目的 探讨肥胖与肺功能参数的相关性。方法 将90例接受肺功能检查的患者依据体质指数（BMI）分为肥胖组（BMI≥25 kg/m²，n=50）和正常体质量组（18.5 kg/m²＜BMI≤24.9 kg/m²，n=40），比较两组各项肺功能参数的差异，包括肺通气功能的参数如［用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）、1秒率（FEV₁/FVC）、最大呼气流量（PEF）］以及反映小气道功能的参数［50%最大呼气流量（MEF₅₀），25%最大呼气流量（MEF₂₅）］；比较肥胖组不同性别间上述肺功能参数的差异及其与腰围（WC）与BMI的相关性。结果 肥胖组FVC、FEV₁、FEV₁/FVC、MEF₅₀、MEF₂₅低于正常体质量组（P＜0.01）；肥胖组中男性FVC及FEV₁低于女性（P＜0.01）。相关分析结果显示，肥胖组中WC与BMI均与肺功能多个参数呈负相关趋势，其中WC的负相关趋势更突出，且与FVC呈负相关关系（P＜0.05）。结论 肥胖影响反映肺功能的多个参数，表现为肺通气功能和小气道功能多个指标水平降低，且肥胖男性更甚；在肥胖人群中，相较于BMI，WC与FVC的关系更密切。

      Objective To investigate the correlation between obesity and pulmonary function parameters．Methods Ninety patients undergoing pulmonary function testing were categorized into an obese group（BMI≥25 kg/m²，n=50）and a normal-weight group（18.5 kg/m²＜ BMI≤24.9 kg/m²，n=40）．Differences in pulmonary function parameters were compared between groups，including ventilatory parameters（forced vital capacity［FVC］，forced expiratory volume in 1 second［FEV₁］，FEV₁/FVC ratio，peak expiratory flow［PEF］） and parameters reflecting small airway function（maximum expiratory flow at 50% of forced expiratory volume［MEF₅₀］，and 25% maximum expiratory flow［MEF₂₅］）．Differences in these pulmonary function parameters between genders within the obese group and their correlations with waist circumference（WC）and BMI were also assessed．Results FVC，FEV₁，FEV₁/FVC，MEF₅₀，and MEF₂₅ were significantly lower in the obese group compared to the normal-weight group（P＜0.01）．Among obese subjects，male FVC and FEV₁ were significantly lower than female values（P＜0.01）．Correlation analysis revealed negative correlations of WC and BMI with multiple pulmonary function parameters in the obese group，with WC exhibiting a more pronounced negative correlation and a significant negative relationship with FVC（P＜0.05）．Conclusions Obesity impacts multiple parameters reflecting lung function，manifesting as reduced levels of several indicators of pulmonary ventilation and small airway function，with male obese individuals exhibiting greater impairment．Within the obese population，WC correlates more closely with FVC than BMI．

       葛根芩连汤作为一种传统中药复方，在治疗代谢性疾病方面展现出显著的疗效。随着中草药现代研究方法的进步，逐渐揭示了葛根芩连汤在代谢性疾病中的治疗作用及其分子机制，包括葛根素、黄芩苷、小檗碱等活性成分的抗炎作用。然而，中草药研究领域的新理论和新机制被不断发现，如影响肠道菌群、产生植物外囊泡、中药汤剂成分自组装等，使得对葛根芩连汤作用机制的理解亟待更新。本文旨在综述葛根芩连汤在代谢性疾病中的作用及机制，并结合最新的研究成果，重点分析其在肠道菌群、植物外囊泡和中药自组装领域的相关发现，探讨其潜在的治疗靶点和未来研究方向，为临床应用和基础研究提供指导。

      Gegen Qinlian decoction（GQD），as a traditional Chinese herbal formula，has demonstrated significant efficacy in treating metabolic diseases．With advancements in modern research methodologies for Chinese herbal medicine，the therapeutic effects and molecular mechanisms of GQD in metabolic diseases have been progressively uncovered，including the anti-inflammatory properties of its active components such as puerarin，baicalin，and berberine．However，emerging theories and mechanisms in the field of herbal research，such as modulation of gut microbiota，production of plant-derived extracellular vesicles，and self-assembly of components in herbal decoctions，continuously refine our understanding，highlighting the need to update insights into GQD’s mechanisms of action．This review aims to summarize the roles and mechanisms of GQD in metabolic diseases，integrating the latest research progress with a focus on findings related to gut microbiota，plant-derived extracellular vesicles，and self-assembly phenomena．It further seeks to explore potential therapeutic targets and future research directions，thereby providing guidance for clinical applications and fundamental studies．

        目的 评估年龄调整内脏脂肪指数（AVAI）与骨关节炎患病率之间的关联。方法 采用加权多元Logistic回归模型和平滑曲线拟合分析AVAI和骨关节炎患病率之间的关系，通过亚组分析和交互作用检验探讨这一关系在不同亚组人群之间的效应差异。此外，通过受试者工作特征曲线（ROC）分析评估AVAI对骨关节炎的预测效能。结果 本研究基于美国国家健康与营养调查（NHANES）2011—2018年数据，共纳入5 929例参与者。较高的AVAI指数与骨关节炎患病率呈正相关（OR=1.22，95%CI：1.07~1.40）。随着AVAI指数的增加，骨关节炎患病风险呈现先上升后缓慢下降的趋势，AVAI的拐点为-4.48。在性别、年龄、教育程度和婚姻状况亚组中观察到交互作用。结论 AVAI与骨关节炎患病率之间存在非线性关系，当AVAI低于-4.48时，骨关节炎的患病风险增加。AVAI可作为一种有效、便捷的筛查工具，用于早期识别骨关节炎高风险人群。

    Objective This study aimed to evaluate the association between the age-adjusted visceral adiposity index（AVAI）and the prevalence of osteoarthritis（OA）．Methods Survey-weighted multivariable logistic regression models and smooth curve fitting were used to examine the relationship between AVAI and OA prevalence．Subgroup analyses and interaction tests were conducted to explore potential effect modifications across different population subgroups．Additionally，the predictive capability of AVAI for osteoarthritis was assessed using receiver operating characteristic（ROC）curve analysis． Results A total of 5 929 participants from the National Health and Nutrition Examination Survey（NHANES）2011–2018 were included．Higher AVAI levels were significantly associated with an increased prevalence of OA（OR=1.22；95%CI：1.07–1.40）．As AVAI increased，the risk of OA initially rose and then gradually declined，with an inflection point observed at ?4.48．Significant interactions were found across subgroups stratified by sex，age，education level，and marital status．Conclusions There exists a nonlinear relationship between AVAI and OA prevalence，with a significant increase in osteoarthritis risk observed when AVAI falls below -4.48．AVAI serves as an effective and convenient screening tool for identifying individuals at high risk of OA at an early stage．

       目的 探究体成分变化对肥胖患者肾小球高滤过的影响。方法 根据纳入排除标准，连续收集在中南大学湘雅二医院营养科及代谢内分泌科就诊的肥胖患者（体质指数≥28 kg/m²），对其随访3个月以上，纳入体质量减轻≥5%的患者，记录一般人口学、人体测量学、体脂率（BFP）、体脂肪量（BFM）、内脏脂肪面积（VFA）和骨骼肌量（SMM）等体成分和实验室检验数据，计算估计肾小球滤过率（eGFR）。肾小球高滤过被定义为eGFR大于普通人群第95个百分位数，根据此标准分为肾小球高滤过组和正常滤过组，比较组间一般人口学资料、生化指标及体成分的差异，绘制限制性立方样条图分析体成分的变化与eGFR变化之间的非线性关联。结果 （1）共收集85例肥胖患者初复诊资料，其中肾小球正常滤过患者43例，肾小球高滤过患者42例，男性35例，女性50例；（2）单因素分析提示肾小球高滤过患者减重前后eGFR差异有统计学意义［143.34 mL/（min·1.73 m²） vs 125.68 mL/（min·1.73 m²）；（3）非线性相关分析结果显示肥胖肾小球高滤过患者eGFR的变化与VFA的变化相关（P=0.015 1），与BFP的变化相关（P=0.022 6）。结论 肥胖患者减重后，随着VFA和BFP的下降可能改善肾小球高滤过。

    Objective This study aimed to investigate the impact of alterations in body composition on glomerular hyperfiltration in obese patients．Methods According to predefined inclusion and exclusion criteria，obese patients（body mass index ≥28 kg/m2）from the department of clinical nutrition and the department of metabolism and endocrinology at Second Xiangya Hospital of Central South University were consecutively enrolled．Patients who achieved a weight loss of ≥5% after more than three months of follow-up were included．Data on general demographics，anthropometric measurements，body composition parameters-including body fat percent（BFP），body fat mass（BFM），visceral fat area（VFA），and skeletal muscle mass（SMM）-and laboratory test results were collected．The estimated glomerular filtration rate（eGFR）was calculated．Glomerular hyperfiltration was defined as an eGFR greater than the 95th percentile for the general population．Based on this criterion，patients were categorized into a hyperfiltration group and a normofiltration group．Differences in demographic characteristics，biochemical indices，and body composition parameters between the two groups were compared．Restricted cubic spline curves were plotted to analyze the non-linear relationship between changes in body composition and changes in eGFR．Results （1）A total of 85 obese patients（35 males and 50 females） with initial and follow-up data were included，comprising 43 patients with normofiltration and 42 with hyperfiltration；（2）Univariate analysis indicated a statistically significant difference in eGFR before and after weight loss in the hyperfiltration group（143.34 mL/min/1.73m² vs 125.68 mL/min/1.73m²，P＜0.001）；（3）Non-linear correlation analysis revealed that changes in eGFR among obese patients with hyperfiltration were significantly associated with changes in VFA（P=0.015 1）and changes in BFP（P=0.022 6）．Conclusions Weight loss in obese patients may ameliorate glomerular hyperfiltration，potentially mediated through reductions in VFA and BFP．

      目的  探讨精子DNA碎片指数（DFI）对体外受精-胚胎移植（IVF-ET）胚胎发育及妊娠结局的影响，为优化男性生育力评估及辅助生殖治疗策略提供依据。方法  回顾性分析2023年1月—2024年1月于徐州市妇幼保健院接受IVF-ET治疗的126对不孕夫妇，根据男方DFI检测结果分为低碎片组（DFI≤15%，n=42）、临界组（15%＜DFI＜30%，n=45）和高碎片组（DFI≥30%，n=39）。比较三组患者受精相关指标、胚胎发育指标及妊娠结局指标的差异，并分析DFI与各指标的相关性。结果  低碎片组双原核率（2PN）率、优质胚胎率及囊胚形成率均高于临界组和高碎片组（P＜0.001），低碎片组1PN率、多PN率均低于临界组和高碎片组（P＜0.001）；三组种植率、临床妊娠率、早期流产率比较差异无统计学意义（P＞0.05），但高碎片组活产率低于低碎片组（P＜0.05）。相关性分析结果表明，DFI与优质胚胎率（r=-0.412，P＜0.001）、囊胚形成率（r=-0.387，P＜0.001）、活产率（r=-0.287，P=0.012）呈负相关，与早期流产率（r=0.206，P=0.059）、种植率（r=-0.215，P=0.058）、临床妊娠率（r=-0.203，P=0.072）无显著相关性。结论  精子DNA碎片指数是影响IVF-ET胚胎发育及妊娠结局的重要因素，高DFI主要通过降低胚胎发育潜能及增加流产风险导致活产率下降，临床需对高DFI患者进行干预以改善治疗结局。

       Objective  To investigate the impact of sperm DNA fragmentation index（DFI）on embryo development and pregnancy outcomes of in vitro fertilization-embryo transfer（IVF-ET），and to provide a basis for optimizing male fertility assessment and assisted reproductive treatment strategies．Methods  A retrospective analysis was performed on 126 infertile couples undergoing IVF-ET treatment at the Reproductive Medicine Center of Xuzhou Maternal and Child Health Hospital from January 2023 to January 2024．According to the male DFI test results，they were divided into three groups：low fragmentation group（DFI≤15%，n=42），critical group（15% ＜ DFI ＜ 30%，n=45），and high fragmentation group（DFI≥30%，n=39）．Differences in fertilization-related indicators，embryo development indicators，and pregnancy outcome indicators were compared among the three groups，and the correlation between DFI and each indicator was analyzed．Results  The 2 pronuclei rate（PN）rate，high-quality embryo rate，and blastocyst formation rate in the low fragmentation group were significantly higher than those in the critical and high fragmentation groups（P＜0.001）．The 1PN  rate and multi-PN  rate in the low fragmentation group were significantly lower than those in the critical and high fragmentation groups（P＜0.001）．There was no significant difference in the three groups of implantation rate，clinical pregnancy rate and early abortion rate（P＞0.05），but the live birth rate of high fragment group was significantly lower than that of low fragment group（P＜0.05）．The results of correlation analysis showed that DFI was significantly negatively correlated with the rate of high quality embryos（r=-0.412，P＜0.001），blastocyst formation rate（r=-0.387，P＜0.001）and live birth rate（r=-0.287，P=0.012），but not with the rate of early abortion（r=0.206，P=0.059），implantation rate（r=-0.215，P=0.058）and clinical pregnancy rate（r=-0.203，P=0.072）．Conclusions  Sperm DFI is an important factor affecting embryo development and pregnancy maintenance in IVF-ET．High DFI leads to a decrease in live birth rate mainly by reducing embryo developmental potential and increasing the risk of early abortion．Clinically，early intervention is needed for patients with high DFI to improve treatment outcomes．

       目的   基于结构方程模型（SEM）验证早产儿母亲育儿胜任感的多路径作用机制。方法  采用便利抽样法选取2024年6月—2025年6月在莆田学院附属医院分娩的早产儿母亲250例作为研究对象。采用一般资料调查表、中文版育儿胜任感量表（C-PSOC）、婴儿母亲育儿支持问卷（PSM）、角色适应问卷、简式亲职压力量表收集数据。通过单因素分析及多元线性回归分析母亲育儿胜任感的影响因素，使用AMOS软件构建结构方程模型，分析早产儿分娩后母亲育儿胜任感的作用路径。结果  250例早产儿母亲的C-PSOC得分为（61.93±6.02）分，多元线性回归分析结果显示，早产儿母亲育儿胜任感的影响因素包括产次、育儿支持、角色适应、亲职压力（均P＜0.05）。结构方程模型拟合良好（χ ² /df=1.026，GFI=0.987，AGFI=0.978，NFI=0.987，CFI=1.000，RMSEA=0.010），其中角色适应正向预测育儿胜任感（β=0.344），育儿支持（β=-0.477）与亲职压力（β=-0.283）负向预测（均P＜0.05），并且角色适应通过育儿支持、亲职压力间接提升育儿胜任感（效应值0.467）；产次经角色适应间接降低压力源影响（效应值0.529）。结论  早产儿母亲育儿胜任感受多路径机制调控，临床需针对角色适应、育儿支持及亲职压力设计级联干预策略。

       Objective  To verify the multi-pathway mechanism of parenting competence of premature infant mothers based on structural equation modeling（SEM）．Methods  A convenience sampling method was used to select 250 mothers of preterm infants who delivered in Affiliated Hospital of Putian University between June 2024 and June 2025 as the study subjects．Data was collected using a general information survey，the Chinese version of the Parenting Sence of Competence Scale（C-PSOC），the Parenting Support Questionnaire for Infant Mothers（PSM），the Role Adaptation Questionnaire，and the Simplified Parenting Stress Scale．By conducting  single factor analysis and multiple linear  regression analysis on the influencing factors of maternal parenting competence，a structural equation model was constructed using AMOS software to analyze the pathway of maternal parenting competence after premature birth．Results  The C-PSOC score of 250 mothers of premature infants was（61.93±6.02）．Multiple linear  regression analysis showed that the influencing factors of parenting competence among mothers of premature infants included parity，parenting support，role adaptation，and parental pressure（all P＜0.05）．The structural equation model fits well（2/df=1.026，GFI=0.987，AGFI=0.978，NFI=0.987，CFI=1.000，RMSEA=0.010），which  role adaptation  positively  predicted parenting competence（β=0.344），parenting support（β=-0.477）and parenting stress（β=-0.283）negatively predicted（all P＜0.05），and role adaptation indirectly enhanced parenting competence through parenting support and parenting stress（effect value 0.467）．The adaptation of roles during childbirth indirectly reduced the impact of stressors（effect value 0.529）．Conclusions  The multi-pathway mechanism of parental competence perception regulation in premature infant mothers requires the design of cascading intervention strategies targeting role adaptation，parenting support，and parental stress in clinical practice．

       目的  压疮是指由于组织受压时间过长引起的严重并发症，2025年的数据显示，压疮在活动受限患者中发生率高。机体代谢紊乱可能会引起压疮，但是否与血清代谢物有因果影响，暂不明确。方法   本文运用孟德尔随机化（MR）方法评价血清代谢物与压疮间风险因素，基于MR方法评价血清代谢物和压疮的因果联系，分别纳入由欧洲人群全基因组关联研究（GWAS）。压疮：FinnGen R10，3 167例；血清代谢物：EMBL-EBI数据库16种代谢物数据作为研究样本；筛选条件：工具变量筛选条件［P＜5×10^-8，连锁不平衡聚类r ² ＜0.001，kb=10 000，F统计量＞10（公式：F=R² ×N-2/1-R² ）］；主要分析方法：使用（IVW）法，辅助采用加权中位数法（WM）、MR-Egger回归法校验；用Benjamini-Hochberg法进行多重检验校正（FDR＜0.05为有统计学意义）。结果  共鉴定出10种代谢物与压疮存在关联（P＜0.01），经FDR校正后4种：代谢物18：2/20：4n6的水平升高（P＜0.000 2）2-Oxopeptide的作用相反，降低压疮的风险（OR=0.73，95%CI：0.59~0.92，P=0.011）；琥珀酸可增加压疮的风险（OR=1.13，95%CI：1.03~1.24，P=0.018）；甘氨酸/丙氨酸比值降低压疮风险（OR=0.849，95%CI：0.76~0.93，P=0.022）。稳定性分析证明上述发现是可信的、稳健的（heterogeneity：P＞0.05，pleoitropy：P＞0.05）。结论  血清代谢物通过调控炎症反应、影响微循环障碍以及干预能量代谢途径，参与压疮的发生发展，可作为构建压疮风险的模型以及制定相关干预策略为压疮评估、治疗、预防提供因果层面的理论依据。

      Objective  Pressure ulcer（PU）is a serious complication caused by prolonged tissue compression．Data of 2025 shows that PUs have a high incidence among patients requiring long-term bed rest．Metabolic disorders may contribute to PU development，but whether serum metabolites causally affect PU risk remains unclear．Methods  this study employed the Mendelian randomization（MR）method to evaluate whether serum metabolites are risk factors for PU．To assess the causal relationship between serum metabolites and PU，data from Genome-Wide Association Studies（GWAS）of European populations were included：PU data from FinnGen R10（3 167 cases）and data on 16 serum metabolites from the EMBL-EBI database．Instrumental variable screening criteria were as follows：P＜5×10^-8，linkage disequilibrium clustering（r ² ＜0.001，kb=10，000），and F-statistic ＞10（Formula：F=［R² ×N-2］/［1-R² ］）．The inverse variance weighting（IVW）method was used as the primary analytical approach，supplemented by the weighted median（WM）method and MR-Egger regression for verification．The Benjamini-Hochberg method was applied for multiple test correction（FDR＜0.05 was considered statistically significant）．Results  A total of 10 metabolites were identified to be associated with PU（P＜0.01），and 4 remained significant after FDR correction：elevated levels of metabolite 18：2/20：4n6（P＜0.0002）；2-Oxopeptide exerted an opposite effect，reducing PU risk（OR=0.73，95%CI：0.59-0.92，P=0.011）；succinic acid increased PU risk（OR=1.13，95%CI：1.03-1.24，P=0.018）；and the glycine/alanine  ratio  reduced PU risk（OR=0.849，95%CI：0.76-0.93，P=0.022）．Stability analysis（PH-TauNE［novel pleiotropy test］） confirmed that the above findings were credible and robust（heterogeneity：P＞0.05，pleiotropy：P＞0.05）．Conclusions  Serum metabolites are involved in the occurrence and development of PU by regulating inflammatory responses，affecting microcirculatory disorders，and interfering with energy metabolism pathways．They can provide causal theoretical basis for constructing PU risk prediction models，formulating relevant intervention strategies，and guiding PU treatment，prevention，and assessment．

       目的  分析对肺癌化学治疗（化疗）患者采取个性化营养干预联合分级步行运动方案的应用价值。方法   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象，通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案，观察组则联合分级步行运动方案，两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏［Piper疲乏修订量表（PFS-R）］、营养状况、睡眠质量［匹茨堡睡眠质量指数（PSQI）］、生活质量［生活质量评估量表（SF-36）］水平予以比较。结果  相较于对照组，干预后观察组PFS-R、PSQI评分较低，白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高（P＜0.05）。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案，有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。

       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy．Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects．They were divided into an observation group and a control group，with 99 cases in each group，by the random number table method．The control group only received individualized nutritional intervention，while the observation group received graded walking exercise additionally．Both groups of patients were enrolled at the same time and received continuous intervention for three months．Cancer-related fatigue（Piper’s Fatigue Scale-Revised［PFS-R］），nutritional status，sleep quality（Pittsburgh Sleep Quality Index［PSQI］），and quality of life（Quality of Life Scale［SF-36］） before and after the intervention were compared between the two groups．Results  Compared with the control group，the observation group had lower PFS-R and PSQI scores and higher albumin，prealbumin，hemoglobin，transferrin levels and SF-36 scores after the intervention（P＜0.05）．Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status，sleep quality and quality of life．

       目的  分析改良经脊柱内椎间孔镜系统技术（TESSYS）对腰椎间盘突出症患者疼痛及功能的影响，以期分析该术式优劣，丰富该研究领域。方法  回顾性选取2022年10月—2024年10月医院治疗的80例腰椎间盘突出症患者作为研究对象，根据治疗方式的不同划分为观察组（TESSYS技术治疗）和对照组（经皮椎间孔镜髓核摘除术治疗），每组各40例。观察两组患者疗效、手术时间、术中出血量、住院时间、透视次数、切口长度等情况。比较两组患者术前、术后6 h、术后1天、术后1周、术后1个月VAS评分情况，比较两组患者术前及术后1个月腰椎功能情况，包括Oswestry功能障碍指数（ODI）、腰椎曲度、腰背肌后伸活动度。比较两组患者术前及术后24 h的血清超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）水平。结果   观察组患者疗效优于对照组（Z=-3.737，P＜0.001）。交互效应下，两组疼痛因不同术式而随着时间增加而有所不同（P＜0.05）；时点效应下，观察组、对照组各组均随着时点增加疼痛随之减少（P＜0.05）；组间效应下，干预前、干预后1个月两组差异不明显，但是观察组疼痛干预后6 h（Z=-2.831，P=0.005）、干预后1天（Z=-3.253，P=0.001）低于对照组。术后1个月，观察组患者的ODI（Z=-4.804，P＜0.001）低于对照组，而腰椎曲度（Z=-6.218，P＜0.001）、腰背肌后伸活动度（Z=-7.014，P=0.001）高于对照组。术后24 h后，观察组患者的hs-CRP（Z=-5.671，P＜0.001）、IL-6（Z=-3.262，P＜0.001）低于对照组。结论  TESSYS相较于经皮椎间孔镜髓核摘除术在治疗腰椎间盘突出症时具有显著优势，可提高疗效，减少出血量，减轻疼痛，减少炎症反应，加快腰椎功能康复，缩短住院时间。

       Objective  The effect of modified transforaminal endoscopic spine system（TESSYS） on pain and function in patients with lumbar disc herniation was analyzed，so as to analyze the advantages and disadvantages of this procedure and enrich the research field．Methods  Retrospectively，80 patients with lumbar disc herniation treated in the hospital from October 2022 to October 2024 were selected as the study subjects．These patients were divided into two groups based on their treatment methods：the observation group（treated with TESSYS technology）and the control group（treated with percutaneous endoscopic discectomy）．Each group consisted of 40 patients．The study evaluated the treatment efficacy，surgical duration，intraoperative bleeding volume，hospital stay fluoroscopy frequency，and incision length for both groups．Additionally，we compared the VAS  scores of  both groups before surgery，six hours post-surgery，one day post-surgery，one week post-surgery，and one month post-surgery．We also compared the lumbar function of both groups before surgery and 1 month post-surgery，including the Oswestry Functional Index（ODI），lumbar lordosis，and lumbar back muscle extension activity．Furthermore，we compared the serum levels of high-sensitivity C-reactive protein（hs-CRP）and interleukin-6（IL-6）in both groups before and 24 hours after surgery．Results  The therapeutic effect of the observation group was better than that of the control group（Z=-3.737，P＜0.001）．Under the interaction effect，the pain of the two groups varied with time due to different surgical procedures（P＜0.05）．Under the time effect，both the observation group and the control group showed a decrease trend in pain as the time to treatment increased（P＜0.05）．Under the inter group effect，there was no significant difference between the two groups before and 1 month after intervention，but the pain in the observation group was less than that in the control group at 6 hours after intervention（Z=-2.831，P=0.005）and 1 day after intervention（Z=-3.253，P=0.001）．One month after surgery，the ODI（Z=-4.804，P＜0.001）of the observation group patients was lower than that of the control group，while the lumbar curvature（Z=-6.218，P＜0.001）and lumbar back muscle extension activity（Z=-7.014，P=0.001）were higher than those of the control group．Twenty-four hours after surgery，the hs-CRP（Z=-5.671，P＜0.001）and IL-6（Z=-3.262，P＜0.001）levels in the observation group were lower than those in the control group．Conclusions  The improved  percutaneous transforaminal endoscopic technique  has  significant advantages over  percutaneous transforaminal discectomy in the treatment of lumbar disc herniation．It can improve efficacy，reduce bleeding，alleviate pain，reduce inflammatory reactions，accelerate lumbar functional recovery，and shorten hospitalization time．

       目的  探讨多组分运动训练对老年慢性阻塞性肺疾病（COPD）稳定期病人骨骼肌功能的影响。方法  前瞻性选择2022年10月—2024年10月90例COPD稳定期患者，采用抽签法随机分为观察组与对照组，对照组45例采取常规运动干预，观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量，四肢肌群力量，运动耐力与肺功能，生活质量。结果 干预后，两组上肢、下肢骨骼肌含量均略增加，观察组高于对照组（P＜0.05）；干预后，两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加，观察组高于对照组（P＜0.05）；干预后，两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高，观察组高于对照组（P＜0.05）；干预后，两组圣乔治呼吸问卷各维度分数及总分均降低，观察组低于对照组（P＜0.05）。结论  针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量，改善患者运动耐力与肺功能，减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。

        Objective  To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease（COPD）．Methods  From October 2022 to October 2024，90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method．The control group consisted of 45 patients who received routine exercise care，while the observation group  consisted of 45 patients who received multi-component exercise training in addition to the routine care．Skeletal muscle content，muscle group strength，exercise endurance，lung function，and quality of life between two groups of patients were compared before and three months after intervention．Results  After intervention，the skeletal muscle content of both upper and lower extremities slightly increased in both groups，with the observation group  being higher than the control group（P＜0.05）．After intervention，the strength of the knee extensor，knee flexor，elbow extensor，and elbow flexor muscle groups increased in both groups，with the observation group  had better results than the control group（P＜0.05）．After intervention，both groups showed an increase in six-minute walking test，forced vital capacity，and forced expiratory volume in first second，with the observation group  had better  results than the control group（P＜0.05）．After intervention，the scores of each dimension and total score of the SGRQ in both groups decreased，and the observation group had lower scores than the control group（P＜0.05）．Conclusions  Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities，enhance exercise endurance and lung function，and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life．