Objective: To explore the clinical features and prognosis of breast cancers with different stages in young women. Methods: A retrospective study was made in 61 cases of young patients with breast cancer (≤35 years as young group) and 74 cases of breast cancer patients of control group (36-69 years), who were with stageⅠto Ⅲ disease underwent surgical treatment. Results: The significant differences were observed in pTNM staging and differentiation between two groups. There were no differences between the two groups in stage Ⅰand Ⅱ patients. Significant differences were found between the two groups in stage Ⅲ patients. Conclusion: Breast cancer was with strong invasion in young patients. Early diagnosis and treatment of young women with breast cancer were important to improve the survival rate.

Objective:In this study we evaluated the diagnostic value of plasma D-dimer level as an early indicator in acute mesenteric ischemia in rats.Methods:Forty-eight mature male Wistar rats were divided equally into experimental group (EG) and control group (CG),The superior mesenteric artery was ligated In EG,and while a simple laparotomy was performed in CG.Blood samples were taken for laboratory test in both groups at 1h、6h、12h respectively.Results:The longer the duration of mesenteric ischemia,the higher were the serum D-dimer levels in the study groups,and statistical significance was obtained between these two groups (P=0.0375).Otherwise,significant difference was not found in other laboratory parameters between them.Conclusions:Serum D-dimer dynamic measurements may be a important valuable screening parameter in the early diagnosis of mesenteric ischemia.

Objective:To study the methods of protecting recurrent laryngeal nerve(RLN) in endoscopic thyroidectomy through the upper part of sternum.Methods:The clinilical data of 46 cases underwent endoscopic thyroidectomy through the upper part of sternum was analyzed.RLN was revealed when we performed nodulectomy or partial thyroidectomy.But during subtotal and near-total thyroidectomy the RLN was always revealed.Results:Forty-five of forty-six cases were compeleted successfully with endoscopic thyroidectomy.One case was converted to open thyroidectomy because of thyroid carcinoma.No intraoperative or postoperative hemorrhage,RLN injuried and deadlimb occurred.Conclusion:In order to reduce the injury of RLN,we should select the fitting cases strictly,master the opportunity and methods of revealed RLN.

Objective:To analyze effects of tectorigenin on improving cognitive deficits in rats with vascular dementia(VD)by regulating Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor-κB(NF-κB)signaling pathway.Methods:A total of 72 rats were randomly divided into sham operation group,model group,low,medium and high doses[25,50,100 mg/(kg·d)]tectorigenin groups and positive control group[piracetam 324 mg/(kg·d)],with 12 rats in each group.Except for sham operation group,VD models were replicated in other groups.After successful modeling,different doses tectorigenin groups and positive control group were administered intragastrically with different doses of tectorigenin and piracetam,while other groups were administered intragastrically with same volume of normal saline for 28 d.Spatial learning and memory ability were detected by Morris water maze.Neurotransmitter levels in hippocampus interstitial fluid were detected by high performance liquid chromatography-electro-chemical.Brain-derived neurotrophic factor(BDNF)and tyrosine kinase receptor b(TrkB)expressions in hippocampus were detected by RT-qPCR and Western blot.TLR4/MyD88/NF-κB pathway-related proteins in hippocampus were detected by Western blot.Results:Compared with sham operation group,escape latency was longer,while stay time in target area and times of crossing platform were lower in model group(P<0.05).Compared with model group,escape latency was shorter,while stay time in target area and times of crossing platform were higher in medium and high doses tectorigenin groups(P<0.05).NE,DA,5-HT and 5-HIAA levels in model group were lower than those in sham operation group(P<0.05),which were higher in medium and high doses tectorigenin groups than model group(P<0.05).Compared with sham operation group,BDNF and TrkB mRNA and proteins levels were lower,while TLR4,MyD88 and p-NF-κB p65/NF-κB p65 proteins levels were higher in model group(P<0.05).Compared with model group,BDNF and TrkB mRNA and proteins levels were higher,while TLR4,MyD88 and p-NF-κB p65/NF-κB p65 proteins levels were lower in medium and high doses tectorigenin groups(P<0.05).Conclusion:Tectorigenin can improve cognitive deficits in VD rats,which may be related to regulating TLR4/MyD88/NF-κB signaling pathway.

Acute suppurative cholecystitis is a complex acute abdomen in general surgery, which usually occurs in middle-aged and elderly people. With the improvement of living standards and the aging of the population, the incidence of the disease is increasing year by year. Elderly patients have certain clinical particularities, and they are often combined with other underlying diseases such as cardiovascular and cerebrovascular diseases. Therefore, specific programs should be implemented for different situations during patient treatment, and a more complete risk assessment should be carried out. The preferred treatment for acute suppurative cholecystitis is surgery, but for patients with poor general conditions or intolerable surgery, percutaneous transhepatic gallbladder drainage may be a good alternative. This article reviews the clinical characteristics, diagnosis and treatment of acute suppurative cholecystitis in the elderly.

Objective:To synthesize the findings of qualitative research on the treatment experience of cancer patients receiving immune checkpoint inhibitors therapy to provide a basis for developing relevant health education strategies and other supportive care interventions.Methods:Qualitative research on the treatment experience of cancer patients receiving immune checkpoint inhibitors therapy, published by May 2022, were searched in English and Chinese databases, including Cochrane Library, PubMed, Embase, PsycINFO, CINAHL, Web of Science, CNKI, Wanfang, VIP, and CBM. The quality of the included studies was evaluated by Joanna Briggs Institute Critical Appraisal Tool for qualitative studies. The research results were summarized and Meta-synthesis using the pooled integration method.Results:A total of 13 articles were included and 62 findings were grouped into 12 new categories according to their similarities. These 12 categories resulted in 4 synthesized findings: life was affected, facing multiple decision scenarios, presence of some unmet needs and gaining positive experiences and personal growth.Conclusions:Although patients experience some positive experiences, a large proportion of them experience significant health distress. Healthcare professionals should develop targeted health education with supportive care strategies on the basis of a comprehensive assessment.

Intrahepatic cholangiocarcinoma(ICC) is a malignant tumor that originates in the epithelium of the proximal proximal to the second-degree bile ducts and has a high degree of malignancy. The causes of ICC are widely geographically diverse. Pathogenesis of ICC involves multiple molecular alterations at the level of genome, epigenome and stromal environment resulting in several deregulated signal transduction pathways. There are three types of pathological classification: mass-forming, periductal infiltrating, and intraductal growth. The mixed type of mass-forming + periductal infiltrating has the highest degree of malignancy. Early diagnosis of ICC is not easy, and tumor biomarkers such as CA19-9, CEA and so on, have some reference values, and multiple imaging examinations are needed to confirm each other. The effect of surgery mainly depends on the characteristics of the tumor, the vascular invasion of the tumor, the resection margin of the tumor and lymphatic metastasis. Lymph node dissection is controversial. If local lymphatic metastasis is identified, standardized lymph node dissection can improve ICC prognosis. Some ICC patients benefit from laparoscopic staging. In experienced centers, minimally invasive treatment can provide oncological outcomes similar to open resection for specific ICC patients. Liver transplantation is feasible in early ICC patients, but further clinical validation is needed.

Objective:To summarize the research on the application of online health community-based user personain the field of cancer at home and abroad, so as to provide reference for the related research and application in this field in the future.Methods:Computer search of CNKI, China biomedical literature database, VIP, Wanfang, Web of Science, Embase, MEDLINE, PubMed, CINAHL, Cochrane Library, a total of 10 Chinese and English databases, focused on the relevant research on building user personas based on online health communities in the field of cancer, and the search time limit was from the establishment of the database to April 20, 2022. Literature was screened, data extracted and summarized.Results:Totally 11 literatures were included. The construction process of user persona based on online health community included data collection, tag extraction and persona presentation. The functional diversity and implementation feasibility were showed in the application content in the field of cancer. It can quickly identify the differences in health information needs of cancer patients, provide personalized decision support and nursing services, strengthen health information education, and improve patients′ self-management ability.Conclusions:The integration of user persona and cancer field based on online health community was in the initial exploration stage, and the feasibility and effectiveness of promoting patients′ health behavior were confirmed by existing studies. In the future, it is still necessary to be promoted in the empirical research on its application in clinical practice, so as to lay a foundation for providing targeted patient health management programs in the future.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.