Synergistic therapeutic effects of Haitongpi Decoction fumigation combined with professional rehabilitation supervision in the treatment of frozen shoulder: A randomized controlled trial

Application of 3D Printing Technology in Standardized Training of Laparoscopic Techniques for Resident Physicians in Hepatobiliary Surgery.

Colorectal cancer (CC) is a major global health burden, and effective management of intermediate and advanced stages remains a clinical challenge. The present study investigated the effect and safety of peritoneal raltitrexed infusion in patients with intermediate and advanced CC. Data from 80 patients with intermediate and advanced CC who visited the Affiliated Hospital of Jiujiang University (Jiujiang, China) between August 2018 and April 2021 were retrospectively analysed. Among them, 42 patients were administered raltitrexed peritoneal infusion as the observation group (OG), and the remaining 38 patients were administered equal amounts of saline as the control group (CG) to compare therapeutic effects. Changes in routine blood indicators [such as number of white blood cells (WBCs), neutrophils (NEs), red blood cells (RBCs) and platelets (PLTs)] and tumour markers (carcinoembryonic antigen and cancer antigen 19-9) before and after 3 days of treatment were compared. Adverse reactions that occurred during treatment were also recorded. Compared with those before surgery, WBC and NE counts were significantly lower (P<0.05), and RBC and PLT counts were significantly greater (P<0.05) in both groups after surgery. The counts in the CG were markedly greater than those in the OG after surgery (P<0.05). Tumour marker levels were significantly higher before surgery than after surgery in both groups (P<0.05). The patients in the CG had a significantly lower disease remission rate than those in the OG (P=0.014). In conclusion, raltitrexed peritoneal infusion chemotherapy is effective and safe for the treatment of patients with intermediate and advanced CC; it can effectively reduce serum tumour marker levels and adverse reaction incidence and improve the survival quality of patients. Raltitrexed peritoneal infusion chemotherapy thus exhibits high clinical application value.

Ischemic vertigo (IV) is the main clinical manifestation of posterior circulation ischemia. Extract of Ginkgo biloba leaves injection (EGBLI) is rich in flavonoids and terpene lactones, which have antioxidant, vasodilator and neuroprotective effects. Triangle Health Management optimizes resource allocation through hierarchical intervention. This prospective study analyzed the effect of EGBLI combined with triangle health management on IV. First, n=177 patients with IV were included who received conventional treatment as a control group and another n=144 patients who received EGBLI as an observation group. The clinical efficacy of the two groups was compared and hemodynamics before and after treatment were examined. In addition, nutritional proteins and symptom improvement were compared between the two groups. Comparison showed that the clinical efficacy of the observation group was better (p<0.05). Meanwhile, hemodynamics and symptom improvement after treatment in the observation group were better than those in the control group (p<0.05). EGBLI combined with triangle health management is an excellent therapeutic regimen for IV.

We aimed to evaluate the improvement effect of proprioceptive enhancement training combined with staged rehabilitation training on knee joint function in patients post-total knee arthroplasty (TKA). This prospective, randomized controlled trial enrolled 80 patients with knee osteoarthritis after TKA, who were randomly allocated to a control group (routine rehabilitation training, n = 40) or an observation group (proprioceptive enhancement training + staged rehabilitation training, n = 40). Both groups underwent continuous training for 4 weeks, with the intensity tailored to the patients' tolerance levels. Outcome measures included pain (VAS), knee function (HSS score), balance (BBS), range of motion (MKFA), and daily living ability (ADL). Postoperative complications were recorded. Both groups showed noticeable post-intervention improvement in all functional measures. After the intervention, the observation group had lower VAS score (Z = -4.448, η² = 0.228, p < 0.001) and ADL score (Z = -2.654, η² = 0.088, p = 0.008), and higher HSS score (t = 3.219, Cohen's d = 0.720, p = 0.002), BBS score (t = 2.980, Cohen's d = 0.665, p = 0.004), and MKFA (t = 4.464, Cohen's d = 0.999, p < 0.001) than the control group. The observation group exhibited a lower incidence of postoperative complications after TKA than the control group (p = 0.048). Proprioceptive enhancement training & staged rehabilitation training provides superior outcomes in pain relief, functional recovery, and complication reduction post-TKA. This combined approach presents a clinically valuable strategy for optimizing postoperative knee rehabilitation.

BACKGROUND Patients with early liver cancer (eLC) commonly experience substantial psychological burden during treatment. High-quality nursing support provision may alleviate such stress. AIM To check how the clinical nursing pathway (CNP) + psychological nursing impacts anxiety, depression, and pain in individuals with eLC surgery. METHODS Total 230 patients with eLC surgery were allocated to the control (routine nursing) and observation (CNP + psychological nursing) groups. We conducted comparative analyses for the following: Generalized Anxiety Disorder-7 (GAD-7); Depression Patient Health Questionnaire-9 (PHQ-9); resilience Connor-Davidson Resilience Scale (CD-RISC); pain Numeric Rating Scale (NRS) and Short-Form McGill Pain Questionnaire (SF-MPQ-2); cancer-related fatigue (CRF); Cancer Fatigue Scale; treatment cooperation; nursing satisfaction. RESULTS Postcare, the scores (points) of the GAD-7 [8.00 (5.00-10.00) vs 10.00 (8.00-12.75)], PHQ-9 [8.00 (6.00-11.00) vs 13.00 (11.00-16.00)], NRS [4.00 (3.00-5.00) vs 4.50 (3.00-5.75)], and SF-MPQ-2 (35.70 ± 5.22 vs 39.63 ± 5.96) scales, as well as the proportion of moderate (34.43% vs 61.11%) and severe (0.82% vs 5.56%) CRF patients, were notably lower in the observation group than in controls. Regarding the CD-RISC scores (points), the observation group scored higher in tenacity [34.00 (31.00-38.00) vs 28.00 (26.00-31.00)], strength [22.00 (18.75-25.00) vs 18.00 (16.00-21.00)], and optimism [10.00 (8.00-12.00) vs 7.00 (5.00-9.00)] domains; the number of patients with absent (15.57% vs 4.63%) or mild (49.18% vs 28.70%) CRF was also greater in the observation cohort, along with higher treatment compliance (95.08% vs 75.00%) and nursing satisfaction (95.08% vs 78.70%). CONCLUSION The above results demonstrate the effectiveness of CNP plus psychological nursing in mitigating anxiety, depression, and pain in patients surgically treated for eLC.

Cardiomyopathy is a devastating complication of end-stage renal disease (ESRD), characterized by complex remodeling and high cardiovascular mortality. While sacubitril/valsartan (Sac/Val) and Qili Qiangxin (QLQX) granules have shown individual benefits in heart failure, their combined efficacy in ESRD patients remains poorly defined. To evaluate the impact of adjunctive QLQX therapy with Sac/Val on quantitative myocardial motion, cardiac function, and hemodynamic parameters in patients with ESRD. In this retrospective cohort study, 109 ESRD patients with heart failure with reduced ejection fraction (HFrEF) were enrolled. Patients were divided into a control group (n = 53, Sac/Val alone) and an observation group (n = 56, Sac/Val plus QLQX). Comprehensive 2D and 4D echocardiography, including speckle-tracking for global longitudinal strain (GLS), was performed after 3 months of treatment. Compared to the control group, the observation group demonstrated significantly higher left ventricular ejection fraction ( LVEF, 45.2 ± 5.8% vs. 40.5 ± 5.2%, t = 4.446, P<0.0001) and improved GLS (-17.1 ± 2.3% vs. -15.2 ± 2.1%, P = 0.018). Significant enhancements were also observed in peak systolic myocardial velocity, cardiac output, and left atrial emptying fraction (all P < 0.05). Furthermore, the observation group showed favorable shifts in diastolic indices (E/E' ratio and isovolumic relaxation time) and right ventricular performance (TAPSE and Tei index) (P < 0.05). The combination of QLQX and Sac/Val is associated with modest but statistically significant improvements in biventricular systolic and diastolic function in ESRD patients. These findings suggest a potential synergistic effect on myocardial mechanics, providing a hypothesis-generating basis for larger prospective trials.

The world population is aging rapidly. Fractures are more frequent in older people are associated with high rates of mortality and morbidity. Several studies have implemented various nursing care interventions to improve health outcomes in older patients following fractures. The current systematic review and meta-analysis aimed to study the effects of various nursing care interventions on the rehabilitation of older patients following fractures. A comprehensive search was conducted across the seven reputable databases (Epistemonikos, Cochrane, Scopus, PubMed, Medline, Embase, and Web of Science) employing four sets of keywords up to April 2025, following the PRISMA approach. The PICOS framework was developed to elucidate the research question, and studies that did not meet the specified criteria were excluded. 94 articles were included in the current review. Among the interventions, multidisciplinary intervention programs, evidence-based nursing, and comprehensive nursing programs demonstrated the highest effectiveness. Nevertheless, educational nursing interventions, exercise programs, discharge programs, family-centered care programs, and pain management programs, despite their low cost, also had a significant positive impact on patient rehabilitation. It was found that nursing interventions in the observational group, compared to the control group, significantly improved satisfaction rates and alleviate complication rates. These findings suggest that various nursing intervention programs can effectively enhance rehabilitation outcomes in older patients following fractures.

The automatic retrieval of boundary information from image objects suffers from the problem of under and over-segmentation, where the former leads to missed object detection, while the latter delivers an improper object shape. A method to optimize the automatic retrieval of complete and proper boundary information is proposed in this research based on an unsupervised approach. The strategy is to utilize the trade-off between the coefficient of variation from shape distribution against the mean of entropy contribution from segmented regions. This mechanism relies on the assumption that the segmentation result of a natural image contains a prominent main object representation with its details which are presented as a normal distribution of segmented regions. The research also enhances the entropy-based segmentation evaluation by redefining the computation of image entropy and segmentation entropy. The experiment shows that the proposed approach is capable of reducing over-segmentation by 57.20% compared to the existing algorithm, while at the same time reducing the consumption time by 85.26%. The empirical evaluation shows that the proposed approach delivers the highest accuracy among other evaluated methods. Qualitative validation based on groups of human observers shows that the proposed approach is the most desired algorithm for producing boundary information and measuring segmentation quality. These findings suggest that the trade-off between the mean of entropy contribution from the segmented regions and the coefficient of variation from shape distribution becomes an effective feature for unsupervised retrieval of boundary information.

Background. Among the factors contributing to unsuccessful treatment outcomes in patients with drug-resistant pulmonary tuberculosis-particularly multidrug-resistant tuberculosis (MDR-TB)-considerable importance is attributed to interindividual variability in pharmacological response, which is largely determined by patients’ genetic characteristics. Recent advances in MDR-TB chemotherapy are closely associated with the introduction of bedaquiline. Bedaquiline is primarily metabolized by the cytochrome P450 enzyme CYP3A4; however, the impact of CYP3A4 gene polymorphisms on bedaquiline pharmacokinetics and treatment efficacy in patients with drug-resistant TB remains insufficiently studied. Personalized therapy based on a patient’s genetic profile represents a key strategy for optimizing dosing regimens, improving treatment efficacy, and reducing the risk of developing further drug resistance. Aims — to evaluate the influence of CYP3A4 polymorphic alleles (*1B/rs2740574 and *1G/rs2242480) on bedaquiline pharmacokinetic parameters and chemotherapy efficacy in patients with drug-resistant pulmonary tuberculosis, including those with MDR-TB. Methods. A prospective, observational cohort study was conducted involving 143 patients with pulmonary tuberculosis and confirmed drug-resistant Mycobacterium tuberculosis (including MDR, pre-XDR, and XDR-TB) treated at the Central TB Research Institute (CTRIT), Russia, between 2022 and 2024 (66 women and 77 men). Three observation groups were formed based on genotype: Group 1 — wild-type CYP3A4*1 (n = 99); Group 2 — *1B (rs2740574) carriers (n = 10); Group 3 — *1G (rs2242480) carriers (n = 34). Genotyping was performed using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). Bedaquiline was administered as part of individualized chemotherapy regimens at a dose of 400 mg once daily for 2 weeks, followed by 200 mg three times weekly for up to 6 months. Bedaquiline pharmacokinetic parameters were assessed in 30 patients using high-performance liquid chromatography. Treatment efficacy was evaluated based on sputum culture conversion by month 6. Statistical analysis employed nonparametric Kruskal–Wallis and Mann–Whitney tests for group comparisons. Results. Patients carrying the CYP3A4 *1G (rs2242480) allele showed significantly higher bedaquiline exposure compared to wild-type individuals: AUC₀–₂₄ (49.06 vs. 41.99 µg·h/mL; p 0.05), Cmax (3.13 vs. 2.21 µg/mL; p 0.05), and AUC₀–₂₄/MIC ratio (196.24 vs. 167.94; p 0.05), suggesting reduced metabolic clearance. In contrast, the *1B variant was associated with lower AUC₀–₂₄. Although culture conversion rates at 6 months did not differ significantly (p = 0.87), a trend toward higher efficacy was observed in *1G carriers (95.8%) versus wild-type patients (84.5%). Conclusion. The CYP3A4 *1G (rs2242480) polymorphism is associated with decreased bedaquiline metabolism, leading to increased systemic drug exposure and a potential improvement in treatment response. These findings highlight the role of CYP3A4 genetics in bedaquiline pharmacokinetics and support the integration of CYP3A4 genotyping into personalized MDR-TB treatment strategies. The *1G allele may serve as a promising pharmacogenetic biomarker for optimizing bedaquiline dosing in drug-resistant tuberculosis.

The aim of this study was to evaluate freedom from tumor progression and clinical outcomes in older adults with small- to medium-sized vestibular schwannoma (VS) managed by observation versus stereotactic radiosurgery (SRS) to better inform optimal management in this patient population. In this international multicenter study, patients aged ≥ 60 years with Koos grade I or II VS managed by observation or SRS were retrospectively reviewed. Propensity score matching was conducted using patient characteristics, tumor size, and hearing assessments. Outcome measures of freedom from tumor progression, serviceable hearing preservation (SHP), and neurological function (tinnitus, vestibulopathy, House-Brackmann grade, and trigeminal nerve function) were assessed for both groups. The observation and SRS groups each comprised 51 matched patients (median age 68 years for both). Ipsilateral serviceable hearing was observed at presentation for 35 patients in each group. The median follow-up duration was 39 months in the observation group versus 27 months in the SRS group (p = 0.5). Tumor progression was significantly lower with SRS than with observation (2% vs 52.9%, p < 0.001). The rate of 5-year freedom from tumor progression was 100% in the SRS group versus 43% (95% CI 29%-64%) in the observation group. The rate of 10-year freedom from tumor progression was 90% (95% CI 73%-100%) in the SRS group versus 20% (95% CI 8.5%-49%) in the observation group. At the last follow-up, hearing loss occurred in 42.9% of the observation group and 51.4% of those who underwent SRS (p = 0.5). The 3-year SHP rate was 68% (95% CI 53%-88%) versus 65% (95% CI 49%-85%) (p = 0.8), and the 5-year SHP rate was 53% in both groups (95% CI 36%-78% in the observation group and 95% CI 35%-79% in the SRS group, p = 0.8). The composite endpoint of tumor progression and/or worsened neurological outcome, including hearing loss, tinnitus, vestibulopathy, facial nerve dysfunction (House-Brackmann grade), or trigeminal dysfunction, demonstrated a significantly lower rate in the SRS group (17.6%) compared with the observation group (66.7%) (p < 0.001). SRS in older patients for management of Koos grade I or II VS resulted in significantly superior rates of freedom from tumor progression, comparable hearing preservation rates, and significantly higher rates of favorable overall radiographic and neurological outcomes than observation alone. Compared with observation, SRS might be the preferred management option in this patient population.

This study assesses the clinical significance of implementing anticipatory nursing interventions in orthopedic surgical care. A total of 100 patients suffering from limb fractures and admitted between January and December 2021 were enrolled in this research. All participants had either moderate or severe orthopedic injuries, with no mild cases included. They were assigned to either the observation group or the control group. Comparisons were made between the 2 groups regarding intraoperative positioning care, psychological support, and condition monitoring, with a specific focus on whether anticipatory nursing was provided. In the surgical setting incorporating anticipatory care, the overall postoperative complication rate was observed at 10.2%. The average sleep quality score stood at 9.01 ± 3.27. The occurrence of upper limb thrombosis was 2%, while lower limb thrombosis was reported at 1%. Nursing satisfaction in the observation group reached 53.06%, compared to 29.41% in the control group. The incidences of lower limb thrombosis, pressure ulcers, and constipation were 4.08%, 13.73%, and 2.04% in the observation group, and 7.84%, 4.08%, and 9.80% in the control group, respectively. Additionally, the rate of intraoperative pain was 24.50% in the observation group versus 50.98% in the control group. Implementing anticipatory nursing care during orthopedic surgeries enables patients to better adjust to treatment procedures, helps alleviate anxiety, and contributes to enhanced clinical outcomes and overall quality of life.

To assess the subthreshold micropulse laser (SML) treatment in patients with acute central serous chorioretinopathy (CSC). This retrospective study included 46 eyes from 46 patients with acute CSC. Twenty-five patients were treated with SML, while 21 were observed without intervention. Outcomes evaluated included best corrected visual acuity (BCVA), outer nuclear layer thickness (ONLT), subfoveal choroidal thickness (SFCT), and subretinal fluid (SRF) height. SML was applied using a 577nm yellow wavelength laser. In the SML group, BCVA improved significantly from 0.33 ± 0.13 LogMAR at baseline to 0.07 ± 0.05 LogMAR at 6 months (p < 0.001). The observation group showed improvement from 0.29 ± 0.13 LogMAR to 0.14 ± 0.16 LogMAR (p = 0.011). SFCT decreased significantly in the SML group (460.36 ± 67.91μm at baseline to 407.44 ± 60.18μm at 6 months, p = 0.013), with no significant change in the observation group. The SML group also showed a significant increase in ONLT (p < 0.001), and complete SRF resorption was achieved in all patients, compared to 23.8% in the observation group. SML treatment is a safe and effective option for managing acute CSC. 2024/010.99/2/21-27.03.2024, retrospective design.

To observe the long-term clinical efficacy and safety of fire needling in the treatment of knee osteoarthritis. Sixty patients with knee osteoarthritis were randomized into an observation group (30 cases, 4 cases dropped out, 1 case was eliminated) and a control group (30 cases, 4 cases dropped out, 2 cases were eliminated). Yanglingquan (GB34), Neixiyan (EX-LE4), Dubi (ST35), Xuehai (SP10), Liangqiu (ST34) and 1-2 ashi points on the affected side were selected in the two groups. Fire needling was applied in the observation group, while conventional filiform needling was applied in the control group. The treatments in both groups were delivered once every other day, 3 times a week for 2 consecutive weeks. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score was observed before and after treatment, as well as at follow-ups of 6 months and 1 year after treatment completion, the clinical efficacy and safety were evaluated after treatment and at follow-ups of 6 months and 1 year after treatment completion. After treatment and at 6-month follow-up, the pain, stiffness, difficulty in daily activities scores and total scores of WOMAC were decreased compared with those before treatment in both groups (P<0.05). At 1-year follow-up, the pain, stiffness, difficulty in daily activities scores and total score of WOMAC were decreased compared with those before treatment in the observation group (P<0.05), the pain score of WOMAC was decreased compared with that before treatment in the control group (P<0.05). After treatment, the pain score, stiffness score and total score of WOMAC in the observation group were lower than those in the control group (P<0.05). At 6-month follow-up, the pain, stiffness, difficulty in daily activities scores and total score of WOMAC in the observation group were lower than those in the control group (P<0.05). At 1-year follow-up, the stiffness score, difficulty in daily activities score and total score of WOMAC in the observation group were lower than those in the control group (P<0.05). At 6-month follow-up, the total effective rate was 76.0% (19/25) in the observation group, which was higher than 41.7% (10/24) in the control group (P<0.05). At 1-year follow-up, the total effective rate was 64.0% (16/25) in the observation group, which was higher than 33.3% (8/24) in the control group (P<0.05). No acupuncture-related adverse reactions or events occurred in the two groups. Fire needling effectively improves the symptoms of KOA, and has a definite long-term clinical efficacy.

To observe the clinical effect of medicated-thread moxibustion of Zhuang medicine on amnestic mild cognitive impairment (aMCI) with sleep disorder. Sixty-four aMCI patients with sleep disorder were randomly divided into an observation group (32 cases, 1 case withdrawn) and a control group (32 cases, 1 case dropped out). Health education was performed in the control group. Besides the intervention as the control group, in the observation group, the medicated-thread moxibustion was delivered at Baihui (GV20) and Guanyuan (CV4), as well as bilateral Zusanli (ST36) and Sanyinjiao (SP6). The treatment was given once every 2 days in the 1st month and twice a week in the 2nd and 3rd months; and the duration of treatment was composed of 30 sessions. Montreal cognitive assessment (MoCA), Pittsburgh sleep quality index (PSQI), and World Health Organization quality of life-BREF (WHOQOL-BREF) were scored before and after treatment in the two groups; and the latency and amplitude of event-related potential P300 were detected. The clinical therapeutic effects for the cognitive function and sleep quality were evaluated in the two groups. Correlation analysis and linear regression analysis were conducted on the event-related potential P300 related to the total scores of MoCA and PSQI as well as the scores of each subscale. After treatment, in the observation group, the scores on attention, abstraction, delayed recall and the total score of MoCA, as well as the score of WHOQOL-BREF were higher in comparison with those before treatment (P<0.05). After treatment, the observation group showed the higher scores on language, abstraction, delayed recall, and the total score of MoCA, as well as the score of WHOQOL-BREF when compared with those in the control group (P<0.05). After treatment, the latency of the event-related potential P300 was shortened (P<0.05) and the amplitude was increased (P<0.05) compared to those before treatment in the observation group; and the latency was shorter (P<0.05), and the amplitude was larger when compared with those in the control group (P<0.05). After treatment, the score on subjective sleep quality, sleep latency, sleep efficiency, use of sleep medication and daytime dysfunction, and the total score of PSQI were lower than those before treatment in the observation group (P<0.05); and the score on sleep duration was reduced in the control group (P<0.05). After treatment, the scores on subjective sleep quality, use of sleep medication, and the total PSQI score in the observation group were lower when compared with those in the control group (P<0.05). The total effective rates for the improvement in cognitive function and sleep quality in the observation group were higher than those in the control group, respectively (61.3% [19/31] vs 19.4% [6/31], 80.6% [25/31] vs 19.4% [6/31], P<0.05). The total score of MoCA was negatively correlated with P300 latency (r=-0.843, P<0.001) and was positively correlated with P300 amplitude (r=0.722, P<0.001). The total score of PSQI was positively correlated with P300 latency (r=0.552, P<0.001) and was negatively correlated with P300 amplitude (r=-0.471, P<0.001). Multiple linear regression analysis indicated that P300 latency was linearly related to abstraction, delayed recall, language, naming, attention and orientation; P300 amplitude showed a linear relationship with naming, abstraction, delayed recall and orientation; and both latency and amplitude of P300 were linearly related to subjective sleep quality and use of sleep medication. The medicated-thread moxibustion of Zhuang medicine ameliorates cognitive function and improves sleep and quality of life in aMCI patients combined with sleep disorder.

To observe the clinical effect of mild moxibustion at Renying (ST9) combined with acupuncture on severe peripheral facial paralysis (PFP) of qi deficiency and blood stagnation. Sixty-six patients with severe PFP of qi deficiency and blood stagnation were randomly divided into an observation group and a control group, with 33 cases in each group. In the control group, acupuncture was operated at Yangbai (GB14), Sibai (ST2), Quanliao (SI18), Jiache (ST6), Dicang (ST4), Yifeng (TE17), Qianzheng (Extra) and etc., on the affected side; and in the observation group, besides the administration as the control group, mild moxibustion was delivered at Renying (ST9) on the affected side. The intervention was given once every other day, 3 sessions weekly, for 8 consecutive weeks in the two groups. The scores of facial nerve function and facial disability index (FDI) were compared before and after treatment in the two groups. The ratio of the root mean square (RMS) average values of the affected facial muscles to those of the healthy side was measured using surface electromyography (sEMG) in both groups, and the clinical effect and safety were evaluated. After treatment, both groups showed the increase in facial nerve function scores, the total scores of FDI and the scores on FDIP (physical function) and FDIS (social function) in comparison with those before treatment in the two groups (P<0.01); and the facial nerve function score, the total score of FDI and the score on FDIP in the observation group were higher than those in the control group (P<0.01, P<0.05). After treatment, the ratio of the RMS average values of the affected facial muscles (frontalis, buccinator, and orbicularis oris) to those of the healthy side was elevated in the two groups when compared with that before treatment (P<0.01), and the increase amplitude in the observation group was larger than that in the control group (P<0.05). The total effective rate in the observation group was 87.9% (29/33), higher than that (66.7%, 22/33) in the control group (P<0.05). No obvious adverse reaction was found in the two groups during trial. On the basis of conventional acupuncture, mild moxibustion at Renying (ST9) may promote the recovery of facial muscles and improve facial nerve function and facial nerve conduction in patients with severe PFP of qi deficiency and blood stagnation.

Non-small cell lung cancer (NSCLC) is associated with high malignancy, mortality, and recurrence. While early symptoms are subtle, timely surgery significantly improves outcomes. Video-assisted thoracoscopic surgery (VATS) anatomic segmentectomy is an increasingly important technique in early-stage NSCLC management. This study evaluates its effects on postoperative pain, stress response, respiratory function, and quality of life (QOL). This study aims to investigate the impact of VATS anatomic segmentectomy on stress response and pulmonary function in early-stage NSCLC patients. From December 2021 to December 2023, 98 early-stage NSCLC patients were allocated by surgical method: 45 underwent VATS pulmonary lobectomy (control group) and 53 underwent VATS anatomic segmentectomy (observation group). Perioperative outcomes, stress markers (cortisol, growth hormone, adrenocorticotrophic hormone, prostaglandin E2), complications, pain (visual analog scale scores), pulmonary function (forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal voluntary ventilation, transfer factor for carbon monoxide of the lung), and QOL were compared. Surgical duration and lymph node retrieval did not differ significantly (P > .05). However, the observation group showed less intraoperative bleeding, lower postoperative drainage, shorter extubation time, and reduced hospital stay (P < .05). Preoperative stress markers were similar between groups. Postoperatively, cortisol and prostaglandin E2 were significantly lower in the observation group, while growth hormone and adrenocorticotrophic hormone levels showed no group difference (P < .05). Rates of complications (pneumonia, atelectasis, atrial fibrillation, prolonged air leak, empyema, hoarseness, arrhythmia) were comparable (P > .05). Pain scores at 24, 48, 72 hours, and day 5 were lower in the observation group (P < .05). Preoperative lung function was similar, but at 1 month, the observation group demonstrated higher forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal voluntary ventilation, and transfer factor for carbon monoxide of the lung (P < .05). QOL was initially comparable, but at 1 and 3 months, the observation group reported significantly better QOL (P < .05). VATS anatomic segmentectomy provides favorable clinical outcomes for early-stage NSCLC. It reduces postoperative stress and pain, enhances lung function recovery, and improves QOL, supporting its value as a surgical option.

Surgical resection is recommended for intraductal papillary mucinous neoplasms (IPMN) with high-risk stigmata (HRS). However, in clinical practice, some patients are managed conservatively because of their advanced age or comorbidities. We aimed to evaluate the clinical course and identify risk factors for malignant progression in patients with HRS-positive IPMN. We retrospectively analyzed 100 consecutive patients with HRS-positive IPMN treated at a single tertiary center between 2015 and 2024. Patients were classified into a surgical group (n = 63) and an observation group (n = 37). Malignant progression was defined as pathologically confirmed invasive carcinoma in resected specimens or as clinical progression in the observation cohort. Logistic regression analysis was performed to identify factors associated with malignant progression. Malignant progression occurred in 18 patients (18%), including 13 with invasive carcinoma in the surgical group and 5 with clinical progression in the observation group. The median time to progression was 12 months (range 1-83 months). In multivariate analysis, carbohydrate antigen 19-9 (CA19-9) > 37 U/mL (odds ratio [OR] 5.6, 95% confidence interval [CI] 1.5-20.7, p = 0.0097) and fluorodeoxyglucose (FDG) uptake with a standardized uptake value (SUV) > 3 on positron emission tomography-computed tomography scan (PET-CT) (OR 4.7, 95% CI 1.3-17.1, p = 0.0189) were independently associated with malignant progression, whereas enhancing mural nodules ≥ 5 mm were not statistically significant. In patients with HRS-positive IPMN, malignant progression was associated with tumor biological and metabolic markers rather than with morphologic criteria alone. Risk-adapted decision-making incorporating CA19-9 and FDG-PET findings may help refine patient selection and avoid unnecessary surgery in selected high-risk patients.

Patients experiencing manic episodes often suffer from significant emotional instability, impairing treatment adherence and prolonging hospitalization. Nonpharmacological interventions such as music therapy may offer additional benefits. This study aimed to evaluate the impact of group music therapy combined with routine nursing on emotional stability, symptom severity, and patient satisfaction in inpatients with manic episodes. In this retrospective study, 102 inpatients diagnosed with manic episodes between January 2022 and December 2023 were enrolled and divided into a control group (n = 50) receiving routine nursing care and an observation group (n = 52) receiving additional group music therapy. Group music sessions were held 3 times weekly for 4 weeks. The Young Mania Rating Scale (YMRS), the Emotional Stability subscale of the Eysenck Personality Questionnaire (EPQ-ES), and patient satisfaction were assessed before and after intervention. Statistical comparisons were performed within and between groups. At baseline, there were no significant differences between groups in age, gender, illness duration, YMRS, or EPQ-ES scores. After intervention, the observation group showed significantly lower YMRS scores (15.2 ± 3.7 vs 21.6 ± 4.1, P < .001), higher EPQ-ES scores (28.5 ± 5.2 vs 22.3 ± 5.0, P < .001), and greater satisfaction (86.5% vs 64.0%, P = .012) compared to the control group. Group music therapy significantly enhances emotional stability and satisfaction among hospitalized manic patients. This intervention is a feasible and effective supplement to routine psychiatric nursing care.

BackgroundElderly patients with both coronary heart disease (CHD) and diabetes mellitus (DM) undergoing off-pump coronary artery bypass grafting (CABG) face high risks of perioperative glucose fluctuations and impaired recovery. We evaluated the impact of a structured, multidisciplinary case management model on cardiac function and glycemic control in this population.Material/MethodsThis single-center, randomized controlled trial enrolled 168 elderly (≥65 years) patients with CHD and type 2 DM scheduled for off-pump CABG. Patients were randomized (1: 1) to a control group (CG, n=84; routine care) or an observation group (OG, n=84). The OG received routine care plus a 6-month multidisciplinary intervention including individualized cardiac rehabilitation, modified Mediterranean diet, psychological support, and intensified follow-up. The primary endpoint was 6-month left ventricular ejection fraction (LVEF); HbA1c was a key secondary endpoint.ResultsAll 168 randomized patients were analyzed. At 6 months, the observation group demonstrated significantly superior primary outcomes. LVEF was significantly higher in the OG (mean difference: 6.2%, P<0.001), and HbA1c was significantly lower (mean difference: 1.3%, P<0.001). The intervention group also showed significant improvements in secondary endpoints, including reduced left ventricular diameters (LVESD, LVEDD), an improved lipid profile (P<0.05), longer 6-minute walk test distance, and higher Diabetes-Specific Quality of Life (DSQL) and Activity of Daily Living (ADL) scores (P<0.0001).ConclusionsStructured, multidisciplinary case management significantly improved cardiac function, metabolic control, and functional capacity in elderly diabetic patients after off-pump CABG, validating its efficacy for this high-risk group.Chinese Clinical Trial Registry (ID: ChiCTR2000034438); https://www.chictr.org.cn/showproj.html?proj=5611