Diabetic foot is one of the most common,severe chronic complications of diabetes mellitus,characterized by high incidence,high disability rate,and high mortality,imposing a tremendous burden on patients′ quality of life,medical resources,and socioeconomic factors.In recent years,medical institutions at all levels in Qingdao have accumulated rich experience in the diagnosis,treatment,and rehabilitation of diabetic foot.This consensus integrates the latest international guidelines and domestic research findings to establish a locally tailored diagnostic and therapeutic model.The Diabetic Foot and Chronic Wound Multidisciplinary Joint Professional Committee of the Qingdao Medical Association organized experts in this field within Qingdao to formulate the “Qingdao expert consensus on the diagnosis and treatment of diabeticfoot” through online and offline meetings,incorporating local prevention and treatment experience.It aims to provide comprehensive guidance for the diagnosis,treatment,and management of diabetic foot.The consensus places core emphasis on lower limb blood supply assessment and reconstruction therapy,highlighting a “Qingdao-style” practice pathway for diabetic foot diagnosis and treatment.

Objective To explore the application value of the Bronchiectasis Severity Index (BSI) scoring system in assessing the severity of bronchiectasis in Chinese patients. Methods A total of 100 patients with bronchiectasis admitted to Zhangjiagang Fifth People′s Hospital from July 2020 to July 2022 were selected as study subjects.According to BSI scores,they were divided into mild,moderate,and severe groups: the mild group (0-4 points,n=30),the moderate group (5-8 points,n=45),and the severe group (≥9 points,n=25).All patients underwent baseline assessment and were followed up for three years,during which hospitalization rates and mortality rates were recorded.The independent relationships between various BSI indicators and hospitalization/mortality rates were analyzed,and the predictive performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). Results The forced expiratory volume in one second as a percentage of predicted (FEV1%) was significantly lower in the severe group than in the mild and moderate groups,while the number of hospitalizations in the past 2 years,the number of acute exacerbations in the past 12 months,the Modified British Medical Research Council Dyspnea Scale (mMRC) grade,the Pseudomonas Aeruginosa (PA) colonization rate,and the imaging Reiff score were significantly higher than those in the mild and moderate groups (P<0.05).The hospitalization rate and mortality rate in the severe group were significantly higher than those in the mild and moderate groups (P<0.05).Cox regression analysis showed that FEV1% predicted,the number of acute exacerbations in the past 12 months,Pseudomonas aeruginosa colonization,and mMRC score were independent predictors of hospitalization and death (P<0.05).The AUC of the BSI score for predicting hospitalization and death were 0.890 and 0.850,respectively,indicating good discriminative ability. Conclusion The BSI scoring system is suitable for assessing the severity of bronchiectasis in Chinese patients,can effectively predict the risk of hospitalization and death,helps achieve individualized stratified management,optimizes clinical decision-making,and improves patient prognosis.It is worthy of clinical application.

Objective To systematically evaluate the bond strength of self-ligating brackets made of metal,alumina ceramic,and zirconia ceramic to dental enamel through in vitro experiments,comparing their shear strength,bond failure modes,and performance stability after hydrothermal aging. Methods Thirty human ex vivo premolars were randomly divided into three groups (n=10 each): Group A (bonded to metal brackets),Group B (alumina ceramic brackets),and Group C (zirconia ceramic brackets).All brackets were bonded using Weston adhesive following standard procedures.After 24-hour storage in a 37°C water bath,shear strength was tested using an electronic universal testing machine,and the adhesive residue index (ARI) was assessed under a stereomicroscope.Additionally,five specimens from each group underwent hydrothermal aging at 134°C for one hour,followed by re-testing of shear strength. Results Shear strength in Group C was comparable to Group A (P>0.05) but significantly higher than Group B (P<0.05).ARI scores revealed statistically significant distribution differences among the three groups (P<0.05).Failures in Groups A and C predominantly occurred within the adhesive or at the interface (predominantly ARI 1-2,accounting for 90% each),whereas the complete retention pattern (ARI 3) indicative of poorer enamel protection was predominant in Group B (70%).Performance after aging: After hydrothermal aging,the shear strength of Group C remained comparable to that of Group A (P>0.05),and both were significantly higher than that of Group B (P<0.05). Conclusion Zirconia ceramic self-ligating brackets demonstrated excellent bond strength comparable to metal brackets and stable performance after aging.Their bond failure mode was more favorable,effectively reducing the risk of enamel damage.Their overall performance significantly outperformed alumina ceramic brackets,establishing them as high-performance aesthetic orthodontic brackets with considerable clinical value.

Objective To explore the influencing factors in the development of simple obesity by investigating the correlation between serum 25-hydroxyvitamin D₃ (25-OH-D₃) and various metabolic indicators in children with simple obesity. Methods A total of 250 children who visited the Department of Child Health Care of Ganzhou People′s Hospital from June 2023 to June 2024 were selected.They were divided into the obese group and the healthy control group based on whether they were obese or not.The obesity group included 125 children with simple obesity (without significant endocrine or metabolic diseases and with relatively even fat distribution),while 125 normal-weight children from routine health examinations during the same period were included as controls.Physical measurement data [(height,weight,and (body mass index,BMI)] were collected from all the children ultimately included in the study,and serum levels of 25-OH-D₃ and metabolic indicators,including triglycerides (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),fasting plasma glucose (FPG),fasting insulin (FINS),2-hour postprandial blood glucose (2h BG),2-hour postprandial insulin (2h INS),and osteocalcin (OC) were measured. Results Univariate analysis showed that the obesity group had significantly higher levels of weight,BMI,FINS,2h BG,2h INS,TC,TG,and LDL-C compared to the healthy control group (all P<0.05),while serum levels of 25-OH-D₃,HDL-C,and OC were significantly lower than the healthy control group (all P<0.05).Correlation analysis revealed that serum 25-OH-D₃ was negatively correlated with weight,BMI,TG,and FINS (all P<0.05),but showed no significant correlation with TC,HDL-C,LDL-C,2h BG,2h INS,or OC (all P>0.05).Stepwise analysis indicated that BMI had a significant negative predictive effect on 25-OH-D₃ levels (P<0.05). Conclusion Compared to children with normal BMI,those with simple obesity have significantly lower serum 25-OH-D₃ levels,which are notably associated with BMI and TG.This suggests that serum 25-hydroxyvitamin D₃ levels may play a role in lipid metabolism in children with simple obesity.

Objective To analyze the risk factors influencing high bleeding risk in patients with liver cirrhosis and esophageal-gastric varices,and to construct a nomogram prediction model based on these factors. Methods This retrospective case-control study included 298 patients with liver cirrhosis and esophageal-gastric varices underwent ultrasound examination at the Department of Ultrasound,Xiang’An Hospital of Xiamen University from April 2019 to June 2025.Patients also underwent gastroscopy,and based on the gastroscopy results,esophageal-gastric varices were classified into high bleeding risk group (G2+G3,n=153) and low bleeding risk group (G1,n=145).Uni-variate and multi-variate logistic regression analyses were conducted to identify ultrasound-related risk factors for high-risk esophageal-gastric varices in liver cirrhosis.A nomogram prediction model was constructed using the “rms” package based on the multivariate logistic regression results,and the stability of the model was assessed by internal validation using the “Bootstrap” method.ROC curves were drawn with the “pROC” package,calibration curves with the “rms” package,and clinical decision curves (Decision Curve Analysis,DCA) were performed with the “rmda” package. Results High systolic peak flow velocity of the splenic artery,enlarged splenic vein diameter,increased splenic vein flow velocity,enlarged splenic area,elevated splenic elasticity,and Child-Pugh grade B or C grade were independent risk factors for high bleeding risk in patients with liver cirrhosis and esophageal-gastric varices (P＜0.05).The nomogram prediction model based on these independent risk factors showed high predictive performance.Internal validation ROC analysis showed an AUC of 0.945 for the training set and 0.931 for the validation set,indicating strong discriminatory ability of the model.The C-index was 0.947 for the training set and 0.941 for the validation set,further confirming the model′s accuracy in predicting high bleeding risk in esophageal-gastric varices.The Hosmer-Lemeshow test showed good model fit (P-values: training set=0.826,validation set=0.249).The calibration curve indicated good agreement between predicted probabilities and actual outcomes,validating the model′s accuracy.DCA showed that the model provided higher net benefit compared to both “all intervention” and “no intervention” strategies across risk thresholds of 0.04-0.96 (training set) and 0.05-0.94 (validation set). Conclusion The nomogram prediction model constructed in this study effectively assesses the high bleeding risk in patients with liver cirrhosis and esophageal-gastric varices.The model demonstrated high predictive performance and accuracy in both training and validation sets,making it a valuable tool for clinical application.

Objective To evaluate the awareness of community residents towards fecal DNA methylation detection technology and explore the practical application value of this technology in community colorectal cancer screening. Methods A retrospective analysis was conducted that included 11200 permanent residents in our community who underwent community screening for colorectal cancer from June 2023 to June 2025.Pathological examination results were used as the diagnostic criteria.538 individuals who tested positive for occult blood in the initial screening were divided into two groups,with 282 individuals receiving fecal DNA methylation testing as the methylation detection group,and 256 individuals not undergoing the test as the undetected methylation group.The screening status of colorectal cancer and compliance with colonoscopy were compared between two groups. Results 11200 people were effectively screened,and 538 people were initially screened positive for occult blood (positive rate 4.80%); 282 individuals underwent methylation testing,of which 120 underwent colonoscopy,with a compliance rate of 42.55%; 256 individuals did not undergo methylation testing,of which 85 underwent colonoscopy,with a compliance rate of 33.20%.The compliance of the methylation detection group was higher than that of the undetected methylation group (P<0.05).There was no significant difference in the awareness of fecal DNA methylation screening between the two groups of patients (P>0.05).The main reasons for screening cognitive impairment include: insufficient understanding of screening methods,concerns about operational procedures,psychological pressure,insufficient understanding of the necessity of examinations,and cost issues.The detection rate of colorectal cancer in the methylation positive subgroup was higher than that in the methylation negative subgroup (P<0.05). Conclusion Fecal DNA methylation testing has shown good efficacy in colorectal cancer screening,but it is necessary to strengthen science popularization and publicity.

Objective To explore the short-term clinical effect of low-dose Tizanidine combined with opioids on cancer pain,and to provide a new drug treatment plan for the treatment of cancer pain. Methods A total of 34 patients with cancer pain in the Department of Pain in the Affiliated Hospital of Qingdao University from January 2024 to September 2024 were collected.On the basis of the opioid treatment,low-dose Tizanidine was given.The numerical rating scale (NRS) of pain,NRS of breakthrough pain,frequency of breakthrough pain,and adverse reactions of patients were recorded at the baseline,1 week,2 weeks,and 4 weeks after medication. Results Compared with the baseline,the average NRS and the frequency of breakthrough pain of patients at 1 week,2 weeks,and 4 weeks after medication were significantly reduced,and the dosage of opioids was also decreased (P <0.05),but there was no significant change in the NRS of breakthrough pain. Conclusion Low-dose Tizanidine combined with opioids can significantly reduce the NRS and the frequency of breakthrough pain in patients with cancer pain,decrease the dosage of opioids,and there are no obvious adverse reactions.

Objective To observe the application value of diaphragmatic electromyography stimulation combined with traditional respiratory training in patients with pulmonary heart disease(PHD). Methods A prospective case-control trial was designed with 100 PHD patients who visited our hospital between March 2022 and August 2024 as the research subjects.The enrolled patients were divided into a control group and an experimental group using stratified randomization,with 50 cases in each group.The conventional group received traditional respiratory training,while the experimental group received diaphragmatic electromyography stimulation combined with traditional respiratory training.The diaphragmatic mechanical function,lung function,cardiac hemodynamics,and prognosis of the two groups of patients were compared. Results After intervention,the maximum inspiratory pressure (MIP),transdiaphragmatic pressure (Pdi),and diaphragm thickening fraction (TFdi) in the experimental group were higher than those in the control group,while the diaphragm tension-time index (TTdi) was lower than that in the control group (P<0.05).The forced expiratory volume in one second (FEV1),forced vital capacity (FVC),and maximal spontaneous ventilation (MVV) of the experimental group were higher than those of the control group (P<0.05).The pulmonary artery systolic pressure (PASP) of the experimental group was lower than that of the control group.The tricuspid annular plane systolic excusion (TAPSE) and right ventricular fractional area change (RVFAC) were both higher than those of the control group(P<0.05).As of the end of follow-up,the incidence of poor prognosis in the experimental group was 10.00%,witch was lower than that in the conventional group 28.00% (P<0.05). Conclusion The combination of diaphragmatic electromyography stimulation and traditional respiratory training can improve the diaphragmatic mechanical function and lung function of PHD patients,and have a positive impact on promoting the recovery of cardiac hemodynamics and reducing the risk of adverse prognosis.

Objective To explore the effects of two anticoagulants,sodium citrate and heparin,on the coagulation function of patients in autologous blood transfusion. Methods The changes in coagulation indicators before and after autologous blood transfusion with different anticoagulants were monitored and statistically analyzed. Results When the volume of autologous blood transfusion was less than 600 ml,both anticoagulants had no significant effect on the coagulation indicators of patients (P＞0.05).When the volume of autologous blood transfusion was greater than 900 ml,the ACT,PT,and APTT indicators were significantly prolonged compared with those before transfusion (P＜0.05).When the volume of autologous blood transfusion reached 1200 ml,the effect of heparin anticoagulation on coagulation function was significantly greater than that of sodium citrate (P＜0.05),and there was no significant difference in the anticoagulation effect between the two anticoagulants (P＞0.05). Conclusion The residual anticoagulant in autologous blood transfusion during surgery has a small effect on the coagulation function of patients.Sodium citrate and heparin have the same anticoagulation effect,and sodium citrate is safer when the volume of autologous blood transfusion is large.

Objective To explore the clinical characteristics,imaging characteristics and correlation with prognosis in young patients with acute coronary syndrome. Methods This study included a total of 98 patients with acute coronary syndrome who underwent coronary CT angiography at Nanyang First People′s Hospital from March 2022 to March 2024.Various baseline data of all patients were collected,and the imaging data were retrospectively analyzed.The patients were divided into groups according to their gender,including 38 patients in the female group and 60 patients in the male group.To compare the coronary angiography results of the two groups of patients and the occurrence of major adverse cardiovascular events (MACE) during the follow-up period of the two groups of patients,multivariate Logistc regression analysis was used to screen the risk factors for MACE events in female and male patients. Results The age and proportion of patients with combined diabetes in the female group were higher than those in the male group,and the proportion of smoking and serum creatinine in the female group were lower than those in the male group (all P<0.05); There was no significant difference in the number of vascular lesions and Gensini scores between the two groups (all P>0.05); During the follow-up period.There were 4 cases of MACE events,accounting for 10.53%,and 7 cases occurred in the male group,accounting for 11.67%.After comparison,there was no statistically significant difference (P>0.05); Age and elevated blood sugar levels were high-risk factors for the occurrence of MACE events in female patients (P<0.05); The high-risk factors for the occurrence of MACE events in male patients were smoking and increased levels of low-density lipoprotein cholesterol (all P<0.05). Conclusion Increasing age and elevated blood sugar levels are high-risk factors for MACE events in female patients.High-risk factors for MACE events in male patients are smoking and elevated low-density lipoprotein cholesterol levels.

Objective To investigate the effect of Yiqi Weixue capsules combined with polysaccharide iron complex in the treatment of iron deficiency anemia of pregnancy (IDAP). Methods 104 patients with IDAP admitted to our hospital from June 2024 to May 2025 were selected and then assigned to different groups based on the random number table.For the control group (52 patients),polysaccharide iron complex was administered,and 52 patients in the study group were treated with Yiqi Weixue capsules on this basis.The clinical efficacy,Traditional Chinese Medicine (TCM) syndrome score,red blood cell related indicators [hematocrit (HCT),hemoglobin (Hb),mean corpuscular hemoglobin volume (MCH),mean corpuscular volume (MCV),mean corpuscular hemoglobin concentration (MCHC)],iron metabolism related indicators [serum ferritin (SF),transferrin (TRF),serum iron (SI),transferrin saturation (TSAT)],and adverse reactions were compared between the two groups. Results In terms of total effective rate comparison,the study group achieved a rate of 96.15%,which was higher than the control group’s 82.69% (P<0.05).After treatment,the TCM syndrome scores (dizziness,fatigue,pale or yellow complexion,fatigue and lazy speech) of the study group had lower values compared to the control group (P<0.05),the red blood cell related indicators (Hb,HCT,MCV,MCH,MCHC) of the study group were higher than that of control group (P<0.05),the levels of SF,SI,TSAT in the iron metabolism related indicators of study group were higher than those of the control group (P<0.05),and the TRF level was lower than the control group (P<0.05). Conclusion The combination of Yiqi Weixue capsule and polysaccharide iron complex yields a definite therapeutic effect in the treatment of IDAP,can effectively improve the anemia symptoms of patients and promote the recovery of red blood cells and iron metabolism indicators,and has good safety,which provides a better scheme of integrated traditional Chinese and Western medicine for the clinical treatment of IDAP.

Objective To explore the therapeutic effect of Compound Huangbai Liquid wet compress on iodine contrast medium extravasation in children. Methods A total of 80 children with contrast medium extravasation who underwent iodine contrast medium imaging examinations in our hospital from August 2023 to July 2025 were selected as the research objects.They were divided into a control group and an observation group with 40 cases in each group according to the random number table method.The control group was treated with magnesium sulfate wet compress,while the observation group was treated with Compound Huangbai Liquid wet compress,with continuous intervention for 48 hours in both groups.The clinical effects of the two groups after intervention were observed and compared,including the degree of swelling regression,pain intensity,and total effective rate of skin repair.Meanwhile,the occurrence of adverse reactions in both groups during the intervention period was recorded. Results After intervention,the pain intensity of the observation group was significantly lower than that of the control group,and the total swelling regression rate and total effective rate of skin repair in the observation group were significantly higher than those in the control group,with statistically significant differences (all P<0.05).There was no statistically significant difference in the adverse reactions between the two groups of children during the intervention period (P>0.05). Conclusion The application of Compound Huangbai Liquid wet compress in the treatment of iodine contrast medium extravasation in children can effectively shorten the pain relief time,promote swelling regression,improve the effect of skin repair,and has high safety.It can be used as an effective intervention method for iodine contrast medium extravasation in children.

Objective To explore the current status of chronic disease resource utilization among elderly patients with coronary heart disease (CHD) and its influencing factors. Methods Using a convenience sampling method,102 elderly CHD patients admitted to Tianjin Chest Hospital from August 2023 to August 2024 were selected as study subjects.Patients were surveyed using a general information questionnaire and a chronic disease social resource utilization questionnaire.Multiple linear regression analysis was used to identify factors influencing resource utilization. Results The total social resource score of elderly CHD patients was (52.34±7.56),with the highest average scores in items related to healthcare personnel and the lowest scores in organizational items.Univariate analysis showed that elderly CHD patients with different occupations,types of medical insurance,long-term residence,use of outpatient medical assistance policies,use of inpatient medical assistance policies,and use of temporary aid policies had significant differences in social resource utilization (P<0.05).Multiple linear regression analysis indicated that type of medical insurance,long-term residence,use of outpatient medical assistance policies,use of inpatient medical assistance policies,and use of temporary aid policies were influencing factors for elderly CHD patients (P<0.05). Conclusion Resource utilization among elderly CHD patients is suboptimal.Type of medical insurance,long-term residence,and the use of outpatient,inpatient,and temporary medical assistance policies are factors influencing social resource utilization.Therefore,effective interventions targeting these factors should be implemented in clinical practice.

Objective To analyze the application value of Red-Furnace Muscle-Pulling therapy combined with neck rehabilitation exercises in mixed-type cervical spondylosis. Methods A total of 60 patients with mixed CS admitted to our hospital from August 2024 to August 2025 were selected and divided into the control group (30 cases) and the observation group (30 cases) by random number table method.On the basis of conventional intervention measures,the control group was given neck rehabilitation exercise,and the observation group was given red furnace tendon drawing therapy combined with neck rehabilitation exercise in addition to the control group′s intervention.The treatment course was 10 days.The rehabilitation effects and recovery indicators of the two groups were compared; Before and after the intervention,the scores of the Cervical spondylosis Efficacy Score Sheet,the quality of life Cervical Spondylosis Clinical Evaluation Scale (CASCS) and the satisfaction levels of the two groups of interventions were compared. Results Compared with the control group,the rehabilitation effect and intervention satisfaction of the observation group were higher (P<0.05); Compared with the control group,the disappearance time of cervical pain and the recovery time of activity function in the observation group were shorter (P<0.05).After the intervention,the therapeutic effect score and CASCS score of cervical spondylosis in both groups increased,and the observation group was higher than the control group (P<0.05). Conclusion The application of red furnace tendon pulling therapy combined with neck rehabilitation exercises in patients with mixed CS has a definite effect.It can promote the disappearance of pain,improve cervical spine function and quality of life,and increase patient satisfaction.

Objective To observe the effect of Modified Buzhong Yiqi Decoction on pain level and knee joint function in patients with periarticular bone contusion of the knee. Methods A total of 98 patients with periarticular bone contusion admitted from April 2022 to April 2025 were selected and divided into the conventional group (n=49) and the experimental group (n=49) by random number table method.There were no cases of loss to follow-up or dropping out during the process,and all completed the study.The conventional group was treated with conventional therapy,while the experimental group was supplemented with Modified Buzhong Yiqi Decoction on the basis of conventional therapy for two consecutive weeks.The total effective rate,bone marrow edema score,Visual Analogue Scale (VAS) for pain,Lysholm score,Traditional Chinese Medicine(TCM) symptom score,incidence of adverse reactions,and matrix metalloproteinase 2 (MMP-2),tumor necrosis factor -α (TNF-α),and matrix metalloproteinase 9 (MMP-9) between the two groups were compared. Results The total effective rate of the experimental group (93.88%) was higher than that of the conventional group (79.59%) (P<0.05).There was no statistically significant difference in the VAS score,bone marrow edema score,Lysholm score and TCM symptom score before treatment between the two groups (P>0.05).Compared with before treatment,the VAS scores,TCM symptom scores,and bone marrow edema scores of both groups decreased at 2 weeks and 8 weeks of treatment,and the scores of the experimental group at 2 weeks and 8 weeks of treatment were lower than those of the conventional group (P<0.05).Compared with before treatment,the Lysholm scores of both groups increased at 2 weeks and 8 weeks of treatment,and the scores of the experimental group were higher than those of the conventional group at 2 weeks and 8 weeks of treatment (P<0.05).There was no statistically significant difference in TNF-α,MMP-2 and MMP-9 between the two groups before treatment (P>0.05).Compared with before treatment,TNF-α,MMP-2 and MMP-9 in both groups decreased at 2 weeks and 8 weeks of treatment,and those in the experimental group were lower than those in the conventional group at 2 weeks and 8 weeks of treatment (P<0.05).The total incidence of adverse reactions in the experimental group (10.20%) was not statistically different from that in the conventional group (4.08%) (P>0.05). Conclusion Modified Buzhong Yiqi Decoction can alleviate pain and bone marrow edema and improve knee joint function in patients with periarticular bone contusion of the knee.