Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Objective To investigate the relationship between serum trimethylamine oxide(TMAO),neurofilament light chain protein(NfL),peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α)expression levels and short-term prognosis in aneurysmal subarachnoid hemorrhage(aSAH)patients.Method A total of 125 aSAH patients(aSAH group)and 125 healthy volunteers in the same period(control group)who were admitted in heji hospital affiliated to Changzhi Medical College from March 2020 to June 2023 were selected.The serum expression levels of TMAO,NfL and PGC-1α were compared between control group and aSAH group.The aSAH patients were followed up for 6 months after discharge.Their prognosis were evaluated using Glasgow Outcome Scale(GOS)and they were further divided into good prognosis and poor prognosis groups according to the GOS results.The serum expression levels of TMAO,NfL and PGC-1α were compared between the two groups.The poor prognosis influencing factors were analyzed by multivariate Logistic regression analysis,the serum TMAO,NfL and PGC-1α value in predicting poor prognosis were analyzed by receiver operating characteristic(ROC)curve.Result The expression levels of serum TMAO and PGC-1 α in the aSAH group were(2.63±0.36)μmol/L and(0.51±0.13)ng/mL,respectively,which were lower than those in the control group(3.18±0.57)μmol/L and(0.81±0.16)ng/mL(P<0.05).The expression level of serum NfL was significantly higher in the aSAH group(64.48±14.35 pg/mL)than in the control group(28.36±8.82 pg/mL)(P<0.05).Compared with the good prognosis group whose serum levels of TMAO and PGC-1 α were(2.80±0.80)μmol/L and(0.58±0.16)ng/mL,respectively,the poor prognosis group had significantly lower serum TMAO[(2.29±0.63)μmol/L]and PGC-1 α[(0.36±0.12)ng/mL](P<0.05).In contrast,poor prognosis group had a significantly higher level of NfL(76.70±15.61)pg/mL compared to good prognosis group(58.52±10.52)pg/mL(P<0.05).The proportion of patients with hypertension,patients with diabetes,patients with large or giant aneurysms,patients with Hunt Hess grade Ⅲ-Ⅳ,patients with onset to hospital time>12 h,and the level of C-reactive protein(CRP)were higher in the poor prognosis group than in the good prognosis group(P<0.05).Hunt Hess grade Ⅲ-Ⅳ,elevated serum CRP and NfL were independent risk factors for poor prognosis in aSAH patients(P<0.05),while elevated TMAO and PGC-1 α were protective factors(P<0.05).The area under the curve(AUC)of serum TMAO,NfL,PGC-1 α,and their combined prediction of poor prognosis in aSAH patients were 0.726,0.830,0.862,and 0.956,respectively.The AUC of the combined detection was greater than that of each indicator detected separately.Conclusion Serum TMAO and PGC-1α are lowly expressed in aSAH patients,and serum NfL is highly expressed,which are related to the occurrence of short-term poor prognosis,the combined detection of the three indicators has a high predictive value for short-term poor prognosis in aSAH patients.

Objective:To investigate the effects of musculoskeletal ultrasound(MSUS)-guided shoulder joint capsule hydraulic expansion method combined with rotator interval(RI)injection method on ultrasound imaging indicators,shoulder function,and serum inflammatory factors in treating patients with early primary frozen shoulder(PFS).Methods:A total of 168 patients with early PFS admitted to Jiangbei District of The Frist Affiliated Hospital to Army Medical University between June 2021 and June 2023 were selected.They were randomly divided into a control group and an observation group by using a random number table,with 84 patients in each group.The control group received the therapy with MSUS-guided shoulder joint capsule hydraulic expansion.The observation group received the therapy with RI injection on the basis of the control group.After 5 weeks of treatment,the changes of the following parameters were compared and analyzed between the two groups:Visual Analog Scale(VAS)score for shoulder pain,Simple Shoulder Test(SST)score,Constant-Murley Score(CMS),thickness of the glenohumeral joint capsule at the axilla of ultrasound imaging,thickness of coracohumeral ligament(CHL),RI thickness,positivity rate of RI blood flow,passive range of motion(ROM)of the shoulder joint,and serum inflammatory factor levels including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6).Results:At 5th week after treatment,both groups showed VAS scores decreased,and SST and CMS scores increased.The VAS score(1.34±0.30)of observation group was significantly lower than(1.97±0.46)of control group,and the SST score and CMS score were significantly higher than those of control group(t=10.514,9.597,7.910,P<0.05),respectively.Both groups showed decreases in thickness of the glenohumeral joint capsule at the axilla,CHL thickness,RI thickness,and positivity rate of RI blood flow,and these indicators of observation group were significantly lower than them of control group,with statistically significant differences(t=5.518,16.106,9.050,25.211,P<0.05).The ranges of backward extension and outward rotation of observation group were larger than those of control group,and the differences were statistically significant(t=9.209,12.447,P<0.05).The serum levels of TNF-α,IL-6 and CRP of observation group were significantly lower than those of control group,and the differences were statistically significant(t=10.523,17.750,19.995,P<0.05),respectively.Conclusion:The treatment of MSUS-guided shoulder joint capsule hydraulic expansion combined with RI injection can effectively alleviate the degrees of shoulder pain and dysfunction in patients with early PFS,and improve indicators of ultrasound imaging,the ROM values of outward rotation and backward extension,and reduce serum levels of inflammatory factors,which have favorable therapeutic effects.

Objective : To explore the therapeutic effect of extracellular vesicles(EVs) of Aspergillus flavus(A. flavus) on A. flavus infection. Methods: The EVs of A. flavus were isolated using ultracentrifugation and detected/identified by nanoparticle tracking analysis(NTA). Quantitative real-time PCR(qRT-PCR) and enzyme-linked immunosorbent assay(ELISA) kits were used to assess the effect of A. flavus EVs on the polarization of bone marrowderived macrophages(BMDMs) and the expression levels of several cytokines,including tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-6(IL-6),and interleukin-10(IL-10). The Galleria mellonella(G.mellonella) infection model was constructed. Three concentration groups of A. flavus EVs(0. 2,2,and 20 μg/larvae) were set as the experimental groups,and PBS was used as the control group for the infection model.Meanwhile,three forms of negative control groups were established,including the PBS group,the pierced controlgroup, and the negative control group. The therapeutic effect of A. flavus EVs on A. flavus infection was evaluated by the survival rate of the G. mellonella infection models. Results: The particle size of A. flavus EVs ranged from 20 to550 nm. A. flavus EVs could polarize BMDMs into both M1 and M2 phenotypes and induce the production of cytokines,including TNF-α,IFN-γ,IL-6,and IL-10. The results of the G. mellonella infection model showed that A.flavus EVs could improve the survival rate of G. mellonella after A. flavus infection. Conclusion The EVs produced by A. flavus can promote the expression of both pro-inflammatory and anti-inflammatory cytokines in BMDMs,induce M1 polarization and M2 polarization of BMDMs,and increase the survival rate of G. mellonella after A. flavus infection.

Objective:To study and establish the UPLC fingerprint and multi-index content determination methods of Hedyotidis chrysotricahae Herba; To provide a reference for the quality control of Hedyotidis chrysotricahae Herba.Methods:The chromatographic column was ACQUITY UPLC HSS T3 (100 mm×2.1 mm,1.8 μm). The mobile phase was acetonitrile-0.1% phosphoric acid solution with gradient elution; the detection wavelength was 254 nm; the flow rate was 0.30 ml/min and column temperature was 35 ℃. The method could determine content and fingerprint of rutin, Kaempferol-3-O-rutinoside, Narcissoside, Neochlorogenic aci, Chlorogenic Acid, Cryptochlorogenic acid and have quality analysis to 17 batches of Hedyotidis chrysotricahae Herba based on the variance of fingerprint, similarity evaluation, clustering analysis along with principal component analysis (PCA) at the same time.Results:The common pattern of UPLC specific chromatogram of Hedyotidis chrysotricahae Herba was established. The 11 common peaks were marked out, among which 7 peaks were identified. 17 batches Hedyotidis chrysotricahae Herba could be divided into 4 categories according to different origins. Quality content of six indicators of Hedyotidis chrysotricahae Herba was in slight difference between different origins, among which the content quality of Hedyotidis chrysotricahae Herba from Duyun in Guizhou Province was the highest.Conclusion:The established UPLC fingerprint and content determination method of 6 indicators from the study can be used for the quality control of Hedyotidis chrysotricahae Herba, which can also provide a theoretical basis for the standard improvement of Hedyotidis chrysotricahae Herba.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Objective:To explore the diagnostic value of multiparametric magnetic resonance imaging (mp-MRI) combined with computed tomography (CT) for brucellar spondylitis (BS).Methods:From March 2019 to March 2024, patients with suspected BS admitted to Yili Kazakh Autonomous Prefecture Friendship Hospital were selected as study subjects. Their clinical characteristics, laboratory tests, and imaging findings (mp-MRI and CT) were analyzed.Results:A total of 60 suspected BS patients were enrolled, including 43 males and 17 females. Among them, 39 cases (65.00%) were diagnosed with BS, while 21 cases (35.00%) were non-BS. CT examination was performed in 48 patients, mp-MRI in 40 patients, and both examinations in 28 patients. Among CT-examined patients, there were 28 BS cases, 1 case had cervical spine involvement, 3 case had thoracic spine involvement, 3 case had thoracolumbar spine involvement, and 21 case had lumbosacral spine involvement. There were 16 cases involved 2 vertebrae, 3 cases involved 3 vertebrae, and 9 cases involved > 3 vertebrae.There were 15 cases had vertebral osteophyte formation, 28 cases had vertebral bone destruction, 22 cases had intervertebral space stenosis, 25 cases had uneven intervertebral disc density, 28 cases had thickening of soft tissues around the vertebrae, 19 cases had paravertebral abscesses, and 6 cases had spinal canal stenosis. In the mp-MRI examination of patients, there were 30 BS patients, among whom 1 case had cervical spine involvement, 2 case had thoracic spine involvement, 4 case had thoracolumbar spine involvement, and 23 case had lumbosacral spine involvement. There were 16 cases involved 2 vertebrae, 3 cases involved 3 vertebrae, and 11 cases involved > 3 vertebrae, 24 cases had intervertebral space stenosis, 27 cases had intervertebral disc destruction. There were 27 cases had swelling and thickening of soft tissues around the vertebrae, and 21 cases had paravertebral, psoas major muscle, and/or spinal canal abscesses. The BS group showed lower fractional anisotropy value and higher apparent diffusion coefficient value compared to the non-BS group, with statistically significant differences ( t = 5.26, 5.63, P < 0.001). The mp-MRI combined with CT showed higher sensitivity (86.36%, 19/22) and specificity (5/6) for BS diagnosis compared to mp-MRI alone (78.57%, 11/14; 80.77%, 21/26) and CT alone (56.25%, 9/16; 71.88%, 23/32). Conclusions:BS patients present diverse imaging manifestations. The combination of mp-MRI and CT demonstrates better diagnostic efficacy for BS than single examinations alone, showing good diagnostic value.

Objective To construct and validate a predictive model for influencing factors of serum uric acid(SUA)in preeclampsia(PE),providing a scientific basis for early identification and intervention.Methods This study collects 19 variables from 171 PE preg-nant women admitted to the Department of Obstetrics at Bengbu Third People's Hospital between March 1,2021 to June 30,2024 inclu-ding hospitalization number,age,height,weight,urine protein,gestational week,SUA,oral glucose tolerance test(OGTT),alanine aminotransferase(ALT),hemoglobin(HB),albumin(ALB),aspartate aminotransferase(AST),serum creatinine(SCR),triglycer-ides(TG),total cholesterol(TC),serum urea(SUR),low-density lipoprotein cholesterol(LDL),high-density lipoprotein choles-terol(HDL),and D-dimer(D2D).According to the expression level of SUA,the important variables affecting SUA were screened by LASSO,multi-factor Logistic and neural network model,and the nomogram prediction model was constructed.The predictive perform-ance and clinical utility of the model were validated using the receiver operating characteristic(ROC)curve,decision curve analysis(DCA),and calibration curve.Results Three variables-ALB(OR=0.893,95％CI:0.808-0.986),AST(OR=4.292,95％CI:2.043-9.016)and SCR(OR=4.2,95％CI:1.495-11.801)-were identified as significant influencing factors of SUA in PE pregnant women through LASSO,multivariate Logistic regression,and neural network models.A nomogram prediction model for SUA was success-fully established,achieving an ROC value of 0.7646.The net benefit range of DCA was 20％-100％,and the calibration curve showed high consistency with the ideal curve.Conclusion ALB,AST,and SCR are critical variables influencing SUA in PE pregnant women,offering a scientific basis for early prediction and intervention.

Objective:To establish a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology, standardize the training process, and provide an effective evaluation method.Methods:Based on literature review and discussions, a preliminary expert consultation questionnaire was developed. From July to November 2024, a modified Delphi method was adopted and relevant experts were invited to assess the importance, validity, and feasibility of each indicator using a 5-point Likert scale. The results were used to screen and refine the entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology.Results:In the two rounds of expert consultation, the valid questionnaire return rate reached 100.00%, with an expert judgment basis coefficient of 0.73 and a familiarity coefficient of 0.90. Based on expert feedback, the final framework retained 3 first-level indicators and 12 second-level indicators. Modifications included renaming "Anesthesia Management" to "Anesthetic Drug Management", swapping the order of "Intraoperative Emergency Management" and "Airway Management", and removing the indicator "Resuscitation Assessment".Conclusions:This study preliminarily developed a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology. The framework provides a simple and practical competency evaluation method for standardized training, which can enhance training quality and effectiveness.