Atherosclerosis （AS） is the main pathological basis of cardiovascular diseases and seriously threatens human quality of life. Its prevention and treatment urgently need breakthroughs. The inflammatory response， which runs through the physiological and pathological evolution process of AS， is one of the important mechanisms for AS occurrence. Currently， the treatment methods for AS in Western medicine are relatively mature. However， they have adverse reactions such as abnormal liver and kidney function， drug tolerance， target vessel restenosis， and stent thrombosis， which remain the key bottleneck restricting clinical efficacy. Traditional Chinese medicine （TCM）， characterized by multiple components， multiple targets， and multi-pathway synergy， shows unique clinical application potential and efficacy advantages in the intervention of AS. This article reviewed the research progress of TCM in intervening in AS by regulating inflammatory-related signaling pathways， such as nuclear factor-κB （NF-κB）， Toll-like receptors （TLRs）， mitogen-activated protein kinase （MAPK）， and Janus kinase/signal transducer and activator of transcription （JAK/STAT）， in the past five years. It summarized the combined mechanism of action of TCM monomers， TCM pairs， and compound preparations in inhibiting the inflammatory cascade reaction through multiple targets， regulating lipid metabolism disorders， and improving vascular endothelial dysfunction and the imbalance of the microenvironment. It deepened the research on the molecular mechanism of TCM in anti-AS， so as to provide a scientific basis for the clinical transformation application and related theoretical research of TCM in anti-AS.

Atherosclerosis （AS） is the main pathological basis of cardiovascular diseases and seriously threatens human quality of life. Its prevention and treatment urgently need breakthroughs. The inflammatory response， which runs through the physiological and pathological evolution process of AS， is one of the important mechanisms for AS occurrence. Currently， the treatment methods for AS in Western medicine are relatively mature. However， they have adverse reactions such as abnormal liver and kidney function， drug tolerance， target vessel restenosis， and stent thrombosis， which remain the key bottleneck restricting clinical efficacy. Traditional Chinese medicine （TCM）， characterized by multiple components， multiple targets， and multi-pathway synergy， shows unique clinical application potential and efficacy advantages in the intervention of AS. This article reviewed the research progress of TCM in intervening in AS by regulating inflammatory-related signaling pathways， such as nuclear factor-κB （NF-κB）， Toll-like receptors （TLRs）， mitogen-activated protein kinase （MAPK）， and Janus kinase/signal transducer and activator of transcription （JAK/STAT）， in the past five years. It summarized the combined mechanism of action of TCM monomers， TCM pairs， and compound preparations in inhibiting the inflammatory cascade reaction through multiple targets， regulating lipid metabolism disorders， and improving vascular endothelial dysfunction and the imbalance of the microenvironment. It deepened the research on the molecular mechanism of TCM in anti-AS， so as to provide a scientific basis for the clinical transformation application and related theoretical research of TCM in anti-AS.

Objective:To explore the design and application effect of a home-based pulmonary rehabilitation checklist for postoperative lung cancer patients and to analyze the feasibility of this innovative rehabilitation approach.Methods:A prospective non-concurrent controlled study was conducted. Eighty postoperative lung cancer patients from the Department of Thoracic Surgery, Henan Provincial People's Hospital, were conveniently selected. According to the time of admission, postoperative lung cancer patients from April to June 2024 ( n=40) were assigned to the control group, while those postoperative lung cancer patients from August to October 2024 ( n=40) were assigned to the experimental group. The control group was given routine home-based pulmonary rehabilitation knowledge education upon discharge, while the experimental group was provided with the application of a home-based pulmonary rehabilitation checklist in addition to the routine home-based pulmonary rehabilitation knowledge education. Assessments were performed on the day of discharge and 1-month post-discharge using the Chinese version-Strategies Used by People to Promote Health (C-SUPPH), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30), the six-minute walk test (6MWT) and the Brog score. Results:A total of 40 patients in each group completed this study. Among them, there were 26 males and 14 females in the control group, aged (51.25 ± 11.39) years, and 23 males and 17 females in the experimental group, aged (53.07 ± 12.21) years. One month after discharge, the scores of positive attitude, self-decision making and self-stress reduction on the C-SUPPH in the experimental group were (44.25 ± 10.29), (30.76 ± 8.31) and (9.51 ± 2.17) points, respectively. They were higher than those in the control group (37.02 ± 7.14), (26.61 ± 6.71) and (7.58 ± 1.09) points, and the differences were statistically significant ( t=-3.65, -2.46, -5.03, all P<0.05). The scores of somatic function, role function, cognitive function and emotional function on the EORTC-QLQ-C30 in the experimental group were (65.77 ± 6.41), (71.46 ± 7.21), (70.11 ± 5.61) and (69.59 ± 5.71) points, respectively. They were higher than those in the control group (57.71 ± 7.01), (64.27 ± 5.25), (62.79 ± 7.18), (61.11 ± 6.25) points, and the differences were statistically significant ( t values were -6.34 to -5.08, all P<0.05). The 6MWT distance in the experimental group was (411.31 ± 35.02) m, which was higher than (376.58 ± 30.26) m in the control group, and the difference was statistically significant ( t=-4.75, P<0.05). The Brog score in the experimental group was (2.12 ± 0.68) points, which was lower than (2.50 ± 0.65) points in the control group, and the difference was statistically significant ( t=2.56, P<0.05). Conclusions:The implementation of home pulmonary rehabilitation list can improve the self-management ability of patients after lung cancer surgery, improve the quality of life, and then enhance the exercise ability, which is worthy of clinical promotion.

Background and Aims:Laparoscopic hiatal hernia repair with mesh reinforcement combined with fundoplication has become the standard surgical approach for treating moderate to severe cases.However,intraoperative and postoperative complications remain a significant concern.This study was conducted to explore the causes of common complications and their prevention and management strategies through retrospectively analyzing clinical data from a single center to optimize perioperative care and improve surgical safety.Methods:The clinical data of 432 patients who underwent laparoscopic hiatal hernia repair with mesh and fundoplication at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to December 2023 were retrospectively analyzed.All procedures were performed by the same surgical team using the standardized seven-step protocol for laparoscopic repair.Postoperative care followed the enhanced recovery after surgery pathway.The incidences of intraoperative and postoperative complications were recorded,and univariate analysis was used to identify risk factors for major postoperative complications.Results:The overall complication rate was 15.3％among 432 patients.The most common intraoperative complication was bleeding(6.9％),primarily from the inferior phrenic vessels(3.2％),short gastric vessels(1.6％),and parenchymal organ injuries(1.9％).The most frequent postoperative complication was dysphagia(12.0％),followed by pneumothorax(3.2％),hernia recurrence(1.9％),mesh infection or erosion(0.7％),gas-bloat syndrome(6.3％),and gastroparesis(0.9％).Most complications were relieved through conservative treatment,endoscopic dilation,or interventional procedures.Two patients with persistent dysphagia underwent reoperation to remove the fundoplication wrap.The median follow-up period was 34 months,with a 6.0％loss to follow-up rate and no perioperative mortality.Univariate analysis showed that patients aged ≥50 years and those who underwent Nissen fundoplication had significantly higher rates of postoperative dysphagia(both P＜0.05).Conclusion:Laparoscopic hiatal hernia repair with mesh and fundoplication is generally safe and effective.However,intraoperative vascular injuries and postoperative dysphagia require special attention.Accurate dissection and identification of anatomical layers are critical during surgery.Surgical strategy should be tailored based on patient age and esophageal motility,with partial fundoplication(Toupet or Dor)preferred when appropriate.Combined with enhanced postoperative recovery protocols,standardized mesh placement and fixation can reduce complication rates and improve long-term outcomes.

Objective:To evaluate the clinical diagnosis and laparoscopic surgical management of diaphragmatic rupture.Methods:Clinical data of 19 patients diagnosed with diaphragmatic hernia secondary to diaphragmatic rupture, admitted to the Sixth Affiliated Hospital of Sun Yat-sen University from Jan 2022 to Sep 2024 was retrospectively analyzed.Results:There were 7 males and 12 females. Traumatic etiology was confirmed in 9 cases, all developed after closed injuries, including one vehicular accident, seven blunt traumas, and one fall from height. Iatrogenic factors accounted for the remaining 10 cases. Left-sided diaphragmatic hernias were observed in 13 patients, while right-sided hernias occurred in 6 patients. Hiatal hernias were complicated in 5 patients. All patients underwent elective laparoscopic tension-free repair using composite patch for defect closure. Postoperatively, one patient was readmitted into ICU due to reexpansion pulmonary edema but was subsequently discharged following recovery. The median postoperative hospital stay was 10 days.Conclusions:The incidence of diaphragmatic rupture is relatively uncommon, primarily occurring as a result of traumatic or iatrogenic injuries. Early diagnosis coupled with prompt laparoscopic surgical intervention has proven to be effective in managing this condition.

The surgical management of gastroesophageal reflux disease (GERD) has completed a paradigm shift from symptomatic palliation to curative intervention. For high-risk patients with pathological acid exposure (AET>6%), progressive anatomical destruction (e.g., ≥2 cm hiatal hernia or Hill grade III/IV lesions), or those requiring interruption of carcinogenic progression (such as Barrett's esophagus with dysplasia), anti-reflux surgery provides superior long-term efficacy compared to pharmacotherapy. Surgical indications require a three-dimensional assessment integrating anatomical, functional, and risk factors: patients with dominant anatomical defects are recommended to undergo combined hernia repair and fundoplication (biological mesh reinforcement for recurrent hernias reduces recurrence rates to 16.7%); functionally decompensated groups require decision-making based on objective reflux metrics (e. g.,>75 reflux events/24 hours); special populations such as post-bariatric GERD should preferentially undergo Roux-en-Y gastric bypass (reflux control rate: 93%), while those with motility disorders (e. g., scleroderma) are suitable for partial fundoplication to mitigate dysphagia risk (OR=0.285). Precision decision-making is achieved through a stepwise evaluation pathway (endoscopy→pH-impedance monitoring→high-resolution manometry). Intraoperative strategies are individualized based on motility status: patients with normal esophageal motility undergo the Nissen procedure, the elderly or those with ineffective esophageal motility are prioritized for Toupet fundoplication for optimized long-term safety, and magnetic sphincter augmentationenables 96% of PPI-responsive but medication-averse patients to discontinue drug dependency. The core value of surgical intervention lies in simultaneously achieving anatomical restoration and functional reconstruction, along with blocking Barrett's esophageal carcinogenesis (OR=0.41). This dual mechanism signifies a fundamental transformation in GERD management strategy.

Objective To explore the application effect of dexmedetomidine combined with ropivacaine for quadratus lumborum block at the lateral supra-arcuate ligament(QLB-LSAL) in open hepatocellular carcinoma resection.Methods A prospective study was conducted in 60 patients who underwent elective open hepatocellular carcinoma resection at Jining First People's Hospital. The patients were randomly divided into the compound group and the control group,with 30 cases in each group. Patients in the compound group received QLB-LSAL combined general anesthesia,and patients in the control group received simple general anesthesia. All patients underwent patient controlled intravenous analgesia (PCIA)postoperatively. The mean arterial pressure (MAP),heart rate (HR) and visual analogue scale (VAS) scores during rest and coughing at different time points were observed and compared between the two groups. The number of postoperative PCIA compressions,the dosage of sufentanil,the first postoperative exhaust time,the first postoperative ambulation time,the hospital stay and the occurrence of adverse reactions of the two groups were recorded. Results In the compound group,the HR and MAP were significantly lower than those of the control group at the time of skin incision (T2) and at the end of surgery (T3);the VAS scores during rest and coughing were significantly lower than those of the control group at the time of exiting the anesthesia recovery room and 6 hours and 12 hours after surgery;and the PCIA compression times were significantly less than those of the control group;the dosage of sufentanil was significantly lower than that in the control group 0 to 24 hours after surgery,and the dosage of sufentanil was higher than that in the control group 25 to 48 hours after surgery;the first postoperative ambulation time and the first postoperative exhaust time were significantly earlier than those in the control group;and the above differences were statistically significant(P<0.05). There was no significant difference in the HR or MAP at 5 minutes into the operating room (T0) and 5 minutes before skin incision (T1),VAS scores during rest and coughing 24 hours and 48 hours after surgery,hospital stay and incidence of adverse reactions between the two groups (P>0.05).Conclusion For patients with open hepatocellular carcinoma resection,dexmedetomidine combined with ropivazine for QLB-LSAL can provide more ideal postoperative analgesia,reduce perioperative opioid consumption,and have less impact on circulatory system,which is conducive to rapid postoperative recovery.

Objective:To evaluate the clinical outcomes of mandibular angle osteotomy combined with wing-shaped genioplasty for the correction of low-angle mandibular prominence with microgenia.Methods:A retrospective analysis was conducted on patients who underwent mandibular angle osteotomy and wing-shaped genioplasty at the Second Hospital of Nanjing between January 2020 and December 2022. Preoperative three-dimensional computed tomography and lateral cephalograms were obtained, and relevant parameters were measured, including the Frankfort horizontal plane to mandibular plane angle (∠FH-MP), the lower lip to soft tissue pogonion angle (∠LiaV-Pog) and the facial height index (FHI). Based on the measurements, surgical experience, and patient preference, the osteotomy lines for the mandibular angle and the wing-shaped genioplasty were designed. During the procedure, mandibular angle osteotomy and wing-shaped genioplasty were performed in accordance with the preoperative surgical plan. The distal genial segment was advanced and inferiorly repositioned according to the predetermined measurements and rigidly fixed to the bilateral mental tubercles using titanium plates and screws. The bone segments resected from the mandibular angle were then longitudinally split into either single- or double-layer bone grafts. These grafts were meticulously implanted into the interpositional gap at the genial region to optimize chin projection and refine the lower facial contour. Postoperative monitoring included assessments of wound healing, complications and lower facial contour. At the final follow-up, lateral cephalograms were taken for remeasurement, and patient satisfaction was surveyed. Statistical analysis was performed using SPSS 22.0 software. Pre- and postoperative data for ∠FH-MP, ∠LiaV-Pog, and FHI were presented as Mean ± SD and compared using paired t-tests, with a P-value < 0.05 considered statistically significant. Results:Twelve female patients, aged 22-35 years (mean 28.3), were included. The follow-up period ranged from 6 to 24 months. All surgical sites achieved primary healing without early complications such as hemorrhage, hematoma, or wound infection. However, all patients experienced transient mental numbness, which resolved within 3 to 6 months. All patients achieved a smooth and natural mandibular contour. CT scans confirmed satisfactory survival of the grafted bone. All patients expressed satisfaction with the aesthetic outcomes. Postoperative measurements of ∠FH-MP, ∠LiaV-Pog, and FHI were (25.2±4.6)°, (24.0±1.2)°, and (52.0±1.3)%, respectively, which were significantly improved compared to the preoperative values of (16.8±5.9)°, (36.5±4.8)°, and (66.0±4.3)% (all P < 0.01). Conclusion:The combination of mandibular angle osteotomy and wing-shaped genioplasty is an effective and safe procedure for correcting low-angle mandibular prominence with microgenia. This technique significantly increases the mandibular plane angle, creates a natural and smooth mandibular contour, and yields stable result with high patient satisfaction.

Objective:To investigate the incidence of shoulder work-related musculoskeletal disorders (WMSDs) among occupational population in China, and to explore their intrinsic association with personal and work-related factors.Methods:In April 2024, 73497 valid questionnaires of the Chinese version of the Musculoskeletal Disorders Electronic Questionnaire were retrospectively analyzed from June 2018 to December 2023 in 22 provinces and 29 key industries in China, and the general information, occurrence of WMSDs and related risk factors of key occupational populations in different regions in China were collected. By using Chi-square test and confirmatory factor analysis, the relationship between shoulder fatigue and pain in key occupational groups and individual factors, work type, work posture and work organization was discussed, and the internal relationship was analyzed based on structural equation model.Results:Higher incidence of shoulder fatigue and pain were associated with female, lack of physical exercise, uncomfortable working posture and neck leaning forward ( P<0.05). Structural equation model analysis showed that work type, work posture and work organization were strongly correlated ( r=0.58, 0.55). Work organization and work type were strongly correlated with shoulder fatigue ( r=0.65) and moderately correlated with shoulder fatigue ( r=0.21). Shoulder fatigue was moderately associated with shoulder pain ( r=0.40). Individual factors, work type, work posture and shoulder fatigue could directly affect shoulder pain ( OR=0.07, -0.09, 0.17 and 0.40), and work type and work posture could also indirectly affect shoulder pain through shoulder fatigue ( OR=0.08, 0.03). Work organization only indirectly affected shoulder pain through shoulder fatigue ( OR=0.26) . Conclusion:The main influencing factor of shoulder pain is shoulder fatigue, followed by work posture and individual factors. Structural equation model can better reflect the complex relationship between work type, work posture and work organization and shoulder WMSDs. Improving work posture and work organization may be an effective way to control the influence of shoulder fatigue on shoulder pain.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.