To investigate the effectiveness of centralized management of surgical instrument packs stored in the central sterile supply department (CSSD) to clarify the role of this management model in ensuring sterile pack quality, optimizing retrieval efficiency, and controlling infections, thereby providing superior solutions for hospital sterile item management.

7,302 surgical instrument packs stored in the operating room from January to May 2023 were selected as the control group, and were managed by the operating room using the conventional storage, inspection, and retrieval procedures, while 7,343 surgical instrument packs stored in the CSSD from January to May 2025 were selected as the observation group. The CSSD adopted a centralized management model, by improving the storage rack structures tailored to instrument pack requirements, upgrading the information traceability system, implementing the labeling management, adherence to the “first-in-first-out” principle, and enhancing full-process control via information technology. Key management indicators included sterile pack rupture rate, expired pack incidence rate, retrieval time, and manual contact frequency.

The observation group exhibited a rupture rate of 0.8% (vs. 3.6% in the control group) and zero expired pack incidence (vs. 1.2% in the control group). Retrieval time was significantly shorter [(17.85±6.49)s vs. (27.61±5.72)s in the control group)], and manual contact frequency was markedly reduced [(2.0±0.8) times vs. (5.0±2.0) times)]. All differences were statistically significant (P<0.05).

The CSSD adopts centralized management combined with process optimization and information-based traceability for surgical instrument packs, which can significantly enhance safety management levels, substantially reduce pack retrieval time, contribute to medical safety assurance and improve work efficiency. This approach is worthy of promotion and application in hospital sterile item management.

This prospective cohort study comparatively analyzed perioperative parameters, safety profiles, and mid-term outcomes between conservative hemodynamic correction for venous insufficiency in ambulatory patients (CHIVA) and conventional high ligation and stripping (HLS) for great saphenous vein varicosities. A machine learning-based prognostic prediction model was developed to identify core factors influencing surgical efficacy.

Using a prospective cohort design, 92 patients with primary great saphenous vein varicosities treated between January 2024 and November 2025 were enrolled and allocated to either the CHIVA group (n=32) or HLS group (n=60) based on surgical approach. The perioperative parameters, numerical rating sale (NRS) scores for pain, venous clinical severity score (VCSS), postoperative complications, and ultrasound-detected recurrence rates were systematicly recorded and compared between the two patient groups. By integrating patients' clinical characteristics with SHUNT classification, a multivariate logistic regression analysis combined with XGBoost machine learning technology was employed to establish and validate a preoperative predictive model for assessing treatment efficacy with the outcome defined as “postoperative VCSS improvement≥50%”.

The CHIVA group had a significantly shorter hospital stay compared to the HLS group [(4.44±1.85)d vs. (5.70±2.13)d, P=0.006)]. Postoperative resting NRS scores remained at low levels in both groups (P=0.498). However, the CHIVA group demonstrated significantly better improvements in VCSS (11.22±3.34 vs. 2.38±3.68, P<0.001) and improvement rates [(98.04±5.08)% vs. (23.87±31.97)%, P<0.001] than the HLS group. The incidence of saphenous nerve injury was significantly lower in the CHIVA group (3.1% vs. 46.7%, P<0.001). However, the incidence of superficial venous thrombosis was slightly higher (12.5% vs. 1.7%, P=0.029). After a follow-up period of (214.86±124.92) days, the overall ultrasound recurrence rate was 16.30% (15/92). Recurrence was significantly associated with CEAP C5 classification and SHUNT type III/V (P<0.001). Kaplan-Meier survival analysis showed that the cumulative non-recurrence probability was lower in the CHIVA group compared to the HLS group (Log-Rank χ²=4.954, P=0.026). The XGBoost prediction model achieved an AUC of 0.97 in the test set. SHAP feature importance analysis revealed that preoperative SHUNT classification was the strongest predictor of “clinically significant improvement” (VCSS improvement rate≥50%), followed by CEAP C5 classification and preoperative VCSS.

The study indicates that compared with traditional high ligation and stripping (HLS), the CHIVA treatment approach can more significantly improve clinical symptoms in patients with great saphenous vein varicosity (as assessed by the VCSS evaluation system), while effectively reducing hospitalization duration and decreasing the incidence of saphenous nerve injury. The machine learning algorithm-based efficacy prediction system provides an innovative auxiliary tool for developing individualized treatment plans.

To investigate the application value of a novel image fusion method based on T2-weighted 3D fast spin echo with fat suppression (T2-MX3D-FS) and three dimensional time of flight magnetic resonance angiography (3D-TOF-MRA) sequences from 5.0 T ultra-high field magnetic resonance imaging in identifying the responsible vessels of primary trigeminal neuralgia (PTN), so as to provide more accurate imaging diagnostic evidence for the clinical confirmation of neurovascular compression (NVC).

A retrospective analysis was performed on the clinical and imaging data of 26 patients who were diagnosed with PTN and underwent microvascular decompression (MVD) at the First Affiliated Hospital of University of Science and Technology of China from September 2024 to August 2025. All patients underwent preoperative T2-MX3D-FS and 3D-TOF-MRA sequence scanning using a United Imaging uMR Jupiter 5.0 T superconducting MRI system, and the original images were transmitted to a post-processing workstation for image fusion analysis. Taking the responsible vessels identified during MVD as the diagnostic gold standard, we evaluated the ability of the T2-MX3D-FS sequence, 3D-TOF-MRA sequence, and the fusion sequence of the two to detect NVC, as well as their accuracy in identifying the responsible vessels.

Among the 26 patients, definite NVC was observed in 24 patients, and a total of 39 responsible vessels were identified during MVD. The accuracy of the T2-MX3D-FS sequence, 3D-TOF-MRA sequence, and fusion sequence in correctly determining the presence or absence of NVC was 84.62% (22/26), 65.38% (17/26), and 100% (26/26), respectively. The fusion sequence had the highest accuracy for NVC detection, which was higher than that of any single sequence. The difference among the three sequences was statistically significant (P=0.003 0). The accuracy of the T2-MX3D-FS sequence, 3D-TOF-MRA sequence, and fusion sequence in correctly identifying responsible vessels was 58.97% (23/39), 48.72% (19/39), and 89.74% (35/39), respectively. The qualitative accuracy of the fusion sequence for responsible vessels was significantly higher than that of the single sequences, the difference among the three sequences was statistically significant (P=0.000 2).

5.0 T ultra-high-field MRI, by virtue of its extremely high signal-to-noise ratio and spatial resolution, allows for clearer visualization of the anatomical relationship between the trigeminal nerve and surrounding microvessels. The T2-MX3D-FS and 3D-TOF-MRA sequences complement each other in displaying nerves and blood vessels. Image fusion of these two sequences significantly improves the detection rate and characterization accuracy of the responsible vessels in PTN, providing a more reliable imaging basis for the precise preoperative assessment of NVC and the formulation of individualized MVD surgical plans, demonstrating significant clinical translational value and promising application prospects.

To observe the effects of intensive tactile feedback training combined with mirror neuron system theory on fine motor function in children with spastic hemiplegic cerebral palsy.

44 children with spastic hemiplegia and cerebral palsy in Affiliated Maternity and Child Health Care Hospital of Nantong University were divided into combined group and control group by randomly. A total of 5 children were lost to follow-up in this study. Finally, 19 children in the control group and 20 children in the combined group completed the study. All patients received routine rehabilitation training and mirror neuron system theory, and the combined group received intensive tactile feedback training in addition. The upper limb function of the two groups were analyzed by the Peabody developmental motor scale-fine motor (PDMS-FM), Carroll upper extremity functional test (UEFT) and Wee function independence measure for children (WeeFIM) before and after treatment for 12 weeks respectively.

After 12 weeks of treatment, both of the PDMS-FM score、the UEFT score and WeeFIM score of two groups were significantly improved than those before the treatment (P<0.001), and the scores of the combined group increased more significantly than the control group (P<0.05).

The intensive tactile feedback training combined with mirror neuron system theory can improve the fine motor function in children with spastic hemiplegic cerebral palsy.

To explore the clinical application effect of digital guide plate technology in oral implant restoration.

A total of 80 patients undergoing oral implant restoration in the hospital from January to December 2024 were selected as the research subjects and randomly divided into a control group and a study group, with 40 cases in each group. The control group was treated with traditional methods for oral implant restoration, while the study group was assisted by digital guide plate technology for oral implant restoration. The accuracy of the implants, the effect of oral restoration, the occurrence of complications, oral function and quality of life were compared between the two groups.

The deviations of the implant neck, apex, depth and angle in the study group were significantly lower than those in the control group, and the differences were statistically significant (t = 6.402, 4.435, 9.521, 9.707, P<0.001); the deviation of the implant crown in the study gruop was lower than that in the control group (t=2.465, P<0.05). The total effective rate of oral restoration in the study group (95.00%) was higher than that in the control group (77.50%), with a statistically significant difference (χ²=5.164, P < 0.05); the total incidence of complications in the study group (5.00%) was lower than that in the control group (20.00%), with a statistically significant difference (χ²=4.114, P < 0.05). After restoration, the bite force and masticatory efficiency in the study group were higher than those in the control group, with a statistically significant difference (P < 0.05); after restoration, the quality of life scores in the four dimensions of the study group were higher than those of the control group, with a statistically significant difference (P < 0.05).

The application of digital guide plate technology in oral implant restoration can significantly improve the accuracy of implants, the masticatory function and quality of life of patients, and reduce the occurrence of complications, which has high clinical application value.

To compare the clinical efficacy and safety of musculoskeletal ultrasound-guided micro-needle knife combined with acupuncture versus simple acupuncture in the treatment of third lumbar transverse process syndrome.

A total of 60 patients with third lumbar transverse process syndrome admitted to our hospital from January to November 2025 were selected and divided into the study group (n=30) and the control group (n=30) by random number table method. Patients in the study group were treated with musculoskeletal ultrasound-guided targeted release of the third lumbar transverse process using micro-needle knife combined with acupuncture, while those in the control group were treated with simple acupuncture. The thickness and cross-sectional area of the affected L₃ multifidus muscle before and after treatment, as well as the total clinical effective rate, were compared between the two groups. The modified Oswestry disability index (ODI) was used to evaluate the lumbar function before and after treatment; the visual analogue scale (VAS) was used to evaluate the pain degree before and after treatment.

After treatment, the thickness and cross-sectional area of the affected L₃ multifidus muscle in both groups increased, and the study group showed a significantly better result compared to the control group (P<0.05); the ODI scores and VAS scores of both groups decreased, and the study group had lower scores (P<0.05); the total clinical effective rate of the study group was significantly higher than that of the control group (P<0.05).

The clinical efficacy of musculoskeletal ultrasound-guided micro-needle knife combined with acupuncture in the treatment of third lumbar transverse process syndrome is superior to that of traditional simple acupuncture. It can more effectively improve the morphology of the multifidus muscle, relieve pain, and enhance lumbar function, with definite curative effect and high safety.

To compare the effects and safety of ultrasound-guided internal jugular venous puncture and femoral venous puncture in clinical elderly patients, and provide a reference for clinicians to choose the best puncture method.

Clinical data of 179 elderly critically ill patients who underwent central venous catheterization at Shanghai Donghai Senior Nursing Hospital from January 2023 to October 2025 were retrospectively collected. All patients were divided into internal jugular vein group (n=89) and femoral vein group (n=90) according to different puncture approaches. Multiple indicators were compared between the two groups, including anteroposterior diameter of vascular lumen, cross-sectional area, needle insertion length, puncture time, one-time puncture success rate, and incidence of catheter-related complications.

The anteroposterior luminal diameter was (7.69±1.61) mm in the internal jugular vein group, significantly longer than (7.04±1.06) mm in the femoral vein group (P<0.01). The vascular cross-sectional area of the internal jugular vein group was (86.25±29.55) mm², which was larger than (78.39±13.11) mm² in the femoral vein group (P=0.02). The needle insertion length was (41.56±6.16) mm in the internal jugular vein group, shorter than (47.67±6.27) mm in the femoral vein group (P<0.01). The puncture time in the internal jugular vein group was (14.20±1.99) min, which was significantly shorter than (18.86±2.49) min in the femoral vein group (P<0.01). The one-time puncture success rate reached 93.26% in the internal jugular vein group, obviously higher than 66.67% in the femoral vein group (P<0.01). Meanwhile, the incidence of puncture-related complications was 8.99% in the internal jugular vein group, markedly lower than 18.89% in the femoral vein group (P<0.01).

Ultrasound-guided internal jugular vein catheterization in elderly critically ill patients can effectively shorten puncture time and needle insertion length, improve the one-time puncture success rate, reduce the incidence of complications, with high safety, which is worthy of clinical promotion and application.

To explore the diagnostic value of whole-tumor apparent diffusion coefficient (ADC) histogram parameters derived from magnetic resonance imaging (MRI) in differentiating adrenal metastases from benign lesions in patients with lung cancer, with a focus on analyzing the differential efficacy of these parameters for small nodules with a diameter <3 cm.

A retrospective analysis was performed on 149 patients with adrenal space-occupying lesions confirmed by pathology or clinical follow-up, including 84 cases in the benign group (adenomas accounting for 83.3%) and 65 cases in the metastatic group. All patients underwent 3.0 T MRI scanning to obtain ADC maps. Three-dimensional whole-tumor regions of interest (ROI) were manually delineated slice by slice using FireVoxel software, and histogram parameters such as mean, standard deviation, skewness, kurtosis, entropy, and the 1st, 25th, 75th, and 95th percentiles (ADC-1%, ADC-25%, ADC-75%, ADC-95%) were extracted. The Mann-Whitney U test or independent samples t-test was used to compare the parameter differences between the two groups. Three diagnostic models were constructed: a tumor size-only model (Model 1), a histogram-only model (Model 2) and a combined model integrating histogram parameters with tumor size (Model 3). Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic efficacy, and subgroup analysis was further performed for lesions with a diameter < 3 cm.

The standard deviation, skewness, kurtosis and ADC-95% in the metastatic group were significantly higher than those in the benign group, while ADC-1% was significantly lower (all P < 0.05). Among the individual parameters, standard deviation exhibited the optimal diagnostic performance, with an area under the curve (AUC) of 0.753 (95%CI: 0.676~0.813). The AUC values of Model 2 and Model 3 were 0.809 (95%CI: 0.740~0.866) and 0.821 (95%CI: 0.756~0.871), respectively, with no statistically significant difference between the two models (P = 0.373). In the subgroup of lesions < 3 cm in diameter, the histogram model achieved an AUC of 0.817 (95% CI: 0.738~0.896), and kurtosis was identified as the only independent predictor (OR=1.538, P=0.035). Calibration curves and decision curve analysis verified that the model yielded favorable clinical net benefits.

Whole-tumor ADC histogram parameters can effectively quantify the heterogeneity of adrenal tumors and hold important value in differentiating adrenal metastases from benign lesions in lung cancer patients. Notably, kurtosis shows prominent performance in the early malignant identification of small nodules < 3 cm, providing a reliable basis for non-invasive and accurate clinical diagnosis.

To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) guided biopsy in the differential diagnosis of benign and malignant liver lesions.

A total of 160 patients with suspected liver cancer admitted to Qinzhou First People's Hospital from December 2022 to December 2023 were retrospectively selected, and all of them received conventional ultrasound-guided and CEUS-guided puncture biopsy after admission, and the detection, diagnostic efficacy and contrast-enhanced ultrasound indexes of benign and malignant lesions were analyzed with the results of pathological examination as the gold standard.

Among the 160 patients with suspected liver cancer, 95 were malignant and 65 were benign confirmed by surgery and pathology. CEUS-guided biopsy detected 84 cases of malignant and 60 cases of benign, with a positive rate of 88.42% (84/95). The sensitivity, specificity and accuracy of CEUS-guided biopsy were 88.42%, 92.31% and 90.00%, respectively, which were significantly higher than those of conventional ultrasound-guided biopsy (69.47%, 75.38% and 71.86%, respectively), while the missed diagnosis rate and misdiagnosis rate of CEUS-guided biopsy were 11.58% and 7.69%, respectively, which were significantly lower than those of conventional ultrasound-guided biopsy (30.53% and 24.62%, respectively), with statistically significant differences (all P<0.05). The regional blood flow (rBF) and perfusion index of malignant lesions in arterial phase were higher than those of benign lesions (P<0.05), and the rBF in delayed phase was lower than that of benign lesions (P<0.05). The initial peak time, peak time, rise time and transit time of contrast agent were shorter than those of benign lesions (P<0.05).

For the differential diagnosis of benign and malignant liver lesions, CEUS-guided biopsy has higher sensitivity, specificity and accuracy than conventional ultrasound. It can observe the blood perfusion characteristics of liver lesions and effectively distinguish between benign and malignant liver diseases.