The “National Health Commission of China：colorectal cancer diagnosis and treatment guidelines （2025 edition） ” builds upon evidence‑based medicine, integrating international cutting‑edge advancements and Chinese clinical practices to deepen and expand previous versions. This article presents a standardized and streamlined version, retaining the core diagnostic and therapeutic framework while highlighting newly added content such as “surgical treatment of anal canal cancer” and “new technologies and advancements in diagnosis and treatment.” It systematically summarizes the key points of five major sections: surgery, internal medicine, radiotherapy, imaging, and pathology, facilitating clinicians′ rapid grasp of the essence of the guidelines and promoting the standardization, precision, and homogenization of colorectal cancer diagnosis and treatment..

To investigate the role of ultrasound-guided total visual access establishment for percutaneous nephrolithotomy (PCNL) skill acquisition by junior surgeons and to establish a novel auxiliary learning method for PCNL.

A retrospective analysis was conducted on the surgical outcomes of PCNL performed by 10 novice urologists using ultrasound-guided conventional access establishment (CAE) and total visual access establishment (VAE) from January 2022 to December 2024, respectively. Items related to PCNL learning such as access establishment success, access establishment time, operation time, hemoglobin decrease, surgery success rate at 1 month postoperatively was evaluated.

One hundred and ninety cases were included. In the CAE group (100 cases), 18 cases failed to establish percutaneous renal access, while 6 failed in the VAE group (90 cases). The 24 cases with failed access establishment in both groups were excluded. The access establishment success rate in the CAE group was significantly lower than that of the VAE group [82% (82/100) vs 93.3% (84/90); P＜0.05]. Access establishment time in the CAE group was significantly longer than that of the VAE group (7.2±1.4 min vs 4.9±1.0 min, P＜0.05). Operation time in the CAE group was significantly longer than that of the VAE group (60.6±56.8 min vs 43.2±10.0 min, P＜0.05). Hemoglobin decrease on the first day after surgery in the CAE group was significantly higher than that of the VAE group (13.1±4.5 g/L vs 9.1±1.4 g/L, P＜0.05). The rate of postoperative Clavien-Dindo Ⅲ/Ⅳ complications in the CAE group was significantly higher than that of the VAE group [6.1% (5/82) vs 0% (0/90), P＜0.05].

Ultrasound-guided total visual access establishment may improve PCNL success rate and safety for novice urologists, establishing a promising new learning aid for beginners.

To evaluate the clinical efficacy of transpercutaneous elongated needle acupuncture combined with pelvic floor magnetic stimulation in the treatment of post-stroke urinary retention.

A single-center controlled clinical trial was conducted, in which 140 patients with stroke-induced urinary retention were enrolled and divided into an observation group and a control group, each with 70 participants. The control group received transpercutaneous elongated needle acupuncture therapy alone, while the observation group received transpercutaneous elongated needle acupuncture therapy combined with pelvic floor magnet stimulation. All treatments were administered once daily for 5 consecutive days per week over 4 weeks. Efficacy was evaluated using urinary diaries, bladder pressure measurements (including bladder capacity, residual urine volume, and filling phase bladder pressure), quality of life (QOL) assessments, and adverse reaction incidence rates (urinary tract infections, hydronephrosis, and ureteral dilation) before and after treatment.

After four weeks of treatment, both groups showed significant improvements in 24-hour urinary frequency and single-micturition volume compared to baseline (P＜0.05), with the observation group exhibiting greater improvement than the control group (P＜0.001). Bladder capacity and filling-phase bladder pressure significantly increased, while residual urine volume significantly decreased in both groups (P＜0.001), with superior improvement noted in the observation group (P＜0.001). QOL scores significantly decreased in both groups (P＜0.001), and the observation group demonstrated significantly lower scores than the control group (P＜0.001). The incidence of urinary tract infection, hydronephrosis, and ureteral dilation was significantly lower in the observation group (P＜0.05). The overall treatment effectiveness was higher in the observation group (87.14% vs 72.86%, P＜0.05).

Percutaneous elongated needle acupuncture combined with pelvic floor magnetic stimulation significantly improves bladder function, relieves urinary retention symptoms, reduces adverse events, and enhances quality of life in patients with post-stroke urinary retention, demonstrating superior efficacy compared to elongated needle acupuncture alone.

The C-reactive protein-to-lymphocyte ratio (CLR) is a novel inflammatory biomarker. However, the role of CLR in osteoarthritis (OA) remains unclear. Therefore, this study aimed to investigate the association between CLR and OA in American adults and explore potential mediating mechanisms.

Participants with complete CLR and OA diagnosis information from the National Health and Nutrition Examination Survey (NHANES) 2017~2020 were included in this study. The CLR was classified according to quartiles, with quartile 1 (Q1) having the lowest ratio and quartile 4 (Q4) having the highest. Weighted logistic regression analysis was used to investigate the association between the CLR and OA. Subgroup analyses were performed to verify the robustness of these findings. Additionally, counterfactual framework-based mediation analysis was conducted to explore the potential mediating roles of body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), and triglyceride-glucose index (TyG) in the association between CLR and OA.

In total, 10319 participants aged ≥18 years were enrolled in the study, including 1640 OA patients and 8679 non-OA controls. There was a positive correlation between the CLR and OA. In the unadjusted model, compared with that in Q1, the osteoarthritis risk (odds ratio [OR]) for participants in Q2, Q3, and Q4 was 1.40 (95% confidence interval [CI]: 1.19~1.66), 1.74 (95%CI: 1.48~2.05), and 2.19 (95%CI: 1.87~2.57), respectively (all P＜0.001). In the fully adjusted model, the OR for Q4 was 1.33 (95% CI: 1.02~1.73, P=0.035). In continuous analyses, the fully adjusted OR for OA prevalence per ln-transformed increment in CLR was 1.06 (95%CI: 1.03~1.09, P＜0.001). Interaction tests showed that the effect of CLR on OA was significantly affected by total cholesterol (TC), history of cardiovascular disease (CVD), diabetes mellitus, and hypertension (P＜0.05). Mediation analysis revealed that BMI played a primary mediating role in the association between CLR and OA, with a mediation proportion of 56.24% (95%CI: 34.91~85.71), followed by hs-CRP (33.52%) and TyG (4.17%).

Using the NHANES data, this study revealed a positive correlation between the CLR and OA, with possible modifications by TC, history of CVD, diabetes mellitus, and hypertension. Mediation analysis results suggest that the effect of CLR on OA may be partially mediated by several factors, with BMI showing the most significant mediating role, indicating a potential "inflammation-obesity-osteoarthritis" biological pathway. These findings suggest that CLR may serve as a novel early-warning biomarker and provide new insights into the multifactorial etiology of OA. It is noteworthy that due to the cross-sectional design of this study, causal relationships and temporal sequences cannot be established. Future prospective cohort studies and mechanistic research are needed to validate these findings and elucidate the causal relationships and specific biological mechanisms between CLR and OA.

To identify the risk factors for recurrence of endometrial cancer (EC) and the prognostic factors for endocrine therapy after recurrence.

Eighty-three EC patients who relapsed after completing initial treatment in our hospital from January 2021 to December 2024 were selected as an observation group. After receiving endocrine therapy, they were divided into a good prognosis subgroup and a poor prognosis subgroup based on follow-up results. Another 332 patients who completed initial treatment during the same period, underwent regular follow-up within the study time range, and did not relapse were selected as a control group. Various indicators were compared between the observation group and the control group, as well as between different subgroups. Univariate and Logistic multivariate regression analyses were performed to screen for the main factors affecting disease recurrence and prognosis.

Among the 83 patients, 51 had a good prognosis (61.45%, 51/83) and 32 had a poor prognosis (38.55%, 32/83). Logistic regression analysis showed that age≥55 years old (odds ratio [OR]=2.298), menopause (OR=2.482), FIGO stage Ⅱ (OR=2.067), tumor diameter≥2 cm (OR=2.094), muscle infiltration depth≥1/2 (OR=1.818), pelvic lymph node positivity (OR=2.392), ER negativity (OR=2.776), PR negativity (OR=3.963), and Ki67 positivity rate≥50% (OR=2.529) were high-risk factors for EC recurrence (P＜0.05). Meanwhile, age at recurrence (OR=6.209), progression-free survival (PFS)＜12 months after initial treatment (OR=16.007), extrapelvic recurrence (OR=3.943), Bokhman classification type Ⅱ (OR=2.252), recurrent ER positivity (OR=3.536), recurrent PR positivity (OR=2.768), and NSMP subtype (OR=3.747) were identified to be independent risk factors affecting the prognosis of endocrine therapy after recurrence (P＜0.05).

The recurrence rate of EC is high, particularly in patients with high-risk pathological features-including advanced age, postmenopausal status at onset, high pathological grade, tumor size ≥2 cm, deep myometrial invasion, lymphovascular space invasion, and positive pelvic lymph nodes-as well as unfavorable molecular markers such as ER negativity, PR negativity, and strong Ki67 positivity. Endocrine therapy is an effective method for recurrent EC, but the prognosis of patients is affected by age, PFS after initial treatment, recurrence site, Bokhman classification, molecular classification, ER and PR expression, and other factors, which should be given special attention.

To investigate the effects of sivelestat sodium on the prognosis and Th17/Treg immune balance in patients with trauma-associated acute respiratory distress syndrome (ARDS), and to evaluate its clinical efficacy and potential mechanisms.

A prospective randomized controlled trial was conducted, enrolling 68 patients with mild-to-moderate trauma-associated ARDS admitted to the Intensive Care Unit (ICU) of Jiangdu People's Hospital of Yangzhou City from March 2022 to December 2024. Participants were randomly divided into a sivelestat sodium group (n=34) and a normal saline group (n=34). Both groups received standard treatment, while the experimental group additionally received sivelestat sodium (4.8 mg/kg/day via intravenous infusion pump for 5 days, extendable up to 14 days). The primary endpoint was 28-day mortality, and secondary endpoints included ICU mortality rate, ICU stay, ventilator-free days, etc. Enzyme-linked immunosorbent assay (ELISA) was used to monitor the levels of IL-6 and IL-10 in the peripheral blood of patients. Flow cytometry was used to detect the expression of Th17 (CD4+IL-17A+) and Treg cells (CD4+CD25+Foxp3+) in peripheral blood of patients. Statistical analyses were performed using STATA 17.0.

The 28-day mortality rate was 5.9% (2/34) in the sivelestat sodium group and 11.8% (4/34) in the control group, with no statistically significant difference between them (P＞0.05). Compared with the saline group, tno statistically significant difference was found in ICU mortality rate and ICU stay in the sivelestat sodium group. However, the 28-day ventilator-free days was longer in the sivelestat sodium group [28 (27.8, 28) vs. 28 (19.9, 28) days, P＜0.05]. Immunological analysis revealed that IL-6 levels [61.7 (45.8~101.7) pg/ml] and Th17 proportions [7.8% (4.8%~12.3%)] in the sivelestat sodium group were significantly lower than those of the control group [97.3 (56.7~133.3) pg/ml and 12.9% (9.1%~18.0%), respectively]. The Th17/Treg cell ratio was also significantly reduced [1.2 (0.6~1.5) vs 1.5 (0.9~2.8), P＜0.05], indicating suppression of inflammation via Th17/Treg balance modulation.

Sivelestat sodium improves oxygenation and prolongs ventilator-free days in trauma-associated ARDS patients, potentially by inhibiting Th17 cell differentiation and correcting immune imbalance. Although no significant mortality reduction was observed, this study provides novel evidence for immunotargeted therapy in trauma-associated ARDS, supporting early application in mild-to-moderate cases to optimize clinical outcomes.

To investigate the awareness, attitudes, and suggestions of grassroots public health physicians in Jiangsu Province toward prescriptive authority, so as to provide evidence and and guidance for further exploration of granting prescription rights to public health physicians in China within the context of medical treatment and prevention integration.

A snowball method was used to distribute an online questionnaire through relevant WeChat groups managed by the Jiangsu Provincial Health Supervision and Guidance Center, and 149 valid responses were collected and analyzed both quantitatively and qualitatively.

Approximately 63% of the respondents indicated a demand for prescription authority in their public health practice, but over 65% reported that their current institutions did not grant them the authority to issue drug prescriptions, examination orders, diagnostic certificates, and treatment orders. About 85% of respondents held an optimistic attitude towards promoting the granting of prescription authority, and around 80% expressed a strong desire to obtain such authority. However, about 38% of respondents expressed doubts or did not recognize whether public health physicians could be competent for prescription authority. The study also found significant differences in the distribution of attitudes related to prescription authority among personnel with different years of experience (P＜0.05). Respondents generally believed that the scope of prescriptions should be limited and reached a clear consensus on the access path and training mechanisms for prescription authority.

The public health physician community has a strong willingness to have prescription rights, but their capability is a concern. To further promote the integration of medical care and prevention, prescription rights should be cautiously granted to public health physicians based on strengthening education in medical schools and postgraduate training, clearly defining prescription scope and eligibility criteria, improving standardized training, and cultivating multidisciplinary talents.

Early diagnosis of gastric cancer is crucial for improving patient survival rates and prognosis. However, traditional endoscopic diagnosis is often hindered by the endoscopist's experience and visual recognition ability, leading to suboptimal detection rates. In recent years, artificial intelligence (AI) technology based on deep learning convolutional neural networks (CNNs) has made significant progress in endoscopic image recognition, greatly enhancing both diagnostic accuracy and efficiency. This article aims to review the current status and future clinical prospects of AI-assisted endoscopy in diagnosing early gastric cancer.

Low back pain (LBP) has a high incidence rate and is the leading cause of activity limitation among people under 45 years old. Its causes include abnormal muscle function, ligament injury, and other factors. Traditional imaging examinations have limitations such as radiation exposure, high cost, or static assessment. Musculoskeletal ultrasound, with advantages such as dynamic observation, portability, and no radiation, has gradually become a key technology in diagnosis and treatment. This article systematically reviews the progress in applications of ultrasound technology in the diagnosis and treatment of lumbosacral pain. In terms of etiological diagnosis, ultrasound can assess soft tissues (multifidus muscle, erector spinae muscle function, and fascia lesions such as thoracolumbar fascia), bone structures (lumbar facet joints and sacroiliac joints), and nerve compression (radeiculopathy and nerve abnormalities related to lumbar disc herniation) through multimodal techniqus, providing a basis for etiological identification. Regarding therapeutic applications, ultrasound-guided techniques enable precise localization and are utilized across a range of interventions targeting muscles, ligaments, and fascia (drug injection and acupuncture); joints and spinal structures (intra-articular injection and radiofrequency neurotomy); and nerve roots (drug delivery and ozone therapy). This approach contributes to reduced complication rates and improved clinical outcomes. Ultrasound technology has advantages such as non-invasive dynamic assessment, improved treatment accuracy, simple operation, and low cost. However, it has limitations such as reliance on the operator's experience, insufficient imaging of deep tissues, and the need for more high-quality research verification. In the future, it can be combined with shear wave elastography and shear wave dispersion imaging technologies to assess the elasticity and viscosity of the lumbosacral muscle fascia to improve disease assessment. In conclusion, ultrasound technology provides an important tool for the diagnosis and treatment of lumbosacral pain. With the development of technology and the accumulation of evidence, it is expected to become one of the core diagnostic and therapeutic methods in this field.

Aplastic anemia (AA) is an immune-mediated hematopoietic failure disease, characterized by pancytopenia in peripheral blood and hypocellular bone marrow without abnormal hyperplasia or fibrosis. Its main clinical manifestations are anemia, bleeding, and infection, and both its incidence and mortality rates are notably high. Investigating the pathogenesis of AA is therefore crucial for identifying potential therapeutic targets at diagnosis or after treatment. Single-cell RNA sequencing (scRNA-seq) technology overcomes the limitation of traditional sequencing, which captures only average transcriptional levels acorss cell populations, by enabling precise transcriptome profiling at single-cell resolution. In contrast to conventional detection methods, scRNA-seq can assess heterogeneity within cell populations and construct gene expression maps for individual cells, thereby helping to elucidate the complex molecular networks underlying intercellular crosstalk. Considering the strengths and limitations of commonly used scRNA-seq platforms, this article reviews the applications of scRNA-seq technology in studying AA.