncture technique was utilized. In the paramedian approach group， positioning was performed by scanning the lamina in the sagittal oblique plane. The dorsal complex structure space with the clearest visibility was centered under the probe， and an in-plane puncture technique was applied， with the needle advanced from the caudal to the cephalad direction to complete the combined spinal-epidural procedure. Data regarding puncture performance， complications， and anesthetic efficacy were systematically recorded and assessed for both groups. Results Intergroup analysis demonstrated that the paramedian approach group exhibited significantly fewer total puncture attempts and a higher success rate on the first attempt （P < 0.05）. No significant differences were observed between the two groups regarding the need to change puncture levels or modify the puncture approach （P > 0.05）. The midline approach group showed a significantly higher incidence of paresthesia and a greater frequency of postoperative puncture site tenderness at two days post-surgery compared to the paramedian approach group （P < 0.05）. Anesthetic efficacy was comparable between the two groups， with no statistically significant difference detected （P > 0.05）. Conclusions In hemorrhoidectomy procedures for AIDS patients， the paramedian approach demonstrates advantages over the median approach in terms of puncture success and reduced complications associated with ultrasound-guided combined spinal-epidural anesthesia. However， no significant difference in anesthetic efficacy is observed between the two approaches.

Objective To investigate the correlation between plasma vitamin D levels and a novel inflammatory marker， the systemic immune-inflammatory index （SII）， in patients with type 2 diabetes. Methods This study adopted a cross-sectional design， in which patients diagnosed with type 2 diabetes who were admitted to the First Affiliated Hospital of Guangxi Medical University were enrolled as study participants. Data on demographic characteristics， medical history， physical examination findings， and laboratory test results were systematically collected. Participants were categorized into three groups based on their serum vitamin D levels： deficient， insufficient， and sufficient. The relationship between vitamin D levels and the SII was evaluated using a multivariate linear regression model. Additionally， a restricted cubic spline model was employed to assess the nonlinear dose-response association between vitamin D levels and SII. Results This study enrolled a total of 5，716 patients with type 2 diabetes. A statistically significant difference in the SII was observed across groups with varying vitamin D levels （P < 0.05）， with the highest SII value found in the vitamin D-deficient group. Multivariate linear regression analysis revealed that， after adjusting for potential confounding factors including gender， age， season of blood collection， body mass index， hypertension， dyslipidemia， and chronic kidney disease， vitamin D levels were negatively associated with SII （β = -2.68， 95%CI： -3.56 to -1.81， P < 0.001）. Compared with the vitamin D-deficient group， the vitamin D-sufficient group exhibited significantly lower SII levels （β = -78.42， 95%CI： -137.90 to -18.93， P = 0.01）. Furthermore， the restricted cubic spline model indicated a nonlinear dose-response relationship between vitamin D levels and SII （P < 0.001）. Conclusion There is a significant inverse correlation between plasma vitamin D levels and the SII in patients with type 2 diabetes.

Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn′s disease （CD） through radiomics-assisted neurophenotyping， utilizing multiparametric brain MRI. Methods This prospective study enrolled patients with CD who underwent brain MRI， MR enterography， and ileocolonoscopy within one week. The Lémann Index was used to quantitatively assess cumulative structural bowel damage. CD patients were stratified into two groups based on a cutoff value of 4.8： those with bowel damage （LI > 4.8） and those without bowel damage （LI ≤ 4.8）. A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD. Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort. Results The final study population comprised 109 patients， including 51 individuals with bowel damage and 58 without bowel damage. The neurophenotype model scores were 0.785 （95%CI： 0.506 ~ 0.945） in the bowel damage group and 0.155 （95%CI： 0.093 ~ 0.394） in the non-bowel damage group， showing a statistically significant difference between the two groups （P < 0.001）. The developed model exhibited strong discriminative performance， with area under the receiver operating characteristic curve （AUC） values ranging from 0.824 to 0.918 across the training， validation， and test cohorts （all P < 0.05）. Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage， which may indicate extraintestinal manifestations associated with cumulative intestinal injury.

Objective To evaluate the respective or synergistic value of cytoplasmic tryptophan-tRNA ligase （WARS1/SYWC） and adenosine deaminase （ADA） in diagnosing tuberculous pleural effusion （TPE）. Methods A retrospective analysis was conducted on 120 patients with pleural effusion （64 cases of TPE， 56 cases of non-TPE） admitted to the First Affiliated Hospital of Jinan University and its affiliated Shunde Hospital from January 2020 to December 2024. Pleural fluid SYWC levels were identified using enzyme-linked immunosorbent assay （ELISA）. Univariate and multivariate logistic regression analyses were performed to identify diagnostic predictors， while receiver operating characteristic （ROC） curves were plotted to assess the diagnostic performance of individual and combined biomarkers. Results Compared to the non-TPE group， TPE group exhibited significantly younger age， lower pleural CEA， less serum CEA， and lower neutrophil-to-lymphocyte ratio （NLR）， but significantly higher levels of pleural ADA， total protein， SYWC， and serum CRP （all P < 0.05）. Univariate analysis identified age， pleural CEA， carbohydrate antigen 199， ADA， SYWC， serum CEA， and NLR as potential predictors. Multivariate analysis confirmed pleural ADA （OR = 1.064， 95%CI：1.017 ~ 1.228） and SYWC （OR = 6.695， 95%CI：2.794 ~ 16.04） as independent diagnostic factors. At optimal cutoffs， SYWC （16.94 μg/L） demonstrated a sensitivity of 71.80% and specificity of 98.21%， while ADA （36.5 U/L） showed a sensitivity of 93.75% and a specificity of 89.29%. Combined detection increased the sensitivity to 95.56%， the specificity to 98.0%， and the accuracy to 97.87%. ROC analysis revealed an AUC of 0.973 （95%CI：0.943 ~ 1.000） for the combination， outperforming ADA （0.897） and SYWC （0.938） alone. Conclusion The combination of SYWC and ADA notably enhances diagnostic efficacy for TPE， providing high sensitivity and specificity as a reliable tool for clinical differentiation.

Objective To construct and validate the efficacy of a risk prediction model for pneumothorax after CT-guided percutaneous pulmonary puncture biopsy （CT-PCNB） based on nomograms. Methods A total of 246 patients who underwent CT-PCNB examination in the hospital from October 2020 to October 2023 were selected and divided into training set （n = 144） and validation set （n = 102） using a random sampling method. In the training set， univariate and multivariate logistic regression analyses were performed to identify risk factors for pneumothorax after CT-PCNB. A nomogram model was constructed based on the identified risk factors， and its accuracy was validated using the validation set. Results Multifactorial logistic regression analysis showed that age ≥ 60 years， concomitant underlying lung disease， lesion diameter < 2 cm， distance from lesion to pleura ≥ 10 mm， puncture through interlobular pleura， and ≥ 2 pleural punctures were the risk factors for pneumothorax after CT-PCNB in the training set （P < 0.05）. A nomogram model was constructed based on these six factors. The ROC curve results for the training set showed an AUC of 0.852， sensitivity of 84.50%， and specificity of 67.50%. The nomogram model was validated using the validation set， with ROC curve results showing an AUC of 0.845， sensitivity of 83.00%， and specificity of 69.50%. There was no statistically significant difference between the predicted and actual values in both the training and validation sets （χ2 = 1.803， 1.225； P > 0.05）， indicating clinical validity. Conclusion The nomogram model constructed based on the risk factors for pneumothorax after CT-PCNB has high predictive efficacy and is clinically meaningful.

Objective To evaluate the clinical efficacy of "Tongdu Tiaoshen" acupuncture combined with hand function rehabilitation training in patients with hand dysfunction following cerebral infarction. Methods A total of 104 patients were randomly assigned to either the observation group （receiving "Tongdu Tiaoshen" acupuncture combined with hand function rehabilitation training） or the control group （undergoing hand function rehabilitation training alone）， with 52 patients in each group. Both groups underwent a 4-week treatment regimen. The following outcome measures were assessed pre- and post-treatment： Modified Ashworth Scale （MAS）， Modified Lindmark Scale （MLS）， Brunnstrom Motor Function Score （BMS） for upper limbs， Fugl-Meyer Assessment （FMA） of upper limb motor function， Modified Barthel Index （MBI）， and grip strength （GS）. Adverse events were documented， and the clinical efficacy in each group was evaluated by calculating the effective rate. Results After excluding dropouts， a total of 94 cases were included in the final statistical analysis， with 48 cases assigned to the observation group and 46 to the control group. Both groups demonstrated significant improvements in MLS， MAS， BMS， FMA， MBI， and GS scores compared to pre-treatment levels， with all differences being statistically significant （P < 0.05）. Following treatment， intergroup comparisons also revealed statistically significant differences in all measured indicators （P < 0.05）. The total effective rate was higher in the observation group （91.7%） than in the control group （82.6%）， and the difference in efficacy grades between the two groups was statistically significant （P < 0.05）. Conclusions "Tongdu Tiaoshen" acupuncture， when combined with hand function training， demonstrates significantly greater efficacy than hand function rehabilitation training alone in improving post-cerebral infarction hand dysfunction. It enhances grip strength and fine motor coordination of the affected limb， alleviates hand muscle spasticity and joint stiffness， and promotes recovery of upper limb motor function， thereby improving patients' activities of daily living. This integrated therapeutic approach warrants further clinical validation and in-depth research for broader implementation.

As population aging intensifies， stroke incidence is rising yearly. Complicated with neurological impairment， this condition often leads to motor dysfunction， affecting walking stability and coordination and severely impacting the patient's daily life and mental state. In recent years， digital technology-assisted walking rehabilitation training has shown great potential in post-stroke rehabilitation. By integrating modern digital technologies such as virtual reality， intelligent feedback systems， and remote rehabilitation， this approach not only provides personalized rehabilitation plans but also promotes the recovery of walking function through immersive training， real-time feedback， and remote monitoring. This article reviews the application status， effectiveness， and limitations of digital-technology-assisted walking rehabilitation for post-stroke hemiplegic patients. It aims to clarify the new direction of post-stroke walking training and explore more effective rehabilitation methods to help patients regain their walking ability.

Lower extremity varicose veins （LEVV） are a common vascular disorder. Emerging evidence suggests that ultrasound-guided microwave ablation （UGMA） is an effective treatment modality for this condition. This minimally invasive technique closes affected veins via leveraging the thermal effects generated from microwave energy. Multiple clinical researches have highlighted its high success rate， low complication rate， rapid postoperative recovery， and significant improvement in patient′s quality of life， particularly among those with C2?C6 stage disease and larger great saphenous vein diameters. Compared with traditional open surgeries and other minimally invasive techniques， UGMA demonstrates superior therapeutic efficacy， safety， and patient satisfaction. This review elucidates the physical principles， operational essentials， and clinical progress of UGMA， exploring its strengths and challenges in LEVV management. Despite current hurdles like high equipment costs and strict operation standards， UGMA holds a promising future and may potentially offer safer and more effective treatment options for LEVV.