Abstract:Objective To assess the level of Traditional Chinese Medicine(TCM)health cultural literacy among university students,providing references for interventions aimed at improving TCM health cultural literacy in this population.Methods By convenience sampling,403 college students enrolled in 2025 were selected as respondents and surveyed using the Chinese Citizens'TCM Health Cultural Literacy Questionnaire.The current status and influencing factors of university students'TCM health cultural literacy were analyzed.Results The respondents'rates for TCM health culture knowledge dissemina-tion,reading,action,and trust were 92.56%,100.00%,74.94%and 99.01%,respectively.The overall TCM health cul-tural literacy rate among respondents was 17.37%.Literacy levels in the five dimensions were:TCM public-appropriate methods 2.48%,basic TCM concepts 32.26%,TCM healthy lifestyle 43.92%,TCM cultural common-knowledge 45.66%,and TCM information comprehension ability 25.81%.Comparative analyses showed that female students scored significantly higher than males in basic TCM concepts,healthy lifestyle,and common-knowledge dimensions(P<0.05).Chinese Han students scored significantly higher than ethnic minority students in the healthy lifestyle dimension(P<0.05);medical-major students scored significantly higher than non-medical-major students in the public-appropriate methods(P<0.05).Conclusion College students demonstrate relatively high rates of knowledge dissemination,reading,and trust of TCM health culture,but translation into action remains insufficient.Government and universities should implement targe-ted,multidimensional measures for specific groups to promote action.Among the five dimensions of TCM health cultural literacy,public-appropriate methods scored lowest;differential training programs focused on key content and population subgroups are needed to comprehensively improve TCM health cultural literacy in college students.

Abstract:Objective To investigate the effects of a case management-based psychological outpatient service combined with health education on disease knowledge mastery and self-efficacy in elderly outpatients with coronary heart disease(CHD),providing references for outpatient management.Methods A total of 120 elderly CHD outpatients from Xichang People's Hospital(July 2022-December 2024)were enrolled.Based on the implementation timeline of the case management-based psychological service,60 patients receiving conventional health education(July 2022-September 2023)were assigned to the control group,while 60 patients receiving the combined intervention(October 2023-December 2024)formed the study group.The control group received routine outpatient health education;the study group received additional case management-based psychological intervention.Psychological status,disease knowledge mastery,self-efficacy,and degree of satisfaction with nursing were compared before and after the intervention.Results Before the intervention,no significant differences were noted between groups in scores for five disease knowledge subscales:dietary management,functional exercise,emo-tional management,medication adherence,and complication awareness(P>0.05).After the intervention,scores in all five subscales increased in both groups compared to pre-intervention levels,with the study group showing significantly higher scores than the control group(P<0.05).Pre-intervention scores for the five subscales of the Chinese General Self-Efficacy Scale(GSES)—negative affect,emotional agitation,physical activity,weather/environment,and safety behavior—showed no intergroup differences(P>0.05).Post-intervention scores for all five GSES subscales increased in both groups versus pre-intervention,with significantly higher scores in the study group(P<0.05).Pre-intervention scores for the three sub-cales of the Connor-Davidson Resilience Scale(CD-RISC)—tenacity,optimism,and strength—showed no intergroup differ-ences(P>0.05).Post-intervention,scores for all three CD-RISC subscales increased in both groups versus pre-interven-tion,with significantly higher scores in the study group(P<0.05).No significant intergroup differences were found in sat-isfaction scores for service environment and medical costs(P>0.05).However,the study group had significantly higher satisfaction scores for service efficiency,service attitude,and service technique than the control group(P<0.05).Conclu-sion The case management-based psychological outpatient service combined with health education helps improve disease knowledge,promote self-efficacy,ameliorate psychological status,and increase the degree of satisfaction with nursing in elderly CHD outpatients,warranting clinical promotion.

Abstract:Shared decision-making(SDM),as a collaborative process,emphasizes the partnership between patients(or their surrogate decision-makers)and clinicians in choosing treatment options that best align with the patient's preferences and val-ues.The advancement of cardiac interventional technology provides more therapeutic options for patients with cardiovascular diseases,but also increases the complexity of clinical decision-making.The application of SDM in cardiac interventional pro-cedures can enhance patients'degree of satisfaction and engagement,reduce decisional conflict,improve the quality of healthcare services,and lead to better health outcomes.This review systematically summerizes the application scenarios,implementation strategies,and core challenges of SDM in cardiac interventional procedures,with a focus on exploring its lo-calized development pathway within China's clinical practice environment.The goal is to promote the application of SDM in cardiac interventional therapy,thereby providing a practical framework for achieving patient-centered precision medicine.

Abstract:Objective To investigate general practitioners'(GPs')knowledge,attitudes,and management practices regarding comorbidity in older adults in general hospitals,providing empirical support for optimizing clinical pathways,resource allo-cation,multidisciplinary collaboration,and GP capacity-building.Methods A cross-sectional online questionnaire survey of GPs in general hospitals was conducted in September 2024.The questionnaire covered basic GP demographics,GPs'knowl-edge of comorbidity and polypharmacy in older adults,deprescribing practices,and training needs.Survey results were ana-lyzed descriptively.Results Only 21.12%of GPs reported being very familiar with comorbidity in older adults;36.34%of GPs frequently performed comprehensive geriatric assessment for multimorbid inpatients.The proactive implementation rate of deprescribing was 60.25%.After discharge,45.65%of patients with comorbidity received follow-up,and 79.51%of GPs considered training in geriatric comorbidity management to be highly necessary.Conclusion Compared with the past,GPs in general hospitals have improved their awareness of comorbidity in older adults,but clear gradients related to profes-sional title remain.Deficiencies persist in polypharmacy management and the implementation capacity for comprehensive geriatric assessment.There is an urgent need to optimize clinical pathways,strengthen GP training,and promote multidisci-plinary collaboration to improve comprehensive management of comorbidity in older patients.

Abstract:Objective To investigate the effects of biofeedback electrical stimulation combined with biofeedback relaxation training on pelvic floor muscle surface electromyographic(sEMG)signals and urinary leakage in patients with postpartum stress urinary incontinence(SUI),providing a reference for clinical practice.Methods From May 2023 to May 2024,319 postpartum SUI patients treated at Tongzhou District Maternal and Child Health Hospital were enrolled and assigned to a control group(n=152)and a study group(n=167)according to treatment method.The control group received biofeedback electrical stimulation;the study group received biofeedback relaxation training in addition to the control-group treatment.After 12 weeks of treatment,the two groups were compared for clinical efficacy and urinary leakage.Before treatment and after 12 weeks the following were compared:pelvic floor muscle work value,maximum peak value,activity value,maxi-mum urethral closure pressure(PMUC),functional urethral length(FUL),maximum urethral pressure(PMU),and scores on the Pelvic Floor Impact Questionnaire-7(PFIQ-7),International Consultation on Incontinence Questionnaire-Uri-nary Incontinence-Short Form(ICI-Q-SF),Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12(PISQ-12),and Generalized Anxiety Disorder scale-7(GAD-7).Results The overall clinical response rate in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences between groups in work value,maximum peak value,or activity value(P>0.05).After treatment,work value,maximum peak value,and activity value in both groups were significantly higher than before treatment,and values in the study group were higher than those in the control group(P<0.05).Before treatment,urinary leakage volume did not differ significantly between groups(P>0.05).After treatment,urinary leakage volume in both groups was signifi-cantly less than before treatment,and the study group had less leakage than the control group(P<0.05).Before treat-ment,PMUC,FUL,and PMU did not differ significantly between groups(P>0.05).After treatment,PMUC and PMU in both groups were significantly greater than before treatment,and values in the study group were greater than those in the control group(P<0.05);after treatment,FUL was significantly longer in both groups than before treatment and longer in the study group than in the control group(P<0.05).Before treatment,PFIQ-7,ICI-Q-SF,PISQ-12,and GAD-7 scores did not differ significantly between groups(P>0.05).After treatment,all these scores were lower than before treatment in both groups;the study group showed greater reductions in PFIQ-7 and GAD-7 than the control group,with statistically sig-nificant differences(P<0.05).Conclusion Biofeedback electrical stimulation combined with biofeedback relaxation training is effective for postpartum SUI:it notably improves pelvic floor muscle sEMG parameters and urinary leakage,optimizes urodynamic indexes,raises quality of life,and ameliorates psychological status.The combined approach is safe and merits clinical promotion.

Abstract:Vitiligo is a common autoimmune dermatosis characterized by skin depigmentation.Recent studies indicate that the impairment and functional decline of melanocyte stem cells(McSCs)serve as a critical basis for persistent depigmenta-tion and limited repigmentation in vitiligo.Under the influence of genetic factors,oxidative stress,and the interferon-γ(IFN-γ)-driven C-X-C motif ligand 9(CXCL9)/C-X-C motif ligand 10(CXCL10)-C-X-C motif chemokine receptor 3(CXCR3)signaling axis,McSCs become more vulnerable to damage,with markedly reduced capacities for survival,differ-entiation,and migration,thereby hindering the re-establishment of a stable pigment cell reservoir.This review summarizes the primary molecular and cellular mechanisms underlying McSC damage.Furthermore,by integrating current treatment modalities such as phototherapy,topical immunomodulators,stem cell transplantation,and novel biologics,it discusses the roles and limitations of these interventions in improving McSC function.Recent research trends reveal a shift in vitiligo treatment from merely suppressing immune responses towards comprehensive strategies that regulate the immune microen-vironment and promote stem cell regeneration.However,further investigation is warranted into the regenerative patterns of McSCs,the remodeling of the local microenvironment,and the pathways to achieving personalized therapy.This review aims to provide references for subsequent basic research and clinical innovation focusing on McSCs.

Abstract:Objective To explore the clinical efficacy of the modified bronchiectasis infection formula combined with convention-al Western medicine in the treatment of acute exacerbation of bronchiectasis,so as to provide a reference for clinical treatment.Methods A total of 120 patients with acute exacerbation of bronchiectasis,treated at the Yueyang Hospital of Integrated Tra-ditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine from October 2022 to December 2024,were selected as the study participants.The patients were randomly assigned to the combined group and the control group,with 60 patients in each group.The control group received Western medicine treatment,while the combined group was treated with the modified bronchiectasis infection formula in addition to the Western medicine treatment.The two groups were compared in terms of Traditional Chinese Medicine(TCM)symptom scores,procalcitonin(PCT)levels,C-reactive protein(CRP)levels,interleukin-6(IL-6)levels,erythrocyte sedimentation rate(ESR),forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC,and peak expiratory flow(PEF)before and after treatment.The occur-rence of adverse reactions was also compared between the two groups.Results Before treatment,there were no statistically significant differences in the main and minor symptom scores of TCM syndrome between the two groups(P>0.05).After treatment,the main and minor symptom scores in both groups were lower than those before treatment,and the combined group had lower scores than the control group,with statistically significant differences(P<0.05).The overall clinical efficacy rate was significantly higher in the combined group than in the control group(P<0.05).Before treatment,there were no sta-tistically significant differences in PCT,IL-6,CRP,and ESR levels between the two groups(P>0.05).After treatment,PCT,IL-6,CRP,and ESR levels were lower than before treatment in both groups,and the combined group had lower levels than the control group,with statistically significant differences(P<0.05).Before treatment,there were no statistically sig-nificant differences in FEV1,FVC,FEV1/FVC,and PEF between the two groups(P>0.05).After treatment,FEV1,FVC,FEV1/FVC,and PEF were higher than before treatment in both groups,and the combined group had higher values than the control group,with statistically significant differences(P<0.05).No statistically significant difference was noted in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion The modified bronchiectasis infection formula combined with conventional Western medicine is effective in treating patients with acute exacerbation of bronchiectasis with the syndrome of phlegm-heat obstructing the lung.This treatment can effectively improve clinical symptoms,reduce inflammatory responses,strengthen lung function,and has a high safety profile,warranting clinical promotion and application.

Abstract:Objective To evaluate the prognostic value of the aggregate index of systemic inflammation(AISI)combined with the confusion,urea,respiratory rate,blood pressure,age≥65(CURB-65)score in emergency severe pneumonia(SP)pa-tients,aiming to provide a reference for clinical treatment.Methods From October 2022 to February 2025,218 patients with SP admitted to Beijing Shijitan Hospital,Capital Medical University were enrolled.According to survival status within 28 days after initiation of inpatient treatment,patients were assigned to the death group(n=62)and the survival group(n=156).General clinical data,including use of mechanical ventilation,pathogen type,prophylactic antibiotic use,and Acute Physiology and Chronic Health Evaluation II(APACHE II)score,were collected.Receiver operating characteristic(ROC)curve analysis was used to evaluate predictive performance;comparisons of AUCs employed DeLong tests.Multivariate stepwise logistic re-gression was used to identify independent factors associated with poor prognosis.Results AISI and CURB-65 scores were sig-nificantly higher in the death group than in the survival group(P<0.05).ROC analysis showed that the combined AISI and CURB-65 AUC for predicting prognosis in emergency SP patients was 0.908,which was significantly higher than AISI alone(AUC=0.841)and CURB-65 alone(AUC=0.769;Z=9.472,11.957;all P<0.001).The death group had significantly higher proportions receiving mechanical ventilation,higher APACHE Ⅱ scores,and higher C-reactive protein(CRP)and ser-um creatinine levels than the survival group(P<0.05).Multivariate stepwise logistic regression analysis identified use of me-chanical ventilation(OR=2.303,95%CI:1.302-4.073),high APACHE Ⅱ score(OR=2.606,95%CI:1.523-4.460),elevated CRP(OR=2.038,95%CI:1.159-3.584),AISI≥1,406.94(OR=3.271,95%CI:1.792-5.970),and CURB-65 score≥3.11(OR=2.883,95%CI:1.725-4.819)as independent risk factors for poor prognosis in emergency SP pa-tients(P<0.05).Conclusion AISI and CURB-65 are independent predictors of prognosis in emergency SP patients and may serve as useful adjunctive prognostic indicators;the combined AISI and CURB-65 score assessment shows higher predictive val-ue and merits clinical application.

Abstract:Objective To explore the correlation between serum levels of fatty acid binding protein 4(FABP4)and throm-bospondin-1(TSP-1)and the disease severity and adverse pregnancy outcomes in patients with hypertensive disorders in preg-nancy(HDP),aiming to provide a reference for clinical decision-making.Methods This study included 202 patients diagnosed with HDP who were hospitalized in the Department of Obstetrics in Xingtai Central Hospital from August 2023 to June 2024.Clinical data such as patient age,gestational age at diagnosis,systolic blood pressure(SBP),diastolic blood pressure(DBP),serum FABP4,TSP-1,and 24-hour urinary protein were collected.Spearman's rank correlation was used to analyze the corre-lation between serum FABP4 and TSP-1 levels and disease severity.Multivariate logistic regression analysis was used to identi-fy factors influencing adverse pregnancy outcomes.Results There were statistically significant differences in SBP,DBP,and 24-hour urinary protein levels among the four groups(P<0.05).In the eclampsia group and severe preeclampsia group,the levels of FABP4 and TSP-1 were significantly higher than in the mild preeclampsia group(P<0.05).The mild preeclampsia group had significantly higher levels of FABP4 and TSP-1 compared to the hypertensive disorder group(P<0.05).Spearman correlation analysis showed a positive correlation between serum FABP4,TSP-1 levels,and disease severity(r=0.738,0.567;all P<0.001).Multivariate logistic regression analysis showed that severe preeclampsia,eclampsia,and high levels of FABP4 and TSP-1 were independent risk factors for adverse pregnancy outcomes(P<0.05).Conclusion Serum levels of FABP4 and TSP-1 increase with the aggravation of HDP,and their clinical detection helps in the early identification of high-risk patients.This can optimize stratified management strategies and improve pregnancy and neonatal outcomes.

Abstract:Objective To investigate the predictive value of the serum C-reactive protein/albumin ratio(CRP/ALB)and alpha-fetoprotein(AFP)for short-term prognosis in patients with acute-on-chronic liver failure(ACLF)receiving artificial liver ther-apy,aiming to provide a reference for clinical treatment.Methods Seventy-five patients diagnosed with ACLF who received artificial liver therapy during hospitalization at the General Hospital of Ningxia Medical University from April 2020 to October 2023 were enrolled.According to clinical outcomes at 12 weeks after treatment,patients were assigned to an improved group(n=52)and a deteriorated group(n=23).Pre-treatment clinical data were collected.Multivariate logistic regression analysis was used to analyze factors affecting short-term prognosis after artificial liver therapy.Receiver operating characteristic(ROC)curves and areas under the curve(AUC)were calculated to evaluate the predictive performance of CRP/ALB and AFP.Results Compared with the improved group,the deteriorated group had longer length of hospital stays,and higher incidences of hepatic encephalopathy and hepatorenal syndrome;Child-Turcotte-Pugh(CTP)scores,total bilirubin(TBIL),CRP,and CRP/ALB were all higher in the deteriorated group,with all differences being statistically significant(P<0.05).Multivariate stepwise logistic regression analysis indicated that AFP and CRP/ALB were independent risk factors for poor short-term prognosis(P<0.05).AFP predicted poor short-term prognosis after artificial liver therapy with an AUC of 0.802(95%CI:0.694-0.910),an optimal cutoff of 54.900 ng/mL,a sensitivity of 0.731,and a specificity of 0.870.CRP/ALB showed a higher predictive performance with an AUC of 0.889(95%CI:0.800-0.978),an optimal cutoff of 0.205,a sensitivity of 0.865,and a specificity of 0.826.Combining AFP and CRP/ALB into a predictive model further increased the AUC to 0.904(95%CI:0.814-0.994),with a sensitivity of 0.870 and a specificity of 0.923,indicating superior predictive performance when used together.Conclusion CRP/ALB and AFP can serve as effective predictors of short-term prognosis for ACLF pa-tients after artificial liver therapy,and their combined use further promotes predictive accuracy.

Abstract:Wound infection not only seriously affects patients'quality of life but also poses tremendous challenges and burdens to the healthcare system.Diagnostic ultrasound holds broad application prospects in the field of wound infection due to its char-acteristics of quantitative imaging,capability for continuous measurement,and non-invasiveness.This article systematically re-views the mechanisms of ultrasound technology in wound infection assessment,the sonographic changes associated with wound infection,and the role of ultrasound technology in wound infection management,aiming to provide a reference for the clinical use of diagnostic ultrasound technology in assessing wound infections.

Abstract:Objective To explore the relationship between the occurrence of major adverse cardiovascular events(MACE)after clopidogrel treatment in patients with coronary heart disease(CHD)following percutaneous coronary intervention(PCI)and the cytochrome P450 2C19(CYP2C19)gene polymorphism,aiming to provide a reference for clinical treatment.Methods This study included 111 patients with CHD who underwent PCI and were treated with clopidogrel and aspirin for 6 months af-ter surgery,admitted to the 901st Hospital of the Joint Logistics Support Force of the People's Liberation Army between Janu-ary 2022 and June 2024.Based on whether MACE occurred within 6 months of treatment,the patients were assigned to the MACE group(n=23)and the non-MACE group(n=88).General data were collected on the first day on admission,including sex,age,cardiac function classification,number of coronary artery stents,and left ventricular ejection fraction.CYP2C19 gen-otyping was determined using polymerase chain reaction(PCR).Multivariate logistic regression analysis was conducted to i-dentify factors influencing MACE occurrence after clopidogrel treatment in CHD patients.Results Among the CHD patients,37(33.33%)had the fast metabolizer CYP2C19 genotype,63(56.76%)had the intermediate metabolizer genotype,and 11(9.91%)had the slow metabolizer genotype.The distribution of CYP2C19 genotypes and metabolic phenotypes between the MACE and non-MACE groups showed statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that the CYP2C19 *2/*2 genotype(OR=5.573,95%CI:1.593-19.500),CYP2C19 *2/*3 genotype(OR=1.774,95%CI:1.051-2.993),and CYP2C19 slow metabolizer phenotype(OR=4.889,95%CI:2.386-10.018)were in-dependent risk factors for MACE occurrence after clopidogrel treatment(P<0.05).Conclusion CYP2C19 gene polymor-phism is closely correlated with the occurrence of MACE in CHD patients treated with clopidogrel.Slow metabolizers are more prone to clopidogrel resistance and have a higher risk of MACE occurrence.Clinically,the use of clopidogrel should be avoided in these patients.

Abstract:Objective To explore the expression levels of TdT-interacting factor 1(TDIF1)and microRNA-452-5p(miR-452-5p)in gastric cancer tissue and their relationship with clinical pathological features and prognosis in gastric cancer patients.Methods This study included 90 gastric cancer patients who underwent surgery at the First Affiliated Hospital of Xi'an Jiao-tong University from May 2018 to May 2021.Tumor tissue and normal gastric mucosal tissue at least 5 cm away from the tumor margin were collected during surgery.The relative expression levels of TDIF1 and miR-452-5p in these tissues were de-tected using quantitative real-time PCR(qRT-PCR).Pearson correlation analysis was performed to assess the correlation be-tween TDIF1 and miR-452-5p expression in gastric cancer tissue.Kaplan-Meier survival curves were used to analyze the rela-tionship between their expression levels and patient prognosis.Cox regression analysis was used to identify the factors affecting the prognosis of gastric cancer patients.Results The expression levels of TDIF1 and miR-452-5p in gastric cancer tissue were significantly higher than in normal tissue(P<0.05).The expression levels of TDIF1 and miR-452-5p in gastric cancer tissue were positively correlated(r=0.452,P<0.05).Significant differences were found in the expression levels of TDIF1 and miR-452-5p in gastric cancer tissue among patients with different differentiation levels,lymph node metastasis,and TNM staging(P<0.05).Kaplan-Meier survival curve analysis showed that the cumulative survival rates for patients with low expression of TDIF1 and miR-452-5p were 73.33%(33/45)and 75.56%(34/45),respectively,significantly higher than the 48.89%(22/45)and 46.67%(21/45)in those with high expression of both(χ2=5.708,7.993,P=0.017,0.005).Multivariate analysis in-dicated that low tumor differentiation(HR=2.159,95%CI:1.333-3.497),lymph node metastasis(HR=2.637,95%CI:1.479-4.701),TNM stage Ⅲ-IV(HR=2.117,95%CI:1.362-3.290),high expression of TDIF1(HR=2.448,95%CI:1.326-4.521),and high expression of miR-452-5p(HR=3.044,95%CI:1.635-5.666)were independ-ent risk factors for poor prognosis in gastric cancer patients(P<0.05).Conclusion TDIF1 and miR-452-5p are highly ex-pressed in gastric cancer tissue,possibly promoting carcinogenesis.Both are closely correlated with clinical pathological fea-tures and prognosis of gastric cancer.Clinically,TDIF1 and miR-452-5p can be used as potential molecular markers for assess-ing gastric cancer progression and prognosis,providing a reference for personalized treatment strategies.

Abstract:Objective To investigate the correlations of serum S100 calcium-binding protein A12(S100A12),red blood cell dis-tribution width(RDW),and Helicobacter pylori infection with the severity of acute upper gastrointestinal bleeding(AUGIB)in elderly patients,so as to provide a reference for clinical assessment and targeted treatment.Methods One hundred and twenty elderly patients with AUGIB admitted to the Second People's Hospital of Huai'an from June 2021 to June 2024 were en-rolled and classified by disease severity into a low-risk group(n=62)and a moderate-to-high-risk group(n=58).Serum S100A12 and RDW levels and Helicobacter pylori infection status were measured.Spearman correlation analysis was used to assess relationships between S100A12,RDW,and Helicobacter pylori infection with bleeding severity in elderly AUGIB pa-tients.Receiver operating characteristic(ROC)curve analysis was used to evaluate the value of S100A12,RDW,and Helico-bacter pylori infection for assessing disease severity in elderly AUGIB patients.Results There were no significant differences between the two groups in age,sex composition,body mass index or bleeding etiology(P>0.05).The moderate-to-high-risk group had significantly higher serum S100A12 and RDW levels and a higher detection rate of Helicobacter pylori than the low-risk group(P<0.05).Spearman correlation analysis showed that serum S100A12,RDW,and Helicobacter pylori detection rate were positively correlated with the severity of bleeding in elderly AUGIB patients(rs=0.534,0.305,0.360,respective-ly;all P<0.05).Logistic regression indicated that high S100A12,high RDW,and Helicobacter pylori infection were risk fac-tors for aggravated disease in elderly AUGIB patients(P<0.05).ROC analysis demonstrated that the areas under the curve(AUC)for S100A12,RDW and Helicobacter pylori infection alone and combined in evaluating disease severity were 0.809,0.676,0.664 and 0.943,respectively;their sensitivities were 65.52%,63.79%,82.76%and 89.66%,and specificities were 90.32%,74.19%,50.00%and 87.10%,respectively,with the combined assessment outperforming each indicator a-lone(Z=3.580,5.311,6.846;all P<0.05).Conclusion Serum S100A12,RDW,and Helicobacter pylori infection are closely associated with the severity of disease in elderly patients with AUGIB.Early combined testing of these indicators can improve the accuracy of severity assessment and provide an important reference for clinical management.

Abstract:Objective To evaluate the clinical effects of a multidimensional intervention based on empowerment theory on pa-tients undergoing surgery for thyroid cancer,with a view to informing perioperative nursing strategies for these patients.Meth-ods From March to December 2024,96 patients who underwent thyroidectomy for thyroid cancer at the Suzhou Hospital of Anhui Medical University were enrolled and randomly allocated by a random number table to a control group(n=48)and a study group(n=48).The control group received routine perioperative nursing;the study group received a multidimensional empowerment-based nursing intervention during the perioperative period.Postoperative recovery indicators,hope level,nega-tive emotional state,self-management initiative,and complication rates were compared between the two groups.Results The study group had a shorter time to first ambulation and shorter length of hospital stay than the control group,and lower Visual Analogue Scale(VAS)scores on postoperative day 1;the differences were statistically significant(P<0.05).Before interven-tion,there were no significant differences between groups in the three subscales of Herth Hope Index(HHI)—taking positive action,maintaining close relationships with others,and positive attitude toward present and future(P>0.05).After interven-tion,scores in all three HHI subscales increased in both groups compared with before intervention,and the study group scored significantly higher than the control group(P<0.05).Before intervention,no significant differences were found between groups in state anxiety and trait anxiety subscales of the State-Trait Anxiety Inventory(STAI;P>0.05);after intervention,these subscales of STAI decreased in both groups and were significantly lower in the study group than in the control group(P<0.05).Before intervention,there was no significant difference in the distribution of self-management initiative grades be-tween groups(Z=0.945,P=0.349);after intervention,the study group showed significantly superior self-management initi-ative grading compared with the control group(Z=3.715,P<0.001).Postoperative complication rates were 4.16%(2/48)in the study group and 8.33%(4/48)in the control group,with no statistically significant difference(χ2=0.711,P=0.399).Conclusion A multidimensional,empowerment-based perioperative intervention for patients undergoing thyroid canc-er surgery markedly improves hope level,relieves negative emotions,and strengthens self-management initiative,thereby pro-moting postoperative recovery.

Abstract:Objective To explore the diagnostic efficacy of multitarget fecal tumor gene combined detection for colorectal tumors,in order to provide a reference for clinical decision-making.Methods A total of 98 patients with suspected colorectal tumors who visited our hospital from January 1,2024,to February 28,2025,were selected as research participants.All par-ticipants underwent both colonoscopy and multitarget fecal tumor gene combined detection.Those with abnormal colonoscopy results underwent further pathological examination.The diagnostic efficacy,specificity,and sensitivity of multitarget fecal tumor gene combined detection for colorectal cancer were analyzed using receiver operating characteristic(ROC)curves,and logistic regression analysis was used to explore factors influencing the occurrence of colorectal cancer.Results Among the pa-tients with no abnormalities in colonoscopy,20 had negative gene test results.Among the 66 patients with advanced adenoma confirmed by colonoscopy and pathological examination,58 had positive gene test results,yielding a positive rate of 87.88%.Among the 9 patients diagnosed with colorectal cancer(7 early-stage cancers and 2 advanced cancers),1 early-stage cancer pa-tient had a negative gene test result,giving a positive rate of 88.89%.Among the 3 patients diagnosed with inflammatory pol-yps,all had negative gene test results.There was no statistically significant difference in the positive rate of multitarget fecal tumor gene combined detection among patients with advanced adenoma of different genders and age groups(P>0.05).Simi-larly,no statistically significant difference was found in the positive rate of multitarget fecal tumor gene combined detection a-mong colorectal cancer patients of different genders,ages,and clinical stages(P>0.05).ROC curve analysis showed that the area under the curve(AUC)for multitarget fecal tumor gene combined detection in diagnosing colorectal cancer was 0.822(95%CI:0.617-1.000),with a diagnostic sensitivity of 0.667 and specificity of 0.978.Logistic regression analysis revealed that chronic ulcerative colitis was an independent risk factor for the occurrence of colorectal cancer(OR=3.442,95%CI:1.467-8.074).Conclusion Multitarget fecal tumor gene combined detection has good diagnostic efficacy for advanced adeno-ma and colorectal cancer,with promising clinical application prospects.Additionally,chronic ulcerative colitis is a contributing factor for the occurrence of colorectal cancer,and clinical attention should be focused on patients with this condition.

Abstract:Objective To analyze the current status of postoperative acute stress disorder(ASD)in colorectal cancer(CRC)pa-tients and its correlation with fear of disease progression and psychological resilience.Methods A total of 160 CRC patients treated at the First Affiliated Hospital with Nanjing Medical University,Longjiang Branch from August 2023 to August 2024 were selected as the study participants.The Stanford Acute Stress Response Questionnaire(SASRQ),the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),and the Connor-Davidson Resilience Scale(CD-RISC)were used to assess postopera-tive ASD,fear of disease progression,and psychological resilience levels in CRC patients.Pearson correlation analysis was per-formed to explore the relationship between postoperative ASD,fear of disease progression,and psychological resilience in CRC patients.Multivariate linear regression was conducted to analyze the factors influencing the occurrence of ASD after surgery in CRC patients.Results The total score of the SASRQ in the 160 CRC patients was 38.67±4.55,with 71 patients(44.38%)scoring≥40.The total score of the FoP-Q-SF was 42.76±5.83,and the total score of the CD-RISC was 51.79±6.44.Postopera-tive ASD scores were positively correlated with FoP-Q-SF scores(r=0.579,P<0.001)and negatively correlated with CD-RISC scores(r=-0.453,P<0.001).Significant differences in SASRQ scores were observed among CRC patients of dif-ferent genders,education levels,per capita monthly income,TNM stages,and postoperative chemotherapy/radiotherapy sta-tuses(P<0.05).Multiple linear regression analysis showed that education level,per capita monthly income,postoperative chemotherapy/radiotherapy,FoP-Q-SF scores,and CD-RISC scores were influencing factors for the occurrence of ASD after surgery in CRC patients(P<0.05).Conclusion The incidence of postoperative ASD remains relatively high in CRC patients,and it is closely correlated with factors such as education level,per capita monthly income,postoperative chemotherapy/radio-therapy,fear of disease progression,and psychological resilience.Therefore,in clinical practice,early identification and screening of patients with these risk factors should be emphasized,and strategies for improving psychological resilience and managing fear of disease progression should be incorporated into comprehensive intervention strategies.This can help reduce the risk of ASD and improve patients'postoperative physical and mental recovery outcomes.

Abstract:Objective To explore the mechanism of action of the lipid-regulating and spot-reducing formula in the treatment of hyperlipidemia combined with atherosclerosis based on network pharmacology.Methods The TCMSP database was used to i-dentify the active ingredients and targets of the lipid-regulating and spot-reducing formula.Disease targets for hyperlipidemia and atherosclerosis were selected from the GeneCard and OMIM databases.The Venny 2.1 platform was used to obtain the in-tersection targets of the drug and the disease,and potential therapeutic targets for hyperlipidemia combined with atherosclerosis were predicted.The String database was used to construct a protein-protein interaction(PPI)network for the intersection tar-gets and identify the core targets.Gene ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses were performed on the intersection targets.Cytoscape 3.7.2 software was used to con-struct a"core active ingredient-core target-core pathway-disease"network.Molecular docking was performed to validate the in-teraction between core active ingredients and core targets.Results A total of 272 potential active ingredients were identified for the lipid-regulating and spot-reducing formula,which could act on 127 targets related to hyperlipidemia combined with athero-sclerosis.Overall,13 core targets,including AKT Serine/Threonine Kinase 1(AKT1),tumor necrosis factor(TNF),inter-leukin-6(IL-6),interleukin-1 beta(IL-1β),and TP53,were selected,which interacted with 29 core active ingredients,inclu-ding quercetin,β-sitosterol,and kaempferol.GO analysis showed 2,040 biological process(BP)entries,79 cellular component(CC)entries,and 202 molecular function(MF)entries.KEGG pathway enrichment analysis revealed 189 related signaling pathways,mainly involving the AGE-RAGE signaling pathway,lipid metabolism and atherosclerosis,and IL-17 signaling pathways.Molecular docking results showed that the binding affinity between quercetin and the core targets AKT1,TNF,IL-6,IL-1β,and TP53 was<-5.0 kcal/mol,suggesting good binding activity between the drug components and core tar-gets.Conclusion The lipid-regulating and spot-reducing formula has a multi-component,multi-target,and multi-pathway ac-tion profile in the prevention and treatment of hyperlipidemia and atherosclerosis.Network pharmacology analysis provides the-oretical support for its lipid-lowering and anti-atherosclerosis pharmacological mechanisms.

Abstract:Objective To explore the predictive value of Wells score combined with serum fibrinogen(FIB)and D-dimer(D-D)for deep vein thrombosis(DVT)after hip arthroplasty(HA)under general anesthesia,in order to provide a reference for clini-cal decision-making.Methods A total of 126 patients who underwent hip arthroplasty under general anesthesia at Xingtai Gen-eral Hospital,North China Medical Health Group,from January 2023 to December 2024 were included in the study.According to the ultrasound diagnosis results 14 days post-surgery,the patients were assigned to the DVT group(n=28)and the non-DVT group(n=98).Clinical data were collected,Wells score was calculated,and serum FIB and D-D levels were measured within 24 hours after admission.Spearman correlation analysis was used to assess the correlation between Wells score and ser-um FIB and D-D levels with DVT formation after HA surgery.Logistic regression analysis was performed to identify the risk factors for DVT formation after HA surgery.Receiver operating characteristic(ROC)curves were used to analyze the predic-tive value of Wells score and serum FIB and D-D levels for DVT formation after HA,and the area under the curve(AUC)was compared using the Delong test.Results There were no significant differences between the DVT group and the non-DVT group in average age,gender distribution,and surgical duration(P>0.05).The proportion of patients with a Wells score≥3 and the levels of serum FIB and D-D were significantly higher in the DVT group than in the non-DVT group(P<0.05).Spearman correlation analysis showed that both Wells score and serum D-D level were significantly positively correlated with DVT formation after HA(P<0.05).Logistic regression analysis revealed that a Wells score≥3(OR=32.267,95%CI:10.583-98.374),high serum FIB(OR=1.859,95%CI:1.176-2.939),and high D-D(OR=25.981,95%CI:1.553-434.640)levels were independent risk factors for DVT formation after HA surgery(P<0.05).Wells score and serum FIB and D-D levels showed predictive value for DVT formation after HA surgery,with AUCs of 0.842(95%CI:0.766-0.901),0.604(95%CI:0.513-0.690),and 0.626(95%CI:0.535-0.710),respectively.The AUC of the combined prediction model was 0.910(95%CI:0.846-0.954),which was significantly higher than the AUC of the single indicator prediction model(P<0.05).Conclusion The Wells score helps to screen high-risk populations,FIB reflects the degree of coagulation activation,and D-D indicates the dynamic changes of the fibrinolytic system.The combination of these three factors offers a more comprehensive assessment of DVT risk.

Abstract:Objective To investigate the relationship between the C-reactive protein-albumin-lymphocyte ratio(CALLY index)and disease outcome in patients with severe acute pancreatitis(SAP).Methods A convenience sample of 186 SAP patients ad-mitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2022 to December 2024 was included.Accord-ing to clinical outcome at 4 weeks after treatment,patients were allocated to an improvement group(n=126)and a deteriora-tion group(n=60).Collected data included age,body mass index(BMI),sex,etiology,presence of pleural effusion,Acute Physiology and Chronic Health Evaluation II(APACHE II)score and modified CT severity index(MCTSI)score on admis-sion,blood routine and biochemical indices,comorbidities,and levels of C-reactive protein(CRP),albumin(ALB)and lym-phocyte count(LYM).The CALLY index on admission was compared between the two groups.Receiver operating character-istic(ROC)curve analysis was used to assess the performance of the CALLY index in predicting disease outcome in SAP pa-tients,and multivariate logistic regression analysis was used to analyze factors influencing disease outcome.Results The CALLY index in the deterioration group was 0.25±0.04,lower than that in the improvement group(0.49±0.07),and the difference was statistically significant(t=24.686,P<0.001).ROC curve analysis showed that the admission CALLY index predicted disease outcome in SAP patients with an area under the curve(AUC)of 0.933(95%CI:0.888-0.983,P<0.001);the optimal cut-off value was 0.43,with a sensitivity and specificity of 85.73%and 86.40%,respectively.No signifi-cant differences were observed between the deterioration and improvement groups in age,BMI,sex,etiology,platelet count,aspartate aminotransferase,alanine aminotransferase levels,or proportions with comorbid diabetes,hypertension,or hypox-emia(P>0.05).The deterioration group had a higher proportion with pleural effusion,and higher APACHE Ⅱ and MCTSI scores on admission,white blood cell count,serum creatinine,and blood urea nitrogen than the improvement group,with sta-tistically significant differences(P<0.05).Multivariate analysis showed that APACHE Ⅱ score on admission(OR=2.314,95%CI:1.339-3.998),MCTSI score on admission(OR=2.168,95%CI:1.186-3.966),and CALLY index(OR=3.206,95%CI:1.877-5.474)were independent factors influencing disease outcome in SAP patients(P<0.05).Conclusion CCALLY index decline is closely correlated with poor disease outcome in SAP patients and may serve as an effective predictor of disease outcome and early prognosis in SAP.