To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

Benign prostatic hyperplasia (BPH) and cardiovascular diseases (CVD) are common in middle-aged and elderly men, and the prevalence of these diseases increases significantly with the increase of age. BPH is usually characterized by lower urinary tract symptoms, and most patients showed a significant improvement in LUTS after receiving active surgical intervention. However, postoperative follow-up showed that patients with BPH combined with CVD risk factors had poor improvement in LUTS after surgery. This article discusses the role of each risk factor, including hypertension, diabetes, obesity and hyperlipidemia, in the development and progression of BPH, and further explores the current research status of LUTS in BPH patients with co-existing CVD risk factors, with the aim of providing certain reference for the prevention and treatment of LUTS in BPH patients with CVD through targeted intervention measures.

Erectile dysfunction and urinary incontinence remain common complications following robot-assisted radical prostatectomy (RARP) in patients suffer from prostate cancer. Preservation of the neurovascular bundles (NVBs) is a critical surgical step for promoting functional recovery, with techniques continuously refined through advances in prostatic anatomy research and robotic platforms. However, the relative merits of cold versus thermal dissection of the neurovascular bundles remain controversial, and pertinent evidence-based investigations have advanced considerably in recent years. This review comprehensively examines cold and thermal techniques in NVBs preservation during nerve-sparing RARP and their impact on postoperative functional outcomes, aiming to provide evidence-based references for clinical decision-making.

Adrenal tumors are highly heterogeneous endocrine disorders with markedly varied prognoses across clinical subtypes, underscoring the critical need for precise diagnosis and treatment. Artificial intelligence (AI) is increasingly employed in this field to improve diagnostic accuracy, refine prognostic assessment, and advance personalized medicine. This review systematically summarizes recent advancements in AI for the precise diagnosis, treatment planning, and prognosis prediction of adrenal tumors, while examining its strengths and limitations. AI has significantly enhanced precision in managing adrenal tumors. It achieves an area under the curve (AUC) of 94.5% for subtype classification, 93.7% for predicting intraoperative hemodynamic risk, and 91.7% sensitivity for tumor metastasis, and 95.5% specificity for prognosis assessment. Additionally, AI effectively supports surgical decision-making and personalized medication recommendations. However, current applications face several challenges, including high heterogeneity in single-center data, insufficient algorithm interpretability, and inadequate integration of multimodal and multi-omics data. Future efforts should focus on establishing standardized multicenter databases, developing explainable AI techniques, enhancing multidimensional data integration, and conducting large-scale clinical validation. These measures are essential to accelerate the clinical translation of AI and to propel the field toward more precise and individualized patient management.

Interstitial cystitis (IC) is also known as bladder pain syndrome (BPS), which is a chronic condition characterized by bladder or pelvic pain, urinary frequency, and urgency, typically without evidence of infection. Its pathogenesis is complex and remains unclear. Current clinical treatments primarily involve behavioral interventions, medications, and minimally invasive surgeries, but long-term efficacy remains limited. In recent years, platelet-rich plasma (PRP), a regenerative medicine therapy, has demonstrated significant efficacy through submucosal bladder injections or intravesical instillation. PRP promotes urothelial healing, alleviates bladder neuropathic pain, and exerts antibacterial effects, offering a safe and effective treatment option for IC patients unresponsive to conventional therapies. Multiple hospitals have now adopted PRP in clinical practice. This article elaborates on the key components, preparation methods, the mechanisms of PRP action, and the current status of PRP therapy for IC.

Percutaneous nephrolithotomy (PCNL) is the main treatment for large renal calculi (>2 cm), and puncture localization is the key to surgical success. This article reviews the research progress of puncture localization techniques in PCNL to provide strategies for improving PCNL surgical skills.

A systematic literature search was conducted across databases including PubMed, Web of Science, and CNKI. The principles, advantages, limitations, and clinical utility of both conventional (fluoroscopy, ultrasound, CT-guidance) and emerging (augmented reality, electromagnetic tracking, robotic assistance, three-dimensional visualization) localization techniques were analyzed.

Novel imaging-guided techniques, such as robot-assisted, augmented reality, CT-ultrasound fusion, and electromagnetic tracking, have shown significant advantages in improving localization accuracy, reducing surgical difficulty, shortening the learning curve, and decreasing radiation exposure.

Key future directions include stereoscopic imaging, radiation dose reduction, image quality optimization, and multimodal image fusion. The integration of artificial intelligence with medical imaging technologies holds promise for further shortening the learning curve and reducing procedural complexity, which is crucial for the broader adoption of PCNL.

To compare the performance of triglyceride-glucose index combined with body mass index (TyG-BMI) and waist-to-height ratio (WHtR) in the diagnosis of visceral fat area (VFA) in overweight and obese people, and to explore their gender differences, so as to provide a simple and accurate assessment tool for clinical screening of central obesity and metabolic risk.

A total of 117 overweight and obese patients were enrolled. The quartiles of VFA (113.60 cm², 146.30 cm², 190.10 cm²)were used as the cut-off values and divided into four groups: S1 to S4. Anthropometric, serological and insulin resistance-related composite indicators were collected. Pearson correlation analysis was used to evaluate the correlation between each indicator and VFA. ROC curve analysis was used to compare the efficacy of each indicator in diagnosing high VFA, and gender subgroup analysis was performed. Clinical decision curve analysis (DCA) was used to evaluate the net clinical benefit of each index, and the positive predictive value (PPV) and negative predictive value (NPV) were calculated.

The body weight (107.07±17.40 vs 80.34±10.28 ), waist circumference (116.31±12.13 vs 97.60±8.81), waist-to-height ratio (0.69±0.07 vs 0.59±0.05) and TyG-BMI (340.34±45.48 vs 265.30±31.29) in group S4 were higher than those in group S1. Blood pressure (135.83±16.50 vs 125.27±18.74), liver function (24.90 vs 22.45) and fatty liver (355.34±42.39 vs 293.20±36.42) were higher than those in S1 group (P<0.05). Correlation analysis showed that TyG-BMI (r=0.559 ) and waist-to-height ratio (r=0.587) were positively correlated with VFA (P<0.05). Gender subgroup analysis showed that the cut-off values of TyG-BMI and waist-to-height ratio at different VFA cut-off points. There were gender differences. The cut-off point of TyG-BMI was 298.12-315.89 in males and 263.76-283.88 in females. The cut-off point of waist-to-height ratio was 0.62-0.65 in males and 0.58-0.63 in females. DCA showed that TyG-BMI had the greatest net clinical benefit, which was better than waist-to-height ratio, waist circumference and BMI. Taking VFA ≥100 cm² as the gold standard, PPV reached 97.7 % when TyG-BMI > 298.64, which was higher than waist-to-height ratio >0.62 (94.5%), waist circumference >103.7 cm (93.8%) and BMI >31.11 (94.8%). However, the NPV of the four indicators was low (24.7%-37.5%), suggesting that the exclusion ability was limited.

TyG-BMI and WHtR can be used as indicators of VFA in overweight and obese people, but there are gender differences. When TyG-BMI >282.73 (male >298.12) and WHtR >0.58 (male 0.62 ), It can be used as an early warning index for abnormal accumulation of visceral fat.it is preliminarily suggested that there may be significant visceral fat accumulation in individuals, which is worthy of further examination and dynamic observation of VFA.TyG-BMI has the best clinical net benefit and diagnostic efficacy in screening visceral obesity, and can be used as a convenient screening tool for high-risk groups, but negative results need to be further evaluated in combination with other indicators.

To explore the relationship between body mass index (BMI), weight-adjusted waist circumference index (WWI), body roundness index (BRI), and relative fat mass index (RFM) and the risk of diabetic foot ulcer (DFU) and all-cause mortality, and to provide a basis for risk stratification in diabetic patients.

Based on the data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004, 1,487 diabetic patients aged ≥35 years were included. Weighted logistic regression was used to analyze the association between BMI, WWI, BRI, and RFM and DFU and the pre-DFU state. ROC curves and restricted cubic splines were used to analyze the discriminatory ability of each index for DFU and its non-linear relationship. By linking to the National Death Index database, the patients were followed up until December 31, 2019, and weighted Cox proportional hazards regression was used to analyze the relationship between each index and all-cause mortality.

A total of 1,487 diabetic patients were included, among whom 100 (6.7%) had DFU and 733 (49.3%) were in the pre-DFU state. After fully adjusting for confounding factors, BMI, WWI, BRI, and RFM were all significantly associated with an increased risk of DFU, with OR values of 1.07, 1.95, 1.47, and 1.13, respectively; however, these indices were not significantly associated with the pre-DFU state. All four indices had moderate discriminatory power for DFU, with AUCs of approximately 0.71 to 0.72. RCS analysis showed a non-linear relationship between WWI and the risk of DFU. The analysis of all-cause mortality revealed that WWI, BRI, and RFM were significantly associated with an increased risk of death, while the association of BMI was relatively weak. Among them, WWI and BRI performed more prominently in the stratification of mortality risk.

Multiple obesity-related anthropometric indices are significantly associated with an increased risk of DFU in diabetic patients, and WWI and BRI are also associated with an increased risk of all-cause mortality. Simple and non-invasive anthropometric indices are promising for identifying high-risk populations for DFU and providing references for early prevention and risk stratification.

To investigate the application effect of a specialized disease management program based on the ORTCC model in perioperative care for patients with metabolic weight loss.

Eighty patients who underwent laparoscopic sleeve gastrectomy in our weight loss and metabolic surgery center from July 2024 to December 2024 were selected as the control group (n=80); another eighty patients who underwent laparoscopic sleeve gastrectomy in our weight loss and metabolic center from January 2025 to June 2025 were selected as the observation group (n=80). The control group received conventional nursing care, while the observation group received a specialized disease management program based on the ORTCC model. The preoperative assessment completeness rate, postoperative first ambulation time compliance rate, incidence of nausea and vomiting during hospitalization, health behavior awareness rate before discharge, and postoperative satisfaction scores were compared between the two groups.

The observation group exhibited higher preoperative assessment completeness rate, postoperative first ambulation time compliance rate, health behavior awareness rate before discharge, and postoperative satisfaction scores than the control group (P<0.05). The incidence of nausea and vomiting during hospitalization was lower in the observation group than in the control group (P<0.05).

The specialized disease management program based on the ORTCC model can reduce postoperative adverse reactions, optimize weight loss outcomes, enhance self-management capabilities in patients undergoing bariatric surgery, improve their quality of life, and achieve higher patient satisfaction.

To investigate the effect of the timing of prophylactic ondansetron administration on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic sleeve gastrectomy (LSG).

This retrospective study reviewed the clinical records of 110 patients who underwent elective LSG at the Bariatric and Metabolic Center of Dalang Hospital, Dongguan, China, between January 2023 and December 2025. Among these patients, 93 eligible cases were included in the final analysis. All procedures were performed by the same surgical and anesthesia team using a standardized three-port, seven-step LSG technique. Patients were divided into two groups according to the timing of prophylactic ondansetron administration: 46 patients received ondansetron at anesthesia induction (group G1), whereas 47 patients received the drug during gastric sleeve formation (group G2). Both groups received identical postoperative antiemetic and analgesic regimens, including the same rescue protocols. Baseline clinical characteristics, the frequency and severity of PONV, rescue antiemetic use, postoperative VAS pain scores, and number of rescue analgesic administrations were compared between the two groups at 0-6 h (T1), 6-12 h (T2), 12-18 h (T3), 18-24 h (T4), and 24-48 h (T5) after surgery.

No significant differences were observed between the two groups with respect to baseline characteristics, including age, sex, body mass index (BMI), and anesthesia duration (all P>0.05). Compared with Group G1, Group G2 had significantly fewer episodes of postoperative nausea and vomiting (PONV) at T1 [1 (1-1) vs 2 (2-3)], T2[2 (1-3) vs 3.5 (3-4)], and T3 [0 (0-1) vs 1 (0-1)] (all P<0.05). Similarly, the median PONV severity scores were significantly lower in Group G2 than in Group G1 at T1 [2 (1-3) vs 3 (3-4)] and T2 [3 (2-4) vs 4 (3-5)] (both P<0.05). In addition, the median postoperative visual analog scale (VAS) pain scores were significantly lower in Group G2 than in Group G1 at T1, T2, and T4 (all P<0.05).

Compared with administration during anesthesia induction, prophylactic administration of ondansetron during gastric sleeve creation more effectively reduces the incidence and severity of early postoperative nausea and vomiting and alleviates postoperative pain in patients with obesity undergoing laparoscopic sleeve gastrectomy.

The prevalence of type 2 diabetes (T2DM) combined with metabolic associated fatty liver disease (MAFLD) is high. Insulin resistance (IR) serves as the link between the two. Their combined effect leads to liver cell damage, liver fibrosis, and even progression to cirrhosis. The liver fibrosis process is more obvious in T2DM patients with MAFLD. The glycerol triose phosphate glucose index (TyG), as a non-insulin-dependent, reliable, economical, and simple-to-perform new indicator for evaluating IR, combined with body mass index (BMI), can be used for screening and management of MAFLD in T2DM patients, thereby strengthening the control of risk factors and avoiding irreversible progression of the disease. This article reviews the possible mechanisms and correlations between the glycerol triose phosphate glucose index (TyG-BMI) and liver fibrosis in T2DM patients with MAFLD, with the aim of providing a basis for early assessment of liver fibrosis and early prediction and intervention of risk factors.

Sleeve gastrectomy is one of the effective interventions for severe obesity; however, long-term weight regain after surgery substantially compromises its clinical benefits. Weight regain is not attributable to a single cause, but rather represents a coordinated defensive response across multiple systems under a state of negative energy balance. This review first outlines the epidemiology and definition of weight regain following sleeve gastrectomy. On this basis, we elaborate on the underlying biological mechanisms, including the "metabolic memory" of adipocytes and immune cells, which constitutes the tissue-level susceptibility basis; the remodeling of the gut microbiota-gut-brain axis, which participates in energy absorption and reprogramming of appetite centers; the loss of lean body mass and associated metabolic adaptation, which drive weight rebound through both energy expenditure and appetite regulation; and the structural and functional alterations in hypothalamic appetite-regulatory networks, which form the neural foundation for sustained increases in food intake. These mechanisms are interconnected and collectively shift energy balance toward a positive direction. Furthermore, we propose a three-tiered stepwise management strategy-"lifestyle intensification-pharmacological intervention-endoscopic and revisional surgery"-with a focused review of the evidence and differential efficacy of GLP-1 receptor agonists and revisional surgery in managing weight regain after sleeve gastrectomy. This review aims to provide clinicians with an integrated framework spanning mechanistic understanding to stratified intervention, facilitating the transition of bariatric surgery toward a long-term chronic disease management model.

With the continuous increase in the global prevalence of obesity, bariatric and metabolic surgery (BMS) has gradually been introduced to address severe obesity and metabolic syndrome. Post-operative patients may be anxious or depressed, suffer from changes in body image, and lose motivation for treatment; thus, their recovery may be impaired. Most current clinical psychological evaluations are self-report questionnaires and interviews; thus, they fail to provide timely, objective and continuous data on alterations in patients' emotions and behaviour. MER is a new objective that can quantify the psychological status and adherence behaviour of patients with BMS more intelligently. Future work will include multiple centre clinical validation trials to examine the actual effects. In addition, improve the interpretability and privacy protection design of the model, promote deeper integration of MER with nursing information systems, and advance the development of precision and continuous psychological nursing care models.