To clarify the correlation between the triglyceride-glucose (TyG) index and endothelial dysfunction in an elderly community-based population, in order to provide new insights for the early prediction of cardiovascular diseases.

A cross-sectional study was conducted, enrolling 1648 elderly individuals with no prior history of cardiovascular disease. General demographic data, past medical history, physical examination findings, and laboratory test indicators were collected. The TyG index was calculated, and endothelial function was evaluated using the Reactive Hyperemia Index (RHI). Participants were divided into three groups (low, medium, and high) according to the tertiles of the TyG index. Pearson correlation analysis was performed to explore the correlation between the TyG index and clinical indicators. Logistic regression models were used to analyze the association between the TyG index and endothelial dysfunction, and stratified interaction tests were conducted to examine potential interaction effects.

The TyG index in the endothelial dysfunction group was significantly higher than that of the normal group (P＜0.05). With the increase of the TyG index, the detection rates of endothelial dysfunction were 41.0%, 45.4%, and 48.4%, respectively (χ²=6.117, P＜0.05). Pearson correlation analysis showed that the TyG index was positively correlated with body mass index, total cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, and diastolic blood pressure (all P＜0.05), and negatively correlated with high-density lipoprotein cholesterol and RHI (both P＜0.05). After adjusting for confounding factors, the risk of endothelial dysfunction in the high TyG index group was 1.43 times that in the low TyG index group (95% confidence interval: 1.09~1.87, P＜0.05). Stratified analysis showed no interaction between the TyG index and hypertension, diabetes, or hyperlipidemia in terms of their effects on endothelial dysfunction (all P＞0.05).

An elevated TyG index is significantly associated with endothelial dysfunction in elderly community populations. The TyG index can serve as a simple indicator for evaluating endothelial function and predicting the risk of cardiovascular diseases, providing a reference for the early prevention of cardiovascular diseases.

To evaluate the clinical efficacy and application value of ultrasound-guided two-step terminal needle-free puncture in the treatment of upper urinary tract stones with percutaneous nephropathy (PCNL) for patients with upper urinary tract stones presenting with no or minimal hydronephrosis.

Fifty-one patients with a large amount of hydronephrosis (renal pelvis hydronephrosis≥2.5 cm) who underwent percutaneous nephropathy (PCNL) for upper urinary tract stones at Huai'an Hospital Affiliated to Yangzhou University from March 2022 to December 2024 were randomly divided into an observation group and a control group. Fifty patients with no or minimal hydronephrosis (renal pelvis hydronephrosis＜1 cm) were also divided into an observation group and a control group. The observation groups underwent ultrasound-guided two-step terminal needle-free puncture, while the control groups underwent ultrasound-guided traditional one-step puncture. The following parameters were analyzed and compared between the 2 groups: puncture time (from skin puncture to effluent from the needle sheath), total number of punctures, one-puncture success rate, tract dilation success rate, blood loss (quantified by hemoglobin reduction), immediate postoperative hemoglobin reduction, postoperative complications, stone clearance rate, and other indicators.

In the management of upper urinary tract stones by PCNL, we compared ultrasound-guided two-step terminal needle-free puncture and traditional one-step puncture. The evaluated metrics included puncture duration (from skin puncture to effluent from the needle sheath), total number of punctures, one-puncture success rate, tract dilation success rate, blood loss (quantified by hemoglobin reduction), immediate postoperative hemoglobin reduction, postoperative complications, and stone clearance rate. It was found that in cases with significant hydronephrosis, there were no statistical differences in these parameters between the two groups. However, in cases without hydronephrosis or with minimal hydronephrosis, the ultrasound-guided two-step terminal needle-free puncture group demonstrated significantly shorter puncture duration, fewer punctures, higher one-puncture success rate, higher tract dilation success rate, less inoperative blood loss, less immediate postoperative hemoglobin reduction, and less postoperative complications.

Ultrasound-guided two-step terminal needle-free puncture is safe, feasible, and simple to operate, shortening the learning curve of PCNL. These findings support the clinical adoption of this technique, particularly for PCNL in cases without hydronephrosis or with minimal hydronephrosis.

To assess the predictive value of a nomogram model constructed based on serum electrolytes levels and related parameters for extensive-stage small cell lung cancer (SCLC).

A retrospective analysis was conducted on the baseline data, serum electrolytes levels, and related parameters of 231 SCLC patients initially diagnosed at the First Hospital of Lanzhou University between September 2016 and August 2019. Receiver operating characteristic (ROC) curve analysis was performed to screen indicators with diagnostic value. Binary logistic regression analysis was utilized to identify independent risk factors for extensive-stage SCLC, and a nomogram model was constructed. The model was evaluated using calibration curve and decision curve analyses.

Seven predictive indicators were identified by ROC curve analysis: lactate dehydrogenase (LDH), lymphocytes, serum magnesium (Mg²⁺), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), lactate dehydrogenase-to-lymphocyte ratio (LDHLR), and mean platelet volume-to-lymphocyte ratio (MPVLR). Univariate logistic regression analysis showed that sex, LDH, lymphocytes, serum Mg²⁺, LDHLR, and MPVLR were significantly associated with the disease stage (limited-stage vs extensive-stage) at initial diagnosis in SCLC. After multivariate analysis adjustment, serum Mg²⁺ and sex were identified as independent predictors of limited-stage/extensive-stage classification in initially diagnosed SCLC patients. The fusion model constructed based on these factors yielded an area under the curve of 0.654 (95% confidence interval: 0.580–0.727), demonstrating a sensitivity of 69.2% and specificity of 59.1%. The calibration curve indicated good consistency between the model-predicted probability of extensive-stage SCLC and imaging examination results. Decision curve analysis further demonstrated the model's high clinical utility.

Sex and serum magnesium level at admission are independent predictive factors for extensive-stage disease in initially diagnosed SCLC patients.

To evaluate the predictive value of red cell distribution width (RDW) for nocturnal hypertension in patients with hypertension.

This study enrolled 293 hypertensive patients who were admitted to the Department of Cardiology, The Third Hospital of Changsha between January 2020 and December 2022, and who underwent measurements of homocysteine (Hcy), N-terminal pro-brain natriuretic peptide (NT-proBNP), and 24-hour ambulatory blood pressure monitoring. Based on ambulatory blood pressure results, the patients were divided into a non-nocturnal hypertension group (n=100) and a nocturnal hypertension group (n=193). The association between RDW and nocturnal hypertension was assessed using receiver operating characteristic (ROC) curve analysis and multivariate logistic regression.

The prevalence of nocturnal hypertension was 65.9%. Significant differences were observed between the two groups in terms of RDW, prevalence of type 2 diabetes mellitus, chronic kidney disease, triglyceride levels, and NT-proBNP levels (all P＜0.05). The area under the ROC curve of RDW for predicting nocturnal hypertension was 0.727 (95% confidence interval [CI]: 0.665–0.788). Using the Youden index, the optimal RDW cut-off value was determined to be 13.25%. At this threshold, the sensitivity of RDW for predicting nocturnal hypertension was 69.9%, and the specificity was 77.0%. After adjusting for potential confounders, multivariate logistic regression analysis confirmed that elevated RDW ≥13.25% was independently associated with nocturnal hypertension (odds ratio=3.280, 95%CI: 1.676~6.421, P＜0.001).

RDW is closely associaled with nocturnal hypertension and may be a potential biomarker for predicting this codition.

To evaluate the therapeutic effects of ursodeoxycholic acid plus rosuvastatin on patients with fatty liver and hyperlipidemia.

A total of 90 patients were enrolled from October 2021 to September 2024 and randomly allocated into three groups (A, B, and C) using the random number table method. All groups received standard treatment. In addition, Group A received ursodeoxycholic acid, Group B received rosuvastatin, and Group C received a combination of ursodeoxycholic acid and rosuvastatin. Comparative analyses were conducted on liver function indices, lipid profile parameters, symptom severity scores, and clinical efficacy rates across the three groups.

The levels of GGT, ALT, AST, TG, TC, and LDL-C in group C were lower than those in groups A and B, and the level of HDL-C was higher than that in groups A and B (P＜0.05). The swelling, discomfort, fatigue, and poor appetite scores in group C were lower than those in groups A and B (P＜0.05). The clinical efficacy in group C was higher than that in groups A and B (P＜0.05).

Compared to monotherapy, combination therapy can better improve liver function indicators, blood lipid indicators, and clinical symptoms in patients with fatty liver and hyperlipidemia. Hence, this strategy holds significant clinical promise and merits broader adoption.

To investigate whether cannabidiol (CBD) has an antagonistic effect on caffeine (CAF)-induced sleep inhibition in mice.

A pentobarbital sodium synergistic hypnosis test was used to observe the effects of different doses of CAF on sleep duration in normal mice and to evaluate the regulatory effect of CBD on CAF-induced sleep inhibition. A spontaneous activity video analysis system was employed to assess the effects of CAF and CBD on autonomous locomotor behavior in mice. Serum adenosine levels were measured using a mouse adenosine detection kit (Enzyme-Linked Immunosorbent Assay, ELISA), and hypothalamic glutamate content was detected by High Performance Liquid Chromatography (HPLC).

CAF (40 mg/kg) significantly prolonged sleep latency (P＜0.001) and shortened sleep duration (P＜0.01) in mice, whereas CBD (10 mg/kg) significantly shortened sleep latency (P＜0.001) and prolonged sleep duration (P＜0.001). In the CAF (10 mg/kg) group, the total distance traveled by mice increased (P＜0.05), the average speed accelerated (P＜0.05), and the time spent in the central area prolonged (P＜0.05). After CBD (10 mg/kg) intervention, the total distance traveled decreased (P＜0.01), the average speed slowed (P＜0.01), and the time spent in the central area shortened (P＜0.001). The hypothalamic glutamate content increased (P＜0.001) and serum adenosine levels also significantly rose (P＜0.01) in the CAF (40 mg/kg) group. CBD (10 mg/kg) treatment significantly reduced both glutamate (P＜0.001) and adenosine (P＜0.001) levels.

CAF disrupts normal sleep in mice and induces abnormalities in glutamate and adenosine levels; CBD counteracts these CAF-induced sleep disturbances and normalizes the neurochemical alterations.

Cancer-associated dermatomyositis (CADM) is a paraneoplastic syndrome highly associated with tumors, and its early identification is crucial for the diagnosis and treatment of malignant tumors. This article systematically reviews the latest progress in the pathogenesis and clinical management of CADM. At the mechanistic level, it focuses on the central role of tumor antigen-driven autoimmune responses, along with the synergistic effects of inflammatory factor cascades, genetic susceptibility, and "inflammatory aging" in the tumor microenvironment. From a clinical perspective, a risk-stratified screening strategy based on antibody profiles and clinical characteristics is proposed. The therapeutic efficacy and safety of immunosuppressants and biologics in patients with concurrent tumors are discussed, as well as the impact of anti-tumor treatment on the improvement of dermatomyositis symptoms. Furthermore, this article highlights the significance of the multidisciplinary team model in disease management, examines prognostic influencing factors, identifies current controversies such as the cost-effectiveness of screening and the safety of targeted therapy, and offers an evidence-based foundation to inform clinical practice.

In recent years, multimodal ultrasound has become an important tool for the diagnosis and treatment of arthritis due to its advantages of real-time dynamic imaging, non-radiation, and multi-joint synchronous examination. The integration of artificial intelligence and musculoskeletal ultrasound effectively solves the limitations of traditional ultrasound in terms of operational variability, image interpretation subjectivity, and data analysis time, significantly improving diagnostic efficiency and accuracy. Bacterial arthritis and non-bacterial arthritis, as two major categories of arthritis, are different in incidence rate, treatment, and prognosis. This review aims to explore the research progress and clinical potential of multimodal ultrasound and artificial intelligence in distinguishing between bacterial arthritis and non-bacterial arthritis, in order to provide a reference for improving diagnostic accuracy and guiding treatment decisions.

Sepsis can lead to multiple systemic complications, with myocardial injury being one of the most frequent and severe complications, and serving as a crucial prognostic marker in septic patients. Ferroptosis, a recently identified form of programmed cell death, has been shown to participate in the pathogenesis of septic cardiomyopathy (SCM). As an inflammatory mediator, 5-hydroxytryptamine (5-HT) has been demonstrated to promote sepsis progression, yet its precise mechanism in mediating cardiac injury via ferroptosis remains incompletely understood. This review systematically summarizes the mechanistic role of 5-HT in SCM, aiming to provide novel therapeutic targets and clinical strategies.

In light of the significant threat posed by Disease X to global public health and the shortcomings of traditional epidemic management models, this study examines precise prevention and control strategies along with implementation pathways for Disease X in large general hospitals. Grounded in risk management and hospital resilience theories, this study focuses on the smallest medical treatment unit as the entry point. It proposes a personalized hierarchical zoning management model for infection prevention and control based on the principle of "one department, one strategy", clarifies the rationale for initiating hierarchical containment, defines the criteria for designating and managing emergency risk zones, specifies operational protocols for infection prevention and control, and formulates strategies for personnel deployment. By developing a "hospital campus-department-ward" tri-zone prevention and control network and a "red-yellow-green" three-tier risk management model, supplemented by visual guidance in the form of "textual specifications + process diagrams", this study achieves precise and differentiated disease prevention and control. The framework offers a practical and viable implementation pathway for the precise prevention and control of Disease X in large general hospitals, providing valuable insights for advancing precise prevention and control of infectious diseases.

Doctor-patient communication skills have become one of the core competencies in medical students' clinical practice, particularly in departments like obstetrics and gynecology, where privacy and ethical sensitivities are prominent. Effective communication is crucial for treatment outcomes and doctor-patient trust. However, in China's medical education, fragmented curriculum design, insufficient practical training, and weak emergency response capabilities remain significant issues. These issues are particularly pronounced in obstetric and gynecological training and require urgent solutions. By analyzing the strengths and weaknesses of mainstream teaching methods such as PBL, TSP, PDCA, and narrative medicine, this study reveals three structural contradictions in the current teaching model: fragmented competency cultivation, segmented stages, and disciplinary barriers. Based on this finding, we propose an innovative integrated and discipline-blended curriculum system. The framework is structured along two dimensions: temporally, it adopts a stepwise training approach that progresses from simulated consultations in the early undergraduate years to supervised clinical practice in the senior years; spatially, it integrates multidisciplinary knowledge from from fields such as traditional culture, psychology, ethics, and jurisprudence, thereby constructing a comprehensive framework encompassing medical technology, humanistic care, and ethical decision-making. This system, through its dual-axis (temporal and spatial) linkage, overcomes the fragmentation inherent in traditional teaching while mitigating the rigidity of single-approach training. It provides a systematic solution for cultivating new obstetricians and gynecologists with both professional skills and humanistic qualities.