ObjectiveTo investigate the correlation between neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， systemic immune-inflammation index （SII） and the severity of intrauterine adhesions （IUA）. MethodsThe retrospective study included 380 patients who underwent transcervical resection of adhesions （TCRA） from December 2019 to March 2025. Based on the American Fertility Society （AFS） classification， patients were divided into mild （n=61）， moderate （n=225）， and severe （n=94） groups. NLR， PLR， and SII were calculated from preoperative blood tests. Statistical analyses included Kruskal-Wallis test and ordinal Logistic regression. ResultsNLR， PLR， and SII were significantly higher in the severe IUA group compared to the mild group （P<0.05）， with SII showing the strongest predictive ability （OR=1.004， P=0.001）. The number of intrauterine procedures was an independent risk factor （OR=1.27/level， P=0.016）. The predictive model ［Logit（P）=-0.676+0.241×operation times+0.004×SII］ effectively identified severe IUA cases. ConclusionInflammatory markers （particularly SII） are correlated with IUA severity and may serve as non-invasive tools for clinical assessment.

Abstract The prevention and control of myopia in Chinese children and adolescents has become a major public health issue. While maintaining increased outdoor activity as a cornerstone intervention, there is an urgent need to explore new complementary approaches that can be effectively implemented in both indoor and outdoor settings. In recent years, environmental spatial frequency has gained increasing attention as one of the key environmental factors influencing the development and progression of myopia. Both animal studies and human research have confirmed that indoor environments lacking mid to high spatial frequency components, often characterized as "visually impoverished", can promote axial elongation and myopia through mechanisms such as disruption of retinal neural signaling, impaired accommodative function, and altered expression of related molecules. Based on the scientific consensus, it is recommended that "enriching of environmental spatial frequency" should be integrated into the myopia prevention and control framework. Following the principles of schoolled organization, family cooperation, community involvement, and student participation, specific measures are put forward in three areas：optimizing school visual settings, improving home spatial environments, and promoting healthy visual behavior. The aim is to create "visually friendly" indoor environments as an important supplement to outdoor activity, thereby providing a novel perspective and strategy for comprehensively advancing myopia prevention and control among children and adolescents.

BACKGROUND/OBJECTIVES: Unhealthy diets are associated with chronic stress. An allostatic load (AL) is a comprehensive physiological index that measures the chronic stress response of the body. As a healthy dietary pattern, the role of Dietary Approaches to Stop Hypertension (DASH) in the development of an AL during pregnancy remains unclear. This study examined the relationship between the DASH dietary pattern and AL during pregnancy. SUBJECTS/METHODS: This study was a prospective study. From January 2024 to November 2024, 134 pregnant women in the second trimester (23–27 weeks) and third trimester (32–36 weeks) of pregnancy who met the inclusion and exclusion criteria in the obstetrics clinic of a tertiary general hospital in Anhui Province were selected for a questionnaire survey, physical examination, and laboratory examination. The DASH dietary pattern was assessed using the DASH scoring tool, and the total AL score was calculated using nine biomarkers that represent the cardiovascular, metabolic, and immune systems. Logistic regression was used to analyze the relationship between the DASH score and AL. RESULTS: One hundred and thirty-four pregnant women were included in this study. At the second and third trimesters, 41.8% and 37% of pregnant women, respectively, were in the high AL group. The binary logistic regression results showed that the DASH score was negatively correlated with the AL in the unadjusted model (odds ratio [OR], 0.878; 95% confidence interval [CI], 0.807–0.957; P = 0.003) and adjusted model (OR, 0.878; 95% CI, 0.792–0.973; P = 0.013) in the second trimester, the DASH score was negatively correlated with the AL in the unadjusted model (OR, 0.832; 95% CI, 0.758–0.913; P < 0.001) and adjusted model (OR, 0.806; 95% CI, 0.716–0.908; P < 0.001) in the third trimester. CONCLUSION The DASH score was negatively correlated with the AL in pregnant women.A low DASH score may increase the risk of a high AL, which may have adverse effects on physical and mental health.

Degenerative retinoschisis(RS)is a common peripheral retinal degeneration that typically remains asymptomatic and follows a benign clinical course. However, its morphological resemblance to rhegmatogenous retinal detachment(RRD)presents a diagnostic challenge, as the two conditions demand fundamentally different management and carry distinct prognoses. Precise differentiation is therefore clinically imperative. Recent advances in multimodal imaging have substantially refined the diagnostic accuracy and differential assessment of degenerative RS, establishing spectral-domain optical coherence tomography(SD-OCT)as the definitive reference standard. When the disease progresses to progressive symptomatic schisis-related retinal detachment(PSSRD), prompt surgical intervention, including scleral buckling, pars plana vitrectomy, or a combined approach, is mandated to preserve visual function. Clinical decision-making must be individualized, with the surgical strategy carefully tailored to the specific characteristics of eachcase. This review provides a systematic synthesis of current evidence on the natural history, imaging hallmarks, and surgical management of degenerative RS and its complications, aiming to inform and optimize clinical practice.

Three-dimensional(3D)printing technology,which is based on computer aided design,presents innovative solutions for clinical surgical treatments and is increasingly being utilized in clinical settings.By integrating medical-image processing software and a 3D printer with customized materials,physicians can efficiently fabricate a 3D model layer by layer,thus realizing the reconstruction of human-body models with specific objectives.These models vividly showcase the anatomical structures,fracture types,and rupture severity,thereby facilitating doctors in understanding the fracture being examined.Beyond serving as a mere demonstration tool,the physi-cal model assists doctors in designing personalized implants and selecting customized surgical guide plates and fixation screws.Surgeons can improve the surgical accuracy and efficacy by refining the surgical plan via preoperative simulation operations.This article presents a summary of the application of computer-simulation surgery in conjunction with 3D printing technology in various complex surgeries.Addi-tionally,the significant potential applications of 3D printing technology in the clinical orthopedics field are discussed.

Hepatic fibrosis(HF)is an inevitable process for many chronic liver diseases to develop into liver cirrhosis and even liver cancer.More than 80%of hepatocellular carcinomas are formed after the process of chronic hepatitis,HF or liver cirrhosis.The immune microenvironment produced by inflammation and fi-brosis plays a significant role in promoting the occurrence and development of hepatocellular carcinoma.He-patic stellate cells(HSC),extracellular matrix(ECM),and fibroblasts are involved in the progression of HF by influencing innate immunity and adaptive immunity.This article,by analyzing the role of immune cells in HF,is expected to provide new intervention approaches and therapeutic targets for the clinical treatment of HF,thereby further enhancing the effectiveness of immunotherapy and offering safer and more effective treat-ment options for HF patients.

Objective:To investigate the effects of dexmedetomidine(DEX)on T cell subsets in rats with rheumatoid arthritis(RA)by regulating interleukin-10(IL-10)/signal transduction factor and transcriptional activator 3(STAT3)signaling pathways.Methods:SD rats were grouped into control group(NC group),Model group,DEX low-dose group(DEX-L group,5 μg/kg),DEX medium-dose group(DEX-M group,10 μg/kg),DEX high-dose group(DEX-H group,20 μg/kg),methotrexate group(MTX group,0.33 mg/kg),AS101 group(IL-10 inhibitor,1.5 mg/kg)and DEX-H+AS101 group(20 μg/kg+1.5 mg/kg),with 18 rats in each group.Except NC group,RA models were established in rats of other groups.The administration was started 24 hours after the second immunization,once a day for 3 weeks.The changes of foot swelling rate and joint index were measured;HE staining was applied to detect the pathological changes of spleen tissue;the levels of TNF-α and IL-1β in rat spleen were detected by ELISA;the percentages of CD3+CD4+T cells,CD3+CD8+T cells and the proportions of helper T cell 17(Th17)and regulatory T cell(Treg)in rat spleen were measured by flow cytometry;and Western blot was applied to detect the expressions of IL-10 and p-STAT3 protein in rat spleen.Results:Compared with NC group,the pathological damage of spleen tissue in Model group was serious,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+T cells,Th17 cells,Th17/Treg were increased,the percentage of CD3+CD8+T cells,Treg,and expression of IL-10 and p-STAT3 protein were decreased(P<0.05);compared with Model group,the pathological damage of spleen tissue in DEX-L group,DEX-M group,DEX-H group and MTX group were reduced,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+T cells,Th17 cells,Th17/Treg decreased,the percent-age of CD3+CD8+T cells,Treg,and expressions of IL-10 and p-STAT3 protein were increased(P<0.05);compared with Model group,the pathological damage of spleen tissue in AS101 group was aggravated,the feet swelling rate,joint index,the levels of TNF-α and IL-1β,the percentage of CD3+CD4+Tcells,Th17 cells,Th17/Treg were increased,the percentage of CD3+CD8+T cells,Treg cells,and expression of IL-10 and p-STAT3 protein were decreased(P<0.05);AS101 attenuated the promoting effect of high dose DEX on the proportion balance of T cell subsets in RA rats.Conclusion:DEX may promote the balance of T cell subsets in RA rats by activating IL-10/STAT3 pathway.

Objective To investigate the causal relationships between anxiety disorders and coronary heart disease(CHD),atrial fibrillation(AF),heart failure(HF),stroke and myocardial infarction(MI)risks by using the bidirectional two-sample Mendelian randomization study method.Methods The data were collected from the genome-wide association study(GWAS)conducted within the population-based Danish Lundbeck Foundation Initiative for Integrative Psychiatric Research(iPSYCH)study,as well as from five other databases related to cardiovascular diseases.The inverse variance weighting(IVW)method was used to produce the main results,and four methods,including MR-Egger regression,weighted median method,weighted model,and simple model,supplemented the results.Sensitivity analyses such as heterogeneity,horizontal pleiotropy,and leave-one-out analysis were also performed.Results The IVW and MR-Egger regression showed that anxiety disorders would increase the risk of coronary heart disease(IVW:OR=1.0001,95％CI=1.0001-1.0025,P=0.040;MR-Egger:OR=1.0030,95％CI=1.0009-1.0058,P=0.013).There was no evidence of a causal effect of cardiovascular diseases on anxiety disorders risks.There was no horizontal pleiotropy and heterogeneity in the instrumental variables of this study.The result of sensitivity analysis was robust.Conclusion The study supports the causal effect of anxiety disorders on CHD risk,but no association is found with an increased risk of other cardiovascular diseases,such as AF,HF,stroke,and MI.No reverse causal association effect is observed.

Objective To explore the basis of PERMA on the overall well-being and social support of elderly patients with maintenance hemodialysis(MHD).Methods A total of 60 elderly patients with MHD were selected from the blood purification center of a tertiary A hospital in Zhejiang Province from January to December 2022 as the study subjects.According to the different disease areas of the patients,they were randomly divided into an experimental group or a control group.Finally,30 patients were included in each group.The control group received routine care,and the experimental group received another 4-week bidirectional social support intervention based on the PERMA model.General well-being scale,social support rating scale,sleep duration,activity duration were used to evaluate the effect before intervention,4 weeks after intervention and 1 month after intervention.Results The results of repeated measurement ANOVA showed that there were statistically significant differences in general happiness score,social support score,sleep duration and activity duration in terms of time effect(P＜0.05),while there were statistically significant differences in general happiness score,social support score and sleep duration in terms of inter-group effect(P＜0.05).Social support score and sleep duration had statistically significant interac-tion effects(P＜0.05).Conclusion The bidirectional social support intervention based on well-being PERMA model can enhance the general well-being and social support level of elderly patients with MHD,and improve the sleep and activity status of elderly patients with MHD.

Objective This study examines the factors influencing oral frailty in the elderly community,develops a risk prediction model,and validates its efficacy,so as to provide references for identifying and preventing oral weakness in the elderly.Methods 556 elderly individuals from 4 communities were selected by convenience sampling from June to August 2024 in Zigong City Sichuan Province.They were randomly divided into a training group(383 cases)and a validation group(165 cases).Data were collected by a general information questionnaire,Social Frailty Scale,Geriatric Depression Scale,and the Oral Frailty Index-8 screening tool.Logistic regression was used to determine the influencing factors,and R software was used to establish a nomogram model for predicting the risk of oral frailty.Bootstrap method and the validation group were used for internally validation of the model.Calibration curve was used to evaluate the prediction performance of the model.Results 548 valid questionnaires were collected.The final model variables included whether the age ≥80 years,wearing removable dentures,reduced frequency of going out,brushing teeth less than twice a day,frequent dry mouth,increased difficulty in eating hard foods,and choking.The area under the receiver operating characteristic curve of the training group was 0.95(95％CI:0.93～0.97),and the best cutoff value was 0.687.The model achieved an accuracy of 87％,sensitivity of 91％,specificity of 85％,positive predictive value of 0.75,and negative predictive value of 0.95.The Hosmer-Lemeshow fitting test show that x2=3.036,P=0.932,indicating a good model fit.Conclusion The oral frailty prediction model demonstrated a good discrimination,calibration,and clinical utility,which can provide a scientific basis for the prevention and early screening of oral frailty in the elderly.