Abstract:Objective To explore the nutritional status of elderly patients with inflammatory bowel disease(IBD)and its cor-relation with quality of life,and to analyze the factors influencing their nutritional status.Methods A total of 237 elderly IBD patients treated at our hospital from September 2020 to March 2024 were enrolled in the study.Nutritional risk was as-sessed using the Nutritional Risk Screening 2002(NRS 2002),and nutritional status of patients at risk of malnutrition was assessed using the Global Leadership Initiative on Malnutrition(GLIM)criteria.Based on the nutritional status,patients were allocated to malnutrition and non-malnutrition groups.The Chinese version of the Inflammatory Bowel Disease Ques-tionnaire(IBDQ)was used to assess the quality of life in both groups.Spearman correlation analysis was conducted to ex-amine the correlation between nutritional status and quality of life,and logistic regression analysis was used to explore the factors influencing malnutrition in elderly IBD patients.Results Among the 237 patients,140(59.07％)had nutritional risk and 97(40.93％)had no nutritional risk.Among the 140 patients with nutritional risk,58(41.43％)were malnour-ished and 82(58.57％)were not malnourished.The emotional ability,systemic symptoms,social ability,and intestinal symptoms subscale and the total score of IBDQ,were significantly lower in the malnutrition group compared to the non-mal-nutrition group(P＜0.05).Correlation analysis showed that the quality of life was significantly negatively correlated with malnutrition(P＜0.05).Among patients at risk of malnutrition,no significant differences were observed in age,gender,smoking history,lesion site,activity stage,course of the disease,disease severity,lymphocyte count,history of intestinal surgery,years of education,payment method,or marital status between the malnourished and non-malnourished groups(P＞0.05).However,significant differences were found between the two groups in hemoglobin,albumin,total cholester-ol,disease type,diabetes status,lesion site,endoscopic score,and IBDQ score(P＜0.05).Stepwise logistic regression a-nalysis revealed that low hemoglobin levels,low albumin levels,Crohn's disease,combined diabetes,lesion site in the co-lon,and higher endoscopic scores were independent risk factors for malnutrition in elderly IBD patients(P＜0.05).Conclu-sion Clinical attention should be given to monitoring hemoglobin and albumin levels in elderly IBD patients,especially those with Crohn's disease,combined diabetes,lesion site in the colon,and higher endoscopic scores.Nutritional support and management for these groups should be emphasized to further increase their quality of life.

Abstract:Objective To analyze the effects of transcranial direct current stimulation(tDCS)combined with progressive re-habilitation intervention on motor function,cognitive function,gait,and quality of life in patients with Parkinson's disease(PD),and to provide a reference for clinical decision-making.Methods A total of 202 PD patients treated at Xingtai Central Hospital from January 2019 to January 2024 were randomly assigned to a research group and a control group,with 101 pa-tients in each.The control group received tDCS combined with conventional intervention,and the research group received tDCS combined with progressive rehabilitation intervention;both groups were treated for 3 months.Cognitive function(Montreal Cognitive Assessment[MoCA]),motor function([Unified Parkinson's Disease Rating Scale Ⅲ(UPDRS-Ⅲ]),gait(gait speed,cadence,step width),mobility(timed up-and-go test[TUGT]-time,TUGT-number of freezing epi-sodes),and quality of life(Parkinson's Disease Questionnaire-39[PDQ-39])were compared before and after intervention.Results Before intervention,there were no significant differences between the two groups in MoCA or UPDRS-Ⅲ scores(P＞0.05).After 3 months of intervention,MoCA scores increased in both groups and were significantly higher in the re-search group than in the control group(P＜0.05);UPDRS-Ⅲ scores decreased in both groups and were significantly lower in the research group than in the control group(P＜0.05).Before intervention,there were no significant differences be-tween the two groups in gait speed,cadence,or step width(P＞0.05).After 3 months,gait speed,cadence,and step width increased in both groups and were significantly greater in the research group than in the control group(P＜0.05).Be-fore intervention,there were no significant differences between the two groups in TUGT-Ⅲ time or TUGT-Ⅲ number of freezing episodes(P＞0.05).After 3 months,TUGT-time was shortened in both groups and was significantly shorter in the research group than in the control group(P＜0.05);TUGT-number of freezing episodes decreased in both groups and were significantly fewer in the research group than in the control group(P＜0.05).Before intervention,there were no sig-nificant differences between the two groups in the eight-dimension scores(physical activity,activities of daily living,emo-tional well-being,stigma,social support,cognition,communication,bodily discomfort)of PDQ-39(P＞0.05).After 3 months,scores of these eight dimensions of PDQ-39 decreased in both groups and were significantly lower in the research group than in the control group(P＜0.05).Conclusion tDCS combined with progressive rehabilitation intervention yields marked benefits for PD patients,promoting motor and cognitive function,enhancing gait,and raising quality of life,which merits clinical promotion and application.

Abstract:Objective To observe changes in gut microbiota structure in pediatric sepsis patients in the pediatric intensive care unit(PICU)and analyze its association with patients' nutritional indicators,so as to provide a reference for clinical decision-making.Methods A total of 104 pediatric sepsis patients admitted to our hospital from January 2022 to June 2024 were enrolled.All pa-tients underwent gut microbiota profiling and nutritional indicator testing(albumin[ALB]and subcutaneous fat thickness),and the relationships between gut microbiota alterations and nutritional indicators were analyzed.Results Children with malnutrition had lower body mass and longer PICU length of stay than children with normal nutrition,and the differences were statistically significant(P＜0.05);no significant differences were noted in sex distribution,age,height,and other baseline characteristics between the two groups(P＞0.05).At the phylum level,the relative abundances of Firmicutes and Bacteroidetes were significantly lower in mal-nourished children than in well-nourished children(P＜0.05),while Proteobacteria relative abundance was significantly higher in malnourished children(P＜0.05).At the genus level,the relative abundances of Lactobacillus,Alistipes,and Coprococcus were significantly lower in malnourished children than in well-nourished children(P＜0.05),whereas Klebsiella,Esche-richia-Shigella,and Streptococcus were significantly more abundant in malnourished children(P＜0.05).Pearson correla-tion analysis showed that,at the phylum level,the relative abundances of Firmicutes and Bacteroidetes,and at the genus level,the relative abundances of Lactobacillus,Alistipes and Coprococcus were positively correlated with patients' ALB and subcutaneous fat thickness(P＜0.05);conversely,the relative abundance of Proteobacteria at the phylum level and Kleb-siella,Escherichia-Shigella,and Streptococcus at the genus level were negatively correlated with ALB and subcutaneous fat thickness(P＜0.05).Multiple linear regression analysis indicated that the relative abundances of Proteobacteria,Klebsiel-la,and Escherichia-Shigella were factors influencing patients' ALB levels(P＜0.05),and the relative abundances of Alis-tipes and Escherichia-Shigella were factors influencing patients' subcutaneous fat thickness(P＜0.05).Conclusion Gut mi-crobiota structure is disrupted among pediatric patients with sepsis in the PICU,and this disorder is associated with de-creased nutritional indicators(ALB levels)and subcutaneous fat thickness.Clinicians should monitor changes in gut micro-biota structure to prevent malnutrition risk and provide early interventions.

Abstract:Objective To investigate whether ICU nurses' occupational coping self-efficacy mediates the relationship between a healthy work environment and work engagement among ICU nurses in Zhuhai,and thereby provide evidence for policy-makers and nursing managers.Methods From 1 May to 30 June 2024,369 ICU nurses from Grade A secondary or above general hospitals in Zhuhai were surveyed using a questionnaire comprising a self-designed general information questionnaire,the American Association of Critical-Care Nurses-Healthy Work Environment Assessment Tool(AACN-HWEAT),the Occupational Coping Self-Efficacy Scale for Nurses(OCSEN),and the Utrecht Work Engagement Scale(UWES).Pearson correlation analysis and structural equation modeling with mediation analysis were used to examine relationships among healthy work environment,occupational coping self-efficacy,and work engagement,and to analyze the pathways and mecha-nisms linking the three variables.Results The total healthy work environment score among Zhuhai ICU nurses was 64.28±12.14,the total occupational coping self-efficacy score was 31.96±5.84,and the total work engagement score was 54.80±18.81.Work engagement was positively correlated with both healthy work environment and occupational coping self-efficacy(r=0.505 and r=0.609,respectively;P＜0.05).Structural equation modeling path analysis showed that healthy work environment(β=0.236,P＜0.05)and occupational coping self-efficacy(β=0.564,P＜0.05)each had direct positive effects on work engagement,and healthy work environment also indirectly affected work engagement through occupational coping self-efficacy,with an indirect effect of 0.303;the mediating effect of occupational coping self-efficacy accounted for 56.21％of the total effect.Conclusion ICU nurses in Zhuhai report healthy work environment and occupational coping self-efficacy at a slightly above-moderate level;both factors positively predict work engagement,and occupational coping self-efficacy partially mediates the relationship be-tween healthy work environment and work engagement.Hospital leaders and nursing managers can enhance nurses' work engagement-and thus support nursing quality and patient safety by improving ICU work environments and strengthening nurses' occupational coping self-efficacy.

Abstract:Objective To investigate the effect of inspiratory muscle training on postoperative pulmonary complications and rehabilitation in patients undergoing cardiopulmonary bypass(CPB)cardiac surgery.Methods From July 2023 to July 2024,110 patients who underwent CPB cardiac surgery in the Department of Cardiovascular Surgery at the First Affiliated Hospital of Air Force Medical University were enrolled and assigned,using a random number table,to a control group(n=55)and an observation group(n=55).During the perioperative period,the control group received routine perioperative re-spiratory training;the observation group received inspiratory muscle training in addition to routine respiratory training.In-terventions continued until postoperative day 14.Maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP)were measured preoperatively,on postoperative day 7,and on postoperative day 14.At the 4-week postoperative follow-up,6-minute walk distance(6MWD)and cardiopulmonary exercise test indicators(peak oxygen uptake[peak VO2],oxygen uptake at anaerobic threshold[AT],and slope of ventilatory equivalent for carbon dioxide[VE/VCO2])were measured.Pulmonary complications during the intervention period and within 4 weeks after discharge were recorded.Results Preoperatively,there were no significant differences between the two groups in MIP or MEP(P＞0.05).On postoperative day 7 and day 14,MIP in the observation group was significantly higher than in the control group(P＜0.05);there were no significant between-group differences in MEP on postoperative day 7 or day 14(P＞0.05).At the 4-week follow-up,the observation group had greater 6MWD,higher peak VO2 and AT,and lower VE/VCO2 than the control group,with all differences reaching statistical significance(P＜0.05).The incidence of postoperative pulmonary complications in the observation group was significantly lower than that in the control group(9.09％[5/55]vs.23.63％[13/55];x2=4.251,P=0.039).Conclusion Inspiratory muscle training effectively increases inspiratory muscle strength in patients undergoing CPB cardiac surgery,promotes cardiopulmonary functional recovery,and reduces the risk of postoperative pulmonary complications;it is worthy of clinical promotion.

Abstract:Objective To explore the relationship between maternal and infant health literacy,prenatal depression,and preg-nancy stress,and to examine the mediating effect of pregnancy stress between maternal and infant health literacy and prena-tal depression,with the aim of providing a reference for the development of more precise clinical interventions.Methods A total of 446 pregnant women from the two wings region of Chongqing(Southeast Chongqing and Northeast Chongqing re-gions)were surveyed using a self-designed general information questionnaire,the Edinburgh Postnatal Depression Scale(EPDS),a maternal and infant health literacy assessment questionnaire,and a pregnancy stress scale.Structural equation modeling was established using Amos to verify the relationships among the three variables.Results Overall,32.29％(144/446)of the participants were identified with prenatal depression.Significant differences were found in the prenatal de-pression detection rate among different groups based on region,years of education,occupation,sleep status,participation in health insurance,self-reported health status,whether they were multiparous,active learning of maternal and infant knowl-edge,participation in antenatal courses,and abnormal prenatal check-ups(P＜0.05).The maternal and infant health litera-cy assessment questionnaire scores,pregnancy stress scale scores,and EPDS scores were 46.64±22.87,0.67(0.28,0.97),and 7.00(4.00,7.00),respectively.Spearman's correlation analysis showed that EPDS scores were significantly negatively correlated with maternal and infant health literacy and its dimensions(P＜0.05),and significantly positively cor-related with pregnancy stress and its dimensions(P＜0.05).Maternal and infant health literacy had a negative predictive effect on both prenatal depression and pregnancy stress(β=-0.344 and β=-0.310,all P＜0.01);pregnancy stress had a positive predictive effect on prenatal depression(β=0.384,P＜0.05).Maternal and infant health literacy also affected prenatal depression through pregnancy stress(β=-0.119,P＜0.05),indicating that pregnancy stress plays a mediating role between maternal and infant health literacy and prenatal depression,with the mediating effect accounting for 25.7％of the total effect.Conclusion The incidence of prenatal depression in pregnant women of these regions remains high.Mater-nal and infant health literacy not only directly affects prenatal depression but also indirectly influences it through pregnancy stress.Medical staff can reduce the occurrence of prenatal depression by improving maternal and infant health literacy and alleviating pregnancy stress,thereby promoting both the physical and psychological health of pregnant women.

Abstract:Objective To explore the risk factors affecting the healing of closed drainage incisions after thoracoscopic surgery in lung cancer patients and to construct a nomogram prediction model.Methods Clinical data of 204 lung cancer patients who underwent thoracoscopic surgery at the First Affiliated Hospital with Nanjing Medical University from April 2023 to July 2024 were retrospectively analyzed.According to the presence or absence of poor wound healing(PWH),the patients were divided into a good healing group(n=158)and a poor healing group(n=46).Multivariate logistic stepwise regression analysis was used to identify the risk factors for PWH after thoracoscopic surgery in lung cancer patients,and a nomogram model was constructed based on the results.The predictive performance of the nomogram model for PWH was evaluated u-sing receiver operating characteristic(ROC)curves.Results Patients in the poor healing group were more likely to be aged ≥60 years,have combined diabetes,have drainage fluid ≥10 mL/24 hours at catheter insertion,have a drainage dura-tion ≥3 days,have a drainage tube indwelling time ≥5 days,have drainage fluid ≥10 mL/24 hours after tube removal,have incision infection,experience unplanned tube removal,and have lower serum albumin levels as compared with the good healing group,with all differences being statistically significant(P＜0.05).Multivariate analysis showed that combined dia-betes(OR=1.978,95％CI:1.398-2.798),large drainage volume at catheter insertion(OR=2.090,95％CI:1.471-2.968),long drainage duration(OR=2.132,95％CI:1.492-3.046),incision infection(OR=2.751,95％CI:1.812-4.177),and decreased albumin levels(OR=0.386,95％CI:0.253-0.591)were independent risk factors for PWH after thoracoscopic surgery in lung cancer patients(P＜0.05).The concordance index(C-index)of the nomogram model was 0.875(95％CI:0.823-0.927),the goodness-of-fit test x2=8.593,P=0.506,and the slope of the calibration curve was close to 1.The area under the curve(AUC)for the nomogram model in predicting PWH after thoracoscopic surgery in lung cancer patients was 0.856(95％CI:0.811-0.902),with a specificity of 68.98％and sensitivity of 91.03％.Conclusion The main factors influencing closed drainage incision healing after thoracoscopic surgery in lung cancer patients include combined diabetes,drainage volume at catheter insertion,drainage duration,incision infection,and serum albumin levels.The nomogram model based on these factors has high predictive value and can provide a reference for clinical prevention and intervention.

Abstract:Objective To analyze and screen three gene chip datasets related to Alzheimer's disease(AD)using bioinformat-ics methods and identify potential biomarkers associated with the disease through bioinformatics analysis and clinical sample verification,providing a reference for the diagnosis and treatment of AD.Methods Differential analysis of the GSE97760,GSE63060,and GSE63061 datasets was performed using the GEO2R online analysis tool.GO/KEGG enrichment analysis was conducted using the DAVID online database.A protein-protein interaction(PPI)network was constructed using the STRING database,and RT-qPCR was used to validate clinical samples.Additionally,AD patients who visited the Depart-ment of Neurology of the Third People's Hospital of Chengdu from 2022 to 2024 were selected for the study.Relevant infor-mation,including patient name,gender,age,medical history,and Montreal Cognitive Assessment(MoCA)scores,was collected through electronic medical records and on-site survey questionnaires.Twenty AD patients diagnosed clinically were randomly selected as the AD group,and 20 volunteers without cognitive impairment were selected as the control group.The expression levels of EIF3E,RPL39,RPS3A,RPS24,RPL31,TOMM7,RPL26,RPL7,RPL17,and EEF1B2 in peripher-al blood of patients in both groups were observed.Results Differential analysis identified 27 common differentially ex-pressed genes across the three datasets.GO enrichment and KEGG pathway analysis were performed,followed by construc-tion of a PPI network,which revealed 10 core genes:EIF3E,RPL39,RPS3A,RPS24,RPL31,TOMM7,RPL26,RPL7,RPL17,and EEF1B2.Functional analysis showed that these genes were mainly involved in processes such as cytoplasmic translation,rRNA processing,biogenesis of ribosomal subunits,and translation initiation.Detection of the mRNA relative expression levels of the 10 core genes showed that RPS3A,RPL26,RPL39,TOMM7,and EEF1B2 were upregulated,but the changes were not statistically significant(P＞0.05).RPL31,RPL7,and RPS24 were significantly upregulated(P＜0.05).EIF3E expression was downregulated,but the changes were not statistically significant(P＞0.05),and RPL17 ex-pression was significantly downregulated(P＜0.05).Conclusion Through bioinformatics analysis,this study identified core genes related to AD and validated them experimentally.These genes may play important roles in the pathogenesis of AD.These findings provide new insights for further research on AD and offer potential novel biomarkers for its clinical diag-nosis and treatment.

Abstract:Objective To investigate the clinical value of serum plasminogen activator inhibitor-1(PAI-1)and Toll-like recep-tor 4(TLR4)levels in predicting recurrence after seton placement for high-position complex anal fistulas.Methods A total of 110 patients with high-position complex anal fistulas treated with seton placement at Xi'an Hospital of Traditional Chinese Medicine from August 2022 to September 2023 were included in the study.The patients were followed for 12 months and assigned to a recurrence group(n=21)and a non-recurrence group(n=89)based on whether recurrence occurred during the follow-up period.Serum PAI-1 and TLR4 levels before surgery were measured using enzyme-linked immunosorbent as-say(ELISA).Receiver operating characteristic(ROC)curve analysis was used to assess the predictive value of serum PAI-1 and TLR4 levels for recurrence after seton placement.Multivariate logistic stepwise regression analysis was performed to explore the factors influencing recurrence after seton placement.Results The serum PAI-1 and TLR4 levels were signifi-cantly higher in the recurrence group than in the non-recurrence group(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for the combined prediction of recurrence after seton placement by serum PAI-1 and TLR4 levels was 0.918(95％CI:0.868-0.963),which was higher than the AUC for PAI-1 alone(AUC=0.781,95％CI:0.736-0.831)and TLR4 alone(AUC=0.865,95％CI:0.820-0.915),and the differences were statistically significant(Z=9.075,11.742,P＜0.001).The recurrence group had a significantly higher proportion of patients with a history of smok-ing,previous fistula surgery,and unclear internal opening compared to the non-recurrence group(P＜0.05).Multivariate logistic stepwise regression analysis showed that a history of fistula surgery(OR=2.492,95％CI:1.371-4.530),un-clear internal opening(OR=2.354,95％CI:1.262-4.390),elevated PAI-1(OR=3.487,95％CI:1.929-6.302),and elevated TLR4(OR=3.238,95％CI:1.813-5.784)were independent risk factors for recurrence after seton place-ment for high-position complex anal fistulas(P＜0.05).Conclusion Serum PAI-1 and TLR4 levels are significantly elevat-ed in patients with recurrence after seton placement for high-position complex anal fistulas.Serum PAI-1 and TLR4 levels have high predictive value for recurrence,and combined testing of both can markedly promote predictive efficacy.

Abstract:Objective To explore the factors influencing rehabilitation training compliance in elderly patients with knee osteo-arthritis(KOA)and construct a prediction model.Methods A total of 237 elderly KOA patients who underwent arthro-scopic surgery at the Department of Orthopedics,Beijing Chao-Yang Hospital,Capital Medical University,from February 2023 to February 2025 were selected for the study.Based on rehabilitation training compliance 3 months after surgery,the patients were assigned to a low compliance group(n=96)and a high compliance group(n=141).General data and scores from the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Tampa Scale of Kinesiophobia-17(TSK-17),and the Family Adaptation,Partnership,Growth,Affection,and Resolve Index Scale(APGAR)were com-pared between the two groups.Multivariate logistic regression analysis was used to identify independent factors associated with low rehabilitation training compliance in elderly KOA patients,and a nomogram was drawn to construct a prediction model for low rehabilitation training compliance in elderly KOA patients.Results There were statistically significant differ-ences between the two groups in living arrangements,monthly household income per capita,type of medical insurance,Kellgren-Lawrence grading,disease location,WOMAC score,flexion angle,extension limitation angle,TSK-17 score,and APGAR score(P＜0.05).Multivariate logistic regression analysis showed that living alone(OR:67.318,95％CI:1.859-2 437.699),self-paid medical expenses(OR:34.541,95％CI:1.295-921.494),high WOMAC score(OR:1.768,95％CI:1.388-2.252),large extension limitation angle(OR:2.311,95％CI:1.247-4.283),and high TSK-17 score(OR:1.204,95％CI:1.067-1.360)were independent risk factors for low rehabilitation training compliance in elderly KOA patients(P＜0.05).A nomogram prediction model was constructed based on seven independent factors and validated.The area under the receiver operating characteristic curve(AUC)of the model was 0.952(95％CI:0.916-0.975),with a sensitivity of 93.75％and specificity of 82.98％,indicating good discriminatory ability.The calibration curve showed good calibration of the prediction model.The decision curve analysis(DCA)suggested that the prediction model has high clinical application value.Conclusion Living arrangement,type of medical insurance,WOMAC score,flexion angle,extension limitation an-gle,TSK-17 score,and APGAR score are relevant risk factors influencing rehabilitation training compliance in elderly KOA patients.The risk prediction model developed in this study can accurately identify the risk of low rehabilitation training com-pliance in elderly KOA patients and has clinical application value.

Abstract:Objective To analyze risk factors for recurrence after Conbercept treatment in patients with diabetic macular ede-ma(DME)and to construct a risk prediction model to inform clinical decision-making.Methods From January 2021 to De-cember 2023,164 DME patients treated with Conbercept at our hospital were included and followed continuously for 12 months after treatment.Patients were grouped by recurrence status into a recurrence group(n=49)and a non-recurrence group(n=115).Multivariable stepwise logistic regression analysis was used to identify factors associated with recurrence after Conbercept,and a nomogram was constructed based on the regression results.The model's predictive value was evalu-ated for recurrence after Conbercept treatment in patients with DME.Results Compared with the non-recurrence group,the recurrence group had significantly higher proportions of patients aged≥60 years,retinal hyperreflective foci,and disor-ganization of the retinal inner layers(DRIL),and had greater pre-treatment foveal central retinal thickness(CRT);addi-tionally,the recurrence group had longer durations of diabetes and DME,and higher fasting blood glucose and glycosylated hemoglobin levels(P＜0.05).Multivariable analysis identified age ≥60 years(OR=1.968,95％CI:1.416-2.735),lon-ger DME duration(OR=2.465,95％CI:1.656-3.669),higher pre-treatment CRT(OR=2.335,95％CI:1.584-3.442),presence of retinal hyperreflective foci(OR=2.492,95％CI:1.671-3.717),and presence of DRIL(OR=3.016,95％CI:1.937-4.697)as risk factors for recurrence after Conbercept treatment(P＜0.05).The nomogram based on these variables showed a concordance index(C-index)of 0.897(95％CI:0.845-0.949).Internal validation indicated good model fit(x2=0.842,P=0.476)and calibration with the calibration curve close to the ideal.The nomogram model predicted an area under the curve(AUC)of 0.905(95％CI:0.853-0.957)for recurrence after Conbercept treatment in DME patients,with a specificity of 68.51％and a sensitivity of 92.74％.Conclusion Age,DME duration,pre-treatment CRT,retinal hyperreflective foci,and DRIL are associated with recurrence after Conbercept treatment in DME patients.The nomogram constructed from these factors demonstrates good predictive performance.

Abstract:Objective To explore the relationship between serum interleukin-8(IL-8)and interleukin-10(IL-10)expression levels and clinicopathological features and sentinel lymph node(SLN)metastasis in breast cancer patients,providing a refer-ence for clinical decision making.Methods From November 2022 to November 2024,152 patients with breast cancer trea-ted at a hospital in Shandong were enrolled.Clinical data were collected and serum IL-8 and IL-10 levels were measured.Se-rum IL-8 and IL-10 levels were compared across patients with different clinicopathological features.SLN biopsy was per-formed and patients were assigned to metastasis and non-metastasis groups.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of serum IL-8 and IL-10 for SLN metastasis.Univariate and multivariate logistic stepwise regression analyses were used to identify risk factors for SLN metastasis.Results Patients with tumor diameter ≥2 cm had higher serum IL-8 and IL-10 levels([72.18±19.91]ng/L and[66.65±16.53]ng/L)than those with tumor di-ameter＜2 cm([65.27±16.82]ng/L and[58.91±15.07]ng/L;t=2.192,2.887,P=0.030,0.004).Poorly differen-tiated tumors were associated with higher IL-8 and IL-10 levels([76.51±21.73]ng/L and[70.60±17.04]ng/L)ver-sus moderate-well differentiated tumors([64.95±16.74]ng/L and[59.16±15.81]ng/L;t=3.697,4.238,P＜0.001).Patients with vascular invasion had higher IL-8 and IL-10([73.26±19.43]ng/L and[67.82±14.59]ng/L)than those without vascular invasion([66.62±17.21]ng/L and[60.46±17.01]ng/L;t=2.232,2.824,P=0.027,0.005).Serum IL-8 and IL-10 levels in the metastasis group were significantly higher than in the non-metastasis group(P＜0.05).ROC a-nalysis showed that combined detection of serum IL-8 and IL-10 for predicting SLN metastasis yielded an area under the curve(AUC)of 0.904(0.859-0.954),which was significantly higher than IL-8 alone(AUC=0.769[0.724-0.819])and IL-10 alone(AUC=0.817[0.772-0.867];Z=10.247,9.612,P＜0.05).Univariate analysis indicated that tumor diameter,histological differentiation,vascular invasion,IL-8,and IL-10 were associated with SLN metastasis(P＜0.05).Multivariate analysis identified low differentiation(OR=2.497,95％CI:1.292-4.824),vascular invasion(OR=2.784,95％CI:1.599-4.849),IL-8 ≥71.50 ng/L(OR=3.165,95％CI:1.857-5.393)and IL-10 ≥66.40 ng/L(OR=3.367,95％CI:2.007-5.649)as independent risk factors for SLN metastasis in breast cancer patients(P＜0.05).Con-clusion Serum IL-8 and IL-10 are highly expressed in breast cancer patients,and their levels are closely associated with tumor di-ameter,histological differentiation,vascular invasion,and SLN metastasis.Serum IL-8 and IL-10 can serve as clinical indicators for predicting SLN metastasis in breast cancer,and combined detection shows superior predictive performance.

Abstract:Patients with type 2 diabetes mellitus(T2DM)and hypertension(HTN)face a substantially increased risk of ma-jor adverse cardiovascular events(MACE),and that risk is further elevated when both conditions coexist.This article sys-tematically reviews advances in risk prediction models for MACE in patients with T2DM and HTN,and analyzes the evolu-tion from traditional prediction models to more recent models as well as their advantages and limitations in clinical applica-tion.The literature indicates that most existing prediction models are derived from data collected at large medical centers or from clinical trials,which limits their applicability in primary care settings.Future research should focus on developing sim-plified prediction tools based on routine clinical indicators,constructing localized models suitable for primary medical condi-tions in China,and strengthening the assessment of the synergistic effects of coexisting T2DM and HTN on MACE risk,so as to improve the clinical applicability of MACE risk prediction models,ultimately reduce the incidence of MACE,improve patient outcomes,and lessen the social medical burden.

Abstract:Objective To explore the clinical effect of three-dimensional balance spinal manipulation combined with spinal sta-bility training in adolescents with idiopathic scoliosis,with the aim of providing a reference for clinical treatment.Methods This study selected 102 adolescents with idiopathic scoliosis treated between January 2023 and December 2024.The control group received conventional treatment and spinal stability training guidance.The study group received three-dimensional bal-ance spinal manipulation in addition to the treatment in the control group.Both groups underwent 4 weeks of intervention.The Cobb angle,pelvic tilt angle,lumbar flexion and extension muscle strength,and lumbar flexion and extension range of motion before and after treatment were compared between the two groups.The clinical effectiveness of both groups was also compared.Results The overall response rate of treatment in the study group was significantly higher than in the control group(P＜0.05).Before treatment,no significant differences were found between the two groups in Cobb angle and pelvic tilt angle(P＞0.05).After treatment,both groups showed a reduction in Cobb angle and pelvic tilt angle,and the study group had a smaller angle compared to the control group,with statistically significant differences(P＜0.05).Before treat-ment,no significant differences were noted between the two groups in flexion and extension muscle strength or range of mo-tion(P＞0.05).After treatment,both groups showed improvements in flexion and extension muscle strength and range of motion,with the study group outperforming the control group,and the differences were statistically significant(P＜0.05).Before treatment,no significant differences were observed in the Scoliosis Research Society-22(SRS-22)scores for function-al activities,pain,self-image,and mental health between the two groups(P＞0.05).After treatment,the SRS-22 for functional activities,pain,self-image,and mental health subscales were all higher than before treatment,with the study group scoring higher than the control group,and the differences were statistically significant(P＜0.05).Conclusion The combination of three-dimensional balance spinal manipulation and spinal stability training significantly improves the spinal morphology,lumbar function,and quality of life in adolescents with idiopathic scoliosis through the synergistic effect of structural correction and functional remodeling,warranting clinical promotion and application.

Abstract:Objective To explore the effects of spring airborne pollen concentration,meteorological factors,and air quality on the symptoms of allergic rhinitis(AR)patients in Nanchong and clarify the relationship between environmental factors and AR symptoms.Methods A total of 1,169 AR patients who visited the outpatient service of the Department of Otorhinolar-yngology & Head and Neck Surgery at the Affiliated Hospital of North Sichuan Medical College during the months of Feb-ruary to April in each of the years 2022,2023,and 2024 were selected as the research participants.The AR symptoms were quantitatively assessed using the four-point symptom score scale,and the environmental data of the same period were col-lected.The correlation between AR symptoms and environmental factors was analyzed.Results The average daily tempera-ture in Nanchong during spring ranged from 7.19 to 27.27℃,the average daily air pressure was 973.79 hPa,the average daily relative humidity was 73.00％RH,the average daily maximum wind speed was 7.20 m/s,the average PM2.5 concen-tration was 33.00 μg/m3,the average O3 concentration was 90.00 μg/m3,and the average airborne pollen concentration was 344.00 particles/1,000 mm2.Stepwise regression analysis showed that airborne pollen concentration had a positive effect on the total nasal symptom score(TNSS)of patients(Beta=0.089,P=0.003),while the daily maximum wind speed had a negative effect on TNSS(Beta=-0.068,P=0.022).The daily minimum temperature(Beta=-0.216,P＜0.001)and the daily average relative humidity(Beta=—0.122,P＜0.001)had negative effects on the total ocular symp-tom score(TOSS)of patients.Multi-factor logistic regression analysis found that environmental factors exerted influence on nasal symptoms in AR patients in two ways.First,the effect on nasal congestion symptoms:Increased daily relative humid-ity was a risk factor for moderate-to-severe nasal congestion(OR=1.018 930,95％CI:1.002 498-1.035 632,P=0.024);increased PM2.5 levels were a risk factor for moderate-to-severe nasal congestion(OR=1.010 691,95％CI:1.001 288-1.020 181,P=0.026);increased airborne pollen concentration was a risk factor for moderate-to-severe nasal congestion(OR=1.000 080,95％CI:1.000 009-1.000 151,P=0.028);increased O3 concentration was a risk factor for moderate-to-severe nasal congestion(OR=1.009 158,95％CI:1.002 721-1.015 635,P=0.005).Second,the effect on nasal itching symptoms:Increased daily relative humidity was a risk factor for moderate-to-severe nasal itching(OR=1.013 965,95％CI:1.000 590-1.027 519,P=0.041);increased PM2.5 levels were a risk factor for moderate-to-severe nasal itching(OR=1.010 234,95％CI:1.002 640-1.017 886,P=0.008);increased airborne pollen concentration was a risk factor for moderate-to-severe nasal itching(OR=1.000 216,95％CI:1.000 125-1.000 307,P＜0.001).Meanwhile,environ-mental factors showed an impact on ocular symptoms in AR patients in two aspects.First,the effect on eye itching symp-toms:Increased daily temperature was a protective factor for moderate-to-severe eye itching,with an OR(95％CI)of 0.914 394(0.872 503-0.958 296);increased PM2.5 levels were a risk factor for moderate-to-severe eye itching,with an OR(95％CI)of 1.016 980(1.009 132-1.024 888).Second,increased daily temperature,daily air pressure,daily relative humidity,and airborne pollen concentration were protective factors for moderate-to-severe tearing,with OR(95％CI)values of 0.894 713(0.806 918-0.992 059),0.944 451(0.893 213-0.998 628),0.895 795(0.864 778-0.927 925),and 0.999 283(0.998 837-0.999 729),respectively.Conclusion In Nanchong,during the spring season,airborne pollen concentration,PM2.5 levels,and meteorological factors(such as daily temperature and relative humidity)significantly affect the symptoms of AR patients.Increased pollen concentration and PM2.5 are important triggers for AR symptom exacerbation,while mete-orological factors indirectly affect AR symptoms by influencing the spread of pollen.This study highlights the substantial role of environmental factors in the onset of AR and provides scientific evidence for the prevention and treatment of AR.

Abstract:Objective To evaluate the effect of a solution-focused approach on cancer-related fatigue in patients after surgery for thyroid cancer(TC)and to provide evidence for clinical practice.Methods From June 2023 to July 2024,150 patients who underwent radical surgery for TC at The First Affiliated Hospital with Nanjing Medical University were enrolled and assigned to a routine care group(n=75)and a study group(n=75)using a random-number table.The routine group re-ceived standard postoperative care;the study group received the solution-focused intervention in addition to routine care.In-terventions continued until one month after discharge.Assessments were performed before intervention(postoperative day 1)and after intervention(one month after discharge)using the Chinese version of the Revised Piper Fatigue Scale(RPFS),the Exercise of Self-care Agency scale(ESCA),the Strategies Used by People to Promote Health-Cancer Self-Management Efficacy scale(SUPPH),and the European Organization for Research and Treatment of Cancer Quality of Life Question-naire-Core 30(EORTC QLQ-C30).Degree of satisfaction with nursing was recorded at one month after discharge.Results Before intervention,there was no significant difference in behavioral,affective,perceived,and cognitive fatigue scores in the RPFS between the 2 groups(P＞0.05).After intervention,the behavioral,emotional,perceived,and cognitive fatigue scores in the RPFS of patients in the 2 groups were lower than those before the intervention,and the study group was lower than the conventional group,and the differences were statistically significant(P＜0.05).Before intervention,there was no significant difference in ESCA and SUPPH scores between the two groups(P＞0.05).After intervention,ESCA and SUP-PH scores in the two groups were higher than those before intervention,and the study group was higher than the conven-tional group,and the differences were statistically significant(P＜0.05).Before intervention,there was no significant difference in cognitive,emotional,role,social,and physical function scores in EORTC-QLQ-C30 between the 2 groups(P＞0.05).After intervention,the cognitive,emotional,role,social,and physical function scores in the EORTC-QLQ-C30 were higher in the 2 groups than before the intervention,and were higher in the study group than in the conventional group,and the differences were statistically significant(P＜0.05).The degree of satisfaction with nursing in the study group was significantly higher than that in the routine group(P＜0.05).Conclusion The application of a solution-focused approach to postoperative care for patients with TC effectively reduces cancer-related fatigue,strengthens self-care ability and self-efficacy,improves quality of life,and increases patients' degree of satisfaction with nursing.This intervention mer-its wider clinical adoption.

Abstract:Objective To develop a nomogram model for individualized prediction of residual pain risk in patients after percu-taneous kyphoplasty(PKP),providing references for prevention and intervention of this population.Methods A total of 210 osteoporotic vertebral compression fracture(OVCF)patients undergoing PKP(June 2021-August 2023)were alloca-ted to residual pain(n=41)and non-residual pain(n=169)groups based on the absence or presence of pain status within six months postoperatively.Multivariate logistic stepwise regression analysis was employed to identify influencing factors,and a nomogram was constructed.Receiver operating characteristic(ROC)curves were used to evaluate the predictive per-formance of this model.Results The residual pain group had higher age,body mass index;higher proportions of≥2frac-tured vertebrae,thoracolumbar fascia injury,intravertebral cleft sign,and clustered bone cement distribution;but lower bone mineral density and bone cement volume per vertebra than the non-residual pain group,with statistically significant differences(P＜0.05).Multivariate logistic stepwise regression analysis identified bone mineral density(OR=2.450,95％CI:1.630-3.683),thoracolumbar fascia injury(OR=2.113,95％CI:1.479-3.018),intravertebral cleft sign(OR=2.843,95％CI:1.844-4.385),bone cement volume per vertebra(OR=2.368,95％CI:1.587-3.532),and bone cement distribution(OR=3.149,95％CI:1.983-5.001)as independent influencing factors(P＜0.05).The nomo-gram model for individualized prediction of residual pain risk in patients after PKP achieved a C-index of 0.881(95％CI:0.823-0.934).The area under the curve(AUC)of the nomogram for predicting residual pain was 0.874(95％CI:0.821-0.927),with 68.16％specificity and 91.47％sensitivity.Conclusion Bone mineral density,thoracolumbar fascia injury,intraver-tebral cleft sign,bone cement volume per vertebra,and bone cement distribution are independent factors influencing residual pain af-ter PKP.The constructed nomogram established based on the above factors demonstrates high predictive value.

Abstract:Objective To investigate the relationship between kinesiophobia levels,Heart Health Self-Efficacy and Self-Man-agement Scale(HH-SESM)scores,and major adverse cardiovascular events(MACE)in patients with stable coronary arter-y disease(SCAD),providing references for reducing MACE risk.Methods A total of 437 SCAD patients admitted to the First Affiliated Hospital of Xinjiang Medical University from October 2021 to October 2022 were followed for 24 months via telephone and outpatient return visit to record MACE.Patients were assigned to MACE(n=78)and non-MACE(n=359)groups based on the presence or absence of MACE.General data,Tampa Scale for Kinesiophobia Swedish Version for the Heart(TSK-SV Heart)scores,and HH-SESM scores were compared.Pearson correlation was used to analyze TSK-SV Heart and HH-SESM score relationships.ROC curves were employed to evaluate their predictive value for MACE risk,and multivariate logistic regression was adopted to identify MACE influencing factors.Results No significant differences were noted in gender or age between groups(P＞0.05).The MACE group had significantly higher proportions of hypertension,diabetes,dyslipidemia,and smoking history(P＜0.05).TSK-SV Heart scores were significantly higher and HH-SESM scores were significantly lower in the MACE group as compared with the non-MACE group(P＜0.05).Pearson correlation analysis showed a negative correlation between TSK-SV Heart and HH-SESM scores(r=-0.192,P＜0.05).ROC analy-sis revealed area unoler the curve(AUC)values of 0.892(0.851-0.933)for TSK-SV Heart scores,0.962(0.937-0.989)for HH-SESM scores,and 0.986(0.965-0.997)for their combination.HH-SESM scores alone and combined demonstra-ted superior predictive efficacy versus TSK-SV Heart scores alone(Z=5.782,7.214;P=0.016,0.004).Multivariate a-nalysis identified TSK-SV Heart scores≥38.01(OR=2.102,95％CI:1.504-2.939)and HH-SESM scores＜49.98(OR=0.556,95％CI:0.423-0.730)as influencing factors of MACE(P＜0.05).Conclusion TSK-SV Heart and HH-SESM scores closely associate with MACE in SCAD patients.Combined assessment provides superior predictive value ver-sus either measure alone.Enhanced risk factor monitoring and dynamic evaluation of kinesiophobia,self-efficacy,and self-management are crucial for early identification and targeted intervention in high-risk patients of MACE.

Abstract:Objective To investigate the application effect of the Foley catheter combined with oxytocin in labor induction for full-term advanced maternal age pregnancy,providing references for clinical treatment.Methods A total of 178 full-term advanced maternal age puerpura admitted to Chongqing Jiangjin Maternal and Child Health Hospital from March 2023 to March 2025 were selected and randomly assigned to the oxytocin group(n=89)and the Foley combination group(n=89).The oxytocin group received oxytocin for labor induction;the Foley combination group received a Foley catheter combined with oxytocin.Cervical Bishop scores before and 12 hours after intervention were compared between groups.Duration from induction to regular contractions and total labor duration in vaginally delivering women,delivery modes,and maternal-neo-natal outcomes were analyzed.Results Before intervention,no significant difference was noted in cervical Bishop scores be-tween groups(P＞0.05).At 12 hours post-intervention,Bishop scores increased significantly in both groups versus pre-in-tervention,with significantly higher scores in the Foley combination group than in the oxytocin group(P＜0.05).The Fo-ley combination group had significantly higher vaginal delivery rates(P＜0.05)and significantly lower cesarean section rates(P＜0.05)than the oxytocin group.Duration from induction to regular contractions and total labor duration were signifi-cantly shorter in the Foley combination group(P＜0.05).Postpartum blood loss was decreased and cervical laceration inci-dence was lower in the Foley combination group,with statistically significant differences(P＜0.05).Neonatal Apgar scores were significantly higher in the Foley combination group than the oxytocin group(P＜0.05).Conclusion For labor induction in full-term advanced maternal age pregnancy,the Foley catheter combined with oxytocin effectively promotes cervical ripeness,shortens labor duration,and reduces cesarean section rates,with high safety profiles,warranting clinical promotion.

Abstract:Objective To evaluate the effect of an"Internet+stroke nursing"continuing nursing care model based on the In-formation-Motivation-Behavioral skills(IMB)theory on rehabilitation outcomes in patients with stroke,and to provide evi-dence for clinical practice.Methods Patients who visited the Fifth Affiliated Hospital of Zunyi Medical University,Zhuhai,in 2023 were selected as the control group(n=93),and those who visited in 2024 as the intervention group(n=98).The control group received routine nursing care,while the intervention group was given information-based transitional care inter-vention constructed based on the IMB theory on the basis of routine nursing care.Patients were assessed before discharge,and at 3 and 6 months after discharge,using the Barthel Index(BI),the Stroke-Specific Quality of Life scale(SS-QOL),the Fugl-Meyer Assessment(FMA),a stroke prevention/treatment knowledge questionnaire,the General Self-Efficacy Scale(GSES),and the Stroke Functional Questionnaire of Exercise Adherence(EAQ).Results Before discharge,compari-sons between the two groups showed no statistically significant differences in FMA,SS-QOL,the stroke prevention/treat-ment knowledge questionnaire,GSES,or EAQ scores(P＞0.05);the BI score in the intervention group was lower than that in the control group,and this difference reached statistical significance(P＜0.05).Generalized estimating equation an-alyses of the multiple outcome measures(fully adjusted models)indicated that some baseline(pre-discharge)characteristics independently influenced intervention effects:patients with higher National Institutes of Health Stroke Scale(NIHSS)scores showed smaller improvements in FMA,BI and SS-QOL;patients with higher educational level showed greater im-provement on the stroke prevention/treatment knowledge questionnaire;older patients had smaller gains on the knowledge questionnaire but showed slight increases on the GSES;and male patients showed less improvement in knowledge mastery than female patients.Conclusion The IMB theory-based"Internet+stroke nursing"continuing nursing care model can produce marked and sustained improvements across multidimensional rehabilitation outcomes in stroke patients,and these effects re-main robust after adjustment for covariates.