Objective To investigate the changes in choroidal blood flow density in the macular region after undergoing phacoemulsification combined with intraocular lens(IOL )implantation in patients with type 2 diabetes mellitus (T2DM), and analyze its correlation with postoperative visual prognosis and macular complications. Methods A retrospective study was conducted that a total of 84 T2DM patients (84 eyes) who underwent unilateral phacoemulsification combined with intraocular lens implantation in our hospital from October 2022 to October 2025 were included as the diabetic group. Based on the presence and stage of diabetic retinopathy (DR), the diabetic group was divided into non-diabetic retinopathy group (NDR group) and mild-to-moderate non-proliferative DR group (NPDR group). A control group of 78 patients (78 eyes) with no history of diabetes and undergoing the same surgery at the same time was selected. Preoperative, at 1 week, 1 month, and 3 months postoperatively measurements of choroidal capillary layer blood flow density in the macular region, best corrected visual acuity (BCVA), and central macular thickness (CMT) were compared between the two groups. Repeated measures analysis of variance (ANOVA), independent samples t-test, and Pearson correlation analysis were employed. Results At 1 week, 1 month, and 3 months postoperatively, blood flow density in the subcentral, pericentral, and overall macular regions decreased compared to preoperative levels in all groups, the decline was more pronounced in the diabetic group than the control group (P<0.0125 after adjustment for bias) and greater in the NPDR group than in the NDR group. The incidence of postoperative macular edema in the diabetic group was 14.29%, significantly higher than that in the control group (2.56%) (P=0.010). In the diabetic group, the magnitude of blood flow at 1 week postoperatively decline showed significant correlations with preoperative HbA1c levels (P=0.004), CMT thickness at 1 month postoperatively (P<0.001), and LogMAR BCVA at 3 months postoperatively (P=0.005). Conclusion Diabetes significantly exacerbates the reduction in choroidal blood flow in the macular region following cataract surgery, with this effect being more pronounced in patients with mild-to-moderate NPDR. Early postoperative choroidal blood flow decline was significantly correlated with increased central macular thickness and worse postoperative visual acuity. Early postoperative choroidal blood flow monitoring holds significant clinical value for diabetic patients, particularly those complicated by DR.

Objective A clinical study on the efficacy of sodium aescinate combined with infrared therapy for postoperative limb swelling and functional rehabilitation in patients with femoral neck fracture. Methods A total of 150 patients with femoral neck fracture underwent surgery in our hospital from May 2022 to May 2024 were retrospectively analyzed and divided into a routine group (n=80) and a combination group (n=70) according to different treatment protocols. Clinical efficacy, limb swelling (swelling area, swelling degree score), visual analog scale (VAS) for pain, Harris hip score(HHS), serum markers [interleukin-6 (IL-6), C-reactive protein (CRP)], and adverse reactions before and after treatment between the two groups were compared. Results After treatment, the combined group showed higher clinical efficacy than the conventional group (P<0.05); The swelling area and swelling degree scores in the combined group were lower than those in the conventional group (both P<0.05); The VAS score was lower (P<0.05) and the HHS score was higher (P<0.05) in the combined group compared to the conventional group; The levels of IL-6 and CRP in the combined group were lower than those in the conventional group (both P<0.05), and the incidence of adverse reactions in the combined group was lower than that in the conventional group (P<0.05). Conclusion The combined regimen can improve clinical outcomes, effectively reduce limb swelling and pain, enhance hip joint function and activities of daily living, lower serum inflammatory markers, and demonstrates good safety in patients after femoral neck fracture surgery.

Objective To investigate the clinical application value of multi-parameter spectral CT imaging in predicting lymph node metastasis of gastrointestinal malignancies, aiming to improve the accuracy of preoperative diagnosis of lymph node metastasis. Methods A total of 50 patients with pathologically confirmed gastrointestinal malignancies treated at Mudanjiang Hospital of Beidahuang Group from October 2024 to June 2025 were enrolled. According to postoperative pathological results, patients were divided into metastatic lymph node group and non-metastatic lymph node group. All patients underwent abdominal and pelvic plain scan and contrast-enhanced spectral CT scans within 2 weeks before surgery. Conventional CT features (long diameter, short diameter, boundary, difference between venous phase CT value and plain CT value) and spectral CT parameters (iodine concentration in arterial phase, iodine concentration in venous phase, slope of spectral curve) were analyzed and compared between the two groups. Independent predictors were identified through Logistic regression analysis. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of individual parameters and their combination. Results The metastatic lymph node group showed significantly higher iodine concentration in arterial phase, iodine concentration in venous phase, and spectral curve slope compared with the non-metastatic group, with statistically significant differences (P<0.05). Iodine concentration at 40-140 keV single energy levels and spectral curve slope were significantly higher in the metastatic group than in the non-metastatic group (P<0.05), with the most significant difference observed at low energy level (40 keV). Logistic regression analysis revealed that iodine concentration in arterial phase, iodine concentration in venous phase, and spectral curve slope were independent predictors of lymph node metastasis (P<0.05). The area under the ROC curve (AUC) of multi-parameter combination was 0.956, with sensitivity (88.57%) and specificity (85.45%) significantly superior to any single parameter, showing statistically significant differences (P<0.05). Conclusion Multi-parameter spectral CT imaging can effectively differentiate metastatic from non-metastatic lymph nodes in gastrointestinal malignancies. Combined analysis of multiple parameters significantly improves diagnostic accuracy, providing an important basis for accurate preoperative assessment of lymph node metastasis status.

Objective To investigate the effects of early skull repair on the neurological function and cerebral blood flow perfusion of patients with hypertensive cerebral hemorrhage. Methods A total of 82 patients with hypertensive cerebral hemorrhage who visited the hospital from March 2024 to March 2025 were selected and divided into the observation group and the control group by random number table method, with 41 cases in each group. The randomization treatment plan was independently implemented by researchers not involved in clinical assessment. The grouping results were sealed in opaque envelopes and revealed before the surgery. Among them, 41 cases in the observation group underwent skull repair after craniectomy, With an average time of (6.3 ± 2.1) weeks; And 41 cases in the control group underwent skull repair after craniectomy, With an average time of (4.2 ± 0.9) months. The neurological function, cerebral blood flow perfusion, stress indicators, treatment effect, and complication situation of the two groups were compared. Results Before treatment, there was no statistically significant difference in neurological function, cerebral blood flow perfusion, and stress indicators between the two groups (P> 0.05); After treatment, the neurological function score, MTT, cortisol, IL-6, and TNF-α in the observation group were lower than that in the control group, and the differences were statistically significant (P<0.05); The rCBV and rCBF in the observation group were higher after treatment, and the differences were statistically significant (P<0.05); The total effective rate of the observation group was higher than the control group, and the difference was statistically significant (P<0.05);There was no statistically significant difference in the incidence of complications between the two groups (P> 0.05). Conclusion Early skull repair for patients with hypertensive cerebral hemorrhage can reduce neurological function damage, improve cerebral blood flow perfusion, reduce the body's stress response, and promote disease prognosis.

Objective To explore the clinical efficacy of modified Brostrom surgery and plaster fixation in the conservative treatment of acute complete rupture of the anterior talofibular ligament (ATFL) and its influence on the plantar pressure distribution, and to compare it with healthy normal people, providing biomechanical basis for the selection of clinical treatment regimens. Methods A retrospective controlled study was conducted, and the clinical data of 60 patients with complete rupture of acute closed ATFL admitted in our hospital from June 2023 to December 2024 were included. The patients were divided into the surgical group (30 cases, receiving the modified Brostrom surgery) and the conservative group (30 cases, receiving plaster fixation) according to the treatment methods. Another 30 healthy volunteers were selected as the normal control group. The general data of the three groups were collected and compared. Before treatment and at the last follow-up, the American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) for pain were used to evaluate ankle joint function and pain degree. The stability of the ankle joint was evaluated by measuring the talus tilt angle (TTA) and talus forward displacement (ATD) through stress position X-ray films. At the last follow-up, the plantar pressure distribution parameters of the three groups of subjects during walking were detected by the plantar pressure analysis system. Results All patients were followed up for 12 to 18 months, mean (14.2±2.1) months. After treatment, the AOFAS score, VAS score, TTA and ATD of both the surgical group and the conservative group were significantly improved compared with those before treatment (P<0.05). At the last follow-up, the AOFAS score of the surgical group was significantly higher than that of the conservative group (P<0.05), while the VAS score, TTA and ATD were significantly lower than those of the conservative group (P<0.05), and there was no statistically significant difference in each index between the surgical group and the normal control group (P>0.05). Plantar pressure analysis showed that compared with the normal control group, the peak pressure and pressure-time integral in the lateral area of the foot (the fifth metatarsal head and the fourth metatarsal head area) in the conservative group were significantly increased, while the parameters in the medial area of the foot (the first metatarsal head) were significantly decreased (P<0.05). The distribution of various plantar pressure parameters in the surgical group showed no statistically significant difference compared with the normal control group (P>0.05), and was significantly better than that in the conservative group (P<0.05). Conclusion For complete rupture of acute ATFL, the modified Brostrom surgery is superior to conservative treatment with plaster fixation in restoring ankle joint function and stability. Plantar pressure analysis indicates that surgical treatment can more effectively reconstruct the normal biomechanical environment of the foot, bringing the patient's gait pattern closer to a healthy and normal level, while there may be a persistent gait compensation mechanism after conservative treatment.However, conservative treatment remains a reasonable option for patients with low activity demands, mild instability, or high surgical risks, and clinical decisions should be individualized.

Objective To explore the effect of a five-step closed-loop theory-practice teaching model on clinical divergent thinking among anesthesiology interns. Methods Sixty medical students who completed anesthesiology internships from January 2022 to December 2024 were selected and randomly assigned to an observation group and a control group, with 30 students in each group. The control group received traditional lectures and operational demonstration, whereas the observation group received focused theory teaching, case discussion, scenario simulation, clinical practice and debriefing under comparable teaching duration, hours and faculty conditions. Theoretical scores, operational scores, divergent thinking scores and teaching satisfaction were compared between the two groups. Results The observation group showed higher theoretical, operational and divergent thinking scores than the control group, and its overall satisfaction rate was also higher (all P<0.05). Conclusion The five-step closed-loop theory-practice teaching model may improve knowledge application, operational training and clinical divergent thinking in anesthesiology interns, but further multicenter studies with larger samples are needed.

Objective To investigate the impact of age-related upper airway anatomical changes on the airway sealing performance of visual laryngeal masks. Methods 60 elderly patients underwent elective laryngeal mask airway(LMA) general anesthesia in our hospital from June 2024 to August 2025 were selected and randomly divided into the 3th laryngeal mask airway group (n=30) and the 4th laryngeal mask airway group (n=30) by the random number table method. All patients underwent preoperative clinical anatomical measurements related to the upper airway, including 5 parameters such as mouth opening, nail chin distance, and neck circumference,et al. Record the success rate, placement time, ideal positioning rate of fiberoptic bronchoscope, sealing pressure of laryngeal mask, and incidence of postoperative adverse reactions in two groups of patients undergoing initial placement of laryngeal mask. Results There was no statistically significant difference in the anatomical parameters of the upper airway between the two groups of patients (P>0.05). On the premise of comparability in anatomical basis, the sealing pressure of the laryngeal mask in group 4 was (32.43±3.15) cm H₂O, which was higher than that in group 3 (28.70±2.88) cm H₂O (P<0.05). The ideal positioning rate of fiberoptic bronchoscopy in the 4th laryngeal mask group was 93.33% (28/30), which was higher than the 76.67% (23/30) in the 3rd laryngeal mask group (P<0.05). There was no statistically significant difference in the success rate of initial implantation between the two groups (96.67% in group 4 vs 90.00% in group 3) and the implantation time (28.43±5.21 s in group 4 vs 30.17±6.34 s in group 3) (P>0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). In terms of the duration of sore throat, the third laryngeal mask group had a duration of (5.40±1.33) hours, while the fourth laryngeal mask group had a duration of (4.87±1.25) hours. There was no statistically significant difference between the two groups (P>0.05). Conclusion Age-related upper airway anatomical changes significantly affect the airway sealing performance of visual laryngeal masks. Appropriate selection of LMA size helps improve airway sealing and reduce the risk of complications, holding important clinical promotion value.

Objective To systematically quantify the overall effects of exercise interventions on cardiorespiratory fitness (CRF) in adolescents and to identify key moderating variables, thereby providing evidence-based support for the precise prescription of exercise programs, the scientific reform of physical education curricula, and the systematization of training regimens. Methods the study adhered to the PRISMA and PICOST principles. The modified Cochrane risk of bias assessment tool was employed for quality appraisal. A random-effects model was used for the Meta-analysis, supplemented by subgroup analyses, sensitivity analyses, and publication bias tests. Results The exercise interventions significantly improved adolescents' cardiorespiratory endurance (Z=2.38, P=0.018), with a pooled effect size of -2.321. Subgroup analyses revealed that moderate-intensity continuous training (MICT) yielded the most pronounced effect on time-based outcomes (MD=-18.997, P<0.001). Whereas high-intensity interval training (HIIT) performed best on non-time-based outcomes (MD=1.023, P<0.001). A 6-week duration was identified as the optimal intervention window (MD=1.038, P<0.001). The heterogeneity of time-based outcomes (69.2%) was the primary source of the overall high heterogeneity (I²=88.6%). Conclusion These findings confirm that exercise can improve cardiorespiratory fitness in adolescents, with its effectiveness depending on the precise alignment of intervention type, assessment indicator, and intervention duration.

Objective To investigate the effects of Tofacitinib citrate adjuvant therapy on joint function recovery, erythrocyte subsidence rate (ESR) and rheumatoid factor (RF) expression in patients with rheumatoid arthritis. Methods 100 patients with major rheumatoid arthritis admitted to our hospital from January 2025 to June 2025, were selected and divided into control group and observation group by random number table method. The observation group was treated with Tofacitinib citrate combined with methotrexate, while the control group was treated with methotrexate. The joint function, erythrocyte sedimentation rate (ESR), level expression of rheumatoid factor (RF), therapeutic effect and adverse reactions were compared before and after treatment. Results There was no significant difference in ODI and HAQ scores between observation group and control group before the intervention (P>0.05). ODI and HAQ scores after the intervention were lower than those before the intervention (P<0.05), and the scores in the observation group was lower than those in the control group (P<0.05). There was no significant difference in ESR and RF between the observation group and the control group before the intervention (P>0.05). After intervention, ESR and RF levels decreased in both groups, and the decreases in the observation group were significantly greater than those in the control group (P<0.05). The total effective rate of observation group was higher than that of control group (P<0.05). The adverse reactions in the observation group were lower than those in the control group (P<0.05). Conclusion Tofacitinib citrate adjuvant therapy has significant value in the treatment of patients with rheumatoid arthritis, which can promote the recovery of joint function, reduce the level of active factor ESR and the expression of rheumatoid factor, has significant clinical application value.

Objective To investigate the effect of water extract of gallate on periodontal inflammation and root resorption in patients with orthodontic invisible correction and its effect on the secretion of inflammatory factors. Methods A total of 80 patients who received orthodontic invisible correction in the Huangdao District Central Hospital of Qingdao from January 2024 to January 2025 were selected as the research objects and divided into the control group and the observation group by the random number table, with 40 participants in each group. Patients in the control group were treated with clear aligners. Patients in the observation group were treated with clear aligners and given water extract of gallate intervention. The visual analogue score (VAS) was used to evaluate the degree of periodontal pain before and after the correction. The periodontal plaque index (PLI) and bleeding on probing (BOP) were compared between the two groups. Gingival crevicular fluid samples were detected by enzyme-linked immunosorbent assay (ELISA) to evaluate the quantitative changes of white blood cells and neutrophils. The levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were detected. Results After the correction, the degree of periodontal pain in the observation group was lower than that in the control group. PLI、BOP and the number of white blood cells, neutrophils, TNF-α and IL-1β levels in the gingival crevicular fluid of the observation group were significantly decreased (P<0.05). Conclusions Water extract of gallate can inhibit the progression of periodontal inflammation and has no effect on the root resorption of patients with orthodontic invisible correction. The use of this method can provide a new way for the treatment of patients with orthodontic invisible correction.

Objective To exlpore the effects of Qishen Yiqi Diwan on the MAPK/ERK pathway and myocardial energy metabolism in patients with chronic heart failure(CHF). Methods A prospective clinical trial were designed to study 103 CHF patients admitted to our hospital from January 2024 to June 2025. The enrolled patients were divided randomly into a conventional group (51 cases) and an experimental group (52 cases) using a simplified numerical table method. The conventional group received conventional anti heart failure treatment, while the experimental group received a combination of Qishen Yiqi Diwan and conventional anti heart failure treatment. The syndrome integration, MAPK/ERK pathway proteins, inflammation, oxidative stress response, and myocardial energy metabolism were compared between the two groups of patients. After six months of follow-up after treatment, the incidence of major adverse cardiovascular events(MACE) was compared between the two groups of patients. The correlation between MAPK/ERK pathway proteins and clinical indicators were analyzed. Results Compare to the control group, the experimental group had lower scores of shortness of breath, wheezing, fatigue, palpitations, laziness, and sweating caused by fatigue after treatment (P＜0.05). The MAPK pathway p38, p-ERK1, and p-ERK2 in the experimental group were all lower than those in the control group (P＜0.05). Compare to the control group, the experimental group had lower levels of Gal-3 sST2 and higher levels of SOD,GSH-Px after treatment(P＜0.05). The levels of ATP and PCr in the experimental group were higher than those in the control group. LAC and FFA were lower than those in the control group (P＜0.05). As of the end of follow-up, the incidence of MACE in the experimental group was 9.62% which was lower than that in the control group 27.45% (P＜0.05). There was no statistically significant difference in the incidence of adverse events between the two groups (P＞0.05).P38, p-ERK1, and p-ERK2 are positively correlated with Gal-3, sST2, LAC, and FFA, and negatively correlated with SOD, GSH Px, ATP, and PCr (P＜0.05). Conclusion Qishen Yiqi Diwan pills can reduce the clinical syndrome, inflammation and oxidative stress, improve myocardial energy metabolism, reduce the risk of MACE in patients with CHF, and have high safety.

Objective To explore the therapeutic efficacy of Xiao’er Feire Kechuan Oral Liquid combined with Budesonide in children with asthmatic bronchopneumonia. Methods A total of 126 children with asthmatic bronchopneumonia admitted to our hospital from June 2023 to December 2025 were recruited as research subjects in this prospective study. The patients were assigned to the control group and combination group using the random number table method, with 63 cases in each group. The control group was given Budesonide for treatment, and the combination group was treated with Xiao’er Feire Kechuan Oral Liquid combined with Budesonide. The two groups were compared in terms of the incidence of adverse reactions, disappearance time of clinical symptoms and clinical efficacy. The traditional Chinese medicine(TCM) syndrome scores, tidal lung function indexes [volume ratio to peak expiratory flow (VPEF/VE), tidal volume (VT), time ratio to peak expiratory flow (TPTEF/TE), respiratory rate (RR)], and inflammatory factors [interleukin-6 (IL-6), CXC chemokine ligand 10 (CXCL10), high-sensitivity C-reactive protein (hs-CRP), annexin A2 (ANXA2)] levels before and after treatment were compared between the two groups. Results The overall effective rate of the combination group (96.83%) was significantly higher than that of the control group (84.13%) (P<0.05). The resolution time of clinical symptoms was shorter in the combination group (P<0.05). After treatment, all TCM syndrome scores were lower in the combination group than in the control group (P<0.05). Compared with the control group, the combination group exhibited higher VPEF/VE, VT and TPTEF/TE and lower RR after treatment (P<0.05). Posttreatment serum levels of IL6, CXCL10, hsCRP and ANXA2 were reduced in the combinationtreatment group (P<0.05). No statistically significant intergroup difference was found in the incidence of adverse reactions (P>0.05). Conclusion Xiao’er Feire Kechuan Oral Liquid combined with Budesonide can improve the therapeutic efficacy of children with asthmatic pneumonia, enhance the clinical symptoms, and reduce lung function damage and inflammatory response in children with asthmatic bronchopneumonia.

Chronic nonspecific low back pain (CNLBP) is a pain syndrome primarily characterized by discomfort in the lower back, lumbosacral region, and buttocks, yet its specific organic etiology remains unclear. This condition is prone to recurrent episodes and difficult to cure in a short period. Current rehabilitation interventions for CNLBP predominantly follow a single biomedical approach, with insufficient exploration of its therapeutic mechanisms. Given the disease's high incidence rate, high recurrence rate, and complex nature, this study analyzes the mechanisms and clinical applications of various rehabilitation protocols from multiple dimensions to achieve more precise diagnostic and therapeutic interventions. Cognitive-motor dual-task training, as a key method for chronic nonspecific low back pain rehabilitation, is systematically examined from biomechanics, neural regulation, and psychological adaptation perspectives in this paper. The study also explores the feasibility of cognitive-motor dual-task training, which is expected to enhance patient treatment compliance and rehabilitation outcomes. This combined model aims to provide theoretical references for precision rehabilitation of CNLBP and promote the transition toward a multifactorial, multidisciplinary integrated rehabilitation approach.

Objective To summarize the epidemiological characteristics of melasma in high-altitude environments, as well as alterations in the skin barrier and skin microecology, and to explore the possible underlying mechanisms. Methods A literature review was conducted to synthesize and analyze relevant studies at home and abroad. Results Existing studies indicate that the prevalence of melasma is relatively high in high-altitude regions and is particularly common among women. Environmental factors associated with high altitude, including intense ultraviolet radiation, cold and dry climate, and hypoxia, may collectively contribute to the pathogenesis of melasma by aggravating oxidative stress, impairing the skin barrier, altering physiological skin parameters, and reshaping the skin microecology. Patients with melasma in high-altitude regions may exhibit decreased skin pH, increased melanin index, and fungal community dysbiosis, with enrichment of Aspergillus and Aureobasidium on the skin, suggesting their potential value as biomarkers. Fungal melanin biosynthesis and the anti-melanogenic effects of postbiotics provide new clues for elucidating related mechanisms and exploring microbiome-based interventions. Conclusion High-altitude environments may affect skin health through a pathway involving environmental exposure, barrier impairment, microecological imbalance, and abnormal pigmentation. There may be an important association between cutaneous fungal dysbiosis and melasma. Microbiome biomarkers and postbiotic interventions show potential in modulating host health, but their causal relationship and clinical efficacy still require further verification through high-quality randomized controlled trials.