Objective   To compare the efficacy of percutaneous poking reduction and fixation with open reduction by internal fixation for Sanders type Ⅲ calcaneal fractures.Methods   A total of 90 patients with Sanders type Ⅲcalcaneal fractures treated in the Xinyu People's Hospital from April 2020 to April 2024 were prospectively selected.Patients were randomly assigned to control group (open reduction internal fixation) and study group (percutaneous poking reduction and fixation),with 45 cases per group.They were postoperatively followed up for 1 year.Postoperative excellent-good rate,Bohler's angle,Gissane's angle,surgical metrics,and complications were compared.Results   Postoperative excellent-good rates(88.89% VS 86.67%),and preoperative and postoperative Bohler's angle and Gissane's angle were comparable between groups (all P>0.05).Postoperative Bohler's and Gissane's angles were significantly elevated in both groups compared to preoperative values.The study group demonstrated significantly shorter operative time,less intraoperative bleeding,smaller incisions,and shorter hospitalization than the control group,along with a lower complication rate (4.44% VS 20.00%) (all P<0.05).Conclusion   Both techniques achieve favorable outcomes and functional recovery,while percutaneous poking reduction and fixation demonstrates superior surgical metrics,fewer complications,and enhanced patient recovery potential.

Objective   To explore the clinical efficacy of Sancao Lidan Decoction in treating cholecystitis of liver-gallbladder damp-heat type.Methods   A total of 82 patients with cholecystitis of liver-gallbladder damp-heat type treated in the Dancheng County Hospital of TCM from May 2023 to May 2024 were selected as the research objects.They were divided into the study group(n=41,receiving basic treatment plus Sancao Lidan Decoction) and control group(n=41,receiving basic treatment) according to different treatment methods.The treatment effects and adverse events of the two groups were compared.The traditional Chinese medicine(TCM) syndrome scores,imaging indicators,and serum indicators (total bile acid[TBA],aspartate aminotransferase[AST],gallbladder contractile function,gallbladder wall thickness) before and after treatment,and inflammatory indicators (tumor necrosis factor-α[TNF-α],interleukin-8 [IL-8],interleukin-6[IL-6]) were compared.Results   After 6 weeks of treatment,the total effective rate in the study group was significantly higher than that in the control group (92.68% VS 63.41%,P<0.05).After 6 weeks of treatment,the scores for TCM symptoms,such as bitter taste in the mouth,dry mouth,right flank pain,abdominal distension,and heavy body feeling and fatigue were significantly lower in the study group than the control group(P<0.05).After 6 weeks of treatment,the levels of TBA,gallbladder wall thickness,and AST in the study group were significantly lower than those in the control group,while the gallbladder contraction function was highe(P<0.05).After 6 weeks of treatment,the levels of serum TNF-α,IL-8,and IL-6 in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between the study group and the control group (9.76% VS 4.88%,P>0.05).Conclusion   For patients with cholecystitis of liver-gallbladder damp-heat type,Sancao Lidan Decoction can improve treatment efficacy and imaging indicators,reduce inflammatory response,and promote rapid recovery.

Objective   Based on the mechanisms of Qi and Jin injuries,this study investigated the clinical efficacy of traditional Chinese medicine Shengmai Decoctionin treating gout induced by exercise fatigue.Methods   A total of 132 gout patients induced by exercise fatigue from April 2020 to December 2024 were selected and randomly divided into the control group(65 cases) and study group(67 cases) using the envelope method.Patients in both groups were treated with colchicine and meloxicam,and those in the study group were additionally given oral Shengmai Decoction.The total effective rate,pain severity score,pain duration,fatigue score,and changes in blood uric acid and creatine kinase levels were compared between groups.Results   After treatment,the total effective rate of the study group was significantly higher than that of the control group,and the duration of pain was significantly shorter than that of the control group ([48.95±8.74]h VS [56.32±9.05]h,P<0.05).The scores of pain degree ([1.65±0.61]points VS [2.38±0.76]points) and fatigue degree ([25.45±10.83]points VS [35.69±11.02]points) were significantly lower in the study group than the control group(P<0.05).Blood uric acid ([365.83±64.25]μmmoL/L VS [423.75±69.38]μmmoL/L) and creatine kinase ([172.41±44.63]U/L VS [285.36±59.45]U/L) were significantly lower in the study group than the control group (P<0.05).Conclusion   Qi and Jin injuries are the early pathogenesis of gout attacks after exercise fatigue,and traditional Chinese medicine Shengmai Decoction has shown good clinical efficacy in treating them.

Objective   To analyze the comprehensive rehabilitation effect of Dandong Wulongbei Hot Spring combined with Tai-Chi therapy on hypertension patients.Methods   A total of 254 hypertension patients who participated in the rehabilitation in Wulongbei Sanatorium Area of Dalian Rehabilitation and Sanatorium Center from April 2022 to April 2024 were selected.They were randomly divided into the control group and experimental group using a random number table method,with 127 cases in each group.Patients in both groups were medicated with oral amlodipine tablets,while those in the experimental group were additionally treated with hot spring combined with Tai-Chi therapy.Blood pressure levels,anxiety scores,body mass index(BMI),and sleep latency,sleep duration,subjective sleep quality and use of sleeping medication in the Pittsburgh sleep quality index(PSQI) after 3 months of treatment were compared between groups.Results   There was no significant difference in the pre-treatment blood pressure between groups(P>0.05).After three months of intervention,the systolic blood pressure ([125.61±7.14]mmHg VS [137.65±5.32]mmHg,1 mmHg=0.133 kPa) and diastolic blood pressure ([75.30±4.10]mmHg VS [83.80±3.40]mmHg) in the experimental group were significantly lower than the control group(P<0.05).The self-rating anxiety scale (SAS) score was significantly lower in the experimental group than the control group ([32.19±4.72]points VS [39.29±5.45]points, P<0.05).After interventions,the sleep duration score in the control group was significantly lower than the pre-treatment value ([2.23±0.69]points  VS  [2.72±0.34]points,P<0.05).In the experimental group,post-treatment scores of sleep latency ([1.68±0.19]points VS [2.71±0.46]points),sleep duration ([1.78±0.43]points VS [2.67±0.85]points) and sleep quality ([1.56±0.72]points VS [2.52±0.26]points) were significantly decreased(P<0.05).Post-treatment scores of sleep latency and sleep quality were elevated in the control group,although no significant differences were detected.Post-treatment outcomes were more reduced in the experimental group than the control group(P<0.05).Pre-treatment BMI was comparable between groups(P>0.05),and it was reduced in both groups after treatment,but no significant difference was detected between groups(P>0.05).Dosages of sleep medications after treatment were significantly lower in the experimental group than the control group([4.08±1.43]mg VS [5.35±1.74]mg,P<0.05).Conclusion   Dandong Wulongbei Hot Spring combined with Tai-Chi therapy shows pronounced outcome of comprehensive rehabilitation of hypertension.

Objective   To explore the application value of suspension techniques combined with functional training in the rehabilitation of staff for special services with knee joint injuries.Methods   A total of 110 patients with knee joint injuries treated from December 2023 to December 2024 were selected.They were randomly divided into two groups, each consisting of 55 patients.Patients in the control group received routine care,while those in the observation group underwent suspension techniques combined with functional training.Knee function, pain level and quality of life before and after treatment were compared between groups.Results   Before interventions,there were no significant differences in the scores of pain, function,range of motion,muscle strength, flexion deformation,and stability between the two groups(all P>0.05).After interventions,the HSS scores of the observation group were higher than those of the control group, and the differences were statistically significant(P<0.05).Before interventions,there was no difference in the numerical rating scale(NRS) scores between the two groups(P>0.05).NRS score after interventions was significantly lower in the observation group than the control group([2.11±0.24]points VS [4.08±0.23]points, P<0.001).The score of quality of life before interventions was comparable between group(P=0.104), which, after interventions, was significantly higher in the observation group than the control group(t=68.773,P<0.001).Conclusion   The combination of suspension techniques and functional training is effective in treating knee joint injuries.It not only significantly improves knee joint function but also helps to alleviate pain and enhance quality of life,making it a recommended approach.

Objective   To explore the impact of gut microbiota imbalance on the prognosis of decompensated liver cirrhosis.Methods   A total of 100 patients with decompensated liver cirrhosis in the Third People's Hospital of Zhengzhou from June 2021 to June 2024 were selected as the study group.Routine treatment was given to all patients upon admission,and the abundances of gut microbiota(Bifidobacterium,Lactobacillus,Escherichia coli,Enterococcus) were measured before treatment.Additionally,100 patients with liver cirrhosis compensation and 100 healthy individuals who underwent physical examinations during the same period were included as control group 1 and control group 2,respectively.The gut microbiota of the three groups was compared.After 6 months of follow-up,patients were divided into the good prognosis group and poor prognosis group based on their survival status.Baseline data and gut microbiota counts were compared between the two groups,and Cox regression analysis was used to determine the relationship between gut microbiota and the prognosis of decompensated liver cirrhosis.The receiver operating characteristic(ROC) curve was drawn,analyzing the value of gut microbiota imbalance in predicting the prognosis of decompensated liver cirrhosis.Results   The abundances of Bifidobacterium and Lactobacillus in the study group were significantly lower than the control group 1,and those in the control group 1 were significantly lower than the control group 2.The abundances of Escherichia coli and Enterococcus in the study group were significantly higher than the control group 1,and those in the control group 1 were significantly higher than the control group 2(P<0.05).During the 6-month follow-up period,14 out of 100 patients in the study group died,accounting for 14.00% (14/100).The Child-Pugh grading,model of end-stage liver disease(MELD) score,and proportion of combined malnutrition in the poor prognosis group were significantly different from those in the good prognosis group(P<0.05).The abundances of Bifidobacterium and Lactobacillus in the good prognosis group were significantly higher than the poor prognosis group,while the abundances of Escherichia coli and Enterococcus were significantly lower than the poor prognosis group(P<0.05).According to Cox regression analysis,Child-Pugh grading,MELD score,combined malnutrition,Bifidobacterium,Lactobacillus,Escherichia coli,and Enterococcus were significantly correlated with the prognosis of decompensated cirrhosis(P<0.05).ROC curveshowed that the area under the curve(AUC) of abundances of Bifidobacterium,Lactobacillus,Escherichia coli,and Enterococcus in predicting the prognosis of decompensated liver cirrhosis alone or in combination was all greater than 0.7,which had certain predictive value,and the combined predictive value was higher.Conclusion  Patients with decompensated liver cirrhosis have a higher probability of experiencing gut microbiota imbalance,and gut microbiota imbalance can increase the risk of poor prognosis in patients with decompensated cirrhosis,and can predict patient prognosis to some extent.

Objective   To investigate the effect of one-piece ultrasonic concentric puncture in percutaneous nephrolithotomy(PCNL).Methods   A total of 120 patients with upper urinary tract stones who received PCNL in Fuzhou Dongxiang District People's Hospital from January 2024 to March 2025 were selected.They were randomly divided into two groups with 60 cases in each group according to random number table method.Non-concentric puncture was performed in the control group,and one-piece ultrasound concentric puncture was performed in the study group.The perioperative indexes,hemostasis under blood transfusion and intervention,puncture accuracy,puncture time and postoperative complications were compared between the two groups.Results   The operation time ([27.44±4.36]min VS [37.25±4.51]min) and the total hospital stay ([4.03±1.06]d VS [5.12±1.12]d) of the study group were both significantly shorter than those of the control group(P<0.05).Postoperative blood loss within 24 h ([9.55±2.12]g/L VS [13.35±2.62]g/L) and intraoperative blood loss ([9.55±1.65]mL VS [16.25±2.35]mL) were significantly less in the study group than those of the control group(P<0.05).Blood transfusion treatment and hemostasis under intervention were not reported in the study group,showing no significant differences than the control group (3.33% and 1.67%,respectively),P>0.05.The one-time puncture success rate (90.00% VS 75.00%) and the total puncture success rate (100% VS 90.00%) of the study group were significantly higher than those of the control group(P<0.05).Significantly shorter duration of puncture ([4.81±0.66]min VS [6.25±1.21]min) and lower incidence of postoperative complications (5.00% VS 16.67%) were detected in the study group than the control group(P<0.05).Conclusion   One-piece ultrasound concentric puncture during PCNL operation can reduce blood loss,improve puncture accuracy,shorten puncture time,reduce the incidence of postoperative complications and promote rehabilitation.

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.

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.

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.

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.

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.

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.

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.

Objective   To investigate the status quo of psychological distress and social support in elderly inpatients with chronic obstructive pulmonary disease(COPD),and to analyze the correlation between the two,so as to provide reference for clinical intervention.Methods   In March 2023,306 elderly patients with COPD were randomly selected by convenient sampling method from 5 Level Ⅲ Grade A general hospitals in the southeast and northwest of Chengdu City.General data questionnaire,the distress thermometer(DT) and problem list(PL),and the social support rating scale(SSRS) were used to investigate the included subjects.The scores of psychological distress and social support in elderly patients with COPD carrying different characteristics were compared,and the influencing factors of psychological distress in elderly patients with COPD were analyzed by multiple linear regression.Results   A total of 306 valid questionnaires were collected from 340 questionnaires,with an effective rate of 90%.The psychological distress score of the elderly patients with COPD was (5.15±2.16)points,and the incidence of DT≥4 score was 78.76%.The social support score was (35.65±7.18)points.Psychological distress was negatively correlated with social support (r=-0.922,P<0.01).The results of multiple linear regression analysis showed that educational level,number of chronic diseases,course of disease,severity of COPD and social support were the main influencing factors of psychological distress in the elderly patients with COPD.Conclusion   Elderly patients with COPD have moderate level of psychological distress and high incidence,and social support can effectively alleviate their psychological distress.Clinical medical staff should attach great importance to the mental health status of elderly COPD inpatients with low educational level,multiple chronic diseases,long course of disease and serious illness,and actively play the effect of social support to improve their clinical rehabilitation.

Objective   To explore the research hotspots and frontiers in the field of nutrition for renal failure in recent 10 years,and to provide references for future research.Methods   Relevant research core literatures published from January 2015 to January 2025 were searched in the China National Knowledge Infrastructure(CNKI) and Web of Science.Included articles were subjected to visual analysis using the CiteSpace 5.8.Results   A total of 740 articles were included.The number of published papers in the field of nutrition for renal failure has maintained a stable and slightly upward trend in the past 10 years.The United Kingdom,France and the United States ranked the largest number of published papers in the field of nutrition for renal failure,with the highest importance and central position.In the field of nutrition for renal failure in the past 10 years,the research hotspots have focused on the mortality rate，nutritional status and risk factors of patients with renal failure.The research frontiers consisted of risk factors,mechanisms,complications,and traditional Chinese and Western medical treatments of malnutrition in patients with renal failure.Conclusion   The field of nutrition for renal failure is in a stage of rapid development.China should further increase research efforts,expand cooperation areas,and focus on the relevant research hotspots and frontiers in the field of nutrition for renal failure,thus promoting the development of nutrition research for patients with renal failure in China.

Objective  To develop a scale of the perception of the risk of stroke in high-risk people of stroke,and to verify its reliability and validity.Methods  Based on the psychometric paradigm as the theoretical basis,the perception of the risk of stroke scale was constructed by literature review,qualitative interviews and expert correspondence.The reliability and validity were tested on 281 cases of high-risk stroke patients.Results   The scale consisted of 27 items in 3 dimensions,and the cumulative variance contribution rate of exploratory factor analysis was 66.292%.The content validity index,Cronbach's alpha coefficient,folded half reliability and 2-week re-test reliability of the scale were 0.969,0.924,0.722,and 0.790,respectively.Conclusion  The perception of the risk of stroke scale is of good reliability,and it can be used to assess the perceived risk of community stroke in high-risk people.

Objective   To thoroughly analyze the hotspots and cutting-edge trends of palliative care in cancer research at home and abroad, thus providing valuable references in domestic research, promoting the development of palliative care in China,and offering better nursing care to cancer patients and their family members.Methods    Relevant literatures were searched from the Web of Science Core Collection and CNKI, and analyzed using CiteSpace for information mining.Results   A total of 2 086 English-language articles and 817 Chinese-language articles were included. The research hotspots and frontiers focused on pain management, psychological care, advance care planning, shared decision-making, and quality assessment of palliative care for cancer patients.Conclusion   The number of studies on palliative care in the field of cancer treatment shows a gradually increasing trend, especially in China, where the current level of research is still in its infancy but has already attracted widespread attention and emphasis. To further promote the development of palliative care for cancer patients in our country, we can draw on advanced experiences and research findings in this field from abroad, combine them with the actual situation in China, and explore and develop a set of palliative care models suitable for our national conditions.

Objective   To investigate the effects of scalp-neck acupuncture combined with swallowing rehabilitation training on swallowing function in stroke convalescent patients with pseudobulbar palsy,with a particular focus on improvements in pharyngeal secretion retention，vallecula/piriform sinus residue,penetration-aspiration,and Kubota Water Swallow Test(KWST) grading.Methods   A randomized single-blind controlled trial was conducted.Eighty patients with dysphagia due to pseudobulbar palsy in the stroke recovery phase，admitted to Guangzhou Panyu Rehabilitation Hospital from October 2022 to June 2024,were randomized into the combined group and control group(40 cases each) using a computer-generated random number table.After excluding one case from the combined group,there were finally 39 cases in the combined group,and 40 cases in the control group.Conventional treatment of stroke and swallowing rehabilitation training were applied to all patients.Patients in the combined group were additionally treated with scalp-needling therapy on the acupoints of the Temporal Three Needles,Brain Three Needles,Fengchi(GB20),Yifeng(TE17),and Wangu(GB12) for 3 weeks.A fiberoptic endoscopic evaluation of swallowing(FEES) test was used to assess pharyngeal secretion retention(Murray secretion scale),food residue in the pyriform sinus/epiglottic vallecula(Yale scale),and penetration-aspiration function(Penetration-aspiration scale,PAS) before and after treatment.The KWST was also employed to evaluate swallowing function.Results   After treatment,significant improvements in the Murray grading(pharyngeal retention),Yale grading(piriform sinus/vallecula residue),PAS grading(penetration-aspiration),and KWST scores compared to baseline were seen in both groups(P<0.05).Intergroup comparisons revealed that the combined group exhibited significantly greater improvements in all outcome measures than the control group(P<0.05).Conclusion   Scalp-neck acupuncture combined with swallowing rehabilitation effectively reduces pharyngeal secretion retention,piriform sinus/vallecula food residue,and penetration-aspiration function in stroke patients with pseudobulbar palsy during recovery.It demonstrates superior efficacy in improving swallowing function compared to the monotherapy of swallowing rehabilitation.

Objective   To explore the combined application effect of acupotomy and Jingshu granules in cervical spondylotic radiculopathy.Methods   According to a random number table,60 patients with cervical spondylotic radiculopathy admitted to Xiangcheng Hospital of Traditional Chinese Medicine of Zhangzhou City from June 2020 to June 2023 were divided into two groups: 30 patients in the control group were treated with oral Jingshu granules,and 30 patients in the observation group were treated with oral Jingshu granules combined with acupotomy.The TCM syndrome scores,pain degree,cervical physiological curvature,cervical functional status and sleep quality of the two groups were compared.Results   After 3 weeks of treatment,the TCM syndrome scores and the scores of each dimension of the Pittsburgh Sleep Quality Index in both groups were lower than those before treatment,and the scores in the observation group were even lower(P<0.05).After 3 weeks of treatment,the cervical physiological curvature and the score of the cervical spondylosis clinical evaluation scale in the observation group were(18.91±3.34)mm and (88.65±11.16)points respectively,which were both higher than those in the control group ([15.35±3.21]mm and [80.76±12.32]points),and the difference was statistically significant([t=-4.209,2.600],P<0.05).The score of the Short-form McGill pain scale was (9.21±2.81)points,which was lower than that of the control group (12.65±3.67)points,and the difference was statistically significant(t=4.076,P<0.05).Conclusion   Based on Jingshu granules,the use of acupotomy can further improve the TCM syndrome of patients with cervical spondylotic radiculopathy,significantly reduce pain,improve the physiological curvature of the cervical vertebrae and enhance sleep quality.

Insomnia is a common clinical problem with a strong tendency towards recurrence and chronic persistence,which seriously damages the physical and mental health of patients and leads to mental and physical illnesses.Clinical interventions such as drug therapy,physical therapy,and psychological therapy used to be conventional treatment approaches of insomnia.However,the overall effect is not ideal,and long-term medication can easily cause varying degrees of adverse reactions and even drug resistance.Traditional Chinese medicine(TCM) therapy in China has a long history and a wide range of clinical applications,reflecting good application advantages.Acupuncture is a common type of TCM external treatment that is widely used in clinical practice because of the simple operation,safety and reliability.It can effectively treat insomnia,with an acceptable curative effect.Through sorting out and analyzing the relevant literatures,this review briefly explored the understanding of insomnia in TCM,described the TCM syndrome type of insomnia,and summarized research progress in acupuncture treatment of insomnia,thus illustrating the scientific basis for acupuncture in treating insomnia,and providing practical treatment methods for clinical treatment of insomnia.

Objective   To explore the mediating effect of self-perceived aging on social isolation and cognitive function among older people in the community.Methods   A questionnaire survey was conducted among 527 elderly people in Chengdu from January to June 2024.SPSS 25.0 and Process were used for statistical analysis.Results   The scores of social isolation,self-perceived aging and cognition were (13.14±4.306)points,(47.21±8.107)points and (25.06±3.587)points,respectively.Self-perceived aging was negatively correlated with social isolation (r=-0.659,P<0.01) and cognitive function(r=-0.541,P<0.01).Social isolation was positively correlated with cognitive function(r=0.600,P<0.01).In the causal path from social isolation to self-perceived aging and cognition,the total effect was 0.581,with a direct effect of 0.359,and an intermediate effect of 0.222,accounting for 38% of the total effect. Conclusion   Social isolation and self-perceived aging have significant effects on cognitive function among older adults in the community,and self-perceived aging plays a partial mediating role between social isolation and cognitive function.

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 explore the research hotspots and trends of health examination literature in China in the past 10 years,and to provide references for future research.Methods   The relevant studies on health examinations from the databases of China National Knowledge Infrastructure(CNKI),Wanfang Data knowledge service platform and VIP journal official website were systematically retrieved,and the literatures were analyzed by Citespace 6.4R1 software.Results   A total of 24 311 Chinese literatures were included in this study.The annual publication volume generally showed a trend of being stable at first and then declining from 2014 to 2024.There is a certain degree of cooperation among the authors,but the degree of institutional dispersion is relatively high.The research hotspots mainly focus on blood glucose,blood pressure,blood lipid,the elderly,health education,health status and nursing intervention.Psychological state,blood glucose control,high-risk population,influencing factors,regular follow-up,etc.are the research hotspots and development trends in the field of health examinations.Conclusion   The content of domestic scientific research articles on health examinations is relatively extensive,and the cooperation among authors needs to be further strengthened.Research related to psychological state,blood glucose control,etc.is a cutting-edge direction in the field of health examinations,providing important references for building a prevention and treatment system for the health of the entire population.

Patellar tendinopathy(PT),as a chronic knee disorder prevalent among jumping athletes,is characterized by pain at the inferior patellar pole,restricted athletic performance， prolonged duration,and high recurrence rates.It severely affects the quality of life.Overload-repair imbalance caused by chronic tendon overloading is the core pathogenesis of PT，leading to collagen disorganization and degenerative changes.This study systematically analyzed the anatomical,biomechanical,and pathophysiological mechanisms of PT.The findings revealed that the proximal patellar tendon is structurally more vulnerable to injuries.Biomechanical abnormalities (ankle inversion,hip muscle weakness) significantly increase tendon stress.Imaging features of PT include tendon thickening,hypoechoic areas,and calcification.Pathological stages encompass reactive tendinopathy,failed healing,and degenerative tendinopathy.Based on these insights,a staged-combined rehabilitation strategy based on the stratification of pain degree is proposed as follows.In the acute phase(marked by severe pain),pain relief and load management are prioritized through isometric training combined with low-intensity shock wave therapy to suppress inflammation.In the chronic phase (characterized by structural degeneration),medium-to-high-intensity shock wave therapy and eccentric training are employed to promote collagen synthesis,integrated with progressive loading exercises to enhance tendon function.Concurrently,comprehensive lower-limb biomechanical adjustments(targeting the ankle,knee,and hip joints) are emphasized to reduce tendon stress at its source.This strategy demonstrates advantages in symptom alleviation,functional restoration,and recurrence prevention.However,future studies are required to validate its long-term efficacy and explore precision staging and individualized treatment approaches,ultimately advancing PT management from symptomatic control to full functional recovery.

Objective   Clinical literatures related to transcutaneous electrical acupoint stimulation(TEAS) at home and abroad in the past five years were collected.Bibliometric methods were adopted to study the progress of TEAS,aiming to provide a theoretical basis for the clinical application and development of TEAS.Methods   The clinical research literatures related to TEAS were retrieved through computer in CNKI,VIP Database,WANFANG DATA,PubMed,Embase and Cochrane library.The first author,the publishing institution and the literature publication journal were analyzed.Meanwhile,the applicable diseases of TEAS were classified according to the ICD-11 system classification.The indications and dominant diseases of TEAS were analyzed and summarized.Results   This study ultimately selected 751 literatures for analysis,among which there were as many as 171 types of diseases,covering a wide range of 19 disease systems.Domestic research on the clinical treatment of TEAS is relatively abundant,but research in related fields abroad is relatively lacking.Conclusion   TEAS has been widely applied in post-surgical operations,stroke and its sequelae,etc.,and has outstanding advantages in treating advantageous diseases.

Abstract: After the reform and transformation, the fire rescue team assumes the important responsibility of preventing and resolving major safety risks and dealing with various disasters and accidents. The author as a medical professional background of fire rescue personnel, combined with the status quo of the current medical aid for fire rescue team, the contrast analysis of the fire department at home and abroad to undertake the task of emergency medical situation, to the responsibility of the national comprehensive fire rescue team tasks, aims at providing a fire rescue team construction and development of medical and rescue work to provide a train of thought.

Objective   To investigate the mechanism by which Yiguanjian Decoction regulates the hippocampal adenylate-activated protein kinase(AMPK)/cAMP response element binding protein(CREB)/brain-derived neurotrophic factor(BDNF) pathway to treat type 2 diabetes mellitus(T2DM) combined with comorbid depression.Methods   Forty male Sprague-Dawley(SD) rats in the specific pathogen-free(SPF) level were randomized into the control,model,Yiguanjian Decoction,and positive drug groups(n =10/group).An in vivo T2DM rat model was created by high-fat diets for 4 weeks combined with a single intraperitoneal injection of Streptozotocin,while depression was induced via chronic unpredictable mild stress(CUMS).Depressive behaviors were assessed using forced swimming test(FST) and open field test(OFT).Random blood glucose was measured via tail vein sampling.Hippocampal histopathology was examined by hematoxylin-eosin staining(H&E).Serological 5-hydroxytryptamine(5-HT) and dopamine(DA) levels were quantified via the enzyme-linked immunosorbent assay(ELISA).Protein levels of p-AMPK,p-CREB,and BDNF were analyzed by Western blotting(WB).Results   Compared to the control group,rats in the model group exhibited decreased immobility time in the FST,decreased total distance traveled and rearing frequency in the OFT,and reduced 5-HT,DA,p-AMPK,p-CREB,and BDNF levels(P<0.01).Both Yiguanjian Decoction and positive drug treatment reversed these behavioral deficits,lowered random blood glucose,and elevated neurotransmitter/pathway protein expressions versus the model group(P<0.01 or P<0.05).Conclusion   Yiguanjian Decoction ameliorates depression-like behaviors in T2DM combined with depression via activating the hippocampal AMPK/CREB/BDNF signaling pathway.

Objective   To study the effect of Snyder Hope theory combined with Five-element Music therapy on patients with coronary heart disease.Methods   The subjects of this study were all patients with CHD admitted to Luoyang Hospital of Dongzhimen Hospital,Beijing University of Chinese Medicine.The inclusion period was from December 2023 to May 2024.According to different intervention plans,they were divided into the control group(n=60 cases,receiving the intervention of Snyder Hope theory) and the study group(n=60 cases,receiving the intervention of Snyder Hope theory combined with the Five-element Music therapy).The psychological state,physical symptoms,self-harmony,quality of life and satisfaction of the two groups were evaluated.Results   The scores of the Patient Health Questionnaire-9(PHQ-9),Generalized Anxiety Disorder-7(GAD-7),and Somatic Self-rating Scale(SSS) Scale in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The score of the self-flexibility dimension of the Self Consistency and Congruence Scale(SCCS) in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).The scores of the self-rigidity and self-disharmony with experience dimensions in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The score of the Chinese Questionnaire of Quality of Life in patients with cardiovascular diseases(CQQC)in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).The satisfaction rate of the study group was 96.67%(58/60),which was higher than that of the control group 78.33%(47/60),and the difference was statistically significant(P<0.05).Conclusion   Patients with CHD who receive Snyder Hope theory combined with the Five-element Music therapy can effectively improve their psychological state and somatization symptoms,promote self-harmony,and enhance the quality of life.

Objective   To analyze the outcome of continuous care based on the Siebens domain management model in patients with diabetic retinopathy after surgery.Methods   A total of 120 patients with diabetic retinopathy admitted in the 910th Hospital from August 2021 to July 2024 were retrospectively analyzed,including 60 patients in the control group and 60 in the study group based on the postoperative nursing mode.Patients in the control group received routine continuity care,while those in the study group received continuity care based on the Siebens domain management.Blood glucose levels,visual function,and quality of life were compared.Results   After the intervention,the fasting blood glucose (6.20±0.52)mmol/L VS (6.41±0.34)mmol/L,glycated hemoglobin (5.78±0.62)mmol/L VS (6.11±0.69)mmol/L,and visual function score (0.29±0.09)points VS (0.32±0.07)points were significantly lower in the study group than the control group,while the score of quality of life was significantly higher (84.72±1.24)points VS (80.29±1.06)points(P<0.05).Conclusion   Both of two continuous nursing models can exert certain effects in improving patients' blood glucose levels and quality of life.The continuous nursing care based on the Siebens domain management model can exert significant effect,showing a better control of visual function.

Noise-induced tinnitus is damage to the inner ear or central auditory system caused by long-term exposure to a noisy environment,especially common among military personnel.Clinically,it is characterized by persistent or intermittent tinnitus,often accompanied by hearing loss,anxiety and sleep disorders.In recent years,the combined therapy of traditional Chinese medicine has gradually become a research hotspot.The combined application of Baduanjin(traditional Qigong) and auricular point press acupuncture (continuous stimulation therapy of auricular points) has shown unique potential in the treatment of noise-induced tinnitus,but its research is still in the exploratory stage.The practice of Baduanjin helps regulate the qi and blood of the internal organs and improve the physical and mental state,which may have a positive impact on noise-induced tinnitus.Its movement design combines respiratory regulation and limb stretching,which can promote blood circulation throughout the body,relieve excessive excitation of the sympathetic nerve,and thereby improve microcirculation disorders in the inner ear.Auricular acupoint press acupuncture continuously stimulate acupoints in the ear(such as the Shenmen acupoint,subcortical,inner ear,etc.) to regulate the levels of neurotransmitters(such as 5-hydroxytryptamine[5-HT] gamma-aminobutyric acid[GABA]),inhibit abnormal neural signal conduction,and exert anti-inflammatory effects,thereby alleviating the pathological conditions of the cochlea and central auditory pathways.The combined application of Baduanjin and auricular point press needles provides a new non-pharmaceutical intervention idea for noise-induced tinnitus,featuring high safety and few side effects.Although most of the existing research focuses on single therapies,based on the theoretical foundations of "holistic view" and "syndrome differentiation and treatment" in traditional Chinese medicine,combined therapies have broad prospects in improving tinnitus symptoms and regulating physical and mental states,which urgently need to be further verified by high-quality clinical research.

Knee osteoarthritis is one of the common chronic diseases among the elderly， characterized by degenerative changes in articular cartilage and osteophyte formation.It may accompany pain,stiffness,limited mobility and other symptoms.Knee osteoarthritis seriously affects walking and balance functions,and significantly reduces the quality of life of patients.Aquatic exercise therapy,as a special treatment method,can alleviate pain,reduce swelling,enhance muscle strength and improve walking function by exercising in water and taking advantage of the special properties of water like buoyancy,viscosity,temperature and pressure.Thus,it can improve the emotional state,sleep quality and quality of life of patients with knee osteoarthritis.With the improvement of medical techniques,the combined application of many rehabilitation regimens and aquatic exercise therapy can greatly enhance the treatment outcome of knee osteoarthritis.This article summarized the mechanism of action of aquatic exercise therapy,the latest treatment results of aquatic exercise therapy and its combination with other treatment methods for knee osteoarthritis,providing new ideas and guidance for the rehabilitation treatment plan of this disease.

Objective   To systematically evaluate the incidence rate of comprehensive fatigue among Chinese military officers and soldiers and explore its development trend.Methods   The Chinese databases were retrieved,the Excel was used to manage and screen the literature,and the quality was evaluated according to the cross-sectional study evaluation criteria of the US Agency for Healthcare Research and Quality(AHRQ).The evaluation was independently conducted by two researchers.The StataMP 18.0 software was adopted for the analysis.Results   After analyzing 26 studies involving 21 955 military officers and soldiers,there were 7,008 cases of fatigue.The the overall incidence rate by random effects models weighted aggregation was 29.8%(95%CI:25.7%-34.5%),and it showed a fluctuating upward trend from 2011 to 2025.The incidence rate among naval officers and soldiers was the highest.There were differences in the results of different assessment tools,and the meta-regression indicated that the work on ships had a significant positive effect on the effect size.Conclusion   The incidence rate of fatigue and chronic fatigue syndrome among our military officers and soldiers is high.The condition of the naval officers and soldiers is worrying.Fatigue is likely related to the mind.Most assessment tools are subjective evaluations.In the future,it is necessary to explore objective indicators and develop specific scales.

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.