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.

Blood glucose monitoring and management in critically ill patients constitutes an important part of intensive care. Continuous glucose monitoring (CGM) can improve the time in the target blood glucose range and reduce hypoglycemic events, and it has been widely used in patients with diabetes. Its advantages, including continuous glucose data collection, multiple glucose dynamic indicators, minimal invasiveness and reduced workload for medical staff, have drawn increasing attention from ICU clinicians. However, the clinical applicability of CGM in ICU patients remains controversial due to the critical conditions and rapid pathophysiological changes. This article elaborates on the recent progress regarding the accuracy of CGM in critically ill patients, as well as whether it can improve the quality of blood glucose control and clinical prognosis.

With the continuous advancement of critical care medicine, early mortality among critically ill patients has significantly declined. However, a subset of survivors continue to experience persistent multi-organ dysfunction, requiring prolonged stays in the intensive care unit (ICU). These patients are clinically defined as having chronic critical illness (CCI). Notably, CCI is characterized by marked hypercatabolism, which severely impacts prognosis and quality of life. This article systematically reviews the definition, epidemiology, and pathophysiological mechanisms of hypercatabolism in CCI, including the roles of sustained inflammatory responses, neuroendocrine dysregulation, and their effects on tissue metabolism—particularly skeletal muscle catabolism. Furthermore, we summarize biomarkers associated with hypercatabolism in CCI patients and evaluate the critical role of nutritional support strategies, such as enteral nutrition, nutritional adjuvants, and anabolic agents, in mitigating metabolic dysregulation. By synthesizing current evidence, this review aims to provide reference for optimizing nutrition-focused interventions in CCI patients, ultimately improving clinical outcomes and guiding future research directions in this evolving field.

Septic shock is one of the most important threats to human life and health. Despite ongoing researches, the morbidity and mortality remain high. As a non-catecholamine-based vasoconstrictor, methylene blue has been shown in many studies to increase mean arterial pressure, reduce the need of catecholamine vasopressors and reduce the mortality of septic shock. However, these findings have not been consistently conclusive. This article reviewed the therapeutic effect of methylene blue in septic shock in this manuscript.

Sepsis can trigger the onset of atrial fibrillation (AF). When AF occurs in septic patients, hospital length of stay is often prolonged, and the risk of in-hospital mortality increases. Compared to septic patients without AF, those with sepsis-induced AF face nearly a threefold increase in the risk of in-hospital stroke. Clinically, there is an ongoing debate over whether anticoagulant therapy should be administered to septic patients with concurrent AF. Some advocate for anticoagulation to reduce the incidence of ischemic stroke, while other caution that it may increase the risk of bleeding. In light of these differing perspectives, this article reviews both domestic and international literature to explore whether anticoagulant therapy should be initiated in septic patients with AF, particularly in cases of new-onset AF. The goal is to enhance clinicians' understanding of anticoagulation strategies in this context and to provide guidance on better balancing the potential benefits of anticoagulation with the associated risks of bleeding.

Camel whey protein (CWP), a by-product derived from camel milk during processing, is a nutritionally rich component characterized by its high protein content, excellent digestibility and efficient absorption. Recognized for its high purity,superior absorption rate, and well-balanced amino acid profile, CWP is often regarded as a"king of protein"and is acknowledged as a high-quality dietary protein supplements. Furthermore, emerging research has revealed that CWP possesses diverse bioactive properties, including anti-inflammatory, antimicrobial, antiviral, antioxidant, and immunomodulatory effects, alongside lowallergenicity. These bioactivities suggest considerable potential for CWP in the treatment and prevention of various diseases. This review summarizes the current evidence biological activities of CWP and its potential clinical applications in promoting health and facilitating recovery from disease, with a specific focus on proposing a novel adjuvant therapeutic strategy forsepsis. Our aim is to provide a theoretical foundation for the future clinical development and utilization of CWP.

Artificial intelligence (AI) is a new quality productive forces of modern information technology. It provides innovative approaches to optimize critical care workflows and improve patient safety and quality of care. In addition, AI promotes the development of scientific and precise critical care. This article reviews AI applications in critical care, analyzes current challenges and proposes corresponding strategies to support future advances of AI technology in critical care.

Cerebral ischemia-reperfusion injury (CIRI) is a complex pathophysiological process characterized by exacerbated brain tissue damage and related functional impairments following the restoration of blood flow after transient cerebral ischemia. Studies indicate that safflower alleviates ischemia-reperfusion injury through multiple mechanisms, including regulating hemodynamics, dilating blood vessels, improving hypoxia, counteracting free radical damage, exerting anti-inflammatory effects, and modulating neuronal autophagy. However, the precise molecular mechanisms underlying its therapeutic effects remain unclear. This review focuses on the neuroprotective roles of safflower in CIRI and its molecular mechanisms. By comprehensively analyzing the recent research advances, we find that bioactive components of safflower can mitigate CIRI through multiple pathways. This work aims to provide theoretical foundations for investigating the molecular mechanisms of traditional Chinese medicine in CIRI management and guide clinical rational drug utilization.

At present, the prevalence of type 2 diabetes mellitus (T2DM) continues to rise, and the prevention and treatment of its multi-system complications have become a major public health challenge. In addition to traditional risk factors such as abnormal glucose and lipid metabolism, abnormal cortisol secretion levels and rhythm disorders caused by hypothalamic-pituitary-adrenal axis dysfunction have increasingly attracted attention in the onset and progression of T2DM and its complications. The authors systematically review the clinical evidence on the impact of abnormal cortisol levels and rhythm disorders on the risk of T2DM, summarize the typical changes in cortisol levels and rhythms in T2DM patients, and focus on elaborating the associations between the two and the cerebrovascular diseases, microvascular diseases, and musculoskeletal system diseases related to T2DM, with the aim of providing a theoretical basis for deeply revealing its mechanism and exploring prevention and treatment strategies that take cortisol levels and rhythms as dual assessment targets.

To investigate the safety and feasibility of improving incision suture and drainage tube fixation after thoracoscopic surgery.

A total of 210 patients who underwent thoracoscopic surgery for pulmonary or mediastinal diseases from January 2025 to January 2026 were prospectively included. They were divided into Group 1, Group 2, and Group 3 according to the different incision suture and drainage tube fixation methods. Group 1 (70 patients) received layered suture with double-layer barbed suture combined with fixation under the suture of the deep tissue within the incision (method 1); Group 2 (70 patients) received layered suture combined with fixation in the Trocar tunnel independent of the incision (method 2); Group 3 (70 cases) received traditional interrupted suture combined with fixed catheter placement at the same incision skin layer (method 3). The incision healing time, total postoperative drainage volume, pain Visual Analog Score (VAS) in the first 3 days after surgery, scar score [Vancouver Scar Scale (VSS) and Observer Scar Assessment Scale (OSAS)] at one month after surgery and the incidence of postoperative incision complications were analyzed and compared among the three groups.

Finally, 185 patients were included in the study—Group 1 (58 patients), Group 2 (62 patients), and Group 3 (65 patients). There were no statistical differences between Group 1 and Group 2 in terms of scar scores (OSAS, VSS) and the incidence of complications such as suture knot reaction, early incision infection, subcutaneous emphysema, and poor incision healing (P>0.05), but both groups were lower than Group 3 (P<0.05). In terms of the incidence of incision exudation or the number of days of incision healing, Group 2 < Group 1 < Group 3 (P<0.05). For postoperative days 1 and 2, the VAS pain scores followed a pattern of Group 1 < Group 3 < Group 2 (P<0.05). There were no statistically significant differences among the three groups on postoperative day 3 (P>0.05), nor in total postoperative drainage volume (P>0.05) or the incidence of complications such as fat liquefaction (P>0.05) and tube dislodgement (P>0.05).

Compared with traditional suture and fixation methods, methods 1 and 2 have better safety and effectiveness, reduce the incidence of related incision complications, reduce excessive scar hyperplasia, and promote primary healing of the incision. Among them, method 2 has advantages in reducing the incidence of incision exudation and accelerating incision healing time, but it has poor postoperative pain control, and still needs further exploration and improvement. To sum up, the first two suture and fixation methods proposed in this study are effective, feasible and worthy of application in clinical practice in specific environments.

To analyze the causes, clinical characteristics and key points of reoperation for thoracic deformity.

From January 2018 to December 2025 in The Affiliated Guangdong Second Provincial General Hospital of Jinan University, the clinical data of patients with thoracic deformity who underwent reoperation after failed surgery outside the hospital were retrospectively analyzed, including general information of patients, deformity characteristics, imaging results, operation time, intraoperative blood loss, postoperative hospital stay, and postoperative complications. The above results were statistically analyzed.

A total of 312 patients were enrolled, including 258 males and 54 females, aged from 3 to 49 (19.98±9.83) years old. There were 270 cases of pectus excavatum, 18 cases of pectus carinatum, 9 cases of compound deformity, and 15 cases of unknown type. The patients were treated with Wang procedure, Wung procedure, Wenlin procedure, Wang + Wung procedure, Wang + Wenlin procedure, Wung + Wenlin procedure and comprehensive procedure, respectively. The total operation time was 55–285 (134.21±52.04) min, the intraoperative blood loss was 2–500 (74.63±114.48) mL, and the postoperative hospital stay was 4–60 (10.54±6.78) days. The longest follow-up time was 93 months, in which the steel plate had been removed in 126 cases, and there was no obvious recurrence of deformity during the follow-up after removal of the steel bars.

Once the thoracic deformity surgery fails, the risk of reoperation is high, and the procedure is technically difficult. Special methods are required for reoperation.

To explore the associations between changes in skeletal muscle index (SMI) and subcutaneous adipose index (SAI) during neoadjuvant immunotherapy combined with chemotherapy and treatment response, treatment-related adverse events, and perioperative outcomes in patients with locally advanced esophageal squamous cell carcinoma (ESCC).

This retrospective study included 109 patients with locally advanced ESCC who received neoadjuvant immunotherapy combined with chemotherapy followed by radical surgery between January 2020 and January 2025 at The First Affiliated Hospital of Suchow University and The Fourth Affiliated Hospital of Suchow University. SMI and SAI were measured on abdominal computed tomography (CT) images at the third lumbar vertebra (L3) level before and after neoadjuvant treatment. Percentage changes (ΔSMI% and ΔSAI%) were calculated, and patients were stratified according to body composition changes. Radiological response, pathological tumor regression grade (TRG), treatment-related adverse events, and perioperative outcomes were compared among groups.

Baseline clinical characteristics were comparable across different ΔSMI% and ΔSAI% groups. No significant associations were observed between changes in SMI or SAI and radiological response or TRG. Patients with decreased SMI experienced a significantly higher incidence and severity of leukopenia. Regarding perioperative outcomes, the group with decreased SMI had a significantly longer postoperative hospital stay and a higher incidence of pleural effusion and pneumonia. Although the overall complication rate tended to be higher in this group, the difference did not reach statistical significance. In contrast, changes in SAI were not significantly associated with perioperative outcomes or complication rates.

Dynamic changes in SMI during neoadjuvant immunotherapy combined with chemotherapy are closely associated with perioperative recovery and postoperative complications in patients with locally advanced ESCC, whereas their correlation with radiological and pathological response is limited. Changes in SAI show limited predictive value for perioperative outcomes. Monitoring skeletal muscle dynamics during neoadjuvant treatment may aid in preoperative risk stratification and optimization of perioperative management.

To establish and compare three prediction models for pulmonary infection after thoracoscopic surgery in lung cancer patients based on multivariate logistic regression, decision tree, and neural network.

Patients with lung cancer who underwent thoracoscopic lung resection in Zhenjiang Third People’s Hospital, Jurong People’s Hospital, and Danyang Third People’s Hospital from October 1, 2022 to March 31, 2025 were selected. Data on patient demographics, physical examination findings, past medical history, pulmonary function indices, surgical conditions, and tumor conditions of the patients were collected. The patients were divided into a pulmonary infection group and a non-pulmonary infection group based on the occurrence of pulmonary infection. The differences between the two groups were compared through univariate analysis. The variables with statistical significance in the univariate analysis were selected as independent variables for multivariate logistic regression, decision tree, and neural network to construct the prediction models, and the sensitivity, specificity, Youden index, and area under the receiver operating characteristic (ROC) curve (AUC) of the three models were compared.

A total of 1 262 patients were included in the study, of whom 230 cases had pulmonary infection, with an incidence of 18.22%. Multivariate logistic regression showed that age (≥60 years), gender, smoking history, history of chronic pulmonary diseases, and hospitalization time (≥10 days) were independent risk factors for postoperative pulmonary infection. The decision tree model obtained 4 explanatory variables: age (≥60 years), serum albumin level (<35 g/L), hospitalization time (≥10 days), and smoking history. The neural network model suggested that the top five risk factors were age (≥60 years), serum albumin level (<35 g/L), history of chronic pulmonary diseases, hospitalization time (≥10 days), and smoking history. The accuracy of the three models was 84.9%, 81.5%, and 86.7%, respectively. The sensitivity was 77.2%, 73.2%, and 75.4%; specificity was 80.3%, 76.8%, and 82.7%; Youden index was 0.575, 0.520, and 0.581; and the AUC was 0.831, 0.796, and 0.857, respectively (all P<0.05).

Compared with the multivariate logistic regression model and the decision tree model, the neural network model has better predictive performance for pulmonary infection after thoracoscopic surgery in lung cancer patients.