With the aggravation of global aging and the increase of incidence rate of stroke, traumatic brain injury, and other neurological diseases, the need for upper limb rehabilitation is increasingly urgent. Traditional rehabilitation methods are limited by the shortage of therapist resources and the difficulty in quantifying treatment intensity and effectiveness. However, upper limb rehabilitation robots provide a new direction to solve these problems. This article systematically reviewed the research progress and clinical application status of terminal traction and exoskeleton upper limb rehabilitation robots. Through in-depth analysis of relevant literature, the technical characteristics, clinical efficacy, and application scenarios of these two types of robots were summarized. Research has found that upper limb rehabilitation robots have shown positive potential in improving limb function and enhancing daily living activities in patients with upper limb motor dysfunction, and have achieved certain results in both short-term and long-term rehabilitation treatments, but there is still a lack of large-scale, long-term research data support to compare with traditional rehabilitation methods. At present, this field is facing challenges such as high equipment costs, complex operations, and insufficient clinical validation. In the future, there is an urgent need to enhance the intelligence, adaptability, and cost-effectiveness of rehabilitation robots through the integration of artificial intelligence, biomechanics, and sensor technology, and to develop user-friendly products that better meet the needs of patients. This will promote the widespread application of rehabilitation robots in clinical practice and effectively improve the quality of life of patients with upper limb dysfunction.

Objective To explore the application effect of ultrasound shear wave elastography （SWE） in the evaluation of efficiency of lower limb spasticity rehabilitation in stroke patients and its potential correlation with the demand for surgical treatment. Methods Sixty stroke patients with hemiplegia and spasticity in the lower limbs （research group） and 60 healthy volunteers （control group） who were treated at Shanghai Ruijin Rehabiliation Hospital from January 2023 to December 2024 were enrolled in the study. The Young’s modulus （YM） values of gastrocnemius muscle in the control group and the research group before and after rehabilitation treatment were measured by SWE, and the lower limb muscle strength of the research group before and after rehabilitation was evaluated by modified Ashworth scale （MAS）. After treatment, the research group was divided into a predictive operation group （the YM values of the affected side >50% of the healthy side, and secondary intervention was required） and a conservative treatment group （no secondary intervention was required） according to the changes of gastrocnemius muscle YM values before and after treatment to compare the YM values before treatment. Results In the research group, the YM value of the gastrocnemius muscle was significantly decreased after treatment [（63.45±19.92） kPa vs （48.32±19.83） kPa, P<0.05], and the MAS score was significantly improved [（2.35±1.02） vs （1.50±1.23）, P<0.05]. There was a positive correlation between YM and MAS scores （r=0.630, P<0.05）. Subgroup analysis showed that the predictive operation group （22 cases） had a significantly higher YM value than the conservative treatment group [（78.35±14.18） kPa vs（46.19±18.40） kPa, P<0.05]. Conclusion SWE can quantitatively analyze the rehabilitation effect of post-stroke spasticity of lower limbs and predict the demand for treatment （High YM value is potentially associated with the demand for surgical treatment）, which provides objective and powerful evidence for clinical treatment.

Objective To explore the effect of bioactive ceramic iRoot BP plus in the treatment of young permanent anterior teeth with complex crown fractures among children undergoing pulpotomy. Methods From January 2021 to January 2025, a total of 82 cases of young permanent anterior teeth with complex crown fractures undergoing pulpotomy were selected and randomly divided into two groups： 41 cases in the control group were treated with mineral trioxide polymer pulp capping, and 41 cases in the observation group were treated with bioactive ceramic iRoot BP Plus pulp capping. The treatment effect, adverse reactions, pain symptoms, discoloration, root canal length, and root canal wall thickness of children in the two groups were compared. Results The treatment success rate of the observation group was higher than that of the control group （P<0.05）, and the incidence of adverse reactions of the observation group was lower than that of the control group （P<0.05）. The pain symptoms and discoloration scores of the observation group were lower than those of the control group at 7 d, 1 month, 3 months, and 6 months after operation （P<0.05）. The root canal length and root canal wall thickness of the observation group were greater than those of the control group at 1 month, 3 months, and 6 months after operation （P<0.05）. Conclusion The application of bioactive ceramic iRoot BP Plus pulp capping in pulpotomy of young permanent anterior teeth with complex crown fractures in children can improve the treatment effect, reduce adverse reactions, alleviate pain symptoms and discoloration, and effectively improve the root canal condition.

Objective To investigate the effects of 3D printing combined with emergency lateral approach surgery on stress response and inflammatory factors in patients with traumatic calcaneal fractures. Methods The research subjects were 126 patients with traumatic calcaneal fractures admitted from February 2021 to February 2024. They were randomly divided into an observation group and a control group using the envelope method, with 63 patients in each group. The control group received emergency lateral approach surgery with traditional X-ray assistance, while the observation group received 3D printing+emergency lateral approach surgery. The differences in serum inflammatory factors, stress indicators, imaging parameters, and ankle joint function at the final follow-up were compared between the two groups. Results Compared with before surgery, the interleukin-6 （IL-6）, C reactive protein （CRP）, tumor necrosis factor-alpha （TNF-α）, and cortisol （Cor） all increased on postoperative day 1, but the increase in the observation group was smaller than that in the control group （P<0.05）. Compared with before surgery, the Bohler angle and Gissane angle significantly increased one week after surgery, and the increase in the observation group was greater than that in the control group （P<0.05）. There was no statistically significant difference in calcaneal width and calcaneal length before and 1 week after surgery （P>0.05）. The calcaneal height of both groups one week after surgery was significantly higher than that before surgery （P<0.05）, but there was no statistical difference between the two groups （P>0.05）. At the final follow-up, the excellent and good rate of ankle joint function in the observation group was significantly higher than that in the control group （P<0.05）. Conclusion The application of 3D printing combined with emergency lateral approach surgery for patients with traumatic calcaneal fractures enables clinicians to become more familiar with the surgical procedure, thereby reducing postoperative inflammatory factors and stress response, and enhancing imaging parameters and ankle joint function.

Objective To compare the effects of compression screw fixation versus wire-anchored strapping fixation on rotator cuff injury combined with rupture of long head biceps tendon （LHBT） under arthroscopy. Methods In this study, 75 patients with rotator cuff injury complicated with LHBT rupture who received compression screw fixation from November 2021 to November 2023 were selected as the screw group, and another 75 patients with rotator cuff injury complicated with LHBT rupture who received wire anchor binding and fixation at the same time period were selected as the anchor group. The clinical data of the two groups were retrospectively analyzed. Results There were no significant differences in visual analog scale （VAS） scores, University of California at Los Angeles Shoulder Rating Scale （UCLA） scores, American Shoulder and Elbow Surgeon’s Form （ASES） scores, and shoulder joint motion between the two groups before surgery （P>0.05）. The VAS, UCLA, and ASES scores and shoulder joint motion between the two groups at all time points （3, 6, and 12 months） were significantly higher than those before surgery （P<0.05）. The VAS scores of the screw group at 3 months and 6 months after surgery were significantly lower than those of the anchor group （P<0.05）, and there was no significant difference in VAS score between the two groups at 12 months after surgery （P>0.05）. There were no significant differences in UCLA and ASES scores and shoulder joint motion between the two groups at each time point after surgery （P>0.05）. The complication rate of the screw group was significantly higher than that of the anchor group （P<0.05）, and there was no significant difference in reoperation rate between the two groups （P>0.05）. Conclusion Both fixation methods have good therapeutic effects. Compression screw fixation can better control the early postoperative pain of patients, and wire anchor binding and fixation can effectively reduce the occurrence of postoperative complications, so the clinical selection should be based on the specific situation.

Objective To investigate the efficacy and safety of neoadjuvant intraperitoneal and systemic chemotherapy （NIPS） combined with sintilimab in the treatment of peritoneal metastasis of gastric cancer. Methods A total of 82 patients with gastric cancer peritoneal metastasis admitted from June 2021 to June 2024 were selected and divided into a control group and an observation group according to treatment methods, with 41 cases in each group. The control group was treated with NIPS therapy, while the observation group was treated with NIPS combined with sintilimab. Clinical efficacy, tumor markers carbohydrate antigen （CA） 125, CA19-9, and carcinoembryonic antigen （CEA）, cytokine levels vascular endothelial growth factor （VEGF）, 6-month survival, and toxic side effects were compared between the two groups. Results The clinical effective rate of the observation group （70.73%, 29/41） was higher than that of the control group （48.78%, 20/41） （P<0.05）. The levels of CA125, CA19-9, CEA, and VEGF were not different between the two groups before treatment; the levels were reduced after 3 months of treatment, and lower in the observation group than in the control group （P<0.05）. During the 6-month follow-up period, compared to the control group （41.46%, 17/41）, the observation group had a higher rate of survival （65.85%, 27/41） （P<0.05）. There was no statistically significant difference in toxic side effects between the two groups （P>0.05）. Conclusion The combination of NIPS and sintilimab has shown high efficacy and good safety in the treatment of gastric cancer peritoneal metastasis, providing a new choice for the treatment of patients with gastric cancer peritoneal metastasis.

Objective To evaluate the efficacy of methylene blue compound for proximal intercostal nerve block during thoracotomy for radical resection of esophageal cancer, and to provide additional options for nerve block techniques in such procedures. Methods A total of 120 patients undergoing thoracotomy for radical resection of esophageal cancer from June 2022 to December 2023 were selected as study subjects and divided into a control group and an experimental group by random number table method, with 60 cases in each group. The control group received general anesthesia alone, while the experimental group received general anesthesia combined with methylene blue and ropivacaine for proximal intercostal nerve block. Operation time, blood loss during operation, the occurrence of hypotension and arrhythmia during surgery, and postoperative thoracic complications （such as pleural effusion and pulmonary infection） were recorded in the two groups. Postoperative pain was assessed using the visual analogue scale （VAS） 1, 3, 7, and 15 d after surgery. Results There were no significant differences in operation time, intraoperative blood loss, and the incidence of hypotension and arrhythmia during surgery between the two groups （P>0.05）. However, the incidence rates of postoperative thoracic complications and VAS scores in the experimental group were significantly lower than those in the control group （P<0.05）. Conclusion Methylene blue compound for proximal intercostal nerve block in thoracotomy for radical resection of esophageal cancer can effectively reduce thoracic complications and alleviate postoperative pain.

Objective To investigate of the application value of ciprofol combined with alfentanil in endoscopic submucosal dissection （ESD） of gastric masses. Methods Sixty patients who underwent gastric mass ESD from January 2023 to January 2024 were selected and randomly divided into a ciprofol anesthesia group （experimental group） and a propofol anesthesia group （control group） using a random number table method, with 30 patients in each group. In the control group, anesthesia was induced using 2 mg/kg propofol, 20 μg/kg alfentanil, and 0.15 mg cisatracurium, and maintained with 5 mg/（kg·h） propofol and 0.5 μg/（kg·min） alfentanil. In the experimental group, anesthesia was induced using 0.4 mg/kg ciprofol, 20 μg/kg alfentanil, and 0.15 mg/kg cisatracurium, and maintained with 1 mg/（kg·h） ciprofol and 0.5 μg/（kg·min） alfentanil. Comparisons were made between the two groups for hemodynamic indicators including non-invasive blood pressure （NIBP）, heart rate （HR）, oxygen saturation （SpO₂）, and partial pressure of end tidal carbon dioxide （PetCO₂）, surgical indicators （including extubation time, eye opening time, and agitation score）, and serum norepinephrine （NE） and cortisol （Cor） levels. Results At the time of entering the operation room （T0）, there was no significant difference in NIBP, HR, SpO₂, and PetCO₂ between the two groups （P>0.05）. After induction （T1）, at tracheal intubation （T2）, and after tracheal extubation （T3）, NIBP, HR, and SpO₂ decreased significantly while PetCO₂ increased, and compared with the control group, the experimental group had significantly higher NIBP, HR, and SpO₂ and significantly lower PetCO₂ （P<0.05）. When leaving the operation room （T4）, NIBP, HR, and SpO₂ increased, while PetCO₂ decreased, and the experimental group was better than the control group （P<0.05）. The extubation time, eye opening time, and agitation score of the experimental group were all lower than those of the control group （P<0.05）. There was no significant difference in the levels of NE and Cor at T0 between the two groups （P>0.05）, while the levels of NE and Cor at T1 and T4 increased significantly in both groups, and the levels of NE and Cor in the experimental group were lower than those in the control group （P<0.05）. Conclusion Compared with propofol combined with alfentanil, the combination of ciprofol and alfentanil in ESD surgery for gastric masses can effectively reduce hemodynamics, downregulate NE and Cor expression, shorten the time for extubation and eye opening, and alleviate patient agitation.

Objective To investigate the anesthetic therapeutic effect of ciprofol combined with remimazolam in painless gastroscopy and to explore its approperiate dose. Methods This study selected 800 patients who received painless gastroscopy in our hospital from February 2024 to December 2024. They were randomly divided into a control group and groups A1, A2, and A3, with 200 patients in each group. The control group patients were induced with remimazolam anesthesia （0.3 mg/kg）, Groups A1, A2, and A3 were induced with 0.20, 0.25, and 0.30 mg/kg ciprofol combined with 0.15 mg/kg remimazolam anethesia. Comparisons were conducted on the anesthesia induction time, gastrointestinal endoscopy duration, awakening time, directional force recovery time, heart rate, blood pressure, blood oxygen saturation, and incidence of adverse reactions. Results The success rate of sedation in Group A2 was significantly higher than that in the control group and Group A1 （P<0.05）, and there was no significant difference compared to Group A3 （P>0.05）. The duration of gastrointestinal endoscopy in Group A2 was significantly shorter than that in the control group and Group A1 （P<0.05）, and there was no significant difference compared to Group A3 （P>0.05）. The awakening time and directional force recovery time in Group A2 were significantly shorter than those in the control group and Group A3 （P<0.05）, and there was no significant difference compared to Group A1 （P<0.05）. The heart rates at loss of ciliary reflex after induction of anesthesia （T1） and at the begining of gastrointestinal endoscopy （T2） of the four groups of patients were all significantly reduced compared to 5 min before pre-anethesia （T0） （P<0.05）, and the decrease in heart rate in Group A2 was significantly lower than those in the control group, Group A1, and Group A3 （P<0.05）. The heart rate in Group A3 at the end of surgery （T3） was significantly lower than those in the control group, Group A1, and Group A2 （P<0.05）, while there was no significant difference between the control group, Group A1, and Group A2 （P>0.05）. The blood pressure values at T1 and T2 of the four groups of patients were significantly lower than those at T0 （P<0.05）, and the decrease in blood pressure in Group A2 was significantly lower than those in Groups A1 and A3 （P<0.05）. The blood pressure in Group A3 at T3 was significantly lower than those in the control group, Group A1, and Group A2 （P<0.05）, and there was no significant difference between the control group, Group A1, and Group A2 （P>0.05）. The blood oxygen saturation levels at T1 and T2 of the four groups of patients were significantly reduced compared to T0 （P<0.05）. The decrease in blood oxygen saturation level in Group A3 was significantly higher than those in the control group, Group A1, and Group A2 （P<0.05）. The blood oxygen saturation level at T3 in Group A3 was significantly lower than those in the control group, Group A1, and Group A2 （P<0.05）, while there was no significant difference between the control group, Group A1, and Group A2 （P>0.05）. The incidence of adverse reactions in Group A2 （10.00%） was significantly lower than those in the control group （21.00%）, Group A1 （12.00%）, and Group A3 （13.00%） （χ²=11.408, P<0.05）. Conclusion The combination of 0.25 mg/kg ciprofol and 0.15 mg/kg remimazolam in painless gastroscopy can exert the same sedative effect of ciprofol at high doses, which is beneficial for maintaining stable vital signs of patients without causing significant impact on their breathing, while reducing the occurrence of adverse reactions.

Objective To analyze the effects of different anesthesia methods on the occurrence of bone cement implantation syndrome in elderly patients undergoing bone cement hemiarthroplasty. Methods A total of 70 elderly patients who underwent bone cement hemiarthroplasty from January 2023 to March 2024 at Guangxi International Zhuang Medical Hospital were selected as study subjects and divided into an observation group and a control group based on different anesthesia methods, with 35 patients in each group. The observation group received combined spinal epidural anesthesia, while the control group received epidural anesthesia. The study compared central venous pressure （CVP） levels before anesthesia （T₀） and 5 min after anesthesia onset （T₁）, anesthesia onset time, recovery time, muscle relaxation effect, analgesic effect, incidence of bone cement implantation syndrome, and cognitive function scores and quality of life scores 3 months post-surgery between the two groups. Results At T₀, there was no statistically significant difference in CVP levels between the two groups of patients（P>0.05）. At T₁,the CVP levels in the observation group increased slightly, but there was no statistically significant difference compared to T₀ （P<0.05）, and the control group showed a significant decrease in CVP levels compared to T₀ （P>0.05）. The observation group showed shorter anesthesia onset time and recovery time, as well as lower dosage of anesthetic drugs and incidence of bone cement implantation syndrome than the control group （P<0.05）. The muscle relaxation and analgesic effects in the observation group were superior to those in the control group （P<0.05）.The cognitive function score and quality of life score at 3 months after surgery in the observation group were higher than those in the control group （P<0.05）. Conclusion Lumbar epidural anesthesia is more effective than epidural anesthesia in elderly patients undergoing bone cement hemiarthroplasty, and can effectively ensure hemodynamic stability and reduce the incidence of bone cement implantation syndrome.

Objective To investigate the effects of esketamine combined with propofol anesthesia on postoperative recovery and delirium in patients undergoing laparoscopic cholecystectomy. Methods A total of 92 patients who underwent laparoscopic cholecystectomy from June 2022 to June 2024 were selected and randomly divided into two groups using a computerized random table, with 46 cases in each group： a control group （odd numbers） and an observation group （even numbers）. The control group received sufentanil combined with propofol anesthesia, while the observation group received esketamine combined with propofol anesthesia. The study compared and analyzed vital signs （mean arterial pressure and heart rate）, postoperative recovery time （postoperatuve awakening time, extubation time, and orientation recovery time）, postoperative pain scores （by visual analog scale）, and the incidence of postoperative delirium between the two groups. Results After anesthesia induction, at tracheal intubation, and at tracheal extubation, the vital signs of the observation group were higher than those of the control group （P<0.05）. The postoperative recovery time of the observation group was shorter than that of the control group （P<0.05）. At 0.5, 2, 6, 12, and 24 h postoperatively, the pain scores （VAS scores） of the observation group were lower than those of the control group （P<0.05）. The incidence of postoperative delirium in the observation group was lower than that in the control group （P<0.05）. Conclusion The use of esketamine combined with propofol anesthesia during laparoscopic cholecystectomy can stabilize vital signs, shorten postoperative recovery time, reduce postoperative pain symptoms, and lower the incidence of postoperative delirium.

Objective To analyze the risk factors for recurrence of intracranial aneurysms after interventional treatment. Methods Forty patients with intracranial aneurysms admitted to our hospital from June 2021 to June 2023 were selected as study subjects. All patients underwent interventional treatment and were followed up for one year after surgery. Arterial angiography was performed 6 months postoperatively and again one year later to check for recurrence. The patients were divided into a recurrence group （11 cases） and a non-recurrence group （29 cases） based on whether the aneurysm had recurred. The aneurysm location, aneurysm diameter, aneurysm neck classification, Raymond grading, smoking and alcohol consumption after treatment were compared between the two groups. Multivariate logistic regression analysis was used to identify the risk factors for recurrence of intracranial aneurysms after interventional treatment, and corresponding prevention strategies were formulated. Results There was no statistically significant difference in the location of aneurysms between the recurrence group and the non-recurrence group （P>0.05）. The recurrence group had higher incidence rates of aneurysms with a diameter of 5-6 mm, a wide neck type, and class Ⅱ-Ⅲ by Raymond grading, and smoking and alcohol consumption rates after treatment compared to the non-recurrence group （P<0.05）.The multivariate logistic regression analysis showed that aneurysm diameter, aneurysm neck classification, Raymond grading, smoking, and alcohol consumption were independent risk factors for recurrence of intracranial aneurysms after interventional treatment. Conclusion The risk factors for recurrence of intracranial aneurysms after interventional treatment include aneurysm diameter, aneurysm neck classification, Raymond grading, smoking, and alcohol consumption. It is recommended that patients with large aneurysm diameter, wide aneurysm neck classification, and high Raymond grading undergo regular postoperative follow-up and early intervention. In addition, it is recommended that patients avoid smoking and alcohol consumption after surgery to reduce the risk of disease recurrence.

Objective To investigate the clinical effect of press needle acupuncture combined with general measures on urinary retention after opeartion of mixed hemorrhoids. Methods A total of 74 female patients who underwent mixed hemorrhoid ligation and stripping surgery from January 2022 to December 2024 were selected and randomly divided into an observation group and a control group, with 37 cases in each group. The observation group was treated with press needles combined with analgesia, while the control group was treated with general analgesia alone. After treatment, the postoperative first urination time,abdominal symptom scores, smooth urination scores, catheterization rate, and effective rate were compared between the two groups. Results After the intervention, the observation group showed shorter time of first postoperative urination （P<0.05）, lower abdominal symptom score at first postoperative urination （P<0.05） and smooth urination score at first postoperative urination （P<0.05）, and higher effective rate （P<0.05） than the control group. Conclusion Press needle acupuncture combined with general analgesiais more effective than conventional treatment in the prevention and treatment of urinary retention after mixed hemorrhoids surgery, effectively improving perioperative medical experience and accelerating postoperative rehabilitation, which is worthy of clinical promotion and application.

Objective To evaluate the clinical efficacy of Jiegumukang decoction in the treatment of femoral shaft fractures. Methods A randomized controlled trial was conducted to compare the differences in fracture healing time, pain relief, and functional recovery between the Jiegumukang decoction treatment group and the conventional treatment group. Results The average healing time of fractures in the Jiegumukang decoction treatment group was shortened by about 26% compared to the conventional treatment group, and there were significant differences in pain scores and knee function scores between the two groups. Conclusion This study indicates that Jiegumukang decoction can effectively promote the healing of femoral shaft fractures and has high clinical application value.

Objective To investigate the effect of laparoscopic transperitoneal preperitoneal hernia repair （TAPP） on elderly inguinal hernia. Methods A total of 100 elderly patients with inguinal hernia admitted to the First Hospital of Sanming City affiliated to Fujian Medical University from January 2022 to September 2023 were selected as study participants, and were divided into an observation group and a control group according to the surgical method, with 50 cases in each group. The control group received open tension-free hernia repair, and the observation group received TAPP treatment. The effects of the two groups were compared and analyzed. Results The operation time in the observation group was significantly longer than that in the control group （P<0.05）. The amount of bleeding in the observation group was significantly less than that in the control group （P<0.05）. The gastrointestinal recovery time and hospital stay in the observation group were significantly shorter than those in the control group （P<0.05）. Before operation, there was no significant difference in visual analogue scale （VAS） score between the two groups （P>0.05）. After operation, the VAS scores at different time points in the observation group were significantly lower than those in the control group （P<0.05）. There was no significant difference in the 36-Item Short Form Health Survey （SF-36） score between the two groups before operation （P>0.05）. After operation, the SF-36 scores in both groups were significantly increased than those before operation （P<0.05）, and the SF-36 score in the observation group was significantly higher than that in the control group （P<0.05）. The incidence of complications in the observation group was significantly lower than that in the control group （P<0.05）, but there was no significant difference in recurrence rate between the two groups （P>0.05）. Conclusion TAPP is safe and effective in the treatment of elderly inguinal hernia, and worthy of promotion.

Objective To investigate the effect of interlocking intramedullary nailing for fracture nonunion on bone metabolism. Methods From May 2018 to March 2023, a total of 60 patients with nonunion after lower limb fracture were randomly divided into two groups, with 30 cases in each group. The control group was treated with dynamic compression plate internal fixation, and the experimental group was treated with interlocking intramedullary nail fixation. Both groups were additionally treated with nerve growth factor. The time of callus appearance and the time of fracture healing were recorded, and clinical efficacy was evaluated. The serum levels of type Ⅰ collagen β C-terminal cross-linked telopeptide （β-CTX）, osteocalcin （BGP）, and type Ⅰ procollagen N-terminal propeptide （PINP） were detected before and after treatment. Results Compared with the control group, the callus appearance time and fracture healing time in the experimental group were significantly shortened （P<0.05）. The excellent and good rate of treatment of the experimental group （86.67%） was significantly higher than that of the control group （56.67%） （P<0.05）. Before treatment, there was no significant difference in bone metabolism indexes between the two groups. After treatment, the changes of bone metabolism indexes in the two groups showed improved osteogenesis compared with that before treatment （the level of β-CTX was reduced, and the levels of BGP and PINP were increased） （P<0.05）; in addition, the level of β-CTX in the experimental group was significantly lower and the levels of BGP and PINP were significantly higher in the experimental group than those in the control group （P<0.05）. Conclusion In the treatment of fracture nonunion, the use of interlocking intramedullary nailing can not only reduce postoperative functional recovery time and complications, but also relieve pain and improve the ability of daily living, which is worthy of recommendation.

Objective To investigate the efficacy and safety of flexible ureteroscopy （FURS） in the treatment of upper urinary tract stones. Methods The clinical data of 60 patients with upper urinary tract stones from April 2022 to December 2023 were retrospectively analyzed. All patients were treated with FURS. Among them, there were 13 cases of renal pelvis stones, 11 cases of upper calyceal stones, 14 cases of middle calyceal stones, 10 cases of lower calyceal stones, 12 cases of upper ureter stones; 39 cases of stone diameter ≤20 mm, 21 cases of 20-40 mm stones. Results All the 60 patients successfully completed the operation, and the operation time was （44.29±11.71） min. No complications occurred during the operation. After operation, 11 cases of fever （18.33%）, 14 cases of hematuria （23.33%）, 1 case of urinary sepsis （1.67%）, 5 cases of lumbago （8.33%） occurred. All patients were followed up, and 53 patients reached the stone removal standard, among which 39 patients had no stone residue and 14 patients had stone residue ≤4 mm, and the total stone removal rate was 88.33%; 7 cases did not meet the standard of stone removal, and the unremoved rate was 11.67%, among which 4 cases received extracorporeal shock wave lithotripsy, 3 cases again underwent FURS.The first-stage removal rates of renal pelvis, upper calyceal, middle calyceal, lower calyceal, and upper ureter stones were 100.00%（13/13）, 81.82%（9/11）, 100.00%（14/14）, 60.00%（6/10）, and 91.67%（11/12）, respectively. The first-stage removal rates of stones with diameter ≤20 mm and 20-40 mm were 92.31% （36/39） and 80.95% （17/21）, respectively. There were no statistically significant differences in the first-stage removal rates of stones in different parts and with different diameters （P>0.05）. The patients were followed up for 8 to 19 months, and no stone recurrence or renal atrophy occurred. Conclusion FURS is safe and reliable in the treatment of upper urinary tract stones with high first-stage stone removal rate.

Objective To explore the application effect of unique identification code in the full lifecycle management of dental handpieces. Methods Sixty newly purchased dental handpieces from August 2023 to August 2024 were selected as research objects. Among them, 30 dental handpieces were assigned to the control group and managed using traditional methods; the other 30 dental handpieces were assigned to the observation group and were coded before use with unique identification code. The differences in usage frequency, completeness of maintenance traceability, scrap rate, nursing staff management time, and healthcare provider satisfaction between the two groups were compared. Results The observation group showed higher usage frequency, higher mainenance treaceability completeness rate, lower scrap rate, lower management time of nursing staff, and higher satisfaction rate of medical staff than the control group （P<0.05）. Conclusion Unique identification code for the full lifecycle information traceability of dental handpieces can improve management quality, reduce labor costs, enhance healthcare provider satisfaction, and effectively ensure medical safety.

This paper first described the principles behind various monitoring functions of multi-parameter monitors in clinical use, including the measurement principles for ECG signals, respiratory rate, blood pressure, and blood oxygen saturation. The paper then detailed the testing methods, which analyzed equipment performance errors and functions through stimulated signals based on national metrological verification regulations （JJG760-2003） and quality control standards. Drawing on hospital maintenance data, it analyzed common fault types and causes, and proposed targeted solutions. Finally, specific strategies for equipment maintenance were presented, emphasizing optimized testing processes, enhanced preventive maintenance, and fault diagnosis to effectively improve the reliability of multi-parameter monitors and the efficiency of clinical operations. This research offers scientific guidance for medical equipment management.

This paper focused on the application and development trend of the Internet of Things technology in intelligent medical system. It started with an overview of the Internet of Things technology from the aspects of perception, data transmission, and blockchain, and then analyed its real-world applications in hospital multidisciplinary collaboration and home service tracking, demonstrating the role of intelligent medical system in optimizing traditional medical services and building new all-field medical service management. Finally, some suggestions on the future development trend were put forward.

Objective To explore the perioperative comprehensive nursing of porous high-density polyethylene（Medpor） implant through endoscopic transcaruncular approach in the treatment of medial orbital fracture. Methods A total of 17 patients with medial orbital fracture accompanied by enophthalmos and diplopia admitted from January 2021 to January 2024 were selected. After determining the fracture scope and soft tissue injury degree by imaging, an endoscopic transcaruncular approach was used under general anesthesia to restore depressed orbital contents into the orbit and reconstruct the fracture site by Medpor implant. The postoperative outcomes were evaluated. In the perioperative period, after comprehensive nursing intervention was implemented, patients' anxiety, depression, and life quality scores were compared before and after nursing, and patients' satisfaction with nursing was recorded. Results After operation, diplopia, binocular prominence difference, eye movement grade, and best corrected visual acuity were all significantly improved than those before （P<0.05）, and the treatment effective rate was 94.12%. All patients successfully completed the operation, and no complications such as infection, displacement of implant, or rejection occurred during the follow-up period. The proportions of patients with conjunctival tissue edema and eyelid edema at 3 months after operation were significantly lower than those at 1 week after operation （P<0.05）. After comprehensive nursing intervention in the perioperative period, the SAS score and SDS score of patients after nursing were significantly lower than before （P<0.05）, the quality of life score was significantly higher than before （P<0.05）, and the nursing satisfaction rate was 88.24%. Conclusion Medpor implant through endoscopic transcaruncular approach is effective in the treatment of medial orbital fracture, with high surgical success rate and rare complications. Perioperative comprehensive nursing intervention can relieve patients' anxiety and depression and improve the quality of life, which is worthy of clinical promotion.

In clinical practice, high-dose vitamin C is used for septic patients to play roles in antioxidant, immunomodulation, and improvement of vascular endothelial function. This article reported a septic patient treated with high-dose vitamin C, which affected the test results of venous blood glucose, and summarized nursing critical thinking. Although the patient ended up with a poor outcome, summarizing nursing management experience would improve the nursing critical thinking for severe patients, and play a feedforward control, so as to positively and effectively improve nursing quality.