Colorectal cancer is one of the most prevalent malignant tumors in China. Chemotherapy， targeted therapy， and immunotherapy constitute the primary treatment modalities for patients with metastatic colorectal cancer. With the advancement of precision medicine， next-generation gene sequencing has become an essential component of the diagnostic and therapeutic process for metastatic colorectal cancer. Gene sequencing results provide critical guidance for the formulation of individualized treatment strategies. However， colorectal cancer exhibits significant tumor heterogeneity. Within the same patient， genetic profiles may differ between primary and metastatic tumors， as well as between tumor tissues obtained before and after treatment. A comprehensive and accurate understanding of these genetic differences is crucial for optimizing treatment efficacy. To address this issue， the Multidisciplinary Diagnosis and Treatment Committee of the Guangdong Anti-Cancer Association convened a panel of domestic multidisciplinary experts to develop the Expert Consensus on Genetic Testing for Patients with Metastatic Colorectal Cancer Based on Tumor Heterogeneity （2025 Edition） following extensive discussions. This consensus aims to maximize patient treatment outcomes and enhance the overall standard of colorectal cancer diagnosis and management in China.

Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder （PEG） combined with linaclotide （Lin） for bowel preparation in elderly constipated patients before colonoscopy. Methods In this prospective， randomized controlled trial， 90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023. Participants were randomly assigned to three groups （n = 30 each）： PEG-3L alone， PEG-3L + Lin， and PEG-2L + Lin. Primary outcome was Boston Bowel Preparation Scale （BBPS） score and secondary outcomes included adverse event rates， colonoscopy completion rate， withdrawal time， and polyp detection rate. Statistical analysis was performed using independent t-tests and chi-square tests. Results The PEG-3L + Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L + Lin groups did （both P < 0.001）. The PEG-2L + Lin group also outperformed the PEG-3L alone group in cleansing efficacy （90.0% vs. 76.7%， P = 0.008）. The PEG-2L + Lin group demonstrated the best tolerability and lowest adverse event rate， the PEG-3L group had the longest withdrawal time （P < 0.05）， but the three groups showed no significant difference in polyp detection rates. Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients. PEG-2L + Lin regimen provides optimal balance between efficacy， safety， and tolerability， making it a preferable choice for this population.

Objective To compare the effects of quadratus lumborum block at the lateral supra-arcuate ligament （QLB-LSAL） versus subcostal transversus abdominis plane block （STAPB） on perioperative analgesia and postoperative inflammation in patients undergoing laparoscopic radical resection of colorectal cancer. Methods In this prospective randomized study， we recruited 102 patients undergoing laparoscopic colorectal cancer surgery between October 2022 and October 2024 under general anesthesia and randomly assigned them to two groups： QLB-LSAL （Group Q， n = 51） and STAPB （Group S， n = 51）. Mean arterial pressure （MAP） and heart rate （HR） were recorded before anesthesia induction （T₀）， before surgical incision （T₁）， start of surgery （T₂）， during pneumoperitoneum establishment （T₃）， during peritoneal lavage （T₄）， at the end of surgery （T₅）， and upon leaving the operating room （T₆）. Intraoperative remifentanil consumption， time to first patient-controlled analgesia demand， and frequency of effective compression and rescue analgesia were recorded. Visual Analog Scale （VAS） scores at rest and during coughing were assessed at 24， 48， and 72 hours postoperatively. Interleukin-6 （IL-6） and systemic immune-inflammatory index （SII） at 1 day preoperatively， 1， and 3 days postoperatively were recorded. Postoperative recovery indicators and adverse events were also recorded. Results Group Q demonstrated significantly lower MAP and HR compared with Group S from T₃ to T₆ （P < 0.05）. Group Q had significantly lower intraoperative remifentanil consumption， significantly longer time to first analgesic pump demand， fewer effective pump compression， and lower frequency for rescue analgesia requests （all P < 0.05）. VAS scores at rest and during coughing in Group Q were significantly lower at 24 h and 48 h postoperatively （P < 0.05）. As compared with preoperative levels， both IL-6 and SII increased at 1 and 3 days postoperatively， but magnitude of increase in Group Q was smaller than in Group S （P < 0.05）. In comparison to Group S， Group Q demonstrated significantly earlier ambulation， shorter hospital stay， and fewer adverse events （P < 0.05）. Conclusion QLB-LSAL is superior to STAPB in enhancing perioperative analgesia， attenuating inflammatory response， and accelerating postoperative rehabilitation in patients undergoing laparoscopic colorectal cancer resection.

Objective To evaluate the effect of quadratus lumborum block combined with etomidate anesthesia on recovery quality and intestinal barrier function in elderly patients undergoing colorectal cancer surgery. Methods One hundred and twenty-six consecutive elderly patients with colorectal cancer who were admitted to The First People's Hospital of Changzhou from January 2023 to February 2025 were randomly divided into a control group and an observation group using an odd-even numbering method， with 63 cases in each group. The control group received general intravenous anesthesia during surgery， while the observation group received quadratus lumborum block on lateral arcuate ligament before general anesthesia. Heart rate and mean arterial pressure fluctuations were recorded pre-operatively （T₀）， at skin incision （T₁）， 15 minutes after the start of operation （T₂）， at lesion resection （T₃）， 5 minutes before the end of operation （T₄）. Intraoperative surgical indicators and postoperative recovery profile were documented as well. The two groups were compared in terms of postoperative pain， stress indicators， intestinal barrier indicators， and safety. Results Repeated-measures analysis of variance showed no statistically significant difference in heart rate and mean arterial pressure between the two groups at T₀， T₁， T₂， T₃， and T₄ （all P > 0.05）， but statistically significant differences in the two indicators within respective group at all the same time points （all P < 0.05）. Both groups showed statistically significant differences in variances at all the time points （P < 0.05）. The two groups had statistically significant differences in postoperative recovery time （40.02 ± 16.31 min vs. 48.61 ± 15.09 min； P < 0.05） and tracheal tube removal time （8.03 ± 1.92 min vs. 9.15 ± 1.23 min； P < 0.05）. Pain scores at 2 hours， 24 hours， 72 hours， and 1 week postoperatively were shorter in the observation group （P < 0.05）， with a parallel decrease over time in both groups （all P < 0.05）. Effective presses of the self-controlled analgesia pump within 48 hours postoperatively was significantly fewer in the observation group （P < 0.05）. Although the postoperative levels of norepinephrine， adrenaline， cortisol， D-lactate， and diamine oxidase increased in both groups， he observation group had significantly lower levels compared with the control group （P < 0.05）. No serious complications or adverse reactions were observed in either group. Conclusion The regimen of quadratus lumborum block combined with etomidate anesthesia in laparoscopic radical surgery for elderly colorectal cancer patients shortens the patient's postoperative recovery time， reduces intestinal barrier damage， alleviates postoperative pain and stress response， promising a favorable safety profile.

Tuberculosis remains the leading cause of death from a single infectious agent worldwide. China is still one of the countries with a high burden of tuberculosis. The structural and functional damage to lung tissue caused by post-tuberculosis pulmonary disease （PTLD） imposes a considerable disease burden on people. However， due to the insufficient understanding of post-tuberculosis lung diseases in the past， the long-term management of this disease has been lacking for the post-tuberculosis population. This article elaborates on the epidemiology and hazards， pathogenesis， clinical manifestations， diagnostic methods， treatment and preventive measures of common PTLD， with the aim of enhancing the awareness and attention of tuberculosis physicians to PTLD. It also summarizes the limitations in the etiological mechanism， diagnosis and treatment methods of PTLD， as well as the urgency of in-depth research.

Objective To explore the role of sevoflurane （SEV） in sepsis-induced acute lung injury （ALI） and observe its impact on the Wnt/β-catenin signaling pathway. Methods Forty C57 mice were randomly divided into 4 groups （n = 10 each）： Sham， CLP， SEV， and SEV + XAV （β-catenin inhibitor）. A sepsis model was established via cecal ligation and puncture. Lung injury was evaluated using HE staining， lung wet/dry weight ratio， and TUNEL staining. Levels of inflammatory factors （TNF-α， IL-1β， IL-6） were detected by ELISA. Oxidative stress indices （SOD， MDA， ROS） were measured by colorimetry and flow cytometry. Hindlimb blood perfusion and oxygenation were assessed with laser speckle flowmetry. Expressions of key Wnt pathway molecules and downstream target genes （c-Myc， Cyclin D1） were detected by RT-qPCR and Western blot. Co-localization of β-catenin and SP-C （a marker of type Ⅱ alveolar epithelial cells） in lung tissues was determined by immunofluorescence staining. Results Compared with the Sham group， the CLP group exhibited significant increases in sepsis severity， lung pathological damage including alveolar structure destruction， inflammatory infiltration， and apoptosis， elevation in pro-inflammatory cytokine levels， and significant decrease in SOD and increase in MDA and ROS. Additionally， lower limb blood flow and oxygenation levels were significantly reduced， while the expression of β-catenin and its downstream target genes， as well as the co-localization signal and fluorescence intensity of β-catenin with SP-C， were significantly downregulated （all P < 0.05）. Compared with the CLP group， the SEV group showed significant improvements in all these indicators. However， compared with the SEV group， the SEV + XAV group demonstrated a reversed protective effect， with all indicators approaching the levels observed in the CLP group （all P < 0.05）. Conclusion Sevoflurane alleviates sepsis-induced ALI by activating Wnt/β-catenin signaling pathway， exerting anti-inflammatory and antioxidant effects， and enhancing the expression and localization of β-catenin in type Ⅱ alveolar epithelial cells.

Objective To elucidate the role of gut microbiota in cognitive impairment induced by adolescent social isolation （ASI） and identify key pathogenic microbial communities. Methods Sixteen male C57BL/6 mice （postnatal days 21 ~ 23） were randomly assigned to a control group （group?housed， 4/cage， n = 8） or an ASI group （single?housed， 1/cage， n = 8）. After 5 weeks of ASI （5?ASI）， fecal samples underwent 16S rRNA sequencing for microbiota analysis. Cognitive behavior was assessed using open field， Y?maze， novel object recognition tests. Correlation analysis integrated microbial abundance with behavioral parameters to screen cognition?associated taxa. Results （1） Behavior： 5?ASI mice showed unchanged locomotion （open field） but significantly reduced spontaneous alternation （Y?maze， P < 0.01） and lower cognitive index （novel object recognition， P < 0.001）， confirming spatial and recognition memory deficits. （2） Microbiota： 5?ASI mice exhibited decreased α?diversity （P < 0.05） and altered β?diversity （P < 0.001）. LEfSe analysis revealed depleted taxa （e.g.， Prevotellaceae_NK3B31_group， Tyzzerella， Allobaculum， Ruminococcus） and enriched taxa （e.g.， Butyricicoccus， Lachnoclostridium）. （3） Correlations： Positive associations with cognitive performance were observed for Prevotellaceae_NK3B31_group， Allobaculum， and Ruminococcus （P < 0.05）， while Butyricicoccus and Lachnoclostridium showed negative correlations （P < 0.05）. Conclusion Adolescent social isolation induces spatial/recognition memory impairment and gut microbiota dysbiosis. Specific microbial alterations （Prevotellaceae_NK3B31_group， Butyricicoccus） correlate with cognitive deficits， providing novel insights into microbiota?mediated mechanisms and potential therapeutic targets.

Objective To investigate the effects of different inspired oxygen concentrations on perioperative cerebrovascular function in patients with a history of ischemic stroke. Methods A total of 150 patients scheduled for elective surgery with a history of ischemic stroke were enrolled from Renji Hospital， Shanghai Jiao Tong University School of Medicine， between June 2020 and March 2024. Using a random number table， patients were allocated into two groups： F30 group （intraoperative fraction of inspired oxygen， FiO? = 30%） and F80 group （FiO? = 80%）， with 75 patients in each group. Bilateral middle cerebral artery （MCA） blood flow was continuously monitored using transcranial Doppler （TCD）， including mean flow velocity （Vm）， resistance index （RI）， and pulsatility index （PI）. Cerebral oxygen saturation （rScO?） was measured using a FORE-SIGHT oximeter. Arterial blood gas analysis was performed preoperatively， 1 hour after induction， and before extubation to assess pH， partial pressure of arterial carbon dioxide （PaCO?）， oxygenation index （OI）， base excess （BE）， hematocrit （Hct）， and lactate （Lac）. Peripheral blood samples were collected 24 hours postoperatively to measure thromboxane A? （TXA?） and prostacyclin （PGI?） levels. At 1 month postoperatively， telephone follow-up was conducted to evaluate the risk of recurrent cerebral ischemic events using the ABCD2 score and Essen Stroke Risk Score （ESRS）. Results No significant differences were observed in baseline characteristics between the two groups. Perioperative arterial blood gas parameters did not differ significantly between groups （P > 0.05）. Compared with the F30 group， the F80 group exhibited a smaller reduction in mean flow velocity （Vm） of the affected MCA at the end of surgery （8.18% ± 3.34% vs. 13.57% ± 5.32%， P < 0.05）， while no significant intergroup differences were found in RI or PI. At 1 hour after induction and before extubation， rScO? of the affected hemisphere was significantly increased in the F80 group as compared with the F30 group （P < 0.05）， whereas no significant difference was observed in the contralateral hemisphere. Before extubation and on postoperative day 1， TXA? levels were significantly lower and PGI? levels higher in F80 group compared with F30 group （P < 0.05）. The proportion of patients at high risk of cerebral ischemia by ABCD2 and ESRS at 1 month postoperatively did not differ between groups （P > 0.05）. Conclusion In patients with a history of stroke， intraoperative administration of 80% FiO? under general anesthesia better maintains perioperative cerebral hemodynamic stability and cerebral oxygen saturation， improves cerebrovascular endothelial function， but does not significantly affect the short-term incidence of postoperative cerebrovascular events compared with 30% FiO?.

Objective To construct a predictive model to explore the factors influencing bowel preparation for colonoscopy and the risks of mild adverse events during colonoscopy. Methods A total of 573 patients undergoing colonoscopy at the digestive endoscopy center of the First Affiliated Hospital of the Air Force Military Medical University from July 2021 to June 2023 were enrolled in this prospective study. The patients were divided into an adequate group （n = 112） and an inadequate group （n = 461） based on bowel preparation assessed with the Boston Intestinal Readiness Score Scale （BBPS）. Again， they were divided into an occurrence group （n = 106） and a non-occurrence group （n = 467） based on minor adverse events within 30 days after colonoscopy. Multivariable logistic regression was utilized to identify independent predictors of inadequate bowel preparation and minor adverse events after colonoscopy； model discrimination was quantified with receiver-operating characteristic （ROC） curve analysis， and the derived coefficients were used to construct a clinically applicable risk-scoring system. Results The adequate group achieved a significantly higher BBPS total score than the inadequate group （P < 0.05）. The 30-day cumulative incidence of minor adverse events after colonoscopy was 18.5%. Inadequate bowel preparation was associated with a markedly higher event rate （36.61%） than adequate preparation （14.10%； P < 0.05）. Multivariable logistic regression identified the following independent predictors of inadequate bowel preparation： age ≥ 60 years， body-mass index ≥ 28 kg/m2， history of constipation， diabetes mellitus， concomitant calcium-channel-blocker use， and Bristol Stool Form Scale types 1 ~ 2 （all P < 0.05）. ROC analysis confirmed that age， constipation history， diabetes， calcium-channel-blocker use， Bristol stool type， and their combined model were all significant predictors （P < 0.05）， whereas BMI alone was not （P > 0.05）. Independent risk factors for post-colonoscopy minor adverse events were age ≥ 60 years， presence of ≥ 1 comorbidity， performance of biopsy or polypectomy， and warfarin use （all P < 0.05）. ROC analysis demonstrated significant predictive value for age， number of comorbidities， biopsy/polypectomy， warfarin use， and their combined model （P < 0.05）. Odds ratios derived from the multivariable models were converted into weighted scores； the resulting composite risk scale ranged from 0 to 100. In the validation cohort， this combined score predicted both inadequate bowel preparation and subsequent minor adverse events （P < 0.05）， with an area under the curve of 0.880 （95% CI not shown）， sensitivity of 0.829， and specificity of 0.707. Conclusion Inadequate bowel preparation and post-colonoscopy minor adverse events are inter-related. Independent predictors of inadequate preparation are age ≥ 60 years， BMI ≥ 28 kg/m2， constipation， diabetes mellitus， concurrent calcium-channel-blocker use， and Bristol Stool Form Scale types 1-2. Independent predictors of minor adverse events are age ≥ 60 years， ≥ 1 comorbidity， biopsy or polypectomy， and warfarin use. Targeted preventive measures against these factors should be implemented to improve clinical outcomes.

Objective To investigate the expression characteristics of poly （rC）-binding protein 1 （PCBP1） in gastric cancer tissues and their clinical significances by bioinformatics analysis combined with experimental verification， and to identify its relationship with STIP1 homology and U-Box containing protein 1 （STUB1）. Specifically， this study aims to verify the expression patterns of PCBP1 and STUB1 in gastric cancer and determine their relationships with clinicopathological features by immunohistochemistry to provide a theoretical framework as well as potential intervention strategies for gastric cancer. Methods Data of PCBP1 expression in gastric cancer and adjacent tissues were obtained from TIMER 2.0 online analysis website. KEGG pathway enrichment analysis was performed using gastric cancer data （STAD） in the TCGA （the Cancer Genome Atlas） database， and its potential mechanism was determined. The main regulatory factor STUB1 was found in the ferroptosis regulatory pathway. Subsequently， PCBP1 and STUB1 expressions in 33 cases of gastric cancer tissues and corresponding adjacent tissues were detected by immunohistochemistry. The collected cases were grouped according to different degrees of differentiation， age， gender， tumor size， depth of tumor invasion， TNM stage and pathological morphology. The positive expression rates of PCBP1 and STUB1 were observed. The correlation between the two proteins and the correlation between clinical and pathological features were analyzed by c2 test. Finally， the relationship between PCBP1 and STUB1 and malignancy of gastric cancer was further explored. Results Immunohistochemical results showed that the positive expression rate of PCBP1 in cancer tissues was 69.7 %， which was significantly higher than that in adjacent tissues （48.5%）. The positive expression rate of STUB1 in cancer tissues was 39.4 %， which was lower than that in adjacent tissues （54.5 %）， statistically significant difference （P < 0.05）. The positive expression rate of PCBP1 was correlated with tumor differentiation， lymph node metastasis and Lauren classification （P < 0.05）， but not with patient's age， gender， depth of invasion， clinical stage， nerve infiltration， and intravascular tumor thrombus （P > 0.05）. The positive expression rate of STUB1 was correlated with tumor differentiation， depth of invasion， lymph node metastasis and Lauren classification （P < 0.05）. The Spearman correlation coefficient between PCBP1 （cancer） and STUB1 （cancer） was -0.413， with P = 0.017 （P < 0.05）， indicating that there was a significant negative correlation between them. Conclusion PCBP1 participates in the malignant progression of gastric cancer by regulating the main regulator STUB1 in the ferroptosis pathway. Theoretically， it provides a new insight into molecular mechanism as well as a potential therapeutic strategy for treating gastric cancer.

Objective To study the association between serum soluble growth stimulating expression factor 2 （sST2）， N?terminal pro?B?type natriuretic peptide （NT?probNP）， and echocardiographic parameters with myocardial remodeling in patients with heart failure （HF） after acute myocardial infarction （AMI）. Methods A total of 120 patients with HF after AMI admitted to the hospital from January 2023 to January 2024 were enrolled. According to the results of echocardiography during a 6?month follow?up， the enrolled patients were divided into a myocardial remodeling group and a non?myocardial remodeling group. Serum sST2， NT?proBNP and echocardiographic parameters were compared between groups， and the predictive value on myocardial remodeling was analyzed. Results According to the Killip heart failure classification， the patients were classified into three groups. The sST2， NT?proBNP， left ventricular end?diastolic diameter （LVEDD）， left ventricular end?systolic diameter （LVESD） and left atrial diameter （LAD） showed progressive increase in the three groups， Killip Ⅱ to Killip Ⅳ （P < 0.05）. Conversely， left ventricular ejection fraction （LVEF） decreased across the three groups （P < 0.05）. Multivariate analysis found that high sST2， high NT?proBNP and high LAD were independent risk factors of myocardial remodeling in patients with HF after AMI （P < 0.05）. ROC curve revealed that the area under the curve （AUC） of the nomogram model was 0.82 （95%CI： 0.71 ~ 0.92）. Hosmer?Lemeshow goodness of fit test of the model indicated that the chi?square value was 3.67 （χ² = 3.67， P = 0.801）， and it was considered that basic consistency was exhibited between the fitted probability value and actual probability value. After 1 000 times of Bootstrap repeated sampling， the calibration curve was drawn and found that the calibration curve had good consistency with the actual curve， and both were close to the ideal curve. Decision curve displayed that the net benefit of patients was higher than that of the other two extreme curves， and when the threshold probability was between 0.16 and 0.94， the model could produce better clinical benefits. Conclusion The nomogram prediction model based on serum sST2， NT-proBNP and echocardiographic parameters has high predictive value on myocardial remodeling in HF patients after AMI.

Objective To explore the relationship between hemorheology and Carotid Atherosclerosis. Methods The clinical data of 153 patients who underwent both hemorheological testing and carotid artery ultrasound were divided into a CAS group (n = 96) and a non?CAS group (n = 57) based on ultrasound findings. Clinical data and laboratory indicators were compared between two groups. Multivariate logistic regression analysis was used to explore the influencing factors of CAS. The ROC curves graph were drawn to observe the role of hemorheological indicators in predicting CAS and select the optimal cutoff value based on the maximum Youden index. Results The CAS group demonstrated higher levels in age， BMI， RBC aggregation index，low & high shear reduced viscosity of whole blood，plasma viscosity and fibrinogen compared to the non?CAS group （P < 0.05）. The multivariate logistic regression analysis showed that plasma viscosity （OR = 38.270， 95% CI：1.206 ~ 1214.508），age （OR = 1.119， 95% CI： 1.065 ~ 1.176） were risk factors for the occurrence of CAS （P < 0.05）. The ROC curves showed that the area under the curve （AUC） of plasma viscosity and age were 0.623、0.728. Conclusion CAS patients have high levels of plasma viscosity and advanged age compared to the patient without CAS. Elevated plasma viscosity and age is a risk factor for CAS， with plasma viscosity ≥ 1.46 mPa·s， over the age of 56.5 as a significant value for predicting CAS.

Objective To compare the short-term outcomes of single-port video-assisted thoracoscopic （VATS） pulmonary surgery using a chest-wall-muscle-sparing incision versus a standard incision. Methods A total of 215 patients undergoing single-port video-assisted thoracoscopic lung surgery in the Department of Cardiothoracic Surgery， The First Hospital of Anhui University of Science & Technology from February 2024 to May 2025 were recruited in this clinical observation. Clinical data were retrospectively analyzed. The patients were divided into a chest wall muscle sparing incision group and a chest wall standard incision group. Short-term prognoses of the two groups were compared. Results A total of 180 patients was included： 80 in the chest wall muscle sparing incision group and 100 in the chest wall standard incision group. The two groups had similar baseline characteristics， including body-mass index （23.86 ± 3.70 vs. 23.45 ± 3.20 kg/m2； P > 0.05）. All procedures were completed successfully without perioperative mortality， conversion to thoracotomy， or extension of the incision. The standard incision group had 4 latissimus dorsi injuries and 5 patients with shoulder joint dysfunction on the 30th day after discharge， characterized by chest wall muscle tightness accompanied by chest pain and limited upper limb mobility （P < 0.05）. Although skin-to-skin incision time was slightly longer in the muscle-sparing group （P = 0.06）， pain scores at every assessed time point were significantly lower （P < 0.05）， and no patient developed shoulder dysfunction. No significant differences were observed in incisional fat-liquefaction rate， incision length， operative time， blood loss， or chest-tube duration （P > 0.05）. Conclusion The chest wall muscle sparing incision in single-port video-assisted thoracoscopic lung surgery not only preserves the latissimus dorsi and serratus anterior muscles， significantly reduces postoperative incision pain， and minimizes chest wall muscles and shoulder dysfunction， exhibiting clear minimally invasive advantages in single-port VATS lung surgery.

Objective To explore the latent profile of health-promoting lifestyle in patients with lumbar disc herniation treated conservatively and analyze its influencing factors， so as to provide reference for the development of targeted interventions. Methods Patients with conservative treatment of Lumbar Disc Herniation at the orthopedic outpatient clinic of a tertiary hospital in Guangzhou from March to December 2024 were selected as study subjects. General Information Questionnaire， Health-Promoting Lifestyle Profile Revised-Ⅱ，Visual Analogue Scale，Oswestry Disability Index and Social Support Rating Scale were used for the investigation. Latent profile analysis was used to explore the potential categories of health-promoting lifestyle in patients with lumbar disc herniation and the influencing factors were identified by univariate analysis and disordered multiple logistic regression analysis. Results A total of 422 lumbar disc herniation patients treated conservatively were included and the score of Health-Promoting Lifestyle Profile Revised-Ⅱ Scale was（102.44 ± 13.19）points. The health-promoting lifestyle of patients with lumbar disc herniation can be divided into three potential profile： low health promotion group-low responsibility and less exercise type （18.7%）， balanced health promotion group （51.7%） and high health promotion group-spiritual social leading type （29.6%）.The results of logistic regression analysis showed that course of disease， oswestry disability index， social support level and take regular physical exercise are the influencing factors of health-promoting lifestyle in patients with conservative treatment of lumbar disc herniation （P < 0.05）. Conclusions There is heterogeneity in the health-promoting lifestyle in patients with conservative treatment of lumbar disc herniation. Nursing staff can carry out targeted interventions according to the latent profile type of health-promoting lifestyle in lumbar disc herniation patients treated conservatively to improve their health-promoting lifestyle.

Objective To investigate the association between gout-related gene polymorphisms and clinical phenotypic heterogeneity among gout patients in the Foshan region， thereby providing a scientific basis for stratified clinical management. Methods A total of 125 gout patients diagnosed at the Foshan Hospital of Traditional Chinese Medicine between June 2022 and May 2025 were enrolled in this study. The collected data included demographic characteristics， frequency of gout attacks， presence of tophi， levels of uric acid， creatinine， C-reactive protein （CRP）， erythrocyte sedimentation rate （ESR）， gout-related genes （ABCG2， SLC2A9， SLC22A12， MTHFR）， and joint ultrasound findings. Group comparisons and rank correlation analyses were conducted to explore potential associations between gene polymorphisms and clinical heterogeneity. Results The male-to-female ratio was 11∶1； the mean age was （35.28 ± 2.67） years； the mean disease duration was （6.03 ± 0.68） years； and the mean frequency of acute attacks in the past 12 months was 4 （2.0， 7.25）. Genotype distributions were as follows： ABCG2： wild-type （C/C）， 23.8%； heterozygous （C/A）， 53.2%； homozygous （A/A）， 23%. SLC2A9： wild-type （A/A）， 24.6%； heterozygous （A/G）， 50%； homozygous （G/G）， 25.4%. SLC22A12： wild-type （A/A）， 4.8%； heterozygous （A/C）， 31.7%； homozygous （C/C）， 63.5%. MTHFR： wild-type （C/C）， 68.3%； heterozygous （C/T）， 28.6%； homozygous （T/T）， 3.2%. Rank correlation analysis revealed that SLC2A9 polymorphisms were significantly correlated with tophi formation （ρ = 0.193， P = 0.031） and crystal deposition on ultrasound （ρ = 0.202， P = 0.025）. SLC22A12 polymorphisms were associated with hypertension （ρ = 0.269， P = 0.003） and diabetes （ρ = 0.200， P = 0.026）. MTHFR polymorphisms showed a correlation with diabetes （ρ = 0.224， P = 0.012）. Conclusions Polymorphisms in SLC2A9， SLC22A12， and MTHFR are significantly linked to clinical phenotypic heterogeneity among gout patients. Genetic testing could facilitate the early identification of individuals at high risk for complications and support the development of stratified and individualized treatment approaches.

Objective To identify children with high-risk systemic adverse reactions （SARs） associated with dust mite subcutaneous immunotherapy prior to immunotherapy. Methods An analysis was conducted on the high-risk factors in patients who experienced SARs prior to initial immunotherapy. A total of 40 pediatric patients with dust mite allergic rhinitis who underwent treatment with Dermatophagoides pteronyssinus （Dp） extracts at our hospital's pediatric department from April 2021 to January 2025 and developed SARs were selected as the observation group， while 54 patients who did not experience SARs served as the control group. Differences in gender， age， disease duration， eosinophil count， polysensitization， multisystem involvement， total IgE （tIgE）， and dust mite-specific IgE （sIgE） were evaluated. Results Significant differences were observed between the observation and control groups in polysensitization， multisystem involvement， and tIgE levels. The polysensitization rates were 70% vs. 48.1% （P = 0.034）， multisystem involvement 55% vs. 22.2% （P = 0.001）， and high tIgE levels （tIgE ≥ 327.8 IU/mL） 82.5% vs. 62.1% （P = 0.025）. Multivariate logistic regression identified multisystem involvement ［OR（95% CI） = 4.278 （1.749 ~ 10.461）］ as an independent risk factor for SARs during allergen immunotherapy （AIT）. Conclusion Patients with dust mite allergic rhinitis accompanied by multi-system damage exhibit poorer conventional prevention efficacy against SARs when undergoing AIT. They remain highly susceptible to SARs occurrence， necessitating more robust preventive measures against SARs to enhance the safety of AIT.

Objective To evaluate the safety and efficacy of non-retrograde intubation combined with selectively tubeless percutaneous nephrolithotomy （NR-ST-PCNL）. Methods A retrospective analysis included 213 patients with upper urinary tract stones and hydronephrosis （renal pelvic separation > 10 mm） undergoing PCNL at our hospital from October 2023 to June 2025. Patients were divided into Group A （non-retrograde intubation， n = 109） and Group B （retrograde intubation， n = 104）. Primary endpoint was postoperative complications and secondary endpoints included operative time， stone-free rate （SFR）， visual analog scale （VAS） pain scores， postoperative hospital stay， and hospitalization costs. Results Group A demonstrated significantly lower rates of postoperative complications ［7.3% （8/109） vs. 18.2% （19/104）， P = 0.017］， shorter operative time ［51.00 （37.00， 65.00） min vs. 71.50 （55.00， 90.75） min， P < 0.001］， lower postoperative VAS scores ［1.00 （0.00， 1.00） vs. 1.00 （0.00， 2.00）， P = 0.008］， shorter hospital stay ［3.00 （2.00， 3.00） days vs. 4.00 （4.00， 4.00） days， P < 0.001］， and lower hospitalization costs ［17 028.00 （15 178.05， 17 934.50） RMB vs. 20 653.00 （19 176.25， 22 630.00） RMB， P < 0.001］ compared with Group B. There was no significant difference in SFR between groups （P > 0.05）. Conclusion For patients with upper urinary tract stones and renal pelvic separation > 10 mm， NR-ST-PCNL performed by experienced surgeons achieves comparable stone clearance to conventional techniques while reducing complication risk， shortening operative and hospitalization times， and lowering costs. It represents a safe， efficient， and optimized clinical approach.

Objective To investigate the prognostic significance of the neutrophil-to-platelet ratio （NPR） in combination with C-reactive protein （CRP） in patients with lower extremity arteriosclerosis obliterans （ASO）. Methods A retrospective analysis was conducted on the clinical data of 209 patients with lower extremity ASO admitted to the Department of Critical Care Medicine at Zhongshan Hospital Affiliated to Fudan University （Xiamen） between January 2020 and February 2024. Patients were categorized into either the survival group or the death group based on their in-hospital prognosis. The NPR was calculated on the day of ICU admission， as was the level of CRP. Differences in NPR， CRP， and the combination of NPR and CRP between the two groups were then compared. The prognostic value of NPR， CRP， and their combined use for predicting outcomes in patients with lower extremity ASO was evaluated using receiver operating characteristic （ROC） curve analysis. Based on the optimal cutoff value derived from the ROC curve for the combination of NPR and CRP， patients were divided into two groups. Kaplan-Meier survival analysis was subsequently performed to assess differences in survival outcomes between these two groups. Results The levels of NPR， CRP， alanine aminotransferase， aspartate aminotransferase， creatinine， B-type natriuretic peptide， troponin， and procalcitonin， as well as the proportion of patients with kidney disease in the survival group， were significantly lower than those in the death group， and the differences were statistically significant （P < 0.05）. The albumin level in the survival group was significantly higher than that in the death group， with a statistically significant difference （P < 0.05）. Binary logistic regression analysis revealed that NPR， CRP， the combination of NPR and CRP， and the presence of comorbid kidney disease were independent risk factors influencing patient survival prognosis. ROC curve analysis showed that the areas under the curve （AUC） for NPR， CRP， and the combination of NPR and CRP were 0.648， 0.812， and 0.828， respectively. Both CRP and the combination of NPR and CRP demonstrated statistically significant （P < 0.05）. Compared with either NPR or CRP alone， their combined use showed improved predictive performance. Based on the ROC curve for the combination of NPR and CRP， the optimal cutoff value was determined as 0.029 using the maximum Youden Index. Patients were then divided into high and low NPR + CRP groups according to this cutoff. Kaplan-Meier survival analysis revealed that the in-hospital survival rate in the low NPR + CRP group was significantly higher than that in the high NPR + CRP group， and the difference in survival between the two groups was statistically significant （P = 0.001）. Conclusion NPR combined with CRP is associated with the prognosis of patients with lower extremity ASO and may serve as an effective predictive indicator for their clinical outcomes.

Objective To evaluate the effects of low-dose intrathecal morphine （ITM） combined with liposomal bupivacaine adductor canal block （LB-ACB） on postoperative analgesia and opioid-sparing efficacy in patients undergoing total knee arthroplasty （TKA）. Methods In this randomized， double-blind， controlled trial， 80 TKA patients were allocated to either an intervention group （ITM 0.1 mg + LB-ACB， n = 40） or a control group （intrathecal saline + LB-ACB， n = 40）. Primary outcomes included resting/movement visual analog scale （VAS） scores at 6， 12， 24， 48， and 72 hours postoperatively， 48-hour morphine consumption， time to first rescue analgesia， and incidence of complications. Results （1） The intervention group showed significantly lower resting and movement VAS scores at 6， 12， 24， and 48 hours postoperatively compared with controls （all P < 0.05）， except at 72 hours （P > 0.05）. （2） The intervention group had a significant reduction in 48-hour morphine consumption （4.58 ± 1.0 mg vs. 9.34 ± 4.8 mg， P = 0.027）， a significantly lower rescue analgesia rate （15.0% vs. 47.5%， P = 0.002）， and a significantly prolonged time to first rescue analgesia （48.8 ± 7.5 h vs. 14.5 ± 5.5 h， P < 0.001）. （3） The intervention group demonstrated a significant decrease in the incidence of nausea （from 15.0% to 35.0%， P = 0.039） and vomiting （from 10.0% to 27.5%， P = 0.045）， but no significant differences were observed in the incidences of pruritus， urinary retention， or motor block （all P > 0.05）. Conclusion Low-dose ITM （0.1 mg） combined with LB-ACB significantly enhances early postoperative analgesia， reduces opioid consumption， and decreases nausea/vomiting risk， without increasing the risks of other complications. This regimen aligns with enhanced recovery after surgery （ERAS） principles.

Objective To evaluate the effect of remimazolam on the incidence of postoperative delirium （POD） in elderly lung cancer patients undergoing thoracoscopic surgery. Methods A total of 114 elderly patients who underwent unilateral thoracoscopic lung surgery at the Affiliated Hospital of Xuzhou Medical University from October 2024 to April 2025 were recruited in this trial. Patients were randomly assigned to remimazolam group （group R） and propofol group （group P）. Anesthesia induction and maintenance were performed with remimazolam and propofol， respectively. In R group， 0.5 mg of flumazenil was intravenously injected at the end of the surgery for specific antagonism. The incidence of delirium and Quality of Recovery-15 （QoR-15） scores on the first and third postoperative days were compared between the two groups. Intraoperative hemodynamic parameters， total opioid dosage， fluid balance， tracheal tube extubation time after surgery， and the incidence of adverse reactions were recorded. Results There were no statistically significant differences between the groups in the incidence of POD or in QoR-15 scores （P > 0.05）. Compared with group P， patients in group R had a shorter extubation time （P < 0.05）， more stable hemodynamics， lower incidences of intra-operative hypotension and bradycardia， and reduced requirement for vasoactive drugs （P < 0.05）. The consumption of rescue analgesics in the post-anesthesia care unit （PACU） was also lower in group R （P < 0.05）. No significant differences were observed between the groups in the amounts of sufentanil and remifentanil administered， fluid balance， bispectral index （BIS） values， or the incidence of nausea and vomiting （P > 0.05）. Conclusion In elderly patients undergoing elective thoracoscopic surgery， remimazolam-based induction and maintenance of anesthesia did not significantly alter the incidence of POD or compromise postoperative recovery quality compared with propofol. However， the remimazolam group required fewer vasoactive agents and exhibited a shorter tracheal extubation time.

Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer. Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study， including 49 cases of lung adenocarcinoma （LUAD）， 30 cases of lung squamous cell carcinoma （LUSC）， and 15 cases of small cell lung cancer （SCLC）. All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE. Two radiologists independently measured the spectral and perfusion parameters of the three groups of images， including spectral curve slope （K）， iodine concentration in the lesion area （ICL）， effective atomic number （Zeff）， surface permeability （PS）， and perfusion index （PI）， and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features. All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1. The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions. The performance of the model was evaluated using the receiver operating characteristic （ROC） curve. Results Statistical analysis showed that the spectral curve slope， ICL， NIC， and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients （P < 0.05）， while there were no significant differences in these parameters between LUSC and SCLC patients （P > 0.05）. Among the perfusion CT parameters， surface permeability （PS） showed significant differences among the three groups （P < 0.05）， while blood volume （BV）， blood flow （BF）， perfusion index （PI）， time to peak （TTP）， and mean transit time （MTT） did not show statistical differences. The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance： the area under the curve （AUC） of the LUAD and LUSC discrimination model was 0.806/0.77 （training group/test group） in the arterial phase and 0.867/0.9 （training group/test group） in the venous phase； the AUC of the LUAD and SCLC discrimination model was 0.885/0.883 （training group/test group） in the arterial phase and 0.851/0.776 （training group/test group） in the venous phase. Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes. The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma， squamous cell carcinoma， and small cell lung cancer， providing precise imaging evidence for the formulation of individualized treatment plans.

Objective To analyze the predictive value of artificial intelligence （AI） quantitative parameters combined with 256?slice spiral CT scans for assessing the invasiveness of lung ground?glass nodules （GGNs）. Methods This study included 98 GGN patients diagnosed by postoperative pathology at the hospital from May 2021 to July 2024. Preoperative assessments involved AI quantitative parameters and 256?slice spiral CT scans. Patients were categorized into non?invasive （AAH， AIS， MIA） and invasive （IAC） groups based on pathology. AI parameters and CT scan results were compared to analyze factors influencing invasiveness and their predictive value. Results Among the 98 GGN patients， there were 29 AAH cases， 22 AIS， 19 MIA， and 28 IAC. The invasive group had higher average CT values， nodule long?axis diameter， maximum area， presence of air bronchogram， vascular clustering signs， and irregular shapes compared to the non?invasive group （P < 0.05）. Binary logistic regression identified these six features （air bronchogram， vascular clustering， irregular shape， average CT value， nodule long diameter， and maximum area） as significant factors affecting GGN invasiveness （P < 0.05）. ROC curve analysis showed that the combined detection of these parameters had higher sensitivity and specificity than single tests， with an AUC of 0.907， indicating a high predictive value for assessing GGN invasiveness. Conclusion The combination of AI quantitative parameters and 256?slice spiral CT scanning effectively predicts the invasiveness of GGN， providing significant clinical guidance for preoperative evaluation.

Objective To observe the effect of rehabilitation nursing pathway in transjugular intrahepatic portosystemic shunt （TIPS）. Methods From January 2022 to December 2024， 160 patients with cirrhotic esophageal and gastric varices bleeding and intractable hydrothorax and ascites who underwent TIPS surgery were selected and randomly divided into path group and control group， with 80 cases in each group. The clinical treatment schemes of the two groups were consistent. The control group was given routine nursing， and the path group was intervened by rehabilitation nursing path model. Six-minute walking test （6 MWT） distance， Activity of Daily Living， ADL） scores， self-rating anxiety scale （SAS） and self-rating depression scale （SDS） scores， as well as the incidence of postoperative complications （hepatic encephalopathy and abdominal hemorrhage）， hospitalization days， hospitalization expenses and nursing satisfaction scores were compared between the two groups. Results The incidence of postoperative complications in the pathway group was 6.25%（5/80）， which was lower than that in the control group （16.25%， 13/80）. The 6MWT distance， ADL score， SAS score and SDS score in the path group were better than those in the control group， and the difference was statistically significant （P < 0.05）. The hospitalization days in the path group were （10.50 ± 2.50） days， which were shorter than those in the control group （12.70 ± 3.50） days. The hospitalization expense was （8.31 ± 0.71） million yuan， which was lower than that of the control group （8.92 ± 0.53） million yuan. The nursing satisfaction score was （93.90 ± 3.31）， which was higher than that of the control group （89.50 ± 4.21）， and the difference was statistically significant （P < 0.05）. Conclusion TIPS rehabilitation nursing path can effectively promote patients' rehabilitation， reduce medical costs and improve patients' satisfaction.

Corneal neovascularization （CNV） is a pathological condition characterized by the invasion of new blood vessels into the normally avascular corneal area from the corneal periphery， leading to severe vision loss and potentially blindness. Currently， surgical， physical， and pharmacological therapies are the main clinical approaches for treating CNV. Surgical treatment aims to remove abnormal vascular tissue or perform corneal transplantation to inhibit angiogenesis； however， it carries a risk of postoperative rejection. Physical therapy involves the direct application of non-invasive modalities， such as laser treatment， to the neovascularized area to suppress vascular growth. Nevertheless， this approach may cause damage to surrounding healthy tissues. Pharmacotherapy has recently become a research hotspot in CNV treatment due to its convenient administration. Clinically， the drugs used for CNV treatment mainly include anti-inflammatory agents， anti-VEGF drugs， and immunosuppressants， which inhibit CNV progression by targeting angiogenesis-related signaling pathways. However， these drugs often lead to drug resistance and toxic side effects. Therefore， there is an urgent need to develop more effective and safer therapeutic agents for CNV. This article reviews the current clinical treatment status of CNV and highlights recent advances in the use of small molecule extracts from traditional Chinese medicine for CNV therapy， aiming to provide potential candidate drugs and a scientific theoretical basis for clinical management of CNV.

Hypertension is an important risk factor that causes cardiovascular diseases and premature death in China. The pathogenesis of hypertension is complex and affected by numerous factors. Gut microbiota are involved in regulating many physiological processes of human body， making it a key factor in human health. Many studies have shown that there are close relationships between gut microbiota dysbiosis and the onset and progression of hypertension. Restoring gut microbiota homeostasis can reduce blood pressure. Thus， gut microbiota has become a potential therapeutic target for hypertension. Therefore， this article mainly reviews the connection between gut microbiota and hypertension， as well as the study progress of adjusting gut microbiota homeostasis for the prevention and treatment of hypertension.