Under the dual drive of the "Healthy China" strategy and ecological civilization construction,forest health care is becoming an important development direction for green health services.This article takes typical forest health and wellness bases in China as the research object,constructs a multidimensional evaluation framework with "resources-ecology-perception" as the core,and comprehensively uses GIS spatial analysis,air and climate environment indicator evaluation,field research,and text frequency analysis methods to systematically analyze the distribution pattern,ecological suitability,and service value of forest health and wellness bases.The results show that the overall clustering characteristics of forest health bases in China are "dense in the east and sparse in the west,strong in the south and weak in the north".The air quality is excellent,and PM2.5 is significantly correlated with AQI.Forest coverage and negative oxygen ion concentration have become the core ecological support factors.High altitude areas have cool summers and suitable humidity,providing outstanding advantages for summer heat dissipation and health preservation.Tourists generally highly recognize wellness experiences such as fresh air and quiet environment,and the frequency of words reflects a strong preference for ecological authenticity and cultural integration wellness projects.The study has constructed a quantitative path for the value of health and wellness,and proposed development suggestions for optimizing spatial layout,improving service facilities,and strengthening the integration of intelligent monitoring and ecological culture,providing theoretical basis and practical reference for the high-quality development of forest health and wellness in China.

Objective   To evaluate the reliability and validity of the Chinese version of the e-Health Literacy Scale(eHEALS) in two elderly care models.Methods   From May to July 2024,a simple random sampling method was used to select 255 elderly people from nursing homes in Guangzhou as the nursing home group.In the community where the nursing home is located,255 elderly people were selected as the community group by age and gender matching in a 1∶1 ratio.Face to face questionnaire surveys were conducted using the eHEALS scale.The reliability and validity of the scale were calculated using Cronbach's α coefficient,Spearman Brown split half coefficient,Pearson correlation coefficient,and factor analysis.Results   A total of 510 questionnaires were distributed and 510 were collected,with an effective response rate of 100%.The Cronbach's α coefficients for the total population,nursing home group,and community group were 0.986,0.974,and 0.997,respectively.The Spearman Brown odd-even half reliability coefficients were 0.976,0.956,and 0.996,respectively,indicating that the questionnaire has good reliability in different elderly care model populations.The correlation coefficients between each item of the scale and its corresponding dimension were 0.913-0.955,0.847-0.919,and 0.908-0.994 in the total population,nursing home group,and community group,respectively(all P<0.001).The KMO values for the total population,nursing home group,and community group were 0.947,0.935,and 0.870,respectively,with Bartlett's sphericity test showing P<0.001.The exploratory factor analysis results showed that the total population,nursing home group,and community group each had a clear factor structure,with contribution rates of 90.99%,84.47%,and 98.04%,respectively.Conclusion   The results of this study indicate that the eHEALS scale exhibits good reliability and validity in both elderly care models,suggesting that the questionnaire is suitable as a reliable tool for evaluating the electronic health literacy of the elderly.

Objective   To develop a prediction model for peripherally inserted central catheter(PICC) occlusion risk in cancer patients,and to validate it externally.Methods   By convenience sampling,this study selected 368 cancer patients who had undergone PICC placement in Lishui People's Hospital from January to October 2023 as the study subjects.A total of 159 patients who had PICC placement from November 2023 to February 2024 were included in the validation group at a ratio of 7:3.Univariate and multivariate Logistic regression analyses were used to establish a risk prediction model.The discriminating ability,consistency,net benefit and clinical utility of the prediction model were assessed by the receiver operating characteristic(ROC) curves,Hosmer-Lemeshow test,calibration curves and decision curve analysis(DCA),respectively.Results   Multivariate logistic regression showed that diabetes,elevated D-dimer,parenteral nutrition,catheter maintenance time≥7 d,and violent coughing were risk factors for PICC occlusion in cancer patients.The area under the curve(AUC) of the model was 0.863 in the training group,with a specificity of  0.639 and a sensitivity of 0.948.The Hosmer-Lemeshow test showed the results of 4.679,and 0.861.The calibration curve showed that the predicted probability was well matched with the actual probability,indicating that the model had good calibration.DCA showed that the model had good clinical utility.The AUC of the model in the validation group was 0.890,with a sensitivity of 0.958 and a specificity of 0.681.Conclusion   The constructed risk prediction model has good predictive performance,which can effectively predict the probability of PICC occlusion in cancer patients.It can provide references for nursing staff to identify high-risk groups in advance and formulate intervention measures.

Objective   To explore the influence of the telemedicine management model of traditional Chinese and Western medicine based on the Zaya therapy of Dai medication and the telemedicine platform on the health behavior ability and quality of life of maintenance hemodialysis patients.Methods   A total of 110 patients who received maintenance hemodialysis treatment at Nanyang Central Hospital from August 2023 to August 2024 were selected as the research subjects and divided into an experimental group and a control group by random number table,with 55 cases in each group.After discharge,the control group received conventional intervention,while the experimental group was intervened with the telemedicine management model of traditional Chinese and Western medicine on the basis of the control group.Before and after intervention,the health behavior ability,quality of life and coagulation condition of the dialysis tubing of the two groups of patients were compared.Results   Three months and six months after discharge,the total score of health behavior ability in the experimental group was higher than that in the control group,and the difference was statistically significant(t=7.343,13.081,P<0.05).The scores of each dimension of quality of life in the experimental group were all higher than those in the control group,and the difference was statistically significant(P<0.05).The incidence of coagulation in the dialysis tubing was 27.27% in the experimental group and 65.45% in the control group and the difference was statistically significant(χ2=16.122,P<0.05).Conclusion   The  telemedicine management model of traditional Chinese and Western medicine is conducive to enhancing the health behavior ability of maintenance hemodialysis patients,reducing the occurrence of related complications,and improving the quality of life.

Objective   To study the influence of graded respiratory rehabilitation training based on BODE index on pulmonary function and arterial blood gas index levels in elderly patients with chronic obstructive pulmonary disease(COPD).Methods   A total of 105 elderly patients with COPD in Puyang Hospital of Traditional Chinese Medicine from June 2023 to October 2024 were selected and grouped by random number table.52 cases in the control group were given conventional pulmonary function rehabilitation training,and 53 cases in the observation group were given graded respiratory rehabilitation training based on BODE index.The pulmonary function,arterial blood gas level,quality of life and complications of the two groups were compared.Results   After intervention,the partial pressure of carbon dioxide in arterial blood[p(CO2)] in the observation group was(48.44±4.37)mmHg(1 mmHg=0.133 kPa),which was lower than that in the control group[54.56±5.44]mmHg).The levels of arterial partial pressure of oxygen[p(O2)] and blood oxygen saturation(SpO2) were(74.01±5.37)mmHg and(82.32±3.49)% respectively,both of which were higher than those of the control group ([69.82±5.75]mmHg and[79.56±3.72]%)(P<0.05);After intervention,the forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and FEV1/FVC levels in the observation group were (3.66±0.34)L,(2.58±0.45)L,and(59.11±3.69),respectively,which were higher than the control group(3.39 ± 0.37)L,(2.38±0.38)L,(56.64±3.52)(P<0.05);After intervention,the score of the St.George's Respiratory Questionnaire(SGRQ) in the observation group was(53.34±6.25)points,which was lower than that in the control group(58.16±6.64)points(P<0.05).The incidence of complications was 5.77% in the control group and 7.55% in the observation group.There was no difference of statistical significance in the incidence of complications between the two groups(P>0.05).Conclusion   Graded respiratory rehabilitation training based on BODE index can effectively improve the pulmonary function of elderly patients with COPD,enhance the level of arterial blood gas,and improve the quality of life.

Guided by the theory of "treating from Yang",this article studies the therapeutic effects of various forms of cupping methods(such as bamboo cupping,fire dragon cupping,warming and tendon-unblocking cupping,balanced cupping,acupressure cupping,Guasha cupping,and massage cupping) in treating low back and leg pain.Low back and leg pain is often caused by wind,cold and dampness obstructing the meridians and poor circulation of Yang qi,presenting symptoms such as local cold pain and restricted movement.By tracing the origin of the traditional Chinese medicine theory of low back and leg pain,the close connection between it and Yang qi is clarified,providing theoretical support and practical reference for the clinical application of multi-form cupping methods in the treatment of low back and leg pain.The theory of "treating from Yang" guides that various forms of cupping can stimulate the body's Yang qi,warm and unblock the meridians,dispel cold and remove dampness,thereby improving the circulation of qi and blood in the waist and legs and reducing pain.Moreover,the operation is safe and patients have high compliance.During the operation,different cupping methods are selected according to the differences in patients' constitutions.This study provides a clinical reference for the TCM characteristic nursing of low back and leg pain,emphasizing the core role of the "Yang following" idea in cupping therapy.

Objective   To explore the influence of acupoint massage combined with oral muscle training on oral motor function and articulation clarity in functional articulation disorder(FAD) children with abnormal blade-palatal.Methods   86 FAD children with abnormal blade-palatal admitted to the General Hospital of Puyang Oilfield from March 2021 to May 2024 were retrospectively selected as the research subjects.They were divided into a control group and a combined group according to different treatment plans,with 43 cases in each group.The control group received oral muscle training treatment,while the combined group received oral muscle training combined with acupoint massage treatment.The clinical efficacy of the two groups after treatment was compared,as well as the oral motor function(jaw,lip,tongue),articulation clarity(single characters,sentences,continuous pronunciation),and the score of the Normal Development of Social Skills from Infancy to Junior High School Children before and after treatment.Results   After treatment,the total effective rate of the combined group was 97.67%,which was higher than that of the control group 83.72%,and the difference was statistically significant(P<0.05).After treatment,the scores of tongue,jaw,lip and overall in both groups increased,and those in the combined group were higher.The difference was statistically significant(P<0.05).After treatment,the scores of single characters,sentences and continuous pronunciation in the combined group were all higher than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the score of the Normal Development of Social Skills from Infancy to Junior High School Children in the combined group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion   Acupoint massage combined with oral muscle training has a remarkable therapeutic effect on FAD children with abnormal blade-palatal.It can enhance oral motor function,improve articulation clarity,and enhance social living ability.

Objective   To observe the therapeutic effect of five-flavor sophora flavescens enteric-coated capsules(FSEC) combined with mesalazine in the treatment of ulcerative colitis(UC).Methods   A total of 159 UC patients admitted to the First Affiliated Hospital of Henan University from June 2023 to September 2024 were selected and randomly divided into group A(n=53,treated with FSEC),Group B(n=53,treated with mesalazine),and Group C(n=53,treated with FSEC combined with mesalazine) according to the random number table.The therapeutic effects of TCM syndromes,immune function,inflammatory indicators,intestinal flora,adverse reactions and recurrence of the three groups of patients were compared.Results   The total effective rate of group C was higher than that of group A and Group B(P<0.05).After treatment,the levels of CD3+,CD4+/CD8+,and Bifidobacterium in the three groups were higher than those before treatment(P<0.05),and those in group C were higher than those in group A and Group B(P<0.05).After treatment,the levels of interleukin(IL)-17,IL-8 and Escherichia coli in the three groups were lower than those before treatment(P<0.05),and those in group C were lower than those in group A and Group B(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions among the three groups(P>0.05).The recurrence rate of group C(3.77%,2/53) was lower than that of group A(18.87%,10/53) and group B(20.75%,11/53),and the difference was statistically significant(χ²=6.014,P=0.014;χ²=7.102,P=0.008).Conclusion   FSEC combined with mesalazine in the treatment of UC can improve the therapeutic effect of traditional Chinese medicine syndromes and immune function,regulate inflammatory indicators and intestinal flora,reduce early recurrence,and does not increase adverse reactions.

Objective   To observe the efficacy of Jianpi Zhidong Decoction combined with Tiaogan Xifeng acupuncture in the treatment of children with multiple tourette syndrome,and to analyze its impact on the traditional Chinese medicine(TCM) syndrome scores and serological indicators.Methods   A total of 93 children with multiple tourette syndrome treated in Xinxiang Maternal and Child Health Hospital from November 2022 to November 2024 were retrospectively selected for analyses.Patients were divided into three groups according to the treatment plans,with 31 cases per group.Patients in the acupuncture group were treated with Tiaogan Xifeng acupuncture,and those in the decoction group were treated with Jianpi Zhidong Decoction.Patients in the combined group were treated with Jianpi Zhidong Decoction combined with Tiaogan Xifeng acupuncture.Clinical efficacy,recurrence rate,TCM syndrome score,Yale Global Tic Severity Scale(YGTSS),muscle function,mental health(mental health scale for child and adolescent[MHS-CA]),quality of life(pediatric quality of life inventory measurement models [PedsQL 4.0]),neurotransmitters(gamma-amino butyric acid[GABA],dopamine[DA],brain-derived neurotrophic factor[BDNF],norepinephrine[NE]),microinflammatory state(interleukin-1β[IL-1β],tumor necrosis factor-α[TNF-α],interleukin-6[IL-6],C-reactive protein[CRP]),and immune function(CD3+,CD4+,CD+/CD8+) before and after treatment were compared among the three groups.Results   The total effective rate of the combined group was significantly higher than that of the acupuncture group and the decoction group(P<0.05).After treatment,the scores of TCM syndrome and YGTSS in the combined group were significantly lower than those of the acupuncture group and decoction group(P<0.05).After treatment,patients in the combined group had significantly lower scores for Tic intensity,frequency,and count than the acupuncture group and the decoction group,while the MHS-CA score and PedsQL 4.0 score were significantly higher than those of the acupuncture group and the decoction group(P<0.05).After treatment,the levels of serum GABA and BDNF in the combined group were significantly higher than those in the acupuncture group and the decoction group,while the levels of DA and NE were significantly lower than those in the acupuncture group and the decoction group(P<0.05).The levels of serum IL-1β,TNF-α,IL-6,and CRP in the combined group were significantly lower than those in the acupuncture group and the decoction group after treatment(P<0.05).After treatment,the levels of CD3+,CD4+,and CD4+/CD8+ in the peripheral blood of the combined group were significantly higher than those of the acupuncture group and the decoction group(P<0.05).There was no significant difference in the above indicators between the acupuncture group and the decoction group(P>0.05).The recurrence rate in the combined group was significantly lower than that in the acupuncture group and the decoction group(P<0.05).Conclusion   The treatment of multiple tourette syndrome in children with Jianpi Zhidong Decoction combined with Tiaogan Xifeng acupuncture can improve clinical efficacy,improve clinical symptoms and mental health status,enhance quality of life,protect neurological and muscular functions,inhibit inflammatory reactions,enhance immunity,and reduce recurrence rates.

Objective   To explore the effects of modified Qingyi decoction combined with acupuncture therapy on the clinical symptoms and the Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MYD88) signaling pathway in patients with acute pancreatitis(AP).Methods   A total of 107 patients with AP admitted to Xinmi Hospital of Traditional Chinese Medicine from May 2022 to July 2024 were selected as the research subjects.According to the random number table,they were divided into an acupuncture group(54 cases) and a study group(53 cases).During the treatment period,one case dropped out in the acupuncture group.The acupuncture group was given acupuncture therapy,while the study group was given the modified Qingyi decoction combined with acupuncture therapy.The clinical efficacy of the two groups was compared,as well as the expression levels of clinical symptoms,motilin(MTL),D-lactic acid,gastrin(GAS),endotoxin,interleukin(IL)-1β,C-reactive protein(CRP),amylase(AMY),IL-6,tumor necrosis factor-α(TNF-α),TLR4 and MYD88 mRNA before and after treatment.Results   After treatment,the clinical symptom score of the study group was lower than that of the acupuncture group(P<0.05).After treatment,the levels of endotoxin,GAS and D-lactic acid in the study group were lower than those in the acupuncture group,and the level of MTL was higher than that in the acupuncture group(P<0.05).After treatment,the expression levels of IL-6,IL-1β,AMY,CRP,TNF-α,TLR4 and MYD88 mRNA in the study group were lower than those in the acupuncture group(P<0.05).After treatment,the clinical efficacy of the study group was 96.23%,which was higher than 84.91% of the acupuncture group(P<0.05).Conclusion   Modified Qingyi decoction combined with acupuncture therapy can improve the clinical symptoms of AP patients,inhibit inflammatory responses,and promote the recovery of gastrointestinal function.

Objective   To analyze the current state,primary areas of interest,and emerging trends in pressure injury research,both domestically and internationally over the past decade,thus providing references for clinical nursing practice.Methods   Publications about pressure injuries from January 2013 to December 2023 were systematically searched in the China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP Information Chinese Journal Service Platform and Web of Science.CiteSpace version 6.2.R3 software was used to conduct a visualization analysis including authors,institutions,countries,and keywords.Co-occurrence maps for authors,institutions,and countries,as well as co-occurrence,clustering,time zone,and burst word maps for keywords were generated.Results   A total of 5 152 Chinese-language articles and 4 178 English-language articles about pressure injury were searched.The results indicated a consistent increase in publication volume both nationally and internationally since 2013.The domestic publication trend displayed an inverted "V" shape,characterized by an initial increase followed by a subsequent decline,while the international trend revealed a steady upward trajectory.The primary research focal points,both domestically and internationally,encompassed the early identification of risk factors for pressure injuries,a widely acknowledged area of inquiry,and precision-customized prevention strategies for pressure injuries,which exhibited varying emphases across domestic and international contexts.The frontiers of research on pressure injuries were continually evolving,necessitating increased attention to orthopedics and innovative dressing materials.Conclusion   The research on pressure injuries both nationally and internationally,indicate a general increase in its prevalence.It is essential for clinical nursing personnel to incorporate contemporary research trends to formulate targeted prevention strategies for pressure injuries.Furthermore,they should become acquainted with the utilization of innovative wound dressings to reduce the risk of these injuries.

With the advancement of the information and digital waves,digital health,as a product of the deep integration of information technology and medical and health care,has developed rapidly,and the importance of digital health literacy has become increasingly prominent.This article,through a systematic review of relevant literature,explores the current situation of digital health literacy among Chinese residents and its influencing factors.At present,the gap in digital health literacy between urban and rural areas in China is gradually narrowing,but there are still regional and population differences.The digital health literacy level of urban residents is generally higher than that of rural residents.Personal factors(such as age,family situation,job differences,educational attainment and economic level),social environmental factors(such as medical security conditions and regional economic and medical information differences),as well as digital resource factors(including the accessibility of digital resources and residents' attitudes towards digital health information) all have a significant impact on digital health literacy.In the future,multi-center,large-sample cross-sectional surveys and longitudinal studies need to be carried out to comprehensively assess residents' digital health literacy,and based on this,targeted intervention strategies should be developed to enhance the digital health literacy level of the entire population.

Objective   To explore and summarize the research status and development trend of military physical training in China.Methods   A total of 257 articles on the theme of military physical training were retrieved on the China National Knowledge Infrastructure(CNKI) (1994-2024),and the map was drawn by CiteSpace software.Authors,research institutions,keyword co-occurrence,keyword clustering,keyword prominence and timeline map of the published articles in the field of military physical training research in the past 30 years were visually analyzed.Results   In terms of the number of publications,the trend of the number of publications in the field of military physical training research in China was mainly divided into three stages: the slow increase stage(1994-2005),the rapid increase stage(2006-2016),and the gradual decline stage(2017-2024).In terms of research authors and institutions,scientific research cooperation between authors and institutions was insufficient,and no core author group has been formed.In terms of research hotspots,it mainly included the exploration of physical training methods and models,the physiological effects of various groups of military personnel and training on the body,etc.With the deepening of the research in the field of military physical training,different research hotspots have also emerged in different periods,and keywords such as prevention and treatment of training injuries,actual combat,and informatization have also become research hotspots in this field in recent years.Conclusion   In the future research,it is suggested that more academic exchanges should be carried out between scholars and institutions,thus strengthening cooperation with local sports colleges and related scientific research institutions,promoting the cross-integration of related disciplines and military physical training,actively learning from advanced training models and methods,and accelerating the development of military physical training research field.It aims to achieve better improvement of the scientific level of military physical training,physical quality of military personnel,and combat effectiveness.

Rapid analgesia plays a crucial role in battlefield treatment and is of vital importance for maintaining the stability of the vital signs of the wounded.After trauma occurs, the vital signs of the injured often fluctuate due to pain.Timely pain relief can effectively prevent the deterioration of vital signs caused by pain.Meanwhile,pain is one of the important inducing factors of post-traumatic stress disorder (PTSD),and rapid analgesia can significantly reduce the risk of PTSD occurrence.In addition,rapid and effective analgesia can enable the wounded to better cooperate with treatment and improve the efficiency of battlefield treatment.This article provides an in-depth and systematic review of the neurobiological mechanisms of pain,analyzing the principles of pain generation from aspects such as neural conduction pathways.Meanwhile, the biochemical assessment indicators of war trauma pain,such as inflammatory factors, and their association with pain are elaborated in detail.It also combines advanced analgesic drugs and technologies of modern medicine,as well as characteristic treatment methods of traditional Chinese medicine such as acupuncture and herbal medicine,to comprehensively explore the application prospects of multimodal analgesic strategies in the treatment of war trauma pain.By integrating existing research results and clinical practice experience, the aim is to provide solid theoretical support and practical guidance for rapid analgesia of war trauma.

Hot springs serve as a pivotal avenue for human exploitation of geothermal resources.Their distinctive physical and chemical properties exhibit significant comprehensive benefits in the aspects of power generation,heating,agriculture,daily life and production,tourism,health,and wellness.Hot springs are strategic resource imbued with natural,economic,health,and cultural significance.China has various hot spring resources,with a broad distribution and significant economic value.Mastering the distribution of hot spring resources in China,understanding the mechanisms,main effects,discomfort and prevention of hot spring health care,and looking forward to the development trend of hot spring health care contribute to better development and use of hot spring resources.It also favors regional economic development,the implementation of the Healthy China Action,and harmonious coexistence between man and nature.Hot spring healthcare presents novel treatment alternatives for numerous diseases.As a non-pharmaceutical therapy,hot spring is developed towards differentiation and personalization.The development and utilization of hot spring resources can start from formulating reasonable industrial plans,improving public awareness,enhancing the added value and competitiveness of the hot spring industry,driving the development of related industries,and exploring and inheriting Chinese hot spring culture.

Patients with chronic kidney disease(CKD) progressing to end-stage renal disease rely on maintenance hemodialysis(MHD) for survival.However,long-term dialysis is often accompanied by multidimensional functional decline,including muscle atrophy,reduced cardiopulmonary function,and psychological disorders,severely impairing quality of life.This study systematically elucidates the mechanisms of a functionally stratified,stepwise exercise intervention in delaying functional decline among MHD patients and establishes a standardized clinical practice pathway.Using tools such as the modified Barthel index(MBI),6-minute walk test,and grip strength test,patients are stratified into three functional tiers:bedridden,semi-bedridden,and self-care.Tailored exercise prescriptions are then implemented:bedridden patients receive active/passive joint mobilization and respiratory training to prevent pressure ulcers and contractures;semi-bedridden patients undergo balance and transfer training to restore basic mobility;self-care patients engage in aerobic and resistance exercises to mitigate sarcopenia and cognitive decline.Evidence demonstrates that this stepwise intervention significantly enhances muscle mass and strength(via resistance training),improves cardiopulmonary endurance and metabolic regulation(via aerobic exercise),and alleviates anxiety and depression by modulating neurotransmitter release(e.g.,endorphins) and cerebral blood flow,thereby disrupting the "fatigue-reduced activity-functional decline" vicious cycle.The protocol integrates physiological and psychological interventions,emphasizing dynamic assessments and adaptive strategies(e.g.,adjusting exercise prescriptions every 3-6 months),optimizes exercise timing and intensity relative to dialysis cycles,and ensures safety and efficacy.Future multicenter,long-term studies are warranted to validate cost-effectiveness and broader applicability,providing evidence-based strategies for preserving functional capacity in MHD patients.

Objective   To explore the effects of high-flow nasal cannula oxygen therapy on cardiopulmonary function,exercise capacity,and biomarkers in patients with chronic obstructive pulmonary disease (COPD) and mild-to-moderate pulmonary hypertension(PH).Methods   Sixty COPD patients with mild-to-moderate PH admitted to the 923rd Hospital of the Joint Logistics Support Force from July 2022 to November 2024 were selected as the subjects.They were randomly divided into the control group and observation group using a random number table method,with 30 cases per group.Patients in the control group received traditional nasal cannula oxygen therapy on the basis of conventional treatment,while those in the observation group received nasal high flow humidified oxygen therapy on the basis of conventional treatment.Vital signs (heart rate [HR],respiratory rate [RR],mean arterial pressure [MAP]),lung function (forced expiratory volume in the first second [FEV1],forced vital capacity [FVC],peak expiratory flow rate [PEFR]),blood gas analysis indicators (partial pressure of arterial oxygen [p(O2)],arterial oxygen saturation [SaO2],partial pressure of arterial carbon dioxide [p(CO2)],exercise capacity (6-minute walking distance[6MWD]),and biomarkers (lactate dehydrogenase[LDH],B-type natriuretic peptide[BNP],troponin I[TnI]) between groups before and after one week of treatment were compared.Results   After one week of treatment,patients in the observation group had significantly higher FEV1([2.92±0.61]L VS [2.47±0.57]L),FVC([3.46±0.86]L VS [2.96±0.74]L) and PEFR([4.04±0.72]L/s VS [3.31±0.59]L/s) than the control group(P<0.05).Patients in the observation group had significantly higher p(O2) ([70.21±6.45]mmHg VS [64.34±6.04]mmHg,1 mmHg=0.133 kPa),SaO2 ([95.51±6.24]% VS [92.09±6.03]%),and p(CO2) ([47.74±4.12]mmHg VS [51.24±4.53]mmHg) than the control group(P<0.05).There were no significant differences in the HR,RR and MAP between the two groups (t=0.085,1.027,and 0.169,respectively,all P>0.05).The 6MWD of the observation group was significantly longer than that of the control group(P<0.05).LDH,BNP and TnI were significantly lower in the observation group than the control group(P<0.05).Conclusion   Nasal high flow humidified oxygen therapy can improve lung function,blood gas analysis indicators,increase 6MWD,and reduce LDH,BNP and TnI in COPD patients with mild-to-moderate PH.

Objective  To investigate the value of plasma heme oxygenase-1(HO-1),apolipoprotein B(ApoB),homocysteine(Hcy) combined with real-time shear wave elastography(SWE) in evaluating the lesion degree of nonalcoholic fatty liver disease(NAFLD).Methods   A total of 150 patients diagnosed with NAFLD in Henan Provincial People's Hospital from May 2022 to May 2024 were selected as the NAFLD group,and another 150 healthy volunteers were selected as the control group.The parameters of HO-1,ApoB,Hcy and SWE of the two groups were compared,and stratified comparative analysis was performed according to the degree of fatty liver lesions.Results   Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglycerid(TG),and total cholesterol(TC),liver hardness and spleen hardness in the NAFLD group were significantly higher than the control group(P<0.05).The measured values of HO-1,ApoB and Hcy in NAFLD group were significantly higher than the control group(P<0.05).Among 150 NAFLD patients,41 had mild disease,63 had moderate disease,and 46 had severe disease.Serum ALT,AST,TG,TC,LDL-C,liver hardness and spleen hardness in the severe NAFLD group were significantly higher than the moderate and mild groups(P<0.05).Serum HDL-C in the severe group was significantly lower than the mild group(P<0.05).Serum TG and liver hardness in the moderate NAFLD group were significantly higher than the mild NAFLD group(P<0.05).Serum HO-1,ApoB and Hcy values in the severe NAFLD group were significantly higher than the moderate and mild groups(P<0.05).The determination values of HO-1,ApoB and Hcy in the moderate NAFLD group were significantly higher than those the mild NAFLD group(P<0.05).The measured values of serum HO-1,ApoB and Hcy in NAFLD patients were significantly positively correlated with liver stiffness and spleen stiffness(P<0.05).Conclusion   Serum HO-1,ApoB,Hcy,liver hardness and spleen hardness significantly increase in NAFLD patients,and they are closely correlated with the severity of NAFLD.

Objective   To analyze the correlation and clinical significance between the levels of serum secreted frizzled related protein 4(SFRP4),C-X-C chemokine receptor 4(CXCR4),fibrinogen(FIB) and Wagner(Wanger) classification in patients with diabetic foot.Methods   90 patients with diabetic foot admitted to Zhoukou Huaihai Hospital from January 2022 to June 2024 were retrospectively collected as the diabetic foot group,and another 90 patients with simple diabetes during the same period were selected as the simple diabetes group.The general clinical data at admission of the two groups were compared.The levels of serum SFRP4,CXCR4 and FIB in diabetic patients with different Wanger classification were compared and their correlations were analyzed.The influencing factors of diabetic foot in diabetic patients and the diagnostic value of combined detection for diabetic foot was analyzed.Results   The levels of serum SFRP4,CXCR4 and FIB in the diabetic foot group at admission were all higher than those in the simple diabetes group(P<0.05).Comparison of serum SFRP4,CXCR4 and FIB levels in patients with different Wanger classifications showed that patients with grade 0-1 were less than those with grade 2-3 and patients with grade 2-3 were less than those with grade 4-5(P<0.05).The levels of serum SFRP4,CXCR4 and FIB at admission were all positively correlated with the Wanger classification of the patients(P<0.05).The duration of diabetes,transcutaneous oxygen partial pressure,serum SFRP4,CXCR4,and FIB were all related to the occurrence of diabetic foot.After adjustment,serum SFRP4,CXCR4,and FIB were risk factors for diabetic foot in patients(P<0.05).The efficacy of combined diagnosis of diabetic foot by serum SFRP4,CXCR4 and FIB levels at admission was 0.821.Conclusion   The levels of serum SFRP4,CXCR4 and FIB in patients with diabetic foot are significantly increased and positively correlated with the Wanger classification of the patients.All of them are influencing factors for the occurrence of diabetic foot,and it is found that their combined detection has a high application value in diagnosing the occurrence of diabetic foot.

Objective   To explore the influencing factors for coagulation dysfunction in elderly patients with severe pneumonia complicated by sepsis,and to create a Logistic regression prediction model to analyze its predictive value for the occurrence of coagulation dysfunction,providing a reference for formulating clinical intervention plans.Methods   A total of 118 elderly patients with severe pneumonia accompanied by sepsis treated in the Second Affiliated Hospital of Zhengzhou University from January 2023 to January 2025 were selected for a retrospective analysis.These patients were categorized into the occurrence group and non-occurrence group based on whether they developed coagulation dysfunction within 72 hours after admission.The clinical data of the two groups were compared,and the influencing factors for coagulation dysfunction were analyzed.A risk prediction model was constructed,and its calibration and discrimination were verified.Results   Among 118 elderly patients with severe pneumonia accompanied by sepsis,the incidence of coagulation dysfunction within 72 hours after admission was 66.10%(78/118).The patients of occurrence group had significantly older age,longer time from onset to admission,longer duration of severe pneumonia,higher acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) scores,D-dimer,blood lactate,serum procalcitonin(PCT),and interleukin-6(IL-6) than the non-occurrence group (P<0.05).Age,time from onset to admission,APACHE Ⅱ score,D-dimer,blood lactate,serum PCT,IL-6 levels were independent risk factors for the occurrence of coagulation dysfunction(P<0.05).Logit(P)=-5.224+0.239×age+0.313×APACHE Ⅱ score+0.138×time from onset to admission+

0.300×PCT+0.192×blood lactate+0.330×IL-6+0.233×D-Dimer.The area under the curve(AUC) of the Logistic regression prediction model for the occurrence of coagulation dysfunction was 0.924 (95%CI:0.861~0.965),with a sensitivity of 84.62% and a specificity of 90.00%.The Hosmer-Lemeshow test obtained the value χ2=7.556 ,P=0.092.The internal validation method revealed a mean absolute error(MAE) of 0.012 and a mean squared error(MSE) of 0.000 15.The Bootstrap test indicated a C-index of 0.585(95%CI:0.485~0.633).Conclusion   Age,time from onset to admission,APACHE Ⅱ score,D-dimer,blood lactate,serum PCT,IL-6 levels are independent risk factors for the occurrence of coagulation dysfunction in elderly patients with severe pneumonia accompanied by sepsis.A Logistic regression prediction model constructed based on these risk factors has good predictive value for the occurrence of coagulation dysfunction and is helpful in guiding the development of individualized treatment plans in clinical practice to reduce the occurrence of coagulation dysfunction.

Objective   To investigate the association between the triglyceride glucose-body mass index (TyG-BMI) and the risk of non-alcoholic fatty liver disease(NAFLD) among military aircrews.Methods   A retrospective analysis was conducted among 1 430 aircrew personnel who underwent health examinations at a sanatorium from January 2022 to December 2024.NAFLD was diagnosed using high-resolution color Doppler ultrasound,and the overall detection rate was calculated.Participants were stratified into quartiles(Q1-Q4) based on TyG-BMI values.Metabolic parameters were compared between NAFLD and non-NAFLD groups,and multivariate logistic regression analysis was performed to identify independent risk factors.The predictive value of metabolic indicators was evaluated using receiver operating characteristic(ROC) curve analysis.Results   The overall NAFLD detection rate was 21.12% (302/1 430),and its prevalence significantly increased with advancing age (trend test,P<0.001).Individuals in the NAFLD group exhibited significantly higher levels of fasting plasma glucose(FPG),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),uric acid(UA),and body mass index(BMI) compared to the non-NAFLD group (all P<0.001).Multivariate analysis identified that UA (OR=1.003,95% CI:1.001~1.005),TC (OR=1.494,95%CI: 1.224~1.823),and TyG-BMI (OR=1.045,95%CI:1.036~1.054) were independent risk factors for NAFLD,while high-density lipoprotein cholesterol(HDL-C) showed a protective effect(OR=0.459,95%CI:0.256~0.823).ROC curve analysis revealed that TyG-BMI had the highest predictive value(AUC=0.821,95% CI: 0.791~0.851),with an optimal cutoff value of 211.11(sensitivity=79.0%,specificity=71.0%).Conclusion   NAFLD prevalence is notably high among military aircrews and positively correlates with age.TyG-BMI,by integrating parameters of glucose-lipid metabolism and body composition,serves as a superior screening indicator for NAFLD in aviation medicine.We recommend a TyG-BMI threshold-based stratified management strategy to enhance metabolic health surveillance systems for this occupational population.

Objective   To understand the difference in the cognition of gout diagnosis and treatment between doctors in a sanatorium and a tertiary hospital in Tengchong City,and its influencing factors.Methods   From August to November 2024,personal information of general practitioners and internal medicine doctors was collected from one military sanatorium and two tertiary grade A hospitals in Tengchong City.A questionnaire survey was conducted on the awareness of gout among the respondents,and the data were analyzed.Chi-square test was used to analyze the differences in the awareness of gout diagnostic criteria among doctors from the two types of medical institutions and the influencing factors.Results   The education level(χ2=26.83,P<0.01) and professional title(χ2=8.185,P<0.01) of doctors in Tengchong military sanatorium were significantly lower than those in the tertiary hospitals.The average cases of hyperuricemia(χ2=18.884,P<0.01) and gout(χ2=14.149,P<0.01) admitted by doctors in military sanatorium were significantly lower than those in the tertiary hospitals.The overall awareness rate of gout diagnosis and treatment was generally low(χ2=14.913,P<0.05),especially the choice of treatment and medication for acute gout was not ideal.Conclusion   Doctors in Tengchong City have a certain blind spot in the diagnosis and treatment of gout.Notably,the military sanatorium doctors can not treat the acute stage of gout timely and correctly,and choose a reasonable comprehensive treatment plan.In order to improve the gout diagnosis and treatment ability of doctors in Tengchong City,we should not only pay attention to the academic qualifications of doctors,but also increase their practice opportunities in professional fields.

Objective   To detect the prevalence and influencing factors of hyperuricemia in seafarers at Chongqing Port,thus providing references for the formulation of targeted intervention measures.Methods   A cross-sectional study method was adopted,with 1 366 seafarers who underwent health examinations at Chongqing Port in 2024 as the research objects.Univariate and multivariate Logistic regression analyses were used to discuss the risk factors of hyperuricemia.Results   The total detection rate of hyperuricemia was 34.63%(473/1 366),which was significantly higher than that of the general population.The average body mass index(BMI) of male seafarers(24.13 kg/m2) exceeded the normal range,and the proportion of overweight/obese seafarers was 47.36%.The risk of hyperuricemia was significantly higher in the overweight group(OR=2.099,95%CI:1.591-2.769) and the obese group(OR=2.297,95%CI:1.507-3.500).The prevalence was negatively correlated with age(all P<0.05),and the prevalence of young seafarers(18-25 years old) was the highest(38.89%).Fatty liver(OR=1.437,P=0.023) and hypertension(OR=1.564,P=0.004) were independent risk factors.The risk of those with a preference for high-calorie foods increased marginally(OR=1.518,P=0.059),while the risk of those with long-term overwork decreased(OR=0.420,P=0.007).Conclusion   The prevalence of hyperuricemia among seafarers at Chongqing Port is high,which is closely related to youth,overweight/obesity,metabolic diseases and poor diet.It is recommended that multiple departments cooperate to reduce the risk of disease,ensure the health of seafarers and promote the sustainable development of the shipping industry.