Objective To explore the changes and significance of exercise cardiopulmonary indexes of pilots with reduced left ventricular diastolic function. Methods Thirty pilots with reduced left ventricular diastolic function were selected as the study group while another 30 healthy pilots served as the control group. Both groups underwent exercise cardiopulmonary function tests. The indexes of echocardiography in the resting state as well as the maximum exercise power, respiratory reserve, stroke output, post-exercise recovery heart rate, maximum kilogram oxygen uptake, estimated maximum oxygen uptake, metabolic equivalent, peak heart rate and oxygen pulse in exercise cardiopulmonary function tests were recorded. Results There were statistically significant differences in maximum motion power, respiratory reserve, stroke volume, rates of heart rate recovery two minutes and three minutes after exercise between the two groups（t=2.019~3.740, all P<0.05）. The maximum kilogram oxygen uptake was positively correlated with the rate of heart rate recovery two minutes and three minutes after exercise（r=0.558, 0.457, P=0.001, 0.011）. The case was the same with the left ventricular end diastolic diameter, left atrial anterior posterior diameter, left ventricular ejection fraction, and Tei index（t=3.179~9.617, P=0.002 or <0.001）. Conclusion Pilots with reduced left ventricular diastolic function may be vulnerable to changes in exercise cardiopulmonary function and to abnormal regulation of the autonomic nervous system in the early stage. The rate of heart rate recovery two and three minutes after exercise can reflect the ability of autonomic nerves for regulation and aerobic exercise, which can be used to serve pilots' physical training and prescriptions for exercise.

Objective To explore the heart rate（HR）, moods and changes of indicators of heart rate variability（HRV）of fighter pilots during simulated training for ejection survival in order to provide data for well-designed and effective training. Methods The changes in electrocardiograms（ECGs）, moods, and blood pressure before and after training among 36 fighter pilots were recorded during two sessions of simulated training for ejection escape and across three phases of ejection（pre-ejection, during ejection, and post-ejection）. For ECG data, HRV was recorded, including the standard deviation of normal R-R intervals（SDRR）, total power（TP）, low frequency（LF）, high frequency（HF）and HR. The results of the questionnaire were analyzed. Results In the first session of ejection escape training, only 13.89% of the pilots were rated as excellent, and one pilot failed the training. In the second session, the excellent rate was 83.33%, and the results of training evaluation were all good or better. Analysis of changes in HR and moods before, during and after the two ejection escape training sessions suggested that in the second ejection survival training session, 72.22% of the subjects scored lower than 3 points in terms of stress while 91.67% scored 4 points or higher in confidence. The difference was not statistically significant（P>0.05）. The results of repeated measures analysis of variance of the changes of HRV before, during and after the two sessions showed that there were statistically significant differences in the subjects' HRV, including SDRR（H=41.016, P<0.001）, TP（H=50.265, P<0.001）, and LF（H=6.316, P=0.006）across training stages. Conclusion Simulated training for ejection escape is effective in improving pilots' emergency response and increasing their confidence during ejection escape.

Objective To analyze the changes in indicators of heart rate variability of pilots and cadets before, during, and after flights in order to provide data for analysis of psychological stress and for safety assurance during flight training. Methods Forty-two male pilots and cadets were selected for collection of physiological data during flights, with electrocardiogram（ECG）parameters recorded. Results The differences in heart rate, low frequency（LF）, high frequency（HF）, and the ratio of low to high frequency（LF/HF）of pilots during non-training periods and before, during, and after flight training were statistically significant（F=4.791~31.909, P<0.05）. During daily flight training, heart rate, LF, and LF/HF of pilots increased（P<0.001, =0.001, 0.004）while HF decreased（P=0.001）. The differences in the standard deviation of normal-to-normal intervals（SDNN）and the root mean square of successive differences of RR intervals（RMSSD）before, during and after flight training between cadets were also of statistical significance（F=6.479, 8.005; P=0.005, 0.002）. During daily flight training, the RMSSD decreased（P=0.008）. Conclusion The heart rate and frequency domain indicators of pilots change significantly during flight training, so do the time domain indicators of cadets, which can provide a reference for aviation health and safety assurance of pilots and flight cadets during flight training.

Objective To compare the results of vestibular function tests conducted on pilots before and after the COVID-19 pandemic and analyze the possible causes of vestibular dysfunction in order to provide data for aeromedical assessment. Methods The medical records of 60 pilots who underwent vestibular function tests at the Air Force Medical Center between 2016 and 2023 were reviewed. The data of pilots diagnosed with unilateral vestibular dysfunction for the first time was selected. January 1, 2020 was taken as the day the COVID-19 pandemic broke out. Among the 60 cases, 51 were diagnosed after this date and assigned to the study group, and 9 were diagnosed before this date and served as the control group. Clinical features of these cases were statistically analyzed. Results The proportion of the study group in all pilots tested during the same period was significantly higher than that of the control group（χ²=4.284, P=0.038）. In the study group, 47 had no vestibular-related symptoms, but 4 did. In the control group, 3 had no vestibular-related symptoms, but6did. The proportion of cases without vestibular-related symptoms was significantly higherin the study group（χ²=15.059, P<0.001）. There was no statisticallysignificant difference between the two groups in the distribution of the abnormal tests. When diagnosed for the first time, 41（80%）were assessed as qualified for flight and 6（12%）were temporarily grounded in the study group, compared with 3（33%）and 5（56%）in the control group. The qualified rate of the study group was significantly higher than that of the control group（χ²=6.424, P=0.011）, while the proportion of temporarily grounded pilotsin the study group was significantly lower（χ²=7.092, P=0.008）. Conclusion The increase of asymptomatic cases of unilateral vestibular dysfunction in pilots may be related to infections with low-virulent strain of SARS-CoV-2 or vaccination. The damage to vestibular function is mild, and detailed classification and aeromedical assessment can be carried out according to vestibular receptor diseases（VRDs）.

Objective To find out about cerebrovascular diseases in aircrews/flight cadets and clinical imaging characteristics. Methods A study was conducted on 13 aircrews admitted to a medical center between December 2020 and April 2024 for diagnosis and treatment of cerebrovascular diseases. Descriptive statistical analysis was conducted of their clinical data, types of aircraft, head MRI data, treatments and follow-up. Results Among the 13 cases, there were 9 flight cadets, 3 pilots, and 1 air combat service personnel. All were diagnosed with cerebrovascular diseases through 3.0 T cranial MRI, including 7 cases of microaneurysms, 4 cases of cavernous hemangiomas, and 2 cases of other vascular abnormity. Two cases underwent surgical treatment, while the rest showed stable conditions through medical follow-up. After discussion, the Medical Appraisal Committee has decided: One air combat personnel resumed flight after surgery. Two pilots converted to dual-seat fighter jets, two pilots to transport planes, three pilots to helicopters and one pilot to air combat personnel. Four cases were deemed unqualified for flight. Conclusion The medical identification requirements for cerebrovascular diseases in flight cadet selection and single-seat aircraft pilots should be strictly controlled. For pilots who are asymptomatic and have a low probability of bleeding, they can be transferred to multi-seat aircraft with lower loads, and relevant cranial MRI examination items should be strengthened during medical follow-up. The high-resolution magnetic resonance imaging（MRI）screening of the head of pilots can help detect and treat cerebrovascular diseases early, thereby contributing to flight safety.

Objective To investigate the clinical efficacy of autologous osteochondral transplantation for treating large osteochondral lesions of the talus（OLT）in pilots and the principles of aeromedical assessment. Methods The clinical data of 6 pilots with Hepple type Ⅴ OLT treated at the Air Force Medical Center between May 2016 and May 2022 was retrospectively analyzed. All these pilots underwent exposure of the talar osteochondral injury lesion through an internal malleolar osteotomy approach, and multi-column mosaic-style transplantation repair was performed using autologous osteochondral transplantation devices to harvest non-weight-bearing articular surface osteochondral columns from the lateral condyle of the ipsilateral femur. Anteroposterior X-ray of the ankle joint, CT, and MRI were used to assess the severity of talar osteochondral injury and the healing of the cartilage transplantation area. The Lysholm knee joint score, American Orthopedic Foot and Ankle Society（AOFAS）ankle-hindfoot score, and Visual Analog Scale （VAS）were used to evaluate the knee joint function, ankle joint activity, and pain conditions of the pilots before surgery and during follow-up（3 months and 6 months postoperatively）. Results Radiographs（anteroposterior/ lateral）, CT, and MRI at 3 and 6 months postoperatively confirmed healing of the medial malleolar osteotomy site and excellent integration of the osteochondral grafts with a smooth articular surface. No complications, such as wound infection or nonunion of the osteotomy, occurred during follow-up. Knee joint function at 3 and 6 months postoperatively was not significantly different from the preoperative levels（F=0.294, P=0.611）. VAS scores significantly improved at both 3 and 6 months postoperatively（both P<0.001）. AOFAS ankle-hindfoot scores also significantly improved during the two follow-ups（both P<0.001）. The AOFAS score at 6 months postoperatively was significantly higher than at 3 months postoperatively（P=0.004）. All the pilots were assessed as eligible for flight at 6 months postoperatively. Conclusion Autologous osteochondral transplantation for treating Hepple V-type talar osteochondral injuries in pilots can significantly relieve pain and improve ankle joint function without affecting the function of the knee joint in the area where the osteochondral graft is taken. It is more appropriate for pilots with talar osteochondral injuries to be permitted to return to duty at 6 months postoperatively.

Objective To analyze the outcomes of surgical treatment and resumption of flight among surgically hospitalized pilots in order to find out about the characteristics of pilots with different re-flight outcomes. Methods A total of 202 pilots who underwent surgical treatment at the Air Force Medical Center between January 1, 2012, and May 22, 2023 were selected. Based on the results of aeromedical assessments, they were divided into a flight qualified group（186 cases）and an unqualified group（16 cases）. The basic information, surgical approaches, and final results of qualification assessments were compared between the two groups. Results In terms of departments where these pilots were hospitalized, the flight qualified group was primarily treated in departments of general surgery, thoracic surgery, and otolaryngology, and the unqualified group in departments of orthopedics and neurosurgery（P=0.009）. The median length of hospital stay was 14.50（10.00, 22.00）days in the flight qualified group, compared with 23.00（16.25, 29.00）days in the unqualified group（Z=－2.817, P=0.005）. After surgery, the proportion of patients transferred to the ICU in the unqualified group was higher than in the flight qualified group（P=0.017）. The average surgical duration of the unqualified group was 110.00（62.50, 195.00） minutes, compared with 60.00（38.50, 100.00）minutes in the flight qualified group（Z=－2.413, P=0.016）. Conclusion There are significant differences between pilots with different re-flight outcomes. These differences may be indirectly affects their eligibility for re-flight.

Objective To simulate the night myopia experience of flight personnel on the ground, analyze the causes of night myopia, evaluate and verify the night myopia experience and the training effect of overcoming night myopia, and provide data basis for further standardizing night myopia experience in night vision training. Methods The new T2/YSX-1 night vision physiological experience training equipment was used to conduct night myopia experience training for flight personnel participating in annual physical examination, and overcome training through blinking and eye saccades. Training data were collected to compare the differences in night myopia simulation training for flight personnel of different ages and flight positions. Results A total of 62 people participated in the night myopia experience and overcoming training, all of them showed night myopia. In the night myopia training, 6 people were excellent, 5 people were good, and 39 people were qualified, with a pass rate of 80.65%. Fisher exact test was carried out on the results of flight personnel of different ages and different positions to overcome the night close training, and there was no statistical significance. The flight personnel of different ages and different positions showed the same training effect.（Results of night myopia simulation training for flight personnel of different ages:（Results of night myopia simulation training for flight personnel of different ages: P=0.542; Results of night myopia simulation training for flight personnel of different positions: P=0.441）. Conclusion This training verifies that providing effective visual stimulation through blinking and eye saccades is an effective method to overcome night myopia, and provides data basis for standardizing night myopia experience and training of flight personnel in night vision training.

Objective To investigate the effects of serum total bilirubin（STB）and alanine aminotransferase （ALT） on blood lipids and the incidence of fatty liver among aviators. Methods A total of 1,318 flight personnel who underwent medical evaluation at Guilin Rehabilitation and Recuperation Center between January 2021 and January 2024 were selected and divided into three groups based on types of aircraft: the fighter jet group（581 cases）, transport aircraft group（376 cases）, and helicopter group（361 cases）. The detection rates of related diseases and abnormal indicators were analyzed under different levels of STB and ALT across the three groups. Results Significant differences were observed in the detection rates of fatty liver between the three groups（χ²=7.820, P=0.021）, with a notable difference between the fighter jet group and the helicopter group （χ²=7.424, P=0.006）. The detection rates of elevated HDL-C also differed significantly（χ²=9.208, P=0.010）, particularly between the fighter jet group and the other two groups（χ²=6.050, 6.029, P=0.014, 0.014）. Total cholesterol（TC）levels were significantly different between the three groups（F=6.307, P=0.002）, with a marked difference between the fighter jet group and the helicopter group（P=0.002）. There were significant differences in HDL-C levels between these groups（F=3.987, P=0.019）, especially between the fighter jet group and the transport aircraft group（P=0.025）. A comparison of incidences of lipid metabolism disorders between elevated STB levels and normal ones suggested that the detection rates of high levels of TG were significantly different between the transporter aircraft group and the helicopter group（χ²=4.704, 11.446, P=0.030, 0.001）, and that the detection rates of fatty liver（χ²=4.762, P=0.031）and abnormalities of low-density lipoprotein cholesterol (LDL-C)（χ²=14.23, P=0.001）were significantly different in the fighter jet group. The comparison of incidences of lipid metabolism disorders between elevated and normal ALT levels showed that the levels of TG differed significantly between the three groups（Z=3.638, 2.509, 5.515, P=0.001, 0.012, 0.001）. The differences in TC levels of the fighter jet and helicopter groups, HDL-C levels of the transport aircraft group, LDL-C levels of the helicopter group were of statistical significance（t=2.850, 3.297, 2.107, 2.617, P=0.005, 0.001, 0.036, 0.009）. Conclusion Fighter crews have better lipid profiles than transport and helicopter crews. Moderate SSTB levels may reduce hypertriglyceridemia and fatty liver risks while elevated ALT levels are associated with increased risks.

Objective To evaluate the effects of butylphthalide combined with tenecteplase on levels of serum sST2 and other cytokines as well as on neurological functional outcomes in patients with acute ischemic stroke. Methods A prospective study was conducted on 108 acute ischemic stroke（AIS）patients eligible for intravenous thrombolysis treated between June 2023 and June 2024 at the Third Department of Critical Care Medicine. Using a random number table method, these patients were assigned to two groups: the butylphthalide group（n=54, tenecteplase+butylphthalide）and the control group（n=54, tenecteplase alone）. Serum levels of soluble suppression of tumorigenicity 2（sST2）, matrix metalloproteinase-9（MMP-9）, interleukin-6（IL-6）and high-sensitivity C-reactive protein（hs-CRP）were measured before treatment（post-thrombolysis）and 14 days after treatment. Neurological function was assessed using the National Institutes of Health Stroke Scale（NIHSS）, functional prognosis was assessed by the Modified Rankin Scale（mRS）and such complications as intracranial hemorrhage were recorded. Results The NIHSS scores of both groups kept decreasing at 24 hours, 7 days, and 14 days after treatment（all P<0.001）. At 14 days post-treatment, neurological recovery in the butylphthalide group was better than in the control group（P=0.011）. In addition, more patients in the butylphthalide group had favorable short-term（14-day） neurological outcomes（mRS≤2）than in the control group（χ²=4.123, P=0.042）. During the long-term follow-up（90 days）, the rate of favorable functional outcomes（mRS≤2）was higher in the butylphthalide group than in the control group（χ²=4.160, P=0.041）. No statistically significant difference was observed in the incidence of hemorrhagic transformation between the two groups（P>0.05）. At 14 days post-treatment, the levels of the cytokines sST2, MMP-9, IL-6, and hs-CRP in the butylphthalide group were significantly lower than in the control group（Z=2.173~3.160, all P<0.05）. Conclusion Butylphthalide combined with tenecteplase can effectively mitigate inflammatory responses in AIS patients, significantly reduce serum levels of sST2 and related pro-inflammatory factors while promoting neurological recovery without increasing hemorrhagic risk.

Objective To construct a risk prediction model for central lymph node metastasis（CLNM）in patients with papillary thyroid carcinoma（PTC）based on contrast-enhanced ultrasound（CEUS）parameters. Methods A total of 105 patients with PTC and treated in Tangshan People's Hospital between January 2022 and March 2023 were selected, and the incidence of CLNM was statistically analyzed. The patients were divided into the CLNM group and non-CLNM group. The basic information, indicators of laboratory tests, and CEUS parameters were compared between the two groups. The contributors to CLNM in patients with PTC were analyzed using a Lasso-Logistic regression model. The predictability and utility of the model were evaluated via the receiver operating characteristic curve and decision curve analysis. Results The incidence of CLNM in these PTC patients was 48.57%（51/105）. The proportion of female patients, age, proportion of multiple lesions, maximum lesion diameter, scores of the thyroid imaging reporting and data system（TI-RADS）, serum thymidine kinase 1（TK1）levels, gene expressions of targeting protein for Xklp2, C-X-C chemokine receptor 4（CXCR4）, and those of a disintegrin and metalloproteinase 9（ADAM9）in cancer tissues in the CLNM group were higher than in the non-CLNM group（t/χ² =2.282~12.302, all P<0.05）. The serum levels of microRNA-363（miR-363）and microRNA-1296（miR-1296）, gene expressions of microRNA-1243（miR-1243）and protein phosphatase 4 regulatory subunit 1, time to peak（TTP）, peak intensity（PI）, and mean transit time（MTT）were lower or shorter than in the non-CLNM group（t/χ²=5.914~8.638, all P<0.001）. The score of TI-RADS, TK1, miR-363, miR-1296, miR-1243, CXCR4, ADAM9, TTP, PI and MTT could make a difference in CLNM among PTC patients（OR=0.267~3.124, all P<0.05）. A risk prediction model of CLNM nomograms was constructed, and_Bootstrap internal validation showed that the area under the curve（AUC）of the model forpredicting CLNM in PTC patients was 0.915（95%CI: 0.884~0.917）; the decision curve（DCA）showed that the model had good clinical utility in predicting the risk of CLNM. The calibrationcurve showed that the coincidence between the observed value and the predicted value of thecalibration curve of the modcl was good. Conclusion The risk prediction model of CLNM nomograms based on CEUS parameters in PTC patients can well predict the risk of CLNM and promises wide clinical applications.

Objective To explore the stress changes in cervical disc structures and balance-related components following vertebral displacement in cervical spondylosis patients, and the potential mechanisms underlying symptom relief after manual reduction. Methods A healthy female volunteer underwent thin-slice computed tomography（CT）scanning of the entire cervical spine. From these CT images, a bone model was extracted, and subsequent modeling of soft tissues culminated in the completion of a cervical spine FEA model. The model's validity was rigorously evaluated through comparison with the literature currently available. With the Z-axis rotational degrees of freedom（DOF）of the upper surfaces of C₄, C₅, and C₆ vertebrae fixed, simulation mimicking changes in spinal mechanical environment after vertebral displacement were observed. Specifically, the lower surface of the C₇ vertebral body was constrained, and a 73.6 N follower load was applied to the upper surface of the C₃ vertebral body. Under leftward rotation conditions, the peak stress and distribution patterns in zygapophysial joint and intervertebral discs were meticulously analyzed. Results A finite element model of the C₃-C₇ cervical spine was established, incorporating a total of 20 ligament groups across five types: the anterior longitudinal ligament（ALL）, posterior longitudinal ligament（PLL）, ligamentum flavum（LF）, supraspinous ligament（SL）, and interspinous ligament（IL）. The vertebral bodies were primarily composed primarily of tetrahedral elements, while the intervertebral discs and facet joints were primarily modeled with hexahedral elements. The entire model consisted of 351 188 nodes and 183 241 elements. The average range of motion of each segment of the model was basically consistent with the results of published research data. When the Z-axis rotational degrees of freedom of the upper surfaces of the C₆, C₅, and C₄ vertebrae were fixed successively, the peak stress of the bilateral facet joints and intervertebral discs changed significantly compared with the untreated group. The peak stress of the bilateral facet joints of C₃-C₄ in the C₅ fixation group decreased slightly compared with the untreated group, while the peak stress of the bilateral facet joints of C₄-C₅ increased significantly. Under other conditions, compared with the untreated group, the overall stress of the facet joints below the fixed segment decreased compared with the untreated group, while the overall stress above the fixed segment increased. The peak stress and distribution characteristics of the bilateral facet cartilage from C₃ to C₇ were mainly concentrated on the opposite side of rotation, with the right cartilage of C₃-C₄ as the stress concentration point. The peak stress and distribution characteristics of the intervertebral discs from C₃ to C₇ were mainly concentrated on C₄-C₅, but after fixing the Z-axis degree of freedom of the upper surface of C₄, the peak stress of the intervertebral discs became C₃-C₄. Conclusion The reduction in rotational degrees of freedom caused by vertebral displacement can lead to obstruction to of biomechanical transmission throughout the cervical spine. The range of motion in the segments below the affected vertebra decreases, while the segments above the affected vertebra compensate by increasing their range of motion to accomplish the overall coupled movement of the cervical spine. This compensatory mechanism accelerates the degeneration of the segments above the affected vertebra.

Objective To investigate the effect of doses of radioactive iodine-131（¹³¹I）therapy on survival and quality of life of patients with differentiated thyroid cancer（DTC）. Methods The clinical data of 126 DTC patients who received ¹³¹I treatment after total thyroidectomy between 2017 and 2020 at Quanzhou First Hospital was retrospectively analyzed. The patients were divided into group A（53 patients, 1.1 GBq）, group B（45 patients, 3.7 GBq）, and group C（28 patients, 5.5 GBq）according to the dose of ¹³¹I treatment before the clearance rate of residual thyroid tissue, the incidence of tumor recurrence or metastasis, adverse reactions, overall survival（OS）, disease-free survival（DFS）and scores of quality of life were compared. Results There were no statistically significant differences in the clearance rate of thyroid residual tissue or the incidence of tumor recurrence or metastasis between the three groups（P>0.05）. The incidence of hematologic adverse reactions in Group C was higher than in Groups A and B（all P<0.05）. Multivariate analysis showed that the ¹³¹I dose（HR=1.989, 95%CI=1.029~3.845）and age（HR=1.080, 95%CI=1.008~1.157）were risk factors for the survival curve. Postoperative complications（HR=0.066, 95%CI=0.014~0.301）was protective factor for the survival curve. The SF-36 scores of group A were higher than those of groups B and C（P=0.046, P<0.001）, and higher in group B than in group C（P=0.020）. EQ-5D scores were higher in Group A than in Group C（P=0.002）. The levels of thyroglobulin（Tg）, thyroglobulin antibody（TgAb）, thyroid stimulating hormone（TSH）, and parathyroid hormone（PTH）in Group B were lower than in Groups A and C（P<0.001 or P<0.05）. Conclusion In patients with DTC, the dose of ¹³¹I therapy should be chosen based on the individual patient's condition. Too high a dose may increase the risk of adverse effects, lower the patient's quality of life, and impact the patient's physical, psychological, and social functioning.

Objective To explore the applicability of three types of irrigations in the root canal therapy of pulpitis. Methods Ninety-three patients with pulpitis treated in the Department of Stomatology, North District of the First Affiliated Hospital of Anhui Medical University, between January 2021 and June 2023 were selected as the subjects, who were randomized into the observation group A（n=31）, observation group B（n=31）and control group（n=31）using the random number table method. During root canal preparation, patients in group A were given 3% sodium hypochlorite irrigation, those in group B 1% sodium hypochlorite irrigation, and those in group C 3% hydrogen peroxide irrigation. The number of root canal bacterial colonies and the endotoxin contentin the affected teethbefore and after root canal preparationusingtheirrigationsolutions, the levels of matrix metalloproteinase（MMP）-2, MMP-8 and MMP-9 levels in root canal exudates.Inflammatory cytokines（IL-8, TNF-α）in gingival crevicular fluidbefore using theirrigationsolutionsandat 1-weekafter using theirrigationsolutions. Occlusal pain（VAS scores）before using the irrigationsolutions and at 24 h, 48 h, and 1-week after using the irrigationsolutions. Treatment success rates were assessed after 1-year follow-up. Results After using the flushing solution, the bacterial count and endotoxin content in the root canal of Group A were lower than those of Group B and Group C. The levels of MMP-2 and MMP-8 in Group A were lower than those in Group B and Group C. The levels of MMP-9 in Group A were lower than those in Group B and Group C, and the differences were statistically significant（all P<0.001）; After using the flushing solution for one week, the IL-8 level in group A was lower than that in group C（P=0.007）, and the TNF-α level was lower in group A than in group B than in group C, with statistically significant differences（P<0.05）; After using the flushing solution for 24 hours, 48 hours, and 1 week, Group A<Group B<Group C, and the differences were statistically significant（P<0.01）. After a one-year follow-up, the success rates of Group A, Group B, and Group C were 96.55%（28/29）, 76.92%（20/26）, and 75.00%（18/24）, respectively, with no statistically significant difference between the groups（P=0.079）. Conclusion In root canal therapy of pulpitis, sodium hypochlorite irrigations can more effectively reduce the number of root canal bacterial colonies and lower the endotoxin content. Meanwhile, 3% sodium hypochlorite irrigation can inhibit the expressions of matrix metalloproteinases and inflammatory factors, relieve pain after treatment and enhance the success rate of treatment, making it the preferred option for root canal irrigations. The overall curative effect can help optimize the treatment process of pulpitis. Future research can explore the concentration gradient effect and the association with long-term prognosis.

Objective To investigate the factors influencing the efficacy of treatment for unilateral sudden deafness. Methods A total of 304 patients with unilateral sudden deafness admitted to the Department of Otolaryngology, Heze Municipal Hospital, from January 2022 to May 2024 were selected. The treatment efficacy rates were compared under different clinical characteristics. Multivariate logistic regression analysis was used to analyse the impact of clinical characteristics on treatment outcomes in patients with unilateral sudden deafness, and the total scores of the Symptom Checklist 90 were compared before and after treatment. Results There were statistically significant differences in treatment efficacy rates among patients with different disease durations, audiogram types, and the presence or absence of anxiety and depression（χ²=7.293, 23.198, 10.743, P=0.001, <0.001, =0.001）. The results of the multivariable logistic regression analysis showed that disease duration（OR=3.669, 95%CI: 1.322~10.177）, hearing curve（OR=2.878, 95%CI: 0.273~30.284）, and anxiety/depression（OR=2.846, 95%CI: 1.177~6.879）were identified as factors influencing treatment efficacy in patients with unilateral sudden sensorineural hearing loss. After 2 weeks of treatment, the total Symptom Checklist 90 score was higher than before treatment, with a statistically significant difference（t=43.504, P<0.001）. Conclusion The factors influencing the efficacy of treatment for unilateral sudden deafness are duration of illness, type of audiometric curve, and anxiety and depression. Therefore, these factors should be prioritised in clinical treatment.

Objective To analyze the clinical characteristics of adult onset Still's disease（AOSD）in order to improve the diagnostic accuracy and therapeutic effect and reduce the incidence. Methods The clinical data of 37 inpatients with adult-onset Still's disease admitted to Air Force Medical Center in 2021-2024 was collected and analyzed retrospectively. Results Thirty-four patients received blood cultures while another 30 patients underwent bone marrow puncture to rule out the possibility of infections or tumors. There was fever in 35 cases, rash in 31 cases, arthralgia in 28 cases, muscle pain in 25 cases, pharyngeal pain in 19 cases, itching in 19 cases, swollen lymph nodes in 15 cases and an enlarged spleen in 1 case. According to laboratory indicators, there were 25 cases whose white blood cells exceeded10×10⁹/L, 23 cases of liver dysfunction, 33 cases of negative rheumatoid factors, and 32 cases of negative antinuclear antibodies. Two cases were not treated symptomatically. Only NSADs were used in 3 cases. while compound glycyrrhizin injection alone was used in 5 cases. Glucocorticoids were used in 27 cases, immunosuppressors combined with glucocorticoids in 4 cases, and IVIG in 2 cases. Two cases were complicated with macrophage activation syndrome, who were treated with high-dose glucocorticoids and IVIG. Conclusion The main manifestations of AOSD are fever, rash, joint pain, muscle pain, sore throat and itching. Specific laboratory indicators for diagnosis of AOSD are still lacking. Glucocorticoids are the first-line treatment of AOSD. In severe cases, immunosuppressants and IVIG can be added for treatment.

Objective To analyze the clinical effects of pelvic floor muscle training combined with regular schedule guidance in patients with urinary incontinence after prostatic hyperplasia surgery. Methods A total of 150 patients with urinary incontinence after transurethral prostatectomy treated in our hospital between December 2022 and December 2024 were selected and divided into a control group（n=75）and a study group（n=75）using the random sampling method. The control group was subjected to bladder function training while the study group underwent pelvic floor muscle training combined with guidance on regular schedules. The efficacy, scores of the International Consultation Incontinence Questionnaire-Short Form（ICIQ SF）, number of times of urine leakage, negative emotions, Chronic Prostatitis Symptom Index（NIH-CPSI）, scores of the Visual Analogue Scale（VAS）and Pain Perception Index（PPI）were compared between the two groups. Results The effective rate of treatment in the study group was higher than in the control group（χ²=8.963, P=0.003）. After treatment, the ICIQ-SF score and the number of times of urine leakage were lower in the study group than in the control group（t=14.208, 9.319, both P<0.001）, so were the scores of the Self-Rating Anxiety Scale（SAS）and Self-Rating Depression Scale（SDS）（t=3.060, 3.570, P=0.003, 0.001）. The scores of NIH -CPSI, VAS and PPI in the study group were also lower（t=6.408, 2.684, 9.826, P<0.001, =0.008, <0.001）. Conclusion The application of pelvic floor muscle training combined with regular schedule guidance in patients with urinary incontinence after transurethral prostatectomy can help reduce the number of times of urine leakage, improve negative emotions and alleviate pain.