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.

To explore the clinical application value of a novel domestic peroral cholangioscopy in the diagnosis of intraductal papillary neoplasms of the bile duct (IPNB).

A retrospective analysis was performed on the clinical data of 12 patients diagnosed with intraductal papillary neoplasm of the bile duct (IPNB) who underwent domestic peroral cholangioscopy between January 2020 and December 2025, including 11 patients from the Digestive Endoscopy Center of Jiangsu Provincial Hospital of Chinese Medicine and 1 patient from Nanjing Drum Tower Hospital..Abdominal imaging examinations (CT/MRI) revealed biliary duct dilation or space-occupying lesions in all patients. All patients further received ERCP combined with domestic peroral cholangioscopy.Endoscopic manifestations, biopsy pathological results and complications were recorded.

Among the 12 patients, there were 5 males and 7 females, aged 55 to 84 years old with an average age of (67.9±8.9) years.The main clinical manifestations included right upper abdominal pain (7 cases), right upper abdominal pain complicated with fever (4 cases), jaundice (1 case).Imaging examinations all indicated intrahepatic and/or extrahepatic bile duct dilation, among which filling defects or soft tissue shadows in the bile duct were observed in 6 cases. The morphological findings under peroral cholangioscopy were fish-egg-like lesions (4 cases), papillary lesions (5 cases) and waterweed-like lesions (2 cases), with mucus secretion identified in 8 patients.Lesions were located in hilar bile duct (5 cases), left hepatic duct (2 cases), right hepatic duct (1 case), hilar combined with left hepatic duct (1 case), upper segment and lower segment of common bile duct (1 case each), and the lesion site was unclear in 1 case.Endoscopic biopsy was performed in 10 patients.Pathological diagnoses included IPNB with carcinogenesis (2 cases), IPNB with high-grade intraepithelial neoplasia (2 cases), IPNB with low-grade intraepithelial neoplasia (3 cases), simple IPNB (1 case), chronic mucosal inflammation (2 cases), and no biopsy was conducted in 2 cases.No severe complications occurred after cholangioscopy.Two patients developed hyperamylasemia and one patient suffered from biliary tract infection, all of whom recovered within 48 hours.

Domestic peroral cholangioscopy can directly observe the morphological characteristics of intraductal biliary lesions, and can achieve accurate diagnosis of IPNB combined with biopsy pathology. It features favorable safety and possesses important clinical application value.

To explore the efficacy of radiofrequency ablation combined with biliary endoscopy in treating restenosis after metal stent implantation for malignant biliary obstruction.

A total of 100 patients with restenosis after metal stent implantation for malignant biliary obstruction admitted to the Department of Endoscopic Surgery, Cangzhou Central Hospital of Hebei Province from January 2021 to December 2022 were enrolled as research subjects.Patients were divided into combination group and control group according to treatment regimens, with 50 cases in each group.The combination group received radiofrequency ablation combined with cholangioscopy-guided debridement and stent recanalization, while the control group underwent conventional balloon dilation and stent recanalization.Observation indicators: Primary outcome: clinical success rate; Secondary outcomes: technical success rate; stent patency rate; incidence of adverse events; perioperative indicators.This is a retrospective observational non-randomized study.Baseline balance was achieved only at the statistical level, and selection bias may still exist.

Compared with the control group, the operation time of the combined group was longer and the intraoperative blood loss was lower, and the difference was statistically significant (P<0.05); there were no statistically significant differences in gender, age, body mass index, jaundice duration, Child-Pugh classification, obstruction site, surgical success rate, hospital stay, tumor type, stent diameter, and stent length between the two groups (P>0.05); Compared with the control group, the biliary tract patency rate at 3 months (94%) and 6 months (86%) after surgery in the combined group increased, and the difference was statistically significant (P<0.05), while the patency rate at 1 month after surgery was not statistically significant between the two groups (P>0.05); The complication rate of the control group was 16%, and that of the combined group was 4%, and the difference was statistically significant (P<0.05); The total effective rate of treatment in the control group was 76%, and that in the combined group was 92%, and the difference was statistically significant (P<0.05).

This study only reflects the true clinical effect differences between the two complete clinical intervention schemes.Due to the confounding effect of the dual intervention of biliary endoscopy and radiofrequency ablation, it cannot be determined that the therapeutic advantage is solely caused by radiofrequency ablation alone.The combined radiofrequency ablation and biliary endoscopy direct vision scheme performs better in increasing the overall clinical effectiveness rate and prolonging the biliary patency time, and does not increase the risk of complications, and thus has clinical reference value.

To explore the associations between lesion severity and lesion location, prior treatment history of achalasia (AC) in patients with AC combined with esophageal neoplastic lesions, and provide evidence for risk stratification and endoscopic surveillance of AC patients.

A single-center retrospective study enrolled patients diagnosed with AC combined with esophageal neoplastic lesions hospitalized in Chinese PLA General Hospital from January 2014 to December 2023.Patients were divided into prior AC treatment group and non-prior AC treatment group based on whether AC intervention was performed before lesion detection.Esophageal lesions were dichotomized into low-grade lesions (low-grade intraepithelial neoplasia, LGIN) and high-grade/invasive lesions(high-grade intraepithelial neoplasia HGIN/Tis+ invasive esophageal cancer).Fisher′s exact test was used to compare categorical variables; independent sampletest or Mann-Whitney U test was adopted for measurement data according to data distribution.Two-sided P<0.05 indicated exploratory statistically significant difference.

A total of 18 eligible patients were enrolled, including 5 cases of LGIN, 2 cases of HGIN/Tis, and 11 cases of invasive esophageal cancer. Nine patients had received AC intervention (prior AC treatment group), and 9 had no AC treatment history (non-prior AC treatment group).Lesions in prior AC treatment group were predominantly located in the lower esophagus (77.8%), including 5 LGIN and 4 HGIN/Tis or invasive cancer.Lesions in non-prior AC treatment group mostly occurred in the middle esophagus (66.7%), all presented as HGIN/Tis or invasive esophageal cancer with an esophageal dilatation rate of 88.9%.Distribution differences between groups: lesion location Fisher P=0.036, prior AC treatment Fisher P=0.029, esophageal dilatation Fisher P=0.099.No obvious distribution difference was observed between dysphagia duration and lesion severity.

Exploratory distribution differences exist between lesion severity and lesion location, prior AC treatment history in AC patients with esophageal neoplastic lesions. Lesions in lower esophagus or patients with AC intervention history are mostly low-grade intraepithelial neoplasia, while patients with middle esophageal lesions and without AC treatment are prone to high-grade and invasive lesions.Long-term endoscopic surveillance is recommended for AC patients with long disease duration, middle esophageal mucosal abnormalities, advanced age, male gender and alcohol drinking history.

To explore the application value of imaging examinations and digestive endoscopy in the diagnosis and treatment of gastrointestinal foreign body in children, especially in complicated cases with unclear history and protracted course.

Two cases of esophageal stenosis in children with dysphagia and no clear history of foreign body ingestion were reported, and the diagnosis and treatment process was shared.The specific application of imaging and endoscopic techniques in diagnosis and treatment was analyzed, providing ideas for clinical diagnosis and treatment.

Both cases were ultimately diagnosed with esophageal foreign bodies via electronic gastroscopy, which revealed impacted foreign bodies at the stricture sites (the parents later recalled histories of foreign body ingestion over 6 months and 2 years prior, respectively).Both children underwent endoscopic foreign body removal in the operating room.Intraoperatively, hook knives were used for gradual radial incisions, and snare devices were employed to piecemeal resect locally hyperplastic granulation tissue.After dissection and exposure of the foreign bodies, they were successfully removed using foreign body forceps combined with guidewires.In Case 1, esophageal perforation and pneumothorax were detected during the procedure, and closed thoracic drainage with placement of a covered retrievable esophageal stent was performed for perforation sealing.In Case 2, esophageal perforation and ulceration were complicated, and a nasogastric feeding tube along with an esophageal drainage tube was inserted. Postoperatively, both patients received regular endoscopic treatment for secondary esophageal strictures.To date, both patients are able to eat normally via the oral route and show satisfactory growth and development.

Esophageal foreign body impaction is a common cause of acquired esophageal stenosis in children.For cases with unclear history of foreign body ingestion, long time of impaction, and high risk of complications, attention should be paid to the detailed evaluation of imaging and digestive endoscopy to obtain key diagnostic clues and assist in making the optimal treatment decision.Multidisciplinary preoperative evaluation and precise endoscopic operation during surgery can help effectively deal with complications and avoid unnecessary surgical operations.At the same time, public health education should be strengthened to raise awareness of gastrointestinal foreign bodies in children and promote early diagnosis and treatment.

To systematically summarize the risk factors for hypoxemia and related adverse events in older patients undergoing gastrointestinal endoscopy under sedation or anesthesia, and to provide evidence for preprocedural risk stratification and perioperative prevention.

A systematic review was conducted in accordance with PRISMA 2020. PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and major Chinese databases were searched from inception to August 23, 2026. Observational studies reporting extractable data on risk factors were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analysis was performed with RevMan 5.3.

Ten studies involving a total of 8, 284 participants were included, with NOS scores ranging from 7 to 9. Pooled analyses showed that advanced age (OR=2.99), higher body mass index (BMI; OR=3.54), hypertension (OR=1.73), a history of smoking (OR=2.58), and a history of alcohol consumption (OR=1.41) were associated with an increased risk of the outcome. Pulmonary disease/chronic obstructive pulmonary disease (COPD; RR=2.41), a history of snoring (OR=3.53), and higher American Society of Anesthesiologists (ASA) physical status (OR=3.11) were also significantly associated with increased risk. Sex (OR=1.17, P=0.07) and diabetes mellitus (random-effects OR=1.30, P=0.16) were not significantly associated with the outcome.

Current evidence suggests that advanced age, higher BMI, a history of snoring, hypertension, smoking, alcohol consumption, pulmonary disease/COPD, and higher ASA physical status may increase the risk of hypoxemia or related adverse events during gastrointestinal endoscopy under sedation or anesthesia in older patients. These factors should be considered in preprocedural assessment and individualized oxygenation and airway-management strategies. Because some included studies used composite adverse-event outcomes and several risk factors showed substantial heterogeneity, these findings require further confirmation in high-quality prospective studies.

Acute biliary pancreatitis (ABP) is a major type of acute pancreatitis in China, with high incidence and rapid progression.Improper management can lead to severe complications. Endoscopic retrograde cholangiopancreatography (ERCP) is a primary therapeutic approach for ABP.It enables the management of intrahepatic and extrahepatic bile duct stones, thereby reducing the occurrence of ABP and improving patient outcomes.This review elaborates on the current application of ERCP in ABP, including the indications, optimal timing for intervention, and associated complications.

To explore the clinical efficacy of endoscopic injection of autologous platelet-rich plasma （PRP） in the treatment of chronic sinus tract，analyze the factors affecting sinus tract healing.

A retrospective analysis was performed on the clinical data of 93 patients with chronic sinus tract admitted to the Department of Burns，Plastic Surgery and Wound Repair，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine，from June 2023 to June 2025，including 42 males and 51 females，with a mean age of （42.2±16.1） years. All patients were divided into the PRP group （43 cases） and the control group （50 cases） according to treatment regimens. Patients in both groups underwent endoscopic sinus tract exploration and debridement. In the PRP group，1-10 mL of PRP was injected into the sinus tract base and wall after debridement based on the size and depth of the sinus tract. The sinus tract healing rate，length of stay and treatment duration were compared between the two groups，and subgroup stratified analysis was conducted according to sinus tract types. Univariate and multivariate Logistic regression analyses were used to identify the influencing factors on sinus tract healing，and the interaction effect between PRP treatment and sinus tract type was tested. Modified Poisson regression was applied for sensitivity analysis. The Enter method was adopted to construct the regression model. The calibration degree and discrimination degree of the model were evaluated by the Hosmer-Lemeshow test and the area under the receiver operating characteristic curve （AUC），respectively.

The sinus tract healing rate of the PRP group was higher than that of the control group （90.7% vs. 58.0%，χ²=12.58，P<0.001）. Subgroup analysis showed that patients with refractory sinus tract derived a relatively greater benifit from PRP treatment （78.6% vs. 5.3%，χ²=18.72，P<0.001）. Univariate analysis indicated that PRP treatment，maximum sinus tract depth，disease course，bacterial detection，sinus tract type and anatomical site were correlated with sinus tract healing （P values all<0.05）. Multivariate Logistic regression analysis revealed that PRP treatment was an independent protective factor for sinus tract healing （OR=15.32，95%CI： 2.91-80.68，P=0.001）. Increased maximum sinus tract depth （OR=0.65，95%CI： 0.49-0.86，P=0.002） and prolonged disease course （OR=0.90，95%CI： 0.82-0.98，P=0.012） were independent risk factors for sinus tract healing. No significant interaction was observed between PRP treatment and sinus tract type （P=0.838）. The AUC of the model was 0.882 （95%CI： 0.795-0.969），and the Hosmer-Lemeshow test verified good calibration of the model （P=0.098）. Modified Poisson regression confirmed the robustness of the conclusions.

Endoscopic PRP treatment can improve the healing rate of chronic sinus tract and serves as an independent protective factor for sinus tract healing. Increased sinus tract depth and prolonged disease course are independent risk factors for sinus tract healing. PRP exhibits a relatively greater efficacy in the treatment of refractory sinus tract，which is recommended as a priority therapy for this subtype.

To investigate the differences between a deep learning model and manual measurement in assessing postoperative parameters of intertrochanteric femoral fractures after intramedullary nail fixation.

A retrospective study was conducted, including 150 patients with intertrochanteric femoral fractures who met the inclusion criteria and underwent unilateral intramedullary nail fixation at the Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, from January to December 2024. Among them, 50 patients each in the proximal femoral nail antirotation (PFNA), Gamma-type intramedullary nail, and InterTan intramedullary nails groups. There were 81 males and 69 females, aged (64.1±17.3) years; 79 cases were on the left side and 71 on the right. The deep learning model and manual method were used to measure the postoperative neck-shaft angle, tip-apex distance (TAD), and medial femoral cortex support, and the results were compared. Bland-Altman analysis was used to evaluate the agreement between the two measurement methods.

For TAD, there was no statistically significant difference between the deep learning model and manual measurement in all cases and each subgroup (P>0.05). The overall mean difference was (-0.21±5.29) mm, and Bland-Altman analysis showed good agreement. The overall Kappa value for the measurement of medial femoral cortical support was 0.716, with the best agreement in the PFNA group (Kappa=0.803), followed by the Gamma-type intramedullary nail group and InterTan intramedullary nail group (0.675 and 0.651, respectively). The overall neck-shaft angle measured by the deep learning model was higher than that measured by the manual method, especially in the InterTan intramedullary nail group, where the difference was statistically significant (P<0.001), while no statistically significant difference was found in the PFNA group or the Gamma-type intramedullary nail group (P>0.05).

The deep learning model showed good agreement with the manual method in measuring TAD and medial femoral cortical support, as well as postoperative neck-shaft angle in the PFNA and Gamma-type intramedullary nail fixation. However, there was a systematic bias in the measurement of postoperative neck-shaft angle in the InterTan intramedullary nail fixation, suggesting that the model still needs further optimization for complex dual-screw configurations.

To systematically evaluate the efficacy and safety of nebulized heparin in patients with inhalation injury.

A systematic search was conducted in PubMed，Embase，the Cochrane Library，the China National Knowledge Infrastructure （CNKI），and the Wanfang Data Knowledge Service Platform for literatures about the use of nebulized heparin in patients with inhalation injury published from database inception to September 1，2025. Two reviewers independently conducted literature screening，data extraction，and risk of bias assessment. Meta-analysis was performed using RevMan 5.4 software.

A total of 11 studies involving 710 patients with inhalation injury were included. Meta-analysis results showed that，compared with conventional treatment，nebulized heparin reduced 28-day mortality （RR=0.74，95%CI：0.59 to 0.92，P=0.008），shortened the duration of mechanical ventilation （MD=-3.86，95%CI： -5.71 to -2.01，P<0.001）. The pooled result of only 2 studies （238 patients） showed that nebulized heparin could improve the oxygenation index （MD=18.07，95%CI： 12.51 to 23.64，P<0.001）. In terms of safety，there was no statistically significant difference in the incidence of pneumonia between patients receiving nebulized heparin therapy and those receiving conventional treatment （RR=0.95，95%CI： 0.68 to 1.32，P=0.76）. The pooled result of only 3 studies （223 patients） showed no statistically significant difference in the incidence of bleeding events between patients treated with the two methods （RR=1.02，95%CI： 0.82 to 1.27，P=0.87）.

Early initiation of a combination regimen centered on nebulized heparin in patients with inhalation injury may help reduce 28-day mortality and shorten the duration of mechanical ventilation, without increasing the risk of pneumonia，indicating a favorable safety profile.

To investigate the predictive value of baseline blood lactate, lactate clearance, and lactate-to-albumin ratio for 28-day all-cause mortality in patients with necrotizing fasciitis (NF) admitted to the intensive care unit (ICU), and to inform early clinical risk stratification and dynamic monitoring.

Data of 156 patients with NF were extracted from the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ) database and retrospectively analyzed. The associations of baseline blood lactate, lactate clearance, and lactate-to-albumin ratio with 28-day all-cause mortality were evaluated. Univariate and multivariate logistic regression, receiver operating characteristic (ROC) curves, likelihood ratio tests, and sensitivity analyses were used to compare the predictive performance of each indicator.

The initial lactate level measured within 24 hours of ICU admission was associated with 28-day all-cause mortality in patients with NF (OR=1.67, 95%CI: 1.39-2.10, P<0.001). After adjusting for lactate, lactate clearance ≥10% was an independent protective factor for 28-day all-cause mortality (OR=0.23, 95%CI: 0.05-0.77, P=0.028). Models constructed using cutoff values of 10%, 15%, and 20% for lactate clearance showed similar assessment efficacy, the area under the curve (AUC) values were 0.826 (95%CI: 0.714-0.937), 0.824 (95%CI: 0.711-0.938), 0.817 (95%CI: 0.701-0.932), respectively, with no statistically significant differences (all P values were >0.05). Likelihood ratio tests indicated that combining lactate and lactate clearance significantly improved model goodness-of-fit (χ²=5.753, P=0.016). The lactate-to-albumin ratio was an independent predictor in the multiple imputation model (OR=2.92, 95%CI: 1.03-9.14, P=0.049), and a consistent trend was observed in the complete case analysis, although it did not reach statistical significance (OR=2.31, 95%CI: 0.81-7.52, P=0.128). After 1∶1 propensity-score matching, 36 well-balanced patients were obtained. Upon further adjusting for the Charlson comorbidity index, both baseline lactate (OR=1.39, 95%CI: 1.10-1.91, P=0.017) and lactate-to-albumin ratio (OR=2.05, 95%CI: 1.23-4.21, P=0.020) remained independent risk factors for 28-day all-cause mortality in patients with NF, and the lactate-to-albumin ratio showed a stronger association.

The initial lactate level measured within 24 hours of ICU admission serves as a core prognostic indicator for 28-day all-cause mortality in patients with NF. The lactate clearance dynamically reflects treatment response, while the lactate-to-albumin ratio offers additional predictive value.

To investigate the effect of carrier-free self-assembled berberine-curcumin nanoparticles （Ber-Cur NPs） on chronic wound healing in rats.

Ber-Cur NPs were prepared using the antisolvent precipitation method. The physicochemical characteristics of Ber-Cur NPs were evaluated by scanning electron microscopy，transmission electron microscopy，energy-dispersive spectroscopy，dynamic light scattering，Fourier transform infrared spectroscopy，and confocal laser scanning microscopy. The in vitro antioxidant activity of Ber-Cur NPs were assessed using 2，2'-azino-bis （3-ethylbenzothiazoline-6-sulfonic acid） （ABTS），1，1-diphenyl-2-picrylhydrazyl （DPPH），and 2-phenyl-4，4，5，5-tetramethylimidazoline-1-oxyl 3-oxide （PTIO） free radical scavenging assays. Intracellular reactive oxygen species （ROS） scavenging ability was detected using the 2'，7'-dichlorodihydrofluorescein diacetate （DCFH-DA） fluorescent probe. Cell compatibility and the protective effect of Ber-Cur NPs against hydrogen peroxide （H₂O₂） -induced oxidative stress injury were evaluated using the methyl thiazolyl tetrazolium （MTT） assay. Twenty-five Sprague-Dawley rats were established chronic wound models on the back and were randomly divided into the control group，model group，and low，medium，and high dose Ber-Cur NPs groups. Wounds in each group were treated with daily dressing changes. The control and model groups received normal saline，while the low，medium，and high dose Ber-Cur NPs groups received 0.1，0.5，and 2.0 mg/mL Ber-Cur NPs，respectively. Wound images were obtained on days 7 and 15 after treatment，and the wound healing rate was calculated. On day 15 after treatment，wound tissues were collected to determine superoxide dismutase （SOD） activity and malondialdehyde （MDA） levels. Interleukin-6 （IL-6） expression was detected by immunohistochemistry，and CD31 expression was detected by immunofluorescence staining. The biosafety of Ber-Cur NPs were evaluated using the MTT assay，hematoxylin and eosin （HE） staining of major organs，and hematological analysis.

Ber-Cur NPs exhibited a quasi-spherical morphology，with a particle size of （44.25±11.73） nm，a hydration particle size of 108.10 nm，and a zeta potential of +7.6 mV. Fourier-transform infrared spectroscopy indicated that hydrogen bonding，π-π stacking，and electrostatic interactions between Ber and Cur may jointly drive the self-assembly process. Dual-channel fluorescence localization showed a high degree of overlap between the fluorescence signals of Ber and Cur in the nanoparticles，suggesting that both components participated in the formation of the self-assembled nanoparticles. In vitro experiments showed that Ber-Cur NPs had favorable scavenging effects on ABTS，DPPH，and PTIO free radicals，as well as intracellular ROS，and improved the survival rate of cells subjected to oxidative stress injury. MTT results showed that the cell survival rates of Ber-Cur NPs treatment were above 80% within the concentration range of 0–200 μg/mL. After high dose Ber-Cur NPs treatment，no significant abnormalities were observed on the liver and kidney function indicators or the HE staining of major organs in the rats. Compared with the model group，Ber-Cur NPs treatment increased the wound healing rate，enhanced SOD activity and CD31 expression，and reduced MDA level and IL-6 expression in wound tissues.

Ber-Cur NPs can improve chronic wound healing in rats by reducing oxidative stress，inhibiting inflammatory responses，and promoting angiogenesis.

To investigate the ameliorative effects of selenium nanoparticles (Se NPs) on induced myoblast injury and inhibition of myogenic differentiation.

Using hyaluronic acid (HA) as a stabilizing component，Se NPs were synthesized by reducing sodium selenite with ascorbic acid. The physicochemical properties of Se NPs were characterized by transmission electron microscopy，nanoparticle tracking analysis，Zeta potential measurement，and ultraviolet-visible absorption spectroscopy. The in vitro antioxidant capacity was assessed using the 3，3'，5，5'-tetramethylbenzidine chromogenic system and the 2，2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) radical cation (ABTS^•+) scavenging assay. C2C12 myoblasts were treated with lipopolysaccharide （LPS） to simulate the effects of the inflammatory microenvironment formed by skeletal muscle aging or injury on myoblasts, and a hydrogen peroxide-induced oxidative damage model was also used. The effects of Se NPs on cell viability，apoptosis，reactive oxygen species (ROS)/reduced glutathione (GSH) levels，mitochondrial membrane potential，and the expression of inflammation- and myogenic differentiation-related genes were examined. Myosin heavy chain （MHC） expression，myotube formation，and fusion index were also evaluated.

Se NPs were spherical and well-dispersed，with an average core diameter of （117.96±14.27） nm，an average hydrodynamic diameter of （136.71±18.48） nm，and an average Zeta potential of （-25.99±7.60） mV，showing a characteristic absorption peak at approximately 290 nm. In vitro antioxidant experiments demonstrated that the antioxidant capacity of Se NPs increased with increasing manner. Se NPs exhibited good colloidal stability and cytocompatibility. Treatment with 100-500 ng/mL Se NPs attenuated LPS-induced decreases in cell viability and increases in apoptosis. After Se NPs intervention，LPS-induced ROS accumulation was reduced，GSH levels were increased，the expression of tumor necrosis factor-α, inducible nitric oxide synthase, and interleukin-1β was downregulated，and glutathione peroxidase 1 expression was restored. Concurrently，MHC-positive myotube formation was enhanced，and myotube length，diameter，and fusion index were increased，the expression of muscle atrophy-related genes Atrogin-1 and muscle RING finger protein 1 was downregulated，and the expression of myogenic regulatory factor myogenic differentiation 1 and myogenin was upregulated.

HA-stabilized Se NPs possess favorable antioxidant capacity and can alleviate C2C12 cell injury and improve suppressed myogenic differentiation by mitigating LPS-induced oxidative stress and inflammatory responses.