To explore the feasibility of using indocyanine green(ICG) visualizing the deep infiltrating endometriosis (DIE) during robotic surgery.

A patient with DIE in Department of Genecology and Obstetrics, Chinese PLA General Hospital was selected and underwent total hysterectomy with bilateral adnexectomy and endometriosis lesion excision with perfect preoperative examination and no surgical contraindication. Near-infrared fluorescence imaging with indocyanine green was used in the operation to visualize the endometriosis lesions.

The location of the lesions were accurate and the patient discharged from hospital successfully.

Near-infrared fluorescence imaging system with indocyanine green may clearly visualize the deep infiltrating endometriosis during robotic surgery. It is characterized by brief operation, accuracy and real time. With this technique, we can comprehensively evaluate the scope of our surgery.

To investigate the predictive value of lung ultrasound combined with diaphragmatic ultrasound for extubation failure in patients with acute respiratory distress syndrome (ARDS).

A total of 126 ARDS patients admitted to our hospital from January 2022 to October 2025 were enrolled. Among them, 99 patients with successful extubation were assigned to the control group, and 27 patients with extubation failure were assigned to the observation group. Bedside ultrasonography was performed 4 hours after the completion of a spontaneous breathing trial. The lung ultrasound (LUS) score was calculated using the 12zone method, and diaphragmatic excursion and diaphragmatic thickening fraction were measured. Clinical data and ultrasound parameters were compared between the two groups. LASSO regression and multivariate logistic regression were used to analyze risk factors for extubation failure, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of each indicator.

Compared with the control group, the observation group had a higher median LUS score (15.00 vs. 9.00, P<0.001), and lower values of quiet breathing diaphragmatic excursion (QDE) (P=0.027), deep breathing diaphragmatic excursion (DDE) (P=0.006), quiet breathing diaphragmatic thickening fraction (QDTF) (P<0.001), and deep breathing diaphragmatic thickening fraction (DDTF) (P<0.001). Multivariate logistic regression analysis showed that sequential organ failure assessment (SOFA) score (OR=1.713), oxygenation index (OR=0.991), duration of mechanical ventilation (OR=1.078), LUS score (OR=1.686), and DDTF (OR=0.872) were independent risk factors for extubation failure in ARDS patients (all P<0.05). The area under the curve (AUC) of the combination of LUS score and DDTF for predicting extubation outcome was 0.923 (95%CI: 0.861~0.963), which was superior to that of LUS score alone [0.817 (95%CI: 0.732~0.876), P=0.003] or DDTF alone [0.812 (95%CI: 0.732~0.876), P=0.009]. ROC curve analysis of the combined model including SOFA score, oxygenation index, duration of mechanical ventilation, LUS score, and DDTF showed that the combined clinical and bedside ultrasound model achieved an AUC of 0.969 (95%CI: 0.921~0.991), with a sensitivity of 88.89% and a specificity of 93.94%. The HosmerLemeshow goodnessoffit test indicated good calibration (χ²=2.448, P=0.964). Clinical decision curve analysis showed that when the highrisk threshold ranged from 0.03 to 0.95, the combined prediction of extubation failure provided a high net clinical benefit.

Bedside multi-organ ultrasound monitoring can serve as an important assessment tool for extubation in patients with ARDS. By combining bedside lung ultrasound with diaphragmatic ultrasound, together with the patient′s clinical symptoms and signs, this approach can effectively guide the selection of extubation timing, help improve the extubation success rate, and is of clinical significance in ensuring that ARDS patients are extubated smoothly and safely.

To investigate the clinical significance of pulmonary CT imaging morphological features combined with coagulation function indicators in predicting the prognosis of patients with chest trauma.

A total of 104 patients with closed chest trauma admitted to our hospital from June 2020 to June 2025 were selected and divided into an observation group 41 cases and a control group 63 cases based on prognosis. Clinical data, laboratory indicators, and chest CT images were collected. Pulmonary involvement extent (≥50% or <50%) and injury pattern (ground-glass opacity or consolidation) were assessed using a visual semi-quantitative method. Multivariate logistic regression was used to analyze prognostic factors, and receiver operating characteristic (ROC) curves were drawn to evaluate the predictive performance of individual and combined indicators.

Compared with the control group, the observation group had significantly higher neutrophil count [7.05(6.59, 7.55) ×10⁹/L vs. 5.02(4.56, 5.46)×10⁹/L], lymphocyte count [1.01(0.87, 1.85)×10⁹/L vs. 0.80(0.77, 0.81)×10⁹/L], NLR[10.40(10.39, 10.98) vs. 7.99(7.68, 8.22)], CRP[80.94 (76.87, 85.95)mg/L vs. 49.43(44.88, 52.46)mg/L], ferritin [902.25 (791.01, 996.27) mcg/dl vs. 661.18(620.57, 700.66)mcg/dl], and D-dimer [2.17(2.09, 2.22)mg/L vs. 1.05(1.04, 1.08)mg/L], as well as a higher proportion of pulmonary involvement ≥50% (41.5% vs. 20.6%) and consolidation pattern (48.8% vs. 23.8%) (P<0.05). Multivariate logistic regression analysis revealed that NLR (OR=9.304, 95%CI: 1.328~65.186, P=0.025), D-dimer (OR=1.250, 95%CI: 1.099~1.422, P=0.001), pulmonary involvement extent ≥50% (OR=3.048, 95%CI: 1.311~7.083, P=0.010), and consolidation-type lung injury (OR=2.724, 95%CI: 1.140~6.508, P=0.024) were independent risk factors for poor prognosis. ROC curve analysis showed that the combined prediction of D-dimer, NLR, pulmonary involvement extent, and lung injury pattern yielded an area under the curve (AUC) of 0.863 (95%CI: 0.785~0.940), with a sensitivity of 85.4% and a specificity of 79.4%. Among the 104 patients, 95 survived (91.35%) and 9 died (8.65%). Causes of death included sepsis complicated by multiple organ dysfunction syndrome in 4 cases, acute respiratory distress syndrome in 3 cases, and pulmonary embolism due to venous thromboembolism in 2 cases.

Pulmonary CT imaging morphological features combined with coagulation function indicators can effectively predict the prognosis of chest trauma, facilitating early identification of high-risk patients.

To investigate the predictive value of dynamic monitoring of circulating tumor DNA (cfDNA), neutrophil-to-lymphocyte ratio (NLR), and programmed cell death ligand 1 messenger RNA (PD-L1 mRNA) for immunotherapy efficacy and prognosis in patients with non-small cell lung cancer (NSCLC).

A total of 42 patients with advanced NSCLC admitted to our hospital from January 2019 to June 2022 were selected and divided into an observation group 22 cases and a control group 20 cases based on immunotherapy efficacy. cfDNA concentration, NLR, and PD-L1 mRNA expression levels were measured before and after treatment, and the rate of change for each indicator was calculated. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of single indicators and the combined model for objective response rate (ORR). Cox proportional hazards regression was used to analyze the association between dynamic changes in the indicators and progression-free survival (PFS).

After treatment, cfDNA, NLR, and PD-L1 mRNA levels in the observation group were lower than those in the control group, and the absolute values of the rate of change were greater than those in the control group (P<0.05). Compared with the control group, the observation group showed: cfDNA rate of change [(-24.46±8.11)% vs. (-16.40±8.93)%, t=3.064, P=0.004]; NLR rate of change [(-24.51±6.86)% vs. (-15.75±10.65)%, t=3.196, P=0.003]; PD-L1 mRNA rate of change [(-20.29±5.89)% vs. (-15.83±5.10)%, t=2.607, P=0.013]. ROC curve analysis showed that the area under the curve (AUC) for predicting ORR was 0.761 (95%CI: 0.605~0.879) for cfDNA rate of change, 0.748 (95%CI: 0.590~0.869) for NLR rate of change, and 0.732 (95%CI: 0.573~0.857) for PD-L1 mRNA rate of change. The combined model of the three indicators yielded an AUC of 0.895 (95%CI: 0.762~0.968), with a sensitivity of 90.91% and a specificity of 80.00%, which was superior to any single indicator. Multivariate Cox regression analysis showed that cfDNA rate of change ≤20% (HR=6.541, 95%CI: 1.336~31.333, P=0.019), NLR rate of change ≤22% (HR=7.910, 95%CI: 1.538~40.684, P=0.013), and PD-L1 mRNA rate of change ≤20% (HR=6.501, 95%CI: 1.038~40.705, P=0.045) were risk factors for shortened PFS in NSCLC patients receiving immunotherapy.

Dynamic monitoring of cfDNA, NLR, and PD-L1 mRNA can effectively predict immunotherapy efficacy and prognosis in NSCLC patients. The combination of these three indicators provides a reference for clinical individualized treatment decisions.

To investigate the value of a nomogram based on non-contrast CT radiomics and morphological features in preoperatively differentiating lung adenocarcinoma from benign pulmonary nodules.

A total of 248 patients with pulmonary nodules admitted to our hospital from January 2018 to December 2024 were retrospectively enrolled and randomly divided into a training set 173 cases and a validation set 75 cases at a 7︰3 ratio. Radiomics features were extracted from non-contrast CT images. The radiomics score (Rads) was calculated from selected features. Morphological features of the pulmonary nodules were also evaluated. Multivariate logistic regression was applied to identify independent risk factors, and a nomogram model was constructed. Model performance was assessed using area under the curve of receiver operating characteristic curves (AUC), confidence interval (CI), calibration curves, and decision curve analysis.

Among the 248 cases, there were 142 lung adenocarcinomas and 106 benign nodules. Eleven key radiomics features and two morphological features (shallow lobulation and vascular convergence) were selected. Multivariate logistic regression revealed that shallow lobulation (OR=3.342, P=0.002), vascular convergence (OR=2.229, P=0.040), and Rads (OR=3.347, P<0.001) were independent risk factors for differentiating lung adenocarcinoma from benign nodules. The nomogram constructed based on these variables achieved an AUC of 0.831 (95%CI: 0.767~0.884) with a sensitivity of 67.0% and specificity of 84.3% in the training set, and an AUC of 0.825 (95%CI: 0.721~0.903) with a sensitivity of 74.4% and specificity of 86.1% in the validation set. Calibration curves demonstrated good model calibration (Hosmer-Lemeshow test: P=0.9434 in the training set, P=0.6345 in the validation set), and decision curve analysis indicated satisfactory clinical net benefit.

The nomogram model incorporating the CT radiomics score, shallow lobulation, and vascular convergence demonstrates stable and robust diagnostic performance in preoperatively differentiating lung adenocarcinoma from benign nodules. It may serve as a non-invasive auxiliary tool to support individualized preoperative decision-making for patients with pulmonary nodules.

To analyze the potential clinical risk factors and imaging characteristics of severe Chlamydia psittaci pneumonia.

A retrospective analysis was conducted on the clinical data of 54 patients with Chlamydia psittaci pneumonia admitted to the First Affiliated Hospital of Anhui Medical University from June 2020 to May 2025. All patients were diagnosed via metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid. Patients meeting the inclusion criteria were divided into a severe group (requiring intensive care unit treatment) and a non-severe group. Clinical data were compared between the two groups. Multivariate logistic regression was used to identify risk factors associated with severe Chlamydia psittaci pneumonia.

The duration of fever after admission was significantly longer in the severe group compared to the non-severe group (P<0.05). The severe group had a higher prevalence of wheezing as a chief complaint and chills as an initial symptom (P<0.05). Compared to the non-severe group, the severe group had significantly lower levels of lymphocytes, partial pressure of oxygen, monocytes, albumin, and platelets (P<0.05). Conversely, the severe group exhibited significantly higher levels of white blood cells, neutrophils, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, aspartate aminotransferase, direct bilirubin, indirect bilirubin, brain natriuretic peptide, procalcitonin, prothrombin time, fibrin degradation products, D-dimer, and a longer recovery time for C-reactive protein (CRP) (P<0.05). CT imaging revealed that the severe group had significantly more consolidations, air bronchograms, pleural effusions, and multilobar lesions compared to the non-severe group (P<0.05). During treatment, the severe group required respiratory support at a higher rate (P<0.05). Multivariate logistic regression analysis identified the following independent risk factors for severe Chlamydia psittaci pneumonia: duration of fever after admission (OR=1.460, 95%CI: 1.151~1.852, P<0.05), chills as an initial symptom (OR=5.473, 95%CI: 1.401~21.109, P<0.05), neutrophil count ≥9.5×10⁹/L (OR=10.500, 95%CI: 2.555~43.143, P<0.05), white blood cell count ≤1.1×10⁹/L (OR=4.952, 95%CI: 1.489~16.466, P<0.05), direct bilirubin ≥19 μmol/L (OR=4.667, 95%CI: 1.410~15.448, P<0.05), lactate dehydrogenase ≥100 U/L (OR=7.286, 95%CI: 1.775~29.907, P<0.05), procalcitonin ≥13 ng/ml (OR=4.062, 95%CI: 1.115~6.131, P<0.05), prothrombin time ≥4 s (OR=4.250, 95%CI: 1.169~15.454, P<0.05), air bronchogram on CT imaging (OR=6.538, 95%CI: 1.793~23.843, P<0.05), and pleural effusion (OR=2.854, 95%CI: 1.329~21.109, P<0.05).

The clinical manifestations of Chlamydia psittaci pneumonia are atypical. Early bronchoscopy with mNGS of bronchoalveolar lavage fluid can aid in early diagnosis. Specific clinical indicators, laboratory parameters, and CT imaging features serve as independent risk factors for severe Chlamydia psittaci pneumonia.

To evaluate the applicability of Nutritional Risk Screening 2002 (NRS2002), Mini Nutritional Assessment (MNA), and Malnutrition Universal Screening Tool (MUST) in hospitalized patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB), using the Global Leadership Initiative on Malnutrition (GLIM) criteria as the reference standard.

A descriptive study was conducted, consecutively enrolling 350 patients diagnosed with MDR-PTB at Xi′an Chest Hospital between June 2019 and December 2021. Nutritional risk screening was performed using the 3 toolsSensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and agreement were calculated for each tool. Receiver operating characteristic (ROC) curves were constructed, and the area under the curve (AUC) was computed. Univariate and multivariate logistic regression analyses were conducted to assess the association between nutritional status and clinical outcomes, with sputum culture conversion at 2 months and the occurrence of adverse events as primary endpoints.

Among the 350 MDR-PTB patients, 204 cases (58.29%) were diagnosed with malnutrition according to the GLIM criteria, and 146 cases (41.71%) were well-nourished. The nutritional risk detection rates of various screening tools were as follows: MNA in 294 cases (84.00%), NRS2002 in 228 cases (65.14%), and MUST in 240 cases (68.57%). The screening time required for MNA [(3.40 ± 2.07) minutes] was significantly longer than that for NRS2002 [(2.23±0.76)minutes] and MUST [(1.54±0.33) minutes], with a statistically significant difference (F=0.578, P<0.001). According to GLIM criteria, 58.29% of patients were diagnosed with malnutrition. Performance analysis revealed that MNA had the highest sensitivity (99.51%) but the lowest specificity (37.67%). NRS2002 and MUST demonstrated higher specificity (66.44% vs. 63.70%) and greater AUC values (0.771 vs. 0.777). Multivariate binary logistic regression indicated that, compared with well-nourished patients, those identified as malnourished by GLIM criteria (OR=20.511, 95%CI: 4.509~93.308) and those at high risk by NRS2002 (OR=3.492, 95%CI: 1.147~10.627) had a significantly higher risk of non-conversion in sputum culture at 2 months. Similarly, the GLIM malnutrition group (OR=2.951, 95%CI: 1.023~8.509) and the MNA high-risk group (OR=17.213, 95%CI: 1.794~165.179) were associated with a higher risk of adverse treatment outcomes.

Among the three nutritional screening tools, MNA showed the highest sensitivity, while NRS2002 exhibited the highest specificity, MUST demonstrated better overall screening performance. For focusing on short-term clinical outcomes, NRS2002 and MUST have higher screening efficacy, while MNA is superior for early identification of nutritional risk and assessment of long-term clinical outcomes, and may be more suitable for the clinical nutritional management strategy of MDR-PTB patients.

To evaluate the effect of omalizumab on the balance of helper T cell 1 (Th1)/Th2 cytokines and its clinical efficacy in elderly patients with bronchial asthma.

A total of 105 elderly patients with bronchial asthma treated at The First People′s Hospital of Xianyang from September 2021 to October 2024 were enrolled and assigned to an observation group 48 cases, receiving conventional inhalation therapy plus subcutaneous injection of omalizumab or a control group 57 cases, receiving conventional inhalation therapy alone based on treatment preference (non-randomized design). The treatment duration was 12 weeks. Clinical efficacy, peripheral blood Th1-type cytokines [interferon-gamma (IFN-γ), interleukin-2 (IL-2)], Th2-type cytokines (IL-4, IL-13), inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), IL-6, tumor necrosis factor-alpha (TNF-α)], total immunoglobulin E (IgE), lung function parameters [forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), maximum mid-expiratory flow (MMEF), FEV₁/FVC ratio], and adverse events were compared between the two groups.

The observation group had higher total effective rate [87.50%(42/48) vs. (70.18%, 40/57)] (P<0.05). After treatment , the observation group had higher IFN-γ and IL-2 [(29.63±6.78) pg/ml and (15.66±4 .42)pg/ml vs. (21.22±5.19)pg/ml and (11.57±3.09)pg/ml], while lower levels of IL-4 and IL-13 [(18.57±4.13) pg/ml and (19.48±4.87)pg/ml vs. (23.99±5.64)pg/ml and (25.22±5.38)pg/ml] (P<0.05); the observation group showed a decreasing trend of hs-CRP(12.27±2.65) mg/L, IL-6 (41.31±8.18) pg/ml, TNF-α(28.44±7.76) pg/ml, and total IgE (181.57±43.82)IU/ml, and those in the observation group were lower [(16.22±3.82) mg/L, (50.46±9.49)pg/ml, (37.68±8.93) pg/ml, (225.46±59.23)IU/ml] (P<0.05); the observation group had higher FEV₁(1.47±0.35)L, FVC(2.36±0.46)L, MMEF (1.31±0.36) L/s, FEV₁/FVC (66.39±5.42)% vs. (1.34±0.36)L, (2.15±0.47)L, (1.08±0.31)L/s, (62.46±5.65)% (P<0.05). The observation group had higher incidence of adverse reactions (14.58% vs. 8.77%), without statistically significant difference (P>0.05).

In elderly patients with bronchial asthma, addition of omalizumab to conventional therapy can restore the Th1/Th2 cytokine balance, reduce systemic inflammation and IgE levels, and improve lung function, with an acceptable safety profile.

To investigate the effect of sputum induction (SI) combined with the active cycle of breathing technique (ACBT) on pulmonary function and rehabilitation compliance in patients with chronic obstructive pulmonary disease (COPD).

A total of 96 COPD patients admitted to our hospital from August 2023 to July 2025 were selected and randomly divided into an observation group (48 cases) and a control group (48 cases) using a random number table. The control group received a conventional pulmonary rehabilitation nursing program, while the observation group received SI combined with ACBT in addition to the treatment given to the control group. The two groups were compared in terms of pulmonary function indices [forced expiratory volume in 1 second (FEV₁), FEV₁% predicted, forced vital capacity (FVC), FEV₁/FVC], total sputum volume and viscosity, 6-minute walk distance (6MWD), General Self-Efficacy Scale (GSES) score, COPD Assessment Test (CAT) score, pulmonary rehabilitation compliance, and adverse reactions.

After treatment, the observation group had significantly better pulmonary function than the control group: FEV₁[(1.49±0.37) L vs (1.23±0.23) L, P<0.001]; FEV₁% pred [(62.62±14.08)% vs (53.18±11.82)%, P<0.001]; FVC[(2.79±0.46) L vs (2.48±0.41) L, P=0.001]; FEV₁/FVC [(53.27±7.40)% vs (49.85±5.66)%, P=0.012]. After treatment, the observation group showed a lower total sputum volume than the control group [(20.99±3.57) ml vs (23.29±5.11) ml, P<0.05], and a significantly greater improvement in sputum viscosity [(grade Ⅰ: 20.83% vs 10.42%, grade Ⅱ: 75.00% vs 56.25%, grade Ⅲ: 4.17% vs 33.33%), Z=-2.561, P=0.001]. The observation group was also superior in 6MWD [(376.85±31.54) m vs (318.29±14.20) m, P<0.001], GSES score [(25.75±3.48) vs (21.77±1.61), P<0.001], and CAT score [(13.58±2.34) vs (20.71±4.59), P<0.001]. The complete compliance rate for pulmonary rehabilitation was 45.83% in the observation group, higher than 25.00% in the control group (χ²=-2.198, P=0.012). The incidence of adverse reactions in the observation group was 9 cases (18.75%), lower than the 19 cases (39.58%) in the control group (χ²=4.084, P=0.043).

SI combined with ACBT can effectively improve pulmonary function, reduce total sputum volume and viscosity, enhance exercise tolerance, self-efficacy, quality of life, and rehabilitation compliance, and reduce adverse reactions in COPD patients, demonstrating clinical significance.