To investigate the clinical curative effect and feasibility of two-needle sutures anastomosis of microvessels and micronerves to replant tiny fingertips under suspended two-point support balance.

A retrospective analysis was performed on 26 patients (26 digits) with completely severed ting fingertips who were admitted to the Department of Hand and Foot Microsuegery of Nanjing Jiangbei Hospital from July 2021 to September 2024. Under the balance of suspended two-point support, two points were located at 12 (9) o’clock and 6 (3) o’clock on the ruptured microvessels and micronerves. One needle suture was performed at 12 (9) o’clock, and the other was performed at 6 (3) o’clock. A total of two needle sutures were performed for end-to-end anastomosis of microvessels and micronerves to restore superior digital arch artery and fingertip nerve connection and balance. The ratio of anastomosed vessels and nerves was 1:1. All patients were entered into scheduled follow-ups through a combination of visit of outpatient clinics or WeChat and telephone reviews, and the recovery of finger shape, function, and sensation was recorded. The clinical efficacy was evaluated according to the standard functional evaluation issued by the Hand Surgery Association of Chinese Medical Association.

All 26 ting fingertips survived completely, and the blood circulation of replanted fingertip was stable after operation. No vascular crisis occurred. The follow-up period ranged from 6 to 22 months, with an average of 8.5 months. At the final follow-up, the appearance and functional recovery of replanted fingertips were good, with the appearance being close to that of the contralateral healthy finger. According to the standard functional evaluation issued by the Hand Surgery Association of Chinese Medical Association: the function was excellent in 23 cases and good in 3 cases, with an excellent/good rate of 100%.

Two-needle suture anastomosis of microvessels and micronerves under suspended two-point support balance is an effective method to replant tiny fingertips, and it can achieve sensory recovery, increased survival rate, and good long-term appearance and functional recovery with no vascular crisis.

Septic cardiomyopathy is a form of reversible myocardial injury caused by sepsis, contributing significantly to the mortality associated with sepsis. The pathophysiological mechanisms underlying septic cardiomyopathy are intricate, involving a multitude of factors such as cytokine release, myocardial cell injury or death, mitochondrial dysfunction, disrupted calcium homeostasis, and abnormal nitric oxide synthesis. As a complex clinical syndrome, the management of septic cardiomyopathy requires a thorough understanding of these pathophysiological processes and the application of multifaceted therapeutic strategies. With ongoing research advancements and the accumulation of clinical insights, enhancements in the diagnosis and treatment of septic cardiomyopathy are expected, potentially leading to a decrease in sepsis-related mortality. This article aims to review the current research developments regarding the pathophysiological mechanisms, clinical presentations, diagnostic approaches, and therapeutic interventions for septic cardiomyopathy.

Cardiovascular diseases (CVD) have emerged as a major disease burden affecting public health both globally and in China. The research and development of innovative technologies for heart and vascular health represent the implementation of whole-life-cycle management for CVD. This approach integrates early detection and reversal strategies with interventional and surgical treatments, establishing a collaborative prevention-diagnosis-treatment-rehabilitation model that bridges tertiary hospitals and community healthcare systems. This initiative implements integrated traditional Chinese-Western medicine strategies for early prevention and rehabilitation of CVD, while promoting the paradigm shift toward primordial prevention in CVD management. The integration of digitization, intelligent healthcare, and deep learning has significantly improved the prospects for CVD prevention. The research and development of cardiovascular health technologies—based on traditional and non-traditional risk factors, clinical and laboratory tests, imaging data, wearable devices, sensor data, and biological datasets—combined with the advancement of information technology and artificial intelligence, will enable the creation of an intelligent whole-life-cycle digital management system for cardiovascular health. This strategy will form a robust prevention and control framework for CVD, greatly helping to implement the "healthy China 2030" plan.

To investigate the prevalence of knee osteoarthritis (KOA) in active steel workers and its correlation with factors such as knee imaging, metabolic diseases, lifestyle, and occupational work habits, in order to provide a theoretical basis for the early prevention and treatment of occupational musculoskeletal diseases among industrial workers in China.

This study was a cross-sectional survey. Knee joint imaging examinations and basic physical examinations were conducted on the on-the-job employees of Qian’an Iron and Steel Company of Shougang Co., LTD. Knee joint force line data such as femoral-tibial angle (FTA), medial proximal tibial angle (MPTA), and posterior tibial plateau angle (PTSA) were measured. The information such as medical history, living habits, and occupational labor habits was collected in the form of questionnaires, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were calculated. KOA screening was carried out for the above-mentioned population based on signs present on imaging, the self-report questionnaire, and objective indicators. Logistic regression analysis and other statistics were conducted to analyze the relationship between the included variables and KOA.

A total of 1230 knees from 615 respondents were included in the survey. Respondents were predominantly male (534 cases, 86.83%) with a mean age of (41.36±6.93) years. There were 925 knees (75.20%) with radiographic evidence of KOA, and 480 respondents (78.05%, including 35 cases or 5.69% with evidence in one knee and 445 cases or 72.36% with evidence in both knees) had at least one knee with radiographic evidence of KOA. There were 46 cases (7.48%) with a self-reported diagnosis of KOA based on the questionnaire, and 65 cases (10.57%) with a diagnosis of KOA based on objective indicators. Statistical analysis of the included variables showed that age, diabetes, arrhythmia, hyperuricemia and/or gout, and bending at work were associated with radiographic signs of KOA. Age, years of employment, family history of osteoarthritis, diabetes, hyperlipidemia, coronary heart disease, sedentary work habits, and objective indicators were associated with the diagnosis of KOA, whereas years of employment, family history of osteoarthritis, diabetes, coronary heart disease, heavy physical activity, and long-distance walking/stair climbing/long standing time/sedentary work habits were associated with the self-reported diagnosis based on questionnaires of KOA. In terms of symptoms and function, the WOMAC score was significantly higher in those with radiographic signs of KOA or diagnosed with KOA. In terms of radiographic measurement indicators, there was no statistically significant difference in the measured angles between those with radiographic signs of KOA or those diagnosed with KOA based on self-report questionnaires, whereas the PTSA angle was significantly increased in those diagnosed with KOA based on objective indicators.

The prevalence of KOA among steelworkers and the proportion of those with radiographic evidence of KOA are both high. Age, years of employment, family history of osteoarthritis, some metabolic diseases, and some work habits may be risk factors for the development of KOA.

Diabetic kidney disease (DKD) is a progressive disease and one of the most serious complications of diabetes, which may lead to renal failure and even death. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel class of hypoglycemic drugs for the treatment of type 2 diabetes mellitus (T2DM), offering notable cardiovascular advantages. Numerous studies have shown that GLP-1RAs play a renal protective role by exerting hypoglycemic and hypertensive effects, weight loss, lipid regulation, improving renal hemodynamics, regulating inflammatory response, reducing oxidative stress. and inhibiting renal fibrosis. GLP-1RAs hold significant promise in the management of DKD. This article reviews the renal protective mechanisms, clinical evidence of renal outcomes, and current guideline recommendations of GLP-1RAs. However, the complex mechanism behind the renal benefits of GLP-1RAs still needs further exploration and more research to clarify.

Bladder cancer is a common malignant tumor of the urinary system, and immunotherapy has brought new opportunities for its treatment. This article synthesizes the relevant literature to elaborate on various methods of immunotherapy for bladder cancer, including immune checkpoint inhibitor therapy and bacille Calmette-Guérin (BCG) intravesical perfusion therapy. By analyzing their curative effects, related biomarkers, and safety profiles, this paper discusses the challenges faced by immunotherapy and its future development directions, aiming to provide a comprehensive reference for immunotherapy of bladder cancer and promote advancements in clinical practice.

To investigate the current status of extracorporeal shock wave lithotripsy (SWL) in the treatment of upper urinary tract calculi in children.

This investigation included the background information of the respondents, the etiology, diagnosis, and assessment of upper urinary tract calculi in children, the indications, procedure, complications, and management of SWL treatment for upper urinary tract calculi in children, as well as the prognosis and follow-up.

The survey was conducted from January to February 2024. There were 224 valid questionnaires, of which over 70% came from East China, North China, and Central China. The proportion of tertiary and above hospitals involved was 75.90%, the proportion of physicians involved was 83.93%, and 56.7% of the hospitals had carried out SWL for children. Between hospitals that carried out SWL for children and did not, there were statistically significant differences in years of conducting SWL, success rate of treatment, types of included children, need for metabolic assessment, application of preoperative antibacterial drugs, and evaluation time of postoperative stone clearance rate (P<0.05).

Although SWL is widely used, its use for managing upper urinary tract stones in children is relatively limited. There are insufficient understandings and standardized demands regarding the etiology, assessment, indications, preoperative preparation, complication management, prevention, and follow-up of SWL in the treatment of upper urinary tract calculi in children. Conducting high-quality research, formulating diagnosis and treatment norms, and providing professional training will play a promoting role in the treatment of upper urinary tract calculi in children by SWL.

To investigate the relationship of high-sensitivity C-reactive protein (hs-CRP), neutrophil/lymphocyte ratio (NLR), and inflammatory burden index (IBI) with malnutrition in patients with chronic heart failure (CHF).

A total of 128 patients with CHF diagnosed in the General Medicine Department of the Eastern Theater Command Hospital of the People's Liberation Army of China from June 2023 to November 2024 were selected. The patients were divided into a mild malnutrition group (CONUT score 2~4), a moderate malnutrition group (CONUT score 5~8), and a normal nutritional status group (CONUT score 0~1) based on the controlled nutritional status (CONUT score). General data, hs-CRP, neutrophils, lymphocytes, albumin, total cholesterol, and other related data of the three groups of patients were collected. The indicators were compared between groups, and Logistic regression analysis was conducted on the inflammatory indicators related to the nutritional status of patients with CHF. The area under the receiver operating characteristic curve (AUC) values of hs-CRP, NLR, and IBI were compared to evaluate their predictive effectiveness for the risk of malnutrition in patients with CHF.

There were statistically significant differences in lymphocyte count, NLR, and IBI between the normal nutritional status group and the mild malnutrition group, and between the moderate malnutrition group and the normal nutritional status group (P<0.05); in hs-CRP between the moderate malnutrition group and the normal nutritional status group (P<0.05); and in hs-CRP and IBI between the moderate malnutrition group and the mild malnutrition group (P<0.05). Malnutrition had significant negative correlations with hs-CRP and IBI (P<0.05). Total cholesterol was weakly negatively correlated with hs-CRP (r=-0.143, P=0.079), NLR (r=-0.081, P=0.323), and IBI (r=-0.155, P=0.057). hs-CRP predicted malnutrition in CHF patients with an AUC of 0.76, a sensitivity of 0.65, and a specificity of 0.86. NLR predicted malnutrition in CHF patients with an AUC of 0.73, a sensitivity of 0.65, and a specificity of 0.84. IBI predicted malnutrition in CHF patients with an AUC of 0.80, a sensitivity of 0.65, and a specificity of 0.86.

The levels of hs-CRP, NLR, and IBI are closely related to the nutritional status of CHF patients, and they have high predictive value for malnutrition in CHF patients. Moreover, the area under the curve of IBI for predicting malnutrition in CHF is larger.

To investigate the clinical characteristics of children with tic disorder (TD) complicated by respiratory tract infection and identify the risk factors for tic symptom aggravation, in order to provide reference and help for clinical treatment of this condition.

A total of 153 children with tic disorder complicated by respiratory tract infection, who were treated in the pediatric tic specialist clinic of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2014 to September 2024, were retrospectively selected. They were divided into two groups according to whether the tic symptoms were aggravated. The clinical characteristics between the two groups were compared, and the risk factors for tic symptom aggravation were identified by univariate analysis.

The main manifestations of respiratory tract infection in the 153 children with tic disorder were fever, cough, and expectoration. After respiratory tract infection, tic symptoms were aggravated in 94 cases (61.44%) and were not in 59 (38.56%). Head and face tic symptoms were most commonly aggravated, followed by vocal symptoms, and the symptoms of limbs and trunk were the least aggravated. Univariate analysis showed that the aggravation of tic symptoms after respiratory tract infection was related to gender, history of allergic diseases, whether there is vocal tic before infection, and whether there is Yinqiaosan in the prescription before infection. The results of multivariate logistic regression analysis suggested that the model failed to identify significant independent risk factors.

Male gender, history of allergic disease, vocal tic before infection, and no use of Yinqiaosan powder in the prescription before infection are risk factors for aggravation of tic symptoms after respiratory tract infection. In seasons with a high incidence of respiratory tract infection, Yinqiaosan powder can be prophylactically used in traditional Chinese medicine prescriptions to reduce the aggravation of tic symptoms.