Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders are the 3 major chronic diseases threatening human health, which are closely related and often coexist, significantly increasing the difficulty of disease management. In response, the American Heart Association (AHA) proposed a novel disease concept of “cardiovascular-kidney-metabolic (CKM) syndrome” in October 2023, which has triggered widespread concern about the co-treatment of heart and kidney diseases and the prevention and treatment of metabolic disorders around the world. This review posits that effectively managing CKM syndrome requires a new and multidimensional paradigm for diagnosis and risk prediction that integrates biological insights, advanced technology and social determinants of health (SDoH). We argue that the core pathological driver is a “metabolic toxic environment”, fueled by adipose tissue dysfunction and characterized by a vicious cycle of systemic inflammation and oxidative stress, which forms a common pathway to multi-organ injury. The at-risk population is defined not only by biological characteristics but also significantly impacted by adverse SDoH, which can elevate the risk of advanced CKM by a factor of 1.18 to 3.50, underscoring the critical need for equity in screening and care strategies. This review systematically charts the progression of diagnostic technologies. In diagnostics, we highlight a crucial shift from single-marker assessments to comprehensive multi-marker panels. The synergistic application of traditional biomarkers like NT-proBNP (reflecting cardiac stress) and UACR (indicating kidney damage) with emerging indicators such as systemic immune-inflammation index (SII) and Klotho protein facilitates a holistic evaluation of multi-organ health. Furthermore, this paper explores the pivotal role of non-invasive monitoring technologies in detecting subclinical disease. Techniques like multi-wavelength photoplethysmography (PPG) and impedance cardiography (ICG) provide a real-time window into microcirculatory and hemodynamic status, enabling the identification of early, often asymptomatic, functional abnormalities that precede overt organ failure. In imaging, progress is marked by a move towards precise, quantitative evaluation, exemplified by artificial intelligence-powered quantitative computed tomography (AI-QCT). By integrating AI-QCT with clinical risk factors, the predictive accuracy for cardiovascular events within 6 months significantly improves, with the area under the curve (AUC) increasing from 0.637 to 0.688, demonstrating its potential for reclassifying risk in CKM stage 3. In the domain of risk prediction, we trace the evolution from traditional statistical tools to next-generation models. The new PREVENT equation represents a major advancement by incorporating key kidney function markers (eGFR, UACR), which can enhance the detection rate of CKD in primary care by 20%-30%. However, we contend that the future lies in dynamic, machine learning-based models. Algorithms such as XGBoost have achieved an AUC of 0.82 for predicting 365-day cardiovascular events, while deep learning models like KFDeep have demonstrated exceptional performance in predicting kidney failure risk with an AUC of 0.946. Unlike static calculators, these AI-driven tools can process complex, multimodal data and continuously update risk profiles, paving the way for truly personalized and proactive medicine. In conclusion, this review advocates for a paradigm shift toward a holistic and technologically advanced framework for CKM management. Future efforts must focus on the deep integration of multimodal data, the development of novel AI-driven biomarkers, the implementation of refined SDoH-informed interventions, and the promotion of interdisciplinary collaboration to construct an efficient, equitable, and effective system for CKM screening and intervention.

OBJECTIVE: To investigate the correlation of seminal plasma oxidation reduction potential (ORP), normalized oxidation-reduction potential (nORP) and sperm DNA fragmentation index (DFI) to sperm motion parameters, and their clinical predictive value for oligoasthenozoospermia (OAZ). METHODS: This study included 433 male subjects visiting the Clinic of Andrology in our hospital from March to May 2024. According to sperm concentration and the percentage of progressively motile sperm (PMS), we divided them into a normal control (n = 119), an oligozoospermia (OZ, n = 118), an athenozoospermia (AZ, n = 119) and an OAZ group (n = 77). Using the electrode method, we measured the seminal plasma ORP, calculated nORP=ORP/sperm concentration (mV/［10⁶/ml］), and determined DFI and high DNA chromatin sperm (HDS) by flow cytometry based on sperm chromatin structure assay (SCSA), followed by comparison among the four groups in age, abstinence days, semen volume, total sperm count, sperm concentration, PMS, non-progressively motile sperm (NPMS), immotile sperm (IMS), curvilinear velocity (VCL), straight line velocity (VSL), average path velocity (VAP), linearity (LIN), straightness(STR), wobble (WOB), DFI, HDS, ORP and nORP. Using the receiver operating characteristic (ROC) curve, we assessed the predictive value of DFI, ORP and nORP for OAZ, and analyzed the correlation of DFI, ORP and nORP to sperm motion parameters by Pearson and Spearman analyses. RESULTS: Statistical analysis revealed statistically significant differences among the four groups in semen volume, abstinence days, total sperm count, sperm concentration, PMS, NPMS, IMS, total sperm motility, VCL, VSL, VAP, STR, DFI, HDS, ORP and nORP (P < 0.05), but not in age, LIN and WOB (P > 0.05). The area under the ROC curve (AUC) for the predictive value of DFI for OAZ was 0.880, with the critical value of 8.920, sensitivity of 74.8% and specificity of 88.2%; that of ORP for AZ was 0.698, with the critical value of 155.375, sensitivity of 70.6% and specificity of 64.7%; and that of nORP for OZ was 0.999, with the critical value of 9.844, sensitivity of 98.3% and specificity of 99.2%. Pearson and Spearman correlation analyses showed that DFI was correlated positively with age, abstinence days, semen volume, IMS, HDS and ORP, but negatively with PMS, NPMS, total sperm motility, VCL, VSL, VAP and STR; ORP positively with abstinence days, semen volume, IMS, DFI and nORP, but negatively with PMS, NPMS, total sperm motility, VSL, LIN and STR; and nORP positively with HDS, but negatively with abstinence days, total sperm count, sperm concentration, PMS and NPMS. CONCLUSION Oxidative stress (OS) may be an important pathological factor for elevated ORP, increased DFI and changes of routine sperm motion parameters, consequently leading to OAZ. As OS markers, DFI and ORP have a high predictive value for OS-induced OAZ.
Male ; Humans ; DNA Fragmentation ; Semen/metabolism* ; Sperm Motility ; Spermatozoa ; Oxidation-Reduction ; Adult ; Oligospermia ; Sperm Count ; Semen Analysis ; Asthenozoospermia

Objective To explore the short and long term efficacy of ultrasound therapy combined with muscle imbalance adjustment training in patients with adhesive capsulitis(AC) ofthe shoulder. Methods A total of 60 AC patients were divided into an observation group and a control group,both each consisting of 30 cases. The observation group underwentultrasound therapy along with muscle imbalance adjustment training,while the control group received acupuncture treatment,both for a duration of 20 days. The Visual Analogue Scale(VAS),goniom-eter for ROM,Manual Muscle Testing(MMT),Constant-Murley Shoulder Score,and modified Barthel index were used to access shoulder jointpain level,range of motion (ROM),peripheral muscle strength,shoulder joint func-tion,and daily living abilities,respectively. The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were utilized to evaluate the levels of anxiety and depression.All the assessments were conducted and compared between the two groups before treatment,at the end of treatment,and at 6 and 12 months after treatment. Results Both groups showed varying degrees of improvement in ROM,MMT,VAS,Constant-Murley score,modified Barthel index,and emotional status compared to pre-treatment. The observation group demonstrated superior outcomes in posterior shoulder extension strength,VAS,Constant-Murley score,modified Barthel index,HAMA,and HAMD scores at the end of treatment (P<0.05). At 6 months post-treatment,the observation group showed better shoulder joint flexion,extension,abduction,and adduction ROM,as well as muscle strength in flexion,external rotation,and internal rotation,VAS,Constant-Murley score,modified Barthel index,HAMA,and HAMD scores. At 12 months after treatment,the observation group continued to show superior outcomes in all the aforementioned indexes (P<0.05). Conclusion The combination of ultrasound therapy and muscle imbalance adjustment training can effectively reduce shoulder joint pain,improve ROM,enhance muscle strength around the shoulder joint,improve shoulder joint function,alleviate anxiety and depression,and ultimately enhance the quality of life for patients with AC.

Patients suffering from stage Ⅳ periodontitis manifest substantial alveolar bone destruction and pronounced tooth loss,fre-quently accompanied by masticatory dysfunction,occlusal disorder and tooth displacement or torsion.Standard periodontal interventions alone are insufficient to stabilize the condition,address masticatory dysfunction,and enhance patients'quality of life.Hence,intricate reconstructive and interdisciplinary regimens,encompassing orthodontic treatment,are often indispensable.Orthodontic therapy can op-timize the masticatory function and esthetic appearance of patients,and promote periodontal well-being.However,individuals with stageⅣ periodontitis present with inadequate periodontal support tissue and a heightened risk profile,rendering their orthodontic management a considerable clinical challenge.This article reviews the orthodontic considerations and optimal timing for intervention in patients with stage Ⅳ periodontitis and presents a representative case of combined periodontal-orthodontic-orthognathic treatment for pe-riodontitis(stage Ⅳ,grade C),in order to provide reference for periodontists and orthodontists.

Objective:To analyze the epidemiological characteristics of mumps in China under the immunization strategies of different doses of mumps-containing vaccines(MuCV) by analyzing the national mumps surveillance data from 2020 to 2023.Methods:Based on the national mumps surveillance data from 2020 to 2023, a comparative analysis was conducted on the mumps incidence and the distribution characteristics of mumps cases in time, region and population in the three different periods of 2004-2007 (without MuCV implementation), 2008-2019 (one-dose MuCV implementation) and 2020-2023 (two-dose MuCV implementation) in China.Results:From 2020 to 2023, the annual incidence rate of mumps was 6.48-9.20/100 000, and the annual number of reported cases was 91 303-129 120 cases. After the implementation of the 2-dose MuCV immunization strategy, the epidemiological characteristics of mumps in China have changed to some extent. Compared with the period of 2004-2007 and 2008-2019, the traditional seasonal epidemic pattern of mumps disappeared from 2020 to 2023, with no obvious epidemic peak throughout the year. There was no significant regional difference in the incidence of mumps. Children and adolescents under 15 years of age were the main population of mumps (accounting for 85.46%), of which children aged 5-9 years accounted for 45.07%. Compared with the period of 2004-2007 and 2008-2019, the proportion of mumps cases in the 0-4 years old group showed an increasing trend, the proportion of mumps cases in the 10-14 years old group showed a decreasing trend, and the proportion of adult cases over 40 years old also increased from 2020 to 2023. The age group with the highest incidence of mumps was found to have shifted from 7 years old to 4 years old.Conclusions:The 2-dose MuCV immunization strategy has effectively reduced the incidence of mumps in China. It is necessary to strengthen the surveillance of mumps in kindergartens and primary school children.

A 44-year-old male presented with a 19-year history of urinary calculi and a 1-year history of polydipsia and weight loss. Laboratory tests revealed hyperparathyroidism and evidence of glucagonoma-associated diabetes. Imaging studies identified masses in the pancreatic head and body/tail, suggestive of glucagonoma and a parathyroid adenoma. Furthermore, the patient exhibited hypercalcitoninemia and elevated cortisol and adrenocorticotropic hormone levels. Genetic testing revealed a heterozygous MEN1 mutation [c.65T>G (p.Leu22Arg)], confirming the diagnosis of multiple endocrine neoplasia type 1 (MEN-1). The patient subsequently underwent near-total parathyroidectomy and total pancreatectomy. Postoperative immunohistochemical staining of the pancreatic tail tumor was positive for glucagon and calcitonin. The patient′s postoperative hormone levels (calcitonin, glucagon, adrenocorticotropic hormone, cortisol) normalized, suggesting a rare pancreatic neuroendocrine tumor (pNET) that was co-secreting multiple hormones. Postoperative management included pancreatic enzyme supplementation, calcium supplementation, vitamin D supplementation, and insulin for glycemic control. Follow-up evaluations at 10 months demonstrated a stable clinical condition, well-controlled blood glucose and biochemical parameters, and an acceptable quality of life. This case study highlights that the presence of pNETs should be considered in patients with MEN-1 and multiple abnormal hormone levels. Timely surgical management of the involved glands and postoperative complications can effectively improve prognosis.

As population aging intensifies,stroke incidence is rising yearly.Complicated with neurological impairment,this condition often leads to motor dysfunction,affecting walking stability and coordination and severely impacting the patient's daily life and mental state.In recent years,digital technology-assisted walking rehabilitation training has shown great potential in post-stroke rehabilitation.By integrating modern digital technolo-gies such as virtual reality,intelligent feedback systems,and remote rehabilitation,this approach not only provides personalized rehabilitation plans but also promotes the recovery of walking function through immersive training,real-time feedback,and remote monitoring.This article reviews the application status,effectiveness,and limita-tions of digital-technology-assisted walking rehabilitation for post-stroke hemiplegic patients.It aims to clarify the new direction of post-stroke walking training and explore more effective rehabilitation methods to help patients regain their walking ability.

Objective To develop an ICU patient care difficulty index based on psychosocial factors and to evaluate its reliability and validity,thereby providing a comprehensive tool for assessing the difficulties in ICU patient care.Methods Guided by Guarinoni theory,an index system was developed through systematic literature reviews,semi-structured interviews,two rounds of Delphi expert consultation and the analytic hierarchy process.Based on the drafted system,a questionnaire was formulated.The tests for validity and reliability were conducted on 290 patients selected by convenience sampling.Results The finalised ICU patient care difficulty index system was composed of 5 primary indices(the general condition of the patient,disease condition,nursing condition,social support,and organizational characteristics),13 secondary indices and 27 tertiary indices.The Kendall's coefficient of coordination W values were 0.380 and 0.498,respectively,indicating a statistically significant agreement(both P<0.001).The system demonstrated a robust reliability(Cronbach's α=0.896)and a good internal consistency.Validity was confirmed through a scale level-content validity index(S-CVI)of 0.94 and the item level-content validity indices(I-CVI)ranged from 0.87 to 1.00.Structural validity analysis,based on 8 extracted public factors,showed a cumulative variance contribution rate of 66.34%.Conclusion The ICU patient care difficulty index system shows a high reliability and validity,making it a valuable tool for accurately quantification of the difficulty in ICU patient care.This system provides a scientific basis for allocation of ICU nursing resource and performance distribution.