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.

OBJECTIVE:Neuromuscular exercise is a new comprehensive rehabilitation therapy in recent years,but its effect on knee osteoarthritis is still controversial.The purpose of this paper is to systematically evaluate the efficacy of neuromuscular exercise on knee osteoarthritis pain and function. METHODS:The randomized controlled trials addressing neuromuscular exercise in the treatment of knee osteoarthritis pain and function were retrieved from PubMed,Cochrane Library,Embase,EBSCO,CNKI,Web of Science,China Biomedical Database(CBM),VIP,and WanFang Database.The retrieval time ranged from database inception to October 2023.The neuromuscular training group(experimental group)was given neuromuscular training or neuromuscular training as the main intervention;the control group was a blank group or given conventional rehabilitation.Outcome indicators included the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,walking time,knee stability,and the maximum number of knee flexion in 30 seconds.The risk of bias was evaluated by the Cochrane Collaboration tool and the Physiotherapy Evidence Database.Meta-analysis was performed using RevMan 5.4 software. RESULTS:A total of 11 randomized controlled trials were included,and 628 samples were extracted.The results of Meta-analysis showed that the experimental group was superior to the control group in terms of WOMAC pain score[standardized mean difference(SMD)=0.38,95%confidence interval(CI):0.08-0.69,P=0.01],knee stability(SMD=0.57,95%CI:0.23-0.92,P=0.001),the maximum number of knee joint flexion in 30 seconds(SMD=0.35,95%CI:0.05-0.65,P=0.02),and WOMAC physical function score(SMD=-0.79,95%CI:-1.30 to-0.28,P=0.002).In both groups,walking speed was increased and walking ability was improved in patients with knee osteoarthritis,but there was no significant difference(walking time:SMD=-0.22,95%CI:-0.48-0.03,P=0.09). CONCLUSION:Neuromuscular exercise can effectively improve knee joint pain,enhance the stability of the knee joint,and promote functional recovery in patients with knee osteoarthritis.However,more high-quality randomized controlled trials are still needed to further confirm the research.

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.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

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 The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective:To investigate the serum level of soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients with multiple myeloma (MM) and its effect on the therapeutic effect of daletumab.Methods:A total of 126 MM patients admitted to the Affiliated Hospital of Jining Medical College from June 2019 to June 2021 were retrospectively selected as the observation group, and 120 healthy subjects in the same period were selected as the control group. The observation group was treated with daletumab. The level of sVCAM-1 in the observation group and the control group was compared, and the relationship between serum sVCAM-1 level and clinicopathological features, different Durie-Salmon (DS) stages, different International Staging System(ISS) stages and treatment outcome of MM patients were analyzed.Results:The serum level of sVCAM-1 in the observation group was higher than that in the control group: (797.69 ± 119.73) μg/L vs. (210.55 ± 73.77) μg/L, there was statistical difference ( P<0.01). There were no statistical differences in serum sVCAM-1 level among MM patients with different sex, body mass index, blood calcium, serum albumin, hemoglobin, lactate dehydrogenase and diagnostic type ( P>0.05). The serum level of sVCAM-1 in MM patients DS stage Ⅰ, Ⅱ and Ⅲ were (649.29 ± 101.02), (694.36 ± 109.88) and (729.66 ± 120.44) μg/L, there was statistical difference ( F = 5.12, P<0.01). The serum level of sVCAM-1 in MM patients with ISS stage Ⅰ, Ⅱ and Ⅲ were (648.73 ± 99.77), (701.05 ± 107.83) and (765.82 ± 111.07) μg/L, there was statistical difference ( F = 11.46, P<0.01). After treatment, the serum level of sVCAM-1 in MM patients with complete remission, partial remission and relapse were (234.05 ± 90.73), (445.36 ± 97.11) and (793.05 ± 121.03) μg/L, there was statistical difference ( F = 245.15, P<0.01). The results of receiver operating characteristic (ROC) curve analysis showed that when the cut-off value of serum sVCAM-1 level was 58.50 μg/L, the area under the curve (AUC) was 0.762 (95% CI 0.699 - 0.825, P<0.01), the sensitivity was 80.95%, the specificity was 67.50%, and the accuracy was 74.39%. Conclusions:The level of serum sVCAM-1 in MM patients is significantly increased, and the higher the level of SVCAM-1, the worse the prognosis of patients, which can be used as one of the indicator to predict the therapeutic effect of MM patients.

Objective To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of axillary lymph node metastasis(ALNM)in breast cancer patients with low HER-2 expression.Methods A total of 297 breast cancer patients with low HER-2 expression treated at the Affiliated Hospital of Xuzhou Medical University were enrolled and divided into ALNM group(n=71)and non-ALNM group(n=226)according to whether there was ALNM.All patients underwent DCE-MRI,and DCE-MRI derived parameters were collected and analyzed.Logistic regression analysis was used to identify the risk factors for ALNM,and the efficacy of DCE-MRI in diagnosing ALNM was assessed using receiver operating characteristic curve.Results Significant differences were observed between two groups in lesion distribution,TNM staging,vascular invasion,and most DCE-MRI derived parameters including short-to-long axis ratio,Ve,Ktrans,Kep,ADC and SER(all P<0.05).Multivariate regression analysis revealed that the short-to-long axis ratio,Ve,Ktrans,Kep,ADC and SER were significant risk factors for ALNM in breast cancer patients.Comparative analysis demonstrated that the combination of DCE-MRI derived parameters yielded a maximum area under the curve of 0.976,with a sensitivity of 91.5%and a specificity of 92.9%.Conclusion DCE-MRI is an effective tool for determining the presence of ALNM in breast cancer patients with low HER-2 expression,providing significant diagnostic evidence for clinical practice.

Objective:To explore the application effect of a student-faculty collaborative dynamic question bank based on outcome based education (OBE) in the teaching of maternal and infant nursing.Methods:A total of 204 junior nursing undergraduates (Grade 2021 and Grade 2022) enrolled at Shantou University Medical College between September 2023 and January 2025 were selected by convenience sampling. Ninety-two students from Grade 2021 were assigned to the control group, and 112 students from Grade 2022 were assigned to the intervention group. The control group received the traditional teaching syllabus before the course, used the People's Medical Publishing House question bank for self-testing, and the original static self-constructed exam question bank in the Kaoyi system for assessment. The intervention group practiced and was assessed using a student-faculty collaborative dynamic question bank based on OBE. The intervention lasted for one semester. Course performance and satisfaction were compared between the two groups.Results:The number of questions in the bank increased from 347 to 2 058. After course completion, the intervention group had higher stage test scores, final exam scores, and overall course scores than the control group ( P<0.05). The intervention group also reported higher levels of overall course satisfaction, perceived personal ability improvement, and satisfaction with course content and instructors than the control group ( P<0.05) . Conclusions:The student-faculty collaborative dynamic question bank based on OBE can effectively improve students' academic performance and satisfaction, and is worthy of wider application.