Objective To evaluate the efficacy of the modified Outside-In Plus suture technique in repairing anterior and middle meniscus tears（MT）. Methods A total of 87 patients with anterior and middle MT admitted to our hospital from February 2022 to April 2024 were randomized into a control group（n =44）and a modified group（n =43）by a random number table．The control group underwent traditional Outside-In suturing, while the modified group received the modified Outside-In Plus suture technique. Intraoperative indicators（blood loss, suture time per stitch, total surgical duration）, pain levels [Visual Analog Scale（VAS）], and knee function [Lysholm Knee Score and International Knee Documentation Committee（IKDC）Subjective Knee Form] were assessed preoperatively at 3 and 6 months postoperatively．Patient satisfaction and complication rates were also compared. Results Compared to the control group, the modified group exhibited significantly reduced intraoperative blood loss, shorter suture time per stitch, and shorter total surgical duration（P<0.05）．At 3 and 6 months postoperatively, VAS scores progressively decreased, while IKDC and Lysholm scores increased more markedly in the modified group（P<0.05）．The modified group also demonstrated lower complication rates（e.g., infection, joint stiffness）and higher patient satisfaction（P< 0.05）. Conclusion The modified Outside-In Plus suture technique reduces surgical suture difficulty, minimizes intraoperative trauma, accelerates functional recovery, promotes the recovery of body function, and improves patient satisfaction．

Objective To analysis of the detection rate and related risk factors of thyroid nodules in adult health examination population in Chengyang District, of Qingdao to provide support for the development of relevant prevention strategies. Methods This paper design through retrospective analysis of 15282 healthy individuals who underwent physical examinations at the Health Management Center of Chengyang District People’s Hospital in Qingdao from January 2013 to December 2022. Clinical data were collected, physical examination palpation and thyroid ultrasound were used to determine whether nodules were present. According to the results, the patients were divided into non-nodular group and nodular group for statistical analysis. Results The detection rate of thyroid nodules in healthy individuals undergoing physical examination is 28.48% , and the detection rate in females is 35.51% higher than that in males 21.47%, with a statistically significant difference（χ² =115.79, P =0.002）, and with age, the detection rate of thyroid nodules shows an increasing trend（χ² =187.32, P =0.001）. In males, the proportion of high C-reactive protein （CRP）, high blood sugar, hypertension, and smoking history in the nodule group was higher than that in the non-nodule group（P<0.05）, while there was no statistically significant difference in the proportion of overweight and obese individuals（BMI≥23.0 kg/m²）, abdominal obesity, high cholesterol（TC）, high LDL-C, low HDL-C, high triglycerides（TG）, high uric acid, and alcohol consumption history between the two groups（P>0.05）. Among women, the proportion of abdominal obesity was higher in the thyroid nodule group than that in non-nodule group（P<0.05）, and there was no difference in the proportion of overweight obesity between the nodule group and the non nodule group（P>0.05）;The proportion of people with high CRP, high blood sugar, hypertension, high TC, high LDL-C, and low HDL-C in the nodule group was higher than that in the non-nodule group（P<0.05）. The logistic regression analysis of factors related to thyroid nodules showed that gender, age, CRP, hyperglycemia, and smoking history were risk factors for thyroid nodule disease（P<0.05）, and the risk of thyroid nodule disease in women was 3.129 times higher than that in men;As age increases by 10 years, the risk of thyroid nodules increases by 1.482 times;The risk of developing high CRP is 1.62 times higher than that of non-high CRP individuals;The risk of hyperglycemia is 1.258 times that of non-hyperglycemic individuals, and the risk of disease is 2.217 times that of non-smokers. Conclusion The detection rate of thyroid nodules among health check ups in Chengyang District, Qingdao City is 28.48%, and the high-risk groups include older adults, women, smokers, people with high blood sugar and high CRP.

Objective To analyze the clinical value of extracorporeal shock wave therapy combined with orthopedic rehabilitation in the treatment of osteoarthritis. Methods 120 patients with osteoarthritis admitted to our hospital from July 2022 to July 2023 were selected and randomly divided into a control group and a study group, with 60 patients in each group, using a random number table method;The control group received orthopedic rehabilitation treatment, while the study group received extracorporeal shock wave therapy combined with orthopedic rehabilitation treatment. Compare the Lysholm score, inflammatory factor levels, WOMAC osteoarthritis index score, pain status, maximum knee flexion angle, femoral tibial angle, knee joint range of motion, negative emotions, and quality of life between two groups before and after intervention, and analyze the clinical efficacy. Results After treatment, Lysholm score, maximum knee bend Angle, femoro-tibial Angle, knee joint motion, quality of life in the study group were higher than those in the control group, VAS score, IL-6, TNF-α and CRP index levels, negative emotion score, and treatment effect were lower than those in the control group （P<0.05）. Conclusion Extracorporeal shock wave therapy combined with orthopedic rehabilitation for osteoarthritis can effectively inhibit serum inflammatory mediators, improve knee joint function and quality of life of patients, and play a good therapeutic effect.

Objective To explore the application of mental image therapy based on psychoneuromuscular theory in postoperative patient with traumatic spinal cord injury. Methods A total of 106 postoperative patient with traumatic spinal cord injury admitted in our hospital from January 2022 to March 2024 were selected as the study objects, whitch were divided into guidance group and image group by Random classification method. In the guidance group, 53 patients were given routine rehabilitation guidance, and in the image group, 53 patients were given mental image therapy based on psychonneuromuscular theory. The recovery of spinal nerve function, health behavior, self-care ability and quality of life of the two groups were compared. Results After 8 weeks of intervention, the scores of ASIA and FIM in two groups were higher than before intervention, and those in imagery group were higher than those in guidance group（P<0.05）. The HPLPII scores of the two groups showed a gradually increasing trend from before intervention to 8 weeks after intervention, and the HPLPII scores of the two groups after 4 and 8 weeks of intervention were higher than those of the control group（P<0.05）After 8 weeks of intervention, BI and SF-36 scores in both groups were higher than those before intervention, and those in imagery group were higher than those in guidance group（P<0.05）. Conclusion Mental image therapy based on psychoneuromuscular theory can regulate the health behavior of postoperative patient with traumatic spinal cord injury, and is beneficial to the recovery of spinal cord nerve function, improving self-care ability and quality of life.

Objective Coronary artery calcification is a key predictive factor for increased cardiovascular events and mortality in dialysis patients. Sarcopenia is also an independent risk factor closely related to decreased physical function and increased mortality. This study aims to explore the correlation between sarcopenia and coronary artery calcification in maintenance hemodialysis patients. Methods In our study, 67 patients with maintenance hemodialysis at the Blood Purification Center of People’s Hospital of Chengyang District from Jun 2022 to Jun 2023 were enrolled. Coronary artery calcification was scored based on the Agatston score standard and all patients were divided into non-coronary artery calcification group（n =33）and coronary artery calcification group（n =34）. The clinical data and laboratory indicators of the two groups were compared. Then, the correlation between coronary artery calcification and skeletal muscle mass index （SMI）, upper limb grip strength（HGS）, and 6-meter walking speed was studied, respectively. Further, risk factor for coronary artery calcification development was performed using logistic regression analysis. Results The patients in the coronary artery calcification group had older age, longer dialysis age, a higher proportion of smoking history, lower BMI level, higher iPTH level, and lower levels of albumin and high-density lipoprotein, with statistically significant differences（all P<0.05）. At the same time, the SMI（male：5.98 ± 0.97 vs. 9.18 ± 1.22;female：4.87 ± 0.97 vs. 8.07 ± 1.28）, HGS（male：23.93 ± 3.34 vs. 29.51 ± 2.66;female：16.43 ± 2.37 vs. 21.11 ± 2.82）, and 6-meter walking speed（0.85 ± 0.21 vs. 1.72 ± 0.42）of patients with coronary artery calcification significantly decreased, with statistically significant differences（all P<0.05）. Further study found that coronary artery calcification score was negatively correlated with SMI（r² =0.539), HGS（r² =0.256）, and 6-meter walking speed（r² =0.552）（P<0.0001）The results of logistic regression analysis showed that body mass index, SMI, HGS, and 6-meter walking speed were independent risk factors for coronary artery calcification development in hemodialysis patients（P<0.05）. In addition, the incidence of cardiovascular events in patients with coronary artery calcification significantly increased（32.35% vs.12.12%）, with a statistically significant difference（P =0.0342）. Conclusion A significant correlation between sarcopenia and coronary artery calcification in maintenance hemodialysis patients was found. Sarcopenia is an important characteristic of coronary artery calcification in maintenance hemodialysis patients, which provides a theoretical basis for the prevention and treatment of coronary artery calcification in clinical practice.

Objective To improve the quality of infusion in-hospital transport of emergency aortic dissection patients and ensure the safety of in-hospital transport of emergency aortic dissection patients. Methods With the help of HFMEA tool, the whole process and potential hazards of infusion operation in-hospital transport of emergency aortic dissection patients were systematically analyzed, failure mode, failure causes and failure consequences were also analyzed, risk scoring matrix and decision tree were adopted to select the link in need of improvement, and action improvement plans were formulated and implemented, so as to standardize the implementation rate of standardized use of vasoactive drugs. Results After the implementation of the improved program, there were significant improvements in five indexes of in-hospital transport：no infusion rack, interruption of use of vasoactive drugs, blood returned, blockage, and fixed auxiliary materials loosed （P <0.05）, the implementation rate of standardized use of vasoactive drugs was significantly increased. Conclusion The application of medical HFMEA method can improve the infusion process in-hospital transport of patients with emergency aortic dissection, improve the safety and standardization of intravenous infusion, improve the implementation rate of standardized use of vasoactive drugs, improve the treatment rate of patients with aortic dissection, and thus reduce the mortality rate of patients with aortic dissection.

Objective To investigate the application value of ICG fluorescence navigation technique in laparoscopic radical gastrectomy of gastric cancer. Methods A total of 80 patients diagnosed with gastric cancer in a hospital from August 2022 to August 2024 were selected and divided into experimental group and control group with 40 cases in each group by random number table method. The control group received conventional operation. The experimental group adopted ICG fluorescence navigation technology. The operative data and relevant indexes of lymph node dissection were compared between the two groups. Results There were no significant differences in operation time, intraoperative blood loss, first postoperative exhaust time and postoperative complications between the two groups（all P > 0.05）. The total number of lymph node dissection in experimental group was higher than that in control group（P < 0.05）. Total gastritis NO.2 in the experimental group was smaller than that in the control group（P< 0.05）, and there was no significant difference in the number of other stations（all P>0.05）. There was no statistically significant difference in the total number of dissections and the number of dissections at each station during distal gastrectomy（all P>0.05）. The total number of lymph node metastases in the experimental group was greater than that in the control group（P<0.05）, and there were no statistically significant differences in the total number of dissections and the number of dissections at each station between total gastrectomy and distal gastrectomy （all P > 0.05）. In all patients, the rate of lymph node nonconformity in the experimental group was lower than that in the control group （P< 0.05）. There was no significant difference in lymph node dissection between the groups of distal gastrectomy and total gastrectomy（P> 0.05）. In the experimental group, 2025 lymph nodes were detected with 684 metastases, and the degree of metastasis was 33.78%;in the control group, 40 patients were detected with 1964 lymph nodes with 515 metastases, and the degree of metastasis was 26.22%. The metastasis of the experimental group was higher than that of the control group （χ²=27.074, P < 0.001）. The sensitivity of the experimental group was 49.70% （340/684）, the false negative rate was 50.30% （344/684）, the specificity was 47.43%（636/1341）, and the false positive rate was 53.62%（719/1341）. Conclusion ICG fluorescence navigation technology can significantly improve the thoroughness of lymphatic clearance during laparoscopic radical gastrectomy of gastric cancer, provide more accurate localization ability for tumor lesions of lymph nodes, protect healthy tissues, and avoid the occurrence of anastomotic fistula and other adverse events to a certain extent.

Objective Focusing on the era of minimally invasive surgery, this study explored the application of a blended teaching approach based on the concept of outcome-based education（OBE）, integrating case-based learning（CBL）, team-based learning（TBL）, and inquiry-based teaching and learning（RBL）in surgical training. Methods A total of 46 trainees who participated in the standardized training of physicians at the Second Affiliated Hospital of Guangdong Medical University from February 2023 to December 2023 were trained in innovative teaching concepts, lectures on cholecystectomy and training on surgical plans were conducted using three-dimensional reconstruction technology;Train the trainees in the depth-of-field control under the endoscope（bead clamping）, instrument suture knotting（simulation on the platform）, and the operation of clinical practical skills. Results After the basic operation training, the trainees were able to complete an average of（31.78±11.24）bead clamping operations within 1 minute, with an average score of（63.48±14.81）. They were able to complete 3 stitches under the endoscope within 8 minutes, with an average time of（5.49±1.15）minutes and an average score of（147.67±15.71）. the average score for the three-dimensional reconstruction technical examination of trained trainees was（84.70±2.64）;he average score of clinical practice skills operation examination for trainees was（86.43±3.80） . Comparing the assessment scores of the trainees before the training, all the assessment scores were significantly improved（P<0.05）. Conclusion In the era of minimally invasive surgery, the training of CBL+TBL+RBL blended teaching method based on the concept of OBE helps to improve the clinical operation skills of trainees.

Objective To analyze the correlation between CT parameters and lymph node metastasis in patients with prostate cancer and its diagnostic value. Methods The clinical data of 93 patients with prostate cancer diagnosed by histopathology were retrospectively collected from February 2023 to October 2024. Preoperative CT examination, radical resection of prostate cancer and lymph node dissection were performed. The pathological results of lymph node dissection were used as the“gold standard”to analyze whether prostate cancer patients had lymph node metastasis, and were divided into lymph node metastasis group and lymph node non-metastasis group based on that. The relevant parameters of CT examination(blood volume（BV）, peak time（TTP）, blood flow（BF）, capillary surface permeability（PS）of the two groups were compared to analyze the correlation between the above parameters and lymph node metastasis of prostate cancer, and the value of single and combined diagnosis of lymph node metastasis of prostate cancer patients. Results In 93 patients with prostate cancer, 66（70.97%）were found to have lymph node metastasis and 27（29.03%）were found to have no lymph node metastasis. The clinical stage of lymph node metastasis group was higher than that of the group without lymph node metastasis, and the degree of tumor differentiation was lower than that of the group without lymph node metastasis（P<0.05）. CT parameters BV, TTP, BF and PS in lymph node metastasis group were higher than those in non-lymph node metastasis group（P< 0.05）. Kendall tau-b correlation analysis showed that CT parameters BV, TTP, BF, PS were positively correlated with lymph node metastasis in patients with prostate cancer （r>0, P<0.05）. ROC curve was drawn, and the results showed that AUC of single and combined CT parameters BV, TTP, BF and PS in the diagnosis of lymph node metastasis of prostate cancer were all greater than 0.7, which had certain diagnostic value. Conclusion CT parameters are closely related to lymph node metastasis in patients with prostate cancer, and multi-parameter combination has high value in the differential diagnosis of lymph node metastasis.

Objective To observe the effects of platelet-rich plasma（PRP）intrauterine perfusion on endometrial thickness and pregnancy outcome in patients with previous frozen embryo transfer（FET）failure, and to provide a new method for treating patients with FET failure. Methods Six patients who were not pregnant after FET at the Reproductive Center from September 2023 to February 2024 were selected, and autologous venous blood was collected to prepare PRP and treated by intrauterine perfusion for 3 days, followed by ultrasonography to examine the changes in endometrial thickness and morphology. D3 cleavage embryos or D5 blastocysts were transferred, and their serum HCG levels were tested after 10-14 days, and clinical pregnancy was detected by ultrasound after 28 days. Results After 6 patients were treated with PRP intrauterine perfusion, ultrasound did not show significant changes in endometrial morphology and thickness;4 of them had successful clinical pregnancies, with a clinical pregnancy rate of 66.67%, an implantation rate of 54.55%, and an early miscarriage rate of 0%;Among the remaining 2 non-pregnant, 1 failed to implant due to poor embryo quality, and the other had an endometrial morphology of C-shape that did not improve after perfusion;There were no significant adverse reactions in all patients after PRP intrauterine perfusion. Conclusion Although PRP intrauterine perfusion did not significantly change the endometrial morphology and thickness in the short term, it may promote pregnancy success through the release of growth factors and cytokines, providing a potential treatment option for patients with FET failure.

Objective To investigate the effect of Wenxin granule combined with amiodarone hydrochloride on patients with paroxysmal atrial fibrillation（PAF）. Methods 94 patients with PAF admitted to our hospital from December 2022 to June 2024 were selected and divided into 2 groups according to the random number table method. The control group （n = 47）was treated with amiodarone hydrochloride, and the observation group（n = 47）was treated with Wenxin granule. Both groups were treated continuously for 6 months. The clinical efficacy, myocardial fibrosis index, cardiac function index and drug safety were compared between the two groups. Results After 6 months of continuous treatment, the total effective rate of observation group was higher than that of control group（P<0.05）. The indexes of myocardial fibrosis before treatment were compared between the two groups（P>0.05）. After treatment, the levels of matrix metalloproteinase-2（MMP-2）and type III amino-terminal peptide（PⅢNP）were decreased in both groups, and the levels in the observation group were even lower（P<0.05）. The indexes of cardiac function before treatment were compared between the two groups （P> 0.05）. After treatment, the levels of left ventricular end-diastolic diameter（LVEDD） and left ventricular end-systolic diameter（LVESD）in observation group were lower than those in control group, but the levels of left ventricular ejection fraction（LVEF）and heart index（CI）were higher than those in control group（P <0.05）. The drug safety of the two groups was similar（P > 0.05）. Conclusion Wenxin granule combined with amiodarone hydrochloride has a definite effect on PAF, that can effectively improve myocardial fibrosis and promote the recovery of cardiac function, and the drug is safe and worthy of clinical promotion.

Objective To analyze the effects of enhanced external counterpulsation（EECP） on walking distance and quality of life in patients with lower extremity arteriosclerotic obliterans. Methods Fifty patients with lower extremity arteriosclerosis obliterators admitted to our hospital from August 2022 to December 2023 were selected and randomly divided into 2 groups, each with 25 cases. The control group was given standard drug treatment and life guidance, and the EECP group was given enhanced external counterpulsation. The walking distance and quality of life of patients with different treatment methods were compared. Results After treatment, the ankle-brachial index of EECP group was significantly higher than that of control group, and NRS score was lower than that of control group（P< 0.05）The 6-minute walking distance, painless walking distance and maximum walking distance in EECP group were significantly higher than those in control group（P< 0.05）. SF-36 scores and ADL scores in EECP group were significantly higher than those in control group, while PSQI scores in EECP group were lower than those in control group（P<0.05）. Conclusion EECP therapy can effectively alleviate lower limb pain symptoms in patients with lower limb arteriosclerosis obliterans, increase painless walking ability and ankle brachial index, improve sleep quality and life ability, enhance quality of life, and improve prognosis outcomes.

Objective To establish a home exercise rehabilitation program for children with bronchial asthma, and to explore its effectiveness. Methods Fifty children with asthma who were regularly follow-up in the outpatient department of the Fifth People’s Hospital, Shunde District, Foshan City, Guangdong Province from January 2024 to July 2024 were selected as the study objects, and were divided into control group and intervention group according to the random number table method, with 25 cases in each group. The control group received routine nursing intervention, and the intervention group received home exercise rehabilitation intervention program on the basis of routine nursing. Lung function, asthma control and quality of life were compared between the two groups. Results After intervention, the lung function 、the control of asthma and the life quality of the intervention group was all better than that of the control group（P <0.05）. Conclusion The application effect of home exercise rehabilitation program for children with bronchial asthma is accurate, which can improve the pulmonary function and asthma control of patients, enhance their quality of life, and is worthy of clinical application.

Objective To investigate the application value of high-frequency ultrasound in the clinical diagnosis of infants with asymmetric hip stripe. Methods Sixty cases of infants with hip stripe asymmetry who visited our hospital from February 2021 to December 2023 were included as study subjects, and all of them underwent high-frequency ultrasound examination. The comprehensive clinical diagnosis was the “gold standard” for diagnosis of developmental dysplasia of the hip （DDH）, the detection situation and diagnostic value of high-frequency color Doppler ultrasound was analyzed and the consistency was calculated;The α-angle and β-angle of the hip were also compared with different methods of examination. Results Among the 60 children with hip asymmetry, 37 cases were positive and 23 cases were negative for DDH by clinical diagnosis, 38 cases were positive and 22 cases were negative for DDH by high-frequency ultrasonography. And in the Graf classification, 22 cases were type I, 36 cases were type II, 1 case were type III, and 1 case were type IV. Therefore, the sensitivity of high-frequency ultrasonography in the diagnosis of DDH was 94.74%（36/38）, the specificity was 95.45%（21/22）, the accuracy was 95.00% （57/60）, the positive predictive value was 97.30%（36/37）, and the negative predictive value was 91.30%（21/23）. The consistency test showed good agreement between high-frequency ultrasonography in the diagnosis of DDH（kappa value = 0.893, P = 0.000）. There was no statistically significant difference in the comparison of α-angle and β-angle of the hip joint between the two examination methods（P>0.05）. Conclusion High-frequency ultrasound is of high value in the diagnosis of infants with hip stripe asymmetry, which can dynamically observe the development of the hip joint and accurately evaluate the morphology of the hip joint, and can be used as an effective imaging tool for early DDH screening, that is worthy of popularization and application.

Objective Ureteroscopy is recommended for the treatment of middle and lower ureteral calculi, and ureteral stricture is one of its complications. Ureteral stricture after ureteral lithotripsy is related to inflammatory reaction, perforation, ischemia and thermal injury, and the incidence of incarcerated calculi is higher. Ureteral stricture is usually asymptomatic and when it is discovered that renal function impairment has already occurred, so it should be treated in time to relieve obstruction and protect renal function. The treatment of ureteral stricture includes intracavitary surgery（balloon dilatation and endoureterotomy）and reconstruction surgery（ureterostomy, intestinal replacement of ureter, etc.）. Permanent ureteral stents can also be implanted if the effect of surgical treatment is not satisfactory.

Objective To explore the clinical effect of traditional Chinese medicine bone-setting manipulation combined with Shentong Zhuyu decoction on lumbago. Methods Patients with lower back pain were recruited according to inclusion and exclusion criteria at the Qingdao West Coast New Area District Hospital from December 2021 to December 2022, they were randomly divided into a control group and a combination group, with 40 cases in each group.Both groups received traditional Chinese medicine bone setting manipulation treatment, and the combined group was also given Shentong Zhuyu decoction treatment for 2 weeks. Pain scores and lumbar function scores were performed before and after treatment, and fasting venous blood was collected. Serum levels of IL-6 and IL-1β were detected. Results After treatment with different methods, the pain degree score of the two groups was significantly decreased compared with that before treatment, and the pain score of the combined group was significantly lower than that of the control group after treatment（P<0.05）. The lumbar function evaluation of different treatment groups showed that the lumbar function scores of the two groups after treatment were significantly higher than that before treatment, and the score of the combined group was significantly higher than that of the control group（P<0.05）. The serum levels of IL-6 and IL-1β in 2 groups after treatment were lower than those before treatment, and the levels in combination group were significantly lower than those in control group after treatment（P<0.05）. Conclusion Combined body pain Zhuyu decoction has better therapeutic effect on patients with low back pain than traditional Chinese medicine bone setting manipulation alone.

Objective This paper presents a detailed report on a case of necrotizing fasciitis of lower extremity complicated with retroperitoneal abscess, and retrospectively analyzes the diagnostic procedures, therapeutic strategies and postoperative clinical manifestations associated with this disease. The sample set of this retrospective study encompasses 20 cases（including the current case report）that were admitted from March 2018 to March 2024. The research findings indicate that the pathogens responsible for necrotizing fasciitis of lower extremity lack specificity. Identifying all pathogen categories precisely via a single bacterial culture test proves challenging, and typically, multiple rounds of sampling and testing are necessary for clarification. In the context of the complication of retroperitoneal abscess, surgical intervention via the incision at the lower border of the transverse abdominal muscle within inguinal area represents a viable and efficacious debridement approach. Furthermore, regression analysis reveals that the preoperative waiting duration exhibits a significant positive correlation with the patient’s surgical frequency and hospitalization period. Given the relative clinical rarity of necrotizing fasciitis of lower extremity complicated with retroperitoneal abscess, this study posits that, within the treatment framework, aside from the active implementation of the combined antibiotic treatment protocol, the timely surgical debridement of necrotic tissue in the infected area at an early stage, in conjunction with negative pressure wound treatment modalities, constitutes crucial intervention measures as well. The findings of this study furnish a valuable reference foundation for the diagnosis, treatment and prognosis evaluation pertaining to this disease.