Objective To explore the service quality of video consultation from the patient's perspective and its in-fluencing factors,and to provide theoretical basis and practical reference for public hospitals to promote the develop-ment of video consultation.Methods Based on the video consultation service quality questionnaire designed by the SUTAQ scale,a questionnaire survey was conducted with 345 patients who participated in the video consultation field trial,and the influencing factors were analyzed by using multiple linear regression.Results The total score of pa-tients' video consultation service quality was 14.80±3.43,and the dimensional scores,from lowest to highest,con-tinue using,and immediacy of consultation.The results of multiple linear regression showed that the differences in the effects of marital status,education,willingness to pay and waiting time on the quality of video consultation ser-vice were statistically significant(P＜0.05).Conclusion Patients' evaluation of the service quality of video consulta-tion is good overall,and there are differences in the scores of each dimension,in which the immediacy of diagnosis and treatment is the most prominent value of video consultation,and the patient's perceived risk is a non-negligible problem.It is recommended to strengthen risk regulation and privacy protection,focus on group heterogeneity and synergize with family doctors,and optimize service pricing and waiting process to enhance patients' trust and ex-perience and promote the healthy and sustainable development of video consultation.

Objective To explore the economic impact and ecological value of video consultations on hospitals and patients,providing a reference for the development of video consultation services.Methods A total of 345 patients and 31 physicians who participated in video consultation practices in 2024 were surveyed using questionnaires and in-terviews.The economic impacts,social benefits,and potential risks and challenges of video consultations for hospi-tals and patients were analyzed.Independent sample t-tests were conducted to compare the differences in video consultation evaluations between patients and physicians.Results During the experimental period,video consulta-tions resulted in a minimum revenue loss of 18 375 yuan for various hospital departments.However,each patient saved no less than 1 000 yuan in transportation,accommodation,and wage loss expenses.Patients' overall satis-faction and timeliness ratings were significantly higher than those of physicians(P＜0.05),while patients' willing-ness to continue using video consultations was significantly lower than that of physicians(P＜0.05).There was no statistically significant difference between patients and physicians in terms of perceived effectiveness(P＞0.05).Conclusion Video consultations effectively reduce patients' economic burden and improve the accessibility of health-care services.The revenue loss for hospitals stems primarily from low service efficiency and the shift of income from pharmaceuticals and diagnostic services.Disease types play a critical role in influencing consultation efficiency and economic outcomes.It is recommended to introduce intelligent triage systems,establish an integrated online and of-fline service model,enhance patient operational experience,and improve regulatory mechanisms to promote the high-quality development of video consultations.

The construction of telemedicine in county public medical institutions is an inevitable choice for the supply of high-quality medical services in remote areas as well as for the coverage of village-level health services,and it is also a new mode of service provision for public hospitals to link with grassroots level within the county medi-cal community.At present,China's county telemedicine has derived three different modes in the development of various regions,and some problems have been exposed in the implementation.By combing the literature and poli-cies and conducting field research in representative telemedicine construction areas,it analyses the existing prob-lems and the logic of their emergence,and put forward corresponding recommendations.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To explore the effect of staged pressure therapy, in addition to rehabilitation training, on scar hyperplasia and motor function after a deep hand burn.Methods:Sixty patients with deep hand burns were randomly divided into a control group ( n=30) and an observation group ( n=30). In addition to specialized burn treatment and early rehabilitation training, the control group was given routine pressure treatment, while the observation group was provided with staged pressure therapy for 6 months. Before the treatment and after 3 and 6 months of treatment, scar hyperplasia and hand function in both groups was evaluated using the Vancouver scar scale (VSS), grip strength and pinch strength tests, and the Jebsen hand function test (JHFT). Total active motion (TAM) and total passive motion (TPM) of the finger joints was quantified, and any complications during the treatment were recorded. Results:After 3 and 6 months of the treatment, all of the observations in both groups had improved significantly, but the improvements were significantly better among the treatment group, on average.Conclusions:Staged pressure therapy can more effectively inhibit scar hyperplasia after a deep hand burn. In conjunction with rehabilitation training, it better improves the mobility of the finger joints, hand muscle strength and the recovery of hand function. It is worthy of clinical promotion and application.

Objective:To explore any myogenic effect of extracorporeal shock wave therapy (ESWT) on shoulder joint contracture.Methods:Sixty-eight patients with shoulder contracture were enrolled and randomly divided into a conventional therapy group ( n=34) and an ESWT group ( n=34) for this clinical trial. The conventional therapy group received standard rehabilitation treatment, while the ESWT group received additional extracorporeal shock wave therapy. In addition, 24 Sprague-Dawley rats were randomly assigned to a blank control group, a model group, a natural recovery group, or an ESWT animal group, each of 6. All of the groups except the blank control group had contracture modeled using plaster cast immobilization of the left shoulder joint. After successful modeling, the natural recovery group was routinely raised for two weeks, while the ESWT animal group received two weeks of extracorporeal shock wave intervention. In both the clinical and animal experiments, ESWT was administered twice weekly (every Tuesday and Friday) for two consecutive weeks. Before and after the treatment, the patient groups were assessed using a visual analog scale (VAS) for pain, shoulder range of motion (ROM), and the root mean square (RMS) values of the surface electromyographs of the peri-shoulder muscles. Shoulder ROM was assessed in all four of the rat groups after the ESWT treatment, and histological analysis of the supraspinatus muscle was performed. Results:After the treatment, both patient groups showed significant improvements in their average VAS scores, active and passive shoulder ROM, and RMS values. On average, the ESWT group demonstrated significantly greater improvements than the conventional therapy group in active forward flexion, passive forward flexion, active abduction, passive abduction, and the RMS values of the deltoid, biceps brachii, and triceps brachii muscles. After the treatment the left shoulder abduction angle had been reduced significantly in the model group (to 96.00±2.37)°, the natural recovery group (103.00±4.05)° and the ESWT animal group (121.33±4.89)° compared to the blank control group (154.50±2.35)°. Both the natural recovery group and the ESWT animal group had significantly greater shoulder abduction angles than the model group, and the ESWT animal group also demonstrated a significantly larger abduction angle than the natural recovery group. After the treatment, significant differences between the model group and the blank control group were observed in the cross-sectional area of left supraspinatus muscle fibers and the proportion of collagen. The ESWT animal group too exhibited significantly improved muscle fiber cross-sectional area and collagen proportion compared to the natural recovery group.Conclusions:Shoulder joint contracture is accompanied by significant myopathic changes (muscle atrophy and fibrosis). ESWT effectively ameliorates these problems while enhancing muscle strength and functional recovery.

Objective To explore the effects of the Otago Exercise Program(OEP)on activities of daily living,muscle strength,balance,and physical function in older adults with sarcopenia,to compare OEP with conventional exercise training,and to provide a basis for clinical rehabilitation programs for older adults with sarcopenia.Methods In this randomized controlled trial,120 older adults clinically diagnosed with sarcopenia were enrolled.The participants were randomly assigned to the OEP intervention group(experimental group)and the conventional exercise intervention group(control group),with 60 in each group.The experimental group underwent 12 weeks of OEP training,three times a week,with each session lasting 45 minutes.The control group underwent conventional exercise training following the same schedule.The Modified Barthel Index was used as the primary outcome measure to assess activities of daily living.Secondary outcome measures included muscle strength,gait stability,dynamic balance,and physical function status,evaluated using grip strength,6-meter walking speed,the Timed Up and Go Test(TUGT),and the Short Physical Performance Battery(SPPB).Results A total of 120 older adults with sarcopenia were included.The mean age of the participants was(80.17±8.48)years.Baseline data before treatment showed no statistically significant differences between the two groups.Both groups completed the treatment within 12 weeks without experiencing any adverse events.The baseline data for the experimental group were as follows,MBI at(67.00±22.76)points,hand grip strength at(15.29±4.94)kg,gait speed at(0.61±0.26)m/s,TUGT time at(15.05±6.74)s,and SPPB score at(6.17±1.40)points,while the corresponding post-intervention findings were as follows,(78.72±15.83)points,(17.67±5.83)kg,(0.77±0.28)m/s,(13.49±6.16)s,and(9.25±1.71)points,respectively.The experimental group showed improvements in all measures from baseline to post-intervention(P＜0.05 for all measures).As for the control group,the baseline data for the corresponding measures were as follows,(67.20±22.12)points,(15.00±5.35)kg,(0.58±0.23)m/s,(17.29±6.90)s,and(6.00±1.24)points,respectively.The post-intervention findings increased to(71.13±20.28)points,(15.47±5.72)kg,(0.64±0.28)m/s,(16.50±6.99)s,and(6.73±1.61)points,respectively,but the changes were not statistically significant(P＞0.05).Furthermore,an intergroup comparison of intervention effects(post-intervention minus preintervention)revealed significant differences in mean changes from baseline.The experimental group demonstrated improvements of(+11.72±6.32)points in modified Barthel Index,(+11.72±6.32)kg in grip strength,(+0.16±0.09)m/s in gait speed,(—1.56±1.32)s in TUGT time,and(—1.56±1.32)points in SPPB score.In contrast,the control group showed smaller changes of(+3.93±5.65)points,(+0.47±1.37)kg,(+0.06±0.07)m/s,(—0.79±1.54)s,and(+0.73±1.12)points,respectively(all P＜0.05).Intergroup comparisons revealed superior outcomes in the experimental group across all measures.Conclusion OEP significantly enhances activities of daily living,improves muscle strength,balance,and physical function in older adults,and is more effective than conventional rehabilitation exercise programs,making it suitable for extensive clinical application.

Standardized clinical trial reporting is crucial for ensuring the scientific validity,reproducibility,and clinical translational value of reported results.The Consolidated Standards of Reporting Trials(CONSORT)statement,an internationally recognized guideline for randomized controlled trials(RCTs),has become an important reference standard for writing research papers in medicine since the 2010 version of CONSORT was published.With advancements in scientific research methodologies and the emergence of new forms of clinical trials,the CONSORT working group released an updated version in April 2025,published in journals such as The BMJ.Herein,we provide a systematic interpretation of the core revisions of CONSORT 2025,as well as a comparison with CONSORT 2010 to highlight the key differences.By providing practical,example-based recommendations,we aim to help domestic researchers apply the new guidelines efficiently,thereby improving the quality of clinical trial reports authored by domestic researchers.

A high-quality clinical trial protocol is the cornerstone for ensuring the scientific integrity and ethical compliance of a study.The Standard Protocol Items:Recommendations for Interventional Trials(SPIRIT)has become the international benchmark for developing clinical trial protocols since its release in 2013.To adapt to the developing trends of open science and patient-centered principles,the SPIRIT group completed a comprehensive update in 2025.While retaining its core structure,this updated guideline introduces a new open science module and incorporates several new elements,including patient and public involvement,trial monitoring,and data sharing,alongside substantial revisions of five pre-existing items.In this article,we critically examine the core revisions in SPIRIT 2025 and,through analysis of representative case studies,illustrate the practical application of the new reporting guideline in drafting trial protocols.Our goal is to to provide Chinese researchers with a valuable reference for understanding and implementing this new reporting guideline,thereby enhancing the quality and rigor of clinical trial protocols developed in the country.

Objective To investigate the feasibility of estimating the real-ear-to-coupler difference(RECD)in children with head circumference,so as to further optimize the personalized and accurate matching scheme of hearing aid fitting for children.Methods A total of 106 children(197 ears)were enrolled in this study.Head circumference was measured using a soft ruler and RECD was measured using OmetroricsAuricalTM.SPSS software was used to analyze the correlation between the head circumference,month age and RECD values at each frequency of children.Results ① The head circumference of boys was slightly larger than that of girls,but there was no significant differ-ence between them(P＞0.05).② Unitary linear correlation analysis showed that RECD values at 750-6 000 Hz were negatively correlated with the head circumference,and a regression equation was established between RECD values at 1 000-6 000 Hz and the head circumference.③ RECD values calculated by regression formula based on the head circumference showed no significant difference between 1 000-3 000 Hz and 6 000 Hz and children's actu-al RECD values.Conclusion The individual RECD values of 0-6 years old children were correlated with the head circumference,and with the increase of the head circumference,RECD values at middle and high frequencies de-creased gradually.For children whose physical developments were not consistent with biological age,the RECD data at middle and high frequencies could be estimated based on the head circumference.